目的：为了解糖尿病患者的疾病负担及促进合理用药提供参考。方法：采用面对面的开放式问卷，对四川省人民医院部分糖尿病患者进行意愿支付调查，采集糖尿病患者个人基本信息、健康状况、疾病经济承担能力和意愿支付等方面的数据，经整...目的：为了解糖尿病患者的疾病负担及促进合理用药提供参考。方法：采用面对面的开放式问卷，对四川省人民医院部分糖尿病患者进行意愿支付调查，采集糖尿病患者个人基本信息、健康状况、疾病经济承担能力和意愿支付等方面的数据，经整理后通过Excel（2013版）软件采用双人双录的方法编录成表，再借助SPSS 17.0软件运用逐步回归的多重线性回归方法进行统计学分析，探讨意愿支付值（WTP值）的影响因素。结果：共发放问卷120份，回收有效问卷106份，有效回收率为88.3％。受访者的平均年龄为（59.9±13.9）岁，平均体质量指数（BMI）为（24.5±0.5）kg/m2，以往每月糖尿病费用≤300元的占比最高，其次是＞300～500元和＞500～1000元；对空腹血糖（FPG）、餐后2 h血糖（2 h PG）和糖化血红蛋白（HbA1c）的知晓率依次为95.3％、86.8％和68.9％；患两种以上合并症的占29.5％。受访者对3个血糖控制指标HbA1c、FPG、2 h PG完全恢复正常的WTP值均值分别为1604.1、1617.9、1683.7元/月，中位数皆为1000元/月，对3种指标恢复10％时的WTP值均值分别为867.4、908.5、877.9元/月，中位数分别为500、575、510元/月。多重线性回归模型分析中对WTP值影响为正且有统计学意义的影响因素为每年家庭总收入、合并症、住院经历、家族糖尿病史、糖尿病心理状态和以往每月糖尿病费用；对WTP值影响为负且有统计学意义的因素为年龄、FPG值和文化程度。结论：完全恢复状态的模型中，有糖尿病足、外周神经病变、高血脂等合并症的患者会有更高的WTP值。这反映合并症对糖尿病患者的疾病经济负担和精神负担较重。10％恢复状态的模型更接近实际的治疗状态，更能反映实际中对患者WTP值的影响因素，相关模型中有家族糖尿病史、心态较抑郁、以往每月糖尿病费用更高、有住院经历的�展开更多
Spinal cord injury(SCI)often results in an inhibitory environment at the injury site.In our previous studies,transplantation of a scaffold combined with stem cells was proven to induce neural regeneration in animal mo...Spinal cord injury(SCI)often results in an inhibitory environment at the injury site.In our previous studies,transplantation of a scaffold combined with stem cells was proven to induce neural regeneration in animal models of complete SCI.Based on these preclinical studies,collagen scaffolds loaded with the patients’own bone marrow mononuclear cells or human umbilical cord mesenchymal stem cells were transplanted into SCI patients.Fifteen patients with acute complete SCI and 51 patients with chronic complete SCI were enrolled and followed up for 2 to 5 years.No serious adverse events related to functional scaffold transplantation were observed.Among the patients with acute SCI,five patients achieved expansion of their sensory positions and six patients recovered sensation in the bowel or bladder.Additionally,four patients regained voluntary walking ability accompanied by reconnection of neural signal transduction.Among patients with chronic SCI,16 patients achieved expansion of their sensation level and 30 patients experienced enhanced reflexive defecation sensation or increased skin sweating below the injury site.Nearly half of the patients with chronic cervical SCI developed enhanced finger activity.These long-term follow-up results suggest that functional scaffold transplantation may represent a feasible treatment for patients with complete SCI.展开更多
Oncogenic osteomalacia (OOM) is an uncommon metabolic and bone disease caused by fibroblast growth factor 23 (FGF23), a phosphaturic factor produced by phosphaturic mesenchymal tumors (mixed connective tissue variant,...Oncogenic osteomalacia (OOM) is an uncommon metabolic and bone disease caused by fibroblast growth factor 23 (FGF23), a phosphaturic factor produced by phosphaturic mesenchymal tumors (mixed connective tissue variant, PMTMCTV) characterized by phosphate leakage from kidneys and subsequent hypophosphatemia. In this paper, we present the case of a patient, 42-year-old woman affected by left side limp and pain involving lumbar spine, pelvis and hip joints, referred to the Rheumatology Department of our Hospital for the treatment of a suspected sero-negative spondilo-arthritis. During hospitalization patient began an immuno-suppressive therapy with TNF-alpha inhibitors associated with Pamidornate, Indometacin, Esomeprazole and vitamin D3. Nevertheless pain did not decrease and a new examination found a worst hypophosphatemia (1 mg/dl) with normal Ca and PTH’s plasma values. During the same check-up a painful bulge on the anterior part of the right knee was observed and the Magnetic Resonance Imaging scan revealed an ovular solid lesion in the soft tissue closed to the upper part of the patella. Histological analysis identified the lesion as a PMTMCTV. After surgical removal patient got complete recovery. We will discuss about diagnostic evaluation, differential diagnosis and treatment.展开更多
目的探讨完全性前置胎盘的麻醉及要点。方法回顾分析2018年1月—2019年11月于医院行剖宫产手术麻醉的完全性前置胎盘大出血产妇的临床资料28例,观察记录产妇术中出血量、输血情况、自体血回收量及洗涤后回输血量,产妇子宫最后处理情况,...目的探讨完全性前置胎盘的麻醉及要点。方法回顾分析2018年1月—2019年11月于医院行剖宫产手术麻醉的完全性前置胎盘大出血产妇的临床资料28例,观察记录产妇术中出血量、输血情况、自体血回收量及洗涤后回输血量,产妇子宫最后处理情况,产妇术后疼痛情况及术后入ICU例数。观察记录新生儿1、5 min Apgar评分和体质量情况。结果28例产妇术后镇痛效果均良好;所有产妇均顺利康复出院。28例新生儿出生情况均良好,1、5 min Apgar评分均在9分以上。结论完全性前置胎盘产妇行剖宫产手术终止妊娠,术中大出血对手术与麻醉风险极大。麻醉医师术前访视应认真查看相关检查资料,做好术前评估,制定合适的麻醉方案,作好充分的术前准备。展开更多
文摘目的：为了解糖尿病患者的疾病负担及促进合理用药提供参考。方法：采用面对面的开放式问卷，对四川省人民医院部分糖尿病患者进行意愿支付调查，采集糖尿病患者个人基本信息、健康状况、疾病经济承担能力和意愿支付等方面的数据，经整理后通过Excel（2013版）软件采用双人双录的方法编录成表，再借助SPSS 17.0软件运用逐步回归的多重线性回归方法进行统计学分析，探讨意愿支付值（WTP值）的影响因素。结果：共发放问卷120份，回收有效问卷106份，有效回收率为88.3％。受访者的平均年龄为（59.9±13.9）岁，平均体质量指数（BMI）为（24.5±0.5）kg/m2，以往每月糖尿病费用≤300元的占比最高，其次是＞300～500元和＞500～1000元；对空腹血糖（FPG）、餐后2 h血糖（2 h PG）和糖化血红蛋白（HbA1c）的知晓率依次为95.3％、86.8％和68.9％；患两种以上合并症的占29.5％。受访者对3个血糖控制指标HbA1c、FPG、2 h PG完全恢复正常的WTP值均值分别为1604.1、1617.9、1683.7元/月，中位数皆为1000元/月，对3种指标恢复10％时的WTP值均值分别为867.4、908.5、877.9元/月，中位数分别为500、575、510元/月。多重线性回归模型分析中对WTP值影响为正且有统计学意义的影响因素为每年家庭总收入、合并症、住院经历、家族糖尿病史、糖尿病心理状态和以往每月糖尿病费用；对WTP值影响为负且有统计学意义的因素为年龄、FPG值和文化程度。结论：完全恢复状态的模型中，有糖尿病足、外周神经病变、高血脂等合并症的患者会有更高的WTP值。这反映合并症对糖尿病患者的疾病经济负担和精神负担较重。10％恢复状态的模型更接近实际的治疗状态，更能反映实际中对患者WTP值的影响因素，相关模型中有家族糖尿病史、心态较抑郁、以往每月糖尿病费用更高、有住院经历的�
基金supported by grants from the National Natural Science Foundation of China(81891000)the National Key Research and Development Program of China(2016YFC1101504 and2016YFC1101505)。
文摘Spinal cord injury(SCI)often results in an inhibitory environment at the injury site.In our previous studies,transplantation of a scaffold combined with stem cells was proven to induce neural regeneration in animal models of complete SCI.Based on these preclinical studies,collagen scaffolds loaded with the patients’own bone marrow mononuclear cells or human umbilical cord mesenchymal stem cells were transplanted into SCI patients.Fifteen patients with acute complete SCI and 51 patients with chronic complete SCI were enrolled and followed up for 2 to 5 years.No serious adverse events related to functional scaffold transplantation were observed.Among the patients with acute SCI,five patients achieved expansion of their sensory positions and six patients recovered sensation in the bowel or bladder.Additionally,four patients regained voluntary walking ability accompanied by reconnection of neural signal transduction.Among patients with chronic SCI,16 patients achieved expansion of their sensation level and 30 patients experienced enhanced reflexive defecation sensation or increased skin sweating below the injury site.Nearly half of the patients with chronic cervical SCI developed enhanced finger activity.These long-term follow-up results suggest that functional scaffold transplantation may represent a feasible treatment for patients with complete SCI.
文摘Oncogenic osteomalacia (OOM) is an uncommon metabolic and bone disease caused by fibroblast growth factor 23 (FGF23), a phosphaturic factor produced by phosphaturic mesenchymal tumors (mixed connective tissue variant, PMTMCTV) characterized by phosphate leakage from kidneys and subsequent hypophosphatemia. In this paper, we present the case of a patient, 42-year-old woman affected by left side limp and pain involving lumbar spine, pelvis and hip joints, referred to the Rheumatology Department of our Hospital for the treatment of a suspected sero-negative spondilo-arthritis. During hospitalization patient began an immuno-suppressive therapy with TNF-alpha inhibitors associated with Pamidornate, Indometacin, Esomeprazole and vitamin D3. Nevertheless pain did not decrease and a new examination found a worst hypophosphatemia (1 mg/dl) with normal Ca and PTH’s plasma values. During the same check-up a painful bulge on the anterior part of the right knee was observed and the Magnetic Resonance Imaging scan revealed an ovular solid lesion in the soft tissue closed to the upper part of the patella. Histological analysis identified the lesion as a PMTMCTV. After surgical removal patient got complete recovery. We will discuss about diagnostic evaluation, differential diagnosis and treatment.
文摘目的探讨完全性前置胎盘的麻醉及要点。方法回顾分析2018年1月—2019年11月于医院行剖宫产手术麻醉的完全性前置胎盘大出血产妇的临床资料28例,观察记录产妇术中出血量、输血情况、自体血回收量及洗涤后回输血量,产妇子宫最后处理情况,产妇术后疼痛情况及术后入ICU例数。观察记录新生儿1、5 min Apgar评分和体质量情况。结果28例产妇术后镇痛效果均良好;所有产妇均顺利康复出院。28例新生儿出生情况均良好,1、5 min Apgar评分均在9分以上。结论完全性前置胎盘产妇行剖宫产手术终止妊娠,术中大出血对手术与麻醉风险极大。麻醉医师术前访视应认真查看相关检查资料,做好术前评估,制定合适的麻醉方案,作好充分的术前准备。
