某高速公路筑路工人艾滋病知识 态度及行为干预效果评价

目的评价应用健康干预工具包,对在建高速公路筑路工人进行艾滋病(AIDS)知识、态度及行为干预的效果。方法将艾滋病相关知识融入各种游戏中,组成一套互动式的健康干预工具包,使用该工具包对筑路工人开展干预活动,调查分析干预前后目标人群艾滋病相关知识、态度及行为情况。结果筑路工人艾滋病知识总知晓率由干预前的60.0%提高到干预后的75.2%(P<0.05),总体正性态度率由干预前的51.5%提高到干预后的64.7%(P<0.05)。结论应用艾滋病防治干预包对目标人群进行系列干预,可提高目标人群艾滋病相关知识知晓和正性态度。     

我国湖沼地区荣宝杀灭血吸虫卵和尾蚴的现场应用研究

目的 探索利用50％氰氨化钙(商品名为荣宝)在洲滩易感地带杀灭血吸虫虫卵和尾蚴的简易方法,继而达到控制传染源的目的.方法 收集含血吸虫虫卵的阳性的新鲜牛粪.在夏、秋、冬3个季节,分别按照每100 g阳性牛粪加荣宝3 g和5 g的比例,在易感地带以搅拌、表面喷撒和粪内中置等3组方式施药,并设不施药阳性牛粪对照组,于不同时段分别取样,用塑料杯顶管孵化法检查毛蚴.用浓度为10 g/m3的荣宝对血吸虫易感水体进行血吸虫尾蚴杀灭,在施药前及施药后不同时段用哨鼠测定血吸虫易感水体.结果 夏季,搅拌组和表面喷撒组施药后第2天均未发现毛蚴,粪内中置组第3天未发现毛蚴;秋季,施药各组第2天取样均可发现毛蚴1～5条,第3天除粪内中置组仍然发现毛蚴1～5条外,其余施药各组未发现毛蚴;冬季,施药各组第3天取样孵化,除搅拌组外均可发现毛蚴2～3条,第7天抽样孵化未发现毛蚴;夏、秋、冬3季对照组第7天仍然有6 ～ 10条毛蚴.用荣宝处置血吸虫易感水体,处置前哨鼠血吸虫感染率为11.11％,处置后第1、15和30天,经解剖检查,哨鼠均为阴性,亦未发现死鱼.结论 3组施药方式在易感地带均具有杀灭血吸虫虫卵的作用.其中,以每100 g牛粪加3 g荣宝的比例,采取表面喷撒的方法适宜现场应用,夏季效果更佳.采用荣宝10 g/m3的比例喷洒于现场血吸虫易感水体,可有效杀灭血吸虫尾蚴.2种方法同时使用,可达到净化血吸虫易感地带的目的.     

大型C臂机实时引导下经超细支气管镜肺大疱减容术有效性及其影响因素的初探

目的 初步探讨大型C臂机实时引导下经超细支气管镜肺大疱减容术的有效性及其影响因素.方法 6例肺大疱患者均在大型C臂机实时引导下经超细支气管镜工作通道先后通过微导管向目标细支气管注入利多卡因、自身血、纤维蛋白原、凝血酶.通过患者客观症状、肺功能FEV1、胸部HRCT、血气分析、6分钟步行距离等指标评价术式的有效性及其影响因素.结果 6例患者中,术后完全有效2例,明显有效1例,基本有效2例,完全无效1例(有效率83.3％).有效性影响因素可能包括肺大疱周围肺组织对所注入的减容药物反应程度、H RCT扫描肺大疱大小时呼吸动度、肺大疱周围组织内源性弹性回缩作用力大小及其各个作用力的方向、患者特异质等.结论 应用大型C臂机实时引导下经超细支气管镜肺大疱减容术,可以避免手术治疗并发症的发生,缩短住院时间,改善肺功能,提高患者生活状态,值得进一步推广.     

脐带间充质干细胞在遗传性痉挛性截瘫中的应用

目的观察脐带间充质干细胞（UC-MSC）治疗遗传性痉挛性截瘫（HSP）的临床疗效及安全性。方法2010年9月及2011年4月,分别给予一HSP家系父子2人行UC-MSC鞘内注射治疗,两个疗程,每次1×106 cells/Kg,每周1次,4次为1个疗程。采用改良的Ashworth肌张力分级标准（MAS）、国际合作共济失调评分量表（ICARS）及日常生活量表（ADL）,对患者治疗前后神经功能、日常生活能力进行评定。结果第一疗程结束1个月与治疗前比较,2人MAS分级、ICARS及ADL评分均降低,两人行走站立稳定性及言语流利程度较治疗前改善;第二疗程结束后1个月与该疗程治疗前比较,2人ICARS及ADL评分降低,儿子肌张力进一步降低,父亲双上肢共济失调减轻。2人治疗后均未见明显不良反应发生。末次治疗结束后随访20个月,父、子俩分别于第二疗程治疗结束7个月及8个月后,症状继续加重。结论 UC-MSC鞘内注射治疗是安全的,可在一定时间内一定程度上减轻患者临床症状,提高患者生活质量,延缓疾病进展,但疗效不能持久。     

The effectiveness of memory rehabilitation following neurological disabilities: A qualitative inquiry of patient perspectives

The evidence for the effectiveness of memory rehabilitation following neurological conditions, mainly studied through quantitative methodologies, has been equivocal. This study aimed to examine feedback from participants who had been through a randomised controlled trial (RCT) comparing two types of memory rehabilitation with a self-help control. It was envisaged that this information would offer a detailed understanding of patient experience of going through a trial and the perceived effects of having attended group sessions. Through 31 in-depth interviews, data collected were thematically analysed. The seven themes identified highlighted improvements in insight and awareness of memory problems and their neurological conditions, knowledge and skills about using memory aids; and as a consequence, improvements in cognitive functions, mood, and confidence, assertiveness and control over their condition. Participants also reported an altered perspective of life that helped them deal with their problems, and the therapeutic effects of attending group sessions. While these improvements were mainly reported in the intervention groups, even those in the control group reported some benefits. This study highlights that it is both feasible and advantageous to embed qualitative research within the traditional RCT methodology to arrive at a more nuanced understanding of patient experiences and intervention outcomes.     

显微手术治疗脊髓髓内肿瘤

目的探讨脊髓髓内肿瘤的显微手术治疗效果。方法回顾性分析经显微手术治疗的27例脊髓髓内肿瘤病人的临床资料。结果肿瘤全切除13例,次全切除10例,大部分切除4例。术后1月症状明显改善21例,稳定3例,加重3例。本组无死亡病例。术后随访6-24个月,复发2例;按McCormick脊髓功能状态分级：Ⅰ级17例,Ⅱ级6例,Ⅲ级3例,Ⅳ级1例。结论MRI是诊断脊髓髓内肿瘤的首选方法,显微手术切除脊髓髓内肿瘤是一种有效的手段。     

Development of a COVID-19 vaccine effectiveness and safety assessment system in Japan: The VENUS study

BackgroundThere are currently no COVID-19 vaccine assessment systems in Japan that allow for the active surveillance of both vaccinated and unvaccinated persons. Herein, we describe the development of Japan’s first COVID-19 vaccine effectiveness and safety assessment system with active surveillance capabilities.MethodsThe Vaccine Effectiveness, Networking, and Universal Safety (VENUS) Study was developed as a multi-source database that links four data types at the individual resident level: Basic Resident Register (base population information), Vaccination Record System (vaccination-related information), Health Center Real-time Information-sharing System on COVID-19 (HER-SYS; information on COVID-19 occurrence), and health care claims data (information on diagnoses, hospitalizations, diagnostic tests, and treatments). These data were obtained from four municipalities. Individual residents were linked across the data types using five matching algorithms based on names, birth dates, and sex; the data were anonymized after linkage. To ascertain the viability of the VENUS Study’s database for COVID-19 vaccine assessments, we examined the trends in COVID-19 vaccinations, COVID-19 cases, and polymerase chain reaction (PCR) test numbers. We also evaluated the linkage rates across the data types.ResultsOur multi-source database was able to monitor COVID-19 vaccinations, COVID-19 cases, and PCR test numbers throughout the pandemic. Using the five algorithms, the data linkage rates between the COVID-19 occurrence information in the HER-SYS and the Basic Resident Register ranged from 85·4% to 91·7%.ConclusionIf used judiciously with an understanding of each data source’s characteristics, the VENUS Study can provide a viable data platform that facilitates active surveillance and comparative analyses for population-based research on COVID-19 vaccine effectiveness and safety in Japan.     

Effectiveness of the COVID-19 vaccines on preventing symptomatic SARS-CoV-2 infections and hospitalizations in Southwestern Alaska,January–December 2021

The population in rural southwest Alaska has been disproportionately affected by COVID-19. To assess the benefit of COVID-19 vaccines, we analyzed data from the regional health system. We estimated vaccine effectiveness (VE) during January 16–December 3, 2021, against symptomatic SARS-CoV-2 infection after a primary series or booster dose, and overall VE against hospitalization. VE of a primary series against symptomatic infection among adult residents was 91.3% (95% CI: 85.7, 95.2) during January 16–May 7, 2021, 50.3% (95% CI, 41.1%–58.8%) during July 17–September 24, and 37.0% (95% CI, 27.8–45.0) during September 25–December 3, 2021; VE of a booster dose during September 25–December 3, 2021, was 92.1% (95% CI: 87.2–95.2). During the overall study period, VE against hospitalization was 91.9% (95% CI: 85.4–95.5). COVID-19 vaccination offered strong protection against hospitalization and a booster dose restored protection against symptomatic infection.     

A retrospective cohort study investigating the comparative effectiveness of pneumococcal vaccines against hospitalisation with otitis media and pneumonia in New Zealand

BackgroundSince 2008 New Zealand has used three different formulations of pneumococcal vaccines on the national infant schedule, PCV7, PCV10 and PCV13, switching between PCV10 and PCV13 twice in 10 years. We have used New Zealand’s linkable, administrative health data to examine the comparative risk of otitis media (OM) and pneumonia hospitalisations among children receiving three different pneumococcal conjugate vaccines (PCV).MethodsThis was a retrospective cohort study using linked administrative data. Outcomes were otitis media, all cause pneumonia and bacterial pneumonia related hospitalisation for children in three cohorts representing periods where PCVs transitioned between PCV7, PCV10, PCV13 and back to PCV10 between 2011 and 2017. Cox’s proportional hazard regression was used to provide hazard ratio estimates to compare outcomes for children vaccinated with different vaccine formulations and to adjust for different sub population characteristics.ResultsEach observation period, where different vaccine formulations coincided, and therefore comparable with respect to age and the environment, included over fifty-thousand infants and children. PCV10 was associated with a reduced risk for OM compared with PCV7 (Adjusted HR 0.89, 95 %CI 0.82–0.97). There were no significant differences between PCV10 and PCV13 in risk of hospitalisation with either otitis media or all-cause pneumonia amongst the transition 2 cohort. In the 18 -month follow-up, after transition 3, PCV13 was associated with a marginally higher risk of all-cause pneumonia and otitis media compared to PCV10.ConclusionThese results should offer reassurance about the equivalence of these pneumococcal vaccines against the broader pneumococcal disease outcomes OM and pneumonia.