Brand-specific rates of pertussis disease among Wisconsin children given 1–4 doses of pertussis Vaccine, 2010–2014

BackgroundAcellular pertussis vaccines were initially licensed based on placebo-controlled efficacy trials, but such trials are no longer ethical. The effectiveness of current pertussis vaccines among properly vaccinated children <5 years is so high that a randomized trial is infeasible. Fluctuations in pertussis incidence and characteristics of the US vaccine marketplace make selection of suitable controls for a case-control study problematic. To satisfy an FDA requirement to evaluate rates of pertussis following licensure of Pentacel® vaccine, we used a case-cohort study design with a novel method for characterizing the cohort population.MethodsThis prospective, observational study was conducted in Wisconsin from 2010 to 2014 among Wisconsin residents <60 months of age who received ≤four doses of pertussis vaccine (surveillance population). Cases were identified by the Wisconsin Division of Public Health. Characteristics and pertussis vaccinations of the surveillance population were estimated by ongoing random telephonic survey. The primary objective was to determine rates of pertussis disease among those who received only Pentacel vaccine (Group 1) vs those who received a single brand of vaccine other than Pentacel vaccine (Group 2).Results1195 pertussis cases were identified. It was estimated that the surveillance population accrued a total of 1,133,403 person-years (Group 1, 39%; Group 2, 41%; Group 3 [those not in Group 1 or Group 2], 20%). Pertussis rates were similar in Group 1 (98.9/100,000) and Group 2 (96.2/100,000); rate ratios were 1.03 (unadjusted; 90% CI, 0.92–1.15) and 0.99 (adjusted; 90% CI, 0.89–1.12). Persons with one or more delayed vaccinations had a 66% higher risk of pertussis (90% CI, 39–96%).DiscussionPertussis protection was not found to differ for recipients of the newly licensed vs other available pertussis vaccines. Delayed vaccination substantially increased risk of pertussis. Sample survey methodology was able to characterize the study cohort and enable an otherwise-infeasible study.Clinical Trial Registry number: ClinicalTrials.gov, NCT01129362.     

《天津市控制吸烟条例》实施十周年控烟监测结果分析

目的评估《天津市控制吸烟条例》实施10周年后各类公共场所的实施效果, 调查人群的烟草暴露和危害认知情况, 为控烟政策和措施的落实提供依据。方法数据源于2012和2021年天津市控烟调查。调查采用现场观察法记录天津市各类公共场所内各项控烟措施的落实情况, 并采用拦截面对面调查方式收集天津市≥15岁常住居民二手烟暴露和烟草相关知识数据。结果 2012-2021年天津市医疗卫生机构禁烟标志张贴率处于较高水平(100.0%), 教育机构、政府办公机构上升至100.0%, 出租车下降幅度较大。医疗卫生机构、公共交通等候场所、互联网上网服务营业场所、公交车的控烟宣传资料摆放率下降, 其他场所均上升。除出租车外, 其他调查场所在观察期间发现有人吸烟的现象均下降。非吸烟人群公共场所和工作场所的二手烟暴露率从43.2%下降至26.6%。公众对吸烟导致中风的知晓率上升11.3%、导致心脏病、肺癌的知晓率分别下降7.7%和7.2%;二手烟导致成年人心脏病、儿童肺部疾病、成年人肺癌的知晓率分别下降21.8%、22.1%、9.1%。结论《天津市控制吸烟条例》实施以来, 二手烟暴露情况得到改善, 但禁烟场所的环境...     

Development and validation of a UHPLC diode array detector method for meropenem quantification in human plasma

ObjectivesMeropenem is a β-lactam antibiotic frequently used to treat serious infections in intensive care unit patients. The main objective was to develop and validate a sensitive and specific ultra high performance liquid chromatography method with photodiode array detection for the quantitation of meropenem in human plasma. The applicability of the method for meropenem monitoring was also examined.Design and methodsThe validation of the method was performed following the FDA's guidelines for bioanalytical methods. In parallel, the method was applied for monitoring meropenem in forty plasma samples from ten critically ill patients treated intravenously at a total dose of 1 g. Drug levels were measured in each patient at 0 h, 2 h, 4 h and 8 h after meropenem infusion.ResultsWith this method, intraday and day-to-day variation was below 10%; intraday and day-to-day accuracy was between 94% and 114%; the limit of quantification was 0.5 μg/mL and recovery was above 70%. The method was successfully applied to quantitate meropenem concentrations and the results showed significant pharmacokinetic interindividual variability. Of special interest is that 50% of treated patients had meropenem plasma levels below the minimum inhibitory concentration at 8 h after the start of infusion, which was strongly related to creatinine clearance > 60 mL/min.ConclusionsThe method meets the requirements to be applied for meropenem concentration measurements in pharmacokinetics studies and clinical routine. The results suggest the need for therapeutic drug monitoring of meropenem in treated critically-ill patients.     

乙肝病毒携带者父母乙肝防治知识现状及其对心理状态影响的研究

目的 了解低龄AsC父母乙肝知识现状及其对心理状态的影响,为乙肝防治提供新的流行病学证据。方法 收集低龄AsC,调查其父母乙肝相关知识知晓率,同时采用SCL-90、SAS、SDS量表对其父母进行测评,并探讨父母不同知晓水平对其心理健康的影响。结果 低龄AsC父母乙肝相关知识总体知晓率偏低,平均知晓率只有57.90%。知晓率较高的知识点有:乙肝病人是传染源(100.00%)、注射乙肝疫苗是预防乙肝的根本措施(80.95%)等;而对于共同进餐(17.1 4%)、握手拥抱(16.19%)不会传播乙肝等知识点知晓率极低。男性(父亲)和文化程度高者知晓水平叫高(P<0.05)。乙肝相关知识知晓高组其SCL-90总分和SDS得分均高于知晓率低组(P <0.05)。在控制AsC父母的人口学混杂因素(性别,年龄,收入,文化程度)后,低龄AsC的父母其乙肝知晓水平对SCL90总分以及SDS得分产生影响(P <0.05)。结论 AsC父母乙肝防治知识的知晓情况会对心理状态影响,应针对此特殊人群开展防治知识宣传、心理干预和社会支持,为低龄群及家人营造良好的家庭和社会环境。     

天津城乡居民膳食微量营养素摄入及与高血压关系的研究

目的 分析天津城乡居民膳食微量营养素摄入状况及与高血压的关系,为提出人群营养改善预防高血压策略提供信息及依据。方法 利用2010-2012年中国居民营养与健康状况监测数据,采用连续3d 24 h回顾及调味品称重的膳食调查方法。结果 天津居民每标准人日维生素A、C、E、B₁、B₂、尼克酸、钙、钠、钾、碘、铁、锌摄入分别为313.79 μg、85.05 mg、27.91 mg、0.81 mg、0.86 mg、13.24 mg、410.85 mg、6 613.17 mg、1 735.10 mg、282.83 μg、22.21 mg、10.37 mg;膳食维生素A、B₁、B₂、钙低于推荐值,钠明显超标;除了钠、总碘农村偏高,其他微量营养素农村均最低;高血压患者膳食钾、钙、镁、铜、硒、维生素A、C、硫胺素、核黄素与血压呈负相关（均有P< 0.05）,钠、碘与血压呈正相关（均有P< 0.05）;高血压组钠、碘明显高于正常血压组和推荐值;其他微量营养素低于正常血压组（均有P<0.05）。结论 天津居民维生素A、B₁、B₂、钙摄入不足是膳食中的主要问题;钠摄入明显过多;农村居民微量营养素缺乏更严重;多种微量营养素摄入与高血压相关,急需膳食干预高血压的营养改善措施。     

2010-2016年天津市居民脑梗死发病特征及趋势分析

目的了解2010 — 2016年天津市居民脑梗死发病特征及变化趋势,分析其在不同特征人群中的特点,为制定防控对策提供参考依据。方法采用2010 — 2016年天津市脑梗死疾病新发病例监测数据,分析脑梗死发病率及其在不同年龄、性别、城乡之间的分布差异。 以2010年全国第六次人口普查为标准人口计算标化发病率。 率的比较采用χ2检验,发病率的时间趋势和年龄趋势分析采用趋势性χ2检验。 Joinpoint软件对7年发病率的变化进行分析,并预测2017 — 2020年发病情况。结果脑梗死患者初始发病平均年龄为65.50岁,吸烟率为32.18%,发病2次以上的比例为34.01%。 2010 — 2016年间天津市居民脑梗死粗发病率为379.70/10万 ~ 583.64/10万;标化发病率为212.40/10万 ~ 291.52/10万,均呈逐年上升趋势（P＜0.001）。 农村上升趋势更加显著。 天津市居民男性脑梗死粗发病率在450.17/10万 ~ 698.82/10万,标化发病率在249.20/10万 ~ 350.34/10万;女性粗发病率为308.44/10万 ~ 467.87/10万,标化发病率为174.48/10万 ~ 232.85/10万,粗发病率和标化发病率男性均高于女性,且均呈上升趋势（P＜0.001）,不同年龄组男性均高于女性（P＜0.001）。 根据预测,到2020年,天津市脑梗死发病率将达到808.58/10万,标化发病率为371.03/10万。结论天津市脑梗死发病7年来一直呈上升趋势,未发现降低的拐点,农村地区和男性人群上升趋势更加明显,应加强关注该疾病并采取有针对性的措施进行人群干预,以减少发病。     

Effectiveness of acellular pertussis vaccine in a routine immunization program: A multicenter,case-control study in Japan

In 2008, the number of pertussis cases increased substantially among Japanese adolescents, despite high coverage with acellular pertussis vaccine (DTaP). This study examined the effectiveness of DTaP vaccine in the routine immunization program in Japan. Between April 2009 and October 2012, we conducted a multicenter, case-control study, and compared the history of DTaP vaccination between 55 newly diagnosed pertussis cases and 90 age- and sex-matched controls. DTaP vaccine history was obtained by a self-administered questionnaire completed by their parents or guardians. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of vaccination for development of pertussis.DTaP vaccination of ≥1 dose revealed a significantly lower OR for pertussis (OR = 0.20, 95%CI, 0.04–0.97), and the OR of complete vaccination (4 doses) was 0.22 (0.04–1.05). Even after limiting subjects to those whose vaccination status could be confirmed by the immunization records, the negative associations were observed. The decreasing ORs of 4-dose vaccinees remained, even among subjects who had received the fourth dose ≥9.2 years earlier (OR = 0.11, 95%CI, 0.01–1.02).In conclusion, DTaP vaccination had a preventive effect for pertussis. Effectiveness was observed even 9 or more years after the final dose.     

我国核电站运行对周围居民健康影响研究进展

近年来随着我国核电事业的发展,核电站的运行对其周围居民健康状况的影响越来越受到关注.该文对我国在运行的浙江泰山、广东大亚湾和江苏田湾核电站周围居民在核电站运行前后的健康状况(包括居民核电认知、核焦虑状况、居民期望寿命、死因分析、恶性肿瘤发病及死亡情况、儿童健康状况和新生儿出生缺陷等)进行综述.结果认为目前我国各核电站的正常运行没有对周围人群的健康带来不利影响,未发现异常的疾病流行及变动.同时提出在我国核电事业迅猛发展的形势下,建立健全健康监测网络,获得核电站从选址至退役多个时期周围人群健康水平基础性国情资料,是做好核事故医学应急准备的重要一环.     

Acellular pertussis vaccine effectiveness and waning immunity in Alberta,Canada: 2010–2015, a Canadian Immunization Research Network (CIRN) study

BackgroundPertussis is still frequently reported in Canada. In Alberta, pertussis incidence ranged from 1.8 to 20.5 cases per 100,000 persons for 2004–2015. Most cases occurred in those aged <15 years. In Alberta, acellular formulations replaced whole-cell in 1997. We investigated pertussis vaccine effectiveness (VE) using a test-negative design (TND) study.MethodsWe included all persons who had a real-time PCR laboratory test for Bordetella pertussis between January 1, 2010 and August 31, 2015, in the province of Alberta, Canada. Vaccination history was obtained from Alberta’s immunization repository. Vaccination status was classified as complete, incomplete, or unvaccinated, based on the province’s vaccination schedule. Persons who had received ≥one dose of whole cell vaccine were excluded from analysis. Multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for pertussis infection by time since last vaccination. We adjusted for vaccination status, age, sex, neighbourhood income, urban/rural status, and the presence of a co-morbid condition. VE was calculated as [(1 − aOR) * 100].ResultsOf the 12,149 tests available, 936 (7.7%) were positive for Bordetella pertussis. Among the full cohort, VE was 90% (95% CI 87–92%) at 1 year, 81% (95% CI 77–85%) at 1–3 years, 76% (95% CI 68–82%) at 4–7 years, and 37% (95% CI 11–56%) at 8 or more years since a last dose of acellular pertussis vaccine.ConclusionsPertussis VE was highest in the first year after vaccination, then declined noticeably as years since a last vaccination increased. Our results suggest that a large number of adolescents and adults are susceptible to infection with Bordetella pertussis. Regular boosters throughout childhood, adolescence, and during pregnancy may be needed.     

空气中氨的离子色谱测定法

目的建立测定空气中氨的更为灵敏、安全、快速的检测方法.方法以装有酸性溶液的多孔玻板吸收管采样,用离子色谱法测定空气中的氨.结果该方法的加标回收率为97.6%～99.8%,RSD为1.08%～2.93%,检出限0.05μg/ml,测定范围为0.50～4.00μg/ml.该法与纳氏试剂分光光度法的测定结果差异无统计学意义(P＞0.05).结论该方法操作简便、快速、灵敏度高、准确度好,可用于空气中的氨的测定.