甲型肝炎减毒活疫苗与灭活疫苗免疫后血清学效果观察

目的比较甲型肝炎减毒活疫苗与灭活疫苗的血清学免疫效果。方法筛选抗 -HAVIgG阴性 ,6 -18岁的甲肝易感人群104名 ,随机分为国产减毒活疫苗组和进口灭活疫苗组 ,免疫程序为0、6月两针法 ,于每针免疫后1个月采集静脉血 ,分离血清检测抗 -HAVIgG。结果首针免疫后抗 -HAVIgG阳转率减毒活疫苗组为80.0 %(40/50) ,灭活疫苗组为96.3 %(52/54) ,两组间差异有高度显著性(χ2=6.75,P<0.01) ;第2针免疫后抗 -HAVIgG阳转率两组均为100.0 %。结论不论应用国产甲肝减毒活疫苗或进口灭活疫苗 ,都应进行两次疫苗接种 ,才能获得较佳的预防效果     

妈咪爱加必奇治疗小儿腹泻与使用抗生素的疗效比较

目的 :通过抗生素与妈咪爱加必奇两个治疗组疗效的比较 ,探讨治疗小儿腹泻的最优方案。方法 :对 6 0例小儿腹泻患儿随机分为两组 :抗生素组在给予补液、纠正水电解质紊乱、纠正酸中毒等综合治疗的基础上 ,加用抗生素 (氨苄青霉素干糖浆 ) ;妈咪爱加必奇组在上述综合治疗的基础上 ,加用妈咪爱、必奇冲剂。结果 :妈咪爱加必奇组与抗生素组相比疗效有显著性差异 (P <0 .0 5 )。结论 :对小儿腹泻的治疗在补液、纠正水电解质紊乱、纠正酸中毒等综合治疗的基础上 ,加用消化道粘膜保护剂 (必奇 )和微生态调节剂 (妈咪爱 )比加用抗生素疗效更好 ,并可避免小儿腹泻滥用抗生素的现象     

Intake of Unprocessed and Processed Meat and the Association with Cardiovascular Disease: An Overview of Systematic Reviews

We conducted an overview of systematic reviews to summarize reviews of cohort studies on intake of unprocessed and processed meat and the risk of cardiovascular disease (CVD), coronary heart disease (CHD), and stroke. Systematic reviews of cohort studies published between January 2010 and August 2020 were identified through a systematic literature search in PubMed, Embase, and Web of Science. The quality of how each review was conducted was assessed and the overall confidence in the results of each review was rated using AMSTAR 2. The quality of evidence of each meta-analysis was graded using NutriGrade. Three reviews were included, with meta-analyses of unprocessed red meat and CVD (n = 1) and stroke (n = 2); unprocessed poultry and stroke (n = 1); and processed meat and CVD (n = 1), CHD (n = 1), and stroke (n = 3). The overall confidence in the results of each review was rated as critically low. The meta-evidence was graded moderate for a positive association between unprocessed red meat and stroke and moderate for a positive association between processed meat and CHD and stroke. For other associations the meta-evidence was graded as low or very low. In conclusion, the associations between unprocessed and processed meat with CVD and major subtypes of CVD have not been extensively investigated.     

卵裂期胚胎发育速度及解冻后发育与复苏周期临床结局的关系

评估Day 3 卵裂期胚胎的卵裂球个数及冷冻解冻后发育情况与复苏周期临床结局的关系.回顾性分析2016 年1 月至2019 年6 月在南京医科大学第一附属医院临床生殖中心行卵裂期单胚胎移植的2 942 个复苏周期.根据冷冻前Day3 卵裂期胚胎的卵裂球个数,分为三组:A1 组:7～9 细胞(n = 2 421);A2:...     

植入前遗传学检测后冻融胚胎移植周期妊娠结局的影响因素

目的：分析经植入前遗传学检测（preimplantation genetic testing,PGT）后,冻融胚胎移植（frozen-thawed embryo transfer,FET）周期时3种常见子宫内膜准备方案对妊娠结局的影响及相关影响因素,指导PGT患者的助孕治疗。方法：回顾性分析2017年1月—2022年1月于兰州大学第一医院行PGT助孕的195例患者共219个FET周期的临床资料及妊娠结局,包括非整倍体筛查检测（PGT for aneuploidies,PGT-A）周期、单基因疾病检测（PGT for monogenic,PGT-M）周期和染色体重排检测（PGT for structural rearrangements,PGTSR）周期。按照内膜准备方案分为自然周期组（natural cycle,NC组,56个）、促性腺激素释放激素激动剂（gonadotropin releasing hormone agonist,GnRHa）联合激素替代疗法（hormone replacement therapy,HRT）周期组（GnRHa+HRT组,102个）及单纯HRT周期组（6...     

枯草杆菌二联活菌颗粒联合美罗培南治疗新生儿坏死性小肠结肠炎的临床研究

目的 探讨枯草杆菌二联活菌颗粒联合美罗培南治疗新生儿坏死性小肠结肠炎的有效性和安全性。方法 选取2020年1月—2021年12月天津市儿童医院收治的70例新生儿坏死性小肠结肠炎患儿,采用随机数字表法将其分为对照组(35例)和治疗组(35例)。对照组静脉滴注注射用美罗培南,20 mg/kg溶解于5～10 m L生理盐水中,日龄≤7 d患儿12 h/次,日龄>7 d患儿8 h/次。治疗组在对照组基础上口服枯草杆菌二联活菌颗粒,1袋/次,2次/d。两组患儿治疗7 d。观察两组患儿临床疗效,比较治疗前后两组患儿肠道菌群变化,CD4⁺、CD8⁺、CD4⁺/CD8⁺值及临床症状改善情况。结果 治疗后,治疗组患儿总有效率97.14%较对照组的82.86%显著增加(P<0.05)。治疗后,两组患儿杆菌总数、球菌总数、球杆菌比值及CD4⁺、CD4⁺/CD8⁺值均显著高于治疗前(P<0.05),且治疗组患儿明显高于对照组(P<0....     

Haemagglutinin stability was not the primary cause of the reduced effectiveness of live attenuated influenza vaccine against A/H1N1pdm09 viruses in the 2013–2014 and 2015–2016 seasons

During the 2013–2014 influenza season, the quadrivalent live attenuated influenza vaccine (QLAIV), had lower than expected vaccine effectiveness (VE) against circulating A/H1N1pdm09 viruses in the USA. The underlying reason proposed for this was that the A/H1N1pdm09 vaccine strain, A/California/07/2009 (A/CA09), had a thermally unstable haemagglutinin (HA) protein. Consequently, a new A/H1N1pdm09 candidate strain, A/Bolivia/559/2013 (A/BOL13), was developed for inclusion in the 2015–2016 QLAIV. A key parameter for selection of A/BOL13 was its more thermostable HA phenotype compared with A/CA09. During the 2015–2016 season, QLAIV containing A/BOL13 was found in some studies to have improved, but still with suboptimal, VE against circulating A/H1N1pdm09 viruses and was not recommended for use by the CDC in the US market in the 2016–2017 influenza season. This suggested that improved HA thermostability had not entirely resolved the reduced VE observed. One hypothesis for this was that, by improving thermostability, the A/BOL13 HA protein had been over-stabilised, compromising its activation at the low endosomal pH required for successful viral entry. Here we demonstrate that, while the A/BOL13 HA protein is more stable than that of A/CA09, its thermal and pH stability were comparable with historically efficacious LAIV strains, suggesting that the HA had not been over-stabilised. Furthermore, studies simulating potential heat exposure during distribution by exposing QLAIV nasal sprayers to 33 °C for 4 h showed that, while remaining within product specification, A/CA09 viral potency was statistically decreased after 12 weeks at 2–8 °C. These data suggest that although unfavourable HA protein stability may have contributed to the reduced VE of A/CA09 in 2013–2014, it was unlikely to have affected A/BOL13 in 2015–2016. We conclude that HA stability was not the primary cause of the reduced effectiveness of LAIV against A/H1N1pdm09 viruses in the 2013–2014 and 2015–2016 seasons.     

Follicular fluid 25-hydroxyvitamin D levels determine fertility outcome in patients with polycystic ovary syndrome

ObjectiveTo determine the possible relationship between follicular fluid 25-hydroxyvitamin D [25(OH)D] levels and fertility outcome of women who underwent IVF/ICSI with the diagnosis of lean polycystic ovary syndrome.Materials and methodsThirty patients who were diagnosed with PCOS according to the Rotterdam criteria and decided on IVF/ICSI were included in the study. Thirty patients who were scheduled for IVF/ICSI for reasons other than PCOS and matched in terms of age and BMI were taken as the control group (non-PCOS). According to BMI values, patients in both PCOS and non-PCOS groups were lean. Women in both groups were aged 21–35 years with a normal BMI (18.5–24.9 kg/m2) and first IVF/ICSI attempt. Both groups of patients were followed up using the antagonist protocol. Vit D levels were measured in serum and follicular fluid (FF) samples taken on the day of oocyte collection. The correlation between FF vit D levels, the number of total oocytes, MII oocytes and 2 PN zygotes, HOMA-IR, hormonal and demographic parameters, clinical pregnancy rate (CPR), live birth rate (LBR), and miscarriage rate were evaluated.ResultsAt the time of oocyte retrieval women with PCOS had similar serum Vitamin D compared to non-PCOS women (21.8 (12.6–24.8) ng/ml vs 22.3 (11.5–25.1) ng/ml, p < 0.54). In FF, assessed on the day of oocyte retrieval, the concentration of Vitamin D was similar in women with PCOS when compared to non-PCOS women (11.2 (9.2–14.4) ng/ml vs 13.3 (11.1–17.4) ng/ml, p < 0.06). For both groups, Vitamin D levels were lower in FF compared to serum vit D. A positive correlation was found between serum and FF Vitamin D concentrations in the full cohort. A positive and significant correlation was found between FF-vit D levels and the number of total oocyte (r = 0.344, p < 0.04) and MII oocyte (r = 0.404, p < 0.02) in the PCOS group. The number of total oocyte, MII oocyte and 2 PN zygotes of the PCOS group were significantly higher than the non-PCOS group. Positive pregnancy test rate, clinical pregnancy and live birth rates were similar in both groups. The miscarriage rates in the non-PCOS group were significantly higher than in the PCOS group. A positive and significant correlation was also found between FF vit D levels and positive pregnancy test (r = 0.566, p < 0.03) and CPR (r = 0.605, p < 0.02) in PCOS group. There was no correlation between FF-vit D levels and live birth and miscarriage rates in neither the PCOS nor the non-PCOS group.ConclusionsBoth serum and FF 25-hydroxyvitamin D level of women with PCOS at the time of oocyte retrieval are similar to non-PCOS controls. While FF 25-hydroxyvitamin D levels correlate with total and MII oocyte counts, positive pregnancy test and CPR, it does not correlate with miscarriage and live birth rates.     

Live birth rate from euploid blastocysts is not associated with infertility etiology or oocyte source following frozen-thawed embryo transfer (FET): analysis of 4148 cycles reported to SART CORS

PurposeTo investigate whether live birth rates from euploid blastocyst frozen-thawed embryo transfer (FET) cycles are associated with infertility diagnosis or oocyte source.DesignRetrospective analysis of FET cycles reported to SART CORS in 2014.MethodsData from fresh IVF cycles with preimplantation genetic testing for aneuploidy (PGT-A), linked to the first FET cycles, were collected from the 2014 SART CORS database for autologous and donor oocyte cycles. Inclusion criteria were patients undergoing FET with euploid embryos (n = 4148). Demographic data including age, BMI, prior fertility, and etiology of infertility were collected from the retrieval cycle and analyzed. Patients with uterine anomalies, preimplantation genetic testing-mutation (PGT-M) for genetic diseases, gender selection, HLA determination, or systemic and immunologic disorders were excluded. The primary outcome measure was live birth (LB) rate. Potential confounders such as age, prior fertility, and maximum baseline FSH values were analyzed with regression models as indicated.ResultsThough age, maximum baseline FSH, and infertility diagnosis were significantly different, LB was similar between patients undergoing autologous or donor oocyte FET cycles. Etiology of infertility was not significantly associated with LB in autologous cycles (p = 0.95). Potential confounders such as maternal age, prior fertility, and maximum baseline FSH were not associated with outcomes; however, maternal BMI was inversely related to LB in autologous cycles, with an odds ratio of 0.97 (95% CI: 0.96–0.98 (rho = − 0.08, p < 0.01)).ConclusionsAfter controlling for confounding variables, a euploid embryo derived from a donor or autologous oocyte results in similar LB in women with different infertility diagnoses.