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.     

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。     

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.     

Stress and consumer behavior

Although stress research has received increased attention in the behavioral and social sciences, it has been virtually ignored by marketing researchers. This paper attempts to advance the stress perspective as a useful framework in consumer research. First, the author presents theoretical and conceptual foundations of stress research. Second, the author develops a general conceptual model of the causes and consequences of stress on the basis of theory and research. The model serves as a blueprint for presenting theory and research on stress, organizing and interpreting findings of consumer studies in the context of stress theory, and developing propositions for needed research. Finally, the author provides a research agenda to guide future studies in this area.     

舒血宁注射液联合丹参滴丸治疗急性冠脉综合征临床研究

目的探讨舒血宁注射液联合丹参滴丸治疗急性冠脉综合征的临床疗效。方法将我院2011年6月至2013年6月收治住院的60例急性冠脉综合征患者分为两组,对照组采用常规治疗,治疗组在对照组基础上采用舒血宁注射液联合丹参滴丸治疗,比较两组患者的临床疗效。结果治疗组总有效率为93.3%,显著高于对照组(73.3%),P<0.05。结论舒血宁注射液联合丹参滴丸治疗急性冠脉综合征疗效显著,值得在临床推广。     

The NHS Plan: Accounting for investment and reform in twenty acute hospital trusts in England (1998–2003)

The National Health Service (NHS) Plan published in 2000 summarised Labour's commitment to modernising the NHS in England. The NHS would receive substantial additional funding bringing expenditure on health, as a share in national income, to levels comparable with a European average. The promise of secure financing from government promised to reduce uncertainty and facilitate medium term resource planning in the NHS. Extra funding, as outlined in the NHS Plan, would also be tied into capital and labour process reform(s) to ensure that investment translated into the much needed additional capacity to treat patients. During the period 1998–2003 funding for an average acute hospital has increased 50% in cash terms satisfying expectations set out in the NHS Plan. It is now an appropriate time to review progress. Using information collected for 20 acute hospitals, selected on the basis that they had started and completed PFI projects in the period 1998–2003. This paper constructs a physical and financial audit which is then used to reveal the degree to which acute hospital finances are now secure and the extent to which physical capacity to treat patients has been robustly transformed.     

手术治疗急性梗阻性大肠癌临床探讨(附168例报告)

目的 探讨急性梗阻性大肠癌的手术治疗原则及预后.方法 分析168 例急性梗阻性大肠癌的手术治疗临床资料,其中右半结肠癌18 例,左半结肠癌60 例,直肠癌90 例.168 例中Dukes B 期24 例,C期80例,D期64 例.168 例均手术治疗,其中行结肠造口18 例,miles 手术64 例,Hartmann 手术18 例,一期切除吻合加肠外置术12 例,结肠灌洗一期切除吻合56 例.结果 治愈164 例,死亡4 例.未能切除癌肿的2 例患者术后5 月死亡.结论 手术治疗是解除急性梗阻性大肠癌的唯一方法.应根据患者的不同情况选择合理的手术方式.