从药品的特殊属性谈医药企业的服务营销

目的 :探讨我国医药企业在市场竞争日益激烈的现状下的服务营销策略选择。方法 :分析处方药品和非处方药品的服务特性 ,并介绍药品市场营销的新观念———服务营销的发展及应用。结果与结论 :医药企业的服务营销应针对处方药品走服务的差异化、有形化、规范化道路 ;针对非处方药品走服务的标准化、技巧化、品牌化道路。     

河南省1963～2002年百日咳流行动态及控制策略分析

目的掌握河南省40年来百日咳的流行病学特征及其影响因素,为制定免疫策略和预测疫情趋势提供依据。方法对河南省不同免疫阶段的百日咳流行病学特征进行分析。结果河南省40年来共报告百日咳3 065 075例,死亡572例。大致可分4个阶段:1963~1978年,年平均发病率为293.47/10万,死亡43例;1979~1983年,年发病率为87.70/10万~17.78/10万,呈逐年下降趋势,死亡6例;1984~1990年,发病率为1.28/10万~6.73/10万,死亡1例;1990年以后发病率为0.25/10万~1.00/10万,连续10年无死亡病例。表明随着百日咳疫苗接种率的不断提高,不但大大降低了百日咳的发病率和死亡率,也改变了其流行周期。结论目前的免疫策略首先应继续做好儿童常规免疫,其次应加强百日咳疫情管理,提高疫情报告的及时性、准确性。     

2001~2004年合肥市麻疹监测系统数据分析

目的评价合肥市麻疹监测系统数据,为控制和消除麻疹提供依据。方法对2001~2004年合肥市确诊的539例麻疹病例进行流行病学分析,并用ELISA(酶联免疫吸附试验)法检测血清麻疹IgM抗体和风疹IgM抗体。结果2001~2004年平均发病率为3.01/10万,2004年较2001年发病下降了43.6%,发病人群主要为中、小学生,<15岁儿童占总病例数的63.1%。结论应进一步对薄弱地区、薄弱人群进行MV的加强免疫活动,控制麻疹爆发;在有条件的地区对1~14岁儿童开展麻疹-腮腺炎-风疹联合疫苗使用,同时注意<1岁和20岁以上人群发病逐渐增长的趋势。     

太子参品种资源特性的研究

目的:探讨不同太子参品种类型的栽培特性,为实施太子参的GAP生产提供了重要的理论与实践依据。方法:采用道地主产区专题调研法和系统选择法,应用系统分离纯化种源,采用随机区组设计或对比设计,连续3年品比试验及专题研究。结果:太子参大叶型、小叶型、野生型品种间的生物学性状及生产力特性具有极显著差异(P<0.01),生态适应性、植株特征、花粉粒、染色体和同功酶均有显著差别。结论:首次确立了太子参的品种资源类型并进行定名,建立了太子参品种资源分型研究的性状和生产力指标体系。     

波棱瓜子的原植物和显微鉴别研究

目的:为藏药波棱瓜子的药材鉴定提供依据。方法:应用粉末制片、徒手切片和石蜡切片进行研究,找出组织和粉末特征。结果:商品调查表明,波棱瓜子各地用药品种基本一致,但也有用木鳖子、王瓜、西藏赤爬等葫芦科其他属植物种子误作波棱瓜子的情况。结论:通过药材性状、组织、粉末特征能将波棱瓜子、木鳖子、苦瓜子、西藏赤爬种子予以准确区分。     

Evaluation of three risk scores to predict postoperative nausea and vomiting

BACKGROUND: So far there are three different scores to predict postoperative vomiting (PV: Apfel et al., 1998) or postoperative nausea and vomiting (PONV: Koivuranta et al., 1997; Palazzo and Evans, 1993). All three scores used logistic regression analysis to identify and create weights for the risk factors for PV or PONV. In short, these were sex, age, history of previous PONV, motion sickness, duration of anaesthesia, and use of postoperative opioids. However, an external evaluation and a comparison of these scores has not been performed so far. METHODS: Patients undergoing a variety of surgical procedures under general anaesthesia were studied prospectively. Preoperatively, they completed a questionnaire concerning potential risk factors for the occurrence of PV or PONV implemented in the three risk scores. Balanced anaesthesia (induction agent, nondepolarising neuromuscular blocker, opioid, and inhalation agent in nitrous oxide/oxygen) was performed. No intravenous anaesthesia or any antiemetic prophylaxis was applied. Postoperatively, the patients were observed in the recovery room for the occurrence of PV and PONV and were visited twice on the ward within the 24-h observation period. Both the patients and the nursing staff were asked whether PV or PONV was present. The severity of PONV was categorised using a standardised scoring algorithm. A total of 1,444 patients was finally included into the analysis. Using information of the predicted risk for the individual patients and the actual occurrence of PV or PONV, Receiver Operator Characteristics (ROC-curves) were drawn. The area under each ROC-curve was calculated as a means of the predictive properties of each score and was compared for statistical differences. RESULTS: For prediction of PONV (any severity) the AUC-values (AUC=area under the curve) and the corresponding 95%-confidence intervals were: Apfel: 0.70 (0.67-0.72); Koivuranta: 0.71 (0.69-0.73); Palazzo: 0.68 (0.65-0.70). For prediction of PV: Apfel: 0.73 (0.71-0.75); Koivuranta: 0.73 (0.70-0.75); Palazzo: 0.68 (0.65-0.70). Thus, all three scores appeared to have a moderate accuracy as measured by the AUC. The score of Koivuranta predicts PONV (P=0.007) and also PV (P=0.002) significantly better than Palazzo's score. Furthermore, for predicting of PV the score of Apfel was also superior to Palazzo's score (P=0.005). All three scores predict PV with the same accuracy as PONV. CONCLUSION: The occurrence of PV and PONV in patients undergoing surgery under balanced anaesthesia can be predicted with moderate but acceptable accuracy using one of the available risk scores, regardless of local surgical or anaesthesiological circumstances. For clinical practice, we recommend the score published by Koivuranta, since its calculation is very simple.     

家庭环境对4～5岁儿童行为问题的影响

目的探讨家庭环境对4～5岁儿童行为问题的影响,以降低学龄前儿童行为问题的发生率.方法采用问卷调查的方法对600名4～5岁儿童的行为及家庭环境进行调查,应用SPSS软件进行多元回归分析.结果不同家庭精神环境特征对4～5岁儿童行为问题的影响不同,且存在明显的性别差异.影响男性儿童行为问题的家庭特征有亲密度、矛盾性、知识性、组织性和成功性;影响女性儿童的家庭特征有亲密度、矛盾性、知识性、组织性、成功性和娱乐性.结论家庭环境对4～5岁儿童行为发育产生重要影响.在进行学龄前儿童行为问题的诊断和干预时,要重视家庭环境的作用,并要注意性别差异.     

Portfolio Theory and Cost-Effectiveness Analysis: A Further Discussion

OBJECTIVES: Portfolio theory has been suggested as a means to improve the risk-return characteristics of investments in health-care programs through diversification when costs and effects are uncertain. This approach is based on the assumption that the investment proportions are not subject to uncertainty and that the budget can be invested in toto in health-care programs. METHODS: In the present paper we develop an algorithm that accounts for the fact that investment proportions in health-care programs may be uncertain (due to the uncertainty associated with costs) and limited (due to the size of the programs). The initial budget allocation across programs may therefore be revised at the end of the investment period to cover the extra costs of some programs with the leftover budget of other programs in the portfolio. RESULTS: Once the total budget is equivalent to or exceeds the expected costs of the programs in the portfolio, the initial budget allocation policy does not impact the risk-return characteristics of the combined portfolio, i.e., there is no benefit from diversification anymore. CONCLUSION: The applicability of portfolio methods to improve the risk-return characteristics of investments in health care is limited to situations where the available budget is much smaller than the expected costs of the programs to be funded.     

甲型H1N1流感病毒基因组序列分析及其特性研究

Objective To analyse the genome of influenza A (H1N1) vires so as to elucidate its molecular characteristics and evolution status. Methods DNA sequences of the influenza viruses were collected from NCBI, and compared with the genomes of referenced intluenza viruses. The phylogenetic trees were constructed by the neighbor-joining method, and the pathogenicity, drug susceptibility and vaccine protection were analyzed. Results Phyiogenetic analysis showed that the genes encoding HA, PB2, PBI, PA, NP, and NS protein were most closely related to those influenza A viruses circulating in swine populations in North America. NA and M gene belonged to Eurasia lineages swine influenza vires. The amino acid sequence of the cleavage site between HA1 and HA2 was PARSSR ↓ GLFGAI with the typical characteristics of the low pathogenic influenza virus. Influenza A(H1N1) virus can spread from person-to-person. It is sensitive to oseltamivir and zanamivir but resistant to amantadine and remantadine. The current human seasonal influenzavaccines confered little protection against influenza A/H1N1 because of the great diversity on antigenic domains between A/H1N1 virus and vaccine virus. Conclusions Influenza A(H1N1) virus is a reassortant virus of North America and Eurasia hneages swine influenza virus. It is important to develop a vaccine against the currently circulating virus strain to control the disease spread.