ABSTRACT Background Several studies have explored the impact of BMI on size and composition of urinary stones. Because there were controversies, a meta-analysis was necessary to be carried out to provide some evidence of the relationship of BMI and urolithiasis. Materials and Methods PubMed, Medline, Embase, Web of Science databases, and the Cochrane Library were searched up to August 12th 2022 for eligible studies. The urolithiasis patients were summarized into two groups: BMI < 25 and ≥ 25 kg/m2. Summary weighted mean difference (WMD), relative risk (RR) and 95% confidence intervals (CI) were calculated through random effects models in RevMan 5.4 software. Results A total of fifteen studies involving 13,233 patients were enrolled in this meta-analysis. There was no significant correlation of BMI and size of urinary stone (WMD -0.13mm, 95% CI [-0.98, 0.73], p = 0.77). Overweight and obesity increased the risk of uric acid stones in both genders and in different regions (RR=0.87, [95% CI] = 0.83, 0.91, p<0.00001). There was a higher risk of calcium oxalate stones formation in overweight and obesity group in total patients (RR=0.95, [95% CI] = 0.91, 0.98, p = 0.006). The relationship of BMI and calcium phosphate was not observed in this meta-analysis (RR=1.12, [95% CI] = 0.98, 1.26, p = 0.09). Sensitivity analysis was performed and indicated similar results. Conclusions The current evidence suggests a positive association between BMI and uric acid and calcium oxalate stones. It would be of great guiding significance to consider losing weight when treating and preventing urinary stones.

Abstract We aimed to evaluate the effects of somatostatin combined with early hemoperfusion on inflammatory and stress responses during acute pancreatitis (AP) treatment. A total of 159 AP patients treated from September 2016 to January 2020 were randomly divided into three groups A-C (n=53). In addition to routine treatment, groups A-C were additionally given somatostatin, early hemoperfusion, and somatostatin combined with early hemoperfusion, respectively. Their inflammatory factors, stress response, intestinal mucosal barrier, hemorheological indices, recovery time, length of stay, clinical efficacy, and adverse reactions were compared. The levels of serum interleukin-10 (IL - 10), catalase and glutathione peroxidase rose in the three groups after ten days of treatment, compared with values before treatment, being the highest rise in group C. The levels of IL -18, tumor necrosis factor-α, soluble intercellular adhesion molecule-1, procalcitonin, high mobility group protein B1, lipid hydrogen peroxide, advanced oxidation protein products, epinephrine, cortisol, D-lactic acid, diamine oxidase, and endotoxin decreased after ten days of treatment compared with those before treatment, which were lowest in group C (P<0.05). After ten days of treatment, the levels of hemorheological indices were significantly lower than those before treatment (P<0.05). Compared with groups A and B, group C had a shorter recovery time of urine amylase, bowel sound and passing gas, remission time of abdominal pain, length of stay, and a higher total response rate (P<0.05). During AP treatment, somatostatin combined with early hemoperfusion effectively relieved inflammatory and stress responses, protected the intestinal mucosal barrier function and improved the hemorheology, thereby promoting the recovery and benefiting the prognosis of patients.

Resumen Nuestro objetivo fue evaluar los efectos de la somatostatina combinada con hemoperfusión temprana sobre las respuestas inflamatorias y de estrés durante el tratamiento de la pancreatitis aguda (PA). Un total de 159 pacientes con PA tratados entre septiembre de 2016 y enero de 2020 se dividieron aleatoriamente en tres grupos A-C (n=53). Con base en el tratamiento de rutina, los grupos A-C recibieron además somatostatina, hemoperfusión temprana y somatostatina combinada con hemoperfusión temprana, respectivamente. Se compararon sus factores inflamatorios, respuesta al estrés, barrera de la mucosa intestinal, índices hemorreológicos, tiempo de recuperación, tiempo de estancia, eficacia clínica y reacciones adversas. Los niveles séricos de interleucina-10 (IL -10), catalasa y glutatión peroxidasa aumentaron en los tres grupos después de 10 días de tratamiento, comparados con los valores antes del tratamiento, siendo más elevados en el grupo C. Los niveles de IL - 18, factor de necrosis tumoral α, molécula de adhesión intercelular 1 soluble, procalcitonina, proteína B1 del grupo de alta movilidad, peróxido de hidrógeno lipídico, los productos proteicos de oxidación avanzada, epinefrina, cortisol, ácido D-láctico, diaminooxidasa y endotoxina disminuyeron después de 10 días de tratamiento en comparación con los previos al tratamiento, que fueron más bajos en el grupo C (P<0,05). Después de 10 días de tratamiento, los índices hemorreológicos fueron significativamente menores que los previos al tratamiento (P<0,05). En comparación con los grupos A y B, el grupo C tuvo un tiempo de recuperación más corto de amilasa en orina, sonido y escape intestinal, tiempo de remisión del dolor abdominal y tiempo de estancia, y una tasa de respuesta total más alta (P<0,05). Durante el tratamiento de la AP, la somatostatina combinada con hemoperfusión precoz alivia eficazmente las respuestas inflamatorias y de estrés, protege la función de la barrera de la mucosa intestinal y mejora la hemorología, favoreciendo la recuperación y beneficiando el pronóstico de los pacientes.

RESUMO Introdução A correta compreensão e implementação das tarefas definidas pelo treinador para o jogador é alcançada através de uma ampla variedade de sessões de treinamento. Até hoje, a questão da eficácia do treinamento e a preparação dos jogadores profissionais de futebol para os jogos não foi suficientemente estudada. Objetivo Estudar os meios e métodos utilizados no treinamento de futebol e, por comparação, descobrir qual dos métodos é mais eficaz para obter um resultado positivo durante o jogo e manter a saúde dos jogadores. Métodos O estudo utilizou métodos matemáticos e físicos, assim como análise comparativa. No decorrer do estudo, foram considerados os principais métodos de treinamento em uma equipe. Foi realizada uma análise comparativa entre dois tipos de treinamento individual de jogadores de futebol, objetivando melhorar parâmetros físicos e técnicos. Resultado Foram estabelecidos quais parâmetros influenciam a escolha do esquema de treinamento. A eficácia de ambos os sistemas de treinamento é comprovada pelos indicadores estatísticos dos jogadores de futebol que treinam de acordo com estes métodos. Conclusão A eficácia da metodologia de treinamento escolhida por um jogador de futebol depende de suas habilidades físicas iniciais e habilidades profissionais. O significado prático do estudo é determinado pelo fato de que os métodos propostos podem ser utilizados no treinamento de atletas profissionais. Evidência nível II; Estudos terapêuticos – pesquisa de resultados.

ABSTRACT Introduction The correct understanding and implementation of the tasks set by the coach for the player are achieved through a wide variety of training sessions. To date, the question of training effectiveness and the preparation of professional soccer players for matches has not been sufficiently studied. Objective Study the means and methods used in soccer training. By comparison, find out which method is most effective in achieving a positive result during the game and maintaining the players’ health. Methods The study used mathematical and physical methods and comparative analysis. In the study, the main training methods in a team were considered. A comparative analysis was made between two types of individual soccer players’ training to improve physical and technical parameters. Result We established which parameters influence the choice of the training scheme. The effectiveness of both training systems is proven by the statistical indicators of soccer players who train according to these methods. Conclusion The effectiveness of the training methodology chosen by a soccer player depends on his initial physical abilities and professional skills. The study’s practical significance is determined by the fact that the proposed methods can be used in training professional athletes. Evidence level II; Therapeutic studies - outcomes research.

RESUMEN Introducción La correcta comprensión y ejecución de las tareas establecidas por el entrenador para el jugador se consigue a través de una amplia variedad de sesiones de entrenamiento. Hasta hoy, la cuestión de la eficacia del entrenamiento y la preparación de los futbolistas profesionales para los partidos no se ha estudiado suficientemente. Objetivo Estudiar los medios y métodos utilizados en el entrenamiento de fútbol y, por comparación, averiguar qué método es más eficaz para conseguir un resultado positivo durante el juego y mantener la salud de los jugadores. Métodos El estudio utilizó métodos matemáticos y físicos, así como análisis comparativos. En el transcurso del estudio, se consideraron los principales métodos de formación en un equipo. Se realizó un análisis comparativo entre dos tipos de entrenamiento individual de jugadores de fútbol, con el objetivo de mejorar los parámetros físicos y técnicos. Resultado Se estableció qué parámetros influyen en la elección del esquema de entrenamiento. La eficacia de ambos sistemas de entrenamiento queda demostrada por los indicadores estadísticos de los futbolistas que entrenan según estos métodos. Conclusión La eficacia de la metodología de entrenamiento elegida por un futbolista depende de sus capacidades físicas iniciales y de sus habilidades profesionales. La importancia práctica del estudio viene determinada por el hecho de que los métodos propuestos pueden utilizarse en el entrenamiento de atletas profesionales. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados.

Resumen Antecedentes: los últimos estudios han demostrado que la deficiencia de vitamina D está relacionada con la aparición de la enfermedad del intestino irritable (SII) y que tomar vitamina D como suplemento puede aliviar los síntomas de la enfermedad del intestino irritable. Sin embargo, el tratamiento clínico de la enfermedad del intestino irritable con vitamina D es controvertido. Objetivo: se realizó un metaanálisis de todos los ensayos clínicos para evaluar las asociaciones entre la vitamina D y la enfermedad del intestino irritable. Métodos: se examinaron todos los ensayos controlados aleatorios que se publicaron antes del 20 de diciembre de 2021 en las siguientes bases de datos: Medline, Web of Science, China National Knowledge Infrastructure (CNKI), Cochrane Central y Clinical Trial. Se utilizaron RevMan 5.4.1 y Stata 16.1 para analizar los datos relevantes. Se utilizó la diferencia de medias estandarizada (DME) con intervalo de confianza del 95 % (IC 95 %) para presentar los tamaños del efecto. La concentración sérica de vitamina D, el riesgo de deficiencia de vitamina D entre los pacientes con SII, la puntuación de gravedad de los síntomas (SSS) y la puntuación de calidad de vida (CdV) son los principales criterios de valoración de este estudio. Resultados: se incluyeron datos de doce ensayos clínicos en 1331 pacientes con SII. los pacientes con SII tienen niveles relativamente bajos de vitamina D en el suero. La suplementación con vitamina D mejora la puntuación de calidad de vida (CdV), pero no tiene un efecto significativo en la puntuación de gravedad de los síntomas (SSS). Conclusiones: la deficiencia de vitamina D se asocia con la patogénesis del síndrome del intestino irritable. Los niveles séricos de vitamina D disminuyeron en pacientes con síndrome del intestino irritable, y la suplementación con vitamina D podría mejorar la calidad de vida de los pacientes.

Abstract Background: latest studies have shown that vitamin D deficiency is related to the occurrence of irritable bowel disease (IBS), and taking vitamin D as a supplement can alleviate the symptoms of irritable bowel disease. However, clinical treatment of irritable bowel disease with vitamin D is controversial. Objective: we conducted a meta-analysis of all clinical trials to evaluate the associations between vitamin D and irritable bowel disease. Methods: we screened all randomized controlled trials that were published before December 20, 2021 from the following databases: Medline, Web of Science, China National Knowledge Infrastructure (CNKI), Cochrane Central, and Clinical Trial. We used RevMan 5.4.1 and Stata 16.1 to analyze the relevant data. The standardized mean difference (SMD) with 95 % confidence interval (95 % CI) was used to report effect sizes. Serum vitamin D concentration, risk of vitamin D deficiency among patients with IBS, Symptom Severity Score (SSS), and Quality of Life (QoL) score are the main endpoint outcomes in this study. Results: data from twelve clinical trials with 1331 IBS patients were included. Patients with IBS have relatively low vitamin D levels in their serum. Vitamin D supplementation improves the Quality of Life (QoL) score but has no significant effect on the Symptom Severity Score (SSS). Conclusions: vitamin D deficiency is associated with the pathogenesis of irritable bowel syndrome. Serum vitamin D levels decreased in patients with irritable bowel syndrome, and vitamin D supplementation could improve patient quality of life.

ABSTRACT Introduction: Severe fever with thrombocytopenia syndrome virus (SFTSV) is a newly emerged virus that poses a great threat to human health because of high fatality rate. Methods: To develop sensitive and specific sero-diagnostic systems for SFTSV infections, monoclonal antibodies (MAbs) against recombinant SFTSV nucleocapsid (rSFTSV-N) protein were developed by immunizing BALB/C mice with rSFTSV-N protein and fusing the spleen cells with SP2/0 myeloma cells. Three hybridoma cell lines secreting MAbs against rSFTSV-N were obtained. MAb based IgG sandwich enzyme linked immunosorbent assay (ELISA) and IgM capture ELISA systems were established by using the newly developed MAbs. One hundred fifteen clinical suspected SFTS patients serum samples were used to evaluate the newly established systems by comparing with the total antibody detecting sandwich ELISA system and indirect ELISA systems. Results: The MAbs based sandwich IgG ELISA was perfectly matched with that of the total antibody sandwich ELISA and the indirect IgG ELISA. IgM capture ELISA results perfectly matched with that of the total antibody sandwich ELISA while detecting eight additional positive samples missed by the indirect IgM ELISA. Conclusions: The MAbs against rSFTSV-N protein offer new tools for SFTSV studies and our newly developed MAb-based IgG and IgM capture ELISA systems would offer safe and useful tools for diagnosis of SFTS virus infections and epidemiological investigations.

Resumo Cryptosporidium é um parasita zoonótico que causa diarreia em uma ampla gama de animais, incluindo veados. Pouco se sabe sobre a prevalência e o genótipo de Cryptosporidium spp. no cervo de Père David. Neste estudo, 137 amostras fecais do cervo de Père David foram coletadas entre julho de 2017 e agosto de 2018, na Reserva Dafeng, e analisadas para Cryptosporidium spp. por nested-PCR baseado no gene do RNA ribossômico da subunidade pequena (SSU rRNA), seguido de análises de sequências para determinar as espécies. O gene da glicoproteína de 60 kDa (gp60) foi utilizado para caracterizar Cryptosporidium spp. Dentre as 137 amostras, 2 (1,46%) foram positivas para Cryptosporidium spp. de acordo com os resultados do sequenciamento gênico de SSU rRNA. Ambas as amostras pertenciam ao genótipo do cervo Cryptosporidium, com duas deleções nucleotídicas e uma substituição nucleotídica. Os dados de prevalência e a caracterização molecular deste estudo fornecem conhecimentos básicos para controlar e prevenir infecções por Cryptosporidium nos cervos de Père David nessa.

Abstract Cryptosporidium is a zoonotic parasite that causes diarrhea in a broad range of animals, including deer. Little is known about the prevalence and genotype of Cryptosporidium spp. in Père David’s deer. In this study, 137 fecal samples from Père David’s deer were collected between July 2017 and August 2018 in the Dafeng Reserve and analyzed for Cryptosporidium spp. by nested-PCR based on the small subunit ribosomal RNA (SSU rRNA) gene, followed by sequence analyses to determine the species. The 60 kDa glycoprotein (gp60) gene was used to characterize Cryptosporidium spp. Among 137 samples, 2 (1.46%) were positive for Cryptosporidium spp. according to SSU rRNA gene sequencing results. Both samples belonged to the Cryptosporidium deer genotype, with two nucleotide deletions and one nucleotide substitution. The prevalence data and molecular characterization of this study provide basic knowledge for controlling and preventing Cryptosporidium infections in Père David’s deer in this area.

ABSTRACT To investigate the genetic variation and molecular epidemiology characteristics of Human Respiratory Syncytial Virus (HRSV) in Guizhou Province, nasopharyngeal aspirates were collected from patients with acute respiratory infection (ARI) in Guizhou Provincial People's Hospital, from December 2017 to March 2018, and inoculated to Hep-2 cells to isolate HRSV. Cells that showed cytopathic effect (CPE) were then confirmed by indirect immunofluorescence assay and reverse transcription. The sequence of the PCR products was determined for HRSV isolates, and the genetic variation was analyzed. Out of 196 nasopharyngeal aspirate samples, HRSV were isolated in 39. The second hypervariable region at the 3' terminal of glycoprotein gene (HVR2) sequence analysis showed that subgroup A was dominant. Seventy-nine percent of the isolates belonged to subgroup A, ON1 genotype, and 21 % belonged to subgroup B, BA9 genotype, which indicates that the dominant HRSV circulating in Guizhou Province was subgroup A, genotype ON1, co-circulating with a less prevalent subgroup B, genotype BA9.

Tumor necrosis factor-alpha (TNF-α) plays an important role in autoimmune diseases. Previous studies have investigated the association of TNF-α-238G/A (rs361525) and -308G/A (rs1800629) polymorphisms with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). However, no agreed conclusion had been made. Therefore, this meta-analysis was conducted to assess the associations of TNF-α-238G/A and -308G/A polymorphisms with RA and SLE risk. A systematic search was conducted in commonly used databases. Meta-analysis was performed by STATA12.0. A total of 43 studies were included. In the overall population, the TNF-α-238A allele was observed to be a protective factor for RA (A vs G: OR=0.75, 95%CI=0.57–0.99, P=0.040) and the TNF-α-308A allele was found to be a risk factor for SLE (A vs G: OR=1.78, 95%CI=1.45–2.19, P<0.001). However, no evidence of association was found between TNF-α-238 G/A polymorphism and SLE nor between -308G/A and RA. In the subgroup analysis, TNF-α-308A allele played a pathogenic role for RA in Latin Americans (A vs G: OR=1.46, 95%CI=1.15–1.84, P=0.002) and for SLE in Latin Americans (A vs G: OR=2.12, 95%CI=1.32–3.41, P=0.002) and Europeans (A vs G: OR=2.03, 95%CI=1.56–2.63, P<0.001), while it played a protective role for RA in Asians (A vs G: OR=0.54, 95%CI=0.32–0.90, P=0.017). No significant association was found between TNF-α-308G/A and SLE susceptibility in Africans and Asians. This meta-analysis demonstrated that TNF-α-238A was associated with decreased risk of RA rather than SLE, while -308G/A polymorphism was associated with SLE rather than RA. Stratification analysis indicated that different ethnicities would have different risk alleles.

Abstract Objectives This retrospective study was aimed to explore the epidemiological and clinical profiles of Mycoplasma pneumoniae infection in neonates. Methods From 2011 to 2014, 1322 hospitalized neonates with lower respiratory tract infections were screened for Mycoplasma pneumoniae by detection of Mycoplasma pneumoniae antibodies using Serion ELISA classic Mycoplasma pneumoniae kits. Results Mycoplasma pneumoniae was identified in 89 (6.7%) patients. The age ranged from 1 day to 28 days with a median of 22 days. The male to female ratio was 1.15:1. Mycoplasma pneumoniae infection peaked in spring (from March through May) and winter (from December through February). Compared with non-Mycoplasma pneumoniae infected neonates, those with Mycoplasma pneumoniae infection were older, presented fever more frequently, and had less tachypnea. Conclusions Mycoplasma pneumoniae could be an important etiologic agent for respiratory tract infection in neonates. In neonates Mycoplasma pneumoniae infection was usually associated with older age, presence of fever, and less tachypnea. Mycoplasma pneumoniae infection in neonates tends to be a mild process.

AbstractA highly efficient photocatalyst Ag3PO4/Ag was prepared by a one-step low temperature chemical bath method. The reflectance spectra (DRS) indicated Ag3PO4/Ag had strong absorption in visible light region. The synthesized Ag3PO4/Ag photocatalyst was used as the efficient photocatalysts for the photocatalytic degradation of Rhodamine B (RhB) under visible-light illumination which showed almost complete degradation (~ 98%) of RhB dye in 90 min. The negative surface of Ag3PO4/Ag photocatalyst also promoted the degradation of a cationic dye like methylene bule (MB; 78% in 90min), while the performance against an anionic dye like methyl orange was poorer (MO; 40% in 90 min). Compared to the pure Ag3PO4 photocatalyst, the Ag3PO4/Ag photocatalyst showed the enhanced visible light photocatalytic informance. The excellent photocatalytic performance is mainly ascribed to the surface plasmon resonance of Ag nanoparticles and a large negative charge of PO43- ions.

Human enterokinase (synonym: enteropeptidase, EC 3.4.21.9) light chain (hEKL) gene was designed and artificially synthesized with built-in codon blas towards Escherichia colicodon preference. The synthetic hEKL gene was cloned into prokaryotic expression vector pMAL-s and transferred into the expression strain E. coli BL21 (DE3). Recombinant hEKL protein with a maltose binding protein (MBP) tag was expressed at high levels in soluble form, which yielded about 42% of the total cellular protein. The target protein was then purified to the homogeneity (> 95%) by affinity chromatography. The peptide substrate GST-Melittin with enterokinase recognition site was completely cleaved by the purified MBP-hEKL at the molar ratio of 1:5000 (enzyme:substrate). Tricine SDS-PAGE analysis showed that the activity of MBP-hEKL was approximately seven times that of bovine enterokinase catalytic subunit (EKMaxTM, Invitrogen). From 1 L flask culture, 206 mg pure active MBP-hEKL was with specific activity of 1.4×104U/mg.

PURPOSE: To construct a new biomaterial-small intestinal submucosa coated with gelatin hydrogel incorporating basic fibroblast growth factor, and to evaluate the new biomaterials for the reconstruction of abdominal wall defects.METHODS: Thirty six Sprague-Dawley rats were used in the animal experiments and randomly divided into three groups. The new biomaterial was constructed by combining small intestinal submucosa with gelatin hydrogel for basic fibroblast growth factor release. Abdominal wall defects were created in rats, and repaired using the new biomaterials (group B), compared with small intestinal submucosa (group S) and ULTRAPROTM mesh (group P). Six rats in each group were sacrificed at three and eight weeks postoperatively to examine the gross effects, inflammatory responses, collagen deposition and neovascularization.RESULTS: After implantation, mild adhesion was caused in groups B and S. Group B promoted more neovascularization than group S at three weeks after implantation, and induced significantly more amount of collagen deposition and better collagen organization than groups S and P at eight weeks after implantation.CONCLUSION: Small intestinal submucosa coated with gelatin hydrogel incorporating basic fibroblast growth factor could promote better regeneration and remodeling of host tissues for the reconstruction of abdominal wall defects.

OBJECTIVE: To examine syphilis testing capacity, screening coverage rates and types of syphilis tests used in medical facilities in southern China. METHODS: Eleven of the 14 municipalities in Guangdong province participated. Data on syphilis testing capacity, screening coverage and types of syphilis tests used were collected from all types of public medical facilities offering prenatal care (n = 109). A total of 494 680 women who delivered during 2004-2008 were studied. FINDINGS: In 2008, 54 196 pregnant women (43.1%) were not screened for syphilis. Among such women, 32 863 (60.6%) attended clinics without any syphilis testing capacity and 21 333 (39.4%) attended clinics that performed testing but were not screened. The likelihood of not having syphilis test capacity was much higher for hygiene stations (odds ratio, OR: 10; 95% confidence interval, CI: 4-25), services at the township level (OR: 33; 95% CI: 10-100) and services with < 1000 deliveries per year (OR: 1.002; 95% CI: 1.001-1.003). These same service characteristics correlated with lower screening coverage rates (P < 0.01). Only one antenatal clinic had the capacity to conduct both treponemal and non-treponemal tests for diagnosing syphilis. CONCLUSION: Syphilis screening is available in very few of the basic medical facilities offering prenatal care where most neonates in southern China are delivered. In light of this and of the increasing incidence of syphilis in the area, expanding point-of-care rapid syphilis testing is a priority.

OBJETIVO: Examinar la capacidad para realizar pruebas de sífilis, evaluar las tasas de cobertura y los tipos de pruebas de sífilis utilizados en centros médicos del sur de China. MÉTODOS: Participaron once de los catorce municipios de la provincia de Guangdong. Se recopilaron datos sobre la capacidad de realizar pruebas de sífilis, la cobertura de evaluación y los tipos de pruebas de sífilis de todos los tipos de centros médicos públicos que ofrecen cuidados prenatales (n = 109). Se estudió a un total de 494 680 mujeres que dieron a luz durante el periodo 2004-2008. RESULTADOS: En el año 2008, 54 196 mujeres embarazadas (el 43,1%) no fueron evaluadas para la sífilis. De estas mujeres, 32 863 (el 60,6%) acudieron a clínicas sin capacidad para realizar pruebas de sífilis y 21 333 (el 39,4%) acudieron a clínicas que realizaban la prueba, aunque ésta no se les realizó. La probabilidad de no disponer de capacidad para realizar la prueba de sífilis era muy superior en puestos de salud (cociente de probabilidades, CP: 10; intervalo de confianza del 95%, IC: 4-25), servicios municipales (CP: 33; IC del 95%: 10-100) y servicios con < 1000 partos al año (CP: 1.002; IC del 95%: 1.001-1.003). Estas mismas características de servicio correlacionadas con tasas de cobertura de evaluación inferiores (P < 0,01). Solo seis (5,5%) tipos de servicios de cuidados prenatales tienen la capacidad de realizar pruebas treponémicas y no treponémicas para el diagnóstico de la sífilis. CONCLUSIÓN: La evaluación de la sífilis está disponible en muy pocas de las instalaciones médicas básicas que ofrecen cuidados prenatales y donde se da a luz a la mayor parte de los neonatos del sur de China. A causa de esto y del aumento de la incidencia de la sífilis en la zona, la ampliación de los puntos de asistencia para la realización de pruebas rápidas de sífilis es una prioridad.

OBJECTIF: Étudier la capacité à effectuer le dépistage de la syphilis, les taux de couverture du dépistage et les types de tests syphilitiques utilisés dans les établissements médicaux en Chine méridionale. MÉTHODES: Onze des 14 municipalités de la province de Guangdong ont participé à cette étude. Les données relatives à la capacité à effectuer le dépistage de la syphilis, à la couverture du dépistage et aux types de tests syphilitiques utilisés ont été recueillies auprès de toutes les sortes d'établissements médicaux proposant des soins prénataux (n=109). Un total de 494 680 femmes ayant accouché entre 2004 et 2008 ont fait l'objet de l'étude. RÉSULTATS: En 2008, 54 196 femmes enceintes (43,1%) n'ont pas subi le dépistage de la syphilis. Parmi ces femmes, 32 863 d'entre elles (60,6%) se sont rendues dans des cliniques ne disposant d'aucune capacité pour effectuer le dépistage de la syphilis et 21 333 d'entre elles (39,4%) n'ont pas subi de dépistage, bien qu'elles soient allées dans des cliniques aptes à le réaliser. La probabilité du manque de capacité de dépistage de la syphilis était beaucoup plus élevée pour les centres de santé (rapport des cotes, RC: 10; intervalle de confiance de 95%, IC: 4-25), les services au niveau communal (RC: 33; IC de 95%: 10-100) et les services réalisant moins de 1000 accouchements par an (RC: 1,002; IC de 95%; 1,001-1,003). Ces mêmes caractéristiques de service étaient en corrélation avec des taux de couverture de dépistage inférieurs (P<0,01). Seuls six (5,5%) types de services de soins prénataux disposaient de la capacité de mener des tests tréponémiques et non tréponémiques pour diagnostiquer la syphilis. CONCLUSION: Le dépistage de la syphilis n'est disponible que dans très peu d'établissements médicaux de base qui proposent des soins prénataux, dans lesquels la plupart des nouveau-nés de Chine méridionale voient le jour. À la lumière de ces informations et de l'incidence croissante de la syphilis dans cette région, l'extension du dépistage rapide de la syphilis aux points sanitaires est une priorité.

OBJECTIVE: The Global Campaign Against Epilepsy demonstration project in rural China aimed: to reduce the treatment gap and morbidity of people with epilepsy by using community-level interventions; to train and educate health professionals; to dispel stigma; to identify potential for prevention and to develop models of integration of epilepsy control into the local health systems. We report the overall results of the demonstration project, focusing on the prevalence and the change in the treatment gap of epilepsy after an intervention. METHODS: Door-to-door epidemiological surveys were carried out before, and 6 months after the end of, an intervention project for epilepsy in rural settings in five provinces of China. The intervention consisted of a treatment programme available to patients without prior appropriate treatment and a public health educational programme about epilepsy. The sampled population in the second survey was 51 644 people. FINDINGS: In the second survey, epilepsy was confirmed in 320 people, yielding a lifetime prevalence of 6.2/1000 and a prevalence of active epilepsy of 4.5/1000. The lifetime prevalence and prevalence of active epilepsy in the first survey were 7.0/1000 and 4.6/1000, respectively. The treatment gap of active epilepsy in the second survey was 49.8%, 12.8 percentage points lower than that of the first survey (62.6%). CONCLUSION: The results of this study suggest that the intervention measures used were possibly effective and evidently feasible in rural China, contributing to a decrease in the treatment gap of epilepsy.

OBJETIVO: El proyecto piloto de la Campaña Mundial Contra la Epilepsia en la China rural se propuso los siguientes objetivos: reducir la brecha de tratamiento y la morbilidad de las personas con epilepsia aplicando intervenciones comunitarias; capacitar y educar a los profesionales de la salud; combatir la estigmatización; identificar las posibilidades de prevención, y desarrollar modelos de integración del control de la epilepsia en los sistemas de salud locales. Se informa aquí de los resultados globales del proyecto piloto, haciendo hincapié en la prevalencia y en la variación de la brecha de tratamiento de la epilepsia después de una intervención. MÉTODOS: Se llevaron a cabo encuestas epidemiológicas domiciliarias antes de iniciar y a los 6 meses de finalizar un proyecto de intervención contra la epilepsia en entornos rurales de cinco provincias de China. La intervención consistió en un programa terapéutico ofrecido a los pacientes sin tratamiento previo apropiado y un programa de educación de salud pública sobre la epilepsia. La población muestreada en la segunda encuesta fue de 51 644 personas. RESULTADOS: En la segunda encuesta se confirmó la existencia de epilepsia en 320 personas, lo que indica una prevalencia durante toda la vida de 6,2/1000 y una prevalencia de epilepsia activa de 4,5/1000. La prevalencia durante toda la vida y la prevalencia de epilepsia activa en la primera encuesta fueron de 7,0/1000 y 4,6/1000, respectivamente. La brecha terapéutica en el caso de la epilepsia activa en la segunda encuesta fue del 49,8%, un 12,8% menos que en la primera encuesta (62,6%). CONCLUSIÓN: Los resultados de este estudio parecen indicar que las medidas de intervención aplicadas fueron posiblemente eficaces y sin duda factibles en la China rural, reduciéndose en consecuencia la brecha de tratamiento de la epilepsia.

OBJECTIF: Le projet de démonstration en Chine rurale de la Campagne mondiale contre l'épilepsie avait pour objectifs : de réduire l'écart de prise en charge thérapeutique et de morbidité entre les épileptiques faisant appel à des interventions communautaires ; de former et d'éduquer les professionnels de santé ; de dissiper la stigmatisation ; d'identifier les possibilités de prévention et de développement de modèles d'intégration de la lutte contre l'épilepsie dans les systèmes de santé locaux. Nous rendons compte des résultats globaux de ce projet de démonstration, en nous concentrant sur la prévalence et l'évolution du déficit de traitement de l'épilepsie après une intervention. MÉTHODES: Des enquêtes épidémiologiques «porte à porte» ont été effectuées avant et 6 mois après un projet d'intervention concernant l'épilepsie dans des zones rurales de cinq provinces chinoises. L'intervention con sistait en un programme de traitement proposé aux patients n'ayant bénéficié auparavant d'aucun traitement approprié, et en un programme d'éducation en santé publique concernant l'épilepsie. La population échantillonnée dans la seconde enquête comprenait 51 644 personnes. RÉSULTATS: Dans la seconde enquête, l'épilepsie a été confirmée chez 320 personnes, ce qui donne une prévalence sur la durée de vie de 6,2/1000 et une prévalence de l'épilepsie active de 4,5/1000. Dans la première enquête, la prévalence sur la durée de vie et la prévalence de l'épilepsie active étaient respectivement de 7,0/1000 et de 4,6/1000. Le déficit de traitement de l'épilepsie active dans la seconde enquête était de 49,8 %, soit 12,8 % de moins que dans la première enquête (62,6 %). CONCLUSION: Les résultats de cette étude laissent à penser que les mesures d'intervention utilisées pouvaient être efficaces et étaient à l'évidence applicables en Chine rurale, où elles ont contribué à une diminution du déficit de traitement de l'épilepsie.