Objective:To report the first case of sever fever with thrombocytopenia syndrome caused by severe fever with thrombocytopenia syndrome virus (SFTSV) in Puyang city, and to study the epidemiological and molecular characteristics of S, M, L fragments of the SFTSV isolate.Methods:The epidemiological characteristics of this case was analyzed with epidemiological methods. SFTSV was isolated from the patient′s serum sample. Nucleic acid of SFTSV was extracted and detected by fluorescent RT-PCR. A multiplex PCR method was constructed to amplify the nucleic acid sequence of the virus. whole-genome sequencing was performed on the next-generation sequencing platform. MEGA11 and DNAStar was used for homology analysis and a phylogenetic tree was constructed.Results:Epidemiological investigation showed that the patient and his close contacts had no history of travel or tick bite within 14 d, but had a history of fieldwork. The patient′s serum sample was positive for SFTSV nucleic acid. Genetic analysis showed that the S, M, L gene fragments of the first SFTSV isolate in Puyang belonged to genotype E. This isolate shared 94.8%-99.6%, 94.0%-99.8% and 95.7%-99.7% nucleotide sequence homology with the representative strains acquired from GeneBank in S, M, L gene fragments, respectively.Conclusions:This case was the first case of SFTSV-caused severe fever with thrombocytopenia syndrome in Puyang. The SFTSV isolate shared a close homology with domestic isolates, but its genotype was significantly different from the SFTSV strains isolated in Henan in recent years, indicating that it might an imported case from other places in Henan Province or Hubei Province. Disease monitoring and professional training for medical personnel should be strengthened and more attention should be paid to the evolution and mutation of SFTSV.

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 investigate the performance of real-time RT-PCR for the detection of SARS-CoV-2 nucleic acid in clinical diagnosis of COVID-19.Methods:Laboratory test data and basic case information of Henan COVID-19 cases were collected from the China′s Infectious Disease Information System as of March 5, 2020. All information was entered by local hospitals and Center for Disease Control and Prevention (CDC). Local hospitals or country CDC were responsible for sampling and municipal CDC was responsible for nucleic acid testing.Results:A total of 6 714 specimens were detected and the positive rate of SARS-CoV-2 nucleic acid was 23.82%. The specimens were collected from 1 200 confirmed cases, 2 178 suspected cases and 77 asymptomatic cases. The nucleic acid diagnosis rate of COVID-19 was 36.96% (1 277/3 455). In all cases, the positive rates of SARS-CoV-2 nucleic acid in nasal swabs, sputum samples and throat swabs were 19.38%, 28.59% and 23.53%, respectively (χ 2=15.896, P<0.01). The positive rate of SARS-CoV-2 nucleic acid in confirmed COVID-19 cases was 63.10%. The positive rates in nasal swabs, sputum samples and throat swabs were 50.80%, 58.71% and 65.21 (χ 2=18.612, P<0.01). The positive rates of SARS-CoV-2 nucleic acid were 43.51%, 23.98%, 22.82%, 12.17%, 14.46% and 13.21% in samples collected on the day of symptom onset and one week, two weeks, three weeks, four weeks, five weeks and above five weeks after the onset, respectively. The positive rates in confirmed cases were respectively 89.03%, 86.57%, 52.30%, 17.53%, 17.69% and 24.14% at those time points. Conclusions:Real-time RT-PCR is the most effective method for early pathogenic diagnosis of COVID-19. The highest detection rate of nucleic acid is achieved within one week after the onset of COVID-19, and the latest time for nucleic acid detection is 38 d after the onset.

Objective:To investigate the etiological characteristics and drug resistance of non-typhoid Salmonella isolated from stool samples of children under 5 years old with diarrhea in Henan Province. Methods:Intestinal bacteria were isolated from fecal samples of 4 250 diarrhea children under five years old in five monitoring sites in Henan Province from 2015 to 2018. Serotypes and drug sensitivity of Salmonella strains were analyzed. The annual change in drug resistance was analyzed by Chi-square test and all data were analyzed retrospectively. Results:The detection rate of non-typhoid Salmonella in fecal samples was 8.73% (371/4 250). The highest detection rate was in the 0-1 age group (51.75%) and the peak season for Salmonella infection was from May to October. The most common serotype was Salmonella enteritidis (36.93%), followed by 4, 5, 12: i: - Salmonella (14.82%) and Salmonella typhimurium (14.02%). The non-typhoid Salmonella isolates were resistant to ampicillin and sulfamethoxazole with drug resistance rates of more than 80%, but more sensitive to ceftazidime, cefepime and cefoxitin. There were significant differences in drug resistance to cefepime, levofloxacin, ciprofloxacin, amikacin, doxycycline, chloramphenicol and compound neoforman among the strains isolated in different years ( P<0.05). Multidrug-resistant strains accounted for 86.52%. Conclusions:There was diversity in the serotypes of non-typhoid Salmonella in diarrheal children under five years old in Henan Province. The predominant serotype was Salmonella enteritidis. Drug resistance to common antibiotics was detected in the isolates, and most of them were multidrug-resistant.

Objective To investigate the significance of androgen and estrogen receptor expression levels on aneurysm walls.Methods From November 2007 to June 2016,32 patients received craniotomy for clipping intracranial aneurysms in the West China Hospital,Sichuan University were enrolled prospectively.Nineteen intracranial aneurysm walls and 26 superficial temporal artery branches were obtained (a total of 45 qualified specimens).Immunohistochemical method was used to detect the superficial temporal artery branches and smooth muscle layer of intracranial aneurysm wall and the expression levels of estrogen receptor-α,β and androgen receptors.Image Pro Plus 6.0 software was used to analyze and detect the integral optical density values of the positive cell expression levels.The χ2 test and rank-sum test were used for statistical analysis.Results The median (M) and interquartile range (P25,P75) of the expression levels of estrogen receptor-α,β of the intracranial aneurysm walls were 3 049 (2 112,5 554) and 4 364 (2 314,5 667) respectively.They were lower than 6 544 (3 507,10 103) and 6 972 (5 694,10 024) of the superficial temporal artery branches.The expression level of androgen receptor of aneurysm wall was 3 299 (1 375,4 895),it was higher than 1 130 (794,1 922) of the superficial temporal artery branches.There was significant difference between the two groups (all P<0.05).Conclusion The decreased expression levels of estrogen receptor-α,β and the increased expression level of androgen receptor in the cerebrovascular walls may promote the progress of intracranial aneurysms,however,the specific mechanism needs further study.

Objective: To investigate human enterovirus (HEV) infection and clinical characteristics of viral encephalitis patients in Pingdingshan, Henan Province. Methods: Cerebrospinal fluid specimens and epidemiological information were collected from 274 viral encephalitis patients in the departments of pediatrics and neurology in hospitals in Pingdingshan, Henan Province, from April 2011 to August 2012. Patients with bacterial infections were excluded from the study. Demographic information was collected by questionnaires and clinical information was mainly obtained from hospital examinations. Viral RNA was extracted using magnetic bead extraction. Real-time RT-PCR was then performed for HEV, CV-A16, and EV-A71 testing. SPSS statistical software was statistical analyses. Significant differences were determined using the chi-squared test (P<0.05). Results: Among 274 cases of viral encephalitis, 180 cases (65.7%) were male and 94 cases were female (34.3%). The median age was 2.17 years. Approximately 61.3% (168) of patients were younger than 3 years of age. A total of 107 (39.1%), 2 (0.7%), and 42 (15.3%) cases were positive for HEV, CV-A16, and EV-A71, respectively. Eleven patients were younger than 6 months of age and one patient was co-infected with HEV and EV-A71. In the<3, 3-5, 6-15, and>15 years old age groups, HEV infections comprised 31.5% (53/168), 52.9% (18/34), 53.0% (35/66), and 16.7% (1/6) (χ²=13.10, P=0.003), respectively. The EV-A71 infection rates were 17.9% (30/168), 23.5% (8/34), 6.1% (4/66), and 0 (χ²=8.04, P=0.045), respectively. The other enterovirus (OEV) infection rates were 12.5% (21/168), 29.4% (10/34), 48.5% (32/66), and 16.7% (1/6) (χ²=35.19, P<0.001), respectively. The rate of vomiting in OEV and EV-A71 infected patients was 73% (44/60) and 26% (11/42), respectively, while the frequency of skin rash in OEV and EV-A71 infected patients was 32% (19/60) and 79% (33/42), respectively. Approximately 95% (99/104) of patients infected with HEV had a fever, and the breathing rhythm change rate was 19% (20/104), which was lower than that of patients without HEV infection (36.8% (60/163)) (χ²=9.35, P=0.002). Conclusion In Pingdingshan, HEV was a major causative agent of viral encephalitis and the rate of OEV infection was high, especially in children aged 3-15 years old. Fever was a common clinical symptom of patients infected with HEV. Patients infected with OEV primarily exhibited vomiting symptoms and EV-A71 infected patients showed skin rash.

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 investigate the training needs of health emergency professionals in centers for disease control and prevention (CDC) ,and to provide evidence for making training plan .Methods Totally 66 health emergency professionals who par‐ticipated in health emergency training class of CDC were surveyed with questionnaires in July ,2014 .The items included training content ,mode ,time ,teachers ,assessment forms and graduation way .Results Forty one persons (62 .12% of all subjects) selected health emergency disposal of all kinds of emergencies as the training contents ,and case analysis as the training mode .There were no statistical significances for the differences of the proportions of the professional staffs between different genders ,education levels ,ti‐tles ,categories and agencies (P>0 .05) .52 persons (78 .79% ) considered that training frequency of 1-2 times per year was appro‐priate ,and 53 persons (80 .30% ) considered that the most appropriate duration for each training was 2 -3 days .Domestic experts as a training teacher had the highest proportion (56 .06% ) ,followed by health emergency management cadres (34 .85% ) ,and foreign experts (6 .06% ) .The proportion of selecting university professor as a training teacher was lowest (3 .03% ) .71 .21% (47 persons) selected analog dealing with practical problems as assessment form ,and 71 .21% (47 persons) selected granting credits as graduation way .Gender and agencies were two important influencing factors for selecting different graduation ways (P< 0 .05) . Conclusion Training program of health emergency should be made according to the training needs .Appropriate training content and form should be selected in order to improve the quality and effectiveness of training ,and to improve the ability of the health e‐mergency professionals .

To investigate the animals infection situation of novel bunyavirus in Xinyang City ,Henan Province ,China , animal serum samples such as cattle ,dog ,swine ,mice were collected in Shangcheng County and Guangshan County in Xinyang City .All the serum samples were detected by novel bunyavirus ELISA and real time RT-PCR method .A total of 292 animal serum samples were collected including 5 kinds of animals .The result of all the animal serum samples were negative by using real time RT-PCR ,and the positive rate was 45 .19% (141/312) by ELISA method .Of the 5 animal serum samples including mice ,cattle ,goats ,swine and dogs ,the positive rate were detected to be 1 .06% ,100 .00% ,76 .27% ,3 .57% ,and 75 .00%respectively .There was significant difference in results among 5 kind of animal serum antibodies .Animals such as cattle and dog may be the host of novel bunyavirus which were detected novel bunyavirus antibodies in cattle and dog in Xinyang City , Henan Province ,China .

To explore the relationship between meteorological factors and incidences of fever, thrombocytopenia and leukopenia syndrome (FTLS), incidence data of FTLS in Xinyang City were collected and described. The relationship between FTLS and monthly meteorological factors such as average atmospheric pressure, average temperature, average relative humidity, average wind speed and precipitation was analyzed with simple correlation and multi-stepwise linear regression. The results showed that there was a significant negative correlation between incidence of FTLS and monthly average atmospheric pressure (P<0.01), and there were significant positive correlations between monthly average temperature, monthly average relative humidity, monthly precipitation and incidence of FTLS (P<0.05). The multi-stepwise regression showed that the regression equation was Y (monthly cases) =-12.70 + 0.28X2 (monthly average temperature), and the coefficient of determination was 0.76. The incidences of FTLS are correlated with temperature.