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In recent years, the incidence of myopia in adolescents has been increasing year by year, and how to effectively control the development of myopia has become a research hotspot in the field of public health.The orthokeratology lens has been widely used in myopia control because of its great safety, reliability, and little impact on daily life.The cornea after overnight orthokeratology lens wear can be divided into a relatively flat central treatment zone and a steep peripheral defocus zone.Decentration of the treatment zone is common in clinical practice and is mainly located in the inferior temporal quadrant.Studies have shown that the greater the asymmetry of the anterior corneal surface, the greater the degree of myopia at baseline, and the smaller the diameter of the lens, the greater the deviation of the treatment zone.In addition, decentration of the treatment zone is also related to the gravity of the lens, Bell phenomenon, eyelid, and so on.Large decentration of the treatment zone results in decreased visual quality, including clinical symptoms such as ghosting vision and glare, which may be caused by the increase in comatic aberration.Decentration of the treatment zone may have better myopia control, due to the increase of defocus in the pupil area.Obvious decentration of the treatment zone can be solved by increasing the sagittal height, adjusting the alignment curve, increasing the lens diameter and switching to toric lenses, etc.This article reviewed the factors that affect the decentration of the treatment zone after overnight orthokeratology wear, the influence of decentration on visual quality and myopia control, and the methods to help solve the problems caused by the decentration of the treatment zone, which can guide fitting and replacement of orthokeratology lenses.
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BACKGROUND@#The new emerging avian influenza A H7N9 virus, causing severe human infection with a mortality rate of around 41%. This study aims to provide a novel treatment option for the prevention and control of H7N9.@*METHODS@#H7 hemagglutinin (HA)-specific B cells were isolated from peripheral blood plasma cells of the patients previously infected by H7N9 in Jiangsu Province, China. The human monoclonal antibodies (mAbs) were generated by amplification and cloning of these HA-specific B cells. First, all human mAbs were screened for binding activity by enzyme-linked immunosorbent assay. Then, those mAbs, exhibiting potent affinity to recognize H7 HAs were further evaluated by hemagglutination-inhibiting (HAI) and microneutralization in vitro assays. Finally, the lead mAb candidate was selected and tested against the lethal challenge of the H7N9 virus using murine models.@*RESULTS@#The mAb 6-137 was able to recognize a panel of H7 HAs with high affinity but not HA of other subtypes, including H1N1 and H3N2. The mAb 6-137 can efficiently inhibit the HA activity in the inactivated H7N9 virus and neutralize 100 tissue culture infectious dose 50 (TCID50) of H7N9 virus (influenza A/Nanjing/1/2013) in vitro, with neutralizing activity as low as 78 ng/mL. In addition, the mAb 6-137 protected the mice against the lethal challenge of H7N9 prophylactically and therapeutically.@*CONCLUSION@#The mAb 6-137 could be an effective antibody as a prophylactic or therapeutic biological treatment for the H7N9 exposure or infection.
Subject(s)
Animals , Humans , Mice , Antibodies, Monoclonal/therapeutic use , Antibodies, Neutralizing/therapeutic use , Antibodies, Viral , Hemagglutinins , Influenza A Virus, H1N1 Subtype , Influenza A Virus, H3N2 Subtype , Influenza A Virus, H7N9 Subtype , Influenza Vaccines , Influenza in Birds , Influenza, Human/prevention & controlABSTRACT
Objective@#To verify the current cut off points of physical activity intensity for adolescents to assess moderate to vigorous physical activity (MVPA) among overweight or obese adolescents.@*Methods@#The total activity counts, heart rate and steps indicators most commonly used to reflect physical activity intensity were adopted, and a total of 15 MVPA cut off points standards for adolescents were included. Ninety four overweight or obese adolescents were tested for walking and running at 3-7 km/h in a free state, while simultaneously wearing MetaMax 3B gas metabolism analyzer, polar belt and actigraph w-GT3x BT triaxial accelerometer to collect energy consumption and activities count, heart rate and steps. Kappa consistency test and paired χ 2 test were used for statistical analysis.@*Results@#Kappa consistency coefficients (0.27-0.53) <0.60 between all cut off points standards and the "gold standard" and the P <0.01, indicating that the consistency is varied and not strong. In the standard diagnosis of each cut points, low sensitivity (49.11-67.59), high specificity (92.50-97.65), high - LR (0.14-0.52, >0.1) and low DOR (8.26-25.19, <30) indicated high rate of misdiagnosis. Low specificity (36.75-69.41), high sensitivity (84.82-96.36) and low + LR (1.52- 9.83 , <10) indicated a high rate of misdiagnosis; AUC of 0.67-0.80 suggested lower diagnostic performance.@*Conclusion@#Existing physical activity intensity cut off points for overweight or obese adolescents were not consistent with MVPA and have low diagnostic capabilities. The following criteria of MVPA for overweight or obese adolescents are supposed.
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There are many limitations in evaluating vaccine efficacy by comparing the incidence of clinical endpoint events (such as morbidity, bacterial colonization) between the vaccine group and the control group. Therefore, the researchers put forward the concept of Surrogate of protection to predict vaccine protection with immunological indicators. In 2012, WHO put forward the immunological substitution endpoint of pneumococcal vaccine, using 0. 35 μg/ml as the protective antibody level of pneumococcal vaccine. But subsequent studies have found that using this threshold to assess all vaccine serotypes may not be accurate.
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Objective@#To construct a method to express ScFv antibody from PCR products, and use it in phage display for high-throughput ScFv expression.@*Methods@#Cytomegalovirus (CMV) promotor, ScFv and BGH-Poly A gene fragments were amplified by PCR. Overlapping PCR was used to form a tandemly linear cassette gene. By transiently transfected into 293T cells, ScFv antibodies expression of cassette gene were tested by Western blot, enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescent antibody (IFA). Ninety-six clones of antibody genes in phage library were selected and expressed by cassette expression system. The expression level was evaluated and analyzed.@*Results@#Three fragments were obtained and a cassette expression system formed. Cassette expression system worked successfully in 293T cells, as a Mr.38×103 brand could observed in Western blot assay. The expressed antibody could specifically bind to its antigen by result of ELISA and IFA. This cassette expression system could also be used in phage display for high-throughput panning.@*Conclusions@#The cassette expression system was constructed successfully and high-throughput antibody expression has been achieved.
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Maternal immunization is an immune strategy that protects both mothers and early-life infants from disease by the vaccination of pregnant women. The effect of maternal immunization is influenced by the types of vaccines, the timing of vaccination, the subtypes of antibodies induced by vaccines, and the health status of mothers themselves. Inactivated influenza vaccination during pregnancy and DPT vaccination during the third trimester of pregnancy have been widely used in the world, while Hepatitis B vaccine, pneumococcal and meningococcal vaccines also show good efficacy and safety in pregnant women. This article reviews the research progress of Maternal Immunization in order to provide a reference for Maternal Immunization planning and policymaking in China.
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Objective@#To analyze the epidemiological characteristics and pathogen types of viral diarrhea in children under 5 years of age in Shandong province, and provide reference for the prevention and control of viral diarrhea.@*Methods@#A total of 1 017 fecal samples were collected from all children aged 5 years and younger with diarrhea who were admitted to the sentinel hospital of Shandong province from 2012 to 2017 within 3 days. Rotavirus antigen was detected by using an ELISA method . Rotavirus G/P typing was performed by RT-PCR; Norovirus (GI and GII), Sapovirus, and Astrovirus were detected by multiplex RT-PCR, and adenovirus was detected by PCR.@*Results@#In the 1 017 fecal specimens, the overall positive rate was 51.62% (525/1017), and viral nucleic acids were detected in at least 421 samples, and mixed virus infection was found in 104 sampes. The mixed infection accounted for 10.23% (104/1017) of all infections. The positive detection rates of Rotavirus, Calicivirus, Adenovirus and Astrovirus were 34.22% (348/1017), 16.91% (172/1017), 2.56% (26/1017), and 9.64% (98/1017)). The total detection rate of diarrhea virus and the detection rate of Rotavirus were the highest at 12 to 17 months of age, which was 51.72% (105/203) and 20.20% (41/203), respectively. The positive rate of diarrhea in children aged 2 years and younger was 49.36% (502/1017), which was much higher than the positive rate of diarrhea in children over 2 years old (2.26% (23/1017)). The peak of viral diarrhea was found to occur between November and April of the following year. The genotype of rotavirus was dominated by G9 (82.76%), the P genotype was dominated by P[8] (80.46%), and the G/P combination was dominated by G9P[8] (83.87%). Norovirus was the main infection in the Calicivirus (87.21%).@*Conclusions@#From 2012 to 2017, viral diarrhea in children under 5 years of age in Shandong Province was mainly caused by Rotavirus infection, followed by Norovirus. The overall prevalence of viral diarrhea in Shandong was moderate in China, and autumn and winter were the main epidemic season for viral diarrhea.
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Genes play an important role in the immune system response,and different gene loci may result in different vaccine immune response rates.This review focuses on the correlation between gene polymorphisms and vaccine immune response in order to investigate the influence of gene polymorphisms on the immune response to vaccines.It discusses the effect of an individual's immune response after vaccination at genetic level and provides a scientific basis for individualized immune development strategies.It reveals that human leukocyte antigen genes,various cytokines and their receptor genes,and Toll-like receptor genes all affect the vaccine immune response.
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The importance of vaccine on public health is related to the herd protection related to the levels of vaccine coverage,which directly influences the vaccinated individuals as well as the unvaccinated community.Reaching the level of herd protection by increasing vaccine coverage is the basic strategy to eradicate related infectious diseases.Again,herd protection has played an important role in public health practices.With the increasing interests in estimating the vaccine herd protection,we however,have seen only few relevant papers including observational population-based and cluster-randomized clinical trials reported in China.We hope to discuss the study designs for evaluating the vaccine herd protection in order to generate evidence-based related research in this field.
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Due to the tumor malignancy or immunosuppressive treatment,patients with cancer in general are more susceptible to vaccine-preventable infections.The types,timing,dose of vaccination or even the immunization program for them may differ from those for the normal persons.At present,it is recommended to use inactivated vaccines for patients with cancer rather than attenuated live vaccines,Vaccinations should be avoided during immunosuppressive therapy;patients with cancer should receive double dosage of hepatitis B vaccines and two doses of inactivated influenza vaccines yearly.This paper summarizes the progress in clinical trials of vaccination for cancer patients in foreign countries,and provide reference for the development and implementation of vaccination strategy for cancer patients in China.
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Genes play an important role in the immune system response,and different gene loci may result in different vaccine immune response rates.This review focuses on the correlation between gene polymorphisms and vaccine immune response in order to investigate the influence of gene polymorphisms on the immune response to vaccines.It discusses the effect of an individual's immune response after vaccination at genetic level and provides a scientific basis for individualized immune development strategies.It reveals that human leukocyte antigen genes,various cytokines and their receptor genes,and Toll-like receptor genes all affect the vaccine immune response.
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The importance of vaccine on public health is related to the herd protection related to the levels of vaccine coverage,which directly influences the vaccinated individuals as well as the unvaccinated community.Reaching the level of herd protection by increasing vaccine coverage is the basic strategy to eradicate related infectious diseases.Again,herd protection has played an important role in public health practices.With the increasing interests in estimating the vaccine herd protection,we however,have seen only few relevant papers including observational population-based and cluster-randomized clinical trials reported in China.We hope to discuss the study designs for evaluating the vaccine herd protection in order to generate evidence-based related research in this field.
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Due to the tumor malignancy or immunosuppressive treatment,patients with cancer in general are more susceptible to vaccine-preventable infections.The types,timing,dose of vaccination or even the immunization program for them may differ from those for the normal persons.At present,it is recommended to use inactivated vaccines for patients with cancer rather than attenuated live vaccines,Vaccinations should be avoided during immunosuppressive therapy;patients with cancer should receive double dosage of hepatitis B vaccines and two doses of inactivated influenza vaccines yearly.This paper summarizes the progress in clinical trials of vaccination for cancer patients in foreign countries,and provide reference for the development and implementation of vaccination strategy for cancer patients in China.
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Due to immature development of the immune system, preterm infants are at increased risk of infections from vaccine-preventable diseases. But at the same time, premature vaccination may not induce a good immune response because of the incomplete development of the neonatal immune system, and may cause serious adverse reactions risk due to the poor immune tolerance, thus vaccination of preterm infants at the appropriate time is the key to reducing the risk of infectious disease and obtaining vaccine protection. At present, it is generally recommended that the gestational age and birth weight should be considered in the vaccination of preterm infants. The timing, type and even the immunization schedule of the vaccine should be differ from that of the full term infants. However, there is a lack of research results and data on immunization program in preterm infants in China, and there is still no provided universal guidelines for their vaccine immunization. This article aims to summarize the guidelines and clinical trials of vaccination of preterm infants in foreign countries, and to provide reference for the formulation and implementation of immunization strategies for preterm infants in China.
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Intestinal microbiota plays an important role in the development of immune system,es-pecially in the formation of immune response. Immune response to vaccination varies with region and popula-tion,which may be related to the differences in intestinal microbiota. This review focused on the correlation between intestinal microbiota and immune response to vaccination in order to find a new way to enhance vac-cine-induced immune response. It was revealed that intestinal microbiota might be involved in the immune responses to vaccines against rotavirus, typhoid and polio. Although probiotics, prebiotics and synbiotics could not significantly enhance vaccine-induced immune response,they might have a beneficial effect on vac-cine by regulating intestinal microbiota.
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Objective To understand the epidemiological and clinical characteristics of ＜ 2 years old children hospitalized due to intussusceptions.Methods Clinical and demographic data of ＜2 years old children hospitalized due to intussusception between January 2007 and August 2013 were retrospectively collected in Affiliated Children' s Hospital of Soochow University in Suzhou.The incidence data,age distribution,seasonality and clinical characteristics of hospitalized intussusceptions cases were analyzed.Results A total of 594 intussusception-related hospitalizations were identified during this period in children aged ＜2 years,no death occurred.The crude incidence of hospitalized intussusception was 57.3 per 100 000 in children aged ＜2 years (95％CI:52.8-62.1),and 100.6 per 100 000 in children aged ＜1 year (95％CI:92.1-109.8).The male to female ratio was 1.90 ∶ 1.Up to 85.4％ (507/594) of the cases were aged ＜ 1 year,and 66.2％ (393/594) of the cases were aged 3-8 months.The incidence peaked in age group 5-8 months.The median age of the cases was 6.8 months (QR=4.4),and increased from 6.3 months (QR=4.2) in 2007 to 7.3 months (QR=4.0) in 2013.No obvious seasonality was observed.Main symptoms or signs included vomiting (83.2％,494/594),abdominal mass (81.1％,482/594),and bloody stool (64.5％,383/594).Abdominal ultrasonic testing was the most frequently used diagnostic approach (98.7％,586/594).Up to 86.2％ (512/594) of patients were successfully treated by surgical intervention.The main sites for acute intussusception in children aged ＜2 years were ileo-colic (34.5％,183/530),ileo-ileo (30.8％,163/530) or ileo-ileo-colic (27.9％,148/530).Conclusion The incidence of hospitalized intussusception in children aged ＜2 years was high in Suzhou.It is necessary to establish an active surveillance system to provide baseline data for the evaluation of rotavirus vaccine safety.
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Objective The objective of this study was to investigate the epidemiological characteristics of disease caused by enterovirus type 71.Methods A total of 10 158 children aged between 6 and 35 months,were recruited from 7 sites where EV71 inactivated vaccine phase 3 clinical trial was carded out.All the subjects were followed up to one year to investigate the epidemiological characteristics of the disease caused by EV71.Results The accumulate incidence density of disease caused by EV71 was 15.17/1 000 person-year.Of all the cases,hand,foot and mouth disease (HFMD),herpangina,respiratory system diseases,digestive system diseases and other diseases accounted for 82.00％,2.67％,13.33％,1.33％ and 0.67％,respectively.The difference of the incidence density between boys and girls showed no statistical significance.Majority of the patients were between 12 and 23 months of age,which accounted for 58.67％ of the total patients.The differences of incidence density between different months of age were statistically significant (x2=7.789,P=0.020).The peak incidence density of disease caused by EV71 occurred from April to June.Nine cases showed severe symptoms or signs that accounted for 6.00％ of all the cases.All severe cases were identified as HFMD,of which 7 were boys and 2 were girls.The number of severe cases in different months of age appeared to be 1,7,and 1,all occurred between April and June.The median courses of HFMD cases and non-HFMD cases were 9 and 6 days,with difference statistically significant (Z=-4.000,P＜0.001).Median of excretion cycle for HFMD and non-HFMD cases were 9 and 11 days respectively.But with no statistically significant difference between the two.Conclusion Majority of the disease that caused by EV71 appeared as HFMD.Most of them were younger children and with seasonal variation.
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<p><b>OBJECTIVE</b>To analyze the dynamic pattern and the distributive characteristics of neutralizing antibody against enterovirus 71 (EV-A71 ) in children aged 6-35 months in Jiangsu province from 2012 to 2014.</p><p><b>METHODS</b>From March, 2012 to March, 2014, a total of 1 276 children aged between 6 and 35 months were regularly followed up on day 0, year 1 and year 2 for EV-A71 neutralizing antibody test based on the enterovirus surveillance system, with the method of reporting by their guardian or being visited in Ganyu Sheyang Taixing Donghai Pizhou and Baoying in Jiangsu province. At the same time, samples were taken from the suspected persons infected by enterovirus. The χ(2) test or variance analysis was used to compare the difference of the positive rates and the geometric mean titer(GMT) of EV-A71 neutralizing antibody in different subjects.</p><p><b>RESULTS</b>In 2 years follow-up, the positive rates of EV-A71 antibody increased as the growth of the age,and the positive rates on day 0, year 1 and year 2 were 22.57% (288/1 276), 37.72%(444/1 177) and 42.84%(422/985), respectively (χ(2) values were 39.33, 56.41, 32.25; P< 0.001).The GMTs were 9.95, 15.37 and 24.05, respectively (F values were 22.90,46.36,41.58;P<0.001). In 2 years, the annually new infection rates were 13.47%(158/1 173) and 20.73%(192/926),respectively, and the annually decay rates of EV-A71 antibody were 2.81%(33/1 173) and 8.10%(75/926).</p><p><b>CONCLUSIONS</b>In 2012 to 2014, the positive rates and the GMTs of EV-A71 antibody of children increased as the growth of the age in Jiangsu. The higher annually new infection rate was in children aged 3 to 4 years. The EV-A71 neutralizing antibody level could maintain at least two years after natural infection.</p>
Subject(s)
Child, Preschool , Humans , Infant , Antibodies, Neutralizing , Blood , Antibodies, Viral , Blood , China , Epidemiology , Enterovirus A, Human , Enterovirus Infections , Blood , Seroepidemiologic StudiesABSTRACT
An immunological surrogate endpoints is a vaccine-induced immune response (either humoral or cellular immune) that predicts protection against clinical endpoints (infection or disease), and can be used to evaluate vaccine efficacy in clinical vaccine trials. Compared with field efficacy trials observing clinical endpoints, immunological vaccine trials could reduce the sample size or shorten the duration of a trial, which promote the license and development of new candidate vaccines. For these reasons, establishing immunological surrogate endpoints is one of 14 Grand Challenges of Global Health of the National Institutes of Health (NIH) and the Bill and Melinda Gates Foundation. From two parts of definition and statistical methods for evaluation of surrogate endpoints, this review provides a more comprehensive description.
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Humans , Biomarkers , Clinical Trials as Topic , Data Interpretation, Statistical , Research Design , Treatment Outcome , Vaccines , Allergy and ImmunologyABSTRACT
@#Objective To apply Canadian Occupational Performance Measure (COPM) on the patients injured in Sichuan Earthquake. Methods COPM was applied to evaluate 51 patients in hospital before and 1 months after treatment. The first evaluation confirmed the problems on occupational activities for them. Then the plan was made to solve the problems. The second evaluation was to assess the effect of the treatment.Results The problem of self-care activity is more than that of productive activities and leisure activities(P<0.01). Total scores of performance of occupational activity and satisfaction improved(P<0.01, P<0.01)Conclusion COPM is helpful to confirm the problems of occupational activities and contribute to develope the primary goals for rehabilitation and treatment programs.