Bridging the gap:Unveiling the crisis of physical inactivity in inflammatory bowel diseases

In this editorial we comment on the article titled“Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity:The BE-FIT-IBD study”published in a recent issue of the World Journal of Gastroen-terology 2023;29(41):5668-5682.Inflammatory bowel diseases(IBD)are emerging as a significant global health concern as their incidence continues to rise on a global scale,with detrimental impacts on quality of life.While many advances have been made regarding the management of the disease,physical inactivity in these patients represents an underexplored issue that may hold the key for further and better understanding the ramifications of IBD.Chronic pain,fatigue,and fear of exacerbating symptoms promotes physical inactivity among IBD patients,while the lack of clear guidelines on safe exercise regimens contributes to a norm of physical inactivity.Physical activity(PA)is accepted to have a positive effect on disease outcomes and quality of life,while inactivity exacerbates comorbidities like cardiovascular disease and mental health disorders.The“BE-FIT-IBD”study,focusing on PA levels and barriers in IBD patients of Southern Italy,revealed that a significant proportion(42.9%)were physically inactive.This lack of PA is attributed to barriers such as fear of flare-ups and misconceptions about exercise exacerbating the disease.The study also highlighted the need for better communication between healthcare providers and patients regarding the benefits of PA and safe incorporation into lifestyles.Moreover,physical inactivity may also contribute to disability in IBD patients,having a great impact on employment status.Of note is the fact that IBD also comes with an important psychological burden with relevant evidence suggesting that regular PA can improve mood,reduce anxiety,and enhance mental health.The“BE-FIT-IBD”study advocated for the integration of PA into IBD management,emphasizing the bidirectional link between PA and IBD.Regular exercise can influence the course of IBD,potentially reducing symptom severity and prolonging remission periods.As such,it is mandatory that healthcare providers actively educate patients,dispel misconceptions,and tailor exercise recommendations to improve the quality of life and reduce IBD-related complications.

High prevalence of vitamin A deficiency in Crohn's disease patients according to serum retinol levels and the relative dose-response test

AIM:To assess the vitamin A status of patients with Crohn's disease(CD) by evaluating serum retinol levels and the relative dose response(RDR) test(liver retinol stores).METHODS:Vitamin A nutritional status was measured by serum retinol obtained by high performance liquid chromatography and the RDR test for evaluation of the hepatic stores.Body composition was performed by densitometry by dual-energy X-ray absorptiometry.Vitamin A dietary intake was assessed from a semiquantitative food frequency questionnaire.RESULTS:This study included 38 CD patients and 33 controls.Low serum retinol concentrations were detected in 29% of CD patients vs 15% in controls(P < 0.005).The RDR test was positive in 37% of CD patients vs 12% in controls,which indicated inadequate hepatic vitamin A stores(P < 0.005).Individuals with hypovitaminosis A had lower BMI and body fat compared with those without this deficiency.There was no association between vitamin A deficiency and its dietary intake,ileal location,presence of disease activity and prior bowel resections.CONCLUSION:Patients with CD have higher prevalence of vitamin A deficiency,as assessed by two independent methods.

Body Composition in Sickle Cell Disease Patients in the Steady State

Introduction: Previous studies in sickle cell disease (SCD) patients have demonstrated low muscle mass (MM) and high fat mass (FM) percentages compared to individuals with normal hemoglobin. The relationship between the evolutions of body composition (BC) parameters in the active SCD population is not well elucidated. The aim of the present study was to assess the body composition in active adult SCD patients in sub-Saharan Africa during the inter-critical period. Methodology: We conducted a descriptive and analytical cross-sectional study over an 8-month period. Eighteen SCD patients (sex ratio = 1) reported regular physical activity (RPA) corresponding to level 3 (RPA of moderate intensity) of the 4-level Saltin-Grimby physical activity scale were recruited. Anthropometric and BC parameters such as BMI, percentage FM and percentage MM were evaluated using an impedance meter. Results: The study population had a mean age of 26 ± 7 years and a mean BMI of 20.5 ± 1.9 kg/m2. We found a significantly higher percentage of FM in women compared to the men (25.6% ± 10.2% vs 11.1% ± 2.1%;p = 0.001). For the proportion of MM, all the women had a normal percentage. The men mostly had high levels of MM compared with reference norms. Men had significantly greater MM percentages than women (45.4% ± 1.8% vs. 26.5% ± 1.4%;p Conclusion: RPA appears to have positive effects on BC in active population with SCD, and a greater-than-expected effect was observed on MM in male patients. Promoting regular, adapted physical activity would be a promising way of improving BC parameters and quality of life in the SCD population. Further studies with larger cohorts will be needed to better substantiate these results.

Decoding an Old 1907 Prescription of Dr.Ing Hay(“Doc Hay”):One of the Earliest Chinese Medicine Doctors in the United States

Objectives:Chinese medicine doctors have practiced in the United States since April of 1854,the world's first Chinese medicine doctor's memorial is Kam Wah Chung Museum in John Day,Oregon,U.S.,to commemorate Dr.Ing Hay(“Doc Hay”伍于念)and his business partner Lung On(梁光荣).There were few studies to explore Doc Hay's real practice and prescription,while most of papers focused on Doc Hay's legend life.This paper aims to analyze and interpret one of the intriguing herbal prescriptions that Doc Hay had hand-written.Materials and Methods:Dr.Arthur Yin Fan made an academic travel to Kam Wah Chung museum on August 5,2018 and examined the books and hand-written prescriptions of Doc Hay,which were not exhibited to the public at that time.This paper analyzes and interprets one of herbal prescriptions that Doc Hay had hand-written in 1907.Interpretation process included four steps:(1):Transform Doc Hay's hand-written prescription(with original herb names)to standard herb names in Chinese.(2):Induct and rearrange the herb name into groups based on herb property characteristics and then translate them into both PinYin names and English names.Analyzation of the prescription may include in what classic formula(s)routinely introduced in Chinese medicine textbooks.(3):Analyze the herbal action for each group and potential symptoms or conditions the patient may have had.An analysis of classic formula(s)used in the prescription may represent what clinical condition was being treated at that time.(4):Combine the analysis to give a comprehensive picture of the patient.Results:The prescription consists of 67 herbs,total 934.6 grams,and including Yin Qiao Powder(银翘散),Sang Ju Decoction(桑菊饮),Zhi Sou Powder(止嗽散),Qing Ying Decoction(清营汤),Xi Jiao Di Huang Decoction(犀角地黄汤),Long Dan Xie Gan Decoction(龙胆泻肝汤)and Chai Hu Shu Gan Powder(柴胡疏肝散).Speculation indicated that the prescription was for a patient who had obvious pulmonary infection accompanied by severe cough,and probably had prolonged pulmonary tuberculosis(TB)also with acute respiratory infection caused by other bacteria or viruses.Based on the analysis of composition of this prescription,it can be used for the treatment of epidemic diseases.Conclusion:The majority of herbs used in this prescription are commonly included in the herbal medicines in China used to effectively counter severe acute respiratory syndrome(SARS),H1N1 and currently COVID-19,it might be Doc Hay's basic formula for patients with“Spanish Flu”during the 1918-1920 pandemic.

Nutritional and Health Benefits of Carrots and Their Seed Extracts

Carrot is a root vegetable with carotenoids, flavonoids, polyacetylenes, vitamins, and minerals, all of which possess numerous nutritional and health benefits. Besides lending truth to the old adage that carrots are good for eyes, carotenoids, polyphenols and vitamins present in carrot act as antioxidants, anticarcinogens, and immunoenhancers. Anti-diabetic, cholesterol and cardiovascular disease lowering, anti-hypertensive, hepatoprotective, renoprotective, and wound healing benefits of carrot have also been reported. The cardio- and hepatoprotective, anti-bacterial, anti-fungal, anti-inflammatory, and analgesic effects of carrot seed extracts are also noteworthy. All are discussed in this review article.

Research progress of 24-hour movement behaviors in chronic non-communicable disease

Chronic non-communicable diseases(NCDs)represent a significant impediment to improve life expectancy and remain a focal point in global public health and disease prevention efforts.24-hour movement behaviors,which include sleep,sedentary behavior(SED),and physical activity,underscore the inherent connections between different daily activities and the comprehensive impact of overall movement patterns on health.Evidence suggested that modifying patterns of 24-hour movement behaviors can aid in preventing and attenuating the progression of NCDs.This study systematically delineated the concept,evolution,analytical methods,and intrinsic associations of 24-hour movement behaviors,emphasizing their pivotal role in the prevention and management of NCDs such as obesity,mental disorders,cardiovascular diseases,diabetes,and renal diseases.Future research endeavors should focus on refining methodologies,broadening study populations,developing research tools,and exploring precise intervention strategies and interdisciplinary approaches to comprehensively enhance the effectiveness of NCDs prevention and management from a temporal perspective.Such efforts are poised to provide substantive guidance and support for public health practices.

Review on the Research Progress of Dictyophora rubrovolvata

Dictyophora rubrovolvata has beautiful shape,good taste and high nutritional value,and has anti-oxidation,anti-tumor,hypoglycemic and other effects.In this review,the biological characteristics,nutritive chemical composition,polysaccharide extraction and functions,cultivation and pest control of D.rubrovolvata were intensively discussed and summarized,and the future research direction was also prospected.This study aims to provide future recommendations for the research of D.rubrovolvata and then promote the development of D.rubrovolvata industry.

Etiological Analysis of 256 Hypouricemia Cases

Objective: To analyze the serum uric acid results of patients with hypouricemia hospitalized in the Affiliated Hospital of Hebei University, thereby providing new insights for the prevention and treatment of hypouricemia. Method: This study employed a retrospective case analysis, dividing patients into two groups: 16 cases with uric acid levels less than 50 μmol/L (group Level 1), and 240 cases with uric acid levels between 50 μmol/L and 119 μmol/L (group Level 2). Basic data such as age, gender, department, and clinical diagnosis were collected for each patient. Renal indices, including creatinine, urea, β2-microglobulin, and cystatin C, were analyzed and compared. Results: The highest percentage of patients with uremia was found in Level 1, with a rate of 31.25%. In Level 2, the highest percentage of patients had malignant tumors, with a rate of 15.41%. Tumor sites included the liver, lungs, endometrium, ovaries, breasts, stomach, pancreas, colon, hypopharynx, and others. The second highest percentage was 13.75% for patients with lung diseases, followed by 10% for patients with cranio-cerebral diseases. Other prevalent conditions included renal diseases, hematological diseases, multiple injuries, orthopedic diseases, rheumatological-immunological diseases, and cardiac diseases. There were significant differences between the two uric acid level groups in terms of prevalent diseases (P < 0.05). Additionally, gender differences were significant between the two groups (P < 0.05). However, for renal disease indicators, no significant differences were found between the two levels (P > 0.05). Conclusion: The types of diseases presented by patients were related to different low uric acid levels. Most patients‘ renal function indices were within normal reference ranges at different low uric acid levels. The prevalence of different low uric acid levels was related to gender.

Salvia ceratophylla L. from South of Jordan: new insights on chemical composition and biological activities

In Jordan,Salvia ceratophylla L.is traditionally used in the treatment of cancer,microbial infections,and urinary disorders.This study aimed:(1)to chemically characterize S.ceratophylla essential oil(EO)from South Jordan,by gas chromatography(GC)and gas chromatography-mass spectrometry(GC-MS);and(2)to evaluate in vitro the cytotoxic,anti-inflammatory,and antiprotozoal activities of the EO,it’s predominant components,and the hexane(A),ethyl acetate(B),methanol(C)and crude-methanol extracts(D).The analysis revealed that the EO has 71 compounds,with linalool(54.8%)as main constitu-ent.Only the hexane extract(A)showed some cytotoxic activity against SK-MEL,KB,BT-549,SK-OV-3,LLC-PK1 and VERO cells lines with IC50 between 60 and>100μg/mL.The EO inhibited NO production(IC5090μg/mL)and NF-κB activity(IC5038μg/mL).The extracts A,B,and D inhibited NO production and NF-κB activity with IC50 between 32 and 150μg/mL.Linalool considerably inhibited NO production(IC5018μg/mL).The extracts tested did not exhibit antileish-manial activity.Regarding antitrypanosomal activity,the EO exhibited significant results with IC502.65μg/mL.In conclu-sion,Jordan S.ceratophylla EO represents a rich source of linalool and bears a promising therapeutic potential for further antitrypanosomal drug development.

Insights on the molecular mechanism of neuroprotection exerted by edible bird’s nest and its bioactive constituents

Neurodegenerative diseases are often associated with the accumulation of oxidative stress and neuroinflammation.Edible bird’s nest(EBN)is a glycoprotein(sialylated mucin glycopeptides)found to be beneficial against neurodegenerative diseases.Antioxidative,anti-inflammatory,and anti-apoptotic properties of EBN in preserving neuronal cells were widely researched using in vitro and in vivo models.Functional effects of EBN are often linked to its great number of antioxidants and anti-inflammatory glycopeptides.Bioactive compounds in EBN,especially sialic acid,add value to neurotrophic potential of EBN and contribute to neuronal repair and protection.Various studies reporting the neuroprotective effects of EBN,their molecular mechanisms,and neuroactive composition were gathered in this review to provide better insights on the neuroprotective effects of EBN.

Some Kinds of New Composite Solutions of a Kind of Coupled Schrodinger Equation

With the help of the method that combines the first kind of elliptic equation with the function transformation, some kinds of new composite solutions of a kind of coupled Schr?dinger equation are constructed. First, a kind of function transformation is presented, and then the problem of solving solutions of a kind of coupled Schr?dinger equation can be changed to the problem of solving solutions of the first kind of elliptic equation. Then, with the help of the conclusions of the B?cklund transformation and so on of the first kind of elliptic equation, the new infinite sequence composite solutions of a kind of coupled Schr?dinger equation are constructed. These solutions are consisting of two-soliton solutions and two-period solutions and so on.

Impact of enteral nutrition on energy metabolism in patients with Crohn's disease

AIM: To investigate the impact of enteral nutrition(EN) on the body composition and metabolism in patientswith Crohn's disease(CD). METHODS: Sixty-one patients diagnosed with CD were enrolled in this study. They were given only EN(enteral nutritional suspension, TPF, non-elemental diet) support for 4 wk, without any treatment with corticosteroids, immunosuppressive drugs, infliximab or by surgical operation. Body composition statistics such as weight, body mass index, skeletal muscle mass(SMM), fat mass, protein mass and inflammation indexes such as C-reactive protein(CRP), erythrocyte sedimentation rate(ESR) and CD activity index(CDAI) were recorded before and after EN support. RESULTS: The 61 patients were divided into three groups according to CDAI before and after EN support: A(active phase into remission via EN, n = 21), B(remained in active phase before and after EN, n = 19) and C(in remission before and after EN, n = 21). Patients in group A had a significant increase in SMM(22.11 ± 4.77 kg vs 23.23 ± 4.49 kg, P = 0.044), protein mass(8.01 ± 1.57 kg vs 8.44 ± 1.45 kg, P = 0.019) and decrease in resting energy expenditure(REE) per kilogram(27.42 ± 5.01 kcal/kg per day vs 22.62 ± 5.45 kcal/kg per day, P < 0.05). There was no significant difference between predicted and measured REE in active CD patients according to the HarrisBenedict equation. There was no linear correlation between the measured REE and CRP, ESR or CDAI in active CD patients. CONCLUSION: EN could decrease the hypermetabolism in active CD patients by reducing the inflammatory response.

Association between Coronary Atherosclerotic Plaque Composition and Cardiovascular Disease Risk

Objective The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease(CVD) risk in Chinese adults. Methods We performed a cross-sectional analysis in 549 subjects without previous diagnosis or clinical symptoms of CVD in a community cohort of middle-aged Chinese adults. The participants underwent coronary computed tomography(CT) angiography for the evaluation of the presence and composition of coronary plaques. CVD risk was evaluated by the Framingham risk score(FRS) and the 10-year atherosclerotic cardiovascular disease(ASCVD) risk score. Results Among the 549 participants, 267(48.6%) had no coronary plaques, 201(36.6%) had noncalcified coronary plaques, and 81(14.8%) had calcified or mixed coronary plaques. The measures of CVD risk including FRS and ASCVD risk score and the likelihood of having elevated FRS significantly increased across the groups of participants without coronary plaques, with noncalcified coronary plaques, and with calcified or mixed coronary plaques. However, only calcified or mixed coronary plaques were significantly associated with an elevated ASCVD risk score [odds ratio(OR) 2.41; 95% confidence interval(CI) 1.09-5.32] compared with no coronary plaques, whereas no significant association was found for noncalcified coronary plaques and elevated ASCVD risk score(OR 1.25; 95% CI 0.71-2.21) after multivariable adjustment. Conclusion Calcified or mixed coronary plaques might be more associated with an elevated likelihood of having CVD than noncalcified coronary plaques.

Rhizoma polygonati from Mount Tai:nutritional value and usefulness as a traditional Chinese medicine,source of herbzyme,and potential remediating agent for COVID-19 and chronic and hidden hunger

Recently,traditional Chinese medicine-based treatment has succeeded in fighting coronavirus disease 2019(COVID-19),and Rhizoma polygonati(Huangjing)has been one of the recommended components.Its processed products play antidiabetic,antiviral,antitumor,antioxidation,antifatigue,antiaging,and immune enhancement roles.The climate in Mount Tai is mild,and the dense forest is suitable for the growth of Rhizome polygonati,which has gradually evolved into a unique specie.Considering the important medicinal value and pleasant taste of Mount Tai-Rhizoma polygonati,various healthy and functional food products,controlled by quality markers with anti-COVID-19 potential,as well as emergency foods can be developed.The study aimed to review current evidence on the nutritional value of Rhizoma polygonati from Mount Tai and its usefulness as a traditional Chinese medicine,source of herbzyme,and potential remediating agent for COVID-19 and food shortage.Most recent findings regarding herbal nanomedicine have revealed that nanoscale chemical compounds are potentially efficient in drug delivery or nanozyme catalysis upon bioprocessing.Nanoflower structure is found in processed Rhizoma polygonati by self-assembly and has wide application in enzymatic events,particularly nanoscale herbzyme.The novel findings regarding Mount Tai-Rhizoma polygonati could enhance its novel applications in chronic and hidden hunger,clinical nanomedicine,and as an anti-COVID-19 agent.

Prescription analysis of traditional chinese medicine for COVID-19treatment

Background:Coronavirus disease 2019 is still spreading all over the world and without any specific medicine.Traditional Chinese medicine has played an important role in the control of epidemics in China and accumulated many experiences.The aim of this study is to summarize the law of traditional Chinese medicine and provide reference for coronavirus disease 2019 traditional Chinese medicine treatment.Methods:We collected the treatment plans of traditional Chinese medicine for coronavirus disease 2019 in 24 provinces of China to evaluate the basic Chinese medicine formulas,and the efficacy types,frequency,“Four Characters”,“Five Tastes”,“Channel Tropism”of herbal medicines.Combination rules between medicines were calculated by Apriori algorithm and Clementine12.0.Results:The formulas for“Relieving Exterior Syndrome”,“Expelling Dampness”,“Clearing Heat”and“Supplementing”have highest proportion.In prevention period and medical observation period,the medicines mainly have effect for“Clearing Heat”,“Relieving Exterior Syndrome”and“Supplementing”.In treatment period,medicines for“Clearing Heat”,“Relieving Superficies”and“Relieving Dampness”had higher frequency.The“Four Characters”of Chinese medicines in all treatment plans were mainly“Cold”and“Warm”.Medicines in the treatment plans always belong to“Pungent Taste”,“Bitter Taste”and“Sweet Taste”.For“Channel Tropism”,most medicines turned over to the“Lung”,“Stoma”and“Spleen”.The common medicine combinations in the recommended formulas during the prevention period and medical observation period were medicines for“Qi-Supplementing”and“Relieving Superficies”.In treatment period(mild,moderate,severe/critical),medicines for“Dampness Expelling”,“Relieving Superficies”and“Qi-Supplementing”were combined in a high frequency.In recovery period,the medicines for“Dispelling Dampness”combined the medicines for“Promoting Blood Circulation”with highest frequency.Conclusions:We found the characteristics of medicine and prescription rules of traditional Chinese medicine for the treatment of coronavirus disease 2019 and provided scientificity and effectiveness of it.More importantly,it provides reference for the development of new clinical prescriptions for coronavirus disease 2019.

Anaortic Off-Pump Complete Arterial Revascularization Using Composite LIMA RIMA Y Sequential 5 Grafts in a Patient with Triple Vessel Disease Performed in a Low Resource Country: A Case Report

The use of bilateral internal thoracic arteries to treat coronary artery disease is very less despite of improved long-term survival. In this case report, a patient presented with TVD has been managed with anaortic off-pump complete arterial revascularization (OPCABG) by using composite LIMA RIMA Y Sequential 5 grafts to achieve complete arterial revascularization successfully. This type of operative procedure is technically difficult in a resource poor country like Bangladesh. However, this has been done by a group of young cardiac surgeon. During follow up, the patient is in a good condition.

Gallbladder bile composition in patients with Crohn's disease

AIM： To further elucidate the pathogenesis and mechanisms of the high risk of gallstone formation in Crohn＇s disease. METHODS： Gallbladder bile was obtained from patients with Crohn＇s disease who were admitted for elective surgery （27 with ileal/ileocolonic disease and 7 with Crohn＇s colitis）. Fourteen gallstone patients served as controls. Duodenal bile was obtained from ten healthy subjects before and after the treatment with ursodeoxycholic acid. Bile was analyzed for biliary lipids, bile acids, bilirubin, crystals, and crystal detection time （CDT）. Cholesterol saturation index was calculated. RESULTS： The biliary concentration of bilirubin was about 50% higher in patients with Crohn＇s disease than in patients with cholesterol gallstones. Ten of the patients with Crohn＇s disease involving ileum and three of those with Crohn＇s colitis had cholesterol saturated bile. Four patients with ileal disease and one of those with colonic disease displayed cholesterol crystals in their bile. About 1/3 of the patients with Crohn＇s disease had a short CDT. Treatment of healthy subjects with ursodeoxycholic acid did not increase the concentration of bilirubin in duodenal bile. Several patients with Crohn＇s disease, with or without ileal resection/disease had gallbladder bile supersaturated with cholesterol and short CDT and contained cholesterol crystals. The biliary concentration of bilirubin was also increased in patients with Crohn＇s colitis probably not due to bile acid malabsorption. CONCLUSION： Several factors may be of importance for the high risk of developing gallstones of both cholesterol and pigment types in patients with Crohn＇s disease.The skillful technical assistance of Ms Lisbet Benthin and Ms Ingela Arvidsson is acknowledged.

The intricate relationship between cold exposure and gut microbiota

In order to advance microbiota-based therapies for cold-related diseases,it is crucial to fundamentally understand the intricate connections between cold exposure and the influence on gut microbiota composition.Identifying unique cold-related microbes and understanding their functionalities will be pivotal in developing effective treatments for cold-related diseases.

不同种源西红花生长及其染病球茎微生物差异分析

以崇明本地和荷兰进口西红花种球为试验材料,对比分析了不同种源种球在叶长、球茎重量、直径、围径、营养物质积累以及关键药用成分西红花苷含量等指标上的差异,并借助Illumina MisSeq高通量测序技术,分析了不同种源西红花染病球茎的微生物差异。结果表明:在“水稻—西红花”轮作模式下,相较于崇明种球,荷兰种球表现出叶片长且绿叶期长、球茎生长迅速、营养物质积累丰富、西红花苷含量高等明显优势。在储藏期,崇明与荷兰种球的腐烂病发生率分别为6.67%和6.00%,荷兰种球的腐烂病发病率略低于崇明种球,但两者在微生物群落组成上表现出较高的一致性。进一步分析揭示了西红花球茎腐烂病的主要致病因素涉及青霉菌属和镰刀菌属,还可能存在水体中常见的黄杆菌属、鞘氨醇杆菌属,以及在其他作物(如葡萄、猕猴桃)腐烂病中频繁出现的Cadophora luteo-olivacea等真菌的潜在复合侵染作用。研究结果初步阐明了不同种源西红花的生长特性及其染病球茎中的微生物多样性与群落结构,可为西红花种质资源的引进、评估与高效利用提供坚实的理论基础和科学依据。

2020—2022年陕西省手足口病病原的监测及主要型别的流行特征分析

目的 了解2020—2022年陕西省手足口病主要病原构成情况和流行规律。方法 收集陕西省各省辖市手足口监测病例的核酸检测结果和病例资料,分离肠道病毒核酸检测阳性样本,并对流行优势病原的肠道病毒VP1区进行PCR扩增、序列测定和毒株基因亚型鉴定。结果 2020—2022年陕西省共采集6 352例手足口病例样本,肠道病毒核酸检测阳性4 417例(69.54%)。2020年和2021年,以除外EV-A71和EV-A16的其他肠道病毒为主要流行型别,构成比分别为95.43%和74.35%;2022年,以CV-A16型为主要流行型别,构成比52.88%。对8个省辖市4 145例手足口实验室确诊病例开展其他肠道病毒中CV-A6型和CV-A10型检测,2020年—2022年CV-A6型在其他肠道病毒的占比分别是75.31%、62.56%和61.15%,是陕西省其他肠道病毒中的优势流行型别。2020—2022年陕西省分离测序毒株239株,CV-A16型151株,CV-A6型72株,CV-A10型6株,CV-A4型2株,CV-B3型8株。CV-A16型和CV-A6型是主要流行型别,经系统进化分析,CV-A6型以D3亚型为主要流行亚型,CV-A16型以B1a和B1b共存,2021年和2022年B1a亚型占比逐年升高,并取代B1b成为主要流行亚型。结论 2020—2022年陕西省手足口病较往年处于低流行水平,主要病原以其他肠道病毒、CVA16交替出现。