安徽省国家疾病监测点2013～2017年死因网报数据质量评估

目的评估安徽省国家疾病监测点死因数据报告质量,分析存在的问题。方法采用分层整群随机抽样方法评估安徽省国家死因监测点(DSPs)2013-2017年死因填报质量。结果2013.2017年安徽省DSPs死因网报个案身份证号、死因链、根本死因及其编码填报年均准确率分别为85.83%.64.14%和82.19%,其中前两项指标准确率均见逐年增高趋势(P<0.05),第3项指标准确率比2013年提高2.77%。3项指标准确率在新老点和城乡之间的差异逐年缩小。除根本死因及其编码准确率外,新点填报准确率均优于老点;身份证号准确率城市点较优,死因链准确率农村点较优,而根本死因及其编码准确率无城乡差异。死因链上疾病编码缺失或错误、多死因链填报不准确是死因填报中主要的错误类型。结论2013-2017年安徽省国家疾病监测点死因网报质量不断提升,但仍有进步空间。在强化培训和督导的同时,各级疾控中心要严把审核工作的质量,并定期开展抽审评估工作,及时发现和解决问题。     

The way forward for ETEC controlled human infection models (CHIMs)

In the absence of good animal models, Controlled Human Infection Models (CHIMs) are useful to assess efficacy of new vaccine candidates against Enterotoxic Escherichia coli (ETEC), as well as other preventive or therapeutic interventions. At the 2018 Vaccines Against Shigella and ETEC (VASE) conference, a workshop was held to further review and discuss new challenge model developments and key issues related to further model standardization. During the workshop, invited speakers briefly summarized for attendees recent developments and main agenda issues before workshop participants were divided into four groups for more focused discussions.The main issues discussed were: (1) whether there is a need for more ETEC strains to test a diversity of vaccine candidates, and if so, what criteria/qualities are desirable in strain selection; (2) how ETEC CHIMs could be more standardized to better support ETEC vaccine development; (3) how volunteer selection criteria and screening should be performed, and; (4) how an expanded sample collection schema and collaborative analysis plan may facilitate a more in-depth assessment of the role of antigen-specific humoral and cellular immune responses in ETEC infection, and provide better insights into ETEC pathogenesis and correlates of protection.The workshop concluded that additional challenge strains may need to be developed to better support new vaccines and therapeutics that are advancing in the development pipeline. In this regard, the need for a well characterized ST-only expressing ETEC strain was highlighted as a priority given that promising new heat stable toxoid based vaccine candidates are on the horizon. In addition, further standardization of the ETEC CHIMs was strongly encouraged, noting that it may not be realistic to standardize across all strains. Also, intensified volunteer screening may result in higher attack rates, although more stringent eligibility criteria may contribute to a more limited application of the model and diminish its representativeness. Finally, a sampling schedule and priority list for minimum set of samples was also proposed. Future workshops could be held to further refine standards for ETEC CHIMS and to facilitate more collaborative work on stored sample sets from previous and future ETEC CHIMs to maximize the contribution of these trials to our understanding of ETEC pathogenesis and our development of better prevention and control measures for this important pathogen.     

The Neighbourhood Effects on Health and Well-being (NEHW) study

Many cross-sectional studies of neighbourhood effects on health do not employ strong study design elements. The Neighbourhood Effects on Health and Well-being (NEHW) study, a random sample of 2412 English-speaking Toronto residents (age 25–64), utilises strong design features for sampling neighbourhoods and individuals, characterising neighbourhoods using a variety of data sources, measuring a wide range of health outcomes, and for analysing cross-level interactions. We describe here methodological issues that shaped the design and analysis features of the NEHW study to ensure that, while a cross-sectional sample, it will advance the quality of evidence emerging from observational studies.     

丹酚酸组分中各代表性成分药效贡献率的评价及其油水分配系数的整合表征

该实验利用人脐静脉内皮细胞氧化损伤实验、家兔体外凝血4项实验和大鼠心肌缺血实验相结合的方法比较了丹酚酸组分中3个代表性成分的药效活性的差异,并利用CRITIC权重法评价代表性成分的药效贡献率;结果得到丹酚酸组分中代表性成分丹酚酸B、迷迭香酸、丹参素的贡献率分别为28.85%,30.11%,41.04%。采用摇瓶法测定了丹酚酸组分在水以及不同p H缓冲液中的油水分配系数,进一步以质量权重系数和药效贡献率相结合的方法整合表征了该组分整体的油水分配系数,结果表明丹酚酸组分在正辛醇-水/p H 1.2的盐酸溶液/p H 2.0,2.5,5.0,5.8,6.8,7.4,7.8的磷酸盐缓冲液中表观油水分配系数0.32,1.06,0.89,0.98,0.90,0.13,0.02,0.20,0.56。该实验为组分整体性质的表征提供了一定的参考。     

举臂拧螺丝作业肩腕部肌电特征与工具重量的相关性

目的应用表面肌电(s EMG)描记技术分析汽车装配作业工人手臂用不同重量工具拧螺丝作业过程中肩部、腕部肌肉的肌电信号特征,初步探讨其与重量负荷的相关性。方法选择某汽车厂总装线7名男性工人为研究对象,采用Biovision表面肌电仪采集受试者进行正常装配活动时右侧三角肌和前臂腕屈肌群的表面肌电信号;应用DASYLab10.0数据处理软件和SPSS16.0统计分析软件,对肌电时域指标RMS和频域指标MF与工具重量的相关性进行统计分析。结果研究对象使用的工具涉及3个重量,分别为0.2 kg、1 kg和1.35 kg。在前臂腕屈肌群工具重量与最大自主收缩百分比(MVE%)和MF均呈负相关,相关系数分别为-0.430和-0.569(P0.01);在三角肌与MVE%和MF分别呈正相关和负相关,相关系数分别为0.598和-0.376(P0.01)。结论在举臂拧螺丝作业中,肩腕部局部肌肉MVE%和MF的变化可反映工具重量的大小。     

玻璃体和视网膜相关组织标本取材及应用研究现状

准确的玻璃体、视网膜相关组织标本取材及保存方法是保证临床诊断及开展严谨基础研究的基础。玻璃体标本取材的临床用途包括微生物培养、细胞学检测、变性性疾病检测、PCR分析、液基细胞学检测细胞形态等;实验研究用途包括DNA基因分析、蛋白定量分析、代谢物检查、RNA含量定量分析、细胞因子测定等。视网膜标本取材主要用于视网膜增生膜的PCR分析、免疫组织化学染色、免疫荧光检查、微血管密度评价以及细胞分离和培养等。了解玻璃体视网膜手术标本的取材和相关检测技术、材料的应用,可为玻璃体视网膜疾病的诊断提供更全面的思路及相关基础研究提供更广泛的参考。     

腹腔镜在肝胆外科的应用效果观察

目的：观察腹腔镜在肝胆外科手术中的应用效果。方法：选取98例肝胆患者作为研究对象，将患者分为对照组和观察组各49例，观察组患者采用腹腔镜进行手术，对照组患者采用常规开腹手术进行治疗。观察两组患者的手术时间、术中出血量、住院时间和术后并发症。结果：观察组患者平均手术时间为（150.72±5.23）min，对照组为（203.25±7.28）min，另外，观察组和对照组患者的术中出血量、平均住院时间和术后并发症等方面均有所不同，两组患者各项指标对比差异均具有统计学意义（P ＜0.05）。结论：肝胆外科手术中使用腹腔镜能够很大程度上减少患者的手术时间、术中出血量、住院时间及术后并发症，这对肝胆疾病的治疗十分有效，值得临床推广应用。     

Optimising sample collection for placental research

Biobanks provide an important repository of samples for research purposes. However, for those samples to reflect the in vivo state, and for experimental reliability and reproducibility, careful attention to collection, processing and storage is essential. This is particularly true for the placenta, which is potentially subjected to stressful conditions during delivery, and sample collection may be delayed owing to routine postpartum inspection by clinical staff. In addition, standardisation of the collection procedure enables samples to be shared among research groups, allowing larger datasets to be established. Here, we provide an evidence-based and experts' review of the factors surrounding collection that may influence data obtained from the human placenta. We outline particular requirements for specific techniques, and propose a protocol for optimal sample collection. We recognise that the relevance of these factors, and of the sample types collected to a particular study will depend on the research questions being addressed. We therefore anticipate that researchers will select from the protocol to meet their needs and resources available. Wherever possible, we encourage researchers to extend their collection to include additional samples that can be shared on an international collaborative basis, with appropriate informed consent, to raise the quality, as well as quantity, of placental research.     

Pro-equity immunization and health systems strengthening strategies in select Gavi-supported countries

BackgroundAchieving universal immunization coverage and reaching every child with life-saving vaccines will require the implementation of pro-equity immunization strategies, especially in poorer countries. Gavi-supported countries continue to implement and report strategies that aim to address implementation challenges and improve equity. This paper summarizes the first mapping of these strategies from country reports.MethodsThirteen Gavi-supported countries were purposively selected with emphasis on Gavi’s priority countries. Following a scoping of different documents submitted to Gavi by countries, 47 Gavi Joint Appraisals (JAs) for the period 2016–2019 from the 13 selected countries were included in the mapping. We used a consolidated framework synthesized from 16 different equity and health systems frameworks, which incorporated UNICEF’s coverage and equity assessment approach – an adaptation of the Tanahashi model. Using search terms, the mapping was conducted using a combination of manual search and the MAXQDA qualitative analysis tool. Pro-equity strategies meeting the inclusion criteria were identified and compiled in an Excel database, and then populated on a tableau visualization dashboard.ResultsIn total, 258 pro-equity strategies were implemented by the 13 sampled Gavi-supported countries between 2016 and 2019. The framework determinants of social norms, utilization, and management and coordination accounted for more than three-quarters of all pro-equity strategies implemented in these countries. The median number of strategies reported per country was 17. Afghanistan, Nigeria, and Uganda reported the highest number of strategies that we considered as pro-equity.ConclusionFindings from this mapping can be useful in addressing equity gaps, reaching partially immunized, and ‘zero-dose’ vaccinated children, and valuable resource for countries planning to implement pro-equity strategies, especially as immunization stakeholders reimagine immunization delivery in light of COVID-19, and as Gavi finalizes its fifth organizational strategy. Future efforts should seek to identify pro-equity strategies being implemented across additional countries, and to assess the extent to which these strategies have improved immunization coverage and equity.     

ELISA检测中全自动加样引起拖带假阳性现象的分析

目的：探讨ELISA检测中全自动加样引起拖带假阳性现象的原因以及所要采取的对策。方法别使用试剂检测筛查血液标本，然后根据检测试剂说明书的要求，在全自动样本处理系统控制微机上编辑程序，程序包括初检和复检。使用一次性探针和永久性探针的污染情况对比，再使用2种标本进行3孔复检，在进行判断是否为强阳性所引起的拖带污染现象。结果整个检测过程中，以HIV检测为例所检测的7324份血液检测中出现拖带假阳性现象的为2例，而2013年1月-2014年5月间共检测血液标本66085份，没有出现拖带假阳性现象。结论一次性加样探针的使用能够很好的减少甚至杜绝拖带假阳性污染现象的发生，在检测过程中由于不同的厂家的试剂有所区别，在设计加样参数时应该遵循科学合理的原则，检测仪器要定期进行检验维修，校准，同时对于血液标本要严格质量控制，提高检测的准确性和安全性，使得全自动检测设备的优势充分。