Dengue viruses(DENV) are seriously affected by cell autophagy in intracellular replication,transmission between host,and the pathogenic mechanism.Here,the latest research progress of complex interplay between DENV and cell autophagy were reviewed in this paper.Autophagy,a cellular procedural protein degradation pathway generally possessed by all eukaryotes plays a key role in response to outside pressure and maintaining cellular homeostasis.This catabolic pathway also promotes cell survival against the invasion of pathogens such as various viruses.However,autophagy plays an opposite role in the replication of DENV.Autophagy not only provides a replication site for viruses to replicate,but also provides a source of energy for this process.Cell autophagy also participates in the pathogenesis of some DENV infection.In short,autophagy contributes to the replication of DENV.

Objective: To explore the spatial-temporal distribution and epidemic characteristics of hemorrhagic fever with renal syndrome (HFRS) in Hebei province from 2005 to 2016. Methods: Records of HFRS cases reported from each county in Hebei during January 2005 to December 2016 were collected from National Notifiable Disease Surveillance System (NNDSS). Global and local spatial association statistics were used to measure the spatial autocorrelation and software GeoDa 1.2.0. Software SaTScan 9.4.1 was used to analyze spatiotemporal clusters. Software ArcGIS 10.2 was used to visualize the yearly scan results. Results: In Hebei province, a total of 8 437 human HFRS cases reported from 170 counties with an annual incidence rate of 0.99/100 000 population during 2005-2016. The peak incidence season was spring. Global spatial autocorrelation analysis on the incidence of HFRS at county-level showed that the value of Moran’s I were all above 0 (P<0.05), indicating that the significant spatial cluster. The result of local indicators on spatial association (LISA) analysis revealed that identified hot spots were mainly in northeastern area, while cold spots were found in some counties of central and southern areas. Spatial-temporal scan detected that the primary cluster of HFRS incidence was mainly distributed in Qinhuangdao city and Tangshan city, including 11 counties (city/district): Beidaihe district, Haigang district, Funing district, Shanhaiguan district, Changli county, Lulong county and Qinglong Manchu autonomous county in Qinhuangdao city, and Qian’an city, Laoting county, Luanzhou city and Luannan county in Tangshan city (RR=39.64, P<0.001), during January-July in 2005. Conclusions There were significant spatial-temporal cluster of HFRS in Hebei from 2005 to 2016. The cluster areas of HFRS were mainly in northeastern Hebei, it is necessary to strengthen the prevention and control programs of HFRS in these areas.

Objective To analyze the status of iodine nutrition after implementing new standard of iodized salt in Hubei Province,and to evaluate the effectiveness of prevention and control measures.Methods In 2016,in 103 counties (cities,districts) of Hubei Province,the townships (streets) under the jurisdiction of each county (city,district) were divided into five regions:east,south,west,north,and middle.One township (street) was selected from each region,and one primary school was selected from each township (street).From each primary school 40 children aged 8-10 (half males half females) were selected to collect salt samples from their households.Twenty pregnant women from townships (streets) near the selected schools were chosen to collect edible salt samples from their households.According to the method of population proportionate sampling (PPS),35 counties (cities,districts) were chosen from 103 counties (cities,districts).Thyroid volume of children aged 8-10 was examined,and urinary iodine of children and pregnant women were tested.Iodine nutrition criteria:the median urinary iodine of children ＜ 100 μg/L is iodine deficiency,100-＜ 200 μg/L is iodine appropriate,200-＜ 300 μg/L is iodine overdose,≥300 μg/L is iodine excess;pregnant women urinary iodine median ＜ 150 μg/L is iodine deficiency,150-＜ 250 μg/L is iodine appropriate,250-＜ 500 μg/L is iodine overdose,and ≥ 500 μg/L is iodine excess.Results Totally 30 967 edible salt samples from children's and pregnant women's households were examined,and the median of salt iodine was 23.85 mg/kg.The coverage rate of iodized salt was 99.46％ (30 799/30 967),the consumption rate of qualified iodized salt was 94.00％ (29 108/30 967).Totally 6 789 children aged 8-10 were examined thyroid volume and detected urinary iodine,the goiter rate was 0.85％ (58/6 789) and the median urinary iodine was 263.54 μg/L.Totally 3 348 urine samples of pregnant women were examined,and the median urinary iodine was 166.71 μg/L.Conclusions The salt iodine content of residents and the goiter rate of children in Hubei Province meet the national standard for eliminating iodine deficiency disorders.The iodine nutrition level of children and pregnant women is iodine appropriate or iodine overdose.The iodine nutrition level monitoring of key populations should be continuously strengthened.

Objective To evaluate the effect of schistosomiasis control in“Oriental Star shipwreck event”in Jianli County, Hubei Province,so as to provide experiences for schistosomiasis prevention and control in rescue of emergency in the future. Methods According to the data of historical schistosomiasis prevalence and the results of the field survey in the townships in the upstream and downstream of the rescue spots,the emergency handling measures of schistosomiasis control were evaluated. Meanwhile,the Oncomelania hupensis snail situation,priority crowd chemotherapy,key aquatic monitoring,and illness moni?toring of people and livestock were investigated to evaluate the schistosomiasis control effect after the events comprehensively. Results There were no schistosome?infected snails found in the place of shipwreck and the rescue spots. The average density of O. hupensis snails in 5 townships of Jianli County was 0.064 snails/0.1 m2 ,and there were no infected snails found. The positive rate of 2 090 migrants in the schistosomiasis serologic tests was 0.29%and there were no positive ones found in the fecal exami?nation. There were no acute schistosomiasis cases found by the sentinel surveillance fever clinics,and also no positive cattle were found. The results of sentinel mice monitoring in the place of shipwreck and 4 villages in the upstream and downstream showed no infected mice were found. Conclusion The schistosomiasis control measures taken after the shipwreck is effective, which achieves the goal of no schistosomiasis transmission after emergency.

Objective To investigate the water infectivity in key water regions,and analyze the transmission risk of schisto-somiasis in suspicious and high-risk environments in Hubei Province in 2016. Methods Schistosome-endemic areas of the Yangtze River,the Hanbei River and the Fu River were chosen as the surveillance and forecast sites. The water infectivity was detected by using the sentinel mice during the flood season. The infection status of residents in the villages around the surveil-lance sites and the activities of human beings and domestic animals were surveyed. The emergency response system was initiated when the water infectivity areas were detected. Results From May to June,among the ten surveillance sites of the first batch, two positive spots with infected mice were found,accounting for 20％. All the recovered mice(totally 200)were dissected:five mice were infected,with a total infection rate of 2.5％. Totally five schistosome adult worms were collected,with mean worm bur-den of 1 worm per infected mouse. The site with cercariae-infected water body started the emergency response and no epidemic occurred. From August to September,among the eight surveillance sites of the second batch,the recovered mice(totally 160) were dissected,and no infected sentinel mice were found. Conclusion The sentinel mice method plays an important role in an-alyzing the schistosomiasis transmission risk in Hubei Province.

Objective To evaluate the molluscicidal effect of suspension concentrate of niclosamide ethanolamine salt(SC-NE)against Oncomelania hupensis snails in laboratory and field. Methods The experiment of SCNE against the snails by using the immersing and spraying methods was performed in laboratory and field,with control groups of wettable powder of ni-closamide ethanolamine salt(WPN). Results In the laboratory,LC50(s) of SCNE for 24,48 h and 72 h by using the immersion method were 0.0926,0.0629 mg/L and 0.0549 mg/L,respectively. The mortality rates of snails for 24,48 h and 72 h by using the immersion method were all 100％ with the concentrations of 0.25 mg/L. The mortality rates of snails were all 100％ while spraying SCNE for 3 d in the laboratory with the concentrations of 0.25 g/m2. In Jiangling County,except 0.5 g/m3 SCNE immers-ing the snails for 24 h,the mortality rates of snails by using SCNE with the immersing method were all 100％. While the concen-tration of SCNE was 0.5 g/m3 or above,the mortality rates were all 100％after the use of it with the immersion method for 2 d in Gong'an County. In Jiangling County,the mortality rates of snails by using SCNE 0.5 g/m3 for 1 d,3 d,and 7 d with the spray-ing method were 87.5％,92.82％and 97.40％respectively. While the concentration of SCNE was 0.5 g/m3,the mortality rates were 85.94％,86.78％and 94.21％respectively after the use of it with the spraying method for 1 d,3 d,7 d in Gong'an Coun-ty,and the molluscicidal effect of SCNE(1.0 g/m2)was higher than that of WPN. Conclusion SCNE has a high molluscicidal effect in the laboratory and field,and it is a novel and simple formulation of niclosamide.

Objective To improve the information level of schistosomiasis control by using the related functions of Corel-DRAW software. Methods Combining with the requirement of schistosomiasis control,the sketch map was drawn according to the linear element drawing,the geometric drawing,the color rendering and the text adding. Results The schistosomiasis epi-demic sketch map and the Oncomelania hupensis snail distribution sketch map at all levels were produced in CorelDRAW soft-ware. Conclusion The sketch map drawing in CorelDRAW software is beautiful and standardizing,and it can improve the lev-el of information management.

Objective To construct the Markov models to reflect the reality of prevention and treatment interventions against hepatitis B virus (HBV) infection,simulate the natural history of HBV infection in different age groups and provide evidence for the economics evaluations of hepatitis B vaccination and population-based antiviral treatment in China.Methods According to the theory and techniques of Markov chain,the Markov models of Chinese HBV epidemic were developed based on the national data and related literature both at home and abroad,including the settings of Markov model states,allowable transitions and initial and transition probabilities.The model construction,operation and verification were conducted by using software TreeAge Pro 2015.Results Several types of Markov models were constructed to describe the disease progression of HBV infection in neonatal period,perinatal period or adulthood,the progression of chronic hepatitis B after antiviral therapy,hepatitis B prevention and control in adults,chronic hepatitis B antiviral treatment and the natural progression of chronic hepatitis B in general population.The model for the newborn was fundamental which included ten states,i.e.susceptiblity to HBV,HBsAg clearance,immune tolerance,immune clearance,low replication,HBeAg negative CHB,compensated cirrhosis,decompensated cirrhosis,hepatocellular carcinoma (HCC) and death.The susceptible state to HBV was excluded in the perinatal period model,and the immune tolerance state was excluded in the adulthood model.The model for general population only included two states,survive and death.Among the 5 types of models,there were 9 initial states assigned with initial probabilities,and 27 states for transition probabilities.The results of model verifications showed that the probability curves were basically consistent with the situation of HBV epidemic in China.Conclusion The Markov models developed can be used in economics evaluation of hepatitis B vaccination and treatment for the elimination of HBV infection in China though the structures and parameters in the model have uncertainty with dynamic natures.

Objective To evaluate the cost effectiveness of nationwide prevention of mother to child transmission (PMTCT) strategy for hepatitis B,and estimate the willing to pay and budget impacts on the PMTCT.Methods The decision analytic Markov model for the PMTCT was constructed and a birth cohort of Chinese infants born in 2013 was used to calculate the cost-effectiveness of the PMTCT among them compared with those receiving no intervention.The parameters in the model were obtained from literatures of national surveys or Meta-analysis.The costs,cases of HBV-related diseases and quality-adjusted life-years (QALYs) were obtained from the societal and payer perspectives,respectively.The incremental cost-effectiveness ratio (ICER) was used as measures of strategy optimization.One-way and probability sensitivity analysis were performed to explore the uncertainty of the primary results.In addition,cost-effectiveness acceptability curve and cost-effectiveness affordability curves were drawn to illustrate the cost effectiveness threshold and financial budget of the PMTCT strategy.Results The lifetime cost for PMTCT strategy was 4 063.5 yuan (RMB) per carrier,which was 37 829.7 yuan (RMB) lower compared with those receiving no intervention.Due to the strategy,a total of 24.516 1 QALYs per person would be gained,which was higher than that in those receiving no intervention.From societal perspective,the ICER was-59 136.6yuan (RMB) per additional QALYs gained,indicating that the PMTCT is cost effective.The results were reliable indicated by one-way,multi-way and probability sensitivity analyses.By the CEAC,the willing to pay was much lower than the cost-effectiveness threshold.From the affordability curve of the PMTCT strategy,the annual budget ranged from 590.4 million yuan (RMB) to 688.8 million yuan (RMB),which was lower than the financial ability.Based on the results of cost-effectiveness affordability curves,the higher annual budget was determined,the higher probability of affordability for the PMTCT would be obtained under the same willing to pay state.Only when the annual budget reaches 688.8 million yuan (RMB),the goal of PMTCT would be fully realized.Conclusions The PMTCT strategy in China was cost effective,and the cost is not beyond the financial budget needed and the willing to pay.The strategy,which is consistent with the global hepatitis B elimination efforts,should be conducted widely in China.