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目的 基于临床信息系统分析总结真实世界的数据,采用数据挖掘的方法探讨中医药治疗糖尿病肾病的用药规律。方法 收集2018年1月-2020年12月上海中医药大学附属曙光医院宝山分院健康信息系统确诊的糖尿病肾病的门诊或住院患者的诊疗信息,建立Excel数据库,采用Excel 2010软件统计高频药物的四气、五味、归经及功效;使用SPSS Modeler 18.0软件中的Apriori算法分析关联规则,采用web节点建构药对关联网状图;运用SPSS 25统计软件进行因子分析。结果 本研究最终纳入477例接受中药饮片治疗的DKD患者,在1203条方剂信息中,涉及中药462种;使用频数排名前5位的中药分别是黄芪、黄精、石斛、山茱萸、麦冬;使用频数前5类的中药类别分别是补气药、补阴药、清热燥湿药、活血调经药、息风止痉药;在30味高频药物中,苦、甘、辛药味最为常见;药性寒、温数量接近;归脾经、肝经、肺经、肾经居多;关联规则提示,药物组合中置信度最高的组合为地龙-当归-僵蚕,因子分析共得到5个有效因子,累积贡献率为47.33%。结论 中医药治疗DKD在补益气血阴阳的同时,兼顾对瘀血、湿邪和痰饮的治疗,结合证型,可考虑使用黄芪、黄精、石斛、山茱萸、麦冬、金蝉花等药物的使用,清热燥湿药物如黄连、黄芩、黄柏可适当加入,为使邪有去处,大黄、车前子或可增添疗效。 相似文献
3.
《Archivos de bronconeumología》2022,58(5):406-411
IntroductionLung cancer (LC) is usually diagnosed at advanced stages with only a 12% 5-year survival. Trials as NLST and NELSON show a mortality decrease, which justifies implementation of lung cancer screening in risk population. Our objective was to show survival results of the largest LC screening program in Spain with low dosage computed tomography (LDCT).MethodsClinical records from International Early Lung Cancer Detection Program (IELCAP) at Valencia, Spain were analysed. This program recruited volunteers, ever-smokers aged 40-80 years, since 2008. Results are compared to those from other similar sizeable programs.ResultsA total of 8278 participants were screened with at least two-rounds until November 2020. A mean of 6 annual screening rounds were performed. We detected 239 tumours along 12-year follow-up. Adenocarcinoma was the most common histology, being 61.3% at stage I. The lung cancer prevalence and incidence proportion was 1.5% and 1.4%, respectively with an annual detection rate of 0.17. One-year survival and 10-year survival were 90% and 80.1%, respectively. Adherence was 96.84%.ConclusionLargest lung cancer screening in Spain shows that survival is improved when is performed in multidisciplinary team experienced in management of LC, and is comparable to similar screening programs. 相似文献
4.
IntroductionThis study was designed to assess whether a dental caries management protocol combining a single application of 38% silver diamine fluoride (SDF) with comprehensive oral health education will successfully divert high-risk children from dental treatment under dental general anaesthesia (DGA), arrest active caries in primary teeth, and improve parent-reported child oral health–related quality of life (OHRQoL).MethodsChildren aged 2 to 10 years, who attended two public dental agencies in Victoria, Australia, and were unable to tolerate restorative treatments in the clinic setting, elected to participate in either a 38% SDF intervention protocol or, alternatively, referral for DGA. Follow-up examinations were completed at 6 months to assess caries progression, decayed missing filled tooth index, PUFA index (pulpal involvement, ulceration, fistula, abscess), DGA referral rates, and OHRQoL (Early Childhood Oral Health Impact Scale [ECOHIS]).ResultsOf the total sample, 89.5% of children (n = 102) [mean (SD) age, 4.1 (1.0) years] with 401 active carious lesions elected to participate in the 38% SDF protocol; 10.5% (n = 12) of parents opted for referral for treatment under DGA. The proportion of active caries subsequently arrested at follow-up (number of arrested lesions/number of lesions treated) was 0.78 (95% CI, 0.69 to 0.87). There was an 88% reduction in referrals for DGA in eligible children over the 6-month period. The 38% SDF intervention group showed a significant improvement in ECOHIS scores at follow-up (P < .001).DiscussionAdoption of the 38% SDF intervention protocol resulted in a significant reduction in the rate of preventable dental hospitalisations. Most parents opted against referral for DGA. Parent-reported OHRQoL for children improved significantly. 相似文献
5.
Omar Abdel-Rahman 《Clinical genitourinary cancer》2019,17(2):e329-e338
Background
The objective of the study was to evaluate the outcomes of clinically localized prostate cancer treated with prostatectomy versus radiation therapy within the context of a prospective prostate cancer screening study.Patients and Methods
Within the PLCO (Prostate, Lung, Colorectal, and Ovary) trial, patients who were diagnosed with clinically localized prostate cancer and subsequently received treatment with prostatectomy or radiation therapy (with or without hormonal treatment) were included. Univariate and multivariate Cox regression analyses were then performed to determine factors affecting overall and prostate cancer-specific survival. Factors with P < .05 in univariate analysis were included in the multivariate analysis.Results
A total of 3953 patients were included in the current analysis. These included 2044 patients treated with prostatectomy and 1909 patients treated with radiation therapy with or without hormonal treatment. In an adjusted multivariate analysis for factors affecting overall survival, prostatectomy was associated with better overall survival compared with radiation therapy (hazard ratio, 0.548; 95% confidence interval [CI], 0.440- 681; P < .001). Likewise, in an adjusted multivariate analysis for factors affecting prostate cancer-specific survival, prostatectomy was associated with better prostate cancer-specific survival compared with radiation therapy (hazard ratio, 0.485; 95% CI, 0.286- 0.822; P = .007). Similar findings were found with propensity score matching and repeating the same analyses on the post-matching cohort.Conclusion
Prostatectomy seems to predict better overall and prostate cancer-specific survival compared with radiation therapy among patients with clinically localized prostate cancer diagnosed within the PLCO trial. 相似文献6.
目的分析妊娠早期阴道微环境变化及与阴道炎症的关系。方法回顾性分析2017年3月-2018年12月韶关市曲江区妇幼保健计划生育服务中心104例妊娠早期孕产妇临床资料。记录其非妊娠期及妊娠早期阴道微环境变化情况,包括酸碱度(pH)、菌群密集度、菌群多样性、阴道微生物功能正常率、乳杆菌阳性率、阴道微生态正常率,并比较妊娠早期阴道炎症发生情况及其阴道微环境。结果孕产妇非妊娠期pH、阴道微生物功能正常率、乳杆菌阳性率及阴道微生态正常率明显高于妊娠早期,菌群密集度、菌群多样性则低于妊娠早期,差异均有统计学意义(P<0.05)。孕产妇妊娠早期阴道炎症组pH、菌群密集度、菌群多样性明显高于无阴道炎症组,阴道微生物功能正常率及乳杆菌阳性率则低于无阴道炎症组,差异均有统计学意义(P<0.05)。结论妊娠早期阴道微环境出现一系列变化,造成阴道炎症发生率升高,对此临床应给予重视。 相似文献
7.
Susumu Shibasaki Koichi Suda Masaya Nakauchi Kenichi Nakamura Kenji Kikuchi Kazuki Inaba Ichiro Uyama 《World journal of gastroenterology : WJG》2020,26(11):1172-1184
BACKGROUND Minimally invasive surgery for gastric cancer(GC) has gained widespread use as a safe curative procedure especially for early GC.AIM To determine risk factors for postoperative complications after minimally invasive gastrectomy for GC.METHODS Between January 2009 and June 2019, 1716 consecutive patients were referred to our division for primary GC. Among them, 1401 patients who were diagnosed with both clinical and pathological Stage Ⅲ or lower GC and underwent robotic gastrectomy(RG) or laparoscopic gastrectomy(LG) were enrolled. Retrospective chart review and multivariate analysis were performed for identifying risk factors for postoperative morbidity.RESULTS Morbidity following minimally invasive gastrectomy was observed in 7.5% of the patients. Multivariate analyses demonstrated that non-robotic minimally invasive surgery, male gender, and an operative time of ≥ 360 min were significant independent risk factors for morbidity. Therefore, morbidity was compared between RG and LG. Accordingly, propensity-matched cohort analysis revealed that the RG group had significantly fewer intra-abdominal infectious complications than the LG group(2.5% vs 5.9%, respectively; P = 0.038), while no significant differences were noted for other local or systemic complications.Multivariate analyses of the propensity-matched cohort revealed that non-robotic minimally invasive surgery [odds ratio = 2.463(1.070–5.682); P = 0.034] was a significant independent risk factor for intra-abdominal infectious complications.CONCLUSION The findings showed that robotic surgery might improve short-term outcomes following minimally invasive radical gastrectomy by reducing intra-abdominal infectious complications. 相似文献
8.
观察并评估角膜电刺激对糖尿病大鼠前部缺血性视神经病变(AION)模型的影响。方法:实验 研究。健康雄性Sparague-Dawley大鼠40只,随机分组后抽出8只作为正常大鼠组。余下32只先予 以链脲佐菌素腹腔注射建立糖尿病大鼠模型,将造模成功的大鼠随机抽出8只作为糖尿病组,余下 24只糖尿病大鼠采用孟加拉玫瑰红联合532 nm激光方法建立AION大鼠模型。将24只造模成功的 AION大鼠随机分成3组,每组8只,分别为AION模型组,不予任何处理;电刺激组,予以角膜电刺 激(刺激参数为:电流1 mA,频率20 Hz,波宽1 ms/phase,刺激时间1 h,隔日1次,刺激2周);假电 刺激组,电极安放位置与电刺激组相同,仅不接通电源。2周后5组大鼠进行眼底照相、光学相干断 层扫描和视觉诱发电位,然后处死,行视网膜及视神经冰冻切片,苏木精伊红染色观察。数据采用 单因素方差分析和LSD-t检验进行分析。结果:正常大鼠组视盘上半部视网膜厚度为(211±13)μm, 糖尿病大鼠组为(206±16)μm,AION模型组为(240±54)μm,假电刺激组为(216±11)μm,电刺 激组为(198±4)μm,5组视盘上半部视网膜厚度差异有统计学意义(F=2.854,P=0.038)。其中AION 模型组视盘上半部视网膜厚度高于正常组、糖尿病组、电刺激组,差异均有统计学意义(P<0.05); 正常组与糖尿病组差异无统计学意义,AION模型组与假电刺激组未见明显差异。视觉诱发电位示 AION模型组N1潜伏期较电刺激组延长,差异有统计学意义(t=4.1,P<0.001);AION模型组P1潜伏 期较正常组、糖尿病组、假电刺激组、电刺激组延长,差异均有统计学意义(t=4.1、2.5、2.6、3.2, P<0.05);电刺激组N1-P1波幅大于假电刺激组,差异有统计学意义(t=4.0,P<0.001)。结论:角膜电 刺激能促进糖尿病大鼠前部缺血性视神经病变模型肿胀的视盘变薄,加速视盘水肿的消退,同时在 一定程度上改善视功能。 相似文献
9.
声带运动障碍的病因和临床表现复杂多变,涉及多学科,从病因上分为神经源性和非神经源性。对于神经源性声带运动障碍的诊治,首先通过喉镜等检查明确有无声带运动障碍及严重程度,值得注意的是声带纵向张力变化障碍也属于运动障碍的范畴;然后采用喉肌电图(LEMG)检查进行定性分析,在确诊神经源性损伤后,进一步对神经损伤部位进行定位诊断并查找导致神经损伤的病因;同时根据喉部神经电生理评估结果,判断预后。最后综合上述的评估结果制定相应的治疗策略。 相似文献
10.
目的 评价碳离子和质子治疗胰腺癌(PaC)的安全性和有效性。方法 检索数据库纳入碳离子和质子治疗PaC的临床研究,检索时间为自建库至2019年6月。两位研究者独立筛选文献、提取资料。采用STATA 12.0和MetaAnalyst Beta 3.13软件进行Meta分析。结果 共纳入8篇文献,包含459例PaC患者。效应模型Meta分析显示,碳离子和质子治疗PaC的2、3、5级胃肠道溃疡发生率分别为7%、2%、0;2、3、4级厌食症发生率分别为6%、3%、0;1、2年总生存率(OS)分别为77%、45%;2年局部控制率为81%;1年无局部进展率为88%;1年局部复发率为15%。碳离子和质子治疗PaC的2、3、2~3级胃肠道溃疡发生率分别为6.8%、1.5%、9.2%和3.5%、8.3%、6.1%(均P>0.05);1、2年OS分别为77.1%、44.4%和77.6%、49.7%(P均>0.05)。结论 碳离子和质子治疗PaC安全有效,两者的安全性和有效性相似。 相似文献