Immunisation with the BCG and DTPw vaccines induces different programs of trained immunity in mice

In addition to providing pathogen-specific immunity, vaccines can also confer nonspecific effects (NSEs) on mortality and morbidity unrelated to the targeted disease. Immunisation with live vaccines, such as the BCG vaccine, has generally been associated with significantly reduced all-cause infant mortality. In contrast, some inactivated vaccines, such as the diphtheria, tetanus, whole-cell pertussis (DTPw) vaccine, have been controversially associated with increased all-cause mortality especially in female infants in high-mortality settings. The NSEs associated with BCG have been attributed, in part, to the induction of trained immunity, an epigenetic and metabolic reprograming of innate immune cells, increasing their responsiveness to subsequent microbial encounters. Whether non-live vaccines such as DTPw induce trained immunity is currently poorly understood. Here, we report that immunisation of mice with DTPw induced a unique program of trained immunity in comparison to BCG immunised mice. Altered monocyte and DC cytokine responses were evident in DTPw immunised mice even months after vaccination. Furthermore, splenic cDCs from DTPw immunised mice had altered chromatin accessibility at loci involved in immunity and metabolism, suggesting that these changes were epigenetically mediated. Interestingly, changing the order in which the BCG and DTPw vaccines were co-administered to mice altered subsequent trained immune responses. Given these differences in trained immunity, we also assessed whether administration of these vaccines altered susceptibility to sepsis in two different mouse models. Immunisation with either BCG or a DTPw-containing vaccine prior to the induction of sepsis did not significantly alter survival. Further studies are now needed to more fully investigate the potential consequences of DTPw induced trained immunity in different contexts and to assess whether other non-live vaccines also induce similar changes.     

以工时为核心的护士绩效考核实践

以护理工时为基础,建立以工时核算为核心的老年科护士绩效考核方案,并与医院信息系统相关联。改革后,护士工作效率提高,护理质量提升,护士满意度增加。认为工时绩效考核方案具有一定科学性和合理性,能够充分体现护理人员劳动价值,促进团队协作,提升护理质量。     

慢性咳喘患者食道测压及24小时pH监测的护理配合

对２０例有返流症状的慢性咳嗽、哮喘患者应用多导胃肠功能测定仪及便携式ＰＨ监测记录仪进行食管测压及２４小时ｐＨ监测时，根据患者对检查的认识和接受程度不同，有针对性地进行宣教和心理护理，并通过熟练的操作技术顺利完成了２０例慢性咳嗽、哮喘患者的食道测压及２４小时食管ｐＨ监测。分析了慢性咳嗽、哮喘患者食道测压及２４小时ｐＨ监测的护理配合，认为患者的密切配合和准确、熟练的操作技术是保证检查成功的重要因素。     

Alcohol and labor supply: the case of Iceland

At a time when the government of Iceland is considering privatization of alcohol sales and a reduction of its governmental fees, it is timely to estimate the potential effects of this policy change. Given that the privatization of sales coupled with a tax reduction should lead to a decrease in the unit price of alcohol, one would expect the quantity consumed to increase. While it is of interest to project the impact of the proposed bill on the market for alcohol, another important consideration is the impact that increased alcohol consumption and, more specifically, probable alcohol misuse would have on other markets in Iceland. The only available study on this subject using Icelandic data yields surprising results. Tómasson et al. (Scand J Public Health 32:47–52, 2004) unexpectedly found no effect of probable alcohol abuse on sick leave. A logical next step would be to examine the effect of probable alcohol abuse on other important labor-market outcomes. Nationally representative survey data from 2002 allow for an analysis of probable misuse of alcohol and labor-supply choices. Labor-supply choices are considered with reference to possible effects of policies already in force, as well as proposed changes to current policies. Contrary to intuition, but in agreement with the previously mentioned Icelandic study, the adverse effects of probable misuse of alcohol on employment status or hours worked are not confirmed within this sample. The reasons for the results are unclear, although some suggestions are hypothesized. Currently, data to test those theories convincingly are not available.

Hours worked and patient visits provided by dentists in Australia

Background

The aim was to examine the numbers of hours worked and patient visits provided by age and gender of dentists in Australia, and compare with previous estimates to describe trends.

Methods

Data were collected from a random sample (N = 2961) of Australian dentists. Private sector dentists working in clinical practise were included in the analysis.

Results

The response rate was 49% (N = 1345 dentists). Hours per year worked and number of patient visits per year were lower for dentists aged 65 years and older compared with younger dentists, and were higher for male compared with female dentists aged 35–45 to 55–64 years. Hours per year worked were lower in 2013–2014 than reported in 2009–2010, but the number of patient visits in 2013–2014 was similar to the previously reported estimate from 2009–2010.

Conclusions

Hours worked and visits provided were only lower among older dentists aged 65 years or more. Male dentists tend to work more hours per year and provide more patient visits per year than female dentists. Over the last decade, Australian dentists maintained a stable output of visits per year despite a trend towards fewer hours worked per year.     

The potential use of urinary transferrin,urinary adiponectin,urinary Retinol Binding Protein,and serum zinc alpha 2 glycoprotein levels as novel biomarkers for early diagnosis of diabetic nephropathy: A case-control study

Background and aimsThe level of albuminuria is used to evaluate diabetic nephropathy (DN). However, to detect or predict the early stages of DN, better biomarkers are needed.MethodsThis study is a case-control observational study. 80 Egyptians participated in the study: 60 patients with type 2 diabetes mellitus (T2DM) were divided into three groups (20 patients each), and 20 healthy subjects with matched age and gender were used as controls. Demographic and laboratory data were analyzed. An enzyme-linked immunosorbent assay was used to determine the levels of four biomarkers of DN; urinary adiponectin (ADP), urinary transferrin, serum Zinc Alpha 2 Glycoprotein (ZAG), and urinary Retinol Binding Protein (RBP).ResultsThe levels of DN biomarkers urinary ADP, transferrin, RBP, and serum, ZAG were significantly higher in patients with T2DM than in controls. The ROC curve of the validity of the simultaneous use of all four biomarkers in predicting albuminuria indicates a sensitivity of 90% and a specificity of 90%. The Area Under the Curve (AUC) was 0.948, the 95% confidence interval was 0.998–0.897, and the p-value was 0.001.ConclusionsIn patients with T2DM, urine adiponectin, transferrin, RBP, and serum ZAG concentration may be useful biomarkers in the early diagnosis of DN. A further longitudinal prospective study is required to explore the potential utility of these biomarkers.     

In Memory of Our Editorial Board Member Prof. ZHANG Zhi-nan

Prof.ZHANG Zhi-nan,China＇s famous hematologist,member of the editorial board of Chinese Journal of Integrative Medicine,passed away at the age of 84 on July 18,2014 in Beijing.Prof.Zhang was born in Beijing in 1929 and graduated from Peiking Union Medical College in 1954.After graduating from the Peiking Union Medical College Hospital,he had worked in the Internal Department and Hematology Department,     

Estimating and testing multiple structural changes in linear models using band spectral regressions

We provide methods for estimating and testing multiple structural changes occurring at unknown dates in linear models using band spectral regressions. We consider changes over time within some frequency bands, permitting the coefficients to be different across frequency bands. Using standard assumptions, we show that the limit distributions obtained are similar to those in the time domain counterpart. We show that when the coefficients change only within some frequency band, we have increased efficiency of the estimates and power of the tests. We also discuss a very useful application related to contexts in which the data are contaminated by some low‐frequency process (e.g. level shifts or trends) and that the researcher is interested in whether the original non‐contaminated model is stable. All that is needed to obtain estimates of the break dates and tests for structural changes that are not affected by such low‐frequency contaminations is to truncate a low‐frequency band that shrinks to zero at rate . Simulations show that the tests have good sizes for a wide range of truncations so that the method is quite robust. We analyse the stability of the relation between hours worked and productivity. When applying structural change tests in the time domain, we document strong evidence of instabilities. When excluding a few low frequencies, none of the structural change tests are significant. Hence, the results provide evidence to the effect that the relation between hours worked and productivity is stable over any spectral band that excludes the lowest frequencies, in particular it is stable over the business‐cycle band.     

公共场所从业人员艾滋病健康教育干预效果评价

目的研究将艾滋病预防知识纳入公共场所从业人员卫生知识培训课程的可行性及有效性。方法采用集中授课的方式,对前来福田区疾病预防控制中心进行健康体检和接受卫生知识培训的公共场所从业人员进行艾滋病预防知识培训,培训前后均以闭卷、匿名形式测试从业人员相关知识掌握情况。结果培训后对艾滋病预防知识有较全面的认识,特别是在艾滋病主要传播途径方面的知识,安全套对预防艾滋病的作用及正确使用的方法等有非常显著的提高。但仍有1/3的人认为得艾滋病是不光彩的,愿与艾滋病病毒(HIV)感染者交往的人仍不到40%,说明人们对艾滋病的恐惧和歧视心理很重;且大部分公共场所从业人员对自身感染性认识不足,对安全套存在认识与行为相分离,安全套使用率低,提醒我们工作重点应放在"百分之百"使用上。结论通过对公共场所从业人员采取深入浅出、通俗易懂,既有基础性知识,又有防治艾滋病的基本方法的培训教育,效果是明显的,措施是可行的,有进一步研究和推广的价值。     

基于病例组合指数和护理工时构建肝胆外科护理人力资源配置模型

护理人力资源配置与护理质量和患者安全密切相关。通过测量某院肝胆外科患者护理工时,从医院信息系统提取患者病例组合指数数据,采用Spearman相关分析及简单线性回归分析量化病例组合指数值与护理工时的关系,进而建立了肝胆外科护理人力资源配置模型,满足了护士合理休假需求,提高了护士满意度。