Objective:To understand the incidence and epidemiological characteristics of enteritis due to norovirus infection in Guizhou Province from 2016 to 2023, and provide reference for the prevention and control of enteritis caused by norovirus.Methods:The data were from National Notifiable Infectious Disease Reporting System of China Information System for Disease Control and Prevention. To collect the data of other infectious diarrhea cards in Guizhou from 2016 to 2023, which were annotated as enteritis due to norovirus and food-borne disease surveillance sentinel report in Guizhou, which were positive for norovirus detection. The data of cluster/outbreaks were from the Public Health Emergency Event Surveillance System and the field investigation reports of CDC at all levels. Descriptive epidemiological method was used to describe the characteristics of its three-dimension distribution, epidemic situation and pathogen spectrum. R 4.2.2 software was used for statistical analysis.Results:A total of 2 340 cases of enteritis due to norovirus were reported in Guizhou Province during this period, with an average annual reported incidence of 0.79/100 000, and the incidence showed an upward trend (trend χ2=1 723.80, P<0.001). The high incidence season is from October to March (winter and spring). The male to female ratio of the cases was 1.39∶1 (1 362∶978). A total 1 382 cases occurred in age group under 5 years old (59.06%) and 1 249 cases occurred in children living scatteredly (53.38%). The average annual reported incidence in 6 prefectures (muniipality)(1.15/100 000 in Qiandongnan Miao and Dong Autonomous Prefecture, 1.08/100 000 in Guiyang, 1.07/100 000 in Liupanshui, 1.06/100 000 in Qianxinan Buyi and Miao Autonomous Prefecture, 0.91/100 000 in Qiannan Buyi and Miao Autonomous Prefecture and 0.89/100 000 in Tongren) in Guizhou Province was higher than provincial level, and the affected areas gradually expanded from southeastern counties (districts) to western and northern counties (districts). The average annual reported incidence rate was higher in urban area (1.12/100 000) than in rural area (0.39/100 000). A total of 31 cluster/outbreaks of enteritis due to norovirus were reported, in which 83.87% (26/31) occurred in child care settings, primary and secondary schools, in which 74.19% (23/31) were caused by human-to-human transmission. In the 2 340 cases, 2 147 were laboratory diagnosed (91.75%), and 193 were clinically diagnosed (8.25%). In the laboratory diagnosed cases, 2 026 (94.36%) were caused by single norovirus infection and 121 (5.64 %) were caused by mixed infection. Conclusions:On the whole, the incidence of enteritis due to norovirus in Guizhou Province was on the rise from 2016 to 2023, and winter and spring were the high incidence seasons. Effective prevention and control measures should be taken for key populations, key regions and key places, and multi-channel and multi-pathogen surveillance and health education should be strengthened.

Objective:To understand the incidence and epidemiological characteristics of enteritis due to norovirus infection in Guizhou Province from 2016 to 2023, and provide reference for the prevention and control of enteritis caused by norovirus.Methods:The data were from National Notifiable Infectious Disease Reporting System of China Information System for Disease Control and Prevention. To collect the data of other infectious diarrhea cards in Guizhou from 2016 to 2023, which were annotated as enteritis due to norovirus and food-borne disease surveillance sentinel report in Guizhou, which were positive for norovirus detection. The data of cluster/outbreaks were from the Public Health Emergency Event Surveillance System and the field investigation reports of CDC at all levels. Descriptive epidemiological method was used to describe the characteristics of its three-dimension distribution, epidemic situation and pathogen spectrum. R 4.2.2 software was used for statistical analysis.Results:A total of 2 340 cases of enteritis due to norovirus were reported in Guizhou Province during this period, with an average annual reported incidence of 0.79/100 000, and the incidence showed an upward trend (trend χ2=1 723.80, P<0.001). The high incidence season is from October to March (winter and spring). The male to female ratio of the cases was 1.39∶1 (1 362∶978). A total 1 382 cases occurred in age group under 5 years old (59.06%) and 1 249 cases occurred in children living scatteredly (53.38%). The average annual reported incidence in 6 prefectures (muniipality)(1.15/100 000 in Qiandongnan Miao and Dong Autonomous Prefecture, 1.08/100 000 in Guiyang, 1.07/100 000 in Liupanshui, 1.06/100 000 in Qianxinan Buyi and Miao Autonomous Prefecture, 0.91/100 000 in Qiannan Buyi and Miao Autonomous Prefecture and 0.89/100 000 in Tongren) in Guizhou Province was higher than provincial level, and the affected areas gradually expanded from southeastern counties (districts) to western and northern counties (districts). The average annual reported incidence rate was higher in urban area (1.12/100 000) than in rural area (0.39/100 000). A total of 31 cluster/outbreaks of enteritis due to norovirus were reported, in which 83.87% (26/31) occurred in child care settings, primary and secondary schools, in which 74.19% (23/31) were caused by human-to-human transmission. In the 2 340 cases, 2 147 were laboratory diagnosed (91.75%), and 193 were clinically diagnosed (8.25%). In the laboratory diagnosed cases, 2 026 (94.36%) were caused by single norovirus infection and 121 (5.64 %) were caused by mixed infection. Conclusions:On the whole, the incidence of enteritis due to norovirus in Guizhou Province was on the rise from 2016 to 2023, and winter and spring were the high incidence seasons. Effective prevention and control measures should be taken for key populations, key regions and key places, and multi-channel and multi-pathogen surveillance and health education should be strengthened.

Objective:To investigate the clinical features and treatment strategies of ischemic stroke during pregnancy and puerperium.Methods:This study retrospectively analyzed the clinical data of six women diagnosed with ischemic stroke during pregnancy and puerperium by cranial CT or MRI at the Second Affiliated Hospital of Shandong First Medical University from January 2013 to December 2021. Descriptive data analysis was performed.Results:There were 31 082 deliveries at the hospital in this period. The incidence of ischemic stroke during pregnancy and puerperium was 0.019% (6/31 082) during the study period. Among the six patients, three occurred in early pregnancy, one in late pregnancy, and two in the puerperium. The most common symptoms included headache, nausea, vomiting, blurred vision, convulsions, and limb movement disorders. All six patients received conservative treatment. Two term neonates were born vaginally, and one preterm infant was delivered by cesarean section. None of the three babies had any significant malformations or abnormalities in growth and development. Two pregnancies were terminated, and one received a medical abortion due to a missed abortion after embryo arrest.Conclusions:Symptoms of ischemic stroke during pregnancy and puerperium are atypical. The treatment should be individualized based on a comprehensive assessment of the etiology, severity, and maternal and fetal conditions. Maternal and fetal conditions and gestational weeks should be considered in obstetric management.

Objective:To understand the etiological characteristics of the patients with fever of unknown origin in Guizhou province through the isolation and identification of Leptospira interrogans and provide evidence for the control, prevention and treatment of human leptospirosis. Methods:Blood and urine samples were collected from patients with fever symptoms in Qiandongnan, an epidemic area, in Guizhou. The suspected Leptospira strains were primarily identified using pathogenic Leptospira specific G1/G2-PCR, and subsequently identified by using Leptospira serogroups specific PCR. The Leptospira strains were then genotyped with multiple locus sequence typing. MLST data based cluster analysis on the isolates and Leptospira reference strains of common serogroups were analyzed by using software NTsys 2.10e. Results:Three suspected strains of Leptospira were isolated from human blood samples, the isolation rate was 8.６%, which were designated as strain 17BX002, 17BX003 and 17AJX008. Strain 17BX002 was further identified as serogroup grippotyphosa by using Leptospira serogroup specific PCR, while the other two strains were negative (excluded as iterohaemorrhagiae, sejroe, canicola, autumnalis, grippotyphosa and hebdomadis). MLST genotyping showed that strain 17BX002 was typed as ST106, most closely clustered with Leptospira grippotyphosa, while strain 17BX003 and 17AJX008 were typed as ST96, the same as serogroup badaviae. Conclusion:There are leptospirosis cases in epidemic area of Guizhou in high incidence season, grippotyphosa and bataviae are the newly discovered serogroups of Leptospira in Guizhou.

Laparoscopic inguinal hernia repair has been widely used in adult inguinal hernia.The spermatic cord,as an important reproductive organ in male patients,should be deperitonealized to avoid injury in order to prevent fertility from being affected.However in female patients,the uterine round ligament not the spermatic cord goes across the inguinal canal,which extends from intraperitoneal and extraperitoneal,banding tightly with the peritoneum.It is difficult to completely strip the uterus round ligament from peritoneum to achieve deperitonealization.Hence there is still controversy about how to handle the uterus round ligament.There is no uniform guidance document for the handling of the uterus round ligament in laparoscopic inguinal hernia repair around the world.Handling methods are investigated in this article based on the summary of related literatures.

Objective: To conduct an epidemiological investigation of two leptospirosis death cases reported in Guizhou Province in 2014. Methods: The information of the patients were investigated and analyzed. The serological detection, samples of the two patients was detected using ELISA and microscopic agglutination test (MAT). Leptospira carrier status of murine host animal in the living environment of the two patients was investigated in October and November of 2014. Leptospires in the kidney were cultured and isolated, the isolates were identified using Leptospira specific PCR and further identified with serogroup specific PCR and the conventional MAT. The relativity between the carrier status of murine and the death cases of human leptospirosis was analyzed. Results: The two death cases of human leptospirosis came from Liping County and the clinical symptoms were consistent with the diagnosis criteria for Leptospirosis. The results of ELISA detection showed that the anti-Leptospira antibody was positive for one of the death cases, MAT identified the serum reacted with sera-group icterohaemorrhagiae Leptospira, while the serum sample of the other case was failed to perform antibody detection due to hemolysis. 1 600 traps were placed in the living environment of the two death cases and 183 murine rodents were trapped. The murine density was 11.44% (183/1 600); 40 leptospirea suspected strains were isolated and all of them were isolated from Apodemus agrarius. The positive rate was 21.86% (40/183); 95 Apodemus agrarius were trapped and the murine density was 5.93% (95/1 600). Species specific PCR identified all the 40 strains as Leptospire. Serogroup specific PCR further identification showed that they were iterohaemorrahgiae serogroup Leptospria. interrogans. Conclusion Anti-iterohaemorrahgiae Leptospira antibody was detected from one of the two patients. 40 strains of iterohaemorrahgiae serogroup Leptospira interrogans were isolated and all of them were isolated from Apodemus agrarius in the living environment and the serogroup of the Leptospira matched with the serological detection results from patients, which indicated that the two death cases were caused by the infection of iterohaemorrahgiae serogroup Leptospira interrogans, and Apodemus agrarius were the potential source of infection.

OBJECTIVEThis study was to evaluate the effects of prevention and control regarding programs on typhoid fever and paratyphoid fever, in Guizhou province, from 2007 to 2012, to provide evidence for the improvement of related programs.

METHODSData on typhoid fever and paratyphoid including information on epidemics, individual, cases, measures for prevention and control programs taken and relative government documents were collected and analyzed in Guizhou province, from 2007 to 2012. Information related to the average annual incidence, nature of outbreaks, time span before confirmed diagnosis was made, unit which carried the case report, proportion of laboratory confirmed diagnosed cases and case-management were compared between 2007-2009 and 2010-2012 descriptively while chi-square test with Excel and EpiInfo software were used for data analysis.

RESULTSIn the period of 2007-2009, a total of 5 978 typhoid fever and paratyphoid fever cases were reported in Guizhou province with the average yearly incidence as 5.29/100 000. In the period of 2010-2012, 2 765 cases were reported with the average yearly incidence as 2.57/100 000. When compared to the former, data from the latter period showed that the average yearly incidence had declined 51.31% in all the prefectures. There were still some outbreaks appeared but the total number of cases involved reduced 87.50%. The time span before the confirmation of diagnosis became shorter but the difference was not statistically significant (χ² = 0.08, P = 0.99). Number of cases reported by hospitals at county or above had 11.51% of increase while those cases reported at the township hospitals or below decreased for 61.47% . The proportion of laboratory diagnosed cases increased 23.63%. Rates of timeliness on cards being filled in, input and audited showed increase of 8.44%, 6.76% and 2.40% respectively.

CONCLUSIONSuccessful measures for prevention and control on typhoid fever and paratyphoid fever had been remarkably taken in Guizhou province, but the potential risk of outbreaks still existed in some areas, suggesting that health education and surveillance programs including laboratory diagnosis, should be strengthened.

China ; epidemiology ; Communicable Disease Control ; methods ; Humans ; Paratyphoid Fever ; epidemiology ; prevention & control ; Typhoid Fever ; epidemiology ; prevention & control

Cause of Death ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; mortality ; Humans ; Infant ; Male

We identified the routes of infection and evaluate the effect of disinfection on the field of an outbreak of an-thrax in a village of Wengan County ,Guizhou ,China ,thus trying to provide with basis for the implementation of policies for pre-vention and control of anthrax .The authors gathered the cases information by searching and interviewing the targeted persons house by house ,and reviewed the medical records in hospitals .The samples including patient’s discharging fluid ,residues of died horse ,and soil from the places where the villagers dismembered horse were gathered and cultured for Bacillus anthracis . The technique of multiple-locus variable-number tandem repeat analysis (MLVA-8) was applied for revealing the genetic rela-tionships among those isolated Bacillus anthracis strains .Five cases of cutaneous anthrax occurred in the outbreak and the total attack rate was 7 .58% (5/66) among those contactors evolved in the activity of carrying ,dismembering ,washing ,chopping and eating the died horse .The attack rate was 100% (3/3) for those who carried ,dismembered ,washed ,chopped and ate that horse ,100% (1/1) for those who carried ,dismembered and ate ,and 7 .14% (1/14) for those who washed ,chopped and ate . The 25% (1/4) of the samples of discharging fluid from the cases with cutaneous anthrax were positive .After disinfection , 15 .38% (4/26) of the soil samples retained positive .The genetic similarity was 100% among the 5 isolate strains .The results suggested that the outbreak of anthrax in villagers occurred through the activities of carrying ,dismembering ,washing and chop-ping the died horse .Strengthening the risk communication and disinfection of the dismemberment places should be the crucial strategies to prevent and control anthrax epidemics in Guizhou in the future .

Objective This study was to evaluate the effects of prevention and control regarding programs on typhoid fever and paratyphoid fever,in Guizhou province,from 2007 to 2012, to provide evidence for the improvement of related programs. Methods Data on typhoid fever and paratyphoid including information on epidemics,individual,cases,measures for prevention and control programs taken and relative government documents were collected and analyzed in Guizhou province,from 2007 to 2012. Information related to the average annual incidence,nature of outbreaks, time span before confirmed diagnosis was made,unit which carried the case report,proportion of laboratory confirmed diagnosed cases and case-management were compared between 2007-2009 and 2010-2012 descriptively while chi-square test with Excelland EpiInfo software were used for data analysis. Results In the period of 2007-2009,a total of 5 978 typhoid fever and paratyphoid fever cases were reported in Guizhou province with the average yearly incidence as 5.29/100 000. In the period of 2010-2012,2 765 cases were reported with the average yearly incidence as 2.57/100 000. When compared to the former,data from the latter period showed that the average yearly incidence had declined 51.31% in all the prefectures. There were still some outbreaks appeared but the total number of cases involved reduced 87.50%. The time span before the confirmation of diagnosis became shorter but the difference was not statistically significant (χ 2=0.08,P=0.99). Number of cases reported by hospitals at county or above had 11.51% of increase while those cases reported at the township hospitals or below decreased for 61.47%. The proportion of laboratory diagnosed cases increased 23.63%. Rates of timeliness on cards being filled in,inputted and audited showed increase of 8.44%,6.76%and 2.40%respectively. Conclusion Successful measures for prevention and control on typhoid fever and paratyphoid fever had been remarkably taken in Guizhou province,but the potential risk of outbreaks still existed in some areas,suggesting that health education and surveillance programs including laboratory diagnosis,should be strengthened.