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Radical prostatectomy in patients aged 75 years or older:review of the literature
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作者 Philipp Mandel Thenappan Chandrasekar +2 位作者 Felix K Chun Hartwig Huland Derya Tilki 《亚洲男性学杂志:英文版》 SCIE CAS CSCD 2019年第1期32-36,共5页
Given the demographic trends toward a considerably longer life expectancy,the percentage of elderly patients with prostate cancer will increase further in the upcoming decades.Therefore,the question arises,should pati... Given the demographic trends toward a considerably longer life expectancy,the percentage of elderly patients with prostate cancer will increase further in the upcoming decades.Therefore,the question arises,should patients ≥75 years old be offered radical prostatectomy and under which circumstances? For treatment decision-making,life expectancy is more important than biological age.As a result,a patient's health and mental status has to be determined and radical treatment should only be offered to those who are fit.As perioperative morbidity and mortality in these patients is increased relative to younger patients,patient selection according to comorbidities is a key issue that needs to be addressed.It is known from the literature that elderly men show notably worse tumor characteristics,leading to worse oncologic outcomes after treatment.Moreover,elderly patients also demonstrate worse postoperative recovery of continence and erectile function.As the absolute rates of both oncological and functional outcomes are still very reasonable in patients ≥75 years,a radical prostatectomy can be offered to highly selected and healthy elderly patients. Nevertheless,patients clearly need to be informed about the worse outcomes and higher perioperative risks compared to younger patients. 展开更多
关键词 age FUNCTIONAL OUTCOME oncological OUTCOME PROSTATE cancer RADICAL prostatectomy
湖南省工业地区夫妻暴力发生状况十年追踪调查
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作者 陈月 曹玉萍 +2 位作者 张亚林 郭果毅 谭进 《中国公共卫生》 CAS CSCD 北大核心 2019年第9期1215-1218,共4页
目的追踪比较湖南省工业地区夫妻暴力发生状况十年间的变化。方法分别于2001—2002年(2002年组)和2011—2012年(2012年组),由相同的调查员采用相同的家庭暴力调查问卷,对湖南省工业地区夫妻暴力发生状况进行调查。结果两组施暴者中男性... 目的追踪比较湖南省工业地区夫妻暴力发生状况十年间的变化。方法分别于2001—2002年(2002年组)和2011—2012年(2012年组),由相同的调查员采用相同的家庭暴力调查问卷,对湖南省工业地区夫妻暴力发生状况进行调查。结果两组施暴者中男性分别占85.7%和69.2%,受虐者中女性分别占87.0%和69.1%,2组施暴者和受虐者的性别差异均有统计学意义(χ2=50.125、19.550,P=0.000);两组夫妻暴力发生的首位诱发因素均为子女教育问题(41.1%vs51.9%),最常见的暴力形式都是羞辱和谩骂(90.5%vs93.2%),差异无统计学意义(P>0.05);2012年受虐者受到精神损伤和身体损伤的比例分别为35.3%和15.0%,明显高于2002年组的16.8%和4.2%,差异均有统计学意义(χ2=9.481、6.897,P<0.01);2组施暴者认可夫妻暴力的比例分别为69.4%和50.8%,受虐者认可夫妻暴力的比例分别为54.3%和35.3%,差异无统计学意义(P>0.0125)。结论夫妻暴力仍以男性施暴为主,精神暴力是夫妻暴力最常见的形式,子女教育问题仍是诱发夫妻暴力的首要因素,受虐者受到较十年前更多的精神损伤和身体损伤,施暴者和受虐者对夫妻暴力的态度十年来无明显变化。 展开更多
关键词 夫妻暴力 诱发因素 表现形式 后果 态度
Relationship between serum homocysteine levels and long-term outcomes in patients with ST-segment elevation myocardial infarction
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作者 Jin Si Xue-Wen Li +6 位作者 Yang Wang Ying-Hua Zhang Qing-Qing Wu Lei-Min Zhang Xue-Bing Zuo Jing Gao Jing Li 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第9期1028-1036,共9页
Background:The mortality of cardiovascular disease is constantly rising,and novel biomarkers help us predict residual risk.This study aimed to evaluate the predictive value of serum homocysteine (HCY) levels on progno... Background:The mortality of cardiovascular disease is constantly rising,and novel biomarkers help us predict residual risk.This study aimed to evaluate the predictive value of serum homocysteine (HCY) levels on prognosis in patients with ST-segment elevation myocardial infarction (STEMI).Methods:The 419 consecutive patients with STEMI,treated at one medical center,from March 2010 to December 2015 were retrospectively investigated.Peripheral blood samples were obtained within 24 h of admission and HCY concentrations were measured using an enzymatic cycling assay.The patients were divided into high HCY level (H-HCY) and low HCY level (L-HCY) groups.Short- and long-term outcomes were compared,as were age-based subgroups (patients aged 60 years and younger vs.those older than 60 years).Statistical analyses were mainly conducted by Student t-test,Chi-squared test,logistic regression,and Cox proportional-hazards regression.Results:The H-HCY group had more males (84.6% vs.75.4%,P=0.018),and a lower prevalence of diabetes (20.2% vs.35.5%,P<0.001),compared with the L-HCY group.During hospitalization,there were seven mortalities in the L-HCY group and 10 in the H-HCY group (3.3% vs.4.8%,P= 0.440).During the median follow-up period of 35.8 (26.9–46.1) months,33 (16.2%) patients in the L-HCY group and 48 (24.2%) in the H-HCY group experienced major adverse cardiovascular and cerebrovascular events (MACCE)(P=0.120).History of hypertension (hazard ratio [HR]:1.881,95% confidence interval [CI]:1.178–3.005,P=0.008) and higher Killip class (HR:1.923,95% CI:1.419–2.607,P<0.001),but not HCY levels (HR:1.007,95% CI:0.987–1.027,P=0.507),were significantly associated with long-term outcomes.However,the subgroup analysis indicated that in older patients,HCY levels were significantly associated with long-term outcomes (HR:1.036,95% CI:1.011–1.062,P=0.005).Conclusion:Serum HCY levels did not independently predict in-hospital or long-term outcomes in patients with STEMI;however,among elderly patients with STEMI,this study reveal 展开更多
关键词 HOMOCYSTEINE Acute ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION PERCUTANEOUS coronary intervention Clinical outcome
Comparing the effects of depression,anxiety,and comorbidity on quality-of-life,adverse outcomes,and medical expenditure in Chinese patients with acute coronary syndrome
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作者 Kun Xia Le-Feng Wang +5 位作者 Xin-Chun Yang Hong-Yan Jiang Li-Jing Zhang Dao-Kuo Yao Da-Yi Hu Rong-Jing Ding 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第9期1045-1052,共8页
Background:Depression and anxiety have been correlated with elevated risks for quality-of-life (QOL),adverse outcomes,and medical expenditure in patients with acute coronary syndrome (ACS).However,the relevant data ar... Background:Depression and anxiety have been correlated with elevated risks for quality-of-life (QOL),adverse outcomes,and medical expenditure in patients with acute coronary syndrome (ACS).However,the relevant data are lacking for Chinese ACS populations,especially regarding different effects of major depression,anxiety,and comorbidity.The objective of this study was to evaluate the dynamic changes of depression and/or anxiety over 12 months and examine the effects of depression,anxiety,and comorbidity on QOL,adverse outcomes,and medical expenditure in Chinese patients with ACS.Methods:For this prospective longitudinal study,a total of 647 patients with ACS were recruited from North China between January 2013 and June 2015.Among them,531 patients (82.1%) completed 12-month follow-ups.Logistic regression model was utilized for analyzing the association of baseline major depression,anxiety,and comorbidity with 12-month all-cause mortality,cardiovascular events,QOL,and health expenditure.Results:During a follow-up period of 12 months,7.3% experienced non-fatal myocardial infarction (MI) and 35.8% cardiac rehospitalization.Baseline comorbidity,rather than major depression/anxiety,strongly predicted poor 12-month QOL as measured by short-form health survey-12 (odds ratio [OR]:1.77,95% confidence interval [CI]:1.22–2.52,P = 0.003).Regarding 12-month non-fatal MI and cardiac re-hospitalization,baseline anxiety (OR:2.83,95% CI:1.33–5.89,P<0.01;OR:4.47,95% CI:1.50–13.00,P<0.01),major depression (OR:2.58,95% CI:1.02–6.15,P<0.05;OR:5.22,95% CI:1.42–17.57,P<0.03),and comorbidity (OR:6.33,95% CI:2.96–13.79,P<0.0001,OR:14.08,95% CI:4.99–41.66,P<0.0001) were all independent predictors,and comorbidity had the highest predictive value.Number of re-hospitalization stay,admission frequency within 12 months and medical expenditure within 2 months were the highest in patients with ACS with comorbidity.Conclusions:Major depression and anxiety may predict 12-month non-fatal MI and cardiac re-hospitalization.However,comorb 展开更多
关键词 Acute CORONARY syndrome Major DEPRESSION ANXIETY COMORBIDITY ADVERSE outcome
三叉神经射频的疗效分析与半月节解剖差异特点回顾 预览
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作者 任志伟 胡永生 +1 位作者 李建宇 郭松 《中国疼痛医学杂志》 CAS CSCD 北大核心 2019年第8期592-596,共5页
目的:回顾分析三叉神经射频疗效与半月节解剖变异特点的关系。方法:回顾2018年至2019年我科诊断为三叉神经痛,行半月节射频术的病人。采用Radiant软件对O形臂扫描结果进行术后重建,分析射频穿刺路径与半月节解剖变异特点,并与卵圆孔穿... 目的:回顾分析三叉神经射频疗效与半月节解剖变异特点的关系。方法:回顾2018年至2019年我科诊断为三叉神经痛,行半月节射频术的病人。采用Radiant软件对O形臂扫描结果进行术后重建,分析射频穿刺路径与半月节解剖变异特点,并与卵圆孔穿刺射频即刻疗效进行对比。结果:纳入研究病人41人,术后即刻疼痛消失30人(73.1%),疼痛减轻7人(17.1%),无效4人(9.8%),上述4例无效及7例减轻的病人中9例均为第Ⅱ支范围疼痛控制不满意。回顾分析其半月节解剖特点均发现,经卵圆孔穿刺射频由于穿刺角度所限,不能完全进入半月节,推测是不能覆盖第Ⅱ支范围导致射频效果不佳的原因。结论:三叉神经痛病人行卵圆孔穿刺射频,特别是累及第Ⅱ支疼痛病人有时效果不佳,可能是由于半月节解剖差异导致,可同期行圆孔穿刺射频。 展开更多
关键词 O形臂 三叉神经痛 射频 解剖 疗效
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妊娠合并梅毒192例患者妊娠结局和子代随访研究 预览
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作者 陈艳 韩国荣 +1 位作者 王根菊 王翠敏 《东南国防医药》 2019年第4期348-351,共4页
目的探讨妊娠期合并梅毒螺旋体感染的患者在妊娠期间进行规范驱梅治疗对妊娠结局及新生儿血清学转归的影响。方法回顾性分析2009年1月至2014年2月在南京中医药大学附属南京医院妇产科收治的192例妊娠合并梅毒螺旋体感染孕妇的临床资料,... 目的探讨妊娠期合并梅毒螺旋体感染的患者在妊娠期间进行规范驱梅治疗对妊娠结局及新生儿血清学转归的影响。方法回顾性分析2009年1月至2014年2月在南京中医药大学附属南京医院妇产科收治的192例妊娠合并梅毒螺旋体感染孕妇的临床资料,所有患者经梅毒快速血浆反应试验(RPR)和梅毒螺旋体颗粒凝集试验(TPPA)筛查,根据孕妇孕期是否接受规范驱梅治疗,分为治疗组162例和未治疗组30例,对所有活产新生儿完成12个月的血清学RPR跟踪随访,比较妊娠期规范驱梅治疗对妊娠结局和分娩新生儿血清RPR转阴率的影响。结果治疗组与未治疗组孕母足月活产率(91.4%vs40.0%)、死胎死产率(0.6%vs10.0%)、畸形引产率(1.2%vs16.7%)、子代先天性梅毒率(0.6%vs13.3%)组间比较差异均有统计学意义(P<0.05)。治疗组与未治疗组子代血清RPR累积转阴率在9个月(96.2%vs75.0%)和12个月(97.4%vs80.0%)差异均有统计学意义(P<0.01)。结论妊娠期梅毒螺旋体的筛查及规范驱梅治疗能显著降低妊娠不良结局的发生,降低子代感染先天梅毒的风险,其影响可持续至出生后12个月。 展开更多
关键词 妊娠合并梅毒感染 驱梅治疗 结局 新生儿
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肝移植治疗慢加急性肝功能衰竭159例的临床效果总结
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作者 李杰群 周政俊 +4 位作者 宾阳阳 陈广顺 李强 齐海智 司中洲 《中华器官移植杂志》 CAS 北大核心 2019年第8期492-496,共5页
目的评价肝移植治疗慢加急性肝衰竭(ACLF)的效果。方法回顾性分析2013年1月至2017年12月453例有肝硬化基础史患者接受肝移植的临床资料。根据欧洲肝病研究协会慢性肝衰竭联盟(EASL-CLIF)标准,分为ACLF组(159例)和非ACLF组(294例),同时对... 目的评价肝移植治疗慢加急性肝衰竭(ACLF)的效果。方法回顾性分析2013年1月至2017年12月453例有肝硬化基础史患者接受肝移植的临床资料。根据欧洲肝病研究协会慢性肝衰竭联盟(EASL-CLIF)标准,分为ACLF组(159例)和非ACLF组(294例),同时对159例ACLF组受者再进行分级评分。记录和分析所有受者的临床数据,比较各组受者术后90 d存活率。结果与非ACLF组比较,ACLF组受者住重症监护室(ICU)的天数明显延长,术后90 d死亡率明显升高,两组比较,差异均有统计学意义。与ACLF 1级组和ACLF 2级组受者相比,ACLF 3级组受者术后住ICU天数明显延长,术后90 d死亡率明显升高,差异均有统计学意义。非ACLF组、ACLF 1级组、ACLF 2级组及ACLF 3级组受者术后90 d存活率分别为93.20%、92.59%、93.33%和73.68%,ACLF1级组及ACLF 2级组与非ACLF组间存活率的差异无统计学意义,而ACLF 3级组较其他三组显著下降,差异有统计学意义。结论肝移植是治疗ACLF的有效手段,早期及时(在出现多器官功能衰竭以前)行肝移植治疗,可以明显改善ACLF患者预后。 展开更多
关键词 慢加急肝衰竭 肝移植 预后 诊断标准 预后评分
Long-term outcomes and life quality in the elderly after cardiac surgery:A single-center retrospective analysis
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作者 梅波 杨嵩 +3 位作者 黄穗青 梁孟亚 陈光献 吴钟凯 《岭南心血管病杂志:英文版》 CAS 2019年第3期182-189,共8页
Background In the past of China,both doctors and patients have historically been reluctant to pursue cardi⁃ac surgery in the elderly because of various reasons.Nowadays,this situation is changing.However,few studies h... Background In the past of China,both doctors and patients have historically been reluctant to pursue cardi⁃ac surgery in the elderly because of various reasons.Nowadays,this situation is changing.However,few studies have been performed to assess quality of life(QoL)in elderly patients after cardiac surgery in China.In this study,we evaluated long-term surgical outcomes and QoL and identified the factors associated with each in elderly patients who underwent cardiac surgery.Methods We recruited 320 patients aged≥70 years old who underwent cardiac surgery in our hospital from January 2003 to December 2018.Risk factors for mortality were identified using a logistic regression analysis.Among survivors,QoL was assessed using the Short Form 36,and the results were compared to those in an age-matched population cohort in China.Results Overall hospital mor⁃tality was 7.2%.However,it has dropped to 3.7%in the last five years.The 1-,3-,5-,and 10-year survival rates were 95.5%,85.7%,74.7%,and 30.5%,respectively.Cardiopulmonary bypass time and EuroSCOREs significantly predicted in-hospital mortality.Chronic pulmonary disease was the only risk factor for long-term mortality.Scores for bodily pain and role emotional were significantly higher in our population than in the gener⁃al Chinese aged population.However,scores were lower for physical functions and vitality in our population than in the controls.Conclusions Cardiac surgery in elderly patients(≥70 years old)can have low in-hospital mortality,excellent long-term survival and high QoL,which are associated with comprehensive preoperative evaluation assesses and excellent perioperative management and post-surgery cardiac rehabilitation. 展开更多
关键词 cardiovascular outcome cardiovascular surgery SURVIVAL quality of life SF-36
脑卒中延续性照护效果评价指标研究进展 被引量:1
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作者 赵庆 施雁 《中国护理管理》 CSCD 北大核心 2019年第1期108-112,共5页
从过程评价指标和结果评价指标两个方面对脑卒中延续性照护效果评价指标的相关研究进行综述。过程评价指标包括信息的延续性、管理的延续性和关系的延续性。结果评价指标包括患者的临床结局、医疗卫生资源利用率和患者满意度。提出了研... 从过程评价指标和结果评价指标两个方面对脑卒中延续性照护效果评价指标的相关研究进行综述。过程评价指标包括信息的延续性、管理的延续性和关系的延续性。结果评价指标包括患者的临床结局、医疗卫生资源利用率和患者满意度。提出了研究的不足和未来的研究方向,以期为今后构建统一、规范的脑卒中延续性照护效果评价指标提供参考。 展开更多
关键词 脑卒中 延续性照护 效果 指标 综述
Submental island flap reconstruction for carcinoma of the oral cavity: Experience in 30 cases
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作者 Pradeep Pradhan Swagatika Samal +2 位作者 Dillip Kumar Samal Chappity Preetam Pradipta Kumar Parida 《世界耳鼻咽喉头颈外科杂志(英文)》 2019年第2期65-70,共6页
Objective:The submental flap can be utilized for soft tissue reconstruction in oral cavity malignancies because due to its close approximation to the surgical site,fewer donor site morbidity and the cost effectiveness... Objective:The submental flap can be utilized for soft tissue reconstruction in oral cavity malignancies because due to its close approximation to the surgical site,fewer donor site morbidity and the cost effectiveness of the procedure.Methods:A total of 30 patients with squamous cell carcinoma of the oral cavity were included in the study from July 2012 to August 2015 in a tertiary care referral hospital.Patients with clinical staging Ⅰ/Ⅱ/Ⅲ (T1/T2/T3,N0) oral malignancy were included in the study.Patients with nodal metastasis irrespective of the stage of disease and patients with chronic medical illness/revision cases were excluded from the study.Submental island flap was utilized for the reconstruction of the soft tissue defect in each patient.Patients were followed at monthly interval till 6 months in the postoperative period.Results:The buccal mucosa (12 patients),tongue (10 patients) and floor of mouth (8 patients) were the subsites in the oral cavity.Partial and complete skin necrosis was found in 4 and 2 patients respectively.Postoperative chemoradiation was required in 5 patients.None of the patients had loco regional recurrence till 6 months of follow-up.Conclusion:The submental island flap is considered to be the reliable option for the soft tissue reconstruction in oral cancer because of dependent vascular pedicle,less donor site morbidity and the lower cost compared to the free flaps,often preferred in patients with a lower socioeconomic condition. 展开更多
关键词 ORAL MALIGNANCIES SUBMENTAL ISLAND FLAP Surgical technique OUTCOME
平时火器伤的流行病学特征及救治 预览
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作者 陈海萍 俞文雅 +1 位作者 刘威 张鹭鹭 《解放军医院管理杂志》 2019年第1期5-8,20共5页
目的 分析平时火器伤的流行病学特征及救治特点,为医务人员改善火器伤的医疗救治水平提供科学性建议。方法 通过调查15例平时火器伤患者的病历数据,利用描述性统计方法进行分析。结果 平时火器伤中男女比例为6.5∶1,高发人群为35~44岁和... 目的 分析平时火器伤的流行病学特征及救治特点,为医务人员改善火器伤的医疗救治水平提供科学性建议。方法 通过调查15例平时火器伤患者的病历数据,利用描述性统计方法进行分析。结果 平时火器伤中男女比例为6.5∶1,高发人群为35~44岁和15~24岁。头部是最常见的伤部,异物存留的发生比例为46.7%。火器伤患者中皮肤软组织损伤的发生率为100.0%,骨折和骨关节损伤以及中枢神经系统损伤的发生比例分别为40.0%和13.0%。火器伤患者中重伤和危重伤所占比例分别为6.7%和13.3%。患者院前时间和住院天数普遍较长,53.3%的患者治愈出院。结论 火器伤的防控和救治时应综合考虑人口学特征、受伤特征和创伤救治因素,关注头部创伤和多发伤救护,缩短院前时间,早期预测和防治失血性休克和意识障碍等并发症。 展开更多
关键词 平时火器伤 流行病学特征 救治 转归
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Comparison of treatment modalities in pancreatic pseudocyst:A population based study 预览
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作者 Yanting Wang Yazan Abu Omar +1 位作者 Rohit Agrawal Zimu Gong 《世界胃肠外科杂志:英文版(电子版)》 2019年第9期365-372,共8页
BACKGROUND Current therapeutic techniques for pancreatic pseudocyst include surgical management with a laparoscopic approach or an open surgical procedure,percutaneous catheter drainage and endoscopic drainage.Yet it ... BACKGROUND Current therapeutic techniques for pancreatic pseudocyst include surgical management with a laparoscopic approach or an open surgical procedure,percutaneous catheter drainage and endoscopic drainage.Yet it remains controversial whether different treatment approaches affect inpatient outcome.AIM To investigate inpatient outcome of different treatment approaches in treating pancreatic pseudocyst.METHODS Here we conducted a retrospective analysis of pancreatic pseudocyst-associated hospitalizations using the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample.International Classification of Diseases 10 clinical modification and procedure codes are used.RESULTS A total of 7060 patients meeting the above criteria were identified.Our study revealed laparoscopic approach associated with the lowest rate of red blood cell transfusion(P<0.001),and it had lower short-term complications including acute renal failure(P=0.01),urinary tract infection(P=0.01),sepsis(P<0.001)and acute respiratory failure(P=0.01).Laparoscopic surgical approach associated with the shortest mean length of stay(P=0.009),and it had the lowest total charge(P=0.03).All three modalities have similar inpatient mortality(P=0.28).The study also revealed that percutaneous drainage associated with more emergent admission(P<0.001),rural hospital performs the most open surgical drainage(P<0.001)and patients who received laparoscopic drainage are more likely to be discharged home(P<0.001).CONCLUSION Laparoscopic drainage of pancreatic pseudocysts associated with the least shortterm complications and had better outcomes comparing to percutaneous and open surgical drainage from 2016 National Inpatient Sample database. 展开更多
关键词 PANCREATIC PSEUDOCYST Acute PANCREATITIS Drainage EPIDEMIOLOGY INPATIENT OUTCOME
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Comparative outcomes of subcutaneous and transvenous cardioverter-defibrillators
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作者 Jin-Jun Liang Hideo Okamura +11 位作者 Roshini Asirvatham Andrew Schneider David O. Hodge Mei Yang Xu-Ping Li Ming-Yan Dai Ying Tian Pei Zhang Bryan C. Cannon Cong-Xin Huang Paul A. Friedman Yong-Mei Cha 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第6期631-637,共7页
Background: The comparative outcomes of subcutaneous implantable cardioverter-defibrillator (S-ICD) and transvenous (T-ICD) have not been well studied. The aim of this study was to evaluate the safety and efficacy of ... Background: The comparative outcomes of subcutaneous implantable cardioverter-defibrillator (S-ICD) and transvenous (T-ICD) have not been well studied. The aim of this study was to evaluate the safety and efficacy of currently available S-ICD and T-ICD. Methods: The study included 86 patients who received an S-ICD and 1:1 matched to those who received single-chamber T-ICD by gender, age, diagnosis, left ventricular ejection fraction (LVEF), and implant year. The clinical outcomes and implant complications were compared between the two groups. Results: The mean age of the 172 patients was 45 years, and 129 (75%) were male. The most common cardiac condition was hypertrophic cardiomyopathy (HCM, 37.8%). The mean LVEF was 50%. At a mean follow-up of 23 months, the appropriate and inappropriate ICD therapy rate were 1.2% vs. 4.7%(X^2= 1.854, P=0.368) and 9.3% vs. 3.5%(X^2 = 2.428, P = 0.211) in S-ICD and T-ICD groups respectively. There were no significant differences in device-related major and minor complications between the two groups (7.0% vs. 3.5%, X^2 = 1.055, P = 0.496). The S-ICD group had higher T-wave oversensing than T-ICD group (9.3% vs. 0%, X^2 = 8.390, P=0.007). Sixty-five patients had HCM (32 in S-ICD and 33 in T-ICD). The incidence of major complications was not significantly different between the two groups. Conclusions: The efficacy of an S-ICD is comparable to that of T-ICD, especially in a dominantly HCM patient population. The S-ICD is assodated with fewer major complications demanding reoperation. 展开更多
关键词 HYPERTROPHIC CARDIOMYOPATHY IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR Outcome SUBCUTANEOUS IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR
Prevention of macrovascular complications in patients with type 2 diabetes mellitus: Review of cardiovascular safety and efficacy of newer diabetes medications 预览
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作者 Ravi Kant Kashif M Munir +1 位作者 Arshpreet Kaur Vipin Verma 《世界糖尿病杂志:英文版(电子版)》 2019年第6期324-332,共9页
Lack of conclusive beneficial effects of strict glycemic control on macrovascular complications has been very frustrating for clinicians involved in care of patients with diabetes mellitus (DM). Highly publicized cont... Lack of conclusive beneficial effects of strict glycemic control on macrovascular complications has been very frustrating for clinicians involved in care of patients with diabetes mellitus (DM). Highly publicized controversy surrounding cardiovascular (CV) safety of rosiglitazone resulted in major changes in United States Food and Drug Administration policy in 2008 regarding approval process of new antidiabetic medications, which has resulted in revolutionary data from several large CV outcome trials over the last few years. All drugs in glucagon-like peptide-1 receptor agonist (GLP-1 RA) and sodium-glucose cotransporter-2 (SGLT-2) inhibitor classes have shown to be CV safe with heterogeneous results on CV efficacy. Given twofold higher CV disease mortality in patients with DM than without DM, GLP-1 RAs and SGLT-2-inhibitors are important additions to clinician’s armamentarium and should be second line-therapy particularly in patients with T2DM and established atherosclerotic CV disease or high risks for CV disease. Abundance of data and heterogeneity in CV outcome trials results can make it difficult for clinicians, particularly primary care physicians, to stay updated with all the recent evidence. The scope of this comprehensive review will focus on all major CV outcome studies evaluating CV safety and efficacy of GLP-1 RAs and SGLT-2 inhibitors. 展开更多
关键词 Newer antidiabetic MEDICATIONS Glucagon-like peptide-1 receptor agonist Sodium-glucose cotransporter-2 inhibitors Type 2 DIABETES MELLITUS Macrovascular complications CARDIOVASCULAR outcome trials Major CARDIOVASCULAR events HEART failure PREVENTION of HEART disease
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心血管术后改良续贯器官衰竭评分在重症患者住院死亡评估中的应用
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作者 刘晓雨 李呈龙 +1 位作者 刘楠 侯晓彤 《中华胸心血管外科杂志》 CSCD 北大核心 2019年第9期556-560,共5页
目的在续贯器官衰竭评估评分(SOFA评分)基础上构建心血管术后改良SOFA评分(pcvsSOFA)模型,对心血管术后患者的危重程度及预后进行早期评估.方法入选2015年7月至2017年12月3872例ICU滞留时间大于24 h的心血管术后患者,构建推导队列.通过... 目的在续贯器官衰竭评估评分(SOFA评分)基础上构建心血管术后改良SOFA评分(pcvsSOFA)模型,对心血管术后患者的危重程度及预后进行早期评估.方法入选2015年7月至2017年12月3872例ICU滞留时间大于24 h的心血管术后患者,构建推导队列.通过单因素及多因素logistic回归分析,确定构成改良评分模型的相关危险因素,建立评分,并在推导队列及验证队列中评价新模型的有效性.结果急诊手术、二次手术、患者滞留ICU第1天的呼吸系统评分、凝血系统评分、神经系统评分、肾脏系统评分构成了新的评分模型.新评分总分20分,1~5分为Ⅰ级、6~10分为Ⅱ级、11~15分为Ⅲ级、16~20分为Ⅳ级.推导队列中,Ⅰ~Ⅳ级患者的预估病死率分别为0.9%(n=2317)、5.7%(n=1367)、26.8%(n=184)、64.2%(n=4).pcvsSOFA的受试者操作曲线(ROC曲线)下面积(AUC)为0.864(95%CI:0.837~0.892),与SOFA评分相比整体判别改善指数(IDI)提高0.035;验证队列中,AUC(pcvsSOFA)=0.832(95%CI:0.735~0.928),较SOFA评分IDI改善0.211,SOFA、APACHEⅡ及SAPSⅡ的AUC分别为0.771、0.793与0.721.结论相较于传统危重症患者评分,pcvsSOFA可在术后早期更好地对患者进行危重程度分层及预后评估. 展开更多
关键词 SOFA评分 心血管手术 结局
南宁市耐多药肺结核患者的发现和接受治疗情况
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作者 黎舒 赵亚玲 邱媛 《中国热带医学》 CAS 2019年第10期988-990,1008共4页
目的分析南宁市2012—2016年耐多药肺结核患者发现和纳入治疗情况,为政府制定针对性的耐多药肺结核防治策略提供参考依据。方法收集南宁市自2012年5月—2016年12月耐多药肺结核可疑者的培养、药敏及接受治疗和转归等资料,分析不同登记... 目的分析南宁市2012—2016年耐多药肺结核患者发现和纳入治疗情况,为政府制定针对性的耐多药肺结核防治策略提供参考依据。方法收集南宁市自2012年5月—2016年12月耐多药肺结核可疑者的培养、药敏及接受治疗和转归等资料,分析不同登记分类、不同年份耐多药肺结核可疑者的涂阳培阳率、耐多药肺结核检出率以及耐多药肺结核患者的接受治疗比例。结果自2012年5月—2016年12月,南宁市共登记耐多药肺结核可疑者7987例,开展痰结核分枝杆菌培养2844例,痰培养阳性1946例,痰培养阳性率为68.42%;开展传统药敏试验1900例,经菌种鉴定结核分枝杆菌复合群1820例,检出耐多药肺结核213例,耐多药肺结核检出率为11.70%;确诊的213例耐多药肺结核患者中,纳入治疗管理106例,纳入治疗率为49.77%,接受治疗的患者中,治愈40例,完成疗程18例,治疗成功率为54.72%。结论2012—2016年南宁市耐多药肺结核防治取得一定效果,但耐多药肺结核检出率较低也可能与涂阳培阳率低导致检出例数减少有关。针对纳入治疗率和治疗成功率相对较低的问题,建议要提高耐多药肺结核患者的治疗管理水平,不断探索改进耐多药肺结核防控策略从而达到降低耐多药肺结核疫情的目的。 展开更多
关键词 耐多药肺结核 发现 治疗 转归
心理护理干预对胸腰椎结核合并压缩性骨折患者负性情绪及预后转归的影响 预览
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作者 范红丽 宁江兰 《海南医学》 CAS 2019年第18期2442-2445,共4页
目的探析心理护理干预对胸腰椎结核合并压缩性骨折患者负性情绪及预后转归的影响。方法选取2015年1月至2018年12月期间北京中医药大学孙思邈医院接诊的28例胸腰椎结核合并压缩性骨折患者,采用随机数表法分为对照组和观察组各14例,对照... 目的探析心理护理干预对胸腰椎结核合并压缩性骨折患者负性情绪及预后转归的影响。方法选取2015年1月至2018年12月期间北京中医药大学孙思邈医院接诊的28例胸腰椎结核合并压缩性骨折患者,采用随机数表法分为对照组和观察组各14例,对照组患者给予常规护理干预,观察组患者在常规护理基础上结合心理护理干预,入组时、出院前1 d评价两组患者的腰椎功能改善情况、生活质量评分、自我效能感评分、社会功能评分和心理状态。结果观察组患者的治疗优良率为78.57%,明显高于对照组的57.14%,差异有统计学意义(P<0.05);出院前1 d,两组患者的生活质量评分均高于入组时,SAS、SDS评分均低于入组时,自我效能感评分均高于入组时,社会功能评分均低于入组时,差异均有统计学意义(P<0.05);出院前1 d,观察组患者的生活质量评分为(89.63±3.25)分,明显高于对照组的(73.12±4.11)分,SAS、SDS得分分别为(35.28±3.21)分、(40.51±2.64)分,明显低于对照组的(43.26±3.56)分、(48.69±1.66)分,自我效能感评分为(22.18±3.60)分,明显高于对照组的(19.57±3.22)分,社会功能评分为(3.96±0.59)分,明显低于对照组的(5.89±0.71)分,差异均有统计学意义(P<0.05)。结论心理护理干预能够明显改善胸腰椎结核合并压缩性骨折患者负性情绪及预后转归,提高了患者社会功能及自我效能感。 展开更多
关键词 心理护理干预 胸腰椎结核 压缩性骨折 负性情绪 预后 转归
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Is the treatment outcome of hepatocellular carcinoma inferior in elderly patients? 预览
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作者 Kevin Ka Wan Chu Kenneth Siu Ho Chok 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第27期3563-3571,共9页
In view of the increasing life expectancy in different parts of the world, a larger proportion of elderly patients with hepatocellular carcinoma(HCC) requiring oncological treatment is expected. The clinicopathologica... In view of the increasing life expectancy in different parts of the world, a larger proportion of elderly patients with hepatocellular carcinoma(HCC) requiring oncological treatment is expected. The clinicopathological characteristics of HCC in elderly patients and in younger patients are different. Elderly patients, in general, also have more comorbidities. Evaluation of the efficacy of different HCC treatment options in elderly patients is necessary to optimize treatment outcomes for them. Treatment modalities for HCC include hepatectomy, liver transplantation, radiofrequency ablation, transarterial chemoembolization, and molecular-targeted therapy with sorafenib. In this review, current evidence on the risks and outcomes of the different HCC treatments for elderly patients are discussed. According to data in the literature, elderly patients and younger patients benefited similarly from HCC treatments. More clinical data are needed for the determination of selecting criteria on elderly HCC patients to maximize their chance of getting the most appropriate and effective treatments. As such,further studies evaluating the outcomes of different HCC treatment modalities in elderly patients are warranted. 展开更多
关键词 HEPATOCELLULAR carcinoma Aged Clinical OUTCOME SURGERY HEPATECTOMY
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疤痕子宫阴道分娩中四位一体产前护理的应用 预览
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作者 周曼丽 《中国继续医学教育》 2019年第29期160-163,共4页
目的研究对疤痕子宫阴道分娩产妇实施四位一体产前护理的效果。方法选择本院2017年1月—2018年4月中的80例疤痕子宫阴道分娩产妇进行研究,其中40例产妇接受常规产前指导,另外40例产妇接受四位一体产前护理,对应视作对照组、观察组,比较... 目的研究对疤痕子宫阴道分娩产妇实施四位一体产前护理的效果。方法选择本院2017年1月—2018年4月中的80例疤痕子宫阴道分娩产妇进行研究,其中40例产妇接受常规产前指导,另外40例产妇接受四位一体产前护理,对应视作对照组、观察组,比较两组产妇分娩结局以及产妇对护理实施的满意度。结果观察组临产前的焦虑评分明显低于对照组,P<0.05;观察组产程中出血量少于对照组,产程总时间短于对照组,P<0.05;观察组剖宫产率、产后出血率、胎儿宫内窘迫率、产妇满意度为25.00%、5.00%、2.50%、95.00%,优于对照组47.50%、22.50%、22.50%、75.00%,P<0.05。结论四位一体产前护理用于疤痕子宫阴道分娩产妇护理中能够明显提升产妇对护理的满意度,改善分娩结局。 展开更多
关键词 四位一体 产前护理 疤痕子宫 阴道分娩 结局 满意度
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Eosinopenia is a predictive factor for the severity of acute ischemic stroke 预览
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作者 Hui-Min Zhao Wen-Qian Qin +1 位作者 Pei-Ji Wang Zhong-Min Wen 《中国神经再生研究:英文版》 SCIE CAS CSCD 2019年第10期1772-1779,共8页
Previous data have revealed an association between eosinopenia and mortality of acute ischemic stroke.However,the relationship of eosinopenia with infarct volume,infection rate,and poor outcome of acute ischemic strok... Previous data have revealed an association between eosinopenia and mortality of acute ischemic stroke.However,the relationship of eosinopenia with infarct volume,infection rate,and poor outcome of acute ischemic stroke is still unknown.The retrospective study included 421 patients(273 males,65%;mean age,68.0± 13.0 years)with first acute ischemic stroke who were hospitalized in the Second Affiliated Hospital of Soochow University,China,from January 2017 to February 2018.Laboratory data,neuroimaging results,and modified Rankin Scale scores were collected.Patients were divided into four groups according to their eosinophil percentage level(<0.4%,0.4-1.1%,1 1-2.3%,≥2.3%).Spearman’s correlation analysis showed that the percentage of eosinophils was negatively correlated with infarct volume(rs=-0.514,P<0.001).Receiver operating characteristic analysis demonstrated that eosinopenia predicted a large infarct volume more accurately than neutrophilia;the area under curve was 0.906 and 0.876,respectively;a large infarct was considered as that with a diameter larger than 3 cm and involving more than two major arterial blood supply areas.Logistic regression analysis revealed that eosinophil percentage was an independent risk factor for acute ischemic stroke(P=0.002).Moreover,eosinophil percentage was significantly associated with large infarct volume,high infection rate(pulmonary and urinary tract infections),and poor outcome(modified Rankin Scale score>3)after adjusting for potential confounding factors(P-trend<0.001).These findings suggest that eosinopenia has the potential to predict the severity of acute ischemic stroke.This study was approved by the Ethics Committee of the Second Affiliated Hospital of Soochow University,China(approval number:K10)on November 10,2015. 展开更多
关键词 nerve REGENERATION eosinopenia EOSINOPHIL ISCHEMIA stroke INFARCT volume infection clinical outcome neutrophilia risk factors PREDICTIVE factor neural REGENERATION
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