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51.
美国作为世界上经济最发达的国家,2005年其医疗卫生的总支出已占GDP的16%,高居全球之首,但是美国迄今尚有15.2%的人群没有医疗保险。如何解决这个问题,最近,马萨诸塞州出台了新措施:通过立法强制未参保人群参保。这种做法或许会对中国当前正在进行的医疗卫生体制改革有所启发。 相似文献
52.
Sanjay Sisodiya J Helen Cross Ingmar Blümcke David Chadwick John Craig Peter B Crino Paul Debenham Norman Delanty Frances Elmslie Mark Gardiner Jeffrey Golden David Goldstein David A Greenberg Renzo Guerrini Michael Hanna John Harris Paul Harrison Michael R Johnson George Kirov Dimitri M Kullman Andrew Makoff Carla Marini Rima Nabbout Lina Nashef Jeffrey L Noebels Ruth Ottman Munir Pirmohamed Asla Pitk?nen Ingrid Scheffer Simon Shorvon Graeme Sills Nicholas Wood Sameer Zuberi 《Epileptic Disord》2007,9(2):194-236
The Sixth Epilepsy Research Foundation workshop, held in Oxford in March 2006, brought together basic scientists, geneticists, epidemiologists, statisticians, pharmacologists and clinicians to consider progress, issues and strategies for harnessing genetics to improve the understanding and treatment of the epilepsies. General principles were considered, including the fundamental importance of clear study design, adequate patient numbers, defi ned phenotypes, robust statistical data handling, and follow-up of genetic discoveries. Topics where some progress had been made were considered including chromosomal abnormalities, neurodevelopment, hippocampal sclerosis, juvenile myoclonic epilepsy, focal cortical dysplasia and pharmacogenetics. The ethical aspects of epilepsy genetics were reviewed. Principles and limitations of collaboration were discussed. Presentations and their matched discussions are produced here. There was optimism that further genetic research in epilepsy was not only feasible, but might lead to improvements in the lives of people with epilepsy. 相似文献
53.
Summary Bayesian analysis is given of a random effects binary probit model that allows for heteroscedasticity. Real and simulated examples illustrate the approach and show that ignoring heteroscedasticity when it exists may lead to biased estimates and poor prediction. The computation is carried out by an efficient Markov chain Monte Carlo sampling scheme that generates the parameters in blocks. We use the Bayes factor, cross‐validation of the predictive density, the deviance information criterion and Receiver Operating Characteristic (ROC) curves for model comparison. 相似文献
54.
Helen J. Michielsen Marcel A. Croon Tineke M. Willemsen Jolanda De Vries Guus L. Van Heck 《Stress and health》2007,23(2):121-130
The main objective of this study was to examine the psychosocial stress model developed by Taylor and Aspinwall with emotional exhaustion as the outcome variable. Respondents, 409 men and 346 women, who had a paid job for at least 20 hours per week, completed questionnaires concerning demographic variables, personality, temperament, work pressure, workload, perceived social support, appraisal, coping, and emotional exhaustion. Structural equation analyses provided only partial support for the validity of the model. First, on theoretical and statistical grounds, one more path linking external resources to social support was added. Second, contrary to expectations, coping styles did not predict emotional exhaustion. To conclude, when coping is measured retrospectively, it does not add to our understanding of emotional exhaustion. It is suggested that future studies should be longitudinal and include objective measures of stressors and psychosocial health outcomes in addition to self‐reports. Copyright © 2007 John Wiley & Sons, Ltd. 相似文献
55.
56.
脂多糖直接诱导对肺微血管内皮细胞IL-8表达的影响及通过NF-κΒ调控机理的研究 总被引:1,自引:0,他引:1
目的 探讨脂多糖 (LPS)的直接诱导作用对肺微血管内皮细胞 (PMVEC)IL 8表达的影响及通过核因子κB(NF κB)的调控机理。方法 以 10 0ng/mlLPS刺激PMVEC 0 ,0 .5 ,1,2 ,4,6,8h或 1ng/ml、10ng/ml、10 0ng/mlLPS刺激 1h或6h为检测时相点 ,ELISA、原位杂交试验分别检测的培养液上清中分泌的IL 8及PMVEC内IL 8mRNA的表达 ;凝胶电泳迁移率分析 (EMSA)检验NF κΒ的活化 ;并观察NF κΒ活化抑制对IL 8表达的影响。结果 LPS能显著促进PMVEC表达IL 8,包括促进IL 8mRNA的表达及IL 8的分泌。在时间上mRNA的表达先于IL 8分泌。且LPS的直接诱导能迅速活化NF κΒ ,1h达到高峰 ,后逐渐下降。PDTC能显著抑制NF κΒ的活化及IL 8的表达 (P <0 .0 1)。结论 表明细菌致病因子LPS的直接诱导确能通过促进NF κΒ的活化 ,从而启动IL 8的高效表达和分泌 ,为多形核中性粒细胞 (PMN)的迁移提供必需的物质条件 ,导致肺损伤。 相似文献
57.
58.
回盲部恶性肿瘤的诊治 总被引:1,自引:0,他引:1
目的:分析回盲部恶性肿瘤的诊断和治疗过程,总结经验.以期提高早期确诊率和患者生存率。方法:回顾性分析近5年53例住院治疗的回盲部恶性肿瘤患者的临床资料。结果:53例患者中腺癌、黏液腺癌50例,恶性淋巴瘤3例。首次确诊率为75.5%。误诊或延迟诊断的疾病主要为阑尾炎、阑尾脓肿,胆囊炎、胆石症、下消化道出血、贫血待查等。结论:60岁以上的老年患者为回盲部恶性肿瘤的主要人群,肿瘤类型主要为腺癌。尽管首发症状缺乏特异性,但提高警觉性,详细询问病史,通过大便隐血试验、钡灌肠或气钡双重造影、纤维结肠镜检查仍能有效的提高首次确诊率,积极手术冶疗,可显著改善患者的预后。 相似文献
59.
Gu Su-juan顾素娟Beijing Chaoyang Hospital BeijingWeng Li-ju翁梨驹Be''ijing Municipal Research Department of Family Planning Beijing 《中华医学杂志(英文版)》1987,100(3):219-223
A combination of levonorgestrel 0.15mg and
ethinyl estradiol 0.03mg, an ultra-low dose oral con
traceptive in pellet form, was tried out in 9 Beijing
clinics. A total of l,035 healthy women of reproduc
tive age participated in 9,413 cycles of treatment.
Only one pregnancy was attributed to medication
failure which resulted in a corrected Pearl index of
0.13/100 women-year. The incidence of breakthrough
bleeding and amenorrhea was 0.12% and 0.05% res
pectively. Using the life-table method, the net
cumulative rate of termination due to medical-related
reasons at one year was only 5.93/100 women. The
incidence of side effects was low. The most frequent
complaints were nausea and drowsiness, which re
duced with the increase of treatment cycles. Some
metabolic changes were studied. In comparison
with other OCs used in China, this formula has the
advantages of ultra-low-dose steroids with higher
contraceptive efficacy, better cycle control and
fewer side effects. 相似文献
60.
病人,男,84岁,因左侧肢体活动不便14h,加重伴短暂意识不清2h,于2005年9月22日以脑出血收入院,病人体型消瘦。10月3日病人发热,体温38.5℃左右,遵医嘱给予消炎痛栓一枚肛入,30min后体温降至36.0℃,继之全身湿冷,大汗淋漓,表情淡漠,脉搏细弱,呼吸急促,测血压7/5.3kPa,立即给予吸氧5L/min、706代血浆、复方氯化钠注射液补充血容量,多巴胺注射液入液静脉输注,并及时更换被汗浸湿的被褥,擦干身体,有效保暖。密切监测生命体征及病情变化。1h后测体温35.6℃,脉搏100/min、血压10.7/8.0kPa,尿量50mL。15h后病人意识清楚,表情正常,测体温36.8℃,脉搏82/min,呼吸19/min,血压13.3/10.0kPa,考虑为低血容量性休克,该对症治疗病情稳定。 相似文献