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State-of-the-art n–i–p perovskite solar cells (PSCs) suffer from stability issues due to ionic interdiffusion. Herein, by enlarging the indacenodithiophene π-bridge donor (D′) to combine with the methoxy triphenylamine donor (D) and benzothiadiazole acceptor (A), three linear molecules termed L1, L2 and L3 with a D–A–D′–A–D structure are developed as dopant-free hole transport materials (HTMs). The π-bridge extension with active sites for coordination leverages the intramolecular dipole effect and intermolecular packing effect, resulting in a conformally bonded ultrathin interface with compact and uniform coverage (∼60 nm) to retard iodine migration and protect the buried perovskite. The unencapsulated L3-PSC (ITO/SnO2/perovskite/L3/MoO3/Au) achieved an impressive PCE of 22.61% (certified 21.79%, 0.0525 cm2). Ultrafast laser spectroscopy reveals that L-series molecules have a sequential reduction of photoexcited energy disorder to illustrate the structure–performance–stability relationship. L3-PSC maintains over 85% of the initial efficiency after 500 h at 85 °C maximum power point tracking (MPP) and enables the possibility of using small molecules to stabilize n–i–p PSCs.

Two-dimensional materials are promising for exploring memristors with excellent performance. However, the memristor still faces challenges in insufficient reliability due to resistance-switching mechanisms of conductive filaments. In this work, a typical metal/heterojunction/metal structure (Ag/MoSe2/MoS2/Au/Ti) was proposed as the device architecture of the memristor. The device exhibits stable bipolar resistive switching behavior with a high on–off ratio, long retention time, and good endurance. The resistance-switching is achieved by adjusting the interface barrier of the MoSe2/MoS2 due to the band modulation. Moreover, we explore the essential synaptic functions of this memristor device, with outstanding voltage pulse potentiation and depression. Our work highlights the significant prospects of MoSe2/MoS2 heterojunction in artificial synapses and neural networks.

Introduction Endemic measles persists in China, despite >95% reported coverage of two measles-containing vaccine doses and nationwide campaign that vaccinated >100 million children in 2010. An increasing proportion of infections now occur among adults and there is concern that persistent susceptibility in adults is an obstacle to measles elimination in China. We performed a case-control study in six Chinese provinces between January 2012 to June 2013 to identify risk factors for measles virus infection and susceptibility among adults. Methods Persons ≥15 years old with laboratory-confirmed measles were age and neighborhood matched with three controls. Controls had blood specimens collected to determine their measles IgG serostatus. We interviewed case-patients and controls about potential risk factors for measles virus infection and susceptibility. Unadjusted and adjusted matched odds ratios and 95% confidence intervals (CIs) were calculated via conditional logistic regression. We calculated attributable fractions for infection for risk factors that could be interpreted as causal. Results 899 cases and 2498 controls were enrolled. Among controls, 165 (6.6%) were seronegative for measles IgG indicating persistent susceptibility to infection. In multivariable analysis, hospital visit and travel outside the prefecture in the prior 1–3 weeks were significant risk factors for measles virus infection. Occupation and reluctance to accept measles vaccination were significant risk factors for measles susceptibility. The calculated attributable fraction of measles cases from hospital visitation was 28.6% (95% CI: 20.6–38.8%). Conclusions Exposure to a healthcare facility was the largest risk factor for measles virus infection in adults in China. Improved adherence to hospital infection control practices could reduce risk of ongoing measles virus transmission and increase the likelihood of achieving and sustaining measles elimination in China. The use of control groups stratified by serological status identified distinct risk factors for measles virus infection and susceptibility among adults.

Poliomyelitis (polio) is a highly infectious intestinal disease caused by the poliovirus. Poliovirus is transmitted by person-to-person spread mainly through the fecal–oral route, or, less frequently, by contaminated water or food. Humans are the only known reservoir of poliovirus, which is transmitted most frequently by persons with inapparent infections. Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases (1 in 200 infections), poliovirus causes paralysis, which is often permanent. Instead of a cure for polio, it can only be prevented. The Polio vaccine, given multiple times, can protect a child for life.

Tin oxide (SnO2) is widely used in perovskite solar cells (PSCs) as an electron transport layer (ETL) material. Ethanol usually serves as a solvent of ETL but no one discussed the possible influences caused by ethanol. In this work, the effects of ethanol were investigated systematically. It is clear that ethanol treatment (EtOH-SnO2) can remove surface disorder of mesoporous SnO2 and thus enhance the conductivity as well. As a result, the champion PCE of 21.62% is obtained in PSC with EtOH-SnO2 ETL, which is higher than that of control device (20.70%) due to improved film quality. Meanwhile, compared with control PSCs, the stability of the perovskite layer deposited on EtOH-SnO2 ETL is gradually improved both for the light and thermal stability. Therefore, we make clear that the ethanol treatment can improve the quality of mesoporous SnO2 and perovskite films for optoelectronic device.

Background and aims Coronavirus disease 2019 (COVID-19) is a new infectious disease. To reveal the hepatic injury related to this disease and its clinical significance, we conducted a multicenter retrospective cohort study that included 5,771 adult patients with COVID-19 pneumonia in Hubei Province. Approach and results We reported the distributional and temporal patterns of liver injury indicators in these patients and determined their associated factors and death risk. Longitudinal liver function tests were retrospectively analyzed and correlated with the risk factors and death. Liver injury dynamic patterns differed in alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBIL). AST elevated first, followed by ALT, in severe patients. ALP modestly increased during hospitalization and largely remained in the normal range. The fluctuation in TBIL levels was mild in the non-severe and the severe groups. AST abnormality was associated with the highest mortality risk compared with the other indicators of liver injury during hospitalization. Common factors associated with elevated liver injury indicators were lymphocyte count decrease, neutrophil count increase, and male gender. Conclusion The dynamic patterns of liver injury indicators and their potential risk factors may provide an important explanation for the COVID-19-associated liver injury. Because elevated liver injury indicators, particularly AST, are strongly associated with the mortality risk, our study indicates that these parameters should be monitored during hospitalization.

Summary COVID-19 was declared a pandemic by WHO on March 11, 2020, the first non-influenza pandemic, affecting more than 200 countries and areas, with more than 5·9 million cases by May 31, 2020. Countries have developed strategies to deal with the COVID-19 pandemic that fit their epidemiological situations, capacities, and values. We describe China's strategies for prevention and control of COVID-19 (containment and suppression) and their application, from the perspective of the COVID-19 experience to date in China. Although China has contained severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and nearly stopped indigenous transmission, a strong suppression effort must continue to prevent re-establishment of community transmission from importation-related cases. We believe that case finding and management, with identification and quarantine of close contacts, are vitally important containment measures and are essential in China's pathway forward. We describe the next steps planned in China that follow the containment effort. We believe that sharing countries' experiences will help the global community manage the COVID-19 pandemic by identifying what works in the struggle against SARS-CoV-2.

Interfacial engineering has been considered as an effective technique to improve the photovoltaic performance of perovskite solar cells (PSCs). Here, the interface between tin oxide (SnO2) film and fluorine-doped tin oxide (FTO) glass is dealt with a piranha solution, resulting in more hydroxyl groups on the surface of FTO glass. SnO2 film is fabricated by spin-coating SnCl2·2H2O precursor. Our results demonstrate that SnO2 film exhibits high electrical conductivity, low electron trap density, and suitable energy level. Furthermore, SnO2 film with low roughness is beneficial to fabricate high-quality perovskite film. Then, the PSCs with the structure of FTO/SnO2/Cs0.05(MA0.17FA0.83)0.95Pb(I0.83Br0.17)3/Spiro-OMeTAD/Au are also fabricated. The highest power conversion efficiency (PCE) of PSCs increases from 18.28% to 19.51%, and the average PCE enhances from 17.82% to 18.89%. The optimized PSC shows the long-term stability and remains 97% of its initial PCE after 4000 h on-shelf lifetime test.

Background: China implemented containment measures to stop SARS-CoV-2 transmission in response to the COVID-19 epidemic After the first epidemic wave, we conducted population-based serological surveys to determine extent of infection, risk factors for infection, and neutralization antibody levels to assess the real infections in the random sampled population Methods: We used a multistage, stratified cluster random sampling strategy to conduct serological surveys in three areas - Wuhan, Hubei Province outside Wuhan, and six provinces selected on COVID-19 incidence and containment strategy Participants were consenting individuals >1 year old who resided in the survey area >14 days during the epidemic Provinces screened sera for SARS-CoV-2-specific IgM, IgG, and total antibody by two lateral flow immunoassays and one magnetic chemiluminescence enzyme immunoassay;positive samples were verified by micro-neutralization assay Findings: We enrolled 34,857 participants (overall response rate, 92%);427 were positive by micro-neutralization assay Wuhan had the highest weighted seroprevalence (4*43%, 95% confidence interval [95%CI]=3*48%-5*62%), followed by Hubei-ex-Wuhan (0*44%, 95%CI=0*26%-0*76%), and the other provinces (

Introduction Endemic measles persists in China, despite >95% reported coverage of two measles-containing vaccine doses and nationwide campaign that vaccinated more than 100 million children in 2010. We performed a case–control study in six Chinese provinces during January 2012 through June 2013 to identify risk factors for measles infection among children aged 0–7 months. Methods Children with laboratory-confirmed measles were neighborhood matched with three controls. We interviewed parents of case and control infants on potential risk factors for measles. Adjusted matched odds ratios (mOR) and 95% confidence intervals (CIs) were calculated by multivariable conditional logistic modeling. We calculated attributable fractions for risk factors that could be interpreted as causal. Results Eight hundred thirty cases and 2303 controls were enrolled. In multivariable analysis, male sex (mOR 1.6 [1.3, 2.0]), age 5–7 months (mOR 3.9 [3.0, 5.1]), migration between counties (mOR 2.3 [1.6, 3.4]), outpatient hospital visits (mOR 9.4 [6.6, 13.3]) and inpatient hospitalization (mOR 107.1 [48.8, 235.1]) were significant risk factors. The calculated attributable fractions for hospital visits was 43.1% (95% CI: 40.1, 47.5%) adjusted for age, sex and migration. Conclusions Hospital visitation was the largest risk factor for measles infection in infants. Improved hospital infection control practices would accelerate measles elimination in China.

The incorporation of renewable bio-based materials/eco-friendly inorganic nanofillers into stimuli-responsive hydrogels meets the need for biocompatible and non-toxic functional materials. However, it remains challenging to build a three-dimensional network with enhanced mechanical properties and desired stimuli-responsive performances. In this study, dual stimuli-responsive hydrogels with interpenetrating polymer network structure are fabricated by the crosslinking of N-isopropylacrylamide (NIPAM) 1 and sodium alginate (SA) 2 . 2,2,6,6-tetramethyl-piperidine-1-oxyl-oxidized cellulose nanofibers (TOCNF) 3 derived from energycane bagasse serves as a carrier material for nanosilicas (NS) 4 and nanoclays (NC) 5 and the effects of TOCNF, TOCNF/NS and TOCNF/NC on the hydrogels are thoroughly explored. Among these hydrogels, PNIPAM/SA-TOCNF-NS possesses the largest compressive strength of 66.7 kPa and it is 5.65 times higher than that of PNIPAM/SA. The thermo-sensitivity and pH-sensitivity of hydrogels are evidenced by swelling behaviors, optical properties, contact angle measurements and fluorescence tests. PNIPAM/SA-TOCNF exhibits the largest contact angle and the swelling processes for all the hydrogels are well fitted by pseudo-second-order swelling kinetic model. In addition, after incorporating carbon quantum dots, all the hydrogels display temperature dependent on–off fluorescence properties and this process are fully reversible with the heating and cooling cycles. These novel hydrogels with pH and temperature responsive characteristics and remarkable mechanical properties will open the door for interesting applications in smart sensors etc.

Introduction Endemic measles persists in China, despite >95% reported coverage of two measles-containing vaccine doses and nationwide campaign that vaccinated more than 100 million children in 2010. In 2011, almost half of the 9943 measles cases in China occurred in children eligible for measles vaccination. We conducted a case-control study during 2012–2013 to identify risk factors for measles infection in children aged 8 months–14 years. Methods Children with laboratory-confirmed measles were age- and neighborhood-matched with three controls. We interviewed parents of case and control infants on potential risk factors for measles. We calculated adjusted matched odds ratios and 95% confidence intervals of risk factors. We calculated attributable fractions for risk factors that could be interpreted as causal and vaccine efficacy (VE) for the measles containing vaccine (MCV) used in the Chinese immunization program. Results In all, 969 case-patients and 2845 controls were enrolled. In multivariable analysis, lack of measles vaccination both overall (mOR 22.7 [16.6, 31.1] and when stratified by region (east region, mOR 74.2 [27.3, 202]; central/western regions mOR 17.4 [12.5, 24.3]), hospital exposure (mOR 63.0, 95% CI [32.8, 121]), and migration among counties (overall mOR 3.0 [2.3, 3.9]) were significant risk factors. The calculated VE was 91.9–96.1% for a single dose of MCV and 96.6–99.5% for 2 doses. Conclusions Lack of vaccination was the leading risk factor for measles infection, especially in children born since the 2010 supplementary immunization activity. Reducing missed vaccination opportunities, improving immunization access for migrant children, and strengthening school/kindergarten vaccine checks are needed to strengthen the routine immunization program and maintain progress toward measles elimination in China.

Two different linear triblock polymer-grafted graphene sheets (GSs) had been synthesized by chemical surface modification reaction. The linear terpolymers PtBMA101-b-PGMA19-b-PSt100 and PtBMA127-b-PHEMA21-b-PDMAEMA132 had been synthesized by reversible addition–fragmentation chain transfer process and with their narrow polydispersity index M w/M n of 1.25 and 1.33, respectively. The results of FTIR showed that the characteristic peak area of hydroxyl in the PtBMA127-g-GS-g-PDMAEMA132 was less than that of the graphite oxide (GO), while the signal of the aromatic ring at 710 cm−1 (from 750 to 690 cm−1) displayed in the PtBMA101-g-GS-g-PSt100. The ratio of the intensities (I D/I G) for the GSs in Raman spectra was markedly increased compared with that of the pristine GO. Both illuminated that the two different terpolymers had taken chemically covalent graft on the surface of the GO. The polymer grafting efficiency in the composite GSs was 44 and 42 mass% determined by thermogravimetry for PtBMA127-g-GS-g-PDMAEMA132 and PtBMA101-g-GS-g-PSt100, respectively. Friedman’s analysis showed that the apparent activation energies of the PtBMA101-g-GS-g-PSt100 were higher than those of the PtBMA127-g-GS-g-PDMAEMA132 during the thermal decomposition, because of the existence of the benzene ring for the former. The results from rheological analysis showed that the amphiphilic GSs solutions both displayed an obvious pseudoplastic fluid behavior, the existence of benzene ring in the amphiphilic PtBMA101-g-GS-g-PSt100 made the flowability of solution even worse than that of the amphiphilic PtBMA127-g-GS-g-PDMAEMA132 solution according to the same content of the GSs, and meanwhile, the flexible polymer arms of the PtBMA and PDMAEMA made the viscosity more sensitive to the shear rate for the PtBMA127-g-GS-g-PDMAEMA132.

In July 2013, the National Immunization Program of China was notified by the US Centers for Disease Control and Prevention that measles was detected in 3 newly adopted, special needs children with cerebral palsy (CP) from China. We report an investigation of measles transmission in China that led to infection of these children. Interviews were conducted with welfare institute staff and panel physicians; health records of the potentially exposed population were reviewed; and immunization coverage was assessed among institute residents. Five residents with CP, all unvaccinated against measles, among who were the 3 adoptees, were linked epidemiologically into 3 generations of measles transmission antecedent to the US outbreak. In a random sample of residents, first dose of measles containing vaccine (MCV1) and MCV2 coverage was 16 of 17 (94%) and 7 of 11 (64%) among children with CP, and 100% (32 of 32) and 96% (21 of 22) among children without CP. Vaccinators reported reluctance to vaccinate children with CP because the China pharmacopeia lists encephalopathy as a contraindication to vaccination. Panel physicians reported to investigators no necessity of vaccination for adoptees to the United States if US parents sign an affidavit exempting the child from vaccination. We recommend that the China pharmacopeia vaccine contraindications be reviewed and updated, the United States should reconsider allowing vaccination exemptions for internationally adopted children unless there are true medical contraindications to vaccination, and US pediatricians should counsel adopting parents to ensure that their child is up-to-date on recommended vaccinations before coming to the United States.

Tonsillitis can promote the progression of IgA nephropathy (IgAN) by aggravating immunopathologic response. Th22 cell disorder is involved in the pathogenesis of IgAN with tonsillitis. This study was determined to explore the possible mechanism of IgAN with tonsillitis underlying Th22 cell chemotaxis response to the effect of CCL20, CCL22, and CCL27. This research was conducted on 65 subjects including 16 healthy controls (HC group), 5 patients with renal carcinoma (HTC group) and 44 patients with IgAN between 2015 and 2016. According to clinical symptoms and results of throat swab culture, patients with IgAN were divided into two groups: IgAN with tonsillitis (IgAN + tonsillitis, n = 14) and IgAN patients without tonsillitis (IgAN, n = 30). Distribution of Th22 cells in IgAN patients was determined. The expression of CCL20, CCL22, and CCL27 in both peripheral blood and kidneys of IgAN patients was investigated. Severity of pathological lesions in IgAN patients was analyzed. Coculture assay and transwell assay were performed to explore the impacts of human mesangial cells (HMC) on Th22 cell chemotaxis and Th22 cell local accumulation under hemolytic streptococcus (HS) infection. Th22 cell percentages in IgAN patients increased compared with healthy controls. This increased Th22 cell percentage was positively correlated with the renal lesions of IgAN patients. Correspondingly, the expression of CCL20, CCL22, and CCL27 in renal tissue increased in IgAN patients. Tonsillitis exacerbated these overrepresentations of Th22 cells and chemokines. It was found that HMC could produce CCL20, CCL22, and CCL27. The supernatant of HMC was chemotactic for Th22 cells. This activity of HMC was stimulated by HS infection, whereas treatment of anti-CCL20, anti-CCL22, and anti-CCL27 antibodies partly blocked this chemoattractant effect of HMC. Tonsil infection may aggravate the renal pathological lesions of IgAN by exacerbating Th22 cell accumulation. Our data suggested a collaboration between HMC and Th22 cells in IgAN with tonsillitis underlying the effects of CCL20, CCL22, and CCL27.

Counterfeits in the medicine market make the authentication of snakes used for Chinese medicine a challenge to Chinese drug regulatory control agencies. This paper explores existing methods that can be used to quickly and accurately distinguish Zaocys (Z. dhumnades) from its counterfeits for routine identification of snake meats in food and drug control laboratories. In this research, the Cytochrome Oxidase I (COI) fragments of 51 samples from 17 species of snakes were amplified using Polymerase Chain Reaction (PCR) and sequenced. The inter- and intra-specific variations of COI sequences were analyzed and compared based on Kimura-2-parameter (K-2P) distances; the minimal interspecific K-2P distance was 0.0934, which was bigger than the maximum intraspecific K-2P distance in Z. dhumnades (0.0523), indicating that Zaocys can be separated from its counterfeits. The Neighbor-Joining (N-J) tree of the snakes was constructed and the results show that snakes of the same species cluster with 100% bootstrap values. Since the Zaocys and its counterfeits are of different species, they can be distinguished using the N-J tree method. Another 10 samples of Zaocys from markets and drug stores were identified at the species level, among which 5 samples were proven to be the counterfeits--Ptyas korros.

Greater use of appropriate specimen collection and confirmatory laboratory testing is needed., During September 2006–December 2009, we conducted active population and sentinel laboratory–based surveillance for bacterial meningitis pathogens, including Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b, in 4 China prefectures. We identified 7,876 acute meningitis and encephalitis syndrome cases, including 6,388 among prefecture residents. A total of 833 resident cases from sentinel hospitals met the World Health Organization case definition for probable bacterial meningitis; 339 of these cases were among children

Background The goal of polio eradication is to complete elimination and containment of all wild, vaccine-related and Sabin polioviruses. Vaccine-derived poliovirus (VDPV) surveillance in China from 2001–2013 is summarized in this report, which has important implications for the global polio eradication initiative. Methods Acute flaccid paralysis (AFP) cases and their contacts with VDPVs isolated from fecal specimens were identified in our AFP surveillance system or by field investigation. Epidemiological and laboratory information for these children were analyzed and the reasons for the VDPV outbreak was explored. Results VDPVs were isolated from a total of 49 children in more than two-thirds of Chinese provinces from 2001–2013, including 15 VDPV cases, 15 non-polio AFP cases and 19 contacts of AFP cases or healthy subjects. A total of 3 circulating VDPVs (cVDPVs) outbreaks were reported in China, resulting in 6 cVDPVs cases who had not been vaccinated with oral attenuated poliomyelitis vaccine. Among the 4 immunodeficiency-associated VDPVs (iVDPVs) cases, the longest duration of virus excretion was about 20 months. In addition, one imported VDPV case from Myanmar was detected in Yunnan Province. Conclusions Until all wild, vaccine-related and Sabin polioviruses are eradicated in the world, high quality routine immunization and sensitive AFP surveillance should be maintained, focusing efforts on underserved populations in high risk areas.

To determine the prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core anti-body (anti-HBc) in a representative population in China 14 years after introduction of hepatitis B vaccination of infants.National serosurvey, with participants selected by multi-stage random sampling. Demographics and hepatitis B vaccination history collected by questionnaire and review of vaccination records, and serum tested for HBsAg, antibody to anti-HBc and anti-HBs by ELISA.The weighted prevalences of HBsAg, anti-HBs and anti-HBc for Chinese population aged 1-59 years were 7.2%, 50.1%, 34.1%, respectively. HBsAg prevalence was greatly diminished among those age15 years compared to that found in the 1992 national serosurvey, and among children age5 years was only 1.0% (90% reduction). Reduced HBsAg prevalence was strongly associated with vaccination among all age groups. HBsAg risk in adults was associated with male sex, Western region, and certain ethnic groups and occupations while risk in children included birth at home or smaller hospitals, older age, and certain ethnic groups (Zhuang and other).China has already reached the national goal of reducing HBsAg prevalence to less than 1% among children under 5 years and has prevented an estimated 16-20 million HBV carriers through hepatitis B vaccination of infants. Immunization program should be further strengthened to reach those remaining at highest risk.

Background In the 1990s, China introduced rubella vaccine into the private market using BRD-II virus strain, which is different than the globally used RA27/3 strain. In 2007, BRD-II rubella containing vaccine was introduced into the national immunization program and recommended for routine use. However, to our knowledge, there are no field vaccine effectiveness (VE) studies of BRD-II rubella vaccine. In April 2011, a rubella outbreak was detected in two daycare centers in Harbin city, China. We conducted an investigation to determine VE of BRD-II rubella vaccine. Methods Rubella cases were either laboratory-confirmed or epidemiologically linked to laboratory-confirmed cases. We collected demographic characteristics, migrant status, and history of rubella and measles vaccination from all children in the two daycare centers. Results The first case of rubella was on 22 November, 2010. Among the 143 children in the two daycare centers, 22 acquired rubella, for an overall attack rate (AR) of 15.4% (22/143). The AR in higher-grade classes (21.7%) was higher than in lower grade classes (3.9%). The AR among migrant children (47.8%) was higher than among local children (9.2%). Rubella vaccine coverage was 17% (24/143), while measles vaccine coverage was 100%. The AR among rubella-vaccinated children was 0% (0/24), and the AR among rubella-unvaccinated children was 18.5% (22/119), for a VE of 100% ( P value = 0.025, 95% CI: 35–100%). Rubella vaccine coverage among children born before 2007 was 10.2% (10/98), and was lower than that for children born in 2007 or after (31.1% (14/45), RR = 0.33, 95%CI: 0.16–0.68). Emergency vaccination was conducted on 11 and 12 April 2011, and the outbreak stopped in one week later. Conclusions Domestic BRD-II strain rubella vaccine showed high vaccine effectiveness against rubella. Rubella vaccine coverage through routine immunization was insufficient. Consideration should be given for measuring rubella vaccine coverage to determine the need for catch-up vaccination in China.

Background Mother to Child Transmission (MTCT) has remained a leading cause of HBV infection in China, accounting for 40% of total infections. Providing hepatitis B vaccine (HepB) to all infants within 24 h of birth (Timely Birth Dose, TBD), and subsequent completion of at least 3 vaccine doses is key to preventing perinatal HBV infection. In 2002, with the financial support of the Global Alliance on Vaccine and Immunization (GAVI) targeted to Western region and 223 poverty-affected counties in Central region, hepatitis B vaccine was provided for free. In 2010, we evaluated the China GAVI project in terms of its activities to prevent perinatal infections. Objective The objectives of the evaluation were to (1) measure achievements in the China GAVI project in terms of TBD coverage, and (2) describe practices for HBsAg screening of pregnant women and HBIG use outside the GAVI China project. Methods We used the methods recommended by WHO to select a cluster sample of health care facilities for the purpose of an injection safety assessment. We stratified China into three regions based on economic criteria, and selected eight counties with a probability proportional to population size in each region. In each selected county, we selected (a) 10 townships at random among the list of townships of the county and (b) the one county level hospital. In each hospital, we abstracted 2002 through 2009 records to collect information regarding birth cohorts, hospitals deliveries, vaccine management, hepatitis B vaccination delivery, HBsAg screening practices and results, and HBIG administration. In addition, in all hospitals, we abstracted records regarding the delivery of TBD. Results We visited 244 facilities in the three regions, including 24 county hospitals and 220 township hospitals. We reviewed 837,409 birth summary records, 699,249 for infants born at county or township hospitals. Hospital delivery rates increased from 58% in 2002 to 93% in 2009. Surveyed TBD coverage increased from 60% in 2002 to 91% in 2009 (+31%). Surveyed TBD coverage among children born in hospitals increased from 73% in 2002 to 98% in 2009. Between 2002 and 2009, the proportion of pregnant women screened for HBsAg increased from 64% in 2002 to 85% in 2009. In 2009, the proportion of infants born to women screened and found to be HBsAg positive who did not receive any immunization within 24 h after birth ranged from 0% to 0.7% across regions. Conclusions Increased availability of hepatitis B vaccine, along with efforts to improve hospital deliveries, increased TBD coverage in China. This decreased perinatal HBV transmission and will reduce disease burden in the future. Screening for HBsAg to guide HBIG administration has begun, but with heterogeneous immuno-prophylaxis practices and a poor system for follow up.

Objective In order to measure hepatitis B coverage and progress in equality with respect to protection against hepatitis B in poverty-affected areas funded by the Global Alliance on Vaccine and Immunization project funded in poverty-affected counties. Methods We reviewed routinely reported coverage data and conducted a national stratified, validation, cross-sectional survey in October 2010, according to WHO recommended sampling method. First, we stratified China into three regions (Eastern, Central and Western) based on economic criteria. Second, in each region, we selected eight counties with a probability proportional to population size. Third, in each selected county, we selected (a) 10 townships at random among the list of townships of the county. Results We visited 244 townships as part of the final evaluation (71 in the East, 86 in the Center and 87 in the West). Overall, in these 244 townships, surveyed TBD coverage increased from 60% in 2002 to 91% in 2009 and surveyed three dose of hepatitis B vaccine coverage increased from 71% in 2002 to 93% in 2009. Overall, in the GAVI supported areas, the HepB3/DTP3 ratio increased from 57% in 2002 to 94% in 2009. Conclusion Pro-poor GAVI approach was an effective way to reduce inequity among children through provision of free vaccination. When vaccine and AD syringes were provided for free, they closed the gap between Eastern and Western regions and between the rich and the poor.

BACKGROUND: Characterisation of the severity profile of human infections with influenza viruses of animal origin is a part of pandemic risk assessment, and an important part of the assessment of disease epidemiology. Our objective was to assess the clinical severity of human infections with avian influenza A H7N9 virus, which emerged in China in early 2013. METHODS: We obtained information about laboratory-confirmed cases of avian influenza A H7N9 virus infection reported as of May 28, 2013, from an integrated database built by the Chinese Center for Disease Control and Prevention. We estimated the risk of fatality, mechanical ventilation, and admission to the intensive care unit for patients who required hospital admission for medical reasons. We also used information about laboratory-confirmed cases detected through sentinel influenza-like illness surveillance to estimate the symptomatic case fatality risk. FINDINGS: Of 123 patients with laboratory-confirmed avian influenza A H7N9 virus infection who were admitted to hospital, 37 (30%) had died and 69 (56%) had recovered by May 28, 2013. After we accounted for incomplete data for 17 patients who were still in hospital, we estimated the fatality risk for all ages to be 36% (95% CI 26-45) on admission to hospital. Risks of mechanical ventilation or fatality (69%, 95% CI 60-77) and of admission to an intensive care unit, mechanical ventilation, or fatality (83%, 76-90) were high. With assumptions about coverage of the sentinel surveillance network and health-care-seeking behaviour for patients with influenza-like illness associated with influenza A H7N9 virus infection, and pro-rata extrapolation, we estimated that the symptomatic case fatality risk could be between 160 (63-460) and 2800 (1000-9400) per 100,000 symptomatic cases. INTERPRETATION: Human infections with avian influenza A H7N9 virus seem to be less serious than has been previously reported. Many mild cases might already have occurred. Continued vigilance and sustained intensive control efforts are needed to minimise the risk of human infection. FUNDING: Chinese Ministry of Science and Technology; Research Fund for the Control of Infectious Disease; Hong Kong University Grants Committee; China-US Collaborative Program on Emerging and Re-emerging Infectious Diseases; Harvard Center for Communicable Disease Dynamics; US National Institute of Allergy and Infectious Disease; and the US National Institutes of Health., link_to_subscribed_fulltext

We investigated a cluster of five cases of severe pneumonia from one village in Yunnan Province, China. We searched for severe pneumonia in the village and hospitals. We interviewed patients and family members about exposures. We tested acute and convalescent sera for antigen and antibody of severe acute respiratory syndrome, avian influenza, and plague. The only common exposure of the five patients was riding together in the enclosed cab of a truck for 1.5 hours while taking the first patient to the hospital. Seroconversion to plague F1 antigen confirmed plague in three survivors. Unfamiliarity of clinicians with plague and lack of sputum examination, blood culture, or postmortem examination delayed the diagnosis. No plague cases occurred among family and village contacts and health care workers. High infectivity in this cluster was limited to a crowded, poorly ventilated truck.

Giving further consideration on linguistic feature, this study proposes an algorithm of Chinese text categorization based on sense group. The algorithm extracts sense group by analyzing syntactic and semantic properties of Chinese texts and builds the category sense group library. SVM is used for the experiment of text categorization. The experimental results show that the precision and recall of the new algorithm based on sense group is better than that of traditional algorithms.

We describe the epidemiology of hepatitis B virus (HBV) infection among women of reproductive age residing in areas of China that are highly endemic for chronic HBV, and provide evidence useful for decision-makers to guide strategies for preventing mother-to-child transmission of HBV, and assess the impact of perinatal transmission PMTCT by projecting HBsAg prevalence trends without interventions. We conducted a cross-sectional HBV serological survey of women, 15-49 years of age, residing in Fujian, Guangdong, Guangxi and Hainan provinces. Demographic and other subject-level data were collected in face-to-face interviews, after which we obtain blood specimens. Specimens were tested for HBV sero-markers by ELISA (Beijing Wantai Biological Pharmacy), and HBV DNA was tested with PCR (Hunan Sansure Biotech). Weighted HBsAg and HBV (either HBsAg+ or anti-HBc+ indicating either present or past infection) prevalences were 11.82% and 57.16%, respectively. Among the HBsAg-positive women, 27% were also HBeAg positive. The proportion of individuals with HBV DNA loads >105 IU/mL declined with increasing age. Among HBsAg-negative women, 0.9% had occult HBV infection. The prevalence of chronic HBV infection among reproductive women in these highly endemic provinces is high, posing a threat to maternal health and risk of mother-to-child transmission. Prevention of mother-to-child transmission remains critically important.

Background The disease burden associated with influenza in developing tropical and subtropical countries is poorly understood owing to the lack of a comprehensive disease surveillance system and information-exchange mechanisms. The impact of influenza on outpatient visits, hospital admissions, and deaths has not been fully demonstrated to date in south China. Methods A time series Poisson generalized additive model was used to quantitatively assess influenza-like illness (ILI) and influenza disease burden by using influenza surveillance data in Zhuhai City from 2007 to 2009, combined with the outpatient, inpatient, and respiratory disease mortality data of the same period. Results The influenza activity in Zhuhai City demonstrated a typical subtropical seasonal pattern; however, each influenza virus subtype showed a specific transmission variation. The weekly ILI case number and virus isolation rate had a very close positive correlation (r = 0.774, P < 0.0001). The impact of ILI and influenza on weekly outpatient visits was statistically significant (P < 0.05). We determined that 10.7% of outpatient visits were associated with ILI and 1.88% were associated with influenza. ILI also had a significant influence on the hospitalization rates (P < 0.05), but mainly in populations 0.05). The impact of ILI on chronic obstructive pulmonary disease (COPD) was most significant (P < 0.05), with 33.1% of COPD-related deaths being attributable to ILI. The impact of influenza on the mortality rate requires further evaluation. Conclusions ILI is a feasible indicator of influenza activity. Both ILI and influenza have a large impact on outpatient visits. Although ILI affects the number of hospital admissions and deaths, we found no consistent influence of influenza, which requires further assessment.