压力对体外培养牛眼小梁细胞的影响

目的 观察压力对小梁细胞的影响。方法 对体外培养牛眼小梁细胞施以不同程度的压力,用倒置相差显微镜、光镜、电镜观察细胞形态结构及吞噬功能的变化。结果 细胞承受２．００ｋｐａ（１ｋｐａ＝７．５ｍｍＨｇ）、２．６７ｋｐａ压力４８小时,各项指标与对照组比较,差异无显著性。４．００ｋｐａ２４小时,细胞形态结构有轻度的损伤,吞噬功能有轻度下降。当压力进一步增加,时间更加延长后,细胞的损伤也更重。结论小梁细胞只     

Ginsenoside Rs3, a genuine dammarane-glycoside from Korean red ginseng

A genuine dammarane-glycoside, named as ginsenoside Rs₃, was isolated from the MeOH extracts of Korean red ginseng (Panax ginseng C.A. Meyer) through repeated silica gel column chromatographies and its chemical structure was determined as (20S)-protopanaxadiol 3-O-[6″-O-acetyl-β-D-glucopyranosyl (1→2)-β-D-glucopyranoside on the basis of several spectral and physical evidences including HMBC and FAB-MS.     

SEARCH FOR HERPES SIMPLEX VIRUS TYPE2（HSV－2）AND HUMAN PAPILLOMAVIRUS（HPV）IN THE NORMAL AND ABNORMAL CERVICAL SAMPLES

ＳＥＡＲＣＨＦＯＲＨＥＲＰＥＳＳＩＭＰＬＥＸＶＩＲＵＳＴＹＰＥ２（ＨＳＶ－２）ＡＮＤＨＵＭＡＮＰＡＰＩＬＬＯＭＡＶＩＲＵＳ（ＨＰＶ）ＩＮＴＨＥＮＯＲＭＡＬＡＮＤＡＢＮＯＲＭＡＬＣＥＲＶＩＣＡＬＳＡＭＰＬＥＳＺｈａｎｇＷｅｉ;张伟;ＪｉｎＳｈｕｎｑｉａ...     

Effects of local muscle fatigue on three-dimensional scapulohumeral rhythm

The relationship of scapulothoracic motion to glenohumeral motion, commonly referred to as the scapulohumeral rhythm, has been the subject of numerous investigations. The purpose of this study was to assess the effects of localized muscular fatigue on three-dimensional scapulothoracic motion and the resulting scapulohumeral rhythm during elevation of the humerus in the plane of the scapula. A six-degree-of-freedom digitizing system (Metrecom(TM)) was used to define scapular and trunk reference frames, and three-dimensional Eulerian angles were determined for scapular motion for 0-135 degrees of humeral elevation before and after fatigue of the upper and lower trapezius muscles. Local muscle fatigue was determined using spectral analysis of electromyographic signals for the upper and lower trapezius muscles. The results demonstrated an average of 22% decrease in the median frequencies of the muscles sampled following resistive exercise, suggesting a state of local muscle fatigue. Concomitant with the fatigue was a selective decrease in scapulothoracic motion about two of the three scapular axes. RELEVANCE: Occupational and recreational conditions often require repetitive overhead elevations of the arms, resulting in muscular fatigue and various pathologies. During repetitive arm elevations the scapulohumeral rhythm or synchronization between the humerus and the scapula is balanced to allow the most efficient elevation of the arm. A better understanding of this much-discussed scapulohumeral rhythm and the changes induced by muscular fatigue may provide insight into the pathomechanics associated with shoulder dysfunction.     

An Approach for Widening the Bioequivalence Acceptance Limits in the Case of Highly Variable Drugs

Purpose. Highly variable drugs pose a problem in bioequivalence assessment because they often fail to meet current regulatory acceptance criteria for average bioequivalence (80–125%). This paper examines alternative approaches to establishing bioequivalence. Methods. Suggested solutions have included alternate study designs, e.g., replicate and multiple dose studies, reducing the level of the confidence interval, and widening the acceptance limits. We focus on the latter approach. Results. A rationale is presented for defining wider acceptance limits for highly variable drugs. Two previously described methods are evaluated, and a new method having more desirable properties is proposed. Conclusions. We challenge the one size fits all current definition of bioequivalence acceptance limits for highly variable drugs, proposing alternative limits or goal posts which vary in accordance with the intrasubject variability of the reference product.     

Crystal Structure of 2-Debenzoyl, 2-Acetoxy Paclitaxel (Taxol®): Conformation of the Paclitaxel Side-Chain

Crystals of the C2-acetate analog of paclitaxel, grown from a mixture of isopropyl alcohol and methanol, belong to the space group P2_l with a = 9.058(3), b = 18.306(5), c = 15.043(1) , = 97.09(1)°, Z = 2, V = 2475.1(9)³, D _calc = 1.269 gcm^–3 and µ = 0.75 cm^–1. The structure was determined by direct methods and refined to R(F) = 0.054 and wR(F) = 0.057 for 605 variables and 3496 observed reflections. The paclitaxel side chain possesses a conformation similar to that observed in the crystal structure of docetaxel (Taxotere^®). A three dimensional network of hydrogen bonds is formed through solvent molecules and stabilizes the crystal lattice.     

Polymeric Microspheres Prepared by Spraying into Compressed Carbon Dioxide

Purpose. The objective was to prepare polymeric microparticles by atomizing organic polymer solutions into a spray chamber containing compressed CO₂ (PCA-process) and to study the influence of various process parameters on their morphological characteristics. Methods. The swelling of various pharmaceutically acceptable polymers [ethyl cellulose, poly(methyl methacrylate), poly(-caprolactone), poly(dl-lactide), poly(l-lactide) and poly(dl-lactide-glycolide) copolymers] in CO₂ was investigated in order to find polymers which did not agglomerate during the spraying process. Poly(l-lactide) (L-PLA) microparticles were prepared by spraying the organic polymer solution into CO₂ in a specially designed spraying apparatus. The effect of various process (pressure and temperature of the CO₂ phase, flow rate) and formulation (polymer concentration) variables on the morphology and particle size of L-PLA-microparticles was investigated. Results. Polymers with low glass transition temperatures agglomerated even at low temperatures. The formation of microparticles was favored at moderate temperatures, low polymer concentrations, high pressures and high flow rates of CO₂. High polymer concentrations and low flow rates resulted in the formation of polymeric fibers. Colloidal L-PLA particles could also be prepared with this technique in a surfactant-free environment. Initial studies on the microencapsulation of drugs resulted in low encapsulation efficiencies. Conclusions. The PCA method is a promising technique for the preparation of drug-containing microparticles. Potential advantages of this method include the flexibility of preparing microparticles of different size and morphology, the elimination of surfactants, the minimization of residual organic solvents, low to moderate processing temperatures and the potential for scale-up.     

天津市1999-2021年0~14岁儿童伤害死亡谱及城乡差异分析

目的 分析天津市0~14岁儿童伤害死亡谱的特征、变化情况及城乡差异。方法 1999-2021年天津市儿童伤害死亡数据来源于天津市全人口全死因监测数据库,计算不同亚组人群和主要伤害原因的构成比、粗死亡率和标化死亡率并比较城乡差异。采用Cochran-Armitage趋势检验分析死亡原因构成比的时间变化趋势。采用Joinpoint回归分析变化趋势,计算平均年变化百分比（AAPC）。伤害死亡风险的季节差异用死亡率比值及其95%CI表示。结果 1999-2021年,伤害是天津市0~14岁儿童的第3位死因。农村儿童死于医疗卫生机构的比例为31.08%,低于城市的37.82%。儿童伤害的总体标化死亡率呈下降趋势（AAPC=-5.54%,P<0.001）。溺水和道路交通伤害的标化死亡率在城市和农村地区呈下降趋势（P<0.001）。意外中毒的标化死亡率仅在农村地区呈下降趋势（AAPC=-8.09%,P<0.001）,在城市地区无明显变化趋势（P>0.05）。自杀标化死亡率在城市地区无明显变化趋势（P>0.05）,在10~14岁农村儿童中呈上升趋势（AAPC=4.58%）。跌倒/坠落标化死亡率在城市和农村地区均无明显变化趋势（P>0.05）。伤害死亡的总体风险和溺水死亡风险在城乡均为夏季最高;道路交通伤害在城市为秋季最高,在农村为夏季最高;意外中毒死亡风险在城乡均为冬季最高。结论 近年来天津市儿童伤害死亡情况得到明显改善。城市和农村地区的儿童伤害死亡水平仍存在较大差异,在未来政策制定中,应充分考虑缩小城乡差距。     

公费医疗门诊项目实行“按人头付费”的效果评价

1998年,上海市普陀区医疗保险办公室改革公费医疗支付方式,对门诊项目实行按人头付费。本文就改革实施一年来公费医疗费用发生情况作一分析,对按人头付费方式实施效果进行评估,得出以下结论:该支付方式较为有效地降低了医疗费用的增长幅度,减少了浪费;对促进医院加强内部管理,转变经营策略,重视医疗成本控制,提高卫生资源的利用效率起到了积极的作用。同时提出,要注意纠正个别医疗机构控制费用方法简单化的偏差,要考虑人群年龄结构因素对医疗费用的影响,适当调整付费标准,以避免医疗机构在承担费用支出方面出现畸轻畸重的问题。     

树立市场经济法律意识繁荣社会主义卫生事业

市场经济是法制经济,社会主义市场经济体制的建立和完善,离不开社会主义市场经济法制体系的建立与完善。在实现两个转变的过程中,加强法制建设,树立和强化法律意识,对推进卫生改革,促进卫生发展具有十分重要的意义。