Study on residents' satisfaction of basic public health services of urban and rural primary health care institutions / 中国卫生政策研究

Objective:To analyze the satisfaction degree and influencing factors of basic public health services in urban and rural areas in Hubei province,and to provide the evidence for further improvement of the quality of basic public health services. Methods:A total of 12 primary health institutions (6 urban community health service centers and 6 rural township hospitals) were selected from Wuhan,Huanggang,Jingzhou of Hubei Province. A questionnaire survey was conducted on the satisfaction,accessibility,comfort,safety and effectiveness of basic public health services among 719 residents. Results:The overall urban and rural residents'satisfaction score of basic public health service was 71.62 points,and the total satisfaction rate was 73.44%. The urban residents overall satisfaction score was 74.67 points,and the overall satisfaction rate was 75. 34%. The rural residents overall satisfaction score was 67.64 points,and the overall satisfaction rate was 71.52%. Among the specific indicators,the most satisfactory items were the convenience of visits (83.03%),privacy protection (80.25%),and indicators least satisfactory were medical technology(61.61%)and equipment facilities(64.53%). Logistics regression analy-sis showed that accessibility,comfort and safety of basic public health services had a greater impact on community residents' satisfaction;and gender and annual medical expenditure had a certain impact on residents'satisfaction. Conclusions:The over-all satisfaction of basic public health services in urban and rural residents of Hubei province is at a general level and still to be promoted. Urban residents'satisfaction is higher than that of the rural area. The basic public health services should further strengthen the quality improvement to further promote the equalization of basic public health services in rural as in urban areas.

Distribution of Pathogenic Bacteria and Its Influence on Expression of BCL-2 and BAX Protein after HSCT in the Patients with Hematological Malignancies / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the distribution of pathogenic bacteria in the patients with hematologic malignancies received hematopoietic stem cell transplantation (HSCT) and its influence on the expression of BCL-2 and BAX proteins.</p><p><b>METHODS</b>The clinical data of 64 patients with malignant lymphoma (ML) received auto-HSCT from January 2011 to December 2015 in our hospital were analyzed. On basis of post-treansplant infection, the patients were divided into infection group (36 cases) and non-infection group (28 cases). The distribution of pathogenic bacteria in 2 groups was identified, the T lymphocyte subsets of peripheral blood, expression level of apoptotic proteins and C-reaction protein (CRP) in 2 group were detected.</p><p><b>RESULTS</b>Thirty-six strains of pathogenic bacteria were isolated from 36 case of hematological malignancy after HSCT, including 24 strains of Gram-negative bacteria (66.67%) with predominamce of klebsiella pneumoniae (19.44%). The periperal blood CD4+ (t=2.637, P<0.01), CD4+/CD8+ ratio (t=8.223, P<0.01), BCL-2 protein (t=5.852, P<0.05), BCL-2/BAX ratio (t=14.56, P<0.01) in infection group were significantly lower than those in non-infection group, while CD8+ (t=2.285, P=<0.01), CRP (t=39.71, P<0.01), BAX level in infection group were higher than those in non-infection group. The pearson correcation analysis showed that the CD4+/CD8+ ratio in infection group positively correlated with BCL-2/BAX ratio (t=0.341, P<0.05), while serum CRP level in infection group negatively correlated with BCL-2/BAX ratio (t=-0.362, P<0.05).</p><p><b>CONCLUSION</b>The pathogenic bacteria infecting ML patients after HSCT were mainly Gram-negative bacteria. The post-transplant infection can promote the expression up-regulation of related inflammatory factors and apoptotic proteins. The pathogens may be involved in cell apoptisis that provides a new strategy to treat the hematologic malignancies.</p>

Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation for Treating Patient with Primary Cutaneous γΔ T Cell Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics of primary cutaneous γΔ T cell lymphoma and its treatment methods.</p><p><b>METHODS</b>The clinical data and treatment process of one woman case of primary cutaneous γ Δ T cell lymphoma diagnosed in our department were analysed. The multiple subcutaneous nodules were the main clinical features, the diagnosis of primary cutaneous γΔ T cell lymphoma was comfired by skin biopsy pathology. The immunophenotypes of lymphocytes showed CD20-, CD3+, CD4-, CD8-, CD56+, TIA-1+, Ki-67+ (about 60%); plasma cells kappa+(part)/lambda predominate+(part); histocytes CD4+, CD68/PGM1+; βF1-, epstein-barr (EB) virus showed negative EBER in situ hybridization.</p><p><b>RESULTS</b>By means of the chemotherapy regimens containing L-Asparaginase, the complete remission (CR) was achieved. Then, the patients were given autologous hematopoietic stem cell transplantation. Neutrophils were implanted after 16 days, and platelet was implanted after 18 days. Now, the patient is still in remission.</p><p><b>CONCLUSION</b>primary cutaneous γΔ T cell lymphoma is rare and easy to be misdiagnosed. This disease is aggressive and its prognosis is poor. The large dose chemotherapy with L-asparaginase shows a certain curative efficacy, the autologous hematopoietic stem cells can prolong survival time of the patient.</p>

Clinical and Pathological Analysis of 9 Patients with Primary Breast Diffuse Large B-cell Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the clinical features, diagnosis and treatment of primary breast diffuse large B- cell lymphoma (PBDLBCL).</p><p><b>METHODS</b>Clinical records of 9 PBDLBCL patients treated in Department of Hematology of Yijishan Hospital Affiliated to Wannan Medical College from August 2001 to January 2014 were analyzed retrospectively.</p><p><b>RESULTS</b>All of the 9 patients were female, with an average age of 48 years (range 28 to 75), 8 cases had unilateral breast tumors and 1 case had bilateral. According to the Ann Arbor stage standard, 2 cases were of stage IE and 7 were IIE. None of them was concurrent with B symptoms; 6 cases had IPI (International prognostic Index) score 0 and 3 had score 1. 2 cases belonged to germinal center B cells type (GCB) and 7 belonged to non-GCB. Double-Hit lymphomas were presented in 3 cases. Out of 9 cases, 3 cases were diagnosed by using tubular needle biopsy, 5 cases were diagnosed by using resection of breast mass, and 1 case was diagnosed by using modified radical mastectomy. 1 case received radical mastectomy, 1 case received unilateral breast removal, 1 case gave up, 1 case received mass excision with chemotherapy and radiotherapy, 5 cases received mass excision with chemotherapy and 1 case received central prophylaxis. A complete response (CR) was observed in 6 cases after first-line chemotherapy. The median follow-up time was 18 months (range 0.1 to 150), 3 cases relapsed and 5 cases died.</p><p><b>CONCLUSION</b>PBDLBCL mostly occurs in female. The main pathological type is non-GCB coupled with Double-Hit lymphoma. Tubular needle biopsy offers benifit in the diagnosis of PBL, R-CHOP or R-CHOP combined with chemotherapy/radiotherapy produce best outcome among all the treatments. Intrathecal injection of chemotherapy drugs may help to prevent recurrence of PBL central.</p>