昆明市2013-2017年丙型病毒性肝炎流行特征及趋势分析

目的分析昆明市2013-2017年丙型病毒性肝炎的流行特征和流行趋势,为科学制定防控策略提供依据。方法运用描述性流行病学方法,统计昆明市2013-2017年丙型病毒性肝炎的发病情况,分析其流行特征和趋势。结果昆明市2013-2017年丙型病毒性肝炎呈现先上升后下降的趋势,2015年达到发病高峰,其发病率高达32.80/10万,总体上2013-2017年丙型病毒性肝炎发病率呈现上升趋势,且肝炎和丙肝以官渡区、五华区和西山区为主要的高发地区;无明显的季节性特点,四季均有发病;易发生丙型病毒性肝炎的人群为35~50岁的农民和家务及待业人员。结论昆明市丙型病毒性肝炎发病状况并不乐观,应加强丙肝防控力度,重点关注高发地区和高发人群,通过有效举措控制丙型病毒性肝炎的发病率。     

Immune responses against hepatitis C virus genotype 3a virus-like particles in mice: A novel VLP prime-adenovirus boost strategy

Chronic hepatitis C virus (HCV) infection represents a major health threat to global population. In India, approximately 15–20% of cases of chronic liver diseases are caused by HCV infection. Although, new drug treatments hold great promise for HCV eradication in infected individuals, the treatments are highly expensive. A vaccine for preventing or treating HCV infection would be of great value, particularly in developing countries. Several preclinical trials of virus-like particle (VLP) based vaccine strategies are in progress throughout the world. Previously, using baculovirus based system, we have reported the production of hepatitis C virus-like particles (HCV-LPs) encoding structural proteins for genotype 3a, which is prevalent in India. In the present study, we have generated HCV-LPs using adenovirus based system and tried different immunization strategies by using combinations of both kinds of HCV-LPs with other genotype 3a-based immunogens. HCV-LPs and peptides based ELISAs were used to evaluate antibody responses generated by these combinations. Cell-mediated immune responses were measured by using T-cell proliferation assay and intracellular cytokine staining. We observed that administration of recombinant adenoviruses expressing HCV structural proteins as final booster enhances both antibody as well as T-cell responses. Additionally, reduction of binding of VLP and JFH1 virus to human hepatocellular carcinoma cells demonstrated the presence of neutralizing antibodies in immunized sera. Taken together, our results suggest that the combined regimen of VLP followed by recombinant adenovirus could more effectively inhibit HCV infection, endorsing the novel vaccine strategy.     

一起食源性群体旋毛虫感染调查报告

2004年2月，云南大理市发生一起食源性群体旋毛虫感染，累计发病132人，发病者年龄2．5～75岁。调查结果显示，患者均有集体食用生猪肉史，用餐12d后陆续发病。经病原治疗和对症治疗后病人均痊愈。     

2010—2020年云南省学校食源性疾病暴发事件流行病学分析

目的 了解云南省学校食源性疾病暴发事件流行病学特征和趋势。 方法 收集2010—2020年云南省各地报告的学校食源性疾病暴发资料,并进行描述性流行病学分析。 结果 2010—2020年共发生学校食源性疾病暴发260起,发病6 600人,死亡2人,总体呈下降趋势。学校食源性疾病暴发高峰期为第二、四季度,占总起数的66.54%(173/260);暴发场所多发生在小学,占总起数的58.08%(151/260)。报告明确或可疑致病因子的185起事件中由微生物或可疑微生物引起的占40.00%(74/185),毒素引起的占46.49%(86/185);明确致病因子的118起暴发事件中,60.17%(71/118)是由4种致病因子引起的,其中蓖麻毒素导致的最多,达22起(18.64%),发病人数428人,其次是蜡样芽孢杆菌20起(16.95%),原因食品被归因为一类食品植物类,主要是大米、三明治、面包。导致暴发污染环节最多的是生产加工环节(50.77%,132/260)。 结论 关注学校食源性疾病暴发事件流行特征,在学生开学季时,加强对小学食堂植物类食品的生产加工环节管理和监督。微生物、毒素感染是学校食源性疾病主要的致病因素,且原因查明率低,进一步强化医疗机构食源性疾病微生物、毒素检测能力,提高原因查明率,最大限度地降低学校食源性疾病的发病率。     

2008-2018年云南省人间布鲁菌病流行特征及灰色GM(1,1)模型预测

目的分析云南省布鲁菌病(简称布病)流行特征,建立灰色GM(1,1)模型,预测云南省布病病情。方法收集中国疾病预防控制信息系统和云南省统计局2008-2018年云南省布病疫情数据和人口资料,分析布病流行病学特征(包括时间、地区、人群分布),并以灰色GM(1,1)模型进行建模,预测2019、2020年云南省布病发病率。结果2008-2018年云南省共报告布病病例1216例,年均发病率为0.2374/10万,呈逐年递增趋势(χ²趋势=843.34,P<0.01)。病例报告主要集中在3-9月份,占总病例数的69.41%(844/1216)。病例报告数居前5位的州市分别为红河州(289例)、曲靖市(264例)、昆明市(258例)、大理州(160例)、玉溪市(134例),占总病例数的90.87%(1105/1216)。职业以农民为主,占79.03%(961/1216)。建立灰色GM(1,1)模型预测2019、2020年云南省布病发病率分别为0.4876/10万和0.4817/10万。结论云南省布病发病较以往上升,应对重点地区、重点人群进行针对性防控,并对预测结果进行前瞻性评价,逐步完善云南省布病预测模型。     

Undocumented Migrants Reintroducing COVID-19, Yunnan Province,China

To limit the spread of severe acute respiratory syndrome coronavirus 2, the government of China has been monitoring infected travelers and minimizing cold-chain contamination. However, other factors might contribute to recurring outbreaks. We analyze the role of undocumented migrants as potential transmitters of severe acute respiratory syndrome coronavirus 2 in China.     

云南省病原学阳性肺结核患者总延迟变化趋势

  目的  分析“十一五”“十二五”和“十三五”中国结核病防治规划期间云南省病原学阳性肺结核患者总延迟时间的变化趋势,获得影响总延迟发生的影响因素,为减少总延迟的发生提供依据。  方法  利用《结核病管理信息系统》中登记报告的云南省2005年、2010年、2015年和2020年病原学阳性肺结核患者的病案资料。描述最终纳入研究患者的人口学特征、延迟特征。构成比的时间趋势检验用χ2趋势检验,采用Kaplan-Meier法进行组间患者总延迟的比较,估计生存概率并绘制生存函数曲线,用Cox比例风险模型进行患者总延迟发生的多因素分析。  结果  云南省病原学阳性肺结核患者的总延迟整体呈下降趋势,且下降趋势与就诊延迟相似。总延迟中位数由2005年的94 d降至2020年的33 d,2020年患者确诊并接受治疗的概率较2005年增长了2.359倍,不同特征患者的总延迟天数均呈下降趋势。多因素回归分析结果显示,除年份外,女性、高年龄、农民、少数民族、流动人口和复治患者也是发生总延迟的危险因素。  结论  在云南省结核病防控措施的实行下,病原学阳性肺结核患者总延迟天数下降,有效控制了结核病疫情的发展。应侧重于降低总延迟天数较高的危险人群的就诊延迟, 寻求符合成本-效益的主动筛查方式,进一步控制结核病疫情发展。     

云南省普洱市思茅区大面积野鼠自毙疫情实验室检测结果与分析

目的 调查引起云南省普洱市思茅区大面积野鼠自毙疫情的病原体,以便为采取相应措施提供科学依据。方法 通过现场流行病学调查,采集119只自毙野鼠样本,解剖取脏器进行鼠疫耶尔森菌病原体分离、噬菌体裂解实验、F1抗原、caf1基因等病原学、免疫学及分子生物学检测,以排除鼠疫。同时,脏器样本接种绵羊血琼脂平板、巧克力平板、麦康凯平板、沙氏琼脂培养基等营养培养基和选择性培养基,分离培养细菌、真菌类病原体;选取10只组织腐败较轻的自毙鼠,按肺组织、脑组织、腹腔脏器组织分为3份样本后,研磨、离心,再以0.22μm滤膜过滤,收集离心上清液、滤膜滤出液和滤膜截留残渣共9份样本,腹腔接种雄性、体质量30~40g昆明小鼠,每组2只,每只0.5ml。另接种0.5ml Hank’s液2只鼠作对照。共接种昆明小鼠20只。死亡小鼠解剖观察病理变化,取脏器组织接种上述培养基进行细菌分离培养。结果 鼠疫耶尔森菌病原学、免疫学和分子生物学检测均为阴性;自毙野鼠脏器镜检、分离培养及接种实验动物均检出G- 短小杆菌,经梅里埃VITEK 2GN、GP卡、16S rRNA扩增鉴定为多杀巴斯德菌 (Pasteurella multocida,Pm) ,概率为99%;分离到的G+粗大杆菌为腊样芽孢杆菌,概率为99%。结论 多杀巴斯德菌可能是这次发生野鼠大面积死亡的病原菌。该病原体的生物学特性及危害值得进一步关注。     

常用炮制对滇产草乌3种乌头碱减毒情况分析

目的 利用几种常规的炮制方法分析草乌中乌头碱、次乌头碱和新乌头碱的减毒情况。方法 将大小形状不同的草乌样品分别经过水煮法、蒸法及烘烤法进行不同时长炮制,采用超高效液相色谱串联质谱进行含量测定分析,外标法定量。结果 3种乌头碱在0.20～100.0μg/L浓度范围内均具有良好的线性关系,相关系数均大于0.9997。草乌不同形状减毒效果为粉末＞片状＞完整个头,不同炮制方法减毒效果为水煮＞蒸＞烘烤,烘烤炮制对草乌样品未有良好减毒效果。浓度为1.0μg/mL的乌头碱、新乌头碱和次乌头碱标准品分别经过0.5h、1.5h和1.5h水煮炮制可达到100%完全降解,但其他炮制样品的减毒效果根据不同的炮制方法显现出较大差异性。结论 3种乌头碱经过足够时长的水煮及蒸法炮制均可达到显著的减毒效果,烘烤法对草乌减毒作用较小,民间食用草乌的安全性应引起高度重视。     

Characterization and phylogenetic analysis of a neurovirulent Zika virus isolated from Cambodia in 2019

The geographic range of Zika virus (ZIKV) has expanded from Asia to the Americas, leading to the 2015–2016 pandemic with enhanced neurovirulence. At present, ZIKV is continuously circulating in many Southeast Asian countries. Unfortunately, the persistent evolution of ZIKV in Southeast Asia and its influence on the biological characteristics of the virus remain incompletely understood. In this study, the in vitro and in vivo properties of a new ZIKV isolate obtained from Cambodia in 2019 (CAM/2019) were characterized and compared with those of the Cambodian strain (CAM/2010). Compared with CAM/2010, the CAM/2019 virus showed similar plaque morphology and growth curves in cell cultures and induced comparable viremia and organ viral loads profiles in both BALB/c and A129 (IFNAR1^−/−) mice upon intraperitoneal (i.p.) inoculation. Remarkably, the CAM/2019 virus exhibited enhanced neurovirulence in neonatal mice compared with CAM/2010, with a 74-fold reduction in the 50% lethal dose (LD₅₀). Consistently, CAM/2019 produced higher viral loads in the brains of BALB/c neonatal mice than CAM/2010 did. Sequence alignment showed that the CAM/2019 virus has acquired 12 amino acid substitutions, several of which were found to be associated with neurovirulence. In particular, the CAM/2019 virus shared an A1204T substitution in NS2A with the Thai isolate SI-BKK02 that was isolated from a microcephaly case. Taken together, our results indicate that a ZIKV strain isolated with specific mutations has emerged in Cambodia, highlighting the need for extensive molecular and disease surveillance in Cambodia and other Asian countries.