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Oluwaseun S, Yang C, Si Tu SJ, Yin J, Song Y, Sun Q, Kanibir N, Hartwig S, Carias C. Health impact of rotavirus vaccination in China. Hum Vaccin Immunother 2024; 20:2386750. [PMID: 39269780 PMCID: PMC11404606 DOI: 10.1080/21645515.2024.2386750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 07/16/2024] [Accepted: 07/29/2024] [Indexed: 09/15/2024] Open
Abstract
Rotavirus (RV) vaccines have demonstrated substantial effectiveness in reducing the healthcare burden caused by gastroenteritis (RVGE) worldwide. This study aims to understand the differential impact of RV vaccination in reducing RVGE burden in children under 7 years old in China. A Markov Model was used to investigate the health impact of introducing two different RV vaccines into the Chinese population. The analysis was conducted for RV5, a live pentavalent human-bovine reassortant vaccine, and Lanzhou Lamb RV (LLR), a live-attenuated monovalent RV vaccine, separately, by comparing the strategy of each vaccine to no vaccination within a Chinese birth cohort, including 100,000 children modeled until 7 years of age. The vaccination scenario assumed a vaccination coverage of 2.5%, 2.5%, 90% and 5% for doses one, two, three and no vaccine, respectively, for both vaccines. Strategies with RV5, LLR, and no vaccination were associated with 9,895, 49,069, and 64,746 symptomatic RV infections, respectively. RV5 and LLR were associated with an 85% and 24% reduction in the total symptomatic RV infections, respectively, suggesting that the health benefits of RV5 are at least three-fold greater than those associated with the LLR. Further, strategies with RV5 and LLR resulted in an estimated 206 and 59-year increase in quality-adjusted life years (QALYs), respectively. Sensitivity and scenario analyses supported the robustness of the base-case findings. Use of RV vaccine is expected to improve RV-associated health outcomes and its adoption will help alleviate the burden of RVGE in China. RV5 use will result in significantly better health outcomes.
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Affiliation(s)
| | | | | | - Jia Yin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yan Song
- HEOR, Epidemiology & Market Access, Analysis Group, Boston, MA, USA
| | - Qiang Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Nabi Kanibir
- Global Medical and Scientific Affairs, MSD International GmBH, Luzern, Switzerland
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Zhang L, Yang Z, Yin Y, Huang W, Yi T, Ping J, Liu L, Shen P, Sun Y, Lin H. Using big data to analyze the vaccination status of children with congenital heart disease in Yinzhou District, China. Hum Vaccin Immunother 2024; 20:2319967. [PMID: 38465660 PMCID: PMC10936686 DOI: 10.1080/21645515.2024.2319967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/14/2024] [Indexed: 03/12/2024] Open
Abstract
Congenital heart disease (CHD) represents a significant population warranting particular attention concerning vaccination coverage. To comprehend the vaccination status of CHD within Yinzhou District, Ningbo City, China, and to facilitate the formulation of preventive, control, and immunization strategies against vaccine-preventable diseases in children with congenital heart conditions. Using the China Yinzhou Electronic Health Record Study (CHERRY) database, we analyzed the vaccination coverage of children with CHD born between January 1, 2016 and September 20, 2021, and analyzed the influencing factors associated with the level of vaccination coverage. This study involved 762 children diagnosed with CHD at the age of 12 months, revealing that 86.74% of these children had received at least one dose of the National Immunization Program (NIP) vaccines. The coverage for non-NIP vaccines, such as the rotavirus vaccine, influenza vaccine, Influenza Haemophilus influenzae Type b (Hib) Conjugate Vaccine, 13-valent pneumococcal conjugate vaccine (PCV13), and inactivated enterovirus type 71 vaccine (EV71), stood at 27.30%, 7.74%, 63.25%, 33.76%, and 34.51%, respectively. The completion coverage for the entire vaccination schedule were 27.30%, 5.51%, 55.77%, 34.25%, and 25.59%, respectively. There was a statistically significant correlation between vaccination coverage in classification of diagnostic medical institutions and the types of diagnosed diseases. Compared to their typically developing counterparts, 12-month-old children afflicted with CHD exhibit a slightly diminished vaccination coverage, alongside a discernible inclination toward delayed vaccination. Notably, the determination to undergo vaccinations seems predominantly influenced by the classification of diagnostic medical institutions. In practical terms, proactive measures involving early diagnosis, comprehensive health assessments, and timely interventions ought to be implemented to enhance vaccination rates while prioritizing safety.
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Affiliation(s)
- Lin Zhang
- Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Ziliang Yang
- Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Yueqi Yin
- Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Wenzan Huang
- Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Tianfei Yi
- Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Jianming Ping
- Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Liya Liu
- Medical School, Department of Preventive Medicine, Ningbo University, Ningbo, Zhejiang, PR China
| | - Peng Shen
- Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Yexiang Sun
- Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Hongbo Lin
- Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China
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Lin SY, Zhang SY, Chantler T, Sun FY, Zou JT, Cheng JJ, Chen YQ, Sun M, Howard N. Vaccination coverage determinants in low uptake areas of China: a qualitative study of provider perspectives in Sichuan, Guangdong, and Henan Provinces. Hum Vaccin Immunother 2022; 18:2030623. [PMID: 35176962 PMCID: PMC8993075 DOI: 10.1080/21645515.2022.2030623] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
China’s immunization programme is relatively strong, with latest WHO-UNICEF monitoring rates for 2019 showing national vaccination coverage over 90%. However, vaccination coverage is heterogeneous, varying across geographic regions, rural–urban communities, and sub-populations. We conducted a qualitative study from a critical realist perspective, analyzing semi-structured interviews with 26 vaccination providers in three provinces, selected to represent regional socioeconomic disparities across Eastern, Central, and Western China. We analyzed data thematically, using deductive and inductive coding. Providers reported vaccination coverage in their areas had increased significantly, but remained lower among migrant and left-behind children. Main coverage determinants were child-related (i.e. gender, number, health status), caregiver-related (i.e. socioeconomic status, role, education level, ethnicity), institution-related (i.e. vaccinator numbers, information system, appointment process), and system-related (i.e. vaccine supply, intersectoral cooperation, vaccine ‘hesitancy’). Potentially effective measures to promote vaccination coverage included using routine maternal and child health-care visits for catch-up vaccination, providing additional health education, conducting follow-up family visits by village doctors, and requiring vaccination verification at school enrollment. This is the first qualitative study to examine potential determinants of low vaccination coverage in these areas of China. Findings can inform policies to strengthen the role of schools, develop the national immunization information system, and promote appointment apps. More consideration is needed to improve service quality and eliminating inequities, such as strengthening health education and service provision for migrant and left-behind children.
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Affiliation(s)
- Shi-Yu Lin
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China.,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shi-Ya Zhang
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China.,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Tracey Chantler
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Fiona Yueqian Sun
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, University of London, London, UK
| | - Jia-Tong Zou
- Department of Organization and Personnel, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jie-Jie Cheng
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China.,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yu-Qian Chen
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China.,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Mei Sun
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China.,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Natasha Howard
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.,Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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Wang C, Su L, Mu Q, Gu X, Guo X, Wang X. Cost-effectiveness analysis of domestic 13-valent pneumococcal conjugate vaccine for children under 5 years of age in mainland China. Hum Vaccin Immunother 2021; 17:2241-2248. [PMID: 33577390 PMCID: PMC8189113 DOI: 10.1080/21645515.2020.1870396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/25/2020] [Indexed: 10/22/2022] Open
Abstract
Background: The first Chinese domestic 13-valent pneumococcal conjugate vaccine (WoAnxin®, PCV-13) is available for children aged 2 months to 5 years and is more economical than import vaccine with equal safety and immunogenicity. However, the cost-effectiveness of this new PCV-13 for children <5 years in mainland China is not clear. Methods: In the present study, we developed a Markov model under societal perspective to evaluate the incremental cost-effectiveness ratios (ICERs) of five birth cohorts of 100,000 Chinese infants across four alternative vaccination programs:1) no vaccination; 2) vaccinate 4 doses of new PCV-13 for children aged 2 to 6 months; 3) vaccinate 3 doses of new PCV-13 for children aged 7 to 11 months; 4) vaccinate 2 doses of new PCV-13 for children aged 12 to 23 months; 5) vaccinate 1 dose of new PCV-13 for children aged 2 to 5 years. We conducted one-way and probability sensitivity analysis to determine the uncertainty of the model findings. Results: We found that with awillingness-to-pay (WTP) threshold of three-times Chinese per-capita gross domestic product (GDP) all vaccination programs were cost-effective compared to no vaccination and children aged 2 to 5 years received 1 dose of new PCV-13 would incur the lowest additional cost of US$2417 per quality-adjusted-life-years (QALYs) compare with other vaccination programs ($15394/QALYs for 4 doses program, $9292/QALYs for 3 doses program, $4445/QALYs for 2 doses program). Conclusions: According to our results, China should give priority to incorporating new PCV-13 into its national immunization program.
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Affiliation(s)
- Caixia Wang
- Institute of Health Education, Gansu Provincial Center for Disease Prevention and Control, Lanzhou, China
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Li Su
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Qiuling Mu
- Clinical Nursing College, Gansu Provincial Health Vocational College, Lanzhou, China
| | - Xueyan Gu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xuejun Guo
- School of Business Administration, Lanzhou University of Finance and Economics, Lanzhou, China
| | - Xuxia Wang
- Institute of Health Education, Gansu Provincial Center for Disease Prevention and Control, Lanzhou, China
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Ye L, Chen J, Fang T, Ma R, Wang J, Pan X, Dong H, Xu G. Vaccination coverage estimates and utilization patterns of inactivated enterovirus 71 vaccine post vaccine introduction in Ningbo, China. BMC Public Health 2021; 21:1118. [PMID: 34112128 PMCID: PMC8194148 DOI: 10.1186/s12889-021-11198-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 06/03/2021] [Indexed: 11/23/2022] Open
Abstract
Background In China, enterovirus 71 (EV71) is the major etiological agents of hand foot mouth disease that poses severe risks to children’s health. Since 2015, three inactivated EV71 vaccines have been approved for use. Previous studies indicated the high willingness of EV71 vaccination in eastern China. However, few studies have assessed coverage and utilization patterns of EV71 vaccine in China. Methods Children born during 2012–2018 were sampled and their records were abstracted from Ningbo childhood immunization information management system. Descriptive statistics characterized the study population and assessed coverage and timeliness for EV71 vaccination. Simultaneous administration patterns as well as type of EV71 vaccine used were also evaluated. Bivariate and multivariable analysis was used to examine the relationship of socio-demographic characteristics with vaccination coverage and timeliness. Results Of 716,178 children living in Ningbo. One hundred seventy-two thousand two hundred thirty-six received EV71 vaccine with a coverage rate of 24.05% and only 8.61% received vaccination timely. 21.97% of children received the complete two dose EV71 series but only 6.49% completed timely. Vaccination coverage and timeliness increased significantly from 2012 birth cohort to 2018 birth cohort. Relatively higher coverage and timeliness were observed in resident children, Inner districts, high socioeconomic areas and large-scaled immunization clinics. Of 329,569 doses of EV71 vaccine, only 5853(1.78%) doses were administered at the same day as other vaccines. Conclusions There is a need for increasing EV71 vaccination coverage and timeliness as well as eliminating disparities among different populations. Our study highlights the importance of simultaneous administration to increasing coverage and timeliness of EV71 vaccination.
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Affiliation(s)
- Lixia Ye
- Ningbo Municipal Center for Disease Prevention and Control, Institute of Immunization and Prevention, Yongfeng Road, Haishu District, Ningbo, 315010, China
| | - Jieping Chen
- Ningbo Municipal Center for Disease Prevention and Control, Institute of Immunization and Prevention, Yongfeng Road, Haishu District, Ningbo, 315010, China
| | - Ting Fang
- Ningbo Municipal Center for Disease Prevention and Control, Institute of Immunization and Prevention, Yongfeng Road, Haishu District, Ningbo, 315010, China
| | - Rui Ma
- Ningbo Municipal Center for Disease Prevention and Control, Institute of Immunization and Prevention, Yongfeng Road, Haishu District, Ningbo, 315010, China
| | - Jianmei Wang
- Ningbo Municipal Center for Disease Prevention and Control, Institute of Immunization and Prevention, Yongfeng Road, Haishu District, Ningbo, 315010, China
| | - Xingqiang Pan
- Ningbo Municipal Center for Disease Prevention and Control, Institute of Immunization and Prevention, Yongfeng Road, Haishu District, Ningbo, 315010, China
| | - Hongjun Dong
- Ningbo Municipal Center for Disease Prevention and Control, Institute of Immunization and Prevention, Yongfeng Road, Haishu District, Ningbo, 315010, China
| | - Guozhang Xu
- Ningbo Municipal Center for Disease Prevention and Control, Institute of Immunization and Prevention, Yongfeng Road, Haishu District, Ningbo, 315010, China.
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Timeliness, completeness, and timeliness-and-completeness of serial routine vaccinations among rural children in Southwest China: A multi-stage stratified cluster sampling survey. Vaccine 2021; 39:3236-3249. [PMID: 33966907 DOI: 10.1016/j.vaccine.2021.04.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/31/2021] [Accepted: 04/23/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Vaccination coverage is widely used as metric of vaccination programme performance. However, VPDs outbreaks were reported in areas with high vaccination coverage. Timeliness and completeness have been considered more important assessment indicators of routine vaccination than overall vaccination coverage, but little is known in rural China. This study aimed to assess the timeliness and completeness of serial routine vaccinations among children in rural Southwest China. METHODS A multi-stage stratified cluster survey was conducted among 1062 children aged 18-48 months in rural Guangxi. Vaccination status was obtained from child's vaccination certificate. We calculated timely vaccination coverage, complete vaccination coverage, timely-and-complete vaccination coverage and 95% CI for routine vaccination through weighted estimation analysis. Weighted Kaplan-Meier analyses were applied to estimate the median delay periods for each dose of serial routine vaccines, including one-dose BCG, three-dose HepB, three-dose OPV, four-dose DTP, two-dose MCV, two-dose JEV and two-dose MPV-A. Complete coverage, and timely-and-complete coverage for combined 5-vaccine series were calculated. RESULTS For each dose of routine vaccines, overall vaccination coverages were over 90%, but timely vaccination coverage ranged from the lowest of 44.4% for JEV1 to the highest of 92.5% for MPV-A1. For multi-dose routine vaccines, complete vaccination coverages varied from the lowest of 92.9% for MCV to the highest of 100% for HepB, and timely-and-complete vaccination coverages were lower than 80%, ranging from the lowest of 30% for JEV to the highest of 77.2% for MPV-A. For combined 5-vaccine series, complete coverage was 77%, while timely-and-complete coverage was 12.1%. MPV-A1 had the longest median delay of 176 days, but BCG and HepB1 had the shortest of 1 day. CONCLUSIONS The overall coverages of serial routine vaccinations were high, but the timeliness and completeness were poor. Relevant agencies of vaccination service should address timeliness-and-completeness into the assessment indicators of routine vaccination service quality.
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Impact of the Universal Two-Child Policy on the Workload of Community-Based Basic Public Health Services in Zhejiang Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162880. [PMID: 31408983 PMCID: PMC6720011 DOI: 10.3390/ijerph16162880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 02/07/2023]
Abstract
We aimed to quantitatively estimate the amount of pressure that was placed on basic public health care services (BPHS) due to the universal two-child policy issued in 2015 by comparing the workload change in maternal and child health management and the immunization of children. BPHS performance surveillance data from 2014 to 2018 in Zhejiang Province, China were analyzed to calculate the workload of the above three services using the equivalent method of BPHS cost estimation of community health services. From 2014 to 2018, the numbers of births from the Statistical Yearbook in Zhejiang Province were 578,000, 581,000, 624,000, 670,000, and 628,000, respectively, and those from the surveillance data were 416,941, 41,490, 434,163, 546,816, and 45,964, respectively. The number of births reached a peak in 2017, with the yearbook and surveillance data showing increases of 15.92% and 31.15%, respectively, over 2014. The workload of maternal and child health management and children’s immunization also peaked in 2017, increasing by 30.37%, 12.70%, and 4.33% over 2014, respectively. In 2018, the workload of maternal and child health management and children’s immunization dropped to 107.34%, 107.73%, and 98.81% over 2014, respectively. The indicators of maternal and child health management and children’s immunization services remained stable, and the related services did not decline, even in 2017. The maternal health management workload was more affected by the universal two-child policy than child health management and children’s immunization.
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Zhang Y, Quan L, Xiao B, Du L. The 100 top-cited studies on vaccine: a bibliometric analysis. Hum Vaccin Immunother 2019; 15:3024-3031. [PMID: 31112440 DOI: 10.1080/21645515.2019.1614398] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective: The objective of this study was to analyze the 100 most cited studies on vaccine.Methods: A comprehensive search of studies on vaccine was performed in the Web of Science Core Collection without year or language restrictions. The 100 top-cited studies were retrieved after screening abstracts or full-texts. The outcomes of bibliometric analysis included citation time, citation density, journal name, impact factor, publication year, article type, category, open access, and country of origin.Results: The citation times for the 100 top-cited studies ranged from 593 to 2406, with a median citation times of 834. The 100 top-cited studies were published in 32 journals, and the journal with the most studies was New England Journal of Medicine (n = 20). They were published between 1969 and 2012, and 4 authors published at least 2 studies as the first author. The USA contributed the most studies (n = 70), followed by Switzerland (n = 4), England (n = 4) and Finland (n = 4). Eighty-one studies were published as Article, while 19 were Review. Eleven studies were about vaccine for therapeutic and 68 studies were about vaccine for prophylactic.Conclusions: This is the first bibliometric analysis to provide a detailed list of the 100 most-cited studies on vaccine and helps to recognize the quality of the works, discoveries, and trends in the field.
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Affiliation(s)
- Yonggang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.,Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Liuliu Quan
- West China School of Medicine, Sichuan University, Chengdu, P.R. China
| | - Bowen Xiao
- West China School of Medicine, Sichuan University, Chengdu, P.R. China
| | - Liang Du
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.,Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
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