[Purple sweet potato anthocyanins attenuates steatohepatitis induced by high fat diet combined with carbon tetrachloride in rats].

OBJECTIVE: To explore the mechanism of purple sweet potato anthocyanins through NF-κB pathway in attenuating steatohepatitis induced by high fat diet combined with carbon tetrachloride in rats. METHODS: Seventy male rats were randomly divided into control group( n = 10) and high-fat diet group( n = 60), models were prepared by highfat diet and intraperitoneal injection of carbon tetrachloride and olive oil( 50 : 50) 2 mL/kg, two times a week. After 10 weeks of feeding, the weight variations of all rats were tested before and after modeling. The colorimetric technique was used to test the concentration of serum ALT, AST, TG, and TC. A total of 58 rats were succeeded in modeling, the random choice of 50 rats were divided into model group, purple sweet potato anthocyanin low dose group( 60 mg/kg), middle dose group( 120 mg/kg), high dose group( 240 mg/kg), positive drug group( 150 mg/kg), 10 rats in each group. After 8 weeks of continuous administration, the method of colorimetric technique was used to test the concentration of ALT, AST, TG, TC, HDL and LDL. The method of ELISA kit was used to test the levels of the pro-inflammatory factors TNF-α, IL-1ß and the levels of the anti-inflammatory IL-4, IL-13. The Real-time PCR was used to test the expression of TNF-α, IL-1ß, IL-4, IL-13, PPAR-γ and HMGB-1 mRNA of rats liver. The western blotting method was adopted to test the level of IκB phosphorylation in liver tissues as well as the PPAR-γ and HMGB-1 protein expression. RESULTS: After modeling, the body weight of rats increased( P < 0. 05), the concentration of serum insulin AST, ALT, TG, TC, and LDL all increased significantly( P < 0. 05), the concentration of HDL decreased obviously( P < 0. 05). Compared with control group, the expression of TNF-α, IL-1ß and HMGB-1 in model group were increased significantly( P < 0. 05), the expression of IL-4, IL-13 and PPAR-γ were decreased significantly( P < 0. 05), the expression of pIκB and NF-κB in the model group increased significantly( P < 0. 05). Compared with the model group, the expression level of NF-κB in the high dose purple sweet potato anthocyanin group decreased obviously, and the phosphorylation degree of IκB decreased( P < 0. 05), the mRNA expression of TNF-α, IL-1ß and HMGB-1 in liver tissue was significantly decreased( P < 0. 05), and the mRNA expression of IL-4, IL-13 and PPAR-γ were significantly increased( P < 0. 05). The purple sweet potato anthocyanin low dose group, middle dose group, high dose group and positive drugs group all improved the above indexes in different degrees. The effect of the high dose group was significantly higher than that of the low dose and medium dose group, but equivalent to that of the positive drug group. CONCLUSION: Purple sweet potato anthocyanins through NF-κB pathway have a role in attenuating steatohepatitis induced by high fat diet combined with carbon tetrachloride in rats.

Cost-effectiveness of varicella vaccination for 1-4-year-olds in Shanghai, China.

INTRODUCTION: Varicella has not yet been included in the National Immunization Program (NIP) in China, and varicella vaccination strategies vary by region. To determine the optimal varicella vaccination strategy in Shanghai, China, the cost-effectiveness and five-year costs of five immunization scenarios were analyzed. METHODS: A static decision tree-Markov model was developed in 2022 to assess the cost-effectiveness and five-year costs of voluntary and routine varicella vaccination programs in the 2019 birth cohort in Shanghai from a societal perspective. Parameters were collected in 2022 from the varicella surveillance system, a questionnaire survey of 414 guardians of patients with childhood varicella, and semi-structured interviews with 20 experts on varicella outbreaks from different institutions in Shanghai. The outcomes included varicella cases avoided, quality-adjusted life year (QALY) loss, and incremental costs per QALY (ICER). The five-year costs were compared with local medical expenditures. RESULTS: Among the five scenarios, one dose of routine varicella vaccination was the most cost-saving (USD 70.2) and cost-effective (Dominant) with a five-year immunization expenditure of USD 9.9 million. Two doses of routine varicella vaccination had the highest QALY (29.9), and its ICER (USD 791.9/QALY) was below the willingness-to-pay threshold (USD 5,203-23,767/QALY). The five-year immunization expenditure was USD 19.8 million. The effectiveness and price of vaccines, vaccination coverage, and per capita income are the four main factors that affect ICERs. CONCLUSIONS: In Shanghai, the two doses of routine varicella vaccination strategy for 1- and 4-year-olds with a 95% coverage rate was found to be the optimal varicella immunization strategy.

Gap between willingness and behavior in the vaccination against influenza, pneumonia, and herpes zoster among Chinese aged 50-69 years.

BACKGROUND: Vaccination uptake of influenza vaccine, 23-valent pneumococcal polysaccharide vaccine (PPV23) and herpes zoster vaccine (HZV) remains low among Chinese aged 50-69 years, posing a significant public health concern. This study's aim is to determine the gap between the vaccination willingness and uptake. RESEARCH DESIGN AND METHODS: We conducted a face-to-face questionnaire survey among the persons aged 50-69 years in 13 communities in Shanghai in November-December 2020 to measure vaccination willingness, vaccine price sensitivity, vaccination service accessibility, and vaccine hesitancy. Then, we explored the factors influencing the vaccination uptake using a structural equation model. RESULTS: Vaccination willingness was 70.5% (self-paid influenza vaccine), 79.4% (free PPV23 for local persons), 54.7% (self-paid PPV23 for non-local persons), and 16.6% (self-paid HZV); however, actual uptake was 10.8% (influenza vaccine), 11.0% (free PPV23), and 2.5% (self-paid PPV23). Moreover, vaccination uptake was strongly influenced by service accessibility (ß = 0.941), followed by willingness (ß = 0.201), price sensitivity (ß = -0.188), and medical history of vaccine-preventable diseases and underlying diseases (ß = 0.176). Related knowledge (ß = 0.017) and vaccine hesitancy (ß = -0.003) affected the uptake indirectly. CONCLUSION: There is a gap between the vaccination willingness and uptake in Chinese elderly. It warrants specific measures, including increasing service accessibility and reforming payment mechanism, to bridge the gap.

Low willingness to vaccinate against herpes zoster in a Chinese metropolis.

BACKGROUND: Herpes zoster vaccine (HZV) has been available in China's mainland since June 2020. This study estimated willingness to receive HZV to characterize factors that may influence vaccination willingness. METHODS: We conducted a face-to-face questionnaire survey in adults aged 50-69 years in 13 communities in Shanghai in late 2020. We explored the relationship between vaccination willingness and independent factors including demographic factors, medical history, knowledge of herpes zoster and HZV, and vaccine hesitancy. Outcomes included participants' willingness to vaccinate themselves, their partners, and their parents, under both the current payment scenario (self-payment) and a hypothetical scenario (payment by basic medical insurance). RESULTS: A total of 1672 respondents aged 50-69 years were included in this study. The proportion of respondents willing to get vaccinated was 16.57% for themselves, 13.88% for their partners, and 8.49% for their parents. If the vaccine was covered under insurance, these numbers increased to 72.25%, 62.50%, and 29.96%, respectively. Younger age, female gender, higher income, higher educational level, local residents, and lower vaccine hesitancy were associated with increased willingness to vaccinate. Knowledge of herpes zoster and HZV positively influenced the willingness in the hypothetical payment scenario. CONCLUSION: We determined a very low willingness to vaccinate HZV in adults aged 50-69 years in a Chinese metropolis. Decreasing costs is important to increase coverage. Additionally, strengthening advocacy and health promotion for the vaccine will be particularly important, especially for groups with certain underlying diseases.

COVID-19 vaccine coverage, concerns, and preferences among Chinese ICU clinicians: a nationwide online survey.

BACKGROUND: Clinicians in intensive care units (ICUs) have been prioritized for COVID-19 vaccination. We aim to understand the reasons behind vaccination refusal, and assess preferences for COVID-19 vaccines among Chinese ICU clinicians. RESEARCH DESIGN AND METHODS: ICU clinicians throughout China's mainland were contacted to participate in an online survey. We compared concerns with vaccination status, and through a discrete choice experiment (DCE) assessed preferences for vaccines in terms of effectiveness, risk of adverse reactions, duration of immunity, and whether coworkers have been vaccinated. RESULTS: Among 11,951 ICU respondents from 252 prefecture-level regions, vaccination coverage was 75.4%, with an additional 9.2% not vaccinated but intending to, and 16.1% not vaccinated and not intending to. ICU clinicians not intending to be vaccinated significantly expressed more concerns about the speed of vaccine development (30.1%) and adverse reactions (65.9%). In the DCE, the only significant difference in preferences of a COVID-19 vaccine was for safety, with those not intending to have a stronger preference for a vaccine with fewer adverse reactions (OR = 4.49), compared to those already vaccinated (OR = 2.90) or those intending to vaccinate (OR = 3.46). CONCLUSION: Increasing vaccination coverage among Chinese ICU clinicians will require strong norms surrounding vaccination and transparency about safety information.