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Objective:To analyze the variation and evolution characteristics of hemagglutinin (HA) and neuraminidase (NA) genes of influenza B virus circulating in Jining from 2017 to 2020.Methods:Throat swab specimens were collected from patients with influenza-like symptoms in sentinel hospitals and influenza outbreaks in Jining from 2017 to 2020 and tested for influenza B virus nucleic acid. After virus isolation, 20 representative strains of influenza B virus were selected to sequence the full length of HA and NA genes. Phylogenetic trees were constructed and the molecular characteristics were analyzed using bioinformatics software. Results:A total of 4 575 specimens were collected and 842 of them were positive for influenza virus, including 398 (8.7%, 398/4 575) influenza B virus-positive specimens. The positive rate of influenza B virus was 47.27% (398/842). The isolated influenza B virus strains of Victoria (BV) and Yamagata (BY) lineages from 2017 to 2020 shared 98.7%-98.8% and 98.5%-99.1% homology in HA gene with vaccine strains, respectively. The BV lineage strains isolated from 2018 to 2020 belonged to Victoria clade 1A branch and the BY lineage strains isolated from 2017 to 2018 belonged to Yamagata clade 3 branch. Mutations were detected in several antigenic sites, but not in the sites related to NA inhibitor resistance. Conclusions:Mutations in several antigenic sites caused antigenic changes in influenza B virus of BV and BY lineages, which might be related to the outbreaks of influenza B virus infection in Jining during 2017 to 2020.
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BACKGROUND:Traditional open reduction and internal fixation for type C pilon fractures is characterized extensive periosteal stripping, severe soft tissue injury, many postoperative complications, and unsatisfactory recovery of joint function. Minimal y invasive technology or external fixation combined with limited internal fixation for type C pilon fractures are usual y difficult to achieve anatomical reduction. OBJECTIVE:To explore the curative efficacy of anterolateral“L”type locking plate implantation combined with interior minimal y invasive plate osteosynthesis in treatment of type C pilon fractures and postoperative complication occurrence in order to find out the efficient fixation method for type C pilon fractures. METHODS:Twenty-six patients with type C pilon fractures (15 males and 11 females, aged from 19 to 68 years, mean age of 39.2 years) were selected and subjected to anterolateral“L”type locking plate implantation combined with interior minimal y invasive plate osteosynthesis. CT three-dimensional reconstruction was performed before and plate implantation. X-ray examination was carried out before and after fixation. Al patients were fol owed up for observation of clinical efficacy and complications. The therapeutic effects were evaluated using the Johner-Wruhs scoring system. RESULTS AND CONCLUSION:The 26 patients were fol owed up for 16 months (from 9 to 24 months). Delayed healing occurred in one case (after 12 months), and the average healing time was 15 weeks (from 11 to 52 weeks). There was no deformity healing. Two patients developed superficial incision infections of Staphylococcus aureus, healed by open wound and dressing change every day for 2 weeks. No deep infection or osteomyelitis was found. One patient was found to have traumatic arthritis of ankle joint, improved by the injection of sodium hyaluronate. There was no flap necrosis and tendon irritation, broken nail or screw withdrawal, and nerve injury. Johner-Wruhs scores were excellent in 11 cases, good in 12 cases, fair in 3 cases, with the total excellent to good rate of 88.5%. These findings indicate that anterolateral“L”type locking plate implantation combined with interior minimal y invasive plate osteosynthesis for delayed treatment of type C pilon fractures can achieve satisfactory fracture reduction, rigid fixation, early functional exercise, less complications, and good recovery of joint function.