中药内服外用治疗湿疹

目的探讨中药内服外用治疗湿疹200例患者的治疗效果.方法回顾性分析2010年~2011年治疗湿疹病例,按类型不同,用中药内服外用,合并应用西医疗法,比较治疗前后症状改善情况.结果治疗1周后,100例急性湿疹患者全部痊愈,60例亚急性湿疹患者全部愈合,40例慢性湿疹患者好转,各类患者在治疗期间均未见任何不良反应.结论中药内服外用治疗湿疹具有重要临床价值,值得推广.     

复方甘草酸苷联合肤疾洗剂治疗湿疹患者的临床疗效

目的：探讨复方甘草酸苷联合肤疾洗剂治疗湿疹患者的临床效果。方法选取高州市人民医院在2012年5月至2014年5月收治的130例湿疹患者为研究对象,将其采用抽签的方式均分为对照组和观察组,各65例。对照组患者采用复方甘草酸苷治疗,观察组患者在对照组基础上联合肤疾洗剂治疗,比较两组患者的治疗效果。结果经治疗后,观察组患者临床治疗总有效率明显高于对照组,且患者不良反应总发生率明显低于对照组,差异均有统计学意义（均P＜0.05）。结论采用复方甘草酸苷联合肤疾洗剂治疗湿疹,效果明显,不良反应少。     

除湿消疹饮治疗湿热证急性湿疹36例疗效观察

目的探讨除湿消疹饮治疗急性湿疹的疗效。方法 66例皮肤科门诊患者,采取随机数字表法分为治疗组和对照组,对照组采用常规西药治疗,治疗组采用经验方除湿消疹饮治疗,比较两组疗效。结果从治疗后EASI评分分析,两组比较治疗组优于对照组。结论采用我科经验方除湿消疹饮的患者急性湿疹的症状明显好转或痊愈,效果较好。     

基于决策树模型的冰黄肤乐软膏治疗湿疹的药物经济学评价

目的 评估冰黄肤乐软膏治疗湿疹的经济性。方法 根据本研究的随机对照试验（RCT）结果,以卫生体系角度为出发点,采用决策树模型对治疗湿疹所用的冰黄肤乐软膏和复方醋酸地塞米松软膏的经济性进行评估。结果 相比复方醋酸地塞米松软膏,使用冰黄肤乐软膏治疗湿疹时,患者每多提升17.8%的效果,需要多花费114.65元,当患者个人意愿支付价格高于114.65元时,冰黄肤乐软膏组更具有经济性的概率优于复方醋酸地塞米松软膏组,敏感性分析结果表明了基础分析结果较稳定。冰黄肤乐软膏组的临床疗效、药品单价和患者用药依从性对研究结果有一定影响,具有更高经济性概率的干预方案同基础分析结果一致。结论 采用冰黄肤乐软膏治疗湿疹比复方醋酸地塞米松软膏更具经济性。     

胶原贴治疗婴儿湿疹65例疗效观察

目的 观察胶原贴治疗婴儿湿疹的疗效和安全性.方法 治疗组给予胶原贴局部外敷治疗,对照组给予丁酸氢化可的松外用治疗,疗程10d.结果 治疗组治疗10d的有效率87.7％,对照组有效率93.4％,两组有效率差异无显著性（P＞0.05）,两组不良反应均不影响治疗,而复发率比较,治疗组优于对照组,差异显著P＜0.05.结论 胶原贴治疗婴儿湿疹疗效好,不良反应发生率及复发率均较低,是一种安全有效的治疗方法.     

复方甘草酸苷片联合西替利嗪片治疗慢性湿疹75例疗效观察

目的评价复方甘草酸苷片联合西替利嗪片治疗慢性湿疹的疗效。方法 150例患者,随机分为治疗组75例,对照组75例,对照组采用口服盐酸西替利嗪片,外用丁酸氢化可的松乳膏,药物治疗4周。治疗组75例,在给予和对照组相同药物治疗的基础上加用复方甘草酸苷片口服。结果 4周后,治疗组基愈47例,显效18例,有效10例,无效0例,对照组基愈28例,显效15例,有效30,无效2例,治疗组疗效明显优于对照组(P<0.05)。结论采用复方甘草酸苷片联合盐酸西替利嗪片治疗慢性湿疹疗效优于单用盐酸西替利嗪片,且使用安全,依从性好。     

西替利嗪联合西咪替丁治疗女阴湿疹的疗效和对复发率的影响

目的 探讨西替利嗪联合西咪替丁治疗女阴湿疹的疗效和对复发率的影响。方法 选取2020年7月至2021年4月朝阳市第二医院收治的女阴湿疹患者78例作为研究对象,随机分为观察组（n=39）和对照组（n=39）。对照组予以西替利嗪治疗,观察组予以西替利嗪联合西咪替丁治疗,比较两组疗效、复发率、不良反应发生率和治疗前后临床症状（瘙痒程度、皮损面积、红肿情况）评分。结果 观察组治疗有效率87.18%与对照组71.79%比较差异无统计学意义（P>0.05）;治疗后,观察组瘙痒程度、皮损面积、红肿情况评分较对照组低（P<0.05）;观察组复发率7.69%(3/39)较对照组25.64%(10/39)低（P<0.05）;观察组不良反应发生率5.13%(2/39)与对照组17.95%(7/39)比较差异无统计学意义（P>0.05）。结论 西替利嗪联合西咪替丁治疗女阴湿疹效果确切,可改善临床症状,降低复发率,且用药安全性较高。     

雷公藤多苷联合咪唑斯汀治疗皮炎湿疹的疗效及安全性观察

目的探讨皮炎湿疹患者采用雷公藤多苷联合咪唑斯汀治疗的临床疗效及不良反应发生率。方法收集湖南省安乡县人民医院皮肤科2015年9月至2016年12月收治的皮炎湿疹患者共116例为研究对象,随机分为对照组和观察组,各58例。对照组患者采用咪唑斯汀缓释片治疗,观察组患者采用咪唑斯汀缓释片联合雷公藤多苷治疗,两组患者共治疗3周。对比两组患者的临床疗效,检测治疗前后的白细胞介素-2(IL-2)、白细胞介素-6(IL-6)和C反应蛋白(CRP)水平,并统计患者的不良反应发生率。结果经检验表明,观察组患者的临床疗效高于对照组,差异有统计学意义(P<0.05);两组患者在治疗前的IL-2、IL-6、CRP水平对比差异无统计学意义(P>0.05),治疗后两组患者IL-2、IL-6、CRP水平较同组治疗前均出现下降,观察组IL-2、IL-6、CRP水平较对照组下降更为明显,差异有统计学意义(P<0.05);对照组不良反应发生率为12.1%,观察组不良反应发生率为1.7%,观察组的不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论雷公藤多苷联合咪唑斯汀治疗皮炎湿疹的效果较佳,临床运用安全性较高。     

卧底妈妈掀翻黑心“田婆婆”

一个年仅3岁的孩子,脖子上长了三、四个像湿疹一样的小红点,被母亲刘建琼带到宣称专治小儿感冒、湿疹等病症的田婆婆洗灸堂医治。可刘建琼万万没想到,儿子的湿疹没治好,反而长了浑身脓疱,一辈子都不能治愈。为了弄清儿子致病的真相,刘建琼先后奔赴云南、贵州和重庆,以服务员的身份卧底田婆婆洗灸堂加盟店,由此揭开了一个惊天黑幕。     

分析PICC置管患者的健康教育需求与对策

目的探讨PICC置管患者的健康教育需求,对患者及家属进行细致全面的健康教育,减少置管并发症的发生。方法采用自行设计的调查表,对100例PICC置管患者进行健康教育需求的问卷调查,并根据患者的要求,有针对性的进行健康教育。结果患者及家属对导管维护相关知识知晓率达100%,发生静脉炎并发症4例,发生湿疹7例,经治疗后痊愈,发生导管堵塞3例,经及时正确处理后恢复通畅。结论对患者及家属进行全面细致、有针对性的健康教育,减少了置管并发症的发生,延长导管的使用寿命,确保患者治疗的顺利完成。     

Expert panel on practice patterns in the management of cow’s milk protein allergy and associated economic burden of disease on health service in Turkey

Aims: To evaluate practice patterns in the management of cow’s milk protein allergy (CMPA) and associated economic burden of disease on health service in Turkey.

Materials and methods: This study was based on experts’ views on the practice patterns in management of CMPA manifesting with either proctocolitis or eczema symptoms and, thereby, aimed to estimate economic burden of CMPA. Practice patterns were determined via patient flow charts developed by experts using the modified Delphi method for CMPA presented with proctocolitis and eczema. Per patient total 2-year direct medical costs were calculated, including cost items of physician visits, laboratory tests, and treatment.

Results: According to the consensus opinion of experts, 2-year total direct medical cost from a payer perspective and societal perspective was calculated to be $US2,116.05 and $US2,435.84, respectively, in an infant with CMPA presenting with proctocolitis symptoms, and $US4,001.65 and $US4,828.90, respectively, in an infant with CMPA presenting with eczema symptoms. Clinical nutrition was the primary cost driver that accounted for 89–92% of 2-year total direct medical costs, while the highest total direct medical cost estimated from a payer perspective and societal perspective was noted for the management of an exclusively formula-fed infant presenting either with proctocolitis ($US3,743.85 and $US4,025.63, respectively) or eczema ($US6,854.10 and $US7,917.30, respectively). The first line use of amino acid based formula (AAF) was associated with total direct cost increment $US1,848.08 and $US3,444.52 in the case of proctocolitis and eczema, respectively.

Limitations: Certain limitations to this study should be considered. First, being focused only on direct costs, the lack of data on indirect costs or intangible costs of illness seems to be a major limitation of the present study, which likely results in a downward bias in the estimates of the economic cost of CMPA. Second, given the limited number of studies concerning epidemiology and practice patterns in CMPA in Turkey, use of expert clinical opinion of the panel members rather than real-life data on practice patterns that were used to identify direct medical costs might raise a concern with the validity and reliability of the data. Also, while this was a three-step study with six experts included in the first stage (developing local guidelines for diagnosis, treatment, and follow-up of infants with CMPA in Turkey) and 410 pediatricians included in the second stage (a cross-sectional questionnaire-survey to determine pediatricians’ awareness and practice of CMPA in infants and children), only four members were included in the present Delphi panel, which allows a limited discussion. Third, lack of sensitivity analyses and exclusion of indirect costs and costs related to alterations in quality of life, behavior of infants, and general well-being of infants and their parents from the cost-analysis seems to be another limitation that may have caused under-estimation of relative cost-effectiveness of the formulae. Fourth, calculation of costs per local guidelines rather than real-life practice patterns is another limitation that, otherwise, would extend the knowledge achieved in the current study. Notwithstanding these limitations, the present expert panel provided practice patterns in the management of CMPA and an estimate of the associated costs, depending on the symptom profile at initial admission for the first time in Turkey.

Conclusions: In conclusion, in providing the first health economic data on CMPA in Turkey, the findings revealed that CMPA imposes a substantial burden on the Turkish healthcare system from both a payer perspective and societal perspective, and indicated clinical nutrition as a primary cost driver. Management of infants presenting with eczema, exclusively formula-fed infants, and first line use of AAF were associated with higher estimates for 2-year direct medical costs.     

A comparison of healthcare resource use for rotavirus and RSV between vulnerable children with co-morbidities and healthy children: a case control study

Abstract

Objective:

To quantify the differences in hospital length of stay (LOS) and cost between healthy and vulnerable children with cystic fibrosis (CF), insulin-dependent diabetes mellitus (IDDM), cancer, and epilepsy who contract rotavirus (RVGE) or respiratory syncytial virus (RSV).

Methods:

Hospital Episode Statistics (HES) data were collected for England, for children <5 years old, admitted between April 2001 and March 2008, using ICD-10 codes for RVGE and RSV. Cases were identified as having RVGE and/or RSV plus CF, IDDM, cancer, or epilepsy. Healthy controls had RVGE and/or RSV only, additional controls had eczema only. Cost, hospital LOS, and demographics were collected.

Results:

Four hundred and eighty-six (0.5%) cases and 101,784 (99.5%) healthy controls were admitted with RVGE or RSV, with 17,420 eczema controls. RVGE was present in 153 (31.5%) cases and 7532 (7.4%) healthy controls, and RSV in 333 (68.5%) cases and 94,252 (92.6%) healthy controls. Cases were older (1.1 years, SD?=?1.3 years), had greater LOS (9.9 days, SD?=?19.9), and cost more (£3477, SD?=?£7765) than healthy controls (age?=?0.2, SD?=?0.5, p?<?0.001; LOS?=?1.9 days, SD?=?3.1, p?<?0.001; cost?=?£595, SD?=?£727, p?<?0.001). Cost for cases was 6-times greater than healthy controls (p?<?0.001). Controls had a 0.3 day greater LOS (p?<?0.001) with RSV, but a £17 (p?=?0.085) lower mean cost than RVGE.

Conclusion:

RVGE and RSV are more serious diseases in vulnerable children, requiring more intense resource use. The importance of preventing infection in vulnerable children is underlined by hygiene and appropriate isolation and vaccination strategies. When universal vaccination is under consideration, as for rotavirus vaccines, evaluation of a vaccination programme should consider the potentially positive impact on vulnerable children.

Limitations:

Limitations of the study include a dependency on accurate coding, an expectation that patients are identified through laboratory testing, and the possibility of unidentified underlying conditions affecting the burden.     

并购中主并公司的可预测性——基于交易成本视角的研究

本文将交易成本划分为显性交易成本和隐性交易成本,认为主并公司进行并购的目的是为了节约显性和隐性交易成本。在此基础上,我们以2003年发生并购的上市公司为样本,采用因子分析法和Logistic回归建立了主并公司的预测模型,发现资产专用性越强,显性交易成本越高,公司发生并购的可能性越大;中间产品市场的不确定性越高,显性交易成本越高,公司发生并购的可能性越大;公司的成长能力越强,成长能力与盈利能力之间的不平衡程度越高,隐性交易成本越高,公司发生并购的可能性越大。     

创业环境动态性、创业学习与创业机会识别关系研究

通过引入创业环境动态变化频率和变化幅度,以及实用主义、顺从主义、贯融主义3种创业认知学习方式,扩展了现有创业机会识别仿真模型,研究了创业环境动态性、创业学习与创业机会识别之间的作用机制。仿真结果表明：在发现观视角下,实用主义是一种高效但不稳定的学习方式;顺从主义是一种效率一般但较为稳定的学习方式;贯融主义是一种低效的学习方式。为了提高创业机会识别能力,创业者需要根据环境类型选择不同学习策略。在变化慢、变化小的环境中,创业者的最佳学习策略是采用实用主义并保持较快的个体学习速率;在变化慢、变化大和变化快、变化小的环境中,创业者的最佳学习策略是采用实用主义并保持较慢的个体学习速率;在变化快、变化大的环境中,创业者的最佳学习策略是采用顺从主义并保持较快的个体学习速率。     

论探究可持续发展战略伦理基础的哲学依据

社会发展不仅是受利益驱动规律作用的纯自然历史进程,也是内含着道德价值意蕴的社会历史进程。可持续发展战略的实现不仅需要相关制度、政策的安排,更重要的是需要与之相适应的伦理基础,运用道德的约束力,依靠内在信念和社会舆论的作用,以人类发自于内心的自觉行为来保证人与环境的共同协调发展。可持续发展战略的伦理基础是其充满生机和活力的精神源泉。     

从自然资源经济学到可持续经济学

随着物质生活水平的快速提高,人类也面临着诸如森林退化、土地荒漠化、物种多样性丧失以及温室效应恶化等生存环境问题。可持续发展问题日益受到人们的关注,通过经济学的视角来研究可持续发展的可持续经济学得到了快速的发展。本文从经济学的角度界定了自然资源的概念,回顾了经济学对自然资源的研究历程,对自然资源经济学的起源、发展进行了评述;论证了自然资源经济学和可持续经济学的关系,指出在可持续发展问题研究中融合自然资源经济学和环境经济学的必然性,以自然资源经济学和环境经济学为重要元素的可持续经济学是可持续问题经济研究的高级阶段,文章进一步探讨了可持续经济学的分析框架、发展现状及存在的问题。     

时间是具有单向度双重意义否定的存在

时间既是抽象的存在,亦是具体的虚无,它是人的自我描影。人的生存意义在于对自我的否定,这个否定是包括同质和异质的否定。人的存在在于把周围世界对象化为为我世界,这个过程和结果就是文化,文化的本质就是人化,是人将自己的本质在时空中刻印。文化作为系统化的有机体,是个产生、发展和没落的过程。文化的发展是呈螺旋状的上升。文化作为一个系统,由各种要素组成也受到种种干扰,要促进文化的发展,需要不断增强文化的免疫力。     

云制造联盟创新生态系统形成、模型构建及演化研究

云制造联盟创新生态系统不同于传统创新系统，其成员创新行为也不同于一般企业创新活动，强调动态开放性，并体现“制造即服务”的思想。在阐释云制造联盟内涵的基础上，借鉴创新生态系统理论，提出云制造联盟创新生态系统定义，详细描述其形成过程及特征变化，构建云制造联盟创新生态系统模型，分析其子系统组成及协同互动关系，探析云制造联盟创新生态系统演化机理，为云制造产业发展提供了崭新的研究视角，具有重要的理论意义及现实指导价值。