White blood cell (WBC) count has been associated with diabetic risk, but whether the correlation is independent of other risk factors has hardly been studied. Moreover, very few such studies with large sample sizes have been conducted in Chinese. Therefore, we investigated the relationship between WBC count and glucose metabolism in china. We also examined the relevant variables of WBC count. A total of 9,697 subjects (mean age, 58.0 ± 9.1 years) were recruited. The subjects were classified into four groups, including subjects with normal glucose tolerance, isolated impaired fasting glucose, impaired glucose tolerance and type 2 diabetes mellitus (T2DM). We found that WBC count increased as glucose metabolism disorders exacerbated. WBC count was also positively correlated with waist hip ratio, body mass index, smoking, triglycerides, glycosylated haemoglobin A1c (HbA1c) and 2-h postprandial glucose. In addition, high density lipoprotein and the female gender were inversely correlated with WBC count. In patients with previously diagnosed T2DM, the course of T2DM was not correlated with WBC count. Our findings indicate that elevated WBC count is independently associated with worsening of glucose metabolism in middle-aged and elderly Chinese. In addition, loss of weight, smoking cessation, lipid-modifying therapies, and control of postprandial plasma glucose and HbA1c may ameliorate the chronic low-grade inflammation.

Streptococcus pneumoniae is an important pathogen causing invasive diseases such as sepsis, meningitis, and pneumonia. Vaccines have become the most effective way to prevent pneumococcal infections. This phase III trial was designed to evaluate the immunogenicity and safety of a 23-valent pneumococcal polysaccharide vaccine in Chinese healthy population aged >2 years. We conducted a randomized, double-blinded, active-controlled, multicenter trial in which 1660 healthy population (>2 years of age) were randomly assigned in a 1 : 1 ratio to receive 2 intramuscular doses of either the treatment vaccine or the active control vaccine, PNEUMOVAX 23. The surveillance period was 30 days. The primary end point was the 2-fold increase rate of anti-pneumococcal antibody for all 23 included serotypes in each group. In the intention-to-treat cohort, the 2-fold increase rate of anti-pneumococcal antibody for 23 included serotypes varied from 62.47% to 97.01% in the treatment group, and from 51.49% to 95.77% in the control group. According to −10% non-inferiority margin and 95% confidence intervals of rate difference, almost all included serotypes of the treatment group reached non-inferiority to control group except for serotype 6B, the lower limit of rate difference of which was −10.00%, equal to the non-inferiority margin. The 2-fold increase rates of anti-pneumococcal antibody were significantly higher in the treatment group for serotype 2, 3, 4, 10A, 11A and 20. Furthermore, for all 23 serotypes, IgG geometric mean concentrations (GMCs) at day 30 were significantly higher in treatment group for serotype 2, 3, 4, 9V, 10A, 11A, 15B, 18C, 19A, 22F and 33F. Higher geometric mean fold increase (GMFI) were also observed in the treatment group correspondingly. Serious adverse events occurred in 3 of 830 participants in the treatment group (0.36%) and 2 of 830 participants in the control group (0.24%). No death occurred during the trial. The frequencies of both solicited and unsolicited adverse events (AEs) were small lower in the treatment group (34.34% vs 35.66% for solicited AEs, 4.34% vs 5.42% for unsolicited AEs). Both vaccines were well tolerated and most AEs were mild or moderate in intensity. The newly vaccine was well tolerated and immunologically non-inferior to the active control vaccine PNEUMOVAX 23 for all 23 vaccine serotypes in the Chinese population (>2 years of age).

Biostatistics is a key but challenging subject in medical curricula that is usually delivered via a didactic approach in China. However, whether it is the best teaching approach to improve the learner’s competency, especially for medical postgraduates is yet to be proved. Therefore, a block curriculum design was initially developed to provide selective education to the postgraduates towards the professional career of their interest. A questionnaire was designed to assess the students’ perceptions toward biostatistics as these affective factors might impact the learning process. Thus, the present study aimed to detect whether the new block curriculum design could promote the students’ positive perceptions and further improve the course achievement. This cohort study investigated and assessed the perceptions toward biostatistics of the first-year postgraduates undergoing traditional teaching and block teaching, respectively. Structural equation modeling was applied to explore the association between perception and course achievement in the block teaching group. With a response rate of 97.84 and 96.67% from the two cohorts respectively, 499 block teaching postgraduates had more positive perceptions as compared to 465 traditionally teaching postgraduates with Likert 5-point agreement response mean of 3.50 vs. 3.31 for course value, 3.66 vs. 2.97 for course comment, and 4.29 vs. 4.10 for expectation. Moreover, block teaching students presented superior confidence about academic statistical knowledge, and therefore, 77.96% of them approved of the new teaching approach. Age, specialty, research experience, logical thinking capacity, mathematical basics, and computer basics might influence the postgraduates’ self-assessment ability (all P < 0.05). Structural equation modeling confirmed a positive correlation between perceptions and the course achievements with a reasonable fit. The block curriculum design in the biostatistics course improved the postgraduates’ positive perception and may have had a positive role in improving postgraduates’ achievement in learning biostatistics.