Eliminating Mother-to-Child Transmission of Syphilis: Chinese Practice before and during COVID-19 Pandemics

Mother-to-child transmission (MTCT) of syphilis remains a leading cause of stillbirth and death among neonates in many developing countries. In 2007, World Health Orgernization launched the global elimination of MTCT (EMTCT) of syphilis. Given the high burden of congenital syphilis, China subsequently released the specific national EMTCT policies and programs to reduce MTCT of syphilis. The congenital syphilis incidence rate per 100,000 live births in China has markedly decreased from 69.9 in 2013 to 11.9 in 2019. However, due to the global pandemic of COVID-19, the current measures for eliminating MTCT of syphilis are greatly challenged. In this article, we summarize the strategies and measures for the EMTCT of syphilis in China in the past 20 years, the remarkable achievements by the policy support under the leadership of the government. In the context of COVID-19 pandemics, strengthening emergency response to the regional outbreaks of COVID-19, adopting safe, rapid, early and high-quality clinical care for 100% of pregnant women to receive prenatal syphilis testing services, ensuring the availability of Benzathine penicillin for the treatment, and strengthening the closed-loop management of pregnant women and newborns infected with syphilis are the key measures to determine the effectiveness of MTCT for syphilis. Lessons from China may be valuable for other countries that are planning to eliminate MTCT of syphilis.     

Resveratrol relieves particulate matter (mean diameter < 2.5 μm)‐induced oxidative injury of lung cells through attenuation of autophagy deregulation

Oxidative stress and inflammation are critically implicated in ambient fine particulate matter (mean diameter < 2.5 μm; PM_2.5)‐induced lung injury. Autophagy, playing a crucial role in various physiopathological conditions, modulates cellular homeostasis and stress adaptation. Resveratrol is a phytoalexin that exerts potent antioxidant effects on cardiopulmonary diseases. To date, the mechanisms by which resveratrol protects against PM_2.5 remain to be elucidated. In the present study, we investigated the effect of resveratrol on PM_2.5‐induced oxidative injury. The potential role of nuclear factor erythroid‐2‐related factor 2 and autophagy in this progress was explored. Human bronchial epithelial cells were treated with PM_2.5 and the cytotoxicity and oxidative stress markers were determined. The results showed that PM_2.5 decreased cell viability and elevated the level of lactate dehydrogenase. The levels of malondialdehyde and reactive oxygen species were increased by PM_2.5 exposure. PM_2.5 also induced a significant increase of the inflammatory cytokines including interleukin (IL)‐6, IL‐8, IL‐1β and tumor necrosis factor α. Meanwhile, PM_2.5 triggered autophagy formation and alteration of the nuclear factor erythroid‐2‐related factor 2 pathway. Furthermore, human bronchial epithelial cells were co‐treated with PM_2.5 and resveratrol in the presence or absence of 3‐methylamphetamine, an inhibitor of autophagic formation. It was revealed that resveratrol intervention abolished PM_2.5‐induced oxidative injury partially through the suppression of autophagy deregulation. Findings from this study could provide new insights into the molecular mechanisms of pulmonary intervention during PM_2.5 exposure.     

江苏省2006-2014年城乡未成年人跌倒病例的时间序列预测分析

目的 建立江苏省城乡地区未成年人跌倒发生情况的预测模型,并对城乡地区跌倒的发生情况进行预测分析,为未成年人跌倒的预防和控制提供参考依据。方法 收集2006-2014年江苏省城乡未成年人每月跌倒的病例数并进行整理,以2006-2013年的数据作为拟合样本,以2014年的数据作为预测样本;采用统计软件SPSS 18.0建立季节性自回归移动平均混合模型（seasonal autoregressive integrated moving average model,SARIMA model）并进行预测分析。结果 通过模型构建最终拟合的模型城乡分别为SARIMA （0,1,1）（0,1,1）₁₂和SARIMA （0,1,1）（1,1,0）₁₂。模型诊断显示模型残差序列均为白噪音序列,且Box-Ljung检验所有Q统计量均无统计学意义,说明所建模型拟合度较好。2014年城市预测值与观测值之间平均相对误差为11.89%,农村相应的平均相对误差为2.10%;两地预测结果与观测结果基本一致。结论 SARIMA模型可对江苏省未成年人跌倒发生情况进行较准确的预测,可为及时、科学地预防和控制未成年人跌倒的发生提供可靠的数据支持。     

青年男男性行为人群艾滋病、梅毒感染的流行病学调查

目的 掌握南京地区近5年青年男男性行为人群（young men who have sex with men,YMSM）艾滋病和梅毒感染率,分析YMSM感染人类免疫缺陷病毒（human immunodeficiency virus,HIV）危险因素。方法 利用2013-2017年南京市MSM人群横断面调查研究,筛选其中16~24周岁YMSM调查资料进行分析。结果 纳入调查的YMSM共1 029名。以未婚、汉族和自我认同为同性恋为主,文化程度大专及以上占73.66%。HIV、现症梅毒和既往梅毒总感染率分别为8.65%、4.18%和8.84%,5年间变化趋势均无统计学意义（均有P>0.05）。YMSM通过网络寻找性伴的比例从63.96%上升至73.86%;最近半年发生无保护性肛交（unprotected anal intercourse,UAI）比例从55.86%下降至36.93%,最近一次肛交安全套使用比例从62.00%上升至80.71%,差异均有统计学意义（均有P<0.05）。多因素Logistic回归分析显示,最近半年发生过UAI、YMSM性角色为被插入方和双重角色、现症梅毒感染是YMSM感染HIV的危险因素。结论 南京市YMSM人群HIV和梅毒感染率均处于较高水平,大部分YMSM接受过高等教育,今后应长期持续学校艾滋病性病预防控制综合措施的落实。应积极开发针对YMSM的网络干预措施和方法。坚持使用安全套和及时规范诊疗性病是降低YMSM人群感染HIV的关键措施。     

Association between dietary zinc intake and mortality among Chinese adults: findings from 10-year follow-up in the Jiangsu Nutrition Study

Purpose

Population studies of the association between zinc intake and mortality yield inconsistent findings. Using data from Jiangsu Nutrition Study, we aimed to assess the association between zinc intake and mortality among Chinese adults.

Methods

We prospectively studied 2832 adults aged 20 years and older with a mean follow-up of 9.8 years. At baseline, food intake was measured by 3-day weighed food record (WFR) between September and December in 2002. Death occurrence was assessed in 2012 during a household visit as well as by data linkage with the regional death registry. Hazard ratios (HRs) and 95% CI were calculated using competing risks regression (CVD and cancer mortality) and Cox proportional hazards analysis (all-cause mortality).

Results

During 27,742 person-years of follow-up, there were 184 deaths [63 cancer deaths and 70 cardiovascular disease (CVD) deaths]. Dietary zinc to energy ratio was positively associated with cancer and all-cause mortality. Across quartiles of the zinc to energy ratio from low to high, the HR (95% CI) for all-cause mortality was 1.00, 1.80 (95% CI 1.10–2.95), 1.55 (95% CI 0.96–2.50), and 1.85 (95% CI 1.11–3.07), respectively. Comparing the extreme quartiles of the zinc to energy ratio, the HR for cancer mortality was 2.28 (95% CI 1.03–5.04).

Conclusion

Zinc intake was positively related to all-cause mortality and cancer mortality.

     

2011—2015年江苏省饮水型氟中毒流行病学特征分析

目的了解江苏省饮水型氟中毒病区防治措施的实施进度,动态监测病情变化趋势,综合评价改水等其他因素对病情的影响。方法于2011-2015年,选择江苏省徐州沛县、连云港东海县、宿迁泗洪县3个氟中毒监测县,每个县抽取3个村共9个村做为监测村,采集水样并检测水氟值,按Dean法对全部8~12岁儿童的氟斑牙进行检查。结果 2011-2015年儿童氟斑牙检出率分别为33.68%(194/576),29.43%(176/598),27.26%(190/697),24.26%(163/672),26.84%(222/827),呈下降趋势(χ^2=88.821,P<0.05)。男童、女童的氟斑牙检出率分别为27.51%(631/2 294)和29.18%(314/1 076),差异无统计学意义(χ^2=6.785,P>0.05)。8~12岁儿童的氟斑牙检出率分别为28.57%(148/518),31.54%(211/669),27.91%(187/670),26.97%(192/712),25.84%(207/801),差异无统计学意义(χ^2=16.423,P>0.05)。未改水监测村、改水水氟超标监测村、改水水氟合格监测村氟斑牙检出率分别为36.58%(117/320),52.46%(192/366),23.70%(636/2 684),其中,改水水氟超标监测村儿童的氟斑牙检出率高于未改水监测村和改水水氟合格监测村,差异均有统计学意义(χ^2=26.694、31.469,均P<0.05);而改水水氟合格监测村与未改水监测村儿童的氟斑牙检出率间比较,差异无统计学意义(χ^2=2.131,P>0.05)。结论江苏省饮水型氟中毒总体病情逐步得到控制,改水后水氟超标对儿童氟斑牙影响较大。     

江苏省噪声作业工人职业体检异常情况分析

目的分析噪声作业工人疑似职业病和职业禁忌证的检出水平及其分布特征。方法依据GBZ 188-2014《职业健康监护技术规范》、GBZ 49-2014《职业性噪声聋的诊断》和GBZ/T 260-2014《职业禁忌证界定导则》,收集江苏省2015年1月1日至2015年12月31日重点职业病监测的149 271名噪声作业工人职业健康检查个案资料,对检查结果进行判定,计算出职业禁忌证和疑似职业性噪声聋检出率,分析检出率在不同性别、年龄、工龄、行业、企业规模等的分布特点。结果噪声作业工人职业禁忌证检出率为2.08%,疑似职业病检出率为2.03%。疑似职业性噪声聋检出率离岗时(2.13%)略高于在岗期间(2.03%)。职业禁忌证检出率在年龄≤20岁、41~50岁以及接触噪声工龄<1年组较高(分别为2.64%、2.48%、5.35%);疑似职业性噪声聋检出率;随年龄、工龄增长而升高(均P<0.05)。职业禁忌证检出率最高的行业是科学研究和技术服务行业(10.46%);疑似职业性噪声聋检出率最高的行业是交通运输、仓储和邮政业(5.88%)。职业禁忌证检出率最高的企业规模是中型企业(2.27%),最低的是微型企业(1.60%);疑似职业性噪声聋检出率最高的企业规模是大型企业(3.21%),最低的是微型企业(1.33%)。 结论应按规范加强噪声作业工人上岗前职业禁忌证以及在岗期间、离岗时疑似噪声聋的筛检。提高对非传统噪声行业噪声危害防治的重视程度和防治力度。     

A randomized,open label trial to evaluate and compare the immunogenicity and safety of a novel liquid hexavalent DTwP-Hib/Hep B-IPV (EasySix™) to licensed combination vaccines in healthy infants

Immunogenicity and safety of a newly developed liquid DTwP-Hib/HepB-IPV hexavalent vaccine (EasySix™) was evaluated and compared with administration of commercially licensed Pentavac SD® (DTwP-HepB/Hib) and Imovax Polio® vaccine in an open-label, randomized multi-centric trial. 284 participants, aged 6–10 weeks, randomized in a 1:1 allocation, received three doses of test or comparator vaccines, administered 4 weeks apart. Immunogenicity of the vaccines was determined by measuring the baseline and post-vaccination antibody responses and comparing the proportions of subjects achieving seroprotection against the vaccine antigens; safety was evaluated in terms of solicited (local and systemic) and unsolicited incidences in the follow up phase. Post-vaccination, seroprotection was achieved against all six vaccine antigens in both vaccine groups. The seroresponse rate as well as geometric mean titers of antibody for all vaccine components were comparable between EasySix™ and Pentavac SD®-Imovax Polio® group. Both vaccines had similar reactogenicity profiles and were well tolerated; all adverse events resolved completely without any sequelae. Only one serious adverse event was reported that completely resolved; it was regarded unconnected to the vaccine administered. This study demonstrated that immunogenicity and safety profiles of EasySix™ vaccine, manufactured by Panacea Biotec Ltd, are non-inferior to the commercially available vaccines.Clinical trial registration: CTRI/2015/02/005578.     

Inclusion of membrane-anchored LTB or flagellin protein in H5N1 virus-like particles enhances protective responses following intramuscular and oral immunization of mice

We previously demonstrated that intramuscular immunization with virus-like particles (VLPs) composed of the haemagglutinin (HA), neuraminidase (NA), and matrix (M1) proteins of A/meerkat/Shanghai/SH-1/2012 (clade 2.3.2.1) protected mice from lethal challenge with viruses from other H5 HPAI clades. The inclusion of additional proteins that can serve as immunological adjuvants in VLPs may enhance adaptive immune responses following vaccination, and oral vaccines may represent the safest choice. Here, we report the generation of H5N1 VLPs composed of the viral HA, NA, and M1 proteins and membrane-anchored forms of the Escherichia coli heat-labile enterotoxin B subunit protein (LTB) or the Toll-like receptor 5 ligand flagellin (Flic). Mice intramuscularly or orally immunized with VLPs containing LTB or Flic generated greater humoural and cellular immune responses than those administered H5N1 VLPs without LTB or Flic. Intramuscular immunization with VLPs protected mice from lethal challenge with homologous or heterologous H5N1 viruses irrespective of whether the VLPs additionally included LTB or Flic. In contrast, oral immunization of mice with LTB- or Flic-VLPs conferred substantial protection against lethal challenge with both homologous and heterologous H5N1 influenza viruses, whereas mice immunized orally with VLPs lacking LTB and Flic universally succumbed to infection. Mice immunized orally with LTB- or Flic-VLPs showed 10-fold higher virus-specific IgG titres than mice immunized with H5N1-VLPs lacking LTB or Flic. Collectively, these results indicate that the inclusion of immunostimulatory proteins, such as LTB and Flic, in VLP-based vaccines may represent a promising new approach for the control of current H5N1 HPAI outbreaks by eliciting higher humoural and cellular immune responses and conferring improved cross-clade protection.     

Vaccines and the risk of acute disseminated encephalomyelitis

BackgroundIt is important to examine the risk of Acute disseminated encephalomyelitis (ADEM) after vaccination.MethodsWe conducted a nested case–control study between January 2011 and December 2015. Four controls per case were matched for age, gender, address. An independent expert committee validated the diagnoses of cases and controls. Data on vaccinations were obtained from computerized vaccination records. The analyses were conducted with the use of conditional logistic regression.ResultsThe analyses include 272 cases of ADEM and 1096 controls. No increase in the risk of ADEM was observed for vaccination against hepatitis B, influenza, polio(live), diphtheria, pertuss(acellular), tetanusis, measles, mumps, rubella, Japanese Encephalitis, meningitis, hepatitis A, varicella and rabies vaccines. Vaccine was associated with a statistically significant increase in risk in the 31–60-day exposure interval (OR, 4.04 [95% CI, 1.07–12.69]), but not the 0–30 and 61–180-day interval. There was no association between vaccine received and the recurrence of ADEM.ConclusionsFindings from the present study do not demonstrate an association of vaccines with an increased risk of ADEM and its recurrence among either paediatric (≤18 years) or adult (>18 years) individuals within the 180 days after vaccinations. The finding in children in the 31–60 day risk interval is likely coincidental and was not confirmed in separate self-control analyses.