Objective: To optimize the Shenzhen universal infant hepatitis B immunization method. Methods: To analyze the long effectiveness of different immunization strategies and disease transition after hepatitis B virus infection by using cost-effectiveness method through decision-tree and Markov models among the Shenzhen newborns cohort in 2010 based on the local parameters. Results:Through the current strategies, the program of screening all pregnant women for HBsAg and vaccinating newborns of single-positive mothers combing with HBIG and vaccine would not only prevent more new cases, hepatic carcinoma and related deaths; but also gain more living years and QALYs. From the social prospect, it will save about RMB 40 million compared with the current program. Conclusion: It is suggested that Shenzhen Government should amend the current universal infant hepatitis B immunization program to gain more economic and social benefits.

Objective To investigate the expression and clinical significance of platelet glycoprotein CD62p,CD63 and neutrophil surface CD64 in sepsis.Methods Fifty-six children with sepsis from March 2010 to March 2013 in Communicable Disease Department of our hospital were divided into severe sepsis group(n =16) and general sepsis group (n =40),normal control group included 34 subjects from health check.CD62p,CD63 and CD64 were detected by flow cytometry in children with sepsis,and compared with normal control group.Results The levels of CD62p,CD63 and CD64 in severe sepsis group were higher than those of general sepsis group (P ＜ 0.01).The levels of CD62p,CD63 and CD64 in general sepsis group were higher than those of normal control group (P ＜ 0.01).Correlation analysis indicated that CD62p and CD63 were in positive correlation with CD64 in children with sepsis(r =0.817,0.796,P ＜0.001).The positive correlations of CD62p,CD63 and CD64 with pediatric critical illness score were also found(CD62p:r =0.883,P ＜0.001;CD63:r=0.862,P ＜0.001;CD64:r=0.805,P ＜0.001).Conclusion CD62p,CD63 and CD64 are closely related to the severity of infection and diseases,and may be used as immune parameters for the estimation of the clinical severity and the prognosis of acute and severe diseases.

Objective To isolate Hantaviruses from reservoir animals captured in natural epidemic areas of hemorrhagic fever with renal syndrome(HFRS)and genotype isolated strains of Hantavirus in Shenzhen.Methods Infant Meriones unguiculatus and Vero-E6 cells were used in virus isolation and direct immunofluorescence assay was used for identifying viruses.The G1,G2 fragments of M segment and S segment were amplified with reverse transcription-nested-polymerase chain reaction(RT-nested-PCR)by using the Hantavirus genotype specific primers.The amplified genes were then sequenced,and subjected to homology and cladogram analysis.Results Two virus strains were isolated successfully and designated as SZ2082 and SZ2083 from Rattus norvegicus captured in Shenzhen and were identified as SEOV type by RT-nested-PCR.The nucleotide sequences of partial M and S segmentS of SZ2082 were consistent with SZ2083 completely.Compared with the G1 and G2 fragments of M gene of SEOV80-39 virus strain,the homologies of nucleotide among them were 96.7% and 95.0%,but the homology were 75.9% and 70.3% of the Hantaviruses strain with HTNV76-118 virus strain,respectively.The homology of S gene with SEOV80-39 and HTNV76-118 showed 95.7% and 69.7% at nucleotide level.The results were similar to that of M genome segment.SZ2082 and BjFT01,Beijing Rn,Guangl99,HN71-L were on the same branch and their homology reached up to 99.0%-99.7%.Conclusions Hantaviruses are isolated from Shenzhen for the first time and are classified as S2 subtype of Seoul virus.

Objective: To verify the costs, benefit and effectiveness of hepatitis B immunoprophylaxis strategies in Shenzhen during 2006-2030. Methods: The markov model was constructed to reflect the reality of the newborn vaccination and prevention of mother to child transmission (PMTCT) strategy, the cost, benefit and effectiveness during 2006-2015 and 2016-2030 was evaluated and predicted by the model. The model was constructed with the basic parameters such as the positive rate of hepatitis B surface antibody, perinatal HBV infection rate, the screening rate and positive rate of HBsAg of pregnant women, the utility value of hepatitis B and the parameters of markov model. and the coverage rates, vaccination fee of hepatitis B and the expenditures of patients with HB-related diseases.The costs were calculated from the payer, medical-care and all society perspective. The effectiveness and benefits of the strategy were evaluated and predicted by the numbers of HBV infection and the patients with HBV-related diseases prevented, life years (LYs), quality adjusted life years (QALYs), the net benefits (NBs) and benefit cost ratio (BCRs). Results: From the payer, medical-care and all society perspectives, the costs for the strategy were 153 million Yuan, 5.51 billion Yuan and 10.92 billion Yuan, respectively from 2006 to 2030 of which the forecast costs for 2016-2030 were 120 million Yuan, 3.87 billion yuan and 7.81 billion yuan. During the year 2006-2030, the numbers of HBV infection and the HBV-related diseases was 2.48 million, more than 1.335 million LYs and 1.619 million QALYs should be obtained from the strategy implemented. From medical-care and all society perspectives, NBs should be 88.68 billion yuan and 150.13 billion yuan with the BCRs of 17.08 and 14.75, respectively. Particularly, the NBs value of 22.37 billion yuan and 37.98 billion yuan and the BCR value of 14.62 and 13.20 was calculated for the past period, but the future NBs of 66.31 billion yuan and 112.15 billion yuan and BCR of 18.12 and 15.36 in the year 2016-2030. The further benefits were increased evidently in the future. Conclusion The hepatitis B immunization in Shenzhen has a high economic effectivenee and benefits, and it is worth to invest sustainably.

Objective To understand the dynamic schistosomiasis situation in Hubei Province so as to provide the evidence for formulating the effective control strategy. Methods According to the Scheme of Schistosomiasis Surveillance in Hubei Province the 2009 edition 207 endemic villages were selected and investigated for the schistosome infections of residents and livestock and the distribution of Oncomelania hupensis snails. Results The average infection rates of residents and cattle were 0.35% and 0.15% respectively and the endemic situation of fishermen and farmers were relatively serious 0.44% and 0.42% respectively . The density of living snails was 0.30 snail/0.1m2 but no infected snails were found. Conclusion The en-demic situation of schistosomiasis in Hubei Province was stable in 2013 but the efforts for the infectious source control still should be strengthened.

Objective To study the endemic trend of schistosomiasis japonica in Hubei Province,so as to provide the theo?retical basis for surveillance and forecasting of schistosomiasis. Methods The time?series auto regression integrated moving av?erage(ARIMA)model was applied to fit the infection rate of residents of Hubei Province from 1987 to 2013,and to predict the shot?term trend of infection rate. Results The actual values of infection rate of residents were all in the 95%confidence inter?nals of value predicted by the ARIMA model. The prediction showed that the infection rate of residents of Hubei Province would continue to decrease slowly. Conclusion The time?series ARIMA model has good prediction accuracy,and could be used for the short?term forecasting of schistosomiasis.

Objective To understand the change of hydrological regime in the Yangtze River and schistosomiasis endemic situation after the implementation of Three Gorges Project in Hubei Province. Methods The data of hydrological regime of the Yangtze River,schistosomiasis epidemic situation,and Oncomelania hupensis snail status were collected and analyzed in Hu-bei Province from 2002 to 2012. Results After the implementation of the Three Gorges Project in 2003,the water level of the Yangtze River slightly rose from January to March,the average water level in May and August both reduced compared with that in 2002,and the time of water withdrawal was moved up. The endemic situation of schistosomiasis showed a decline tendency in areas along the Yangtze River in Hubei Province. The positive rate of serological tests in the residents and the Schistosoma ja-ponicum infection rate in bovine decreased by 2.97%and 92.64%respectively. The numbers of human and bovine infected with S. japonicum decreased by 48.35%and 94.48%,respectively. Conclusion After the implementation of the Three Gorges Proj-ect,the schistosomiasis endemic situation shows a decline tendency in the areas along the Yangtze River in Hubei Province ,but the long-term monitoring still need to be carried out.

Objective To explore the changing rules of schistosomiasis infection and Oncomelania hupensis snail situation in areas where schistosomiasis transmission was controlled or interrupted or transmission rebounded after the interruption. Meth-ods Daye City,Wuxue City and Jingshan County were selected and investigated retrospectively to collect the schistosomiasis epidemiological information 10 years before they reached the criteria of transmission controlled and the subsequent years until 2008. The database of retrospective investigation was established for analyzing the trends and rules of the changes of snail status and human infection status. Results In Daye City,there was no snail areas and schistosomiasis patients and cattle after reach-ing the criteria of transmission interrupted in 1987. The infection rate of residents were positively correlative with the infection rate of cattle and snail areas(r=0.865,0.843,P<0.01). In Wuxue City,the proportion of snail areas occupying the historic snail areas kept a steady from the transmission controlled to transmission interrupted,but it began to rebound to the highest level in the history(8.93%)after the transmission interrupted for 3 years. In Jingshan County,the infection rates of residents and cat-tle were all stable from 1%to 2%after the transmission controlled. The proportion of snail areas occupying the historic snail ar-eas was rebounded from 1.63% in 1985 to 21.50% in 2008,and the densities of living snails rebounded from 2005. Conclu-sions The infected snails could be the sensitive indicator of the rebound of snail situation and human infection. The elimination of schistosomiasis still depends on the control of snail areas,including strengthening the infected snail control.

Objective To analyze the Oncomelania hupensis snail situation in schistosomiasis surveillance sites in Hubei Province from 2009 to 2014. Methods From 2009 to 2014,207 schistosomiasis endemic villages from 13 cities were selected as the surveillance sites in Hubei Province,where the surveillance of snail situation was performed,and the data about the in?dexes of snail situation during the 6 years were collected and analyzed statistically. Results From 2009 to 2014,totally 80 963.47 hm2 of snail areas were investigated,and 45 309.77 hm2 of area with snails as well as 364.93 hm2 of area with infected snails were found out,and 1 646 125 snails were captured. In the 207 surveillance sites,the density of living snails was reduced from 0.493 3 snail/0.1 m2 in 2009 to 0.339 3 snail/0.1 m2 in 2014,with a decline rate of 31.22%;the density of infected snails was reduced from 0.000 7 snail/0.1 m2 in 2009 to 0 in 2014;the infection rate of snails was reduced from 0.14%in 2009 to 0 in 2014. The infection rates of snails in the third?rank villages,endemic areas in inner embankment,ditch environment and weed environment were relatively higher. Conclusions The snail situation of Hubei Province has been declined steadily. However, the environment of snail breeding has not been changed completely. In order to consolidate the control achievements further ,the measures including mollusciciding and snail control projects should be strengthened.

WHO has developed and issued global hepatitis B elimination program.Continuing hepatitis B immunization and conducting community based antiviral treatment for chronic hepatitis B are the most important strategies for hepatitis B elimination.According to the estimation of related cost by WHO,the cost of antiviral therapy would be very high.Great achievement has been made in hepatitis B immunization in China,but the prevalence of chronic hepatitis B is high.Elimination of hepatitis B needs a large amount of public resource,posing serious challenge to public health policy making.Economics research on hepatitis B prevention and treatment can provide evidence and technical support for hepatitis B elimination.In this column “Economic evaluations of hepatitis B”,the related articles in this issue summarize the progress in this research field,which is inspiring and encouraging.