Objective To analyze the epidemiological characteristics and risk factors of common viruses in children with respiratory tract infection in Yangling District, and to provide scientific basis for clinical formulation of effective prevention and control strategies. Methods The study subjects were 502 children with respiratory tract infection in Yangling Demonstration Zone Hospital from February 2022 to February 2024. 10 kinds of common respiratory infection viruses such as respiratory syncytial virus, parainfluenza virus, human rhinovirus, influenza B virus, influenza A virus, human adenovirus, enterovirus, coronavirus, human metapneumovirus and human Boca virus were detected by multiple real-time fluorescent polymerase chain reaction (PCR). According to the results of viral nucleic acid detection, 502 children were divided into positive detection group and negative detection group. Univariate and logistic multivariate regression analyses were adopted to analyze the risk factors of respiratory virus infection in children. Results Among the 502 children with respiratory tract infection, 112 cases were positive for viral nucleic acid detection, with a positive rate of 22.31%. Among the 95 cases were with single virus infection with a positive rate of 18.92%, mainly respiratory syncytial virus and parainfluenza virus, and 17 cases were with mixed virus infection, with the positive rate of 3.39%, mainly respiratory syncytial virus+parainfluenza virus mixed infection. After logistic multivariate analysis, it was found that age≤1 year old, onset in autumn and winter, monthly family income≤5000 yuan, concomitant congenital heart disease, maternal atopic disease history, maternal gestational diabetes mellitus, malnutrition and anemia were independent risk factors for respiratory virus infection in children (P<0.05). Conclusion Respiratory virus infection in acute hospitalized children in Yangling District is mainly a single virus, and is affected by many factors such as age of children, onset season, family monthly income and so on. Clinically, it is necessary to actively screen the above indicators of children and take active preventive measures to reduce viral infection.

Objective To analyze the epidemiological characteristics and risk factors of common viruses in children with respiratory tract infection in Yangling District, and to provide scientific basis for clinical formulation of effective prevention and control strategies. Methods The study subjects were 502 children with respiratory tract infection in Yangling Demonstration Zone Hospital from February 2022 to February 2024. 10 kinds of common respiratory infection viruses such as respiratory syncytial virus, parainfluenza virus, human rhinovirus, influenza B virus, influenza A virus, human adenovirus, enterovirus, coronavirus, human metapneumovirus and human Boca virus were detected by multiple real-time fluorescent polymerase chain reaction (PCR). According to the results of viral nucleic acid detection, 502 children were divided into positive detection group and negative detection group. Univariate and logistic multivariate regression analyses were adopted to analyze the risk factors of respiratory virus infection in children. Results Among the 502 children with respiratory tract infection, 112 cases were positive for viral nucleic acid detection, with a positive rate of 22.31%. Among the 95 cases were with single virus infection with a positive rate of 18.92%, mainly respiratory syncytial virus and parainfluenza virus, and 17 cases were with mixed virus infection, with the positive rate of 3.39%, mainly respiratory syncytial virus+parainfluenza virus mixed infection. After logistic multivariate analysis, it was found that age≤1 year old, onset in autumn and winter, monthly family income≤5000 yuan, concomitant congenital heart disease, maternal atopic disease history, maternal gestational diabetes mellitus, malnutrition and anemia were independent risk factors for respiratory virus infection in children (P<0.05). Conclusion Respiratory virus infection in acute hospitalized children in Yangling District is mainly a single virus, and is affected by many factors such as age of children, onset season, family monthly income and so on. Clinically, it is necessary to actively screen the above indicators of children and take active preventive measures to reduce viral infection.

Objective:To compare the results of invasive prenatal diagnosis and preimplantation genetic testing (PGT) and explore the underlying mechanism.Methods:Clinical data of pregnant women undergoing PGT and invasive prenatal diagnosis at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2022 were collected. The results of PGT and invasive prenatal diagnosis were compared, and the outcomes of pregnancies were followed up. This study has been approved by the Medical Ethics Committee of the the Sixth Affiliated Hospital of Sun Yat-sen University (No. 2022SLYEC-491).Results:A total of 172 couples were included in this study, and 26 non-targeted variants were discovered upon prenatal diagnosis, including 10 cases (38.5%) by chromosomal karyotyping, 15 (57.7%) by chromosomal microarray analysis (CMA), and 1 (3.8%) by whole exome sequencing. The 10 karyotypic anomalies had included 6 chromosomal polymorphisms, 2 chromosomal mosaicisms, 1 paternally derived translocation, and 1 missed maternal chromosomal inversion. CMA has identified 15 copy number variations (CNVs), which included 11 microdeletions and microduplications, 3 loss of heterozygosity, and 1 low-level mosaicism of paternal uniparental disomy. One CNV was classified as pathogenic, and another one was likely pathogenic, whilst the remaining 13 were classified as variants of uncertain significance. Therefore, 8.7% of CNVs was detected by invasive prenatal diagnosis after PGT. 92.3% (24/26) of the non-targeted variants have been due to technological limitations of next-generation sequencing (NGS).Conclusion:Invasive prenatal diagnosis after PGT can detect non-targeted variants, which may further reduce the incidence of birth defects.

Purpose To study the consistency of NTRK fu-sion gene in the thyroid carcinoma detected by four technology platforms:immunohistochemistry,DNA-based NGS,FISH and qRT-PCR.Methods NTRK fusion gene was detected by FISH,immunohistochemical(IHC),DNA-based NGS and qRT-PCR in a same group of 40 clinical cases(among them,31 cases were thyroid cancer samples).Results In a group of 31 thyroid cancer cases detected by four techniques,compared with FISH,the sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and total coincidence rate(TCR)of IHC was 100%(9/9),90.9%(20/22),81.8%(9/11),100%(20/20),93.5%(29/31),respectively.The PPV of IHC was poor.The sensitivity,specificity,PPV,NPV and TCR of DNA-based NGS was 44.4%(4/9),100%(22/22),100%(4/4),81.5%(22/27),83.9%(26/31),respectively,and the sensitivity was poor.The TCR of qRT-PCR was 100%(31/31).Compared with FISH,Kappa value of IHC,DNA-based NGS and qRT-PCR was 0.853,0.532 and 1.000,respectively.Of the 40 clinical cases,the concordance between qRT-PCR and FISH was observed for 39 samples,for the qRT-PCR assay did not cover the NTRK fusion type(LM-NA:exon4-NTRK1:exon10).Compared with FISH,the coinci-dence rate of qRT-PCR was highest.Conclusion The RNA-based assay of qRT-PCR does have the advantages of high sensi-tivity and high specificity,and may be an optimal scheme for routine clinical detection of NTRK fusion variation in thyroid cancer in pathology department.

Objective To analyze the epidemiological characteristics of morning hypertension in people with eseential hypertension in Dali Bai autonomous prefecture,and to study the management model for morning hypertension. Methods From May 2015 to January 2017,302 patients with hypertension in the People's Hospital of Dali Bai Autonomous Prefecture were divided voluntarily into two groups,including single management group (group 1)and systematic management group (group 2 ).During six to twelve months follow －up,the changes in control rate of morning hypertension,serum biochemical indicators,KAP and Mofisky score were observed before and after intervention. Results The proportion of morning hypertension in people with hypertension was 62.25%,61.11% in men and 62.86%in females.The patients with morning hypertension had higher age,BMI,WC,TC,LDL－C,SBP,DBP,CRP, FBG,SCr,Sokolow－Lyon,Cornell,LVMI,UACR and MAU,more cervical plaque,and lower HDL －C and eGFR compared with non－morning hypertension(P＜0.05 －0.001).The number of patients with target organ damage was most in patients with morning hypertension by home blood pressure monitoring(HBPM),second in ambulatory blood pressure monitoring(ABPM),least in clinic blood pressure monitoring (CBPM)(P＜0.05 －0.001).After six to twelve months follow－up,compared with before intervention,the control rate of morning hypertension was increased (43.78%vs.61.39%),and SBP,DBP,HR,BMI,WC,TC,TG,UA,Scr were decreased in both two groups,which in the group 2 were lower than those in the group 1(P＜0.05 ).Compared with before intervention,the KAP score and Mofisky in the two groups after intervention were significantly improved(P＜0.05－0.01)[K score:(9.63 ±3.01)points vs.(14.26 ±2.89)points in the group 1,(10.11±2.34)points vs.(17.23 ±1.06)points in the group2;A score:(2.05 ±1.21)points vs.(2.98 ±0.25)points in the group 1,(2.08 ±1.65)points vs.(3.56 ±0.42)points in the group 2,P score:(4.39 ±2.36)points vs.(5.89 ±3.24)points in the group 1,(4.71±3.42)points vs.(7.26 ± 1.21)points in the group 2,Mofisky questionnaire score:(61.23 ±5.79)points vs.(72.36 ±6.18)points in the group 1,(60.89 ±6.47)points vs.(88.45 ±5.48)points in the group 2],which in the group 2 were higher than those in the group 1(P＜0.01).Conclusion The control rate of morning hypertension in patients with hypertension in Dali Bai autonomous prefecture is low,the HBPM is better way to predict the target organ damage,and systematic management model is effective to improve the control rate of morning hypertension and so do in KAP and Morisky score.

Objective: To explore the value of plasma cell-free DNA (cfDNA) in the assessment of inflammatory bowel disease (IBD) activity. Methods: From July 2014 to June 2017, 145 IBD patients from the First Affiliated Hospital of Fujian Medical University were selected. The plasma content of cfDNA was detected by picogreen-based fluorescent quantitative method. At the same period, 37 healthy individuals were enrolled as control group. The correlation between cfDNA content and C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and IBD activity was analyzed. The diagnostic capability of cfDNA in IBD activity was assessed by the receiver operating characteristic (ROC) curve. T-test was performed for comparison between two independent samples, and Pearson correlation coefficient test was used for correlation analysis between two variants. Results: The content of plasma cfDNA of patients with Crohn′s disease (CD) and patients with ulcerative colitis (UC) were (29.17±2.07) μg/L and (26.86±1.97) μg/L, respectively; which were both higher than those of healthy control group (21.10±1.02) μg/L, and the differences were statistically significant (t=2.609 and 2.082, both P<0.05). Moreover, the content of cfDNA of patients with active CD or UC were (35.72±3.26) μg/L and (32.37±3.42) μg/L, respectively, which were both higher than those of patients with CD or UC in remission ((21.12±1.43) μg/L and (20.82±1.02) μg/L), and the differences were statistically significant (t=3.806 and 3.116, both P<0.01). The cfDNA content of CD patients was positively correlated with CRP, ESR and disease activity (r=0.555, 0.393 and 0.400, all P<0.01). The cfDNA content of UC patients was also positively correlated with CRP, ESR and disease activity (r=0.640, 0.421 and 0.360, all P<0.01). The diagnostic capability of the combination of CRP and ESR was the highest in CD diagnosis, with the area under curve (AUC) value being 0.841, and the sensitivity and specificity being 81.4% and 74.3%, respectively. The diagnostic capability of the combination of cfDNA, CRP and ESR was the highest in UC diagnosis, with the AUC value being 0.851, and the sensitivity and specificity being 74.3% and 96.9%, respectively. Conclusions Increased cfDNA levels in IBD patients are correlated with IBD activity. Detection of cfDNA is helpful in the identification of active IBD, and the combination of ESR and CRP can improve the diagnostic efficiency of UC.

Objective To assess the value of double balloon enteroscopy (DBE) in etiological diagnosis of small bowel ulcer.Methods The clinical and endoscopic data of patients undergoing DBE at the Department of Gastroenterology, Renmin Hospital of Wuhan University from January 2010 to January 2016 were reviewed.For patients with small bowel ulcer revealed by DBE, the etiologic diagnosis was retrospectively analyzed.Results One hundred and three patients with small bowel ulcer were included in the analysis.The initial diagnosis based on morphology of ulcer was Crohn's disease (58.3%, 60/103), intestinal tuberculosis (18.4%,19/103), etiology unknown (24.3%, 25/103).The final diagnosis comprehensively based on pathology, clinical data and disease outcome was Crohn's disease (44.7%,46/103), intestinal tuberculosis (18.4%,19/103), lymphoma (3.8%,4/103), eosinophils enteritis (1.9%,2/103), non-steroidal anti-inflammatory drug enteritis (1.9%,2/103), adenocarcinoma (1.0%,1/103), stroma tumor (1.0%,1/103),ischemic enteritis (1.0%,1/103), vascular malformation (1.0%,1/103), Henoch-Schonlein purpura (1.0%,1/103), etiology unknown (24.3,25/103).The accurate diagnosis rate and misdiagnosis rate for Crohn's disease by DBE were 73.3%(44/60)and 10.0%(6/60).The accurate diagnosis rate and misdiagnosis rate for intestinal tuberculosis by DBE were 14/18 and 2/18.Conclusion There are diversity and complexity in etiologic diagnosis of small bowel ulcer.The diagnosis should be based on the comprehensive analysis of morphology of ulcer, endoscopic and surgical pathology and clinical data.Follow up of small bowel ulcer by DBE may provide important information for etiologic diagnosis.

Objective To investigate the feasibility and application value of total enteroscopy with double balloon enteroscopy(DBE)for diagnosis and treatment of patients with obscure gastrointestinal bleeding(OGIB). Methods The clinical and endoscopic data of patients underwent DBE for OGIB in the Department of Gastroenterology,Remin Hospital of Wuhan University from January 2010 to December 2015 were retrospectively analyzed. Results Total enteroscopy was indicated in 36.3%(136/375)of patients. The success rate was 86.0%(117/136)and complication rate was 1.5%(2/136). Negative findings,non-small bowel lesions and small bowel lesions were detected in 44.4%(52/117), 6.8%(8/117), and 48.7%(57/117)of patients with total enteroscopy. Re-bleeding occurred in 8.9%(4/45)of patients with negative total enteroscopy,while 1 small bowel mesenchymoma and 1 gastric fundus Dieulafoy′s lesion were revealed subsequently. Re-bleeding occurred in 33.3%(5/15)of patients with incomplete enteroscopy,and 1 small bowel polyp and 1 small bowel angiectasis were revealed subsequently. Conclusion DBE can complete total enteroscopy within one day and provide important clinical information of OGIB. Non-small bowel lesions,small bowel lesion missed by DBE and potential bleeding lesions in small bowel beyond the reach of DBE should be considered in patients with negative enteroscopy.

were no significant differences in the detection rate of recto-sigmoid colon,mid colon,right colon and total detection of polyps among the 3 groups (P >0.05).Conclusion 4-L split-dose PEG is better than the oth-er 2 regimens in the colon cleansing quality,so it can better reach the intestinal cleaning standards before enteroscopy,which is a more suitable regimen for bowel preparation.