The Acquired Immunodeficiency Syndrome Professional Group of the Society of Infectious Diseases of the Chinese Medical Association formulated the first edition of theChinese Guidelines for the Diagnosis and Treatment of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (referred to as the Guidelines) in 2005. The 2024 edition of the Guidelines has been compiled by updating the 2021 fifth edition, incorporating the latest research advancements in antiviral therapy, comprehensive management, opportunistic infections, concurrent tumors, and the prevention and intervention of HIV infection. The new edition also introduces a new section on "Incomplete immune reconstitution", proposes the concept of "HIV vulnerable populations" for the first time with recommendations for their diagnosis and treatment. This edition of the Guidelines covers 14 sections: epidemiology, pathogenic characteristics, laboratory tests, pathogenesis, clinical presentation and staging, diagnostic criteria, common opportunistic infections, antiretroviral therapy, immune reconstitution inflammatory syndrome, incomplete immune reconstitution, AIDS-related neoplasms, prevention of mother-to-child transmission and conception in serodiscordant couples, pre- and post-exposure prophylaxis, and whole-course management of HIV infection. This edition of the Guidelines aims to assist clinical physicians in making informed decisions in the diagnosis, treatment, and management of HIV/AIDS and will be periodically revised and updated based on domestic and international research progress.
In order to achieve the target of eliminating viral hepatitis as a public health threat by 2030 and to prioritize the role of hepatitis B vaccination in reducing new hepatitis B virus infections,the Chinese Preventive Medicine Association commissioned experts to develop the Expert Recommendations on Hepatitis B Vaccination in Adults to scientifically guide adult hepatitis B vaccination,build the herd immunity in population,and reduce the hepatitis B virus infection rate and incidence of hepatitis B.
Hepatitis A is a significant global public health concern, with severe clinical symptoms in adult cases that can progress to acute hepatic failure. With the implementation of comprehensive prevention and control measures based on vaccination, the reported incidence of hepatitis A in children has notably decreased in China, while the incidence of hepatitis A in adults has gradually increased. Vaccination against hepatitis A in adults remains a crucial preventive measure. This recommendation is formulated based on the World Health Organization's position paper on hepatitis A vaccines (2022), incorporating the latest domestic and international research advancements and opinions from domestic experts. Its aim is to provide recommendations for hepatitis A vaccination among Chinese adults, offering evidence for public health and vaccination professionals to scientifically use hepatitis A vaccines and maximize their preventive efficacy, thereby enhancing hepatitis A prevention and control efforts.
Background Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection in young children. We previously estimated that in 2015, 33.1 million episodes of RSV-associated acute lower respiratory infection occurred in children aged 0-60 months, resulting in a total of 118 200 deaths worldwide. Since then, several community surveillance studies have been done to obtain a more precise estimation of RSV associated community deaths. We aimed to update RSV-associated acute lower respiratory infection morbidity and mortality at global, regional, and national levels in children aged 0-60 months for 2019, with focus on overall mortality and narrower infant age groups that are targeted by RSV prophylactics in development. Methods In this systematic analysis, we expanded our global RSV disease burden dataset by obtaining new data from an updated search for papers published between Jan 1, 2017, and Dec 31, 2020, from MEDLINE, Embase, Global Health, CINAHL, Web of Science, LILACS, OpenGrey, CNKI, Wanfang, and ChongqingVIP. We also included unpublished data from RSV GEN collaborators. Eligible studies reported data for children aged 0-60 months with RSV as primary infection with acute lower respiratory infection in community settings, or acute lower respiratory infection necessitating hospital admission; reported data for at least 12 consecutive months, except for in-hospital case fatality ratio (CFR) or for where RSV seasonality is well-defined; and reported incidence rate, hospital admission rate, RSV positive proportion in acute lower respiratory infection hospital admission, or in-hospital CFR. Studies were excluded if case definition was not clearly defined or not consistently applied, RSV infection was not laboratory confirmed or based on serology alone, or if the report included fewer than 50 cases of acute lower respiratory infection. We applied a generalised linear mixed-effects model (GLMM) to estimate RSV-associated acute lower respiratory infection incidence, hospital admission, and in-hospital mortality both globally and regionally (by country development status and by World Bank Income Classification) in 2019. We estimated country-level RSV-associated acute lower respiratory infection incidence through a risk-factor based model. We developed new models (through GLMM) that incorporated the latest RSV community mortality data for estimating overall RSV mortality. This review was registered in PROSPERO (CRD42021252400). Findings In addition to 317 studies included in our previous review, we identified and included 113 new eligible studies and unpublished data from 51 studies, for a total of 481 studies. We estimated that globally in 2019, there were 33.0 million RSV-associated acute lower respiratory infection episodes (uncertainty range [UR] 25.4-44.6 million), 3.6 million RSV-associated acute lower respiratory infection hospital admissions (2.9-4.6 million), 26 300 RSV-associated acute lower respiratory infection in-hospital deaths (15100-49 100), and 101 400 RSV-attributable overall deaths (84 500-125 200) in children aged 0-60 months. In infants aged 0-6 months, we estimated that there were 6.6 million RSV-associated acute lower respiratory infection episodes (4.6-9.7 million), 1.4 million RSV-associated acute lower respiratory infection hospital admissions (1.0-2.0 million), 13 300 RSV-associated acute lower respiratory infection in-hospital deaths (6800-28 100), and 45 700 RSV-attributable overall deaths (38 400-55 900). 2.0% of deaths in children aged 0-60 months (UR 1.6-2.4) and 3.6% of deaths in children aged 28 days to 6 months (3.0-4.4) were attributable to RSV. More than 95% of RSV-associated acute lower respiratory infection episodes and more than 97% of RSV-attributable deaths across all age bands were in low-income and middle-income countries (LMICs). Interpretation RSV contributes substantially to morbidity and mortality burden globally in children aged 0-60 months, especially during the first 6 months of life and in LMICs. We highlight the striking overall mortality burden of RSV disease worldwide, with one in every 50 deaths in children aged 0-60 months and one in every 28 deaths in children aged 28 days to 6 months attributable to RSV. For every RSV-associated acute lower respiratory infection in-hospital death, we estimate approximately three more deaths attributable to RSV in the community. RSV passive immunisation programmes targeting protection during the first 6 months of life could have a substantial effect on reducing RSV disease burden, although more data are needed to understand the implications of the potential age-shifts in peak RSV burden to older age when these are implemented. Copyright (c) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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 60 years and older, and individuals with comorbidities or underlying medical conditions are at the highest risk of severe illness and death from influenza. Given the ongoing COVID-19 pandemic, some provinces in southern China had a summer peak of influenza. 2019-nCoV may co-circulate with influenza and other respiratory viruses in the upcoming winter-spring influenza 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 is produced as a split virus vaccine and subunit vaccine; IIV4 is produced as a split virus vaccine; and LAIV3 is a live, attenuated virus vaccine. Except for some jurisdictions in China, the influenza vaccine is a non-immunization program vaccine-voluntarily and self-paid. China CDC has issued "Technical Guidelines for Seasonal Influenza Vaccination in China" every year from 2018 to 2021. Over the past year, new research evidence has been published at home and abroad. To better guide the prevention and control of influenza and vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccination Technical Working Group updated and revised the 2021-2022 Technical Guidelines with the latest research progress into the "Technical Guidelines for Seasonal Influenza Vaccination in China (2022-2023)." 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 that were issued by the government over the past year; (3) influenza vaccines approved for marketing in China this year; (4) composition of trivalent and quadrivalent influenza vaccines for the 2022-2023 northern hemisphere influenza season; and (5) recommendations for influenza vaccination during the 2022-2023 influenza season. The 2022-2023 Guidelines recommend that vaccination clinics provide influenza vaccination services to all people aged 6 months and above who are willing to be vaccinated and have no contraindications to the influenza vaccine. For adults ≥18 years, co-administration of COVID-19 and inactivated influenza vaccines in separate arms is acceptable regarding immunogenicity and reactogenicity. For people under 18 years old, 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. To minimize harm from influenza and limit the impact on the effort to prevent and control COVID-19 in China, the Technical Guidelines recommend priority vaccination of the following high-risk groups during the upcoming 2022-2023 influenza season: (1) healthcare workers, including clinical doctors and nurses, public health professionals, and quarantine professionals; (2) volunteers and staff who provide services and support for large events; (3) people living in nursing homes or welfare homes and staff who take care of vulnerable, at-risk individuals; (4) people who work in high population density settings, including teachers and students in kindergartens and primary and secondary schools, and prisoners and prison staff; and (5) people at high risk of influenza, including adults ≥60 years of age, children 6-59 months of age, individuals with comorbidities or underlying medical conditions, family members and caregivers of infants under 6 months of age, and pregnant women. 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 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.
Objective To identify the pathogen and track the genetic source of a cluster of cases with fever in a kindergarten in Fengtai district during the normalization of COVID-19 prevention and control in Beijing.Methods A descriptive analysis method was used to investigate this cluster of cases with fever in April 2021.Pharyngeal swabs were collected and viral nucleic acid was extracted, real-time PCR was performed to identify SARS-CoV-2 and other common respiratory virus. G gene of human metapneumovirus（hMPV） was amplified by RT-PCR and was then sequenced. BioEdit was used for G gene sequence analysis and the Neighbor-Joining model in MEGA 5. 0 software was used to construct the phylogenic tree of G gene. Results A total of 16 cases were reported in one class with the incidence of 53. 3%（16/30） during 8 days of a cluster outbreak. All pharyngeal swabs collected from 12 cases were tested SARS-CoV-2 negative, six were found to be hMPV positive by multiplex-PCR, and one was positive for both human adenovirus and hMPV. Full-length sequences of G genes were obtained from 2 strains of hMPV. Sequence analysis showed that both strains were hMPV B2 and the nucleic acid homology of G gene was 96. 73%-98. 01% with strains from Japan（LC337940, LC337935, LC1922349） in 2016 and over 98. 40%with strains from Shandong（OL625642, OL625644） in 2019, Henan MN944096 in 2019.Compared with the amino acid sequence of hMPV-B2 reference strain（AY297748）, six amino acid insertions containing EKEKEK were identified between 161-166 amino acid location and N-glycosylation of G protein analysis showed that the two strains had four N-glycosylation sites. Conclusions The leading pathogen for this cluster outbreak is found to be hMPV-B2, which are highly homologous with strains from Japan, Shandong and Henan. Therefore, a non-stop surveillance of hMPV is necessary during the normalization control and prevention period for COVID-19.
Objective To analyze the epidemiological characteristics of respiratory syncytial virus（RSV） before and after the COVID-19 epidemic in Guangzhou in recent years. Methods Nasopharynx swabs from hospitalized patients with acute respiratory infection were collected from two sentinel hospitals in Guangzhou（Guangdong Maternal and Child Health Hospital and Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University） from 2018 to 2022. Luminex respiratory multi-pathogen detection technology was used to detect and type RSV in samples. Results A total of 1 243 nasopharyngeal swab samples were collected. The overall positive rate of RSV was 6. 11%（76/1 243）, including 39 RSV-A（51. 32%, 39/76） and 37 RSV-B（48. 68%, 37/76）. The highest detection rate of RSV in children under 3 years old was 8. 79%（66 cases）. Compared with 2018（8. 30%, 22/265） and 2020（14. 78%, 30/203）, the positive rate of RSV decreased significantly in 2019（3. 13%, 10/319）, 2021（4. 08%, 10/245） and 2022（1. 90%, 4/211）. Compared with 2018（8. 30%,22/265） and 2020（14. 78%,30/203）,the positive rate of RSV decreased significantly in 2019（3. 13%,10/319）, 2021（4. 08%,10/245） and 2022（1. 90%,4/211）. Type A prevailed in 2018（19/22） and 2022（4/4）, type B（25/30） prevailed in 2020, type A and type B coexisted in 2019 and 2021. The detection rate showed had no statistically significant seasonal difference except for 2020 [7. 14%（3/42）, 16. 39%（10/61）, 27. 12%（16/59）, 0（0/42）,χ~2= 16. 975,P＜0. 001]. Among all the 76 RSV positive samples, 17（22. 37%） showed multiple infections. Among them, human rhinovirus was the most common virus causing mixed infection, accounting for 58. 83%（10/17） of the mixed infection. Conclusion RSV is a common respiratory virus prevalent in Guangzhou, and children under 3 years old are the main population infected with RSV. RSV infection is prevalent every other year, with the characteristics of alternating epidemic of type A and type B, and the anti-seasonal epidemic appeared after the COVID-19. After the outbreak of COVID-19, the detection rate of RSV increased significantly in 2020. With the change of the national COVID-19 epidemic prevention and control policy, the detection rate of RSV declined significantly during 2021—2022.
Cytokine storm is one of the mechanisms causing acute respiratory distress syndrome and multiple organ failure in COVID-19. As an important prognostic factor, cytokines have gradually become a hotspot in the research on treatment of COVID-19 in recent years. Based on literature regarding the key cytokines, related signaling pathways and existing therapeutic drugs of COVID-19 cytokine storm, this article summarizes the therapeutic drugs for COVID-19 that block the cytokine storm signaling pathways. After summarizing and analyzing the latest research results, it is proposed that therapeutic drugs with stronger targeting capacity could be the focus of COVID-19 drug development in the future, and different treatment regimens should be adopted for different patients.
Objective To evaluate and compare the effect and disease characteristics of primary genital herpes HSV-2 guinea pig model created through natural infection route and mucosal-damaged infection route.Methods A total of 78 female guinea pigs weighing 300-350 g were divided into 5 groups,including control group（n=6,group 1）,naturally inoculated DMEM group （n=6,group 2）,DMEM group inoculated through damaged mucosa （n=6,group 3）,naturally infected HSV-2 group （n=30,group 4）,and HSV-2 group infected through damaged mucosa （n=30,group 5）.DMEM （0.1 ml）and HSV-2 （1×10~5 PFU）were inoculated into the guinea pig vaginas,through natural infection and damaged infection,respectively for the naturally infected DMEM group,the naturally infected HSV-2 group,the damaged DMEM group and the damaged HSV-2 group.Vaginal samples were collected 3 days after the infection to determine HSV-2 DNA copies,and the symptoms were recorded and scored daily during the acute infection period.The infection rate,morbidity,duration,frequency and severity of disease were compared between the two HSV-2 groups.Results The infection rates of HSV-2 in guinea pigs in group 4 and group 5 were 96.67%（29/30） and 100.00%（30/30）,the difference was not statistically significant（χ~2=1.017,P＞0.05）.However,the incidence rate （96.67%vs 56.67%，χ~2=17.865,P＜0.01）,disease duration[6 （4,8） vs1（0,3）,Z=4.852,P＜0.01],disease frequency[2 （1,2.25） vs 1（0,2）,Z=4.047,P＜0.01]and disease severity[average symptom score daily:1.80 （1.10,2.15） vs 0.33 （0.00,0.87）,Z=3.625,P＜0.01]in group5 were significantly higher than those in grop 4.Conclusions Natural infection route is more suitable than mucosadamaged infection route in the creation of an animal model by inoculating HSV-2 virus to the vagina of guinea pigs for evaluating the effect of vaccines and therapeutic drugs of HSV-2 genital herpes disease.
目的 分析人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者个案管理抗病毒治疗(antiretroviral therapy,ART)的病毒学及免疫学效果,为建立精准有效的个体化管理模式提供理论依据.方法 2019年5月-2020年10月在新疆伊犁州第二人民医院招募符合纳入标准的HIV感染者和艾滋病(ac-quired immune deficiency syndrome,AIDS)患者,根据性别和年龄进行1∶ 1匹配分为个案管理组(977例)与常规干预组(977例),开展为期18个月的治疗随访.常规干预组进行免费的抗逆转录病毒治疗(anti-retroviral therapy,ART)、心理支持、健康教育和实验室检测;个案管理组在常规干预的基础上开展个案管理,包括全面评估HIV感染者和AIDS患者的身体状况,制定"一对一"服务计划,提供持续的医疗、社会及心理支持,定期监测病毒载量、CD4+T细胞水平、耐药性及不良反应情况,并及时调整治疗方案.随访结束后,采用logistic回归模型分析HIV感染者个案管理模式的ART效果及影响ART效果的因素.结果 随访结束后,个案管理组与常规干预组发生病毒学失败的患者分别为64例(64/977,6.6％)和104例(104/977,10.6％),发生免疫学失败的患者分别为48例(48/971,4.9％)和80例(80/970,8.2％),差异均有统计学意义(wald x2值分别为10.233和8.426,均P＜0.05).多因素logistic回归分析结果显示,接受个案管理的HIV感染者和AIDS患者发生病毒学失败(OR=0.617,95％CI:0.441～0.862)以及免疫学失败(OR=0.642,95％CI:0.417～0.989)的风险较低,其他影响ART效果的保护因素包括文化程度高中及以上以及ART一线方案,危险因素包括注射吸毒、临床晚期、确证-治疗间隔时间较长.结论 个案管理可以有效提高ART的病毒学及免疫学效果,作为一种以个体为中心的综合管理方法,该方法有助于提高HIV感染者随访管理的服务质量.针对注射吸毒、临床晚期以及确证-治疗间隔时间较长的HIV感染者和AIDS患者应进一步加强随访管理.
Objective To understand the current status of self-concealment of men who have sex with men（MSM） in Mianyang of Sichuan province, and to analyze the related factors. Methods A snowball sampling method was used to recruit MSM and an anonymous questionnaire survey was conducted using self-concealment scale（SCS） in Mianyang city from January to December, 2021. HIV antibody was also tested. t-test/variance analysis（F）, Pearson correlation and multiple linear regression were used to analyze the related factors of selfconcealment. Results A total of 1 089 valid questionnaires were obtained. The mean score of self-concealment was 27. 6±8. 0. It was 30. 3±7. 2 among MSM with positive HIV antibody and was 27. 3±7. 8 among those with negative antibody（t=1. 888, P=0. 059）. Multivariate analysis showed that age（β=0. 100, P=0. 001）, college or above degree（β=1. 627, P=0. 003）, workers/farmers/catering service（β=1. 572, P=0. 046）, having more than 10 community friends（β=1. 688, P=0. 001）, seeking sexual partners using traditional ways（β=1. 655, P=0. 035） and having unprotected anal sex in recent 6 months（β=1. 701, P=0. 008） were positively correlated with self-concealment score, however, cadre/business men（β=-2. 358, P=0. 001）, local residence of over 2 years（β=-2. 670, P＜0. 01）, receiving peer education in recent 12 months（β=-3. 212, P＜0. 01） and having multiple sex partners in recent 6 months（β =-1. 406, P=0. 003） were negatively correlated with self-concealment score. Conclusion MSM tend to be self-concealed. Self-concealment is related to demographic characteristics, social behavior and high-risk sexual behaviors. Therefore, it is necessary to actively create a social environment to prevent the self-concealment of MSM and to carry out targeted behavioral intervention.
Objective To analyze the composition and epidemiological characteristics of respiratory pathogens in hospitalized patients with respiratory tract infections in Huairou district before and after the outbreak of corona virus disease 2019（COVID-19）. Methods Respiratory specimens were collected from hospitalized patients who met the case definition in Huairou district during the period of January 2018 and December 2021. The samples were tested for influenza virus, respiratory syncytial virus, adenovirus, parainfluenza virus, metapneumovirus, coronavirus, rhinovirus, bocavirus, enterovirus, mycoplasma pneumoniae, chlamydophila pneumoniae and other respiratory pathogens by using ABI 7500 real-time fluorescent quantitative PCR assay. Results From January 2018 to December 2021, a total of 1 148 samples were tested and the overall positive rate was 24. 65%（283cases）. The positive detection rate after the outbreak of COVID-19 in 2020—2021（79/522） was significantly lower than that before the outbreak of COVID-19 in 2018—2019（204/626）（15. 13% vs 32. 59%, χ~2=46. 683, P＜0. 01）. The positive rates in children aged 0—＜2 years and 2—＜5 years after the outbreak of COVID-19were 46. 15% and 45. 45% respectively, were significantly higher than those in other age groups （χ~2=73. 053,P＜0. 01）. Mycoplasma pneumoniae（12. 75%）, enterovirus（10. 29%） and adenovirus（10. 29%） were the top three pathogens before the outbreak, while, after the outbreak, the top three pathogens were syncytial virus（21. 52%）, parainfluenza（17. 72%） and rhinovirus（17. 72%）. In Huairou district, the detection rate of respiratory pathogens peaked in winter, there was also a small peak in summer. Conclusion After the outbreak of COVID-19, children under 5 years old are still the main population for respiratory infection control. The change of pathogen spectrum before and after the outbreak of covid-19 is helpful for clinician to recognize and diagnose the disease.
Objective To understand the epidemiological characteristics of norovirus infections in patients with food-borne diseases in Changzhou sentinel hospitals from 2016 to 2020, and to provide a basis for formulating prevention and control measures. Methods The etiological data of patients with food-borne diseases reported from sentinel hospitals in Changzhou during 2016 and 2020 were obtained from the national foodborne disease surveillance and reporting system. The distribution of norovirus infections in different populations, seasons, eating places and suspicious exposed foods were investigated. Univariate and multivariate logistic regression models were used to analyze the influencing factors of norovirus infections. Results A total of 3 120 stool or anal swab specimens were collected from four sentinel hospitals in Changzhou for etiological testing. Among them, 188 noroviruspositive specimens were detected, with a detection rate of 6. 0%. Univariate logistic regression analysis showed that the distribution of foodborne norovirus varied significantly among patients with different ages, occupations, and in different seasons （χ~2=26. 364,23. 923,30. 339, all P＜0. 01）. Multivariate analysis showed that occupation and season were related to the positive rate of norovirus（Wald χ~2=25. 113, 20. 890, both P＜0. 01）. The detection rate was the highest of 9. 0% in preschool children（OR=2. 120）, and was higher in spring and autumn than that in summer and winter. Conclusion Foodborne norovirus infection rate is higher in spring and autumn in Changzhou, and younger children are more susceptible to norovirus infection. Therefore, public education, health monitoring and management should be strengthened to reduce food safety risk.
Objective To investigate the prevalence, genotypes, and genetic characterization of Japanese encephalitis virus（JEV） carried by mosquitoes in Shandong province, and to provide scientific basis for the prevention and control of Japanese encephalitis. Methods Mosquitoes were captured using ultraviolet mosquito trap lamp and electric mosquito suction device in 3 counties of Weishan, Junan and Kenli in Shandong province in August 2020 and August 2021. The mosquitoes were homogenized and JEV RNA was detected by RT-PCR.The number of JEV positive mosquitoes per 100 was estimated by maximum likelihood estimation method. E gene and PrM gene were amplified, sequenced and the sequences were analyzed using Bioedit 7. 0 and Mega 11software. Results A total of 37 455 mosquitoes were captured and were classified into 6 species, of which Culex tritaeniorhynchus was found to be the dominant species（31 452, 83. 97%）, followed by Armigeres obturbans（2 508, 6. 70%）, Anopheles sinensis（2 468, 6. 59%）, Culex pipiens pallens（970, 2. 59%）, Aedes（40, 0. 11%）, and Culex pipiens（17, 0. 04%）. The mosquitoes were grouped into 737 pools, and 53 pools were RT-PCR positive. The overall JEV infection rates were 0. 19 and 0. 14 per 100 mosquitoes in 2020 and 2021, respectively. The highest infection rate of 0. 84 per 100 mosquitoes was found in Weishan in 2020. Phylogenetic analysis on E gene and PrM gene showed that all Shandong JEVs belonged to G1-b subtype of genotype 1, but were segregated into multiple evolutionary branches. Conclusion Mosquitoes in Shandong province mainly carry genotype 1 JEV. The infection rate of JEV in mosquitoes varies dramatically in different regions. The persistent infection of JEV in mosquitoes underscores the importance of high inoculation rate of JE vaccine.
Objective To compare the performance of two qPCR instruments in detecting SARS-CoV-2 virus in the nasopharyngeal swab samples of suspected COVID-19 isolated individuals in Jinghu district Wuhu city.Methods A total of 151 nasopharyngeal swab samples were collected from individuals with suspected COVID-19isolated during January 2021 and July 2022 at a quarantine site in the Jinghu district. Nucleic acid of SARS-CoV-2virus was quantified parallelly using ABIQ5 real-time fluorescence quantitative analyzer（Q5 analyzer） and Bole CFX96 fluorescence quantitative PCR analyzer（Bole analyzer） in the laboratory. Q5 analyzer was used as the reference instrument, while Bole analyzer was used as an experimental instrument. The detection results of N gene, ORF1ab fragment and CT value of the two RT-PCR machines were analyzed and compared using paired four grid test, Spearman test and paired sample t-test in SPSS 22 statistical software. Results The results of 151samples for different target genes tested by two instruments were in good agreement（N gene: Kappa=1, P＜0. 05; ORF1ab fragment: Kappa=0. 972, P＜0. 05）. The inter-batch repeatability rates were 4. 01% and 3. 04%for N gene and ORF fragment of the same batch positive quality controls by Q5 analyzer, and were 4. 90% and 3. 57% by Bole analyzer. The intra batch repeatability rates of the two instruments at different hole locations were similar, and CV values were less than 3%. The results of 23 positive samples showed that the differences in CT values of N gene（29. 38±7. 22） and ORF1ab（30. 83±6. 27） detected by Q5 analyzer were statistically significant（t=2. 765, P＜0. 05）, while the differences in CT values of N gene（29. 58±7. 27） and ORF1ab（30. 77±8. 02） detected by Bole analyzer were not statistically significant（t=1. 753, P＞0. 05）. The correlation coefficients of CT values of different target genes detected by the two instruments were r N =0. 960 and r ORF =0. 865, showing correlated CT values（P＜0. 05）. Conclusion The CT values of N gene and ORF1ab fragment of SARS-CoV-2 virus detected by the two instruments have strong correlation and agreement, indicating that either of the instrument can be used for laboratory sample detection and analysis. The repeatability of Q5 analyzer is better than that of Bole analyzer. The detection stability of ORF fragments of both instruments is better than that of N gene, and the detection sensitivity of Q5 analyzer for N gene is higher than that for ORF fragment. The sample tubes should be placed in the middle of the PCR machine in order to reduce the system error.
Objective To understand the epidemiological characteristics and laboratory test results of COVID-19 infections among passengers in an inbound flight to Beijing, and to provide reference for the management of imported COVID-19 cases. Methods Flight information, centralized quarantine sites, transfer vehicle, laboratory test results, clinical progression and outcome and other information of all passengers in an inbound flight to Beijing on August 6, 2021 were collected and analyzed. Results A total of 15 passengers were COVID-19 positive. They were all tested negative for nucleic acid 48 h before boarding. The earliest positive was on the day of entry, and the longest was on the 13th day of entry, with the median of being the 3rd day after entry. There were inconsistent nucleic acid test results of 8 positive passengers reported by two institutions and the CT values were close to cutoff. The initial serum antibody levels were higher than 100（s/co） in 6 positive passengers. Nobody was infected during transportation and quarantine. Conclusions Nucleic acid testing before boarding the flight should be able to identify majority of positive cases. Accordingly, joint screening strategy such as blood serum antibody test for inbound passengers with suspicious preliminary screening results of COVID-19 should be implemented to determine the infection history of the case.
Human cytomegalovirus（HCMV） is a member of the β herpesvirus subfamily, which is one of the largest human viruses. HCMV is widely spread in the world, and the seropositive rate in the population is between 40% and 100%. HCMV has little effect on individuals with normal immune function, and most infected individuals have no clinical symptoms. However, in individuals with low or defective immune function, it can cause serious complications, leading to multiple organ failure and even life-threatening. There is no effective vaccine against HCMV infection, and approved antiviral drugs（such as ganciclovir, valganciclovir, foscarnet, cidofovir, and letemovir） are the only methods available. But in clinical use, these drugs are characterized by low oral bioavailability, moderate antiviral activity and drug resistance, which greatly limit their clinical therapeutic utility. So the development of new HCMV inhibitors is urgently needed. HCMV contains a variety of self encoded proteins and an uncertain number of host cell proteins, which play an important role in its replication process. In this paper, we will review the inhibitors in clinical trials and new inhibitors under research from two aspects of targeting viral proteins and host proteins, so as to provide a theoretical basis for the treatment of HCMV disease and drug development.
Objective To develop a novel gold immunochromatographic double antibody sandwich assay for the detection of SARS-CoV-2 antigen, and to evaluate the performance of major reagents. Methods Potassium carbonate, large colloidal gold and SARS-CoV-2 antibody were used to prepare colloidal gold antibody markers, SARS-CoV-2 antibody concentration was optimized to prepare the binding pad, SARS-CoV-2 antibody and goat anti-mouse IgG were coated on nitrocellulose membrane as detection line and quality control line, according to the process requirements to assembly the assay. The minimum detection limit, cross-reactivity, accelerated stability test and clinical evaluation of the antigen detection reagent were determined. Results The minimum detection limit of SARS-CoV-2 inactivated virus was 3. 3×10~2 TCID 50 /ml, and no cross-reaction was found in the samples containing 10 common pathogens. The results of 37 °C high temperature accelerated test for 28 d showed high stability of the reagent. The sensitivity, specificity and total coincidence rate were 92. 00%, 100. 00% and 98. 67% and the Kappa value of concordance test was 0. 939, P＜0. 01. Conclusion The developed antigen detection assay has high sensitivity and specificity, which is also simple to operate in a short time. It can be used as a rapid detection method for large-scale screening of novel coronavirus.
新型冠状病毒感染最常累及呼吸系统,导致肺炎.重症病例的心脏、肾脏、肠道、神经系统等多个器官或系统也可受累.因此,新型冠状病毒感染需要针对多器官进行综合性的预防和治疗. 一、适用人群 (一)新型冠状病毒感染重型和危重型病例,统称"重症病例". (二)对于未达到重症病例诊断标准,但出现新型冠状病毒感染导致的肺炎且有以下情况之一者,亦可按重症病例管理:年龄＞65岁、未完成全程疫苗接种、合并较为严重慢性疾病(包括高血压、糖尿病、冠心病、慢性肺部疾病、恶性肿瘤,以及免疫功能低下等).
目的 分析2017-2020年深圳市盐田区H3N2亚型流感病毒血凝素(hemagglutinin,HA)基因变异情况.方法 对盐田区2017-2020年分离的34株流感分离株HA基因进行扩增及序列测定,从GISAID流感数据库下载推荐疫苗株序列信息并利用MEGA X和NetNGlyc 1.0 Server在线分析软件对HA基因进行分析.结果 2017-2020年盐田区H3N2分离株位于3c.2a分支,2017年上半年分离株位于3C.2a2分支,7月份之后位于3C.2a1分支;2018-2020年位于3C.2a1b分支.2019-2020年流感分离株与当年疫苗株的核苷酸一致性与氨基酸同源性均低于其他年份.与同年疫苗株相比,2017-2018年分离株A 区存在 T135N(2/13)和 R142K/G(13/13)变异;2018-2019 年分离株 A 区存在 T135K(10/10)和S137F(10/10)变异、B 区存在 F193S(8/10)和 S198P(1/10)变异;2019-2020 年分离株 A 区存在T135K(11/11)和 S137F(11/11)变异、B 区存在 N158S(4/11)、N171K(11/11)和 S198P(2/11)变异,E区存在G78S(11/11)变异.盐田区流感分离株受体结合位点前壁存在T131K(34/34),T135N/K(23/34)和S137F(21/34)变异.各年度分离株出现糖基化位点增加或消失现象.结论 盐田区H3N2流感病毒HA基因变异呈现多样性,应加强流感病毒监测.
