秩和比法在碘缺乏病防治工作综合评价中的应用

目的利用秩和比法（RSR）综合评价儿童碘缺乏病防治工作质量,为今后制定科学的防治对策提供依据。方法在重庆市采用人口比例概率抽样法抽取30个监测点,每点抽取1所小学8~10岁儿童40名,调查碘盐、尿碘和甲状腺肿大率。利用SPSS13.0软件,对30个调查点监测结果进行秩和比综合评价。结果调查食用盐1 322份,碘含量中位数为30.7 mg/kg;尿碘中位数为245.4μg/L,8~、9~和10~岁儿童尿碘中位数分别为252.4、261.4和256.1μg/L,各年龄组尿碘差异无统计学意义（H=8.24,P〉0.05）;甲状腺肿大率为5.45%,其中8~、9~和10~岁儿童分别为5.41%、6.01%和4.80%,各年龄组甲状腺肿大率差异无统计学意义（χ^2=0.65,P〉0.05）;30个区县加权秩和比值（WRSR）与概率单位的直线回归方程为：RSR=0.5167＋0.033Probit,R2=0.098,分4档时差异性假设检验,P〈0.0001,且4档间的两两比较差异均有统计学意义,进行方差齐性检验均为方差齐。结论总体上重庆市儿童碘营养充足,碘缺乏病防治工作存在地区间差距,应采取不同的防治对策。     

秩和比法在大学生心理健康状况综合评价中的应用

目的 了解独立学院大学生心理状况。为大学生开展心理教育提供依据。方法 应用秩和比法封独立学院大学生的SCL90结果追行综合评价，得到了不同年级心理健康状况的排序与分类。结果 心理健康水平整体低于全国青年组，最严重的是大二学生。结论 应加强独立学院大学生的心理教育，以提高他们的心理健康水平。     

应用医疗指标自增长率的秩和比法综合评价临床科室发展潜能

目的探讨对医疗指标的自增长率采用秩和比法综合评价科室发展潜能的应用价值。方法选取医院近4年的主要医疗指标,对其自增长率采用秩和比法计算秩和值(RSR),根据秩和值大小进行科室排名,秩和值大为优,由所得排序结果去综合评价各临床科室的发展潜能[1-3]结果表2排序结果与我院目前各科室发展现状基本相符。结论对临床科室主要医疗指标的自增长率采用秩和比法来评价科室发展,可以排除各科室因为收治病种不同、规模不同、以及科室发展的不平衡等各种因素的影响,使原本可比性较差或不可比的指标有了较好的可比性。实践证明,该方法不失为一种评价临床科室发展的一种有效的方法。     

应用秩和比法评价我院2009年病床利用情况

目的 应用秩和比法对我院2009年各病区床位利用情况进行综合分析.方法 选取病床使用率、床位周转次数、平均病床工作日采用秩和比法进行分析,评价医院各病区病床利用情况.结果 通过分析得出,我院有9个病区管理最好,为医院创造了较好的经济效益.结论 应用加权秩和分析法对病床的利用情况进行分析,弥补了其他分析方法的不足,较全面的得出合理的结论.     

调查和分析我国结核病防治工作现状

结核病是一种传染性极强的疾病,会给人们的身体健康造成严重的危害,因而有效控制与遏制结核病的流行,就需要对我国的结核病工作开展详细的调查与分析,为防治工作打好基础。本文就当前我国的结核病含义、指标、现状加以深入分析,尽管控制结核病面临许多的难题,疫情的实际情况制定相应的防治措施,才能取得事半功倍的效果。     

广州市中小学校结核病防治知识调查问卷的信度、效度评价

目的评价通过Delphi法形成的“广州市中小学校结核病防治知识调查问卷”的信度、效度。方法使用调查问卷对135名广州市小学生、中学生及学生家长进行测试，分层随机抽取其中65例进行重测，计算该问卷的内部一致性、重测信度和结构效度。结果该问卷各部分和问卷总体Cronbaeh’s系数在0．7870～0．8420之间．13个指标的Spearman相关系数均〉0．7，P值均小于0．01。对13个指标进行因素分析，产生4个公共因子．它们总共能解释总体方差的63．83％，13个指标因子负荷在0．492～0．866之间，均大于0．40的基本要求。结论该问卷的信度、效度良好，具有良好的可靠性和有效性，可用于评价中小学校结核病防治知识水平。     

利用科学统计方法对医院工作质量进行综合评价

目的 利用科学的统计学法对医院的工作质量进行评价，从中找出差距和不足。为决策提供科学依据。方法 采用层次分析法、综合评价法对医院工作质量进行综合评价。结果 该院工作质量相对平稳，1991年的工作质量最好，1996年最差。结论 将两种方法结合，能够取长补短，有效反映医院的工作质量水平，为科学管理提供信息，优于单一统计方法。有利用价值。     

应用TOPSIS法与综合法综合评价医院医疗质量

国内对医院医疗质量的评价有病例评价法、统计指标评价法、综合指标评价法、单病种质量评价法、病人满意度调查法等，其中综合指标评价法方法很多，如综合指数法、模糊评价法、秩和比法、TOPSIS法、Ridit法、灰色系统法等。这些方法各具特色，各具利弊，由于受多方面因素影响，怎样使评价方法更为准确和科学，是人们在不断研究和探讨的课题。本文采用同一指标评价体系进行TOPSIS法、综合评价法对某综合性医院的医疗质量进行评价。     

综合评价方法在医院统计工作中的应用

综合评价方法逐渐被运用到医院统计工作中,本文运用综合评价方法对医院工作效率进行综合评价。     

传染病医院医疗质量的综合评价

目的 为了进一步提高医院医疗质量和医疗技术综合管理水平.方法 运用综合指数法,将10项评审指标进行归纳,计算出门诊工作效率、病房工作效率及病房工作质量综合指标,分别求得5a来综合指数.结果 近5a来我院的综合指数持续上升,综合质量一年比一年好.结论 运用综合指数法评价医院的综合达标水平是合理的选择.     

Early detection of Pre-XDR TB with line probe assay in a high TB burden country

BackgroundWorldwide, tuberculosis (TB) is one of the top 10 causes of death. Drug resistant tuberculosis has lately become a major public health problem that threatens progress made in Tuberculosis (TB) care and control worldwide. The aim of this study was to determine the prevalence of Pre-extensive drug resistant TB among MDR TB in North Central of Nigeria.MethodsThis study was conducted from October, 2018 to August, 2019 with 150 samples. In Nigeria, guidelines for DR-TB as recommended by WHO is followed. All the samples from the patients who gave their consent were transported to a zonal reference TB laboratory (ZRL).ResultsMean age was 38.6 ± 13.4 years with peak age at 35–44. Out of these 103 samples processed with LPA, 101(98%) were rifampicin resistant and 2 were rifampicin sensitive, 99(96%) were INH resistant and 4 (4%) were INH sensitive, 5(5%) were fluoroquinolone resistant, 98(95%) were fluoroquinolone sensitive, 12 (12%) were Aminoglycoside + Capreomycin resistant, 91(83%) were Aminoglycoside + Capreomycin sensitive.ConclusionMultidrug resistant TB and its severe forms (Pre-extensive & extensively drug resistant TB) can be detected early with rapid tool- Line Probe Assay rapid and prevented timely by early initiation on treatment.     

Potential Function of Granulysin,Other Related Effector Molecules and Lymphocyte Subsets in Patients with TB and HIV/TB Coinfection

Background: Host effector mechanism against Mycobacterium tuberculosis (Mtb) infection is dependent on innate immune response by macrophages and neutrophils and the alterations in balanced adaptive immunity. Coordinated release of cytolytic effector molecules from NK cells and effector T cells and the subsequent granule-associated killing of infected cells have been documented; however, their role in clinical tuberculosis (TB) is still controversy.Objective: To investigate whether circulating granulysin and other effector molecules are associated with the number of NK cells, iNKT cells, Vγ9⁺Vδ2⁺ T cells, CD4⁺ T cells and CD8⁺ T cells, and such association influences the clinical outcome of the disease in patients with pulmonary TB and HIV/TB coinfection.Methods: Circulating granulysin, perforin, granzyme-B and IFN-γ levels were determined by ELISA. The isoforms of granulysin were analyzed by Western blot analysis. The effector cells were analyzed by flow cytometry.Results: Circulating granulysin and perforin levels in TB patients were lower than healthy controls, whereas the granulysin levels in HIV/TB coinfection were much higher than in any other groups, TB and HIV with or without receiving HAART, which corresponded to the number of CD8⁺ T cells which kept high, but not with NK cells and other possible cellular sources of granulysin. In addition, the 17kDa, 15kDa and 9kDa isoforms of granulysin were recognized in plasma of HIV/TB coinfection. Increased granulysin and decreased IFN-γ levels in HIV/TB coinfection and TB after completion of anti-TB therapy were observed.Conclusion: The results suggested that the alteration of circulating granulysin has potential function in host immune response against TB and HIV/TB coinfection. This is the first demonstration so far of granulysin in HIV/TB coinfection.     

宁夏某医院患者TB DNA检测分析

目的 探讨宁夏某医院TB DNA感染现状及临床特点。方法 对我院就诊的疑似结核病感染患者1828例进行回顾分析,用实时荧光定量PCR检测血浆TB DNA。结果 TB DNA阳性患者32例,总阳性率为1.75%,男、女性阳性率分别为2.17%和1.17%,差异无统计学意义（P＞0.05）。童年组（0~6岁）阳性率最高为2.86%,与其他年龄组相比,差异无统计学意义（P＞0.05）。春季（3~5月份）TB DNA阳性率最高为3.21%,与其他季节相比,差异有统计学意义（P＜0.05）。2015年~2017年TB DNA阳性率有逐年下降趋势（2.06%、2.00%、1.16%）。TB DNA阳性患者就诊临床科室主要以泌尿外科（6.11%）、呼吸内科（5.26%）、肝胆外科（4.35%）为主。结论 TB DNA检测有助于结核病的早期诊断,为临床防治结核病提供重要依据。     

家庭综合干预对社区精神分裂症患者的影响

目的探讨家庭综合干预对社区精神分裂症患者的影响。方法将精神分裂症患者随机分为家庭综合干预组和对照组。干预组接受药物治疗和家庭综合干预,对照组仅接受药物治疗。采用简明精神病评定量表（BPRS）、社会功能缺陷筛选量表（SDSS）进行评估。结果3年末干预组BPRS分及SDSS分、复发率、再住院率显著低于对照组（P〈0.01）。结论社区家庭综合干预可以有效减轻精神分裂症患者的症状,预防疾病复发,改善患者社会功能。     

Use of bactec 460 TB system in the diagnosis of tuberculosis

PurposeTo evaluate, the efficacy of BACTEC 460 TB system for the diagnosis of tuberculosis in a tertiary care hospital in Mumbai, India. Methods: We compared 12,726 clinical specimens using BACTEC 460 TB system and conventional method for detection of Mycobacterium tuberculosis over a period of six years. Result: The overall recovery rate was 39% by BACTEC technique and 29% using Lowenstein-Jensen (LJ) medium. An average detection time for BACTEC 460 TB system was found to be 13.3 days and 15.3 days as against 31.2 days and 35.3 days by LJ method for respiratory and nonrespiratory specimens respectively. The average reporting time for drug susceptibility results ranged from 6-10 days for the BACTEC 460 TB system. Conclusions: The BACTEC system is a good system for level II laboratories, especially in the diagnosis of extrapulmonary and smear negative tuberculosis.     

Evaluation of GeneXpert and liquid culture for detection of Mycobacterium tuberculosis in pediatric patients

PurposeEvaluation of GeneXpert in comparison to liquid culture using Mycobacteria Growth Indicator Tube (MGIT) as gold standard for detection of Mycobacterium tuberculosis (MTB) in children.MethodsA total of 8123 samples, both pulmonary (5830) and extra pulmonary (2293) received from pediatric patients were processed for Acid Fast Bacilli (AFB) smear, GeneXpert and MGIT culture simultaneously.ResultsOut of 8123 samples, 493 (6.1%) samples were found positive by GeneXpert and 508 (6.2%) samples by MGIT culture, 371 (4.6%) were found positive by both GeneXpert and MGIT culture. MGIT detected 137 (1.7%) extra positive than GeneXpert while GeneXpert detected 122 (1.5%) extra samples more positive than by MGIT. Sensitivity of GeneXpert was 73% and concordance between both methods was 96.8%. Rifampicin resistance was found in 49 (9.9%) samples among MTB positive by GeneXpert. Turnaround time for GeneXpert was approx. 2 ?h and for MGIT, it was 12–28 days.ConclusionGood sensitivity (73%) and concordance (96.8%) were observed for GeneXpert against MGIT culture in this study. GeneXpert can simultaneously detect MTB and rifampicin resistance in less than 2 ?h while MGIT takes 12–28 days for MTB detection only.     

A rapid and low-cost microscopic observation drug susceptibility assay for detecting TB and MDR-TB among individuals infected by HIV in South India

Background: The converging epidemics of HIV and tuberculosis (TB) pose one of the greatest public health challenges of our time. Rapid diagnosis of TB is essential in view of its infectious nature, high burden of cases, and emergence of drug resistance. Objective: The purpose of this present study was to evaluate the feasibility of implementing the microscopic observation drug susceptibility (MODS) assay, a novel assay for the diagnosis of TB and multi-drug-resistant tuberculosis (MDR-TB) directly from sputum specimens, in the Indian setting. Materials and Methods: This study involved a cross-sectional, blinded assessment of the MODS assay on 1036 suspected cases of pulmonary TB in HIV-positive and HIV-negative patients against the radiometric method, BD-BACTEC TB 460 system. Results: Overall, the sensitivity, specificity, positive predictive value, and negative predictive value of the MODS assay in detecting MTB among TB suspected patients were 89.1%, 99.1%, 94.2%, 95.8%, respectively. In addition, in the diagnosis of drug-resistant TB, the MODS assay was 84.2% sensitive for those specimens reporting MDR, 87% sensitivity for those specimens reporting INH mono-resistance, and 100% sensitive for specimens reporting RIF mono-resistance. The median time to detection of TB in the MODS assay versus BACTEC was 9 versus 21 days (P < 0.001). Conclusion: Costing 5 to 10 times lesser than the automated culture methods, the MODS assay has the potential clinical utility as a simple and rapid method. It could be effectively used as an alternative method for diagnosing TB and detection of MDR-TB in a timely and affordable way in resource-limited settings.     

UL84-independent replication of human cytomegalovirus strain TB40/E

The UL84 gene of human cytomegalovirus is implicated in the initiation of viral DNA replication during lytic infection. UL84 is essential for replication of a cloned viral origin of lytic replication (oriLyt) in vitro and mutants of strains AD169 or Towne with deletions or insertions in UL84 fail to grow in cells permissive for wild type virus. Here we show that UL84 is dispensable for replication of a strain TB40/E clone derived from a bacterial artificial chromosome. The genomes of the fibroblast-adapted strains AD169 and Towne are altered substantially from the consensus for strains that have not been propagated extensively in cell culture. The parental TB40/E genome conforms to the consensus genomic organization. Accordingly, natural HCMV strains may possess replication capability that extends beyond the known oriLyt-dependent replication system of laboratory strains.     

活动性结核病人PBMCs中转录因子PLZF的表达降低与iNKT细胞的减少相关

目的:比较活动性结核病人和健康人外周血单个核细胞(PBMCs)中转录因子PLZF(Promyelocytic leukemiazinc finger)的表达和iNKT细胞含量的差异,研究活动性结核病人PBMCs中PLZF的表达与iNKT细胞含量的相关性。方法:采集活动性结核病人和健康人新鲜的抗凝血,淋巴细胞分离液分离PBMCs。每个样本的PBMCs分两份,一份细胞用Trizol法提取总RNA,荧光定量PCR检测PLZF mRNA的相对表达量;另一份细胞用特异性抗体标记iNKT细胞,流式细胞仪检测iNKT细胞的含量。统计学软件分析两组样本PLZF的表达和iNKT细胞含量的差异,以及PLZF的表达与iNKT细胞含量的相关性。结果:活动性结核病人PMBCs中PLZF的表达和iNKT细胞含量均显著低于健康对照(P值分别为0.010 2和0.001 2),PLZF的表达与iNKT细胞的含量成正相关(r=0.480 4,P=0.027 5)。结论:活动性结核病人PLZF的表达降低与iNKT细胞百分含量的减少相关。