论当前疾病预防控制体系面临的主要问题

对当前的疾病预防控制体系和机构面临的体系不健全、政府投入不充分、事业发展不平衡、人才缺失和能力不足、缺乏系统的理论指导、体系的碎片化严重、与社会经济发展的战略衔接不力、机构内部内生动力和活力不足以及体系治理能力不足等问题做了讨论分析,以期进一步分析在健康中国战略和事业单位机构改革等宏观环境变化所带来的机遇以及疾控体系的发展策略和具体措施,促进疾病预防控制事业在改革中谋发展。     

Interleukin 1 alpha (IL1A) polymorphisms and risk of endometriosis in Iranian population: a case-control study

Abstract

Endometriosis is one of the most common gynecological diseases and a major cause of pain and infertility. It is influenced by genetic, epigenetic, and environmental factors. Recently, genome-wide association studies have revealed a strong association between IL1A single nucleotide polymorphisms (SNPs) and increased risk of endometriosis in Japanese women. The aim of the present study was to evaluate the association of three IL1A SNPs, rs17561, rs1304037, and rs2856836 with the risk of endometriosis in Iranian population. Totally, 105 women with diagnosis of endometriosis and 102 healthy women as control group were included. Three SNPs of the IL1A, rs17561?G/T, rs1304037 A/G, and rs2856836 T/C, were genotyped by PCR and RFLP. The rs2856836?TC genotype was significantly higher (p?=?.002; OR?=?3.1, 95% CI: 1.5–6.5) in the patients (28.1%) than the control group (12.7%). The rs2856836?CC genotype was significantly higher (p?=?.047; OR?=?2.3, 95% CI: 1.0–5.3) in the patients (17.5%) than the control group (10.8%). The rs2856836 C allele was significantly higher (p?=?.001; OR?=?2.2, 95% CI: 1.4–3.6) in the patients (31.6%) than the control group (17.2%). The IL1A rs2856836 T/C SNP was associated with susceptibility to endometriosis and the rs2856836 C allele may increase the risk of endometriosis in Iranian women.     

不同非密闭雾化治疗方式在不合作患儿中的应用效果

目的 探讨不同非密闭雾化方式在不合作患儿接受布地奈德雾化治疗中的应用效果。方法 选取本院门诊270例3岁以下使用布地奈德雾化治疗的患儿,采用随机数字表法将患儿分为Pari雾化系统、Philips雾化系统及Salter雾化系统3个治疗组,毎组90例,各组又依据面罩距离面部0 cm、2 cm、4 cm分为3个小组,毎组30例,分别测量各组雾化气流流速及吸入雾化颗粒量占总雾化颗粒量的比例。采用方差分析及Bonferroni进行统计分析。结果 雾化气流流速及雾化吸入量在不同雾化系统组间差异有统计学意义(P<0.05)。在3种距离下,Pari系统均能使患儿吸入最多量的雾化颗粒,其次是Salter系统,再是Philips系统,与此相反,气流流速Pari系统最低。Pari系统离开面部4 cm及Salter系统离开面部2 cm的吸入量均高于Philips系统0 cm的吸入量。结论 选择合适的非密闭雾化系统方式,是提高不合作患儿布地奈德雾化治疗的有效方式。     

医养结合型养老机构卫生服务质量指标体系构建研究

目的:构建基于SERVQUAL模型的医养结合型养老机构卫生服务质量评价指标体系。方法:围绕医养结合型养老机构卫生服务的概念、特性、内涵、内容等,采用文献研究法、半结构式访谈法、Delphi—AHP法等定性与定量相结合的研究方法,构建指标体系并确定指标权重。结果:构建了具有7个一级指标,27个二级指标和77个三级指标的养老机构卫生服务质量评价指标体系。指标体系三轮咨询专家权威系数Cr均高于0.84,专家综合权威性系数均高于0.83;总体专家协调系数Kendall W第一、二轮为0.309,第三轮为0.706,且均通过显著性检验;内容效度指数I-CVI介于0.90~1.00之间,S-CVI为0.94,kappa值均高于0.74;信度系数Cronbachα总体为0.972,各维度Cronbachα系数在0.792~0.921之间。评价指标体系具有较好的稳定性、可靠性和一致性。结论:本研究建立的评价指标体系有利于医养结合型养老机构全面建立贴近老年人卫生服务需求的内设医疗机构,改善机构内卫生服务质量。在对指标体系进行应用时,可转化为机构中老年人对各指标项目的感受(P)与期望(E),以两者的差值(P-E)代表机构的卫生服务质量。根据专家赋权结果,应重点加强医养结合养老机构对可靠性、有效性、经济性等指标项目的建设。