四川省卫生总费用的结构变动及预测研究

目的 分析2008—2019年四川省卫生总费用结构变动及影响因素和预测研究,为助力“健康四川”建言献策。方法 使用四川省卫生统计年鉴的相关卫生总费用数据,在描述性分析的基础上,使用结构变动度分析卫生总费用的结构变动,灰色关联法研究卫生总费用的影响因素并进行GM(1,1)预测。结果 2008—2019年卫生总费用持续增加,政府、社会和个人卫生支出结构逐步合理;人均卫生费用水平排名靠后,社会卫生支出成为卫生总费用的主要构成单元;千人口床位、常住人口和农村居民人均可支配收入是影响卫生总费用的主要因素;预测发现,2020—2025年卫生总费用仍呈增加趋势,个人卫生支出占比进一步下降。结论 四川省卫生总费用结构渐趋合理,医疗服务水平得到大幅度改善;但仍需重点关注人均卫生费用等相对性指标。     

药品零加成政策对慢性心力衰竭患者次均住院费用变化影响结构分析

目的 分析药品零加成政策对于慢性心衰住院费用的影响和结构变动趋势,为推进医改的实施和加强医院内部管理提供依据。方法 收集上海某医院2016—2019年慢性心衰患者住院费用,采用结构变动度法和灰色关联度法分析各项费用的结构变动情况及其与总费用的关联程度。 结果 2016—2019年住院费用总结构变动度为24.49%;药费及耗材费呈下降趋势,诊断费及综合服务费上升;药费结构变动贡献率最大（34.75%）,其次是诊断费（31.24%）,两项累积贡献率达65.99%;与次均住院费用关联度从高到低前三项为诊断费（0.86）、药费（0.79）和耗材费（0.72）。 结论 样本医院药品零加成政策的实施取得显著的成效。今后医院应建立合理评估机制,进一步控制药费及耗材费,加强诊断费的监督管理,优化医疗费用结构。     

Examining community pharmacists’ intention to provide pharmacist-driven vaccination services: A structural equation modelling

BackgroundThe evidence of pharmacists' current involvement in vaccination services in low- and middle-income countries (LMICs) is uncertain. This study would be a first step to develop vaccination services by investigating community pharmacists’ intention to be involved in PDV services not just during COVID-19 pandemic but also during standard service provision in Turkey which can be taken as an example across LMICs.ObjectiveConsidering the efforts to empower community pharmacists in service provision, the goal of the present study was to develop a structural equation model to explain the “Pharmacist-Driven Vaccination Service Intention Model (PDV-SIM)” by using the theory of planned behavior (TPB).MethodsBased on the constructs of TPB, a measurement tool was developed. Sub-factors of PDV service intention was determined by conducting exploratory factor analysis (EFA). In the second step, confirmatory factor analysis (CFA) was conducted to prove the theoretical structure of the tool. Finally, a model explaining the relationship between observed variables, latent constructs from TPB was developed by SEM analysis.ResultsIn the proposed PDV-SIM, patient related attitude toward PDV services, attitude toward negative consequences of PDV services, and subjective norm about PDV services had an impact on the behavioral intention of community pharmacists. Nevertheless, professional development attitude toward PDV services and perceived behavioral control were not evaluated as determinants of the behavioral intention.ConclusionResults of this study revealed that TPB is appropriate for modelling PDV service intention of community pharmacists. This model can be utilized as a guide to potential pharmacy regulatory bodies and policy makers in their efforts to enable community pharmacists as vaccinators across LMICs.     

用二核苷酸简单串联重复顺序多态位点进行中国人个体鉴别

为建立二核苷酸简单串联重复顺序（ＳＴＲ）多态位点个体鉴别技术系统，应用６个位于不同染色体呈共显性传递的二核苷酸ＳＴＥ多态位点进行中国汉族人个体鉴别研究，这６个位点是Ｄ１Ｓ１０３、Ｄ４Ｓ１７５、Ｄ５Ｓ１０７、Ｄ１９Ｓ４９、Ｄ６Ｓ８９及Ｄ９Ｓ５８。结果显示：（１）６个ＳＴＲ位点基因型数１４～３９个，等位片段数０～２０个；（２）杂合度观察值及估测值分别为０．６５～０．９１及０．６３～０．９３．多态信息含量０．５９～０．９０；（３）６个位点均符合Ｈａｒｄｙ－Ｗｅｉｎｂｅｒｇ平衡；（４）６个位点１５次配对分析中，未见非随机关联；（５）６个位点的亲子关系排除概率０．９９；（６）普通群体中两个无亲缘关系随机个体间６个位点基因型完全一致的概率在１．７×１０－１２～９．２×１０－３３间。结果表明，应用这六个二核苷酸ＳＴＲ位点适于亦足以在中国汉族人中进行个体鉴别．故将此检测及数据处理系统，命名为ＤＮＡ身份号码。     

用双剂量实验数据分析药物的米氏消除参数的识别问题

本文分析了给药剂量对按一级过程吸收，米氏过程消除药物的血药浓度的峰值与达峰时间的影响。并据此讨论了利用较少的双剂量实验数据改善识别米氏参数的方法。     

北京地区病毒性脑炎患者病原体的分离和初步鉴定

１９９１年夏秋季，我们从４１例北京儿童医院临床诊断为病毒性脑炎（非乙脑）患者的７５份急性期血和／或脑脊液中分离到３３株病毒。对其中１２株进行电镜观察，电镜下均见大小相同的球形病毒颗粒，毒粒的直径约为４４．７８±１．３５ｕｍ，无囊膜，具双层蛋白外壳，视野内多见空心颗粒。超薄切片显示病毒在感染细胞的胞浆内发生，直径约为４７．６±２．３ｕｍ。正常细胞中未见病毒颗粒。对其中３株病毒进行理化性状分析，多次试验均显示该病毒抵抗５＇－碘脱氧尿苷，抵抗乙醚，耐酸，能在地鼠肾ＢＨＫ－２１和白纹伊蚊Ｃ６／３６细胞上增殖并出现细胞病变。该病毒与本室制备的披膜病毒科甲组、乙脑病毒和布尼亚病毒科的组特异性免疫腹水均不反应。脑内接种３日龄乳小白鼠可引起不规律的发病和死亡。上述结果表明，该病毒是一类４５ｕｍ左右、无囊膜、耐酸的ＲＮＡ病毒。     

中药地榆的性状及显微鉴定

研究国内来源于地榆属8个不同种、变种与变型的地榆及2种混淆品的生药性状、组织构造及其粉末的鉴别特征,并分别列出生药性状、组织构造及粉末特征的检索表。