丙型肝炎病毒标志物测定的临床应用

目的 :探讨丙型肝炎病毒 (HCV)感染者血清及初乳中该病毒标志物存在状况。　方法 :对 2 44份 HCV感染者、33份对照血清和 35份 HCV特异性 Ig G抗体阳性的产妇、41份健康产妇的初乳进行 HCV四种标志物测定。抗HCV- Ig G、Ig M和 GOR抗体采用间接 EL ISA法 ,HCV C33抗原采用双抗体夹心 EL ISA法。　结果 :抗 HCV- Ig G、抗 HCV- Ig M、HCV C33和抗 GOR抗体四种标志物在慢性活动性丙型肝炎组检出率最高 ,分别为 10 0 .0 %、85 .7%、46 .4%和 6 4.3% ;急性输血后丙型肝炎组检出率为 6 6 .7%、10 0 .0 %、2 2 .9%和 42 .9% ;慢性稳定性丙型肝炎组为 94.1%、2 6 .5 %、17.6 %和 5 2 .9% ;血透患者组为 6 2 .6 %、31.3%、4.8%和 45 .6 %。血清抗 HCV Ig G阳性组初乳为 17.1%、2 .9%、8.5 %和 37.1%。血清和初乳对照组除 1例献血员血清抗 HCV- Ig G阳性外 ,其余均为阴性结果。　结论 :除抗 HCV- Ig G外 ,抗 HCV- Ig M、HCV C33和 GOR抗体三种标志物在 HCV感染的相关疾病组中 ,有一定的阳性检出率 ,均可作为 HCV感染的标志 ,可用于 HCV感染后的实验室诊断。     

国人牙直丝托槽定位值的测量研究

为建立适合国人牙直丝托槽定位值,选择符合Ａｎｄｒｅｗ ｓ 正常牙合成年人６０ 例,男女各３０ 例,１８～２１ 岁,平均１９．２ 岁,均具有协调的面部比例,未接受正畸治疗。弓丝平面定义为大多数牙临床牙冠中点所在的平面,用游标卡尺测量每一牙齿切缘（或牙合缘）,至弓丝平面的距离,为直丝托槽应就位的位置。结果显示,托槽并非全部位于每个牙的临床牙冠中点,在上颌双尖牙区,托槽位于临床牙冠中点龈方０．５ｍ ｍ 处,第二磨牙托槽位于临床牙冠中点偏牙合方０．５ｍ ｍ ～１．０ｍ ｍ 处,在下颌尖牙及第一、二磨牙处,托槽位于临床牙冠中点偏牙合方０．５ｍ ｍ 处。表明本研究建立的托槽定位值适合于国人,且可明显提高直丝托槽垂直置入精确度     

Using data from studies of health-related quality of life to describe clinical issues Examples from a longitudinal study of patients with advanced stages of cervical cancer

The focus of the paper is to describe how to present data from studies on health-related quality of life (H-QoL) in a way that is simple and clinically relevant. Data from a longitudinal study of patients with advanced stages of cervix cancer are used. One hundred and eighteen patients filled out questionnaires (including EORTC QLQ-C30) 7 times over a period of 2 years. The following issues are considered: (1) The use of a panel for an initial overview of data. (2) The visual difference between using mean and median values. (3) Box-whisker plots to illustrate the variability of the data. (4) The effect of combining categorical data into fewer categories. (5) Individual patient profiles showing the wide variability among patients. (6) A table showing the change of scores over a one-year period. (7) “Prognostic plots” dividing the initial scores and the following scores. (8) Plotting changes over time. (9) Illustration of the impact of non-random drop-out. (10) The effect of drop-out for the patients who fill out two sequential assessments. (11) The use of healthy controls to help answer the question “what is normal?”.     

Seizures and civilian head injuries

Although several studies have reported on the risk of "early seizures" (seizures occurring within 7 days following a head injury), the reported proportions of patients experiencing these seizures vary from 1.4 to 15%. This wide divergence may be due to problems with methodology such as case selection and definitions of head injury and early seizures. In a series of 702 patients admitted with a head injury to Cook County Hospital (CCH), Chicago, Illinois, 29 (4.1%) had early seizures. This proportion is twice as high as one previously reported in a comparable series. This may reflect an actual difference between the two series or a case selection bias serving to elevate the proportion of patients with early seizures at CCH.     

Risk assessment in clinical pharmacy

Medication error forms a major proportion of the errors in the medical system. Despite many studies of adverse drug events, there are no systematic ways of ensuring safety, or of assessing how safe a pharmaceutical system is. Risk assessment is required in hazardous industries such as nuclear power or oil and gas. Risk assessments involve identifying the defences and assessing their effectiveness and are relatively uncommon in clinical pharmacy , as opposed to reactive approaches involving incident analyses. Risk factors, that degrade barriers, can be identified and their effect measured. A risk assessment structure for pharmacy processes is proposed that can also be used to support incident investigation and analysis processes and provide a standard for audit.     

Applying health technology assessment to pharmaceutical care: pitfalls and future directions

It has been argued in previous issues of this journal that health technology assessment can be used as a tool to assess the efficiency of pharmaceutical care by linking its impact on clinical and humanistic outcomes to the resources required to achieve these outcomes. Additionally, as policy-makers appreciate the need to evaluate projects on the basis of their costs and benefits, the application of health technology assessment to pharmaceutical care may serve as a way of communicating with policy-makers and informing policy on pharmaceutical care.This article elaborates on this idea by arguing that policy-makers will be more likely to appreciate the value of pharmaceutical care if researchers pay more attention to some methodological principles underlying health technology assessment in the context of pharmaceutical care, and if they take into account the decision-making context facing policy-makers. In order to raise the methodological quality of studies, researchers need to take care to define better the pharmaceutical care intervention; to evaluate the costs of the intervention and its impact on the utilization of other health services; and to aggregate the various clinical and humanistic outcome measures that are commonly used in this type of research. In order to increase the usefulness of study findings to policy-makers, researchers need to identify the multiple objectives that policy-makers pursue, and show how study findings will aid policy-makers in attaining these objectives.     

挖掘中医证候结构的方法学研究

从研究中医证候的发生规律入手,发现了中医证候内蕴的拓扑结构,形成了挖掘中医证候结构的拓扑学方法。这一方法学的优势体现在,可以实现中医证候信息完整保留基础上的分析运算,使证候结构拓扑分析结果的自然性与病机演变规律相吻合。运用拓扑学的方法,可以破解出中医证候的复杂结构,阐释中医证候判定标准的科学内涵,建立中医证候的判定诊断标准,形成"四特征五阶段"新辨证方法,并为探索中医证候的生物学基础提供理论依据;可以阐释中医理法方药精准对应的规律,建立中医辨证论治过程的可视化系统,形成辨证论治水平的评价体系;可以还原中医诊疗原型的基本结构,阐释中医诊疗原型系统,建立中医临床疗效评价体系。随着中医证候复杂结构的破解和释译,找到了中医证候理论的数学科学基础,使中医证候理论与现代科学有了对话与交流的结合点,有希望开启中医理论发展与临床实践的新时代。     

中医自我发展的哲学研究初探

中医与西医各有自身的思想轨道,所以在各自"自我"的视角上指责对方不可取;双方在哲学基础、身体观和方法论上自成体系,以现代西医理论解释中医只会使中医丧失了自我解释的能力。中西医两者沟通的渠道是实践的效果而非理论的解释。唯有保持自己的理论解释系统,中医的发展才有可能。     

磷酸氯喹片微生物限度检查方法适用性研究

目的:建立磷酸氯喹片微生物限度的限度检查方法.方法:按照《中国药典》2015年版通则1105、1106和1107,采用平皿法及培养基稀释法建立磷酸氯喹片的微生限度检查方法.结果:对4个厂家7批产品行常规平皿法检查,B、D厂家3次试验各菌株的回收均在0.5～2范围内;而A、C厂家检查,不能消除本品对铜绿假单胞菌或枯草芽孢...     

创新中药研制的关注要点

基于现代科学技术及理念的创新中药研究并没有脱离传统天然药物研究思路,在继承与创新中 医药理论体系中,基本没有继承,创新又不足,使创新中药新药研究陷入一种尴尬境地。我们在总结“十一五”、 “十二五”课题经验的同时,结合即将开展的“十三五”组分中药的研发思路,分析了影响中药新药现代化研究的 3个问题并提出了解决的方法：①高水平候选处方的科学筛选始终是中药新药研制的瓶颈,是中药现代化的基 本前提;②大力开展中药转化医学研究,制定科学、合理的中药转化模式是推动中药现代化的重要出路和举措; ③从组分中药剂型发展和改革的角度,需要遵循传统中医基础理论,综合考虑组分中药成药性的特点,给组分 中药剂型的筛选和研发奠定基础。