Organism diversity between women with and without bacterial vaginosis as determined by polymerase chain reaction denaturing gradient gel electrophoresis and 16S rRNA gene sequence.

AIMS: The aim of this study was to characterize the different structures of microbial communities between 20 healthy women and 17 bacterial vaginosis (BV)-positive women of reproductive age using denaturing gradient gel electrophoresis (DGGE). MATERIAL AND METHODS: Vaginal samples from 17 BV-positive and 20 BV-negative women were subjected to DNA extraction, and amplified with eubacterial 16S rRNA gene-specific primers via polymerase chain reaction. The polymerase chain reaction products were separated using DGGE. Bands were excised, re-amplified, purified and sequenced. DNA sequences were compared with GenBank database. Phylip software packages were used to calculate sequencing data and form a phylogenetic tree to identify the genetic relations for microbiota inhabited in vaginal ecosystems of BV-positive women. RESULTS: In total, 28 kinds of organisms were detected that comprised BV(+) vagina microbial community, varying from three to nine kinds with an average of 5.71 kinds per woman. Only seven species were detected in BV(-) women, ranging between one and five species with an average of 2.40 species per woman, which was significantly lower than that detected in BV(+) women (t = 7.39, P < 0.001). A strain of Uncultured Lactobacillus sp. clone EHFS1_S05c (29/37; 78.38%) was most commonly presented in both BV-negative and BV-positive women, but the mean proportion of this Lactobacillus sp. strain to the whole microbial population colonized in the vaginal tract of BV(-) women was sharply higher than that calculated from BV(+) women (t = 2.92, P < 0.01). CONCLUSIONS: The findings indicate further diversity in the category of vaginal microorganisms associated with BV. The presence of Gardnerella vaginalis is not necessary as a sign for gynecologists to determine whether or not a woman is affected by BV.

Polymorphisms in the MTHRF, VDR, MMP-9 and IL-ß genes and the risk of premature rupture of membranes.

BACKGROUND: Premature rupture of membranes (PROM) occurs 2.5-3 times more often in premature births than in births that are full term, is accompanied by many complications for both the mother and fetus and can cause serious adverse consequences. Little is known about the genetic susceptibility of PROM. OBJECTIVE: The purpose of this study was to evaluate the association between several genotypes and PROM in a high-risk hospital-based population. METHODS: The cases were 206 pregnant women who had PROM in labor, and the controls were 287 pregnant women who did not have PROM in labor. All subjects were selected between July 2006 and July 2007 from the Maternal and Child Health Hospital in Jinan City. We genotyped the following genes: the MTHFR C677T, MMP-9 C1562T, VDR C352T and IL-1ß C3593T genotypes. The associations between the genotypes and risk of PROM were analyzed. RESULTS: The CC genotype at MTHFR C677T, combined with bacterial vaginosis, was associated with a significantly increased risk of PROM (odds ratio, OR: 3.55; 95% confidence interval, CI: 1.05-12.02). Compared to those in the stratum of 40 or more weeks of gestation, those in the stratum of 37 or less weeks of gestation had an increased risk of PROM (OR: 5.11, 95% CI: 2.0-13.05 for the TT/TC genotype of MTHFR C677T; OR: 5.31, 95% CI: 1.07-26.44 for the TC/TT genotype of MMP-9 C1562T, and OR: 6.08, 95% CI: 1.39-26.60 for the TT genotype of VDR C352T). CONCLUSION: The results indicated that an interaction exists between genetic and environmental factors that are related to the occurrence of PROM.

Interchangeability of two Enterovirus 71 inactivated vaccines in Chinese children: A phase IV, open-label, and randomized controlled trial.

BACKGROUND: In China, three inactivated Enterovirus 71 (EV71) vaccines have been approved. Although the vaccines in an immunization series should be from a single manufacture, children sometimes have to receive EV71 vaccines from more than one manufacturers. The aim of this study was to evaluate the interchangeability and safety of vaccination with EV71 vaccines from two manufacturers among Chinese children. METHODS: We conducted an open label and randomized controlled study among children aged 6-35 months from November 2018 to January 2019. The participants were randomly assigned (1:1:1:1) to receive EV71 vaccines in one of the four different schedules (two using a single vaccine for all doses from one manufacture, and two mixed schedules using vaccines from two manufactures). Blood samples were collected pre-vaccination (Day 0) and one month after the second dose (Day 60) for neutralizing antibody assay. Immunogenicity was assessed in the per-protocol cohort and safety was assessed in the total vaccinated cohort. RESULTS: A total of 300 children were enrolled and randomized, of whom 89.0% (267/300) were included in the per-protocol cohort for immunogenicity analysis. The seroconversion rates of the EV71 neutralizing antibody in four groups ranged from 98.4% to 100.0%, and were not significantly different among the groups. Compared with other groups, geometric mean titer was higher in group D, in which the participants received Institute of Medical Biology Chinese Academy of Medical Sciences (CAMS) vaccine in the first dose and the Sinovac vaccine in the second dose. Safety profiles were similar among the four groups and no serious adverse events related to the vaccination were reported. CONCLUSIONS: Interchangeability of EV71 vaccines from two manufactures to complete an immunization series showed good immunogenicity and safety. The antibody response levels may vary by vaccination sequences of EV71 vaccines from the two manufacturers. TRIAL REGISTRATION: ClinicalTrials.govNCT03873740.

Molecular characterization of measles viruses in China: Circulation dynamics of the endemic H1 genotype from 2011 to 2017.

Due to the Expanded Program on Immunization (EPI) and supplementary immunization activities (SIAs) in China, the incidence of measles in China has decreased extensively. The incidence reached its lowest levels in contemporary history in 2012 and 2017, with incidence rates of 4.6 and 4.3 per million population, respectively. However, more than 147,000 measles cases were reported from 2013 to 2016. Furthermore, the proportions of cases in infants < 8 months and adults have been increasing since 2013, representing a considerable challenge for measles elimination in China. A total of 14,868 measles viruses were isolated from confirmed measles cases from 2011 to 2017, of which 14,631 were identified as the predominant endemic genotype, H1; 87 were identified as genotype A viruses that were vaccine associated strains; and 150 were identified as non-H1 genotype viruses. The non-H1 genotype viruses included 62 D8 viruses, 70 D9 viruses, 3 D11 viruses, 14 B3 viruses, and 1 G3 virus, which were identified as imported or import-related viruses that caused sporadic cases or small outbreaks. Most of the transmission chains detected during the period 2011-2012 were interrupted and were followed by many new transmission chains of unknown origin that spread, causing a large measles resurgence in China during 2013-2016. After 4 years of measles resurgence and continuous implementation of the routine immunization program and SIAs, the population immunity reached a sufficiently high level to interrupt most of the transmission chains; only a few strains survived, which continued to be sporadically detected in China in 2017. In the present study, the results from the combined epidemiological and molecular virological data demonstrated the great progress towards measles elimination in China by the further analysis of circulation dynamics for the endemic H1 genotype measles virus from 2011 to 2017. And this study accumulated critical baseline data on circulating wild-type measles viruses in China and provides comprehensive information to the world. These comprehensive baseline data provide evidence to support measles elimination in the future, not only in China but also in other countries worldwide. In addition, the information will be very useful to other countries for tracing their sources of measles cases and for identifying transmission links, which can help prevent potential measles outbreaks.

Association of the polymorphisms of MTHFR C677T, VDR C352T, and MPO G463A with risk for esophageal squamous cell dysplasia and carcinoma.

BACKGROUND: From January 2004 to December 2006 a program of endoscopic screening for esophageal lesions was carried out in the high incidence area of esophageal cancer in Feicheng County, China. It provided the samples to evaluate the association of polymorphisms of methylenetetrahydrofolate reductase (MTHFR) C677T, vitamin D receptor (VDR) C352T, and myeloperoxidase (MPO) G463A genotypes with esophageal squamous cell dysplasia and carcinoma. METHODS: The subjects in the study were divided into 127 dysplasia cases, 126 squamous cell carcinoma cases, and 169 normal controls. Analyses of the MTHFR C677T, VDR C352T, and MPO G463A genotypes were performed using the PCR-restriction fragment length polymorphism (RFLP) method, whereas the multinomial logistic regression model was used in the data analysis to assess the odds ratios (ORs) related to dysplasia and carcinoma. RESULTS: Compared with the CC genotype of MTHFR C677T, the TT/TC of the genotype significantly increased the risk of the esophageal squamous cells dysplasia [OR, 2.25; 95% confidence interval (CI), 1.18-4.31]; the OR of esophageal squamous cancer was 1.58 (95% CI, 0.85-2.97) after adjustments for age, sex, and years of education. There was an interaction between the TT/TC genotype and alcohol drinking, smoking, and family history of esophageal cancer in the risk of esophageal dysplasia and carcinoma. CONCLUSIONS: Neither the VDR C352T nor the MPO G463A genotype had manifested association with the dysplasia and carcinoma of the disease, whereas the MTHFR 677TT genotype may be a genetic risk factor for esophageal dysplasia and carcinoma.

[The distribution of the pre-cancerous condition and pathological changes of esophageal cancer of the community residents in high-incidence area].

OBJECTIVE: To observe the distribution of the pre-cancerous condition and pathological changes of esophageal cancer of the community residents in high-incidence area, and to provide etiological evidences for secondary prevention. METHODS: An iodine-staining endoscope census was conducted in 9536 residents with high-risk factors at Feicheng, a high esophageal cancer incidence community in Shandong province. Of which, 1507 pathologic biopsies were performed and chi2 test administrated. RESULTS: There was no statistical significance found in biopsy pathologic diagnosis between females and males among 1507 samples. The mild and medium atypical hyperplasia was taken as pre-cancerous condition and severe atypical hyperplasia was taken as pre-cancerous lesion. Taking all the population attending census as denominator, the detection rate of the precancerous state and precancerous lesion were 6.98% (294/4214) and 1.23% (52/4214) for the males, and 3.68% (196/5322) and 0.47% (25/5322) for the females, respectively. A statistical significance was observed when comparing males with females (chi2 were 52.349 and 15.267, respectively, P < 0.05). Analyzed by age group, severe atypical hyperplasia pathological changes were mainly distributed in the age group of 50- and 65-. The constituent ratio between 45 - and 50 - was the highest for CIS. Early carcinoma was mainly distributed in five age groups from 45- to 65-. It showed that high incidence town had a high detection rate of cancer and pathological changes of esophageal cancer in the analysis of urban and rural distribution. CONCLUSION: The distribution of the pre-cancerous state and pathological changes of esophageal cancer of the residents should have provided a scientific basis for the primary and secondary prevention.

Relation between plasma oxLDL antibodies and oxLDL in the circulation.

OBJECTIVES: To investigate the possible relationship between circulating oxLDL and oxLDL Ab concentrations in order to better understand the role of oxLDL Ab in atherosclerosis. DESIGN: In a cross-sectional study of 86 patients undergoing ultrasonographic scanning of the carotid artery, concentration of circulating oxLDL and oxLDL Ab were determined by ELISA. For multivariate analysis, we also measured many conventional cardiovascular risk factors. Spearman's rank correlation test and chi-square test were used to evaluate the correlation between circulating oxLDL and oxLDL Ab. A stepwise multiple regression analysis and Logistic regression analysis were used to study the influencing factors. RESULTS: There was no linear correlation between circulating oxLDL and oxLDL Ab. Circulating oxLDL was influenced by HDL, systolic blood pressure and body mass index, while only TC was independent factor associating with oxLDL Ab. CONCLUSIONS: The present study showed that oxLDL was present at a low concentration in the circulation, and that plasma oxLDL had no linear correlation with oxLDL antibodies. However, the issue still needs further study.

Prevalence and risk factors of trichomoniasis, bacterial vaginosis, and candidiasis for married women of child-bearing age in rural Shandong.

The aim of this study was to examine the prevalence rates and risk factors for reproductive tract infections (RTIs) among married women of reproductive age in a rural area of Shandong Province in China. A population-based cohort of 4,039 married women of reproductive age was cluster-randomly selected from the local birth control registry. All subjects underwent clinical and microbiological tests and an interview in the form of a standardized questionnaire. The prevalences of trichomoniasis, bacterial vaginosis (BV), and candidiasis as diagnosed by clinical tests were 2.8, 5.9, and 3.1%, respectively. The infection rates of Trichomonas, BV, and Candida were 2.9, 6.6, and 3.9%, respectively. The infection rates of gonorrhea and syphilis were low and no cases of HIV infection were found. After adjustment for confounding factors the risk factors for trichomoniasis were income higher than $200, lack of knowledge about sexually transmitted diseases, and marriage to a businessmen. For candidiasis the risk factors were three or more abortions, income higher than $200, age of 30-39 years, and women with extramarital sex partner(s). For BV the risk factors were three or more abortions and age of 30-39 years. The prevalence of RTI/sexually transmitted infection (STI) and the risk behavior observed in this study indicate a need for primary programs to prevent the increase of RTI/STI and HIV infections in rural areas.

Role of serum angiopoietin-2 level in screening for esophageal squamous cell cancer and its precursors.

BACKGROUND: Angiopoietin-2 (Ang-2) is one of the critical regulators of tumor angiogenesis. Studies have shown a significant correlation of Ang-2 expression to tumor invasion and metastasis in various human cancers, but little is known about the serum Ang-2 (sAng-2) levels in esophageal squamous cell cancer (ESCC) and its precursors. In this study, we aimed to investigate its role in screening for ESCC and its precursors. METHODS: We carried out a free endoscopic screening in Feicheng City, a high ESCC incidence area in Shandong Province of China. Serum samples were collected as follows: 91 from normal subjects, 44 from patients with esophagitis, 85 from patients with hyperplasia, and 13 from patients with early ESCC. In addition, 28 serum samples were obtained from patients with invasive ESCC undergoing surgery in People's Hospital of Feicheng City. All the subjects of the five groups were diagnosed by histopathology. The sAng-2 levels were tested and compared, and the diagnostic power in early or/and invasive ESCC was calculated in terms of sensitivity and other parameters. RESULTS: The sAng-2 levels were (22.0 +/- 5.5), (21.3 +/- 3.2), (20.5 +/- 3.3), (24.0+/- 5.0), and (29.8 +/- 5.0) U/ml in normal, esophagitis, hyperplasia, early ESCC, and invasive ESCC groups respectively. It was significantly higher in early ESCC than inhyperplasia group (P = 0.009). The invasive ESCC group showed the highest Ang-2 level among all groups (all P = 0.000). The sensitivities of sAng-2 to early and invasive ESCC were 23.1% and 78.6% respectively. CONCLUSION: sAng-2 level is related to carcinogenesis and progression of ESCC, but it can not be used to screen for early ESCC.

[The risk factors related to esophageal squamous cell cancer in Feicheng county, China].

OBJECTIVE: To investigate the risk factors related to the esophageal squamous cell cancer in Feicheng county in Shandong province. METHODS: A case-control study was carried out in Feicheng county. There were two parts consisted in the cases. 253 cases, aged from 40 to 69 years old, were recruited from the screened endoscopic survey program from January 2004 to December 2006. The other part of cases was recruited from the people's Hospital of Feicheng city. 8159 subjects whose had normal endoscope test result were recruited as the control group. Besides cardiograph and ventral ultrasound examination the screening program also included an endoscope test during which mucosal stain with 1.2% iodine solution. The biopsies were taken from the screen and underwent pathologic evaluation by two pathologists; A self-administrative questionnaire survey was conducted in all the subjects to collect information about smoking, alcohol consumption and dietary. The binary Logistic regression was used to estimate odds ratio (OR) and 95% confidence interval (95% CI). The study protocol was approved by the local ethics committee and the study was conducted with the informed consents of all the study subjects. RESULTS: There were 235 esophageal cancers cases (70 identified in screening program, 183 were hospitalized patients) and 8159 controls in the case-control study. Three potential confounders were detected after univariate analysis. After adjusted the three confounders, age, sex and education, we found, smoking, alcohol drinking were the top ranked risk factors for esophageal cancer. When combing smoking and alcohol drinking, the or was 2.73 (95% CI: 1.54 - 4.82) for male, and the proportional attribute relative risk was 51.47%. We also observed that more dietary cellulose and vitamin C intake have protective effects. CONCLUSION: Smoking and alcohol drinking could increase the risk of esophageal cancer, and taking more dietary cellulose and vitamin C might decrease the risk.

Progress towards rubella elimination after implementation of rubella immunization for over 20 years in Shandong province, China.

The rubella vaccine has been included in the immunization program in Shandong province of China since 1995. Here we observed the rubella vaccine coverage, epidemiology, serosurvey, and virological surveillance data, in order to identify the challenges impeding the progress towards to its elimination following the implementation of rubella immunization over a 21-year period in Shandong province. We first noted that the annual increase in vaccination coverage resulted in decreased rate of rubella incidence, which was maintained at a low level. Second, the average age of rubella patients had shifted to the 15-29-year age group, making this group the main population affected by the rubella virus (RV). Third, more than 90% of the study population were immune to rubella. However, the positive rate of rubella IgG in some cities was relatively lower indicating that an insufficient proportion of individuals had been vaccinated. Finally, the transmission of the genotype 1E RV was gradually interrupted due to the implementation of rubella vaccination. Unfortunately, the endemicity of the imported genotype 2B RV was established due to the pockets with unvaccinated people. Therefore, comprehensive vaccination coverage of the population, combined with high quality monitoring of rubella, is necessary to achieve the rubella elimination goal.

Mumps Epidemiology and Mumps Virus Genotypes Circulating in Mainland China during 2013-2015.

With the implementation of mumps virus (MuV) vaccination in the expanded program on immunization (EPI) in mainland China since 2008, the incidence of mumps has decreased, and the natural epidemic pattern of mumps has slightly changed during 2013-2015. The two epidemic peaks (April-July and November-December) became less obvious than those observed from 2004 to 2012. Children and adolescents younger than 15, particularly in the five-to-nine-year-old age group, remain the target group and should be the focus of high-quality immunization activities in mainland China. However, it was also found that the incidence and reported cases of mumps decreased in each age group during 2013-2015, particularly in the five-to-nine-year-old and ten-to-fourteen-year-old age groups. The proportion of mumps cases among adults in some provinces also increased. Unlike the changes in the epidemiological characteristics of mumps affected by vaccination, the data of MuV virology surveillance indicated that most of the MuV transmission chains have not yet been effectively interrupted, and MuV remains a natural epidemic pattern in mainland China. In the MuV virology surveillance, 194 MuV strains during 2013-2015 were isolated from 10 of 31 provinces in mainland China. Based on the phylogenetic analysis of the small hydrophobic (SH) gene, both genotype F (99.0%) and G (1.0%) were identified, and genotype F was still the predominant genotype continuously circulating in mainland China. Representative genotype F and G strains isolated in China from 1995 to 2012 were selected for further analysis. The results indicated that there were multiple transmission chains within genotype F, with no obvious geographical or time differences. The high genetic diversity of genotype F strains could be a result of the continuous transmission and evolution of the MuV in mainland China. Genotype G was also detected in four provinces in mainland China. Because of the limited epidemiological data, it was uncertain whether the genotype G MuV strains found in 2011 and 2013 were imported from other countries. Therefore, combined high-quality epidemiological and virological surveillance is necessary for mumps control; it can also be used to observe the changes in epidemiological characteristics and viral transmission of mumps over time after mumps-containing vaccine (MuCV) implementation and to provide a comprehensive epidemiological and genetic baseline for mumps elimination in mainland China.

[Genetic Characteristic Analysis of H Gene among Four Genotypes of MeasIes Viruses Isolated in Mainland China during 2013-2014].

To study the genetic characterization and amino acid mutation of hemagglutinin protein of four genotypes of wild type measles Viruses isolated in 2013 and 2014year,in China, including H1,B3,D8 and D9.Four genotype isolates of H1,D8,D9 and B3measles viruses were selected, and RNA of MV isolates were extracted. The complete sequence of hemagglutinin (1854nt) were amplified by RT-PCR and sequenced and Sequencher5.0was used to splice sequence. Phylogenetic analysis and the diversity of gene and amino acid were done by MEGA version 5.0,compared with 24 representative strains, repectively 4 H a sub-genotype strains,8D8 genotype strains,2D9 genotype strains,8B3 genotype strains and 2Chinese vaccine Strains, which were downloaded from GenBank. The homology of H gene nucleotide sequence and amino acid between the four genotype measles virus strains including H1,B3,D8,D9 and A genotype strains were respectively 94.2%-96.7%and 95.4%-96.7%and there were 20-28 amino acids difference between them; And the homology of H gene nucleotide sequence between Beijing14-1(H1a)and A genotype vaccine strains was 97.7%-98.2%.The N-glycosylation site in 240th was losen because of mutation. The homology of H gene nucleotide sequence and amino acid between the four genotype measles virus strains including H1,B3,D8,D9 and A genotype strains were high, and the Chinese vaccine can effectively prevent infection caused by H1asub-genotype,D8,D9 and B3imported genotypes virus strains.

The first measles outbreak caused by imported genotype D9 measles virus in Shandong Province, China, 2013.

This study represents a measles outbreak caused by the genotype D9 measles virus (MeV), which was imported by Burmese individuals. Urine and throat swab specimens were collected from suspected measles cases. Viruses were isolated, and a 634-bp target fragment of the N gene was amplified by reverse transcription-PCR and sequenced. Phylogenetic results indicated that the 6 isolates belonged to genotype D9 MeV. Through appropriate prevention and control measures, the transmission of genotype D9 MeV was interrupted. Genotype D9 MeV was isolated for the first time in Shandong and was imported by Burmese individuals.

Epidemiologic and genetic characteristics of mumps viruses isolated in China from 1995 to 2010.

The epidemiologic and genetic characteristics of mumps viruses detected in China from 1995 to 2010 were analyzed in this study. Mumps remains endemic in China with a high overall incidence rate. The incidence of mumps in Western China was higher than that in other regions of the country. Each year, most of mumps cases occurred between April and July, but a small peak also occurred in November and December. Mumps cases primarily affected the under 15 year old age group. Virologic data demonstrated that genotype F was the predominant circulating genotype throughout China for at least 15 years and no other genotype was detected between 1995 and 2010. Analysis of sequence data from the small hydrophobic (SH) gene indicated that multiple transmission chains of genotype F were found in various provinces of China, with no apparent chronologic and geographic restriction. This is the first report describing the epidemiology of mumps and genetic characterization of mumps viruses at the national level in China.

[Economic burden and related factors on inpatients with HBV-related diseases in Shandong province].

OBJECTIVE: To investigate the economic burden of patients with acute and chronic hepatitis B, cirrhosis and liver cancer caused by hepatitis B virus (HBV). METHODS: Cluster sampling was used on cases consecutively collected during the study period. Questionnaire survey was conducted and information on the expenses during hospitalization was collected from the hospital records and through interviewing those patients. RESULTS: Yearly costs related to patients with acute hepatitis B, severe hepatitis B, chronic hepatitis B, cirrhosis, hepatocellular carcinoma were 66.7, 138.1, 127.4, 151.7 and 377.2 thousand Yuan, respectively. RESULTS: from multiple linear regression model showed that the type of medical insurance scheme, annual days of hospitalization, classifications of HBV-related diseases and personal income were major influencing factors on the cost. CONCLUSION: HBV infection caused considerable burden to families and the society, indicating that HBV infection control programs would bring huge potential benefits. The reform of insurance scheme should be administrated to promote social fairness.

Varicella vaccine uptake in Shandong Province, China.

Varicella vaccine has been licensed in China for decade to be used as single dose in children aged ≥ 12 mo of age in private sector. Little data were available on varicella uptake to date in China yet. A cross-sectional study was conducted in Shandong Province in May 2011 to examine varicella vaccination coverage among children aged 16-40 mo and examine factors associated with varicella vaccine uptake. The overall coverage among children eligible for varicella vaccine was 62% (range 16.7-94.7% by county), much lower than the coverage of the eight vaccines included in the national immunization program (all above 97%). Though proximity to immunization services (< 5 km) was linked with higher vaccine uptake (62.6 vs. 37.4%, p = 0.02), county-level economic development (77.8, 61.0 and 47.1% for developed, sub-developed and developing regions, respectively, p < 0.001) played an even more important role in varicella vaccination. Moreover, there was little variation in coverage of vaccines included in the national immunization program along with county-level economic development. Even though varicella vaccine uptake is relatively high for use on a private basis, the vaccination coverage is not high enough to prevent epidemiology shift to adolescents and adults who are more prone to develop severe outcomes to varicella. Further enhancement on varicella vaccination coverage is necessary and inclusion to national immunization program seems to be a promising option for achieving and maintaining high coverage.

Rubella epidemics and genotypic distribution of the rubella virus in Shandong Province, China, in 1999-2010.

BACKGROUND: The rubella vaccine was introduced into the immunization program in 1995 in the Shandong province, China. A series of different rubella vaccination strategies were implemented at different stages of measles control in Shandong province. METHODOLOGY/PRINCIPAL FINDINGS: The average reported incidence rate of rubella cases remained at a low level in Shandong province after 1999. However, rubella epidemics occurred repeatedly in 2001/2002, 2006, and 2008/2009. The age of the onset of rubella cases gradually increased during 1999-2010, which showed that most cases were found among the 10 years old in 1999 and among the 17 years old in 2010. Phylogenetic analysis was performed and a phylogenetic tree was constructed based on the World Health Organization standard sequence window for rubella virus isolates. All rubella viruses isolated in Shandong province were divided into 4 genotypes: 1E, 1F, 2A, and 2B. Genotype 1E viruses accounted for the majority (79%) of all these viruses. The similarity of nucleotide and amino acid sequences among genotype 1E viruses was 98.2-100% and 99.1-100%, respectively. All Shandong genotype 1E strains, differed from international genotype 1E strains, belonged to cluster 1 and interdigitated with the viruses from other provinces in mainland China. The effective number of infections indicated by a bayesian skyline plot remained constant from 2001 to 2009. CONCLUSIONS/SIGNIFICANCE: The gradual shift of disease burden to an older age group occurred after a rubella-containing vaccine was introduced into the childhood immunization schedule in 1995 in Shandong province. Four genotypes, including 1E, 1F, 2A, and 2B, were found in Shandong province during 2000-2009. Genotype 1E, rather than genotype 1F, became the predominant genotype circulating in Shandong province from 2001. All Shandong genotype 1E viruses belong to the genotype 1E/cluster 1; they have constantly circulated, and co-evolved and co-circulated, with those from other provinces.

Single endemic genotype of measles virus continuously circulating in China for at least 16 years.

The incidence of measles in China from 1991 to 2008 was reviewed, and the nucleotide sequences from 1507 measles viruses (MeV) isolated during 1993 to 2008 were phylogenetically analyzed. The results showed that measles epidemics peaked approximately every 3 to 5 years with the range of measles cases detected between 56,850 and 140,048 per year. The Chinese MeV strains represented three genotypes; 1501 H1, 1 H2 and 5 A. Genotype H1 was the predominant genotype throughout China continuously circulating for at least 16 years. Genotype H1 sequences could be divided into two distinct clusters, H1a and H1b. A 4.2% average nucleotide divergence was found between the H1a and H1b clusters, and the nucleotide sequence and predicted amino acid homologies of H1a viruses were 92.3%-100% and 84.7%-100%, H1b were 97.1%-100% and 95.3%-100%, respectively. Viruses from both clusters were distributed throughout China with no apparent geographic restriction and multiple co-circulating lineages were present in many provinces. Cluster H1a and H1b viruses were co-circulating during 1993 to 2005, while no H1b viruses were detected after 2005 and the transmission of that cluster has presumably been interrupted. Analysis of the nucleotide and predicted amino acid changes in the N proteins of H1a and H1b viruses showed no evidence of selective pressure. This study investigated the genotype and cluster distribution of MeV in China over a 16-year period to establish a genetic baseline before MeV elimination in Western Pacific Region (WPR). Continuous and extensive MeV surveillance and the ability to quickly identify imported cases of measles will become more critical as measles elimination goals are achieved in China in the near future. This is the first report that a single endemic genotype of measles virus has been found to be continuously circulating in one country for at least 16 years.

Relationship between oxidized LDL antibodies and different stages of esophageal carcinoma.

BACKGROUND: The aim of the study was to evaluate the association of antibodies against oxidized low-density lipoproteins (oxLDL-Ab) with esophageal carcinogenic progression. METHODS: All 40- to 69-year-old residents from Feicheng were screened for esophageal lesions by endoscopic staining with 1.2% iodine solution combined with pathological evaluations. In this study there were 33 controls with normal esophageal squamous epithelium cells, 37 patients with basal cell hyperplasia, 47 with esophageal squamous cell dysplasia, and 43 with esophageal squamous cell carcinoma (ESCC). OxLDL-Ab was determined by ELISA. Total cholesterol (TC), high-density lipoproteins (HDL), triglycerides, serum albumin and blood pressure were co-estimated. Analysis of covariance (ANCOVA) was used when comparing oxLDL-Ab among the four groups to control the influence of covariates. Cumulative logistic model was applied to study the influencing factors for the multistage development of esophageal carcinoma. RESULTS: The level of oxLDL-Ab decreased gradually along with the different stages of esophageal carcinogenic progression, with the ESCC group being the lowest after controlling for possible covariates. Cumulative logistic model showed that oxLDL-Ab had a negative correlation with the development of esophageal carcinoma. LDL, HDL, and TC were also decreased in patients with ESCC. CONCLUSIONS: Antibodies against oxLDL were decreased in patients with esophageal carcinoma. Although the unambiguous role of oxLDL-Ab needs further studies to elucidate, the results may give us some insight in the research of etiological factors for esophagael cancer in the future.