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Purpose: The aim of this study was to explore the relationships between single-nucleotide polymorphisms (SNPs) of crucial molecules in the cGAS-STING signalling pathway and the susceptibility to, induction chemotherapy response of, and prognosis of acute myeloid leukaemia (AML) in Chinese patients. Methods: Thirteen SNPs of crucial molecules in the cGAS-STING signalling pathway were genotyped in 262 AML patients using the Sequenom MassARRAY system. The associations of SNPs with susceptibility, and induction chemotherapy response were analysed using the chi-square test or Fisher's exact test and univariate binary logistic regression, the connection of SNPs with prognosis of AML was analysed using the log-rank test, and Kaplan–Meier curves were applied for survival estimation. Results: In our study, gene polymorphisms of cGAS-STING signalling pathway molecules could be vitally associated with AML. In the recessive model, the cGAS rs311678 gene polymorphism could be closely related to AML susceptibility (CC vs. TT + TC, odds ratio (OR) = 0.480, 95% confidence interval (CI) = 0.260–0.889, p = 0.020). Moreover, IKKA rs3808917 might be associated with the WBC count, cGAS rs311678 could be associated with the bone marrow (BM) blast percentage, and NF-κB rs1056890 under codominant and recessive models could be connected with the HGB level. Patients who were STING rs7380272 TT/CT carriers was likely to have higher insensitivity to induction chemotherapy than CC carriers (TT + CT vs. CC, OR = 2.917, 95% CI = 1.073–7.929, p = 0.036). Survival analysis indicated that the IKKB rs3747811 TT genotype might be associated with decreased overall survival (OS) (p < 0.05). Conclusions: SNPs of molecules in the cGAS-STING signalling pathway could be significantly associated with AML. The cGAS rs311678 gene polymorphism could be associated with AML susceptibility, the STING rs7380272 variant might be related to induction chemotherapy response, and IKKB rs3747811 tended to be associated with AML overall survival. Moreover, IKKA rs3808917 could be associated with the WBC count, cGAS rs311678 could be associated with the BM blast percentage, and NF-κB rs1056890 might be related to the HGB level. [ABSTRACT FROM AUTHOR]

Dengue fever is one of the biggest threats to public health in China, causing huge disease burden and economic loss. Aedes-mosquito surveillance could be a cornerstone for predicting the risk of Aedes-borne diseases and evaluating the effect of vector management during diseases outbreaks. The human landing catch (HLC) method is regarded as the "gold standard" for catching Aedes mosquitoes, but it potentially exposes field professionals to vectors of known or unknown pathogens. Human-baited double net (HDN) was recommended to replace HLC for emergency monitoring in China when Aedes-borne diseases break out, but it had been reported with low efficiency for capturing Aedes mosquitoes. In this study, we compared HLC with HDN and BG traps for field Aedes albopictus monitoring, with the aim of evaluating the effectiveness of HDN replacing HLC and finding an effective and safe alternative to the HLC for monitoring Aedes albopictus. Six sites in Hangzhou, Shaoxing, and Yiwu, Zhejiang Province, China, were chosen to conduct outdoor HLC, HDN, and BG trap catches from June to October 2021. The tests were performed 3 h apart: 8:30–9:30 AM, 16:30–17:30 PM, and 17:30–18:30 PM. A total of 2330 adult mosquitoes were collected, and Aedes albopictus was the most abundant species in all three catches with 848(98.95%), 559(97.39%) and 867 (96.44%) caught in HLC, HDN and BG traps respectively. Compared to HLC, HDN collected significantly less Ae. albopictus and Ae. albopictus females per trapping period (P < 0.001, P < 0.001), whereas no statistical differences were found between the HLC and BG trap (P = 0.970, P > 0.05). Statistically significant positive spatial correlations for Ae. albopictus sampling was found between HLC and HDN traps (r = 0.543, P < 0.001) and HLC and BG traps (r = 0.658, P < 0.001). In conclusion, both the BG trap and HDN have a significant positive spatial correlation with HLC, making them safer alternatives to HLC for Ae. albopictus monitoring in China. However, with better a sampling efficiency, being less labor intensive, and no human-baited attraction bias, the BG trap could be a better choice than the HDN trap. [ABSTRACT FROM AUTHOR]

Aedes albopictus is the only vector that can transmit the dengue virus in Zhejiang Province, central China, and it can develop insecticide resistance due to long-term exposure to pyrethroids. The presence of knockdown resistance (kdr) mutations is one of the mechanisms responsible for pyrethroid resistance, and has been reported in some Ae. albopictus populations in southern China. However, little is known about the DNA diversity of the voltage-gated sodium channel (VGSC) gene in Ae. albopictus populations in central China. Four Ae. albopictus field populations were collected, in Yiwu (YW), Quzhou (QZ), Wenzhou (WZ), and Jiaxing (JX) from Zhejiang Province, central China. The susceptibility of Ae. albopictus adults to three pyrethroids (beta-cypermethrin, deltamethrin, and permethrin) was tested using the WHO tube assay, and Kdr mutations were identified via PCR and sequencing. The relationship between kdr mutations and pyrethroid phenotypes was also analyzed. Of the four populations, none was sensitive to any pyrethroid tested, and the YW population showed the strongest pyrethroid resistance. Non-synonymous kdr mutations were detected in codons 1532 and 1534, domain III. At codon 1534, one mutant allele, TCC(S), was detected in the four populations with a frequency of 42.08%, while at codon 1532, one mutant allele, ACC(T), was detected in the JX and QZ populations, with frequencies of 4.22 and 3.03%, respectively. The F1534S mutant allele was positively correlated with both beta-cypermethrin and deltamethrin resistance phenotypes (OR > 1, P < 0.05), whereas the I1532T mutant allele was possibly negatively correlated with beta-cypermethrin, deltamethrin, and permethrin resistance phenotypes (OR < 1, P > 0.05). In conclusion, resistance and resistance mutations regarding to three pyrethroids are already present in the Ae. Albopictus populations from Zhejiang, central China, which prompts the need to use non-insecticide-based methods of insect control. [ABSTRACT FROM AUTHOR]

Background: We are currently faced with an increasing burden of cardiovascular disease in China and the inadequacy of the application of guidelines in clinical practice. In the past decade, China has been strengthening the healthcare system, but it still lacked a national performance measurement system and an appropriate quality improvement strategy. Therefore, in order to improve the implementation of guideline recommendations in clinical practice, China has learnt from the successful experience of Get With The Guidelines project in 2014. Under the guidance of the Medical and Health Hospital of the National Health and Family Planning Commission, the Chinese Society of Cardiology and the American Heart Association jointly launched the Improving Care for Cardiovascular Disease in China (CCC) project. The project team provided an analysis report on the completion of key medical quality evaluation indicators of each hospital every month, supplied guidance through education, training, experience exchange and on-site investigation for problems, and certified hospitals with outstanding performance and obvious progress. The circle pattern, including evaluation, training, improvement and re-evaluation, will boost the guidelines compliance on clinical practice in China and improve the quality of medical services.Methods: This study was conducted in a centre of the Third Xiangya Hospital of Central South University. It included patients with ACS from December 2009 to December 2011 (n=225), patients with ACS in the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome project coming from the Third Xiangya Hospital of Central South University (n=665), 12 hospitals in Hunan Province (n=4333) and 150 hospitals in China (n=63 641) from November 2014 to April 2017. It assessed the situation of drug therapy, hospitalisation day, mortality during hospitalisation, median of door-to-needle (D-to-N) time and median of door-to-balloon (D-to-B) time of patients with ST-segment elevation myocardial infarction (STEMI), the proportion of D-to-N within 30 min and D-to-B within 90 min, and the proportion of reperfusion therapy. Patients with ACS from the centre from November 2014 to April 2017 were divided into five groups (every 6 months as a group according to time). The study observed change trends in all the above-mentioned indexes.Results: Compared with before participating in the CCC project, there were increases after participating in the CCC project in the drug usage rates of aspirin, P2Y12 inhibitor (clopidogrel or ticagrelor), β-blocker, statin and angiotensin converting enzyme inhibitor (ACEI)/angiotensin-receptor blocker (ARB). Hospitalisation day and mortality during hospitalisation were shortened. D-to-N and D-to-B times of patients with STEMI were shorter. Compared with Hunan Province and China, the drug usage rates were higher; hospitalisation day and D-to-N time were shorter; D-to-B time was longer; and the proportion of reperfusion therapy was higher. The trend of drug usage rates was on the rise. There was no significant change in the hospitalisation day and D-to-N and D-to-B times. The mortality during hospitalisation showed a downward trend. The proportion of D-to-N within 90 min and reperfusion therapy showed upward trends.Conclusion: Quality of care for patients with ACS improved over time in the CCC project, including taking medicine following the guidelines, increased use of reperfusion therapy and faster time to treatment. Although overall mortality has improved, we also should attach importance to high-risk patients. The influence of the CCC project, which is based on guidelines on prognosis of ACS in the centre, presents an important clinical implication that it is necessary to enhance adherence to the guidelines in the treatment of ACS. [ABSTRACT FROM AUTHOR]

To investigate the prevalence of Anaplasma, Ehrlichia, Bartonella and Theileria, we collected ticks from small mammals in six counties of Zhejiang Province in southeastern China. Polymerase chain reaction (PCR) amplification was performed to test Anaplasma, Ehrlichia, Bartonella and Theileria in tick samples. Positive PCR products were sequenced and then compared with previously published sequences deposited in GenBank using BLAST. About 292 adult ticks were captured and the dominant tick species were Ixodes sinensis and Haemaphysalis longicornis. Overall, 34 ticks (11.6%) were tested positive for at least one pathogen of Anaplasma, Ehrlichia, Bartonella and Theileria. Rates of PCR-positivity to Anaplasma, Ehrlichia, Bartonella and Theileria were 5.5, 1.7, 2.4 and 2.4%, respectively. Positive rates of Anaplasma, Bartonella and Theileria were significantly different among ticks of different species. Prevalence of Anaplasma and Theileria varied significantly among ticks of different counties. Anaplasma, Ehrlichia, Bartonella and Theileria were widely prevalent in ticks in Zhejiang Province suggesting other tick-borne pathogens should also be suspected if patients had history of tick bites. [ABSTRACT FROM AUTHOR]

Highlights: [•] We modeled students’ antitoxins for diphtheria and tetanus. [•] Mean antitoxin levels for both diphtheria and tetanus decreased with increasing age. [•] The decrease for both diphtheria and tetanus was much slower for DTwP than DTaP. [•] Booster vaccinations at 7 and 12 years of age would be recommended. [ABSTRACT FROM AUTHOR]

Mosquito-borne diseases are still threats to public health in the Zhejiang province of China. Surveillance of mosquitoes and the mosquito-borne pathogen is a vital approach for early warning, prevention, and control of the infectious disease. In this study, from 2018 to 2020, a total of 141607 female mosquitoes were caught by means of the light trap method. The main species were Culex pipiens quinquefasciatus/pallens (41.32%), Culex tritaeniorhynchus (47.6%), Aedes albopictus (2.5%), Anopheles sinensis (5.87%), Armigeres subalbatus (2.64%) and other mosquito species (0.07%). Cx. pipiens s.l. were the dominant species in two urban habitats and rural residential areas while Cx. tritaeniorhynchus was the main dominant species in the rural livestock sheds. In terms of seasonal fluctuation, Cx. pipiens s.l fluctuated at a high level from May to October. The peaks of Cx. tritaeniorhynchus, An. sinensis and Ar. subalbatus were in July. In addition, a total of 693 Ae. albopictus were collected with Biogents Mosquitaire CO 2 traps in emergency surveillance of dengue fever (DF) and screened for dengue virus infection. There were three circumstances of collection: The first: the sampling time before mosquito control during the local outbreak of DF in Lucheng of Wenzhou, 2019; The second circumstance: the sampling time after mosquito control during the local outbreak of DF of other cities in 2018-2019; The third circumstance: past DF epidemic areas the sampling time before mosquito control during the local outbreak of DF in Lucheng, Wenzhou, Zhejiang, 2019. The pools formed by mosquitoes collected in these three circumstances were 3 (6.1%), 35 (71.5%), and 11 (22.4%) respectively. Of the 49 pools tested, only one in the first circumstance was positive. The full-length dengue virus sequence of ZJWZ/2019 was obtained by sequencing and uploaded to the NCBI as number OK448162. Full-length nucleotide and amino acid homology analyses showed that ZJWZ2019 and Wenzhou DF serum isolates ZJWZ-62/2019 (MW582816) and ZJWZ-18/2019 (MW582815) had the highest homology. The analysis of full genome and E gene phylogenetic trees showed that ZJWZ2019 belonged to serotype 1, genotype I, lineage II, which was evolutionarily related to OK159963/Cambodia/2019. It implies that ZJWZ2019 originated in Cambodia. This study showed the species composition, seasonal dynamics of mosquitoes in different habitats in Zhejiang province and confirmed the role of Ae. albopictus in the transmission cycle of in outbreak of DF in the Lucheng district of Wenzhou in 2019, suggesting the importance of monitoring of vector Aedes infected dengue virus in the prevention and control of DF., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Liu, Wang, Hou, Wu, Zhang, Xing, Gao, Li, Guo, Jiang, Gong and Zhao.)

Mosquito-borne Diseases are a common but severe public health threat. However, there is a lack of consensus on the effect of different mosquito trapping devices in China. This study firstly compared the BGM trap with the CDC light trap, commonly used in Chinese mosquito surveillance. Field trials of traps' efficiency were conducted in Yiwu city, China, from May 21st, 2018 to November 31st, 2018. Sixty-five comparisons were completed in five different biotopes (an urban residential area, a rural residential area, a park, a hospital, and a pig shelter). Concerning the number of mosquitoes per trap, the BGM trap outperformed three out of five biotopes. In contrast, the CDC light trap only showed better performance in the pig shelter. For specific species, the BGM trap outperformed in capturing Ae. albopictus, while the CDC light trap caught significantly more Cx. tritaeniorhynchus. Regarding Ae. albopictus and Cx. pipiens s.l. surveillance, the BGM trap is more suitable. The BGM trap shows significantly higher or similar efficiency than the CDC light trap in trapping common mosquito species in China, except in the pig shelter. Therefore, we recommend that Chinese researchers and public health practitioners use the BGM trap in future mosquito surveillance.

Carbon dioxide (CO2) attracts host-seeking adult mosquitoes; this fact is exploited for mosquito monitoring, which is important for evaluating the effects of mosquito-control operations. A field experiment was designed to explore the relationship between the CO2 flow rate and the trapping effect of BG traps. The aim was to select an appropriate flow rate for monitoring Aedes albopictus. Six sampling sites were selected for field experiments in Hangzhou city, Zhejiang Province, China. A total of six CO2 flow rates (0.00 L/min, 0.075 L/min, 0.15 L/min, 0.30 L/min, 0.60 L/min and 1.20 L/min) were tested to compare their effects on mosquito trapping. The catches were performed in six trapping periods between 15:30 and 18:30, and each catch period lasted 0.5 h. A total of 3068 adult mosquitoes were captured at six sampling sites in six days using BG traps (with BG-Sweetscent), among which 86.96% were Ae. albopictus. The total number of Ae. albopictus (males and females) captured at a flow rate of 0.00 L/min was significantly lower than the numbers captured at 0.075 L/min, 0.15 L/min, 0.30 L/min, 0.60 L/min and 1.20 L/min (P<0.001, P<0.001, P<0.001, P<0.001, and P<0.001 respectively). The total number of Ae. albopictus captured and the number of Ae. albopictus females captured increased with increasing CO2 flow and peaked at 0.3 L/min, above which these capture numbers did not increase significantly. In conclusion, the appropriate CO2 flow rate for monitoring Ae. albopictus with BG traps was 0.3 L/min., Competing Interests: The authors have declared that no competing interests exist

Background: We are currently faced with an increasing burden of cardiovascular disease in China and the inadequacy of the application of guidelines in clinical practice. In the past decade, China has been strengthening the healthcare system, but it still lacked a national performance measurement system and an appropriate quality improvement strategy. Therefore, in order to improve the implementation of guideline recommendations in clinical practice, China has learnt from the successful experience of Get With The Guidelines project in 2014. Under the guidance of the Medical and Health Hospital of the National Health and Family Planning Commission, the Chinese Society of Cardiology and the American Heart Association jointly launched the Improving Care for Cardiovascular Disease in China (CCC) project. The project team provided an analysis report on the completion of key medical quality evaluation indicators of each hospital every month, supplied guidance through education, training, experience exchange and on-site investigation for problems, and certified hospitals with outstanding performance and obvious progress. The circle pattern, including evaluation, training, improvement and re-evaluation, will boost the guidelines compliance on clinical practice in China and improve the quality of medical services., Methods: This study was conducted in a centre of the Third Xiangya Hospital of Central South University. It included patients with ACS from December 2009 to December 2011 (n=225), patients with ACS in the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome project coming from the Third Xiangya Hospital of Central South University (n=665), 12 hospitals in Hunan Province (n=4333) and 150 hospitals in China (n=63 641) from November 2014 to April 2017. It assessed the situation of drug therapy, hospitalisation day, mortality during hospitalisation, median of door-to-needle (D-to-N) time and median of door-to-balloon (D-to-B) time of patients with ST-segment elevation myocardial infarction (STEMI), the proportion of D-to-N within 30 min and D-to-B within 90 min, and the proportion of reperfusion therapy. Patients with ACS from the centre from November 2014 to April 2017 were divided into five groups (every 6 months as a group according to time). The study observed change trends in all the above-mentioned indexes., Results: Compared with before participating in the CCC project, there were increases after participating in the CCC project in the drug usage rates of aspirin, P2Y12 inhibitor (clopidogrel or ticagrelor), β-blocker, statin and angiotensin converting enzyme inhibitor (ACEI)/angiotensin-receptor blocker (ARB). Hospitalisation day and mortality during hospitalisation were shortened. D-to-N and D-to-B times of patients with STEMI were shorter. Compared with Hunan Province and China, the drug usage rates were higher; hospitalisation day and D-to-N time were shorter; D-to-B time was longer; and the proportion of reperfusion therapy was higher. The trend of drug usage rates was on the rise. There was no significant change in the hospitalisation day and D-to-N and D-to-B times. The mortality during hospitalisation showed a downward trend. The proportion of D-to-N within 90 min and reperfusion therapy showed upward trends., Conclusion: Quality of care for patients with ACS improved over time in the CCC project, including taking medicine following the guidelines, increased use of reperfusion therapy and faster time to treatment. Although overall mortality has improved, we also should attach importance to high-risk patients. The influence of the CCC project, which is based on guidelines on prognosis of ACS in the centre, presents an important clinical implication that it is necessary to enhance adherence to the guidelines in the treatment of ACS., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

From 2003 until 2018, a total of 12 outbreaks with 1,654 confirmed dengue cases have been reported in Zhejiang Province. The emergence of insecticide resistance in mosquitoes will affect the control of dengue. Our study aims to investigate the current situation of insecticide resistance of Ae. albopictus in Zhejiang Province and compares it with the situation in 2016. Ae. albopictus were collected from 12 Zhejiang Province cities in 2019. Resistance to three major categories of insecticides, including 8 commonly used insecticides, was evaluated according to the tube test protocol recommended by China CDC. Ae. albopictus in all cities, except Hangzhou, Wenzhou, Lishui and Shaoxing, showed decreased susceptibility to beta-cypermethrin, deltamethrin and permethrin. For malathion, 3 cities Ae. albopictus have developed resistance, 3 cities Ae. albopictus have decreased susceptibility. For propoxur, in 3 cities Ae. albopictus showed decreased susceptibility with mortality ranging from 94.24% to 96.67%. The resistance to alpha-cypermethrin, lambda-cyhalothrin and fenitrothion is rare in Ae. albopictus in that only Zhoushan's mosquitoes showed decreased susceptibility to alpha-cypermethrin. The resistance to beta-cypermethrin, deltamethrin and permethrin was significantly correlated with each other. Compared to the situation in 2016, the insecticide resistance of Ae. albopictus in Zhejiang Province has become more common in 2019. In the emergency preparedness for future mosquito-borne diseases, two things should be done: 1) the selection of insecticides should be made based on information from insecticide resistance surveillance 2) the use of insecticide should follow scientific guidance.