[Diagnostic value of rapid antigen testing for the detection of SARS-CoV-2 infection]

Objective: To investigate the diagnostic value of rapid antigen test based on colloidal gold immunochromatographic assay for the detection of SARS-CoV-2 infection in symptomatic patients. Methods: From May 20 to June 5 2022, 76 hospitalized children and their 55 accompanying family members with confirmed SARS-CoV-2 infection in the COVID-19 isolation unit of the Children's Hospital of Fudan University (designated referral hospital for SARS-CoV-2 infection in Shanghai) enrolled. Their nasopharyngeal swab specimens were consecutively collected. The samples were tested for SARS-CoV-2 nucleic acid by real-time quantitative. SARS-CoV-2 antigen was tested by immunochromatography. The correlation between the antigen detection results and the change of the cycle threshold (Ct) values were evaluated, as well as the sensitivity and specificity of SARS-CoV-2 antigen detection at different periods after the onset of the disease. Kappa consistency test was conducted to investigate the consistency between the 2 diagnostic methods. Results: Of the enrolled SARS-CoV-2 symptomatic infections, 76 were children, including 41 males and 35 females, with an age of 5 (2, 9) years; 55 were accompanying families, including 8 males and 47 females, with an age of 38 (32, 41) years. All 478 samples were simultaneously tested for SARS-CoV-2 antigen and nucleic acid. In any period from disease onset to negative conversion of viral nucleic acid, the overall sensitivity of the rapid antigen test was 48.2% (119/247), the specificity was 98.3% (227/231), and antigen test and nucleic acid test showed moderate consistency (κ=0.46, P<0.05). The sensitivity of antigen test was 100% (82/82) when the Ct value was ≤25. And the sensitivity of antigen test was 8/10, 4/15 and 8.3% (3/36) when the Ct value was 26, 30 and 35, respectively. All antigen tests were negative when Ct value was >35. During the period of 1-2 days, 3-5 days, 6-7 days, 8-10 days and >10 days after onset, the sensitivity and specificity of SARS-CoV-2 antigen test were 5/8 and 5/5, 90.2% (37/41) and 5/5, 88.9% (24/27) and 2/5, 45.0% (36/80) and 94.1% (32/34), 18.7% (17/91) and 98.9% (183/185) respectively. The Ct values of nasopharyngeal swabs were<26 during 2 to 7 days after onset, 28.7±5.0 on day 8, 34.5±2.9 on day 13 and > 35 after 14 days, respectively. Conclusion: SARS-CoV-2 antigen test in the patients with SARS-CoV-2 infection shows acceptable sensitivity and specificity within 7 days after onset of disease, and the sensitivity was positively correlated with viral load and negatively correlated with onset time.

[Characteristics of SARS-CoV-2 Omicron infection in children imported from Hong Kong]

Objective: To understand the clinical characteristics of children with SARS-CoV-2 Omicron infection imported from Hong Kong Special Administrative Region. Methods: This retrospective study was conducted to collect the data including clinical manifestations, outcomes and vaccination of 107 children with SARS-CoV-2 Omicron infection imported from Hong Kong Special Administrative Region to be admitted to the designated referral hospital in Shanghai from February to March 2022. According to the occurrence of clinical symptoms, the cases were divided into asymptomatic group and symptomatic group. According to the age of diagnosis, the cases were divided into <3 years group, 3-<6 years group and 6-<18 years group, and the clinical manifestations in different age group were analyzed with t-test and Mann-Whitney rank-sum test. Besides, to analyze the effectiveness of vaccination against SARS-CoV-2 Omicron infection in different age group, the cases aged 3-<18 years were also subdivided into unvaccinated group, 1-dose group and 2-dose group, and the relative risk (RR) was used to demonstrate the effectiveness. Results: Among the 107 cases, 66 were male and 41 were female, with infection age of 10 (5, 14) years. There were 29 cases in the asymptomatic group, and 78 cases in the symptomatic group, and no significant difference in the age of infection was observed between the 2 groups (11 (6, 14) vs. 10 (5, 14) years, Z=0.49, P>0.05). And there were no severe cases in symptomatic group. The length of hospitalization was (18±6) days, and was longer in symptomatic group than that in asymptomatic group ((19±6) vs. (16±7) d, t=0.17, P=0.030). Eight-two cases (76.6%) had a history of epidemiological exposure and, among whom, 81 cases (75.7%) were associated with household transmission. Among symptomatic group, 57 cases (73.1%) had fever and 20 cases (25.6%) had cough. Of the 74 cases undergoing chest CT examination, 17 cases (23.0%) showed mild abnormalities. Of the 83 cases who received the lab tests, 23 cases (27.7%) had white blood cell counts<4×10⁹/L, 3 cases (3.6%) had C-reaction protein >8.0 mg/L, and 6 cases (7.2%) had slightly elevated aspartate transaminase and alanine aminotransferase. Among the 92 children aged 3-<18 years, 31 cases were unvaccinated, 34 cases received 1 dose, and 27 cases received 2 doses. The interval between the last vaccination and infection was 2.2 (0.6, 6.0) months; the interval between the last vaccination and infection in the 2-dose group was longer than that in 1-dose group (6.0 (4.5, 7.3) vs. 0.7 (0.3,2.0) months, Z=3.59, P<0.001).The risk of symptomatic infection was reduced by 45% (RR=0.55, 95% CI 0.35-0.87) with two-dose vaccination compared to non-vaccination in cases aged 3-<18 years. All these cases recovered completely. Conclusions: Children infected with SARS-CoV-2 Omicron are usually mild or asymptomatic. Household transmission is the main pattern of infection with SARS-CoV-2 Omicron in children. Two-dose SARS-CoV-2 vaccination in children aged 3-<18 years can provide partial protection against disease caused by SARS-CoV-2 Omicron.

[Surveillance of potential transmission factors of schistosomiasis in Xiuzhou District of Jiaxing City from 2013 to 2015]

OBJECTIVE

To understand the potential risk of schistosomiasis transmission in Xiuzhou District of Jiaxing City, so as to provide the scientific evidence for consolidating schistosomiasis control achievements.

METHODS

Fixed and mobile surveillance sites were set up in Xiuzhou District of Jiaxing City from 2013 to 2015. Oncomelania hupensis snails was surveyed historical snail habitats, current snail habitats, and suspected snail habitats. The schistosome infections were identified using serological and parasitological testing among local residents and mobile populations. In addition, the survival and reproduction of snails imported into Xiuzhou District was observed, and the schistosome infection in wild reservoir hosts was detected.

RESULTS

A total of 540.14 hm² of settings were surveyed in Xiuzhou District, Jiaxing City from 2013 to 2015, and 1.65 hm² of snail habitats were identified. The snail habitats were mainly located in dry lands, and no infected snails or importation of snails were found. During the period from 2013 to 2015, a total of 7 668 local residents and mobile populations were examined in Xiuzhou District, and no new local infections were detected; however, three imported schistosomiasis cases were identified. Field simulation experiment showed that the imported snails laid eggs and reproduced in Xiuzhou District, and no schistosome infections were found in wild animals.

CONCLUSIONS

There are still residual Oncomelania snails and imported schistosomiasis patients in Xiuzhou District of Jiaxing City; therefore, the surveillance and management of local Oncomelania snails and imported schistosomiasis should be intensified to reduce the risk of schistosomiasis transmission.

[Screening on key techniques used for surveillance and disposal of public health emergencies]

Objective: To explore the key techniques used for surveillance and disposal of infectious diseases, food poisoning and hospital infection to improve the ability of surveillance and disposal on public health emergency. Methods: Framework on surveillance and disposal of infectious diseases, food poisoning and hospital infection was set up, based on literature review and expert group discussion. Delphi method and technique for order preference by similarity to ideal solution comprehensive evaluation method were used for ordering preference by similarity, to screen key techniques set for surveillance and disposal of the above said events. Results: Framework to be used for selecting key techniques was designed, based on the classification of emergency events, processing cycle of emergency events and level of techniques. Twenty six public health experts were selected for a 2-round consultation, with their authority as 0.796. Ten key techniques with important significance for surveillance and disposal of infectious diseases, food poisoning and hospital infection were selected from each event. Among these key techniques, the early-warning system was recognized as the key technique, important for the surveillance and disposal of all three emergency events. Items as technology used for unknown pathogenic microorganism detection, personal protection, gene sequencing and tracing technology, microorganism molecular typing technology, nucleic acid detection technology etc. were the key techniques and need to develop for the surveillance and disposal of infectious diseases and iatrogenic infection. Data regarding key technologies on security and privacy, early warning and forecasting, field rapid detection were sorted out that all in need to improve the surveillance programs on disposal of infectious diseases and food poisoning. Data exchange appeared another key technique on infectious diseases, with toxin detection and other 5 techniques the key techniques for food poisoning. Data collection, standardization and other 3 techniques appeared as the key techniques on iatrogenic infection. Conclusions: Key techniques were selected in this study to meet the requirements of surveillance, disposal of infectious disease, food poisoning and iatrogenic infection. Authority of the experts got improved in the two-round consultation, ensuring the reliability of the results of screening and providing a scientific basis for the further research and priority development of the key techniques.

[The relationship between type Ⅱ diabetes mellitus and hearing loss：a Meta-analysi]

Objective:Analysis of the relationship between type 2 diabetes and hearing loss through the available literature.Method:According to the main keyword retrieval databases at home and abroad,and in accordance with the inclusion and exclusion criteria for the literature,the listening incidence rate,OR value,the frequency of pure tone hearing threshold,tests the average standard deviation were chose as the evaluation index. Meta analysis was carried out using Rev Man5.3 software. Result:According to the inclusion and exclusion criteria,the articles were screened and included in the final to meet the requirements of the 17 studies. The prevalence of hearing loss in patients with type II diabetes mellitus was 21.0%-74.6%,which was 2.54 times higher than the control group. The difference was statistically significant between the two groups(OR=2.54,95% CI 1.85-3.49,P<0.000 01). In addition,the hearing threshold of all frequencies in type Ⅱ diabetes group was higher than that of control group(Z=5.03,P<0.000 01). Conclusion:Type 2 diabetes can affect hearing loss,especially at the high frequencies.

[Influencing factors for the use of earplugs in workers exposed to noise in a city]

OBJECTIVE

To investigate the current status of hearing loss and the use of earplugs in workers exposed to noise who have been provided earplugs in a city, as well as major influencing factors for the use of earplugs.

METHODS

Cluster random sampling was used to conduct a questionnaire survey in workers exposed to noise who had been provided earplugs in 15 enterprises with noise exposure in a city from June to December, 2014.

RESULTS

In the workers exposed to noise who had been provided earplugs, the rate of high-frequency anomaly in both ears was 57.8%, and the workers who kept wearing earplugs only accounted for 55.4%. The results of binary logistic regression analysis showed that the protective factors for the use of earplugs included workers' own feeling of hearing condition (OR=1.704), comfort of earplugs (OR= 1.892), enterprise's inspection of the use of earplugs (OR=1.461), workers' knowledge of the function and usage of earplugs (OR=1.581), workers' understanding of the necessity of earplugs (OR=4.482), workers' initiative to search for related data (OR=4.029), the use of earplugs by colleagues (OR=5.071), and reminders from family members or friends (OR=2.678) (all P<0.05).

CONCLUSION

The workers exposed to noise in this city have a high rate of abnormal hearing, and only half of the workers keep wearing earplugs during work. The use of earplugs is related to the factors including workers' own feeling of hearing condition, comfort of earplugs, workers' knowledge of protection, the enterprise' s management of hearing protection, and environmental support.

Breastfeeding does not pose any additional risk of immunoprophylaxis failure on infants of HBV carrier mothers

Whether babies born to hepatitis B (HB) carrier mothers with HB immunoprophylaxis at birth can be breastfed safely is controversial. A total of 230 such babies were followed up for one year to assess the influence of feeding method on the efficacy of HB immunoprophylaxis. The positive rates of anti-HBs at different ages are not statistically different between the breastfed group and the bottle-fed group. At 1 year, the rate was 80.9% in the breastfed group and 73.2% in the bottle-fed group in infants with HB vaccine alone, and 90.9% in the breastfed group and 90.3% in the bottle-fed group in infants with HBIG plus HB vaccine. There were no significant differences in the incidence of immunoprophylaxis failure between breastfed and bottle-fed babies. The results indicated that breastfeeding does not have a negative influence on the response of anti-HBs and on the failure rates of immunoprophylaxis in the infants born to HB carrier mothers.

Infection of the fetus with hepatitis B e antigen via the placenta

Evidence that hepatitis B e antigen (HBeAg) can pass through the human placenta has been questioned. We investigated 15 HBeAg-positive mothers who were hepatitis B carriers and their newborn babies, and found that HBeAg does indeed cross the human placenta.

Mutations in the 'a' determinant of hepatitis B surface antigen among Chinese infants receiving active postexposure hepatitis B immunization

Twenty-four infants who became positive to the surface antigen of hepatitis B virus (HBsAg) despite a complete course of active postexposure immunization with plasma derived hepatitis B vaccine were studied. The polymerase chain reaction amplified products of the common neutralizing epitope 'a' determinant of HBsAg (Nucleotide 419-598) from serum samples were sequenced and analyzed for nucleotide mutations. Four cases (16.7%) had mutations that led to amino acid substitutions between codons 124 and 147. Only one case (N1) showed a substitution at codon 145 (from glycine to arginine, 145R), the other three were at codons 126-129. The mother of N1 was co-infected with the wild type and the mutant virus. Five years later, serum of N1 showed only the wild type virus. There was no significant relationship between the mutation rate and the anti-HBs response to hepatitis B vaccination. Results suggest that without immune selective pressure, 145R variant was not frequently observed, and was not stable. Mutation in the 'a' determinant was not an important cause of failure to prevent maternal-infant transmission of HBV by active postexposure hepatitis B immunization in Chinese children.

p53 oncoprotein accumulation in adenoid cystic carcinoma of parotid and palatine salivary glands

Previous studies have suggested that alterations of the p53 gene are the most common genetic abnormality in human cancer. The aims of the present study were to evaluate p53 protein (p53P) immunostaining in adenoid cystic carcinoma (ACC) of the salivary gland and to correlate the expression with patient survival. A total of 27 cases of ACC in the parotid gland (n = 12) and the minor palatine glands (n = 15) were studied, with ten cases each of normal parotid and palatine glands as non-neoplastic controls. Staining was performed with mouse monoclonal antibody DO-7 against p53 (Dako, USA) using the ABC method. Stained nuclei irrespective of intensity or frequency were considered as positive. The frequency of positive nuclei was evaluated as the p53P index (p53PI), the percentage of the total nuclei in the reference epithelium. Clinical survival data were available for patients for periods up to 156 months. Our data showed that no normal tissues showed immunoreactivity with p53P in their nuclei. Thirteen of 15 (87%) cases of palatal and two of 12 (17%) cases of parotid neoplasms stained with p53P and the p53PI ranged from 0.01 to 10%. The number of p53P positive tumors was significantly higher in palatal than in parotid neoplasms, suggesting that palatal ACCs may be more aggressive in comparison with parotid ACCs. Our data also showed that the number of p53P positive tumors was significantly increased in patients who died of tumors than in patients with no evidence of disease at the end of the follow-up period between 60 to 156 months. These results suggest that p53P may be involved in the development of salivary gland ACCs and that p53P analysis may be a useful indicator of poor prognosis.

Long-term efficacy of active postexposure immunization of infants for prevention of hepatitis B virus infection. United States-People's Republic of China Study Group on Hepatitis B

Perinatal transmission of hepatitis B virus (HBV) contributes to the high prevalence of chronic infection in China and many other countries. In a placebo-controlled trial among 166 infants, the 12-month efficacy of active postexposure prophylaxis to prevent chronic perinatal HBV infection varied by vaccine (range, 45%-89%). In a 5-year follow-up study, 2 additional infants became chronically infected with HBV, and the efficacy of active prophylaxis was estimated to be 38% and 72% for the two vaccines at 5 years. In addition, 80% of immunized infants continued to have protective levels of antibody at the end of 5 years. However, among 27 infants who received passive-active immunoprophylaxis with high-dose hepatitis B immune globulin, only 60% (11/19) had protective antibody levels. These data indicate that active postexposure immunization initiated soon after birth continues to provide protection during early childhood when there is a high risk of chronic HBV infection.

Long-term immunogenicity and efficacy of recombinant yeast derived hepatitis B vaccine for interruption of mother-infant transmission of hepatitis B virus

Recombinant DNA Yeast-Derived Hepatitis B Vaccine (RYHB vaccine) is comparable to and can replace Plasma-Derived Hepatitis B Vaccine (PHB vaccine) for the prevention of mother-infant transmission of hepatitis B virus (HBV), but the duration of immune efficacy of RYHB vaccine is not clear. This study indicates the long-term efficacy for the prevention of mother-infant transmission of HBV. One hundred and six neonates born to HBsAg-carrier mothers with HBeAg positive were randomly divided into two groups, one receiving 20 micrograms per dose of RYHB vaccine and the another receiving 20 micrograms per dose of PHB vaccine on the day of birth, at 1 month and at 6 months (three times). Physical examination and blood tests were performed for all infants at 6, 12, 24, 36, 48 and 60 months of age. The results showed that the protective efficacies at 6, 12, 24, 36, 48 and 60 months were 67%, 75%, 63%, 62%, 57% and 56%, respectively for the RYHB vaccine group and 58%, 76%, 51%, 41%, 24% and 18%, respectively for the PHB vaccine group. The protective efficacy was notably significant in the last two years. The study indicates that the duration of protective efficacy is over 5 years with RYHB vaccine, being longer than that of PHB vaccine. These recipients of RYHB vaccine showed no side effects, and the vaccine is regarded as safe and effective.

[Enzyme cytochemistry and morphometric study of the effects of macrophages on A549 pulmonary alveolar cell carcinoma cell line]

In order to study the mechanism of the effects of M phi on tumor cells, enzyme cytochemistry and morphometry were used to investigate the activities of cytochrome oxidase (CO), succinate dehydrogenase (SD), lactate dehydrogenase (LDH) and acid phosphatase (ACP) in A549 pulmonary alveolar cell carcinoma cells which had been interacted with normal and CP-activated macrophages respectively. It was found that when E/T = 10:1, the enzyme activity of the cancer cell mitochondria, CO, SD, LDH were decreased, and when E/T = 20:1, the activity of the lysosomal enzyme ACP was increased. These results indicate that when the E/T ratio was appropriate, activated M phi may injure the mitochondria and lysosomes and affect the aerobic respiration and oxidative phosphorylation of cancer cells. This may be one of the cytostatic and cytotoxic mechanisms of activated M phi on tumor cells.

[Lung biopsies with light microscopic and ultrastructural observations in 34 cases of diffuse pulmonary diseases]

Lung biopsies with light microscopic and ultrastructural observations were performed in 34 cases of diffuse pulmonary diseases. Open lung biopsy 2 cases, transfiberoptic bronchoscopy lung biopsy 32 cases. There were 19 (56%) idiopathic interstitial fibrosis, 3 (9%) pulmonary alveolar proteinosis, 3 (9%) pulmonary sarcoidosis, 1 (3%) idiopathic pulmonary hemosiderosis, 2 (6%) pulmonary mycosis, 1 (3%) alveolar cell carcinoma, 2 (6%) pulmonary tuberculosis and 3 (9%) pulmonary collagen diseases. Diagnosis was based on clinical data and pathologic manifestation. Lung biopsy with light and electronic microscopic examination is useful in etiologic diagnosis and differential diagnosis for diffuse pulmonary diseases.

A six-year survey of immunogenicity and efficacy of hepatitis B vaccine in infants born to HBsAg carriers

Although the efficacy of hepatitis B vaccine is well documented, the duration of immunity of healthy infants after vaccination is unknown. 99 infants born to hepatitis B surface antigen (HBsAg)-carrier mothers were studied and found to have positive anti-HBs (titer: greater than or equal to 10 mIU/mL) after a first injection of vaccine at the ages of 1 to 6 years. The infants were randomly divided into four groups of recipients treated with the vaccine of the National Institute of Allergy and Infectious Diseases (NIAID), U.S.A. or that of the Beijing Biological Products Research Institute (BBPRI), BBPRI vaccine in combination with hepatitis B immune globulin (HBIG) and placebo. The results showed that the protective efficacy dropped considerably after 5 years with NIAID vaccine, after 3 years with BBPRI vaccine and after 4 years with BBPRI vaccine plus HBIG. This suggests that a booster injection is needed 5 years after the first injection of NIAID vaccine, 3 years after BBPRI vaccine, and 4 years after BBPRI vaccine plus HBIG.

[Behavior of intermediate filaments in human epithelial cells during mitosis]

By indirect immunofluorescence microscopy and electron microscopy, we studied the behavior of intermediate filaments during mitosis in three human epithelial cell lines, derived from normal epidermis (PcaSE-1, from a cancer patient), stratified epithelium (CNE, from nasopharyngeal carcinoma) and simple epithelium (SPC-A-1 from lung adenocarcinoma) respectively. CNE cells and SPC-A-1 cells express two different intermediate filament systems; keratin filaments and vimentin filaments, but PcaSE-1 cells only express keratin filaments. The keratin filament system in PcaSE-1 cells remained intact and encircled the developing mitotic spindle as the cells entered mitosis. In contrast, in CNE cells and SPC-A-1 cells, keratin filaments appeared to disassemble into amorphous cytoplasmic bodies during mitosis. However, their vimentin filaments remained morphologically intact throughout mitosis. We propose; (1) The disassembly of keratin filaments in mitotic epithelial cells is more or less associated with the degree of their cell malignancy rather than with the abundance of keratin filaments in interphase. (2) Intermediate filaments may be involved in the positioning and/or centering of the spindle during mitosis. (3) The possible function of vimentin filament system in CNE cells is positioning and orientation of chromosomes.

[A novel monoclonal antibody against human keratins]

In this paper, we reported a novel monoclonal antibody against human keratins, R 6-2-14. The antigen used for immunization was derived from human callus, keratins in which traditionally are classified as "Soft" keratins. However, when we studied the tissue specificity of this antibody, it was found that it only reacted strongly with "Hard" keratins of various mammalian species, but no detectable cross-reactivity with any of the "Soft" keratins. This antibody may provide a useful tool for the study of hair regeneration, nail regeneration, corn pathology and differentiation of mammalian epidermal derivatives.