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Objective:To construct a comprehensive community management platform for prevention and treatment of chronic obstructive pulmonary disease (COPD) and evaluate its effectiveness and feasibility in the prevention and treatment of COPD.Methods:A comprehensive community management platform for prevention and treatment of COPD was established based on the information network. The platform mainly includes COPD screening, establishment of electronic health files of COPD patients living in the community, and hierarchical management of COPD patients. Patients who met COPD criteria were admitted by two community health centers (control and study groups, n = 1 000/group) with similar environments. In the control group, comprehensive community management platform for prevention and treatment of COPD was not established, and only diagnosis and conventional treatment were performed. In the study group, comprehensive community management platform was established to screen COPD patients, establish electronic health files of COPD patients, and hierarchically manage the COPD patients. All patients were followed up for 1 year. The number of acute exacerbations of COPD, treatment cost, the improvement in pulmonary function, dyspnea, and quality of life were compared between the two groups. The effects of the established comprehensive community management platform on prevention and treatment of COPD were analyzed. Results:One-year follow-up results revealed that an acute exacerbation of COPD occurred in 578 patients from the control group and 326 patients from the study group. The proportion of an exacerbation of COPD, the number of exacerbations of COPD, treatment cost in the study group were 32.60% (326/1 000), (1.52 ± 0.58), (2 014.21 ± 122.29) yuan, respectively, which were significantly lower than those in the control group [57.80% (578/1 000), (2.28 ± 2.15), and (4 201.34 ± 210.25) yuan, t = 12.34, 3.19, 21.24, all P < 0.05]. Before establishment of the comprehensive community management platform, there were no significant differences in pulmonary function, modified Medical Research Council (mMRC) dyspnea score, COPD assessment test (CAT) score between the two groups (all P > 0.05). In the control group, the ratio of forced expiratory volume in 1 second (FEV 1)/forced vital capacity (FVC), predicted FEV 1 value, mMRC dyspnea score, and CAT score were (60.32 ± 12.31)%, (63.65 ± 9.37)%, (1.89 ± 1.01) points, (18.82 ± 5.35) points, respectively after 1 year of treatment. There were no significant differences in these indexes between before and after 1 year of treatment ( t = 0.79, 0.87, 1.05, 0.83, all P > 0.05). In the study group, FEV 1/FVC ratio, predicted FEV 1 value, mMRC dyspnea score, and CAT score were (65.27 ± 13.59)%, (68.92 ± 10.67)%, (1.41 ± 0.72) points, (13.24 ± 5.21) points, respectively after 1 year of treatment. Significant differences in these indexes were found between before and after 1 year of treatment ( t = 3.28, 3.39, 4.17, 5.71, all P < 0.05). Conclusion:The established comprehensive community management platform is highly effective for prevention and treatment of COPD. It can effectively reduce the frequency of acute exacerbations of COPD, reduce treatment cost, improve pulmonary function, alleviate dyspnea, and improve quality of life.
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Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoemblization (TACE) using raltitrexed and lobaplatin in treating advanced hepatocellular carcinoma (HCC).Methods From March 2009 to November 2014,95 cases were treated by raltitrexed combined with lobaplatin (raltitrexed group) through TACE and 124 cases by fluorouracil combined with oxaliplatin (fluorouracil group) through TACE.Disease control rate (DCR),median progression-free survival (mPFS) time and median overall survival (mOS) time were compared between the two groups.Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis in SPSS 16.0.Results The disease control rate of raltitrexed group was 91.6％ (87/95),compared with fluorouracil group of 84.6％ (105/124) in fluorouracil group (x2 =2.505,P =0.474).The mPFS of raltitrexed group was 6.8 months and that of fluorouracil group was 5.9 months (x2 =5.542,P =0.019);mOS of raltitrexed group was 13.6 months and fluorouracil group was 11.4 months (x2 =5.953,P =0.015).The main adverse reactions in the two groups were not statistically significant (P ＞ 0.05).Conclusions TACE using rahitrexed and oxaliplatin prolongs the progression free survival and overall survival time of patients with advanced hepatic carcinoma.
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Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoemblization (TACE) using raltitrexed and lobaplatin in treating advanced hepatocellular carcinoma (HCC).Methods From March 2009 to November 2014,95 cases were treated by raltitrexed combined with lobaplatin (raltitrexed group) through TACE and 124 cases by fluorouracil combined with oxaliplatin (fluorouracil group) through TACE.Disease control rate (DCR),median progression-free survival (mPFS) time and median overall survival (mOS) time were compared between the two groups.Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis in SPSS 16.0.Results The disease control rate of raltitrexed group was 91.6％ (87/95),compared with fluorouracil group of 84.6％ (105/124) in fluorouracil group (x2 =2.505,P =0.474).The mPFS of raltitrexed group was 6.8 months and that of fluorouracil group was 5.9 months (x2 =5.542,P =0.019);mOS of raltitrexed group was 13.6 months and fluorouracil group was 11.4 months (x2 =5.953,P =0.015).The main adverse reactions in the two groups were not statistically significant (P ＞ 0.05).Conclusions TACE using rahitrexed and oxaliplatin prolongs the progression free survival and overall survival time of patients with advanced hepatic carcinoma.
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Objective To detect the levels of retinol binding protein(RBP)and adiponectin during the second trimester in the serum of women in normal pregnancy and women who subsequently develop gestational diabetes mellitus(GDM )and to evaluate their role in predicting GDM .Methods A case‐control study was performed to detect and compare the levels of RBP and adiponec‐tin between women who subsequently develop GDM (n= 88)and normal control from 16 to 20 pregnancy weeks (n= 88) . Results Maternal serum RBP levels and the RBP/adiponectin ratio were significantly higher in GDM women than that in normal controls(P<0 .01) .The levels of maternal serum adiponectin were significantly lower in GDM women than that in normal controls (P<0 .01) .The levels of RBP≥30 .45 mg/L ,adiponectin≤9 .93 mg/L and the ratio of RBP/adiponetin≥3 .18 as early markers for predicating development of GDM ,their sensitivities were 63 .6% ,80 .7% and 81 .8% ,and specificities were 75 .0% ,65 .1% and 79 .7% ,respectively .Conclusion The combination of RBP and adiponetin as early marker for predicating development of GDM from 16 to 20 pregnancy weeks was more valuable than single use of them .
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Objective To explore of the color Doppler ultrasound diagnosed choledocholithiasis.Methods 100 cases with choledocholithiasis diagnosed by color ultrasonography and cholangiography were analysed retrospectively.The sensitivity,specificity,accuracy and the inspection time of two methods were compared.Results 90 cases were diagnosed after operation,90％ in 100 patients.The diagnostic accuracy of Doppler ultrasound was 88 cases,2 false negative cases,no false positive.The diagnostic accuracy of cholangiography was 87 cases,3 false negative cases,2 false positive cases.The sensitivity,specificity and accuracy of two groups were not statistically significant (x2 =0.23,1.25,0.57,P ＞ 0.05).The inspection time of color ultrasound was 12 ～ 28 min,the average inspection time was (16.57 ±4.12)min.The inspection time of cholangiography was 12 ～37min,the average inspection time was (21.09 ± 6.24) min.The inspection times of two ways were statistically significant (t =6.53,P ＜ 0.05).Followed up between 5 months and 2 years,there was no residual gallstone patients.Conclusion Color Doppler ultrasound is a noninvasive,safe,time-saving,simple,good repeatability,high successful rate,for common bile duct stones in the main examination methods.