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131.
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133.
Michael W. Manning Yi-Ju Li Dean Linder John C. Haney Yi-Hung Wu Mihai V. Podgoreanu Madhav Swaminathan Jacob N. Schroder Carmelo A. Milano Ian J. Welsby Mark Stafford-Smith Kamrouz Ghadimi 《Journal of cardiothoracic and vascular anesthesia》2021,35(5):1310-1318
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134.
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
135.
Eloise R. Galligan Leila H. Shayegan Christine T. Lauren Kimberly D. Morel 《Pediatric dermatology》2019,36(5):753-754
Shaving and other modes of epilation can cause undue anxiety, pain, or skin irritation in children. Here, we present hair trimming as a safe, painless, and cost‐effective alternative for patients with unwanted hair which may be performed indefinitely or until the child is old enough to direct management. In select cases, removing unwanted hair using this technique may facilitate dermatologic surveillance. 相似文献
136.
Xiaojie Wu Leyan Zhang Jiadi Zhou Luying Liu Qiang Fu Aili Fu Xiaoying Feng Rui Xin Hongrui Liu Yong Gao Jiangnan Xue 《Current problems in cancer》2019,43(1):18-26
Aim
Leukocyte-associated immunoglobulin-like receptor-1 (LAIR-1) is an immune inhibitory receptor which is expressed within most types of hematopoietic cells and negatively regulates immune responses. Recently, we found LAIR-1 expression to be present within tumors of nonhematopoietic lineages. However, the roles of LAIR-1 in hepatocellular carcinoma (HCC) have yet to be examined. The purpose of this study was to investigate the expression of LAIR-1 in HCC tissue and assess its clinical significance at this site.Materials and methods
Expression levels of LAIR-1 within HCC samples collected from 90 patients and compared with that of slides of normal liver tissue collected from 9 non-HCC patients were measured by immunohistochemistry using tissue microarrays. A semiquantitative score was assigned, as was based on staining intensity and percent of positive cells and a Spearman Rank correlation test was used to assess any potential significant correlations between LAIR-1 expression and clinicopathological factors. Overall survival analysis was performed using the Kaplan-Meier and Log Rank statistical test.Results
LAIR-1 expression was detected in cancer tissue and adjacent tumor tissue, but not in normal liver tissue. The percent of LAIR-1-positive expression in cancer tissue of HCC samples was 97.78% (88/90) while that in adjacent tumor tissue was 96.67% (87/90). Significantly greater expression levels of LAIR-1 were obtained from cancer tissue (Mean?±?SD?=?5.722?±?2.145) than that in adjacent tumor tissue (4.141?±?1.486). In addition, LAIR-1 expression was found to be significantly correlated with pathological grade of HCC, T stage, and age. Expression levels of LAIR-1 were related with worse overall survival rates of HCC patients, especially in HCC patients with hepatic cirrhosis.Conclusion
Results of this study show that LAIR-1 is expressed in HCC tissues and that high levels of LAIR-1 expression are associated with the poor cancer differentiation. In addition, overexpression of LAIR-1 was significantly associated with worse overall survival in the patients with HCC. These data suggest that LAIR-1 may be an independent predictor for clinical outcomes in patients with HCC. 相似文献137.
138.
Julia H. Vermylen Gordon J. Wood Elaine R. Cohen Jeffrey H. Barsuk William C. McGaghie Diane B. Wayne 《Journal of pain and symptom management》2019,57(3):682-687
Introduction
Physician communication impacts patient outcomes. However, communication skills, especially around difficult conversations, remain suboptimal, and there is no clear way to determine the validity of entrustment decisions. The aims of this study were to 1) describe the development of a simulation-based mastery learning (SBML) curriculum for breaking bad news (BBN) conversation skills and 2) set a defensible minimum passing standard (MPS) to ensure uniform skill acquisition among learners.Innovation
An SBML BBN curriculum was developed for fourth-year medical students. An assessment tool was created to evaluate the acquisition of skills involved in a BBN conversation. Pilot testing was completed to confirm improvement in skill acquisition and set the MPS.Outcomes
A BBN assessment tool containing a 15-item checklist and six scaled items was developed. Students' checklist performance improved significantly at post-test compared to baseline (mean 65.33%, SD = 12.09% vs mean 88.67%, SD = 9.45%, P < 0.001). Students were also significantly more likely to have at least a score of 4 (on a five-point scale) for the six scaled questions at post-test. The MPS was set at 80%, requiring a score of 12 items on the checklist and at least 4 of 5 for each scaled item. Using the MPS, 30% of students would require additional training after post-testing.Comments
We developed a SBML curriculum with a comprehensive assessment of BBN skills and a defensible competency standard. Future efforts will expand the mastery model to larger cohorts and assess the impact of rigorous education on patient care outcomes. 相似文献139.
140.
Kelly H. M. Cooijmans Roseriet Beijers Bonnie E. Brett Carolina de Weerth 《Maternal & child nutrition》2022,18(1):e13241
This randomized controlled trial evaluated the effect of a 5-week daily skin-to-skin contact (SSC) intervention between mothers and their full-term infants, compared with care-as-usual, on exclusive and continued breastfeeding duration during the first post-natal year. Healthy pregnant women (n = 116) from a community sample were enrolled and randomly allocated to the SSC or care-as-usual condition. SSC mothers were requested to provide one daily hour of SSC for the first five post-natal weeks. Twelve months post-partum, mothers indicated the number of exclusive and continued breastfeeding months. Multiple regression analyses were conducted using intention-to-treat, per-protocol and exploratory dose–response frameworks. In intention-to-treat analyses, exclusive and continued breastfeeding duration was not different between groups (exclusive: 3.61 ± 1.99 vs. 3.16 ± 1.77 months; adjusted mean difference 0.28, 95% confidence interval [CI] ?0.33 to 0.89; p = 0.36; continued: 7.98 ± 4.20 vs. 6.75 ± 4.06 months; adjusted mean difference 0.81, 95% CI ?0.46 to 2.08; p = 0.21). In per-protocol analyses, exclusive and continued breastfeeding duration was longer for SSC than care-as-usual dyads (exclusive: 4.89 ± 1.26 vs. 3.25 ± 1.80 months; adjusted mean difference 1.28, 95% CI 0.31–2.24; p = 0.01; continued: 10.81 ± 1.97 vs. 6.98 ± 4.08 months; adjusted mean difference 2.33, 95% CI 0.13–4.54; p = 0.04). Exploratory dose–response effects indicated that more SSC hours predicted longer exclusive and continued breastfeeding duration. This study demonstrates that for the total group, the 5-week daily SSC intervention did not extend exclusive and continued breastfeeding duration. However, for mothers performing a regular daily hour of SSC, this simple and accessible intervention may extend exclusive and continued breastfeeding duration by months. Future studies are required to confirm these promising findings. Trial registration: Netherlands Trial Register (NTR5697). 相似文献