Hepatitis B vaccine and the need for a booster dose after primary vaccination

ObjectivesProtective antibodies levels, induced by Hepatitis B virus (HBV) vaccine, persist for long-term after primary immunization, but there is evidence that, as the time since vaccination increases, there is a reduced ability to maintain immune memory. The study aim was to determine the prevalence and the duration of persistence of an anti-HBs titer with ≥10 mIU/mL and eventual predictors of reduced seroprotection.MethodsThe study was conducted among students attending medical and healthcare professions schools from January 2014 to June 2016. Data were collected through the review of medical records completed during the medical surveillance visit. All subjects had received HBV vaccine according to the Italian Ministry of Health indications.ResultsThe results are reported for 722 subjects. Positive anti-HBs titer was found in 72.6% (95% CI = 69–76). The mean age of the subjects was 25.5 years. Subjects vaccinated during adolescence and students that had received an adult vaccine dose were significantly more likely to be seroprotected. The longer the time interval since vaccination the lower the probability of being seroprotected; however if the role of time since vaccination was considered after stratification by vaccine dose, a statistically significant association with a lower percentage of seroprotected remains only in the subgroup of subjects who received the pediatric dose. The findings of the multivariate regression analysis partially confirmed those of the univariate analysis.ConclusionsIn conclusion, our findings show that over 25% of HBV vaccine recipients had an antiHBs titer <10 mIU/ml after 18 years of more from the primary vaccination. Furthermore, in the case a booster dose would be needed, our results suggest that the vaccination strategy should prefer administration of a vaccine adult dose during early adolescence, since it might offer longer-term protection through adulthood.     

Ex vivo antigen-pulsed PBMCs generate potent and long lasting immunity to infection when administered as a vaccine

Numerous studies have demonstrated that administration of antigen (Ag)-pulsed dendritic cells (DCs) is an effective strategy for enhancing immunity to tumors and infectious disease organisms. However, the generation and/or isolation of DCs can require substantial time and expense. Therefore, using inactivated F. tularensis (iFt) Ag as a model immunogen, we first sought to determine if DCs could be replaced with peripheral blood mononuclear cells (PBMCs) during the ex-vivo pulse phase and still provide protection against Ft infection. Follow up studies were then conducted using the S. pneumoniae (Sp) vaccine Prevnar ®13 as the Ag in the pulse phase followed by immunization and Sp challenge. In both cases, we demonstrate that PBMCs can be used in place of DCs when pulsing with iFt and/or Prevnar ®13 ex vivo and re-administering the Ag-pulsed PBMCs as a vaccine. In addition, utilization of the i.n. route for Ag-pulsed PBMC administration is superior to use of the i.v. route in the case of Sp immunization, as well as when compared to direct injection of Prevnar ®13 vaccine i.m. or i.n. Furthermore, this PBMC-based vaccine strategy provides a more marked and enduring protective immune response and is also capable of serving as a multi-organism vaccine platform. The potential for this ex-vivo vaccine strategy to provide a simpler, less time consuming, and less expensive approach to DC-based vaccines and vaccination in general is also discussed.     

PCR—SSCP银染技术分析乙肝病毒的逃脱变异

目的；分析受乙肝疫苗保护后部分儿童的“免疫无效”现象。方法：采用巢式ＰＣＲ－ＳＳＣＰ银染技术对１５例曾受疫苗保护的儿童血清中ＨＢＶ ＤＮＡ Ｓ基因片段进行研究。结果：在ＨＢｓＡｇ阴性血清中存在ＨＢＶ Ｓ基因点突变，该突变位于从ＨＢＶ基因组ＥｃｏＲ Ｉ位点算起的第３６７￣７６９核地酸区域内。结论：在肝癌高产地区启东发现存在ＨＢＶ逃脱变异。疫苗刺激机体所产生的抗体不能中和入侵的ＨＢＶａ决定簇并阻断ＨＢ     

1972 - 2016年江苏省启东市肺癌死亡流行特征分析

目的 研究启东市1972 - 2016年肺癌死亡水平及变化趋势。方法 根据启东市1972 - 2016年癌症死亡登记数据库，分别计算粗死亡率（CR）、中国标化率（CASR）、世界标化率（WASR）、35～64岁截缩率、0～74岁累积率、累积风险，死亡率年度变化百分比等。结果 1972 - 2016年启东肺癌死亡18 662例， CR为36.91/10万，占全部癌症死亡的18.88%，位居癌症死亡第2位。CASR和WASR分别为15.13/10万和25.26/10万；35～64岁截缩死亡率为32.98/10万；0～74岁累积死亡率为3.14%；肺癌死亡的累积风险为3.10%。男性肺癌死亡13 384例，CR、CASR、WASR分别为53.63/10万、23.19/10万与39.64/10万，女性肺癌死亡5 278例，CR、CASR、WASR分别为20.61/10万、8.06/10万和13.17/10万。肺癌男女死亡性比值CR、CASR、WASR分别为2.60、2.88、3.01。45年间肺癌死亡的CR、CASR、WASR的变化百分比（PC）分别为+842.85%、+194.28%与+250.01%，年均变化百分比（APC）分别为+4.88%、+1.92%、+2.18%。用年龄 - 出生队列方法分析显示，各低年龄组出生队列死亡率变化趋势也不明显，而55岁以后的各年龄组出生队列死亡率有明显的上升趋势。结论 启东45年来肺癌死亡率水平较高，且上升趋势明显。     

经脐单孔腹腔镜与开腹胆囊切除术对患者肝功能和免疫功能的影响

目的 探讨经脐单孔腹腔镜与开腹胆囊切除术对患者肝功能和免疫功能的影响.方法 将120例胆囊炎、胆石症患者根据手术方式分为经脐单孔腹腔镜胆囊切除术组（NC组,58例）及开腹胆囊切除术组（OC组,62例）,均于术前1d及术后第3d检测肝功能和免疫功能,并进行比较分析.结果 NC组术后肝功能和免疫功能测定值与术前差异均无统计学意义（t =3.94、0.13、1.34、0.76,均P＞0.05）；而OC组术后肝功能和免疫功能测定值与术前差异均有统计学意义（t =27.04、34.49、18.52、21.45,均P＜0.05）；两组术后肝功能和免疫功能测定值差异均有统计学意义（t=15.31、31.42、12.32、12.68,均P＜0.05）.结论 经脐单孔腹腔镜胆囊切除术是安全可行的,其对肝功能和免疫功能的影响明显优于传统腹腔镜胆囊切除术.     

Analysis on 113 Cases of Adverse Reactions Caused by β-Lactam Antibiotics

The objectives of this study were to learn about the characteristics and rules of the occurrence of adverse reactions caused by lactam antibiotics and provide a reference for clinical drug use. Methods: A retrospective study was made to analyse the 113 case reports of adverse reactions caused by β-lactam antibiotics collected in our hospital between 2007 and 2009. Results: 113 cases of ADR involved 17 kinds of β-lactam antibiotics, headed by ceftriaxone sodium. The most common manifestation was skin and accessory damage; nervous system and gastrointestinal system damage were also easier to find, and the administration route was mainly intravenous infusion. Conclusion: The clinical application of β-lactam antibiotics should pay attention to adverse reaction monitoring and rational drug use to reduce the incidence of adverse reactions.     

Susceptibility to hepatocellular carcinoma associated with null genotypes of GSTM1 and GSTT1

ALM In order to study the association between the null genotypes of GSTM1 and GSTT1 and the genetic susceptibility to hepatocellular carcinoma (HCC). METHODS The genotypes of GSTM1 and GSTT1 of 63 cases of HCC and 88 controls were detected with the multiple PCR technique. RESULTS The frequency of GSTM1 null genotype was 57.1% among the cases, and 42.0% among the controls, the difference being statistically significant (x2 = 3.35, P = 0.067),but X2 value approaching the significance level.The odds ratio was 1.84 (95% Cl=0.91 - 3.37).The frequency of GSTT1 non-null genotype was 87.3% among the cases and 62.5% among the controls, the difference being statistically significant (X2=11.42, P=0.0007274). The odds ratio was 4.13 (95% Cl = 1.64 - 10.70).According to the cross analysis, the GSTT1 nonnull genotype was more closely associated with HCC than GSTM1 null genotype, and these two factors play an approximate addlitive interaction in the occurrence of HCC. CONCLUSION The persons with GSTM1 nullgenotype and GSTT1 non-null genotype have the increased risk to HCC.     

2型糖尿病患者T细胞亚群与胰岛素抵抗指数及病程关系的研究

目的探讨2型糖尿病患者外周血CD4+T和CD8+T淋巴细胞水平与患者胰岛素抵抗指数及病程关系。方法检测2型糖尿病患者外周血CD4+T、CD8+T淋巴细胞水平并与患者胰岛素抵抗指数及病程进行相关性分析。结果糖尿病组患者CD4+T/CD8+T淋巴细胞比例高于对照组健康人群;2型糖尿病患者外周血CD4+T/CD8+T淋巴细胞比例与胰岛素抵抗指数呈正相关;与病程无相关性。结论 2型糖尿病患者存在细胞免疫功能紊乱,且与胰岛素抵抗指数关系密切。     

阻断Ras在肝癌靶向治疗中的意义

目的探讨阻断Ras在肝癌靶向治疗中的价值。方法 MTT检测不同浓度Ras抑制剂farnesylthiosalicylic acid(FTS)对肝癌细胞生长的影响,显微镜观察细胞形态变化,流式细胞仪检测细胞凋亡,Western blot检测Erk磷酸化水平。结果 FTS可以抑制HepG2和Huh-7细胞生长,诱导HCC细胞凋亡,降低Erk磷酸化水平。结论 Ras可作为HCC治疗的潜在靶点。     

68例子宫内膜癌临床分析

目的探讨子宫内膜癌患者的临床特点。方法回顾性分析了近十年来收治于我院的68例子宫内膜癌患者的临床资料、诊治过程与结果。结果术前MRI检查癌浸润深度与术后病理检查比较无统计学差异;68例患者存活5年以上者59例,死亡9例,总生存率为76.5%。结论子宫内膜癌的复发与脉管浸润、手术病理分期及组织学分级有关,MRI对判断癌浸润深度有一定价值。