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151.
目的观察全椎板切除脊柱内固定术治疗老年退行性腰椎管狭窄症的临床疗效。方法选取2007年5月~2011年12月我院收治54例老年退行性腰椎管狭窄症患者为研究对象,所有患者均行全椎板切除加脊柱内固定手术治疗,观察患者手术后疗效以及X线表现的改变。结果①本组术后1个月时椎体间相对距离为0.812±0.048,与术前比较有所增加,差异有统计学意义(P<0.05);椎体间矢状面活动角度、椎体间冠状面活动角度和椎体间水平面活动角度手术前后变化不明显,差异无统计学意义(P>0.05)。②术后疗效,优29例,良18例,中7例,优良率为87.04%。术后随访1~3个月,X线检查显示植骨均融合,内固定未见松动或断裂。结论全椎板切除减压脊柱内固定术治疗老年退行性腰椎管狭窄症,在正确掌握适应症的情况下,可获得满意的效果,既可实现彻底减压的目的,又能维持术后脊柱稳定性。 相似文献
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153.
目的:了解江苏省某市2008~2010年新农合基金运行状况和住院情况,提出促进新农合可持续发展的政策建议?方法:收集相关资料,应用统计学描述和关键知情人访谈法?结果:研究地区新农合整体运行状况良好,但仍需研究和解决政策及管理方面存在的一些问题:如筹资时间与方案调整不够同步;县外医疗机构住院费用高;目录外用药及项目费用偏高;人口老龄化对新农合影响较大?结论:研究地区新农合需建立稳定的筹资机制;及时调整补偿方案;加大对医疗机构的监管?完善绩效考核;加强支付改革?完善转诊制度;加强基层医疗卫生机构建设? 相似文献
154.
The obesity epidemic continues to grow. As the number of obese people increases, it is logical to expect an increasing number of obese patients and increasing costs to care for these patients. Orthopedic surgeons will see many of these patients who need treatment for injuries and chronic conditions. Care of obese patients requires more work and time in providing nonoperative and operative care. No system has been proposed to handle reimbursement disparities, particularly for providers. The model for health care will change and, along with it, should be all parties coming together to address inequalities and inequities in care for obese and morbidly obese patients. 相似文献
155.
Ploussard G Xylinas E Durand X Ouzaïd I Allory Y Bouanane M Abbou CC Salomon L de la Taille A 《BJU international》2011,108(4):513-517
Study Type – Diagnostic (case series) Level of Evidence 4
OBJECTIVE
- ? To investigate the role of magnetic resonance imaging (MRI) in selecting patients for active surveillance (AS).
PATIENTS AND METHODS
- ? We identified prostate cancers patients who had undergone a 21‐core biopsy scheme and fulfilled the criteria as follows: prostate‐specific antigen (PSA) level ≤10 ng/mL, T1–T2a disease, a Gleason score ≤6, <3 positive cores and tumour length per core <3 mm.
- ? We included 96 patients who underwent a radical prostatectomy (RP) and a prostate MRI before surgery.
- ? The main end point of the study was the unfavourable disease features at RP, with or without the use of MRI as AS inclusion criterion.
RESULTS
- ? Mean age and mean PSA were 62.4 years and 6.1 ng/mL, respectively. Prostate cancer was staged pT3 in 17.7% of cases.
- ? The rate of unfavourable disease (pT3–4 and/or Gleason score ≥4 + 3) was 24.0%. A T3 disease on MRI was noted in 28 men (29.2%).
- ? MRI was not a significant predictor of pT3 disease in RP specimens (P = 0.980), rate of unfavourable disease (P = 0.604), positive surgical margins (P = 0.750) or Gleason upgrading (P = 0.314).
- ? In a logistic regression model, no preoperative parameter was an independent predictor of unfavourable disease in the RP specimen.
- ? After a mean follow‐up of 29 months, the recurrence‐free survival (RFS) was statistically equivalent between men with T3 on MRI and those with T1–T2 disease (P = 0.853).
CONCLUSION
- ? The results of the present study emphasize that, when the selection of patients for AS is based on an extended 21‐core biopsy scheme, and uses the most stringent inclusion criteria, MRI does not improve the prediction of high‐risk and/or non organ‐confined disease in a RP specimen.
156.
BACKGROUND
Endoscopy accounts for a significant proportion of income for physicians practicing gastroenterology. Fees are set provincially, and the consistency with regard to compensation for colonoscopy and gastroscopy across the provinces has yet to be established.OBJECTIVE
To compare and contrast provincial endoscopy fees across Canada and internationally.METHODS
Provincial and territorial ministries responsible for health care were contacted for their most current fee schedule. This was reviewed, and the billing amounts for colonoscopy and endoscopy collected. International contacts were made with regard to rates outside of Canada.RESULTS
The mean (± SD) national fee for gastroscopy was $114.19±$31.47 per procedure, with a range of $52.50 to $156.10. Physician billing nationally averaged $170.99±$33.49 per colonoscopy procedure, with a range of $105.00 to $223.00. The province of Quebec provided the least amount of compensation for both procedures, and the province of Nova Scotia provided the most for both procedures.CONCLUSION
Physician fees for gastroscopy and colonoscopy vary widely among the provinces, and, on average, seem to be less than international rates. 相似文献157.
李雪峰 《中国现代药物应用》2013,(21):36-37
目的 探讨线性合型在下颌牙槽嵴严重吸收患者的临床应用和效果.方法 选择27例牙槽嵴重度吸收的无牙颌患者为其制作线性合型全口义齿和非解剖合型全口义齿患者使用3个月后检测其咀嚼效率并采用问卷调查对患者的总体满意度进行调查.结果 与传统的非解剖合型对比,线性合型的咀嚼效率和满意度高于非解剖合型.结论 对牙槽峙重度吸收的无牙颌患者应用线性合型全口义齿可以取得较好的综合满意度 相似文献
158.
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160.
[目的]建立一个具有中国特色的以医院为引导,社区为主体的脾瘅(糖尿病前期)中医综合防治方案。[方法]立足于中医药防治脾瘅(糖尿病前期)临床研究结果及行业标准,经同行专家多次讨论,再修订,达成共识。[结果]36.20%糖尿病高危人群因饮食失节发生脾瘅(糖尿病前期),病位在脾胃占43.60%,中医综合防治方案干预脾瘅(糖尿病前期)1a,42.15%血糖恢复为正常水平。[结论]制定国内具有代表性的、可复制的、易推广的糖尿病前期中医综合"三早"防治体系。 相似文献