Prediction of all-cause mortality with malnutrition assessed by nutritional screening and assessment tools in patients with heart failure：a systematic review

Background and aimsIn the absence of a gold standard or scientific consensus regarding the nutritional evaluation of heart failure (HF) patients, this study aimed to summarize and systematically evaluate the prognostic value of nutritional screening and assessment tools used for all-cause mortality in HF patients.Methods and resultsRelevant studies were retrieved from major databases (PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang Data, and China Biology Medicine disc (CMB)) and searched from the earliest available date until July 2021. If three or more studies used the same tool, meta-analysis using RevMan 5.3 was performed. This systematic review was registered at PROSPERO (number CRD42021275575). A total of 36 articles involving 25,141 HF patients were included for qualitative analysis and 31 studies for quantitative analysis. Meta-analysis of these studies indicated, poor nutritional status evaluated by using 5 nutritional screening tools (Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), Controlling Nutritional Status Score (CONUT), Nutritional Risk Index (NRI), and Short Form Mini Nutritional Assessment (MNA-SF)) or 2 nutritional assessment tools (the Mini Nutritional Assessment (MNA) and Generated Subjective Global Assessment (SGA)) predicted all-cause mortality in HF patients. Of all tools analyzed, MNA had the maximum HR for mortality [HR = 2.62, 95%CI 1.11–6.20, P = 0.03] and MNA-SF [HR = 1.94, 95%CI 1.40–2.70, P＜0.001] was the best nutritional screening tools.ConclusionPoor nutritional status predicted all-cause mortality in HF patients. MNA may be the best nutritional assessment tool, and MNA-SF is most recommended for HF patient nutritional screening. The application value of MNA, especially in patients with reduced left ventricular ejection fraction (LVEF), needs to be further confirmed. The clinical application value of Mini-Nutrition Assessment Special for Heart Failure (MNA-HF) and Global Leadership Initiative on Malnutrition (GLIM) in HF patients needs to be confirmed.     

青岛市男性新型毒品滥用人群艾滋病病毒感染及危险行为调查

目的 了解山东省青岛市新型毒品滥用者使用新型毒品的情况、性行为特征及HIV感染状况。方法 采用横断面调查设计,2015-2016年在青岛市依托MSM社会组织和社区中男性新型毒品滥用者志愿者,滚雪球法招募男性新型毒品滥用者,样本量估计为933人。收集其吸毒、性行为,检测HIV、梅毒、HCV抗体,检测新型毒品滥用情况。采用EpiData 3.1软件建立数据库、SAS 9.4软件进行统计分析。结果 共招募1 034人,MSM组431人（占41.7%）和非MSM组603人（占58.3%）。与非MSM组相比,MSM组年龄较低,未婚比例较高,文化程度较高。最近6个月用过冰毒的比例MSM组和非MSM组分别为49.7%（214/431）和100.0%（603/603）,用过零号胶囊的比例分别为66.8%（288/431）和0.0%。最近6个月与多人共用毒品者的比例MSM组和非MSM组分别为87.9%（379/431）和97.7%（588/602）（χ²=39.84,P<0.01）。最近6个月使用毒品后发生性行为从未使用安全套的比例,非MSM组（47.5%,285/600）高于MSM组（7.4%,32/430）（χ²=190.10,P<0.01）。最近6个月使用新型毒品后发生多人性行为的比例,MSM组和非MSM组分别为78.1%（335/429）和5.5%（33/600）（χ²=573.73,P<0.01）。MSM组的和非MSM组的HIV抗体阳性率、梅毒抗体阳性率、HCV抗体阳性率分别为2.1%和0.2%、3.3%和6.3%、0.0%和0.3%。结论 青岛市男性新型毒品滥用人群中有较高比例的多人共同吸毒,在有男男性行为的新型毒品滥用人群中,使用毒品后的群体性行为发生率高,HIV抗体阳性率较高,安全套使用率低,应重点加强对这部分亚人群的干预。     

A randomized,open label trial to evaluate and compare the immunogenicity and safety of a novel liquid hexavalent DTwP-Hib/Hep B-IPV (EasySix™) to licensed combination vaccines in healthy infants

Immunogenicity and safety of a newly developed liquid DTwP-Hib/HepB-IPV hexavalent vaccine (EasySix™) was evaluated and compared with administration of commercially licensed Pentavac SD® (DTwP-HepB/Hib) and Imovax Polio® vaccine in an open-label, randomized multi-centric trial. 284 participants, aged 6–10 weeks, randomized in a 1:1 allocation, received three doses of test or comparator vaccines, administered 4 weeks apart. Immunogenicity of the vaccines was determined by measuring the baseline and post-vaccination antibody responses and comparing the proportions of subjects achieving seroprotection against the vaccine antigens; safety was evaluated in terms of solicited (local and systemic) and unsolicited incidences in the follow up phase. Post-vaccination, seroprotection was achieved against all six vaccine antigens in both vaccine groups. The seroresponse rate as well as geometric mean titers of antibody for all vaccine components were comparable between EasySix™ and Pentavac SD®-Imovax Polio® group. Both vaccines had similar reactogenicity profiles and were well tolerated; all adverse events resolved completely without any sequelae. Only one serious adverse event was reported that completely resolved; it was regarded unconnected to the vaccine administered. This study demonstrated that immunogenicity and safety profiles of EasySix™ vaccine, manufactured by Panacea Biotec Ltd, are non-inferior to the commercially available vaccines.Clinical trial registration: CTRI/2015/02/005578.     

The 2015–2016 influenza epidemic in Beijing,China: Unlike elsewhere,circulation of influenza A(H3N2) with moderate vaccine effectiveness

BackgroundWhile the 2015–2016 influenza season in the northern hemisphere was dominated by A(H1N1)pdm09 and B/Victoria viruses, in Beijing, China, there was also significant circulation of influenza A(H3N2) virus. In this report we estimate vaccine effectiveness (VE) against influenza A(H3N2) and other circulating viruses, and describe further characteristics of the 2015–2016 influenza season in Beijing.MethodsWe estimated VE of the 2015–2016 trivalent inactivated vaccine (TIV) against laboratory-confirmed influenza virus infection using the test-negative study design. The effect of prior vaccination on current VE was also examined.ResultsOf 11,000 eligible patients included in the study, 2969 (27.0%) were influenza positive. Vaccination coverage was 4.2% in both cases and controls. Adjusted VE against all influenza was 8% (95% CI: −16% to 27%): 18% (95% CI: −38% to 52%) for influenza A(H1N1)pdm09, 54% (95% CI: 16% to 74%) for influenza A(H3N2), and −8% (95% CI: −40% to 18%) for influenza B/Victoria. The overall VE for receipt of 2015–2016 vaccination only, 2014–2015 vaccination only, and vaccinations in both seasons was −15% (95% CI: −63% to 19%), −25% (95% CI: −78% to 13%), and 18% (95% CI: −11% to 40%), respectively.ConclusionsOverall the 2015–2016 TIV was protective against influenza infection in Beijing, with higher VE against the A(H3N2) viruses compared to A(H1N1)pdm09 and B viruses.     

2015—2019年宁波市0~36月龄婴幼儿癫痫发病的流行病学研究

目的: 描述浙江省宁波市0~36月龄婴幼儿癫痫发病的三间分布及其变化趋势。方法: 采用出生队列设计,回顾性收集2015—2019年宁波市全民健康信息平台中本地出生的婴幼儿,以平台内电子病历首次癫痫就诊作为新发病例。采用泊松分布估算癫痫发病密度及其95%CI。结果: 2015—2019年宁波市累计出生29.49万儿童,男性占51.92%,总人年59.53万,中位随访人年2.31年[四分位距(interquartile range, IQR):1.90]。观察期间癫痫新发575例,总就诊人次2 599,平均就诊人次4.52,总发病密度96.59/10万人年(95%CI:88.85~104.82)。中位发病月龄13月龄(IQR:15),0~12月龄发病密度最高(102.18/10万人年),25~36月龄最低(89.68/10万人年),差异无统计学意义(P>0.05)。男性发病密度97.58/10万人年,女性95.53/10万人年,差异无统计学意义(P>0.05)。下辖10个区县中,奉化最高(130.54/10万人年,95%CI:94.47~175.83),宁海最低(66.44/10万人年,95%CI:47.02~91.19), 差异有统计学意义(P<0.05)。不同出生年份发病差异无统计学意义(P>0.05)。不同日历年0~12月龄发病密度差异有统计学意义(P_trend<0.05)。该年龄组下, 2015年发病密度最低(69.41/10万人年,95%CI:41.79~108.39), 2019年最高(225.61/10万人年,95%CI:186.10~271.03)。不同日历年13~24、25~36月龄发病密度差异无统计学意义(P>0.05)。结论: 2015—2019年宁波市0~36月龄婴幼儿癫痫发病密度整体较低,年龄组、性别、出生年份等发病密度差异均无统计学意义,0~12月龄婴幼儿发病密度随年份呈递增趋势。     

Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study

Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.Methods The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study.A total of 105,922 community-dwelling adults aged≥40 years underwent the oral glucose tolerance test and uric acid assessment.The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.Results A total of 30,941 men and 62,361 women were eligible for the current analysis.Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels,but with different inflection points in men and women.The thresholds for FPG,2 h-PG,and HbA1 c for men and women were 6.5/8.0 mmol/L,11.0/14.0 mmol/L,and 6.1/6.5,respectively(SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes,while the inflection points were reached earlier in men than in women.     

2013-2014年季节性流行性感冒疫苗免疫血清针对我国流行株的抗体水平分析

目的 分析季节性流行性感冒(流感)疫苗免疫血清针对我国流行株的抗体水平及我国流行株与疫苗株的匹配性. 方法 采集不同年龄组人群疫苗接种前后的血清,利用流感流行株和疫苗株作为病毒抗原,应用血凝抑制试验(HI)方法对血清进行检测. 结果 三价流感疫苗对我国A(H1N1)Pdm09亚型流行株产生的抗体平均几何滴度(GMT)低于针对疫苗株病毒的GMT,血清抗体滴度 40的比例为57.0%～63.3%;对我国A(H3N2)亚型流行株产生的GMT与针对疫苗株病毒的GMT类似,血清抗体滴度超过40的比例为57.6%～63.0%;对B型流行株产生的血清抗体GMT低于针对疫苗株的GMT,不过超过了疫苗株抗体GMT的50%.不同年龄组的血清抗体反应不同,成年组相对较高. 结论 2013-2014年季节性流感疫苗与同期流行的A(H1N1)Pdm09亚型流感病毒和B型流行株Yamagata系流感病毒较为匹配;H3N2亚型疫苗与流行株的匹配性较低,有可能会导致疫苗的保护效果降低.     

Molecular genetic analysis of Plasmodium vivax isolates from Eastern and Central Sudan using pvcsp and pvmsp-3α genes as molecular markers

In Sudan, Plasmodium vivax accounts for approximately 5–10% of malaria cases. This study was carried out to determine the genetic diversity of P. vivax population from Sudan by analyzing the polymorphism of P. vivax csp (pvcsp) and pvmsp-3α genes. Blood samples (n = 76) were taken from suspected malaria cases from 2012–2013 in three health centers of Eastern and Central Sudan. Parasite detection was performed by microscopy and molecular techniques, and genotyping of both genes was performed by PCR-RFLP followed by DNA sequence for only pvcsp gene (n = 30). Based on microscopy analysis, 76 (%100) patients were infected with P. vivax, whereas nested-PCR results showed that 86.8% (n = 66), 3.9% (n = 3), and 3.9% (n = 3) of tested samples had P. vivax as well as Plasmodium falciparum mono- and mixed infections, respectively. Four out of 76 samples had no results in molecular diagnosis. All sequenced samples were found to be of VK210 (100%) genotype with six distinct amino acid haplotypes, and 210A (66.7%) was the most prevalent haplotype. The Sudanese isolates displayed variations in the peptide repeat motifs (PRMs) ranging from 17 to 19 with GDRADGQPA (PRM1), GDRAAGQPA (PRM2) and DDRAAGQPA (PRM3). Also, 54 polymorphic sites with 56 mutations were found in repeat and post-repeat regions of the pvcsp and the overall nucleotide diversity (π) was 0.02149 ± 0.00539. A negative value of dN − dS (−0.0344) was found that suggested a significant purifying selection of Sudanese pvcsp, (Z test, P < 0.05). Regarding pvmsp-3α, three types were detected: types A (94.6%, 52/55), type C (3.6%, 2/55), and type B (1.8%, 1/55). No multiclonal infections were detected, and RFLP analysis identified 13 (Hha I, A1-A11, B1, and C1) and 16 (Alu I, A1-A14, B1, and C1) distinct allelic forms. In conclusion, genetic investigation among Sudanese P. vivax isolates indicated that this antigen showed limited antigenic diversity.     

北京市基层医疗机构空气消毒效果调查

为了解北京市基层医疗机构空气消毒效果情况,以便加强管理,采用现场调查和抽检的方法进行了检测评价。结果,北京市基层医疗机构空气消毒效果总合格率为82.53%。紫外线灯安装数量未达到≥1.5μw/m2的诊所有15所,紫外线辐照度未达标的诊所有18所,有6所诊所无紫外线灯。结论,北京市基层医疗机构空气消毒设备落后,紫外线灯安装数量不足,辐射强度合格率较低,使用不合理,需要加强管理。