Rabies is a fatal zoonotic infectious disease primarily caused by the rabies virus. Anti-rabies monoclonal antibody (mAb) is developed using modern genetic engineering technology. However, no bibliometric assessment has been conducted to evaluate the scientific progress in this area. A search of articles in the Web of Science (WoS) from January 1, 1991, to November 17, 2024, yielded 455 papers that were analyzed using various online analysis tools. The cumulative publications from 1991 to 2023 followed a linear distribution. The United States and China led this research initiative. Keywords were divided into two clusters, including “monoclonal-antibody” and “post-exposure prophylaxis.” This systematic bibliometric analysis of the literature on anti-rabies monoclonal antibodies will help to reveal the internal relationship of the whole research and development network and promote the perfection of related research and development work to a considerable extent. This study not only delineates the historical trajectory and current status of mAb research but also provides valuable insights and concrete recommendations for future directions.

Background: The 4-dose Essen intramuscular (IM) regimen for rabies post-exposure prophylaxis (PEP) has been recommended by Advisory Committee on Immunization Practices (ACIP) and World Health Organization (WHO), but the large-sample clinical evidence is still limited. Method: Rabies virus neutralizing antibodies of 11,752 patients were detected from 409 rabies prevention clinics in 27 provinces in China. Patients with serum collected before or no later than 1 h after injection on the day of the fifth dose (day 28) of 5-dose Essen regimen were included in Group A to observe the immune efficacy of 4dose Essen IM regimen, and patients with serum collected 14-28 days after injection of the fifth dose were included in Group B to observe the immune efficacy of 5-dose Essen IM regimen. Results: Finally, 2351 cases met the inclusion and exclusion criteria, including 2244 cases in Group A and 107 cases in Group B. The antibody titer of Group A was higher than that of Group B [12.21 (4.15, 32.10) IU/ml vs. 9.41 (3.87, 27.38) IU/ml] (P= 0.002). In Group A, the median antibody titers were 4.01IU/ml, 11.63IU/ml and 29.46IU/ml in patients vaccinated with purified hamster kidney cell vaccine (PHKCV), purified Vero cell vaccine (PVRV), and human diploid cell rabies vaccine (HDCV), respectively, with statistical significance (P< 0.001). Conclusions: The 4-dose Essen IM regimen could provide satisfactory immune effect, and HDCV induced higher antibody titer than PHKCV or PVRV.

本研究对三种人用狂犬病疫苗进行了综合评价和比较。系统搜索了七个电子数据库。使用Cochrane手册v5.1.0评估偏倚风险。个体发病率采用随机效应模型进行整合，成对比较采用网络荟萃分析。共收录了27篇文章，共有18 630名参与者。HDCV总不良反应的合并发生率显著低于PCECV。HDCV导致局部疼痛、发热和乏力的发生率低于PVRV。HDCV引起局部疼痛和发热的发生率低于PCECV。在第7天的血清转化率或第14天的狂犬病病毒中和抗体滴度方面没有观察到显著差异。与其他两种狂犬病疫苗相比，HDCV在安全性方面表现出优势，但在免疫原性方面没有观察到相同的情况。

Objective:To analyze the immune effect of tetanus toxoid (TT) and to provide reference for improving immunoprophylaxis strategies against tetanus.Methods:From 2019 to 2021, the TT-containing vaccine (TTCV) immunization history of patients treated for trauma in Luoshan Street Community Health Service Center of Jinjiang City were investigated. Serum tetanus antibody (TAB) levels were detected in 353 subjects (group A) 5-10 years after TTCV immunization, and the proportions of subjects with different TAB levels (<0.01 IU/ml, 0.01-0.10 IU/ml, >0.10 IU/ml) in different age groups were compared. Sixty-eight subjects (group B) aged 14-83 years with TTCV immunization history and TAB level of 0.01-0.10 IU/ml and 133 subjects (group C) aged 17-77 years without TTCV immunization history were inoculated with one dose and three doses of TT respectively, and the changes in TAB level were observed 28 d after immunization.Results:In group A, the proportions of subjects with different TAB levels in different age groups were statistically significant (χ 2=47.69, P<0.001). The proportions of subjects in which TAB levels were <0.01 IU/ml and 0.01-0.10 IU/ml increased with age. In group B, 66 out of the 68 subjects had TAB >0.10 IU/ml 28 d after one dose of TT immunization. There were statistically significant differences in the proportions of subjects whose TAB levels were 0.01-0.10 IU/ml and >0.10 IU/ml before and after TT immunization (χ 2=128.23, P<0.001). In group C, before three doses of TT immunization, 129 patients had TAB <0.01 IU/ml and four patients had TAB in the range of 0.01-0.10 IU/ml; 28 d after three doses of TT immunization, only one case had TAB in the range of 0.01-0.10 IU/ml and 132 cases had TAB >0.10 IU/ml. The proportions of group C subjects with different TAB levels before and after TT immunization were statistically significant (χ 2=262.80, P<0.001). Conclusions:Five years after TTCV immunization, the proportions of individuals with TAB <0.01 IU/ml and in the range of 0.01-0.10 IU/ml increased with age. For people without TTCV immunization history and those with decreased TAB protection after TTCV immunization, strengthening TT immunization could significantly improve the TAB protection.

目的 了解当前中国蚂蚁螫伤的现状,并提出针对性解决方案.方法 对福建、广东、广西等蚂蚁螫伤高发区的蚂蚁螫伤和蚂蚁螫伤救治数据进行汇总分析.在福建省厦门市、晋江市等蚂蚁螫伤救治医院及华南农业大学红火蚁研究中心开展现场调研,对蚂蚁螫伤事件、蚂蚁螫伤救治情况进行记录.结合蚂蚁螫伤救治专家建议,提出改进中国蚂蚁螫伤救治总体状况的策略及具体工作方案.结果 当前国内蚂蚁螫伤及蚂蚁螫伤救治基线数据缺乏.在蚂蚁分布区域,蚂蚁螫伤事件发生率较高,但是蚂蚁螫伤规范救治率低,蚂蚁螫伤导致的过敏,甚至过敏性休克事件时常可见.国内尚未形成统一的蚂蚁螫伤诊疗规范和治疗标准.群众对蚂蚁螫伤救治的知识了解不足,相关科普宣传严重不足.此外,蚂蚁螫伤相关的破伤风预防工作被严重忽视.为总体提高我国蚂蚁螫伤救治水平,应尽快掌握国内蚂蚁螫伤基线数据,制定国家层面的蚂蚁螫伤诊治规范和治疗标准,广泛开展蚂蚁螫伤救治科普宣传,重视蚂蚁螫伤的破伤风防治工作.结论 中国蚂蚁螫伤救治现状有待改进,应通过系统性工作提高蚂蚁螫伤救治水平.

目的 汇总分析中国蚂蚁螫伤文献,了解我国蚂蚁螫伤的现状及发展态势,从而为进一步规范蚂蚁螫伤的诊治及开展相关研究提供思路和指导.方法 检索万方医学网、维普网及中国知网三大数据库中有关蚂蚁螫伤的文献,以"蚂蚁咬伤、蚂蚁螫(蜇)伤、红火蚁咬伤、红火蚁螫(蜇)伤"为检索词在"主题"字段进行检索,经过遴选后,对纳入文章从年份、期刊、地区及发文机构、研究类型,患者性别、年龄、螫伤部位、就诊时间、治疗方法、治愈时间等资料,进行汇总分析.结果 通过检索筛选最终纳入32篇有效文献,平均每年(1.39±1.28)篇,均为临床研究或报道;共纳入蚂蚁螫伤病例862例,以福建省泉州市、广东省阳江市、广东省广州市报道病例居多;蚂蚁螫伤病情程度来看,轻中型患者居多,重型患者少见,病情严重者可合并心肺等多器官功能损伤;中西医结合治疗均能起到一定疗效,但尚无特效药物.结论 我国蚂蚁螫伤整体研究水平偏低,蚂蚁毒素的成分及致病机制尚未完全明确,其治疗上暂无特效药物,应加强预防宣传工作以减少蚂蚁螫伤及危重患者数量.

Objective:To evaluate the immunogenicity and immune persistence of purified Vero cells rabies vaccine (PVRV) with Zagreb and Essen regimen.Methods:Prospective study: Patients with first Class II exposure to rabies were recruited from the Dog Injury Cinic of Guangxi Center for Disease Control and Prevention (Guangxi CDC) and randomly divided into the Zagreb (2-1-1) and Essen (1-1-1-1-1) regimen group. All patients were inoculated with the vaccines from the same manufacturer and batch, and 3 ml serum was collected at the 45th day and in 1-year, 2-year and 3-year after immunization. Rapid fluorescent inhibition test (RFFIT) was used to detect rabies virus neutralizing antibody (RVNA). The attenuation of RVNA positive rate and geometric mean titer (GMT) with time was analyzed. Retrospective study: The informed consents for rabies vaccine in the Dog Injury Clinic of Guangxi CDC were checked out. The patients who were injected with PVRV (same manufacturer but unlimited batch) but without passive immune agents for the first time within 3 years were selected and divided into 1-year, 2-year and 3-year group. Each group was further divided into Zagreb and Essen regimen group. The serum (3 ml) was collected at 1 year, 2 years and 3 years after immunization and detected the RVNA by RFFIT.Results:Prospective study: The RVNA positive rates on the 45th day and in 1-year, 2-year and 3-year after immunizationin in the Zagreb and Essen regimen group were 100%, 95%, 85%, 80% and 98.25%, 89.47%, 89.47%, 85.96%, respectively. There was no statistically significant difference in the RVNA positive rates at the same time point between the two regimen groups ( P>0.05). The RVNA GMT on the 45th day and in 1-year, 2-year, and 3-year in the Zagreb and Essen regimen group were 11.32 IU/ml, 1.69 IU/ml, 1.30 IU/ml, 1.30 IU/m and 13.18 IU/ml, 2.13 IU/ml, 1.87 IU/ml, 1.84 IU/m, respectively. There was no significant difference in the RVNA GMT levels at the same time point between the two regimen groups ( F=1.971, P=0.164). The RVNA GMT levels in the two regimen groups had the same trend of attenuation over time (time*group F=0.702, P=0.435). Retrospective study: The RVNA positive rates in 1-year, 2-year and 3-year after immunization in the Zagreb and Essen regimen group were 100%, 95%, 91.43%和94.73%, 86.21%, 87.5%, respectively. There was no statistically significant difference in the RVNA positive rates at the same time point between the two regimen groups ( P>0.05). The RVNA GMT in 1-year, 2-year, and 3-year groups after immunization in the Zagreb and Essen regimen group were 2.65 IU/ml, 2.03 IU/ml, 1.57 IU/ml和3.2 IU/ml, 2.58 IU/ml, 2.45 IU/ml, respectively. There was no significant difference in the RVNA GMT levels at the same time point between the two regimen groups ( P>0.05). Conclusions:The PVRV showed the same excellent immunogenicity and immune persistence after the vaccination with the Zagreb and Essen regimens.

狂犬病是由狂犬病病毒感染引起的人畜共患传染病,病死率几乎100％.预防人狂犬病暴露后狂犬病发生的唯一有效手段是规范的暴露后预防处置.本文介绍了暴露后狂犬病疫苗免疫程序的演变,总结了狂犬病疫苗简化4针法免疫程序的效果和优势,从疫苗质量、疫苗监管政策、公共卫生体系等方面分析了推行狂犬病疫苗简化4针法免疫程序的基础条件和可行性.

目的 通过文献分析了解动物和人咬伤患者发生破伤风的情况.方法 检索中国知网数据库、万方数据库、维普数据库和MEDLINE、Web of Science、EMBASE数据库,中文检索词为动物咬伤、动物致伤、犬咬伤、蛇咬伤和破伤风,英文检索词为dog bite、snake bite、cat bite、human bite和tetanus,检索时间1889年1月—2019年12月.采用Excel表整理资料,总结动物和人咬伤患者发生破伤风的特征.结果 共检索到46篇文献,其中21篇明确记录了动物和人咬伤患者并发破伤风,包括中文文献8篇、英文文献13篇;共31例患者,其中中国13例、尼日利亚9例、印度3例、日本2例、津巴布韦1例、爱尔兰2例、泰国1例;1例人咬伤部位为舌头,1例狮子咬伤部位为颈部及四肢,1例无明显伤口,其余28例均为四肢;3例为人咬伤,7例为犬咬伤,18例为蛇咬伤,1例为猫咬伤,1例为狮子咬伤;6例咬伤前注射了破伤风疫苗,2例咬伤后注射了破伤风抗毒素,死亡7例.结论 动物和人咬伤是破伤风发生的高风险因素,破伤风类毒素主动免疫不足是主要发病原因.动物和人咬伤需要加强破伤风的防治.

目的 了解福建省晋江市健康人群破伤风抗体(TAB)状况.方法 采用分层随机抽样法,采集晋江市2019年各年龄段健康人群血清,通过酶联免疫吸附试验(ELISA)检测血清TAB水平.使用Excel软件整理数据,运用SPSS 22.0软件进行不同组间TAB阳性率差异比较.结果 775份调查样本中,TAB总体阳性率为39.2％(304/775),各年龄组TAB阳性率分别为71.9％(87/121,8～20岁)、53.6％(82/153,21～30岁)、39.3％(57/145,31～40岁)、25.2％(38/151,41～50岁)、16.2％(17/105,51～60岁)和23.0％(23/100,61岁以上);有含破伤风类毒素疫苗(TTCV)免疫史人群TAB阳性率为70.7％(164/232),无免疫史或免疫史不明人群TAB阳性率为25.8％(140/543);TAB阴性者从事破伤风高危行业和低危行业的人群,年龄组分布差异有统计学意义(x2=62.185;P＜0.000);破伤风高危行业人群中40～50岁年龄组比例为46.79％.结论 晋江市健康人群TAB阳性率随年龄增长呈下降趋势,应重视开展TTCV的加强免疫工作.

动物伤害比较普遍存在,可导致人的创伤、感染、中毒、过敏等.动物伤害救治涉及临床医学、预防医学、生物制品学等多学科交叉.我国动物伤害的基线研究资料匮乏,动物伤害救治发展相对滞后.把握动物伤害救治的独特性,整合专业力量,加强学术工作,制定诊治标准,开展疾病监测,倡导创新研究,发展动物伤害救治医学,有效保障人民群众生命健康.我国动物伤害救治医学在学科化、专业化轨道上稳步发展.

随着对狂犬病研究的深入,狂犬病的定义内涵已经改变,现代狂犬病免疫预防技术手段已经成熟,狂犬病治疗取得较大突破.犬的免疫预防是狂犬病控制最具成效的手段,狂犬病免疫预防生物制品质量的普遍提高和广泛应用为狂犬病控制提供了坚实的保障,得益于医疗救治条件和抗狂犬病治疗药物的进步,人类治疗狂犬病已经可以期待.我国对狂犬病控制高度重视,将2030年消除犬传人的狂犬病作为既定目标,中国消除犬传人的狂犬病将是人类公共卫生事业中的又一重大事件.

目的 揭示非标准方法检测狂犬病病毒抗体阴性血清真实的狂犬病病毒中和抗体状态,指导基层狂犬病门诊正确认识非标准方法检测结果的意义.方法 收集狂犬病疫苗免疫个体经酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)和胶体金(colloidal gold,CG)法检测狂犬病病毒抗体阴性血清,采用快速荧光灶抑制试验(rapid fluorescent focus inhibition test,RFFIT)进行复核,Excel表统计数据.结果 ELISA、CG法检测1 053、1 321份血清,其中102(9.69％,102/1053)、183(13.86％,183/1321)份血清为阴性,经RFFIT复核确证6(5.88％,6/102)、14(7.65％,14/183)份血清阴性.ELISA、CG法阴性结果的多数样品(88.55％、96.45％)经RFFIT检测狂犬病病毒中和抗体效价0.5～2.0 IU/mL.结论 狂犬病病毒抗体非标准检测方法灵敏性有待提高,对其阴性检测结果应谨慎解读.

Objective To improve the ability of medical staff to carry out post-exposure prophylaxis (PEP) and deal with emergencies through the investigation and treatment of the dog-biting event. Methods Epidemiological investigation was conducted on rabies exposed cases in an incident of dog-biting event by using "Rabies Case Questionnaire". PEP was carried out in time. The effects of PEP were ob?served by laboratory test and follow-up. Results One dog injured 41 people. The standard wound disposal rate was 100%, vaccination rate of rabies vaccine was 100%, human immunoglobulin (HRIG) use rate was 97.56%. Antibodies against rabies virus of all cases were positive 20 days after the end of the vaccination. No cases of rabies occurred during the follow-up. Conclusion Standardized PEP after rabies expo?sure can effectively prevent the occurrence of rabies and reduce the social hazards of serious dog injury incident. Dog management should be strengthened to prevent the occurrence of dog injury incident.