中华预防医学杂志最新文献

Objective: To analyze the epidemic trend and spatiotemporal distribution characteristics of pertussis in Shandong Province from 2015 to 2024. Methods: Data on pertussis cases in Shandong Province from 2015 to 2024 were collected from the China Information System for Disease Control and Prevention. The ArcGIS spatiotemporal method was used to analyze the epidemic trend and spatiotemporal distribution characteristics of pertussis, and determine the hotspots of incidence. Results: From 2015 to 2024, 46 172 cases of pertussis were reported in Shandong Province, with an average annual incidence rate of about 4.60/100 000. The reported incidence rate showed an overall upward trend, and in 2024, the reported incidence rate reached the highest level in history (19.20/100 000) since the implementation of children's planning immunization. The areas with high incidence rates were mainly located in the central and western regions of Shandong Province, including Jinan city, Liaocheng city, Tai'an city, Zibo city, Binzhou city, Jining city, Dezhou city, Zaozhuang city, and Dongying city. The global spatial autocorrelation analysis showed that the Moran's I index of incidence rate of pertussis in Shandong Province in each year from 2015 to 2024 was >0.00, showing obvious spatial clustering. Local spatial autocorrelation analysis showed that the "high high" clustering areas were mainly distributed in some counties (cities, districts) in the central and western regions of Shandong Province, which were hotspots for pertussis incidence in Shandong Province. The spatial trend surface analysis showed that the annual incidence rate of pertussis in each year basically decreased from west to east. In the early stage of the north-south direction, there was a curved trend of low north-south and high in the middle. In the middle and later stages, the northern part was mostly in a higher position, indicating that the central and western regions were the high-risk areas for pertussis in Shandong Province. Conclusions: The pertussis epidemic in Shandong Province from 2015 to 2024 has obvious spatiotemporal clustering, and the central and western regions are the key areas for pertussis prevention and control.

Objective: To evaluate the epidemiological protective effect of a booster dose of acellular DTP vaccine (DTaP) against pertussis in 6-year-old children. Methods: A retrospective cohort study was conducted to compare the incidence of pertussis in 6-year-old children who received DTaP versus DT vaccine boosters in 2023 over a two-year period from May 2023 to May 2025. The protective effect of the fifth dose of DTaP against pertussis in 6-year-old children was evaluated. Results: A total of 960 participants were enrolled in this study, including 480 children in the experimental group who received the fifth dose of DTaP vaccine and 480 children in the control group who received the DT vaccine booster. Baseline characteristics were balanced between the two groups. There were six confirmed cases of pertussis in the experimental group, with a reported incidence rate of 1.25%. In the control group, 14 pertussis cases were reported, with a reported incidence rate of 2.92%. The protective effectiveness(VE) of the DTaP vaccine against pertussis was 57.14% (95%CI:-10.59%-83.39%). For 6-year-old children who completed the booster immunization, the incidence data of pertussis were collected from the 14^th day after vaccination (i.e., the study day 0). Based on the annual cumulative incidence rate, the VE of DTaP against pertussis at 6, 12, 18, and 24 months after vaccination was 100%, 63.80% (95%CI:-14.49%-88.55%), 64.59% (95%CI: 1.17%-87.31%), and 57.60% (95%CI:-10.80%-83.78%), respectively. In the DTaP group, the annual cumulative incidence rate of 12 to 24 months did not show a significant upward or downward trend (Z=-0.995, P=0.320). Conclusion: Boosting 6-year-old children with the DTaP vaccine provides measurable protection against pertussis. The protective efficacy is significant in the early stage (0 to 6 months) after vaccination, and it still remains effective at 12 to 24 months.

To investigate the potential mechanism of histone crotonylation in the phenotypic switching of vascular smooth muscle cells (VSMC) and to identify novel therapeutic targets for the prevention and treatment of aortic dissection and aortic aneurysm. Experimental approaches, including in vitro cellular and molecular biology assays, were employed. The study design was as follows: VSMCs were cultured in vitro and treated with 100 nmol/L angiotensin Ⅱ to induce phenotypic switching. Morphological observation and Western blot analysis were used to examine the expression of phenotypic switching markers and chromodomain Y-like protein (CDYL). Interference and overexpression experiments were performed to assess the role of CDYL in VSMC phenotypic switching and its regulatory effect on histone crotonylation. Quantitative real-time PCR (qRT-PCR) and chromatin immunoprecipitation (ChIP) assays were applied to measure the expression of serum and glucocorticoid-regulated kinase 1 (SGK1) during VSMC phenotypic switching and to analyze the potential mechanism by which CDYL regulates SGK1 expression through H3K18 crotonylation. The results showed that CDYL was significantly downregulated during VSMC phenotypic switching (0.51±0.05,P<0.001) and functionally suppressed this process. Western blot analysis revealed that CDYL negatively regulated the level of H3K18 crotonylation. Compared to the AngII group, CDYL inhibition upregulated H3K18cr (3.14±0.22 vs. 4.24±0.16,P<0.05), whereas CDYL overexpression restored H3K18cr levels (3.14±0.22 vs. 1.76±0.07,P<0.001). Meanwhile, SGK1 was markedly upregulated during VSMC phenotypic switching (3.14±0.18,P<0.001) and was negatively regulated by CDYL. ChIP assays demonstrated that CDYL-mediated H3K18 crotonylation suppressed SGK1 expression. In conclusion, downregulation of CDYL promotes histone H3K18 crotonylation, thereby increasing SGK1 expression and accelerating VSMC phenotypic switching.

Schools are crowded places and may facilitate the transmission and outbreaks of influenza. The implementation of a free influenza vaccination program can significantly improve vaccination coverage among students and reduce the disease-related and economic burdens associated with influenza. The Expert Group on the Implementation and Evaluation of the Free Influenza Vaccination Program for Students convened to develop a consensus addressing nine key issues regarding the importance, feasibility, organization, implementation, supervision, management, and evaluation of free influenza vaccination programs for students. Based on relevant literature and applying the GRADE methodology to assess evidence and recommendations, the group developed 13 evidence-based recommendations. These recommendations are informed by China's national context and practical experience, and are intended to provide guidance and serve as a reference for health administrative departments, disease control and prevention institutions, community health service centers, and medical institutions in regions where the free student influenza vaccination program has been or will be implemented.

The number of pertussis cases reported through hospital-based passive surveillance severely underestimated the actual disease incidence. This may be due to factors such as atypical symptoms in the vaccine era, limited diagnostic criteria, insufficient clinician awareness, poor access to diagnostic technologies, and problems in monitoring and reporting management. Atypical pertussis often lacks specific symptoms or signs, making it prone to underdiagnosis or missed diagnosis in clinical practice. As a result, patients are not managed or treated effectively. This enables the pathogen to continue spreading. This is an important reason for the difficulty in accurately assessing the actual prevalence of pertussis. This study reviews the global understanding and evolving perspectives of atypical pertussis. It also examines the challenges this condition poses to prevention and control efforts. These challenges include low consultation rates, frequent underdiagnosis or missed diagnoses, limited laboratory testing access, and insufficiently targeted prevention strategies. The study also proposes countermeasures to optimize diagnosis, surveillance, and overall prevention and control efforts.

Butylated hydroxytoluene (BHT) is a synthetic phenolic antioxidant widely used in food additives, pharmaceuticals, personal care products, and other industries. It has been frequently detected in various environmental media, including oceans, soils, and the atmosphere. Human exposure to BHT can occur through multiple routes, and it has the potential to accumulate in the body while being readily transformed into several metabolites that are often more toxic than the parent compound. In recent years, numerous studies have investigated the levels of BHT and its metabolites in human populations and their potential health risks. Most current research on BHT exposure and its metabolites has focused on vulnerable groups such as pregnant women and children. These compounds have been detected in various biological samples-including human serum, urine, cerebrospinal fluid, and placenta-with relatively high frequencies.The metabolites of BHT demonstrate greater toxicity than BHT itself and have been implicated in pathological processes such as diminished ovarian reserve and miscarriage. Potential mechanisms include endocrine disruption, oxidative stress, and DNA damage. This article reviews current research on human exposure to BHT and its metabolites, as well as their potential health effects, aiming to provide a scientific basis for establishing usage standards and assessing health risks associated with BHT.

Objective: This study aimed to investigate the association between genetic factors and the risk of developing treatment-resistant depression (TRD), as well as the efficacy of modified electroconvulsive therapy (MECT), with a specific focus on identifying gene polymorphisms that can differentiate TRD from non-TRD. Methods: This case-control study included inpatients with depression in Adult Psychiatry Department, Affective Disorders Department and Geriatrics Department of Guangzhou Medical University Affiliated Brain Hospital from January 2023 to June 2024, as well as healthy individuals undergoing physical examinations in the outpatient department. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was utilized to genotype 16 loci across 10 candidate genes in 107 non-TRD patients, 101 TRD patients and 281 healthy controls. Hardy-Weinberg equilibrium testing, genotype frequency distribution analysis, and genetic association studies were conducted using PLINK software. Univariate binary logistic regression under a dominant model was performed using R software to analyze gene loci associated with non-TRD and TRD. Results: All 16 gene loci in the control group, the TRD group, and the non-TRD group were found to be in Hardy-Weinberg equilibrium (P>0.05). No significant differences were observed in the genotype distribution of these gene loci across the groups (P>0.05). Univariate binary logistic regression analysis revealed that individuals with depression carrying the HTR2A-rs7997012 G allele had a significantly lower risk of developing TRD (OR=0.26, P=0.047). Among the patients receiving MECT, the proportion of G allele carriers who showed improvement at 2, 4, and 6 weeks of treatment was significantly higher compared to those who did not show improvement (96.61% vs. 80.95%, 96.55% vs. 50.00%, 96.59% vs. 46.15%, respectively), with χ² values of 6.743, 29.295, and 32.300, respectively, and all P values <0.05. Conclusion: The HTR2A-rs7997012 polymorphism may represent a genetic distinction between TRD and non-TRD. Depressed patients with the rs7997012 G allele have a reduced likelihood of developing TRD, moreover, MECT demonstrates superior efficacy in this patient population.

Objective: To construct a nanoparticle vaccine displaying the prefusion F (preF) protein of respiratory syncytial virus (RSV) using the I53-50 protein nanoparticle platform, and to systematically evaluate its immunogenicity and protective efficacy. Methods: The RSV preF trimer antigen was genetically fused to I53-50A and assembled in vitro with I53-50B to form preF-I53-50 nanoparticles, theoretically displaying 20 preF antigens per particle. The structure and purity were characterized by size-exclusion chromatography, SDS-PAGE, and negative-stain electron microscopy. BALB/c mice were intramuscularly immunized with varying doses (1 μg or 5 μg) of preF antigen or an equimolar amount of preF-I53-50 nanoparticles. Humoral immunity, B-cell responses, and protective efficacy were assessed following intranasal viral challenge. Results: The preF-I53-50 nanoparticles self-assembled into spherical structures (50-60 nm in diameter) with uniformly arrayed antigens. The nanoparticle vaccine enhanced RSV-specific IgG1 and IgG2a antibody responses, promoting a Th1-biased immune profile. At equimolar preF doses, the neutralizing antibody titers induced by 1 μg and 5 μg nanoparticle formulations were 2.8-fold and 2.3-fold higher, respectively, than those elicited by preF alone (P<0.05). Notably, even the low-dose nanoparticle group outperformed the high-dose preF group (1.6-fold increase). Viral challenge experiments demonstrated that preF-I53-50 effectively suppressed pulmonary viral replication, mitigated pathological damage, and induced stronger germinal center and memory B-cell responses, suggesting enhanced B-cell affinity maturation and long-term immune memory. Conclusion: The preF-I53-50 vaccine improves the immunogenicity and protective efficacy of RSV preF through multivalent antigen display.

Antimicrobial resistance caused by irrational use of antimicrobials has become an important public health problem. Antimicrobial stewardship (AMS) requires multi-disciplinary interaction, including medical department, clinical department, clinical microbiology laboratory, hospital sensory department, pharmacy department, information department, etc. Based on the role of microbiology in AMS management, this consensus reviews the key issues in the application of microbiology examination in AMS from three aspects: pre-analytical, analytical and post-analytical phase to control the quality of etiological detection, improve the efficiency of etiological diagnosis, and promote the scientific management of antimicrobials.