Chinas Progress and Challenges in Improving Child Nutrition

正China has achieved the first Millennium Development Goal(MDG)of halving,between 1990and 2015,the proportion of people who suffer from hunger.Particularly impressive progress has been made to improve the nutritional status of Chinese children in recent years.The international scientific community has recognized stunting,with its long-term impact on the development of children as well as economic performance,as a major nutritional challenge facing families and countries[1].In this issue,Yu Dongmei et     

Carriage of Haemophilus influenzae in the oropharynx of young children and molecular epidemiology of the isolates after fifteen years of H. influenzae type b vaccination in Italy

BackgroundHaemophilus influenzae is an important pathogen able to cause a wide spectrum of diseases in children. Colonization of the upper respiratory tract is a risk factor for developing disease. This study aimed to investigate the oropharyngeal carriage rate of H. influenzae in young children in two Italian cities, 15 years after H. influenzae type b (Hib) vaccination was introduced. Antibiotic resistant traits and genotypes of the colonizing H. influenzae isolates were investigated.MethodsOropharyngeal swabs were obtained from 717 healthy children aged <6 years (June 2012–July 2013). Potential risk factors for H. influenzae colonization were investigated. H. influenzae isolates from carriage were characterized by PCR capsular typing, ampicillin susceptibility testing, resistance-associated gene sequencing and multilocus sequence typing (MLST). For comparison purposes, 38 non-typeable H. influenzae (NTHi) isolates from invasive disease were genotyped by MLST.ResultsThe overall H. influenzae carriage rate was 14.1% (101/717). Age, study site, presence of young siblings, and complete Hib vaccination status were independently associated with colonization. Of 101 isolates, 98 were NTHi, 2 were type e and 1 was type f. The overall ampicillin resistance rate was 15.8% (16/101). Resistance was mediated by TEM-1 β-lactamase production in half of isolates (n = 8) or modifications in penicillin-binding protein (PBP) 3 in the other half (n = 8). Several substitutions were discovered in PBP3 including the Asn526Lys change. Seventy-six different STs were identified among 98 NTHi isolates from carriage, with only 4 STs (ST12, ST57, ST238, ST1238) encompassing ≥3 isolates. Comparison of carriage and disease isolates found that several STs were shared between the two sources, although none of the major disease-associated STs were observed in carriage isolates.ConclusionsNTHi is the predominant serotype in carriage. The importance of monitoring both NTHi colonization rate and circulating genotypes should be emphasized in the era of the Hib conjugate vaccines.     

磁共振定量测定儿童及青少年戈谢病肝脾脏体积及脂质含量

目的 探讨MRI定量分析儿童及青少年戈谢病患者肝脏、脾脏体积及脂质含量的价值。方法 对经骨髓穿刺证实的42例戈谢病患者（其中12例已行脾脏切除）行腹部MR检查,序列为冠状位三维梯度回波Dixon水脂分离（3D FFE mDIXON）和T2WI-STIR序列。所有患者均正在接受酶替代治疗。评估患者肝脏、脾脏脂质含量的差异及相关性。结果 42个肝脏校正的体积值为25.15~48.99 ml/kg,平均（33.66±6.03）ml/kg,脂质含量4.63%~10.09%,平均（5.90±1.10）%;30个脾脏校正的体积值为4.48~56.04 ml/kg,平均（16.36±10.65）ml/kg,脂质含量4.78%~19.39%,平均（6.63±2.62）%。同一患者脾脏脂质含量高于肝脏（t=2.16,P=0.04）。结论 采用MRI测量肝脾脏体积及脂质含量具有一定的可行性,可用于监测儿童及青少年戈谢病患者的病情及治疗效果。     

不同方药对大鼠急性酒精性胃黏膜损伤炎性因子的影响

目的研究中医不同治法及复方对大鼠急性酒精性胃黏膜损伤的预防和治疗效果。方法建立酒精所致大鼠急性胃黏膜损伤的模型,用ELASE法测定胃黏膜组织匀浆后的白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)以及肿瘤坏死因子(TNF)含量的变化。结果柴胡疏肝散组、保和丸组、黄芪建中汤组分别能升高15、30及60 min大鼠胃液中IL-2含量。保和丸组30 min时大鼠胃液中IL-6含量最高。黄芪建中汤组和丹参饮合失笑散组均能显著降低酒精作用15 min后大鼠胃液IL-10含量。酒精损伤30及60 min时,各个方药组大鼠胃液中IL-10含量均显著降低,其中作用最强的是丹参饮合失笑散组。酒精作用15、30及60 min时各个方药均能使大鼠胃液TNF含量显著降低,其中15 min时黄芪建中汤组作用最强,30 min时丹参饮合失笑散组作用最强,60 min时黄芪建中汤组作用最强。结论不同方证中药在抗炎、降低炎性介质等方面均可起到有效作用,其结果的不同可为临床治疗急性酒精性胃黏膜损伤性疾病提供科学的选药组方规律以及指导意义。     

基于WS523-2019标准对单光子发射断层成像设备进行性能检测及探讨

目的 通过对单光子发射断层成像设备（SPECT）进行性能检测,探讨我国卫生行业标准WS 523-2019在实施过程中存在的问题。方法 测量了10台SPECT设备的断层空间分辨力、系统平面灵敏度、系统空间分辨力、全身成像系统空间分辨力、固有均匀性、固有最大计数率、固有空间分辨力和固有空间线性等指标。结果 按照WS523-2019标准对合格限值的要求,固有空间线性不合格的设备有3台,其余的指标都合格,WS523-2019标准基本满足临床需求,能够反映出SPECT的整体性能。结论 放射源到探测器的距离对空间分辨力的影响很大,测试时一定满足标准中规定的距离要求;固有空间线性测试时需要x和y方向独立的两块铅栅,在成像时铅栅模体的狭缝要两边对称;建议在新标准中增加旋转中心指标。     

Emotional and Behavioral Problems of Left-Behind Children in Impoverished Rural China: A Comparative Cross-Sectional Study of First Grade Junior High School

Objective: To investigate the prevalence of emotional and behavioral problems and related factors of left-behind children in impoverished rural China (mainly in the first grade of junior high school). Methods: A cross-sectional survey of rural households in 27 poverty-stricken counties in 12 provinces across China was conducted using the Strengths and Difficulties Questionnaire (SDQ). Results: The prevalence of emotional and behavioral problems in left-behind children was 11.7%, and that of non-left-behind children was 8.9%. There was statistical difference between the two groups (P < 0.01). There are no differences between the two groups in terms of the various factors of SDQ. The incidence of insomnia in the left-behind group was 58.3%, which was higher than that in the non-left-behind group 50.9% (P < 0.01); loneliness (62.1% vs. 51.8%, P < 0.01); running away from home (23.1% vs. 18.8%, P < 0.01), and self-injury behavior (16.8% vs. 12.2%, P < 0.01). Left-behind children are more likely to have negative psychological feelings including insomnia, loneliness, self-injury, and run away from home. They also experienced more bullying including maliciously teased by peers, intentionally excluded or isolated, physically threatened or intimidated. All of these factors are associated with their abnormal emotional and behavioural development. Conclusion: The incidence of emotional and behavioral problems of left-behind children in rural areas in poverty-stricken areas is significantly higher than that of non-left-behind children; Logistic regression analysis showed that bullying behavior and abnormal psychological characteristics are significantly associated with left-behind adolescents abnormal emotional and behavioral development.     

我国专利保护制度下涉及重大公共健康问题高价药品的经济可及性

目的通过典型案例分析,研究我国专利制度下涉及重大公共健康问题高价药品的可及性,提出促进这部分药物经济可及性的政策建议。方法通过文献分析和市场调查,以我国疾病负担较重,对社会、经济和政治影响较大的八类疾病临床必需的专利药物为例,测算专利制度下高价药品对个人及医保的药物治疗直接经济负担。结果化合物专利强化了专利药品的价格垄断。目标药品对我国居民,尤其是农村居民的个人经济负担十分沉重。突破化合物专利,实现平行进口或国内仿制药上市,可节约巨额药品采购费用,惠及广大国人。结论制定并实施具有公共健康视角的药品注册和知识产权保护策略,配以不断稳步扩大和加强的基本医疗保险制度,可有效促进对公共健康有重要意义,对社会、政治和经济影响重大的高价专利药品的经济可及性。     

The Feasibility of Sputum Transportation System in China:Effect of Sputum Storage on the Mycobacterial Detection

<正>Sputum transportation from county-level to prefecture-level is an ideal strategy to cover the shortage of the laboratory capability in the resource-poor setting.Here,we firstly evaluated the feasibility of sputum transportation system in China by analyzing the culture and molecular diagnosis results from 1982 smear-positive patients with different delay in processing for culture.In this     

缓激肽对脑胶质瘤大鼠紧密连接影响的形态学观察

目的研究缓激肽(BK)对脑胶质瘤大鼠血肿瘤屏障紧密连接的影响。方法采用伊文氏兰(EB)法检测缓激肽作用后血肿瘤屏障(BTB)通透性的变化;应用透射电镜(TEM)观察BK作用后内皮细胞间紧密连接的变化,同时应用硝酸镧[La(NO3)3]和辣根过氧化物酶(HRP)作示踪剂,检测缓激肽作用后,小分子和大分子示踪剂通过紧密连接的情况。结果缓激肽可使血肿瘤屏障对伊文氏兰的通透性增加,在15min时达到高峰,以后逐渐下降。透射电镜显示缓激肽作用15min时,肿瘤组织毛细血管内皮细胞间紧密连接的完整性明显破坏,缝隙指数显著增加,同时可见硝酸镧和辣根过氧化物酶在紧密连接处沉积。结论缓激肽能够通过开放紧密连接选择性增加血肿瘤屏障的通透性。     

国际社区康复理念及其在中国社区康复中的应用

本文运用当代国际社区康复的理论与方法,回顾国际助残在中国的实践,并讨论国际助残本土化计划。