[Estimates of influenza-associated excess mortality by three regression models in Shanxi Province during 2013-2017].

Objective: Using three models too estimate excess mortality associated with influenza of Shanxi Province during 2013-2017. Methods: Mortality data and influenza surveillance data of 11 cities of Shanxi Province from the 2013-2014 through 2016-2017 were used to estimate influenza-associated all cause deaths, circulatory and respiratory deaths and respiratory deaths. Three models were used: (i) Serfling regression, (ii)Poisson regression, (iii)General line model. Results: The total reported death cases of all cause were 157 733, annual death cases of all cause were 39 433, among these cases, male cases 93 831 (59.50%), cases above 65 years old 123 931 (78.57%). Annual influenza-associated excess mortality, for all causes, circulatory and respiratory deaths, respiratory deaths were 8.62 deaths per 100 000, 6.33 deaths per 100 000 and 0.68 deaths per 100 000 estimated by Serfling model, respectively; and 21.30 deaths per 100 000, 16.89 deaths per 100 000 and 2.14 deaths per 100 000 estimated by General line model, respectively; and 21.76 deaths per 100 000, 17.03 deaths per 100 000 and 2.05 deaths per 100 000, estimated by Poisson model, respectively. Influenza-related excess mortality was higher in people over 75 years old; influenza-associated excess mortalityfor all causes, circulatory and respiratory deaths, respiratory deaths were 259.67 deaths per 100 000, 229.90 deaths per 100 000 and 32.63 deaths per 100 000, estimated by GLM model, respectively; and 269.49 deaths per 100 000, 233.69 deaths per 100 000 and 31.27 deaths per 100 000, estimated by Poisson model,respectively. Conclusion: Excess mortality associated with influenza mainly caused by A (H3N2), Influenza caused the most associated death amongold people.

Association between air pollution and upper respiratory tract infection in hospital outpatients aged 0-14 years in Hefei, China: a time series study.

OBJECTIVE: To investigate the association between air pollution and upper respiratory tract infection (URTI) in children aged 0-14 years in Hefei, China in 2014-2015. STUDY DESIGN: An ecological method (i.e. generalised additive model [GAM]) was used to explore the effects of air pollutants on paediatric hospital outpatients with URTI. METHODS: GAM was used to evaluate the lag effects (including lag0 to lag6, lag01 and lag06) between daily changes in particulate matter (PM10), fine particulate matter (PM2.5), sulphur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3) and carbon monoxide (CO) and the number of hospital outpatients with URTI in 2014-2015, after controlling for the confounding effects of long-term trends, seasonality, day of the week, public holidays and meteorological factors. RESULTS: PM10, PM2.5, SO2, NO2 and CO in the single-pollutant models had significant positive effects on the number of paediatric hospital outpatients with URTI. It was found that per 10 µg/m3 increasing in concentrations of PM10 at lag3, PM2.5, SO2, NO2 and CO at lag06 were associated with an increase of Excess risk (ER) with 0.15% (95% CI: 0.07%∼0.23%), 0.38% (95% CI: 0.17%∼0.60%), 2.92% (95% CI: 1.88%∼3.97%), 4.47% (95% CI: 3.69%∼5.25%) and 0.05% (95% CI: 0.02%∼0.08%), respectively. Only NO2 remained significantly positively associated with the number of hospital outpatients with URTI in the full-pollutant models, and ERs were 4.72% (95% CI = 3.76%-5.69%) and 4.70% (95% CI = 3.76%-5.65%) per 10 µg/m3 increase in NO2 in Model 1 (including PM10, SO2, NO2, O3 and CO) and Model 2 (including PM2.5, SO2, NO2, O3 and CO), respectively. CONCLUSION: This study showed that short-term exposure to air pollution was associated with increased risk of URTI among paediatric hospital outpatients aged 0-14 years in Hefei. NO2 was the major air pollutant affecting the daily number of paediatric hospital outpatients with URTI.

[Epidemiological characteristics and risk factors of primary intussusception in children among two years old and below, Ji'nan city].

Objective: To study the epidemiological characters and risk factors of primary intussusception among children who were ≤2 years old in Jinan city. Methods: A retrospective study was also applied to collect the disease information of inpatient cases through hospital information system of inpatient during 2011 and 2015. The attack rate (AR) was calculated in total and each year, respectively. 1∶(1) matched pared case-control study was conducted to explore the risk factors of primary intussusception. A total of new confirmed 93 residential cases were enrolled with ≤2 years old, diagnosed as primary intussusception or diseases coded as K56.1 according to the International Classification of Diseases, tenth version (ICD-10), and without any other reason for organic lesions. The 93 patients without primary intussusception inpatients were selected from the same hospital and departments as the controls, and matched with the cases as the same gender, ±3 months old, and disease onset within 7 days, visiting the hospital during January 1, 2016 and June 30, 2016. Clinical and epidemiological information was collected both from cases and controls. The difference of AR among different years was compared by Trend Chi-squiare test, and difference between gender, month old and regions was compared by Chi-squiare test, respectively. Multiple-variables factor analysis was applied to analysis the risk factors of cases compared with controls by conditional logistic regression model. Results: A total of 574 cases were found and the overall AR was 86.3 per 100 000. A significant decreasing trend (χ(2trend)=23.43, P<0.001) of AR was showed between 2011 and 2015, with the highest AR in 2011 (117.6 per 100 000), and the lower AR in 2014 (66.0 per 100 000). The lowest AR was also observed in male (106.9 per 100 000) compared with the female (63.2 per 100 000) (χ(2)=13.76, P<0.001), and in ≤12 months old (102.1 per 100 000) compared with the >12 months old (70.4 per 100 000) (χ(2)=19.46, P<0.001). The higher proportion of 57.1% (328/574) was found in 4-12 months old cases. The cases with an overweight before illness (OR=4.98, 95%CI: 1.27-19.50), with mixed feeding of breast-milk and milk-powder (OR=16.90, 95%CI: 5.25-54.20), and with instruction of solid food before 6 months old (OR=16.50, 95%CI: 1.91-143.10) could increase the risk of illness compared with keeping a healthy weight, breast feeding, and instruction of solid food after 6 months old, separately. Conclusion: A higher attack rate of primary intussusception in children with a ≤2 years old in Jinan was observed. Male and 4-12 months group had a higher risk. Body weight, breast feeding, and the instruction of solid food before and after 6 months old were related to the risk of primary intussusception among children who were ≤2 years old.

[Association between ambient PM(l0)/PM(2.5) concentration and outpatient department visits due to respiratory disease in a hospital in Jinan, 2013-2015: a time series analysis].

Objective: To estimate the influence of the ambient PM(l0) and PM(2.5) pollution on the hospital outpatient department visit due to respiratory diseases in local residents in Jinan quantitatively. Methods: Time serial analysis using generalized addictive model (GAM) was conducted. After controlling the confounding factors, such as long term trend, weekly pattern and meteorological factors, considering lag effect and the influence of other air pollutants, the excess relative risks of daily hospital visits associated with increased ambient PM(10) and PM(2.5) levels were estimated by fitting a Poisson regression model. Results: A 10 µg/m(3) increase of PM(10) and PM(2.5) levels was associated with an increase of 0.36%(95%CI: 0.30%-0.43%) and 0.50%(95%CI: 0.30%-0.70%) respectively for hospital visits due to respiratory diseases. Lag effect of 6 days was strongest, the excess relative risks were 0.65% (95% CI: 0.58% -0.71% ) and 0.54% (95% CI: 0.42%-0.67%) respectively. When NO(2) concentration was introduced, the daily hospital visits due to respiratory disease increased by 0.83% as a 10 µg/m(3) increase of PM(10) concentration (95% CI: 0.76%-0.91%). Conclusion: The ambient PM(l0) and PM(2.5) pollution was positively associated with daily hospital visits due to respiratory disease in Jinan, and ambient NO(2) concentration would have the synergistic effect.

Identification of amino acid residues involved in hemin binding in Porphyromonas gingivalis hemagglutinin 2.

Porphyromonas gingivalis (P. gingivalis) is a major etiological agent in the development and progression of chronic periodontitis. It produces cysteine proteases (gingipains), including a lysine-specific gingipain and two arginine-specific gingipains. Heme binding and uptake are fundamental to the growth and virulence of P. gingivalis. The recombinant hemagglutinin 2 domain (rHA2) of gingipain binds hemin with high affinity. The aim of the present work was to identify the key residues involved in its hemin-binding activity. A functional rHA2 was expressed and bound to hemin-agarose, and then digested with endopeptidases. The peptides bound to hemin-agarose were identified by mass spectrometry and the amino acids were assessed by mutation and peptide binding inhibition analysis. The DHYAVMISK sequence was identified in peptides derived from both Asp-N and Lys-C endopeptidase digestions of rHA2. A monoclonal antibody, mAb QB, was produced and its epitope was associated with the DGFPGDHYAVMISK peptide within the HA2 domain. Hemin was shown to competitively inhibit the immunoreactivity of rHA2 or the peptide to mAb QB. The peptide DHYAVMISK inhibited hemin-binding activity; although, this inhibition was not seen when the peptide contained the H1001E mutation (DEYAVMISK). Based on these results, we propose that residue His1001 is involved in the hemin-binding mechanism of the P. gingivalis rHA2 and the peptide containing this residue, DHYAVMISK, may be an inhibitor of hemin binding.