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

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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.     

上海市50岁及以上人群维生素D水平与握力的关联研究

目的 探讨上海市≥50岁人群维生素D水平与握力的关系。方法 数据来源于WHO全球老龄化与成人健康研究我国上海市2018-2019年数据,采用logistic回归模型分析维生素D水平与握力的关系,进一步按照性别、年龄及乳制品摄入情况进行分层;采用限制性立方样条曲线绘制维生素D水平与低握力的剂量-反应曲线。结果 共4 391人纳入研究,其中男性2 054人（46.8%）;年龄（67.02±8.81）岁;低握力1 421人（32.4%）;维生素D不足及缺乏分别为1 533人（34.9%）和401人（9.1%）。在调整相关混杂因素后,logistic回归分析结果显示,维生素D缺乏的人群发生低握力的风险更高（OR=1.41,95%CI：1.09~1.83）;在男性中,调整相关混杂因素后,维生素D缺乏与低握力发生风险呈显著正相关（OR=1.67,95%CI：1.12~2.50）,而女性中两者之间无关联（OR=1.30,95%CI：0.97~1.74）;在60~69岁及≥80岁年龄组中,调整相关混杂因素后,维生素D缺乏与低握力发生风险呈显著正相关（OR=1.57,95%CI：1.05~2.35;OR=2.40,95%CI：1.08~5.31）,在乳制品摄入<250 ml/d的人群中,调整相关混杂因素后,二者之间呈显著正相关（OR=1.57,95%CI：1.17~2.09）,而在乳制品摄入≥250 ml/d的人群中无明显关联。限制性立方条样图显示,低握力的发生风险可能随维生素D含量的上升而降低,但差异无统计学意义（P>0.05）。结论 维生素D水平与握力存在一定的关系,维生素D缺乏人群出现低握力的风险更高。     

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。     

血吸虫病与原发性肝癌关系的队列研究

为探讨日本血吸虫病与原发性肝癌的关系, 对大丰市455 人进行了12年的前瞻性观察。血吸虫病组表抗携带率为14.21% , 比非血吸虫病组的9.56% 高; 肝癌20岁以上截缩标化人年死亡率, 血吸虫病组为283.82/10 万, 非血吸虫病组为38.66/10万, RRM H为5.72,SMR分别为3.76 和0.65,P< 0.01;前者组内男女肝癌死亡率比RRM H 为1.51, P> 0.05,后者组内RRM H 为3.98,P< 0.01。用叉生法分析血吸虫病和表抗携带两因素的作用,则肝癌20岁以上截缩标化人年死亡率,血吸虫病和表抗携带双阴者为21.16/10万, 血吸虫病单阳者为118.47/10 万,表抗携带单阳者为232.33/10 万,血吸虫病和表抗携带双阳者为1228.75/10 万; 后三者与前者相比, RRM H 分别为3.99, 8.47, 34.57, P均< 0.01; 血吸虫病和表抗携带对肝癌联合作用指数S为3.2,Poisson 回归乘法模型拟合良好。结果提示两者与肝癌分别有密切联系,且有明显的相乘作用     

医学院校教师血压水平及高血压病患病率的调查

为探讨医学高教职业对教师血压的影响,我们对我院579名在职教师的血压及其高血压患病率进行了统计分析,并同对照组进行了比较。结果表明,高教教师无论在总体上,还是与相同工龄段的其他人群相比较,其血压水平及高血压患病率均显著增高(P<0.05,P<0.01),而且随高教教龄的延长,血压及高血压患病率均有明显增高的趋势(P<0.05,P<0.01);中青年高级职称者血压水平较非高级职称者明显增高(P<0.01)。从而提示高教职业长期紧张、高负荷、大工作量的特点是高教教师高血压病患病率增高的重要因素,高教教师尤其高教龄教师是高血压病的高危人群。     

早孕妇女中沙眼衣原体感染及产前诊断的研究

用PCR法对100例早孕妇女的子宫颈标本和绒毛组织进行沙眼衣原体(CT)检测,结果发现:孕妇宫颈感染率为11％(11/100),绒毛感染率为7％(7/100),在11例宫颈CT阳性的孕妇中,发现有5例绒毛CT为阳性(45.5％)。同时显示无业、个体经商者、多次妊娠(>3次)、宫颈糜烂分别是孕期感染CT的高危人群和重要因素。结论:在孕期保健中,应开展CT筛查,尤其对具有高危因素的孕妇进行检查,以利于早期发现衣原体感染,及时治疗,从而提高人口素质。