丁香油水门汀联合一次根管治疗急性牙髓炎的疗效及对患儿血清炎症介质的影响

目的探讨丁香油水门汀联合一次根管治疗急性牙髓炎疗效及对患儿血清炎症介质的影响。方法选取2019年6月至2020年6月沈阳市儿童医院牙科门诊收治的98例急性牙髓炎患儿作为研究对象,随机分为对照组与观察组,各49例。对照组给予一次根管治疗,观察组在对照组治疗基础上加用丁香油水门汀联合治疗,比较两组患者治疗效果、并发症发生情况、患牙髓炎齿疼痛评分、松动度、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)以及白三烯B4(LTB4)水平变化。结果两组急性牙髓炎患者经不同方式治疗后,观察组近期疗效和远期疗效优于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05);治疗后,两组患牙叩痛评分和松动度下降,且观察组患牙叩痛评分、松动度明显低于对照组,差异有统计学意义(P<0.05);治疗后,两组血清炎症介质IL-8、IL-6、TNF-α以及LTB4下降,且观察组血清炎症介质IL-8、IL-6、TNF-α以及LTB4水平显著低于对照组,差异有统计学意义(P<0.05)。结论丁香油水门汀联合一次根管能够有效治疗患者急性牙髓炎,降低患者牙齿疼痛、松动度,并且降低炎症介质水平,不良反应较少。     

中西医结合治疗急性病毒性心肌炎的临床疗效

目的探讨中西医结合治疗急性病毒性心肌炎的临床疗效。方法选取80例病毒性心肌炎患者,根据治疗方法不同将其分为两组,单纯西药组患者采用常规的西医综合治疗,中西医结合组患者在此基础上加用黄芪注射液,共治疗4周。结果中西医结合组患者总有效率为95.0%,单纯西药组患者总有效率为82.5%,两组比较差异有统计学意义(P<0.05)。结论中西医综合疗法是治疗急性病毒性心肌炎的一种有效措施。     

降钙素原在慢性阻塞性肺疾病急性加重期患者抗生素使用中的价值

目的：探讨降钙素原（PCT）在慢性阻塞性肺疾病急性加重期患者抗生素使用中的价值。方法将120例患者按随机数字表法分为对照组与PCT组,各60例。PCT组结合PCT检测结果指导患者应用抗生素,对照组则由医师结合患者病情发展判断是否使用抗菌药物,比较两组患者的抗生素使用时间、住院时间、住院费用、治疗效果。结果 PCT组患者的抗生素使用时间、住院时间均明显短于对照组,住院费用明显少于对照组,差异均有统计学意义（均P＜0.05）;PCT组患者临床治疗总有效率为91.7%,明显高于对照组的75.0%,差异有统计学意义（P＜0.05）。结论 PCT可为慢性阻塞性肺疾病急性加重期患者的病因诊断、分层级监测治疗、预后评估提供依据,为抗菌药物的使用提供参考,减少抗生素的使用强度及降低医疗总费用,具有重要的经济及社会效益。     

大剂量盐酸氨溴索配合护理干预治疗成人急性呼吸窘迫综合征患者的临床疗效

目的：探讨大剂量盐酸氨溴索配合护理干预治疗成人急性呼吸窘迫综合征（ARDS）患者的临床疗效。方法选取2012年7月至2014年7月内江市东兴区人民医院收治的57例ARDS患者资料,按随机数字表法将其分为对照组（27例）和观察组（30例）。对照组患者积极治疗原发病,并行机械通气呼吸支持,试验组患者在对照组基础上给予大剂量盐酸氨溴索治疗,且两组患者均给予积极护理干预。比较两组患者的肺通气指标、氧化应激指标及临床疗效。结果治疗后,试验组患者的内源性呼气末正压（PEEPi）、气道阻力（RAW）均明显低于对照组,氧合指数（PaO2/FiO2）、肺顺应性（CL）均明显高于对照组,丙二醛（MDA）明显低于对照组,谷胱甘肽（GSH）、超氧化物歧化酶（SOD）、总氧化能力（TAO）均明显高于对照组,差异均有统计学意义（均P＜0.05）;观察组患者总有效率为73.3%,明显高于对照组的55.6%,差异有统计学意义（P＜0.05）。结论积极正确的治疗和护理措施是严重ARDS患者抢救成功的重要条件。     

手术治疗急性重症胆管炎患者的临床疗效

目的：探讨手术治疗急性重症胆管炎（ACST）患者的临床疗效。方法收集2012年1月至2014年8月云南省西双版纳州人民医院收治的23例急性重症胆管炎患者的临床资料,给予手术治疗（引流胆汁、解除胆道梗阻）与非手术治疗（营养支持、纠正水电解质酸碱失衡、解痉止痛、抗感染以及抗休克）。结果23例ACST患者经手术治疗后,治愈21例;病死2例;其中,多器官功能衰竭1例,中毒性休克1例;术后出现并发症6例,多器官功能衰竭1例,切口感染2例,肺部感染3例。结论 ACST患者一旦明确诊断,应尽快做好术前准备,给予手术治疗,提高抢救成功率的关键在于选取合理的手术方式、准确把握手术时机。     

雾化吸入布地奈德混悬液治疗慢性阻塞性肺疾病急性加重期的效果观察

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者选择雾化吸入布地奈德混悬液治疗后的临床效果。方法选取我院2011年1月至2013年6月AECOPD患者150例。通过随机数表法将其分为A1组(观察组75例)与A2组(对照组75例)。A2组患者选择常规治疗+甲泼尼松龙治疗;A1组患者选择常规治疗+布地奈德混悬液(雾化吸入)治疗;比较两组患者治疗7 d后在相关指标方面表现的差异性。结果两组AECOPD患者完成7 d治疗后,与治疗前比较,在动脉血氧分压(Pa O2)以及动脉血二氧化碳分压(Pa CO2)等指标差异有统计学意义(P<0.05)。结论针对AECOPD患者选择雾化吸入布地奈德混悬液治疗,表现出较高的有效性及安全性。     

Economic outcomes with prasugrel versus clopidogrel in acute coronary syndrome patients: observations from prasugrel users and matched clopidogrel users

Abstract

Objective:

To compare healthcare costs between clopidogrel and prasugrel over 30-day and 365-day periods after discharge from the hospital or emergency room (ER) in patients treated with prasugrel who were hospitalized or had an ER visit for an acute coronary syndrome (ACS) event.     

Health state utilities associated with treatment options for acute myeloid leukemia (AML)

Abstract

Aims: Acute myeloid leukemia (AML) treatment typically involves remission induction chemotherapy followed by consolidation chemotherapy. New treatments for AML have recently been introduced, including a chemotherapy formulation called CPX-351, which is administered via less time-intensive IV infusion than the standard “7?+?3” continuous infusion regimen of cytarabine plus an anthracycline. The purpose of this study was to estimate utilities that could be used in economic modeling of AML treatment.

Materials and methods: In time trade-off interviews, participants from the UK general population valued 12 health states drafted based on literature and clinician interviews. To identify disutility associated with chemotherapy, two types of induction and four types of consolidation were added to an otherwise identical health state describing AML. The decrease in utility when adding these chemotherapy regimens represents the disutility of each regimen. Five additional health states were valued to estimate utilities associated with other AML treatments.

Results: Two hundred participants completed interviews. Mean (SD) utilities were 0.55 (0.31) for pre-treatment AML and 0.66 (0.29) for AML in temporary remission. Adding any chemotherapy significantly decreased utility (p?<?0.0001). Induction had a mean disutility of –0.11 with CPX-351 and –0.15 with 7?+?3. Mean disutility for consolidation ranged from –0.03 with outpatient CPX-351 to –0.11 with inpatient 5?+?2. Utilities are also reported for other AML treatments (e.g. transplant, low-intensity chemotherapy).

Limitations: One limitation is that the differences in adverse event profiles between the treatment regimens were based on clinician opinion. Future use of CPX-351 in clinical trials or clinical settings will provide additional information on its adverse event profile.

Conclusions: While all chemotherapy regimens were associated with disutility, regimens with shorter hospitalization and less time-intensive infusion were generally perceived as preferable. These utilities may be useful in cost-utility models comparing the value of AML treatments.     

Hospitalization expenses of acute ischemic stroke patients with atrial fibrillation relative to those with normal sinus rhythm

Background and objective: Atrial fibrillation (AF) is a risk factor for acute ischemic stroke (AIS). In mainland China, little is known of the hospitalization expenses of AIS patients with AF compared to those with normal sinus rhythm (SR). This study compared the itemized expenses of AIS patients with or without AF in a hospital in Huizhou City.

Methods: Patients hospitalized for AIS from March 2014 to March 2015 were enrolled, including 73 with AF and 751 with normal SR. Stroke severity was scored using the National Institutes of Health Stroke Scale (NIHSS). Non-parametric statistical tests were used to determine differences in hospital expenses between the two groups, of which influencing factors were analyzed using single factor and multiple stepwise linear regression analyses.

Results: Medicine was the predominant expense during hospitalization of all AIS patients. Patients with AF incurred significantly higher expenses for medicine, bed, treatments, examinations, laboratory tests, and nursing than patients with normal SR (p?p?p?Conclusion: AIS patients with AF incurred higher expenses during hospitalization compared with those with normal SR, due to greater stroke severity, higher rates of pulmonary infection and congestive heart failure, and longer hospital stays.     

Cost-effectiveness of prasugrel in a US managed care population

Abstract

Objective:

Decision-makers in the US may be interested in the applicability to their populations of cost-effectiveness results generated from clinical trial populations.

Methods:

An economic model estimating the cost-effectiveness of prasugrel plus aspirin relative to clopidogrel plus aspirin for patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) was developed from a managed care organization (MCO) perspective. The model estimated 15-month cardiovascular events or bleeding-related outcomes, life expectancy, and costs for patients who received thienopyridine treatment during and after a PCI following a diagnosis of ACS. Post-ACS event rates for patients treated with clopidogrel were from an MCO. The relative risks of these events with prasugrel compared with clopidogrel were from a head-to-head clinical trial.

Results:

The results of the base-case analysis indicated that, in an MCO population, use of prasugrel-based therapy rather than clopidogrel-based therapy at current prices resulted in cost-savings and fewer clinical events over the 15 months after an ACS diagnosis followed by PCI. At possible lower prices for generic clopidogrel-based therapy, the cost-effectiveness ratio for prasugrel-based therapy compared with clopidogrel-based therapy was between $6643 and $13,906 per life-year gained. The results were most sensitive to the relative costs of the two treatments and the cost for hospital stays.

Limitations:

Limitations of the study included lack of follow-up of patients disenrolling from the MCO before the end of the 15-month observation period, the assumption of equal relative risks of events in an MCO as in the clinical trial, and the lack of information on the ratio of cost to charges in the MCO database.

Conclusions:

Use of prasugrel-based therapy compared with clopidogrel-based therapy in ACS patients having a PCI resulted in cost-savings at current prices and favorable cost-effective ratios at likely generic prices for clopidogrel-based therapy because of offsetting savings in the costs of rehospitalization.