健全我国药品不良反应管理制度的思考

通过对我国现阶段药品不良反应制度现状进行研究,参照美国、日本等发达国家的相关制度进行分析发现,我国药品不良反应的相关制度目前仍然存在空白,亟待完善。只有我国的药品不良反应体系更加健全,才能更好地保护患者的合法权益。     

广州市气象因素对手足口病发病的短期效应研究

有研究表明,手足口病在潮湿季节有病例增加的趋势[1].广州市近年来手足口病流行,并有夏秋季高发的特点[2].本研究使用分布滞后非线性模型(DLNM)探索气象对手足口病发病的影响[3].     

Persistence of long-term immunity to hepatitis B among adolescents immunized at birth

The long-term duration of recombinant hepatitis B vaccine-induced immunity among persons vaccinated starting at birth is still not well understood. Waning of vaccine-induced immunity could leave young adults at risk of hepatitis B virus infection due to behavioral or occupational exposures. We followed a cohort of children immunized starting at birth with a 3-dose regimen of recombinant hepatitis B vaccine (5 mcg, 2.5 mcg, 2.5 mcg). They were challenged with a booster dose of the hepatitis B vaccine 10 and 15 years after vaccination to assess anamnestic response as a measure of persistence of protection. Among 108 participants who had lost protective antibody levels against hepatitis B, the majority (>70%) had an anamnestic response to the booster dose; response rates did not decline significantly between 10 and 15 years follow-up periods. A high antibody concentration following primary vaccination was independently associated with an anamnestic response later on in life. Nonetheless, ~20-30% of participants were unable to mount an immune response after boosting. Hepatitis B revaccination might be required for persons vaccinated starting at birth if opportunities for hepatitis B virus exposure exist. Future vaccine recommendations should be based on studies ascertaining protection against clinically significant disease.     

Risk for Developmental Coordination Disorder Correlates with Gestational Age at Birth

Background: Studies suggest that children born very preterm have a high risk of developmental coordination disorder (DCD). We examined the relation between the larger spectrum of gestational age at birth and the risk of DCD. Methods: We used the 7‐year follow‐up data from 22898 singletons in the Danish National Birth Cohort. We calculated a total score from the Developmental Coordination Disorder Questionnaire (DCDQ), incorporated in the 7‐year follow‐up, and defined children with a score of 46 or below as having probable DCD. Information on gestational age was obtained from the Medical Birth Register. Results: Gestational age at birth was inversely associated with the risk of DCD; a decline in gestational age by a week was associated with a 19% [95% confidence interval 14%, 25%] increased risk of DCD screening positive among children delivered before 40 weeks. No significant increased risk of DCD was seen for children born post‐term. Conclusion: Our data indicate that short gestational age at birth in a range up to gestational week 37 is related to an increased risk of DCD.     

Home care or long‐term care? Setting the balance of care in urban and rural Northwestern Ontario,Canada

The objective of the study was to determine the extent to which community care packages could be provided at a lower cost than facility-based long-term care (LTC) for 864 individuals on the LTC waiting list in urban and rural parts of Northwestern Ontario, Canada. A sequential mixed methods design was used entailing a retrospective chart review, the formation of case vignettes, the creation of community care packages with an 'expert panel' of care managers, the costing of care packages and the calculation of potential diversion rates from LTC. Data collection took place in Northwestern Ontario between the months of March and June 2008. Eight per cent of individuals in the urban area and 50% of individuals from the rural areas could potentially be safely diverted to the community and provided with a community care package at a cost lower than facility-based LTC. There is potential for home and community care to substitute for more costly long-term care, but doing so requires building capacity in this sector, particularly in rural areas, which are currently underserviced. Reconfiguring the 'balance of care' may lead to long-term cost efficiencies for an ageing population.     

不同手术时机对高血压脑出血患者治疗效果的比较

目的 研究不同手术时机对高血压脑出血患者康复效果的影响,从而为该类最佳手术时机的选择提供参考.方法 对某院近两年进行高血压脑出血手术的182例患者进行回顾性分析,对手术治疗时间分别为0～8 h、8～16 h、16～24 h的患者分为对应的3组,利用COS评分进行近期疗效评价,利用Barthel评分进行远期疗效评价,对组间进行统计学分析.结果 利用COS评分表对不同手术时机组近期疗效的评价结果显示,8～16h组的恢复良好率达到了63％,与其他两组的差异具有统计学意义(P＜0.05).利用Barthel评价体系对不同手术时机组远期疗效的评价结果显示,8～16 h组中优等率达到73％,明显高于其他两组.结论 8～16 h可能是高血压脑出血患者最佳的治疗时机,值得借鉴.