浅谈慢性胃炎的病因和治疗

慢性胃炎是多种病因引起的各种慢性胃粘膜炎性病变,主要与不合理的饮食习惯以及某些药物有关。慢性胃炎的治疗尚缺乏特效的治疗,主要有饮食疗法及药物疗法,其治疗原则是以内科治疗为主。     

银杏叶提取物制剂序贯疗法对老年血管性痴呆患者记忆、认知及血流状态的影响

目的 探讨银杏叶提取物制剂序贯疗法对老年血管性痴呆患者记忆、认知及血流状态的影响.方法 选取2017年9月至2018年12月沈阳医学院附属中心医院收治的86例老年脑血管性痴呆患者作为研究对象,按治疗方法不同分为对照组(40例)与观察组(46例).两组给予常规治疗,其中包括改善微循环、抗血小板聚集等,对照组在常规治疗基础...     

The cost-effectiveness of disease-modifying therapies for the treatment of relapsing-remitting multiple sclerosis

Background: The safety and efficacy of disease-modifying therapies (DMTs) for relapsing-remitting multiple sclerosis (RRMS) has been established; however, it is not clear which provides optimal value, given benefit-risk profiles and costs.

Aims: To compare the cost-effectiveness of current DMTs for patients with RRMS in the US.

Materials and methods: A Markov model predicting RRMS course following initiation of a DMT was created comparing outcomes (e.g. relapses, disease progression) and costs of natalizumab (NTZ), dimethyl fumarate (DMF), and peginterferon beta-1a (PEG) with fingolimod (FIN), glatiramer acetate (GA, 20?mg daily), and subcutaneous interferon beta-1a (IFN, 44?mcg), respectively, over 10 years. RRMS and secondary-progressive MS (SPMS) EDSS state transitions were predicted in 3-month cycles in which patients were at risk of death, relapse, or discontinuation. Upon DMT discontinuation, natural history progression and relapse rates were applied. Incremental cost-effectiveness ratios (ICERs) were estimated for the cost per relapse avoided, relapse-free years gained, progression avoided, and progression-free years gained. The impact of model parameters on outcomes was evaluated via one-way sensitivity analyses.

Results: Costs ranged from $561,177 (NTZ) to $616,251 (GA). NTZ, DMF, and PEG were dominant (less costly and more effective) compared to FIN, GA, and IFN, respectively, for all ICERs. Variability in drug costs and parameters that affected drug cost accrual (e.g. discontinuation rates and the decision to drop out after SPMS conversion) had a considerable impact on ICERs.

Limitations: Several simplifying assumptions were made that may represent potential limitations of this analysis (e.g. a constant treatment effect over time was assumed).

Conclusions: The results from this analysis suggest that the NTZ, DMF, and PEG are cost-effective DMT choices compared to FIN, GA, and IFN, respectively. The actual impact on a particular plan will vary based on drug pricing and other factors affecting drug cost accrual.     

俄罗斯的经济转轨与市场规则构建

苏联的解体,俄罗斯的独立,标志着俄罗斯经济转轨的正式开始。俄罗斯的经济转轨的目标,就是建立在私有制基础上的市场经济体制。俄罗斯政府最初选择了英美的自由市场经济模式的发展道路,采取"休克"疗法。但这一切并没有像预期的那样消除俄罗斯的经济危机。普京就任俄罗斯总统,俄罗斯的经济转轨进入了一个新时代。在目标模式上,由转轨之初对英美模式的推崇逐渐转变为对近似于德国的社会市场经济模式的追求;在转轨方法上,由转轨之初激进的"休克疗法"逐渐转变为追求渐进的改革。俄罗斯的经济转轨过程也就是其构建市场规则、建立市场经济秩序的过程。     

波兰经济转轨概观(1989-2000)

从1989年开始,波兰采用"休克疗法"式的改革,对国有经济实行快速私有化,成功地进行了经济转轨,使波兰的经济增长速度不断加快,综合国力显著提高,取得了良好的经济效果.波兰现已成为中东欧地区经济转轨最成功的国家.     

走出失恋误区的女大学生的个案研究

当前，女大学生因失恋引发的心理和行为问题较多。应认真分析女大学生因失恋引发心理和行为问题的深层原因，合理运用情绪疗法并构建良好社会支持系统，使之在失恋个体心理和行为问题干预中得到有效运用，使受到失恋困扰的学生早日走出失恋误区，健康成长。     

Promoting shared health care decision making using the analytic hierarchy process

Recent developments in medical technology and bioethics have led to a shift in the traditional framework of physician–patient responsibility in health care decision making. Patients are increasingly participating in serious health care decisions, resulting in a “shared decision-making model“ that both patients and their doctors agree is a significant improvement over the traditional system in which a doctor served as the primary decision maker. However, patients are finding they need to develop strategies that allow them to understand and evaluate their health care options in a clear manner. T.L. Saaty’s “Analytic Hierarchy Process” (AHP) is a decision methodology that has been successfully applied to a wide variety of situations and has great potential as a methodology for improved shared health care decision making. This paper reports the results of an experimental use of AHP as a tool to facilitate shared decision making for two specific health care populations. Both groups of patients were deciding amongst their options in terms of two important elective health care procedures: estrogen replacement therapy and cosmetic eyelid surgery. After using AHP, the majority of both patients and physicians agreed that this technique improved physician–patient communication, thus greatly assisting shared health care decisions. When considering other criteria in addition to physician–patient communication, including the entire physician–patient relationship, the patients felt that AHP was preferable to the conventional doctor-patient mode of decision making.