Objective: To analyze the effectiveness and response status of China Infectious Disease Automated Alert and Response System (CIDARS) in Hunan province from 2012 to 2016 for improving the system. Methods: To collect the early warning signals, the number of suspected events, the result of on-site investigation, the signal response time and the result of public health emergencies, and the χ² test, correlation analysis and non-parametric test were used to analyze the information on CIDARS in Hunan Province during the period from 2012 to 2016. Results: A total of 108 188 signals were generated by the CIDARS in Hunan Province; The warning involved 30 kinds of infectious diseases and 138 counties (districts), and each county (district) received 3.00 weekly warning messages on average; 100% early warning signal was responded, 2 h response rate was 92.43%; The median response time (P25-P75) was 0.28 (0.11-0.77) h in the single case warning, and the five-year timely response rate showed an upward trend year by year (trend χ²=58.89, P<0.05); the median response time (P25-P75) was 0.56 (0.28~1.06) h in the time series warning, and the five-year timely response rate showed no trend (trend χ²=2.43, P>0.05); the time series warning response was more timely than the single case warning, and the difference between the two timely response rates was statistically significant(χ²=5156.60, P<0.05). The studies showed that the sensitivity, specificity, and detection timeliness of the system were 84.80%, 69.53%, and 2.80 d, respectively; There was no significant difference in the infectious diseases detecting timeliness of CIDARS(H=8.75, P>0.05); the system had the best effect in rubella, and the positive likelihood ratio of rubella is 4.36. Conclusions CIDARS in Hunan province runs well overall with high sensitivity and timely response to the early warning signals, but the specificity of the early warning system needs to be improved. The quality of the epidemic report of infectious diseases needs to be further improved, and the early warning parameters and warning method should be adjusted according to the characteristics of different diseases and the differences among different regions.

Objective To explore the clinical features of ABO hemolytic disease in newboms,red blood cell glucose-6-phosphate dehydrogenase(G-6-PD) deficiency and the combined. Methods In the study, 160 cases of ABO hemolytic disease in newborn (ABO group) ,219 cases of G-6-PD deficiency(G6PD group) ,52 cases of the combined(ABO + G6PD group). The three groups were analyzed. Results The hemoglobin in the G6PD group ( (159. 7 ± 24.9) g/L) was significantly higher than in the ABO group ((150. 2 ± 23.0) g/L) and ABO + G6PD group( (149. 2 ±22. 8) g/L) (P < 0. 01). TBIL in the G6PD group ( (419. 0 ± 152. 9)μmol/L) was significantly higher than that in the ABO group ( ( 355. 4 ± 113. 2 )μmol/L) ( P < 0. 01). The Jaundice dissipated time in the G6PD group were significantly longer than ABO group ( ( 9.4 ± 2. 3) d vs. ( 8. 2 ± 2. 2 ) d) ( P < 0. 01 ) . In the ABO + G6PD group, the Jaundice dissipated time, time of phototherapy and number of phototherapy was (12. 0 ± 2. 7)d,(43. 2±16. 0)h and (3.5 ± 1. 2) times, which was significantly longer (or more) than those of the ABO group ((8. 1 ±2.2)d,(36. 1 ±15.9)h and (2. 6 ±1. 2)times) and G6PD group( (9.4 ±2. 3)d,(37. 6 ± 17. 3)h and (2. 8 ± 1. 3) times) (P<0. 05). The incidence of the bilirubin encephalopathy, hypocalcemia rate in the G6PD group (16. 0% ,32.9% ) were significantly higher than those in the ABO group(6. 9% and 20.0% ) (P <0. 05 ) . However, the incidence of anemia (23. 3% ) in the G6PD group was significantly lower than that in the ABO group (40. 0% ) and ABO + G6PD group (51.9%) ( P < 0. 01) . Conclusions In the newborns with ABO hemolytic disease and G-6-PD deficiency,the time jaundice appear,the degree of jaundice,bilirubin encephalopathy rate were not significantly different from those in the ABO hemolytic disease and G-6-PD group, but the jaundice persisted longer,and more easily repeated. Compared to the neonatal ABO hemolytic disease, the degree of jaundice, jaundice persisted longer in the G-6-PD deficiency,bilirubin encephalopathy is more likely to occur,whereas the incidence of anemia is much lower.