急性脑梗死介入治疗围术期的护理效果

目的探讨急性脑梗死介入治疗围术期的护理效果。方法对49例急性脑梗死介入治疗患者的围术期护理进行分析。结果 49例患者术后影像学检查显示血管再通44例,血管未通5例,有效率达89.8%,均未出现脑出血、脑水肿等不良后遗症。患者3~4周出院,出院时可独立行走。结论加强急性脑梗死患者的围术期护理,严密观察病情及预防并发症的发生,对手术的成功起着至关重要的作用。     

Exploring the causal relationship between hospital length of stay and re-hospitalization among Japanese AMI patients

We explore the causal relationship between hospital length of stay (LOS) and re-hospitalization for Acute Myocardial Infarction (AMI) patients in Japan, where the average LOS is the longest among OECD countries. Using chart-based data, we address the endogeneity between LOS and re-hospitalization probability by using an exogenous variation based on Rokuyo (the six basic labels allocated to each day), which is found to be irrelevant to admission day but relevant to discharge day. While we do find a significant and positive association between LOS and re-hospitalization probability in the OLS estimation, we do not find a significant relationship once LOS is instrumented by Rokuyo in various instrumental variable estimations. This implies that additional stay that was induced owing to patient’s choice of preferred Rokuyo at discharge has no effect on re-hospitalization probability.     

贝前列素钠联合大株红景天治疗腔隙性脑梗死患者的临床效果

目的 探讨腔隙性脑梗死患者应用贝前列素钠与大株红景天联合治疗的临床疗效及安全性.方法 选取2017年6月至2020年5月辽宁省鞍山市中心医院铁东院区收治的60例腔隙性脑梗死患者作为研究对象,按随机数字表法将其分为观察组与对照组,各30例.对照组行口服常规西药(辛伐他汀、尼莫地平、阿司匹林肠溶片)治疗,观察组采用贝前列素...     

Cardiovascular event costs in patients with Type 2 diabetes mellitus

Abstract

Objective:

To quantify the cost of acute major adverse cardiac events (MACE; myocardial infarction [MI] and stroke) stratified by cardiovascular disease (CVD) risk factors in commercially, Medicare Supplemental-, and Medicaid-insured patients with type 2 diabetes mellitus (T2DM).     

脑梗死合并肺部感染临床分析

目的分析探讨急性脑梗死合并肺部感染的危险因素,以便积极预防及治疗,提高疗效,降低死亡风险。方法回顾性分析2006年12月～2013年8月本院收治的180例急性脑梗死患者,分为肺部感染组90例和非感染组90例,对相关危险因素进行对照分析。结果肺部感染组合并吞咽困难、意识障碍、大面积脑梗死以及慢性阻塞性肺疾病、冠心病、糖尿病等基础疾病较非感染组明显升高。结论年龄、COPD病史、吞咽困难、意识障碍、大面积脑梗死以及基础疾病冠心病、糖尿病是脑梗死合并肺部感染的危险因素,临床应高度重视,并积极预防及治疗。     

急性脑梗死患者早期血清C-反应蛋白测定及临床意义

为了探讨血清C-反应蛋白（CRP）测定在急性脑梗死早期的临床价值 ,采用透射比浊法测定158例急性脑梗死患者入院后48小时内血清标本和30例体检健康者的血清标本中CRP水平,以CRP＞8mg/L为阳性,按临床及CT扫描结果分组比较.结果发现急性脑梗死患者轻、中、重各组血清CRP水平均明显升高,均显著高于正常对照组.在轻、中、重各组中,CRP水平也存在明显不同,随临床神经功能缺损程度的加重,CRP水平升高;急性脑梗死患者发病早期血清CRP阳性率为53.8%,而正常对照组中无1例阳性;急性脑梗死患者发病早期血清CRP阳性者其病死率显著高于CRP阴性者.认为可通过临床上检测急性脑梗死患者血清CRP的变化来判断病情及评估预后.     

Book reviews

Valid measures of how people view risks due to combinations of hazards are needed. 320 adult smokers responded to four vignettes in which hypothetical men were described as having high or low levels of (1) smoking and (2) either (a) blood cholesterol or (b) family history of CHD (coronary heart disease). Ratings of the risk of a heart attack were made using one of three different rating scales: (a) nine‐point, (b) 101‐point, and (c) unbounded. The nine‐point scale yielded a strong sub‐additive interaction, the 101‐point scale yielded a weak sub‐additive interaction, and the unbounded scale yielded a weak synergistic interaction. Although respondents preferred the nine‐point scale, evidence from this and other studies suggest that scales with nine points or fewer should not be used to assess perceptions of risks due to multiple hazards.     

依达拉奉联合阿托伐他汀钙治疗急性脑梗死患者的临床疗效

目的 探讨依达拉奉联合阿托伐他汀钙治疗急性脑梗死患者的疗效.方法 选取2019年1月至2020年1月于大连市中心医院神经内科住院治疗的急性脑梗死患者68例作为研究对象,据其住院病例号码随机分为他汀组与联合组,各34例.两组患者接受抗血小板聚集、改善循环、降低颅内压、改善脑水肿等基础治疗,并监测各项生命指征指标,如血压、...     

Hospital costs associated with intraoperative hypotension among non-cardiac surgical patients in the US: a simulation model

Objective: Recent studies indicate intraoperative hypotension, common in non-cardiac surgical patients, is associated with myocardial injury, acute kidney injury, and mortality. This study extends on these findings by quantifying the association between intraoperative hypotension and hospital expenditures in the US.

Methods: Monte Carlo simulations (10,000 trial per simulation) based on current epidemiological and cost outcomes literature were developed for both acute kidney injury (AKI) and myocardial injury in non-cardiac surgery (MINS). For AKI, three models with different epidemiological assumptions (two models based on observational studies and one model based on a randomized control trial [RCT]) estimate the marginal probability of AKI conditional on intraoperative hypotension status. Similar models are also developed for MINS (except for the RCT case). Marginal probabilities of AKI and MINS sequelae (myocardial infarction, congestive heart failure, stroke, cardiac catheterization, and percutaneous coronary intervention) are multiplied by marginal cost estimates for each outcome to evaluate costs associated with intraoperative hypotension.

Results: The unadjusted (adjusted) model found hypotension control lowers the absolute probability of AKI by 2.2% (0.7%). Multiplying these probabilities by the marginal cost of AKI, the unadjusted (adjusted) AKI model estimated a cost reduction of $272 [95% CI?=?$223–$321] ($86 [95% CI?=?$47–$127]) per patient. The AKI model based on relative risks from the RCT had a mean cost reduction estimate of $281 (95% CI?=?–$346–$750). The unadjusted (adjusted) MINS model yielded a cost reduction of $186 [95% CI?=?$73–$393] ($33 [95% CI?=?$10–$77]) per patient.

Conclusions: The model results suggest improved intraoperative hypotension control in a hospital with an annual volume of 10,000 non-cardiac surgical patients is associated with mean cost reductions ranging from $1.2–$4.6 million per year. Since the magnitude of the RCT mean estimate is similar to the unadjusted observational model, the institutional costs are likely at the upper end of this range.     

桑叶乙酸乙酯提取物对心脏作用的研究

通过观察桑叶乙酸乙酯提取物对离体大鼠心脏活动的影响,发现桑叶乙酸乙酯提取物能显著增加左室收缩压、左室发展压、冠脉流量,降低左室舒张末压和心率。结果表明桑叶乙酸乙酯提取物具有增加心肌收缩力、减慢心率和增加冠脉流量的作用。