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941.
近年来陆续发现了许多新的趋化因子和受体,研究发现趋化因子及其受体参与机体的多种生理和病理过程,并在肿瘤的侵袭转移中通过不同机制发挥着重要作用。本文对其进行简要综述。 相似文献
942.
Decisions about which health-care interventions represent adequate value to collectively funded health-care systems are as widespread as they are unavoidable. In the case of new pharmaceuticals, many countries now require formal cost-effectiveness analysis to inform this decision-making process. This requires evidence on parameters associated with health-related utilities, treatment effects, resource use, and costs, for which data from available regulatory trials are invariably absent or highly uncertain. This uncertainty results from a number of factors including the predominance of intermediate end points in the clinical evidence-base and the limited period of follow-up of patients in clinical studies. Despite these imperfections in the evidence base, decisions about whether new pharmaceuticals are sufficiently cost-effective for reimbursement cannot be side-stepped. Data limitations do, however, require the use of rigorous analytical methods to support decision making. Probabilistic decision models and value of information analysis offer a means of structuring decision problems, synthesizing all available data, characterizing the uncertainty in the decision, quantifying the cost of uncertainty, and establishing the expected value of perfect information. This analytical framework is important because it addresses two fundamental questions about new pharmaceuticals. First, is the product expected to be cost-effective on the basis of existing evidence? Second, is additional research concerning the product itself cost-effective? In addressing these questions, the analytical framework can establish when sufficient evidence exists to sustain a claim for a new pharmaceutical to be cost-effective. 相似文献
943.
K. P. Burdon C. D. Langefeld L. E. Wagenknecht J. J. Carr B. I. Freedman D. Herrington D. W. Bowden 《Diabetic medicine》2006,23(3):228-234
Aims Cardiovascular disease (CVD) is a major complication of Type 2 diabetes mellitus. The renin‐angiotensin system (RAS) and nitric oxide production are both important regulators of vascular function and blood pressure. Genes encoding proteins involved in these pathways are candidates for a contribution to CVD in diabetic patients. We have investigated variants of the angiotensinogen (AGT), angiotensin converting enzyme (ACE), angiotensin type 1 receptor (AT1R) and endothelial nitric oxide synthase (NOS3) genes for association with subclinical measures of CVD in families with Type 2 diabetes mellitus (T2DM). Methods Atherosclerosis was measured by carotid intima‐media thickness and calcification of the carotid and coronary arteries in 620 European Americans and 117 African Americans in the Diabetes Heart Study. Because of the role of these systems in blood pressure regulation, blood pressure was also investigated. Results Compelling evidence of association was not detected with any of the SNPs with any outcome measures after adjustments for covariates despite sufficient power to detect relatively small differences in traits for specific genotype combinations. Conclusions Genetic variation of the RAS and NOS3 genes do not appear to strongly influence subclinical cardiovascular disease or blood pressure in this diabetic population. 相似文献
944.
N. M. van Schoor D. L. Knol C. A. W. Glas R. W. J. G. Ostelo A. Leplège C. Cooper O. Johnell P. Lips 《Osteoporosis international》2006,17(4):543-551
Introduction Vertebral deformities are a common consequence of osteoporosis and are known to decrease quality of life. The Qualeffo–41
is a quality-of-life questionnaire especially developed for measuring quality of life in patients with vertebral deformities.
It consists of 41 questions arranged in five domains: pain, physical function, social function, general health perception,
and mental function. The objectives of this study were: (1) to develop a shorter version of the Qualeffo–41 by removing redundant
questions; and (2) to investigate the scale characteristics, reliability, and validity of this shorter version.
Methods The study was performed using data from the Qualeffo validation study and the Multiple Outcomes of Raloxifene Evaluation (MORE)
study. The analyses were performed in patients with vertebral deformities (n=579). Factor analysis on polychoric correlations and an item response theory (IRT) model, i.e., the generalized partial credit
model (GPCM), were used to create a shorter version of Qualeffo–41. Using GPCM, scoring weights were computed for all items.
Results Three items were removed from the data set because of too many missing values. Factor analysis identified three instead of
five domains: (1) pain, (2) physical function, and (3) mental function. Five items had factor loadings <0.4 and were not included
in the GPCM. After excluding several items, the domains pain (four items), physical function (18 items), and mental function
(nine items) showed a good, reasonable, and excellent fit, respectively. This indicates that the mental function domain and
the pain domain are more unidimensional than the physical function domain. All three domains showed a very high correlation
(r ≥0.95) with the corresponding domains of the Qualeffo–41.
Conclusions Qualeffo–31 was developed, consisting of three domains with a reasonable to excellent fit to the GPCM. Although the fit to
the GPCM supports the construct validity of the Qualeffo–31, validation in a new study should be performed before using it
in practice. 相似文献
945.
运用市场手段实现医药自然分开的理论探讨 总被引:1,自引:0,他引:1
回顾了韩国、我国台湾和大陆实行医药分开改革的过程,认为我国以往的相关改革陷入了“管制”的思维误区。认为通过制度设计,创造医疗机构门诊处方自由流动的环境,依靠市场竞争形成处方流向结构多元化,可以实现医药自然分开状态。提出了“医药自然分开”、“处方流向结构”和“处方分散度”等新概念。 相似文献
946.
947.
M Atasoy† C Aliagaoglu‡ O Sahin§ M Ikbal¶ N Gursan§ 《Journal of the European Academy of Dermatology and Venereology》2006,20(3):337-340
Linear atrophoderma of Moulin has a distinctive disease pattern characterized by hyperpigmented atrophoderma and was described originally in 1992. It follows the line of Blaschko, and occurs without preceding inflammation, subsequent induration or scleroderma. The lesions usually develop during childhood or adolescence, and the prognosis is good. The diagnosis is made clinically and histopathologically. In our 18-year-old male patient, there were atrophic plaques unilaterally located on the trunk and arm, and white discoloration on all finger nails. Histopathological examination revealed epidermal atrophy together with disruption of collagen fibres. 相似文献
948.
Reviewing the definition of "elderly" 总被引:1,自引:0,他引:1
Hajime Orimo Hideki Ito Takao Suzuki Atsushi Araki Takayuki Hosoi Motoji Sawabe 《Geriatrics & Gerontology International》2006,6(3):149-158
Conventionally, "elderly" has been defined as a chronological age of 65 years old or older, while those from 65 through 74 years old are referred to as "early elderly" and those over 75 years old as "late elderly." However, the evidence on which this definition is based is unknown. We have attempted to review the definition of elderly by analyzing data from long-term longitudinal epidemiological studies, and clinical and pathological studies that have been accumulated at the Tokyo Metropolitan Geriatric Hospital and the Tokyo Metropolitan Institute of Gerontology. Our recommendation might be a starting point in developing a strategy for a successful society by reviewing the definition of elderly based on comprehensive evidence in all aspects of social, cultural and medical sciences. 相似文献
949.
950.
Pieter F Vos Oliver Zilch Aag Jennekens-Schinkel Miriam Salden Jasper Nuyen Menno P Kooistra M Alexander C van Huffelen Margriet M Sitskoorn 《Nephrology, dialysis, transplantation》2006,21(9):2529-2535
BACKGROUND: End-stage renal disease patients have a poor quality of life (QoL), suffer from impaired cognitive functioning, and their electroencephalogram (EEG) shows abnormalities. Conventional haemodialysis (CHD) only partially restores these disorders. Short daily haemodialysis (SDHD) has been reported to improve QoL, but effects on cognitive functioning and EEG have yet to be described. METHODS: Of the 13 patients (11 male, 2 female, age 45.5 +/- 8.1 years), 11 completed the Kidney Disease Quality of Life and Affect Balance Scale questionnaires, 10 underwent neuropsychological testing, and all 13 underwent EEG examination. For the neuropsychological assessments, nine patients (six male, three female, age 45.4 +/- 12.6) who remained on the CHD schedule, served as controls. The dialysis schedule of thrice-a-week for 4 h was changed in the experimental group to six times a week for 2 h (SDHD) over a period of 6 months and back to thrice a week for 4 h. RESULTS: When on SDHD, patients rated several dimensions of health-related QoL as being improved. After resuming CHD, one of these dimensions again decreased and several others worsened even lower than baseline. Cognitive functioning did not change when compared with control data. On the EEG, alpha peak frequency increased slightly when on SDHD but decreased significantly after resuming CHD. CONCLUSIONS: SDHD improves health-related QoL, but has no clear effects on cognitive functioning and EEG. Resumption of CHD after SDHD decreases aspects of QoL and EEG alpha peak frequency but has no effect on cognitive functioning. 相似文献