Application of multiple methods to study the immunization programme in an urban area of Guinea

During 1988-89, studies were conducted to evaluate the immunization system in Conakry, Guinea. The first, a health facility survey, found that health staff screened the vaccination status of only 30% of children who presented for curative care. A sterile syringe and needle were used for less than half of the injections. In the second survey, key informant interviews with vaccinators and health centre chiefs showed that there were minimal lines of communication between health workers and the community, but that health workers did not perceive this to be a problem. Focus group discussions in the community revealed a high level of general knowledge about vaccine-preventable diseases. However, mothers did not know how many vaccinations their children should receive or by what age they should be completed. They complained of long waiting times in health centres, the high costs of vaccination, poor rapport with health workers, and the occurrence of abscesses after vaccination. The final study, a "knowledge, attitudes, and practice" community survey, showed that missed immunization opportunities and inappropriately timed vaccinations reduced potential vaccine coverage by almost 30% among children with vaccination cards. Higher socioeconomic status, delivery in hospital, and whether mothers perceived the vaccinations to be affordable affected whether the child began the immunization series. Once a child had entered the immunization system, completion of the series was determined by the mother's education level, employment status, and experience with vaccination services.     

Innate immunity of surfactant protein A and D in urinary tract infection with uropathogenic Escherichia coli

Objective To investigate the role of surfactant protein (SP) - A and SP - D in urinary tract infection mouse model, and evaluate the effects of SP-A and SP-D absence on urinary tract infection. Methods SP-A and SP-D double knockout (SP-A/D KO) mice were made. SP-A/D KO and wild-type (WT) C57BL/6 female mice were used for this study. The expression of SP-A and SP-D in kidney was detected by immunohistochemistry (IHC). The levels of p - p38 and p38 protein in kidneys were measured by Western blotting. Uropathogenic Escherichia coli or buffer was delivered into the bladder of female mice. At 24 and 48 h after inoculation, CFU of Escherichia coli in the kidney and urine of the treated and control mice were measured. Histological, cellular and molecular analysis were performed by several methods of H/E staining, IHC and Western blotting. The effects of SP-A and SP-D on bacterial growth were studied in vitro. Results SP-A and SP-D in kidney were located in the proximal tubules and collecting tubules. Compared with WT mice, infected SP - A/D KO mice with UPEC had higher CFU in kidneys and urine at 24 h and 48 h, increased inflammatory cells infiltration in kidneys（P＜0.05）. Compared with WT mice, SP - A/D KO mice had higher p38 MAPK phosphorylation levels in kidneys（P＜0.05）. Growth of Escherichia coli was greatly inhibited by both SP-A and SP-D（P＜0.05）. Conclusions Both SP-A and SP-D are expressed in kidney. SP-A and SP-D can attenuate UTI induced by UPEC which may be through inhibiting bacterial growth and modulating renal inflammation.     

A 2000 patient retrospective assessment of a new strategy for burn wound management in view of infection prevention and treatment

Infections in burn patients are still the principal cause of complications in burn injuries. The aim of this study is to assess a new strategy for burn wound management in view of infection prevention and treatment in the experience of the Burn Treatment Center in Siemianowice Śląskie. The applied methodology involved the analysis of patient records describing the hospital''s epidemiological situation between 2014 and 2016. The analysis also included the use and cost of antibiotics, silver‐containing dressings, and other antiseptics relative to the number of sepsis cases, including those caused by Pseudomonas aeruginosa, as well as the mortality ratio. The total costs of prevention and treatment of infections were reduced, while the use of silver‐containing dressings and antiseptics increased. The number of patients with sepsis decreased, including cases caused by P. aeruginosa, and the mortality ratio was reduced. Introducing a strategy for burn wound‐oriented infection prevention and treatment in burn patients provides a number of benefits. It is also cost‐effective. Using locally applied active dressings and antiseptics can be a welcome choice for often‐unnecessary antibiotic therapy of a suspected or existing burn wound infection.     

透明细胞性肾细胞癌在不同组织学分类中的比较研究

比较2004年WHO肾细胞癌组织学分类标准与1997年WHO及更早的分类标准的异同,总结常见的诊断差异及可能原因,纠正及更新对肾细胞癌的传统病理分类的观念。方法:收集天津医科大学肿瘤医院2004年2月至2008年2月间,根治性肾切除术后病理诊断为透明性肾细胞癌249例,按2004年WHO肾癌组织学分类标准重新分类,并收集相关临床资料进行分析。结果:原分类法的249例透明细胞癌,经重新分类后,发现透明细胞癌176例,乳头状肾细胞癌42例,嫌色细胞癌5例,多房性囊性肾细胞癌3例,混合型肾细胞癌23例（透明细胞癌+乳头状肾细胞癌21例,乳头状肾细胞癌+嫌色性肾细胞癌2例）。结论:部分乳头状肾细胞癌与嫌色肾细胞癌过去易被诊断为透明细胞癌,两者具有相似的胞浆特点,及对其组织学特点认识不清是其主要原因;中国人乳头状肾细胞癌的发病率与国外相近,且其亚型的分类及诊断有待进一步的研究。      

Terrorism-Related Fear and Avoidance Behavior in a Multiethnic Urban Population

Objectives. We sought to determine whether groups traditionally most vulnerable to disasters would be more likely than would be others to perceive population-level risk as high (as measured by the estimated color-coded alert level) would worry more about terrorism, and would avoid activities because of terrorism concerns.Methods. We conducted a random digit dial survey of the Los Angeles County population October 2004 through January 2005 in 6 languages. We asked respondents what color alert level the country was under, how often they worry about terrorist attacks, and how often they avoid activities because of terrorism. Multivariate regression modeled correlates of worry and avoidance, including mental illness, disability, demographic factors, and estimated color-coded alert level.Results. Persons who are mentally ill, those who are disabled, African Americans, Latinos, Chinese Americans, Korean Americans, and non-US citizens were more likely to perceive population-level risk as high, as measured by the estimated color-coded alert level. These groups also reported more worry and avoidance behaviors because of concerns about terrorism.Conclusions. Vulnerable populations experience a disproportionate burden of the psychosocial impact of terrorism threats and our national response. Further studies should investigate the specific behaviors affected and further elucidate disparities in the disaster burden associated with terrorism and terrorism policies.One public health definition of terrorism proposes that the effects of terrorism “real or threatened” may include “adverse health effects in those immediately affected and their community, ranging from a loss of well-being or security to injury, illness, or death.”¹ The events of September 11, 2001, influenced well-being and security beyond the regions directly attacked.^2–4 Many people throughout the United States felt they were at risk from terrorism. Risk perceptions, along with antiterrorism programs, laws, and policies (e.g., airport security regulations, visa restrictions, and warrantless surveillance) affected Americans’ lifestyles and behaviors. In the months following the attacks, 40% to 50% of US adults still feared for their safety^4,5 and 11% reported changed behaviors such as avoiding public gatherings.^6,7Risk perception theories and research posit that individuals assess risks based on a balance of many factors, including the probability of a hazard or risk personally affecting them, the severity of the personal consequences from risk exposure, feelings of personal control, the perceived inequality of risk distribution across society, and trust in institutions managing risks.^8,9 For instance, a national survey conducted 2 months after the attacks of September 11 found that the distance between one''s home and the World Trade Center was inversely correlated with perceptions of terrorism risk among non-Hispanic Whites.⁹ By contrast, Latinos’ and African Americans’ judgments of future terror risks were not affected by how far they lived from New York City.These results are consistent with findings of lower risk perceptions among politically conservative White males, who feel greater control over their environment and greater trust in the institutions protecting them.¹⁰ As noted by Fischhoff,

The processes determining terror risks are so complex and poorly understood (by experts, much less the general public) that all citizens might feel equally at risk. On the other hand, people might use even rudimentary theories of terrorism to derive differential predictions of vulnerability: Who are the terrorists’ targets? Who can take effective protective action?^{9(pp 137–138)}

The estimation of personal risk and vulnerability to terrorism may act as a key motivator to behavioral adaptations, including avoidance of usual activities or increased adoption of protective behaviors.^11–14 Those who believe they are particularly vulnerable to a risk may be motivated to perform risk reduction. Studies document that vulnerable populations, such as the chronically ill, the physically disabled, non-White racial/ethnic minorities, and immigrants, bear a disproportionate burden of harm from natural disasters^15–18 and that there are racial/ethnic differences in perceived risks of natural disasters.¹⁵Similarly, research finds specifically that African Americans and Latinos perceive they are at greater risk from terrorism than do non-Latino Whites.^9,19 A survey conducted less than a year after September 11, 2001, reported that African Americans were most likely to limit their outside activities and change their mode of transportation in response to fears of terrorism.⁵ Also, a national survey found that persons with disabilities were more anxious about their personal risk from terrorism than were persons without disabilities, even when equally prepared.²⁰ Another study reported that persons who increased their disaster preparations in response to the possibility of terrorist attacks included African Americans, Latinos, persons with disabilities or household dependents, and non–US-born populations.²¹As with health and disasters generally, these populations may experience disparities in the effects of terrorism and terrorism policies including their risk perceptions and avoidant behavior. An Israeli survey found that large social groups, including women, had adapted their daily behaviors to minimize the impact of terrorism risks.¹⁴ As studies continue to document the long-term and indirect health effects of the September 11 attacks, it remains important to understand how long these risk perceptions and behavioral effects have lasted and who has been most affected.^22–27The Homeland Security Advisory System (HSAS) is a post–September 11 program that may influence risk perceptions and avoidant behavior—although that is not its intended purpose. The HSAS announces the Department of Homeland Security''s assessed risk of a terrorist attack on the United States via a color-coded threat level and disseminates information regarding that level''s risk to public safety officials and the general public. The HSAS has 5 color-coded conditions: green, blue, yellow, orange, and red corresponding to threat levels of low, guarded, elevated, high, and severe, respectively. At each level are recommended actions for the public and government agencies to implement to reduce the “likelihood or impact of an attack.”²⁸ The value of the HSAS is debated, considering its adverse effects on well-being caused by unnecessarily raising fears and anxieties.^29–31 To our knowledge, there are no studies examining how vulnerable groups perceive the HSAS alert level, an important issue for researchers interested in disaster vulnerability and how population characteristics affect perceptions of overall population risk.We examined how the characteristics of a population affect its overall, population-level risk perceptions, worry about terrorism, and avoidance of certain activities as a result of terrorism concerns, focusing on these outcomes in vulnerable population groups. Three sets of hypotheses underlay our study. We hypothesized that vulnerable populations would be most likely to perceive population-level risk as high, as measured by the estimated HSAS level. Although there is little systematic study of this topic, previous US studies have documented disparities in terrorism fears by gender, race, ethnicity, and education level. We studied 4 vulnerable groups of interest to public health and policy officials: persons with mental illness, persons with disabilities, non-White racial/ethnic groups, and immigrants. We hypothesized that vulnerable groups would be most likely to fear terrorism and would avoid activities because of terrorism fears. We also hypothesized persons who estimated the HSAS level to be red (severe) or orange (high) at the time of the survey, when the HSAS level was yellow (elevated), would report greater worry about terrorism and greater avoidance of activities as a result of terrorism concerns.     

药物对TNF诱导的牛脑微血管平滑肌细胞增值的拮抗作用

研究表明,肿瘤坏死因子(TNH)在50～5000U·mL^-1范围内呈剂量依赖性地诱导牛脑微血管平滑肌细胞增殖,TNF与该细胞培养24h时,即可明显刺激细胞增殖,48h时达最大刺激效应。欧芹素乙(imperatorin,Imp),异欧芹素乙(iso-imperatorin,Isi)在浓度为10^-6～10^-4mol·L^-1时,均可剂量依赖性地拮抗TNF诱导该细胞增殖。6-(α,α-二苯基乙酰哌嗪基苯基)-4,5-二氢-5-甲基-3(2H)哒嗪酮,6-(α-苯基乙酰哌嗪基苯基)-4,5-二氢-5-甲基-3(2H)哒嗪酮,则只在低浓度(10^-6mol·L^-1)时拮抗TNF诱导该细胞的增殖。