国际托育质量评估与监测体系

高质量的托育服务能为儿童、家庭和社会带来持续性的收益。建立完备的托育质量评估和监管体系,有助于保障托育服务的高质量发展。目前我国尚未建立托育机构质量监测系统,也缺少专业化和标准化的托育质量评估工具。本研究系统梳理了国际组织、发达国家和地区的托育质量监测和评估体系,包括政府的监管部门、评估内容架构和评估方式等。提示我国应尽快建立完善托育质量管理和评估体系,加强对托育机构的结构质量、过程质量和结局质量的系统评估。从政策保障、制度建设、专业评估工具研发等方面着手,逐步形成由政府主导,多方参与的托育质量监管模式,以保障托育机构健康和高质量发展。     

Response to hepatitis B vaccination is co-determined by HLA-DPA1 and -DPB1

Background and aimsNo report explored the combined effects of HLA-DPA1 and -DPB1 with long-term response to hepatitis B (HB) vaccination (HBVac). The specific aims of the study were to assess the combined effects and relative contributions of DPA1 and DPB1 genes.MethodsThe cases were 152 adolescents who had undetectable (<1.0 mIU/mL) post-booster anti-HBs titers and the controls were adolescents who had residual anti-HBs ≥ 10 mIU/mL at aged 16 years (n = 207) or had detectable (≥1.0 mIU/mL) anti-HBs titers after booster HBVac (n = 481). HLA-DPA1 and -DPB1 genotypes were determined by sequence-based typing.ResultsHLA-DPA1*01:03:01 was correlated with lower ORs of undetectable anti-HBs titers, while -DPA1*02:02:02 and -DPB1*05:01:01 were correlated with higher ORs. The ORs for HLA-DPA1*01:03:01-DPB1*05:01:01 and DPA1*02:02:02-DPB1*protective combinatory types were significantly less than 1.0. As compared with subjects who had no protective allele, the adjusted ORs (95% CI) were 0.545 (0.328–0.906), 0.350 (0.174–0.702), and 0.122 (0.058–0.257), for subjects who had protective alleles on DPA1only, DPB1 only, and both genes, respectively. Analyses of amino acid polymorphisms showed that subjects who carried Arg81-Pro158-Val191-Pro259α + Met234β and Gln62-Arg82α + Met234β combinations had 4.3-to-4.6 folds of risks.ConclusionBoth DPA1 and DPB1 genes contribute to the persistence of immunological response to primary infantile HBVac. The effects of HLA-DP risk alleles were dominated by the protective alleles and there were significant gene-gene interactions. Our findings provide evidences for the design of more potent HB vaccine.     

The pyrethroid metabolites 3-phenoxybenzoic acid and 3-phenoxybenzyl alcohol do not exhibit estrogenic activity in the MCF-7 human breast carcinoma cell line or Sprague–Dawley rats

Synthetic pyrethroids are one of the most frequently and widely used class of insecticides, primarily because they have a higher insect to mammalian toxicity ratio than organochlorines or organophosphates. The basic structure of pyrethroids can be characterized as an acid joined to an alcohol by an ester bond. Pyrethroid degradation occurs through either oxidation at one or more sites located in the alcohol or acid moieties or hydrolysis at the central ester bond, the latter reaction being important for mammalian metabolism of most pyrethroids. The primary alcohol liberated from the ester cleavage is hydroxylated to 3-phenoxybenzyl alcohol, which for most pyrethroids is then oxidized to 3-phenoxybenzoic acid. These products may then be conjugated with amino acids, sulfates, sugars, or sugar acids. In vitro studies have suggested that some of the pyrethroids may have estrogenic activity. Interestingly, the chemical structure of specific pyrethroid metabolites indicates that they may be more likely to interact with the estrogen receptor than the parent compounds. Two of the pyrethroid metabolites, 3-phenoxybenzoic acid (3PBA) and 3-phenoxybenzyl alcohol (3PBalc) have been reported to have endocrine activity using a yeast based assay. 3PBAlc exhibited estrogenic activity with reported EC₅₀s of 6.67 × 10^?6 and 2 × 10^?5 while 3PBAcid exhibited anti-estrogenic activity with a calculated IC₅₀ of 6.5 × 10^?5. To determine if the metabolites were able to cause the same effects in a mammalian system, the estrogen-dependent cell line, MCF-7, was utilized. Cells were treated with 1.0, 10.0 or 100.0 μM concentrations of each metabolite and cytotoxicity was assessed. The two lowest concentrations of both metabolites did not induce cell death and even appeared to increase proliferation over that of the control cells. However, when cellular proliferation was measured using a Coulter counter neither metabolite stimulated proliferation (1.0 nM, 10.0 nM, or 10.0 μM) or induced an estrogen receptor α/ERE-controlled luciferase reporter in the MCF-7 cells. Following the in vitro screenings, the metabolites were then evaluated for estrogenic activity in vivo using the uterotrophic assay in Sprague–Dawley rats. Animals were orally gavaged (10.0, 5.0, and 1.0 mg/kg) once daily for 3 days. Neither metabolite had any effect on uterine wet weight, body weight, or organ weight. Lastly, in order to determine if either metabolite was able to alter the onset of puberty, immature female rats were orally gavaged (10.0, 5.0, and 1.0 mg/kg) once a day with the metabolites beginning 1 day post-weaning until the onset of puberty as evidenced by vaginal opening (VO). Again, neither metabolite had any effect on the onset of VO.     

垃圾焚烧区周边居民血浆中细胞因子的表达水平及其影响因素

[目的]探讨垃圾焚烧区周边居民外周血中细胞色素P450 1A1（CYP1A1）基因mRNA表达水平和血浆中细胞因子白介素（IL）-6、IL-17A、IL-17F、IL-21、IL-23的表达水平。[方法]选择居住社区位于垃圾焚烧厂烟囱下风向〈10 km范围内某社区的男性居民42名为暴露组;居住区距垃圾焚烧区＞10 km且无明显环境接触垃圾焚烧污染物的44名男性居民为对照组。采用半定量逆转录-聚合酶链反应检测研究对象外周血中CYP1A1基因mRNA相对表达水平;Bio-PlexTM悬液芯片测定研究对象血浆中IL-6、IL-17A、IL-17F、IL-21、IL-23细胞因子的浓度。[结果]暴露组人群外周血CYP1A1基因mRNA相对表达水平高于对照组人群的平均水平（P〈0.05）。暴露组人群血浆中细胞因子IL-17F、IL-21、IL-23的浓度均高于对照组（P〈0.05）。细胞因子IL-17F、IL-21、IL-23的浓度经自然对数转换后分别与暴露、年龄、体质指数等因素做多元线性回归分析,发现暴露与IL-17F、IL-23表达水平的升高有关（P〈0.05）。[结论]暴露组人群外周血CYP1A1基因mRNA表达水平高于对照组人群的平均水平,且两组人群血浆中IL-17F、IL-23的表达水平亦有差异。     

零膨胀对数正态分布左删失的过敏原的最大似然估计

 目的  探讨最大似然法处理左删失过敏原数据的效果。方法  运用实例与模拟试验比较最大似然法与常用的LOD/2替代法和删除法在分析左删失蟑螂过敏原与哮喘病发作与否的关系的优劣。最大似然法分别选择对数正态分布和零膨胀对数正态分布作为左删失蟑螂过敏原的分布,并以Logistic回归来模拟过敏原与哮喘病发作的关系。结果  总体上,最大似然法构建的零膨胀对数正态分布左删失模型是处理左删失蟑螂过敏原数据较合理及稳定的方法。LOD/2替代法则可导致相反及错误的过敏原与哮喘病关系。结论  对于左删失过敏原的处理,建议先构建零膨胀对数正态分布左删失模型,据此再采用最大似然法进行参数估计和假设检验。     

Recreational Screen-Time Among Chinese Adolescents: A Cross-Sectional Study

Background

Rapid urbanization in China has led to a proliferation of electronic entertainment media among youth. Prolonged screen time (ST; includes watching television and playing on computers, video game consoles, or mobile phones) is linked to poor health profiles. The aim of this study was to report recreational ST behaviors and ST correlates among Chinese adolescents living in two regions with different degrees of urbanization.

Methods

A cross-sectional, school-based survey (n = 3461 adolescents; aged 12–14 years old) living in inner-city Shanghai and a peri-urban region of Hangzhou. Students completed a questionnaire including family characteristics, daily ST, and information on family environment related to screen use. Recreational ST was categorized into two groups according to recommendations by the American Academy of Pediatrics (< or ≥2 h/day). Parents reported their own ST and also reported educational attainment as a proxy for socioeconomic status.

Results

ST was higher among boys than girls and on weekends than weekdays. Peri-urban girls were more likely to exceed 2 h/day ST compared to inner-city girls on weekends. Having a father with no university degree, mother’s TV viewing ≥2 h/day, no ST rules at home, and eating meals in front of the TV were associated with higher ST on both weekdays and weekends, and regional differences were found for weekend ST.

Conclusions

TV viewing and playing on the computer were the most prevalent ST behaviors among Chinese adolescents. Mobile phone playing was less prevalent but persistent throughout the week. More population-level surveillance and research is needed to monitor the trends in ST behaviors and to better understand the characteristics of those who are at risk.Key words: screen time, adolescents, China, urban     

台州市HIV感染者高血压治疗率与控制率现状

  目的   了解台州市人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染者高血压治疗与控制现状,为针对性开展高血压控制工作提供依据。   方法   基于2017年“HIV与衰老相关疾病前瞻性队列研究”的基线数据,于2019年9―12月对到台州市各区县疾病预防控制中心符合基线高血压标准的242名HIV感染者进行问卷调查和体格检查。   结果   本次调查时,HIV感染者的高血压治疗率和控制率分别为44.2%和54.5%。年龄≥45岁、有高血压家族史以及合并高血脂的病人高血压治疗率较高（均有P < 0.05）;未接受治疗者高血压控制率高于采用药物治疗者（χ2=12.067,P < 0.001）;接受治疗者高血压控制率影响因素为有高血压家族史（aOR=0.153,95% CI:0.055~0.420）、基线调查时为轻度（aOR=0.130,95% CI:0.041~0.406）或中重度高血压（aOR=0.263,95% CI:0.075~0.915）;未接受治疗者高血压控制率影响因素为抗病毒治疗时间≥6年（aOR=0.355,95% CI:0.165~0.765）;单一用药与联合用药者高血压控制率差异无统计学意义。   结论   HIV感染者的高血压治疗率和控制率有待提高。应加强该人群血压监测和管理工作,并进一步研究HIV感染合并高血压者的治疗方案。