中国成年双生子人群的冠心病遗传度估计

目的 分析中国成年双生子人群的冠心病遗传度。方法 利用中国双生子登记系统在11省、市募集的20 477对≥ 25岁同性别双生子,构建结构方程模型计算遗传度。结果 调整年龄、性别后,冠心病的遗传度为0.75（0.68~0.81）。亚组分析显示≥ 40岁组和女性人群中,冠心病患病主要受遗传因素的影响;而25~39岁组和男性的患病主要受环境因素的影响。结论 冠心病患病受遗传和环境因素的影响,且遗传度较高。     

Comparative immunogenicity and efficacy of thermostable (lyophilized) and liquid formulation of anthrax vaccine candidate AV7909

The anthrax vaccine candidate AV7909 is being developed as a next-generation vaccine for a post-exposure prophylaxis (PEP) indication against anthrax. AV7909 consists of the anthrax vaccine adsorbed (AVA) (Emergent BioSolutions Inc., Lansing, MI) bulk drug substance adjuvanted with the immunostimulatory oligodeoxynucleotide (ODN) compound, CPG 7909. The addition of CPG 7909 to AVA enhances both the magnitude and the kinetics of antibody responses in animals and human subjects, making AV7909 a suitable next-generation vaccine for use in a PEP setting. Emergent has produced a thermostable (lyophilized) formulation of AV7909 vaccine utilizing drying technology. The purpose of the study described here was to assess the immunogenicity and efficacy of the lyophilized formulation of the AV7909 vaccine candidate as compared with the liquid formulation in the guinea pig general-use prophylaxis (GUP) model. The study also provides initial information on the relationship between the immune response induced by the thermostable formulation of the vaccine, as measured by the toxin neutralization assay (TNA), and animal survival following lethal anthrax aerosol challenge. Results demonstrated that there were no significant differences in the immunogenicity or efficacy of lyophilized AV7909 against lethal anthrax spore aerosol challenge in the guinea pig model as compared to liquid AV7909. For both vaccine formulations, logistic regression modeling showed that the probability of survival increased as the pre-challenge antibody levels increased.     

Sex differences in cardiovascular risk factors of children and adolescents with type 1 diabetes mellitus: A role for diet?

Background and aimsCardiovascular disease is the leading cause of morbidity and mortality in individuals with type 1 diabetes mellitus (T1DM). Cardiovascular risk is higher in women with diabetes than in men. With this study, we wanted to determine whether female children and adolescents with T1DM are more prone to cardiovascular risk factors (CVRFs) and an atherogenic diet than boys.Methods and resultsFor this cross-sectional study, anthropometric, clinical, biochemical, and dietary intake data of 314 children with diabetes (3–18 years; 178 boys) were analysed according to age and sex. Linear and binary logistic regression was performed to test independent associations between sex, dietary intake, and CVRFs.Low-density lipoprotein -cholesterol (LDL-c), triglyceride (TG), fibre, monounsaturated fatty acid levels (all p < 0.01), and lipid (p = 0.022) intake were higher in the girls than in the boys. Multiple regression analysis showed that LDL was associated with sex, glycated haemoglobin (HbA1c), and lipid intake percentage (R (Kannel, 1979) [2] = 0.130; p = 0.0004) independent of age, pubertal stage, body mass index (BMI), duration of diabetes, energy, and fibre intake. Logistic regression analysis showed that high LDL-c levels were present more often in girls [odds ratio, OR; confidence interval, CI = 2.569 (1.178–5.604); p = 0.018] who had a higher dietary lipid intake percentage [OR (CI) = 1.089 (1.011–1.173); p = 0.025].ConclusionsGirls with diabetes have higher LDL-c levels associated with higher dietary lipid intake. Our findings suggest that young people with diabetes, especially girls, may benefit from early dietary interventions to reduce their cardiovascular risk.     

2006年江苏省血吸虫病监测点疫情分析Ⅰ居民和家畜感染情况

目的了解、掌握江苏省居民和家畜血吸虫感染情况,为制订防治规划提供科学依据。方法根据全国和江苏省血吸虫病疫情监测方案的要求,在全省血吸虫病流行区选择有代表性的82个流行村作为监测点,开展居民和家畜血吸虫感染情况的监测调查。结果全省监测点常住居民血检阳性率为1.63%、粪检阳性率为0.035%;流动人群血检阳性率为2.42%,粪检阳性率为0.988%。推算全省流行区居民平均血吸虫感染率为0.0074%,牛感染率为0.80%,羊感染率为1.90%。结论全省血吸虫病疫情继续呈较为稳定的低流行态势;流动人群血吸虫感染率远高于常住居民;全省流行区中散放的家畜较少,总体感染率较低,但局部地区家畜感染率仍较高。流动人群和家畜仍为全省局部地区重要的血吸虫病流行因素。     

Measuring and estimating insulin resistance in clinical and research settings

AimThis short review provides a theoretical outline for the measurement of insulin secretion and insulin resistance in humans.Data synthesisTo evaluate the ability to secrete insulin, disposition index must be considered, and it is necessary to assess insulin sensitivity when insulin secretion is induced for assessment. The clinical application of the measurement of insulin resistance is also introduced for further debate. The term “insulin effectiveness” is clinical jargon for insulin sensitivity. However, for clinical application, you need at least two types of insulin effectiveness to calculate a basal and bolus insulin administration dose, while peripheral (mainly muscle) and liver are two major target organs for insulin action. The term “insulin sensitivity” may be used to express insulin action of the muscle or of specific organs through their insulin receptors, while “insulin resistance” may be used to express the necessity of a dose of insulin administration to suppress hepatic glucose production that can be induced by substrates, glucagon, catecholamine, and so on.ConclusionsThis article covers several important issues on the measurement of insulin secretion and resistance that had not been well described in other review articles, and may be of help for future clinical investigation.     

江苏省血吸虫病疫情控制效果与评估

目的 评估江苏省血吸虫病疫情控制的效果。方法采用回顾性分析与现场抽样调查相结合的方法,统计2004-2006年居民粪检阳性率、家畜粪检阳性率、急性血吸虫病发病人数、实有钉螺面积和感染性钉螺面积变化情况;2007年采用Kato-Katz法（1粪3检）和粪便毛蚴孵化法调查居民和家畜血吸虫感染情况,并现场抽查核对防治资料的准确性和完整性。结果2004-2006年全省居民血吸虫感染率分别为0．09％、0．07％、0．02％,家畜感染率分别为0．19％、0．06％、0．02％;发生急性血吸虫病人数分别为38、11、3例;钉螺面积分别为7882、5357、4067hm^2;感染性钉螺面积分别为2131、1185、703hm^2。2007年在12个县（市、区）共调查193个村,检查居民42227人,查出粪检阳性14人,人群平均感染率为0．03％。其中有10个村查到了粪检阳性病人,病人最多的村查出阳性3例,感染率为1．42％;调查各种家畜4292头（只）,其中牛906头,羊3386只,未查到粪检阳性家畜;现场走访140户427人,其中送粪查病231人,查病登记结果和走访情况完全一致。结论2004年以来江苏省血吸虫病疫情逐年稳定下降,各项血吸虫病疫情指标已达到我国血吸虫病疫情控制标准的指标要求。     

Hepatitis B vaccination and the putative risk of central demyelinating diseases – A systematic review and meta-analysis

BackgroundThe anti-hepatitis B immunization campaigns launched in the early 1990s were a major public health breakthrough and targeted various populations (at-risk adults, newborns, adolescents). However, debate is still active about a possible link between this vaccine and central demyelination. This study provides a pooled estimate of this risk based on a comprehensive review and meta-analysis of all available epidemiologic studies.MethodsA systematic review was conducted in Medline, Embase, ISI Web of Science and the Cochrane Library from database inception to 10 May 2017. Grey literature was searched and snowballing was also undertaken. Only observational studies including a control group were retained. Primary outcome was multiple sclerosis diagnosed by recognized criteria. Study selection was performed by two independent reviewers with disagreements solved through discussion. This meta-analysis based on crude, adjusted estimates, or risks limited to the 3 months following immunization was performed using a generic inverse variance random-effect model. Heterogeneity was investigated; sensitivity and subgroup analyses were performed when necessary. This study followed the PRISMA statement and the MOOSE reporting guideline (Study protocol registered in PROSPERO: CRD42015020808).FindingsOf the 2804 references reviewed, 13 studies with a control group were analysed. None of the pooled risk estimates for either multiple sclerosis or central demyelination following HB immunization reached statistical significance. When considering adjusted risk ratios, the following non-significant figures were obtained: 1.19 (95%CI: 0.93 – 1.52) and 1.25 (95%CI: 0.97 – 1.62), for multiple sclerosis and central demyelination, respectively.ConclusionsNo evidence of an association between hepatitis B vaccination and central demyelination was found.     

Remnant cholesterol as a risk factor for all-cause and cardiovascular mortality in incident peritoneal dialysis patients

Background and aimsRemnant cholesterol (RC) adversely contributes to cardiovascular disease (CVD) and overall survival in various diseases. However, its role in CVD outcomes and all-cause mortality in patients undergoing peritoneal dialysis (PD) is limited. Therefore, we aimed to investigate the association between RC and all-cause and CVD mortality in patients undergoing PD.Methods and resultsBased on lipid profiles recorded using standard laboratory procedures, fasting RC levels were calculated in 2710 incident patients undergoing PD who were enrolled between January 2006 and December 2017 and followed up until December 2018. Patients were divided into four groups according to the quartile distribution of baseline RC levels (Q1: <0.40 mmol/L, Q2: 0.40 to <0.64 mmol/L, Q3: 0.64 to <1.03 mmol/L, and Q4: ≥1.03 mmol/L). Associations between RC and CVD and all-cause mortality were evaluated using multivariable Cox models. During the median follow-up period of 35.4 months (interquartile range, 20.9–57.2 months), 820 deaths were recorded, of which 438 were CVD-related. Smoothing plots showed non-linear relationships between RC and adverse outcomes. The risks of all-cause and CVD mortality increased progressively through the quartiles (log-rank, p < 0.001). Using adjusted proportional hazard models, a comparison of the highest (Q4) to lowest (Q1) quartiles revealed significant increases in the hazard ratio (HR) for all-cause mortality (HR 1.95 [95% confidence interval (CI), 1.51–2.51]) and CVD mortality risk (HR 2.60 [95% CI, 1.80–3.75]).ConclusionAn increased RC level was independently associated with all-cause and CVD mortality in patients undergoing PD, suggesting that RC was important clinically and required further research.     

Short-term beneficial effects of human dental pulp stem cells and their secretome in a rat model of mild ischemic stroke

Although cell therapy has been applied in regenerative medicine for decades, recent years have seen greatly increased attention being given to the use of stem cell-based derivatives such as cell-free secretome. Dental pulp stem cells (DPSCs) are widely available, easily accessible, and have high neuroprotective and angiogenic properties. In addition, DPSC-derived secretome contains a rich mixture of trophic factors. The current investigation evaluated the short-term therapeutic effects of human DPSCs and their secretome in a rat model of mild ischemic stroke.Mild ischemic stroke was induced by 30 min middle cerebral artery occlusion, and hDPSCs or their secretome was administered intra-arterially and intranasally. Neurological function, infarct size, spatial working memory, and relative expression of seven target genes in two categories of neurotrophic and angiogenic factors were assessed three days after stroke. In the short-term, all treatments reduced the severity of neurological and histological deficits caused by ischemic stroke. Moreover, transient middle cerebral artery occlusion led to the striatal and cortical over-expression of BDNF, NT-3, and angiogenin, while NGF and VEGF expression was reduced. Almost all interventions were able to modulate the expression of target genes after stroke. The obtained data revealed that single intra-arterial administration of hDPSCs or their secretome, single intranasal transplantation of hDPSCs, or repeated intranasal administration of hDPSC-derived secretome was able to ameliorate the devastating effects of a mild stroke, at least in the short-term.