微滴式数字PCR和实时荧光定量PCR对新型冠状病毒肺炎患者不同时间血便尿中核酸检测结果初步探讨

目的 分析微滴式数字PCR(droplet digital PCR, ddPCR)和实时荧光定量PCR(quantitative real-time PCR,qPCR)的核酸检测结果,比较两种方法检测各类样本的差异性,为改进新型冠状病毒核酸检测方案提供数据支持。 方法 利用ddPCR和qPCR技术对已经确诊的3例新型冠状病毒肺炎患者发病不同时间的全血、尿液、粪便共22份标本进行新型冠状病毒核酸检测。 结果 两种方法对人保守区域基因扩增结果一致:全血标本信号最强,尿液次之,粪便最少;ddPCR在1份全血,1份尿液,5份粪便中检出ORF-1ab和N基因的阳性微滴,qPCR仅在3份粪便中检出上述基因,漏检的3个标本基因拷贝数平均浓度为128 copies/ml;ddPCR在发病<5、5~15、>15 d的各类标本中都有检出,qPCR检出以中晚期为主;重症病例用ddPCR均可测到阳性微滴,qPCR检测的各类标本均为阴性;轻症病例的各类标本中qPCR只有粪便核酸检测阳性,ddPCR检出率高于qPCR。 结论 ddPCR可以有效克服qPCR 灵敏度不足的难题,是对qPCR 的有益补充,尤其是针对病毒载量比较低的血液、尿液和可疑的粪便或肛拭子标本,适用于早期感染的判断及患者治愈后出院诊断。     

Evaluation of effectiveness,safety and cost-benefit of the 23– valent pneumococcal capsular polysaccharide vaccine for HIV-Infected patients

IntroductionDue to the lack of understanding of the protective effects and safety of 23-valent pneumococcal polysaccharide vaccine (PPV23) in immune-deficient populations, the vaccination rate of PPV23 among HIV-infected patients is still very low in China. The main objectives of this study were to determine whether the efforts to assess measures for the prevention of pneumococcal pneumonia are still worthwhile, and provide designated vaccination program of HIV-infected persons for government policy based on.Methods60 HIV-infected adults in Lanshan county who had never been vaccinated with any pneumococcal vaccine were enrolled in this study, voluntary vaccination of PPV23 and One-year follow-up after vaccination can be completed.Result76.67% patients (46/60) had serologic response at 12 months after vaccine, CD4 count(≤500 cells/ul or > 500 cells/ul) and Month from diagnosis to first antiviral therapy (≤1 month or > 1 month) were related to antibody responses (p < 0.05).In this study, PPV23 was well tolerated, no adverse reaction was reported.11 Streptococcus pneumoniae pneumonia (9.17%,11/120) occurred in the Unvaccinated group and 1 case(1.67%,1/60)in the vaccination group within one year after vaccination(Fisher's exact probability, P = 0.225). The VE was 81.79%. The per capita benefit was 39.32 dollars, the benefit-cost ratio = 1.19. There are significant statistical differences between the vaccinated group and the non-vaccinated group in outpatient costs (p < 0.05, 95 %CI: 9.29–32.11), Medicine costs (p = 0.017, 95 %CI: 2.47–24.44), and disease related indirect costs (p = 0.038, 95 %CI: 0.93–33.63) within one year of vaccination.ConclusionOur study results showed that PPV23 can be safely and effectively administered to HIV-1 infected individuals and effectively preventing Streptococcal pneumonia. Considering the cost-benefit of vaccination among HIV-infected persons, as it has been reported in our study, it is necessary to promote the widespread use of the vaccine among HIV-infected persons in the future.     

miR-146a-5p regulates autophagy and NLRP3 inflammasome activation in epithelial barrier damage in the in vitro cell model of ulcerative colitis through the RNF8/Notch1/mTORC1 pathway

Ulcerative colitis (UC) is a chronic inflammatory disease affecting the colon that can be influenced by microRNAs (miRNAs). This study aims to investigate the impact of miR-146a-5p on lipopolysaccharide (LPS)-induced Caco-2/HT-29 cell autophagy and NLRP3 inflammasome activation and the underlying mechanism, with the aim of identifying potential therapeutic targets. We used LPS to establish Caco-2/HT-29 cell models and measured cell viability by CCK-8. The levels of miR-146a-5p, RNF8, markers of NLRP3 inflammasome activation and autophagy, proteins involved in the Notch1/mTORC1 pathway, and inflammatory factors were assessed by RT-qPCR, Western blot, and ELISA. Intestinal epithelial barrier function was evaluated by measuring transepithelial electrical resistance. Autophagic flux was measured using tandem fluorescent-labeled LC3. miR-146a-5p was highly-expressed in LPS-induced Caco-2/HT-29 cells, and autophagy flux was blocked at the autolysosomal stage after LPS induction. Inhibition of miR-146a-5p suppressed NLRP3 inflammasome activation, reduced intestinal epithelial barrier damage, and facilitated autophagy inhibition in LPS-induced Caco-2/HT-29 cells. The autophagy inhibitor NH4Cl partially nullified the inhibitory effects of miR-146a-5p inhibition on NLRP3 inflammation activation. miR-146a-5p targeted RNF8, and silencing RNF8 partly abrogated the action of miR-146a-5p inhibition on promoting autophagy and inhibiting NLRP3 inflammasome activation. miR-146a-5p inhibition suppressed the Notch1/mTORC1 pathway activation by upregulating RNF8. Inhibition of the Notch1/mTORC1 pathway partially nullified the function of silencing RNF8 on inhibiting autophagy and bolstering NLRP3 inflammasome activation. In conclusion, miR-146a-5p inhibition may be a potential therapeutic approach for UC, as it facilitates autophagy of LPS-stimulated Caco-2/HT-29 cells, inhibits NLRP3 inflammasome activation, and reduces intestinal epithelial barrier damage by upregulating RNF8 and suppressing the Notch1/mTORC1 pathway.     

宜春市麻疹强化免疫前后发病状况的研究

目的 了解宜春市2006年1月～2012年12月麻疹强化免疫前后麻疹流行病学的特征,为更好地制订消除麻疹措施提供依据.方法 根据中国疾病预防控制信息系统及宜春市疾控中心麻疹强化免疫接种率报表,采用描述性流行病学方法,分析宜春市麻疹强化免疫前后的发病状况.结果 宜春市2006～2012年共报告麻疹病例1107例,男女性别比为2.2∶1,以散发为主,年平均发病率为2.88/10万;以散居儿童居多;发病年龄以＜15岁为主,其中,＜2岁发病例数最多（x2=52.64,P＜0.05）;麻疹强化接种前年平均发病率与强化接种后相比下降率为95.49％（x2=709.48,P＜0.05）;麻疹强化接种前后均以4～8月份为发病高发季节,且4月份为高峰期.年平均发病率排在前5位分别是万载县、丰城市、高安市、靖安县、袁州区;麻疹强化接种前后各县市区麻疹年平均发病率的下降率均＞75％,其中铜鼓县2010～2012年连续3年发病率为0％.结论 宜春市麻疹以散发为主,麻疹强化接种后,各年龄段、各地区麻疹发病率显著下降,部分儿童接种麻疹疫苗后仍有发病,0～2岁儿童发病率最高;建议在常规免疫的基础上,间隔2～3年对全市范围大规模实施麻疹强化免疫,保护易感人群,形成较牢固的免疫屏障,使麻疹发病率保持低态势.     

2003～2007年湘江长沙段洲滩钉螺分布调查

目的全面了解湘江长沙段各洲滩钉螺的分布现状和数量变化,考核近年来的灭螺效果。方法采用系统抽样结合环境抽查的方法,对湘江长沙段洲滩进行连续5年的螺情调查。结果2003～2007年跟踪调查24个洲滩,结果有螺洲滩数分别为当年调查洲滩的77.8%、66.7%、70.8%、75.0%和62.5%,5年共查出有螺洲滩20个,占洲滩总数的83.3%。湘江长沙段各洲滩有螺框出现率、活螺率不相同,但下降趋势明显（P均〈0.01）;药物与环改灭螺相结合的效果远好于单纯的药物灭螺。结论湘江长沙段洲滩的螺情得到了较好的控制。     

应急接种等措施在一起流行性腮腺炎暴发疫情防控中的效果评价

目的 评价应急接种等措施在一起流行性腮腺炎暴发疫情防控中的效果。方法 根据病例定义收集该起暴发疫情中的所有病例发病、隔离日期,疫情中采取的应急接种、病例隔离、停课、洗手宣传教育等防控措施信息,计算应急接种的疫苗保护效率(vaccine efficiency,VE),采用离散时间模型对拟合实际暴发疫情数据计算传播能力,计算应急接种、病例隔离、停课和洗手的效果指数。结果 该起暴发疫情共调查共1 471人,发生4代病例,三代间距均为15 d;暴发期间共339人接种了麻腮风疫苗,应急接种率为73.38%,发病3人,罹患率0.88%。未应急接种的人数为123人,发病25人,罹患率20.33%。应急接种的疫苗保护效率为95.6%。隔离在第二至第四代的效果系数分别为0.43、0.46和0.47;停课和洗手联合措施在第二、三代病例发生时产生了作用,效果系数分别为0.279和0.078。模型模拟结果显示,接种率达到90%~100%,罹患率、疫情持续时间、疫情高峰出现周才能产生明显防控效果。结论 在流腮暴发疫情中,应急接种率达到90%~100%才能起到好的防控效果;停课和洗手等健康教育能起到一定作用,但主要防控措施应为高接种率和及时病例隔离。     

湖南省狂犬病病毒种群划分情况及防控形势分析

  目的  更新湖南省流行的狂犬病病毒（RABV）种群类型及进化特征,分析研判湖南省狂犬病疫情防控形势。  方法  对湖南省2012—2017年收集的犬脑组织标本采用直接免疫荧光法或者反转录聚合酶链式反应法进行检测,对阳性标本进行N基因全序列（1 353 bp）测定及序列同源性分析,并与我国7个RABV种群的代表株一起进行系统发育分析。  结果   新测的25株湖南省RABV毒株的N基因核苷酸同源性为91.9%～100%,氨基酸同源性为83.6%～100%;种群划分结果显示其中84%（21/25）的毒株为China Ⅰ群,4株为China Ⅱ群,未监测到2010年前在湖南流行的China Ⅲ群和China V群。  结论  湖南省RABV流行种群类型未增加,且局限于我国两个主要的犬源种群。 切实加强犬的管理,尤其是农村犬的管理和免疫工作,才能进一步控制湖南省狂犬病疫情。     

含镉粉尘治理前后工人尿镉与血镉水平分析

目的 分析某锌粉加工厂含镉粉尘治理前后作业工人尿镉、血镉和尿β2-微球蛋白的变化.方法 对锌粉加工厂粉尘进行治理,对粉尘治理前后84名镉作业工人尿镉、血镉、β2-微球蛋白水平进行自身对照分析.结果 治理后,作业场所锌尘几何均数由3.38mg/m3降至2.22mg/m3,差异有统计学意义(P＜0.01).治理前调查对象的血镉、尿镉几何均数浓度[血镉(2.19±1.19)μg/L,尿镉(1.96±0.74)μg/gCr]明显高于治理后1年[(1.63±0.83)μg/L,(1.25±0.83)μg/g Cr]和治理后2年[(1.36±0.95)μg/L,(0.94±0.72)μg/g Cr],差异有统计学意义(P＜0.01).治理前及治理后1年、2年接触工人尿镉与血镉浓度作相关分析,r=0.466,差异有统计学意义(P＜0.01).结论 粉尘治理能降低低浓度镉作业工人的血镉、尿镉水平,对防止镉中毒效果明显.