Allergic diseases are a major public health challenge for children. To date, a comprehensive assessment of the disease burden of major allergic diseases in Chinese children is still limited. This study aimed to analyze the epidemiological characteristics of major allergic diseases in China through the Global Burden of Disease Study 2021 (GBD 2021). The incidence and prevalence of asthma, atopic dermatitis (AD), and urticaria among children aged 0 to 14 years in China from 1990 to 2021 were assessed through data from GBD 2021. Moreover, subgroup analyses by sex, age, and China/global comparisons were performed to analyze the differences more accurately. We used Joinpoint regression analyses to quantify temporal trends, calculate annual percentage changes, and average annual percentage changes. From 1990 to 2021, China experienced significant declining trends in childhood asthma, with incidence and prevalence falling by approximately −26% and −23%, respectively. These rates were consistently higher in boys (male-to-female ratio >1.3). In contrast, AD presented a mixed pattern: a slight decrease in incidence (−6.7%) alongside a marginal rise in prevalence (+1.5%), diverging from the global decline. AD showed a consistent female predominance. Meanwhile, urticaria remained relatively stable nationally (incidence: −2.3%, prevalence: −0.4%), but exhibited a pronounced female skew, with incidence and prevalence rates about 60% higher in girls. Although the burden of asthma has decreased, the prevalence of AD has been increasing, whereas the prevalence trend of urticaria has been relatively stable. The burden of allergic diseases is still large, and there are obvious sex differences.

BackgroundThree years into the SARS-CoV-2 pandemic, the virus continues to mutate despite widespread vaccination, posing ongoing challenges for epidemic prevention and control. The relationship between viral shedding and immune escape remains under investigation. This study aims to examine the association between viral shedding and immune escape in the BA.4/5 and BF.7 variants.MethodWe included 542 patients infected with the Omicron variant from Beijing Xiaotangshan shelter hospital. Based on the viral strain, patients were divided into BA.4/5 group and BF.7 group. Additionally, we categorized patients into rapid viral shedding and slow viral shedding groups according to their viral shedding rates. We explored the relationship between viral shedding and immune-related clinical indicators during this period.ResultOf the 542 patients, 118 were infected with BA.4/5 variant, and 424 were infected with BF.7 variant. The viral shedding duration differed significantly between BA.4/5 and BF.7 groups (p < 0.0001). However, there was no statistically significant correlation between viral shedding duration and immune-related indicators, such as WBC, Hb, PLT, Neu, Lym, CRP, allergy, fever, and vaccination status (p > 0.05). Furthermore, viral shedding duration was not associated with vaccination status, intervals between vaccinations, or vaccine types (p > 0.05).ConclusionThe duration of viral shedding in patients infected with Omicron variants BA.4/5 and BF.7 is not associated with WBC, Hb, Lym, CRP, fever, allergy, or vaccine-related indicators. This lack of association may be attributed to immune escape mechanisms.

Exosomes are nanoscale vesicles secreted by cells, with a diameter ranging from 30 nm to 150 nm. Composed of lipid bilayers, proteins, and genetic material, they can deliver bioactive molecules to target cells, playing a crucial role in cell communication, immune regulation, inflammation, and other processes. Exosomes are associated with various human diseases. In recent years, as research on exosomes in ophthalmic diseases has progressed, their significant role in ophthalmic diseases has been increasingly recognized. This review summarizes current research progress on exosomes in sicca syndrome, glaucoma, age.related macular degeneration, diabetic retinopathy and uveal melanoma, with a focus on their applications as diagnostic biomarkers and therapeutic delivery vehicles.

BackgroundLianhuaqingwen (LHQW), a traditional Chinese medicine comprised of 13 herbal extracts renowned for their robust heat-clearing and detoxifying properties, has gained widespread utilization in China but has yet to garner similar recognition abroad. It is believed to exhibit efficacy in ameliorating symptoms in individuals afflicted with coronavirus disease 2019 (COVID-19). However, the precise impact of LHQW on viral shedding (VS), particularly in the context of mild or asymptomatic infections caused by the Omicron BF.4/5 or BF.7 variants of COVID-19, remained inadequately elucidated. Consequently, a real-world study was conducted, involving patients diagnosed with COVID-19, with the primary objective of ascertaining the effectiveness of LHQW in this specific clinical context.MethodsWe conducted an investigation on Omicron-infected patients through a single-center, propensity score-matched real-world study conducted at Xiaotangshan Fangcang Hospital from May to November 2022. A total of 3,368 COVID-19 patients were enrolled in the study, all of whom presented mild or asymptomatic infections caused by either BF.4/5 or BF.7 strains of the virus. Demographic and clinical data were systematically collected from medical records. Patients were allocated to receive treatment with LHQW (designated as the treatment group) or received no LHQW treatment (designated as the not-treated/no-treatment group). Viral load was quantified utilizing quantitative real-time PCR (qPCR), and the duration of VS was defined as the time interval between the initial negative test result and the date of COVID-19 diagnosis or symptom onset.ResultsThe study encompassed a cohort of 3,368 patients, and following propensity score matching, a subset of 296 patients was meticulously chosen for subsequent analysis. Notably, baseline characteristics exhibited disparities between the treatment and not-treated/no-treatment groups. However, post-matching, these characteristics achieved a commendable level of comparability. Our findings unequivocally demonstrated that there existed no statistically significant disparity in VS. This holds true when comparing patients subjected to LHQW treatment against those not administered LHQW, as well as when contrasting individuals presenting asymptomatic and mild COVID-19 manifestations.ConclusionNo statistically significant difference in VS was observed between patients who underwent LHQW treatment and those who did not. Additional investigations are imperative to provide a comprehensive assessment of LHQW’s efficacy, particularly in patients afflicted with severe COVID-19 or those infected with viral strains distinct from BF.4/5 or BF.7.

Exosomes play a crucial role in various biological processes, such as human development, immune responses, and disease occurrence. The membrane proteins on exosomes are pivotal factors for their biological functionality. Currently, numerous membrane proteins have been identified on exosome membranes, participating in intercellular communication, mediating target cell recognition, and regulating immune processes. Furthermore, membrane proteins from exosomes derived from cancer cells can serve as relevant biomarkers for early cancer diagnosis. This article provides a comprehensive review of the composition of exosome membrane proteins and their diverse functions in the organism’s biological processes. Through in-depth exploration of exosome membrane proteins, it is expected to offer essential foundations for the future development of novel biomedical diagnostics and therapies.

Background. Most international treatment guidelines recommend rapid initiation of antiretroviral therapy (ART) for people newly diagnosed with human immunodeficiency virus (HIV)-1 infection, but experiences with rapid ART initiation remain limited in China. We aimed to evaluate the efficacy and safety of efavirenz (400 mg) plus lamivudine and tenofovir disoproxil fumarate (EFV + 3TC + TDF) versus coformulated bictegravir, emtricitabine, and tenofovir alafenamide (BIC/FTC/TAF) in rapid ART initiation among HIV-positive men who have sex with men (MSM). Methods. This multicenter, open-label, randomized clinical trial enrolled MSM aged >= 18 years to start ART within 14 days of confirmed HIV diagnosis. The participants were randomly assigned in a 1:1 ratio to receive EFV (400 mg) + 3TC + TDF or BIC/FTC/TAF. The primary end point was viral suppression (<50 copies/mL) at 48 weeks per US Food and Drug Administration Snapshot analysis. Results. Between March 2021 and July 2022, 300 participants were enrolled; 154 were assigned to receive EFV + 3TC + TDF (EFV group) and 146 BIC/FTC/TAF (BIC group). At week 48, 118 (79.2%) and 140 (95.9%) participants in the EFV and BIC group, respectively, were retained in care with viral suppression, and 24 (16.1%) and 1 (0.7%) participant in the EFV and BIC group (P < .001), respectively, discontinued treatment because of adverse effects, death, or lost to follow-up. The median increase of CD4 count was 181 and 223 cells/mu L (P = .020), respectively, for the EFV and BIC group, at week 48. The overall incidence of adverse effects was significantly higher for the EFV group (65.8% vs 37.7%, P < .001). Conclusions. BIC/FTC/TAF was more efficacious and safer than EFV (400 mg) + 3TC + TDF for rapid ART initiation among HIV-positive MSM in China.

Background Data on viral kinetics and variants affecting the duration of viral shedding were limited. Our objective was to determine viral shedding in distinct severe acute respiratory syndrome coronavirus 2 variants, including Omicron BA.4/5 and BF.7, and to identify the relevant influencing factors. Methods We carried out a longitudinal cohort study at Beijing Xiaotangshan Fangcang shelter hospital from May to June 2022 (Omicron BA.4/5) and from November to December 2022 (Omicron BF.7). Nucleocapsid protein (N) and open reading frame (ORF) genes were considered as the target genes of the reverse transcription PCR. The daily results of cycle threshold (CT), including lowest ORF1ab-CT values for days 1–3 post-hospitalisation and lowest N-CT values for days 1–3 post-hospitalisation (CT3minN) and demographic and clinical characteristics were collected. Results 1433 patients with coronavirus disease 2019 (COVID-19) were recruited from the Fangcang shelter hospital, in which 278 patients were diagnosed with Omicron BA.4/5 and 1155 patients with Omicron BF.7. Patients with BF.7 infection showed a longer duration of viral shedding. The duration of viral shedding was associated with the variants age, alcohol use, the severity of COVID-19 and CT3minN. Moreover, the nomogram had excellent accuracy in predicting viral shedding. Conclusions Our results indicated that patients with Omicron BF.7 had a longer period of contagiousness than those with BA.4/5. The duration of viral shedding was affected by a variety of factors and the nomogram may become an applicable clinical instrument to predict viral shedding. Furthermore, we developed a new COVID-19 viral shedding predicting model that can accurately predict the duration of viral shedding for COVID-19, and created a user-friendly website to apply this prediction model ( https://puh3.shinyapps.io/CVSP_Model/ ).

ObjectiveTo use SIV-mac239-infected Chinese rhesus monkeys to study white matter changes with and without regular combined antiretroviral therapy (cART) and the relationships between the changes and clinical results.MethodsDiffusion tensor imaging (DTI) data were collected at baseline and 10 days, 4 weeks, 12 weeks, 24 weeks, and 36 weeks after viral inoculation. Plasma CD4 T cell counts, CD4/CD8 ratio, plasma viral load, and cerebrospinal fluid (CSF) viral load were collected at baseline and 1 week, 5 weeks, 12 weeks, 24 weeks, and 36 weeks after viral inoculation. Microstructural characteristics were examined within 76 white matter areas defined by the DTI-white matter (WM) atlas for rhesus macaques. Corrections for multiple comparisons were performed using a false discovery rate (p < 0.05, FDR). Correlation analyzes between imaging markers and clinical markers (plasma CD4 T cell counts, CD4/CD8 ratio, plasma viral load, and cerebral spinal fluid viral load) were performed using Pearson correlations.ResultsWhite matter changes in SIV-infected macaques were detected in different brain regions as early as 4 weeks after inoculation. As time progressed, cART reversed, ameliorated, or even enhanced the effects. The CD4 T cell count was mainly associated with DTI metrics before cART, while the CD4/CD8 ratio was associated with white matter changes with and without cART. Viral load was positively associated with mean diffusivity in HIV patients without cART, and the opposite results were seen in HIV patients with cART.ConclusionSIV-mac239 infection may be an ideal tool for studying HIV-induced changes in the brain. The first white matter changes appeared in a structure adjacent to the periventricular area as early as 4 weeks after inoculation. As time progressed, cART had different effects on different regions, reversing, attenuating, or even progressing the pathology. Moreover, these changes were closely related to the CD4/CD8 ratio and viral load, even after cART.

Abstract Background Recurrence continues to place significant burden on patients and tuberculosis programmes worldwide, and previous studies have rarely provided analysis in negative recurrence cases. We characterized the epidemiological features of recurrent pulmonary tuberculosis (PTB) patients, estimated its probability associated with different bacteriology results and risk factors. Methods Using 2005–2018 provincial surveillance data from Henan, China, where the permanent population approximately were 100 million, we described the epidemiological and bacteriological features of recurrent PTB. The Kaplan–Meier method and Cox proportional hazard models, respectively, were used to estimate probability of recurrent PTB and risk factors. Results A total of 7143 (1.5%) PTB patients had recurrence, and of 21.1% were bacteriological positive on both laboratory tests (positive–positive), and of 34.9% were negative–negative. Compared with bacteriological negative recurrent PTB at first episodes, the bacteriological positive cases were more male (81.70% vs 72.79%; P < 0.001), higher mortality risk (1.78% vs 0.92%; P = 0.003), lower proportion of cured or completed treatment (82.81% vs 84.97%; P = 0.022), and longer time from onset to end-of-treatment. The probability of recurrence was higher in bacteriological positive cases than those in bacteriological negative cases (0.5% vs 0.4% at 20 months; P < 0.05). Conclusions Based on patient’s epidemiological characteristics and bacteriological type, it was necessary to actively enact measures to control their recurrent.

Exosomes play an important role during human immunodeficiency virus (HIV) acute infection. Yet, information regarding its cargo and its association with HIV rapid progressors (RPs) and typical progressors (TPs) remain largely unknown. In this study, exosomal miRNAs sequencing and mass cytometry were used to identify differential exosomal miRNAs and membrane proteins that participate in the pathogenesis of TPs and RPs. We discovered that miR-144-5p, miR-1180-3p, miR-451a, miR-362-5p, and miR-625-5p are associated with the TPs and miR-362-5p with the RPs. Decreased autophagy, amino acid metabolism, immune response, and IL-6 are closely related to RPs. In addition, SP1 was selected as the most significant transcription factor (TF) associated with disease progression. CD49D, CD5, CCR5, CD40, CD14, and CD86 were selected as the differential exosomal membrane proteins between TPs and RPs. This study provides valuable information for clarifying the mechanism in people with acute HIV infection.

OBJECTIVETo investigate how the structural connectivity altered in combined antiretroviral therapy-treated (cART+) HIV patients and cART-naive (cART-) HIV patients by conducting Network analysis of Diffusion Tensor Imaging (DTI) data.METHODSWe enrolled 22 cART-, 23 cART+ and 28 normal controls (NC) in our current study. Firstly, the DTI imaging data pre-processing was conducted and the asymmetric 90 × 90 matrix for each participant from their DTI data was obtained with the use of PANDA. Then, we applied a graph-theoretical network analysis toolkit, GRETNA v2.0, to calculate metrics such as small-"worldness," characteristic path length, clustering coefficient, global efficiency, local efficiency, and nodal "betweenness". Finally, we took comparisons among the three groups to investigate topological alterations.RESULTSResults (1) the regional characteristics (nodal efficiency) were altered in cART- and cART+ patients predominantly in the frontal cortical regions; (2) changes in various network properties in cART+treat and cART-patients were associated with the performance of behavior functions; (3) Hubs redistributed in HIV subjects especially in cART+ patients.CONCLUSIONThe regional characteristics (nodal efficiency) were altered in cART- and cART+ patients predominantly in the frontal cortical region, and changes in various network properties in cART- and cART+ patients were associated with the performance of behavior functions. In addition, Hubs redistributed in HIV subjects especially in cART+ patients.

Background: Fine particulate matter (PM) (PM with an aerodynamic diameter <2.5 μm, PM2.5) exposure contributes to respiratory disease development and exacerbation. Objective: We sought to investigate the effect of PM2.5 exposure on mucociliary function in primary human nasal epithelial cells (HNECs) and the underlying mechanism. Methods: HNECs derived from control subjects and patients with chronic rhinosinusitis with nasal polyps were established as air-liquid interface cultures. Confluent cultures were exposed to 100 or 200 μg/mL PM2.5 for 24 h and assessed for expression of specific mucociliary-associated factors, the percentage of β-tubulin IV-positive and MUC5AC-positive cells, expression of epidermal growth factor receptor (EGFR) ligand and activation of phosphoinositide 3-kinase (PI3K)-AKT/ERK. In addition, cultures pretreated for 30 min with AG1478 (an EGFR inhibitor) or LY294002 (a PI3K inhibitor) following PM2.5 exposure were assessed for MUC5AC mRNA and protein expression. Results: PM2.5 exposure at 100 or 200 μg/mL for 24 h did not affect geminin coiled-coil domain containing, multiciliate differentiation and DNA synthesis associated cell cycle protein, FOXJ1, or DNAI2 mRNA expression or the percentage of β-tubulin IV-positive cells. However, 200 μg/mL PM2.5 exposure significantly increased mRNA expression of SAM-pointed domain-containing ETS transcription factor and MUC5AC and the percentage of MUC5AC-positive cells. PM2.5 also increased expression of EGFR ligands, including heparin-binding EGF-like growth factor and amphiregulin. Furthermore, PM2.5induced activation of PI3K, AKT, and ERK, and pretreatment of HNECs with AG1478 or LY294002 attenuated PM2.5-induced MUC5AC mRNA and protein expression. Conclusions and Clinical Relevance: This study demonstrates that short-term PM2.5 exposure increases MUC5AC expression in HNECs. Furthermore, this study shows that PM2.5-induced MUC5AC expression is likely mediated through the EGFR-PI3K pathway.

目的 采用Meta分析综合评价基于随机对照临床试验中药治疗结核病临床疗效,研究中药治疗与结核病治疗结局的相关性.方法 在中国期刊全文数据库(CNKI)、万方数据库(Wanfang Data)、PubMed、EMBASE、The Co-chrane Library数据库中,采用主题词检索的方式检索有关中药治疗结核病的随机对照临床试验(randomized controlled clinical trials,RCTs)检索时间为建库截至2022年1月30日.采用改良Jadad评分对纳入文献的质量进行评价,以比值比(odds ratio,OR)及95％可信区间(confidential interval,CI)比较试验组和对照组治疗效果,采用漏斗图和Begg检验评价发表偏倚.应用Revman5.4和Stata12.0软件统计分析.结果 对10项RCTs文献进行定性分析,其中,4篇RCT报道芩部丹治疗,样本量共517例,试验组261例,对照组256例.4篇RCT报道芪甲利肺治疗,样本量共473例,试验组239例,对照组234例.2篇RCT报道益肺通络辅助治疗,样本量共有325例,试验组174例,对照组151例.对8项RCTs进行定量分析,Meta分析结果显示芩部丹治疗明显提高痰菌转阴率[OR=2.21,95％CI(1.47～3.33),P=0.000 1],促进病灶吸收[OR=1.61,95％CI(1.05～2.46),P=0.03],未改善空洞闭合[OR=2.22,95％CI(0.78～6.29),P=0.13].芪甲利肺治疗显著提高痰菌转阴率[OR=2.24,95％CI(1.13～4.40),P=0.02)],促进病灶吸收[OR=2.15,95％C/(1.44～3.20),P=0.000 2]和空洞闭合[OR=1.99,95％CI(1.30～3.07),P=0.002].漏斗图对称和Begg检验(P=0.216)提示不存在发表偏倚.结论 中药辅助治疗可能提高抗结核治疗的效果,但安全性指标需进一步评价.

Abstract Background Hypoxia is considered a key factor in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). However, the specific mechanism driving polypogenesis under hypoxic conditions is unclear. This study aimed to explore hypoxia‐induced alterations in the transcriptome of human nasal epithelial cells (HNECs) in vitro. Methods HNECs derived from the tissue of patients with CRSwNP were established as air–liquid interface (ALI) cultures. Confluent cultures were kept submerged or treated with cobalt chloride (CoCl2) to induce hypoxia. Transcriptome analysis was used to identify key mRNAs involved in this process. Real‐time PCR (RT–PCR), Western blotting, and immunofluorescence were used to observe the effects of hypoxia on ciliogenesis. Results Numerous genes, biological processes and pathways were altered under submerged culture conditions or after CoCl2 treatment. Analysis of the results under both hypoxic conditions revealed that the transcriptional program responsible for ciliogenesis was significantly impaired. Downregulation of cilia‐related genes and inhibition of ciliated cell differentiation under hypoxia were confirmed by RT–PCR, Western blot and immunofluorescence analyses. Conclusion Hypoxia impairs ciliogenesis and ciliary function in HNECs, which might play a role in the pathogenesis of CRSwNP.

大规模在线开放课程又称慕课(massive open online courses,MOOC),近年来发展迅猛.首都医科大学附属北京佑安医院建设的传染病学慕课自2018年12月上线清华大学学堂在线平台以来受到了广泛欢迎,并于2020年获批教育部首批国家级线上一流课程.本文阐述了传染病学慕课的建设背景,包括慕课的起源及发展、慕课的特征及优势、传染病学慕课建设的必要性,介绍了传染病学慕课的内容及特色、应用情况及效果,旨在为其他高校在线开放课程的建设提供借鉴经验.

黄芩苷是源于中药黄芩根部的黄酮类化合物,是黄芩的主要活性成分,其药理作用广泛,具有良好的抗炎、抗癌、抗病毒和抗氧化等作用.以慢性鼻窦炎、过敏性鼻炎和哮喘为主的呼吸道黏膜慢性炎症性疾病是影响人类日常生活的严重慢性疾病之一,其发病机制复杂,目前对于此类疾病的治疗易产生不良反应且有一定的局限性.中药成分黄芩苷因其抗炎效果好,不良反应小而具有开发为治疗呼吸道黏膜慢性炎症性疾病的药物潜能.本文对黄芩苷在呼吸道黏膜慢性炎症性疾病中的抗炎作用及机制研究进展进行总结和归纳,为其在相关疾病的临床应用提供理论依据.

Background: The novel coronavirus disease 2019 (COVID-19) pandemic has tested the ability of universities to provide a high-quality, safe educational experience for students due to campuses shutting down. As a result, online learning could shift from a traditional classroom teaching mode and make education accessible to students. Previous studies have used individual online teaching cases to exploit a variety of online learning tools to ensure the continuation of medical education during this difficult time in China. However, for the first time, we have conducted a systematic review of local online teaching approaches, existing challenges, and potential solutions. Purpose: We present the issues and experience of conducting online medical teaching practices in China with the aim of communicating them to our peers in other countries or regions when examining the transition to e-learning during the COVID-19 pandemic and beyond. Methods: We searched the keywords below from public databases and reviewed relevant publications reporting on medical online teaching in China during the COVID-19 pandemic to analyze and summarize the online tools, modalities, and challenges. Results: We listed common online teaching tools and described a variety of online teaching modalities, as well as possible challenges. We also discussed potential solutions for those challenges, as well as the impact of the transition to online teaching on traditional education. Conclusion: By investigating local online medical teaching in China, we present useful tools and modalities that have been successfully exploited in education during the difficult time of COVID-19, although some challenges remain. The exploration of the transition to online teaching or learning will likely continue to have a profound impact on traditional classroom teaching.

MUC5AC是呼吸道黏液中重要的黏蛋白，感染、炎症因子、环境污染物等多种因素可在转录、转录后和表观遗传等多水平实现对其表达调控。在多种气道黏液高分泌疾病，如哮喘、慢性阻塞性肺疾病、慢性鼻窦炎的发生、发展及预后中，MUC5AC表达异常发挥重要作用。随着研究的不断深入，对MUC5AC的表达调控是临床诊疗和新药研发的重要靶点。本文就黏蛋白生理特点、MUC5AC表达调控机制及在呼吸道疾病中的研究进展做一综述。

Background In 2005, China established an internet-based Tuberculosis Information Management System (TBIMS) to monitor changes in tuberculosis (TB). Many scholars have conducted epidemiological research using TBIMS; however, few studies assessing control strategies have been performed based on this platform data. Henan province is a high TB incidence area in China where, in addition to following the nationwide TB strategies, a series of local intervention combinations have been implemented. Objective Our study aims to evaluate the impact of nationwide TB intervention combinations on epidemiological changes and determine whether Henan province can achieve the World Health Organization’s (WHO) goal of reducing TB incidence by 50% and TB mortality by 75% by the year 2025. Methods We used descriptive statistical methods to show the spatial and temporal distribution of pulmonary tuberculosis (PTB) reported to the TBIMS database from 2005 to 2018, and logistic regression analysis was performed to identify the risk factors of bacteriological-positive TB. The dynamic compartmental model and Bayesian melding approach was adopted to estimate the burden of TB under the impact of different TB control policies. Results In total, 976,526 PTB cases were notified to the TBIMS in Henan in a period of 14 years. Although the overall incidence of PTB declined from 91.4/105 to 58.5/105, and the overall incidence of bacteriological-positive PTB declined from 44.5/105 to 14.7/105, the WHO’s 2025 goal could not be met. The distribution of high incidence and poverty-stricken counties were basically overlapped. Men, farmers and herdsmen (in rural areas), and subjects aged ≥60 years were more likely to develop bacteriological-positive PTB. The increasing treatment success for drug-susceptible tuberculosis and multidrug-resistant tuberculosis has not provided the desired reduction in incidence and mortality. Conclusions To achieve the targeted goal, while improving the cure rate of TB, new active (rather than passive) detection and intervention strategies should be formulated based on epidemiological characteristics in Henan province.