Objective To investigate the rural residents’ payment will for disease control and its influencing factors, so as to provide evidence for the government to make policy of combing disease control and New Rural Co-operative Medical system (NRCMS). Methods The self-designed questionnaire was adopted to investigate 1 117 rural residents from 156 villages, 44 towns, 19 counties (cities, districts) in Henan province. The frequency analysis and the multiple logistic regression analysis were conducted by using SPSS 11.5 software. Results On the basis of NRCMS payment, 68.3% of the rural residents were willing to pay extra for disease control, 62.3% of whom were willing to pay RMB 1.00 or more, and the average willing payment were RMB 3.01±7.66. The multiple logistic regression analysis revealed that the people willing to pay extra were as follows: self-employed, graduates from a secondary technical school, dink family, and the respondents who believed NRCMS had relieved their medical financial burden. Conclusion In practicing the rural public health policy of combining disease control and NRCMS, it is suggested to ask rural residents to pay a little extra money on the basis of current NRCMS payment. The foundation of bringing this policy into force is to keep practicing NRCMS well so as to relieve more financial burdens for rural residents. During the implementation, low income families should be taken into consideration according to their occupation, educational level and family structure.
Objective To investigate and analyze the epidemic characteristics and factors of pulmonary tuberculosis (PTB) to provide foundation and make prevention and treatment policy. Methods Statistical analysis was conducted to analyze the current existing PTB prevention and control data in the Center for Disease Control and Prevention of Zhushan County and corresponding prevention and treatment policy was proposed. Results Since 1997 when PTB was included into B infectious diseases in Zhushan County, 4 431 cases of PTB had been reported by the end of 2009. Annual reported incidence rate was 74.73 per 100 000 and the disease was found in 17 towns. All seasons witnessed the incidence but winter and summer had more sufferer. The youngest patient was 4 months whereas the oldest was 86 years old. The majority of the patients were from 20 to 59 years old, peasants were the main patients, and the incidence of male was higher than that of female. The use of chemotherapy resulted in a significant decline of PTB death rate. Poor immunity of elder group, population flow caused by poverty, low detection rate of patients and AIDS were the major causes to PTB epidemic. A lack of prevention and treatment in the grassroots hospital and difficulty to fully implement the Directly Observed Treatment, Short-course (DOTS) strategy in remote areas were also bottlenecks to PTB control process. Conclusion The followings should be performed to improve the quality of DOTS strategy implementation: strengthen the government’s commitment, provide policy and funding safeguard, conduct health education and health promotion widely, reinforce management according to the law, fully implement the DOTS strategy, and fortify the prevention and control construction.
With the dissemination and popularization of EBM around the world, the evidence-based laboratory medicine has boomed gradually. However, the substantial researches in tbe field are still inadequale now. Based on the facts of hospital laboratory medicine, this article discussed the feasibility that apply the rationale and methods to orient the laboratory quality control.
Objective To determine the effects of controlled hypotension (CH) on cerebra1 blood flow, cerebra1metabolism, and cognitive functions. Methods Randomized controlled trials (RCTs) were identified from MEDLINE (1966 to 2008), EMbase (1974 to 2008), The Cochrane Library (Issue 2, 2008), CBM (1978 to 2008), and CNKI (1994 to 2008). The quality of included trials was assessed by two reviewers independently. RevMan 4.2.7 software provided by The Cochrane Collaboration was used for statistical analysis. Results Nine RCTs involving a total of 295 patients were included. Most of the studies were of poor methodological quality. Meta-analysis was performed because the outcomes were the comparisons of the means of several repeated measures, and so a descriptive analysis was conducted. There were no significant differences in cerebral blood flow velocity, hypoxia-induced metabolites, and cognitive function between the CH group and the control group (Plt;0.05). But the S100B protein level in cerebrospinal fluid or blood was significantly higher in the CH group than that in the control group (Plt;0.02). Conclusion CH has no adverse effects on cerebra1 blood flow, cerebra1 metabolism, or cognitive functions. But isoflurane-induced hypotension may increase the release of S100B, indicating worse brain injury. The above conclusions were made from the limited evidence, and more rigorous RCTs are needed.
Objective To evaluate the effects of a preoperative pain education program on patients’ knowledge of postoperative pain management, measures taken for such pain management and the actual postoperative pain. Methods A total of 84 patients undergoing abdominal surgery were non-randomly divided into two groups, 42 in each group. Patients in group A received routine preoperative care and 30 minutes of education about pain management, while patients in group B received routine preoperative care only. All patients completed the Postoperative Pain Management Questionnaire on the second postoperative day. Results Patients in group A achieved higher scores for their knowledge about postoperative pain management than those in group B (Plt;0.05). More patients in group A took non-medical pain relief methods after surgery (Plt;0.05); and patients in group A were able to use the PCA pump more correctly than those in group B (Plt;0.05). No significant differences were observed between the two groups in the frequency of asking for analgesics or their pain score when they requested analgesics (Pgt;0.05). The average score for postoperative pain was lower for group A compared to group B (Plt;0.05). Conclusions A program of preoperative pain education can improve patients’ knowledge of postoperative pain management and encourage them to participate actively in such pain management, so as to further relieve the postoperative pain.
目的 探讨3种不同助孕方案在≥40岁妇女体外受精-胚胎移植（IVF-ET）周期中的临床效果。 方法 回顾性分析2010年8月－2012年2月期间，于四川大学华西第二医院生殖中心行IVF-ET助孕、年龄≥40岁妇女共245个周期的临床资料，排除一侧卵巢缺如患者3例，余242个周期根据助孕方案不同分为3组：拮抗剂组（GnRH-A方案组）44个周期、长方案组109个周期及短方案组89个周期，比较3种方式助孕的临床效果。 结果 3组均无早发黄体生成素峰；长方案组应用促性腺激素（Gn）的时间最长，应用Gn数量最多，获得最高的获卵数及获胚数（P＜0.05）；3组的受精率、优胚率、冷冻胚胎数、周期取消率、卵巢过度刺激综合征发生率、早期流产率均无统计学意义（P＞0.05），短方案组的种植率及临床妊娠率最低（P＜0.05）。 结论 GnRH-a长方案在≥40岁妇女的IVF-ET周期中具有较好的临床结局，在≥40岁妇女IVF-ET周期中具有与长方案相似的结局，并且可以减少Gn使用量，提高卵泡及胚胎质量，短方案组对≥40岁妇女临床效果较差。
【摘要】 目的 探讨损伤控制理论（damage control theory，DCT）在脑动静脉畸形（arteriovenous malformations，AVM）诊断与治疗中的应用意义，以及指导治疗脑AVM的可行性。 方法 依据DCT原则，对2007年3月-2009年3月脑AVM患者进行积极治疗，并分析其治疗结果。 结果 根据DCT原则制订脑AVM患者的治疗方案，控制脑AVM的危险因素，降低其疾病发展风险，患者治疗结果比较满意。 结论 应用DCT原则指导脑AVM患者急性期处理及介入等治疗措施，可以提高患者的生存率，有效控制疾病的危险因素，提高治疗总有效率，具有临床指导意义。【Abstract】 Objective To investigate the significance and feasibility of damage control theory (DCT) in diagnosing and treating cerebral arteriovenous malformations (AVM). Methods According to the disease treatment principle of DCT, 76 patients with AVM diagnosed in our hospital from March 2007 to March 2009 were treated actively, and the treatment results were analyzed. Results The risk factors of AVM was controlled, the development risk of AVM slowed down, and the therapeutic effect was satisfactory. Conclusion According to the DCT principle, we could improve the survival rate of the patients, control the risk factors effectively, and improve the prognosis of the disease. DCT principle is clinically significant to guide the treatment of AVM.
目的：探讨硝普钠控制性降压在脊柱手术中的临床应用。方法：72例拟在全麻下行脊柱手术患者随机分成两组：观察组（硝普钠组，n=36）与对照组（n=36）。所有患者均静脉注射咪唑安定0.1mg·kg-1、丙泊酚2mg·kg-1、芬太尼2μg·kg-1和采用预注给药的阿曲库铵进行气管内插管，以异氟醚或氨氟醚、阿曲库铵和芬太尼维持麻醉。观察组在手术进入椎体前3～5min由输液泵输入001％硝普钠，控制速度使收缩压维持于60～80mmHg的范围。记录两组出血量、输血量、输液量、手术时间，术后1h血红蛋白与术前血红蛋白等。结果：两组患者基本情况、手术类型、晶体液、胶体液输入量无统计学差异；观察组术中失血量和输血量均明显少于对照组，且手术时间明显缩短；两组术后1h血红蛋白与术前比较均有所下降，但差异无显著性。结论：脊柱手术中采用硝普钠控制性降压效果安全、可靠，可明显减少术中出血量及输血量，缩短手术时间。
创伤、手术、感染、烧伤等极度应激状况下的危重患者常出现应激性高血糖； 非糖尿病危重患者类似糖尿病的症状； 糖尿病危重患者则高血糖程度明显加重。 创伤后出现不同水平的高血糖，随着血糖的增高，其死亡危险性也呈阶梯样成倍增长［1，2］……
In this study, hypertonic saline infusion (experimental group ) and blood transfusion plus normal saline infusion (control group) were used for the treatment of uncontrolled hemorrhagic shock in dogs. The amount of blood loss from injured vessels are compared between two groups. Results: the amount of blood loss from injured vessels in shock stage were 35.2ml in the experimental group and 34.6ml in the control group, which showed no marked difference between two groups(Ｐ＞0.05).The amount of blood loss in resuscitation stage for experimental group was 15.10±1.52ml(early stage) and 14.00±1.37ml(late stage) and for control group was 14.20±1.52ml and 12.90±1.71ml respectively(Ｐ＞0.05).The amount of blood loss in resuscitation stage for both groups is much less than that in shock stage (Ｐlt;0.05).The results showed that infusion of hypertonic saline 30 min after uncontrolled shock is a safe and effective treatment which dose not cause further bleeding from the injured vessels. Clinical observation also confirmed the result.