1.Connotation of Xiao Chaihu Decoction combined with Maxing Shigan Decoction based on severe cases and modern pathophysiological mechanism and application for severe pulmonary infection and acute exacerbation of chronic obstructive pulmonary disease in critical care medicine.
China Journal of Chinese Materia Medica 2023;48(10):2606-2612
Xiao Chaihu Decoction combined with Maxing Shigan Decoction is a classic herbal formula. All of them are derived from Treatise on Cold Damage(Shang Han Lun) by ZHANG Zhong-jing. This combination has the effects of harmonizing lesser yang, relieving exterior syndrome, clearing lung heat, and relieving panting. It is mainly used for treating the disease involving the triple-Yang combination of diseases and accumulation of pathogenic heat in the lung. Xiao Chaihu Decoction combined with Maxing Shigan Decoction is a classic combination for the treatment of exogenous diseases involving the triple-Yang combination. They are commonly used in exogenous diseases, especially in the north of China. This combination is also the main treatment strategy for coronavirus disease 2019(COVID-19) accompanied by fever and cough. Maxing Shigan Decoction is a classical herbal formula for treating the syndrome of phlegm-heat obstructing the lung. "Dyspnea after sweating" suggests the accumulation of pathogenic heat in the lung. Patients with mild symptoms may develop cough and asthma along with forehead sweating, and those in critical severe may develop whole-body sweating, especially the front chest. Modern medicine believes that the above situation is related to lung infection. "Mild fever" refers to syndromes rather than pathogenesis. It does not mean that the heat syndrome is not heavy, instead, it suggests that severe heat and inflammation have occurred. The indications of Xiao Chaihu Decoction combined with Maxing Shigan Decoction are as follows.(1) In terms of diseases, it is suitable for the treatment of viral pneumonia, bronchopneumonia, lobar pneumonia, mycoplasma pneumonia, COVID-19 infection, measles with pneumonia, severe acute respiratory syndrome(SARS), avian influenza, H1N1 influenza, chronic obstructive pulmonary disease with acute exacerbation, pertussis, and other influenza and pneumonia.(2) In terms of syndromes, it can be used for the syndromes of bitter mouth, dry pharynx, vertigo, loss of appetite, vexation, vomiting, and fullness and discomfort in the chest and hypochondrium. It can also be used to treat alternate attacks of chill and fever and different degrees of fever, as well as chest tightness, cough, asthma, expectoration, dry mouth, wanting cold drinks, feeling agitated, sweating, yellow urine, dry stool, red tongue, yellow or white fur, and floating, smooth, and powerful pulse, especially the right wrist pulse.
Animals
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Humans
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Cough
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Syndrome
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Influenza A Virus, H1N1 Subtype
;
Influenza, Human
;
COVID-19
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Drugs, Chinese Herbal/pharmacology*
;
Lung
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Pulmonary Disease, Chronic Obstructive/drug therapy*
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Asthma
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Critical Care
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Medicine, Chinese Traditional
3.Spatial and temporal distribution characteristics of seasonal A(H3N2) influenza in China, 2014-2019.
Ya Yun HAN ; Jing YANG ; Xiao Xu ZENG ; Jia Ying YANG ; Guang Xue HE ; Da Yan WANG ; Tao CHEN
Chinese Journal of Epidemiology 2023;44(6):937-941
Objective: To analyze the spatial and temporal distribution characteristics of seasonal A(H3N2) influenza [influenza A(H3N2)] in China and to provide a reference for scientific prevention and control. Methods: The influenza A(H3N2) surveillance data in 2014-2019 was derived from China Influenza Surveillance Information System. A line chart described the epidemic trend analyzed and plotted. Spatial autocorrelation analysis was conducted using ArcGIS 10.7, and spatiotemporal scanning analysis was conducted using SaTScan 10.1. Results: A total of 2 603 209 influenza-like case sample specimens were detected from March 31, 2014, to March 31, 2019, and the influenza A(H3N2) positive rate was 5.96%(155 259/2 603 209). The positive rate of influenza A(H3N2) was statistically significant in the north and southern provinces in each surveillance year (all P<0.05). The high incidence seasons of influenza A (H3N2) were in winter in northern provinces and summer or winter in southern provinces. Influenza A (H3N2) clustered in 31 provinces in 2014-2015 and 2016-2017. High-high clusters were distributed in eight provinces, including Beijing, Tianjin, Hebei, Shandong, Shanxi, Henan, Shaanxi, and Ningxia Hui Autonomous Region in 2014-2015, and high-high clusters were distributed in five provinces including Shanxi, Shandong, Henan, Anhui, and Shanghai in 2016-2017. Spatiotemporal scanning analysis from 2014 to 2019 showed that Shandong and its surrounding twelve provinces clustered from November 2016 to February 2017 (RR=3.59, LLR=9 875.74, P<0.001). Conclusion: Influenza A (H3N2) has high incidence seasons with northern provinces in winter and southern provinces in summer or winter and obvious spatial and temporal clustering characteristics in China from 2014-2019.
Humans
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Influenza, Human/epidemiology*
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China/epidemiology*
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Influenza A Virus, H3N2 Subtype
;
Seasons
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Cluster Analysis
4.Epidemiologic characteristics and influencing factors of influenza outbreaks in Guangdong Province, 2015-2022.
Ya Li ZHUANG ; Jie LU ; Shu Kai WU ; Zhan Hui ZHANG ; Zhi Mei WEI ; Yi Hong LI ; Ting HU ; Min KANG ; Ai Ping DENG
Chinese Journal of Epidemiology 2023;44(6):942-948
Objective: To grasp the epidemiological characteristics of influenza outbreaks in Guangdong Province by analyzing the outbreaks of influenza-like cases reported in Guangdong Province from January 2015 to the end of August 2022. Methods: In response to the outbreak of epidemics in Guangdong Province from 2015 to 2022, information on on-site epidemic control was collected, and epidemiological analysis was conducted to describe the characteristics of the epidemics. The factors that influence the intensity and duration of the outbreak were determined through a logistic regression model. Results: A total of 1 901 influenza outbreaks were reported in Guangdong Province, with an overall incidence of 2.05%. Most outbreak reports occurred from November to January of the following year (50.24%, 955/1 901) and from April to June (29.88%, 568/1 901). A total of 59.23% (1 126/1 901) of the outbreaks were reported in the Pearl River Delta region, and primary and secondary schools were the main places where outbreaks occurred (88.01%, 1 673/1 901). Outbreaks with 10-29 cases were the most common (66.18%, 1 258/1 901), and most outbreaks lasted less than seven days (50.93%,906/1 779). The size of the outbreak was related to the nursery school (aOR=0.38, 95%CI:0.15-0.93), the Pearl River Delta region (aOR=0.60, 95%CI:0.44-0.83), the time interval between the onset of the first case and the time of report (>7 days compared with ≤3 days: aOR=3.01, 95%CI:1.84-4.90), the influenza A(H1N1) (aOR=2.02, 95%CI:1.15-3.55) and the influenza B (Yamagata) (aOR=2.94, 95%CI: 1.50-5.76). The duration of outbreaks was related to school closures (aOR=0.65, 95%CI: 0.47-0.89), the Pearl River Delta region (aOR=0.65, 95%CI: 0.50-0.83) and the time interval between the onset of the first case and the time of report (>7 days compared with ≤3 days: aOR=13.33, 95%CI: 8.80-20.19; 4-7 days compared with ≤3 days: aOR=2.56, 95%CI: 1.81-3.61). Conclusions: An influenza outbreak in Guangdong Province exhibits two peaks, one in the winter and spring seasons and the other in the summer. Primary and secondary schools are high-risk areas, and early reporting of outbreaks is critical for controlling influenza outbreaks in schools. Furthermore, comprehensive measures should be taken to prevent the spread of the epidemic.
Humans
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Influenza A Virus, H1N1 Subtype
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Influenza, Human/epidemiology*
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Disease Outbreaks
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Epidemics
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China/epidemiology*
5.Distribution of non-bacterial pathogens in 1 788 children with community-acquired pneumonia.
Shuang WANG ; Xue-Feng WANG ; Na LI ; Yue-Xin ZHANG ; Jing CHEN ; Gai-Mei WANG
Chinese Journal of Contemporary Pediatrics 2023;25(6):633-638
OBJECTIVES:
To investigate the distribution characteristics of non-bacterial pathogens in community-acquired pneumonia (CAP) in children.
METHODS:
A total of 1 788 CAP children admitted to Shenyang Children's Hospital from December 2021 to November 2022 were selected. Multiple RT-PCR and capillary electrophoresis were used to detect 10 viral pathogens and 2 atypical pathogens, and serum antibodies of Chlamydial pneumoniae (Ch) and Mycoplasma pneumoniae (MP) were detected. The distribution characteristics of different pathogens were analyzed.
RESULTS:
Among the 1 788 CAP children, 1 295 children were pathogen-positive, with a positive rate of 72.43% (1 295/1 788), including a viral pathogen positive rate of 59.68% (1 067/1 788) and an atypical pathogen positive rate of 22.04% (394/1 788). The positive rates from high to low were MP, respiratory syncytial virus (RSV), influenza B virus (IVB), human metapneumovirus (HMPV), human rhinovirus (HRV), human parainfluenza virus (HPIV), influenza A virus (IVA), bocavirus (BoV), human adenovirus (HADV), Ch, and human coronavirus (HCOV). RSV and MP were the main pathogens in spring; MP had the highest positive rate in summer, followed by IVA; HMPV had the highest positive rate in autumn; IVB and RSV were the main pathogens in winter. The positive rate of MP in girls was higher than that in boys (P<0.05), and there were no significant differences in other pathogens between genders (P>0.05). The positivity rates of certain pathogens differed among age groups (P<0.05): the positivity rate of MP was highest in the >6 year-old group; the positivity rates of RSV and Ch were highest in the <1 year-old group; the positivity rates of HPIV and IVB were highest in the 1 to <3 year-old group. RSV, MP, HRV, and HMPV were the main pathogens in children with severe pneumonia, while MP was the primary pathogen in children with lobar pneumonia, and MP, IVB, HMPV, RSV, and HRV were the top 5 pathogens in acute bronchopneumonia.
CONCLUSIONS
MP, RSV, IVB, HMPV, and HRV are the main pathogens of CAP in children, and there are certain differences in the positive rates of respiratory pathogens among children of different ages, genders, and seasons.
Humans
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Child
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Female
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Male
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Infant
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Child, Preschool
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Pneumonia
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Respiratory Syncytial Virus, Human
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Antibodies
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Community-Acquired Infections
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Hospitalization
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Influenza B virus
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Mycoplasma pneumoniae
6.Establishment of a rapid method for detection of influenza A/B virus' antigens.
Xi Rong WANG ; Sen LI ; Ji Ye LIU ; Bing GU ; Zhi Jun JIA ; Bo TANG
Chinese Journal of Preventive Medicine 2023;57(10):1608-1612
This study aims to develop a rapid and convenient test card for simultaneous detection of influenza A and influenza B viruses using quantum dot-based immunochromatographic assay. The test card consists of a test strip and a plastic casing. The test strip is composed of absorbent paper, a buffer pad, nitrocellulose membrane (NC membrane), sample pad, quantum dot-labeled antibody pad, and polyvinyl chloride (PVC) board. The NC membrane is coated with mouse monoclonal antibodies against influenza A and influenza B viruses for the T lines (test lines), and reference proteins A and B for the C line (control line). The quantum dot-labeled antibody pad contains mouse monoclonal antibody-quantum dot conjugates against influenza A and influenza B viruses. The results showed that the detection limit of the test card for both viruses ranged from 1.51 ×102 to 2.71×103 TCID50/ml, indicating its sensitivity for accurate detection of influenza A and influenza B viruses without being affected by various variants. The test card exhibited specific reactions with different subtypes of influenza A and influenza B virus culture fluids and showed no cross-reactivity with adenovirus, novel coronavirus, Mycoplasma pneumoniae, respiratory syncytial virus, Staphylococcus aureus, and other pathogens. Overall, the sensitivity and specificity of the test card for simultaneous detection of influenza A and influenza B viruses meet the requirements for clinical use. It offers the advantages of simplicity, rapidity, and no requirement for special equipment, enabling quick auxiliary diagnosis to prevent disease transmission.
Animals
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Mice
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Humans
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Influenza, Human/diagnosis*
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Herpesvirus 1, Cercopithecine
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COVID-19
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Sensitivity and Specificity
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Influenza B virus
7.Analysis of the common respiratory viruses in children with acute respiratory infection in a hospital in Lanzhou City from 2021 to 2022.
Lin Yan WANG ; Zhen Ya LIU ; Jiao Jiao YIN ; Lu Wei YAN ; Ping Ping WANG ; Yun Shen SHI ; Ying ZHANG ; Hui Min ZHAO
Chinese Journal of Preventive Medicine 2023;57(10):1635-1639
To explore the situation of 8 common respiratory pathogens in children with acute respiratory infection (ARI) from 2021 to 2022.The retrospective study selected 8 710 ARI patients from September 2021 to August 2022 in the Maternal and Child Health Hospital of Gansu Province as the study object, patients aged 0 to 17 years old, including 5 048 male children and 3 662 female children. Indirect immunofluorescence was used to detect 8 common respiratory pathogens, including influenza virus A (FluA), influenza virus B (FluB), parainfluenza virus (PIV), respiratory syncytial virus (RSV), adenovirus (ADV), Mycoplasma pneumoniae (MP), Chlamydia pneumoniae (CP), and Coxsackie virus group B (CoxB) IgM antibodies. χ2 test was used to analyze the results. The results showed that 1 497 of 8 710 children with ARI were positive, with a positive rate of 17.19%. The detection rate of MP among 8 common respiratory pathogens was 11.34%, accounting for 66.0%, followed by FluB, CoxB, PIV, RSV, ADV, FluA and CP, accounting for 13.83%, 9.55%, 6.01%, 2.61%, 1.47%, 0.40% and 0.13%, respectively. Respiratory tract viruses (FluA, FluB, RSV, ADV, PIV, CoxB) accounted for 33.86%.There were significant differences in the detection rates of PIV, ADV and MP among children of different genders (χ2=6.814, 5.154 and 17.784, P<0.05). The detection rate of school-age children (6-17 years old) was the highest, accounting for 33.27% (184/553). The detection rates of 8 common respiratory pathogens in patients with ARI were higher in spring and winter and lower in summer and autumn. To sum up, from 2021 to 2022, MP and FluB infection were dominant in ARI patients in our hospital. The peak period of 8 common respiratory pathogens was in spring and winter. The physical examination rate of 8 common respiratory pathogens in ARI patients aged 6-17 years old was the highest.
Child
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Humans
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Male
;
Female
;
Infant
;
Infant, Newborn
;
Child, Preschool
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Adolescent
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Retrospective Studies
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Respiratory Tract Infections/epidemiology*
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Respiratory Syncytial Virus, Human
;
Seasons
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Mycoplasma pneumoniae
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Adenoviridae
;
Influenza B virus
8.Establishment of a rapid method for detection of influenza A/B virus' antigens.
Xi Rong WANG ; Sen LI ; Ji Ye LIU ; Bing GU ; Zhi Jun JIA ; Bo TANG
Chinese Journal of Preventive Medicine 2023;57(10):1608-1612
This study aims to develop a rapid and convenient test card for simultaneous detection of influenza A and influenza B viruses using quantum dot-based immunochromatographic assay. The test card consists of a test strip and a plastic casing. The test strip is composed of absorbent paper, a buffer pad, nitrocellulose membrane (NC membrane), sample pad, quantum dot-labeled antibody pad, and polyvinyl chloride (PVC) board. The NC membrane is coated with mouse monoclonal antibodies against influenza A and influenza B viruses for the T lines (test lines), and reference proteins A and B for the C line (control line). The quantum dot-labeled antibody pad contains mouse monoclonal antibody-quantum dot conjugates against influenza A and influenza B viruses. The results showed that the detection limit of the test card for both viruses ranged from 1.51 ×102 to 2.71×103 TCID50/ml, indicating its sensitivity for accurate detection of influenza A and influenza B viruses without being affected by various variants. The test card exhibited specific reactions with different subtypes of influenza A and influenza B virus culture fluids and showed no cross-reactivity with adenovirus, novel coronavirus, Mycoplasma pneumoniae, respiratory syncytial virus, Staphylococcus aureus, and other pathogens. Overall, the sensitivity and specificity of the test card for simultaneous detection of influenza A and influenza B viruses meet the requirements for clinical use. It offers the advantages of simplicity, rapidity, and no requirement for special equipment, enabling quick auxiliary diagnosis to prevent disease transmission.
Animals
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Mice
;
Humans
;
Influenza, Human/diagnosis*
;
Herpesvirus 1, Cercopithecine
;
COVID-19
;
Sensitivity and Specificity
;
Influenza B virus
9.Analysis of the common respiratory viruses in children with acute respiratory infection in a hospital in Lanzhou City from 2021 to 2022.
Lin Yan WANG ; Zhen Ya LIU ; Jiao Jiao YIN ; Lu Wei YAN ; Ping Ping WANG ; Yun Shen SHI ; Ying ZHANG ; Hui Min ZHAO
Chinese Journal of Preventive Medicine 2023;57(10):1635-1639
To explore the situation of 8 common respiratory pathogens in children with acute respiratory infection (ARI) from 2021 to 2022.The retrospective study selected 8 710 ARI patients from September 2021 to August 2022 in the Maternal and Child Health Hospital of Gansu Province as the study object, patients aged 0 to 17 years old, including 5 048 male children and 3 662 female children. Indirect immunofluorescence was used to detect 8 common respiratory pathogens, including influenza virus A (FluA), influenza virus B (FluB), parainfluenza virus (PIV), respiratory syncytial virus (RSV), adenovirus (ADV), Mycoplasma pneumoniae (MP), Chlamydia pneumoniae (CP), and Coxsackie virus group B (CoxB) IgM antibodies. χ2 test was used to analyze the results. The results showed that 1 497 of 8 710 children with ARI were positive, with a positive rate of 17.19%. The detection rate of MP among 8 common respiratory pathogens was 11.34%, accounting for 66.0%, followed by FluB, CoxB, PIV, RSV, ADV, FluA and CP, accounting for 13.83%, 9.55%, 6.01%, 2.61%, 1.47%, 0.40% and 0.13%, respectively. Respiratory tract viruses (FluA, FluB, RSV, ADV, PIV, CoxB) accounted for 33.86%.There were significant differences in the detection rates of PIV, ADV and MP among children of different genders (χ2=6.814, 5.154 and 17.784, P<0.05). The detection rate of school-age children (6-17 years old) was the highest, accounting for 33.27% (184/553). The detection rates of 8 common respiratory pathogens in patients with ARI were higher in spring and winter and lower in summer and autumn. To sum up, from 2021 to 2022, MP and FluB infection were dominant in ARI patients in our hospital. The peak period of 8 common respiratory pathogens was in spring and winter. The physical examination rate of 8 common respiratory pathogens in ARI patients aged 6-17 years old was the highest.
Child
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Humans
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Male
;
Female
;
Infant
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Infant, Newborn
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Child, Preschool
;
Adolescent
;
Retrospective Studies
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Respiratory Tract Infections/epidemiology*
;
Respiratory Syncytial Virus, Human
;
Seasons
;
Mycoplasma pneumoniae
;
Adenoviridae
;
Influenza B virus
10.Technical guidelines for seasonal influenza vaccination in China (2023-2024).
Chinese Journal of Epidemiology 2023;44(10):1507-1530
Influenza is an acute respiratory infectious disease that is caused by the influenza virus, which seriously affects human health. The influenza virus has frequent antigenic drifts that can facilitate escape from pre-existing population immunity and lead to the rapid spread and annual seasonal epidemics. Influenza outbreaks occur in crowded settings, such as schools, kindergartens, and nursing homes. Seasonal influenza epidemics can cause 3-5 million severe cases and 290 000-650 000 respiratory disease-related deaths worldwide every year. Pregnant women, infants, adults aged 60 years and older, and individuals with comorbidities or underlying medical conditions are at the highest risk of severe illness and death from influenza. China has experienced a influenza epidemic season dominated by A (H1N1) pdm09 subtype from mid-February to the end of April 2023, and the intensity was slightly higher than the epidemic year before the COVID-19. We may face the risk of interaction or co-circulation of respiratory infectious diseases such as COVID-19 and influenza during the coming season. Annual influenza vaccination is an effective way to prevent influenza, reduce influenza-related severe illness and death, and reduce the harm caused by influenza-related diseases and the use of medical resources. The currently approved influenza vaccines in China include trivalent inactivated influenza vaccine (IIV3), quadrivalent inactivated influenza vaccine (IIV4), and trivalent live attenuated influenza vaccine (LAIV3). IIV3 and IIV4 are produced as a split virus vaccine and subunit vaccine; LAIV3 is a live, attenuated virus vaccine. The influenza vaccine is a non-immunization program vaccine, which means that residents are voluntarily vaccinated. China CDC has issued "Technical guidelines for seasonal influenza vaccination in China" every year from 2018 to 2022. Over the past year, new research evidence has been published at home and abroad, and new influenza vaccines have been approved for marketing in China. To better guide the prevention and control of influenza and vaccination in China, the National Immunization Advisory Committee (NIAC) Technical Working Group (TWG), Influenza Vaccination TWG updated and revised the 2022-2023 technical guidelines with the latest research progress into the "Technical guidelines for seasonal influenza vaccination in China (2023-2024)." The new version has updated five key areas: (1) new research evidence-especially research conducted in China-has been added, including new estimates of the burden of influenza disease, assessments of influenza vaccine effectiveness and safety, and analyses of the cost-effectiveness of influenza vaccination; (2) policies and measures for influenza prevention and control were issued by the National Health Commission of the People's Republic of China and National Disease Control and Prevention Administrationy over the past year; (3) influenza vaccines approved for marketing in China this year; (4) composition of trivalent and quadrivalent influenza vaccines for the 2023-2024 northern hemisphere influenza season; and (5) recommendations for influenza vaccination during the 2023-2024 influenza season. The 2023-2024 guidelines recommend that all people aged 6 months and above who have no contraindications should get the influenza vaccination. For adults aged ≥18 years, co-administration of inactivated SARS-CoV-2 and influenza vaccines in separate arms is acceptable regarding immunogenicity and reactogenicity. For people under 18 years of age, there should be at least 14 days between influenza vaccination and COVID-19 vaccination. The guidelines express no preference for influenza vaccine type or manufacturer-any approved, age-appropriate influenza vaccines can be used. Combining the influenza epidemic tendency and the prevention and control strategy of multiple diseases, the technical guidelines recommend priority vaccination of the following high-risk groups during the upcoming 2023-2024 influenza season to minimize harm from influenza: (1) healthcare workers, including clinical doctors and nurses, public health professionals, and quarantine professionals; (2) adults ≥60 years of age; (3) individuals with comorbidities; (4) people living in nursing homes or welfare homes and staff who take care of vulnerable, at-risk individuals; (5) pregnant women; (6) children 6-59 months of age; (7) family members and caregivers of infants under 6 months of age; and (8) people who work in nursery institutions, primary and secondary schools, and supervision places. Children 6 months to 8 years of age who receive inactivated influenza vaccine for the first time should receive two doses, with an inter-dose interval of 4 or more weeks. Children who previously received the influenza vaccine and anyone aged 9 years or older need only one dose. LAIV is recommended only for a single dose regardless of the previous influenza vaccination. Vaccination should begin as soon as influenza vaccines become available, and preferably should be completed before the onset of the local influenza season. Repeated influenza vaccination during a single influenza season is not recommended. Vaccination clinics should provide immunization services throughout the epidemic season. Pregnant women can receive inactivated influenza vaccine at any stage of pregnancy. These guidelines are intended for use by staff of CDCs, healthcare workers, maternity and child care institutions and immunization clinic staff members who work on influenza control and prevention. The guidelines will be updated periodically as new evidence becomes available.
Adult
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Infant
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Female
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Humans
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Pregnancy
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Middle Aged
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Aged
;
Adolescent
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Infant, Newborn
;
Influenza Vaccines
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Influenza, Human/drug therapy*
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Seasons
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COVID-19 Vaccines
;
Influenza A Virus, H1N1 Subtype
;
Vaccination
;
COVID-19
;
China/epidemiology*
;
Vaccines, Attenuated

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