Coping with economic crisis: policy development in China and India

This paper explores health policy options in response to economiccrises in developing countries. The paper is based upon thepremise that policy is best pursued within a broad understandingof the determinants of health of populations. To provide anempirical base for analysis, the health status and health caresystems of China and India are compared. A conceptual frameworkon the determinants of the health status of populations is thendeveloped, incorporating both the performance of health caresystems and non-medical factors which influence health. Usingthe China and India experiences, the paper reviews the strengthsand weaknesses of traditional tools used in the analysis ofhealth policy. Significant policy change, it is argued, is bestimplemented through structural change of several health caresystem components simultaneously. Health policy analysis, itis further argued, must consider the broader political economyof the society. Moreover, there remain many imperfectly understoodsociocultural aspects of behaviour which enable some familiesto produce good health despite economic constraints. The paperconcludes that economic crisis presents an opportunity for astructural review of a society's health systems. Health policyoptions in response to economic crisis cannot be confined tothe health care sector. Rather, health policy should be viewedas only one, perhaps important, element of a package of socioeconomicpolicy options. Critical to policy choices are reliable informationon the condition of the poor and high political priority tominimize the adverse impact of economic crisis on the health,nutrition and social welfare of disadvantaged groups.     

Percutaneous management of lymphatic fluid collections

Eight lymphatic fluid collections were drained percutaneously. There were no immediate or late complications. Seven patients had follow-up; 1 required surgical drainage of a residual or recurrent lymphocele, and another had reaccumulated fluid in a lymphocele which was detected on autopsy. The remaining lymphatic collections responded to percutaneous drainage. Percutaneous drainage is safe and can be an effective tool in the management of lymphatic collections.     

Modulating effects of posttraining epinephrine on memory: Involvement of the amygdala noradrenergic system

These experiments examined the effects, on retention, of posttraining intra-amygdala administration of norepinephrine (NE), and propranolol. Rats were trained on a one-trial step-through inhibitory avoidance task and tested for retention 24 h later. Injections were administered bilaterally (1.0 microliter/injection) through chronically-implanted cannulae. Low doses of NE (0.1 or 0.3 microgram) administered shortly after training enhanced retention while higher doses (1.0 or 5.0 micrograms) were ineffective. Retention was not affected by NE administered 3 h after training. The effect of intra-amygdala NE on retention is blocked by simultaneous administration of propranolol (0.2 microgram). This finding suggests that the memory-enhancing effect of NE may be mediated by beta-receptors. Posttraining intra-amygdala NE also attenuated the retention deficit produced by adrenal demedullation. Further, intra-amygdala injections of propranolol (0.2 microgram) blocked the enhancing effect, on retention, of posttraining s.c. injections of epinephrine. These findings suggest that activation of noradrenergic receptors in the amygdala may be involved in memory processing and may play a role in the memory-modulating effect of peripheral epinephrine.     

Kinetic fluorometric determination of aluminum in serum

We describe a simple fluorometric method for determining aluminum in serum samples by monitoring the rate of reaction of 2-hydroxy-1-naphthaldehyde-p-methoxybenzoylhydrazone with aluminum ions. The emission of the resulting fluorescent metal-chelate formed is measured at 475 nm. Aluminum was measured in the supernate of serum after proteins were removed by precipitation with concentrated nitric acid, and calculations were based on the technique of standard additions. Within-run precision (CV) was 7.8% and 4.8% at mean aluminum concentrations of 7.7 and 60.7 micrograms/L, respectively (n = 10); between-run precision (CV) was 8.9% and 5.7% at mean aluminum concentrations of 23.3 and 46.8 micrograms/L, respectively (n = 10). The standard curve for the method is linear over the range of 0-250 micrograms of aluminum per liter. Samples from 49 patients were analyzed for aluminum by the proposed method (y) and by electrothermal atomic absorption spectroscopy (x). Linear regression analysis of the results yielded the equation y = 0.98x + 2.3 (r = 0.989, Syx = 6.7). The proposed method is comparable in sensitivity to the well-accepted atomic absorption spectrometric method but is simpler and less expensive.     

Choice of an ovarian stimulation protocol according to the follicular puncture method in an in vitro fertilization programme

In order to ascertain the adequacy of ovarian stimulation protocols with a type of follicular puncture, 126 women undergoing in vitro fertilization received either combination clomiphene/hMG or hMG alone according to a randomized test protocol. Within both groups patients for whom a pelvic examination was required had laparoscopies, while others had transvaginal ultrasonically guided punctures as far as possible. Clomiphene/hMG was more efficient than hMG alone as assessed from the cleavage rate (68% vs. 54%; p less than 0.01) and the pregnancy per attempt rate (16% vs. 5%; p less than 0.05). Laparoscopic punctures were more efficient than ultrasonically guided punctures (mean number of recovered oocytes: 4.8 +/- 2.6 vs. 3 +/- 2.5; p less than 0.001), but slightly better results were achieved by this latter method in ongoing pregnancy per puncture rate (18% vs. 8%; NS). With ultrasonically guided punctures, stimulation by clomiphene/hMG allowed better oocyte recoveries (3.8 +/- 2.5 vs. 2.3 +/- 1.9, p less than 0.05). Such results constitute an argument for preferential use of the clomiphene/hMG stimulation protocol with ultrasonically guided punctures.     

以病人选择医生为契机 全力推进人事分配制度改革

介绍了邯郸市中心医院在病人选医生中,努力完善制度,提高素质,深化内容,并以此为突破口,建立了灵活、高效的人事分配制度.用较为低廉的医疗费用,为人民群众提供了较好的医疗服务.     

种植受体血管内皮细胞在异种血管移植中的实验研究

目的　探讨种植受体血管内皮细胞在抗异种血管移植超急排斥反应 (HAR)方面的意义。方法　选用豚鼠→大鼠移植模型 ,先将分离、培养的大鼠动脉内皮细胞种植于去内皮的豚鼠动脉内壁 ,再将此豚鼠动脉植入大鼠体内 ,观察动脉血栓形成时间 ,并采用免疫组化技术检测了 Ig M、C3在移植后豚鼠动脉壁上沉积的情况。结果　已种植大鼠内皮细胞的豚鼠动脉血栓形成时间 (2 0 .3± 4.42 h)较植入大鼠体内的正常豚鼠动脉 (0 .35± 0 .2 84h)以及单纯去内皮豚鼠动脉血栓形成时间 (0 .16 5± 0 .0 77h)显著延长 (P<0 .0 0 1)。免疫组化结果显示 ,植入大鼠体内的正常豚鼠内皮细胞表面有 Ig M和 C3沉积 ,而预先种植大鼠内皮细胞的豚鼠动脉内壁无 Ig M和 C3沉积。结论　在异种供体血管壁上预先种植受者血管内皮细胞 ,可延长移植的异种供体血管通畅时间 ,该技术可能在抗异种血管移植 HAR方面具有重要意义