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.
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.
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.
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.
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.
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 relationship between smoking and lung cancer by evidence-based evaluation. Methods Using Meta-analysis method, the results of 29 case-control studies involving the relationship between smoking and lung cancer in recent decade were analyzed by Review Manager 4. 2 software. Results The association between smoking and lung cancer was significant ( Z =12. 16, P lt; 0. 000 01) , and the pooled OR value was 5. 75( 4. 34, 7. 62) . The population attributable risk percentage( PARP) of smoking was 69. 16% . The pooled OR of 1-10 cpd( cigarettes per day) , 10-20 cpd, 20-40 cpd and more than 40 cpd were 1. 97( 1. 69, 2. 30) , 5. 20( 3. 54, 7. 62) , 7. 46( 5. 22, 10. 67) and 15. 14 ( 5. 27, 43. 44) respectively. The pooled OR of less than 20 years of smoking duration, 20-40 years and more than 40 years were 1. 25( 1. 01, 1. 53) , 5. 10( 3. 03, 8. 57) and 10. 77( 7. 30, 15. 89) respectively. While the pooled ORof less than 10 pack-years, 10-20 pack-years, 20-40 pack-years and more than 40 pack-years were 1. 73( 1. 01, 2. 96) , 3. 73 ( 3. 02, 4. 61) , 5. 69 ( 3. 79, 8. 54) and 8. 41 ( 4. 56, 15. 51) respectively. The pooled OR of initial smoking age less than 15 years old, 15-20 years old and more than 20 years old were 13. 31( 7. 09, 24. 97) , 7. 21( 4. 51, 11. 52) and 4. 74( 3. 47, 6. 47) respectively. The pooled OR of quitting smoking for 1-10 years, 10-20 years and more than 20 years were 7. 16( 4. 70, 10. 91) , 2. 12( 1. 16, 3. 86)and 1. 47 ( 0. 67, 3. 20 ) respectively, and more than 20 years of quitting smoking had no significant difference. The pooled OR of light smoking and deep smoking were 3. 26( 1. 24, 8. 58) and 8. 07( 4. 67, 13. 94) respectively. Conclusions Smoking is an important risk factor of lung cancer. Meta-anlalysis revealed cigarettes comsuption per day, smoking duration, total amount of cigarettes ( pack-years) , smoking behaviour( depth) , initial age of smoking and duration of quitting smoking can increase the risk of lung cancer.
Objective To assess the quality of diagnostic studies on detecting the tuberculosis antibody to diagnose tuberculosis.Methods CBM (1978 to 2006) and VIP (1994 to 2006) were searched; any author-claimed diagnostic studies which used the dot immunogold filtration assay (DIGFA) to detect the tuberculosis antibody and to diagnose tuberculosis were included. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) was used to assess the quality of included diagnostic studies by two reviewers independently.Results Thirty-eight papers were included and assessed. We found that most of the quality items were not met with QUADAS. Most papers adopted the retrospective diagnostic case-control design. Thirty-one papers did not describe the selection criteria clearly, 18 did not describe whether all the included patients were verified by using a reference standard of diagnosis, 36 did not describe whether the index test results were interpreted without knowledge of the results of the reference standard, 37 did not report the uninterpretable/intermediate test results, and 34 did not report the withdrawals from the study.Conclusion There are few high quality studies on using DIGFA to detect tuberculosis antibody to diagnose tuberculosis.
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.