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Background: Atrial fibrillation (AF) is a major cause of morbidity and mortality, especially in patients with congestive heart failure.
Objectives: The purposes of this international, prospective multicenter study were to evaluate the efficacy of atrial shock therapy in patients with a cardiac resynchronization therapy defibrillator (CRT-D) and to evaluate the safety of the new CRT-D. The effectiveness of a new wireless telemetry system was also evaluated.
Methods: A total of 282 patients, without permanent AF, who had indications for a CRT-D were included. Atrial shock therapy was tested on both spontaneous and induced AF episodes. The effectiveness of the Medtronic wireless telemetry system (Conexus; Medtronic Inc., Minneapolis, MN, USA) was also tested. Secondary endpoints included the heart failure Clinical Composite Response, system performance evaluation, and adverse event summary.
Results: Atrial shock therapy was successful in 168 of 171 episodes (98.2%). Of these, 138 episodes were induced and 33 were spontaneous. Successful cardioversion occurred in 137 of the 138 induced-AF episodes (86.1% with 12 joule (J), 13.1% with 24 J, and 0.7% with 35 J). During the first 3 months of implant, there were 43 system-related complications in 37 subjects out of 278 subjects. There were 1,999 Conexus telemetry uses recorded during this study. This includes 282 uses during the implant procedure. There were no cases of complete loss of telemetry or any adverse events reported using this system.
Conclusion: We achieved an atrial shock efficacy of 98.2% in patients who met standard CRT-D indications. The wireless telemetry performed well with no reported unanticipated adverse device effects.  相似文献   
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Abstract   Objective: Echinococcosis is a serious health problem in some regions of the world. Although cardiovascular hydatid cyst is rare, its early diagnosis and surgical management is important. Methods: We reviewed 10 patients with cardiovascular hydatid cyst who underwent surgery in our department between January 1982 and 2007. Standard cardiopulmonary bypass and antegrade cardioplegia with aortic cross-clamping were used in all but one patient. After the cysts were removed, the cavity was cleaned and then obliterated with purse-string sutures. Albendazole was used in all patients. The mean follow-up was 4.5 years. Results: The mean age was 27 years (range 12 to 76 years). Eight patients were men. The hydatid cysts were located on left ventricle (five patients), left atrium (two patients), right ventricle (three patients), right atrium (one patient), pericardium (one patient), and aorta (one patient). Except for two patients who died, all were discharged without postoperative complications. There was no late cardiac mortality or recurrence. Conclusions: Cardiac hydatid cyst should be treated surgically without delay. Although its surgical treatment carries a high complication rate, gentle handling of the heart during cardiopulmonary bypass minimizes operative risk.  相似文献   
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Objective To identify and determine the optimal method to screening for fetal Down’s syndrome (DS). Methods Three large cohorts with 17 118, 39 903, 16 646 subjects were enrolled for the first trimester double marker (pregnancy-associated plasma protein A and free β-human chorionic gonadotropin) screening (FTDMS), second trimester double marker (α-fetoprotein and free β-human chorionic gonadotropin) screening (STDMS), and second trimester triple marker (α-fetoprotein, free β-human chorionic gonadotropin and unconjugated estriol 3) screening (STTMS), respectively. The sensitivity, specificity, false positive rate (FPR), false negative rate (FNR) and the areas under ROC curves (AUCs) were estimated in order to determine the optimal screening method in women under or above 35 years old. Results For women under 35 years old, STTMS was the best method with a detection rate of 68.8% and FPR of 4.3% followed by the STDMS with a detection rate (sensitivity) of 66.7% and FPR of 4.9%. The FTDMS had a lower detection rate of 61.1% and FPR of 6.3%. For women above 35 years old, the detection rate of all the methods was similar, but STTMS method had a lowest FPR of 15.9%. For women under 35 years old AUCs were 0.77 (95% CI, 0.64 to 0.91), 0.81 (95% CI, 0.71 to 0.91), and 0.82 (95% CI, 0.69 to 0.96) for FTDMS, STDMS, and STTMS methods, respectively; for those above 35 years old, AUCs were 0.70 (95% CI, 0.56 to 0.83), 0.70 (95% CI, 0.59 to 0.82), 0.78 (95% CI, 0.58 to 0.97) for FTDMS, STDMS and STTMS , respectively. Conclusion Findings from our study revealed that STDMS is optimal for the detection of fetal DS in pregnant women aged under 35. For individual women, if economic condition permits, STTMS is the best choice, while for women aged above 35, STTMS is the best choice in this regard.  相似文献   
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腹部术后早期肠内营养支持的临床研究   总被引:4,自引:1,他引:3  
为了研究手术后早期胃肠内营养支持的有效性及安全性,我们将腹部手术病人随机分为肠内与肠外营养两组。自术后第一天起给予等氮等热量的营养支持,持续8天。结果发现营养支持前后研究组病人前白蛋白、转铁蛋白水平较对照组明显升高且手术后第二日即达到正氮平衡,无明显的肝肾功能影响,消化道反应轻。认为术后早期营养支持是安全有效的。  相似文献   
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腰椎间盘突出症的非手术治疗   总被引:4,自引:0,他引:4  
孙锦年 《颈腰痛杂志》1994,15(4):208-210
近三年来运用药物、牵引、手法推拿、硬膜外腔注射、功能锻炼等治疗方法,对312例腰椎间盘突出症进行了治疗和观察,结果:治愈267例,占85.5%;有效33例,占11%;无效12例,占3.5%。总有效率为96.5%。中西医结合疗效有助于腰椎间盘突出症的症状缓解和恢复,疗效显著。  相似文献   
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目的 应用新型杆状病毒表达系统快速构建含有HBsAg基因的重组杆状病毒,高效表达HBsAg,为HBV诊断试剂、疫苗及治疗研究提供依据。方法 构建含有HBsAg基因的供体质粒pFB-BS,转化Bac-to-Bac杆状病毒表达试剂盒中的DH10Bac致敏菌,利用其含有的细菌Tn7转座繁忙将HBsAg基因重组至穿梭质粒Bacmid上,快速筛选出含有HBsAg基因的重组杆状病毒。结果 此重组病毒能在昆虫细  相似文献   
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