Surveillance of Vaccination Coverage of Inactivated Influenza Vaccines and Allergic Rash Adverse Events Following Immunization for Children From 6 Manufacturers.

The composition of influenza vaccines is updated annually. To ensure vaccine safety, the coverage and adverse events following immunization (AEFI) of 6 manufacturers of trivalent inactivated influenza vaccine (TIV3) need to be evaluated. In January 2022, we analyzed data from more than 1.59 million children in the Childhood Vaccination Information Management System and the AEFI Surveillance Information Management System and evaluated influenza vaccines for children aged 6 to 35 months in Guangzhou from 2016/17 to 2019/20 Vaccination rates and AEFI reporting rates. From 2016/17 to 2019/20, the 1-dose influenza vaccination rate was 25.0% (range: 20.7%-30.2%), and the 2-dose (full course) influenza vaccination rate was 21.6% (range: 17.7%-26.4%). The full vaccination coverage rate has trended down since 2017/2018 (2017/18: 26.0%; 2018/19: 8.3; 2019/20: 17.7%). Fifty-two cases (13.1/100 000) and 24 cases (6.9/100 000) received AEFI reports for 1 dose and 2 doses, respectively, mainly due to fever ≥38.6°C (39 cases for 1 dose, 9.8/100 000; 15 cases for 2 dose, 4.3/100 000) and allergic rash (9 cases with 1 dose, 2.3/100 000; 5 cases with 2 doses, 1.4/100 000). Patients who received A and F manufacturers were more likely to report side effects. The safety of influenza vaccines from 6 manufacturers is good, and it is necessary to improve the recommended information on influenza vaccines to dispel people's concerns and increase the vaccination rate.

Related donor platelet transfusion improves platelet transfusion refractoriness in hematological patients.

Objective: Transfusion of HLA-matched platelets can reduce the effect of alloimmune responses on platelet transfusion efficacy; however, finding HLA-matched platelets in the population is nearly impossible. Almost all HLA-matched platelets from related are half-matched, but the hemostatic efficacy of related donor platelets is unclear. Our goal was to compare the hemostatic effect of related donated platelets and unrelated donors platelets. Methods: In this retrospective cohort study, we included acute leukemia and myelodysplastic syndrome patients with thrombocytopenia after chemotherapy. These patients were all transfused with platelets. This study excluded patients younger than 16 years and older than 65 years, or patients with abnormal coagulation parameters during platelet transfusion. We compared the hemostatic effect of related donated platelets and unrelated donors platelet. The primary outcome was transfusion efficacy after platelet transfusion, and the number of platelet counts and corrected count increments at 24 h after platelet transfusion. Result: We analyzed 31 patients who received platelet transfusions from related donors (Treatment group) and 35 patients who received platelet transfusions from unrelated donors (Comparator group). Except for the relatively small proportion of patients with myelodysplastic syndrome in the treatment group, baseline clinical and laboratory characteristics were similar between the two groups. Hemostasis and prevention of bleeding in the treatment group showed significant superiority; the number of platelets increased 24 h after platelet transfusion in the treatment group was significantly higher than that in the comparator group. After 24 h, the corrected count increments treatment group was also higher than the comparator group; in the treatment group, the transfusion effect was better when the three sites of HLA-A, B, and C were identical, and the different blood types of platelet donors and recipients did not affect the transfusion effect. Conclusion: Related donated platelets have better hemostasis and prevention effects, and no increase in adverse blood transfusion reactions. It may be a better transfusion strategy for platelet refractoriness patients in emergency situations.

Impact of Donor-to-Recipient ABO Mismatch on Outcomes of Antithymocyte Globulin-Based Peripheral Blood Stem Cell-Derived Myeloablative Conditioning Haploidentical Stem Cell Transplantation.

ABO incompatibility is common in hematopoietic stem cell transplantation (HSCT); however, the impact of donor-recipient ABO compatibility on transplantation outcomes in different HSCT settings is controversial. Moreover, haploidentical stem cell transplantation (haplo-SCT) with peripheral blood stem cell (PBSC)-derived grafts has not been well investigated. The present study aimed to investigate the impact of ABO incompatibility on post-transplantation outcomes, engraftment kinetics, blood product requirements, transfusion independence, and the incidence of poor graft function (PGF) in antithymocyte globulin (ATG)-based haplo-SCT with PBSC grafts during long-term follow-up. We prospectively evaluated 510 patients with hematologic malignancies who underwent haplo-SCT after myeloablative conditioning (MAC). The primary endpoint was overall survival (OS), and secondary endpoints were nonrelapse mortality (NRM), graft-versus-host disease (GVHD), relapse, neutrophil and platelet engraftment, blood transfusion requirements, transfusion independence, and the incidence of PGF. There was no significant association between ABO matching and OS, disease-free survival (DFS), relapse, NRM, grade II-IV acute GVHD, grade III-IV acute GVHD, and moderate and severe chronic GVHD. There were also no significant differences in neutrophil and platelet engraftment, blood transfusion independence, and transfusion requirements at 30, 60, 90, 180, and 365 days post-transplantation among patients with ABO matching and those with minor, major, or bidirectional ABO incompatibility. Donor-recipient ABO matching did not differ significantly according to graft function (good versus poor). ABO incompatibility status has no major impact on patient outcomes in patients with hematologic malignancies undergoing ATG-based MAC haplo-SCT with PBSC-derived grafts.

Effectiveness of prophylactic antiviral therapy in reducing HBV reactivation for HBsAg-positive recipients following allogeneic hematopoietic stem cell transplantation: a multi-institutional experience from an HBV endemic area.

Hepatitis B virus reactivation (HBVr) is not uncommon in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Hepatitis B surface antigen (HBsAg)-positive patients receiving allo-HSCT have a very high risk of HBVr. However, the validity of prophylactic antiviral treatment in HBsAg-positive allo-HSCT recipients has not been well studied. We aimed to add experience in dealing with HBsAg-positive patients following allo-HSCT. We conducted a cohort study that included 11 years of data of HBsAg-positive allo-HSCT patients in multiple centers. The cumulative incidence of HBVr with antiviral prophylaxis at 60 months following transplantation was 8.9%. Both lamivudine (LAM) and entecavir (ETV) effectively reduced the incidence of HBVr. Patients with absent-mild cGVHD had a lower HBVr rate than that of patients with moderate-severe cGVHD (HR = 0.201, P = 0.020). The incidence of HBsAg seroclearance at 60 months following transplantation was 34.3%. Recipients accepting from anti-HBs-negative donors were associated with a lower HBsAg seroclearance rate than that of those accepting from anti-HBs-positive donors (HR=0.255, P < 0.001). The peripheral blood stem cell (PBSC) donor source had a higher HBsAg seroclearance rates than that of the PBSC plus bone marrow stem cell source (HR = 4.700, P = 0.047). The prophylactic antiviral treatment effectively reduced HBVr in HBsAg-positive recipients receiving allo-HSCT. HBsAg-positive recipients accept anti-HBs-positive PBSC donor sources may facilitate the acquisition of HBsAg seroclearance after transplantation.

Analysis of the coverage of inactivated enterovirus 71 (EV71) vaccine and adverse events following immunization with the EV71 vaccine among children from 2016 to 2019 in Guangzhou.

Background: Since 2016, China has approved the use of inactivated enterovirus 71 (EV71) vaccines produced by three manufacturers. The coverage and safety of different EV71 vaccines need to be evaluated.Research design and methods: The EV71 vaccination and AEFI data were collected from the Guangzhou Children's Vaccination Information Report Management System and the China AEFI Monitoring Information Management System, and the EV71 vaccine coverage rate and the AEFI incidence rate were analyzed.Results: From 2016 to 2019, the number of people who should have been vaccinated in Guangzhou was 2,781,618, and the coverage rates for doses 1 and 2 were 24.71% and 19.44%, respectively. The inoculation rates of vaccines from manufacturers A and B were between 3.03 and 10.46%. The reported incidence of AEFIs was 11.97 per 100,000 (147 cases), with fever (106 cases, 8.63 per 100,000) and allergic rash (59 cases, 4.80 per 100,000) being the most common reactions. There were no differences in the AEFI responses to the EV71 vaccines from the three manufacturers.Conclusion: The EV71 vaccines from the three manufacturers have good safety, but the EV71 vaccine coverage rate is low. It is recommended that vaccine publicity be strengthened and that the vaccine coverage rate in children be increased.

Safety of pentavalent DTaP-IPV/Hib combination vaccine in post-marketing surveillance in Guangzhou, China, from 2011 to 2017.

BACKGROUND: The DTaP-IPV/Hib combination vaccine can replace the acellular tetanus vaccine, polio vaccine, and the Haemophilus influenzae type B vaccine. Data on the safety of DTaP-IPV/Hib vaccines are required. We aimed to evaluate the safety of the vaccination program. METHODS: Using the National Adverse Events Following Immunization (AEFI) surveillance system (CNAEFIS) in Guangzhou, China, a retrospective study was performed from May 11, 2011, to December 31, 2017. There were 376 cases of adverse events after vaccination with the DTaP IPV/Hib vaccine. The primary analysis indicators were the number of vaccines used, the number of AEFI reports received, and the reporting rate (per 100,000). RESULTS: From May 1, 2011, to December 31, 2017, 516,000 doses of vaccine were inoculated, and 376 cases of adverse reactions were reported; the reporting rate was 72.8 per 100,000 vaccines. There were eight cases of serious AEFIs (1.5 per 100,000), with four cases of thrombocytopenic purpura (0.8 per 100,000); three cases of cyanosis of the lips, stiffness, and flexion of limbs, and convulsions (0.6 per 100,000); and one case of a high fever (0.2 per 100,000). The highest incidence of AEFIs occurred after the fourth dose (n = 207, 55.0%, 40.1 per 100,000), followed by the first dose (n = 81, 21.5%, 15.7 per 100,000), second dose (n = 48, 12.8%, 9.3 per 100,000) and third dose (n = 40, 10.6%, 7.7 per 100,000). The AEFI incidence was higher after injection of the vaccine into the deltoid muscle of the upper arm (n = 276, 73.4%, 53.5 per 100,000) than after injection of the vaccine into the thigh (n = 100, 26.6%, 19.4 per 100,000). There was a significant difference between AEFIs after injection into the deltoid of the upper arm deltoid and the thigh (x2 = 164.8, P < 0.05). CONCLUSIONS: Most of the reported AEFIs after DTaP-IPV/Hib vaccination are not serious. There were four cases of TP in this study; vaccination may be a rare cause of thrombocytopenic purpura.

HIF-1α Preconditioning Potentiates Antioxidant Activity in Ischemic Injury: The Role of Sequential Administration of Dihydrotanshinone I and Protocatechuic Aldehyde in Cardioprotection.

Aims: The management of myocardial ischemia has been challenged by reperfusion injury. Reactive oxygen species (ROS) production is the critical cause of reperfusion injury, but antioxidant treatment failed to gain satisfactory effects. We hypothesized that improvement of redox homeostasis by preconditioning regulation should potentiate the ability of antioxidants to protect the heart from reperfusion injury. Results: By phenotype-based screening, we identified that dihydrotanshinone I (DT) and protocatechuic aldehyde (PCA) potently protected cardiomyocytes through preconditioning regulation and antioxidant activity, respectively. DT induced transient ROS generation via reversible inhibition of mitochondrial respiratory complex I and thereby stabilizing HIF-1α, while PCA elevated the levels of reduced glutathione (GSH) by providing reducing equivalents to scavenge ROS. HIF-1α, stabilized by DT, transcriptionally upregulated Nrf2 and thereby activated antioxidant enzymes, potentiating PCA to protect cardiomyocytes from reperfusion injury by strengthening intrinsic ROS scavenging capacity. In rat ischemia/reperfusion (I/R) model, sequential administration of DT and PCA, but not in reverse, additively protected the heart from I/R injury, manifested by reduced infarct size and improved cardiac function. These results were further supported by sequential administration of metformin and vitamin E in the rat and porcine I/R models. Innovation and Conclusion: Our work demonstrates that preconditioning regulation of redox state is essential for antioxidants to protect the heart from I/R injury, providing a new direction for the treatment of myocardial injury.

[An investigation on a case of hand-foot-mouth disease caused by coxsackie-virus A6 associated with a vaccine-derived poliovirus co-infection].

OBJECTIVE: To identify the pathogen and characteristics on a case of hand-foot-mouth disease (HFMD) caused by coxsackie-virus A6 (CA6) associated with vaccine-derived poliovirus (VDPV) co-infection. METHODS: Field epidemiological study at the epidemic area was conducted and 16 stool samples including from the patient and close contacts were collected for isolation and identification of the enterovirus (EV). 21 stool samples from patients diagnosed as HFMD were collected in the same hospital at the same month to detect CA16,EV71, CA6 and PV by real-time RT-PCR or RT-PCR. The VP1 gene of the CA6 was amplified by RT-PCR and PCR products were sequenced and analyzed. RESULTS: The patient showed only HFMD symptoms, but no symptoms related to acute flaccid paralysis (AFP). No EVs were isolated from 16 samples collected from the patient and close contacts. And no AFP cases were found by an active search. A total of 21 samples from patients diagnosed as HFMD were collected in the same hospital at the same month and 4 were found to be EV71, 2 were CA16 and 15 (include the patient)were CA6. Only this patient was found to have had VDPV II infection. The CA6 VP1 gene was amplified from the HFMD patient and 9 other cases from the same hospital at the same month. Nucleotide sequences of the VP1 gene among the 9 strains shared 98.9%-100.0% in homology and 96.0%-100.0% in the deduced amino acid sequences. Phylogenetic analysis of the VP1 sequences categorized the 9 strains into the same branch. There were 6 nucleotides changes including U2909A between the VP1 region of the VDPV strain of the case and Sabin II. Results from phylogenetic analysis on the VP1 sequences indicated that the VDPV strain of the case was different from other VDPVs strains isolated in the world. CONCLUSION: This case was a HFMD which caused by CA6 co-infection with VDPV II and the VDPV was newly discovered. HFMD symptoms of the case were caused by CA6. The reason why this case did not have AFP symptoms was probably due the protective effect of IPV vaccine. No AFP cases were found by the active search for AFP cases conducted in the area, which indicated that VDPV did not cause virus circulation in this area.

Negative pressure induced ferroelectric phase transition in rutile TiO(2).

First-principles pseudopotential calculations by means of the local density approximation (LDA) within density-functional theory (DFT) are carried out to investigate the negative pressure induced ferroelectric phase transition in rutile TiO(2) in the range of -25 to 25 GPa. The softening behavior of the A(2u)(TO) modes at the Γ point following the decreasing pressure leads to a ferroelectric phase transition from P4(2)/mnm (rutile) space group to P42nm (ferro) space group. The calculated pressure dependence of the phonon frequencies, A(1)(TO), E(TO), and B(2) modes of the ferro TiO(2) relative to A(2u)(TO), E(u)(TO), and B(1u) modes of rutile TiO(2), indicates that the phase transition occurs at around -10 GPa, consistent with the total energy results. The dramatic increase of the c-axial dielectric tensor in the vicinity of the phase transition indicates it to be a typical ferroelectric phase transition. The character of the phase transition is generally identified in terms of the calculated order parameters, displaying a second order.