Comparison on the Treatments of Three Methods for Knee Osteoarthritis

目的 探讨膝关节骨性关节炎（knee osteoarthritis,KOA）的较佳治疗方案。方法 从双氯芬酸钠治疗组（A组）、正清风痛宁口服治疗组（B组）、正清风痛宁关节腔注射与片剂序贯疗法组（C组）各随机抽取60例病例,比较3组治疗前后疗效、不良反应等指标。结果 3组患者治疗后的Lequesne指数均较治疗前下降（P均〈0.01）;A组治疗后的Lequesne指数与B组差异无统计学意义（P〉0.05）;C组治疗后的Lequesne指数均低于A组与B组（P均〈0.01）。A、B、C 3组治疗总有效率分别为73.3%、75.0%、93.3%,A组疗效与B组比较差异无统计学意义（P〉0.05）,C组疗效优于A组与B组（P均〈0.01）。A、B、C 3组不良反应发生率分别为26.7%、10.0%、11.7%,A组不良反应发生率高于B组与C组（P均〈0.05）;B组与C组的不良反应发生率差异无统计学意义（P〉0.05）。结论 正清风痛宁关节腔注射与片剂序贯疗法治疗KOA疗效好,不良反应较少。Objective To investigate the better treatments of knee osteoarthritis.Methods Randomly selected 60 case from each of the following groups：diclofenac sodium treatment group（A）,zhengqingfengtongning oral treatment group（B）,zhengqingfengtongning articular cavity injection with tablet sequential therapy group（C）.Comparative analysis of the curative effect before and after treament,effective rate and the incidence of adverse reactions between each group.Results The lequesne index of all the 3 groups dropped significantly before and after treament（P〈0.01）.Compared each group after treatment,A and B had no statistical difference（P〉0.05）,C was significantly lower than A and B（P〈0.01）.The total effective rate of A,B and C were 73.3%,75.0% and 93.3%,A and B had no statistical difference（P〉0.05）,C was better than A and B（P〈0.01）.The incidence of adverse reactions of A,B and C were 26.7%,10.0% and 11.7%;A higher than B and C（P〈0.05）,but B and C had no significant difference（P〉0.05）.Conclusion Zhengqingfengtongning articular cavity injection with tablet sequential therapy have good curative effect and less adverse in treatment of KOA,worthy of clinical recommendations

Necessity of treating subclinical hypothyroidism in early pregnant women

目的评估早孕妇女亚临床甲状腺功能减退症(subclinical hypothyroidism,SCH)对妊娠结局的影响及药物治疗的必要性。方法收集18 243例在厦门大学附属第一医院产前检查直至分娩的病例,诊断标准为妊娠10~12周产前检查时TT4与FT4正常而TSH≥2.5 m IU/L为SCH,甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)≥34 U/L为阳性。根据TSH的升高程度不同、TPOAb情况、能否遵医嘱按时按量服用L-T4使TSH控制在正常范围内进行分组:2.5 m IU/L≤TSH≤5.0 m IU/L且TPOAb阳性且能遵医嘱者为A组,不能遵医嘱者为B组;TSH>5 m IU/L且TPOAb阳性且能遵医嘱者为C组,不能遵医嘱者为D组;2.5 m IU/L≤TSH≤5.0 m IU/L且TPOAb阴性且能遵医嘱者为F组,不能遵医嘱者为G组;TSH>5 m IU/L且TPOAb阴性且能遵医嘱者为H组,不能遵医嘱者为K组。并随机抽取200例同期甲状腺功能正常的病例作为对照组(E组),回顾分析早孕妇女甲状腺功能异常的发生率、SCH对妊娠结局的影响、早孕妇女SCH行左旋甲状腺素片(L-T4)替代治疗的剂量及影响因素。结果早孕妇女SCH检出率为5.20%,甲状腺功能正常率为79.00%。A组早产3.31%(8/242)、妊娠期高血压7.02%(17/242)、胎儿生长受限7.02%(17/242)、出生低体质量儿6.61%(16/242)的发生率均低于B组的8.79%(8/91)、14.29%(13/91)、15.38(14/91)、14.29(13/91)(P均 5 m IU / L,TPOAb was positive and had good compliance; Group D: TSH and TPOAb as Group C but not have good compliance; Group F: 2. 5 m IU / L≤TSH≤5. 0 m IU / L,TPOAb was negative and had good compliance; Group G: as Group F,but not have good compliance; Group H: TSH > 5 m IU / L,TPOAb was negative and had good compliance; Group K: as Group H,but not have good compliance. Randomly selected 200 cases with normal thyroid function at the same period as the control group( Group E). Retrospective analysis the occurrence rate of thyroid gland dysfunction,the influence of SCH to pregnancy outcome,the doses and influencing factors of replacement therapy by L-T4 to SCH of early pregnant women. Results Relevance ratio of SCH in early pregnant women was5. 20%,the ratio of normal thyroid function was 79. 00%. In group A,premature birth 3. 31%( 8 /242),gestational hypertension 7. 02%( 17 /242),fetal growth restriction 7. 02%( 17 /242),low birth weight infant 6. 61%( 16 /242),were lower than that in group B 8. 79%( 8 /91),14. 29%( 13 /91),15. 38( 14 /91),14. 29( 13 /91) respectively( P < 0. 05). In group C,spontaneous abortion 3. 31%( 6 /181),premature birth 3. 89%( 7 /181),gestational hypertension 8. 29%( 15 /181),gestational diabetes mellitus 3. 89%( 7 /181),fetal growth restriction 7. 73%( 14 /181),low birth weight infant 6. 63%( 12 /181),were lower than that in group D 11. 54%( 6 /52),11. 54%( 6 /52),19. 23%( 10 /52),11. 54%( 6 /52),17. 31( 9 /52),15. 38( 8 /52)( P < 0. 05). No significant statistical difference were found in multiple comparison of the above six indexes of group A,B,C. And just the same as the multiple comparison of group F,G,H,K,E. When TSH reach the standard,the dosage of L-T4 in group A and C had significant difference [( 0. 757 ± 0. 378 vs. 1. 106 ± 0. 454) μg / kg,t = 8. 39,P < 0. 001]. There were also significant differences of group F compared with group H[( 0. 443 ± 0. 198 vs. 0. 813 ± 0. 378) μg/kg,t = 8. 22,P < 0. 001],group( A + F) compared with group( C + H) [( 0. 634 ± 0. 358 and 1. 017 ±0. 427) μg / kg,t = 11. 77,P < 0. 001],group A compared with group F [( 0. 757 ± 0. 378 vs. 0. 443 ± 0. 198) μg / kg,t = 9. 85,P < 0. 001 ],group C compared with group H [( 1. 106 ± 0. 45 vs. 0. 813 ± 0. 378) μg / kg,t = 5. 59,P < 0. 001],group( A + C) compared with group( F + H) [( 0. 932 ±0. 463 vs. 0. 693 ± 0. 388) μg / kg,t = 6. 53,P < 0. 001]. Conclusion The early pregnant women with SCH and TPOAb positive could increase the occurrence rate of spontaneous abortion,premature birth,gestational hypertension,gestational diabetes mellitus,fetal growth restriction and low birth weight infant. The early intervening treatment of L-T4 could efficiently decrease the adverse event occurrence ratio of pregnant woman with SCH and positive TPOAb,but no effect for that with SCH and TPOAb negative. The TSH level and condition of TPOAb could affect the replacement therapy dosage of early pregnancy with SCH

The Applied Research of Noble Metal Nanomaterials as Peroxidiase Mimic

贵金属纳米材料模拟酶由于克服了天然酶类容易受环境中物理、化学因素影响而失活的缺陷,同时由于纳米材料具有的高体表面积比及在生物稳定性、光谱特性方面的优越性,使其研究备受关注。H2O2是多种反应的中间产物,在食品、环境、工业、制药等邻域有重要作用,因此对贵金属纳米材料模拟过氧化物酶的研究意义重大。目前关于其应用的研究主要有如下方面:离子检测(如Hg2+、Pb2+、k+);有机化合物检测(如葡萄糖、黄嘌呤、小鼠白介素Ⅱ)以及肿瘤细胞检测。Noble met al nanomaterials used as enzyme mimics are a current interest,because they can overcome the disadvantages of natural enzymes whose catalytic activity can be inhibited by the physical and chemical factors of environment,and they have large surface-to-volume ratio,good properties in biology and spectrum.H2O2 is a intermediate product of many kinds of reactions,and plays an important part in food,environment,industrial and pharmaceutical.Therefore,the research of noble met al nanomaterials as peroxidiase mimics is of great significance.At present,the mainly applied research include ion detection( e.g.Hg2 +,Pb2 +,K+),organic chemical compound detection( e-.g.glucose,xanthine,mouse interleukin 2),and the detection of tumour cell

清洁手术围手术期抗菌药物预防使用PDCA模式干预效果评价

目的 探讨规范清洁手术围手术期抗菌药物预防使用的方法,为其合理使用提供指导。方法 回顾性调查某院2012年4-6月及2015年1-3月清洁手术病例抗菌药物预防使用情况。结果 经PDCA循环干预后,清洁手术围手术期抗菌药物预防使用率由34.2%降至18%（P〈0.01）,品种选择合理率由73.3%升至93.8%（P〈0.01）,给药时机合理率由48.9%升至81.3%（P〈0.01）,预防用药疗程合理率由33.3%升至77.1%（P〈0.01）,平均预防用药时间由2.91天降至1.5天（P〈0.01）,干预前后有显著性差异。结论 PDCA循环干预能够显著提高清洁手术围手术期抗菌药物预防用药水平

基于医院的使用管理探讨辅助用药管理的不足与改进

目的 了解医院辅助用药使用情况,探讨辅助用药管理的不足及改进措施。方法 对每月进入金额前20名的辅助用药进行抽样分析与监管,比较3个时间段的使用变化。通过分析不合理使用原因,探讨辅助用药管理的不足及改进措施。结果 经过管理,辅助用药逐渐退出金额前20名;分析不合理使用情况,主要存在适应证、溶媒、给药方法、疗程及合并用药等方面使用不合理;分析其深层次原因,辅助用药管理在政策、药品审批与准入、医保、市场监管等方面有待加强。结论 辅助用药的使用尚存改进空间,需进一步加强管理,促进临床合理使用

研究HIMSS EMRAM 7级评审在住院药房中的应用

目的探讨美国医疗信息与管理系统学会电子病历应用模型(Healthcare Information and Management Systems Society Electronic Medical Record Adoption Model,HIMSS EMRAM)7级评审在住院药房工作中的应用价值。方法回顾性统计厦门大学附属第一医院住院药房2016年10月1日—2017年7月31日HIMSS EMRAM 7级评审前每条医嘱(非包药机摆药医嘱,以下简称医嘱)平均调剂时间、人力成本、医嘱调配差错率、耗材使用量等指标,与2017年9月1日—2018年6月30日HIMSS EMRAM 7级评审后的相应指标进行比较分析。结果 (1)评审后每条医嘱平均调剂时间为(19.24±0.31)s,低于评审前的(29.73±0.56)s(t=244.73,P <0.01)。(2)同样调剂1 642 867条医嘱,评审后比评审前节省人员2.75人,节省人力成本137 500元。(3)评审后的医嘱调配差错率为1.35‰(2 219/1 642 867),低于评审前的2.13‰(3 455/1 625 694)(χ2=282.89,P <0.01)。(4)评审后打印纸消耗、打印机维保及打印机损耗等耗材使用量仅为评审前的5.14%,可节约43 597.67元。结论 HIMSS EMRAM 7级评审过程,通过对住院药房进行信息化管理,缩短了医嘱平均调剂时间、减少了医嘱调配差错率、节约人力成本、减少耗材消耗,是实现药品安全质量管理目标的有效措施

金融资源与企业并购——从地区不平衡到企业再平衡的解释

中国区域发展的不平衡造成了金融资源在地区层面的不平衡,这也会影响不同地区企业的并购决策。以中国A股上市公司的国内股权并购交易事件为研究样本,可对企业并购行为与地区金融资源不平衡的关系进行研究。研究发现:企业所在地区内金融资源越丰富,国有企业越偏好于选择异地并购,但非国有企业则越倾向于减少异地并购。在并购完成后,国有企业的负债水平会显著降低,而非国有企业的负债水平与融资能力却出现了显著提高,意味着两类企业通过并购缩小了在负债融资上的差距,并且异地并购有助于企业实现金融资产的跨地区优化配置。由此可见,企业的并购行为一定程度上缓解了金融资源不平衡现象对企业自身的消极影响,进而在企业层面实现了金融资源的再平衡。国家社会科学基金重大项目“新常态下金融部门与实体经济良性互动的现代经济治理体系问题研究”(15ZDA028);;\n国家自然科学基金面上项目“资本市场中的社会关系与政治地理中的资本市场:来自中国的理论与实证”(71373219);;\n中央高校基本科研业务费专项资金资助项目“政府干预、产业政策与企业行为:基于中国资本市场的实证发现”(20720181109

是谁加剧了知情交易?——基于股改前后EKOP模型的实证检验

本文从2004年至2009年间股票分笔成交高频数据中挑选出640个股票样本进行研究,运用经典的EkOP模型估计出股票的知情交易概率,在此基础上运用分位数回归分析的方法检验了基金持股、高管持股以及公司其他特征对知情交易概率的影响,实证研究发现:基金持股和高管持股对股票的知情交易概率具有显著影响,会加剧知情交易;上市公司在股改期间存在着较大的知情交易概率,而股权分置改革之后,中国股票市场的知情交易水平呈现明显降低趋势。This paper applies the classic EKOP model to estimate the probability of informed trading with the tick data of the chosen 640 stocks from 2004 to 2009.After that, our regression analysis comes to the conclusion that the equity holdings of mutual funds and corporate executives would significantly affect the probability of informed trading, which might cause informed trading; during the non-tradable shares reform period, the probability of informed trading was comparatively high.However, after the reform, the informed trading tends to decline significantly.国家自然科学基金青年项目71103150; 国家自然科学基金面上项目71373219; 中央高校基本科研业务费专项资金的资

家族企业二代的成长经历影响并购行为吗——基于我国上市家族企业的发现

我国家族企业正面临着代际传承与转型升级的双重压力。本文以我国上市家族企业为样本,手工收集家族企业二代的成长经历与家族企业一代的创业经历信息,从高阶理论出发分析了家族企业二代的成长经历对所涉入企业跨行业并购行为的影响。实证研究发现,如果二代有童年时期父辈创业经历、海外留学经历以及家族企业外工作经历,会促使所涉入的家族企业进行跨行业并购,跨行业并购经营是二代避免与父辈在价值观和经营理念上冲突的合理选择。同时,行业景气度作为企业前景预期的重要参考点,会对这一关系起负向调节作用。进一步研究表明,二代的童年时期父辈创业经历与家族企业外工作经历会促使所涉入企业向金融和房地产等高收益行业并购。本文的研究框架将家族企业代际传承、二代成长经历、行业景气度与企业并购结合起来,为我国家族企业代际传承的研究及企业的跨行业并购行为提供了新的逻辑和证据。国家社会科学基金重大项目(15ZDA028);;国家自然科学基金项目(71373219);;中央高校基本科研业务费项目(20720181109)资

Efficacy and safety of buprenorphine transdermal patches in relieving moderate to severe chronic pain

目的观察丁丙诺啡透皮贴剂治疗中重度慢性疼痛的疗效和安全性。方法收集2015年10月至2016年3月在我院骨科门诊确诊为中重度慢性疼痛患者68例,给予丁丙诺啡透皮贴剂进行止痛治疗,初始剂量5 mg,qw,根据疼痛情况调整剂量至无痛或基本无痛状态。对每位患者随访1个月,分别评估患者治疗前后疼痛强度、镇痛效果、生活质量、用药依从性,同时监测药物不良反应。结果治疗前、后患者疼痛数字评分分别为（5.90±1.05）分和（1.35±0.75）分,P〈0.05;疼痛总缓解率为91.18%;治疗后SF-36生活质量量表（中文版）8个方面维度分数和用药依从性均较治疗前显著提高（P〈0.05）;药物不良反应发生率为8.82%。结论丁丙诺啡透皮贴剂具有镇痛稳定、作用持久、不良反应轻、用药依从性高等特点,可倡导应用于中重度慢性疼痛的治疗。AIM To observe the efficacy and safety of buprenorphine transdermal patches in relieving moderate to severe chronic pain. METHODS From October 2015 to March 2016,a total of 68 patients with moderate to severe chronic pain in orthopaedics clinic in our hospital were treated with buprenorphine transdermal patches,used with an initial dose of 5 mg qw and adjusted dose until pain disappeared. After one-month follow-up,the patients with moderate to severe chronic pain were respectively evaluated and pain relief,quality of life,medication compliance and adverse drug reactions were compared. RESULTS At pre-therapy and post-treatment,the scores of NRS（ numerical rating scale） of the patients were（ 5. 90 ± 1. 05） and（ 1. 35 ± 0. 75） respectively,P 〈0. 05.There was significant difference befor and after treatment in pain relief,life quality and medication compliance（ P 〈0. 05）. The total remission rate in pain was 91. 18%. It was 8. 82% in incidence rate of adverse drug reactions. CONCLUSION Buprenorphine transdermal patches have the characteristics of stable analgesia,long duration of effect,less adverse drug reactions and higher compliance,and can be advocated for in the treatment of moderate to severe chronic pain