Health technological innovation has helped to improve health care delivery and patient outcomes. However, the proliferation of health care technology has accompanied burgeoning health care costs and evoked social, ethical, legal, and political concerns. Health technology assessment (HTA) is the systematic evaluation of properties, effects and/or other impacts of health care technology. The main purpose of HTA is to inform persons of technology-related policy making in health care. There is great variation in the scope, selection of methods and level of detail in the practice of HTA. This paper will introduce the basic concepts and methods of HTA in order to help those who are interested in conducting HTA.
Random allocation to intervention groups remains the best method of ensuring that the groups being compared are similar at the onset of study and of avoiding removing selection bias between groups of patients. The success of randomization depends on two interrelated processes. First, an unpredictable allocation sequence must be generated based on a random procedure. Second, strict implementation of that sequence must be secured through an assignment mechanism called allocation concealment to prevent those involved in a trial from knowing upcoming assignments. Inadequate allocation concealment can lead to clinicians scheduling patient’s assignment and compromising the unpredictable allocation sequence.
This article illustrates the development, current status and future prospects of knowledge translation. Its importance and necessity are introduced and some measurements or approaches to promote knowledge translation are discussed.
Interstitial lung disease is the most common pulmonary complication in patients with inflammatory myopathy, with a high case fatality rate, unknown pathogenesis, and complex clinical manifestations, and the treatment is difficult. Early and timely treatment can improve the patient’s clinical symptoms and inhibit the development of the disease. The present treatment protocols can be mainly summarized as the commonly used drugs (corticosteroids, azathioprine, cyclophosphamide, mycophenolate mofetil, and intravenous immunoglobulin) and new drugs (cyclosporin A, tacrolimus, biological agents, and anti-fibrosis drug), etc. In this paper, the treatment progress of inflammatory myopathy-related interstitial lung disease and different myositis antibody-related interstitial lung disease in recent years at home and abroad is reviewed, so as to provide a basis for clinical treatment.
Objective To investigate the application and advancement of hepatocyte t ransplantation ( HCT) .Methods Literatures about the advancement of HCT were reviewed and analyzed. Results There have been manynovel technologies and advancement s in the application of HCT. For example , gene modified cell can be used as seedcell , subcutaneous t ransplantation can be taken when combined with giant molecule material and the encap sulationpreconditioning technique can also carried before operation to improve the rate of survival. Conclusion With moreand deeper understanding of hepatocyte t ransplantation and the development of advanced techniques such as the application of giant molecule , HCT will be extensively used in the clinical t reatment of acute and chronic hepatic diseases.
Bone tumor surgery involves tumor resection and subsequent reconstruction. With the development of surgical technique and new material, there is a great step toward bone and joint reconstruction in bone tumor surgery. Generally speaking, there are two major reconstructive methods including bio-reconstruction and mechanical reconstruction. In addition, three-dimensional printed prosthesis has been widely applied in the field of bone tumor surgery. The short-term result is encouraged; however, long-term results and related complications are seldom reported.
Objective To investigate the impact of bone marrow mesenchymal stem cell transplantation on a rat model of experimental autoimmune uveitis (EAU) and analyze its immune regulatory mechanisms in vivo.Methods Eighteen Lewis rats were randomly divided into three groups: model control group, intervention group and normal control group, six animals in each group. Human retinal S-antigen peptide (HS-AgP35, 1 mg/ml) was mixed and emulsified with complete Freundprime;s adjuvant and injected into hind foot pad of rats on the first and eighth day to establish the animal model of EAU. For bone marrow mesenchymal stem cell transplantation, 1 ml of cell suspension (2times;106 cells/ml) was injected into tail vein of the intervention group rats on the first day when the emulsified S-antigen was injected. EAU manifestation, pathological change and IFN-gamma; level were evaluated and compared among those three groups after two weeks. Results No abnormal signs were found in the eyes of rats in normal control group. The manifestation grading of the intervention group (two rats at grade 0, three rats at grade 0.5, one rat at grade one) was significantly different from the model control group (one rat at grade one, one rat at grade two, three rats at grade three, one rat at grade four) (P=0.015). The retina of rats in normal control group was ordinary under light microscope. The histopathologrical grading of the intervention group (one rat at grade 0, four rats at grade 0.5,one rat at grade one) and the model control group (four rats at grade three, two rats at grade four) was also statistically different (P＜0.01). Furthermore, the IFN-gamma; level in peripheral blood of the intervention group rats declined significantly compared to the model control group (t=9.0574, P=0.01). Conclusions Bone marrow mesenchymal stem cells can inhibit EAU significantly, possibly by lowering the level of IFN－gamma;, thereby reduce the severity of uveitis and improve the condition of uveitis in rats.
Objective To investigate the mass casualty triage system and its application, to provide evidence and advice for its future standardized use. Method Based on the principles and methods of systematic reviews, we searched MEDLINE (1950 to 2008), The Cochrane library (Issue 2, 2008) and CBM (from establishment to May 2008) to identify papers written in English of Chinese which described mass casualty triage systems or triage systems specific to the aftermath of earthquakes. We extracted information on name, grades, criteria, main characteristics and application of each triage system from the papers involving mass casualty triage systems. We also extracted information on setting, personnel performing the triage, grades, and characteristics from those papers describing any specific triage system for earthquake. We compared the colour of tags, codes and other materials used in different triage systems. Result We included 38 English and 6 Chinese papers. For mass casualty triage systems, we identified 7 primary triage methods with 4 grades.Three of these had relevant application reports. There were 6 secondary triage methods with 3-5 grades, and none had relevant application reports. Four tag methods were identified. Seven papers, 2 of which were published in China, reported specific secondary triage methods for earthquakes. Conclusion Based on the current evidence, there is no universally accepted mass casualty triage system with documented reliability and validity. No triage system has been developed specifically for the wounded in earthquakes. There are large differences between the triage methods for earthquake and other mass casualty incidents. Future research should focus on the development of a reliable and valid mass casualty triage system, aimed at maximizing the capacity for medical rescue.
Objective To explore the influencing factors and improving measures of hand hygiene among healthcare workers. Methods From June to August 2016, several healthcare workers from clinical departments and nosocomial infection control department in Chengdu were selected by purposive sampling method. Data was collected by individual in-depth interviews, and was three-rank coded by Nvivo 8 software based on Grounded Theory. Results After three-rank coding, 6 important influencing factors were generalized which were re-categorized into 3 levels: personal cognition, behavior capacity and social support. At the last, the whole framework of the theory was constructed through core coding. Conclusion In clinical practice, we should take reasonable measures to strengthen the training of hand hygiene, improve the hand hygiene facilities, strengthen supervision and management, and effectively improve the implementation rate of hand hygiene.
Features and interaction between features of liver disease is of great significance for the classification of liver disease. Based on least absolute shrinkage and selection operator (LASSO) and interaction LASSO, the generalized interaction LASSO model is proposed in this paper for liver disease classification and compared with other methods. Firstly, the generalized interaction logistic classification model was constructed and the LASSO penalty constraints were added to the interactive model parameters. Then the model parameters were solved by an efficient alternating directions method of multipliers (ADMM) algorithm. The solutions of model parameters were sparse. Finally, the test samples were fed to the model and the classification results were obtained by the largest statistical probability. The experimental results of liver disorder dataset and India liver dataset obtained by the proposed methods showed that the coefficients of interaction features of the model were not zero, indicating that interaction features were contributive to classification. The accuracy of the generalized interaction LASSO method is better than that of the interaction LASSO method, and it is also better than that of traditional pattern recognition methods. The generalized interaction LASSO method can also be popularized to other disease classification areas.