芪柏塌渍治疗小儿静脉炎的疗效及对TLR-4/核因子-κB信号通路的影响

目的观察芪柏塌渍对静脉炎的疗效,同时探讨其对TLR-4/核因子-κB信号通路上标志蛋白表达的影响。方法选取2018年1月至2019年6月大连市中心医院收治的40例静脉炎患儿作为研究对象,按随机数字表法分为常规组和试验组,各20例,另取20例健康儿童为对照组。对照组患儿取50%硫酸镁溶液浸湿的无菌纱布敷于发生静脉炎处,面积以超过静脉炎范围1~2 cm为宜,并用保鲜膜包裹于纱布外,每2小时换药1次,3 d为一个治疗周期。试验组用无菌棉签蘸取适量芪柏塌渍膏涂于发生静脉炎处,面积以大于静脉炎范围1~2 cm为宜,厚度0.2~0.5 cm,予以无菌纱布覆盖,最后用胶布固定,每4~6小时换药1次,3 d为一个治疗周期。于治疗前及治疗2个周期时,采用蛋白免疫印迹法检测外周血中TLR-4和核因子-κB水平变化,酶联免疫吸附试验(ELISA)检测患儿血清肿瘤坏死因子-α(TNF-α)、白细胞介素-11(IL-11)、白细胞介素-4(IL-4)、白细胞介素-33(IL-33)蛋白表达。结果治疗后两组患儿数字评分法(NRS)评分、红肿面积有所改善,且试验组改善程度优于常规组,差异有统计学意义(P<0.05);静脉炎患儿血清TLR-4、核因子-κB、TNF-α、IL-11、IL-4、IL-33水平明显高于健康对照组(P<0.05);治疗后,常规组和试验组患儿TLR-4、核因子-κB、TNF-α、IL-11、IL-4、IL-33水平明显下降(P<0.05),且试验组上述指标明显低于常规组(P<0.05)。结论静脉炎患儿存在TLR-4/核因子-κB信号通路表达紊乱,芪柏塌渍可明显调节TLR-4/核因子-κB信号通路上标志性蛋白的表达,该效应可能是芪柏塌渍从机体炎症方面改善静脉炎患儿的作用机制之一。     

浅谈渐进多焦点配装眼镜

近年来随着人们生活质量的改善、专业需求的不断提高,以及广告宣传的大力推广、眼镜技术的不断发展和验光装配技术水平的提高,渐进多焦点眼镜镜以其优越的性能、日趋成熟的技术,为越来越多的人们所接受,更是成为了广大中老年屈光不正患者和青少年近视眼患者的首选。     

慢性病患者就医行为的文献综述研究

慢性病患者选择就诊方式受到各种因素的影响,本文主要对慢性病患者的就医行为的相关理论和国内外相关研究进行了梳理。     

某综合性医院住院病人死因的简要分析

本文以2005~2010年期间1164例住院病人死亡病例进行调查分析,从不同时间段死因变化、男女性别死因构成情况进行分析,目的是了解该地区居民健康的主要疾病危险因素,合理分配卫生资源。     

Cost-effectiveness of telaprevir in combination with pegylated interferon alpha and ribavirin in treatment-experienced chronic hepatitis C genotype 1 patients

Background:

Telaprevir (TVR,T) and boceprevir (BOC,B) are direct-acting antivirals (DAAs) used for the treatment of chronic genotype 1 hepatitis C virus (HCV) infection. This analysis evaluated the cost-effectiveness of TVR combined with pegylated interferon (Peg-IFN) alfa-2a plus ribavirin (RBV) compared with Peg-IFN alfa-2a and RBV (PR) alone or BOC plus Peg-IFN alfa-2b and RBV in treatment-experienced patients.

Methods:

A Markov cohort model of chronic genotype 1 HCV disease progression reflected the pathway of experienced patients retreated with DAA therapy. The population was stratified by previous response to treatment (i.e., previous relapsers, partial responders, and null responders). Sustained virologic response (SVR) rates were derived from a mixed-treatment comparison that included results from separate Phase III trials of TVR and BOC. Incremental cost per life year (LY) gained and quality-adjusted-life-year (QALY) gained were computed at lifetime, adopting the NHS perspective. Costs and health outcomes were discounted at 3.5%. Uncertainty was assessed using deterministic and probabilistic sensitivity analyses. Sub-group analyses were carried out by interleukin (IL)-28B genotype.

Results:

Higher costs and improved outcomes were associated with T/PR relative to PR alone for all experienced patients (ICER of £6079). T/PR was cost-effective for each sub-group population with high SVR advantage in relapsers (ICER of £2658 vs £7593 and £20,875 for partial and null responders). T/PR remained cost-effective regardless of IL-28B sub-type. Compared to B/PR, T/PR prolonged QALYs by 0.57 and reduced lifetime costs by £13,960 for relapsers. For partial responders T/PR was less costly but less efficacious than B/PR, equating to an ICER of £128,117 per QALY gained.

Limitations:

No head-to-head trial provides direct evidence of better efficacy of T/PR vs B/PR.

Conclusion:

T/PR is cost-effective compared with PR alone in experienced patients regardless of treatment history and IL-28B genotype. Compared to B/PR, T/PR is always cost-saving but only more effective in relapsers.     

家庭随访健康教育对缺血性脑卒中并发阻塞性睡眠呼吸暂停综合征的影响

缺血性脑卒中并发阻塞性睡眠呼吸暂停综合征作为一种复杂性疾病,在一定程度上影响了患者的生后质量。本文通过实施家庭随访健康教育,对患者进行干预,从而改善缺血性脑卒中并发阻塞性睡眠呼吸暂停综合征情况,提高患者生活质量。让患者从思想上重视,提高治疗依从性,为提高治疗效果提供参考依据。     

Measuring the Perceived Quality of Professional Business Services

Professional firms serving business clients are recognizing the need for improved quality services. Unfortunately, measures of professional service quality have proven difficult to develop. This paper reports on the use of SERVQUAL, an instrument commonly used to assess consumer perceptions of service quality. This instrument was employed with a sample of business owners who were asked to rate the quality of service received from their accounting firm. Although several dimensions of the scale proved useful, additional quality related factors emerged from the analysis.     

The NHS Plan: Accounting for investment and reform in twenty acute hospital trusts in England (1998–2003)

The National Health Service (NHS) Plan published in 2000 summarised Labour's commitment to modernising the NHS in England. The NHS would receive substantial additional funding bringing expenditure on health, as a share in national income, to levels comparable with a European average. The promise of secure financing from government promised to reduce uncertainty and facilitate medium term resource planning in the NHS. Extra funding, as outlined in the NHS Plan, would also be tied into capital and labour process reform(s) to ensure that investment translated into the much needed additional capacity to treat patients. During the period 1998–2003 funding for an average acute hospital has increased 50% in cash terms satisfying expectations set out in the NHS Plan. It is now an appropriate time to review progress. Using information collected for 20 acute hospitals, selected on the basis that they had started and completed PFI projects in the period 1998–2003. This paper constructs a physical and financial audit which is then used to reveal the degree to which acute hospital finances are now secure and the extent to which physical capacity to treat patients has been robustly transformed.     

创伤骨科病人服装结构解析

创伤骨科病人服装首先应具备良好的功能性、舒适性、卫生性,其次应考虑服装结构便于创伤骨科病人的穿脱。为此本文从服装的开口部位、宽松量、紧固件等方面针对创伤骨科病人进行服装结构探讨,提出了这些部位的设计方法,为创伤骨科病员服结构设计提供理论依据。     

新型农村合作医疗基本模式创新探析

现行农村合作医疗是中央、地方政府和农户个人多方筹资,以大病统筹为主、农民自愿参加的医疗互助共济组织,自建立以来取得了不少成绩但也存在很多问题．特别是制度设计方式和原则上还有可改进的空间,鉴于此,文章提出了适度强制、分区类指导、以户参保、动态管理全新的新型农村合作医疗模式。