初中生甲型H1N1流感疫苗接种效果分析及抗体水平监测

目的了解初中生接种甲型H1N1流感疫苗的流行病学效果及抗体水平。方法采用非随机对照临床试验方法,选择9 123名初中生,分甲型H1N1流感疫苗接种组(3 726人)和对照组(5 397人),随访观察一个流行周期(6个月),比较两组流感样病例、甲型H1N1流感病例、季节性流感病例的发生率及接种前后阳性率和阳转率。结果接种组与对照组除甲型H1N1流感发病密度(接种组:0/1 000人年,对照组:2.22/1 000人年)差异有统计学意义外(P=0.0121),其他流感相关疾病(流感样病例、乙型流感、流感病毒核酸阳性)发病密度差异无统计学意义(P>0.05);不管是接种组还是对照组,不同住宿情况(住校和走读)流感样病例发生差异均有统计学意义,接种组中,季节性流感接种对乙型流感和流感病毒核酸阳性差异均有统计学意义;对照组中,流感症状史对甲型H1N1、乙型流感和流感病毒核酸阳性差异均有统计学意义;疫苗接种前与接种后1个月比较,流感抗体几何平均滴度(GMT)与阳性率都增高(P<0.05)。结论初中生大规模接种甲型H1N1流感疫苗能有效预防甲型H1N1流感,其免疫及保护效果良好,住校生较走读生更易发生流感样病例,疫苗接种可能不存在交叉保护作用。     

无锡市甲型H1N1流感及季节性流感疫苗接种效果分析

目的调查流感样病例(ILI)和无锡市一般人群中甲型H1N1流感疫苗及季节性流感疫苗的接种情况,评估疫苗接种后对人群的保护效果。方法以无锡市2家哨点医院为基础,采集流感样病例病毒核酸检测阳性的病例作为病例组,共1 529人,同时按照"病例"的电话信息,随机产生电话号码选择、年龄匹配的一般人群作为对照组,共380人。结果病例组甲型H1N1流感疫苗接种率为6.1%(94/1 529),对照组甲型H1N1流感疫苗接种率为12.1%(46/380),两组比较,差异有统计学意义(P0.01);甲型H1N1流感病例中接种甲型H1N1流感疫苗的比例为12.5%(3/24),门诊检测阴性的ILI病例接种甲型H1N1流感疫苗的比例为6.1%(78/1 273),"接种甲型H1N1流感疫苗"因素的OR值为0.457(P=0.201);以电话调查一般人群(330例)作为对照组,接种甲型H1N1流感疫苗的比例为13.3%(44/330),OR值为1.077(P=0.908)。结论该次调查说明接种甲型H1N1流感疫苗对预防流感样病例有一定效果,但由于样本量较少,24种方法病例对照分析均未得出差异有统计学意义。     

甲型H1N1流感疫苗免疫效果及影响因素研究

目的了解学生大规模接种甲型H1N1流感疫苗的免疫效果及影响因素,为探索甲型H1N1流感免疫策略和防控措施提供科学依据。方法分别对344名中学生在甲型H1N1流感疫苗接种前及接种后1个月采集血清标本,进行抗体水平的检测。并收集中学生在接种疫苗前季节性流感疫苗接种史、流感样症状等有关流行病学信息,评价甲型H1N1流感疫苗的免疫效果及影响因素。结果 344名中学生在免前H1N1流感抗体几何平均滴度(GMT)为1∶16.97(95%CI:1∶14.49~1∶19.86),抗体阳性率为36.50%(95%CI:31.35%~41.89%);免后GMT为1∶167.41(95%CI:1∶145.08~1∶193.18),阳性率为89.91%(95%CI:86.19%~92.91%),阳转率为72.54%(95%CI:67.76%~77.32%),均明显高于免前。接种疫苗前3个月的季节性流感疫苗接种史、流感样症状史等因素分组后,各组间免疫学效果指标间差异无统计学意义(P>0.05)。结论接种甲型H1N1流感疫苗后免疫成功率70%以上,符合欧盟和美国FDA的有关规定,免疫效果良好。季节性流感疫苗接种史、流感症状史等对疫苗的免疫学保护效果无明显影响。     

学生甲型H1N1流感影响因素病例对照研究

目的 探讨学生甲型H1N1流感感染的影响因素,为制定相应的预防控制措施提供依据.方法 采用1∶2匹配的病例对照研究方法,对北京市昌平区学生甲型H1N1流感病例和所选对照进行回顾性问卷调查,对调查结果进行分析.结果 单因素分析结果显示,教室人均面积、课间活动范围、教室通风状况、学校有专供学生洗手香皂、接种甲型H1N1流感疫苗、接种季节性流感疫苗和班级出现过流感样病例对学生甲型H1N1流感感染率影响有统计学意义(P值均＜0.05).多因素条件Logistic回归分析结果显示,接种甲型H1N1流感疫苗为保护因素(OR=0.01),班级内出现过流感样病例为危险因素( OR=1222.95).结论 早期发现传染源并采取相应控制措施,同时加强学生免疫预防接种是控制甲型H1N1流感的关键.     

甲型H1N1流感疫苗预防接种效果观察

目的探讨接种甲型H1N1流感疫苗的有效性和安全性。方法选择120例18～60岁在我院接种甲型H1N1流感疫苗人员为接种组,同时按照年龄、性别、疾病匹配的情况选取未接种甲型H1N1流感疫苗者110例为对照组。调查分析甲型H1N1流感疫苗接种后90d内两组甲型H1N1流感发病率和其他流感样疾病发生情况。同时观察接种甲型H1N1流感疫苗后48h内不良反应发生情况。结果接种组甲型H1N1流感发病率和就诊率为0%,对照组甲型H1N1流感发病率和就诊率为7.3%,两组比较有显著统计学差异（P〈0.01）;接种组90d内甲型H1N1流感的保护率为100%,减少就诊率100%。接种组其他流感样疾病发生率（15.0%）和就诊率（8.3%）均明显低于对照组（22.7%和16.3%）,有统计学差异（P〈0.05）;接种组90d内其他流感样疾病的保护率为33.9%,减少就诊率49.4%;接种组共出现不良反应8例,总体不良反应率6.7%,给予适当的处理,症状很快消失。结论接种甲型H1N1流感疫苗是有效和安全的。     

高校甲型H1N1流感的流行病学特征及疫苗预防的效果分析

[目的]观察高校甲型H1N1流感的流行病学特征,评价甲型H1N1流感疫苗的预防效果.[方法]回顾性分析2009年10月5日～11月9日我院隔离病房收治的甲型H1N1流感确诊病例29例,观察患者流感相关症状、体征的动态情况.对13 197名高校教职工及学生进行甲型H1N1流感疫苗接种,与同期匹配的未接种人群比较甲型H1N1流感发生情况、流感样症状发生情况及上呼吸道感染发生情况.[结果]29例甲型H1N1患者均咽部充血,大部分患者发热,部分患者头痛、鼻塞、流涕、乏力、肌肉酸痛等.接种疫苗可显著减少甲型H1N1流感的发生率(P<0.05),预防有效率为77.81%;且接种后流感样症状发生率明显降低,与对照组有统计学差异(P<0.05),预防有效率为78.35%;此外,两组上呼吸道感染发生率有统计学差异(P<0.05),预防有效率为53.84%.接种疫苗后副反应发生率为0.77%.[结论]掌握甲型H1N1流感的流行病学特征,有助于为疫情的防控提供科学依据,甲型H1N1流感疫苗可有效预防甲型H1N1流感及其他相关疾病的发生.     

湘西自治州甲型H1N1流感血清流行病学调查

目的 了解湘西自治州人群甲型H1N1流感病毒感染状况和免疫水平,分析流感流行趋势,为制定针对性的防治措施提供依据.方法 采用多阶段分层随机抽样方法,于2010年1月4月8月共选取675人进行问卷调查,并采集血液标本进行甲型H1N1流感病毒血凝抗体检测.结果 在不同季节,不同职业人群中H1抗体阳性率不同(P＜0.05),同时在出现过急性呼吸道症以及接种过甲型H1N1流感疫苗的人群中H1抗体阳性率相对较高(P＜0.05).H1抗体GMT呈现季节性变化(P＜0.05),在不同年龄,不同职业人群中抗体水平大小差异有统计学意义(P＜ 0.05,P＜ 0.01).调查还发现发现出现过急性呼吸道症人群中抗体GMT和中位数高于未出现呼吸道症状者(P＜ 0.001);接种过甲型H1N1流感疫苗者抗体GMT和中位数也同样高于未接种者(P＜ 0.001).在不同性别和民族人群中,抗体的阳性率和水平大小无统计学差异.结论 目前湘西地区甲型H1N1流感已经得到有效控制,但鉴于人群中保护性抗体水平季节性变化,下一阶段重点是定期开展快速的血清学监测,并且继续对高危人群实施甲型H1N1流感疫苗接种.     

重庆市3所医疗机构2014人甲型H1N1流感血清流行病学分析

[目的]了解对医疗机构就诊者甲型H1N1流感抗体水平现状,为制定针对性的防治措施提供依据.[方法]对1 367名门诊病例、277名健康体检人群和370名献血者进行流行病学调查并采集血清进行甲型H1N1流感血凝抑制(HI)试验.[结果]HI试验总体阳性率为11.8％ (95％CI:10.5％～13.3％),高滴度者(≥1:320)占阳性数的11.3％（95％CI:7.0％～15.6％),2周前出现过流感样症状之间、5～年龄组与其余3个年龄组间和是否接种甲型H1N1流感疫苗之间阳性几何平均倒数滴度(GMRT)的差异有统计学意义(P＜ 0.05);Logistic回归分析结果均显示抗体阳性率与年龄、接种甲型H1N1流感疫苗和2周前出现过流感样症状者有统计学意义.[结论]重庆市甲型H1N1流感免疫水 平较低,易发生流行,及时接种甲型H1N1流感疫苗可提高人群免疫水平.     

2010年合肥市蜀山区居民甲型H1N1流感血清流行病学调查

目的 了解合肥市蜀山区居民甲型H1N1流感病毒感染状况和免疫水平,为制定科学有效的防控策略和措施提供基础资料.方法 采用分层随机抽样方法,从蜀山区8个街道及1个乡镇选取772人进行问卷调查,收集居民年龄、性别、职业等相关信息,采集血液标本提取甲型H1N1流感病毒血清,应用红细胞血凝抑制试验检测病毒抗体.结果 本次调查蜀山区居民甲型H1N1流感抗体阳性率为39.25％ (303/772);5个年龄组0～5岁,6～15岁,16 ～24岁,25～59岁,60岁及以上抗体阳性率分别为31.11％、70.99％、49.04％、28.16％、13.89％;按特定人群比较,学生抗体阳性率(74.29％)高于散居或幼托儿童(31.25％)、教师(33.33％)、医护人员(33.86％)、离退人员(18.32％)以及其他人群(18.18％);按有无甲型H1N1流感疫苗免疫史进行统计,接种组与未接种组的抗体阳性率分别为75.66％、24.18％.蜀山区未接种甲型H1N1流感疫苗人群的隐性感染率为24.64％;蜀山区城区与城乡结合部(井岗镇街道、南岗镇)的居民抗体阳性率分别为32.81％、58.16％,抗体阳性率差异有统计学意义(x2=39.41,P＜0.001);本次选取的772人中,在2009年5月～2010年1月期间曾患流感样症状病例、普通感冒病例、健康人群的抗体阳性率分别为44.15％、33.00％、39.14％,差异有统计学意义(x2 =5.99,P=0.050).结论 合肥市蜀山区居民甲型H1N1流感病毒抗体阳性率在不同年龄段、不同人群、不同地区、是否曾有流感样症状、是否有甲型H1N1流感疫苗免疫史等方面均存在不同.     

H1N1 vaccination

Early results (January to April) from the 2010 Canadian Community Health Survey show that an estimated 41% of Canadians (excluding those in the territories) aged 12 or older had been vaccinated for H1N1 by April 2010. The percentages were higher in the Atlantic provinces, Quebec and Saskatchewan than in Canada overall. Relatively high percentages of females and people aged 45 or older were vaccinated; the percentage of immigrants who had done so was relatively low. Being in a priority group (health-care worker, having children younger than 5 in the household, or having a chronic condition that could increase the risk for complications from H1N1) increased the likelihood of vaccination. A history of seasonal flu vaccination and having a regular doctor were also associated with H1N1 vaccination. Nearly three-quarters of those who had not been vaccinated reported that they did not think it was necessary.     

被动吸烟与cyp1b1、gstp1、sult1a1基因多态性对乳腺癌发病的影响

目的 探讨被动吸烟、cyp1b1、gstp1、sult1a1基因多态性及其联合作用对乳腺癌发病的影响。方法 2014 - 2015年间,采用病例-对照研究方法,收集病例794例,对照805例。问卷调查收集研究对象信息。采用飞行质谱技术,进行cyp1b1、gstp1、sult1a1基因单核苷酸多态性分型检测。采用多因素非条件 logistic 回归,分析环境烟草烟雾暴露及cyp1b1、gstp1、sult1a1基因多态性与乳腺癌发病风险的关系。结果 调整年龄、教育程度、家庭年总收入、职业、婚姻状况后,环境烟草烟雾暴露与gstp1基因多态性未发现协同作用。以环境烟草烟雾低暴露且携带 cyp1b1 rs1056836 C等位基因为参照,环境烟草烟雾高暴露且携带 GG 基因在绝经前女性中乳腺癌风险明显增高（OR = 1.678,95%CI:1.039～2.711）。以环境烟草烟雾组合低暴露且携带sult1a1 rs9282861GG基因型为参照,环境烟草烟雾高暴露且携带A等位基因绝经前乳腺癌风险明显增高（OR = 2.389,95%CI:1.157～4.931）,但交互作用系数无统计学意义。结论 环境烟草烟雾高暴露与cyp1b1 及sult1a1基因对乳腺癌发病风险可能存在协同作用,但尚扩大样本进行验证。     

Echo-AM1-1 encephaloscope]

A new miniature model of the A-mode ultrasonic echoencephaloscope, 0.88 MHz, has been developed and adopted to practical use in neurology. The device contains a detector for amplitude determination of echopulsation and curve (echopulsograms) recording. It is highly sensitive, cost-effective, which enhances the quality of rapid diagnosis of central nervous diseases, including those of vascular genesis, in in- and outpatient settings.     

接种甲型H1N1流感疫苗后患甲型H1N1流感分析

目的 分析接种甲型H1N1流感疫苗后发生甲型H1N1流感感染的病例,探讨发病原因,为进一步提高疫苗预防效果提供参考依据.方法 对接种甲型H1N1流感疫苗后发生甲型H1N1流感感染148例,进行回顾性调查分析.结果 接种甲型H1N1流感疫苗11176例.发生甲型H1N1感染148例,感染率1.32%,其中1～14 d感染81例,感染率0.72%,＞15 d感染67例,感染率0.60%.结论 甲型H1N1流感病毒裂解疫苗是一种安全高效的疫苗,不足之处尚待进一步探讨、完善.     

NF1 gene and neurofibromatosis 1

Neurofibromatosis 1 (NF1), also known as von Recklinghausen disease, is an autosomal dominant condition caused by mutations of the NF1 gene, which is located at chromosome 17q11.2. NF1 is believed to be completely penetrant, but substantial variability in expression of features occurs. Diagnosis of NF1 is based on established clinical criteria. The presentation of many of the clinical features is age dependent. The average life expectancy of patients with NF1 is probably reduced by 10-15 years, and malignancy is the most common cause of death. The prevalence of clinically diagnosed NF1 ranges from 1/2,000 to 1/5,000 in most population-based studies. A wide variety of NF1 mutations has been found in patients with NF1, but no frequently recurring mutation has been identified. Most studies have not found an obvious relation between particular NF1 mutations and the resulting clinical manifestations. The variability of the NF1 phenotype, even in individuals with the same NF1 gene mutation, suggests that other factors are involved in determining the clinical manifestations, but the nature of these factors has not yet been determined. Laboratory testing for NF1 mutations is difficult. A protein truncation test is commercially available, but its sensitivity, specificity, and predictive value have not been established. No general, population-based molecular studies of NF1 mutations have been performed. At this time, it appears that the benefits of population-based screening for clinical features of NF1 would not outweigh the costs of screening.     

GSTM1及GSTT1和GSTP1基因多态性对尿中1-羟基芘水平的影响

目的 研究GSTM1、GSTT1和GSTP1基因多态性对多环芳烃接触工人尿中1-羟基芘(1-OHP)水平的影响.方法 分别选取2个炼焦厂共447名多环芳烃职业接触工人(接触组)和某线材厂220名非职业接触工人(对照组)作为研究对象,采用高效液相色谱法测定尿中1-OHP水平,采用线性回归统计模型分析GSTM1和GSTT1缺失型及GSTP1 I105V位点的多态性对不同人群尿中1-OHP水平的修饰作用.结果 接触组工人尿中1-OHP浓度为4.61 μmol/mol Cr,明显高于对照组(0.34μmol/mol Cr),差异有统计学意义(P＜0.05).接触类别和吸烟分别是影响尿中1-OHP水平的主要因素,在控制各混杂因素的影响后,线性回归分析显示,接触组尿中1-OHP水平和GSTP1 I105V位点多态性有关(单基因分析,P=0.012;多基因分析,P=0.011),对总体样本,单基因模型和多基因模型均显示,尿中1-OHP水平可能和GSTT1缺失型多态有关(P=0.055),多基因交互作用分析显示,GSTT1和GSTP1基因多态对接触组尿中1-OHP水平具有交互作用.结论 谷胱甘肽硫转移酶(GSTs)基因的多态性对接触多环芳烃工人尿中1-OHP水平有影响.

Abstract：

Objective To investigate the modification of GSTM1, GSTT1 and GSTP1 gene polymorphisms on urinary 1-hydroxypyrene (1-OHP) excretions in workers under different exposure levels. Methods Four hundred and forty-seven occupationally exposed workers from two coking plants and 220 control workers from a wire rod plant were genotyped to analyze the modification of GSTM1, GSTT1 and GSTP1 gene polymorphisms on urinary 1-OHP excretions. Results The urinary 1-OHP concentration in exposed group was much higher than that in control group (4.61 vs 0.34 μmol/mol Cr, P＜0.05). Occupational exposure levels and cigarette smoking were of the dominating factors affecting 1-OHP excretions in urine. After controlling potential confounders, decreased excretion of urinary 1-OHP was associated with GSTP1 I105V AG + GG genotype in coke oven workers (single-gene model, P=0.012; multi-gene model, P=0.011 ) and with GSTT1 null type in the analysis including all subjects (P=0.055 in both single-gene and multi-gene models). GSTT1 and GSTP1 were interacted on the urinary concentrations of 1-OHP. Conclusion Urinary 1-OHP concentrations can be modified by GSTM1, GSTT1 and GSTP1 gene polymorphisms, indicating that these genes are involved in the metabolism of polycyclic aromatic hydrocarbons.     

Co-circulation of pandemic 2009 H1N1, classical swine H1N1 and avian-like swine H1N1 influenza viruses in pigs in China

The pandemic A/H1N1 influenza viruses emerged in both Mexico and the United States in March 2009, and were transmitted efficiently in the human population. They were transmitted occasionally from humans to other mammals including pigs, dogs and cats. In this study, we report the isolation and genetic analysis of novel viruses in pigs in China. These viruses were related phylogenetically to the pandemic 2009 H1N1 influenza viruses isolated from humans and pigs, which indicates that the pandemic virus is currently circulating in swine populations, and this hypothesis was further supported by serological surveillance of pig sera collected within the same period. Furthermore, we isolated another two H1N1 viruses belonging to the lineages of classical swine H1N1 virus and avian-like swine H1N1 virus, respectively. Multiple genetic lineages of H1N1 viruses are co-circulating in the swine population, which highlights the importance of intensive surveillance for swine influenza in China.