云南省卫生资源配置标准的弹性系数研究

目的　在进行云南省区域分类基础上制定云南省区域卫生资源配置标准标志值后 ,根据云南省各个地区的特点增加不同弹性系数。方法　采用流行病学研究方法 ,收集和分析云南省不同地州市 1990～ 1999年有关人口、社会经济状况及卫生经费的投入、居民健康状况、居民文化、生活水平、少数民族状况、旅游地区、边境线长短及贫困状况等资料。结果　研究结果表明曲靖地区、玉溪市、保山地区增加弹性系数最少 ,分别为 0 67%、 1 5 8%和1 68% ,怒江州、迪庆州和西双版纳州增加弹性系数最多 ,分别为 11 15 %、 10 2 5 %和 9 84 %。其它地区的弹性系数分别为昆明市 5 88% ,昭通地区 2 3 1% ,楚雄州 2 3 0 % ,红河州 7 0 3 % ,文山州 5 5 3 % ,思茅地区 7 4 3 % ,大理州4 94 % ,德宏州 6 78% ,丽江地区 4 3 5 % ,临沧地区 6 13 %。结论　云南省区域卫生配置标准的弹性系数研究为云南省卫生资源区域分类配置标准提供了科学依据 ,不同弹性系数体现了云南省不同地区的卫生资源区域分类配置标准的公平性、合理性及实用性     

计算机在医学领域中的应用及展望

对计算机在医学文献检索、医学统计软件包的编制、疾病诊断、医院管理等医学领域中的应用作了简要的综述，并对未来的发展进行了预测。     

0～14岁儿童意外伤害危险因素病例对照研究

为探讨导致儿童意外伤害的危险因素，为预防和减少发病提供依据，对４６８例意外伤害儿童进行１：１配对的病例对照研究，资料分析采用条件ｌｏｇｉｓｔｉｃ分析方法。结果：单因素分析发现与多子女、父母文盲、低收入、室内放置农、鼠药、无我照看、房周危险环境等因素有关，多因素分析发现父母文盲、室内放置农药、家庭低收入、室内放置农药、家族低收入、房周危险环境等为较稳定的影响因素。结论：儿童意外伤害是多因素相互作用的     

严重急性呼吸综合征传播影响因素病例对照研究

目的探讨严重急性呼吸综合征(SARS)传播的影响因素。方法采用病例对照研究,分别对有明确流行病学接触史的SARS患者与密切接触者,无明确流行病学接触史的SARS患者与一般人群进行比较。结果工作环境不通风、去公共场所无戴口罩的习惯、和患者接触时不通风与SARS呈正相关;疫情流行期间未到过医院,外出不采用人口密度相对较大的公交车、地铁等交通工具与SARS负相关。结论应加强医院建设和管理,以应对传染病的流行;当与患者接触时应注意通风;疫情暴发期间到公共场所应戴口罩;患者尽量减少到医院的机会和使用人口密度相对较大的交通工具。     

Prevalence,severity and correlates of fatigue in newly diagnosed patients with myelodysplastic syndromes

The primary objective of this study was to investigate factors associated with fatigue severity in newly diagnosed patients with higher‐risk myelodysplastic syndromes (MDS). The secondary objectives were to assess symptom prevalence and to examine the relationships between fatigue, quality of life (QoL) and overall symptom burden in these patients. The analyses were conducted in 280 higher‐risk MDS patients. Pre‐treatment patient‐reported fatigue was evaluated with the Functional Assessment of Chronic Illness Therapy (FACIT)‐Fatigue scale and QoL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire‐Core 30 (EORTC QLQ‐C30). Female gender (P = 0·018), poor performance status (i.e., ECOG of 2–4) (P < 0·001) and lower levels of haemoglobin (Hb) (P = 0·026) were independently associated with higher fatigue severity. The three most prevalent symptoms were as follows: fatigue (92%), dyspnoea (63%) and pain (55%). Patients with higher levels of fatigue also had greater overall symptom burdens. The mean global QoL scores of patients with the highest versus those with the lowest levels of fatigue were 29·2 [standard deviation (SD), 18·3] and 69·0 (SD, 18·8), respectively and this difference was four times the magnitude of a clinically meaningful difference. Patient‐reported fatigue severity revealed the effects of disease burden on overall QoL more accurately than did degree of anaemia. Special attention should be given to the female patients in the management of fatigue.     

人乳头状瘤病毒57感染与鼻内翻性乳头状瘤发生的相关性

目的:研究人乳头状瘤病毒(HPV)感染与鼻内翻性乳头状瘤(IP)发生的相关性,进一步明确HPV57在IP发生中的作用。方法:随机收集经病理确诊的IP病变组织石蜡包埋标本60个,分别采用HPVL1通用引物MY09/11和HPV57型特异性引物进行多聚酶链反应(PCR),对标本的HPV相关DNA序列扩增,计算其阳性率;另取10个慢性鼻窦炎病变组织标本作为对照,采用HPVL1通用引物MY09/11及HPV57型特异性引物进行PCR扩增。结果:60个鼻内翻性乳头状瘤组织标本经HPVL1通用引物MY09/11扩增后,均为阴性。经HPV57型特异性引物扩增后有47个(78.3%)为阳性。10个慢性鼻窦炎标本DNA模板均未能扩增出DNA片断。结论:HPV57型感染可能在IP的发生中起重要作用。     

消瘤汤治疗鼻内翻性乳头状瘤的疗效及其作用机理研究

目的 观察消瘤汤对鼻内翻性乳头状瘤术后复发与恶变的抑制作用及对宿主细胞免疫功能的影响.方法 鼻内翻性乳头状瘤患者60例,术后随机分为治疗组和对照组,每组各30例.治疗组术后服消瘤汤半年,对照组不用药物治疗,均随访8个月以上,观察病变复发和恶变情况.分别在术前及术后半年,以流式细胞仪检测患者外周血T淋巴细胞亚群及NK细胞活性,观察消瘤汤对宿主细胞免疫功能的影响.结果 治疗组复发2例（2/30,6.7%）,对照组复发8例（8/28,28.6%,其中3例存在轻至中度不典型增生）,差异具有统计学意义（P＜0.05）.与术前检测结果比较,治疗组的CD3^＋、CD4^＋T细胞及NK细胞比例升高,CD8^＋T细胞比例降低,对照组的CD3^＋、CD4^＋T细胞及NK细胞比例均降低,而CD8^＋T细胞比例升高.结论 消瘤汤可降低鼻内翻性乳头状瘤患者的术后复发率,并通过改善宿主细胞免疫功能而起到抑制其复发与恶变的作用.     

陆良县农村已婚育龄妇女生育意愿及影响因素分析

采用整群抽样的方法，对云南省陆良县２２８７名已婚育龄妇女的生育意愿进行了调查分析，并采用多元逐步回归分析法对影响生育意愿的因素进行了多因素分析。结果表明。该地５５．４％的妇女都只希望生育２胎，但仍有４３．１％的妇女愿意生育３胎以上，甚至个别的愿意生育１０胎，影响已婚育龄妇女生育意愿的因素主要有初婚年龄、人均耕地，是否有妇科病、住房类型、丈夫民族和家里的劳动力是否足够。     

Meta分析法在生命质量评价中的应用

简要介绍了Ｍｅｔａ 分析的思想， 并将其用于多中心生命质量评价的综合分析中． 对广东５ 个地区的生命质量综合结果表明， 用ＷＨＯＱＯＬ－１００ 量表测定的住院者与非住院者的生命质量有显著性差异．     

Pharmacodynamic assessment of clarithromycin in a murine model of pneumococcal pneumonia

The pharmacodynamic profile of clarithromycin (CLR) was evaluated with a murine model of pneumonia. Eight Streptococcus pneumoniae isolates, including three macrolide-sensitive and five macrolide-resistant strains, were inoculated intratracheally into immunocompromised ICR mice as 10(8)-CFU bacterial suspensions. Orally administered CLR daily doses ranging from 5 to 600 mg/kg of body weight were given over 5 days, during which animal survival was monitored. The bacterial density in lung tissues was examined after 24 h of CLR treatment and in control groups. Pharmacokinetic analysis of CLR in mice demonstrated that the regimen of 150 mg/kg twice a day was representative of human pharmacokinetics and was used to compare the efficacy of CLR against sensitive and resistant S. pneumoniae strains. Immunocompetent CBA/J mice were also infected and treated as described above and evaluated for bacterial density and survival to assess the effect of the presence of leukocytes. All three pharmacodynamic parameters, the duration (percent) of the time that serum CLR concentrations remain above the MIC (%T>MIC), the ratio of the area under the concentration-time curve from 0 to 24 h (AUC(0-24)) to the MIC, and the ratio of the maximum concentration of drug in serum to the MIC, were found to be closely correlated to CLR bacterial efficacy (P < 0.001). Furthermore, all parameters had close correlation to bacterial density (r(2) = 0.72 to 0.82), median survival (r(2) = 0.93 to 0.94), and total percent survival (r(2) = 0.91 to 0.92). These in vivo data suggest that the bacterial activity of CLR is closely correlated with all three parameters over a wide range of exposures and, as a consequence of parameter interdependency, AUC(0-24)/MIC is the most reasonable predictor of antibiotic efficacy. In this neutropenic pneumonia model, CLR was less efficacious against S. pneumoniae strains for which MICs were >or=4 microg/ml. However, the presence of leukocytes in the immunocompetent mice resulted in improved bactericidal activity, relative to that in the neutropenic animals, despite an MIC of 4 microg/ml.