Objective To observe value of 0D-1D coupling model and 3D fluid-structure interaction(FSI)model based on coronary CT angiography(CCTA)for displaying hemodynamic characteristics of coronary artery stenosis.Methods Base...Objective To observe value of 0D-1D coupling model and 3D fluid-structure interaction(FSI)model based on coronary CT angiography(CCTA)for displaying hemodynamic characteristics of coronary artery stenosis.Methods Based on CCTA data of the stenosed left anterior descending branch(LAD)in a patient with coronary heart disease,an 0D-1D coupling model and 3D FSI model were built,respectively.Then hemodynamic characteristic indexes,including the pressure,flow velocity and wall shear stress(WSS)were obtained in every 0.01 s during 1 s at 5 sampling points(i.e.sampling point 1—5)using these 2 models,respectively,and the consistencies of the results between models were evaluated with Spearman correlation coefficient r s.Results The time consuming for construction of 0D-1D coupling model and 3D FSI model was 0.033 min and 704 min,respectively.Both models showed basically distribution of the pressure,flow velocity and WSS of the stenosed LAD.For more details,the pressure at the stenosed segment of LAD and the proximal segment of stenosis were both higher,which gradually decreased at the distal segment of stenosis,and the flow velocity at the proximal segment of stenosis was in a relatively slow and uniform condition,with significantly increased flow velocity and WSS at the stenosed segment.Compared with 3D FSI model,0D-1D vascular coupling model was relatively unrefined and lack of distal flow lines when displaying blood flow velocity.For sampling point 2 at the stenosed segment of LAD,no significant consistency for pressure between 2 models was found(P=0.118),but strong consistency for the flow velocity and WSS(r s=0.730,0.807,both P<0.05).The consistencies of pressure,flow velocity and WSS between 2 models at the proximal and distal segment of stenosis,i.e.1,3—5 sampling points were week to moderate(r s=0.237—0.669,all P<0.05).Conclusion 0D-1D coupling model exhibited outstanding computational efficiency and might provide relatively reasonable results,while 3D FSI model showed higher accuracy for details and streamline when simulating LAD stenosis.展开更多
目的:探索临床药师在疾病诊断相关分组(diagnosis related groups,DRGs)付费模式中的药学服务对神经外科患者的药品费用及住院时间的影响。方法:以BY15疾病组(颅脑闭合性损伤,不伴并发症与合并症)为例,临床药师对该疾病组的用药情况进...目的:探索临床药师在疾病诊断相关分组(diagnosis related groups,DRGs)付费模式中的药学服务对神经外科患者的药品费用及住院时间的影响。方法:以BY15疾病组(颅脑闭合性损伤,不伴并发症与合并症)为例,临床药师对该疾病组的用药情况进行分析,找出不合理原因进行干预。结果:与干预前(2022年1—6月)相比,干预后(2022年7—12月)BY15疾病组的平均药品费用显著减少(15468.96元vs 9246.91元,P<0.05),用药不合理占比也显著降低(70.83%vs 40.91%,P<0.05),而患者平均住院时间的变化差异无统计学意义,但仍呈减少的趋势(9.29 d vs 6.68 d,P>0.05)。结论:在DRGs的付费模式下,临床药师参与DRGs疾病组的药物治疗管理在降低患者药品费用、减少住院时间以及提高用药合理占比方面具有积极作用。展开更多
Statin has been proposed to have a capacity to reduce the risk of pancreatic cancer,while the obtained results are not consistent.To gain a clearer picture of the relationship between statin use and pancreatic cancer,...Statin has been proposed to have a capacity to reduce the risk of pancreatic cancer,while the obtained results are not consistent.To gain a clearer picture of the relationship between statin use and pancreatic cancer,the present meta-analysis took into consideration data from eight cohort studies,ten case-control studies and three RCTs.We searched all relevant studies on the effect of statin use on the risk of pancreatic cancer using PubMed,Embase and the Cochrane library database from inception to July 30,2018.The following search terms were used:(1)statin("statins","statin","3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitors","atorvastatin","cerivastatin","fluvastatin","lovastatin","pravastatin","rosuvastatin","simvastatin");(2)pancreatic cancer("cancer","neoplasm","malignancy").We manually examined the references of the relevant articles and reviews to identify additional studies.A total of 21 studies,published between 2001 and July 2018 and involving 1148680 cases and 2177842 controls,fulfilled the selection criteria.The pooled results revealed a significant relationship between statin use and pancreatic cancer risk(OR=0.84,95%CI 0.72-0.98,P=0.000,I^2=84.30).However,lipophilic statins(OR=1.07,95%CI 0.97-1.18,P=0.651,I^2=0.0%)had no significant effect on the risk of pancreatic cancer.In contrast,short-term statin use(OR=0.72,95%CI 0.54-0.96,P=0.000,I^2=80.1%)and long-term statin use(OR=0.70,95%CI 0.54-0.92,P=0.000,12=79.8%)significantly reduced pancreatic cancer risk.Notably,the high heterogeneity among the selected studies was eliminated by excluding the three studies that focused on restricted populations.Statin could significantly reduce the risk of pancreatic cancer.展开更多
文摘Objective To observe value of 0D-1D coupling model and 3D fluid-structure interaction(FSI)model based on coronary CT angiography(CCTA)for displaying hemodynamic characteristics of coronary artery stenosis.Methods Based on CCTA data of the stenosed left anterior descending branch(LAD)in a patient with coronary heart disease,an 0D-1D coupling model and 3D FSI model were built,respectively.Then hemodynamic characteristic indexes,including the pressure,flow velocity and wall shear stress(WSS)were obtained in every 0.01 s during 1 s at 5 sampling points(i.e.sampling point 1—5)using these 2 models,respectively,and the consistencies of the results between models were evaluated with Spearman correlation coefficient r s.Results The time consuming for construction of 0D-1D coupling model and 3D FSI model was 0.033 min and 704 min,respectively.Both models showed basically distribution of the pressure,flow velocity and WSS of the stenosed LAD.For more details,the pressure at the stenosed segment of LAD and the proximal segment of stenosis were both higher,which gradually decreased at the distal segment of stenosis,and the flow velocity at the proximal segment of stenosis was in a relatively slow and uniform condition,with significantly increased flow velocity and WSS at the stenosed segment.Compared with 3D FSI model,0D-1D vascular coupling model was relatively unrefined and lack of distal flow lines when displaying blood flow velocity.For sampling point 2 at the stenosed segment of LAD,no significant consistency for pressure between 2 models was found(P=0.118),but strong consistency for the flow velocity and WSS(r s=0.730,0.807,both P<0.05).The consistencies of pressure,flow velocity and WSS between 2 models at the proximal and distal segment of stenosis,i.e.1,3—5 sampling points were week to moderate(r s=0.237—0.669,all P<0.05).Conclusion 0D-1D coupling model exhibited outstanding computational efficiency and might provide relatively reasonable results,while 3D FSI model showed higher accuracy for details and streamline when simulating LAD stenosis.
文摘目的:探索临床药师在疾病诊断相关分组(diagnosis related groups,DRGs)付费模式中的药学服务对神经外科患者的药品费用及住院时间的影响。方法:以BY15疾病组(颅脑闭合性损伤,不伴并发症与合并症)为例,临床药师对该疾病组的用药情况进行分析,找出不合理原因进行干预。结果:与干预前(2022年1—6月)相比,干预后(2022年7—12月)BY15疾病组的平均药品费用显著减少(15468.96元vs 9246.91元,P<0.05),用药不合理占比也显著降低(70.83%vs 40.91%,P<0.05),而患者平均住院时间的变化差异无统计学意义,但仍呈减少的趋势(9.29 d vs 6.68 d,P>0.05)。结论:在DRGs的付费模式下,临床药师参与DRGs疾病组的药物治疗管理在降低患者药品费用、减少住院时间以及提高用药合理占比方面具有积极作用。
基金Doctoral Fund of Ministry of Education of Jiangsu Province(Grant No.2018K256C)
文摘Statin has been proposed to have a capacity to reduce the risk of pancreatic cancer,while the obtained results are not consistent.To gain a clearer picture of the relationship between statin use and pancreatic cancer,the present meta-analysis took into consideration data from eight cohort studies,ten case-control studies and three RCTs.We searched all relevant studies on the effect of statin use on the risk of pancreatic cancer using PubMed,Embase and the Cochrane library database from inception to July 30,2018.The following search terms were used:(1)statin("statins","statin","3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitors","atorvastatin","cerivastatin","fluvastatin","lovastatin","pravastatin","rosuvastatin","simvastatin");(2)pancreatic cancer("cancer","neoplasm","malignancy").We manually examined the references of the relevant articles and reviews to identify additional studies.A total of 21 studies,published between 2001 and July 2018 and involving 1148680 cases and 2177842 controls,fulfilled the selection criteria.The pooled results revealed a significant relationship between statin use and pancreatic cancer risk(OR=0.84,95%CI 0.72-0.98,P=0.000,I^2=84.30).However,lipophilic statins(OR=1.07,95%CI 0.97-1.18,P=0.651,I^2=0.0%)had no significant effect on the risk of pancreatic cancer.In contrast,short-term statin use(OR=0.72,95%CI 0.54-0.96,P=0.000,I^2=80.1%)and long-term statin use(OR=0.70,95%CI 0.54-0.92,P=0.000,12=79.8%)significantly reduced pancreatic cancer risk.Notably,the high heterogeneity among the selected studies was eliminated by excluding the three studies that focused on restricted populations.Statin could significantly reduce the risk of pancreatic cancer.
