异维A酸组和维胺酯组治疗痤疮的比较

为了比较分析异维A酸组和维胺酯组治疗痘疮的临床疗效、费用和不良反应,于服药前后观察疗效、不良反应和相关费用.结果显示,异维A酸组治疗痤疮起效快.在治疗中度痤疮,两组总体疗效、医疗费用相当,但雏胺酯组不良反应较轻.而在治疗重度痤疮方面,异维A酸组临床疗效较维胺酯组高,且医疗成本较低.     

年龄相关性黄斑变性治疗的比较分析

从治疗原理、费用、疗效、不良反应等方面对年龄相关性黄斑变性的不同治疗方法进行比较和分析,为患者进行治疗上的选择提供帮助,同时指导和规范该类疾病治疗的临床决策,以期能在目前条件下不仅提高病人的治疗效果和生活质量同时又达到降低医疗费用的目的。     

年龄相关性黄斑变性治疗的比较分析

从治疗原理、费用、疗效、不良反应等方面对年龄相关性黄斑变性的不同治疗方法进行比较和分析,为患者进行治疗上的选择提供帮助,同时指导和规范该类疾病治疗的临床决策,以期能在目前条件下不仅提高病人的治疗效果和生活质量同时又达到降低医疗费用的目的.     

两种方法治疗慢性乙型肝炎合并轻度脂肪肝的疗效分析

探讨阿德福韦酯联合双歧杆菌四联活菌片对脂肪肝合并慢性乙型肝炎抗病毒疗效影响。选择2011年1月至2014年4月在笔者所在医院门诊就诊的HBeAg阳性慢性乙肝合并非酒精性脂肪肝(NAFLD)患者50例随机分为2组,A组采用单纯阿德福韦酯抗病毒治疗48周,B组采用阿德福韦酯联合双歧杆菌四联活菌片治疗48周,分析2组疗效。B组在治疗48周时其病毒学应答和生化学应答率上明显高于A组,且B组在改善肝脏脂肪化疗效上明显优于A组。对脂肪肝合并慢性乙型肝炎患者,在抗病毒治疗同时加用双歧杆菌调节肠道微生物环境,可提高该类患者病毒学应答率和生化学应答率,同时还可改善肝脏脂肪化程度。     

两种治疗方案对老年多发性骨髓瘤的临床疗效

比较硼替佐米联合地塞米松(BD方案)和沙利度胺联合地塞米松(TD方案)在老年多发性骨髓瘤(MM)治疗的临床疗效及安全性。选择50例老年MM患者随机分为BD组(25例)和TD组(25例),分别接受BD方案治疗和TD方案治疗,4个疗程后评价疗效、不良反应发生情况。经治疗后,BD组和TD组的血红蛋白较治疗前显著升高,β_2微球蛋白、M蛋白、骨髓瘤细胞比例均较治疗前显著下降(P0.05);治疗后BD组的血清肌酐和骨髓瘤细胞比例均低于治疗后TD组水平(P0.05)。BD组治疗总有效率为78%,明显高于TD组的52%(P0.05)。BD治疗组不良反应包括血小板减少、白细胞减少、乏力、外周神经病变,TD组不良反应包括便秘、皮疹、头晕,该7类不良反应发生率两组差异有统计学意义(P0.05)。BD方案在老年MM治疗中具有更高的有效性和适用性。     

单用他克莫司和联合五酯胶囊治疗免疫性肾小球疾病的单中心回顾性研究

对单用他克莫司和联合五酯胶囊治疗免疫性肾小球疾病疗效、安全性和药物-经济效益进行比较。回顾性分析大连医科大学附属第一医院2011年1月~2015年12月行肾活检证实为免疫性肾小球疾病并伴大量蛋白尿的患者60例,分为单用他克莫司组和联合五酯胶囊组。主要评价指标:蛋白尿缓解率、各个时间点蛋白尿缓解率等;次要评价指标:药物副作用、治疗费用及药物-经济学效益。随访第3个月、6个月,他克莫司联合五酯胶囊组蛋白尿缓解人数高于单用他克莫司组(P0.05),两组副作用无差异(P0.05),而治疗费用及成本-疗效比有统计学差异(P0.05);他克莫司联合五酯胶囊可有效降低免疫性肾小球疾病蛋白尿,且具有较好药物经济学效益。     

雷替曲塞治疗老年晚期结直肠癌的疗效分析

比较雷替曲塞与5-氟尿嘧啶联合奥沙利铂治疗老年晚期结直肠癌的临床疗效及生存分析。经病理明确诊断的老年晚期结直肠癌患者42例分为A、B两组,分别采用雷替曲塞和5-氟尿嘧啶／亚叶酸钙联合奥沙利铂方案化疗,观察两组疗效、不良反应及生存分析。结果A、B两组患者有效率接近,无统计学差异。A、B组疾病进展时间分别是7．5个月和5．...     

右美托咪定基础麻醉联合局麻在Ⅰ期乳腺癌保乳手术中的应用

探讨右美托咪定基础麻醉联合局麻在Ⅰ期乳腺癌保乳手术中应用的可行性。将108例患者随机分为局麻组(A组)、右美托咪定基础麻醉联合局麻组(B组)、全身麻醉组(C组),每组36例,进行比较分析。结果显示A组和C组的麻醉不良反应事件发生率相近,但均高于B组(P0.05)。B组和C组的麻醉成功率相等,但均高于A组(P0.05)。三组的麻醉费用比较,差异均有统计学意义(P0.05),其中B组较A组略高,C组最高。右美托咪定基础麻醉联合局麻可以满足Ⅰ期乳腺癌保乳手术的麻醉需要,麻醉安全,不良反应最少,费用较低,值得临床应用。     

原发性三叉神经痛两种治疗方法的比较

原发性三叉神经痛的治疗方法以神经毁损术最为常用。通过对经皮射频热凝毁损术和阿霉素化学毁损术的疗效、安全性、复发率、并发症及费用等方面的比较,揭示两种方法的利弊。用比较治疗学的理念及方法来指导三叉神经痛治疗的临床决策,以期能在目前条件下提高患者的治疗效果、降低医疗费用及提高生活质量。     

利奈唑胺治疗ICU革兰阳性球菌感染的疗效及安全性观察

为了评估利奈唑胺治疗ICU革兰阳性球菌感染的疗效与安全性,回顾性分析了我院中心ICU接受利奈唑胺治疗的28例革兰阳性球菌感染患者的临床资料.结果显示治疗的总有效率为75%(21/28),耐甲氧西林金黄色葡萄球菌感染惠者有效率73.33%(11/15),表皮葡萄球菌感染患者有效率66.67%(4/6),屎肠球茵感染患者有效率80%(4/5),溶血葡萄球菌感染患者有效率100%(2/2),人葡萄球菌感染患者有效率100%(2/2).治疗过程中不良反应发生率为25%.不良反应经对症处理后好转,无需停药.故得出结论,利奈唑胺是治疗革兰阳性球菌感染有效、安全的药物,值得进一步临床验证.     

Incidence of depression related to isotretinoin treatment in 100 acne vulgaris patients

The incidence of depression in acne patients using isotretinoin was assessed in 100 patients with moderate and nodulocystic acne. All patients received 0.75-1.00 mg/kg/day of isotretinoin for 20-28 weeks after acne was assessed. All patients' acne lesions were improved at the end of the treatment period. Psychological state was evaluated at baseline, at Month 3, and Month 6 by a psychiatrist using a Turkish version of the Hamilton Depression Rating Scale. Only one patient's score increased to the clinical level of depression at Month 3 of treatment and declined to subclinical levels at Month 6. Although Hamilton scores increased at Month 3 over baseline scores, except for one patient, others' scores remained below the subclinical level for depression. At the end of Month 6, the mean score decreased below that at Month 3. These changes in means might be related to the onset of clinical effect of isotretinoin.     

Relative Cost Effectiveness of In-Person and Internet Interventions for Relationship Distress

While the efficacy of couple therapy has been repeatedly demonstrated, most distressed couples do not seek treatment. To improve reach and overcome barriers to therapy, Integrative Behavioral Couple Therapy (IBCT) was translated into a web-based program, OurRelationship (OR). While both IBCT and OR have been shown to improve relationship and individual functioning, the goal of the present study was to compare the relative cost effectiveness of these two treatment modalities. In IBCT, 74% of couples experienced reliable improvement, compared to 55% of couples in OR. Within-group Cohen's d effect sizes during treatment for relationship satisfaction were d = 0.87 for IBCT and d = 0.96 for OR. Relative cost effectiveness analyses revealed that even at the highest expense estimates for OR and the lowest expense estimates for IBCT, OR was more cost effective in creating reliable improvement once at least 229 couples were served and was more cost effective in creating large-size effects once at least 153 couples were served. Cost-effectiveness increases for both IBCT and OR as more couples are served; however, this cost savings occurs at a much more rapid rate for OR. These findings demonstrate that despite higher initial development costs, Internet programs are a cost-effective option for dissemination either as a stand-alone service or as an initial intervention in a stepped care model with more intensive in-person services.     

Group Counseling with College Underachievers

Some of the controversy concerning the efficacy of psychotherapy or counseling has been resolved by recent evidence that studies reporting no effects had indiscriminately lumped together the high and low therapeutic conditions that are associated with successful and unsuccessful outcomes. The present study extends these findings to a group of essentially neurotic underachieving college freshmen. The 24 experimental students who received group counseling showed greater improvement in grade-point average than 24 matched, non-counseled control subjects. Further, those counseled subjects who received the highest therapeutic conditions tended to show the greatest improvement.     

肿瘤临床治疗中应关注肝脏

抗肿瘤细胞毒性药物有不同程度毒副作用,有些严重毒副反应是限制药物剂量或使用的直接原因。肝脏是药物代谢的主要器官,也是药物损伤的主要靶器官。随着临床肿瘤治疗关注治疗带来的副作用与关注疗效同等重要的发展,本文对抗肿瘤细胞毒性药物与肝损伤、发生机制、诊断、分型和临床治疗进展进行了阐述。     

The effectiveness of drug treatment programs in reducing criminal behavior: a meta-analysis

The main aim of this paper is to assess the effectiveness of drug treatment programs in reducing criminal behavior. The research is based on a systematic review and meta-analysis of evaluations of drug treatment programs. The research investigated various drug treatment programs including methadone treatment, therapeutic communities, post-release supervision for drug-misusing offenders, and drug courts, and focused on drug treatment programs that were primarily concerned with heroin, crack and cocaine misuse. The main outcome variable analyzed was reoffending following treatment as measured by self-reports or official records. The study was based on a meta-analysis of 28 evaluations of drug treatment programs. The meta-analysis involved calculating individual effect sizes for each study and weighted mean effect sizes for groups of studies. The mean odds of offending following treatment were significantly lower among clients of the drug treatment programs than among the comparison groups. However, the results varied by type of program, type of evaluation methods used, and characteristics of clients.     

鼻咽癌治疗方法的比较

鼻咽癌是我国南方省市最常见的头颈恶性肿瘤,放疗为其首选治疗方案,但患者五年生存率仍然不高。本文阅读国内外对鼻咽癌多种治疗方案的报道,结合湘雅医院、湘雅二医院对鼻咽癌某些治疗方案,通过分析对比不同治疗方案的疗效、患者生存质量及费用,讨论该病的最佳治疗方案,以期能在目前条件下提高鼻咽癌患者的治疗效果及生存质量。     

Effect of Self- and Group Efficacy on Group Performance in a Mixed-Motive Situation

The effect of self- and group efficacy on the performance of three-person (N = 26) and seven-person (N = 28) groups on a mixed-motive investment task was investigated. The correlations between group efficacy for making money and the actual amount of money made by the groups were positive and significant. The relation between group efficacy and the group's performance was reciprocal. The results also indicated that members of three-person groups had significantly higher perceptions of group efficacy than members of seven-person groups even though they faced the identical mixed-motive investment task. The correlations between group efficacy and the group's performance were significantly higher than the correlations between aggregated values of self-efficacy for individual performance and the group's performance. Finally, multiple regression analyses showed that self-efficacy for individual performance had a negative effect on the group's performance.     

经颅直流电刺激技术在物质依赖治疗中的应用

物质依赖是一种慢性、复发性脑部疾病, 给个体及社会带来极大损害。研究发现, 经颅直流电刺激(transcranial direct current stimulation, tDCS)可以通过调节背外侧前额叶(dorsolateral prefrontal cortex, DLPFC)脑区的兴奋性降低物质依赖者的渴求, 并改善受损的认知功能。tDCS具有副作用小、操作简便、费用低廉等优点, 因此在物质依赖治疗领域应用前景广泛。未来应考虑确定最佳的刺激参数及刺激位置, 同时考虑物质依赖者的种类及个体差异, 与其他疗法结合使用, 并进一步深入探索tDCS治疗物质依赖的神经机制。