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Six-minute walking test performance is associated with survival in cirrhotic patients

World Journal of Hepatology 2021年第11期13卷 1791-1801页

作者： Carolina Frade m G Pimentel Ana Cristina de Castro Amaral Adriano miziara Gonzalez michelle Lai Danielde Oliveira mota maria Lucia Gomes Ferraz Wilson mathias Junior mario Kondo Department of medicine Federal University of Sao PauloSao Paulo 04026090Brazil Department of Gastroenterology Federal University of Sao PauloSao Paulo 04023062Brazil Department of Surgery Liver Transplantation ServiceFederal University of Sao PauloSao Paulo 04026090Brazil Department of medicine Division of Gastroenterology and HepatologyBeth Israel Deaconess Medical CenterBostonMA 02215United States Department of Industrial Engineering University of Sao PauloSao Paulo 05508010Brazil Department of Cardiology Heart InstituteUniversity of Sao PauloSao Paulo 05403900Brazil

BACKGROUND Patients with cirrhosis are at risk of cirrhotic cardiomyopathy,with resulting cardiac dysfunction and exercise *** minute walking test(6mWT)assesses functional status and predicts morbidity and mortality in cardiopulmonary *** To determine if it associates with mortality by analyzing 6mWT performance in patients with liver *** A cohort of 106 cirrhotic patients was evaluated in the outpatient setting with echocardiogram and 6mWT and follow up for one year to document hepatic decompensation and *** distance in meters was recorded at the end of 6 min(6mWD).RESULTS This cohort had a mean age of 51 years and 56%male;patients were staged as Child A in 21.7%,B 66%and C 12.3%.Walk distance inversely correlated with Child scores,and was significantly reduced as Child stages *** who died(10.4%)showed shorter mean 6mWD(P=0.006).Low 6mWD was an independent predictor of mortality(P=0.01).CONCLUSION 6mWT is a noninvasive inexpensive test whose result is related to Child scores and *** is useful to identify patients with liver cirrhosis at high risk of mortality for closer monitoring and potential early intervention.

关键词： Six-minute walking test Liver cirrhosis Hospital admission and mortality Child score

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Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID- 19 pandemic

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Stroke & Vascular Neurology 2021年第4期6卷 542-552,I0026-I0032页

作者： Thanh N Nguyen Diogo C Haussen muhammad m Qureshi Hiroshi Yamagami Toshiyuki Fujinaka Ossama Y mansour mohamad Abdalkader michael Frankel Zhongming Qiu Allan Taylor Pedro Lylyk Omer F Eker Laura mechtouff michel Piotin Fabricio Oliveira Lima Francisco mont'Alverne Wazim Izzath Nobuyuki Sakai mahmoud mohammaden Alhamza R Al-Bayati Leonardo Renieri Salvatore mangiafico David Ozretic Vanessa Chalumeau Saima Ahmad Umair Rashid Syed Irteza Hussain Seby John Emma Griffin John Thornton Jose Antonio Fiorot Rodrigo Rivera Nadia Hammami Anna m Cervantes-Arslanian Hormuzdiyar H Dasenbrock Huynh Le Vu Viet Quy Nguyen Steven Hetts Romain Bourcier Romain Guile melanie Walker malveeka Sharma Don Frei Pascal Jabbour Nabeel Herial Fawaz Al-mufti Atilla Ozcan Ozdemir Ozlem Aykac Dheeraj Gandhi Chandril Chugh Charles matouk Pascale Lavoie Randall Edgell Andre Beer-Furlan michael Chen monika Killer-Oberpfalzer Vitor mendes Pereira Patrick Nicholson Vikram Huded Nobuyuki Ohara Daisuke Watanabe Dong Hun Shin Pedro SC magalhaes Raghid Kikano Santiago Ortega-Gutierrez mudassir Farooqui Amal Abou-Hamden Tatsuo Amano Ryoo Yamamoto Adrienne Weeks Elena A Cora Rotem Sivan-Hoffmann Roberto Crosa markus möhlenbruch Simon Nagel Hosam Al-Jehani Sunil A Sheth Victor S Lopez Rivera James E Siegler Achmad Fidaus Sani Ajit S Puri Anna luisa Kuhn Gianmarco Bernava Paolo machi Daniel G Abud Octavio m Pontes-Neto Ajay K Wakhloo Barbara Voetsch Eytan Raz Shadi Yaghi Brijesh P mehta Naoto Kimura mamoru murakami Jin Soo Lee Ji man Hong Robert Fahed Gregory Walker Eiji Hagashi Steve m Cordina Hong Gee Roh Ken Wong Juan F Arenillas mario martinez-Galdamez Jordi Blasco Alejandro Rodriguez Vasquez luisa Fonseca m luis Silva Teddy Y Wu Simon John Alex Brehm marios Psychogios William J mack matthew Tenser Tatemi Todaka miki Fujimura Roberta Novakovic Jun Deguchi Yuri Sugiura Hiroshi Tokimura Rakesh Khatri michael Kelly Lissa Peeling Yuichi murayama Hugh Stephen Winters Johnny Wong mohamed Teleb Jeremy Payne Hiroki Fukuda Kosuke miyake Junsuke Shimbo Yusuke Sug Neurology RadiologyBoston Medical CenterBostonMassachusettsUSA Neurology Marcus Stroke&Neuroscience CenterGrady Memorial HospitalEmory University School of MedicineAtlantaGAUSA Radiology Radiation OncologyBoston University School of MedicineBostonMassachusettsUSA Neurology National Hospital Organization Osaka National HospitalOsakaJapan Neurosurgery National Hospital Organization Osaka National HospitalOsakaJapan Neurology Alexandria UniversityAlexandriaEgypt Radiology Boston Medical CenterBostonMassachusettsUSA Department of Neurology Xinqiao HospitalChongqingChina Neurosurgery University of Cape TownRondeboschWestern CapeSouth Africa Neurosurgery Interventional NeuroradiologyClinica La Sagrada FamiliaBuenos AiresArgentina Neuroradiologie Neurologie VasculaireHospices Civils de LyonLyonAuvergne-Rhône AlpesFrance Neurologie Vasculaire Hospices Civils de LyonLyonAuvergne-Rhône AlpesFrance Interventional Neuroradiology Fondation Ophtalmologique Adolphe de RothschildParisÎle-de FranceFrance Neurology Hospital Geral de FortalezaFortalezaBrazil Interventional Neuroradiology Hospital Geral de FortalezaFortalezaBrazil Neuroradiology Nottingham University Hospitals NHS TrustNottinghamUK Department of Neurosurgery Kobe City Medical Center General HospitalKobeHyogoJapan Interventional Neurovascular Unit University Hospital CareggiFirenzeToscanaItaly Neuroradiology University Hospital Centre ZagrebZagrebCroatia Interventional Neuroradiology Hopital BicetreLe Kremlin-BicetreFrance Stroke and Interventional Neuroradiology Lahore General HospitalLahorePakistan Neurological Institute Cleveland Clinic Abu DhabiAbu DhabiUAE Department of Radiology Beaumont HospitalDublinIreland Neurology Stroke UnitHospital-Estadual CentralVitoriaBrazil Neuroradiology Instituto de Neurocirugia Dr AsengoSantiagoChile Interventional Neuroradiology Institut National de NeurologieTunisTunisia Neurology Boston Medical CenterBostonMassachusettsUSA Neurosurgery Boston Medical Center

Background During the COVID-19 pandemic,decreased volumes of stroke admissions and mechanical thrombectomy were *** study’s objective was to examine whether subarachnoid haemorrhage(SAH)hospitalisations and ruptured aneurysm coiling interventions demonstrated similar *** We conducted a cross-sectional,retrospective,observational study across 6 continents,37 countries and 140 comprehensive stroke *** with the diagnosis of SAH,aneurysmal SAH,ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases,10th Revision,*** 3-month cumulative volume,monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before(1 year and immediately before)and during the pandemic,defined as 1 march-31 may *** prior 1-year control period(1 march-31 may 2019)was obtained to account for seasonal *** There was a significant decline in SAH hospitalisations,with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic,representing a relative decline of 22.5%(95%CI−24.3%to−20.7%,pmbolisation of ruptured aneurysms declined with 1170-1035 procedures,respectively,representing an 11.5%(95%CI−13.5%to−9.8%,p=0.002)relative *** analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations,a 24.9%relative decline(95%CI−28.0%to−22.1%,pm coiling was noted in low coiling volume hospitals of 41.1%(95%CI 32.3%to 50.6%,p=0.008)despite a decrease in SAH admissions in this *** There was a relative decrease in the volume of SAH hospitalisations,aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 *** findings in SAH are consistent with a decrease in other emergencies,such as stroke and myocardial infarction.

关键词： diagnosis representing subarachnoid

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Antimicrobial and Antioxidant Activity of Anacardium occidentale L. Flowers in Comparison to Bark and Leaves Extracts

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Journal of Biosciences and medicines 2016年第4期4卷 87-99页

作者： Rubenice Amaral da Silva Silvana Amado Liberio Flavia m. m. do Amaral Flavia Raquel Fernandes do Nascimento Luce maria Brandão Torres Valério monteiro Neto Rosane Nassar meireles Guerra Laboratory of Immunophysiology Universidade Federal do Maranhao Campus do Bacanga Sao Luis Brazil Instituto Botanico de Sao Paulo Sao Paulo Brazil Departament of Pathology Universidade Federal do Maranhao Sao Luis Brazil Universidade Ceuma Sao Luís Brazil

Anacardium occidentale L., Anacardiaceae, is frequently used to treat infections. We evaluated the antimicrobial and antioxidant activity of extracts obtained from aerial parts of the plant in comparison with the extract prepared with the flowers. Ethanol extracts of the leaves (EEL), stem bark (EEB), and flowers (EEF) were prepared separately. The antimicrobial activity was evaluated by agar diffusion and broth dilution methods. The minimum bactericidal and fungicidal concentrations were determined against: Streptococcus mutans, Lactobacillus acidophilus, Staphylococcus aureus, mRSA, Enterococcus faecalis, Streptococcus pyogenes, Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli, Klebsiella pneumoniae, Helicobacter pylori, Salmonella choleraesuis, Candida albicans, and Candida tropicalis. The antioxidant activity of the extracts was evaluated based on their scavenger capacity of 2,2-diphenyl-1-picrylhydrazyle. The phytochemical profile was analyzed by colorimetric methods and by HPLC with UV detection. All extracts exhibited antioxidant and antimicrobial activity. Although, the EEF was the most effective since it inhibited the growth of all 14 microorganisms tested. Anacardic and galic acids were identified in all extracts as well phenolic compounds, triterpenes, flavones and xanthones. In conclusion, the extracts obtained from the aerial parts of A. occidentale, mainly the extract of flowers that was the most effective, are rich in bioactive metabolites that exert a potent antioxidant and antimicrobial effect. Taken together, the results indicate an important biotechnological potential of A. occidentale as a source of compounds with broad-spectrum antimicrobial and of antioxidant activity to be used in the food and cosmetics industry.

关键词： Anacardium occidentale Antimicrobial Agents Flowers Cashew Caju Antioxidant

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modeling Violence Among and Against University Students in a mexican medium-Sized City

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Chinese Business Review 2020年第6期19卷 226-239页

作者： Alicia Sylvia Gijón-Cruz Rafael G.Reyes-morales Blanca Azucena García-Ramírez Juan luis Bautista-martínez Nadia Esteva-Duran Universidad Autónoma Benito Juárez de Oaxaca State of OaxacaMexico Tecnológico Nacional de méxico/Instituto Tecnológico de Oaxaca State of OaxacaMexico

Violence against university students and among them is analyzed on campus and the household as well as the relationships of violence between these two social *** study was undertaken through an anonymous random survey in the two larger public universities in a mexican medium-sized *** violence and types of violence-verbal,psychological,sexual,and physical-were evaluated by sex and by universities;and the aggressors were identified.A students’concept of violence was built,considering causes of intimate-partner violence,violence in general and ethical judgment on gender ***,it was measured the relationships between violence on campus and in the household using bivariate statistical *** indicate the main aggressors on campus are classmates and professors,whereas in the household are the mother,relatives together with the parents and relatives without the ***-campus,there were found statistically significant associations between professors-aggressors and students as victims of violence by *** the household,the bivariate analysis confirmed mothers as single aggressors and fathers exerting violence together with relatives against student-children;and direct relationships between on-campus(psychological and sexual violence)and domestic(physical and sexual violence).

关键词： types of violence violence by sex aggressors students’concept of violence

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Evaluation of the frequency of micronucleus in epithelial cells of children exposed to arsenic and heavy metals pollution in a mining area of mexico

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Chinese Journal Of Geochemistry 2006年第B8期25卷 72-73页

作者： Sandra P. Gamino Fernando Diaz-Barriga Eugenia m. Gonsebatt marcos monroy Laboratorio de Geoquimica y Geomicrobiologia Ambiental Instituto de Metalurgia UASLP / San Luis Potosi S.L.P. México Laboratorio de Toxicologia Ambiental Facultad de Medicina UASLP / San Luis Potosl S.L.P. México Instituto de Investigaciones Biomédicas UNAM/Mexico D.E México

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甘蔗渣芦笋皮加入提高了甘薯淀粉发泡性能

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绿色包装 2019年第3期 74-74页

作者： Jam Pier Cruz-Tirado Ricardo Vejarano Delia R. Tapia-Blácido luis m. Angelats-Silva Raúl Siche 不详

利用甘蔗蔗渣(SB)和芦笋皮(AP)这两种农业工业废弃物,对以甘薯淀粉为基础的泡沫托盘(分别为淀粉/SB 和淀粉/AP托盘)进行了生物降解,提高了泡沫托盘的性能。制备了含不同浓度SB 和AP(0%-40%w/w)的淀粉/SB和淀粉/AP 托盘,并对其微观结构... 详细信息

利用甘蔗蔗渣(SB)和芦笋皮(AP)这两种农业工业废弃物,对以甘薯淀粉为基础的泡沫托盘(分别为淀粉/SB 和淀粉/AP托盘)进行了生物降解,提高了泡沫托盘的性能。制备了含不同浓度SB 和AP(0%-40%w/w)的淀粉/SB和淀粉/AP 托盘,并对其微观结构、物理、热学和力学性能进行了表征。纤维废料的加入使发泡托盘发黄,与无纤维的甘薯淀粉发泡托盘相比,发泡托盘亮度低,孔隙率高,机械阻力大,变形性好,吸水性好。添加SB的泡沫托板多孔性较低,吸水能力较低,抗拉强度较AP高。AP纤维的浓度越高(大于30%),泡沫托盘就越容易膨胀。纤维废弃物的加入提高了甘薯淀粉泡沫托盘的热稳定性。所制备的复合发泡托盘可作为膨化聚苯乙烯在食品干包装中的替代品。

关键词：甘薯淀粉发泡性能甘蔗渣芦笋皮工业废弃物纤维废弃物无纤维生物降解

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增长、创新、规模标度及城市节奏

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城市与区域规划研究 2017年第2期9卷 31-44页

作者：路易斯·m.A.贝当古何塞·洛沃德克·黑尔宾克里斯蒂安·屈纳特杰弗里·B.韦斯特寇晓东洛斯·阿拉莫斯国家实验室mS B284理论部圣塔菲研究所亚利桑那州立大学全球可持续性研究所德累斯顿理工大学交通与经济学研究所西北工业大学自动化学院

一直以来，城市被认为是社会创新和创富的最有力引擎，然而城市也同时是犯罪、污染和疾病的主要来源地。城市化这一不可阻挡的世界趋势向人们提出了一项紧迫挑战：需要构建出一套关于城市组织及可持续发展的定量预测理论。文章所提供的... 详细信息

一直以来，城市被认为是社会创新和创富的最有力引擎，然而城市也同时是犯罪、污染和疾病的主要来源地。城市化这一不可阻挡的世界趋势向人们提出了一项紧迫挑战：需要构建出一套关于城市组织及可持续发展的定量预测理论。文章所提供的经验证据表明，城市化与经济发展和知识创新联系过程具有普遍性，不仅仅适合于属于同一城市体系的城市，而且不同国家、不同阶段也遵循这一规律。城市的许多不同属性，从专利产出、个人收到电缆长度等，都显示出是人口规模的幂律函数，其规模标度指数B在整体上分成了几类。反映财富创造和创新属性的β≈1．2〉1（收益递增），而代表基础设施属性的β≈0．8〈1（规模经济）。本文预测，城市中社会生活节奏会随着人口规模的加大而加快，这和已有数据相吻合。文中还讨论了城市如何与生物有机体相似或相异，后者的β〈1。最后，通过推导增长方程定量探讨了这些标度关系的可能后果，结果显现：由创新驱动增长和规模经济驱动增长之间有巨大差异。这种差异表明，伴随人口增长，主要的创新周期必须持续加速运行，这样才能维持城市增长，从而避免停滞及垮塌。

关键词：人口可持续性城市研究收益递增规模经济

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Development of a Construction material for Indoor and Outdoor, metakaolinite-Based Geopolymer, with Environmental Properties

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材料科学与工程（中英文A版） 2019年第4期9卷 131-142页

作者： m.mondragón-Figueroa Héctor.R.Guzmán-Carrillo miguelÁngel Rico Joséluis.Reyez-Araiza Jorge.Pineda-Piñón Edgar J.López-Naranjo maría C.Columba-Palomares Jóse.m.López-Romero Josè.Ramón Gasca-Tirado Alejandro.manzano-Ramírez CINVESTAV-Querétaro Libramiento Norponiente#2000Fraccionamiento Real de JuriquillaQuerétaro 76230Qro.México Facultad de Química Universidad Autónoma de Querétaro centro de estudios Académicos sobre contaminación AmbientalQuerétaro 76010Qro.México DIPFI Facultad de IngenieríaUniversidad Autónoma de QuerétaroC.U.Cerro de las CampanasCentroQuerétaro 76010Qro.México Instituto Politécnico Nacional Centro de Investigación en Ciencia Aplicada y Tecnología AvanzadaUnidad QuerétaroCerro Blanco No.141Colinas del CimatarioQuerétaro76090Qro.México DIP-CUCEI Universidad de GuadalajaraJoséGuadalupe Zuno#48Los BelenesZapopan 45100Jal.México Facultad de Farmacia Universidad Autónoma del Estado de MorelosAv.Universidad#1001Cuernavaca 62209Mor.México Departamento de Ingeniería Universidad de GuanajuatoGuanajuato 36000México

Environmental problems that came from the human activity have many facets,since pollution of the atmosphere arises from vehicles,industrial emissions while pollution of water could be from organic compounds,pesticides *** can cause serious health effects,such as respiratory diseases,including asthma and lung ***,in the present work,a kinetic study on the effective adsorption and photo degradation of methylene blue(mB)dye,under ultraviolet A(UVA)irradiation of an alkali activated inorganic polymer(geopolymer)with homogeneously dispersed titanium dioxide(TiO2)micro-particles is *** addition,antimicrobial testing of the alkali activated TiO2 material was performed showing a bacteriostatic effect.

关键词： Heterogeneous photocatalysis semiconductor alkali activated bacteriostatic effect

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Outcome in obscure gastrointestinal bleeding after capsule endoscopy

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World Journal of Gastrointestinal Endoscopy 2013年第11期5卷 551-558页

作者： Alex Caas-Ventura Lucia márque Xavier Bessa Josep maria DedeuDepartment of Gastroenterology Hospital del mar Research Institute Pompeu Fabra University marc Puigvehí Sílvia Delgado-Aros Ines Ana Ibáez Agustin Seoane luis Barranco Felipe Bory montserrat Andreu Begoa González-Suárez Department of Gastroenterology Hospital del Mar Research InstitutePompeu Fabra University Endoscopic Unit Gastroenterology DepartmentICMDiM. Hospital Clínic

AIm: To investigate the clinical impact of capsule endoscopy(CE) after an obscure gastrointestinal bleeding(OGIB) episode, focusing on diagnostic work-up, followup and predictive factors of rebleeding. mETHODS: Patients who were referred to Hospital del mar(Barcelona, Spain) between 2007 and 2009 for OGIB who underwent a CE were retrospectively analyzed. Demographic data, current treatment with non-steroid antiinflammtory drugs or anticoagulant drugs, hemoglobin levels, transfusion requirements, previous diagnostic tests for the bleeding episode, as well as CE findings(significant or non-significant), work-up and patient out-comes were analyzed from electronic charts. Variables were compared by χ 2 analysis and Student t test. Risk factors of rebleeding were assessed by Log-rank test, Kaplan-meier curves and Cox regression model. RESULTS: There were 105 patients [45.7% women, median age of 72 years old(interquartile range 56-79)] and a median follow-up of 326 d(interquartile range 123-641) included in this study. The overall diagnostic yield of CE was 58.1%(55.2% and 63.2%, for patients with occult OGIB and overt OGIB, respectively). In 73 patients(69.5%), OGIB was resolved. multivariate analysis showed that hemoglobin levels lower than 8 g/dL at diagnosis [hazard ratios(HR) = 2.7, 95%CI: 1.9-6.3], patients aged 70 years and above(HR = 2.1, 95%CI: 1.2-6.1) and significant findings in CE(HR = 2.4, 95%CI: 1.1-5.8) were independent predictors of rebleeding. CONCLUSION: One third of the patients presented with rebleeding after CE; risk factors were hemoglobin levels < 8 g/dL, age ≥ 70 years or the presence of significant lesions.

关键词： Capsule endoscopy Obscure gastrointestinal bleeding Small bowel Angiodysplasia Enteroscopy

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2019年全球、地区和国家5岁以下儿童呼吸道合胞病毒引发急性下呼吸道感染疾病负担研究的系统分析

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中国病毒病杂志 2023年第2期13卷 81-95页

作者： You Li Xin Wang Dianna m.Blau mauricio T.Caballero Daniel R.Feikin Christopher J.Gill Shabir A.madhi Saad B.Omer Eric A.F Simoes Harry Campbell Ana Bermejo Pariente Darmaa Bardach Quique Bassat Jean-Sebastien Casalegno Giorgi Chakhunashvili Nigel Crawford Daria Danilenko Lien Anh Ha Do marcela Echavarria Angela Gentile Aubree Gordon Terho Heikkinen QSue Huang Sophie Jullien Anand Krishnan Eduardo luis Lopez Josko markic Ainara mira-Iglesias Hannah Cmoore Jocelyn moyes Lawrence mwananyanda DJames Nokes Faseeha Noordeen Evangeline Obodai Nandhini Palani Candice Romero Vahid Salimi Ashish Satav Euri Seo Zakhar Shchomak Rosalyn Singleton Kirill Stolyarov Sonia K Stoszek Anne von Gottberg Danielle Wurzel Lay-myint Yoshida Chee Fu Yung Heather J Zar Harish Nair 张甜甜从兵兵邓舒予不详南京医科大学公共卫生学院江苏南京211166

背景呼吸道合胞病毒(respiratory syncytial virus,RSV)是引起婴幼儿急性下呼吸道感染最常见的病原体。此前估计,2015年全球60月龄以下儿童共发生3 310万次RSV相关急性下呼吸道感染,导致118 200人死亡。此后,几项社区监测研究获得了对RS... 详细信息

背景呼吸道合胞病毒(respiratory syncytial virus,RSV)是引起婴幼儿急性下呼吸道感染最常见的病原体。此前估计,2015年全球60月龄以下儿童共发生3 310万次RSV相关急性下呼吸道感染,导致118 200人死亡。此后,几项社区监测研究获得了对RSV相关社区死亡的更精确估计。本文旨在更新2019年全球、地区和国家层面60月龄以下儿童RSV相关急性下呼吸道感染的发病率和死亡率,重点关注总体死亡率和在研RSV免疫制剂针对的更窄的婴儿年龄组。方法检索获得mEDLINE、Embase、Global Health、CINAHL、Web of Science、LILACS、OpenGrey、中国知网、万方和维普数据库2017—2020年发表文献中的新数据,并纳入RSV GEN合作者提供的未发表数据,以扩展全球RSV疾病负担数据集。纳入的研究符合以下条件:报告了社区中或需要住院治疗的60月龄以下儿童RSV原发性急性下呼吸道感染的数据;报告了至少连续12个月的数据,但院内病死率或RSV季节性定义明确的地区除外;报告了RSV相关急性下呼吸道感染的发病率、住院率、院内病死率或急性下呼吸道感染住院的RSV阳性比例。如果病例定义不明或应用不一致、RSV感染未经实验室确认或仅基于血清学检测、报告的急性下呼吸道感染病例少于50例,则排除该研究。本研究应用广义线性混合效应模型(generalized linear mixed-effects model,GLmm)估计了2019年全球和地区(按国家发展状况和世界银行收入分类)RSV相关急性下呼吸道感染的发病率、住院率和院内病死率;通过基于危险因素的模型估计了国家层面RSV相关急性下呼吸道感染的发病率;通过GLmm开发了新模型,纳入最新的RSV社区死亡率数据,用于估计RSV的总体死亡率。本综述已在PROSPERO注册(CRD42021252400)。结果除了先前综述中纳入的317项研究外,还纳入了113项符合条件的新研究以及51项未发表的研究,共计481项研究。据估计,2019年全球60月龄以下儿童中,共发生3 300万(置信区间为2 540万~4 460万)次RSV相关急性下呼吸道感染,导致360万(290万~460万)例住院、26 300(15 100~49 100)例院内死亡以及101 400(84 500~125 200)例可归因于RSV的总死亡数。在0~6个月的婴儿中,共发生660万(460万~970万)次RSV相关急性下呼吸道感染,导致140万(100万~200万)例住院、13 300(6 800~28 100)例院内死亡以及45 700(38 400~55 900)例可归因于RSV的总死亡数。60月龄以下和28 d~6月龄儿童的死亡中分别有2.0%(置信区间为1.6%~2.4%)和3.6%(3.0%~4.4%)归因于RSV。在各年龄组中,95%以上的RSV相关急性下呼吸道感染事件和97%以上的可归因于RSV的死亡事件都发生在中低收入国家。结论 RSV显著增加了全球60月龄以下儿童的发病和死亡负担,尤其是在出生后前6个月和中低收入国家。本研究强调了全球RSV疾病的总体死亡率负担,60月龄以下儿童中,每50例死亡就有1例可归因于RSV;28 d至6个月大的婴儿中,每28例死亡就有1例可归因于RSV。每1例RSV相关急性下呼吸道感染院内死亡,对应社区中约3例可归因于RSV的死亡。对6月龄内婴儿提供保护的RSV被动免疫计划有望对减轻RSV疾病负担,但实施计划时,仍需要更多数据来了解RSV疾病负担高峰可能向大龄转移的影响。

关键词：呼吸道合胞病毒下呼吸道感染儿童疾病负担住院发病率死亡率病死率模型估计系统分析

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