The modern Silk Road spirit advocating for win-win cooperative partnerships, aligns with the target of the “Belt and Road” Initiative, which provides new opportunities for collaboration on tropical disease control among countries along the “Belt and Road”. The modern Silk Road spirit may effectively facilitate tropical disease control programmes and improve disease control concepts and approaches through collaborative research, information sharing, infrastructure development, and joint efforts in pharmaceuticals and vaccine development; however, there are still multiple challenges that require to be overcome, including political and cultural differences, and data sharing. Therefore, countries participating in the “Belt and Road” Initiative need to work together with mutual respects, build effective collaborative mechanisms and improve communications to jointly facilitate the sustainable development of global tropical disease control programmes and cultural exchange, so as to contribute to global health and prosperities. This article discusses the contribution of the modern Silk Road spirit to facilitating global tropical disease control programmes in the context of the “Belt and Road” Initiative.

Objective:To investigate the prevalence of enterovirus 71 (EV71) and the genetic characteristics of VP1 region in common hand, foot and mouth disease (HFMD) cases in Shenzhen from 2016 to 2022.Methods:Throat swabs from mild HFMD in Shenzhen sentinel hospitals were collected from 2016 to 2022. A total of 38 EV71-positive samples were screened from these throat swabs and were sequenced. Then, the VP1 sequence of these EV71-positive samples were analyzed for their phylogenetic evolution by bioimformatics software DNAStar and MEGA 6.Results:From 2016 to 2022, the number of EV71 infections among HFMD patients in Shenzhen sentinel hospitals decreased from 136 in 2016 to 0 in 2022. The mumber of EV71 infections in 2018 and 2019 decreased by 96.3%(257/267) compared to that in 2016 and 2017. From 2020 to 2022, the number of EV71 infections decreased to 0. During this period, the EV71 vaccination rate among HFMD patients increased from 6.4% to 39.6%; Evolutionary analysis showed that the nucleotide homology and amino acid homology between 38 EV71 sample strains in Shenzhen from 2016 to 2022 were 91.8%-99.9% and 98.3%-100.0%, all belonging to the C4a subgenotype; Among them, 26 strains wene local epidemic strains, and 11 strains were imported from other provinces, with a close genetic relationship with epidemic strains in Hainan, Yunnan, Sichuan, Tianjin, Henan, Jilin, and other places. One strain from 2017 had the closest genetic relationship with the US epidemic strain OP207969-USA-2017. Further comparing the EV71 epidemic strains in Shenzhen from 2016 to 2022 and EV71 severe strains, it was found that the EV71 strains in Shenzhen carried four amino acid mutation sites related to severe condition, named R22H, K43R, I249V and T289A.Conclusions:The EV71 epidemic strains in Shenzhen from 2016 to 2022 all belong to the C4a subgenotype, and the number of EV71 infection shows a downward trend with the increase of vaccine coverage rate. At the same time, the distribution of EV71 virus strains in Shenzhen shows a significant decrease in local strains and a predominance of imported strains. There are a total of four amino acid mutation sites associated with severe cases in the EV71 sample strains in Shenzhen from 2016 to 2022. Among them, 22R and 289T are located at the N and C ends of VP1, which are related to EV71 adsorption and targeting cells. The 43R site is associated with binding ability to Annexin2 protein, which enhances cell binding ability.

Objective To analyze the genetic characteristics of VP1-VP4 genes carried by cox-sackievirus A6 (CVA6) strains isolated from severe cases of hand, foot, and mouth disease (HFMD) in Shenzhen during 2012 to 2015. -ethods The VP1-VP4 genes of CVA6 strains isolated from severe HFMD cases in Shenzhen during 2012 to 2015 were amplified and sequenced. Phylogenetic analysis was performed to analyze the VP1-VP4 genes of CVA6 isolates and sequences downloaded from GenBank by using DNASTAR6. 0 and MEGA6. 02 software packages. Results Four cases of severe HFMD were caused by CVA6 in Shenzhen during 2012 to 2015. All of the patients had the symptom of fever, skin rash and aseptic encephalitis. The CVA6 strain causing severe HFMD in 2013 shared 98. 8％-98. 9％ homology in nucleotide sequences and 99. 3％-99. 8％ in amino acid sequences with the strains isolated in 2012. Two amino acid mutations were found in the CVA6 strain isolated in 2013, which were G73E in VP2 region and S13G in VP1 region. However, the CVA6 strain isolated in 2015 only shared 95. 0％ homology in nucleotide sequences and 99. 3％ homology in amino acid sequences with the strain isolated in 2013. Six amino acid mutations were identified including E73G in VP2 region and T5A, S27N, A30V, N137S and V242I in VP1 region. The phylogenetic analysis revealed that the four CVA6 strains belong to D3 sub-genotype. The CVA6 strains causing severe cases in 2012 had the nearest genetic relationship with the strain isolated in Changsha in 2012 (KJ156349). The CVA6 strain isolated in Shenzhen in 2013 had the nearest genetic relationship with the strain isolated in Shanghai in 2013 (KJ612513). The Shenzhen CVA6 isolate in 2015 showed high similarity to Weifang CVA6 isolate in 2014 (KX752785). Conclusions All CVA6 strains causing severe HFMD ca-ses in Shenzhen during 2012 to 2015 belongs to D3 sub-genotype. Mutations of S27N and A30V in the VP1 region of the CVA6 isolate in 2015 are located in the B cell epitopes. In addition, the VP1-V242I mutation in the CVA6 strain isolated in 2015 is located in the binding site of PSGL-1 receptor. These mutations may affect the binding of CVA6 strains to the cellular receptors and their infectivity to people.

Objective: To investigate the genetic characteristics of VP1 genes carried by coxsackievirus A16 strains isolated from cases of hand foot and mouth disease (HFMD) in Shenzhen during 2016 to 2017. Methods: Fecal and anal swab specimens were collected from patients with mild HFMD in four sentinel hospitals and the Institute of Pathogen Biology, Shenzhen Center for Disease Control and Prevention, China during 2016 to 2017. All specimens were tested for CVA16 viral RNA using real-time RT-PCR. The VP1 genes of 51 randomly selected CVA16 strains were amplified by RT-PCR and then sequenced using TaKaRa Biomedical Technology (Dalian). Bioinformatics software, including Mega6.02, BioEdit and DNAStar, was used for comparison and analysis of the VP1 genes. Results: CVA16 strains in Shenzhen during 2016 to 2017 mainly belonged to B1a and B1b subtypes as well as an emerging subtype B3. The epidemic of B1b subtype was found in both 2016 (28 strains) and 2017 (19 strains), while the B1a subtype (two strains) was only detected in 2017. Two B3 subtype strains were detected in 2017. The strains of B1b subtype were closely related to the strains isolated in Shanghai (JQ314149), Wenzhou (KP289416) and Beijing (KU254598), while the B1a subtype strains were closely related to the strains isolated in Kunming (JQ316639) and Tailand (GQ184139). The B3 subtype strain was an emerging CVA16 epidemic strain in mainland China. Further comparison of the CVA16 epidemic strains in Shenzhen area during 2016 to 2017 with the CVA16 strains causing severe neurological symptoms showed that two amino acid mutations (S14N and M23L) were found in VP1 protein. Conclusions The epidemic strains of CVA16 were B1b subtype in Shenzhen area in 2016. However, B1a, B1b and the emerging B3 subtype strains were prevalent in 2017. Compared with the CVA16 strains causing severe neurological symptoms, the CVA16 strains circulating in Shenzhen during 2016 to 2017 carried two amino acid mutations inVP1 protein.

Objective? To establish a digital protection system for incontinence-associated dermatitis based on earlier prevention to reduce the incidence of incontinence-associated dermatitis. Methods? Based on the informationization of nursing platform, we run the digital protection system module of incontinence-related dermatitis based on the forward moving of the prevention gateway in Zhejiang Provincial People＇s Hospital. Through comparative study, 108 patients with incontinence and incontinence-related dermatitis from January to March 2018 were randomly selected as the pre-operation data, and 108 patients with incontinence and incontinence-related dermatitis from January to March 2019 as the post-operation data. The nurses of the two groups were observed and compared in terms of their assessment accuracy in patients＇ incontinence risk, position and Incontinence Associated Dermatitis Severity(IADS), clinical staging, and implementation of prevention strategies. Meanwhile, the incidence of incontinence-related dermatitis among all inpatients in the hospital from January to March in 2018 was compared with the same period of 2019. Results? After the operation of the digital protection system for incontinence-related dermatitis based on earlier prevention, the nursing staff's accuracy rate in the risk assessment of incontinence (χ2=38.095,P＜0.01), IADS (χ2=64.901,P＜0.01), clinical staging accuracy (χ2=42.424,P＜0.01) and the implementation of protective measures (χ2=50.000, P＜0.01) had significant statistical differences. The incidence of incontinence-related dermatitis in hospitalized patients decreased from 0.35% before operation to 0.06% after operation with statistical significance(χ2=41.031, P＜0.01). Conclusions? The operation of the digital protection system for incontinence-associated dermatitis based on earlier prevention can reduce the incidence of incontinence-associated dermatitis and improve the prevention and management competence of nursing staff.

Objective To evaluate the effect of short-term training of objective structured clinical examination (OSCE) examiner in general practice residency training final examination.Methods Sixty examiners from Xinjiang Uygur Autonomous Region participated in half-day workshop of OSCE.The participants were interviewed with questionnaire before and after the training program and the effect of training was evaluated.Results The study showed that 78.3％ (47/60) examiners knew OSCE and understood the concept and implementation steps before the training;21.7％ (13/60)had used it before;95.0％ (57/60) examiners intended to learn the performance of OSCE.After training most participants completely or basically understood the 6 test stands and implementation methods of OSCE;the participants were highly satisfied with the training duration,contents and methods,and the satisfaction rates were all over 70％.Conclusion The examiners recognize the advantages of OSCE in assessment of clinical skills and have strong intention of application.Short-term training has a certain effect and feasibility.

Objective To analysis the implementation of the objective structured clinical examination (OSCE) for completion of general practice residency training in Xinjiang Uygur autonomous region.Methods Ninety eight general practice residents took training-completion examination applying OSCE in Xinjiang Uygur Autonomous Region.The examiners (including SP examiners) and examinees were interviewed with questionnaire after the OSCE.Results All 60 examiners and 98 examinees were generally in favor of using OSCE in general practice residency training completion examination;100.0％ (60/60) examiners and 86.7％ (85/98) examinees thought that it was necessary;98.3％ (59/60) examiners and 89.8％ (88/98) examinees thought that the OSCE was able to evaluate the clinical competence of general practice;95.0％ (57/60) examiners and 78.6％ (77/98) examinees thought the OSCE examination stations reasonable;40.8 ％ (40/98) examinees thought that the difficulty degree of the exam was moderate,35.7％ (35/98) and 20.4％ (20/98) examinees thought that it was difficult or very difficult,particularly for history writing and case analysis.Conclusions The examiners and examinees recognize the advantages of OSCE in assessment of clinical competence.This study provides useful information for application of OSCE in general practice residency training completion assessment.

Objective Analyzing epidemiological characteristics and etiology of hand,foot and mouth disease outbreaks from 2011 to 2012 in Shenzhen to provide the basis for prevention and control of hand,foot and mouth disease.Methods The data about epidemiology of hand,foot and mouth disease outbreaks was analyzed and Viral RNA was used for enterovirus type 71 (EV71),coxsackie virus type A16 (CA16) and Pan-enterovirus (PE) detection by real-time RT-PCR.Results A total of 501 specimens from 160 hand,foot and mouth disease outbreaks were collected and detected between 2011 and 2012.EV71 was responsible for 36 outbreaks (22.50％),CA16 was responsible for 52 outbreaks (32.50％) and other enteroviruses were responsible for 40 outbreaks (25％).84 outbreaks (52.50％) occurred in Nanshan District in Shenzhen and 36 outbreaks (22.50％) occurred in Luohu District in Shenzhen.Outbreaks occurred throughout the year except August between 2011 and 2012.There were two peak periods from March to July and September to November,respectively.The positive rates of male and female are 72.3％ and 73.4％,respectively.Conclusion There was variation in hand,foot and mouth disease outbreaks in different regions and months.There was no significant difference between gender.CA16 was the main causative agent of hand,foot and mouth disease in 2011,while non-EV71and non-CA16 human enterovirus were main pathogens of hand,foot and mouth disease outbreaks in 2012.

Objective: To explore the relationship between left coronary plaque character with the bifurcation angle and diameter by 256-slice CT angiography (CTA). Methods: A total of 387 consecutive patients who received CTA in our hospital were retrospectively studied. There were 102 patients with normal image including 60 male and 42 female at the mean age of (52.10 ± 9.65) years and 285 patients with left coronary plaque including 166 male and 119 female at the mean age of (55.65 ± 10.40) years. All patients were divided into 4 groups according to the plaque condition, Normal group,n=102 patients without plaque, Non-calciifcation group,n=137, Calciifcation group,n=79 and Mixed group,n=69. The patients with non-calciifcation plaque included 73 of mild stenosis and 57 of moderate to severe stenosis in proximal LDA. Left coronary bifurcation angle, proximal diameter and area were measured by multi-planar reconstruction (MPR) and the maximum density projection (MIP) techniques to analyze the relationship between the above indexes and plaque position, character, degree of local stenosis. Results: Left coronary bifurcation angle, the proximal diameter, area in LDA and LCX in 3 plaque groups were all larger than those in Normal group,P<0.05. In Non-calciifcation group, the above indexes were similar between the patients with mild stenosis and moderate to severe stenosis,P>0.05, while in patients with moderate to severe stenosis, the bifurcation angle and diameter were larger in male than those in female patients,P<0.05. Conclusion: 256-slice CTA could objectively evaluate left coronary bifurcation angle, stenosis degree and plaque character, which are valuable for coronary artery disease prevention, diagnosis and treatment in clinical practice.

The manifestations of current poor doctor -patient communication are: doctors have insufficient communication beforehand , randomness is big , communication is not detailed or in -depth , the patients also have certain shortcomings .The causes of this situation are: interests driven factors , lack of education supervision and management , service responsibility consciousness weakening .Therefore , should strengthen the propaganda and ed-ucation, raise awareness, constantly enhance the consciousness of doctor -patient communication; to strengthen the construction of medical ethics , to reconstruct the doctor -patient integrity , play up the solid foundation of doc-tor-patient communication;Strengthen supervision and management , establish and improve the system , to insure the good doctor-patient communication , orderly and transparent;reinforcement learning training , pay attention to the accumulation of human skills to develop and enhance the effectiveness of doctor -patient communication .