Reproductive health for refugees by refugees in Guinea IV: Peer education and HIV knowledge, attitudes, and reported practices

Fragile states are home to a sixth of the world's population, and their populations are particularly vulnerable to infectious disease outbreaks. Timely surveillance and control are essential to minimise the impact of these outbreaks, but little evidence is published about the effectiveness of existing surveillance systems. We did a systematic review of the circumstances (mode) of detection of outbreaks occurring in 22 fragile states in the decade 2000-2010 (i.e. all states consistently meeting fragility criteria during the timeframe of the review), as well as time lags from onset to detection of these outbreaks, and from detection to further events in their timeline. The aim of this review was to enhance the evidence base for implementing infectious disease surveillance in these complex, resource-constrained settings, and to assess the relative importance of different routes whereby outbreak detection occurs. We identified 61 reports concerning 38 outbreaks. Twenty of these were detected by existing surveillance systems, but 10 detections occurred following formal notifications by participating health facilities rather than data analysis. A further 15 outbreaks were detected by informal notifications, including rumours. There were long delays from onset to detection (median 29 days) and from detection to further events (investigation, confirmation, declaration, control). Existing surveillance systems yielded the shortest detection delays when linked to reduced barriers to health care and frequent analysis and reporting of incidence data. Epidemic surveillance and control appear to be insufficiently timely in fragile states, and need to be strengthened. Greater reliance on formal and informal notifications is warranted. Outbreak reports should be more standardised and enable monitoring of surveillance systems' effectiveness.     

Consensus guidelines for diagnosis,treatment and follow-up of patients with pancreatic cancer in Spain

The management of patients with pancreatic cancer has advanced over the last few years. We convey a multidisciplinary group of experts in an attempt to stablish practical guidelines for the diagnoses, staging and management of these patients. This paper summarizes the main conclusions of the working group. Patients with suspected pancreatic ductal adenocarcinoma should be rapidly evaluated and referred to high-volume centers. Multidisciplinary supervision is critical for proper diagnoses, staging and to frame a treatment plan. Surgical resection together with chemotherapy offers the highest chance for cure in early stage disease. Patients with advanced disease should be classified in treatment groups to guide systemic treatment. New chemotherapeutic regimens have resulted in improved survival. Symptomatic management is critical in this disease. Enrollment in a clinical trial is, in general, recommended.     

Determination of gallic acid in the traditional Chinese medicine by high-performance capillary electrophoresis

Rhizoma Polygoni Bistortae has been widely used as an important medicinal herb in the Far East for a few thousand years, and it has gained more recognition in the last few decades. In the present study, we used a high-performance capillary electrophoresis (HPCE) method for determination of the gallic acid (GA) in Quanshen (QS) pieces. The analysis of GA in QS pieces was successfully achieved in less than 6 min by capillary electrophoresis with UV detection at a wavelength of 290 nm. The background electrolyte was 20 mmol/L sodium borate solution (pH 9.00). The separation was performed in an uncoated fused-silica capillary (52 cm×50 μm) with an effective length of 40 cm, and the applied voltage was 20 kV. Sample solutions were injected for 10 s at an atmospheric pressure of 5 KPa. The result showed good resolution and precision (the intra-day RSD was 0.37%). The calibration curves of the standard solutions were linear in the range of 0.22–2.25 mg/mL, with correlation coefficients greater than 0.9990. The recovery of the method ranged from 100.6% to 107.9%, and the average recovery of GA was 105.9% with an RSD of 3.63%. HPCE is a powerful technology, and it is the first time to successfully apply such a method for the determination of GA in the traditional Chinese medicine.     

目标教学法在眼科护生实习带教中的应用

[目的]探讨目标教学法在眼科护生带教中的应用效果.[方法]将实习护生164人按实习时间分为对照组和实验组,对照组79人,采用传统的带教方法;实验组85人,采用目标教学法带教,实习结束进行理论及操作考试,同时发放带教老师考评表对带教老师进行评价.[结果]两组护生的出科理论、操作考试成绩比较,差异有统计学意义(P<0.01);两组护生对带教老师的考评结果比较,除遵章守纪两组比较无差异外,其余项目比较差异均有统计学意义.[结论]目标教学法可提高眼科护生的实习质量,提升带教老师的自身素质.     

278例人类免疫缺陷病毒感染患者的眼部表现

目的探讨人类免疫缺陷病毒（HIV）感染患者眼部表现的特点,为早期诊断、及时治疗提供依据。方法回顾性分析2002年9月至2004年7月中非共和国278例HIV感染患者的临床资料,对眼部病变病程、症状、体征、全身情况及首诊病因进行分析。结果102例（36．7％）HIV感染患者眼部有病变表现,同时伴慢性全身消耗性症状和体征,CD4细胞值降低。其中20例（7．2％）患者将眼部病变作为首诊的病因。眼部病变表现为机会性感染和肉瘤形成,依次为HIV视网膜病变、葡萄膜炎、眼外肌麻痹、眼部带状疱疹及眼睑卡波济肉瘤等。HIV视网膜病变不具特异性,表现为视网膜出血、棉絮状斑、血管闭塞、视网膜坏死、视网膜脱离及视神经萎缩等。结论HIV感染后可出现多种眼部病变,严重视网膜、葡萄膜病变是造成患者失明的重要因素。我国HIV感染患者日益增多,其早期症状和体征应引起眼科医师的高度关注。     

中山市小学生近视状况调查分析

目的了解小学生近视发病情况,探讨学生视力减退原因及相关预防对策,为社区护理干预提供科学依据。方法随机抽样选取中山市5所城区小学及3所乡镇小学一至六年级4617名学生进行视力检查。结果小学生近视发生率较高(14.81%),二至六年级学生近视发生率随着年级的升高而递增,女生组高于男生组(χ2=58.42,P<0.01),乡镇组高于城区组(χ2=20.06,P<0.01)。结论小学生近视的发生与其学习环境、生活习惯以及学习负担重等密切相关。建议家庭、学校及医院实施针对性的社区干预,降低小学生近视发病率。     

In vitro anti-biofilm activity of macelignan isolated from Myristica fragrans Houtt. against oral primary colonizer bacteria

In early dental plaque formation, oral primary colonizers such as Streptococcus mutans, Streptococcus sanguis and Actinomyces viscosus are initially attached to the pellicle-coated tooth surface to form a biofilm. The study aimed to determine the efficacy of macelignan, isolated from nutmeg (Myristica fragrans Houtt.), in removing each single oral primary biofilm in vitro on a polystyrene 96-well microtiter plate. Four biofilm growth phases (4, 12, 20 and 24 h) were evaluated in this study after treatment with macelignan at various concentrations (0.2, 2 and 10 microg/mL) and exposure times (5, 10 and 30 min). Anti-biofilm activity of macelignan was measured as the percentage of the remaining biofilm absorbance after macelignan treatment in comparison with the untreated control. At 24 h of biofilm growth, S. mutans, A. viscosus and S. sanguis biofilms were reduced by up to 30%, 30% and 38%, respectively, after treatment with 10 microg/mL macelignan for 5 min. Increasing the treatment time to 30 min resulted in a reduction of more than 50% of each of the single primary biofilms. The results indicate that macelignan is a potent natural anti-biofilm agent against oral primary colonizers.     

EGFR抑制剂通过c-myc途径影响PD-L1在肺癌细胞中的表达

目的:以EGFR抑制剂为介质,研究EGFR/KRAS通路对人非小细胞肺癌A549和H1299细胞中免疫检查点抑制剂PD-L1表达的影响,探讨靶向治疗与免疫治疗联用在相关肿瘤临床治疗中的潜在价值。方法:Western blotting检测A549和H1299细胞经Erlotinib处理后细胞中c-myc的表达量变化; RT-PCR法检测Erlotinib对A549和H1299细胞中c-myc下游基因分化抗原簇47（cluster of differentiation 47,CD47）及PD-L1转录水平的调控,同时平行检测在c-myc基因沉默后,Erlotinib对CD47及PD-L1转录水平的调控;Western blotting检测Erlotinib用量与PD-L1表达的相关性;通过与肿瘤浸润T细胞（tumor infiltrating T cell,TIL-T）共培养,检测Erlotinib影响前后A549和H1299细胞对TIL-T细胞治疗的敏感度。结果:Erlotinib能显著下调c-myc在A549和H1299细胞内的表达量（P<0.01）;c-myc蛋白表达量受Erlotinib影响下调后,PD-L1的转录水平也受到了明显的影响（P<0.01）,但Erlotinib对于c-myc沉默的A549和H1299细胞株中CD47及PD-L1的转录水平影响很小（P>0.05）;Erlotinib剂量对A549和H1299细胞中PD-L1的表达量呈现出显著的正相关性,但对c-myc沉默的细胞株影响不大（P>0.05）,结果与转录水平一致;Erlotinib处理后,A549和H1299细胞对TIL-T细胞的抵抗能力显著降低,细胞凋亡信号caspase-3激活更加明显。结论:Erlotinib能通过EGFR通路调控c-myc在细胞中的表达水平,进而介导PD-L1表达水平降低,增强TIL-T细胞对A549和H1299细胞的杀伤能力。     

异基因造血干细胞移植患者生活质量变化轨迹及影响因素研究

目的探讨异基因造血干细胞移植患者3年内的生活质量变化轨迹及影响因素。方法采用便利抽样法,选取2016年7月—2017年10月于苏州市某三级甲等医院行异基因造血干细胞移植的患者作为调查对象,在患者移植前(入仓前1～2 d)、移植后1个月、3个月、半年、1年、1年半及3年时采用一般资料调查表及癌症治疗功能评价-骨髓移植测评量表进行调查。结果异基因造血干细胞移植患者的癌症治疗功能评价-骨髓移植测评量表总分在移植后1个月时降至最低,此后呈逐渐上升趋势,半年时基本恢复至移植前水平,3年时总分显著高于移植前,差异具有统计学意义(P<0.05)。生理健康、功能健全及干细胞移植3个维度得分与癌症治疗功能评价-骨髓移植测评量表总分变化轨迹一致,呈波动上升型;情绪稳定维度在移植前得分最低,随移植时间延长逐渐上升;社交/家庭健全维度移植前得分与移植后各时间点得分比较,差异无统计学意义(P>0.05)。多元线性回归分析结果显示,影响患者移植后3年时生活质量的主要因素为居住地(t=3.175,P=0.002)、家庭人均月收入(t=3.320,P=0.001)、移植相关并发症(t=-6.955,P&l...     

Heavy Metal Sources,Contamination and Risk Assessment in Legacy Pb/Zn Mining Tailings Area: Field Soil and Simulated Rainfall

This study investigated heavy metal(HM) soil pollution and evaluated the risk and sources at a legacy tailings pond’s area in Meizhou, China. Result shows that HM accumulation in soil, particularly Cd, Pb, and Zn, were serious. Zn and Cd in tailing soil and all studied elements in field soil had a significant release potential. Four HM sources were identified by positive matrix factorization (PMF) model: cinder and vehicle emissions (11.3%), natural sources (16.3%), tailings pond and human activities (32.8%), tailings pond (39.7%). The soil was severely polluted with Cd, Pb, and Zn, which posed a high potential environmental risk near surrounding area. Column leaching tests showed that large quantities of HMs were released from the tailings soil during simulated rainfall with different pH. This study indicates that the study area has been severely polluted and continues to have a great risk of HM pollution under natural conditions.