Quantitative analysis of immune responses to hepatitis B vaccination in children in Hangzhou and discussion on age of booster immunization / 中华实用儿科临床杂志

Objective:To investigate the appropriate age for booster doses of hepatitis B vaccine in children aged 0-14.Methods:Retrospective study.A total of 3 118 children aged 0-14 years who underwent quantitative serological marker testing for hepatitis B virus at the Affiliated Hospital of Hangzhou Normal University from January 2015 to October 2021 were recruited in this analysis.There were 1 702 males and 1 416 females, with a male to female ratio of 1.20∶1.00.Children were divided into 15 groups according to their age, and the classifying interval was 1 year.The hepatitis B virus surface antibody (Anti-HBs) titer was quantified by chemiluminescent microparticle immunoassay.The Anti-HBs positivity rates and hepatitis B immune response among groups of different sexes and age were compared by the chi- square test and rank- sum test, respectively. Results:A total of 3 118 children were investigated.The titer and effective response rate of Anti-HBs decreased gradually with age.The difference in the titer and effective response rate of Anti-HBs was statistically significant among groups of different age (all P<0.01), but not significant between males and females (all P>0.05). The median titer of Anti-HBs in children aged above 3 years was 58.49 IU/L(0-1 001.00 IU/L). About 59.1% (1 477/2 497 cases) of children aged 3 years and above had no immune response or low immune response (i.e., the titer of Anti-HBs was below 100 IU/L). Conclusions:The immune protective effect of the hepatitis B vaccine decreases year by year in children who have received the standardized vaccine, and the vaccine has poor protective effect on most children aged 3 years and above.Therefore, booster dose vaccination for preventing hepatitis B is necessary for children aged 3 and above.

Influence of Addition and Subtraction Therapy of Guyinjian to Ovarian Reserve Function for Patients with Poor Ovarian Response with Kidney Yin Deficiency Syndrome / 中国实验方剂学杂志

Objective:To observe the effect of addition and subtraction therapy of Guyinjian on oocyte quality, pregnancy outcome and ovarian reserve function in patients with poor ovarian response (POR) with kidney Yin deficiency syndrome. Method:Ninety patients were randomly divided into control group (45 cases) and observation group (45 cases) by random number table. The patients in both groups got antagonist. Based on such treatment, the patients in observation received additional addition and subtraction therapy of Guyinjian. The using time and amount of gonadotropin (Gn), ovum taking cycle, cycle canceling rate, fertilization rate, available embryo rate, quality embryo rate, ovulation cycle clinical pregnancy rate were recorded. Levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), serum estradiol (E2) and endometrial thickness, anti mullerian hormone (AMH), resistance index (RI), pulsation index (PI), end diastolic velocity (EDV) and peak systolic velocity (PSV) were detected. Ratio of PSV/EDV (S/D) was calculated, and scores of kidney yin deficiency syndrome were graded before and after treatment. Result:Total amount of Gn in observation group was less than that in control group (PP2 were higher than those in control group (PPPχ2=5.124, Pχ2=5.767, PPPPPConclusion:Addition and subtraction therapy of Guyinjian can increase ovarian blood supply, improve high ovarian reserve function, reduce Gn consumption, increase number of acquired eggs, alleviate symptoms of kidney yin deficiency, and can ameliorate ovarian responsiveness and pregnancy outcome.

Hypersensitivity to ticagrelor and low response to clopidogrel: a case report

Ticagrelor is widely used to treat acute coronary syndrome. Hypersensitivity reaction of ticagrelor is rarely recognized. A low response to clopidogrel, which occurs in up to 23% of patients, is an independent risk factor for stent thrombosis. Management of patients with a low response to clopidogrel and ticagrelor hypersensitivity who are undergoing antithrombotic therapy remains to be a challenge. Herein, we report a patient with low response to clopidogrel and ticagrelor hypersensitivity, who was successfully managed using aspirin and warfarin.

Influencing factors for non/low-response to hepatitis-B vaccine in infants of HBsAg positive mothers / 中华流行病学杂志

Objective To investigate the influencing factors for non/low-response to hepatitis B vaccine in infants of HBsAg-positive mothers.Methods A total of 286 HBsAg-positive pregnant women and their infants were recruited from the Third People's Hospital of Taiyuan during July 2011 to January 2013.The infants were immunized with hepatitis B vaccine according to the 0-1-6 month vaccination schedule and followed up for 12 months.The serum HBV DNA level of mothers,neonates and infants were detected by electro chemilum inescence immunoassay kits and fluorescene quantiative polymerase chain rection.Results Among 286 infants,the rate of non/low-response to hepatitis B vaccine was 18.53％ (53/286).Non-conditional logistic regression analysis indicated that the mother's HBV DNA level ≥ 1 × 107 copies/ml (0R=2.592,95％CI:1.121-5.996) and natural birth (OR=1.932,95％CI:1.021-3.654) were the risk factors for non/low-response to hepatitis B vaccine,the risks were 2.592 times and 1.932 times higher compared with the infants whose mothers were HBV DNA negative and the infants whose mothers had cesarean delivery.There was no multiplicative or additive interaction between high HBV DNA load and natural birth (OR=1.055,95％CI:0.209-5.321),(RERI=1.617,95％CI:-4.038-7.272;AP=0.364,95％CI:-).527-1.225;SI=1.195,95％CI:0.270-13.135).After stratified analysis of mother's HBV DNA level,delivery mode of mothers was not associated with non/low-response of their infants.Conclusion The mother's load of HBV DNA ≥ 1 × 107 copies/ml might be the factor for non/low-response to hepatitis B vaccine in infants of HBsAg positive mothers.

Influencing factors for non/low-response to hepatitis-B vaccine in infants of HBsAg positive mothers / 中华流行病学杂志

Objective To investigate the influencing factors for non/low-response to hepatitis B vaccine in infants of HBsAg-positive mothers.Methods A total of 286 HBsAg-positive pregnant women and their infants were recruited from the Third People's Hospital of Taiyuan during July 2011 to January 2013.The infants were immunized with hepatitis B vaccine according to the 0-1-6 month vaccination schedule and followed up for 12 months.The serum HBV DNA level of mothers,neonates and infants were detected by electro chemilum inescence immunoassay kits and fluorescene quantiative polymerase chain rection.Results Among 286 infants,the rate of non/low-response to hepatitis B vaccine was 18.53％ (53/286).Non-conditional logistic regression analysis indicated that the mother's HBV DNA level ≥ 1 × 107 copies/ml (0R=2.592,95％CI:1.121-5.996) and natural birth (OR=1.932,95％CI:1.021-3.654) were the risk factors for non/low-response to hepatitis B vaccine,the risks were 2.592 times and 1.932 times higher compared with the infants whose mothers were HBV DNA negative and the infants whose mothers had cesarean delivery.There was no multiplicative or additive interaction between high HBV DNA load and natural birth (OR=1.055,95％CI:0.209-5.321),(RERI=1.617,95％CI:-4.038-7.272;AP=0.364,95％CI:-).527-1.225;SI=1.195,95％CI:0.270-13.135).After stratified analysis of mother's HBV DNA level,delivery mode of mothers was not associated with non/low-response of their infants.Conclusion The mother's load of HBV DNA ≥ 1 × 107 copies/ml might be the factor for non/low-response to hepatitis B vaccine in infants of HBsAg positive mothers.

Pantoprazole Does Not Reduce the Antiplatelet Effect of Clopidogrel: A Randomized Controlled Trial in Korea

BACKGROUND/AIMS: Concerns that proton pump inhibitors (PPIs) diminish the efficacy of clopidogrel could hamper the appropriate prescription of PPIs. We evaluated the influence of pantoprazole on the antiplatelet effect of clopidogrel compared with ranitidine, which is regarded as safe, after stratification of the population according to the presence of a cytochrome (CYP) 2C19 polymorphism in Korea. METHODS: Forty patients who underwent dual antiplatelet therapy were randomized to receive pantoprazole (n=20) or ranitidine (n=20). Platelet aggregation was evaluated by impedance aggregometry at baseline (D0) and 8 days after acid-lowering treatments (D9). CYP2C19 was genotyped by polymerase chain reaction restriction fragment length polymorphism. RESULTS: After co-treatment, the percentage of clopidogrel low-response was 11.1% (2/18) in the pantoprazole group and 10.5% (2/19) in the ranitidine group (p=0.954). The impedance values with adenosine diphosphate stimulus after acid-lowering treatments did not significantly differ between the two groups. In a multiple regression analysis, only ST-elevation myocardial infarction was marginally associated with a reduced antiplatelet effect (odds ratio, 12.07; 95% confidence interval, 0.84 to 173.78). However, pantoprazole use did not affect the antiplatelet effect after correction for the CYP2C19 polymorphism. CONCLUSIONS: This study showed that pantoprazole does not increase platelet aggregation in patients receiving dual antiplatelet therapy (ClinicalTrials.gov number: NCT02733640).

Study on immune status of patients with schistosomiasis japonica in Poyang Lake region Ⅲ Humoral and cellular immune characteristics between Schistosoma ja-ponicum high and low antibody responders / 中国血吸虫病防治杂志

Objective To explore the immune mechanism of negative results of immune tests of schistosomiasis japonica pa?tients. Methods Totally 142 schistosomiasis patients(positive stool examinations)of Poyang Lake region were tested by ELI?SA method,and the ROC curve was applied to determine the high and low response of the patients. The levels of cellular immu?nity and cytokines of high and low responders were compared. Results Totally eight schistosomiasis patients were found as low responders. Besides SWAP?IgA(t= -1.588,P > 0.1),the levels of isotype antibodies were significantly lower in the low re?sponders compared with those in the high responders(t = -14.517 to -2.866,all P 0.05)compared with those in the high responders. The differences of IFN?γ and IL?10 between the high and low responders were both not significant(t= -2.426 to 0.216,all P >0.05). Conclusions There is a significant difference between the high and low responders only in the levels of isotype antibod?ies. One of the reasons of low response in the immune tests is the much lower antibody level after the antigen?antibody compound is completely formulated.

Study on the non-and-low response and its determinants to recombinant yeast-derived hepatitis B vaccines among neonates after primary immunization in Shanghai / 中华流行病学杂志

Objective To evaluate the non-and-low response to primary immunization of recombinant yeast-derived hepatitis B vaccines (YDVs) among neonates and to probe its determinants, in Shanghai. Methods Two thousand and forty-seven infants, born during 2008-2009 in three districts of Shanghai and administered with 3 dosages of YDVs according to 0-1-6 month schedule, were selected as subjects. Anti-HBs titers were evaluated by Chemiluminescence Microparticle Immuno Assay and related information was collected from parents through questionnaires. Univariate analysis and logistic regression model were used to probe the determinants among those infants with non-and-low response. Results The max-titer of anti-HBs in 2047 subjects was 14 982.7 mIU/ml, whereas the min-titer was 0.52 mIU/ml. The GMC was 408.04 mIU/ml after primary immunization of YDVs. The proportion of infants with titers of ＜100 mIU/ml (non-and-low response) was 17％, in which the proportion with titers of ＜ 10 mIU/ml (non response)was 1.86％ and the proportion with titers of 10-99 mIU/ml (low response) was 15.14％. Data from both univariate analysis and Ordinal logistic regression suggested that gender, age, premature labor,type of vaccines, double positive for both HBsAg and HBeAg were determinants of non-and-low response for infants, with the OR value of 1.365 for male infants, 3.133 for infants with 13-18 months old, 2.824 fo r prematured infants, 4.540 for infants administered by 5 μg YDVs and 2.298 for infants whose mother was double positive for both HBsAg and HBeAg. Conclusion Male infants,infants with 13-18 months old, prematured infants, infants administered by 5 μg YDVs and infants whose mother were double positive for both HBsAg and HBeAg had comparatively worse response for YDVs, suggesting that the anti-HBs titer surveillance programs set for these infants should be strengthened.

The Prevalence of a Low Response to Aspirin and its Association with Recurrent Ischemic Cerebrovascular Events / 대한뇌혈관외과학회지

BACKGROUND: Aspirin is one of the effective antiplatelet agents with proven benefits for the prevention of ischemic stroke. However, ischemic stroke may recur in some patients despite aspirin therapy. We investigated the prevalence of laboratory assessed low-responsiveness to aspirin in patients who are treated with aspirin for secondarily preventing cerebrovascular events, and we did so by using the VerifyNow(R) Aspirin assay. METHODS: We measured the platelet function using the VerifyNow(R) test in the recurrent (RG) and no-recurrent groups (NRG) that were treated with aspirin for secondarily preventing cerebrovascular events, We analyzed the association of a low response to aspirin with the clinical ischemic events and the factors associated with a low response. RESULTS: There were 110 patients on aspirin for secondary prevention and the mean treatment duration was 17 months. The incidence of a low response to aspirin was significantly higher in the RG than that in the NRG (26.2% vs. 5.8%, respectively, p=0.03). Multivariate analysis revealed that smoking was an independent predictor of a low response to aspirin (p=0.003). CONCLUSIONS: We found that up to 26.2% of the patients with recurrent stroke are laboratory assessed aspirin low-responsive (as measured with the VerifyNow(R) Aspirin assay), despite that they are on chronic aspirin therapy. Aspirin lowresponsiveness may be associated with the clinical failure to prevent recurrent ischemic cerebrovascular diseases, and this is known as clinical aspirin low-responsiveness.