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Objective To compare the effects of honey dressing and silver sulfadiazine dressing for wound healing in burn patients by Meta-analysis.Methods All the randomized controlled trials were collected by searching many kinds of databases in or out of the country to compare honey dressing with silver sulfadiazine dressing for wound healing in burn patients.Review Manager 5.2 was used to analyze the effects.Results Six randomized controlled trials (RCT) were included.Honey dressing was much better than silver sulfadiazine dressing for burn wounds,while there were no significant differences in positive rate of wound swab culture and healing days.Conclusions It can be proved that honey dressing has an advantage over silver sulfadiazine dressing in the wound healing days within 21 and final outcome.Whether honey dressing is superior to silver sulfadiazine dressing in antibacterial effects and healing days remains to be studied with adequate,powerful,high quality randomized controlled trials.
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Objective To evaluate the incremental value of 131I SPECT/CT over 131I whole body scan (WBS) in the patients with DTC.Methods A total of 97 patients with DTC (31 males,66 females,mean age:44.1 years,age range:17 to 74 years) were retrospectively reviewed.All subjects underwent 131I WBS and SPECT/CT after 131I treatment.The images were interpreted by 2 experienced nuclear medicine physicians.The final diagnosis was based on the pathologic findings and clinical follow-up.The diagnostic accuracies between 131I WBS and 131I SPECT/CT were compared using x2 test with SPSS 13.0.Results 131I WBS detected 175 lesions (128 neck and 47 distant lesions),while 131I SPECT/CT found 176 lesions (128 neck and 48 distant lesions).Out of the 176 lesions,78 were confirmed as benign and 95 as malignant,including 51 lesions in thyroid bed,67 cervical lymph nodes or local residual lesions,7 lesions related to local physiological uptake,30 distant metastases and 18 distant foci due to physiological uptake.The other 3 lesions were still in follow-up.The sensitivity and specificity of 131 I WBS was 73.7％ (70/95) and 78.2％ (61/78),respectively.The accuracy of 131I WBS (106/173,61.3％) was lower than that of 131I SPECT/CT (171/173,98.8％; x2=72.3,P＜0.05).131I SPECT/CT corrected the diagnosis of 131I WBS in 67 lesions,including 37 local lesions (37/128,28.9％) and 30 (30/48,62.5％) distant metastases.The sources of error for the 67 lesions were due to wrong location (n =27) or wrong characterization (n =40).Compared with 131I WBS,131I SPECT/CT changed the location in 27 lesions,clinical staging in 8 cases and therapeutic strategy in 14 cases.Conclusions 131 I SPECT/CT could improve the differentiation of malignant local lesions from residual thyroid,of distant metastatic lymph node,lung or bone lesions from physiological uptake.Such incremental values would be valuable to the management of DTC patients compared with WBS.
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Prospective payment rates based on diagnosis related groups (DRGs)have been established as the basis of Medicare' s hospital reimbursement system.The purpose of the DRGs is to relate a hospital's case mix to the resource demands and associated costs experienced.The patient characteristics included in the definition of each DRG relate to a common organ system or etiology,and each DRG should contain patients,who are similar from a clinical perspective,with a similar pattern of resource intensity.DRGs were divided by principle diagnosis,major surgery,major complication and/or comorbidity,age,sex,birth weight etc.Using a grouping software(version 18)by DRG definitions used in the United Stated,we encoded the hospital discharge data of all secondary and senior hospitals in Beijing.After analyzing the DRG grouping,as well as rationality and weighting of these DRG groups,we concluded that it was feasible to encode Chinese data using US DRG definitions with specific adjustments accommodating to relevant conditions in China.
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Objective In order to provide information for the health administration and the price authorities to establish the reasonable price,the practical cost of special nursing of the chronic wound be analyzed,and be compared with the present charge,and the deviation be studied.Methods The cost of nursing care for all items was measured,recorded and collected,then calculating the special nursing cost for chronic wound using the method of ladder sharing the project cost.Rusults The true cost on a single special care for chronic wound was (29.42±9.29)yuan,and it reached 2.5 times of present charge ( 12 yuan).Conclusions The present charge on the special care for chronic wound was seriously deviated from the practical cost,and the labor value of special care of nurses could not be embodied.
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OBJECTIVE: To study the status quo and features of serious ADR case in our hospital in order to improve the rational use of drug. METHODS: A total of 215 cases of serious ADR collected in our hospital in 2008 were evaluated and analyzed statistically, according to causality of ADR criteria. RESULTS: Sex and age have nothing to do with serious ADR. The ADR were predominantly induced by antimicrobial drugs accounting for 28.21% (n=101), followed by antipyretic,analgesics and anti-inflammatory drugs and antirheumatic 12.85% (n=46) and TCM preparation 11.73% (n=42). Organs and systems involved in ADR were characterized by the damage of skin and its appendants (33.49%, n=73), followed by liver lesion in 70 cases (32.11%). 160 improved cases, 54 cured cases and 1 sequela cases were include in 215 cases of serious ADR reports. CONCLUSION: Several factors result in serious ADR,so rational use of drug should be enhanced to reduce and avoid occurrence of ADR and guarantee the safety and effectiveness of drug therapy.