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Background: Certain bacterial infectious diseases are categorized as notifiable infectious diseases in China. Understanding the time-varying epidemiology of bacterial infections diseases can provide scientific evidence to inform prevention and control measures. Methods: Yearly incidence data for all 17 major notifiable bacterial infectious diseases (BIDs) at the province level were obtained from the National Notifiable Infectious Disease Reporting Information System in China between 2004 and 2019. Of them 16 BIDs are divided into four categories, respiratory transmitted diseases (RTDs, 6 diseases), direct contact/fecal-oral transmitted diseases (DCFTDs, 3 diseases), blood-borne/sexually transmitted diseases (BSTDs, 2 diseases), and zoonotic and vector-borne diseases (ZVDs, 5 diseases), and neonatal tetanus is excluded in the analysis. We characterized the demographic, temporal, and geographical features of the BIDs and examined their changing trends using a joinpoint regression analysis. Results: During 2004‒2019, 28 779 thousand cases of BIDs were reported, with an annualized incidence rate of 134.00 per 100 000. RTDs were the most commonly reported BIDs, accounting for 57.02% of the cases (16 410 639/28 779 000). Average annual percent changes (AAPC) in incidence were − 1.98% for RTDs, − 11.66% for DCFTDs, 4.74% for BSTDs, and 4.46% for ZVDs. Females had a higher incidence of syphilis than males, and other BIDs were more commonly reported in males. Among 0-5-year-olds, the diseases with the largest increases in incidence were pertussis (15.17% AAPC) and scarlet fever (12.05%). Children and students had the highest incidence rates of scarlet fever, pertussis, meningococcal meningitis, and bacillary dysentery. Northwest China had the highest incidence of RTDs, while South and East China had the highest incidences of BSTDs. Laboratory confirmation of BIDs increased from 43.80 to 64.04% during the study period. Conclusions: RTDs and DCFTDs decreased from 2004 to 2019 in China, while BSTDs and ZVDs increased during the same period. Great attention should be paid to BSTDs and ZVDs, active surveillance should be strengthened, and timely control measures should be adopted to reduce the incidence. [ABSTRACT FROM AUTHOR]

Based on the annual maximum water level record spanning about 60 years at 34 gauging stations, we conduct flood frequency analysis in the Pearl River Delta (PRD) with generalized extreme value (GEV) distribution. The GEV model performs sound estimation with the correlation coefficient at most stations larger than 0.99. To better understand the flood risk especially in ungauged regions, the spatial distribution of flood-stage is displayed for three given return periods, 10-year, 20-year and 50-year. Similar pattern can be identified for different return periods except the difference in magnitude, which generally exhibits a decreasing trend from the upper region to offshore area with a scope of about 2–9 m. Additionally, a comparison between pre-1980 and post-1980 is carried out to quantify the flood-stage alteration. The results show that most stations display increasing flood risk except for some stations in the upper estuaries, which experienced slight water level decline. Particularly, the lower part of the PRD is vulnerable to the most severe flood-stage increment. The estimated extreme water level increases by 0.35 m (14.96%), 0.59 m (21.23%) and 1.06 m (29.96%) on average at stations corresponding to 10-year, 20-year and 50-year return period, respectively. [ABSTRACT FROM AUTHOR]

Abstract: This paper focuses on identifying changes in the tidal range and the duration of the flood tide in the Pearl River Delta region, China. Mann–Kendall test and regression methods are employed to verify the existence of trends in the annual tidal range and duration series (from the 1950s to 2005) at 17 stations in the 3 major tributaries of the delta. The research results indicate that generally there is an increasing trend in the tidal range and flood tide duration at most of the stations in the channel network. Moreover, the more upstream the location of the station, the more obvious the change in trend is, and these increasing trends are all significant at the stations in the upper part of the delta. Specifically, the tidal range at Shilong station in the East River has increased abruptly since the middle of the 1980s such that the mean level of post-1990 data is approximately three times that for pre-1985. Most stations near the mouth of the estuary show significant downward trends in the tidal range and flood tide duration. Results of the intersection point of the Mann–Kendall test curves for these Pearl River Delta stations appear mostly in 1980s–1990s, indicating that a noticeable change point occurs during this period. Human activities in the Pearl River Delta reached their peak during the 1980s. Among these, large-scale and long-term sand excavation modified the hydrodynamic regime dramatically in a way that increased the water depth and lowered the level of the riverbed, leading to an increased tidal prism and upstream movement of the tidal limit. Land reclamation is also likely to have had a relatively large effect on the tidal range and flood tide duration at stations near to the estuary mouth. Changes in other factors, such as freshwater flow and sea-level rise, seem to be of relatively minor importance. It is noteworthy that in a dry season the tidal dynamics are greatly enhanced and has resulted in strong saltwater intrusion into the estuary in recent years. [Copyright &y& Elsevier]

Knowledge of the clinical progress of severe fever with thrombocytopenia syndrome (SFTS) and the associated predictors of mortality is important for providing appropriate treatment in severe cases. A multihospital retrospective study was conducted in three SFTS-endemic cities, in 2018. Of the 208 SFTS-confirmed cases, there were 189 survivors and 19 deaths. The median age was 64 years; 104 (50.0%) patients were men, and 188 (90.4%) were farmers. Furthermore, 203 (97.6%) patients reported fever and 70 (33.7%) reported fatigue. Most fatal cases had complications including multiple-organ failure, central nervous syndrome (CNS) abnormalities, and disseminated intravascular coagulation. During the fever phase, alanine transaminase, aspartate aminotransferase (AST), blood urea nitrogen (BUN), creatinine, D-dimer, glucose, hydroxybutyrate dehydrogenase, lactate dehydrogenase (LDH), procalcitonin, prothrombin time, and uric acid levels were higher in fatal than in nonfatal cases (P < 0.05). Creatine kinase (CK), CK-MB (CKMB), AST, and LDH levels were significantly lower in nonfatal than in fatal cases (P < 0.05). Central nervous syndrome abnormalities (odds ratio [OR] = 20.9, 95% CI: 4.3, 100), body temperature ≥ 38.5°C (OR = 23.2, 95% CI: 3.4, 158), BUN levels ≥ 6.4 mmol/L (OR = 9.9, 95% CI: 2.2, 44), CKMB levels ≥ 100 U/L (OR = 33.2, 95% CI: 5.8, 192), and LDH levels ≥ 1,000 U/L (OR = 8.3, 95% CI: 1.9, 37) were predictors of mortality. Our findings reveal that the presence of specific complications and laboratory parameters may serve as predictors of mortality and aid in early identification of severe SFTS cases in clinical practice.

Solid neuroendocrine breast carcinoma (solid NEBC) is a relatively uncommon malignant tumor of the breast. The purpose of our study was to explore the incidence and clinical features of this tumor, and to evaluate the efficacy of adjuvant chemotherapy and endocrine therapy for patients with solid NEBC. Of 7542 breast cancers registered during the period from March 2004 to April 2011, 22 patients (0.29%) who underwent surgery had tumors that were histologically confirmed as solid NEBC, and were enrolled in this study. The age range of these patients was 29-77 years (mean 52.5 years). Patients were staged according to the 7th edition of the pathologic tumor-node-metastasis (pTNM) staging system. Biopsies or resection specimens were reviewed and reclassified according to the World Health Organization (WHO) 2003 classification. We recorded clinical features including gender and age, chief complaint, and past medical history, tumor characteristics including size, location, preoperative diagnosis, and pathologic and immunohistochemical findings, the therapeutic schedule, and the follow-up results. Solid NEBC is a rare and distinct category of malignant disease of the breast, with good prognosis, and in most early-stage cases, is resectable. The role of adjuvant chemotherapy and endocrine therapy in solid NEBC may be limited and should be studied further., (© 2013 Wiley Periodicals, Inc.)