5985名学生乙肝疫苗接种后免疫效果分析

目的探讨中小学生乙肝疫苗接种后免疫应答状况,为制定有效的乙肝预防措施提供科学依据。方法应用ELISA法测定中、小学生血清三项乙肝感染标志（HBsAg、HBeAg、HBeAb）,对三项标志全阴性者再应用时间分辨荧光免疫分析法（TRFIA）测定血清二项感染标志（HBsAb、HBcAb）。结果血清三项感染标志（HBsAg、HBeAg、HBeAb）全阴性者其HBsAb阳性率为81.27%,中学生阳性率为80.27%,小学生阳性率为82.50%,差异有统计学意义（χ2=4.82,P〈0.05）。HBsAb有应答者HBcAb阳性率为5.12%,中学生阳性率为8.82%,小学生阳性率为0.68%,差异有非常显著性（χ2=164.58,P〈0.01）。HBsAb无应答者HBcAb阳性率为21.14%,中学生阳性率为19.73%,小学生阳性率为7.68%,差异有非常显著性（χ2=87.70,P〈0.01）。HBsAb有应答者和HBsAb无应答者其HBcAb阳性率差异有非常显著性（χ2=313.48,P〈0.01）。结论该地区学生HBsAb阳性率较低,免疫效果不理想,小学生HBsAb阳性率较高,中学生HBcAb阳性率较高,提示学生中乙肝疫苗接种需加强和改进。     

Patterns of non-response to a mail survey

This paper describes a basic investigation of possible non-response bias in a mail survey. We compare characteristics of responders and non-responders to a mail survey of health outcomes among participants of a longitudinal study of physical activity, physical fitness, and health. Results indicate that, at the first clinic visit, the responders were essentially the same as the non-responders on personal health history and laboratory measurements, while reporting significantly more family history of specific chronic diseases (cardiovascular disease, hypertension, stroke). The male responders were younger and reported more positive health behaviors as well as better weight and treadmill times at the first clinic visit. These results suggest that both response groups were equally healthy at entry, and that individuals who had family members with certain chronic conditions and who had positive health behaviors were more likely to respond (participate) in this health-related survey. Differences of this type could affect interpretation of future analyses. This work illustrates the importance of incorporating methods to examine non-response into any epidemiologic study.     

Efficacy of almotriptan 12.5 mg in achieving migraine-related composite endpoints: a double-blind,randomized, placebo-controlled study in patients with previous poor response to sumatriptan 50 mg

ABSTRACT

Background: Triptans are not identical and migraine sufferers respond differently to different triptans. Few studies have evaluated the efficacy of switching triptans in migraine patients who have shown poor response to another agent.

Objective: To investigate the efficacy and tolerability of almotriptan 12.5?mg in patients who did not achieve 2‐h pain relief with sumatriptan 50?mg.

Methods: This double-blind, placebo-controlled study recruited patients with IHS-defined migraine and at least 2 previous unsatisfactory responses to sumatriptan. Those who did not achieve pain relief (moderate or severe pain decreasing to mild or no pain) 2?h after taking oral sumatriptan 50?mg on an open-label basis for the treatment of their first migraine attack during this trial (Attack 1) were randomized to receive either oral almotriptan 12.5?mg or placebo for the treatment of their next migraine attack (Attack 2).

Results: Of 302 patients receiving sumatriptan 50?mg for the treatment of their first migraine attack, 221 (73%) did not achieve 2‐h pain relief and were randomized to almotriptan 12.5?mg or placebo for the treatment of Attack 2. The majority (70%) of randomized patients treating their headache in Attack 2 reported severe pain at baseline characterizing this as a difficult-to-treat population. In the intent-to-treat population (n = 198), significantly more patients in the almotriptan group compared with the placebo group achieved 2‐h complete relief (free from pain and migraine-associated symptoms) at 2?h (17.1% vs. 4.4%; p < 0.05) and sustained pain free (20.9% vs. 9.0%; p < 0.05). Adverse events of mild-to-moderate intensity occurred in 7.1% of patients in the almotriptan group compared to 5.1% in the placebo group (not statistically different).

Conclusion: Almotriptan is more effective than placebo and similarly well-tolerated for the acute treatment of migraine in patients who responded poorly to oral sumatriptan.     

Estimating Non-Response Bias in Family Studies: Application to Mental Health and Lifestyle

Non-response to mailed surveys reduces the effective sample size and may introduce bias. Non-response has been studied by (1) comparison to available data in population based registers, (2) directly contacting non-respondents by telephone or single-item reply cards, and (3) longitudinal repetition of the survey. The goal of this paper was to propose an additional method to study non-response bias: when the variable of interest has a familial component, data from respondents can be used as proxy for the data from their non-responding family members. This approach was used with data on smoking, alcohol consumption, physical activity, coffee- and tea-use, education, body mass index, religion, burnout, life events, personality and mental health in large number of siblings and DZ twins registered with the Netherlands Twin Register. In addition, for smoking behavior, we also used the second strategy by sending a reply card. Results show that scores of members from less cooperative families or incomplete twin pairs tended to be more unfavorable than the scores from highly cooperative families or complete twin pairs. For example, family members from less cooperative families cycled less often and scored higher on anxious depression and neuroticism. For smoking, both the results of the reply card and the results of the additional method suggested a higher percentage smokers among the non-respondents but this was only significant with reply card method. In general, differences between highly/less cooperative families and complete/incomplete DZ twins were small. Results suggest that, even for studies with moderate response rates, data collected on health, personality and lifestyle are relatively unbiased.     

Missing Values in Responses to Questions on Drug Use: The Case of Classroom Questionnaire-Surveys in Swiss Public Schools

In Switzerland in 1986, an anonymous classroom questionnaire-survey on the consumption of solvents and illegal drugs carried out on a representative sample of 15 to 16-year-old schoolchildren showed a lifetime prevalence of about 10% for cannabis consumption, 12% for the use of solvents, and almost no use of other illegal drugs. These results, however, are contaminated by a relatively high percentage of non-responses to questions on use of illegal drugs (10%).

This paper deals first with an approach to solving the general problem of missing information in responses to interviews or questionnaires on the use of illegal drugs, and the specific problem of non-response to particular questions. It then describes a probabilistic estimation of effective prevalence rate on the basis of a number of known and credible predictors of illegal-drug use.

The methods used consist of a review of the scientific literature on methodological problems of asking questions about drug use. Discriminant and logistic regression analyses are applied to assess possible reasons for non-responses as well as to calculate the probabilistic estimation of effective prevalence rate. The discussion of the results considers ways of reducing the numbers of non-responders in similar future surveys.     

我镇成人大规模免疫乙肝疫苗的无应答状况及影响因素分析

目的探讨自然人群中成人接种重组乙肝疫苗后无应答者分布状况和影响因素。方法对我镇21，699名16岁以上成人按0、1、6方案接种10μg乙肝疫苗后进行免疫学检测，描述无应答的分布并分析影响因素。结果成人全程接种重组乙肝疫苗第三针后1个月，总抗体保护性阳转率97．23％，无应答率2．77％，16—49岁人群无应答率低于50岁以上人群。影响因素分析表明年龄越大抗体保护性阳转率越低（P〈0．01），无应答率越高，男性无应答率高于女性（P〈0．05）。结论成人全程接种10μg重组乙肝疫苗免疫效果较好，无应答率较低，50岁以上男性无应答率较高。     

Response and Non-response to a Quality-of-Life Question on Sexual Life: A Case Study of the Simple mean Imputation Method

We investigated the non-response rates to the question “I am satisfied with my sex life” in the Functional Assessment of Cancer Therapy – General questionnaire in Chinese (n = 769), Malay (n = 41) and Indian (n = 33) patients in Singapore, a multi-ethnic society whose residents are said to have a conservative sexual attitude. Non-response rates to the question were 44%, 22% and 24% in the three groups respectively. The rates were much higher than that reported previously in a US study (7%) and used in the associated simulation study of the simple mean imputation method. We further examined the Chinese respondents in detail. The odds of non-response and the scores among the responders were associated with several demographic and clinical characteristics. Using the checklist proposed by Fayers et al. [Stat Med 1998; 17: 679–696] to assess the data patterns, we found that the application of the simple mean imputation is questionable. We employed an alternative (multiple) imputation procedure that took into account covariates that predicted the odds of non-response and the observed response scores. We compared the analytic results based on different approaches to handling missing values, and found that analysis based on the simple mean imputation gave results similar to that based on multiply imputed data even in this quite extreme example.     

The morbidity and outcome of surgery in children with large pre-treated Wilms’ tumour: size matters

Sixty-seven patients with resected Wilms’ tumour > 1.0 kg are reported. Surgery in this group is difficult, may result in the sacrifice of adjacent structures, and frequently upstages the patient. Mortality is related to tumour burden. Whilst there is little agreement on the therapeutic implications of failure to respond to neoadjuvant therapy, these surgical and anaesthetic hazards must be recognized, and alternative stratagems considered, prior to attempting a surgical procedure.     

25-year Trends and Socio-demographic Differences in Response Rates: Finnish Adult Health Behaviour Survey

When estimating population level changes in health indicators, the declining response rate, especially if also the characteristics of non-respondents are changing may bias the outcome. There is evidence that survey response rates are declining in many countries. It is also known that respondents and non-respondents differ in their socio-economic and demographic status as well as in their health and health behaviours. There is no information about the changes in the differences between respondents and non-respondents over time. Our purpose was to investigate the changes over time in the differences between respondents and non-respondents in respect to their sex, age, marital status and educational level. The data from the Finnish Adult Health Behaviour Survey (1978–2002) was used. The response rate declined over the past 25 years for both men and women in all age groups. The decline was faster among men than women, and also faster in younger age groups than older age groups. There is a marked difference in the response rate between married and non-married persons but it did not change over time. Also the response rate between different educational levels differed for both men and women, and this difference increased over the years. The declining response rate and at the same time occurring change in the non-respondent characteristics will decrease the representativeness of the results, limit the comparability of the results with other surveys, increase the bias of the trend estimates and limit the comparability of the results between population groups.