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1.
目的 考察注射用丹参多酚酸(SAFI)对脑缺血大鼠急性期用药的可行性,明确大鼠脑缺血再灌注后脑血流的变化及其与远期运动功能恢复之间的相关性。方法 将Wistar大鼠随机分为假手术组、模型组及SAFI (21 mg·kg-1)组。SAFI组根据不同给药时机又分为3个亚组,分别是再灌后立即给药组(SAFI 0周)、再灌后1周给药组(SAFI 1周)、再灌后2周给药组(SAFI 2周),每组每天给药1次,连续ip 7 d,为保持一致性,其余时间均ip生理盐水,假手术组及模型组分别ip等量生理盐水。采用线栓法构建大鼠脑缺血再灌注模型,假手术组仅分离血管。通过观测大鼠一般状态、评估大鼠神经功能和脑梗死体积百分比考察SAFI急性期给药的药效作用;利用激光多普勒技术检测大鼠局部脑血流量(rCBF);通过转棒实验和步态实验分析大鼠的运动能力;通过Pearson相关性分析方法评估不同时间点的脑血流变化与远期运动功能恢复之间的相关性。结果 与模型组比较,SAFI 0周组大鼠的神经功能评分显著降低(P<0.01),脑梗死体积百分比显著降低(P<0.01),rCBF显著提升(P<0.05、0.01),死亡率明显下降;与模型组比较,SAFI 0周组大鼠在转棒仪上跌落潜伏期显著增加(P<0.05、0.01),SAFI 0周组大鼠在步态仪上运动速度显著增加(P<0.01),四肢的摆动时间、站立时间和步态周期显著下降(P<0.05、0.01),四肢(除左后肢外)的步幅显著增加(P<0.05、0.01)。与SAFI 1、2周组比较,SAFI 0周组脑梗死体积百分比显著降低(P<0.01),死亡率降低,rCBF显著升高(P<0.05、0.01),明显促进了神经行为学功能及运动功能的恢复。Pearson相关性分析结果表明脑缺血再灌注损伤后早期的脑血流恢复与远期运动功能呈线性相关。结论 SAFI在缺血急性期给药具有一定的可行性;脑缺血后梗死周边区域血流恢复对远期运动功能的恢复至关重要。  相似文献   
2.
目的 建立同时测定注射用胸腺法新中乙腈、二氯甲烷、醋酸乙酯、苯和苯甲醚5种有机溶剂残留量的顶空气相色谱法。方法 采用Agilent DB-624(30 m×0.53 mm×3 μm)毛细管色谱柱;火焰离子化检测器;进样口温度200℃;检测器温度250℃;载气为氮气;载气体积流量为2.0 mL·min-1;分流比为10:1;升温程序:起始温度40℃,保持6 min,以8℃·min-1的速率升温至90℃,保持2 min,再以20℃·min-1的速率升温至200℃,保持5 min;采用顶空进样方式,顶空加热箱温度80℃,样品瓶平衡时间30 min。进行系统适用性、检测限(LOD)与定量限(LOQ)、线性关系和范围、加样回收率、精密度、稳定性、耐用性考察。结果 注射用胸腺法新中5种残留溶剂在各自线性浓度范围内与峰面积线性关系良好;平均加样回收率在95.7%~106.3%;精密度、稳定性、耐用性均符合要求。5批胸腺法新中均未检出5种有机溶剂。结论 建立的顶空气相色谱法操作简单、灵敏度和准确度高、重现性和耐用性好,可用于注射用胸腺法新中5种有机溶剂残留量的测定。  相似文献   
3.
《Vaccine》2022,40(52):7604-7612
Background and ObjectiveVaccine uptake during pregnancy remains low. Our objectives were to describe 1) development and adaptation of a clinician communication training intervention for maternal immunizations and 2) obstetrics and gynecology (ob-gyn) clinician and staff perspectives on the intervention and fit for the prenatal care context.MethodsDesign of the Motivational Interviewing for Maternal Immunizations (MI4MI) intervention was based on similar communication training interventions for pediatric settings and included presumptive initiation of vaccine recommendations (“You’re due for two vaccines today”) combined with motivational interviewing (MI) for hesitant patients. Interviews and focus group discussions were conducted with ob-gyn clinicians and staff in five Colorado clinics including settings with obstetric physicians, certified nurse midwives (CNMs), and clinician-trainees. Participants were asked about adapting training to the ob-gyn setting and their implementation experiences. Feedback was incorporated through iterative changes to training components.ResultsInterview and focus group discussion results from participants before (n = 3), during (n = 11) and after (n = 25) implementation guided intervention development and adaptation. Three virtual, asynchronous training components were created: a video and two interactive modules. This virtual format was favored due to challenges attending group meetings; however, participants noted opportunities to practice skills through role-play were lacking. Training modules were adapted to include common challenging vaccine conversations and live-action videos. Participants liked interactive training components and use of adult learning strategies. Some participants initially resisted the presumptive approach but later found it useful after applying it in their practices. Overall, participants reported that MI4MI training fit well with the prenatal context and recommended more inclusion of non-clinician staff.ConclusionsMI4MI training was viewed as relevant and useful for ob-gyn clinicians and staff. Suggestions included making training more interactive, and including more complex scenarios and non-clinician staff.  相似文献   
4.
5.
目的:分析无创呼吸机治疗慢性阻塞性肺疾病的临床疗效。方法:选取2019年3月~2020年12月天津市第四中心医院收治的84例慢性阻塞性肺疾病患者为研究对象,应用随机数字表法将其分为两组,组间一般资料差异无统计学意义(P>0.05)。患者入院后均给予祛痰以及解除气道痉挛等常规治疗,在此基础上对照组采用鼻导管持续低流量吸氧治疗,研究组采用无创呼吸机进行治疗。观察两组患者治疗前后肺通气功能指标和动脉血气指标,以及患者住院时间。结果:治疗前各项观察指标组间差异均无统计学意义(P>0.05)。治疗后研究组FEV1%和FEV1/FVC分别为(62.71±7.30)和(67.63±7.75)%,均显著优于对照组的(50.12±5.81)和(60.27±7.38)%(P<0.05)。治疗后研究组PaO2和PaCO2分别为(81.46±7.23)mmHg和(46.31±5.09)mmHg,均显著优于对照组的(67.70±6.44)mmHg和(58.28±6.62)mmHg(P<0.05)。同时研究组住院时间为(18.26±3.71)d,显著短于对照组的(22.65±3.84)d(P<0.05)。结论:无创呼吸机可以显著改善慢性阻塞性肺疾病患者病情。  相似文献   
6.
黎淑玲  刘俊杰  蒋邦好  罗劲根 《安徽医学》2022,43(11):1264-1267
目的 观察痔上动脉结扎(HAL)术对中重度混合痔患者的手术效果及对术后并发症的影响。方法 选取2019年6月至2020年6月广州市番禺区中心医院收治的148例混合痔合并出血性内痔患者作为研究对象,采用随机数字表法分为对照组与观察组,每组74例。对照组行痔上黏膜环切术(PPH)术,观察组行PPH联合HAL。观察比较两组患者手术时间、住院时间、住院费用,术后急性尿潴留,术后3个月内出血、脱垂、水肿、肛门狭窄、视觉疼痛模拟评分(VAS)、Wexner肛门失禁评分、疗效等指标的差异。结果 观察组手术时间较对照组更长,住院时间较对照组更短,住院费用较对照组更低,差异有统计学意义(P<0.05)。观察组术后出血比例为5.41%、水肿发生率为9.46%、Wexner肛门失禁评分为(2.32±1.25)分,均低于对照组,差异有统计学意义(P<0.05);观察组有效率为94.59%,高于对照组,差异有统计学意义(P<0.05)。手术后,两组VAS评分均降低,术后观察组VAS低于对照组,差异有统计学意义(P<0.05)。观察组术后急性尿潴留、脱垂、肛门狭窄发生情况与对照组比较,差异无统计学意义(P>0.05)。结论 PPH联合直视下HAL治疗出血性中重度混合痔安全有效,并发症发生率更低,具有临床应用价值。  相似文献   
7.
We propose a Deep learning-based weak label learning method for analyzing whole slide images (WSIs) of Hematoxylin and Eosin (H&E) stained tumor tissue not requiring pixel-level or tile-level annotations using Self-supervised pre-training and heterogeneity-aware deep Multiple Instance LEarning (DeepSMILE). We apply DeepSMILE to the task of Homologous recombination deficiency (HRD) and microsatellite instability (MSI) prediction. We utilize contrastive self-supervised learning to pre-train a feature extractor on histopathology tiles of cancer tissue. Additionally, we use variability-aware deep multiple instance learning to learn the tile feature aggregation function while modeling tumor heterogeneity. For MSI prediction in a tumor-annotated and color normalized subset of TCGA-CRC (n=360 patients), contrastive self-supervised learning improves the tile supervision baseline from 0.77 to 0.87 AUROC, on par with our proposed DeepSMILE method. On TCGA-BC (n=1041 patients) without any manual annotations, DeepSMILE improves HRD classification performance from 0.77 to 0.81 AUROC compared to tile supervision with either a self-supervised or ImageNet pre-trained feature extractor. Our proposed methods reach the baseline performance using only 40% of the labeled data on both datasets. These improvements suggest we can use standard self-supervised learning techniques combined with multiple instance learning in the histopathology domain to improve genomic label classification performance with fewer labeled data.  相似文献   
8.
9.
BackgroundRecent guidelines for the treatment of moderate or severe ischemic mitral regurgitation (IMR) in patients undergoing coronary artery bypass grafting (CABG) have changed. This study assessed the real-world impact of changing guidelines on the management of IMR during CABG over time. We hypothesized that the utilization of mitral valve repair for IMR would decrease over time, whereas mitral valve replacement for severe IMR would increase.MethodsPatients undergoing CABG in a statewide collaborative database (2011-2020) were stratified by severity of IMR. Trends in mitral valve repair or replacement were evaluated. To account for differences of the patients, propensity score–matched analyses were used to compare patients with and without mitral intervention.ResultsA total of 11,676 patients met inclusion criteria, including 1355 (11.6%) with moderate IMR and 390 (3.3%) with severe IMR. The proportion of patients undergoing mitral intervention for moderate IMR decreased over time (2011, 17.7%; 2020, 7.5%; Ptrend = .001), whereas mitral replacement for severe IMR remained stable (2011, 11.1%; 2020, 13.3%; Ptrend = .14). Major morbidity was higher for patients with moderate IMR who underwent mitral intervention (29.1% vs 19.9%; P = .005). In a propensity analysis of 249 well-matched pairs, there was no difference in major morbidity (29.3% with mitral intervention vs 23.7% without; P = .16) or operative mortality (1.2% vs 2.4%; P = .5).ConclusionsConsistent with recent guideline updates, patients with moderate IMR were less likely to undergo mitral repair. However, the rate of replacement for severe IMR did not change. Mitral intervention during CABG did not increase operative mortality or morbidity.  相似文献   
10.
Background & aimsTo determine the trends of self-reported non-adherence rates among adults taking Type 2 medicines (T2D) medicines between 2017 and 2019 and to identify the patterns for the frequently reported reasons for non-adherence in the United States.Methods & resultsData from the National Health and Wellness Survey, a self-administered, internet-based cross-sectional survey of US adults from 2017 to 2019 was used. Non-adherence was measured using the self-reported Medication Adherence Reasons Scale (MAR-Scale). Frequencies were used to identify the reasons for non-adherence for insulin and non-insulin therapies for T2D.Data were obtained from 2983 respondents in 2017, 5416 in 2018, and 5268 in 2019. Based on the MAR-Scale, the self-reported medication non-adherence rate was 25% in 2017, 21% in 2018, and 27% in 2019. The most common reason for non-adherence across all the three years was simple forgetfulness, yet patients reported the lowest mean number of days missing medication for that reason. Though less frequently reported, non-adherence lasted longer when patient did not know how to take their medicines, cost was a reason, or had concerns about the long term effects of the medicines.ConclusionsWith no significant improvement in adherence with T2D medicines over time, regardless of better awareness and extensive diabetes education, focus should be on individualized non-adherence reasons-based interventions.  相似文献   
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