BACKGROUND Many classification systems of thoracolumbar spinal fractures have been proposed to enhance treatment protocols,but none have achieved universal adoption.AIM To develop a new patient scoring system for case...BACKGROUND Many classification systems of thoracolumbar spinal fractures have been proposed to enhance treatment protocols,but none have achieved universal adoption.AIM To develop a new patient scoring system for cases with thoracolumbar injury classification and severity score(TLICS)=4,namely the load-sharing thoracolumbar injury score(LSTLIS).METHODS Based on thoracolumbar injury classification and severity score,this study proposes the use of the established load-sharing classification(LSC)to develop an improved classification system(LSTLIS).To prove the reliability and reproducibility of LSTLIS,a retrospective analysis for patients with thoracolumbar vertebral fractures has been conducted.RESULTS A total of 102 cases were enrolled in the study.The scoring trend of LSTLIS is roughly similar as the LSC scoring,however,the average deviation based on the former method is relatively smaller than that of the latter.Thus,the robustness of the LSTLIS scoring method is better than that of LSC.LSTLIS can further classify patients with TLICS=4,so as to assess more accurately this particular circumstance,and the majority of LSTLIS recommendations are consistent with actual clinical decisions.LSTLIS is a scoring system that combines LSC and TLICS to compensate for the lack of appropriate inclusion of anterior and middle column compression fractures with TLICS.Following preliminary clinical verification,LSTLIS has greater feasibility and reliability value,is more practical in comprehensively assessing certain clinical circumstances,and has better accuracy with clinically significant guidelines.展开更多
目的评估标准化急诊预检分诊模式在急诊胸痛患者中的应用效果。方法选择2023年2—5月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为对照组,2023年6—9月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为研...目的评估标准化急诊预检分诊模式在急诊胸痛患者中的应用效果。方法选择2023年2—5月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为对照组,2023年6—9月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为研究组。对照组采用传统急诊预检分诊方法,研究组采用基于改良早期预警评分系统(modified early warning score,MEWS)的标准化急诊预检分诊模式。比较2组患者急诊处理时间、急性冠脉综合征患者首次医疗接触到球囊开通时间(first medical contact to balloon,FMC-to-B)、进入医院大门至球囊开通时间(door to ballon,D-to-B)、不良事件发生情况。结果研究组预检分诊时间[(2.2±0.5)min vs.(3.6±1.4)min]、首份心电图时间[(6.1±1.9)min vs.(8.9±2.6)min]、床旁即时检测完成时间[(21.4±3.2)min vs.(30.6±6.8)min]、急诊科停留时间[(40.2±7.6)min vs.(54.6±11.8)min]均短于对照组(P<0.05)。研究组急性冠脉综合征患者FMC-to-B[(50.4±9.3)min vs.(71.3±14.7)min]与D-to-B[(78.6±11.7)min vs.(106.9±15.4)min]短于对照组(P<0.05)。研究组心力衰竭、休克、心律失常累计发生率低于对照组(10.0%vs.28.0%,P<0.05)。结论基于MEWS的标准化急诊预检分诊模式可提升急性胸痛救治效率,改善患者预后。展开更多
目的:探讨改良早期预警评分(modified early waring scores,MEWS)指导下改良急诊护理流程对心脏骤停(cardiac arrest,CA)患者恢复自主循环(return of spontaneous circulation,ROSC)后神经功能及生存情况的影响。方法:选取2022年1月—2...目的:探讨改良早期预警评分(modified early waring scores,MEWS)指导下改良急诊护理流程对心脏骤停(cardiac arrest,CA)患者恢复自主循环(return of spontaneous circulation,ROSC)后神经功能及生存情况的影响。方法:选取2022年1月—2023年12月鹰潭市人民医院急诊科收治的82例CA后ROSC的患者,根据入院顺序,将2022年1—12月收治的41例CA后ROSC患者纳入对照组,将2023年1—12月收治的41例CA后ROSC患者纳入研究组。对照组实施常规急诊护理流程,研究组实施MEWS指导下改良急诊护理流程。比较两组48 h存活率和出院存活率;比较两组干预前和干预1、3个月后的美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分。结果:研究组48 h存活率和出院存活率分别为43.90%和34.15%,均显著高于对照组的21.95%和14.63%,差异均有统计学意义(P<0.05)。干预前,两组NIHSS评分比较,差异无统计学意义(P>0.05);干预1个月和3个月后,两组NIHSS评分均明显低于干预前,且研究组均明显低于对照组,差异均有统计学意义(P<0.05)。结论:MEWS指导下改良急诊护理流程可有效改善CA后ROSC患者神经功能和生存情况,可在临床推广应用。展开更多
AIM: To evaluate the clinical outcomes of 240-wk treatment with entecavir(0.5 mg) in Chinese nucleosidenaive patients with cirrhosis.METHODS: A total of 204 nucleoside-naive patients with compensated(n = 96) or decomp...AIM: To evaluate the clinical outcomes of 240-wk treatment with entecavir(0.5 mg) in Chinese nucleosidenaive patients with cirrhosis.METHODS: A total of 204 nucleoside-naive patients with compensated(n = 96) or decompensated(n = 108) hepatitis B virus(HBV)-induced cirrhosis at the Department of Gastroenterology of the China-Japan Union Hospital(Jilin University, Changchun, China) who were treated with entecavir(0.5 mg) for 240 wk were enrolled in this study. Liver biopsy samples obtained from 38 patients prior to treatment(baseline) and at week 240 were evaluated by different independent histopathologists. Efficacy assessments included the proportions of patients who achieved an HBV DNA level < 500 copies/m L, the association of interleukin-28 B genetic variation with antivirus therapy, clinical outcomes, and histologic improvement. Changes in liver disease severity were analyzed, and liver histologic evaluation was performed in 38 patients with paired biopsies. Student t tests were used to compare the means of continuous variables between the groups, and the proportions of patients who achieved the endpoints were compared using the χ2 test.RESULTS: At week 240, 87.5% of the patients with compensated cirrhosis and 92.6% of the patients with decompensated cirrhosis achieved a HBV DNA level < 500 copies/m L. Three patients had genotypic entecavir resistance within the 240-wk period. No significant association was observed between virologic response and interleukin-28 genotype(CT, 88.2% vs CC, 90.6%). The proportion of patients with Child-Pughclass A disease was significantly increased at week 240(68%) from the baseline(47%; P < 0.01). The proportion of patients with Child-Pugh class B disease was significantly decreased at week 240(25%) from the baseline(39%; P = 0.02). In the patients with paired liver biopsies, the mean reduction in the Knodell necroinflammatory score from the baseline was 3.58 ± 1.03 points(7.11 ± 1.80 vs 3.53 ± 1.35, P < 0.01). The mean reduction in Ishak fibrosis score from the baseline was 1.26 ± 0.64 points(5.58 ± 0.50 vs 4.32 ± 0.81, P < 0.01).CONCLUSION: Entecavir is an effective treatment option for patients with HBV-related compensated or decompensated cirrhosis that can result in sustained virologic suppression and histologic improvement.展开更多
This study examines the impact of farmers’cooperatives participation and technology adoption on their economic welfare in China.A double selectivity model(DSM)is applied to correct for sample selection bias stemming ...This study examines the impact of farmers’cooperatives participation and technology adoption on their economic welfare in China.A double selectivity model(DSM)is applied to correct for sample selection bias stemming from both observed and unobserved factors,and a propensity score matching(PSM)method is applied to calculate the agricultural income difference with counter factual analysis using survey data from 396 farmers in 15 provinces in China.The findings indicate that farmers who join farmer cooperatives and adopt agricultural technology can increase agricultural income by 2.77 and 2.35%,respectively,compared with those non-participants and non-adopters.Interestingly,the effect on agricultural income is found to be more significant for the low-income farmers than the high-income ones,with income increasing 5.45 and 4.51%when participating in farmer cooperatives and adopting agricultural technology,respectively.Our findings highlight the positive role of farmer cooperatives and agricultural technology in promoting farmers’economic welfare.Based on the findings,government policy implications are also discussed.展开更多
基金Supported by Multicenter Clinical Trial of hUC-MSCs in the Treatment of Late Chronic Spinal Cord Injury,No.2017YFA0105404the Project of Shanghai Science and Technology Commission,No.19441901702.
文摘BACKGROUND Many classification systems of thoracolumbar spinal fractures have been proposed to enhance treatment protocols,but none have achieved universal adoption.AIM To develop a new patient scoring system for cases with thoracolumbar injury classification and severity score(TLICS)=4,namely the load-sharing thoracolumbar injury score(LSTLIS).METHODS Based on thoracolumbar injury classification and severity score,this study proposes the use of the established load-sharing classification(LSC)to develop an improved classification system(LSTLIS).To prove the reliability and reproducibility of LSTLIS,a retrospective analysis for patients with thoracolumbar vertebral fractures has been conducted.RESULTS A total of 102 cases were enrolled in the study.The scoring trend of LSTLIS is roughly similar as the LSC scoring,however,the average deviation based on the former method is relatively smaller than that of the latter.Thus,the robustness of the LSTLIS scoring method is better than that of LSC.LSTLIS can further classify patients with TLICS=4,so as to assess more accurately this particular circumstance,and the majority of LSTLIS recommendations are consistent with actual clinical decisions.LSTLIS is a scoring system that combines LSC and TLICS to compensate for the lack of appropriate inclusion of anterior and middle column compression fractures with TLICS.Following preliminary clinical verification,LSTLIS has greater feasibility and reliability value,is more practical in comprehensively assessing certain clinical circumstances,and has better accuracy with clinically significant guidelines.
文摘目的评估标准化急诊预检分诊模式在急诊胸痛患者中的应用效果。方法选择2023年2—5月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为对照组,2023年6—9月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为研究组。对照组采用传统急诊预检分诊方法,研究组采用基于改良早期预警评分系统(modified early warning score,MEWS)的标准化急诊预检分诊模式。比较2组患者急诊处理时间、急性冠脉综合征患者首次医疗接触到球囊开通时间(first medical contact to balloon,FMC-to-B)、进入医院大门至球囊开通时间(door to ballon,D-to-B)、不良事件发生情况。结果研究组预检分诊时间[(2.2±0.5)min vs.(3.6±1.4)min]、首份心电图时间[(6.1±1.9)min vs.(8.9±2.6)min]、床旁即时检测完成时间[(21.4±3.2)min vs.(30.6±6.8)min]、急诊科停留时间[(40.2±7.6)min vs.(54.6±11.8)min]均短于对照组(P<0.05)。研究组急性冠脉综合征患者FMC-to-B[(50.4±9.3)min vs.(71.3±14.7)min]与D-to-B[(78.6±11.7)min vs.(106.9±15.4)min]短于对照组(P<0.05)。研究组心力衰竭、休克、心律失常累计发生率低于对照组(10.0%vs.28.0%,P<0.05)。结论基于MEWS的标准化急诊预检分诊模式可提升急性胸痛救治效率,改善患者预后。
文摘目的:探讨改良早期预警评分(modified early waring scores,MEWS)指导下改良急诊护理流程对心脏骤停(cardiac arrest,CA)患者恢复自主循环(return of spontaneous circulation,ROSC)后神经功能及生存情况的影响。方法:选取2022年1月—2023年12月鹰潭市人民医院急诊科收治的82例CA后ROSC的患者,根据入院顺序,将2022年1—12月收治的41例CA后ROSC患者纳入对照组,将2023年1—12月收治的41例CA后ROSC患者纳入研究组。对照组实施常规急诊护理流程,研究组实施MEWS指导下改良急诊护理流程。比较两组48 h存活率和出院存活率;比较两组干预前和干预1、3个月后的美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分。结果:研究组48 h存活率和出院存活率分别为43.90%和34.15%,均显著高于对照组的21.95%和14.63%,差异均有统计学意义(P<0.05)。干预前,两组NIHSS评分比较,差异无统计学意义(P>0.05);干预1个月和3个月后,两组NIHSS评分均明显低于干预前,且研究组均明显低于对照组,差异均有统计学意义(P<0.05)。结论:MEWS指导下改良急诊护理流程可有效改善CA后ROSC患者神经功能和生存情况,可在临床推广应用。
基金Supported by Grant from the Youth scientific research fund,No.2013207059
文摘AIM: To evaluate the clinical outcomes of 240-wk treatment with entecavir(0.5 mg) in Chinese nucleosidenaive patients with cirrhosis.METHODS: A total of 204 nucleoside-naive patients with compensated(n = 96) or decompensated(n = 108) hepatitis B virus(HBV)-induced cirrhosis at the Department of Gastroenterology of the China-Japan Union Hospital(Jilin University, Changchun, China) who were treated with entecavir(0.5 mg) for 240 wk were enrolled in this study. Liver biopsy samples obtained from 38 patients prior to treatment(baseline) and at week 240 were evaluated by different independent histopathologists. Efficacy assessments included the proportions of patients who achieved an HBV DNA level < 500 copies/m L, the association of interleukin-28 B genetic variation with antivirus therapy, clinical outcomes, and histologic improvement. Changes in liver disease severity were analyzed, and liver histologic evaluation was performed in 38 patients with paired biopsies. Student t tests were used to compare the means of continuous variables between the groups, and the proportions of patients who achieved the endpoints were compared using the χ2 test.RESULTS: At week 240, 87.5% of the patients with compensated cirrhosis and 92.6% of the patients with decompensated cirrhosis achieved a HBV DNA level < 500 copies/m L. Three patients had genotypic entecavir resistance within the 240-wk period. No significant association was observed between virologic response and interleukin-28 genotype(CT, 88.2% vs CC, 90.6%). The proportion of patients with Child-Pughclass A disease was significantly increased at week 240(68%) from the baseline(47%; P < 0.01). The proportion of patients with Child-Pugh class B disease was significantly decreased at week 240(25%) from the baseline(39%; P = 0.02). In the patients with paired liver biopsies, the mean reduction in the Knodell necroinflammatory score from the baseline was 3.58 ± 1.03 points(7.11 ± 1.80 vs 3.53 ± 1.35, P < 0.01). The mean reduction in Ishak fibrosis score from the baseline was 1.26 ± 0.64 points(5.58 ± 0.50 vs 4.32 ± 0.81, P < 0.01).CONCLUSION: Entecavir is an effective treatment option for patients with HBV-related compensated or decompensated cirrhosis that can result in sustained virologic suppression and histologic improvement.
基金the Special Project of Major Theoretical Research and Interpretation of Philosophy and Social Sciences of Chongqing Municipal Education Commission,China(19SKZDZX15)the Key Project of Humanities and Social Sciences Research of Chongqing Education Commission,China(18SKSJ003)the Funding for Cultivating Major Projects in Humanities and Social Sciences of Southwest University,China(SWU1809009)。
文摘This study examines the impact of farmers’cooperatives participation and technology adoption on their economic welfare in China.A double selectivity model(DSM)is applied to correct for sample selection bias stemming from both observed and unobserved factors,and a propensity score matching(PSM)method is applied to calculate the agricultural income difference with counter factual analysis using survey data from 396 farmers in 15 provinces in China.The findings indicate that farmers who join farmer cooperatives and adopt agricultural technology can increase agricultural income by 2.77 and 2.35%,respectively,compared with those non-participants and non-adopters.Interestingly,the effect on agricultural income is found to be more significant for the low-income farmers than the high-income ones,with income increasing 5.45 and 4.51%when participating in farmer cooperatives and adopting agricultural technology,respectively.Our findings highlight the positive role of farmer cooperatives and agricultural technology in promoting farmers’economic welfare.Based on the findings,government policy implications are also discussed.
