江苏省丹阳市465例丙型肝炎病毒感染者自然转归及相关因素调查

目的 了解HCV感染者感染多年后临床和病原特征及其相关因素。方法 2012年在江苏省丹阳市对465例HCV感染者开展问卷调查、临床体征检查、血生化检测、病原检测,以明确感染者转归情况,对不同转归的感染者通过多因素logistic回归方法分析人口学特征、行为习惯、人类白细胞抗原DQ基因单核苷酸位点（rs7453920和rs2856718）、病原特征等因素对转归的影响。结果 465名HCV感染者临床表现主要为乏力（15.70%,73/465）,消化道症状（17.63%,82/465）,关节痛（10.32%,48/465）,B超肝炎病变（11.83%,55/465）,ALT值>80 IU/L（12.70%,59/465）,AST值>80 IU/L（11.18%,52/465）。HCV RNA阳性占68.60%（319/465）,病毒载量M为76.01×10⁴拷贝数/ml（592~1.08×10¹⁰拷贝数/ml）。多因素分析显示男性相比女性（OR=2.298,95%CI：1.247~4.238）、rs2856718的GA型相比AA基因型（OR=1.716,95%CI：1.070~2.752）、饮酒每周≥7次（OR=2.966,95%CI：0.979~8.988）是HCV持续感染的相关危险因素;男性（OR=1.694,95%CI：0.975~2.942）、50~岁年龄组（OR=2.414,95%CI：1.156~5.042）、有其他肝脏疾病（OR=2.592,95%CI：1.105~6.079）以及HCV RNA阳性（OR=3.479,95%CI：1.648~7.343）是肝功能异常的相关危险因素。结论 HCV感染20~30年后,病毒持续感染和肝功能异常的比例高,年龄、性别、嗜酒、个体基因特征、基础疾病是影响HCV感染转归的相关危险因素。     

Maternal prepregnancy overweight and obesity and the risk of preeclampsia: A meta-analysis of cohort studies

ObjectiveThe aim of our meta-analysis was to explore whether overweight and obesity was associated with preeclampsia or not.DesignThree databases were systematically reviewed and reference lists of relevant articles were checked. Meta-analysis of published cohort studies comparing whether overweight and obesity was associated with preeclampsia and adjusting for potential confounding factors. Calculations of pooled estimates were conducted in random-effects models. Heterogeneity was tested by using Chi-square test with Cochrane and heterogeneity was explored with meta-regression. Publication bias was estimated from Egger’s test (linear regression method) and Begg’s test (rank correlation method).ResultsNineteen studies met the inclusion criteria. The meta-analysis showed that overweight and obesity was associated with an increased risk of preeclampsia. The aOR calculated for 13 studies (compared overweight to normal weight) was 1.71, 95% CI (1.52, 1.91) for random-effects models and 19 studies (compared obesity to normal weight) was 2.48, 95% CI (2.05, 2.90) for random-effects models, stratified analyses showed no differences regarding quality grade, location of study and period of anthropometric measurement. There was no indication of a publication bias either from the result of Egger’s test or Begg’s test.ConclusionsOur results suggested that prepregnancy maternal overweight and obesity are significantly associated with an increased risk of preeclampsia.     

The complete genomic analysis of an imported Vibrio cholerae from Myanmar in southwest China

We sequenced and analyzed an imported Vibrio cholerae from Mynamar in 2011 by using whole genome sequencing method in Yunnan Province, southwest China. Other 3 isolates of V. cholerae in Yunnan were also sequenced for comparing purpose. Illumina Hiseq2500 was used and the sequencing results were assembled and annotated. The comparative genomic analysis was also performed with 101 reference strains from China and abroad. The results showed the imported V. cholerae (YN2011004) had two chromosomes and one plasmid; chr1 contained 2727 predicted genes, and 958 genes for chr2. Phylogenomic tree results showed YN2011004 belonged to the seventh pandemic strain, clustered into wave 3 and clade 3B. The strain had the highly homology with SN083 and 4remapscaff isolated in 2010 from other parts of China, and clustered with SN117, VC50 remapscaff, VC57 remapscaff and SN034. These references V. cholerae mostly isolated from coastal areas of China in 2008. For the other 3 strains' comparison, it suggested that V. cholerae in 1990s in Yunnan had the close relationship with the prevalence of cholera in Southeast Asia. Therefore, we thought that the cholera in Yunnan was consistent with the epidemic trend of China, being the “sink” for external source and also acted as a “source” for spread. Moreover, we considered that the imported V. cholerae from Myanmar in 2011 actually was the exported strain from China, and it provided us a new sight for the bacterial change and evolution.     

ARIMA模型在安徽省流行性感冒发病预测中的应用

目的探讨ARIMA模型在安徽省流感发病预测应用中的可行性并开展预测,为流感的防控提供理论依据。方法收集安徽省2005-2012年流感发病资料建立数据库,运用SPSS 13.0对逐月发病率进行ARIMA建模与拟合,在数据平稳化、定阶和参数估计后,建立ARIMA数学模型,并利用模型对2013年发病情况开展预测。结果建立ARIMA(2,2,1)(2,2,0)12模型,预测结果符合实际发病趋势,该模型具有实用性。结论 ARIMA模型可用于流感发病率在短期内变化趋势的拟合与预测。     

The diagnosis and treatment of hereditary angioedema patients in Japan: A patient reported outcome survey

BackgroundThe rate at which patients are accurately diagnosed with hereditary angioedema (HAE), as well as diagnosed patients access to modern treatments differs greatly among countries. Moreover, the severity and burden of HAE on patients have been reported mostly on the basis of physician-reported surveys. To gain insight into the real-world conditions of patients with HAE through a patient-reported survey in Japan and identify any unmet needs.MethodsA questionnaire was distributed to 121 patients with HAE via a Japanese HAE patient organization during 2016–2017. Responses were collected from 70 patients (57.9%) and subjected to analysis.ResultsThe average periods from the initial appearance of symptoms (e.g. edema) to a HAE diagnosis was 15.6 years (min–max, 0–53). Patients visited an average of 4.6 different departments until receiving a definitive diagnosis. The average age at the first visit was 25.6 years (3–73) and at diagnosis 32.8 years (0–73). Patients reported an average of 15.7 (0–100) attacks per year, but only 53.1% of attacks were treated. The days of hospitalization due to severe attacks was 14.3 (0–200) before diagnosis, but these declined to 4.3 (0–50) after diagnosis. In the treatment for attacks, 82% of the patients were treated with the plasma-derived C1 inhibitor concentrate, and 69% of the patients reported experiencing a therapeutic effect.ConclusionsThere is a long gap between first attack and diagnosis of HAE, and the number of non-treated attacks is high in Japan. Steps are needed to improve the diagnostic and treatment environments to address these issues.     

A serological and molecular survey of hepatitis B in children 15 years after inception of the national hepatitis B vaccination program in eastern China

The emergence of mutations in the hepatitis B virus (HBV) S gene has threatened the long‐term success of vaccination programs since the worldwide introduction of effective vaccines against hepatitis B. This study was conducted on 5,407 children (0–8 years old) in eastern China in 2007. We analyzed the prevalence of HBsAg, anti‐HBs, and “a”‐determinant mutations in the HBV S gene by microparticle enzyme immunoassays, PCR, and DNASTAR software. The total HBsAg prevalence was 1.52% (82/5,407) in the children and increased with age. In contrast, the positive rate (65.42%, 2,374/3,629) and the titers of anti‐HBs decreased with age. The predominant infection was HBV of genotype C and serotype adr (45/51; 88% of cases). Mutations of I126T, amino acid 137 (nt553T deletion mutation), G145A, G145R, and F158S were found in the children; the mutations of amino acid 137 and F158S have not been reported previously. The total prevalence of mutant strains was 14% (7/51). To investigate whether the infection resulted from maternal transmission, we compared the S gene sequences in 16 mother–child pairs. Fourteen mother–child pairs exhibited the same HBV genotype, with 99.5–100% sequence homology in the S gene, while two pairs exhibited different genotypes. This study suggested that the hepatitis B vaccination strategies in eastern China have been successful. Although the emergence of “a”‐determinant mutations in the HBV S gene have resulted in HBV infection in immunized children, this does not pose a threat to the vaccination strategies. The HBV‐infected children had contracted the infection via vertical transmission. J. Med. Virol. 81:1517–1524, 2009. © 2009 Wiley‐Liss, Inc.