2006年江苏省血吸虫病监测点疫情分析Ⅱ钉螺和感染性钉螺分布情况

目的了解江苏省钉螺和感染性钉螺分布情况,为制定防治规划提供科学依据。方法根据全国和江苏省血吸虫病疫情监测方案的要求,在全省血吸虫病流行区选择有代表性的82个流行村作为监测点,开展钉螺和感染性钉螺分布情况的监测调查。结果全省监测村中有42个监测村发现了钉螺,占监测村的51.22%;有10个监测村发现了感染性钉螺,占监测村的12.20%。监测村发现的钉螺面积占调查总面积的27.86%,发现的感染性钉螺面积占总有螺面积的17.35%。监测村总的钉螺密度为0.16只/0.1m2,总的感染性钉螺平均密度为0.00044只/0.1m2。结论全省螺情仍不容乐观,有可能成为2010年实现江苏省达到"血吸虫病传播控制"目标的主要制约因素。全省在今后的防治策略上,仍应加强钉螺,尤其是感染性钉螺的控制工作,以从根本上消除和降低血吸虫病的危害。     

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.     

Prevalence analysis of different human bocavirus genotypes in pediatric patients revealed intra-genotype recombination

BackgroundHuman bocavirus (HBoV) genotypes 1–4 have been detected worldwide in respiratory samples and stool samples, and are increasingly associated with respiratory and intestinal infections of previously unknown etiology in young children. Several studies revealed evidence of extensive recombination among HBoV genotypes at the NP1 and VP1 gene boundary region. This study explored the prevalence of HBoV genotypes in pediatric patients in Beijing, and studied their phylogeny.MethodsA total of 4941 respiratory specimens and 1121 fecal specimens were collected from pediatric patients with respiratory infections from January 2006 to December 2013, or with acute diarrhea from October 2010 to December 2012. Conventional PCR was used to detect HBoV1–4 within these samples. Gene fragments at the NP1 and VP1 gene boundary were amplified from HBoV-positive specimens, sequenced, and their phylogenetic inferences constructed using MEGA 6.0 software. Recombination events were identified with SimPlot software.ResultsHuman bocavirus 1, 2, and 3 were detected in 9 (0.80%), 15 (1.33%), and 1 (0.08%) of 1121 stool samples, respectively. However, only HBoV1 (82, 1.65%) was detected in respiratory specimens. Phylogenetic analysis of gene fragments at the HBoV NP1 and VP1 gene boundary indicated that HBoV1 sequences obtained from fecal or respiratory specimens across 8 years were highly conserved (99–100%), while 15 HBoV2 sequences collected across 2 years in Beijing were more diverse with up to 4.40% variation. Of the 15 HBoV2 sequences, 14 clustered into a new lineage divergent from other HBoV2 sequences in GenBank. Five HBoV2 genomic sequences were analyzed for recombination, revealing intra-genotype recombination between HBoV2A and HBoV2B.ConclusionsMore HBoV1 were detected in children with respiratory tract diseases, and HBoV2 in patients with acute diarrhea. Phylogenetic analysis revealed a new cluster of HBoV2 was prevalent in China, which may be the result of intra-genotype recombination between HBoV2A and HBoV2B.     

江苏省血吸虫病监测预警系统的研究 Ⅴ长江水域血吸虫毛蚴感染性的监测

目的建立长江水体血吸虫毛蚴监测方法,监测水体受血吸虫虫卵污染情况,为追踪与控制传染源、切断传播途径及灭螺提供参考依据。方法在长江江苏段选择45个监测点,采用浮瓶-尼龙袋哨螺测定法,每个点投放500只阴性钉螺,于2009年5-9月每月投放1次,每次投放28 h,钉螺收回后置于25℃恒温箱内饲养。首次回收2个月后每月采用群体逸蚴法检测1次钉螺感染性,在末次投放3个月后,采用压碎法解剖全部钉螺,观察钉螺血吸虫感染情况,并调查出现感染螺环境的人畜活动情况。建立江苏省长江水域哨螺监测数据库,绘制哨螺阳性点地理分布图,计算江水中钉螺单位时间被血吸虫毛蚴感染的阳性率。结果 45个点5个月共投放哨螺44 717只,回收43 477只,回收率为97.23%;钉螺逸蚴81 410只次,未发现感染性钉螺;解剖钉螺13 033只,发现5只感染血吸虫,钉螺感染率为0.038%,水体中钉螺感染血吸虫的阳性率为4.11/100万。在45个监测点中检出阳性点5个,阳性点出现率为11.11%;其中哨螺阳性点分布在长江南岸3个、北岸1个、江心洲1个,其阳性点出现率分别为21.43%、5.56%和7.69%,南岸哨螺阳性点出现率是北岸的3.8倍。5个阳性点中有3个为渔船民集散地。结论江苏省长江南岸水域受血吸虫虫卵污染程度高于北岸,渔船民集散地是重要的污染地之一。浮瓶-尼龙螺袋哨螺测定法是监测水体受血吸虫虫卵污染的有效方法。     

Are refugees arriving in Denmark an under-immunised group for measles? A cross-sectional serology study

BackgroundIn 2018, Europe faced the highest number of Measles cases in a decade. In Denmark, the childhood vaccination programme has a coverage of approximately 90%. To eliminate the disease, vaccine coverage needs to be above the herd immunity threshold of 95%. This can be even more difficult to obtain, when vaccination programmes break down due to war, natural disasters etc. and concern has been raised, that unvaccinated refugees could facilitate spread of measles when migrating.MethodsIn order to address this concern, we tested 513 newly arrived refugees and family reunified refugees aged between 0 and 70 years for measles IgG antibodies. The participants were tested as part of a general health assessment between May 2016 and October 2018. In the cohort, 50% were males and the majority came from Syria (55%).ResultsWe found that 85% of the total group of refugees had immunity against measles. The 15% lacking antibodies were evenly distributed between the various countries of origin. Moreover, we found immunity to increase with age, leaving young children most vulnerable to infection, 79.9% (<19 years) vs 89.1% (≥19 years). Interview questions on previous vaccinations did not correlate to serology.ConclusionRefugees have measles immunity slightly lower than the host population.     

298例接受抗病毒治疗艾滋病患者的心理健康状况及其影响因素分析

目的 了解安徽省接受抗病毒治疗的艾滋病（acquired immunodeficiency syndrome,AIDS）患者的心理健康状况及其影响因素,为促进该人群的身心健康提供参考。方法 采取定量调查的方式对2013年1月~2014年6月在安徽省3个城市中接受CD4+T细胞检查的AIDS患者进行问卷调查,收集病人的一般人口学特征以及心理健康状况等信息进行分析。结果 研究的参与者中,有63人（21.1%）存在焦虑状况;有126人（42.3%）存在抑郁状况。多因素Logistic回归分析中,AIDS患者有宗教信仰是焦虑状况发生的相关因素（OR=2.221,95%CI:1.094~4.509）;患者具有依从性、婚姻状况为已婚或同居、文化程度为初中和大专及以上、所在地为淮北市、知晓抗病毒治疗需终生服药是抑郁状况发生的相关因素（均有P<0.05）。结论 3个城市AIDS患者焦虑和抑郁状况较为普遍且受多重因素的影响,因此增加患者的依从性、抗病毒治疗需终生服药的知晓情况等可能对于降低焦虑和抑郁情况的发生具有重要意义。     

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.     

Epidemiology of maternal morbidity and mortality

Maternal morbidity and mortality remains a significant health care concern in the United States, as the rates continue to rise despite efforts to improve maternal health. In 2013, the United States ranked 60th in maternal mortality worldwide. We review the definitions, rates, trends, and top causes of severe maternal morbidity and mortality, as well as risk factors for adverse maternal outcomes. We describe current local and national initiatives in place to reduce maternal morbidity and mortality and offer suggestions for future research.     

MPO-ANCA–positive crescentic glomerulonephritis: A distinct entity of scleroderma renal disease?

Scleroderma renal crisis is characterized by intimal thickening of the afferent glomerular arterioles resulting in hypertension and fibrinoid necrosis of the capillary tuff. We report a 67-year-old man with long-standing systemic sclerosis who developed normotensive progressive renal failure, proteinuria, and a nephritic urinary sediment with serum myeloperoxidase-antineutrophil cytoplasmatic antibodies (MPO-ANCA). Renal biopsy showed pauci-immune crescentic glomerulonephritis but none of the typical vascular changes of scleroderma renal crisis. Because comparable cases have recently been reported from Japan, normotensive MPO-ANCA—positive crescentic glomerulonephritis may form an entity of progressive renal failure in scleroderma.