不同种类和剂量乙型肝炎疫苗成年人快速免疫效果观察

目的 探讨不同种类和剂量乙型肝炎（乙肝）疫苗（HepB）在成年人中的快速免疫效果。方法 在北京市朝阳区筛选≥ 20周岁、乙肝5项指标检测为阴性或单独核心抗体阳性者为接种对象,以社区为单位分成4组,按"0-1-2"免疫方案分别接种10、20 μg酒酿酵母乙肝疫苗（HepB-SCY）、20 μg中国仓鼠卵巢乙肝疫苗（HepB-CHO）、10 μg汉逊酵母乙肝疫苗（HepB-HPY）。全程接种1~2个月后采用化学发光法定量检测抗-HBs水平。结果 共有1 772名符合条件的研究对象完成疫苗接种和效果观察。平均年龄48.50岁,女性占62.75%。10、20 μg HepB-SCY组,20 μg HepB-CHO组和10 μg HepB-HPY组的抗-HBs阳转率和几何平均滴度（GMT）分别为79.49%、84.34%、82.50%、74.15%（P=0.005）和39.53、62.37、48.18、33.64 mIU/ml（P=0.025）;总体抗-HBs阳转率和GMT分别为79.01%和41.18 mIU/ml。4组研究对象抗-HBs水平均随年龄增长均呈下降趋势,组间抗-HBs的GMT的差异随年龄增大而缩小。logistic回归分析显示,控制了"是否单独核心抗体阳性"和"乙肝疫苗接种史"2个变量后,"接种疫苗种类和剂量"、"年龄"、"是否吸烟"均与抗-HBs有统计学关联。结论 "0-1-2"快速免疫方案中采用20 μg剂量仍能在中高年龄组人群中获得80%以上的阳转率,可作为"0-1-6"乙肝疫苗常规免疫程序的补充。     

急性毒性体外筛选方法的比较

目的比较4种急性毒性的体外筛选方法,为建立高通量的急性毒性筛选方法提供依据。方法选用人HepG2细胞,运用96孔板体外细胞培养技术,对47种已知体内急性毒性的化合物用4种细胞毒性的检测方法及5个评价指标进行检测,并将体外评价指标与体内评价指标LD50进行分析比较。结果MTT、中性红、LDH及刃天青4种检测方法中,以中性红法检测结果与体内LD50的相关性最好,评价指标中4种检测方法均以IC45与LD50的相关性最高。结论选用人HepG2细胞,运用微孔板体外细胞培养技术,4种细胞毒性检测方法中以中性红法方法最好,评价指标以IC45为宜,可作为建立高通量的急性毒性筛选方法的依据。     

Veganism does not reduce the risk of the metabolic syndrome in a Taiwanese cohort

The purpose of the present study was to assess the risk of the metabolic syndrome (MS) with vegan, pescovegetarian, lactovegetarian and nonvegetarian diets in Taiwan. The design was a retrospective cohort study using secondary data analysis from a Taiwan longitudinal health check-up database provided by MJ Health Screening Center during 1996-2006. A total of 93209 participants were classified as vegans (n=1116), pescovegetarians (n=2461), lactovegetarians (n=4313) and nonvegetarians (n=85319) by food frequency list of self-administered questionnaire at baseline. The association between MS or MS components and different dietary groups was evaluated using Cox proportional-hazards regression models with adjustment for confounders. During the mean 3.75 years of follow up, a total 8006 MS incident cases occurred and the incidence of MS was 229 (95% CI, 224, 234) per 10000 person year. Compared with vegans, hazard ratios of MS for nonvegetarians, pescovegetarians, lactovegetarians were 0.75 (95% CI, 0.64, 0.88), 0.68 (95% CI, 0.55, 0.83) and 0.81 (95% CI, 0.67, 0.97) after adjusting for sex, age, education status, smoking status, drinking status, physical activity at work and leisure, respectively. As for MS components, nonvegetarians and pescovegetarians had 0.72 (95% CI, 0.62, 0.84), 0.70 (95% CI, 0.57, 0.84) times risk of developing low high density lipoprotein cholesterol (HDL-C), while nonvegetarians had 1.16 (95% CI, 1.02, 1.32) times risk of developing high fasting plasma glucose. Our data suggest that the vegan diets did not decrease the risk of metabolic syndrome compared with pescovegetarian, lactovegetarian and nonvegetarian diets in a Taiwanese cohort.     

应用广义估计方程评估儿童肥胖综合干预效果

目的 评估儿童肥胖综合干预项目在控制儿童超重/肥胖及改善儿童肥胖相关知识-态度-行为的效果, 为制定儿童肥胖干预措施提供依据。方法 通过整群随机对照实验设计并采用广义估计方程模型对儿童肥胖相关重复测量数据进行统计分析。结果 实验组965 人, 对照组895 人。实验组的学生从正常体重发展为超重/肥胖的风险是对照组学生的0.824 倍, 即干预措施降低了17.6%成为超重/肥胖的风险（P＝0.031）。此外, 实验组学生肥胖相关知识正确率的均值提高一个单位的可能性是对照组学生的1.044 倍（P＝0.001）;实验组学生肥胖相关正确态度率的均值提高一个单位的可能性是对照组学生的1.023 倍（P＝0.001）;实验组学生肥胖相关行为的均值提高一个单位的可能性是对照组学生的1.522 倍（P＝0.046）。结论 基于知识-态度-行为模式建立的针对儿童肥胖的干预措施可有效降低正常体重儿童发展为超重/肥胖的风险, 并在改善儿童肥胖相关知识-态度-行为方面呈现一定的效果。     

嵊泗县居民海水淡化水知信行调查

目的调查嵊泗县居民对海水淡化水的态度、相关知识的知晓程度和用水行为,了解海水淡化水用于市政供水可能存在的问题。方法采用整群分层抽样方法,对嵊泗县常住居民进行问卷调查。结果发放调查问卷690份,收回675份,应答率97.8%。淡化水知晓率为48.47%。34.5%的居民选择放心使用淡化水,跟随大多数人意见的比例为30.4%,有34.7%的居民选择坚决不使用淡化水。完全不以自来水作为饮用水的占47.2%。对淡化水相关信息的获取渠道主要是与他人的交流(44.6%),其次是网络等电子媒体(40.4%)。结论调查人群对海水淡化水的水质安全性存在一定的疑虑,对淡化水的接受程度不高。淡化水的相关知识了解不够全面可能是重要的影响因素。     

2007年9～10月份杭州市大学生无偿献血分析

通过对9、10月份间杭州高校的无偿献血情况的分析,并以街头流动点的献血者作为对照,笔者发现高校大学生普遍对无偿献血有着积极态度,踊跃参加无偿献血.在这两个月间,此两类采血点共有14892例无偿献血者,其中高校学生5120例,占34.4%,是献血队伍中不可低估的力量.针对高校学生心理承受能力较差的特点,尤其是新生和初次献血者,心理疏导是重要的环节,采取防范措施,减轻献血后的不适反应,防止严重反应,确保在校大学生的安全,是有积极意义的.     

住院病人满意度影响因素调查分析

目的为了了解病人对深圳市医疗服务的满意度情况和评价深圳市医疗服务质量.方法采用自行设计的调查问卷,对深圳市6家综合医院进行满意度调查.结果病人对医疗服务的总的满意度达到98.3%:三级和二级医院的满意度差别没有统计学意义;除选择医院原因、就诊科室、付费方式和居住地外,年龄、性别等人口学特征对满意度没有影响;护理人员态度等7个单项满意度指标对综合满意度有影响.结论要针对意向病人满意度的因素,加强管理,提高医疗服务质量.     

Changes in the spectrum of kidney diseases: a survey of 2803 patients from 2010 to 2018 at a single center in southeastern China

Primary glomerular disease was the leading cause of chronic kidney disease (CKD) in China; however, changes in the economy and environment introduce variations in the spectrum of kidney diseases. This study aimed to analyze renal biopsy data to inform disease prevention and public health interventions. In this retrospective cohort study, data from 2,803 consecutive renal biopsies conducted at our center between January 2010 and December 2018 were analyzed. The sample was disaggregated by age and the date of biopsy to facilitate analysis. Primary glomerulonephritis (PGN) is the most frequent (81.84%) finding, followed by secondary glomerulonephritis (SGN; 15.38%), tubulointerstitial nephritis (15.38%), and others (1.57%). IgA nephropathy (IgAN), idiopathic membranous nephropathy (iMN), and minimal change disease were the primary causes of PGN. Among PGN cases, the incidence of iMN arose, especially among those aged ≥ 60 years old, during the observation period. Contrary to the case of iMN, the proportion of IgAN in PGN trended downward, continuously, and at length. Moreover, IgAN mainly affected those aged 25–44 years old and less so those aged ≥ 60 years old. Lupus nephritis, Henoch–Schönlein purpura nephritis, and diabetic nephropathy (DN) were key causes of SGN. A ratio reversal between infectious disease and chronic disease dramatically changed SGN patterns. In the past year, the incidence of hepatitis B–related nephritis has constantly declined; however, the proportion of DN among SGN had steadily increased. The incidence of iMN significantly increased during these years. Among SGN cases, the proportion of DN has increased.     

Response of the xenograft endothelium in the concordant xenotransplantation

Objective: To investigate the response of the xenograft endothelium in the concordant hamster to rat cardiac xenotransplantation and the mechanism of acute vascular rejection. Methods: The animals were divided into 5 groups randomly: control group,CsA group, splenectomy group, D0 splenectomy+CsA group and D3 splenectomy+CsA group. Hamster heart was heterotopicaly transplanted to rat abdominal cavity. The graft survival was monitored by palpation of the rat abdominal wall. The histological and ultrastructural changes of the xenogafts were investigated. NF-κB and P-selectin expression in the xenograft were detected. Hene Oxigenase-1 and Bcl-2 expression were also detected in the xenografts of different groups. Results: The mean survival time of the xenografts in control group, CsA group, splenectomy group, D0 splenectomy+CsA group and D3 splenectomy+CsA group was 3.4±0.55, 3.8±0.45, 6.4±1.52, 30 and 7.4±1.14 days. The rejected graft showed typical acute vascular rejection in control group, CsA group,splenectomy group and D3 splenectomy+CsA group. Endothelial cells of the rejected xenograft showed dramatic assembly of ribosomes and expansion of the rough endoplasmic reticulum. However, the endothelium of the long-term survived grafts in D0 splenectomy+CsA group showed normal architecture. NF-κB and P-selectin expression were detected in the rejected xenografts. HO-1 expression was observed in the long-term survived xenografts in D0 splenectomy+CsA group. Conclusion: The endothelial cells of the xenograft might be activated during the acute vascular rejection. Expression of HO-1 might inhibit the upregulation of NF-κB and adhesion molecular which decreases the activation of the endothelium of the graft.