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Seizures are caused by increased neuronal firing activity resulting from reduced inhibitory effect and enhancement of inhibitory modulation to suppress this activity is used as a therapeutic tool. However, recent experiments have shown a counterintuitive phenomenon that inhibitory modulation does not suppress but elicit post-inhibitory rebound (PIR) spike along with seizure to challenge the therapeutic tool. The nonlinear mechanism to avoid the PIR spike can present theoretical guidance to seizure treatment. This paper focuses on identifying credible bifurcations that underlie PIR spike by modulating multiple parameters in multiple theoretical models. The study identifies a codimension-2 bifurcation called Saddle-Node Homoclinic Orbit (SNHOB), which is an intersection between saddle node bifurcation on invariant cycle (SNIC) and other two bifurcations. PIR spike cannot be evoked for the SNIC far from the SNHOB but induced for the SNIC close to the SNHOB, which extends the bifurcation condition for PIR spike from the well-known Hopf to SNIC. Especially, in a thalamic neuron model, increases of conductance of T-type Ca2+ (TCa) channel induce SNIC bifurcation approaching to the SNHOB to elicit PIR spikes, closely matching experimental results of the absence seizure or Parkinson diseases. Such results imply that, when inhibition is employed to relieve absence seizure and Parkinson diseases related to PIR spike, modulating SNIC to get far from the SNHOB to avoid PIR spike is the principle. The study also addresses the complex roles of TCa current and comprehensive relationships between PIR spike and nonlinear conceptions such as bifurcation types and shapes of threshold curve.

Objectives Despite the importance of immunological memory for protective immunity against viral infection, whether H7N9-specific antibodies and memory T-cell responses remain detectable years after the original infection is unknown. Methods A cross-sectional study was conducted to investigate the immune memory responses of H7N9 patients who contracted the disease and survived during the 2013–2016 epidemics in China. Sustainability of antibodies and T-cell memory to H7N9 virus were examined. Healthy individuals receiving routine medical examinations in a physical examination centre were recruited as control. Results A total of 75 survivors were enrolled and classified into four groups based on the time elapsed from illness onset to specimen collection: 3 months (n = 14), 14 months (n = 14), 26 months (n = 28) and 36 months (n = 19). Approximately 36 months after infection, the geometric mean titres of virus-specific antibodies were significantly lower than titres in patients 3 months after infection, but 16 of 19 (84.2%) survivors in the 36-month interval had microneutralization (MN) titres ≥40. Despite the overall declining trend, the percentages of virus-specific cytokine-secreting memory CD4+ and CD8+ T cells remained higher in survivors at nearly all time-points in comparison with control individuals. Linear regression analysis showed that severe disease (mean titre ratio 2.77, 95% CI 1.17–6.49) was associated with higher haemagglutination inhibition (HI) titre and female sex for both HI (1.92, 1.02–3.57) and MN (3.33, 1.26–9.09) antibody, whereas female sex (mean percentage ratio 1.69, 95% CI 1.08–2.63), underlying medical conditions (1.94, 95% CI 1.09–3.46) and lack of antiviral therapy (2.08, 95% CI 1.04–4.17) were predictors for higher T-cell responses. Conclusions Survivors of H7N9 virus infection produced long-term antibodies and memory T-cell responses. Our findings warrant further serological investigation in general and high-risk populations and have important implications for vaccine design and development.

Objectives Hypermucoviscous Klebsiella pneumoniae (HMKP) has been increasingly observed among clinical isolates. This study sought to examine the microbiological and epidemiological characteristics of HMKP strains in a tertiary hospital in Hangzhou, China. Methods HMKP isolates were collected and were identified via matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). A string test was performed for the hypermucoviscous phenotype. Susceptibility to various antimicrobial agents was determined. Multilocus sequence typing (MLST), capsular serotypes and virulence-associated genes of HMKP isolates were assessed. Results A total of 42 HMKP strains with a positive string test were collected, of which 32 (76.2%) were carbapenem-susceptible HMKP (CS-HMKP) and 10 (23.8%) were carbapenem-resistant HMKP (CR-HMKP). CS-HMKP strains were more susceptible to antimicrobial agents than CR-HMKP strains. Capsular serotypes K1 (38.1%; 16/42) and K2 (11.9%; 5/42) were the main capsular serotypes of all HMKP isolates. K57 was first reported in CR-HMKP strains. ST163 was the main sequence type (37.5%; 12/32) among CS-HMKP strains, whilst ST11 was unique to CR-HMKP strains. The regulator of the mucoid phenotype A gene (rmpA) and other virulence factors (allS, kfu, iutA, entB, iroN, fimH and wabG) were present in >80% of HMKP strains. Patients with CR-HMKP strains had a higher mortality rate than those with CS-HMKP strains. Conclusion Capsular serotypes K1 and K2 were the main capsular serotypes of the isolated HMKP strains. The emergence of CR-HMKP should be a concern as it was associated with an increased mortality rate, especially for ST11 CR-HMKP strains, demonstrating the global epidemic of carbapenem resistance.

Among arthropod vectors, ticks transmit the most diverse human and animal pathogens, leading to an increasing number of new challenges worldwide. Here we sequenced and assembled high-quality genomes of six ixodid tick species and further resequenced 678 tick specimens to understand three key aspects of ticks: genetic diversity, population structure, and pathogen distribution. We explored the genetic basis common to ticks, including heme and hemoglobin digestion, iron metabolism, and reactive oxygen species, and unveiled for the first time that genetic structure and pathogen composition in different tick species are mainly shaped by ecological and geographic factors. We further identified species-specific determinants associated with different host ranges, life cycles, and distributions. The findings of this study are an invaluable resource for research and control of ticks and tick-borne diseases.

Elevated plasma level of homocysteine (Hcy) represents an independent risk for neurological diseases, and induction of oxidative damage is considered as one of the most important pathomechanisms. Astaxanthin (ATX) exhibits strong antioxidant activity in kinds of experimental models. However, the potential of ATX against Hcy-induced neurotoxicity has not been well explored yet. Herein, the neuroprotective effect of ATX against Hcy-induced neurotoxicity in rat hippocampal neurons was examined, and the underlying mechanism was evaluated. The results showed that ATX pre-treatment completely reversed Hcy-induced neurotoxicity through inhibiting cell apoptosis in rat primary hippocampal neurons. The mechanical investigation revealed that ATX effectively blocked Hcy-induced mitochondrial dysfunction by regulating Bcl-2 family and opening of mitochondrial permeability transition pore (MPTP). ATX pre-treatment also attenuated Hcy-induced oxidative damage via inhibiting the release of intracellular reactive oxide species (ROS) and superoxide anion through regulating MPTP opening. Moreover, normalization of MAPKs and PI3K/AKT pathways also contributed to ATX-mediated protective effects. Taken together, these results above suggested that ATX has the potential to reverse Hcy-induced neurotoxicity and apoptosis by inhibiting mitochondrial dysfunction, ROS-mediated oxidative damage and regulation of MAKPs and AKT pathways, which validated the strategy of using ATX could be a highly effective way in combating Hcy-mediated neurological disorders.

Background To discuss the clinical significance of interleukin (IL)-6 in the differential diagnosis of sepsis and its capability of differentiating the sepsis induced by Gram-negative bacteria from that induced by Gram-positive bacteria. Methods A total of 379 children with sepsis were involved in this study to form the case group, and their C-reactive protein (CRP), procalcitonin (PCT) and IL-6 levels before antibiotics and after recovery were checked. Receiver operating characteristic curve was applied to evaluate the significance of CRP, PCT and IL-6 in the differential diagnosis of sepsis and their capability of differentiating the sepsis induced by Gram-negative bacteria from that induced by Gram-positive bacteria. Results When these 3 indicators were applied to the differential diagnosis of sepsis, the area under the curve (AUC) of IL-6, PCT and CRP was 0.881, 0.877 and 0.754, respectively. The combination of IL-6 and PCT presented highest diagnostic efficiency. CRP, PCT and IL-6 levels in children with sepsis induced by Gram-negative bacteria were significantly higher than those in children with sepsis induced by Gram-positive bacteria. Conclusions CRP, IL-6 and PCT are applicable to the differential diagnosis of sepsis and differentiating the sepsis induced by Gram-negative bacteria from Gram-positive bacteria. Appropriate combinations of these indicators are capable of increasing differential diagnosis efficiency. These indicators can be used as markers of antibiotics usage, but whether they can be used as markers to withdraw antibiotics is still needed to be observed.

Carbapenem-resistant Acinetobacter baumannii (CRAB) is a common nosocomial bacterial pathogen with limited treatment options. CRAB outbreaks are disastrous for critically ill patients. This study investigated carbapenemase-produced A. baumannii outbreaks in a tertiary hospital. Although multiple outbreaks were suggested by pulse-field gel electrophoresis, the genetic lineages and evolution between these isolates were not clear. To investigate the genomic epidemiology of these outbreaks and to reveal possible transmission routes, whole genome sequences (WGS) were compared and analyzed. From the WGS data, thirty isolates had the same sequence type (ST208); acquired resistance genes and chromosome resistant genes were detected and were responsible for multidrug resistance. A phylogenetic tree of single-nucleotide polymorphisms (SNPs) compared to the earliest index isolate found that three outbreaks had emerged and disseminated simultaneously. Of these

Designing and/or searching for novel antioxidants against oxygen glucose deprivation (OGD)-induced oxidative damage represents an effective strategy for the treatment of human ischemic stroke. Selenium is an essential trace element, which is beneficial in the chemoprevention and chemotherapy of cerebral ischemic stroke. The underlying mechanisms for its therapeutic effects, however, are not well documented. Selenocysteine (SeC) is a selenium-containing amino acid with neuroprotective potential. Studies have shown that SeC can reduce irradiation-induced DNA apoptosis by reducing DNA damage. In this study, the in vitro protective potential and mechanism of action of SeC against OGD-induced apoptosis and neurotoxicity were evaluated in HT22 mouse hippocampal neurons. We cultured HT22 cells in a glucose-free medium containing 2 mM Na2S4O2, which formed an OGD environment, for 90 minutes. Findings from MTT, flow cytometry and TUNEL staining showed obvious cytotoxicity and apoptosis in HT22 cells in the OGD condition. The activation of Caspase-7 and Caspase-9 further revealed that OGD-induced apoptosis of HT22 cells was mainly achieved by triggering a mitochondrial-mediated pathway. Moreover, the OGD condition also induced serious DNA damage through the accumulation of reactive oxygen species and superoxide anions. However, SeC pre-treatment for 6 hours effectively inhibited OGD-induced cytotoxicity and apoptosis in HT22 cells by inhibiting reactive oxygen species-mediated oxidative damage. Our findings provide evidence that SeC has the potential to suppress OGD-induced oxidative damage and apoptosis in hippocampal neurons.

Increased plasma levels of homocysteine (Hcy) can cause severe damage to vascular endothelial cells. Hcy-induced endothelial cell dysfunction contributes to the occurrence and development of human cerebrovascular diseases (CVDs). Our previous studies have revealed that astaxanthin (ATX) exhibits novel cardioprotective activity against Hcy-induced cardiotoxicity in vitro and in vivo. However, the protective effect and mechanism of ATX against Hcy-induced endothelial cell dysfunction requires further investigation. In the present study, treatment of human umbilical vascular endothelial cells (HUVECs) with Hcy inhibited the migration, invasive and tube formation potentials of these cells in a dose-dependent manner. Hcy treatment further induced a time-dependent increase in the production of reactive oxygen species (ROS), and downregulated the expression of vascular endothelial growth factor (VEGF), phosphorylated (p)-Tyr-VEGF receptor 2 (VEGFR2) and p-Tyr397-focal adhesion kinase (FAK). On the contrary, ATX pre-treatment significantly inhibited Hcy-induced cytotoxicity and increased HUVEC migration, invasion and tube formation following Hcy treatment. The mechanism of action may involve the effective inhibition of Hcy-induced ROS generation and the recovery of FAK phosphorylation. Collectively, our findings suggested that ATX could inhibit Hcy-induced endothelial dysfunction by suppressing Hcy-induced activation of the VEGF-VEGFR2-FAK signaling axis, which indicates the novel therapeutic potential of ATX in treating Hcy-mediated CVD.

The Article contains an error in Fig. 2a. Two images in Fig. 2a (control group and ATX-treated group) were inadvertently duplicated. The control group and ATX-treated group both showed no significant cell apoptosis, the experimenter misunderstood that the same image should be used. (Note: A similar error by the same experimenter was also found in Fig. 2c in another publication "Natural borneol is a novel chemosensitizer that enhances temozolomide-induced anticancer efficiency against human glioma by triggering mitochondrial dysfunction and reactive oxide species-mediated oxidative damage”, 10.2147/OTT.S174498.

Alzheimer's disease (AD) is the leading cause of dementia and has become an important public health concern. Accumulating evidence indicates that estradiol can both facilitate and impair memory-related processes and, as a result, the precise nature of the role that estradiol plays during AD pathology remains elusive. Therefore, the present study established a mouse model of AD using stereotactic brain injection of Aβ1-42 in which the mice were bilaterally ovariectomized to investigate the effects of 17β-estradiol (E2) treatment during different stages of the AD process (early and late stages). The cognitive deficits associated with this AD model were significantly ameliorated, and there was a significant increase in hippocampal neurogenesis in Aβ1-42 mice that received E2 treatment during the early stage of AD pathology. On the other hand, Aβ1-42 mice that received E2 treatment during the late stage of AD pathology did not exhibit any improvements in cognitive function or hippocampal neurogenesis. To reveal the mechanisms, underlying these effects, levels of oxidative stress, activity in death-associated pathways, gliosis, and synaptic function were assessed in the hippocampus. The Aβ1-42 mice that received E2 treatment during the early stage of AD pathology exhibited significant reductions in the production of nitric oxide (NO) and reactive oxygen species (ROS), a marked decrease in the activation of Cytochrome-c/Bax/Bcl-2/caspase-3 pathway, a notable decrease in the level of gliosis a significant increase in the number of synapses (ultrastructural investigation), and a marked upregulation in synaptic function-related proteins compared to mice that received E2 treatment during the late stage of AD pathology. Taken together, these findings indicate that E2 treatment during the early stage of AD pathology might be an efficient approach to ameliorate the development of this disease.

By two-dimensional nonlinear finite element strength reserve coefficient method and the rigid body limit equilibrium method respectively, a comprehensive study of the stability of the 12th sluice section of XiangJiaba hydropower station is made and some conclusions of the instability mode and the lack of safety are reached. The reinforcement measures, which set up concrete cogging at the dam heel and put up additional drainage holes at the stilling basin,are proposed and calculated by the strength reserve coefficient method and the rigid body limit equilibrium method respectively again,Results show that the dam foundation safety meets the code’s standards if the . reinforcement measures are adopted.

A new high-speed infrared video-based fatigue detection system was developed using a system on a programmable chip (SoPC) in this study. Based on the limitations of PERCLOS, we merged the eyes and mouth fatigue related characteristics to improve detection accuracy, used a Difference of Gaussian (DoG) filter and Ada-boosting algorithm to implement driver fatigue detection based on multi-feature fusion. The detection system was produced using FPGA with a parallel processing structure and pipeline technology. This system is innovative and it can detect fatigued states efficiently and rapidly.

Influence of different heat treatment on microstructure and mechanical properties of mining machinery steel Plate containing molybdenum niobium was investigated. As-rolled steel plate was processed by normalizing and normalization-tempering respectively. Mechanical properties of as-rolled steel plate, normalizing steel plate and normalizing-tempering steel plate and their microstructures was made a contrast. The experiment result showed that formation of coarse ferrite grain in as-rolled state leads to lower impact toughness. Normalizing treatment can refine coarse ferrite formed in hot rolling process but formation of carbon oversaturation induced new dislocation and distortion. Processing of proper normalizing-tempering can eliminate coarse ferrite in as-rolled state and relieve new dislocation and distortion formed in normalizing process, and therefore made the mechanical properties of the as-rolled plate be the best state.

Alzheimer's disease (AD) is the leading cause of dementia and has become an important public health concern. Accumulating evidence indicates that estradiol can both facilitate and impair memory-related processes and, as a result, the precise nature of the role that estradiol plays during AD pathology remains elusive. Therefore, the present study established a mouse model of AD using stereotactic brain injection of Aβ

The microstructure and properties of grade 700MPa steel with large heat input welding and its heat affected zone (HAZ) were investigated by use of the metallography, scanning electron microscopy, mechanical testing and welding thermal simulation. The results showed that the mechanical properties of the steel meet the technical requirements, namely the yield strength ReL≥570 MPa, the tensile strength 685MPa≤Rm≤830MPa, the elongation A≥17%, the -20°C impact energy KV2≥54J and the -20°C impact energy of HAZ≥47J. The steel also had good match between strength, toughness and anti-high heat input welding, the microstructure was tempered sorbite with small dispersed composite inclusions, which promoted the formation of acicular ferrite and were beneficial to the improvement of HAZ toughness.

A comprehensive experiment was conducted for heat transfer characteristics for an array of impinging gaseous slot jets to a flat plate with strong turbulence (nozzle exit Reynolds number Re=22500~64700).Find that turbulence intensity of flow has an important influence on local forced convective heat transfer coefficient. Meanwhile, the nozzle-to-plate spacing and nozzle exit Reynolds number Re would affect the mean forced convective heat transfer coefficient of the slot jets. And heat transfer efficiency of slot jets has been set to show the relation between ability of the jets and energy consumption of gas supply.

Gravity dam foundation failure progress is always associated with its deformation development. So dam foundation deformation should be paid more attention in gravity dam stability analysis. Key node plays an important role in analyzing the dam foundation deformation development. But how to select key node is worth researching. A gravity dam foundation stability is studied by the development of plastic zone and key nodes’ displacements in dam foundation. The problem of key node selection is researched and a key node selection method is brought up also in this paper.

Hemorrhagic fever with renal syndrome (HFRS) is an important public health problem in Shandong Province, China. In this study, we combined ecologic niche modeling with geographic information systems (GIS) and remote sensing techniques to identify the risk factors and affected areas of hantavirus infections in rodent hosts. Land cover and elevation were found to be closely associated with the presence of hantavirus-infected rodent hosts. The averaged area under the receiver operating characteristic curve was 0.864, implying good performance. The predicted risk maps based on the model were validated both by the hantavirus-infected rodents' distribution and HFRS human case localities with a good fit. These findings have the applications for targeting control and prevention efforts.

In this paper, we propose a new super resolution (SR) reconstruction method to handle license plate numbers of vehicles in real traffic videos. Recently, SR reconstruction shemes based on regularization have been demonstrated to be effective because SR reconstrction is an ill-posed problem. Working within this promising framework, the residual data (RD) term can be weighted according to the differences among the observed LR images in the SR reconstruction model. Moreover, L1 norm is used to measure the RD term in order to improve the robustness of our method. Experiments show the proposed method improves the subjective visual quality of the high resolution images.

In this paper, by using minimax methods in critical point theory, we obtain some existence theorems for periodic solutions of p ( t ) -Laplacian system { ( | u ′ ( t ) | p ( t ) − 2 u ′ ( t ) ) ′ + ∇ F ( t , u ( t ) ) = 0 , u ( 0 ) − u ( T ) = u ′ ( 0 ) − u ′ ( T ) = 0 and our results generalize some existed theorems.

Aim and Methods: Estradiol (E2) is reported to attenuate β-amyloid (Aβ) accumulation and slow the progression of Alzheimer's disease (AD). This study explored the beneficial effect of E2 in AD using histological examination and electrophysiological recording technique in AD model mice created by intracerebroventricular injection of β-amyloid 25–35 (Aβ25–35). Results: Infusion of Aβ25–35 reduced the number of newborn neurons in the 2nd week after birth, a critical period for neurite growth, and impaired high-frequency stimulation-dependent long-term potentiation (LTP) induction in perforant path-granular synapses of hippocampal dentate gyrus (DG). Administration of E2 from the 2nd to 4th week after cell birth in Aβ25–35-mice ameliorated the impairment of newborn neurons and LTP induction in DG. Acute application of E2 failed to increase the newborn neurons and rescue LTP induction in the DG of Aβ25–35-mice. Conclusions: The effect of E2 in Aβ25–35-impaired LTP induction depends on its neuroprotection impro...

To investigate the epidemiology of hand, foot, and mouth disease (HFMD) and the genetic characteristics of enterovirus A71 (EV-A71) in Linyi of Shandong Province, China during 2007-2012. The number of reported HFMD cases were obtained from the National Notifiable Disease Reporting System (NNDRS) were analyzed by descriptive epidemiology method; the VP1 region of EV-A71 isolated from HFMD patients in Linyi was amplified and sequenced. Finally, the genetic variability and phylogenecity of VP1 sequences of EV-A71 were analyzed by MEGA 5.0. The results showed that HFMD incidence was reported in each year from 2007 to 2012 in Linyi, and the highest incidence and mortality were reported in 2009, when there were total 14697 cases and 9 of death. The reported incidence was 140.28/100000, and the mortality was 0.086/100000. The peak incidence usually occurred between April and July, and the summit occurred in May. Scattered children accounted for 77.37%-92.00% of all cases. The peak age was 2.5 years during 2007-2009 and 1.5 years during 2010-2012. A total of 1365 laboratory-confirmed HFMD cases were reported in the 6 consecutive years, accounting for 2.98% of the gross number. Among these reports, the ratio of EV-A71 was 44.18%, and the ratio of coxsackievirus A16 (CVA16) was 46.59%. All EV-A71 strains isolated in Linyi during 2007-2012 belonged to the C4a evolutionary branch of C4 genotype. In conclusion, HFMD outbreaks occurred every year in Linyi during 2007-2012. Incidence varied significantly among different counties. The peak incidence in each year lasted from April to July. Most of the patients were children under 3 years of age, and scattered children took the highest proportion. Co-circulation of EV-A71 and CVA16 was the major cause of HFMD in each year. Since the first report of HFMD prevalence caused by EV-A71 (C4a) in 2007, the virus has been prevalent continuously in Linyi for 6 years.

To understand the clinical features of death from hand, foot and mouth disease (HFMD) and to explore the early warning index of HFMD death.A total of 41 HFMD death cases were collected as case group in Shandong province between 2009 and 2011, and another 123 serious HFMD cases were selected as control group according to the similar gender, place of origin and hospital level, with the ratio at 1:3. We investigated the general situation, clinical treatment, past medical history, clinical symptoms and signs of the ill children, and applied the conditional logistic regression to explore early warning index of HFMD death.The rate of patients who had symptoms in nervous system, digestive system, circulatory system and respiratory system were separately 90.2% (37/41), 58.5% (24/41), 53.7% (22/41) and 90.2% (37/41) in case group; and the proportions were 44.7% (55/123), 13.8% (17/123), 10.6% (13/123) and 12.2% (15/123) respectively in control group. The difference between the two groups showed statistical significance (χ(2) = 25.881, 32.791, 34.011, 86.505, P0.05). In case group, 37 patients had neurogenic pulmonary edema, 26 patients got encephalitis, 15 patients had respiratory and circulatory failure, 7 patients got pulmonary hemorrhage, 4 patients had multiple organ failure, 4 patients got myocarditis and 1 patient had cerebral hernia. According to multi-factor logistic regression analysis, the early warning indicators of HFMD death included neck resistance (case group: 34.1% (14/41), control group: 4.1% (5/123); OR = 7.145, 95%CI: 1.748 - 29.204), vomiting (case group: 58.5% (24/41), control group: 13.8% (17/123); OR = 5.632, 95%CI: 1.793 - 17.685) and increase of heart rate (case group: 53.7% (22/41), control group: 10.6% (14/123), OR = 6.370, 95%CI: 1.517 - 26.743).In the process of clinical treatment and care, we should interfere the serious HFMD patients with neck resistance, vomiting and increase of heart rate, and thereby reduce the death from HFMD.

More and more new human enteroviruses (HEVs) types were identified with the broad application of the molecular serotyping methods for enteroviruses. Since enterovirus 71 (EV71) was first reported in 1969, numerous epidemic outbreaks associated with new enteroviruses have occurred all around the world, and pose a significant threat to public health . The epidemics of hand, foot and mouth disease (HFMD) caused by EV71 infection in China have raised great concern of global scholars. This paper reviewed research progress in recent years of the molecular typing, evolution, epidemiology, and pathogenesis attributable to new enterovirus types.

Background No studies on the risk factors of 2009 pandemic influenza A (H1N1) in China have been reported. We aimed to investigate the risk factors for severe manifestations of 2009 pandemic H1N1 influenza in China Methods A case–control study with 343 severe hospitalized patients and 343 randomly selected mild controls was conducted. The diagnosis was established by assessment of clinical symptoms and confirmed by the real-time reverse-transcriptase-polymerase chain reaction assay. Severe or mild patients were classified by uniform criteria issued by the Ministry of Health in China. Results The multivariable logistic regression analysis showed that the overweight or obese subjects admitted to hospital with H1N1 influenza were more likely to experience severe manifestations. The ORs were 3.70 (95% CI: 2.04-6.72) and 35.61 (95% CI: 7.96-159.21) respectively. Subjects at age less than 5 years or older than 60 years had an increased risk of severe manifestations (OR = 21.14, 95% CI: 7.79-57.33). We also observed increased risk among subjects with longer time interval from symptom onset to hospital admission (OR = 3.26, 95% CI: 2.08-5.11) or peasants (OR = 9.79, 95% CI: 5.11-18.78). Those with chronic disorders had increased risk of severe manifestations of H1N1 influenza. Conclusion We provide evidence on the risk factors associated with severe manifestations of 2009 pandemic H1N1 influenza in a study of hospitalized subjects in China.

Here, we report a Chinese case of Creutzfeldt-Jakob disease (CJD) with a rare mutation in the prion protein gene (PRNP) leading to an exchange of amino acid from valine (Val) to isoleucine (I) at codon 203 (V203I). The 80-y-old male presented with sudden memory loss, rapid loss of vocabulary, inattention and slow responses, accompanied by dizziness, blurred vision and ataxia. Two weeks after admission, he exhibited tremor, myoclonus and bilateral Babinski signs. At the end of the clinical course, he developed severe akinetic mutism. The cerebrospinal fluid (CSF) was positive for 14-3-3 protein. Increased bilateral signal intensity in the frontal and parietal lobes was seen on diffusion-weighted imaging (DWI); periodic activity was recorded on an electroencephalogram (EEG). There was no family history of similar symptoms. The total clinical course was approximately two months.

Objective Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever caused by a tick-borne bunyavirus (SFTSV) in East Asian countries. The role of human leukocyte antigen (HLA) in resistance and susceptibility to SFTSV is not known. We investigated the correlation of HLA locus A, B and DRB1 alleles with the occurrence of SFTS. Methods A total of 84 confirmed SFTS patients (patient group) and 501 unrelated non-SFTS patients (healthy individuals as control group) from Shandong Province were genotyped by PCR-sequence specific oligonucleotide probe (PCR-SSOP) for HLA-A, B and DRB1 loci.Allele frequency was calculated and compared using χ2 test or the Fisher's exact test. A corrected P value was calculated with a bonferronis correction. Odds Ratio (OR) and 95% confidence intervals (CI) were calculated by Woolf’s method. Results A total of 11 HLA-A, 23 HLA-B and 12 HLA-DRB1 alleles were identified in the patient group, whereas 15 HLA-A, 30 HLA-B and 13 HLA-DRB1 alleles were detected in the control group. The frequencies of A*30 and B*13 in the SFTS patient group were lower than that in the control group (P = 0.0341 and 0.0085, Pc = 0.5115 and 0.252). The ORs of A*30 and B*13 in the SFTS patient group were 0.54 and 0.49, respectively. The frequency of two-locus haplotype A*30-B*13 was lower in the patient group than in the control group(5.59% versus 12.27%, P = 0.037,OR = 0.41, 95%CI = 0.18–0.96) without significance(Pc>0.05). A*30-B*13-DRB1*07 and A*02-B*15-DRB1*04 had strong associations with SFTS resistance and susceptibility respectively (Pc = 0.0412 and 0.0001,OR = 0.43 and 5.07). Conclusion The host HLA class I polymorphism might play an important role with the occurrence of SFTS. Negative associations were observed with HLA-A*30, HLA-B*13 and Haplotype A*30-B*13, although the associations were not statistically significant. A*30-B*13-DRB1*07 had negative correlation with the occurrence of SFTS; in contrast, haplotype A*02-B*15-DRB1*04 was positively correlated with SFTS., Author Summary Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever caused by a tick-borne bunyavirus (SFTSV) in East Asian countries. The role of human leukocyte antigen (HLA) in resistance and susceptibility to SFTSV is not known. In this study, we investigated the correlation of HLA locus A, B and DRB1 alleles with the occurrence of SFTS. Our results have expanded the knowledge of the association of HLA genes with SFTS. Our study may be helpful to state the relationship between the occurrence of SFTS with HLA alleles or haplotypes and provide scientific basis for study on pathogenesis and vaccine development.

To explore the characteristics of temporal distribution and epidemic trend of autumn-winter type scrub typhus using the time series analysis.Based on the data of scrub typhus collected from Shandong Diseases Reporting Information System from 2006 to 2011, both spectral analysis and moving average analysis were used to analyze the annual data of scrub typhus while scrub typhus incidence in 2012 - 2014 was forecasted. Seasonal decomposition analysis was applied to analyze the monthly data from January of 2006 to October of 2011, followed by Autoregressive Integrated Moving Average Model (ARIMA) which was constructed to forecast case number in November and December of 2011 and compared to the actual incidence.The results of spectral analysis showed that the prevalence of autumn-winter type scrub typhus had a feature of '3-year-periodicity'. A long-term up-trend was confirmed by method of moving average analysis, with annually case numbers of 310, 337 and another number of 366 forecasted for 2012 to 2014, respectively, with the annual increase rate as 9% per-year. Data from analysis of monthly data of scrub typhus showed that through multiple seasonal decomposition analysis, the results indicated that the prevalence of this disease possessed a typical autumn-winter type. The seasonality indexes for scrub typhus in October and November were 8.454 and 2.230, respectively, while others were less than 1.000. The ARIMA(0,1,1) (0,1,0)(12) model of (1-B)(1-B(12))X(t) = (1-0.811B)u(t) that was used to forecast the prevalence of autumn-winter type scrub typhus and was constructed with the residual error of 16 lags as white noise. The Box-Jenkins test statistic for the model was 3.116, giving a P value of 0.999. The model fitted the data well. Good accordance was achieved between the observed values and the forecasted values of scrub typhus in November and December of 2011 which was produced by the ARIMA model, and all observed values were within the forecasted 95%CI.The prevalence of autumn-winter type scrub typhus showed a 3-year-periodicity, with a long-term up-trend, and the case numbers of 2012 to 2014 were forecasted, rising on the end with an increasing rate of 9% per year, which occurred seasonally with October as the peak time in every year. The ARIMA(0,1,1) (0,1,0)(12) model seemed to be quite appropriate in predicting the autumn-winter type scrub typhus.

To explore the epidemic features of scrub typhus between year 2006 and 2010 in Shandong Province.Based on the data collected through Diseases Reporting Information System between year 2006 and 2010 in Shandong province, 1291 cases of scrub typhus were selected. The study described the population distribution features of the scrub typhus patients, and explored the temporal and spatial distribution features of the disease by applying the methods of spatial thematic mapping, inverse distance weighted, spatial autocorrelation analysis, spatial clustering analysis, temporal clustering analysis and spatial variation analysis in temporal trends based on Geographic Information software (ArcGIS 9.3) and Spatial Clustering Software (SatScan 7.0).The onset age of the 1291 patients ranged between 1 and 92 years old.639 out of 1291 patients were over 55 years old, accounting for 49.5%.640 patients were male and the other 651 patients were female, occupying 49.6% and 50.4% respectively. The gender ratio was 1:1.02. Patients were found in farmers, workers, students and preschool children. However, most of the cases were farmers, up to 84.8% (1095/1291). Global Moran's I index was 0.324 (P0.01). The local Moran's I index in 8 locations were proved to have statistical significance (P0.01); all of which were H-H clustering areas. Gangcheng (38 cases), Laicheng (154 cases), Xintai (160 cases) and Donggang (105 cases) were important locations, whose local Moran's I index were 2.111, 1.642, 1.277 and 0.775 respectively. The clustering period of scrub typhus in respective year were as follows: 2006.09.23 - 2006.11.20 (202 cases), 2007.10.02 - 2007.11.11 (197 cases), 2008.09.30 - 2008.11.07 (302 cases), 2009.09.25 - 2009.11.10 (204 cases), and 2010.10.05 - 2010.11.13 (226 cases), whose RR values were separately 45.55, 34.60, 50.64, 53.09 and 79.84 (P0.01). Two spatial clustering area were found in the study, one was the area centered Taian and Xintai with radiation radius at 58.28 km (542 cases) and the other one was the area centered Rizhao and Donggang with radiation radius at 22.68 km (134 cases), whose RR values were 4.52 and 3.96 (P0.01). The spatial features of the two clustering areas were inland low hills area and coastal hills area. The highest annual growth rate of the disease was 45.04%, found in the area centered Linyi and Mengyin counties, with the radiation radius at 45.82 km. The RR value was 3.68 (P0.01).The majority of the scrub typhus patients were middle-aged and elderly farmers. The epidemic peak was between the last 10 days of September and the first 10 days of November. A positive spatial correlation of the disease was found; and most cases clustered in inland low hills area and costal hills area; especially the area around Linyi and Mengyin, with the highest annual growth rates of the disease.