目的探讨不同年龄组健康人群接种不同类型、不同剂量乙型肝炎(乙肝)疫苗(Hepatitis B Vaccine,HepB)的再免疫抗体应答。方法采用分层随机抽样方法,按地域分布选取东莞市5个镇2～4、6～8、13～15、16～40岁4个年龄组健康人群,用酶联免疫...目的探讨不同年龄组健康人群接种不同类型、不同剂量乙型肝炎(乙肝)疫苗(Hepatitis B Vaccine,HepB)的再免疫抗体应答。方法采用分层随机抽样方法,按地域分布选取东莞市5个镇2～4、6～8、13～15、16～40岁4个年龄组健康人群,用酶联免疫吸附试验筛查乙肝病毒核心抗体、乙肝病毒表面抗原和乙肝病毒表面抗体均为阴性,且有3剂HepB免疫史的人作为再免疫研究对象。采用5μg重组HepB(酵母)(HepB Made by Recombinant DNA Techniques in Yeast,HepB-Y)、10μg HepB-Y、10μg重组HepB(中国仓鼠卵巢细胞)(HepB Made by Recombinant DNA Techniques in CHO Cell,HepB-CHO)、10μg重组HepB(汉逊酵母)(HepB Made by Recombinant DNA Techniques in Hansenula Yeast,HepB-HY)、20μg HepB-CHO和20μg HepB-Y,均按0、1、6个月程序再免疫3剂。结果不同类型不同剂量HepB在人群中的再免疫成功率和抗体水平中位数[毫国际单位/毫升(mIU/ml)]分别为:5μg HepB-Y94.34%和226.53,10μg HepB-Y86.46%和175.36,10μg HepB-CHO97.39%和331.44,10μg HepB-HY91.30%和439.01,20μg HepB-CHO99.20%和386.66,20μg HepB-Y89.04%和372.97。各年龄组的再免疫成功率和抗体水平中位数(mIU/ml)分别是:2～4岁98.25%和353.42,6～8岁96.80%和320.31,13～15岁94.67%和282.12,16～40岁87.76%和305.24。结论年龄、疫苗种类和剂量是影响再免疫抗体应答的主要因素,随年龄的增长再免疫抗体应答下降,更换疫苗种类可提高再免疫抗体应答。展开更多
目的了解新生儿接种乙型肝炎(乙肝)疫苗(Hepatitis B Vaccine,HepB)后低/无应答者的再免疫效果。方法对北京市、浙江省、广东省2004～2005年出生的新生儿,按照0、1、6月龄免疫程序完成3剂重组HepB(酵母)[HepB Made by Recombinant Deoxy...目的了解新生儿接种乙型肝炎(乙肝)疫苗(Hepatitis B Vaccine,HepB)后低/无应答者的再免疫效果。方法对北京市、浙江省、广东省2004～2005年出生的新生儿,按照0、1、6月龄免疫程序完成3剂重组HepB(酵母)[HepB Made by Recombinant Deoxyribonucleic Acid(DNA)Techniques in Yeast,HepB-Y]免疫后,出现的低/无应答者,随机分为4组,按0、1、6个月程序再次免疫不同种类和剂量的HepB。结果低/无应答儿童再免疫前、再免疫1剂和再免疫3剂后,抗乙肝病毒表面抗原抗体[Antibody to Hepatitis B Virus Surface Antigin(HBsAg),Anti-HBs]几何平均浓度(Geometric Mean Concentration,GMC)分别为18.7mIU/m(l毫国际单位/毫升)、88.8mIU/ml、178.2mIU/ml,无应答者所占比例分别为20.4%、9.1%、1.9%。103名低/无应答儿童再免疫1剂和3剂后,>100mIU/ml所占的比例分别为61.2%和84.5%,差异有统计学意义(χ2=14.13,P<0.01);5μg重组HepB-Y、10μgHepB-Y、10μg重组HepB(中国仓鼠卵巢细胞)[HepB Made by Recombinant DNA Techniquesin Chinese Hamster Ovary(CHO)Cell,HepB-CHO]、10μg重组HepB(汉逊酵母)(HepB Made by Recombinant DNA Techniques in Hansenula Polymorpha Yeast,HepB-HPY)四种HepB再免疫3剂后,GMC分别为168.8mIU/ml、174.7mIU/ml、184.9mIU/ml、182.9mIU/ml,四种HepB再免疫3剂后,>100mIU/ml所占的比例分别为79.0%、85.7%、88.2%、84.6%,差异均无统计学意义(χ2=0.75,P>0.05)。结论 HepB全程免疫三剂后,低/无应答儿童按照0、1、6个月程序再次免疫3剂HepB后,抗体阳转率和GMC均有较大的提高,再免疫3剂HepB免疫效果优于再免疫1剂。展开更多
Background: Acute kidney injury associated with proteinuria has been reported following vaccination against SARS-CoV-2 several times since 2021. Decisions about subsequent revaccination in these patients have been dif...Background: Acute kidney injury associated with proteinuria has been reported following vaccination against SARS-CoV-2 several times since 2021. Decisions about subsequent revaccination in these patients have been difficult because of the uncertainty of the consequences of doing so, and the absence of publications to help determine whether revaccination may be considered safe or not. Purpose: We present a case report of a 59-year-old Canadian man who developed severe acute kidney injury associated with moderate proteinuria following his first COVID-19 vaccine with the Moderna vaccine (an mRNA vaccine). He required haemodialysis for 2 weeks, which was initiated when his creatinine reached 1002 μmol/l. A kidney biopsy showed changes consistent with acute tubular necrosis. The patient was cautioned that repeat vaccination might result in further kidney injury which might be irreversible. However, he badly wanted to attempt a second COVID-19 vaccination, to facilitate a family vacation across several countries in Europe, at a time when travel restrictions were in place in many countries for persons who had not completed a course of vaccines. Method: Following deliberations, the patient chose to try a different type of Covid-19 vaccine. On this occasion, he was vaccinated with the Novavax vaccine (a subunit COVID-19 vaccine). Following this, close monitoring of his urine to detect proteinuria and blood testing for acute kidney injury were carried out on days 1, 3, 7, and 60 after vaccination. Furthermore, a year after his repeat vaccination, his kidney function and urinalysis were again assessed. Result and Conclusions: The patient did not develop acute kidney injury or worsening proteinuria following repeat vaccination. It remains unclear if acute kidney injury with proteinuria is caused by Covid-19 vaccination, or simply an incidental association. This case report suggests that it is may be reasonable for patients with acute kidney injury after COVID-19 vaccination to consider trying a different type of vaccine. In展开更多
Objective:To investigate whether there is an association between diameter of bacille CalmetteGuerin(BCG)sears and effect of purified protein derivative(PPD)reaction anil to determine whether vitamin A(VA)combined vita...Objective:To investigate whether there is an association between diameter of bacille CalmetteGuerin(BCG)sears and effect of purified protein derivative(PPD)reaction anil to determine whether vitamin A(VA)combined vitamin I)(VD)supplementation influences the immune response to BCG revueeinated in Chinese infants.Methods:A cross-section and 3-month community-randomised trial was conducted.A total of 5 629 infants at 3,6 and 12 months of age in Junan County of China were examined for BCG scar fonnation.Then,597 revuccinated infants were randomly assigned to supplementation(n=307)and control(n=290)groups.The supplementation group were daily assigned to 1 500 IU VA and 500 IU VD for 3 months.Then all infants were subjected to skin test with PPD.Results:The diameter of BCG sears was positively con-elated with diameter of skin indurations of PPD(r=0.17,P<0.05)in the 5 629 infants.The rate of positive response to PP1)was higher in the supplementation group than in the control group(96.1%versus 89.7%,P<0.05,prevalence ratio 1.07.95%CI 1.02-1.12).The prevalence ralio of PPD response for the supplementation group compared with that for the control group was 1.07(95%CI 1.01-1.13)for the males and 1.08(95%CI 1.00-1.17)for the females.For the supplementation group,the males got larger tuberculin induration than the females[(0.73±0.2l)cm versus(0.67±0.20)cm.P<0.05)after intervention.Conclusions:The diameter of BCG scars was effectively correlated with PPD response,which indicates BCG scar formation may be an useful tool Io evaluate the effect of tuberculosis prevention.VA combined VD supplementation may play an immunoregulatory rale in BCG revuecination.This may contribute to the prevention of childhood tuberculosis.展开更多
Immuuoresponsiveness of revacclnation in nonresponders and hyporesponders to hepatitis B vaccine was evaluated.10 nonresponders and kyporesponders as well as 18 normal responders to the primary vaccination were offere...Immuuoresponsiveness of revacclnation in nonresponders and hyporesponders to hepatitis B vaccine was evaluated.10 nonresponders and kyporesponders as well as 18 normal responders to the primary vaccination were offered a 10μg dose or blood-derived vaccine in May 1989,three years after a 3-dose primary vaccine schedule,and were rollowed up and checked at 2,6,12 and 36 months after the booster dose.The results showed that Anti-HBs titre increased in both poor and normal responders,but the antibody level in nonresponders and hyporesponders was lower and the duration of persistence was much shorter,while the antibody GMT in normal responders remained above protective level at 36 months arter revaccination.Thererore,it is difficult to say,according to the data,that revaccination can satisfactorily boost anti-HBs level in the poor responders.展开更多
Objective With the same times of injection to compare low-dose intradermal regimen with routine-dose intramuscular inoculation in revaccination of non-responders to hepatitis B vaccine. Methods 40 healthy non-responde...Objective With the same times of injection to compare low-dose intradermal regimen with routine-dose intramuscular inoculation in revaccination of non-responders to hepatitis B vaccine. Methods 40 healthy non-responder children collected by screening were administrated a three-dose revaccination randomly by intramuscular or intradermal route (10vs 2g per dose), and regularly tested for serologic markers up to five years. By the end of follow-up, a booster dose (5μg) was given to those who had lost anti-HBs of ≥10mIU/mL (seroprotection) and anamnestic response was estimated thereafter. Results All 17 intramuscular and 22 of 23 intradermal children effected seroprotection after revaccination. Intradermal children lost seroprotection over time significantly rapider compared with intramuscular children (Log Rank test, P= 0.029). In year 5, 50% of intramuscular but only 18.2% of intradermal children still maintained seroprotection (P=0.075). 12-14 days after the booster dose, all the eight intramuscular children developed an anamnestic response with anti-HBs titer increasing greater, but two of the 18 intradermal children failed to mount seroprotective level. Conclusion Three-routine-dose intramuscular revaccination was significantly effective than low-dose intradermal one with the same times of injection, especially in long-term immunity. We recommend routine-dose intramuscular protocol in revaccination of non-responders.展开更多
文摘目的探讨不同年龄组健康人群接种不同类型、不同剂量乙型肝炎(乙肝)疫苗(Hepatitis B Vaccine,HepB)的再免疫抗体应答。方法采用分层随机抽样方法,按地域分布选取东莞市5个镇2～4、6～8、13～15、16～40岁4个年龄组健康人群,用酶联免疫吸附试验筛查乙肝病毒核心抗体、乙肝病毒表面抗原和乙肝病毒表面抗体均为阴性,且有3剂HepB免疫史的人作为再免疫研究对象。采用5μg重组HepB(酵母)(HepB Made by Recombinant DNA Techniques in Yeast,HepB-Y)、10μg HepB-Y、10μg重组HepB(中国仓鼠卵巢细胞)(HepB Made by Recombinant DNA Techniques in CHO Cell,HepB-CHO)、10μg重组HepB(汉逊酵母)(HepB Made by Recombinant DNA Techniques in Hansenula Yeast,HepB-HY)、20μg HepB-CHO和20μg HepB-Y,均按0、1、6个月程序再免疫3剂。结果不同类型不同剂量HepB在人群中的再免疫成功率和抗体水平中位数[毫国际单位/毫升(mIU/ml)]分别为:5μg HepB-Y94.34%和226.53,10μg HepB-Y86.46%和175.36,10μg HepB-CHO97.39%和331.44,10μg HepB-HY91.30%和439.01,20μg HepB-CHO99.20%和386.66,20μg HepB-Y89.04%和372.97。各年龄组的再免疫成功率和抗体水平中位数(mIU/ml)分别是:2～4岁98.25%和353.42,6～8岁96.80%和320.31,13～15岁94.67%和282.12,16～40岁87.76%和305.24。结论年龄、疫苗种类和剂量是影响再免疫抗体应答的主要因素,随年龄的增长再免疫抗体应答下降,更换疫苗种类可提高再免疫抗体应答。
文摘目的了解新生儿接种乙型肝炎(乙肝)疫苗(Hepatitis B Vaccine,HepB)后低/无应答者的再免疫效果。方法对北京市、浙江省、广东省2004～2005年出生的新生儿,按照0、1、6月龄免疫程序完成3剂重组HepB(酵母)[HepB Made by Recombinant Deoxyribonucleic Acid(DNA)Techniques in Yeast,HepB-Y]免疫后,出现的低/无应答者,随机分为4组,按0、1、6个月程序再次免疫不同种类和剂量的HepB。结果低/无应答儿童再免疫前、再免疫1剂和再免疫3剂后,抗乙肝病毒表面抗原抗体[Antibody to Hepatitis B Virus Surface Antigin(HBsAg),Anti-HBs]几何平均浓度(Geometric Mean Concentration,GMC)分别为18.7mIU/m(l毫国际单位/毫升)、88.8mIU/ml、178.2mIU/ml,无应答者所占比例分别为20.4%、9.1%、1.9%。103名低/无应答儿童再免疫1剂和3剂后,>100mIU/ml所占的比例分别为61.2%和84.5%,差异有统计学意义(χ2=14.13,P<0.01);5μg重组HepB-Y、10μgHepB-Y、10μg重组HepB(中国仓鼠卵巢细胞)[HepB Made by Recombinant DNA Techniquesin Chinese Hamster Ovary(CHO)Cell,HepB-CHO]、10μg重组HepB(汉逊酵母)(HepB Made by Recombinant DNA Techniques in Hansenula Polymorpha Yeast,HepB-HPY)四种HepB再免疫3剂后,GMC分别为168.8mIU/ml、174.7mIU/ml、184.9mIU/ml、182.9mIU/ml,四种HepB再免疫3剂后,>100mIU/ml所占的比例分别为79.0%、85.7%、88.2%、84.6%,差异均无统计学意义(χ2=0.75,P>0.05)。结论 HepB全程免疫三剂后,低/无应答儿童按照0、1、6个月程序再次免疫3剂HepB后,抗体阳转率和GMC均有较大的提高,再免疫3剂HepB免疫效果优于再免疫1剂。
文摘Background: Acute kidney injury associated with proteinuria has been reported following vaccination against SARS-CoV-2 several times since 2021. Decisions about subsequent revaccination in these patients have been difficult because of the uncertainty of the consequences of doing so, and the absence of publications to help determine whether revaccination may be considered safe or not. Purpose: We present a case report of a 59-year-old Canadian man who developed severe acute kidney injury associated with moderate proteinuria following his first COVID-19 vaccine with the Moderna vaccine (an mRNA vaccine). He required haemodialysis for 2 weeks, which was initiated when his creatinine reached 1002 μmol/l. A kidney biopsy showed changes consistent with acute tubular necrosis. The patient was cautioned that repeat vaccination might result in further kidney injury which might be irreversible. However, he badly wanted to attempt a second COVID-19 vaccination, to facilitate a family vacation across several countries in Europe, at a time when travel restrictions were in place in many countries for persons who had not completed a course of vaccines. Method: Following deliberations, the patient chose to try a different type of Covid-19 vaccine. On this occasion, he was vaccinated with the Novavax vaccine (a subunit COVID-19 vaccine). Following this, close monitoring of his urine to detect proteinuria and blood testing for acute kidney injury were carried out on days 1, 3, 7, and 60 after vaccination. Furthermore, a year after his repeat vaccination, his kidney function and urinalysis were again assessed. Result and Conclusions: The patient did not develop acute kidney injury or worsening proteinuria following repeat vaccination. It remains unclear if acute kidney injury with proteinuria is caused by Covid-19 vaccination, or simply an incidental association. This case report suggests that it is may be reasonable for patients with acute kidney injury after COVID-19 vaccination to consider trying a different type of vaccine. In
基金funded by National Natural Science Foundation of China(81172662)Specialized Research Fond for the Doctoral Program of Higher Education(20123706110004)
文摘Objective:To investigate whether there is an association between diameter of bacille CalmetteGuerin(BCG)sears and effect of purified protein derivative(PPD)reaction anil to determine whether vitamin A(VA)combined vitamin I)(VD)supplementation influences the immune response to BCG revueeinated in Chinese infants.Methods:A cross-section and 3-month community-randomised trial was conducted.A total of 5 629 infants at 3,6 and 12 months of age in Junan County of China were examined for BCG scar fonnation.Then,597 revuccinated infants were randomly assigned to supplementation(n=307)and control(n=290)groups.The supplementation group were daily assigned to 1 500 IU VA and 500 IU VD for 3 months.Then all infants were subjected to skin test with PPD.Results:The diameter of BCG sears was positively con-elated with diameter of skin indurations of PPD(r=0.17,P<0.05)in the 5 629 infants.The rate of positive response to PP1)was higher in the supplementation group than in the control group(96.1%versus 89.7%,P<0.05,prevalence ratio 1.07.95%CI 1.02-1.12).The prevalence ralio of PPD response for the supplementation group compared with that for the control group was 1.07(95%CI 1.01-1.13)for the males and 1.08(95%CI 1.00-1.17)for the females.For the supplementation group,the males got larger tuberculin induration than the females[(0.73±0.2l)cm versus(0.67±0.20)cm.P<0.05)after intervention.Conclusions:The diameter of BCG scars was effectively correlated with PPD response,which indicates BCG scar formation may be an useful tool Io evaluate the effect of tuberculosis prevention.VA combined VD supplementation may play an immunoregulatory rale in BCG revuecination.This may contribute to the prevention of childhood tuberculosis.
文摘Immuuoresponsiveness of revacclnation in nonresponders and hyporesponders to hepatitis B vaccine was evaluated.10 nonresponders and kyporesponders as well as 18 normal responders to the primary vaccination were offered a 10μg dose or blood-derived vaccine in May 1989,three years after a 3-dose primary vaccine schedule,and were rollowed up and checked at 2,6,12 and 36 months after the booster dose.The results showed that Anti-HBs titre increased in both poor and normal responders,but the antibody level in nonresponders and hyporesponders was lower and the duration of persistence was much shorter,while the antibody GMT in normal responders remained above protective level at 36 months arter revaccination.Thererore,it is difficult to say,according to the data,that revaccination can satisfactorily boost anti-HBs level in the poor responders.
文摘Objective With the same times of injection to compare low-dose intradermal regimen with routine-dose intramuscular inoculation in revaccination of non-responders to hepatitis B vaccine. Methods 40 healthy non-responder children collected by screening were administrated a three-dose revaccination randomly by intramuscular or intradermal route (10vs 2g per dose), and regularly tested for serologic markers up to five years. By the end of follow-up, a booster dose (5μg) was given to those who had lost anti-HBs of ≥10mIU/mL (seroprotection) and anamnestic response was estimated thereafter. Results All 17 intramuscular and 22 of 23 intradermal children effected seroprotection after revaccination. Intradermal children lost seroprotection over time significantly rapider compared with intramuscular children (Log Rank test, P= 0.029). In year 5, 50% of intramuscular but only 18.2% of intradermal children still maintained seroprotection (P=0.075). 12-14 days after the booster dose, all the eight intramuscular children developed an anamnestic response with anti-HBs titer increasing greater, but two of the 18 intradermal children failed to mount seroprotective level. Conclusion Three-routine-dose intramuscular revaccination was significantly effective than low-dose intradermal one with the same times of injection, especially in long-term immunity. We recommend routine-dose intramuscular protocol in revaccination of non-responders.
