Risk of peripheral facial palsy following parenteral inactivated influenza vaccination in the elderly Chinese population.

Background: Concern about the risk of peripheral facial palsy (PFP) following vaccination is one reason for hesitancy in influenza vaccination. However, the association between the flu vaccine and PFP is still controversial, and further evidence is urgently needed. Methods: This self-controlled case series study evaluated PFP risk following inactivated influenza vaccine in the elderly using a large linked database in Ningbo, China. Relative incidence ratios (RIRs) and 95% confidence intervals (CIs) estimated using conditional Poisson regression were utilized to determine whether the risk of PFP was increased after vaccination. Results: This study included 467 episodes, which occurred in 244 females and 220 males. One hundred twenty-four episodes happened within 1-91 days after vaccination, accounting for 26.7%. The adjusted RIRs within 1-30 days, 31-60 days, 61-91 days, and 1-91 days after influenza vaccination were 0.95 (95% CI 0.69-1.30), 1.08 (95% CI 0.78-1.49), 1.01 (95% CI 0.70-1.45), and 1.00 (95% CI 0.81-1.24), respectively. Similar results were found in subgroup analyses and sensitivity analyses. Conclusions: Influenza vaccination does not increase PFP risk in the elderly population. This finding provides evidence to overcome concerns about facial paralysis after influenza vaccination.

Long-term vaccine efficacy of a 2-dose varicella vaccine in China from 2011 to 2021: A retrospective observational study.

Objective: A 2-dose varicella vaccine immunization strategy has been implemented in many cities in China, but there is few evidence on a long-term evaluation of the efficacy of the 2-dose varicella vaccine from China. This study aims to assess the long-term vaccine efficacy of the two doses varicella vaccine and analysis of its influencing factors. Methods: A retrospective study was carried out in 837,144 children born between 2011 and 2017 in Ningbo, Easten China. The logistic regression was performed to estimate varicella vaccine effectiveness (VE). Results: The overall VE of 2 doses of varicella vaccine compared without the vaccine was 90.31% (89.24-91.26%), and the overall incremental VE of 2 doses of varicella vaccine compared to the 1-dose was 64.71% (59.92-68.93%). Moreover, the varicella vaccination age of the second dose and the interval between 2 doses were both associated with VE. The VE compared to that without the vaccine in children vaccinated at <4 years old was 91.22% (95%CI: 90.16-92.17%) which was higher than in children vaccinated at ≥4 years old (VE: 86.79%; 95%CI: 84.52-88.73). And the effectiveness of the vaccine was 93.60% (95%CI: 92.19-94.75%) in children with the interval of the 2 doses ≤ 24 months significantly higher than in children with the interval of ≥36 months (VE: 85.62%, 95%CI: 82.89-87.91%). Conclusions: This study provides evidence for long-term VE of the 2-dose varicella vaccine and the better age for 2-dose vaccination and the interval between 2 doses of the vaccine in China.

DNA Methylation of Patatin-Like Phospholipase Domain-Containing Protein 6 Gene Contributes to the Risk of Intracranial Aneurysm in Males.

Objective: This study is aimed to investigate the contribution of patatin-like phospholipase domain-containing protein 6 (PNPLA6) DNA methylation to the risk of intracranial aneurysm (IA) in the Han Chinese population. Methods: A total of 96 age- and sex-matched participants were recruited to evaluate PNPLA6 methylation via bisulfite pyrosequencing. The PNPLA6 mRNA expression in the plasma was determined using real-time quantitative reverse transcription-polymerase chain reaction. Human primary artery smooth muscle cells (HPCASMC) were used for the in vitro function study. Results: PNPLA6 methylation was significantly higher in patients with IA than in healthy controls (p < 0.01). Sex group analysis showed that this correlation appeared in the male group (p < 0.01) but not in the female group (p > 0.05). PNPLA6 methylation was significantly associated with age in all participants (r = 0.306, p = 0.003) and in the control group (r = 0.377, p = 0.008) but not in the IA group (r = 0.127, p = 0.402). Furthermore, the PNPLA6 mRNA expression significantly decreased in patients with IA than that in the controls (p = 0.016). PNPLA6 expression was significantly inversely correlated with elevated DNA methylation in participants (r = -0.825, p < 0.0001). In addition, PNPLA6 transcription was significantly enhanced following treatment with 5-aza-2'-deoxycytidine methylation inhibitor in HPCASMC.The receiver operating characteristic analyses of curves showed that the PNPLA6 mean methylation [area under the curve (AUC) = 0.74, p < 0.001] and mRNA expression (AUC = 0.86, p < 0.001) could have a diagnostic value for patients with IA. Conclusion: Although future functional experiments are required to test our hypothesis, our study demonstrated that PNPLA6 methylation and mRNA expression were significantly associated with the risk of IA; thus, they show potential for use in the early diagnosis of IA.

Vaccination coverage estimates and utilization patterns of inactivated enterovirus 71 vaccine post vaccine introduction in Ningbo, China.

BACKGROUND: In China, enterovirus 71 (EV71) is the major etiological agents of hand foot mouth disease that poses severe risks to children's health. Since 2015, three inactivated EV71 vaccines have been approved for use. Previous studies indicated the high willingness of EV71 vaccination in eastern China. However, few studies have assessed coverage and utilization patterns of EV71 vaccine in China. METHODS: Children born during 2012-2018 were sampled and their records were abstracted from Ningbo childhood immunization information management system. Descriptive statistics characterized the study population and assessed coverage and timeliness for EV71 vaccination. Simultaneous administration patterns as well as type of EV71 vaccine used were also evaluated. Bivariate and multivariable analysis was used to examine the relationship of socio-demographic characteristics with vaccination coverage and timeliness. RESULTS: Of 716,178 children living in Ningbo. One hundred seventy-two thousand two hundred thirty-six received EV71 vaccine with a coverage rate of 24.05% and only 8.61% received vaccination timely. 21.97% of children received the complete two dose EV71 series but only 6.49% completed timely. Vaccination coverage and timeliness increased significantly from 2012 birth cohort to 2018 birth cohort. Relatively higher coverage and timeliness were observed in resident children, Inner districts, high socioeconomic areas and large-scaled immunization clinics. Of 329,569 doses of EV71 vaccine, only 5853(1.78%) doses were administered at the same day as other vaccines. CONCLUSIONS: There is a need for increasing EV71 vaccination coverage and timeliness as well as eliminating disparities among different populations. Our study highlights the importance of simultaneous administration to increasing coverage and timeliness of EV71 vaccination.

Varicella breakthrough infection and effectiveness of 2-dose varicella vaccine in China.

BACKGROUND: 2-dose varicella vaccination has been available in Ningbo city, China since 2014 in the private sector. This study aimed to evaluate the breakthrough varicella infection rate, and to examine overall and incremental effectiveness of 2-dose varicella vaccination among Chinese children. METHODS: A retrospective investigation was done among native children born from 2008 to 2013 in active surveillance area in Ningbo, China. Between 2009 and 2016, demographic information and data on varicella vaccination were collected by Ningbo's Immunization Information System, and information of varicella infections were obtained from China Information System for Disease Control and Prevention. The logistic regression was conducted to estimate varicella vaccine effectiveness (VE). RESULT: A total of 107,324 local children were enrolled in the cohort analysis and 95.11% of these children with no varicella disease history received at least 1-dose varicella vaccine from 2009 to 2016. The total breakthrough varicella infection rate (BVR) was 0.37% for all the vaccinated children and 0.04% for 2-dose vaccination. The annual BVR ranged from 0.01% to 0.49% for 1-dose of varicella vaccine and from 0.01% to 0.02% for 2-dose. The infection rates both in the unvaccinated children and the 1-dose children were decreasing after 2-dose vaccination implemented in 2014 (Unvaccinated: P < 0.001 for trend; 1-dose: P = 0.003 for trend). The VE against all varicella was 50.3% (95% CI: 39.8%-59.0%) for 1-dose (P < 0.001) and 98.7% (95% CI: 98.1%-99.1%) for 2-dose (P < 0.001), and the incremental VE was 97.4% (95% CI: 96.2%-98.2%) compared with 1-dose (P < 0.001). CONCLUSION: The 2-dose regimen provided excellent protection to prevent all varicella, and the universal 2-dose regimen of varicella vaccine should be recommended to prevent the varicella disease among children in China.

[Varicella breakthrough infection and vaccine effectiveness with 1-dose varicella].

OBJECTIVE: To evaluate the breakthrough varicella infection rate and varicella vaccine effectiveness (VE) among children who received 1-dose varicella vaccine. METHODS: A total of 57 180 subjects for the consecutive 4-year birth cohorts were selected from the local children born between 2007 and 2010 in Yinzhou District, Ninghai County and Yuyao City. And they were followed up for varicella from 2008 to 2013. The recipients of the vaccinations were identified through Ningbo Immunization Information System and data on breakthrough infections among the recipients were collected by using China Information System for Disease Control and Prevention. The breakthrough varicella rate and the VE were calculated and the trends of them were described from 2008 to 2013 among 4-year birth cohorts. The cumulative incidence of varicella was compared between vaccinated and unvaccinated children among the consecutive 4-year birth cohorts. RESULTS: The rate of varicella vaccine coverage, vaccine cumulative incidence among the cohorts was 96.74% (55 317/57 180) and 0.56% (321/57 180). The breakthrough varicella infection for 4-year birth cohorts was 0.44% (244/55 317), and for each birth cohort was 0.95% (142/14 928), 0.44% (61/13 855), 0.22% (29/13 433) and 0.09% (12/13 101), respectively. It was on the rise from 2008 to 2013 and the 2007 birth cohort of it increased fastest from 0.04% (6/14 928) in 2007 to 0.32% (48/14 834) in 2013. The vaccine cumulative incidence of these who vaccinated 1-dose varicella (the breakthrough varicella infection) was lower than these who were unvaccinated (the incidence: 6.25% (37/592), 3.52% (15/426), 3.69% (17/461) and 2.08% (8/384)) by each birth cohort (χ²= 130.27, P < 0.001 for 2007 birth cohort; χ²= 74.11, P < 0.001 for 2008 birth cohort; χ²= 162.80, P < 0.001 for 2009 birth cohort; χ²= 100.01, P < 0.001 for 2010 birth cohort). The vaccine effectiveness for 4-year birth cohorts was 89.33% (95% CI: 86.7%-92.1%) and for each birth corhort was 84.78% (95% CI: 77.94%-89.50%), 86.82% (95% CI: 77.82%-92.95%), 93.99% (95% CI: 89.27%-96.81%) and 95.60% (95% CI: 89.18%-98.21%), respectively. The effectiveness of each birth cohort declinedgradually from 2008 to 2013 and the 2009 birth cohort of it decreased fastest from 98.86% in 2010 to 66.83% in 2013. CONCLUSIONS: The 1-dose varicella vaccine effectiveness was good, but breakthrough varicella infection rate was on the rise with time and the VE declined gradually from 2008 to 2013.

[Association of aldosterone synthase (CYP11B2) gene -344T/C polymorphism with essential hypertension in Mongolian nationality].

OBJECTIVE: To explore the relationship between the -344T/C polymorphism of aldosterone synthase (CYP11B2) gene and essential hypertension in Chinese Mongolian population. METHODS: By cluster-sampling method, a total of 1575 Mongolian people in Tongliao city of Inner Mongolia were included in this study. And 417 subjects were normotension, 596 subjects were prehypertension and 562 subjects were essential hypertension. A survey was conducted to collect data by personal interview using a standard questionnaire, meanwhile fasting blood samples were drawn. Height, weight, waist circumference, blood pressure, blood-fat indexes and fasting plasma glucose were measured. The variant genotypes of CYP11B2 were identified by PCR assays. The relationship between the -344T/C polymorphism of CYP11B2 gene and essential hypertension were analyzed by multinomial logistic regression model. RESULTS: Crude prevalence of prehypertension among Mongolian people was 37.84% (596/1575) and hypertension was 35.68% (562/1575). The age-standardized prevalence of prehypertension was 38.57% and hypertension was 31.53%. The frequency of the T and C allele was 0.66 (481/728) and 0.34 (247/728) for normotension group, 0.69 (696/1042) and 0.33 (346/1042) for prehypertension group, 0.71 (706/998) and 0.29 (292/998) for hypertension group. The multiple logistic models showed CYP11B2 variant genotypes were associated with prehypertension (TT/CC, OR = 1.33, 95%CI: 0.87 - 2.01; TC/CC, OR = 1.74, 95%CI: 1.13 - 2.67; TC + TT/CC, OR = 1.49, 95%CI: 1.01 - 2.22); CYP11B2 variant genotypes were associated with hypertension (TT/CC, OR = 1.70, 95%CI: 1.07 - 2.70; TC/CC, OR = 1.59, 95%CI: 0.98 - 2.50; TC + TT/CC, OR = 1.66, 95%CI: 1.06 - 2.58). CONCLUSION: CYP11B2 gene -344T/C polymorphism were associated with essential hypertension in Chinese Mongolian population.

Interaction between the C(-344)T polymorphism of CYP11B2 and alcohol consumption on the risk of essential hypertension in a Chinese Mongolian population.

The present study aimed to explore gene-gene and gene-environment interactions among three candidate genes and several environmental risk factors, and their impacts on hypertension in Chinese Mongolian population. A cross-sectional study was conducted in 2003-2004 among 1,575 Mongolian people in Tongliao City of Inner Mongolia, China. Epidemiologic and clinical data and blood samples were obtained from subjects. Multifactor dimensionality reduction (MDR) and logistic regression were used to analyze gene-gene and gene-environment interactions. The MDR model indicated a significant interactions among the CYP11B2 gene C(-344)T polymorphism, body mass index, age, and alcohol consumption on the risk of hypertension, with a cross-validation consistency of 10 of 10 and a prediction error of 34% (P < 0.001). Logistic regression suggested alcohol consumption (≥200 g/d) was associated with an OR of 2.4 (95% CI, 1.6-3.5) for hypertension. When stratified by the CYP11B2 genotype, the estimated OR was 1.2 (95% CI, 0.5-3.0) on hypertension for the CC genotype group, but was 3.0 (95% CI, 1.5-5.7) and 2.9 (95% CI, 1.4-5.7) for the TC and TT genotype groups, respectively. A significant interaction between the CYP11B2 genotype and alcohol consumption was also found by the logistic models (P (crude) = 0.035, P (adjusted) = 0.048). This study demonstrates a significant interaction between the CYP11B2 genotype and alcohol consumption on the risk of hypertension in Chinese Mongolian population.

Interaction of the C-344T polymorphism of CYP11b2 gene with body mass index and waist circumference affecting diastolic blood pressure in Chinese Mongolian population.

Abstract Background. The relationship between the C-344T polymorphism of CYP11b2 gene and blood pressure (BP) is controversial. The present study aimed to investigate whether it was affected by environmental determinants in Chinese Mongolian population. Methods. A cross-sectional study was conducted between 2003 and 2004 in Tongliao City of Inner Mongolia, China. Epidemiological and clinical data and blood samples were obtained from subjects. Multiple linear regression models were used to estimate the associations between the CYP11b2 genotype and BP. Results. In univariate model, the CYP11b2 genotype was associated with diastolic BP. When stratified by the body mass index (BMI) tertile, the estimated association was significant in the highest tertile of the BMI group with adjustment for age and gender (TT:ß=3.3, p=0.042), but was not significant in the other tertiles. After multivariate adjustment, the estimated association was still significant only in highest tertile of BMI group (TC:ß=3.7, p=0.030; TT:ß=3.7, p=0.023). A similar pattern emerged in analyses stratified by the waist circumference (WC) tertile. Conclusion. In this study, the association between the CYP11b2 genotype and diastolic BP was modified by BMI and WC, suggesting an interaction of the C-344T polymorphism of CYP11b2 with BMI and WC in a Chinese Mongolian population.

[Impact of gene-environment interaction between the C (-344) T polymorphism of CYP11B2 and drinking index on the risk of hypertension under multifactor dimensionality reduction model in Chinese Mongolian population].

OBJECTIVE: To explore the interaction between C (-344) T polymorphism of CYP11B2 and drinking index (DI) as well as their impact on the risk of hypertension in Chinese Mongolian population. METHODS: A total of 1575 Mongolian people aged 20 and older including 562 hypertensive and 1013 normal-tensive from agricultural and pastoral areas in Tongliao city of Inner Mongolia, were included in this study. A cross-sectional survey was conducted to collect data by personal interview with local residents, using a standard questionnaire. Fasting blood samples were drawn and height, weight and blood pressure were measured. The variant genotypes of CYP11B2, ACE and eNOS were identified by PCR assays. Gene-environment interactions were analyzed, using multifactor dimensionality reduction (MDR) model. Based on the result of the best MDR model, a multiple logistic regression model was constructed as the final cause-effect interpretative model. RESULTS: The interaction between CYP11B2 variant genotype and drinking index appeared the best MDR model with statistical significance (chi(2) = 66.35, P < 0.01). Testing balance accuracy of the model was 0.604. The cross-validation consistency was 10/10. Data from the final multiple logistic regression based on the MDR model showed that the main effects of both CYP11B2 variant genotype and the DI were not significantly different but the interaction between the genotype (TC) and the DI (90-) was, with regard to hypertension (OR, 10.25; 95%CI, 2.23 - 47.18; P = 0.003). The combined effects between CYP11B2 variant genotype and the DI showed that following indices as: genotype TT or TC combining non-zero drinking index, including genotype (TT) combining the drinking index (> or = 168), the genotype (TT) combining the drinking index (> or = 40), the genotype (TT) combining the drinking index (> or = 1) and the genotype (TC) combining the drinking index (> or = 90), were all risk factors of hypertension when comparing with genotype (CC) combining the drinking index (0), and the ORs (95%CI) appeared to be 2.07 (1.15 - 3.70), 2.35 (1.22 - 4.56), 2.05 (1.07 - 3.94) and 5.56 (2.54 - 12.18) respectively. CONCLUSION: Essential hypertension might positively be affected by the interaction of the C (-344) T polymorphism of CYP11B2 and the drinking index in Chinese Mongolian population.