OBJECTIVEIn order to evaluate the distribution of genetic subtypes and epidemiological feature of HIV-1 circulating strains in Fujian province.

METHODSBlood samples and epidemiological data were collected from 104 newly infected patients who were distinguished by BED-CEIA methodology, during 2011-2012. Viral sequences(n = 81) of HIV-1 gag, env, and pol segments were amplified by nested PCR.

RESULTSSubtypes B and four Circulating Recombinant Forms, (CRF01_AE, CRF07_BC, CRF08_BC and CRF55_01B) were found in the samples, CRF01_AE(45.68%)and CRF07_BC(35.80%) were the two main HIV-1 strains in Fujian province. Compared with previous data, the proportion of CRF07_BC rose significantly while it gradually decreased in CRF01_AE. Heterosexual contact was still the principal transmission route in Fujian province, but the number of infection among men-who-have-sex-with- men grew rapidly.

CONCLUSIONResults from this study suggested that different subtypes of HIV-1 strain existed in Fujian province. The distribution of subtypes and the mode of transmission were changing with the progress of epidemic. Dynamic monitoring of the molecular epidemiology trends of HIV-1 infection should be enhanced.

Adult ; China ; epidemiology ; Female ; Genotype ; HIV Infections ; epidemiology ; HIV-1 ; classification ; genetics ; Humans ; Male ; Molecular Epidemiology ; Young Adult

OBJECTIVETo determine the association between U2 small nuclear ribonucleoprotein auxiliary factor 35/65 (U2AF35 and U2AF65) and pancreatic cancer (PC).

METHODSA two-stage analysis case-control study was conducted. Four candidate tag single nucleotide polymorphisms (tagSNPs) were genotyped by Taqman Openarray assay in a screening population living in Central China (298 PC cases and 525 controls). Thereafter, rs310445 in U2AF65 was genotyped by TaqMan real-time polymerase chain reaction (RT-PCR) in a validation Chinese Han population from Beijing (413 cases and 557 controls).

RESULTSrs310445 in U2AF65 gene was significantly associated with PC in both screened population and combined population. Subjects with C allele had a higher risk of PC compared to those with the TT genotype, with OR of 1.31 (95%CI:1.07-1.60, P = 0.010) for the combined population. A synergic effect of smoking and C allele of rs310445 was also observed in the combined population, with Synergic Index of 2.08 (95% CI:1.37-2.78) in the combined population.

CONCLUSIONOur findings suggested the interaction between smoking and U2AF65 might play a role in PC. These findings should be confirmed by further independently large-scale population studies.

Aged ; Case-Control Studies ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Nuclear Proteins ; genetics ; Pancreatic Neoplasms ; genetics ; Polymorphism, Single Nucleotide ; Ribonucleoproteins ; genetics ; Risk Factors ; Smoking ; Splicing Factor U2AF

OBJECTIVETo investigate the epidemiological characteristics of hand-foot-mouth disease.

METHODSA total of 589 children from Xianju county, Zhejiang province with hand-foot-mouth disease in 2013 were recruited in the study and the diagnosis went through clinical and laboratory confirmation. Attributes that were analyzed included gender, age, month of occurrence, regional distribution and clinical presentation.

RESULTSThe incidence rate of hand-foot-mouth disease in Xianju county for the year was 102.72/100 000, with 12 severe cases but no death. There were clearly more boys than girls, with a male to female ratio of 1.29 :1, which was statistically significant (χ(2) = 14.274, P < 0.001). The vast majority of patients were 0-3 years old, representing 94.74% of the patients. The occurrences were concentrated in the period from April to August and November, with April as the high-incidence season. High incidence areas were the countryside and suburbs, making up 45.50% and 30.73%, respectively, of all cases. Most patients were in preschools or scattered home care environments, accounting for 51.10% and 40.92% , respectively. Clinical presentation was characterized by fever and various kinds of vesicles or papules at the hand, foot, mouth or buttocks.

CONCLUSIONMost of hand-foot-mouth disease cases occur in younger children in areas with inadequate knowledge of hygiene, with seasonal variation.

Child ; Child, Preschool ; China ; epidemiology ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; Humans ; Infant ; Male

OBJECTIVETo study the infection status of Helicobacter pylori (H. pylori) and sensitivity to commonly used antibiotics in Taizhou district,Zhejiang province.

METHODS39 099 cases aged between 5 and 95 years old (mean as 48.42 years) were involved during January 2010 to December, 2013 for this study. Sex ratio was 1 : 0.95. Yearly distribution of the number of cases were 5 031, 6 709, 11 902 and 15 457 in 2010, 2011, 2012 and 2013, respectively. Gastric mucosal specimens were collected and H. pylori strains were isolated and cultured in the same platform in Zhiyuan Medical Inspection Institute of Hangzhou. Resistance tests of all the H. pylori isolates were performed to 6 commonly used antibiotics:metronidazole, clarithromycin, amoxicillin, gentamicin, levofloxacin and furazolidone with the agar dilution method. The antibiotic resistance rates of H. pylori strains isolated during year 2010-2013 and the changing trends were analyzed.

RESULTSResistance rates to levofloxacin and clarithromycin kept at higher level and the highest was in 2011 and then decreased in both 2012 and 2013 (P < 0.01). The resistance rates to both levofloxacin and clarithromycin reached the highest in 2011 (P < 0.01), and decreased thereafter, with no significant change in 2013 to 2012 (P > 0.05).

CONCLUSIONAntibiotic resistance rate against metronidazole for HP isolate was highest. Resistance rate against amoxicillin and furazolidone, gentamicin was low. Clinical treatment should choose amoxicillin and furazolidone, gentamicin. The resistance rates to levofloxacin and clarithromycin had been seen at a significantly downward trend since 2011. However, the combined resistance rates to levofloxacin and clarithromycin did not seem to reduce since 2012.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; pharmacology ; Child ; Child, Preschool ; Drug Resistance, Multiple, Bacterial ; Helicobacter pylori ; drug effects ; isolation & purification ; Humans ; Middle Aged ; Young Adult

OBJECTIVETo estimate the rates due to influenza-associated-excess-hospitalization in children aged 0-14 years in Wuxi city,Jiangsu province in 2005-2010.

METHODSWe collected data on hospitalization due to influenza, pneumonia and other respiratory diseases from fourteen 2nd level or above hospitals in Wuxi, as well as data on influenza virological surveillance in southern China to fit the negative binomial regression models, to estimate the rate on influenza-associated-excess hospitalization.

RESULTSDuring 2005-2010, an average annual hospitalization rate appeared as 91.6‰ (79.2‰ -99.3‰). Among the total hospitalization eases, respiratory diseases accounted for 54.2%, while both influenza and pneumonia accounted for 38.1%. The average annual influenza- associated-excess-hospitalization rates due to influenza and pneumonia appeared as 1.28‰ (95% CI:0.29‰ -4.84‰), while 2.18‰ (95% CI:0.61‰ -6.79‰) due to respiratory diseases. In 2009, A (H1N1) pdm induced influenza pandemic caused 993 excess hospitalizations due to influenza/pneumonia and 1 042 excess hospitalizations due to respiratory diseases, with rates as 1.14‰ and 1.20‰ respectively.

CONCLUSIONBoth seasonal and pandemic A(H1N1)pdm influenza caused considerable burden on hospitalization in children aged 0-14 years inWuxi.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Hospitalization ; statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Influenza, Human ; epidemiology ; Male

OBJECTIVETo understand the general feature of patients with Mycobacterium tuberculosis (MTB) and human immunodeficiency virus (HIV) co-infectious (TB/HIV) in Guangxi, from 2007 to 2012.

METHODSInformation regarding individuals that the contributory causes of death were due to MTB infection among HIV as the underlying cause of death from the Vital Registration System, together with bacterium smear or culture results, onset of TB, time that TB was diagnosed and entered an Internet base TB surveillance system was collected and checked. Data including information on time of death, age, occupation, the underlying cause of death among TB patients, bacterium distribution, average age of death, interval from onset to death, percentage of TB/HIV co-infection patients among all the patients etc, were all analysed.

RESULTS203 patients died from HIV associated with TB from the Guangxi Vital Registration System were identified between 2007 and 2012. The average percentage of TB/HIV co-infection cases accounted for 8.24% (ranging from 3.94% in 2007 to 13.27% in 2012) among all the deaths of HIV infection while it accounted for 9.90% (ranging from 2.56% to in 2007 to 26.88% in 2012) among patients with MTB infection in the same period. The average percentage of deaths from TB/HIV co-infection in 2010 and 2012 accounted for 10.66% (ranging from 8.83% to 13.27%)and 22.17% (ranging from 20.60% to 26.88%)among patients died of HIV and TB infection respectively. The male-female ratio was 4.21 for 1, with the average age of death as 44.65 (44.65 ± 15.52) years;median time from TB symptoms onset to diagnosis as 37 (mean 94.31, standard deviation 206.07) days, record as (94.31 ± 206.07); median time from diagnosis to death as 46 (165.22 ± 282.19) days, 54.68% TB/HIV patients died within two months of being diagnosed with TB and the median time from TB symptoms onset to death as 131 (257.68 ± 340.79) days. 16.26% of the TB/HIV cases were bacterium confirmed TB cases.

CONCLUSIONCompare to those TB patients without HIV, less bacterium evidence was found in TB/HIV patients. High burden caused by HIV disease was seen if they were co-infected with TB. An increasing proportion of deaths was noticed among patients co-infected with HIV and TB in the last three years, suggesting that the coverage of antiretroviral therapy be scaled up together with the strengthening of the capability on early TB case-finding among people live with HIV.

Adult ; China ; epidemiology ; Coinfection ; mortality ; Female ; HIV Infections ; microbiology ; mortality ; Humans ; Male ; Middle Aged ; Tuberculosis ; mortality ; virology ; Young Adult

OBJECTIVETo analyze the situation of survival among AIDS patients under cotrimoxazole prophylaxis as initial anti-retroviral therapy (ART), in Henan province during 2007-2011.

METHODSInformation on AIDS patients receiving initial ART during 2007-2011 was collected from the Chinese HIV/AIDS Integrated Control System. Kaplan-Meier estimation was used to generate survival curves, and Cox proportional hazard regression model was used to determine associated factors of survival status. According to the previous CTX use before ART, the subjects were divided into 3 groups including who had never taken CTX, who had taken CTX and still taking now, who had taken CTX and not current taking.

RESULTSA total of 13 103 eligible AIDS patients were identified. 1 702 patients died within 6 years after the initiation of ART, with the mortality as 4.46/100 person year. Among the 455 patients who died within 3 months and 970 died within 12 months, the mortality rates were 14.15/100 person year and 7.78/100 person year, respectively. The Kaplan-Meier survival curves showed that the survival time and mortality of the patients who had taken CTX was longer AND lower than those patients who had never taken CTX when starting the ART program. Results from the log-rank test showed that the difference of two groups was statistically significant during 12 months after the ART(log-rank = 5.15, P = 0.02). After controlling for other variables, results from multivariable analysis of COX model showed that factors as age, gender, marital status, perion between confirmed diagnosis and receiving the ART, baseline CD4(+) T cells count, clinical stage, initial therapy schedule, date when starting the ART, number of symptoms at baseline, use of CTX before starting the ART and ART being skipped in the last seven days etc, were associated with the time of survival in patients after the initiation of ART. Patients who had been taking CTX at ART initiation were at lower risk of death (adjusted HR = 0.71, 95% CI:0.63-0.80; P = 0.00), compared to those who had never taken the CTX.

CONCLUSIONThe co-trimoxazole prophylaxis program was associated with the reduced mortality among AIDS patients who were on ART in Henan province, especially during the first year.

Acquired Immunodeficiency Syndrome ; drug therapy ; Adolescent ; Adult ; Anti-Retroviral Agents ; therapeutic use ; China ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Proportional Hazards Models ; Trimethoprim, Sulfamethoxazole Drug Combination ; therapeutic use ; Young Adult

OBJECTIVETo study the relationship between daily temperature and non-accidental deaths in four districts of Jinan, and to investigate the impact of temperature on cause-specific mortality.

METHODSData on daily mortality of the four districts (Shizhong, Huaiyin, Tianqiao, Lixia) as well as data related to meteorology and air pollution index were collected from January 1, 2008 to December 31, 2012. Distributed lag non-linear model (DLNM) was then used to assess the effects of temperature on all non-accidental deaths and deaths caused by cardiovascular diseases (CVD), respiratory diseases (RD), digestive diseases, urinary diseases, and also subcategories to hypertension, ischemic heart diseases (IHD), acute myocardial infarction (AMI), cerebro-vascular diseases (CBD) and chronic lower respiratory diseases.

RESULTSA W-shaped relationship was noticed between daily average temperature and non-accidental deaths. The effect of low temperature last for more than 30 days, much longer than that of high temperature, in which presented a harvesting effect less than 5 days. As to the cause-specific mortality, short-term heat effects were seen in CVD and RD as well as related subgroups as IHD, CBD and AMI, with RRs at lag 0 as 1.12 (95%CI:1.07-1.17), 1.06 (95% CI:1.02-1.31), 1.08 (95% CI:1.003-1.16), 1.10 (95% CI:1.02-1.20) and 1.13 (95% CI: 1.003-1.26). Relatively higher RRs were seen in urinary diseases and hypertension under extremely high temperature, reaching as high as 2.30 (95%CI:1.18-4.51) and 1.65 (95%CI:1.02-2.69). Cold weather presented a delayed effect for 30 days, with cumulative RRs as 1.51 (95%CI:1.42-1.60), 1.90 (95%CI:1.64-2.20), 2.12 (95%CI:1.67-2.69), 1.48 (95%CI:1.08-2.03), 1.60 (95%CI:1.46-1.75), 1.40 (95%CI:1.26-1.55), 1.68 (95%CI:1.45-1.95) for CVD, RD, chronic lower respiratory diseases, hypertension,IHD, CBD and AMI, on sequence.

CONCLUSIONA relationship was seen between daily temperature and non-accidental deaths as well as cause-specific mortality. Either high or low temperature seemed to be detrimental. Related measures on disease prevention should be taken during the cold and hot seasons.

Cause of Death ; China ; epidemiology ; Humans ; Mortality ; Nonlinear Dynamics ; Temperature

OBJECTIVETo quantify the burden of disease related to high blood pressure in the Chinese population.

METHODSWe used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) in China. Data for mean systolic blood pressure, burden of deaths,Years of Life Lost(YLLs), Years Lived with Disability (YLDs), disability-adjusted life years (DALYs), and relative risk were corrected for regression dilution bias to calculate the population impact fractions and estimate the attributable deaths and DALYs.

RESULTSAmong all the deaths due to cardiovascular diseases and DALYs, 64.0% of them were caused by high blood pressure. In 2010, a total number of 2.043 million deaths were caused by high blood pressure, including 1.154 million males. 2.007 million deaths were due to cardiovascular diseases, 35 000 due to chronic kidney diseases. Deaths caused by high blood pressure accounted for 24.6% of all the deaths. In total, 37.94 million person-years DALYs were caused by high blood pressure, of which 23.33 million person-years were males and 14.61 million person-years were females. There were 2.365 million person-years of YLDs and 35.57 million person-years of YLLs, which both accounted for 12% of the total DALYs.

CONCLUSIONCompared to the global results of GBD 160, on either deaths or DALYs, the proportion attributable to high blood pressure were quite high for a country like China. The health effects caused by high blood pressure seemed to be quite serious which called for attention.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Cost of Illness ; Female ; Humans ; Hypertension ; epidemiology ; Male ; Middle Aged ; Young Adult

OBJECTIVETo assess the policies and programs on the capacity of prevention and control regarding non-communicable diseases (NCDs) at the Centers for Disease Control and Prevention (CDCs) at all levels and grass roots health care institutions, in China.

METHODSOn-line questionnaire survey was adopted by 3 352 CDCs at provincial, city and county levels and 1 200 grass roots health care institutions.

RESULTS1) On policies: 75.0% of the provincial governments provided special funding for chronic disease prevention and control, whereas 19.7% city government and 11.3% county government did so. 2) Infrastructure:only 7.1% county level CDCs reported having a department taking care of NCD prevention and control. 8 263 staff members worked on NCDs prevention and control, accounting for 4.2% of all the CDCs' personnel. 40.2% CDCs had special funding used for NCDs prevention and control. 3)Capacity on training and guidance:among all the CDCs, 96.9% at provincial level, 50.3% at city level and 42.1% at county level had organized training on NCDs prevention and control. Only 48.3% of the CDCs at county level provided technical guidance for grass-roots health care institutions. 4) Capacities regarding cooperation and participation: 20.2% of the CDCs had experience in collaborating with mass media. 5) Surveillance capacity: 64.6% of the CDCs at county level implemented death registration, compare to less than 30.0% of CDCs at county level implemented surveillance programs on major NCDs and related risk factors. In the grass roots health care institutions, 18.6% implemented new stroke case reporting system but only 3.0% implemented program on myocardial infarction case reporting. 6) Intervention and management capacity: 36.1% and 32.2% of the CDCs conducted individualized intervention on hypertension and diabetes, while less than another 20% intervened into other NCDs and risk factors. More than 50% of the grass roots health care institutions carried follow-up survey on hypertension and diabetes. Rates on hypertension and diabetes patient management were 12.0% and 7.9% , with rates on standard management as 73.8% and 80.1% and on control as 48.7% and 50.0%, respectively. 7) Capacity on Assessment: 13.3% of the CDCs or health administrations carried out evaluation programs related to the responses on NCDs in their respective jurisdiction. 8) On scientific research: the capacity on scientific research among provincial CDCs was apparently higher than that at the city or county level CDCs.

CONCLUSIONPolicies for NCDs prevention and control need to be improved. We noticed that there had been a huge gap between county level and provincial/city level CDCs on capacities related to NCDs prevention and control. At the grass-roots health care institutions, both prevention and control programs on chronic diseases did not seem to be effective.

China ; Chronic Disease ; prevention & control ; Community Health Services ; manpower ; organization & administration ; Humans