Assessment of bioequivalence after subcutaneous and intramuscular administration of urinary gonadotrophins

The objective was to demonstrate bioequivalence between s.c. and i.m. administration of Humegon (FSH/LH ratio 1:1) and Normegon (FSH/LH ratio 3:1). In two randomized, single-centre, cross-over studies, 18 healthy volunteers on each formulation were assigned to one of the two administration sequences. Subjects were given single doses of one of the above gonadotrophins after endogenous gonadotrophin production had first been suppressed using high-dose oral contraceptive. Subsequently, rate (Cmax, tmax) and extent (AUC) of absorption of follicle stimulating hormone (FSH) and luteinizing hormone (LH) were determined for 14 days. For Cmax and AUC, analysis of variance (ANOVA) was performed on log-transformed data and for tmax ANOVA was performed on ranks. Intramuscular and s.c. injections of Humegon were bioequivalent with respect to the main pharmacokinetic parameters, being AUC and Cmax of FSH absorption. Intramuscular and s.c. injections of Normegon were bioequivalent with respect to the AUC of FSH and not bioequivalent with respect to the Cmax of FSH. For tmax of FSH as well as for most LH variables of both preparations, bioequivalence could not be proven due to the high intra- and interindividual variability and/or concentrations being close to the detection limit. Thus, the main pharmacokinetic FSH variables after i.m. and s.c. administration of Humegon and Normegon were bioequivalent.      

传染性肺结核患者家庭中儿童结核感染发病及预防的研究

目的　分析传染性肺结核患者家庭中的儿童结核感染和发病情况 ,探讨预防儿童发病的有效方案。方法　对与传染性肺结核患者密切接触的儿童进行X线胸透和做结核菌素试验 ;对结核菌素强阳性者给予预防性治疗。结果　与传染性肺结核患者密切接触的儿童感染率为 88 2 %。规则预防治疗组、不规则预防治疗组和不接受预防治疗组的患病率分别为 :8 3%、4 7 6 %、5 8 8%。结论　与传染性肺结核患者密切接触的儿童属于高危人群 ,给予预防性治疗可减少发病。     

Peroral Cholangioscopy with Intracorporeal Electrohydraulic Lithotripsy for Choledocholithiasis

Five patients with choledocholithiasis refractory to standard extraction methods after endoscopic sphincterotomy underwent peroral cholangioscopy with the "mother-daughter" endoscopy system. Electrohydraulic lithotripsy of nine stones was performed successfully and without complication, other than minor transient bleeding in one patient. The outer sheath of the "daughter scope" sustained a linear burn in one instance. This method of stone fragmentation is a useful adjunct to achieve ductal clearance in difficult cases.     

延边地区肺结核病人归口转诊模式的探讨

目的　分析延边地区建立肺结核归口转诊模式对肺结核病人的转诊到位率的影响,探讨提高转诊到位率的方法。方法 对全州8个县(市)医院、中医医院、中心卫生院、大型厂矿企事业单位职工医院的执法检查考核资料进行评价。结果 1.建立归口转诊模式前期转诊率为48.3%,转诊到位率为29.0%,后期转诊率为89.0%,转诊到位率为72.4%,有明显提高;2.前期年平均涂阳病人新登记率为13.36/10万,后期为17.86/10万,实施归口转诊模式前期与实施后期的指标有显著性差异(P<0.01)。结论 延边地区实施的肺结核病人归口转诊模式,对提高肺结核病的转诊到位率十分有效,应不断完善并深入推广。     

Effect of Helicobacter mustelase infection on ferret gastric epithelial cell proliferation

The effect of Helicobacter mustelae infection on gastric epithelialproliferation was studied in ferrets colonized with H.mustelaeand specific pathogen-free (SPF) ferrets not infected with H.mustelae.Thirteen H.mustelae-infected ferrets between the ages of 13and 32 months and 16 SPF ferrets between 6 and 18 months wereanalyzed. Bacterial cultures, urease tests and Warthin-Starrystains were used to identify H.mustelae. Tissues obtained fromthe antrum and the body regions of the stomach were assayedby proliferating cell nuclear antigen (PCNA) immunohisto-chemistryand measured using a computerized color image analysis system.PCNA-expressing gastric epithelia in the antrum and the bodyregions were significantly increased in the H.mustelae-infectedferrets versus the SPF ferrets (P <0.001). PCNA positivityin the antrum regions of both the H.mustelae-infected ferretsand SPF ferrets was significantly higher than that of the bodyregions (P <0.001). Comparison of the histopathology of infectedferrets indicated that PCNA positivity correlated with the histologicalseverity of gastritis. This study suggests that cell proliferationin ferret gastric mucosa increases with H.mustelae infectionand provides evidence that PCNA is a useful biomarker for studyingthe changes in cell kinetics in the ferret stomach. The dataalso further support the use of the H.mustelae-infected ferretas an animal model for studying the pathogenesis of Helicobacterpylori-induced gastric diseases of humans.     

复治肺结核病人的成因分析

目的　探讨复治肺结核病人形成原因。方法　使用调查表的方法 ,对前来诊治的复治涂阳肺结核病人的首次诊疗 ,管理情况进行问卷调查。结果　综合医院仍然为大多数患者的首次诊疗单位 ,因此部分肺结核患者未能得到正确的诊断、治疗和化疗管理。导致 67.2 %病人“中断”或“间断”治疗 ;另外结核病健康教育宣传做得不够 ,60 .3 %的患者诊断前未接受过防痨宣教 ,3 4.5 %的患者接受初次化疗时仍未得到宣教。这些均在导致复治病人的产生中起了重要作用。结论　加大DOTS覆盖面 ,加强归口管理力度 ,做好防治结核病教育工作是防止复治肺结核病人产生的重要环节。     

Long-term care for people with developmental disabilities: a critical analysis

This article explores how the trends toward long-term community care affecting people with developmental disabilities developed. Appropriateness of care and quality of life issues are discussed. The article also reviews the development of long-term care for frail and disabled elderly people and explores the arguments for a continuum of care that have developed in this area. The authors conclude that future policies with respect to meeting long-term care needs for people with developmental disabilities must be addressed flexibly on an individual basis, related to individual needs, and must provide a continuum of care services.