1995年苏州地区双胎妊娠结局分析

【目的】分析出生指标。评价双胎妊娠结局。【方法】采用1995年苏州地区围产保健监测资料，比较单、双胎孕周、出生体重、Apgar评分、新生儿死亡率及死亡原因。【结果】双胎妊娠中早产儿占35．0％；低出生体重儿占49．2％；1min和5min Apgar评分窒息者分别占13．9%和5．6％；各指标均显著高于单胎。双胎新生儿死亡率为45．9‰；早期新生儿死亡率42．8‰；新生儿主要死亡原因为早产。【结论】与单胎儿相比，双胎妊娠胎儿宫内发育时间、发育状况、产后适应能力等均明显偏差，新生儿死亡率显著偏高。应采用多种干预措施，改善双胎妊娠不良结局。     

Blurring the distinctions between on and off the job injuries: similarities and differences in circumstances.

OBJECTIVES: To compare the causes of non-fatal work and non-work injuries and the places or environments where they occur. It has been suggested that many injuries may have similar etiologies on and off the job and thus involve some common prevention strategies. However lack of comparable data on work relatedness has prevented testing this proposition. METHODS: The National Health Interview Survey (NHIS) now collects information on the cause, location, and work relatedness of all medically attended injuries. National US estimates of non-fatal work and non-work injuries were compared by cause and place/location for working age adults (18-64 years). RESULTS: Overall 28.6% of injuries to working age adults were work related (37.5% among employed people). The causes and locations of many work and non-work injuries were similar. Falls, overexertion, and struck/caught by were leading causes for work and non-work injuries. Motor vehicle injuries were less likely to be work related (3.4% at work v 19.5% non-work) and overexertion injuries more likely to be work related (27.1% v 13.8%). Assaults were less than 1% of work injuries and 1.8% of non-work injuries. Both work and non-work injuries occurred in every location examined-including the home where 3.5% of injuries were work related. CONCLUSIONS: Work and non-work injuries share many similarities suggesting opportunities to broaden injury prevention programs commonly restricted to one setting or the other. Comprehensive efforts to prevent both non-work and work injuries may result in considerable cost savings not only to society but also directly to employers, who incur much of the associated costs.     

论非酒精性脂肪肝与中医体质的关系

非酒精性脂肪肝(NAFLD)是临床常见慢性肝病,随着生活水平的提高,生活方式的改变,其患病率及检出率逐年上升。通过检索有关文献总结NAFLD的病因、病机、主要证型、体质类型及特征,从体质可分性、体质与证型相关性、体质可调性认识NAFLD与体质的关系,并在综合阐述的基础上提出对NAFLD防治研究的展望,以期更好地发挥中医治未病的优势。     

我院门诊患者退药情况分析及对策

目的：对我院门诊患者退药情况进行分析,采取合理措施降低退药率,保证药品质量,从而提高我院药房管理质量,保证患者安全。方法：分析2013年6～12月我院门诊药房退药数据,根据退药科室、退药原因、退药剂型分类进行统计分析,并提出改进措施。结果：在退药原因中所占比例最大的是因医生开错处方导致退药的高达17.1%,患者退药金额共计52732.9元,其中神经类用药的退药金额最大,为23648.72元,所占比例为21.32%,皮肤外用药的退药比例和退药金额都较大,分别为48.34%和16705.85元,口服片剂占59.76%,注射剂占29.83%。结论：为加强医院管理,提高医务人员的责任心,强化医生合理用药意识,保证患者安全,减少退药,需要药师与医生协作与配合。     

3种银杏叶制剂治疗冠心病心绞痛的成本—效果分析

目的:比较3种银杏叶制剂治疗冠心病心绞痛的成本-效果。方法:将103例符合诊断标准的冠心病心绞痛患者按照不同的用药方案分成A组(34例)、B组(35例)、C组(34例)。A、C组分别给予生产厂商及规格不同(2mL vs.5mL)的舒血宁注射液20mL、B组给予银杏达莫注射液20mL,3组均静脉滴注,qd,治疗14d后观察疗效,并进行成本-效果分析。结果:3组心绞痛改善总有效率分别为70.59%、91.43%、73.53%。成本分别为5207.86元、3575.46元、5065.06元,成本-效果比分别为7377.62、3910.60、6888.43。结论:与A、C组比较,B组治疗方案成本-效果比更优。     

深圳市2017年-2019年常住居民恶性肿瘤死因分析

目的 分析深圳市恶性肿瘤死亡特征和分布情况,为政府制定恶性肿瘤的防控策略提供参考依据.方法 采用国际疾病分类标准(ICD-10)进行编码分类,运用描述流行病学研究,对2017年1月1日-2019年12月31日深圳市常住居民恶性肿瘤10 612例死亡病例进行分析,分别计算死亡率、死因顺位等.结果 2017年-2019年间...     

Causes of death in primary plasma cell leukemia differ from multiple myeloma: A STROBE-compliant descriptive study based on SEER database

The primary plasma cell leukemia (pPCL) is a rare but aggressive variant of multiple myeloma (MM). Few studies have focused on the differences in the causes of death between pPCL and MM. This study aimed to compare and evaluate the causes of death of patients with pPCL and MM.The data were collected from the Surveillance Epidemiology, and End Results (SEER) database. The demographic characteristics, survival, and causes of death in pPCL and MM patients were evaluated and compared. The competing risk regression model was performed to predict the cause of death.Between 1975 and 2009, the overall mortality rate was 96.13% and 88.71% for pPCL and MM, and the median survival was 9 and 26 months, respectively. In pPCL, leukemia caused 45.05% of the deaths, followed by myeloma (38.83%). In MM, myeloma was the leading cause of death, accounting for 74.89% of the deaths. Older age at diagnosis was a risk factor for dying of leukemia in pPCL patients (HR = 1.49, 95% CI: 1.16–1.91), while older age at death was associated with reduced risk (HR = 0.67, 95% CI: 0.52–0.86). Although the survival of pPCL patients increased with time periods of diagnosis since 1975 to 2009, the risk of dying of leukemia increased with the periods. For MM, most of the demographic characteristics were found to have independently predicting influence on the cause of death.Patients with pPCL and MM had distinct causes of death. Leukemia was the leading and the most serious cause of death in pPCL patients. The demographic factors could not predict the causes of death in pPCL. More large-scale and multi-center studies are needed to evaluate the effect of novel agents in pPCL patients, especially for patients who have progressed to leukemia.     

Ataxia in childhood: a pragmatic approach

Ataxia is a term used to describe a clinical presentation of incoordinated or inaccurate movements which occur without an alteration of tone or weakness. It is not a diagnosis, but its presentation has a wide differential diagnosis depending upon its onset. These can be a challenging group due to its varied aetiology. Broadly causes can be divided into genetic and acquired. Investigations are invasive and expensive. It is extremely important to liaise with a paediatric neurologist early following presentation as some of the ataxia are treatable. A methodological approach with history taking, detailed clinical evaluation and appropriate investigations are essential in establishing a diagnosis although it is still not uncommon to not to find a diagnosis in some of these children. Next generation exome sequencing is likely to improve the diagnostic yield in this group.