Onehealth, an evidence-based decision-making software, is based on the United Nations' epidemiological reference modules to predict the effect of health services. Onehealth is a large database. The software is using activitybased costing, simulating investment costs of health system and changes of mortality in different coverage levels. By the cost of inputs/avoid deaths, it could quantify the cost of health services effectiveness and provide an intuitive basis for the rational allocation of health resources. This study introduces the relevant concepts, model structures and applications of Onehealth. We took the study of child nutrition interventions in Sudan for example and to present Onehealth tool's operating. As a new auxiliary and evidence-based decision-making software with scientific and rigorous theoretical approach, Onehealth has practical significance on the national or regional macro decision-making.
The results of clinical studies are usually described with statistical data. When we conduct systematic reviews of clinical studies it is important that the statistical methods used in the original research are evaluated. By doing so, we can assess the validity and reliability of the evidence.
ObjectivesTo construct a follow-up evaluation indicator system on the implementation of the WHO resolution of " Access to essential medicines” by systematic review, and to provide a methodological support for tracking the implementation of the resolution, with a view to providing evidence of decision-making to promote the accessibility of essential medicines and further promote and improve the national essential medicine policy. It also provides a methodological reference for investigating the implementation of other public health sector resolutions.MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang Data and CNKI databases and relevant international or national official websites of pharmaceutical administration department or academic organization were searched to collect studies on accessibility of WHO essential drugs from inception to February, 2016. Two researchers independently screened literature, extracted data, and qualitative analysis was used to sort out and screen the evaluation indicators for the implementation of the WHO resolution of "Access to essential medicines".ResultsA total of 60 relevant literatures, three guides and 19 progress reports of the World Health Assembly from official websites were included. Through the screening of indicators, we could get two parts: the indicators of measures to implement the resolution and the indicators of the results of the implementation of the resolution.ConclusionsThis study analyzes the implementation of the resolution of the health system in the progress report of the World Health Assembly 2013–2015, divides the implementation of the resolution into two parts: the implementation of the resolution and the results of the implementation of the resolution. An indicator system for establishing measures and evaluation the resolution has been found. Expert consultations will be further developed to establish the final indicators for the implementation of the "Access to essential medicines".
ObjectiveTo explore the feasibility and clinical application value of low attenuation areas (LAA) scoring system in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).MethodsA total of 380 patients with AECOPD were included. Clinical data including general information, laboratory examinations and treatments during hospitalization were collected. According to the high-resolution computed CT (HRCT) imaging performance, the patients were divided into bronchitis phenotype and emphysema phenotype. The clinical data between these two groups were compared to analyze the differences between different phenotypes and the feasibility of LAA scoring system.ResultsIn patients of bronchitis phenotype, the levels of body mass index, C-reactive protein, interleukin-6, procalcitonin, neutrophil-to-lymphocyte ratio, and eosinophil counts on admission were higher than those of emphysema phenotype (P<0.05). Patients with emphysema phenotype had a higher proportion of male, a higher smoking index, higher cystatin C levels and lower bilirubin levels on admission (P<0.05), the rates of using mechanical ventilation and systemic glucocorticoids were higher as also (P<0.05). LAA scores had a positive correlation with the use of mechanical ventilation and systemic glucocorticoids and cystatin C levels, and a negative correlation with interleukin-6 levels (P<0.05).ConclusionsFor patients with AECOPD, using LAA scoring system to classify different phenotype through HRCT has relevant accuracy and clinical practicability. The LAA scoring system might help to evaluate the patient's condition and prognosis to a certain extent.
目的 總結分析普通B超監測引導PTCD方法改進后的優點及經驗。方法 用普通B型超聲診斷儀，腹部扇掃探頭和國產配套的專用PTCD套針及引流管，改進監測引導PTCD的方法，總結分析其方法的優越性。結果 95例梗阻性黃疸患者PTCD成功率為100%，引流效果良好，并發癥發生率為零。結論 用改進普通B超監測引導的方法進行PTCD，能克服在X線下進行PTCD的盲目性，對碘過敏者無禁忌，避免了長時間X線對人體的傷害。同時具有定位準確、費時少、成功率高、并發癥少、價格便宜、適宜在基層醫院推廣應用等優點。
目的:探討汶川地震傷中開放性骨折原因分析及治療策略。方法:回顧性分析280例汶川地震中開放性骨折患者病例,總結骨折原因及治療方法。結果:患者壓砸傷266例,占95%,其他受傷方式約占5%。治療上急診行內固定手術者88例,占31%,行外支架固定者69例,占24%,單純石膏外固定者60例,占21%,截肢患者63例,占22%,63例截肢患者中40例為肢端缺血壞死引起,占14%,15例為肢體毀損引起,占5%,8例為氣性壞疽引起,占2%。結論:汶川地震傷中開放性骨折原因多為壓砸傷,治療首先考慮全身治療,搶救生命,骨折治療根據Gustilo分度及肢體有無氣性壞疽或壞死而進行相應的治療。又因為地震傷有受傷人群多,受傷時間長,感染嚴重及救治困難等特點,故應根據病情采取相應的特殊救治方法。
In the process of guideline development and construction of clinical questions, it is necessary to guide clinicians to propose clinical problems into PICO (population, intervention, control, outcome) structured clinical questions. However, there are still unclear criteria to define and judge the appropriateness of the width of the PICO elements of a clinical question. Either too wide or too narrow can make the PICO question unsuitable to be a question for clinical practice guidelines to answer. We graded the clinical questions to be eight grades (3, 2, 1, 0, ?1, ?2, ?3, mixed) according to the number of the PIC elements, which obviously needed to be adjusted to evaluate applicability of the appropriateness of the width of the clinical questions. Our work can provide methodological references for clinicians and guideline developers.