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Three inactivated enterovirus A71 (EV-A71) vaccines have been widely vaccinated among children in the targeted age group in mainland China since mid-2016. However, comprehensive virological surveillance of hand, foot and mouth disease (HFMD) over multiple years after the use of EV-A71 vaccines has rarely been conducted. Using long-term data extracted from the Public Health and Clinical Center of Chengdu, we described the clinical, aetiological, and epidemiological characteristics of HFMD inpatients after the use of EV-A71 vaccines from 2017 through 2022. A total of 5115 patients were selected for analysis with a male-to-female ratio of 1.63:1 and were mostly under 5 years of age (97.6%). Among these cases, 4.3% presented with severe symptoms, and 4.1% of severe cases experienced significant complications. EV-A71 was no longer the major serotype for laboratory-confirmed HFMD, responsible for 15.6% of severe cases and 1.2% of mild cases. A significant downwards trend of EV-A71 infections was observed after the use of EV-A71 vaccines (P for trend < 0.001). Coxsackievirus A6 was the predominant pathogen, accounting for 63.5% of mild cases and 36.2% of severe cases. Coxsackievirus A10 (CV-A10) and A16 were sporadically detected, and an upwards trend was observed in the proportion of CV-A10 infections. This study provides baseline molecular epidemiology for the evaluation of EV-A71 vaccination impact and potential serotype replacement based on HFMD inpatients. Additional nationwide and population-based epidemiologic and serologic studies are essential to elucidate HFMD dynamics after the use of EV-A71 vaccines, and to inform public health authorities to introduce optimized intervention strategies.

Abstract Background Meteorological factors and air pollutants have been reported to be associated with hand, foot, and mouth disease (HFMD) epidemics before the introduction of vaccine. However, there is limited evidence for studies with long-term dimensions. Methods We collected the daily HFMD counts, weather and air pollution data from 2014 to 2020 in Chengdu. Distributed lag non-linear models (DLNM) were used to assess the associations of meteorological factors and air pollutants on HFMD cases. Results From 2014–2020, high relative humidity and precipitation and extremely high and low levels of PM10, O3, SO2 and CO increased the risk of HFMD. In pre-vaccination period, extreme high and low temperatures, PM10 and NO2, low precipitation and high concentrations of PM2.5 and O3 significantly increase the risk of HFMD; In post-vaccination period, high relative humidity and low level of CO can significantly increase the incidence of HFMD; During the period of COVID-19, only low temperature will significantly increase the risk of HFMD; Low concentration of air pollutants has the greatest impact on the 6–14 age group, while the high concentration of air pollutants has the greatest impact on the 0–1 age group. Conclusions Our study suggest that high relative humidity and precipitation and extremely high and low levels of PM10, O3, SO2 and CO increased the risk of HFMD from 2014 to 2020. The results of this study provide a reference for local authorities to formulate intervention measures and establish an environment-based disease early warning system.

Abstract Background The duration of virus shedding is necessary for determining the infectious period. But there were few quantitative studies on the changes of viral load and the law of the viral shedding in hand foot and mouth disease (HFMD) patients has not yet been clarified. Methods This study will prospectively recruit coxsackievirus A10 (CV-A10), coxsackievirus A16 (CV-A16) and coxsackievirus A6 (CV-A6) infected inpatients from January 2022 to December 2022. A series of samples and questionnaire information will be collected regularly to establish the dynamic function relationship between time and viral load changes and a Bayesian multilevel model will be constructed to clarify the evolvement rules which reflect the dynamic changes of viral load and the duration of viral shedding in patients with HFMD. Discussion The results of this study is expected to further clarify the evolvement rules which reflect the dynamic changes of viral load and the duration of viral shedding in HFMD patients under the influence of related factors. It can also provide important evidence for the scientific definition of the infectious period and isolation period of HFMD in China.

There is growing empirical evidence that certain types of chemotherapy and phototherapy trigger immunogenic cell death and enhance the therapeutic anticancer efficacy of genetic immunotherapy. However, the main challenge is spatiotemporally co-delivering different drugs to maximize the therapeutic index of the combination therapy. In this study, a drug delivery system (HTCP-Au/shPD-L1/DOX) was designed with a polysaccharide-wrapped shell and a condensed DNA core. To construct the HTCP-Au vector, dodecyl side chains with a polyethylenimine (PEI) head were grafted onto hyaluronic acid, and AuNPs were grafted via Au-S bonds. During drug loading, PEI arrested shRNA plasmid DNA targeting programmed cell death ligand 1 (shPD-L1) via electrostatic interactions. It also formed a PEI-DNA core that was automatically enclosed when aliphatic hydrocarbons pulled the hyaluronic acid backbone. A hydrophobic interlayer consisting of dodecyl bridge chains between the PEI-DNA core and the hyaluronic acid shell was required to accommodate hydrophobic doxorubicin. In vitro and in vivo assays demonstrated that this core-shell drug delivery system could efficiently load and transport three different drugs and effectively target tumors. Moreover, it could activate the immune system, thereby providing promising therapeutic efficacy against tumor growth and metastasis.

Chronic lung diseases (CLDs) can reduce patients’ quality of life. However, evidence for the relationship between CLD and occurrence with depressive symptoms remains unclear. This study aims to determine the associations between CLD and depressive symptoms incidence, using the data from the China Health and Retirement Longitudinal Study (CHARLS). CLD was identified via survey questionnaire and hospitalization. The follow-up survey was conducted in 2018 and depressive symptoms were assessed by the 10-item Center for Epidemiological Studies Depression Scale (CES-D-10). A total of 10,508 participants were studied with an average follow-up period of 3 years. A total of 2706 patients (25.8%) with newly diagnosed depressive symptoms were identified. The standardized incidence rate of depressive symptoms in baseline population with and without chronic pulmonary disease was 11.9/100 and 8.3/100 person-years, respectively. The Cox proportional risk model showed that CLD was a significant predictor of depressive symptoms (HR: 1.449, 95% CI: 1.235–1.700) after adjusting for covariates, and the HRs of depressive symptoms were higher in those participants with current smoking (HR: 1.761, 95% CI: 1.319–2.352), men (HR: 1.529, 95% CI: 1.236–1.892), living in rural areas (HR: 1.671, 95% CI: 1.229–2.272), with dyslipidemia (HR: 1.896, 95% CI: 1.180–3.045), and suffering from comorbidity (HR: 1.518, 95% CI: 1.104–2.087) at baseline survey. CLD was an independent risk factor of depressive symptoms in China. The mental health of CLD patients deserves more attention.

Background: Lower serum lipid metabolism might be associated with the decline of activity of daily living in the extreme longevity group. However, studies on models and possible paths of this correlation between total cholesterol (TC) and disability in centenarians are scarce. The aim of this study was to verify this correlation and explore the mediating effect of BMI and blood pressure on this relationship in Hainan centenarians.Methods: We conducted a cross-sectional analysis of 1002 centenarians from the China Hainan Centenarians Cohort Study (CHCCS). Data on demographics, anthropometry data, lifestyle, and TC levels were collected through interviews, physical examinations, and laboratory tests. The Barthel index and Lawton index, measuring the disability status, were used to estimate the activity of daily living (ADL) and instrumental activity of daily living (IADL). A multivariable logistic regression model was used to explore the correlation between disability and TC levels. Mediation analyses were used to explore the both direct and indirect effects of TC level on disability.Results: After adjusting for covariates, with 1 mmol/L increment in TC, the adjusted odds ratios (ORs) of ADL severe disability and ADL moderate & severe disability were 0.789(95%CI: 0.650–0.959) and 0.822(95%CI: 0. 0.699–0.966), respectively. There was a significant declining trend in the prevalence of different types of disability with increment in TC. The correlation was more pronounced among Hainan female centenarians. In the analysis of mediating effect among the female population, BMI significantly mediated the effect of TC levels on different types of disability. BMI and SBP, as chain mediators, multiply and chain mediated the effect of TC levels on IADL.Conclusion: Low TC levels might be correlated with a higher frequency of disability in female centenarians, and this correlation might be mediated by BMI and blood pressure.

Due to the difference in the physical and mechanical properties between the optical fiber, protective layer, adhesive layer, and the host material, the strains measured by a fiber Bragg grating (FBG) sensor may not be the actual strains of the host material, which impedes the reliable applications of FBG sensors. To overcome this problem, in this paper, the strain transfer formula was derived by using elastic analysis, the shear-lag method, and several reasonable assumptions taking into account temperature variations and nonaxial stresses, which was an improvement to an existing study (Li, H. N., Zhou, G. D., Ren, L., and Li, D. S., "Strain Transfer Analysis of Embedded Fiber Bragg Grating Sensor Under Nonaxial Stress," Optic. Eng., Vol. 46, No. 5, 2007, 054402). The analytical results were validated by simulating the behavior of a bare optical fiber through finite element analysis. The data enabled the identification of the parameters that influence the strain transfer from the host material to the embedded FBG sensors and the impact of the temperature variation and sensor alignment angle on the measurement accuracy. This work provided additional knowledge for the improvement of the existing strain transfer theory of FBG sensors in order to achieve a more accurate strain measurement with this sensing technology. [ABSTRACT FROM AUTHOR]