Objectives:This study aimed to evaluate the effect of the strategies on COVID-19 outbreak control in Shenzhen, and to clarify the feasibility of these strategies in metropolitans that have high population density and strong mobility.Methods:The epidemic feature of COVID-19 was described by different phases and was used to observe the effectiveness of intervention. Hierarchical spot map was drawn to clarify the distribution and transmission risk of infection sources at different time points. The Susceptible-Exposed-Infectious-Asymptomatic-Recovered model was established to estimate case numbers without intervention and compare with the actual number of cases to determine the effect of intervention. The positive rate of the nucleic acid test was used to reflect the risk of human exposure. A survey on COVID-19 related knowledge, attitude and behaviors were used to estimate the abilities of personal protection and emergency response.Results:The epidemic of COVID-19 in Shenzhen experienced the rising, plateau and decline stage. The case number increased rapidly at the beginning, with short duration of peak period. Although the epidemic curve showed human-to-human transmission, the "trailing" was not obvious. From the spot map, during the intervention period, the source of infection was widely distributed. More cases and higher transmission risk were observed in areas with higher population density. After the effective intervention measures, both infection sources and the risk of transmission decreased. After compared with the estimated case numbers without intervention, actual number proved the COVID-19 control strategies were effective. The positive rate of nucleic acid test for high risk populations decreased and no new cases reported since February 16. Shenzhen citizens had high knowledge, attitude and behavior level, and high protection ability and emergency response.Conclusions:Although the response initiated by the health administration department played a key role at the early stage of the epidemic, it was not enough to contain the outbreak of COVID-19. The first-level emergency response initiated by provincial and municipal government was effective and ensured the start of work resumption after the Spring Festival. Metropolitans like Shenzhen can also achieve the goals of strategies and measures for containment and mitigation of COVID-19.

Objective: To investigate the epidemiological characteristics of norovirus outbreaks in Shenzhen during 2005 to 2017 in order to provide reference for disease control and prevention. Methods: Monitoring data of norovirus outbreaks in Shenzhen from January 1, 2005 to December 31, 2017 were collected from Shenzhen Communicable Disease Information System and China Information System for Disease Control and Prevention. Descriptive epidemiological methods were used for data analysis. Results: From January 2005 to December 2017, 346 norovirus outbreaks (five or more cases in one community within one week) were reported in Shenzhen, of which 6.36% (22/346) were public health emergency events. Fewer outbreaks were reported during 2006 to 2013 and they were mainly caused by GⅡ.4 genotype, but the number increased sharply since 2014 with 57.80% (200/346) occurred in 2016—2017 and the epidemic genotype changed from GⅡ.4 to GⅡ.17 and GⅡ.2. The outbreaks peaked during November to March (76.88%, 266/346). There were 63.87% (221/346) reported in urban areas, 67.05% (232/346) in nurseries and 23.70% (82/346) in primary/middle schools. Among the 22 public health emergency events, 40.91% (10/22) were caused by person-to-person contacts, 40.91% (10/22) by foodborne transmission and 13.64% (3/22) by waterborne transmission. Moreover, 75.80% (238/314) of the outbreaks in nurseries and primary/middle schools were confined to one classroom and most were due to contact transmission. Conclusions Norovirus outbreaks increased obviously since 2014, which might be related to the changes of the predominant genotype from GⅡ.4 to GⅡ.17 and GⅡ.2. It is necessary to strengthen a comprehensive prevention and control in key units such as nurseries and primary/middle schools in winter and spring.

Objective: Positron emission tomography-computed tomography (PET-CT) has been used to quantify inflammatory response in the body. The aim of the present study was to explore the possibility of using this method to evaluate the stability of atherosclerotic plaques and the efficacy of atorvastatin in stabilizing atherosclerotic plaques. Methods: Twenty New Zealand male white rabbits were included and divided into the atorvastatin intervention group and the control group, with 10 rabbits in each group. Rabbits in both groups were fed with a high fat diet for 20 weeks, and treated with thoracoabdominal aortic balloon-pulling to establish atherosclerosis model at the end of the 2nd week. Rabbits in atorvastatin intervention group was given atorvastatin intragastrically once a day. At the 8th week, thoracoabdominal aortic ultrasound was used to detect plaques in all rabbits. Blood was drawn at the 3rd and the 20th week, respectively, to measure blood lipids, high-sensitive C-reactive protein (hs-CRP) and matrix metalloproteinase-9 (MMP-9). At the end of experiment, survival animals were scanned by ¹⁸F-FDG PET-CT, and the average and maximum standard uptake values (SUVmean, SUVmax) of aortic segments were measured. Thereafter, the animals were sacrificed and aortic specimens of rabbits were taken and examined by immunohistochemistry. The pathological indexes were measured and compared. Results: At the end of experiment, the total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), hs-CRP [ (4.58±0.51) ng/ml vs.(5.87±0.66) ng/ml, P<0.01], MMP-9[ (43.93±2.16) ng/ml vs. (50.77±2.32) ng/ml, P<0.01], SUVmean (0.59±0.15 vs. 0.68±0.20, P<0.05) , SUVmax (0.68±0.20 vs. 0.81±0.27, P<0.05) , plaque area [ (0.36±0.24) mm² vs. (0.50±0.34) mm², P<0.05) ] and density of macrophage[ (4.34±1.54) % vs. (5.65±1.89) %, P<0.01] in the atorvastatin intervention group were significantly lower than those in the control group. In contrast, fiber cap thickness of the plaque[ (4.12±0.66) μm vs. (2.96±0.37) μm, P<0.01] in the atorvastatin intervention group was higher than that of the control group, and the difference was statistically significant. The arterial plaque areas were positively correlated with SUVmean (r=0.27, P<0.05) and SUVmax (r=0.43, P<0.01) . Fiber cap thickness was negatively correlated with SUVmean (r=-0.38, P<0.05) and SUVmax (r=-0.47, P<0.01) . The density of macrophage were positively correlated with SUVmean (r=0.52, P<0.01) and SUVmax (r=0.51, P<0.01) . Conclusion ¹⁸F-FDG PET/CT can be used to evaluate the efficacy of atorvastatin by the stability of atherosclerotic plaques.

Objective To analyze the clinical efficacy of acupuncture and moxibustion in treating acute cerebral infarction.Methods A thorough literature search of randomized and controlled tests of acupuncture and moxibustion in treating the acute cerebral infarction was conducted.A meta-analysis was performed using version 5.3 of the ReviewManager software.Results Thirty-nine reports covering 3792 cases were found and analyzed.The neurologic impairment analysis found that in the experimental group mean difference (MD) was-1.86,with the 95％ credibility interval (CI) of between-2.06 and-1.66 showing significant differences compared with the control group.The average clinical effectiveness rate of the experimental groups was 3.95,with a 95％ CI of between-3.02 and 5.16,significantly higher than the control groups'.The experimental groups' markedly effective rate was 1.54,with a 95％ CI of 1.40 to 1.70,showing significant differences compared with the control groups.Conclusion Acupuncture and moxibustion are effective in treating acute cerebral infarction.They are worth popularizing in clinical practice.

Objective To evaluate the curative effect of imipenem on stroke associated pneumonia(SAP).Methods Seventy-two inpatients with SAP in ICU of the Affiliated Hospital of Southwest Medical University from January 2014 to January 2016 were selected.The patients were given the stroke associated treatment and symptomatic treatment.On this basis imipenem 1.0 g+ 0.9％ normal saline 100 mL was injected,once per 8 h.The disease condition change during treatment process was observed.The laboratory test results and chest CT changes were compared between before and after 2-week treatment.And the correlation analysis of risk factors was performed.Results Twelve cases died during treatment,60 cases were survival.The body temperature was declined to normal at 2 weeks after using imipenem.The NIHSS score,white blood cell (WBC) count,neutrophil count and C-reactive protein level after treatment were decreased compared with before treatment,the blood gas analysis showed that the arterial partial pressure of oxygen and oxygenation index were elevated compared with before treatment.The chest CT showed that pulmonary inflammatory exudation lesions and hydrothorax were absorbed and improved compared with before treatment.Among 72 cases,55 cases were cured,5 cases were remarkably effective,12 cases were ineffective,the total effective rate was 83.3 ％.The risk factors correlation analysis indicated that swallowing dysfunction,consciousness disturbance and acute attack history of chronic obstructive pulmonary disease were negatively correlated with the curative effect.Conclusion Imipenem has satisfactory effect in treating SAP.

Objective To discuss the effects of Paclitaxel(PTX) on levels of CD28 and CTLA-4,B lymphocyte stimulator(BAFF) in experimental autoimmune encephalomyelitis(EAE).Methods The 50 rats were divided into 5 groups by the random number table, 10 rats in each group,the doses of small group,Middle group, High group were 1 mg/kg,2 mg/kg,4 mg/kg by intraperitoneal injection for 10 consecutive days, the normal group and model group were injected 0.9% NS 2 mL,Using brain tissue score to estimate the neurological dysfunctions of rats.Using flow cytometry to detect the levels of CD28 and CTLA-4,using enzyme-linked immunosorbent (ELISA) to detect the levels of BAFF.Results The brain tissue score in PTX experimental groups were lower than model group,the comparative differences between groups were statistically significant(P < 0.01);The levels of CD28 in PTX groups were lower than EAE group,the comparative differences between groups were statistically significant(P < 0.01).The levels of CTLA-4 in PTX groups were higher than EAE group,the comparative differences between groups were statistically significant(P < 0.01);the content of BAFF in all PTX groups were lower than EAE control group.Conclusions PTX could decrease the brain tissue score,the mechanism may adjust the express of CD28、CTLA-4 in brain and the expression of BAFF.PTX may have preventive and therapeutic effects on EAE rats.

Microglia play a pivotal role in clearance of Aβ by degrading them in lysosomes, countering amyloid plaque pathogenesis in Alzheimer's disease (AD). Recent evidence suggests that lysosomal dysfunction leads to insufficient elimination of toxic protein aggregates. We tested whether enhancing lysosomal function with transcription factor EB (TFEB), an essential regulator modulating lysosomal pathways, would promote Aβ clearance in microglia. Here we show that microglial expression of TFEB facilitates fibrillar Aβ (fAβ) degradation and reduces deposited amyloid plaques, which are further enhanced by deacetylation of TFEB. Using mass spectrometry analysis, we firstly confirmed acetylation as a previously unreported modification of TFEB and found that SIRT1 directly interacted with and deacetylated TFEB at lysine residue 116. Subsequently, SIRT1 overexpression enhanced lysosomal function and fAβ degradation by upregulating transcriptional levels of TFEB downstream targets, which could be inhibited when TFEB was knocked down. Furthermore, overexpression of deacetylated TFEB at K116R mutant in microglia accelerated intracellular fAβ degradation by stimulating lysosomal biogenesis and greatly reduced the deposited amyloid plaques in the brain slices of APP/PS1 transgenic mice. Our findings reveal that deacetylation of TFEB could regulate lysosomal biogenesis and fAβ degradation, making microglial activation of TFEB a possible strategy for attenuating amyloid plaque deposition in AD.
Alzheimer Disease ; metabolism ; pathology ; Amyloid beta-Peptides ; metabolism ; Amyloid beta-Protein Precursor ; genetics ; metabolism ; Animals ; Basic Helix-Loop-Helix Leucine Zipper Transcription Factors ; chemistry ; genetics ; metabolism ; Brain ; metabolism ; Cells, Cultured ; Chloride Channels ; genetics ; metabolism ; Disease Models, Animal ; HEK293 Cells ; Humans ; Lysosomes ; genetics ; metabolism ; Mice ; Mice, Transgenic ; Microglia ; cytology ; metabolism ; Mutagenesis, Site-Directed ; Peptides ; analysis ; chemistry ; Protein Binding ; RNA Interference ; Sirtuin 1 ; antagonists & inhibitors ; genetics ; metabolism

Objective To explore the effect of vasoactive intestinal peptide ( VIP) on the prevention and treatment of experimental autoimmune encephalomyelitis(EAE) rats by regulating the levels of IFN-γand IL-17A in brain tissue. Methods Sixty healthy female Wistar rats were randomly divided into 4 groups:normal control group, EAE control group, VIP low-dose group and VIP high-dose group.Myelin basic protein ( MBP)+complete Freurd′s adjuvant ( CFA) was used to establish an EAE model.The low and high-dose VIP groups were intraperitoneally injected with VIP 4 nmol/kg(0.2 ml) and 16 nmol/kg (0.8 ml) respectively every other day,while normal control group and EAE group with 0.8 ml saline for ten consecutive days.The incubation period, progression and peak of neurological dysfunction score ( NDS) changes of rats were recorded.The pathological changes, the GFAP+astrocyte activation in the brain at the morbidity peak of rats and the cytokine levels of IFN-γand IL-17A in brain tissue were observed.Results The incubation period was extended, the progression and peak NDS were shortened in the two VIP groups.In normal control group, there was no inflammatory cell infiltration or active astrocytes in brain tissue.The degree of infiltration of inflammatory cells and the degree of astrocyte activation in the VIP control group were significantly lower than in the EAE group.The cytokine levels of IFN-γand IL-17A in brain tissue were reduced in VIP groups.Conclusion By lowering IFN-γand IL-17A content in brain tissue, the infiltration of inflammatory cells and astrocyte activation are inhibited.VIP plays an important role in prevention and control of EAE.

OBJECTIVE:To observe the clinical efficacy and safety of Buzhong yiqi wuling decoction combined with western medicine in the treatment of chronic congestive heart failure(CHF). METHODS:120 CHF patients were divided into observation group and control group by random number table method,with 60 cases in each group. Control group received conventional western medicine treatment as rest,low salt diet and diuretics. Observation group was additionally given Buzhong yiqi wuling decoction,one dose a day,at twice,on the basis of control group. Treatment course of 2 groups lasted for 2 weeks. Average TCM symptom score, level of plasma NT-proBNP,6 min walk test(6MWT)distance before and after treatment,clinical efficacy and the occurrence of ADR were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in average TCM symptom score,level of plasma NT-proBNP and 6MWT distance between 2 groups(P>0.05). After treatment,average TCM symptom score and level of plasma NT-proBNP of 2 groups were decreased significantly,and the observation group was more significant than the control group,with statistical significance(P<0.05);6MWT distance of 2 groups were improved significantly compared to before treatment,and the observation group was significantly longer than the control group,with statistical significance(P<0.05). After treatment,total effective rate of observation group(93.33%)was significantly higher than that of control group(83.33%),with sta-tistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Buzhong yiqi wuling decoction is an ef-fective prescription to treat CHF,and can relieve clinical symptoms,improve the cardiac function,decrease NT-proBNP level and en-hance the patient exercise tolerance with good safety.

Objective To analyze the clinical features and image characteristic of neuro-Behcet disease with epileptic seizure as the primary symptom. Methods The data of 4 patients with neuro-Behcet disease with epileptic seizure as the first symptom were collected and retrospectively analyzed. Results One patient had recurrent joint pain in the department of dermatology, and 1 patient had blurred vision in the department of ophthalmology. They were shifted to department of neurology because of epileptic seizure. Head CT of four patients were normal. There were abnormal signal in brainstem in 2 cases, and in the other 2 cases, there were symmetry abnormal signals in periventricle, centrum semiovale. The abnormal signal was low in T1 weighted image and high in T2 weighted image, flair, diffuse weighing imaging , but there were no abnormal signals in cortex in these 4 cases. In CSF examination, 3 patients′cell number was high, 1 patient′s cell number was normal, 2 patients′protein levels were high, and the other 2 patients′protein levels were normal. One patient had spike wave and sharp wave in video-EEG, and the other 3 patients were normal. Conclusions Epileptic seizure is rare in neuro-Behcet disease, and CT and MRI is frequently-used in diagnosing nervous system disease. There are no abnormal signals in cortex, but there are generalized tonic-clonic seizure, which may relate with the abnormal discharge of cortex.