First Known Human Death After Infection With the Avian Influenza A/H3N8 Virus: Guangdong Province, China, March 2023.

Here, we report on a case of human infection with the H3N8 avian influenza virus. The patient had multiple myeloma and died of severe infection. Genome analysis showed multiple gene mutations and reassortments without mammalian-adaptive mutations. This suggests that avian influenza (A/H3N8) virus infection could be lethal for immunocompromised persons.

Maackiain suppresses the development of cervical cancer via AMPK priming autophagy.

BACKGROUND: Maackiain (Mac), a flavonoid analog isolated from Sophora flavescens, exhibits neuroprotective, anti-allergic, anti-inflammatory, and pro-apoptotic effects. It is not clear whether Mac has a therapeutic effect on cervical cancer. METHOD: In this work, we used RT-qPCR, western blot, immunofluorescence, and related methods to detect the therapeutic mechanism of Mac for cervical cancer. RESULTS: We demonstrated that Mac significantly inhibited the proliferation, migration, and invasion of human cervical cancer cell lines HeLa and SiHa. And, Mac enhanced the pro-apoptotic effects of cisplatin in treating cervical cancer cells. Mac has shown good efficacy in treating cervical cancer. Furthermore, Mac inhibited the mammalian target of the rapamycin (mTOR) pathway, thereby inducing autophagy in cervical cancer cells. The regulation of mTOR/autophagy pathway by Mac relied on the activation of AMP-activated protein kinase (AMPK), and the inhibition of the AMPK reversed the Mac's anti-cervical cancer activity. In addition, experimental study of Mac in mouse xenograft tumor model further confirmed its good anti-cervical cancer activity. CONCLUSION: Mac inhibits human cervical cancer by activating the AMPK/mTOR/autophagy pathway, indicating that it is a potential natural compound for the treatment of cervical cancer. This study also provides a feasible molecular mechanism for the treatment of cervical cancer.

Clinicopathological characteristics and prognostic risk factors of cervical cancer patients aged ≤35 years old.

We aimed to explore the clinicopathological characteristics and prognostic risk factors of cervical cancer in patients aged ≤35 years. A total of 256 cervical cancer patients treated at Anhui Medical University Affiliated Maternity and Child Health Hospital and The First Affiliated Hospital of Anhui Medical University from January 2016 to October 2018 were divided into ≤35-year-old (n = 136) and >35-year-old (n = 120) groups. Their clinicopathological characteristics and 3-year cumulative disease-free survival (DFS) and overall survival (OS) rates were compared. The factors influencing the 3-year cumulative DFS rate of patients in the ≤35-year-old group were analyzed using univariate and multivariate Cox regression models. The human papillomavirus (HPV) infection rate, incidence rate of contact vaginal bleeding, depth of cervical interstitial infiltration, and incidence rates of parametrial metastasis and vascular infiltration were all significantly higher in the ≤35-year-old group than in the >35-year-old group. The 3-year cumulative DFS rates of all patients and those with HPV infection and contact vaginal bleeding were significantly lower in the ≤35-year-old group than in the >35-year-old group (69.12% vs. 77.50%, 68.29% vs. 80.85%, and 66.04% vs. 81.48%) (log-rank χ2 = 7.429, 4.339, and 4.276, P < .05). Depth of cervical interstitial infiltration >4 mm, parametrial metastasis, lymph node metastasis, and vascular infiltration were independent risk factors for the prognosis of cervical cancer patients aged ≤35 years (P < .05). Cervical cancer aged ≤35 years have a worse postoperative prognosis than those aged >35 years, which is affected by the depth of cervical interstitial infiltration >4 mm, parametrial metastasis, lymph node metastasis, and vascular infiltration. Therefore, it is necessary to identify more effective treatment methods for young patients with cervical cancer to improve the therapeutic effect and reduce the risk of recurrence and metastasis.

Spatial-temporal clustering of an outbreak of SARS-CoV-2 Delta VOC in Guangzhou, China in 2021.

Background: In May 2021, the SARS-CoV-2 Delta variant led to the first local outbreak in China in Guangzhou City. We explored the epidemiological characteristics and spatial-temporal clustering of this outbreak. Methods: Based on the 153 cases in the SARS-CoV-2 Delta variant outbreak, the Knox test was used to analyze the spatial-temporal clustering of the outbreak. We further explored the spatial-temporal clustering by gender and age groups, as well as compared the changes of clustering strength (S) value between the two outbreaks in Guangzhou. Results: The result of the Knox analysis showed that the areas at short distances and brief periods presented a relatively high risk. The strength of clustering of male-male pairs was higher. Age groups showed that clustering was concentrated in cases aged ≤ 18 years matched to 18-59 years and cases aged 60+ years. The strength of clustering of the outbreak declined after the implementation of public health measures. The change of strength of clustering at time intervals of 1-5 days decreased greater in 2021 (S = 129.19, change rate 38.87%) than that in 2020 (S = 83.81, change rate 30.02%). Conclusions: The outbreak of SARS-CoV-2 Delta VOC in Guangzhou has obvious spatial-temporal clustering. The timely intervention measures are essential role to contain this outbreak of high transmission.

Comprehensive narrative review of real-world COVID-19 vaccines: viewpoints and opportunities.

Currently, people all over the world have been affected by coronavirus disease 2019 (COVID-19). Fighting against COVID-19 is the top priority for all the countries and nations. The development of a safe and effective COVID-19 vaccine is considered the optimal way of ending the pandemic. Three hundred and 44 vaccines were in development, with 149 undergoing clinical research and 35 authorized for emergency use as to March 15 of 2022. Many studies have shown the effective role of COVID-19 vaccines in preventing SARS-CoV-2 infections as well as serious and fatal COVID-19 cases. However, tough challenges have arisen regarding COVID-19 vaccines, including long-term immunity, emerging COVID-19 variants, and vaccine inequalities. A systematic review was performed of recent COVID-19 vaccine studies, with a focus on vaccine type, efficacy and effectiveness, and protection against SARS-CoV-2 variants, breakthrough infections, safety, deployment and vaccine strategies used in the real-world. Ultimately, there is a need to establish a unified evaluation standard of vaccine effectiveness, monitor vaccine safety and effectiveness, along with the virological characteristics of SARS-CoV-2 variants; and determine the most useful booster schedule. These aspects must be coordinated to ensure timely responses to beneficial or detrimental situations. In the future, global efforts should be directed toward effective and immediate vaccine allocations, improving vaccine coverage, SARS-CoV-2 new variants tracking, and vaccine booster development.

Primary ovarian Burkitt lymphoma: report of a case and review of literature.

We report a case of primary ovarian Burkitt lymphoma that occurred in a 25-year-old woman. The patient complained of a mass in the right ovary discerned by physical examination 2 months prior. Ultrasound examination indicated that the right ovary was enlarged and abundant blood flow signals were observed. Right salpingo-oophorectomy was subsequently performed. Histology was characterized by diffuse sheets of monotonous medium-sized lymphoid cells with plentiful mitotic figures and apoptosis. Numerous tingible-body macrophages were found in the ovarian tissue, presenting a starry sky pattern. The tumor cells expressed CD20, CD10, BCL6 and MYC in the absence of BCL2. Ki-67 proliferative index was very high with a proliferation rate of near 100%. MYC (8q24) rearrangement was detected by fluorescence in situ hybridization (FISH) with no BCL2 (18q21) and BCL6 (3q37) gene rearrangements. Cumulative evidence established primary ovarian Burkitt lymphoma as the final histopathologic diagnosis with clinical stage I (FIGO). The patient received HyperCVAD chemotherapy after surgery and remained complete response (CR) for 18 months. We aim to provide insight into the future treatment of this rare but lethal disease.

Clinical Characteristics of COVID-19 Patients' Postvaccination.

To investigate the clinical characteristic of domestic coronavirus disease 2019 (COVID-19) patients after vaccination campaign conducted in China. According to vaccination status and months from first vaccine dose to infection detection, patients were divided into unvaccinated, <3 months, 3-6 months, and >6 months groups. The information of demographic and clinical characteristics, laboratory and thoracic computed tomography (CT) findings, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid and IgM, IgG antibodies was retrospectively collected. Therapeutic approaches, temperature-normalizing and viral shedding times, outcomes were also summarized. SARS-CoV-2 antibody levels were further analyzed based on the other following variables: time from second vaccine dose to infection, vaccine dose, the interval from the first to the second dose, and vaccine brand. Among 208 COVID-19 patients, 13 (6.28%) were unvaccinated. No significant differences in demographic and clinical characteristics, laboratory and CT findings, and SARS-CoV-2 nucleic acid loads were detected between groups (all p > 0.05). In comparison with the unvaccinated group, the median SARS-CoV-2 IgG levels were noticeably increased in those vaccinated groups (0.603 in unvaccinated, 15.925 in <3 months, 14.04 in 3-6 months, and 4.94 in >6 months, respectively, p < 0.05). However, SARS-CoV-2 IgG levels were not altered between groups divided based on the other variables. Vaccination does not affect the clinical characteristics in COVID-19 patients. COVID-19 patients with vaccination have high SARS-CoV-2 IgG levels. Underscore the necessity of rapid implementation of vaccination campaigns can be speculated.

Probable Evidence of Fecal Aerosol Transmission of SARS-CoV-2 in a High-Rise Building.

BACKGROUND: The role of fecal aerosols in the transmission of severe acute respiratory syndrome coronavirus 2 has been suspected. OBJECTIVE: To investigate the temporal and spatial distributions of 3 infected families in a high-rise apartment building and examine the associated environmental variables to verify the role of fecal aerosols. DESIGN: Epidemiologic survey and quantitative reverse transcriptase polymerase chain reaction analyses on throat swabs from the participants; 237 surface and air samples from 11 of the 83 flats in the building, public areas, and building drainage systems; and tracer gas released into bathrooms as a surrogate for virus-laden aerosols in the drainage system. SETTING: A high-rise apartment building in Guangzhou, China. PARTICIPANTS: 9 infected patients, 193 other residents of the building, and 24 members of the building's management staff. MEASUREMENTS: Locations of infected flats and positive environmental samples, and spread of virus-laden aerosols. RESULTS: 9 infected patients in 3 families were identified. The first family had a history of travel to the coronavirus disease 2019 (COVID-19) epicenter Wuhan, whereas the other 2 families had no travel history and a later onset of symptoms. No evidence was found for transmission via the elevator or elsewhere. The families lived in 3 vertically aligned flats connected by drainage pipes in the master bathrooms. Both the observed infections and the locations of positive environmental samples are consistent with the vertical spread of virus-laden aerosols via these stacks and vents. LIMITATION: Inability to determine whether the water seals were dried out in the flats of the infected families. CONCLUSION: On the basis of circumstantial evidence, fecal aerosol transmission may have caused the community outbreak of COVID-19 in this high-rise building. PRIMARY FUNDING SOURCE: Key-Area Research and Development Program of Guangdong Province and the Research Grants Council of Hong Kong.

Epidemiological characteristics of asymptomatic Norovirus infection in a population from oyster (Ostrea rivularis Gould) farms in southern China.

The following paper investigates the prevalence and characteristics of asymptomatic norovirus infection in the population living around oyster farm sites. Two consecutive surveys were conducted from January 2014 to December 2014 and 4549 stool samples were screened during the same time period. The total asymptomatic infection rate was 4.04% (184/4549). Norovirus infection rate was 5.20% in oyster farming population which was significantly higher compared with non-farming population where the infection rate was 3.65% (χ2 = 5.49, P < 0.05). A total of 184 NoV positive samples were identified by real time-quantitative polymerase chain reaction (RT-qPCR) and semi-nested RT-PCR and 136 sequences were obtained. The sequences were clustered into 14 genotypes. GI strains were clustered into six genotypes, including GI.2, GI.3, GI.5, GI.6, GI.8 and GI.9; while GII strains were clustered into GII.2, GII.3, GII.4, GII.5, GII.6, GII.8 and GII.13. GI.9 and GII.17 were the predominant and most prevalent genotypes, respectively. The GII.17 genotype replaced GII.4 becoming the dominant genotype in the oyster farming area in 2014. To sum up, long-term monitoring of asymptomatic infection is crucial for the detection of new variant strains and for identifying outbreaks during the early stage.

Proportion of Uterine Malignant Tumors in Patients with Laparoscopic Myomectomy: A National Multicenter Study in China.

BACKGROUND: The Food and Drug Administration recently announced that the use of morcellation may cause fibroids or pelvic dissemination and metastasis of uterine sarcoma; therefore, the use of morcellation is limited in the USA. A large sample study is necessary to assess the proportion of uterine malignant tumors found in patients with laparoscopic myomectomy. METHODS: A national multicenter study was performed in China. From 2002 to 2014, 33,723 cases were retrospectively selected. We calculated the prevalence and recorded the clinical characteristics of the patients with malignancy after morcellation application. A total of 62 cases were finally pathologically confirmed as malignant postoperatively. Additionally, the medical records of the 62 patients were analyzed in details. RESULTS: The proportion of postoperative malignancy after morcellation application was 0.18% (62/33,723) for patients who underwent laparoscopic myomectomy. Nearly 62.9% (39/62) of patients had demonstrated blood flow signals in the uterine fibroids before surgery. And, 23 (37.1%) patients showed rapid growth at the final preoperative ultrasound. With respect to the pathological types, 38 (61.3%) patients had detectable endometrial stromal sarcoma, 13 (21.0%) had detectable uterine leiomyosarcoma, only 3 (3.2%) had detectable carcinosarcoma, and 5 (8.1%) patients with leiomyoma had an undetermined malignant potential. CONCLUSIONS: The proportion of malignancy is low after using morcellation in patients who undergo laparoscopic myomectomy. Patients with fast-growing uterine fibroids and abnormal ultrasonic tumor blood flow should be considered for malignant potential, and morcellation should be avoided.

Characterization of Antigenic Relatedness between GII.4 and GII.17 Noroviruses by Use of Serum Samples from Norovirus-Infected Patients.

A novel GII.17 norovirus variant caused major gastroenteritis epidemics in China in 2014 to 2016. To explore the host immune factors in selection of the emergence of this new variant, we characterized its antigenic relatedness with the GII.4 noroviruses that have dominated in China for decades. Through an enzyme-linked immunosorbent assay (ELISA) and a histo-blood group antigen (HBGA) blocking assay using sera from GII.4 and the GII.17 variant-infected patients, respectively, we observed limited cross-immune reactivity by the ELISA but little reactivity by the HBGA blocking assay between GII.4 norovirus and the new GII.17 variant. Our data suggest that, among other possible factors, GII.4-specific herd immunity had little role in the emergence of the new GII.17 variant. Thus, GII.17 may be an important active antigenic type or immunotype that needs to be considered for future vaccine strategies against human noroviruses.

[Norovirus infection surveillance in early warning of outbreaks in population in oyster farming areas].

OBJECTIVE: To have an insight into the prevalence tendency caused by Noroviruses( NoVs) in population of oyster farming areas, and evaluate the early warning signification of acute gastroenteritis( AGE) monitoring. METHODS: Between January and December in 2014, a retrospective household survey of AGE during past four weeks was conducted to residents using multi-stage sampling in oyster farming areas. Norovirus capsid genome was detected using real-time RT-PCR and semi-nested PCR, sequenced and phylogenetic analyzed. RESULTS: A total of 75 cases of AGE were reported. The incidence rate was 0. 10 per person-year, the detection rate of norovirus was 20. 0%( 15 /75). The dominant epidemic No Vs strain in oyster farming was still GII. 4 Sydney 2012. Furthermore, a newly GII. 17 variant was detected and early in March 2014. CONCLUSION: The GII. 4 Sydney 2012 genotype is still prevalent strain that caused AGE currently in the community residents of oyster farming areas. NoVs GII. 17 variant was found in sporadic patients of sentinel hospital AGE monitoring in March 2014 that have an early warning effect to the outbreaks of winter in 2014.

Relationship between occupational stress and job burnout among rural-to-urban migrant workers in Dongguan, China: a cross-sectional study.

OBJECTIVES: In China, there have been an increasing number of migrant workers from rural to urban areas, and migrant workers have the highest incidence of occupational diseases. However, few studies have examined the impact of occupational stress on job burnout in these migrant workers. This study aimed to investigate the relationship between occupational stress and job burnout among migrant workers. DESIGN: This study used a cross-sectional survey. SETTING: This investigation was conducted in Dongguan city, Guangdong Province, China. PARTICIPANTS: 3806 migrant workers, aged 18-60 years, were randomly selected using multistage sampling procedures. PRIMARY AND SECONDARY OUTCOME MEASURES: Multistage sampling procedures were used to examine demographic characteristics, behaviour customs and job-related data. Hierarchical linear regression and logistic regression models were constructed to explore the relationship between occupational stress and burnout. RESULTS: Demographics, behaviour customs and job-related characteristics significantly affected on burnout. After adjusting for the control variable, a high level of emotional exhaustion was associated with high role overload, high role insufficiency, high role boundary, high physical environment, high psychological strain, high physical strain, low role ambiguity, low responsibility and low vocational strain. A high level of depersonalisation was associated with high role overload, high role ambiguity, high role boundary, high interpersonal strain, high recreation, low physical environment and low social support. A low level of personal accomplishment was associated with high role boundary, high role insufficiency, low responsibility, low social support, low physical environment, low self-care and low interpersonal strain. Compared to the personal resources, the job strain and personal strain were more likely to explain the burnout of rural-to-urban migrant workers in our study. CONCLUSIONS: The migrant workers have increased job burnouts in relation to occupational stress. Relieving occupational stress and maintaining an appropriate quantity and quality of work could be important measures for preventing job burnout among these workers.