Introduction:Human respiratory syncytial virus subgroup A (HRSV-A) lineage A.D is characterized by a unique 72-nucleotide duplication in the second hypervariable region of the G-gene (G-HVR2) and has become the predominant global circulating strain since 2010. Molecular evolutionary features of this region should be monitored. Methods:A global HRSV-A G-HVR2 sequence dataset (2010-2024) was assembled that included 144 Chinese sequences and the molecular characteristics and evolutionary patterns in lineage A.D were analyzed. Results:Molecular clock analysis based on G-HVR2 estimated that HRSV-A lineage A.D originated in 2006, with subsequent diversification into four distinct lineages. A.D.4 and A.D.5 were grouped as A.D.4/A.D.5. Lineages circulate globally with temporal fluctuations and sequential dominance shifts. The evolutionary rate of A.D was high, with the highest rate observed in A.D.4/A.D.5. Amino acid analysis indicated five shared, lineage-specific mutations in A.D.1 and A.D.4/A.D.5 that coincided with high-frequency mutation sites. Nine positively-selected sites were predicted across all lineages, three of which resided within the 72-nucleotide duplication. A.D.1 and A.D.4/A.D.5 lost conserved N- and O-glycosylation sites. A 72-nucleotide duplication in lineage A.D introduced two extra β-strands and two unique α-helical motifs relative to the prototype strain. Conclusion:Adaptive evolution in the G-HVR2 region of HRSV-A lineage A.D was evident, likely facilitating the rapid transmission of this lineage. Sustained monitoring of lineage-specific evolution in this region is critical for targeted prevention and control of HRSV infections.

ABSTRACT To advance our understanding of the molecular recombination dynamics of circulating human adenovirus species C (HAdV‐C) strains, whole genome sequence (WGS) analysis of seven strains representing five genotypes (P1H1F1, P1H2F2, P89H5F5, P2H2F2, and Px1/Ps3H1F1) isolated from pediatric severe acute respiratory infection (SARI) cases in China were performed, involving sequence similarity assessment, phylogenetic inference, and recombination mapping. The genomic analysis of seven strains showed substantial nucleotide identity (93.5%–99.2%) and distinct recombination patterns. Further comparative recombinant analysis with eight prototype strains and 214 publicly available strains revealed that strains with high genomic similarity or evolutionary relatedness showed substantial conservation in the posterior genomic regions, while the 5′‐proximal ~14 000 bp region, particularly E1 and E2B regulatory and replication‐associated genes, displayed significant recombination activity. In addition, identical or similar recombination patterns were found in the genomes of strains with high sequence identity and homology, which had been detected by different surveillance systems, and in multiple provinces in China and other countries. Further analysis revealed an independent evolutionary cluster for two strains (Henan2018‐431 and Jilin2019‐101), which also harbored fragments of unknown origin within the E3 region, potentially representing novel HAdV‐C variants. These findings highlight the critical role of frequent recombination in HAdV‐C evolution, particularly in low‐diversity genomic regions, and emphasize the importance of WGS‐based surveillance for tracking emerging recombinant strains with public health implications.

Introduction:Recent sentinel surveillance has revealed a rising prevalence of human adenovirus type 21 (HAdV-21) among HAdV infections in China. This study aimed to elucidate the molecular features of currently circulating HAdV-21 strains in China. Methods:Whole-genome sequencing (WGS) was performed on 23 HAdV-21 strains isolated from acute respiratory infection cases, 56.5% involving lower respiratory tract infections, across 7 Chinese sentinel surveillance provincial-level administrative divisions (PLADs) (2023-2024). These sequences, along with 50 previously reported HAdV-21 genomes from 6 countries (1956-2019), were integrated into a WGS dataset for comprehensive phylogenetic, genetic variation, and recombination analyses. Results:WGS categorized the HAdV-21 strains into 3 subtypes: HAdV-21a, HAdV-21b, and historical HAdV-21p (isolated in the 1950s). HAdV-21a (1956-2024, involving 5 of the 6 countries) and HAdV-21b (2005-2024, involving 3 of the 6 countries) exhibited extensive spatiotemporal distributions. Recent Chinese strains (2023-2024) belonged to HAdV-21a and HAdV-21b (HAdV-21a/b), showing extremely high genetic homology with Chinese 2019 strains (genetic distance: 0.00007) and global strains (distance: <0.00040). Phylogenetic analysis confirmed that HAdV-21a/b shared a common ancestor and maintained a highly conserved genome despite decades of circulation. Sequence variation analysis identified shared and subtype-specific mutations in these two subtypes. Recombination pattern analysis further revealed that HAdV-21a/b acquired an HAdV-3-derived fragment in the E4 region (breakpoint: nt32,843). Conclusions:Recombinant HAdV-21a/b subtypes have co-circulated in China in recent years with remarkable genetic conservation. Enhanced surveillance is essential to quantify associated disease burden and guide targeted prevention and control strategies.

Human bocavirus (HBoV) is a common respiratory virus among patients with acute respiratory infection (ARI). To investigate the prevalence and genetic characteristics of HBoV, clinical specimens from 13,109 ARI patients were collected through active surveillance from 12 provinces of China during 2012-2021. Extracted nucleic acid was screened and the viral protein 1 (VP1) gene was directly amplified and sequenced in HBoV-positive specimens. 3.51 % of patients were HBoV-positive, with children under 5 years old accounting for 93.48 % of cases. HBoV detection rate increased from 2.35 % in 2012-2019 to 5.38 % in 2020 and 7.68 % in 2021, with a pronounced increase in children aged 2-4 years and in Southern China. The age group with the highest detection rate shifted from infants under 2 years in 2012-2019 to children aged 2-4 years in 2020-2021. The proportion of HBoV co-detections increased significantly in 2020-2021, from 43.98 % to over 60.00 %. All HBoV cases were identified as HBoV-1 with 165 full length sequences of VP1 gene obtained. No temporal or geographic clustering was observed. The VP1 gene evolved at a rate of 7.99 × 10 -5 substitutions/site per year, with ω-value less than 1, indicating that the VP1 protein was under negative selection pressure. Multiple antigen-associated amino acid mutations and positive selection sites were found in the VP1 protein. In conclusion, HBoV1 remains a major cause of pediatric ARI in China, but its epidemic pattern exhibited dynamic shifts during the coronavirus disease 2019 pandemic, while the viral genetic evolution remained relatively stable.

To better understand the epidemiological characteristics of human adenovirus (HAdV) infections in China during and after the coronavirus disease 2019 (COVID-19) pandemic, respiratory specimens were collected from 17,562 enrolled patients with acute respiratory infections (ARIs) in 14 sentinel surveillance provinces during 2020-2023. Eight common respiratory viruses were detected using commercially available nucleic acid detection kits. HAdV-positive cases were statistically analyzed for detection rates, geographic distribution, seasonal patterns, demographic characteristics, and co-infection status. The results of this study showed that the overall HAdV detection rate was 5.09 % (894/17,562) during 2020-2023, with a gradual decrease in the annual detection rate from 6.66 % in 2020 to 3.89 % in 2022 and a rebound in 2023 (5.19 %). The overall HAdV detection rate was significantly higher in the southern region (6.15 %) than in the northern region (4.76 %) (P < 0.001). The median age of patients with HAdV infection was 3 years, with infants aged 0-2 years accounting for the majority (41.39 %). HAdV-positive cases were detected throughout the year, with no clear seasonal pattern, and the HAdV epidemic in China during 2020-2023 may have been driven primarily by the virus infection in the southern region. Co-infections were frequent in HAdV-positive cases (overall rate: 36.01 %), primarily consisting of dual infections (79.28 %), with human rhinovirus and human respiratory syncytial virus being the most common coinfecting pathogens. In conclusion, this study suggested the significant regional and temporal variation in HAdV detection rate in China during 2020-2023, and thus ongoing surveillance should be conducted to elucidate the epidemiological dynamics of HAdV infections.

To elucidate the evolutionary dynamics of human parainfluenza virus type 1 (HPIV1), we obtained 78 Chinese HPIV1 hemagglutinin-neuraminidase (HN) gene sequences between 2011 and 2017-2023 and generated two databases: global (482 sequences, 1956-2023) and Chinese HPIV1 (122 sequences, 2011-2023). Our results showed that global HPIV1 circulating since the 1990s could be classified into five genotypes (A, B, C, D, and E) using a genetic distance threshold of 0.02. Among these, genotypes B and C were predominantly prevalent worldwide, including in China, whereas genotype D showed distinct spatial clustering (mainly in China) and was believed to undergo relatively rapid transmission and evolution. We also confirmed the conserved nature of HPIV1 over the last six decades, with an overall evolutionary rate of 9.41 × 10-4 substitutions/site/year. Additionally, genotype-specific amino acid substitutions and potential N-glycosylation sites in HN were identified. These findings provide insights into the genetic characteristics of HPIV1.

To understand the prevalence of rhinovirus (RV) among acute respiratory infection (ARI) patients, 10-year ARI surveillance in multiple provinces of China were conducted during 2012-2021. Of 15 645 ARI patients, 1180 (7.54%) were confirmed to have RV infection and 820 (69.49%) were children under 5 years of age. RV typing was performed on the 527 VP1 gene sequences, and species A, B, and C accounted for 73.24%, 4.93%, and 21.82%, respectively. Although no significant difference in the proportions of age groups or disease severity was found between RV species, RV-C was more frequently detected in children under 5 years of age, RV-A was more frequently detected in elderly individuals (>= 60), and the proportions of pneumonia in RV-A and RV-C patients were higher than those in RV-B patients. The epidemic peak of RV-A was earlier than that of RV-C. A total of 57 types of RV-A, 13 types of RV-B, and 35 types of RV-C were identified in RV-infected patients, and two uncertain RV types were also detected. The findings showed a few differences in epidemiological and clinical features between RV species in ARI patients, and RV-A and RV-C were more prevalent than RV-B.

The aim of the study was to investigate the virulence factors in Escherichia coli producing extended-spectrum β-lactamase (ESBL) derived from the perinatal fecal colonization flora of mothers and their newborns in a Chinese obstetric ward.Rectal swabs were obtained from mothers prenatally and from their newborns postnatally, and analyzed for ESBL-producing Escherichia coli. The isolates were then whole-genome sequenced.Maternal and neonatal colonization by ESBL-producing E. coli in a Chinese obstetric ward was 18% (31/177) and 5% (9/170), respectively. Fecal ESBL-producing isolates exhibited a significantly lower frequency of virulence factors compared with invasive E. coli.Providing balanced information on screening results is essential, along with conducting a risk assessment for antibiotic treatment strategies. · High ESBL E. coli colonization rates in mothers and neonates perinatally. · Fecal ESBL-producing E. coli showed fewer virulence traits.. · ESBL-producing E. coli knowledge may prompt antibiotic overuse..

The phylogenetic analysis showed that global HPIV2 could be classified into two distinct clusters (I and II) and five lineages (IA to IIE) with at least 0.049 and 0.014 genetic distances between clusters and lineages, respectively. Furthermore, lineages IB and IIE could be further divided into two sublineages (IB1-2 and IIE1-2).

Objective:This study comprehensively analyzed the genomic characterizations of human parainfluenza virus type 3 (HPIV3) strains circulating in six provinces and cities of China (Beijing, Henan, Jilin, Anhui, Gansu, and Shandong) during the period of 2019-2020. The aim was to elucidate the intricate genetic variations and molecular evolutionary trends within the HPIV3 genome.Methods:Based on genotypic differentiation, genetic divergence, and spatial and temporal distribution, 12 representative HPIV3 strains (including 7 of C3a subtype, 2 of C3b subtype and 3 of C3f subtype) were selected from the aforementioned provinces, and the complete genome sequence was successfully obtained by overlapping amplification of fragments using nested RT-PCR. Subsequently, a complete genome database of global representative HPIV3 strains was constructed and analyzed using bioinformatics tools.Results:The length of complete genome of the 12 HPIV3 strains in the present study varied between 15 227 bp and 15 370 bp, the G+ C content ranged from 35.1% to 35.3% and the nucleotide identity intermediated from 97.6% to 99.6%. Compared with the prototype strain (GenBank accession number: NC_001796.2), the nucleotide identity of 12 HPIV3 strains ranged from 94.2% to 94.5%. Analysis of the complete genome of HPIV3 available in China and globally showed that the genomic variation of HPIV3 was mainly shaped by substitution mutations, and no base deletions or gene recombination were observed.Only a six-base insertion (ATTAAA) was found in the F gene’s 3′UTR region of a representative strain originating from Jilin province (CHN/Jilin036/2019/C3b) in this study, and its potential pathogenic significance needs to be further investigated. Amino acid analysis of the encoded proteins revealed that the C3a lineage of HPIV3, widely prevalent both in China and worldwide, exhibits lineage-specific mutation sites in the N, P and L proteins. Furthermore, within the Chinese prevalent C3a strains, a distinctive mutation site (N216S) in L protein was also identified. Notably, specific variant sites have not been found in Chinese C3b and C3f branch strains. Based on the complete genome, the comprehensive evolutionary analysis showed that the time to the most recent common ancestor (tMRCA) of global HPIV3 strains was estimated to 1927 (95% HPD: 1901-1945), with an average molecular evolutionary rate of 5.29 × 10 -4 substitutions/site/year, while the average molecular evolutionary rate of HPIV3 strains in China is 5.24 × 10 -4 substitutions/site/year. In addition, each gene of HPIV3 was subjected to negative selection pressure, with the P, HN and F genes showing the most significant nucleotide variation and higher rates of molecular evolution than the other genes. Conclusions:This study reveals that the complete genome of HPIV3 strains circulating in six provinces and cities of China tend to evolve conservatively. Moreover, substitution emerge as the main driving force for molecular evolution of HPIV3.

目的 探讨小儿急性阑尾炎的临床特点,寻找导致发生复杂性阑尾炎的危险因素.方法 收集2019年7月-2022年6月在长春市儿童医院住院的临床诊断为急性阑尾炎行腹腔镜手术治疗的299例患儿临床资料,包括性别、年龄、临床表现、化验检查及术后病理诊断.分析发病到就诊时间、发热、腹痛、恶心、呕吐、腹泻、食欲不振、精神萎靡、腹部压痛、CRP及白细胞总数(WBC)等因素对病理诊断的影响.绘制CRP和WBC接受者工作特征曲线,计算CRP、WBC在诊断复杂性阑尾炎的特异度、灵敏度、约登指数及截点.结果 小儿急性阑尾炎100％存在腹痛;45.92％发热;食欲不振、恶心、精神萎靡、呕吐、腹胀及腹泻占比分别为 40.47％(121/299)、31.10％(93/299)、29.36％(88/299)、25.42％(76/299)、23.41％(70/299)及19.40％(58/299).临床体征主要为腹部压痛,该组患儿100％存在腹部压痛.发病到住院时间,最短为5h,最长为3d,平均(22.04±9.87)h.平均住院时间(10.86±3.41)d.≤3岁婴幼儿33例,精神萎靡、呕吐及食欲不振占比最多;＞3岁为266例,出现频率最多的是发热;两组临床表现发生率比较差异有统计学意义(x2=26.924,P＜0.001).病理诊断单纯性阑尾炎63例,复杂性阑尾炎236例(化脓性阑尾炎81例,坏疽穿孔性阑尾炎155例).复杂性阑尾炎与单纯性阑尾炎比较,CRP和WBC均明显增高(t=5.221,t=5.139,均P＜0.001).发病到就诊时间、CRP及WBC为出现复杂性阑尾炎的危险因素.CRP判断复杂性阑尾炎的约登指数0.279,灵敏度0.581,特异度0.698;WBC判断复杂性阑尾炎的约登指数0.49,灵敏度0.619,特异度0.873.在ROC曲线上CRP的截点为32.39,WBC的截点为16.41.结论 小儿急性阑尾炎的主要临床表现为腹痛和腹部压痛;发病到就诊时间增多、CRP及WBC升高是发生复杂性阑尾炎的危险因素.

目的:检测发育性语言障碍(DLD)共病注意缺陷多动障碍(ADHD)患儿外周血维生素D(VD)水平及存在形式,阐明VD在DLD共病ADHD发生中的作用,为其治疗提供新的方法.方法:选择就诊的DLD共病ADHD患儿90例为观察组,以50名同期在本院健康体检中心体检的身心健康儿童为对照组.DLD和ADHD诊断参照《国际疾病分类》第11次修订本(ICD-11)和《美国精神障碍诊断及统计手册》第5版(DSM?5)相关章节,采用格里菲斯精神发育量表(GMDS)语言能分量表测评并计算语言发育商(DQ),根据斯诺佩评定量表Ⅳ(SNAP-4)家长及教师问卷进行ADHD分型,采用Conners父母症状问卷(PSQ)进行ADHD评分,采用液相色谱质谱法检测2组研究对象血清中VD水平.收集所有研究对象GMDS和PSQ及观察组患儿SNAP-4测评结果;测试者DQ小于100-1×标准差(SD)为语言能力低于同龄人;根据PSQ将儿童行为问题分为学习问题、心身问题、焦虑、多动-冲动、品行问题和多动指数共6种因子,6种因子得分均大于2分可诊断存在相关问题;根据SNAP-4将ADHD分为注意缺陷为主型(ADHD-I)、多动/冲动型为主型(ADHD-HI)和混合型(ADHD-C).结果:观察组男性占71.1％,女性占28.9％.观察组患儿血清中VD3和VD水平明显低于对照组(P<0.01);观察组DLD-ADHD-C、DLD-ADHD-HI和DLD-ADHD-I 3种类型患儿VD和VD3水平均明显低于对照组(P<0.01).对照组研究对象DQ值与血清中VD和VD3水平呈正相关关系(r=0.512,P<0.01;r=0.529,P<0.01);观察组患儿DQ值与血清中VD和VD3水平呈正相关关系(r=0.299,P<0.01;r=0.279,P<0.01),与VD2水平呈负相关关系(r=-0.122,P<0.01).观察组DLD-ADHD-C、DLD-ADHD-HI和DLD-ADHD-I 3种类型患儿PSQ测评学习问题、心身问题、品行问题、焦虑、多动/冲动和多动指数分值与对照组比较差异有统计学意义(P<0.01).血清中VD3水平与DLD-ADHD-C型观察组患儿上述6种因子测评分值均呈明显负相关关系(r=-0.438,r=-0.357,r=-0.422,r=-0.465,r=-0.583,r=-0.593,P<0.01),与DLD-ADHD-HI型观察组患儿品行问题呈正相关关系(r=0.522,P<0.01),与多动/冲动和多动指数呈明显负相关关系(r=-0.455,P<0.05;r=-0.424,P<0.01),与心身问题和多动/冲动呈负相关关系(r=-0.468,r=-0.496,P<0.05),与多动指数呈正相关关系(r=0.694,P<0.01).VD水平与DLD-ADHD-C型观察组患儿上述6种因子测评分值均呈明显负相关关系(r=-0.444,r=-0.498,r=-0.450,r=-0.501,r=-0.594,r=-0.522,P<0.01),与DLD-ADHD-HI型观察组患儿心身问题、品行问题、多动/冲动和多动指数均呈负相关关系(r=-0.355,r=-0.578,r=-0.509,r=-0.422,P<0.05或P<0.01),与心身问题和多动/冲动呈负相关关系(r=-0.485,r=-0.497,P<0.05),与多动指数呈明显正相关关系(r=0.682,P<0.01).结论:VD3缺乏可能是DLD共病ADHD的病因之一.补充VD3可能对预防和治疗DLD共病ADHD患儿有积极作用.

Objective:To understand the pathogenic characteristics of rotavirus (RV) in infants with diarrhea in Jilin province from 2017 to 2022. To provide basis for development and draw up infectious disease prevention and control strategies of infants with diarrhea.Methods:A total of 2565 stool samples were collected from children with infectious diarrhea from 2017 to 2022. The RVA antigens were detected by ELISA method, and the positive samples were classified by RT-PCR. The results were statistically analyzed with SPSS 24.0 software.Results:There were 982 positive samples, with a total positive rate of 38.3%. From 2017 to 2022, the positive rates of RV were 52.5%、42.2%、36.8%、23.8%、41.7%、26.1% per year. There are two peaks from October to May of the next year.The positive rate of 12-23 months old was the highest, followed by 24-35 months old.G-type is dominated by G9, and P-type is dominated by P[8], G/P combination is G9P[8], G2P[4], G3P[8], G1P[8], G4P[6] according to the detection rate. G9P[8] was the only type in 2022.Conclusions:RV is one of the important pathogens of diarrhea in children under 5 years of age in Jilin province. It occurs frequently in winter and spring, It mainly affects children aged between 12 and 23 months. The dominant strain is G9P[8] in Jilin province.

手足口病(HFMD)是由肠道病毒(EV)感染引起的主要在儿童中传播的急性传染病,H FMD发病率为 37.01/10万～205.06/10 万,近年报告病死率在 6.46/10万～51.00/10 万之间[1].引起 HFMD的肠道病毒有 20 多个血清型,A 组柯萨奇病毒(CV-A)和肠道病毒A组 71 型(EV71 )等新型肠道病毒是引起 HFMD的主要致病病原体[2].监测发现我国2013 年以后,其他非 EV-A71 和非 CV-A16型EV,如 CV-A6 型和 CV-A10 型也常与手足口病相关[3].重症 HFMD 可出现肺水肿、无菌性脑膜炎、暴发性心肌炎等中枢神经系统、呼吸系统、循环系统严重并发症[4],严重威胁患儿健康及生命.本文分析了 2018 年-2019 年长春市儿童医院住院H FMD病原谱及不同病原感染患儿的心肌酶水平,报道如下.

A comparative analysis of confirmed cases of human influenza virus (HIFV), human respiratory syncytial virus (HRSV), and human metapneumovirus (HMPV) was conducted to describe their clinical and epidemiological characteristics. During 2009-2021, active surveillance of acute respiratory infections (ARIs) was performed in nine provinces of China. Clinical and epidemiological information and laboratory testing results of HIFV, HRSV, and HMPV were analyzed. Among 11591 ARI patients, the single-infection rates of HIFV, HRSV, and HMPV were 15.00%, 9.59%, and 2.24%, respectively; the coinfection rate of these three viruses was 0.64%. HIFV infection was mainly in adults aged 15-59 years, accounting for 39.10%. HRSV and HMPV infections were mainly in children under 5 years old, accounting for 87.13% and 83.46%, respectively. Patients with HRSV infection were younger than HMPV. HRSV and HMPV had high similarities in clinical manifestations, presenting with lower respiratory symptoms. HIFV mainly presented with an upper respiratory infection. The epidemic peak of HRSV was earlier than that of HIFV, and that of HMPV was later than those of HRSV and HFIV. A total of 85.14% of coinfection cases were children under 5 years old. Coinfection might increase the risk of pneumonia in HIFV cases. During 2020-2021, the positive rates and seasonal patterns of these three viruses changed due to the impact of the COVID-19 pandemic. Certain clinical and epidemiological features were observed in HIFV, HRSV, and HMPV infections, which could be beneficial for guiding clinical diagnosis, treatment, and prevention of these three viruses in China.

轮状病毒(Rotavirus,RV)是引起急性肠胃炎的主要病原体,分析RV感染患者的人外周血单个核细胞(Peripheral blood mononuclear cell,PBMC)中差异表达基因(Differentially expressed genes,DEGs)有利于探讨人PBMC在清除RV中的作用.为此,本研究采集2019年2月-2019年6月长春儿童医院中RV感染患者和健康儿童血液,分离PBMC,通过转录组测序(RNA sequencing,RNA-seq)技术比较RV感染患者与健康儿童之间的RNA表达图谱,借助基因本体论(Gene Ontology,GO)数据库功能富集分析、京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)、Reactome通路富集分析DEGs,使用实时荧光定量PCR(Real-time quantitative PCR,qPCR)技术进行验证.结果 显示,与健康对照组相比,RV感染轻症患者PBMC中有1619个DEGs;重症患者PBMC中有2816个DEGs,主要与干扰素(Interferon,IFN)反应、中性粒细胞、溶酶体、核小体、染色质等相关.qPCR验证轻症患者干扰素刺激基因(IFN-stimulated genes,ISGs)15表达上调,白介素(Interleukin,IL)1β表达下调;重症患者IL15、ISG15表达上调,IL1β表达下调,与转录组结果相一致.本研究提示,RV感染可能激活人Ⅰ型和Ⅱ型IFNs反应抵御病毒感染,但也会抑制溶酶体相关基因,对细胞自噬过程产生影响.

腹泻病是由多种病因引起的以大便次数增多和大便性状改变为主要特点的多发病、常见病,是导致5 岁以下儿童高发病率和高死亡率的重要原因之一,每年可导致全球范围内大于 50万人死亡[1].腹泻病因主要为感染性和非感染性,感染性的原因主要考虑病毒、细菌、真菌等病菌感染,其中病毒感染占大多数.引起小儿病毒性腹泻的主要病原有HRV、HuCV、EAdV和HAstV.由于各地气候、卫生状况等因素的差异,导致小儿病毒性腹泻的病原谱及其流行特征也存在一定的差异.本文主要对2017-2020年长春市儿童医院住院疑似病毒性腹泻的 2019 例患儿的粪便标本进行 HRV、HuCV、EAdV和 HAstV 核酸和基因型检测,并分析其变化规律.

目的 为了解2019年6月至2021年5月吉林省长春市急性呼吸道感染住院儿童病例中鼻病毒感染状况并对鉴定出的鼻病毒进行分子分型研究.方法 采用实时荧光聚合酶链式反应技术对采集的1 251份咽拭子标本进行常见8种呼吸道病毒的检测.针对鉴定结果为阳性的鼻病毒标本,使用巢式反转录聚合酶链式反应扩增VP1区并进行序列测定和分析.结果 61.87％(774/1 251)的标本至少检出有1种呼吸道病毒,其中呼吸道合胞病毒和鼻病毒检出率较高,分别为19.18％(240/1 251)和18.63％(233/1 251).男女性间鼻病毒检出率比较差异无统计学意义,检出年龄主要集中在1～3岁组,占所有鼻病毒感染病例的67.81％;呈现为以夏秋季为感染高峰的季节性流行,9-10月为鼻病毒的检出高峰.本研究从233份阳性鼻病毒标本中共获得161条鼻病毒VP1序列,通过分子分型鉴定属于55个型别,其中A种鼻病毒37个,B种鼻病毒4个,C种鼻病毒14个.RV-A12和RV-A49两个型别检出数目最多,均为12条.结论 2019年6月至2021年5月长春市急性呼吸道感染病例咽拭子标本中鼻病毒检出阳性率位居第二,仅次于呼吸道合胞病毒.长春市儿童急性呼吸道感染相关的鼻病毒流行以A种鼻病毒为主,C种次之,B种最少;RV-A12和RV-A49是长春市2019-2021年流行的优势型别.

目的:了解长春地区住院重症社区获得性肺炎病原谱及临床特点，为其病原学诊断和针对性治疗提供科学依据。方法:2016年1月至2019年12月长春市儿童医院住院的618例临床诊断为重症社区获得性肺炎患儿，采集患儿咽拭子和肺泡灌洗液标本。应用病毒分离、细菌培养、飞行时间质谱和PCR/RT-PCR技术检测标本中的核酸和蛋白质谱。结果:住院重症社区获得性肺炎患儿男性多于女性。发病高峰年龄段为7～12月龄小儿。发病多集中在冬春季。重症社区获得性肺炎病毒检出率最高，为56.15%(347/618)；检出一种病毒病原阳性73.49%(255/347)，其中前5位的是呼吸道合胞病毒(27.8%)、甲型流感病毒(23.9%)、乙型流感病毒(16.1%)、鼻病毒(12.2%)和偏肺病毒(10.2%)；两种病毒阳性19.88%(69/347)；3种病毒阳性4.32%(15/347)；4种病毒阳性2.31%(8/347)。非典型微生物感染占29.77%(184/618)，其中肺炎支原体感染占95.65%(176/184)。细菌感染17.31%(107/618)，以肺炎链球菌(39.25%，42/107)和金黄色葡萄球菌(24.30%，26/107)为主。多种病原混合感染7.61%(47/618)，其中肺炎支原体和肺炎链球菌、病毒混合感染分别为40.43%和34.04%。高热、呼吸增快和口周发绀是重症社区获得性肺炎的危险因素( OR值和95% CI分别为7.71和4.56～13.04、2.43和2.02～2.93、3.53和2.56～4.86)；病毒混合感染36.96%(34/92)出现心力衰竭、中毒性脑病、心肌损害等并发症；肺炎支原体与其他病原混合感染35.29%出现胸腔积液。 结论:长春地区重症社区获得性肺炎的病原以病毒为主，呼吸道合胞病毒是优势病原，肺炎支原体次之，细菌病原以肺炎链球菌为主。高热、呼吸增快和口周发绀是重症肺炎的危险因素。多病原混合感染易出现严重并发症。