Co-located Substance Use Treatment and HIV Prevention and Primary Care Services,New York State, 1990–2002: A Model for Effective Service Delivery to a High-Risk Population

The New York State Department of Health (NYSDOH) AIDS Institute (AI) began an initiative in 1990 in collaboration with the Office of Alcoholism and Substance Abuse Services (OASAS) to colocate HIV prevention and clinical services at drug treatment clinics. In 1990, the initiative began funding drug treatment programs to provide HIV counseling, testing, and prevention services. HIV primary care was added the following year. Program implementation and development are described. An analysis is included of HIV counseling and testing data for the period 1990–2002 and quality of care data for five standardized quality measures with comparisons to data from other clinical settings. In the first 13 years of the initiative 168,340 HIV-antibody tests were conducted including 52,562 tests of injection drug users (IDUs) identifying 14,612 HIV-infected persons; the seroprevalence was 8.68%. By the end of 2000, the HIV primary care caseload peaked at 3,815 patients. Quality of primary medical care services among participating drug treatment programs has consistently matched or exceeded that provided in more conventional health care settings such as the hospitals and community health centers that were used as a basis for comparison. Colocating HIV primary care within substance use treatment is an effective strategy for providing accessible high-quality HIV prevention and primary care services. Rothman is with the Bureau of HIV Ambulatory Care, AIDS Institute, New York State Department of Health, Albany, New York, USA; Rudnick and Slifer are with the Substance Abuse Unit, AIDS Institute, New York, NY, USA; Agins is with the Office of the Medical Director, AIDS Institute, New York, NY, USA; Heiner is with the Karl Heiner Statistical Consulting, Ltd., Schenectady, New York, USA; Birkhead is with the AIDS Institute, Albany, New York, USA.     

The Puerto Rico–New York Airbridge for Drug Users: Description and Relationship to HIV Risk Behaviors

This study examined mobility on the airbridge between New York (NY) and Puerto Rico (PR) for Puerto Rican drug users and its relationship to HIV risk. Over 1,200 Puerto Rican injection drug users (IDUs) and crack smokers were recruited by outreach workers in NY and PR; interview data included questions on mobility (lifetime residences and recent trips). Two-thirds of the NY sample had lived in PR; one-quarter of the PR sample had lived in NY; the most commonly sited reasons for moving were family-related. Fewer than 10% had visited the other location in the prior 3 years. Variables related to risk were number of moves, recent travel, and having used drugs in PR (all with p < 0.05). Implications included the need to enhance risk reduction efforts for IDUs in PR and address sexual risk among mobile drug users.     

眼底血管造影中荧光素钠的注射速度与副反应的分析及对策

目的分析荧光素钠的注射速度与发生副反应的相关性及其对策。方法将荧光素钠眼底血管造影的400例患者按先后时间分成两组，对照组200例按常规速度（3—5s内）静脉注射20％荧光素钠3ml观察组静脉注射速度为（8-10s）。结果观察组较对照组病例副反应的发生明显减少，并对副反应的发生进行了护理干预，两组无一例因荧光素钠的注射速度而影响检查结果。结论对于准备做荧光素钠眼底血管造影的患者，副反应的发生除了与性别、体重、空腹等有关外，延长静脉注射高浓度荧光素钠是降低副反应的主要措施。     

正交试验优选复方苦黄乳膏乳化工艺

目的:优选复方苦黄乳膏的乳化工艺。方法:采用正交试验法,以所制乳膏离心分层后油层的高度为考察指标,对影响乳膏稳定性的主要因素进行优选。结果:最佳工艺为油相硬酯酸∶单硬酯酸甘油酯∶羊毛脂∶液体石蜡∶白凡士林=4∶1∶2∶2∶1,乳化剂用量为4%,亲水疏水平衡值为13,乳化温度为80℃。结论:优选得到的工艺稳定可行,可为工业化生产提供理论依据。     

红花注射液致不良反应文献分析

目的探讨红花注射液致不良反应（ADR）的临床特点。方法检索《中国医院数字图书馆》全文数据库中2000-2006年国内医药学期刊有关红花注射液致ADR的报道，并进行统计、分析。结果有关红花注射液致ADR的报道共涉及患者39例，其中男20例，女19例，年龄50岁以上发生率较高；ADR主要为过敏反应，且过敏性休克发生率较高；ADR在30min内发生者22例（56．41％），首次用药发生者有30例（76．92％），提示红花注射液致ADR以首用即发型和速发型为主。结论临床应重视红花注射液的ADR，合理用药。     

复方荔枝草颗粒体内外抗菌消炎作用研究

目的:研究复方荔枝草颗粒的抗菌消炎作用。方法:采用体内和体外抗菌、二甲苯致小鼠耳肿胀及二甲苯致小鼠腹部毛细血管通透性实验,研究复方荔枝草颗粒的抗菌消炎作用。结果:复方荔枝草颗粒在体外对金黄色葡萄球菌、绿脓杆菌、大肠杆菌及变形杆菌有不同程度的抑制作用;能够显著降低变形杆菌感染小鼠的死亡率,但对大肠杆菌感染小鼠的死亡率没有显著作用;能显著抑制二甲苯所致小鼠耳肿胀和小鼠腹部毛细血管通透性增加。结论:复方荔枝草颗粒体内、外均具有良好的抗菌消炎作用。     

31批复方甘草口服溶液的质量考察

目的:考察31批不同厂家复方甘草口服溶液的内在质量。方法:采用高效液相色谱法测定复方甘草口服溶液中吗啡和愈创甘油醚的含量,并检测溶液的pH值。结果:31批复方甘草口服溶液中有13批的吗啡含量不合格,1批愈创甘油醚含量不合格,1批pH值不合格。结论:有关厂家应严格按照《中国药典》相关规定控制产品的内在质量,以保证临床用药安全、有效。     

参附注射液治疗急性胰腺炎临床探讨

目的观察参附注射液在急性胰腺炎治疗中的作用。方法将86例轻症急性胰腺炎患者随机分为治疗组与对照组各43例,对照组采用常规治疗方案,治疗组则在此方案基础上加用参附注射液40ml静滴,每日1次,连用5～10d;比较两组症状体征及胃肠功能恢复情况及住院时间。结果治疗组多项观察指标的恢复明显优于对照组,平均住院日明显缩短。结论参附注射液可能通过改善胰腺微循环,促进胰腺组织的修复,促进胃肠蠕动功能,减轻各种炎性介质和细胞因子对胰外器官的损害,从而快速改善患者的病情,减少并发症的发生,缩短住院时间。     

动态浊度法测定双黄连注射液细菌内毒素含量

目的：建立双黄连注射液细菌内毒素定量测定方法，控制药品质量。方法：采用动态浊度法，对双黄连注射液进行定量干扰实验检测。结果：双黄连注射液稀释5倍和10倍时有干扰作用。而稀释20倍和40倍时则无干扰作用。结论：用动态浊度法定量测定双黄连注射液的细菌内毒素是可行的。     

复方黄毛豆腐柴搽剂免疫增强的实验研究

目的观察复方黄毛豆腐柴搽剂免疫增强作用。方法采用单核巨噬细胞吞噬试验方法,复方黄毛豆腐柴搽剂以2.25 g生药/ml和0.75 g生药/ml剂量分别给小鼠连续腹部涂药5 d。结果复方黄毛豆腐柴搽剂大、小剂量组均能明显提高单核巨噬细胞吞噬指数K值,分别与阴性对照组比较均有统计学意义,P<0.05。结论复方黄毛豆腐柴搽剂具有显著的免疫增强作用。