小细胞肺癌3种化疗方案的成本-效果分析

目的应用药物经济学分析方法评价小细胞肺癌3种化疗方案的成本-效果．方法55例小细胞肺癌患者随机分为3组：CAV方案、PE方案、GP方案组，运用药物经济学的成本-效果分析方法进行评价、结果3种化疗方案中CAV方案有效率为50％，1个疗程费用为340．76元，有效率每增加1个百分点，成本为6、82元；PE方案有效率为71．9％，1个疗程费用为755．26元，有效率每增加1个百分点，成本为10．5元；GP方案有效率为85．7％，1个疗程费用为12372．04元，有效率每增加1个百分点，成本为144．36元．结论 □PE方案是3种化疗方案中最为合理的方案．     

单样本法及其在出生缺陷监测中的应用

本文介绍单样本法的原理及其在出生缺陷监测中的应用,探讨其应用条件,并以四川省1984～1986三年资料为基线,对1987年腭裂和唇腭裂的消长进行了分析,未发现各月发生数有显著性变化。     

从流行病学效果探讨A群流脑多糖体菌苗免疫方案

我省自1980年以来在重点地区进行流脑多糖体菌苗流行病学与血清流行病学效果观察。一次接种30μg 后保护效果可达4年之久,在预测的流行地区进行菌苗接种可降低发病率。1985年以来我省2800万儿童大面积现场观察流脑多糖体菌苗效果仍维持4年以上。验证了在菌群没有变迁的情况下,A 群流脑多糖体菌苗控制流脑是比较理想的,所制订的免疫方案是可行的。     

Open Channel Block by Physostigmine and Procaine in Embryonic-like Nicotinic Receptors of Mouse Muscle

Embryonic-like nicotinic channels were studied in mouse myotubes. Channel currents were measured by patch-clamping outside-out excised patches to which pulses of agonists and drugs could be applied by a liquid filament switch. The holding potential of the patches was generally around -40 mV. Pulses of 10^-4 M acetylcholine elicited average channel currents which reached a peak open probability, P_{o, peak}, of 0.93 within 0.5 ms and decayed with a time constant of desensitization of 20-80 ms. When physostigmine (10^-5 to 10^-3 M) or procaine (3 × 10^-5 to 10^-3 M) was added to the acetylcholine pulses, a fast decay component of the current appeared which shortened to a time constant of 0.5 ms for the maximal drug concentrations. The fast decay was followed by a slow one which declined in amplitude with increasing concentrations of the drugs. After the end of pulses of 10^-4 M acetylcholine plus 3 × 10^-4 M physostigmine the average current rose again, reaching a peak with -5 ms delay, and then decayed slowly. The amplitude of this recovery current was -0.4 P_{o, peak} after 5 ms pulses and decreased with increasing pulse duration due to desensitization. The results can be quantitatively modelled based on a circular reaction scheme involving desensitization. Physostigmine and procaine bind to the open state to cause channel block. Also, the blocked channel was subject to desensitization. The rate constants of block were 6 × 10^-6 M^-1 s^-1 for physostigmine and 2 × 10⁶ M^-1 s^-1 for procaine, and the rate of unblocking was 200 s^-1 for both blockers (at -40 mV and 20°C).     

Assessing the Effect of Sampling Strategies on the Power of Linkage Analysis to Identify Pathway‐Specific Loci Underlying a Complex Disease

Using the simulated general population data sets, we first examined the effect of sampling strategies on the power of identifying linkage by selecting samples with (A) two affected sibs in a nuclear family and (B) one affected sib and one sib with an intermediate trait value in the upper quantiles. Second, we evaluated the improvement in power when analyzing correlated traits simultaneously. Under each selection criteria, 100 replicates of 300 nuclear families were sampled and analyzed with two‐point linkage analysis for ten markers (1 cM apart) from each of the candidate regions. Different genes were identified under different sampling strategies. When a gene has a pleitropic effect, it is more powerful to analyze correlated traits simultaneously, either by using a linear combination or the larger value of standardized traits, than to analyze each trait separately. © 2001 Wiley‐Liss, Inc.     

急性心肌梗塞程序康复治疗7例报告

7例急性心肌梗塞患者,在实施合理临床医疗措施同时,采用《四阶段十二步》程序康复方案进行“早活动,早离床”的康复治疗,取得明显医疗效果:患者身体活动能力和心脏贮备功能得到早期恢复,心功能改善,避免了卧床引起的并发症;对于重症或伴有合并症患者,只要掌握好康复活动量和康复进度,同样可以进行程序康复治疗,并获得相同的康复效果。作者认为程序康复治疗是急性心肌梗塞比较合理的医疗方法,《四阶段十二步》程序康复方案是安全、有效和易行的康复程序方案。     

The introduction of a quality assessment scheme for extra-laboratory blood glucose analysis

An external quality assessment scheme is described for on-ward testing of blood glucose by nursing staff using the Glucometer II/Glucostix system. This involved the distribution of two concentrations of glucose solutions to the wards at 2-week intervals. Initially, results were examined prior to the introduction of a formal training programme for use of the blood glucose meters when the hospital CV was 25% (low glucose) and 19% (high glucose). Some improvement was shown after 6 months, with CVs of 13 and 8%, and a greater improvement after 12 months with CVs of 6 and 8%, respectively. A ward report was designed to allow easy interpretation of performance by the participants in the scheme. The introduction of this report was well received and generated enthusiasm among the ward staff.     

Reimbursing for the costs of teaching and research in finnish hospitals: A stochastic frontier analysis

In this study stochastic frontier cost function was used to estimate the teaching and research costs of Finnish hospitals. Predicted efficiency adjusted costs were calculated and compared to evaluate the current level of teaching and research reimbursement. The efficiency adjustment had significant impact on the marginal and average cost estimates of the teaching and research output. The results suggest that the average rate of teaching and research reimbursement should be approximately 14.6% of the total operating costs in university teaching hospitals. The main finding was that the university teaching hospitals were underfunded with respect to both research and teaching output. JEL Code C14 . C23 . D24 . I10     

Ictal Body Scheme Disturbance Induced by Looking Through a Small Opening

The case of a patient is reported in which seizures consisting of a feeling that the left arm was absent were induced by looking through a small opening (e.g. camera view finder). The EEG showed right parietal sharp wave discharges between and during such seizures. This observation is interpreted as an example of a reflex epilepsy triggered by the specific stimulus of looking through a small opening, and involving the right parietal lobe.