沙门氏菌信息管理系统的设计与应用

介绍了沙门氏菌信息管理系统的建设情况,阐述了系统的建设背景与现状、系统业务分析、系统功能模块等内容。该系统的建设为沙门氏菌监测提供了信息化监测手段,并为进一步建立全国沙门氏菌监测网络奠定了基础。     

美国技术贸易壁垒对中国药品出口影响的实证分析

采用引力模型,分析技术性贸易壁垒对中国药品出口美国的影响。结果显示,美国药品领域技术性贸易壁垒对中国药品进入美国市场有阻碍作用,并提出了跨越美国技术性贸易壁垒的建议。     

云南省普洱市镇沅县男性流动人群艾滋病相关知识、干预和行为学调查分析

目的通过对镇沅县五一水库2009—2011年男性流动人群艾滋病相关知识和行为学进行分析,了解镇沅县最近三年男性流动人群干预效果的变化,为制定防治对策提供科学依据.方法每年均采用PPS法随机抽取镇沅县五一水库施工区的部分民工,进行艾滋病相关知识和行为学调查.结果2009-2011年共进行1070份男性流动人群艾滋病相关知识和行为学问卷调查,艾滋病相关知识知晓率呈逐年上升趋势,分别为41.70%,65.63%和77.10%;接受过艾滋病相关干预服务的比例逐年有所提高,分别为59.11%,76.20%和79.36%;有过性行为的人群占92.71%,最近1年与小姐发生过性关系的人群占36.36%,最近1年与小姐发生性关系时每次均使用安全套的比例占63.50%,最近1次与小姐发生性关系时使用安全套的比例占79.70%;对1070份血清进行HIV和梅毒检测,HIV检出率分别为0.40%(1/247)、0.48%(2/416)、0.25%(1/407),梅毒检出率分别为1.62%(4/247)、0.24%(1/416)、0%(0/407).结论通过艾滋病相关知识的宣传和行为干预,艾滋病相关知识知晓率和接受过艾滋病相关干预服务的比例均有所提高,但最近1次与商业性性伴发生商业性性行为时安全套的使用率在75.33%-85.71%之间,相对于高危人群其安全套的使用率较低,应继续加强此类人群的高危行为干预,推广使用安全套,提高安全套的可及性,降低艾滋病在此类人群中的传播速度.     

试论聋儿早期教育中的五大关系

聋儿早期教育是全面的素质教育,要遵循儿童教育规律和聋儿语言发展的特点,促进聋儿认知、语言、情感、社交等素质的同步协调发展.为此,必须认识并处理好五大关系,即聋儿与儿童、听力语言训练与早期教育、医学康复与聋儿早期教育、手语与口语、听力语言训练与全语言学习的关系.     

聋儿助听器验配中值得思考的问题

随着数字助听器时代的到来,助听器在听力障碍婴幼儿中得到了广泛应用。我国也出台了有关文件,对婴幼儿助听器选配时的主、客观听力测试,耳模制作．助听器效果评估以及跟踪听力变化的随访制度等,做了明确要求,并强调要科学地进行言语训练。现有的康复机构和少部分医疗机构正在努力做到这一要求。随着耳聋干预措施的实施．耳聋得到早期发现,出生数天后即可被发现,并得到及时的干预,基本做到了早发现、早治疗、早验配、早训练。     

Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice

OBJECTIVE: Selective serotonin reuptake inhibitors (SSRIs) are widely used to treat depression, but the rates, timing, and baseline predictors of remission in "real world" patients are not established. The authors' primary objectives in this study were to evaluate the effectiveness of citalopram, an SSRI, using measurement-based care in actual practice, and to identify predictors of symptom remission in outpatients with major depressive disorder. METHOD: This clinical study included outpatients with major depressive disorder who were treated in 23 psychiatric and 18 primary care "real world" settings. The patients received flexible doses of citalopram prescribed by clinicians for up to 14 weeks. The clinicians were assisted by a clinical research coordinator in the application of measurement-based care, which included the routine measurement of symptoms and side effects at each treatment visit and the use of a treatment manual that described when and how to modify medication doses based on these measures. Remission was defined as an exit score of or=50% in baseline QIDS-SR score. RESULTS: Nearly 80% of the 2,876 outpatients in the analyzed sample had chronic or recurrent major depression; most also had a number of comorbid general medical and psychiatric conditions. The mean exit citalopram dose was 41.8 mg/day. Remission rates were 28% (HAM-D) and 33% (QIDS-SR). The response rate was 47% (QIDS-SR). Patients in primary and psychiatric care settings did not differ in remission or response rates. A substantial portion of participants who achieved either response or remission at study exit did so at or after 8 weeks of treatment. Participants who were Caucasian, female, employed, or had higher levels of education or income had higher HAM-D remission rates; longer index episodes, more concurrent psychiatric disorders (especially anxiety disorders or drug abuse), more general medical disorders, and lower baseline function and quality of life were associated with lower HAM-D remission rates. CONCLUSIONS: The response and remission rates in this highly generalizable sample with substantial axis I and axis III comorbidity closely resemble those seen in 8-week efficacy trials. The systematic use of easily implemented measurement-based care procedures may have assisted in achieving these results.     

Does the clinical outcome of hepatitis C infection vary with the infecting hepatitis C virus type?

Whether differences in the natural history of hepatitis C virus (HCV) can be explained by differences in the infecting HCV type is unknown. The aim of this study was to investigate whether the HCV type might influence the clinical outcome of infection. Study serum samples were assembled from 749 individuals enrolled into the UK HCV National Register from which data on clinical outcomes were extracted. HCV-RNA-positive specimens were genotyped and HCV-RNA-negative specimens serotyped. Logistic regression analysis was used to investigate the independent effect of HCV type on viral clearance by comparing patients who were HCV RNA negative (n = 86) with those who were HCV RNA positive (n = 508). The same method was used to investigate whether HCV type was associated with histological stage of liver disease. The prevalence of HCV type 1 among those who cleared infection was 69% and among those who remained HCV RNA positive was 51%: Type 1 infections were more likely to be HCV RNA negative than non-1 types (OR 0.47, 95% CI 0.29-0.78, P = 0.003). Type 1 infections were also more likely to be associated with histological stage scores above the median when compared with non-1 types (OR 2.03, 95% CI 1.07-3.83, P = 0.03). In conclusion, HCV type 1 infection was more often HCV RNA negative, suggesting that spontaneous clearance may occur more commonly with this type. Among the RNA-positive infections, type 1 infection may be more aggressive than types 2/3.     

EFFECT OF LOSARTAN ON SLOWING PROGRESSION OF CHRONIC ALLOGRAFT NEPHROPATHY

Objective To investigate the effects of losartan, a specific angiotensin Ⅱ receptor blocker, on slowing progression of renal insufficiency in patients with biopsy-proven chronic allograft nephropathy (CAN) and the molecular mechanism of the therapy.Methods Twenty-two renal transplant recipients with biopsy-proven CAN (group A) were treated with losartan within two months after renal dysfunction for at least one year. Losartan was administered at a dose of 50 mg/d. Twenty-four recipients in the same fashion (group B) who never received angiotensin Ⅱ receptor antagonist were studied as control. The investigation time for each patient lasted one year. Renal functions and concentrations of plasma and urine transforming growth factor-beta1 (TGF-beta1) were compared between the two groups at the initiation and end of the study. In group A, expressions of TGF-beta1 mRNA and immunofluorescence intensity of TGF-beta1 protein and pathological alterations in renal biopsy specimens were compared between before losartan therapy and after one year of the therapy.Results At the initiation of the investigation, no significant differences were found between group A and group B in clinical data such as donor age, cold-ischemia time, HLA mismatch, levels of creatinine clearance (Ccr), plasma and urineTGF-beta1 concentrations. One year later, 14 of 22 (63.6%) patients showed stable or improved graft functions in group A,and 4 of 24 (16.7%) in group B. The difference was significant (P＜0.05). At the end of the study, urine TGF-beta1 loss of Ccr was 6.6±5.4 mL/min in group A and 16.2±9.1 mL/min in group B. Both of the differences were significant between the two groups (P＜0.01). No significant differences were found in plasma TGF-beta1 concentrations between the four values determined at the initiation and end of the study in the two groups (F = 2.56, P ＞ 0.05). After one year losartan therapy, group A showed a significant decrease in expressions of TGF-beta1 mRNA and TGF-beta1 protein in renal biopsy specimens [from 1.59±0.35 to 0.96±0.27 and from (10.83 ± 2.33)×106 to (6.41±1.53)×106, respectively; both P＜0.01],but in light microscopy the histological changes were similar to the first renal biopsy. Losartan was excellently tolerated in all patients in group A. No cases with losartan therapy showed too low blood pressure and other side effects.Conclusion This study suggests that losartan have an effect on slowing progression of CAN. Reducing production of intrarenal TGF-betal may play a decisive role in the efficacy of losartan.     

中药复方对抗雷公藤多苷毒性的研究△ Ⅱ.对抗雷公藤多苷对雌性大鼠生殖系统的影响

以瓜蒌、石斛、白芍、川芎、生地、元参、牛膝、五味子、菟丝子、枸杞子、车前子、覆盆子、益母草、泽兰、麦冬、当归组成的中药复方,其水提剂11.27,5.64,2.82 g/kg与雷公藤多苷合用给大鼠ig,3 个剂量均能不同程度地纠正雷公藤多苷所致的大鼠动情周期异常、子宫重量减轻及子宫肌层变薄,光镜下各试验组卵巢均无明显改变。