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Objective To analyze the genetic characteristics of mumps virus ( MuV) isolated from an outbreak in Henan province in 2016 and to provide reference data for the control of mumps in Henan prov-ince. Methods Swab specimens were collected from a mumps outbreak in Henan province in 2016. One virus strain was selected for whole genome sequencing after virus isolation and genotyping. MEGA7. 0 soft-ware was used to construct phylogenetic tree, to calculate P-distance and to analyze the characteristics of genes encoding small hydrophobic protein ( SH ) , fusion protein ( F ) and hemagglutinin neuraminidase ( HN) . Results Five swab specimens were collected in the outbreak and five MuV strains were successfully obtained. Phylogenetic analysis showed that all of them belonged to genotype F with a P-distance of 0. 047 (0. 046-0. 049 ) with the reference strain. The P-distance among the five MuV strains was 0. 001 ( 0-0. 003). Results of the whole genome sequencing of one MuV strain showed that the P-distance with the ref-erence virus was 0. 053 (0. 018-0. 072) and the smallest P-distance with genotype F was 0. 018. Compared with the vaccine strain (HQ416907. 1), the amino acid at 28-30 site of SH protein was IML. The 91, 195 and 383 amino acid sites in F protein were related to the pathogenicity of MuV, but no mutations were found in these sites. Some mutations were found in HN protein, such as P354Q, E356D and K464N, which were associated with the immunological characteristics of MuV. Conclusions MuV strains isolated from the out-break in Henan province in 2016 belonged to genotype F. The genetic characteristics of these MuV strains were similar to those prevalent in other provinces of China.
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Objective@#Analyze the genetic characteristic of Hemagglutinin(H) gene of measles viruses isolated in Henan Province in 2017.@*Methods@#Swab samples collected from 7 lab confirmed measles cases, and we got the measles virus by Vero/Slam inoculation. Fragment of H genes were amplified by reverse transcription polymerase chain reaction(RT-PCR), then the PCR products were sequenced and analyzed.@*Results@#The age of the 7 measles confirmed cases were between 1 and 50 years old, and all of them were males. All the 7 measles viruses were identified as H1a genotype, and the average distance of the nucleotides and the amino acids was 0.005, respectively. Compared with the Shanghai-191/China-vaccine, there were some changes in isolated virus, such as 240th, 397th and 381st sites in the amino acid sequence.@*Conclusion@#The measles genotype which isolated in Henan Province in 2017 was H1a. There were some difference from Shanghai-191/China-vaccine in the nucleotides sequence of H gene, which suggested that it′s necessary to strengthen the monitor the variation of measles virus.
ABSTRACT
Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and its complications.Currently,China has licensed trivalent (IIV3) and quadrivalent inactivated influenza vaccine (IIV4),including split-virus influenza vaccine and subunit vaccine.In most parts of China,influenza vaccine is a category Ⅱ vaccine,which means influenza vaccination is voluntary,and recipients need to pay for it.To strengthen the technical guidance for prevention and control of influenza and the operational research on influenza vaccination in China,the National Immunization Advisory Committee (NIAC),Influenza Vaccine Technical Working Group (TWG),updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)",based on most recent existing scientific evidences.The main updates include:epidemiology and disease burden of influenza,types of influenza vaccines,northern hemisphere influenza vaccination composition for the 2018-2019 season,and,IIV3 and IIV4 vaccines' major immune responses,durability of immunity,immunogenicity,vaccine efficacy,effectiveness,safety,cost-effectiveness and cost-benefit.The recommendations include:Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications.No preferential recommendation is made for any influenza vaccine product for persons who can accept ≥ 1 licensed,recommended,and appropriate products.To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups,the recommendations prioritize seasonal influenza vaccination for children aged 6-60 months,adults ≥60 years of age,persons with specific chronic diseases,healthcare workers,the family members and caregivers of infants ＜6 months of age,and pregnant women or women who plan to pregnant during the influenza season.Children aged 6 months to 8 years old require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection.If they were vaccinated in previous influenza season,1 dose is recommended.People ≥ 9 years old require 1 dose of influenza vaccine.It is recommended that people receive their influenza vaccination by the end of October.Influenza vaccination should be offered as soon as the vaccination is available.Influenza vaccination should continue to be available for those unable to be vaccinated before the end of October during the whole season.Influenza vaccine is also recommended for use in pregnant women during any trimester.These guidelines are intended for CDC members who are working on influenza control and prevention,PoVs members,healthcare workers from the departments of pediatrics,internal medicine,and infectious diseases,and members of materuity and child care institutions at all levels.
ABSTRACT
Influenza can be prevented through annual appropriate vaccination against the virus concerned.In China,influenza vaccine is categorized as "Class Ⅱ " infectious diseases which the cost is paid out of the user's pockets.The annual coverage of influenza vaccination had been 2％-3％.The main reasons for the low coverage would include the following factors:lacking awareness on both the disease and vaccine,poor accessibility of vaccination service,and the cost of vaccination.To reduce the health and economic burden associated with influenza,comprehensive policies should be improved,targeting the coverage of seasonal influenza vaccination.These items would include:① Different financing reimbursement schemes and mechanisms to improve the aspiration on vaccination and on the vaccine coverage in high-risk groups,as young children,elderly,people with underlying medical conditions;② to ameliorate equality of vaccination services;③ to improve knowledge of the health care workers (HCWs) and the public on influenza and related vaccines;④ to improve clinical and preventive medical practice and vaccination among HCWs through revising clinical guidelines,pathway and consensus of experts;⑤ to provide more convenient,accessible and normative vaccination service system;⑥ to strengthen research and development as well as marketing on novel influenza vaccines;⑦ to revise items regarding the contraindication for influenza vaccine on pregnancy women,stated in the Chinese Pharmacopoeia.
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Objective To standardize the reporting system on hepatitis B in order to improve the quality of monitoring program in Henan province.Methods A total of 6 sites of Hepatitis B pilot surveillance were selected in Xinzheng of Zhengzhou city,Linzhou of Anyang city,Shanyang district of Jiaozuo city,Shaoling district of Luohe city,Yongcheng of Shangqiu city,Pingqiao district of Xinyang city in Henan province.Subjects under study were those reported hepatitis B cases,from 2012 to 2016.Cases diagnosed in 2011 were chosen as controls.Data on classification of hepatitis B,time that HBsAg became positive and ALT value of the cases were analyzed annually.5 ml venous blood was collected and anti-HBc IgM confirmed test was made for those suspected acute cases on hepatitis B.Based on the 2016 data from the monitoring system,the incidence of acute hepatitis B in Henan province was estimated.Results The number of reported hepatitis B cases had declined in 6 sites of Hepatitis B pilot surveillance substantially.A total of 17 436 hepatitis B reported in 2011 but only 2 632 cases were reported in 2016,with a reduction of 84.90％(14 804/17 436) in these six monitoring sites.The number of unclassified hepatitis B cases also dropped sharply.In 2011,36.87％ of the cases were unclassified,but the figure reduced to 0.08％ in 2016,from the six sites.The rate on ALT detection also gradually improved.The rate of misdiagnosis on HBV carrier from hepatitis B almost disappeared.From 2013 to 2016,777 blood samples were collected from six pilot sites.29.34％ (228/777) of the blood samples were tested positive for anti-HBc IgM after confirmed by the hepatitis laboratory of the China Center for Disease Control and Prevention.Conclusions Since the development of the pilot surveillance program,the quality of reporting system on hepatitis B had been improved,as well as the accuracy of diagnosis.Rate on the accuracy of reporting on hepatitis B and the methods of testing should be improved at the monitoring sites.
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Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) and quadrivalent inactivated influenza vaccine (IIV4), including split-virus influenza vaccine and subunit vaccine. Except for a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients must pay for it. To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccine Technical Working Group (TWG), updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)" . The main updates in this version include: epidemiology, disease burden, types of influenza vaccines, northern hemisphere influenza vaccination composition for the 2018-2019 season, IIV3 and IIV4 immune response, durability of immunity, immunogenicity, vaccine efficacy, effectiveness, safety, cost-effectiveness and cost-benefit. The influenza vaccine TWG provided the recommendations for influenza vaccination for the 2018-2019 influenza season based on existing scientific evidence. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2017-2018 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels.
ABSTRACT
Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and its complications.Currently,China has licensed trivalent (IIV3) and quadrivalent inactivated influenza vaccine (IIV4),including split-virus influenza vaccine and subunit vaccine.In most parts of China,influenza vaccine is a category Ⅱ vaccine,which means influenza vaccination is voluntary,and recipients need to pay for it.To strengthen the technical guidance for prevention and control of influenza and the operational research on influenza vaccination in China,the National Immunization Advisory Committee (NIAC),Influenza Vaccine Technical Working Group (TWG),updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)",based on most recent existing scientific evidences.The main updates include:epidemiology and disease burden of influenza,types of influenza vaccines,northern hemisphere influenza vaccination composition for the 2018-2019 season,and,IIV3 and IIV4 vaccines' major immune responses,durability of immunity,immunogenicity,vaccine efficacy,effectiveness,safety,cost-effectiveness and cost-benefit.The recommendations include:Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications.No preferential recommendation is made for any influenza vaccine product for persons who can accept ≥ 1 licensed,recommended,and appropriate products.To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups,the recommendations prioritize seasonal influenza vaccination for children aged 6-60 months,adults ≥60 years of age,persons with specific chronic diseases,healthcare workers,the family members and caregivers of infants ＜6 months of age,and pregnant women or women who plan to pregnant during the influenza season.Children aged 6 months to 8 years old require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection.If they were vaccinated in previous influenza season,1 dose is recommended.People ≥ 9 years old require 1 dose of influenza vaccine.It is recommended that people receive their influenza vaccination by the end of October.Influenza vaccination should be offered as soon as the vaccination is available.Influenza vaccination should continue to be available for those unable to be vaccinated before the end of October during the whole season.Influenza vaccine is also recommended for use in pregnant women during any trimester.These guidelines are intended for CDC members who are working on influenza control and prevention,PoVs members,healthcare workers from the departments of pediatrics,internal medicine,and infectious diseases,and members of materuity and child care institutions at all levels.
ABSTRACT
Influenza can be prevented through annual appropriate vaccination against the virus concerned.In China,influenza vaccine is categorized as "Class Ⅱ " infectious diseases which the cost is paid out of the user's pockets.The annual coverage of influenza vaccination had been 2％-3％.The main reasons for the low coverage would include the following factors:lacking awareness on both the disease and vaccine,poor accessibility of vaccination service,and the cost of vaccination.To reduce the health and economic burden associated with influenza,comprehensive policies should be improved,targeting the coverage of seasonal influenza vaccination.These items would include:① Different financing reimbursement schemes and mechanisms to improve the aspiration on vaccination and on the vaccine coverage in high-risk groups,as young children,elderly,people with underlying medical conditions;② to ameliorate equality of vaccination services;③ to improve knowledge of the health care workers (HCWs) and the public on influenza and related vaccines;④ to improve clinical and preventive medical practice and vaccination among HCWs through revising clinical guidelines,pathway and consensus of experts;⑤ to provide more convenient,accessible and normative vaccination service system;⑥ to strengthen research and development as well as marketing on novel influenza vaccines;⑦ to revise items regarding the contraindication for influenza vaccine on pregnancy women,stated in the Chinese Pharmacopoeia.
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Objective To standardize the reporting system on hepatitis B in order to improve the quality of monitoring program in Henan province.Methods A total of 6 sites of Hepatitis B pilot surveillance were selected in Xinzheng of Zhengzhou city,Linzhou of Anyang city,Shanyang district of Jiaozuo city,Shaoling district of Luohe city,Yongcheng of Shangqiu city,Pingqiao district of Xinyang city in Henan province.Subjects under study were those reported hepatitis B cases,from 2012 to 2016.Cases diagnosed in 2011 were chosen as controls.Data on classification of hepatitis B,time that HBsAg became positive and ALT value of the cases were analyzed annually.5 ml venous blood was collected and anti-HBc IgM confirmed test was made for those suspected acute cases on hepatitis B.Based on the 2016 data from the monitoring system,the incidence of acute hepatitis B in Henan province was estimated.Results The number of reported hepatitis B cases had declined in 6 sites of Hepatitis B pilot surveillance substantially.A total of 17 436 hepatitis B reported in 2011 but only 2 632 cases were reported in 2016,with a reduction of 84.90％(14 804/17 436) in these six monitoring sites.The number of unclassified hepatitis B cases also dropped sharply.In 2011,36.87％ of the cases were unclassified,but the figure reduced to 0.08％ in 2016,from the six sites.The rate on ALT detection also gradually improved.The rate of misdiagnosis on HBV carrier from hepatitis B almost disappeared.From 2013 to 2016,777 blood samples were collected from six pilot sites.29.34％ (228/777) of the blood samples were tested positive for anti-HBc IgM after confirmed by the hepatitis laboratory of the China Center for Disease Control and Prevention.Conclusions Since the development of the pilot surveillance program,the quality of reporting system on hepatitis B had been improved,as well as the accuracy of diagnosis.Rate on the accuracy of reporting on hepatitis B and the methods of testing should be improved at the monitoring sites.
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Objective@#To explore the clinical useness of intraoperative functional neuronavigation and fluorescent indocyanine green(ICG) angiography as well as electrophysiological evaluation during microsurgical resection of cerebral arteriovenous malformations (AVM).@*Methods@#A series of 42 consecutive cases with AVM underwent microsurgery by intraoperative functional neuronavigation at Department of Neurosurgery of People′s Liberation Army General Hospital from January 2009 to February 2015 were retrospectively analyzed. Of the 42 patients, 29 were males and 13 were females aging from 4 to 62 years (mean age 32.6 years). Preoperative assessment included functional magnetic resonance imaging and diffusion tensor imaging to identify the relationship between lesions and eloquent areas. The results of images were integrated into three-dimensional datasets to achieve intraoperative microscopic-based functional neuronavigation during AVM resection. Operations involved in motor areas and corticospinal tract were performed under continuous electrophysiological monitoring. ICG angiography was performed at pre-dissection, post-clipping of the feeders, and post-resection of the nidus. FLOW 800 software presented a color map and ICG intensity-time curve to demostrate the vascular architecture. Postoperative digital subtraction angiography was re-examined routinely to evaluate the extent of resection. Clinical outcomes were evaluated with the modified Rankin Scale.@*Results@#All patients underwent surgery under intraoperative navigation. Of the 42 patients, total resection was achieved in 36 cases (85.7%, 36/42) including 14 cases of AVM in eloquent areas. A total of 40 ICG angiographies were successfully performed among 11 patients. Average number of ICG injections per operation was 3.6 (ranging from 3 to 6). Feeders were visualized in 10 patients and drainers were visualized in 9 cases. The post-surgical follow-up period varied from 3 months to 70 months (mean 22.5 months). 83.8% of the patients returned to normal work and life during the followed-up period.@*Conclusion@#Combining intraoperative neuronavigation and electrophysiological monitoring, as well as fluorescent ICG angiography contribute to microsurgical resection of cerebral AVM effectively in selecting suitable patients, further avoiding neurologic compromise as well.
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<p><b>OBJECTIVE</b>To investigate the clinical features, surgical transcranial approaches and outcomes of giant pituitary adenomas.</p><p><b>METHODS</b>A series of 112 consecutive cases of giant pituitary adenomas underwent microsurgery through transcranial approaches at People' s Liberation Army General Hospital were retrospectively analyzed. Of the 112 patients, 58 were male and 54 were female, with age ranging from 3 to 72 years(mean age 44. 3 years). There were 91 non-functioning adenomas and 21 hormone-secreting adenomas. The maximum tumor diameter varied from 4. 0 to 7. 2 cm, with mean diameter of 4. 8 cm. Unilateral subfrontal approach was chosen in 16 cases, pterional approach in 41 cases, anterior interhemispheric approach in 34 cases, transcallosal-interforniceal approach in 6 cases, transcortical- transventricular approach in 5 cases, combined approach in 6 cases and other approaches in 4 cases. Postoperative MRI and endocrine function were re-examined routinely to evaluate the therapeutic efficacy. Staged operation through transsphenoidal approach or adjuvant treatments including medical and radiation therapies were administered in patients with hormone-secreting adenomas when hormonal excess persisted after surgery and in patients with non-functioning adenomas who had postoperative MRI evidence of residual tumor.</p><p><b>RESULTS</b>Total removal of the lesion was achieved in 57 cases (50. 9%) , 26 patients (23. 2%) underwent subtotal resection, and 29 patients (25. 9%) underwent partial removal. Postoperative mortality occurred in 3 patients (2. 7%). Major surgical morbidity occurred in 38 patients (33. 9%). Vision was preserved or improved in 98 patients (87. 5%). The postsurgical follow-up period varied from 3 to 64 months (mean 19. 5 months) . Nineteen of the 21 patients with hormone-secreting adenomas were considered to be in hormonal remission, and 87. 2% of the cases were capable of normal work and life and 8 patients suffered recurrence during the followed-up period.</p><p><b>CONCLUSIONS</b>Selection of appropriate transcranial approaches is the key to successful microsurgery for giant pituitary adenomas according to the morphological characteristics presented in image examinations and clinical symptoms. Staged transsphenoidal operation and/or adjuvant therapies including medical and radiation therapies offer the best chances to control the residual tumors after the maximal surgical removal of giant adenomas through transcranial approaches.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Adenoma , General Surgery , Combined Modality Therapy , Magnetic Resonance Imaging , Microsurgery , Methods , Neurosurgical Procedures , Methods , Pituitary Neoplasms , General Surgery , Postoperative Period , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To investigate the techniques and effect of surgical resection of large intra- and extra-ventricular craniopharyngiomas via anterior interhemispheric trans-lamina terminalis approach.</p><p><b>METHODS</b>Fifty-two patients who were surgically treated for large intra- and extra-ventricular craniopharyngiomas were retrospectively analyzed. All patients underwent surgery via anterior interhemispheric trans-lamina terminalis approach. Of the 52 patients, 28 were male and 24 were female, with age ranging from 3 to 67 years (mean age 33.5 years). The maximum tumor diameter varied from 4.0 to 7.8 cm, with mean diameter of 5.1 cm. Contrast-enhanced MRI was underwent to determine the extent of tumor resection on the 1 to 3 months after surgery.</p><p><b>RESULTS</b>Total removal of the lesion was achieved in 47 cases (90.4%), 5 patients underwent subtotal resection (9.6%). Division of the anterior communicating artery was performed in 6 patients with no early or late complications related to division of the artery. Visual acuity was preserved or improved in 44 patients (84.6%). Preservation of the pituitary stalk were achieved in 33 patients (63.5%). No surgery-related deaths occurred. The postsurgical follow-up period varied from 3 months to 68 months (mean 25.4 months). Twenty-three cases had endocrinological deficit and received some form of hormonal replacement after surgery. Permanent diabetes insipidus occurred in 18 cases. Three patients died and 6 patients suffered recurrence during the followed-up period.</p><p><b>CONCLUSIONS</b>The anterior interhemispheric approach, with opening of the lamina terminalis, is a valid choice for large intra- and extra-ventricular craniopharyngiomas. These tumors can be removed without significant sequelae related to the surgical approach because optic nerves, optic chiasm, internal carotid artery, hypothalamic structures and pituitary stalk can be seen and effectively protected.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Carotid Artery, Internal , Craniopharyngioma , General Surgery , Heart Ventricles , Hypothalamus , General Surgery , Magnetic Resonance Imaging , Neoplasm Recurrence, Local , Neurosurgical Procedures , Methods , Pituitary Neoplasms , General Surgery , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To study the techniques and efficacy of neuronavigation-guided puncture and drainage in the treatment of brain abscesses.</p><p><b>METHODS</b>From February 2006 to December 2012, 31 patients with brain abscesses treated by the technique of neuronavigation-guided puncture and drainage were retrospectively analyzed. There were 27 male and 4 female patients, age ranged from 10 months to 69 years, average (34 ± 19) years.Single brain abscesses were found in 26 patients, multiple abscesses in 5 patients. The abscesses were located in eloquent regions in 19 patients. The mean diameter of the abscess was 4.1 cm (2.5-6.7 cm). The first follow-up visit was on the first month after surgery, and if residual was observed on enhanced MRI, then the patient was followed up every 3 months until the abscess disappeared completely. After residual absorbed, the patient was followed up every year.</p><p><b>RESULTS</b>Incisions of all patients were healed well and no infection. The length of hospital stay after surgery was 6-42 days, mean (14 ± 9) days. Bacterial culture of pus was performed regularly including aerobic, anaerobic and fungal culture after surgery. Thirteen patients had positive culture whereas the other 18 patients had negative culture. The duration of antibiotic use was 18-42 days, mean (22 ± 5) days. All the patients were followed up for 3 months to 3 years. Twenty-nine patients recovered well postoperatively, 1 case died 2 months after operation.One case was performed the second drainage after 10 days from the first surgery.Eighteen patients showed the improvement of neurological status within the first day following surgery, 4 patients got improvement in the next day, 1 patient with hemiplegia showed improvement in 10 days postoperatively, 1 patient with aphasia recovered gradually after 1 month, 1 patient with hemiplegia showed deterioration temporarily after surgery, and recovered gradually after 15 days.</p><p><b>CONCLUSION</b>The technique of puncture and drainage guided by neuronavigation has many advantages to treat brain abscesses, such as small trauma, short operation time, high accuracy and safety, simple surgical procedures and good prognosis.</p>