In randomized clinical trials with right-censored time-to-event outcomes,the popular log-rank test without adjusting for baseline covariates is asymptotically valid for treatment effect under simple randomization of t...In randomized clinical trials with right-censored time-to-event outcomes,the popular log-rank test without adjusting for baseline covariates is asymptotically valid for treatment effect under simple randomization of treatments but is too conservative under covariate-adaptive random-ization.The stratified log-rank test,which adjusts baseline covariates in the test procedure by stratification,is asymptotically valid regardless of what treatment randomization is applied.In the literature,however,under simple randomization there is no affirmative conclusion about whether the stratified log-rank test is asymptotically more powerful than the unstratified log-rank test.In this article we show when the stratified and unstratified log-rank tests aim for the same null hypothesis and that,under simple randomization,the stratified log-rank test is asymp-totically more powerful than the unstratified log-rank test in the region of alternative hypothesis that is specified by a Cox proportional hazards model.We also provide some discussion about why we do not have an affirmative conclusion in general.展开更多
目的探讨全麻复合腹横肌平面阻滞(TAP)和髂腹下髂腹股沟神经阻滞(INB)对腹腔镜下疝气修补术患者的麻醉效果。方法前瞻性选择2021年6月—2022年5月在靖江市中医院就诊的80例腹腔镜下疝气修补术患者为研究对象,以随机数表法分为研究组、...目的探讨全麻复合腹横肌平面阻滞(TAP)和髂腹下髂腹股沟神经阻滞(INB)对腹腔镜下疝气修补术患者的麻醉效果。方法前瞻性选择2021年6月—2022年5月在靖江市中医院就诊的80例腹腔镜下疝气修补术患者为研究对象,以随机数表法分为研究组、对照组,每组40例。对照组实行TAP,研究组采用INB麻醉,比较两组麻醉疗效、麻醉前后体征指标[血压(MAP)、心率(HR)、血氧饱和度(SpO2)]、不良反应发生情况以及麻醉指标(苏醒时间、麻醉后疼痛评分、芬太尼用量、定向力恢复时间)。结果研究组麻醉有效率高于对照组,差异有统计学意义(P<0.05);两组患者神经阻滞前MAP、HR、SpO2比较,差异无统计学意义(P>0.05),两组患者神经阻滞后2 min MAP、HR均降低,并且研究组患者MAP、HR低于对照组,差异有统计学意义(P<0.05),两组患者SpO2比较,差异无统计学意义(P>0.05);研究组不良反应发生率显著低于对照组,差异有统计学意义(P<0.05);研究组苏醒时间、麻醉后镇痛评分、芬太尼用量、定向力恢复时间均短于或少于对照组,差异有统计学意义(P<0.05)。结论针对腹腔镜下疝气修补术患者采取INB,麻醉效果稳定,患者体征指标平稳,不易出现不良反应,值得临床应用。展开更多
文摘In randomized clinical trials with right-censored time-to-event outcomes,the popular log-rank test without adjusting for baseline covariates is asymptotically valid for treatment effect under simple randomization of treatments but is too conservative under covariate-adaptive random-ization.The stratified log-rank test,which adjusts baseline covariates in the test procedure by stratification,is asymptotically valid regardless of what treatment randomization is applied.In the literature,however,under simple randomization there is no affirmative conclusion about whether the stratified log-rank test is asymptotically more powerful than the unstratified log-rank test.In this article we show when the stratified and unstratified log-rank tests aim for the same null hypothesis and that,under simple randomization,the stratified log-rank test is asymp-totically more powerful than the unstratified log-rank test in the region of alternative hypothesis that is specified by a Cox proportional hazards model.We also provide some discussion about why we do not have an affirmative conclusion in general.
文摘目的探讨全麻复合腹横肌平面阻滞(TAP)和髂腹下髂腹股沟神经阻滞(INB)对腹腔镜下疝气修补术患者的麻醉效果。方法前瞻性选择2021年6月—2022年5月在靖江市中医院就诊的80例腹腔镜下疝气修补术患者为研究对象,以随机数表法分为研究组、对照组,每组40例。对照组实行TAP,研究组采用INB麻醉,比较两组麻醉疗效、麻醉前后体征指标[血压(MAP)、心率(HR)、血氧饱和度(SpO2)]、不良反应发生情况以及麻醉指标(苏醒时间、麻醉后疼痛评分、芬太尼用量、定向力恢复时间)。结果研究组麻醉有效率高于对照组,差异有统计学意义(P<0.05);两组患者神经阻滞前MAP、HR、SpO2比较,差异无统计学意义(P>0.05),两组患者神经阻滞后2 min MAP、HR均降低,并且研究组患者MAP、HR低于对照组,差异有统计学意义(P<0.05),两组患者SpO2比较,差异无统计学意义(P>0.05);研究组不良反应发生率显著低于对照组,差异有统计学意义(P<0.05);研究组苏醒时间、麻醉后镇痛评分、芬太尼用量、定向力恢复时间均短于或少于对照组,差异有统计学意义(P<0.05)。结论针对腹腔镜下疝气修补术患者采取INB,麻醉效果稳定,患者体征指标平稳,不易出现不良反应,值得临床应用。