目前,新型农村合作医疗正在我国300多个县(市)开展试点工作.然而,在农村总体经济实力不强又面临市场经济冲击的大形势下,建立新型农村合作医疗制度将是一项十分艰难、复杂的工程.本文讨论了新型农村合作医疗制度产生的历史背景及如何增强农民对新型农村合作医疗制度的信心问题.
ObjectiveTo optimize HSP65-MUC1 fusion protein purification in pilot scale through protein purification techniques and identify the methods for biological activity detection. MethodsE. coli expressing HSP65-MUC1 was obtained by fermentation, then homogenized to obtain the supernatant. To acquire high-purity, high-quality HSP65-MUC1, the supernatant was treated with saturated ammonium sulfate, phenyl sepharose FF column and Q FF ion-exchange chromatography column purification. The expression of CD86 on the surface of DC cells treated with HSP65-MUC1 was determined with flow cytometry. ResultsE. coli containing pET28a-HSP65-MUC1 recombinant plasmid can effectively express target protein. A total of 413.7 mg of HSP65-MUC1 was obtained after 10 g of fermented cells was treated with saturated ammonium sulfate, phenyl sepharose FF column and Q FF ion-exchange chromatography column, and the purity was nearly 96%. Compared with negative control (10.13%±0.89%), purified HSP65-MUC1 could significantly improve the expression of CD86 on the surface of DC cells (29.98%±1.02%). ConclusionThe pilot scale production of purified HSP65-MUC1 has been effectively optimized, and the methods of its biological activity detection have been identified, which simultaneously provides the basis for clinical studies.
With the increasing demand for health technology decision making in hospitals, the activities of hospital-based health technology assessment are increasing globally. Several developed countries, such as France, Finland, Denmark, Italy, Canada, The United State and Australia have carried out hospital-based health technology assessment activities. In order to further promote the development of health technology assessment in China and establish evidence-based management and decision-making concept of hospitals, the National Center for Medical Service Administration has carried out theoretical and practical research on hospital technology assessment by fully drawing on foreign advanced experience. This paper introduces the background, object, method and content of the research, the achievements of the pilot project and the prospect of the future, so as to provide a reference for readers to understand the overall situation of the project and related work.
In medical research, pilot and feasibility studies are conducted to reduce the uncertainty of future main trial and enhance its overall quality and probability of successful completion. The objective of a pilot and feasibility study is to answer whether the main trial can be performed, should be performed, and if so, how. Due to the tremendous resources, time, and funding required for a phase Ⅲ clinical trial, conducting a pilot and feasibility study is generally a pivotal step. While pilot and feasibility studies are gaining increasing attention in clinical research, efforts are largely required to promote the dissemination in China. Therefore, in this article, we briefly introduce the concepts of a pilot and feasibility study, its importance to the main trial, and current practice. Examples are also provided to help illustrate the introduction.
ObjectiveTo understand the cervical spine function, core stability and strength of fighter pilots, and to explore the difference of that between fighter pilots with and without neck pain.MethodsFrom October to December 2020, a double-blind design was used to test the cervical spine function, core stability and strength of fighter pilots of a certain part of the Air Force. At the same time, the area of deep cervical flexor and the thickness of transverse abdominis and multifidus muscles were measured. According to the presence or absence of neck pain in the last 3 months, they were divided into neck pain group and non-neck pain group. The cervical spine function, core stability and core strength, deep cervical flexor and transversus abdominis endurance of the two groups were compared and analyzed.ResultsA total of 38 pilots were included. There was no significant difference in age, body mass index, service life, flight time, total flight time and weekly flight time between the neck pain group and the non-neck pain group (P>0.05). There was no significant difference in cervical spine mobility between the two groups of pilots (P>0.05). The cervical flexor muscle strength [(15.5±4.9) vs. (12.1±3.0) N] and the ratio of cervical flexion/neck extension (0.6±0.1 vs. 0.5±0.1) in the non-neck pain group were higher than in the neck pain group (P<0.05). There was no significant difference in the muscle strength of other superficial cervical muscles between the two groups (P>0.05). The average value of deep neck flexor endurance in the neck pain group [25.36 mm Hg(1 mm Hg=0.133 kPa)] better than the non-neck pain group group (17.11 mm Hg) (P=0.026). There was no significant difference in test values of transverse abdominis endurance between the two groups (P>0.05). The left hip internal rotator strength [(11.9±2.6) vs. (10.0±2.1) N] and the left hip external rotator strength [(13.7±2.2) vs. (11.9±2.0) N] in the non-neck pain group were higher than in the neck pain group (P<0.05). There was no significant difference in the muscle strength of the other hip joint muscles between the two groups (P>0.05). The thickness of the right transversus abdominis in the neck pain group [(1.1±0.3) vs. (0.8±0.3) cm] was higher than that in the non-neck pain group (P<0.05). There was no significant difference in the thickness of the left transversus abdominis, the cross-sectional area of deep cervical flexor muscle and the thickness of lumbar multifidus muscle between the two groups (P>0.05).ConclusionsFighter pilots with neck pain have superficial cervical flexor muscle strength and decreased left hip internal and external rotation muscle strength, and the superficial cervical flexor and extensor muscle strength is unbalanced. Strengthening the superficial cervical flexor muscle strength, improving the balance between the superficial cervical flexor and extensor muscles, and enhancing the hip internal and external rotator muscle strength may help prevent neck pain.
Objective To investigate the prevalence and risk factors of degenerative disc disease (DDD) in pilots. Methods From January 2021 to May 2022, pilots were surveyed using a whole group sampling method and relevant imaging data were collected. The contents of the survey included basic information, DDD-related information, flight-related information, and personal habits. The prevalence of DDD was calculated, and univariate χ2 test, t-test, and multivariate logistic regression analysis were performed for the diseased and healthy groups to screen the risk factors of DDD. Results A total of 170 copies of questionnaire were sent out and 162 valid copies were returned. The prevalence of DDD was 47.5% (77/162), including 27.8% (45/162) for cervical spondylosis, 29.6% (48/162) for lumbar disc herniation, and 3.1% (5/162) for degenerative lumbar spondylolisthesis. The results of univariate analysis showed that body mass index (t=2.594, P=0.010), driving age (t=2.160, P=0.032), maximum load in flight (t=2.953, P=0.004), mean load in flight (t=2.575, P=0.011), insomnia (χ2=4.756, P=0.029) and smoking (χ2=7.977, P=0.005) were significantly different between the diseased group and the healthy group. Multivariate logistic regression showed that driving age [odds ratio (OR)=1.077, 95% confidence interval (CI) (1.025, 1.132), P=0.004], maximum load in flight [OR=1.279, 95%CI (1.109, 1.475), P=0.001], helmet weight [OR=1.516, 95%CI (1.056, 2.175), P=0.024], insomnia [OR=2.235, 95%CI (1.114, 4.483), P=0.024], and smoking [OR=2.527, 95%CI (1.255, 5.087), P=0.009] were risk factors for DDD. Conclusions The prevalence of DDD is high in pilots. High driving age, high maximum load in flight, high helmet weight, insomnia, and smoking may be independent risk factors for DDD.
This paper studies the active force characteristics of the neck muscles under the condition of rapid braking, which can provide theoretical support for reducing the neck injury of pilots when carrier-based aircraft blocks the landing. We carried out static loading and real vehicle braking experiments under rapid braking conditions, collected the active contraction force and electromyography (EMG) signals of neck muscles, and analyzed the response characteristics of neck muscle active force response. The results showed that the head and neck forward tilt time was delayed and the amplitude decreased during neck muscle pre-tightening. The duration of the neck in the extreme position decreased, and the recovery towards the seat direction was faster. The EMG signals of trapezius muscle was higher than sternocleidomastoid muscle. This suggests that pilots can reduce neck injury by pre-tightening the neck muscles during actual braking flight. In addition, we can consider the design of relevant fittings for pre-tightening the neck muscles.
Objective To preliminarily assess the ameliorative effect of Mom’s Good Mood (MGM) on the prevalence of antenatal depression based on a pilot study, and to provide evidence for a scale-up study. Methods This study was conducted in Ma’anshan Maternal and Child Health Center as a pilot study of an implementation study conducted in China called the Perinatal Depression Screening and Management (PDSM) program. In 2019, 1 189 participants (gestational week ≤14+6 weeks) were included in the implementation group. Females were recruited in the first trimester and followed up in the second and third trimesters. At each time point, the participants’ depression status was screened by the Edinburgh postpartum depression scale (EPDS), and those who were screened as having depression were provided the MGM intervention. In 2020, 1 708 participants who underwent screening with the EPDS in either the first, second or third trimester at Ma’anshan Maternal and Child Health Center were included in the control group. Mann‒Whitney U test, Chi-square, and multivariate logistic regression analysis were used to compare the EPDS scores and depression prevalence between the control and implementation groups to assess the ameliorative effect of MGM (screening and intervention) on antenatal depression. Results In the first trimester, there were no statistically significant differences in EPDS scores or depression prevalence between the two groups (P>0.05). In the second and third trimesters, both the EPDS scores and depression prevalence of the implementation group were lower than those of the control group (P<0.05). After adjusting for confounders, logistic regression analysis showed that the risks of depression in the implementation group in both the second and third trimesters were lower than those in the control group (ORsecond trimester=0.55, 95%CI 0.37 to 0.81, P=0.003; ORthird trimester=0.51, 95%CI 0.35 to 0.74, P<0.001). Conclusion Implementation of the MGM based on the primary care system can effectively reduce the prevalence of antenatal depression, providing evidence for further scale up.