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Objective:To evaluate the detection accuracy of hepatitis B virus (HBV) serological markers among grassroots medical institutions in the demonstration areas of infectious diseases.Methods:A fixed sampling method was used among the followed-up hepatitis B cohort in general population of six infectious disease demonstration areas nationwide. Blood samples of chosen objects were collected, in which HBsAg and anti-HBs were tested by grassroots medical institutions and were also parallely tested by the third-party platform. The test results were compared between the two groups. Statistical analyses were conducted by SAS 9.4 software.Results:A total of 5 756 and 5 263 samples of HBsAg and anti-HBs were successfully tested, respectively. Comparing the results of HBsAg and anti-HBs from grassroots medical institutions with the results from the third platform, the agreement of HBsAg and anti-HBs was 97.13% and 77.33%, respectively. The Kappa value was 0.56 (95% CI 0.50-0.62) for HBsAg and 0.54 (95% CI 0.52-0.56) for anti-HBs, respectively; and the McNemar tests indicated the difference between the results (all P<0.01). There were also significant differences in agreement of testing results with the third platformin among different regions ( P<0.05 or <0.01). The Kappa values indicated that Jiangsu province and Guangdong province had high accordance rates of HBsAg (0.87 and 0.81, respectively), and Gansu province and Guangdong province had high accordance rates of anti-HBs (Both were 0.74). Regarding the results from the third platform as the standard, the sensitivity of HBsAg testing in grassroots medical institutions was moderate (40.51%) and the specificity was well (99.96%). The sensitivity of anti-HBs testing was substantial (73.18%) and the specificity was well (84.31%). Guangdong province (Youden index: 0.69) and Jiangsu province (Youden index: 0.80) had high identification ability for HBsAg, and for indicator of anti-HBs, Gansu province (Youden index: 0.78) and Guangdong province (Youden index: 0.76) had high identification ability. Conclusion:There are certain differences in results of HBV serological markers tests between the grassroots medical institutions in the demonstration areas of infectious diseases and the third platform. Current testing strategies in grassroots medical institutions are suitable for identifying people without hepatitis B infection, while it is necessary to pay attention to the situation of potential false negative error.
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Although the flu vaccine is the most effective strategy for preventing influenza currently,the population incidence and mortality of influenza present an unstable trend.Due to the rapid variability of influenza virus,the conventional flu vaccine components and dominant lineage are not matching;more importantly,trivalent influenza vaccine (T IV) contains only A/H3N2,A/H1N1 and B/Victoria lineage,which does not match the B/Yamagata lineage that have prevailed in recent years.Quadrivalent influenza vaccine (QIV) adds the B/Yamagata lineage,and it has been used abroad for susceptible populations.Compared with TIV,QIV provides better protection for susceptible populations and is considered to have better public health benefits.This article reviews the history of development and current status,the safety,immunogenicity,efficacy of prevention and control and cost-effectiveness of QIV,to provide reference for the promotion and implementation of influenza vaccination.
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Objective To explore the onset incentives, clinical features, treatment and prognosis of diabetic foot. Methods The clinical data of 80 patients with diabetic foot from January 2000 to October 2009 were analyzed retrospectively. Results The 53 cases had bacterial infection.Thirty cases had severe lower limb arterial stenosis or occlusion (stenosis rate ＞70%). And iliac arteries of 5 cases and popliteal arteries of 4 cases were completely occluded. Sixty-five cases had diabetic peripheral neuropathy. Seventy two cases had clear incentive. Forty 40 cases recovered, 20 cases were amputated, 12 cases were discharged without cure, and 8 cases died. Conclusions Most of the occurrences of diabetic foot have incentives. Prognosis and degree of lower limb arterial occlusion are significantly correlated. Infection and the severity of other underlying diseases are associated with the prognosis. The diabetic patients should be treated comprehensively including controlling blood sugar, anti-infection, improving lower limb blood supply, nurturing nerve and local treatment.
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Objective To investigate the morbidity and related factors for osteoporosis in postmenopausal patients with type 2 diabetes mellitus (T2DM).Methods The bone mineral density (BMD) at lumbar vertebrae(L1-4), left femoral neck, femoral trochanter and total hip were measured by dual energy X-ray absorptiometry (DEXA) in 79 postmenopansal patients with T2DM.The patients were divided into two groups: osteoporosis group and non-osteoporosis group.The correlations between BMD and age, course of disease, menopausal age, menopausal duration and body mass index (BMI) were analyzed by multivariate regression analysis.Results There were significantly statistical differences in age, BMI, interleukin 6 (IL-6), osteocalcin and menopause duration between two groups.Linear correlation analysis showed IL-6 was positively correlated with osteoporosis (r=0.260, P=0.020) and glycosylated hemoglobin (GHbAlc) (r=0.259, P=0.023) Logistic regression analysis showed that the morbidity of osteoporosis had an independent positive correlation with age, but an independent negative correlation with BMI.Conclusions In postmenopausal patients with T2DM, age and low BMI are independent risk factors for osteoporosis.
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control relatives.A ratio of s/q approached1/q with Penrose' s method.Heritability of SLE was78.8%?4.45%in the first-degree relatives,58.8%?10.9%in the second-degree relatives,and39.2%?32.0%in the third-degree relatives.The weighted mean heritability was75.2%?4.12%.Conclusions SLE has characteristics of polygenic disease.Genetic factor might play an important role in the liability of SLE.
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Objective To evaluate the gene mutation of RANTES and CCR5 in SLE and its significance. Methods One hundred and forty-six definitive SLE patients and 159 controls were collected. SNPs of RANTES promoter and polymorphism of CCR5 were performed by PCR or PCR/RFLP assay, and further confirmed by direct DNA sequencing. Results The frequence of RANTES-403G/G compounded with 28C/C and CCR5/CCR5 was significantly different between SLE and control groups (72.6% vs 58.5%, P 0.05). Conclusions These results indicate that the two SNPs are linkage disequilibrium. Interaction of two SNPs in RANTES and CCR5 is related with SLE. RANTES-403G/G compounded with 28C/C and CCR5/CCR5 may be one of risk factors of SLE. RANTES-403A is probably related with renal damage of SLE.