美国针对慢性病患者取药的方便措施与各州的实践情况

摘 要美国针对慢性病患者取药的方便措施主要依托于长程取药模式。本文通过数据分析论证美国处方重配多样性及未来的研究重点,并从管理学角度评价处方重配对提高慢性病患者用药依从性的意义及如何实践医药护技多方共赢。美国长程处方取药操作流程、技术支撑的流程详细、具体,但面对美国本土情况仍需不断完善。     

Host specificity of avian metapneumoviruses

To date, four subgroups of avian metapneumoviruses have been defined (AMPV-A, B, C and D) based on genetic and antigenic differences. The extent of infection in the three principal species (turkeys, chickens and ducks) by these subgroups is, however, not well defined. Here, a series of controlled and ethically approved experimental infections were performed in specific pathogen-free turkeys, chickens and ducks with each of the four AMPV subgroups. For subgroup C, one strain isolated from turkeys in the USA (turkey AMPV-C) and one isolated from ducks in France (duck AMPV-C) were compared. Globally, these extensive experimental trials demonstrated that AMPV-A, B, turkey C and D were well adapted to Galliformes, especially turkeys; however, chickens showed limited clinical signs and differences in seroconversion and transmission. Notably, chickens did not transmit AMPV-A to contacts and were shown for the first time to be susceptible to AMPV-D. The duck AMPV-C was well adapted to ducks; however, chickens and turkeys seroconverted and were positive by virus isolation. In addition, seroconversion of contact turkeys to duck AMPV-C demonstrated horizontal transmission of this virus in a non-palmiped species under our experimental conditions. Interestingly, in chickens and turkeys, duck AMPV-C isolation was possible despite a lack of detection of viral RNA. Likewise, the turkey AMPV-C virus was well adapted to turkeys yet was also isolated from chickens despite a lack of detection of viral RNA. These results would suggest a selection for viral genetic sequences that differ from the original strain upon adaptation to a ‘non-conventional host’.     

安阳市正常儿童尿氟正常值初探

目的　了解安阳市正常儿童（８～１２岁）的尿氟水平。方法　采用氟离子电极法测定尿氟含量。结果　安阳市８～１２岁儿童尿氟正常值９５％ 的范围是０．２５～２．１１ｍ ｇ／ Ｌ。结论　尿氟正常值对地氟病的调查、病区的划分有指导意义,且可作为评价防治效果的指标之一。     

孕妇和新生儿碘缺乏病研究V.孕妇群体尿碘分布与参考值

本文采用群体比较的方法分析了５３５０ 例正常孕妇、４８２０ 例正常男性和３０９２ 例正常女性的尿碘分布状态。正态检验结果表明,孕妇、正常男性和女性以及总体尿碘均属正偏态分布。根据百分位数,本地区正常孕妇尿碘参考值范围在５３４１８Ｉμｇ／Ｌ。正常人总体尿碘参考值范围在５６４０６Ｉμｇ／Ｌ。     

Long term potentiation of single WDR neurons in spinalized rats

We report long-term potentiation (LTP) in single spinal wide dynamic range (WDR) neurons in urethane-anaesthetized spinalized rats with a complete neuromuscular blockade. Peripheral influences were excluded by a complete lidocaine block distal to the stimulation site on the sciatic nerve. As previously shown A-β fibre evoked responses were not increased by the tetanic stimulation when there was a neuromuscular blockade during the experiment. Spinalization, excluding influences from supraspinal structures, increased all firing responses, and the LTP of C-fibre evoked responses when calculated in number of action potentials compared to intact animals and to previous studies. Furthermore, an LTP of the post discharge was observed after spinalization. An LTP of the post discharge has previously not been reported. Therefore, we conclude that LTP in the dorsal horn normally seems to be inhibited by descending pathways.     

凹陷型睑袋手术方法及睑袋分型商榷

探讨一种睑袋新术式 ,并进行睑袋分型的讨论。方法　在局麻下形成皮肤和眼轮匝肌 ,释放眶隔脂肪 ,将脂肪翻折后固定于眶骨缘 ,与翻转眼轮匝肌瓣缝合填充睑袋凹陷。结果　本组共 37例 ,男性 8例 ,女性 2 9例。年龄 36～ 6 2岁 ,睑袋及凹陷均得到纠正。结论　利用眶隔脂肪 -眼轮匝肌复合组织瓣的形成加强了下眶前壁的张力 ,保证了眶内外的生理屏障的形成及充填脂肪、肌肉的血供 ,本术式为一种安全 ,有效的睑袋矫治术。依据局部区域内组织张力程度对眼袋进行分型的理论有必要进一步完善。     

借助CT图像评价心脏左右斜位摄影体位

目的 借助ＣＴ图像分析心脏斜位摄影体位的正确性,进一步加强质量控制。方法 将８０例胸部ＣＴ图像按胸厚分为〉２０ｃｍ和〈２０ｃｍ两组经数码相机输入计算机,ＣＴ图像通过计算机处理后得到一组参考数值;并以此分析８０例心脏斜位的摄影体位。结果 １．体形对测量脊柱与前后胸壁比值影响不大。右前斜位两组不同胸厚的平均值均为１．３９～１．４０,左前斜位胸厚〉２０ｍｃ组平均值为１．５０～１．５５,胸厚〈２０ｍｃ组平均值为１．５０～１．５４;２．不符要求的斜位片中,右前斜位主要以角度偏大为主,共８例（１０％）;左前斜位以角度偏小为主,共１１例（１３．８％）。结论 通过测量心脏斜位片脊柱与前后胸壁比值。能评价心脏斜位片摄影体位正确性。     

The burden of herpes zoster disease in Norway

BackgroundNo national vaccination program against herpes zoster (HZ) is currently in place in Norway. We aimed to quantify the burden of medically attended HZ to assess the need for a vaccination program.MethodsWe linked data from several health registries to identify medically attended HZ cases during 2008–2014 and HZ-associated deaths during1996–2012 in the entire population of Norway. We calculated HZ incidences for primary and hospital care by age, sex, type of health encounter, vaccination status, and co-morbidities among hospital patients. We also estimated HZ-associated mortality and case-fatality.ResultsThe study included 82,064 HZ patients, of whom none were reported as vaccinated against HZ. The crude annual incidence of HZ was 227.1 cases per 100,000 in primary healthcare and 24.8 cases per 100,000 in hospitals. Incidence rates were higher in adults aged ≥50 years (461 per 100,000 in primary care and 57 per 100,000 in hospitals), and women than in men both in primary healthcare (267 vs 188 per 100,000), and hospitals (28 vs 22 per 100,000). Among hospital patients, 47% had complicated zoster and 25% had comorbidities, according to the Charlson comorbidity index. The duration of hospital stay (median 4 days) increased with the severity of comorbidities. The estimated mortality rate was 0.18 per 100,000; and in-hospital case-fatality rate was 1.04%.ConclusionsMedically attended HZ poses a substantial burden in the Norwegian healthcare sector. The majority of the zoster cases occurred among adults aged ≥50 years – the group eligible for zoster vaccination – and increased use of zoster vaccination may be warranted, especially among persons with co-morbidities.