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Compared with ordinary tuberculosis, multidrug resistant tuberculosis (MDR-TB) is more difficult to treat, with longer time of regime, lower cure rate and higher cost of treatment. It is estimated that the cost of multidrug resistant tuberculosis is about 100-200 times that of ordinary tuberculosis, resulting in the catastrophic health expenditure of some patients and their families, which seriously affects the patients’ compliance with treatment, and makes effective prevention and control of tuberculosis face huge resistance. So far, only a limited number of studies have analyzed the economic burden of the disease and its impact on patients, families and societies from different perspectives. Therefore, this article systematically reviews the economic burden of MDR-TB patients, and reveals the current economic burden of MDR-TB tuberculosis and related research progress, to provide a reference for optimizing or improving relevant medical insurance policies to control the tuberculosis and also for future studies.
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Objective To systematically evaluate the effectiveness and safety of interleukin-2 plus cisplatin for treating ma-lignant pleural effusion(MPE)to provide a basis for clinical treatment strategy.Methods CBM,CNKI,VIP,Wanfang,Pubmed, Embase,Cochrane library clinical trial registration database were systematically retrieved.The randomized controlled trial(RCT) quality assessment criteria of Cochrane collaboration network was adopted for including the study quality.The data were extracted by meta analysis.Results (1)Thirty-four RCT involving 2 037 MPE patients were included,the quality of included RCT was ordi-nary;(2)compared with simple cisplatin,the merged RR values and their 95%CI of meta-analysis for ORR,fever,were 1.45 (1.36-1.54),2.37 (1.53 -3.66),respectively,the differences between the two groups were statistically significant(P 0.05).Conclusion This study indicates that IL-2 plus cisplatin can significantly improve the clinical curative effect in the pa-tients with MPE,but has the adverse reactions of fever,etc.and the quality of included RCT is general.
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Objective To analyze risk factors and complication characteristics of healthcare-associated infection (HAI)in patients with lung cancer,and provide evidence for the formulation of HAI management strategy. Methods HAI-related articles were retrieved from China Biology Medicine (CBM),China National Knowledge Infrastructure (CNKI),Wanfang database,Vip database,PubMed,and Embase,all data were conducted Meta-analysis.Results A total of 19 articles involving 8 069 hospitalized patients with lung cancer (1 280 had HAI)were included.Meta-analysis on combined values of medical factors for HAI were as follows:OR(95%CI )of anti-tumor therapy(radiotherapy and chemotherapy),number of chemotherapy (≥ 2 times ),antimicrobial prophylaxis, immunosuppressant therapy,and invasive operation were 3.13 (1 .82,5.39),9.20 (3.04,27.87),3.23 (1 .77, 5.91),2.00(1 .56,2.57),and 2.28(1 .81 ,2.88),respectively;Meta-analysis on combined values of complication factors for HAI were as follows:OR (95% CI )of pulmonary diseases,chronic obstructive pulmonary disease (COPD),diabetes,renal dysfunction,malnutrition,hypoalbuminemia,neutropenia,and leukopenia were 2.65 (1 .74,4.02),2.40 (1 .76,3.27),2.25 (1 .85,2.73 ),2.56 (1 .18,5.52),5.51 (1 .70,17.89),2.05 (1 .56, 2.70),3.38(1 .40,8.18),and 2.10 (1 .22,3.62),respectively.Conclusion HAI-related factors of medical treat-ment and complications in patients with lung cancer are diversity,risk factors for HAI in patients with lung cancer are anti-tumor therapy,immunosuppressant therapy,antimicrobial prophylaxis,invasive operation,pulmonary dis-eases,COPD,diabetes,renal dysfunction,malnutrition,hypoalbuminemia,neutropenia,and leucopenia.
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Objective To investigate clinical interns' mastery and understanding status of medical core systems in order to provide reference for formulating training programs. Methods The questionnaires including medical core systems trained and self-assessment and test paper were de-signed. Then survey was carried out among 188 clinical interns of Grade 2009 of Zunyi Medical Col-lege at the end of training. All data were obtained, collected and analyzed with Excel and a SPSS 17.0. The result was described with percentage. Results ①78/41.34% and 117/62.33% clinical interns accepted training of medical core systems respectively before or during clinic training. 74/39.43%hos-pitals or 70/37.30% departments were systematically trained by medical core systems and the propor-tion of teachers who systematically or non-systematically explained medical core systems for clinical interns was 42/22.29%and 61/32.37%respectively.②The clinical interns who mastered first diagnosis responsibility systems, patient communication system, and systems of discussing difficult cases were 178/94.68%, 178/90.43%or 168/89.36%. The clinical interns who mastered rescue systems in critically ill patients, surgical classification management systems and audit system in clinical blood transfusion were 84/44.68%, 67/35.64%or 34/18.28%respectively.③8/6.90%interns fully grasped the core system of the medical situation. 165/87.71% and 165/83.43% clinical interns believed medical core systems should be mastered and 157 interns (83.43%) thought that mastering medical core system can help them better adapt to clinical medical work. Conclusion Systematic training of medical core system should be enhanced for clinical interns and mastering medical core systems is better for their future.
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Objective To provide the evidences for the management strategies of ventilator-associated pneumonia (VAP) in neonates,we systematically reviewed all related studies and analyzed the high-risk primary disease and medical factors of VAP in neonates.Methods We retrieved all related studies in CNKI,Wanfang,VIP,CBM,Pubmed and Embase and evaluated their quality by Newcastle-Ottawa Scale and analyzed all data by qualitative and Meta-analysis.Results There were 12 case-control studies with higher methodological quality and involving 1 994 neonates and with 708 VAP patients.Six studies involving 872 neonates were included,the odds ratio of respiratory distress syndrome(OR=2.81) and malnutrition(OR=5.18) had significant differences between VAP and non-VAP group.Seven studies involving 1 110 neonates were included and the odds ratio of patients with corticosteroids (OR=3.12),central inhibitors (OR=2.31),antacids (OR=4.35) and Gamma globulin with large doses (OR=2.35) had significant differences between VAP group and non VAP.Four studies involving 554 neonates were included and the odds ratio of patients with closed chest drainage (OR=1.81)and umbilical vein catheterization (OR=9.19) had significant differences between VAP group and non VAP.Six studies involving 1 139 neonates were included and the odds ratio of patients with parenteral nutrition (OR=1.82)and blood transfusions (OR=2.49) had significant differences between VAP group and non VAP.Conclusions Our study confirms that the respiratory distress syndrome and malnutrition corticosteroids,central inhibitors,antacids,Gamma globulin with large doses,closed chest drainage,umbilical vein catheterization,parenteral nutrition and blood transfusions are important risk and early-warning factors.