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This article introduces the health management service specification for a chronic patient population. The concept of this specification comes from the whole process of people-centered and integrated health management of the chronic patient population. It is also based on the World Health Organization′s integrated chronic patient population management model. The completion of the specification has gone through several rounds of expert discussion in related fields in China. The contents include seven key links: suspect selection, clinical diagnosis, health assessment, intervention plan development, intervention plan implementation, follow-up, and health reassessment. It also includes establishing a professional team and developing a support system and mechanism of financing, compensation, and incentives. The specification aims at integrating regional health resources through standardizing service technology and scientific management concepts. It would help to improve the efficiency and quality of health management of chronic patient population in China, thereby reducing the economic burden of chronic diseases for patients and their families, and achieving the goal of improving residents′ health.
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Objective: To explore the relationship between different dimensions of infectious disease-specific health literacy scale in China. Methods: Structural equation model (SEM) was employed to assess the psychometric properties of the infectious disease-specific health literacy scale. Based on the database from a randomly selected sample of 4 499 adult residents in three provinces in China, from March to May 2015. AMOS 21.0 software was used to build the SEM for data analyses. Results: SEM analyses showed a good model fit of data, with the following satisfied parameters: goodness-of-fit index was 0.969, adjusted goodness-of-fit index was 0.962, root mean square residual was 0.038, root mean square error of approximation was 0.038, standardized root mean square residual was 0.032, Tacker-Lewis index/non-normed fit index was 0.926, comparative fit index was 0.934, normed fit index was 0.925, relative fit index was 0.915, incremental fit index was 0.934, parsimony goodness-of-fit index was 0.782, parsimony-adjusted normed fit index was 0.817, parsimony-adjusted comparative fit index was 0.825 and critical N was 702. The established SEM showed that the total influence path coefficient of "infectious disease-related knowledge and values" on the "infectious disease prevention" , "management or treatment of infectious diseases" and "identification of infection sources" were 0.771, 0.744 and 0.843, respectively. The total influence path coefficients of "identification of infection sources" , "infectious disease prevention" on "management or treatment of infectious diseases" were 0.164 and 0.535, respectively. The effect of "infectious disease-related knowledge and values" on "management or treatment of infectious diseases" appeared the greatest (55.4%), followed by "infectious disease prevention" (28.6%) and "identification of infection sources" (2.7%). Conclusion: This SEM could be optimistically used for planning and evaluation of health education and promotion programs on infectious diseases prevention.
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Adulto , Humanos , China , Letramento em Saúde , Modelos Teóricos , Psicometria , Inquéritos e QuestionáriosRESUMO
Objective To explore the relationship between different dimensions of infectious disease-specific health literacy scale in China.Methods Structural equation model (SEM) was employed to assess the psychometric properties of the infectious disease-specific health literacy scale.Based on the database from a randomly selected sample of 4 499 adult residents in three provinces in China,from March to May 2015.AMOS 21.0 software was used to build the SEM for data analyses.Results SEM analyses showed a good model fit of data,with the following satisfied parameters:goodness-of-fit index was 0.969,adjusted goodness-of-fit index was 0.962,root mean square residual was 0.038,root mean square error of approximation was 0.038,standardized root mean square residual was 0.032,Tacker-Lewis index/non-normed fit index was 0.926,comparative fit index was 0.934,normed fit index was 0.925,relative fit index was 0.915,incremental fit index was 0.934,parsimony goodness-of-fit index was 0.782,parsimony-adjusted normed fit index was 0.817,parsimony-adjusted comparative fit index was 0.825 and critical N was 702.The established SEM showed that the total influence path coefficient of "infectious disease-related knowledge and values" on the "infectious disease prevention","management or treatment of infectious diseases" and "identification of infection sources" were 0.771,0.744 and 0.843,respectively.The total influence path coefficients of "identification of infection sources","infectious disease prevention" on "management or treatment of infectious diseases" were 0.164 and 0.535,respectively.The effect of "infectious disease-related knowledge and values" on "management or treatment of infectious diseases" appeared the greatest (55.4%),followed by "infectious disease prevention" (28.6%) and "identification of infection sources" (2.7%).Conclusion This SEM could be optimistically used for planning and evaluation of health education and promotion programs on infectious diseases prevention.
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Indoleamine 2,3-dioxygenase 1 (IDO1) is the rate-limiting enzyme which catalyses the metabolism of L-tryptophan(L-Trp) in the kynurenine pathway.It is overexpressed in many tumor cells and antigen presenting cells.This enzyme inhibits local immune response and supports tumor cells to evade immune surveillance by depleting L-Trp and producing kynurenine metabolites,thus,it is an important target for cancer immunotherapy.There are several IDO1 inhibitors with different scarfold under investigation,three of which have already entered clinical stage.The role of IDO1 in tumor immune tolerance and the research progress on IDO1 inhibitors in recent years are summarized in this paper.
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@#c-Met receptor tyrosine kinase plays an important role in signaling pathways including cell proliferation, metabolism as well as tumorigenic growth, migration and angiogenesis. c-Met has emerged as an attractive target for cancer therapy. Moreover, the interactive cross-talk between c-Met signaling and several other signaling pathways underlies a key effect for resistance of anti-cancer drugs. Thus, multi-target inhibitors become a new approach to cancer therapy. This paper introduces the c-Met signaling pathway and the resistance of kinase inhibitors caused by the cross-talk between c-Met and other membrane receptors and then will reviews the progress of single-target and multi-target c-Met inhibitors.
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Objective To study the epidemiological status of reproductive health related behaviors of out of school adolescents in Kunming and Shenzhen City,and to explore the social-psychological influencing factors of the behaviors.Methods A cross-sectional study was conducted in 410 out of school adolescents aged 15-24 years who were recruited with accidental sampling.All the subjects were required to complete a self-administrated questionnaire.Single factor Chi-square analysis and multi-factor Logistic method were used for data analysis.Results The correct respondent rate of the questions on reproductive health knowledge among the adolescents was low.The sexual intercourse rate was 42.9% (176/410).Nearly 44.9% (79/176) of the adolescents who had sexual experience did not use condom in the latest sexual intercourse,and those who had no less than one sexual partner accounted for 48.9% (86/176).The prevalence of genital discomfort and sexual transmitted disease was 48.8% (200/410) and 2.9% (12/ 410),respectively.Chi-square test showed that marriage,living statue,behaviors of holding hands,kiss,caress the body,sexual intercourse and having no less than one sexual partner influenced the prevalence of genital discomfort(x2 values were 4.667,10.862,10.032,15.619,17.423,28.239,17.817 and 21.369,respectively ; all P < 0.05).In binary Logistic analysis,living in a dormitory or with other people,behaviors of caress the body,sexual intercourse and having no less than one sexual partner influenced the prevalence of genital discomfort (odds ratio (OR) was 0.449 (95% CI:0.216-0.933),0.377 (95% CI:0.147-0.967),4.364 (95% CI:1.594-11.949),0.312 (95% CI:0.111-0.877) and2.646 (95% CI:1.417-4.941),respectively ; all P < 0.05).Conclusions The status of reproductive health was poor among out of school girls in kunming and Shenzhen,and living status,behaviors of caress the body,sexual intercourse and having no less than one sexual partner could influence the prevalence of genital discomfort.Comprehensive measures should be taken to strengthen the reproductive health management in this population.
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Objective To investigate the effects of high-fat diet induced insulin resistance on fibroblast growth factor-21 (FGF-21) and its receptors expression in ApoE~(-/-) mice. Method Male ApoE~(-/-) mice were randomly divided into normal-chow group(NF,n=20)and high-fat fed group(HF,n=20) and fed for 16 weeks. The insulin sensitivity and glucose-lipid metabolism in awake mice were evaluated by hyperinsulinemic-euglycemic clamp technique combined with 3-[~3H]-glucose as a tracer. The Mrna expressions of FGF-21,β-klotho, and FGFR1-4 were measured by quantitative real-time PCR. FGF-21 protein levels were determined by Western blot. Results Fasting blood glucose, plasma insulin and free fatty acids, triglycerides, free fatty acids, and cholesterols were significantly elevated in HF group compared with NF group(all P<0.01). During the steady-state of clamp, plasma insulin was significantly higher in HF group than that in NF group(P<0.01), and glucose infusion rate was also significantly decreased(P<0.01). At the end of insulin clamp, glucose disappearance rate was significantly lower in HF group than that in NF groups(P<0.01). Hepatic glucose production in NF group was suppressed by 70% ,while in HF group it was suppressed by 51%. The FGF-21 Mrna expressions of hepatic and adipose tissues in HF group were significantly increased compared with NF group(both P<0.01), and β-klotho Mrna expressions increased(P<0. 05). In hepatic and adipose tissues, FGFRI, Mrna expressions were higher in HF group than those in NF group(both P<0.01) ,and FGFR3 Mrna increased(P<0.01 and P<0.05, respectively). In hepatic tissue,FGFR4 Mrna levels were significantly up-regulated in HF group(P<0. 05). Plasma FGF-21 levels were elevated in HF group compared with NF group(P<0.01) ,and FGF-21 protein expressions of hepatic and adipose tissues were also increased(both P<0.05). Conclusion FGF-21, β-klotho, FGFR1, and FGFR3 were significantly up-regulated in ApoE~(-/-) mice fed by high-fat diet, and they might be the targets in regulating glucose-lipid metabolism by FGF-21.