Epidemiological profile of dengue in Zhejiang Province, southeast China

BACKGROUND

Dengue is one of the most important vector-bore infectious diseases in China because of its drastic increase in incidence, geographic extension and profound influence on China's economy. This study aims to retrospectively uncover the epidemiological profile of dengue in Zhejiang, one of the most developed provinces in China, and to find the problem existing in dengue control and prevention.

METHODOLOGY

Descriptive analyses on the dengue incidence and associated factors were performed. We also identified potential space-time cluster and generated the risk map of dengue.

PRINCIPAL FINDINGS

A total of 529 cases were reported in Zhejiang Province from 2005 to 2016, and 44.4% were imported. 67.7% of cases were 25~60 years old and the overall male-to-female sex ratio was 1.09:1. Dengue was reported all year round and 70.7% of cases occurred between August and October. Indigenous cases were only reported in the period between July to November and more than half occurred in September. Geographically, dengue was most distributed in Jinghua (3.62 per million), Shaoxing (1.00 per million) and Taizhou (0.81 per million) prefecture level cities. Outbreaks were confirmed in Yiwu, Keqiao and Huangyan counties in 2009, 2015, and 2016, respectively. 73.9% cases would seek medical advice within two days after onset and be confirmed within 9 days after onset. 75.6% would be recognized as dengue within 8 days after their first visit. The time intervals between onset and confirmation (median 7 vs 6 days; Wilcoxon rank sum test Z = -2.40, P = 0.016), first visit and confirmation (median 7 vs 6 days; Wilcoxon rank sum test Z = -2.59, P = 0.009) of indigenous cases were significantly longer than those of imported ones. However, the time intervals between onset and first visit for indigenous cases was shorter (median 0 vs 1 days; Wilcoxon rank sum test Z = -2.10, P = 0.036). Fever (99.1%), fatigue (81.9), rash (63.7%), headache (67.2%) and myalgia (52.60%) were the most frequently mentioned symptoms.

CONCLUSIONS

Zhejiang has recently witnessed an increase in incidence and geographic extension of dengue. Timely diagnosis is important to stop local transmission and outbreak.

Body mass index, waist-to-hip ratio and cognitive function among Chinese elderly: a cross-sectional study

OBJECTIVES

To investigate the associations between body mass index (BMI), waist-to-hip ratio (WHR) and cognitive function among Chinese elderly.

DESIGN

Cross-sectional study.

SETTING

Community.

PARTICIPANTS

Data were obtained from the baseline survey of a community-based cohort in Zhejiang Province, and 9326 persons aged 60 years and older were enrolled.

PRIMARY OUTCOME MEASURES

We investigated the association between BMI and cognition, and then explored the association between WHR and cognition across different quartiles of BMI.

RESULTS

A sample of 9087 persons was used in this study, including 4375 men and 4712 women. Higher WHR increased cognitive impairment risk in those with BMI >25.3 kg/m² (OR (per 0.1 increase) 1.39; 95% CI 1.13 to 1.70). No statistically significant association was found in other BMI categories.

CONCLUSIONS

Higher WHR could increase the risk of cognitive impairment among elderly with BMI >25.3 kg/m². Our results suggest that it could be of benefit to the elderly with high BMI to control WHR.

Spatial-temporal characteristics and the epidemiology of haemorrhagic fever with renal syndrome from 2007 to 2016 in Zhejiang Province, China

Zhejiang Province is one of the six provinces in China that has the highest incidence of haemorrhagic fever with renal syndrome (HFRS). Data on HFRS cases in Zhejiang Province from January 2007 to July 2017 were obtained from the China Information Network System of Disease Prevention and Control. Joinpoint regression analysis was used to observe the trend of the incidence rate of HFRS. The monthly incidence rate was predicted by autoregressive integrated moving average(ARIMA) models. Spatial autocorrelation analysis was performed to detect geographic clusters. A multivariate time series model was employed to analyze heterogeneous transmission of HFRS. There were a total of 4,836 HFRS cases, with 15 fatal cases reported in Zhejiang Province, China in the last decade. Results show that the mean absolute percentage error (MAPE) of the modelling performance and the forecasting performance of the ARIMA model were 27.53% and 16.29%, respectively. Male farmers and middle-aged patients account for the majority of the patient population. There were 54 high-high clusters and 1 high-low cluster identified at the county level. The random effect variance of the autoregressive component is 0.33; the spatio-temporal component is 1.30; and the endemic component is 2.45. According to the results, there was obvious spatial heterogeneity in the endemic component and spatio-temporal component but little spatial heterogeneity in the autoregressive component. A significant decreasing trend in the incidence rate was identified, and obvious clusters were discovered. Spatial heterogeneity in the factors driving HFRS transmission was discovered, which suggested that a targeted preventive effort should be considered in different districts based on their own main factors that contribute to the epidemics.

[Association between blood pressure related dietary patterns and identified cognitive performance in the elderly Chinese-a study by reduced rank regression method]

Objective: To study the association between blood pressure related dietary pattern and cognitive impairment in the elderly. Methods: In 2015, all participants who were aged ≥60 and participated in the Nutrition and Chronic disease family cohort were involved in the study. Information on demographic variables, lifestyle and health status was collected. Cognitive performance was assessed by the Mini Mental State Evaluation (MMSE) scale. Blood pressure, height and weight were measured by trained medical personnel and fasting venous blood samples were collected for testing on serum level of triglycerides and total cholesterol. Both SBP and DBP were used as response variables when dietary patterns were identified by reduced rank regression method. Logistic regression models were fit to explore the associations of scores on blood pressure-related dietary pattern and cognitive impairment. Results: Two blood related dietary patterns were identified. The first one was characterized by high consumption of vegetables and less meat, eggs and dessert (Pattern 1), while the second one was with high consumption of meat, soy products, wine and fried foods and less intake of dairy (Pattern 2). Data showed that the Pattern 1 was associated with the risk of cognitive impairment. Comparing with the lowest quartile of score of this dietary pattern, the risk of cognitive impairment in the highest quartile group showed a significant (P<0.01) increase, with OR=1.94 (1.21-3.11) and showing significant (P=0.002) linear trend. However, no significant association was observed (P>0.05) with cognitive impairment in the second dietary pattern. Conclusion: Blood pressure-related dietary pattern was positively associated with cognitive impairment.

[Risk assessment for emergency events of infectious disease in outlying areas of large-scale activities]

OBJECTIVE

To identify and assess the potential public health risks of emergency events of infectious disease in the surrounding areas of Hangzhou during the 11th G20 summit, and to assess their impacts on the G20 summit.

METHODS

The surrounding cities of Hangzhou included Ningbo, Wenzhou, Jiaxing, Huzhou, Shaoxing, Jinhua, Quzhou, Zhoushan, Taizhou and Lishui. Background information on infectious diseases in Zhejiang province was collected, and the brainstorming and expert consultation methods were used to identify the risks. The local risks and the impact of local risks on the G20 summit were assessed.

RESULTS

The criteria for public health risk was first established. Through the assessments,a total of 27 kinds of infectious diseases in 4 types of public health risks were identified. The impact of these risks on Hangzhou G20 summit was divided into 1 item of high-risk, 12 items of medium risk and 14 items of low risk.According to the results of risk assessment, the recommendations for risk management of respiratory infectious diseases, intestinal infectious diseases, imported infectious diseases like Middle East respiratory syndrome and other infectious diseases were made. With risk management, Middle East respiratory syndrome was not occurred during the G20 summit, and the epidemic situation of other infectious diseases with middle or low risks was almost the same with that of past years.

CONCLUSIONS

sThe public health risks of Hangzhou G20 summit from sudden infectious diseases in outlying areas are mainly medium and low risks. The recommendations on risk management provide a basis for reducing the adverse consequences of public health risks in the event of an outbreak of infectious diseases, avoiding the impact of various risk factors in the outlying areas on G20 summit.

MiR-30a relieves migraine by degrading CALCA

OBJECTIVE

To investigate both the relationship and underlying mechanism between miR-30a and migraine.

PATIENTS AND METHODS

Peripheral blood samples were collected from migraine patients and healthy people to extract RNA for quantitative Real-time PCR (qRT-PCR). The relationship between mRNA expressions and patient data was analyzed by t-test. Target genes of miR-30a were predicted by the TargetScan. The binding of miR-30a to the target gene was verified by dual fluorescein reporter assay. The protein expression of calcitonin/alpha-CGRP gene (CALCA), the miR-30a target gene, was detected by Western blot.

RESULTS

Expression levels of miR-30a in peripheral blood of migraine patients were significantly lower than those of healthy controls detected by qRT-PCR, and the methylation level of miR-30a in promoter region was remarkably increased. In addition, expression levels of miR-30a were significantly decreased in patients with bilateral seizures, persistent pain and high pain index. CALCA was found to be the target gene of miR-30a via bioinformatics analysis. We verified that miR-30a degrades CALCA by dual-luciferase reporter assay. Western blot results showed that overexpression of miR-30a down-regulated the CALCA expression, and knockdown of miR-30a upregulated the CALCA expression.

CONCLUSIONS

Expression levels of miR-30a are significantly decreased in migraine patients and can relieve migraine through the degradation of CALCA.

The interferon response as a common final pathway for many preconditioning stimuli: unexpected crosstalk between hypoxic adaptation and antiviral defense

Despite major advances in understanding how the brain goes awry in disease, identification of therapeutics for neuroprotection in stroke remains an unsolved challenge. A promising strategy to delineate endogenous mechanisms of neuroprotection is to understand adaptive homeostatic transcription induced by sublethal ischemia. Homeostatic adaptation is defined as the body's restorative responses to stress. Activating adaptive homeostatic pathways can lead to transcription of a panoply of genes involved in cell survival and repair, can suppress pro-death signaling, and can stimulate metabolic changes congruent with survival. All of these mechanisms have been shown to be operative in protection induced by sublethal stress. In this context, central mediators of cellular adaptation to hypoxic and viral stress have been implicated in preconditioning. Here we present data that suggest an unexpected convergence in the pathways triggering adaptation to hypoxia and viral infection leading to preconditioning neuroprotection in the CNS.

Immunization with dendritic cell-based DNA vaccine pRSC-NLDC145.gD-IL21 protects mice against herpes simplex virus keratitis

Aim: The aim of this study is to investigate the effects of constructed dendritic cell (DC)-based DNA vaccine (pRSC-NLDC145.gD-IL21) carried by chitosan nanoparticle in preventing primary or recurrent herpes simplex virus keratitis (HSK) in mice. Methods: The expression of constructed plasmid ‘pRSC-NLDC145.gD-IL21’ was verified by western blot and immunofluorescence. Plasmids that were embedded in chitosan were inoculated to test its therapeutic effect against primary or recurrent HSK in mice. Humoral and cellular immune response, clinical scores of herpes keratitis and inflammatory infiltration were measured. Results: The expressed glycoprotein D (gD) of pRSC-NLDC145.gD-IL21 DNA/chitosan nanoparticle vaccine could effectively target corneal DCs and significantly alleviate the symptoms of both primary and recurrent HSK mice via eliciting strong humoral and cellular immune response. Conclusion: Our data suggested that DC-based DNA vaccine could be a better choice for HSK treatment in the future.

Agricultural constraints on microbial resource use and niche breadth in drainage ditches

Background

Microorganisms govern important ecosystems processes, in particular the degradation of organic matter (OM). However, microorganisms are rarely considered in efforts to monitor ecosystem health and functioning. Evidence suggests that environmental perturbations can adversely affect microbial communities and their ability to use available substrates. However, whether impacted microbial efficiencies in extracting and utilizing the available resources (resource niche breadth) translate to changes in OM degradation in natural systems remains poorly understood.

Methods

Here we evaluated effects of differences in OM related to agricultural land use (OM derived from ditches adjacent to grasslands, bulb fields and a pristine dune area) on microbial functioning. We specifically assessed (1) resource niche breadths of microbial communities during initial community assembly in laboratory microcosms and already established natural communities, and (2) how changes in community resource niche breadth translates to the degradation of natural OM.

Results

A disparity existed between microbial resource niche breadth in laboratory incubations and natural microbial communities. Resource utilization and niche breadth of natural microbial communities was observed to be constrained in drainage ditches adjacent to agricultural fields. This outcome coincides with retarded degradation of natural OM collected from ditches adjacent to hyacinth bulb fields. Microbial communities in bulb field ditches further showed functional redundancy when offered grassland OM of seemingly higher substrate quality.

Discussion

Results presented in this study suggest that agricultural practices can impose constraints on microbial functional diversity by reducing OM resource quality, which can subsequently translate to confined microbial resource niche differentiation and reduced organic matter degradation rates. This hints that assessments of actual microbial resource utilization and niche differentiation could potentially be used to assess the ecological health and functioning of natural communities.

[Retrospection and reflection on international progress of sugar-sweetened beverages tax policies]

Since the invention of sugar, added sugars bring us enjoyment. As consumption continues to rise, especially the advent of sugary drinks makes it easier for people to consume added sugars, less sugars and reduced sugars have also become a of concern around the world. In recent years, in WHO and several countries, tax on sugary beverages has been designed to reduce the intake of sugar and prevent the economic costs of obesity and other diseases. This paper reviews the WHO's proposal on sugary drinks tax and the progress of sugary drinks tax in Hungary, Finland, France, Mexico, the United States, South Africa and other countries and regions. The effect of policy on sugary drinks tax was analyzed and considered. Suggestion and support for the progress of China's reduced sugars was provided in the last.

[Epidemiological characteristics of waist circumference and abdominal obesity among Chinese adults in 2010-2012]

Objective: To investigate the epidemiological characteristics of waist circumference (WC) and abdominal obesity (AO) among Chinese adults aged 18 and above. Methods: Data were collected from China National Nutrition and Health Surveillance in 2010-2012. Multi-stage stratifies proportion to the population cluster random sampling method was conducted to determine 120 265 subjects aged 18 and above at 150 counties in 31 provinces in China mainland. WC was determined for all subjects, and AO was judged according to the "Healthy Adult Weight Determination" (WS/T 428-2013). Using the demographic data published by the National Bureau of Statistics of China in 2009, we performed complex sampling weighted treatment to calculate the WC, AO rate and 95%CI. Results: The mean WC of Chinese men aged 18 and above was 82.8 cm, which of urban men (84.1 cm) was higher than that of rural men (81.4 cm) (P<0.001). The average WC of women was 78.5 cm. There was no statistical difference between urban (78.7 cm) and rural women (78.4 cm) (P=0.965). With the increase of education level, the mean WC of male increased gradually from 81.2 cm to 84.3 cm (P<0.001), and the mean WC of female decreased from 80.3 cm to 74.3 cm (P<0.001). With the family income rose, the mean WC of men increased gradually from 81.9 cm to 84.7 cm (P<0.001), and the mean of WC of women decreased from 78.8 cm to 77.6 cm (P<0.001). The AO rate was 25.7% (95% CI: 23.7%-27.7%) in adults aged 18 years and older. The AO rate in urban males (29.8% (95%CI: 26.5%-33.1%)) was significantly higher than that of rural males (22.3% (95%CI: 19.3%-25.2%)) (P=0.001). There was no significant difference in the female AO rate between urban (25.6% (95%CI: 22.8%-28.4%)) and rural areas (25.1% (95%CI: 22.2%-27.9%)) (P=0.772). With the increase of the educational level, the AO rate of men increased from 20.1% (95%CI: 18.0%-22.1%) to 32.6% (95%CI: 28.6%-36.6%) (P<0.001), the rate of women decreased gradually from 31.3% (95%CI: 28.7%-33.9%) to 13.5% (95%CI: 10.9%-16.1%) (P<0.001). With the increase of family income, the AO rate of male increased gradually from 23.3% (95%CI: 20.7%-25.9%) to 31.8% (95%CI: 27.6%-36.1%) (P<0.001), the rate of female decreased from 26.5% (95% CI: 24.2%-28.7%) to 20.0% (95% CI: 17.2%-22.8%) (P<0.001). Conclusion: The prevalence of AO among Chinese residents aged 18 years and above was high, and there were significant differences in WC and AO rate between men and women under different age, region, educational level and family income level.

Determining the target protein localization in 3D using the combination of FIB-SEM and APEX2

Determining the cellular localization of proteins of interest at nanometer resolution is necessary for elucidating their functions. Besides super-resolution fluorescence microscopy, conventional electron microscopy (EM) combined with immunolabeling or clonable EM tags provides a unique approach to correlate protein localization information and cellular ultrastructural information. However, there are still rare cases of such correlation in three-dimensional (3D) spaces. Here, we developed an approach by combining the focus ion beam scanning electron microscopy (FIB-SEM) and a promising clonable EM tag APEX2 (an enhanced ascorbate peroxidase 2) to determine the target protein localization within 3D cellular ultrastructural context. We further utilized this approach to study the 3D localization of mitochondrial dynamics-related proteins (MiD49/51, Mff, Fis1, and Mfn2) in the cells where the target proteins were overexpressed. We found that all the target proteins were located at the surface of the mitochondrial outer membrane accompanying with mitochondrial clusters. Mid49/51, Mff, and hFis1 spread widely around the mitochondrial surface while Mfn2 only exists at the contact sites.

Importance of exposure dynamics of metal-based nano-ZnO, -Cu and -Pb governing the metabolic potential of soil bacterial communities

Metal-based engineered nanomaterials (ENMs) are known to affect bacterial processes and metabolic activities. While testing their negative effects on biological components, studies traditionally rely on initial exposure concentrations and thereby do not take into consideration the dynamic behavior of ENMs that ultimately determines exposure and toxicity (e.g. ion release). Moreover, functional responses of soil microbial communities to ENMs exposure can be caused by both the particulate forms and the ionic forms, yet their relative contributions remain poorly understood. Therefore, we investigated the dynamic changes of exposure concentrations of three different types of ENMs (nano-ZnO, -Cu and -Pb) and submicron particles (SMPs) in relation to their impact on the capacity of soil bacterial communities to utilize carbon substrates. The different ENMs were chosen to differ in dissolution potential. The dynamic exposures of ENMs were considered using a time weighted average (TWA) approach. The joint toxicity of the particulate forms and the ionic forms of ENMs was evaluated using a response addition model. Our results showed that the effect concentrations of spherical nano-ZnO, -Cu and SMPs, and Pb-based perovskites expressed as TWA were lower than expressed as initial concentrations. Both particulate forms and ionic forms of spherical 18nm, 43nm nano-ZnO and 50nm, 100nm nano-Cu contribute to the overall response at the EC₅₀ levels. The particulate forms for 150nm, 200nm and 900nm ZnO SMPs and rod-shaped 78nm nano-Cu mainly affected the soil microbial metabolic potential, while the Cu ions released from spherical 25nm nano-Cu, 500nm Cu SMPs and Pb ions released from perovskites mainly described the effects to bacterial communities. Our results indicate that the dynamic exposure of ENMs and relative contributions of particles and ions require consideration in order to pursue a naturally realistic assessment of environmental risks of metal-based ENMs.

A risk-score model for predicting risk of type 2 diabetes mellitus in a rural Chinese adult population: A cohort study with a 6-year follow-up

BACKGROUND

Several prediction tools have been developed to identify people with type 2 diabetes mellitus (T2DM) and to quantify the probability of developing T2DM. However, most of the risk models were constructed based on cross-sectional studies and tea-drinking was not included.

METHODS

A total of 15 768 participants without known T2DM were followed up from 2007-2008 to 2013-2014; 12 654 were randomly assigned to the derivation dataset and 3114 to the validation dataset. We constructed a risk-score model for T2DM by using a Cox proportional-hazards model. Risk scores were calculated by multiplying β by 10 in the derivation cohort and were verified in the validation dataset. The model's accuracy was assessed by the area under the receiver operating characteristic curve (AUC).

RESULTS

Predictors for T2DM risk in the derivation dataset were drinking tea frequently, body mass index ≥28.0 kg/m² , waist to height ratio ≥ 0.5, triglycerides level 1.70 to 2.25 and ≥2.26 mmol/L, and fasting plasma glucose 5.6 to 6.0 and ≥6.1 mmol/L. The corresponding scores were -2, 7, 7, 4, 6, 11, and 25, respectively. The sensitivity, specificity, and AUC (95% confidence interval) for this full model were 69.63%, 75.56%, and 0.791 (0.783-0.799), respectively. The ability of the non-invasive models to predict T2DM was not superior to that of the full model. With the validation dataset, the predictive performance was better for our full model than the Framingham risk-score model (AUC 0.731 vs 0.525, P < .001).

CONCLUSIONS

Our risk-score model has fair efficacy for predicting 6-year risk of T2DM in a rural adult Chinese population.