ObjectiveTo provide a basis for human enteroviruses prevention and control by monitoring the enterovirus （EV） and its main virus types. MethodsSamples of hand-foot-and-mouth disease， herpetic angina and fever clinic patients in Dapeng New District of Shenzhen from 2016 to 2022 were tested for EV with real-time polymerase chain reaction （PCR）. To identify the isolates of EV， VP1 genes of EV were amplified with nested reverse transcription PCR， and then sequenced.A geneticphylogenetic tree was constructed based on the VP1 gene. ResultsAmong the 1 124 suspected hand-foot-and-mouth disease cases， 740 （65.84%） tested EV positive. Coxsackievirus A6 （CVA6） and Coxsackievirus A16 （CVA16） were the main two serotypes with regular cycle trends. Of the 137 suspected herpetic angina cases， 88 （64.23%） were EV positive， with Coxsackievirus A4 （CVA4） and CVA16 as the dominant serotypes. Among 428 respiratory infection specimens， 71 （16.59%） were EV positive. Coxsackievirus A4 （CVA4） was the predominant serotype which caused herpetic angina and respiratory infection. The epidemic EV isolates CVA6 from Shenzhen had a close genetic relationship with isolates in China’s mainland. ConclusionThe main serotypes EV CVA6 and CVA16 which caused hand-foot-and-mouth disease exhibit cyclical trends . The risk of EV transmitted from abroad is low， but their genetic variation and virulence change should be monitored continuously. In addition， the monitoring of dominant isolates CVA4 which cause herpetic angina and respiratory infection should be strengthened.

Liver cancer is one of the most common cancers in China. In recent years, liver cancer tends to be treated with comprehensive therapies, including surgery, ablation, interventional embolization, radiotherapy, chemotherapy, targeted therapy, immunotherapy, and liver transplantation. At present, the low surgical resectionrate is one of the main factors affecting the prognosis of liver cancer patients. Preoperative neoadjuvant therapy or conversion therapy for liver cancer can maximize the rate of surgical resection and improve the prognosis. With the rapid development of radiotherapy and immunotherapy in the comprehensive treatment of liver cancer, it has been gradually confirmed that the unique effects of preoperative radiotherapy and immune therapy for liver cancer can improve the prognosis of the patients. Therefore, this paper reviewed the research progress in the preoperative radiotherapy and immunotherapy for liver cancer by searching relevant literature and reports at home and abroad.

The most common metastatic site of breast cancer is the bone. Metastatic bone disease can alter the integrity of the bone and cause serious complications, thereby greatly reducing health-related quality of life and leading to high medical costs. Although diagnostic methods and treatments for bone metastases (BM) are improving, some patients with early breast cancer who are at high risk of BM are not diagnosed early enough, leading to delayed intervention. Moreover, whole-body scintigraphy cannot easily distinguish BM from nonmalignant bone diseases. To circumvent these issues, specific gene and protein biomarkers are being investigated for their potential to predict, diagnose, and evaluate breast cancer prognosis. In this review, we summarized the current biomarkers associated with BM in breast cancer and their role in clinical applications to assist in the diagnosis and treatment of BM in the future.

Objective: To investigate the application and surgical experience of total laparoscopic pancreaticoduodenectomy (TLPD) in treating children with solid pseudopapillary neoplasm (SPN) of pancreas. Methods: Clinical data 4 children with SPN who underwent TLPD in Jilin University First Hospital from April 2017 to June 2018 were retrospectively analyzed. Results: Among the 4 children, a case was male and 3 cases were female. Their age ranged from 9 to 14 year-old, the height ranged from 1.2 to 1.7 meters, and body weight ranged from 30 to75 kg. All patients complained of upper abdominal pain, one child had nausea and vomiting, and one child had abdominal mass. All patients underwent abdominal enhanced CT scan before operation, which showed a mass-like low-density shadow or mixed density shadow in the pancreatic head, with slightly uneven enhancement or no obvious enhancement. All 4 patients underwent TLPD, and the operation was successful without conversion to open surgery. The duration of operation time ranged from 250 to 365 minutes, the intraoperative blood loss ranged from 80 to 120 ml, the tumor size ranged from 4 to 8 cm, and the hospital stay ranged from 10 to 22 days. One patient developed grade B pancreatic fistula after surgery and was cured after conservative treatment. Pathological examinations of all patients confirmed the diagnosis of pancreatic SPN. All patients were followed up until February 2019, and no significant discomfort was observed and no recurrence or metastasis was found. Conclusions TLPD was safe and feasible in children in relatively large pancreatic surgery centers with extensive laparotomy and TLPD experience.

Objective To report the treatment of type A3 distal tibiofibular fractures with the fibular posterolateral approach and minimally invasive percutaneous plate osteosynthesis (MIPPO).Methods We reviewed 61 patients with type A3 distal tibiofibular fracture (observation group) who had been treated with MIPPO and the fibular posterolateral approach from June 2011 to May 2015.Our control group included 78 patients with type A3 distal tibiofibular fracture who had been treated by traditional open reduction and internal fixation from April 2009 to September 2013.Interval between injury and surgery,surgical time,intraoperative bleeding,hospital stay,postoperative complications,X-ray Lane-Sandhu osteotylus score and limb weight-bearing score one year after operation were compared between the 2 groups.Results All the 139 patients were followed up for more than one year.There were significant differences between the 2 groups in terms of interval between injury and surgery (8.0 ± 3.5 h versus 140.7 ± 52.4 h),surgical time (66.2 ± 7.2 min versus 92.1 ±6.6 min),intraoperative bleeding (59.8 ± 12.8 mL versus 209.5 ±50.4 mL),hospital stay (9.4 ± 1.9 d versus 26.1 ± 15.7 d),postoperative complications,X-ray Lane-Sandhu osteotylus score (3.9 ±0.2 points versus 3.0 ±0.6 points) and limb weight-bearing score (3.9 ±0.1 points versus 3.0 ±0.7 points) one year after operation,favoring the observation group(P ＜ 0.001).Conclusions In the treatment of type A3 tibiofibular fractures,MIPPO plus the fibular posterolateral approach is superior to the traditional open reduction and internal fixation because it can benefit fracture healing by shortening the time for preoperative preparation,surgery and hospitalization,and decreasing the amount of intraoperative bleeding and the incidence of postoperative complications.

BACKGROUND:The output of computed tomography (CT) is Digital Imaging and Communications in Medicine (DICOM), whereas the input of three-dimensional (3D) printing is an object Standard Template Library model represented by a triangular mesh. The process of data handing and forrmat conversion are keys to the combination of these two techniques. OBJECTIVE:To explore how to convert CT data into a stereoscopic 3D model efficiently. METHODS:The DICOM in Medicine format data of the patients with femoral fractures were edited and produced by Mimics. We made a 3D model by adjusting the parameters of the 3D printer slicing software, and discussed the significance of 3D model in medical field, especially orthopedics. RESULTS AND CONCLUSION:Mimics software is the bridge to connect two-dimensional CT scan images and 3D images, to create a 3D model by editing the data of DICOM which comes from the CT scanner, with a 3D printing technology. The 3D Model can help doctors for routine clinical diagnosis and treatment, to improve the communication between doctors and patients and the quality of clinical medical teaching. 3D printing also makes medicine more personalized, remote, minimally invasive, and promote the development of medicine to the direction of digital medicine.

Objective To investigate the factors related to death of thoracic trauma emergency in children.Methods Total 528 children and infants aged 0-14 years with thoracic injuries , including 317 boys and 211 girls, admitted in emergency department from January 2010 to January 2014 were included in the study.The factors related to emergency death were investigated by using conditional logistic analysis.Results Among 528 cases, emergency death occurred in 34 cases with an emergency mortality rate of 6.44%.Single-factor analysis showed that emergency death was correlated with complication with other organ trauma, the time of first medical intervention , the time of arriving at first contact hospital , the rank of first contact hospital , hypoxemia and causes of injuries ( all P<0.05 ); however , not correlated with the gender, age, of patients, areas of residence, family economic status and seasons of injury occurring (all P>0.05).Logistic analysis showed that the time of first medical interventio n>30 min ( B=1.467,95%CI:0.412-0.975), complication with other organ trauma (B=2.342,95%CI:0.415-0.943), hypoxemia (B=2.915,95%CI:0.749-0.819), and first visiting to tertiary hospital (B=-1.861,95%CI:1.023-1.742) were influencing factors of emergency death.Conclusion The results indicate that to improve the success rate of emergency treatment of thoracic trauma in children , it is necessary to reduce the time of first medical intervention and to correct the hypoxemia promptly.

Aim Toanalyzethekeyqualityandestablishmeth-ods for essential quality control of human recombinant ASPP2 adenovirus.Methods TheviralstructuralgeneofE2Bandtar-get gene of ASPP2 were identified by PCR;The number of virus particles was measured by UV-SDS methods;Infectious titer was determined by TCID50 assay;Target protein of ASPP2 was ob-served by Western blot assay;The biological effects of recombi-nant adenovirus on liver cancer cells were evaluated by MTT as-say;A549 cells were used to check replication of the competent adenovirus(RCA)by the observation of the cytopathic effect. Results PCRanalysisofE2BandASPP2wasinconsistent with theoretical values;Particle numbers of virus were 5. 6 × 1012 VP/mL,infectious titer was 2 ×1011 IU/mL and specific activity was 3. 5%;ASPP2 protein expression could be detected when cells were infected with virus for 24 h;Growth inhibition of liver cancer cells could be found by adding recombinant ASPP 2 adenovirus;The level of RCA was less than 1 RCA/3. 0 ×1010 VP,in line with the standards of China Food and Drug Adminis-tration(SFDA).Conclusion Thequalitycontrolmethodswere established aiming at key characters of human recombinant AS-PP2 adenovirus,which may provide foundations for its quality standard and future applications.

Objective Negative pressure aspirator clogging ( OSAC) frequently occurs in orthopedic surgery .This study was to investigate the frequency , location , and mechanisms of OSAC in China by analysis of the current status and clinical observation of OSAC so as to provide evidence for the solution of the problem . Methods Using the two-stage random sampling method , we conduc-ted a questionnaire survey on OSAC among 738 clinical orthopedists during the 16th and 17th Chinese Orthopedic Association Confer-ences.Totally, 160 out 1200 orthopedic surgeries were randomly selected in the time order of operation , including 38 cases of total hip arthroplasty ( THA) , 39 cases of total knee arthroplasty ( TKA) , 43 cases of extremity and spinal fractures surgery , and 40 cases of other orthopedic surgeries .We also obtained the satisfaction scores with the existing aspirators from related medical professionals . Results Among the 738 respondents included into the analysis , 706 (95.7%) thought that OSAC often occurred during surgery , 631 (85.5%) considered THA to be the leading cause of OSAC , and 714 (96.7%) regarded the tip and hose joint of the aspirator as the common causes . The mean satisfaction score with the existing aspirators was 7.62 ±0.74.Clinical observation showed the mean frequency of OSAC to be 2.55 ±1.62 in THA, 1.95 ±1.33 in TKA, 1.52 ±1.18 in extremity and spinal fracture surgeries , and 0.95 ± 0.68 in other orthopedic surgeries , and the satisfaction score to be 7.36 ±0.84. Conclusion OSAC has a high incidence rate during orthopedic surgeries in China , thus affecting orthopedic surgery and reducing orthopedists'satisfaction with the aspirators . The current negative pressure aspirator system demands prompt improvement .

BACKGROUND:Increasing evidence col ected from animal experiments or laboratories shows that bone mesenchymal stem cel s possess potent immunosuppression and anti-inflammation effects and cartilage regenerative capability. The microenvironment in human knee joint of osteoporosis is more complex and involves lots of bioactive factors and immunologic mechanisms. OBJECTIVE:The analyze the therapeutic effects of intra-articular injection of autologous bone marrow mesenchymal stem cel s on mild-to-moderate osteoporosis, and to investigate the mechanisms for anti-inflammation, immunoregulation and reversion of cartilage degradation. METHODS:About 15 mL bone marrow was aspired from 26 patients with mild-to-moderate osteoporosis and taken to the laboratory where bone marrow mesenchymal stem cel s were isolated and characterized in terms of some surface markers by a flow cytometer, and the ability of osteogenic and adipogenic differentiation was analyzed. The bilateral knees of each patient were divided into two groups at random. The experiment group were treated with autologous bone marrow mesenchymal stem cel s by intra-articular injection (2×107 cel s), while the control group injected the same volume of control medium without bone marrow mesenchymal stem cel s. Western Ontario and McMaster Universities Osteoarthritis Index was used to estimate the function of the knee joints before and after the treatment. We col ected the joint fluid before, 2 and 4 weeks post treatment, and then measured the production of interleukin-1, interleukin-10, tumor necrosis factor-α, cartilage oligomeric matrix protein using ELISA. RESULTS AND CONCLUSION:According to the standardized culture-expansion protocol, a sufficient number of bone marrow mesenchymal stem cel s (more than 2×107 passage 3 cel s) were obtained for intra-articular injection. The bone marrow mesenchymal stem cel s isolated from patients were positive for CD105, CD29 and negative for CD45, CD34, and had the fair osteogenic and adipogenic capacities. The function of the knee joints was improved obviously after treatment. In the experimental group, the secretion of both interleukin-1, tumor necrosis factor-αand cartilage oligomeric matrix protein in the joint fluid was suppressed, while the interleukin-10 level was up-regulated compared to the control group. The results suggest that intra-articular injection of autologous bone marrow mesenchymal stem cel s can exert good effect in mild-to-moderate osteoporosis patients. Furthermore, bone marrow mesenchymal stem cel s via intra-articular injection can function through anti-inflammation and reversion of degradation of the articular cartilage, which is a new promising approach for treating mild-to-moderate osteoarthritis.