1.Seroprevalence and influencing factors of low-level neutralizing antibodies against SARS-CoV-2 in community residents
Shiying YUAN ; Jingyi ZHANG ; Huanyu WU ; Weibing WANG ; Genming ZHAO ; Xiao YU ; Xiaoying MA ; Min CHEN ; Xiaodong SUN ; Zhuoying HUANG ; Zhonghui MA ; Yaxu ZHENG ; Jian CHEN
Shanghai Journal of Preventive Medicine 2025;37(5):403-409
ObjectiveTo understand the seropositivity of neutralizing antibodies (NAb) and low-level NAb against SARS-CoV-2 infection in the community residents, and to explore the impact of COVID-19 vaccination and SARS-CoV-2 infection on the levels of NAb in human serum. MethodsOn the ground of surveillance cohort for acute infectious diseases in community populations in Shanghai, a proportional stratified sampling method was used to enroll the subjects at a 20% proportion for each age group (0‒14, 15‒24, 25‒59, and ≥60 years old). Blood samples collection and serum SARS-CoV-2 NAb concentration testing were conducted from March to April 2023. Low-level NAb were defined as below the 25th percentile of NAb. ResultsA total of 2 230 participants were included, the positive rate of NAb was 97.58%, and the proportion of low-level NAb was 25.02% (558/2 230). Multivariate logistic regression analysis indicated that age, infection history and vaccination status were correlated with low-level NAb (all P<0.05). Individuals aged 60 years and above had the highest risk of low-level NAb. There was a statistically significant interaction between booster vaccination and one single infection (aOR=0.38, 95%CI: 0.19‒0.77). Compared to individuals without vaccination, among individuals infected with SARS-CoV-2 once, both primary immunization (aOR=0.23, 95%CI: 0.16‒0.35) and booster immunization (aOR=0.12, 95%CI: 0.08‒0.17) significantly reduced the risk of low-level NAb; among individuals without infections, only booster immunization (aOR=0.28, 95%CI: 0.14‒0.52) showed a negative correlation with the risk of low-level NAb. ConclusionsThe population aged 60 and above had the highest risk of low-level NAb. Regardless of infection history, a booster immunization could reduce the risk of low-level NAb. It is recommended that eligible individuals , especially the elderly, should get vaccinated in a timely manner to exert the protective role of NAb.
2.Efficacy evaluation of extending or switching to tenofovir amibufenamide in patients with chronic hepatitis B: a phase Ⅲ randomized controlled study
Zhihong LIU ; Qinglong JIN ; Yuexin ZHANG ; Guozhong GONG ; Guicheng WU ; Lvfeng YAO ; Xiaofeng WEN ; Zhiliang GAO ; Yan HUANG ; Daokun YANG ; Enqiang CHEN ; Qing MAO ; Shide LIN ; Jia SHANG ; Huanyu GONG ; Lihua ZHONG ; Huafa YIN ; Fengmei WANG ; Peng HU ; Xiaoqing ZHANG ; Qunjie GAO ; Chaonan JIN ; Chuan LI ; Junqi NIU ; Jinlin HOU
Chinese Journal of Hepatology 2024;32(10):883-892
Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the efficacy of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects who were previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extended or switched TMF treatment for 48 weeks. Efficacy was evaluated based on virological, serological, biological parameters, and fibrosis staging. Statistical analysis was performed using the McNemar test, t-test, or Log-Rank test according to the data. Results:593 subjects from the initial TMF group and 287 subjects from the TDF group were included at week 144, with the proportions of HBV DNA<20 IU/ml at week 144 being 86.2% and 83.3%, respectively, and 78.1% and 73.8% in patients with baseline HBV DNA levels ≥8 log10 IU/ml. Resistance to tenofovir was not detected in both groups. For HBeAg loss and seroconversion rates, both groups showed a further increase from week 96 to 144 and the 3-year cumulative rates of HBeAg loss were about 35% in each group. However, HBsAg levels were less affected during 96 to 144 weeks. For patients switched from TDF to TMF, a substantial further increase in the alanine aminotransferase (ALT) normalization rate was observed (11.4%), along with improved FIB-4 scores.Conclusion:After 144 weeks of TMF treatment, CHB patients achieved high rates of virological, serological, and biochemical responses, as well as improved liver fibrosis outcomes. Also, switching to TMF resulted in significant benefits in ALT normalization rates (NCT03903796).
3.Safety profile of tenofovir amibufenamide therapy extension or switching in patients with chronic hepatitis B: a phase Ⅲ multicenter, randomized controlled trial
Zhihong LIU ; Qinglong JIN ; Yuexin ZHANG ; Guozhong GONG ; Guicheng WU ; Lvfeng YAO ; Xiaofeng WEN ; Zhiliang GAO ; Yan HUANG ; Daokun YANG ; Enqiang CHEN ; Qing MAO ; Shide LIN ; Jia SHANG ; Huanyu GONG ; Lihua ZHONG ; Huafa YIN ; Fengmei WANG ; Peng HU ; Xiaoqing ZHANG ; Qunjie GAO ; Peng XIA ; Chuan LI ; Junqi NIU ; Jinlin HOU
Chinese Journal of Hepatology 2024;32(10):893-903
Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the safety profile of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects that previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extending or switching TMF treatment for 48 weeks. Safety profiles of kidney, bone, metabolism, body weight, and others were evaluated.Results:666 subjects from the initial TMF group and 336 subjects from TDF group with at least one dose of assigned treatment were included at week 144. The overall safety profile was favorable in each group and generally similar between extended or switched TMF treatments from week 96 to 144. In subjects switching from TDF to TMF, the non-indexed estimated glomerular filtration rate (by non-indexed CKD-EPI formula) and creatinine clearance (by Cockcroft-Gault formula) were both increased, which were (2.31±8.33) ml/min and (4.24±13.94) ml/min, respectively. These changes were also higher than those in subjects with extending TMF treatment [(0.91±8.06) ml/min and (1.30±13.94) ml/min]. Meanwhile, switching to TMF also led to an increase of the bone mineral density (BMD) by 0.75% in hip and 1.41% in spine. On the other side, a slight change in TC/HDL ratio by 0.16 (IQR: 0.00, 0.43) and an increase in body mass index (BMI) by (0.54±0.98) kg/m 2 were oberved with patients switched to TMF, which were significantly higher than that in TMF group. Conclusion:CHB patients receiving 144 weeks of TMF treatment showed favorable safety profile. After switching to TMF, the bone and renal safety was significantly improved in TDF group, though experienceing change in metabolic parameters and weight gain (NCT03903796).
4.Establishment and application of a prospective follow-up research method for acute infectious diseases in Shanghai community residents
Yaxu ZHENG ; Xiao YU ; Huanyu WU ; Liming WU ; Jian CHEN ; Wenjia XIAO ; Zhuoying HUANG ; Sheng LIN ; Qiwen FANG ; Rui LIU ; Hao ZHANG ; Xin CHEN
Shanghai Journal of Preventive Medicine 2024;36(1):5-10
ObjectiveTo present the exploration and application of a prospective follow-up research method for acute infectious disease surveillance based on natural community populations, using COVID-19 infection as an example, and to provide a reference for improving the infectious disease surveillance and early warning system. MethodsA multi-stage probability proportional sampling method was employed to sample residents from all communities of 16 administrative districts in Shanghai, with households as the units. A cohort for acute infectious diseases based on natural community populations was established. The baseline survey was conducted for all cohort subjects, and COVID-19 antigen test kits were distributed. From December 21, 2022 to September 30, 2023, prospective follow-up monitoring of COVID-19 antigen and nucleic acid was carried out on the study subjects on a weekly basis. The baseline characteristics and follow-up information of the cohort subjects were described. ResultsThe cohort for acute infectious diseases included a total of 12 881 subjects, comprising 6 098 males (47.3%) and 6 783 females (52.7%). The baseline survey revealed that 35.2% (4 540/12 881) of the subjects had a history of COVID-19 infection. During the follow-up period from December 21, 2022 to September 30, 2023, the average incidence density in the cohort was 0.61/person-year, with a higher incidence density in females (0.63/person-year) compared to males (0.59/person-year). Individuals aged 60 and above (0.64/person-year) and those with underlying health conditions (0.67/person-year) had a higher incidence density. Healthcare workers showed a notably higher incidence density (0.84/person-year) than that in other occupational groups. As of September 30, 2023, a total of 340 subjects in the cohort experienced secondary infections, with a median interval of 170 days between the first and second infections. ConclusionThis study applies cohort study method to acute infectious disease surveillance, providing crucial data support for estimating infection rates and forecasting alerts for acute infectious diseases in the community. This method can be promoted and applied as a new approach for acute infectious disease surveillance.
5.A Potential Novel Targeted Drug for the Treatment of Pulmonary Arterial Hypertension:Imatinib
Shanshan XIE ; Ye LI ; Lingling YU ; Jinjin WAN ; Zhiying HUANG ; Huanyu LIN ; Weifang ZHANG
Herald of Medicine 2024;43(2):262-266
Pulmonary hypertension has a high mortality rate,and although targeted therapy is available,it is still incurable,and the long-term prognosis for patients is poor.As a tyrosine kinase inhibitor,imatinib was approved for marketing in China in 2002 for the treatment of chronic myelogenous leukemia and other tumor diseases.In addition to the antitumor effects,imatinib was found to improve hemodynamics and exercise tolerance in patients with severe pulmonary arterial hypertension,but the safety was suboptimal.With the emergence of new formulations of imatinib targeted at the lungs,it is expected to become a new targeted drug for pulmonary arterial hypertension.
6.Analysis on the surveillance of infectious disease related public health bud-events in Shanghai from 2017 to 2020
Yinhao LU ; Yongchao HE ; Yi HE ; Huanyu WU ; Chunyan LUO ; Xiaoyan HUANG
Shanghai Journal of Preventive Medicine 2022;34(1):17-21
Objective To determine the epidemiological characteristics of infectious disease related public health bud-events in Shanghai and assess the effects of bud-event surveillance, so as to provide scientific evidence for improving the surveillance system. Methods Surveillance data of infectious disease related public health bud-events were collected from 16 districts of Shanghai from 2017 through 2020. Then the data were analyzed and compared with infectious disease related public health emergencies during the same period. Results A total of 6 376 infectious disease related public health bud-events were documented in Shanghai in 2017‒2020, which involved 29 792 cases. There were two seasonal peaks, April through June and November through December. Clustered events accounted for 38.85%, mainly caused by chickenpox (14.10%), hand,foot and mouth disease (11.17%) and norovirus-associated infectious diarrhea (6.54%). The 36.73% of the bud-events occurred in school settings, which involved 24 718 cases (accounting for 83.00% of all cases). Median time duration between onset date of the first cases and report date of the events was 4 days, and median duration of the events was 14 days, demonstrating positive correlation. In addition, all the infectious disease related public health emergencies(
7.Epidemiological analysis on bud-events of Norovirus-associated infectious diarrhea in Shanghai, 2018
Yi HE ; Yinhao LU ; Xiaoyan HUANG ; Wenjia XIAO ; Fangfang TAO ; Huanyu WU ; Chunyan LUO ; Zhengan YUAN
Chinese Journal of Epidemiology 2020;41(4):547-551
Objective:To analyze the epidemiological characteristics related to Norovirus-associated infectious diarrhea bud events in Shanghai, and to discuss the value of bud events surveillance, so as to help Norovirus-associated infectious diarrhea control, prevention and to improve the surveillance system on bud events.Methods:Data related to 142 Norovirus-associated infectious diarrhea bud events were gathered from 16 districts of Shanghai areas in 2018 and were analyzed.Results:There were 2 peaks, April and November for 142 Norovirus-associated infectious diarrhea bud events reported in 2018. 98.59 % (140/142) of the bud events occurred in schools and kindergartens. 80.28 % (114/142) of the bud events would involve 6-19 cases per each event. The median time duration between the onset date of the first case and the reporting date of the event was 2 days and the median event duration was 7 days. The bud event scale and regional incidence of bud events as well as the reporting timelines were influential factors on the duration of the bud events. Conclusions:Two peaks, spring and winter bud events of the Norovirus-associated infectious diarrhea were seen in Shanghai in 2018. Schools and kindergartens were to be prioritized locations for control and prevention of Norovirus-associated infectious diarrhea bud events. Surveillance system was proved to have contributed to the early detection, reporting and control of bud events.
8.Effects of nutrition status on activities of daily living among nursing home residents: the mediating role of physical function
Liqun HUANG ; Jie GAO ; Huanyu MOU ; Dongjuan XU ; Kefang WANG
Chinese Journal of Practical Nursing 2019;35(2):132-136
Objective To explore the relationship between nutrition status and activity of daily livingof elders in nursing homes and the mediating effect of physical activity. Methods From Apr to Sep in 2016,320 elders in nursing homes were selected and were surveyed using the standardized tools. The mediating effects were analyzed with PROCESS. Results The scores of elders′ nutrition status, physical function and activities of daily living were (11.88±2.27), (3.61±3.51), (79.13±26.00) points, respectively. And there were 66.9% elders suffering from activities of living life impaired. The nutrition status were significantly positive correlated with physical function and activities of daily living of elders, and the physical function were significantly positive correlated with activities of daily living of elders. The physical function partly mediated the association between nutrition status and activities of daily living, and the effect was reached to 39.1%. Conclusions The elders′activities of daily life was poor in nursing home in China. The physical function partly mediated the association between nutrition status and activities of daily living. The related departments could combine the long time and short time plans targeting at improving of nutrition status and physical function respectively, to enhance the outcomes of elders in nursing homes.
9.Study on the influence of frailty on quality of life among nursing homes elders
Meng ZHAO ; Liqun HUANG ; Shanshan ZHU ; Huanyu MOU ; Kefang WANG
Chinese Journal of Practical Nursing 2018;34(12):891-894
Objective To study the influence of frailty on quality of life among nursing homes elders,to improve the elders′quality of life and provide references for health ageing. Methods Totally 369 nursing homes elders in Jinan were investigated by using the general information and health status questionnaires, Mini-mental State Examination (MMSE), FRAIL scale, European Quality of Life 5-Dimensions(EQ-5D). Results Of the samples,52.8%(195/369)were pre-frail and 23.0%(85/369)were frail.After controlling the confounding factors,pre-frail and frail elders had lower quality of life than the other elders(OR=0.097,0.016,P<0.01).Resistance and ambulationclosely associated with quality of life in FRAIL scale(OR=0.030,0.364,P<0.05). Conclusion Measures for improving the quality of life and physical and mental well-being of nursing homes elders can be designed based on frailty.
10.The safety and efficacy of raltitrexed combined with oxaliplatin in TACE treatment for BCLC B/C hepatocellular carcinomas
Fang HUANG ; Huanyu GONG ; Zhengping XIONG
Journal of Interventional Radiology 2018;27(1):76-79
Objective To evaluate the efficacy and safety of trascatheter arterial chemoembolization (TACE) with raltitrexed and oxaliplatin (RO) regimen as well as lipiodol emulsion in treating BCLC B/C hepatocellular carcinomas.Methods A total of 183 patients with BCLC B/C hepatocellular carcinoma were treated with TACE by using RO regimen and lipiodol emulsion.The therapeutic regimen included raltitrexed 3 mg/m2 for hepatic artery perfusion,oxaliplatin 130 mg/m2 mixed with lipiodol 5-30 ml emulsion for embolization.The toxicities were assessed according to WHO anti-cancer drug toxicity grading standards.Liver damage was determined by Child-Pugh classification.All the patients were followed up and the survival time was calculated.Results In 183 patients,the hematologic toxicity was characterized by bone marrow suppression.The incidences of neutropenia,anemia and thrombocytopenia were 21.9%,8.3% and 2.7%,respectively.The degree Ⅰ,Ⅱ,Ⅲ and Ⅳ of neutrophil count decrease were seen in 15.85%,5.46%,0.55% and 0% of patients,respectively.Nausea and vomiting of degree Ⅰ-Ⅱ was observed in 71.58% of patients.Liver function damage was presented as elevated transaminase and elevated bilirubin level.Preoperative Child-Pugh grade A was seen in 96 patients and grade B in 87 patients.Child-Pugh grade was elevated from preoperative grade A to postoperative grade B in 48 patients,from preoperative grade A to postoperative grade C in 6 patients,and from preoperative grade B to postoperative grade C in 12 patients.In this series,no symptoms or signs of cardiac,urinary or nervous system toxicity were observed.The survival time of 183 patients was 5-35 months,with the median survival time being 20 months.Conclusion For the treatment of BCLC B/C hepatocellular carcinomas,TACE using RO regimen and lipiodol emulsion is safe and effective,and it can reliably improve the quality of life of patients.

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