尿石症相关危险因素的研究进展

尿石症（urinary stone disease,USD）是临床上一种常见病和多发病。伴随着工业化的发展,USD的发病率也在逐年递增。USD的病因可能与遗传、环境、机体代谢异常等诸多因素有关,具体到每个患者,发病原因可能是以上诸多因素共同作用的结果。本文从以下几个方面就近年来关于USD危险因素的研究进展予以综述。     

尿石症危险因素研究进展

尿石症(urinary stone disease,USD)是一种严重威胁人类健康的多发病,与人们的日常生活息息相关.USD的病因形成过程极为复杂,涉及到外界环境因素、内在个体因素、泌尿系统异常和尿液的改变等.本文就近年关于USD危险因素的研究进展作一综述.     

尿路结石症发病危险因素的研究进展

尿路结石症(urinary stone disease,USD)是一种世界范围的常见病和多发病,以肾结石最为常见,迄今为止,病因不明.目前普遍认为尿路结石症是由多种因素造成的,与自然环境、社会生活条件、营养状况、泌尿系统自身疾患以及种族遗传因素等有关.现将泌尿系统结石的发病危险因素的研究近况作一综述,为人群预防提供依据.     

尿液pH改变与尿石症的研究进展

尿石症(USD)是一种常见病、多发病,对健康的危害极大。导致USD高发的因素多种多样,其重要原因之一是尿pH值改变。尿液pH5.0,容易发生纯尿酸结石,尿液pH6.5,容易产生尿酸盐、草酸盐、磷酸盐和各种混合金属盐结石。控制尿液pH值在5.5~6.5范围能有效预防USD。本文综述报道尿液pH改变与USD关系的研究进展。     

人物介绍

尿石症(USD)是一种常见病、多发病,导致USD发病率高的关键因素是饮食成分.针对不同的尿结石成分,选择性控制食物种类或食物结构、以及通过USD术后饮食干预,能够预防USD和降低USD术后复发率.本文综述报道相关研究进展,同时简要评述研究中存在的问题和不足.     

饮食与尿石症相关性的研究进展

尿石症(USD)是一种常见病、多发病,导致USD发病率高的关键因素是饮食成分。针对不同的尿结石成分,选择性控制食物种类或食物结构、以及通过USD术后饮食干预,能够预防USD和降低USD术后复发率。本文综述报道相关研究进展,同时简要评述研究中存在的问题和不足。     

鄂西山区1592例成人泌尿系统疾病(USD)调查分析

本文对鄂西自治州一市二县三所医院近八年来(1980年元月～1987年12月)成人USD住院患者1592例的构成比作了回顾性调查分析.结果表明:USD患者占同期住院总人数的3.90%,其常见病种依次为尿路结石,尿路感染,慢性肾炎.急性肾炎、肾结核,慢性肾衰和肾病综合征;上尿路结石病人数有逐年上升趋势,且右侧显著高于左侧(P<0.001);慢性肾衰的病人数每隔1～2年有突然增高现象,1987年比1980年增加了四倍;急性肾炎和肾结核占有较大比例,肾结核为慢性肾衰病因的第三位.这些均为本组USD的临床流行病学特点.作者对各常见病种的特点进行了讨论.     

心室间隔缺损合并动脉导管未闭漏诊的原因及手术中的处理

心室隔缺损(USD)合并动脉导管未闭(PDA)的发生率占先天性心脏病的6％。自1981年2月至1992年5月,我们对6例USD合并PDA、并发肺动脉高压的病人在体外循环下进行了一期手术治疗,现总结如下。临床资料     

临床流行病学(二)——疾病的病因及危险因素研究与评价

病因学研究对于疾病的特异性诊断、针对性治疗和预后估计以及对疾病的预防都有重要的意义 ,始终是医学各领域研究的热点。1　病因的概念病因系指由外界环境客观存在的生物因素、物理因素、化学因素、社会因素 ,以及机体本身的心理因素、遗传因素等作用于人体 ,可以引起致病效应者 ,或称为致病因素。许多致病因素导致机体发病 ,是相当复杂的效应过程。病因可以直接或间接地对机体发生作用 ,同时也受到机体的反作用。病因又与环境之间相互影响、相互作用。而病因和机体又同处在环境之中 ,一旦环境、机体或病因的某一方面或几个方面的变化强度…     

慢性鼻窦炎病因及发病机制

慢性鼻窦炎的病因及发病机制非常复杂,本文从外因(环境性因素)和内因(宿主局部因素及宿主系统性因素)等来阐述慢性鼻窦炎的病因和机制,对深入认知慢性鼻窦炎的病因、确立诊断、明确治疗方向提供参考。     

环境库兹涅茨假设是否成立?——基于CO2排放量的国际数据验证

运用1960-2009年110个国家面板数据,验证环境库兹涅茨EKC假设是否成立。按照世界银行2011年标准将样本划分为不同收入组分别进行估计。估计结果表明低收入组的转折点为2029美元,中收入组为14396美元和高收入组为23513美元。发达国家人均收入普遍超过临界值,应该承担更多的减排责任。     

Health spending,illicit financial flows and tax incentives in Malawi

This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax revenues foregone by the government of Malawi by two main routes

• Illicit financial flows (IFF) from the country
• Tax incentives.

We find that there are significant financing gaps in the health sector; for example, government expenditure is United States Dollars (USD) 177 million for 2013/2014 while projected donor contribution in 2013/2014 is USD 207 million and the total cost for the minimal health package is USD 535 million. Thus the funding gap between the government budget for health and the required spending to provide the minimal package for 2013/2014 is USD 358 million. On the other hand we estimate that almost USD 400million is lost through IFF and corporate utilization of tax incentives each year.The revenues foregone plus the current government health spending would be sufficient to cover the minimal public health package for all Malawians and would help tackle Malawi''s disease burden. Every effort must be made, including improving transparency and revising laws, to curtail IFF and moderate tax incentives.     

Prevalence of ruminants fascioliasis and their economic effects in Kashan,center of Iran

ObjectiveTo determine the prevalence and economic losses of Fasciola spp. isolates and costs incurred due to liver condemnation from ruminants in Kashan region, center of Iran from 2012 to 2013.MethodsIn this cross-sectional study, a total number of 251 325 slaughtered sheep, goats and cattle (88 939 sheep, 151 924 goats and 10 462 cattle) were examined via necropsy for fasciolasis in industrial Kashan abattoirs located in center of Iran. The average weight was calculated as 1 000 g for sheep, 900 g for goat and 5 000 g for cattle in this study region. Based on market value, the average price of a kilo gram of normal liver at Kashan city during the study period was 8 USD. The amount of main nutrients and vitamins elimination in liver contaminated to fascioliasis was determined.ResultsOverall 3.28% of the livers were found to be infected. For total number of sheep, goats and cattle slaughtered annually in region study, it was estimated that 7 505 livers were infected and total annual economic losses of fascioliasis of studied animals was 41 784 USD (based on market prices in study period). Of this, 23 360 USD, 30 240 USD and 15 400 USD were associated with the fascioliasis of sheep, goats and cattle, respectively.ConclusionsThis study indicated that the Fasciola sp. clearly remains prevalent and causes considerable economic losses in study region in sheep, goats and cattle and presumably, other areas and hosts of Iran, providing baseline data for the future monitoring of this potentially important parasitic infection in the country.     

The cost of diabetes mellitus and its impact on health spending in Mexico

BACKGROUND: The objective of this study was to determine the cost of diabetes mellitus, its impact on health spending in Mexico, and its percentage of the gross domestic product (GDP). METHODS: There was a four-stage approach: identification of the epidemiology of the use of health services; estimate of treatment cost; determination of the diabetic population, and calculation of the percentage of health spending. RESULTS: The average annual cost per diabetic patient was $708 U.S. dollars (USD), the total annual cost of diabetics was $2,618,000 USD, the percentage of health spending was 15.48%, and the percentage of the GDP was 0.79%. CONCLUSIONS: It is necessary to seek strategies that allow for a more efficient use of resources designated for type 2 diabetes treatment.     

中医在美国发展的概况

从上世纪90年代开始,美国政府包括白宫、国会、公共卫生服务部和美国国家卫生研究院(Na-tional Institutes of Health,NIH)决定发展补充替代医学(Complementary&Alternative Medicine),在美国现代医学史翻开了崭新的一页。补充替代医学的范围涵盖除西医以外的各种医学和疗法,相当于世界卫生组织所规范的"传统医学"(Traditional Medi-cine),补充替代医学正在美国医疗保健系统中发挥     

Direct medical costs for partial refractory epilepsy in Mexico

BACKGROUND: The aim was to determine the direct medical costs in patients with partial refractory epilepsy at the Mexican Institute of Social Security (IMSS) in Mexico. METHODS: We carried out a multicenter, retrospective-cohort partial-economic evaluation study of partial refractory epilepsy (PRE) diagnosed patients and analyzed patient files from four secondary- and tertiary-level hospitals. PRE patients >12 years of age with two or more antiepileptic drugs and follow-up for at least 1 year were included. The perspective was institutional (IMSS). Only direct healthcare costs were considered, and the timeline was 1 year. Cost techniques were microcosting, average per-service cost, and per-day cost, all costs expressed in U.S. dollars (USD, 2004). RESULTS: We reviewed 813 files of PRE patients: 133 had a correct diagnosis, and only 72 met study inclusion criteria. Fifty eight percent were females, 64% were <35 years of age, 47% were students, in 73% maximum academic level achieved was high school, and 53% were single. Fifty one percent of cases experienced simple partial seizures and 94% had more than one monthly seizure. Annual healthcare cost of the 72 patients was 190,486 USD, ambulatory healthcare contributing 76% and hospital healthcare with 24%. CONCLUSIONS: Annual mean healthcare cost per PRE patient was 2,646 USD; time of disease evolution and severity of the patient's illness did not affect costs significantly.     

Cost of post-stroke outpatient care in Malaysia

INTRODUCTION

This study aimed to investigate the direct cost of outpatient care for patients with stroke, as well as the relationship between the aforementioned cost and the sociodemographic and stroke characteristics of the patients.

METHODS

This was a cross-sectional study involving patients with first-ever stroke who were attending outpatient stroke rehabilitation, and their family members. Participants were interviewed using a structured questionnaire designed to obtain information regarding the cost of outpatient care. Stroke severity was measured using the National Institute of Health Stroke Scale.

RESULTS

This study comprised 49 patients (28 men, 21 women) with a mean age of 60.2 (range 35–80) years. The mean total cost incurred was USD 547.10 (range USD 53.50–4,591.60), of which 36.6% was spent on attendant care, 25.5% on medical aids, 15.1% on travel expenses, 14.1% on medical fees and 8.5% on out-of-pocket expenses. Stroke severity, age > 70 years and haemorrhagic stroke were associated with increased cost. The mean cost of attending outpatient therapy per patient was USD 17.50 per session (range USD 6.60–30.60), with travelling expenses (41.8%) forming the bulk of the cost, followed by medical fees (38.1%) and out-of-pocket expenses (10.9%). Multiple regression analysis showed that stroke severity was the main determinant of post-stroke outpatient care cost (p < 0.001).

CONCLUSION

Post-stroke outpatient care costs are significantly influenced by stroke severity. The cost of attendant care was the main cost incurred during the first three months after hospital discharge, while travelling expenses was the main cost incurred when attending outpatient stroke rehabilitation therapy.     

改进CPA—矩阵法同时测定撒痛风注射液各组分的含量

采用改进CPA-矩阵法用于分光光度法以改善求逆的精度。测定撒痛风各组分的含量,结果为:水杨酸钠的平均回收率为99.3％,RSD为0.66％;咖啡因平均回收率为101.1％,RSD为0.34％;安替比林平均回收率为99.5％,RSD为0.58％。