Effectiveness of needle and syringe programmes for preventing HIV transmission

Objective: To examine the effectiveness of needle and syringe programmes (NSPs) in preventing HIV transmission among injecting drug users (IDUs).Methods: An ecological study design was used to determine change in HIV prevalence among injecting drug users between cities with and without NSPs. Several data sources, such as electronic journal databases, surveillance reports, websites, and index review of relevant journals, were used to identify studies of HIV seroprevalence among IDUs, and presence of NSPs. The rate of change in HIV prevalence was estimated by regression analysis.Results: There were 778 years of data from 99 cities globally included in the analysis. HIV prevalence decreased by 18.6% per annum in cities that introduce NSPs, and increased by 8.1% in cities that had never introduced NSPs (mean difference −24.7% [95% CI: −43.8, 0.5%], P=0.06). The mean difference was –33% when comparison was weighted to one over the variance of the regression estimator (29% decrease in cities with NSPs and 5% increase in cities without NSPs, P<0.001). When analysis was restricted to cities with first HIV seroprevalence less than 10%, the average annual change in seroprevalence was 18% lower in cities with NSPs (P=0.03).Conclusions: Despite the inherent limitations within an ecological study design, the study provides additional evidence that NSPs reduce transmission of HIV infection. The rapid spread of HIV among IDU populations and increasing rates of injecting in many countries calls for scaling up of NSPs as well as other harm reduction strategies.     

Iridium‐mediated β‐deuteration of enones

Exposure of captodative enone systems to deuterium in the presence of Crabtree's catalyst ( 1 ) results in deuteration at the vinylic site β‐ to the ketone carbonyl, as well as at any accessible ortho‐position. β‐exchange is also observed during the reduction of ethyl cinnamate ( 3 ) catalyzed by 1 . Copyright © 2003 John Wiley & Sons, Ltd.     

Enhancing laboratory report contents to improve outpatient management of test results

In today''s environment, providers are extremely time-constrained. Assembling relevant contextual data to make decisions on laboratory results can take a significant amount of time from the day. The Regenstrief Institute has created a system which leverages data within Indiana Health Information Exchange''s (IHIE''s) repository, the Indiana Network for Patient Care (INPC), to provide well-organized and contextual information on returning laboratory results to outpatient providers. The system described here uses data extracted from INPC to add historical test results, medication-dispensing events, visit information, and clinical reminders to traditional laboratory result reports. These “Enhanced Laboratory Reports” (ELRs) are seamlessly delivered to outpatient practices connected through IHIE via the DOCS4DOCS clinical messaging service. All practices, including those without electronic medical record systems, can receive ELRs. In this paper, the design and implementation issues in creating this system are discussed, and generally favorable preliminary results of attitudes by providers towards ELRs are reported.     

探究医院电子信息交换标准HL7

医药信息学在医学应用中的最大领域就是医院信息系统(Hospital Infornation System,HIS),随着HIS的快速发展,需要我们有一个开放的,统一的HIS开发和交换的标准.HL7是1987年开始发展起来的一个专门规范医疗机构用于临床信息,财务信息和管理信息电子信息交换的标准.它特别适合于解决不同厂商开发的医院信息系统、临床实验室系统及药学信息系统之间的互连问题.HL7在国内的发展刚刚起步,但是我国医疗卫生信息化发展很快,尤其是医疗保险、社区医疗和区域卫生信息系统等,都十分需要标准化的支持,HL7将成为建设这些系统的重要基础和关键技术.     

新生儿Rh溶血病不同血源换血疗法的疗效观察

目的:探讨新生儿 Rh溶血病实行换血疗法时的血源选择和换血量的确定。方法 :选取在我院接受换血治疗的 6 3例 Rh溶血病患儿 ,其中用 Rh阳性血换血 32例 ,Rh阴性血换血 31例 ,分析其换血前后血清总胆红素(TB)和血红蛋白 (Hb)变化以判断疗效。 结果 :两种换血术均获得满意疗效 ,换血后胆红素值明显下降 ,所有患儿均痊愈出院。 结论 :在紧急情况下 ,若无法及时得到 Rh阴性血 ,可用 Rh阳性血换血 ,换血量至少应 >2 0 0 m l/ kg(为 Rh阴性血的 2倍 ) ,若应用得当 ,是一项安全有效的替代疗法     

血浆置换及大剂量甲泼尼龙治疗蜂螫伤致溶血性贫血的疗效分析

目的比较血浆置换(PE)与大剂量甲泼尼龙治疗蜂螫伤致溶血性贫血的疗效。方法蜂螫伤导致溶血性贫血患者35例,入院后除常规的对症处理外,拒绝行PE治疗的患者分为大剂量甲泼尼龙治疗组(n=13),其余的22位患者采用PE方法治疗,比较两组的溶血控制时间、并发症发生率、死亡率、平均住院天数。结果与大剂量甲泼尼龙治疗组相比,PE治疗组溶血控制的时间相当,差异没有统计学意义,但该组患者的并发症发生率、死亡率、平均住院天数均低于前者,差异有统计学意义(P0.05)。结论 PE治疗能够有效治疗蜂螫伤所致溶血性贫血,且降低并发症的发生率,从而减低死亡率,缩短病程,减少平均住院天数,是早期治疗蜂螫伤中毒的有效手段。     

The Effect of Total Blood Exchange with PHP Solution on Cardiac Xenotransplantation

Abstract: Prevention of hyperacute rejection is a difficult and unsolved problem in xenotransplantation. Natural antibodies and complement activation have been known to play an important role in the xenotransplantation between discordant species pairs. In the present study, total blood exchange (TBE) was performed with pyridox-alated-hemoglobin-polyoxyethylene conjugate (PHP) solution (Ajinomoto Co., Inc., Kawasaki, Japan) before cardiac xenotransplantation in order to remove the immunoglobulins and prolong xenograft survival time. Guinea pigs and rats were used as the discordant species combination for donor and recipient. Two groups were established: Group 1, untreated control (n = 8) and Group 2, TBT with PHP solution (n = 8). The exchange blood transfusion was carried out at the rate of 15–20 ml/h utilizing PHP solution using a blood pump. After the blood exchange was processed, hematocrit (Ht) levels dropped to 4 or 5%, and a cardiac xenotransplantation was performed within 24 h. The levels of serum IgA, IgM, and IgG were decreased to less than 25, 25, and 10% of the base line, respectively, after blood exchange. A mean xenograft survival time in Group 2 was prolonged to 472 ± 74 min and to 10.4 ± 1.8 min in Group 1 (p < 0.01). A titer of the anti-guinea pig lymphocytotoxic antibody in rat serum was decreased to almost nil. The data from this study suggest that total blood exchange with PHP solution may be useful in preoperative removal of xenograft antibodies in xenotransplantation.     

The effects of changes to action potential duration on the calcium content of the sarcoplasmic reticulum in isolated guinea-pig ventricular myocytes

. We have estimated sarcoplasmic reticulum calcium content using rapid application of caffeine on voltage clamped, isolated guinea-pig ventricular myocytes. Caffeine induces the release of calcium from the sarcoplasmic reticulum and this calcium is extruded from the cells by the sarcolemmal Na/Ca exchange. Integrating the inward Na/Ca exchange current thus allows estimations of sarcoplasmic reticulum calcium content. Ventricular myocytes were stimulated to reach new steady-states by action potential voltage clamps of varying duration. Once contractile steady-state had been reached caffeine was rapidly applied in place of the next action potential and sarcoplasmic reticulum calcium content measured. Prolonging the action potential duration increased sarcoplasmic reticulum calcium content and vice-versa. This calcium loading may underlie the positive inotropic effect of increased action potential duration. Received: 11 July 1996 / Received after revision: 15 October 1996 / Accepted: 26 November 1996     

指示肺通气不均匀性的熵变及其同其他指标的理论比较

熵代表无序的水平，作者使用通气的熵变（ＥＣＶ）指示肺通气的不均匀性，ＥＣＶ定义为当前泡潮气量趋近于零时每摩尔被吸入气体从不均匀通气到均匀通气的熵变的极限。本文从熵的基本公式民地出ＥＣＶ的计算方程。用几个数学模型肺将ＥＣＶ同其他７个洗出指标进行了比较。８个指标中，只有ＥＣＶ仅取决于通气分布，其他７个指标不仅取决于通气分布，还同潮气量和死腔的大小有关。这影响了它们评价肺通气不均匀性的效果，ＥＣＶ的另一     

酸性成纤维细胞生长因子的分离纯化及活性鉴定

目的：从牛脑中分离纯化酸性成纤维细胞生长因子（aFGF)并鉴定生物活性，方法：根据DenisGOSPODAROW-ICZ的方法，新鲜牛脑匀浆，三步硫酸铵盐析。最后沉淀物溶解透析后予离子交换层析及琼脂糖胶亲和层析，促3T3细胞DNA合成率鉴定生物活性。结果：用1.0mol/LNaCl的缓冲液洗脱得到分子量为13600的多肽，得率为610μg/kg牛脑，氨基酸组成分析与已知的aFGF相同，促3T3细胞DNA合成的最低浓度为0.5ng/ml，最大效应浓度50ng/ml，ED50值为8ng/ml。结论：aFGF具有强烈的促细胞增殖作用。