妇幼卫生扶贫基金计划可持续性发展的探讨

妇幼卫生扶贫基金计划在云南的实施将随卫 项目和“降消”项目的结束而终止。但妇幼扶贫基金计划仍有可能持续发展 ,基于政府和人民群众的意愿、国家农村卫生改革的思路、基金筹资的可能性和对基金的运行已形成的较完善的管理能力 ,建议在以后的妇幼卫生扶贫救助中 ,进一步加强宣传动员、扩宽筹资渠道、加强对基金的管理和监督、加大产前保健的扶贫覆盖面、严格把握住院补偿费用 ,使有限的卫生扶贫基金能进一步得到合理的使用     

综合医院科研经费沉淀现象分析

随着科技体制改革的不断深化,科学技术研究越显重要.国家财政和企事业单位在科学研究方面的投入也不断加大,科研经费呈现明显的上升趋势,但科研经费的"沉淀"现象也逐渐凸现出来,引起政府和各界学者的关注,同时也是科研管理人员最为"头疼"的问题.本文根据医院实际,分析了综合医院科研经费沉淀现象产生的原因及其弊端,并提出了防止科研经费沉淀现象产生的几点建议,与同行交流探讨.     

山西省实施全球基金结核病项目7年效果分析

目的：评价山西省实施全球基金结核病项目取得的成效。方法：对山西省2003～2009年实施全球基金结核病项目的情况进行总体分析。结果：项目实施后,督导短程化疗（directly obeserved treatment ＋ short -course, DOTS ）覆盖率达100％;2003～2009年共发现72523例新涂阳肺结核患者,新涂阳肺结核患者发现率达到72．03％;治愈68132例,治愈率达到93．9％。结论：项目实施效果显著,实现了高发现率和高治愈率的目标,DOTS策略得到扩展。为本省结核病控制工作可持续发展提供了成功模式。     

万宁市原疟疾高流行地区全球基金疟疾项目实施效果评价

目的 通过评价和分析万宁市原疟疾高流行地区全球基金疟疾项目的实施效果,揭示海南山区消除疟疾的过程和规律,为海南消除疟疾提供参考.方法 对该地区4个乡镇和4个国营农场近10年来疟疾发病率监测、居民疟原虫率监测、外来流动人口疟疾监测和媒介按蚊监测资料进行综合分析.结果 显示10年来4个乡镇和4个农场均达到较高的发热病人年血检率(15％～25％),其疟疾发病率变化趋势相一致,疟疾发病率自2010年下降至零、居民疟原虫率和外来流动人口疟疾感染率也下降至零,当地两种主要传疟媒介微小按蚊和大劣按蚊种群密度已下降至很低的水平.结论 传疟媒介密度大幅度降低,加之及时发现和治疗病人,是疟疾得以稳定快速下降的主要原因.当地已步入消除疟疾阶段.全球基金疟疾项目实施加速了当地消除疟疾的进程.     

美英法生物安全领域基金资助布局

目的：探讨发达国家在生物安全相关领域的主要发展。方法：从美、英、法3国政府资助平台获取信息,分析生物安全相关领域的基金资助情况。结果：美国于2001年以后对生物安全研究的资助力度显著增加,双重布局基础研究与防控措施研究。英国原RCUK近5年对传染病的检测与预防,以及水产养殖的生物安全等的资助力度逐年加大。法国生物安全资助项目较少,主要为传染病传播机制与防治研究。结论：美国2001年的炭疽事件引发生物安全研究的投入大幅增加,英、法的研究晚于美国,且资助力度远不及美国。     

Vial usage,device dead space,vaccine wastage,and dose accuracy of intradermal delivery devices for inactivated poliovirus vaccine (IPV)

IntroductionIntradermal delivery of a fractional dose of inactivated poliovirus vaccine (IPV) offers potential benefits compared to intramuscular (IM) delivery, including possible cost reductions and easing of IPV supply shortages. Objectives of this study were to assess intradermal delivery devices for dead space, wastage generated by the filling process, dose accuracy, and total number of doses that can be delivered per vial.MethodsDevices tested included syringes with staked (fixed) needles (autodisable syringes and syringes used with intradermal adapters), a luer-slip needle and syringe, a mini-needle syringe, a hollow microneedle device, and disposable-syringe jet injectors with their associated filling adapters. Each device was used to withdraw 0.1-mL fractional doses from single-dose IM glass vials which were then ejected into a beaker. Both vial and device were weighed before and after filling and again after expulsion of liquid to record change in volume at each stage of the process. Data were used to calculate the number of doses that could potentially be obtained from multidose vials.ResultsResults show wide variability in dead space, dose accuracy, overall wastage, and total number of doses that can be obtained per vial among intradermal delivery devices. Syringes with staked needles had relatively low dead space and low overall wastage, and could achieve a greater number of doses per vial compared to syringes with a detachable luer-slip needle. Of the disposable-syringe jet injectors tested, one was comparable to syringes with staked needles.DiscussionIf intradermal delivery of IPV is introduced, selection of an intradermal delivery device can have a substantial impact on vaccine wasted during administration, and thus on the required quantity of vaccine that needs to be purchased. An ideal intradermal delivery device should be not only safe, reliable, accurate, and acceptable to users and vaccine recipients, but should also have low dead space, high dose accuracy, and low overall wastage to maximize the potential number of doses that can be withdrawn and delivered.     

Pharmacological characterization of the postjunctional beta-adrenoceptors in the rat gastric fundus

In order to characterize the postjunctional beta-adrenoceptors in the rat gastric fundus, we studied the influence of beta-agonists and beta-antagonists on methacholine-contracted fundus strips. The mixed beta-agonist isopropylnoradrenaline and the beta 2-selective agonist fenoterol had a concentration-dependent relaxing effect and at higher concentrations completely inhibited the methacholine-induced tone. The reputedly beta 1-selective agonist prenalterol only produced about 50% inhibition and another reputedly beta 1-selective agonist, tazolol, had almost no relaxing effect. The beta-antagonists propranolol (beta 1 + beta 2), practolol (beta 1), H35/25 (beta 2) and ICI 118,551 (beta 2) all shifted the concentration-response curves for isopropylnoradrenaline and fenoterol in a parallel way to the right, but the slope of the Schild plot was not significantly different from 1 only for the antagonism of isopropylnoradrenaline by H35/25. The relaxing effect of prenalterol was only clearly antagonized by ICI 118,551. The results suggest that postjunctional beta 1- and beta 2-adrenoceptors are present in the rat gastric fundus.     

Cardiac and subjective response to cognitive challenge and to controlled physical exercise by male and female coronary prone (Type A) and non-coronary prone persons

Male and female subjects who were classified as either Type A or Type B took a cognitive test (digit symbol) and also participated in an exercise task in which they stepped up and down a step in time to a pace established by the experimenter. Results indicated that prior to the IQ test there were no differences between Type A and Type B subjects in heart rate or subjective arousal. During the IQ test, Type A subjects showed a higher heart rate than Type B subjects, and that effect was most pronounced among males (A-males had rates that were 20.3 b.p.m. higher than their resting level and 14.6 b.p.m. higher than B-males). Although during the IQ test Type A subjects had higher heart rates than Type B subjects, they did not report higher subjective arousal. Type A and Type B subjects did not show different heart rate responses to the controlled physical exercise.     

Assessing debt-to-health swaps: a case study on the Global Fund Debt2Health Conversion Scheme

The Debt2Health Conversion Scheme of the Global Fund to Fight AIDS, Tuberculosis and Malaria is used to reassess a range of recent initiatives that propose debt relief in exchange for spending in the health sector. The experience with debt swaps in the mid 1990s was far from positive, and recent improved insight in the economics of debt relief suggests extreme caution. We argue that the recent spade of debt swap proposals, even if targeting countries and debt titles that fall outside current major international debt relief mechanisms, share most of the design faults of previous initiatives. Proposals such as Debt2Health do not constitute efficient vehicles to increase net transfers to poor countries, to reduce the economic disadvantages of indebtedness, or to strengthen public health systems of partner countries. For debt relief to constitute a valuable mechanism to provide aid, it should be designed as a large-scale and comprehensive operation, with spending earmarked to broad country-established priorities, and reinforce rather than undermine national implementation systems.     

人参皂甙对大鼠输精管和肛尾肌中α受体效应的影响

人参皂甙(G,10~(-4)g/ml)对离体大鼠输精管(RVD)的正常张力无影响,但能增强电场刺激引起的RVD收缩效应,对抗可乐定(Clo)抑制和育亨宾(Yoh)增强电场刺激引起的RVD收缩。G使苯福林(Phe)对RVD和肛尾肌(RAM)α_1受体作用的量效曲线右移。上述结果进一步支持G在突触前后膜α受体水平上可能均起着调谐剂(modulator)样作用的观点。