股骨干骨折合并侧髋关节脱位临床分析

本文报告了三例临床上少见的股骨干骨折合并同侧髋关节脱位，其特点是：发生率低，合并其他部位损伤多；早期确诊率低，髋关节脱位漏诊率高；徒手复位成功率低，手术率高。分析了漏诊原因及其防止措施，并提出了处理骨折与脱位的方法。     

Systemic risk and bank consolidation: International evidence

This paper analyzes the systemic risk effects of bank mergers to test the “concentration-fragility” hypothesis. We use the marginal expected shortfall as well as the lower tail dependence between a bank’s stock returns and a relevant bank sector index to capture the merger-related change in an acquirer’s contribution to systemic risk. In our empirical analysis of a dataset of international domestic and cross-border mergers, we find clear evidence for a significant increase in the merging banks’, the combined banks’ as well as their competitors’ contribution to systemic risk following mergers, thus confirming the “concentration-fragility” hypothesis.     

G310国道加宽改建差异沉降分析与处理技术

结合G310国道旧路加宽改建工程施工初期探索,阐述了加宽工程新、旧路基沉降的主要影响因素、分析沉降变形机理及主要防治控制技术措施,分析了加宽路基沉降计算方法及沉降动态观测要求。     

Comment

From the point of view of a practitioner, I found Professor Keane's paper interesting and stimulating. I do not agree with the arguments, mainly because the model I have in mind of the way in which the world really works is not consistent with the theoretical model which Keane is addressing. His puzzles and paradoxes do not seem to me to be particularly puzzling or paradoxical when certain unrealistic theoretica assumptions are relaxed.

This paper provides a brief summary of some of Professor Keane's arguments; presents an alternative view of the way equity markets actually behave in the real world; and finally contrasts the implications of this alternative view with Professor Keane' own conclusions on such issues as managements' approach to investment decisions and executive renumeration packages.     

岩溶地基人工挖孔桩施工处理措施

在岩溶地基上设计人工挖孔桩时，尽最大限度地利用原场地基岩，不作大的处理，满足桩的承载力要求，论述了常见问题的处理方法。     

掘进机履带销有限元分析

通过合理的三维建模及力学分析,对掘进机履带销关键受力部位进行有限元载荷分析及计算,同时与传统力学计算进行对比分析,发现传统力学计算存在的缺陷,为履带销有限元计算方法提供计算依据。     

云南腾冲勐蚌铌钽锡矿矿床成矿地质条件

矿体赋存于燕山晚期中酸性花岗岩的云英岩化带中铌钽锡矿为主,伴生黑钨矿、白钨矿、黄铜矿、辉钼矿等。断裂构造、云英岩化与成矿关系密切,花岗岩应是成矿母岩。     

年股骨颈骨折骨牵引术后的护理体会

总结了30年老年股骨颈骨折单纯骨牵引治疗的临床护理体会，探讨了老年股骨颈骨折患者的异常心态及针对性护理方法，阐述了治疗阶段配合医生的临床护理要点及康复期的护理指导。     

焊接钢结构的脆性断裂分析

通过简述钢结构的脆性断裂事故,应用断裂力学的原理对结构发生断裂的因素进行分析,指出其主要影响因素.最后,分别从焊接钢结构的设计,施工工艺、质量控制以及维修监控等方面对钢结构的脆性断裂提出防治措施,以期为实际工程提供参考.     

Cost effectiveness and impact on quality of life of abobotulinumtoxinA and onabotulinumtoxinA in the treatment of children with lower limb spasticity in Canada

Abstract

Background: Injectable botulinum neurotoxins are a mainstay of treatment for pediatric spasticity. AbobotulinumtoxinA and onabotulinumtoxinA are both injectable toxin therapies used to treat pediatric lower limb (PLL) spasticity in Canada. The objective of this study was to assess the cost-effectiveness of abobotulinumtoxinA vs. onabotulinumtoxinA in the treatment of PLL spasticity in Canada.

Methods: A probabilistic Markov cohort model with a 2-year time horizon was developed, with health states defined by response to therapy, as characterized by the goal attainment scale (GAS). Based on randomized controlled trial evidence, response to therapy was similar or higher for abobotulinumtoxinA relative to onabotulinumtoxinA; uncertainty was incorporated into model parameters, however, as the two therapies have not been compared head-to-head. Canadian resource use and cost data were incorporated.

Results: In the base case, abobotulinumtoxinA generated 1.48 quality-adjusted life years over the model time horizon, compared to 1.47 for onabotulinumtoxinA. AbobotulinumtoxinA was associated with cost savings of $123 CAD, reflecting lower costs in both medication acquisition and health services. The estimated improvement to quality of life and reduced costs result in an estimate of economic dominance for abobotulinumtoxinA over onabotulinumtoxinA. This dominant result persisted across probabilistic and scenario analyses.

• Key points for decision makers

• Based on a review of available clinical evidence, abobotulinumtoxinA was found to have significant and/or numerical efficacy benefits to onabotulinumtoxinA on functional outcomes (Goal Attainment Scale) and tone (Modified Ashworth Scale) and in the treatment of pediatric lower limb spasticity

• In this cost-effectiveness analysis, abobotulinumtoxinA was found to be associated with greater quality-adjusted life years and lower costs than onabotulinumtoxinA (economically dominant)

• A limitation of this analysis was the uncertainty around key parameters. Specifically, the lack of head-to-head comparison data for the two therapies, and variable data regarding likely onabotulinumtoxinA dosing in PLL in clinical practice. However, across a range of plausible scenarios, the economic dominant result remained.