Comprehensive assessment of patients with irritable bowel syndrome with constipation and chronic idiopathic constipation using deterministically linked administrative claims and patient-reported data: the Chronic Constipation and IBS-C Treatment and Outcomes Real-World Research Platform (CONTOR)

Abstract

Aims

To characterize a US population of patients with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC) using CONTOR, a real-world longitudinal research platform that deterministically linked administrative claims data with patient-reported outcomes data among patients with these conditions.     

Economic evaluation of human urinary kallindinogenase for patients with acute ischemic stroke in China

Objectives: In China, both human urinary kallindinogenase (HUK) and 3-n-butylphthalide (NBP) are recommended for clinical use to improve cerebral blood circulation during an acute ischemic stroke (AIS). The objective was to evaluate the economic value of HUK vs NBP for patients with AIS from a Chinese payer’s perspective.

Methods: An economic evaluation based on data of patients who have been treated with either HUK (n?=?488) or NBP (n?=?885) from a prospective, phase IV, multi-center, clinical registry study (Chinese Acute Ischemic Stroke Treatment Outcome Registry, CASTOR) was conducted to analyze the cost and effectiveness of HUK vs NBP for AIS in China. Before the analysis, the patients were matched using propensity score. Both a cost-minimization analysis and a cost-effectiveness analysis were conducted to compare the matched pairs. A bootstrapping exercise was conducted for the matched arms to demonstrate the probability of one intervention being cost-effective over another for a given willingness-to-pay for an extra quality-adjusted life-year (QALY).

Results: After propensity score matching, 463 pairs were matched. The overall medical cost in the HUK arm is USD 2,701.20, while the NBP arm is USD 3,436.83, indicating HUK is preferred with cost-minimization analysis. Although the QALY gained in the HUK arm (0.77176) compared with the NBP arm (0.76831) is statistically insignificant (p?=?.4862), the cost-effectiveness analysis as exploratory analysis found that, compared with NBP, HUK is a cost-saving strategy with the lower costs of USD 735.63 and greater QALYs gained of 0.00345. Among the 5,000 bootstrapping replications, 100% indicates that HUK is cost-effective compared with NBP under a 1-time-GDP threshold; and 97.12% indicates the same under a 3-time-GDP threshold.

Conclusion: This economic evaluation study indicates that administrating HUK is a cost-saving therapy compared with NBP for managing blood flow during AIS in the Chinese setting.     

试探IGF2和H19基因与韦伯综合征的关系

笔者就韦伯综合征（Beckwith Wiedemannsyndrome,BWS）的特征,及IGF2与H19印迹基因各自生物学生性、印迹状况以及与BWS疾病的关系展开了详尽阐述。     

Incorporating annoyance in airport environmental policy: noise, societal response and community participation

Airport capacity continues to be one of the air transport issues that creates the most concern. The major environmental constraint for airports is the noise generated by aircraft. Annoyed communities living around airports have become a limiting factor for airport capacity and operability. This paper brings together the existing literature in the fields of airport environmental capacity, non-acoustic factors of noise annoyance, NIMBYism and environmental conflicts. We also analyze the socio-environmental conflict between Barcelona airport and the community of Gavà Mar. This case shows that the lack of trust between parties, the impossibility of predicting noise exposure, the absence of opportunities for civil society to speak and the difficulty of accessing relevant information foster annoyance and mobilization in the communities that live around the airport. In addition, it is shown that, in such a situation, communities’ reactions can evolve to a post-NIMBY stage in which proactive attitudes replace reactive ones.     

瑞舒伐他汀与替格瑞洛联合用药方案治疗非ST段抬高型急性冠脉综合征患者的临床效果及不良反应

目的探讨瑞舒伐他汀与替格瑞洛联合用药方案治疗非ST段抬高型急性冠脉综合征(ACS)患者的临床效果及不良反应。方法选取2018年1月至2019年7月沈阳积水潭医院收治的70例非ST段抬高型ACS患者作为研究对象,依据随机数字表法分为对照组和观察组,每组35例。对照组采用替格瑞洛治疗,观察组采用瑞舒伐他汀与替格瑞洛联合用药方案治疗,比较两组临床疗效、心肌损伤指标、炎症介质水平、不良反应发生率。结果观察组治疗有效率高于对照组,差异有统计学意义(P<0.05);观察组肌酸激酶同工酶、肌钙蛋白水平低于对照组,差异有统计学意义(P<0.05);观察组炎症介质水平、不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论瑞舒伐他汀与替格瑞洛联合用药方案治疗非ST段抬高型ACS临床效果显著,不仅可以改善临床相关指标、心肌损伤,还可减轻炎症反应,且不良反应发生率低。     

老年综合征的评估研究

随着现阶段人口老龄化趋势越来越明显,我国的老年综合征患者数量逐渐增多,《老年综合征管理指南》对老年综合征有相关阐述,认为老年综合征是指老年人因多种非疾病原因或是疾病原因所引起的同一（或临床表现）老年病症,例如睡眠障碍、吞咽障碍、跌倒、褥疮等均属于老年综合征病症。     

尿激酶静脉溶栓联合中药银杏二萜内酯葡胺治疗急性脑梗死患者的临床疗效

目的 探讨尿激酶静脉溶栓联合银杏二萜内酯葡胺治疗急性脑梗死患者的临床疗效.方法 按照不同的治疗方法将2019年6月至2020年6月鞍山市长大医院收治的97例急性脑梗死患者分为对照组和观察组,对照组(n=46)给予尿激酶静脉溶栓治疗,观察组(n=51)给予尿激酶静脉溶栓+银杏二萜内酯葡胺联合治疗.比较两组患者治疗效果、美...     

冠状动脉造影术病人综合护理的效果研究

通过对行冠状动脉造影术患者术前、术中及术后积极有效的护理，最大限度的减少并发症的发生率。将54例年龄在38—76岁的接受冠状动脉造影术的患者，其中男46例，女8例，随机选择实验组24例，对照组30例，每组女4例。对照组患者于术前、术中、术后只给予基础护理；对实验组患者予以综合护理，即除给予基础护理外，在术前还进行积极的心理护理及相关的功能训练，术中进行严密观察并安慰患者，术后指导其饮食与活动并进行积极的心理疏导。结果显示实验组患者并发症发生率为4．17％，而对照组患者并发症发生率为33．33％，实验组患者并发症发生率明显低于对照组（P〈0．05）。积极有效的综合护理能最大限度的减少并发症的发生。     

The impact of SARS on China's human resources: implications for the labour market and level of unemployment in the service sector in Beijing,Guangzhou and Shanghai

In this paper, we examine the effects of SARS (Severe Acute Respiratory Syndrome) on China's human resources, its labour-market and its level of employment and unemployment, looking specifically at what was one of its economically most vulnerable points, the hotel industry. The paper hypothesizes that the greatest impact would be on human resources in the service-industries and on particular sub-sectors, such as employment in hotels, located in three main cities in the PRC, in Beijing, Guangzhou and Shanghai, catering to both overseas as well as domestic tourism. It tentatively concludes that the almost dramatic demand and supply ‘shocks’ may have directly affected both the demand for and the supply of labour in the sub-sector, with discernable employment consequences.     

Medical resource use and costs associated with chylomicronemia

Abstract

Background:

The prevalence of severe hypertriglyceridemia (TG?>?1000?mg/dl) is estimated at 150–400 per 100,000 individuals in North America. Severe hypertriglyceridemia in the fasting state is associated with increased acute pancreatitis risk and is a sign of chylomicronemia which reflects the accumulation in the bloodstream of chylomicrons, the large lipoprotein particles produced in the gut after a meal.

Objective:

To assess medical resource use and costs associated with chylomicronemia.

Methods:

Patients with chylomicronemia of different causes (≥2 diagnoses with ICD-9 code 272.3) were identified from a large US claims database (years 2000 to 2009) and matched 1:1 to controls free of chylomicronemia based on age, gender, demographics, comorbidities, and use of lipid lowering drugs. During a 1-year study period, medical resource use and costs associated with chylomicronemia or acute pancreatitis were compared between matched cases and controls.

Results:

Among 6472 matched pairs, annual per-patient medical costs, calculated independently of the occurrence of acute pancreatitis, were significantly greater by $808 for chylomicronemia cases vs controls ($8029 vs $7220, p?<?0.01), half of which was attributable to chylomicronemia-related services (p?<?0.01). Chylomicronemia cases with a history of acute pancreatitis (n?=?46) had greater rates of inpatient visits (p?<?0.05) and greater average costs for subsequent acute pancreatitis or abdominal pain (p?<?0.01) as well as greater total medical costs ($33,587 vs $4402, p?<?0.01) vs matched controls. The average episode of acute pancreatitis (n?=?104 episodes) generated medical costs of $31,820, almost entirely due to inpatient stays.

Limitations:

Triglyceride levels were not available to characterize disease severity.

Conclusions:

Patients with chylomicronemia, and especially those with a history of acute pancreatitis, incurred significantly greater total medical costs compared with individuals without chylomicronemia but with an otherwise comparable health profile.