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71.
72.
目的 对生化汤加味促进剖宫产后子宫复旧的有效性与安全性进行系统评价,为其在临床应用提供循证医学证据。方法 检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方资源数据库(WanFang)、维普期刊数据库(VIP)、Cochrane Library、PubMed、Web of Science等,检索时限为建库至2020年7月,选择生化汤加味促进剖宫产后子宫复旧的随机对照试验(RCT),采用Cochrane系统评价员手册提供的偏倚风险评估工具进行文献质量评价,应用RevMan5.3软件进行Meta分析。结果 共纳入12篇RCT文献,共计1804例剖宫产产妇;Meta分析结果显示,生化汤加味联合缩宫素组在产后第1、3、5天子宫底高度[MD = -0.75,95%CI(-1.35, -0.15),P < 0.00001;MD = -1.92,95%CI(-3.13, -0.72),P < 0.00001;MD = -1.92,95%CI(-3.79, -0.06),P < 0.00001]低于单用缩宫素组,联合用药组血性恶露时间[MD = -1.52,95%CI(-2.71,-0.34),P < 0.00001]和产后恶露持续时间[MD = -4.47,95%CI(-6.20,-2.75),P < 0.00001]均短于单用缩宫素组。结论 生化汤加味联合缩宫素与单用缩宫素比较,更能促进产后子宫复旧;不良反应少,报道的仅有4例出现轻微腹泻,安全性较高;但由于纳入文献质量较低,上述结论尚需更多的随机对照临床研究加以证实。 相似文献
73.
目的 观察膝骨性关节炎患者穴位体表温度分布规律。方法 以256例膝骨性关节炎患者和256例健康受试者为观察对象。使用Fotric 226红外热像仪检测患者和健康受试者腧穴的温度值,每名患者每周固定时间检测1次,共检测4次,健康人检测1次,比较患者组与健康受试者组穴位温度值的差异,比较不同时间点不同部位、经脉温度值的差异。结果 膝骨性关节炎患者血海穴、鹤顶穴、梁丘穴、曲泉穴、内膝眼穴、犊鼻穴、委阳穴、阴陵泉穴、膝关穴、阳陵泉穴、大杼穴、悬钟穴、足三里穴、命门穴、腰阳关穴温度值高于健康受试者(P < 0.05);患者组胃经的4次皮温均较高(P < 0.05),腰背部的4次皮温均较高(P < 0.05);KOA相关腧穴4次温度值变化趋势不显著(P > 0.05)。结论 膝关节骨性关节炎患者部分腧穴皮温升高;膝骨性关节炎患者的穴位升温现象具有规律性,与经络、部位相关;膝关节骨性关节炎相关穴位升温效应具有稳定性。 相似文献
74.
Kishor Devalaraja-Narashimha Karoline Meagher Yifan Luo Cong Huang Theodore Kaplan Anantharaman Muthuswamy Gabor Halasz Sarah Casanova John OBrien Rebecca Peyser Boiarsky John McWhirter Hans Gartner Yu Bai Scott MacDonnell Chien Liu Ying Hu Adrianna Latuszek Yi Wei Srinivasa Prasad Tammy Huang George Yancopoulos Andrew Murphy William Olson Brian Zambrowicz Lynn Macdonald Lori G. Morton 《Journal of the American Society of Nephrology : JASN》2021,32(1):99
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Sen Yang Dongfang Tang Yu C. Zhao Hongliang Liu Sheng Luo Thomas E. Stinchcombe Carolyn Glass Li Su Sipeng Shen David C. Christiani Qiming Wang Qingyi Wei 《International journal of cancer. Journal international du cancer》2020,147(2):392-403
The endosome is a membrane-bound organ inside most eukaryotic cells, playing an important role in adaptive immunity by delivering endocytosed antigens to both MHC class I and II pathways. Here, by analyzing genotyping data from two published genome-wide association studies (GWASs), we evaluated associations between genetic variants in the endosome-related gene-set and survival of patients with nonsmall cell lung cancer (NSCLC). The discovery included 44,112 (3,478 genotyped and 40,634 imputed) single-nucleotide polymorphisms (SNPs) in 220 genes in a singlelocus analysis for their associations with survival of 1,185 NSCLC patients from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. After validation of the 821 survival-associated significant SNPs in additional 984 NSCLC patients from the Harvard Lung Cancer Susceptibility Study, 14 SNPs remained significant. The final multivariate stepwise Cox proportional hazards regression modeling of the PLCO dataset identified three potentially functional and independent SNPs (i.e., KIF16B rs1555195 C>T, NEDD4L rs11660748 A>G and rs73440898 A>G) with an adjusted hazards ratio (HR) of 0.86 (95% confidence interval [CI] = 0.79–0.94, p = 0.0007), 1.31 (1.16–1.47, p = 6.0 × 10−5) and 1.27 (1.12–1.44, p = 0.0001) for overall survival (OS), respectively. Combined analysis of the adverse genotypes of these three SNPs revealed a trend in the genotype-survival association (ptrend < 0.0001 for OS and ptrend < 0.0001 for disease-specific survival). Furthermore, the survival-associated KIF16B rs1555195T allele was significantly associated with decreased mRNA expression levels of KIF16B in both lung tissues and blood cells. Therefore, genetic variants of the endosome-related genes may be biomarker for NSCLC survival, possibly through modulating the expression of corresponding genes. 相似文献
78.
Juhua Luo Xiwei Chen JoAnn E. Manson Aladdin H. Shadyab Jean Wactawski-Wende Mara Vitolins Thomas E. Rohan Ting-Yuan D. Cheng Zhenzhen Zhang Lihong Qi Michael Hendryx 《International journal of cancer. Journal international du cancer》2020,147(1):65-75
Breast cancer has been suggested to potentially have prenatal origins. We examined associations between birth weight, body mass index (BMI) at four-time points over 25 years of adulthood, and risk of postmenopausal breast cancer, with emphasis on whether the association between birth weight and risk of breast cancer was mediated by weight and height changes over the adult life course. Postmenopausal women (n = 70,397) aged 50–79 years without breast cancer at enrollment (1993–1998) were followed up to 25 years. Weight and height were measured at baseline. Birth weight, and weights at ages 18, 35 and 50 were self-reported. Breast cancer cases were centrally adjudicated. Compared to women with birth weight of 6–8 pounds, women with birth weight of <6 pounds had lower risk of breast cancer (HR = 0.88 95% CI: 0.79–0.99). 44% and 21% of the relationship between birth weight and breast cancer risk was mediated by adult height and weight at baseline, respectively. Birth weight of 8 pounds or more was not associated with risk of postmenopausal breast cancer. Weight gain in adulthood was associated with increased risk of breast cancer regardless of time periods. In conclusion, lower birthweight was associated with lower risk of postmenopausal breast cancer, and this reduction in risk was significantly mediated by childhood or adolescent growth, especially by adult height. Our data suggest that reaching and maintaining a healthy weight during adulthood is key in the prevention of breast cancer. 相似文献
79.
目的总结分析胃癌D2根治术后发生大出血的原因及治疗方法并探讨其对生存预后的影响。方法回顾性分析广东省中医院2012年1月至2016年3月258例行胃癌D2根治术患者的临床资料,根据术后是否发生大出血分为出血组和非出血组。结果14例患者(5.4%)术后发生大出血;吻合口出血、十二指肠残端瘘或破裂是出血的主要原因;二次手术和胃镜止血是主要治疗措施。两组的短期总生存期有统计学意义(1年:P=0.017,3年:P=0.011)。结论吻合口出血、十二指肠残端瘘或破裂是胃癌D2根治术后出血的主要原因,及时诊断和治疗能有效降低病死率。胃癌D2根治术后大出血会降低患者的短期总生存期。 相似文献
80.
Xiuhua Weng Shaohong Luo Shen Lin Lixian Zhong Meiyue Li Rao Xin Pinfang Huang Xiongwei Xu 《Oncology research》2020,28(2):117-125
To evaluate the cost–utility of pembrolizumab versus chemotherapy as the first-line setting for metastatic nonsmall cell lung cancer (NSCLC) from the US health care system perspective, a Markov model was developed
to compare the lifetime cost and effectiveness of pembrolizumab versus chemotherapy for untreated metastatic NSCLC, based on the clinical data derived from phase III randomized controlled trial (KEYNOTE-
042; ClinicalTrials.gov; NCT02220894). Weibull distribution was fitted to simulate the parametric survival
functions. Drug costs were collected from official websites, and utility values were obtained from published literature. Total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios
(ICERs) were computed as primary output indicators. The impact of different PD-L1 expression levels
on ICER was also evaluated. One-way and probabilistic sensitivity analyses were performed to assess the
model uncertainty. Compared with chemotherapy, patients treated with pembrolizumab provided an additional 1.13, 1.01, and 0.59 QALYs in patients with PD-L1 expression levels of ≥50%, ≥20%, and ≥1%,
with corresponding incremental cost of $53,784, $47,479, and $39,827, respectively. The resultant ICERs
of pembrolizumab versus chemotherapy were $47,596, $47,184, and $68,061/QALY, in three expression
levels of PD-L1, respectively, all of which did not exceed the WTP threshold of 180,000/QALY. Probability
sensitivity analysis outcome supported that pembrolizumab exhibited evident advantage over chemotherapy
to be cost-effective. One-way sensitivity analysis found that ICERs were most sensitive to utility value of
pembrolizumab in progression survival state. All the adjustment of parameters did not qualitatively change
the result. For treatment-naive, metastatic NSCLC patients with PD-L1+, pembrolizumab was estimated
to be cost-effective compared with chemotherapy for all PD-L1 expression levels at a WTP threshold of
$180,000/QALY in the context of the US health care system. 相似文献