中国贫困医疗救助模式的制度缺陷及其改进思路

讨论现行国内医疗救助模式的基本经验与存在的缺陷。现行国内医疗救助模式无论在制度设计还是具体实施中部存在许多缺陷，如在制度设计方面，救助标准与水平总体上都比较低，大病痛种的规定大大限制和缩小了贫困医疗救助的范围，而定点医院限制了救助对象选择的空间等。     

STANDARD IMAGING TECHNIQUES OF ENDOSCOPIC ULTRASOUND‐GUIDED FINE‐NEEDLE ASPIRATION USING A CURVED LINEAR ARRAY ECHOENDOSCOPE

Standard imaging techniques using a curved linear array echoendocope are summarized to facilitate the attainment of expertise in endoscopic ultrasonography and endoscopic ultrasound‐guided fine needle aspiration, and to promote the widespread use of this diagnostic and therapeutic tool. Typical images of the mediastinal organs, the bilio‐pancreatic systems and neighboring organs by scanning from the esophagus, stomach, duodenal bulb, and descending portion of the duodenum, are shown in a sequential manner. The basic techniques of endoscopic ultrasound‐guided fine needle aspiration are also presented.     

Macular electroretinogram as a function of age of subjects

Macular and paramacular electroretinograms in response to two adjacent checks (6 deg/side), alternating at constant mean luminance, were recorded in 34 normal subjects ranging in age from 16 to 74 years. The macular electroretinogram declines progressively in amplitude with age (R = –0.42; P = 0.013). The amplitude ratio between macular and paramacular responses tends to be independent of age (R = -0.21; P = 0.22).Age-related changes in the macular electroretinogram shown in our study are consistent with previous anatomical and functional studies, which indicate a deterioration of photoreceptors beyond 20 years of age. These results suggest a possible use of this technique for future studies on macular degeneration.     

全国部分城乡家鼠鼠情监测三年结果分析——Ⅰ.鼠种组成及地区分布

对全国部分城乡家鼠鼠情监测三年结果的分析表明:城乡家鼠组成均以三大家鼠(褐家鼠、小家鼠、黄胸鼠)为主,其次为食虫目臭鼩鼱~#和黑线姬鼠。五种主要鼠种在家鼠组成中的数量比基本稳定,但三年中城乡少数鼠种间的顺位有所变化。监测结果亦表明,五种主要鼠种的地区分布是:褐家鼠、小家鼠遍布所有监测的省、市、区,同以往文献中遍布全国的说法一致;黄胸鼠分布于黄河以南;食虫目中的臭鼩鼱分布于华中区以南的广大地区。这在以往文献中均已有记载,但以往文献有关黄胸鼠和臭鼩鼱分布的其他说法,则被证实为不确切的。黑线姬鼠的分布范围已超过以往文献中关于分布于东北、华北及长江流域的说法,但以往文献中关于该鼠种遍及全国的说法是否正确,则有待进一步证实。     

应用因特网对SARS病毒M蛋白B细胞抗原表位的预测

目的：预测SARS冠状病毒M蛋白的B细胞表位。方法：采用EMBOSS软件结合Hopp＆woods亲水性参数、Janin可及性参数、极性参数、柔韧性参数及二级结构方案对SARS冠状病毒M蛋白的B细胞表位进行了预测，并用吴玉章等已建立的B细胞表位预测方法进行评述。结果：SARS冠状病毒M蛋白B细胞识别的表位可能位于第3～13和153～166位氮基酸等区域内或附近，这2个被预测的表位均含有β—转角和无规卷曲结构。结论：该研究对应用合成肽抗原进行SARS早期诊断研究及相关抗体的制备具有重要指导意义。     

车间空气中石棉纤维卫生标准的研制

在上海、苏州、北京及四川的石棉厂矿进行了长期的职业流行病学调查，分别取得各厂矿石棉尘重量浓度与石棉纤维计数浓度的换算关系，进而计算各厂矿工人接触石棉计数剂量与石棉肺发病的剂量－反应关系，并按工人平均接尘３５年计，推算出将患病率控制在１％时的容许浓度。上海和苏州两厂调查中，工人接尘浓度已计算成时间加权平均浓度；北京和四川二厂矿则用瞬时浓度。据此制订的车间空气中石棉纤维卫生标准为：最高容许浓度１．５ｆ     

扩散管配制甲醛标准气体的研究

介绍了扩散法配制标准气体的方法。以三聚甲醛为原料，通过加热催化分解三聚甲醛蒸气，来配制甲醛标准气体。讨论了配制甲醛标准气体的准确性、稳定性、重复使用性，以及温度、扩散管几何尺寸、载气气流、配气源物质的量等因素对三聚甲醛扩散率的影响。本方法制备的甲醛标准气体，扩散率（２～５０μｇ／ｍｉｎ）测定总不确定度小于５％。     

七种常见MBL基因单倍型标准质粒的构建

目的 构建7种常见的MBL基因单倍型标准质粒。方法以已确认MBL基因单倍型及基因型的DNA样本为模板．利用SSP-PCR技术扩增出包含MBL基因启动子区及第一外显子的单倍型片段并将其克隆人T载体；用定点突变技术分别将其第一外显子52和57位密码相应的碱基突变；采用PCR和测序进行鉴定。结果以单倍型及基因型已确认的DNA样本为模板，采用SSP-PCR和分子克隆技术获得单倍型HYPA、LXPA、LYOA、LYPA和LYPB重组质粒；以单倍型HYPA及LYOA重组质粒为模板，采用定点突变技术获得单倍型HYPD及LYOC标准质粒。结论构建成功常见的7种MBL基因单倍型标准质粒，为采用SSP-PCR、Real-time PCR等技术分析MBL基因相应的SNP及其单倍型与基因型提供了标准对照。     

Simulation for population analysis of Michaelis-Menten elimination kinetics

A simulation study was conducted to compare the cost and performance of various models for population analysis of the steady state pharmacokinetic data arising from a one-compartment model with Michaelis-Menten elimination. The usual Michaelis-Menten model (MM) and its variants provide no estimate of the volume of distribution, and generally give poor estimates of the maximal elimination rate and the Michaelis-Menten constant. The exact solution to the Michaelis-Menten differential equation (TRUE) requires a precise analysis method designed for estimation of population pharmacokinetic parameters (the first-order conditional estimation method) and also considerable computational time to estimate population mean parameters accurately. The one-compartment model with dose-dependent clearance (DDCL), in conjunction with the first-order conditional estimation or Laplacian method, ran approximately 20-fold faster than TRUE and gave accurate population mean parameters for a drug having a long biological half-life relative to the dosing interval. These findings suggest that the well-known MM and its variants should be used carefully for the analysis of blood concentrations of a drug with Michaelis-Menten elimination kinetics, and that TRUE, in conjunction with a precise analysis method, should be considered for estimating population pharmacokinetic parameters. In addition, DDCL is a promising alternative to TRUE with respect to computation time, when the dosing interval is short relative to the biological half-life of a drug. This work was supported in part by the Epilepsy Research Foundation, the Nakatomi Foundation, and a Grant-in-Aid for Scientific Research from the Ministry of Education, Science, and Culture of Japan.