卫生总费用与国民经济和职工收入增长规律的比较研究

目的：比较分析我国国民经济、卫生总费用和职工收入增长的客观规律，为评价各项卫生政策的合理性、公平性和现行的医疗保险制度的完善提供基础资料。方法：收集1990—2003年国内生产总值（GDP），卫生总费用（THE）和城镇职工可支配收入的增长情况并进行比较。结果：卫生总费用增长速度过快，年平均增长率达12.6％；人们的医疗保健支出比例快速增长，医疗费用负担增加。     

Out of sight but not out of mind: Home countries' macroeconomic volatilities and immigrants' mental health

We provide the first empirical evidence that better economic performances by immigrants' countries of origin, as measured by lower consumer price index (CPI) or higher gross domestic product, improve immigrants' mental health. We use an econometrically‐robust approach that exploits exogenous changes in macroeconomic conditions across immigrants' home countries over time and controls for immigrants' observable and unobservable characteristics. The CPI effect is statistically significant and sizeable. Furthermore, the CPI effect diminishes as the time since emigrating increases. By contrast, home countries' unemployment rates and exchange rate fluctuations have no impact on immigrants' mental health.     

The cost-effectiveness of trivalent and quadrivalent influenza vaccination in communities in South Africa,Vietnam and Australia

BackgroundTo inform national healthcare authorities whether quadrivalent influenza vaccines (QIVs) provide better value for money than trivalent influenza vaccines (TIVs), we assessed the cost-effectiveness of TIV and QIV in low-and-middle income communities based in South Africa and Vietnam and contrasted these findings with those from a high-income community in Australia.MethodsIndividual based dynamic simulation models were interfaced with a health economic analysis model to estimate the cost-effectiveness of vaccinating 15% of the population with QIV or TIV in each community over the period 2003–2013. Vaccination was prioritized for HIV-infected individuals, before elderly aged 65+ years and young children. Country or region-specific data on influenza-strain circulation, clinical outcomes and costs were obtained from published sources. The societal perspective was used and outcomes were expressed in International$ (I$) per quality-adjusted life-year (QALY) gained.ResultsWhen compared with TIV, we found that QIV would provide a greater reduction in influenza-related morbidity in communities in South Africa and Vietnam as compared with Australia. The incremental cost-effectiveness ratio of QIV versus TIV was estimated at I$4183/QALY in South Africa, I$1505/QALY in Vietnam and I$80,966/QALY in Australia.ConclusionsThe cost-effectiveness of QIV varied between communities due to differences in influenza epidemiology, comorbidities, and unit costs. Whether TIV or QIV is the most cost-effective alternative heavily depends on influenza B burden among subpopulations targeted for vaccination in addition to country-specific willingness-to-pay thresholds and budgetary impact.     

A test of the resource security and the body mass index reference point hypotheses of body dissatisfaction amongst adolescents in eight countries

Objective. This study aimed to identify cultural-level variables that may influence the extent to which adolescents from different cultural groups are dissatisfied with their bodies.

Design. A sample of 1730 male and 2000 female adolescents from Australia, Fiji, Malaysia, Tonga, Tongans in New Zealand, China, Chile, and Greece completed measures of body satisfaction, and the sociocultural influences on body image and body change questionnaire, and self-reported height and weight. Country gross domestic product and national obesity were recorded using global databases.

Results. Prevalence of obesity/overweight and cultural endorsement of appearance standards explained variance in individual-level body dissatisfaction (BD) scores, even after controlling for the influence of individual differences in body mass index and internalization of appearance standards.

Conclusions. Cultural-level variables may account for the development of adolescent BD.     

Ammonia metabolism,the brain and fatigue; revisiting the link

This review addresses the ammonia fatigue theory in light of new evidence from exercise and disease studies and aims to provide a view of the role of ammonia during exercise. Hyperammonemia is a condition common to pathological liver disorders and intense or exhausting exercise. In pathology, hyperammonemia is linked to impairment of normal brain function and the onset of the neurological condition, hepatic encephalopathy. Elevated blood ammonia concentrations arise due to a diminished capacity for removal via the liver and lead to increased exposure of organs, such as the brain, to the toxic effects of ammonia. High levels of brain ammonia can lead to deleterious alterations in astrocyte morphology, cerebral energy metabolism and neurotransmission, which may in turn impact on the functioning of important signalling pathways within the neuron. Such changes are believed to contribute to the disturbances in neuropsychological function, in particular the learning, memory, and motor control deficits observed in animal models of liver disease and also patients with cirrhosis. Hyperammonemia in exercise occurs as a result of an increased production by contracting muscle, through adenosine monophosphate (AMP) deamination (the purine nucleotide cycle) and branched chain amino acid (BCAA) deamination prior to oxidation. Plasma concentrations of ammonia during exercise often achieve or exceed those measured in liver disease patients, resulting in increased cerebral uptake. In this article we propose that exercise-induced hyperammonemia may lead to concomitant disturbances in brain function, potentially through similar mechanisms underpinning pathology, which may impact on performance as fatigue or reduced function, especially during extreme exercise.     

From the Cover: Global mapping of Al,Cu, Fe,and Zn in-use stocks and in-ground resources

Human activity has become a significant geomorphic force in modern times, resulting in unprecedented movements of material around Earth. An essential constituent of this material movement, the major industrial metals aluminium, copper, iron, and zinc in the human-built environment are mapped globally at 1-km nominal resolution for the year 2000 and compared with the locations of present-day in-ground resources. While the maps of in-ground resources generated essentially combine available databases, the mapping methodology of in-use stocks relies on the linear regression between gross domestic product and both in-use stock estimates and the Nighttime Lights of the World dataset. As the first global maps of in-use metal stocks, they reveal that a full 25% of the world''s Fe, Al, Cu, and Zn in-use deposits are concentrated in three bands: (i) the Eastern seaboard from Washington, D.C. to Boston in the United States, (ii) England, Benelux into Germany and Northern Italy, and (iii) South Korea and Japan. This pattern is consistent across all metals investigated. In contrast, the global maps of primary metal resources reveal these deposits are more evenly distributed between the developed and developing worlds, with the distribution pattern differing depending on the metal. This analysis highlights the magnitude at which in-ground metal resources have been translocated to in-use stocks, largely from highly concentrated but globally dispersed in-ground deposits to more diffuse in-use stocks located primarily in developed urban regions.     

疾病预防控制机构投入机制分析

通过全国系统抽样,获取疾病预防控制机构2002年~2005年各样本地区国内生产总值(GDP)、疾病预防控制机构总收入和政府财政投入、地区财政支出数据资料,进行各指标间的对比和年度间的分析。结果显示与地区GDP的稳定增长相比,疾病预防控制机构的总收入不稳定,平均低于GDP的增长,而只在2003年有短暂的提高。从政府对疾病预防控制机构的财政投入和地区财政支出比例来看,也呈现同样的趋势。     

G protein-coupled receptor for nicotinic acid in mouse macrophages

The use of the HDL-elevating drug nicotinic acid in the treatment and prevention of atherosclerotic disease is limited by the frequent induction of skin flushing. The therapeutic effects of nicotinic acid are attributed to inhibition of lipolysis in adipose tissue via a G protein-coupled receptor, whereas the mechanism of flush induction by release of prostaglandin D(2) from macrophages is not understood. In this study, we investigated if macrophages contain nicotinic acid receptors. Specific guanine nucleotide sensitive binding sites for [(3)H]nicotinic acid were detected in membranes from mouse RAW 264.7 macrophages. Nicotinic acid and related heterocycles stimulated activation of pertussis toxin-sensitive G proteins. The rank orders of potency in macrophage membranes were identical for inhibition of [(3)H]nicotinic acid binding and G protein activation, and were pharmacologically indistinguishable from that of the G protein-coupled nicotinic acid receptor in spleen membranes. These results indicate that the effects of nicotinic acid on macrophages, spleen and probably adipocytes are mediated via an identical, unique G protein-coupled receptor.     

Effects of hypercholesterolemia on the nucleotide content in human blood cells

In hypercholesterolemia significant changes in the nucleotide pattern of erythrocytes and lymphocytes as determined by high performance liquid chromatography were found. The decrease in ATP of lymphocytes in hypercholesterolemia from 10.4 +/- 0.3 to 7.0 +/- 0.4 nmol mg-1 protein (n = 8) was associated with an increase in ADP from 2.2 +/- 0.2 to 4.0 +/- 0.2 nmol mg-1 protein (P less than 0.005). The pattern of guanosine phosphates likewise was found to be changed in hypercholesterolemia. Akin to lymphocytes, red blood cells displayed marked changes in nucleotide levels. No such changes were observed in platelets. Cultured lymphocytes incubated with human plasma low density lipoproteins (LDL) (140 mg cholesterol dl-1) displayed a reversible fall in ATP and an increase in ADP by about 40% and 160%, respectively, with high density lipoproteins (HDL) or very low density lipoproteins (VLDL) being essentially ineffectual. It is concluded that in hypercholesterolemia a significant change in the nucleotide pattern of blood cells is exerted by the increase in LDL. Possible pathophysiological implications are discussed.