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Objective To analyze the epidemiological characteristics of leptospirosis in China from 2010 to 2022, so as to provide insights into formulation of the leptospirosis control strategy. Methods All data pertaining to clinically diagnosed cases and confirmed cases of leptospirosis reported in China from January 1, 2010 to December 31, 2022 was collected from Chinese Disease Prevention and Control Information Management System. The spatial, temporal and population distributions, and report and diagnosis institutions of leptospirosis cases were analyzed using a descriptive epidemiological method. Results A total of 4 559 leptospirosis cases were reported in China from 2010 to 2022, with an annual average number of 351 cases, and the number of reported leptospirosis cases reduced from 679 cases in 2010 to 158 cases in 2018. A total of 4 276 leptospirosis cases were reported in Sichuan Province, Yunnan Province, Guangdong Province, Hunan Province, Fujian Province, Zhejiang Province, Guangxi Zhuang Autonomous Region, Anhui Province, Jiangxi Province and Guizhou Province, accounting for 93.79% of the total number of leptospirosis cases in China. The number of leptospirosis cases had recently appeared a remarkable decline in Yunnan Province, while a significant rise was seen in the number of leptospirosis cases in two provinces of Zhejiang and Guangdong. No leptospirosis cases were reported in Henan Province from 2010 to 2020; however, there were 5 cases and 2 cases reported in 2021 and 2022, respectively. There was only one leptospirosis case reported in Shaanxi Province from 2010 to 2017; however, leptospirosis cases were reported in the province for 5 consecutive years since 2018. Leptospirosis cases were reported throughout the year in China from 2010 to 2022, with the peak of incidence found during the period between August and October, and the peak of leptospirosis incidence varied in provinces. A higher number of leptospirosis cases was seen among men than among women, with a male to female ratio of 2.3:1, and the median age of leptospirosis cases was 50 years (interquartile range, 23 years), with the highest proportion of leptospirosis cases reported at ages of 51 to 60 years (23.21%). Among all reported leptospirosis cases, 53.28% were confirmed cases, and the proportion of confirmed cases increased from 35.05% in 2010 to 61.66% in 2022. In addition, there were 67.22% of leptospirosis cases (2 937 cases) reported by comprehensive hospitals, 20.44% (893 cases) by disease control and prevention institutions, 7.23% (316 cases) by grassroots healthcare institutions and 5.10% (223 cases) by other healthcare and medical institutions, and the mortality of reported leptospirosis cases was 1.07% in China from 2010 to 2022, with a higher mortality seen among men than among women (1.39% vs. 0.36%; χ2 = 9.52, P = 0.002). Conclusions The incidence of leptospirosis remained at a low level in China from 2010 to 2022, and southern China was still the main endemic area for leptospirosis. The epidemiological characteristics of leptospirosis cases varied in endemic provinces, and leptospirosis cases had been continued to be reported in Shaanxi and Henan provinces, which should be paid much attention to. Intensified surveillance of leptospirosis, improved diagnosis and treatment capability of leptospirosis cases and leptospirosis control with adaptations to local circumstance are recommended.
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Objective:To study the epidemiological characteristics and spatio-temporal aggregation of hemorrhagic fever with renal syndrome (HFRS) in Shandong Province, and to provide reference for formulating reasonable prevention and control strategies.Methods:Retrospective analysis was used to collect HFRS surveillance data and confirmed case data in Shandong Province from 2017 to 2020 in the "China Disease Prevention and Control Information System Infectious Disease Surveillance System". Geoda 1.18 software was used for global and local spatial autocorrelation analysis, SaTScan 9.6 software was used for spatio-temporal scanning analysis, and ArcGis 10.7 software was used for map drawing and visual display.Results:A total of 3 753 cases of HFRS were reported in Shandong Province from 2017 to 2020, including 56 deaths. The annual incidence rate was 1.26/100 000, 1.22/100 000, 0.75/100 000 and 0.53/100 000, respectively, with an average annual incidence rate of 0.94/100 000. The incidence of HFRS was obviously seasonal, mainly concentrated in autumn and winter from October to December, accounting for 50.41% (1 892/3 753). The age of onset was mainly 30-59 years old, accounting for 61.68% (2 315/3 753). The male to female ratio was 2.76 ∶ 1.00 (2 756 ∶ 997). The occupation distribution was mainly farmers, accounting for 81.99% (3 077/3 753). The global spatial autocorrelation analysis showed that HFRS showed spatial aggregation areas in each year from 2017 to 2020 (Moran' I = 0.38, 0.33, 0.59, 0.46, Z = 7.47, 7.23, 10.69, 8.66, P < 0.001). The local spatial autocorrelation analysis showed that "high-high" aggregation areas were mainly concentrated in central and southeast of Shandong Province, while "low-low" aggregation areas were mainly concentrated in northwest of Shandong Province. Spatio-temporal scanning analysis revealed 1 type Ⅰ agglomerations and 2 type Ⅱ aggregation areas. The type Ⅰ aggregation areas occurred from October to November 2018, covering 22 counties (districts) of 5 cities in Qingdao, Yantai, Weifang, Weihai and Rizhao. The first type Ⅱ aggregation area occurred from October to November 2017, involving 23 counties (districts) of 8 cities in Jinan, Zibo, Zaozhuang, Weifang, Jining, Tai 'an, Rizhao and Linyi. The second type Ⅱ aggregation area occurred in Jinxiang County, Jining City from February to March 2017. Conclusion:The incidence of HFRS in Shandong Province from 2017 to 2020 has obvious spatio-temporal aggregation, and the hot spots are concentrated in central and southeast of Shandong Province, which should be regarded as a key area for prevention and control of HFRS.
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Objective To investigate the effect of fasting blood glucose control and its influencing factors in patients with type 2 diabetes mellitus (T2DM) in community.Methods 905 cases of patients with T2DM were collected in Rencheng District of Jining city according to the stratified cluster random sampling method.The general demographic characteristics and lifestyle of the subjects were collected by questionnaire survey,and the height,body weight,blood glucose,blood pressure and blood lipids were measured by physical examination.Multivariate Logistic regression analysis was used to analyze the influencing factors of blood glucose control.Results A total of 905 subjects were recruited in the analysis.74.70％ of the subjects were aged 35 years above.The proportion reaching the control criteria of the blood glucose,blood pressure and cholesterol was 71.27％ (645),29.83％ (270) and 26.74％(242) of the subjects respectively.The influencing factors for blood glucose control in the subjects were age,duration of disease,blood pressure,weight,diet condition and psychological states and treatment compliance,and the differences were statistically significant(x2 =7.58,23.18,7.08,5.22,5.46,5.16,5.65,all P＜0.05).Multivariate Logistic regression analysis showed that age and duration of disease were the risk factors of blood glucose control in patients with T2DM.Standard blood pressure control was the protective factor that affects the effect of blood glucose control (OR=1.430,95％ CI=1.015-2.015,P＜0.05).Conclusion The blood glucose control of T2DM patients need to be improved comprehensively in community.By strengthening the control of blood glucose and blood pressure,establishing good habits of life behavior and improving the ability of self management,patients with T2DM can improve their quality of life.
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Objective To investigate the effect of folic acid combined with Helicobacter pylori (Hp) eradication therapy on chronic atrophic gastritis.Methods From December 2009 to March 2011 at the First Affiliated Hospital of Nanjing Medical University,184 patients with endoscopic and pathological diagnosis of chronic atrophic gastritis (90 Hp positive and 94 Hp negative) were selected.Hp positive patients were divided into group A and group B.Forty-three patients in group A were treated with standard triple Hp eradication therapy and follow by folic acid therapy for three months.Forty-seven patients in group B and Hp negative patients received three months of folic acid therapy.The clinical symptoms of each group were scored before treatment,one month after folie acid therapy and three months after folic acid therapy and analyzed by t test. Patients of each group received gastroscopy before treatment and three months after medicine withdrawal. Endoscopic scores,pathological scores and t test were recorded.The serum levels of pepsinogen ( Ⅰ,Ⅱ ) and gastrin 17 in venous blood of 55 Hp negative patients were detected by enzyme-linked immunosorbent assay (ELISA) method before treatment and three months after medicine withdrawal.Results Compared with three months therapy (1.15 ± 0.03),after one month folic acid therapy (1.55 ± 0.04) was statistically significant in clinical symptoms score of all patients (t =8.18,P＜0.01).By the end of therapy,clinical symptom score of group A (1.06 ± 0.04) was lower than that of group B (1.56 ±0.08),and the difference was significant (t=6.00,P＜0.01).There was significant difference in endoscopic scores of all patients between before treatment (1.57±0.95) and after treatment (1.00±0.76,t=11.12,P＜0.01).The differences in each pathological score of all patients (inflammatory scoring,active scoring,atrophy scoring,intestinal metaplasia scoring,atypical hyperplasia degree scoring) were significant between before treatment and after treatment (t=5.51,6.90,7.53,6.34,2.90,respectively,all P＜0.01).The serum level of pepsinogen Ⅰ before treatment of 55 Hp negative patients [(1.03±0.19) nmol/L] was lower than that after treatment [(2.24±0.33) nmol/L],and the difference was statistically significant (t=3.19,P＜0.01).After treatment the level of gastrin 17 [(0.86±0.05) nmol/L] was higher than that before treatment [(0.47±0.05) nmol/L],and the difference was statistically significant ( t =5.33,P＜ 0.01 ).Conclusion Folic acid in combination with Hp eradication therapy can be favorable to atrophic gastritis,which may promote the secretion of pepsinogen and gastrin.
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OBJECTIVE:To raise the price fixing of drugs to a scientific and reasonable level.METHODS:From the view of the whole society,the economic efficiency of newly-developed drugs and original drugs was compared with cost-effec?tiveness analysis.RESULTS&CONCLUSION:Through comparison,the price ranges with economic efficiency of newly-de?veloped drugs would be obtained,which could guide the price fixing.
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OBJECTIVE:Using the result of pharmacoeconomic evaluation to instruct the management of drug prices.ME_ THODS:Establishing a reference price and combining economic benefit to decide the price of a drug.RESULTS&CONCLU_ SION:According to the rational value scope,the prices of new drugs can be fixed.A reasonable and timely adjustment of the price can be made.
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The urgent approval of the use of the inactivated COVID-19 vaccine is essential to reduce the threat and burden of the epidemic on global public health, however, our current understanding of the host immune response to inactivated vaccine remains limited. Herein, we performed serum IgG antibody detection and transcriptomics analysis on 20 SARS-CoV-2 naive individuals who received multiple doses of inactivated vaccine and 5 SARS-CoV-2 recovered individuals who received single dose of inactivated vaccine. Our research revealed the important role of many innate immune pathways after vaccination, identified a significant correlation with the third dose of booster vaccine and proteasome-related genes, and found that SARS-CoV-2 recovered individuals can produces a strong immune response to a single dose of inactivated vaccine. These results help us understand the reaction mechanism of the hosts molecular immune system to the inactivated vaccine, and provide a basis for the choice of vaccination strategy.