New vaccine production platforms used in developing SARS-CoV-2 vaccine candidates

The threat of the current coronavirus disease pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is accelerating the development of potential vaccines. Candidate vaccines have been generated using existing technologies that have been applied for developing vaccines against other infectious diseases. Two new types of platforms, mRNA- and viral vector-based vaccines, have been gaining attention owing to the rapid advancement in their methodologies. In clinical trials, setting appropriate immunological endpoints plays a key role in evaluating the efficacy and safety of candidate vaccines. Updated information about immunological features from individuals who have or have not been exposed to SARS-CoV-2 continues to guide effective vaccine development strategies. This review highlights key strategies for generating candidate SARS-CoV-2 vaccines and considerations for vaccine development and clinical trials.     

The association between decision-making skills and subjective decision outcomes among administrative officers in the Swedish Social Insurance Agency

Social insurance administrative officers’ decision-making skills influence their efficiency at work and their general well-being. At work their tasks are characterised by complexity and a need for order and accountability. Moreover, cases should usually be handled and finalised within the imposed time frames. We investigated skills related to decision-making success among social insurance officers. In total, 118 administrative officers at the Swedish Social Insurance Agency (66% response rate) responded to questions on scales and measures relating to cognitive-rational, socio-emotional and time approach features of decision-making skill. In addition, they responded to questions on three scales pertaining to outcomes of everyday decisions in terms of subjective everyday difficulties, tendencies to burnout and depressive symptoms. The results showed that cognitive-rational competence was associated with lower reports of subjective everyday difficulties and depressive symptoms and thereby contributed to the explained variance in decision outcomes. Furthermore, socio-emotional and time approach features of decision-making skills contributed to the explanation for subjective everyday difficulties, tendencies to burnout and depressive symptoms. The results corroborate the basic assumption and usefulness of a broad approach in the definition and assessment of decision-making skills in human service professions in general, and of administrative officers in social insurance agencies in particular. Recommendations for future research and the implications of the results are discussed.     

云南省盈江县蚊虫调查及乙型脑炎病毒分离

1984年及1989年7～8月,在盈江县捕获成年雌性蚊虫7属32种632O只,霜背库蚊、三带喙库蚊和棕头库蚊是农村畜圈的主要蚊种,伪白纹伊蚊和白纹伊蚊是野外竹林区的优势蚊种。对所获蚊虫用C6/36细胞和小白鼠方法分离病毒,从三带喙库蚊和窄翅伊蚊中各分离到1株乙型脑炎病毒。分析认为三带喙库蚊是当地乙型脑淡病毒的主要传播媒介,窄翅伊蚊亦可参与该病毒的传播。     

Assessment of general practitioners by video observation of communicative and medical performance in daily practice: issues of validity, reliability and feasibility

OBJECTIVES: To develop a video assessment method for General Practitioners (GPs) by analysing issues of validity, reliability and feasibility of observation of videotaped regular consultations. DESIGN: In a cross-sectional study consultations of 93 GPs were video recorded in the practice during 1 week. The GPs registered consultation and patient data in a logbook; 16 consultations per GP were selected using preset criteria. The quality of communicative and medical performance of these consultations was assessed by GP observers with a validated instrument. The validity of the procedure was evaluated by checking the content of each GP's sample using specific sample criteria. Selection bias was estimated by multiple regression analysis, with sample characteristics as independent variables and scores on communication and medical performance as dependent variables. The influence of observation on GPs and patients was assessed by a questionnaire. Generalizability theory was used to estimate reliability. Feasibility was assessed by conducting a questionnaire, by keeping accounts, and by checking the technical quality of the videotaped consultations. SETTING: Universities of Nijmegen and Maastricht, The Netherlands. SUBJECTS: General Practitioners (GPs). RESULTS: The domain of general practice was well covered in the samples; content validity was satisfactory. With regard to the sample characteristics, only the total duration of consultations appeared to correlate significantly with both the score on communication and the score on medical performance. A majority (71%) of GPs reported not being influenced by the observation, except in the first cases, and recognizing their usual daily performance in the videotaped consultations. An acceptable level of reliability was reached after 2.5 hours of observation, i.e. 12 cases by a single observer. The method was well accepted by both GPs and patients. The costs were pound250 per GP. CONCLUSIONS: Video assessment of GPs in daily practice according to the procedures described is a valid and reliable method, one which is useful for education and quality improvement. There is a trade-off between feasibility on one hand and validity, reliability and credibility on the other hand. Compared to investments in observation methods in standardized settings, the costs of video observation of GPs' actual performance are acceptable.     

挖掘原始创新潜力 创办研究型医院

我院在确立了研究型医院的定位后，采取了一系列的科研改革举措，如重新整合科研力量，发展重点学科，加大对科研的投入，设立院所青年科研启动基金，强调人才建设，加强科研管理工作等，这些举措对促进原始创新，增强我院核心竞争力将起到重要作用，从而使我院发展成国内最大、国际知名的心脏病研究中心。     

自杀基因质粒表达载体pcDNA3.1(-)CMV.TK在鼻咽癌细胞中的构建及转染研究

目的 构建含TK自杀基因的质粒表达载体并进行转染研究。方法 根据已发表的Hsv-TK基因的核苷酸序列，设计并合成一对引物，以含TK基因的PGEM/TK质粒为模板扩增出TK基因全长CDS序列，将其克隆到质粒表达载体pcDNA3．1(-)CMV中，进行序列分析和酶切鉴定后，运用电穿孔法将重组体pCDNA3．1(-)CMV-CD车专人鼻咽癌CNE-2细胞中，观察其表达情况以及无毒前体药物GCV干预下对CNE-2细胞生长的抑制作用。结果 酶切和序列分析证明pcDNA3．1(-)(2MV．TK含完整的TK基因序列，RT-PCR从转染细胞总RNA中扩出预期片段；鼻咽癌CNE-2细胞在无毒前体药物GCV干预下，其生长受到抑制。结论 成功构建了质粒载体pcDNA3．1(-)CMVTK，可以将其作为鼻咽癌自杀基因治疗的一种载体。     

''I found myself to be a down to earth Dutch girl'': a qualitative study into learning outcomes from international traineeships

OBJECTIVE: To explore learning outcomes from international traineeships for undergraduate medical students. METHODS: In-depth interviews were conducted with 24 undergraduate medical students at Maastricht University Medical School, The Netherlands. The 24 subjects were selected by purposeful sampling. RESULTS: Students reported meaningful learning outcomes in 6 domains: medical knowledge; skills; international health care organisation; international medical education; society and culture, and personal growth. DISCUSSION: International traineeships appear to provide good opportunities for students to meet the requirements of globalisation as well as some of the generic objectives of undergraduate medical education. The tentative findings of this study need to be confirmed by further studies.     

婴幼儿社会性和情绪发展的影响因素研究

[目的]了解武汉市1～3岁幼儿社会性和情绪发展的影响因素.[方法]采用整群随机抽样的方法抽取武汉市江汉、桥口、汉阳、武昌、江岸5城区1～3岁幼儿520名作为调查对象.应用自拟＂1～3岁幼儿社会人口学问卷＂及＂1～3岁幼儿社会性和情绪发展评价量表＂（美国）进行调查.原始调查表经核查整理后进行编码,用Foxpro6.0建立数据库,然后用SAS8.1进行逻辑检查及处理分析.[结果]各量表筛检出可疑阳性人数依次为外化量表112人,占总人数的21.5%;内化量表62人,占11.90%人;失调量表83人,占15.93%;反应能力量表111人,占21.31%,其中女童反应能力检出率（25.93%）高于男童（17.33%）;母亲孕期精神状况对儿童的外化行为、内化行为和失调行为的影响经x2检验,差异有显著性（P＜0.05）;父亲职业、父母文化程度和家庭结构不同的儿童外化量表评分的差异均有非常显著性（P均＜0.01）;不同家庭收入水平的儿童反应能力量表评分的差异有显著性（P＜0.05）.[结论]幼儿社会性和情绪发展受家庭环境和社会环境等众多因素的影响,应充分发挥父母在幼儿情绪发育上的积极作用,提高育儿者的自身素质;尽快制定一个适合我国幼儿社会性和情绪发展的评价量表,以促进幼儿身心的健康发展.     

基层医生的儿童功能性便秘诊疗能力研究

背景 功能性便秘(FC)是儿童常见健康问题,也是儿童父母在基层医疗卫生机构门诊就诊中咨询频率较高的问题。尽管便秘不是急症,但如果处理不当,可能会引起严重的并发症,进而影响儿童及其家庭的生活质量。目的 了解基层医生的儿童FC诊疗水平,为针对性提高基层医生的儿童FC诊疗与管理能力提供依据。方法 于2020年7月,在北京市西城区基层医疗卫生机构中选取在日常诊疗中能接触到儿童患者的医生130例。采用本研究组自行设计的问卷对纳入医生开展调查,内容包括对≥6个月儿童FC诊断中常见症状的认知,以及对儿童FC的推荐治疗方法、推荐治疗药物、药物治疗时机及治疗持续时间等。结果 108例(83.1%)基层医生的问卷被有效回收,其中全科医生34例(31.5%)、儿科医生30例(27.8%)、中医科医生30例(27.8%),平均每月门诊接触儿童患者(10.1±4.4)例。对于儿童FC的诊断：当≥6个月患儿出现排便次数少、大便坚硬、排便时出血、大便失禁、排便困难、排出稠便前哭泣症状时,分别有40.7%(44/108)、39.8%(43/108)、23.1%(25/108)、9.3%(14/108)、39.8%(4...     

恶性肿瘤患者临终关怀护士岗位胜任力指标体系的构建

目的构建恶性肿瘤患者临终关怀护士岗位胜任力指标体系。方法在质性研究基础上,拟定初期指标体系及专家函询问卷,通过两轮Delphi专家咨询,确定指标及各级指标权重。结果两轮函询问卷的有效回收率分别为100.00%和88.89%,专家的权威系数为0.875,两轮函询总指标重要性的专家意见肯德尔协调系数由0.123增至0.379(P<0.01)。最终构建了涵盖4个一级维度、14个二级维度和83个三级条目的恶性肿瘤患者临终关怀护士岗位胜任力指标体系。结论本研究构建的恶性肿瘤患者临终关怀护士岗位胜任力指标体系符合我国基本国情,对恶性肿瘤患者临终关怀护士的岗位培训、考核评价、能力培养等具有借鉴意义。