策略调整前后无偿献血者血液检测结果分析

目的:了解策略调整对降低不合格率的效果。方法:对乐山市无偿献血者5项血液检测结果进行统计分析,获得无偿献血者健康状况及血液检测不合格原因的资料。结果:2010-2012年血液检测总不合格率为6.47%,分项不合格率:ALT(4.35%)抗-TP(0.98%)HBsAg(0.80%)抗-HCV(0.54%)抗-HIV(0.07%),其中ALT与抗-TP为主要不合格原因:2012年全面实行献血前ALT快速初筛检测,并对应急预案进行优化后,总不合格率较2011年呈明显下降趋势,差异有统计学意义(χ2=145.118,P0.01)。结论:策略调整有效。针对乐山市不断增长的用血需求,加强无偿献血前的健康征询,在献血者采血前已有HBsAg以及ALT快速初筛项目的基础上,考虑有针对性地增加抗-TP快速初筛项目,可进一步降低血液不合格率。     

青浦区社区滚雪球式健康教育模式研究

目的 探讨社区滚雪球式健康教育模式的可行性和有效性,为缓解健康教育人力资源不足提供一种方法.方法 由区疾控中心逐级增量培训方式培训出来的社区志愿者对干预组的社区居民开展健康教育,区疾控中心对对照组社区居民开展健康教育,通过评价两种方式的健康教育效果,评价社区滚雪球式健康教育模式的可行性和有效性.结果 干预组和对照组社区居民的健康基本知识和理念知晓率、健康生活方式与行为形成率和健康技能掌握率比接受健康教育前均得到提高（P＜0.05）;干预后两组居民的健康基本知识和理念知晓率、健康生活方式与行为形成率和健康技能掌握率之间的差异无统计学意义（P＞0.05）.结论 运用滚雪球式方法培训出来的社区志愿者对社区健康教育工作是有意义的,其健康教育模式是可行和有效的.     

The impact of HLA genotyping on survival following unrelated donor haematopoietic stem cell transplantation

One of the major factors that have contributed to improving the outcomes of Stem Cell Transplantation is progress made in the field of human leucocyte antigen(s) (HLA). This is evident not only in developing techniques for rapid and accurate tissue typing, but also in the greatly improved understanding of the HLA system and the impact of HLA matching on transplant complications. It is now accepted that high‐resolution HLA matching for transplant recipients and unrelated donors is associated with the best clinical outcomes. The most important HLA determinants are the six ‘classical’ polymorphic HLA loci: HLA‐A, ‐B, ‐C, ‐DRB1,‐DQB1, ‐DPB1. For several years, based on the outcome of numerous studies, a 10/10 matched donor (HLA‐A, ‐B, ‐C, ‐DRB1, ‐DQB1) was considered the ideal. The impact of HLA‐DPB1 has been less clear, in view of reduced likelihood of patient/donor matching for this locus. More recently, several large studies have questioned the importance of HLA‐DQB1 matching on outcome. Based on the findings of recent studies, the current gold standard unrelated donor is believed to be one matched for 8/8 alleles at high resolution i.e. matched for HLA‐A, ‐B, ‐C, ‐DRB1, however, in certain circumstances, mismatches may be tolerated and/or permissive.     

探讨健康志愿者多次口服复方尼群地平片的耐受性

目的探讨健康志愿者多次口服复方尼群地平片的安全性及安全、有效的临床用药方案。方法9名健康志愿者连续口服复方尼群地平片(每片含尼群地平5 mg和阿替洛尔10 mg)4片,qd×7 d。观察BP,HR,ECG,血、尿常规,肝、肾功能等实验室指标及不良事件。结果多次服药后9名健康志愿者的血压均有所下降,心率也减慢;实验室检查与给药前相比差异无统计学意义(P>0.05).未出现严重不良事件。结论健康志愿者对复方尼群地平片多次给药有很好的耐受性,服药前及服药过程中应做ECG监测。     

上海某公立医院开展志愿者活动的调查与分析

目的：探讨在我院成人病区患者中开展志愿者活动的可行性，提出相应的对策。方法：采用分层随机抽样方法，对成人病区住院患者或家属，进行实地问卷调查。结果：患者或家属对志愿者服务有一定需求，并希望志愿者以5人以下每周一次的形式协助护理患者和提供心理辅导等服务，其中内科病区患者或家属特别需要协助护理患者服务。结论：采取多种培训形式，不断提高志愿者队伍素质；关注内科病区患者，开展志愿者定期服务；重视心理关护，不断提高志愿者服务质量。     

Pharmacokinetics and tolerability of intravenous infusion of adenosine (SUNY4001) in healthy volunteers

AIMS: To examine the tolerability and disposition of i.v. adenosine (SUNY4001) in healthy male Japanese volunteers. METHODS: SUNY4001 was infused i.v. for 6 min at 0 (placebo), 60, 100, 120 and 140 microg kg-1 min-1 in a dose-escalating manner in 30 healthy subjects. Adenosine and its metabolites were determined in the plasma and urine. RESULTS: Only plasma hypoxanthine was increased from 3 min during until 5-10 min after SUNY4001 infusion at the higher rates without any significant dose-related changes in plasma adenosine, inosine, xanthine or uric acid, or in urinary adenosine and all metabolites compared with the placebo. There was a dose-related increase in the incidence of subjective symptoms such as heat sensation, flushed face, dyspnoea, chest discomfort, etc. Transient and self-subsiding episodes of second-degree atrioventricular block were found in two subjects each at the higher doses. CONCLUSIONS: Adenosine infusion at < or = 140 microg kg-1 min-1 was concluded to be generally well tolerated.     

Japan’s silver human resource centers and participant well-being

Japans Silver Human Resource Center (SHRC) program provides part-time, paid employment to retirement-aged men and women. We studied 393 new program participants and examined whether part-time work influenced their well-being or ikigai. The participants were divided into those who had worked in SHRC-provided jobs in the preceding year, and those who had not. Gender-stratified regression models were fitted to determine whether SHRC employment was associated with increased well-being. For men, actively working at a SHRC job was associated with greater well-being, compared to inactive members. And men with SHRC jobs and previous volunteering experience had the greatest increase in well-being. Women SHRC job holders did not experience increased well-being at the years end. The study concludes that there is justification for exploring the usefulness of a similar program for American retirees who desire post-retirement part-time work.     

A comparison of the tolerability of two dilution volumes (0.5 mL and 1.0 mL) of a purified chick embryo cell rabies vaccine administered intramuscularly to healthy adult volunteers: A randomized, intraindividual, assessor-blind study

Background: The current recommendation of the manufacturer for administering purified chick embryo cell rabies vaccine (PCECV) is to reconstitute the contents with 1.0 mL of water for injection (WFI). However, it has been debated whether a lower volume of WFI (0.5 mL) is likely to cause less pain.Objectives: The aims of this study were to compare the tolerability of PCECV administered IM at a volume of 0.5 mL versus 1.0 mL of diluent and to determine the immunogenicity of the vaccine when administered according to the World Health Organization-recommended preexposure prophylaxis regimen for rabies immunization.Methods: This comparative, intraindividual, assessor-blind study was conducted at the Department of Clinical Pharmacology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital Mumbai, India). Healthy volunteers aged 18 to 50 years received, by randomized sequence, 3 IM injections of PCECV, diluted in 0.5 mL or 1.0 mL of WFI, on study days 0, 7, and 28. Tolerability was assessed at 30 minutes and 24 hours after injection and included assessments for local and systemic reactions. For immunogenicity assessment, rabies virus-neutralizing antibody 0RVNA) titers were assayed at baseline and on day 49 (ie, 3 weeks after the third injection).Results: Twenty-six subjects (24 men, 2 women; mean [SD] age, 22.4 [2.4] years; mean [SD] body weight, 59.0 [11.3] kg) entered the study. Twenty-five subjects were included in the tolerability assessment; 24 in the immunogenicity assessment. No statistically significant differences were found between dilutions in the frequency of local and systemic reactions. Most reactions were mild. All subjects developed RVNA titers >0.5 IU/mL (indicative of protection) by day 49.Conclusions: In this population of healthy volunteers, a full antigenic dose of PCECV in a dilution of 0.5 mL WFI is as well tolerated locally and systemically as in a dilution of 1.0 mL. All subjects developed levels of RVNA far exceeding 0.5 IU/mL, which is indicative of protection against rabies.     

健康成年志愿者盐酸洛非西定的耐受性试验

本文通过对２０例健康成年志愿者服用不同剂量盐酸洛非西定后不良反应尤其是对血压的连续观察,发现服用单剂量盐酸洛非西定后１ｈ开始出现口干、乏力、困倦等不良反应,４－５ｈ达到高峰,７－８ｈ后基本消失。盐酸洛非西定可降低正常成年人卧位和立位血压,降低立位血压的作用更为突出。此外,盐酸洛非西定也有降低卧位心率的作用。盐酸洛非西定的不良反应有随剂量加大而加重的倾向。