Assessment of the combined vulnerability to droughts and heatwaves in Shandong Province in summer from 2000 to 2018.

Droughts and heat waves exhibit synergistic effects and are among the world's most costly disasters. To explore the spatiotemporal differences and formation mechanisms of the combined vulnerability to droughts and heat waves in Shandong Province over the past 20 years, a vulnerability scoping diagram (VSD) model with three dimensions-exposure, sensitivity, and adaptability-was constructed to assess and compare the combined vulnerability to high-temperature and drought events, considering economic and social conditions. The results showed that (1) over the past 20 years, heat waves and droughts have increased in Shandong Province. The number of high-temperature events significantly increased in the west and decreased along the eastern coast, and drought change was characterized by an increase in the south and a decrease in the north. (2) The combined exposure to summer droughts and heat waves in Shandong Province showed a significant increasing trend (P < 0.05) at a rate of approximately 0.072/10a; the combined sensitivity significantly decreased (P < 0.05) at a rate of approximately 0.137/10a, and the combined adaptability continued to increase at a rate of approximately 0.481/10a. (3) The combined vulnerability to summer droughts and heat waves in the western inland area of Shandong Province was high and gradually decreased toward the southeastern coast. The overall decrease trend was nonsignificant with a decrease of approximately 0.126/10a, and the decline rate decreased from northwest to southeast, in which Laiwu, Yantai, Jinan, and Zibo cities exhibited a significant decreasing trend (P < 0.05). Although the compound vulnerability of Shandong Province has decreased insignificantly, the frequency of combined drought and heat wave events has increased, and the combined vulnerability will increase in the future.

Evaluation of the evolutionary genetics and population structure of Culex pipiens pallens in Shandong province, China based on knockdown resistance (kdr) mutations and the mtDNA-COI gene.

BACKGROUND: Mosquitoes are important vectors for a range of diseases, contributing to high rates of morbidity and mortality in the human population. Culex pipiens pallens is dominant species of Culex mosquito in northern China and a major vector for both West Nile virus and Bancroftian filariasis. Insecticide application were largely applied to control the mosquito-mediated spread of these diseases, contributing to increasing rates of resistance in the mosquito population. The voltage-gated sodium channel (Vgsc) gene is the target site of pyrethroids, and mutations in this gene cause knockdown resistance (kdr). While these kdr mutations are known to be critical to pyrethroid resistance, their evolutionary origins remain poorly understood. Clarifying the origins of these mutations is potential to guide further vector control and disease prevention efforts. Accordingly, the present study was designed to study the evolutionary genetics of kdr mutations and their association with the population structure of Cx. p. pallens in Shandong province, China. METHODS: Adult Culex females were collected from Shandong province and subjected to morphological identification under a dissection microscope. Genomic DNA were extracted from the collected mosquitoes, the Vgsc gene were amplified via PCR and sequenced to assess kdr allele frequencies, intron polymorphisms, and kdr codon evolution. In addition, population genetic diversity and related population characteristics were assessed by amplifying and sequencing the mitochondrial cytochrome C oxidase I (COI) gene. RESULTS: Totally, 263 Cx. p. pallens specimens were used for DNA barcoding and sequencing analyses to assess kdr allele frequencies in nine Culex populations. The kdr codon L1014 in the Vgsc gene identified two non-synonymous mutations (L1014F and L1014S) in the analyzed population. These mutations were present in the eastern hilly area and west plain region of Shandong Province. However, only L1014F mutation was detected in the southern mountainous area and Dongying city of Shandong Province, where the mutation frequency was low. Compared to other cities, population in Qingdao revealed significant genetic differentiation. Spatial kdr mutation patterns are likely attributable to some combination of prolonged insecticide-mediated selection coupled with the genetic isolation of these mosquito populations. CONCLUSIONS: These data suggest that multiple kdr alleles associated with insecticide resistance are present within the Cx. p. pallens populations of Shandong Province, China. The geographical distributions of kdr mutations in this province are likely that the result of prolonged and extensive insecticide application in agricultural contexts together with frequent mosquito population migrations. In contrast, the low-frequency kdr mutation detected in central Shandong Province populations may originate from the limited selection pressure in this area and the relative genetic isolation. Overall, the study compares the genetic patterns revealed by a functional gene with a neutral marker and demonstrates the combined impact of demographic and selection factors on population structure.

Trends and prediction in the incidence rate of hepatitis C in Shandong Province in China from 2004 to 2030.

BACKGROUND: Hepatitis C threatens human health and brings a heavy economic burden. Shandong Province is the second most populous province in China and has uneven regional economic development. Therefore, we analyzed the incidence rate trend and regional differences of hepatitis C in Shandong Province from 2004 to 2021. METHODS: The monthly and annual incidence rates of hepatitis C in Shandong Province from 2022 to 2030 were predicted by fitting Autoregressive Integrated Moving Average model (ARIMA), Long Short-Term Memory (LSTM) and ARIMA-LSTM combined model. RESULTS: From 2004 to 2021, annual new cases of hepatitis C in Shandong Province increased from 635 to 5834, with a total of 61,707 cases. The incidence rate increased from 0.69/100 thousand in 2004 to 6.40/100 thousand in 2019, with a slight decrease in 2020 and 2021. The average annual incidence rate was 3.47/100 thousand. In terms of regional distribution, the hepatitis C incidence rate in Shandong Province was generally high in the west and low in the east. It is estimated that the hepatitis C incidence rate in Shandong Province will be 9.21 per 100 thousand in 2030. CONCLUSION: The hepatitis C incidence rate in Shandong Province showed an increasing trend from 2004 to 2019 and a decreasing trend in 2020 and 2021. Significant regional variations in incidence rate existed. An upward trend in incidence rate is predicted from 2022 to 2030. It is necessary to strengthen the prevention and control of hepatitis C to achieve the goal of eliminating viral hepatitis by 2030.

Molecular detection and species identification of Plasmodium spp. infection among imported cases in Eastern China, 2012-2018.

Due to the increasing number of returnees from malaria endemic areas, imported malaria has become a public health challenge in China. To better understand the characteristics of imported Plasmodium species and adjust appropriate strategies for malaria prevention and control in Eastern China, we conducted molecular detection and species identification on 1282 imported malaria cases in Shandong Province between 2012 and 2018. The findings showed that P. falciparum was predominant, particularly in cases imported from Africa. P. vivax was the dominant species imported from Asian countries. Additionally, imported P. ovale and P. malariae emerged in the province. Further surveillance and control of imported malaria among returnees from Africa and Southeast Asia is needed to be strengthened in Eastern China.

The Spatio-Temporal Patterns of Regional Development in Shandong Province of China from 2012 to 2021 Based on Nighttime Light Remote Sensing.

As a major coastal economic province in the east of China, it is of great significance to clarify the temporal and spatial patterns of regional development in Shandong Province in recent years to support regional high-quality development. Nightlight remote sensing data can reveal the spatio-temporal patterns of social and economic activities on a fine pixel scale. We based the nighttime light patterns at three spatial scales in three geographical regions on monthly nighttime light remote sensing data and social statistics. Different cities and different counties in Shandong Province in the last 10 years were studied by using the methods of trend analysis, stability analysis and correlation analysis. The results show that: (1) The nighttime light pattern was generally consistent with the spatial pattern of construction land. The nighttime light intensity of most urban, built-up areas showed an increasing trend, while the old urban areas of Qingdao and Yantai showed a weakening trend. (2) At the geographical unit scale, the total nighttime light in south-central Shandong was significantly higher than that in eastern and northwest Shandong, while the nighttime light growth rate in northwest Shandong was significantly highest. At the urban scale, Liaocheng had the highest nighttime light growth rate. At the county scale, the nighttime light growth rate of counties with a better economy was lower, while that of counties with a backward economy was higher. (3) The nighttime light growth was significantly correlated with Gross Domestic Product (GDP) and population growth, indicating that regional economic development and population growth were the main causes of nighttime light change.

[Resource components and utilization values of different parts of Panax quinquefolium in Shandong province].

To explore the resource components and availability of different parts of Panax quinquefolium in Shandong province, the paper employed the non-targeted metabolomics technology based on ultra-high performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS) to analyze the metabolites and their metabolic pathways in the root, fibril, stem, and leaf of P. quinquefolium. The content of seven ginsenosides and polysaccharides in different parts was determined by high performance liquid chromatography(HPLC) and ultraviolet-visible spectrophotometry(UV-Vis). The results showed that the metabolites were mainly sugars, glycosides, organic acids, amino acids and their derivatives, terpenoids, etc. The total abundance of metabolites followed the trend of leaf > root > fibril > stem. Most of the differential metabolites were concentrated in phenylpropane biosynthesis, flavonoid biosynthesis, citric acid cycle, and amino acid biosynthesis. The leaf contained high levels of sugars, glycosides, amino acids and their derivatives, and flavonoids; the root was rich in terpenoids, volatile oils, vitamins, and lignin; the fibril contained rich organic acids; and the stem had high content of nucleotides and their derivatives. The content of ginsenosides Re and Rb_1 was significantly higher in the root; the content of ginsenosides Rg_1, Rg_2, Rd, F_(11), and polysaccharide was significantly higher in the leaf; and the content of ginsenoside Rb_2 was significantly higher in the stem. We analyzed the resource components and availability of different parts of P. quinquefolium, aiming to provide basic information for the comprehensive development and utilization of P. quinquefolium resources in Shandong province.

Confirmation of Rickettsia conorii Subspecies indica Infection by Next-Generation Sequencing, Shandong, China.

We describe 3 similar cases of rickettsial disease that occurred after tick bites in a mountainous rural area of Shandong Province, China. Next-generation sequencing indicated the etiologic agent of 1 patient was Rickettsia conorii subspecies indica. This agent may be more widely distributed across China than previously thought.

Detection and phylogenetic analysis of a novel tick-borne virus in Haemaphysalis longicornis ticks and sheep from Shandong, China.

Dabieshan tick virus (DTV) was first identified in Haemaphysalis longicornis from Hubei Province, China in 2015. However, its pathogenic potential to animals and human remains to be further explored. In this study, a total of 170 engorged ticks and 22 sheep serum samples were collected from Taian and Yantai city, Shandong Province to investigate the presence of DTV. The results of qRT-PCR revealed the positive rate of 13.6% (3/22) in sheep serum and 8.2% (14/170) in attached ticks, respectively. Phylogenetic analysis demonstrated a close evolutionary relationship among those DTV isolates from animal and ticks, and DTV might be relatively conservative in evolution. These findings are the first to demonstrate molecular evidence of DTV in domestic animals. Nonetheless, whether or not causing disease in animals, DTV deserves further investigation.

Epidemiological investigation of porcine circovirus type 2 and its coinfection rate in Shandong province in China from 2015 to 2018.

BACKGROUND: Porcine circovirus type 2 (PCV2) is one of the crucial swine viral pathogens, caused porcine circovirus associated diseases (PCVAD). Shandong province is one of the most important pork producing areas and bears a considerable economic loss due to PCVAD. However, there is limited information on epidemiology and coinfection rate of PCV2 with other critical swine diseases in this area, such as porcine reproductive and respiratory syndrome virus (PRRSV), classical swine fever virus (CSFV), Pseudorabies virus (PRV), and porcine epidemic diarrhea virus (PEDV). RESULTS: Overall, 89.59% serum samples and 36.98% tissue samples were positive for PCV2 specified ELISA and PCR positive for PCV2, respectively. The coinfection rates of PCV2 with PRRSV, PRV, CSFV, and PEDV were 26.73%, 18.37%, 13.06%, and 3.47%, respectively. Moreover, genetic characteristic of PCV2 were analyzed based on the cap genes showing that PCV2d is the dominant sub-genotype circulating in the province. CONCLUSIONS: Our findings reveal that PCV2d, as the dominant strain, is prevailing in pig farms in Shandong province at high levels. There was a high frequency of coinfection of PCV2 and PRRSV.

Association between polymorphisms rs2228001 and rs2228000 in XPC and genetic susceptibility to preeclampsia: a case control study.

BACKGROUND: Xeroderma pigmentosum complementation group C (XPC) is a DNA damage recognition protein that plays an important role in nucleotide excision repair and can reduce oxidative stress, which may be involved in the development of preeclampsia (PE). Therefore, the aim of this study was to explore whether XPC polymorphisms were relevant to the genetic susceptibility to PE in Chinese Han women. METHOD: A total of 1276 healthy pregnant women were included as the control group and 958 pregnant women with PE as the case group. DNA was extracted from peripheral blood samples to perform genotyping of loci rs2228001 and rs2228000 in XPC through real-time quantitative polymerase chain reaction (PCR). The relationship between XPC and susceptibility to PE was evaluated by comparing the genotypic and allelic frequencies between the two groups of pregnant women. RESULTS: Polymorphism of rs2228000 may be associated with PE risk and allele T may play a protective role (genotype, χ2 = 38.961, P < 0.001 and allele χ2 = 21.746 P < 0.001, odds ratio (OR) = 0.885, 95% confidence interval (CI) = 0.840-0.932). No significant difference was found between the two groups in rs2228001,(genotype χ2 = 3.148, P = 0.207 and allele χ2 = 0.59, P = 0.442, OR = 1.017, 95% CI = 0.974-1.062). When the frequencies of genotypes and alleles for early- and late-onset PE, mild PE and severe PE were compared with those of controls, the results were consistent with the large clinical sample. CONCLUSION: Our data suggest that the genetic variant rs2228000 in XPC may be associated with PE risk in Chinese Han women, and that pregnant women with the TT genotype have a reduced risk of PE. Further investigations are needed to confirm these findings in other regions or larger prospective populations.

Epidemiological characteristics and spatiotemporal analysis of hand-foot-mouth diseases from 2010 to 2019 in Zibo city, Shandong, China.

BACKGROUND: Hand-foot-mouth disease (HFMD) is a global public health issues, especially in China. It has threat the health of children under 5 years old. The early recognition of high-risk districts and understanding of epidemic characteristics can facilitate health sectors to prevent the occurrence of HFMD effectively. METHODS: Descriptive analysis was used to summarize epidemic characteristics, and the spatial autocorrelation analysis and space-time scan analysis were utilized to explore distribution pattern of HFMD and identify hot spots with statistical significance. The result was presented in ArcMap. RESULTS: A total of 52,095 HFMD cases were collected in Zibo city from 1 Jan 2010 to 31 Dec 2019. The annual average incidence was 129.72/100,000. The distribution of HFMD was a unimodal trend, with peak from April to September. The most susceptible age group was children under 5 years old (92.46%), and the male-to-female ratio is 1.60: 1. The main clusters were identified in Zhangdian District from 12 April 2010 to 18 September 2012. Spatial autocorrelation analysis showed that the global spatial correlation in Zibo were no statistical significance, except in 2012, 2014, 2015, 2016 and 2018. Cold spots were gathered in Boshan county and Linzi district, while hot spots only in Zhangdian District in 2018, but other years were no significance. CONCLUSION: Hot spots mainly concentrated in the central and surrounding city of Zibo city. We suggest that imminent public health planning and resource allocation should be focused within those areas.

A characterization of groundwater fluoride, influencing factors and risk to human health in the southwest plain of Shandong Province, North China.

This study investigated 324 groundwater samples collected from the southwest plain of Shandong Province during the dry and wet seasons. Groundwater fluoride in the study area and the influencing factors were characterized and discussed using statistical analysis, ion ratios, Piper diagrams, the saturation index (SI) and ArcGIS software. In addition, the risk posed by groundwater fluoride to human health was assessed. The results showed that groundwater in the study area had elevated fluoride concentrations, with average dry and wet season concentrations of 1.15 mg·L-1 and 1.08 mg·L-1, respectively. Groundwater fluoride showed consistent spatial variations during the dry and wet seasons, with a significant regionalization pattern of low concentrations in the east and high concentrations in the west. Groundwater F- was significantly negatively correlated with Ca2+ and positively correlated with pH, HCO3- and Na+. Important factors identified as having an effect on groundwater F- in the study area included the balance of dissolution of fluorite and calcite, the weakly alkaline environment and cation exchange. In addition, hydrochemical types of high-fluoride groundwater in the study area were identified as mainly HCO3-Na and SO4·Cl-Na. The assessment of the risk of high groundwater fluoride to human health showed that children are more at risk compared to adults, with the risk during the dry season exceeding that over the wet season. It is recommended that water quality management in the study area prioritize the formulation of measures to mitigate high concentrations of fluoride in groundwater .

Prevalence and genotype distribution of Enterocytozoon bieneusi in farmed raccoon dogs (Nyctereutes procyonoides) in Shandong Province, eastern China.

Enterocytozoon bieneusi is a common microsporidian species, which can infect humans and various species of animals. However, little is known about E. bieneusi prevalence and genotypes in farmed raccoon dogs (Nyctereutes procyonoides) in Shandong Province, China. In this study, a total of 356 fecal samples were collected from farmed raccoon dogs in Weihai, Weifang, and Yantai cities in Shandong Province, China. A total of 23 (6.5%) samples were E. bieneusi-positive by nested PCR amplification of the internal transcribed spacer (ITS) region of ribosomal DNA. Statistical analysis showed that E. bieneusi prevalence in male raccoon dogs was higher than that in female raccoon dogs, and the highest E. bieneusi prevalence was detected in adult raccoon dogs. Sequence analysis revealed four known E. bieneusi genotypes (D, type IV, CHG1, and Peru8), and type IV (11/23) was the predominant genotype. The genotypes type IV, Peru8, and CHG1 were reported in raccoon dogs for the first time in China. Phylogenetic analysis showed that three human-pathogenic genotypes (D, type IV, and Peru8) were clustered into group 1, and the CHG1 belonged to group 2. These findings expand the current understanding of E. bieneusi prevalence and genotype distribution in raccoon dogs in China. Our study also shows that raccoon dogs are hosts for E. bieneusi belonging to several genotypes, including zoonotic ones, highlighting the possibility of transmission of this pathogen between raccoon dogs and humans.

Molecular detection and genotype distribution of Enterocytozoon bieneusi in farmed silver foxes (Vulpes vulpes) and arctic foxes (Vulpes lagopus) in Shandong Province, eastern China.

Enterocytozoon bieneusi is an opportunistic enteric pathogen which can infect a wide range of animal species and humans. It is the most diagnosed species of Microsporidia in humans and has an impact on public health. Many infected animals including foxes may be a potential source for transmitting E. bieneusi to humans. However, limited information is available on the E. bieneusi prevalence and genotypes in farmed foxes in China. Therefore, in the present study, 344 fresh fecal samples were collected from farmed foxes (Vulpes vulpes and Vulpes lagopus) in Shandong Province, and the prevalence and genotypes of E. bieneusi were examined based on sequence analysis of the ribosomal internal transcribed spacer (ITS) region. The overall E. bieneusi prevalence was 9% (31/344); of them, 6.5% (9/138) in farmed silver foxes (V. vulpes) and 10.7% (22/206) in farmed arctic foxes (V. lagopus). Moreover, four known (Hum-q1, NCF2, HND-1, and Type IV) and two novel E. bieneusi genotypes (SDF1 and SDF2) were identified in farmed foxes in the present study. All of the E. bieneusi genotypes belonged to the zoonotic group based on phylogenetic analysis. In addition, 2, 4, 0, and 11 samples were successfully amplified at MS1, MS3, MS4, and MS7 loci, respectively. The present study reveals E. bieneusi prevalence and genotype distribution in farmed foxes in Shandong Province and enlarged the host and geographic information of E. bieneusi in China.

Serum lipid and lipoprotein levels of middle-aged and elderly Chinese men and women in Shandong Province.

BACKGROUND: Cardiovascular and cerebrovascular diseases have become leading causes of death in China as the economy develop and lifestyles change. This study aimed to estimate the relationship of the age, gender, and glucose metabolism with the serum lipid and lipoprotein levels of middle-aged and elderly Chinese men and women in Shandong Province. METHODS: We conducted a cross-sectional study in Shandong Province that included 10,028 adults aged ≥40 years. Fasting serum total, low-density lipoprotein (LDL), high-density lipoprotein (HDL) cholesterol and triglycerides were measured by standard methods. RESULTS: The estimates of total, LDL, and HDL cholesterol and triglycerides were as follows: 5.35, 3.18, 1.51, and 1.34 mmol/L in the middle-aged and elderly Chinese adult population; 5.14, 3.08, 1.42, and 1.33 mmol/L in male subjects; 5.46, 3.24, 1.56, and 1.34 mmol/L in females; 5.27, 3.11, 1.54, and 1.24 mmol/L in the normal glucose tolerance population, 5.49, 3.27, 1.50, and 1.41 mmol/L in the population with pre-diabetes, and 5.39, 3.23, 1.43, and 1.58 mmol/L in the population with diabetes, respectively. Moreover, 36.92 and 19.10% of the adults had borderline-high and high total cholesterol. The population estimates for borderline-high, high LDL and low HDL cholesterol levels were 25.24, 13.39, and 5.64%, respectively. Meanwhile, borderline high and high triglyceride levels accounted for 16.7 and 17.47% of the population, respectively. CONCLUSIONS: Serum total and LDL cholesterol levels were high in the ≥40 years old population of Shandong Province. Age, gender, glucose metabolism status, body mass index (BMI) and glycosylated hemoglobin (HbA1c) can affect serum lipid and lipoprotein levels.

Cysticercosis in Shandong Province, Eastern China.

We analyzed demographic and clinical data and estimated the incidence of cysticercosis in Shandong Province, China, during 1975-2014. Our analyses showed that a cysticercosis-endemic area is present in Shandong Province, especially in its western regions. Improved surveillance and control are needed to address the elevated risk for cysticercosis in this region.

Japanese Spotted Fever in Eastern China, 2013.

We isolated Rickettsia japonica from a febrile patient in Lu'an City, China, in 2013. Subsequently, we found an R. japonica seroprevalence of 54.8% (494/902) in the rural population of Anhui Province and an R. japonica prevalence in Haemaphysalis longicornis ticks of 0.5% (5/935). R. japonica and its tick vector exist in China.

Chigger Mite (Acari: Trombiculidae) Survey of Rodents in Shandong Province, Northern China.

Chigger mites are parasites of rodents and other vertebrates, invertebrates, and other arthropods, and are the only vectors of scrub typhus, in addition to other zoonoses. Therefore, investigating their distribution, diversity, and seasonal abundance is important for public health. Rodent surveillance was conducted at 6 districts in Shandong Province, northern China (114-112°E, 34-38°N), from January to December 2011. Overall, 225/286 (78.7%) rodents captured were infested with chigger mites. A total of 451 chigger mites were identified as belonging to 5 most commonly collected species and 3 genera in 1 family. Leptotrombidium scutellare and Leptotrombidium intermedia were the most commonly collected chigger mites. L. scutellare (66.2%, 36.7%, and 49.0%) was the most frequently collected chigger mite from Apodemus agrarius, Rattus norvegicus, and Microtus fortis, respectively, whereas L. intermedia (61.5% and 63.2%) was the most frequently collected chigger mite from Cricetulus triton and Mus musculus, respectively. This study demonstrated a relatively high prevalence of chigger mites that varied seasonally in Shandong Province, China.

Cancer incidence and mortality in Shandong province, 2012.

OBJECTIVE: Population-based cancer registration data in 2012 from all available cancer registries in Shandong province were collected by Shandong Center for Disease Control and Prevention (SDCDC). SDCDC estimated the numbers of new cancer cases and cancer deaths in Shandong province with compiled cancer incidence and mortality rates. METHODS: In 2015, there were 21 cancer registries submitted data of cancer incidence and deaths occurred in 2012. All the data were checked and evaluated based on the National Central Cancer Registry (NCCR) criteria of data quality. Qualified data from 15 registries were used for cancer statistics analysis as provincial estimation. The pooled data were stratified by area (urban/rural), gender, age group (0, 1.4, 5.9, 10.14, …, 85+ years) and cancer type. New cancer cases and deaths were estimated using age-specific rates and corresponding provincial population in 2012. The Chinese census data in 2000 and Segi's population were applied for age-standardized rates. All the rates were expressed per 100,000 person-year. RESULTS: Qualified 15 cancer registries (4 urban and 11 rural registries) covered 17,189,988 populations (7,486,039 in urban and 9,703,949 in rural areas). The percentage of cases morphologically verified (MV%) and death certificate-only cases (DCO%) were 66.12% and 2.93%, respectively, and the mortality to incidence rate ratio (M/I) was 0.60. A total of 253,060 new cancer cases and 157,750 cancer deaths were estimated in Shandong province in 2012. The incidence rate was 263.86/100,000 (303.29/100,000 in males, 223.23/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 192.42/100,000 and 189.50/100,000 with the cumulative incidence rate (0.74 years old) of 22.07%. The cancer incidence, ASIRC and ASIRW in urban areas were 267.64/100,000, 195.27/100,000 and 192.02/100,000 compared to 262.32/100,000, 191.26/100,000 and 188.48/100,000 in rural areas, respectively. The cancer mortality was 164.47/100,000 (207.42/100,000 in males, 120.23/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 117.54/100,000 and 116.90/100,000, and the cumulative mortality rate (0.74 years old) was 13.53%. The cancer mortality, ASMRC and ASMRW were 141.59/100,000, 101.17/100,000 and 100.33/100,000 in urban areas, and 173.79/100,000, 124.20/100,000 and 123.64/100,000 in rural areas, respectively. Cancers of the lung, stomach, liver, esophagus, colorectum, female breast, brain, leukemia, bladder and pancreas were the most common cancers, accounting for about 82.12% of all cancer new cases. Lung cancer, stomach cancer, liver cancer, esophageal cancer, colorectal cancer, female breast cancer, pancreatic cancer, brain tumor, leukemia and lymphoma were the leading causes of cancer death, accounting for about 89.01% of all cancer deaths. The cancer spectrum showed difference between urban and rural, males and females both in incidence and mortality rates. CONCLUSIONS: Cancer surveillance information in Shandong province is making great progress with the increasing number of cancer registries, population coverage and the improving data quality. Cancer registration plays a fundamental role in cancer control by providing basic information on population-based cancer incidence, mortality, survival and time trend. The disease burden of cancer is serious in Shandong province, and so cancer prevention and control in Shandong province should be enhanced including health education, health promotion, cancer screening and cancer care services.

Severe fever with thrombocytopenia syndrome, Shandong Province, China, 2011.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease in China. The incidence and clinical and laboratory characteristics of SFTS are not clearly defined. During May 22-October 2, 2011, a total of 24 patients with fever, thrombocytopenia, and leukopenia were clinically diagnosed as having SFTS in Yiyuan County, Shandong Province, China. We conducted laboratory tests for these SFTS patients. SFTS virus (SFTSV) infection was confirmed in 22 patients by using reverse transcription PCR and ELISA by acute-phase and convalescent-phase serum samples. Clinical and laboratory manifestations included fever (100%), gastrointestinal symptoms (91%), myalgia (55%), chills (41%), thrombocytopenia (100%), and leukopenia (95%).