Construction of a predictive model for the incidence of pulmonary tuberculosis in Nantong based on multivariate regression / 公共卫生与预防医学

Objective To establish a prediction model for tuberculosis incidence in Nantong area by multivariate regression analysis, and to provide theoretical support for the implementation of combined prevention work in this area. Methods A total of 37 338 registered patients with pulmonary tuberculosis in Nantong City from 2010 to 2021 were enrolled in the observation group. A total of 28,721 healthy people who underwent physical examination during the same period were selected as the control group. Results From 2010 to 2021, there were a total of 37 338 cases of pulmonary tuberculosis in central Nantong. From 2010 to 2015, more than 3,000 cases were reported annually, with the largest number (4 142 cases) in 2011, accounting for 11.09% of the total. The number of cases reported from 2016 to 2021 was all less than 3 000, and the number of cases reported from 2021 was the least , 1 803 cases, accounting for 4.83% of the total. The number of cases decreased each year in the past 12 years. The incidence of pulmonary tuberculosis in males was 70.97% (26 497 cases) and that in females was 29.03% (10 841 cases). In terms of age, the lowest incidence rate was 0.06% (23 cases) in the age group of 0-9 years old, and the highest incidence rate was 19.56% (7 304 cases) in the age group of 60-69 years old. Logistics regression analysis showed that male, age ≥60 years old, occupation as a farmer and smoking history were the risk factors for pulmonary tuberculosis (P < 0.05). ROC curve results showed that the AUC value of the risk prediction model for pulmonary tuberculosis in the Nantong area was 0.872, with a predictive sensitivity of 86.32% and a specificity of 89.21%. Conclusion There are many risk factors for pulmonary tuberculosis in Nantong area, and different factors interact and influence each other. The construction of a risk prediction model for pulmonary tuberculosis can better predict the clinical incidence, which is helpful to guide clinical diagnosis and treatment.

Enlightening from optimizing post-authorization safety monitoring system of SARS-CoV-2 vaccines in major economies worldwide / 中华预防医学杂志

Ongoing global pandemic of Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has promoted the unprecedented rapid development and large-scale rolling out of different platform-based COVID-19 vaccines worldwide. How to effectively respond to the expected scale increasing adverse events after vaccination campaign of COVID-19 vaccines is a common problem faced by the world. A lot of countries and regions around the world have arranged in advance at different levels, optimizing the original vaccine safety monitoring system from the perspectives of strengthening the foundation and capabilities, promoting internal and external cooperation, upgrading methods, as well as improving transparency and public communication, which has ensured the good and efficient operation of the system and can provide reference for the construction of relevant fields in China.

Effect of Erjing Pills on alleviating neuroinflammation of AD rats based on TLR4/NF-κB/NLRP3 pathway and its mechanism / 中国中药杂志

This paper aimed to study the effect of Erjing Pills on the improvement of neuroinflammation of rats with Alzheimer's di-sease(AD) induced by the combination of D-galactose and Aβ_(25-35) and its mechanism. SD rats were randomly divided into a sham group, a model control group, a positive drug group(donepezil, 1 mg·kg~(-1)), an Erjing Pills high-dose group(9.0 g·kg~(-1)), and an Erjing Pills low-dose group(4.5 g·kg~(-1)), with 14 rats each group. To establish the rat model of AD, Erjing Pills were intragastrically administrated to rats for 5 weeks after 2 weeks of D-galactose injection. D-galactose was intraperitoneally injected into rats for 3 weeks, and then Aβ_(25-35) was injected into the bilateral hippocampus. The new object recognition test was used to evaluate the learning and memory ability of rats after 4 weeks of intragastric administration. Tissues were acquired 24 h after the last administration. The immunofluorescence method was used to detect the activation of microglia in the brain tissue of rats. The positive expressions of Aβ_(1-42) and phosphory protein Tau~(404)(p-Tau~(404)) in the CA1 area of the hippocampus were detected by immunohistochemistry. The levels of inflammatory factors interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) in the brain tissue were determined by enzyme-linked immunosorbent assay(ELISA). Toll-like receptor 4(TLR4)/nuclear factor kappa B(NF-κB)/nucleotide-binding oligomerization domain-like receptors 3(NLRP3) pathway-associated proteins in the brain tissue were determined by Western blot. The results showed that as compared with the sham group, the new object recognition index of rats in the model control group decreased significantly, the deposition of Aβ_(1-42) and p-Tau~(404) positive protein in the hippocampus increased significantly, and the levels of microglia activation increased significantly in the dentate gyrus. The levels of IL-1β, TNF-α, and IL-6 in the hippocampus of the model control group increased significantly, and the expression levels of TLR4, p-NF-κB p65/NF-κB p65, p-IκBα/IκBα, and NLRP3 proteins in the hippocampus increased significantly. Compared with the model control group, the Erjing Pill groups enhanced the new object recognition index of rats, decreased the deposition of Aβ_(1-42) and the expression of p-Tau~(404) positive protein in the hippocampus, inhibited the activation of microglia in the dentate gyrus, reduced the levels of inflammatory factors IL-1β, TNF-α, and IL-6 in the hippocampus, and down-regulated the expression levels of TLR4, p-NF-κB P65/NF-κB P65, p-IκBα/IκBα, and NLRP3 proteins in the hippocampus. In conclusion, Erjing Pills can improve the learning and memory ability of the rat model of AD presumably by improving the activation of microglia, reducing the expression levels of neuroinflammatory factors IL-1β, TNF-α, and IL-6, inhibiting the TLR4/NF-κB/NLRP3 neuroinflammation pathway, and decreasing hippocampal deposition of Aβ and expression of p-Tau, thereby restoring the hippocampal morphological structure.

Pharmacological Mechanism of Curcumae Radix in Treatment of Post-stroke Depression： A Review / 中国实验方剂学杂志

Post-stroke depression， a common mental complication after stroke， seriously affects the quality of life and even endangers the life safety of patients. It is difficult to be cured due to the complex and diverse pathogenesis. At present， the widely accepted pathogenesis mechanisms include inflammatory mechanism， neurotransmitter mechanism， and endocrine mechanism. According to the theory of Chinese medicine， Qi stagnation， blood stasis， and phlegm turbidity lead to the occurrence of mental diseases after stroke. Curcumae Radix， as a commonly used Chinese herbal medicine， can activate blood circulation for relieving pain， regulate Qi， and relieve depression. The summary of the medication rules of DENG Tie-tao， ZHANG Xue-wen and other Chinese medical physicians showcases that Curcumae Radix is frequently used in the clinical treatment of depression， stroke， and post-stroke depression. Modern pharmacological studies have demonstrated that Curcumae Radix contains β-sitosterol， curdione， curcumin and other medicinal ingredients. This study reviewed the pharmacological effects of effective components in Curcumae Radix and the pharmacological mechanism in the treatment of post-stroke depression and summarized the processing methods of Curcumae Radix， aiming to clarify the important role and determine the optimal processing method of Curcumae Radix in the treatment of post-stroke depression. The results indicate that Curcumae Radix has the effects of regulating neurotransmitters， inhibiting neuroinflammation， protecting neurons， regulating neuroendocrine and antithrombosis， which can prevent and treat post-stroke depression through multiple components， targets， and pathways. The wine-processed Curcuma longa has the best effect.

Clinical characteristics and risk factors of lower extremity arterial disease in patients with diabetic foot ulcer / 南方医科大学学报

OBJECTIVE@#To investigate the clinical characteristics of lower extremity arterial disease (LEAD) and its risk factors in patients with diabetic foot ulcer (DFU).@*METHODS@#We retrospectively collected the clinical and follow-up data of 650 patients with DFU treated in the Department of Endocrinology and Metabolism of Nanfang Hospital between January, 2017 and December, 2019. We compared the data between patients who had LEAD and those without LEAD and used a multivariate logistic regression model to analyze the risk factors of LEAD in DFU patients.@*RESULTS@#Among the 650 DFU patients, 470 (72.4%) had LEAD. The patients were followed up for a mean of 3.5 months, and the mean healing time of DFU was 2.55 months; healing of DFU occurred in 453 patients and 183 patients received amputation. The patients with LEAD and those without LEAD differed significantly in age, hospitalization costs, diastolic blood pressure (DBP), glycated hemoglobin, blood lipid levels, disease course, ankle brachial index, healing time, smoking history, clinical outcomes, Wagner grade and imaging results (P < 0.05). Multivariate logistic regression analysis identified age (OR=1.070, 95% CI: 1.049-1.091), smoking history (OR= 2.013, 95% CI: 1.268-3.195), and a decreased DBP (OR=0.980, 95% CI: 0.963-0.997) as independent risk factors for LEAD in DFU patients. A prolonged healing time was a prominent clinical feature of DFU complicated by LEAD.@*CONCLUSION@#DFU patients have a high incidence of LEAD, which leads to high rates of disability and mortality and is associated with an advanced age, high smoking rate and longer healing time. A decreased DBP is also a risk factor for LEAD in DFU patients.

Effects of sorafenib on hypoxia inducible factor-1 and vascular endothelial growth factor levels and recurrence in patients with intrahepatic cholangiocarcinoma with microvascular invasion / 中国基层医药

Objective:To investigate the effects of sorafenib on hypoxia inducible factor-1 (HIF-1) and vascular endothelial growth factor (VEGF) levels and recurrence in patients with intrahepatic cholangiocarcinoma with microvascular invasion.Methods:Ninety-two patients with intrahepatic cholangiocarcinoma who received treatment in Yiwu Central Hospital between November 2013 and November 2019 were included in this study. They were randomly assigned to undergo either conventional basic treatment (control group, n = 46) or conventional basic treatment and sorafenib treatment (study group, n = 46). Clinical efficacy, the incidence of adverse reactions and recurrence rate were compared between the two groups. Before and after treatment, HIF-1, alpha fetoprotein (AFP) and VEGF levels were also compared between the two groups. Results:After treatment, total effective rate in the study group was significantly higher than that in the control group [63.04% (29 /46) vs. 28.26% (13/46), χ2 = 11.215, P < 0.05]. After treatment, HIF-1, AFP and VEGF levels in each group were significantly lower than those before treatment (all P > 0.05). After treatment, HIF-1 [(165.23 ± 39.67) pg/mL], AFP [(109.16 ± 67.31) ng/mL] and VEGF [(297.28 ± 42.41) pg/mL] levels in the study group were significantly lower than those in the control group [(205.56 ± 40.23) pg/mL, (235.17 ± 106.41) ng/mL, (365.16 ± 40.91) pg/mL, t = 4.841, 6.788, 7.813, all P < 0.05]. There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Six-month follow-up revealed that the incidence of recurrence in the study group was significantly lower than that in the control group ( χ2 = 4.792, P < 0.05). Conclusion:Sorafenib can reduce the HIF-1, AFP and VEGF levels in patients with intrahepatic cholangiocarcinoma with microvascular invasion, improve the clinical efficacy, decrease the incidence of recurrence, but cannot increase the incidence of adverse reactions.

Association of alcohol drinking with the incident risk of type 2 diabetes among rural adult males in Deqing County， Zhejiang Province： a prospective cohort study / 上海预防医学

Objective:To investigate the association of alcohol drinking and the incident risk of type 2 diabetes in men and to provide evidences for early prevention of diabetes. Methods:Rural adult males without diabetes in Deqing County， Zhejiang Province were enrolled. A dynamic prospective cohort study was conducted. Data were collected through questionnaires， physical examination， experimental measurements and a electronic follow-up database. Cox multivariate regression was performed to assess the association of alcohol drinking and the incident risk of type 2 diabetes in men. Results:During the follow-up period （7.15±2.90 years）， 354 men developed diabetes， and the incidence rate was 4.15/1 000 person-years. After adjusting for confounding factors， the incident risk of type 2 diabetes among the men with high alcohol drinking frequency （≥7 times/week） and low single alcohol intake （0.1-19.9 g/occasion） was lower than that among non-alcohol drinkers， and the value of HR （95%CI） was 0.72 （0.56-0.94） and 0.54 （0.30-0.99）， respectively. Consumption of ≥40.0 g alcohol per occasion 3-6 times a week increased the incidence of type 2 diabetes， and consumption of <40.0 g alcohol per occasion over 7 times a week decreased the incidence of type 2 diabetes， with the value of HR （95%CI） of 1.53 （1.02-2.30） and 0.52 （0.28-0.99） respectively. Conclusion:Different alcohol drinking patterns affect the incident risk of type 2 diabetes among rural adult males in Deqing County. Further study on alcohol drinking and diabetes may have ethical and practical significance for the prevention and control of diabetes in rural China.

Prevention and control of malaria in Deqing County from 1951 to 2015 / 上海预防医学

Objective:To make a retrospective analysis on malaria epidemic history and control efforts in Deqing County from 1951 to 2015， and so as to provide a scientific basis for further consolidating the achievements after malaria elimination. Methods:Data on the epidemic， monitoring， prevention and control of malaria in Deqing from 1951 to 2015 were collected and analyzed by the method of descriptive research. Results:Totally 123 000 cases of malaria were reported in Deqing County from 1951 to 2015， and the annual average incidence was 529.61/100 000. There were 49 deaths with the mortality rate of 39.84/100 000. The epidemic peaked in 1960-1964 and reached its highest in 1963 with 21 942 cases and an incidence of 7825.25/100 000. After decades of the comprehensive prevention and control， eliminating malaria was accomplished in Deqing County in 2015. Conclusion:The prevention and control strategies/measures of malaria in different stages in Deqing County are effective. However， monitoring， health education and management for the migrant population， especial the returning workers from high-risk areas of malaria， should be further strengthened.

Thoracoscopic surgery versus traditional open surgery for infants with congenital diaphragmatic eventration: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective    To compare and analyze the treatment effect of thoracoscopic surgery and traditional open surgery on infants with congenital diaphragmatic eventration, and summarize the experience of thoracoscopic surgery in infants with congenital diaphragmatic eventration. Methods    We retrospectively analyzed the clinical data of 105 children with congenital diaphragmatic eventration who received operation in the Department of Cardiothoracic Surgery of Children’s Hospital of Chongqing Medical University from January 2010 to January 2019. The patients were divided into an open group and a thoracoscopic group according to the operation methods. There were 41 patients in the thoracoscopic group, including 30 males and 11 females, with an average of 13.42±11.08 months (range: 1 d to 3 years). There were 64 patients in the open group, including 44 males and 20 females, with an average age of 8.21±9.33 months (range: 15.0 d to 1.6 years). The operation time, intraoperative bleeding volume, postoperative mechanical ventilation time, hospital stay and other operation indexes as well as the mortality, recurrence rate and complication rate of the two groups were observed. Results    The operation indexes such as operation time, intraoperative bleeding volume, postoperative mechanical ventilation time, thoracic drainage time, CCU stay and hospital stay of the thoracoscopic group were better than those in the open group (P<0.05). There was no statistical difference between two groups in postoperative diaphgram muscles descent, postoperative feeding time or patients needing thoracic drainage (P>0.05). The incidence of postoperative complications in the thoracoscopic group (19.51%) was lower than that in the open group (23.44%, P>0.05), and the difference in mortality and recurrence rate between the two groups was not statistically significant (P>0.05). Conclusion    Both thoracoscopic diaphragmatic plication and traditional open surgery can effectively treat congenital diaphragmatic eventration, but compared with traditional open surgery, thoracoscopic diaphragmatic plication has the advantages of shorter operation time, less trauma, more rapid recovery and fewer complications, so it should be the first choice for children with congenital diaphragmatic eventration.

Clinical analysis of hormone combined with cerebral glycoside carnosine and dehydrating drugs in the treatment of traumatic optic nerve injury / 中华急诊医学杂志

Objective:To retrospectively analyze the effect of hormone combined with cerebral glycoside carnosine and dehydration drugs in traumatic optic neuropathy (TON) patients.Methods:The enrolled 215 TON patients in our hospital from February 2014 to September 2021 were randomly divided into the combination group ( n=143) and routine group ( n=142). The baseline data, visual acuity recovery before and after treatment and adverse reactions of each group were compared. Univariate analysis was conducted to analyze the differences in indicators of good prognosis and visual acuity improvement between the two groups. Results:The effective rate of vision recovery in the combination group was significantly increased than that in the routine group ( P<0.05). After treatment, the intraocular pressure and visual field defect in the combination group were significantly decreased than those in the routine group ( P<0.05). Univariate subgroup analysis showed that there were statistically significant differences between TON patients with age ≤40 years, residual light sensation after injury, visit time ≤24 h, and VEP not extinguished with combined treatment of hormone, brain glycoside carnotin and dehydrating drugs and the routine group ( P<0.05). Univariate subgroup analysis showed that TON patients with optic canal fracture without optic nerve swelling and tortuosity had a good prognosis after treatment with combined hormone, cerebral glucoside carnosine and dehydration, which was statistically different from that in the routine group ( P<0.05). Conclusions:Brain glycosides carnosine and dehydration therapy on the basis of combined hormone a prednisolone sodium succinate treatment can improve vision in TON patients, lighten the optic nerve injury, will not increase the occurrence risk of adverse reactions, and have higher security. It is necessary to focus on high-risk patient over 40 years old, more than 24 h of treatment time, VEP extinction, optic nerve swelling poor efficacy. It is worthy of clinical promotion.

Clinical Characteristics and Bone Marrow Histopathology Features in Essential Thrombocythaemia Patients with Different Gene Mutation in China / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical characteristics, laboratorial and bone marrow pathological features of primary thrombocytopenia (ET) patients with different mutations of CALR, JAK2 and MPL genes.@*METHODS@#The chinical data of 120 cases of ET in Jiangsu provincial people's hospital/ The First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2017 were collected and analyzed, including 76 cases with JAK2 gene mutation, 40 cases with CALR gene mutation, 2 cases with MPL gene mutations, 2 cases without gene mutation.@*RESULTS@#Among the ET patients, compared with the JAK2 gene mutation, CALR gene mutation showed statistically significant deareament of white blood cells and hemoglobin (P=0.001, P=0.01) and the male platelets in CALR group showed significant increament (P=0.04). Fourthermore, the average number of megakaryocytes and its cluster numbers in each hight power field of vision showed statistically significant decreament in CALR group as compared with JAK2 group (P=0.001, P=0.001), and thrombotic events in CALR group were signicantly lower than those in JAK2 group (7.5% vs 18.4%) (P=0.03).@*CONCLUSION@#Mutations of CALR, JAK2 have different clinical characteristics and blood pathological changes of Chinese ET patients, and their clinical significance is worth to explore.

Effect of acupuncture on patients with cancer-related fatigue and serum levels of CRP, IL-6, TNF-α and sTNF-R1 / 中国针灸

OBJECTIVE@#To observe the therapeutic effect of acupuncture on cancer-related fatigue (CRF) and to explore its possible mechanism.@*METHODS@#A total of 80 patients with CRF were randomized into an observation group and a control group, and finally 67 patients completed the trial (36 patients in the observation group, 31 patients in the control group). Patients in the control group were treated with conventional chemoradiotherapy and symptomatic treatment, while no particular anti-fatigue intervention was adopted. On the basis of treatment in the control group, acupuncture was applied at Baihui (GV 20), Guanyuan (CV 4), Qihai (CV 6), Fengchi (GB 20), Zusanli (ST 36), Sanyinjiao (SP 6) in the observation group, once a day, 5 times as one course, with 2 days interval between each course, totally 4 courses were required. Before and after treatment, scores of functional assessment of cancer therapy-fatigue (FACT-F) in Chinese and McGill quality of life questionnaire (MQOL), serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and soluble TNF receptor-1 (sTNF-R1) were observed in the two groups.@*RESULTS@#①Compared before treatment, the FACT-F score was decreased after treatment in the observation group (<0.05), while there was no significant difference in the control group (<0.05). The change of the FACT-F score in the observation group was larger than that in the control group (<0.05). ②In the observation group, scores of physiological and psychological dimension were decreased (<0.05), score of social support dimension was increased after the treatment (<0.05). The score changes of physiological, psychological and social support dimension in the observation group were larger than those in the control group (all <0.05). ③After treatment, the serum levels of IL-6, TNF-α and sTNF-R1 were decreased in the observation group (<0.05), while the serum levels of CPR and IL-6 were increased in the control group (<0.05). The serum levels of CPR, IL-6 and TNF-α in the observation were lower than those in the control group (<0.05).@*CONCLUSION@#①Acupuncture can improve the related symptoms of depression, weakness and headache in patients with CRF, strengthen their cognition of the support from society and family, and boost the confidence in curing the disease. ②Acupuncture can effectively down-regulate serum levels of the relative inflammatory factors, which may be its possible mechanism on treating CRF.

Small-cell carcinoma of the prostate: A report of 2 cases and review of the literature / 中华男科学杂志

Objective@#To investigate the clinicopathological characteristics and improve the clinical treatment of prostatic small-cell carcinoma (PSCC).@*METHODS@#We reported 2 cases of PSCC derived from prostate cancer after treated by androgen blockade and prostate electrotomy and reviewed the relevant literature.@*RESULTS@#Two patients with PSA elevation were diagnosed with prostate cancer by prostatic puncture biopsy and treated by maximum androgen blockade, which reduced their total PSA to the normal level. Later, due to difficult urination, they both underwent prostate electrotomy, followed by chemotherapy or radiotherapy for PSCC confirmed by postoperative pathology. Nevertheless, they died at 8 to 9 months after the discovery of PSCC.@*CONCLUSIONS@#PSCC can derive from prostate cancer after treatment, which may be attributed to the pathological mutation induced by long-term endocrine therapy. PSCC is more malignant than prostate cancer, and its prognosis is poor.

Clinical analysis of 100 adult patients with pure red cell aplasia / 中国实用内科杂志

OBJECTIVE: To evaluate clinical characteristics and treatment response of 100 patients with pure red cell aplasia(PRCA).METHODS: We retrospectively analyzed the clinical data of 100 adult patients with acquired PRCA from October2009 to July 2019, and compared the difference in efficacy between idiopathic and secondary patients.RESULTS: 100 patients were evaluated, including 60 idiopathic patients and 40 secondary patients.The most common reasons for secondary PRCA were large granular lymphocytic leukemia(LGLL)(28 cases,70.0%)and thymoma(6 cases, 15.0%). The remission induced regimens included corticosteroids(CS), cyclosporine A(CsA), or other agents, and the response rate were 66.7%,71.4% and 50%, respectively(P=0.336). Secondary PRCA was less effective than idiopathic PRCA(52.5%,78.3%,P=0.007). PRCA related to large granular lymphocytic leukemia was also less effective compared to idiopathic PRCA(46.4%,79.3%,P=0.003). When treated by CsA, idiopathic PRCA was more effective than secondary PRCA and LGLL related PRCA(P=0.001, P=0.000). Logistic regression analysis showed that lower response rate was related to secondary PRCA and LGLL related PRCA.CONCLUSION: The response rate were similar by different induced regimens. Idiopathic PRCA could acquired better response to CsA than secondary, LGLL related PRCA was less effective to treatment.

Eltrombopag for the treatment of refractory acquired pure red cell aplasia / 中国实用内科杂志

OBJECTIVE: To investigate the efficacy of eltrombopag in the treatment of refractory acquired pure red cell aplasia(PRCA). METHODS: Three patients with refractory acquired PRCA treated in the First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital from March 2018 to May 2019 were treated with eltrombopag(75 mg/d). The clinical data were collected for evaluating efficacy and tolerance. RESULTS: The erythrocyte count(P=0.039), hemoglobin concentration(P=0.018) and reticulocyte percentage(P=0.046) in 3 patients were significantly higher than those before treatment. The platelet count was higher than that before treatment(P=0.024). The leukocyte count and absolute neutrophil count increased in 2 patients, and decreased in 1 patient, but still remained in the normal range(P=0.924; P =0.565). Total bilirubin(TBIL) and direct bilirubin(DBIL) increased in 1 case; alanine aminotransferase(ALT), aspartate aminotransferase(AST) and serum creatinine(Scr) increased in 1 case; palpitation occurred in 1 case. All the side effects were alleviated after symptomatic treatment. CONCLUSION: Eltrombopag has certain efficacy and good tolerance in the treatment of refractory acquired PRCA, which is worthy of further exploration.

Surveillance results of adverse events following immunization of enterovirus 71 inactvated vaccine / 预防医学

Objective@#To evaluate the safety of enterovirus 71（EV71）inactivated vaccines produced by Wuhan Institute of Bio Products through learning the incidence of adverse events following immunization（AEFI）in children aged 6 months to 3 years old after vaccination.@*Methods@#According to the national requirement for vaccine safety monitoring program，data of AEFI cases after inoculated EV71 vaccines from September 2017 to October 2018 in Zhejiang Province was collected by combining active and passive monitoring. Demographic characteristics，space distribution，dose and incidence of AEFI were analyzed.@*Results@#A total of 107 503 children were included in this study，of which 27 173 were actively monitored and 80 330 were passively monitored. The monitoring results showed that 288 cases of AEFI occurred after inoculated EV71 vaccines，the reported incidence rate was 267.90/100 000. Of 288 cases，266 cases had common reactions（247.43/100 000），14 cases had abnormal reactions（13.02/100 000）and 8 cases had complications（7.44/100 000）；145 cases were passively monitored（180.51/100 000）and 143 cases were actively monitored（526.26/100 000）；150 cases were males and 138 cases were females，with the males to females ratio of 1.09∶1. The AEFI of EV71 vaccines were reported in all the cities of Zhejiang Province，with Jinhua，Taizhou and Hangzhou ranking the top three and accounting for 50.69% of all the reported cases. About 202 cases of AEFI（70.14%）occurred after the first dose of EV71 vaccines，and 163 cases（56.60%）occurred on the day of inoculation.Most of common reactions were fever，swelling and sclerosis. The harm of the reported abnormal reactions was mild，with 8 cases of anaphylactic rash and no other serious abnormal reactions were found. @*Conclusion@#The reported incidence rate of AEFI of the domestic EV71 vaccine in children aged from 6 months to 3 years is 267.90/100 000，without serious abnormal reactions，suggesting that the EV71 vaccine is safe.

Post-marketing safety analysis of inactivated enterovirus A71 vaccines / 中华预防医学杂志

Objectives@#To evaluate the safety of inactivated enterovirus A71(EV-A71) vaccines after large-scale immunization in the community.@*Methods@#We selected EV-A71 susceptible people (healthy children) aged 6-59 months in vaccination clinics from 89 counties in Zhejiang Province between April 2016 and March 2018. All local and systematic adverse actions were collected by 30 min on-site inspection, within 3 days and 4-30 days follow-up. Chi-square test and Fisher′s exact test were used to compare the difference of AEs incidence in various characteristics among two groups.@*Results@#A total of 71 663 doses of vaccines were included for active safety analysis, which included 37 331 doses in boys and 34 332 doses in girls. Among all the doses, children aged 6 to 11 months, 12 to 23 months and 24 to 59 months were received 13 707, 32 639 and 25 317 doses respectively. The incidence of adverse reactions within 30 min, 3 days and 4-30 days were 0.33% (239 doses), 1.58% (1 133 doses) and 0.34% (244 doses) respectively. Adverse reactions within 3 days were 1 372 doses, with a incidence of 1.91%; among all the cases, 539 doses (0.75%) were grade 1, 677 doses (0.94%) were grade 2 and 156 doses (0.22%) were grade 3, no grade-4 adverse reaction was reported. The common local adverse reactions were redness, swelling and pruritus, with the incidence rates were 0.05% (39 doses), 0.02% (16 doses) and 0.02% (12 doses), respectively, while the most common systemic adverse reaction was pyrexia with an incidence of 1.19% (856 doses), followed by diarrhea and anorexia with the incidence rates were 0.15% (104 doses) and 0.13% (90 doses) respectively.@*Conclusion@#Most adverse actions of EV-A71 vaccines were mild and moderate and majority of them were common adverse actions. No new adverse reactions were found in the study.

Post-marketing observation on safety of inactivated enterovirus A71 vaccine (human diploid cell) / 中华预防医学杂志

Objective@#To evaluate the post-marketing safety of inactivated Enterovirus type 71 (EV-A71) vaccine (human diploid cell) .@*Methods@#A total of 20 191 healthy children aged 6 to 59 months were invited to receive 2 doses of EV-A71 vaccine in Zhejiang Province from September 2016 to December 2017. Child caregivers were followed up on the 4th or 5th day after each EV-A71 vaccination, and the incidence of local, systemic, and other adverse events within 3 days after vaccination was recorded to assess vaccine safety. Describe the differences in adverse events among children with different characteristics.@*Results@#A total of 32 230 doses were observed in this study, of which 20 191 and 12 039 were vaccinated for the first and the second dose, respectively; and the incidence of adverse events within 3 days was 2.045% (413 doses) and 1.611% (194 doses), respectively. After the first and the second dose, the number of systemic adverse events was the highest, 371 and 175 cases, respectively, with an incidence of 1.837% and 1.454%, respectively; the number of local adverse events was the lowest, 14 and 2 doses, respectively, with an incidence of 0.069% and 0.017%. Local adverse events occurred after vaccination were generally mild, and only 2 patients had level of 3; among the systemic adverse events, 39 patients had a fever level of 3 or higher, accounting for 8.2% of the total fever. Most of the symptoms in the local adverse events did not require treatment, only 3 cases of vaccination site rash and 2 cases of pruritus were self-purchased drugs or outpatient treatment; except for 5 cases of fever, the other symptoms were not hospitalized in the case of systemic adverse events.@*Conclusion@#The incidence of adverse events within 3 days after vaccination with EV-A71 vaccine was low in children, mainly systemic adverse events, and the prognosis was good.

Research Progress on Diagnosis and Treatment of Chronic Osteomyelitis / 中国医学科学杂志(英文版)

We review the representatives literatures on chronic osteomyelitis, sum up the new insights in recent years into diagnostic options and treatment regimens, analyze the advantages and disadvantages of various diagnostic approaches and treatment strategies, and propose areas of interest to make current diagnostic and treatment strategies more specific.

Efficacy and Mechanism of Danlu Tongdu Tablets on Lumbar Disc Herniation with Kidney Deficiency and Stasis Syndrome / 中国实验方剂学杂志

Objective: To observe short-term and long-term efficacies of Danlu Tongdu tablets on lumbar disc herniation (LDH) with kidney deficiency and stasis syndrome, and its effect on nucleus pulposus reabsorption and immunoinflammatory factors. Method: One hundred and sixty patients were randomly divided into control group (80 cases) and observation group by random number table. Patients in control group (80 cases) got acupoint massage and acupuncture, 1 time/day. In addition to the therapy of control group, patients in observation group were also given Danlu Tongdu tablets, 4 tablets/time, 3 times/days. A course of treatment was 12 weeks, and a 9-month follow-up was recorded. Lumbago and leg pain were recorded by visual simulation (VAS) before treatment and at the first, second, third month after treatment. Before and after treatment, Japanese orthopaedic association (JOA), symptoms and signs were scored. During the 9-month follow-up, relapse rate and relapse time were recorded, and VAS and JOA were scored. Absorption of nucleus pulposus was assessed, and levels of interleukin-1 (IL-1), IL-17, tumor necrosis factor-α (TNF-α), matrix metalloproteinases-3 (MMP-3) were detected. Result: By rank sum test, the clinical efficacy in observation group was better than that in control group (Z=2.125, PZ=1.924, PPPPPχ2=5.138, Pα and MMP-3 were lower than that in control group (Pχ2=4.668, PPPPConclusion: In addition to acupuncture and massage therapy, Danlu Tongdu tablets can also be used to relieve pain and ameliorate function, improve clinical efficacy, reduce relapse rate, promote nucleus pulposus reabsorption, and relieve inflammation of nerve root.