肾综合征出血热Ⅰ型灭活疫苗接种和对照人群隐性感染的比较

目的比较肾综合征出血热Ⅰ型灭活疫苗接种组和对照组人群隐性感染率,了解肾综合征出血热Ⅰ型灭活疫苗时发生隐性感染有无增强作用。方法1994年7月-1997年11月在建德市肾综合征出血热Ⅰ型灭活疫苗随机对照试验现场,采集接种组和对照组双份血清各401和360人份,检测间接荧光抗体。分别按对照组免疫前间接荧光抗体阳性和阴性的第2份血清间接荧光抗体滴度分布清况确定cut－off值,由此判断免疫前间接荧光抗体阳性和阴性这两组人群发生隐性感染情况。结果采用不同的cut－off值来比较接种组和对照组免疫前间接荧光抗体阳性人群的隐性感染率,差异无显著性。在免疫前抗体阴性的接种组和对照组中,对照组隐性感染率为7.62％,按cut－off值为1：160和1：320,接种组人群隐性感染率分别是2．17％和1．63％,与对照组隐性感染率比较差异有显著性;按cut-off值为1：20和1：40,接种组隐性感染率分别是11.38％和6．78％,同对照组隐性感染率差异无显著性。结论未见肾综合征出血热Ⅰ型灭活疫苗对接种人群隐性感染的发生有增强作用。     

肾综合征出血热I型灭活疫苗接种和对照人群隐性感染的比较

目的 比较肾综合征出血热Ｉ型灭活疫苗接种组和对照组人群隐性感染率,了解肾综合征出血热Ｉ型灭活疫苗对发生隐性感染有无增强作用。方法 １９９４年７月～１９９７年１１月在建德市肾综合征出血热Ｉ型热灭活疫苗随机对照现场,采集接种组和对照组双份血清各４０１和３６０人份,检测间接荧光抗体,分别按对照免疫前间接荧光抗体阳性和阴性的第２份血清间接荧光抗体滴度分布情况确定ｃｕｔ－ｏｆｆ值,由此判断免疫前接荧光抗体阳     

双价肾综合征出血热灭活疫苗免疫反应的动态观察

为动态观察沙鼠肾原代细胞双价肾综合征出血热灭活疫苗免疫动物后的免疫反应 ,采用人用剂量的 1/ 2 0肌内注射免疫小鼠 ,局部麻醉下采集尾血 ,分离血清 ,用间接酶联免疫吸附试验 (ELISA)测定血清抗体水平 ;处死动物时分离腹股沟淋巴结和脾脏淋巴细胞进行分类计数。结果显示 :双价肾综合征出血热疫苗在初次免疫后第 2针血清抗体有较大提高 ,并维持在高水平。流式细胞分类计数 ,疫苗注射组腹股沟淋巴结CD+ 4 细胞的免疫荧光强度显著高于对照组 (P<0 0 5 ) ,但脾脏的B细胞荧光强度却显著低于对照组 (P<0 0 5 ) ,提示接种该疫苗后细胞免疫亢进。表明沙鼠肾原代细胞双价肾综合征出血热灭活疫苗随接种时间的推移 ,产生良好的免疫反应。这种反应在免疫 2针后能够维持较高水平。该疫苗的免疫机理可能是通过局部淋巴结对抗原呈递来实现的。同时提示 ,疫苗可能造成细胞免疫功能亢进     

肾综合征出血热双价灭活疫苗免疫原性和安全性观察

目的　在肾综合征出血热双价灭活疫苗随机对照试验现场,观察接种人群的免疫效果和副反应发生情况。方法　分别检测１６７ 名和６９ 名基础三针接种者免疫后２ 周血清荧光抗体和中和抗体（Ⅰ和Ⅱ型） ,重点观察６５７ 名接种者免疫后７２ 小时内副反应发生情况。结果　荧光抗体阳转率和几何平均滴度分别为９９．０４％ （１６６／１６７）和２４．５１±２．０６;中和抗体总阳转率为１００ ％ ,其中Ⅰ型为９１．３０％ （６３／６９）、Ⅱ型为８８．４１％（６１／６９） ;中和抗体对Ⅰ型和Ⅱ型几何平均滴度分别为１８．２７±２．２１ 和１２．４７±２．１６ ;接种３ 针疫苗局部反应发生率为１．４８％ ,全身体温反应发生率为０ ．３６ ％ ;未见人群接种后发生严重副反应和异常反应。结论　肾综合征出血热双价灭活疫苗免疫效果良好,接种副反应低。     

肾综合征出血热疫苗接种后血清抗体水平变化

目的 观察肾综合征出血热疫苗在高发疫区大面积人群接种后的血清抗体水平变化,评价疫苗免疫效果。方法 以村为单位,１６～６０岁健康（删除既往患肾综合征出血热、外出〉９个月及疫苗禁忌证）为观察对象,按接种和对照各半的原则随机分组,接种组共１０４６０人,对照组１６１５９人。采用间接免疫荧光法测特异性ＩｇＧ荧光抗体,用微量细胞病变中和试验测中和抗体。结果 接种前血清抗体阴性全程接种后２周,荧光抗体阳转     

肾综合征出血热疫苗效果免疫(感染)增强和免疫策略研究中期评估报告

目的：继续观察沙鼠肾细胞Ⅰ型灭活疫苗、乳鼠脑纯化Ⅰ型灭活疫苗和地鼠肾细胞Ⅱ型灭活疫苗的安全性、血清学和防病效果。方法：采取现场与实验室结合的方法。现场试验人群采用整体随机分组，分为疫苗接种组和对照组。实验室血清抗体采用间接免疫荧光法（ＩＦＡＴ）、微量安全性较好，临床上未出现接种人群免疫（感染）增强反应。从３种疫苗全程基础免疫后１４天、１年、２年和３年时中和抗体和荧光抗体的抽样检出情况看，在基础免疫     

流行性出血热双价灭活疫苗的安全性和免疫原性观察

目的　观察流行性出血热 (EHF)沙鼠肾细胞双价灭活疫苗的安全性和免疫原性。方法　以高发疫区现场青壮年为对象 ,基础免疫 3针 ,一年后加强 1针。采用间接免疫荧光试验、微量细胞病变中和试验检测接种后荧光抗体和中和抗体 ,重点观察部分接种者免疫后 72h内的全身体温反应和局部副反应。结果　基础免疫后 2周 ,荧光抗体阳转率及几何平均滴度 (GMT)分别为99 .0 4%、2 4.5 1± 2 .0 6 ;中和抗体阳转率及平均滴度对 76 118(Ⅰ型 )为 91.30 %、18.2 7± 2 .2 1,对UR(Ⅱ型 )为 88.41%、12 .47± 2 .16。基础免疫后 1年 ,荧光抗体阳转率下降为 37.34% ,中和抗体总阳转率近 80 %。加强后 2周 ,荧光抗体和中和抗体阳转率均为 10 0 % ,中和抗体滴度对Ⅰ型为 37.0 9±2 .2 4,对Ⅱ型为 32 .6 1± 2 .0 5。接种后全身体温反应发生率为 0 .46 % ,局部反应发生率为 1.98% ,未见严重副反应发生。结论　流行性出血热双价灭活疫苗近期免疫效果良好 ,接种副反应率低     

肾综合征出血热灭活疫苗免疫效果观察

目的　观察肾综合征出血热 (HFRS)灭活疫苗在黑线姬鼠型为主的混合型疫区使用的安全性、血清学及流行病学效果。方法　 1994年 7月至 2 0 0 0年 7月在HFRS高发区　浙江省建德市采用HFRS (Ⅰ型 )灭活疫苗免疫接种 ,逐年测定抗体和观察发病情况。结果　疫苗基础免疫后抗体阳转率为 5 0 % ,1年后抗体阳转率和平均滴度均明显下降 ;5年后未能检出中和抗体 ,荧光抗体阳性率为 10 %。免疫后 7年内未发现病例 ,与对照组比较 ,保护率为 82 49%。结论　HFRS (Ⅰ型 )灭活疫苗具有良好的免疫效果和现场流行病学保护作用。     

肾综合征出血热灭活疫苗接种后抗体阳转效果观察

１９９８年哈尔滨抗洪抢险中，某部官兵宿营地受到野鼠侵袭，现场鼠密度较高。经调查，该地区为肾综合征出血热高发区。为此，我们为疫区部队普种肾综合征出血热灭活疫苗。现将抗体阳转观察结果报告如下。１　材料与方法　接种对象：为该部抗洪抢险官兵共１７００人。（２）方法：肾综合征出血热（Ⅰ型）灭活疫苗由杭州天元生物药业公司生产（批号：９７０８０２）。于０、７、２８ｄ各肌注１ｍｌ。于第三针疫苗注射后１０ｄ采血，分离做抗体检测。检测方法为间接免疫荧光法。抗原试剂由沈阳军区军事医学研究所提供；阳抗人ＩｇＧ荧光血清来…     

建德市肾综合征出血热Ⅰ型灭活疫苗的安全性及免疫效果研究

采用以家庭为单位的随机对照设计，在以肾综合征出血热野鼠型为主的混合型疫区，考核肾综合征出血热沙鼠肾细胞灭活疫苗（Ⅰ型）的现场效果。全程接种７８６６人，接种反应轻微。接种后两周血清中和抗体阳转率为４８．０％，滴度为５．９５；血清ＥＬＩＳＡ抗体阳转率为８１．３％，１年后降为２４．０％，加强接种后两周回升为８７．０％。接种后１年，全程接种组无一病例发生，而全程对照组有９例病例，疫苗保护率为１００％（６０．５％～１００％）。     

Focus Group Interviews with Seniors

The focus group interview technique provides indepth information on a specific topic in a group discussion setting and can be effectively used with older adults. Successful focus group interviews include careful question preparation and participant recruitment as well as securing a capable moderator and comfortable setting. The technique is used as a preliminary research step to elicit feelings, attitudes and perceptions about a topic. However, results should not be generalized without further quantitative research.     

Group work with emphysema patients.

This article describes group work services to ambulatory emphysema patients in a community hospital. The group is viewed as an essential component in the treatment of patients with a chronically disabling illness. These patients experience devastating changes in their lives in the community, in the world of work, and in their families. Physical and respiratory therapy and medication comprise the medical treatment, group work provides the peer support necessary for coping with the disease in a way as to assist with maintaining health and improving the quality of life.     

B群脑膜炎球菌外膜蛋白偶联A＋C群脑膜炎球菌结合疫苗的免疫原性研究

目的了解B群脑膜炎球菌外膜蛋白（Group B Meningococcal Outer Membrane Protein,MenB-OMP）偶联A＋C群脑膜炎球菌结合疫苗（Meningococcus Group A and Group C Conjugate Vaccine,MCVA＋C）的免疫原性。方法按2：1比例随机双盲对照试验设计原则,观察3～5月龄、6～23月龄、2～6岁、7～24岁四个年龄组,检测免疫前、后A、B、C群血清杀菌抗体（Serum Bactericidal Antibody,SBA）。结果观察疫苗对不同年龄组免疫前、后A、B、C群SBA同时≥4倍增长率为97.65%～100%,SBA同时≥1：128的占88.89%～96.47%,几何平均滴度为1：194～1：420,与对照组相比差异有统计学意义。结论MenB-OMP偶联MCVA＋C有良好的免疫原性。     

Group testing regression models with dilution submodels

Group testing, where specimens are tested initially in pools, is widely used to screen individuals for sexually transmitted diseases. However, a common problem encountered in practice is that group testing can increase the number of false negative test results. This occurs primarily when positive individual specimens within a pool are diluted by negative ones, resulting in positive pools testing negatively. If the goal is to estimate a population‐level regression model relating individual disease status to observed covariates, severe bias can result if an adjustment for dilution is not made. Recognizing this as a critical issue, recent binary regression approaches in group testing have utilized continuous biomarker information to acknowledge the effect of dilution. In this paper, we have the same overall goal but take a different approach. We augment existing group testing regression models (that assume no dilution) with a parametric dilution submodel for pool‐level sensitivity and estimate all parameters using maximum likelihood. An advantage of our approach is that it does not rely on external biomarker test data, which may not be available in surveillance studies. Furthermore, unlike previous approaches, our framework allows one to formally test whether dilution is present based on the observed group testing data. We use simulation to illustrate the performance of our estimation and inference methods, and we apply these methods to 2 infectious disease data sets.     

Group Work with Young Adult Epilepsy Patients

The legacy of a childhood of chronic illness may be a sense of helplessness in adulthood. Group work with these adult patients may remediate a lifetime of parental overprotection and underexpectation.     

Group Psychotherapy with Female-to-Male Transsexuals in Turkey

The change in Turkish law to allow local sex reassignment surgery was passed in May 1988. By law, a candidate for such surgery must obtain a medical certificate attesting that the operation is necessary. However, the law does not specify conditions for granting such a certificate, so any physician can give a certificate based on his own criteria. Sex reassignment surgery can therefore be performed without preoperative psychiatric evaluation and preparation. This is a report of 40 female-to-male transsexuals. They had completed psychiatric assessment and participated in group therapy. These meetings provided a valuable setting for getting to know transsexuals and their families. Participants' long, regular attendance and low dropout rate demonstrate high group cohesion. The aim of the study is to report characteristics of a group of transsexuals living in a different cultural setting from other studies of this patient population in order to identify problems of Turkish transsexuals and advocate changes in current Turkish laws for sex reassignment.