Abstract Background Ischemia-reperfusion (IR) induces increased release of extracellular vesicles in the heart and exacerbates myocardial IR injury. We have previously shown that propofol attenuates hypoxia/reoxygenation (HR)-induced injury in human umbilical vein endothelial cells (HUVECs) and that microvesicles derived from propofol-treated HUVECs inhibit oxidative stress in endothelial cells. However, the role of microvesicles derived from propofol post-treated HUVECs ((HR + P)-EMVs) in IR-injured cardiomyocytes is unclear. In this study, we aimed to investigate the role of (HR + P)-EMVs in cardiac IR injury compared to microvesicles derived from hypoxic/reoxygenated HUVECs (HR-EMVs) and to elucidate the underlying mechanisms. Methods Hypoxia/reoxygenation (HR) models of HUVECs and AC16 cells and a mouse cardiac IR model were established. Microvesicles from HR-injured HUVECs, DMSO post-treated HUVECs and propofol post-treated HUVECs were extracted by ultra-high speed centrifugation, respectively. The above EMVs were co-cultured with HR-injured AC16 cells or injected intracardially into IR mice. Flow cytometry and immunofluorescence were used to determine the levels of oxidative stress and apoptosis in cardiomyocytes. Apoptosis related proteins were detected by Western blot. Echocardiography for cardiac function and Evans blue-TTC staining for myocardial infarct size. Expression of lncCCT4-2 in EMVs and AC16 cells was analysed by whole transcriptome sequencing of EMVs and RT-qPCR. The molecular mechanism of inhibition of myocardial injury by (HR + P)-EMVs was elucidated by lentiviral knockdown of lncCCT4-2, plasmid overexpression or knockdown of CCT4, and actinomycin D assay. Results In vitro and in vivo experiments confirmed that HR-EMVs exacerbated oxidative stress and apoptosis in IR-injured cardiomyocytes, leading to increased infarct size and worsened cardiac function. Notably, (HR + P)-EMVs induced significantly less oxidative stress and apoptosis in IR-injured cardiomyocytes compared to HR-EMVs. Mechanistically, RNA sequencing of EMVs and RT-qPCR showed that lncCCT4-2 was significantly upregulated in (HR + P)-EMVs and cardiomyocytes co-cultured with (HR + P)-EMVs. Reduction of lncCCT4-2 in (HR + P)-EMVs enhanced oxidative stress and apoptosis in IR-injured cardiomyocytes. Furthermore, the anti-apoptotic activity of lncCCT4-2 from (HR + P)-EMVs was achieved by increasing the stability of CCT4 mRNA and promoting the expression of CCT4 protein in cardiomyocytes. Conclusions Our study showed that (HR + P)-EMVs uptake by IR-injured cardiomyocytes upregulated lncCCT4-2 in cardiomyocytes and promoted CCT4 expression, thereby inhibiting HR-EMVs induced oxidative stress and apoptosis. Highlights Microvesicles from hypoxic/reoxygenated HUVECs (HR-EMVs) exacerbated oxidative stress and apoptosis in IR-injured cardiomyocytes. Microvesicles from propofol post-treated HUVECs ((HR + P)-EMVs) induced diminished oxidative stress and apoptosis in IR-injured cardiomyocytes compared with microvesicles from hypoxic/reoxygenated HUVECs (HR-EMVs). lncCCT4-2 was significantly highly expressed in (HR + P)-EMVs and cardiomyocytes co-cultured with (HR + P)-EMVs, and reduction of lncCCT4-2 in (HR + P)-EMVs enhanced oxidative stress and apoptosis in IR-injured cardiomyocytes. lncCCT4-2 inhibited HR-EMVs induced oxidative stress and apoptosis in HR-injured AC16 cells by increasing the stability of CCT4 mRNA and promoting the expression of CCT4 protein in AC16 cells.

Abstract Vitamin D (VD) was reported to play protective roles in skeletal muscle. This study aimed to explore whether endoplasmic reticulum (ER) stress inhibition is associated with the protective effects of VD/VD receptor (VDR) signaling on skeletal muscle functions. C2C12 skeletal muscle cells were treated with palmitic acid (PA) and then incubated with different concentrations of 1,25-(OH)2-vitamin D3 (VD3), and we found that VD3 improved the impaired cell viability induced by PA and increased VDR expression in a dose-dependent manner. Then 100 nM VD3 treatment and VDR overexpression both ameliorated PA-induced ER stress, apoptosis, inflammation and glucose uptake inhibition in C2C12 myocytes. Furthermore, VDR knockdown reversed the protective effects of VD3 on C2C12 cell functions. Additionally, PA-treated C2C12 cells were treated with VD3 alone or together with AMPK signaling inhibitor Compound C. VD3 promoted phosphorylation of AMPK and SIRT1 expression, while Compound C reversed these effects and abolished the protective effects of VD3 in C2C12 cells. High-fat diet (HFD)-fed mice were treated with VD3, and VD3 alleviated skeletal muscle loss and insulin resistance in mice. In conclusion, VD inhibited AMPK/SIRT1-mediated ER stress by increasing VDR expression, and further ameliorated skeletal muscle loss and insulin resistance in mice.

ABSTRACT To investigate the effects of soy isoflavones (ISF) on the laying performance of Xueshan breeder hens at different phases of the egg production cycle, 32 weeks (wks) old local Chinese breeder hens were assigned to two groups with three replicates (750 hens/replicate) for control and treatment groups. Then every group was divided into three sub-groups following 4, 12, and 20 wks administration of control or ISF diet. General Linear Model procedure was used (2× 3), and treatments were considered of two factors (diets and time) with different levels (control and ISF diets; 4, 12, and 20 wks of diet supply time). Basal diet with 3 mg/kg ISF was used. Performance, egg quality, organs relative weight and cholesterol level were measured at three time-points of 36, 44, and 52-wks of age old. The results showed that both diets and time significantly affected the production performance and physiological parameters. In details, ISF inclusion significantly (p=0.02) decreased average egg weight and average feed intake compared to control at 52-wks of age old, however, feed conversation ratio was not affected by ISF diet. Moreover, ISF diet caused to an increase hatching rate (p=0.01) at 36-wks old hens, an abnormal egg rate decrease (p=0.02) at 44-wks old, an increase in yolk color (p=0.035) and Haugh unit (p=0.039), and a decrease in low-density lipoprotein cholesterol level (p=0.03) at 52-wks of age old. ISF diet also increased spleen relative weight (p=0.041) and total antioxidant capacity compared to the control group. The results revealed that ISF inclusion exerted some benefits, thus it could be a potential feed additive for the breeder hens.

ABSTRACT The melanocortin 1 receptor (MC1R) gene plays a key role in controlling the deposition of melanin. In mammals, the MC1Rgene is regarded as a major candidate gene in the control of melanin formation. In domestic animals, the MC1R gene mainly controls the expression of coat, skin, and plumage color in mammals and birds. In order to breed chickens with dark-green shank faster, we screened the molecular markers for shank color in a HS chicken population by exploring the relationship between polymorphism of the MC1R gene and three different shank colors (light green, dark green and yellow). Two primer pairs for code region of the MC1R gene were designed in the basic of chicken genomic sequence. DNA sequencing was performed to detect the polymorphisms and PCR was used to amplify DNA fragment. Sequences analysis indicated that 7 SNPs were predominant the three HS chicken populations with different shank color, including g.18,287,945C>T, g.18,288,088T>C, g.18,288,150G>A, g.18,288,303A>G, g.18,288,512G>A, g.18,288,513T>C, and g.18,288,520A>C. Association analysis revealed that the dark-green shank population showed moderate polymorphism, whereas the light-green shank population showed low polymorphism among overall 7 SNPs and that SNP6 (g.18,288,513T>C) may be significantly associated with three different shank colors in HS chickens. The haplotype CTGGACA had the largest haplotype frequencies, accounting for 56.22%, and the haplotype combination H1H1 is mainly distributed in the dark-green shank population, and may be used as molecular maker for marker-assisted selection of shank color in HS chickens.

ABSTRACT The Region of D eletion 2 (RD2) of Mycobacterium tuberculosis encodes reserved antigens that contribute to bacterial virulence. Among these antigens, Rv1983, Rv1986, Rv1987, and Rv1989c have been shown to be immunodominant in infected cattle; however, their diagnostic utility has not been evaluated in humans.In this study, we screened 87 overlapping synthetic peptides encoded by five RD2 proteins for diagnosing tuberculosis epitopes in 50 active tuberculosis (TB) cases, 31 non-tuberculosis patients and 36 healthy individuals. A pool of promising epitopes was then assessed for their diagnostic value in 233 suspected TB patients using a whole blood IFN-γ release assay.Only 10 peptides were recognized by more than 10% of active tuberculosis patients. The IFN-γ release responses to Rv1986-P9, P15, P16, Rv1988-P4, P11, and Rv1987-P11 were significantly higher in the active TB group than in the control groups (p < 0.05). The whole blood IFN-γ release assay based on these epitopes yielded a sensitivity of 51% and a specificity of 85% in diagnosing active tuberculosis, and the corresponding results using the T-SPOT.TB assay were 76% and 75%, respectively.In conclusion, these results suggest that the six epitopes from the RD2 of M. tuberculosis have potential diagnostic value in TB.

ABSTRACT Goose fatty liver is a delicious food product and the overfeeding will cause the abnormal physiology of the geese. The objective of this study was to investigate the effect of supplementation with hydrated sodium calcium aluminosilicate (HSCAS) on the fatty liver, ileal and cecal microbiota of Landes geese during overfeeding. Sixty 70-day-old Landes geese (body weight= 3.0 ± 0.05 kg) were randomly divided into three groups, two of which were overfed with whole corn supplemented with or without HSCAS for 20 days when the fatty liver reaches to the maximum size and the negative control group was ad libitum access to the corn basal diet. The intestinal contents of the ileum and cecum from three geese per group were used for high-throughput sequencing. As a result of this study, the HSCAS-treatment led to an increase in relative liver weight (p<0.05) of geese compared with the overfeeding control group. The richness and diversity of the bacterial communities decreased in the ileum and ceca after overfeeding. Overfeeding increased the relative abundance of Firmicutes, especially Lactobacillus, in ileal samples. HSCAS supplementation increased the relative abundance of Lactobacillus, and decreased the relative abundance of Actinobacillus in the ileum and the relative abundance of Erysipelotrichi, Bacteroides and Escherichia in the ceca. Bacterial richness indicators were also increased in samples from ileum and ceca after HSCAS supplementation. In conclusion, dietary HSCAS supplementation promoted liver performance in overfed Landes geese. HSCAS treatment had a beneficial effect on the intestinal microbiota composition in geese during the overfeeding.

ABSTRACT Reticuloendotheliosis virus (REV) infection has frequently affected the poultry industry in recent years. The infection with REV weakens the immune responses of the infected poultry. It is reported that Enteromorphaclathrata polysaccharides are capable of regulating immune function. In order to investigate the immuno regulatory effects of Enteromorphaclathrata polysaccharides (EPS) on the response of REV-infected broilers to a live attenuated Newcastle disease (ND) vaccine. Broilers were intraperitoneally injected with REV at one day of age, subcutaneously infected with EPS at 2 days of age, and vaccinated by nasal drip with a live attenuated ND (Lasota strain) vaccine at 5 days of age. Immune organ index, secretory immunoglobulinA (SIgA), peripheral blood heterophil to lymphocyte ratios (H/L ratio), peripheral blood lymphocyte transformation rates, and interferon-gamma (IFN-γ) and interleukin-2 (IL-2) levels were measured at 3, 7, 14, 21, 28, 35, 42, and 56 days of age. The results showed that EPS increased the immune organ index, and the secretion of small intestine secretory immunoglobulin A, serum ND antibody titers, blood H/L ratio, peripheral blood lymphocyte transformation rates, and IL-2 and IFN-γ levels. These results indicate that EPS are able to enhance the immune responses of chickens both to REV infection and to ND vaccination. Therefore, Enteromorphaclathrata polysaccharides can be considered as an immune regulator in the future.

ABSTRACT The purpose of this study was to demonstrate the in vitro free radical scavenging activity and antioxidant capacity in solid-state fermented wheat bran and its potential modulation of antioxidative molecular targets in chicken peripheral blood mononuclear cells (PBMC). After solid-state fermentation of wheat bran by white rot fungi for 12 d, the scavenging action of the fermented wheat bran extracts was 1, 1-diphenyl-2-picrylhydrazyl (DPPH), and the free radicals increased significantly, approximately 1.5-fold. Trolox equivalent antioxidant capacity of 1 mg/mL fermented wheat bran extracts was increased from 100 to 150 mM trolox antioxidant capacity after 12 d of fermentation. Moreover, the extracts exhibited 50% of the chelating capacity observed for ferrous iron (Fe2+) after fermenting for 12 d. In vitro, and under the stimulus of fermented wheat bran, the antioxidant gene expression (GST, HO-1, Nrf2, and GCLC genes) of PBMC was more than double that of the PBS, ascorbic acid, and unfermented wheat bran. The expression of fermented wheat bran was the lowest for the NOX1 and ROMO1 genes. Solid-state wheat bran fermented by white rot fungi can increase the scavenging action of DPPH, the trolox equivalent antioxidant capacity, and the chelating capacity of ferrous iron; in addition, in vitro, it can regulate the expression of antioxidant molecular targets in chicken PBMC.

ABSTRACTThis study aimed at examining the effect of overfeeding on the activity of the mTOR pathway in the liver and muscle tissues of Gang geese. Eighty healthy male Gang geese were reared under the same feeding conditions, and were divided at 14 weeks of age into a control group and an overfed group. All birds were slaughtered after three weeks of over feeding. Gene expression and protein content of several genes involved in the mTOR pathway were evaluated. The results showed that the gene expression of mTOR, raptor, and rictor, and the protein contents of mTOR and PI3K were higher in liver, breast muscle, and leg muscle of the overfed group than that of control group. However, the S6K expression level was clearly lower in the liver of the overfed group than that of control group, and there was no evident difference in both breast muscle and leg muscle between the control group and the overfed group. These results suggest that overfeeding induces the activity of raptor, rictor, and mTOR, and that mTOR signaling pathway was closely linked with PI3K pathway in the evaluated geese.

RESUMOIntrodução:A deficiência de vitamina D em pacientes com doença inflamatória intestinal submetidos a ileostomia não foi estudada sistematicamente. O objetivo desse estudo foi avaliar a frequência e os fatores de risco associados com a deficiência de vitamina D nesses pacientes.Resultados:112 pacientes elegíveis foram incluídos. A média dos níveis de vitamina D na população estudada foi de 21.47 ± 1.08 ng/dl. Níveis de vitamina D abaixo do normal (<30 ng/dl) e deficiência de vitamina D (<20 ng/dL) foram encontrados em 92 pacientes (82%) e em 55 pacientes (49%) respectivamente. Encontrou-se uma associação entre deficiência de vitamina D e níveis mais baixos de fosforo (p = 0.020), hemoglobina (p = 0.019) e duração da doença inflamatória intestinal (p = 0.047). Na análise multivariada, níveis mais baixos de fósforo (odds ratio [OR]: 1.83, 95% confidence interval [CI]: 1.16-2.89, p = 0.009) e hemoglobina (OR: 1.32, 95% CI: 1.08-1.60, p = 0.006) permaneceram associados com deficiência de vitamina D.Conclusão:A deficiência de vitamina D é comum em pacientes com doença inflamatória intestinal submetidos a ileostomia e está associada com níveis baixos de hemoglobina. Mais estudos são necessários para avaliar se a suplementação de vitamina D pode ser um adjuvante no tratamento de anemia da doença crônica nesses pacientes.

ABSTRACTBackground:Vitamin D deficiency is commonly seen in patients with inflammatory bowel disease (IBD). Vitamin D deficiency in IBD patients with ileostomy has not been systemically studied. The aim of the study was to assess the frequency and risk factors associated with low 25(OH) D3 levels in those patients.Methods:112 eligible IBD patients with ileostomy were studied. Demographic, clinical, and endoscopic variables were analyzed. Vitamin D levels before and after ileostomy were compared when available. Levels of serum 25(OH)D3 <20 ng/mL were classed as being deficient.Results:112 eligible ileostomy patients were included. The mean vitamin D level was 21.47 ± 1.08 ng/dl. Low levels of vitamin D (<30 ng/dl) were present in 92 patients (82%). Vitamin D deficiency (<20 ng/dL) was seen in 55 patients (49%). There was no difference between patients with or without vitamin D deficiency regarding demographic variables, medication use and duration of ileostomy. Neo-ileal inflammation on endoscopy was not associated with vitamin D deficiency (p= 0.155). Lower levels of phosphorus (p= 0.020) or hemoglobin (p= 0.019) and shorter duration of IBD (p= 0.047) were found in patients with vitamin D deficiency. In multivariate analysis, lower levels of phosphorus (odds ratio [OR]: 1.83, 95% confidence interval [CI]: 1.16-2.89, p= 0.009) and hemoglobin (OR: 1.32, 95% CI: 1.08-1.60, p= 0.006) remained significantly associated with vitamin D deficiency.Conclusion:Vitamin D deficiency is common in IBD patients with ileostomy and is associated with low hemoglobin levels. Further studies are needed to evaluate vitamin D supplementation as a possible adjuvant in the treatment of anemia of chronic disease in IBD patients.

BACKGROUND: The CCCTC-binding factor (CTCF) is a highly conserved insulator protein that plays various roles in many cellular processes. CTCF is one of the main architecture proteins in higher eukaryotes, and in combination with other architecture proteins and regulators, also shapes the three-dimensional organization of a genome. Experiments show CTCF partially remains associated with chromatin during mitosis. However, the role of CTCF in the maintenance and propagation of genome architectures throughout the cell cycle remains elusive. RESULTS: We performed a comprehensive bioinformatics analysis on public datasets of Drosophila CTCF (dCTCF). We characterized dCTCF-binding sites according to their occupancy status during the cell cycle, and identified three classes: interphase-mitosis-common (IM), interphase-only (IO) and mitosis-only (MO) sites. Integrated function analysis showed dCTCF-binding sites of different classes might be involved in different biological processes, and IM sites were more conserved and more intensely bound. dCTCF-binding sites of the same class preferentially localized closer to each other, and were highly enriched at chromatin syntenic and topologically associating domains boundaries. CONCLUSIONS: Our results revealed different functions of dCTCF during the cell cycle and suggested that dCTCF might contribute to the establishment of the three-dimensional architecture of the Drosophila genome by maintaining local chromatin compartments throughout the whole cell cycle.

OBJETIVO: Reinternações frequentes por exacerbações agudas da DPOC (EADPOC) são um fator de risco independente para maior mortalidade e uso de recursos de saúde. A gravidade da doença e o nível de proteína C reativa (PCR) são preditores validados do prognóstico em longo prazo para tais pacientes. Investigamos a utilidade da combinação do nível sérico de PCR com a classificação de risco de exacerbação da Global Initiative for Chronic Obstructive Lung Disease (GOLD) para predizer a reinternação por EADPOC. MÉTODOS: Estudo observacional prospectivo de pacientes consecutivos hospitalizados por EADPOC no Peking University Third Hospital, in Pequim, China. Avaliamos a idade; gênero, história e carga tabágicas (anos-maço), função pulmonar, frequência de EADPOC no último ano; qualidade de vida; categoria de risco GOLD (A-D, D indicando maior risco); e nível sérico de PCR de alta sensibilidade na alta (PCRas-A). RESULTADOS: A amostra final consistiu em 135 pacientes. Desses, 71 (52,6%) foram reinternados ao menos uma vez durante o período de seguimento de 12 meses. A mediana (intervalo interquartílico) do tempo de reinternação foi de 78 dias (42-178 dias). A análise multivariada revelou que PCRas-A sérico ≥ 3 mg/L e categoria GOLD D foram preditores independentes de reinternação (razão de risco = 3,486; IC95%: 1,968-6,175; p < 0,001 e razão de risco = 2,201; IC95%: 1,342-3,610; p = 0,002, respectivamente). A ordem das combinações dos fatores por risco cumulativo de readmissão, da maior para a menor foi a seguinte: PCRas-A ≥ 3 mg/L e categoria GOLD D; PCRas-A ≥ 3 mg/L e categorias GOLD A-C; PCRas-A < 3 mg/L e categoria GOLD D; e PCRas-A < 3 mg/L e categorias GOLD A-C. CONCLUSÕES: O nível sérico de PCRas-A e a classificação GOLD são preditores independentes de reinternação por EADPOC, e seu valor preditivo aumenta quanto usados conjuntamente.

OBJECTIVE: Frequent readmissions for acute exacerbations of COPD (AECOPD) are an independent risk factor for increased mortality and use of health-care resources. Disease severity and C-reactive protein (CRP) level are validated predictors of long-term prognosis in such patients. This study investigated the utility of combining serum CRP level with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) exacerbation risk classification for predicting readmission for AECOPD. METHODS: This was a prospective observational study of consecutive patients hospitalized for AECOPD at Peking University Third Hospital, in Beijing, China. We assessed patient age; gender; smoking status and history (pack-years); lung function; AECOPD frequency during the last year; quality of life; GOLD risk category (A-D; D indicating the greatest risk); and serum level of high-sensitivity CRP at discharge (hsCRP-D). RESULTS: The final sample comprised 135 patients. Of those, 71 (52.6%) were readmitted at least once during the 12-month follow-up period. The median (interquartile) time to readmission was 78 days (42-178 days). Multivariate analysis revealed that serum hsCRP-D ≥ 3 mg/L and GOLD category D were independent predictors of readmission (hazard ratio = 3.486; 95% CI: 1.968-6.175; p < 0.001 and hazard ratio = 2.201; 95% CI: 1.342-3.610; p = 0.002, respectively). The ordering of the factor combinations by cumulative readmission risk, from highest to lowest, was as follows: hsCRP-D ≥ 3 mg/L and GOLD category D; hsCRP-D ≥ 3 mg/L and GOLD categories A-C; hsCRP-D < 3 mg/L and GOLD category D; hsCRP-D < 3 mg/L and GOLD categories A-C. CONCLUSIONS: Serum hsCRP-D and GOLD classification are independent predictors of readmission for AECOPD, and their predictive value increases when they are used in combination.

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: To estimate the shortage of mental health professionals in low- and middle-income countries (LMICs). METHODS: We used data from the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS) from 58 LMICs, country-specific information on the burden of various mental disorders and a hypothetical core service delivery package to estimate how many psychiatrists, nurses and psychosocial care providers would be needed to provide mental health care to the total population of the countries studied. We focused on the following eight problems, to which WHO has attached priority: depression, schizophrenia, psychoses other than schizophrenia, suicide, epilepsy, dementia, disorders related to the use of alcohol and illicit drugs, and paediatric mental disorders. FINDINGS: All low-income countries and 59% of the middle-income countries in our sample were found to have far fewer professionals than they need to deliver a core set of mental health interventions. The 58 LMICs sampled would need to increase their total mental health workforce by 239 000 full-time equivalent professionals to address the current shortage. CONCLUSION: Country-specific policies are needed to overcome the large shortage of mental health-care staff and services throughout LMICs.

OBJETIVO: Calcular la escasez de profesionales psiquiátricos en los países de ingresos medios y bajos (PIMB). MÉTODOS: Para calcular el número de psiquiatras, personal de enfermería y psicólogos que serían necesarios para proporcionar asistencia psiquiátrica al total de la población de los países estudiados, utilizamos los datos del Instrumento de Evaluación de los Sistemas de Salud Mental de la Organización Mundial de la Salud (OMS-AIMS) de 58 PIMB, la información específica de cada país sobre la carga de los distintos trastornos mentales y la prestación hipotética de servicios básicos. Nos centramos en los ocho problemas siguientes, a los que la OMS ha otorgado prioridad: depresión, esquizofrenia y otras psicosis, suicidio, epilepsia, demencia, trastornos asociados al abuso del alcohol y las drogas ilegales, así como los trastornos mentales pediátricos. RESULTADOS: Todos los países de ingresos bajos y el 59% de los países de ingresos medios de la muestra tenían muchos menos profesionales sanitarios de los que necesitarían para proporcionar un conjunto básico de intervenciones sanitarias en materia de salud mental. Los 58 PIMB muestreados deberían aumentar su personal sanitario total del área de psiquiatría a 239 000 profesionales sanitarios a tiempo completo (o equivalente) para hacer frente a la escasez actual. CONCLUSIÓN: Para poder superar la gran escasez de trabajadores y servicios sanitarios en el área de salud mental en todos los PIMB, se necesitan políticas específicas para cada país.

OBJECTIF: Estimer le manque de professionnels de la santé mentale dans les pays à revenu faible ou intermédiaire (PRFI). MÉTHODES: Nous avons utilisé les données fournies par l'instrument d'évaluation des systèmes de santé mentale de l'Organisation mondiale de la Santé (OMS-AIMS) et relatives à 58 PRFI, les informations spécifique aux pays sur la charge des différents troubles mentaux, ainsi qu'une hypothétique offre groupée de prestations de services essentiels et ce, afin d'estimer le nombre de psychiatres, d'infirmiers et de spécialistes psychosociaux qui serait nécessaire pour fournir des soins de santé mentale à l'ensemble de la population des pays étudiés. Nous avons mis l'accent sur les huit problèmes suivants, que l'OMS tient pour prioritaires: dépression, schizophrénie, psychoses autres que la schizophrénie, suicide, épilepsie, démence, troubles liés à l'alcoolisme et aux substances illicites et troubles mentaux infantiles. RÉSULTATS: Tous les pays à revenu faible et 59% des pays à revenu moyen de notre échantillon disposaient d'un nombre de professionnels largement inférieur par rapport à leurs besoins en prestations de santé mentale essentielles. Les 58 PRFI de l'échantillon devraient créer 239 000 emplois supplémentaires à temps complet dans le secteur de la santé mentale afin de parer au manque actuel. CONCLUSION: Des politiques inhérentes à chaque pays sont nécessaires pour surmonter le vaste manque de personnel et de services de santé mentale dans les PRFI.