高碘地区儿童甲状腺结节的调查分析

目的了解高碘地区学龄儿童甲状腺结节的检出率,为高碘甲状腺肿的防治工作提供科学依据。方法对山东省巨野县6~13岁儿童226名和山西省平遥县6~15岁256名儿童进行甲状腺B超检查和尿碘检测。结果本次调查共发现患有甲状腺结节的儿童为6例,检出率1.2%,尿碘中位数为437.7μg/L。尿碘<100μg/L组学龄儿童的甲状腺结节检出率较高,为6.3%;100~199μg/L组学龄儿童甲状腺结节检出率为2.6%;200~299μg/L组的检出率最低,为0.0%;≥300μg/L组的检出率为1.3%,不同尿碘水平甲状腺结节检出率无统计学意义,χ2=3.387,P>0.05。不同年龄甲状腺结节检出率无差异,χ2=0.194,P>0.05。儿童的性别之间甲状腺结节检出率无差异,χ2=0.604,P>0.05。不同年龄组尿碘中位数无明显差异(H=0.281,P>0.05)。不同性别儿童尿碘中位数无明显差异(Z=-0.467,P>0.05)。检出有结节组与无结节组学龄儿童的尿碘中位数分别为324.2μg/L和440.9μg/L,两者之间无统计学意义(Z=-1.688,P>0.05)。结论高碘地区存在儿童甲状腺结节,儿童甲状腺结节的成因有待进一步研究。     

Factors associated with establishment-based female sex workers accessing health care services in Shanghai

Female sex workers are a priority population for HIV prevention and health promotion in China. This paper examines the patterns of and factors associated with the utilisation of HIV-related and general health services by establishment-based sex workers in Hongkou District, Shanghai. Participants were recruited through a three-stage sampling strategy and invited to self-complete a brief survey in 2012. The median age of the 400 participants included in the analyses was 33 years (range = 18–52 years old), with over three-quarters being married at the time of the survey. Participants were mostly internal migrants, more than half had lived in Shanghai for six months or longer and nearly two-thirds were working in an establishment with a total of less than five female sex workers. Routine physical examination and HIV testing were the most commonly accessed health services in the previous 12 months. Altogether, 347 women (86.8%) had actively sought, including 157 women had obtained, free health services mainly from local Community Health Service Centres (CHSCs) in the previous 12 months. The active seeking of free, largely CHSC-provided health services was associated with a longer duration of residence in Shanghai (adjusted odds ratio [AOR] = 2.55, 95% CI = 1.32–4.93; p < 0.01) and having tested for HIV in the previous 12 months (AOR = 3.68, 95% CI = 1.84–7.38; p < 0.001). Conversely, a higher annual income (AOR = 0.41, 95% CI = 0.21–0.80; p < 0.01), working in a larger establishment (AOR = 0.40, 95% CI = 0.20–0.79; p < 0.01) and knowing that HIV can be transmitted through blood transfusion with unscreened blood (AOR = 0.21, 95% CI = 0.05–0.91; p < 0.05) were associated with not actively seeking such services. Free, community-based health services are highly demanded by establishment-based female sex workers in Shanghai. Scaling-up of free and integrated health services provided by community-based health service providers in metropolitan areas in China and beyond holds promise for promoting health and well-being of female sex workers.     

临床腹泻患者贾第虫感染和分子特征研究

目的初步了解临床腹泻患者贾第虫的感染情况及分子特征。方法以2014年5-7月上海市某医院临床腹泻患者为研究对象,收集粪便样本95份,进行卢戈氏碘液染色,用光学显微镜检查贾第虫包囊。采用巢式PCR法扩增贾第虫磷酸丙糖异构酶基因(tpi),扩增产物测序后用BLAST、Clustal X 1.83和MEGA6.0软件进行同源性和系统发育分析。结果形态学观察发现1例腹泻患者感染贾第虫,阳性检出率为1.05%。其粪便样本经卢戈氏碘液染色后显微镜下可见清晰的包囊。对样本进行PCR检测,扩增片段大小约为530 bp,测序结果显示为贾第虫。经序列比对分析,并以tpi基因构建系统发育树,分析鉴定该分离株为集聚体B,与已报道的人源贾第虫分离株(KF271445)同源性为100%。结论临床腹泻患者中存在贾第虫感染,本研究结果可为了解贾第虫基因型特点及贾第虫病流行病学研究提供参考。     

基于人畜疫情分层的血吸虫病流行区综合治理投入与效果评价Ⅱ2006-2013年湖沼垸内型地区疫情变化与费用投入关联分析

目的研究湖沼垸内型血吸虫病流行区血吸虫病疫情变化与经费投入和防治费用的关联性,为优化血吸虫病防治策略提供参考。方法选择江陵县为研究区,采用直线相关与回归法分析当地2006-2013年血吸虫病疫情;采用两阶段最小二乘法与路径递归模型分析经费投入与防治费用对当地疫情变化的可能影响。结果 2006-2013年,江陵县人群校正感染率、耕牛存栏数与钉螺面积分别下降了77.42%、76.34%和19.43%;钉螺感染率与人群血检、粪检阳性率及耕牛感染率均呈显著相关,且与耕牛感染率呈直线回归关系(P均0.05)。各级投入与人群血检和粪检阳性率、耕牛和钉螺感染率,以及各类费用与人群粪检阳性率、耕牛和钉螺感染率的回归模型均有统计学意义(P均0.05),但各类费用与人群血检阳性率回归模型无统计学意义(P0.05);影响人群血检阳性率、人群粪检阳性率、耕牛感染率和钉螺感染率的分别为县级投入、综合治理费用、人工费用与查治病费用、国家级投入与查治病费用(P均0.05)。结论 2006-2013年,江陵县血吸虫病疫情变化与各级投入、防治费用均有关联;各疫情指标相互显著相关的现象提示应开展综合性监测体系研究。     

Association between killer cell immunoglobulin‐like receptor 2DS5 gene with essential hypertension in the Chinese Han patients

Hypertension has been suggested to be mediated by immunity and inflammation. As immune system genes, killer cell immunoglobulin‐like receptors (KIRs) genes play an important role in the pathogenesis of autoimmune diseases. We conducted a community population‐based case–control study to analyse associations between KIR genes and hypertension. KIR genes were genotyped using sequence‐specific primer polymerase chain reaction in 380 unrelated essential hypertensives and 527 normotensives. The frequencies of KIR2DS5 gene were significantly decreased in participants with high high‐sensitivity C‐reactive protein (hsCRP) compared with participants with low hsCRP (17.02% vs 34.08%, p = .016). The presence of KIR2DS5 gene was independently associated with decreased risk of hypertension (odds ratio = 0.62; 95% confidence interval: 0.43–0.89), after adjusted for conventional risk factors, hsCRP and other KIR genes. We found that participants with KIR2DS5 gene had a decreased risk of hypertension compared with participants without KIR2DS5 gene. Our findings suggested that KIR2DS5 gene may be protective against hypertension.     

Inflammatory chemokines and their receptors in human visceral leishmaniasis: Gene expression profile in peripheral blood,splenic cellular sources and their impact on trafficking of inflammatory cells

Chemokines play an important role in determining cellular composition at inflammatory sites, and as such, influence disease outcome. In this study, we investigated the expression profile and splenic cellular source of various inflammatory chemokines and their receptors in human visceral leishmaniasis (VL). The expression of chemokines or their receptors was measured at the gene and protein level by employing real time qPCR and a cytometric bead array assay, respectively. In addition, the cellular source of chemokines and their receptors in the spleen was identified employing gene expression analyses in sequentially selected cell subsets. We identified elevated expression of CXCL10, CXCL9, CXCL8, and decreased CCL2 from VL patients. Further, we found reduced expression of the chemokine receptors CXCR1, CXCR2, CXCR3 and CCR2, but increased expression of CCR7 on VL PBMC, compared to endemic healthy controls. Additionally, splenic monocytes were found to be the major source of CXCL10, CXCL9 and CCR2, whereas T cells were the main source of CXCR3 and CCR7. We also report a strong association between plasma IFN-γ and CXCL-10, CXCL-9 levels. Enhanced parasite burden positively correlates with increased expression of CXCL10, CXCL9, IFN-γ and IL-10. Overall our result indicates that VL patients have an elevated inflammatory chemokine milieu which correlated with disease severity. However, expression of their chemokine receptors was significantly impaired, which may have contributed to reduced frequencies of blood monocytes and neutrophils in peripheral blood. In contrast, enhanced expression of CCR7 was associated with increased numbers of activated T cells in circulation. These findings highlight the importance of chemokines for recruitment of various cell populations in VL, and the knowledge gained may help in global understandings of the complex interaction between chemokines and pathological processes, and therefore will contribute towards the design of novel chemokine based immunological therapies against VL.     

The Global Influenza Hospital Surveillance Network (GIHSN): a new platform to describe the epidemiology of severe influenza

Background

Influenza is a global public health problem. However, severe influenza only recently has been addressed in routine surveillance.

Objectives

The Global Influenza Hospital Surveillance Network (GIHSN) was established to study the epidemiology of severe influenza in consecutive seasons in different countries. Our objective is to describe the GIHSN approach and methods.

Methods

The GIHSN uses prospective active surveillance to identify consecutive influenza admissions in permanent residents of well-defined geographic areas in sites around the world. A core common protocol is followed. After consent, data are collected on patient characteristics and clinical outcomes, respiratory swabs are obtained, and the presence of influenza virus and subtype or lineage is ascertained by polymerase chain reaction. Data are collated and analyzed at the GIHSN coordination center.

Results

The GIHSN has run its activities for two consecutive influenza seasons, 2012–2013 and 2013–2014, and hospitals in Brazil, China, France, Russian Federation, Turkey, and Spain have been involved in one or both seasons. Consistency on the application of the protocol and heterogeneity for the first season have been addressed in two previous publications. During both seasons, 19 677 eligible admissions were recorded; 11 843 (60%) were included and tested, and 2713 (23%) were positive for influenza: 991 (37%) A(H1N1); 807 (30%) A(H3N2); 583 (21%) B/Yamagata; 56 (2%) B/Victoria and 151 (6%) influenza A; and 125 (5%) influenza B were not characterized.

Conclusions

The GIHSN is a platform that provides information on severe influenza worldwide, applying a common core protocol and a consistent case definition.     

NLRC5 polymorphism is associated with susceptibility to chronic periodontitis

Periodontitis is a chronic oral pathology caused by impaired immune response against oral bacteria resulting in tissue inflammation and damage. Among the members of innate immune response, the first line of defence against pathogens, inflammasomes are macro-molecular protein complexes that can be activated by different stimuli, comprised bacteria infections. Different proteins are involved in inflammasoma formation; the most important are molecules belonging from the family of nucleotide-binding and oligomerization domain (NOD)-like receptors (NLRs).In this study, polymorphisms within 20 NLRs related genes were analysed in order to investigate their possible association with periodontitis susceptibility in a population from North-East Italy.One polymorphism, namely rs289723, in NLRC5 gene resulted associated with chronic slight and chronic localized periodontitis susceptibility, specifically A/A genotype was correlated with increased risk of disease development.Our study, for the first time, identified the possible involvement of a polymorphism within NLRC5 gene as a possible biomarker for periodontitis condition susceptibility among Italian individuals from genetic isolates.