A guide to oral vaccination: Highlighting electrospraying as a promising manufacturing technique toward a successful oral vaccine development

Most vaccines approved by regulatory bodies are administered via intramuscular or subcutaneous injections and have shortcomings, such as the risk of needle-associated blood infections, pain and swelling at the injection site. Orally administered vaccines are of interest, as they elicit both systemic and mucosal immunities, in which mucosal immunity would neutralize the mucosa invading pathogen before the onset of an infection. Hence, oral vaccination can eliminate the injection associated adverse effects and enhance the person's compliance. Conventional approaches to manufacturing oral vaccines, such as coacervation, spray drying, and membrane emulsification, tend to alter the structural proteins in vaccines that result from high temperature, organic and toxic solvents during production. Electrohydrodynamic processes, specifically electrospraying, could solve these challenges, as it also modulates antigen release and has a high loading efficiency. This review will highlight the mucosal immunity and biological basis of the gastrointestinal immune system, different oral vaccine delivery approaches, and the application of electrospraying in vaccines development.     

Novel vaccination strategies and approaches against human tuberculosis

Tuberculosis (TB) remains one of a major health problem worldwide. Tuberculosis vaccine research has made an extraordinary progress over the past few years. However, there is still no replacement for the Bacillus Calmette‐Guérin vaccine, the only TB vaccine licensed for human use. Therefore, the discovery and development of new TB vaccines remains a priority. This article discusses current strategies used to diversify TB vaccines and includes discussion of the status of efforts to improve protection against Mycobacterium tuberculosis (M tb) infection or TB disease by developing new and safe TB vaccines. This article also highlights the current research efforts in immune‐enhancing approaches to improve vaccination efficacy. The development of more effective TB vaccines might have significant impact on global TB control.     

3D打印制备不同重量比例的n-HA/PLA/PVA复合膜性能比较

目的:通过3D打印的方法制备的不同重量比例的纳米羟基磷灰石/聚乳酸/聚乙烯醇(n-HA/PLA/PVA)复合膜,并对其相关性能检测。方法:采用3D打印技术制备不同重量比例的n-HA/PLA/PVA复合膜,分别为PLA/PVA复合膜、15%n-HA/PLA/PVA复合膜、50%n-HA/PLA/PVA复合膜、75%n-HA/PLA/PVA复合膜。扫描电镜下观察各组膜形态,对其力学性能、细胞毒性及动物实验相应指标进行检测。结果:扫描电镜下观察,n-HA/PLA/PVA复合膜呈现三维网状结构,各材料间相互结合,孔隙分布不均,大小不一。随着n-HA质量浓度的提高,电镜下见各材料间孔隙逐渐减小,形成结构均匀的复合膜。力学性能及吸水率检测中,随着nHA含量的增加,n-HA/PLA/PVA复合膜的拉伸强度及吸水率呈下降趋势;细胞毒性检测,不同比例复合膜的细胞增殖率无明显差别,无细胞毒性。动物实验测量牙周菌斑指数及龈沟出血指数未发现不同比例n-HA/PLA/PVA复合膜有统计学差异。结论:3D打印不同比例的n-HA/PLA/PVA复合膜具有良好的物理性能和细胞生物相容性,n-HA比例更高的复合膜可能具有更好的物理性能及良好的生物相容性。     

2009-2019年西安市肺结核流行特征及治疗转归分析

目的 了解2009-2019年西安市肺结核的流行特征及治疗转归情况，为完善西安市肺结核防治策略提供依据。方法 收集2009-2019年《传染病信息管理系统》中登记的肺结核患者病案信息数据，通过描述性研究方法对肺结核流行病学特征和治疗转归情况进行分析。结果 2009-2019年间西安市肺结核年平均发病率为49.06/10万。郊县、郊区、城区肺结核年平均发病率分别为54.13/10万、47.46/10万和46.19/10万；男性发病率是女性的1.85倍。职业分布排在前5位的为农民（47.48%），家政、家务及待业（14.65%），离退人员（9.55%），学生（8.63%）和工人（5.23%）。利福平敏感或耐药性未知患者的成功治疗率平均为98.03%，利福平耐药患者治疗成功率为51.47%。结论 西安市近年来肺结核发病率和治疗率呈增长趋势，利福平耐药患者治疗成功率较低，要加强对重点人群的健康促进工作，加大肺结核发现力度及患者治疗管理工作。     

Arachidonic acid-stimulated platelet tests: Identification of patients less sensitive to aspirin treatment

Serum thromboxane-B2 (TxB2), together with arachidonic acid (AA)-induced platelet aggregation, are, at the moment, the most used tests to identify patients displaying high on-aspirin treatment platelet reactivity (HAPR). Both tests are specific for aspirin action on cyclooxygenase-1. While the correlation between serum TxB2 assay and clinical outcome is established, data are conflicting with regard to aspirin treatment and a possible association with AA-stimulated platelet markers and clinical outcome. To understand such discrepancy, we performed a retrospective study to compare both assays. We collected data from 132 patients receiving a daily dose of aspirin (100?mg/day) and data from 48 patients receiving aspirin on alternate days. All Patients who received a daily dose of aspirin were studied for AA-induced platelet aggregation together with serum TxB2 levels and AA-induced TxB2 formation was also studied in 71 patients out of entire population. Consistent with recommendations in the literature, we defined HAPR by setting a cut-off point at 3.1?ng/ml for serum levels of thromboxane B2 and 20% for AA-induced platelet aggregation. According to this cut-off point, we divided our overall population into two groups: (1) TxB2?<?3.1?ng/ml and (2) TxB2?>?3.1?ng/ml. We found low agreement between such tests to identify patients displaying HAPR. Our results show that AA-induced platelet aggregation >20% identify a smaller number of HAPR patients in comparison with TxB2. A good correlation between serum TxB2 and arachidonic acid-induced TxB2 production was found (r?=?0.76619).     

一起学校耐药肺结核聚集性疫情的调查

目的 对北京市朝阳区某学校一起耐药肺结核疫情进行分析,为今后耐药结核病疫情的处置提供参考。方法 对病例进行流行病学调查,对病例密切接触者采用PPD试验、X线胸片和CT相结合的方式筛查。结果 2018年10月—2019年6月,该校共发生36例肺结核病例,发病率为4.5%。其中5例耐多药,3例耐利福平。36例病例分布在四个班,15a班27例、15b班4例、15c班2例、17d班3例。各班发病率分别为56.3%、8.3%、5.7%、7.1%,差异有统计学意义(P<0.01)。8例耐药病例中6例为15a班学生,占耐药病例总数的75.0%。经CT筛查68名密切接触者中确诊23例肺结核患者,检出率33.8%。结论 该起学校聚集性疫情为全国首起耐药肺结核聚集性疫情,首发病例未及时就医,传染源隐匿存在时间长,是导致该起疫情发生的主要原因。疫情处置中开展密切接触者筛查对于及时发现新病例非常重要。     

经纤支镜气道内膜下注射药物治疗对支气管内膜结核患者并发症的影响

目的探讨纤支镜气道注射药物治疗对支气管内膜结核患者并发症的影响。方法选择2018年1月—2019年1月在湖北省潜江市中心医院治疗的支气管内膜结核患者66例,分为对照组和研究组各33例。对照组给予药物雾化吸入疗法,研究组经过纤支镜气道内膜下注射药物治疗。比较两组治疗效果和症状缓解的影响。结果研究组总有效率为90.91%,对照组总有效率为84.85%,研究组的治疗效果均高于对照组(P<0.05);对照组并发症发生率为39.39%,研究组并发症发生率18.18%,研究组并发症发生率明显低于对照组(P<0.05)。结论经纤支镜气道内膜下注射药物治疗支气管内膜结核患者并发症的发生率较小。     

The technological imperative in tuberculosis care and prevention in Vietnam

ABSTRACT

A monocausal bacteriological understanding of infectious disease orients tuberculosis control efforts towards antimicrobial interventions. A bias towards technological solutions can leave multistranded public health and social interventions largely neglected. In the context of globalising biomedical approaches to infectious disease control, this ethnography-inspired review article reflects upon the implementation of rapid diagnostic technology in low- and middle-income countries. Fieldwork observations in Vietnam provided a stimulus for a critical review of the global rollout of tuberculosis diagnostic technology. To address local needs in tuberculosis control, health managers in resource-poor settings are readily cooperating with international donors to deploy novel diagnostic technologies throughout national tuberculosis programme facilities. Increasing investment in new diagnostic technologies is predicated on the supposition that these interventions will ameliorate disease outcomes. However, suboptimal treatment control persists even when accurate diagnostic technologies are available, suggesting that promotion of singular technological solutions can distract from addressing systemic change, without which disease susceptibility, propagation of infection, detection gaps, diagnostic delays, and treatment shortfalls persist.