Seroepidemiological Study on Hepatitis E Virus Infection in Rural General Population in Jiangsu Province

目的调查江苏省部分农村地区一般人群戊型肝炎的感染情况以及流行特征,为防治工作提供依据。方法利用分层整群抽样的方法,按不同的地区抽取若干个行政村的4139名自然人群,采用酶联免疫吸附试验(ELISA)检测该人群中HEV-IgG,HEV-IgM抗体水平。结果在调查的4139名自然人群中,抗HEV-IgG和抗HEV-IgM平均阳性率分别为52.0%和2.5%,男性和女性间的抗HEV-IgG和抗HEV-IgM阳性率差异有统计学意义,男性抗HEV-IgG阳性率(56.1%)高于女性(49.0%),而女性抗HEV-IgM阳性率(3.0%)高于男性(1.8%);同时戊肝感染可见于各个年龄段,但流行分布不平衡,差异有统计学意义,随着年龄的增长感染率呈上升的趋势。结论江苏省部分农村地区人群戊型肝炎病毒感染率明显高于国内已报道其他地区,各个年龄组均有感染。为降低感染率,探讨针对性的防治措施对策已刻不容缓。Objective To investigate the seroprevalence,epidemiological characteristics of hepatitis E virus(HEV) infection in an rural area of Jiangsu province. Methods Stratified-cluster sampling was carried out in different areas,4 139 persons were surveyed.Anti-HEV IgG and IgM were tested by commercial ELISA kits. Results The total anti-HEV IgG and IgM prevalence were 52.0% and 2.5% respectively in the general population. There were statistically significant differences in the seropositivity rates of anti-HEV IgG and IgM between male and female.The seropositivity rate of anti-HEV IgG in male(56.1%)is higher than that in female(49.0%),while the seropositivity rates of anti-HEV IgM in female (3.0%)is higher than that in male(1.8%). The antibodies increased with advancing age. Conclusion The prevalence of hepatitis E virus infection in those districts was higher than any other reported districts in China. HEV infection was found in every age, and increased with age, so there was no time to delay to take measures against prevalence of hepatitis E virus infection

江苏省部分地区散发戊型肝炎流行病学及病毒基因型

目的了解江苏省部分地区散发戊型肝炎病例的流行特征及病毒基因型。方法在江苏省部分地区开展为期一年戊型肝炎病例监测,用酶联免疫吸附试验(enzyme-linked immunosor-dent assay,ELISA)对各医疗单位报告的急性肝炎病例进行血清学分型,对其中确诊为急性戊型肝炎病例进行流行病学分析以及戊型肝炎病毒(hepatits E virus,HEV)RNA检测和序列分析。结果男女戊型肝炎病例比例为4.4∶1,84.0%的病例集中在40岁及以上的年龄组,全年均有戊型肝炎病例发生,70.5%的病例集中在上年12月份至次年的4月份间;HEV基因分型检测结果为HEV-1型与HEV-4型,所占比例分别为5.1%、94.9%。结论江苏省戊型肝炎发病比例男性高于女性,多见于40岁以上人群,冬春季节发病较高,戊型肝炎病毒株以HEV-4型为主

江苏省农村地区自然人群戊型肝炎感染状况的研究

目的:了解江苏省农村地区戊型肝炎病毒(HEV)感染的特征及相关影响因素。方法:在江苏省部分农村地区,以整群抽样的方式进行戊型肝炎感染的血清学横断面调查以及1年的随访性研究,并对分离到的毒株进行基因分型,同时调查感染的相关影响因素。结果:横断面调查的4139例自然人群中,抗-HEV-IgG阳性率为52.0%,男性阳性率显著高于女性,各年龄组阳性率随年龄升高而增加。经1年的随访,抗-HEV-IgG年阳转率为11.6%,20岁以上年龄组的阳转率显著高于20岁以下年龄组;抗-HEV-IgG年阴转率为5.8%,0～9岁以下年龄组的阴转率显著高于10岁以上年龄组。从亚临床感染者分离到的5份HEV毒株中,基因Ⅰ型3株、基因Ⅵ型2株。相关影响因素分析显示,男性、年龄增加和接触生猪是感染的危险因素。结论:江苏省农村地区的HEV感染程度较高,亚临床感染的HEV基因分型为Ⅰ型和Ⅳ型;除性别、年龄外,接触生猪是感染的重要影响因素

Analysis of partial sequences of Hepatitis E virus isolated from human and swine in a certain area of Jiangsu province

目的:调查了解江苏省某农村地区人源与猪源戊型肝炎病毒(HEV)的相关性。方法:应用逆转录-巢式聚合酶链法(rT-PCr)对同一地区内一般人群中HEV IgM阳性者、急性戊型肝炎患者血标本和生猪胆囊标本进行HEV rnA检测,并对HEV rnA阳性标本进行克隆测序和序列分析。结果:一般人群中检出的HEV基因1、4型比例相近,临床散发性戊肝病例绝大部分为HEV-4型病毒感染所致(95.24%);生猪胆汁标本PCr阳性率为12.11%,猪源HEV基因分型均为HEV-4型;分离于人和生猪的HEV-4型病毒高度同源,同源性81%~97%。结论:该地区人群HEV基因分型以HEV-4型为优势毒株;猪源HEV均为基因4型;人源和猪源的HEV-4型病毒高度同源,猪是当地HEV主要宿主动物之一。Objective:To explore the correlation between swine and human hepatitis E virus(HEV) in Jiangsu province.Methods:Specimens collected from HEV-IgM positive people of the general population,patients with acute hepatitis E and cholecyst from swine in the same area,were detected for HEV RNA by nested reverse transcription polymerase chain reaction(RT-PCR).HEV-positive samples were further analyzed by direct nucleotide sequencing.Results:Among the HEV IgM carriers,8 positive cases were identified,and the subtype of HEV were type 1 and type 4.The majority cases of clinical sporadic HEV were type 4(95.24%).The HEV-positive rate of swine bile samples was 12.11%,and the virus genotype was type 4.The type 4 HEV of human and swine showed a high degree of homology(81%～97%).Conclusion:Both HEV-1 and HEV-4 were found in human in this area with the dominant type of HEV-4.All the swine HEV-positive samples showed HEV-4 genotype.The HEV-4 of human and swine in the Dongtai area showed a high degree of homology.These findings suggest that swine may be one of the main hosts of HEV in this region

Analysis on the epidemiological characteristics of the sporadic cases with hepatitis E infection in the rural area in Jiangsu province

目的了解江苏省农村散发性戊型肝炎的流行病学特征。方法通过建立覆盖市、镇、村三级医疗卫生服务机构的疑似肝炎主动监测网络,系统全面地监测戊型肝炎病例的发病情况。结果主动监测网络的敏感性明显高于网络报告系统,能更加准确、全面地掌握戊肝的发病规律。结果显示戊型肝炎病例占疑似急性肝炎病例的26.7%,男性戊肝发病率高于女性(P<0.01);发病随着年龄增长而上升,多见35岁以上人群;全年均有发病,冬春季节较高;戊型肝炎病毒株HEV1、4型并存,但以HEV4型为主(92.5%)。结论疑似肝炎主动监测系统数据显示目前戊肝发病率有被低估的风险。To understand the epidemiological characteristics of the sporadic cases with hepatitis E infection in the rural area of Jiangsu province,the prevalence of hepatitis E infection was surveyed systemically and completely through the initiatively monitoring system for the suspected cases of hepatitis E covering the city,town and village levels of medical and health service organizations.It was found that the initiatively monitoring system for suspected hepatitis E cases reflected the incidence of hepatitis E more accurately and comprehensively and was proved to be more sensitive than the network reporting system.The cases with hepatitis E accounted to 26.7% of the suspected cases with acute hepatitis and they were more frequent in male than in female.The incidence of hepatitis E increased with advance of age and most of cases occurred with age over 35.Estimated incidence was stable on the whole year,but rose up in winter and spring.The HEV type 1 and type 4 co-existed,but the HEV type 4 was proved to be the main type(92.5%).From the above observations,it seems that the initiatively monitoring system for the suspected cases of hepatitis E may be under-estimated for the risk of the hepatitis E infection in rural area of Jiangsu province.国家高技术研究发展计划(863计划)(2006AA02A209)资

散发型戊型肝炎与急性乙肝临床特征比较

目的比较散发型急性戊型肝炎与乙肝临床特征。方法分析戊肝和急性乙肝间年龄、性别、肝脏损伤、症状体征以及病程的差异。结果急性肝炎病例中,戊型肝炎最常见(28.0%),急性乙肝次之(9.2%);戊肝平均发病年龄为56.3±13.1岁,急性乙肝为43.0±12.5岁,平均发病年龄戊肝较急性乙肝大(t=4.4723,P<0.0001),均为男性多发;两者常见的临床症状和体征基本相当,但戊肝患者黄疸症状更多见(P<0.05);戊肝病程较急性乙肝长(t=3.7249,P=0.0003);通过年龄性别进行1:1匹配分析,戊肝比急性乙肝对肝脏的损伤程度严重(t=3.5978,P=0.0019)。结论戊肝多见于中老年,急性乙肝多见于中青年,均为男性多于女性。临床特征比较戊肝较急性乙肝更为严重

Y型聚乙二醇干扰素琢-2b注射液治疗HCV基因2/3型慢性丙型肝炎患者疗效和安全性的多中心随机对照试验研究

目的以标准剂量的聚乙二醇干扰素(Peg IFN)α-2a联合利巴韦林作为阳性对照,评价新型试验药物Y型Peg IFNα-2b注射液联合利巴韦林治疗2型/3型慢性丙型肝炎(CHC)患者的疗效和安全性。方法采用多中心、随机开放、阳性药对照的Ⅲ期临床试验,筛选符合要求的2型/3型CHC患者,按照2:1的比例随机分配到Y型Peg IFNα-2b组和Peg IFNα-2a组,同时口服利巴韦林,疗程24 w,停药随访24 w。采用Abbott Real Time HCV Genotype II检测HCV基因型,采用Cobas Taq Man实时定量PCR法检测血清HCV RNA水平。详细记录不良事件。主要疗效指标为持续病毒学应答(SVR),并进行非劣效检验。结果本试验实际入组2型/3型CHC患者255例,实际治疗241例。全分析集(FAS)数据显示,158例试验组和83例对照组患者SVR分别为85.4%(95%CI 79.94%~90.94%)和79.5%(95%CI 70.84%~88.20%,P=0.2402);对符合方案分析集(PPS)人群分析显示,试验组和对照组患者SVR分别为87.9%(95%CI 82.45%~93.27%)和85.9%(95%CI 77.82%~94.01%,P=0.7060),率差的95%可置信区间均符合非劣效标准;对PPS人群分析显示,85.8%受试者获得了早期病毒学应答(RVR),RVR的阳性预测值为90.1%;试验组和对照组不良事件发生率相似,分别为95.6%和95.2%,严重不良事件发生率分别为3.8%和3.6%。结论应用Peg IFNα联合利巴韦林治疗2型/3型CHC患者,新型试验药物Y型Peg IFNα-2b具有与对照药物Peg IFNα-2a相似的疗效和安全性。国家科技部“十二五”重大专项(编号:2012ZX10002-003)；“重大新药创制”十二五科技重大专项(编号:2012ZX09303019)

Compound die design of steel pick by once forming

花针是大批量生产的花艺消耗品,属于典型的冲裁、弯曲成形冲压件,材料较薄。降低生产成本、提高生产效率是该件生产的主要问题。本文介绍了一种采用一次成 形花针的复合模具,在一个工位中同时完成了冲裁和弯曲两道工序,解决了一般方法生产中冲裁和弯曲两道工序带来的送料困难问题;采用了滚动导向模架解决了冲 裁间隙极小的问题;在模具结构中引入了电器控制,采用接近开关、计数器和滑台气缸解决了工件计数及叠合的问题,达到了自动化生产。该模具具有结构简单、多 功能的特点,达到了节约材料和提高生产效率的目的。The steel pick is a kind of floriculture consumable of mass production, and it is a thin part formed by the typical blanking-bending stamping.The critical issues in production are cost control and efficiency improvement. A compound die producing steel pick was introduced,which completed blanking and bending simultaneously in the same station and solved feeding difficulty that caused by general method of punching and bending in two different stations. The problem of minimal blanking clearance was solved by rolling guide die base. The electrical apparatus control was adopted in the die structure, and the problems of workpiece counting and superposition were solved by proximity switch, counter and slide cylinder,which realized the automation production. The die, with features of simple structure and multi functions, can achieve goals of saving materials and improve production efficiency