Spatial distribution of Oncomelania hupensis spread in Hubei Province from 2020 to 2022 / 中国血吸虫病防治杂志

OBJECTIVE@#To identify the spatial distribution pattern of Oncomelania hupensis spread in Hubei Province, so as to provide insights into precision O. hupensis snail control in the province.@*METHODS@#Data pertaining to emerging and reemerging snails were collected from Hubei Province from 2020 to 2022 to build a spatial database of O. hupensis snail spread. The spatial clustering of O. hupensis snail spread was identified using global and local spatial autocorrelation analyses, and the hot spots of snail spread were identified using kernel density estimation. In addition, the correlation between environments with snail spread and the distance from the Yangtze River was evaluated using nearest-neighbor analysis and Spearman correlation analysis.@*RESULTS@#O. hupensis snail spread mainly occurred along the Yangtze River and Jianghan Plain in Hubei Province from 2020 to 2022, with a total spread area of 4 320.63 hm2, including 1 230.77 hm2 emerging snail habitats and 3 089.87 hm2 reemerging snail habitats. Global spatial autocorrelation analysis showed spatial autocorrelation in the O. hupensis snail spread in Hubei Province in 2020 and 2021, appearing a spatial clustering pattern (Moran's I = 0.003 593 and 0.060 973, both P values < 0.05), and the mean density of spread snails showed spatial aggregation in Hubei Province in 2020 (Moran's I = 0.512 856, P < 0.05). Local spatial autocorrelation analysis showed that the high-high clustering areas of spread snails were mainly distributed in 50 settings of 10 counties (districts) in Hubei Province from 2020 to 2022, and the high-high clustering areas of the mean density of spread snails were predominantly found in 219 snail habitats in four counties of Jiangling, Honghu, Yangxin and Gong'an. Kernel density estimation showed that there were high-, secondary high- and medium-density hot spots in snail spread areas in Hubei Province from 2020 to 2022, which were distributed in Jingzhou District, Wuxue District, Honghu County and Huangzhou District, respectively. There were high- and medium-density hot spots in the mean density of spread snails, which were located in Jiangling County, Honghu County and Yangxin County, respectively. In addition, the snail spread areas negatively correlated with the distance from the Yangtze River (r = -0.108 9, P < 0.05).@*CONCLUSIONS@#There was spatial clustering of O. hupensis snail spread in Hubei Province from 2020 to 2022. The monitoring and control of O. hupensis snails require to be reinforced in the clustering areas, notably in inner embankments to prevent reemerging schistosomiasis.

Gastrointestinal ALK-positive anaplastic large cell lymphoma: a clinicopathological analysis of five cases / 中华病理学杂志

Objective: To investigate the clinicpathological characteristics of ALK-positive anaplastic large cell lymphoma (ALCL) of the gastrointestinal tract, and to discuss its diagnosis and differential diagnosis. Methods: Five cases of gastrointestinal ALK-positive ALCL diagnosed and treated in Xijing Hospital of the Fourth Military Medical University, between 2011 and 2019 were collected. There were three male and two female patients, aged 5-42 years (mean 25 years). These patients clinically presented with fever and night sweats, weight loss, abdominal pain, abdominal mass, ulcers, bleeding, or intestinal obstruction, and underwent surgical resection of the tumors or endoscopic biopsy. The clinical manifestations, auxiliary examinations, histopathological characteristics, immunophenotypes and genetic alterations were analyzed. Results: In this cohort, one case was common type, two cases were monomorphic variant of common type, and two cases were small cell variant. The tumor cells in all cases expressed ALK, CD30, and one or more T lymphocyte markers, while all the markers of B lymphocyte and plasmacyte were negative. Clonality analysis showed that two cases had clonal T cell receptor (TCR) and immunoglobulin (Ig) gene rearrangement, one case had no clonal TCR but Ig gene rearrangement, and one case had no clonal TCR and Ig gene rearrangements. During the 4 to 67 months' follow-up, two patients died of the disease, two were alive with free of disease and one had a relapse. Conclusions: ALK-positive ALCL of the gastrointestinal tract is extremely rare, and has poor prognosis. Lymphoma originating from this site with CD30 and ALK-positive phenotypes may be considered to be ALCL; however differentiation from other tumors that had anaplastic features, expressed CD30 and or ALK, in particular, ALK positive large B-cell lymphoma is necessary.

Malignant gastrointestinal neuroectodermal tumor: a clinicopathological analysis of three cases / 中华病理学杂志

Objective: To investigate the clinicopathological characteristics of malignant gastrointestinal neuroectodermal tumors (GNET), and to describe their clinical, histological, immunophenotypic, ultrastructural, and molecular features, diagnosis and differential diagnosis. Methods: Three cases of malignant GNET were collected at Xijing Hospital of the Fourth Military Medical University, from 2013 to 2022. All patients underwent surgical resection of the tumor. Histological, immunohistochemical (IHC), ultrastructural and molecular genetic analyses were performed, and the patients were followed up for six months, three years and five years. Results: There were two males and one female patients. The tumors were located in the ileum, descending colon, and rectum, respectively. Grossly, the tumors were solid, firm, and poorly circumscribed, measured in size from 2 to 4 cm in greatest dimension, and had a greyish-white cut surface. These tumors were histologically characterized by a sheet-like or nested population of oval to spindled cells or epithelioid cells with weakly eosinophilic or clear cytoplasm, small nucleoli and scattered mitoses. Electron microscopy showed neuroendocrine differentiation, and no evidence of melanogenesis. IHC staining showed that the tumor cells were diffusely positive for S-100 protein, SOX10, CD56, synaptophysin and vimentin. They were negative for melanocytic markers, HMB45 and Melan A. All three cases showed split EWSR1 signals consistent with a chromosomal translocation involving EWSR1. Next-generation sequencing in one case confirmed the presence of EWSR1-ATF1 fusion. These patients were followed up for 6 months, 3 years and 5 years, respectively, and all of them developed possible lung or liver metastases, and one of them died of multiple pulmonary metastases. Conclusion: Malignant GNET has distinctive morphological, IHC, and molecular genetic features and it should be differentiated from other malignancies of the gastrointestinal tract, especially clear cell sarcoma and melanoma.

High-Throughput Discovery and Characterization of Viral Transcriptional Effectors in Human Cells

Viruses encode transcriptional regulatory proteins critical for controlling viral and host gene expression. Given their multifunctional nature and high sequence divergence, it is unclear which viral proteins can affect transcription and which specific sequences contribute to this function. Using a high-throughput assay, we measured the transcriptional regulatory potential of over 60,000 protein tiles across [~]1,500 proteins from 11 coronaviruses and all nine human herpesviruses. We discovered hundreds of new transcriptional effector domains, including a conserved repression domain in all coronavirus Spike homologs, dual activation-repression domains in VIRFs, and an activation domain in six herpesvirus homologs of the single-stranded DNA-binding protein that we show is important for viral replication and late gene expression in KSHV. For the effector domains we identified, we investigated their mechanisms via high-throughput sequence and chemical perturbations, pinpointing sequence motifs essential for function. This work massively expands viral protein annotations, serving as a springboard for studying their biological and health implications and providing new candidates for compact gene regulation tools.

El papel de los parámetros metabólicos de la 18F-FDG PET/TC en el linfoma linfoblástico pediátrico / The role of 18F-FDG PET/CT metabolic parameters in pediatric lymphoblastic lymphoma

Objetivo: Este estudio retrospectivo tuvo como objetivo evaluar el papel de los parámetros metabólicos de la 18F-FDG PET/TC en el linfoma linfoblástico pediátrico (LBL).Métodos: Treinta pacientes con LBL se sometieron a 42 exploraciones. Los parámetros metabólicos, que incluyeron el valor máximo de captación estandarizado (SUVmax), el volumen tumoral metabólico total (TMTV) y la glucólisis de lesión total (TLG), se midieron en la PET/TC basal. Se realizaron análisis univariantes y multivariantes de la supervivencia para evaluar su valor pronóstico. Doce pacientes se sometieron a PET/TC después del régimen de reinducción, y se calcularon la sensibilidad, la especificidad, el valor predictivo positivo (VPP), el valor predictivo negativo (VPN) y la precisión de la PET/TC para predecir la recaída.Resultados: Los pacientes con estadio IV tuvieron una TMTV más alta que los que tenían un estadio III (p=0,031). Además, los pacientes con T-LBL o afectación mediastínica tenían una TMTV y TLG altos (p<0,05). No hubo diferencias significativas en los parámetros metabólicos de la PET/TC entre los pacientes con diferente evolución (p>0,05). Los niños con una TMTV baja (<242,91cm3) tuvieron una mejor EFS a los 3 años comparados con aquellos con una TMTV elevada (88.9% vs. 56,3%; p=0,036). El SUVmax y el TLG no fueron predictivos de la EFS (p=0,874; p=0,152). Sin embargo, ninguno de los parámetros metabólicos de la PET/TC basales fueron factores pronósticos independientes para los resultados del LBL pediátrico. La PET/TC realizada después del régimen de reinducción presentó una mayor sensibilidad (50% vs. 0%) y VPN (90% vs. 83,3%) para predecir la recaída que la TC sola.Conclusiones: Los parámetros metabólicos de la PET/TC de referencia no fueron predictivos de los resultados en los niños con LBL. La PET/TC realizada después del régimen de reinducción tuvo una mejor sensibilidad y VPN que la TC sola, y una exploración

Objective: This retrospective study aimed to evaluate the role of metabolic parameters of 18F-FDG PET/CT in pediatric lymphoblastic lymphoma (LBL).Methods: Thirty patients with LBL underwent 42 scans. Metabolic parameters including maximum standardized uptake value (SUVmax), total metabolic tumor volume (TMTV), and total lesion glycolysis (TLG) were measured at baseline PET/CT. Univariate and multivariate analysis for survival were performed to assess their prognostic value. Twelve patients underwent PET/CT after reinduction regime, and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT for predicting relapse were calculated.Results: Patients with stage IV had a higher TMTV than those with stage III (P=0.031). Besides, patients with T-LBL or mediastinal involvement had a high TMTV and TLG (P<0.05). There was no significant difference in PET/CT metabolic parameters between patients with different outcomes (P>0.05). Children with a low TMTV (<242.91cm3) had a better 3-year EFS compared with those with a high TMTV (88.9% vs. 56.3%; P=0.036). SUVmax and TLG were not predictive of EFS (P=0.874; P=0.152). However, none of the metabolic parameters of baseline PET/CT were independent prognostic factors for outcomes of pediatric LBL. PET/CT underwent after reinduction regime present with higher sensitivity (50% vs. 0%) and NPV (90% vs. 83.3%) for predicting relapse than CT alone.Conclusions: Metabolic parameters of baseline PET/CT were not predictive of outcomes in children with LBL. PET/CT done after the reinduction regime had better sensitivity and NPV than CT alone, and a negative scan could be a reliable indicator for sustained remission (AU)

SARS-CoV-2 Infects Syncytiotrophoblast and Activates Inflammatory Responses in the Placenta

SARS-CoV-2 infection during pregnancy leads to an increased risk of adverse pregnancy outcomes. Although the placenta itself can be a target of virus infection, most neonates are virus free and are born healthy or recover quickly. Here, we investigated the impact of SARS-CoV-2 infection on the placenta from a cohort of women who were infected late during pregnancy and had tested nasal swab positive for SARS-CoV-2 by qRT-PCR at delivery. SARS-CoV-2 genomic and subgenomic RNA was detected in 23 out of 54 placentas. Two placentas with high virus content were obtained from mothers who presented with severe COVID-19 and whose pregnancies resulted in adverse outcomes for the fetuses, including intrauterine fetal demise and a preterm delivered baby still in newborn intensive care. Examination of the placental samples with high virus content showed efficient SARS-CoV-2 infection, using RNA in situ hybridization to detect genomic and replicating viral RNA, and immunohistochemistry to detect SARS-CoV-2 nucleocapsid protein. Infection was restricted to syncytiotrophoblast cells that envelope the fetal chorionic villi and are in direct contact with maternal blood. The infected placentas displayed massive infiltration of maternal immune cells including macrophages into intervillous spaces, potentially contributing to inflammation of the tissue. Ex vivo infection of placental cultures with SARS-CoV-2 or with SARS-CoV-2 spike (S) protein pseudotyped lentivirus targeted mostly syncytiotrophoblast and in rare events endothelial cells. Infection was reduced by using blocking antibodies against ACE2 and against Neuropilin 1, suggesting that SARS-CoV-2 may utilize alternative receptors for entry into placental cells.

Short-term high-dose gavage of hydroxychloroquine changes gut microbiota but not the intestinal integrity and immunological responses in mice.

AIMS: Hydroxychloroquine (HCQ), a widely used antimalarial drug, is proposed to treat coronavirus disease 2019 (COVID-19). However, no report is currently available regarding the direct effects of HCQ on gut microbiota, which is associated with the outcomes of elderly patients with COVID-19. Here, we first investigated the effects of HCQ on intestinal microecology in mice. MAIN METHODS: Fifteen female C57BL/6J mice were randomly divided into two groups: HCQ group (n = 10) and control group (n = 5). Mice in the HCQ group were administered with HCQ at dose of 100 mg/kg by gavage daily for 14 days. The feces of mice were collected before and on the 7th and 14th days after HCQ challenge, and then analyzed by 16S rRNA amplicon sequencing. At the end of the experiment, the hematology, serum biochemistry and cytokines were determined, respectively. The mRNA expression of tight junction proteins in colonic tissues were also studied by RT-PCR. KEY FINDINGS: HCQ challenge had no effects on the counts of white blood cells, the levels of serum cytokines, and the gene expression of tight junction proteins in colon. HCQ also did not increase the content of serum d-lactate in mice. Notably, HCQ significantly decreased the diversity of gut microbiota, increased the relative abundance of phylum Bacteroidetes whereas decreased that of Firmicutes. SIGNIFICANCE: Short-term high dose HCQ challenge changes gut microbiota but not the intestinal integrity and immunological responses in mice. Special attention should be paid to the effects of HCQ on intestinal microecology in future clinical use.

Evaluation of the therapeutic effects and micro-structural influence of rTMS on esophageal cancer patients with depression by using DTI / 实用放射学杂志

Objective To investigate the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS)on esophageal cancer patients with depression and the influence on the brain micro-structure by using the DTI technology.Methods Ten esophageal cancer patients with depression (6 male,4 female)were enrolled in this study according to the inclusion criteria.All patients received 1 0 days of rTMS treatment (stimulation frequency:10 Hz;stimulation site left:dorsolateral prefrontal cortex (DLPFC);stimulation intensity:1 10 % rest motor threshold).Before the first time and after the last time of the rTMS treatment,the DTI image acquisition and the coefficient assessment of hamilton depression scale(HAMD),self-rating depression scale(SDS),and self-rating anxiety scale (SAS)were conducted.Comparison of the mean fractional anisotropy (FA)of the depression related brain regions between pre-and post-rTMS was performed.Pearson correlation coefficient was calculated between the changes of FA value and the depression scale changes as well to understand their relationship.Results The HAMD,SAS and SDS were significantly decreased after pos-t rTMS (t＝7.69, P＝0.000;t＝12.86,P＝0.000;t＝10.51,P＝0.000)compared with pre-rTMS.Also,after rTMS depression patients showed significantly increased FA value in the bilateral hippocampus,left pallidum,bilateral thalamus,left middle frontal cortex,bilateral anterior cingulate cortex, and bilateral superior temporal cortex.Significant negative correlation was observed between the FA changes of the left pallidum and SAS(r＝－0.646,P＝0.044),and between the FA changes of right thalamus and HAMD (r＝－0.712,P＝0.021).Conclusion High frequency rTMS over the left DLPFC has significant antidepressant effect on esophageal cancer patients with depression.This may be related to the modulation of rTMS on the micro-structure of the left pallidum and right thalamus.

Management of Clinical T1N0M0 Esophageal Cancer

BACKGROUND/AIMS: Endoscopic resection is a standard treatment for stage T1a esophageal cancer, with esophagectomy or radical radiation therapy (RT) performed for stage T1b lesions. This study aimed to compare treatment outcomes of each modality for clinical stage T1 esophageal cancer. METHODS: In total, 179 patients with clinical T1N0M0-stage esophageal cancer treated from 2006 to 2016 were retrospectively evaluated. Sixty-two patients with clinical T1a-stage cancer underwent endoscopic resection. Among 117 patients with clinical T1b-stage cancer, 82 underwent esophagectomy, and 35 received chemoradiotherapy or RT. We compared overall survival (OS) and recurrence-free survival (RFS) rates for each treatment modality. RESULTS: The median follow-up time was 32 months (range, 1 to 120 months). The 5-year OS and RFS rates for patients with stage T1a cancer receiving endoscopic resection were 100% and 85%, respectively. For patients with stage T1b, the 5-year OS and RFS rates were 78% and 77%, respectively, for the esophagectomy group; 80% and 44%, respectively, for the RT alone group; and 96% and 80%, respectively, for the chemoradiation group. The esophagectomy group showed significantly higher RFS than the RT alone group (p=0.04). There was no significant difference in RFS between the esophagectomy and chemoradiation groups (p=0.922). Grade 4 or higher treatment-related complications occurred in four patients who underwent esophagectomy. CONCLUSIONS: Endoscopic resection appeared to be an adequate treatment for patients with T1a-stage esophageal cancer. The multidisciplinary approach involving chemoradiation was comparable to esophagectomy in terms of survival outcome without serious complications for T1b-stage esophageal cancer.

Molecular transmission clusters on HCV genotypes among newly reported HIV/HCV co-infection in Dehong Dai and Jingpo autonomous prefecture of Yunnan province, 2016 / 中华流行病学杂志

Objective: To understand the characteristics on major strain subtypes of hepatitis C virus among HIV/HCV co-infected patients, so as to explore the molecular transmission clusters and related risk factors of HCV strains. Methods: A total of 336 newly reported HIV-infected patients were diagnosed as HIV/HCV co-infection in Dehong Dai and Jingpo autonomous prefecture (Dehong) in 2016. We used Nested PCR to amplify CE1 and NS5B genes among 318 samples with plasma levels above 200 μl, before using the combining phylogenetic tree and constructing molecular propagation network method to analyze the related data. Results: A total of 267 HIV/HCV co-infection patients who had met the HCV genotyping requirements were screened the gene subtypes were diversified. Among these genotypes, proportions of 3b, 6n, 6u, 1a, 3a and other subtypes appeared as 32.6% (87/267), 18.4% (49/267), 15.7%(42/267), 13.1%(35/267), 11.2%(30/267) and 9.0%(24/267) respectively. Molecular transmission network of five major HCV genotypes was constructed with a clustering rate of 39.1% (95/243). The clustering rate of subtype 1a was the highest, as 71.4% (25/35). Results from the multivariate logistic regression showed that ethnic minorities other than the Yi and Jingpo (vs. the Han, OR=0.17, 95%CI: 0.04-0.71), the married spouses (vs. the unmarried, OR=0.42, 95%CI: 0.18-0.94), the 6n and 3a subtype (vs. the 3b subtype, OR=0.34, 95%CI: 0.12-0.95; OR=0.22, 95%CI: 0.05-0.93) were more difficult to form transmission clusters. However, the 6u and 1a subtype (vs. the 3b subtype, OR=3.10, 95%CI: 1.21-7.94; OR=4.00, 95%CI: 1.32-12.11) seemed more likely to form the transmission clusters. Conclusion: Ethnicity, marital status and genetic subtypes were factors significantly associated with the formation of transmission clusters related to the major HCV gene subtypes among newly reported HIV/HCV co-infection in Dehong.

Application of restricted mean survival time in clinical follow-up study / 中华流行病学杂志

In clinical follow-up studies, hazard ratio (HR) is routinely used to quantify the differences between-groups, however, it is being estimated by the Cox procedure. HR, the ratio of two hazard functions has abstract meaning only and is in lack of the context to give an intuitive explanation of the survival of patients and the assumption of proportional hazards (PH) must be satisfied. Under this context, the restricted mean survival time (RMST) can be used as a relatively effective measure or index of statistics. This paper introduces the RMST-based statistical analysis methods, including estimation of RMST and its difference, hypothesis testing and regression analysis. The application of RMST in data analysis is also introduced. All the evidence demonstrates that RMST can be used as an effective analytical tool with straightforward interpretation. RMST is also more effective than HR in comparing differences between groups, when non-PH is observed. Therefore, RMST is suggested to be stated along with HR in the process of disease efficacy evaluation and prognosis analysis. Cooperation and complement of the two, a precise reflection on the characteristics of data can be expected.

Next Generation Sequencing Identified a Novel Multi Exon Deletion of the NF1 Gene in a Chinese Pedigree with Neurofibromatosis Type 1.

Neurofibromatosis type 1 (NF1) is a genetic disease involving neurocutaneous abnormalities. Neurofibromatosis type 1 is an autosomal dominant disorder characterized by the neurofibromas and café-au-lait spots. Mutation in the NF 1 gene causes NF1. The NF 1 gene encodes neurofibromin. In this study, we found a 31-year-old Chinese boy with NF1. He presented only with café-au-lait spots over the whole body. The proband's mother had a severe phenotype with neurofibroma and café-au-lait macules over her whole body, mostly in the facial region. A novel multi exon deletion c.(4661+1_4662-1)_(5748+1_5749-1)del; [EX36_39DEL] on the NF 1 gene has been identified in the proband. Quantitative real-time polymerase chain reaction (qPCR) confirmed that this mutation is co-segregated well and was inherited from the proband's mother. The mutation was absent in the proband's father and normal individuals. The novel multi exon deletion results in the formation of a truncated NF1 protein that caused the NF1 phenotype in this family. Our present study also emphasized the significance of rapid, accurate and cost-effective screening for the patient with NF1 by next generation sequencing (NGS).

Retrospective study of combination chemotherapy with etoposide and ifosfamide in patients with heavily pretreated recurrent or persistent epithelial ovarian cancer

OBJECTIVE: This retrospective study is to evaluate the efficacy and toxicity of combination chemotherapy with etoposide and ifosfamide (ETI) in the management of pretreated recurrent or persistent epithelial ovarian cancer (EOC). METHODS: Patients with recurrent or persistent EOC who had measurable disease and at least one chemotherapy regimen were to receive etoposide at a dose of 100 mg/m²/day intravenous (IV) on days 1 to 3 in combination with ifosfamide 1 g/m²/day IV on days 1 to 5, every 21 days. RESULTS: From August 2008 to August 2016, 66 patients were treated with ETI regimen. Most patients were heavily pretreated prior to ETI: 53 (80.3%) patients had received 3 or more chemotherapy regimens. The response rate (RR) of ETI chemotherapy was 18.2% and median duration of response was 6.8 months (range, 0–30). Median survival of all patients was 5 months at a median follow up of 7.2 months. Platinum-free interval (PFI) more than 6 months prior to ETI has statistically significant correlation with overall survival (OS; 9.2 vs. 5.6 months; P=0.029) and RR (34.5% vs. 5.4%; P < 0.010). However, treatment free interval before ETI, number of prior chemotherapy regimen, and optimality of primary surgery did not show significant difference for RR or OS. Grade 3 or 4 hematologic toxicities were observed in 7 cases (3%) of the 232 cycles of ETI. CONCLUSION: The ETI combination regimen shows comparatively low toxicity and modest activity in heavily pretreated recurrent or persistent EOC patients with more than 6 months of PFI after last platinum treatment.

Prevalence, awareness, status of treatment and control on type 2 diabetes mellitus among Chinese premenopausal women aged 18-49 in 2013 / 中华流行病学杂志

Objective: To analyze the rates on prevalence, awareness, status on treatment and control of type 2 diabetes mellitus among Chinese premenopausal women aged 18-49, in 2013. Methods: Data on China Chronic and Non-Communicable Disease Surveillance in year 2013 was used for analysis. Source of data covered 302 surveillance points which were selected by Multi-stage cluster random sampling method that including 176 534 adults over 18 years of age, with 46 674 premenopausal women aged 18-49. Plasma glucose and hemoglobin A1c levels were determined after a 10-hour overnight fast for all the participants, before a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes. Diabetes was defined according to the 1999 WHO diagnostic criteria-fasting blood glucose level as ≥7.0 mmol/L and/or 2 hours oral glucose tolerance test (OGTT-2 h) level as ≥11.1 mmol/L. After being weighed, according to complex sampling scheme and post-stratification, the sample was used to estimate the rates of prevalence, awareness, treatment and control of type 2 diabetes mellitus by age, education, urban and rural areas, and geographic locations. Results: The overall prevalence of type 2 diabetes mellitus was 5.6% among the Chinese premenopausal women aged 18-49. No statistical difference on the prevalence rates (5.7% and 5.4%, respectively) was seen, between participants from the rural or the urban areas. Prevalence rates in the eastern, central or western geographic areas were 5.8%, 6.2% and 4.4% respectively. The rates of awareness, treatment and control of diabetes appeared as 29.3%, 27.9% and 29.4% in childbearing women aged 18-49. The rate of treatment was 95.4% among those who knew their diabetic situation in childbearing women aged 18-49 years. The control rate of diabetes was 38.9% among those who had taken measures to control glucose, in 18-49-year-old childbearing women. The rate of awareness on diabetes in childbearing women aged 18-49 years in urban areas was higher than that in the rural areas. There were significantly statistical differences on the treatment rates among groups of different education levels but not in the trend test. Conclusion: The prevalence of type 2 diabetes mellitus in childbearing women aged 18-49 appeared high, but with low rates on awareness, treatment and control. However, statistical difference was seen on awareness, between urban and rural areas.

Characteristics and influencing factors regarding social relations among men who have sex with men / 中华流行病学杂志

Objective: To study the characteristics of social relations and relative factors among MSM in Guangzhou. Methods: Data was collected through a cross-sectional study in Guangzhou from November 2016 to May 2017. Sample size was estimated and participants were recruited from the voluntary counseling and testing services (VCT) which were set for MSM population, by nongovernmental organizations (NGOs) and the Centers for Disease Control and Prevention (CDC). Social ties and demographic characteristics of the respondents and their sexual partners were analyzed through both Chi square test and generalized estimating equations (GEE). Results: A total of 1 073 MSM, together with their nominated 4 301 partners were successfully recruited and involved in this study. Age (OR=1.2, P=0.01) and non-internet based intercourse (OR=1.65, P<0.01) were easy to form close relation with strong ties. Compared with MSM traditional venues (chess and cards room, tea room bathhouse, club), general public venue (bars, KTV, parks, shopping malls, schools, restaurants) (OR=1.46-3.12, P<0.01) showed close relation with strong ties. Our finding showed that MSM at the age of 18-25 preferred to build weak ties with the older MSM, while the 26-30-year-olds and 31-40-year-olds prefer to establish weak ties with younger partners but the 41-50-year-olds preferred to develop weak ties with one that were ten years younger. Conclusions: Clusters were noticed in the MSM populations when grouping and making friends with ones at different age. Characteristics regarding the relationship between sexual partners in choosing venues and ways of dating were different. Targeted intervention programs need to be explored innovatively.

Association between total cholesterol and risk of lung cancer incidence in men: a prospective cohort study / 中华流行病学杂志

Objective: To assess the association and intensity of baseline TC level with the incidence of lung cancer in men in China. Methods: Since May 2006, all the male workers, including the employees and the retirees in Kailuan Group were recruited in the Kailuan male dynamic cohort study. Information about demographics, medical history, anthropometry and TC level were collected at the baseline interview, as well as the information of newly-diagnosed lung cancer cases during the follow-up period. According to guidelines for blood lipids in Chinese adults and the distribution in the population, TC level was classified into five groups as followed: <160, 160-, 180-, 200- and ≥240 mg/dl, with the second quintile group (160- mg/dl) serving as the referent category. Cox proportional hazards regression model and restricted cubic spline (RCS) model were used to evaluate the association and the nonlinear association between baseline TC level and the risk of lung cancer in the men. Results: By December 31, 2014, for the 109 884 men, a follow up of 763 819.25 person-years was made with a median follow-up period of 7.88 years. During the follow up, 808 lung cancer cases were identified. After adjustment for age, education level, income level, smoking status, alcohol consumption level, history of dust exposure, FPG level and BMI, HR (95%CI) of lung cancer for men with lower TC level (<160 mg/dl) and higher TC level (≥240 mg/dl) were 1.34 (1.04- 1.72) and 1.45 (1.09-1.92), respectively, compared with men with normal TC level (160- mg/dl). The results didn't change significantly after exclusion of newly diagnosed cancer cases within 2 years of follow up and subjects with the history of hyperlipidemia. Conclusion: Our results showed that TC might be associated with higher risk of lung cancer. Men with lower TC level or higher TC level had higher risk for lung cancer. Keep moderate TC level might be one of the effective precaution for the prevention of lung cancer.

HIV gene subtypes of newly reported HIV/AIDS cases in Dehong Dai and Jingpo autonomous prefecture of Yunnan province, 2016 / 中华流行病学杂志

Objective: To explore distribution of HIV gene subtypes among newly reported HIV/AIDS cases from China and Myanmar in Dehong Dai and Jingpo prefecture of Yunnan province in 2016. Methods: We conducted DNA extractions from newly reported HIV/AIDS cases in 2016. The gag, env and pol genes were amplified by using reverse transcription-PCR (RT-PCR) and sequenced to identify HIV subtypes. Results: A total of 1 112 newly diagnosed HIV cases were reported in Dehong in 2016, and the HIV subtypes were identified for 860 cases. Subtype C was predominant (33.6%), followed by unique recombinant forms (URFs) (28.4%), CRF01_AE (18.6%) and so on. URFs include four recombination, among which the recombination of CRF01_AE and C subtype were predominant. The HIV subtype distribution was associated with nationality and transmission route in HIV/AIDS cases from Myanmar. Conclusions: The gene subtypes of C, URFs and CRF01_AE were mainly distributed; distribution of URFs remained complex and diverse among newly reported HIV/AIDS cases in Dehong in 2016.

Current situation and related policies on the implementation and promotion of influenza vaccination, in China / 中华流行病学杂志

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.

The influence of statutory holidays on the proportion of the outpatient and emergency visits for influenza-like illness / 中华流行病学杂志

Objective: To analyze the reasons for the fluctuations in the percentage of outpatient or emergency visits for influenza-like illness (ILI) during the Spring Festival and National Day in 2014-2018 surveillance season. Methods: ILI surveillance data was collected during the period of Spring Festival and National Day in mainland China, and downloaded from Chinese Influenza Surveillance Information System, during the 2014-2018 surveillance season. Results: There was no significant difference noticed in the number of ILI reports in the festival week with weeks before or after in both the southern and northern provinces. The number of outpatient visits was much less than that of the week before and after, but the number of emergency visits was statistically significantly increased. Conclusion: In the holiday peak of ILI%, the major causes was the impact of holiday-off at sentinel hospitals, resulting in a large reduction in the number of outpatient visits in the consulting room during the festivals.

Evaluation on follow-up intervention program in men who have sex with men in Tianjin / 中华流行病学杂志

Objective: To evaluate the behavior intervention program on men who have sex with men (MSM) in Tianjin. Methods: From April 2013 to September 2017, MSM were enrolled from MSM gathering places and through mobile internet to establish an open prospective cohort. Interventions were conducted in every follow-up meeting, while the changes of behaviors and HIV infection and syphilis incidences in the MSM before and after intervention were compared. Results: A total of 1 822 MSM were interviewed at baseline survey, with 1 007 eligible MSM were enrolled in the cohort. A total of 39 new cases of HIV infection were reported, and the cumulative observation time on cohort follow-up was 2 216.96 person-year, with the HIV incidence rate as 1.76 per 100 person-years. Among them, 934 MSM were sero-negative for syphilis in baseline survey. A total of 100 new cases of syphilis were reported, and the cumulative observation time of cohort follow-up was 1 959.94 person-year, the syphilis incidence rate was 5.10 per 100 person-years. With health education and intervention conducted, the awareness rate of AIDS related knowledge for MSM increased. Though the rate of anal sex increased after intervention, the rate of condom use in anal sex increased, too. The rate of condom use decreased after receiving more than 3 interventions. Data from the multivariate GEE analysis indicated that protective factors might be as follows: education level of college and above (aOR=0.81, 95%CI: 0.68-0.98), awareness of AIDS related knowledge (aOR=0.52, 95%CI: 0.36-0.75), ever receiving condom promotion and distribution in the past six months (aOR=0.60, 95%CI: 0.49-0.74), being recruited from mobile internet (aOR=0.85, 95%CI: 0.73-1.00) and times of cumulative intervention: one time (aOR=0.55, 95%CI: 0.45-0.66), two times (aOR=0.38, 95%CI: 0.30-0.49), three times (aOR=0.26, 95%CI: 0.20-0.35), four times and above (aOR=0.24, 95%CI: 0.17-0.33). Diagnoses of STDs in the past six months (aOR=1.43, 95%CI: 1.06-1.96), using rush-poppers (aOR=1.22, 95%CI: 1.02-1.47) might be risk factors. Conclusions: After continuous behavior intervention, the incidence of HIV infection and syphilis were at a low level in the MSM cohort in Tianjin. Their awareness rate of AIDS related knowledge and the rate of condom use increased. But there are still many risk factors influencing the unprotected anal sex in MSM. We should continuously carry out behavioral intervention programs to prevent unprotected anal sex among MSM.