医疗行业志愿者服务模式探讨

从国内外医疗机构志愿服务发展现状,以及基层医疗机构开展志愿服务活动的实际情况出发,认为社会认同度不高、管理体制不顺、组织能力不强、服务质量不高以及法制建设滞后是影响我国医疗机构志愿服务发展的主要问题,提出建立志愿服务动员、激励机制,提高志愿服务组织能力,拓展志愿服务领域,提高志愿者服务能力,完善志愿者服务相关法律,促进医疗机构志愿服务进一步发展。     

Azithromycin modulates neutrophil function and circulating inflammatory mediators in healthy human subjects

Effects on human neutrophils and circulating inflammatory mediators were studied in 12 volunteers who received azithromycin (500 mg/day, p.o.) for 3 days. Blood was taken 1 h before treatment, 2.5, 24 h and 28 days after the last dose. An initial neutrophil degranulating effect of azithromycin was reflected in rapid decreases in azurophilic granule enzyme activities in cells and corresponding increases in serum. The oxidative response to a particulate stimulus was also acutely enhanced. These actions were associated with high plasma and neutrophil drug concentrations. A continuous fall in chemokine and interleukin-6 serum concentrations, within the non-pathological range, accompanied a delayed down-regulation of the oxidative burst and an increase in apoptosis of neutrophils up to 28 days after the last azithromycin dose. Neutrophils isolated from blood at this time point still contained detectable drug concentrations. Acute neutrophil stimulation could facilitate antibacterial effects of azithromycin, while delayed, potentially anti-inflammatory activity may curtail deleterious inflammation.     

对健康成人志愿者进行临床试验的药物安全起始剂量估计

推荐一种确定在健康成人志愿者进行新药临床试验的最大推荐起始剂量(MRSD)的方法.将相关动物研究得到的不良反应未明显增加的最高剂量(NOAEL)用标准系数换算成人等效剂量(HED),根据科学判断,从最合适动物得到的HED除以安全系数(SF)得到MRSD.这种计算方法可用于已做动物研究的新药或新的生物制剂确定MRSD,但不包括预防性疫苗和用生理浓度的内生蛋白.     

Pharmacokinetics of metadoxine for injection after repeated doses in healthy volunteers

Alcohol-induced liver disease is one of the main epidemic problems nowadays. Metadoxine is a pyridoxine-pyrrolidone carboxylate with significant scavenging property. Metadoxine is able to accelerate the elimination of alcohol from the blood and tissues, help restore the functional structure of the liver and relieve neuro-psychological disorders associated with alcohol intoxication.1-3 The purpose of the study was to assay the pharmacokinetics of domestic metadoxine after repeated doses.     

TRAINING ALLIES TO REDUCE VARIANCE IN A NURSING HOME STUDY: A COMMUNICATION INTERVENTION

Communication training was undertaken within a study the prime purpose of which is to determine the influence of light levels on rhythms and patterns of wandering behavior in a nursing home sample of cognitively impaired individuals. The purpose of this training was to control variance in the social environment of an experimental lounge since it is posited that a number of environmental influences may impact wandering. Heron six-category intervention analysis (Heron, 1976) was used to interpret the existing social environment and inform ally training. This article outlines ally training methods, introduces training implementation issues and evaluates training outcomes.     

空巢老人舒缓照护志愿服务对本科护生临终关怀及死亡态度的影响

目的评价空巢老人舒缓照护志愿服务对本科护生临终关怀及死亡态度的影响。方法将2014级本科176名护生随机分为两组,每组88名。对照组开展临终关怀课程,观察组在对照组的基础上开展空巢老人舒缓照护志愿服务。干预前后,采用临终关怀态度量表、死亡态度描绘量表评估护生临终关怀及死亡态度。结果干预后,观察组临终关怀态度量表得分显著高于对照组,死亡态度描绘量表中死亡恐惧、死亡逃避、逃离接受维度得分显著低于对照组,而自然接受及趋近接受维度得分显著高于对照组(均P0.01)。结论开展空巢老人舒缓照护志愿服务有利于改善护生临终关怀照护态度及对待死亡的态度,为日后从事临终关怀工作做好准备。     

献血人群HCV感染者自然转归与HLA－Ⅱ类等位基因的关系

目的：了解广州献血人群中丙型肝炎病毒（ HCV）感染者自然转归与HLA多态性的相关性,为HCV治疗策略的制定、预后的评估及疫苗的研制提供科学依据。方法选取广州献血人群中373例HCV感染者,分为两组：自发清除组（133例）和慢性感染者（240例）,利用HLA－SBT方法对373份感染者进行HLA－Ⅱ类等位基因分型,用χ2检验分析每个HLA等位基因频率在自发清除组和慢性感染组的分布是否存在差异,并应用多因素Logistic回归对可能影响HCV自然转归的多种因素进行分析。结果自发清除组与慢性感染组相比年龄较小[（28．2±9．9）岁vs（31．3±9．0）岁,t＝－2．998,P＝0．003],HCV自发清除组女性比例较高（34．6％ vs 17．9％,χ2＝13．090,P＜0．01）。 DQB1*05：02（P＝0．002,OR＝0．411,95％CI＝0．232～0．727）和DRB1*14：54（P＝0．027, OR＝0．350,95％CI＝0．132～0．926）在慢性感染组中更为多见,DRB1*11：01在自发清除组较为常见（ P＝0．007, OR＝2．169,95％CI＝1．223～3．848）。多因素logistic回归分析发现,年龄（ P＜0．01,OR＝1．035,95％CI＝1．018～1．053）、性别（P＜0．01,OR＝0．423,95％CI＝0．297～0．603）和DQB1*05：02（P＝0．016,OR＝0．480,95％CI＝0．264～0．873）、DRB1*11：01（P＝0．016,OR＝2．072,95％CI＝1．142～3．758）等位基因是HCV感染自然转归的独立相关因素。结论女性、较年轻的HCV感染者比较容易发生自发清除,携带DQB1*05：02等位基因的人群在感染HCV后更易发生慢性化,携带DRB1*11：01基因则容易发生自发清除。     

全国肿瘤医院患者服务中心模式的探索与推广

针对肿瘤患者及家属的特点,成立肿瘤医院患者服务中心,组建志愿者团队,在就诊的各环节开展医疗专业及志愿服务.用专业知识和爱心奉献为患者提供医院医疗诊治外的服务,帮助人们科学有效就诊、正确认识肿瘤、树立信心、提高生活质量,推动肿瘤疾病由“单一治疗”转向“全人关怀”.随着对患者服务中心项目的探索和研究,以点带面,可以进一步构建出全国肿瘤医院患者服务中心网络,使更多的患者及家属受益,具有重要推广意义.