Epidemiology of pathogenic tick-borne viruses in China: a review / 中国血吸虫病防治杂志

Ticks are obligate, haematophagous arthropods that are distributed across the world, which may transmit more than 200 pathogens, including viruses, bacteria and parasites. A large number of tick species are widespread in China, and their transmitting tick-borne viral diseases pose a great threat to human health in endemic foci. This review describes the epidemiology of common, emerging and potentially pathogenic tick-borne viruses in China, and recommends the assessment of public health significance and pathogenicity of emerging tick-borne viruses using reverse microbial etiology, so as to provide insights into the management of emerging tick-borne diseases in China.

Spike-specific CXCR3+ TFH cells play a dominant functional role in supporting antibody responses in SARS-CoV-2 infection and vaccination

CD4+ T follicular helper (TFH) cells are required for high-quality antibody generation and maintenance. However, the longevity and functional role of these cells are poorly defined in COVID-19 convalescents and vaccine recipients. Here, we longitudinally investigated the dynamics and functional roles of spike-specific circulating TFH cells and their subsets in convalescents at the 2nd, 5th, 8th, 12th and 24th months after COVID-19 symptom onset and in vaccinees after two and three doses of inactivated vaccine. SARS-CoV-2 infection elicited robust spike-specific TFH cell and antibody responses, of which spike-specific CXCR3+ TFH cells but not spike-specific CXCR3- TFH cells and neutralizing antibodies were persistent for at least two years in more than 80% of convalescents who experienced symptomatic COVID-19, which was well coordinated between spike-specific TFH cell and antibody responses at the 5th month after infection. Inactivated vaccine immunization also induced spike-specific TFH cell and antibody responses; however, these responses rapidly declined after six months with a two-dose standard administration, and a third dose significantly promoted antibody maturation and potency. Functionally, spike-specific CXCR3+ TFH cells exhibited better responsiveness than spike-specific CXCR3- TFH cells upon spike protein stimulation in vitro and showed superior capacity in supporting spike-specific antibody secreting cell (ASC) differentiation and antibody production than spike-specific CXCR3- TFH cells cocultured with autologous memory B cells. In conclusion, spike-specific CXCR3+ TFH cells played a dominant functional role in antibody elicitation and maintenance in SARS-CoV-2 infection and vaccination, suggesting that induction of CXCR3-biased spike-specific TFH cell differentiation will benefit SARS-CoV-2 vaccine development aiming to induce long-term protective immune memory. HighlightsO_LISARS-CoV-2 infection elicited robust spike-specific TFH cell and antibody responses, which persisted for at least two years in the majority of symptomatic COVID-19 convalescent patients. C_LIO_LIInactivated vaccine immunization also elicited spike-specific TFH cell and antibody responses, which rapidly declined over time, and a third dose significantly promoted antibody maturation and potency. C_LIO_LISpike-specific CXCR3+ TFH cells exhibited more durable responses than spike-specific CXCR3- TFH cells, correlated with antibody responses and showed superior capacity in supporting ASC differentiation and antibody production than spike-specific CXCR3- TFH cells. C_LI

Optimal vaccination with time-varying based on immunity barrier in Hunan Province, China

The current outbreak of novel coronavirus disease 2019 (COVID-19) is already causing a serious disease burden worldwide, this paper analyzed data of a delta variant Covid-19 outbreak in Hunan, China, and proposed an optimal dose-wise dynamical vaccinating process based on local contact pattern and vaccine coverage that minimize the accumulative cases in a certain future time interval. The optimized result requires an immediate vaccination to that none vaccinated at age group 30 to 39, which is coherent to the prevailing strategies. The dose-wise optimal vaccinating process can be directive for countries or regions where vaccines are not abundant. We recommend that vaccination should be further intensified to increase the coverage of booster shots, thus effectively reducing the spread of COVID-19.

Spatial-temporal clustering analysis of hand, foot and mouth disease in Hunan Province in 2016 - 2020 / 公共卫生与预防医学

Objective To analyze the spatial and temporal characteristics of hand, foot and mouth disease (HFMD) in Hunan Province from 2016 to 2020. Methods The data of HFMD in Hunan Province from 2016 to 2020 were collected from China's Disease Prevention and Control Information System. HFMD spatial autocorrelation analysis was conducted by ArcGIS 10.2 software at county level, and spatial-temporal scan statistical analysis was performed by SaTScan 9.7 software. Results A total of 714 157 cases was reported in Hunan Province during 2016-2020, with an average annual incidence rate of 208.36/100 000. Global spatial autocorrelation showed that HFMD had a positive spatial correlation on the county scale in Hunan Province during this period. Local spatial autocorrelation indicated that the hot spots were mainly concentrated in the north of central Hunan, the east of central Hunan and the west of Hunan. Spatial-temporal scanning analysis revealed the first class clusters (RR = 6.65, P< 0.001) covering 34 counties in northern and central Hunan, mainly distributed in Yueyang City, Changsha City, Zhuzhou City, Yiyang City and Xiangtan City from May 2018 to June, and the second class clusters (RR = 3.02, P < 0.001) covering 40 counties in western Hunan and central and southwest Hunan from April 2016 to June 2016. Conclusion HFMD incidence exhibits seasonal and regional characteristics in Hunan Province. The prevention and control of HFMD should be guided by combining the characteristics of spatial-temporal clustering.

Transmission heterogeneities, kinetics, and controllability of SARS-CoV-2

A long-standing question in infectious disease dynamics is the role of transmission heterogeneities, particularly those driven by demography, behavior and interventions. Here we characterize transmission risk between 1,178 SARS-CoV-2 infected individuals and their 15,648 close contacts based on detailed contact tracing data from Hunan, China. We find that 80% of secondary transmissions can be traced back to 14% of SARS-CoV-2 infections, indicating substantial transmission heterogeneities. Regression analysis suggests a marked gradient of transmission risk scales positively with the duration of exposure and the closeness of social interactions, after adjusted for demographic and clinical factors. Population-level physical distancing measures confine transmission to families and households; while case isolation and contact quarantine reduce transmission in all settings. Adjusted for interventions, the reconstructed infectiousness profile of a typical SARS-CoV-2 infection peaks just before symptom presentation, with ~50% of transmission occurring in the pre-symptomatic phase. Modelling results indicate that achieving SARS-CoV-2 control would require the synergistic efforts of case isolation, contact quarantine, and population-level physical distancing measures, owing to the particular transmission kinetics of this virus.

Infectivity, susceptibility, and risk factors associated with SARS-CoV-2 transmission under intensive contact tracing in Hunan, China

BackgroundSeveral parameters driving the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain unclear, including age-specific differences in infectivity and susceptibility, and the contribution of inapparent infections to transmission. Robust estimates of key time-to-event distributions remain scarce as well. MethodsWe collected individual records for 1,178 SARS-CoV-2 infected individuals and their 15,648 contacts identified by contact tracing and monitoring over the period from January 13 to April 02, 2020 in Hunan Province, China. We provide descriptive statistics of the characteristics of cases and their close contacts; we fitted distributions to time-to-key-events distributions and infectiousness profile over time; and we used generalized linear mixed model to estimate risk factors for susceptibility and transmissibility of SARS-CoV-2. ResultsWe estimated the mean serial interval at 5.5 days (95%CI -5.0, 19.9) and the mean generation time at 5.5 days (95%CI 1.7, 11.6). The infectiousness was estimated to peak 1.8 days before symptom onset, with 95% of transmission events occurring between 7.6 days before and 7.3 days after the date of symptom onset. The proportion of pre-symptomatic transmission was estimated to be 62.5%. We estimated that at least 3.5% of cases were generated asymptomatic individuals. SARS-CoV-2 transmissibility was not significantly different between working-age adults (15-59 years old) and other age groups (0-14 years old: p-value=0.16; 60 years and over: p-value=0.33), whilst susceptibility to SARS-CoV-2 infection was estimated to increase with age (p-value=0.03). In addition, transmission risk was higher for household contacts (p-value<0.001), decreased for higher generations within a cluster (second generation: odds ratio=0.13, p-value<0.001; generations 3-4: odds ratio=0.05, p-value<0.001, relative to generation 1), and decreased for infectors with a larger number of contacts (p-value=0.04). InterpretationOur findings warn of the possible relevant contribution of children to SARS-CoV-2 transmission. When lockdown interventions are in place, we found that odds of transmission are highest in the household setting but, with the relaxation of interventions, other settings (including schools) could bear a higher risk of transmission. Moreover, the estimated relevant fraction of pre-symptomatic and asymptomatic transmission highlight the importance of large-scale testing, contact tracing activities, and the use of personnel protective equipment during the COVID-19 pandemic.

Application of directed acyclic graphs in evidence-based medicine / 中国医师杂志

Evidence-based medicine (EBM) is a kind of clinic practice where clinicians use the best and the latest available evidence to diagnose and treat patients, and both evidence providers and users need to identify and control different kinds of biases in medical research.Directed acyclic graphsis is a tool to explore the causal relationship.The possible biases in the study can be revealed in a simple graphical language.The use of directed acyclic graphs could avoid the occurrence of bias and improve the quality of medical research and better guide clinical practice.

Quality assessment of reports of clinical randomized controlled trials published in Chinese Journal of Dermatology from 2007 to 2016 / 中华皮肤科杂志

Objective To assess the quality of reports of clinical randomized controlled trials (RCTs) published in Chinese Journal of Dermatology from 2007 to 2016,and to provide a reference for standardization of clinical paper writing.Methods Based on the consolidated standards of reporting trials (CONSORT) 2010 statement,an evaluation form was designed and used to assess the quality of the clinical RCT articles published in Chinese Journal of Dermatology from 2007 to 2016.Results A total of 94 RCT articles were enrolled,including 45 articles from 2007 to 2011,and 49 articles from 2012 to 2016.Among these articles,the writing of introduction and discussion parts was relatively standardized.In the method and result parts,the proportions of articles correctly reporting blinding (23 articles,24.47％),sample size (0 article),primary and secondary outcome measures (21 articles,22.34％),participant flow (0 article),loss to follow-up (32 articles,34.04％) and compliance (13 articles,13.83％) were low,while the proportions of those correctly reporting inclusion and exclusion criteria,intervention measures,statistical methods,starting and ending time of follow-up and baseline data were all over 80％.Conclusion Most contents of the RCT articles published in Chinese Journal of Dermatology are standardized and clear,but the reporting of blinding,compliance,sample size,participant flow and so on,is insufficient,and close attention should be paid to these items.

Literature Analysis of ADR Induced by Dasatinib / 中国药房

OBJECTIVE:To investigate ADR induced by dasatinib,and to provide reference for clinical rational drug use. METHODS:By means of literature metrology method,dasatinib-induced ADR cases domestically and internationally reported were analyzed. RSEULTS:A total of 63 ADR cases were induced by dasatinib,and the age of patients were mainly 41-60 years old. The most cases(25.4%)occurred within 1 month of medication. The patients mainly were from Asian countries and regions(53.9%). Organs/systems involved in dasatinib induced ADRs were mainly respiratory system(40.1%),digestive system(17.5%)and hema-tologic system(11.7%). Main clinical manifestations were pleural effusion(23 cases),pulmonary artery hypertension(15 cases), expiratory dyspnea(8 cases),diarrhea(8 cases),etc. CONCLUSIONS:Daring the use of dasatinib,great importance should be attached to ADR monitoring and prevention so as to avoid serious ADR.

The effects of HIF-1α on the growth of transplanted oral cancer in nude mice and on the expression of CEACAM1 and VEGF-C in the tumor / 实用口腔医学杂志

Objective:To explore the effects of HIF-1α on the growth of transplanted oral cancer and on the expression of CEACAM1 and VEGF-C in the tumor.Methods:Nude mouse model of oral cancer was established by transplantation of Tca8113 cells respectively treated by HIF-1α siRNA and negative control siRNA subcutaneously into right axillary region of nude mice.3 weeks after transplantation the mice were sacrificed,the tumor volum and weight were measured.The tumor tissue was examined by ELISA method for the detection HIF-1α protein expression,by real-time quantitative PCR and western blot for the detection of mRNA and protein expression of HIF-1α,CEACAM1 and VEGF-C respectively.Results:The volume and weight of the transplanted tumor in HIF-1 α siRNA group were significantly less than those in the control group(P＜0.05),CEACAM1 and VEGF-C mRNA and protein were down-regulate in HIF-1α siRNA group (P＜0.05).Conclusion:HIF-1α expression is positively related to the expression of CEACAM1 and VEGF-C in the regulation of oral tumor growth.

Comparison of Lugol chromoendoscopy and NBI with magnify endoscopy in preoperative assessment of early esophageal cancer / 中国内镜杂志

Objective To compare the value of NBI with magnify endoscopy (NBI-ME) and Lugol chromoendoscopy (LCE) in preoperative assessment of early esophageal cancer, and assess whether the former can replace the latter. Methods 59 patients, sampled in the Second Hospital of Lanzhou University, the First Hospital of Lanzhou University and the Second Hospital of Lanzhou City from January 2014 to December 2015, were examined respectively by NBI-ME and Lugol chromoendoscopy not only to distinguish the lesion boundaries but also predict the pathological types as well for statistical analysis with the combination of the final postoperative pathological results. Results Only 64.4 % (38/59) of lesion boundaries can be well-distinguished by NBI-ME, which is significantly lower than that distinguished by Lugol chromoendoscopy (91.5 %, 54/59), with its kappa value 0.208 0.05 (0.369), Kappa > 0.4 (0.429), P 0.05 (0.475), Kappa <0.4 (0.286), P < 0.01 (0.001), showing the poor concordance instead. Conclusions To some extent, pathological type predicted by NBI-ME indeed had an concordance with postoperative pathology, which was also superior to the results examined by Lugol chromoendoscopy, while there was no denying that Lugol chromoendoscopy had an obvious advantage over NBI-ME in terms of distinguishing lesion boundaries, therefore, it can not be completely replaced with NBI-ME at present.

Minimal anchorage invasive extraction of horizontally impacted mandibular third molar: A case report / 实用口腔医学杂志

Horizontal impacted lower third molars are often adjacent to the inferior alveolar nerve,direct extraction may cause trauma and complications,the most serious complication is inferior alveolar nerve damage.This article reports one case of horizontal impacted lower third molar adjacent to the mandibular nerve canal,the molar was extracted by minimal anchorage pulling for 1 week and then removed smoothly.

Treatment of acute gastroesophageal variceal bleeding with combination of endoscopic cyanoacrylate injection and endoscopic variceal ligation / 中华消化内镜杂志

Objective To evaluate the efficacy of endoscopic cyanoacrylate injection combined with endoscopic variceal libation (EVL) in treatment of acute gastroosophageal variceal bleeding. Methods Twenty-three patients with acute esophagogastric variceal bleeding received endoscopic cyanoacrylate injec-tion combined with EVL within 12 hours of hemostssis. Somatostatin were given intravenously at the dosage of 250 μg/h postoperatively for 72 h. The patients received follow-up endoscopy at 2 weeks and 3 months after the procedure, respectively. The variants including the rate of re-bleeding, mortality, and degree of esopha-gogastric varices were evaluated. Results Success in immediate hemostasis was achieved in all cases and a second EVL was performed in 6 patients 2 weeks later. The effective rate of variceal alleviation in gastric fun-dus was 95.65% and 91.30% in esophageal varices. No recurrent bleeding or death was observed in follow-up of 3 months. Conclusion Endoscopic eyanoaerylate injection combined with EVL is a safe and effective technique in the treatment of patients with acute gastroesophageal variceal bleeding.