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Assessing the association of appropriateness of coronary revascularization and 1-year clinical outcomes for patients with stable coronary artery disease in china

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Chinese Medical Journal 2020年第1期133卷 1-8页

作者： Shen Lin Heng Zhang Chen-Fei Rao Si-Peng Chen Shu-Bin Qiao Hong-Bing Yan Ke-Fei Dou Yong-Jian Wu Yi-Da Tang Xin-Chun Yang Zhu-Jun Shen Jian Liu Zhe Zheng National Clinical Research Center of Cardiovascular Diseases State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of Cardiovascular Surgery Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of information Center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of Cardiology Beijing Chao-Yang HospitalCapital Medical UniversityBeijing 100020China Department of Cardiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Cardiology Peking University People's HospitalBeijing 100044China.

Background:The Chinese appropriate use criteria(AUC)for coronary revascularization was released in 2016 to improve the use of coronary *** study aimed to evaluate the association between the appropriateness of coronary revascularization based on the Chinese AUC and 1-year outcomes in stable coronary artery disease(CAD)***:We conducted a prospective,multi-center cohort study of stable CAD patients with coronary lesion stenosis≥50%.After the classification of appropriateness based on Chinese AUC,patients were categorized into the coronary revascularization group or the medical therapy group based on treatment *** primary outcome was a composite of death,myocardial infarction,stroke,repeated revascularization,and ischemic symptoms with hospital ***:From August 2016 to August 2017,6085 patients were consecutively *** revascularization was associated with a lower adjusted hazard of 1-year major adverse cardiovascular and cerebrovascular events(MACCEs;hazard ratio[HR]:0.62;95%confidence interval[CI]:0.45-0.86;P=0.004)than medical therapy in patients with appropriate indications(n=1617).No significant benefit in 1-year MACCEs was found after revascularization compared to after medical therapy in patients with uncertain indications(n=2658,HR:0.81;95%CI:0.52-1.25;P=0.338)and inappropriate indications(n=1810,HR:0.80;95%CI:0.51-1.23;P=0.308).Conclusions:In patients with appropriate indications according to Chinese AUC,coronary revascularization was associated with significantly lower risk of MACCEs at 1 *** benefit was found in coronary revascularization in patients with inappropriate *** findings provide evidence for using Chinese AUC to guide clinical decision-making.

关键词： Stable coronary artery disease Appropriate use criteria Coronary revascularization

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中国肝癌筛查卫生经济学研究的系统评价

中国循证医学杂志 2018年第5期18卷 442-449页

作者：白方舟王乐王宇婷黄慧瑶刘成成朱娟任建松赵建军韩优莉曲春枫代敏石菊芳国家癌症中心/中国医学科学院北京协和医学院肿瘤医院癌症早诊早治办公室北京100021 国家癌症中心/中国医学科学院北京协和医学院肿瘤医院免疫学研究室/分子肿瘤学国家重点实验室北京100021 国家癌症中心/中国医学科学院北京协和医学院肿瘤医院肝胆外科北京100021 首都医科大学卫生管理与教育学院北京100069

目的系统评价中国人群肝癌筛查卫生经济学研究现状,为后续进一步开展相关研究提供依据。方法计算机检索Pub Med、EMbase、The Cochrane Library、Web of Science、CNKI、Wan Fang Data、CBM和VIP数据库,搜集我国人群肝癌筛查卫生经济学... 详细信息

目的系统评价中国人群肝癌筛查卫生经济学研究现状,为后续进一步开展相关研究提供依据。方法计算机检索Pub Med、EMbase、The Cochrane Library、Web of Science、CNKI、Wan Fang Data、CBM和VIP数据库,搜集我国人群肝癌筛查卫生经济学研究,检索时限均从建库至2017年12月31日。由2位研究者独立筛选文献、提取资料,对纳入研究基本特征、卫生经济学评价方法及主要结果等进行描述性分析,并对研究质量及报告规范性进行评价。结果共纳入5个研究。纳入研究的肝癌筛查起始年龄在35~45岁,筛查技术多选用甲胎蛋白(AFP)联合超声,频率以每半年1次居多。5个研究整体质量尚可;整体报告规范性尚可,得分中位数为78%(60%,78%)。2个研究报道了基于每检出1例肝癌的成本,分别为4.4万元和57.5万元。3个研究报道了基于挽救生命年(LYS)和质量调整生命年(QALY)的成本-效果比(CER)指标,仅1个中国内地研究报道了每挽救一个LYS的成本,为1 775元,其与当地人均国内生产总值(GDP)比值为0.1;另2个我国台湾地区的研究报道了4组筛查的成本-效果比,其与当地人均GDP比值范围为1.0~2.2。结论肝癌高发地区我国台湾地区研究提示在普通人群中开展肝癌筛查经济有效;而我国大陆研究提示在高危人群中开展AFP联合超声筛查经济有效,但仅有1个地区性研究支持,仍需更多基于随机对照试验或队列研究的卫生经济学评价予以验证。

关键词：肝癌筛查卫生经济学评价成本-效果分析系统评价中国

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中国碳封存项目的环境应急管理研究

环境工程 2018年第2期36卷 1-5页

作者：周颖蔡博峰曹丽斌王保登赵兴雷王永胜李琦马劲风胡丽莎环境保护部环境规划院气候变化与环境政策研究中心北京100012 北京低碳清洁能源研究所工艺工程研发中心北京102209 神华鄂尔多斯煤制油分公司内蒙古鄂尔多斯017209 中国科学院武汉岩土力学研究所岩土力学与工程国家重点实验室武汉430070 西北大学地质学系二氧化碳捕集与封存技术国家地方联合T程研究中心西安710069 中国地质调查局水文地质环境地质调查中心河北保定071051

碳封存是在当前条件下快速将大气中CO_2浓度控制在450 mg/L以下的一种重要减排方式。我国已经开展了多项示范项目,但当前的环境应急管理政策并不能对其进行有效监管。主要从信息上报制度、环境应急预案编制与备案制度、监测管理和资金... 详细信息

碳封存是在当前条件下快速将大气中CO_2浓度控制在450 mg/L以下的一种重要减排方式。我国已经开展了多项示范项目,但当前的环境应急管理政策并不能对其进行有效监管。主要从信息上报制度、环境应急预案编制与备案制度、监测管理和资金保障制度4方面进行分析,并针对碳封存项目环境应急管理的几个关键问题进行分析,提出了完善碳封存环境应急管理政策的相关建议。

关键词：指南环境应急碳封存政策

china Patient-centered Evaluative Assessment of Cardiac Events Prospective Study of Acute Myocardial Infarction： Study Design

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Chinese Medical Journal 2016年第1期129卷 72-80页

作者： Rachel P Dreyer Xi Li Xue Du Nicholas S Downing Li Li Hai-Bo Zhang Fang Feng Wen-Chi Guan Xiao Xu Shu-Xia Li Zhen-Qiu Lin Frederick A Masoudi John A Spertus Harlan M Krumholz Li-Xin Jiang National Clinical Research Center of Cardiovascular Diseases State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven Connecticut USA Section of Cardiovascular Medicine Department of Internal Medicine Yale School of Medicine New Haven Connecticut USA Department of Obstetrics Gynecology and Reproductive Sciences Yale School of Medicine New Haven Connecticut USA Division of Cardiology University of Colorado Anschutz Medical Campus Aurora Colorado USA Department of Biomedical and Health Informatics University of Missouri - Kansas City Kansas City Missouri USA Saint Luke's Mid America Heart Institute Kansas City Missouri USA The Robert Wood Johnson Foundation Clinical Scholars Program Department of Internal Medicine Yale School of Medicine New Haven Connecticut USA Department of Health Policy and Management Yale School of Public Health New Haven Connecticut USA

Background： Despite the rapid growth in the incidence of acute myocardial infarction （AMI） in china, there is limited information about patients＇ experiences after AMI hospitalization, especially on long-tern1 adverse events and patient-reported outcomes （PROs）. Methods： The china Patient-centered Evaluative Assessment of Cardiac Events （PEACE）-Prospective AMI Study will enroll 4000 consecutive AM I patients from 53 diverse hospitals across china and follow them longitudinally for 12 months to docunlent their treatment, recovery, and outcomes. Details of patients＇ medical history, treatment, and in-hospital outcomes are abstracted from medical charts. Comprehensive baseline interviews are being conducted to characterize patient demographics, risk factors, presentation, and healthcare utilization. As part of these interviews, validated instruments are administered to measure PROs, including quality of life, symptoms, mood, cognition, and sexual activity. Follow-up interviews, measuring PROs, medication adherence, risk factor control, and collecting hospitalization events are conducted at 1, 6, and 12 months after discharge. Supporting documents for potential outcomes are collected for adjudication by clinicians at the National Coordinating Center. Blood and urine samples are also obtained at baseline, 1 - and 12-month follow-up. In addition, we are conducting a survey of participating hospitals to characterize their organizational characteristics. Conclusion： The china PEACE-Prospective AMI study will be uniquely positioned to generate new information regarding patient＇s experiences and outcomes alter AMI in china and seiwe as a foundation for quality improveinent activities.

关键词： Acute Myocardial Infarction Outcomes Research Patient-reported Outcome Measures Prospective Cohort

北斗导航卫星星间／星地链路实时定轨中通道延迟估计方法

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测绘科学与工程 2018年第2期38卷 34-38页

作者：任夏朱俊杨宇飞信息程大学河南郑州450001 地理信息工程国家重点实验室陕西西安710054 宇航动力学国家重点实验室陕西西安710043 北京卫星导航中心北京100094

通道延迟的精确标定是影响卫星定轨结果的重要因素，本文重点研究基于扩展Kalman滤波（EKF）的星间／星地链路实时定轨中通道延迟参数的估计方法。理论分析表明，在现行星空构型下，滤波解算的通道延迟参数较位置、速度参数的收敛速度... 详细信息

通道延迟的精确标定是影响卫星定轨结果的重要因素，本文重点研究基于扩展Kalman滤波（EKF）的星间／星地链路实时定轨中通道延迟参数的估计方法。理论分析表明，在现行星空构型下，滤波解算的通道延迟参数较位置、速度参数的收敛速度更慢，主要啄因在于备历元的观测量和动力学模型对通道延迟参数的贡献相对较弱。因此，本文提出采用先验值在滤波中对通道延迟参数进行约束以提高该参数的收敛速度。北斗星间／星地链路定轨结果表明：对通道延迟参数进行先验约束后，可将通道延迟参数的收敛时间由24h缩短至2h主右，且卫星轨道精度提高约1．5m。

关键词：通道延迟星间链路星地链路扩展Kalman滤波批处理

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现代胸部战伤分级救治的专家共识

解放军医学杂志 2018年第1期43卷 901-909页

作者：宗兆文王志农陈思旭秦昊张连阳沈岳杨磊杜文琼陈灿钟鑫张琳霍江涛蒯丽萍舒丽芯杜国福赵玉峰无陆军军医大学陆军卫勤训练基地战救技能训练教研室创伤烧伤与复合伤国家重点实验室重庆400038 海军军医大学附属长征医院胸心外科上海200003 陆军军医大学附属大坪医院创伤外科重庆400042 白求恩医务士官学校特诊教研室石家庄050000 中国人民解放军军事医学科学院卫生勤务与医学情报研究所北京100850 海军军医大学药学院上海200433 中国医学救援协会创伤分会中华医学会创伤分会青年委员会全军灾难医学专业委员会及青年委员会重庆市中西医结合学会灾难医学分会

历次战争中,胸部战伤发生率占伤员总数的4.4%-33.0%,是战伤阵亡和伤死的重要原因,占所有可预防战伤伤亡原因的1%-3%。在近年美军主导的自由伊拉克行动(Operation Iraqi Freedom,OIF)和持久自由行动(Operation Enduring Freedom,OEF)中,... 详细信息

历次战争中,胸部战伤发生率占伤员总数的4.4%-33.0%,是战伤阵亡和伤死的重要原因,占所有可预防战伤伤亡原因的1%-3%。在近年美军主导的自由伊拉克行动(Operation Iraqi Freedom,OIF)和持久自由行动(Operation Enduring Freedom,OEF)中,胸部战伤呈现与既往战伤不同的流行病学特点和救治需求。

关键词：胸部伤分级救治专家共识

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