Surveillance for respiratory infectious diseases caused by 6 common viruses in a recruit training site in the Northern region of China

Background: Recruit training sites are places with a high incidence of respiratory infectious diseases. Effective surveillance for acute respiratory infectious diseases in a recruit training site is an important way to prevent disease outbreaks.Methods: Eight hundred recruits(722 males and 78 females) enlisted in autumn 2015 received a background survey within 24 h of settlement at the recruit training site, including their general personal information, vaccination history, mental status and clinical symptoms. Then, nasopharyngeal swabs of these recruits were collected to detect common respiratory pathogens [influenza virus type A, influenza virus type B, adenovirus(Adv), human respiratory syncytial virus, human bocavirus and human metapneumovirus] by PCR. In addition, fasting venous blood was collected in the morning for Adv Ig G antibody detection. During the three months of training, the recruits were monitored for symptoms of respiratory infection, and nasopharyngeal swabs were collected from those with an axillary temperature ≥38℃ and other respiratory symptoms within 4 h of symptom onset. Samples were further examined by PCR.Results: Among the 795 effective nasopharyngeal swab samples collected during survey, two cases of group C type 1 Adv were identified by PCR. During the 3 months of training, fever and respiratory symptoms occurred in 39 recruits(incidence rate of 4.9%) and 5 cases of Adv were detected(positive rate of 12.8%). Genotyping showed 3 cases of type 4 Adv and 2 of type 3 Adv. No type 7, 14 or 55 Adv was detected. The Adv-Ig G positive rate of recruits was 48.2%. Among the 5 Adv positive cases with fever and respiratory symptoms, 4 were Adv-Ig G positive.Conclusion: The pathogen carrier rate in recruits was low, and only group C Adv, which causes mild infection in humans, was detected. No respiratory outbreak was observed at the recruit training site, and sporadic cases were mainly caused by type 3 and type 4 Adv.

Population diversity of cardiovascular outcome trials and real-world patients with diabetes in a Chinese tertiary hospital

Background:Recent cardiovascular outcome trials(CVOTs)changed the therapeutic strategy of guidelines for type 2 diabetes.We compared the characteristics of patients from real-world hospital settings with those of participants in recent pragmatic randomized trials.Methods:This electronic medical record(EMR)-based retrospective observational study investigated the data of patients with diabetes from inpatient and outpatient settings in West China Hospital of Sichuan University from January 1,2011,to June 30,2019.We identified patients meeting the inclusion criteria of a pragmatic randomized trial(EMPA-REG OUTCOME)based on EMRs and compared their baseline characteristics with those of the trial participants.The cutoff for the clinical significance of each characteristic was set as its minimal clinically important difference based on expert consultation.Results:We included 48,257 inpatients and 36,857 outpatients with diabetes and found that 8389(17.4%)inpatients and 2646(7.2%)outpatients met the inclusion criteria for the EMPA-REG OUTCOME trial.Compared with the trial population,the realworld inpatients meeting the eligibility criteria of the EMPA-REG OUTCOME had similar age,blood pressure,and lipid profiles but comprised of fewer males,metformin users,anti-hypertensive drug users,and aspirin users,and had a lower body mass index.The group of outpatients meeting the eligibility criteria had fewer males,similar age,fewer metformin users,fewer insulin users,fewer anti-hypertensive drug users,and fewer aspirin users compared with the trial population.Conclusions:The trial population in EMPA-REG OUTCOME represents only a small portion of patients with diabetes from the inpatient and outpatient departments of a Chinese tertiary medical center.Evidence localization in different clinical settings and validation are essential to enabling extrapolation of the results from CVOTs in patients with diabetes to Chinese clinical practice.