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991.
目的探讨不同容量小水囊对足月妊娠产妇促宫颈成熟的效果。方法选择2013年1月—2015年1月收治的150例足月妊娠并进行引产产妇,按随机数字表法平均分为3组,每组各50例,30 ml小水囊组(A组)、80ml小水囊组(B组)及150 ml小水囊组(C组)。比较3组产妇引产前后宫颈评分情况、促宫颈成熟效果、产妇分娩结局及新生儿结局。结果 B组产妇促宫颈成熟有效率为96.0%(48/50),C组为98.0%(49/50),均明显高于A组的84.0%(42/50),差异具有统计学意义(χ~2=3.90、4.03,P<0.05);B组及C组产妇的产后Bishop评分明显高于A组,而引产至临产时间及第一产程时间均明显短于A组(P=3.96、3.85、4.05,P<0.05);B组与C组经阴道分娩率分别为90.0%(45/50)及92.0%(46/50),均明显高于A组的54.0%(27/50),比较差异具有统计学意义(χ~2=4.52,P<0.05),而B组与C组比较差异无统计学意义(P>0.05);3组产妇产后出血量、3组新生儿Apgar评分、新生儿体质量比较差异无统计学意义(F=1.24、0.47、0.37,P>0.05),而C组新生儿窒息率、脐带脱垂率明显高于A组及B组,比较差异具有统计学意义(P<0.05)。结论 80 ml小水囊应用于足月妊娠产妇的促宫颈成熟效果好,对产妇及新生儿均不会造成严重不良反应,值得临床推广应用。 相似文献
992.
CorVue algorithm efficacy to predict heart failure in real life: Unnecessary and potentially misleading information?
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993.
Response to flecainide test in Andersen‐Tawil syndrome with incessant ventricular tachycardia
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994.
目的:分析2007年以来国内外有关患者安全与医疗质量评价指标的引用情况,为首都医科大学附属北京儿童医院患者安全与医疗质量评价指标体系的构建提供借鉴。方法:采用循证分析的方法对搜集到的367篇中英文文献进行分析。结果:最终纳入146篇文献,中文文献132篇,共提取150项指标,总引用频次≥10的指标共27项;英文文献14篇,共提取34项指标,总引用频次≥5的指标共16项。结论:各级医疗机构应加大对患者安全的关注,规范指标的应用,学会善于使用负向指标,不断拓宽患者安全指标的涵盖广度。 相似文献
995.
996.
分析了医学教育虚拟社区的研究现状,以医学在线开放式学习平台——医学教育虚拟社区的"基础医学教学资源网"为例,从个性化学习资源和个性化学习平台两个方面入手,探讨了学习资源在虚拟学习社区内的个性化服务的实现。 相似文献
997.
Martin O. Weickert Gregory Kaltsas Dieter Hörsch Pablo Lapuerta Marianne Pavel Juan W. Valle Martyn E. Caplin Emily Bergsland Pamela L. Kunz Lowell B. Anthony Enrique Grande Kjell Öberg Staffan Welin Catherine Lombard-Bohas John K. Ramage Ashwin Kittur Qi M. Yang Matthew H. Kulke 《Clinical therapeutics》2018,40(6):952-962.e2
Purpose
In the placebo-controlled Phase III TELESTAR (Telotristat Etiprate for Somatostatin Analogue Not Adequately Controlled Carcinoid Syndrome) trial, the oral tryptophan hydroxylase inhibitor telotristat ethyl significantly reduced bowel movement (BM) frequency during a 12-week, double-blind treatment period in 135 patients with metastatic neuroendocrine tumors with carcinoid syndrome and ≥4 BMs per day. Patients (mean [SD] age, 63.5 [8.9] years; mean [SD] body mass index, 24.9 [4.9] kg/m2) received placebo, telotristat ethyl 250 mg, or telotristat ethyl 500 mg 3 times per day (TID) in addition to somatostatin analogue therapy. Weight loss is associated with uncontrolled carcinoid syndrome and may be associated with reduced survival.Methods
Assessment of the occurrence of weight change ≥3% at week 12 was prespecified in the statistical analysis plan.Findings
In 120 patients with weight data available, weight gain ≥3% was observed in 2 of 39 patients (5.1%) taking placebo TID, 7 of 41 (17.1%) taking telotristat ethyl 250 mg TID, and 13 of 40 (32.5%) taking telotristat ethyl 500 mg TID (P = 0.0017) at week 12. Weight loss ≥3% was observed in 5 of 39 patients (12.8%) taking placebo TID, 4 of 41 (9.8%) taking telotristat ethyl 250 mg TID, and 6 of 40 (15.0%) taking telotristat ethyl 500 mg TID (P = 0.77). Biochemical and metabolic parameters of serum albumin and cholesterol significantly increased (P = 0.02 and P = 0.001, respectively) in patients gaining weight and decreased in patients who lost weight, suggesting an improvement in overall nutritional status.Implications
Up to 32.5% of patients treated with telotristat ethyl experienced significant, dose-dependent weight gain, associated with reduced diarrhea severity and improved biochemical and metabolic parameters. Improved nutritional status could be an additional aspect of telotristat ethyl efficacy among patients with functioning metastatic neuroendocrine tumors. ClinicalTrials.gov identifier: NCT01677910. 相似文献998.
999.
Zi-Meng Liu Juan Chen Qiuye Kou Qinhan Lin Xiaobo Huang Zhanhong Tang Yan Kang Ke Li Lixin Zhou Qing Song Tongwen Sun Ling Zhao Xue Wang Xiandi He Chunting Wang Benquan Wu Jiandong Lin Shiying Yuan Qin Gu Kejian Qian Xianqing Shi Yongwen Feng Aihua Lin Xiaoshun He Study Group of investigators Xiang-Dong Guan 《Intensive care medicine》2018,44(11):1816-1825
Purpose
Recent clinical data suggest that terlipressin, a vasopressin analogue, may be more beneficial in septic shock patients than catecholamines. However, terlipressin’s effect on mortality is unknown. We set out to ascertain the efficacy and safety of continuous terlipressin infusion compared with norepinephrine (NE) in patients with septic shock.Methods
In this multicentre, randomised, double-blinded trial, patients with septic shock recruited from 21 intensive care units in 11 provinces of China were randomised (1:1) to receive either terlipressin (20–160 µg/h with maximum infusion rate of 4 mg/day) or NE (4–30 µg/min) before open-label vasopressors. The primary endpoint was mortality 28 days after the start of infusion. Primary efficacy endpoint analysis and safety analysis were performed on the data from a modified intention-to-treat population.Results
Between 1 January 2013 and 28 February 2016, 617 patients were randomised (312 to the terlipressin group, 305 to the NE group). The modified intention-to-treat population comprised 526 (85.3%) patients (260 in the terlipressin group and 266 in the NE group). There was no significant difference in 28-day mortality rate between the terlipressin group (40%) and the NE group (38%) (odds ratio 0.93 [95% CI 0.55–1.56]; p?=?0.80). Change in SOFA score on day 7 was similar between the two groups: ??7 (IQR ??11 to 3) in the terlipressin group and ??6 (IQR ??10 to 5) in the NE group. There was no difference between the groups in the number of days alive and free of vasopressors. Overall, serious adverse events were more common in the terlipressin group than in the NE group (30% vs 12%; p?<?0.001).Conclusions
In this multicentre, randomised, double-blinded trial, we observed no difference in mortality between terlipressin and NE infusion in patients with septic shock. Patients in the terlipressin group had a higher number of serious adverse events.Trial registration
This trial is registered at ClinicalTrials.gov: ID NCT01697410.1000.
Lucrecia María Burgos Juan Pablo Costabel Victoria Galizia Brito Alan Sigal Daniela Maymo Ana Iribarren Marcelo Trivi 《The American journal of emergency medicine》2018,36(6):911-915