介绍了某院部分骨科手术疾病诊断相关分组(diagnosis related groups,DRGs)的基本情况,重点分析了IS02B、IS05Z、IS10B 3个DRGs医用耗材费用占比情况,采用差异性分析方法确定了同一DRGs下影响医用耗材费用的关键因素,提出了加强成本控...介绍了某院部分骨科手术疾病诊断相关分组(diagnosis related groups,DRGs)的基本情况,重点分析了IS02B、IS05Z、IS10B 3个DRGs医用耗材费用占比情况,采用差异性分析方法确定了同一DRGs下影响医用耗材费用的关键因素,提出了加强成本控制、加快执行骨科耗材带量采购结果、强化对关键医用耗材及关键医疗组的监管、确定骨科重点DRGs医用耗材费用控制区间等建议,为加强医疗资源精细化管理、合理控制医疗费用增长提供了决策依据。展开更多
OBJECTIVE To explain the high inter-individual variability and the frequency of exceeding the therapeutic reference range and the laboratory alert level of amisulpride,a popula⁃tion pharmacokinetic model in Chinese pa...OBJECTIVE To explain the high inter-individual variability and the frequency of exceeding the therapeutic reference range and the laboratory alert level of amisulpride,a popula⁃tion pharmacokinetic model in Chinese patients with schizophrenia was built based on therapeu⁃tic drug monitoring data to guide individualized therapy.METHODS Plasma concentration data(330 measurements from 121 patients)were ana⁃lyzed using a nonlinear mixed-effects model⁃ing approach with first-order conditional estima⁃tion with interaction(FOCE I).The concentra⁃tions of amisulpride were detected by HPLC-MS/MS.Age,weight,sex,combination medication history and renal function status were evaluated as main covariates.The model was internally val⁃idated using goodness-of-fit,bootstrap and nor⁃malized prediction distribution error.Recom⁃mended dosage regimens for patients with key covariates were estimated on the basis of Monte Carlo simulations and the established model.RESULTS A one-compartment model with first-order absorption and elimination was found to adequately characterize amisulpride concentra⁃tion in Chinese patients with schizophrenia.The population estimates of the apparent volume of distribution(V/F)and apparent clearance(CL/F)were 12.7 L and 1.12 L·h-1,respectively.Age sig⁃nificantly affected the clearance of amisulpride and the final model was as follow:CL/F=1.04×(AGE/32)-0.624(L·h-1).To avoid exceeding the lab⁃oratory alert level(640μg·L-1),the model-based simulation results showed that the recommended dose of amisulpride was no more than 600 mg per day for patients aged 60 years,800 mg per day for those aged 40 years and 1200 mg per day for those aged 20 years,respectively.CON⁃CLUSION Dosage optimization of amisulpride can be carried out according to age to reduce the risk of adverse reactions.The model can be used as a suitable tool for designing individual⁃ized therapy for Chinese patients with schizo⁃phrenia.展开更多
The effect of multipole resonance in the interaction between a spherical metallic nanoparticle （MNP） and an emitting dipole is studied with the Mie theory. The results show that the absorption peak of the MNP with r...The effect of multipole resonance in the interaction between a spherical metallic nanoparticle （MNP） and an emitting dipole is studied with the Mie theory. The results show that the absorption peak of the MNP with respect to the field of the emitting dipole is blue-shifted with the decrease of the spacing between MNP and emitting dipole due to the enhanced multipole resonance. At a short distance, the enhanced multipole terms of scattering are not obvious compared with the dipole term. For the decay rate of the emitting dipole, multipole resonance brings about the enhancement of it largely at short spacing. For the radiative decay rate, the behavior is quite different. The dipole term is dominant at a short spacing, and the multipole term is dominant at a larger spacing.展开更多
Objective:Epilepsy is a multi-etiological brain dysfunction syndrome characterized by synchronously repeated spontaneous discharges from neuronal cells.Its pathogenesis involves excitatory/inhibitory imbalance,ion cha...Objective:Epilepsy is a multi-etiological brain dysfunction syndrome characterized by synchronously repeated spontaneous discharges from neuronal cells.Its pathogenesis involves excitatory/inhibitory imbalance,ion channel abnormalities and may be related to the abnormal structure and function of neurotransmitter receptors.The research was to observe the effects of rapid increase inhbitory neurotransmitter GABA on the excitatory/inhibitory imbalance,ion channel abnormalities and abnormal neurotransmitter receptors in living epileptic mice from the level of free moving animal,cell,sub-cell and receptor.Methods:The techniques of fiber photometry and laser uncage of Rub-GABA for epileptic free moving mice induced by administration of Kainic acid(KA)or 4-AP,local field potentials(LFP),multicell bolus lording of calcium(OGB-1AM),virus transfection of calcium-sensitive protein GCaMP6f,transfection of fluorescent labeled AMPA receptors in cortical neurons by in utero electroporation,two-photon uncage of Rubi-GABA,two-photon imaging,two-photon calcium imaging,twophoton cell attach,two-photon targeted patch clamp and two-photon shadow patch clamp in living epileptic mice induced by 4-AP were used.Results:Laser photolysis of Rubi-GABA in hippocampal CA1 could immediately alleviate KA induced acute epileptic seizures in living mice.In cellular level,two-photon uncage Rub-GABA or rapid release of GABA significantly decreased the number of neurons releasing the calcium signals by multicell bolus lording of calcium,inhibited spikes recording by LFP and immediately inhibited both calcium signals and spikes using two-photon cell attaching technique in the living epileptic mice induced by 4-AP.Two-photon uncage Rub-GABA significantly decreased spikes induced by 4-AP recording with two-photon shadow patch clamp in vivo.In sub-cellular level,two-photon Rubi-GABA uncage of dendritic spines of cortical neurons transfected with GCaMP6f obviously decreased the frequency and amplitude of calcium signal on those dendritic spines in 4-AP induced epileptic living mice.Two-photon targeted patch clamp and shadow patch clamp were performed separately to both the cortical neurons transfected fluorescent labeled AMPA receptors in the mice by in utero electroporation and the cortical neurons with no fluorescent labeled AMPA receptors in control mice.The results showed that there was no difference in the electrophysiological indices between the two kinds of cortical neurons,meaning that there was no obvious change of electrophysiological characteristics in the cortical neurons transfected fluorescent labeled AMPA receptors.Further study showed that rapid disappearance of the AMPA receptors was found before disappearance of dendritic spines in epileptic living mice induced by high concentration of 4-AP,and the disappearance of the AMPA receptors was significantly delayed or the AMPA receptors even reappeared after rapid release of GABA with the different concentration of 4-AP in the living mice.Conlusion:Rapid release of GABA can rectify the excitatory/inhibitory imbalance and ion channel abnormalities of epilepsy,and rapidly inhibits epilepsy in free moving mice,and from cellular and sub-cellular level in vivo.It also protects the structure and function of neurotransmitter receptors during epilepsy in vivo.展开更多
文摘介绍了某院部分骨科手术疾病诊断相关分组(diagnosis related groups,DRGs)的基本情况,重点分析了IS02B、IS05Z、IS10B 3个DRGs医用耗材费用占比情况,采用差异性分析方法确定了同一DRGs下影响医用耗材费用的关键因素,提出了加强成本控制、加快执行骨科耗材带量采购结果、强化对关键医用耗材及关键医疗组的监管、确定骨科重点DRGs医用耗材费用控制区间等建议,为加强医疗资源精细化管理、合理控制医疗费用增长提供了决策依据。
文摘OBJECTIVE To explain the high inter-individual variability and the frequency of exceeding the therapeutic reference range and the laboratory alert level of amisulpride,a popula⁃tion pharmacokinetic model in Chinese patients with schizophrenia was built based on therapeu⁃tic drug monitoring data to guide individualized therapy.METHODS Plasma concentration data(330 measurements from 121 patients)were ana⁃lyzed using a nonlinear mixed-effects model⁃ing approach with first-order conditional estima⁃tion with interaction(FOCE I).The concentra⁃tions of amisulpride were detected by HPLC-MS/MS.Age,weight,sex,combination medication history and renal function status were evaluated as main covariates.The model was internally val⁃idated using goodness-of-fit,bootstrap and nor⁃malized prediction distribution error.Recom⁃mended dosage regimens for patients with key covariates were estimated on the basis of Monte Carlo simulations and the established model.RESULTS A one-compartment model with first-order absorption and elimination was found to adequately characterize amisulpride concentra⁃tion in Chinese patients with schizophrenia.The population estimates of the apparent volume of distribution(V/F)and apparent clearance(CL/F)were 12.7 L and 1.12 L·h-1,respectively.Age sig⁃nificantly affected the clearance of amisulpride and the final model was as follow:CL/F=1.04×(AGE/32)-0.624(L·h-1).To avoid exceeding the lab⁃oratory alert level(640μg·L-1),the model-based simulation results showed that the recommended dose of amisulpride was no more than 600 mg per day for patients aged 60 years,800 mg per day for those aged 40 years and 1200 mg per day for those aged 20 years,respectively.CON⁃CLUSION Dosage optimization of amisulpride can be carried out according to age to reduce the risk of adverse reactions.The model can be used as a suitable tool for designing individual⁃ized therapy for Chinese patients with schizo⁃phrenia.
基金Project supported by the National Natural Science Foundation of China （Grant Nos. 61138004 and 61107068） and the National Basic Research Program of China （Grant No. 2012CB921904）.
文摘The effect of multipole resonance in the interaction between a spherical metallic nanoparticle （MNP） and an emitting dipole is studied with the Mie theory. The results show that the absorption peak of the MNP with respect to the field of the emitting dipole is blue-shifted with the decrease of the spacing between MNP and emitting dipole due to the enhanced multipole resonance. At a short distance, the enhanced multipole terms of scattering are not obvious compared with the dipole term. For the decay rate of the emitting dipole, multipole resonance brings about the enhancement of it largely at short spacing. For the radiative decay rate, the behavior is quite different. The dipole term is dominant at a short spacing, and the multipole term is dominant at a larger spacing.
文摘Objective:Epilepsy is a multi-etiological brain dysfunction syndrome characterized by synchronously repeated spontaneous discharges from neuronal cells.Its pathogenesis involves excitatory/inhibitory imbalance,ion channel abnormalities and may be related to the abnormal structure and function of neurotransmitter receptors.The research was to observe the effects of rapid increase inhbitory neurotransmitter GABA on the excitatory/inhibitory imbalance,ion channel abnormalities and abnormal neurotransmitter receptors in living epileptic mice from the level of free moving animal,cell,sub-cell and receptor.Methods:The techniques of fiber photometry and laser uncage of Rub-GABA for epileptic free moving mice induced by administration of Kainic acid(KA)or 4-AP,local field potentials(LFP),multicell bolus lording of calcium(OGB-1AM),virus transfection of calcium-sensitive protein GCaMP6f,transfection of fluorescent labeled AMPA receptors in cortical neurons by in utero electroporation,two-photon uncage of Rubi-GABA,two-photon imaging,two-photon calcium imaging,twophoton cell attach,two-photon targeted patch clamp and two-photon shadow patch clamp in living epileptic mice induced by 4-AP were used.Results:Laser photolysis of Rubi-GABA in hippocampal CA1 could immediately alleviate KA induced acute epileptic seizures in living mice.In cellular level,two-photon uncage Rub-GABA or rapid release of GABA significantly decreased the number of neurons releasing the calcium signals by multicell bolus lording of calcium,inhibited spikes recording by LFP and immediately inhibited both calcium signals and spikes using two-photon cell attaching technique in the living epileptic mice induced by 4-AP.Two-photon uncage Rub-GABA significantly decreased spikes induced by 4-AP recording with two-photon shadow patch clamp in vivo.In sub-cellular level,two-photon Rubi-GABA uncage of dendritic spines of cortical neurons transfected with GCaMP6f obviously decreased the frequency and amplitude of calcium signal on those dendritic spines in 4-AP induced epileptic living mice.Two-photon targeted patch clamp and shadow patch clamp were performed separately to both the cortical neurons transfected fluorescent labeled AMPA receptors in the mice by in utero electroporation and the cortical neurons with no fluorescent labeled AMPA receptors in control mice.The results showed that there was no difference in the electrophysiological indices between the two kinds of cortical neurons,meaning that there was no obvious change of electrophysiological characteristics in the cortical neurons transfected fluorescent labeled AMPA receptors.Further study showed that rapid disappearance of the AMPA receptors was found before disappearance of dendritic spines in epileptic living mice induced by high concentration of 4-AP,and the disappearance of the AMPA receptors was significantly delayed or the AMPA receptors even reappeared after rapid release of GABA with the different concentration of 4-AP in the living mice.Conlusion:Rapid release of GABA can rectify the excitatory/inhibitory imbalance and ion channel abnormalities of epilepsy,and rapidly inhibits epilepsy in free moving mice,and from cellular and sub-cellular level in vivo.It also protects the structure and function of neurotransmitter receptors during epilepsy in vivo.
