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Objective: To understand the acceptance and personal demand for cancer screening service among the urban residents who had never been involved in any national level cancer screening programs in China and identify the key factors influencing the sustainability of cancer screening. Methods: A questionnaire survey was conducted among the local people aged 40-69 years selected through convenience sampling in 16 provinces of China to collect the general information about their demands for the screening service and others. Results: A total of 16 394 qualified questionnaires were completed. The average age of the people surveyed was (53.8±8.0) years, and men accounted for 44.6%. Without concerning the cost, 4 831 people (29.5%) had no demands for cancer screening services, the reasons are as follow: they would like to go to see doctors only when they were ill (61.8%); they had already received similar medical examinations (36.8%) and they would like to receive cancer screening directly without pre-health risk assessment (33.0%). Among the people surveyed, 10 795 (65.8%) had demands for cancer screening services, but they had choice on the screening settings, 43.7% wanted to receive the service in a general hospitals, while 36.5% would like to go to cancer-specialized hospitals. As for the level of medical institutes providing cancer screening service, 61.4% of the people surveyed would choose a higher level one, while 36.4% would choose an ordinary one. On screening procedures, 61.5% of the people surveyed would accept the mode of "clinical examination after questionnaire-assessment" . Conclusion: Most people surveyed had demands for cancer screening services and they would like to receive the screening services in higher level medical institutes. It is suggested to spread cancer screening know ledge, and strengthen the capability building of screening in grass root medical institutes to attract more people to receive cancer screening.

Objective: To understand the constituent and workload of service providers engaged in cancer screening in China and provide evidence for the assessment of the sustainability of national cancer screening project. Methods: Using either questionnaire or online approach, the survey was conducted in 16 provinces, where Cancer Screening Program in Urban China (CanSPUC) was conducted, from 2014 to 2015. The medical institutes surveyed included hospitals [71.1% were class Ⅲ(A) hospitals], centers for disease control and prevention (CDCs) and community centers where cancer screening was undertaken during 2013-2015. The questionnaire survey was conducted among the staffs responsible for the overall coordination, management and implementation of the screening project to collect the information about the allocation, workload and compensation of the service providers from different specialties. Results: A total of 4 626 staffs were surveyed in this study, their average age was (37.7±9.5) years, and males accounted for 31.0%. Human resources allocated differed with province. The number of senior staff ranged from 6 (Chongqing) to 43 (Beijing) among the 8 comparable provinces. Among the staffs surveyed, 2 192 were from hospitals, 431 were from CDCs and 1 990 were from community centers, and the staffs who complained heavy workload accounted for 19.9%, 24.6% and 34.1% respectively ( P <0.001). Among 227 staffs for overall coordination, 376 management staffs and 3 908 staffs for implementation, those who complained heavy workload accounted for 23.6%, 22.3% and 28.2% respectively ( P <0.001). A total of 3 244 staffs (73.8%) got compensations for heavy workload. The compensation types were manly labor fee linked with workload (67.5%) and labor fee regardless workload (26.6%). Conclusion: The province specific differences in human resources allocation indicated the differences in screening project's organizing pattern and capability. It is suggested to conduct routine cancer screening (using specialized staffs), reduce the workload of the first line and community staffs and increase the compensation for the service providers for the sustainability of cancer screening project in China.

Objective: To explore the sustainability of cancer screening strategy from potential demander's perspective in Chinese country, we conducted a study on the use of cancer screening services and willingness-to-pay among the urban community residents. All the participants of this study had not been on the Cancer Screening Program in Urban China (CanSPUC) or any other national level cancer screening projects. Methods: Target communities and populations were selected from the 16 project provinces in China which were on the program between 2014 and 2015, by using the multi-center cross-sectional convenience sampling method. Chi-square was used to compare the rates on the utilization of service and willingness-to-pay across the different subgroups. Logistic progression was conducted to examine factors that associated with the service utilization and willingness-to-pay. Results: A total of 16 394 participants were included in this study. Among them, 12.1% (1 984/16 394) had ever been on a cancer screening program. Populations with following characteristics as: being elderly (60-69 years, OR =1.27, 95% CI : 1.13-1.43), female (male, OR = 0.56, 95% CI : 0.50-0.62), having had higher education (high school/specialized secondary school, OR = 1.51, 95% CI : 1.35-1.70; college or over, OR =2.10, 95% CI : 1.36-3.25), working for public ( OR =2.85, 95% CI : 2.26-3.59), enterprises or self-employed agencies ( OR =1.32, 95% CI : 1.06-1.64), having higher income (60 000-150 000 Chinese Yuan, OR =1.55, 95% CI : 1.39-1.73; ≥150 000 Chinese Yuan, OR =2.57, 95% CI : 2.09-3.15), under basic medical insurance programs for urban employees/for government servants'( OR =1.15, 95% CI : 1.01-1.32), on basic medical insurance set for urban residents'/on commercial medical insurance programs etc . ( OR =1.01, 95% CI : 0.84-1.22), were in favor of the services. When neglecting the fee for charge, 65.8% (10 795/16 394) of the participants said that they could accept the cancer screening program, particularly in those who had already been on the screening program ( P <0.05). 61.2% (10 038/16 392) of all the participants showed the willingness-topay for a long-term packaging screening services, particularly in those who were relatively younger (60-69 years, OR =0.80, 95% CI : 0.74-0.87), working for public ( OR =1.76, 95% CI : 1.56-1.98) or enterprise sectors or self-employed households ( OR =1.32, 95% CI : 1.18-1.47), having higher income (60 000-150 000 Chinese Yuan, OR =1.51, 95% CI : 1.40-1.63; ≥150 000 Chinese Yuan, OR = 1.95, 95% CI : 1.60-2.38), utilized screening services ( OR =2.18, 95% CI : 1.94-2.46). Conclusions: The rate of using the cancer screening services should be improved. Factors including age, gender, education, occupation, income and insurance appeared as major factors related to the use of cancer screening services. Willingness-to-pay seemed relatively high, but the amount of payment they could afford was limited. Factors including age, occupation, income and insurance appeared as major factors to the willingness-to-pay.

Objective: Based on the investment for potential suppliers of cancer screening services, we assessed the reasons that affecting their participation motivation related to the long-term sustainability of cancer screening in China. Methods: Hospitals that had never been involved in any national level cancer screening project were selected by using the convenient sampling method within the 16 project cities of Cancer Screening Program in Urban China (CanSPUC) with 1 or 2 hospitals for each city. All the managers from the institutional/department level and professional staff working and providing screening services in these hospitals, were interviewed by paper-based questionnaire. SAS 9.4 was used for logical verification and data analysis. Results: A total of 31 hospitals (18 hospitals at the third level and, 13 hospitals at the second level) and 2 201 staff (508 hospital and clinic unit managers, 1 693 professional staff) completed the interview. All the hospitals guaranteed their potential capacity in service providing. 92.5% hospital managers showed strong willingness in providing cancer screening services, while 68.3% of them declared that the project fund-raising function was the responsibility of the government. For professional staff, their prospect gains from providing screening service would include development on professional skills (72.4%) and material rewards (46.8%). Their main worries would include extra work for CanSPUC might interfere their routine work (42.1%) plus inadequate compensation (41.8%). Medians of the prospect compensation for extra work ran between 20 to 90 Chinese Yuan per screening item respectively. For all the screening items, workers from the third-level hospitals expected their compensation to be twice as much of those working at the second level hospitals. Conclusion: Professional capacity building and feasible material incentive seemed to be the two key factors that influenced the sustainability and development of the programs.

Objective: From the perspective of actual service suppliers regarding cancer screening, this study aimed to assess the long-term sustainability of cancer screening programs in China. Methods: Based on a Cancer Screening Program in Urban China (CanSPUC), our survey focused on all the hospitals, centers for disease control and prevention (CDC) and community service centers across 16 provinces in China which participated in the programs between 2013 and 2015. All the managers (institutional/department level) and professional staff involved in the program were interviewed using either paper-based questionnaire or online approach. Results: A total of 4 626 participants completed the interview. It showed that the main gains from providing screening service emphasized promotion in social value (63.6%), local reputation (35.9%), and professional skills (30.6%), whereas difficulties encountered included inadequate compensation (30.9%) and discordance among information systems (28.3%). When the service remuneration amounts to about 50 Chinese Yuan per screening item, those professional staff self-reported that they would like to work overtime. More than half (63.7%) of the staff expressed willingness to provide routine screening service, the main expectations were to promote their reputation to the local residents (48.7%) and to promote professional skills (43.1%). Those who were not willing to provide screening services were worried about the potential heavy workload (59.8%) or being interfered with their routine work (49.8%). Further detailed results regarding the different organization types and program roles were presented in the following detailed report. Conclusions: Findings of gains and difficulties showed that if cancer screening is expected to become a long-term running, incentive mechanism from the program, external promotion and advocacy as well as capacity building should be strengthened; furthermore, rewards to staff's screening services should be raised according to the local situations. Results regarding the "willingness to provide service" showed that management of the program should also be strengthened, including information system building and inter-agency and inter-department coordination at the government levels.

Objective: Arenavirus is a negative single-stranded RNA virus and an important human pathogen, mainly harbored and transmitted by rodents, causing severe diseases, including hemorrhagic fever and encephalitis. Following the discovery of a novel pathogenic arenavirus (Wenzhou virus, WENV), the prevalence of WENV in local small rodents was investigated. Methods: By using RT-PCR, WENV was screened in 48 and 156 rodents sampled from Wenzhou and Longquan, respectively. Results: Consequently, WENV was detected in 5 (10.41%) rodents sampled from Wenzhou. However, no WENV was identified in all the rodents sampled from Longquan. Genetic analysis of complete genome sequences indicated that 4 of 5 virus strains were closely related to the known Wenzhou viruses with high homology. Especially, the L and S segments of Wencheng-Rn-288 strain shared homology of 87.5% and 91.6% with other viruses, respectively. They formed a distinct lineage, suggesting that this strain might be a novel variant of WENV. Conclusions: Our results indicate that WENV has a high prevalence and high genetic diversity among rodents in Wenzhou. As the respiratory disease caused by WENV has been detected in Cambodia, it is necessary to strengthen the surveillance for WENV in China.

Objective: To understand the genetic and molecular epidemiologic characteristics of 63 strains of Japanese encephalitis virus (JEV) isolated in Yunnan province, China during 1977-2010. Methods: Suckling mice were inoculated with viruses continuously and the viral nucleic acid were extracted from the brain-grinding supernatants of the infected and moribund mice, then the gene fragments of E region were amplified by RT-PCR. Bioinformatics (Clustal X, DNAstar, Mega 5.0 and other software) was used to analyze the nucleotide and deduced amino acid sequences and phylogenetic trees. Results: Yunnan strains of JEV could cause illness and deaths in suckling mice. The results of virus nucleic acid detection and sequencing indicated that nucleotide sequences of E gene of the 63 virus strains were obtained. Phylogenetic tree and homology analyses based on E genomes showed that 47 strains of the experimental virus belonged to genotype 1 (G-1) and 16 strains belonged to genotype 3 (G-3). The 47 isolates of G-1 were divided into 2 clades, of them, the earliest isolates of G-1 (M28, 1977 and BN82215, 1982) in Yunnan of China and the early isolates of G-1 (U70416, 1982; DQ084229, the year is unknown) in Thailand were in one clade, and the isolates of G-1 from 2007-2010 in Yunnan could be divided into 2 subgroups. The 16 isolates of G-3 from Yunnan were divided into 3 clades, among them, the isolates from 1970-1990s in Yunnan were in two clades, and the isolates from 2004 in Yunnan were in one clade. In addition, their main amino acid sites of antigenicity, pathogenic, virulence of both G-1 and G-3 had no significant change. Conclusion: JEV G-1 and G-3 co-circulated in Yunnan, and G-1 was predominant. The JEV strains isolated in different years and areas in Yunnan had different molecular epidemiologic characteristics and genetic diversity. The results of this study suggested that JEV G-1 might originate from Yunnan of China and adjacent Southeast Asia region.

Objective: To explore the risk factors of lung cancer in non-smoking Chinese women and to provide evidence for lung cancer prevention and control., Methods: Information was collected on case-control studies published in the journals, both nationally and internationally from January, 1995 to November, 2014 that reported correlations between lung cancer and risk factors. Pooled odds ratio (OR) and 95% confidence interval (CI) of risk factors on lung cancer in non-smoking Chinese women were calculated, using the Meta-analysis method, with sensitivity and publication bias tested., Results: Information on 24 case-control studies was selected including 11 946 cumulative cases and 12 596 controls. Pooled ORs (95% CI) were shown as: history of lung diseases 1.89 (1.57, 2.27), history of tuberculosis 1.86 (1.53, 2.27), history of chronic bronchitis 1.51 (1.04, 2.19), family history of cancers 2.02 (1.67, 2.44), family history of lung cancers 2.45 (1.80, 3.34), passive smoking (at workplace in adult period 1.47 (1.28, 1.69), at home in adulthood 1.22 (1.09, 1.36), in all life's time 1.52 (1.29, 1.79), kitchen smog while cooking 2.21 (1.27, 2.96), position of kitchen 1.76 (1.48, 2.09), and frequency of deep frying per week 2.24 (1.61, 3.12) etc. respectively., Conclusion: Major risk factors related to lung cancer in non-smoking Chinese women would include lung diseases, family history of cancers, and passive smoking (tobacco smog and cooking smog). Particularly, the combination of family history and the degree of cooking presented stronger correlation effects, indicating that genetic and environmental factors jointly played an important role in the development of lung cancer.

Objective: To understand the epidemiologic characteristics of dengue fever, imported from Myanmar to the border of Yunnan province, China. Viral molecular epidemiologic features were also studied., Methods: Questionnaires were used on each diagnosed, suspected dengue fever, case or unknown cases with fever when coming from Myanmar entering the port and hospitals in Ruili city of Yunnan province. Serum samples of these patients were collected to detect IgM antibody against dengue virus and RT-PCR assay. Homology and phylogenetic tree based on the whole nucleotide sequence of PrM-C and NS5 gene of dengue virus were further analyzed., Results: A total of 103 sera were collected from patients at acute stage in Ruili city in July to November 2008. Among them, 49 cases were confirmed for dengue fever according to IgM and nucleic acid testings. Except one, other 48 cases were all imported into Ruili, from Myanmar. Of those, 18 patients were residents from Mujie city of Myanmar and hospitalized in Ruili and the rest 30 patients were Chinese citizens who had finished business and returned from Myanmar. Two isolates of serum samples from the imported cases were identified and both homology and phylogenetic analysis were performed, using the nucleotide sequences of PrM and NS5 genes. They were divided into dengue type 1 (RLB61) and dengue type 3 (RLC31) and were closer to the dengue virus strains isolated from Southeast Asia countries., Conclusion: It is confirmed that an epidemic of dengue fever which was imported from Myanmar to Ruili city of Yunnan province, China. Evidence also showed that both type I and III epidemic strains of dengue virus did exist in Mujie city of Myanmar in 2008.

Objective: To analyze the viral genetic characteristics of hantaviruses carried by Microtus maximowixzii in Yakeshi of Inner Mongolia Autonomous Region and its relationship with Hantaan virus (HTNV) and Seoul virus (SEOV) viruses as well as to identify the natural host of Khabarovsk virus (KHAV)., Methods: HV specific RNAs were detected by RT-PCR. Complete S and M segment were amplified from the RNA-positive samples. Phylogenetic analysis were performed to estimate the genetic characterization and the relationship with other hantaviruses., Results: Fifty two Microtus maximowixzii voles were captured in Yakeshi areas. Of those voles, hantaviral RNA was tested positive in 5 samples (9.62%). Complete S and M segments sequences were obtained from 5 and 2 lung samples, respectively. The complete S segment was consisted of 1848 to 1861 bp, and the M segment consisted of 3662 bp. These viruses were closely related to each other with 92.5% - 96.4% for the S segment sequences and 88.9% - 95.4% for the M segment sequences. They shared a higher identity with KHAV found previously in Yakeshi and KHAV of Russia. However, they were obviously different from the other hantavirus species. The 5 strains had the consistent secondary structure of nucleocapsid protein (NP) and glycoprotein (GP). When further comparing their secondary structures with those of HTNV and SEOV, our results indicated that there were no obvious differences in NP between KHAV and both HNTV, SEOV but with obvious difference in GP. Based on the S and M segment sequences, phylogenetic analyses revealed that these 5 strains clustered together with KHAV and formed a distinct lineage. Furthermore, all known KHAV strains could be divided into two small branches with a nucleotide divergence more than 5.3%., Conclusion: Our research data revealed that KHAV was highly endemic among Microtus maximowixzii in Yakeshi area which supported the notion that Microtus maximowixzii had been the natural host of KHAV in the area.

Objective: To establish a method combined morphology and molecular marker for identifying Haemaphysalis longicornis and Rhipicephalus microplus., Methods: Ticks were collected from domestic animals and wild environment in epidemic area of Hubei and Henan provinces where cases of fever with thrombocytopenia syndrome were prevalent. We classified the ticks by morphology characteristics before 12S rDNA of ticks were amplified by PCR and subsequently sequenced. Phylogenetic tree was constructed by PAUP4.0., Results: The ticks belonged to Haemaphysalis longicornis and Rhipicephalus microplus through observation and analysed by the morphological characteristics of the ticks. 12S rDNA was cloned and sequenced while data confirmed the morphological identification of the results., Conclusion: The method based on morphology that combined with molecular marker seemed a good method for the identification of ticks.

Objective: To investigate the situation of the natural infection of hantaviruses (HV) in small mammals and to provide evidence for the control and prevention of hemorrhagic fever with renal syndrome (HFRS) in Longquan area, Zhejiang province., Methods: Small mammals were captured by night trap, and lung tissue samples were collected and stored in liquid nitrogen. HV antigens were detected by indirect immuno-fluorescence assay (IFA). The partial S genome segment sequences were amplified by RT-PCR. DNAStar program was used for editing and comparing the sequences. Phylogeny was analyzed through PAUP*4.0 software., Results: 319 small animals were collected in Longquan, and 9 hantavirus antigen-positive samples were identified. The positive rate of hantavirus in Apodemus agrarius was 4.97%. Phylogenetic tree constructed by partial S segment (620 - 999 nt) showed that the 9 strains carried by A. agrarius from Longquan all belonged to HTNV, and had a closer evolutionary relationship with isolate Z251 from Zhejiang province., Conclusion: Our results indicated that the main host was A. agrarius and the infection rate of HTNV was high in Longquan area.

Objective: To explore the role of silent information regulation 2 homolog 1 (SIRT1) in the regulation of IL-1β mRNA transcription in lipopolysaccharide (LPS) tolerant THP-1 cells., Methods: THP-1 human promonocyte model of endotoxin tolerance that simulates the sepsis leukocyte phenotype was used. Chromatin immunoprecipitation assay (ChIP) and real-time PCR were applied to quantify the binding of SIRT1 and histone H3 lys9/H4 lys16 acetylation to IL-1β promoter. IL-1β mRNA transcription was studied after knocking down the SIRT1., Results: The binding of SIRT1 to IL-1β promoter increased about 5 times in tolerant THP-1 cells (P < 0.05), which was accompanied by the low level of histone H3 lys9/H4 lys16 acetylation (P < 0.05, compared with normal cells). Knocking-down of SIRT1 increased the transcription of IL-1β mRNA up to the level of 68% of normal cells (P < 0.05), which was accompanied by the increase of histone H3 lys9/H4 lys16 acetylation (P < 0.05). However, there was no significant difference of p65 lys310 acetylation between normal and tolerant cells., Conclusion: SIRT1 inhibited the IL-1β mRNA transcription in tolerant THP-1 cells but had not related to p65 lys310 acetylation. However, it was related to IL-1β promoter acetylation.

Background: From April to July in 2009 and 2010, unexplained severe hemorrhagic fever-like illnesses occurred in farmers from the Huaiyangshan mountains range., Methods: Clinical specimens (blood, urine, feces, and throat swabs) from suspected patients were obtained and stored. Mosquitoes and ticks in affected regions were collected. Virus was isolated from 2 patients and characterized by whole genome sequencing. Virus detection in additional patients and arthropods was done by virus-specific reverse transcription (RT) PCR. Clinical and epidemiological data of RT-PCR confirmed patients were analyzed., Results: An unknown virus was isolated from blood of two patients and from Haemaphysalis ticks collected from dogs. Whole genome sequence analysis identified the virus as a novel member of the family Bunyaviridae, most closely related to the viruses of the genus Phlebovirus within which it forms a separate lineage. Subsequently, infection was confirmed by RT-PCR in 33 of 58 suspected patients. The illness in these patients was characterized by fever, severe malaise, nausea, vomiting, and diarrhea. Prominent laboratory findings included low white cell- and platelet counts, coagulation disturbances, and elevation of liver enzymes. Hemorrhagic complications were observed in 3 cases, 5 (15%) patients died., Conclusions: A novel tick-borne Bunyavirus causing life-threatening hemorrhagic fever in humans has emerged in the Huaiyangshan mountain areas of China. Further studies are needed to determine the epidemiology, geographic distribution and vertebrate animal ecology of this virus.

Objective: Genetic analysis was performed to infer the relationship between hantaviruses carried by Rattus norvegicus from Henan and Neimenggu provinces and the other known hantavirus and the vaccine strain., Methods: Total RNA was extracted from lung tissues with Trizol reagent. The complete M and S segment sequences of strains NM133 and Q12 were amplified by RT-PCR. The purified DNA fragments were directly subjected to sequencing, and then to sequence analysis and phylogenetic analysis., Results: The complete S segment sequences of strains NM133 and Q12 were found to be 1770 nt and 1772 nt in length respectively, with one open reading frame encoding 429 amino acids. The complete M segment sequences of both two strains are 3654 nucleotide in length encoding a protein of 1133 amino acids. The two strains shared a high degree of homology with most of known Seoul virus (SEOV) but quite different from Hantaan virus and other hantaviruses. Furthermore, the nucleoprotein and glycoprotein of the two strains had the congruent structure with the vaccine strain Z37. On the S- and M-phylogenetic trees, both strains (NM133 and Q12) were grouped into the first cluster of SEOV, and were more closely related to the strains, such as: Hb8610, R22, HB55, L99, and K24-e7., Conclusion: Both strains (NM133 and Q12) belonged to SEOV, and sharing a high degree of homology and similar secondary structure with strains including the vaccine strains Z37, our data suggested that the present vaccine used in China could effectively prevent HFRS caused by SEOV.

Objective: To evaluate the effect of comprehensive prevention programs on HIV, HBV and syphilis transmission from mother to child and between premarital couples., Methods: HIV, HBV and syphilis were screened among pregnant women with interventional measure for infected women; HIV, HBV and syphilis (TP) were screened among premarital couples with medical advice., Results: The HIV, HBsAg and TP positive rates were 8.4‰ (111/13 280), 54‰ (711/13 186) and 12.8‰ (159/12 401) respectively among pregnant women and the total positive rate of the three diseases was 73.8‰ which was significantly higher than HIV positive rate (P < 0.001). The positive rates of HIV, HBsAg and TP were 17.6‰ (464/26 324), 95.3‰ (1826/19 152) and 18.6‰ (355/19 099) respectively among premarital couples and the total positive rate of the three diseases was 131.5‰ which was significantly higher than HIV positive rate alone (P < 0.001). Comprehensive prevention was more economical than prevention for HIV alone., Conclusion: The comprehensive strategies for prevention of HIV, HBV and syphilis was feasible, effective and economical that could help to actively conduct the preventive measures.

Objective: Complete S and M segments of two Seoul virus (SEOV) strains were obtained to determine their genetic types and characteristics., Methods: The complete S and M segments from the isolate Li and lung tissue (sample LF18) were amplified by RT-PCR. Genetic analyses were performed by using DNAStar and PHYLIP program package., Results: Their sequences consisted of 1772 nucleotides, and had an open reading frame (ORF, 43 to 1332 nt) encoding a nucleoprotein of 429 amino acids for both two strains. The complete M segment sequences consisted of 3653 nucleotides and had an ORF encoding a GnGc precursor of 1133 amino acids. The GnGc precursor of the two strains had 62 cysteine and 6 N-glycosylation sites. Both two strains shared a high degree of homology with other known SEOV strains including strains L99, Gou3, and vaccine strain Z37, with 87.6% to 99.2% and 83.6% to 97.3% nucleotide identities, respectively. On the S- and M-trees, the two strains LF18 and Li were grouped into the third cluster of SEOV., Conclusion: Both LF18 and Li strains belonged to SEOV and shared the congruent genetic characteristics with the vaccine strains Z37. Thus, the bivalent vaccine including the strain Z37 could effectively prevent HFRS which was caused by SEOV in Hebei province.

Objective: To better understand the epidemiology of rabies during the past ten years in Yancheng city, Jiangsu province., Methods: Data was collected and analyzed on rabies cases in Yancheng. Density and vaccination rate on Canine, Rate of injured people bit by dogs, and the information of post-exposure prophylaxis were studied. Rabies virus in the dog brains, collected around the epidemic areas of Yancheng, were detected and analyzed., Results: A total of 135 human rabies cases occurred from 1999 through 2008, and formed the second epidemic peak since 1958. Of these victims, 84% (114) were farmers. In general, the rate of people having dogs were 3% - 6% per 100 people, and the injured person-times of 100 dogs were 6.37 per year. Notably, the vaccination rate of dogs was only 20%. Of those people injured by dogs and other animals, 77% had received post-exposure treatment, and only 5% - 10% had been administered anti-rabies serum. Rabies virus antigen was found in 4 (3.6%) of 111 brain specimens among dogs collected from epidemic areas. Genetic analysis of N and G genes, which were amplified from brain specimens, indicated that these viruses belong to genotype I rabies and expressing a close relationship with the Chinese vaccine strain CTN., Conclusion: The large number of dogs with low vaccination rate among them, together with the incorrect and low post-exposure treatment in rural areas seemed to be responsible for the outbreak of rabies in Yancheng city.

Objective: Comparing the difference of virulence between the strain CGRn5310 (HTNV) and the strain HR54 (SEOV) isolated both from Rattus norvegicus., Methods: Suckling mice were used to compare the difference of virulence between the two strains. Hantavirus antigens were detected in brain and lung tissues collected from the infected mice., Results: Compared with the control group, all infected mice grew slowly. Furthermore, the mice inoculated intracerebrally with either CGRn5310 or HR45 appeared ruffled fur, and reduced activity, followed by neurological symptoms, such as paralyses and convulsions. The half lethal dose (LD(50)) of CGRn5310 strain was 10(-6.42), whereas the LD(50) of HR54 strain was 10(-4.51). Hantavirus antigens were identified in brain and lung tissues from the mice infected with the strain CGRn5310 and the strain HR54., Conclusion: LD(50) of the strain CGRn5310 was significantly higher than that of the strain HR54. Our results suggested that the virulence of the spillover hantavirus might only slightly be influenced by the non-reservoir rodents.

Objective: Feasibility of using MNA cell-culture inoculation test to detect and isolate the street rabies virus., Methods: Using MNA cell-culture inoculation test, fluorescent antibody test (FAT) and sandwich ELISA with double-antibodies to detect 33 specimens of street rabies virus, 20 specimens of negative canine brains and 4 specimens of healthy mice brains., Results: 33 specimens of street rabies virus were positive to the cell-culture inoculation test but the others were negative. The concordances of MNA cell-cultured inoculation test with FAT and sandwich ELISA with double-antibodies were both 100%., Conclusion: MNA cell-culture inoculation test appeared to be both highly sensitive and specific in detecting the street rabies virus, and could be used in detection and isolation of the virus.

Objective: To determine the hosts of hantavirus (HV) and its molecular epidemiological characteristics, to provide evidence for prevention and control on hemorrhagic fever with renal syndrome (HFRS)., Methods: Rodents were captured by a special trap within the residential area. The antigens of HV in lung tissues were detected by direct immuno-fluorescence assay (DFA). Nucleotide sequences of HV were amplified by RT-PCR with HV genotype-specific primer. The amplified genes were then sequenced. Phylogenetic tree were built on nucleotide sequence with ClustalX 1.83 software., Results: 1421 rodents were captured and classified into 8 species of 4 Genera in the epidemic area within 10 counties of Chuxiong prefecture, Yunnan province, between 2005 and 2006. Out of the 1421 rodents, 1056 (74.31% ) of them were Rattus norvegicus and 280 (19.70%) belonged to Rattus flavipectus. The antigens of HV were detected by DFA in lung tissues and the total positive rate of HV was 5.15% (53/ 1029). After applying the sequencing nucleotide method to the 53 positive specimens, data showed that 21 specimens were positive and all of them belonged to Seoul type (15 samples were from Rattus norvegicus, 4 samples Rattus flavipectus, 2 samples Rattus nitidus). The partial S segments from 12 specimens were sequenced which appeared homologic with R22, L99 and HLD65 from GenBank in relatively high level (87.1% -99.7%). When compared to 76-118 strain of Hantaan type, their homologic degree was only 64.4%-69.1%. Results from Phylogenetic analysis showed that 12 specimens belonged to Seoul type. As for their homology, they were significantly similar to Seoul type and could be tentatively divided into two subtypes S1 and S3., Conclusion: It was confirmed that the Seoul type virus, as HFRS's pathogenetic agent mainly carried by rats, prevailed widely in Chuxiong prefecture. Owing to the local ecological environment, we also noticed the characteristics of different HV subtypes among Seoul type.

Objective: To study the epidemiological and etiological characteristics of typhoid and paratyphoid fever in high epidemic areas., Methods: Reported data on typhoid and paratyphoid fever during 1988-2007 in Ningbo were analyzed epidemiologically. Shellfish from the market was collected for laboratory testing and Salmonella typhi strains collected from the patients were also studied., Results: Number of reported cases on both typhoid and paratyphoid fever was 19 404 with 7 deaths, from 1988 to 2007. The annual mean incidence was 17.68 per one hundred thousand with the fatality rate as 0.36 per thousand. Most cases were among adults aged 20-50 years and an obvious regional distribution was observed with high incidence seen in winter and spring. Since 1990s, the advantage strain had changed from Salmonella typhi to Salmonella paratyphi A. Etiologic studies showed that raw Anadara subcrenata and oyster were the main risk factors. One Salmonella paratyphi A strain was detected in both Anadara subcrenata and oysters collected from the market, which contained TEM-1 drug resistance gene. PFGE genotyping showed that PFGE-X2 was the strain which causing pandemic in Ningbo., Conclusion: Eating contaminated raw shellfish like oysters and hairy clams was the primary risk factor, responsible for the outbreaks. Salmonella paratyphi A was the advantages pandemic strain in Ningbo. Strategies as supervision on personal hygiene and health education should be strengthened.

Objective: In order to detect Hokkaido virus (HOKV), a recombinant baculovirus containing the nucleoprotein (NP) gene of HOKV was constructed, and then the NP was expressed in insect cell., Methods: The NP gene was cloned into plasmid PCR 2.1TA vector and then was ligated into baculovirus donor plasmid pFastBac after cutting by the restriction enzyme Kpn I and Not I. pFastBac 1 was subsequently transferred into the One Short TOP10 competent cells and then into DH1OBac E. coli competent cells, which contained the baculovirus shuttle vector (Bacmid) and the helper plasmid to generate a recombinant bacmid., Results: The NP gene was successfully expressed in Sf9 insect cell. The expressed recombinant nucleoprotein had been identified in the Sf9 insect cell by indirect immunofluorescence assay, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot. The results showed that the recombinant nucleoprotein appeared a molecular weight of 50 x 10(3) Mr, and could reacted with anti-recombinant Puumala virus (PUUV) nucleocapsid monoclonal antibodies and polyclonal antibodies against hantavirus., Conclusion: Our results indicated that the recombinant nucleoprotein was successfully expressed and having the immunogenicity and reactivity of natural nucleoprotein of HOKV.

Objective: To study the public health emergent events (PHEE) in Fujian province, from 2004 to 2007., Methods: Descriptive and analytic methods were used to analyze the PHEE in Fujian province according to the internet-based surveillance reports., Results: From 2004 to 2007, there were 304 emergency events being surveyed. Of all the events, there were 7 (2.30%) belonged to serious-degree of grade II, 57(18.75%) to grade III and 240 (78.95%) to grade IV, but with no grade I. Results showed that the attack rate in affected population was 25.82 per thousand, the mortality rate was 0.08 per thousand and the fatality rate was 0.32%. The numbers of emergency events decreased 2.82% on average, each year. A total number of 169 (55.60%) events occurred in schools with 71 (23.36%) in the countryside. Numbers due to infectious disease-born was 233 (76.64%) including avian flu, cholera and dengue fever were predominant pathogens of the grade II and grade III emergency events. 57 (18.75%) of the events was due to food poisoning. The epi-garph showed that there were two peaks. i.e. in Mar-Apr and Sep, contributed 43.1% to the total number of events., Conclusion: Emergency events showed a stable decrease in Fujian province with communicable disease and food poisoning the two major sources and more commonly seen in schools and countryside. We suggest that the government and community pay more attention to the emergency events of avian flu, cholera and dengue fever.

Objective: To study the epidemiological features of hantavirus in rodents in Wenzhou, Zhejiang province., Methods: Rodents were captured in Wenzhou, where hemorrhagic fever with renal syndrome (HFRS) had been endemic. Hantavirus antigens in the rat lungs were detected by immunofluorescence assay (IFA). Partial S segment (nt 620-999) and partial M segment (nt 2001-2301) sequences were amplified by RT-PCR, and then sequenced. Neighbor-joining method was used to construct for phylogenetic analysis., Results: A total of 96 rodents were trapped in the epidemic areas, and 6 hantavirus antigens were identified from these lung samples (6.3%). Partial S and partial M segment sequences were successfully recovered from 5 samples and determined. Phylogenetic analysis of these sequences indicated that all viruses belonged to Seoul virus (SEOV), regardless of the sources (Rattus norvegicus, Rattus tanezumi and Rattus rattoide) that they were derived. However, the clustering pattern in the partial S-tree was different from that in the partial M-tree, suggesting that the re-assortment between SEOVs had occurred., Conclusion: All Rattus rats carried SEOV in Wenzhou and the genetic reassortment with SEOV had occurred naturally.

Objective: To understand the epidemiological features of two rabies cases in Baoshan city year 2006 and 2007 and to analyze its source of infection., Methods: Questionnaires were used to do the epidemiological survey on each of the rabies cases. Brain tissue samples of rabies patients were collect to detect the rabies virus by direct immunofluorescence assay (DFA) and RT-PCR assay. Homology and phylogenetic tree were analyzed, based on the whole nucleotide and deduced amino acid sequence of P, M and N gene of rabies virus followed by molecular epidemiological analysis., Results: In July 2006, one human rabies case was identified in Longyang district, and another one in Tengchong county in Baoshan city in 2007. The degrees of exposure of these two patients was all at degree III. Two brain tissue samples among the dead patients (No. CYN0601H and CYN0701H) were confirmed positive by both DFA and RT-PCR assay. The homology analysis of P, M and N gene sequences among CYN0601H, CYN0701H and other rabies strains isolated from other provinces and other counties, showed that the samples in Baoshan city shared the highest homology with the strains in Thailand. Phylogenetic analysis indicated that the two samples were very close and all belonged to genetype 1 Lyssavirus, with the closest relationship between samples in Baoshan city and strains in Thailand., Conclusion: It was confirmed on the virus molecular level that the two patients in Baoshan city were both suffered from rabies. The prevalent strains in Baoshan city was probably imported from foreign country, suggesting that prevention and control measures on rabies virus in the boarder areas of Yunnan should be strengthened.

Objective: To collect more data on the epidemiology of hantavirus in rodents in Cixi, Zhejiang province., Methods: Rodents were captured in Cixi, where hemorrhagic fever with renal syndrome (HFRS) appeared endemic. Hantavirus antigens in the rat lungs were detected by immunofluorescence assay. Partial S segment sequences were amplified by reverse transciption-polymerase chain reaction (RT-PCR) and then sequenced. The phyologenetic trees were constructed by maximum likelihood method to detect the genetic characteristics of hantavirus., Results: A total of 243 rodents were trapped in the epidemic areas, and hantavirus antigens were identified in 7 out of these lung samples (2.88%). Partial S segment sequences (620-999 nt) were recovered from 6 samples and sequenced. Data from phylogenetic analysis of these S segment sequences indicated that all viruses belonged to Seoul virus (SEOV), despite the origins of sources were either from Rattus norvegicus or from R. flabipectus. These viruses could further be divided into two distinct lineages but the viruses carried by R. norvegicus were different from those carried by R. flabipectus., Conclusion: Two distinct lineages of SEOV had been cocirculating in rodents in Cixi.

Objective: In order to better understand the epidemiological features of Hantviruses in Inner Mongolia., Methods: Epidemiological surveillance data during the period of the past 52 years were analyzed. An epidemiological survey was carried out in the main epidemic areas in 2005., Results: A total of 8310 hemorrhagic fever with renal syndrome (HFRS) cases were reported in Inner Mongolia from 1955 to 2006, and distributed in 61 counties. HFRS cases were mainly distributed in the east part of Inner Mongolia before 1990. However, HFRS cases had occurred in the middle and western parts since 1990. Hulunbeier prefecture, from the eastern part of Inner Mongolia, had been the most severe area being hit by HERS since the first outbreak in 1955, with 7369 cases reported over the past 52 years, and accounted for 88.68% of the total cases in the whole autonomous region. Although no HFRS cases had been reported before 1999 in Bayannaoer which located in the western part of Inner Mongolia, a total of 95 cases were reported in 2005. Hantavirus antigens had been detected in 11 species of rodents so far,including Apodemus agrarius, Rattus norvegicus, Mus Musculus, Cricetulus barabensis, meriones meridianus, Microtus maximowiczii , Clethrionomys rutilus, Apodemus peninsulae, Phodopus roborvskii, Dipus sagitta and Allactaga sibirica., Conclusion: Results suggested that the epidemics might remain at a relatively high level in the years to come in Inner Mongolia. Furthermore, there might be other types of Hantaviruses in addition to the already identified Seoul viral type in this area.

Objective: To analyze the genetic characteristics of two rabies virus isolates from Henan province and to compare their relations hip with known rabies virus isolates and vaccine strains., Methods: Rabies viral antigens were detected in 100 canine brains by immunofluorescence assay method. Rabies virus was isolated through inoculating the suspensions of positive brains into suckling mice. N gene and G were amplified by RT-PCR and sequenced. Phylogenetic trees were constructed for the analysis on genetic characteristics of rabies virus., Results: Two rabies virus strains were isolated (Henan Hb1 and Henan Sq1). Data from sequential comparison revealed that the nucleotide and amino acid identities of N and G gene between the two isolates were 99.3% and 98.9%, and 98.7% and 98.4% respectively. The two isolates were more closely related to CTN, with the homogeny of N gene and G gene as 89.1% and 85.6%-85.7% at the nucleotide level, but 97.6%-98.0% and 92.3% at the amino acid level respectively, than to other vaccine strains. When comparing with other known viruses including Chinese isolates, the two stains shared closer identity with the isolates from Indonesia, and the rates of homogeny of N and G gene were 92.1%-93.2% and 91.9%-92.1% at the nucleotide level, 97.5%-98.6% and 96.0%-96.2% at the amino acid level, respectively. Data from the deduced amino acid sequences revealed that some amino acid residues including the residues in the N and G antigenic sites were substituted in the two isolates. Furthermore, phylogenetic analysis showed that the two isolates were also more closely related to the strains from Indonesia and vaccine strain CTN than to any other known street viruses and vaccine strains., Conclusion: Both Henan Hbl and Henan Sql belonged to genotype 1. However, the N and G gene diverged from known street viruses and vaccine strains at either nucleotide level or amino acid level.

Objective: To explore the hantavirus infection and their genotype in rodents in Hunan., Methods: Hantavirus antigens in the rat lungs from Hunan province were detected by immunofluorescence assay. Partial S and M segment in antigen-positive samples were amplified by RT-PCR, and then sequenced. The phyologenetic trees were constructed for the analysis of genetic characters of hantavirus., Results: A total of 344 rats were trapped in the main epidemic area of Hunan province, and hantavirus antigens were found in 6 of the 344 rats( 1.74% ).The phylogenetic trees constructed by partial S segment( nt 620-990) or partial G2 segment (nt 2001- 2301) showed that the hantaviruses carried by Rattus norvegicus, R . flabipectus and R. rattoides from Xiangxiang district were genetic subtype SEOV4. The virus carried by R. norvegicus in Ningyuan district was phylogenetically different from the known SEOV. The hantavirus carried by Mus musculus from Shimen district was genetic subtype HTNV4., Conclusion: The hantaviruses in the main epidemic areas in Hunan province mainly belonged to SEOV, and R. flabipectus and R. rattoides carried the same genotype of SEOV as R. norvegicus.

Objective: To investigate the Hantavirus infection and their genotype in rodents in Huludao., Methods: Rodents were collected from the main epidemic areas to detect antigen of Hantavirus in rat lungs by indirect immunofluorescence assay. Antigen-positive samples were inoculated onto cultures of confluent Vero E6 cells for the isolation of virus. The genotypes of viruses in all antigen-positive samples were identified by reverse transcriptase-polymerase chain reaction (RT-PCR)., Results: 200 rats were collected in the main epidemic areas, and 11 Hantavirus-positive samples were tested. The positive rate of Hantavirus in rats was 5.5%. Three strains of Hantavirus were isolated in Vero E6 cell culture. Data from the phylogenetic trees constructed by partial S segment (620-999 nt) or partial G1 segment (180-580 nt) showed that the three isolates carried by rats from Huludao were all genetic subtype SEOV 3. Furthermore, the phylogenetic tree constructed by partial G2 segment (2003-2302 nt) divided SEOV strains into 7 genetic subtypes, and the three isolates were having a closer evolutionary relationship with isolates CP211, ch302 and dc501 from Beijing, and the isolates SD10 and SD227 form Shandong., Conclusion: Data indicated that the rate of carrying virus was high and the main genetic subtype of Hantavirus was S3 of Seoul virus in Huludao area.

Objective: To evaluate visual inspection with Lugol's iodine (VILI) in cervical cancer screening program and to provide evidence for designing a cervical cancer screening algorithm in high risk areas of existing low-resource settings to reduce the incidence and mortality of cervical cancer., Methods: Women in Yangcheng county, Shanxi province were screened with VILI, colposcopy, liquid-based cytology test and human papilloma virus (HPV) DNA test. The efficacy of different screening tests was compared by Youden's index based on the pathology as the gold standard., Results: In the population being screened, the mean age was 40.80 +/- 10.75 years old. Based on pathological findings, 4.35% (32/735) of the subjects had >or= CIN (cervical intraepithelial neoplasia) II. The sensitivity and specificity for the VILI test (>or= positive) were 53.13 and 82.19, while 56.25 and 79.09 were for colposcopy (>or= low grade dysplasia) respectively. Comparing by the Youden's indexs, there was no statistically significant difference (P > 0.05) between VILI and colposcopy. However, statistical significant difference (P < 0.05) was found between VILI and liquid-based cytology test and HPV DNA test. In addition, there was no statistically significant difference (P > 0.05) found between the experienced doctors and the newly-trained doctors working in the field station., Conclusion: With low sensitivity when using microscope but low cost of equipments, VILI can be one of the primary screening tests in China's rural area with low-resource settings if the screening frequency is to be increased.

Objective: To investigate the sub-genotypes and distribution ot Seoul virus in Henan., Methods: Rodents were collected in the major epidemic areas and rats lungs were studied by indirect immunofluorescence assay. Partial M and S segments were amplified with nested reverse transcription-polymerase chain reaction using Hantavirus genotype-specific primers, sequenced, analyzed and compared with other known sequences., Results: The Hantavirus carried by Rattus norvegicus, Rattus flavipectus and Mus musculus were all belonged to Seoul virus in the main epidemic areas of Henan. We constructed two phylogenetic tree based on the partial M and S segment sequences while phylogenetic analysis distinguished three genetic subtypes (S1, S2 and S3). S1 and S3 were found main subtypes in Henan., Conclusion: The results indicated that the genetic subtypes of Hantavirus were complicated and widely distributed in Henan.

Objective: To analyze 21 cases of rabies from February 8 to May 1 in 2004 in Anlong county in Guizhou province, and to explore the possible factors causing the epidemics., Methods: 21 cases of rabies were investigated. The canine brains were collected, and indirect immunofluorescence assay was used to detect rabies virus antigen in the brains., Results: From February 8 to May 1st in this year, 21 cases of rabies were reported, with 5.12/100,000 of the prevalence rate. Dogs accounted for 20 cases, and cat for one case. Median incubation period was 36.52 days, but less than 15 days in 6 cases. Among 21 cases, 17 cases were not correctly treated, and 9 cases received vaccine, with 3 cases vaccinated in time. No cases received passive immunization of antirabies serum or human antirabies immune globulin. A total of 73 dogs' brains were examined for rabies viral antigen by IFA, and 9 (12.33%) were positive., Conclusion: The increasing number of dog, high rate of virus carrier in dogs, incorrect treatment of the wound, and as well as low inoculating rate of rabies vaccine might be responsible for the outbreak of rabies in Anlong county.

Objective: To summarize and analyze the epidemic situation of hantaviruses including geographic distribution, types and prevalent intensity of epidemic areas of hantavirus for the last 30 years in China, and to discuss relative preventive measures., Methods: Collecting and analyzing the data of hantaviruses epidemics in China., Results: The annual number of cases of hantavirus disease rapidly increased from 3295 in 1970 to 115,804 in 1986 then sustained between 40,000 and 60,000 cases annually in the 1990's, and then decreased thereafter. The epidemic areas existed in all provinces except Qinhai and Xinjiang and there were the hospitalized cases of hantavirus disease reported in other provinces. In recent years, the prevalence of hantavirus infection had increased in some cities, and the seasonal distribution of the cases changed as well., Conclusion: Data suggested that the new epidemic characteristics of hantaviruses had emerged in China suggesting that it was necessary to strengthen surveillance programs and to take comprehensive preventive measures for the control and prevention of hantaviruses in China.

Objective: To summarize and analyze the epidemic situation of human rabies from 1984 to 2002 in China, and to explore the possible factors causing the increase of cases so as to provide evidence for preventive and control measures., Method: National and some provincial data on the prevalence of rabies during 1984 to 2002 were collected and analyzed., Results: From 1984 to 1989, the annual reported cases were between 4 000 and 6 000 but decreased after 1990. In 1996, the reported cases decreased to the lowest level from 3 520 in 1990 to 159. However, number of reported cases has been continuously increasing since 1998 which reached 1 122 in 2002, a 7.06 times increase as compared to the number in 1996. The epidemic areas were mainly located in the southeast and southwest parts of the country, such as Sichuan, Hunan, Guangxi, Guangdong, Anhui, Fujian, etc. Furthermore, there was no significant seasonal distribution as it showed before., Conclusion: Such facts as the increasing numbers of dogs, low inoculation rate to dogs, poor control on the quality of rabies vaccine, mistreatment to the wounds, and lacking good cooperation between different official departments regarding rabies control might serve as important factors responsible for the recurrence of rabies. Therefore, it is necessary to focus on the above mentioned points and to take comprehensive preventive measures to bring down the prevalence of rabies in China.