Clinicopathologic characteristics and prognostic analysis of testicular diffuse large B-cell lymphoma / 中华血液学杂志

Objective: To analyze the clinicopathologic characteristics and prognosis of testicular diffuse large B-cell lymphoma (DLBCL) . Methods: A retrospective analysis was performed on 68 patients with testicular DLBCL admitted to Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine from October 2001 to April 2020. The gene mutation profile was evaluated by targeted sequencing (55 lymphoma-related genes) , and prognostic factors were analyzed. Results: A total of 68 patients were included, of whom 45 (66.2% ) had primary testicular DLBCL and 23 (33.8% ) had secondary testicular DLBCL. The proportion of secondary testicular DLBCL patients with Ann Arbor stage Ⅲ-Ⅳ (P<0.001) , elevated LDH (P<0.001) , ECOG score ≥ 2 points (P=0.005) , and IPI score 3-5 points (P<0.001) is higher than that of primary testicular DLBCL patients. Sixty-two (91% ) patients received rituximab in combination with cyclophosphamide, adriamycin, vincristine, and prednisone (R-CHOP) -based first-line regimen, whereas 54 cases (79% ) underwent orchiectomy prior to chemotherapy. Patients with secondary testicular DLBCL had a lower estimated 5-year progression-free survival (PFS) rate (16.5% vs 68.1% , P<0.001) and 5-year overall survival (OS) rate (63.4% vs 74.9% , P=0.008) than those with primary testicular DLBCL, and their complete remission rate (57% vs 91% , P=0.003) was also lower than that of primary testicular DLBCL. The ECOG scores of ≥2 (PFS: P=0.018; OS: P<0.001) , Ann Arbor stages Ⅲ-Ⅳ (PFS: P<0.001; OS: P=0.018) , increased LDH levels (PFS: P=0.015; OS: P=0.006) , and multiple extra-nodal involvements (PFS: P<0.001; OS: P=0.013) were poor prognostic factors in testicular DLBCL. Targeted sequencing data in 20 patients with testicular DLBCL showed that the mutation frequencies of ≥20% were PIM1 (12 cases, 60% ) , MYD88 (11 cases, 55% ) , CD79B (9 cases, 45% ) , CREBBP (5 cases, 25% ) , KMT2D (5 cases, 25% ) , ATM (4 cases, 20% ) , and BTG2 (4 cases, 20% ) . The frequency of mutations in KMT2D in patients with secondary testicular DLBCL was higher than that in patients with primary testicular DLBCL (66.7% vs 7.1% , P=0.014) and was associated with a lower 5-year PFS rate in patients with testicular DLBCL (P=0.019) . Conclusion: Patients with secondary testicular DLBCL had worse PFS and OS than those with primary testicular DLBCL. The ECOG scores of ≥2, Ann Arbor stages Ⅲ-Ⅳ, increased LDH levels, and multiple extra-nodal involvements were poor prognostic factors in testicular DLBCL. PIM1, MYD88, CD79B, CREBBP, KMT2D, ATM, and BTG2 were commonly mutated genes in testicular DLBCL, and the prognosis of patients with KMT2D mutations was poor.

Clinical characteristics and prognosis of primary and secondary diffuse large B-cell lymphoma of the pancreas / 中华血液学杂志

Objective: To analyze the clinical characteristics and prognosis of primary and secondary pancreatic diffuse large B-cell lymphoma (DLBCL) . Methods: Clinical data of patients with pancreatic DLBCL admitted at Shanghai Rui Jin Hospital affiliated with Shanghai Jiao Tong University School of Medicine from April 2003 to June 2020 were analyzed. Gene mutation profiles were evaluated by targeted sequencing (55 lymphoma-related genes). Univariate and multivariate Cox regression models were used to evaluate the prognostic factors of overall survival (OS) and progression-free survival (PFS) . Results: Overall, 80 patients were included; 12 patients had primary pancreatic DLBCL (PPDLBCL), and 68 patients had secondary pancreatic DLBCL (SPDLBCL). Compared with those with PPDLBCL, patients with SPDLBCL had a higher number of affected extranodal sites (P<0.001) and had higher IPI scores (P=0.013). There was no significant difference in the OS (P=0.120) and PFS (P=0.067) between the two groups. Multivariate analysis indicated that IPI intermediate-high/high risk (P=0.025) and double expressor (DE) (P=0.017) were independent adverse prognostic factors of OS in patients with pancreatic DLBCL. IPI intermediate-high/high risk (P=0.021) was an independent adverse prognostic factor of PFS in patients with pancreatic DLBCL. Targeted sequencing of 29 patients showed that the mutation frequency of PIM1, SGK1, BTG2, FAS, MYC, and MYD88 in patients with pancreatic DLBCL were all >20%. PIM1 (P=0.006 for OS, P=0.032 for PFS) and MYD88 (P=0.001 for OS, P=0.017 for PFS) mutations were associated with poor OS and PFS in patients with SPDLBCL. Conclusion: There was no significant difference in the OS and PFS between patients with PPDLBCL and those with SPDLBCL. IPI intermediate-high/high risk and DE were adverse prognostic factors of pancreatic DLBCL. PIM1, SGK1, BTG2, FAS, MYC, and MYD88 were common mutations in pancreatic DLBCL. PIM1 and MYD88 mutations indicated worse prognosis.

One-stop strategy for treatment of atrial fibrillation: feasibility and safety of combining catheter ablation and left atrial appendage closure in a single procedure / 中华医学杂志(英文版)

BACKGROUND@#Catheter ablation is effective in restoring sinus rhythm and left atrial appendage closure (LAAC) is increasingly used for stroke prevention in patients with atrial fibrillation (AF). We aimed to observe the feasibility and safety of performing AF ablation and LAAC in a single (one-stop) procedure.@*METHODS@#Consecutive AF patients who underwent the combined procedure of AF ablation and LAAC with WATCHMAN device between March 2017 and September 2018 were prospectively enrolled. Baseline and intra-procedural parameters were evaluated. Three-month and subsequent 1-year follow-up were performed in all and earlier-enrolled subjects, respectively.@*RESULTS@#A total of 178 AF patients (94 males, 68.9 ± 8.1 years) underwent the one-stop procedure with CHA2DS2-VASc score 3.3 ± 1.5 and HAS-BLED score 1.6 ± 1.0, respectively. Pulmonary vein isolation was achieved in all patients while additional linear ablation was applied if the operator deemed necessary, yielding immediate ablation success rate of 98.9% (176/178). In the subsequent LAAC, satisfactory seal (residual leak <5 mm) was achieved in all patients. One stroke and four cardiac perforations occurred peri-operatively. At 3-month follow-up, sinus rhythm and satisfactory seal were maintained in 153/178 (86.0%) and 178/178 (100%) patients, respectively. One stroke and one delayed cardiac tamponade occurred, while no device-related thrombus or device migration was observed. During the 1-year follow-up for the earlier enrolled subjects, 52/72 (72.2%) of the patients maintained sinus rhythm. There was no stroke or systemic embolism observed.@*CONCLUSION@#Combining catheter ablation and LAAC in a single procedure can be successfully and safely performed in non-valvular AF patients of Chinese population.

Feasibility and perioperative safety of the combined procedure of catheter ablation and watchman left atrial appendage closure / 中华心血管病杂志

Objective: We aimed to explore the feasibility and perioperative safety of performing catheter ablation and left atrial appendage closure (LAAC) in a single (one-stop) session in patients with atrial fibrillation (AF). Methods: This study is an observational study. Consecutive AF patients who underwent the combined procedure of catheter ablation and LAAC with Watchman device of Xinhua Hospital in Shanghai between March 2017 and May 2019 were prospectively enrolled. Baseline, intra-and peri-procedural parameters were evaluated. Results: A total of 358 AF patients (189 males, (69.0±8.0) years) underwent the one-stop procedure. The CHA2DS2-VASc score was 3.2±1.5 and HAS-BLED score was 2.4±1.1, respectively in this patient cohort. Pulmonary vein isolation was achieved in all patients, while additional linear ablation was applied in 180 (50.3%) patients, yielding immediate success rate of 99.7%. Successful Watchman implantation was achieved in all patients. The perioperative serious adverse event occurred in 14 cases (3.9%). including 6 pericardial effusions (1.7%), 1 stroke (0.3%) and 5 vascular complications (1.4%), yielding procedure-related complication rate of 3.4%. In addition, 2 (0.6%) new-onset heart failures occurred postoperatively. There was no major bleeding or death during the perioperative period. Conclusions: Combined catheter ablation and LAAC can be successfully and safely performed in AF patients with high stroke risk. Follow-up data are needed to evaluate the outcome of this one-stop procedure.

The Advance of Escitalopram's Drug-induced QTc Prolongation / 中国药学杂志

Escitalopram, a selective serotonin re-uptake inhibitor (SSRI) antidepressant which is the (S)-enantiomer of citalopram, is worldwide used for the treatment of depressive and anxious disorders in clinical practice, however, recent data have indicated that high therapeutic escitalopram doses may cause the potential of QTc prolongation effect, which is a predisposing factor for arrhythmia. Nevertheless, in March 2012, the Food and Drug Administration (FDA) issued a safety bulletin advising the daily dosage of escitalopram should be restricted to a maximum of 20 mg daily in healthy adults and 10 mg maximum in high risk patients (eg>60 years of age). In this review, we aimed to investigate what factors can affect and how escitalopram gives rise to QTc prolongation.

Polymorphism analysis of microsatellite marker loci of Plasmodium falciparum from different geographical origins / 中国血吸虫病防治杂志

Objective To compare the genetic diversity of imported Plasmodium falciparum by Polyα and TAA87 microsatellite markers in Southeast Asian and African geographical isolates. Methods Ninety-two and 126 filter paper samples from patients infected with P. falciparum from Southeast Asia (Myanmar) and Africa (Ghana) were collected, respectively. Two neutral microsatellite loci, Polyα and TAA87 were amplified by PCR. The length of PCR fragments was detected by capillary electrophoresis. The allele frequency and expected heterozygosity (He) were calculated by Excel 2010 and GenALEx 6.0 software. Results A total of 146 P. falciparum samples were analyzed as single infection samples with a total of 26 alleles in locus Polyα and 12 alleles in locus TAA87. The mean He value of the two loci was 0.86 ± 0.02. Ten alleles in locus Polyα and 8 alleles in locus TAA87 were distributed in Myanmar isolates, with the He values of 0.86 and 0.81 respectively. Fifteen alleles in locus Polyα and 11 in locus TAA87 were detected in Ghana isolates, with the He values of 0.91 and 0.86 respectively. In addition, the haplotype of 174 bp (Polyα) and 113 bp (TAA87) were only detected in Myanmar isolates with more than 17% gene frequency, whereas they were absent in Ghana isolates. Conclusions The two different geographical sources of imported P. falciparum strains have different allele frequencies and haplotypes at the two neutral microsatellite markers, Polyα and TAA87. Therefore, these two microsatellite loci may be considered as the potential molecular marker candidates for identifying P. falciparum strains with different geographical sources.

Polymorphism analysis of microsatellite marker loci of Plasmodium falciparum from different geographical origins / 中国血吸虫病防治杂志

Objective To compare the genetic diversity of imported Plasmodium falciparum by Polyα and TAA87 microsatellite markers in Southeast Asian and African geographical isolates. Methods Ninety-two and 126 filter paper samples from patients infected with P. falciparum from Southeast Asia (Myanmar) and Africa (Ghana) were collected, respectively. Two neutral microsatellite loci, Polyα and TAA87 were amplified by PCR. The length of PCR fragments was detected by capillary electrophoresis. The allele frequency and expected heterozygosity (He) were calculated by Excel 2010 and GenALEx 6.0 software. Results A total of 146 P. falciparum samples were analyzed as single infection samples with a total of 26 alleles in locus Polyα and 12 alleles in locus TAA87. The mean He value of the two loci was 0.86 ± 0.02. Ten alleles in locus Polyα and 8 alleles in locus TAA87 were distributed in Myanmar isolates, with the He values of 0.86 and 0.81 respectively. Fifteen alleles in locus Polyα and 11 in locus TAA87 were detected in Ghana isolates, with the He values of 0.91 and 0.86 respectively. In addition, the haplotype of 174 bp (Polyα) and 113 bp (TAA87) were only detected in Myanmar isolates with more than 17% gene frequency, whereas they were absent in Ghana isolates. Conclusions The two different geographical sources of imported P. falciparum strains have different allele frequencies and haplotypes at the two neutral microsatellite markers, Polyα and TAA87. Therefore, these two microsatellite loci may be considered as the potential molecular marker candidates for identifying P. falciparum strains with different geographical sources.

Practice and Exploration of Regional Medical Equipment Cloud Management Platform Based on the Internet of Things / 中国医疗器械杂志

<p><b>OBJECTIVE</b>Establish a regional cloud account of hospital medical equipment based on dynamic two-dimensional code link.</p><p><b>METHODS</b>Establish a medical equipment data platform based on B/S architecture. Combined with mobile internet means such as WeChat and try the industrial 4.0 designed intelligent boxes.</p><p><b>RESULTS</b>The problem of no interface transmission and integration of the regional medical equipment account information is solved. It dynamically collects equipment data, operation cost and efficiency. The real-time operation data is visualized.</p><p><b>CONCLUSIONS</b>The dynamic management platform of regional medical equipment helps to standardize the management of large medical equipment and improve the utilization ratio of medical equipment. The platform provides basis of management decisions and equipment allocation for relevant departments.</p>

Clinical and pathological features and the misdiagnosis of childhood Alport syndrome: a retrospective analysis of 91 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore the clinical and pathological features and the diagnosis of childhood Alport syndrome (AS).</p><p><b>METHODS</b>A retrospective analysis was performed on clinical data of 91 children with AS.</p><p><b>RESULTS</b>Hematuria was observed in all 91 patients, of whom 86 were accompanied with proteinuria. Sixty-one children with X-Linked AS (XL-AS) had positive family history. Renal biopsy was performed on 82 children. Mild to moderate mesangial proliferation was observed in 74 cases. Small amounts of immune complexes deposits in the glomerular mesangial area were observed in 48 cases. Glomerular basement membrane (GBM) attenuation, thickening and layering were observed in 53 cases by electron microscopy (EM). In 63 cases receiving renal tissue type IV collagen α3 and α5 chain immunofluorescence detection, 58 were diagnosed with AS, including 53 cases of XL-AS and 5 cases of autosomal recessive AS. In 91 cases of AS, 58 were diagnosed as AS by renal tissue type IV collagen α3 and α5 chain immunofluorescence, 21 were diagnosed by EM, one was diagnosed by skin biopsy, and 12 were diagnosed by gene detection. Six novel mutations of COL4A5 gene were found. Forty-five cases were misdiagnosed before the diagnosis of AS. Forty-one of the 45 cases received steroids and/or immunosuppressant therapy.</p><p><b>CONCLUSIONS</b>The clinical manifestations and pathological changes are not specific in children with AS, resulting in a higher rate of misdiagnosis. Typical lesions of GBM under EM are only observed in a part of patients. There is a high novel mutation rate of COL4A5 in the detected AS children.</p>

Discussion on Management of Vinum Health Food / 中国中医药信息杂志

This article introduced basic information of production composition, health preservation functions and main raw materials of authorized vinum health food. It also made comparison and analysis among vinum health food, medicinal liquor and compound wine on the basis of product orientation, raw materials, and evaluation system. It conducted analysis on turmoil and main problems in health preservation wine market. Combined with the problems in the supervision of health preservation, it proposed the policy suggestions of strehgthening administration of vinum health food and identify the production orientation of vinum health food, medicinal liquor and compound wine from the aspects of raw materials, function claimation and management. It also put forward rational consumption suggestions, with a purpose to offer references to related authorities, researchers, and consumers.

Expression of bone morphogenetic protein receptor 2 in cleft mouse embryonic palate induced by retinoic acid / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of all-trans retinoic acid (atRA) on the function of bone morphogenetic protein receptor 2 (BMPR2) expression in embryonic palate.</p><p><b>METHODS</b>Cleft palate mice model was established by atRA. On gestation day (GD) 15 and GD 17, the pregnant mice were killed to obtain the embryos from the uteri. The embryonic palates were stained with hematoxylin-eosin, and the remaining sections were used for the immunohistochemistry of BMPR2 detection. Reverse transcription-polymerase chain reaction was performed to detect the expression levels of Bmpr2 mRNA.</p><p><b>RESULTS</b>In the atRA-treated group, short extensions and failure to fuse with each other were observed. The positive expression of BMPR2 was detected in developing palatal process from GD 15 to GD 17 in the control group. Compared with those of the control group, BMPR2 protein and Bmpr2 mRNA decreased in the atRA-treated group (P<0.05).</p><p><b>CONCLUSION</b>The treatment of pregnant mice with retinoic acid produces small palatal shelves in their fetuses and down-regulates BMPR2 expressions.</p>

The influence of all-trans retinoic acid on the craniomaxillofacial development of mice / 实用口腔医学杂志

Objective:To study the influence of all-trans retinoic acid (atRA)on craniomaxillofacial development of C57 mice. Methods:Pregnant C57BL mice were divided into 4 groups(n =5)at gestation day (GD)1 0.Mice in three atRA-induction groups were given atRA of 60,80 and 1 00 mg/kg,respectively.The mice in control group were given the equivalent volume of corn oil.All pregnant mice were sacrificed at GD1 9 and the embryos were collected.Stereo microscope was used to observe the craniomaxillofacial morphology.Standardized radiographs were taken and cephalometric analysis was performed.Results:The embryonic body length and body mass of control group surpassed those of 80 and 1 00 mg/kg atRA groups(P <0.05,P <0.01 ).atRA induced craniomaxillofacial malformations and maldevelopment.The mice induced by atRA exhibited a shorter mandibular body and more retrusive position of max-illary and mandibular(∠NAK and ∠NBD)when compared with their norm(P <0.01 ).Significant decrease in craniofacial length (Op-Rh)was observed in all atRA-induced groups(P <0.01 ).Decreases in cranial vault height(Fp-Os)and cranial vault length(Pa-Na)dimensions were observed in 80 and 1 00 mg/kg atRA groups(P <0.05,P <0.01 ).Conclusion:Exogenous atRA dose-depend-ently induces retardation of craniomaxillofacial morphology in embryo of C57BL mice by inhibition of the sagital and vertical dimension development of the bone.

Inhibitory effect of all￣trans retinoic acid on osteogenic differentiation of mouse embryonic palate mesenchymal cells and its possible mechanism / 中国药理学与毒理学杂志

OBJECTIVE To investigate the effect and related mechanism of all￣trans retinoic acid (atRA) exposure on osteogenic differentiation of mouse embryonic palate masenchymal cells MEPM. METHODS MEPM were cultured in osteogenic medium (OM) with atRA 0.1 and 1.0 μmol??L-1 for 1, 3,5, 7 and 9 d. MTT assay was performed to measure the cell viability. The alkaline phosphatase (ALP) activity was measured by chemical colorimetry. The cells were stained using the Von￣Kossa technique to detect the formation of mineralization nodules after 21 d of culture. RT￣PCR was performed to determine expression Runx2, osteopontin, bone morphogenetic protein receptor ( Bmpr) 1b, Bmpr2 and Smad5 mRNA. RESULTS The result of MTT on 9 d showed that, compared with normal control group, the cell viability of OM, OM+atRA 0.1 and 1.0 μmol??L-1 groups decreased significantly(P<0.01). Compared with normal control group, ALP activity of OM group increased significantly(P<0.05), while the ALP activity of OM+atRA 0.1 and 1.0 μmol??L-1 groups was lower than OM group(P<0.05). On 21 d, the Von￣Kossa stai￣ning results showed that the percentage of mineralization nodules formation of OM+atRA 1.0 μmol??L-1 group was (3.65±1.24)%, which was significantly lower than that of OM group(10.33±2.29)%(P<0. 05). On 9 d, the relative Run expression of OM group was the highest one in the four groups, while at￣RA 1.0 μmol??L-1 treatment negatively regulated 20% in comparsion with OM group(P<0.05). Compared with normal control group, the mRNA expression of osteopontin of OM, OM+atRA 0.1 and 1.0 μmol??L-1 groups increased significantly(P<0.05); BDNF mRNA expression of OM group was 2.6￣fold to normal control group, while that of OM+atRA 1.0 μmol??L-1 group was 33% to OM group(P<0.05) . The level of Smad5 mRNA of OM+atRA 1.0 μmol??L-1 group was significantly lower than that of OM group(P<0.05). CONCLUSION atRA Might inhibit osteogenic differentiation of MEPM by down￣regulated the expression of Bmpr1b.

Study on the efficacy of quarantine during outbreaks of acute hemorrhagic conjunctivitis outbreaks at schools through the susceptive-infective-quarantine-removal model / 中华流行病学杂志

To assess the efficacy of quarantine for acute hemorrhagic conjunctivitis (AHC)outbreaks control in schools,by using the Compartment Model.Through combining the characteristics of both AHC and compartment model,we built a susceptive-infective-removal (SIR) model suited for AHC outbreaks control in schools,and then quarantine was added into the model to develop a susceptive-infective-quarantine-removal (SIQR) model.An outbreak of AHC in Changsha in 2011 was employed as a sample to assess the effect of quarantine for the prevention and control of AHC.Basic reproduction number (λ 0) of the AHC outbreak without intervention was 6.80,thus the transmission speed of the disease became quite fast.If no intervention had been adopted,almost all the students,faculties and staff members would have been infected within 23 days,and the accumulative cases would become 738,with the total attack rate (TAR) as 99.73％.The peak of the outbreak was at Sep.11th and the number of new cases was 126 on that day.The efficacy would have been different if quarantine forces had been taken at different time and differently.The bigger and earlier the quarantine force had been adopted,the lower morbidity peak and the smaller TAR would have been appeared,with better efficacy of outbreak control.If the quarantine rate had been taken at the level of 90％ on the sixth day,the accumulative case would have been reduced to 132 and the TAR had become 17.84％ consequently.Quarantine program could be used as a main intervention approach to be employed for ACH outbreak at schools.

Genetic analysis of the NS genes of H5N1 avian influenza viruses isolated from sewage in poultry markets / 病毒学报

In order to investigate the transmission risk of H5N1 avian influenza viruses (AIV) from sewage in Changsha poultry markets, the evolution relationship and molecular characteristics of non-structural (NS) genes of H5N1 AIV from sewage were analyzed. Nine H5N1 AIV environmental sewage specimens were collected from Changsha poultry markets. The NS genes were amplifyed by PCR and then sequenced with TA cloning. Amino acid(aa) sequence alignment and phylogenetic tree analysis were conducted by Lasergene and Mega5 software. Eight NS genes TA cloning were constructed successfully. Phylogenetic tree indicated that they were belonged to the allele A subgroup. Aa homology analysis showed 90.1% 92.5% identity in NS1 proteins and 91.0% - 92.6% identity in NS2 proteins compared with reference viruses of the allele A (A/chicken/ Hubei/ w h/ 1999). The homologies of the amino sequences of NS1 and NS2 in this study were 93.8%-100.0% and 98.4%-100.0%, respectively. The C terminal of all eight H5N1 NS1 proteins from sewage in poultry markets carried a ESEV of PL motif and the 92 amino acids were E, furthermore, the 80 to 84aa were missed which were the characteristics of highly pathogenic AIV. The NS genes of H5N1 AIV from sewage in poultry markets have molecular characteristics of highly pathogenic and have the potential risk of H5N1 virus spreading.

Risk related to the transmission of H5N1 subtype avian influenza virus in the environment of poultry markets in Changsha, China / 中华流行病学杂志

Objective To investigate the risk of H5Nl subtype avian influenza virus (AIV)transmission in the poultry market environment in Changsha city.H5N1 antibody levels among the groups related occupational exposure and AIV nucleic acid in the environment of poultry markets were detected.The characteristics of hamagglutinin (HA) genes of H5N1 AIV in the environment were analyzed.Methods One district and one county from Changsha city were selected randomly and two poultry markets at inner city or township levels were selected in the same district or county respectively.H5N1 antibody of the occupational exposure groups in the poultry market was tested and AIV nucleic acid in the poultry market environnent monitored.One hundred and two blood samples of the occupational exposure groups were tested for H5N1 antibody with single radioimmunoassay diffusion hemolysis (SRH) while 160 environment samples(from sewage,birds stools,feathers and smearing samples of poultry cages) in the poultry market were also detected for AIV nucleic acid with real-time PCR method.Four sewage samples of H5N1 subtype AIV were collected from poultry markets in Changsha,and the HA genes of H5N1 subtype AIV amplified by RT-PCR and then sequenced with TA cloning.Amino acid sequence alignment and phylogenetic tree analysis were conducted by Lasergene and Mega 5.0 software.Results The results through H5N1 antibody monitoring program showed that H5N1 antibody positive rates from workers were 25.5％ (26/102),50.0％ (9/18) and 25.4％ (17/67) respectively in the poultry markets of township and inner cities.H5N1 antibody positive rate in the township poultry markets was higher than in the inner cities poultry markets.Results from the surveillance on AIV nucleic acid showed that the overall H5 subtype positive rate in Changsha poultry markets was 31.3％ (50/160),and the positive rate of townships poultry markets was 37.3％ (31/83 ),which were both higher than those from the inner cities poultry markets (24.7％,19/77).H5 subtype AIV positive rate was different in the tested specimens,with ranking of positive rates were sewage (50.0％,24/48),feathers (44.5％,4/9 ),birds stools ( 29.8％,14/47) and smearing samples of poultry cages (14.3％,8/56),with statistically significant differences (P＜0.01).Four H5N1 HA genes TA cloning were successfully constructed and identified as Eurasian branch,similar to viruses isolated in mainland China and Hong Kong in the same group,according to genetic analysis.Sequence data of the four HA genes showed the same feature of high pathogenicity,compared to the H5N 1 AIV from mainland China of human origin.The receptor specificities were still with avian influenza origin (QSG)and the connecting peptide between HA1 and HA2 possessing the polybasic motif (RERRRKK or RERRGKK).Conclusion One of the reasons for H5N1 antibody positive rate of 25.5％ among poultry markets workers was that there were large numbers of H5N 1 subtype AIV detected in the environment of poultry markets and HA genes of H5N 1 subtype AIV in the poultry markets environment carried molecular characteristics of highly pathogenic which could increase the risk for H5N1 subtype AIV transmission in the environment of poultry markets.

Application of Susceptible-Infected-Recovered model in dealing with an outbreak of acute hemorrhagic conjunctivitis on one school campus / 中华流行病学杂志

To simulate intervention measures in controlling an outbreak of acute hemorrhagic conjunctivitis on one school campus by using the Susceptible-Infected-Recovered (SIR) model, to provide evidence for preparedness and response to the epidemic. Classical SIR model was used to model the epidemic. Malthusian exponential decline method was employed to estimate the infective coefficient β for interventions. The initial value of parameters was determined based on empirical data. The modeling was implemented using Matlab 7.1 software. Without interventions, the outbreak was expected to experience three phrases: (1)early stage (the first 5 days) in which the epidemic developed slowly and could be intervened easily; (2) rapid growing stage (6-15 days) in which the number of infected cases increased quickly and the epidemic could not be well controlled;and (3) medium and late stage (16 days and later) in which more than 90% of the susceptible persons were infected but the intervention measures failed to prevent the epidemic. With the implementation of interventions, the epidemic was predicted to be controlled in the early stage, under the SIR model. The simulation based on the SIR model kept an acceptable consistency with the actual development of epidemic after the implementation of intervention measures. The SIR model seemed effective in modeling interventions to the epidemic of acute hemorrhagic conjunctivitis in the schools.

The warning model and influence of climatic changes on hemorrhagic fever with renal syndrome in Changsha city / 中华预防医学杂志

<p><b>OBJECTIVE</b>To realize the influence of climatic changes on the transmission of hemorrhagic fever with renal syndrome (HFRS), and to explore the adoption of climatic factors in warning HFRS.</p><p><b>METHODS</b>A total of 2171 cases of HFRS and the synchronous climatic data in Changsha from 2000 to 2009 were collected to a climate-based forecasting model for HFRS transmission. The Cochran-Armitage trend test was employed to explore the variation trend of the annual incidence of HFRS. Cross-correlations analysis was then adopted to assess the time-lag period between the climatic factors, including monthly average temperature, relative humidity, rainfall and Multivariate Elño-Southern Oscillation Index (MEI) and the monthly HFRS cases. Finally the time-series Poisson regression model was constructed to analyze the influence of different climatic factors on the HFRS transmission.</p><p><b>RESULTS</b>The annual incidence of HFRS in Changsha between 2000 - 2009 was 13.09/100 000 (755 cases), 9.92/100 000 (578 cases), 5.02/100 000 (294 cases), 2.55/100 000 (150 cases), 1.13/100 000 (67 cases), 1.16/100 000 (70 cases), 0.95/100 000 (58 cases), 1.40/100 000 (87 cases), 0.75/100 000 (47 cases) and 1.02/100 000 (65 cases), respectively. The incidence showed a decline during these years (Z = -5.78, P < 0.01). The results of Poisson regression model indicated that the monthly average temperature (18.00°C, r = 0.26, P < 0.01, 1-month lag period; IRR = 1.02, 95%CI: 1.00 - 1.03, P < 0.01), relative humidity (75.50%, r = 0.62, P < 0.01, 3-month lag period; IRR = 1.03, 95%CI: 1.02 - 1.04, P < 0.01), rainfall (112.40 mm, r = 0.25, P < 0.01, 6-month lag period; IRR = 1.01, 95CI: 1.01 - 1.02, P = 0.02), and MEI (r = 0.31, P < 0.01, 3-month lag period; IRR = 0.77, 95CI: 0.67 - 0.88, P < 0.01) were closely associated with monthly HFRS cases (18.10 cases).</p><p><b>CONCLUSION</b>Climate factors significantly influence the incidence of HFRS. If the influence of variable-autocorrelation, seasonality, and long-term trend were controlled, the accuracy of forecasting by the time-series Poisson regression model in Changsha would be comparatively high, and we could forecast the incidence of HFRS in advance.</p>

Spatio-temporal process and the influencing factors on influenza A (H1N1) pandemic in Changsha / 中华流行病学杂志

Objective To analyze the spatio-temporal process on 2009 influenza A (HlNl) pandemic in Changsha and the influencing factors during the diffusion process. Methods Data were from the following 5 sources, influenza A (HlNl) pandemic gathered in 2009, Geographic Information System (GIS) of Changsha, the broad range of theorems and techniques of hot spot analysis, spatio-temporal process analysis and Spearman correlation analysis. Results Hot spot areas appeared to be more in the economically developed areas, such as cities and townships. The cluster of spatial-temporal distribution of influenza A (HlNl) pandemic was most likely appearing in Liuyang city (RR=22.70,P<0.01). The secondary cluster would include districts as Yuelu (RR=6A9,P< 0.01) , Yuhua (RR=81.63, P<0.01). Xingsha township appeared as the center in the Changsha county (RR=2.90, P<0.01) while townships as Yutangping (RR=19.31, P<0.01) , Chengjiao (RR=73.14,P<0.01) and Longtian appeared as the center in the west of Ningxiang county (RR= 14.43,P<0.01) and Wushan as the center in the Wangcheng county (RR= 13.84,P<0.01). As time went on, the epidemic moved towards the eastern and more developed regions. Regarding factor analysis, population, the amount of students, geographic relationship and business activities etc. appeared to be the key elements influencing the transmission of influenza A (H1N1) pandemic. At the beginning of the epidemic, population density served as the main factor (r=0.477, P<0.05) but during the initial and fast growing stages, it was replaced by the size of students to serve as the important indicator (r=0.831, P<0.01; r=0.518, P<0.01). However, during the peak of the epidemics, the business activities played an important role (r=-0.676, P<0.01). Conclusion Groups under high risk and districts with high incidence rates were shifting, along with the temporal process of influenza A(H1N1) pandemic, suggesting that the protection measures need to be adjusted, according to the significance of influencing factors at different stages.

An epidemiological survey on the incidence of non-fatal injury and influencing factors among children under 5 years old in China / 中华流行病学杂志

Objective To determine the incidence of non-fatal injuries and related influencing factors among children under 5 years old in China. Methods Data involving 10 819 children under 5 years old was from the Fourth National Health Service Survey of China. Injury-related indicators include: history of ever having had an injury, its frequency, cause, location and severity of the injury.A two-level Poissun regression was used to examine the significance of related socio-economic variables. Results The overall incidence rate of nonfatal injuries among children under 5 years old was 16.0 per 1000 population in the prior 12 months. The first three leading causes of non-fatal injuries were falls,animal bite, fire/bum among children under 1 year old,with the rates as 3.9, 1.8 and 1.8 per 1000 population, respectively. For children aged I to 4 years old, the first three leading causes were animal bite, fall, fire/burn with rates as 6.5,6.0 and 2.9 per 1000 population, respectively. 83.0% and 69.0% of last injuries occurred at home for the above said two age groups. No disability was found among children younger than 1 year old who suffered from a nonfatal injury while for the 1-4 age group, the disability accounted for 1.0% of injury-induced outcomes. After adjusting other variables,boys had 1.57 times the risk of injury compared with girls in the 1-4 age group (P＜0.05). The differences on the effects regarding ethmicity,per capita household income, and place were insignificant (P＞0.05). None of the socio-economic variables was found that significantly related to the non-fatal injury risk among children under 1 year old (P＞0.05). Conclusion The incidence of nonfatal injuries among children under 5 years old was 16.0 per 1000 population in the prior 12 months. The three leading causes of injuries were animal bite, falls, fire/bum respectively. Home was the most common place that non-fatal injuries occurred. Boys had a higher risk of injury compared with girls among children aged 1 to 4 years old and the difference was significant.