目的了解中国血液病患者中性粒细胞缺乏（粒缺）伴发热的发生率、临床和微生物学特征及危险因素。方法前瞻性研究2014年10月20日至2015年3月20日来自全国11家血液病中心发生粒缺伴发热的连续血液病患者发热情况及危险性因素。结果1 139...目的了解中国血液病患者中性粒细胞缺乏（粒缺）伴发热的发生率、临床和微生物学特征及危险因素。方法前瞻性研究2014年10月20日至2015年3月20日来自全国11家血液病中心发生粒缺伴发热的连续血液病患者发热情况及危险性因素。结果1 139例患者共发生784例次粒缺伴发热，粒缺持续21 d时发热的累积发生率为81.9%。多因素分析显示中心静脉置管（P〈0.001，HR= 3.407，95% CI 2.276-4.496 ）、胃肠道黏膜炎（P〈0.001，HR=10.548, 95% CI 3.245-28.576）、既往90 d内暴露于广谱抗生素（P〈0.001，HR=3.582，95% CI 2.387-5.770）和粒缺持续时间〉7 d （P〈0.001，HR= 4.194，95% CI 2.572-5.618）是粒缺伴发热的危险因素。无任何危险因素、具备1项、2项、3-4项危险因素患者发热的累计发生率依次增加（35.4%、69.2%、86.1%及95.6%，P〈0.001）。784例次粒缺伴发热中，不明原因发热253例次（32.3%），临床证实的感染429例次（54.7%），微生物学证实的感染102例次（13.0%）。最常见的感染部位依次为肺（388例次，49.5%）、上呼吸道（159例次，16.0%）、肛周组织（77例次，9.8%）、血流（60例次，7.7%）。最常见的病原菌为革兰阴性菌（44.54%），其次为革兰阳性菌（37.99%）和真菌（17.47%）。发热与未发热患者相比，两组之间总体病死率差异无统计学意义（9.2%对4.8%，P=0.099）。多因素分析显示年龄〉40岁（P=0.047 ，HR=5.000 ，95% CI 0.853-28.013 ）、血流动力学不稳（P=0.001，HR=13.185, 95% CI 2.983-54.915）、既往耐药菌的定植或感染（P=0.005 ，HR=28.734， 95% CI 2.921-313.744）、血流感染（P=0.038 ，HR=9.715, 95% CI 1.110-81.969）和肺部感染（P=0.031， HR=25.905, 95% CI 1.381-507.006）是与总体死亡相关的危险因素。展开更多
African swine fever(ASF)is a devastating infectious disease in swine that is severely threatening the global pig industry.An efficacious vaccine is urgently required.Here,we used the Chinese ASFV HLJ/18 as a backbone ...African swine fever(ASF)is a devastating infectious disease in swine that is severely threatening the global pig industry.An efficacious vaccine is urgently required.Here,we used the Chinese ASFV HLJ/18 as a backbone and generated a series of genedeleted viruses.The virulence,immunogenicity,safety,and protective efficacy evaluation in specific-pathogen-free pigs,commercial pigs,and pregnant sows indicated that one virus,namely HLJ/18-7GD,which has seven genes deleted,is fully attenuated in pigs,cannot convert to the virulent strain,and provides complete protection of pigs against lethal ASFV challenge.Our study shows that HLJ/-18-7GD is a safe and effective vaccine against ASFV,and as such is expected to play an important role in controlling the spread of ASFV.展开更多
Severe fever with thrombocytopenia syndrome （SFTS） is an emerging infectious disease caused by SFTS virus （SFTSV）. SFTSV is associated with a high mortality rate and has been reported in China, South Korea and Jap...Severe fever with thrombocytopenia syndrome （SFTS） is an emerging infectious disease caused by SFTS virus （SFTSV）. SFTSV is associated with a high mortality rate and has been reported in China, South Korea and Japan. SFTSV undergoes rapid changes owing to evolution, gene mutations, and reassortment between different strains of SFTSV. In this review, we summarize the recent cases and general properties of SFTS, focusing on the epidemiology, genetic diversity, clinical features, and diagnostics of SFTSV in China. From 2010 to October 2016, SFTS cases were reported in 23 provinces of China, with increased numbers yearly. Infection and death cases are mainly found in central China, where the Haemaphysalis Iongicornis ticks are spread. The national average mortality rate of SFTS infection was 5.3%, with higher risk to elder people. The main epidemic period was from May to July, with a peak in May. Thus, SFTS reminds a significant public health problem, and development of prophylactic vaccines and effective antiviral drugs will be highly needed.展开更多
African swine fever virus(ASFV)has been circulating in China for more than two years,and it is not clear whether the biological properties of the virus have changed.Here,we report on our surveillance of ASFVs in seven...African swine fever virus(ASFV)has been circulating in China for more than two years,and it is not clear whether the biological properties of the virus have changed.Here,we report on our surveillance of ASFVs in seven provinces of China,from June to December,2020.A total of 22 viruses were isolated and characterized as genotype II ASFVs,with mutations,deletions,insertions,or short-fragment replacement occurring in all isolates compared with Pig/HLJ/2018(HLJ/18),the earliest isolate in China.Eleven isolates had four different types of natural mutations or deletion in the EP402R gene and displayed a nonhemadsorbing(non-HAD)phenotype.Four isolates were tested for virulence in pigs;two were found to be as highly lethal as HLJ/18.However,two non-HAD isolates showed lower virulence but were highly transmissible;infection with 106 TCID50 dose was partially lethal and caused acute or sub-acute disease,whereas 103 TCID50 dose caused non-lethal,sub-acute or chronic disease,and persistent infection.The emergence of lower virulent natural mutants brings greater difficulty to the early diagnosis of ASF and creates new challenges for ASFV control.展开更多
Hantaviruses are comprised of tri-segmented negative sense single-stranded RNA, and are members of the Bunyaviridae family. Hantaviruses are distributed worldwide and are important zoonotic pathogens that can have sev...Hantaviruses are comprised of tri-segmented negative sense single-stranded RNA, and are members of the Bunyaviridae family. Hantaviruses are distributed worldwide and are important zoonotic pathogens that can have severe adverse effects in humans. They are naturally maintained in specific reservoir hosts without inducing symptomatic infection. In humans, however,hantaviruses often cause two acute febrile diseases, hemorrhagic fever with renal syndrome(HFRS) and hantavirus cardiopulmonary syndrome(HCPS). In this paper, we review the epidemiology and epizootiology of hantavirus infections worldwide.展开更多
Background Despite the recent advances in medicine, fever of unknown origin （FUO） remains a diagnostic and therapeutic challenge even to expert physicians. To increase the knowledge of FUO, we conducted a retrospect...Background Despite the recent advances in medicine, fever of unknown origin （FUO） remains a diagnostic and therapeutic challenge even to expert physicians. To increase the knowledge of FUO, we conducted a retrospective study to investigate the causes of FUO and the change of major causes of FUO during the past 26 years. Methods The clinical data were retrospectively analyzed from 997 patients with FUO hospitalized at the Peking Union Medical College Hospital （PUMCH） between January 2004 and October 2010. Furthermore, the results were compared to that reported in previous studies of FUO in PUMCH since 1985. Results Of the 997 FUO cases, definite diagnosis was eventually achieved in 797 （79.9%） patients. The most common cause of FUO was infectious diseases （479 cases, 48.0%）, with tuberculosis accounting for 45.3% （217/479） of the cases of infections. One hundred and sixty-eight （16.9%） patients were diagnosed with connective tissue diseases, with Still＇s disease and vasculitis accounted for 31.5% （53/168） and 24.4% （41/168） of this category, respectively. Neoplasms and miscellaneous causes were found in 7.9% （79/997） and 7.1% （71/997）, respectively. However, no definite diagnosis had been made in the remaining 200 （20.1%） cases until they were discharged from the hospital. Conclusions During different periods, infectious diseases, especially tuberculosis, were the leading etiology of FUO and the proportion of tuberculosis had no significant difference. While the frequency of neoplasms was descending, the proportion of lymphoma in neoplasm was ascending; the frequency of undiagnosed＇cases was increasing, but in most FUO cases the causes can be diagnosed eventually after careful analysis of clinical data.展开更多
Purpose To summarize the major achievements of Chinese work on the epid emiology and prevention of hemorrhagic fever with renal syndrome (HFRS) in recen t years, and to give a general review on the present situation ...Purpose To summarize the major achievements of Chinese work on the epid emiology and prevention of hemorrhagic fever with renal syndrome (HFRS) in recen t years, and to give a general review on the present situation of HFRS in China.Data sources Reviews and papers published in Chinese journals, relevant to the objectives, written or collected by the author; and the research work of the author.Study selection An outline was drafted according to the purpose given a bove, and the relevant materials and data were grouped together into different i tems outlined.Data extraction All the materials and data extracted were published or specially assessed.Results HFRS was first recognized in the northeastern China in 1931. It has been found prevalent also in many other parts of China since 1955, and p resently, 28 out of 31 provinces (autonomous regions, or municipalities) have b een proved to be its endemic areas. The total number of cases is 1?256?431 from 1950 to 1997, with 44?304 death (3.53%). 50-100 thousands of cases co uld be registered annually since 1981 when the presence of the Rattus type HFRS wa s first identified serologically in China, with the highest peak in 1986 ( 115 ?985 cases). Three types of endemicity have been differentiated: the Apodemus type, the Rattus type and the mixed type of the two, by their peculiar season al distributions of cases and by methods of serotyping (HI, MAbs serotyping kits ). The epidemiologic features of the Rattus type HFRS are quite different from that of the Apodemus type. 67 species of vertebrates were found to harbor hanta virus antigen or antibodies, but the chief or primary reservoir hosts are A podemus agrarius and Rattus norveg icus only. Besides the commonly recognized enzootic mode of transmission (via co ntact s with the reservoir rodents or their excreta), mite transmission (including cer tain species of gamasid mites, and chigger mites) has been identified as the po tential vectors and reservoir hosts with HFRS. Vertical transmission展开更多
文摘目的了解中国血液病患者中性粒细胞缺乏（粒缺）伴发热的发生率、临床和微生物学特征及危险因素。方法前瞻性研究2014年10月20日至2015年3月20日来自全国11家血液病中心发生粒缺伴发热的连续血液病患者发热情况及危险性因素。结果1 139例患者共发生784例次粒缺伴发热，粒缺持续21 d时发热的累积发生率为81.9%。多因素分析显示中心静脉置管（P〈0.001，HR= 3.407，95% CI 2.276-4.496 ）、胃肠道黏膜炎（P〈0.001，HR=10.548, 95% CI 3.245-28.576）、既往90 d内暴露于广谱抗生素（P〈0.001，HR=3.582，95% CI 2.387-5.770）和粒缺持续时间〉7 d （P〈0.001，HR= 4.194，95% CI 2.572-5.618）是粒缺伴发热的危险因素。无任何危险因素、具备1项、2项、3-4项危险因素患者发热的累计发生率依次增加（35.4%、69.2%、86.1%及95.6%，P〈0.001）。784例次粒缺伴发热中，不明原因发热253例次（32.3%），临床证实的感染429例次（54.7%），微生物学证实的感染102例次（13.0%）。最常见的感染部位依次为肺（388例次，49.5%）、上呼吸道（159例次，16.0%）、肛周组织（77例次，9.8%）、血流（60例次，7.7%）。最常见的病原菌为革兰阴性菌（44.54%），其次为革兰阳性菌（37.99%）和真菌（17.47%）。发热与未发热患者相比，两组之间总体病死率差异无统计学意义（9.2%对4.8%，P=0.099）。多因素分析显示年龄〉40岁（P=0.047 ，HR=5.000 ，95% CI 0.853-28.013 ）、血流动力学不稳（P=0.001，HR=13.185, 95% CI 2.983-54.915）、既往耐药菌的定植或感染（P=0.005 ，HR=28.734， 95% CI 2.921-313.744）、血流感染（P=0.038 ，HR=9.715, 95% CI 1.110-81.969）和肺部感染（P=0.031， HR=25.905, 95% CI 1.381-507.006）是与总体死亡相关的危险因素。
基金supported by the National Key R&D Program of China(2018YFC1200601)Applied Technology Research and Development Project of Heilongjiang Province(GA19B301)+1 种基金Key-Area Research and Development Program of Guangdong Province(2019B020211004)the grant from the State Key Laboratory of Veterinary Biotechnology Program(SKLVBP201801)。
文摘African swine fever(ASF)is a devastating infectious disease in swine that is severely threatening the global pig industry.An efficacious vaccine is urgently required.Here,we used the Chinese ASFV HLJ/18 as a backbone and generated a series of genedeleted viruses.The virulence,immunogenicity,safety,and protective efficacy evaluation in specific-pathogen-free pigs,commercial pigs,and pregnant sows indicated that one virus,namely HLJ/18-7GD,which has seven genes deleted,is fully attenuated in pigs,cannot convert to the virulent strain,and provides complete protection of pigs against lethal ASFV challenge.Our study shows that HLJ/-18-7GD is a safe and effective vaccine against ASFV,and as such is expected to play an important role in controlling the spread of ASFV.
基金supported by grants from the China Mega-Project for Infectious Diseases (2012ZX10004207)the China-US Collaborative Program on Emerging and Re-emerging Infectious Diseases (S2012Y03)+1 种基金the key project of the Health Ministry of Hubei Province (JX5A06)the Hubei Provincial Outstanding Medical Academic Leader program
文摘Severe fever with thrombocytopenia syndrome （SFTS） is an emerging infectious disease caused by SFTS virus （SFTSV）. SFTSV is associated with a high mortality rate and has been reported in China, South Korea and Japan. SFTSV undergoes rapid changes owing to evolution, gene mutations, and reassortment between different strains of SFTSV. In this review, we summarize the recent cases and general properties of SFTS, focusing on the epidemiology, genetic diversity, clinical features, and diagnostics of SFTSV in China. From 2010 to October 2016, SFTS cases were reported in 23 provinces of China, with increased numbers yearly. Infection and death cases are mainly found in central China, where the Haemaphysalis Iongicornis ticks are spread. The national average mortality rate of SFTS infection was 5.3%, with higher risk to elder people. The main epidemic period was from May to July, with a peak in May. Thus, SFTS reminds a significant public health problem, and development of prophylactic vaccines and effective antiviral drugs will be highly needed.
基金the National Key Research and Development Program of China(2018YFC1200601)Applied Technology Research and Development Project of Heilongjiang Province(GA19B301)+2 种基金Key-Area Research and Development Program of Guangdong Province(2019B020211004)the State Key Laboratory of Veterinary Biotechnology Program(SKLVBP201801)the National Natural Science Foundation of China(31941002)。
文摘African swine fever virus(ASFV)has been circulating in China for more than two years,and it is not clear whether the biological properties of the virus have changed.Here,we report on our surveillance of ASFVs in seven provinces of China,from June to December,2020.A total of 22 viruses were isolated and characterized as genotype II ASFVs,with mutations,deletions,insertions,or short-fragment replacement occurring in all isolates compared with Pig/HLJ/2018(HLJ/18),the earliest isolate in China.Eleven isolates had four different types of natural mutations or deletion in the EP402R gene and displayed a nonhemadsorbing(non-HAD)phenotype.Four isolates were tested for virulence in pigs;two were found to be as highly lethal as HLJ/18.However,two non-HAD isolates showed lower virulence but were highly transmissible;infection with 106 TCID50 dose was partially lethal and caused acute or sub-acute disease,whereas 103 TCID50 dose caused non-lethal,sub-acute or chronic disease,and persistent infection.The emergence of lower virulent natural mutants brings greater difficulty to the early diagnosis of ASF and creates new challenges for ASFV control.
基金supported by the National Natural Science Foundation of China (No. 81373118)the National Basic Research Programme of China (973 Programme No. 2012CB518905)
文摘Hantaviruses are comprised of tri-segmented negative sense single-stranded RNA, and are members of the Bunyaviridae family. Hantaviruses are distributed worldwide and are important zoonotic pathogens that can have severe adverse effects in humans. They are naturally maintained in specific reservoir hosts without inducing symptomatic infection. In humans, however,hantaviruses often cause two acute febrile diseases, hemorrhagic fever with renal syndrome(HFRS) and hantavirus cardiopulmonary syndrome(HCPS). In this paper, we review the epidemiology and epizootiology of hantavirus infections worldwide.
文摘Background Despite the recent advances in medicine, fever of unknown origin （FUO） remains a diagnostic and therapeutic challenge even to expert physicians. To increase the knowledge of FUO, we conducted a retrospective study to investigate the causes of FUO and the change of major causes of FUO during the past 26 years. Methods The clinical data were retrospectively analyzed from 997 patients with FUO hospitalized at the Peking Union Medical College Hospital （PUMCH） between January 2004 and October 2010. Furthermore, the results were compared to that reported in previous studies of FUO in PUMCH since 1985. Results Of the 997 FUO cases, definite diagnosis was eventually achieved in 797 （79.9%） patients. The most common cause of FUO was infectious diseases （479 cases, 48.0%）, with tuberculosis accounting for 45.3% （217/479） of the cases of infections. One hundred and sixty-eight （16.9%） patients were diagnosed with connective tissue diseases, with Still＇s disease and vasculitis accounted for 31.5% （53/168） and 24.4% （41/168） of this category, respectively. Neoplasms and miscellaneous causes were found in 7.9% （79/997） and 7.1% （71/997）, respectively. However, no definite diagnosis had been made in the remaining 200 （20.1%） cases until they were discharged from the hospital. Conclusions During different periods, infectious diseases, especially tuberculosis, were the leading etiology of FUO and the proportion of tuberculosis had no significant difference. While the frequency of neoplasms was descending, the proportion of lymphoma in neoplasm was ascending; the frequency of undiagnosed＇cases was increasing, but in most FUO cases the causes can be diagnosed eventually after careful analysis of clinical data.
文摘Purpose To summarize the major achievements of Chinese work on the epid emiology and prevention of hemorrhagic fever with renal syndrome (HFRS) in recen t years, and to give a general review on the present situation of HFRS in China.Data sources Reviews and papers published in Chinese journals, relevant to the objectives, written or collected by the author; and the research work of the author.Study selection An outline was drafted according to the purpose given a bove, and the relevant materials and data were grouped together into different i tems outlined.Data extraction All the materials and data extracted were published or specially assessed.Results HFRS was first recognized in the northeastern China in 1931. It has been found prevalent also in many other parts of China since 1955, and p resently, 28 out of 31 provinces (autonomous regions, or municipalities) have b een proved to be its endemic areas. The total number of cases is 1?256?431 from 1950 to 1997, with 44?304 death (3.53%). 50-100 thousands of cases co uld be registered annually since 1981 when the presence of the Rattus type HFRS wa s first identified serologically in China, with the highest peak in 1986 ( 115 ?985 cases). Three types of endemicity have been differentiated: the Apodemus type, the Rattus type and the mixed type of the two, by their peculiar season al distributions of cases and by methods of serotyping (HI, MAbs serotyping kits ). The epidemiologic features of the Rattus type HFRS are quite different from that of the Apodemus type. 67 species of vertebrates were found to harbor hanta virus antigen or antibodies, but the chief or primary reservoir hosts are A podemus agrarius and Rattus norveg icus only. Besides the commonly recognized enzootic mode of transmission (via co ntact s with the reservoir rodents or their excreta), mite transmission (including cer tain species of gamasid mites, and chigger mites) has been identified as the po tential vectors and reservoir hosts with HFRS. Vertical transmission
