A sesquiterpene natural substance called artemisinin was discovered in Artemisia annua. One of its derivatives， artesunate （ART）， has the properties of economy， immediate effect， low toxicity， and good tolerance. Since it has a quick and powerful killing effect on plasmodium in the erythrocyte phase and can quickly handle clinical seizure and symptoms， it is currently mostly utilized to treat cerebral malaria and other severe instances of malaria. In addition， it has antitumor， antivirus， anti-hepatic fibrosis， anti-inflammatory， antibacterial， hepatocyte protection， immunological modulation， and other pharmacological properties and can inhibit cell proliferation， induce cell apoptosis， and reduce the incidence of sepsis. In many countries， artemisinin-based combination therapies （ACTs）， such as artemether-benflumetol， artesunate-amodiaquine， and artemether-lumefantrine， are the first-line treatments for malaria. Recent research on artesunate by Chinese and international scholars has revealed that compared with monotherapy， artesunate combination therapy offers more benefits in terms of improving pharmacological effects， shortening the duration of medicine， and minimizing adverse effects. Through systematic retrieval of Web of Science Core Collection and integration through CiteSpace （6.2.1） software， this article reviewed the mechanism of artesunate combined with other medications with regard to antimalarial， antitumor， antibacterial， and antiviral features in the previous five years， so as to provide some theoretical basis for rational development and utilization of ART and new drug research and development.

Objective:To analyze the effects of multidisciplinary cooperative nutrition management model in acute stroke patients with dysphagia.Methods:From February 2019 to February 2020, 69 acute stroke patients with dysphagia were enrolled in this study. After exclusion of those unable to complete the trial, patients were randomized into control group ( n=30) and experimental group ( n=30). Patients in the control group were given routine nutrition management, while patients in the experimental group were treated under multidisciplinary cooperative nutrition management model. Nutritional indicators were compared between the two groups on Day 1, 7 and 14 after admission, including levels of albumin (ALB), pre-albumin (PALB), hemoglobin (HB), triceps skin-fold (TSF) thickness on the uninjured side, upper arm muscle circumference etc. Incidence of gastrointestinal complications and infectious complications was also recorded. Results:There was no difference between two groups in the levels of HB, TSF thickness and upper arm muscle circumference on the uninjured side (all P>0.05). However, the serum levels of ALB and PALB on Day 7 and 14 in the experimental group were higher than that in the control group(all P<0.05), The incidence of gastrointestinal complications ( P=0.015)and infectious complications ( P=0.016) in the experimental group was lower than that in the control group. Conclusion:Multidisciplinary collaborative nutrition management improved nutritional indicators, reduced the incidence of gastrointestinal complications and infectious complications in acute stroke patients with dysphagia, making multidisciplinary collaborative nutrition management model worthy of clinical promotion and application.

Objective:To analyze the epidemiological and etiological characteristics of sever fever with thrombocytopenia syndrome (SFTS) cases in Henan province during 2017-2020.Methods:Descriptive epidemiology method was used to analyze the characteristics of SFTS cases in Henan during 2017-2020. Patients' sera in acute phase were collected and tested using real-time fluorescence RT-PCR. The S segment complete sequences of the isolated sever fever with thrombocytopenia syndrome virus (SFTSV) strains were amplified and homology analysis was performed to construct the phylogenetic tree.Results:A total of 1 767 SFTS cases, including 1 000 suspected cases and 767 confirmed cases, were reported in Henan during this period, and 11 cases, including 3 suspected cases and 8 confirmed cases died, the case fatality rate was 0.62% (11/1 767). The incidence decreased year by year. The cases were distributed in 28 counties of 6 cities, and 1 681 cases were reported in Xinyang, accounting for 95.13% (1 681/1 767) of the total. The cases mainly occurred from April to October, accounting for 96.10% (1 698/1 767) of the total. The incidence in males (0.38/100 000) was significantly lower than that in females (0.54/100 000) ( χ 2=54.855, P<0.001). Up to 93.44% (1 651/1 767) of the cases were aged between 40 and 84 years. Farmers accounted for 96.10% (1 698/1 767) of the total cases. One family cluster outbreak occurred in 4 years. A total of 1 110 samples were detected by Henan CDC, in which 435 were SFTS virus positive with an average positive rate of 39.19% (435/1 110). The differences in positive rates of SFTS virus among different years were significant ( χ2=25.405, P<0.001). The sequence homology of complete S segment of the 39 SFTS virus strains ranged from 94.76% to 99.82%. The genetic evolution analysis on the complete S segment of the 39 SFTS virus strains showed that 34 strains belonged to genotype A, 2 strains belonged to genotype B, and 3 strains belonged to genotype D. Conclusions:The incidence of SFTS in Henan was sporadic, and decreased year by year. SFTS had obvious regional and seasonal characteristics, and the area affected by SFTS expanded. The incidence of SFTS was high in elderly female farmers, and the positive rate of SFTS virus varied greatly in different years. The main type of SFTS virus in Henan was genotype A, but the etiological surveillance is still needed.

Objective: To understand the possible transmission route of a family cluster of COVID-19 in Zhengzhou and the potential infectivity of COVID-19 in incubation period, and provide scientific evidence for the timely control of infectious source and curb the spread of the epidemic. Methods: Epidemiological investigation was conducted for a family cluster of COVID-19 (8 cases) with descriptive epidemiological method, and respiratory tract samples of the cases were collected for the nucleic acid detection of 2019-nCoV by RT-PCR. Results: Two primary cases, which occurred on 31 January and 1 February, 2020, respectively, had a common exposure history in Wuhan. The other six family members had onsets on 30 January, 31 January, 1 February (three cases) and 3 February, 2020. Conclusions In this family cluster of COVID-19, six family members were infected through common family exposure to the 2 primary cases. Five secondary cases had onsets earlier than or on the same day as the primary cases, indicating that COVID-19 is contagious in incubation period, and the home isolation in the early phase of the epidemic might lead to the risk of family cluster of COVID-19.

Objective:To analyze data gathered from the laboratory records related to imported Dengue cases in Henan province in 2018.Methods:Suspected Dengue cases were found out through the Dengue fever surveillance network from the National infectious Disease reporting management information system. Serum samples of suspected Dengue cases were collected while case study and tested for Dengue NS1 antigen, IgM, IgG antibodies and Dengue RNA in Henan province in 2018. According to the standardized Dengue diagnosis criteria, confirmed cases were identified under the results of testing. Dengue RNA was checked by Real-time PCR genotyping and amplification of E gene in the samples being tested, before the PCR products were sequenced and analyses of homological and phylogenetic were performed.Results:In 2018, a total of 29 cases of Dengue fever was reported in Henan province, with all of which were imported cases, mainly from Southeast Asian countries and Africa. Majority of the cases were young and middle-aged farmers under 45 years old, and the number of males was significantly higher than that of females. The imported cases were dispersed in time and space. Among the 29 Dengue reported cases, 22 cases were with NS1 antigen and/or IgM positive through testing, while 6 cases were positive by detection of the Dengue virus RNA. These 6 samples with Dengue RNA were genotyped successfully, including 3 cases of Dengue virus type 1 and 3 cases of type 2. One of the Maldives import Dengue virus type 2 samples was sequenced. Result showed that the sequence belonged to the Asian Ⅰ genotype, which was most consistently similar to the Cambodia’s Dengue virus type 2 JF730046, identified in 2008.Conclusions:The incidence of imported Dengue fever cases increased significantly in Henan province in 2018, compared to that in 2017, but fortunately did not cause any local epidemics.

To study the epidemiology and etiology characteristics of first imported Chikungunya fever case in Henan province, China, 2017. The patient was confirmed by Chikungunya virus (CHIKV) infected as CHIKV ribonucleotide was continuously detected in his serum specimens. BHK-21 cell line was used for virus isolation, the strain was named CHIKV/Henan001/2017. CHIKV/Henan001/2017 belonged to genotype ECSA. The highest ribonucleotide homology sequence of highly conserved region E1 with CHIKV/Henan001/2017 was hk02 strain (99.8%), who was an imported strain to Hong Kong, China, 2016. Epidemiological information and laboratory testing confirmed it was an imported Chikungunya fever case in Henan province, 2017. No secondary case has been reported.

Objective To monitor the environmental contamination with avian influenza virus (AIV) in Henan Province. Methods Environmental samples were collected every month from seven moni-toring sites in Henan from 2013 to 2017. Real-time RT-PCR method was performed to detect the nucleic acid of influenza A (Flu A), H5, H7 and H9 viruses in poultry environmental samples. Results A total of 2538 environmental samples were collected and 202 (7. 96％ ) of them were positive for Flu A nucleic acid, including 16 positive for H5 (0. 63％ ), eight positive for H7 (0. 32％ ) and 161 positive for H9 (6. 34％ ). The detection rate of Flu A increased dramatically from 2013 to 2017 except for a small fluctuation in 2015. However, H7 subtype AIV was detected only in 2015 and 2017. The highest detection rate of AIV was in February, followed by that in January. Among different environments, the highest detection rate of Flu A was in live poultry market, which was 13. 69％ , followed by that in poultry slaughtering plant (2. 58％ ) and poultry farm (0. 58％ ). The detection rates of Flu A in swab samples of poultry plucker and cutting board, stool specimens and poultry drinking water were 28. 57％ , 13. 76％ , 5. 70％ and 5. 26％ , respectively.Conclusion Contamination of H5 / H7 / H9 AIV did exist in poultry environment in Henan and was getting worse. Increasingly diversified sources and sale channels were the main causes of serious contamination of AIV. In order to effectively prevent and control human infection with AIV, live poultry in areas where human infection with AIV was confirmed should be blocked and banned to be sold to others areas.

Objective: To confirm the laboratory diagnosis of dengue bordline cases reported in Henan Province and trace its origin from molecular level in 2017. Methods: The study samples were blood samples (3-5 ml), which came from 8 suspected cases of dengue fever reported in the 2017 direct reporting system of Henan provincial infectious disease monitoring network. Meanwhile, case investigation was conducted according to National dengue fever surveillance programme. Serum were separated from blood samples and tested for Dengue NS1 antigen, IgM & IgG antibodies, and dengue RNA. According to dengue diagnosis criteria, confirmed cases were identified by testing results. Samples carried dengue RNA performed for real-time PCR genotyping and amplification of E gene. Then, the amplicons were sequenced and homological and phylogenetic analyses were constructed. Results: 8 serum samples of suspected dengue cases were collected in Henan Province, 2017. Six of them were diagnosed as dengue confirmed cases. All the dengue confirmed cases belonged to outside imported cases, 5 of them were positive by dengue RNA testing. Genotyping results showed there were 1 DENV1 case, 2 DENV2 cases and 2 DENV3 cases. A DENV2 case and a DENV3 case of this study were traced its origin successfully. The sequence of Pakistan imported DENV2 case belongs to cosmopolitan genotype, which was the most consistent with Pakistan's DENV2 KJ010186 in 2013 (identity 99.0%). The sequence of Malaysia imported DENV3 case belongs to genotype I, which was the most consistent with Singapore's DENV3 KX224276 in 2014(identity 99.0%). Conclusion The laboratory diagnosis and molecular traceability of dengue cases in Henan Province in 2017 confirmed that all cases were imported and did not cause local epidemics.

Objective To explore the characteristics regarding temporal,spatial and spatiotemporal distribution on severe fever with thrombocytopenia syndrome (SFTS) in Henan province.Methods Surveillance data related to SFTS was collected in Henan province,from year 2014 to 2016.Descriptive method was used to analyze the distribution of SFTS.1.7.0 software related to the Public health geographic information system (PHGIS),was applied to draw the spatial distribution map of SFTS.Chi-square test was used to compare the different incidence rates.Results A total of 2 781 SFTS cases,including 34 deaths,were reported in Henan province from 2014 to 2016,with an average annual fatality rate as 1.22％.There were statistically significant differences for the incidence rates of SFTS between different years (P＜0.01).Cases were mainly concentrated from April to October,which accounted for 96.66％ of the total number,with the incidence peak seen in May.Incidence rates of SFTS in spring,summer,autumn were higher than that in winter.The cases were scattering around in 26 counties of 8 cities.Xinyang city reported 2 714 cases,accounting for 97.59％ of the total number of cases in the province.The average annual incidence rate in Xinyang city was 17.22 per 100 000,much higher than that for the whole Henan province (0.98 per 100 000),with statistically significant difference (P＜0.01).Six counties reported having death cases,that accounted for 23.08％ of the total number of counties,reported to have death cases.Two kinds of incidence patterns of SFTS were noticed in Henan province,with aggregation in some local regions or sporadic in individual counties.The number of counties with reporting cases increased annually.The epidemic area was expanding and gradually spreading from south to north areas of the province.Conclusions SFTS was characterized with both temporal and spatial clusters in Henan province.Effective prevention and control measures should be made in accordance with the spatiotemporal distribution and the trend on SFTS.

Objective To analyze the genotyping of hantavirus and investigate the pathogenic features of local rats in Henan province. Methods A total of 600 rats captured in Queshan county, Zhumadian city from 2014-2016 were chosen to find out the major species and density. Rat lung specimens were detected by RT-PCR using partial M and S segment primers, then sequencing and phylogenetic analysis based on M segment (2003-2302 nt) were performed to analyze gene subtype and evolution. Results In the field of Queshan county, major species were sewer rats and apodemus agrarius, and the average density of rats was 1.33%-1.83%. Sewer rats, mus musculus and apodemus agrarius were major species in the residential area, and the average density of rats was 1.36%-1.97%. Hantaviruses were detected by RT-PCR in three captured rats in 2014, and the species were mus musculus, cricetulus triton and sewer rats. Nucleotide homology similarity based M and S segment of three positive products was 100%. Phylogenetic analysis indicated the virus was belonged to S4 subgenotype of Seoul virus, which was similar with the strains in Korea and Hubei province, China. Conclusion The virus from rats in Queshan county, Henan province is seoul virus, S4 subgenotype. It is necessary to take the relevant prevention and control measures to prevent hemorrhagic fever of renal syndrome because of wide host range.