中国部分地区妇幼卫生信息系统的现状分析

本文通过研究卫生 项目地区报表资料和现场调查 ,对项目地区妇幼卫生信息系统的建设及运作情况进行了分析 ,并对报表数据质量进行了评价。分析显示 :卫 项目推动了贫困地区信息系统建设 ,项目地区已建立起系统的妇幼卫生信息管理体系 ,但分析也反映出项目地区妇幼卫生常规报表的数据质量仍存在一定问题。分析结果提示 ,应进一步加强妇幼卫生信息系统建设 ,提高妇幼卫生统计信息专业队伍的业务水平。     

Assessment of the Severity of Asthma in a Family Practice

The objective of this study was to evaluate clinical history and self-perception of severity as predictors of asthma severity. A short-term longitudinal study was conducted in a family practice in Melbourne, Australia, utilizing peak flow monitoring, medication diary, and self-administered asthma severity questionnaire. Seventy-two asthmatic subjects with a positive bronchodilator or exercise test, aged between 6 and 79 years, were studied. Symptom and treatment items were correlated with peak flow variability and minimal peak expiratory flow rate (PEFR). An asthma severity scale was generated using the partial credit version of Item Response Theory and the participants' severity scores were validated against lung function tests and medication usage. Quantitative modeling procedures were used to investigate the interrelationships of factors associated with peak flow variability. Severity scores demonstrated significant relationships with peak flow variability (partial r = 0.34) and treatment items. Self-perceived severity of asthma in the preceding 2 weeks showed significant association with peak flow variability (partial rho = 0.46) and minimal PEFR (rho = -0.41). The severity module of the Monash Respiratory Questionnaire is a valid and reliable instrument. The most important symptoms appear to be the frequency of use of bronchodilator and frequency of nocturnal attacks. A carefully structured clinical history in conjunction with the peak flow criteria of variability and minimal peak flow rate would be appropriate in the evaluation of asthma severity. Patients' self-perception of the severity of their asthma needs further evaluation.     

穿支蒂皮瓣修复臀骶部软组织缺损

目的探讨应用穿支蒂皮瓣修复臀骶部软组织缺损的手术方法及临床效果。方法1998年以来临床应用8例,其中男5例,女3例。年龄15～79岁。根据缺损部位及大小设计以臀部、骶旁或腰动脉的皮穿支为血管蒂的轴型穿支蒂皮瓣移位修复臀骶部褥疮、溃疡及外伤性软组织缺损创面。切取皮瓣达6cm×5cm～19cm×11cm,穿支血管口径1.3～2.1mm,游离穿支血管蒂长度为2.5～4.5cm。结果皮瓣全部成活,伤口期愈合。随访6～24个月,皮瓣质地优良,外形满意,溃疡无复发。结论穿支蒂皮瓣设计灵活,切取方便,血供可靠,不损伤臀部肌肉,供区无需植皮,是修复臀骶部软组织缺损创面的理想方法。     

Multiple Copies of the Upstream Regulatory Region of the Major Capsid Protein Gene of Bacteriophage MB78 Inhibit Phage Morphogenesis

The 2.311 kb EcoRI F fragment of bacteriophage MB78 has been cloned in multicopy vectors pUC19 and pCR90. Salmonella typhimurium strains carrying such plasmids cannot support development of phage MB78 while other Salmonella phages like P22 and 9NA grow normally. Most of the phage MB78 induced functions are normal in such transformed hosts but proper maturation of the phage particles does not take place. Deletion of 138 bp from the 3 end of the cloned fragment reverses the inhibitory effect. Analysis of nucleotide and the deduced amino acid sequence of a 1.2 kb HindIII-SalI fragment of the phage genome which overlaps the 138 bp confirms that this part contains the upstream regulatory region of the major structural protein gene. It seems that in presence of multiple copies of the upstream regulatory region (which includes a number of promoter like sequence) of the coat protein gene, the maturase gene is down regulated and this is effective only in cis, a situation quite similar to that of Q RNA phages.     

Isolation and characterisation of a defective measles virus from a subacute sclerosing panencephalitis patient.

A cytopathic measles virus was isolated from a brain biopsy of a subacute sclerosing panencephalitis (SSPE) patient. The agent could be transferred to Vero cells by cocultivation, but the infectivity always remained cell-associated -ie, a defective virus infection. The cell-associated nature of the virus was retained through 25 passages in Vero cells. Intracerebral inoculation of hamsters (2-6 days old) with the cocultured Vero cells gave rise to 100% mortality in 5-7 days. The virus retained its cell-associated nature after passage in hamsters. Electron microscopy of the brain and Vero cocultures showed the presence of virus-like ribonucleoparticles mainly in the nucleus. The presence of viral antigens in the nucleus, cytoplasm, and on the plasma membranes was confirmed by immunofluorescence. Using a combination of immunological and biochemical techniques, it was shown that all the viral proteins were synthesized with the exception of the haemagglutinin. Inclusion of the fusion inhibitor SV4814 (CBZ-D phenylalanine-L-phenylalanine-L-arginine-NO2) in the culture medium led to the elimination of the SSPE infection.     

Functional Health Literacy: Psychometric Properties of the Newest Vital Sign for Portuguese Adolescents (NVS-PTeen)

Self-management of health requires skills to obtain, process, understand, and use health-related information. Assessment of adolescents’ functional health literacy requires valid, reliable, and low-burden tools. The main objective of this study was to adapt and study the psychometric properties of the Newest Vital Sign for the Portuguese adolescents’ population (NVS-PTeen). Classic psychometric indicators of reliability and validity were combined with item response theory (IRT) analyses in a cross-sectional survey, complemented with a 3-month test-retest assessment. The NVS-PTeen was self-administered to students enrolled in grades 8 to 12 (12 to 17 years old) in a school setting. Overall, 386 students (191 girls) from 16 classes of the same school participated in the study (mean age = 14.5; SD = 1.5). Internal reliability of the NVS-PTeen was α = 0.60. The NVS-PTeen total score was positively and significantly correlated with Portuguese (r = 0.28) and mathematics scores (r = 0.31), school years (r = 0.31), and age (r = 0.19). Similar to the original scale (for the U.S.), the NVS-PTeen is composed of two dimensions, reading-related literacy and numeracy. Temporal reliability is adequate, though with a learning effect. IRT analyses revealed differences in difficulty and discriminative capacity among items, all with adequate outfit and infit values. Results showed that the NVS-PTeen is valid and reliable, sensible to inter-individual educational differences, and adequate for regular screening of functional health literacy in adolescents.     

Research trends of prostatitis over past 20 years: A bibliometric analysis

In the past two decades, thousands of documents in the field of prostatitis have been published. This bibliometric analysis aimed to assess the characteristics, hotspots and frontiers trend of global scientific output on prostatitis. With the trend of moderate growth, altogether 2,423 papers were reviewed. The leading role of the United States in global prostatitis research was obvious, while China had developed rapidly in recent years. Queen's University and JOURNAL OF UROLOGY were the most prolific affiliation and journal respectively. Nickel, J. C made the greatest contribution to the field of prostatitis. Five hotspots have been confirmed: (a) male infertility associated with prostatitis and the molecular mechanisms; (b) diagnosis and treatment of prostatitis; (c) inflammation, pain and bladder irritation symptoms; (d) relationship between chronic prostatitis/chronic pelvic pain syndrome, benign prostatic hyperplasia and prostate cancer; (e) epidemiology, complications of prostatitis and improvement of acupuncture. This bibliometric analysis reveals that the international cooperation was becoming more and more close. Hotspot analysis shows that the molecular mechanism of prostatitis will be a hotspot in the future, mainly focussing on inflammatory immunity and oxidative stress.     

The value of the Hospital Anxiety and Depression Scale (HADS) for comparing women with early onset breast cancer with population-based reference women

BACKGROUND: The Hospital Anxiety and Depression Scale (HADS) is frequently used in cancer studies, yet its utility for comparing people with cancer with people in the community is uncertain. METHODS: HADS scores were obtained from population-based samples of women with (n = 731) and without (n = 158) early-onset breast cancer. Psychometric properties were examined using differential item functioning (DIF) which is the presence of systematic group differences in certain response items independent of the trait being measured. RESULTS: Women with breast cancer scored lower than reference women on anxiety (mean (SD) 7.5 (4.3) vs. 8.2 (4.0); p = 0.06) and depression (3.3 (3.2) vs. 4.2 (3.0); p = 0.003). Group differences remained following adjustment for demographics. Time since diagnosis was not related to anxiety or depression scores. DIF was present in two anxiety and five depression items. Adjustment for DIF did not substantially change the anxiety or depression group differences. CONCLUSION: Specific sampling or DIF effects do not explain the observation that women with breast cancer have lower levels of anxiety and depression than population controls. The psychometric properties of the HADS appear to be acceptable in these groups.     

医疗服务项目实际成本与收费标准比较研究

通过对北京市4所三级甲等综合医院20个医疗服务项目的实际成本进行调查分析，主要包括平均实际成本分析、收费标准与成本的差量分析和收费标准与成本差量的极值分析、收费覆盖率分析、收费覆盖率极值分析。调查分析发现大部分项目的实际成本高于现行收费标准。为此，应完善医疗服务项目价格形成机制和健全医疗服务项目价格调整机制，建立科学有效的医疗服务项目价格评价指标体系，以确保其价格的调整效果。     

试论医院工程项目的经济评价

工程项目经济评价的战略性、前瞻性、科学性、经济性、有效性和安全性是项目决策的前提与基础。目前,医院对工程项目的经济评价沿用的是传统的成本核算方法,是对医院内部之间的财务成本核算与管理的评价,评价缺乏对医院隐含的成本因素中的战略性定位分析、成本动因分析、价值链分析、全寿命周期经济效益分析和医疗市场发展态势分析。传统的评价方法己不能满足和适应医院战略管理的需要,实施战略成本管理方法,全方位、多角度采集信息,进行战略性的分析、评价,是现阶段医院工程项目经济评价的有效方法。