Cost of Medical Treatment for Primary Open-Angle Glaucoma in Relation to Patients’ Income and Its Impact on the Prognosis of the Disease, in Bouaké University Hospital

Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this relationship on treatment compliance. Materials and Methods: Prospective cross-sectional study with a descriptive aim covering sociodemographic data, average incomes, and direct and indirect costs of treatment of 57 patients followed for POAG during the period from January 1, 2012, to December 31, 2016 (5 years). Results: The patients were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector (14.04%) and housewives (12.28%). Patients who had an annual income less than or equal to 900,000 CFA francs (€1370.83) per year represented 56.14% and those who did not have health coverage represented 57.89%. The treatment was monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the average ratio of “annual cost of treatment to annual income” was 0.56 with for maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment unbearable for their income represented 78.95%. Conclusion: Prevention of blindness due to glaucoma requires early detection but also the establishment of health coverage mechanisms to improve compliance with medical treatment. In addition, consideration should be given to the development of glaucoma surgery in our country, the indication of which could be the first intention in certain patients, considering for those patients, the geographical and financial accessibility of medical treatment. .

Long-term medical treatment of patients with severe burns at exposed sites

BACKGROUND Body parts such as the face and hands are highly exposed during daily life and burns may accumulate in these areas.In addition,residual wounds,scar hyperplasia and contracture often exist in the late stage of a deep burn in these areas,which may affect patients’appearance,movements,and mental health.However,inadequate attention has been paid to this issue which can result in problems,such as difficulty in healing,possibility of carcinoma,chronic pain and a heavy mental burden.AIM To investigate the long-term medical treatment of patients with severe burns at exposed sites following a mass burn casualty event.METHODS A retrospective analysis of 13 patients with severe burns at exposed sites was performed to determine their respective long-term medical treatment.A combined wound dressing scheme consisting of traditional Chinese and Western medicine was introduced to repair residual wounds.Active and passive functional exercises with massage,Chinese herbal baths and compression fixation were proposed to ameliorate the condition of the hands.A combination of physical,chemical and photoelectrical measures was adopted for anti-scar treatment.A psychological intervention and recovery guide was provided which corresponded to the patients’psychological status.RESULTS Compared to patients who did not simultaneously receive the same treatment,patients who underwent systematic treatment recovered with a lower woundinfection rate(P<0.05),a shorter healing time(13.6±3.2 d)compared with(19.1±3.5 d)and more bearable pain during wound dressing at three days,one week and two weeks after a Chinese herbal bath(P<0.05).Satisfactory results were achieved with regard to restored function of patients’joints and blood supply to nerve endings,closure of the eyelids and the size of mouth opening tended to be normal,and only 7.1%of patients were diagnosed with severe scar hyperplasia and contracture deformity compared with 30.7%in the control group.In addition,the color,thickness,vascular distribution and softness score of the scars improved(P<0.01),and the effects of the psychological intervention was remarkable as shown by the Self-Rating Anxiety Scale and Self-Rating Depression Scale.CONCLUSION A better prognosis can be achieved in patients in the late stage of a burn with active residual wound repair,limb functional exercise,anti-scar and psychological rehabilitation.

Advances in medical treatment for pancreatic neuroendocrine neoplasms

Pancreatic neuroendocrine neoplasms(PanNENs)are rare neoplasms with strong heterogeneity that have experienced an increasing incidence rate in recent years.For patients with locally advanced or distant metastatic PanNENs,systemic treatment options vary due to the different differentiations,grades and stages.The available options for systemic therapy include somatostatin analogs,molecularly targeted agents,cytotoxic chemotherapeutic agents,immune checkpoint inhibitors,and peptide receptor radionuclide therapy.In addition,the development of novel molecularly targeted agents is currently in progress.The sequence of selection between different chemotherapy regimens has been of great interest,and resistance to chemotherapeutic agents is the major limitation in their clinical application.Novel agents and high-level clinical evidence continue to emerge in the field of antiangiogenic agents.Peptide receptor radionuclide therapy is increasingly employed for the treatment of advanced neuroendocrine tumors,and greater therapeutic efficacy may be achieved by emerging radiolabeled peptides.Since immune checkpoint inhibitor monotherapies for PanNENs appear to have limited antitumor activity,dual immune checkpoint inhibitor therapies or combinations of antiangiogenic therapies and immune checkpoint inhibitors have been applied in the clinic to improve clinical efficacy.Combining the use of a variety of agents with different mechanisms of action provides new possibilities for clinical treatments.In the future,the study of systemic therapies will continue to focus on the screening of the optimal benefit population and the selection of the best treatment sequence strategy with the aim of truly achieving individualized precise treatment of PanNENs.

Medical treatment for a fish bone-induced ileal micro-perforation:A case report

Ingested fish bone induced intestinal perforations are seldom diagnosed preoperatively due to incomplete patient history taking and difficulties in image evidence identification.Most literature suggests early surgical intervention to prevent sepsis and complications resulting from fish bone migrations.We report the case of a 44-year-old man suffered from acute abdomen induced by a fish bone micro-perforation.The diagnosis was supported by computed tomography(CT) imaging of fish bone lodged in distal ileum and a history of fish ingestion recalled by the patient.Medical treatment was elected to manage the patient's condition instead of surgical intervention.The treatment resulted in a complete resolution of abdominal pain on hospital day number 4 without complication.Factors affecting clinical treatment decisions include the nature of microperforation,the patient's good overall health condition,and the early diagnosis before sepsis signs develop.Micro-perforation means the puncture of intestine wall without CT evidence of free air,purulent peritoneum or abscess.We subsequently reviewed the literature to support our decision to pursue medical instead of surgical intervention.

Impact of the adherence to medical treatment on the main urinary metabolic disorders in patients with kidney stones

Objective:To assess the effect of the adherence to medical treatment on urinary parameters in the 24-h metabolic study of patients with kidney stones.Methods:A retrospective,longitudinal,descriptive,and observational study was carried out by reviewing the hospital electronic medical record from 2014 to 2018.The adherence to drug treatment was measured 6 months after its initiation,and the numerical values of the metabolic studies were compared.Wilcoxon tests were performed to compare the difference before and after treatment.Results:Ninety patients were evaluated,with 73.3% of adherence.The 180-day overall adherence rate was 61.2% in patients treated with a single drug and 85.4% in patients treated with multiple drugs.There is a statistically significant increase in citrate levels in patients with good adherence in comparison with non-adherent patients(p=0.031 vs.p=0.528).Conclusions:Medical treatment and dietary measures in patients with kidney stones have an initial impact at 6 months on the values of the main urinary metabolic alterations that predispose to calculi formation;the most significant is seen in those patients with adherence to medical treatment for hypocitraturia.

Nursing Effects of Medical Treatment Combination on Patients at High Risk of Developing Pressure Ulcers at Rural Homes

Objective:To explore the nursing effects of medical treatment combination on patients at high risk of developing pressure ulcers at rural homes.Methods:From January 2018 to December 2018,86 patients at high risk of developing pressure ulcers at rural homes who were in Wenjiang Hospital were randomly divided into a control group and an observed group.The control group received the routine publicity and education and visiting,while the observed group adopted the cooperative nursing model of medical treatment combination.Then compare the healing status and nursing satisfaction of the two groups.Results:Of the 43 patients with pressure ulcers in the observed group,18 had been in the second stage of pressure ulcers and 16 had been healed;14 had been in the third stage of pressure ulcers and 8 had been healed;11 had been in the fourth stage of pressure ulcers and 5 had been healed.The nursing satisfaction of the patients in the observed group was 95.35%.Conclusion:Conducting medical treatment combination on patients at high risk of developing pressure ulcers at rural homes can effectively improve the patients’and their families’awareness of pressure ulcer nursing,standardize their nursing behaviour,help recover the patients themselves and promote the patients’satisfaction.

Exploration and Research on the Integrated Development of“Internet Plus Medical Treatment”

Objective To analyze the development of“internet plus medical treatment”and to explore advantages.Methods The literature of“internet plus medical treatment”was systematically combed and analyzed.Results and Conclusion After exploring the status quo of“internet plus hospitals”,smart pharmacy and web-assisted health management in China,we find that there are some problems in the medical service at present,such as the imperfect laws and regulations,the hidden dangers of information security and the obstacles of medical insurance payment.Therefore,we propose that the development of web-assisted medical service should be led by the government and relevant policies must be improved.Then,self-regulation should be strengthened,and industry standards should be enhanced.Three suggestions are made to improve medical insurance payment and benefit both hospitals and patients,which can provide reference for promoting the development of“internet plus medical treatment”in China.

The medical treatment of cardiogenic shock

Cardiogenic shock (CS) is a leading cause of mortality worldwide. CS presentation and management in the current era have been widely depicted in epidemiological studies. Its treatment is codified and relies on medical care and extracorporeal life support (ECLS) in the bridge to recovery, chronic mechanical device therapy, or transplantation. Recent improvements have changed the landscape of CS. The present analysis aims to review current medical treatments of CS in light of recent literature, including addressing excitation–contraction coupling and specific physiology on applied hemodynamics. Inotropism, vasopressor use, and immunomodulation are discussed as pre-clinical and clinical studies have focused on new therapeutic options to improve patient outcomes. Certain underlying conditions of CS, such as hypertrophic or Takotsubo cardiomyopathy, warrant specifically tailored management that will be overviewed in this review.

Medical treatments of endometriosis: a review

Endometriosis is a chronic gynecological disorder that affects approximately 10%of women of reproductive age.Most medical treatments used today for endometriosis pain are hormonal therapies,which are not an option for those trying to conceive and are not tolerated by a subset of patients due to side effects.In this article,we offer a comprehensive review of current and investigational medical therapeutic options used to treat endometriosis pain,as well as a symptom-based systematic approach for patients with painful endometriosis.We have also included recommendations for research to enhance the evolution of novel therapeutic options.A thorough literature search was carried out,and the data were synthesized using a synthesis matrix that classifies and categorizes various arguments.

The promoting effect of health education on medical treatment seeking behavior in the context of healthy China:based on the comparison of migrants and registered local residents

The migrants are the important participant and contributor in China’s economic and social construction,but they still have many restrictions on their access to health services.This paper analyzes the differences between the migrants and the regis-tered local residents in looking for medical treatment and explores the relationship between health education and medical treatment seeking behavior,so as to find an appropriate way to improve the health level of the migrants.By using the compara-tive survey data of the floating population and registered population in 2017 and establishing the binary Logit model,this paper finds that the health education has a promoting effect on medical treatment seeking behaviors.In terms of the influence mechanism of health education on medical treatment seeking behavior,the mediat-ing effect of social participation factors is stronger in the migrants’group because making new friends and learning about local public health resources through health education is of great significance to the migrants.It is proposed to expand the cov-erage of health education among migrant groups and improve the accessibility of health education.At the same time,public medical and health services should be used as a window to guide the migrants to seek medical treatment in an orderly manner while assisting their social integration.

Study to Explore Laughter As Adjunct to Medical Treatment

笑,真的是一帖良药吗?首次进行该类研究的是加利福尼亚大学洛杉矶分校的的乔森癌症中心,研究将确定笑是否能减轻疼痛,是否有助于对儿童或青少年癌症患者、获得性免疫缺陷病毒感染者或爱滋病患者的治疗。

Medical Waste Treatment Station Selection Based on Linguistic q-Rung Orthopair Fuzzy Numbers

During the COVID-19 outbreak,the use of single-use medical supplies increased significantly.It is essential to select suitable sites for establishing medical waste treatment stations.It is a big challenge to solve the medical waste treatment station selection problem due to some conflicting factors.This paper proposes a multi-attribute decision-making(MADM)method based on the partitioned Maclaurin symmetric mean(PMSM)operator.For the medical waste treatment station selection problem,the factors or attributes(these two terms can be interchanged.)in the same clusters are closely related,and the attributes in different clusters have no relationships.The partitioned Maclaurin symmetric mean function(PMSMF)can handle these complex attribute relationships.Hence,we extend the PMSM operator to process the linguistic q-rung orthopair fuzzy numbers(Lq-ROFNs)and propose the linguistic q-rung orthopair fuzzy partitioned Maclaurin symmetric mean(Lq-ROFPMSM)operator and its weighted form(Lq-ROFWPMSM).To reduce the negative impact of unreasonable data on the final output results,we propose the linguistic q-rung orthopair fuzzy partitioned dual Maclaurin symmetric mean(Lq-ROFPDMSM)operator and its weighted form(Lq-ROFWPDMSM).We also discuss the characteristics and typical examples of the above operators.A novel MADM method uses the Lq-ROFWPMSM operator and the Lq-ROFWPDMSM operator to solve the medical waste treatment station selection problem.Finally,the usability and superiority of the proposed method are verified by comparing it with previous methods.

Exploring exosomes to provide evidence for the treatment and prediction of Alzheimer’s disease

Exosomes are extracellular vesicles with a 30–150 nm diameter originating from endosomes.In recent years,scientists have regarded exosomes as an ideal small molecule carrier for the targeted treatment of Alzheimer’s disease(AD)across the blood-brain barrier due to their nanoscale size and low immunogenicity.A large amount of evidence shows that exosomes are rich in biomarkers,and it has been found that the changes in biomarker content in blood,cerebrospinal fluid,and urine are often associated with the onset of AD patients.In this paper,some recent advances in the use of exosomes in the treatment of AD are reviewed,and various exosome markers and some latest detection methods are summarized to provide some evidence for the detection or treatment of AD by exosomes.

Clinical Characteristics of 42 SARS Patients and Their Treatment of Integrative Chinese and Western Medicine

Objective:To understand the clinical manifestation of severe acute respiratory syndrome (SARS) and explore its effective treatment with integrative Chinese and western medicine (ICWM). Methods:The data of patients, whose diagnosis of SARS had been confirmed were summarized and analyzed, and clinical observation was conducted when the patients were treated with ICWM. Results:In the early stage of the 42 patients, the symptoms revealed were fever in 100% of SARS patients, headache in 92. 9%, aversion to cold in 76. 2%, chest stuffiness in 76. 2% , cough in 73. 8% and myalgia in 88.1%; pulmonary lesion involves >3 lobes in 42. 9%, 2 lobes in 47. 6% and 1 lobe in 9. 5%; 61. 9% of them showed liver function abnormality (increase of ALT or AST), 47. 6% showed elevated myocardial enzyme (CK or CK-MB) , 0. 48% showed an inclination of renal function (higher of BUN or Cr); in their T lymphocyte subsets, 91. 2% (31/34 patients) had lowered CD3 and 76. 5% (26/34 patients) lowered CD4/CD8 ratio. In the mid-late stage, the symptoms were lassitude and weakness in 85. 7%, scare in 81. 0%, short of breath or chest stuffiness in 71. 4%, loss of appetite in 64. 3%;light dark tongue proper in 52. 4%, yellow and white tongue coating in 45. 2%, and yellow thick coating on the middle-root part of the tongue in 21. 4%. Most of them were asymptomatic when discharged from hospital, with 92. 8% of their pulmonary lesion, according to chest film, completely absorbed and liver function, myocardial enzyme and renal function all normalized. However, of the 30 patients who had CD3 reexamination, 70% of the CD3 showed lower than normal range and 36. 7% showed their CD4/CD8 inclined to lower margin, follow-up should be done for these patients. Of the 42 patients, who received western medicine (WM) alone in the early stage and ICWM in the mid-late stage, 10 were severe cases and 3 critical cases, but none of them died. The mean defervescent time was 3. 52±0. 85 days, the time for complete absorption of pulmonary lesion judged by chest X-ray film was 26. 82±5. 98 days, and the mean hospitalization time was 33. 60±4. 37 days. Conclusion:The manifestation of SARS is multifarious, showing that there were damage in multiple organs. The T lymphocyte count percentage and its subsets, CD3 and CD4 /CD8 ratio, are valuable for early diagnosis and follow-up in the rehabilitation stage. Majority of the patients could be clinically cured. Combined treatment of WM and TCM according to syndrome differentiation and psychiatric intervention are beneficial to remit partial symptoms and promote rehabilitation.

Development of IT Triage System （TRACY） to Share Regional Disaster Medical Information

We developed an IT （Information Technology） triage system for collecting disaster medical information in real time. FeliCa cards and card readers are used to obtain the number and condition of patients. The system is composed of two elements. First, the number of patients for each triage level and the accepted number of patients in each diagnosis and treatment department are obtained in real time, including response for changing triage level. Second, this information is shared in real time among hospitals, the admim＇stration, and residents who are searching for their family. A disaster drill utilizing this system was held at the University of Yamanashi Hospital with 450 participants. From the result of that, the present system could work for those two elements. TRACY was examined its availability and practicability in this drill.

Research on the Problems and Countermeasures of New Rural Cooperative Medical System

Our country rural area has carried out broad practice on new model system of rural cooperative medical services, and the rural new medical treatment system has developed quickly. However, there are still many problems which needs us to solve. This article will analysis its present situation, problems and reasons, then give some suggestions to solve these problems. The new rural cooperative medical system has made great achievements since its implementation, which is a radical reform of the traditional medical systen. Lcd by thc govcmmcnt, trying to solve the majority of the Chinese population of the peasant groups to see the doctor difficult and expensive medical problems, and effectively protect the vital interests of farmers, so that people=oriented, establish and improve the rural medical service system. This paper analyzes the status quo of the new rural cooperative medical system, puts forward the problems, finds the reasons, and puts forward the corresponding countermeasures on the basis of this.

The elderly problems and countermeasures of exploring rehabilitation medical services

with the rising proportion of our aging population, the prevalence of chronic diseases in the elderly has increased, but most of the elderly body aging, action inconvenience, self-care ability is poor, become the thorny problem for the treatment of chronic diseases.Medical rehabilitation is a effective way to improve the sick old man body health.But with an aging that meet the needs of the elderly health service system in the aspect of construction and rehabilitation medical resources configuration, there are still some problems to be solved. In this article, through analyzing problems existing in the old medical service recovery to further explore its countermeasures.

Study on the difference of payment time of medical insurance in China

Since medical insurance of our country developed, it is continued to deepen reform and became the basic form of the pcrfcct medical insurance system. However, regional differences still exist. The current medical insurance system of China＇s urban and rural structure background of two structures of serious, city residents, workers and rural residents is significantly difference in the payment period ,for this question ,the difference between our country will solve the basic medical insurance payment period, the relative level of regulating wages and medical people in our country and develop the medical insurance level, narrow the regional differences, reduce cost problem caused by population flow management, the basic medical insurance system for suggestions to improve the unified and promoting the social and economic level, people＇s medical security level, perfect improvement of physical insurance system of medical insurance according to the long-term sustainable development has a far-reaching significance.

COMMENTS ON THE STUDY OF ACUPOINT COMBINATION AND REMEDIES FOR TREATMENT OF DIABETES MELLITUS WITH ACUPUNCTURE AND MOXIBUSTION

In the present paper, the author reviews the progresses in the study on acumoxi (acupuncture-moxi-bustion) treatment of diabetes mellitus (DM) from Chinese ancient classical works, Chinese and foreign journals. The therapeutic results reveal that acupuncture treatment of DM is effective in improving DM patients' symptoms via vagal-nerve reflex, regulation of neuroendocrine and immune functions. The author holds that ① correct selection of acupoints in accordance with syndrome differentiation and the related meridians and combined application of acupuncture and Chinese herbal medicines (for oral administration) are the key points for raising the therapeutic effect; and ② acupoint combination and curative methods need to be researched further.