Systems pharmacology dissection of action mechanisms for herbs in osteoporosis treatment / 中草药·英文版

Objective: Osteoporosis has become the biggest cause of non-fatal health issue. Currently, the limitations of traditional anti-osteoporosis drugs such as long-term ill-effects and drug resistance, have raised concerns toward complementary and alternative therapies, particularly herbal medicines and their natural active compounds. Thus, this study aimed to provide an integrative analysis of active chemicals, drug targets and interacting pathways of the herbs for osteoporosis treatment. Methods: Here, we introduced a systematic pharmacology model, combining the absorption, distribution, metabolism, and excretion (ADME) screening model, drug targeting and network pharmacology, to probe into the therapeutic mechanisms of herbs in osteoporosis. Results: We obtained 86 natural compounds with favorable pharmacokinetic profiles and their 58 targets from seven osteoporosis-related herbs. Network analysis revealed that they probably synergistically work through multiple mechanisms, such as suppressing inflammatory response, maintaining bone metabolism or improving organism immunity, to benefit patients with osteoporosis. Furthermore, experimental results showed that all the five compounds (calycosin, asperosaponin VI, hederagenin, betulinic acid and luteolin) enhanced osteoblast proliferation and differentiation in vitro, which corroborated the validity of this system pharmacology approach. Notably, gentisin and aureusidin among the identified compounds were first predicted to be associated with osteoporosis. Conclusion: Herbs and their natural compounds, being characterized as the classical combination therapies, might be engaged in multiple mechanisms to coordinately improve the osteoporosis symptoms. This work may contribute to offer novel strategies and clues for the therapy and drug discovery of osteoporosis and other complex diseases.

A comparison of curriculum design for undergraduate education of rehabilitation therapy in mainland China and Taiwan area / 中华医学教育探索杂志

Undergraduate education started late in rehabilitation medicine in mainland China.At present,there are some shortcomings in current undergraduate education for rehabilitation medicine in mainland China,mainly due to the shortage of teachers,the poor pertinence of professional subjects,the broad and superficial knowledge,and the lack of close connection with the necessary professional knowledge of rehabilitation technologies.The Department of Rehabilitation in Taiwan starts its undergraduate education earlier.The curriculum has been sub-professionally oriented.Its subjects are highly targeted and detailed in content.At the same time,it emphasizes forward-looking education such as "statistics".In view of this,the mainland colleges and universities should standardize the undergraduate education of rehabilitation therapies,strengthen the training of professional teachers,pay attention to the cross-mutualism of theory and practice in the teaching plan,enrich the number of professional courses,the appropriate introduction of teaching methods of scientific research,standardize the teaching management system.

A study on the awareness of influenza and pneumonia and thewillingness of vaccination among chronic disease patients / 预防医学

Objective To provide evidence for effective implementation of influenza and pneumonia immune strategies, we investigated the awareness of influenza and pneumonia and the willingness of vaccination among chronic disease patients.Methods A stratified multistage cluster sampling method was used to investigate 720 patients less than 75 years of age.Results Overall, 717 completed responses were received.The awareness rates of influenza and pneumonia diseases were 59.83% and 59.55%, respectively.However, the awareness rates of influenza and pneumonia vaccine were 17.71% and 6.00%, respectively.The vaccination rate of influenza vaccine was 1.26% while no patients received pneumonia vaccination.Among those not vaccinated the most frequent reasons for not receiving the vaccine included "Believed oneself unlikely to be infected with influenza/pneumonia" and "No recommendation has been received for influenza/pneumonia vaccination".The influence on recommendations by doctors at vaccine clinic and by general practitioner had no significant statistical difference (P>0.05).Conclusion The main reasons for such low awareness and willingness may be due to their poorly knowledge on the risk of influenza/pneumonia diseases, and related vaccines.Health education and intervention should be taken to heighten the vaccination rates of influenza/pneumonia vaccines.

Study on Oncomelania hupensis snails infected with Schistosoma japonicum miracidia under different conditions in snail-existent non-endemic areas of schistosomiasis in Nantong City / 中国血吸虫病防治杂志

Objective To understand the forming cause of the Oncomelania hupensis snail-existent non-endemic areas of schistosomiasis(SENEAS),and to verify the conclusion of previous studies,so as to provide the evidence for schistosomiasis monitoring in such areas in Nantong City,Jiangsu Province. Methods The controlled field tests were carried out to observe the O. hupensis snails artificially infected by schistosome miracidia in SENEAS. The influence of the soil from SENEAS and the en-demic areas on O. hupensis snails artificially infected by miracidia were observed. Results All the experimental snails could be infected by schistosome miracidia except the smooth-shell snails from Tangyuan Village in the controlled field test environment of SENEAS or the endemic areas. The infection rates of the smooth-shell snails were lower than those of the ribbed-shell snails , but there were no statistically significant differences. The mortality rates of the smooth-shell snails were higher than those of the ribbed-shell snails,which were statistically significant (χ2Xindian = 135.118,χ2Shuangdian = 122.836,χ2Baipu =154.436,χ2Dingyan =138.288,χ2Control=151.923,all P<0.01). There were no significant differences in the infection rates of snails between each test group of the soil from SENEAS and the endemic areas(χ2Rugao=0.071,χ2Rudong=0.216,both P>0.05). Also there was no signifi-cant difference between each test group and the control group without soil(χ2=7.148,P>0.05). Conclusion It is likely to form the spread of schistosomiasis in SENEAS in Nantong City with sufficient amount of infection source of schistosomiasis im-ported. It is still necessary to implement the surveillance of schistosomiasis and O. hupensis snails in Nantong City.

Investigation on current situation of malaria blood examinations in township-level hospitals of Nantong City / 中国血吸虫病防治杂志

Objective To understand the quality of malaria blood examinations in township?level hospitals,so as to provide the evidence for continuing the malaria blood examinations in the stage of post?malaria elimination. Methods A total of 64 township hospitals were investigated and 640 negative malaria blood slides were scored individually according to 10 indicators inMalaria Elimination Technical Schemein 2013 and 2014. The single and multiple indicators were calculated,and the work of blood examinations and situation of technicians were investigated. The data of malaria blood examinations and patient discovery in township hospitals of Nantong City were collected and analyzedduring the period of 2011-2014. Results Forthe single indi?cator,29.5%of the thick blood films did not reach the standard,and 35.8%of thin blood films did not reach the standard. For the multiple indicators,blood slides with more than 4 indicators below the standard(poor quality)accounted for 32.5%. From ma?laria blood examinations and malaria situation,the number of slides was 194 635 during the period of 2011-2014,and there were no local vivax malaria casesin 4consecutive years from 2011 to 2014,andlocal malaria has been effectively controlled in Nantong City. For health facilities where malaria patients initially presented,the township and village level accounted for 16.3%,and county and higher level accounted for 83.7%. Conclusions The quality of malaria blood examinations in township level hospitals of Nantong City is not high and the microscopic examination has a relatively low efficiency in the discovery of ma?laria cases. A new model for malaria blood examinations needs to be further explored.

Effects of lithium chloride on isoflurane-induced neuroapoptosis in neonatal rat hippocampus / 中国药学杂志

OBJECTIVE: To investigate the effects of lithium chloride (LiCl) on neuroapoptosis in hippocampus induced by isoflurane and the relationships with GSK-3β/CRMP2 pathway in neonatal rats. METHODS: Sixty neonatal rats at postnatal day 7 were assigned randomly into air + NS group, air + LiCl group, Iso + NS group, Iso + LiCl2, Iso + LiCl4 and Iso + LiCl8 group. Rats in groups of air + NS and air + LiCl were exposed to air for 6 h. Rats in groups of Iso + NS, Iso + LiCl2, Iso + LiCl4 and Iso + LiCl8 were exposed to 0.75% isoflurane for 6 h. Rats in groups of Air + NS and Iso + NS were injectedintracerebroventricularlywith NS 5 μL separately 30 min before exposure to air or isoflurane. Rats in groups of air + LiCl, Iso + LiCl2, Iso + LiCl4 and Iso + LiCl8 were injected intracerebroventricularly with LiCl 5 μL separately 30 min before exposureto air or isoflurane. Rats in groups of Iso + LiCl2, Iso + LiCl4, Iso + LiCl8 and Air + LiCl were injected intracerebroventricularly with LiCl5 μL separately 30 min before exposure with the different concentrations(20, 40, 80, 80 mmol·L-1, respectively). At the end of exposure, the hippocampus of some rats were separated and proteins expression of cleaved caspase-3, phospho-GSK-3β(p-GSK-3β), GSK-3β, phospho-CRMP2 (p-CRMP2) and CRMP2 were detected by Western blot (n=5); other rats were perfused and their brain were embedded by paraffin 2 h after exposure, the neuroapoptosis in the hippocampus CA1 area was detected by TUNEL staining (n=5). RESULTS: Lithium chloride (80 mmol·L-1) significantly decreased the cleaved caspase-3 levels(P < 0.01) induced by isoflurane in hippocampus of neonatal rats. TUNEL positive cells in CA1 area were significantly decreased by 41.69%(P < 0.01) in group Iso + LiCl8 when compared with those in group Iso + NS. The protein expressionof p-GSK-3β and p-CRMP2 in group Iso + NS were significantly decreased and increased respectivelycompared to those in group air + NS. The ratio of p-GSK-3β/GSK-3β and p-CRMP2/CRMP2 in the hippocampal increased 41.03% (P < 0.05) and decreased 23.64%(P < 0.05) respectively in Iso + LiCl8 group when compared with Iso + NS group. CONCLUSION: Lithium chloride attenuates isoflurane-induced neurodegeneration through inhibiting hippocampal neuroapoptosis in neonatal rats. Inhibition of the activation of GSK-3β/CRMP2 signaling pathways may involve in the mechanisms.

Advance of Functional Magnetic Resonance Imaging in Motor Function of Hand in Patients with Stroke (review) / 中国康复理论与实践

@#Functional magnetic resonance imaging (fMRI), a newly developing technique, contains function, anatomy and image, which makes the real-time, dynamic and non-invasive measurement of the functional brain imaging availability. This paper summarized the characteristics of fMRI in health and stroke populations, introduced the advances of fMRI in neuroplasticity, rehabilitation assessment and prognosis in hand movement dysfunction in patients with stroke, and discussed the difficulty fMRI faced in rehabilitation assessment and the further researches.

Evaluation and Accreditation of Physical Therapy Education in United States / 中国康复理论与实践

With the rapid progress of rehabilitation in China, how to construct the accreditation system of physical therapy (PT) educa-tion has become a critical consideration. This article introduced the background, role, management and process about the accreditation sys-tem of PT education in United States in order to promote the development of PT education in China.

Influence of knee extension in sitting position with hip adduction on surface EMG of quadriceps muscles in patients with patellofemoral pain syndrome / 医用生物力学

Objective To investigate the possible effect of fully knee extension in sitting position with or without hip adduction on quadriceps imbalance in patients with patellofemoral pain syndrome (PFPS) by using surface electromyography (sEMG). Methods sEMG signals of vastus lateralis (VL) and vastus medialis oblique (VMO) muscles from 30 patients with PFPS as PFPS group and 30 healthy subjects as control group were collected, during their fully knee extension in sitting position with or without hip adduction. All the EMG data were then analyzed by extracting time domain indexes, namely, the root mean square (RMS) and integrated EMG (IEMG), to compare the balanced relationship between VL and VMO muscles. Results In PFPS group, there were no significant differences in VL time domain indexes during knee extension in sitting position with or without hip adduction, while statistical differences were found in VMO time domain indexes, and values of RMS and IEMG of VMO were higher under hip adduction, which indicated that the VMO muscle recruitment was strengthened. Conclusions Fully knee extension in sitting position with hip adduction can promote EMG activities of VMO muscles in patients with PFPS, which will help to balance the VL and VMO muscles.

CYP2C19 polymorphism and clinical outcomes among patients of different races treated with clopidogrel: A systematic review and meta-analysis / 华中科技大学学报（医学）（英德文版）

Several studies have investigated the association between CYP2C19 polymorphism and clinical outcomes of patients treated with clopidogrel, but few have noticed the difference in association between Westerners and Asians. We searched MEDLINE, EMBASE and Cochrane Library database and conducted a systematic review and meta-analysis. Thirty-six studies involving 44 655 patients with coronary artery disease (CAD) treated with clopidogrel were included, of which more than 68% had undergone percutaneous coronary intervention (PCI). The primary outcome of our interest was the recurrence of major adverse cardiovascular events (MACE) in those CAD patients. Firstly, we found that the distribution of reduced-function CYP2C19 allele varied between Westerners and Asians. Among Asians, 1 and 2 reduced-function CYP2C19 mutant allele carriers accounted for 42.5% and 10%, respectively. While among Westerners, 1 and 2 reduced-function CYP2C19 mutant allele carriers accounted for 25.5% and 2.4%, respectively. Secondly, the impact of CYP2C19 polymorphism on clinical outcomes of patients treated with clopidogrel varied with races. Among Asians, only 2 reduced-function CYP2C19 mutant allele carriers had the reduced effect of clopidogrel. And the reduced effect was significant only after the 30th day of treatment. While among Westerners, both 1 and 2 reduced-function CYP2C19 allele carriers had the reduced effect, and it mainly occurred within the first 30 days. Thirdly, the safety of clopidogrel was almost the same among races. Reduced-function allele non-carriers had higher risk for total bleeding but did not have higher risk for major bleeding. It is suggested that CYP2C19 polymorphism affects the efficacy of clopidogrel differently among Westerners and Asians.

CYP2C19 polymorphism and clinical outcomes among patients of different races treated with clopidogrel: A systematic review and meta-analysis / 华中科技大学学报（医学）（英德文版）

Several studies have investigated the association between CYP2C19 polymorphism and clinical outcomes of patients treated with clopidogrel, but few have noticed the difference in association between Westerners and Asians. We searched MEDLINE, EMBASE and Cochrane Library database and conducted a systematic review and meta-analysis. Thirty-six studies involving 44 655 patients with coronary artery disease (CAD) treated with clopidogrel were included, of which more than 68% had undergone percutaneous coronary intervention (PCI). The primary outcome of our interest was the recurrence of major adverse cardiovascular events (MACE) in those CAD patients. Firstly, we found that the distribution of reduced-function CYP2C19 allele varied between Westerners and Asians. Among Asians, 1 and 2 reduced-function CYP2C19 mutant allele carriers accounted for 42.5% and 10%, respectively. While among Westerners, 1 and 2 reduced-function CYP2C19 mutant allele carriers accounted for 25.5% and 2.4%, respectively. Secondly, the impact of CYP2C19 polymorphism on clinical outcomes of patients treated with clopidogrel varied with races. Among Asians, only 2 reduced-function CYP2C19 mutant allele carriers had the reduced effect of clopidogrel. And the reduced effect was significant only after the 30th day of treatment. While among Westerners, both 1 and 2 reduced-function CYP2C19 allele carriers had the reduced effect, and it mainly occurred within the first 30 days. Thirdly, the safety of clopidogrel was almost the same among races. Reduced-function allele non-carriers had higher risk for total bleeding but did not have higher risk for major bleeding. It is suggested that CYP2C19 polymorphism affects the efficacy of clopidogrel differently among Westerners and Asians.

Effect of double-leg semi-squats with hip adduction on the vastus medialis oblique of patients with patellofemoral pain syndrome / 中华物理医学与康复杂志

Objective To investigate the possible effect of performing double-leg semi-squats with hip adduction on the imbalance between vastus lateralis (VL) and vastus medialis oblique (VMO) muscles of patients with patellofemoral pain syndrome (PFPS).Methods Thirty patients with PFPS were selected to be in the study group,matched with 30 healthy subjects who were enrolled as the control group.Electromyography was used to record VL and VMO activities while the subjects performed double-leg semi-squats (DSs) and double-leg semi-squats with hip adduction (DSs-HA).Results In the study group,when performing DSs,the average RMS was (103.31 ± 44.54) μV and the IEMG was (8.02 ±3.45) μVs for VL.For VMO the RMS was (85.02 ±41.19) μV and the IEMG was (6.72 ±3.20) μVs.The differences in the time domain indexes (RMS,IEMG) between VL and VMO were both significant during DSs (P ＜ 0.05).There was no significant differences during DSs-HA (P ＞ 0.05).The time domain indexes (RMS,IEMG) of VMO were significantly different in both the DSs and DSs-HA (P ＜ 0.05).Conclusions Stronger sEMG signals were seen from the VMO in the double-leg semi-squats with hip adduction than without hip adduction,which indicates that more selective VMO activation can be obtained in the exercise with hip adduction to help balance the VL and VMO.

Surface Electromyography of Lumbar Muscles in Non-specific Low Back Pain Patients during Different Bridging Exercise / 中国康复理论与实践

Objective To investigate the features of surface electromyography of lumbar muscles in non-specific low back pain (NLBP) patients when they were practicing different types of bridging exercise. Methods 18 healthy subjects (control group) and 18 NLBP patients (NLBP group) were included and asked to practice bridging exercise with single and double feet. The root mean square (RMS) of surface electromyography of both sides of lumbar muscles were recorded. Results No significant difference was found in the control group. The RMS of erector spinae was more in the supported side than in the contra side for NLBP patients in bridging exercise with single foot. There was no significant difference among different time points in the same muscle. Conclusion The contractions of erector spinae in both sides are not equal in asymmetric bridging exercise in NLBP patients.

An establishment of theoretical structure of PRO questionnaire in treating chronic liver disease by Chinese medicine / 中国中西医结合杂志

By reviewing research contents of patient-reported outcome (PRO) and discussing Chinese medicine (CM) theories related to chronic liver disease (CLD), we have followed international PRO questionnaire development specification, combined CM theories such as uniformed spirit and body, correspondence between human and the universe, yin in property and yang in function of Gan, and seven emotions, and constructed theoretical structure of PRO questionnaire of treating CLD, including four major areas as physiology, psychology, independence, and society and nature. Of them, the physiological field contained six aspects such as blood deficiency, yin deficiency, bleeding, disorder of qi movement, improper transformation and transportation of Pi-Wei, and abnormal biliary excretion. The psychological field contained two aspects: Gan-related emotions and general disease related emotions. The independence field contained two aspects: daily life and study and work. The field of society and nature contains three aspects: social relations, social environment, and natural adaptability.

Regulatory effect of anti-IL-6Rβ(gp130) mAb on IL-6 signaling pathway / 中国免疫学杂志

Objective:To analyse the biological function of anti-IL-6Rβ(gp130) monoclonal antibody and its regulatory effect on IL-6 signaling.Methods:Biological characteristics of anti-IL-6Rβ(gp130) mAb were assessed by Western blot analysis, capture ELISA and peptide ELISA .The phosphorylation of STAT 3 was tested by Western blot analysis in IL-6-stimulated U266/RA-FLS/RA-PBMC with or without anti-IL-6Rβ(gp130) mAb treatment.Results:3 strains of mouse anti-human gp130 mAb were with high affini-ty and different binding epitopes , the kaff of 10A1 was 2.62E-10.In U266, RA-PBMC and RA-SFMC, IL-6 signaling highly activated STAT3 which could be inhibited by anti-gp130 mAb.Conclusion: Anti-IL-6Rβ( gp130 ) mAb might have different binding epitopes and could affect IL-6 stimulated phosphorylation of STAT3, which provides a preliminary experiment for analyse the correlation of IL-6 signaling and RA .

Surface Electromyography of Lumbar Muscles in Non-specific Low Back Pain Patients during Different Bridging Exercise / 中国康复理论与实践

@#Objective To investigate the features of surface electromyography of lumbar muscles in non-specific low back pain (NLBP) patients when they were practicing different types of bridging exercise. Methods 18 healthy subjects (control group) and 18 NLBP patients (NLBP group) were included and asked to practice bridging exercise with single and double feet. The root mean square (RMS) of surface electromyography of both sides of lumbar muscles were recorded. Results No significant difference was found in the control group. The RMS of erector spinae was more in the supported side than in the contra side for NLBP patients in bridging exercise with single foot. There was no significant difference among different time points in the same muscle. Conclusion The contractions of erector spinae in both sides are not equal in asymmetric bridging exercise in NLBP patients.

Experimental study on therapeutic effect of Dabuyin Wan on true precocious puberty in female rats / 中国中药杂志

<p><b>OBJECTIVE</b>To study the therapeutic effect of Dabuyin Wan on true precocious puberty of female rats and its possible mechanism.</p><p><b>METHOD</b>Twenty-two-day-old female SD rats were subcutaneously injected with 40 mg x kg(-1) N-methyl-DL-aspartic acid (NMA) at 14:00 and 16:00 every day; meanwhile, the rats were given Dabuyin Wan for intervention. Visual inspection was conducted for the time of vaginal opening. The first estrus was observed by yaginal smear test. Their ovaries and uterus were weighed to calculate organ coefficients. Conventional pathological slices were made to observe morphological changes in ovaries and uterus and calculate the thickness of uterine walls and the number of corpus luteums. The level of E2 in serum was detected to assess the therapeutic effect of Dabuyin Wan on NMA precocious puberty in rats. expressions of GnRH, GPR54 and Kiss-1 mRNA in hypothalamus were measured by semi-quantitative RT-PCR to investigate the possible mechanism of Dabuyin Wan.</p><p><b>RESULT</b>Dabuyin Wan at 3.24 g x kg(-1) and 1.62 g x kg(-1) significantly decreased the organ coefficients in rats with precocious puberty (P < 0.05), decrease the number of vaginal openings in rats (P < 0.01) and the thickness of uterine walls and the number of corpus luteums (P < 0.05), and notably down-regulated expressions of GnRH, GPR54 and Kiss-1 mRNA in hypothalamus (P < 0.05), without significant impact on E2 in serum.</p><p><b>CONCLUSION</b>Dabuyin Wan may inhibit GnRH synthesis and release as well as startup of hypothalamic-pituitary-gonadal axis by down-regulating Kiss-1/GPR54 mRNA expression in hypothalamus, in order to realize the therapeutic effect on true precocious puberty.</p>

Retrospective analysis of clinical and epidemiological characteristics of hand-foot-and-mouth disease deceased cases in Zhejiang Province / 中华儿科杂志

<p><b>OBJECTIVE</b>To understand the clinical and epidemiological characteristics of hand-foot-and-mouth disease (HFMD) deceased cases.</p><p><b>METHOD</b>Information of demographics, diagnosis and treatment, clinical symptoms and signs, laboratory test results, and epidemiological contact history of 72 HFMD cases who died between May 2008 and September 2011, in Zhejiang Province, were collected and analyzed.</p><p><b>RESULT</b>The average age of the 72 cases was 1.8 years, 45 were males, accounting for 62.5%, 63 (87.5%) of the cases were scattered children. Eighteen counties reported 2 or more deaths, accounting for 46.1% (18/39) among the counties where the deaths were reported. The deaths occurred mainly in April to August, the peak occurred in May and June. Fever (98.4%, 63/64) and rash (95.1%, 58/61) were the most common symptoms, but the rash was not obvious at the first diagnosis. Fever occurred before the rash (79.0%, 49/62), persisted for 4 days in average. Vomiting (71.9%, 46/64), dyspnea (65.6%, 42/64), cyanosis (53.1%, 34/64) and impaired consciousness (51.6%, 33/64) were often seen among the cases; 53.1% (34/64) cases went to see the doctor on the first day, but 82.5%(52/63)cases were misdiagnosed. Time to diagnosis of HFMD was in average 3 days. About 3 to 4 days after the onset, the disease deteriorated sharply, deaths occurred within 1 day after admission in 78.9%(45/57)of the deceased cases; 85.0% (34/40) cases had high white blood cells level, mainly neutrophils increased, the ratio of neutrophil was more than 70% in 55.6% (15/27) of cases. Enterovirus 71 (EV71) infection was found in 93.3% (56/60) cases, the deceased cases often died of pulmonary hemorrhage (42.9%, 21/49) and encephalitis (34.7%, 17/49). The sanitary conditions of the cases' family were poor (65.5%, 36/55), but 73.3% (33/45) cases had no exposure history.</p><p><b>CONCLUSION</b>The HFMD deceased cases were mostly younger aged boys, scattered children, nonlocal-residents, and had poor sanitation. They were often infected with EV71, had high fever but had no typical rash, no clear exposure history, they had increased leukocyte, and were often misdiagnosed. Three or 4 days after onset, the disease deteriorated abruptly, most cases died within 1 week after onset. To decrease the HFMD mortality, early detection of severe cases should be stressed, and relative measures should be taken. The guardian should be aware of having good sanitary situation and healthy habits.</p>

Epidemiological characteristics of influenza virus and respiratory syncytial virus among children in Wuhan area from 2008 to 2012 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the infection status and epidemiological characteristics of influenza virus and respiratory syncytial virus (RSV) in influenza-like illness (ILI) of children ( ≤ 14 years) in Wuhan area from 2008 to 2012.</p><p><b>METHODS</b>A total of 2854 cases of ILI patients ( ≤ 14 years) in a hospital of Wuhan were recruited in the study from July 2008 to June 2012. The sample of pharyngeal swab was collected from each patient, to extract the virus nucleic acids. Real-time fluorescent quantitation reverse transcription PCR (RT-PCR) method was applied to detect the subtypes of influenza virus and RSV, and then analyzed the time and age characteristics.</p><p><b>RESULTS</b>Out of the 2854 cases, 758 (26.6%) were positive for influenza virus,including 547 (19.2%) influenza A virus positive samples and 211 (7.4%) influenza B virus positive samples. Usually, there were two peaks present in the annual curve of influenza virus, namely summer peak and winter/spring peak. The positive rate of influenza virus in 6-14 years old children (48.0%, 275/573) was significantly higher than that in 3-5 years old children (26.6%, 213/801) and that under 3 years old children (18.3%, 270/1480). The difference showed statistical significance (χ(2) = 187.432, P < 0.01). A total of 219 (7.7%) cases were positive for RSV,including 108 RSV-A positive samples and 112 RSV-B positive samples (1 co-infection). The epidemic of RSV showed an obvious seasonal pattern with peaks in autumn,winter and spring,which accounted for 96.8% (212/219) of all the cases; however, the annual incidence of RSV fluctuated greatly. The predominant subtype shifted every 2 years. RSV-B predominated during September 2008 and May 2009, December 2009 and March 2010, accounting for 76.6% (36/47) and 96.9% (62/64) respectively. RSV-A predominated during November 2010 and March 2011, September 2011 and April 2012, accounting for 92.5% (37/40) and 100.0% (48/48) respectively. With the increase of the age, the positive rate of RSV-A and RSV-B decreased gradually (RSV-A: χ(2) = 36.223, P < 0.01; RSV-B: χ(2) = 36.281, P < 0.01). The positive rates of RSV-A in children < 1,1,2,3,4,5-9 and 10-14 years old were 7.0% (26/373), 5.9% (39/662), 4.0% (18/445), 3.2% (13/406), 1.3% (3/236), 1.4% (7/517) and 0.9% (2/215) respectively; while, the positive rates of RSV-B in each age group were 6.4% (24/373), 6.0% (40/662), 4.5% (20/445), 4.4% (18/406), 1.3% (3/236), 1.0% (5/517) and 0.9% (2/215) respectively. The children aged 0-3 years old were more susceptible for RSV infection,accounting for 90.0% (197/219) of the total positive samples. During the outbreak of influenza A H1N1 in November 2009, the positive rate of RSW was 3.0% (3/100), lower than that in the same month of 2008, 2010 and 2011,which were separately 18.2% (6/33), 10.8% (10/93) and 10.0% (4/40). The difference showed statistical significance (χ(2) = 8.450, P < 0.05). During the outbreak of influenza A (H1N1) in January 2011,the positive rate of RSV was 5.7% (3/53), lower than those in the same month of 2009, 2010 and 2012, which was separately 21.7% (5/23), 28.6% (22/77) and 16.0% (8/50). The difference showed statistical significance (χ(2) = 11.233,P < 0.05). During the period of less influenza happened in September 2011, the RSV positive rate was 25.0% (10/40), higher than those in the same month of 2008, 2009 and 2010, which was separately 11.4% (4/35), 1.7% (2/118) and 0.0% (0/109). The difference showed statistical significance (χ(2) = 32.521, P < 0.01).</p><p><b>CONCLUSION</b>Both influenza virus and RSV were important etiological agents of ILI of children in Wuhan. The characteristics of seasonal and age distributions of the two viruses were notably different; meanwhile, a certain inhibitional effect of influenza virus on RSV could be observed.</p>

Etiological and molecular-epidemiological analysis on enterovirus associated encephalitis in Zhejiang, 2008-2012 / 中华流行病学杂志

Objective In order to investigate etiology and molecular-epidemiological characteristics of enterovirus associated encephalitis (EAE) in Zhejiang,2008-2012.Method Cerebrospinal fluid and stool specimens were collected from suspected EAE patients,who were admitted to our hospitals.RD and Hep-2 cell lines were used to isolate enterovirus (EV).Serotypes of these EV isolates were identified through neutralization test by using serotype specific anti-sera.VP 1 genes of these isolates were sequenced,compared and used for the construction of phylogenetic tree.Results 127 (20.6％) human enterovirus (HEV) strains were isolated from 616 samples,which were collected from 610 patients.Serotypes of these EV isolates,including 60 coxsackievirus (CV),and 67 Echovirus (E) appeared to be CVA9,CVB1,CVB3-5,E3,E4,E6,E9,El4,E25 and E30,respectively.Predominant EV serotypes on EAE from 2008 to 2012 were seen as CVB3,CVB5,E6,E30 and E30,respectively.The full length of VP1 genes from different EV isolates was between 834 and 918 nucleotides.The VP1 gene similarities between these isolates and the reference strains were from 76.7％ to 85.0％ (nucleotides level) and 91.1％ to 97.9％ (amino acids level).The VP1 genes from E6 serotype isolates appeared most diverged,reaching 20.4％ (nucleotides level) attd 4.8％ (amino acids level).Based on the generated phylogenetic tree,all the EV isolates were fallen on the same branch of HEV-B,and the isolates in the same serotype formed one sub-branch,suggesting there existed geographical and temporal effects.E6 isolates diverged into two branchlets.Conclusion EVs from HEV-B were the etiologic agents for EAE in Zhejiang province from 2008 to 2012.All these EV isolates showed 12 serotypes,with predominant isolates varied every year.E30 was determined as the most dominant serotype while serotype E6 diverged into two sub-genetypes.