小榄镇综合管治肺结核患者模式应用效果评价

目的 探讨在肺结核患者治疗管理中实施“微信+DOTS”综合管治模式的应用效果,并探讨其影响因素,为防控肺结核提供科学参考依据。方法 选择2022年小榄镇社区卫生服务中心下辖社区卫生服务站管治的疗程半年的206名肺结核患者,在建立以中山市结核病防治所为指导、镇社区卫生服务中心督导、社区卫生服务站归口管治的三级结核病防控网基础上,对符合条件的119名患者实施“微信+DOTS”综合管治模式(微信+DOTS组),实施单DOTS管治模式的有87名患者(单DOTS组)。结果 对实施“微信+DOTS”综合管治模式和单一DOTS管治模式两组患者的规范管理率、规则服药率、成功治疗率分别进行组间比较,差异均有统计学意义(P<0.05)。微信+DOTS组治疗效果明显优于单DOTS组。结论 实施“微信+DOTS”综合管治模式对患者管理的积极作用成效明显,可提高患者服药依从性和成功治疗率,是对单一DOTS管治模式有效且可行的完善与补充,有利于控制区域肺结核病疫情,值得进一步探索完善和推广应用。

后回归时代澳门特区政府的综合管治能力

澳门回归以来,特区政府的宏观管治环境发生了历史变迁;相应地,澳门的管治模式也由澳葡政府时期的"弱政府—强社会"模式向高度自治下的"强政府—强社会"模式转变。管治模式的制度转型,要求澳门特区政府发展和提升自身的综合管治能力,包括政府治理能力、社会治理能力、经济调适能力、区际协作能力和中央政策的选择性代理能力。对澳门政府综合管治能力的现状与问题进行全面评估,有助于在此基础上就如何提升特区政府的综合管治能力提供若干政策建议。

糖尿病患者3年社区综合管治效果评价

糖尿病是世界上四大慢性病之一,由于它发病率高、并发症多、危害严重,被世界卫生组织(WHO)列为重点防治疾病.

生态工业园区综合管治系统建设研究——以内蒙古西部工业集中区为例

内蒙古自治区是我国西部地区以化石能源开采、加工为主发展的地区之一。为了集中发展工业,内蒙古西部的四个盟市先后把原有的几个工业集中区进行优化升级,整合为目前的6个工业园区,各自形成园区管委会来实施对园区的管理。由于发展水平总体较低,因此由传统的工业园区向国家级生态工业园区升级是未来该工业集中区面临的主要挑战。另一方面,由于6个工业园区的地理位置相对集中,空间经济区域一体化趋势日渐显露。因此弱化行政边界、对六个工业园区实现统一协商管治成为大势所趋。本文通过对这6个工业园区区域管治系统的建设研究,为工业园区综合管治系统的建设提出建设构想。

基于利益相关者理论的区域管治模式创新及其综合评价研究——以滨海新区为例

应用利益相关者理论,结合文献研究法和实证研究法,对滨海新区的区域管治模式创新进行了研究。通过对滨海新区区域管治模式的纵向及横向对比,提出了基于利益相关者理论的区域管治的内涵,指出了滨海新区区域管治的创新方向。对管治模式进行了创新性研究,并尝试建立了滨海新区区域管治的综合评价指标体系。

深圳生态空间综合精细化治理探讨

文章从城市生态空间的典型特征入手,结合深圳生态空间管理面临的问题及当前的政策形势要求,提出了从粗放式管制走向精细化治理、从单一被动保护转向综合保护与利用、从多头分散管理转向统一协调全过程管理等生态空间综合治理的思路,以及生态空间综合治理体系构建方案,并结合深圳开展的综合生态调查评估与动态监测,划定生态空间管制分区,开展精细化空间规划,完善生态空间管治政策,开展生态清退与生态补偿等方面的探索实践。

Indwelling catheter and conservative measures in the treatment of abdominal compartment syndrome in fulminant acute pancreatitis

AIM： To study the effect of combined indwelling catheter, hemofiltration, respiration support and traditional Chinese medicine （e.g. Dahuang） in treating abdominal compartment syndrome of fulminant acute pancreatitis. METHODS： Patients with fulminant acute pancreatitis were divided randomly into 2 groups of combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring and routine conservative measures group （group 1） and control group （group 2）. Routine non-operative conservative treatments including hemofiltration, respiration support, gastrointestinal TCM ablution were also applied in control group patients. Effectiveness of the two groups was observed, and APACHE Ⅱ scores were applied for analysis. RESULTS： On the second and fifth days after treatment, APACHE Ⅱ scores of group 1 and 2 patients were significantly different. Comparison of effectiveness （abdominalgia and burbulence relief time, hospitalization time） between groups 1 and 2 showed significant difference, as well as incidence rates of cysts formation. Mortality rates of groups 1 and 2 were 10.0% and 20.7%, respectively. For patients in group 1, celiac drainage quantity and intra-abdominal pressure, and hospitalization time were positively correlated （r = 0.552, 0.748, 0.923, P 〈 0.01） with APACHE Ⅱ scores. CONCLUSION： Combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring, short veno-venous hemofiltration （SVVH）, gastrointestinal TCM ablution, respiration support have preventive and treatment effects on abdominal compartment syndrome of fulminant acute pancreatitis.

Metabolic syndrome and chronic kidney disease:Current status and future directions

Metabolic syndrome(Met S) is a term used to denote a combination of selected,widely prevalent cardiovascular disease(CVD)-related risk factors.Despite the ambiguous definition of Met S,it has been clearly associated with chronic kidney disease markers including reduced glomerular filtration rate,proteinuria and/or microalbuminuria,and histopathological markers such as tubular atrophy and interstitial fibrosis.However,the etiological role of Met S in chronic kidney disease(CKD) is less clear.The relationship between MetS and CKD is complex and bidirectional,and so is best understood when CKD is viewed as a common progressive illness along the course of which MetS,another common disease,may intervene and contribute.Possible mechanisms of renal injury include insulin resistance and oxidative stress,increased proinflammatory cytokine production,increased connective tissue growth and profibrotic factor production,increased microvascular injury,and renal ischemia.MetS also portends a higher CVD risk at all stages of CKD from early renal insufficiency to end-stage renal disease.Clinical interventions for MetS in the presence of CKD should include a combination of weight reduction,appropriate dietary modification and increase physical activity,plus targeting of individual CVD-related risk factors such as dysglycemia,hypertension,and dyslipidemia while conforming to relevant national societal guidelines.

Multi-disciplinary treatment for cholangiocellular carcinoma

Cholangiocarcinoma(CC)is rare malignant tumors composed of cells that resemble those of the biliary tract.It is notoriously difficult to diagnose,and is associated with a high mortality.Traditionally,CC is divided into intrahepatic and extraheaptic disease according to its location within the biliary tree.Intrahepatic cholangiocellular carcinoma(IH-CCC)or peripheral cholangiocellular carcinoma(CCC)appears within the second bifurcation of hepatic bile duct,and is the second most common primary liver cancer following hepatocellular carcinoma(HCC),IH-CCC or peripheral CCC often presents with advanced clinical features,and the cause for this cancer rise is still unclear.MRI,CT and PET provide useful diagnostic information in those patients.Surgical resection is the only chance for cure,with results depending on selected patients and careful surgical technique.Liver transplantation could offer long-term survival in selected patients when combined with chemotherapy.Chemotherapy,radiation therapy or combination therapies remain as the only treatment for inoperable patients.However,these are uniformly ineffective in patients' survival.

Influence of irritable bowel syndrome on treatment outcome in gastroesophageal reflux disease

AIM: To investigate the influence of irritable bowel syndrome (IBS)-like symptoms on treatment outcomes with pantoprazole in gastroesophageal reflux disease (GERD) in a real life setting. METHODS: For this prospective, open-label, multinational, multicentre study, 1888 patients assessed by the investigators as suffering from GERD were recruited. The patients were additionally classified as with or without IBS-like symptoms at baseline. They were treated with pantoprazole 40 mg once daily and completed the Reflux Questionnaire (ReQuest) short version daily. Response rates and symptom scores were compared after 4 and 8 wk of treatment for subgroups defined by the subclasses of GERD [erosive(ERD) and non-erosive reflux disease (NERD)] and the presence of IBS-like symptoms. RESULTS: IBS-like symptoms were more prevalent in NERD than in ERD (18.3% vs 12.7%, P = 0.0015). Response rates after 4 and/or 8 wk of treatment were lower in patients with IBS-like symptoms than in patients without IBS-like symptoms in both ERD (Week 4: P < 0.0001, Week 8: P < 0.0339) and NERD (Week 8: P = 0.0088). At baseline, ReQuest "lower abdominal com- plaints" symptom scores were highest in NERD patients with IBS-like symptoms. Additionally, these patients had the strongest symptom improvement after treatment compared with all other subgroups. CONCLUSION: IBS-like symptoms influence treatment outcome and symptom burden in GERD and should be considered in management. Proton pump inhibitors can improve IBS-like symptoms, particularly in NERD.

Assessment of duodenal circular drainage operations to treat superior mesenteric artery syndrome

Objective To assess the clinical value of duodenal circular drainage operation to treat superior mesenterie artery syndrome（SMAS）. Methods Forty two cases of SMAS were treated with duodenal circular drainage operation from 1959 to 2001. Clinical data were analyzed retrospectively. Results In this group, 37 cases were treated with duodenal circular drainage operation,and had good effect after follow- up of 1-15 years, the other 5 cases were first treated with anterior repositioning of the duodenum （ 1 case）, gastroieiunostomy （ 1 case）, duodeojejunostomy （2 cases）, subtotal gastrectomy and Billroth 11 gastrojejunostomy（1 case） ,but vomiting was not relieved until duodenal circular drainage operation was performed again. Follow - up of 9- 10 years revealed good effect. Conclusion In SMAS, if the reversed peristalsis is stronger and continuous, and vomiting appears frequently, the symptom can not be relieved even if the obstruction of duodenum is removed by operation. The key treatment is the relief of reversed peristalsis. Only the duodenal circular drainage operation could resolve the drainage direction of duodenal content and relieve the symptom of vomiting.

The Local Process of Governance in Integrated Water Resource Management： An Example of the Wadi El K^bir Watershed （Northeast of Algeria）

Alternatives to the sectoral and public policies and regulations of environmental and water resources＇ protection, and the experiments of integrated management have been rapidly multiplied since the year 1990. Water constitutes a principal stake of these environmental policies in the majority of the countries and especially in the countries of North Africa as Algeria, where this resource is threatened by repeated dryness and by the impact of the climate change. The integrated water resource management reflects today the world tendency of the governments to exploit and preserve this resource by a way based on a process of governance, which passes by the dialog of diversified actors （various sectors）. According to this policy and to the promulgation of the Algerian National Report on State effective implementation and coordination mechanisms are required. How this principle of integrated water management will be executed with various scenarios in Algeria and what are the main difficulties that can be met？ Or, more exactly, what are the variables that can influence the operation of the local water process governorship？ This analysis will be carried out through the example of the Wadi El K6bir watershed located in the northeast of Algeria, which is real natural area of water supply that feeds the communities, the natural and artificial basins, and preserves the perenniality of the existing natural ecosystems especially the one of the natural park classified by the United Nations Educational Scientific and Cultural Organization （U.N.E.S.C.O） in 1989 as the inheritance of humanity and six other sites classified according to the Ramsar convention as wetlands of international importance to be preserved.

Effect of a comprehensive therapy plus Gushenyutai plaster administered at Guanyuan(CV 4) on male infertility associated with semen non-liquefaction

OBJECTIVE: To observe the clinical effect of Gushenyutai plaster administered at the Guanyuan(CV4) acupoint on male infertility associated with semen non-liquefaction.METHODS: Sixty-two male patients with infertility caused by semen non-liquefaction were random-ized into a treatment and control group. The control group received comprehensive therapy, which included oral administration of clarithromycin sustained release tablets, hip bath with Zhongyaoxiaoyan granules, prostate massage, and transurethral microwave treatment. The treatment group was administered Gushenyutai plaster in addition to the comprehensive therapy. Both groups were treated for 8 weeks. After treatment, the clinical effect and pregnancy rate were assessed and compared between the two groups.RESULTS: The effective rate of the treatment group was significantly higher than that of the control group(96.77% vs 70.97%, P<0.05) and the pregnancy rates of the treatment group and control groups were 38.71% and 16.13%, respectively(P<0.05).CONCLUSION: The effect of Gushenyutai plaster plus comprehensive therapy was better than that of the comprehensive therapy alone on male infertility induced by semen non-liquefaction.

Clinical Research on Comprehensive Treatment of Senile Vascular Dementia

Objective:To observe the curative effect of combined Chinese medicine,acupuncture and rehabilitation therapy on vascular dementia(VD),and to compare the Western medicine piracetam.Methods:Total 134 VD patients screened in reference to the standard for VD diagnosis in DSM-IV were randomly divided into a Chinese medicine plus rehabilitation group(32 cases),a Chinese medicine plus acupuncture group(33 cases),a Chinese medicine and acupuncture plus rehabilitation group(37 cases) and a Western medicine piracetam group(32 cases).Mini Mental State Examination(MMSE) and Bless Behavior Scale(BBS) were used to assess changes in intelligence disorder before treatment and after 12-week treatment.Results:BBS score,living ability and daily habit were enhanced after treatment in all groups.Cognitive function and behavioral ability were improved with similar total curative effects in all the 4 groups.Directional ability and short-term memory ability were significantly enhanced after treatment(P<0.05) in both the Chinese medicine plus rehabilitation group and the Chinese medicine plus acupuncture group groups.Living ability was significantly improved after treatment in the Chinese medicine and acupuncture plus rehabilitation group(P<0.01).However,no obvious difference was shown before and after treatment in the piracetam group.Conclusion:The improvement of living ability in the comprehensive treatment group is better than that in the other groups.Chinese medicine and acupuncture plus rehabilitation treatment can improve intelligence and living ability of senile VD patients.