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Previous studies have demonstrated the characteristics of patients with 2019 novel coronavirus disease (COVID-19). However, the effect of non-pharmaceutical interventions on the epidemic in Shenzhen, China remains unknown. Individual data of 417 cases were extracted from the epidemiological investigations and the National Infectious Disease Information System between January 1, 2020 and February 29, 2020. On the basis of important interventions, the epidemic was divided into four periods (January 1-15, January 16-22, January 23-February 5 and after February 6). We used a susceptible-exposed-infectious-asymptomatic-recovered model to evaluate the effect of interventions. Results suggested that about 53.7% were imported from Wuhan. The median age was 47 years and 52.8% were women. Severity risk increased with age and associated with male and co-existing disorders. The attack rate peaked in the third period and drastically decreased afterwards across sex, age groups and geographic regions. Children younger than 5 years showed a higher attack rate than those aged of 6~19. The effective reproductive number decreased from 1.44 to 0.05 after the highest level emergency response since January 23. Overall, the non-pharmaceutical interventions have effectively mitigated the COVID-19 outbreak in Shenzhen, China. These findings may facilitate the introduction of public health policies in other countries and regions.
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BackgroundRapid spread of SARS-CoV-2 in Wuhan prompted heightened surveillance in Shenzhen and elsewhere in China. The resulting data provide a rare opportunity to measure key metrics of disease course, transmission, and the impact of control. MethodsThe Shenzhen CDC identified 391 SARS-CoV-2 cases from January 14 to February 12, 2020 and 1286 close contacts. We compare cases identified through symptomatic surveillance and contact tracing, and estimate the time from symptom onset to confirmation, isolation, and hospitalization. We estimate metrics of disease transmission and analyze factors influencing transmission risk. FindingsCases were older than the general population (mean age 45) and balanced between males (187) and females (204). Ninety-one percent had mild or moderate clinical severity at initial assessment. Three have died, 225 have recovered (median time to recovery is 21 days). Cases were isolated on average 4.6 days after developing symptoms; contact tracing reduced this by 1.9 days. Household contacts and those travelling with a case where at higher risk of infection (ORs 6 and 7) than other close contacts. The household secondary attack rate was 15%, and children were as likely to be infected as adults. The observed reproductive number was 0.4, with a mean serial interval of 6.3 days. InterpretationOur data on cases as well as their infected and uninfected close contacts provide key insights into SARS-CoV-2 epidemiology. This work shows that heightened surveillance and isolation, particularly contact tracing, reduces the time cases are infectious in the community, thereby reducing R. Its overall impact, however, is uncertain and highly dependent on the number of asymptomatic cases. We further show that children are at similar risk of infection as the general population, though less likely to have severe symptoms; hence should be considered in analyses of transmission and control.
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Objective To investigate the characteristics of distribution and expression profiles of plasma miRNA in childhood acute lymphocytic leukemia (cALL) patients;the association between cALL incidence risk and plasma miRNA levels;the feasibility of plasma miRNA serving as cALL diagnostic biomarker.Methods A total of 111 pairs of newly diagnosed cALL patients and patients with fractures were collected from Shenzhen Children's Hospital,China,between January 2015 and November 2016.Age and sex of the cases and controls were 1 ∶ 1 matched and LNATM miRNA microarray was performed using 4 pairs of cALL and controls selected from the sample population.The expression level of miRNA was validated by real time quantitative PCR.Conditional logistic regression analysis was applied to evaluate the association between miRNA expression levels and the incidence risk of cALL.The receiver operating characteristic curve (ROC) and reclassification analysis were conducted to assess the feasibility of miRNAs serving as biomarkers for cALL.Results A total of 204 differentially expressed miRNA were screened out and let-7f-5p,miR-5100,miR-25-3p and miR-3654 were selected for validation identified according to the inclusion criteria.The expression levels of let-7f-5p,miR-5100 and miR-25-3p in the cALL patients were significantly lower than those of the controls (P＜0.01).After adjusting for confounding factors,3 miRNAs remained significantly associated with the risk of cALL (OR and 95％CI were 0.84 (0.76-0.92),0.81 (0.73-0.90)and 0.81 (0.74-0.89),respectively.Results from both the ROC analysis and reclassification analysis showed that introduction of one or more miRNA to traditional risk factors improved the area under the curve (P＜0.05) and provided additional values to diagnosis (P＜0.01).Conclusion The expression levels of let-7f-5p,miR-5100 and miR-25-3p were significantly associated with the incidence rate of cALL,and these miRNAs might serve as promising biomarkers for cALL.
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Objective To investigate the characteristics of distribution and expression profiles of plasma miRNA in childhood acute lymphocytic leukemia (cALL) patients;the association between cALL incidence risk and plasma miRNA levels;the feasibility of plasma miRNA serving as cALL diagnostic biomarker.Methods A total of 111 pairs of newly diagnosed cALL patients and patients with fractures were collected from Shenzhen Children's Hospital,China,between January 2015 and November 2016.Age and sex of the cases and controls were 1 ∶ 1 matched and LNATM miRNA microarray was performed using 4 pairs of cALL and controls selected from the sample population.The expression level of miRNA was validated by real time quantitative PCR.Conditional logistic regression analysis was applied to evaluate the association between miRNA expression levels and the incidence risk of cALL.The receiver operating characteristic curve (ROC) and reclassification analysis were conducted to assess the feasibility of miRNAs serving as biomarkers for cALL.Results A total of 204 differentially expressed miRNA were screened out and let-7f-5p,miR-5100,miR-25-3p and miR-3654 were selected for validation identified according to the inclusion criteria.The expression levels of let-7f-5p,miR-5100 and miR-25-3p in the cALL patients were significantly lower than those of the controls (P＜0.01).After adjusting for confounding factors,3 miRNAs remained significantly associated with the risk of cALL (OR and 95％CI were 0.84 (0.76-0.92),0.81 (0.73-0.90)and 0.81 (0.74-0.89),respectively.Results from both the ROC analysis and reclassification analysis showed that introduction of one or more miRNA to traditional risk factors improved the area under the curve (P＜0.05) and provided additional values to diagnosis (P＜0.01).Conclusion The expression levels of let-7f-5p,miR-5100 and miR-25-3p were significantly associated with the incidence rate of cALL,and these miRNAs might serve as promising biomarkers for cALL.
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Objective To verify the correlation between rs17118 polymorphism of xyluloknase homolog (XYLB) gene and risk of ischemic stroke in a Chinese Han population.Methods A case-control study design was used.The case group was the patients with first-ever ischemic stroke and the control group was the healthy subjects from hospital physical examination.Taqman probe fluorescence quantitative polymerase chain reaction technique was used to detect the genotype distribution of rs17118 C/A polymorphisms.Results A total of 475 patients with ischemic stroke and 483 controls were enrolled in the study.The proportion of hypertension (67.9％ vs.22.2％;x2 =292.982,P ＜ 0.001) and diabetes (24.2％ vs.7.3％;x2 =25.864,P ＜ 0.001),as well as the levels of triacylglycerol (1.649 ± 1.126 mmol/L vs.1.157 ±1.480 mmol/L;t=3.592,P＜0.001),and low-density lipoprotein cholesterol (3.499 ± 1.163 mmol/L vs.3.105 ± 0.627 mmol/L;t =-6.227,P ＜ 0.001) in the case group were significantly higher than those in the control group,but the total cholesterol level was significantly lower than that in the control group (5.144 ± 1.296 mmol/L vs.5.491 ± 1.335 mmol/L;t =4.650,P ＜ 0.001).The AA genotyp e (11.4％ vs.7.5 ％;x2 =6.136,P =0.016) and A allele (32.3 ％ vs.26.4％;x2 =8.093,P =0.005) frequencies in the case group were significantly higher than those in the control group.Multivariatelogistic regression analysis showed that after adjusting for traditional risk factors,the risk of ischemic stroke in AA genotype carriers was 1.97 times of the CC genotype carriers (odds ratio 1.971,95％ confidence interval 1.040-3.736,P=0.038).Conclusions The rsl7118C/A polymorphism of XYLB gene may be associated with the risk of ischemic stroke in the Chinese Han population.
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<p><b>OBJECTIVE</b>To investigate the effects of rs10916581, a common single nucleotide polymorphism (SNP) located in the promoter region of pre-miR-320b-2, on coronary heart disease (CHD) risk and circulating microRNA-320b (miR-320b) level. To explore potential factors influencing circulating miR-320b level.</p><p><b>METHODS</b>Rs10916581 was genotyped in a case-control study with 1 507 CHD cases and 1 379 age- and sex-frequency-matched controls. The cases were consecutively recruited from 3 hospitals (Tongji Hospital, Union Hospital, and Wugang Hospital) in Wuhan city (Hubei, China) between May 2004 and October 2009 and all the controls resided in Wuhan communities. A subgroup of 174 CHD cases and 181 non-diabetes controls without acute infection were randomly selected and their circulating miR-320b levels were detected using quantitative reverse transcriptase polymerase chain reaction assays. The association of rs10916581 with CHD susceptibility was analyzed with multivariable logistic regression model. Generalized linear regression model was used to explore the associations of rs10916581 and some other factors with circulating miR-320b level.</p><p><b>RESULTS</b>In single-factor logistic regression analysis, no association was found between rs10916581 and CHD risk. After adjustment for age, sex, BMI, smoking status, hypertension, diabetes, total triglyceride, total cholesterol/high density lipoprotein (TC/HDL-C), the result did not materially alter(compared with CC genotype, the OR (95%CI) of CHR in the subjects carried CT, TT, CT+TT genotypes were 0.94 (0.76-1.15), 0.99 (0.74-1.33) and 0.95 (0.78-1.16) ). No significant interactions were observed between the conventional risk factors of CHD (age, gender, smoking status, BMI, hypertension, diabetes, CHD family history) and rs10916581 on CHD risk (P > 0.05). Rs10916581 showed no significant association with circulating miR-320b level in cases, controls or total population (β(95%CI) was -0.028 (-0.495-0.440), 0.250 (-0.226-0.727) and 0.134 (-0.218-0.486) respectively, P > 0.05). However, circulating miR-320b level was negatively associated with BMI (β (95%CI) was -0.140 (-0.261--0.020), P = 0.022) while positively associated with TC/HDL(β (95%CI) was 0.620 (0.261-0.979), P = 0.001) in cases, and in total population, its circulating level tended to be lower in diabetes or hypertension patients (β(95%CI) was -1.025 (-1.696--0.354) and -0.594 (-1.138--0.049) respectively, P = 0.003, 0.033 respectively) and was positively associated with TC/HDL-C (β(95%CI) was 0.108 (0.027-0.190), P = 0.009).</p><p><b>CONCLUSION</b>The common SNP (rs10916581) in the promoter region of pre-miR-320b-2 might have little contribution to the CHD predisposition in Chinese Han population, and it might not affect circulating miR-320b level. Conventional CHD risk factors (BMI, TC/HDL-C, hypertension and diabetes) might have effects on its circulating level.</p>
Assuntos
Idoso , Humanos , Estudos de Casos e Controles , China , Etnologia , Doença das Coronárias , Genética , Diabetes Mellitus , Genótipo , Hipertensão , Modelos Logísticos , MicroRNAs , Sangue , Genética , Polimorfismo de Nucleotídeo Único , Genética , Regiões Promotoras Genéticas , Fatores de Risco , TriglicerídeosRESUMO
In order to standardize and perfect the medical psychology teaching at college level and improve the teacahing quality,the reform ideas are put forward based on the existing problems in the medical psychology teaching.The accurate positioning of the teaching objective of medical psychology is set according to the training objective,learning period and teaching hours of medical vocational schools.The teaching objective can be realized via the teaching con-tent system which is constructed with necessary basic pshcology knowledge,proper enlargement in the knowledge of psychology health and reasonable acceptance or reject in clinical psychology.
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<p><b>OBJECTIVE</b>To analyse the features of gray scale and colour Doppler sonography for carotid body tumor, to improve the sonographic diagnostic accuracy.</p><p><b>METHODS</b>A retrospective review was performed of sonographic material of 18 carotid body tumors by gray scale sonography and 11 by colour Doppler sonography, with comparison with other diseases which are frequently misdiagnosed as carotid tumor.</p><p><b>RESULTS</b>Well-defined, even weakly hypoechoic masses were noted on gray scale ultrasonogram at the carotid bifurcation, commonly broadening the carotid bifurcation and often encasing the common, external and internal carotid arteries. Disorderly non-echoic channel- like structures in the tumor were sometimes observed. Colour Doppler sonography showed abundant flow in the tumor. The non-echoic channel- like structures were vascularities. Seventeen masses diagnosed by ultrasound were proved to be carotid body tumors. The other was confirmed as a neurogenic tumor, giving an accuracy rate of 94.4% for sonographic diagnosis.</p><p><b>CONCLUSION</b>Sonographic examination of the carotid body tumor is highly accurate. It is safe and reliable.</p>
