Objective:To study the epidemic characteristics and healthcare-seeking behavior of dengue fever cases in Zhejiang Province, and to provide a scientific basis for developing dengue fever prevention and control strategies.Methods:Data on dengue fever epidemic in Zhejiang Province from January to December 2024 were collected from the Information System for China Disease Control and Prevention and individual case reports. Descriptive epidemiological methods were used to analyze the distribution by the three dimensions (time, region, and population), healthcare-seeking behavior, importation sources, and laboratory test results of dengue fever cases in Zhejiang Province.Results:From January to December 2024, Zhejiang Province reported a total of 289 dengue fever cases (including 25 foreigners), with an incidence rate of 0.44/100 000, including one severe case and no death, and 13 were local, 108 were domestically imported, and 168 were internationally imported. The epidemic had affected 70 districts (counties, cities) across all 11 cities in the province. Cases were reported monthly, with the peak incidence concentrated from July to November. The age of dengue fever cases was 38 (30, 48) years old, ranging from 2 to 75 years old, with a higher incidence in the 30 - 39 age group (31.14%, 90/289). The male-to-female ratio was 1.86 ∶ 1.00 (188 ∶ 101). Occupational distribution was predominantly commercial service workers (28.03%, 81/289). The number of healthcare-seeking for local cases was 2 (1, 2) times, ranging from 1 to 6 times. The number of healthcare-seeking for imported cases was 1 (1, 2) times, ranging from 1 to 4 times. The interval between the onset and diagnosis of local cases was 3.5 (1.0, 5.0) days, ranging from 0 to 6 days. The interval between the onset and diagnosis of imported cases was 3(1, 4) days, ranging from 0 to 6 days. Domestically imported cases originated from Guangdong Province (102 cases), Yunnan Province (3 cases), Hunan Province (1 case), with 2 cases had unknown original provinces. Internationally imported cases mainly came from Indonesia (33 cases), Thailand (22 cases), Laos (18 cases). Serotyping of dengue virus was determined for 283 cases, with 157 cases of type Ⅰ, 88 cases of type Ⅱ, 34 cases of type Ⅲ, and 4 cases of type Ⅳ.Conclusions:The dengue fever cases in Zhejiang Province in 2024 is primarily international importation, the interval between the onset and diagnosis of local cases is relatively long. Prevention and control efforts should strengthen surveillance and early warning based on dengue fever's epidemic characteristics, and reinforcing port quarantine, mosquito vector control, and health education for high-risk populations.

Objective:To study the epidemic characteristics and healthcare-seeking behavior of dengue fever cases in Zhejiang Province, and to provide a scientific basis for developing dengue fever prevention and control strategies.Methods:Data on dengue fever epidemic in Zhejiang Province from January to December 2024 were collected from the Information System for China Disease Control and Prevention and individual case reports. Descriptive epidemiological methods were used to analyze the distribution by the three dimensions (time, region, and population), healthcare-seeking behavior, importation sources, and laboratory test results of dengue fever cases in Zhejiang Province.Results:From January to December 2024, Zhejiang Province reported a total of 289 dengue fever cases (including 25 foreigners), with an incidence rate of 0.44/100 000, including one severe case and no death, and 13 were local, 108 were domestically imported, and 168 were internationally imported. The epidemic had affected 70 districts (counties, cities) across all 11 cities in the province. Cases were reported monthly, with the peak incidence concentrated from July to November. The age of dengue fever cases was 38 (30, 48) years old, ranging from 2 to 75 years old, with a higher incidence in the 30 - 39 age group (31.14%, 90/289). The male-to-female ratio was 1.86 ∶ 1.00 (188 ∶ 101). Occupational distribution was predominantly commercial service workers (28.03%, 81/289). The number of healthcare-seeking for local cases was 2 (1, 2) times, ranging from 1 to 6 times. The number of healthcare-seeking for imported cases was 1 (1, 2) times, ranging from 1 to 4 times. The interval between the onset and diagnosis of local cases was 3.5 (1.0, 5.0) days, ranging from 0 to 6 days. The interval between the onset and diagnosis of imported cases was 3(1, 4) days, ranging from 0 to 6 days. Domestically imported cases originated from Guangdong Province (102 cases), Yunnan Province (3 cases), Hunan Province (1 case), with 2 cases had unknown original provinces. Internationally imported cases mainly came from Indonesia (33 cases), Thailand (22 cases), Laos (18 cases). Serotyping of dengue virus was determined for 283 cases, with 157 cases of type Ⅰ, 88 cases of type Ⅱ, 34 cases of type Ⅲ, and 4 cases of type Ⅳ.Conclusions:The dengue fever cases in Zhejiang Province in 2024 is primarily international importation, the interval between the onset and diagnosis of local cases is relatively long. Prevention and control efforts should strengthen surveillance and early warning based on dengue fever's epidemic characteristics, and reinforcing port quarantine, mosquito vector control, and health education for high-risk populations.

Objective:To explore the clinical effectiveness of high-frequency color Doppler ultrasound (HFCDU) assisted harvest of radial artery perforator-pedicled lateral forearm neurocutaneous vascular flap to repair soft tissue defect below the elbow.Methods:A retrospective study was conducted on the clinical data of patients who underwent repair of soft tissue defects below the elbow using the radial artery perforator-pedicled lateral forearm neurocutaneous vascular flap at the Second Hospital of Tangshan from January 2016 to June 2021. Prior to the surgery, HFCDU was utilized to identify and measure the course of the lateral forearm cutaneous nerve and the perforating branch of the radial artery surrounding the wound. Subsequently, the flap rotation point, axis, and area were meticulously designed. During the surgical procedure, the skin flap was harvested either through a subcutaneous tunnel or by direct transfer, while the nerve stump at the defect site was anastomosed end-to-end with the lateral cutaneous nerve of the forearm contained in the skin flap. After reducing the wound at the donor site, it was either directly sutured or repaired using a medium-thick skin graft harvested from the thigh. After surgery, the survival of the skin flap, wound healing at the donor site, and the survival of the skin graft were observed. At the last follow-up, the static two-point discrimination of the flap was measured, and patient satisfaction with the appearance of the flap was assessed using the Michigan hand outcomes questionnaire(MHQ). This questionnaire categorized satisfaction into five levels: very dissatisfied (1 point), dissatisfied (2 points), fair (3 points), satisfied (4 points), and very satisfied (5 points). The scar condition of the donor site was evaluated according to the Vancouver scar scale (VSS), which scored from 0 to 15 points, with higher scores indicating more severe scarring. Descriptive analysis of the data was performed using SPSS 27.0 software.Results:A total of 33 patients were included in the study, comprising 20 males and 13 females, with an average age of (41.0±11.7) years (range, 23-65 years). The defect locations included 6 forearms, 9 wrists, and 18 hands, with all patients having exposed bones and (or) tendons. The defect area ranged from 3.0 cm × 2.5 cm to 12.0 cm × 5.0 cm. The detection result of cutaneous nerves and perforating blood vessels using HFCDU were consistent with the actual findings during surgery, showing no discrepancies. The area of the skin flaps ranged from 3.5 cm × 3.0 cm to 13.0 cm × 6.0 cm. All 33 skin flaps survived postoperatively, with good blood supply and no infections reported; the wounds at the donor site healed primarily, and all grafted skin survived. The duration of postoperative follow-up was (15.6±2.9) months (range, 10-24 months), and the patients’ static two-point discrimination of the flap was measured at (12.5±3.3) mm (range, 8-20 mm). The result of the MHQ indicated that 23 patients were very satisfied with the appearance of the flap (5 points), while 10 patients were satisfied (4 points). The VSS score for the donor site was (4.3±0.9) points (range, 3-6 points), indicating that the scar at the donor site was mild.Conclusion:HFCDU can accurately identify the lateral forearm cutaneous nerve and the perforating branch of the radial artery.The radial artery perforator-pedicled lateral forearm neurocutaneous vascular flap can provide a reliable blood supply, good appearance, sense and patient satisfaction, which is suitable for repairing soft tissue defects below the elbow.

Objective:To explore the clinical effectiveness of high-frequency color Doppler ultrasound (HFCDU) assisted harvest of radial artery perforator-pedicled lateral forearm neurocutaneous vascular flap to repair soft tissue defect below the elbow.Methods:A retrospective study was conducted on the clinical data of patients who underwent repair of soft tissue defects below the elbow using the radial artery perforator-pedicled lateral forearm neurocutaneous vascular flap at the Second Hospital of Tangshan from January 2016 to June 2021. Prior to the surgery, HFCDU was utilized to identify and measure the course of the lateral forearm cutaneous nerve and the perforating branch of the radial artery surrounding the wound. Subsequently, the flap rotation point, axis, and area were meticulously designed. During the surgical procedure, the skin flap was harvested either through a subcutaneous tunnel or by direct transfer, while the nerve stump at the defect site was anastomosed end-to-end with the lateral cutaneous nerve of the forearm contained in the skin flap. After reducing the wound at the donor site, it was either directly sutured or repaired using a medium-thick skin graft harvested from the thigh. After surgery, the survival of the skin flap, wound healing at the donor site, and the survival of the skin graft were observed. At the last follow-up, the static two-point discrimination of the flap was measured, and patient satisfaction with the appearance of the flap was assessed using the Michigan hand outcomes questionnaire(MHQ). This questionnaire categorized satisfaction into five levels: very dissatisfied (1 point), dissatisfied (2 points), fair (3 points), satisfied (4 points), and very satisfied (5 points). The scar condition of the donor site was evaluated according to the Vancouver scar scale (VSS), which scored from 0 to 15 points, with higher scores indicating more severe scarring. Descriptive analysis of the data was performed using SPSS 27.0 software.Results:A total of 33 patients were included in the study, comprising 20 males and 13 females, with an average age of (41.0±11.7) years (range, 23-65 years). The defect locations included 6 forearms, 9 wrists, and 18 hands, with all patients having exposed bones and (or) tendons. The defect area ranged from 3.0 cm × 2.5 cm to 12.0 cm × 5.0 cm. The detection result of cutaneous nerves and perforating blood vessels using HFCDU were consistent with the actual findings during surgery, showing no discrepancies. The area of the skin flaps ranged from 3.5 cm × 3.0 cm to 13.0 cm × 6.0 cm. All 33 skin flaps survived postoperatively, with good blood supply and no infections reported; the wounds at the donor site healed primarily, and all grafted skin survived. The duration of postoperative follow-up was (15.6±2.9) months (range, 10-24 months), and the patients’ static two-point discrimination of the flap was measured at (12.5±3.3) mm (range, 8-20 mm). The result of the MHQ indicated that 23 patients were very satisfied with the appearance of the flap (5 points), while 10 patients were satisfied (4 points). The VSS score for the donor site was (4.3±0.9) points (range, 3-6 points), indicating that the scar at the donor site was mild.Conclusion:HFCDU can accurately identify the lateral forearm cutaneous nerve and the perforating branch of the radial artery.The radial artery perforator-pedicled lateral forearm neurocutaneous vascular flap can provide a reliable blood supply, good appearance, sense and patient satisfaction, which is suitable for repairing soft tissue defects below the elbow.

Objective: To evaluate the effectiveness for the construction of "mosquito-free village" in Xuejia Village, Pujiang County, Zhejiang Province, so as to provide the guidance for the construction of "mosquito-free village" in other rural areas. Methods: Density of adult mosquitoes in Xuejia Village was investigated using light trap method and density of larval mosquitoes was investigated using larval straw method from April to November each year. Totally 30 households of villagers were randomly selected, and their awareness rates of mosquito control knowledge, mosquito control behavior forming rates and satisfaction rates were surveyed through questionnaires. Investment during construction (from August 2016 to December 2018) and maintenance period (from 2019 to 2023) of "mosquito-free village" were investigated through data review and interviews. Long-term effects of "mosquito-free village" construction in Xuejia Village were evaluated in terms of mosquito density from 2016 to 2023, effectiveness of health education for villagers, satisfaction and investment. Results: Compared with the year 2016, the densities of adult and larval mosquitoes in Xuejia Village were significantly decreased from 2017 to 2023. The average monthly density of adult mosquitoes in 2023 decreased by 98.34%, and the average monthly 100 household index of larval mosquitoes decreased by 98.45% compared to 2016. The average monthly density of adult mosquitoes from 2019 to 2023 was less than or equal to one mosquito per light trap in a night, and the average monthly 100 household index of larval mosquitoes was less than or equal to five places per 100 households. The awareness rate of mosquito control knowledge was 93.33%, the behavior forming rate was 86.67%, and the satisfaction rate was 90.00%. By December 2023, the total investment during construction and maintenance period was 450 thousand Yuan, with an average annual investment of 60.7 thousand Yuan and average annual investment of 206.61 Yuan per household. The average annual investment during maintenance period was 36.2 thousand Yuan, and the average annual investment per household was 109.70 Yuan. Conclusion The mosquito density, effectiveness of health education for villagers and satisfaction of "mosquito-free village" in Xuejia Village all meet the evaluation criteria of "mosquito-free village", and the investment is reasonable, making it suitable for promotion to other rural areas.

Objective:The epidemiological and host animal pathogen data of leptospirosis in the population of Zhejiang Province in 2023 were analyzed, providing scientific basis for formulating prevention and control strategies of leptospirosis.Methods:The data of human leptospirosis in the population were collected from the China Information System for Disease Control and Prevention, and analyzed using descriptive epidemiological methods. The data on isolation, culture, and nucleic acid testing of Leptospira pathogens from mouse kidneys, frog kidneys, pig kidneys, and duck kidneys as well as duck serum antibody data were collected from Zhejiang Provincial Center for Disease Control and Prevention "Leptospirosis Surveillance Project of Zhejiang Province". The carrying and changing status of Leptospira epidemic microbiota in populations and host animals were analyzed. Results:In 2023, a total of 83 cases of leptospirosis were reported in Zhejiang Province, with a incidence rate of 0.126 2/ 100 000, aged (62.66 ± 11.31) years, including 68 males and 15 females. Leptospirosis cases were reported in 11 cities, mainly concentrated in the southern cities of Wenzhou City, Lishui City and Taizhou City(a total of 68 cases), accounting for 81.93% of the total number of cases. August to October were high incidence months for leptospirosis (a total of 70 cases), accounting for 84.34% of the total number cases. The male to female ratio of patients was 4.53 ∶ 1.00, and all were adults ≥20 years old, the middle and old people aged 45 - 79 years were the high-risk population (a total of 77 cases), accounting for 92.77% of the total number of cases. The patient's occupation was mainly farmers, with a total of 54 cases, accounting for 65.06% of the total number cases. The shortest time from onset to initial diagnosis for patients with leptospirosis was 0 day, and the longest was 13 days. The shortest time from initial diagnosis to confirmed diagnosis was 0 day, and the longest was 16 days. The 72.29% of the leptospirosis cases (60 cases) had a history of field labor or suspected contact with contaminated water within one month before the onset of the disease, and 18.07% of the leptospirosis cases (15 cases) had a history of contact with animals such as mice, frogs, pigs, cows, dogs, fish or ducks, or their excreta within one month before the onset of the disease. The average nucleic acid positive rate of host animals with leptospirosis was 5.92% (31/524) in mouse kidney, 6.74% (36/534) in frog kidney, and 0.66% (1/151) in pig kidney. The isolation and culture of leptospirosis from duck kidney, nucleic acid detection, and antibody detection in duck blood were all negative. The leptospirosis bacteria detected in human population were serogroup Icterohaemorrhagiae (3 samples) and Hebdomadis (4 samples), and the bacteria group detected in host animals was serogroup Icterohaemorrhagiae (3 samples). Conclusions:The outbreak of leptospirosis in Zhejiang Province mainly occurs in the summer and autumn, with the affected areas mainly concentrated in the southern region of Zhejiang Province. The affected population is mainly middle-aged and elderly males, and the population carrying Leptospira is still mainly composed of the serogroup Icterohaemorrhagiae and the Hebdomadis, with the host animal being the serogroup Icterohaemorrhagiae.

Objective:To investigate the epidemic characteristics and current situation of animal plague in Zhejiang Province, in order to provide data support for prevention and control of the plague in the whole province.Methods:A retrospective study was carried out to collect surveillance data of animal plague in Zhejiang Province from 2006 to 2020 from the "Pubonic Plague Control Management Information System". Descriptive epidemiological methods were used to analyze the density of domestic and wild rodents, the distribution of rodent species and flea species, and the serological and pathogenic test results of host animals.Results:From 2006 to 2020, the annual average density of domestic rodent in Zhejiang Province was 3.99%, which was lower than that in 2006, 2007, 2008, 2009, 2019 and 2020. The annual average density of wild rodents was 4.52%, which was lower than that in 2013, 2016, 2017, 2018, 2019 and 2020. From 2006 to 2020, a total of 173 432 rodents were captured, belonging to 3 orders, 5 families, 12 genera and 17 species; in the composition of rodent species, Rattus norvegicus was the most, accounting for 32.15% (55 765/173 432). A total of 107 736 rodents were examined, the number of flea-infected rodent was 3 885, and the flea-infested rate was 3.61%; the total number of flea collected was 9 039 and the total flea index was 0.083 9. A total of 172 235 serological samples were tested at various monitoring sites in Zhejiang Province, and 10 positive samples were detected, there were 7 copies of Apodemus agrarianus, 2 copies of Smelly Shrew and 1 copy of Rattus norvegicus, with titers ranging from 1 ∶ 40 - 1 ∶ 320; a total of 163 618 copies of rodent liver and spleen organs were cultured, and no Yersinia pestis was isolated. Conclusions:Positive host animals have been detected in Zhejiang Province for many years. It is necessary to further standardize plague surveillance and make emergency preparations to prevent relapse and import of the epidemics.

The coronavirus disease 2019 (COVID-19) pandemic is caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is spread primary via respiratory droplets and infects the lungs. Currently widely used cell lines and animals are unable to accurately mimic human physiological conditions because of the abnormal status of cell lines (transformed or cancer cells) and species differences between animals and humans. Organoids are stem cell-derived self-organized three-dimensional culture in vitro and model the physiological conditions of natural organs. Here we showed that SARS-CoV-2 infected and extensively replicated in human embryonic stem cells (hESCs)-derived lung organoids, including airway and alveolar organoids which covered the complete infection and spread route for SARS-CoV-2 within lungs. The infected cells were ciliated, club, and alveolar type 2 (AT2) cells, which were sequentially located from the proximal to the distal airway and terminal alveoli, respectively. Additionally, RNA-seq revealed early cell response to virus infection including an unexpected downregulation of the metabolic processes, especially lipid metabolism, in addition to the well-known upregulation of immune response. Further, Remdesivir and a human neutralizing antibody potently inhibited SARS-CoV-2 replication in lung organoids. Therefore, human lung organoids can serve as a pathophysiological model to investigate the underlying mechanism of SARS-CoV-2 infection and to discover and test therapeutic drugs for COVID-19.
Adenosine Monophosphate/therapeutic use* ; Alanine/therapeutic use* ; Alveolar Epithelial Cells/virology* ; Antibodies, Neutralizing/therapeutic use* ; COVID-19/virology* ; Down-Regulation ; Drug Discovery ; Human Embryonic Stem Cells/metabolism* ; Humans ; Immunity ; Lipid Metabolism ; Lung/virology* ; RNA, Viral/metabolism* ; SARS-CoV-2/physiology* ; Virus Replication/drug effects*

Objective:To analyze the epidemiological characteristics and spatiotemporal distribution of hemorrhagic fever with renal syndrome (HFRS) in Zhejiang province from 2005 to 2020, and provide scientific information for the precise prevention and control of HFRS.Methods:Data on HFRS cases in Zhejiang province during 2005-2020 were collected from the China National Notifiable Infectious Disease Reporting Information System (NNDS) for a descriptive analysis, and software ArcGIS 10.2 was used for global autocorrelation and local autocorrelation analyses. Spatiotemporal clusters were scanned with SaTScan 9.4.4 and visualized with ArcGIS 10.2.Results:A total of 7 724 HFRS cases were reported in Zhejiang province from 2005 to 2020, including 25 deaths. There were two incidence peaks each year, in late spring and early summer (May-June) and in winter (November-January). The top three areas with high cumulative cases were Ningbo (1 875, 24.27%), Taizhou (1 642, 21.25%), and Shaoxing (1 123, 14.54%). Among the reported cases, with a male to female ratio of 2.73∶1(5 656∶2 068). The majority of HFRS cases were middle-aged and elderly people, with cases aged 41-70 years accounting for 60.95%. Most HFRS cases were farmers, accounting for 69.89% (5 398/7 724). The spatial distribution of HFRS in most years was correlated. SaTScan was used for retrospective spatiotemporal scanning and three clusters were detected: the first type clusters were in 21 counties in eastern Zhejiang province and central Zhejiang province, among which 4 were in Ningbo, Shaoxing and Jinhua, 8 were in Taizhou, and 1 was in Lishui ( RR=13.69, LLR=5 522.60, P<0.001); the second type clusters were in Longquan and Qingyuan counties ( RR=31.20, LLR=1 232.46, P<0.001); the third types of clusters were in Changxing and Anji counties of Huzhou in northern Zhejiang province ( RR=3.42, LLR=23.93, P<0.001). Conclusions:HFRS mainly occurred in middle-aged,elderly and male farmers in Zhejiang province. The incidence was high in late spring, early summer and winter in eastern Zhejiang province. Precise prevention and control measures are needed for populations at high risk before the epidemic season.

Objeetive: To learn the epidemic status of COVID-19 in some high-epidemic countries, so as to provide reference for prevention and control of imported COVID-19 in China. Methods: We collected the data of all the countries who totally reported over ten thousand cases of COVID-19 by March 29, 2020, and analyzed the epidemic trend by using the incidence rate, the case fatality rate, the five-day moving average time dependent reproduction number (Rt) as well as the average daily increase rate. Results : Spain, Switzerland, Italy, Germany, France, lran, UK, USA and China were inchuded in the analysis. Spain( 15.46/100 000), Switzerland(15.44/100 000) and Italy ( 15.30/100 000)ranked top three in the incidence rate of COVID-19. Italy (10.84%), Spain (7.88%) andlan (7.11%) ranked top three in the case atality rate. By March27, the values of five-day moving average Rt in USA, UK, Iran, Spain and France were all more than one. The average daily increase rate in China had changed negative since March 6. The average daily increase rates in the other eight countries ranged from 41.58% to 18.17%, and the trend was slow down from March 20 to 29, among which Germany, Switzerland and Italy had the largest decline of 35.60%, 29.76% and 25.56%, respectively Conclusions By March 29, the epidemie situation of COVID-19 in China was under controls; the situations in ltaly, Germany and Switzerland tended to be stable; while the situations in USA, UK, Iran, Spain and France maintained an upward tmend.