Objective To be aware of the treatment status and economic burden of people with hemophilia (PWH) in mainland China, so as to seek the optimal therapy for them. Methods The relevant Chinese and English databases such as CBM, CNKI, VIP, WanFang Database, PubMed, EMbase and The Cochrane Library (Issue 6 of 12, June 2011) were searched in June, 2011. The economic analyses and studies on PWH treatment and economic burden published from 1980 to 2011 were collected. Results The diagnosis and treatment of PWH in mainland China lagged behind. More than 30% of PWH did not receive or occasionally received treatment, and less than 10% received prophylactic therapy. Lots of PWHs still used FFP or cryoglobulin which were easily to cause blood-borne viral diseases. More than half of PWH families could afford a little or completely could not afford the therapy. Low dose prophylactic therapy was cost-efficient than on-demand therapy. Based on the therapy status, it was estimated that approximately RMB 53 844 yuan per year per patient should be put into practice in order to have PWH received low-dose prophylactic therapy, and to prevent 80% of bleeding. Conclusion PWH in mainland China is poor in treatment status and heavy in economic burden, so it is an optimal way to adopt comprehensive care model and low-dose prophylactic therapy in mainland China.
Objective To report the screening, prevention and treatment of venous thrombosis for Lushan earthquake victims in the West China Hospital of Sichuan University. Methods Among the Lushan earthquake victims screened by vascular color Doppler, those with detected venous thrombosis were treated reasonably, and those without detected venous thrombosis were prevented early. Results There were total 235 Lushan earthquake victims in the hospital as of the 11th day after earthquake, and they were screened by vascular color Doppler. Among 26 cases with detected venous thrombosis, 25 were lower limb venous thrombosis, and the other one was upper limb venous thrombosis. Three cases were treated by rehabilitation intervention alone, three cases were treated by drug intervention alone, and the other 20 cases were treated by both rehabilitation and drug intervention. As of 30 days after the earthquake, the reexamination results of 26 victims with venous thrombosis showed that: 11 cases improved, including 5 completely recanalization and 6 incompletely recanalization. Among the three cases with drug intervention alone, one got completely recanalization, accounted for 33.33%. Among the three cases with rehabilitation intervention alone, one got incompletely recanalization, accounted for 33.33%. Among the 20 cases with both rehabilitation and drug intervention, four got completely recanalization, accounted for 20.0%, and five got incompletely recanalization, accounted for 25.0%. Conclusion Most Lushan earthquake victims with venous thrombosis are the elderly and women, stay in the ICU, and suffer from fractures in different degrees. The timely prevention and treatment can relieve local pain, promote early entry in the rehabilitation treatment, and prevent pulmonary embolism and other risks. The rehabilitation intervention and/or drug intervention should be adopted to the victims with detected venous thrombosis as well as the victims without detected venous thrombosis but have high risk factors, for it can effectively prevent and treat the further thrombosis and other bad consequences of the detachment of thrombus.
H7N9, a novel avian influenza A virus that causes human infections emerged in February, 2013 in Anhui and Shanghai, China. The epidemic quickly spread to Zhejiang, Jiangsu and other neighbor provinces. As of May 30th, 2013, WHO had reported 132 cases, 37 (28%) of which died. Aiming at such serious outbreak of epidemic, we retrospectively analyzed its etiology, epidemiology, clinical characteristics, treatment, prevention and control based on data and evidence. Experience and evidence of the risk surveillance and management of such a novel anthropozoonosis lacks in China, or even lacks around the world. Quick and accurate identification of the rules and of the variation and transmission of avian influenza virus becomes a key to prevention, control and treatment. According to current best available evidence around the world, Chinese medicine and biomedicine should be put in to parallel use. Only realizing evidence-based decision making can we effectively prevent and control the epidemic, treat patients, and reduce the loss.
With clinical medicine science transforming from traditional medicine to evidence-based medicine, how to practice evidence-based medicine has become a new challenge to clinical doctors. Therapy studies play an important part in clinical studies and how to practice evidence-based medicine in the therapy of diseases is an important question that doctors are concerned. This paper will introduce as on how to practice evidence-based medicine in the therapy of diseases.
目的 探讨胰性脑病的可能的发病机制、发病情况及防治措施.方法 计算机检索中文科技期刊全文数据库(1989～2004),收集有关胰性脑病的临床研究,并进行统计分析.结果 共纳入43篇文献,435例患者.胰性脑病在重症急性胰腺炎中的发病率远高于轻症急性胰腺炎;发病年龄趋向中、老年;病死率为43.67%;病因仍以胆系疾病为主;伴发低氧的几率不高于未并发胰性脑病患者.结论 胰性脑病的发生可能是多因素共同作用的结果,仍需进一步探讨其发病机制.血清髓鞘碱性蛋白有望成为有价值的诊断指标.防治以治疗原发病急性胰腺炎为主,重在预防.胰酶抑制剂和早期营养支持有一定预防作用.
目的 探讨应用双吻合器低位直肠癌前切除术后吻合口漏的早期诊断和防治措施。方法 回顾性分析 2005～2011年期间笔者所在医院收治的160例应用双吻合器行低位直肠癌前切除患者的临床资料。结果 本组患者术后发生吻合口漏13例（8.1%），发生吻合口漏的时间为术后 3～12d，平均7d；8例经保守治疗后治愈，4 例经二次手术行结肠或回盲部造瘘后好转，1 例于术后12d死亡。结论 直肠癌前切除术后吻合口漏的早期正确诊断和合理治疗是降低患者死亡率的关键；早期的造瘘手术和通畅引流是治愈吻合口漏的必要措施。
Objective To investigate the prevention and treatment strategy of bile duct injury (BDI) in laparoscopic cholecystectomy (LC). MethodsLatest progress was reviewed based on recent documents and the experience on BDI in LC in our department. ResultsWith the popularity of LC, BDI in LC is increasing. The reasons include illegibility and variability of local anatomy in gallbladder trigone,injury caused by galvanothermy, as well as operator’s overconfidence. In order to prevent BDI, we should apply more blunt dissection, not to use electrocogulation if possible and to study local anatomy and its variance clearly. The common bile duct and common hepatic duct should be clearly identified. Intraoperative cholangiography, laparoscopic ultrasonography and hepatobiliary scintigraphy are selections as necessary.The treatment of BDI depends on the type of BDI and its site and local condition.The treatment includes end to end anastomosis, repairing the defect, choledochoduodenostomy, RouxenY choledochojejunostomy and so on. T tube should be maintained in place for more than half a year after operation.Conclusion The key to improve the prognosis of BDI is prevention and treatment in proper time and in correct way.