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Objective@# To assess the implementation of National Leprosy Control Plan (2011-2020) in Zhejiang Province, so as to provide insights into leprosy control. @*Methods@#Leprosy control data were collected from the National Leprosy Management Information System of China, and health administrative sectors, centers for disease control and prevention and professional leprosy control institutions at each level in Zhejiang Province. According to the scheme for the final evaluation of National Leprosy Control Plan (2011-2020), the implementation of 12 indicators in Zhejiang Province in 2020 was investigated, including the current number of leprosy patients, prevalence of leprosy, proportion of training on leprosy control skills, proportion of regular leprosy treatment, proportion of treatment of adverse reactions, annual examination rate of close contacts, proportion of early case identification and awareness of leprosy control knowledge.@*Results@#There were 50 registered leprosy cases in Zhejiang Province by the end of 2020, with a decrease of 50.98% relative to in 2010. The prevalence of leprosy was less than 1/105 in 93 counties (districts) of Zhejiang Province, and the rate of training on leprosy control skills, rate of regular leprosy treatment, rate of treatment of adverse reactions, annual examination rate of close contacts, rate of early case identification were all 100% in Zhejiang Province. There were no new confirmed cases with diagnosis of leprosy having grade 2 deformity or disability, or no new cases with deformity or disability within 2 years following anti-leprosy therapy. In addition, the awareness of leprosy control knowledge was 91.67% among the public and 98.12% among the close contacts. All of the 12 indicators reached the requirements of the National Leprosy Control Plan (2011-2020). @* Conclusions @# The implementation of the National Leprosy Control Plan (2011-2020) in Zhejiang Province had achieved the targets defined in the final evaluation of the plan. Intensifying multi-sectoral joint leprosy prevention and control and improving early identification and standardized therapy of leprosy cases are recommended for future leprosy control in Zhejiang Province.
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Objective:To analyze spatiotemporal distribution characteristics of syphilis in Zhejiang province from 2016 to 2020, to explore cluster areas of syphilis cases, and to provide a theoretical basis for accurate prevention and control of syphilis.Methods:Data on reported syphilis cases in Zhejiang province from 2016 to 2020 were collected from the notifiable infectious disease surveillance system in China Disease Control and Prevention Information System. The ArcGIS10.2 software was used as a data management and presentation platform to establish a database for spatial analysis of syphilis in Zhejiang province from 2016 to 2020, and spatial autocorrelation analysis of reported syphilis incidence was conducted. The SaTScan 9.6 software was used for spatiotemporal scanning analysis.Results:A total of 158 420 cases of syphilis were reported in Zhejiang province from 2016 to 2020, and the average annual reported incidence rate was 49.07 per 100 000 in all counties and districts (range: 20.52 per 100 000-124.29 per 100 000) . The overall spatial distribution pattern of syphilis cases in Zhejiang province was characterized by higher reported syphilis incidence in the West area and lower incidence in the middle area. Global autocorrelation analysis showed that all the global Moran′s I indices from 2016 to 2020 were over 0, Z values were over 1.96, and P values were below 0.001, suggesting the spatial clustering of reported syphilis cases. Local autocorrelation analysis showed that there were 2 high-high clustering areas (Tonglu and Chun′an counties in Hangzhou city, Jingning county in Lishui city) , and 1 low-low clustering area (Jindong district, Dongyang and Yongkang county-level cities in Jinhua city) . Local hot-spot analysis with G statistic showed that there were 6 positive hot-spot areas and 8 negative hot-spot areas of syphilis cases in Zhejiang province. SaTScan spatiotemporal scanning analysis revealed 3 clustering areas, mainly distributed in Taizhou and Zhoushan cities along the eastern coast, and some counties and districts in the southwestern mountainous areas. Conclusions:The reported incidence rate of syphilis in Zhejiang province is characterized by spatial clustering. In the future, prevention and control of syphilis should be strengthened in southwestern mountainous areas, eastern islands, and other remote areas as well as areas with poor transportation.
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Objective:To investigate epidemiological features and trends of genital herpes in Zhejiang province, and to provide scientific evidence for developing control strategies.Methods:Data on reported cases of genital herpes in Zhejiang province between 2011 and 2020 were collected from national notifiable infectious disease surveillance system in China Disease Control and Prevention Information System, and a descriptive epidemiological study was conducted.Results:The reported incidence rate of genital herpes in Zhejiang province between 2011 and 2020 ranged from 4.92 per 100 000 to 6.19 per 100 000, without a significant upward or downward trend (trend χ2 = 0.03, P = 0.959) ; the reported incidence rate in females showed an increasing trend (from 4.50 per 100 000 to 6.02 per 100 000, trend χ2 = 5.13, P = 0.034) , with an average annual increase rate of 3.27%; among all the age groups, the sexually active population aged 20 - 39 years showed a high reported incidence rate of genital herpes, but the incidence rate increased significantly in the groups aged 15 - 19 years and over 50 years, with the average annual increase rates being 8.10%, 9.24%,7.81% and 4.27% in the groups aged 15 - 19 years, 50 - 54 years, 55 - 59 years and over 60 years respectively. The largest proportion of cases was found in farmers (28.38%, 8 779/30 931) , and high average annual increase rates in proportions were observed in healthcare workers, retirees, students, unemployed population and cadres (13.71%, 13.14%, 10.74%, 9.36% and 7.00%, respectively) . The reported incidence rates were high (over 5 per 100 000) in Eastern coastal areas such as Ningbo, Wenzhou, Taizhou, as well as Jinhua city with relatively developed industrial economies in central Zhejiang; the reported incidence rate markedly increased in Hangzhou city, with an average annual increase rate of 5.39%. Conclusions:There was no obvious downward trend in the prevalence of genital herpes in Zhejiang province from 2011 to 2020. Attention should be paid to the prevention and treatment of genital herpes in females, adolescents and the elderly, and the monitoring of herpes simplex virus infections and investigation of infection routes and exposure history should be strengthened.
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Objective:To analyze the genomic characteristics of H9N2 subtype avian influenza virus in external environmental specimens collected in Huainan city from February to April, 2016.Methods:Specimens positive for H9N2 nucleic acid (Ct value≤30) were screened by fluorescent PCR and cultivated in chicken embryos to extract RNA. Eight gene segments were amplified and analyzed with whole genome sequencing. The molecular characteristics of each gene segment of Huainan strains were analyzed. A phylogenetic tree was constructed based on the sequences.Results:The hemagglutinin (HA) and neuramidinase (NA) genes of two Huainan H9N2 avian influenza strains and the human-derived strain A/Anhui-Lujiang/39/2018/H9N2 shared the homology of 98.2%-98.3% and 97.2%-94.9% in nucleotide and 98.9%-98.8% and 99.2%-98.6% in amino acid. The other six endogenous genes were highly homologous to those of the A/Anhui/1/2013/H7N9 and A/Anhui/33163/2016/H5N6 strains. The phylogenetic tree showed that two H9N2 subtype avian influenza strains isolated in Huainan city in 2016 belonged to G57 genotype, and the endogenous genes of two Huainan H7N9 isolates and human-derived A/Anhui/1/2013/ H7N9 and A/Anhui/33163/2016/H5N6 strains were G57-like genotype. Amino acid mutations in the HA protein receptor binding domain including S132D, K138T, T189D, V/A190T and Q226L were detected. The " TEI" sequence was deleted from the NA stem region. Amino acid mutations associated with drug resistance including H274Y, R292K and N294S were not detected in the isolates, but they carried the mutations of I550L in PA gene, I368V in PB1 gene, I504V in PB2 gene, P42S in NS1 gene, N30D and T215A in M1 gene and S31N in M2 gene.Conclusions:The two H9N2 viruses isolated in the live poultry market in Huainan city were highly homologous to the A/Anhui-Lujiang/39/2018/H9N2 strain isolated from humans. The three strains were within the same evolutionary branch and belonged to G57 genotype. The endogenous genes of the two H9N2 viruses could recombine with H7N9 and H5N6 subtype avian influenza viruses that caused human infection. Amino acid mutations in the HA protein receptor binding domain, deleted sequences in the NA stem region and increased polymerase activity strengthened the ability of viruses to infect humans and were related to the drug resistance to M2 ion channel inhibitors (adamantane). The two Huainan H9N2 viruses remained sensitive to NA inhibitors (oseltamivir phosphate).
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Objective To investigate the effects of acute hypervolemic hemodilution (AHH) with different fluids on blood rheology in patients with deep vein (femoral and iliac) thrombosis. Methods Thirty ASA I or II patients aged 40-64 yr who had developed deep vein thrombosis in 48 h and were scheduled for embolectomy were randomly divided into 3 groups ( n = 10 each) ; group I normal saline (NS) ; group II 6 % HES 200/0.5 ( HES) ; group IE gelofusine (GEL). AHH was performed with normal saline, 6% HES or gelofusine infusion at 20 ml·kg-1 ·h-1 for 40 min. MAP, HR and SpO2 were monitored. Blood loss, volume of blood transfusion and fluid infused and urine output during operation were recorded. Anesthesia was induced with fentanyl 3-5 fig/kg, etomidate 0.15-0.30 mg/kg, propofol 1-2 mg/kg and succinylcholine 1-2 mg/kg and maintained with 2% isoflurane and propofol infusion at 5-8 mg·kg-1·h-1 and intermittent iv boluses of vecuronium. The patients were mechanically ventilated (VT 8 ml/kg, RR 12 bpm). PaO2 and PaCO2 were maintained within normal range. Venous blood samples were obtained before and after AHH for measurement of hematocrit (Hct), whole blood viscocity (WBV) at low or high shear rates, plasma viscosity, RBC aggregation and RBC deformation. RBC aggregation index and RBC deformation index were calculated. Results MAP and HR were stable in all patients. The amount of blood transfusion and fluid infused was significantly less in group HES and GEL than in group NS. The WBV at low or high shear rates in group HES and GEL, Hct in all 3 groups and RBC aggregation index in group HES were significantly decreased after AHH, but the RBC deformation index was significantly increased in group HES. Conclusion Colloid is better than crystalloid and HES is better than gelofusine in improving intraoperative hypercoagulability and sluggish blood flow.
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@#Objective To investigate the protective effect of the emulsified isoflurane preconditioned intravenously on the myocardial ischemia/reperfusion injury in rats.Methods The 40 rats were randomly divided into the pseudo-operation group,saline group,lipid emulsion group and emulsified isoflurane group with 10 animals in each group.The animal model of myocardial ischemia reperfusion injury was established,the pseudo-operation group was not occluded coronary artery,the other three groups were received intravenous 0.9% saline,30% lipid emulsion,or infusions(3.5 ml/kg/h for 30 min)of emulsified isoflurane(6.9%)before a 30-min coronary occlusion and 3 h of reperfusion.The content of myocardial malondialdehyde(MDA)and the activity of superoxide dismutase(SOD)were determined after treatment.The myocardial samples were studied by HE staining to observe hispathological changes.The myocardial ultrastuctures were observed and pictures were taken by electron microscope.Results The myocardial MDA content in the emulsified isoflurane group was significantly lower than that in the saline group and lipid emulsion group,while the activity of SOD in the emulsified isoflurane group was significantly higher than that in the saline group and lipid emulsion group(P<0.05).Conclusion The emulsified isoflurane preconditioned intravenously has protective effect on myocardial ischemia/reperfusion injury in rats.
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@#ObjectiveTo investigate the mechanism and the protective effect of heat shock protein 27 (HSP27) on rat cardiomyocytes when ischemic preconditioning performed.MethodsCultured rat cardiomyocytes were divided into four groups: control group, ischemic group,ischemic preconditioning group and cyclohexamide group. Cell viabilities were analyzed by MTT. The apoptosis was evaluated with DNA ladder and flow cytometry Annexin V Flous staining. Western Blot was used to determine the expression of HSP27 and caspase-3 in cardiomyocytes.ResultsIschemic preconditioning could improve cell viability. The apoptosis ratio in ischemic preconditioning group was significantly less than that in ischemic group. These were accompanied by an increase in the expression of HSP27 and a decrease in caspase-3. The expression of the increased HSP27 and the protective effect induced by ischemic preconditioning were completely abolished by the presence of cycloheximide, a translation inhibitor.ConclusionThe expression of HSP27 induced by ischemic preconditioning plays an important role in protecting cardiomyocytes, and the mechanism is possibly related to the inhibition of cell apoptosis.
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ObjectiveTo observe the effect of thiopental on T lymphocyte subsets in mice. MethodsT lymphocyte subsets were measured by flow cytorneter and monoclonal antibodies and immunofluorescence technic. ResaltsThe CD4 T cell and the CD4/CD8 ratio decreased after thiopental anaesthesia in mice. At the same time the whole amount of white blood cells has no statistical significant difference between test group and control group. ConclusionThiopental anaesthesia inhibits immune function.