重组人凝血因子Ⅷ在中国人血友病A患者中的安全性和有效性探讨

目的:探讨第2代基因重组抗血友病因子(Kogenate FS)在中国人血友病A患者中使用的安全性和有效性。方法:应用Kogenate FS治疗16例血友病A志愿者患者,用药前后分别进行FⅧ抗体、FⅧ促凝活性(FⅧ∶C)测定。结果:采用Kogenate FS治疗的16例血友病A志愿者患者中,好转15例(占93.75%),改善1例(占6.25%)。只有1例发生可逆的不良反应。结论:Kogenate FS治疗中国人血友病A患者耐受性好,安全、有效。     

南京市影响孕前妇女血铅水平的因素

目的了解南京地区影响计划妊娠妇女血铅的因素。方法在南京市妇幼保健院孕前门诊随机选择前来进行健康体检的孕前高血铅妇女100例、正常血铅的妇女104例,取指血用石墨炉原子吸收光谱法测定血铅水平,同时用问卷法分别了解其居住环境、生活习惯及饮食习惯等。结果高血铅孕前妇女常食用皮蛋、食用贝壳类食品、边看报纸边吃食物、烹调用油量≥750g／月、常食用彩色包装食物或居住于化工厂或炼油厂的周围。多因素分析结果显示,经常食用贝壳类食品（OR 2．37）,边看报纸边吃食物（OR 2．09）,烹调用油过多（OR 2．48）,居住于化工厂或炼油厂附近（OR 29．8）为孕前妇女发生高血铅的最主要因素。结论常食用贝壳类食品,边看报纸边吃食物,烹调用油过多,居住于化工厂或炼油厂附近是南京市孕前妇女高血铅的危险因素。     

苁蓉总苷胶囊治疗痴呆的神经精神症状的随机对照双盲临床试验

目的评估苁蓉总苷胶囊对伴有神经精神症状的轻到中度痴呆的影响。方法采取双盲的方式,人组了400例50岁或以上的阿尔茨海默病（AD）或血管性痴呆（VaD）患者,随机给予苁蓉总苷胶囊或安慰剂,疗程22周。结果SKT测试中苁蓉总苷胶囊治疗组平均提高．3．2分,安慰剂组病情加重平均＋1．3分（P〈0．01,双向,ANOVA）。苁蓉总苷胶囊在所有次要测试结果中显示均显著优于安慰剂,包括NPI和日常生活活动量表的测试。结论试验数据和进一步的证据显示苁蓉总苷胶囊在治疗痴呆的认知和非认知症状方面疗效好、安全性高。     

食管癌放化疗治疗对淋巴细胞黏附分子表达的作用及临床意义

目的：探讨放化疗治疗对食管癌患者外周血淋巴细胞CD44V6、CD54表达的作用及临床意义。方法：采用流式细胞术对食管癌及正常成人外周血淋巴细胞CD44V6、CD54的表达水平进行检测,并比较不同病理类型、分期及放化疗前后淋巴细胞黏附分子表达水平的变化。结果：食管癌患者外周血CD44V6、CD54的表达水平显著高于正常对照组（P〈0．01）,其表达水平与肿瘤病理类型和临床分期密切相关,放化疗后患者的黏附分子表达水平明显下降。结论：食管癌患者外周血淋巴细胞CD44V6、CD54的高表达与肿瘤分期及转移密切相关,经治疗后其表达水平明显下降．检测其表达的动态变化可以为评估肿瘤发展及疗效判断提供依据。     

Safety,pharmacokinetics and pharmacodynamics of single/multiple doses of the oral,direct Factor Xa inhibitor rivaroxaban in healthy Chinese subjects

AIMS

To investigate the safety, pharmacokinetics and pharmacodynamics of rivaroxaban, an oral, direct Factor Xa (FXa) inhibitor, in healthy, male Chinese subjects.

METHODS

Two randomized, single-blind, placebo-controlled, dose-escalation studies were conducted in healthy Chinese men aged 18–45 years. In the single-dose study, subjects received single, oral doses of rivaroxaban 2.5, 5, 10, 20 and 40 mg. In the multiple-dose study, oral rivaroxaban was administered in doses of 5, 10, 20 and 30 mg twice daily for 6 days.

RESULTS

Rivaroxaban, in single and multiple doses up to 60 mg, was well tolerated. Rapid absorption was observed in both studies (time to C_max 1.25–2.5 h). In the multiple-dose study, rivaroxaban exposure increased dose-proportionally after the first dose and at steady state (for the 5–20-mg doses). The half-life of rivaroxaban was up to 7.9 h in the single-dose study. Maximal inhibition of FXa activity was achieved within 1–3 h of dosing in the single-dose study [at 20 mg FXa inhibition as a median percentage change from baseline, 45.92; 95% confidence interval (CI) 44.64, 50.70] and 2–3 h after administration at steady state in the multiple-dose study (at 20 mg median FXa inhibition as a median percentage change from baseline, 60.25; 95% CI 56.16, 63.05), in line with maximum rivaroxaban plasma concentrations.

CONCLUSIONS

Rivaroxaban demonstrated predictable pharmacokinetics and pharmacodynamics in healthy Chinese subjects, in line with findings observed previously in White subjects. This suggests that fixed doses of rivaroxaban may be administered to all patients, regardless of their ethnic origin.     

乡村医生报酬水平及影响因素分析

目的了解新农合乡村医生报酬水平,为制订合理的补偿方案提供参考。方法采用流行病学现场研究方法进行调查。结果昆明市乡村医生的平均补偿水平较低,仅为120．0元／月。累积比数模型分析表明,影响乡村医生报酬的因素有文化程度、累计工作年限、职称、开展医疗活动的地点、卫生服务活动的区域和从事计划免疫的天数。结论目前,昆明市新农合乡村医生卫生服务工作报酬水平较低。相关部门应适当提高报酬水平,并不断调整和完善补偿方案。     

某县参合农民对新农合监督的影响因素分析

目的了解新农合参合农民的监督情况,寻找影响参合农民监督力度的因素,为完善新农合监督机制提供科学依据。方法采用流行病学现场研究方法进行调查。结果参合农民的监督力度与监督意识、文化程度、合管办是否设立投诉电话等成正相关。结论相关部门应加强对参合农民的宣传教育,提高参合农民的监督意识,并提供切实有效的监督途径,让参合农民能有效实行监督。