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Practice of Infection Prevention and control Strategies in Risk departments during the COVID-19 Epidemic

Advances in infectious diseases 2024年第1期14卷 1-12页

作者： Minfang Wang Wenyi Ye Jiefeng Huang Yuexian Zhu Xuxia Yu Hao Huang Fang Xu Bo Jin Ying Yang Tieer Gan department of Hospital Infection control The First Affiliated Hospital of Zhejiang Chinese Medical University Zhejiang Provincial Hospital of Traditional Chinese Medicine Hangzhou China Medical department The First Affiliated Hospital of Zhejiang Chinese Medical University Zhejiang Provincial Hospital of Traditional Chinese Medicine Hangzhou China department of Orthopaedics & Traumatology The First Affiliated Hospital of Zhejiang Chinese Medical University Zhejiang Provincial Hospital of Traditional Chinese Medicine Hangzhou China department of Stomatology The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine) Hangzhou China Nursing department The First Affiliated Hospital of Zhejiang Chinese Medical University Zhejiang Provincial Hospital of Traditional Chinese Medicine Hangzhou China State Key Laboratory for Diagnosis and Treatment of infectious diseases The First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China

Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to provide advice and guidance in risk departments. Methods: According to the latest plan of diagnosis and treatment, prevention and control issued by the National health Commission, expert advice and consensus, combined with the actual situation in our hospital, a series of infection prevention and control measures of COVID-19 in risk department was formulated. Results: During the epidemic period, the prevention and control measures of nine risk departments including emergency operation, anesthesiology, endoscopy center, blood purification center, otolaryngology, stomatology, medical imaging department, medical cosmetology department and pulmonary function room were established from six aspects, including pre-examination and screening, medical technology control, personnel management, personal protection, environmental disinfection, medical waste disposal, etc. Conclusion: During the epidemic period, the infection prevention and control strategy of risk departments is one of the key links to control the spread of the epidemic, and risk departments must pay attention to and strictly implement various infection prevention and control measures.

关键词： COVID-19 Risk department Infection Prevention and control Strategy Practice

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Real-world effectiveness and safety of direct-acting antivirals in hepatitis C virus patients with mental disorders

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World Journal of Gastroenterology 2023年第25期29卷 4085-4098页

作者： Dorota Dybowska Dorota Zarebska-Michaluk Piotr Rzymski Hanna Berak Beata Lorenc Marek Sitko Michal Dybowski Wlodzimierz Mazur Magdalena Tudrujek-Zdunek Justyna Janocha-Litwin Ewa Janczewska Jakub Klapaczynski Anna Parfieniuk-Kowerda Anna Piekarska Barbara Sobala-Szczygiel Krystyna Dobrowolska Malgorzata Pawlowska Robert Flisiak department of infectious diseases and Hepatology Faculty of MedicineNicolaus Copernicus UniversityBydgoszcz 85-030Poland department of infectious diseases and Allergology Jan Kochanowski UniversityKielce 25-317Poland department of infectious diseases Provincial HospitalKielce 25-317Poland department of Environmental Medicine University of Medical SciencesPoznań60-806Poland Integrated Science Association Universal Scientific Education and Research NetworkPoznań60-806Poland Outpatient Clinic Hospital for Infectious Diseases in WarsawWarsaw 01-201Poland Pomeranian Center of infectious diseases Medical UniversityGdańsk 80-214Poland department of infectious and Tropical diseases Jagiellonian UniversityKraków 31-088Poland Utrecht University School of Economics Utrecht UniversityUtrecht 3584 ECNetherlands Clinical department of infectious diseases Medical University of SilesiaChorzów 41-500Poland department of infectious diseases Medical University of LublinLublin 20-059Poland department of infectious diseases and Hepatology Medical University of WrocławWrocław 50-367Poland department of Basic Medical Sciences Faculty of Public Health in BytomMedical University of SilesiaKatowice 40-007Poland department of Internal Medicine and Hepatology Central Clinical Hospital of the Ministry of Internal Affairs and AdministrationWarsaw 00-241Poland department of infectious diseases and Hepatology Medical University of BiałystokBiałystok 15-089Poland department of infectious diseases and Hepatology Medical University ofŁódźŁódź91-347Poland department of infectious diseases and Hepatology Medical University of SilesiaBytom 41-902Poland Collegium Medicum Jan Kochanowski UniversityKielce 25-317Poland

BACKGROUND It is estimated that 58 million people worldwide are infected with the hepatitis C virus(HCV).Patients with severe psychiatric disorders could not be treated with previously available interferon-based therapies due to their unfavorable side effect *** has changed with the introduction of direct-acting antivirals(DAA),although their real-life tolerance and effectiveness in patients with different psychiatric disorders remain to be *** To evaluate the effectiveness and safety of DAA in patients with various mental *** This was a retrospective observational study encompassing 14272 patients treated with DAA for chronic hepatitis C in 22 Polish hepatology centers,including 942 individuals diagnosed with a mental disorder(anxiety disorder,bipolar affective disorder,depression,anxiety-depressive disorder,personality disorder,schizophrenia,sleep disorder,substance abuse disorder,and mental illness without a specific diagnosis).The safety and effectiveness of DAA in this group were compared to those in a group without psychiatric illness(n=13330).Antiviral therapy was considered successful if serum ribonucleic acid(RNA)of HCV was undetectable 12 wk after its completion[sustained virologic response(SVR)].Safety data,including the incidence of adverse events(AEs),serious AEs(SAEs),and deaths,and the frequency of treatment modification and discontinuation,were collected during therapy and up to 12 wk after treatment *** entire study population was included in the intent-to-treat(ITT)***-protocol(PP)analysis concerned patients who underwent HCV RNA evaluation 12 wk after completing *** Among patients with mental illness,there was a significantly higher percentage of men,treatmentnaive patients,obese,human immunodeficiency virus and hepatitis B virus-coinfected,patients with cirrhosis,and those infected with genotype 3(GT3)while infection with GT1b was more frequent in the population without psychia

关键词： Hepatitis C Mental disorders Direct-acting antivirals

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2022 Multiple-country Monkeypox Outbreak and Its Importation Risk into China:An Assessment Based on the Risk Matrix Method

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Biomedical and Environmental Sciences 2022年第10期35卷 878-887页

作者： DU Min ZHANG Shi Mo SHANG Wei Jing YAN Wen Xin LIU Qiao QIN Chen Yuan LIU Min LIU Jue department of Epidemiology and Biostatistics School of Public HealthPeking UniversityBeijing 100191China Institute for Global health and Development Peking UniversityBeijing 100871China Global Center for infectious Disease and Policy Research&Global health and infectious diseases Group Peking UniversityBeijing 100191China

Objective To analyze the 2022 multiple-country monkeypox outbreak and assess its importation risk into *** Data was from United States Centers for Disease control and *** described the global epidemic and calculated concentration index to measure economic-related *** risk into China was evaluated and ranked by using risk matrix method and Borda count method,*** As of July 29,2022,of 79 countries or territories,39(49.37%,39/79),17(21.52%,17/79),6(7.59%,6/79),12(15.19%,12/79),and 5(6.33%,5/79)country or territories identified cases1,*** were economic-related health disparities exist in the distribution of cases(the concentration index=0.42,P=0.027),and the inequality disadvantageous to the rich(pro-poor).There were 12(15.38%,12/78),15(19.23%,15/78),6(7.69%,6/78),and 45(57.69%,45/78)countries or territories with extremely high,high,moderate,and low importation *** States and France ranked first with the highest Borda points of 156,and counts of *** Of 78 countries or territories,the key attention need be paid to the United States and France,*** the epidemic progresses,preparing prevention and control measures to further reduce importation risk was crucial.

关键词： Monkeypox Importation risk China Risk matrix method

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SARS-CoV-2 variants,immune escape,and countermeasures

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Frontiers of Medicine 2022年第2期16卷 196-207页

作者： Yi Zhang Haocheng Zhang Wenhong Zhang department of infectious diseases National Medical Center for Infectious DiseasesShanghai Key Laboratory of Infectious Diseases and Biosafety Emergency ResponseHuashan HospitalFudan UniversityShanghai 200040China State Key Laboratory of Genetic Engineering and Institute of Biostatistics School of Life SciencesFudan UniversityShanghai 200040China

Coronavirus disease 2019(COVID-19)has become a global pandemic ***-CoV-2 variants have aroused great concern and are expected to continue *** many countries have promoted rollout vaccination,the immune barrier has not yet been fully established,indicating that populations remain susceptible to *** this review,we summarize the literature on variants of concern and focus on the changes in their transmissibility,pathogenicity,and resistance to the immunity constructed by current ***,we analyzed relationships between variants and breakthrough infections,as well as the paradigm of new variants in countries with high vaccination *** transmission,continuing to strengthen variant surveillance,and combining nonpharmaceutical intervention measures and vaccines are necessary to control these variants.

关键词： SARS-CoV-2 COVID-19 vaccine immune escape breakthrough prevention

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Measles,mumps,and rubella revaccination in children after completion of chemotherapy and hematopoietic stem cell transplantation:a single-center prospective efficacy and safety analysis

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World Journal of Pediatrics 2023年第11期19卷 1062-1070页

作者： Min Wang Qing Yuan Peng-Fei Deng Yi Fei Hua Zhang Fen Zhou Wen-Juan Chen Qing Cao Jing Chen Yi-Jin Gao department of Hematology and Oncology Shanghai Children’s Medical CenterSchool of MedicineShanghai Jiao Tong UniversityNo.1678 Dongfang RoadPudong DistrictShanghai200127China Center for diseases control and Prevention Fudan University Pudong Institute of Preventive MedicineShanghai200136China department of infectious diseases Shanghai Children’s Medical CenterShanghai Jiao Tong University School of MedicineShanghaiChina

Background Chemotherapy and hematopoietic stem cell transplantation(HSCT)can damage the immune system,and may result in a loss of protection from infectious *** study aimed to evaluate the impact of these treatments on the decrease in antibody titers of the measles,mumps,and rubella(MMR)vaccine and seroconversion post-revaccination of *** After completion of treatment for primary diseases,participants received an MMR *** titers for MMR before revaccination were analyzed for all 110 *** revaccination,68 participants received a follow-up evaluation of antibody titer and adverse *** Multivariable analysis showed that therapeutic schedules were the only factor correlated with lack of antibody titers for measles after completing treatment(P=0.008),while for mumps and rubella,no statistically significant difference was ***,our study clearly demonstrated positive seroconversion rates for measles(97.5%),mumps(81.0%),and rubella(93.2%),with antibody levels rising across the board and peaking at around 6 months following ***,6 months after revaccination,a downtrend of antibody titer levels was observed,which is comparatively earlier than the waning immunity observed in healthy ***,we found MMR revaccination to be safe,with only a single adverse reaction(local pain at the injection site)*** MMR revaccination is immunogenic for the *** suggest periodic monitoring of antibody titers,in addition to a booster vaccination,although the optimal timing of booster vaccination remains to be investigated further.

关键词： Adjuvant Chemotherapy Children Hematopoietic stem cell transplantation Immunogenicity Mumps-measles-rubella.Vaccine

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Immunomodulatory and Antiviral Therapy Improved Functional Cure Rate in CHB Patients with High HBsAg Level Experienced NA

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Journal of Clinical and Translational Hepatology 2023年第5期11卷 1003-1010页

作者： Hongyu Jia Guodong Yu Jiong Yu Xiaoli Zhang Lisha Yang Bin Wang Jiming Zhang Lang Bai Xinxin Zhang Kai Wang Ping Zhao Dongliang Yang Yingren Zhao Yanyan Yu Yimin Zhang Jueqing Gu Chanyuan Ye Huan Cai Yingfeng Lu Dairong Xiang Liang Yu Jiangshan Lian Jianhua Hu Shanyan Zhang Ciliang Jin Yida Yang State Key Laboratory for Diagnosis and Treatment of infectious diseases National Clinical Research Center for Infectious DiseasesNational Medical Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalZhejiang University School of MedicineResearch Units of Infectious disease and MicroecologyChinese Academy of Medical SciencesHangzhouZhejiangChina department of infectious diseases Branch of the First Affiliated Hospital of Zhejiang University School of MedicineNingboZhejiangChina Key Laboratory of Medical Molecular Virology(MOE/NHC/CAMS) Shanghai Institute of Infectious Disease and BiosecurityShanghaiChina department of infectious diseases Huashan HospitalFudan UniversityShanghaiChina Center of infectious diseases West China Hospital of Sichuan UniversityChengduSichuanChina department of infectious Disease Research Laboratory of Clinical VirologyRuijin HospitalShanghai Jiao Tong UniversitySchool of MedicineShanghaiChina department of Hepatology Qilu Hospital of Shandong UniversityJinanShandongChina International Center for Liver Disease Treatment 302 Hospital BeijingBeijingChina department of infectious diseases Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina department of infectious diseases The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxiChina department of infectious diseases Peking University First HospitalBeijingChina

Background and Aims:A functional cure,or hepatitis B virus(HBV)surface antigen(HBsAg)loss,is difficult to achieve in patients with hepatitis B virus e antigen(HBeAg)-positive chronic hepatitis *** HBV vaccine and granulocyte-macrophage colony-stimulating factor(GM-CSF)have been reported to help reduce HBsAg levels and promote HBsAg *** this prospective randomized trial,we evaluated HBsAg loss in patients receiving pegylated interferon α2b(PEGIFN-α2b)and tenofovir disoproxil fumarate(TDF),with and without GM-CSF and HBV ***:A total of 287 patients with HBeAg positive chronic hepati-tis B and seroconversion after nucleot(s)ide analog treat-ment were assigned randomly to three treatment groups for 48 weeks,TDF alone(control),PEGIFN-α2b+TDF,and PEGIFN-α2b+TDF+GM-CSF+HBV *** prima-ry endpoints were the proportions of patients with HBsAg loss and seroconversion at 48 and 72 ***/ts:The cumulative HBsAg loss rates in the control,PEGIFN-α2b+TDF,and PEGIFN-α2b+TDF+GM-CSF+HBV vaccine groups at week 48 were 0.0%,28.3%,and 41.1%,*** cumulative HBsAg seroconversion rates in these groups at week 48 were 0.0%,21.7%,and 33.9%,*** regression analysis showed that GM-CSF use plus HBV vaccination was significantly associated with HBsAg loss(p=0.017)and seroconversion(p=0.030).Con-clusions:In patients with HBeAg-positive chronic hepatitis B and seroconversion after nucleot(s)ide analog treatment,immunomodulatory/antiviral treatment regimens effective-ly improved HBsAg loss,and the regimen including GM-CSF and HBV vaccination was most effective.

关键词： Chronic hepatitis B HBsAg loss Functional cure Immunomodulatory/antiviral therapy Pegylated interferon-α2b Tenofovir disoproxil fumarate Granulacyte-macrophage colony-stimulating factor Hepatitis B virus vaccine

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Longitudinal analysis of immune reconstitution and metabolic changes in women living with HIV:A real-world observational study

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Chinese Medical Journal 2023年第18期136卷 2168-2177页

作者： Xiaolei Wang Jiang Xiao Leidan Zhang Ying Liu Na Chen Meiju Deng Chuan Song Tingting Liu Yuanyuan Zhang Hongxin Zhao Clinical and Research Center of infectious diseases Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Institute of infectious diseases Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Beijing Key Laboratory of Emerging infectious diseases Institute of Infectious DiseasesBeijing Ditan HospitalCapital Medical UniversityBeijing 100015China National Center for infectious diseases Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China department of Infection Beijing Ditan HospitalPeking UniversityBeijing 100015China

Background:Women comprise more than half of people living with human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS)worldwide and incomplete immune recovery and metabolic abnormalities affect them *** of HIV antiretroviral therapy(ART)have a low female representation in *** aimed to investigate immune reconstitution and metabolic changes of female HIV-positive cohort in China ***:HIV-positive women who initiated ART from January 2005 to June 2021 and were followed up regularly at least once a year were included in this *** indicators(cluster of differentiation 4[CD4]counts and CD8 counts),viral load(VL),and metabolic indicators were collected at *** data were collected from the China Disease Prevention and control Information System(CDPCIS).VL was tested half a year,1 year after receiving ART,and every other year subsequently according to local ***4/CD8 ratio normalization was considered as the primary outcome and defined as a value≥*** rate and probability of CD4/CD8 ratio normalization were estimated through per 100 person-years follow-up(PYFU)and Kaplan-Meier curve,*** Cox regression was used to identify independent risk factors associated with CD4/CD8 ratio *** further studied the rate of dyslipidemia,hyperuricemia,diabetes,liver injury,and renal injury after ART initiation with the chi-squared tests or Fisher’s exact probability tests,and a generalized estimating equation model was used to analyze factors of dyslipidemia and ***:A total of 494 female patients with HIV/AIDS started ART within 16 years from January 2005 to June 2021,out of which 301 women were enrolled with a median duration of ART for 4.1 years(interquartile range,2.3-7.0 years).The overall incidence rate of CD4/CD8 ratio normalization was 8.9(95%confidence interval[CI],7.4-10.6)per 100 PYFU,and probabilities of CD4/CD8 normalization after initiatin

关键词： Women Human immunodeficiency virus Immune reconstitution CD4/CD8 ratio HIV

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Calcium/calcimimetic via calcium-sensing receptor ameliorates cholera toxin-induced secretory diarrhea in mice

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World Journal of Gastroenterology 2024年第3期30卷 268-279页

作者： Lie-Qi Tang Johnathan Fraebel Shi Jin Steven P Winesett Jane Harrell Wen-Han Chang Sam Xianjun Cheng department of Pediatrics University of FloridaGainesvilleFL 32610United States College of Medicine University of FloridaGainesvilleFL 32610United States Applied Physiology and Kinesiology University of FloridaGainesvilleFL 32610United States Brain Rehabilitation Research Center Malcom Randall VA Medical CenterGainesvilleFL 32610United States department of Medicine Endocrine Research UnitVeterans Affairs Medical CenterUniversity of CaliforniaSan FranciscoSan FranciscoCA 94121United States department of Pediatric Gastroenterology Hepatologyand NutritionUniversity of Florida Shands Children’s HospitalGainesvilleFL 32608United States

BACKGROUND Enterotoxins produce diarrhea through direct epithelial action and indirectly by activating the enteric nervous ***-sensing receptor(CaSR)inhibits both *** latter has been well documented in vitro but not in *** hypothesis to be tested was that activating CaSR inhibits diarrhea in *** To determine whether CaSR agonists ameliorate secretory diarrhea evoked by cholera toxin(CTX)in *** CTX was given orally to C57BL/6 mice to induce *** and calci-mimetic R568 were used to activate *** maximize their local intestinal actions,calcium was administered luminally via oral rehydration solution(ORS),whereas R568 was applied serosally using an intraperitoneal *** verify that their actions resulted from the intestine,effects were also examined on Cre-lox intestine-specific CaSR *** outcome was measured biochemically by monitoring changes in fecal Cl-or clinically by assessing stool consistency and weight *** CTX induced secretory diarrhea,as evidenced by increases in fecal Cl-,stool consistency,and weight loss following CTX exposure,but did not alter CaSR,neither in content nor in ***,calcium and R568 were each able to ameliorate diarrhea when applied to diseased *** CaSR involvement is suggested by gene knockout experiments where the anti-diarrheal actions of R568 were lost in intestinal epithelial CaSR knockouts(villinCre/Casrflox/flox)and neuronal CaSR knockouts(nestinCre/Casrflox/flox).CONCLUSION Treatment of acute secretory diarrheas remains a global *** advances in diarrhea research,few have been made in the realm of diarrhea *** therapy has remained the standard of care,although it does not halt the losses of intestinal fluid and ions caused by *** is no cost-effective therapeutic for *** and other studies suggest that adding calcium to ORS or using calcimimetics to activate intestinal CaSR might

关键词： Cholera Enteric nervous system Secretory diarrhea Oral rehydration solution Calcium-sensing receptor Gene knockout

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Genomic Epidemiology of ST34 Monophasic Salmonella enterica Serovar Typhimurium from Clinical Patients from 2008 to 2017 in Henan,China

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Engineering 2022年第8期8卷 34-44页

作者： Yujiao Mu Ruichao Li Pengcheng Du Pei Zhang Yan Li Shenghui Cui Séamus Fanning Li Bai Henan Center for Disease control and Prevention Zhengzhou 450016China Key Laboratory of Food Safety Risk Assessment&China National Center for Food Safety Risk Assessment National Health Commission of the People’s Republic of ChinaBeijing 100021China Jiangsu Co-Innovation Center for Prevention and control of Important Animal infectious diseases and Zoonoses College of Veterinary MedicineYangzhou UniversityYangzhou 225009China Beijing Key Laboratory of Emerging infectious diseases Institute of Infectious DiseasesBeijing Ditan HospitalCapital Medical UniversityBeijing 100015China department of Food Science National Institutes for Food and Drug ControlBeijing 100050China Centre for Food Safety School of Public HealthPhysiotherapy and Sports ScienceUniversity College DublinDublin D04 N2E5Ireland

Salmonella enterica serovar 4,[5],12:i:-(S.4,[5],12:i:-)is a monophasic variant of Salmonella enterica serovar Typhimurium that has emerged as a global serovar causing public health *** date,the epidemiology and genomic characterization of this pathogen in China have not been well *** investigated the prevalence,antimicrobial resistance(AMR)phenotypes,and population genomics of sequence type 34(ST34)S.4,[5],12:i:-among cases of human salmonellosis in Henan Province,China.A total of 100 ST34 S.4,[5],12:i:-isolates were studied from 2008 to 2017 and found mostly resistant to ampicillin(AMP),streptomycin(STR),sulfonamides(SUL),and tetracycline(TET)(ASSu T).Bayesian phylogenetic analysis demonstrated that isolates identified in China were mostly related to the European lineage and evolved into two major clades with different resistance genes and plasmid ***,clade 1 showed a significantly higher rate of mutations in gyr A and plasmid-mediated quinolone resistance *** carrying of the resistance-containing region(encoding R-type ASSu T),including bla(conferring resistance to AMP),str AB(STR),sul2(SUL),and tet(B)(TET)inserted into the flj BA operon,was responsible for most of the monophasic variants in clade *** HI2 plasmids were the dominant multi-drug resistance mobile genetic elements accounting for the transmission of acquired resistance genes in this serovar,and these were more prevalent in clade *** findings highlighted the increasing prevalence of multi-drug resistant S.4,[5],12:i:-in China,along with the differential characteristics of resistance gene acquisition among various *** on our data,control measures are required to address the spread of this zoonotic *** owing to its potential origin in food-producing animals,a"One health"approach,should be implemented to support surveillance whilst informing interventional strategies.

关键词： Salmonella Typhimurium monophasic variant ST34 Prevalence Phylogenetic analysis Chinese lineages

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The frst avian infuenza A (H7N9) viral infection in humans in Zhejiang Province, China: a death report

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Frontiers of Medicine 2013年第3期7卷 333-344页

作者： Enfu Chen Fenjuan Wang Huakun Lv Yanjun Zhang Hua Ding Shelan Liu Jian Cai Li Xie Xiaoping Xu Chengliang Chai Haiyan Mao Jimin Sun Junfen Lin Zhao Yu Lianhong Li Zhiping Chen Shichang Xia department of infectious diseases Zhejiang Center for Disease Control and Prevention department of infectious diseases Xiaoshan District Center for Disease Control and Prevention department of infectious diseases Hangzhou Center for Disease Control and Prevention department of infectious diseases Jiande Center for Disease Control and Prevention

This study reports the frst death caused by a novel avian infuenza A(H7N9)virus in Zhejiang Province,*** patient had chronic hepatitis B and history of exposure to *** patient initially complained of diarrhea and infuenza-like symptoms on March 7 and 14 *** disease progressed to severe pneumonia,sustained hypoxia,and coagulation *** patient died on March 27 because of respiratory failure,multiple organ failure,and disseminated intravascular coagulation without oseltamivir *** H7N9 virus from Zhejiang is highly similar to isolates obtained from Shanghai,Jiangsu,Anhui,*** of hemagglutinin,neuramidinase,and matrix genes indicated that the isolates share the same avian origin,have low virulence,and are sensitive to oseltamivir,but are resistant to *** the isolate that caused the fatality exhibited substitution of Q226I in the HA gene,which indicates a potentially enhanced human *** secondary transmission rate was 1.6%(2/125).Only two health workers presented with infuenza-like symptoms,and they subsequently tested negative for H7N9 *** conclusion,underlying disease,late diagnosis,and untimely antiviral treatment are possible high-risk factors for infections and death caused by the lowpathogenicity avian infuenza A(H7N9).Person-to-person transmission of the H7N9 virus was not detected among close contacts,but such transmission should be investigated in the *** and enhancing surveillance will help in the early discovery and diagnosis of suspected cases,which will reduce the number of severe cases and deaths.

关键词： avian influenza A (H7N9) virus epidemiology contacts person-to-person transmission

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