生物标志物的联合检测对矽肺早期辅助诊断的价值

目的：探讨联合检测生物标志物应用于矽肺早期辅助诊断的灵敏度和特异性。方法：采用立意抽样法，选取65例男性矽肺患者为病例组，以70例接触游离二氧化硅的在岗作业人员为对照组。清晨空腹采集外周血并分离血清，采用比色法测定对照人群和矽肺患者血清中超氧化物歧化酶（SOD）和丙二醛（MDA）水平；酶联免疫吸附法测定白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）水平，以矽肺I期患者血清中有显著性变化的生物标志物（MDA、IL-6和TNF-α）检测数据为数据集，绘制受试者工作特征曲线（ROC）并建立Logistic回归模型，评估联合检测上述生物标志物对矽肺早期辅助诊断的价值。结果：与对照组相比，矽肺患者血清中SOD表达水平无显著变化（P > 0.05）；矽肺I期及Ⅱ期患者血清中MDA及IL-6表达水平显著升高（P < 0.05）；矽肺I期患者血清中TNF-α表达水平显著升高（P < 0.05）。回归模型结果显示，ROC曲线下面积排序为：3个指标联合检测（0.89） > IL-6（0.86） > MDA（0.81） > TNF-α（0.65）。结论：IL-6、TNF-α和MDA的联合检测可以提高矽肺早期辅助诊断的灵敏度和特异性。     

Step UP! To Stamp Out Stigma: adapting and testing a bystander intervention to reduce HIV-related stigma

Aim

HIV-related stigma is a traumatizing experience operating across socioecological levels. Few interventions have combined multiple methods of stigma reduction into a comprehensive approach. This study adapted bystander training to the context of HIV-related stigma and pilot tested the model.

Subjects and methods

The study drew upon the team’s prior research to create an adapted bystander intervention. Thirty-nine participants met in three separate workshop sessions, which consisted of didactic training, group discussions, and contact between people living with HIV (PLHIV) and their friends/family members, and healthcare workers. Participants completed pre-/post-intervention questionnaires that included demographic characteristics and standardized measures of stigma and empowerment. A person living openly with HIV served as the moderator. The study’s principal investigator led a discussion to evaluate the workshop model.

Results

The workshops were associated with decreased feelings of powerlessness but did not show any immediate effects on feelings of stigmatization. Subjects unanimously recommended requiring the training for all healthcare providers.

Conclusion

The study showed the feasibility of adapting a bystander approach to HIV-related stigma. Interactive participation across different stakeholder groups allows for addressing various types of stigma and incorporating multiple evidence-based approaches to stigma reduction. Future research will incorporate further adaptations and test the approach using a large-scale randomized controlled trial.