A device to select the optimal time to replace the pacemaker activated by a lithium-iodine battery: results of 8 years of experience

The discharge curve of lithium-iodine batteries does not havefeatures which make the clinical decision to replace the pacemakereasy. The output voltage fall corresponding to the end of theirlife is evidenced by variations of the output variables (frequencyand/or length of pulse) and the time of elective replacementtime (ER) is arbitrarily established by the manufacturer, ERmay be too early or too late in relation to the threshold valueof myocardial stimulation. Furthermore, the variables indicatingend of life may be changed by troubles in the circuit components,irrespective of the state of battery. A device to detect theoptimal time for replacement (OR) of pacemaker was studied in1692 subjects with implanted LEM VVl electro-stimulators. Thisdevice consists of a resistance of 110 connected in serieswith the catheter through a magnetic switch, which is activatedby placing a magnet over the skin. The transient connectionof the resistor reduces the output voltage by an amount dependingon the resistive load between the electrodes. In a follow-up of 35 000 months the OR device revealed a verygood reliability. Pacemaker replacement, established when stimulation becomesineffective during the application of the magnet or when thespike amplitude in the standard oscilloscope rapidly declined,was necessary in 77 patients (six of them were excluded dueto a circuit blackout). The OR device was useful in 53 patients(74.6%) with a chronic myocardial threshold of more than 2.5V, useless in 18 patients with a myocardial threshold lowerthan 2.5 V; to obviate this limitation a new OR device is describedfeigning a temporary increment of battery impedance. The employmentof the OR device rather than using ER enabled the patients togain 1333 months of stimulation. The gain of pacing varied froma few months to 3 years, with an average of 18.7 months.     

Olanzapine optimal dose: results of an open-label multicenter study in schizophrenic patients. Olanzapine Late-Phase II Study Group

This open-label clinical study was conducted for patients with schizophrenia in order to investigate the efficacy, safety and optimal dose of olanzapine. One hundred and fifty-six of the 159 enrolled patients were included in the analysis set. For the primary efficacy measure, the Final Global Improvement Rating (FGIR) score, 15.4% of patients had remarkable improvement, 58.3% of patients had moderate improvement or more, 79.5% of patients had slight improvement or more, and 10.3% of patients had increase in disease symptomatology (worsening). Results from the Brief Psychiatric Rating Scale (BPRS) in all individual items were improved from baseline. Olanzapine was effective not only against positive psychotic symptoms but also against negative symptoms. This was consistent with results from the Positive and Negative Syndrome Scale (PANSS). For the majority of patients, a dose range of 7.5-10.0mg/day, as a lower bound on the minimally effective dose, was suggested by the results of the dose to first response based on improvement in Global Improvement Rating (GIR) analyses. The ratio of olanzapine dose to equivalent haloperidol dose was estimated at 1.2 :1. The most commonly reported treatment-emergent signs and symptoms (TESS) occurring at a frequency of 10% or more were insomnia, weight increase, excitement, sleepiness, anxiety, malaise and dull headaches. There was a low incidence of extrapyramidal treatment-emergent signs and symptoms; the most commonly reported were akathisia (6.4%), tremor (5.8%) and muscle rigidity (2.6%).     

多目标优化技术在中药复方药物筛选及组方优化中的应用

介绍多目标优化技术在中药复方药物筛选及组方优化中的应用，阐述了多目标优化技术在中药复方研究应用的思路与方法。其方案是以均匀设计法安排实验，综合主要目标法、虚拟目标法和约束条件法等多目标优化方法，以网格法作为优化算法实现复方药物筛选及优化，使多项药效指标都达到较好的平衡，从而取得最佳复方配伍组合。本研究探索建立的基于均匀设计的多目标优化技术在药物复方研究中的应用，有助于解决中药复方药物配伍研究方法的关键技术问题，有助于释放出中药复方中潜在的巨大经济效益。     

多目标优化技术在中药复方药物筛选及组方优化中的应用

介绍多目标优化技术在中药复方药物筛选及组方优化中的应用,阐述了多目标优化技术在中药复方研究应用的思路与方法。其方案是以均匀设计法安排实验,综合主要目标法、虚拟目标法和约束条件法等多目标优化方法,以网格法作为优化算法实现复方药物筛选及优化,使多项药效指标都达到较好的平衡,从而取得最佳复方配伍组合。本研究探索建立的基于均匀设计的多目标优化技术在药物复方研究中的应用,有助于解决中药复方药物配伍研究方法的关键技术问题,有助于释放出中药复方中潜在的巨大经济效益。     

统筹城乡卫生资源合理配置的途径探讨

解决目前我国城乡二元卫生经济结构问题,必须坚持科学发展观和统筹的思路,建立健全城乡卫生资源合理配置的新体制,逐步实现城乡卫生资源配置的合理化和科学化,实现城乡卫生事业发展的良性互动和一体化发展.     

深圳市3家市级综合医院2002年综合效益评价

目的:比较分析深圳市2002年3家综合医院的优劣,找出3家医院在运行和管理上可能存在的问题,并讨论相关对策.方法:运用层次分析法,建立多指标评价体系对医院进行评价,包括医院规模、资源配置和综合效益3个体系.结果:A医院规模最大,C医院在资源配置和综合效益上均为最优,B医院总体评价最劣.结论:根据评价结果,提出建议和对策.     

An Analysis for the Comprehensive Evaluation of Health Resources Allocation in Shenzhen

INCREASING HEALTH COSTS are a dilemmafaced by the health administration. In order to en-hance the productivity, we must invest in healthservices. Meanwhile, limited health resources shouldbe properly allocated to obtain maximal socioeco-nomic benefits at lowest input. Thus, it is especiallyimportant to comprehensively assess the allocationof health resources from the perspectives of theInput and Output. The comprehensive evaluation ofhealth resources is a topic of interest for multi-objective assessment, wh...     

政府卫生职责界定方法探讨

在总结现有相关研究的基础上，提出了划分政府卫生职责应遵循的9项基本标准或原则；围绕这些标准构建了一个直观而简便的分析模型；讨论了应用该模型确定政府卫生职责范围的具体而实用的方法。     

陕西省医疗资源分布的聚类分析研究

运用统计学原理和方法对收集的数据进行整理，建立了由7组指标构建的评价体系，定量地评价了2002年陕西省各个地区的医疗资源分布状况，为进一步合理配置陕西省医疗资源提供了依据。