利用1986—2015年辽宁省60个气象站逐日降雨量观测资料和1986—2015年美国国家环境预报中心/美国国家大气研究中心(National Centers for Environmental Prediction/National Center for Atmospheric Research,NCEP/NCAR)逐月全球的再...利用1986—2015年辽宁省60个气象站逐日降雨量观测资料和1986—2015年美国国家环境预报中心/美国国家大气研究中心(National Centers for Environmental Prediction/National Center for Atmospheric Research,NCEP/NCAR)逐月全球的再分析资料,对辽宁省年径流总量控制率区域划分及其分区分布的差异进行分析。结果表明:辽宁省年径流总量控制率可以划分为Ⅱ区、Ⅲ区、Ⅳ区、Ⅴ区共4个区,比《海绵城市建设技术指南—低影响开发雨水系统构建》中辽宁省年径流总量控制率分区多1个Ⅴ区,且相同分区对应的空间分布差异明显;年平均降雨量对年径流总量控制率的分区趋势具有一定指示作用,总暴雨量占总降雨量的比例与年径流总量控制率的分区关系密切,辽宁省水汽输送的特征和地形地势是形成年径流总量控制率区域分布差异的内在成因。展开更多
Objective: To determine the efficacy and tolerability of topical pimecrolimus and tacrolimus compared with other treatments for atopic dermatitis. Design: Systematic review and meta- analysis. Data sources: Electronic...Objective: To determine the efficacy and tolerability of topical pimecrolimus and tacrolimus compared with other treatments for atopic dermatitis. Design: Systematic review and meta- analysis. Data sources: Electronic searches of Cochrane Library, Medline, and Embase. Study selection: Randomised controlled trials of topical pimecrolimus or tacrolimus reporting efficacy outcomes or tolerability. Data extraction: Efficacy: investigators’ global assessment of response; patients’ global assessment of response; proportions of patients with flares of atopic dermatitis; and improvements in quality of life. Tolerability: overall rates of withdrawal, withdrawal due to adverse events, and the proportions of patients with burning of the skin and skin infections. Data synthesis: 4186 of 6897 participants in 25 randomised controlled trials received pimecrolimus or tacrolimus. Both drugs were significantly more effective than a vehicle control. Tacrolimus 0.1% was as effective as potent topical corticosteroids at three weeks and more effective than combined treatment with hydrocortisone butyrate 0.1% (potent used on trunk) plus hydrocortisone acetate 1% (weak used on face) at 12 weeks (number needed to treat (NNT)=6). Tacrolimus 0.1% was also more effective than hydrocortisone acetate 1% (NNT=4). In comparison, tacrolimus 0.03% was more effective than hydrocortisone acetate 1% (NNT=5) but less effective than hydrocortisone butyrate 0.1% (NNT=- 8). Direct comparisons of tacrolimus 0.03% and tacrolimus 0.1% consistently favoured the higher strength formulation, but efficacy differed significantly between the two strengths only after 12 weeks’ treatment (rate ratio 0.80, 95% confidence interval 0.65 to 0.99). Pimecrolimus was far less effective than betamethasone valerate 0.1% (NNT=- 3 at three weeks). Pimecrolimus and tacrolimus caused significantly more skin burning than topical corticosteroids. Rates of skin infections in any of the comparisons did not differ. Conclusions: Both topical pimecrolimus and topical tacrolimus are more effective than placebo treatments for atopic dermatitis, but in the absence of studies that show long term safety gains, any advantage over topical corticosteroids is unclear. Topical tacrolimus is similar to potent topical corticosteroids and may have a place for long term use in patients with resistant atopic dermatitis on sites where side effects from topical corticosteroids might develop quickly. In the absence of key comparisons with mild corticosteroids. the clinical need for topical pimecrolimus is unclear. The usefulness of either treatment in patients who have failed to respond adequately to topical corticosteroids is also unclear.展开更多
国家卫生保健支出为卫生服务体系贡献了收入来源,但很少有人知道这些收入在各个部门的分布情况。2016年7月,Health Affairs一篇题为“Where The Money Goes：The Evolving Expenses Of The US Health Care System”的文章,利用美国劳工...国家卫生保健支出为卫生服务体系贡献了收入来源,但很少有人知道这些收入在各个部门的分布情况。2016年7月,Health Affairs一篇题为“Where The Money Goes：The Evolving Expenses Of The US Health Care System”的文章,利用美国劳工统计局和美国人口普查局的数据,计算了1997、2002、2007、2012年全科诊所、医院、门诊服务中心的收入和详细支出情况。从1997年开始,这三个领域占美国卫生费用的份额（占总费用近50%）一直相对稳定。从1997年到2012年,对三个领域的总支出增长了5800亿美元,雇佣的人员增加了170万人。展开更多
文摘利用1986—2015年辽宁省60个气象站逐日降雨量观测资料和1986—2015年美国国家环境预报中心/美国国家大气研究中心(National Centers for Environmental Prediction/National Center for Atmospheric Research,NCEP/NCAR)逐月全球的再分析资料,对辽宁省年径流总量控制率区域划分及其分区分布的差异进行分析。结果表明:辽宁省年径流总量控制率可以划分为Ⅱ区、Ⅲ区、Ⅳ区、Ⅴ区共4个区,比《海绵城市建设技术指南—低影响开发雨水系统构建》中辽宁省年径流总量控制率分区多1个Ⅴ区,且相同分区对应的空间分布差异明显;年平均降雨量对年径流总量控制率的分区趋势具有一定指示作用,总暴雨量占总降雨量的比例与年径流总量控制率的分区关系密切,辽宁省水汽输送的特征和地形地势是形成年径流总量控制率区域分布差异的内在成因。
文摘Objective: To determine the efficacy and tolerability of topical pimecrolimus and tacrolimus compared with other treatments for atopic dermatitis. Design: Systematic review and meta- analysis. Data sources: Electronic searches of Cochrane Library, Medline, and Embase. Study selection: Randomised controlled trials of topical pimecrolimus or tacrolimus reporting efficacy outcomes or tolerability. Data extraction: Efficacy: investigators’ global assessment of response; patients’ global assessment of response; proportions of patients with flares of atopic dermatitis; and improvements in quality of life. Tolerability: overall rates of withdrawal, withdrawal due to adverse events, and the proportions of patients with burning of the skin and skin infections. Data synthesis: 4186 of 6897 participants in 25 randomised controlled trials received pimecrolimus or tacrolimus. Both drugs were significantly more effective than a vehicle control. Tacrolimus 0.1% was as effective as potent topical corticosteroids at three weeks and more effective than combined treatment with hydrocortisone butyrate 0.1% (potent used on trunk) plus hydrocortisone acetate 1% (weak used on face) at 12 weeks (number needed to treat (NNT)=6). Tacrolimus 0.1% was also more effective than hydrocortisone acetate 1% (NNT=4). In comparison, tacrolimus 0.03% was more effective than hydrocortisone acetate 1% (NNT=5) but less effective than hydrocortisone butyrate 0.1% (NNT=- 8). Direct comparisons of tacrolimus 0.03% and tacrolimus 0.1% consistently favoured the higher strength formulation, but efficacy differed significantly between the two strengths only after 12 weeks’ treatment (rate ratio 0.80, 95% confidence interval 0.65 to 0.99). Pimecrolimus was far less effective than betamethasone valerate 0.1% (NNT=- 3 at three weeks). Pimecrolimus and tacrolimus caused significantly more skin burning than topical corticosteroids. Rates of skin infections in any of the comparisons did not differ. Conclusions: Both topical pimecrolimus and topical tacrolimus are more effective than placebo treatments for atopic dermatitis, but in the absence of studies that show long term safety gains, any advantage over topical corticosteroids is unclear. Topical tacrolimus is similar to potent topical corticosteroids and may have a place for long term use in patients with resistant atopic dermatitis on sites where side effects from topical corticosteroids might develop quickly. In the absence of key comparisons with mild corticosteroids. the clinical need for topical pimecrolimus is unclear. The usefulness of either treatment in patients who have failed to respond adequately to topical corticosteroids is also unclear.
文摘国家卫生保健支出为卫生服务体系贡献了收入来源,但很少有人知道这些收入在各个部门的分布情况。2016年7月,Health Affairs一篇题为“Where The Money Goes：The Evolving Expenses Of The US Health Care System”的文章,利用美国劳工统计局和美国人口普查局的数据,计算了1997、2002、2007、2012年全科诊所、医院、门诊服务中心的收入和详细支出情况。从1997年开始,这三个领域占美国卫生费用的份额（占总费用近50%）一直相对稳定。从1997年到2012年,对三个领域的总支出增长了5800亿美元,雇佣的人员增加了170万人。
