Modelling the optimal target age group for seasonal influenza vaccination in Japan

BackgroundIn Japan, the current influenza vaccination programme is targeting older individuals. On the other hand, epidemics of influenza are likely to be mainly driven by children. In this study, we consider the most cost-effective target age group for a seasonal influenza vaccination programme in Japan.MethodsWe constructed a deterministic compartmental Susceptible-Exposed-Infectious-Recovered (SEIR) model with data from the 2012/13 to 2014/15 influenza seasons in Japan. Bayesian inference with Markov Chain Monte Carlo method was used for parameter estimation. Cost-effectiveness analyses were conducted from public health care payer’s perspective.ResultsA scenario targeting children under 15 was expected to reduce the number of cases 6,382,345 compared to the current strategy. A scenario targeting elderly population (age over 49 years) was expected to reduce the number of cases 693,206. The children targeted scenario demonstrated negative ICER (incremental cost-effectiveness ratio) value. On the other hand, elderly targeted scenario demonstrated higher ICER value than the willingness to pay (50,000 USD/QALY).ConclusionsA vaccination programme which targets children under 15 is predicted to have much larger epidemiological impact than those targeting elderly.     

2018年陕西省农村校园环境卫生现状调查

目的 调查分析陕西省2018年农村学校环境卫生基本情况，了解陕西省不同地区学校环境卫生存在的主要问题，为政府制定农村环境卫生措施提供工作依据。方法 在全省各地市按比例分层随机选取高中及以下农村学校254所，制定农村校园环境卫生调查表收集调查数据，并按照关中、陕南、陕北分区域就供水情况和厕所情况进行统计推断分析。结果 陕西省农村学校学生饮水方式以学校提供开水（133/254）和桶装水或净水器水（113/254）为主；农村学校供水方式以村镇水厂（139/254）和学校自备集中式供水（68/254）为主。关中农村学校独立式公厕和独立式卫生公厕均数（3.54±0.41；2.75±0.43）高于陕南（1.50±0.18；1.21±0.19）和陕北（2.15±0.27；0.69±0.24），差异有统计学意义（F = 10.590，P＜0.001和F = 8.595，P＜0.001）；陕南农村学校的平均蹲位比（男厕9.60，女厕7.63）高于陕北（男厕7.00，女厕6.18）和关中（男厕6.97，女厕5.84）；陕西省男厕蹲位合格率（97.24％）高于女厕（81.89％），差异有统计学意义（χ2 = 32.041，P＜0.001）；陕西省农村学校厕所有专人管理的关中最高且学生参与管理的最低（65.79％，34.21％），与陕南（47.83％，52.17％）比较差异有统计学意义（χ2 = 7.632，P = 0.022）。结论 进一步加强对陕西省农村学校供水的设施改造投入，针对性加强饮水安全宣教。适当增加陕北和陕南地区卫生厕所数目，并加强厕所维护管理。增加陕北和关中地区厕所蹲位数，适当提升陕西省女厕蹲位数目。     

Independent and joint associations of non-exercise cardiorespiratory fitness and obesity with risk of type 2 diabetes mellitus in the Rural Chinese Cohort Study

Background and aimsAn association between cardiorespiratory fitness (CRF) and type 2 diabetes mellitus (T2DM) has not been established in the Chinese population. This study aimed to estimate the independent and joint associations of CRF and obesity with T2DM incidence in the rural Chinese population.Methods and resultsWe conducted a prospective study of 11,825 non-T2DM subjects among rural Chinese adults. Cox regression models were used to estimate the independent and joint associations between CRF and obesity exposure on T2DM. Restricted cubic splines were used to model the dose–response association. During a median follow-up of 6.01 years, 835 participants developed T2DM. In comparison to quartile 1 of CRF, the multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) of quartiles 2, 3, 4 were 0.75 (0.61–0.91), 0.54 (0.43–0.68), and 0.42 (0.32–0.55), respectively. When stratified by sex, the results were similar. Joint analyses showed that overweight/obesity-unfit individuals had a 2.28 times higher risk of developing T2DM than the normal weight-fit referent (HR 2.28, 95% CI 1.84–2.83; P_interaction <0.001). The risk for the overweight/obesity-fit category (HR 1.61, 95% CI 1.21–2.15) was larger than for the normal weight-unfit category (HR 1.38, 95% CI 0.97–1.95) versus the normal weight-fit referent. Similar joint associations for waist circumference and CRF with T2DM were also observed.ConclusionA negative association was observed between CRF and risk of T2DM. Overweight/obese or abdominal obesity and unfit participants showed the highest risks of T2DM. It is therefore strongly recommended that fitness-enhancing be encouraged for the prevention of T2DM, especially among obesity participants.     

纳米孔测序技术鉴定陕西省首例马尔尼菲青霉菌感染病例

目的 对1例严重感染性疾病进行病原学检测,查明感染来源,为临床诊断治疗提供依据。方法 调查了解患者流行病学史、临床症状及体征,开展一般实验室检测。提取患者血样核酸,利用基于纳米孔测序的宏基因组分析技术,查询病原线索;利用真菌ITS通用引物、马尔尼菲青霉菌PCR以及利什曼原虫、组织荚膜胞浆菌PCR引物进行鉴别;对患者血样进行真菌双相培养确诊。结果 患者曾有不洁同性及异性性交史,常去东南亚地区旅行,临床症状及体征符合HIV感染表现,HIV初筛及确证实验为阳性,利什曼原虫抗体阴性。利用纳米孔测序仪MinION实际测序时间3.5 h,共获得84 000条Reads,序列长度均值7 088.7 base,最长为87 471 base,最短为562 base,总数据量为495 Mb。将basecalling所获数据上传EPI2Me,以WIMP workflow分析,有63 617条为人类基因组数据,13条马尔尼菲青霉菌序列;真菌ITS扩增测序结果鉴定为马尔尼菲青霉菌,马尔尼菲青霉菌PCR结果阳性,组织荚膜胞浆菌PCR阴性;真菌双相培养在25 ℃为霉菌样菌落,37 ℃为酵母样菌落,经鉴定均为马尔尼菲青霉菌。结论 该患者为中国陕西省首次报道的HIV合并马尔尼菲青霉菌感染病例,基于纳米孔测序的宏基因组分析技术可做为临床疑难感染性疾病快速诊断的一种指示方法。     

陕西省陕南地区一起人间布鲁氏菌病暴发疫情的调查研究北大核心CSCD

目的调查2021年陕西省陕南地区一起人间布鲁氏菌病(简称布病)暴发疫情的原因,为今后该地区布病疫情防控提供借鉴依据。方法通过现场流行病学调查和实验室检测,对2021年7月份商洛市丹凤县龙驹寨鹿池社区一起布病暴发疫情进行传染源追踪调查和传染途径分析。结果共发现5例确诊病例、6例隐性感染者和1例疑似病例,病例性别比为3∶1,发病到确诊时间间隔87~123 d,中位数为119 d,临床表现以发热为主;12例病例血清抗体滴度从1∶50(++)到1∶1600(++)不等;病例感染途径与清理圈舍有关联(OR=6.4,95%CI:1.195~34.285);畜间检测结果显示53只羊和2只犬均为布病阳性。结论该起布病暴发疫情的主要原因是未及时清理羊只粪便、未定期对圈舍和生活居住环境进行消毒,导致养殖户及其家人、雇工等相继感染布病,建议畜牧部门调整陕南地区人间布病重点地区的牲畜免疫政策,同时人畜间联合加强圈舍、生活居住等环境消毒及个人防护等养殖科学卫生知识的宣传教育。     

硫酸铟对V79细胞内活性氧和线粒体膜电位的影响

[目的]观察硫酸铟对中国仓鼠肺纤维细胞（V79细胞）内活性氧（ROS）和线粒体膜电位的影响。[方法]不同浓度硫酸铟（0.5、1.0、2.0、4.0、8.0mmol/L）染毒体外培养的V79细胞,MTT法检测细胞存活率;以2’,7’-荧光素乙二酯和碘化四氯代四乙基苯咪唑羰花青为探针,采用流式细胞术,检测经不同浓度硫酸铟染毒12h后V79细胞内ROS和线粒体膜电位的水平。[结果]硫酸铟能明显降低V79细胞的存活率;不同浓度硫酸铟作用于V79细胞12h后,细胞内的平均荧光强度从21.60增加到31.10,线粒体膜电位从0.1913降低到0.1090,与对照组相比,差异有统计学意义（P〈0.05）。[结论]硫酸铟能增加V79细胞内ROS的释放、降低线粒体膜电位,影响细胞的正常代谢功能,对细胞造成损伤。     

陕西省鼠疫疫区夜行鼠生态学调查

目的掌握陕西省鼠疫疫区夜行鼠的生态学特征。方法在不同生境内逐月捕获夜行鼠，并梳检鼠体蚤、解剖观察、细菌培养以及血清学检测。结果捕获夜行鼠类8种192只，以黑线仓鼠为优势种；夜行鼠密度春夏季高于秋冬季；黑线仓鼠主要栖息于成年林地，子午沙鼠主要栖息于固定沙丘和半固定沙丘；采集夜行鼠鼠体蚤188匹，隶属于4科8属8种，以二齿新蚤和同型客蚤为优势种；夜行鼠繁殖高峰在夏季；主要夜行鼠能自然感染鼠疫。结论陕西省鼠疫疫区夜行鼠生态学指征有别于邻省（自治区），开展连续系统的夜行鼠密度及血清学监测对有效预防鼠疫的发生和流行具有重要意义。     

陕西省放射卫生技术服务机构基本情况调查

目的 了解陕西省放射卫生技术服务机构基本情况,分析存在的主要问题,加强我省放射卫生技术服务机构能力建设。方法 采用问卷调查、查阅文献的方式调查分析陕西省辖区内注册的放射卫生技术服务机构。结果 陕西省放射卫生技术服务机构共20家,其中国营7家,私营13家;机构中疾控机构3家;机构中同时获得放射防护评价、放射卫生防护及个人剂量检测资质的15家;机构放射工作人员数共237人,其中< 35岁占比48.5%、本科及以上学历占比68.8%、中级及以上占比54.4%、放射防护相关专业占比26.5%、参加国家及省级培训占比79.3%;机构共配备检测设备309台件,其中放射诊断性能检测设备占比最多为52.4%。结论 陕西省放射卫生技术服务机构服务范围和能力可满足我省目前需求,但机构从人员、设备、服务质量方面需要改善,需加强对机构质量控制,规范全省服务行为。     

HPV vaccination intent and willingness to pay for 2-,4-, and 9-valent HPV vaccines: A study of adult women aged 27–45 years in China

ObjectiveThis study aims to investigate acceptance and willingness to pay for HPV vaccination among adult women in China.MethodsAn online survey was sent to mothers aged 27–45 years of primary school pupils in the Fujian province, China. Participants completed questions about HPV related knowledge and health beliefs, intention to take the HPV vaccine and the willingness to pay for bivalent vaccine (2vHPV), quadrivalent vaccine (4vHPV), and 9-valent HPV vaccine (9vHPV).ResultsOf a total of 2339 complete responses, 58.3% reported intent to obtain HPV vaccine. Mothers who were younger in age, residing in urban, working in managerial or professional occupations, who knew someone with cervical cancer and who were able to make independent decisions about the HPV vaccine (vs. joint decision with spouse) were more likely to express intent to have HPV vaccination. Perceived barriers, cues to action and self-efficacy were three of the constructs in the health belief model that significantly influenced HPV vaccination intent. A higher proportion of participants expressed willingness to pay for 2vHPV (81.2%) and 4vHPV (75.9%), as compared to 9vHPV (67.7%).ConclusionAdults women expressed moderate intention to receive the HPV vaccine. Intervention to address barriers to uptake of the HPV vaccine among adult women in China is warranted.