tbuckley/cabot-search huggingface dataset:
The increasing incidence of colorectal cancer in younger patients in the United States: Who, what, when, and where?
Authors: Mary Kathryn Abel, Cheng-I Liao, Katherine Van Loon, Chunqiao Tian, Kathleen M. Darcy, Amandeep Kaur Mann, Daniel Stuart Kapp, John K. Chan
Journal: Journal of Clinical Oncology (2020)

1573 Background: Prior studies have shown an increase in the rate of colorectal cancer (CRC) in young individuals in the United States. However, few studies have evaluated the health disparities that exist in this population, particularly using large, national cohorts. We examined differences in age, race, stage, region, and tumor location in younger and older patients with CRC. Methods: Data were extracted from the United States Cancer Statistics (USCS) for individuals diagnosed between 2001 and 2014. CRC incidence data among individuals &lt; 50 years old were compared to those &gt; 50 years old. Age-specific and age-adjusted incidences and trend analyses reported as annual percent change (APC) were performed using SEER*Stat and Joinpoint regression. Results: Of 1,886,441 individuals, the overall age-adjusted incidence of CRC decreased from 52.59 (per 100,000) in 2001 to 35.22 in 2014, with an APC of -3.24. Although over 35% cases were diagnosed in the Southern United States, the Northeast had the highest age-adjusted incidence at 45.26 per 100,000 patients. Younger patients were diagnosed with distant disease at 25.8% compared to only 18.4% in older patients. Younger patients were also more likely to have sigmoid or rectal cancers compared to older patients (64.3% vs. 45.7%). Of the 170,244 individuals &lt; 50 years, 90,855 (53.4%) were men and 79,389 (46.6%) were women. The age-specific incidence in this younger cohort increased from 5.63 to 6.48 between 2001-2014, with an APC of +1.24 in 2001-2008 compared to +2.55 in 2012-2014. The incidence of CRC in patients aged 0-29, 30-39, and 40-49 years was 0.41 (per 100,000), 6.08, and 21.09, respectively. Black individuals &lt; 50 years had the highest age-specific incidence of CRC (7.16 per 100,000) compared to Asian (6.43), White (6.07), or Hispanic (4.76) individuals. Conclusions: Our data suggests that CRC is increasing in young patients, particularly for those between 40-49 years and Black individuals. In our younger cohort, CRC was more commonly found in the sigmoid colon and rectum compared to older patients. Further research is warranted to direct resources towards improved colonoscopy or sigmoidoscopy screening for younger patients at risk.
FDG PET/CT in a Patient With Mantle Cell Lymphoma and COVID-19
Authors: Margot Playe, Justine Siavellis, Thorsten Braun, Michaël Soussan
Journal: Clinical Nuclear Medicine (2020)

A 52-year-old woman with no medical history was admitted on March 18, 2020, presenting since 3 days asthenia, abdominal pain, and dry cough but no fever. Adenomegalies, splenomegaly, leukocytosis, and elevated LDH suggested mature lymphoproliferation. Considering the current health context, an RT-PCR testing for COVID-19 (coronavirus disease 2019) was performed and found to be positive. Early chest CT showed no sign of pulmonary infection but multiple adenomegalies. An 18F-FDG PET/CT performed 5 days later to assess the extent of the hemopathy revealed the apparition of FDG-avid bilateral ground glass and subpleural curvilinear opacities suggesting COVID-19–associated pneumopathy.
Application of glucose-6-phosphate isomerase and auto-antibodies in diagnosis of rheumatoid arthritis
Authors: Yan-yan Sun, Liang Zhang, Xue-mei Wu, Ying-jiu Zhang, Ye Li, Yan He
Journal: BMJ (2011)

Blood samples were collected from 90 patients with confirmed rheumatoid arthritis (RA), 73 patients with other rheumatic diseases and 50 normal controls. Serum glucose-6-phosphate isomerase (GPI) and anti-cyclic citrullinated peptide (CCP) were detected with ELISA method, rheumatoid factor IgM( RF IgM)was measured with turbidimetric immunoassay and antikeratin antibody (AKA) was determined with indirect immunofluorescence assay. The serum GPI levels of RA group[1.73 (0. 43 -4. 40)mg/L]were significantly higher than those of rheumatic disease[0. 14 (0. 10 -0. 18 )mg/L]and normal controls[0. 12 (0. 09 - 0. 15 ) mg/L], ( H = 18. 13, P ＜ 0. 01 ). The sensitivities of GPI, anti-CCP,RF-IgM, AKA, GPI + CCP, GPI + RF-IgM were 80% (72/90), 57% (51/90), 68% (61/90), 29% (26/90) ,92% (83/90) and 96% (86/90), respectively; the specificities were 97% (119/123) ,95% ( 117/123 ) ,77% (95/123) ,95% ( 117/123 ), 93% ( 115/123 ) and 76% ( 93/123 ), respectively. GP1 level was significantly correlated with CCP and RF-IgM ( r = 0. 674 and 0. 533, P ＜ 0. 01 ), but not correlated with AKA ( r = 0. 12, P ＞ 0. 05 ). The results suggest that serum glucose-6-phosphate isomerase level is a valuable indicator for early diagnosis of rheumatoid arthritis.

Key words: 
Arthritis, Rheumatoid;  Enzymes;  Diagnosis
Th9 and Th17 cells: the controversial twins in cancer immunity
Authors: Chi Yan, Ann Richmond
Journal: Journal of Clinical Investigation (2020)

Th17 cells (producing IL-17) and Th9 cells (producing IL-9) exhibit functional plasticity, and their role in tumorigenicity is controversial. Th17/IL-17 and Th9/IL-9 exhibit critical, but often opposing, roles in tumor progression. In this issue of the JCI, Salazar et al. show that while IL-17 and IL-9 induced distinct but complementary molecular pathways, both cytokines also induced epithelial-mesenchymal transition (EMT) in lung cancer cells and promoted metastatic spreading. A key question before us now is whether IL-9 and IL-17 contribute to tumor progression in a sequential and stage-specific manner within the tumor microenvironment.
Error-free, automated data integration of exosome cargo protein data with extensive clinical data in an ongoing, multi-omic translational research study.
Authors: Ana Oromendia, Dorina Ismailgeci, Michele Ciofii, Taylor Donnelly, Linda Bojmar, John Jyazbek, Arnaub Chatterjee, David Lyden, Kenneth H. Yu, David Paul Kelsen
Journal: Journal of Clinical Oncology (2020)

e16743 Background: Major advances in understanding the biology of cancer have come from genomic analysis of tumor and normal tissue. Integrating extensive patient-related data with deep analysis of omic data is crucial to informing omic data interpretation. Currently, such integrations are a highly manual, asynchronous, and costly process as well as error-prone and time-consuming. To develop new blood assays that may detect very early stage PDAC, a multi-omic investigation with deep clinical annotation is needed. Using pilot data from an on-going study, we test a new platform allowing automated error-free integration of an extensive clinical database with extensive omic data. Methods: Demographic, clinical, family pedigree and pathology data were collected on the Rave EDC platform. Exosomes were purified from 46 plasma samples from 14 controls and 24 PDAC patients and cargo proteins were quantified via SILAC. The Rave Omics platform was used to ingest and integrate clinical and omic data, run quality checks and generate integrated clinical-omic datasets. Data fidelity was validated by systematically computing differences between corresponding values in the source flies with those present in the extracted data object (integrated data). The root mean squared error (RMSE) was calculated for numeric values in each sample. Additional validation was conducted by manual inspection to ascertain data integrity. Results: We demonstrated automatic integration, without human intervention, of a subset of the clinical data and all available SILAC data into an analysis-ready data object. Data transfer was completely faithful, with 100% concordance between the source and the integrated data without loss of features. All proteins (n = 1515) and clinical variables (n = 64) were imported. Their nomenclature and corresponding sample values (n = 69690) and clinical values (n = 2432) matched exactly between datasets. In all samples, the RMSE was exactly zero, indicating no deviation between data sources. Conclusions: We demonstrated that automatic, efficient, and reliable integration of clinical-omic data is achievable during an in-flight PDAC trial. Automatic exploratory analytics supporting biomarker discovery are currently being used to uncover associations between omic and clinical features. The Rave Omics platform is disease-agnostic and we plan to expand to trials of varying size, indication, and completion status where systematic, automated integration of clinical and (multi)omic data is needed.
以全身皮肤结节为首发症状的非霍奇金淋巴瘤一例
Authors: 孙厚斌, 熊艳, 宋军霞
Journal: BMJ (2004)

患者女,36岁,因全身皮肤结节就诊,诉2个月前在前胸及后背出现直径1～2 cm的皮肤结节,伴压痛及瘙痒,有恶心、乏力,无明显发热,盗汗及体重下降.入院查体:生命体征正常,全身可见散在大小不等的皮肤结节,高低不平,质韧,有压痛、破溃及结痂,浅表淋巴结无肿大,咽部无异常.胸部CT示前中纵隔内偏右方气管前缘见9 cm×7 cm大小块状影,边缘光整,其内不规整低密度块.骨髓涂片无异常.皮肤结节活检示皮肤非霍奇金淋巴瘤(B细胞型),后经湖北省肿瘤医院及同济医院确诊.免疫组化显示LCA(+)、CD20(+)、CD3(-)。
危重症患者的应激性高血糖
Authors: 何新华, 李春盛
Journal: BMJ (2009)

危重症患者常伴有应激性高血糖,这种急性一过性的高血糖可产生有害的病理生理反应.胰岛素反向调节激素的分泌增加、细胞因子大量释放和胰岛素抵抗等是产生应激性高血糖的主要原因.正确对待危重症高血糖具有非常重要的意义.近年来研究显示[1],胰岛素强化治疗把血糖控制在4.0～6.1mmol/L范围内能有效地减少高血糖所致的并发症,促进疾病的恢复,改善疾病的预后。
Immune profiling and clinical outcomes in patients treated with ramucirumab and pembrolizumab in phase I study JVDF.
Authors: Roy S. Herbst, Hendrik-Tobias Arkenau, Emiliano Calvo, Johanna C. Bendell, Nicolas Penel, Charles S. Fuchs, Samuel McNeely, Erik R Rasmussen, Hong Wang, Joana M Oliveira, David Raymond Ferry, Ian Chau
Journal: Journal of Clinical Oncology (2020)

3089 Background: In Study JVDF (NCT02443324), we combined ramucirumab (VEGFR2 antagonist) and pembrolizumab (PD-1 antagonist) to simultaneously target the tumor microenvironment and immune checkpoints in patients with advanced non-small cell lung cancer (NSCLC), gastric or gastroesophageal junction adenocarcinoma (G/GEJ), urothelial carcinoma (UC) or biliary tract cancer (BTC). We reported that this combination was associated with increased antitumor activity in patients with PD-L1 positive tumors by immunohistochemistry (IHC) compared with PD-L1 negative tumors.1) Here we explore the association between baseline gene expression profiles and clinical outcomes. Methods: JVDF was a nonrandomized phase 1a/b trial that treated patients with intravenous ramucirumab at 8 mg/kg on days 1 and 8 (G/GEJ, BTC) or 10 mg/kg on day 1 (G/GEJ, NSCLC, UC) plus pembrolizumab (200 mg day 1) every 3 weeks. 1 Baseline tumor samples from 53 patients across 7 study cohorts were analyzed with the NanoString PanCancer Immune Profiling Panel for RNA expression and the DAKO PD-L1 IHC 22C3 pharmDx assay for PD-L1 protein expression. Clinical outcomes included progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). Results: Across cohorts, PD-L1 gene expression was correlated with increased IFNγ gene expression and immune-related gene signatures (T effector, T cell-inflamed (TIS)), and trended with PD-L1 protein expression. Expression of immune checkpoint-related genes and myeloid-derived suppressor cell /regulatory T cell markers was increased in the NSCLC TPS≥50% PD-L1 IHC subgroup (N=8), while no clear pattern of expression was observed in other cohorts. Higher T effector and TIS scores appeared associated with better survival and response in NSCLC cohorts (mean TIS: 1.21±0.80 in responders (N=7) vs -0.13±0.57 in non-responders (N=7); p=0.004), and a trend was observed in G/GEJ cohorts (mean TIS: -0.18±0.30 (N=5) vs -0.39±0.21 (N=13); p=0.207). Of note, partial responses and stable disease were also observed in NSCLC and G/GEJ patients with a low baseline inflammatory signature score. Additional analyses are ongoing and will be presented. Conclusions: Baseline PD-L1 gene and protein expression tends to correlate with immune-related gene expression, and an inflamed tumor microenvironment may be associated with better clinical outcomes with ramucirumab and pembrolizumab. However, interpretation is limited by lack of control arm and sample size.1) Herbst et al. Lancet Oncol. 2019 Aug; 20 (8):1109-1123. Clinical trial information: NCT02443324 .
Abstract 11013: Differences in Primary Prevention Recommendations for Statin Therapy Based on National Guidelines Using the Pooled Cohort Equation Risk versus the Coronary Artery Calcium Score: Preliminary Findings From the Vanguard Study for the CorCal Randomized Clinical Outcomes Trial
Authors: Joseph B Muhlestein, Kirk U Knowlton, Viet T Le, Donald L Lappe, Heidi T May, David B Min, Kevin Johnson, Shanelle Cripps, Lesley Schwab, Shelbi Braun, Tami L Bair, Jeffrey L Anderson
Journal: Circulation (2019)

Background: Primary prevention therapy (PPT) is the best way to treat atherosclerotic cardiovascular disease (ASCVD), and statins are the standard for PPT. However, determining which patients will ...
澳大利亚的农村医疗机构网络
Authors: 姚建红
Journal: BMJ (2006)

澳大利亚的农村医疗机构网络是实现国家初级卫生保健战略的重要载体.基于澳大利亚地广人稀、农村人口相对较少且分布较为分散的状况,澳大利亚政府在考虑人口分布、交通条件、服务半径、农民需求、经济状况等因素的基础上,逐步形成和发展了农村医疗机构网络体系。
Phase Ib/IIa study of GC1118 in combination with irinotecan or FOLFIRI in patients with metastatic solid tumors.
Authors: Keun Wook Lee, Sae-Won Han, Ji-Won Kim, Dae-Won Lee, Yong Sang Hong, Joong Bae Ahn, Yung-Jue Bang
Journal: Journal of Clinical Oncology (2020)

3592 Background: GC1118 is a novel anti-EGFR monoclonal antibody which has a unique binding epitope and superior ligand inhibition potential. It showed promising antitumor activity as a single agent in the phase I study. This study aimed to determine the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D) of GC1118 in combination with irinotecan or FOLFIRI in metastatic solid tumors and evaluate the efficacy of GC1118 plus FOLFIRI as a second line therapy for RAS and BRAF wild-type metastatic colorectal cancer. Methods: Phase 1b part was designed to evaluate weekly GC1118 (starting from 3 mg/kg) in combination with biweekly irinotecan (180mg/m 2 ) or FOLFIRI (irinotecan 180mg/m 2 , leucovorin 400mg/m 2 , 5-FU 400 mg/m 2 bolus, and 5-FU 2400mg/m 2 over 46hrs) in a 3+3 design. In the phase 2a part, the RP2D of GC1118 is administered in combination with FOLFIRI in a Simon’s two stage design with objective response rate (ORR) as the primary endpoint. Results: 13 pts were enrolled in phase 1b and received 3mg/kg of GC1118 with irinotecan (N = 6) or FOLFIRI (N = 7). DLT occurred in 2 pts (G4 neutropenia, G2 rash) in irinotecan arm and 1pt (G3 neutropenia) in FOLFIRI arm with 3mg/kg of GC1118 and it was determined as MTD and RP2D. Adverse events (AE) of grade ≥ 3 included neutropenia (61.5 %), skin rash (15.4 %) and diarrhea (15.4%). Dose reductions due to GC1118-related AE were required in 6 (46.2%) patients. Among 10 response-evaluable pts in phase 1b, best overall response was PR in 3 and SD in 6, and median PFS was 12 months. In stage 1 of phase 2a (N = 9), 4 PR and 5 SD were observed (ORR 44.4%, 95% CI 13.7 – 78.8). We moved to stage 2, and are currently enrolling additional 20 pts. AE of grade ≥ 3 included neutropenia (66.7%), skin rash (22.2%) and diarrhea (11.1%). Updated data of the phase 2a part will be presented at the meeting. Conclusions: The MTD and RP2D of weekly GC1118 in combination with irinotecan or FOLFIRI was 3mg/kg. Preliminary results of GC1118 and FOLFIRI as a 2nd line treatment in mCRC suggests promising antitumor activity and acceptable safety profile. Clinical trial information: NCT03454620 .
Response to: ‘Comment on ‘Metagenome-wide association study of gut microbiome revealed novel aetiology of rheumatoid arthritis in the Japanese population’ by Kishikawa<i>et al.</i>’ by Kitamura<i>et al</i>
Authors: Toshihiro Kishikawa, Yuichi Maeda, Takuro Nii, Yukinori Okada
Journal: Annals of the Rheumatic Diseases (2020)

The positive correlation between Porphyromonas gingivalis and Prevotella spp.Response to: 'Comment on 'Metagenome-wide association study of gut microbiome revealed novel aetiology of rheumatoid arthritis in the Japanese population' by Kishikawa et al.' by Kitamura et al We thank Kitamura et al. for their interest in our study and for providing their thoughts through correspondence. 1 They reported interesting characteristics of Porphyromonas gingivalis (Pg) regarding rheumatoid arthritis (RA) as follows: (1) oral infection of Pg increased serum levels of lipopolysaccharide (LPS) 2 3 ; (2) oral administration of Pg decreased the proportion of phylum Bacteroidetes 3 ; and ( 3) serum LPS levels were inversely associated with Bacteroides counts.In our metagenome-wide association study (MWAS) of the RA gut microbiome, 4 5 we had identified high abundances of five species belonging to the genus Prevotella (i.e., P. denticola, P. marshii, P. disiens, P. corporis, and P. amnii) in the RA metagenome.Considering that Prevotella in the RA gut microbiome showed an inverse relationship with Bacteroides, 6 7 disentanglement of gut microbiome link between Pg and the Prevotella spp.should be of interest.In our RA MWAS, we had excluded Pg from the analysis because the average relative abundance of Pg was below the quality control threshold of 0.001%.Here, we additionally examined the case-control association test of Pg and found no significant association (P = 0.78).However, we found significant Correspondence responseFigure 1 Characteristics of Porphyromonas gingivalis (Pg) in the rheumatoid arthritis (RA) gut microbiome.(A) Correlation between the relative abundance of Pg and that of Prevotella spp.The x-axes indicate the relative abundance of Pg in a logarithmic scale.The y-axes indicate the relative abundance of each of the five Prevotella species with significant RA-control discrepancy (ie, P. denticola, P. marshii, P. disiens, P. corporis, and P. amnii) and the total abundance of the five Prevotella spp. in a logarithmic scale.(B) Correlations between the relative abundance of the taxa and RA activity indices and biomarkers.Only correlations with p values less than 0.05 were coloured (positive correlations in red and negative correlations in blue).Wilcoxon rank-sum tests were used to compare the high-level and low-level groups.Stage indicates Steinbrocker classification of the joint X-rays.RF,
小肠间质瘤急性出血12例临床分析
Authors: 王琼, 杨晓钟
Journal: BMJ (2012)

回顾性分析12例小肠间质瘤急性出血患者的临床表现、影像学检查、手术病理等资料.多见于中老年人,临床表现为便血和不同程度的贫血,小肠CT或MRI、血管造影检查有助于明确病灶,12例患者均行手术治疗,诊断经病理学及免疫组化证实,CD117、CD34阳性率分别为12/12、8/12。
Circulating tumor DNA is prognostic and potentially predictive of eryaspase efficacy in patients with advanced pancreatic adenocarcinoma.
Authors: Jean-Baptiste Bachet, Helene Blons, Pascal Hammel, Iman El Hariry, Fabienne Portales, Laurent Mineur, Jean-Philippe Metges, Claire Mulot, Camille Bourreau, Jason Cain, Jerome Cros, Pierre Laurent-Puig
Journal: Journal of Clinical Oncology (2020)

4617 Background: Eryaspase is composed of L-asparaginase encapsulated in erythrocytes. It has demonstrated significant efficacy in combination with chemotherapy in a randomized phase 2 trial in second-line in patients with advanced pancreatic adenocarcinoma. We assessed, in this study, the prognostic and predictive value of circulating tumor DNA (ctDNA) in plasma samples of patients included in the eryaspase phase 2 trial. Methods: Samples prospectively collected pre-treatment at each 28-day cycle were centrally analyzed by next-generation sequencing (BPER method). Prognostic values of baseline ctDNA and ctDNA early changes between day 0 and 28 were assessed in both arms combined on objective response rate (ORR), progression free survival (PFS) and overall survival (OS). We conducted interaction test between ctDNA positivity and treatment arm, and the predictive value of ctDNA for eryaspase efficacy was investigated. Results: Patients with at least one available plasma sample have been included (n = 122/141). The presence of ctDNA at baseline was identified in 68% (77/113) of patients and was an independent negative prognostic factor for OS (4.6 vs 8.8 months; p = 0.0025) and PFS (1.6 vs 3.3 months; p = 0.00043). Early change in ctDNA levels was assessed by separating patients into three categories (one without detectable ctDNA, and two according to radio median value between day 0 and day 28) that were significantly correlated with ORR, PFS and OS. A significant interaction was observed between the presence of ctDNA and eryaspase efficacy. In patients with ctDNA detectable at baseline, eryaspase was associated with better PFS (HR = 0.53; 95% CI: 0.3-0.94) and OS (HR = 0.52; 95% CI: 0.29-0.91). Conclusions: We confirm from a prospective randomized trial that 1/ the presence of ctDNA at baseline is a major prognostic factor, 2/ the early change of ctDNA correlates with treatment outcome and 3/ the ctDNA could be a predictive biomarker of eryaspase efficacy. Clinical trial information: NCT02195180 .
早期康复治疗脑卒中30例
Authors: 徐思振, 孔秀梅, 张春华, 绪桂贤, 王吉普, 周旋, 张青, 吴晓阜, 钱芳
Journal: BMJ (2004)

为研究脑卒中早期康复治疗对其预后的影响,我院对2002年2月～2003年3月收治的60例急性脑卒中患者进行随机对照研究,报道如下.1.对象与方法:患者入选标准:均为大脑中动脉供血区脑梗死或脑出血,颅脑CT证实;生命征稳定,1周内无进展:脑梗死未行溶栓治疗,病程1周,脑出血未行血肿抽吸治疗,病程2周;年龄在80岁以下。
PDGFC signaling is a potential therapeutic target for radiation proctopathy.
Authors: Lekun Fang, Yunling Xie, Shaomin Zou, Ziqing Yang
Journal: Journal of Clinical Oncology (2020)

e24105 Background: Radiation proctopathy(RP), with acute or chronic rectal dysbiosis, arises as one of the most crucial complications of radiation therapy for pelvic malignancies. Common symptoms of RP patients include rectal breeding, incontinence and so on. However, its efficacy is disappointing due to lack of specific therapeutic drugs. Moreover, limitied scientific studies have been carried out to elucidate the mechanism of RP progression. Herein, we aim to study the underlying mechanism of RP with mouse model and clinical samples, and dig out its potential therapy. Methods: Firstly, chronic radiation proctopathy(CRP) mouse model is established by administering 25 Gy γ-irradiation in the pelvic region shielding the rest of bodies with lead blocks. Eight weeks later, the mice are harvested, and their colorectal tissues are used for RT-qPCR, western blot, immunostaining and transcriptome sequence analysis. Secondly, the outcomes of irradiated Pdgfc +/+ and Pdgfc −/− mice are compared and gene set enrichment analysis(GSEA) is used to further clarify the differences between these two groups. Lastly, crenolanib, a selective inhibitor of PDGFR, is subjected to mice before or after γ-irradiation to study its potential role in RP prevention and treatment. Results: In our RP mouse model, pdgfc and fibrosis markers are shown to highly express in the distal colorectal tissues after irradiation, Similarily, accumulation of PDGFC and fibrosis-related proteins is observed in RP patients’ tissues and serum. Besides, pdgfc appears in the list of cytokine and cytokine receptor interaction gene set which is the most enriched one in the radiation group. Furthermore, pdgfc knockout significantly alleviates radiation induced colorectal injuries in vivo, including mucosal lesions, submucosal thickening, and hyperplasia and edema of muscular layer. Moreover, GSEA reveals that pdgfc knockout may suppress RP progression through repression of pro-inflammatory cytokines and chemokines. Finally, crenolanib overcomes irradiation-induced injuries in the colorectal region of mice. Conclusions: PDGFC is an important regulator of RP progression, which may serve as a potentially therapeutic target for RP treatment.
Factors associated with the uptake of seasonal influenza vaccination in older and younger adults: a large, population based survey in Beijing, China
Authors: 吴双胜, 苏健婷, 杨鹏, 张海艳, 李洪军, 初艳慧, 华伟玉, 李超, 唐雅清, 王全意
Journal: BMJ (2018)

目的
本研究旨在估计北京市老年人和年轻成年人的季节性流感疫苗接种覆盖率及其影响因素。


方法
在2015年5—6月使用自填式匿名问卷对成年人进行调查。主要研究变量为季节性流感疫苗的接种情况，应用logistic回归模型分析流感疫苗接种的影响因素。


结果
总共7 106名调查对象完成问卷调查。2014/2015流感流行季北京市成人季节性流感疫苗接种覆盖率为20.6%[95%可信区间（CI）：19.7%~21.5%]。学历低[老年人：比值比（OR）=1.6，95% CI：1.2~2.1；年轻成年人：OR=1.9，95%CI：1.4~2.6]、慢性病（老年人：OR=1.9，95%CI：1.5~2.4；年轻成年人：OR=1.4，95%CI：1.2~1.7）和医务人员建议（老年人：OR=5.4，95%CI：3.9~7.4；年轻成年人：OR=4.5，95%CI：3.7~5.4）对接种有积极影响；担心流感疫苗副作用对接种有负面影响（老年人：OR=0.6，95% CI：0.4~0.7；年轻成年人：OR=0.8，95% CI：0.7~1.0）。认知到流感易感性（OR=1.5，95%CI：1.2~2.0）和知道北京市免费接种政策（OR=1.9，95% CI：1.2~2.9）只与老年人接种相关，而认知到流感疫苗的有效性（OR=2.2，95%CI：1.7~2.8）只与年轻成年人接种相关。与年轻成年人相比，老年人更有可能接收到医务人员建议和认知到流感的危害性，而且更不担心流感疫苗的副作用。


结论
北京市成年人流感疫苗接种覆盖率较低。除外老年人免费接种政策，医务人员推荐程度和自身认知水平的不同是造成老年人和年轻成年人接种率差距（分别为48.7%和16.0%）的可能原因。在将来流感疫苗接种活动中应着重增加专业人员推荐和提升公众认知水平。