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外部验证支持下万古霉素群体药物动力学模型外推用于儿童患者模型引导的精准用药
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作者 吕萌 周宇雪 +1 位作者 王丹姝 张胜男 《中国抗生素杂志》 CAS CSCD 北大核心 2024年第9期1051-1056,共6页
目的本研究旨在对前期在皮肤软组织和骨关节感染的儿童患者中建立的万古霉素群体药物动力学模型进行外部验证,从而判断其是否可以外推至其他患者人群,用于指导万古霉素在儿童患者中的个体化应用。方法从医院信息系统中回顾性提取2021年... 目的本研究旨在对前期在皮肤软组织和骨关节感染的儿童患者中建立的万古霉素群体药物动力学模型进行外部验证,从而判断其是否可以外推至其他患者人群,用于指导万古霉素在儿童患者中的个体化应用。方法从医院信息系统中回顾性提取2021年6月—2022年12月入住我院儿童患者的年龄、性别、体重、实验室检查和万古霉素血药浓度等基本信息。将前期建立的儿童患者群体药物动力学模型在Phoenix软件中重建,通过贝叶斯法预测得到每个患者万古霉素的个体预测值,计算个体预测值与观测值的相对预测误差和均方根误差(百分比)等统计量和作图分析,对已建立的万古霉素群体药代动力学模型进行外部验证。结果共342例儿童患者的399个万古霉素稳态血药浓度数据用于最终的外部验证。除新生儿患者外,婴幼儿、儿童及青少年患者万古霉素血药浓度观测值及预测值计算获得平均预测误差和预测误差中位数均在±20%之内,均方根误差(百分比)在30%之内。根据感染类型分层,除新生儿患者外,呼吸系统感染、中枢神经系统感染及其他感染儿童患者万古霉素血药浓度观测值及预测值计算获得平均预测误差和预测误差中位数均在±20%之内,均方根误差(百分比)在30%之内(呼吸系统感染患者为31.1%)。结论前期建立的儿童患者万古霉素群体药物动力学模型可以外推至婴幼儿、儿童及青少年患者中用于模型引导的精准用药,从而指导万古霉素在儿童患者中的个体化应用。 展开更多
关键词 群体药物动力学模型 外推 万古霉素 儿童 模型引导的精准用药
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老年缺血性脑卒中患者用药偏差预测模型构建与验证
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作者 程美娟 邱凯丽 《临床护理杂志》 2024年第3期14-18,共5页
目的分析老年缺血性脑卒中患者发生用药偏差的危险因素,以此构建风险预测模型并验证。方法选取2022年5月-2023年9月我院治疗且出院2周的老年缺血性脑卒中患者120例作为模型组,根据有无发生用药偏差分为偏差组47例和非偏差组73例。按同... 目的分析老年缺血性脑卒中患者发生用药偏差的危险因素,以此构建风险预测模型并验证。方法选取2022年5月-2023年9月我院治疗且出院2周的老年缺血性脑卒中患者120例作为模型组,根据有无发生用药偏差分为偏差组47例和非偏差组73例。按同样的纳排标准选取2022年7月-2023年12月的老年缺血性脑卒中患者51例作为验证组。采用单因素及多因素Logistic回归分析老年缺血性脑卒中患者发生用药偏差的独立危险因素,应用R语言软件绘制相应的列线图,并以此构建风险预测模型。同时在模型组数据(内部验证)和验证组数据(外部验证)中采用受试者工作特征(ROC)曲线、校准曲线及Hosmer-Lemeshow(H-L)拟合优度检验评估模型的预测性能;采用临床决策曲线评估模型的临床适用性。结果多因素Logistic回归分析结果显示,无照护者、用药史不完整、服药依从性差、患者用药数量≥5种和合并慢性疾病≥2种为影响老年缺血性脑卒中患者发生用药偏差的独立危险因素(P<0.05)。基于以上5个独立危险因素构建相应的风险预测模型。模型组ROC曲线下面积(AUC)为0.836(95%CI=0.763~0.910,P<0.001),敏感度为72.30%、特异度为78.10%,H-L拟合优度检验结果显示,χ2=6.751,P=0.564,模型拟合情况良好;校准曲线结果显示,模型预测概率与实际发生情况之间具有良好的一致性,预测准确率为82.35%;临床决策曲线结果显示,模型具有较高的临床适用价值。结论老年缺血性脑卒中患者发生用药偏差受多种因素影响,构建的预测模型具有较高的临床应用价值,医护人员可针对危险因素采取相应措施以降低风险。 展开更多
关键词 缺血性脑卒中 用药偏差预测模型
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门诊用药安全监测与智能化用药审核模型的应用评价 被引量:9
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作者 罗艳 裴丽 +3 位作者 刘皈阳 周亮 李翔 黄显金 《中国药业》 CAS 2014年第10期53-55,共3页
目的开发合理用药软件系统,应用智能化信息技术提高电子处方审核质量,协助药师开展工作,促进安全合理用药。方法在原有医院信息系统的基础上,以及中文操作系统环境下,采用C++程序编辑工具和用药系统,结合条形码技术,开发医院门诊药房自... 目的开发合理用药软件系统,应用智能化信息技术提高电子处方审核质量,协助药师开展工作,促进安全合理用药。方法在原有医院信息系统的基础上,以及中文操作系统环境下,采用C++程序编辑工具和用药系统,结合条形码技术,开发医院门诊药房自动化合理用药监管软件。结果窗口合理用药软件及合理用药处方审查和报告系统的应用,可实时监测处方不安全用药状况,为门诊患者安全用药提供客观的数据支持。结论信息化技术结合临床用药监测需求开发软件,可方便、快捷地辅助药师审核处方,促进合理用药,是药师开展临床安全用药监测与评价的药学服务工具。 展开更多
关键词 用药安全 智能化用药审核模型 医院信息系统
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模型中医学的治疗思路 被引量:1
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作者 李秀美 王全年 《河南中医》 2013年第7期1183-1184,共2页
模型中医学从物质、功能、信息三个层面来界定阴阳。它有具体的物质寄托,又以不同的功能或能量表达其质,并以不同的信息,产生出人类可认识的"现象"。其治疗原则、组方用药、药性、治法均模型化。
关键词 模型中医学 治疗思路 太极模型 阴阳模型 治疗原则模型 组方用药模型 药性模型 治法模型
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模型引导的儿童万古霉素个体化用药程序的编制及临床应用
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作者 王俊 刘茂昌 +3 位作者 李思婵 聂刚 庹亚莉 汪洋 《中国药学杂志》 CAS CSCD 北大核心 2024年第14期1347-1352,共6页
目的 应用模型引导的精准用药技术促进万古霉素(Vam)在儿科临床中的个体化治疗。方法 收集患儿用药后Vam血药浓度数据,通过文献检索和外部验证筛选出适用于中国儿童的Vam群体药动学(PPK)模型。将优选模型嵌入JPKD软件的用户自定义模块,... 目的 应用模型引导的精准用药技术促进万古霉素(Vam)在儿科临床中的个体化治疗。方法 收集患儿用药后Vam血药浓度数据,通过文献检索和外部验证筛选出适用于中国儿童的Vam群体药动学(PPK)模型。将优选模型嵌入JPKD软件的用户自定义模块,建立基于贝叶斯最大后验概率法(MAPB)的个体化用药预测程序。应用该程序辅助临床为患儿提供个体化剂量调整服务。通过案例分析展示本研究编制的个体化用药程序应用效果。结果 本研究共收集了22名患儿的32个Vam血药浓度外部验证数据,患儿年龄中位数为6.04岁(44周~14.58岁)。程序预测浓度与实测浓度相比较,平均预测误差、平均绝对预测误差、平均预测误差平方分别为(0.098 4±0.141)(0.109±0.133) mg·L^(-1)、(0.029 0±0.087 2) mg^(2)·L^(-2),外部验证结果表明所选模型具有良好的预测性能,适用于本研究目标群体。4名患儿基于个体化用药辅助程序预测结果调整了Vam用药方案,有效提升了Vam的目标谷浓度和AUC_(24 h)达标情况,明显改善了临床症状和炎性指标,且无不良反应发生。结论 本研究通过自主编程建立了Vam个体化用药预测程序,并将该程序应用于临床实际病例,保障了患者抗感染治疗的有效性和安全性。 展开更多
关键词 万古霉素 模型引导的精准用药 儿童 个体化治疗 临床应用
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Virtual Dressing Room Application with Virtual Human Using Kinect Sensor
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作者 Muhammed Kotan Cemil OZ 《Journal of Mechanics Engineering and Automation》 2015年第5期322-326,共5页
This study proposes a real time 3D virtual model controll and a virtual dressing room application to enable users to try virtual garments and shoes on in front of a virtual mirror. A virtual representation of the user... This study proposes a real time 3D virtual model controll and a virtual dressing room application to enable users to try virtual garments and shoes on in front of a virtual mirror. A virtual representation of the user appears in a virtual changing room and the user's hand motions select the clothes from a list on the screen. Afterwards, the selected virtual clothes appear on a humanoid model in the virtual mirror. For the purpose of aligning the 3D garments and shoes with the model, 3D locations of the joints are used for positioning, scaling and rotating. By using our developed algorithm, small, medium, large or xlarge garment size is selected automatically and this information is shown on the screen. Then, we apply skin color detection to handle the unwanted occlusions between the user and the model. To create a more realistic effect, the system takes into account different images of the clothes according to different human poses and movements. Optional mirror selection buttons make it possible to have multiple viewing angles on the model. Additionally, we developed an algorithm for matching up all motions between the model and garments. In this study, we benefit from the Microsoft Kinect SDK (software development kit) in order to follow the user's movements, coordinate the suitable clothe try-ons and provide depth sort effect to the human body and clothes. In order to use the rapid calculation attributes of game engines, we used unity 3D game engine. 展开更多
关键词 Virtual mirror virtual try-on virtual reality virtual dressing room Kinect for windows human-computer interaction.
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基于真实世界人工智能分析的脑血疏口服液治疗脑卒中的回顾性研究 被引量:4
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作者 李倩 郭艳 +2 位作者 徐梓铭 高翔 王腾蛟 《中华中医药杂志》 CAS CSCD 北大核心 2022年第2期1056-1061,共6页
目的:基于真实世界人工智能方法分析中国中医科学院西苑医院脑血疏口服液患者群,建立脑血疏口服液的用药模型,为中成药的临床适用证探索真实世界数据研究的方法。方法:筛选2006—2015年患者病历信息,纳入门诊患者13159例及住院患者1875... 目的:基于真实世界人工智能方法分析中国中医科学院西苑医院脑血疏口服液患者群,建立脑血疏口服液的用药模型,为中成药的临床适用证探索真实世界数据研究的方法。方法:筛选2006—2015年患者病历信息,纳入门诊患者13159例及住院患者1875例,通过人工智能分析方法,采用Apriori算法、R语言绘图进行描述性分析并建立使用脑血疏口服液的决策树模型。结果:使用脑血疏口服液的患者群以中老年人为主(70~79岁最多),男性(门诊占64.17%,住院占63.73%)发病率均高于女性;缺血性脑卒中(90.60%)远多于出血性脑卒中(6.22%),症状多见偏瘫、肢体力弱,辨证以痰阻、气虚、血瘀为主。住院患者的好转率约为82.03%,门诊患者复诊率为83.21%。凝血功能数据均在正常值范围内,治疗前后比较,APTT、TT、FIB有统计学意义(P<0.05),但没有明显临床意义。缺血性脑卒中及出血性脑卒中症候群均可作为脑血疏口服液用药模型;有脑梗死病史或基础疾病有高血压病也可作为脑血疏口服液预防脑卒中或再次脑卒中用药模型。结论:脑血疏口服液不仅适用于出血性脑卒中,临床更多应用于缺血性脑卒中的治疗,其治疗的脑血管疾病人群特征明确,可能因其具有双向调节作用,本研究对于脑血管疾病的预后及预防发作有积极意义。 展开更多
关键词 脑血疏口服液 脑卒中 人工智能 关联规则分析 用药模型
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Effects of magnesium sulfate on traumatic brain edema in rats 被引量:2
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作者 冯东福 朱志安 卢亦成 《Chinese Journal of Traumatology》 CAS 2004年第3期148-152,共5页
Objective: To investigate the effects of magnesium sulfate on traumatic brain edema and explore its possible mechanism. Methods: Forty-eight Sprague-Dawley (SD) rats were randomly divided into three groups: Control, T... Objective: To investigate the effects of magnesium sulfate on traumatic brain edema and explore its possible mechanism. Methods: Forty-eight Sprague-Dawley (SD) rats were randomly divided into three groups: Control, Trauma and Treatment groups. In Treatment group, magnesium sulfate was intraperitoneally administered immediately after the induction of brain trauma. At 24 h after trauma, total tissue water content and Na +, K +, Ca 2+, Mg 2+ contents were measured. Permeability of blood-brain barrier (BBB) was assessed quantitatively by Evans Blue (EB) dye technique. The pathological changes were also studied. Results: Water, Na +, Ca 2+ and EB contents in Treatment group were significantly lower than those in Trauma group (P< 0.05). Results of light microscopy and electron microscopy confirmed that magnesium sulfate can attenuate traumatic brain injury and relieve BBB injury. Conclusions: Treatment with MgSO 4 in the early stage can attenuate traumatic brain edema and prevent BBB injury. 展开更多
关键词 Brain injuries Brain edema Magnesium sulfate
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Effect of puerarin on neural function and histopathological damages after transient spinal cord ischemia in rabbits 被引量:7
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作者 桑韩飞 梅其炳 +3 位作者 徐礼鲜 王强 程虹 熊利泽 《Chinese Journal of Traumatology》 CAS 2004年第3期143-147,共5页
Objective: To investigate the effect of puerarin on the neural function and the histopathological changes after ischemic spinal cord injury in rabbits. Methods: Thirty male New Zealand white rabbits were randomly divi... Objective: To investigate the effect of puerarin on the neural function and the histopathological changes after ischemic spinal cord injury in rabbits. Methods: Thirty male New Zealand white rabbits were randomly divided into three groups as follows: puerarin group (n=10) receiving intravenous infusion of 30 mg/kg puerarin for 10 minutes, control group (n=10) receiving intravenous infusion of the same volume of normal saline as puerarin for 10 minutes, and sham operation group (n=10) undergoing only the surgical exposure of the abdominal aorta. Temporary spinal cord ischemia was induced by infrarenal aortic occlusion for 20 minutes and followed by reperfusion. The neural status was scored with the Tarlov criteria at 8, 12, 24 and 48 hours after reperfusion. All the animals were killed at 48 hours after reperfusion and the spinal cords (L 5) were removed immediately for histopathological study. Results: The neural function scores at 8, 12, 24 and 48 hours after reperfusion were higher in the puerarin group and sham operation group than those in the control group (P< 0.05). More normal motor neurons in the anterior horn of spinal cord were present in the puerarin group and sham operation group than those in the control group (P< 0.01). There was a strong correlation between the final neural function scores and the number of normal motor neurons in the anterior horn of spinal cord (r= 0.839, P< 0.01). Conclusions: Puerarin can significantly ameliorate the neural function and the histopathological damages after transient spinal cord ischemia in rabbits. 展开更多
关键词 Spinal cord Reperfusion injury RABBITS PUERARIN
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Effect of methylprednisolone on reperfusion injury in severe uncontrolled hemorrhagic shock
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作者 夏芳 曹经山 +3 位作者 詹丽英 夏中元 夏正远 黄海波 《Chinese Journal of Traumatology》 CAS 2003年第6期359-362,共4页
Objective: To study the effect of methylprednisolone (MP) on reperfusion injury in severe uncontrolled hemorrhagic shock and explore the possible mechanism involved. Methods: Twelve dogs were randomly divided into two... Objective: To study the effect of methylprednisolone (MP) on reperfusion injury in severe uncontrolled hemorrhagic shock and explore the possible mechanism involved. Methods: Twelve dogs were randomly divided into two groups, control group (Group I, n=6) and MP group (Group II, n=6). The animals were bled continuously from a femoral artery catheter to produce uncontrolled hemorrhagic shock models. Resuscitation with lactated Ringer’s (LR) solution was initiated when mean arterial pressure (MAP) decreased to 20 mm Hg, and MAP was maintained at 30-40 mm Hg. MP (4 mg/kg) was injected intravenously in Group II when resuscitation began. While in Group I, normal saline (NS) was injected instead. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) were measured before exsanguination (T 1), when MAP decreased to 20 mm Hg (T 2), 60 min (T 3) and 120 min (T 4) after resuscitation. Heart rate, MAP and cardiac output (CO) levels were recorded concomitantly. Results: Infusion volume and hemorrhage volume shed from the superior mesenteric artery in Group I were higher than those in Group II (P< 0.01 and P< 0.05). After reperfusion, blood SOD levels decreased progressively and MDA levels increased rapidly in Group I. In Group II, blood SOD levels at T 3 and T 4 decreased as compared with that at T 1 but a stepwise increase was present. At T 4, blood SOD level was significantly higher in Group II than in Group I (P< 0.01). At T 3 and T 4, MDA levels were markedly lower in Group II than in Group I. During reperfusion, MAP was more steady in Group II than in Group I and survival rate after 120 min (at T 4) was higher in Group II than in Group I (P< 0.05). Conclusions: MP has a protective effect on severe uncontrolled hemorrhagic shock and subsequent reperfusion injury. The mechanism mainly involves the anti-lipid peroxidation activity of MP. 展开更多
关键词 METHYLPREDNISOLONE Reperfusion injury Lipid peroxidation Shock hemorrhagic
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