Efficacy of a Pre-S Containing Vaccine in Patients Receiving Lamivudine Prophylaxis after Liver Transplantation for Chronic Hepatitis B

Lamivudine monoprophylaxis against hepatitis B virus (HBV) reinfection after liver transplantation is associated with recurrence due to escape mutants and second generation recombinant HBV vaccine is not effective. We studied the efficacy of two courses each of three double-doses (20 microg) of third-generation recombinant pre-S containing vaccine (Sci-B-Vac) in 20 patients on lamivudine prophylaxis at a median of 637 days (range, 390-2666 days) after transplantation. At enrollment, all patients were seronegative for HBsAg, anti-HBs and HBVDNA (by qPCR). Lamivudine (100 mg/day) was continued throughout the study. Five patients (25%) responded to the first course and five additional patients responded after the second course (overall response rate 50%). The response rate was 88% in patients younger than 50 years old and 25% in older patients (p = 0.02). The median peak anti-HBs titer was 153 mIU/mL with six responders having a titer >100 mIU/mL and seven sustained >6 months. Among seven previous nonresponders to second generation recombinant vaccine, three (44%) responded. At the end of the study, all patients remained seronegative for HBsAg. In conclusion, Sci-B-Vac is effective in about 50% of patients receiving lamividine prophylaxis and may prevent recurrence due to escape mutants.     

MN-151酶联免疫法检测双链DNA抗体

检测双链DNA抗体是诊断系统性红斑狼疮的特异方法。应用MN-151固相载体建立了检测双链DNA抗体的ELISA法。本法检测双链DNA抗体的敏感度达93％,高于传统ELISA法。     

一种新型静脉输液控制器的研制

介绍了一种静脉输液控制器的硬件结构和软件的设计 ,对出现的滴速不稳、抖动 ,步进电机的控制迟滞及掉电保护电路等问题提出了独到的解决方案。     

我国药品零售业价格战的起因和影响探析

目的:为我国药品零售业走出“价格战”提供参考。方法:分析我国药品零售业的现状,探讨价格战形成的原因及影响。结果与结论:我国药品零售业价格战弊多利少,价格战必将被以服务为基础的品牌战略所替代。     

The Day That the START Triage System Came to a STOP: Observations from the World Trade Center Disaster

The Fire Department of the City of New York--Emergency Medical Services (EMS) Operations is one of the largest EMS systems in the country. On a daily basis, this system responds to approximately 3,000 to 3,500 calls for ambulance requests. This equates to 1.2 to 1.5 million calls annually. As part of its response, EMS deals on a daily basis with multiple casualty and disaster-type situations. The magnitude of the attacks on the World Trade Center, however, was on a scale not previously seen by any system. This article is a case report of the September 11, 2001, incident.     

现代战争与医疗卫生保障的对策研究

本文从福建省所处地理位置的特殊性出发，探究了现代战争与医疗卫生保障的对策，把加强国防经济建设与促进卫生事业发展结合起来，提出建设福建省医疗卫生动员指挥中心、构建平战结合的流动医院、加强医疗救护网络建设力度、实施战备药品和医疗机械的储备等措施，确保战时的医疗卫生保障，这是一项利国、利军、利民的系统工程。     

Respiratory protection and the risk of Mycobacterium tuberculosis infection

Tuberculosis (TB) can be transmitted to susceptible healthcare workers via inhalation of droplet nuclei carrying viable Mycobacterium tuberculosis bacilli. Several types of respiratory protective devices are compared with respect to efficacy against droplet nuclei penetration: surgical masks, disposable dust/mist particulate respirators (PRs), elastomeric halfmask respirators with high-efficiency (HEPA) filters, and powered airpurifying respirators (PAPRs) with elastomeric halfmask facepieces and HEPA filters. It is estimated that these devices permit, respectively, 42%, 5.7%, 2%, and 0.39% penetration of droplet nuclei into the facepiece. More limited data for the disposable HEPA filtering-facepiece respirator suggest that it would allow droplet nuclei penetration of 3% or less, similar to the value estimated for the elastomeric halfmask HEPA filter respirator. Because a respirator wearer's cumulative infection risk depends on the extent of droplet nuclei penetration, the cumulative risk will differ, given use of these different respirators. Hypothetical but realistic “low-exposure” and “high-exposure” scenarios are posed that involve, respectively, a 1.6% and a 6.4% annual risk of infection for healthcare workers. For the low-exposure scenario, the 10-year cumulative risks given no respirators versus surgical masks versus disposable dust/mist PRs versus elastomeric halfmask HEPA filter respirators versus HEPA filter PAPRs are, respectively, 15%, 6.7%, 0.94%, 0.33%, and .064%. For the high-exposure scenario, the 10-year cumulative risks for no respirator use versus use of the same four types of respirators are, respectively, 48%, 24%, 3.7%, 1.3%, and 0.26%. The use of disposable HEPA filtering-facepiece respirator should permit cumulative risks close to those estimated for the elastomeric halfmask HEPA filter respirator. It is concluded that when an infectious TB patient undergoes a procedure that generates respiratory aerosols, and when droplet nuclei source control is inadequate, healthcare workers attending the patient may need to wear highly protective respirators, such as HEPA filter PAPRs.     

野战条件下震荡对血液技术指标的影响

目的：研究野战条件经历物理震荡（包手空投、汽车野外山路运送、海水浸泡）后，血液各技术指标的变化。方法：采集20袋CPDA全血400ml,分成四组，分别经历高空下抛等震荡，观察血液技术指标发生的变化。结果：较对照组，空投组FHb明显升高，汽车运送组轻微上升，但在正常范围内，海水浸泡组各指标均无显著变化，结论：剧烈的物理震荡如空投对血液技术旨标有明显影响，其它形式的轻微震荡不会对血液有损害。