中华预防医学杂志最新文献

Mucosal immunity can effectively prevent pathogen invasion of the mucosa at the initial stage of infection and inhibit pathogen replication within the body at later stages of infection. Therefore, the development of mucosal vaccines is of great significance for the prevention and control of infectious diseases. Intranasal vaccines can induce cellular, humoral, and mucosal immunity in the nasal mucosa and nasal-associated lymphoid tissue, producing secretory IgA, which plays a crucial role in preventing respiratory infections. However, the dilution of antigens by nasal mucus, clearance of antigens by cilia, and the barrier function of nasal epithelial cells in the nasal cavity can reduce the bioavailability of antigens and limit the efficacy of intranasal vaccines. This article reviews the structure of the nasal mucosal immune system and its mediated immune response, as well as intranasal vaccines that have been launched or are currently in clinical research, and explores the challenges faced in intranasal vaccine research.

Objective: To analyze the associated factors and cumulative effects of cardiometabolic multimorbidity (CMM) among residents in southern Xinjiang. Methods: A stratified random cluster sampling method was used to conduct questionnaire surveys, physical examinations and laboratory tests among the personnel of the 51st Brigade, 3rd Division, Xinjiang, in 2016. The multivariate logistic regression, multivariate linear regression, restricted cubic spline, and network analysis methods were used to study the association of lifestyle (smoking, alcohol consumption and physical activity), socioeconomic (occupation, education and marital status) and clinical factors (waist circumference, body mass index and family history) with CMM. Results: A total of 12 773 study subjects were included. The prevalence of cardiovascular metabolic diseases among residents in southern Xinjiang was 52.49%. Specifically, the prevalence rates of dyslipidemia, hypertension, coronary heart disease, diabetes, and stroke were 31.14%, 29.95%, 6.78%, 6.26%, and 2.47%, respectively, and the prevalence of CMM was 19.06%. Multivariate logistic regression analysis revealed that the associations between clinical and socioeconomic factors and CMM significantly increased with higher scores. Specifically, the OR rose from 1.75 (clinical factors) and 1.07 (socioeconomic factors) on a score of 1 to 4.41 and 1.93 on a score of 3, respectively. The association between lifestyle factors and CMM was only observed at higher scores (OR=1.26, 95%CI:1.07~1.62). The trend test using the scores of each group as continuous variables in the model showed that the risk of disease increased with the accumulation of clinical, socioeconomic and lifestyle factors (all P<0.05). Restricted cubic spline analysis demonstrated a non-linear relationship between the total number of associated factors and CMM (P_overall<0.05 and P_non-linear<0.05). Network analysis identified hypertension (strength=0.42) as the "core node" among the five diseases. When analyzing the three types of influencing factors, hypertension (strength=0.68), dyslipidemia (strength=0.47), coronary heart disease (strength=0.37), and clinical factors (strength=0.53) emerged as "core nodes". In the network of nine associated factors, abnormal waist circumference and BMI (strength=0.90 and 0.84) were identified as "key factors", while hypertension (strength=0.68) and dyslipidemia (strength=0.52) were identified as "key diseases". Conclusion: The prevalence of CMM among residents in southern Xinjiang is high, and there is a cumulative effect of multiple factors. Hypertension and dyslipidemia are key diseases in the multimorbidity network, while abnormal BMI and waist circumference are key associated factors.

To establish and optimize the venous thromboembolism(VTE), whole process prevention and treatment information system based on electronic medical record system. Improving the convenience and efficiency of VTE prevention and control management to achieve continuous, dynamic, effective monitoring and other advantages of the management, reduce the incidence of VTE and improve medical quality and safety. Beijing Friendship Hospital established a hospital VTE prevention and treatment management system in 2020. Through the system management, it explores effective ways to prevent and manage VTE in hospitalized patients. This study took all hospitalized patients from January 1, 2020 to December 31, 2022 as the research subjects, and standardized diagnosis and treatment pathway was established based on clinical pathway. The hospital independently developed VTE prevention and management system, and built VTE assessment scales and risk assessment scales, based on the electronic medical record system of hospital information system. The relevant workload table is embedded in the electronic medical record. The system integrates clinical data, conducts unified analysis and structuring, realizes system functions such as VTE risk assessment, VTE risk warning, VTE standardized prevention and treatment, VTE quality control, etc. And evaluates and analyzes the implementation effect of the VTE prevention and management system in the hospital, comparing the VTE prevention and management effect of hospitalized patients before and after system management. The results showed that the medical staff's awareness and ability of prevention and treatment of VTE were significantly improved. In 2020, the rate of VTE dynamic risk assessment reached to 55.9%, and which was increased to 88.0% in 2022(χ²=15 551.302,P<0.001). In 2020, the rate of VTE preventive measures was 22.8%, which was increased to 61.2% in 2022(χ²=4 669.675,P<0.001). In conclusion, the application of the hospital VTE prevention and treatment management system can effectively improve the standardization, scientific and management efficiency, which further ensure medical safety, and provide necessary decision support for clinical medicine.

To enhance the practical ability and job competency of full-time master of public health (MPH) postgraduates and explore a collaborative training mode that integrates medical education with a prevention-and-control approach, in line with standardized public health physician training, the Beijing Center for Disease Control and Prevention, in collaboration with the School of Public Health affiliated to Capital Medical University, had recruited full-time MPH postgraduates since 2015. These students were trained and assessed through a collaborative training mode based on the Beijing public health physician training mechanism. Through the introduction and analysis of the training objectives, training process, practical assessment methods, training quality, and results, this article suggests that the construction of a collaborative training mode integrating MPH postgraduate education of public health professionals and standardized public health physician training has explored a new pathway for cultivating "four-certification integration" public health professionals. This aligns with the Chinese national strategy for public health talent development and can alleviate the problems of "contradictions between work and study", including the current shortage of public health physicians at present and the difficulties in standardized training enrollment. In addition, this collaborative training mode provides valuable experience for other medical schools in training applied public health professionals who meet national public health standards and combine prevention with treatment.

Objective: To investigate the safety of the tetravalent meningococcal conjugate vaccine (MPCV-ACYW) in combination with the inactivated poliomyelitis (IPV) vaccine and diphtheria-tetanus-acellular pertussis (DTaP) vaccine for infants aged 3-5 months and provide real-world evidence for the immunization strategy of vaccine combination. Methods: From June to October 2023, a total of 600 3-month-old infants were selected and divided into three groups: control group, mono-vaccination group and combined vaccination group. They were simultaneously or individually vaccinated with MPCV-ACYW, IPV and DTaP vaccines at 3, 4, and 5 months of age, respectively. The incidence rate of adverse reactions within 30 days after each dose was observed. Results: All 600 infants completed at least one vaccination and entered the safety data analysis. The age of the control group (100 infants), the mono-vaccination group (250 infants), and the combination group (250 infants) was (101.20±7.88), (102.26±7.94), and (102.35±7.76) days, respectively. The body lengths were (63.00±3.02), (62.55±3.06), and (63.14±4.02) cm, respectively. The body weights were (6.90±0.77), (6.86±0.94), and (6.99±0.95) kg, respectively. Boys accounted for 49%, 50.4%, and 52.4%, respectively, with no statistically significant differences (all P>0.05). The overall incidence rates of adverse reactions in the control group, mono-vaccination group, and combined vaccination group were 4.00%, 2.80%, and 3.20%, respectively, with systemic adverse reaction rates of 3.00%, 2.40%, and 2.00%. The incidence rates of local adverse reactions were 1.00%, 0.40%, and 1.20%, with no statistically significant differences (all P>0.05). Adverse reactions were mainly grade 1, with incidence rates of grade 1 adverse reactions of 3.00%, 2.00%, and 1.60% in the three groups, and incidence rates of grade 2 adverse reactions of 1.00%, 0.80%, and 1.60%, respectively. No grade 3 or 4 serious adverse reactions occurred, and the differences were not statistically significant (all P>0.05). The adverse reaction symptoms of the three groups were mainly systemic reactions, among which fever and diarrhea symptoms were reported in individual cases in each group, with no statistically significant differences in the incidence rate (all P>0.05). The symptoms of adverse reactions were mostly transient and self-relieved, all of which were cured. Conclusion: The combination of MPCV-ACYW and IPV or DTaP vaccines is safe for infants aged 3-5 months.

Objective: To investigate the current status and related factors of antiviral treatment for chronic hepatitis B virus (HBV) infection in rural communities in China. Methods: In 2023, 866 chronic HBV-infected individuals from rural communities in Zhangqiu District, Jinan City, were included in the study. Basic information, disease status and antiviral treatment conditions of the infected individuals were collected through questionnaires, specimen collection and laboratory tests. Univariate and multivariate logistic regression were used to analyze the related factors of the antiviral treatment rate of those who met the indications for hepatitis B antiviral treatment. Results: The median age (Q₁, Q₃) of subjects was 56 (48, 66) years old, among which 436 (50.4%) were males. There were 712 (82.2%) individuals who met the indications for hepatitis B antiviral treatment, and 110 individuals received antiviral treatment with a rate of 15.5%. Multivariate logistic regression analysis showed that compared with males, families with an average monthly income per capita of <1 000 yuan, no alcohol consumption, no smoking, and a family history of HBV infection, females (OR=4.66, 95%CI: 2.88-7.53), families with an average monthly income per capita of 1 000-1 999 yuan (OR=1.64, 95%CI: 1.00-2.68) and ≥2 000 yuan (OR=2.78, 95%CI: 1.54-5.03), alcohol consumption (OR=6.42, 95%CI: 2.80-14.7), smoking (OR=1.98, 95%CI: 1.04-3.77), and no family history of HBV infection (OR=1.90, 95%CI: 1.16-3.09) had a lower antiviral treatment rate for chronic HBV infection. Conclusion: The antiviral treatment rate of chronic HBV-infected individuals in rural communities of Zhangqiu District, Jinan City is low, and the related factors are female, high monthly income per capita, alcohol consumption, smoking, and no family history of HBV infection.