"PALS for life!" A required trauma-oriented pediatric advanced life support course for pediatric and emergency medicine housestaff

While advanced cardiac life support (ACLS) and advanced trauma life support (ATLS) courses have become accepted standards for physicians who care for the critically ill and injured patient, only recently have pediatric advanced life support (PALS) courses been developed. The American Academy of Pediatrics has shown renewed interest in pediatric cardiopulmonary arrest after impressive gains made in adult resuscitation. The American Heart Association filled a void by including new chapters on Pediatric and Neonatal Resuscitation in the Textbook of Advanced Cardiac Life Support, 1981. A joint committee of AHA and AAP is seeking to unify course objectives and materials for standard curriculum. Because trauma is the most common cause of death and disability in children, pediatric trauma life support measures should be incorporated into any program directed toward emergency physicians and pediatricians who function in an emergency department or rural primary care setting. The Department of Pediatrics and Surgery and its division of Emergency Medicine has developed and implemented a PALS curriculum which is different from most other programs in that emphasis has been placed on pediatric trauma in addition to traditional cardiac (ACLS) resuscitation. This 20-hour program combines a modified ACLS curriculum with specific pediatric trauma lectures and laboratory sessions. It includes a canine surgical procedure lab and modified ATLS skill stations. At the completion of the course, students are eligible for ACLS certification. In the two years in which the course was given, 39 pediatric houseofficers were enrolled in the course.(ABSTRACT TRUNCATED AT 250 WORDS)     

Medical reliability of advanced prehospital cardiac life support

Records of 263 consecutive patients receiving prehospital advanced cardiac life support for dysrhythmias associated with clinical cardiac arrest were reviewed to determine 1) accuracy of diagnosis of presenting rhythm by the paramedic in the field and the medical control physician at the telemetry base station; and 2) whether the treatment rendered was appropriate. The initial rhythm was misinterpreted by the paramedic in 41 patients (16%) and by the medical control physician in 22 patients (11%). In 16 patients (8%) both paramedic and physician misinterpreted the initial rhythm. Treatment errors occurred in 120 patients (46%). Forty-seven errors (18%) resulted from failure to establish an intravenous line, 17 (6%) resulted from failure to secure a controlled airway, and 38 (14%) were medication errors from failure to adhere to protocol. We conclude that errors in management of prehospital cardiac arrest victims in our emergency medical services system result most often from mistakes in specific therapy rather than from failure to identify the precipitating dysrhythmia.     

Contributions of Cardiovascular Mortality to Spanish Life Expectancy From 1980 to 2009

Introduction and objectives

This article describes the contribution of the decrease in cardiovascular mortality to the increase in life expectancy at birth in Spain from 1980 to 2009. We explain the demographic factors underlying the decrease in mortality from cardiovascular diseases at older ages and the effect of this decrease on lifespan.

Methods

The contribution of these decreases to Spanish life expectancy at birth was calculated using decomposition methods for life expectancy. We calculated standardized mortality rates by sex and 3 causes of death (cerebrovascular disease, ischemic heart disease, and other heart disease) for 3 age groups: 65 to 79 years, 80 to 89 years, and ≥90 years.

Results

From 1980 to 2009, life expectancy at birth in Spain increased by more than 6 years for both sexes. The contribution of the decrease in cardiovascular mortality to the total increase in life expectancy at birth was 63% among women and 53% among men. Among the ≥65-year-old age group, this contribution was 93% among women and 87% among men.

Conclusions

The decrease in cardiovascular mortality, mainly at older ages, has been the main contributor to increased Spanish life expectancy at birth during the last 3 decades.     

Geographic variations of life history strategies in Drosophila melanogaster III. New data

A crucial assumption of evolutionary theories of aging is that age-specific differences of life history traits may have genetic causes. The present study focuses on the existence of such differences between eight freshly caught populations of Drosophila melanogaster. A highly significant differentiation of the populations is observed, yet it accounts for a relatively small part of the variance. It is also shown that large discrepancies may be found between the estimations of fitness based, on the one hand, on data for egg production and, on the other hand, on fertility data. This stresses the need for accurate measurements of fitness for the assessment of evolutionary theories. Finally, the results suggest that neither of the current evolutionary theories of aging is generally valid. Indeed, the age-specific differences that are found between the populations match either the antagonistic pleiotropy mechanism, or the concordant pleiotropy mechanism, or none of them.     

From the Cover: Geographically varying associations between personality and life satisfaction in the London metropolitan area

Residential location is thought to influence people’s well-being, but different individuals may value residential areas differently. We examined how life satisfaction and personality traits are geographically distributed within the UK London metropolitan area, and how the strength of associations between personality traits and life satisfaction vary by residential location (i.e., personality–neighborhood interactions). Residential area was recorded at the level of postal districts (216 districts, n = 56,019 participants). Results indicated that the strength of associations between personality traits and life satisfaction depended on neighborhood characteristics. Higher openness to experience was more positively associated with life satisfaction in postal districts characterized by higher average openness to experience, population density, and ethnic diversity. Higher agreeableness and conscientiousness were more strongly associated with life satisfaction in postal districts with lower overall levels of life satisfaction. The associations of extraversion and emotional stability were not modified by neighborhood characteristics. These findings suggest that people’s life satisfaction depends, in part, on the interaction between individual personality and particular features of the places they live.Where is the best place to live? Numerous “livability” rankings of cities and neighborhoods have been published in academic journals and newspapers (1–4). Such rankings tend to imply that all people would value the same residential areas equally. Places are often ranked by residents’ average happiness or life satisfaction—without considering how these places might match with specific dispositions of individuals. However, it seems likely that people’s life satisfaction depends on the interactions between neighborhood characteristics and individual dispositions (5, 6). For example, a location with high cultural diversity might enhance the lives of residents who are eager to explore new customs and cuisines, but increase the anxiety and discomfort of residents who prefer to live by their own social traditions.A growing number of studies have shown that personality traits are geographically clustered, and that these regional personality clusters are correlated with many sociocultural factors (6, 7). For example, the west coast of the United States is characterized by higher openness and emotional stability compared with the rest of the country, whereas the east coast has lower emotional stability and conscientiousness (7). One important question arising from these findings is whether the geographical clustering of personality represents adaptive patterns, so that people with certain personality traits are found in specific neighborhoods because these locations provide them higher levels of happiness for their personalities (6, 8–10). High extraversion, for instance, might be clustered in specific neighborhoods because these neighborhoods provide more opportunities of social interaction for individuals with high extraversion (11, 12). Thus, personality provides a psychological measure to test whether and how the people’s dispositions and neighborhood characteristics jointly influence life satisfaction.In the present study, we used data from more than 56,000 individuals living in the metropolitan area of London (United Kingdom) to examine the role of personality–neighborhood interactions in predicting life satisfaction. First, we examined how mean levels of life satisfaction and personality traits are spatially distributed across London. Although earlier studies have reported geographical differences in aggregated levels of personality and life satisfaction (6), these studies have not used the relevant spatial statistics to assess the geographical patterns. We used spatial analysis to quantify how strongly life satisfaction and different personality traits are geographically clustered. To further contextualize these geographical patterns, we assessed how the mean levels of life satisfaction and personality traits of neighborhoods were related to specific neighborhood characteristics, such as population density and crime rate.Second, we investigated whether personality traits correlate with life satisfaction differently depending on residential location. This analysis addressed the issue of personality–neighborhood interactions in determining people’s life satisfaction, because the focus was on geographically varying associations between personality traits and life satisfaction. The “person–environment fit” hypothesis postulates that a better match between person and environment leads to higher satisfaction, because the person’s behavior is better in line with the prevailing social norms, and the person’s needs are better fulfilled (13–15). To test how personality was differently related to life satisfaction in different neighborhoods, we fitted regression models that allowed personality traits to be differently associated with life satisfaction in different neighborhoods. To examine the specific neighborhood characteristics associated with higher or lower fit with personality traits, the neighborhood-specific regression slopes were then correlated with neighborhood characteristics and mean levels of personality. A positive correlation between the regression slope and mean personality level would indicate an adaptive spatial clustering of personality, so that people with high levels of the trait are living in neighborhoods where the trait is most strongly associated with higher life satisfaction.Most previous studies have examined psychological differences between relatively large geographical units, such as states and counties (7). To get more detailed measures of people’s residential locations and their surroundings, we determined neighborhoods at the finer resolution of postal districts. Life satisfaction was rated by the participants using the Satisfaction with Life Scale (16), and personality was self-reported by using the Big Five Inventory (17) that measures extraversion, neuroticism, agreeableness, conscientiousness, and openness to experience. Given the lack of previous research on the topic at the small-area spatial scale, we did not have predefined hypotheses of spatial patterns of life satisfaction or personality traits.     

影响慢性咳嗽患者生活质量的相关因素分析

目的 探讨影响慢性咳嗽患者生活质量的相关因素.方法 按照慢性咳嗽病因诊断流程入选患者.通过支气管乙酰甲胆碱激发试验测定患者气道反应性,记录患者莱斯特咳嗽问卷(LCQ)评分、咳嗽严重程度[采用视觉模拟尺(VAS)评价]、咳嗽症状积分,并分析其相关性.结果 100例慢性咳嗽患者纳入本研究.引起慢性咳嗽的前5位病因依次为咳嗽变异性哮喘、感染后咳嗽、变应性咳嗽、嗜酸粒细胞性支气管炎、上气道咳嗽综合征.不同病因、不同性别问的LCQ评分筹异无统计学意义(P>0.05).女性患者LCQ中的生理领域评分和心理领域评分显著低于男性;支气管乙酰甲胆碱激发试验阳性患者LCQ评分较阴性患者显著减低(t=-2.22,P<0.05).经过2周针对性治疗后,70例患者LCQ评分较治疗前显著提高(P值均<0.01).100例慢性咳嗽患者LCQ评分与年龄、咳嗽严重程度、咳嗽症状积分呈负相关(r分别为-0.239、-0.470、-0.448,P值均小于0.05),与BMI无相关性(r=-0.029,P>0.05).结论 性别与年龄可能影响慢性咳嗽患者的生活质量,LCQ、咳嗽严重程度、咳嗽症状积分可协同评估咳嗽的严重程度及疗效.

Abstract：

Objective To constitute a correlation with the subjective indicators by investigation of the causes and clinical features in patients with chronic cough.Methods Totally 100 patients with chronic cough were recruited followed a diagnostic program.Airway responsiveness[by methacholine challenge test (MCT)],Leicester cough questionnaire(LCQ),visual analogue scale(VAS),cough score,age,gender and disease duration were all recorded for analysis.Results The top five causes of chronic cough in these patients were variant asthma,post infectious cough,atopic cough,eosinophilic bronchitis and upper airway cough syndrome.LCQ total score was negatively correlated with age and the VAS score(r=-0.239 and -0.470 respectively,all P<0.05),while no difference was found among patients with different causes of disease or gender(F=1.233,t=1.918,all P>0.05)and no correlation was found with BMI(r=-0.029,P>0.05).The physiological and psychological field score in female patients significantly reduced(t=2.174,1.990,P<0.05),and LCQ total score of MCT positive patients obviously reduced than negative ones(t=-2.22,P<0.05).After the treatment of two weeks,LCQ three component field and total score could be improved significantly(all P<0.01).Conclusion Gender and age may have some impact on the quality of life in patients with chronic cough.LCQ,VAS and cough score should be used to assess cough severity and evaluate therapeutic effect in patients with chronic cough.     

Autophagy and leucine promote chronological longevity and respiration proficiency during calorie restriction in yeast

We have previously shown that autophagy is required for chronological longevity in the budding yeast Saccharomyces cerevisiae. Here we examine the requirements for autophagy during extension of chronological life span (CLS) by calorie restriction (CR). We find that autophagy is upregulated by two CR interventions that extend CLS: water wash CR and low glucose CR. Autophagy is required for full extension of CLS during water wash CR under all growth conditions tested. In contrast, autophagy was not uniformly required for full extension of CLS during low glucose CR, depending on the atg allele and strain genetic background. Leucine status influenced CLS during CR. Eliminating the leucine requirement in yeast strains or adding supplemental leucine to growth media extended CLS during CR. In addition, we observed that both water wash and low glucose CR promote mitochondrial respiration proficiency during aging of autophagy-deficient yeast. In general, the extension of CLS by water wash or low glucose CR was inversely related to respiration deficiency in autophagy-deficient cells. Also, autophagy is required for full extension of CLS under non-CR conditions in buffered media, suggesting that extension of CLS during CR is not solely due to reduced medium acidity. Thus, our findings show that autophagy is: (1) induced by CR, (2) required for full extension of CLS by CR in most cases (depending on atg allele, strain, and leucine availability) and, (3) promotes mitochondrial respiration proficiency during aging under CR conditions.     

宠物犬犬钩虫的调查及生活史各期形态观察

目的犬钩虫(Ancylostoma canium)幼虫可以感染人体,但不能发育为成虫,仅引起皮肤幼虫移行症。方法采用饱和盐水漂浮法和涂片法检查钩虫卵;用"T"滤纸条培养犬钩蚴;皮肤感染和灌喂人工感染实验狗。感染后不同时间解剖狗,从狗小肠获取钩虫,镜下观察和拍照。结果厦门市30只宠物犬样本犬钩虫感染率为3.33%(1/30),蛔虫感染率为10.00%(3/30)。对犬钩虫生活史各期的形态进行观察。结论厦门市存在宠物犬犬钩虫感染,特别是农家狗的犬钩虫感染为多。     

伴有肛周疾病的炎症性肠病患者肛门功能及生活质量分析

目的分析肛周疾病对炎症性肠病（IBD）患者肛门直肠功能和生活质量的影响。 方法回顾性分析2018年6月至2020年6月淮安市第二人民医院收治的伴有肛门不适的53例IBD患者（IBD组）。其中CD43例，UC10例。包括肛瘘35例，大便失禁15例，肛门纤维化8例。选择同期来淮安市第二人民医院体检的健康人20名作为健康对照组。通过肛门直肠测压对IBD患者和健康对照组受试者肛门功能进行评估并进行比较。采用炎症性肠病患者生活质量量表（IBDQ）评分对IBD患者生活质量进行评估。 结果IBD患者与健康对照组最大肛门静息压、最大挤压压、直肠容量感觉阈值、最大耐受容量、肛管抑制反射阳性水平差异均无统计学意义（P均>0.05）。大便失禁的IBD患者最大肛门静息压、IBDQ评分均低于非大便失禁的IBD患者，且差异均有统计学意义（P<0.05）。CD与UC患者IBDQ评分差异无统计学意义（P>0.05）；大便失禁IBD患者IBDQ评分低于非大便失禁IBD患者，且差异有统计学意义（P<0.05）。 结论合并肛周疾病的IBD患者肛门直肠功能受损，大便失禁的患者生活质量差。     

双侧丘脑底核交叉电脉冲脑深部电刺激对帕金森病步态障碍的疗效观察

目的评价双侧丘脑底核（STN）交叉电脉冲脑深部电刺激（DBS）对帕金森病（PD）步态障碍（GD）的治疗效果。 方法纳入南通市第四人民医院神经外科自2019年6月至2021年6月收治的35例行双侧STN-DBS治疗的PD患者为研究对象。所有患者采用交叉电脉冲DBS持续刺激3个月,其后转为单极DBS刺激3个月,通过世界运动障碍学会第三版统一帕金森病评估量表（MDS-UPDRS Ⅲ）评估患者运动症状的变化,起立行走试验（TUG）评估患者GD的治疗效果,帕金森病生活质量量表-39（PDQ-39）评估患者生活质量变化,并收集患者不良反应表现。 结果35例PD患者采取交叉电脉冲DBS和单极DBS治疗后的MDS-UPDRS Ⅲ评分为（27.31±9.14）和（27.74±9.62）分,对比差异无统计学意义（P>0.05）;交叉电脉冲DBS治疗后FOG-Q评分为（9.40±1.70）分,TUG步数（19.29±1.47）步,TUG时长为（10.97±1.40）s,PDQ-39评分分别为（59.46±1.71）分,均低于单极DBS治疗后[（12.54±1.99）分,（22.46±1.24）步,（13.97±1.24）s,（67.80±1.83）分],差异均具有统计学意义（P<0.05）。 结论双侧STN交叉电脉冲DBS治疗可以明显改善PD患者的GD,有效提升患者的生活质量。     

Faecal incontinence and health related quality of life in inflammatory bowel disease patients: Findings from a tertiary care center in South Asia

AIM: To analyze the frequency and severity of faecal incontinence(FI) and its effect on the quality of life(QOL) in inflammatory bowel disease(IBD) patients. METHODS: All patients who attended surgical and medical gastroenterology outpatient clinics in a tertiary care center with an established diagnosis of either ulcerative colitis(UC) or Crohn's disease(CD) over a period of 10 mo were included in this study. Before enrollment into the study, the patients were explained about the study and informed consent was obtained. The patients with unidentified colitis were excluded. The data on demographics, disease characteristics, FI(Vaizey score), and quality of life(IBD-Q) were collected. Data were analyzed using SPSS version 21.RESULTS: There were 184 patients(women = 101, 54.9%; UC = 153, 83.2%) with a female preponderance for UC(male/female ratio = 1:1.5) and a male preponderance for CD(male/female = 2:1). Forty-eight(26%) patients reported symptoms of FI. Among the patients with FI, 70.8% were women(n = 34) and 29.2% were men(n = 14) with an average age of 52.7 years(range, 20-78 years). Average age of onset of FI was 48.6(range, 22-74) years. Ten percent(n = 5) reported regular FI. Incontinence to flatus was seen in 33.3%(n = 16), to liquid faeces in 56.2%(n = 27), to solid faeces in 6.2%(n = 3) and to all three in 4.1%(n = 2). Twenty-one percent(n = 10) complained of disruption of their physical and social activity. There was no association between FI and type of IBD. Significant associations were found between FI and age(P = 0.005) and gender(P 0.001). QOL in our cohort of patients was significantly affected by FI.CONCLUSION: In our study, nearly a quarter of patients reported FI. There was a significant correlation between FI and QOL. Therefore, enquiring about FI in IBD patients can lead to identification of this debilitating condition. This will enable early referral for continence care in this group of patients.     

Efficacy and safety of adalimumab in Canadian patients with moderate to severe Crohn's disease: results of the Adalimumab in Canadian SubjeCts with ModErate to Severe Crohn's DiseaSe (ACCESS) trial

OBJECTIVE:

To evaluate open-label adalimumab therapy for clinical effectiveness, fistula healing, patient-reported outcomes and safety in Canadian patients with moderate to severe Crohn’s disease (CD) who were either naive to or previously exposed to antitumour necrosis factor (anti-TNF) therapy.

METHODS:

Patients with moderate to severe CD (CD activity index [CDAI] score of greater than 220, or Harvey-Bradshaw index [HBI] of 7 or greater) were eligible. Patients received open-label adalimumab as induction (160 mg and 80 mg subcutaneously [sc]) at weeks 0 and 2, respectively and maintenance (40 mg sc every other week) therapy. At or after eight weeks, patients with flare or nonresponse could have their dosage increased to 40 mg sc weekly. Patients were followed for a minimum of six months or until adalimumab was commercially available in Canada.

RESULTS:

Of the 304 patients enrolled, 160 were infliximab experienced, while 144 were anti-TNF naive. HBI remission (HBI score of 4 or lower) at week 24 was achieved by 53% of anti-TNF-naive and 36% of infliximab-experienced patients (P<0.01; P<0.001 for both groups for all visits versus baseline). Fistula healing rates at week 12 were 48% for anti-TNF-naive patients, and 26% for infliximab-experienced patients. At week 24, fistula healing rates were significantly greater for the anti-TNF-naive group (60% versus 28%; P<0.01). Improvements in quality of life and work productivity were sustained from week 4 to week 24 for all patients. Serious infections occurred in 2% of patients.

CONCLUSIONS:

Adalimumab therapy induced and sustained steroid-free remission in both infliximab-experienced and anti-TNF-naive patients with moderate to severe CD. Clinically meaningful rates of fistula healing were also observed. Improvements in patient-reported outcomes were sustained throughout the 24-week study period.     

Study of Wear Phenomenon of a Dental Milling Cutter by Statistical–Mathematical Modeling Based on the Experimental Results

The wear phenomenon of a dental milling cutter is studied based on experimental results and data and validated by statistical–mathematical modeling. The results of the statistical–mathematical modeling by the interpolation of the experimental results (data) regarding the wear of the dental milling cutter analyzed and obtained in the work process are presented in this paper. These results (data) are important because they lead to polynomial functions which by interpolation approximate very well the dependent parameter, specifically the wear process (mass lost due to dental milling cutter wear, m_w), considered in the experimental program. The polynomial interpolation functions are valid, only during the experimental testing range of the dental milling cutter, to describe the wear phenomenon; the extrapolations do not lead to satisfactory results. However, by using a controlled interpolation function with an exponential component, the extrapolation of the results is possible. Therefore, the purpose of this paper is the statistical–mathematical modeling by the interpolation of the experimental results of the mass lost due to dental milling cutter wear, m_w, using the deterministic differential model for the work process of it. Thus, interesting conclusions can be drawn relating to the phenomenon. In support of these statements come the results of the statistical–mathematical modeling by the interpolation of the experimental data obtained in the work process of the dental milling cutters, leading to practical applications, such as the extension of the life of dental milling cutter, useful even for its operation optimization; determination of possible criteria for replacing the worn dental milling cutters; the extension of the life of the materials from which dental milling cutters are built; or the provision of ideas for constructive solutions. Based on the modeling results by interpolation, it was found that the dental milling cutter during the milling operation works with high efficiency (mass loss due to wear is very reduced) in the first 11 h of operation, i.e., about a 10% increase in lifetime. After 11 h of operation, mass loss due to wear of the dental milling cutter increases relatively exponentially; thus, it is recommended that, in the normal way, the dental milling cutter be replaced with a new one to ensure high standards of materials processing.     

Fatigue Life Prediction of CFRP-Strengthened RC Beams with Flexural Crack under Hygrothermal Environments

The durability of reinforced concrete (RC) beams strengthened with carbon fiber-reinforced polymer (CFRP) is a worldwide concern in structural engineering. As an important part of the strengthened beam, the performance of the CFRP–concrete interface under hygrothermal environments is a delicate problem. In this paper, the fatigue behavior of CFRP-strengthened RC beams is analyzed by a theoretical model. In the model, CFRP–concrete interface degradation under hygrothermal environments is involved. Since interface debonding and rebar fracture induced by intermediate cracking are two typical failure modes, the damage models of rebar and the CFRP–concrete interface are established. Based on the theoretical model, the failure mode of CFRP-strengthened RC beams can be predicted, and fatigue life can be determined. The results showed that IC debonding is more likely to occur under hygrothermal environments. The accurate prediction of failure modes is essential for fatigue life prediction.     

Major flowering time gene,FLOWERING LOCUS C,regulates seed germination in Arabidopsis thaliana

FLOWERING LOCUS C (FLC) is a major regulator of flowering responses to seasonal environmental factors. Here, we document that FLC also regulates another major life-history transition-seed germination, and that natural variation at the FLC locus and in FLC expression is associated with natural variation in temperature-dependent germination. FLC-mediated germination acts through additional genes in the flowering pathway (FT, SOC1, and AP1) before involving the abscisic acid catabolic pathway (via CYP707A2) and gibberellins biosynthetic pathway (via GA20ox1) in seeds. Also, FLC regulation of germination is largely maternally controlled, with FLC peaking and FT, SOC1, and AP1 levels declining at late stages of seed maturation. High FLC expression during seed maturation is associated with altered expression of hormonal genes (CYP707A2 and GA20ox1) in germinating seeds, indicating that gene expression before the physiological independence of seeds can influence gene expression well after any physical connection between maternal plants and seeds exists. The major role of FLC in temperature-dependent germination documented here reveals a much broader adaptive significance of natural variation in FLC. Therefore, pleiotropy between these major life stages likely influences patterns of natural selection on this important gene, making FLC a promising case for examining how pleiotropy influences adaptive evolution.     

慢性阻塞性肺疾病患者生命质量及其相关因素研究进展

随着医学模式从单纯的生物-医学模式向生物-心理-社会模式的转变,目前对"健康"的理解已不局限于寿命的延长,提高生命质量更为重要.本文综述了慢性阻塞性肺疾病患者生命质量概念、生命质量测量表及其选择以及生命质量的影响因素.     

中国13个城市经皮冠状动脉介入治疗的成本疗效分析

目的 对经皮冠状动脉介入治疗(PCI)进行成本疗效分析.方法 连续收集2006年1月至6月在中国13个城市行PCI的冠心病患者资料.利用SF-36健康调查量表对患者住院期间及出院9个月后的生命质量进行问卷调查,并依此进行成本疗效分析.结果 (1)51.8%接受PCI的冠心病患者年龄在60岁以下.(2)患者住院成本中材料成本占82.5%、西药费占6.8%、手术费占5.9%,这3项共占总住院成本的95.2%,其中支架费用占材料成本的69.8%.(3)术后1年内患者再次入院成本:44例由于发生不良反应事件而再次入院患者的平均再次住院成本为17 841.5元.(4)术后1年内的药物费用:以使用频率最高的5种药(阿司匹林、氯吡格雷、美托洛尔、阿托伐他汀和辛伐他汀)的使用量和价格为依据,通过对患者术后1、3、6、9、12个月的随访调查显示,患者在术后平均每个月的药费为831.5元,每个月药费为400.0元的患者最多.(5)患者治疗后的生命质量显著提高,平均得分提高20.59分;每提高一个分值的生命质量需花费3975.7元;每获得一个质量调整生命年花费59 898.3元.结论 我国PCI的成本疗效比在一个较为理想的范围内.