伤寒Vi多糖菌苗免疫后长期效果观察

目的研究伤寒Vi多糖菌苗免疫后长期效果。方法现场实验流行病学。结果接种后伤寒Vi多糖菌苗1~3年的有一定的保护作用,且在这3年中保护效果无差别。结论接种伤寒Vi多糖菌苗是今后预防伤寒的重要措施之一,但不必要每年均接种。     

1994-2005年汕头市濠江区伤寒流行病学分析

目的 分析1994-2005年濠江区伤寒流行规律,为有效预防和控制伤寒的发生与流行提供依据.方法 对1994-2005年濠江区伤寒疫情资料进行描述性流行病学分析.结果 12年来,共发病565例,年平均发病率为26.56/10万,各年发病率在9.25/10万～56.29/10万之间.全年均可发病,3～8月份发病率偏高,占65.31%;性别没有明显差别;20～59岁的青壮年发病率较高,占发病总数的69.91%;职业分布以待业或家务人员、农民、工人、学生为主,占发病总数的86.02%.结论 濠江区伤寒发病率仍处于相对较高水平,应采取有效措施防制.     

1994～2004年泰安市城区饮食服务业从业人员查体资料分析

[目的]了解饮食服务业从业人员病毒性肝炎、伤寒、痢疾、肺结核及皮肤病（“五病”）感染状况，进一步加强对饮食服务业从业人员的健康管理。[方法]对泰安市城区直接管辖的饮食服务业从业人员1994～2004年查体资料进行分析。[结果]1994～2004年合计检查183532人，“五病”检出率为3．15％，呈逐年下降趋势；HBsAg阳性率为2．18％，伤寒检出率为0．27／万，细菌性痢疾检出率为0．03％，肺结核患病率为0．07％，皮肤病（手癣、指甲癣、手部湿疹、银屑或鳞屑病、化脓性皮肤病、渗出性皮肤病）患病率为0．87％。[结论]“五病”检出率呈逐年下降趋势，但乙肝病毒感染率仍然较高。     

临沂市2001～2005年伤寒、副伤寒资料分析

[目的]探讨临沂市伤寒、副伤寒流行特征,制定有效的控制措施.[方法]对临沂市2001～2005年伤寒疫情报告及流行病学调查资料进行分析.[结果]2001～2005年临沂市共报告伤寒、副伤寒病人2330例,无死亡病例,年平均发病率为4.61/10万.发病具有明显的季节性;年龄主要集中在15～40岁年龄段,占70.86%(1651/2330);农民和中、小学生是主要的发病人群,分别占33.05%(770/2330)、17.85%(416/2 330);平原伤寒、副伤寒发病率高于山区;临床特征不典型;近3年我市以甲型副伤寒发病为主.[结论]应采取以切断经水传播、免疫接种和敏感药物治疗为主的综合性防治措施以控制临沂市的伤寒、副伤寒疫情.     

A brief review on the immunological scenario and recent developmental status of vaccines against enteric fever

Enteric fever has been one of the leading causes of severe illness and deaths worldwide. S. Typhi and S. Paratyphi A, B and C are important enteric fever-causing organisms globally. This infection causes about 21 million cases among which 222,000 typhoid related deaths occurred in 2015. These estimates do not reflect the ultimate and real status of the disease due to the lack of unified diagnostic and proper reporting system from typhoid endemic and other regions. Current control strategies have become increasingly ineffective due to the emergence of multi-drug resistance among the strains. This situation worsens the disease-burden in developing as well as in developed countries. Moreover the emergence of S. Paratyphi A as a major enteric fever-causing organism in several Asian countries, demands a prophylactic measure at this hour. Other than two licensed vaccines of S. Typhi, there are no exsisting vaccines for S. Paratyphi A. Moreover, travelers returning from endemic regions are becoming more susceptible to have these infections. In this situation, a need for bivalent approach is required where a single immunogen (consisting from each organism) will be effective against the disease. In this review, we have focused on the general information about typhoidal fever, its spread and epidemiology in brief and the present status of typhoidal vaccines and its future. This review highlights existing gaps in the typhoidal salmonellae research with a special emphasis on the status of present typhoidal salmonellae vaccine research.     

《伤寒杂病论》中“和百药”药对的应用探析

目的:基于"甘能缓"理论,对张仲景《伤寒杂病论》中应用"和百药"药对的配伍规律。方法:选取符合"甘能缓"理论的张仲景"和百药"药对标准的经方建立数据库,采用频数分析、网络图链接关系、关联规则等方法探讨张仲景的"和百药"药对的用药及配伍规律。结果:在166方中,有122味药物,其中最常用甘草进行药对配伍。数据挖掘得出与甘草高频配伍的有毒药为半夏、附子、苦杏仁,解毒关联规则13条、强链接2组,得到药对"甘草-附子""蜂蜜-乌头"等;缓和药性关联规则24条、强链接11组,得到药对"甘草-石膏-麻黄""甘草-桂枝"等。结论:"和百药"药物可通过药对配伍缓和药物毒性、缓和药物寒热之性、缓和药力、缓留药效、缓和药物滋味。     

Phase I clinical trial of O-acetylated pectin conjugate,a plant polysaccharide based typhoid vaccine

Background

Typhoid fever remains an important cause of morbidity and mortality in the developing countries. Vi capsular polysaccharide conjugate vaccine demonstrated safety and efficacy in young children in high endemic regions. A novel typhoid conjugate vaccine based on plant polysaccharide pectin was studied in a phase I trial.

Methods

Fruit pectin, having the same carbohydrate backbone structure as Vi, was purified from citrus peel and used as the polysaccharide source to prepare a semi-synthetic typhoid conjugate vaccine. Pectin was chemically O-acetylated (OAcPec) to antigenically resemble Vi and conjugated to carrier protein rEPA, a recombinant exoprotein A from Pseudomonas aeruginosa. 25 healthy volunteers, 18–45 years old, were injected once with OAcPec-rEPA. Safety and IgG antibodies reactive with Vi and pectin were analyzed.

Results

No vaccine associated serious adverse reaction was reported. Six weeks after the injection of OAcPec-rEPA, 64% of the volunteers elicited >4-fold rise of anti-Vi IgG. At 26 weeks the level declined, but the difference between the levels at 6 and 26 weeks are not statistically significant. There is a direct correlation between the level of anti-Vi IgG before and after the injection (R² = 0.96). The anti-Vi IgG can be absorbed by Vi, but not by pectin. There was no corresponding increase of anti-pectin after the injection, indicating the antibody response to OAcPec-rEPA was specific to Vi. There is no Vi-rEPA data in US adults for comparison of immune responses. The OAcPec-rEPA elicited significantly less IgG anti-Vi in US adults than those by Vi-rEPA in Vietnamese adults.

Conclusion

The O-acetylated pectin conjugate, a plant based typhoid vaccine, is safe and immunogenic in adult volunteers.ClinicalTrial.gov identifier: NCT00277147, NIH Protocol ID number: OH06-CH-0070, FDA BB Investigation New Drug (IND) number 6989.     

Evaluation of immune responses to an oral typhoid vaccine,Ty21a,in children from 2 to 5 years of age in Bangladesh

Young children are very susceptible to typhoid fever, emphasizing the need for vaccination in under five age groups. The parenteral Vi polysaccharide vaccine is not immunogenic in children under 2 years and the oral Ty21a vaccine (Vivotif) available in capsular formulation is only recommended for those over 5 years.