Genetic variation and evolutionary characteristics of Echovirus 11: new variant within genotype D5 associated with neonatal death found in China.

Echovirus 11 (E11) has gained attention owing to its association with severe neonatal infections. From 2018 to 2023, a surge in severe neonatal cases and fatalities linked to a novel variant of genotype D5 was documented in China, France, and Italy. However, the prevention and control of E11 variants have been hampered by limited background data on the virus circulation and genetic variance. Therefore, the present study investigated the circulating dynamics of E11 and the genetic variation and molecular evolution of genotype D5 through the collection of strains from the national acute flaccid paralysis (AFP) and hand, foot, and mouth disease (HFMD) surveillance system in China during 2000-2022 and genetic sequences published in the GenBank database. The results of this study revealed a prevalent dynamic of E11 circulation, with D5 being the predominant genotype worldwide. Further phylogenetic analysis of genotype D5 indicated that it could be subdivided into three important geographic clusters (D5-CHN1: 2014-2019, D5-CHN2: 2016-2022, and D5-EUR: 2022-2023). Additionally, variant-specific (144) amino acid mutation sites and positive-selection pressure sites (132, 262) were identified in the VP1 region. Cluster-specific recombination patterns were also identified, with CVB5, E6, and CVB4 as the major recombinant viruses. These findings provide a preliminary landscape of E11 circulation worldwide and basic scientific data for further study of the pathogenicity of E11 variants.

Treatment of insomnia according to the liver in TCM：a study of 224 patients / 国际中医中药杂志

Objective To evaluate the efficacy in patients with insomnia treated according to the liver in TCM. Methods A total of 224 patients with insomnia were enrolled and treated according to the liver in TCM. The principle of suppressing hyperactive liver and subsiding yang and promoting blood circulation for tranquillization was adopted, and Longgu Muli decoction was used as basic therapeutic formula. The therapeutic effects were evaluated using Spiegel Sleep Questionnaire according to the syndrome differentiation type, whether the body disease appeared, whether taking hypnotics before the treatment, and the variation of disease course. Results The total effective rate was 89.73%(201/224) in 224 patients with insomnia. There were no significant difference in effective rate among different syndrome differentiation types (χ2=11.293, P=0.721), between simple and non-simple insomnia (χ2=1.216, P=0.704). There were significant difference in effective rate between taking and not taking hypnotics before the treatment (χ2=6.510, P=0.011), and among different disease course (χ2=9.278, P=0.001). Conclusion Treatment according to the liver in TCM can reduce the dependence on hypnotics and has certain efficacy in patients with insomnia.