浙江省农村自然人群隐匿性乙型肝炎病毒感染（OBI）情况及进化特征分析

 【摘要】目的 了解浙江省德清县农村一般人群隐匿性及实际乙型肝炎病毒(hepatitis B virus,HBV)感染情况及病毒株S基因的分子特征。方法 采用多级抽样方法进行横断面调查,在取得调查对象知情同意的基础上采集调查表信息并采血。采用Epidata 3.2软件录入调查表信息,双录入并核对;采用SPSS 18.0软件进行数据分析;对所有样品进行乙型肝炎表面抗原（hepatitis B surface antigen,HBsAg) ELISA检测及病毒载量real time PCR测定,并对HBsAg检测阳性或病毒载量测定阳性的标本进行后续HBV S基因PCR扩增和测序;采用MEGA 5.0软件对测得序列进行进化分析。结果 共调查对象1 720例,调查人群中HBsAg阳性者共162例,隐匿性乙型肝炎病毒感染(occult hepatitis B virus infection,OBI)者共4例,实际HBV感染率为9.65% (166/1 720),OBI感染率为2.57‰ (4/1 558)。显性和隐匿性病毒株病毒载量中位数及四分位数范围分别为866 (425,12 500)IU/mL和314 (216,677.5)IU/mL,前者显著高于后者。HBsAg阳性血清样本扩增得到71株显性病毒株S基因序列,HBsAg阴性血清样本扩增得到4株OBI病毒株S基因序列。OBI病毒株均为C基因型,adrq+血清型。显性HBV病毒株54株为B基因型,其中有2例标本为adw3血清型,其余52例均为adw2血清型;余17株为C基因型,adrq+血清型。OBI病毒株中C基因型的比例显著高于显性HBV病毒株中C基因型的比例。B基因型显性病毒株发生I104F、L109V、I110L、S113T、T126I、P127T、Q129R、M133L、F134L、P135A、T140A、K141I、T143M/S、V159A、Y161F、A166G和R169P突变,C基因型显性病毒株发生I126S、I126T及F158S突变。OBI病毒株发生Q129R、I126T、 M133T及F161Y突变。结论 浙江省德清县一般人群存在一定比例的OBI感染,OBI感染病毒载量较低,OBI病毒株存在氨基酸突变,C基因型为其可能的优势基因型,需重视OBI预防问题。     

2005-2010年中国城市居民期望寿命趋势分析

 目的 了解中国城市男女期望寿命的现状,分析期望寿命受年龄和死因影响的不同变化,探讨哪个年龄组、何种死因是导致我国近5年期望寿命变化的主要因素。方法利用2005-2010年《中国卫生统计年鉴》中中国城市居民年龄别死亡率及死因别死亡率等数据,采用绘制寿命表法、期望寿命上升下降增减差异的年龄分解和死因分解法,进行城市居民期望寿命差异的分析比较。结果 2005-2010年中国城市的期望寿命不断上升,2005年为76.57岁,2008年达到峰值,为80.03岁。2005-2010年中国城市的居民死亡主要是循环系统疾病、恶性肿瘤及呼吸系统疾病造成的。在所有年龄组中,2005-2006年期望寿命的快速提高主要由55~85岁居民期望寿命的提高所引起;2008-2009年,期望寿命下降0.49岁,主要是因80岁以上、尤其是85岁以上老人期望寿命下降所致。从病因别分析,2005-2008年,期望寿命3年内增加3.46岁,主要是循环系统疾病对于期望寿命作用的快速增加(2.15岁,62.14%),其次为呼吸系统疾病和损伤中毒等外部原因,分别导致期望寿命上升0.75岁(21.68%)和0.64岁(18.50%)。肿瘤对期望寿命增长的作用为0.28岁(8.09%),传染病为0.06岁(1.73%)。2008-2010年,期望寿命在2年内下降了1.94岁,主要是循环系统疾病的作用(1.22岁,62.89%)。结论 针对循环系统疾病的危险因素,尽早采取干预措施,大力宣传戒烟、减少肥胖、提倡健康生活方式、预防糖尿病和高血压,将有助于期望寿命的进一步提高。呼吸系统疾病是影响期望寿命的第二大因素,肺炎对于期望寿命的影响始终为负作用,建议在5岁内的婴幼儿和儿童以及65岁以上的老年人等发病高危人群中接种肺炎疫苗,可有效提高机体的免疫力,减少肺炎发病,降低影响期望寿命的负面因素。     

A research agenda for ageing in China in the 21st century (2nd edition): Focusing on basic and translational research,long-term care,policy and social networks

One of the key issues facing public healthcare is the global trend of an increasingly ageing society which continues to present policy makers and caregivers with formidable healthcare and socio-economic challenges. Ageing is the primary contributor to a broad spectrum of chronic disorders all associated with a lower quality of life in the elderly. In 2019, the Chinese population constituted 18 % of the world population, with 164.5 million Chinese citizens aged 65 and above (65+), and 26 million aged 80 or above (80+). China has become an ageing society, and as it continues to age it will continue to exacerbate the burden borne by current family and public healthcare systems. Major healthcare challenges involved with caring for the elderly in China include the management of chronic non-communicable diseases (CNCDs), physical frailty, neurodegenerative diseases, cardiovascular diseases, with emerging challenges such as providing sufficient dental care, combating the rising prevalence of sexually transmitted diseases among nursing home communities, providing support for increased incidences of immune diseases, and the growing necessity to provide palliative care for the elderly. At the governmental level, it is necessary to make long-term strategic plans to respond to the pressures of an ageing society, especially to establish a nationwide, affordable, annual health check system to facilitate early diagnosis and provide access to affordable treatments. China has begun work on several activities to address these issues including the recent completion of the of the Ten-year Health-Care Reform project, the implementation of the Healthy China 2030 Action Plan, and the opening of the National Clinical Research Center for Geriatric Disorders. There are also societal challenges, namely the shift from an extended family system in which the younger provide home care for their elderly family members, to the current trend in which young people are increasingly migrating towards major cities for work, increasing reliance on nursing homes to compensate, especially following the outcomes of the ‘one child policy’ and the ‘empty-nest elderly’ phenomenon. At the individual level, it is important to provide avenues for people to seek and improve their own knowledge of health and disease, to encourage them to seek medical check-ups to prevent/manage illness, and to find ways to promote modifiable health-related behaviors (social activity, exercise, healthy diets, reasonable diet supplements) to enable healthier, happier, longer, and more productive lives in the elderly. Finally, at the technological or treatment level, there is a focus on modern technologies to counteract the negative effects of ageing. Researchers are striving to produce drugs that can mimic the effects of ‘exercising more, eating less’, while other anti-ageing molecules from molecular gerontologists could help to improve ‘healthspan’ in the elderly. Machine learning, ‘Big Data’, and other novel technologies can also be used to monitor disease patterns at the population level and may be used to inform policy design in the future. Collectively, synergies across disciplines on policies, geriatric care, drug development, personal awareness, the use of big data, machine learning and personalized medicine will transform China into a country that enables the most for its elderly, maximizing and celebrating their longevity in the coming decades. This is the 2nd edition of the review paper (Fang EF et al., Ageing Re. Rev. 2015).     

关注胍类阳离子消毒剂对肺的损害

本文概述了胍类消毒剂在我国的使用情况和胍类阳离子消毒剂在韩国使用引发了肺纤维化等严重肺损伤事件。评述了我国学者利用超声雾化技术,模拟人类实际暴露场景染毒,证明了聚六亚甲基胍能引起肺纤维化。这些结果警示需充分重视胍类消毒剂引起的肺损伤问题,探究健康危害的机制,从而为保护公共卫生安全及其相应政策的制定提供重要科学依据。     

饮用水卤乙醛类消毒副产物的生成及毒效应研究进展

卤乙醛类消毒副产物是饮用水中新发现的消毒副产物,位居饮用水中消毒副产物总量第三,其生成与水中天然有机物和卤化物水平、饮用水处理工艺和消毒剂类型有关。新近研究显示卤乙醛类消毒副产物比饮用水中受控的三卤甲烷类消毒副产物和卤乙酸类消毒副产物有更强的细胞毒性和遗传毒性。目前仅有少数国家和地区对饮用水中检出率高的三氯乙醛设定了限值,但日益积累的证据表明非受控的卤乙醛类消毒副产物对人群健康的潜在风险更高。本文综述了当前饮用水中卤乙醛类消毒副产物的生成与转化、细胞毒性、遗传毒性等方面的研究进展,展望了未来卤乙醛类消毒副产物毒理学研究应关注的问题,以支撑科学的饮用水卫生标准研制。     

儿童发育性协调障碍孕产期危险因素的初步探讨

【目的】初步探讨儿童发育性协调障碍(developmental coordination disorder,DCD)的孕产期危险因素,为在国内开展DCD的预防和干预提供线索。【方法】在苏州市区选择一幼儿园339名儿童,采用结构式问卷对其父母进行调查。DCD筛查采用儿童发育协调障碍评估工具(Movement Assessment Battery for Children,M-ABC)。采用单因素和多因素的非条件Logistic回归模型分析DCD的危险因素。【结果】在控制了儿童性别、年龄、家庭文化和经济水平以及其他纳入分析的因素后,母亲妊娠时间大于(aOR=6.075,P=0.005)或小于(aOR=3.917,P=0.034)最佳年龄者,急性胎儿宫内窘迫史(aOR=4.415,P=0.018)和儿童出生体重(aOR=4.562,P=0.014)与DCD相关。【结论】母亲妊娠时年龄、急性胎儿宫内窘迫史和儿童出生体重可能是孕产期DCD的主要危险因素。     

儿童微塑料经食品与空气暴露特征分析

[目的]分析中国儿童及上海市浦东新区6～7岁学龄儿童经食物摄入及空气吸入微塑料(MPs)(粒径<5 mm)暴露特征.[方法]关键词检索PubMed、Web of Science、Scopus、中国知网、万方和维普等国内外数据库,建立数据集,结合中国儿童人群食物消费量和人体呼吸参数,计算中国儿童经食物摄入和空气吸入的MP...