Psychiatric morbidity among people aged 85+ in 1987. A follow-up study at two and a half years: Associations with changes in psychiatric morbidity

This article reports findings from a longitudinal survey of very elderly people living at home in London. The research aimed to identify social, psychological and physical characteristics associated with positive ageing and successful survival in the community in later life and its converse—negative ageing—as well as the associated policy implications. Associations with psychiatric morbidity, measured using the General Health Questionnaire, among sample members without cognitive impairment between the baseline interviews in 1987 and at follow-up, two and a half years later in 1990, are reported. Twenty-five per cent of survivors scored over the threshold of the GHQ in 1987 and 30% scored over the threshold in 1990. Half of those with a score over the threshold in 1990 also scored over the threshold in 1987. Hierarchical regression (using residualized change analysis) was used to estimate the effects of the independent variables on changes in psychiatric morbidity. The most significant predictor of psychiatric morbidity (GHQ score) in 1990 was baseline GHQ score, followed by health and functional status scores. Health and functional status were also the strongest predictors of baseline (1987) GHQ scores. The uniqueness of the study lies in the collection of follow-up data on a sample of very elderly people, given that most surveys are corss-sectional and contain too few people aged 85+ to merit separate analysis. It contributes to the small body of literature on outcome of depression. The lack of consistent associations with recovery from psychiatric morbidity in the literature enhances the importance of studies aiming to identify factors associated with different outcomes.     

Safety and immunogenicity of Haemophilus type b-tetanus protein conjugate vaccine, mixed in the same syringe with diphtheria-tetanus-pertussis vaccine in young infants

As new vaccines are developed there is increasing interest in reducing the number of injections given to children by combining vaccines in one syringe. We studied the safety and immunogenicity of Haemophilus influenzae type b-tetanus protein conjugate vaccine (PRP-T) administered at ages 2, 4 and 6 months mixed in the same syringe with DTP vaccine and its effects on the seroresponse to DTP vaccine. A group of 112 healthy 2-month-old infants received DTP-PRP-T or DTP-placebo mixed immediately before immunization in the same syringe. The addition of PRP-T to DTP did not increase the rate of local or systemic reactions. After the first, second and third dose, the PRP-T recipients showed a geometric anti-PRP antibody mean of 0.13, 2.31 and 6.40 micrograms/ml vs. 0.07, 0.05 and 0.05 micrograms/ml among the DTP-placebo recipients, respectively. Of the PRP-T recipients, 94 and 98% attained antibody concentration of greater than or equal to 0.15 micrograms/ml protein after the second and third dose, respectively, and 65 and 94% attained a concentration of greater than or equal to 1.0 micrograms/ml after the second and third dose, respectively. At the age of 1 year 94 and 52% of the DTP-PRP-T recipients vs. 12% and 0% of the placebo recipients still maintained titers of greater than or equal to 0.15 and greater than or equal to 1.0 micrograms/ml, respectively. The administration of DTP in the same syringe with PRP-T did not affect significantly the antibody response to diphtheria and tetanus toxoid and to pertussis agglutinins. It is concluded that PRP-T vaccine could be administered in the same syringe as DTP.     

Quality control in cervical cytology

From surveys conducted by the authors it is concluded that the best and most acceptable quality control methods in cytology are those from within the laboratory. Most of these have results which can be reported centrally. Where the overall control and codes of practice are high, there the results are the most reliable, as sources of error from whatever cause are quickly brought to light. These conclusions are illustrated by data from the five centres and correlated in the tables.     

Rinderpest virus lineage differentiation using RT-PCR and SNAP-ELISA

An RT-PCR/ELISA system has been developed that detects and differentiates Rinderpest virus (RPV) from the other closely related morbillivirus of ruminants, Peste des petits Ruminants virus (PPRV). In addition, using lineage specific probes, it is possible to determine whether the virus sample is wild-type or vaccine, and the likely origin of the outbreak if it is wild-type. It involves carrying out a RT-PCR with one digoxygenin (Dig)-labelled primer followed by a hybridisation step with a virus-specific, biotin-labelled, probe. The hybridisation step is carried out in an ELISA format on a streptavidin-coated plate. The DIG-labelled products are detected using a specific anti-DIG monoclonal antibody and an anti-mouse horseradish peroxidase conjugate. The hybridisation step replaces nucleotide sequencing or nested PCR for confirmation of the identity of DNA product. The assay is fast and easy to carry out and can give semi-quantitative estimates of the virus content of samples.     

Prevalence of antibody to current influenza virus strains in adolescents

During the Spring of 1986, 118 pupils aged 15-18 years were surveyed for the presence of humoral antibodies to five influenza strains. Prevalence of humoral immunity (HI) antibodies and immunity was found to be related to the year of the strain's emergence and to length of circulation time in the community. A high percentage of the adolescents were not immune to one or more of the tested strains. More than 40% of the studied group were not immune to the old A strains A/Philipines 2/82 (H3N2) and A/Chile 1/83 (H1N1), nearly 70% were not immune to the two B strains (B/USSR 100/83 and B/Ann Arbor 1/86), and almost the entire group (96%) was unprotected against the recent strain A/Singapore 6/86. Only one pupil was immune to all five strains; 35.6%, 22.2%, 17.8%, and 9.2% were immune to one, two, three, or four of the strains, respectively; and 14.4% were not immune to even one strain.     

中文科技期刊封面设计与探索——以《协和医学杂志》为例

【目的】 探索中文科技期刊封面发展的可行途径。【方法】 分析我国科技期刊封面设计现状以及制约中文科技期刊封面发展的瓶颈,并以《协和医学杂志》为例,介绍其封面设计团队的建立和运营经验,展示封面设计在其期刊品牌建设中发挥的作用。【结果】 中文科技期刊在编委人才梯队化建设过程中,通过主动发现和利用青年人才,能够建立稳定的封面设计团队,呈现高水平的封面设计,进而显著提升期刊品牌影响力。【结论】 封面质量建设对提升期刊品牌影响力具有重要作用,紧密结合中文期刊自身发展特点,善于借助可利用的优势资源,是中文科技期刊突破封面发展瓶颈的可行途径。     

医学科技期刊新媒体爆款文章的特征及生成策略——以《协和医学杂志》实践为例

【目的】 探析医学科技期刊新媒体爆款文章的特征及生成策略。 【方法】 以《协和医学杂志》为例,筛选出其在今日头条平台2018年10月至2020年12月阅读量为“10万+”的爆款文章,分析文章特征,并从资源挖掘、内容生产及推广传播环节提出有效策略。 【结果】 医学科技期刊新媒体爆款文章具有话题热、标题靓、排版精、互动深的特点;借力平台优势、融合科普定位、发挥“意见领袖”作用、巧搭新闻热点事件、精心设计版式以及多网媒滚筒式传播均为医学科技期刊新媒体爆款文章生成的有力之举。 【结论】 医学科技期刊新媒体深挖优势资源,把好内容及传播环节,策略性运营,可为爆款文章生成提供保障,进而提升期刊品牌影响力和新媒体综合实力。     

完全右半肝-左半肝劈离式肝移植的临床应用:附四例报告

目的探讨完全右半肝-左半肝劈离式肝移植在成人-成人或成人-大体重儿童中的临床应用。方法回顾2019年1月至12月间首都医科大学附属北京友谊医院完成的4例完全右半肝-左半肝劈离式肝移植的供受者临床资料,分析劈离式肝移植的手术方式、冷缺血时间、手术时间、术中输血量,观察患者术后并发症及相关预后。结果4例完全右半肝-左半肝劈离式肝移植的受者包括3例成人和1例大体重儿童(45 kg),年龄范围14~48岁,体重范围45~61 kg,终末期肝病模型评分分别为21、12、41和30分。移植物质量与受者体质量比为0.85%~1.35%。冷缺血时间457~650 min,手术时长460~575 min。4例患者移植术后早期肝功能恢复顺利,均未出现小肝综合征。随访至术后6个月,其中1例出现胆道吻合口漏,经内镜逆行胰胆管造影术治疗后治愈;1例出现胆道狭窄,经皮肝穿刺胆道引流术治疗后反复胆道感染;1例术后6个月死于肺部感染。结论在严格病例选择的情况下,可以开展完全右半肝-左半肝劈离式肝移植。     

Dental care in the NHS: reforms with teeth?

Dental services in the UK are currently undergoing a period of major upheaval. This paper examines recent policy initiatives with respect to patient charges, dentists' remuneration, information and patient choice, the supply of dental personnel, and the prevention of dental diseases. It is argued that changes in dentists' remuneration and the greater use of auxiliary personnel are likely to improve efficiency, whereas changes in patient charges are not. Water fluoridation remains the most efficient and equitable means of promoting dental health.