Long-term immune persistence induced by two-dose BBIBP-CorV vaccine with different intervals, and immunogenicity and safety of a homologous booster dose in high-risk occupational population. Secondary Study Based on a Randomized Clinical Trial

BackgroundBBIBP-CorV vaccine with two doses and an interval of 3-4 weeks had been proved to have good immunogenicity and efficacy as well as an acceptable safety profile according to our initial research and other similar studies. Maintaining adequate neutralizing antibody levels is also necessary for long-term protection, especially in the midst of the COVID-19 pandemic. Our aim was to evaluate the immune persistence of neutralizing antibody elicited by BBIBP-CorV vaccines with day 0-14, 0-21 and 0-28 schedule, and assess the immunogenicity and safety of a homologous booster dose in the high-risk occupational population aged 18-59 years. MethodsA total of 809 eligible participants, aged 18-59 years, were recruited and randomly allocated to receive BBIBP-CorV vaccine with day 0-14, 0-21 or 0-28 schedule respectively between January and May 2021 in Taiyuan City, Shanxi Province, China among the public security officers and the airport ground staff in initial study. In this secondary study, the responders (GMT [≥] 16) at day 28 after priming two-dose vaccine were followed up at months 3, 6 and 10 to evaluate the immune persistence of three two-dose schedules. At month 10, eligible participants of three two-dose schedules were received a homologous booster dose respectively (hereafter abbreviated as 0-14d-10m group, 0-21d-10m group and 0-28d-10m group), and followed up at day 28 post-booster to assess the safety and immunogenicity of the booster dose. The contents of follow-up included the blood samples, oropharyngeal/nasal swabs, and adverse reactions collection. The main outcomes of the study included geometric mean titers (GMT) of neutralizing antibody to live SARS-CoV-2, the positive rates of different criteria and the constituent ratio of GMT of neutralizing antibodies at different follow-up point. Meanwhile, we explored the kinetics of antibody levels of different vaccination regimens by generalized estimating equations (GEE) and used exponent curve model to predict the duration of maintaining protected antibody after the booster dose. We also determined predictors of maintaining protected antibody level within 10 months after the second dose by Cox proportional hazards regression model and nomogram. The trial was registered with ChiCTR.org.cn (ChiCTR2100041705, ChiCTR2100041706). ResultsThe number of 241, 247 and 256 responders (GMT [≥] 16) at day 28 after two-dose BBIBP-CorV vaccine in 0-14d, 0-21d and 0-28d schedule were followed-up at months 3, 6, and 10 for immune persistence evaluation. At month 10, a total of 390 participants were eligible and received a booster dose with 130 participants in the 0-14d-10m, 0-21d-10m and 0-28d-10m group respectively, of whom 74.1% (289/390) were male, with a mean age of 37.1{+/-}10.3 years. The GMT of neutralizing antibody in 0-28d-10m and 0-21d-10m group were significantly higher than 0-14d-10m group at month 3 (GMT: 71.6 & 64.2 vs 46.4, P<0.0001), month 6 (GMT: 47.1 & 42.8 vs 30.5, P < 0.0001) and month 10 (GMT: 32.4 vs 20.3, P < 0.0001; 28.8 vs 20.3, P=0.0004) after the second dose. A sharply decrease by 4.85-fold (GMT: 94.4-20.3), 4.67-fold (GMT: 134.4-28.8) and 4.49-fold (GMT: 145.5-32.4) was observed from day 28 to month 10 after the second dose in 0-14d-10m, 0-21d-10m and 0-28d-10m group, respectively, and they had similar decline kinetics (P=0.67). At 28 days after booster dose, a remarkable rebound in neutralizing antibody (GMT: 246.2, 277.5 and 288.6) were observed in three groups, respectively. Notably, the GMT after booster dose was not affected by priming two-dose schedule. The predictive duration of neutralizing antibody declining to the cutoff level of positive antibody response may be 18.08 months, 18.83 months and 19.08 months after booster dose in three groups, respectively. Long-term immune persistence within 10 months after the second dose was associated with age<40, female, and history of influenza vaccination. All adverse reactions were mild after the booster injection. None of the participants were infected SARS-CoV-2 during the trial period. ConclusionsThe priming two-dose BBIBP-CorV vaccine with 0-28 days and 0-21 days schedule could lead a longer persistence of neutralizing antibody than 0-14 days schedule. Maintaining long-term immune persistence was also associated with age<40, female, and history of influenza vaccination. Regardless of priming two-doses vaccination regimens, a homologous booster dose led to a strong rebound in neutralizing antibody and might elicit satisfactory persistent immunity.

Evaluation on the reliability and validity of the social networking using status scale among medical students / 中华医学教育探索杂志

Objective:To understand the social networking using status of medical students, develop the social networking using status scale (SNUSS) and evaluate its reliability and validity.Methods:In March 2018, 665 valid questionnaires were collected via cluster sampling. The scale was retest in 46 subjects after an interval of 2 months. Factor analysis, correlation analysis and t-test were used to calculate the structure validity and content validity of the scale to evaluate the scale validity, and internal consistency reliability, broken half reliability and retest reliability were used to evaluate the scale reliability. Results:The result of exploratory factor analysis showed NSUSS had two subscales: the dimension of maintaining existing social relations and social network use and the dimension of expanding circle of friends and social network use. The result of confirmatory factor analysis showed that the factor load value of each item was greater than 0.500 ( P < 0.05), and the model fitted well ( χ2/ df = 2.873, GFI = 0.970, CFI = 0.971, RMSEA = 0.074). The r value of correlation between SNUSS and MSPSS was 0.295. I-CVIs were all equal to 0.90, and S-CVI was 0.90, the internal consistency reliability was 0.764, the split-half reliability was 0.555, and the retest reliability was 0.526. Conclusion:SNUSS has good reliability and validity for the use of social network among medical college students, and the use of social network is related to perceived social support.

Safety and Immunogenicity of Inactivated SARS-CoV-2 Vaccine in High-Risk Occupational Population: a randomized, parallel, controlled clinical trial

Vaccination is urgently needed to prevent the global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we conducted a randomized, parallel, controlled clinical trial for assessment of the immunogenicity and safety of an inactivated SARS-CoV-2 vaccine, aiming to determine an appropriate vaccination interval for high-risk occupational population. Participants were randomly assigned to receive two doses of inactivated SARS-CoV-2 vaccine (4 {micro}g per dose) at an interval of either 14 days, 21 days or 28 days. The primary immunogenicity endpoints were neutralization antibody seroconversion and geometric mean titer (GMT) at 28 days after the second dose. Our results showed that the seroconversion rates (GMT [≥] 16) were all 100% in the three groups and the 0-21 and 0-28 groups elicited significantly higher SARS-CoV-2 neutralizing antibody level. All reported adverse reactions were mild. (Chinese Clinical Trial Registry: ChiCTR2100041705, ChiCTR2100041706)

Identifying potential anti-COVID-19 pharmacological components of traditional Chinese medicine Lianhuaqingwen capsule based on human exposure and ACE2 biochromatography screening

Lianhuaqingwen (LHQW) capsule, a herb medicine product, has been clinically proved to be effective in coronavirus disease 2019 (COVID-19) pneumonia treatment. However, human exposure to LHQW components and their pharmacological effects remain largely unknown. Hence, this study aimed to determine human exposure to LHQW components and their anti-COVID-19 pharmacological activities. Analysis of LHQW component profiles in human plasma and urine after repeated therapeutic dosing was conducted using a combination of HRMS and an untargeted data-mining approach, leading to detection of 132 LHQW prototype and metabolite components, which were absorbed

A Vegetable Dietary Pattern Is Associated with Lowered Risk of Gestational Diabetes Mellitus in Chinese Women

Background@#Identification of modifiable dietary factors, which are involved in the development of gestational diabetes mellitus (GDM), could inform strategies to prevent GDM. @*Methods@#We examined the dietary patterns in a Chinese population and evaluated their relationship with GDM risk using a case-control study including 1,464 cases and 8,092 control subjects. Propensity score matching was used to reduce the imbalance of covariates between cases and controls. Dietary patterns were identified using factor analysis while their associations with GDM risk were evaluated using logistic regression models. @*Results@#A “vegetable” dietary pattern was characterized as the consumption of green leafy vegetables (Chinese little greens and bean seedling), other vegetables (cabbages, carrots, tomatoes, eggplants, potatoes, mushrooms, peppers, bamboo shoots, agarics, and garlic), and bean products (soybean milk, tofu, kidney beans, and cowpea). For every quartile increase in the vegetables factor score during 1 year prior to conception, the first trimester, and the second trimester of pregnancy, the GDM risk lowered by 6% (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.89 to 0.99), 7% (OR, 0.94; 95% CI, 0.88 to 0.99), and 9% (OR, 0.91; 95% CI, 0.86 to 0.96). @*Conclusion@#In conclusion, our study suggests that the vegetable dietary pattern is associated with lower GDM risk; however, the interpretation of the result should with caution due to the limitations in our study, and additional studies are necessary to explore the underlying mechanism of this relationship.

Effect of kangaroo care on neurological behavior in neonates with neonatal intensive care unit asphyxia / 中国实用护理杂志

Objective:To explore the effect of kangaroo care on the neurological behavior of neonatal intensive care unit (NICU) neonates with asphyxia.Methods:Totally 76 cases of neonatal asphyxia admitted to NICU from January 2018 to December 2018 were randomly divided into observation group (40 cases) and observation group (36 cases). The control group was given routine nursing care, while the observation group was given kangaroo nursing intervention on the basis of the control group. The neurobehavioral changes, the occurrence of nervous system damage and the physical development after 42 days of birth were compared between the two groups.Results:The scores of behavior ability (11.64 ± 0.26), original reflex (5.89 ± 0.32), passive muscle tension (7.64 ± 0.46), active muscle tension (7.83 ± 0.55), general reaction (6.17 ± 0.46) in the intervention observation group were significantly higher than those in the control group (11.02 ± 0.39), original reflex (5.53 ± 0.31), passive muscle tension (7.21 ± 0.47), active muscle tension (6.17 ± 0.46) Tension (7.41 ± 0.41), general reaction (5.88 ± 0.41) ( t values were 8.227, 4.970, 4.027, 3.740, 2.888, P<0.05). The incidence of neurological damage in the observation group was 2.50% (1/40) which was significantly lower than 16.67% (6/36) in the control group ( χ 2=4.117, P < 0.05). The growth of body weight (2.17 ± 0.42) kg, length (7.15 ± 1.74) cm and head circumference (4.38 ± 0.93) cm in the observation group were significantly higher than those in the control group (1.68 ± 0.39) kg, (5.89 ± 1.81) cm, (3.81 ± 0.79) cm ( t values were 5.252, 3.093, 2.863, P<0.05). Conclusion:Kangaroo nursing can effectively promote the neurological development and physical development of neonatal asphyxia, and reduce the nervous system damage of asphyxiated neonates, and the operation is simple and easy, which is worthy of clinical application.

A Vegetable Dietary Pattern Is Associated with Lowered Risk of Gestational Diabetes Mellitus in Chinese Women

Background@#Identification of modifiable dietary factors, which are involved in the development of gestational diabetes mellitus (GDM), could inform strategies to prevent GDM. @*Methods@#We examined the dietary patterns in a Chinese population and evaluated their relationship with GDM risk using a case-control study including 1,464 cases and 8,092 control subjects. Propensity score matching was used to reduce the imbalance of covariates between cases and controls. Dietary patterns were identified using factor analysis while their associations with GDM risk were evaluated using logistic regression models. @*Results@#A “vegetable” dietary pattern was characterized as the consumption of green leafy vegetables (Chinese little greens and bean seedling), other vegetables (cabbages, carrots, tomatoes, eggplants, potatoes, mushrooms, peppers, bamboo shoots, agarics, and garlic), and bean products (soybean milk, tofu, kidney beans, and cowpea). For every quartile increase in the vegetables factor score during 1 year prior to conception, the first trimester, and the second trimester of pregnancy, the GDM risk lowered by 6% (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.89 to 0.99), 7% (OR, 0.94; 95% CI, 0.88 to 0.99), and 9% (OR, 0.91; 95% CI, 0.86 to 0.96). @*Conclusion@#In conclusion, our study suggests that the vegetable dietary pattern is associated with lower GDM risk; however, the interpretation of the result should with caution due to the limitations in our study, and additional studies are necessary to explore the underlying mechanism of this relationship.

Dental remineralization via poly(amido amine) and restorative materials containing calcium phosphate nanoparticles / 国际口腔科学杂志·英文版

Tooth decay is prevalent, and secondary caries causes restoration failures, both of which are related to demineralization. There is an urgent need to develop new therapeutic materials with remineralization functions. This article represents the first review on the cutting edge research of poly(amido amine) (PAMAM) in combination with nanoparticles of amorphous calcium phosphate (NACP). PAMAM was excellent nucleation template, and could absorb calcium (Ca) and phosphate (P) ions via its functional groups to activate remineralization. NACP composite and adhesive showed acid-neutralization and Ca and P ion release capabilities. PAMAM+NACP together showed synergistic effects and produced triple benefits: excellent nucleation templates, superior acid-neutralization, and ions release. Therefore, the PAMAM+NACP strategy possessed much greater remineralization capacity than using PAMAM or NACP alone. PAMAM+NACP achieved dentin remineralization even in an acidic solution without any initial Ca and P ions. Besides, the long-term remineralization capability of PAMAM+NACP was established. After prolonged fluid challenge, the immersed PAMAM with the recharged NACP still induced effective dentin mineral regeneration. Furthermore, the hardness of pre-demineralized dentin was increased back to that of healthy dentin, indicating a complete remineralization. Therefore, the novel PAMAM+NACP approach is promising to provide long-term therapeutic effects including tooth remineralization, hardness increase, and caries-inhibition capabilities.

Association between maternal dietary intake and the incidence of babies with small for gestational age / 中华流行病学杂志

Objective@#To investigate the relations between dietary intake during pregnancy and the incidence of their babies with small for gestational age (SGA).@*Methods@#Data on demographics, dietary intake of protein, fat, and carbohydrates of the pregnant mothers during the first, second and third trimester, were collected. Information related to birth weight and gestational age of the infants were also gathered. A total of 8 102 women, who delivered their babies at the First Affiliated Hospital of Shanxi Medical University from March 2012 to September 2016, were enrolled in this project. Among them, 961 mothers had infants with SGA but the other 7 141 of them having normal infants. Unconditional logistic regression model was used to analyze the effect of dietary nutrient intake on SGA the first, second and third trimester.@*Results@#We found that low dietary intake of protein during the first trimester and following trimesters during pregnancy were positively associated with higher risk of SGA (OR=1.534, 95%CI: 1.217-1.934; OR=1.268, 95%CI: 1.005-1.599; OR=1.310, 95%CI: 1.036-1.655). When adjusting for maternal pre-pregnancy BMI, we found that when mothers were with a pre-pregnancy BMI less than 18.5 or with low maternal intake of protein during the first trimester, positive association with higher risk of SGA (OR=1.872, 95%CI: 1.033-3.395; OR=1.754, 95%CI: 1.125-2.734), was noticed. However, for mothers with a pre-pregnancy BMI between 18.5 and 24.0 or with low protein intake during the first trimester, significant association with higher risk of SGA (OR=1.465, 95%CI: 1.089-1.972) was found.@*Conclusions@#Through our observation, maternal dietary intake during pregnancy seemed to be associated with the risk of SGA but the effects of dietary intake were different, according to the BMI of pre-pregnancy population. Early pregnancy appeares as the key period for dietary intake which may influence the SGA.

An animal experiment regarding the effect of lipopolysaccharide intervention program on Legionella pneumonia / 中华流行病学杂志

Objective@#To explore the effect of lipopolysaccharide intervention program on Legionella pneumonia.@*Methods@#C3H/HeN mice (6-8 weeks old) were used as experimental animals. The mice were randomly divided into lipopolysaccharide intervention, non-lipopolysaccharide intervention and control groups. Each group was again divided into three time points: 12 h, 24 h and 48 h. Mice in the lipopolysaccharide intervention group were intraperitoneally injected with E. coli lipopolysaccharide (100 ng per mice), and the rest groups were intraperitoneally injected with normal saline. After 24 hours, mice in the lipopolysaccharide intervention and the non-intervention groups mice were infected with Legionella by tracheal injection and the control group was given the same amount of saline. All the mice were killed at 12, 24 and 48 hours respectively. The mice were anatomized, lungs of the mice were separated and weighed. Organ coefficients (lung weight/body weight of mice) were calculated. 1 ml Orbital blood was collected. Toll-like receptor 4 (TLR4) levels of peripheral blood mononuclear cells were measured by flow cytometry. The contents of TNF-α and IL-1β in the upper left lung lobe were measured by ELISA.@*Results@#In the lung organs, the coefficients of lipopolysaccharide non-intervention group were higher than the other groups and there was no significant difference seen between the lipopolysaccharide intervention group and the controls. TLR4 peaked at 12 hours in both the lipopolysaccharide intervention and the non-intervention groups while the TLR4 level in the intervention group was higher than that in the non-intervention group. There were no significant differences appeared on the TLR4 expression levels between the two Legionella pneumonia modelled groups at 24 or 48 hours. There was no significant difference seen regarding the concentration of TNF-α and IL-1β between the intervention and the control groups. The secretion levels of TNF-α and IL-1β in the non-intervention group were higher than those in the intervention group at each time point.@*Conclusion@#The lipopolysaccharide intervention program may alleviate the inflammatory symptoms of Legionella infection.

Interaction between dietary cholesterol intake and the risk of gestational diabetes mellitus / 中华流行病学杂志

Objective To investigate the influence of dietary cholesterol intake on gestational diabetes mellitus (GDM),at one year prior to and first and second trimesters of pregnancy.Methods Between March 2012 and September 2016,the pregnant women from the First Affiliated Hospital of Shanxi Medical University were asked to fill in a set of questionnaires,by which information on general demographic characteristics,diagnosis of GDM and dietary cholesterol intake was collected.Unconditional logistic regression method was used to analyze the influence of dietary cholesterol intake on GDM,at one year prior to and first and second trimesters of pregnancy.The association on dietary cholesterol intake and GDM between age groups was also analyzed.Results Data on 9 005 subjects,including 1 388 pregnant women with GDM,was collected.When the amount of cholesterol intake was stratified into quartile,results from the unconditional logistic regression showed that dietary cholesterol intake appeared ≥76.50 mg/d,both in the periods of one year prior to and the second trimester of pregnancy.This amount of dietary cholesterol intake would increase the risk of GDM (one year prior to pregnant:OR=1.230,95％CI:1.018-1.485;second trimester:OR=1.228,95％C1:1.014-1.486).Women who took ≥76.50 mg/d of daily cholesterol during the period of one year prior to,or 46.75-76.50 mg/d during the second trimester of pregnancy,the risks of GDM (OR=4.644,95％CI:1.106-19.499) would increase.Women with daily cholesterol intake over 76.50 mg/d during the period of one year prior to or at the second trimester of pregnancy,there appeared a risk on GDM (OR=1.217,95％ CI:1.012-1.463).When maternal age was divided in two different subgroups and the cholesterol intake level was ≥76.50 mg/d both in the period of one year prior to pregnancy or at the second trimester,the risk of GDM appeared in the subgroup of ＜35 years old (OR=1.336,95％CI:1.083-1.647;OR=1.341,95％CI:1.087-1.654).However,no significant association was found in the maternal age group of ≥35 years old.Conclusion High level of dietary cholesterol intake would increase the risk of GDM,both in the period of one year prior to and at the second trimester of pregnancy.

Relationship between the HBsAg-positive infection status of mothers and the non/low-response to hepatitis B vaccine of their infants / 中华流行病学杂志

Objective To explore the relationship between the status of HBsAg-positive infection of mothers and the non/low-response to hepatitis B vaccine of their infants.Methods A total of 225 pairs of mothers and their infants were recruited in our cohort from June 2011 to July 2013.Infants were given three doses of hepatitis B vaccine at hour 24,first month and month 6th respectively and were followed up for one year after birth.HBV serological markers and HBV DNA in the peripheral blood of both mothers and infants were detected by Electro-chemiluminescence immunoassay and fluorescence quantitative Polymerase Chain Reaction.Results Six HBV infection models were detected in HBsAg-positive mothers,and "HBsAg (+),HBeAg (+),anti-HBc (+)" (model one) and "HBsAg (+),anti-HBe (+),anti-HBc (+)" (model two) accounted for 92.5％ (208/225) of all the models.Rate of non/low-response to hepatitis B vaccine in infants born to mothers in model one was lower than those in model two,the differences are statistically significant (x2=4.80,P=0.029).The rate of non/low-response to hepatitis B vaccine in infants showed a downward trend with the rising of HBeAg level in their mothers (x2=4.86,P=0.028).Results from the unconditional logistic regression analysis showed that the HBeAg of the HBsAg-positive mothers was significantly correlated with the low risk of non/low-response to hepatitis B vaccine in infants (OR=0.598,95％CI:0.378-0.947).The positive rate of serum HBV DNA in HBsAg-positive mothers was 54.2％,while the rate of non/low-response to hepatitis B vaccine in infants born to HBV DNA positive mothers was similar to those infants born to HBV DNA negative mothers (X2=0.22,P=0.640).Conclusions "HBsAg (+),HBeAg (+),anti-HBc (+)" and "HBsAg (+),anti-HBe(+),anti-HBc (+)" were the common models seen in HBsAg-positive mothers,and the rate of non/low-response to hepatitis B vaccine was different between the two models.HBeAg of HBsAg-positive mothers might have positive effects on the immune response to hepatitis B vaccine in infants but the mechanisms remained not clear.HBV DNA of the HBsAg-positive mothers did not seem to be correlated with the immune response to hepatitis B vaccine in infants.

Related factors and interaction on HIV/HCV co-infection of patients access to methadone maintenance treatment / 中华流行病学杂志

Objective To estimate the prevalence of HIV/HCV co-infection and explore the influence factors and their interaction on HIV/HCV co-infection of patient's access to methadone maintenance treatment (MMT).Methods A face to face interviews were conducted among 750 patients at two MMT clinics in Guangxi Zhuang Autonomous Region.The questionnaires information included demographic characteristics,HIV and HCV infection status,history of drug abuse,urine test for morphine,high risk sex behaviors,needle sharing,dropped out etc.Methods of x2 test one-way,multivariate logistic regression and interactions were used to analyze the related factors of HIV/HCV co-infection.Results The study subjects included 750 participants,18.31％ (127/691) of patients were co-infected with HIV and HCV.The HIV/HCV co-infection rate in patients who shared needles with others or dropped out of treatment was 35.84％ (81/226) and 19.88％ (64/322) respectively,which were higher than those who have never shared needles or dropped out (9.89％,46/465 and 17.07％,63/369).Logistic regression analysis results showed that after adjusted for confounding factors,patients who shared needles (OR=4.50,95％CI:2.72-7.43) and dropped out of treatment (OR=1.71,95％CI:1.04-2.80) were more likely to be infected with HIV/HCV.Interaction analysis showed that sharing needles and dropping out of treatment exist additive effect on co-infection of HIV and HCV (RERI=4.21,AP=0.44,SI=1.95).Conclusions Needle sharing and dropping out of treatment are associated with HIV/HCV co-infection.Health education,psychological counseling and other measures should be taken to reduce needle sharing and dropping out of MMT.

Approaches and Methods of Promoting Doctor-patient Communication under "Internet +" Era / 中国医学伦理学

Under the"Internet +" era, some medical staff' s treatment philosophy cannot adapt to the current situation, and patients are prone to produce high expectations because of inadequate basic medical knowledge and the habit of acquiring medical information from Internet. However, when the difference between reality and expec-tations are large, they might be in disputes with medical staffs, and coupled with the lag of hospital management, the doctor-patient communication often is not smooth situation. Therefore, it is recommended that medical staffs improve humanistic quality meanwhile improving technology, patients should develop the habit of acquiring medical information from Internet correctly, hospital needs to optimize management and allocate medical resource reasona-bly, and society should also create positive atmosphere.

Research advances on factors relevant to the progression of acute isolated pontine infarction / 中华神经科杂志

Progression of acute isolated pontine infarction (IPI) is a common clinical event that positively correlates with the patients' adverse prognosis.Therefore,exploration on the relevant factors and predictors to the progression of IPI has become the current research hotspot.To date,the relevant factors that have been proposed include basilar artery branch disease,female,hypertension and blood pressure fluctuation,hyperglycemia,morphological features of the lesions (ventral surface of pons involvement,located at the lower pons,multiple axial slices affected,conglomerated beads shape),severe white matter diseases,atherosclerosis,long diameter and midline location of basilar artery,and so on.However,the interpretation on existing results has to be cautious as the definition for progressive IPI,criteria for inclusion and exclusion,and examinations are inconsistent in different studies.The investigation on relevant factors to the progression of IPI still requires standardized,large-scale prospective clinical studies.

Interaction between dietary cholesterol intake and the risk of gestational diabetes mellitus / 中华流行病学杂志

Objective To investigate the influence of dietary cholesterol intake on gestational diabetes mellitus (GDM),at one year prior to and first and second trimesters of pregnancy.Methods Between March 2012 and September 2016,the pregnant women from the First Affiliated Hospital of Shanxi Medical University were asked to fill in a set of questionnaires,by which information on general demographic characteristics,diagnosis of GDM and dietary cholesterol intake was collected.Unconditional logistic regression method was used to analyze the influence of dietary cholesterol intake on GDM,at one year prior to and first and second trimesters of pregnancy.The association on dietary cholesterol intake and GDM between age groups was also analyzed.Results Data on 9 005 subjects,including 1 388 pregnant women with GDM,was collected.When the amount of cholesterol intake was stratified into quartile,results from the unconditional logistic regression showed that dietary cholesterol intake appeared ≥76.50 mg/d,both in the periods of one year prior to and the second trimester of pregnancy.This amount of dietary cholesterol intake would increase the risk of GDM (one year prior to pregnant:OR=1.230,95％CI:1.018-1.485;second trimester:OR=1.228,95％C1:1.014-1.486).Women who took ≥76.50 mg/d of daily cholesterol during the period of one year prior to,or 46.75-76.50 mg/d during the second trimester of pregnancy,the risks of GDM (OR=4.644,95％CI:1.106-19.499) would increase.Women with daily cholesterol intake over 76.50 mg/d during the period of one year prior to or at the second trimester of pregnancy,there appeared a risk on GDM (OR=1.217,95％ CI:1.012-1.463).When maternal age was divided in two different subgroups and the cholesterol intake level was ≥76.50 mg/d both in the period of one year prior to pregnancy or at the second trimester,the risk of GDM appeared in the subgroup of ＜35 years old (OR=1.336,95％CI:1.083-1.647;OR=1.341,95％CI:1.087-1.654).However,no significant association was found in the maternal age group of ≥35 years old.Conclusion High level of dietary cholesterol intake would increase the risk of GDM,both in the period of one year prior to and at the second trimester of pregnancy.

Relationship between the HBsAg-positive infection status of mothers and the non/low-response to hepatitis B vaccine of their infants / 中华流行病学杂志

Objective To explore the relationship between the status of HBsAg-positive infection of mothers and the non/low-response to hepatitis B vaccine of their infants.Methods A total of 225 pairs of mothers and their infants were recruited in our cohort from June 2011 to July 2013.Infants were given three doses of hepatitis B vaccine at hour 24,first month and month 6th respectively and were followed up for one year after birth.HBV serological markers and HBV DNA in the peripheral blood of both mothers and infants were detected by Electro-chemiluminescence immunoassay and fluorescence quantitative Polymerase Chain Reaction.Results Six HBV infection models were detected in HBsAg-positive mothers,and "HBsAg (+),HBeAg (+),anti-HBc (+)" (model one) and "HBsAg (+),anti-HBe (+),anti-HBc (+)" (model two) accounted for 92.5％ (208/225) of all the models.Rate of non/low-response to hepatitis B vaccine in infants born to mothers in model one was lower than those in model two,the differences are statistically significant (x2=4.80,P=0.029).The rate of non/low-response to hepatitis B vaccine in infants showed a downward trend with the rising of HBeAg level in their mothers (x2=4.86,P=0.028).Results from the unconditional logistic regression analysis showed that the HBeAg of the HBsAg-positive mothers was significantly correlated with the low risk of non/low-response to hepatitis B vaccine in infants (OR=0.598,95％CI:0.378-0.947).The positive rate of serum HBV DNA in HBsAg-positive mothers was 54.2％,while the rate of non/low-response to hepatitis B vaccine in infants born to HBV DNA positive mothers was similar to those infants born to HBV DNA negative mothers (X2=0.22,P=0.640).Conclusions "HBsAg (+),HBeAg (+),anti-HBc (+)" and "HBsAg (+),anti-HBe(+),anti-HBc (+)" were the common models seen in HBsAg-positive mothers,and the rate of non/low-response to hepatitis B vaccine was different between the two models.HBeAg of HBsAg-positive mothers might have positive effects on the immune response to hepatitis B vaccine in infants but the mechanisms remained not clear.HBV DNA of the HBsAg-positive mothers did not seem to be correlated with the immune response to hepatitis B vaccine in infants.

Related factors and interaction on HIV/HCV co-infection of patients access to methadone maintenance treatment / 中华流行病学杂志

Objective To estimate the prevalence of HIV/HCV co-infection and explore the influence factors and their interaction on HIV/HCV co-infection of patient's access to methadone maintenance treatment (MMT).Methods A face to face interviews were conducted among 750 patients at two MMT clinics in Guangxi Zhuang Autonomous Region.The questionnaires information included demographic characteristics,HIV and HCV infection status,history of drug abuse,urine test for morphine,high risk sex behaviors,needle sharing,dropped out etc.Methods of x2 test one-way,multivariate logistic regression and interactions were used to analyze the related factors of HIV/HCV co-infection.Results The study subjects included 750 participants,18.31％ (127/691) of patients were co-infected with HIV and HCV.The HIV/HCV co-infection rate in patients who shared needles with others or dropped out of treatment was 35.84％ (81/226) and 19.88％ (64/322) respectively,which were higher than those who have never shared needles or dropped out (9.89％,46/465 and 17.07％,63/369).Logistic regression analysis results showed that after adjusted for confounding factors,patients who shared needles (OR=4.50,95％CI:2.72-7.43) and dropped out of treatment (OR=1.71,95％CI:1.04-2.80) were more likely to be infected with HIV/HCV.Interaction analysis showed that sharing needles and dropping out of treatment exist additive effect on co-infection of HIV and HCV (RERI=4.21,AP=0.44,SI=1.95).Conclusions Needle sharing and dropping out of treatment are associated with HIV/HCV co-infection.Health education,psychological counseling and other measures should be taken to reduce needle sharing and dropping out of MMT.

Prevalence and related factors of HIV/HBV coinfection among HIV/AIDS patients / 中华流行病学杂志

Objective To reveal the prevalence and the related factors of hepatitis B (HepB) virus infection among HIV/AIDS patients.Methods We conducted a cross-sectional study in two HIV clinics,affiliated to local Centers of Disease Control and Prevention in Guangxi Zhuang Autonomous Regional.A face-to-face interview,with questionnaire was conducted to collect information on socio-demographic characteristics,drug use,and sexual behavior.Blood samples were used to test HBsAg.x2 test or Fisher's exact test and unconditional logistic regression models were used to identify the influencing factors.Results The prevalence of HBV and HIV co-infection was 13.85％ (113/816).Results from multivariate logistic regression analyses showed that age (25-45),family history of HBV and history of HepB vaccination were independent influencing factors for HBV and HIV coinfection,with OR (95％ CI) as 1.738 (1.031-2.931),2.898 (1.678-5.005) and 1.744 (1.052-2.892),respectively.Conclusion The prevalence of HBV among HIV/AIDS patients was significantly higher than that in general population.HIV/AIDS patients aged between 25 and 45 and with family history of HBV were more likely to be infected with HBV,while HepB vaccination was associated with the reduction of HIV/HBV coinfection.Specific comprehensive prevention and treatment programs on HIV/AIDS patients need to be set up.

Relationship between HBeAg from HBsAg positive mothers and regulatory T cells in neonates and its influence on HBV intrauterine transmission / 中华流行病学杂志

Objective To explore the relationship between HBeAg in HBsAg positive mothers and CD4 + CD25 + Foxp3 + regulatory T cells (Treg) in newborns,as well as how they would influence the increasing risk on HBV intrauterine transmission.Methods We collected information on general demographic characteristics and delivery on 270 HBsAg positive mothers and their newborns from the Third People's Hospital of Taiyuan.Fluorescence quantitative polymerase chain reaction (FQ-PCR) and chemiluminescence immunoassay (CLIA) were used to detect HBV DNA and HBV serological markers in peripheral blood from both mothers and neonates.The expression of Treg and other immune cells in peripheral blood of neonates were detected with flow cytometry (FCM).Results Maternal HBeAg positive rates were associated with an increased risk of intrauterine transmission (0R=4.08,95％ CI:1.89-8.82).Rates of T.reg in newborns born to HBsAg-positive mothers were higher than that of the negative group (Z=2.29,P=0.022).Each pair of the subjects was assigned to five different groups according to the HBeAg titers of mothers.Frequencies of both Treg and HBeAg in newboms and HBV DNA in mothers between the above said 5 groups showed similar trends of changing patterns and the differences between groups were statistically significant (x2=18.73,P＜0.001;x2=181.60,P＜0.001;x2=183.09,P＜0.001).Results from partial correlation analysis showed that after adjusting for neonatal HBeAg and maternal HBV DNA,mother's HBeAg titers were positively related to the percentage of Treg in their newboms (rs=0.19,P=0.039).In addition,the frequencies of Treg were negatively correlated with pDC and CD4 + T cell in their newborns (rs=-0.21,P=0.017;r,=-0.23,P=0.009).Conclusion HBeAg from HBsAg positive mothers might have inhibited the function of neonatal DC cells and T cells to reduce the immune response to HBV by up-regulating the proportion of Treg and finally increased the risk of HBV intrauterine transmission.