九连山自然保护区冬青属植物资源的初步研究

通过对九连山自然保护区冬青属植物资源的调查研究，发现保护区内共有34种(包括变种)冬青属植物，其中8种为江西新分布，其垂直分布范围较广，以海拔800m以下最为集中。与邻近山体冬青属植物比较结果表明谈属内不同种的数量存在差异。     

浅谈我国卫生资源配置现状

当前,我国卫生资源配制在地域上分布不合理。此外,公共卫生投入不足及卫生人力资源配制失衡也制约着卫生资源的合理配置。     

学生视域下的医学院校大学英语课程思政教学资源库建设研究

目的 探索医学生团队对大学英语思政教学资源的发掘与整合,并建设医学院校大学英语课程思政教学资源库,为医学生英语教学与思政教育的融合提供可行性经验。方法 对某医学院校1 030名学生进行问卷调查,并采用SPSSAU统计软件对调查结果进行分析,了解学生对英语教学与思政教育融合的态度与需求、大学英语思政教学资源库的建设方式,以及资源的呈现方式和类型。基于问卷结果、教材主题、教学模块与学生专业,采用内容分析与归类法,建设符合医学生期望的大学英语思政教学资源库。数据均以占比百分率的形式呈现。结果 ①836名学生认为大学英语有必要与思政教育融合,希望通过日常生活（731人）、医学背景知识（664人）、社会实践（622人）、新闻时事（604人）等相关的视频、音频建设思政资源库,并以“教师讲授+课堂讨论”（528人）的形式引导学生学习上述资源。②根据教材主题匹配问卷结果中的思政融入点,根据单元模块内容进一步细化思政融入点为普适性与医学专属思政教学元素两类,最终建成了医学院校大学英语思政教学资源库。结论 好的课程与资源是师生共研共建的。     

因特网上医学影像学资源获取技术

目的探讨医学网络资源的一般获取技巧,以及医学影像学资源的获取途径。方法应用因特网等关键词,采用医学专业检索引擎Medical Matrix,并在此基础上链接其他医学检索引擎,获得有关医学影像学文献的网址和相关网页。结果网上有一些专门的医学影像学资源网站,在高等医学院校和医学科研机构中经常包含医学影像学的资源。结论本文具体阐述了医学影像学资源的获取途径和技巧。     

Osteotomy around the knee: Assessment of quality,content and readability of online information

BackgroundAs knee osteotomy surgery becomes increasingly accessible, more patients may turn to the Internet for information. This study examined the source, quality, content and readability of online information regarding osteotomy around the knee.MethodsThe first 70 websites returned by the top four search engines were identified using the key words: “knee osteotomy” and “high tibial osteotomy.” The websites were categorised by type and assessed using the DISCERN score, Journal of the American Medical Association (JAMA) benchmark criteria and a novel Knee Osteotomy-Specific Score (KOSS). The presence of the Health On the Net (HON) code accreditation seal was noted. Readability of each website was assessed using eight readability formulae. The mean reading grade level (RGL) was compared to the 6th and 8th grade reading levels. The mean RGL of each category was also compared.ResultsOf the 45 unique websites analysed, the majority were Physician (33%) and Journal websites (31%). The mean DISCERN score was 36.7 (±8.9) which is classified as ‘poor.’ The mean JAMA benchmark criteria score was 2.04 (±1.5) and Physician websites were most likely to be scored zero. The mean KOSS was 15.4 (±5.7). The highest scoring website was a Commercial site but, overall, Journal category sites provided the best quality information. Websites that bore the HONcode seal obtained higher DISCERN, JAMA benchmark criteria and Knee Osteotomy - Specific Scores.The cumulative mean RGL was 13.2 (±2.2) which exceeded the 6th grade level by an average of 7.2 grade levels and the 8th grade level by an average of 5.2 grade levels. No website (0%) was written at or below either the 6th or the 8th grade reading levels. The mean Flesch Reading Ease Score of all websites was 41.13 (±14.7) which is classified as ‘difficult.’ Journal websites had the highest RGL.ConclusionThe information available online regarding osteotomy around the knee varies tremendously in quality and completeness. Physician sites predominate, but these were among the lowest scoring of all websites. Even where high quality information is available, it is set at too high a level to be easily understood.Level of evidenceSurvey of materials – Internet.     

Community participation in primary health care (PHC) programmes: lessons from tuberculosis treatment delivery in South Africa

Background

Currently, there is renewed interest in the role community participation can play in Primary Health Care (PHC) programmes such as the delivery of effective anti-TB treatment to patients in high-burden settings.

Objectives

To explore the feasibility of community participation in a high-burden Tuberculosis Control Programme and to establish how supervision of treatment by lay volunteers compares with other methods of tuberculosis treatment delivery in the Northern Cape province of South Africa.

Methods

Prospective study involving 769 patients with confirmed pulmonary TB who were followed-up over a one-year period. Questionnaire interviews were also carried out with 135 lay volunteers participating in the TB programme.

Results

One-third of the TB patients in the study received their treatment from lay volunteers in the community. Treatment outcomes for new patients supervised from the community were found to be equivalent to those who received treatment through other modes of treatment delivery (RR=1.04[0.94–1.16], p=0.435). For the re-treatment patients, community-based treatment was found to be superior (RR=5.89[2.30–15.09], p<0.001), to self-administered therapy.

Conclusions

Health care planners should consider community participation as a viable way of ensuring accessibility and effectiveness in PHC programmes. There is need for more research into ways of achieving sustainability in resource-limited but high disease burden settings.     

“沙漠人参”肉苁蓉研究概况

肉苁蓉(Cistanche deserticola Y.C.Ma)为国家二级保护植物,具有极好的药用价值。为保护肉苁蓉资源,充分发挥其经济价值,本文总结了肉苁蓉资源分布、生物学特性、炮制方法、化学成分、药理作用、组织培养以及栽培技术等研究概况,并分析了研究中存在的问题,提出了今后肉苁蓉开发利用的研究方向。     

Total lymphocyte count of 1200 is not a sensitive predictor of CD4 lymphocyte count among patients with HIV disease in Kampala, Uganda

Introduction

Total Lymphocyte Count (TLC) has been found to be an inexpensive and useful marker for staging disease, predicting progression to AIDS and death and monitoring response to ART. However, the correlation between TLC and CD4 has not been consistent. Access to HAART is expanding in Kampala, Uganda, yet there are no published data evaluating the utility of TLC as inexpensive surrogate marker of CD4 cell count to help guide therapeutic decisions.

Objective

To evaluate clinical illnesses and total lymphocyte count (TLC) as surrogate markers of the CD4 cell count in HIV infected persons being considered for ART.

Methods

A total of 131 patients were enrolled and evaluated by clinical assessment, TLC and CD4 count. Clinical illnesses and TLC dichotomized at various cut-point values were used to determine the sensitivity, specificity, and positive and negative predictive values (PPV and NPV) for the diagnosis of CD4 count <200 cells/mm³ among 100 participants fulfilling criteria for WHO clinical stage 2 and 3.

Results

A strong correlation was observed between TLC and CD4 (r = 0.73, p<0.0001). For all clinical syndromes, except pulmonary tuberculosis, the positive predictive values (PPV) for a CD4 count <200 cells/mm³ were high (>80%) but the negative predictive values (NPV) were low. Using the WHO recommended TLC cut-off of 1200 cells/mm³ to diagnose a CD4 less than 200 cells/mm³, the PPV was 100%, and the NPV was 32%.

Conclusion

Our data showed a good correlation between TLC and CD4 cell count. However, the WHO recommended TLC cutoff of 1200 did not identify the majority of WHO stage 2 and 3 patients with CD4 counts less than 200 cells/mm³. A more rational use of TLC counts is to treat all patients with WHO stage 2 and 3 who have a TLC <1200 and to limit CD4 counts to patients who are symptomatic but have TLC of >1200.     

江苏省护理院卫生资源配置现状和效率研究

目的:分析江苏省护理院卫生资源配置现状与效率,并提出完善对策。方法:应用描述性统计方法分析2013~2019年护理院卫生资源配置和利用情况,采用数据包络分析法评价卫生资源投入产出效率,采取TOPSIS法综合评估床位利用效率。结果:2019年江苏省护理院为246家,其中71.95%集中在城市地区;2019年护理院床位数为38274张,床位医生比和床位护士比分别为1:0.06和1:0.18,床位使用率为72.32%,平均住院天数比2013年缩短20.5天。数据包络分析结果显示,2016~2018年综合技术效率值均为1.0,2019年为0.990。TOPSIS法评估结果显示,2013~2017年床位利用效率逐年上升,2018和2019年有所下降。结论:护理院城乡分布不均衡,人员配置不足,近年来投入产出效率为相对有效或弱有效,但床位总体利用率偏低。今后合理规划设置护理机构,增加人力资源配置,提升护理院服务质量,最大限度发挥护理院卫生资源的作用。