Objective To evaluate the cost?effectiveness of seasonal influenza vaccination, compared to no vaccination, for the elderly aged ≥60 years old in China. Methods A static life?time Markov model is conducted to simulate the Chinese elderly population aged≥60 years old. Taking the health care system perspective, one?year analytic cycle length is used for each influenza season. The model was assumed to be repeated until the individual reaches 100 years old. Three interventions were evaluated, including no vaccination, annual trivalent influenza vaccination, and annual quadrivalent influenza vaccination. Using the threshold of 3 times GDP per capita per Quality?adjusted life year (QALY) (193 932/QALY), the incremental cost?effectiveness ratio (ICER) was calculated to compare the cost?effectiveness of every two interventions.Model inputs like data for costs and utilities were from studies on Chinese population if they were available. QALY was used to measure health utility. One?way sensitivity analysis and probabilistic sensitivity analysis were adopted to quantify the level of confidence of the model output. Results The total influenza associated costs of no vaccination would be 603 CNY per person, while the total costs of annual trivalent vaccination would be 1 027 CNY. Using trivalent vaccine would result in 0.007 QALY gained per person compared to no vaccination, with an increased cost of 424 CNY per person. The ICER of trivalent vaccination over no vaccination for all the elderly population in China would be 64 026 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. The total costs of annual quadrivalent vaccination would be 1 988 CNY. Using quadrivalent vaccine would result in 0.008 additional QALY gained per person compared to no vaccination, with an increased cost of 1 385 CNY per person. The ICER of quadrivalent vaccination over no vaccination would be 174 081 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. Conclusion Vaccinating elderly population would improve health utilities at higher health care costs for the elderly. Using the threshold of 3 times GDP per capita per QALY (193 932/QALY), both trivalent and quadrivalent vaccination would be cost?effective compared to no vaccination in elderly Chinese population.

Objective To evaluate the cost?effectiveness of seasonal influenza vaccination, compared to no vaccination, for the elderly aged ≥60 years old in China. Methods A static life?time Markov model is conducted to simulate the Chinese elderly population aged≥60 years old. Taking the health care system perspective, one?year analytic cycle length is used for each influenza season. The model was assumed to be repeated until the individual reaches 100 years old. Three interventions were evaluated, including no vaccination, annual trivalent influenza vaccination, and annual quadrivalent influenza vaccination. Using the threshold of 3 times GDP per capita per Quality?adjusted life year (QALY) (193 932/QALY), the incremental cost?effectiveness ratio (ICER) was calculated to compare the cost?effectiveness of every two interventions.Model inputs like data for costs and utilities were from studies on Chinese population if they were available. QALY was used to measure health utility. One?way sensitivity analysis and probabilistic sensitivity analysis were adopted to quantify the level of confidence of the model output. Results The total influenza associated costs of no vaccination would be 603 CNY per person, while the total costs of annual trivalent vaccination would be 1 027 CNY. Using trivalent vaccine would result in 0.007 QALY gained per person compared to no vaccination, with an increased cost of 424 CNY per person. The ICER of trivalent vaccination over no vaccination for all the elderly population in China would be 64 026 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. The total costs of annual quadrivalent vaccination would be 1 988 CNY. Using quadrivalent vaccine would result in 0.008 additional QALY gained per person compared to no vaccination, with an increased cost of 1 385 CNY per person. The ICER of quadrivalent vaccination over no vaccination would be 174 081 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. Conclusion Vaccinating elderly population would improve health utilities at higher health care costs for the elderly. Using the threshold of 3 times GDP per capita per QALY (193 932/QALY), both trivalent and quadrivalent vaccination would be cost?effective compared to no vaccination in elderly Chinese population.

The annual deaths associated with influenza is estimated to be between 290 000 and 650 000,which caused substantial burden to the society.Children have the highest incidence of influenza among all age groups,which can cause overloaded medical visits and a significant increase of hospitalization risk.The severe economic burden includes not only the direct medical costs due to outpatients and hospitalization,but also the indirect burden of school absence of children and work absence of their family members.Annual vaccination is the best measure to prevent influenza,however,influenza vaccination coverage among children in China is very low,and influenza vaccination has not yet been included in the National Immunization Program.Now,the disease burden of influenza and the vaccine usage in children in China were reviewed,and in order to provide evidence for influenza control and prevention.

OBJECTIVETo investigate the feasibility of Ultrasmall superparamagnetic iron oxide-enhanced magnetic resonance angiography (USPIO-MRA) combined with interleukin-6 (IL-6) and IL-10 detection for detecting atherosclerotic plaques in rabbits.

METHODSTwenty-four normal male rabbits were randomly assigned (n=8) into group A with atherosclerosis induced by damaging the aortic tunica intima with Foley's tube in combination with a high fat diet, group B with a high fat diet, and group C without any intervention. At week 12, plain and USPIO-MRA was performed in all the 24 rabbits and the results were compared with pathological examinations; blood samples were collected from the ear vein to examine blood lipids and levels of IL-6 and IL-10.

RESULTSThe rabbits in groups A and B showed significantly different IL-6 levels (167 ± 21.3 vs 116 ± 14.3 pg/ml, P<0.05) but comparable blood lipids and IL-10 levels (P>0.05). The levels of IL-6, IL-10, TC, TG, and LDL, but not HDL, differed significantly between groups A and C and between groups B and C (P<0.01). Continuous MRA scan showed significantly different signal-to-noise ratios (SNR) between the 3 groups.

CONCLUSIONUSPIO-MRA combined with IL-6 and IL-10 detection is feasible in detecting atherosclerotic plaques in rabbits.

Animals ; Atherosclerosis ; Contrast Media ; Dextrans ; Interleukin-10 ; analysis ; Interleukin-6 ; analysis ; Magnetic Resonance Angiography ; Magnetite Nanoparticles ; Male ; Plaque, Atherosclerotic ; diagnosis ; Rabbits

Objective: To understand characteristics of demographic, seasonal and spatial distribution of H5N1 cases in major countries of Asia (Indonesia, Cambodia, Vietnam, China) and Africa (Egypt). Methods: Through searching public data resource and published papers, we collected cases information in five countries from May 1st, 1997 to November 6th, 2017, including general characteristics, diagnosis, onset and exposure history, etc. Different characteristics of survived and death cases in different countries were described and χ² test was used to compare the differences among death cases and odds ratio (OR) and 95%CI value was used to compare death risk in different countries. Results: A total of 856 cases were reported in five countries with Egypt had the most cases (44.3%). The highest number of cases were reported in 2015 (18.3%). 53% cases were reported from January to March, and 96.1% of cases had the history of poultry exposure. 64.2% (43 cases) cases in China had live poultry market exposure, but the sick/dead poultry exposure was the major exposure for cases in other four countries. 452 death cases were reported in five countries, and the fatality rate was 52.8%. With Egypt as the reference group, the highest death risk was seen in Indonesia (OR (95%CI): 11.52 (7.46-17.77)), followed by Cambodia (OR (95%CI): 4.27(2.37-7.69)) and China (OR (95%CI): 2.87 (1.73-4.74)). The age distribution of death cases among 5 countries was statistically significant, and the highest fatality rate was in 15-54 years group in Egypt (83.6%, 102 cases), while in Cambodia the highest fatality rate was in 0-14 years group (76.9%, 30 cases). The highest number of deaths were reported in 2006, and 48.3% were reported from January to March. There was difference in exposure routes among 5 countries (χ²=43.85, P=0.001), 63.2% (24 cases) of the death cases in China had live poultry market exposure. 92.9% (79 cases), 83.3% (40 cases) and 100.0% (38 cases) death cases in Indonesia, Vietnam and Camodia had sick/dead poultry exposure, respectively;and 81.6% (31 cases) of the death cases in Egypt had backyard poultry exposure. Conclusion The geographical distribution, seasonal age, gender, exposure matter and outcome of H5N1 cases in five countries were different.

Health care workers have higher risk of influenza infection because of their occupational exposure to infected patients. Infection of the health care workers may not only result in the increasing risk of the nosocomial infection and family transmission, but also disrupt the health services due to absence from work. Health care workers were recommended as a priority group of influenza vaccinationin more than 40 countries and regions in the world. In recent years, domestic surveys show that the influenza vaccine coverage among health care workers was low. This paper outlines the current status and related policies of influenza vaccination among health care workers in China and global. Additionally, we analyzed and discussed the proper immunization strategy of influenza vaccine for medical staff in China.

Objective We planned to evaluate the effectiveness of moving epidemic method (MEM) in calculating influenza epidemic threshold of 7 climatic zones in China mainland. Methods The positive rate of influenza virus was obtained from the National Influenza Surveillance Network System from 2010/2011 to 2017/2018. We divided the 31 provinces into 7 climatic zones according to previous literatures and applied MEM to calculate the influenza epidemic threshold of 2018/2019 influenza season for these climatic zones. Sensitivity, specificity, positive predictive value and negative predictive value were calculated to evaluate the effectiveness of MEM. Results Pre?epidemic threshold (the positive rate of influenza virus) varied from 9.66% (temperate zone) to 16.36% (subtropical zone) for 2018/2019 influenza season. The gap between pre?epidemic and post?epidemic thresholds was less than 5% except for plateau zone. The sensitivity was 86.16% (95CI: 66.81% - 98.23%), the specificity was 94.92% (95CI:91.13%-98.41%), the positive predictive value was 89.87% (95% CI : 84.39%-94.38%), the negative predictive value was 92.96% (95%CI: 84.46%-99.17%). Conclusion Overall, moving epidemic Method performs well in calculating influenza epidemic threshold in China, much better than the previous study.

Objective To systematically review the mortality burden study of influenza in mainland China. Method "influenza","flu","H1N1","pandemic","mortality","death","fatality","burden","China" and"Chinese" were used as keywords, and a systematic literature search was conducted to identify articles in three English databases (PubMed, Web of Science and Embase) and three Chinese database (CNKI, WanFang and VIP) during 1990-2018 (excluding Hong Kong, Macao and Taiwan). The language of literature was restricted to Chinese and English. The inclusion criteria were human?oriented researches with method based on population, and research indexes included mortality and excess mortality. The exclusion criteria were non?primary research materials, predictive research and research on the burden of avian influenza related deaths. A total of 17 literatures were included, and the basic information to descriptive characteristics, methodology of modeling and the corresponding results were extracted. Results All the 17 studies adopted indirect statistical models, with 14 of which adopted the regression model, and all the research index was excess mortality. All causes (16 studies), respiratory and circulatory diseases (14 studies) and pneumonia and influenza (10 studies) were the main causes of death associated with influenza. Influenza associated mortality burden in the elderly was higher, with the lowest excess mortality rates of all causes, respiratory and circulatory diseases, pneumonia and influenza being 49.57, 30.80 and 0.69 per 100 000 people, and the highest rates being 228.16, 170.20 and 30.35 per 100 000 people, respectively. In the non?elderly, the corresponding lowest rates were-0.27,-0.08 and 0.04 per 100 000 people respectively, and the highest rates were 3.63, 2.6 and 0.91 per 100 000 people, respectively. The influenza?related excess mortality was higher in the north, with a minimum of 7.8 per 100 000 and a maximum of 18.0 per 100 000, and slightly lower in the south, with a minimum of 6.11 per 100 000 and a maximum of 18.7 per 100 000. There were also differences in deaths caused by different influenza virus subtypes, with influenza A(H3N2) and influenza B virus possibly posing a heavier mortality burden. Conclusions Studies on influenza mortality burden is mainly based on indirect model and urban level in China. The mortality burden of influenza in the elderly,the northern and subtype A(H3N2) and B were more severe.

Health care workers have higher risk of influenza infection because of their occupational exposure to infected patients. Infection of the health care workers may not only result in the increasing risk of the nosocomial infection and family transmission, but also disrupt the health services due to absence from work. Health care workers were recommended as a priority group of influenza vaccinationin more than 40 countries and regions in the world. In recent years, domestic surveys show that the influenza vaccine coverage among health care workers was low. This paper outlines the current status and related policies of influenza vaccination among health care workers in China and global. Additionally, we analyzed and discussed the proper immunization strategy of influenza vaccine for medical staff in China.

Objective We planned to evaluate the effectiveness of moving epidemic method (MEM) in calculating influenza epidemic threshold of 7 climatic zones in China mainland. Methods The positive rate of influenza virus was obtained from the National Influenza Surveillance Network System from 2010/2011 to 2017/2018. We divided the 31 provinces into 7 climatic zones according to previous literatures and applied MEM to calculate the influenza epidemic threshold of 2018/2019 influenza season for these climatic zones. Sensitivity, specificity, positive predictive value and negative predictive value were calculated to evaluate the effectiveness of MEM. Results Pre?epidemic threshold (the positive rate of influenza virus) varied from 9.66% (temperate zone) to 16.36% (subtropical zone) for 2018/2019 influenza season. The gap between pre?epidemic and post?epidemic thresholds was less than 5% except for plateau zone. The sensitivity was 86.16% (95CI: 66.81% - 98.23%), the specificity was 94.92% (95CI:91.13%-98.41%), the positive predictive value was 89.87% (95% CI : 84.39%-94.38%), the negative predictive value was 92.96% (95%CI: 84.46%-99.17%). Conclusion Overall, moving epidemic Method performs well in calculating influenza epidemic threshold in China, much better than the previous study.