目的探讨艾司氯胺酮术后静脉镇痛对乳腺癌患者疼痛和情绪的影响。方法采用随机数字表法将择期行乳腺癌手术的60例患者分为艾司氯胺酮组和对照组(每组30例)。手术结束后连接静脉镇痛泵,艾司氯胺酮组给予艾司氯胺酮复合舒芬太尼静脉泵注,...目的探讨艾司氯胺酮术后静脉镇痛对乳腺癌患者疼痛和情绪的影响。方法采用随机数字表法将择期行乳腺癌手术的60例患者分为艾司氯胺酮组和对照组(每组30例)。手术结束后连接静脉镇痛泵,艾司氯胺酮组给予艾司氯胺酮复合舒芬太尼静脉泵注,对照组给予舒芬太尼泵注,其余配方相同。记录两组患者术前1 d和术后3 d的焦虑自评量表(Self-Rating Anxiety Scale,SAS)评分、抑郁自评量表(Self-Rating Depression Scale,SDS)评分,术后1 d和术后2 d的VAS疼痛评分、Ramsay镇静评分,记录两组患者不良反应、辅助镇痛药使用情况、镇痛满意度。结果两组患者术前1 d SAS及SDS评分差异无统计学意义(P>0.05);术后3 d艾司氯胺酮组SAS及SDS评分较对照组降低(P<0.05);艾司氯胺酮组术后3 d SAS及SDS评分较术前1 d下降(P<0.05),而对照组患者术后3 d SAS及SDS评分较术前1 d升高(P<0.05)。两组患者术后1 d及术后2 d Ramsay镇静评分差异无统计学意义(P>0.05);与对照组比较,艾司氯胺酮组患者术后1 d、术后2 d VAS疼痛评分均降低(P<0.05)。两组患者均未发生呼吸抑制现象,头晕、恶心呕吐发生率差异无统计学意义(P>0.05);与对照组比较,艾司氯胺酮组患者术后低血压及辅助镇痛药使用率降低(P<0.05)。艾司氯胺酮组镇痛满意度优于对照组(P<0.05)。结论艾司氯胺酮术后静脉镇痛可减轻患者术后疼痛,稳定患者情绪,减少不良反应发生,提高患者满意度。展开更多
Objective:To determine the effects of a community hospital integrated model on the longitu-dinal management of diabetic patients.Methods:Four hundred forty-one patients with type 2 diabetes residing in Jingsong Commu-...Objective:To determine the effects of a community hospital integrated model on the longitu-dinal management of diabetic patients.Methods:Four hundred forty-one patients with type 2 diabetes residing in Jingsong Commu-nity were randomly assigned to intensive and standard groups.Metabolic parameters were meas-ured in the two groups at baseline and after 36 months of management to compare the rate of goal achievement.Results:After comprehensive management,the overall control rate in the intensive group was increased from 2.7%to 9.6%compared with 2.3%-4.5%in the standard group.Specifically,the control rates for fasting plasma glucose,glycosylated hemoglobin,and blood pressure in the intensive group were significantly increased from 54.1%,40.0%,and 68.2%to 85.5%,74.6%,and 89.1%,respectively.The control rate for glycosylated hemoglobin in the intensive group was significantly higher than the standard group after 36 months of treatment.Conclusion:The community hospital integrated model for longitudinal management effec-tively improved the control rate of glycosylated hemoglobin and the overall control rate in patients with type 2 diabetes.展开更多
In this paper, we propose a Packet Cache-Forward(PCF) method based on improved Bayesian outlier detection to eliminate out-of-order packets caused by transmission path drastically degradation during handover events in...In this paper, we propose a Packet Cache-Forward(PCF) method based on improved Bayesian outlier detection to eliminate out-of-order packets caused by transmission path drastically degradation during handover events in the moving satellite networks, for improving the performance of TCP. The proposed method uses an access node satellite to cache all received packets in a short time when handover occurs and forward them out in order. To calculate the cache time accurately, this paper establishes the Bayesian based mixture model for detecting delay outliers of the entire handover scheme. In view of the outliers' misjudgment, an updated classification threshold and the sliding window has been suggested to correct category collections and model parameters for the purpose of quickly identifying exact compensation delay in the varied network load statuses. Simulation shows that, comparing to average processing delay detection method, the average accuracy rate was scaled up by about 4.0%, and there is about 5.5% cut in error rate in the meantime. It also behaves well even though testing with big dataset. Benefiting from the advantage of the proposed scheme in terms of performance, comparing to conventional independent handover and network controlled synchronizedhandover in simulated LEO satellite networks, the proposed independent handover with PCF eliminates packet out-of-order issue to get better improvement on congestion window. Eventually the average delay decreases more than 70% and TCP performance has improved more than 300%.展开更多
Objective:CDK4/6 inhibitors(CDK4/6is)in combination with endocrine therapy have secured a central role in the treatment of hormone receptor(HR)-positive advanced breast cancer(ABC)and have transformed the therapeutic ...Objective:CDK4/6 inhibitors(CDK4/6is)in combination with endocrine therapy have secured a central role in the treatment of hormone receptor(HR)-positive advanced breast cancer(ABC)and have transformed the therapeutic landscape.Cross-line CDK4/6i therapy in which another CDK4/6i is continued after progression on a prior CDK4/6i may still offer advantageous therapeutic effects.Cross-line CDK4/6i therapy is an area of active investigation in the ongoing pursuit to improve outcomes for patients with HR+/human epidermal growth factor receptor 2(HER2)–ABC.Methods:This retrospective study enrolled 82 patients with HR+/HER2–ABC who were treated with cross-line CDK4/6is(abemaciclib,palbociclib,ribociclib,and dalpiciclib)after progression with another CDK4/6i.The primary endpoint was progression-free survival(PFS)according to version 1.1 of the Response Evaluation Criteria in Solid Tumors.Secondary endpoints included toxicity,objective response rate,disease control rate,and overall survival.Adverse events(AEs)were graded according to version 5.0 of the Common Terminology Criteria for Adverse Events,as promulgated by the U.S.Department of Health and Human Services.Results:Eighty-two HR+/HER2–ABC patients who received cross-line CDK4/6i therapy from January 2022 to February 2024 were enrolled.The median age of the patients was 60 years.The median PFS of all patients was 7.6 months(95%CI,5.9-9.2).Cox regression analysis identified lung metastasis and a switch to endocrine therapy following prior CDK4/6i therapy as independent predictive factors for PFS.Notably,patients who previously received abemaciclib and switched to palbociclib upon disease progression had a median PFS of 10.7 months.The strategy of transitioning to chemotherapy after progression on a prior CDK4/6i,then to a subsequent CDK4/6i merits further investigation.Hematologic toxicity was the most common grade≥3 AEs.No instances of fatal safety events were observed.Conclusions:Cross-line CDK4/6i therapy is associated with significant clinical benefits and 展开更多
Objective:To systematically assess the effectiveness and safety of acupuncture for spastic hemiplegia after ischemic stroke.Methods:Randomized controlled trials(RCTs)of acupuncture treatment for spastic hemiplegia aft...Objective:To systematically assess the effectiveness and safety of acupuncture for spastic hemiplegia after ischemic stroke.Methods:Randomized controlled trials(RCTs)of acupuncture treatment for spastic hemiplegia after ischemic stroke meeting the inclusion criteria in Cochrane Library,Medline,Excerpta Medica Database(EMBASE),PubMed,China National Knowledge Infrastructure(CNKI),SinoMed,Chongqing VIP Database(VIP),and Wanfang Data Knowledge Service Platform(Wanfang)published from each database’s inception to February 2023 were retrieved by computer.Two reviewers independently extracted data and evaluated the risk of bias using Cochrane’s risk of bias tool.Review Manager 5.4 was used for data analysis.Continuous data were evaluated using mean difference(MD)with a 95%confidence interval(CI),and dichotomous data were analyzed using risk ratio(RR).Results:A total of 24 trials,including 1970 participants,were included in the study.The meta-analysis of 7 trials showed that compared to the rehabilitation therapy,acupuncture therapy was more effective in improving the simplified Fugl-Meyer assessment score after 1-month treatments[MD=10.52,95%CI(7.81,13.23),P<0.001].The meta-analysis of 2 articles showed the same tendency after 6-month treatments[MD=19.18,95%CI(11.34,27.02),P<0.001],and the 6-month treatment course resulted in better outcomes than the 1-month course.The meta-analysis of 8 trials showed that acupuncture had a better improvement on the Barthel index score than rehabilitation therapy after 1-month treatments[MD=10.78,95%CI(8.91,12.64),P<0.001].The meta-analysis of 2 articles showed the same tendency after 6-month treatments[MD=19.94,95%CI(19.02,20.87),P<0.001],and the 6-month course was better than the 1-month course.The meta-analysis of 2 trials showed that the effective rate of the modified Ashworth scale score improvement was more notable in the acupuncture group after 1-month treatments[RR=1.20,95%CI(1.02,1.40),P=0.020].One trial reported no adverse event,and 1 trial reported 3 adverse events without展开更多
文摘目的探讨艾司氯胺酮术后静脉镇痛对乳腺癌患者疼痛和情绪的影响。方法采用随机数字表法将择期行乳腺癌手术的60例患者分为艾司氯胺酮组和对照组(每组30例)。手术结束后连接静脉镇痛泵,艾司氯胺酮组给予艾司氯胺酮复合舒芬太尼静脉泵注,对照组给予舒芬太尼泵注,其余配方相同。记录两组患者术前1 d和术后3 d的焦虑自评量表(Self-Rating Anxiety Scale,SAS)评分、抑郁自评量表(Self-Rating Depression Scale,SDS)评分,术后1 d和术后2 d的VAS疼痛评分、Ramsay镇静评分,记录两组患者不良反应、辅助镇痛药使用情况、镇痛满意度。结果两组患者术前1 d SAS及SDS评分差异无统计学意义(P>0.05);术后3 d艾司氯胺酮组SAS及SDS评分较对照组降低(P<0.05);艾司氯胺酮组术后3 d SAS及SDS评分较术前1 d下降(P<0.05),而对照组患者术后3 d SAS及SDS评分较术前1 d升高(P<0.05)。两组患者术后1 d及术后2 d Ramsay镇静评分差异无统计学意义(P>0.05);与对照组比较,艾司氯胺酮组患者术后1 d、术后2 d VAS疼痛评分均降低(P<0.05)。两组患者均未发生呼吸抑制现象,头晕、恶心呕吐发生率差异无统计学意义(P>0.05);与对照组比较,艾司氯胺酮组患者术后低血压及辅助镇痛药使用率降低(P<0.05)。艾司氯胺酮组镇痛满意度优于对照组(P<0.05)。结论艾司氯胺酮术后静脉镇痛可减轻患者术后疼痛,稳定患者情绪,减少不良反应发生,提高患者满意度。
基金This project[ST12-024]is supported by a BRIDGES Grant from the International Diabetes Federation(BRIDGES,an International Diabetes Federation project,is supported by an educational grant from Lilly Diabetes.)a Grant of Special Scientific Research on Capital Health Development[2011-2005-01].
文摘Objective:To determine the effects of a community hospital integrated model on the longitu-dinal management of diabetic patients.Methods:Four hundred forty-one patients with type 2 diabetes residing in Jingsong Commu-nity were randomly assigned to intensive and standard groups.Metabolic parameters were meas-ured in the two groups at baseline and after 36 months of management to compare the rate of goal achievement.Results:After comprehensive management,the overall control rate in the intensive group was increased from 2.7%to 9.6%compared with 2.3%-4.5%in the standard group.Specifically,the control rates for fasting plasma glucose,glycosylated hemoglobin,and blood pressure in the intensive group were significantly increased from 54.1%,40.0%,and 68.2%to 85.5%,74.6%,and 89.1%,respectively.The control rate for glycosylated hemoglobin in the intensive group was significantly higher than the standard group after 36 months of treatment.Conclusion:The community hospital integrated model for longitudinal management effec-tively improved the control rate of glycosylated hemoglobin and the overall control rate in patients with type 2 diabetes.
基金supported by National High Technology Research and Development Program of China(863 Program,No.2014AA7011005)National Nature Science Foundation of China(No.91438120)
文摘In this paper, we propose a Packet Cache-Forward(PCF) method based on improved Bayesian outlier detection to eliminate out-of-order packets caused by transmission path drastically degradation during handover events in the moving satellite networks, for improving the performance of TCP. The proposed method uses an access node satellite to cache all received packets in a short time when handover occurs and forward them out in order. To calculate the cache time accurately, this paper establishes the Bayesian based mixture model for detecting delay outliers of the entire handover scheme. In view of the outliers' misjudgment, an updated classification threshold and the sliding window has been suggested to correct category collections and model parameters for the purpose of quickly identifying exact compensation delay in the varied network load statuses. Simulation shows that, comparing to average processing delay detection method, the average accuracy rate was scaled up by about 4.0%, and there is about 5.5% cut in error rate in the meantime. It also behaves well even though testing with big dataset. Benefiting from the advantage of the proposed scheme in terms of performance, comparing to conventional independent handover and network controlled synchronizedhandover in simulated LEO satellite networks, the proposed independent handover with PCF eliminates packet out-of-order issue to get better improvement on congestion window. Eventually the average delay decreases more than 70% and TCP performance has improved more than 300%.
基金supported by grants from the CAMS Innovation Fund for Medical Sciences[CIFMS](Grant Nos.2021-I2M-1-014 and 2022-I2M-2-002).
文摘Objective:CDK4/6 inhibitors(CDK4/6is)in combination with endocrine therapy have secured a central role in the treatment of hormone receptor(HR)-positive advanced breast cancer(ABC)and have transformed the therapeutic landscape.Cross-line CDK4/6i therapy in which another CDK4/6i is continued after progression on a prior CDK4/6i may still offer advantageous therapeutic effects.Cross-line CDK4/6i therapy is an area of active investigation in the ongoing pursuit to improve outcomes for patients with HR+/human epidermal growth factor receptor 2(HER2)–ABC.Methods:This retrospective study enrolled 82 patients with HR+/HER2–ABC who were treated with cross-line CDK4/6is(abemaciclib,palbociclib,ribociclib,and dalpiciclib)after progression with another CDK4/6i.The primary endpoint was progression-free survival(PFS)according to version 1.1 of the Response Evaluation Criteria in Solid Tumors.Secondary endpoints included toxicity,objective response rate,disease control rate,and overall survival.Adverse events(AEs)were graded according to version 5.0 of the Common Terminology Criteria for Adverse Events,as promulgated by the U.S.Department of Health and Human Services.Results:Eighty-two HR+/HER2–ABC patients who received cross-line CDK4/6i therapy from January 2022 to February 2024 were enrolled.The median age of the patients was 60 years.The median PFS of all patients was 7.6 months(95%CI,5.9-9.2).Cox regression analysis identified lung metastasis and a switch to endocrine therapy following prior CDK4/6i therapy as independent predictive factors for PFS.Notably,patients who previously received abemaciclib and switched to palbociclib upon disease progression had a median PFS of 10.7 months.The strategy of transitioning to chemotherapy after progression on a prior CDK4/6i,then to a subsequent CDK4/6i merits further investigation.Hematologic toxicity was the most common grade≥3 AEs.No instances of fatal safety events were observed.Conclusions:Cross-line CDK4/6i therapy is associated with significant clinical benefits and
文摘Objective:To systematically assess the effectiveness and safety of acupuncture for spastic hemiplegia after ischemic stroke.Methods:Randomized controlled trials(RCTs)of acupuncture treatment for spastic hemiplegia after ischemic stroke meeting the inclusion criteria in Cochrane Library,Medline,Excerpta Medica Database(EMBASE),PubMed,China National Knowledge Infrastructure(CNKI),SinoMed,Chongqing VIP Database(VIP),and Wanfang Data Knowledge Service Platform(Wanfang)published from each database’s inception to February 2023 were retrieved by computer.Two reviewers independently extracted data and evaluated the risk of bias using Cochrane’s risk of bias tool.Review Manager 5.4 was used for data analysis.Continuous data were evaluated using mean difference(MD)with a 95%confidence interval(CI),and dichotomous data were analyzed using risk ratio(RR).Results:A total of 24 trials,including 1970 participants,were included in the study.The meta-analysis of 7 trials showed that compared to the rehabilitation therapy,acupuncture therapy was more effective in improving the simplified Fugl-Meyer assessment score after 1-month treatments[MD=10.52,95%CI(7.81,13.23),P<0.001].The meta-analysis of 2 articles showed the same tendency after 6-month treatments[MD=19.18,95%CI(11.34,27.02),P<0.001],and the 6-month treatment course resulted in better outcomes than the 1-month course.The meta-analysis of 8 trials showed that acupuncture had a better improvement on the Barthel index score than rehabilitation therapy after 1-month treatments[MD=10.78,95%CI(8.91,12.64),P<0.001].The meta-analysis of 2 articles showed the same tendency after 6-month treatments[MD=19.94,95%CI(19.02,20.87),P<0.001],and the 6-month course was better than the 1-month course.The meta-analysis of 2 trials showed that the effective rate of the modified Ashworth scale score improvement was more notable in the acupuncture group after 1-month treatments[RR=1.20,95%CI(1.02,1.40),P=0.020].One trial reported no adverse event,and 1 trial reported 3 adverse events without
