黑龙江省乙型肝炎血清流行病学调查分析

为了掌握黑龙江省乙型肝炎(乙肝)病毒(HBV)流行现状和人群免疫水平,评价我省儿童乙肝疫苗预防接种效果,为制订乙肝预防控制策略提供依据。采用横断面调查方法,选择全省7个国家级疾病监测点,在每个监测点随机抽取2个乡级单位,1～59岁作为目标人群共调查3337名人群。黑龙江省1～59岁人群乙肝病毒表面抗原(HBsAg)阳性率、乙肝病毒表面抗体(抗-HBs)阳性率和乙肝病毒核心抗体(抗-HBc)阳性率经标化后为5.65%、55.45%、30.50%,1～3岁人群乙肝表面抗原阳性率明显低于15～59岁人群。1～3岁、4～10岁和11～14岁人群乙肝疫苗全程接种率为99.43%、89.40%和64.81%;首针及时接种率分别为86.64%、75.57%和49.87。城市和农村HbsAg阳性率分别为3.26%和5.04%。医院出生儿童乙肝疫苗首针及时接种率高于在家出生儿童。结果显示接种乙肝疫苗可明显提高抗-HBs阳性率,提高人群对HBV的免疫保护能力,降低HBsAg携带率。     

低出生体重儿乙肝疫苗免疫持久性与安全性分析

目的:研究低出生体重儿乙肝疫苗免疫持久性与安全性。方法:选择86例低出生体重儿作为研究组,另选取86例正常出生体重儿作为对照组,分别对两组接种全程酵母乙肝疫苗后的抗-HBs阳性率、抗体平均滴度进行检测,并观察不良反应的发生情况。结果:研究组与对照组接种全程乙肝疫苗后3年内的抗-HBs的有效阳性率分别是74%和72.1%(P0.05),抗体平均滴度分别是214.2 mIU/mL与210.8 mIU/mL(P0.05);6年内的抗-HBs的有效阳性率分别是82.6%和81.4%(P0.05),抗体平均滴度分别是178.6 mIU/mL与170.4 mIU/mL(P0.05)。研究组与对照组接种第1针、第2针乙肝疫苗后均未发现发热、体温波动与败血症等不良反应。结论:免疫后数年内,低出生体质量对乙肝疫苗抗体的持久性没有影响,也不影响乙肝疫苗抗体的安全性。     

潍坊市坊子区2012年产前HBsAg筛检及新生儿首针乙肝疫苗接种情况分析

目的：了解住院分娩产妇乙肝病毒表面抗原（ HBsAg）检测及其所生新生儿首针乙肝疫苗及时接种情况,为进一步完善新生儿乙型肝炎的免疫预防策略提供依据。方法对2012年坊子区设有产科的医院每月上报的产妇HBsAg 检测和新生儿首针乙肝疫苗接种资料进行分析。结果坊子区2012年设有产科的医疗机构共报告住院分娩产妇2975名,产前HBsAg筛检2881名,筛检率为96．84％,各医疗机构筛检率在96．55％和97．50％之间;检出HBsAg阳性者66例,阳性率为2．29％,各医疗机构阳性率在0．00％和5．52％之间。新生儿共2975名,其中常住者所生新生儿2612名,流动者所生新生儿363名,常住和流动的新生儿乙肝疫苗接种率分别为96．13％和94．21％,及时接种率分别为93．87％和90．36％,差异均无统计学意义（χ2＝2．98、3．67,P＞0．05）。122名未及时接种首针乙肝疫苗的新生儿系患各种疾病所致。结论坊子区2012年设有产科的医院对住院的孕产妇产前HBsAg筛查率较高,其所生的新生儿24 h内乙肝疫苗及时接种率较高。     

乙型肝炎疫苗-卡介苗联合疫苗动物安全性试验研究

为评价乙型肝炎疫苗-卡介苗联合疫苗的安全性,分别给豚鼠皮下注射、小鼠皮内注射乙型肝炎疫苗-卡介苗联合疫苗或卡介苗,豚鼠每2周称体重一次,观察6周,解剖检查其病理变化;小鼠也进行病理检查。结果乙型肝炎疫苗-卡介苗联合疫苗接种组和卡介苗接种组的豚鼠体重均增加,疫苗注射局部及各脏器病理改变相似;小鼠接种局部皮肤病理改变也未见差异。结论为乙肝表面抗原(HBsAg)没有促使卡介苗毒力增强,乙型肝炎疫苗-卡介苗联合疫苗接种实验鼠是安全的。     

HBsAg阴性母亲及其婴儿乙肝疫苗接种情况和免疫效果研究

目的：了解乙肝表面抗原阴性（HBsAg阴性）母亲及其婴儿乙肝疫苗接种情况及抗-HBs滴度水平,从而为今后针对该特殊人群进行更好的乙肝疫苗免疫策略提供依据。方法：2010年5月～2010年10月,对陕西省227对HBsAg阴性母亲及其婴幼儿（月龄为8～24月）进行流行病学调查并采集血液标本,对母婴血清抗-HBs进行定性及定量检测。结果：母亲乙肝表面抗体（抗-HBs）阳性率为45.4%,抗-HBs平均滴度为12.88 mIU/mL（95%CI：8.91-18.19）。婴儿乙肝疫苗首针、第二针和第三针的及时接种率分别为95.2%,93.8%和85.9%。婴儿抗-HBs阳性率为77.1%,抗-HBs平均滴度为37.15 mIU/mL（95%CI：28.18-48.98）。结论：婴儿乙肝疫苗首针及时接种率较高,但三针全程及时接种率仍需提高。母亲抗-HBs阳性率较低,应当重视HBsAg阴性孕龄妇女的乙肝疫苗接种及乙肝标志物的检测,从而提高该人群的乙肝免疫水平。     

鱼山镇1岁以上人群不同年龄组乙肝表面抗原携带率与乙肝疫苗接种关系的调查

研究鱼山镇乙肝疫苗接种率不同人群的乙肝病毒表面抗原(HBsAg)携带率的差异。将该镇所有户籍登记在册人员按出生日期分成3组,再按随机抽样法对每个年龄组抽取一定数量的人组成样本,调查乙肝疫苗接种史;对每位参加者采集静脉血5ml,无菌分离血清,使用固相放射免疫试剂和酶联免疫试剂检测乙肝病毒表面抗原和抗乙肝病毒表面抗原抗体(HBsAb,抗-HBs)。小年龄组、中年龄组、大年龄组乙肝疫苗接种率依次为80.00%、50.46%、25.36%,差异具有统计学意义(χ2=262.24,P<0.005);小年龄组、中年龄组、大年龄组HBsAg携带率依次为2.07%、11.93%、17.87%,差异具有统计学意义(χ2=77.48,P<0.005);小年龄组、中年龄组、大年龄组HBsAb依次为43.38%、24.77%、10.95%,差异具有统计学意义(χ2=107.28,P<0.005)。乙肝疫苗接种率在小年龄组、中年龄组、大年龄组依次降低,HBsAg携带率依次增高,HBsAb阳性率依次降低。因此,接种乙肝疫苗对人群有较好的保护作用,人群乙肝疫苗接种率越高,HBsAb阳性率越高,HBsAg携带率越低。     

河南省9个县农村地区儿童第二类疫苗接种率及影响因素调查

目的 了解河南9个县农村地区第二类疫苗接种情况及其影响因素,评价第一类替代疫苗现状,为全省提高第二类疫苗接种率和制定第一类疫苗使用策略提供参考依据.方法 采用单纯随机抽样方法,抽取濮阳市、新乡市、南阳市、商丘市、洛阳市5个地市9个县18个乡镇32个村的1 463名2～7周岁农村儿童,疫苗接种知识及主要影响因素从调查儿童监护人获得,疫苗接种记录来自于儿童预防接种证,用EPiData 3.1软件建立数据库,采用Excel 2003和SPSS 17.0进行数据统计分析.结果 9个县农村儿童中第一类替代疫苗率最高的是甲肝灭活疫苗第一针,占20.6％,其次是首针次ACYW135(1)流脑疫苗和AC流脑结合疫苗(1),分别占适龄接种对象的13.8％、12.9％.第二类疫苗以b型流感嗜血杆菌(Hib)第一针次接种率最高,达到46.4％,Hib疫苗三针次接种率为12.6％,其次是水痘疫苗接种率为23.2％;口服轮状疫苗(RV)、23价肺炎(PPV23)疫苗接种率较低,分别为9.5％和7.3％.单因素与多因素logistic回归分析结果表明,接种方式、儿童类别、疫苗价格高低都是影响第二类疫苗接种针次多少的主要因素,乡镇门诊化接种4～6针次和7针次以上的比例分别为22.5％、6.9％,高于村级接种比例12.8％和1.9％;散居儿童疫苗接种针次高于托幼儿童(P＜0.01);监护人文化程度、家庭收入、接种通知方式、儿童是否留守等对二类疫苗接种针次影响不大或无影响(P＞0.05).结论 不同县第二类疫苗替代一类疫苗率和种类不同;第二类疫苗接种率因各地接种方式、价格因素、重视程度和家长认知程度不同而差别较大;扩大以乡为单位接种门诊实施范围、降低第二类疫苗接种价格并加大托幼机构第二类疫苗的宣传等有利于提高第二类疫苗的接种率和接种针次.     

钦南区1～6岁儿童乙肝及白喉疫苗免疫效果分析

目的分析钦南区儿童乙肝及白喉疫苗接种后的免疫效果,为该地区儿童免疫规划工作提供科学依据。方法采用整群随机抽样方法,选取5个乡镇1~6岁常住儿童151名为调查对象,进行病毒性乙型肝炎(乙肝)、白喉血清学检测,并对结果进行分析。结果 HBsAg阳性2人,阳性率1.32%;抗-HBs阳性112人,阳性率74.17%。白喉IgG阳性142人,阳性率94.04%。抗-HBs中位数21.32 mIU/mL,白喉IgG中位数0.14 mIU/mL,乙肝疫苗首针及时接种率83.44%;男女抗-HBs阳性率、白喉IgG阳性率、抗体中位数差异均无统计学意义(P0.05),抗-HBs阳性率、白喉IgG阳性率随年龄的增长而下降(P0.01)。结论钦南区1~6岁儿童乙肝疫苗接种率、首针及时接种率均达到了国家免疫规划的目标,白喉IgG阳性率维持较高的水平,但HBsAg阳性率略高于国家免疫规划的目标,儿童免疫规划工作仍需进一步加强。     

广州市15岁以下人群乙肝疫苗查漏补种项目实施效果评价

目的评价广州市2001—2011年15岁以下人群乙肝疫苗查漏补种效果,为制定乙肝免疫策略提供依据。方法对广州市2001年、2008年和2009—2011年15岁以下儿童乙肝疫苗查漏补种项目实施效果进行评价。结果 3次乙肝疫苗查漏补种实施,可调查儿童6 973～319 478人,2001年、2008年和2009—2011年实施乙肝疫苗查漏补种项目首针及时接种率分别为90.88%9、5.1%和96.92%,全程接种率分别为92.44%、97.14%和99.08%。2009—2011年乙肝疫苗首针及时接种率比2001年、2008年分别提高了15.21%和88.70%;2009—2011年乙肝疫苗全程接种率比2001年、2008年分别提高了15.27%和88.71%。结论乙肝疫苗查漏补种项目的实施,显著提高了乙肝疫苗首针及时接种率和全程接种率,起到了良好的预防作用。     

新疆生产建设兵团儿童乙型肝炎疫苗接种率现况分析

目的:了解新疆生产建设兵团1992年以后出生儿童乙型肝炎疫苗接种情况和影响因素,为相关部门决策提供依据.方法:在南疆、北疆的8个年龄层等比例随机抽取儿童918名,进行乙型肝炎疫苗接种率问卷调查.用SPSS13.0软件进行统计学处理.结果:①儿童乙型肝炎疫苗首针及时接种率为65.7%(标准化率79.28%);全程接种率为70.2%(标准化率72.15%).②南疆、北疆儿童首针及时接种率分别为51.O%、82.5%,全程接种率分别为54.9%、87.6%.③在医院内、医院外出生儿童首针及时接种率分别为90.4%、54.1%,全程接种率分别为89.8%、61.0%.④汉族、少数民族儿童首针及时接种率分别为68.2%、60.9%,全程接种率分别为72.1%、66.3%.结论新疆生产建设兵团儿童乙型肝炎疫苗全程接种率低于全国平均水平.乙型肝炎疫苗接种率南疆高于北疆、在医院出生儿童高于在医院外出生儿童.汉族儿童的全程接种率相对较高.     

Immunisation of neonates at high risk of hepatitis B in England and Wales: national surveillance.

The results of a voluntary programme of immunisation against hepatitis B in neonates at high risk (mother being positive for hepatitis B surface antigen and without hepatitis B e antibody or having had acute hepatitis B late in pregnancy) are reported. The programme was offered in England and Wales from November 1982. Passive immunisation alone was available in the first six months of life until 1985, after which infants received passive and active immunisation from birth; in addition, some infants received passive immunisation for six months followed by a course of hepatitis B vaccine. All but a few infants received the first immunising dose within 48 hours after birth. Blood samples for analysing markers of hepatitis B virus were available at 1 year from 147 of the 223 infants given passive immunisation, 54 of the 72 given passive followed by active immunisation, and 102 of the 155 given passive and active immunisation at birth. At 1 year 11 of the 127 (9%) infants given four or more doses of specific hepatitis B immunoglobulin were positive for hepatitis B surface antigen compared with four of the 20 given three or fewer doses; 11 had levels of hepatitis B surface antibody greater than 50 IU/l. Only one of the 54 infants given passive then active immunisation was positive for hepatitis B surface antigen at 1 year and four infants had low (less than or equal to 50 IU/l) levels of hepatitis B surface antibody. Four of the 102 infants who received passive and active immunisation at birth were positive for hepatitis B surface antigen. Two had received the fill course of vaccine, whereas in the other two vaccination was incomplete or unstated. In 79 of the 89 infants who received a complete course of vaccination the level of hepatitis B surface antibody was known, and 70 had levels at 1 year greater than 100 IU/1. Reactions to immunisation were not severe at any age. The incidence of side effects was 8% for the immunoglobulin, 11% for the vaccine, and 9% when immunoglobulin and vaccine were given together. Wider collaboration in the programme is requested.     

新生儿国产重组(酵母)乙型肝炎疫苗免疫效果考核

为了考核新生儿接种国产重组(酵母)乙型肝炎(乙肝)疫苗后的免疫效果,并与血源乙肝疫苗效果比较。对1997年出生并接种重组(酵母)乙肝疫苗的新生儿隔年随访一次,采血检测乙肝病毒表面抗原(HBsAg),乙肝病毒表面抗体(抗-HBs)和乙肝病毒核心抗体(抗-HBc),1998年以后对乙肝免疫人群开展急性乙肝发病监测。显示五年期间3次随访检测HBsAg阳性率平均为1.5%,较免前本底的HBsAg阳性率呈较大幅度下降,疫苗保护率为83%(95%可信区间为76.97%~89.02%),无论母亲HBsAg阳性或阴性,使用不同乙肝疫苗的儿童HBsAg阳性率没有统计学差异。接受重组(酵母)乙肝疫苗免疫的对象中,无一例急性乙肝病例报告。重组(酵母)乙肝疫苗有较好的近期保护效果和免疫原性,与以前使用血源乙肝疫苗效果相当。     

Presence of maternal anti-HBs antibodies does not influence hepatitis B vaccine response in Brazilian neonates

Recently, it was suggested that maternal hepatitis B surface antigen antibodies (anti-HBs) acquired transplacentally could play a negative role in newborn infants' immune response to the hepatitis B vaccine. We compared the hepatitis B virus (HBV) vaccine response in infants born to mothers previously vaccinated against HBV (n = 91) to infants born to mothers who were not previously vaccinated (n = 221). All newborn infants received three intramuscular doses (10 μg) of HBV vaccine (Butang?) at 0,1 and six months. The first dose was administered at the maternity hospital within 12 h of birth. The geometric mean titres of anti-HBs were not different among newborn infants born to mothers who were anti-HBs-negative (492.7 mIU/mL) and anti-HBs-positive (578.7 mIU/mL) (p = 0.38). Eight infants did not respond to the HBV vaccine. Of them, six were born to anti-HBs-negative mothers and two were born to mothers with anti-HBs titres less than 50 mlU/mL. Despite the mother's anti-HBs-positive status, our data show a good immunogenicity of the Brazilian HBV recombinant vaccine in neonates.     

Associative effect of Rhizobium and phosphate-solubilizing bacteria on the yield and nutrient uptake of chickpea

Combined inoculation of Rhizobium and ‘Phosphate-solubilizing’Pseudomonas striata orBacillus polymyxa with and without added chemical fertilizer on chickpea yield and nutrient content was studied under greenhouse conditions. While the single inoculation of Rhizobium increased the nodulation and nitrogenase activity, the ‘phosphate-solubilizers’ increased the available phosphorus content of the soil. Combined inoculation of Rhizobium andP. striata orB. polymyxa increased the above parameters and also the dry matter content, the grain yield and nitrogen and phosphorus uptake significantly over the uninoculated control. The inoculation effects were more pronounced in the presence of added fertilizers. The possibilities of saving half the dose of N and replacing superphosphate with rockphosphate and inoculation with ‘phosphate-solubilizers’ are discussed.     

Understanding and enhancing compliance with the second dose of hepatitis B vaccine: a cohort analysis and a randomized controlled trial

OBJECTIVE: To determine the predictors and extent of noncompliance with a second dose of hepatitis B vaccine and the effectiveness of a compliance enhancement strategy. DESIGN: Cohort analysis and randomized clinical trial. SUBJECTS: A total of 256 consecutive adults attending a sexually transmitted diseases clinic from October 1992 to July 1993 who were seronegative for hepatitis B virus and agreed to receive hepatitis B vaccination. SETTING: Hamilton, Ont. INTERVENTION: Subjects were followed up for 4 months. Those who did not return for the second dose of vaccine by 6 weeks after the first (2 weeks overdue) were randomly assigned to the enhanced intervention group (telephone and mail reminders) or the regular intervention group (mail reminder only). Subjects were considered noncompliant if they did not return for the second dose by 4 months after the first. RESULTS: The risk of not returning for the second dose of vaccine within 4 months after the first was strongly and linearly associated with level of education (p = 0.004). The noncompliance rate among those with less than a grade 10 education was 50%, grade 10-13 education 34%, some college education 15% and some university education 9%. In the randomized controlled trial the enhanced intervention group had twice the compliance rate of the regular intervention group (48% v. 25%; p = 0.008). Subjects with no postsecondary education were highly responsive to the enhanced intervention (relative risk 2.1; p = 0.02) compared with those with a higher level of education (relative risk 1.0; p = 1.0). CONCLUSION: Hepatitis B vaccine recipients with lower educational levels are at increased risk of noncompliance with the second dose of vaccine but are highly responsive to telephone reminders.     

A modified immunisation schedule for the hepatitis B vaccine Recombivax HB suitable for mass vaccination in childhood.

Following the demonstration of a fully satisfactory immunogenic activity of a hepatitis B vaccination protocol consisting of three doses of Hevac B Pasteur vaccine given at 3,5 and 11 months of age, it was possible to administer this vaccine at the same times as the vaccinations for diphtheria, tetanus and polio which are mandatory in Italy at those ages. We have also shown that both another plasma-derived vaccine, H-B-VAX (MSD), as well as the DNA-recombinant Engerix B (SK&F) are highly immunogenic when given at the same times as the mandatory childhood vaccinations. In this paper we demonstrate that the same schedule can be used for another hepatitis B vaccine prepared by a DNA-recombinant technique, Recombivax HB (MSD) recently introduced in Italy. In fact two doses of this vaccine, the first given at three months of age and the second two months later, resulted in a 100% seroconversion rate and a mean anti-HBs titre of 440 mUI/ml. Although the date are incomplete since the third dose will be given at 11 months of age, we conclude that this hepatitis B vaccine can also be used in the mass vaccination campaigns of infants in Italy, the first of which was initiated in January 1987 in an hyperendemic area near Naples (HBsAg prevalence about 14%). We underline that this mass vaccination campaign is the first in Europe.     

301例早产儿视网膜病变筛查结果及其高危因素分析

目的:调查早产儿视网膜病变(ROP)的发生情况并分析其高危因素。方法:选取2017年6月至2018年6月在我院进行眼底检查的301例早产儿,依据《早产儿治疗用氧和视网膜病变防治指南》和《中国早产儿视网膜病变筛查指南》对早产儿进行筛查和随诊,同时收集早产儿及其母亲的相应病历信息,采用多因素Logistic回归分析分析ROP的高危因素。结果:301例早产儿中,共检出ROP患儿43例,其中须接受治疗的患儿13例,所有患儿经过2-6个月的治疗和随诊后均好转。围产因素中,胎龄小、出生体重低、吸氧、输血、有急性呼吸窘迫综合征(ARDS)的早产儿ROP检出率更高(均P0.05);母体因素中,多胎分娩的早产儿ROP检出率高于单胎分娩的早产儿(P0.05)。Logistic回归分析显示,胎龄小、出生体重低、吸氧、输血和有ARDS为早产儿ROP的高危因素(P0.05)。结论:早产儿ROP发病率较高,胎龄小、出生体重低、吸氧、输血和有ARDS是其高危因素,在临床实践中应给予重视,及早发现ROP并规范治疗,以降低早产儿ROP的发病率。