Can routinely collected laboratory and health administrative data be used to assess influenza vaccine effectiveness? Assessing the validity of the Flu and Other Respiratory Viruses Research (FOREVER) Cohort

BackgroundLinking data on laboratory specimens collected during clinical practice with health administrative data permits highly powered vaccine effectiveness (VE) studies to be conducted at relatively low cost, but bias from using convenience samples is a concern. We evaluated the validity of using such data for estimating VE.MethodsWe created the Flu and Other Respiratory Viruses Research (FOREVER) Cohort by linking individual-level data on respiratory virus laboratory tests, hospitalizations, emergency department visits, and physician services. For community-dwelling adults aged > 65 years, we assessed the presence and magnitude of information and selection biases, generated VE estimates under various conditions, and compared our VE estimates with those from other studies.ResultsWe included 65,648 unique testing episodes obtained from 54,434 individuals during the 2010–11 to 2015–16 influenza seasons. To examine information bias, we found the proportion testing positive for influenza for patients with unknown interval from illness onset to specimen collection was more similar to patients for whom illness onset date was ≤ 7 days before specimen collection than to patients for whom illness onset was > 7 days before specimen collection. To assess the presence of selection bias, we found the likelihood of influenza testing was comparable between vaccinated and unvaccinated individuals, although the adjusted odds ratios were significantly greater than 1 for some healthcare settings and during some influenza seasons. Over 6 seasons, VE estimates ranged between 36% (95%CI, 27–44%) in 2010–11 and 5% (95%CI, –2, 11%) in 2014–15. VE estimates were similar under a range of conditions, but were consistently higher when accounting for misclassification of vaccination status through a quantitative sensitivity analysis. VE estimates from the FOREVER Cohort were comparable to those from other studies.ConclusionsRoutinely collected laboratory and health administrative data contained in the FOREVER Cohort can be used to estimate influenza VE in community-dwelling older adults.     

Method development of immunoglobulin G purification from micro-volumes of human serum for untargeted and targeted proteomics-based antibody repertoire studies

Immunoglobulins (Igs) are major serum proteins which play important roles in immunity. Both untargeted and targeted proteomic workflows can be applied to investigate antigen-binding sites and the glycosylation profiles of Igs. For a more-comprehensive picture of IgG from human serum, we developed an IgG purification process and coupled the standardized method to untargeted and targeted proteomic workflows for IgG investigations. Parameters such as the type of purification beads, volume of the bead slurry, incubation conditions, and binding capacities were evaluated in this study. Only 2 μL of human serum was required for each sample. The performance of coupling the purification process to untargeted proteomics in the IgG analysis was evaluated by comparing normalized abundances of IgG subclass-specific peptides with quantification results from an ELISA. Pearson's correlation values were all >0.82. Targeted proteomic workflow was applied to serum samples from patients with autoimmune pancreatitis and from healthy controls, and the results corresponded to clinical findings that IgG4-related peptides/glycopeptides showed higher abundances in the diseased group. The developed IgG purification process is simple and requires small sample volume, and it can be coupled to targeted and untargeted proteomic workflows for clinical investigations in the future.     

全国著名骨伤专家梁铁民教授学术思想和正骨经验

总结了全国著名骨伤专家梁铁民教授的学术思想和正骨经验,简述了梁老生平。梁老学术思想表现在突出整体观念,主张辨证施术;注重调理气血,强调药物接续;重视望问切触量法五诊结合等三个方面。对于梁老正骨经验先进行了综合论述,进一步佐证其学术思想;后分别从小儿桡骨头半脱位、颈椎错位、胸腰椎小关节错位、肋骨骨折等梁老研究较深入和比较擅长的几个方面进行了阐述。特别是颈椎错位这种高难度高风险的手法操作,体现出梁老高超的手法技艺。     

手术视频联合PBL教学在胸外科实习教学中的应用及探讨

目的胸腔镜手术目前在胸外科已成为主流,这也给本科生实践教学带来了新的变革需求,我们鉴于上述教学问题,基于实习生反馈。对手术视频结合PBL的实践教学方式,进行了应用和探讨。方法本研究对象为2018年10月-2019年6月进入华西医院胸外科的本科实习生,随机分为两组:实验组(手术视频+PBL),对照组(传统教学组)。实验组通过微创手术视频,并配置PBL问题,进行讨论学习。结果本研究共纳入实习生61名(实验组26名,对照组35名),两组间基本资料差异无统计学意义(P> 0.05)。实验组理论成绩平均(92.7±4.9)分,显著高于对照组(84.6±5.8)分(P <0.01)。学生问卷显示在学习兴趣、专业理论、实习目标3个项目的评分,实验组均显著优于对照组。结论本研究初步探索并建立手术视频+PBL讨论的教学模式,该教学模式一定程度上解决了外科微创手术的教学障碍,有助于学生对专业知识的掌握。     

内脏利什曼病合并HIV感染患者诊断和治疗研究进展

内脏利什曼病是全球被忽视的传染病之一,危害严重。而利什曼原虫-人类免疫缺陷病毒(human immunodeficiency virus,HIV)合并感染对流行地区造成的威胁更甚。利什曼原虫与HIV存在相互作用,合并感染者在临床表现、诊断及治疗方面具有一定特殊性,其病死率及复发率均高于HIV阴性的内脏利什曼病患者。本文对利什曼原虫-HIV合并感染患者的临床表现、诊断和治疗进展进行综述。     

深圳市卫生人力资源现状分析

目的了解深圳市卫生人力资源的现状,并与北京、上海的一线城市做出比较,从而为深圳市“人才梯队”的建设提供数据基础。方法通过描述性研究法对卫生人员的数量、结构、分布进行描述,运用比较分析法对深圳、北京、上海三地进行比较。结果卫生人员总量不足且结构比例失衡,不同区之间分布不合理。结论创新制度机制,加强卫生人才引进;加强护理队伍建设,改善医护比例;出台专门倾斜政策,均衡区域人才分布。     

基于“翻转课堂”模式的自主学习在人体形态学教学中的探索和实践

人体形态学是由解剖学、组织胚胎学、细胞学融合而来的一门课程,属于广义的解剖学,是实践性很强的一门医学基础课。课程理论知识专业名词繁多,内容繁琐,对于很多刚步入大学的医学生来讲比较枯燥乏味,成绩不理想。为了提高本科护理专业人体形态学教学质量,本教研室对课程的教学方法进行了探索和实践,根据教学内容采用以“翻转课堂”自主学习的教学模式,整合现代化的教学资源,合理利用新媒体技术,在教学上取得了显著的效果。