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Objective:To systematically evaluate the efficacy and safety of obinutuzumab-based regimen versus rituximab-based regimen in treatment of B-cell non-Hodgkin lymphoma (B-NHL).Methods:The Cochrane clinical controlled trials database, PubMed, Embase, American Society of Hematology meeting proceedings, American Society of Clinical Oncology annual meeting proceedings and ClinicalTrails database were searched for studies on the use of regimens containing obinutuzumab or rituximab for the treatment of B-NHL. Patients were divided into obinutuzumab group and rituximab group according to their medication status. Review Manager 5.3 software was used to compare the efficacy and safety of the two groups.Results:A total of 7 randomized controlled trials were selected, including 4 235 patients (1 430 cases of follicular lymphoma, 2 102 cases of diffuse large B-cell lymphoma, and 703 cases of other B-NHL); 2 121 cases were in the obinutuzumab group and 2 114 cases were in the rituximab group. Among 4 162 patients who could be evaluated, the objective response rate (ORR) in the obinutuzumab group was higher than that in the rituximab group [75.1% (1 565/2 083) vs. 72.7% (1 512/2 079); OR = 1.19, 95% CI 1.01-1.41, P = 0.03]. Progression-free survival (PFS) in the obinutuzumab group was better than that in the rituximab group ( HR = 0.86, 95% CI 0.75-0.99, P = 0.03). Among 3 542 patients who could be evaluated for adverse reactions, the incidence of grade 3-4 adverse reactions in the otuzumab group was higher than that in the rituximab group [61.8% (1 098/ 1 776) vs. 54.2% (958/1 766); OR = 1.50, 95% CI 1.29-1.74, P < 0.001], the incidence of grade 3-4 infusive-related adverse reactions [7.5% (158/1 776) vs. 3.1% (65/1 766); OR = 2.56, 95% CI 1.91-3.45, P < 0.001] and neutropenia [34.1% (597/1 749) vs. 29.4% (511/1 738); OR = 1.27, 95% CI 1.09-1.47, P = 0.002] in the obinutuzumab group were higher than those in the rituximab group. Conclusions:The ORR and PFS of B-NHL patients treated with obinutuzumab-based regimen are better than those treated with rituximab-based regimen, but the influence of adverse reactions should be considered when selecting the regimen.
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The over-activation of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mechanistic target of rapamcyin (mTOR) pathway is closely related to the occurrence, development and clinical prognosis of malignant tumors. Taking this signal pathway as a target can effectively inhibit tumor progression. At present, the Food and Drug Administration of the United States has approved three drugs (CAL-101, BAY80-6946, IPI-145) for the treatment of recurrent and refractory indolent non-Hodgkin lymphoma, which demonstrates significant efficacy and a manageable safety profile.
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Objective:To investigate the prognostic significance of D-dimer level in patients with diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 70 newly diagnosed DLBCL patients who were admitted to Tianjin People's Hospital from January 2015 to June 2019 were retrospectively analyzed. The optimal cut-off value of D-dimer for survival was determined according to the receiver operating characteristic (ROC) curve, and the patients were grouped. The differences of coagulation related indexes and clinicopathological features between patients with different D-dimer levels were compared. Kaplan-Meier method was used for univariate analysis of overall survival (OS), and Cox regression model was used for multivariate analysis of OS.Results:According to ROC curve, the best cut-off value of D-dimer for survival was 0.75 mg/L. The proportion of patients with different clinical staging, international prognostic index score, lactate dehydrogenase level had statistically significant differences between the D-dimer ≥0.75 mg/L group (36 cases) and <0.75 mg/L group (34 cases) (all P < 0.05). The prothrombin time of D-dimer ≥ 0.75 mg/L group and < 0.75 mg/L group were (13.5±0.9) s and (13.0±0.8) s, respectively, and the activated partial thromboplastin time were (37±5) s and (34±6) s, respectively,and the differences were statistically significant (all P < 0.05). Univariate analysis showed that the 5-year OS rates of DLBCL patients with Ann Arbor stage Ⅲ-Ⅳ, international prognostic index score > 2, lactate dehydrogenase level > 240 U/L, B symptoms, D-dimer level ≥0.75 mg/L were decreased (all P < 0.05). Multivariate Cox regression analysis showed that D-dimer ≥0.75 mg/L was an independent risk factor for OS of DLBCL patients ( HR=0.368, 95% CI 0.144-0.944, P= 0.038). Conclusion:The level of D-dimer can be used as a clinical indicator to judge the prognosis of DLBCL patients, and the prognosis of patients with high D-dimer level is poor.
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Malignant lymphoma is a common malignant tumor of the lymphatic system. In recent years, immunotherapy is a new direction in the field of lymphoma treatment after targeted therapy, radiotherapy and chemotherapy. Immune checkpoint inhibitors (ICPi) have achieved significant efficacy in Hodgkin lymphoma (HL), with an overall response rate of about 80%, which makes the clinical application of ICPi in patients with malignant lymphoma become the focus of attention. This article reviews the recent progress in the biological mechanism of programmed cell death 1 (PD-1) and cytotoxic T lymphocyte-associated antigen (CTLA-4), and the application of ICPi in the treatment of HL and non-Hodgkin lymphoma.
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The serine protease inhibitor Kazal type 1 (SPINK1) is a member of the protease inhibitor family. As SPINK1 plays an essential role in the occurrence, development and prognosis of tumors, such as ovarian cancer, pancreatic cancer, hepatocellular carcinoma, colorectal cancer and prostate cancer, the clinical application of SPINK1 as a tumor marker has been widely concerned by researchers.
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Peripheral T-cell lymphomas (PTCLs) are a group of heterogeneous diseases originating from post-thymic T-cells, with poor prognosis using traditional therapy, especially in patients with relapsed/refractory PTCLs (r/rPTCLs). In recent years, a variety of new anti-tumor drugs have emerged in the treatment of r/rPTCLs, including different types of enzyme inhibitors, monoclonal antibodies, immunomodulators and immune checkpoint inhibitors, which have been proved to be effective. The discovery and clinical application of new drugs are expected to improve the outcomes of the diseases.
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At present, there are few treatment protocols with limited efficacy for relapsed and refractory non-Hodgkin lymphoma (NHL). Histone deacetylase inhibitors (HDACi) exert anti-tumor effects by inhibiting the activation of histone deacetylase (HDAC) and regulating gene expression. HDACi alone or combined with other anti-tumor drugs have shown good efficacy in the treatment of relapsed and refractory NHL. This article reviews the progress of HDACi in the treatment of NHL.
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Hodgkin lymphoma (HL) is a kind of malignant lymphoma with a good prognosis. With the constant development of medical technology, the cure rate of HL has increased significantly. At present, the main problem is risk-adapted therapy according to the disease condition and prognosis-related factors to increase or decrease the intensity of treatment, in order to increase the cure rate and reduce the side effects, prolong the survival time and improve the quality of life of patients. This article focuses on the analysis of HL prognosis-related factors, common treatment methods for HL, and the effect of PET-CT results on the implementation of risk-adapted therapy.
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We compared the epidemiological and clinical characteristics of severe acute respiratory syndrome (SARS), pandemic (H1N1) 2009 and COVID-19 and found that COVID-19 was more contagious, more concealed in transmission, with greater infectious intensity and more severe clinical manifestations. If the COVID-19 epidemic is not effectively controlled, it will have a serious impact on human health, and even social development. Recognizing the characteristics of three diseases, especially COVID-19, and improving the disease awareness of COVID-19 will help better implement the guidelines of 'scientific prevention and treatment, precise implementation' and prevent and control COVID-19.
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Objective@#To analyze the changing epidemiological characteristics of hepatitis E cases in China, in order to promote in preventing and controlling hepatitis E.@*Methods@#Data of hepatitis E and outbreaks reported through national notifiable diseases reporting system were analyzed from 2004 to 2017, but data of Hongkong, Macau and Taiwan were not included. Data of hepatitis E were divided into three phases as 2004-2007, 2008-2011 and 2012-2017, representing eight years before, four years before and years after the postmarketing of hepatitis E vaccine. Linear regression was used for analyzing the trend of hepatitis E, improved muster method was used for analyzing the seasonal intensity.@*Results@#From 2004 to 2017, 329 519 hepatitis E cases were reported and the annual incidence were increasing from 1.27/100 000 to 2.10/100 000 (t=6.87, P<0.001). The concentrations of hepatitis E during 2004-2007, 2008-2011 and 2012-2017 were 17.43, 16.06, 11.17, respectively, with low seasonal intensity. Number of cases reported by Jiangsu, Guangdong and Zhejiang accounted for 31.54% of national cases. The incidence were lower in central (1.45/100 000) and western (1.11/100 000) region than that in eastern region (2.67/100 000), but were increasing continuously. There was an increasing trend of incidence with growing ages (t=7.85, P<0.001). The incidence was higher than 2/100 000 among cases aged ≥40, and was the highest (5.22/100 000) in the age group of 65-69 years old. Farmers, retired persons, houseworkers and unemployees accounted for 67.46% of total cases. A total of 7 outbreaks were reported, among which 3 were in nursing homes.@*Conclusion@#The incidence of hepatitis E in central and western regions were increasing continuously and the surveillance should be strengthened. There was higher risk among middle-aged population, farmers and nursing homes, so strategy for immunization among those population was in great need.
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Objective@#To analyze the occurrence features of adverse events following immunization (AEFI) of Seasonal Influenza Vaccines (InfV) used in China, 2015-2018 influenza season.@*Methods@#InfV (including concurrent administered with other vaccines) AEFI data were collected through the Chinese national AEFI information system during 2015.9.1-2018.8.31 (excluding Chinese Hong Kong, Macao and Taiwan data). The vaccine lot release data were collected from National Institutes for Food and Drug Control published database. Time periods of three influenza season were 2015.9.1-2016.8.31, 2016.9.1-2017.8.31, 2017.9.1-2018.8.31. The vaccines used and included in this analysis were trivalent inactivated influenza vaccine (IIV3)-Split, IIV3-Split (Children) and IIV-subnit. The incidence of AEFI were calculated (per 100 000 release doses), and epidemiological characteristic were analyzed using descriptive methodology.@*Results@#A total of 8 464 InfV AEFIs were collected in 2015-2018 influenza season from National AEFI Information System, in which 5 646 were IIV3-split, with the rate of 10.64/100 000 release doses, 2 818 were IIV3-split (Children), with the rate of 9.355/100 000 release doses. The most common symptom was fever (axillary temperature ≥37.1 ℃) within vaccine reactions, with a number of 6 207 cases. In which, there were 3 554 cases with fever (axillary temperature ≥38.6 ℃) and the estimated reporting rate was 4.274/100 000 release doses. In all rare vaccine reactions, the most common diagnosis was anaphylactic rash(442, 0.531/100 000 release doses) and angioedema (70, 0.084/100 000 release doses). Even the rates of serious rare vaccine reactions were low, febrile Convulsion (27, 0.032/100 000 release doses) and Henoch-Schönlein Purpura(HSP) (21, 0.025/100 000 release doses) were relatively common in serious rare vaccine reactions during the study period.@*Conclusion@#The estimated rate of rare vaccine reactions related toInfV was relatively low. In all vaccine reactions, fever was the most common symptoms. The most common diagnosis of non-serious rare vaccine reaction were anaphylactic rash and angioedema. The incidence of serious rare vaccine reactions was low.
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Objective: To investigate the prognostic value of prognostic nutritional index (PNI) in patients with diffuse large B-cell lym-phoma (DLBCL). Methods: We retrospectively reviewed the medical records of 82 patients with DLBCL treated at Tianjin Union Medi-cal Center between June 2010 and June 2016. The optimal cutoff value of PNI was determined using a receiver operating characteristic (ROC) curve and the Youden index. The relationship of high and low PNI with the clinical characteristics of the patients, therapeutic ef-ficacy, and prognosis were analyzed. Results: Overall, mean PNI of the patients was 46.17±8.8. When the PNI was 44.15, the Youden in-dex was found to be maximal, with a sensitivity of 74.6% and specificity of 67.2%. There were 38 patients (46.3%) in the low PNI group (<44.15) and 44 patients (53.7%) in the high PNI group (≥44.15). Data analysis showed that PNI was correlated with Eastern Coopera-tive Oncology Group performance status (ECOG PS), Ann Arbor stage, international prognostic index (IPI) score, and lactic acid dehydro-genase (LDH) level (P<0.05). The total effective rate of the low PNI group was significantly lower than that of the high PNI group (65.8% vs. 86.4%; χ2=4.848; P=0.028). The 3-year overall survival (OS) rate of the entire group of patients was 69.1%. The 1-, 2-, and 3-year OS rates of the low PNI group (86.8%, 67.8%, and 56.9%, respectively) were significantly lower than that of the high PNI group (96.7%, 89.5%, and 80.2%, respectively; χ2=9.421, P=0.002). Univariate analysis showed that PNI<44.15, ECOG PS≥2, IPI>2, stageⅢ/Ⅳ, and lymphocyte count<1.0×109/L had a significant impact on predicting OS (P<0.05). Multivariate analysis showed that PNI<44.15 (P=0.006) and stageⅢ/Ⅳ(P=0.011) were independent factors for predicting OS. Conclusions: PNI might be used as a simple and feasible clinical prognostic indicator in patients with DLBCL.
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Objective To explore the prognostic value of peripheral blood absolute lymphocyte count (ALC) for patients with peripheral T-cell lymphoma,not otherwise specified (PTCL-NOS).Methods The clinical data of 69 patients with PTCL-NOS treated in Tianjin Union Medical Center from January 2008 to January 2016 were analyzed retrospectively.The relationship between different levels of ALC and clinical characteristics,therapeutic efficacy and prognosis was analyzed.Results Among 69 patients,23 cases (33.3％) had low ALC (＜1.0×109/L),and 46 cases (66.7％) had high ALC (≥ 1.0×109/L).Compared with the high ALC group,the low ALC group showed the higher International Prognostic Index (IPI) and PTCL-NOS Prognostic Index (PIT) scores,advanced clinical stage and higher lactate dehydrogenase level (all P ＜ 0.05).The total efficacy rate in the low ALC group was lower than that in the high ALC group [56.5％ (13/23) vs.67.4％ (31/46)],but the difference was not statistically significant (x2 =0.784,P =0.376).The 3-year survival rate in the low ALC group was significantly lower than that in the high ALC group,and the difference was statistically significant (40.5％ vs.68.6％,x2 =7.846,P =0.010).Univariate analysis showed that the US Eastern Cooperative Oncology Group performance status score ≥ 2,IPI score ≥2,Ann Arbor stage Ⅲ-Ⅳ and ALC＜1.0×109/L were the poor prognostic factors (all P ＜ 0.05),while Cox multivariate analysis showed that the Ann Arbor stage Ⅲ-Ⅳ and ALC＜1.0×109/L were the independent risk factors for prognosis of patients with PTCL-NOS (P =0.008,P =0.029).Conclusion The decrease of peripheral blood ALC in patients with PTCL-NOS at the initial diagnosis suggests a poor prognosis,and ALC can be used as a new indicator for prognosis evaluation of PTCL-NOS patients.
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Objective@#To analyze the effect and adverse reactions of radiotherapy in patients with primary orbital lymphoma.@*Methods@#A total of 28 patients with primary orbital lymphoma from Tianjin Union Medical Center, the First Central Hospital of Tianjin and Tianjin Dagang Oil Company Hospital between March 2006 and August 2012 were retrospectively analyzed. All the patients received orbital tumor dissection or biopsy, then received radiation therapy. Three patients received chemotherapy with CHOP protocol before radiotherapy. Radiotherapy was delivered routinely with 3D-conformal radiation therapy (CRT) technique with daily 2-2.5 Gy for 5 times per week and 3-5 fields. Total dosage was 20-50 Gy. There were 18 cases of 30 Gy, 1 case of 22 Gy, 1 case of 25 Gy, 1 case of 20 Gy, 1 case of 28.8 Gy, 3 cases of 40 Gy, 1 case of 42 Gy, 1 case of 46 Gy and 1 case of 50 Gy.@*Results@#All the patients had complete remission (CR) after radiotherapy during follow-up. One patient recurred after radiotherapy of 4 months and received CR with radiotherapy again. One patient died of lung infiltration. Acute complications during radiotherapy were conjunctivitis (28 cases, 100.0%) and keratitis (1 case, 3.6%), long-term complications with ophthalmoxerosis (10 cases, 35.7%) and decreased visual acuity (1 case, 3.6%).@*Conclusion@#Radiotherapy is an effective method for primary orbital lymphoma, and the adverse reactions can be tolerated for most patients.
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Objective To evaluate the efficacy and safety of neurokinin1 (NK1) receptor antagonist aprepitant combined with prednisone and tropisetron in prevention of nausea and vomiting (CINV) induced by R-CHOP or CHOP regimen. Methods A total of 90 patients with diffuse large B-cell lymphoma (DLBCL) who accepted R-CHOP or CHOP regimen in the People''s Hospital of Tianjin from October 2015 to January 2016 were divided into aprepitant group (45 cases) and the control group (45 cases) according to the random number table. In aprepitant group, day 1: aprepitant 125 mg 1 h before chemotherapy, prednison 100 mg, tropisetron 10 mg, and tropisetron 5 mg 2 hours after chemotherapy;day 2-3:aprepitant 80 mg and prednison 100 mg, tropisetron 10 mg; day 4-5: prednison 100 mg. In the control group, day 1: prednison 100 mg 1 h before chemotherapy, tropisetron 10 mg, and tropisetron 5 mg 2 h after chemotherapy; days 2-3: prednison 100 mg, tropisetron 10 mg; day 4-5: prednison 100 mg. Data on nausea, vomiting and remission treatment were collected every day. The complete remission (CR) rates of CINV without vomiting and remission drugs in the whole cycle were recorded. Functional living index-emesis questionnaire (FILE) was used to assess the effect of CINV on the life quality of the patients. Results CR in aprepitant group was higher than that in the control group (77.8 ％ vs. 55.6 ％, χ2= 5.000, P= 0.025). The rate of no vomiting in aprepitant regimen was higher than that in the control regimen (82.2 ％ vs. 62.2 ％, χ2 = 4.486, P= 0.034). The average scores of FILE between the two groups were (113 ±10) and (100 ±11) scores respectively, and there was a significant difference (t=12.437, P<0.001). The related adverse reactions of vomiting-stopping drugs in both groups had no statistical difference. Conclusion The aprepitant combined with tropisetron and prednisone can improve effectively nausea and vomiting induced by R-CHOP or CHOP chemotherapy regimen for DLBCL patients.
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Objective Through analyzing the epidemiological characteristics of hepatitis A and E and the situation of vaccination,to promote the recommendation profile on Hepatitis E vaccination program,in China.Methods Three phases of time span were divided as 2004-2007,2008-2011 and 2012-2015,with age groups divided as ＜20,20-29,30-39 and ≥40.Incidence rates in both different phases and age groups were compared.Numbers of Hepatitis A and E vaccines released and used,were described.Results Between 2004 and 2015,a declining trend in the reported incidence of hepatitis A (t=-12.15,P＜0.001),but an increasing trend in hepatitis E (t=6.63,P＜0.00l) were noticed.The mean number of hepatitis A cases declined from 6 515 to 1 986 between 2004 and 2007 while the number of hepatitis E cases increased from 1 491 to 2 277 between 2012 and 2015.The peaks of hepatitis E appeared persistent annually,in March.The incidence of hepatitis A declined in three regions,with the western region (3.46/100 000) much higher than the eastern (1.13/100 000) or central regions (1.14/100 000) (x2=32 630,P＜0.01).The incidence of hepatitis E increased both in the central (1.74/100 000) and western regions (1.58/100 000),but more in the eastern region (2.66/100 000) (x2=6 009,P ＜ 0.01).Incidence of hepatitis A declined in all age groups and declined by 84.36％ among the 0-19 group.However,the incidence of hepatitis E showed an increasing trend among the ≥20 group.Incidence rates appeared higher in the older age groups.The coverage of hepatitis A vaccine increased from 62.05％ to 93.54％,but with a negative association seen between the coverage of Hepatitis A vaccine and the incidence (F=10.69,x2＜0.05).Conclusion The incidence of Hepatitis A declined sharply in China while hepatitis E was still increasing from 2004to 2015,calling for the expansion on the coverage of Hepatitis E vaccine in the whole population.
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Objective Through analyzing the epidemiological characteristics of hepatitis A and E and the situation of vaccination,to promote the recommendation profile on Hepatitis E vaccination program,in China.Methods Three phases of time span were divided as 2004-2007,2008-2011 and 2012-2015,with age groups divided as ＜20,20-29,30-39 and ≥40.Incidence rates in both different phases and age groups were compared.Numbers of Hepatitis A and E vaccines released and used,were described.Results Between 2004 and 2015,a declining trend in the reported incidence of hepatitis A (t=-12.15,P＜0.001),but an increasing trend in hepatitis E (t=6.63,P＜0.00l) were noticed.The mean number of hepatitis A cases declined from 6 515 to 1 986 between 2004 and 2007 while the number of hepatitis E cases increased from 1 491 to 2 277 between 2012 and 2015.The peaks of hepatitis E appeared persistent annually,in March.The incidence of hepatitis A declined in three regions,with the western region (3.46/100 000) much higher than the eastern (1.13/100 000) or central regions (1.14/100 000) (x2=32 630,P＜0.01).The incidence of hepatitis E increased both in the central (1.74/100 000) and western regions (1.58/100 000),but more in the eastern region (2.66/100 000) (x2=6 009,P ＜ 0.01).Incidence of hepatitis A declined in all age groups and declined by 84.36％ among the 0-19 group.However,the incidence of hepatitis E showed an increasing trend among the ≥20 group.Incidence rates appeared higher in the older age groups.The coverage of hepatitis A vaccine increased from 62.05％ to 93.54％,but with a negative association seen between the coverage of Hepatitis A vaccine and the incidence (F=10.69,x2＜0.05).Conclusion The incidence of Hepatitis A declined sharply in China while hepatitis E was still increasing from 2004to 2015,calling for the expansion on the coverage of Hepatitis E vaccine in the whole population.
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Objective To investigate the malignant biological behavior and mechanism of LncRNA TCF7 in lung cancer cells by regulating miR-29 and activating JAK/STAT2 signaling pathway.Methods qPCR was used to detect the expression of TCF7 and miR-29 in lung cancer tissues and different lung cancer cell lines.The relationship between TCF7 and clinicopathological data of lung cancer patients was analyzed.The dual luciferase reporter assay was used to detect the interaction between TCF7 and miR-29.MTT proliferation assay and Transwell invasion assay was used to detect the proliferation and invasion of lung cancer cells after inhibition of TCF7,respectively,and to analyze the relevant recovery after the overexpression of miR-29.The expression of JAK/STAT2 signaling pathway protein was detected by Western Blotting after TCF7 inhibition.The effect of TCF7 on tumor formation in vivo was detected by in vitro tumor formation assay in nude mice.Results Compared with other lung cancer cell lines,A549 cells had the highest expression of TCF7 and miR-29.The expression of TCF7 was associated with the pathological stage of lung cancer and lymph node metastasis,in which TCF7 was positively correlated with cancer stage and lymph node metastasis.The dual luciferase assay confirmed that TCF7 can specifically bind to the target of miR-29,and regulate the expression and activity of miR-29.The inhibition of the expression of TCF7 can promote the proliferation and invasion of lung cancer cells.After inhibiting the expression level of miR-29,the proliferation and invasion ability of lung cancer cells were partly restored.After inhibiting the expression of TCF7,JAK/STAT2 signaling pathway was activated accordingly.Compared with the non-small carcinoma group,the average tumor volume and mass of the transplanted tumor in the TCF7-siRNA group were reduced.Conclusions TCF7 can regulate the expression of miR-29 and affect the proliferation and invasion of lung cancer cells through JAK/STAT2 signaling pathway.
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Objective@#To analyze the epidemiological characteristics of hepatitis A cases in China from 2004 to 2015.@*Methods@#Data of hepatitis A were reported through national notifiable disease information reporting system, which covered the 31 provinces (Hong Kong, Macau and Taiwan excluded). The inclusion criteria was: date of illness onset was between January 1st 2004 and December 31st 2015, the status of reported card was confirmed, the case was classified as laboratory confirmed or clinical diagnosed, the disease was Hepatitis A. The information such as sex, date of birth, date of illness onset, place of residence was collected. The data was divided into three phases, 2004-2007, 2008-2011, 2012-2015, which represented the phase before expanded program on immunization (EPI), first 4 years after EPI, second 4 years after EPI.@*Results@#From 2004 to 2015, there were totally 574 697 hepatitis A cases in China, the mean annual incidence was 3.62/100 000. The risk ratio of hepatitis A in 2015 was 0.23 when compared with 2004. Sichuan, Xinjiang and Yunnan contributed to 27.27% of the total cases in China. In 2012-2015, the incidence of western (3.46/100 000) region was significantly higher than that in central (1.21/100 000) and eastern (1.08/100 000) regions. From 2004-2015, number of cases in each age group declined greatly, with number of cases declining from 43 711 to 5 938 in the age group of 5-9 years, from 29 722 to 3 438 in 10-14, from 23 212 to 3 646 in 15-19. The number of cases declined from 24 079 to 10 304 in the age group of 0-4 (declined by 57.21%), but in 2012-2015, the incidence of 0-4 age group was still the highest, with 77.72% cases in Xinjiang and Sichuan. Famers, students and scattered children accounted for 69.95% of total cases, with student cases declined from 24.08% (2004-2007) to 8.67% (2012-2015).@*Conclusion@#The incidence of hepatitis A in China is decreasing year by year, the risk has been decreasing to a relatively low level. However, in western regions and children under age five, the risk is still high. Precision intervention is needed for further prevention and control of hepatitis A.
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Objective@#To evaluate the effect of hepatitis B prevention and control by comparative analysis on the results of HBsAg, anti-HBs and anti-HBc prevalence from national hepatitis B seroepidemiological surveys in 1992 and 2014 in different epidemic regions of China.@*Methods@#Data was from the national seroepidemiological surveys of hepatitis B conducted in 1992 and 2014. The survey in 1992 was conducted in 145 disease surveillance points of 30 provinces (excluding Hong Kong, Macao Special Administrative Region and Taiwan province) in China. The survey in 2016 was conducted in 160 disease surveillance points of 31 provinces (excluding Hong Kong, Macao Special Administrative Region and Taiwan province) in China. In the two surveys, face-to-face interviews with the subject by door to door or on the investigation site were conducted by trained staff using standard questionnaires to obtain basic information including birth date, gender, ethnicity, resident place and so on. And then 5 ml venous blood was collected to test the sero-markers of HBsAg, anti-HBs and anti-HBc. We analyzed unweighted point prevalence and 95% CI of HBsAg, anti-HBs and anti-HBc in 1992 which had no design weighting, and analyzed weighted point prevalence and 95%CI of HBsAg, anti-HBs and anti-HBc in 2014 which had design weighting.@*Results@#34 291 and 31 713 people aged 1-29 years were involved in 1992 and 2014 national serosurveys of China, respectively. For the people aged 1-29 years, HBsAg prevalence was 2.64% (95%CI: 2.28%-3.06%) in 2014 and decreased by 73.92% as compared with the rate 10.13% (95% CI: 9.81%-10.45%) in 1992. Anti-HBc prevalence was 13.01% (95%CI: 12.09%-14.00%) in 2014 and decreased by 71.61% as compared with the rate 45.84% (95% CI: 45.31%-46.37%) in 1992. Anti-HBs prevalence was 57.79% (95%CI: 56.33%-59.25%) in 2014 and ascended by 127.41% as compared with the rate 25.41% (95% CI: 24.95%-25.87%) in 1992. In high, medium and low epidemic region, for the people who born during 1992-2001 when hepatitis B vaccine was introduced in routine immunization management, HBsAg prevalence was 4.74% (95%CI: 3.79%-5.69%), 1.59% (95%CI: 1.09%-2.10%) and 2.53% (95%CI: 1.66%-3.39%), respectively, and anti-HBs prevalence was 64.25% (95% CI: 62.11%-66.39%), 56.34% (95% CI: 54.50%-58.57%), 54.49% (95%CI: 51.75%-57.23%), respectively, and anti-HBc prevalence was 15.16% (95%CI: 13.56%-16.76%), 11.07% (95%CI: 9.80%-12.33%), 7.61% (95%CI: 6.15%-9.07%), respectively. In high, medium and low epidemic region, for the people who born during 2002-2013 the duration which hepatitis B vaccine was integrated in expanded immunization program born during when HBsAg prevalence was 0.88% (95%CI: 0.66%-1.11%), 0.37% (95%CI: 0.24%-0.49%)and 0.71% (95%CI: 0.48%-0.94%), respectively, and anti-HBs prevalence was 60.74% (95%CI: 59.57%-61.90%), 59.46% (95%CI: 58.44%-60.49%), 52.56% (95% CI: 51.20%-53.92%), respectively, and anti-HBc prevalence was 3.30% (95% CI: 2.87%-3.72%), 1.91% (95%CI: 1.63%-2.20%), 2.25% (95%CI: 1.85%-2.66%), respectively.@*Conclusion@#China had made great achievement in hepatitis B prevention and control. HBsAg prevalence among people aged 1-29 years old in 2014 decreased dramatically as compared with that in 1992. Since hepatitis B vaccine was integrated into expanded immunization program, China reduced HBsAg prevalence to less than 1% among people aged 1-12 years in 2014 in different epidemic region.