Comparison of China Reference with Different National and International References: The Prevalence of High Blood Pressure in 695,302 Children and Adolescents in a Metropolis of Yangtze River Delta, China.

OBJECTIVES: This study aimed to compare performances of China reference and different national references on high blood pressure (HBP). METHODS: A cross-sectional study including 695,302 children and adolescents aged 7 to 17 years in Suzhou, China, was conducted to determine the prevalence of HBP based on U.S., international, Europe, and China references in 2016. RESULTS: Different percentiles of height and blood pressure were found among four references. Referring to U.S. reference, the prevalence of HBP was the highest with 26.0%, followed by International reference with 20.0%, Europe reference with 19.5%, and China reference with 19.2%. McNemar tests indicated statistically significant differences between HBP prevalence comparing China reference with the other 3 references (P < 0.001). The area under the curve was 0.947, 0.851, and 0.949 for U.S., international, and Europe reference, respectively. U.S. reference showed the highest sensitivity (98.2%), but the lowest specificity (91.2%), and Europe reference showed the highest kappa value (0.893). CONCLUSIONS: The prevalence of HBP varied among these four references, and the appropriate choice of reference would be important to recognize high-risk children and judge the trends of HBP prevalence in the targeted population.

A Centralized Outbreak of Varicella among Children Attending Preschool in Suzhou, China.

BACKGROUND: Varicella vaccine is available for voluntary purchase with a single dose currently recommended for children aged ≥12 months. An epidemiological study was undertaken in order to determine the characteristics of the outbreak, assess vaccine effectiveness, and examine risk factors for vaccine failure. METHODS: A varicella case was defined as a generalized papulovesicular rash (without other apparent causes) in a child without prior varicella attending the kindergarten during February 22 to April 7 of 2016. Varicella among vaccinated children (breakthrough varicella) was defined as varicella occurring >42 days after vaccination. Children's vaccination status was verified with immunization records through local vaccination information platform. RESULTS: Of the 738 children, 664 (90.0%) had no prior varicella history. Of these, 364 (54.8%) had received a single-dose varicella vaccine before outbreak. A total of 30 cases occurred in the outbreak, and 9 of them (30%) had breakthrough varicella. Age at vaccination (<15 months vs. ≥15 months) and time since vaccination before the outbreak (<3 years vs. ≥3 years) were not related to the occurrence of breakthrough varicella (P > 0.05). Single-dose varicella vaccination was 64.7% effective in preventing any varicella. CONCLUSIONS: Single-dose varicella vaccine is effective in reducing the varicella attack rate, but not high enough to prevent outbreak. Timely detection and effective isolation are key factors in controlling varicella. Improving single-dose vaccination coverage and implementing two-dose vaccination strategy should be recommended to provide excellent protection to prevent varicella in the future in Suzhou.

Tumor necrosis factor gene polymorphisms are associated with silicosis: a systemic review and meta-analysis.

Studies investigating association between tumor necrosis factor (TNF) gene polymorphisms and silicosis susceptibility report conflicting results. The aim of this meta-analysis was to assess association between TNF gene polymorphisms and silicosis susceptibility. A systematic literature search was conducted to find relevant studies. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to estimate the strength of association. Finally, a total of 12 articles, involving 1990 silicosis patients and 1898 healthy controls were included in the meta-analysis. Overall, meta-analysis revealed a significant association between the TNF -308A allele and silicosis (OR = 1.348, 95%CI = 1.156-1.570, P<0.001). A significant association of AA+AG genotype of the TNF -308 A/G polymorphism with susceptibility to silicosis was also found (OR = 1.466, 95%CI = 1.226-1.753, P<0.001). After stratification by ethnicity, significant associations were detected under the genetic models (A allele and AA+AG genotype) for TNF -308A/G polymorphisms in the Asian population (P<0.05). Similarly, meta-analysis of the TNF -238A/G polymorphism revealed the same pattern as that shown by meta-analysis of TNF -308A/G. The meta-analysis suggests that the TNF -308A/G and -238A/G polymorphisms are associated with susceptibility to silicosis, especially in Asians.

[The use of antiviral drugs in treating novel influenza A (H1N1) inpatients in Suzhou city, Jiangsu province, China, 2009 - 2010].

OBJECTIVE: To explore the use of antiviral drugs in treating the hospitalized patients of novel influence A (H1N1) in Suzhou city during the 2009 - 2010 influenza pandemic, so as to make the proper use of antiviral drugs during influenza epidemics. METHODS: We selected 3 municipal hospitals and reviewed the medical records of hospitalized patients suffered from novel influence A (H1N1) during June 2009 to March 2010, to gather antiviral use and other related information. RESULTS: 98% (222/226) of the hospitalized patients received antiviral treatment. Among them, 92% (205/222) were given the neuraminidase inhibitor oseltamivir. However, only 18% of the patients who received oseltamivir were given the treatment within 2 days after the onset of the illness. Amantadine and rimantadine were not used for any of the hospitalized patients. Through interview on the physicians, we identified that delay in seeing care, misdiagnosis, delay in laboratory diagnosis were factors affecting the timely use of oseltamivir. CONCLUSION: The majority of the hospitalized patients suffered from novel influence A (H1N1) in the three municipal hospitals received oseltamivir treatment. However, in most occasions the drug was not used timely. Techniques of rapid detection and diagnosis for novel influenza A (H1N1) virus should be developed, and the diagnostic capabilities of the physicians improved, to increase the effectiveness of these antiviral drugs.