云南省德宏州1 989--20 1 1年HIV感染者死亡率及其影响因素研究

目的
了解1989-2011年云南省德宏州HIV感染者死亡率及其影响因素。方法以德宏州1989-2011年报告的所有现住址为本地的HIV感染者为研究对象,收集其死产相关信息,计算死亡率和累积生存率,并应用Cox比例风险同归模型分析死亡的影响因素。结果共有13006例H1V感染者纳入分析,男性占73.2％,农民占79.1％,48.％已婚有配偶,少数民族占64.5％,68.7％为文盲或小学文化程度。研究对象累计观察55962.30人年,死4648人,死亡率为8.31／100人年。死亡率在1990--2004年间总体呈上升趋势,自2005年起开始持续下降。研究对象白报告发现HIV感染至观察期末的平均生存时间为9.48年,其中,接受过抗病毒治疗者的平均生存时间为16.65年,而从未接受过抗病毒治疗者的平均生存时间为7.67年。多因素分析显示抗病毒治疗以及年龄、性别、民族、职业、婚姻状况和文化程度等社会人口学因素显著影响HIV感染者的死亡和生存状态。结论包括抗病毒治疗在内的艾滋病综合防治措施有效地降低r德宏州HIV感染者的死亡率,今后仍需扩大抗病毒治疗覆盖面,并针对HIV感染者的社会人口学特征加强分类管理和随访,以减少HIV感染者死亡。     

急诊患者满意度模糊综合评价

目的：探索影响医院急诊患者满意度的因素,为医院科学管理提供客观依据。方法：对某医院2003-2005年急诊患者或家属1564名进行问卷调查,进行模糊综合评价分析。结果：3年急诊患者满意率分别为90．16％、91．71％、92．56％,模糊评价总评分为J=0．7648、0．8961、0．9577,2005年诊疗环境与总体医疗服务质量模糊控制量占前两位（C=0．4843,0．2037）。结论：大多数急诊患者感到满意,且逐年提高,但诊疗环境与总体医疗服务质量有待进一步提高。     

A new role for interleukin-7 in the induction of LFA-1 and VLA-4 adhesion molecules in Phorbol 12myristate 13acetate activated CD4+CD23+ T-cell subset

Background The low affinity receptor for IgE, CD23, has been described in several pathological conditions. However, the factors involved in the upregulation or downregulation of this receptor are still debated. Methods and Results We studied the effect of interleukin 7 (IL-7) on the expression of CD23 in normal PBT cells stimulated with PMA + Ca². The data indicate that activated PB-T cultured in the presence of IL-7 showed an increased expression of CD23. The induction of IL-7 on CD23 production appears to be independent of IL-2, IL-4, IL-9, IL-15. Indeed, the addition of specific MoAbs anti-IL-2, IL-4, IL-9, IL-15 oranti-IL2R was unable to block the effect of IL-7 on CD23. The addition of IL-7 to a specific subset CD4⁺CD23⁺ was able to augment the adhesiveness of T cells to parenchymal cell monalayers. The use of different cytokine (IL-2, IL-4, IL-9, IL-15) resulted in no increase of adhesiveness. In contrast the addition of IL-7 to a different T-cell subset (i.e. CD4⁺CD23^-) was unable to rescue the lack of adhesiveness observed in these cells. Blocking experiments with MHM6 MoAb were able to drastically reduce the adhesiveness observed in CD4+FCD23+ subsets. The presence of LFA-1 and VLA-4 adhesion molecules were responsible for the augmented adhesiveness of activated CD4⁺CD23⁺ T cells cultured in the presence of IL-7. Blocking experiments with anti-LFA-1, VLA-4. anti-LFA-1β plus VLA-4α MoAbs or anti-ICAM-1 MoAb added to the monolayers resulted in a complete inhibition of adhesion to parenchymal monolayers. In contrast, the addition of anti-IL-7 oranti-IL-7R MoAbs were able to block the augmented adhesiveness of CD4⁺CD23⁺ cells to monolayers observed in the presence of IL-7. Conclusions Taken together these findings point to the likelihood that IL-7 is responsible for the observed quantitative difference in the level of adhesion molecules and may open a new role of CD23 in the immune regulation.