The volume of blood serum originally required for the estimation of alkaline phosphatase by Boclanaky's method has been reduced from 1.0 ml to 0.02 ml. The results obtained with this micro method were in close agreement with those obtained from the original macro procedure. Using this improved method the activity of the serum alkaline phosphatase of 144 apparently normal infants aged from 1-0 months were determined, giving an average value of .11.3 Bodansky units per 100 ml serum which is slightly higher than those found in the literature.

Objective To study the relationship of TNF-? G308A and G238A polymorphism with type 2 diabetes mellitus in elderly patients.Methods Blood specimens were collected from 60 elderly patients with type 2 diabetes mellitus and 30 normal elderly volunteers.Genomic DNA was extracted.The primers of PCR for the SNPs of G308A and G238A were optimized and the polymorphism of amplicons was analyzed by DNA sequencing.Results There was a significant difference of TNF-?-308 gene in DM patients compared with control group,while no difference of TNF-?-238.Conclusions The 308 G-A polymorphism of TNF-? promoter gene may be associated with type 2 diabetes mellitus in elderly patients.

Respiratory syncytial virus（RSV）is the most common pathogen of lower respiratory infection among infants,leading to serious burden of disease all over the world. The surveillance of RSV plays an important role in preventing and controlling its epidemic. At present,the surveillance systems of RSV are not as global as that of influenza,which have been established much more and earlier in the developed countries. The RSV surveillance system are manifested in two types：specific and standard surveillance systems established by very few developed countries and surveillance systems based on the influenza surveillance established by most other countries. This article reviews the current status and prospect of RSV surveillance systems to provide reference for the development of RSV surveillance system in the future.

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Objective To examine the clinical features of sporadic patients with H7N9 avian influenzain Taizhou city of Zhejiang province and to characterize its viral genes.Methods Fifteen patients with H7N9 influenza infection confirmed by Zhejiang Provincial Centre for Disease Control and Prevention during January 201 4 and January 201 5 were included in the study.The basic diseases,poultry exposure history,clinical manifestation,laboratory examination,imaging features,treatment and outcome and viral gene sequencing were analyzed retrospectively.Results The first clinical symptoms were fever and cough in all patients,acuterespiratory distress syndrome(ARDS)occurred in 1 3 patients,the average time from onset to antiviral therapy was (7 ±2)d.Among 1 5 patients,9 survived and 6 died,including 2 died of multiple organ failure (MOF).The phylogenetic tree showed that there was highly homologous in hemagglutinin (HA)and neuraminidase(NA)genes between human H7N9 virus strains and poultry reference strains.The result of genetic sequencing indicated that human H7N9 virus strains had mutations at 226 (Q226L)sites in HA protein.Conclusions ARDS is likely to occur in patients with H7N9 viral infection,and early antiviral treatment usually leads to a good prognosis.With the occurrence of adaptive mutation in avian influenza virus H7N9,spread from poultry to the human beings may take place.

Objective To observe the clinical effects of insulin glargine combined with novonorm in treatment of patients with newly diagnosed type 2 diabetes. Methods 112 cases of newly diagnosed type 2 diabetes patients were randomly separated into observation group(56 cases)and control group(56 cases). Observation group was treated with insulin glargine combined with novonorm. Control group was treated with novolin30R. The levels of FPG,2hPG and HbA1c before and after treatment,the control time of blood sugar,amounts of insulin and incidence of low blood sugar were observed in both groups. Results Compared with pre-treatment, FPG,2hPG and HbA1 c were significantly decreased (all P ＜0.05) after treatment, but there were no significant differences in both two groups (P ＞0. 05). The control time of blood sugar, amounts of insulin and incidence of low blood sugar in observation group were significantly lower than those in control group (all P ＜ 0.05). Conclusion Insulin glargine combined with novonorm in treatment of patients with newly diagnosed type 2 diabetes could effectively control blood sugar,shorten the control time of blood sugar,decrease amounts of insulin,and low incidence of low blood sugar.

Objeetive: To learn the epidemic status of COVID-19 in some high-epidemic countries, so as to provide reference for prevention and control of imported COVID-19 in China. Methods: We collected the data of all the countries who totally reported over ten thousand cases of COVID-19 by March 29, 2020, and analyzed the epidemic trend by using the incidence rate, the case fatality rate, the five-day moving average time dependent reproduction number (Rt) as well as the average daily increase rate. Results : Spain, Switzerland, Italy, Germany, France, lran, UK, USA and China were inchuded in the analysis. Spain( 15.46/100 000), Switzerland(15.44/100 000) and Italy ( 15.30/100 000)ranked top three in the incidence rate of COVID-19. Italy (10.84%), Spain (7.88%) andlan (7.11%) ranked top three in the case atality rate. By March27, the values of five-day moving average Rt in USA, UK, Iran, Spain and France were all more than one. The average daily increase rate in China had changed negative since March 6. The average daily increase rates in the other eight countries ranged from 41.58% to 18.17%, and the trend was slow down from March 20 to 29, among which Germany, Switzerland and Italy had the largest decline of 35.60%, 29.76% and 25.56%, respectively Conclusions By March 29, the epidemie situation of COVID-19 in China was under controls; the situations in ltaly, Germany and Switzerland tended to be stable; while the situations in USA, UK, Iran, Spain and France maintained an upward tmend.

Objective: To estimate the influenza-associated excess mortality (IEM) in Zhejiang Province from 2016 to 2019, so as to provide insights into estimates of mortality burden due to influenza. Methods: The data pertaining to all-cause death and influenza surveillance in Zhejiang Province from 2016 to 2019 were retrieved from Zhejiang Provincial Cause of Death Registration System and Influenza Surveillance System to create distributed lag non-linear models (DLNMs). The year-, influenza subtype- and age-specific IEM rates were estimated. Results: The overall IEM was 18.67/105 (95%CI: 15.32/105-21.97/105) in Zhejiang Province from 2016 to 2019, with the lowest in 2016 (14.19/105, 95%CI: 12.00/105-16.37/105) and the highest in 2018 (22.92/105, 95%CI: 19.23/105-26.56/105). The IEM rates of influenza A (H1N1), influenza A (H3N2) and influenza B were 9.32/105 (95%CI: 7.65/105-10.98/105), 5.68/105 (95%CI: 4.24/105-7.11/105), and 3.66/105 (95%CI: 2.13/105-5.18/105). The greatest IEM was seen among residents at ages of 65 years and older (142.91/105, 95%CI: (115.99/105-169.55/105, followed by among individuals at ages of 15 to 64 years (2.74/105, 95%CI: 1.87/105-3.61/105), and the lowest was seen among individuals under 15 years of age (0.41/105, 95%CI: -0.33/105-1.14/105). Conclusions From 2016 to 2019, the highest IEM was seen in Zhejiang Province in 2018, and the elderly residents at ages of 65 years and above presented the greatest IEM, with influenza A (H1N1) as the predominant influenza subtype. Influenza surveillance and vaccination is recommended to be reinforced.

Human infections with novel avian influenza A(H7N9)virus was an emerging infectious disease discovered in March, 2013. As of June30, 2016, 770 cases of H7N9 were reported in worldwide including 315 deaths with 40.9% of high case fatality rate. Yangtze River Delta and Pearl River Delta were the high-prevalence area. Formerly, the cases of H7N9 were concentrated on the municipalities. However, most of the case-patients were from smaller cities or rural areas nowadays. The H7N9 human infections mainly occurred in winter and spring every waves as similar as seasonal and H5N1 human infections. Middle aged and old (the median age was 61 years) male patients were occupied the large proportion among the cases of H7N9. In addition, the phenomenon of the limited and unsustained human-to-human transmission were existed. At present, the 4 major epidemic waves had happened and human infections with novel avian influenza A (H7N9) virus could be outbreak regularly in China. In this paper, the pathogenic characteristics and disease distribution of H7N9 influenza A viruses were elaborated, with both transmission factors and control measures, which were helpful to provide the scientific evidence for prevention and control in H7N9avian influenza epidemic.

Objective To investigate the epidemiological characteristics of gonorrhea,and to analyze its temporal-spatial clustering in Zhejiang province.Methods Data on the incidence and demographic characteristics of gonorrhea in Zhejiang province from January 2004 to December 2012 were obtained from the China Information System for Disease Control and Prevention.The population,time and space distributions of gonorrhea were described.Epidemic curve and incidence maps were drawn.A space-time permutation scan statistic was used to detect space-time clusters,and spatial autocorrelation analysis was performed to calculate the Moran's I value and draw Local Indicators of Spatial Association (LISA) cluster maps.Results In Zhejiang province,a total of 199 956 cases of gonorrhea were reported with a decreasing trend in incidence rate from 2004 to 2012.The male to female ratio was 3.51:1 (155 634/44 331).People aged between 25 and 60 years accounted for 75.21％ of these patients,whereas the constituent ratio of people aged 0-1 years and ＞ 60 years increased with time.The incidence rate of gonorrhea was significantly higher in middle and north parts than in the south part of Zhejiang province,and higher in summer than in winter and spring with the peak incidence observed in August.Thirteen temporal-spatial clusters were detected,with the large clusters in Hangzhou,Huzhou,Ningbo,Shaoxing and their neighbor counties/cities/ districts,as well as some counties/cities/districts in Jinhua.All of the above clusters lasted 4.5 years.LISA maps showed an increasing trend in high-high aggregation counties/cities/districts which spread from the north to south part of Zhejiang province.Conclusion There is a temporal-spatial aggregation of gonorrhea in Zhejiang province with young and middle-aged men as the main affected population.