福建省扩大国家免疫规划前后疫苗预防接种服务效果评价

目的了解福建省扩大免疫规划后预防接种服务现状,以调整策略推进扩大免疫规划工作。方法设计调查表,逐级培训调查员进行填报,省级派调查员到现场随机抽查复核;调查数据录入Excel数据库,用EPI info软件进行统计分析。结果全省1 144家预防接种门诊中,省级规范化预防接种门诊占98.60%,比扩大免疫规划前增加7.69%。全省平均每万人口1.03名免疫规划工作人员,大专及本科以上学历、中高级职称人员所占比例显著高于扩大免疫规划前（P〈0.01）。城镇（或乡镇）接种门诊、村卫生室接种和入户上门接种三种服务形式的接种单位数分别占总接种单位数的82.00%、17.49%、0.14%,城镇（或乡镇）接种门诊数所占比例比扩大免疫规划前提高12.96%。扩大免疫规划后全省所有接种点每年均提供12次以上的免疫接种服务。按日接种、按周（旬）接种所覆盖人口的比例分别增加16.65%、6.56%。结论福建省实施扩大国家免疫规划后,预防接种服务机构数量、服务频次有所增加,本科以上学历、高中级职称比例的免疫规划服务人员有所提高。但免疫规划服务人员的总体数量无明显增加,农村预防接种单位每万服务人口工作人员数有所减少。     

二类疫苗纳入深圳市社会医疗保险研究概述

目的为推广二类疫苗纳入社会医疗保险支付范围的卫生策略提供决策信息。方法综合运用问卷调查、专题访谈、专家咨询、基金风险测算等方法,研究深圳市二类疫苗纳入社会医疗保险支付范围的具体可操作政策。结果90%的社区居民认为将二类疫苗纳入社会医疗保险支付有必要;医务人员对社保支付二类疫苗基本持支持态度;二类疫苗纳入社保支付具有显著的经济效益;二类疫苗纳入社保支付的基金风险具有可控性。结论二类疫苗有必要纳入深圳市社会医疗保险支付,但在实施和技术操作方面仍然存一定的局限和挑战。     

2006年普格县儿童计划免疫接种调查

目的了解和掌握普格县当前的计划免疫工作现状和存在的问题。方法采取典型调查和多阶段随机抽样的方法,抽查2004年全年出生儿童的建卡率,基础免疫接种率和1997、2000、2003年3年间出生儿童的加强免疫接种率。结果共调查15个乡的420名适龄儿童,建卡率为94.23%;卡介苗、口服脊髓灰质炎疫苗、百白破联合疫苗,麻疹疫苗接种率和四苗全程免疫覆盖率,分别为68.57%、92.36%、71.42%、74.33%和62.85%;乙型肝炎疫苗（HepB）全程接种率为34.00%、（HepB）首针及时接种率和全程及时接种率均为20.00%;DPT4、OPV4、MV2加强免疫接种率分别为66.52%、93.33%、87.61%;儿童计划免疫接种率普遍较低,矮山乡高于二半山和高山乡。造成未接种的原因主要为不知道要接种,不合格的原因主要是超期接种和提前接种。结论普格县除脊髓灰质炎疫苗接种率相对较高外,其他儿童计划免疫疫苗接种率普遍较低,高山、二半山乡是预防接种工作的难点,HepB纳入儿童计划免疫进展困难。     

功能MRI的伪影校正方法

分析对功能MRI数据分析影响较为严重的头部运动伪影、生理运动伪影、血流伪影、ghost伪影及敏感性伪影的产生机制,综述现有的伪影校正方法,并提出功能MRI伪影校正方法研究的一些新方向.     

Interleaved asymmetric echo-planar imaging

A version of interleaved echo-planar imaging (EPI) is presented in which only one polarity of the readout gradient is used for signal acquisition to avoid ghosting artifacts. Two possible forms of the phase encoding gradient, blipped and constant, are discussed. With the constant phase encoding, interleaving of partial trajectories in the Fourier domain (k-space) is controlled automatically by the echo train delay. The constant phase encoding gradient introduces a shear distortion of the k-space grid. A modification of the reconstruction procedure is given which corrects for this effect. The method provides a 128 × 128 image in 1 s on a clinical system with standard gradients.     

Magnetic resonance imaging in neonatal encephalopathy

Magnetic resonance imaging may provide invaluable information in the term born neonate with encephalopathy. However, both hardware and sequences may need adaptation from normal adult protocols. Sedation is often required to obtain good quality imaging, but anaesthesia is not necessary in this population. The perinatal history may predict the pattern of brain lesions, which, in turn, may be used to predict the neurodevelopmental outcome. Image interpretation is not easy and requires a full clinical history in addition to experience of both normal and abnormal neonatal brain appearances. Lesions evolve rapidly, and perinatally acquired leasions are at the most obvious 1-2 weeks from delivery. Early imaging in the first few days from presentation should always include diffusion-weighted sequences to identify early ischaemic change. Advanced techniques such as venography, angiography and perfusion-weighted imaging may be useful in certain situations, and serial imaging may help differentiate perinatal-acquired lesions from other pathologies.