AIM:To report an acute gastroenteritis outbreak caused by a genogroup 2 genotype 6(GII.6) strain norovirus in Shanghai,China.METHODS:Noroviruses are responsible for approximately half of all reported gastroenteritis o...AIM:To report an acute gastroenteritis outbreak caused by a genogroup 2 genotype 6(GII.6) strain norovirus in Shanghai,China.METHODS:Noroviruses are responsible for approximately half of all reported gastroenteritis outbreaks in many countries.Genogroup 2 genotype 4 strains are the most prevalent.Rare outbreaks caused by GII.6 strains have been reported.An acute gastroenteritis outbreak occurred in an elementary school in Shanghai in December of 2013.Field and molecular epidemiologic investigations were conducted.RESULTS:The outbreak was limited to one class in an elementary school located in southwest Shanghai.The age of the students ranged from 9 to 10 years.The first case emerged on December 10,2013,and the last case emerged on December 14,2013.The cases peaked on December 11,2013,with 21 new cases.Of 45 students in the class,32 were affected.The main symptom was gastroenteritis,and 15.6%(5/32) of the cases exhibited a fever.A field epidemiologic investigation showed the pathogen may have been transmitted to the elementary school from employees in a delicatessen via the first case student,who had eaten food from the delicatessen one day before the gastroenteritis episodes began.A molecular epidemiologic investigation identified the cause of the gastroenteritis as norovirus strain GII.6;the viral sequence of the student cases showed 100% homology with that of the shop employees.Genetic relatedness analyses showed that the new viral strain is closely related to previously reported GII.6 sequences,especially to a strain reported in Japan.CONCLUSION:This is the first report to show that norovirus strain GII.6 can cause a gastroenteritis outbreak.Thus,the prevalence of GII.6 noroviruses requires attention.展开更多
Dear Editor,Noroviruses are positive-sense, single-stranded RNA viruses belonging to Caliciviridae and account for more than 50%of all acute gastroenteritis (AGE) outbreaks worldwide and cause an estimated 200,000 dea...Dear Editor,Noroviruses are positive-sense, single-stranded RNA viruses belonging to Caliciviridae and account for more than 50%of all acute gastroenteritis (AGE) outbreaks worldwide and cause an estimated 200,000 deaths per year among children\5 years of age, primarily in developing countries (Hall et al. 2012;Glass et al. 2009). The norovirus genome contains three open reading frames (ORFs).展开更多
目的分析总结青少年起病的成人型糖尿病2型(maturity-onset diabetes of the young type 2,MODY2)患儿的临床表现及遗传学特点,提高临床工作中对MODY2的识别能力。方法回顾性分析2017年8月—2023年7月在华中科技大学同济医学院附属同济...目的分析总结青少年起病的成人型糖尿病2型(maturity-onset diabetes of the young type 2,MODY2)患儿的临床表现及遗传学特点,提高临床工作中对MODY2的识别能力。方法回顾性分析2017年8月—2023年7月在华中科技大学同济医学院附属同济医院儿科确诊的13例MODY2患儿的临床资料。结果13例MODY2患儿(编号P1~13)均有糖尿病家族史,均为健康体检或因感染性疾病偶然发现的轻度空腹高血糖[(6.4±0.5)mmol/L)]。其中2例空腹血糖达到糖尿病诊断标准,其他病例均为空腹血糖受损或糖耐量受损;1 h血糖(one-hour post-glucose,1-hPG)波动在8.31~13.06 mmol/L,已到达国际糖尿病联盟推荐的糖尿病诊断标准。13例MODY2患儿均为葡萄糖激酶(glucokinase,GCK)基因杂合变异,其中P6为GCK c.1047C>A(p.Y349X)、P11为GCK c.1146_1147insGCAGAGCGTGTCTACGCGCGCTGCGCACATGTGC(p.S383Alafs*87)和P13为GCK c.784_785insC(p.D262Alafs*13),均为尚未报道过的变异。结论该研究丰富了MODY2的基因变异谱;临床对于有糖尿病家族史、偶然发现的轻度空腹血糖增高、糖尿病相关抗体阴性的患儿,需警惕MODY2可能。展开更多
BACKGROUND Exogenous insulin may trigger immune-mediated complications,particularly among East Asian populations.Double diabetes,characterized by overlapping features of type 1 diabetes(T1D)and type 2 diabetes(T2D),ma...BACKGROUND Exogenous insulin may trigger immune-mediated complications,particularly among East Asian populations.Double diabetes,characterized by overlapping features of type 1 diabetes(T1D)and type 2 diabetes(T2D),may arise from insulin-induced autoimmunity.This study aimed to explore the association between high-risk human leukocyte antigen(HLA)class Ⅱ genotypes and susceptibility to double diabetes in patients initially diagnosed with T2D.AIM To investigate clinical and immunogenic features of patients who develop double diabetes following exogenous insulin therapy.METHODS We retrospectively analyzed five cases from Peking Union Medical College Hospital and 18 cases identified from published literature.Patients were categorized into two groups:The T2D→T1D group,characterized by autoimmune progression,and the stable T2D(T2D→T2D).Clinical characteristics and HLA class Ⅱ genotypes were compared descriptively between the two groups.RESULTS A total of 23 patients were included in the analysis.Of these,10 progressed from theT2D→T1D with autoimmune features,while 13 remained in the stable T2D→T2D group.There was no statistically significant difference in age at diagnosis between the two groups(57.10±16.11 years vs 60.31±17.41 years).In the T2D→T1D group,70%of patients carried the HLA-DRB104:05 allele and 40%carried DRB109:01,both of which are commonly associated with a high risk of T1D.In contrast,the T2D→T2D group showed greater genetic heterogeneity,with a broader distribution of HLA-DRB1 alleles,including DRB103:02(n=4),DRB109:01(n=4),and several lower frequency alleles such as DRB1*04:05,*08:03,*03:01,*04:06,*14:01,*04:01,*12:02,*15:02 and*02:01.CONCLUSION These findings suggest that patients in the T2D→T1D group exhibit a stronger autoimmune genetic predisposition,characterized by an enrichment of high-risk HLA class II alleles.In contrast,individuals with stable T2D demonstrate greater HLA diversity and lack definitive autoimmune-associated markers.展开更多
文摘AIM:To report an acute gastroenteritis outbreak caused by a genogroup 2 genotype 6(GII.6) strain norovirus in Shanghai,China.METHODS:Noroviruses are responsible for approximately half of all reported gastroenteritis outbreaks in many countries.Genogroup 2 genotype 4 strains are the most prevalent.Rare outbreaks caused by GII.6 strains have been reported.An acute gastroenteritis outbreak occurred in an elementary school in Shanghai in December of 2013.Field and molecular epidemiologic investigations were conducted.RESULTS:The outbreak was limited to one class in an elementary school located in southwest Shanghai.The age of the students ranged from 9 to 10 years.The first case emerged on December 10,2013,and the last case emerged on December 14,2013.The cases peaked on December 11,2013,with 21 new cases.Of 45 students in the class,32 were affected.The main symptom was gastroenteritis,and 15.6%(5/32) of the cases exhibited a fever.A field epidemiologic investigation showed the pathogen may have been transmitted to the elementary school from employees in a delicatessen via the first case student,who had eaten food from the delicatessen one day before the gastroenteritis episodes began.A molecular epidemiologic investigation identified the cause of the gastroenteritis as norovirus strain GII.6;the viral sequence of the student cases showed 100% homology with that of the shop employees.Genetic relatedness analyses showed that the new viral strain is closely related to previously reported GII.6 sequences,especially to a strain reported in Japan.CONCLUSION:This is the first report to show that norovirus strain GII.6 can cause a gastroenteritis outbreak.Thus,the prevalence of GII.6 noroviruses requires attention.
基金supported by the Special National Project on Research and Development of Key Biosafety Technologies (2016YFC1201900)the National Natural Science Foundation of China (31500139)
文摘Dear Editor,Noroviruses are positive-sense, single-stranded RNA viruses belonging to Caliciviridae and account for more than 50%of all acute gastroenteritis (AGE) outbreaks worldwide and cause an estimated 200,000 deaths per year among children\5 years of age, primarily in developing countries (Hall et al. 2012;Glass et al. 2009). The norovirus genome contains three open reading frames (ORFs).
文摘目的分析总结青少年起病的成人型糖尿病2型(maturity-onset diabetes of the young type 2,MODY2)患儿的临床表现及遗传学特点,提高临床工作中对MODY2的识别能力。方法回顾性分析2017年8月—2023年7月在华中科技大学同济医学院附属同济医院儿科确诊的13例MODY2患儿的临床资料。结果13例MODY2患儿(编号P1~13)均有糖尿病家族史,均为健康体检或因感染性疾病偶然发现的轻度空腹高血糖[(6.4±0.5)mmol/L)]。其中2例空腹血糖达到糖尿病诊断标准,其他病例均为空腹血糖受损或糖耐量受损;1 h血糖(one-hour post-glucose,1-hPG)波动在8.31~13.06 mmol/L,已到达国际糖尿病联盟推荐的糖尿病诊断标准。13例MODY2患儿均为葡萄糖激酶(glucokinase,GCK)基因杂合变异,其中P6为GCK c.1047C>A(p.Y349X)、P11为GCK c.1146_1147insGCAGAGCGTGTCTACGCGCGCTGCGCACATGTGC(p.S383Alafs*87)和P13为GCK c.784_785insC(p.D262Alafs*13),均为尚未报道过的变异。结论该研究丰富了MODY2的基因变异谱;临床对于有糖尿病家族史、偶然发现的轻度空腹血糖增高、糖尿病相关抗体阴性的患儿,需警惕MODY2可能。
基金Supported by CAMS Innovation Fund for Medical Sciences,No.2021-I2M-1-002Healthcare Quality and Safety Incubation Programme of the Peking Union Medical Foundation,No.XHFY 2406the National High-Level Hospital Clinical Research Funding,No.2022-PUMCH-B-015.
文摘BACKGROUND Exogenous insulin may trigger immune-mediated complications,particularly among East Asian populations.Double diabetes,characterized by overlapping features of type 1 diabetes(T1D)and type 2 diabetes(T2D),may arise from insulin-induced autoimmunity.This study aimed to explore the association between high-risk human leukocyte antigen(HLA)class Ⅱ genotypes and susceptibility to double diabetes in patients initially diagnosed with T2D.AIM To investigate clinical and immunogenic features of patients who develop double diabetes following exogenous insulin therapy.METHODS We retrospectively analyzed five cases from Peking Union Medical College Hospital and 18 cases identified from published literature.Patients were categorized into two groups:The T2D→T1D group,characterized by autoimmune progression,and the stable T2D(T2D→T2D).Clinical characteristics and HLA class Ⅱ genotypes were compared descriptively between the two groups.RESULTS A total of 23 patients were included in the analysis.Of these,10 progressed from theT2D→T1D with autoimmune features,while 13 remained in the stable T2D→T2D group.There was no statistically significant difference in age at diagnosis between the two groups(57.10±16.11 years vs 60.31±17.41 years).In the T2D→T1D group,70%of patients carried the HLA-DRB104:05 allele and 40%carried DRB109:01,both of which are commonly associated with a high risk of T1D.In contrast,the T2D→T2D group showed greater genetic heterogeneity,with a broader distribution of HLA-DRB1 alleles,including DRB103:02(n=4),DRB109:01(n=4),and several lower frequency alleles such as DRB1*04:05,*08:03,*03:01,*04:06,*14:01,*04:01,*12:02,*15:02 and*02:01.CONCLUSION These findings suggest that patients in the T2D→T1D group exhibit a stronger autoimmune genetic predisposition,characterized by an enrichment of high-risk HLA class II alleles.In contrast,individuals with stable T2D demonstrate greater HLA diversity and lack definitive autoimmune-associated markers.
