Evaluation on effect of new model of community-based hypertension self-management / 上海预防医学

To explore the new model of community-based hypertension self-management, through literature review and qualitative interviews with experts and stakeholders.Among 15 000 patients with informed consents and voluntary participation, 1 080 patients were randomly selected as the intervention group, and 588 patients were randomly selected from hypertension management database of community health service centers as the control group.Analysis of covariance based on rank scores was employed to compare the score changes in two survey questionnaires, before and after six months of the intervention project, and between the intervention group and the control group, on self-assessment of overall health status, and qual-ity of health care services received in the community.Analysis of covariance was employed to compare the changes of blood pressure. Results The self-assessment of overall health status significantly improved for the intervention group, compared with the control group (P<0.05).The blood pressure of the inter-vention group remained stable, while the diastolic pressure for the control group increased as compared with that before intervention, the difference was statistically significant (P<0.05).During six months of the intervention project, as to the incremental value of scores in dimensions like initiative and design of health care service system, the difference between the intervention group and the control group was statistically significant ( P <0 .05 ) . Conclusion The intervention based on the new model of community-based hypertension self-management has a positive role in improving the patients'overall health status, stabilizing the blood pressure, and optimizing hypertension health care services in community.

Rash and fever illness caused by herpes simplex virus type 1 needs to be distinguished from hand, foot and mouth disease / 病毒学报

An epidemic of rash and fever illnesses suspected of hand, foot and mouth disease (HFMD) occurred in Gansu Province of China in 2008, laboratory tests were performed in order to identify the pathogen that caused this epidemic. Eight clinical specimens collected from the 4 patients (each patient has throat swab and herpes fluid specimens) with rash and febrile illness, were inoculated onto RD and HEp-2 cells for virus isolation, and the viral nucleic acid was then extracted with the positive virus isolates, the dual-channel real-time reverse transcript-polymerase chain reaction (RT-PCR) was performed to detect the nucleic acid of human enterovirus (HEV) in the viral isolates at the same time. For the viral isolates with the negative results of HEV, a sequence independent single primer amplification technique (SISPA) was used for "unknown pathogen" identification. Totally, 6 viral isolates were identified as herpes simplex virus type 1 (HSV-1). Comprehensive analyses results of the clinical manifestations of the patients, epidemiological findings and laboratory test indicated that this epidemic of rash and febrile illness was caused by HSV-1. The differences among the gG region of 6 HSV-1 isolates at nucleotide level and amino acid level were all small, and the identities were up to 98. 8% and 97.9%, respectively, showing that this outbreak was caused by only one viral transmission chain of HSV-1. HSV-1 and other viruses that cause rash and febrile illnesses need differential diagnosis with HFMD. The etiology of rash and febrile illness is sometimes difficult to distinguish from the clinical symptoms and epidemiological data, the laboratory diagnosis is therefore critical.

Surgical treatment of the tumors of posterior part of third ventricle and pineal region / 军事医学科学院院刊

Objective:To summarize the experiences of the surgical treatment of tumors in the posterior part of the third ventricle and pineal region. Methods: Twenty-seven patients with tumors in this region treated microsurgically from 1990 to 2000 were analyzed. The surgical indications, approaches, and operative key points were discussed. The prognostic factors were also analyzed. Results:Tumors were removed totally in 11 patients, removed subtotally in 7 and removed partially in 5. Biopsy and ventriculo-peritoneal shunt was performed in 4 patients. Of 17 patients in follow-up, 13 patients survived longer than 5 years. Conclusions: Most tumors in the posterior part of the third ventricle and pineal region can be surgically removed.Sufficient specimen obtained in the operation can confirm pathologic property of the tumor,guiding next chemotherapy and radiotherapy.