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1.
2.
myPKFiT是药代动力学(pharmacokinetic,PK)指导下的A型血友病管理工具,能够快速准确地输出患者PK参数和给药方案供临床参考。目前血友病A的标准治疗手段为预防治疗,然而由于个体间差异的影响,仅以体重为参考来计算凝血因子Ⅷ(FⅧ)的用量,并不能满足血友病A患者的个体化治疗需求。PK参数可以协助临床医生更好地制订个体化治疗方案,从而改善血友病患者的治疗效果和生活质量。本文将对应用myPKFiT解析PK指导血友病A患者个体化用药的进展进行概述。  相似文献   
3.
目的分析前列腺癌根治术患者采用围术期康复干预对尿失禁的预防效果。方法 42例行前列腺癌根治术的患者,随机分为研究组与对照组,每组21例。对照组患者给予常规干预,研究组患者采取围术期康复干预。对比两组患者的尿失禁发生率,下尿路症状改善情况,生活质量。结果研究组患者的尿失禁发病率14.29%明显低于对照组的47.62%,差异具有统计学意义(P<0.05)。干预后,两组患者的下尿路症状评估量表(LUTS)评分均低于本组干预前,且研究组患者的LUTS评分(10.25±2.02)分明显低于对照组的(15.63±2.59)分,差异具有统计学意义(P<0.05)。研究组患者的生理功能、情感职能、社会功能、总体健康评分分别为(75.14±4.28)、(76.67±4.31)、(74.98±4.25)、(75.87±4.26)分,均高于对照组的67.21±4.35)、(68.22±4.39)、(66.58±4.37)、(68.01±4.36)分,差异具有统计学意义(P<0.05)。结论前列腺癌根治术患者采用围术期康复干预可以有效降低术后并发症发生率,改善患者临床症状,提高患者生活质量,效果显著,值得在临床上进一步推广应用。  相似文献   
4.
孕妇感染新型冠状病毒(简称新冠病毒)后易发生重型或危重型肺炎,增加不良妊娠和分娩结局,因此孕妇是预防新冠病毒感染的重点人群。研究证实,孕妇接种新冠病毒疫苗后能有效预防新冠病毒感染,未出现不良事件增多。结合我国实际情况,本专家建议提出妊娠不是接种新冠病毒疫苗(尤其是灭活疫苗)的禁忌证。在存在感染新冠病毒风险的情况下,建议按程序接种新冠病毒疫苗,孕早、中、晚期均可接种。备孕或哺乳期妇女亦可按常规接种新冠病毒疫苗,接种疫苗后可正常哺乳。  相似文献   
5.
目的 系统评价PBL教学模式对预防医学生课程教学效果的影响。方法 检索PubMed、CNKI、WanFang Data、CBM和VIP数据库,搜集PBL应用于预防医学生教学的RCT研究,采用R软件(3.6.2版本)进行Meta分析。结果 共纳入23篇文献,包括2 108例研究对象。Meta分析结果显示,PBL组预防医学生的理论成绩[ SMD =1.13,95% CI (0.65,1.60)]、实践操作成绩 [ SMD =1.27,95% CI (0.91,1.63)]、教学满意度[ RR =1.33,95% CI (1.17,1.52)]、学习兴趣[ RR =1.61,95% CI (1.37,1.89)]、自主学习能力 [ RR =1.63, 95% CI (1.39,1.92)]、团队协作能力[ RR =2.11,95% CI (1.54,2.89)]、解决问题能力[ RR =1.58,95% CI (1.36,1.83)]均显著优于LBL组。亚组分析结果显示PBL联合教学组预防医学生的理论成绩[ SMD =1.27,95% CI (0.46,2.09)]、实践操作成绩[ SMD =1.39,95% CI (0.82,1.96)]、团队协作能力[ RR =2.27,95% CI (1.41,3.64)]均优于单独使用PBL组,PBL在毒理学课程中对提高预防医学生的理论成绩[ SMD =1.44,95% CI (1.10,1.79)]和实践操作成绩[ SMD =1.16,95% CI (0.74,1.59)]效果均较为显著。结论 PBL对预防医学生的教学效果具有显著影响;PBL联合教学比单独使用PBL的教学效果更显著;未来需纳入更多严谨的试验设计来验证其应用效果。  相似文献   
6.
刘杰  张春铜  刘葛  董悦  卫丽琴 《安徽医药》2022,26(10):2111-2116
目的分析静脉用药调配中心用药错误( medication error,ME)的发生情况及特点,提出防范用药错误、保障病人用药安全的策略。方法统计 2018年 1月至 2020年 10月淮南朝阳医院静脉用药调配中心发生的 ME,采用回顾性分析和描述性统计方法,分析 ME的分级、错误内容、引发因素、引发人员、发现人员以及错误涉及药物等。结果共收集到 690例 ME,除 2例为 C级 ME外,其余 688例均为 B级 ME。ME的错误内容中,处方错误发生率最高,其次为核对错误和摆药错误。 ME的引发因素中,以知识欠缺、培训不足和责任心不足为主。 ME的引发人员以医师为主。 ME处方错误中涉及药物以抗微生物类药物、心血管系统药物和消化系统药物为主,这三类药 ME的发生各有其特点; ME处方错误中部分药物呈现错误形式单一的情况。结论该院应加强医师的专业技能培训,静配中心药师医嘱审核应重点关注药物浓度、溶媒和用量,静配中心工作人员责任心亟需加强,应构建精细化、信息化安全用药管理体系,以减少 ME的发生,保障病人安全用药。  相似文献   
7.

Background/Objectives

Due to its rarity, epidermoid cyst in intrapancreatic accessory spleen (ECIPAS) is still a diagnostic dilemma during clinical practice. The aim of this review was to summarize the epidemiologic features and management of ECIPAS.

Methods

MEDLINE and EMBASE were searched for English articles reporting on ECIPAS up to April 30th, 2018 following the methodology suggested by the PRISMA guidelines. Categorical variables were reported as frequency and percentage. Continuous variables were reported as median (range).

Results

A total of 56 patients from 47 full articles were included for the final data synthesis. More than half of the ECIPASs (59%) were found incidentally. The female/male ratio was 1.33. ECIPAS is typically a single mono-/multi-lobular cystic lesions in the pancreatic tail with thickened cystic wall or various amount of solid component which had identical density/signal to the spleen on imaging examinations. The cyst is filled with serous or non-serous fluid. Recognition of the surrounding ectopic splenic tissue is the key point to diagnose ECIPAS. However, no preoperative examination was able to make a definite diagnosis. Almost all the patients (96%) received surgical treatment, due to the suspicion of pancreatic malignant or potentially malignant cystic tumor, especially mucinous cystic neoplasm (MCN).

Conclusions

Although seldom encountered, ECIPAS should be considered as a differential diagnosis for pancreatic cystic lesions, especially when solid component was detected. As a benign disease, unnecessary surgery should be avoided. Because it is difficult to make a definite diagnosis preoperatively by one single examination, multiple modalities may be required.  相似文献   
8.
《Vaccine》2019,37(41):6076-6084
Human Q fever is recognized as a worldwide public health problem. It often occurs by inhalation of airborne aerosols contaminated with Coxiella burnetii, a gram-negative intracellular bacterium, mainly from domestic livestock. In this study, we analyzed the possibility to establish mucosal and systemic immunity against C. burnetii infection using a pulmonary delivery of chloroform-methanol residue of C. burnetii (CMR) vaccine. Mice were immunized by the intratracheal inoculation of CMR (IT-CMR) or the subcutaneous injection of CMR (SC-CMR), and the immunized mice were challenged with C. burnetii by the intratracheal route. The levels of IFN-γ, IL-12p70, IL-5, and IL-4 in the IT-CMR group in splenic T cells stimulated ex vivo were significantly higher than in the SC-CMR group. Significantly elevated sIgA to C. burnetii was detected in the bronchoalveolar lavage fluid of mice immunized by IT-CMR but not by SC-CMR, which might have contributed to the significant reduction in C. burnetii load and pathological lesions in the lungs of the mice after the challenge of C. burnetii. These results suggest that compared with SC-CMR in mice, IT-CMR was more efficient to elicit cellular and lung mucosal immune responses against aerosol infection of C. burnetii.  相似文献   
9.
Understanding why persons with human immunodeficiency virus (HIV) have accelerated atherosclerosis and its sequelae, including coronary artery disease (CAD) and myocardial infarction, is necessary to provide appropriate care to a large and aging population with HIV. In this review, we delineate the diverse pathophysiologies underlying HIV-associated CAD and discuss how these are implicated in the clinical manifestations of CAD among persons with HIV. Several factors contribute to HIV-associated CAD, with chronic inflammation and immune activation likely representing the primary drivers. Increased monocyte activation, inflammation, and hyperlipidemia present in chronic HIV infection also mirror the pathophysiology of plaque rupture. Furthermore, mechanisms central to plaque erosion, such as activation of toll-like receptor 2 and formation of neutrophil extracellular traps, are also abundant in HIV. In addition to inflammation and immune activation in general, persons with HIV have a higher prevalence than uninfected persons of traditional cardiovascular risk factors, including dyslipidemia, hypertension, insulin resistance, and tobacco use. Antiretroviral therapies, although clearly necessary for HIV treatment and survival, have had varied effects on CAD, but newer generation regimens have reduced cardiovascular toxicities. From a clinical standpoint, this mix of risk factors is implicated in earlier CAD among persons with HIV than uninfected persons; whether the distribution and underlying plaque content of CAD for persons with HIV differs considerably from uninfected persons has not been definitively studied. Furthermore, the role of cardiovascular risk estimators in HIV remains unclear, as does the role of traditional and emerging therapies; no trials of CAD therapies powered to detect clinical events have been completed among persons with HIV.  相似文献   
10.
《中国现代医生》2020,58(18):189-192
众所周知,近视可由遗传、外界环境、不良用眼习惯等综合性因素导致,主要预防措施为定期进行视力筛查,并及时对症治疗,与此同时养成良好用眼习惯,保持充足睡眠,保证一定运动量及营养均衡。若判定为近视,可通过光学镜片、西药治疗及中医治疗等方式延缓度数增加,若以上方式均无效,还可通过手术方式进行矫正。目前,近视给青少年的健康及成长带来的重大影响已成为公论,故我国近视低龄化问题也越发受到社会各界的关注。针对社会人群而言,了解近视成因,对精准预防与有效控制格外重要。本文对近年来文献报道进行总结,从近视形成原因、预防、筛查及控制措施等方面进行综述。  相似文献   
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