Objective:The aim of this study is to establish an evaluation framework for an integrated health care service system,which provides evidence for the further construction of the evaluation index system. Methods:A sys-tematic review,thematic system and expert consultation were synthetically used to screen,construct and improve the evaluation framework of the integrated health care service system. Results:The results of this study show that the fi-nalized evaluation framework of the integrated health care system contains 4 first-level indexes which include system integration,organizational integration,professional integration and service integration; and 25 corresponding second level indictors. Conclusions:The evaluation framework of the integrated health care service system constructed in this study has a strong effectiveness and suitability, which lays a good foundation for further development of the corre-sponding evaluation index system.

Objective:To investigate the accuracy of next-generation sequencing technology(NGS)in detecting the polymorphisms of HLA-DRB1,DQB1,DQA1,DRB3,DRB4,DRB5,DPA1 and DPB1 alleles in randomly-selected unrelated healthy individuals from Shenzhen Han population,investigate the potential reason for HLA-DRB1 allele dropout in routine NGS,and establish an internal quality control system.Methods:NGS-based HLA class Ⅱ genotyping was performed on 1 012 samples using the MiSeqDxTM platform.The suspected missed alleles indicated by the quality control software and HLA-DRB1 homozygotes were confirmed by PCR-SSOP or PCR-SBT methods.Results:A total of 139 alleles were detected,including HLA-DRB1(45),DRB3(7),DRB4(5),DRB5(7),DQA1(17),DQB1(21),DPA1(10)and DPB1(27).HLA-DRB 1*09:01(17.09％),15:01(10.72％);DRB3*02:02(25.99％),03:01(10.18％);DRB4*01:03(36.46％);DRB5*01:01(15.42％);DQA1*01:02(20.01％),03:02(17.19％);DQB1*03:01(19.47％),03:03(17.98％),05:02(11.66％),06:01(10.67％);DPA1*02:02(54.45％),01:03(31.18％)and DPB1*05:01(39.13％),02:01(16.90％)alleles were the most common alleles in Shenzhen Han population(frequencies＞10％).There was no statistical difference between the gene frequencies of HLA-DRB1 and DQB1 loci in our study.The HLA Common and Well-Documented Alleles in China(CWD2.4)(x2=12.68,P＞0.05).94 cases of HLA-DRB1 homozygous samples detected by NGS were retested by PCR-SSOP or SBT method,and one case of allele dropout at HLA-DRB1 locus was found.SBT method confirmed that the allele of DRB1*04:03 was missed.The laboratory internal quality control system was established.Two cases of new alleles were detected and named by WHO Nomenclature Committee for Factors of the HLA System.Conclusion:The HLA genotyping results based on NGS showed a significantly lower ambiguity rate.The HLA class Ⅱ alleles exhibit genetic polymorphism in the Han population of unrelated healthy individuals in Shenzhen.The independent method based on NGS in clinical histocompatibility testing has limitations and requires internal quality control strategies to avoid allele-dropout events.

OBJECTIVETo understand the types of, reasons for and sources of stigma and discrimination in a rural community where the majority of people living with HIV/AIDS (PLHA) are former plasma donors (FPDs).

METHODSEighty local residents, including 20 HIV-positive villagers, 20 family members, 20 villagers from non-HIV-positive households and 20 health workers, were selected as study subjects by using purposive sampling method in rural areas of Anhui Province. Face-to-face interviews and focus group discussions were held to collect information on HIV/AIDS-related stigma and discrimination and its contributing factors.

RESULTSOf the 80 study subjects, 1 didn't finish the survey. Of the 79 subjects who finished the survey, the main forms of stigma and discrimination were expanded stigma [81.0% (64/79)], abandonment and avoidance, stigma and discrimination in healthcare setting [47.4% (28/59)], loss of social support [33.3% (13/39)]. The level of stigma was less in village where were more HIV-positive villagers living and vice versa. The reasons for stigma and discrimination included: ignorance or misunderstanding of HIV/AIDS [57.5% (23/40)], fear of HIV/AIDS [32.5% (13/40)] and morality judgment toward PLHA. The majority of HIV positive participants were unwilling to disclose their positive status to others in order to protect their family members and children.

CONCLUSIONIgnorance and misunderstanding of HIV/AIDS were main contributing factors to HIV/AIDS-related stigma and discrimination and it is very important to implement appropriate intervention programs to reduce stigma and discrimination.

Adolescent ; Adult ; Blood Donors ; Female ; HIV Infections ; Humans ; Male ; Middle Aged ; Prejudice ; Rural Population ; Young Adult