Immune response to hepatitis B vaccine with high antigen content in non-responders after standard primary vaccination in Chinese adults

Context

Alternative schedules are needed to provide greater immunogenicity in adults who fail to respond to the standard hepatitis B (HB) vaccine regimen.

Objective

To evaluate the immunogenicity and safety of high antigen content HB vaccine formulations administered to non-responders after routine primary vaccination.

Design setting, and participants

This was a phase III, double-blind, controlled clinical trial in China. We enrolled healthy participants (16–60 years old) seronegative for HB surface (HBs) antigen after primary vaccination, who had HBs antibody (anti-HBs) titres <10 mIU/ml at 28 days following routine vaccination with licensed HB vaccine containing 10 μg of antigen. Participants were randomised (2:2:1) to receive three booster doses of HB vaccine formulations containing 60 μg, 30 μg or 10 μg of antigen per dose 28 days apart. Blood samples were obtained pre-vaccination and 28 days after each dose to assess immunogenicity. Reactogenicity and safety were evaluated up to 28 days after each vaccine dose.

Results

Seroconversion rates were ≥92.1% and ≥87.1% as from the second dose of the 60 μg and 30 μg HB vaccine formulations, respectively, with geometric mean concentrations (GMCs) of ≥286.0 mIU/ml and ≥164.0 mIU/ml. In the 10 μg HB vaccine group the seroconversion rates were ≥83.0% and the GMCs ≥110.1 mIU/ml as from the second vaccine dose. All HB vaccine formulations were well tolerated: 352/1091 (32.3%) participants reported at least one injection-site or systemic adverse reaction (145/434 [33.4%] from the 60 μg group; 138/435 [31.7%] from the 30 μg group and 69/222 [31.1%] from the 10 μg group). Most reactions were mild or moderate and resolved within 24 h. No serious adverse events were reported.

Conclusion

Booster vaccination with a three-dose schedule of a high antigen content HB vaccine formulation was immunogenic and well tolerated in healthy adults.

Clinicaltrials.gov identifier

NCT01203319.     

复方托品酰胺对不同年龄段低度近视人员验光结果的影响

目的:观察复方托品酰胺滴眼液对不同年龄近视患者的屈光检查、睫状肌麻痹效果的影响,探究睫状肌麻痹对低度近视验光结果的影响,为临床患者合理使用散瞳药物提出指导。方法:分别选取三个年龄段低度近视患者45例,在自然瞳孔状态下及散瞳后不同时间点使用“Shin-Nippon”开放式电脑验光仪测量双眼屈光度及调节幅度。结果:各年龄组在使用散瞳剂后在20~60min区间均出现明显调节幅度下降趋势,但调节幅度的下降与散瞳前后的“Shin-Nippon”开放式电脑验光结果无统计学意义。结论:我们应根据调节幅度随着散瞳后不同时间的变化规律安排好患者的验光窗口,而针对低度近视人群,使用开放式电脑验光仪可以有效减少睫状肌麻痹剂的使用。     

HLA-A/B/C/DRB1/DQB1对非血缘造血干细胞移植影响的分析

本研究探讨供受者HLA-A/B/C/DRB1/DQB1等位基因不合的数目和位点对非血缘造血干细胞移植的影响。选取北京市道培医院101例非血缘造血干细胞移植病例,分别根据供受者HLA-A/B/C/DRB1/DQB1位点0-3个等位基因不合和HLA-C位点的不同,分组统计移植后1年以上总生存率、急性GVHD发生率和复发率。结果表明:①按供受者HLA等位基因水平10/10全相合组(30例)与9/10相合组(32例),8/10相合组(31例)以及7/10相合组(8例)分组比较,10/10和9/10组的1年以上总活存率(OS)较8/10组(78%and 82%vs50%,p=0.39)增多;10/10组、9/10组和8/10组复发率为16%和18%vs20%;10/10组没有Ⅱ度以上GVHD发生,9/10和8/10组10%左右。7/10组虽然病例数少,缺乏统计学意义,但结果证实安全有效。②)对比HLA-C位点等位基因不合组与HLA-10/10全合组,HLA-C不合组有延长1年以上总生存率(77%vs85%,p=0.30),降低复发率的趋势(8%vs17%,p=0.47),其Ⅱ度以上GVHD发生率明显增高,统计学有明显差异(0%vs25%,p=0.006)。③按抑制性KIR的配体HLA-C1/C2将HLA-10/10组与HLA-C一个等位基因不合组按供受者HLA-C1/C2 match和mismatch分为两组(37例和5例),发现1年以上总生存率、复发率,GVHD发生率无明显差异(78%vs80%,14%vs20%,和5%vs20%)。结论:供受者HLA-A/B/C/DRB1/DQB1等位基因不相合数目0-2个情况下,数目越少,1年以上生存率越高,复发率和急性GVHD无明显差异。7/10组是安全的。HLA-C不相合组GVHD发生率明显增高,有减少复发和延长生存率的趋势,但其原因是否与抑制性KIR与其配体HLA-C1/C2有关,尚待研究。     

Activation of the spinal extracellular signal-regulated kinase 5 signaling pathway contributes to morphine physical dependence in rats

The activation of mitogen-activated protein kinases (MAPKs) has been observed in synaptic plasticity processes of learning and memory in morphine dependence. However, the role of extracellular signal-regulated protein kinase 5 (ERK5), a member of MAPKs, has not been studied yet in morphine dependence. To identify the function of ERK5 in the formation and development of morphine physical dependence, morphine withdrawal-like behavioral test and western blot technique were used in this research. Morphine was subcutaneously injected by an intermittent and escalating procedure to induce physical dependence, which was measured by withdrawal symptoms. In this study, spinal ERK5 signaling pathway was remarkably activated by chronic morphine injection and naloxone-precipitated withdrawal. Intrathecal injection of BIX02188, a novel specific inhibitor of mitogen-activated protein kinases kinase 5 (MEK5), produced a dose- and time-dependent inhibition of the activation of spinal ERK5, without affecting activation of other MAPKs. Moreover, selective attenuation of spinal p-ERK5 expression by BIX02188 could significantly relieve morphine withdrawal symptom, accompanying with the decreased phosphorylation of cAMP response-element binding protein (CREB) in the spinal cord. These findings suggested that activation of the ERK5 signaling pathway might contribute to morphine physical dependence and its specific pharmacological inhibitor BIX02188 could be a potential therapeutic choice for alleviation of morphine withdrawal symptoms in the future.     

妊娠合并甲状腺功能减退对妊娠及胎儿的影响

目的:探讨妊娠合并甲状腺功能减退(以下简称甲减)对妊娠和胎儿的影响。方法:对住院分娩的88例甲减孕产妇(临床甲减组38例、亚临床甲减组50例)及正常对照组100例分别统计其不良妊娠发生率。结果:临床甲减组早产、妊娠期高血压疾病、贫血、胎窘、低出生体重发生率均高于正常对照组(P<0.05);亚临床甲减组的妊娠期高血压疾病、贫血、胎窘发生率亦高于正常对照组(P<0.05)。结论:妊娠合并甲减的不良妊娠发生率与甲减的程度有关。因此有必要在孕前或孕早期筛查,做到早诊断、早治疗,严密监测孕妇、胎儿情况,以改善甲减孕妇母儿结局。     

Enhanced surveillance of newly acquired hepatitis C virus infection in Canada, 1998 to 2004

The purpose of this study was to determine trends in disease incidence and recent patterns of hepatitis C virus (HCV) transmission in Canada, using the Enhanced Hepatitis Strain Surveillance System (EHSSS). Demographic, clinical, and potential risk factor information on newly acquired HCV infection, from 1998 to 2004, was collected using standardized questionnaires. During this time period, the reported incidence of newly acquired HCV infection declined by 36.4% from 3.3 cases per 100,000 in 1998, to 2.1 cases per 100,000 in 2004. The disease incidence peaked at 15 to 39 y of age, confirming injecting drug use as the most frequently reported route of transmission. The proportion of cases attributed to health care-acquired HCV infection decreased over this time period. Although the incidence of newly acquired HCV infection in the EHSSS was found to be declining, hepatitis C remains an important public health threat to Canadians. Prevention efforts for HCV should focus on injection drug use, especially for people aged 15 to 39 y.     

PACS的结构与实现

１　概述ＰＡＣＳ（ｐｉｃｔｕｒｅａｒｃｈｉｖｉｎｇａｎｄｃｏｍｍｕｎｉｃａｔｉｏｎｓｙｓｔｅｍｓ;ＰＡＣＳ）又称ＩＭＡＳ（ｉｍａｇｅａｒｃｈｉｖｉｎｇａｎｄｃｏｍｍｕｎｉｃａｔｉｏｎｓｙｓｔｅｍｓ）,即图像归档与传输系统,是应用于医院放射科或医院及更大范围的医学图像信息管理系统,图像主要来源于医院的放射医疗设备如ＣＴ、ＭＲＩ、ＰＥＴ、Ｂ超等产生的影像,在这里医学影像又称为医学图像。ＰＡＣＳ的起源和发展是与计算机科学的发展密切相关的。传统的放射科医生的诊断方式主要是根据由特定影像设备产生的胶…     

苦参素对LPS诱导的人肾小球系膜细胞中p-STAT3和SOCS-3的影响

目的:观察苦参素对LPS诱导的人肾小球系膜细胞(HMC)中磷酸化信号转导和转录活化因子3(p-STAT3)和细胞因子信号抑制因子3(SOCS3)的表达及相互关系.方法:体外原代培养的HMC,分为正常组、LPS(10 mg/L)组、LPS(10mg/L)+苦参素(320 mg/L)组,每组分3个时间点(12,24,48h).采用MTT法检测HMC的增殖,RT-PCR方法检测STAT3和SOCS3 mRNA的表达,Western Blot方法检测p-STAT3和SOCS3蛋白的表达.结果:苦参素能明显抑制LPS诱导的HMC增殖,与正常组相比,p-STAT3和STAT3 mRNA的表达在12,24,48 h均上调,SOCS3蛋白和mRNA的表达也同步上调.与LPS诱导组相比,苦参素组p-STAT3和STAT3 mRNA的表达在12,24,48 h均下调,而SOCS3蛋白和mRNA表达有明显上调的趋势.结论:苦参素能抑制LPS诱导的HMC的增殖,且能上调LPS诱导的HMC中SOCS3 mRNA和蛋白表达,下调P-STAT3和STAT3 mRNA的表达,其作用可能与上调SOCS3、抑制STAT3磷酸化有关.     

MUC1基因疫苗对膀胱肿瘤抑制的免疫学实验研究

目的：研究人粘蛋白MUC1基因DNA疫苗诱导小鼠细胞毒性T细胞（CTL）及体液免疫应答的作用，为膀胱癌的疫苗治疗提供实验资料。方法：接种pcDNA3．1（＋）-MUC1质粒，通过ELISA法检测小鼠血清MUC1抗体生成和脾细胞产生IL-2和1FN-7的量，通过LDH释放法测定CTL对BIU-87细胞的杀伤活性。结果：接种pcDNA3．1（＋）-MUC1疫苗后，小鼠血清中抗MUC1抗体水平明显升高，与对照组相比有显著性差异（P〈0．01）。脾细胞产生的IL-2和IFN-7水平较对照组高（P〈0．01）。在效靶比为100：1、50：1、25：1、12．5：1时，MUC1基因疫苗免疫组小鼠CTL对BIU-87杀伤率（分别为58．4％、47．2％、35．7％、27．4％），较空载体pcDNA3．1（＋）组小鼠和灭菌生理盐水组小鼠（分别为11％、19．2％、9．5％、14％和16．5％、11．9％、8．6％、10．3％）均明显升高，且有显著性差异（P〈0．01）。结论：MUC1基因DNA疫苗能够诱导小鼠产生抗MUC1特异性抗体，诱导产生杀伤表达MUC1细胞的CTL，为MUC1基因疫苗用于膀胱肿瘤生物治疗提供了一定的实验依据。