我国疾病预防控制体系建设政策效力与政策效果评估

目的 评估我国疾病预防控制体系建设相关政策文件效力和实施效果,为我国疾病预防控制体系政策制定建言献策。方法 通过国家卫生健康委员会官网、“北大法宝”检索系统以“疾病预防控制”、“疾控体系”、“疾控”为主要检索词检索2003—2022年中央、国家及各部委发布的政策文件,经筛选后最终纳入52项疾病预防控制相关政策。将政策效力划分为政策力度、政策措施、政策目标3个维度,用疾病预防控制支出表示政策效果,通过构建多元线性回归模型对环境型、供给型、需求型三种不同政策工具疾病预防控制体系建设政策实施效果进行回归分析。结果 2003—2022年,我国疾控体系建设相关政策数量与总体效力值呈现平稳波动,且具有明显的正相关关系,政策平均效力值呈M型稳定变化趋势,整体水平偏低; 政策措施得分最高,政策目标次之,政策力度得分最低。相较于其他两种政策工具,环境型政策工具使用频率最高,需求型政策工具使用频率最低; 环境型(Coef.=0.732,P=0.015)、供给型(Coef.=0.64,P=0.010)、需求型(Coef.=0.523,P=0.035)三种政策工具对政策实施效果均具有促进作用,滞后期保持在1～2年; 上一年度的疾控支出对下一年度的政策效果具有促进作用(Coef.=0.74,P=0.032)。结论 我国疾病预防控制政策效力不断提高主要源于政策颁布数量的累计效应; 不同政策工具使用过程中存在不平衡、不充分问题; 三类政策工具均对我国疾病预防控制体系政策实施效果起到一定影响,且环境型政策工具最优; 疾病预防控制相关支出会强化政策实施效果,推动疾控体系建设快速发展。     

樟树化学型形成关键萜类合酶的系统鉴定

樟树Cinnamomum camphora为我国重要的经济树种。根据叶片挥发油中主要成分的种类和含量,樟树通常被分为龙脑型、樟脑型、芳樟醇型、桉叶油型和橙花叔醇型5种化学型,萜类合酶(terpene synthase, TPS)是形成这些化合物的关键酶。虽然多个关键酶基因已得到鉴定,但最具经济价值的(+)-龙脑的生物合成途径未见报道。该研究通过对4种化学型叶片的转录组分析,克隆了9个萜类合酶基因CcTPS1～CcTPS9。经过大肠杆菌诱导表达重组蛋白后分别以香叶基焦磷酸(GPP)和法尼基焦磷酸(FPP)为底物进行酶促反应,结果CcTPS1和CcTPS9均可催化GPP生成冰片基焦磷酸,并在磷酸水解酶的作用下得到(+)-龙脑,产物占比分别为0.4%、89.3%。CcTPS3和CcTPS6均可催化GPP生成单一产物芳樟醇,CcTPS6还可与FPP反应生成橙花叔醇。CcTPS8与GPP反应生成1,8-桉叶油(30.71%)。9个萜类合酶共计产生9个单萜和6个倍半萜类化合物。该研究首次确定樟树中负责(+)-龙脑生物合成的关键酶基因,为进一步阐明化学型形成的分子机制及利用生物工程技术培育高产龙脑新...     

ECG-6511心电图机导联电路故障1例

开机后做Ⅰ、Ⅱ、Ⅲ导联时,导联指示灯亮,按1ma定标健,有定标信号,但无心电信号,其余导联心电信号正常。     

腹部内生场热疗联合化疗治疗恶性腹水的临床研究

目的:评价腹部内生场热疗联合化疗治疗恶性腹水的近期疗效及毒副反应。方法:将2015年1月至2016年12月期间江门市人民医院收治的98例恶性腹水的患者按随机分为两组,观察组(50例),采用化疗结合腹部内生场热疗;对照组(48例),采用单纯化疗,比较两组近期效果、毒副反应以及卡氏百分法(KPS)评分的情况。结果:与对照组比较,观察组腹水控制有效率以及KPS评分提高率明显高于对照组,差异具有统计学意义(P0.05);肢端感觉异常及面部感觉异常的发生率低于对照组,差异具有统计学意义(P0.05)。结论:腹部内生场热疗联合化疗治疗恶性腹水近期效果显著,不良反应少,是晚期肿瘤姑息治疗的一种好手段。     

中国少数民族中小学生视力不良特征分析

了解中国26个少数民族7~18岁学生视力不良现状及特征,为少数民族学生制定具有针对性的视力防控与治理措施提供依据.方法 使用2014年中国学生体质健康调研中26个少数民族的80 766名中小学生视力不良数据,采用x2检验进行组间比较.结果 少数民族中小学生视力不良率为39.17%,各学段女生视力不良率均高于男生,性别间差异有统计学意义(x2=1 127.28,P<0.01).高中(16~18岁)女生视力不良率最高,达63.13%;小学低年级(7~9岁)男生视力不良率最低,为20.50%.各民族视力不良检出率在14.68%~62.94%之间,其中视力不良检出率最高的前5个民族分别为藏族(62.94%)、壮族(62.39%)、朝鲜族(57.92%)、回族(56.48%)、纳西族(51.35%),最低的前5个民族为水族(14.68%)、佤族(17.96)、柯尔克孜族(18.30%)、黎族(19.22%)、哈尼族(22.30%),民族间差异有统计学意义(x2=7 910.34,P<0.01).结论 中国26个少数民族中小学生视力水平民族间差异明显.在针对藏、壮等重点民族学生干预的同时,应注重性别差异,加强全民族学生的视力防控与治理.     

内生场深部热疗治疗恶性胸腹水患者的临床护理策略

目的:探讨内生场深部热疗治疗恶性胸腹水患者的临床护理策略。方法:选取2015年10月~2017年6月我院收治的恶性胸腹水行深部热疗患者160例,对所有患者行恶性胸腹水护理干预,比较分析患者在护理干预前后的SAS,SDS以及生活质量量表(QLQ-C 30)的评分情况。结果:患者护理干预后SAS和SDS评分,功能领域、症状领域和总体健康3个维度评分与护理干预前相比均有所下降,护理前后评分相比差异有统计学意义(P0.05)。结论:对恶性胸腹水患者采用内生场深部热疗中,护理干预可改善患者的心理状态和生活水平,具有临床推广价     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.     

格列本脲乳胶剂的制备及初步药效学

目的制备格列本脲乳胶剂,并观察其对正常大鼠的降血糖作用。方法采用改进的Franz扩散池,考察不同浓度二乙胺、不同有机胺和促进剂对格列本脲透皮吸收的影响,并评价优选处方对正常大鼠的降血糖作用。结果当二乙胺和氮酮的质量分数分别为0.70%和3%时,格列本脲乳胶剂的稳态渗透速率最高,并且能显著降低正常大鼠空腹血糖(P<0.01)。结论格列本脲乳胶剂的降血糖作用显著,有望成为一种治疗糖尿病的新型制剂。     

全身热化疗治疗儿童蝾螈瘤1例报道

今年3-6月我院成功地为1例身患恶性蝾螈瘤的3岁儿童施行3次全身热化疗术.蝾螈瘤是一种罕见的恶性肿瘤,而且据文献检索此为国内首例对儿童施行全身热化疗术,现报道如下.