Prototypes virus of hand, foot and mouth disease infections and severe cases in Gansu, China: a spatial and temporal analysis.

BACKGROUND: Little research has been conducted on the spatio-temporal relationship between the severe cases and the enteroviruses infections of hand, foot and mouth disease (HFMD). This study aimed to investigate epidemic features and spatial clusters of HFMD incidence rates and assess the relationship between Enterovirus 71 (EV71) and Coxsackievirus A16 (CoxA16) and severe cases of HMFD in Gansu province, China. METHODS: Weekly county-specific data on HFMD between 1st January and 31st December 2018 were collected from the China Infectious Disease Information System (CIDIS), including enterovirus type (EV71 and CoxA16), severe and non-severe cases in Gansu province, China. Temporal risk [frequency index (α), duration index (ß) and intensity index (γ)] and spatial cluster analysis were used to assess epidemic features and identify high-risk areas for HFMD. Time-series cross-correlation function and regression model were used to explore the relationship between the ratios of two types of viruses (i.e. EV71/Cox16) (EC) and severe cases index (i.e. severe cases/non-severe cases) (SI) of HFMD. RESULTS: Some counties in Dingxi City, Gansu were identified as a hot spot for the temporal risk indices. Time-series cross-correlation analysis showed that SI was significantly associated with EC (r = 0.417, P < 0.05) over a 4-week time lag. The regression analysis showed that SI was positively associated with EC (ß = 0.04, 95% confidence interval (CI) 0.02-0.06). CONCLUSION: The spatial patterns of HFMD incidence were associated with enteroviruses in Gansu. The research suggested that the EC could be considered a potential early warning sign for predicting severe cases of HFMD in Gansu province.

Acrylamide treatment alters the level of Ca2+ and Ca2+-related protein kinase in spinal cords of rats.

This study aimed to analyze the neurological changes induced by acrylamide (ACR) poisoning and their underlying mechanisms within the spinal cords of male adult Wistar rats. The rats were randomly divided into three groups (n = 9 rats per group). ACR was intraperitoneally injected to produce axonopathy according to the daily dosing schedules of 20 or 40 mg/kg/day of ACR for eight continuous weeks (three times per week). During the exposure period, body weights and gait scores were assessed, and the concentration of Ca2+ was calculated in 27 mice. Protein kinase A (PKA), protein kinase C (PKC), cyclin-dependent protein kinase 5 (CDK5), and P35 were assessed by electrophoretic resolution and Western blotting. The contents of 3'-cyclic adenosine monophosphate (cAMP) and calmodulin (CaM) were determined using ELISA kits, and the activities of calcium/calmodulin-dependent protein kinase II (CaMKII), PKA, and PKC were determined using the commercial Signa TECTPKAassay kits. Compared with control rats, treatment with 20 and 40 mg/kg of ACR decreased body weight and increased gait scores at 8 weeks. Intracellular Ca2+ levels increased significantly in treated rats; CaM, PKC, CDK5, and P35 levels were significantly decreased; and PKA and cAMP levels remained unchanged. CaMKII, PKA, and PKC activities increased significantly. The results indicated that ACR can damage neurofilaments by affecting the contents and activities of CaM, CaMKII, PKA, cAMP, PKC, CDK5, and P35, which could result in ACR toxic neuropathy.

Epidemic features of seasonal influenza transmission among eight different climate zones in Gansu, China.

BACKGROUNDS: Seasonal influenza remains epidemic globally with a substantial health burden. Understanding the transmission patterns and epidemic features of influenza may facilitate the improvement of preventive and control measures. This study aims to assess the epidemic features of influenza among different climate zones and identify high-risk zones across Gansu province, China. METHODS: We collected weekly influenza cases at county-level between 1st January 2012 and 31st December 2016, as well as climate zones classification shapefile data from Köppen-Geiger climate map. We compared the epidemic features (Frequency index (α), Duration index (ß) and Intensity index (γ)) of influenza among different climate zones. Spatial cluster analysis was used to examine the high-risk areas of transmission of influenza. RESULTS: The distribution of cases existed significant differences among eight climate zones (F-test: 267.02, p < 0.05). The highest mean weekly incidence rate (per 100,000 population) was 0.59 in snow climate with dry winter and warm summer (Dwb). The primary (relative risk (RR): 3.61, p < 0.001) and secondary (RR: 2.45, p < 0.001) clusters were located in Dwb. The highest values of α, ß and γ were 1.00, 261 and 154.38 in Dwb. The hot spots (high-high clusters) of the epidemic indices were detected in Dwb. CONCLUSIONS: This study found the variability of epidemic features of influenza among eight climate zones. We highlight that Dwb was the high-risk zone where influenza clustered with the highest incidence rate and epidemic temporal indices. This provide further insight into potential improvement of preventive measures by climate zones to minimize the impact of epidemics.

Different responses of weather factors on hand, foot and mouth disease in three different climate areas of Gansu, China.

BACKGROUND: To determine the linear and non-linear interacting relationships between weather factors and hand, foot and mouth disease (HFMD) in children in Gansu, China, and gain further traction as an early warning signal based on weather variability for HFMD transmission. METHOD: Weekly HFMD cases aged less than 15 and meteorological information from 2010 to 2014 in Jiuquan, Lanzhou and Tianshu, Gansu, China were collected. Generalized linear regression models (GLM) with Poisson link and classification and regression trees (CART) were employed to determine the combined and interactive relationship of weather factors and HFMD in both linear and non-linear ways. RESULTS: GLM suggested an increase in weekly HFMD of 5.9% [95% confidence interval (CI): 5.4%, 6.5%] in Tianshui, 2.8% [2.5%, 3.1%] in Lanzhou and 1.8% [1.4%, 2.2%] in Jiuquan in association with a 1 °C increase in average temperature, respectively. And 1% increase of relative humidity could increase weekly HFMD of 2.47% [2.23%, 2.71%] in Lanzhou and 1.11% [0.72%, 1.51%] in Tianshui. CART revealed that average temperature and relative humidity were the first two important determinants, and their threshold values for average temperature deceased from 20 °C of Jiuquan to 16 °C in Tianshui; and for relative humidity, threshold values increased from 38% of Jiuquan to 65% of Tianshui. CONCLUSION: Average temperature was the primary weather factor in three areas, more sensitive in southeast Tianshui, compared with northwest Jiuquan; Relative humidity's effect on HFMD showed a non-linear interacting relationship with average temperature.

Socio-ecological factors and hand, foot and mouth disease in dry climate regions: a Bayesian spatial approach in Gansu, China.

The influence of socio-ecological factors on hand, foot and mouth disease (HFMD) were explored in this study using Bayesian spatial modeling and spatial patterns identified in dry regions of Gansu, China. Notified HFMD cases and socio-ecological data were obtained from the China Information System for Disease Control and Prevention, Gansu Yearbook and Gansu Meteorological Bureau. A Bayesian spatial conditional autoregressive model was used to quantify the effects of socio-ecological factors on the HFMD and explore spatial patterns, with the consideration of its socio-ecological effects. Our non-spatial model suggests temperature (relative risk (RR) 1.15, 95 % CI 1.01-1.31), GDP per capita (RR 1.19, 95 % CI 1.01-1.39) and population density (RR 1.98, 95 % CI 1.19-3.17) to have a significant effect on HFMD transmission. However, after controlling for spatial random effects, only temperature (RR 1.25, 95 % CI 1.04-1.53) showed significant association with HFMD. The spatial model demonstrates temperature to play a major role in the transmission of HFMD in dry regions. Estimated residual variation after taking into account the socio-ecological variables indicated that high incidences of HFMD were mainly clustered in the northwest of Gansu. And, spatial structure showed a unique distribution after taking account of socio-ecological effects.

An injectable and antifouling hydrogel prevents the development of abdominal adhesions by inhibiting the CCL2/CCR2 interaction.

Abdominal adhesion, a serious complication of abdominal surgery, often resists mitigation by current drug administration and physical barriers. To address this issue, we developed an injectable, antifouling hydrogel through the free-radical polymerization of methacrylate chondroitin sulfate (CS-GMA) and 2-methacryloyloxyethyl phosphorylcholine (MPC) monomers, dubbed the CGM hydrogel. We systematically analyzed its physicochemical properties, including rheological strength, biocompatibility, and antifouling capabilities. A rat abdominal cecum adhesion model was constructed to assess the effectiveness of CGM hydrogel in preventing postoperative adhesion and recurrent adhesion. In addition, multi-omics analyses identified the relationship between adhesion development and CCL2/CCR2 interaction. Notably, CGM hydrogel can thwart the recruitment and aggregation of fibroblasts and macrophages by inhibiting the CCL2/CCR2 interaction. Moreover, CGM hydrogel significantly dampens the activity of fibrosis-linked cytokines (TGF-ßR1) and recalibrates extracellular matrix deposition-related cytokines (t-PA and PAI-1, Col Ⅰ and MMP-9). Cumulatively, the dual action of CGM hydrogel-as a physical barrier and cytokine regulator-highlights its promising potential in clinical application for abdominal adhesion prevention.

Astragalus polysaccharides driven stretchable nanofibrous membrane wound dressing for joint wound healing.

Joint wound dressings are currently significantly limited in their clinical applications due to their inferior mechanical properties and single therapeutic effect. Therefore, it is imperative to develop a versatile joint wound dressing that integrates adequate stretchability, desirable biocompatibility, and multiple biological effects into one system. We implemented the electrospinning technique in this study to fabricate a novel nanofibrous membrane (NFM) composed of gelatin (GEL) and astragalus polysaccharides (APS), termed GEL/APS NFM. The selection of GEL and APS confers excellent biocompatibility to GEL/APS NFM. Furthermore, the optimally proportioned GEL/APS NFM exhibits satisfactory stretchability and desirable wound healing efficiency. Furthermore, released APS can exert anti-inflammatory, procollagen deposition, and proangiogenic effects to accelerate epithelial tissue, enhancing joint wound healing. In summary, GEL/APS NFM offers a convenient and effective approach to promoting rapid joint wound healing, providing a novel approach to joint wound care.

The Effect of Flavonoids on Chronic Prostatitis: A Meta-analysis of Published Randomized Controlled Trials.

OBJECTIVE: To assess the effect of flavonoids on chronic prostatitis, a meta-analysis of randomized controlled trials was performed. METHODS: Through using subject word and random word, PubMed, Scopus, Web of Science, and Cochrane Library were searched for related records up to July 2018. The response rate and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) were used to evaluate the therapeutic efficacy of the flavonoids. The Cochrane handbook for systematic reviews of interventions version was used to evaluate the quality of included studies. The model of determining odds ratio (OR) was chose according to the value of I2. RESULTS: A total of 11 studies involving 975 subjects (experiment 516, control 459) were included. The overall OR of response rate was 0.31 (95%CI 0.11-0.89, P = 0.03). At the subgroup analysis, the OR of response rate of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) was 0.57 (95%CI 0.18-1.77, P = 0.33), while the OR of response rate of chronic bacterial prostatitis (CBP) was 0.08 (95%CI 0.02-0.33, P = 0.0005). The OR of response rate of CP/CPPS (control was placebo) was 0.29 (95%CI 0.16-0.52, P < 0.0001). The overall OR of baseline NIH-CPSI was -0.1 (95%CI -0.61-0.41, P = 0.70). The overall OR of posttreatment NIH-CPSI was -6.96 (95%CI -8.32∼ -5.60, P < 0.00001). CONCLUSIONS: This meta-analysis indicates that the flavonoids may be clinically beneficial through significantly improving the response rate and NIH-CPSI in chronic prostatitis patients and short-lasting antibiotics therapy in association with the flavonoids could be a better choose for CBP. Moreover, the flavonoids therapy has an excellent safety profile with minor adverse effects.

[Spatial-temporal distribution of hepatitis B in Gansu province, 2009-2014].

OBJECTIVE: To understand the hot/cold spots and the spatial-temporal clustering of hepatitis B in Gansu province during 2009-2014 by using spatial statistics, and provide scientific evidence for the prevention and control of hepatitis B. METHODS: The spatial hot/cold spots and its trend, and the time frame and areas of its spatial-temporal clustering of hepatitis B in Gansu were analyzed by using the county specific incidence of hepatitis B from 2009 to 2014 and spatial statistical software GeoDa and SatScan. RESULTS: The incidences of hepatitis B from 2009 to 2014 in Gansu were spatial autocorrelated respectively. Local G scan statistics indicated that the number of hot spots was in decline in Hexi area, while the hot spots was in increase in Linxia Hui autonomous prefecture and Gannan Tibetan autonomous prefecture. There was no obvious pattern in cold spots. Temporal-spatial scan statistics showed that the areas with high hepatitis B incidence most likely clustered in Hexi area during 2009-2011, and the areas with low hepatitis B incidence most likely clustered in eastern Gansu during 2012-2014. CONCLUSIONS: The spatial and temporal clustering of hepatitis B was observed in Gansu from 2009 to 2014. The number of hot spots in Hexi area was in decline, while the numbers of hot spots in Linxia and Gannan were in increase, suggesting that the hepatitis B control and prevention in these areas should be strengthened.

[Spatial clustering of hand-foot-mouth disease in Gansu, 2012].

OBJECTIVE: The purpose of this study was to explore the spatial distribution and spatial clustering of hand-foot-mouth disease (HFMD) in Gansu, 2012. METHODS: Spatial autocorrelation and Spatial scanning analysis were used to conduct spatial statistical analyses for the HFMD at the county/district level. RESULTS: HFMD cases did not show a random distribution but with significant spatial aggregation. When Local Autocorrelation analysis was applied at the county/district level, with nine hot spot areas as Jiayuguan, Yumen, Dunhuang, Jinta, Suzhou, Chengguan, Anning, Xigu and Gaolan, were discovered. Four statistically significant HFMD clusters were identified by spatial scan statistics. CONCLUSION: HFMD was noticed geographically clustered in Gansu in 2012. Results from this study indicated that the spatial autocorrelation and spatial scanning analysis could effectively detect the areas which presenting significant clusters. Cluster Detection System (CDS) could provide evidence for the development of an effective measure concerning the prevention and control of HFMD.

[Spatial-temporal specific incidence of pulmonary tuberculosis in Gansu, 2009-2013].

OBJECTIVE: To understand the spatial-temporal specific incidence of pulmonary tuberculosis (TB) in Gansu. METHODS: The county-based incidence of pulmonary TB in Gansu from 2009 to 2013 was used to calculate Moran's I and G statistics, and analyze the spatial-temporal distribution of areas with different pulmonary TB incidences. RESULTS: The spatial correlation in incidence of pulmonary TB was found in Gansu from 2009 to 2013 (P<0.001), and the hot spot areas were mainly in Hexi area, Linxia, part of Dingxi, while the cold spot areas were in Lanzhou, part of Dingxi, Tianshui, Pingliang and Qingyang. Spatial-temporal analysis showed that the clustering of high pulmonary TB incidence areas were most likely in the Hexi area during 2009-2010 (LLR=3,031.10, RR=2.27, P<0.001), and the clustering of low pulmonary TB incidence areas were most likely in Lanzhou during 2011-2013 (LLR=1,545.52, RR=0.37, P<0.001). CONCLUSION: The analysis on spatial and spatial-temporal specific incidences of pulmonary TB in Gansu from 2009 to 2013 indicated that Hexi area is the key area in pulmonary TB prevention and control in Gansu.

[Epidemiological features and pathogenic characteristics of hand, foot and mouth disease in Gansu Province, China during 2008-2012].

This study aims to analyze the epidemiological features and pathogenic characteristics of hand, foot and mouth disease (HFMD) in Gansu Province, China and to provide a basis for the development of effective prevention and control measures. The descriptive epidemiological analysis was used to analyse the data of HFMD cases in Gansu. The specimens collected from hospitals were subjected to RT-PCR or real-time PCR to detect human enterovirus (HEV) nucleic acid, and HEV strains were isolated using human rhabdomyosarcoma cells and human laryngeal carcinoma cells. The complete VP1-encoding region of several identified enterovirus A71 (EV71) and coxsackievirus A16 (CVA16) was subjected to full-length amplification by RT-PCR and then to sequencing and analysis. A total of 52 550 HFMD cases were reported in Gansu from 2008 to 2012, including 205 severe cases and 27 deaths. The incidence rates in the whole province from 2008 to 2012 were 22.42/10(5), 49.29/10(5), 47.20/10(5), 27.27/10(5), and 55.84/10(5), respectively. There were cases in all the 14 cities or prefectures in Gansu, and Lanzhou had the largest number of cases (16 001 cases), accounting for 30.45% of all cases in the province. HFMD cases were mostly reported during May to July, accounting for 51.69% of all cases throughout the year. The male-to-female ratio was 1.69:1. Of all the cases, 87.59% were under the age of five. Of the 5 416 cases for laboratory tests, 3 322 (61.34%) were positive for HEV nucleic acid, including EV71 (46.96%), CVA16 (41.57%), and other HEVs (11.47%). Among the 186 severe cases, 114 (61.29%) were positive for HEV nucleic acid, and 82.46% of the positive cases for EV71. All the 25 dead cases were infected with EV71. A total of 402 strains were isolated from 3 111 specimens collected from hospitals (2 123 throat swab specimens, 705 stool specimens, and 705 herpes specimens), including EV71 (70.15%), CVA16 (27.11), other coxsackievirus A (3.98%), coxsackievirus B (2.49%), echovirus (1.74%), and adenovirus (1.99%). The genotyping of VP1- encoding region showed that all the 194 EV71 strains isolated during 2008-2012 belonged to the C4a evolutionary branch of C4 subtype; among the 45 CVA16 strains, 12 belonged to the Bla evolutionary branch of B1 subtype and 33 to the B1b evolutionary branch, and B1b became the predominant subtype in 2012. In conclusion, in Gansu Province, HFMD occurs mostly in children under the age of five; EV71 and CVA16 are the main pathogens of this disease, and the two are predominant alternately from 2008 to 2012; the severe and dead cases of HFMD are closely related to infection with EV71; the types of pathogens varied across different regions in the same year during 2008-2012.