泸州市基层疾病预防控制机构人力结构现状分析

目的：：了解泸州市基层疾病预防控制机构人力结构现状,为建立合理的疾病预防控制机构人才队伍提供依据。方法：采用全市普查的方法,应用问卷对泸州市基层疾病预防控制中心人员结构进行调查。结果：泸州市基层疾病预防控制机构在编人数266人、占84.98%;以初级职称(69.82%)与中级职称(25.68%)为主,叙永县无高级职称人员;除江阳区与龙马潭区疾病预防控制中心人员女性比例大于男性外,其余地区男性所占比例均高于女性;江阳区、纳溪区和叙永县疾病预防控制中心40岁以上的人员比例分别为52.43%、52.78%、85.96%,泸县疾病预防控制中心35岁以下人员占50.00%;泸州市各区县疾病预防控制中心人员学历均以本科(37.28%)、大专(41.94%)为主;专业以预防医学(20.43%)和临床医学专业(24.73%)为主,检验专业、其他医学专业和卫生事业管理专业人员比例分别为15.77%、13.98%、7.53%。结论：泸州市基层疾病预防控制机构人员编制不足,缺乏高职称人员,年龄结构不合理,高等学历人才匮乏,专业结构单一,个别县或区情况较严重。     

68例慢性乙型肝炎患者对疾病认知及心理和行为问卷调查

目的 了解患者对慢乙肝疾病相关知识认知、对疾病的心理和行为应对情况,以更好评估慢乙肝患者对疾病的认知、防治需求,对待疾病的态度和行为,疾病带给慢乙肝患者的心理压力,为慢乙肝患者的健康管理、心理干预提供依据.方法 对在2011年1月至2013年6月到昆明医科大学第二附属医院肝胆胰内科门诊就诊和住院的68位慢乙肝患者在诊疗前后进行个人访谈和问卷调查,并由受过专业培训的医护人员对问卷调查中发现的问题进行一对一的指导.结果 大部分患者知道疾病的一般知识,对疾病缺乏较深层次的认识.宣教前与宣教后患者在乙肝传播途径、带来的后果认知、加重肝损伤因素的认知及保护家人不受感染的措施等方面问卷得分进行t检验,P＜0.05具有统计学意义.对自我护理和预防保健没有充分认识,患者对乙肝相关疾病知识的认识和了解与文化程度和病程长短有关,69.1％的患者存在一定的心理问题.结论 医护人员加强对慢乙肝相关疾病知识的深度和广度的宣传,针对患者的心理问题给予积极的心理疏导,争取社会支持系统对患者提供有针对性的帮助,提供准确的健康指导和连续的干预,促进患者主动采纳健康行为建议,对监测和防控患者的病情发展,对慢性乙肝患者的未来的健康管理有重要意义.     

A comparison of treatment and outcomes of perihilar cholangiocarcinoma between Eastern and Western centers

Background

Perihilar cholangiocarcinoma (PHC) often requires extensive surgery which is associated with substantial morbidity and mortality. This study aimed to compare an Eastern and Western PHC cohort in terms of patient characteristics, treatment strategies and outcomes including a propensity score matched analysis.

Identification and validation of functional gastrointestinal disorder subtypes using latent class analysis: a population-based study

Objective: Attempts to categorize distinct functional gastrointestinal disorders based on reported symptoms continue but symptoms frequently overlap. The study objective was to use latent class analysis (LCA) which accommodates both continuous and discrete manifest variables to determine mutually exclusive subgroup assignments of a population-based sample using gastrointestinal symptom and patient data.

Materials and methods: A validated bowel disease questionnaire and somatic symptom questionnaire were mailed to an age and gender stratified randomly selected community sample. Responses to the symptom questions were dichotomized as frequent vs. infrequent based on Rome IV criteria. A LCA model was developed using a calibration subset and the results applied to the validation subset.

Results: There were 3831 total respondents (48%) with 3425 having complete data. The LCA algorithm was run for each of 10 (random) splits of the dataset and 2–6 latent classes were specified. Using the values of Akaike’s Information Criterion coefficient c to determine fit of the data, 4 latent classes yielded better values resulting in four subgroups: ‘asymptomatic,’ ‘upper’ abdominal symptoms, ‘lower’ abdominal symptoms, and ‘mixed’ (upper and lower abdomen).

Conclusions: Latent class analysis identified 4 groups based on symptoms. This approach resulted in differentiation by anatomical region rather than the Rome IV classification of symptoms.     

The quest for accuracy of blood pressure measuring devices

The accuracy of blood pressure (BP) measuring devices is fundamental to good practice and scientific research. International guidelines on BP measurement are provided for clinicians who diagnose and treat patients with hypertension, clinical researchers who conduct trials on the efficacy of BP lowering drugs and interventional strategies, epidemiologists who conduct population surveys to determine the demographic consequences of hypertension on society, and researchers who perform meta‐analyses on published research to further influence the practice of medicine and the provision of resources. Although the outcomes of the endeavors of all these groups are dependent on the accuracy of BP measurements, the equipment is often of doubtful accuracy and the methodology of measurement is often poorly described and frequently not standardized. Thus, the fundamental element of hypertension evaluation has been largely ignored by both clinical practitioners and scientific researchers. Here, the authors briefly review the development of efforts to improve and validate the accuracy of BP measuring devices and highlight the deficiencies that persist. We conclude that, to protect the public from the serious consequences of inaccurate BP measurements, the following steps are required: (1) regulatory requirement for mandatory independent validation of all BP measuring devices using a universal protocol; (2) accreditation of laboratories for the performance of BP device validations; (3) online evaluation of validation studies with detection of protocol violations prior to publication of results; and (4) establishment of an independent scientific forum for the listing of accurate BP measuring devices.     

Regulation of cytotoxic T lymphocyte triggering by PIR-B on dendritic cells

Priming of cytotoxic T lymphocytes (CTLs) by dendritic cells (DCs) is crucial for elimination of pathogens and malignant cells. To activate CTLs, DCs present antigenic peptide-complexed MHC class I molecules (MHC-I) that will be recognized by the CTLs with T cell receptors and CD8 molecules. Here we show that paired Ig-like receptor (PIR)-B, an MHC-I receptor expressed on antigen-presenting cells, can regulate CTL triggering by blocking the access of CD8 molecules to MHC-I. PIR-B-deficient DCs evoked CTLs more efficiently, leading to accelerated graft and tumor rejection. PIR-B(+) non-DC transfectant cells served as less efficient stimulators and targets for CTLs than PIR-B(-) cells at the effector phase in vitro. On surface plasmon resonance analysis, PIR-B and CD8alpha alpha were revealed to compete in binding to MHC-I. Our results may provide a novel strategy for regulating CTL-mediated immunity and diseases in a sterical manner.     

Degradation of circulating thyroglobulin

Reported half lives of rat Tg were different according to various investigators. In order to elucidate whether the derivatives of rat Tg in the peripheral circulation affect the results of kinetic studies of Tg, the present study was performed to investigate kinetics of rat Tg after separation of 19S Tg from its derivatives using gel-filtration. Radiolabeled Tg was obtained from thyroids of rats injected with 125I 24 hours before death, and subsequently purified by ammonium sulfate precipitation. The plasma samples obtained at varying time intervals after intravenous injection of 125I-rat Tg were fractionated on a Sephacryl S-300 column. As determined by sucrose density gradient, 99% of in vivo radiolabeled Tg was 19S. On gel-filtration, the injected labeled Tg and plasma samples obtained within two hours after injection showed a single peak in an identical area. A second peak in an area corresponding to a molecular weight of 60,000 to 70,000 appeared within six hours, and became as high as the first within 24 hours. In the second peak, 22.8 +/- 3.8% (mean +/- SE) of radioactivity was precipitated by anti-rat Tg antibody, and 14.4 +/- 1.7% (mean +/- SE) of radioactivity of its TCA precipitate was not extracted by n-butanol. Thus, the second peak could affect the results of Tg kinetic studies which utilize TCA precipitation, n-butanol extraction or RIA procedures. The half life of rat Tg in the present study was calculated from the disappearance curves of radioactivity of 19S Tg separated from other radioactive substances.(ABSTRACT TRUNCATED AT 250 WORDS)