Features and clinical implications of hepatitis B virus genotypes and mutations in basal core promoter/precore region in 507 Chinese patients with acute and chronic hepatitis B

BackgroundThe association of hepatitis B virus (HBV) genotypes and basal core promoter (BCP) and precore (PC) mutations with the clinical characteristics is increasingly recognized.ObjectiveTo investigate virologic features and clinical implications of HBV genotypes, BCP and PC mutations between large-size patients with acute hepatitis B (AHB) and chronic hepatitis B (CHB).Study designOne hundred and eighty-two AHB patients and 325 CHB patients were investigated. HBV genotypes and BCP/PC mutations were determined by direct sequencing. Mutations at 10 interested sites of the BCP/PC region were compared between the two groups of patients.ResultsAHB patients had a significantly higher ratio of genotype B to C than CHB patients (37.4–62.6% vs. 16.6–83.4%, P < 0.001). The prevalence of BCP/PC wild-type virus was 60.4% in AHB patients in contrast to 28.9% in CHB patients. Significantly lower prevalence of A1762T, G1764A, G1896A, and G1899A but higher prevalence of T1758C was found in AHB patients. Interestingly, T1758C and A1762T/G1764A appeared mutual restraint. Genotype B virus had lower BCP mutation frequency and similar PC mutation frequency compared to genotype C virus. AHB patients with BCP/PC mutant virus had higher viral load, whereas CHB patients with BCP/PC mutant virus had lower viral load and elevated alanine aminotransferase, in comparison with those with the wild-type virus.ConclusionPatients with genotype B virus, BCP/PC wild-type virus or T1758C mutant virus were more susceptible to develop AHB, whereas high prevalence of the BCP/PC mutations was associated with CHB development.     

锦江区2008～2010年手足口病流行病学特征分析

目的分析锦江区2008～2010年手足口病流行病学特征,为采取有效的防治措施提供科学依据。方法收集国家疾病报告信息管理系统和成都市疾病控制信息管理系统中相关的手足口病疫情监测资料,进行流行病学特征描述。结果 2008～2010年手足口病发病率分别为74.68/10万、110.87/10万、203.63/10万;在15份实验室检测样本中,EV71、COXA16阳性率分别占20.00%、46.67%,其他肠道病毒阳性率为33.33%;锦江区所辖16个街道均有发病,以城郊结合部的涉农街道辖区发病最高;患者男女之比为1.47︰1,年龄小于5岁为1615(95.06%)例,4～8月为发病高峰,共计1190(70.04%)例;幼托儿童、散居儿童、学生分别占59.56%、37.32%、2.41%。结论锦江区手足口病疫情逐年大幅上升,出现重症病例,分离病原主要是EV71、COXA16和其他肠道病毒。     

不同时间口服磷酸钠盐液对肠道清洁的效果评价

【摘要】目的 探讨不同时间口服磷酸钠盐液对肠镜检术前肠道准备时肠道清洁效果和不良反应的比较。方法 选取2017年5~6月来我科行结肠镜检查的患者160例,随机分为观察组和对照组,每组各80例。观察组的患者在手术前一天16:00口服磷酸钠盐口服液890ml,检查当日5:00（上午检查）或9:00（下午检查）再口服890ml;对照组患者上午检查则于检查当日4:00和5:00口服磷酸钠盐口服液各890ml,下午检查者于8:00和9:00分别口服磷酸钠盐口服液各890ml。比较两组患者的肠道清洁度及患者肠道准备时的不良反应。结果 观察组患者肠道清洁度优于对照组(2=7052,P＜0008),且观察组患者肠道准备时的不良反应率低于对照组(2=29330,P＜0001）。结论 对于行结肠镜检查的患者,在术前一天口服890ml磷酸钠盐口服液,检查当日再口服890ml磷酸钠盐口服液,这种分次服用的方法患者依从性高,肠道准备安全、方便,患者清肠时不良反应发生率低,且其肠道清洁度优于常规的方法,可在临床推广应用。     

2006-2010年成都市锦江区水痘疫情分析

目的了解2006-2010年成都市锦江区水痘疫情情况,为制定水痘防制措施提供科学依据。方法对2006-2010年锦江区水痘疫情资料进行分析。结果 2006-2010年共报告水痘1 372例,年均发生率为62.63/10万。水痘发病数较高的涉农街道辖区分别为东光(14.58%,200/1 372)、狮子山(10.71%,147/1 372)、柳江(9.32%,128/1 372)和三圣(8.53%,117/1 372)。男性747例,女性625例;0～3岁占13.56%(186/1 372)、4～9岁占50.58%(694/1 372)、10～15岁占19.02%(261/1 372),学生占41.84%、托幼儿童占33.89%、散居儿童占11.08%;发病时间集中在4～6月和11月～次年1月,分别占43.00%和27.11%。2007和2009年发病率较高,分别为78.84/10万和76.28/10万。结论 2006-2010年锦江区水痘发病率以2007和2009年较高,并呈现间隔1年发病高峰态势,病例比例以涉农街道辖区较高。     

Intent to obtain pediatric influenza vaccine among mothers in four middle income countries

BackgroundDespite a large burden of influenza in middle income countries, pediatric vaccination coverage remains low. The aims of this study were to (1) describe mothers’ knowledge and attitudes about influenza illnesses and vaccination, and (2) identify characteristics associated with mothers’ intent to vaccinate their child.MethodsFrom 2015 to 2017, infants 0–11 months old in Nicaragua, Philippines, Jordan, and Albania were enrolled from community settings and hospitals. Interviewers administered a questionnaire to their mothers. Mothers of infants aged 6–11 months rated their intention (small-to-moderate vs. large chance) to accept pediatric vaccination if it was offered at no-cost. The importance of knowledge, attitudes, and sociodemographic characteristics in predicting influenza vaccination intention was measured as the mean decrease in Gini index when that factor was excluded from 1000 decision trees in a random forest analysis.ResultsIn total, 1,308 mothers were enrolled from the community setting and 3,286 from the hospital setting. Prevalence of at least some knowledge of influenza illness ranged from 34% in Philippines to 88% in Albania (in the community sample), and between 23% in Philippines to 88% in Jordan (in the hospital sample). In the community sample, most mothers in Albania (69%) and Philippines (58%) would accept the influenza vaccine, and these proportions were higher in the hospital sample for all countries except Albania (48%) (P < 0.0001). Perceived vaccine safety (mean decrease in Gini index = 61) and effectiveness (55), and perceived knowledge of influenza vaccine (45) were the most important predictors of influenza vaccination intention in models that also included country and community versus hospital sample.ConclusionIntent to vaccinate infants aged 6–11 months in four middle income countries was tied primarily to knowledge of the vaccine and perceptions of vaccine safety and effectiveness. These findings were noted among mothers interviewed in the community and mothers of recently hospitalized infants.     

2005-2011年成都市锦江区流行性腮腺炎流行病学特征分析

目的分析2005-2011年锦江区流行性腮腺炎流行病学特征,为制定预防控制流行性腮腺炎的措施提供科学依据。方法对疾病监测信息报告管理系统报告的锦江区2005-2011年流行性腮腺炎发病资料进行分析。结果 2005-2011年锦江区共报告流行性腮腺炎病例901例,年均报告发病率为31.91/10万,无死亡病例报告。流行性腮腺炎报告发病率2005年为24.70/10万,2006年为25.68/10万,2007年为27.78/10万,2008年为29.44/10万,2009年23.61/10万,2010年为33.54/10万,2011年为56.92/10万,发病呈逐年上升趋势。4~7月及10~12月为发病高峰,累计发病627例,占总发病数的69.59%。发病年龄以小于15岁为主（85.24%）,其中,3~14岁儿童发病最多（733例）,占总发病数的81.35%。发病人群以学生（57.60%）和托幼儿童（24.20%）为主。男性564例,女性337例,男女性别比为1.67∶1。结论 2005-2011年锦江区流行性腮腺炎发病率总体呈上升趋势,加强对重点人群、重点年龄组和易感人群的保护,提高疫苗接种率,降低流行性腮腺炎发病率。     

多联细菌疫苗预防儿童呼吸道感染临床效果观察

目的研究多联细菌疫苗(兰菌净)预防儿童呼吸道感染的临床疗效。方法将反复呼吸道感染的患儿分为试验组和对照组,试验组给予舌下滴入多联细菌疫苗,随访观察12周,记录相关临床指标并采集患儿唾液检测sIgA含量,比较其接种前后的差异。对照组随访12周,进行相应记录和检测,比较2组对象的差异。结果试验组患儿接种后月平均呼吸道感染天数、发热天数、咽痛天数、咳嗽天数均较接种前显著减少;唾液sIgA在随访第4、8、12周均比首次接种前提高(P<0.01)。对照组患儿随访12周时月平均呼吸道感染天数、发热天数、咽痛天数、咳嗽天数均高于对照组(P<0.01);试验组患儿随访12周时唾液sIgA高于对照组(P<0.01)。结论多联细菌疫苗有助于降低儿童反复呼吸道感染,可在该人群中推广应用。     

中国3个地区儿童家长对国家免疫规划类疫苗犹豫现状研究

目的 了解我国儿童家长对国家免疫规划类疫苗犹豫发生率和影响因素,并探索不同种类疫苗的犹豫现状。方法 在北京市通州区、四川省成都市及甘肃省白银市进行横断面调查,采用成比例概率抽样和便利抽样的方法选取符合标准的研究对象进行问卷调查。结果 共纳入研究对象3 592人,38.22%的家长完全接受所有疫苗,59.35%的家长给儿童接种了所有疫苗但表示有轻微的担忧,2.42%的儿童家长对国家免疫规划类疫苗有疫苗犹豫行为。其中家长产生疫苗犹豫最多的是脊髓灰质炎疫苗（0.89%）,其次为百白破疫苗（0.70%）和甲肝疫苗（0.64%）。疫苗犹豫产生的主要原因是对疫苗的风险效益判断（31.03%）,其次为家长的认知情况较低（21.84%）,第三为交通/时间因素带来的不便（21.84%）。结论 我国儿童家长对国家免疫规划类疫苗犹豫行为的发生率较低,但半数以上家长对疫苗持担忧态度。进一步改进我国免疫规划体系的服务质量,加强疫苗相关知识宣教,对减少疫苗犹豫是至关重要的。     

社区卫生服务机构开展艾滋病防治工作的成效及问题分析

目的 分析社区卫生服务机构开展艾滋病防治工作的成效和问题,为推进社区艾滋病防治工作提供科学依据。 方法 调查获得2013年1月－12月某区社区卫生服务机构开展艾滋病防治工作相关资料和数据,分析以社区为基础开展艾滋病综合防治模式在病案管理、实验室检测和抗病毒治疗等方面的效果和问题。 结果 截止2013年底,某区社区服务机构对符合管理的艾滋病感染者和患者的建档情况从2012年的无档案到建档率达100%,CD4 T淋巴细胞检测率从76.60%（360/470）提高到88.35%（508/575）,抗病毒治疗覆盖率从81.40%（175/215）提高到84.41%（287/340）。但是在实际工作中仍然存在一些问题需要解决。 结论 社区卫生服务服务机构开展艾滋病综合防治工作能够促进病案信息的准确性,提高管理率、检测率和治疗率。建议在感染者和患者集中的城市推广社区艾滋病综合防治管理模式。