中西医结合治疗单纯性淋病58例

中西医结合治疗单纯性淋病５８例天津医科大学第二医院（天津３００２１１）李文全天津中医学院第一附属医院姜湘德我们采用中西医结合疗法治疗５８例男性急性淋菌性尿道炎，获得满意疗效，现报告如下。临床资料根据中华人民共和国卫生部防疫司１９９３年制定的淋病诊断标...     

Comparison Between Different Effects Gained by Courses Of Different Length in Treating Falciparum Malaria with Artesunate Tablet

Ｃｏｍｐａｒｉｓｏｎ　Ｂｅｔｗｅｅｎ　Ｄｉｆｆｅｒｅｎｔ　Ｅｆｆｅｃｔｓ　Ｇａｉｎｅｄ　ｂｙ　Ｃｏｕｒｓｅｓ　Ｏｆ　Ｄｉｆｆｅｒｅｎｔ　Ｌｅｎｇｔｈ　ｉｎ　Ｔｒｅａｔｉｎｇ　Ｆａｌｃｉｐａｒｕｍ　Ｍａｌａｒｉａ　ｗｉｔｈ　Ａｒｔｅｓｕｎａｔｅ　Ｔａｂ...     

脑卒中的归因疾病负担分析

目的探讨归因于高血压的疾病负担对脑卒中总疾病负担的影响。方法采用DALY指标测量脑卒中及其归因于高血压的疾病负担,并分析高血压患病率下降后脑卒中疾病负担的变化情况。结果归因于高血压的负担占脑卒中总疾病负担的1／2左右。结论降低人群高血压患病率是降低脑卒中疾病负担的有效途径。     

下呼吸道感染疾病负担及影响因素研究进展

下呼吸道感染对人群健康产生重大威胁, 特别在婴幼儿及老年人群, 其造成的健康损害与疾病负担尤为显著。受到地域、人群、病原检测手段等多方面的影响, 下呼吸道感染在各个国家和地区的流行情况、病原谱差异很大。该组疾病的流行及严重程度受到病原体、人群特征、外界环境多种因素的共同影响。及时了解当地下呼吸道感染的疾病流行情况、病原谱及其影响因素, 有助于因地制宜地制定综合防控策略及更加合理地分配和利用医疗卫生资源。     

Cost-effectiveness of monoclonal antibody and maternal immunization against respiratory syncytial virus (RSV) in infants: Evaluation for six European countries

BackgroundRespiratory syncytial virus (RSV) imposes a substantial burden on pediatric hospital capacity in Europe. Promising prophylactic interventions against RSV including monoclonal antibodies (mAb) and maternal immunizations (MI) are close to licensure. Therefore, we aimed to evaluate the cost-effectiveness of potential mAb and MI interventions against RSV in infants, for six European countries.MethodsWe used a static cohort model to compare costs and health effects of four intervention programs to no program and to each other: year-round MI, year-round mAb, seasonal mAb (October to April), and seasonal mAb plus a catch-up program in October. Input parameters were obtained from national registries and literature. Influential input parameters were identified with the expected value of partial perfect information and extensive scenario analyses (including the impact of interventions on wheezing and asthma).ResultsFrom the health care payer perspective, and at a price of €50 per dose (mAb and MI), seasonal mAb plus catch-up was cost-saving in Scotland, and cost-effective for willingness-to-pay (WTP) values ≥€20,000 (England, Finland) or €30,000 (Denmark) per quality adjusted life-year (QALY) gained for all scenarios considered, except when using ICD-10 based hospitalization data. For the Netherlands, seasonal mAb was preferred (WTP value: €30,000-€90,000) for most scenarios. For Veneto region (Italy), either seasonal mAb with or without catch-up or MI was preferred, depending on the scenario and WTP value. From a full societal perspective (including leisure time lost), the seasonal mAb plus catch-up program was cost-saving for all countries except the Netherlands.ConclusionThe choice between a MI or mAb program depends on the level and duration of protection, price, availability, and feasibility of such programs, which should be based on the latest available evidence. Future research should focus on measuring accurately age-specific RSV-attributable hospitalizations in very young children.     

Prevalence,impact and treatment of spasticity in nursing home patients with central nervous system disorders: a cross-sectional study

Purpose To assess prevalence, impact and treatment of spasticity in nursing home patients with central nervous system (CNS) disorders. Methods The Modified Ashworth Scale was used as the main indicator of spasticity to assess muscle tone of the extremities. Further information was obtained on burden of care, level of independence, sleeping pattern, complaints, restrictions in functions/activities/participation and indication for treatment. Clinical assessments included coordination/sensibility parameters and various tests to assess motor performance. Results Fifty-six out of 77 participants (73%) with CNS disorders had spasticity, of whom 38 subjects also showed pathologically enhanced reflexes and 45 subjects had contractures in various joints. A high burden of care was observed in 71% and cramps/pain, cosmetic problems or other complaints due to spasticity were seen in 46, 20 and 26%, respectively. The vast majority of subjects were dependent for daily living activities and ambulation. Extra treatment of spasticity was indicated for 36% of the patients. Conclusion A high prevalence of spasticity was observed in nursing home residents with CNS disorders associated with substantial impact in terms of caregiving, complaints and compromised clinical outcome measures. To further optimize the treatment of spasticity in this vulnerable population, regional treatment plans should be developed.

• Implications for Rehabilitation

• The prevalence of spasticity in nursing home residents with central nervous system disorders is high (73%).

• The impact of spasticity is substantial in terms of increased dependency in activities of daily living, increased burden of care, sleeping problems and many complaints.

• Thirty-six percent of patients could be helped by extra specialized treatment, so the challenge for the multidisciplinary rehabilitation team is huge.

• Regional treatment plans should be developed to further optimize the treatment of spasticity in the vulnerable ageing population of nursing home residents.

     

动态心电图对评估心肌缺血价值的探讨

目的探讨动态心电图对评估心肌缺血的诊断价值。方法对在本院住院行动态心电图检查及行冠状动脉造影诊断为冠心病的123例患者进行分析,并且选择同期就诊于本院行动态心电图检查及行冠状动脉造影阴性的120例患者作为对照。结果冠心病组患者动态心电图异常改变83例(67.48%),对照组动态心电图异常改变34例(28.33%),两组差异有统计学意义(P0.05),心电图改变主要为ST段的改变,心肌缺血总负荷值增大。冠心病组平均心率明显快于正常对照组,冠心病组心率(79.72±12.98)次/min,对照组心率(71.29±10.14)次/min,两组差异有显著统计学意义(P0.05)。冠心病患者中,多支病变者较单支病变者心肌缺血总负荷值明显增大,两者比较差异有统计学意义(P0.05)。结论动态心电图对冠心病的诊断及预后评估有重要的参考价值。