Early diagnosis of cancer by imaging: The primary care perspective

The United Kingdom (UK) performs relatively badly in cancer survival, much of which underperformance is attributed to delays in diagnosis. As a result, increased access to cancer diagnostics for general practitioners is proposed. Four cancer sites and their associated tests have been chosen: lung/chest X-ray, colorectal/colonoscopy, ovarian/trans-vaginal ultrasound and brain tumours/MRI scanning. This article elaborates on the need for these, which patients are likely to be chosen for investigation, and the effect this will have on radiology departments.     

Associations between serum amino acids and incident type 2 diabetes in Chinese rural adults

Background and aimsSome amino acids (AAs) may be associated with type 2 diabetes (T2DM). This study aimed to determine the associations of individual AAs with the development of T2DM in rural Chinese adults.Methods and resultsA cohort study of 1199 individuals aged 18 years or older was conducted from 2006 to 2008 in a rural community of Deqing, China, a repeated survey was done in 2015 and data linkage with the electronic health records system was performed each year for identifying new T2DM cases. A high-performance liquid chromatography approach was used to measure the baseline serum concentrations of 15 AAs. Cox proportional hazards models were used to examine the associations between AAs and the risk of incident T2DM. A total of 98 new T2DM cases were identified during the follow-up of 12 years on average. Among 15 AAs, proline was associated with an increased risk of incident T2DM after adjusted for age, sex, body mass index, fasting plasma glucose, family history of T2DM, smoking status, alcohol use, and history of hypertension, the adjusted hazard ratio for 1-standard deviation increment was 1.20 (95% confidence interval: 1.00, 1.43). The association tended to be more marked in subjects younger than 60 years and overweight/obese subjects. Among participants without hypertension, proline and phenylalanine were associated with an increased risk of incident T2DM, while aspartic acid was associated with a decreased risk.ConclusionSerum proline was associated with the risk of incident T2DM in rural Chinese adults and might be a potential predictor.     

A novel linear neutralizing epitope of hepatitis E virus

Hepatitis E virus (HEV) is a serious public health problem that causes acute hepatitis in humans and is primarily transmitted through fecal and oral routes. The major anti-HEV antibody responses are against conformational epitopes located in a.a. 459–606 of HEV pORF2. All reported neutralization epitopes are present on the dimer domain constructed by this peptide. While looking for a neutralizing monoclonal antibody (MAb)-recognized linear epitope, we found a novel neutralizing linear epitope (L2) located in a.a. 423–437 of pORF2. Moreover, epitope L2 is proved non-immunodominant in the HEV-infection process. Using the hepatitis B virus core protein (HBc) as a carrier to display this novel linear epitope, we show herein that this epitope could induce a neutralizing antibody response against HEV in mice and could protect rhesus monkeys from HEV infection. Collectively, our results showed a novel non-immunodominant linear neutralizing epitope of hepatitis E virus, which provided additional insight of HEV vaccine.     

临床医生在产前诊断咨询中伦理两难问题态度与选择——基于情景案例分析

目的试图通过情景案例分析法,聚焦产前诊断中的伦理两难事件,探究临床医生的伦理道德抉择及可能的影响因素。方法采用分层随机抽样对624名临床医生进行了匿名问卷调查。结果针对相应的情景案例,大多数临床医生能够遵循尊重原则,保障孕妇夫妻双方知情权与自主权,但在具体案例的处理上,与其他国家的同类调查相比存在差异。结论临床医生的生命伦理意识有显著提升,但仍存在不足,应进一步加大相关法律与伦理理念知识的教育与普及;此外,对基因缺陷严重性的认知,在不同文化背景下也可能有所差异。     

以财富指数测量生活水平的相关问题研究

目的:研究以不同方法构建的财富指数的一致性,及其与传统方法测量的生活水平结果的比较。方法:利用2011年对宁夏回族自治区6 612户农村家庭(共28 886人)开展的入户调查数据,分别采取主成分分析、等权重等不同的赋权方法并纳入不同变量类型,构建4种不同的财富指数,对其结果的一致性进行分析;并分别与家庭总消费、家庭人均消费和家庭等值人均消费这三种传统方法得到的人群生活水平结果进行比较。结果:采用不同方法构建的财富指数间一致性较强;财富指数与消费指标间一致性较弱。结论:反映生活水平的不同指标各有优缺点,其测量结果间的一致性也较弱,因此当生活水平作为主要研究结果或影响结果的主要因素时,应结合采用不同生活水平指标得到的研究结果以及专业知识和经验,选择合适的生活水平指标。