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Infectious diarrhea cases have increased during the past years in the Anhui Province of China, but little is known about its spatial cluster pattern and associated socioeconomic factors. We obtained county-level total cases of infectious diarrhea in 105 counties of Anhui in 2016 and computed age-adjusted rates. Socioeconomic factors were collected from the Statistical Yearbook. Hot spot analysis was used to identify hot and cold spot counties for infectious diarrhea incidence. We then applied binary logistic regression models to determine the association between socioeconomic factors and hot spot or cold spot clustering risk. Hot spot analysis indicated there were both significant hot spot (29 counties) and cold spot (18 counties) clustering areas for infectious diarrhea in Anhui (P < 0.10). Multivariate binary logistic regression results showed that infectious diarrhea hot spots were positively associated with per capita gross domestic product (GDP), with an adjusted odds ratio (AOR): 3.51, 95% CI: 2.09-5.91, whereas cold spots clustering were positively associated with the number of medical staffs (AOR: 1.18, 95% CI: 1.08-1.29) and negatively associated with the number of public health physicians (AOR: 0.27, 95% CI: 0.09-0.86). We identified locations for hot and cold spot clusters of infectious diarrhea incidence in Anhui, and the clustering risks were significantly associated with health workforce resources and the regional economic development. Targeted interventions should be carried out with considerations of regional socioeconomic conditions.

Understanding the socioeconomic burden of severe fever with thrombocytopenia syndrome (SFTS) is important for making decisions on health resources allocation. This study aimed to assess the economic burden of patients with this syndrome in endemic areas of the Anhui Province in 2018. A total of 114 patients were recruited, and the median age was 63.5 years, 62 (54.4%) were female, 97 (85.1%) were farmers, 108 (94.7%) were survival patients, and 71 (62.3%) had a family monthly income less than $453.3. The median times of hospital visits and hospitalizations of patients were three times, and the median lost work days of these patients, caregivers and visitors were 14.5 days, 14.5 days and 7.5 days, respectively. The median direct costs of the patient were $3,761.6, and the median indirect costs were $508.3. Taking direct and indirect costs into consideration, the median total economic costs of patients were $4,323.9, and the total annual cost of 2018 was $1,396,913.6. Although 113 (99.1%) patients had medical insurance, only 25.8% of costs were covered by reimbursement, and the total cost paid for by the patients and their families was $1,041,073.6 in 2018. Our findings revealed that the patients and their families had a significant economic burden, and preventive measures should be strengthened in endemic areas. The findings also provided baseline data for assessing the cost‐effectiveness of the vaccines or anti‐viral drugs in the near future in China.

BackgroundIschemic stroke is widely recognized as a major health problem and social burden worldwide, and it usually leads to dementia. In this study, we aimed to better understand the pathogenesis in the development of dementia following ischemic stroke.Material/MethodsWe exploited miRNA database to search for the target for miR-125a and validated the found target using luciferase assay. Further, we performed real-time PCR and Western blot analysis to examine the expression of miR-125a and its target in the tissue samples. In addition, a polymorphism was genotyped and its association with post-stroke dementia was analyzed.ResultsWe identified enthothelin-1 (ET-1) as a target of miR-125a, and this relationship was validated using luciferase assay. Furthermore, transfection of miR-125a inhibitor substantially upregulated the expression of ET-1, while miR-125a and ET-1 siRNA caused downregulation of ET-1 in endothelial cells. In addition, we found that a polymorphism (rs12976445) interferes with the expression of miR-125a, which in turn caused an increase in the expression of ET-1 in human endothelial cells. Logistic regression analysis showed that rs12976445 is significantly associated with the risk of dementia after ischemic stroke.ConclusionsOur study demonstrated the pathogenesis mechanism during the development of dementia after ischemic stroke by investigating the relationship between miR-125a and its target ET-1, promising a potential pathological solution for post-stroke dementia in the future.

Background COVID-19 has spread worldwide and become a pandemic. We report the epidemiological and clinical characteristics of cluster infections. Methods Data of clustered cases were retrieved from the public health emergency monitoring information system of China. We analyzed the incubation period, generation gap, secondary attack rate, and viral load in various grouped cases. Results A total of 60 COVID-19 infection clusters including 226 patients and 19 asymptomatic cases involving four generations were analyzed. With the increase of transmission generations, secondary attack rate decreased ( P ＜0.001) and severity alleviated ( P = 0.008). The median incubation period and intergenerational interval were 9 and 6 days, respectively. The secondary attack rate was 7.1% in the index cases, 5.0% in the first generation, 1.0% in the second generation, and 4.7% overall. Severe cases were seen more in the index (13, 65%) and first generation (7, 35%) ones, who had a significantly higher viral load than the mild and moderate ones. Conclusions With the increase of transmission generation, secondary infection rate and severity decreased. Severe patients had a higher virus load. Patients in the incubation period and asymptomatic carriers were potential infection sources who might play an important role in transmission.