东莞市结核病患者就诊延迟及影响因素分析

目的 分析东莞市结核病患者的就诊延迟特征及影响因素,为结核病防治提供科学依据.方法 收集2018年东莞市3 865例结核病患者病案信息.采用秩和检验和多重线性回归分析就诊天数的影响因素,采用x2检验和logistic回归分析就诊延迟率的影响因素.结果 结核病患者就诊天数的中位数为28 d,就诊延迟率为69.5％.多重线...     

豁达放松治疗:一种新型的心理治疗方法

豁达放松治疗是基于帮助癌症患者康复、参考长期存活且生活质量高的癌症患者共同特点而创立。理论精髓为通过规范治疗,豁达放松可融入认知、情感、行为和日常生活方式中,并逐渐渗透到潜意识,成为人的习惯性心理行为模式。治疗目标是使接受治疗的个体达到在任何情况下都可调整到豁达的心境、全心身放松状态。疗法特点为简单易行、方法多样、富于吸引力。治疗形式主要包括电脑版与操作版、故事版与游戏版等。     

高血压患者心肌缺血与颈动脉粥样硬化的相关性研究

目的探讨高血压患者的心肌缺血与颈动脉粥样硬化之间的相关性。方法收集2005年5月至2008年9月在本院经查冠脉CTA排除冠心病的高血压患者共85例,首先根据平板运动负荷试验的结果将资料分为有无心肌缺血2组,与其影响因素间行单因素及多因素分析;然后再分析其与颈总动脉IMT及斑块的Crouse评分、室间隔及左室壁的厚度之间的相关性;最后建立ROC曲线评估颈总动脉的IMT及斑块的Crouse评分预测心肌有无缺血的价值。结果颈动脉斑块形成被发现是高血压患者心肌缺血的主要危险因素(OR=4.982,P=0.004),伴有颈动脉斑块形成的高血压患者其心肌缺血的发生率明显高于颈动脉无斑块形成的高血压患者(χ2=9.317,P=0.002);高血压患者的心肌缺血与室间隔及左室壁的厚度呈正相关(r=0.362,P=0.001;r=0.298,P=0.009),颈总动脉的IMT与室间隔厚度呈正相关(r=0.231,P=0.045);以Crouse评分预测高血压患者心肌有无缺血的ROC曲线下面积AUC为0.726±0.061,P=0.001;IMT的ROC曲线下面积AUC为0.682±0.061,P=0.006。结论颈动脉斑块形成...     

中西医结合防治糖尿病视网膜新生血管的疗效研究

目的探讨中西医结合防治糖尿病视网膜新生血管的临床效果。方法分析137例糖尿病视网膜病变病人临床资料,其中非增殖型82例,增殖型55例。78例用中西医结合治疗,59例单纯用西药治疗;通过眼底检查及荧光素眼底血管造影观察评价疗效,比较两组的临床效果。结果中西医结合治疗组的保护、改善眼底视网膜病变的作用明显优于对照组,尤其对视网膜新生血管的形成具有显著的抑制效果。结论中西医结合治疗能有效防止视网膜病变的发展,抑制视网膜新生血管的形成。     

复方石栗喷雾剂对大鼠烫伤后创面愈合作用的实验研究

目的:观察复方石栗喷雾剂时实验性大鼠烫伤后创面愈合的影响.方法:将72只大鼠造成Ⅱ度烫伤模型,取2只做病理检查,将其余70只随机分为复方石栗喷雾剂大剂量组(含生药材0.688 g/mL)、复方石栗喷雾剂中剂量组(含生药材0.344 g/mL)、复方石栗喷雾剂小剂量组(含生药材0.172 g/mL)、生理盐水组(阴性对照组)、磺胺嘧啶银组(0.5g/只,阳性对照组),每组14只.试药组创面每日用药2次,均匀喷覆,对照组每日用药1次,用药后创面不加覆盖,逐日观察创面感染愈合情况及动物的全身情况.比较各组第3天、第7天、第14天、第21天创面愈合率和最后创面愈合时间,并对创面进行病理切片分析.结果:复方石栗喷雾剂各组大鼠体征正常,创面无感染,与生理盐水组比较,大、中剂量组大鼠创面愈合倾向明显.与生理盐水组比较,复方石栗喷雾剂大、中剂量组在各个计时点创面愈合率明显提高,创面愈合时间明显减少(P＜0.01,P＜0.05),低剂量组则无明显差异(P＞0.05).病理切片显示大、中剂量组大鼠创面愈合较快.结论:复方石栗喷雾剂对实验性大鼠烫伤模型有确切疗效,且与剂量有一定关系.     

人卵巢腺癌多药耐药细胞株OVCAR/DDP的建立及生物学特性评价

目的:建立人卵巢腺癌多药耐药细胞株OVCAR/DDP,并评价其生物学特性。方法:采用顺铂(DDP)浓度梯度递增法,建立人卵巢腺癌OVCAR细胞株的多药耐药细胞株OVCAR/DDP,通过细胞生长曲线和群体倍增时间测定、四甲基偶氮唑盐法检测多药耐药性,蛋白印迹法检测细胞膜中P-糖蛋白表达水平,评价OVCAR/DDP的生物学特性。结果:成功建立OVCAR/DDP多药耐药细胞株。与亲本细胞OVCAR相比,OVCAR/DDP生长速度减慢,倍增期延长,其对DDP的耐药指数是OVCAR细胞的19.80倍,且对多柔比星、氟尿嘧啶、紫杉醇有交叉耐药。OVCAR/DDP细胞的细胞膜P-糖蛋白表达水平明显高于亲本细胞OVCAR(P<0.01)。结论:OVCAR/DDP细胞对DDP耐药性稳定,并呈现一定的多药耐药特性。     

Zinc increases vulnerability of rat thymic lymphocytes to arachidonic acid under in vitro conditions

Previous studies on the cytotoxicity of arachidonic acid (ARA) elucidated the involvement of oxidative stress and Ca²⁺. In the present study, the Zn²⁺-related cytotoxicity of ARA was studied by a flow cytometric technique with appropriate fluorescent probes in rat thymocytes. Addition of 10 μM ZnCl₂ enhanced the increase in cell lethality induced by 10 μM ARA. The removal of Zn²⁺ by Zn²⁺ chelators attenuated the ARA-induced increase in cell lethality. Thus, Zn²⁺ is suggested to be involved in ARA cytotoxicity. ARA at 3–10 μM elevated intracellular Zn²⁺ level. The Zn²⁺ chelators attenuated the ARA-induced increase in intracellular Zn²⁺ level while ARA significantly increased intracellular Zn²⁺ level in the presence of 3 μM ZnCl₂, suggesting the involvement of external Zn²⁺. Zn²⁺ reportedly exerts cytotoxic action under oxidative stress induced by hydrogen peroxide, via an excessive increase in intracellular Zn²⁺ levels. Since ARA induces oxidative stress, the simultaneous administration of zinc and ARA may be harmful.     

基于PubMed数据库及共词聚类分析的心脏康复研究热点

目的了解近5年国际范围内心脏康复研究的热点及现状,以期对我国心脏康复事业的发展方向起到一定的借鉴和指导作用。方法在PubMed数据库检索2013年11月至2018年11月发表的相关文献,采用Bicomb2.0软件和SPSS 22.0软件对主题词进行词频分析和共词聚类分析。结果共纳入4598篇文献,获得高频主题词81个,通过共词聚类分析总结出心脏康复研究的6个热点:心力衰竭患者的康复、运动能力的评估、心脏康复应用对象及病理生理学、心血管疾病二级预防、心脏康复指南及患者的依从性、心脏康复知信行。结论目前国内、外学者对于心脏康复研究日益增多,研究对象、研究主题趋于多样化,但高质量研究不多。我国可积极探索具有中国特色的心脏康复模式,加强对心血管疾病的二级预防的落实及心脏康复体系的规范化。     

Cost-effectiveness of Dabigatran Compared With Rivaroxaban for Prevention of Stroke and Systemic Embolism in Patients With Atrial Fibrillation in China

PurposeIn China, dabigatran and rivaroxaban are the only approved non–vitamin K antagonist oral anticoagulants for the treatment of atrial fibrillation (AF). The goal of this article was to assess the cost-effectiveness of dabigatran versus rivaroxaban for the prevention of stroke and systemic embolism in Chinese patients with AF from the perspective of the Chinese health care system.MethodsA Markov model was constructed to estimate the cost-effectiveness of dabigatran versus rivaroxaban. Clinical events were modeled for a lifetime horizon, based on clinical efficacy data from indirect treatment comparisons. The weighted average of the most recent prices of these 2 drugs was used as the drug acquisition cost. Other costs, including follow-up costs and event costs, were collected by using a survey from a panel of local experts. Utility inputs (health state utilities, clinical event disutilities, and event history utility) were obtained from published literature. Sensitivity analyses that included scenario analyses and a probabilistic sensitivity analysis were conducted to examine the robustness of the economic model.FindingsOver a lifetime, patients treated with dabigatran experienced fewer ischemic strokes (2.14 dabigatran vs 2.61 rivaroxaban) and fewer intracranial hemorrhage (0.48 vs 0.94) per 100 patient-years. In the base case analysis, dabigatran had an incremental cost of ¥28,128 but with higher life years (10.38 vs 10.14) and quality-adjusted life years (QALYs) (7.95 vs 7.70). The resulting incremental cost-effectiveness ratio of ¥112,910 per QALY gained and net monetary benefit of ¥12,214 versus rivaroxaban showed that dabigatran was a cost-effective alternative to rivaroxaban. Extensive sensitivity analyses indicated that the results were robust over a wide range of inputs. The probabilistic sensitivity analysis indicated that dabigatran was cost-effective in 84.2% of the 10,000 Monte Carlo simulations compared with rivaroxaban.ImplicationsDabigatran reduced the occurrence of clinical events and increased QALYs compared with rivaroxaban. The use of dabigatran for the prevention of stroke and systemic embolism is a cost-effective option compared with rivaroxaban among patients with AF in China.     

中国大学生睡眠质量性别差异的Meta分析

目的 了解中国大学生的睡眠质量是否存在性别差异,为推动大学生睡眠质量相关因素的研究提供依据.方法 计算机检索中国知网、中国学术期刊网、万方和Pubmed数据库.收集1991至2010年在国内外公开发表的关于中国大学生睡眠质量影响因素的相关文献,以“大学生睡眠质量、影响因素、性别、匹兹堡睡眠质量指数”为选择标准,对符合纳入条件的12篇文献进行Meta分析,采用Stata软件进行数据统计分析.结果 不同性别大学生的睡眠质量指数各成份和睡眠指数总分之间的差异均无统计学意义.其中睡眠质量d=0.01,95％ Cl=-0.14～0.14;入睡时间d=-0.09,95％ CI=-0.25～0.07;睡眠时间d=-0.21,95％ Cl=-0.61～0.19;睡眠效率d=-0.33,95％ CI=-0.17～0.11;睡眠障碍d=-0.11,95％ CI=-0.28～0.05;安眠药物d=0.11,95％Cl=-0.02～0.23;日间功能d=-0.15,95％ CI=0.41～0.11;睡眠质量总分d=-0.09,95％ CI=-0.29～0.10.结论 大学生的睡眠质量各个方面差异均无统计学意义.