全程管理科研课题确保科研工作质量

医院课题管理是科研管理人员的重要任务之一，各级领导亦应将其沉为发展医院的战略性内容而给予足够的重视。作者从课题研究的质量分析和整个科研过程人手，找出各研究时期的关键环节，进行有重点的管理。探讨以课题管理为主线，牵动学科建设、论文管理、成果管理的科研管理新模式，从科研的根基和深层次上提高医院的科研水平。     

Effect of HIV posttest counseling on STD incidence.

OBJECTIVE--To evaluate the effectiveness of human immunodeficiency virus (HIV) testing and posttest counseling in reducing subsequent high-risk behavior. METHODS--The incidence of sexually transmitted diseases (STDs) in the Baltimore, Md, public STD clinic population after HIV testing and counseling was determined by chart review and was compared in two groups, 868 HIV-seropositive patients and 1104 HIV-seronegative patients, matched by age, sex, and month in which HIV test was conducted. Patients were observed for incident STDs at intervals of 6 through 23 months. Patients with incident STDs were classified hierarchically after being notified of the HIV test result and receiving posttest counseling. RESULTS--Of HIV-seropositive patients, 615 (71%) returned for their test results and received posttest counseling; 694 HIV-seronegative patients (63%) returned. Of all those who returned for results and posttest counseling, 60 (9.7%) of 615 HIV-seropositive patients and 61 (8.8%) of 694 HIV-seronegative patients were diagnosed at least once with definite STD (syphilis, gonorrhea, or trichomoniasis) (P, not significant). Twenty-four HIV-seropositive patients (3.9%) and 71 HIV-seronegative patients (10.2%) returned with probable STD (nongonococcal urethritis or pelvic inflammatory disease) (P less than .001). Nine HIV-seropositive patients (1.5%) and 23 HIV-seronegative patients (3.3%) returned having had an STD-infected sexual partner (P less than .03). Age, sexual orientation, and drug use behavior did not predict return with STD. CONCLUSIONS--Both HIV-seropositive and HIV-seronegative patients showed high rates of repeat STDs after posttest counseling, an important public health challenge in creating effective high-risk behavior prevention strategies.     

The rights and wrongs of intentional exposure research: contextualising the Guatemala STD inoculation study

In its recent review of the US Public Health Service Sexually Transmitted Disease Inoculation Study, conducted in Guatemala from 1946 to 1948, the Presidential Commission for the Study of Bioethical Issues identified a number of egregious ethical violations, but failed to adequately address issues associated with the intentional exposure research design in particular. As a result, a common public misconception that the study was wrong because researchers purposefully infected their subjects has been left standing. In fact, human subjects have been exposed to disease pathogens for experimental purposes for centuries, and this study design remains an important scientific tool today. It shares key features with other types of widely accepted research on human subjects and can be conducted ethically, provided certain safeguards are implemented. That these safeguards were not implemented in Guatemala is what made that study wrong, rather than the fact of intentional exposure itself. To preserve public trust in the clinical research enterprise, this conclusion ought to be stated explicitly and emphasised.     

595例性病门诊就诊者性病／艾滋病感染状况

目的监测高危人群艾滋病的流行特征，为制订艾滋病防制措施提供科学依据。方法对2006年济宁市某性病门诊就诊者的艾滋病哨点监测资料进行统计分析。结果595例就诊者中，感染由多到少依次是非淋菌性尿道炎268例（45．0％）、淋病208例（35．0％）、尖锐湿疣178例（29．9％）、梅毒13例（2．2％）等。最近3个月中有非婚性行为史的有454例（占76．3％）；与非婚性伴发生性行为时每次都用安全套的39例（占8．59％）。结论性病门诊就诊者中存在HIV传播的危险因素，应加强对这一人群宣传教育和干预，以促进艾滋病防制。