替考拉宁在中国成人患者中的群体药动学研究

目的建立中国成年患者的替考拉宁(teicoplanin,TEC)群体药动学(population pharmacokinetics,PPK)模型,考察TEC药动学参数的影响因素。方法前瞻性收集139例革兰阳性球菌感染患者静脉注射TEC后的222份常规监测血药浓度和相关信息,采用一级消除的一室模型进行数据拟合,并应用非线性混合效应模型(nonlinear mixed effect model,NONMEM)程序建立PPK模型。采用Bootstrap、正态预测分布误差法(normalized predictive distribution error,NPDE)进行最终模型评价。利用蒙特卡洛模拟法对给药方案进行优化。结果确定了肌酐清除率(creatinine clearance,CLcr)、白蛋白(albumin,ALB)为影响TEC清除率的主要因素。最终模型为:CL(L·h^-1)=1.24×(CLcr/77)0.564×31/ALB;V(L)=69.2。验证表明,模型稳定、有效,且有较好的预测效能。对于不同ALB和CLcr的多数患者起始负荷剂量400 mg/q12h,iv,3次,维持剂量400~800 mg·d^-1的给药方案可达有效治疗谷浓度。严重感染者需调整负荷剂量至800 mg/q12h,iv,3次,维持剂量400~800 mg·d^-1的给药方案来确保血药浓度达到15 mg·L^-1以上。结论本实验报道了CLcr、ALB对TEC清除率有显著影响,所建模型对TEC在中国成人患者中实现个体化给药具有重要应用价值。     

“一带一路”倡议布局下培养高等中医药专业人才的对策

培养中医药创新人才是实现中医药传承和国际化的重要条件。但目前中医药专业人才短缺,尤其紧缺精通中医药翻译和国际贸易服务的人才。因此,在"一带一路"倡议指导下,高等中医药院校应积极合理地开设课程,选择教材,建立科学合理的教学模式,完善考试制度,从而更好地培养中医药人才。     

劳动参与对退休老年群体健康的影响研究

目的:了解退休老年群体劳动参与行为对其健康状况的影响。方法:利用2011年、2013年、2015年中国健康与养老追踪调查(CHARLS)全国数据,以报告已办理退休手续的1757名60岁及以上老年人作为研究对象,使用倾向得分匹配法研究退休后劳动参与行为对健康的影响。结果:劳动参与对退休老年群体自评健康、日常生活能力及慢性病患病情况的平均处理效应分别为0.099、0.324和0.562,存在正向促进作用且效应具有显著性;而对认知功能、抑郁情绪及生活满意度的作用则并不显著。结论:总体而言,劳动参与行为不会对退休老年群体的健康状况产生显著负面影响,且在一定程度上对提升退休老年群体的自评健康、日常生活能力及改善老年群体慢性病患病情况具有积极作用,积极鼓励退休老年群体参与劳动将有利于我国健康老龄化、积极老龄化的实现。     

我国农村老年人抑郁倾向与认知功能变化轨迹关系研究

目的 探索我国农村老年人抑郁倾向与认知功能变化轨迹的关系。方法 基于中国老年健康影响因素跟踪调查（CLHLS）中2011-2018年农村≥65岁老年人的数据,分别构建无条件和条件潜变量增长曲线模型,分析我国农村老年人简易精神状态评价量表（MMSE）得分变化轨迹及与抑郁倾向的关系。结果 最终纳入了1 788名2011/2012年开始调查的农村老年人,其中有抑郁倾向者占19.1%;有、无抑郁倾向者基线MMSE得分别为26.62±3.54和27.59±3.17。无条件和条件潜变量增长曲线模型结果显示：MMSE得分下降率为0.52分（P<0.05）;纳入协变量前后,有抑郁倾向者MMSE初始得分比无抑郁倾向者分别低0.84分（P<0.05）和0.81分（P<0.05）,有抑郁倾向者MMSE得分下降速度比无抑郁倾向者分别慢0.33分（P<0.05）和0.40分（P<0.05）。结论 我国农村老年人抑郁倾向与认知功能变化轨迹有关,有抑郁倾向者处于更低水平轨迹,提示应积极关注我国农村老年人的心理健康并及时干预,以延缓或防止老年痴呆的发生发展。     

中国中老年人共病发展轨迹及其对新发失能的影响

目的 探索我国中老年人共病发展轨迹及其对新发失能的影响,以识别具有相似共病发展历程的同质群体,为我国中老年人群的失能风险干预提供依据。方法 基于中国健康与养老追踪调查2011-2018年4期数据,采用组基轨迹模型拟合共病发展轨迹,进而采用含时间依存协变量Cox回归模型分析其对新发失能的影响。结果 共纳入8 580名中老年人,依据中老年共病发展轨迹趋势,可分为无共病型（2 136人,24.90%）、新发-发展型（3 758人,43.80%）、适度-发展型（2 270人,26.45%）和严重-发展型（416人,4.85%）4种类型。适度-发展型和严重-发展型人群中女性、自评健康差、超重/肥胖、单身、居住在农村、家庭年人均支出水平高、发生新发失能的占比较高。调整人口学、行为学协变量后,与新发-发展型相比,严重-发展型（HR=3.132,95%CI：1.884~5.207）的失能风险最高,适度-发展型（HR=1.400,95%CI：1.026~1.909）次之,无共病型（HR=0.631,95%CI：0.424~0.938）最低。结论 我国中老年人的共病发展轨迹存在异质性,共病发展轨迹的失能风险随共病水平的升高而增加,提示共病发展轨迹升高是发生失能的危险因素。     

医疗器械全生命周期管理服务评价体系的建立

目的建立医疗器械全生命周期管理服务评价体系。方法从2019年1月1日—12月31日,于医院建立医疗器械全生命周期管理服务评价体系考核表,对医院器械科的维修服务、资产管理服务、工程师服务态度、质控管理能力等方面进行评价考核。结果在医院医疗器械全生命周期管理服务评价体系中,器械科管理人员及工程师维修服务方面、资产管理能力方面、质控管理能力方面、服务态度方面的平均满意率分别为76.1%、78.8%、82.3%、68.9%。结论建立医疗器械全生命周期管理服务评价体系,有助于加强器械科工程师服务临床工作的能力,从而提高医务人员的诊疗质量。     

Simultaneous ECG-gated PET imaging of multiple mice

IntroductionWe describe and illustrate a method for creating ECG-gated PET images of the heart for each of several mice imaged at the same time. The method is intended to increase “throughput” in PET research studies of cardiac dynamics or to obtain information derived from such studies, e.g. tracer concentration in end-diastolic left ventricular blood.MethodsAn imaging bed with provisions for warming, anesthetic delivery, etc., was fabricated by 3D printing to allow simultaneous PET imaging of two side-by-side mice. After electrode attachment, tracer injection and placement of the animals in the scanner field of view, ECG signals from each animal were continuously analyzed and independent trigger markers generated whenever an R-wave was detected in each signal. PET image data were acquired in “list” mode and these trigger markers were inserted into this list along with the image data. Since each mouse is in a different spatial location in the FOV, sorting of these data using trigger markers first from one animal and then the other yields two independent and correctly formed ECG-gated image sequences that reflect the dynamical properties of the heart during an “average” cardiac cycle.ResultsThe described method yields two independent ECG-gated image sequences that exhibit the expected properties in each animal, e.g. variation of the ventricular cavity volumes from maximum to minimum and back during the cardiac cycle in the processed animal with little or no variation in these volumes during the cardiac cycle in the unprocessed animal.ConclusionECG-gated image sequences for each of several animals can be created from a single list mode data collection using the described method. In principle, this method can be extended to more than two mice (or other animals) and to other forms of physiological gating, e.g. respiratory gating, when several subjects are imaged at the same time.     

The Effects of Music Therapy on Pain in Patients with Neuropathic Pain

The aim of this study was to investigate the effect of relaxing music on pain intensity in patients with neuropathic pain. A quasi-experimental study, repeated measures design was used. Thirty patients, aged 18–70 years, with neuropathic pain and hospitalized in an Algology clinic were identified as a convenience sample. Participants received 60 minutes of music therapy. Classical Turkish music was played to patients using a media player (MP3) and headphones. Participants had pain scores taken immediately before the intervention and at the 30th and 60th minutes of the intervention. Data were collected over a 6-month period in 2012. The patients' mean pain intensity scores were reduced by music, and that decrease was progressive over the 30th and 60th minutes of the intervention, indicating a cumulative dose effect. The results of this study implied that the inclusion of music therapy in the routine care of patients with neuropathic pain could provide nurses with an effective practice for reducing patients’ pain intensity.     

Live recombinant Lactococcuslactis expressing avian hepatitis virus ORF2 protein: Immunoprotection against homologous virus challenge in chickens

Avian hepatitis E virus (aHEV) is a pathogen associated with hepatitis-splenomegaly syndrome in chickens. To date, no commercial vaccine is available for preventing aHEV infection. In this study, three recombinant LactococcuslactisNZ9000experimental live vaccines expressing cytoplasmic, secreted, and cell wall-anchored forms of aHEV truncated ORF2 protein spanning amino acids 249–606 (ΔORF2) were constructed using pTX8048 vector and characterized. Each chicken was immunized three times at two-week intervals with one of the three live aHEV ORF2 vaccines (experimental group) or with live vaccine containing empty vector only (control group). Both groups were then challenged with aHEV and evaluated to compare immune responses and immunogenic effects. Serum IgG levels, secretory IgA (sIgA) levels in bile and jejunal lavage fluid, and mRNA expression levels ofIL-2 and IFN-γ in liver and spleen were significantly higher in experimental chickens than in controls. Meanwhile, post-challenge serum and fecal virus loads were significantly lower in experimental chickens versus controls. Moreover, on day 7 post infection (PI), serum lactose dehydrogenase (LDH) levels were significantly higher in controls than experimental chickens. Furthermore, at day 28 PI, obvious gross pathological lesions and histopathological changes typical for aHEV infection were observed in control livers and spleens, with only moderate pathological changes observed in the experimental group. The results of this study collectively demonstrate that an oral vaccineusing L.lactisNZ9000 as a delivery vector for aHEV immunogenic antigen could effectively control aHEV infection of chickens.