ObjectiveTo investigate the clinical effects of systems integrative rehabilitation therapy for cervival spdylotsis myelopathy.MethodsFrom April 2002 to October 2004, 68 cases were intervened with the integrative rehabilitation treatment, which linked up the pre- and post-operational rehabilitation interventions into a continuum. The cases were followed up, and serial radiological evaluations were applied. Then the height of involved interspinal space was measured preoperatively and 12 months after operation, and the spinal function was evaluated according to the standard of Japanese Orthopeadic Association (JOA).ResultsAll the cases were followed up, of which 49 were better, 1 was improved, none was worsened. 12 months after operation, roentgenographic appearance showed that the allograft healing and interbody fusion of all patients were achieved, and the reserving height of involved interspinal space and JOA evaluation postoperatively were significantly superior to preoperatively. There was no complications such as cervical spinal cord injury, internal fixation loosening and hematoma turned up.ConclusionThe integration rehabilitation therapy has satisfactory effects in the cervical spondylotsis myelopathy.

Objective:To assess the effectiveness of 1 dose varicella attenuated live vaccine (VarV) for healthy children aged 1-12 years in China and explore the application of the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) framework in observational studies of vaccine effectiveness (VE).Methods:We searched studies about the VE of 1-dose VarV for children aged 1-12 years in China which published before 2019 and evaluated the quality of the studies by the Newcastle Ottawa Scale (NOS) table. We used Meta-analysis models to obtain the pooled 1-dose VE and that in subgroups by study design, outbreak or not, study quality and age of subjects. The evidences of VEs were rated by means of the GRADE system.Results:Thirty-two studies were included and the pooled 1-dose VE was 75% [95% confidence interval ( CI): 68%-80%]. The VE of outbreak studies [VE=66% (95 %CI: 57%-73%)] was lower than non-outbreak studies [VE=85% (95 %CI: 78%-89%)], and the VE in <6 years old children [VE=84% (95 %CI:77%-89%)] was higher than that in ≥6 years old children [VE=60% (95 %CI: 51%-68%)]. There was no significant difference in VE among studies with different design and quality. The quality of the evidences of pooled 1-dose VE was"very low", which was downgraded in bias risk and inconsistency and not downgraded in indirectness, imprecision and publication bias. Conclusions:The 1-dose VarV can provide medium level protection for 1-12 years old children in China, but it will decrease significantly for ≥6 years old children, so it is suggested to implement the strategies of two-dose vaccination of VarV in children <6 years old. The GRADE framework can be used in the observational studies of VE and it is suggested that the technical guidelines of observational study should be worked out to improve the overall quality of evidence.

OBJECTIVETo analyze the polio immunity level of persistent population in Beijing, 2012.

METHODSA total of 1 676 subjects residing more than 6 months in Beijing were selected by stratified random cluster sampling design in 2012. Demographic characteristics, history of oral poliovirus vaccine (OPV) immunization were investigated by questionnaire. All 5 ml blood sample were collected for testing of polio neutralizing antibody using the method of microcell neutralization. The positive rate and the geometric mean titer (GMT) of polio neutralizing antibody type I, II and III were analyzed in different groups.

RESULTSThe positive rate of type I, II and III were 98.2% (1 645/1 676), 98.1% (1 644/1 676), 97.6% (1 635/1 676); The GMT were 1:130.2, 1: 113.4 and 1: 79.7. Three types of positive rates in<15 years group (99.7% (664/666), 99.8% (665/666), 99.5% (663/666)) were higher than those of ≥ 15 years group (97.1% (981/1 010), 96.9% (979/1 010), 96.2% (972/1 010)), the differences were significant (all the values of P < 0.01); The GMT in<15 years group (1:325.9, 1:250.5, 1:190.7) were higher than that of ≥ 15 years group (1: 71.1, 1: 67.2, 1: 44.8), the difference was significant (all the values of P < 0.01). The positive rate (99.0%-100%) and GMT (1: 128.8-1: 300.7) in vaccination information confirmed population were higher. The highest positive rate (all were 100%) and GMT(1: 409.7-1: 636.7) were observed in children who vaccinated three times.

CONCLUSIONThe polio antibody of healthy population was at a high level in Beijing in 2012; Especially the age groups of < 15 years which were covered by vaccines.Immunization barrier had been formed firmly to interrupt the transmission of wild poliovirus and vaccine-derived poliovirus.

Adaptive Immunity ; Adolescent ; Antibodies, Neutralizing ; Antibodies, Viral ; Child ; Humans ; Poliomyelitis ; Poliovirus ; Poliovirus Vaccine, Oral ; Vaccination ; statistics & numerical data

Objective:To analyze the changing trend of polio vaccine immunization effectiveness and vaccine titer in Beijing in 2012, 2014, 2016 and 2018 before and after the adjustment of polio vaccine immunization program strategy.Methods:According to the convenient sampling method,the vaccination clinics of Chaoyang and Yanqing Districts in 2012, Fengtai and Daxing Districts in 2014, Tongzhou and Pinggu Districts in 2016, Dongcheng and Shunyi Districts in 2018 were selected as monitoring points. A total of 292 children were selected 4-8 weeks after the completion of 3 doses polio vaccine basic immunization which were 3 doses of trivalent oral poliovirus vaccine（tOPV）schedule before the strategy adjustment in 2012-2014 and 1 dose of inactivated poliovirus vaccine (IPV) following 2 doses of bivalent oral poliovirus vaccine (bOPV) sequential schedule after the adjustment in 2016-2018. About 1.0 ml blood samples were collected to detect type Ⅰ and Ⅲ neutralizing poliovirus antibody. A total of 9 oral poliovirus vaccines (8 vaccines in 2012) were selected from different sources of vaccine storage every year to test the vaccine titer using random number method .Results:The [ M（ P25， P75）] age of 292 children was 5 (5, 6) months, and the ratio of male to female was 1.04 (149/143). In 2012, 2014, 2016 and 2018, 66,72,68 and 86 children were investigated respectively. After basic immunization, antibody positive rates for type Ⅰ and Ⅲ poliovirus were 100%, except 98.61% (71) for type Ⅰ poliovirus in 2014. The neutralizing antibody titer of type Ⅰ and Ⅲ poliovirus was higher in 2016 and 2018 than that in 2012 and 2014 ( P<0.001). The average titer of tOPV were (6.05±0.15) and (6.16±0.12) lgCCID 50 per dose in 2012 and 2014. The average titer of bOPV were (6.88±0.21) and (6.26±0.14) lgCCID 50 per 100 μl in 2016 and 2018 ( P<0.001). Conclusion:Before and after the adjustment of polio vaccine immunization strategy in Beijing, the basic immunization success rate of the IPV-bOPV sequential immunization schedule was good as well as full tOPV schedule. The level of polio antibody produced by the IPV-bOPV sequential immunization schedule was higher. After adjustment, bOPV titer in 2016 was significantly higher than those before adjustment, while bOPV titer decreased significantly in 2018.

Objective:To analyze the etiological features and clinical characteristics of herpes zoster cases under 20 years old in Beijing City from 2017 to 2021.Methods:Herpes zoster cases were collected from a surveillance system in Beijing City from December 2017 to April 2021. The cases included individuals under 20 years old from seven sentinel hospitals located in two districts (Miyun District and Changping District). The basic information, the rash date of rash onset and the location and number of lesions were investigated at the first visit to the hospital, and the lesion swab samples were collected for laboratory testing. A telephone follow-up was conducted 21 days after the onset of the rash to investigate the degree of pain, duration of the rash and duration of pain. The individuals who still experienced neuralgia were further investigated for their pain condition at 90 days after the onset of the rash, to discover cases with postherpetic neuralgia. DNA was extracted from the rash fluid, and the ORF62 gene region was amplified and sequenced to obtain the viral sequence. The wild-type strain or chickenpox vaccine strain was identified by using sequence alignment, and the clinical characteristics of cases with different varicella vaccinations were compared.Results:A total of 78 herpes zoster cases under 20 years old were investigated during 2017-2021 in Beijing City, and 61 cases completed the follow-up survey. The age range of 61 cases was 1.83 to 20.54 years with a median age of 17.50 years. There were 36 males (59.02%) and 25 females (40.98%). Among them, there were 29 cases with the chickenpox vaccine immunization history (18 cases with one dose, 5 cases with two doses and 6 cases with unknown doses), 13 cases with no vaccination history and 19 cases with unknown vaccination history. Among the 78 cases, the herpetic fluid samples of 64 cases were positive for VZV, including 62 cases identified as wild-type strains and two cases as vaccine strains. The two vaccine strain cases were both 2-year-old girls who had received one dose of varicella vaccine and developed herpes zoster 3 months and 13 months after vaccination. Among the 29 cases with chickenpox vaccine immunization history, the majority had 10 to 49 lesions, accounting for 58.62% (17 cases). The trunk was the most common site of lesions, accounting for 44.83% (13 cases). About 51.72% (15 cases) reported "no or mild" pain intensity. The median ( Q1, Q3) scores for the worst pain, duration of pain and the time to crusting of lesions in the herpes zoster cases were 3 (1.5, 5) points, 10 (1.5, 12.5) days and 10 (6.5, 13) days, respectively. There was no statistically significant difference in the constituent ratio of the location of lesions, number of lesions and pain degree among the cases with vaccination history, without vaccination history and with unknown vaccination history ( P>0.05). There was also no statistically significant difference in the distribution of pain score, duration of lesions and duration of pain across the three groups ( P>0.05). Conclusion:Wild strains are the predominant pathogens in herpes zoster cases under 20 years old in Beijing City during 2017-2021. The varicella vaccination has no significant impact on the clinical manifestations of herpes zoster cases.

Objective To analyze the polio immunity level of persistent population in Beijing , 2012.Methods A total of 1 676 subjects residing more than 6 months in Beijing were selected by stratified random cluster sampling design in 2012.Demographic characteristics , history of oral poliovirus vaccine ( OPV) immunization were investigated by questionnaire.All 5 ml blood sample were collected for testing of polio neutralizing antibody using the method of microcell neutralization.The positive rate and the geometric mean titer ( GMT ) of polio neutralizing antibody type Ⅰ,Ⅱ and Ⅲ were analyzed in different groups.Results The positive rate of type Ⅰ,Ⅱ and Ⅲ were 98.2%( 1 645/1 676 ) , 98.1%( 1 644/1 676),97.6%(1 635/1 676);The GMT were 1∶130.2,1∶113.4 and 1∶79.7.Three types of positive rates in<15 years group(99.7%(664/666),99.8%(665/666),99.5%(663/666)) were higher than those of≥15 years group (97.1%(981/1 010),96.9%(979/1 010),96.2%(972/1 010)),the differences were significant(all the values of P<0.01); The GMT in<15 years group(1∶325.9,1∶250.5,1∶190.7)were higher than that of ≥15 years group (1∶71.1,1∶67.2,1∶44.8),the difference was significant (all the values of P<0.01).The positive rate(99.0%-100%) and GMT(1∶128.8-1∶300.7) in vaccination information confirmed population were higher.The highest positive rate (all were 100%) and GMT(1∶409.7-1∶636.7) were observed in children who vaccinated three times.Conclusion The polio antibody of healthy population was at a high level in Beijing in 2012; Especially the age groups of <15 years which were covered by vaccines.Immunization barrier had been formed firmly to interrupt the transmission of wild poliovirus and vaccine-derived poliovirus.

Objective Using data of health information system (HIS) of medical institutions to study the incidence and hospitalization of herpes zoster in three districts of Beijing. Methods According to the different level of economic development and geographical features in Beijing, 3 districts of Xicheng, Changping and Miyun were chosen and all 110 medical institutions of the first level and above in the 3 districts are included in the survey. All the outpatient and inpatient herpes zoster cases in 2015 were retrospectively reviewed by HIS system. After distinguishing the reduplicated cases, Using the first outpatient case as a molecule and the resident population as denominator to estimate the annual incidence rate, as well as the annual hospitalization rate was estimated based on primary diagnostic hospitalized cases as molecule and the resident population as denominator. Results A total of 32 313 primary visit outpatient cases were investigated, of which 18 360 cases (56.8%) were women and 20 923 cases (64.8%) were ≥50 years old. The overall estimated incidence of the 3 districts was 8.8‰with an increase trends with age and reached to the highest in ≥80 years old (30.5/1 000). The incidence of Xicheng, Changping and Miyun districts are respectively 16.2‰, 4.0‰ and 5.7‰. A total of 701 primary visit inpatient cases were identified, of which 366 cases (52.2%) were women and 651 cases (92.9%) were ≥50 years old. The estimated annual hospitalization rate was 19.4/100 000, with the primary and secondary diagnostic hospitalization rate are respectively 5.9/100 000 (212 cases) and 13.5/100 000 (489 cases). The disease types of secondary diagnostic inpatient herpes zoster cases were as follows: cardiovascular disease (19.0%, 93 cases), stroke (14.5%, 71 cases), pneumonia/chronic obstructive pulmonary disease (14.1%, 69 cases), tumor (12.5%, 61 cases) and diabetes (5.7%, 28 cases). Conclusion Most of the herpes zoster cases in Beijing are over 50 years old, and the incidence of female is slightly higher than male. This disease should become a public health issue of great concern.

Objective:To analyze the changing trend of polio vaccine immunization effectiveness and vaccine titer in Beijing in 2012, 2014, 2016 and 2018 before and after the adjustment of polio vaccine immunization program strategy.Methods:According to the convenient sampling method,the vaccination clinics of Chaoyang and Yanqing Districts in 2012, Fengtai and Daxing Districts in 2014, Tongzhou and Pinggu Districts in 2016, Dongcheng and Shunyi Districts in 2018 were selected as monitoring points. A total of 292 children were selected 4-8 weeks after the completion of 3 doses polio vaccine basic immunization which were 3 doses of trivalent oral poliovirus vaccine（tOPV）schedule before the strategy adjustment in 2012-2014 and 1 dose of inactivated poliovirus vaccine (IPV) following 2 doses of bivalent oral poliovirus vaccine (bOPV) sequential schedule after the adjustment in 2016-2018. About 1.0 ml blood samples were collected to detect type Ⅰ and Ⅲ neutralizing poliovirus antibody. A total of 9 oral poliovirus vaccines (8 vaccines in 2012) were selected from different sources of vaccine storage every year to test the vaccine titer using random number method .Results:The [ M（ P25， P75）] age of 292 children was 5 (5, 6) months, and the ratio of male to female was 1.04 (149/143). In 2012, 2014, 2016 and 2018, 66,72,68 and 86 children were investigated respectively. After basic immunization, antibody positive rates for type Ⅰ and Ⅲ poliovirus were 100%, except 98.61% (71) for type Ⅰ poliovirus in 2014. The neutralizing antibody titer of type Ⅰ and Ⅲ poliovirus was higher in 2016 and 2018 than that in 2012 and 2014 ( P<0.001). The average titer of tOPV were (6.05±0.15) and (6.16±0.12) lgCCID 50 per dose in 2012 and 2014. The average titer of bOPV were (6.88±0.21) and (6.26±0.14) lgCCID 50 per 100 μl in 2016 and 2018 ( P<0.001). Conclusion:Before and after the adjustment of polio vaccine immunization strategy in Beijing, the basic immunization success rate of the IPV-bOPV sequential immunization schedule was good as well as full tOPV schedule. The level of polio antibody produced by the IPV-bOPV sequential immunization schedule was higher. After adjustment, bOPV titer in 2016 was significantly higher than those before adjustment, while bOPV titer decreased significantly in 2018.

Objective:To analyze the etiological features and clinical characteristics of herpes zoster cases under 20 years old in Beijing City from 2017 to 2021.Methods:Herpes zoster cases were collected from a surveillance system in Beijing City from December 2017 to April 2021. The cases included individuals under 20 years old from seven sentinel hospitals located in two districts (Miyun District and Changping District). The basic information, the rash date of rash onset and the location and number of lesions were investigated at the first visit to the hospital, and the lesion swab samples were collected for laboratory testing. A telephone follow-up was conducted 21 days after the onset of the rash to investigate the degree of pain, duration of the rash and duration of pain. The individuals who still experienced neuralgia were further investigated for their pain condition at 90 days after the onset of the rash, to discover cases with postherpetic neuralgia. DNA was extracted from the rash fluid, and the ORF62 gene region was amplified and sequenced to obtain the viral sequence. The wild-type strain or chickenpox vaccine strain was identified by using sequence alignment, and the clinical characteristics of cases with different varicella vaccinations were compared.Results:A total of 78 herpes zoster cases under 20 years old were investigated during 2017-2021 in Beijing City, and 61 cases completed the follow-up survey. The age range of 61 cases was 1.83 to 20.54 years with a median age of 17.50 years. There were 36 males (59.02%) and 25 females (40.98%). Among them, there were 29 cases with the chickenpox vaccine immunization history (18 cases with one dose, 5 cases with two doses and 6 cases with unknown doses), 13 cases with no vaccination history and 19 cases with unknown vaccination history. Among the 78 cases, the herpetic fluid samples of 64 cases were positive for VZV, including 62 cases identified as wild-type strains and two cases as vaccine strains. The two vaccine strain cases were both 2-year-old girls who had received one dose of varicella vaccine and developed herpes zoster 3 months and 13 months after vaccination. Among the 29 cases with chickenpox vaccine immunization history, the majority had 10 to 49 lesions, accounting for 58.62% (17 cases). The trunk was the most common site of lesions, accounting for 44.83% (13 cases). About 51.72% (15 cases) reported "no or mild" pain intensity. The median ( Q1, Q3) scores for the worst pain, duration of pain and the time to crusting of lesions in the herpes zoster cases were 3 (1.5, 5) points, 10 (1.5, 12.5) days and 10 (6.5, 13) days, respectively. There was no statistically significant difference in the constituent ratio of the location of lesions, number of lesions and pain degree among the cases with vaccination history, without vaccination history and with unknown vaccination history ( P>0.05). There was also no statistically significant difference in the distribution of pain score, duration of lesions and duration of pain across the three groups ( P>0.05). Conclusion:Wild strains are the predominant pathogens in herpes zoster cases under 20 years old in Beijing City during 2017-2021. The varicella vaccination has no significant impact on the clinical manifestations of herpes zoster cases.

Objective To analyze the polio immunity level of persistent population in Beijing , 2012.Methods A total of 1 676 subjects residing more than 6 months in Beijing were selected by stratified random cluster sampling design in 2012.Demographic characteristics , history of oral poliovirus vaccine ( OPV) immunization were investigated by questionnaire.All 5 ml blood sample were collected for testing of polio neutralizing antibody using the method of microcell neutralization.The positive rate and the geometric mean titer ( GMT ) of polio neutralizing antibody type Ⅰ,Ⅱ and Ⅲ were analyzed in different groups.Results The positive rate of type Ⅰ,Ⅱ and Ⅲ were 98.2%( 1 645/1 676 ) , 98.1%( 1 644/1 676),97.6%(1 635/1 676);The GMT were 1∶130.2,1∶113.4 and 1∶79.7.Three types of positive rates in<15 years group(99.7%(664/666),99.8%(665/666),99.5%(663/666)) were higher than those of≥15 years group (97.1%(981/1 010),96.9%(979/1 010),96.2%(972/1 010)),the differences were significant(all the values of P<0.01); The GMT in<15 years group(1∶325.9,1∶250.5,1∶190.7)were higher than that of ≥15 years group (1∶71.1,1∶67.2,1∶44.8),the difference was significant (all the values of P<0.01).The positive rate(99.0%-100%) and GMT(1∶128.8-1∶300.7) in vaccination information confirmed population were higher.The highest positive rate (all were 100%) and GMT(1∶409.7-1∶636.7) were observed in children who vaccinated three times.Conclusion The polio antibody of healthy population was at a high level in Beijing in 2012; Especially the age groups of <15 years which were covered by vaccines.Immunization barrier had been formed firmly to interrupt the transmission of wild poliovirus and vaccine-derived poliovirus.