Background:Sleeve lobectomy is widely used for the treatment of centrally located non-small cell lung cancer (NSCLC), aiming to preserve lung function while achieving complete tumor resection. Reinforcement of the bronchial anastomosis with autologous tissues, such as pericardium, has been proposed to reduce postoperative complications. However, the clinical necessity and prognostic significance of this technique remain controversial. This study aimed to evaluate whether wrapping of the bronchial anastomosis with autologous pericardium influences perioperative complications and long-term survival in patients undergoing sleeve lobectomy, thereby providing evidence for optimizing surgical decision-making and individualized management strategies. Methods:In this retrospective study, 91 patients with NSCLC who underwent sleeve lobectomy were included between 2012 and 2017. Group A (29 patients) did not undergo wrapping and group B (62 patients) underwent bronchial wrapping. After propensity score matching, 20 patients were included in each group. Overall survival (OS) was estimated using the Kaplan-Meier method and compared using the Log-rank test. Results:Wrapping of the bronchial anastomosis did not improve the 30- and 90-day mortality (3.45% and 3.45% vs. 9.68% and 12.9%, P=0.54 and P=0.30, respectively, before matching; 5% and 5% vs. 5% and 5%; P>0.99 and P>0.99, after matching), and there was no significant difference in 5-year OS (55.17% vs. 48.39%, P=0.79, before matching; 60% vs. 65%, P=0.58, after matching) between the two groups. Conclusions:This study concludes no evidence that bronchial anastomotic wrapping improves either short-term or long-term outcomes. Therefore, routine wrapping is not recommended; however, an individualized surgical strategy based on patient selection should still be considered.

Abstract Background Enterovirus 71(EV71)-associated hand, foot and mouth disease (HFMD) decreased dramatically in Beijing from 2009 to 2019. This study was to investigate the epidemiological characteristics, evolutionary dynamics, geographic diffusion pathway, and other features of EV71 in Beijing, China. Methods We conducted a retrospective study of EV71-associated HFMD and its causative agent in Beijing, China, from 2009 to 2019. Phylogenetic and phylogeographic methods based on the EV71 genome were used to determine the evolution features, origin, and spatiotemporal dynamics. Positive selection sites in the VP1 gene were identified and exhibited in the tertiary structure. Bayesian birth-death skyline model was used to estimate the effective reproductive number (Re). Results EV71-associated HFMD decreased greatly in Beijing. From 2009 to 2019, EV71 strains prevalent in Beijing shared high homology in each gene segment and evolved with a rate of 4.99*10− 3 substitutions per site per year. The genetic diversity of EV71 first increased and peaked in 2012 and then decreased with fluctuations. The time to the most recent common ancestor (TMRCA) of EV71 in Beijing was estimated around 2003 when the EV71 strains were transmitted to Beijing from east China. Beijing played a crucial role in seeding EV71 to central China as well. Two residues (E145Q/G, A293S) under positive selection were detected from both the VP1 dataset and the P1 dataset. They were embedded within the loop of the VP1 capsid and were exposed externally. Mean Re estimate of EV71 in Beijing was about 1.007. Conclusion In recent years, EV71 was not the primary causative agent of HFMD in Beijing. The low Re estimate of EV71 in Beijing implied that strategies for preventing and controlling HFMD were performed effectively. Beijing and east China played a crucial role in disseminating EV71 to other regions in China.

Vascular smooth muscle cells (VSMCs) phenotype switching plays a crucial role in vein graft restenosis following coronary artery bypass grafting (CABG) surgery. To discover novel clinically relevant therapeutic targets for vein graft restenosis after CABG, we therefore investigated whether miRNA-18a-5p mediated phenotype switching plays a critical role in the development of vein graft restenosis. We studied miRNA-18a-5p expression in plasma samples of patients with or without vein graft restenosis at 1, 3 and 5 years after coronary artery bypass graft surgery, and in normal vs. atherosclerotic human femoral artery samples, to prove its role in VSMC phenotype switching. We found that the expression of miRNA-18a-5p significantly increased in vein grafts restenosis rat model after bypass surgery at 7, 14, 28 days and human blood specimens with vein grafts failure after grafting surgery. Through gain- and loss-of-function approaches, we determined that miRNA-18a-5p affects VSMC proliferation, migration, differentiation, and contractility. Notch2 was found to be a direct target of miRNA-18a-5p, which is critical for VSMC phenotype switching. Finally, miRNA-18a-5p knockdown used miRNA sponge via AAV6 locally delivery in vivo, miRNA-18a-5p sponge gene transfer therapy reduced the neointimal area, neointimal thickness, and intimal/media area ratio in vein grafts compared with the controls and improved vein graft hemodynamics. miRNA-18a-5p is a critical modulator of VSMC phenotypic switch during development of vein graft restenosis by downregulating Notch2, therefore targeting miRNA-18a-5p may be a helpful strategy for the treatment of vein grafts restenosis or failure after CABG surgery.

During the routine surveillance of HIV-1 pretreatment drug resistance in Beijing, five men who have sex with men (MSM) and a woman were observed to get infected by newly identified CRF103_01B strain. To elucidate the genetic characteristics, the near full-length genome (NFLG) was obtained. Phylogenetic inference indicated that CRF103_01B NFLG was composed of six mosaic segments. Segments IV and V of CRF103_01B were located among the clusters subtype B and CRF01_AE (group 5), respectively. The CRF103_01B strain was deduced to originate from Beijing MSM population around 2002.3–2006.4 and continued to spread among MSM population at a low level, then to the general population via heterosexual contact in northern China. Molecular epidemiology surveillance of CRF103_01B should be reinforced.

目的:研究多体征感知设备的网络化管理在北京冬奥会和冬残奥会期间疫情防控中的应用价值.方法:采用Java语言开发,使用MySQL数据库,设置多体征感知设备系统、数据上传系统和闭环管理系统,设计基于人工智能(AI)化的防控体系,对北京冬奥会和冬残奥会期间闭环外运行保障工作人员进行体征管理.选取北京冬奥会和冬残奥会期间25个北京赛区和10个张家口赛区共35个奥运场馆和(或)部门累计配发的34172台多体征感知设备,对保障工作人员的核心体征数据进行持续监测.结果:冬奥会和冬残奥会期间的34172台多体征感知设备共识别35个场馆和(或)部门的保障工作人员体征异常278人次,其中由感冒引发预警237人次(占85.3％),由呼吸道感染引发预警17人次(占6.1％),由口腔疾病引发预警7人次(占2.5％),由肠炎引发预警5人次(占1.8％),无新冠肺炎预警.结论:基于多体征感知设备的网络化管理可助力提升疫情防控干预能力和应急响应能力,为疫情防控提供新的科技手段.

To propose a new mode of HIV test and surveillance among population of men who have sex with men (MSM): Internet-based Self-sampling at home plus Laboratory testing of HIV total nucleic acid (TNA) in dried blood spot (DBS) (ISL of DBS TNA). Feasibility of ISL of DBS TNA was studied. Characteristics of the new mode and that of conventional surveillance mode at HIV voluntary counseling and testing clinic (VCT) were compared. A non-governmental organization (NGO) published the recruitment information on the WeChat public account. MSM filled in the questionnaire online, applied for self-sampling service package, and mailed the self made DBS to professional laboratory. The laboratory performed HIV TNA test and submitted the test results to online platform. Participants queried test results online with their unique ID. Center for Disease Control and Prevention (CDC) followed up participants with positive nucleic acid results using IDs and contact information. Rates were compared by using the Chi-Square test or Fisher's exact test. Four hundred twenty-three questionnaires were completed. 423 self-sampling service packages were sent out and 340 DBSs were returned to professional laboratory within one month with qualified rate of sampling as high as 95.0

To clarify the characteristics in immunogenicity and safety of inactivated SARS-Cov-2 vaccines among HIV-infected individuals, a longitudinal cohort study was performed on HIV-infected and HIV-uninfected participants with no history of COVID-19 infection and COVID-19 vaccine inoculation. Participants information and adverse events were collected. Blood samples were collected on the same day before vaccination, 21 days after the first shot, 28 days after the second shot, 6 months after the second vaccination and 14 days after the third dose to test anti-receptor-binding domain IgG antibody, viral load, CD4+, CD8+ T cell count. Our result showed that although HIV-infected adults with low nadir CD4+ T cell count ≤ 350 cells/mm3 generate significantly lower immune response after three shots of vaccine compared with HIV-negative controls, 100% of all the HIV-infected and healthy controls were seroconverted after the third shot. Seroconversion ratio and antibody level of 190 days after two shots of vaccination for HIV-infected with nadir CD4+ T cell count ≤ 350 were significantly lower than that of healthy controls. No significant difference was found in viral load among blood samples collected at each time points. CD4 and CD4/CD8 ratio value were found increased greatly after each shot of inoculation in HIV-infected individuals with nadir CD4+ T cell count ≤ 350. Multiple logistic regression analysis showed that among HIV-infected individuals, PLWH with CD4+ T cell count ≤ 350 were less likely experience seroconversion 21 days after the first shot, and less likely maintained antibody immunity 6 months post 2nd dose. Adverse events after each inoculation were not serious and recovered within 1 week. In conclusion, inactivated COVID-19 vaccine was safe and effective in people living with HIV after three shots of vaccination. HIV-infected individuals with low nadir CD4+ T cell count ≤ 350 was associated with a nonoptimal antibody response. Further vaccination strategies could be developed for those with low CD4+ T cell counts.

Objective:To conduct follow-up and nucleic acid test for individuals with negative or indeterminate HIV confirmatory results, and to analyze the genotypic subtyping.Methods:Follow-up tests and nucleic acid tests were carried out for three cases with screening reactive and negative or indeterminate Western Blot (WB) results. Pol gene fragment was amplified by one-step reverse transcriptase polymerase chain reaction, and phylogenetic tree was constructed to analyze its genotype. Results:Three cases were reactive for first HIV screening, and cases 1 and 3 were detected with p24 band and case 2 was negative without specific band. The genotypic analysis by HIV-1 pol gene indicated that cases 1 and 3 got infected by CRF07_BC, and case 2 by CRF01_AE (cluster 5). Cases 1 and 3 were followed up 2 weeks later, with evolving WB bands. The viral loads for the two cases were 476 385 cp/ml and 103 462 cp/ml, and the CD4 + T lymphocyte counts were 220/μl and 550/μl, respectively. Conclusions:Acute HIV-1 infection may express reactive screening with negative or indeterminate WB results.

Two HIV-1 infections with unassigned genotypes were identified during HIV-1 pretreatment drug resistance surveillance. The near full-length genome sequences of BL5040-00 and BL5085-00 were obtained and were classified as unique recombinant forms (URFs) between CRF01_AE and CRF07_BC. Simplot (version 3.5) analyses showed that the two URFs shared similar recombinant forms, and in the backbone belonging to CRF01_AE, the gag-pol, vpu, env, and nef gene fragments were genetically substituted by CRF07_BC. BL5040-00, with 10 breakpoints, had 6 CRF07_BC fragments and 5 CRF01_AE fragments, whereas BL5085-00, with 6 breakpoints, had 4 CRF07_BC fragments and 3 CRF01_AE fragments. BL5040-00 strain had two additional recombination breakpoints in pol-vif gene. The presence of URFs suggests that the men who have sex with men population in Beijing has an active HIV epidemic and the genetic diversity of HIV-1 is complex, emphasizing molecular epidemiology and disease progression monitoring should be strengthened.

BACKGROUND:A limited amount of information is available about the immunogenicity of the quadrivalent inactivated influenza vaccine among human immunodeficiency virus (HIV)-infected individuals, especially in low and middle-income countries (LMICs). METHODS:HIV-infected adults and HIV-uninfected adults received a dose of quadrivalent inactivated influenza vaccine including strains of H1N1, H3N2, BV and BY. Enzyme-linked immunosorbent assay (ELISA) and hemagglutination-inhibition assay (HAI) were used to determine IgA, IgG antibody concentration and geometric mean titers (GMT) at day 0 and day 28, respectively. Associated factors contributing to seroconversion or GMT changes were analyzed using simple logistic regression model. RESULTS:A total of 131 HIV-infected and 55 HIV-uninfected subjects were included in the study. In both HIV-infected and uninfected arms, IgG and IgA against influenza A and B all increased significantly at day 28 after receiving QIV (P < 0.001). GMTs of post-vaccination at day 28 showed that HIV-infected persons with CD4 + T cell counts ≤ 350 cells/mm3 were statistically less immunogenic to all strains of QIV than HIV-uninfected ones (P < 0.05). HIV-infected participants with CD4 + T cell counts ≤ 350 cells/mm3 were less likely to achieve seroconversion to QIV (H1N1, BY and BV) than HIV-uninfected individuals at day 28 after vaccination (P < 0.05). Compared with HIV-infected patients with baseline CD4 + T cell counts ≤ 350 cells/mm3, individuals with baseline CD4 + T cell counts > 350 cell/mm3 seemed more likely to generate antibody responses to H1N1 (OR:2.65, 95 %CI: 1.07-6.56) and BY (OR: 3.43, 95 %CI: 1.37-8.63), and showed a higher probability of seroconversion to BY (OR: 3.59, 95 %CI: 1.03-12.48). Compared with nadir CD4 + T cell count ≤ 350 cell/mm3, individuals with nadir CD4 + T cell count > 350 cell/mm3 showed a higher probability of seroconversion to H1N1(OR: 3.15, 95 %CI: 1.14-8.73). CONCLUSION:Influenza vaccination of HIV-infected adults might be effective despite variable antibody responses. HIV-positive populations with CD4 + T cell counts ≤ 350 are less likely to achieve seroconversion. Further vaccination strategies could be developed for those with low CD4 T cell counts.

Objective:To elucidate the existence of a novel circulating HIV-1 recombinant form, HIV-1 CRF103_01B in Beijing and to explore its genetic characteristics using the near full-length genome (NFLG).Methods:Five individuals were identified as suspect cases of CRF103_01B strain infection in the surveillance of HIV-1 genotypic drug resistance for new diagnosis or antiretroviral therapy in Beijing from 2017 to 2020. The two overlapping segments of HIV-1 genome were amplified by nested PCR with near endpoint dilution method after reverse transcription. The obtained NFLG sequences were aligned with subtyping reference sequences, and neighbor-joining (NJ) phylogenetic tree was constructed using MEGA11. SimPlot 3.5 software was used to determine the breakpoints of recombinant and to draw the map of genome structure. Based on alignment from the homologous NFLG sequences with the putative parental strains, the longer segments were selected to construct the NJ trees, to infer the possible origins of the parental strains. Genotypic drug resistances were interpreted using the Stanford University HIV drug resistance database.Results:Five NFLG sequences of CRF103_01B were obtained from four individuals who were infected by men who have sex with men (MSM) and one female. The sequences were analyzed with the four NFLGs of CRF103_01B previously reported in Hebei province to explore the characters of recombination. On the backbone of CRF01_AE, the corresponding segments of gag, pol and nef-3'- LTR gene were substituted by subtype B [HXB2 nt 1111±19-1539±16, 2531-4478±16 (region V), 9008±23-9615]. Phylogenetic inference analysis showed that regions IV and V of CRF103_01B clustered into large monophyletic clusters with subtype B (BJMP3294B) and g5 CRF01_AE (JX112804) from Beijing, with bootstrap values of 97% and 100%, respectively. All 9 CRF103_01B individuals carried V106I mutation of non-nucleoside reverse transcriptase inhibitor. Conclusions:CRF103_01B strain was mostly convinced to be originated from MSM population in Beijing, and continued to circulate among this population in Beijing and Hebei at a low level. This strain spread to general population via heterosexual contact. Molecular epidemiology and drug resistance surveillance should be reinforced, focusing on the disease progression.

The safety and efficacy of several vaccine candidates have been tested and found to be effective and safe against COVID-19. But little is known about the actual level of people with lung cancer willing to accept a COVID-19 vaccine and the impact factors that affect acceptability. The purpose of this study was to determine the prevalence of vaccine hesitancy in lung cancer patients after surgery and characterize underlying factors contributing to reluctance. An clinical survey was inducted from May 1, 2021, to August 20, 2021. Eligible participants were 18 years or older, were diagnosed with lung cancer, and received lung cancer surgery, including lobectomy, sublobectomy, and pneumonectomy. Data were collected on a self-administered questionnaire from 294 lung cancer patients after surgery. Among the final included 281 participants, 54.1% were female, and 93.6% were of Han ethnicity. 48.0% were in pathologic stage I, 36.3% in stage II, 10.3% in stage III, and 5.3% in stage IV. The vaccination hesitancy/refusal rate was 41.6%. In multivariable regression analysis, age over 60 years old, low educational level, duration of cancer (< 1 year), subjective health status, current cancer treatments use, presence of postoperative pain, and report of the items “ever hesitated or refused to get a vaccination,” “get negative information about getting the COVID-19 vaccine”, “worried about vaccine adverse reactions,” and “worried about the COVID vaccine interferes with cancer treatments” were independently associated with hesitant of the COVID-19 vaccine. Vaccine hesitancy is common among lung cancer patients after surgery, related mainly to health status and concerns about side effects, worsens cancer prognosis, and interferes with cancer treatments. These results suggest that vaccination programs may need tailoring to specific populations’ hesitancy.

The Beijing 2022 Olympic and Paralympic Winter Games in Beijing (Beijing 2022 Games) were taking place at the height of the fourth wave of the global COVID-19 pandemic caused by the Omicron variant. Through a set of adjustments of COVID-19 prevention and control policies and practices, such as vaccine coverage, whole-journey closed-loop management, daily nucleic acid testing, wearing N95 masks, as well as social distancing, Beijing 2022 Games obtained exceptional achievement of public health security that the Games were held as scheduled and the health safety of all participants was under protection. It further provides valuable reference to the countermeasures at societal level.

Objective:To compare and analyze preliminarily the countermeasure strategies against coronavirus disease 2019 (COVID-19) in the Tokyo 2020 Olympic Summer Games (Tokyo 2020 Games) and Beijing 2022 Olympic Winter Games (Beijing 2022 Games), and to summarize the experience obtained from the two Games.Methods:Public available data were collected from the official websites of Beijing 2022 Games, Tokyo 2020 Games, International Olympic Committee and World Health Organization, as well as publications in academic journals. The countermeasure strategies applied by the host countries and at Games time as well as the effectiveness were compared.Results:The 'Closed-loop Management’ or 'Bubble Regime’ was employed in the two Games. The Closed-loop Management of Beijing 2022 Games covered the whole journey of the participants who were completely apart from the local residents. In Tokyo 2020 Games, COVID-19 antigen tests of saliva were adopted for screening followed by PCR tests of nasopharyngeal swab samples as the confirmation. The test frequencies were in line with the four types of participants. In Beijing 2022 Games, daily PCR tests for oropharyngeal swab samples were conducted for screening to all individuals in the closed loop followed by PCR tests for nasopharyngeal swab samples as the confirmation. In addition, participants of Beijing 2022 Games were required to wear N95 respirator or face masks of equivalent protection. Furthermore, only the participants with full vaccination or completion of 21-day isolation were allowed to enter the closed loop in Beijing 2022 Games.Conclusions:The countermeasure strategies of Beijing 2022 Games and Tokyo 2020 Games were developed on their specific situations and achieved noticeable effects. These provided references for preparedness of future mass-gathering events within the period of infectious disease pandemic.

Amid the ongoing global COVID-19 pandemic, limited literature exists on immune persistence after primary immunization and the immunogenic features of booster vaccines administered at different time intervals. Therefore, this study aimed to determine the immune attenuation of neutralizing antibodies against the SARS-CoV-2 wild-type strain, and Delta and Omicron variants 12 months after the primary administration of the COVID-19 inactivated vaccine and evaluate the immune response after a booster administration at different time intervals. A total of 514 individuals were followed up after primary immunization and were vaccinated with a booster. Neutralizing antibodies against the wild-type strain and Delta and Omicron variant spike proteins were measured using pseudovirus neutralization assays. The geometric mean titers (GMTs) after the primary and booster immunizations were 12.09 and 61.48 for the wild-type strain, 11.67 and 40.33 for the Delta variant, and 8.51 and 29.31 for the Omicron variant, respectively. The GMTs against the wild-type strain declined gradually during the 12 months after the primary immunization, and were lower against the two variants. After implementing a booster immunization with a 6 month interval, the GMTs against the wild-type strain were higher than those obtained beyond the 7 month interval; however, the GMTs against the two variants were not statistically different across 3–12 month intervals. Overall, SARS-CoV-2 variants showed remarkable declines in immune persistence, especially against the Omicron variant. The booster administration interval could be shortened to 3 months in endemic areas of the Omicron variant, whereas an appropriate prolonging of the booster administration interval did not affect the booster immunization effect.

目的 分析结核感染T细胞斑点试验(T-SPOT.TB)、结核抗体、痰涂片与痰培养联合检测在活动性肺结核诊断中的临床意义.方法 收集2014年1月至2019年12月北京结核病控制研究所门诊收治的疑似活动性肺结核患者715例,最终诊断为活动性肺结核患者412例(肺结核组),非结核病患者303例(非结核组).715例患者均行T-SPOT.TB检测、结核抗体检测及痰涂片、痰培养检查;以临床诊断结果为标准,分析4种方法单独及联合检测的临床意义.结果 肺结核组患者中,T-SPOT.TB阳性检出率为83.7％(345/412);非结核组患者中,T-SPOT.TB阳性检出率为20.8％(63/303);两组阳性检出率差异有统计学意义(x2=2.823,P=0.000).T-SPOT.TB对活动性肺结核检测的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为83.7％(345/412)、79.2％(240/303)、84.6％(345/408)、78.2％(240/307)、81.8％[(345+240)/715];4种方法联合诊断的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为93.7％(386/412)、50.8％(154/303)、72.1％(386/535)、85.6％(154/180)、75.5％[(386-154)/715].T-SPOT.TB检测、结核抗体检测及痰涂片、痰培养检查的ROC曲线下面积(AUC)分别为0.815、0.575、0.593、0.715,四项联合检测的AUC为0.894.结论 T-SPOT.TB检测的敏感度、阴性预测值较好,T-SPOT.TB检测联合结核抗体、痰涂片和痰培养检测的敏感度、AUC较高,联合检测可提高对肺结核的诊断效能.

Supplemental Digital Content is available in the text Introduction: People with severe hypertension have high risk of target organ damage, yet few studies focus specifically on this population. We sought to assess the characteristics, prevalence, awareness, and treatment patterns of severe hypertension among middle-aged adults in China. Methods: We enrolled 2 660 666 participants aged 35–75 years from 31 provinces between 2014 and 2018 in the cross-sectional China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project. Severe hypertension was defined as SBP of at least 160 mmHg or DBP of at least 100 mmHg. Awareness and treatment were defined as self-reported diagnosis of hypertension and current use of antihypertensive medication, respectively. Analyses were completed in 2019. Results: Our sample included 2 618 757 adults with a mean age of 55.6 years (SD 9.8), 59.6% of whom were women. A total of 378 457 (14.5%) participants had severe hypertension, of whom 222 533 (58.8%) were untreated. The age--sex-standardized rate of severe hypertension was 11.6% based on the 2010 Chinese Census data. Advanced age, female sex, current drinking, obesity, lower income, diabetes, and prior cardiovascular events were associated with higher risk of severe hypertension (all P < 0.01). Of untreated participants with severe hypertension, only 60 484 (27.1%) were aware of their conditions. Among participants with severe hypertension despite treatment, 84.7% reported taking one class of antihypertensive medication; only 15% reported taking guideline-recommended combination therapy. Conclusion: Many millions of people in China have severe hypertension and the vast majority are unaware of their condition and undertreated. There are immense opportunities to improve outcomes in this high-risk group.

目的 了解北京市新冠肺炎集中隔离医学观察点各项工作开展情况.方法 2020年3-12月,从全市280个观察点随机抽取了170个进行调查,有效调查169个(99.4％),采用现场勘查、查阅工作痕迹及询问等方式获取信息,由调查员填写问卷.结果 87个(51.5％)观察点的各调查指标全部合格,组织框架健全、各方责任落实、卫生学要求、工作流程、个人防护、隔离管理的合格率分别为85.8％、89.3％、60.9％、84.6％、94.1％和89.3％.城区观察点的组织框架健全、各方责任落实、卫生学要求和工作流程合格率均低于郊区,3星酒店及以下的观察点的个人防护合格率高于4星酒店及以上,密接隔离观察点的组织健全和工作流程合格率低于入境隔离观察点,上述差异都具有统计学意义(P＜0.05).结论 近一半的观察点存在某些工作未按要求执行到位,需引起各相关部门的高度重视.

Objective:To explore the characteristics of HIV-1 genotypic drug resistance for protease-reverse transcriptase (PR-RT) and integrase (IN) among antiretroviral therapy (ART)-naive individuals in Beijing, and provide evidence for clinical diagnosis and treatment.Methods:Newly diagnosed individuals or cases initiating ART were recruited in Beijing covering 2019 to 2020, then pol gene fragments and integrase gene were synchronously amplified and sequenced. Phylogenetic analyses were performed to determine subtypes, and the pol gene and integrase gene sequences were submitted to Stanford University HIV drug resistance database for the interpretation of mutations and drug resistance. Results:Among 168 ART-naive individuals, 93.6% were infected via men who have sex with men (MSM). The top two subtypes were CRF01_AE (41.0%) and CRF07_BC (30.3%), and unique recombinant forms accounted for 16.1% infections. Six individuals carried surveillance drug resistance mutations in PR-RT, with a prevalence of transmitted drug resistance (TDR) at 3.7%. And one case carried nucleoside reverse transcriptase inhibitor mutation of K65R, accompanied with major integrase mutation of T66I (0.6%), conveying resistance to elvitegravir and raltegravir at high and low levels, respectively.Conclusions:The prevalence of transmitted drug resistance was considerably low among ART-naive individuals in Beijing, and the surveillance of genotypic drug resistance should be strengthened, including integrase drug resistance.

Abstract Background A local coronavirus disease 2019 (COVID-19) case confirmed on June 11, 2020 triggered an outbreak in Beijing, China after 56 consecutive days without a newly confirmed case. Non-pharmaceutical interventions (NPIs) were used to contain the source in Xinfadi (XFD) market. To rapidly control the outbreak, both traditional and newly introduced NPIs including large-scale management of high-risk populations and expanded severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR-based screening in the general population were conducted in Beijing. We aimed to assess the effectiveness of the response to the COVID-19 outbreak in Beijing’s XFD market and inform future response efforts of resurgence across regions. Methods A modified susceptible–exposed–infectious–recovered (SEIR) model was developed and applied to evaluate a range of different scenarios from the public health perspective. Two outcomes were measured: magnitude of transmission (i.e., number of cases in the outbreak) and endpoint of transmission (i.e., date of containment). The outcomes of scenario evaluations were presented relative to the reality case (i.e., 368 cases in 34 days) with 95% Confidence Interval (CI). Results Our results indicated that a 3 to 14 day delay in the identification of XFD as the infection source and initiation of NPIs would have caused a 3 to 28-fold increase in total case number (31–77 day delay in containment). A failure to implement the quarantine scheme employed in the XFD outbreak for defined key population would have caused a fivefold greater number of cases (73 day delay in containment). Similarly, failure to implement the quarantine plan executed in the XFD outbreak for close contacts would have caused twofold greater transmission (44 day delay in containment). Finally, failure to implement expanded nucleic acid screening in the general population would have yielded 1.6-fold greater transmission and a 32 day delay to containment. Conclusions This study informs new evidence that in form the selection of NPI to use as countermeasures in response to a COVID-19 outbreak and optimal timing of their implementation. The evidence provided by this study should inform responses to future outbreaks of COVID-19 and future infectious disease outbreak preparedness efforts in China and elsewhere. Graphical abstract