HCV体内感染裸鼠模型的建立

目的:探讨利用裸鼠建立感染丙型肝炎病毒(HCV)体内动物模型的可能性。方法:将体外感染了HCV的人胎肝细胞(HFH)移植到裸鼠脾脏。移植术后3个月,取脾作病理学检查,以评估感染了HCV的HFH是否还存活。并且通过透射电镜检查,以评估移植入裸鼠脾脏的HFH胞浆中是否仍有HCV。同时,取裸鼠的外周血液作液相RT-PCR检查,以明确外周血液中HCV RNA是否为阳性。结果:移植术后3个月,移植入裸鼠脾脏内的HFH依然存活,经检查移植入裸鼠脾脏中的HFH胞浆内仍然存在HCV样颗粒。然而,体内有HCV感染的裸鼠外周血液仅70％HCV RNA为阳性。结论:裸鼠可作为“活试管”,支持体外感染了HCV的HFH在其脾脏内较长期生存。但仅使用外周血液HCV RNA检查这一个指标来判断裸鼠体内是否有HCV感染是不够的。     

重型颅脑损伤患者持续意识障碍的相关因素分析

目的 分析影响重型颅脑损伤患者持续意识障碍的危险因素,建立风险预测模型,并评价其预测能力.方法 回顾性研究山西医科大学第一附属医院急诊科2011年7月至2013年11月收治的重型颅脑损伤患者,符合纳入/排除标准165例.按照收治顺序分组,推导组(115例),验证组(50例).纳入标准:(1)年龄＞15岁;(2)有明确颅脑外伤史;(3)行头颅CT或MRI检查确诊颅脑损伤;(4)格拉斯哥评分(glasgow coma scale,GCS)≤8分;(5)入院当日呈昏迷或意识障碍逐渐加重至昏迷状态.排除标准:(1)外伤后仅有短暂意识丧失或昏迷的患者(昏迷时间＜6h);(2)外伤后癔病或精神抑郁状态致昏迷样表现;(3)外伤后情绪诱发癫痫持续状态而呈意识障碍.对28个可能影响因素进行单因素筛选及logistic多重回归分析并建立风险模型.运用Hosmer-Lemeshow检验和受试者工作特征曲线(receiver operating characteristic,ROC)对模型进行拟合优度检验及判别.结果 入院时GCS、神经系统并发症、弥漫性轴索损伤(diffuse axonal injury,DAI)、电解质紊乱是影响颅脑损伤患者持续昏迷的独立风险因素.推导组Hosmer-Lemeshow检验显示x2 =4.380,P=0.496,预测昏迷率与实际昏迷率差异无统计学意义,风险模型的辨识度在推导组(AUC=0.87; 95％CI:0.798～0.942)及验证组(AUC=0.90;95％ CI:0.803 ～0.997)中均较好.结论 预测模型虽有一定局限性,但仍能对颅脑损伤患者持续意识障碍进行较准确的估计.     

Smoking Cessation Intervention on Facebook: Which Content Generates the Best Engagement?

Background

Social media offer a great opportunity to deliver smoking cessation treatment to young adults, but previous online and social media interventions targeting health behavior change have struggled with low participant engagement. We examined engagement generated by content based on the Transtheoretical Model of Behavior Change (TTM) in a motivationally tailored smoking cessation intervention on Facebook.

Objective

This study aimed to identify which intervention content based on the TTM (Decisional Balance and 10 processes of change) generated the highest engagement among participants in pre-action stages of change (Precontemplation, Contemplation, and Preparation).

Methods

Participants (N=79, 20% female, mean age 20.8) were assessed for readiness to quit smoking and assigned to one of 7 secret Facebook groups tailored to their stage of change. Daily postings to the groups based on TTM Decisional Balance and the 10 processes of change were made by research staff over 3 months. Engagement was operationalized as the number of participant comments to each post. TTM content-based predictors of number of comments were analyzed and stratified by baseline stage of change, using negative binomial regression analyses with and without zero inflation.

Results

A total of 512 TTM-based posts generated 630 individual comments. In Precontemplation and Contemplation groups, Decisional Balance posts generated above average engagement (P=.01 and P<.001). In Contemplation groups, posts based on the TTM processes Dramatic Relief and Self-Liberation resulted in below average engagement (P=.01 and P=.005). In Preparation groups, posts based on Consciousness Raising generated above average engagement (P=.009). Participant engagement decreased over time and differed between groups within Precontemplation and Contemplation stages, but was independent of day of the week and time of day the content was posted to the groups. No participant baseline characteristics significantly predicted engagement.

Conclusions

Participants not ready to quit in the next 30 days (in Precontemplation or Contemplation) engaged most when prompted to think about the pros and cons of behavior change, while those in the Preparation stage engaged most when posts increased awareness about smoking and smoking cessation. Findings support tailoring intervention content to readiness to quit and suggest intervention components that may be most effective in generating high participant engagement on social media.     

Alternatives to animal testing: A review

The number of animals used in research has increased with the advancement of research and development in medical technology. Every year, millions of experimental animals are used all over the world. The pain, distress and death experienced by the animals during scientific experiments have been a debating issue for a long time. Besides the major concern of ethics, there are few more disadvantages of animal experimentation like requirement of skilled manpower, time consuming protocols and high cost. Various alternatives to animal testing were proposed to overcome the drawbacks associated with animal experiments and avoid the unethical procedures. A strategy of 3 Rs (i.e. reduction, refinement and replacement) is being applied for laboratory use of animals. Different methods and alternative organisms are applied to implement this strategy. These methods provide an alternative means for the drug and chemical testing, up to some levels. A brief account of these alternatives and advantages associated is discussed in this review with examples. An integrated application of these approaches would give an insight into minimum use of animals in scientific experiments.     

模型研究方法在药物经济学中的应用概述

摘 要 目的： 概述国内外药物经济学研究中应用到的模型研究方法,为我国药物经济学研究提供参考。方法: 以近年来国内外发表的文献为依据,进行分析、整理和归纳。结果: 概述各研究模型在药物经济学中的应用方法及注意事项,为我国进行药物经济学研究提供一定的理论及案例支持。结论: 各模型研究方法所针对的研究范围及研究方向各不相同,通过对文献进行综述,讲述了各模型的具体应用方法,为我国开展高质量的药物经济学研究提供参考。     

艾滋病疫情估计与预测方法研究进展

近年来,由于艾滋病监测系统的不断完善以及监测资料来源的多样性,艾滋病疫情估计与预测方法已成为了解艾滋病流行状况及预测发展趋势的重要工具,为此国内外学者采用了多种方法对艾滋病疫情进行了估计与预测。本研究对目前常用艾滋病疫情估计与预测方法的基本原理、适用条件、应用、优点及局限性进行综述,为疫情估计方法的选择与应用提供参考。     

Prevalence and associated factors of seasonal influenza vaccination among 24- to 59-month-old children in Hong Kong

BackgroundInfluenza results in severe complications among 24- to 59-month-old children, who are recommended by the WHO to take up influenza vaccination (IV) annually. Health promotion is warranted. Yet, there is a dearth of studies on IV prevalence and associated factors in this age group.MethodsA random population-based telephone survey interviewed 540 parents of Chinese children aged 24–59 months in Hong Kong during March through June, 2011. Constructs of the Health Belief Model (HBM) and subjective norm formed basis for assessing parental perceptions on influenza and IV. For data analysis, adjusted, and stepwise multiple logistic regression models were fit.ResultsThe prevalence of having taken up at least one dose and two doses of IV among children aged 24–59 months was 58.9 and 42.4%, respectively. Significant associated factors included family members’ IV experience (ORu = 5.37, 95% CI: 3.48, 8.29), variables related to the HBM constructs (except perceived severity) [perceived susceptibility of seasonal influenza (ORu = 2.03, 95% CI: 1.39, 2.95), perceived benefits of IV (ORu = 3.11, 95% CI: 2.05, 4.71), perceived barriers (ORu = 0.49, 95% CI: 0.25, 0.96) of IV, and cue to action (ORu = 4.79, 95% CI: 2.87, 7.99)], supportive subjective norm (ORu = 4.26, 95% CI: 2.91, 6.25), and level of fear felt during the H1N1 pandemic (ORu = 1.97, 95% CI: 1.01, 3.87). Adjusted for the child's age, the same significant factors were found. Exposure to related media messages was statistically non-significant.ConclusionThe reported IV prevalence was higher than that of 24- to 59-month-old children reported in other studies. There is room for improvement through health promotion, which should modify parental cognitions related to HBM (except perceived severity and self-efficacy) and involve family members to create subjective norm. Media campaigns may be inadequate for promotion of IV; use of the setting approach may be considered.     

基于语义网和SOA的医学图书馆信息服务模型设计

提出了基于语义网关联数据和本体技术的用户检索方式的转变及基于本体的学科馆员信息服务模型。该模型利用SOA技术为基于语义网的信息服务提供了开放的应用接口,通过建立基于关联数据技术的驱动引擎和知识库,使资源之间具有了语义上的可扩展的关联关系,并搭建了学科馆员平台、医学领域专家平台、学科专业用户平台,学科馆员在医学领域专家的协助下,应用本体模型为医学专业用户提供语义层面的智能化检索服务。     

精神分裂症啮齿类动物模型及其行为学检测

精神分裂症是一种常见而严重的精神疾病,给患者及其家人的生活造成极大的危害。由于该疾病发病因素复杂,因此在药物治疗上还存在诸多问题。在候选药物筛选和药物研发的临床前研究中,需要可靠稳定的动物模型。本文对精神分裂症阳性症状、阴性症状和认知相关的啮齿类动物模型以及行为学检测方法做一综述,希望能够为抗精神分裂症药物的筛选和临床前研究提供动物模型的参考。