Chronic illness in adolescents: Transfer or transition to adult services?

It is widely believed that the improved survival of young people with chronic diseases will be associated with the development of appropriate services within the adult healthcare domain. There is, however, little evidence to suggest that this is happening at a rate commensurate with clinical requirements. This paper highlights the multiplicity of barriers that impede the development of transition services to facilitate the transfer of medical care from the paediatric to the adult domain. Different models of transition care are described, and the terms 'transfer' and 'transition' are differentiated. The clinical demand for service development is highlighted, as well as the need for specific research in this area of healthcare delivery.     

环枢关节紊乱症的临床研究

环枢关节紊乱症，从发病机理到临床表现，乃是颈椎病中较复杂的疑难顽症。用常规诊治方法，疗效不佳。本研究提出新的诊断依据与治疗方法，对３２０例病者随机分为治疗组１６６例（采用改进的诊治方法），对照组１５４例（用常规诊治方法）对照进行疗效观察。结果显示：治疗组治愈率与总有效率及康复率均高于对照组。有非常显著差异，Ｐ＜０．０１。而疗程较对照组短。环枢关节紊乱症的临床研究有利于颈椎病诊治水平的提高，运用于临床，疗效好，效益高，具有推广应用价值。     

中医研究的三个重要趋势

就科学理念对实验设计的指导作用而言，当前中医研究有三个重要趋势：1．从线性的简单系统走向开放的复杂巨系统；2．由模式生物走向人体实验；3．由“纯粹”科学走向与人文科学相融合。     

Experience of spirituality, mental illness and occupation: A life-sustaining phenomenon

Background and Aim:  This article provides an overview of a phenomenological investigation of spirituality with six people who have experienced mental illness. The study aimed to gain a greater understanding of the phenomenon of spirituality and its relationships to occupation and the experience of mental illness.
Methods and Results:  Participants were interviewed and the interviews were audiotaped and transcribed verbatim. Findings emerged through multiple readings and gradually constructed meanings from the data. Spirituality was found to be: unique to each participant, a journey through life, vitally important to participants, manifested as 'spiritual occupations', the foundation of meaningful doing, important socially as well as individually, and was found to support participants in coping with mental illness. This article focuses on the 'meta', integrative theme of spirituality as life sustaining. It concludes with the notion that spirituality is essential to the participants and is a significant aspect of their occupational behaviour.
Conclusion:  It is recommended that occupational therapists give themselves a 'licence' to discuss spirituality in practice and that they commit to learning more about how spirituality is a part of the lives of their clients.     

Conduct of trials in private clinical practice

PURPOSE: Trials of antiepileptic medications are usually based in tertiary referral centers with teaching hospital resources. Epilepsy Research & Services (ERS) is part of a private outpatient neurological clinic that is involved in research as part of multicenter clinical trials, adhering to Good Clinical Research Practice. ERS is subject to external monitoring and auditing, but does so outside of the teaching hospital environment. METHODS: The clinic is operated by a neurologist supported by a research assistant, administrative and nursing staff and has no formal university attachment. Patients are recruited for trials from routine referrals for clinical care. The center has formal ties with the ethics committee of the local teaching hospital, but none of the team is formally attached to that hospital. RESULTS: The center conducted trials of zonisamide, oxcarbazepine, gabapentin, remacemide, tiagabine, vigabatrin, felbamate, and lamotrigine both as add-on trials in refractory seizure disorders and as monotherapy trials in de novo epilepsy. More than 200 patients have been recruited for trials at ERS (with some patients being involved in more than one trial). External review endorsed ERS as a superior environment for such research and as a model for other centers. CONCLUSIONS: Private practice is a viable alternative for the conduct of clincial trials and should be considered when establishing such protocols. Simplicity of administration and clinical practice, which more closely mirrors standard patient care, may enhance recruitment and management.     

新型多功能前列腺治疗仪和临床应用

目前前列腺疾病是男性的常见疾病和多发病,已引起全社会的广泛重视。当前治疗该疾病的方法主要有药物治疗、手术治疗和物理治疗。本文介绍了一种新型前列腺治疗仪,该仪器通过射频电流作用于患处,使病变组织升温,加快局部血液循环起到杀灭病菌、清除炎症之能效,从而达到治疗目的。同时探头内设有震动装置和静磁场,促进病变部位坏死脱落细胞组织的排泄,同时不影响病变周围的正常组织。该仪器安全、有效,是一种值得推广的产品。该仪器应用于临床100例,患者均取得了良好的治疗效果。     

1995～2004年广东省医院管理研究文献量的统计分析

引用中国生物医学光盘数据库(CBMdisc)收录全国及广东省十年间医院管理发表的文献量、全国10大城市医院管理的文献量排名和广东省内21个省市级医院发表医院管理文献量排名等进行统计分析,并且提出建议。     

乐胃饮干预功能性消化不良大鼠SP和VIP的研究

[目的]通过实验研究,揭示乐胃饮治疗功能性消化不良的作用机制。[方法]Wistar大鼠随机分为正常对照组、自然恢复组、吗叮啉组、参苓白术丸组、乐胃饮低剂量组、乐胃饮中剂量组、乐胃饮高剂量组等7组,每组6只。分别给予各组按2ml/100g按组分别灌服蒸馏水、吗叮啉、参苓白术丸液、乐胃饮低中高剂量液,每天1次,自造模结束后一天起连续给药14天。观察胃黏膜形态,检测胃肠激素SP和VIP。[结果]乐胃饮能有效增加实验鼠胃窦组织中SP和降低VIP含量。[结论]乐胃饮能提高胃肠道神经兴奋性,调节胃肠道平滑肌的收缩,这可能是乐胃饮治疗FD的主要作用机制。     

我国药品需求弹性的研究

目的定量研究药品需求量与人均可支配收入、人们的健康水平、药品广告投入、药品价格等因素间的相关性。方法以经济学理论为基础,采用经济计量学方法和Eviews软件构建药品需求函数模型。结果与结论随着人们生活水平的提高,药品需求量将显著上升,而药品价格的变化对药品需求影响较小。     

Two important factors affecting the prognosis of patients treated with sorafenib followed by regorafenib for advanced hepatocellular carcinoma

ObjectiveTo investigate the effects of hand–foot syndrome (HFS) and fatigue on disease progression and survival in patients treated with sorafenib followed by regorafenib for advanced hepatocellular carcinoma.MethodsA retrospective analysis of patients with advanced hepatocellular carcinoma treated with sorafenib in our hospital from 1 October 2018 to 31 October 2021 was performed, and clinical and pathological data and follow-up results were obtained. Patients were divided into groups according to the severity of HFS and fatigue. Survival analysis among the groups was performed using the Kaplan–Meier method, continuous variables were analyzed using the t-test, and factors associated with survival were evaluated using multivariate Cox regression analysis.ResultsThe study included 150 men and 23 women with a mean age of 60.77 years (range: 40–85 years). The median overall survival (OS), progression-free survival (PFS), and time to tumor progression (TTP) increased with increasing severity of HFS. Conversely, the median OS, PFS, and TTP decreased with increasing severity of fatigueConclusionHFS and fatigue were independent risk factors affecting TTP, PFS, and OS among patients treated with sorafenib followed by regorafenib for advanced hepatocellular carcinoma.