人口导入居民和原住地居民的公共卫生需求调查分析

目的：了解不同类型社区居民对预防保健的需求情况及影响因素,以指导社区卫生人员有针对性地开展工作。方法：上海市顾村镇菊泉新城社区30岁以上的迁入居民和原住地居民公共卫生服务需求的现况调查。结果：共计调查居民1790人,其中迁入居民884人,原住地居民906人;两类居民中,接受公共卫生服务的比例以原住地居民较高,为95．91％,服务内容主要是测血压和建立健康档案。新城区迁入居民有47．23％和原住地居民有39．33％认为需要公共卫生服务,其中最需要的分别是健康体检和健康指导。而原住地居民对公共卫生服务“都不需要”的比例较高,达60．66％,在“都不需要”者中,主要是认为“目前很健康”。对体检支付比例的看法是大部分居民表示不愿意自己支付,小部分居民只愿意支付10％。结论：迁入居民对公共卫生的需求较高,而原住地居民的公共卫生服务则有待提高,该辖区存在着较大的公共卫生服务需求空间。可根据实际情况开展健康体检,结合健康教育工作,提高居民的健康知识水平,特别是预防保健方面的知识。     

“邪毒传舍”理论与转移性卵巢癌

目前,转移性卵巢癌的发病率逐年上升,因此,探讨其病因病机以指导临床治疗意义重大。而文章则在经络理论、疾病传变的基础上运用“邪毒传舍”理论分析了转移性卵巢癌的发病机制。     

肥胖糖尿病病人注射胰岛素针皮下停留时间的研究

摘要:目的:探讨肥胖糖尿病病人皮下注射胰岛素针停留时间.方法:根据每日皮下注射胰岛素剂量的不同分为30单位以下、30 ～40单位(不含40单位)和40～60单位三个组,每个组再分为传统方法(6s)、9 s、11 s和13 s四个小组,分别计算注射80次后进行分析.结果:三个组均显示针停留时间在11s和13 s时,针眼药...     

Age at menarche and place of residence (Marrakesh,Morocco)

Purpose

The aim of the study was to determine the age at menarche of Moroccan girls by place of residence (rural vs. urban).

Stunting and Anemia in Children from Urban Poor Environments in 28 Low and Middle-income Countries: A Meta-analysis of Demographic and Health Survey Data

Child malnutrition remains a global concern with implications not only for children’s health and cognitive function, but also for countries’ economic growth. Recent reports suggest that global nutrition targets will not be met by 2025. Large gaps are evident between and within countries. One of the largest disparities in child malnutrition within counties is between urban and rural children. Large disparities also exist in urban areas that have higher rates of child malnutrition in the urban poor areas or slums. This paper examines stunting and anemia related to an urban poverty measure in children under age 5 in 28 low and middle-income countries with Demographic and Health Survey data. We used the United Nations Human Settlements Programme (UN-HABITAT) definition to define urban poor areas as a proxy for slums. The results show that in several countries, children had a higher risk of stunting and anemia in urban poor areas compared to children in urban non-poor areas. In some countries, this risk was similar to the risk between the rural and urban non-poor. Tests of heterogeneity showed that these results were not homogeneous across countries. These results help to identify areas of greater disadvantage and the required interventions for stunting and anemia.     

Immunogenicity of immunoliposomes

Multilamellar immunoliposomes were prepared from dipalmitoylphosphatidylcholine (DPPC), cholesterol (CH), sphingomyelin (SPH) and biotinylated dipalmitoylphosphatidylethanolamine (PEB) in the molar ratio of 1:1:1:0.1 with surface linked avidin-biotinylated sheep (anti-mouse IgG) IgG (AV-sIgG_B) or GK1.5 monoclonal rat (anti-mouse L3T4 antigen) IgG (AV-GK1.5_B). The ability of these immunoliposomes to induce antibody responses against AV, sIgG or GK1.5 was determined. GK1.5_B and sIgG_B elicited a low-level antibody response (5–10 μg/ml serum) after i.v. immunization and boosting. Liposomes (1 μmol) containing GK1.5_B or sIgG_B were more effective than free GK1.5_B or sIgG_B in eliciting antibodies (20–30 and 100–120 μg/ml serum, respectively). Liposomal AV mixed with either sIgG or GK1.5 gave antibody levels comparable to immunization with free GK1.5_B or sIgG_B. Liposomes with surface AV-sIgG_B or AV-GK1.5_B elicited antibodies against AV and high levels against GK1.5 or sIgG. Immunoliposomes possessing surface AV-sIgG_B or AV-GK1.5_B were eliminated from the circulation of normal mice relatively slowly (T_1/2 15.5 and 30 min): in contrast, liposomal AV-sIgG_B or AV-GK1.5_B was rapidly eliminated from the circulation of immunized mice (T_1/2 4.5 and 4.0 min). These results demonstrate that liposomes with surface IgG (immunoliposomes) are immunogenic, and that repeated administration elicits anti-IgG antibodies that result in a significant reduction in blood circulation residence times.     

Involvement of intestinal efflux and metabolic instability in the pharmacokinetics of platycodin D in rats

We aimed to investigate the underlying mechanisms for low bioavailability of Platycodin D (PD) in rats. The bioavailability of PD was 1.89% with different half-lives depending on the administration route (2.14 ± 0.18 h for intravenous injection vs 5.42 ± 1.9 h for oral administration). The mean absorption time was 6.3 h calculated from the mean residence time of both administration routes. Consistent with these parameters, rat intestinal permeability using 3 different intestinal segments showed a low but greatest permeability in lower ileum (0.05 × 10⁻⁶ cm/s in jejunum and upper ileum vs 0.13 × 10⁻⁶ cm/s in lower ileum). The involvement of efflux system, probably Mrps, in upper ileum, could be explained from the efflux ratio of 6.4 and reduced efflux ratio by an Mrp inhibitor, MK571. The recovery of unchanged PD after the intravenous and oral administration was 50% and 5.2%, respectively, suggesting the contribution of gastrointestinal metabolism. In the gastrointestinal content, 4 metabolites of PD were identified: acetylated PD (m/z 1265.6), deglucose PD (m/z 1061.5), deapiose PD (m/z 1091.5), and deapiose-dexylose-derhamnose PD (m/z 813.4). In conclusion, the intestinal first-pass effect such as the presence of efflux functions in the upper ileum, limited but steady intestinal permeability, and gastrointestinal metabolism could explain the low bioavailability and prolonged absorption time of orally administered PD.     

Pharmacokinetics of Ethionamide Delivered in Spray-Dried Microparticles to the Lungs of Guinea Pigs

The use of ethionamide (ETH) in treating multidrug-resistant tuberculosis is limited by severe side effects. ETH disposition after pulmonary administration in spray-dried particles might minimize systemic exposure and side effects. To explore this hypothesis, spray-dried ETH particles were optimized for performance in a dry powder aerosol generator and exposure chamber. ETH particles were administered by the intravenous (IV), oral, or pulmonary routes to guinea pigs. ETH appearance in plasma, bronchoalveolar lavage, and lung tissues was measured and subjected to noncompartmental pharmacokinetic analysis. Dry powder aerosol generator dispersion of 20% ETH particles gave the highest dose at the exposure chamber ports and fine particle fraction of 72.3%. Pulmonary ETH was absorbed more rapidly and to a greater extent than orally administered drug. At T_max, ETH concentrations were significantly higher in plasma than lungs from IV dosing, whereas insufflation lung concentrations were 5-fold higher than in plasma. AUC_(0-t) (area under the curve) and apparent total body clearance (CL) were similar after IV administration and insufflation. AUC_(0-t) after oral administration was 6- to 7-fold smaller and CL was 6-fold faster. Notably, ETH bioavailability after pulmonary administration was significantly higher (85%) than after oral administration (17%). These results suggest that pulmonary ETH delivery would potentially enhance efficacy for tuberculosis treatment given the high lung concentrations and bioavailability.     

In vivo retention of poloxamer-based in situ hydrogels for vaginal application in mouse and rat models

The purpose of this study is to evaluate the in vivo retention capabilities of poloxamer-based in situ hydrogels for vaginal application with nonoxinol-9 as the model drug. Two in situ hydrogel formulations, which contained 18% poloxamer 407 plus 1% poloxamer 188 (GEL1, relative hydrophobic) or 6% poloxamer 188 (GEL2, relative hydrophilic), were compared with respect to the rheological properties, in vitro hydrogel erosion and drug release. The vaginal retention capabilities of these hydrogel formulations were further determined in two small animal models, including drug quantitation of vaginal rinsing fluid in mice and isotope tracing with ^99mTc in rats. The two formulations exhibited similar phase transition temperatures ranging from 27 to 32 °C. Increasing the content of poloxamer 188 resulted in higher rheological moduli under body temperature, but slightly accelerated hydrogel erosion and drug release. When compared in vivo, GEL1 was eliminated significantly slower in rat vagina than GEL2, while the vaginal retention of these two hydrogel formulations behaved similarly in mice. In conclusion, increases in the hydrophilic content of formulations led to faster hydrogel erosion, drug release and intravaginal elimination. Rats appear to be a better animal model than mice to evaluate the in situ hydrogel for vaginal application.     

Acute Abortive Therapies for Seizure Clusters in Long-Term Care

ObjectivesTo describe acute seizure treatment for the long-term care setting, emphasizing rescue (acute abortive) medications for on-site management of acute unexpected seizures and seizure clusters.DesignNarrative review.Setting and ParticipantsPeople with seizures in long-term care, including group residences.MethodsPubMed was searched using keywords that pertained to rescue medications, seizure emergencies/epilepsy, seizure action plans, and long-term care.ResultsSeizure disorder, including epilepsy, is prevalent in long-term care residences, and rescue medications can be used for on-site treatment. Diazepam rectal gel, intranasal midazolam, and diazepam nasal spray are US Food and Drug Administration (FDA)–approved seizure-cluster rescue medications, and intravenous diazepam and lorazepam are approved for status epilepticus. Benzodiazepines differ by formulation, route of administration, absorption, and metabolism. Intranasal formulations are easy and ideal for public use and when rectal treatment is challenging (eg, wheelchair). Intranasal, intrabuccal, and rectal formulations do not require specialized training to administer and are easier for staff at all levels of training compared with intravenous treatment. Off-label rescue medications may have anecdotal support; however, potential disadvantages include variable absorption and onset of action as well as potential risks to patients and caregivers or care partners. Delivery of intravenous-administered rescue medications is delayed by the time needed to set up and deliver the medication and is subject to dosing errors. Seizure action plans that include management of acute seizures can optimize the quality and timing of treatment, which may reduce emergency service needs and prevent progression to status epilepticus.Conclusions and ImplicationsSeizure disorder is prevalent across all ages but is increased in older adults and in those with intellectual and developmental disabilities. Prompt intervention may reduce negative outcomes associated with acute unexpected seizures and seizure clusters. Seizure action plans that include acute seizures can improve the treatment response by detailing the necessary information for staff to provide immediate treatment.