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1.
BMC Genomics ; 25(1): 391, 2024 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-38649797

RESUMEN

Developmental delay (DD), or intellectual disability (ID) is a very large group of early onset disorders that affects 1-2% of children worldwide, which have diverse genetic causes that should be identified. Genetic studies can elucidate the pathogenesis underlying DD/ID. In this study, whole-exome sequencing (WES) was performed on 225 Chinese DD/ID children (208 cases were sequenced as proband-parent trio) who were classified into seven phenotype subgroups. The phenotype and genomic data of patients with DD/ID were further retrospectively analyzed. There were 96/225 (42.67%; 95% confidence interval [CI] 36.15-49.18%) patients were found to have causative single nucleotide variants (SNVs) and small insertions/deletions (Indels) associated with DD/ID based on WES data. The diagnostic yields among the seven subgroups ranged from 31.25 to 71.43%. Three specific clinical features, hearing loss, visual loss, and facial dysmorphism, can significantly increase the diagnostic yield of WES in patients with DD/ID (P = 0.005, P = 0.005, and P = 0.039, respectively). Of note, hearing loss (odds ratio [OR] = 1.86%; 95% CI = 1.00-3.46, P = 0.046) or abnormal brainstem auditory evoked potential (BAEP) (OR = 1.91, 95% CI = 1.02-3.50, P = 0.042) was independently associated with causative genetic variants in DD/ID children. Our findings enrich the variation spectrums of SNVs/Indels associated with DD/ID, highlight the value genetic testing for DD/ID children, stress the importance of BAEP screen in DD/ID children, and help to facilitate early diagnose, clinical management and reproductive decisions, improve therapeutic response to medical treatment.


Asunto(s)
Discapacidades del Desarrollo , Secuenciación del Exoma , Discapacidad Intelectual , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Discapacidades del Desarrollo/genética , Discapacidades del Desarrollo/diagnóstico , Pueblos del Este de Asia/genética , Mutación INDEL , Discapacidad Intelectual/genética , Fenotipo , Polimorfismo de Nucleótido Simple
2.
Data Brief ; 53: 110232, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38439992

RESUMEN

A structured sentiment analysis dataset, derived from social media comments, is introduced in this paper. The dataset spans 22 diverse domains and comprises over 200,000 reviews, providing a rich resource for sentiment analysis tasks in the Chinese language context. Each comment within the dataset has been manually annotated with a sentiment label, either positive, negative, or neutral, and grouped by topic. This meticulous annotation process ensures the dataset's reliability for training, validating, and testing sentiment analysis models. The construction of the dataset involved a three-step process. Initially, data was collected from the topics that garnered high attention and discussion rates, thereby reflecting the authentic opinions of users. Following data collection, preprocessing was undertaken to remove extraneous elements, while preserving emoticons that are crucial for sentiment analysis. The final step involved manual annotation by researchers, who assigned sentiment labels to each comment based on various factors. The dataset stands as a valuable contribution to the field of natural language processing, particularly for sentiment analysis tasks in the Chinese language context.

3.
Entropy (Basel) ; 25(8)2023 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-37628247

RESUMEN

The entity-relationship joint extraction model plays a significant role in entity relationship extraction. The existing entity-relationship joint extraction model cannot effectively identify entity-relationship triples in overlapping relationships. This paper proposes a new joint entity-relationship extraction model based on the span and a cascaded dual decoding. The model includes a Bidirectional Encoder Representations from Transformers (BERT) encoding layer, a relational decoding layer, and an entity decoding layer. The model first converts the text input into the BERT pretrained language model into word vectors. Then, it divides the word vectors based on the span to form a span sequence and decodes the relationship between the span sequence to obtain the relationship type in the span sequence. Finally, the entity decoding layer fuses the span sequences and the relationship type obtained by relation decoding and uses a bi-directional long short-term memory (Bi-LSTM) neural network to obtain the head entity and tail entity in the span sequence. Using the combination of span division and cascaded double decoding, the overlapping relations existing in the text can be effectively identified. Experiments show that compared with other baseline models, the F1 value of the model is effectively improved on the NYT dataset and WebNLG dataset.

4.
World J Gastrointest Oncol ; 15(5): 859-877, 2023 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-37275443

RESUMEN

BACKGROUND: Hepatocellular carcinoma (HCC) is a common malignant tumor worldwide. Many regions across the world have issued various HCC diagnosis and treatment protocols to improve the diagnosis and targeted treatment of patients with HCC. However, real-world studies analysing the practice, application value, and existing problems of the China Liver Cancer (CNLC) staging system are scarce. AIM: To analyze the current situation and problems associated with the Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China. METHODS: We collected the medical records of all patients with HCC admitted to the First Affiliated Hospital of Zhengzhou University from January 1, 2011 to December 31, 2019, and recorded the hospitalization information of those patients until December 31, 2020. All information on the diagnosis and treatment of the target patients was recorded, and their demographic and sociological characteristics, CNLC stages, screening situations, and treatment methods and effects were analyzed. The survival status of the patients was obtained from follow-up data. RESULTS: This study included the medical records of 3022 patients with HCC. Among these cases, 304 patients were screened before HCC diagnosis; their early-stage diagnosis rate was 69.08%, which was significantly higher than that of patients with HCC who were diagnosed without screening and early detection (33.74%). Herein, patients with no clinical outcome at discharge were followed up, and the survival information of 1128 patients was obtained. A Cox model was used to analyse independent risk factors affecting overall survival, which were revealed as age > 50 years, no screening, alpha-fetoprotein > 400 ng/mL, Child-Pugh grade B, and middle and late CNLC stages. Based on the Cox model survival analysis, in our study, patients with HCC identified via screening had significant advantages in overall and tumor-free survival after hepatectomy. CONCLUSION: Early diagnosis and treatment can be achieved by screening groups at high risk for HCC based on the guidelines; however, real-world compliance is poor.

5.
Entropy (Basel) ; 24(10)2022 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-37420474

RESUMEN

Named entity recognition is a basic task in natural language processing, and there is a large number of nested structures in named entities. Nested named entities become the basis for solving many tasks in NLP. A nested named entity recognition model based on dual-flow features complementary is proposed for obtaining efficient feature information after text coding. Firstly, sentences are embedded at both the word level and the character level of the words, then sentence context information is obtained separately via the neural network Bi-LSTM; Afterward, two vectors perform low-level feature complementary to reinforce low-level semantic information; Sentence-local information is captured with the multi-head attention mechanism, then the feature vector is sent to the high-level feature complementary module to obtain deep semantic information; Finally, the entity word recognition module and the fine-grained division module are entered to obtain the internal entity. The experimental results show that the model has a great improvement in feature extraction compared to the classical model.

6.
BMJ Open ; 11(9): e047475, 2021 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-34526336

RESUMEN

OBJECTIVES: The health-related quality of life (HRQoL) and utilities of patients with chronic hepatitis B (CHB) virus infection, including compensated cirrhosis (CC), decompensated cirrhosis (DC) and different stages of hepatocellular carcinoma (HCC), have not been well described in China. This study aimed to evaluate HRQoL and utilities and provide parameters for the economic evaluation of CHB-related diseases. METHODS: We conducted a multicentre cross-sectional and study to measure the HRQoL of patients with CHB, CC, DC and HCC using the Chinese short form (SF) 36 health survey V.2. The utilities were extracted based on the SF-six dimension scoring model. Multivariable regression analyses identified the effects on HRQoL. RESULTS: A total of 1071 patients (639 with CHB, 125 with CC, 85 with DC and 222 with HCC) were invited to complete the questionnaire. Physical HRQoL was not impaired in the CHB stage, while mental HRQoL was significantly impaired. Physical composite summary scores have a more significant decrease than mental composite summary scores at the advanced stages (CC, DC and HCC). The utility scores of CHB only, CC, DC and HCC were 0.773, 0.750, 0.683 and 0.640, respectively. The utility scores in the early, middle and terminal stages of HCC were 0.656, 0.635 and 0.615, respectively. CONCLUSION: Slowing the progress of CHB-related diseases and providing psychological support early are the key points to improving the quality of life with the diseases. The utility values estimated in this study can provide a vital instrument for cost-effectiveness studies on CHB-related diseases.


Asunto(s)
Carcinoma Hepatocelular , Hepatitis B Crónica , Neoplasias Hepáticas , China/epidemiología , Estudios Transversales , Hepatitis B Crónica/complicaciones , Humanos , Calidad de Vida
7.
Travel Med Infect Dis ; 37: 101660, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32247931

RESUMEN

BACKGROUND: Since the outbreak of 2019-nCoV in December, Chinese government has implemented various measures including travel bans, centralized treatments, and home quarantines to slowing the transmission across the country. In this study, we aimed to estimate the incidence of 2019-nCoV infection among people under home quarantine in Shenzhen, China. METHODS: We used a stratified multistage random sampling method to recruit participants and collected demographic information and laboratory results of people under home quarantine. We conducted descriptive analysis to estimate the basic characteristics and to calculate the incidence in out study population. RESULTS: A total of 2004 people under home quarantine participated in this study, of which 1637 participants finished the questionnaire with a response rate of 81.7%. Mean age of the participants was 33.7 years, ranging from 0.3 to 80.2 years. Of people who provided clear travel history, 129 people have traveled to Wuhan city and 1,046 people have traveled to other cities in Hubei province within 14 days before the home quarantine. Few (less than 1%) participants reported contact history with confirmed or suspected cases during their trip and most of these arrived at Shenzhen between Jan 24, 2020 to Jan 27, 2020. The incidence of COVID-19 in the sample was 1.5‰ (95% CI: 0.31‰-4.37‰). CONCLUSION: Home quarantine has been effective in preventing the early transmission of COVID-19, but that more needs to be done to improve early detection of COVID-19 infection.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Cuarentena , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , COVID-19 , Niño , Preescolar , China/epidemiología , Trazado de Contacto , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Femenino , Humanos , Incidencia , Lactante , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/virología , SARS-CoV-2 , Viaje , Adulto Joven
8.
Sensors (Basel) ; 19(22)2019 Nov 18.
Artículo en Inglés | MEDLINE | ID: mdl-31752178

RESUMEN

Task assignment is a crucial problem in wireless sensor networks (WSNs) that may affect the completion quality of sensing tasks. From the perspective of global optimization, a transmission-oriented reliable and energy-efficient task allocation (TRETA) is proposed, which is based on a comprehensive multi-level view of the network and an evaluation model for transmission in WSNs. To deliver better fault tolerance, TRETA dynamically adjusts in event-driven mode. Aiming to solve the reliable and efficient distributed task allocation problem in WSNs, two distributed task assignments for WSNs based on TRETA are proposed. In the former, the sink assigns reliability to all cluster heads according to the reliability requirements, so the cluster head performs local task allocation according to the assigned phase target reliability constraints. Simulation results show the reduction of the communication cost and latency of task allocation compared to centralized task assignments. Like the latter, the global view is obtained by fetching local views from multiple sink nodes, as well as multiple sinks having a consistent comprehensive view for global optimization. The way to respond to local task allocation requirements without the need to communicate with remote nodes overcomes the disadvantages of centralized task allocation in large-scale sensor networks with significant communication overheads and considerable delay, and has better scalability.

10.
Jpn J Infect Dis ; 68(1): 70-4, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25702790

RESUMEN

An outbreak of norovirus GII.4/Sydney_2012 affected a China elder care facility in December 2012. A total of 39 elderly people and staff met the outbreak case definition. The attack rates in the elderly and the staff were 15.9% (31/195) and 23.2% (19/82), respectively, including 13 asymptomatic cases in the staff. The result of gene sequencing revealed that the outbreak was caused by norovirus GII.4 Sydney. The mode of transmission of this outbreak was proven to be person-to-person. The first case (a self-cared elder) was affected outside the elder care facility and was not isolated after returning. Norovirus was transmitted via close contact among the self-cared elderly. Then, through service-related close contact, the attendants promoted the cross-transmission between the self-cared elderly and the nursed elderly. The virus was also spread among the staff via daily contact. In the elder care facility, the asymptomatic cases in the attendants played an important role in the transmission of norovirus, which deserves high attention.


Asunto(s)
Infecciones por Caliciviridae/epidemiología , Infecciones por Caliciviridae/virología , Infección Hospitalaria/epidemiología , Infección Hospitalaria/virología , Brotes de Enfermedades , Genotipo , Norovirus/clasificación , Adulto , Anciano , Anciano de 80 o más Años , Infecciones por Caliciviridae/transmisión , China/epidemiología , Análisis por Conglomerados , Infección Hospitalaria/transmisión , Transmisión de Enfermedad Infecciosa , Femenino , Instituciones de Salud , Personal de Salud , Humanos , Pacientes Internos , Masculino , Norovirus/genética , Norovirus/aislamiento & purificación , Filogenia , ARN Viral/genética , Análisis de Secuencia de ADN , Homología de Secuencia
11.
PLoS One ; 10(2): e0117505, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25658843

RESUMEN

This study aims to evaluate the effect of different afforestation models on soil microbial composition in the Loess Plateau in China. In particular, we determined soil physicochemical properties, enzyme activities, and microbial community structures in the top 0 cm to 10 cm soil underneath a pure Hippophae rhamnoides (SS) stand and three mixed stands, namely, H. rhamnoides and Robinia pseucdoacacia (SC), H. rhamnoides and Pinus tabulaeformis (SY), and H. rhamnoides and Platycladus orientalis (SB). Results showed that total organic carbon (TOC), total nitrogen, and ammonium (NH4(+)) contents were higher in SY and SB than in SS. The total microbial biomass, bacterial biomass, and Gram+ biomass of the three mixed stands were significantly higher than those of the pure stand. However, no significant difference was found in fungal biomass. Correlation analysis suggested that soil microbial communities are significantly and positively correlated with some chemical parameters of soil, such as TOC, total phosphorus, total potassium, available phosphorus, NH4(+) content, nitrate content (NH3(-)), and the enzyme activities of urease, peroxidase, and phosphatase. Principal component analysis showed that the microbial community structures of SB and SS could clearly be discriminated from each other and from the others, whereas SY and SC were similar. In conclusion, tree species indirectly but significantly affect soil microbial communities and enzyme activities through soil physicochemical properties. In addition, mixing P. tabulaeformis or P. orientalis in H. rhamnoides plantations is a suitable afforestation model in the Loess Plateau, because of significant positive effects on soil nutrient conditions, microbial community, and enzyme activities over pure plantations.


Asunto(s)
Hippophae/crecimiento & desarrollo , Microbiología del Suelo , Suelo/química , Compuestos de Amonio/análisis , Compuestos de Amonio/metabolismo , Biomasa , Carbono/análisis , Carbono/metabolismo , Hippophae/metabolismo , Nitrógeno/análisis , Nitrógeno/metabolismo , Peroxidasa/metabolismo , Monoéster Fosfórico Hidrolasas/metabolismo , Fósforo/análisis , Fósforo/metabolismo , Potasio/análisis , Potasio/metabolismo , Análisis de Componente Principal , Ureasa/metabolismo
12.
Ying Yong Sheng Tai Xue Bao ; 26(12): 3634-40, 2015 Dec.
Artículo en Chino | MEDLINE | ID: mdl-27111999

RESUMEN

The study aimed to assess the effect of different afforestation modes on microbial composition and nitrogen functional genes in soil. Soil samples from a pure Hippophae rhamnoides stand (SS) and three mixed stands, namely, H. rhamnoides and Pinus tabuliformis (SY), H. rhamnoides and Platycladus orientalis (SB), H. rhamnoides and Robinia pseucdoacacia (SC) were selected. The results showed that the total PLFA (TPLFA), bacterial PLFA, gram positive bacterial PLFA (G⁺PLFA) were significantly higher in soil samples from other three stands than those of the pure one. However, no significant difference was found for fungal PLFA among them. The abundance of nifH, amoA, nirK and narG genes were higher in SY and SC than in SS. The TPLFA, G⁺PLFA, gram negative bacterial PLFA (G⁻PLFA), and all of the detected gene abundance were significantly and positively correlated with soil pH, total organic carbon, total nitrogen, ammonium nitrogen and available potassium. Afforestation modes affected indirectly soil microbial composition and functional genes through soil properties. Mixing P. tabuliformis or P. orientalis with H. rhamnoides might be suitable afforestation modes, which might improve soil quality.


Asunto(s)
Bosques , Genes Bacterianos , Hippophae/microbiología , Nitrógeno/análisis , Microbiología del Suelo , Compuestos de Amonio/análisis , Bacterias/genética , Carbono/análisis , Hongos , Pinus , Potasio/análisis , Robinia , Suelo/química
13.
Zhonghua Yu Fang Yi Xue Za Zhi ; 48(9): 819-22, 2014 Sep.
Artículo en Chino | MEDLINE | ID: mdl-25492296

RESUMEN

OBJECTIVE: To establish the single genome amplification (SGA) method and analyze the quasispecies in HIV-infected patients. METHODS: All 6 sample RNA acquired in 2010 in Shenzhen and genetic sequenced as overlap peaks were extracted and diluted to a single copy, nest-PCR after one step RT-PCR was employed to amplify HIV-1 genome, and then PCR products was purified and sequenced. Mega 4.02 software was used to analyze the genetic distance among HIV-1 quasispecies, and phylogenetic tree was constructed. RESULTS: Our data showed that viral sequences derived from different patients were grouped into different clusters. Subcluster was also observed in several clusters, indicating these existed competition and preferential replication of certain viral strains. The genetic distance within one cluster of 6 samples were between 0.008 and 0.06, it was likely to associate with the duration since infection and viral load. CONCLUSION: SGA is a useful approach to gain information on quasispecies, the genetic distance within one cluster may help to determine the infection time and immune escaping. The analysis of related affecting factors need more samples.


Asunto(s)
Genoma Viral , Infecciones por VIH , Reacción en Cadena de la Polimerasa , Secuencia de Bases , VIH-1 , Humanos , Filogenia , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Carga Viral
14.
PLoS One ; 9(4): e95430, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24769673

RESUMEN

Patterns of poultry exposure in rural and urban areas in China have not been systematically evaluated and compared. The objective of our study is to investigate patterns in human exposure to poultry in rural and urban China. We conducted a two-stage household-based clustered survey on population exposure to live/sick/dead poultry in Xiuning and Shenzhen. Half of the rural households (51%) in Xiuning raised poultry, mostly (78%) free-range. Around half of those households (40%) allowed poultry to stay in their living areas. One quarter of villagers reported having contact with sick or dead poultry. In Shenzhen, 37% urban residents visited live poultry markets. Among these, 40% purchased live poultry and 16% touched the poultry or cages during purchase. Our findings indicated that human exposure to poultry was different in rural and urban areas in China. This discrepancy could contribute to the observed differences in epidemiologic characteristics between urban and rural cases of influenza A(H7N9) and A(H5N1) virus infection.


Asunto(s)
Exposición a Riesgos Ambientales , Gripe Aviar/transmisión , Gripe Humana/transmisión , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Niño , Preescolar , China/epidemiología , Femenino , Humanos , Gripe Aviar/epidemiología , Gripe Aviar/virología , Gripe Humana/epidemiología , Gripe Humana/virología , Masculino , Persona de Mediana Edad , Aves de Corral , Factores de Riesgo , Población Rural , Encuestas y Cuestionarios , Población Urbana , Adulto Joven , Zoonosis
15.
Zhonghua Liu Xing Bing Xue Za Zhi ; 34(9): 906-10, 2013 Sep.
Artículo en Chino | MEDLINE | ID: mdl-24331968

RESUMEN

OBJECTIVE: Both epidemiologic characteristics and transmission mode of a varicella outbreak among schoolchildren in Shenzhen city were studied and related control measures were discussed. METHODS: Case definition was established. Case-finding and face-to-face investigation were conducted, followed by analysis on distributions of time, place and persons of the outbreak. Association between possible modes of transmission and the outbreak was explored. Retrospective cohort study was carried out. RESULTS: The overall attack rate of this outbreak was 4.4% (122 of 2742). The attack rate among primary schoolchildren(8.3%, 118/1419)was higher than that in the middle-school children(0.3%, 4/1323). There were no statistically significant differences on the attack rates between male and female students. A total of 22 classes from the 9 grades were affected by this outbreak and the aggregation of varicella cases was found in classes. The highest attack rates was found in the students of fifth grade(23.7%), followed by from the third grade (13.4%). The main transmission mode appeared to be close personal contact. The outbreak, with four peaks of incidence, lasted 72 days. Data from the investigation suggested that the primary case was introduced into the school during military training involved by the students. Activities related to physical examination for all the schoolchildren seemed to have contributed to the spread of this disease among classes. Delayed isolation of cases appeared to be the major factor causing the spread of disease among classes. Intensive off-school activities or free community bus for children did not seem to be associated with the spreading of the disease. 52.5% (64/122) of the cases had received one-dose of varicella vaccine, with the median of onset after the vaccination as 7 years. The results demonstrated that one single-dose vaccine or long vaccination period were factors related to the insufficient immunity that causing the outbreak of disease. CONCLUSION: Varicella outbreak has been one of the most grievous public health problems in schools, posting challenges on the implementation of isolation measures, in particular. Once the chain of transmission is in place, it is difficult to make the universal measures effective within a short period.


Asunto(s)
Varicela/epidemiología , Brotes de Enfermedades , Estudios Epidemiológicos , Adolescente , Niño , China/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Factores de Riesgo , Instituciones Académicas , Estudiantes
16.
Zhonghua Liu Xing Bing Xue Za Zhi ; 34(4): 371-3, 2013 Apr.
Artículo en Chino | MEDLINE | ID: mdl-23937843

RESUMEN

OBJECTIVE: To compare the field epidemiological investigation and the criminal investigation on a nitrite poisoning event caused by deliberate contamination. METHODS: Cases were searched according to the definition of the disease. Information on the histories of onset and diet of all the cases and normal population on site, were investigated face to face. Information as ingredients, processing and sales of foods was also gathered. Samples were collected and nitrite detection were performed. Relevant materials were searched, cases were interviewed and data related to criminal results were collected. RESULTS: Poisoned persons were staff of a big company in Longgang district of Shenzhen. The overall attack rate was 56.25% (63/112), with suspected and confirmed rates as 41.96% and 14.28%, respectively. The fatality rate was 3.17% (2/63). Clinical manifestation and effect of treatment were in accordance with the characteristics of an episode related to acute nitrite food poisoning in terms of factors as the time of onset, involving different age, sex and jobs of the patients. A total of 191 samples, including vomits from patients and seven batches of food and environment samples, were collected, with a positive detected rate of nitrite as 18.84%. Information gathered from the field environment, food distribution and processing supported the assumption that this was an incident of nitrite poisoning event with intention. RESULTS: from the criminal investigation showed that the suspect stemmed from the market management rivalry, bought nitrite, dissolved and spread on food stalls F9 and F10. CONCLUSION: This event of intentional nitrite release resulting in food contamination which further leading to food poisoning, was completely proved by the joint efforts of the teams and expertise from the field epidemiology survey and the criminal investigation.


Asunto(s)
Enfermedades Transmitidas por los Alimentos/epidemiología , Nitritos/envenenamiento , Adolescente , Adulto , Femenino , Humanos , Masculino
17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 34(3): 273-8, 2013 Mar.
Artículo en Chino | MEDLINE | ID: mdl-23759236

RESUMEN

OBJECTIVE: To synthesize relevant data and to analyze the benefit-cost ratio on strategies related to preventing the maternal-infantile transmission of hepatitis B virus infection and to explore the optimal strategy. METHODS: A decision tree model was constructed according to the strategies of hepatitis B immunization and a Markov model was conducted to simulate the complex disease progress after HBV infection. Parameters in the models were drawn from meta-analysis and information was collected from field study and review of literature. Economic evaluation was performed to calculate costs, benefit, and the benefit-cost ratio. Sensitivity analysis was also conducted and a tornado graph was drawn. RESULTS: In view of the current six possible strategies in preventing maternal-infantile transmission of hepatitis B virus infection, a multi-stage decision tree model was constructed to screen hepatitis B surface antigen (HBsAg) or screen for HBsAg then hepatitis B e antigen (HBeAg). Dose and the number of injections of HBIG and hepatitis B vaccine were taken into consideration in the model. All the strategies were considered to be cost-saving, while the strategy of screening for HBsAg and then offering hepatitis B vaccine of 10 µg×3 for all neonates with hepatitis B immunoglobulin (HBIG) of 100 IU×1 for the neonates born to mothers who tested positive for HBsAg appeared with most cost-saving. In the strategies, the benefit-cost ratio of using 100 IU HBIG was similar to 200 IU HBIG, and one shot of HBIG was superior to two shots. RESULTS: from sensitivity analysis suggested that the rates of immunization and the efficacy of the strategy in preventing maternal-infantile transmission were the main sensitive variables in the model. CONCLUSION: The passive-active immune-prophylaxis strategy that using 10 µg hepatitis B vaccine combined with 100 IU HBIG seemed to be the optimal strategy in preventing maternal-infantile transmission, while the rates of immunization and the efficacy of the strategy played the key roles in choosing the ideal strategy.


Asunto(s)
Vacunas contra Hepatitis B/economía , Hepatitis B/economía , Hepatitis B/transmisión , Transmisión Vertical de Enfermedad Infecciosa/economía , Análisis Costo-Beneficio , Árboles de Decisión , Femenino , Hepatitis B/prevención & control , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control
18.
BMC Health Serv Res ; 13: 37, 2013 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-23368750

RESUMEN

BACKGROUND: Although the expenses of liver cirrhosis are covered by a critical illness fund under the current health insurance program in China, the economic burden associated with hepatitis B virus (HBV) related diseases is not well addressed. In order to provide evidence to address the economic disease burden of HBV, we conducted a survey to investigate the direct economic burden of acute and chronic hepatitis B, cirrhosis and liver cancer caused by HBV-related disease. METHODS: From April 2010 to November 2010, we conducted a survey of inpatients with HBV-related diseases and who were hospitalized for seven or more days in one of the seven tertiary and six secondary hospitals in Shandong, China. Patients were recorded consecutively within a three-to-five month time period from each sampled hospital; an in-person survey was conducted to collect demographic and socio-economic information, as well as direct medical and nonmedical expenses during the last month and last year prior to the current hospitalization. Direct medical costs included total outpatient, inpatient, and self-treatment expenditures; direct nonmedical costs included spending on nutritional supplements, transportation, and nursing. Direct medical costs during the current hospitalization were also obtained from the hospital financial database. The direct economic cost was calculated as the sum of direct medical and nonmedical costs. Our results call for the importance of implementing clinical guideline, improving system accountability, and helping secondary and smaller hospitals to improve efficiency. This has important policy implication for the on-going hospital reform in China. RESULTS: Our data based on inpatients with HBV-related diseases suggested that the direct cost in US dollars for acute hepatitis B, severe hepatitis B, chronic hepatitis B, compensated cirrhosis, decompensated cirrhosis and primary liver cancer was $2954, $10834, $4552, $7400.28, $6936 and $10635, respectively. These costs ranged from 30.72% (for acute hepatitis B) to 297.85% (for primary liver cancer) of the average annual household income in our sample. Even for patients with health insurance, direct out-of-pocket cost of all HBV-related diseases except acute hepatitis B exceeded 40.00% of the patient's disposable household income, making it a catastrophic expenditure for the household. CONCLUSION: Hepatitis B imposes considerable economic burden on a family. Our findings will help health policy makers' understanding of the magnitude of the economic burden of HBV-related diseases in China. Evidence from our study also contributes to our understanding of potential benefits to society from allocating more resources to preventing and treating HBV infection, as well as increasing insurance coverage in China. These findings have important policy implications for health care reform efforts currently underway in China focusing on how to reduce the burden of catastrophic disease for its citizens.


Asunto(s)
Costo de Enfermedad , Costos Directos de Servicios/estadística & datos numéricos , Virus de la Hepatitis B , Hepatitis B/economía , Cirrosis Hepática/economía , Neoplasias Hepáticas/economía , Adulto , China/epidemiología , Femenino , Encuestas Epidemiológicas , Hepatitis B/epidemiología , Hospitalización/economía , Hospitalización/estadística & datos numéricos , Humanos , Entrevistas como Asunto , Cirrosis Hepática/epidemiología , Cirrosis Hepática/virología , Neoplasias Hepáticas/epidemiología , Neoplasias Hepáticas/virología , Masculino , Persona de Mediana Edad , Evaluación de Procesos y Resultados en Atención de Salud , Relaciones Profesional-Paciente , Factores Socioeconómicos , Estadísticas no Paramétricas , Adulto Joven
19.
J Infect Dis ; 207(1): 106-14, 2013 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-22930808

RESUMEN

BACKGROUND: Understanding the epidemiological dynamics of influenza virus is central to surveillance and vaccine strain selection. It has been suggested that tropical and subtropical regions represent the global source of influenza epidemics. However, our understanding of the epidemiological dynamics of influenza virus in these regions is limited by a relative lack of long-term data. METHODS: We analyzed epidemiological and virological data on influenza recorded over a period of 15 years from the metropolitan city of Shenzhen in subtropical southern China. We used wavelet analysis to determine the periodicity of influenza epidemics and molecular phylogeographic analysis to investigate the role of Shenzhen and southern China in the global evolution of influenza virus. RESULTS: We show that southern China is unlikely to represent an epicenter of global influenza activity, because activity in Shenzhen is characterized by significant annual cycles, multiple viral introductions every year, limited persistence across epidemic seasons, and viruses that generally are not positioned on the trunk of the global influenza virus phylogeny. CONCLUSIONS: We propose that novel influenza viruses emerge and evolve in multiple geographic localities and that the global evolution of influenza virus is complex and does not simply originate from a southern Chinese epicenter.


Asunto(s)
Virus de la Influenza A/genética , Virus de la Influenza B/genética , Gripe Humana/epidemiología , Animales , Embrión de Pollo , China/epidemiología , Perros , Epidemias , Evolución Molecular , Humanos , Virus de la Influenza A/clasificación , Virus de la Influenza A/aislamiento & purificación , Virus de la Influenza B/clasificación , Virus de la Influenza B/aislamiento & purificación , Gripe Humana/prevención & control , Gripe Humana/virología , Células de Riñón Canino Madin Darby , Datos de Secuencia Molecular , Periodicidad , Filogenia , Filogeografía , Estaciones del Año
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 34(12): 1203-7, 2013 Dec.
Artículo en Chino | MEDLINE | ID: mdl-24518020

RESUMEN

OBJECTIVE: All news reports (NR) that were related to public health emergency (PHE) were collected from the Southern Metropolis Daily (SMD) to explore the characteristics of epidemiology in the fields. METHODS: Based on the theory of communication that including both case and text analysis, qualitative analysis on all the NR regarding PHE published in SMD from the years of 2008 to 2012, was carried out and input to database using the EpiData. Numbers of articles as indicators were compared to show the yearly change of different types of events. Various features of the NR including coverage, source of information, location of the incident, style and size of news, with or without editorials etc. were statistically analyzed by SPSS version 18.0. RESULTS: Among all the 998 reports related to PHE, higher proportion was found in the events of Infectious diseases (35.3%) and food safety (34.1%)respectively. Events on vaccines and drugs used for disease prevention and control (8.9%), environmental pollution caused incidents (8.0%)appeared to be less frequent. Events related to occupational disease, poisoning, bioterrorism and biochemical events were rare. Looking at the monthly distribution of reports, we noticed that the peaks occurred in 2008 and in 2009, which were caused by the Melamine-contamination events and the 2009 H1N1 pandemic. Between 2010 and 2012, figures of monthly reports were smooth, including some critical events from the interests of the media. Most events took place in Guangdong province (34.3%) and other provinces (50.9%), with some were from Hong Kong, Macao and Taiwan regions (9.5%). However, international events (5.2%)were less seen. Extensive coverage accounted for 17.6% of all of reports, and 11.5% allotted the editorials or other forms of in-depth reports. Most of the source of reports on infectious diseases and food safety were from the official release, however. The main sources of occupational diseases and poisoning, vaccines and drug incidents, environmental pollution related incidents were reported by active journalists through interview. Reports on hand, foot and mouth disease, influenza, milk safety, AIDS and lead pollution showed continued concern in the past five years by SMD. CONCLUSION: NR on public health emergencies by SM had encompassed all 10 categories-related events formulated by the Ministry of Health. Sustained and in-depth coverage were more commonly seen. Field-epidemiologists should learn interdisciplinary sciences on the theory and methodology of communication. They also need to interact with media people during the whole processes of public health emergency preparedness and responses.


Asunto(s)
Urgencias Médicas , Medios de Comunicación de Masas , Salud Pública , Brotes de Enfermedades , Estudios Epidemiológicos , Humanos
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