[Seroepidemiological analysis of hepatitis B virus infection among adolescents aged 0-14 years in Henan Province and preliminary evaluation of the effectiveness of childhood hepatitis B vaccine immunization program]

Objective: To analyze the seroepidemiological characteristics of hepatitis B virus (HBV) infection among adolescents aged 0-14 years in Henan Province and to evaluate the effectiveness of the childhood hepatitis B vaccine (HepB) immunization program. Methods: From September 2021 to March 2022, a total of 4 883 adolescents aged 0-14 years were selected from 25 villages or communities of 18 provincial-level cities in Henan Province by using the multi-stage random cluster sampling method. Demographic data were collected through questionnaires. The 3 ml of blood samples were collected from individuals aged 0-4 years and 5 ml of blood samples were collected from individuals aged 5-14 years to test HBsAg, HBcAb and HBsAb. Data on vaccination were collected through Henan Provincial Immunization Information System and hepatitis B cases in Henan Province were collected through China Infectious Disease Reporting System. The effectiveness of the childhood HepB immunization program was analyzed. Results: The average age of 4 883 subjects was (7.32±2.81) years old. The positive rates of HBsAg and HBcAb were 0.1% (7/4 883) and 1.0% (50/4 883), and the population standardized rates were 0.3% and 1.7%. In 2002, the positive rate of HBsAg among adolescents aged 0-14 years in Henan Province was 3.39%. Compared with that in 2002, the number of chronic HBV infections among adolescents in Henan Province in 2022 decreased by about 0.7 million. In 2002, the vaccination rate of newborns who completed all three doses of vaccine was 6.26%. In 2003, the vaccination rate of the hepatitis B vaccine rose rapidly, reaching 90% in 2013 for the first time. After 2014, the vaccination rate in Henan Province continued to remain above 95%. The proportion of cases among children aged 1-4 years in clinical reports decreased from 0.43% (1 108/256 566) in 2006 to 0.01% (78/80 655) in 2021. The proportion of cases among adolescents aged 5-19 years decreased from 18.21% (46 710/256 566) in 2006 to 1.1% (827/80 655) in 2021. Conclusions: From 2002 to 2022, the positive rate of HBsAg among adolescents aged 0-14 years has decreased significantly in Henan Province. The effectiveness of the HepB immunization program for children is good.

[Predictive value of net water uptake with respect to early neurological improvement after endovascular treatment in patients with acute anterior circulation large vessel occlusion stroke]

Objective: To investigate the value of net water uptake (NWU) for predicting early neurological improvement (ENI) after endovascular treatment in patients with acute anterior circulation large vessel occlusion stroke. Methods: A case-control study. A total of 132 patients (80 men, 52 women, median age 68 years) with acute anterior circulation large vessel occlusive stroke receiving endovascular treatment were retrospectively analyzed at Jinling Hospital from October 2014 to September 2019. Patients were divided into two groups based on the occurrence of ENI, which was defined as either an improvement of NIHSS score of ≥4 points, or an NIHSS score of 0 or 1 at 24 hours after endovascular treatment. The rank sum test, Chi square test, and other methods were used to compare differences in baseline characteristics between the two groups. Logistic regression analysis was used to investigate independent predictors of postoperative ENI. Receiver operating characteristic curve analysis used to assess the capacity of NWU to predict ENI. Results: Of the 132 patients in the study, ENI occurred in 47 and did not occur in 85. In multivariate logistic regression analysis age [odds ratio (OR)=0.940, 95% confidence interval (CI) 0.903-0.979, P=0.003], time from stroke onset to puncture (OR=0.995, 95%CI 0.991-0.999, P=0.025), time from puncture to recanalization/end of operation (OR=0.985, 95%CI 0.974-0.996, P=0.007), NWU (OR=0.762, 95%CI 0.620-0.937, P=0.010), and mTICI (OR=1.644, 95%CI 1.043-2.590, P=0.032) were predictive factors for ENI. Receiver operating characteristic curve analysis indicated that NWU could effectively predict ENI (area under the curve=0.642, 95%CI 0.543-0.741, P=0.007), and prediction accuracy was improved when it was combined with other clinical parameters. Conclusion: NWU is an independent predictor of ENI in patients with acute anterior circulation large vessel occlusive stroke undergoing endovascular treatment.

[SWOT analysis of influenza vaccination promotion of primary care staff based on the perspective of the supplier, customer, and management]

Objective: To analyze the situation of influenza vaccination among primary healthcare workers, find out the problems, and explore the strategies and measures to promote influenza vaccination among grass-roots medical staff. Methods: From April to May 2021, key insider interviews and literature research were carried out based on the perspectives of influenza vaccine suppliers (influenza vaccine manufacturers), consumers (primary medical institutions and primary healthcare workers), and managers (governments at all levels, health administrative departments and disease prevention and control departments). The SWOT (strengths, weaknesses, opportunities, and threats) analysis technique was used to comprehensively evaluate the current situation of influenza vaccination among grass-roots healthcare workers, and a SWOT analysis matrix was established. Results: Influenza vaccination of grass-roots healthcare workers have advantages and opportunities, including primary medical and health institutions' vital influenza vaccination accessibility, influenza vaccine safety is higher, COVID-19 outbreak improves the public awareness of respiratory infectious diseases and vaccine production enthusiasm, coronavirus vaccination has strengthened the capacity of the vaccine distribution system. There are also disadvantages and threats such as the high price of influenza vaccine, insufficient supply, low awareness of influenza vaccine vaccination among grass-roots healthcare workers, lack of demand assessment mechanism on influenza vaccine, poor vaccine deployment, structural imbalance in vaccine supply in different areas, and severe vaccine waste. SWOT analysis matrix of the influenza vaccination status of grass-roots healthcare workers was established, forming dominant opportunity (SO) strategy, dominant threat (ST) strategy, inferior opportunity (WO) strategy, and inferior threat (WT) strategy. Conclusion: Measures should be taken by the supplier, the demand-side, and the management side to improve the influenza vaccine coverage rate of primary healthcare workers, but the emphasis should be on the coordination and management of the management side.

[Follow-up and retrospective investigation of patients with pneumoconiosis in Jiangsu Province, China]

Objective: To investigate the features, changing trend, and rules of pneumoconiosis in Jiangsu Province, China, as well as the health status of patients with pneumoconiosis. Methods: From July to October 2019, the patients with pneumoconiosis, reported up to the end of 2018 in Jiangsu Province, were enrolled as respondents, and follow-up and retrospective investigation were performed. A total of 24405 patients with pneumoconiosis were investigated, and related data were collected from the monitoring system of cause of death for residents, pneumoconiosis network reporting system, occupational disease diagnosis institution, management institutions for the reporting of occupational diseases, and related residents' committee or village committee. The patients with pneumoconiosis, who had been reported, were followed up by telephone or on-site visit to obtain the information on their conditions. A descriptive analysis was performed for age of onset, working years, sex, category of industry, type of pneumoconiosis, annual disease onset, geographic distribution, and medical security. Results: Among the 24405 patients, a male/female ratio was 16.81∶1. Of all 24405 patients, 15948 (65.35%) had stage 1 pneumoconiosis, 5289 (21.67%) had stage 2 pneumoconiosis, and 1637 (6.71%) had stage 3 pneumoconiosis. The mean working years for dust exposure was 16.25±9.95 years for all patients, and the mean working years for dust exposure was 15.80±9.95 years for patients with stage 1 pneumoconiosis, 17.82±9.80 years for patients with stage 2 pneumoconiosis, and 16.31±9.90 years for patients with stage 3 pneumoconiosis. The highest number of cases of pneumoconiosis was reported in Wuxi (5744 cases, accounting for 23.54%) , followed by Zhenjiang (4160 cases, accounting for 17.05%) , Xuzhou (3851 cases, accounting for 15.78%) , Yancheng (3340 cases, accounting for 13.69%) , and Suzhou (2948 cases, accounting for 12.08%) . Major types of pneumoconiosis included silicosis (15392 cases, accounting for 63.07%) and coal workers' pneumoconiosis (5253 cases, accounting for 21.52%) . In this survey, 21115 completed follow-up, among whom 15924 survived and 5191 died, 15924 patients with pneumoconiosis survived, among whom 7461 (46.85%) had an age of ≥70 years and 2515 (15.79%) were exposed to dust for 5-9 years. The industries involved were mainly coal mining and washing industry (5687 cases, accounting for 35.71%) and public management, social security, and social organization (3349 cases, accounting for 21.03%) ; in terms of security, 7999 patients (50.23%) were covered by occupational injury insurance, 946 (5.94%) were compensated by employers, 4537 (28.49%) were covered by basic medical insurance for urban and rural residents, 1590 (9.98%) were covered by critical illness insurance, and 5458 (34.28%) were covered by other types of social security, such as medical assistance and poverty relief. Conclusion: Silicosis and coal worker's pneumoconiosis are the key points for the prevention and treatment of pneumoconiosis in Jiangsu Province, and supervision should be strengthened for industries and regions with serious dust hazards.

Substance P-induced enhanced permeability of dura mater microvessels is accompanied by pronounced ultrastructural changes, but is not dependent on the density of endothelial cell anionic sites

Experimental data point to a determinant role for endothelial cell (EC) anionic sites in the regulation of vascular permeability. Previous studies have shown that EC anionic sites density is reduced in conditions of enhanced permeability. The pathophysiology of migraine and vascular headache encompasses dilatation of dural vessels and extravasation of plasma proteins. The current study was carried out to determine if the density of EC anionic sites is reduced in enhanced permeability of dural vessels. Enhanced permeability was chemically induced in rats by intravenous injection of substance P and was tested by assessing leakage of horseradish peroxidase (HRP). Anionic sites were labelled with cationic colloidal gold and their density was quantified from electron microscopy negatives. Experimental animals showed increased leakage of HRP from dural vessels. However, anionic sites in EC membranes (luminal and abluminal) showed no statistical differences when their mean densities in experimental and control animals were compared. The results indicate that in this model, factors other than the density of anionic sites may be important determinants in the permeability of dural vessels. Such factors may include structural alteration of ECs consistent with an increased permeability. In this study pronounced ultrastructural changes in ECs were noted in experimental animals including widening of intercellular junctions and an increase in the number of EC gaps and vesicles.

Thalamic and temporal cortex input to medial prefrontal cortex in rhesus monkeys

To determine the source of thalamic input to the medial aspect of the prefrontal cortex, we injected retrograde tracers (wheat germ agglutinin conjugated to horseradish peroxidase, nuclear yellow, and/or bisbenzimide) into seven medial prefrontal sites and anterograde tracers (tritiated amino acids) into six thalamic sites, in a total of nine rhesus monkeys. The results indicated that ventral precallosal and subcallosal areas 14 and 25, and the ventral, subcallosal part of area 32, all receive projections from the mediodorsal portion of the magnocellular division of the medial dorsal nucleus (MDmc). The dorsal, precallosal part of area 32 receives projections mainly from the dorsal portion of the parvocellular division of the medial dorsal nucleus (MDpc), which also provides some input to area 14. Polar area 10 receives input from both MDpc and the densocellular division of the medial dorsal nucleus (MDdc), as does supracallosal area 24. Area 24 receives additional input from the anterior medial nucleus and midline nuclei. All medial prefrontal cortical areas were also found to receive projections from a number of cortical regions within the temporal lobe, such as the temporal pole, superior temporal gyrus, and parahippocampal gyrus. Areas 24, 25, and 32 receive, in addition, input from the entorhinal cortex. Combining these results with prior anatomical and behavioral data, we conclude that medial temporal areas that are important for object recognition memory send information directly both to dorsal medial prefrontal areas 24 and 32 and to ventral medial prefrontal areas 14 and 25. Only the latter two areas have additional access to this information via projections from the mediodorsal part of MDmc.

Ingestion of chlorinated water has no effect upon indicators of cardiovascular disease in pigeons

Cardiovascular disease (CVD) accounts for nearly half the deaths, yearly, in the United States. The arterio(athero)sclerotic plaque is the principal lesion of CVD. The White Carneau (WC) pigeon is an animal model that has been employed extensively for studying CVD. Cholesterol (CHOL) feeding aggravates atherosclerosis in WC pigeons greater than 2 years old. In 1986, two reports appeared from a single laboratory claiming a direct effect of drinking chlorinated (Cl) water upon lipid levels and plaque development in young (less than 1 year) WC pigeons. These are the only reports of such direct effects, to date. Three months' exposure to 2 ppm or 15 ppm Cl in the drinking water, resulted in increased circulating CHOL levels in young male WC pigeons fed a normocholesterolemic (NC) diet in which Ca2+ levels were reduced. In addition, at both Cl concentrations there was a significant increase in plaque size, compared to controls. Pigeons in the 2 ppm group also exhibited elevated low density lipoprotein (LDL) levels after 3 months on the NC diet. These findings, if extrapolated to man, could have considerable public health consequences, since nearly 200 million people in the United States drink Cl water. We have carried out a similar set of studies but with strikingly different results. We used the same suppliers of pigeons and feed as did the authors of the 1986 reports and followed their approach where possible. Six month-old male WC pigeons drank water with 2 ppm or 15 ppm Cl (pH 8.5) and ate a NC diet with Ca2+ reduced to 80% of normal. At both 1 and 3 months, body weight, CHOL, triglyceride and LDL levels were unaffected by drinking Cl water. There was also no effect of Cl water on plaque size after 3 months. Thus, we found no evidence that drinking chlorinated water has any effect upon circulating lipid levels or upon the development of arteriosclerotic plaques, in this animal model.