Anti-HBs persistence after revaccination with three doses of hepatitis B vaccines among non-responsive adults: 24-month of follow-up / 中华预防医学杂志

<p><b>OBJECTIVE</b>To access the antibody persistence 24-month after revaccination with 3-dose of hepatitis B vaccine (HepB) among non-response adults.</p><p><b>METHODS</b>A total of 24 237 healthy adults who had no histories of hepatitis B infection and hepatitis B vaccination, resided in the local area for more than six months and were aged 18-49 years were selected from 79 villages of Zhangqiu county, Shandong province, China in 2009. Blood samples were obtained and hepatitis B surface antigen (HBsAg), antibody against hepatitis B surface antigen (anti-HBs) and antibody against hepatitis B core antigen (anti-HBc) were detected using ELISA method. A total of 11 590 persons who were negative for all of these indicators were divided into four groups by cluster sampling methods. Each group was vaccinated with one of the following four types of HepB at 0-, 1-, 6-months schedule: 20 µg HepB derived in Saccharomyces Cerevisiae (HepB-SC), 20 µg HepB derived in Chinese hamster ovary cell (HepB-CHO), 10 µg HepB-SC and 10 µg HepB derived in Hansenula Polymorpha (HepB-HP). Blood samples were collected one month after the third dose of primary immunization and tested for anti-HBs using chemiluminescence microparticle immunoassay (CMIA). The non-responders were revaccinated with three doses of HepB at 0-, 1-, 6-months schedule and the type of HepB was the same as which was used for primary immunization. Blood samples were collected one month (T1) and two years (T24) after revaccination and anti-HBs, antibody against hepatitis B core antigen (anti-HBc) and hepatitis B surface angtigen (HBsAg) (if anti-HBs < 10 mU/ml) were detected by CMIA. χ(2) test was used to compared age, gender and body mass index (BMI) between different groups and the anti-HBs positive rate at T1 and T24; analysis of variance (ANOVA) was used to compare the geometric mean concentration (GMC) of anti-HBs between difference groups. The risk factors associated with positive rate of anti-HBs and GMC of anti-HBs were identified by multiple logistic regression analysis and multifactor linear regression model analysis respectively.</p><p><b>RESULTS</b>A total of 900 non-responders were identified and 71.7% (645/900) of them completed three-dose revaccination and blood collection after revaccination. 467 (72.4%) non-responsive adults were followed up at T24. The anti-HBs positive rate decreased from 85.65% (95% CI: 82.14%-88.71%) at T1 to 60.60% (95% CI: 56.01%-65.06%) at T24 and the corresponding GMC decreased from 175.62 (95% CI: 139.03-221.84) mU/ml to 21.43 (95% CI: 17.62-26.06) mU/ml. Multivariate analysis showed that positive rate of anti-HBs at T24 was associated with gender, HepB type for revaccination and anti-HBs level at T1, but only anti-HBs level at T1 was associated with the anti-HBs titer at T24. No subject showed HBsAg seroconversion and anti-HBc conversion rate was 3.64% (17/467) at T24.</p><p><b>CONCLUSION</b>Anti-HBs titer decreases rapidly two years after HepB revaccination among non-responsive adults, but more than half non-responderd still kept anti-HBs above protective level. The immunity durability after revaccination was associated with gender, HepB type for revaccination and anti-HBs titer one month after revaccination.</p>

Antibody persistence following booster vaccination with three doses of hepatitis B vaccines among low-response adults in Zhangqiu county of Shandong province: 24-month of follow-up from 2009 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To assess the 24-month efficacy after booster vaccination with 3 doses of hepatitis B vaccine among low-response adults in Zhangqiu county of Shandong province.</p><p><b>METHODS</b>A total of 24 237 adults aged 18-49 years old, never received HepB vaccination, without HBV infection history, and had been living at 3 towns of Zhangqiu county in Shandong province for more than half a year in september, 2009, were collected blood samples of 3-5 ml. A total of 11 590 adults who were negative for hepatitis B virus (HBV) surface antigen (HBsAg) , antibody to HBsAg (Anti-HBs) and antibody to HBV core antigen (Anti-HBc), were divided into four groups randomly and were vaccinated following the schedule of 0-1-6 with 20 µg hepatitis B vaccine made by recombinant deoxyribonucleic acid techniques in Saccharomyces cerevisiae (HepB-SC), 20 µg hepatitis B vaccine made by Chinese hamster ovary cell (HepB-CHO), 10 µg HepB-SC and 10 µg hepatitis B vaccine made by recombinant deoxyribonucleic acid techniques in Hansenula Polymorpha (HepB-HP), respectively. The adults who were low-response to the primary hepatitis B vaccination (10 mU/ml ≤ anti-HBs<100 mU/ml) were divided into four groups by cluster random sampling. These groups were revaccinated with 3-dose of above-mentioned four kinds of HepB respectively. Blood samples were drawn from 1 month (T1) and 24 month (T24) after the 3 dose revaccination, respectively. Anti-HBs and anti-HBc was detected by Chemiluminescence Microparticle Imunoassay (CMIA).</p><p><b>RESULTS</b>Out of the 8 592 adults who have accepted the primary vaccination of hepatitis B and been collected the blood samples, 1 306 subjects showed low-response. A total of 718 low-response subjects were collected blood samples after T1 and T24 following 3 doses of booster vaccination. The proportion of the four groups was 32.3% (232/718), 25.8% (185/718) , 19.3% (139/718) , 22.6% (162/718) , respectively. The average proportion of anti-HBs ≥ 100 mIU/ml were decreased from 77.58% after T1 to 35.63% after T24 (χ² = 256.87, P < 0.01). The proportion of anti-HBs ≥ 100 mIU/ml in T24 were 38.8% (90/177), 39.5% (73/185), 25.2% (35/139) and 35.8% (58/162) in four groups, respectively. The proportion of anti-HBs>100 mIU/ml in T24 was significantly different among groups (χ² = 8.81, P = 0.032). The average geometric mean concentration (GMC) was significantly reduced from 443.53 mIU/ml after T1 to 48.98 mIU/ml after T24 (F = 439.41, P < 0.01). The GMC was 60.26 (45.71-77.62), 1.29 (38.90-69.18) , 35.48 (25.70-48.98) and 46.77 (33.88-6.07) mIU/ml in four groups, respectively (F = 1.97, P = 0.117) . Compared with vaccinated 20 µg HepB-SC, the proportion of anti-HBs ≥ 100 mIU/ml and GMC was 0.56 (0.35-0.91) and -0.20 (-0.39--0.02) times. The positive of HBsAg was not found and the positive rate of anti-HBc was 2.6% (18/692) in T24.</p><p><b>CONCLUSION</b>Protective antibody following booster vaccination with three doses of hepatitis B vaccines among low-response adults after 2 years fade faster. Antibody level of anti-HBs in T24 was corrected with the booster vaccine type and age. 20 µgHepB-SC seemed better than 10 µg HepB-SC.</p>

Differential expression of adiponectin in different Chinese medicine syndrome of central obesity and its correlation with obesity character / 中华中医药杂志

Objective:to observe the differential expression of adiponectin in different Chinese medicine syndrome of central obesity and its correlation with obesity character.Methods:To establish xu and shi syndrome of central obesity groups,with normal group as control.The metabolic symptoms and adiponectin expression will be tested and be used to study their correlation with obesity character.Results:The level of adiponectin,ratio of VA/SA,and fast insulin(FIns),HOMA-IR had signifi cantly difference between the xu and shi groups(P

Basic biology research on different types of syndrome of obese type 2 diabetes / 中华中医药杂志

Objective:Combining with modern medical research progress in a number of target selections,to explore basic biology of different types of syndrome of obese type 2 diabetes.Methods:To research abnormal metabolic status from three levels of anthropometry,blood metabolism and fat factors.Results:The resistin secretion in phlegm-heat syndrome group was significant higher than that in the endogenous heat due to yin deficiency syndrome group,suggesting that resistin could be used as evidence to distinguish phlegm-heat syndrome and endogenous heat due to yin defi ciency syndrome.There was no signifi cant difference of the levels of leptin,IL-6,E-selectin,TNF-?,GLP-1,body mass index,waist-hip ratio,sugar metabolism in the target fasting blood glucose,glycosylated hemoglobin insulin,C-peptide levels,lipid metabolism in the target cholesterol,triglyceride,low-density lipoprotein,very low density lipoprotein,three renal urinary albumin excretion rate in urine,sugar protein and ?2-microglobulin,blood pressure,hematocrit,fibrinogen,C-reactive protein between the phlegm-heat syndrome group and endogenous heat due to yin deficiency syndrome group,but there was marked change tendency.Conclusion:There were differences of different types of syndrome of type 2 diabetes in basic biology from the aspect of spleen heat,and evidence of the possible differences need further study.

A discussion on preventive treatment of pre-diabetes mellitus in traditional Chinese medicine / 中华中医药杂志

Pre-disease is a condition in which characteristic symptoms are not prominent.That is to say pre-disease is lack of key proof to be diagnosed as a disease,but has common symptoms as well as signs.It is said in Inner Canon of Huangdi that "prefer prevention to treatment",which needs doctors to find unusual symptoms in early stage of diseases then take positive preventive measures to help patients regain health.Diabetes mellitus(DM) is one of the life style-related diseases which associated with unhealthy habits of human beings.Pre-diabetes mellitus mainly refers to impaired glucose tolerance(IGT).With the help of modern medical technology,doctors and patients should focus on pre-diabetes by combining TCM treatment based on syndrome differentiation and health care,in order to stop DM at early stage.