ObjectiveTo evaluate the disease characteristics,medical consultation model and barrier to get basic medical service rural patients with chronic obstructive pulmonary disease(COPD) in Chinese western. MethodsThe subjects were collected from a COPD epidemiology study conducted in Western rural district.The factors which were associated with disease characteristics,medical consultation model,and barrier to get basic medical service were analyzed by questionnaire,individual conversation,and laboratory tests. ResultsThis study enrolled 343 COPD patients confirmed by spirometry test.118 subjects consulted their doctors frequently because of apparent symptom.73(62%) subjects had symptom with 5 to 10 years,while 22(19%) subjects with more than 10 years.Among the symptomatic COPD subjects,only 2(2%) cases were diagnosed as COPD previously,15(13%) subjects with chronic bronchitis,and only 1(1%) subject underwent spirometry test.110(93%) subjects were prescribed as antibiotics,68(58%) subjects with theophylline,5(4%) subjects with ICS+LABA.COPD education was acceptable in most subjects(98%),however,the regular follow-up was acceptable in only 26% of subjects. ConclusionLack of disease information,inappropriate medical consultation model,and irregular COPD management in primary care are the major factors which influence diagnosis and treatment of COPD in Western rural area of China.
Objective To evaluate systematically the effectiveness and safety of procalcitonin ( PCT) -guided therapy in comparison with standard therapy in patients with suspected or confirmed severe bacterial infections in intensive care unit ( ICU) . Methods Five randomized controlled trials ( 927 patients) were included for statistical analysis by the cochrane collaboration′s RevMan5. 0 software. Results PCT-guided therapy was associated with a significant reduction in duration of antibiotic therapy [ MD =- 2. 01, 95% CI ( - 2. 37, - 1. 64) , P lt;0. 00001] , but the mortality [ OR =1. 11, 95% CI ( 0. 83, 1. 49) ,P =0. 47] and length of ICU stay[ MD = 0. 49, 95% CI( - 1. 44, 2. 42) , P = 0. 62] were not significantly different. Conclusions An algorithmbased on serial PCT measurements would allow a more judicious use of antibiotics than currently traditional treatment of patients with severe infections in ICU. It can reduce the use of antibiotics and appears to be safe.