2009-2017年江苏省手足口病病原谱及柯萨奇A16型的分子流行病学研究

目的 描述2009-2017年江苏省手足口病(HFMD)病原谱及柯萨奇A16型(CVA16)的流行病学、基因变异及遗传进化特征。方法 对2009-2017年江苏省手足口病发病资料和病原学检测情况进行统计分析,选取120株CVA16病毒分离株进行VP1区全长基因序列测定,并对核苷酸及氨基酸序列进行同源性比较及系统进化分析。结果 2009-2017年江苏省共报告手足口病1 013 771例。其中, 手足口病肠道病毒阳性病例37 389例,主要病原构成为EV71(39.85%)和CVA16(30.13%);重症病例中,以EV71为主要病原,CVA16及其他肠道病毒引起的重症病例较少。CVA16在每年的3~7月和9~11月出现流行高峰,主要感染1~4岁年龄段儿童,男性比例高于女性。江苏省地区流行的CVA16毒株属于B1a亚型和B1b亚型,其中B1b亚型为优势流行基因亚型。120株CVA16病毒分离株VP1区核苷酸及编码氨基酸序列同源性分别为87.5%~100%、97%~100%。结论 2009-2017年,江苏省地区流行的CVA16具有明显的时间、人群分布特征;120株CVA16分离株属于B1a亚型和B1b亚型。CVA16分离株核苷酸序列变异较大,但氨基酸同源性较高,推断存在一定的同义突变。     

Enterovirus spectrum from the active surveillance of hand foot and mouth disease patients under the clinical trial of inactivated Enterovirus A71 vaccine in Jiangsu,China, 2012‐2013

Epidemiological data from active surveillance on human enterovirus, which could cause hand, foot, and mouth disease, were limited. An active surveillance system was used to investigate the enterovirus spectrum and the incidence of different enteroviruses in infants aged 6–35 months in Jiangsu Province from 2012 to 2013. Fifty‐nine infants were randomly selected from 522 non‐EV‐A71/CV‐A16 HFMD patients. We collected 173 throat swabs and 174 rectal swabs from these infants. RT‐PCR was used to amplify 5'‐UTR and VP1 regions of enteroviruses and the serotypes were determined by the sequence comparison using BLAST. Twenty‐one non‐EV‐A71/CA16 enterovirus serotypes were detected in those infants. E16, E18 were firstly reported in HFMD patients. The four top common non‐EV‐A71/CV‐A enteroviruses among infants were CV‐B3, CV‐A10, CV‐A6, and E9 with the HFMD incidence rates at 1.4%, 0.84%, 0.56%, and 0.47%, respectively. Over 20.8% patients were co‐infected with multiple enteroviruses. Neither the course of sickness nor clinical symptoms of the co‐infected patients was more severe than those infected with single enterovirus. Two patients were infected different enterovirus successively within 2 months. Several new enterovirus serotypes and multiple models of infection associated with HFMD were discovered through the active surveillance system. These data provide a better understanding of the viral etiology of HFMD. J. Med. Virol. 87:2009–2017, 2015. © 2015 Wiley Periodicals, Inc.

     

血液透析及丙肝病毒感染者F蛋白抗体分析

目的探讨丙型肝炎病毒(hepatitis C virus,HCV)F蛋白抗体在血液透析人群HCV感染者中的分布特点及其影响因素。方法利用pEGX-4T-2/HCV-F融合载体表达蛋白HCV-F/GST作为抗原,包被酶联反应板,间接ELISA法检测128例血液透析HCV感染者血清中的HCV-F抗体;Logistic回归分析患者特征与HCV-F抗体是否阳性的关系。结果 128例HCV感染者中F抗体阳性率为45.3%;单因素分析显示,血透时间、HBcAb、HCV RNA与F抗体是否阳性的差异有统计学意义(分别P=0.038、P=0.012和P=0.002);多因素分析显示,血透时间>10年(OR=4.153,95%CI=1.435～12.023)、HCV RNA阳性(OR=3.6979,5%CI=1.498～9.123)是HCV-F抗体阳性的影响因素。结论血液透析人群HCV感染者中可检出F抗体;F蛋白的表达可能与HCV复制有关。     

二甲基乙酰胺对人胚肺细胞凋亡及Bcl-2和Caspase-3表达的影响

目的探讨二甲基乙酰胺(DMAC)诱导人胚肺成纤维细胞(HELF凋亡)的可能机制。方法用MTT法检测细胞生长抑制率,用Hoechst染色法检测细胞凋亡,用Western blot法检测Bcl-2、Caspase-3蛋白表达。结果DMAC处理HELF细胞24 h均可诱导细胞发生凋亡,并呈现明显的剂量-效应关系;DMAC诱导HELF细胞凋亡过程中伴随着Bcl-2蛋白表达下降、Caspase-3蛋白表达增加。结论 DMAC可诱导HELF细胞凋亡,其机制可能与Bcl-2蛋白表达下降从而激活Caspase-3的表达有关。     

江苏省2011年流行性腮腺炎病毒分子流行病学分析

目的:分离江苏省2011年流行性腮腺炎病毒(Mumps Virus,MuV),并分析其基因特征。方法:对江苏省2011年腮腺炎咽拭子进行病毒分离,对MuV分离株针对SH基因进行PCR扩增,并对该PCR产物进行序列测定,结合从基因库下载的中国MuV毒株序列以及世界卫生组织(WHO)MuV基因型参考株一起进行分子流行病学研究。结果:通过比较核苷酸和氨基酸同源性和构建亲缘关系树发现,江苏省2011年MuV分离株属F基因型,但序列相互间存在差异。此外,通过分析江苏省2011年MuV分离株的遗传距离发现,MuV毒株序列同源性和亲缘关系树分析结果一致。结论:江苏省2011年流行的MuV同属F基因型,是由F基因型MuV的多个传播链引起的。并且2011年的MuV毒株间存在序列差异,说明在江苏省流行的MuV发生了一定程度的变异。     

一起水源苯酚污染引起饮用水异味事件的调查

[目的]调查分析某城市生活饮用水异味事件的发生原因,查明污染物质,以利采取有效措施消除或控制危害因素,确保生活饮用水卫生安全,保障消费者身体健康. [方法]对某自来水厂进行现场调查和水源水、出厂水、末梢水水质进行卫生监测与评价. [结果]水源水水质的挥发酚类不符合国家《地面水环境质量标准》(GB 3838-2002)规定的Ⅲ类水质标准;出厂水和末梢水水样中的挥发酚类检测值为＜0.002～0.132 mg/L,存在臭和味、挥发酚类等指标不符合国家《生活饮用水卫生标准》(GB 5749-2006)规定要求. [结论]水源水苯酚污染是造成此次饮用水异味事件的主要原因.     

The role of adiposity,diet and inflammation on the discordance between LDL-C and apolipoprotein B

Background and aimsWhile low-density lipoprotein cholesterol (LDL-C) is a good predictor of atherosclerotic cardiovascular disease, apolipoprotein B (ApoB) is superior when the two markers are discordant. We aimed to determine the impact of adiposity, diet and inflammation upon ApoB and LDL-C discordance.Methods and resultsMachine learning (ML) and structural equation models (SEMs) were applied to the National Health and Nutrition Examination Survey to investigate cardiometabolic and dietary factors when LDL-C and ApoB are concordant/discordant. Mendelian randomisation (MR) determined whether adiposity and inflammation exposures were causal of elevated/decreased LDL-C and/or ApoB. ML showed body mass index (BMI), dietary saturated fatty acids (SFA), dietary fibre, serum C-reactive protein (CRP) and uric acid were the most strongly associated variables (R² = 0.70) in those with low LDL-C and high ApoB. SEMs revealed that fibre (b = ?0.42, p = 0.001) and SFA (b = 0.28, p = 0.014) had a significant association with our outcome (joined effect of ApoB and LDL-C). BMI (b = 0.65, p = 0.001), fibre (b = ?0.24, p = 0.014) and SFA (b = 0.26, p = 0.032) had significant associations with CRP. MR analysis showed genetically higher body fat percentage had a significant causal effect on ApoB (Inverse variance weighted (IVW) = Beta: 0.172, p = 0.0001) but not LDL-C (IVW = Beta: 0.006, p = 0.845).ConclusionOur data show increased discordance between ApoB and LDL-C is associated with cardiometabolic, clinical and dietary abnormalities and that body fat percentage is causal of elevated ApoB.     

Visceral adipose tissue quality was associated with nonalcoholic fatty liver disease,independent of its quantity

Background and aimsNonalcoholic fatty liver disease (NAFLD) is a serious liver disease. Recent studies have shown that both visceral adipose tissue (VAT) quantity and density (as an indirect measure of quality) are associated with metabolic profiles. Therefore, we investigated the association between VAT quantity and quality, and the prevalence and incidence of NAFLD.Methods and resultsIn this cross-sectional, retrospective cohort study, the prevalence and incidence of NAFLD were analyzed in 627 and 360 middle-aged subjects, respectively. VAT was evaluated using an unenhanced computed tomography scan, while NAFLD was evaluated using ultrasonography. The VAT area was normalized to the square value of the subjects’ height in meters, the visceral fat area (VFA) index. The VAT density was described as the visceral fat density (VFD). The VFA index and VFD had an interaction effect on the prevalence of NAFLD (P = 0.0059). The VFA index (adjusted odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01–1.07; P = 0.0145, per 1.0 cm²/m²) and the VFD (OR, 0.90; 95% CI, 0.84–0.96; P = 0.0026, per 1.0 Hounsfield unit [HU]) were independently associated with the prevalence of NAFLD. In our cohort, 36 subjects developed NAFLD. The VFD (adjusted hazards ratio [HR], 0.84; 95% CI, 0.77–0.91; P < 0.0001, per 1.0 HU) was independently associated with the incidence of NAFLD, whereas the VFA index was not.ConclusionBoth the VFA index and VFD were independently associated with NAFLD prevalence. The VFD might be more related to the incidence of NAFLD than the VFA index.     

江苏两市MSM抗病毒治疗效果及其影响因素的研究

目的:分析江苏男男性行为(men who have sex with men,MSM)人群的艾滋病抗病毒治疗效果及其影响因素,首次建立江苏省MSM抗病毒治疗评价方法?方法:通过整群抽样的方式选取江苏两市接受免费高效抗逆转病毒治疗(highly active antiretroviral therapy,HAART)的MSM作为研究对象,进行生活史和用药情况的问卷调查;从江苏省艾滋病治疗信息库中获知其CD4值,采用Epidata 3.0和SAS 9.0分别进行资料录入与统计分析?结果:157例MSM总体CD4值提高,服药依从性低?经单因素及多因素分析,确诊后安全套使用水平低?吸烟量大?确诊至治疗时间间隔长是影响治疗效果的危险因素;首次CD4值较高及服药天数较长是保护因素?结论:江苏目前男男性行为人群抗病毒治疗效果显著,建议对符合治疗条件的MSM进行早期治疗,并提高患者服药依从性?     

江苏省两县柯萨奇病毒A组16型流行病学特征分析

目的:探讨柯萨奇病毒A组16型(CVA16)的流行病学特征,以期为手足口病的综合防治和CVA16疫苗研制提供流行病学依据?方法:基于在江苏建立的肠道病毒所致疾病监测系统,通过主动与被动报告相结合的方式对东海县2 875人?宝应县2 080人进行监测;使用统一调查表格对病例进行个案调查,并采集咽?肛拭子进行实时荧光定量PCR法快速检测?结果:截至2013年2月,东海?宝应两县CVA16感染所致发病率分别为16.73%(481/2 875)和9.28%(193/2 080), 整个监测期间均只出现1个发病高峰,均在2012年5月中下旬;两县病例均覆盖所有乡镇,但不同乡镇间发病率存在地区差异;两县所发现病例年龄范围为9~42月龄,男?女性别比分别为1.59∶1和1.47∶1,不同性别发病率无统计学差异?结论:2012年3月~2013年2月江苏省东海和宝应两县肠道病毒流行以CVA16为主,病毒流行具有明显的季节性以及地区差异性?