乙型病毒性肝炎疫苗快速接种方案效果初步观察"的验证

我们读了新医学2001年第3期"乙型病毒性肝炎疫苗快速接种方案效果初步观察"[1]一文后,受到很大启发.     

对“乙型病毒性肝炎疫苗快速接种方案效果初步观察”一文的验证

偶读贵刊 1999年第 6期“90 %乙醇注射治疗鸡眼 5 8例疗效分析”[1] 一文后深受启发 ,我院地处胶东半岛 ,鸡眼发病率较高 ,但治疗方法单一且疗效不佳。 4年来我们用此法先后治疗鸡眼患者 6 4例 ,其中男 4 3例 ,女 2 1例 ,年龄2 5～ 6 2岁 ,中位年龄 4 4岁。所有病人停用鸡眼膏外贴 ,具体用药方法同该文[1] 。经注射治疗 2周后 ,其中 5 0例鸡眼出现发黑、坏死、自行脱落 ,余 14例因用药不足疗效欠佳 ,经重复注射后亦脱落 ,有效率及痊愈率均为 10 0 %。治疗过程未发现不良反应。通过实践我们发现 :该治疗方法操作简单、疗效确切 ,无不良反应 ,…     

1501例献血者乙肝疫苗接种效果观察

<正> 我国为乙型肝炎感染高发区,而输血则是传播乙型肝炎重要的途径之一。因此,对献血者除了应严格作HBsAg检测外,还应进行乙肝疫苗接种预防。我站从1990年开始对献血者进行乙肝疫苗全程免疫,并于1992年应用RPHA法及EIA法分别对本站1501例志愿献血者的乙肝免疫应答能力进行了调查,分析了男女性别之间及不同血型之间乙肝免疫应答能力的异同。现报告如下。     

对"乙型病毒性肝炎疫苗快速接种方案效果初步观察"一文的验证

我们阅读了新医学 2 0 0 1年第 3期“乙型病毒性肝炎疫苗快速接种方案效果初步观察”[1] 一文后 ,受到很大启发。于 2 0 0 1年 4月～ 2 0 0 2年 12月进行了验证 ,疗效满意。先后用该法在门诊接种疫苗 15 0例 ,男 89例 ,女 6 9例 ,年龄 7～ 4 5岁。用药方法[1] :接种日、接种日后 10日、接种日后 2 1日 ,分别给予深圳康泰生物制品有限公司产用重组 (酵母 )技术生产的乙型肝炎疫苗 ,每支 0 5mL ,含HBsAg 5 μg。在第 3针注射完成后 1个月取肘部静脉血 ,检测乙型肝炎病毒标记物抗 HBc、抗 HBe、HBeAg、抗 HBs、HBsAg。验证结果与该文…     

成年血液透析患者对重组乙型病毒性肝炎疫苗的应答与影响情况的初步研究

目的本研究探讨了国产重组乙型病毒性肝炎（乙型肝炎）疫苗在我国成年血液透析患者中应用的安全性、效果和影响疫苗应答的可能因素。方法29位年龄（53．1±13．3）。岁,己开始规律性透析一月以上终末期肾病（ESRD）患者,透析龄（32．9±25．5）月,病情稳定,乙型肝炎全套,丙型肝炎抗体均为阴性,肝功能正常,从未接种过乙型肝炎疫苗的患者。分别于0,1,6月接受皮下注射10μg乙型肝炎疫苗共三次,在接受最后一次注射后3月测定乙型肝炎表面抗体（HbsAb）的阳性率。血液透析室乙型肝炎全套和丙型肝炎抗体均阴性的工作人员10人接受皮下注射乙型肝炎疫苗作为正常对照组,注射剂量、方法、时间相同。结果：疫苗的耐受性好,血液透析组和对照组各有一人次出现轻度发热（〈38℃）,没有发生其它的不良反应。所有患者均完成三次注射和复查,血液透析组HbsAb的阳性率为51．7％,对照组HbsAb的阳性率为70％,5年后HbsAb阳性组存活11人,9人HbsAb仍为阳性,2人HbsAb转阴（一人2年后转阴、另一人3年）。结论血液透析患者因细胞免疫功能受损HbsAb的阳性率较对照组低。本研究中HbsAb阳转的血液透析患者同未阳转的患者比较,在性别、年龄、原发病、体重及红细胞压积（Hct）、血钙、磷、全段甲状旁腺激素（iPTH）、透析充分性方面无差别,但两组在白蛋白、前白蛋白值上有显著性差异（P〈0．05）,提示营养情况可能和透析患者对重组乙型肝炎疫苗的应答有关。     

启东市乙型肝炎疫苗的接种情况及影响因素分析

目的了解启东市15岁以下儿童乙型肝炎（简称乙肝）疫苗的接种情况以及完成乙肝疫苗的补种并分析其影响因素。方法以镇为单位分阶段统计儿童的乙肝疫苗的接种情况并对未接种的儿童进行补种,分析影响接种因素。结果第一阶段目标人群数为19939人,需补种1针次的儿童1041人,实际完成补种1023人（98．27％）;需补种2针次儿童1023人,实际完成补种1005人（98．24％）;需补种3针次儿童l015人,实际完成补种994人（97．93％）。第二阶段目标人群登记造册34655人,确定应补种2378人,第一轮实际完成补种2324人（97．73％）;第二轮实际完成补种2325人（97．77％）;第三轮实际完成补种2328人（97．90％）。结论加大对乙肝疫苗预防知识的宣传与普及,提高农村产妇的住院分娩率,落实分娩医院乙肝疫苗首针及时接种,是提高乙型肝炎疫苗接种率的关键。     

血液透析患者两种方法接种乙型肝炎疫苗的疗效分析

目的有效的免疫保护方法对血液透析(hemodialysis,HD)患者这种乙肝病毒(hepatitisB virus,HBV)感染的高危人群有极大的益处,然而大部分HD患者对乙肝疫苗的血清转换率低下。本研究探讨了对HD患者应用两种接种方法的免疫效果。方法 50例具备正常转氨酶水平、HBsAg(-)、anti-HBc(-)及anti-HBs(-)的慢性HD患者分为两组,A组:维持性HD患者32例,进行长疗程(O月、l月、6月、9月)肌肉注射基因重组乙肝疫苗,每次注射剂量为20ìg;B组:维持性HD患者18例,进行多次小剂量皮内注射基因重组乙肝疫苗,总共6次,间隔时间为2周,每次皮内注射剂量5ìg。以乙肝表面抗体滴度≥l0mIU/ml为产生保护性血清转换。注射结束后l～3月检测乙肝表面抗体滴度,分析两组之间保护性血清转换率及抗体滴度水平的差异。结果 A组患者有25例产生了保护性抗体,保护性血清转换率为78.12%,B组患者有16例产生了保护性抗体,保护性血清转换率为88.89%,两组差异无统计学意义(χ2=0.904,P0.05);A组的抗体滴度高于B组,两组差异有统计学意义(t=2.197,P0.05)。两组患者抗体滴度水平与患者性别、年龄、病程、肌酐水平、白蛋白水平、血红蛋白水平等无明显相关性(P0.05)。结论血液透析患者长疗程肌肉注射以及多次小剂量皮内注射基因重组乙型肝炎疫苗与传统方法的乙肝疫苗注射相比,均可较高比率的产生保护性抗体,多次小剂量皮内接种乙肝疫苗阳性率更高一些,但长疗程肌肉注射的抗体滴度明显高于小剂量组。本实验的样本量较小,可能需要扩大样本量进一步研究。     

Evaluation of influenza vaccination in health-care workers, using rapid antigen detection test

A study was conducted to assess the effectiveness of trivalent influenza vaccine in preventing influenza and reducing absenteeism in health-care workers of Gifu Red Cross Hospital during the 2002–2003 influenza season. Questionnaires were distributed to 370 health-care workers, and 366 were returned showing that 237 had received influenza vaccine and 129 were unvaccinated. The criterion for influenza was febrile episodes with a positive reaction on a rapid antigen detection test. Among vaccine recipients, the number of influenza infections was 3.4 per 100 subjects, compared with 8.5 per 100 subjects in nonrecipients (P = 0.034), and the number of days absent from work per 100 subjects was 9.5, compared with 15.1 per 100 subjects in nonrecipients (P = 0.0003). The prevalence of adverse reactions to the vaccine was rather low. No serious adverse reactions were recorded and no one was absent from work because of adverse reactions. It is concluded that influenza vaccine is effective in preventing influenza and reducing absenteeism in health-care workers. The results of this study support recommendations for influenza vaccination in health-care workers.     

不同剂量乙型病毒性肝炎疫苗母婴阻断效果评价

目的评价不同剂量重组乙型病毒性肝炎(乙肝)疫苗(hepatitis B vacc ine,HepB)对母亲乙肝病毒表面抗原(HBsAg)阳性新生儿的免疫效果。方法选择2005-2007年孕期或住院分娩时检测HBsAg阳性母亲的新生儿637例,分5、10、20μg三组分别接种相应剂量重组HepB,免后1~6月采血,使用微粒子酶免疫测定法检测HBsAg、化学发光法检测乙肝病毒表面抗体(抗-HBs)。结果 5μg组新生儿HBsAg阳性率为3.80%、抗-HBs阳性率为66.30%;10μg组新生儿HBsAg阳性率为4.64%、抗-HBs阳性率为89.29%;20μg组新生儿HBsAg阳性率为2.89%、抗-HBs阳性率为91.33%。3种剂量免后HBsAg阳性率差异无统计学意义(χ2=0.881,P=0.644),抗-HBs阳性率差异有统计学意义(χ2=53.183,P(0.001),10μg组和20μg组的抗-HBs阳性率及几何平均浓度明显高于5μg组。结论采用10μg重组酵母HepB或20μg重组HepB(中国仓鼠卵巢细胞,CHO)接种为适宜方案。     

Hepatitis B vaccination safety

BACKGROUND: Recent studies have suggested that adult hepatitis B vaccination may be associated with adverse reactions. OBJECTIVE: To further examine the relative risk, percentage association, and statistical significance of arthritic, immunologic, and gastrointestinal adverse reactions reported after adult hepatitis B vaccination compared with control vaccines. DESIGN: The Vaccine Adverse Events Reporting System (VAERS) database was analyzed for the incidence of adverse reactions after adult hepatitis B immunization compared with the incidence of adverse reactions reported to VAERS about vaccine control groups. SETTING: The medical and scientific communities have generally accepted that hepatitis B vaccine, a highly purified, genetically engineered single-antigen vaccine, is a safe vaccine. METHODS: The VAERS database was analyzed from 1997 to 2000 for adverse reactions associated with adult hepatitis B vaccination and from 1991 to 2000 for adverse reactions reported about vaccine control groups. RESULTS: The results showed a statistically significant increase in the incidence of adverse reactions reported after adult hepatitis B vaccination when compared with the incidence of adverse reactions reported to VAERS about control vaccines. CONCLUSIONS: Patients and physicians need to be fully informed of the potential adverse reactions associated with hepatitis B vaccination so that together they can make an informed consent decision about the risk versus the benefit. Patients who may have had an associated adverse reaction to hepatitis B vaccine should be made aware that they may be eligible for compensation from the no-fault Vaccine Compensation Act, administered by the US Court of Claims.     

儿童接种乙型肝炎疫苗后不同时间HBsAb阳性率评价

目的观察儿童接种乙型肝炎(简称乙肝)疫苗后不同时间的乙肝表面抗体(HBsAb)阳性率。方法回顾性研究2006年1月至2018年3月于首都医科大学附属北京同仁医院进行检查的4831例儿童血清学数据,接种乙肝疫苗后按时间分为接种当年、接种后1年、2年、3年、4年、5年、6年、7年、8~14年等九组和按性别分为女性儿童和男性儿童两组进行HBsAb阳性率统计分析。结果4831例儿童中,HBsAb总体阳性率约为73.00%,接种1年后随时间延长HBsAb阳性率均逐年下降,除接种后1年以内和接种后5年、6年以外,女性儿童HBsAb阳性率均明显高于男性儿童,1年组女性儿童和男性儿童分别为88.74%和84.37%,7年组女性儿童和男性儿童分别为69.12%和58.65%差异具有统计学意义(P<0.05)。结论儿童接种乙肝疫苗后,HBsAb滴度会随接种后时间延长而降低,应适时检测HBsAb水平,女性儿童HBsAb阳性率高于男性儿童,应结合实际情况加强免疫,以降低乙肝患病率。     

Evaluation of a flow cytofluorometric method for rapid determination of amphotericin B susceptibility of yeast isolates.

A rapid-flow cytofluorometric susceptibility test for in vitro amphotericin B testing of yeasts was evaluated and compared to the National Committee for Clinical Laboratory Standards (NCCLS) M27-T reference broth macrodilution method. The flow cytofluorometric method is based on the detection of decreased green fluorescence intensity of cells stained with DiOC5(3), a membrane potential-sensitive cationic dye, after drug treatment. Testing was performed on 134 clinical isolates (Candida spp. and Torulopsis glabrata). From the dose-response curve obtained for each isolate, three endpoints were calculated by computer analysis (the concentrations at which the fluorescence intensity was reduced by 50, 80, and 90%, i.e., 50% inhibitory concentration [IC50], IC80, and IC90, respectively). A regression analysis correlating these endpoints with the M27-T MICs showed that the best agreement was obtained with IC80. The flow cytofluorometric method showed good reproducibility with control strains. These initial results suggest that the flow cytofluorometric method is a valid alternative to the NCCLS reference method.     

Evaluation of a real-time fluorescent PCR assay for rapid detection of Group B Streptococci in neonatal blood

Streptococcus agalactiae (Group B Streptococcus: GBS) is the major causative agent of neonatal sepsis. Neonates at risk for GBS infections are empirically administered broad-spectrum antibiotics for at least 48 h pending blood culture results. A rapid assay to expedite detection of GBS would facilitate initiation of specific antibiotic therapy. Conversely, expeditious proof of absence of infection will avoid unnecessary antibiotic use. Using the LightCycler, we evaluated a hybridization probe polymerase chain reaction (PCR) assay to detect GBS-specific cfb gene target DNA sequence in blood specimens. Both sensitivity and specificity of the real-time PCR assay was 100%. The assay demonstrated 100% specificity when tested against 26 non-GBS bacteria. This method is capable of detecting as few as approximately 100 copies or 10 pg of GBS genomic DNA. This real-time PCR method is rapid, sensitive, and specific for the detection of GBS in neonatal blood samples and holds great promise in its utility in the diagnostic laboratory.     

尿激酶加速给药方法的探讨

目的　探讨急性心肌梗死 (AMI)尿激酶静脉溶栓加速给药方法的临床疗效和安全性。方法　① 4 5例AMI患者 ,均用尿激酶 2 0 0万U静脉溶栓治疗 ,其中 2 5例先静脉推注尿激酶 10 0万U ,余 10 0万U 30min静脉点滴 (A组 ) ;另 2 1例为全量 30min匀速静脉点滴 (B组 )。②在完成上述 4 5例对比观察后 ,连续按A组的方法治疗 10 2例 (C组 )。观察内容 :临床再通指标、溶栓并发症和溶栓前后的血液纤溶活性检测。结果　①A组在溶栓 15min血液PAI活性被明显抑制 (已降到最低点 ) ,B组在 15min血液PAI活性的降低仅约 5 0 % (P <0 0 0 1) ,30min时两组PAI活性均降到最低点 ;②A组出现临床再通迹象 (ST段迅速回落 ;再灌注心律失常 )的时间比B组提前 ;③A组临床评价再通率高于B组 (76 %比 6 1 9% ,P >0 0 5 ) ;④C组临床观察结果与A组相似 ,临床再通率 78 4 %。 3组均未出现严重溶栓并发症。结论　尿激酶加速给药可加快对血液PAI活性的的抑制 ,从而使临床再通指标的出现提前 ,2h临床评价再通可能高于以往常用的方法 ,此方法安全可靠 ,操作简便 ,值得进一步推广和验证。