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Resumo Fundamento A associação entre o status de saúde cardiovascular ideal ( ideal cardiovascular health ( ICVH) e diagnóstico de fibrilação ou flutter atrial (FFA) foi menos estudado em comparação a outras doenças cardiovasculares. Objetivos Analisar a associação entre o diagnóstico de FFA e métricas e escores de ICVH no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Métodos Este estudo analisou dados de 13141 participantes com dados completos. Os traçados eletrocardiográficos foram codificados de acordo com o Sistema de Minnesota, em um centro de leitura centralizado. As métricas do ICVH (dieta, atividade física, índice de massa corporal, tabagismo, glicemia de jeju, e colesterol total) e escores do ICVH foram calculados conforme proposto pela American Heart Association . Modelos de regressão logística bruta e ajustada foram construídos para analisar associações de métricas e escores do ICVH com diagnóstico de FFA. O nível de significância foi estabelecido em 0,05. Resultados A idade mediana da amostra foi de 55 anos, e 54,4% eram mulheres. Nos modelos ajustados, os escores de ICVH não apresentaram associação significativa com diagnóstico de FFA prevalente [odds ratio (OR):0,96; intervalo de confiança de 95% (IC95%):0,80-1,16; p=0,70). Perfis de pressão arterial ideal (OR:0,33; IC95%:0,1-0,74; p=0,007) e colesterol total ideal (OR:1,88; IC95%:1,19-2,98; p=0,007) foram significativamente associados com o diagnóstico de FFA. Conclusões Não foram identificadas associações significativas entre escores de ICVH global e diagnóstico de FFA após ajuste multivariado em nossas análises, devido, ao menos em parte, às associações antagônicas da FFA com métricas de pressão arterial e de colesterol total do ICVH. Nossos resultados sugerem que estimar a prevenção da FFA por meio de escore de ICVH global pode não ser adequado, e as métricas do ICVH devem ser consideradas separadamente.

Abstract Background The association between ideal cardiovascular health (ICVH) status and atrial fibrillation or flutter (AFF) diagnosis has been less studied compared to other cardiovascular diseases. Objective To analyze the association between AFF diagnosis and ICVH metrics and scores in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods This study analyzed data from 13,141 participants with complete data. Electrocardiographic tracings were coded according to the Minnesota Coding System, in a centralized reading center. ICVH metrics (diet, physical activity, body mass index, smoking, blood pressure, fasting plasma glucose, and total cholesterol) and scores were calculated as proposed by the American Heart Association. Crude and adjusted binary logistic regression models were built to analyze the association of ICVH metrics and scores with AFF diagnosis. Significance level was set at 0.05. Results The sample had a median age of 55 years and 54.4% were women. In adjusted models, ICVH scores were not significantly associated with prevalent AFF diagnosis (odds ratio [OR]:0.96; 95% confidence interval [95% CI]:0.80-1.16; p=0.70). Ideal blood pressure (OR:0.33; 95% CI:0.15–0.74; p=0.007) and total cholesterol (OR:1.88; 95% CI:1.19–2.98; p=0.007) profiles were significantly associated with AFF diagnosis. Conclusions No significant associations were identified between global ICVH scores and AFF diagnosis after multivariable adjustment in our analyses, at least partially due to the antagonistic associations of AFF with blood pressure and total cholesterol ICVH metrics. Our results suggest that estimating the prevention of AFF burden using global ICVH scores may not be adequate, and ICVH metrics should be considered in separate.

https://doi.org/10.36660/abc.20210970

Prevalence of bovine tuberculosis in the Aksu Region of Xinjiang, China, between 1985 and 2016
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Liu, Y.H.

; Kang, Q.

; Yang, B.

; Li, F.

; Li, X.Q.

; Zhang, L.

; Zhao, L.

Arquivo Brasileiro de Medicina Veterinária e Zootecnia

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Abr 2019, Volume 71 Nº 2 Páginas 374 - 378

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO Prevalência de infecção por tuberculose bovina em gado na prefeitura de Aksu determinada por teste cutâneo tuberculínico (TST) entre 1985 e 2016 foi avaliada. O gado foi analisado de acordo com região, padrão alimentar, rebanho e idade. Um total de 890009 animais foram testados, com prevalência de 0,13% de tuberculose bovina (1172/890009). Diferença estatisticamente significativa foi encontrada em padrão alimentar e rebanhos. Prevalência em vacas (0,19%, 615/327022) foi mais alta que em bois (P< 0,01, OR= 1,903, 95% CI = 1,696 a 2,134). Diferenças significativas (P< 0,01; OR= 2,238, 95%; CI= 1,937 a 2,585) foram evidentes em taxas para tuberculose bovina em casas de camponeses (0,12%, 942/802343) e grupos de fazendeiros (0,26%, 230/87666). A prevalência de bTB caiu na prefeitura Aksu, a taxa positiva se encontrava abaixo de 0.1% a partir de 2010. Conclui-se que as medidas de controle para tuberculose bovina na região de Aksu foram eficazes.

ABSTRACT Prevalence of bovine tuberculosis infection in cattle in Aksu Prefecture determined by intradermal tuberculin skin test (TST), between 1985 and 2016. Cattle were analyzed according to region, feeding pattern, herds and age. A total of 890,009 cattle were tested, with overall bovine tuberculosis prevalence of 0.13% (1172/890009). Statistically significant difference was found in feeding pattern and herds. Prevalence in cows (0.19%, 615/327022) was higher than that in beeves (P< 0.01, OR= 1.903, 95% CI = 1.696 to 2.134). Significant difference (P< 0.01; OR= 2.238, 95%; CI= 1.937 to 2.585) was evident for rates for bovine tuberculosis in the peasant household (0.12%, 942/802343) and farm groups (0.26%, 230/87666). The overall prevalence of bTB was decreased in the Aksu Prefecture, especially the positive rate was under 0.1% in 2010s. We concluded that the control measures forbovine tuberculosis in the Aksu region cattle herds are effective.

https://doi.org/10.1590/1678-4162-10550 876 downloads

Analysis of serum microRNA expression in male workers with occupational noise-induced hearing loss
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Li, Y.H.

; Yang, Y.

; Yan, Y.T.

; Xu, L.W.

; Ma, H.Y.

; Shao, Y.X.

; Cao, C.J.

; Wu, X.

; Qi, M.J.

; Wu, Y.Y.

; Chen, R.

; Hong, Y.

; Tan, X.H.

; Yang, L.

Brazilian Journal of Medical and Biological Research

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2018, Volume 51 Nº 3 elocation e6426

Resumo: En | Texto: En | PDF: En

Occupational noise-induced hearing loss (ONIHL) is a prevalent occupational disorder that impairs auditory function in workers exposed to prolonged noise. However, serum microRNA expression in ONIHL subjects has not yet been studied. We aimed to compare the serum microRNA expression profiles in male workers of ONIHL subjects and controls. MicroRNA microarray analysis revealed that four serum microRNAs were differentially expressed between controls (n=3) and ONIHL subjects (n=3). Among these microRNAs, three were upregulated (hsa-miR-3162-5p, hsa-miR-4484, hsa-miR-1229-5p) and one was downregulated (hsa-miR-4652-3p) in the ONIHL group (fold change >1.5 and Pbon value <0.05). Real time quantitative PCR was conducted for validation of the microRNA expression. Significantly increased serum levels of miR-1229-5p were found in ONIHL subjects compared to controls (n=10 for each group; P<0.05). A total of 659 (27.0%) genes were predicted as the target genes of miR-1229-5p. These genes were involved in various pathways, such as mitogen-activated protein kinase (MAPK) signaling pathway. Overexpression of miR-1229-5p dramatically inhibited the luciferase activity of 3′ UTR segment of MAPK1 (P<0.01). Compared to the negative control, HEK293T cells expressing miR-1229-5p mimics showed a significant decline in mRNA levels of MAPK1 (P<0.05). This preliminary study indicated that serum miR-1229-5p was significantly elevated in ONIHL subjects. Increased miR-1229-5p may participate in the pathogenesis of ONIHL through repressing MAPK1 signaling.

https://doi.org/10.1590/1414-431x20176426 1385 downloads

Abiotic Factors Affecting Seed Germination and Early Seedling Emergence of Large Crabgrass (Digitaria sanguinalis)
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WANG, Y.H.

; MA, Y.L.

; FENG, G.J.

; LI, H.H.

Planta Daninha

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2018, Volume 36 elocation e018166895

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO: A milhã é uma das piores plantas daninhas exóticad em regiões tropicais, subtropicais e temperadas do mundo. Neste estudo, os fatores abióticos que afetam a germinação e a emergência inicial da plântula de milhã foram investigados em laboratório. As melhores temperaturas de germinação foram observadas entre 25 e 35 oC sob o regime de 12 horas de luz/12 horas de escuridão. Algumas sementes conseguem germinar no escuro, mas a exposição à luz estimulou a germinação consideravelmente. A semente de milhã apresentou tolerância à salinidade (entre 0 a 160) e baixo potencial hídrico (11% de germinação a -0,8 MPa). Não foi observado efeito significativo do pH médio sobre a germinação das sementes e mais de 90% da germinação das sementes ocorreu ao longo de uma grande faixa de variação de pH (entre 4,0 e 10,0). A germinação das sementes foi bastante influenciada pelo choque térmico, sendo completamente inibida a 140 oC durante 5 min. A maior taxa de emergência das plântulas foi de 96%, com as sementes que haviam sido plantadas a uma profundidade do solo de 1 cm. O conhecimento gerado a respeito da biologia de germinação neste estudo será útil no desenvolvimento de estratégias de manejo integrado para esta espécie, e também no combate ao estabelecimento da milhã como uma planta daninha problemática em regiões de cultivo economicamente importantes.

ABSTRACT: Large crabgrass is one of the worst exotic weed in tropical, subtropical, and temperate regions of the world. In this study, the abiotic factors affecting seed germination and early seedling emergence of large crabgrass were investigated under laboratory conditions. The optimum temperatures of germination occurred at the range from 25 to 35 oC under 12 h light/12 h dark condition. Some seeds could germinate in the dark, but light exposure significantly stimulated the germination. Large crabgrass seed was tolerant to salinity level range of 0 to 160 and low water potential (11% germination at -0.8 MPa). Medium pH had no significant effect on seed germination and more than 90% seeds germination was obtained over a broad pH range from 4.0 to 10.0. Seed germination was significantly influenced by heat-shock and completely inhibited at 140 oC for 5 min. The greatest seedling emergence rate was 96% when seeds were planted at a soil depth of 1 cm. Knowledge of germination biology obtained from this study will be useful in the development of the integrated weed management strategies for this species, and to avoid its establishment as a troublesome weed in economically important cropping regions.

https://doi.org/10.1590/s0100-83582018360100068 3428 downloads

Effect of microRNA-21 on the proliferation of human degenerated nucleus pulposus by targeting programmed cell death 4
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Chen, B.

; Huang, S.G.

; Ju, L.

; Li, M.

; Nie, F.F.

; Zhang, Y.

; Zhang, Y.H.

; Chen, X.

; Gao, F.

Brazilian Journal of Medical and Biological Research

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2016, Volume 49 Nº 6 elocation e5020

Resumo: En | Texto: En | PDF: En

This study aims to explore the effect of microRNA-21 (miR-21) on the proliferation of human degenerated nucleus pulposus (NP) by targeting programmed cell death 4 (PDCD4) tumor suppressor. NP tissues were collected from 20 intervertebral disc degeneration (IDD) patients, and from 5 patients with traumatic spine fracture. MiR-21 expressions were tested. NP cells from IDD patients were collected and divided into blank control group, negative control group (transfected with miR-21 negative sequences), miR-21 inhibitor group (transfected with miR-21 inhibitors), miR-21 mimics group (transfected with miR-21 mimics) and PDCD4 siRNA group (transfected with PDCD4 siRNAs). Cell growth was estimated by Cell Counting Kit-8; PDCD4, MMP-2,MMP-9 mRNA expressions were evaluated by qRT-PCR; PDCD4, c-Jun and p-c-Jun expressions were tested using western blot. In IDD patients, the expressions of miR-21 and PDCD4 mRNA were respectively elevated and decreased (both P<0.05). The miR-21 expressions were positively correlated with Pfirrmann grades, but negatively correlated with PDCD4 mRNA (both P<0.001). In miR-21 inhibitor group, cell growth, MMP-2 and MMP-9 mRNA expressions, and p-c-Jun protein expressions were significantly lower, while PDCD4 mRNA and protein expressions were higher than the other groups (all P<0.05). These expressions in the PDCD4 siRNA and miR-21 mimics groups was inverted compared to that in the miR-21 inhibitor group (all P<0.05). MiR-21 could promote the proliferation of human degenerated NP cells by targeting PDCD4, increasing phosphorylation of c-Jun protein, and activating AP-1-dependent transcription of MMPs, indicating that miR-21 may be a crucial biomarker in the pathogenesis of IDD.

https://doi.org/10.1590/1414-431x20155020 1671 downloads

Changes in cardiac aldosterone and its synthase in rats with chronic heart failure: an intervention study of long-term treatment with recombinant human brain natriuretic peptide
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Zhu, X.Q.

; Hong, H.S.

; Lin, X.H.

; Chen, L.L.

; Li, Y.H.

Brazilian Journal of Medical and Biological Research

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Ago 2014, Volume 47 Nº 8 Páginas 646 - 654

Resumo: En | Texto: En | PDF: En

The physiological mechanisms involved in isoproterenol (ISO)-induced chronic heart failure (CHF) are not fully understood. In this study, we investigated local changes in cardiac aldosterone and its synthase in rats with ISO-induced CHF, and evaluated the effects of treatment with recombinant human brain natriuretic peptide (rhBNP). Sprague-Dawley rats were divided into 4 different groups. Fifty rats received subcutaneous ISO injections to induce CHF and the control group (n=10) received equal volumes of saline. After establishing the rat model, 9 CHF rats received no further treatment, rats in the low-dose group (n=8) received 22.5 μg/kg rhBNP and those in the high-dose group (n=8) received 45 μg/kg rhBNP daily for 1 month. Cardiac function was assessed by echocardiographic and hemodynamic analysis. Collagen volume fraction (CVF) was determined. Plasma and myocardial aldosterone concentrations were determined using radioimmunoassay. Myocardial aldosterone synthase (CYP11B2) was detected by quantitative real-time PCR. Cardiac function was significantly lower in the CHF group than in the control group (P<0.01), whereas CVF, plasma and myocardial aldosterone, and CYP11B2 transcription were significantly higher than in the control group (P<0.05). Low and high doses of rhBNP significantly improved hemodynamics (P<0.01) and cardiac function (P<0.05) and reduced CVF, plasma and myocardial aldosterone, and CYP11B2 transcription (P<0.05). There were no significant differences between the rhBNP dose groups (P>0.05). Elevated cardiac aldosterone and upregulation of aldosterone synthase expression were detected in rats with ISO-induced CHF. Administration of rhBNP improved hemodynamics and ventricular remodeling and reduced myocardial fibrosis, possibly by downregulating CYP11B2 transcription and reducing myocardial aldosterone synthesis.

https://doi.org/10.1590/1414-431x20143474 2197 downloads

Particle collision during the tribo-electrostatic beneficiation of fly ash based on infrared thermography
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Li, H.S.

; Chen, Y.H.

; Wu, K.B.

; Zhang, X.X.

Journal of the Southern African Institute of Mining and Metallurgy

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Jan 2013, Volume 113 Nº 12 Páginas 899 - 904

Resumo: En | Texto: En | PDF: En

Tribo-electrostatic beneficiation is effective for separating unburned carbon from fly ash. During the process, the fly ash particles become charged owing to friction and collision inside a tribo device. The intensity of friction and collision between particles can be deduced from the tribo device temperature field, obtained by infrared thermography. The purpose of this research was to establish whether an appropriate configuration of tribo device models can be obtained from particle collision experiments using infrared thermography. An experimental set-up was configured to study tribo devices with different arrangements and spacing of the friction rods, and the effect that this has on interparticle collision and the tribo-electrostatic beneficiation process. The experimental material was fly ash particles with a size range from 38 µm to 74 µm and loss on ignition (LOI) 12.65%. The operating conditions were electric field voltage 40 kV and the air flux ranged from 12 to 24 m³/h. The results show that the temperature inside the tribo devices is directly proportional to air flux and particle collision rate. The arrangement and spacing of the friction rods has an important effect on the temperature field distribution. An equilateral triangular arrangement with 20 mm spacing significantly increases the temperature value and collision probability. The optimum operating parameters were established through tribo-electrostatic beneficiation experiments on the fly ash, and the results (LOI of the product at the two electrodes and rate of removal of unburned carbon at the negative plate) were consistent with those of the infrared thermography experiments. A tribo device with friction rods configured in an equilateral triangle arrangement and with 20 mm spacing again yielded the best results. This approach constitutes a new technique for the optimization of tribo device design.

277 downloads

High expression of the circadian gene mPer2 diminishes the radiosensitivity of NIH 3T3 cells
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Chang, L.

; Liu, Y.Y.

; Zhu, B.

; Li, Y.

; Hua, H.

; Wang, Y.H.

; Zhang, J.

; Jiang, Z.

; Wang, Z.R.

Brazilian Journal of Medical and Biological Research

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Out 2009, Volume 42 Nº 10 Páginas 882 - 891

Resumo: En | Texto: En | PDF: En

Period2 is a core circadian gene, which not only maintains the circadian rhythm of cells but also regulates some organic functions. We investigated the effects of mPeriod2 (mPer2) expression on radiosensitivity in normal mouse cells exposed to 60Co-γ-rays. NIH 3T3 cells were treated with 12-O-tetradecanoylphorbol-13-acetate (TPA) to induce endogenous mPer2 expression or transfected with pcDNA3.1(+)-mPer2 and irradiated with 60Co-γ-rays, and then analyzed by several methods such as flow cytometry, colony formation assay, RT-PCR, and immunohistochemistry. Flow cytometry and colony formation assay revealed that irradiated NIH 3T3 cells expressing high levels of mPer2 showed a lower death rate (TPA: 24 h 4.3% vs 12 h 6.8% and control 9.4%; transfection: pcDNA3.1-mPer2 3.7% vs pcDNA3.1 11.3% and control 8.2%), more proliferation and clonogenic survival (TPA: 121.7 ± 6.51 vs 66.0 ± 3.51 and 67.7 ± 7.37; transfection: 121.7 ± 6.50 vs 65.3 ± 3.51 and 69.0 ± 4.58) both when treated with TPA and transfected with mPer2. RT-PCR analysis showed an increased expression of bax, bcl-2, p53, c-myc, mre11, and nbs1, and an increased proportionality of bcl-2/bax in the irradiated cells at peak mPer2 expression compared with cells at trough mPer2 expression and control cells. However, no significant difference in rad50 expression was observed among the three groups of cells. Immunohistochemistry also showed increased protein levels of P53, BAX and proliferating cell nuclear antigen in irradiated cells with peak mPer2 levels. Thus, high expression of the circadian gene mPer2 may reduce the radiosensitivity of NIH 3T3 cells. For this effect, mPer2 may directly or indirectly regulate the expressions of cell proliferation- and apoptosis-related genes and DNA repair-related genes.

1871 downloads

Genetic variations of EBV-LMP1 from nasopharyngeal carcinoma biopsies: potential loss of T cell epitopes
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Tang, Y.L.

; Lu, J.H.

; Cao, L.

; Wu, M.H.

; Peng, S.P.

; Zhou, H.D.

; Huang, C.

; Yang, Y.X.

; Zhou, Y.H.

; Chen, Q.

; Li, X.L.

; Zhou, M.

; Li, G.Y.

Brazilian Journal of Medical and Biological Research

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Fev 2008, Volume 41 Nº 2 Páginas 110 - 116

Resumo: En | Texto: En | PDF: En

To find Epstein-Barr virus (EBV) strains with genetic variations of EBV latent membrane protein 1 (EBV-LMP1) from nasopharyngeal carcinoma (NPC), the full-length DNA of LMP1 genes from 21 NPC biopsies obtained in Hunan province in southern China was amplified and sequenced. Our sequences were compared to those previously reported by the Clustal V method. Results showed that all 21 sequences displayed two amino acid changes most frequently in LMP1 of CD4+ T cell epitopes at codons 144 (F®I, 21/21) and 212 (G®S, 19/21) or (G®N, 2/21). We also show that type A EBV strain is prevalent in the cases of NPC from Hunan province with a 30-bp 18/21 deletion, and we highlight that this deletion resulted in loss of one of the CD4+ T cell-restricted epitopes. The other 3 sequences without this deletion all had a change at codon 344 (G®D). Furthermore, in the major epitope sequence of CD8+ T cells restricted by HLA-A2, all 21 sequences showed changes at codons 126 (L®F) and 129 (M®I). Our study discovered that one of the 21 sequence variations harbored a new change at codon 131 (W®C), and 5/21 specimens showed another novel change at codon 115 (G®A) in the major epitope sequence of CD8+ T cells restricted by HLA-A2. Our study suggests that these sequence variations of NPC-derived LMP1 may lead to a potential escape from host cell immune recognition, protecting latent EBV infection and causing an increase in tumorigenicity.

3365 downloads

10.

Composite coatings of titanium-aluminum nitride for steel against corrosion induced by solid NaCl deposit and water vapor at 600 °C
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Li, M.S.

; Wang, F.H.

; Shu, Y.H.

; Wu, W.T.

Materials Research

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Mar 2004, Volume 7 Nº 1 Páginas 27 - 33

Resumo: En | Texto: En | PDF: En

Composite coatings (Ti,Al)N with different Al content were deposited on a wrought martensite steel 1Cr11Ni2W2MoV by reactive multi-arc ion plating. With the addition of Al to the coatings, the crystallographic structure of them changed from B1 NaCl to B4 ZnS, the relevant hardness and adhesive strength firstly increased then decreased and their oxidation-resistance was also dramatically improved. It was indicated that the introduction of Al was beneficial to (Ti,Al)N coatings against corrosion induced by NaCl(s) in wet oxygen at 600 °C as well as wet corrosion in NaCl solution at ambient temperature.

21246 downloads

11.

Efficacy trial of Vi polysaccharide vaccine against typhoid fever in south-western China
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Yang, H.H.

; Wu, C.G.

; Xie, G.Z.

; Gu, Q.W.

; Wang, B.R.

; Wang, L.Y.

; Wang, H.F.

; Ding, Z.S.

; Yang, Y.

; Tan, W.S.

; Wang, W.Y.

; Wang, X.C.

; Qin, M.

; Wang, J.H.

; Tang, H.A.

; Jiang, X.M.

; Li, Y.H.

; Wang, M.L.

; Zhang, S.L.

; Li, G.L.

Bulletin of the World Health Organization

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Jul 2001, Volume 79 Nº 7 Páginas 625 - 631

Resumo: En Es Fr | Texto: En Es Fr | PDF: En | PDF: Es | PDF: Fr

OBJECTIVE: To test the efficacy of locally produced Vi vaccine over a time period of longer than one year. METHODS: A double-blinded, randomized field trial was performed in Guangxi Zhuang Autonomous Region in south-western China, using 30 mg doses of locally produced Vi. Enrolled subjects were 3-50 years of age, although the majority (92%) were school-aged children, who have the highest rate of typhoid fever in this setting. A total of 131 271 people were systematically allocated a single dose of 30 mg of Vi polysaccharide or saline placebo. The study population was followed for 19 months, with passive surveillance conducted in the Ministry of Health and the Regional Health and Anti-epidemic Centre (HAEC). Clinically suspected cases of typhoid fever were confirmed by blood culture, or by serological reaction with O-antigen (Widal tests). FINDINGS: After 19 months, there were 23 culture-confirmed cases of typhoid fever in the placebo group versus 7 cases in the Vi group (Protective efficacy (PE) = 69%; 95% CI = 28%, 87%). Most of the isolates were from school-aged children: 22 cases in the placebo group versus 6 in the Vi group (PE = 72%; 95% CI = 32%, 82%). No serious post-injection reactions were observed. The locally produced Vi polysaccharide vaccine showed levels of protective efficacy similar to those for Vi vaccine produced in industrial countries. CONCLUSION: The slightly higher dose of vaccine did not seem to alter efficacy significantly in China.

OBJETIVO: Determinar la eficacia de la vacuna de Vi producida localmente a lo largo de un periodo superior a un año. MÉTODOS: Se llevó a cabo un ensayo sobre el terreno aleatorizado y en doble ciego en la región autónoma (provincia) de Guangxi Zhuang, en el suroeste de China, usando dosis de 30 mg de la vacuna Vi producida localmente. El intervalo de edades de las personas participantes era de 3-50 años, si bien la mayoría de ellas (92%) eran niños en edad escolar, los más afectados por la fiebre tifoidea en ese lugar. Se asignó de forma sistemática a un total de 131 271 personas para que recibieran ya fuera una dosis única de 30 mg de polisacárido Vi o bien un placebo constituido por suero fisiológico. La población estudiada fue objeto de seguimiento durante 19 meses, y la vigilancia pasiva corrió a cargo del Ministerio de Salud y del Centro Regional de Salud y Lucha contra las Epidemias (HAEC). Los casos con manifestaciones clínicas sugestivas de fiebre tifoidea fueron confirmados mediante cultivo sanguíneo o mediante la reacción serológica con el antígeno O (pruebas de Widal). RESULTADOS: Al cabo de 19 meses se habían confirmado mediante cultivo 23 casos de fiebre tifoidea en el grupo placebo, frente a 7 casos en el grupo tratado con la vacuna Vi (eficacia protectora (EP) = 69%; IC95% = 28-87%). La mayoría de los aislados correspondían a niños en edad escolar: 22 casos en el grupo placebo, frente a 6 en el grupo tratado con Vi (EP = 72%; IC95% = 32-82%). No se observó ninguna reacción grave postinyección. La vacuna basada en el polisacárido Vi producida localmente demostró tener una eficacia protectora similar a la de la vacuna Vi producida en los países industrializados. CONCLUSIÓN: El ligero aumento de la dosis de vacuna no parece haber influido de forma significativa en su eficacia en China.

OBJECTIF:Tester l’efficacité du vaccin antityphoïdique polyosidique Vi de production locale sur une période de plus d’un an. MÉTHODS: Un essai de terrain randomisé en double aveugle a été réalisé dans la région autonome (province) de Guanxi Zhuang dans le sud-ouest de la Chine, au moyen de doses de 30 mg de polyoside Vi de production locale. Les sujets recrutés dans l’étude étaient âgés de 3 à 50 ans, mais étaient pour la plupart (92 %) des enfants d’âge scolaire, groupe qui présente le taux le plus élevé de fièvre typhoïde dans cette région. Au total, 131 271 personnes ont reçu systématiquement une dose unique de 30 mg de polyoside Vi ou un placebo (soluté physiologique). La population d’étude a été suivie pendant 19 mois dans le cadre d’une surveillance passive exercée par le Ministère de la Santé et le Centre régional de la santé et de la lutte contre les épidémies (HAEC). Les suspicions cliniques de fièvre typhoïde ont été confirmées par hémoculture ou par réaction sérologique en présence d’antigène O (test de Widal). RÉSULTATS: Au bout de 19 mois, on a dénombré 23 cas de fièvre typhoïde confirmés par culture dans le groupe placebo contre 7 cas dans le groupe Vi (efficacité protectrice (EP) = 69% ; intervalle de confiance à 95% (IC 95 %) : 28-87 %). La plupart des isolements ont été réalisés chez les enfants d’âge scolaire, avec 22 cas dans le groupe placebo contre 6 cas dans le groupe Vi (EP = 72%; IC 95%: 32-82 %). Aucune réaction grave n’a été observée après l’injection. Le vaccin polyosidique Vi de production locale a montré des taux d’efficacité protectrice similaires à ceux des vaccins produits dans les pays industrialisés. CONCLUSION: La dose légèrement plus forte de vaccin n’a pas semblé modifier l’efficacité de fac¸on significative en Chine.

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