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Clinical comprehensive treatment protocol for managing diabetic foot ulcers:A retrospective cohort study
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作者 Yan-Bin Wang Yan Lv +3 位作者 Guang-Yu Li Ji-Ting Zheng Qing-Xin Jiang Ran Wei 《World Journal of Clinical Cases》 SCIE 2024年第17期2976-2982,共7页
BACKGROUND Diabetic foot ulcers(DFUs)are a common complication of diabetes,often leading to severe infections,amputations,and reduced quality of life.The current standard treatment protocols for DFUs have limitations ... BACKGROUND Diabetic foot ulcers(DFUs)are a common complication of diabetes,often leading to severe infections,amputations,and reduced quality of life.The current standard treatment protocols for DFUs have limitations in promoting efficient wound healing and preventing complications.A comprehensive treatment approach targeting multiple aspects of wound care may offer improved outcomes for patients with DFUs.The hypothesis of this study is that a comprehensive treatment protocol for DFUs will result in faster wound healing,reduced amputation rates,and improved overall patient outcomes compared to standard treatment protocols.AIM To compare the efficacy and safety of a comprehensive treatment protocol for DFUs with those of the standard treatment protocol.METHODS This retrospective study included 62 patients with DFUs,enrolled between January 2022 and January 2024,randomly assigned to the experimental(n=32)or control(n=30)group.The experimental group received a comprehensive treatment comprising blood circulation improvement,debridement,vacuum sealing drainage,recombinant human epidermal growth factor and anti-inflammatory dressing,and skin grafting.The control group received standard treatment,which included wound cleaning and dressing,antibiotics administration,and surgical debridement or amputation,if necessary.Time taken to reduce the white blood cell count,number of dressing changes,wound healing rate and time,and amputation rate were assessed.RESULTS The experimental group exhibited significantly better outcomes than those of the control group in terms of the wound healing rate,wound healing time,and amputation rate.Additionally,the comprehensive treatment protocol was safe and well tolerated by the patients.CONCLUSION Comprehensive treatment for DFUs is more effective than standard treatment,promoting granulation tissue growth,shortening hospitalization time,reducing pain and amputation rate,improving wound healing,and enhancing quality of life. 展开更多
关键词 Diabetic foot ulcers Comprehensive treatment protocol clinical study White blood cell count Wound healing Amputation rate
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Human umbilical cord mesenchymal stem cells to treat spinal cord injury in the early chronic phase: study protocol for a prospective, multicenter, randomized, placebo-controlled, single-blinded clinical trial 被引量:9
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作者 Yang Yang Mao Pang +5 位作者 Yu-Yong Chen Liang-Ming Zhang Hao Liu Jun Tan Bin Liu Li-Min Rong 《Neural Regeneration Research》 SCIE CAS CSCD 2020年第8期1532-1538,共7页
Human umbilical cord mesenchymal stem cells(hUC-MSCs)support revascularization,inhibition of inflammation,regulation of apoptosis,and promotion of the release of beneficial factors.Thus,they are regarded as a promisin... Human umbilical cord mesenchymal stem cells(hUC-MSCs)support revascularization,inhibition of inflammation,regulation of apoptosis,and promotion of the release of beneficial factors.Thus,they are regarded as a promising candidate for the treatment of intractable spinal cord injury(SCI).Clinical studies on patients with early chronic SCI(from 2 months to 1 year post-injury),which is clinically common,are rare;therefore,we will conduct a prospective,multicenter,randomized,placebo-controlled,single-blinded clinical trial at the Third Affiliated Hospital of Sun Yat-sen University,West China Hospital of Sichuan University,and Shanghai East Hospital,Tongji University School of Medicine,China.The trial plans to recruit 66 early chronic SCI patients.Eligible patients will undergo randomization at a 2:1 ratio to two arms:the observation group and the control group.Subjects in the observation group will receive four intrathecal transplantations of stem cells,with a dosage of 1×106/kg,at one calendar month intervals.Subjects in the control group will receive intrathecal administrations of 10 mL sterile normal saline in place of the stem cell transplantations.Clinical safety will be assessed by the analysis of adverse events and laboratory tests.The American Spinal Injury Association(ASIA)total score will be the primary efficacy endpoint,and the secondary efficacy outcomes will be the following:ASIA impairment scale,International Association of Neural Restoration-Spinal Cord Injury Functional Rating Scale,muscle tension,electromyogram,cortical motor and cortical sensory evoked potentials,residual urine volume,magnetic resonance imaging–diffusion tensor imaging,T cell subtypes in serum,neurotrophic factors and inflammatory factors in both serum and cerebrospinal fluid.All evaluations will be performed at 1,3,6,and 12 months following the final intrathecal administration.During the entire study procedure,all adverse events will be reported as soon as they are noted.This trial is designed to evaluate the clinical safety and efficacy of subarachnoid transplantation of hUC-MSCs to treat early chronic SCI.Moreover,it will establish whether cytotherapy can ameliorate local hostile microenvironments,promote tracking fiber regeneration,and strengthen spinal conduction ability,thus improving overall motor,sensory,and micturition/defecation function in patients with early chronic SCI.This study was approved by the Stem Cell Research Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University,China(approval No.[2018]-02)on March 30,2018,and was registered with ClinicalTrials.gov(registration No.NCT03521323)on April 12,2018.The revised trial protocol(protocol version 4.0)was approved by the Stem Cell Research Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University,China(approval No.[2019]-10)on February 25,2019,and released on ClinicalTrials.gov on April 29,2019. 展开更多
关键词 clinical study early chronic phase efficacy human umbilical cord mesenchymal stem cell multicenter trial prospective study randomized controlled trial safety spinal cord injury study protocol
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Possible effect of blonanserin on gambling disorder:A clinical study protocol and a case report 被引量:1
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作者 Akihiro Shiina Tadashi Hasegawa Masaomi Iyo 《World Journal of Clinical Cases》 SCIE 2021年第11期2469-2477,共9页
BACKGROUND Gambling disorder is characterized by excessive and recurrent gambling and can have serious negative social consequences.Although several psychotherapeutic and pharmacological approaches have been used to t... BACKGROUND Gambling disorder is characterized by excessive and recurrent gambling and can have serious negative social consequences.Although several psychotherapeutic and pharmacological approaches have been used to treat gambling disorder,new treatment strategies are needed.Growing evidence suggests that dopamine D3 receptor plays a specific role in the brain reward system.AIM To investigate if blonanserin,a dopamine D3 receptor antagonist,would be effective in reducing gambling impulses in patients with gambling disorder.METHODS We developed a study protocol to measure the efficacy and safety of blonanserin as a potential drug for gambling disorder,in which up to 12 mg/d of blonanserin was prescribed for 8 wk.RESULTS A 37-year-old female patient with gambling disorder,intellectual disability,and other physical diseases participated in the pilot study.The case showed improvement of gambling symptoms without any psychotherapy.However,blonanserin was discontinued owing to excessive saliva production.CONCLUSION This case suggests that blonanserin is potentially an effective treatment for patients with gambling disorder who resist standard therapies,but it also carries a risk of adverse effects. Further studies are needed to confirm the findings. 展开更多
关键词 BLONANSERIN Gambling disorder MEDICATION clinical trial protocol D3 receptor Case report
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Clinical Observarion on 50 Cases of Long-Standing Infantile Diarrhea Treated Mainly with Massotherapy
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作者 Jiang Qilong,Liu xiaoping(Qiqihar Municipal Hospital of Traditional Chinese Medicine,Heilongjiang,161000) 《中国针灸》 CAS CSCD 北大核心 1995年第S2期326-326,共1页
ClinicalObservarionon50CasesofLong-StandingInfantileDiarrheaTreatedMainlywithMassotherapy¥JiangQilong;Liuxia... ClinicalObservarionon50CasesofLong-StandingInfantileDiarrheaTreatedMainlywithMassotherapy¥JiangQilong;Liuxiaoping(QiqiharMuni... 展开更多
关键词 standING Observarion DIARRHEA INFANTILE Long Mainly Massotherapy CASES clinical TREATED
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Necessities and feasibilities of the establishment of traditional Chinese medicine clinical research protocol database
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作者 Jin-Hua Si Nan Li +2 位作者 Liang Du Yao-Long Cheng Hong-Cai Shang 《TMR Integrative Medicine》 2018年第3期133-139,共7页
With the internationalization and modernization of traditional Chinese medicine (TCM), TCM clinical research has accumulated a lot of research information resources. However, these information resources are often sc... With the internationalization and modernization of traditional Chinese medicine (TCM), TCM clinical research has accumulated a lot of research information resources. However, these information resources are often scattered in various retrieval systems, which brings some difficulties to the reference and use of this information. Therefore, we collected TCM clinical research protocols which were published in international journals and established Traditional Chinese Medicine Clinical Research Protocol Database (TCMCRPD), in order to promote the localization of high-quality researches and improve the ability of TCM clinical research in China. After analyzing the major existing problems of TCM clinical research protocols, this essay describes the necessities and feasibilities of building Traditional Chinese Medicine Clinical Research Protocol Database (TCMCRPD) and puts forward some basic technological ideas, so as to provide a theoretical foundation for building the database. 展开更多
关键词 Traditional Chinese Medicine clinical research protocol database NECESSITY Feasibility
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Xi-Feng-Hua-Shi granules for diarrhea-predominant irritable bowel syndrome:protocol for a randomized,double-blind,placebo-controlled multi-center clinical trial
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作者 Hui Li Kai-Li Luo +13 位作者 Dan Wang Yun Huang Xiao-Mei Xu Xue Zou Ren-Jing Qiu Ting Chen Chuan-Wang Zhu Jie Li Yong-Shuang Wang Han-Lin Wang Zu Yang Yong-Yue Wei Yao-Zhou Tian Xu-Dong Tang 《Clinical Research Communications》 2022年第2期15-21,共7页
Background:Irritable bowel syndrome(IBS)is a common functional bowel disorder that can severely affect the quality of life of patients.Limited drugs have been reported for modern medical IBS treatment.The advantages o... Background:Irritable bowel syndrome(IBS)is a common functional bowel disorder that can severely affect the quality of life of patients.Limited drugs have been reported for modern medical IBS treatment.The advantages of traditional Chinese medicine(TCM)treatment are gradually becoming prominent.Xi-Feng-Hua-Shi granules have been clinically used for diarrhea-predominant IBS(IBS-D)treatment for many years in TCM practice.Thus,this study aimed to further verify the effectiveness and safety of Xi-Feng-Hua-Shi(XFHS)granules in IBS-D treatment through a randomized,double-blind,placebo-controlled multi-center clinical trial and provide high-quality evidence for its effectiveness and safety in treatment,as well as provide a basis for clinical rational drug use and explore new clinical IBS-D treatment plans.Methods:A randomized,double-blind,placebo-controlled multi-center clinical trial will be performed in 23 hospitals.A total of 300 participants will be randomly divided into the experimental group(prescribed with XFHS granules)and the control group(prescribed with the placebo granules),with 150 participants in each group.The appearance,shape,color,and taste of the placebo granules are the same as those of XFHS granules.All participants will receive a 4-week treatment and a 6-month follow-up.The primary outcome is the overall clinical efficacy;the secondary outcomes are the IBS-Symptom Severity Score(IBS-SSS),TCM Syndrome Evaluation,and the IBS-Quality of Life(IBS-QoL)score,mental state assessment,and recurrence rate.Outcome measures(including primary and secondary outcome measures)are collected at baseline,as well as 2,4,16,and 28 weeks post-intervention.Discussion:This randomized,placebo-controlled,multi-center trial may provide high-quality evidence for the clinical XFHS granule efficacy in IBS-D treatment.Additionally,this study will conduct safety evaluations to provide a basis for clinical rational drug use. 展开更多
关键词 Xi-Feng-Hua-Shi granules diarrhea-predominant irritable bowel syndrome Randomized double-blind placebo-controlled multi-center clinical trial protocol
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A Protocol for Developing Chinese Clinical Practice Guidelines of Hypertension
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作者 Ying Lou Wenjun Ma +12 位作者 Zijun Wang Nan Yang Yajia Sun Yunlan Liu Ruobing Lei Junxian Zhao Xufei Luo Lu Wang Yaolong Chen Yaling Han Yingxian Sun Yuming Li Jun Cai 《Cardiology Discovery》 2024年第3期187-191,共5页
To improve the standard screening, diagnosis, and treatment of hypertension in patients in China;realize the standardization of clinical practice of hypertension;and improve the prevention and control level of hyperte... To improve the standard screening, diagnosis, and treatment of hypertension in patients in China;realize the standardization of clinical practice of hypertension;and improve the prevention and control level of hypertension in China, it is both important and necessary to develop a clinical practice guideline for hypertension according to a recognized methodology. Jointly sponsored by the National Center for Cardiovascular Diseases, Chinese Medical Doctor Association, Hypertension Committee of the Chinese Medical Doctor Association, Chinese Society of Cardiology, and Hypertension Committee of Cross-Straits Medicine Exchange Association, the “Chinese Clinical Practice Guidelines of Hypertension” was proposed. Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences, Guideline and Standards Research Centre of Chinese Medical Association Publishing House, Lanzhou University Institute of Health Data Science, and Lanzhou University GRADE Center will provide methodological support for the guidelines. 展开更多
关键词 HYPERTENSION clinical practice guidelines protocol
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Transcranial direct current stimulation for auditory verbal hallucinations:a systematic review of clinical trials 被引量:5
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作者 Samaneh Rashidi Myles Jones +3 位作者 Eric Murillo-Rodriguez Sergio Machado Youguo Hao Ali Yadollahpour 《Neural Regeneration Research》 SCIE CAS CSCD 2021年第4期666-671,共6页
Transcranial direct current stimulation(tDCS)has been reportedly beneficial for different neurodegenerative disorders.tDCS has been reported as a potential adjunctive or alternative treatment for auditory verbal hallu... Transcranial direct current stimulation(tDCS)has been reportedly beneficial for different neurodegenerative disorders.tDCS has been reported as a potential adjunctive or alternative treatment for auditory verbal hallucination(AVH).This study aims to review the effects of tDCS on AVH in patients with schizophrenia through combining the evidence from randomized clinical trials(RCTs).The databases of PsycINFO(2000–2019),PubMed(2000–2019),EMBASE(2000–2019),CINAHL(2000–2019),Web of Science(2000–2019),and Scopus(2000–2019)were systematically searched.The clinical trials with RCT design were selected for final analysis.A total of nine RCTs were eligible and included in the review.Nine RCTs were included in the final analysis.Among them,six RCTs reported a significant reduction of AVH after repeated sessions of tDCS,whereas three RCTs did not show any advantage of active tDCS over sham tDCS.The current studies showed an overall decrease of approximately 28%of AVH after active tDCS and 10%after sham tDCS.The tDCS protocols targeting the sensorimotor frontal-parietal network showed greater treatment effects compared with the protocols targeting other regions.In this regard,cathodal tDCS over the left temporoparietal area showed inhibitory effects on AVHs.The most effective tDCS protocol on AVHs was twice-daily sessions(2 mA,20-minute duration)over 5 consecutive days(10 sessions)with the anode over the left dorsolateral prefrontal cortex and the cathode over the left temporal area.Some patient-specific and diseasespecific factors such as young age,nonsmoking status,and higher frequencies of AVHs seemed to be the predictors of treatment response.Taken together,the results of tDCS as an alternative treatment option for AVH show controversy among current literatures,since not all studies were positive.However,the studies targeting the same site of the brain showed that the tDCS could be a promising treatment option to reduce AVH.Further RCTs,with larger sample sizes,should be conducted to reach a conclusion on the efficacy of tDCS for AVH and to develop an effective therapeutic protocol for clinical setting. 展开更多
关键词 auditory verbal hallucinations dorsolateral prefrontal cortex effective protocol randomized clinical trial schizophrenia temporoparietal area transcranial direct current stimulation treatment efficacy
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Clinical outcomes in patients with stage non-seminomatous germ cell cancer 被引量:1
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作者 Zhao-Jie Lv Song Wu +6 位作者 Pei Dong Kai Yao Yin-Yin He Yao-Ting Gui Fang-Jian Zhou Zhuo-Wei Liu Zhi-Ming Cai 《Asian Journal of Andrology》 SCIE CAS CSCD 2013年第4期558-563,I0011,共7页
This study assesses the long-term outcomes in Han Chinese patients with clinical stage I non-seminomatous germ cell testicular cancer (CSI NSGCT) treated with surveillance, retroperitoneal lymph node dissection (RP... This study assesses the long-term outcomes in Han Chinese patients with clinical stage I non-seminomatous germ cell testicular cancer (CSI NSGCT) treated with surveillance, retroperitoneal lymph node dissection (RPLND) and adjuvant chemotherapy. We retrospectively evaluated 89 patients with a mean age of 26.5 years. After orchiectomy, 37 patients were treated with surveillance, 34 underwent RPLND and 18 were managed with chemotherapy. The overall survival rate, the recurrence-free survival rate and the risk factors were evaluated. The median follow-up length was 92 months (range: 6-149 months). Thirteen of the 89 patients (14.6%) had relapses, and one died by the evaluation date. The overall survival rate was 98.9%. The cumulative 4-year recurrence-free rates were 80.2%, 92.0% and 100% for the surveillance, RPLND and chemotherapy groups, respectively. The disease-free period tended to be briefer in patients with a history of cryptorchidism and those with stage Is. Therefore, surveillance, RPLND and adjuvant chemotherapy might be reliable strategies in compliant patients with CSI NSGCT. Surveillance should be recommended for patients with the lowest recurrence rate, especially those without lymphovascular invasion. This study might aid the establishment of a standard therapy for CSI NSGCT in China. 展开更多
关键词 CHEMOTHERAPY clinical stage I non-seminomatous germ cell testicular cancer (CSI NSGCT) OUTCOME retroperitoneallymph node dissection (RPLND) surveillance treatment protocols
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Clinical Application of Dynamic Gait Index-Brazilian Brief Version
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作者 Carlos Kazuo Taguchi élida Pinto Costa +5 位作者 Lucas Vieira Alves Larissa Karoline Santos Erbson Rodrigues de Oliveira Silva Brenda Carla de Lima Araújo Fabíola Andréa Andrade dos Santos Allan Robert da Silva 《Advances in Aging Research》 2018年第6期113-118,共6页
Introduction: In elderly, the progressive degenerations in the nervous system and vestibular system compromise the human body balance leading to a greater risk of falls. The Dynamic Gait Index is a protocol that predi... Introduction: In elderly, the progressive degenerations in the nervous system and vestibular system compromise the human body balance leading to a greater risk of falls. The Dynamic Gait Index is a protocol that predicts risks to falls in seniors. Objective: To analyze the results of the application of the Dynamic Gait Index (DGI)-Brazilian brief proposal and establish correlation with the original version. Methods: Study approved by the Ethics and Research Committee of Federal University of Sergipe (number 0197.0.107000.09). We analyzed 223 files of socially active elderly, female gender, aged ranged 60 to 85 years, mean 68.54 (±7.61) years since 2014. The volunteers were evaluated by the DGI-Brazil. For the statistical analysis, the Pearson Correlation Momentum Correlation Test with Spearman Correlation was used, with p ≤ 0.05 and r = 1.0. Results: Sixty-three (27.8%) of the volunteers presented an altered DGI scores. The statistical analysis indicated that Task 1 and Task 2 did not contribute to decrease the total score in the test. The worst performances occurred in Tasks 3, 5 and 6. There was founded a positive correlation between Tasks 1 and 2;1 and 8;3 and 4;3 and 5;4 and 5;2 and 4;2 and 7. Negative correlation occurred between Tasks 4 and 8, and 6 was not correlated with another Task. Conclusion: The DGI-Brazilian brief version presented an excellent correlation with the original proposal and may be useful in clinical practice as a tool to evidence future risks of falls in the elderly people. 展开更多
关键词 Aged POSTURAL BALANCE ACCIDENTAL FALLS clinical protocols
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不同治疗方案对卵巢储备功能正常年轻女性夫精人工授精妊娠结局的影响 被引量:2
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作者 贺玲 黄永汉 林静 《生殖医学杂志》 CAS 2024年第1期42-48,共7页
目的探讨不同治疗方案对年龄<35岁卵巢储备功能正常女性夫精人工授精(AIH)妊娠结局的影响。方法回顾性分析2015年1月至2021年8月在本中心行AIH助孕的年龄<35岁卵巢储备功能正常女性的3024个周期的临床资料。根据治疗方案分为6组:... 目的探讨不同治疗方案对年龄<35岁卵巢储备功能正常女性夫精人工授精(AIH)妊娠结局的影响。方法回顾性分析2015年1月至2021年8月在本中心行AIH助孕的年龄<35岁卵巢储备功能正常女性的3024个周期的临床资料。根据治疗方案分为6组:自然周期组(NC组,n=380)、克罗米芬组(CC组,n=57)、CC联合促性腺激素(Gn)组(CC+Gn组,n=78)、Gn组(n=1712)、来曲唑组(LE组,n=430)以及LE联合Gn(LE+Gn组,n=367),比较各组患者的一般情况和妊娠结局,并采用多因素Logistic回归分析影响AIH临床妊娠率及活产率的相关因素。结果一般情况比较:6组间体质量指数(BMI)、窦卵泡数(AFC)、基础卵泡刺激素(FSH)水平、优势卵泡数、不孕因素整体比较有统计学差异(P<0.05),而女方年龄、不孕年限、不孕类型及精液处理方式比较均无统计学差异(P>0.05)。妊娠结局比较:6组患者间临床妊娠率和活产率整体比较有统计学差异(P<0.05),其中LE+Gn组的临床妊娠率和活产率显著高于NC组(分别为20.7%vs.9.5%;16.3%vs.7.4%)(P<0.05);6组间流产率、异位妊娠率及多胎率比较无统计学差异(P>0.05)。多因素Logistic回归分析结果显示,矫正混杂因素后,LE+Gn治疗方案和优势卵泡数均是临床妊娠和活产的保护因素(OR>1,P<0.05),而不孕年限是临床妊娠和活产的危险因素(OR<1,P<0.05)。结论LE联合Gn方案可显著提高AIH的临床妊娠率和活产率,可作为年龄<35岁卵巢储备功能正常女性AIH助孕的首选治疗方案。 展开更多
关键词 宫腔内人工授精 治疗方案 年轻女性 临床妊娠率 活产率
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医疗失效模式与效应分析在临床试验方案偏离管理中的应用
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作者 邱博 杨浩天 +5 位作者 杜润璇 宋浩静 孙雪 丁琮洋 白万军 董占军 《医药导报》 CAS 北大核心 2024年第10期1645-1650,共6页
目的规范临床试验的管理,降低方案偏离的发生率,为提高临床试验的质量提供参考。方法运用医疗失效模式与效应分析方法(HFMEA)确定目前方案偏离发生的潜在失效模式,量化并评估失效模式发生频率、严重程度及可探测度,计算风险优先数(RPN)... 目的规范临床试验的管理,降低方案偏离的发生率,为提高临床试验的质量提供参考。方法运用医疗失效模式与效应分析方法(HFMEA)确定目前方案偏离发生的潜在失效模式,量化并评估失效模式发生频率、严重程度及可探测度,计算风险优先数(RPN),提出相应的改进措施,统计分析HFMEA实施前后RPN值,评估改进效果。结果开展HFMEA活动后,14项潜在失效模式的RPN值明显下降(P<0.05);12项潜在失效模式的风险等级下降。HFMEA小组成员在发现问题和解决问题能力、沟通配合等方面得到了显著提高。结论HFMEA活动的实施有助于临床试验方案偏离的管理,可有效降低方案偏离的发生,为提高药物临床试验质量提供经验。 展开更多
关键词 临床试验 方案偏离 医疗失效模式与效应分析
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蕈样肉芽肿误诊为寻常型银屑病临床分析
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作者 吴明明 肖晶 +3 位作者 潘翠翠 沈小雁 赵肖庆 郑捷 《临床误诊误治》 CAS 2024年第12期8-13,共6页
目的探讨蕈样肉芽肿的临床特点及误诊为银屑病原因、防范措施。方法对误诊40年蕈样肉芽肿1例的临床资料进行回顾性分析,并复习相关文献。结果患者主因全身红斑鳞屑40年,躯干红色丘疹伴瘙痒4年就诊。40年前双下肢出现皮疹,逐渐增大为斑块... 目的探讨蕈样肉芽肿的临床特点及误诊为银屑病原因、防范措施。方法对误诊40年蕈样肉芽肿1例的临床资料进行回顾性分析,并复习相关文献。结果患者主因全身红斑鳞屑40年,躯干红色丘疹伴瘙痒4年就诊。40年前双下肢出现皮疹,逐渐增大为斑块,长期诊断为银屑病,治疗效果差。4年前躯干出现粟粒样丘疹伴瘙痒,外院经病理检查考虑蕈样肉芽肿,后因皮疹反复,更换部位病理检查再次诊断为寻常型银屑病,对症治疗效果差。入院后完善相关检查,明确诊断为蕈样肉芽肿(ⅣB期),调整治疗方案,目前病情稳定。结论蕈样肉芽肿早期临床及病理表现不典型,易误诊。对于非典型的或常规治疗无反应的银屑病患者,特别是在开始使用免疫抑制剂之前,建议进行组织病理及其他特异性检查以明确诊断并排除蕈样肉芽肿,降低误诊率,改善患者预后。 展开更多
关键词 蕈样肉芽肿 皮肤T细胞淋巴瘤 误诊 银屑病 诊断 鉴别 治疗方案 预后
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雄关漫道真如铁 而今迈步从头越——中国儿童骨科临床多中心研究参与体会
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作者 唐欣 《临床小儿外科杂志》 CAS CSCD 北大核心 2024年第6期501-504,共4页
中国儿童骨科多中心研究协作组(Chinese Multicenter Pediatric Orthopedic Study Group,CMPOS)作为国内第一个以儿童骨科临床多中心研究为特色的学术组织,自2013年成立以来,致力于推动多中心研究在中国的开展。经过10年的耕耘,不仅在... 中国儿童骨科多中心研究协作组(Chinese Multicenter Pediatric Orthopedic Study Group,CMPOS)作为国内第一个以儿童骨科临床多中心研究为特色的学术组织,自2013年成立以来,致力于推动多中心研究在中国的开展。经过10年的耕耘,不仅在各成员单位内完成了从临床研究理论培训、病例资料收集整理的均质化建设,到青年医师科研思维及人才梯队培养,还取得了在The New England Journal of Medicine等国际知名学术期刊发表多篇中国儿童骨科多中心临床研究论文的成绩。本文旨在回顾该学术组织近10年的发展历程,将该组织探索并实践的儿童骨科多中心临床研究之路分享给读者,以资借鉴。 展开更多
关键词 临床方案 临床研究 多中心研究 骨科 儿童
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药物临床试验815例次方案违背的帕累托图分析
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作者 陈云艳 李晓晖 文娱 《现代医药卫生》 2024年第10期1700-1702,共3页
目的分析药物临床试验的方案违背情况,找出需重点关注的方案违背,并提出解决方案,以保证药物临床试验质量。方法收集2022年1-12月该院815例次药物临床试验方案违背报告数据,包括类别、例数等。采用Excel2007软件进行数据分析,绘制帕累托... 目的分析药物临床试验的方案违背情况,找出需重点关注的方案违背,并提出解决方案,以保证药物临床试验质量。方法收集2022年1-12月该院815例次药物临床试验方案违背报告数据,包括类别、例数等。采用Excel2007软件进行数据分析,绘制帕累托图,明确构成方案违背的主要因素。结果815例次药物临床试验中药物漏服/少服/多服、检查漏查、访视超窗是方案违背的主要因素。导致方案违背的责任主体中61.84%(504/815)为受试者,25.64%(209/815)为研究者。结论药物临床试验实施过程中,需重点关注药物服用情况,检查完整性及访视窗问题,加强研究者及受试者培训,规范药物临床试验管理,提高药物临床试验质量。 展开更多
关键词 方案违背 药物临床试验 帕累托图 质量控制
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抗黑色素瘤分化相关基因5抗体阳性的皮肌炎诊疗进展
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作者 谈文峰 《中国临床保健杂志》 CAS 2024年第4期433-438,共6页
抗黑色素瘤分化相关基因5(MDA5)抗体阳性的皮肌炎是皮肌炎的一种亚型,该类患者易出现间质性肺病,特别是快速进展的间质性肺病(RPILD),发生RPILD后,常对激素和免疫抑制剂治疗产生抵抗,尽管积极治疗,死亡率仍高达70%,严重危害患者生命安... 抗黑色素瘤分化相关基因5(MDA5)抗体阳性的皮肌炎是皮肌炎的一种亚型,该类患者易出现间质性肺病,特别是快速进展的间质性肺病(RPILD),发生RPILD后,常对激素和免疫抑制剂治疗产生抵抗,尽管积极治疗,死亡率仍高达70%,严重危害患者生命安全。该文阐述了抗MDA5阳性皮肌炎发病机制、临床特征和治疗进展,还重点介绍了抗MDA5阳性皮肌炎RPILD早期识别和预警方法。 展开更多
关键词 皮肌炎 体征和症状 抗黑色素瘤分化相关基因5 临床方案
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药物生物等效性临床试验中方案偏离的分析与改进
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作者 陈莹蓉 叶丽冰 +1 位作者 田孟丽 杨水新 《医院管理论坛》 2024年第1期71-73,70,共4页
目的 研究药物生物等效性临床试验实施中发生方案偏离的原因,并探讨解决对策,为提高临床试验质量提供依据。方法 以方案偏离的年度分布、发生率和类别为评价指标,分析造成方案偏离现象的原因,并提出解决对策。结果 2018年1月至2022年12... 目的 研究药物生物等效性临床试验实施中发生方案偏离的原因,并探讨解决对策,为提高临床试验质量提供依据。方法 以方案偏离的年度分布、发生率和类别为评价指标,分析造成方案偏离现象的原因,并提出解决对策。结果 2018年1月至2022年12月湖州市中心医院共开展生物等效性试验项目27个,发生方案偏离项目23个,共计229例次。发生方案偏离的类别主要为血样采集过程(59.40%)、违反试验流程(33.17%)和生物样本管理(7.43%)。结论 建议组建职业化的临床试验人才队伍,建立完善的质量管理体系;研究人员应持续学习和培训,严格遵循GCP原则及试验方案,减少方案偏离的发生。 展开更多
关键词 药物临床实验 生物等效性试验 方案偏离
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针刀松解联合Mulligan手法治疗中期膝骨关节炎临床观察
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作者 唐占英 肖静 +3 位作者 李唯薇 王诗云 胡志俊 仲卫红 《世界中医药》 CAS 北大核心 2024年第1期47-51,共5页
目的:观察针刀松解联合Mulligan手法治疗中度膝骨关节炎的临床效果。方法:选取2019年9月至2020年9月上海中医药大学附属龙华医院和上海中医药大学附属龙华医院金山分院门诊收治的KOA患者120例作为研究对象,按照随机数字表法随机分为针... 目的:观察针刀松解联合Mulligan手法治疗中度膝骨关节炎的临床效果。方法:选取2019年9月至2020年9月上海中医药大学附属龙华医院和上海中医药大学附属龙华医院金山分院门诊收治的KOA患者120例作为研究对象,按照随机数字表法随机分为针刀组、手法组和联合组,每组40例。针刀组采用单纯针刀治疗,手法组采用Mulligan手法治疗,联合组采用针刀联合Mulligan手法治疗。分别观察2组患者治疗前、治疗后及随访24周骨关节炎指数、疼痛视觉模拟评分变化情况、5次坐立试验情况和2组患者临床疗效情况。结果:与针刀组、手法组比较,联合组在治疗后和随访24周,在疼痛视觉模拟评分、骨关节炎指数评分和5次坐立试验情况改善方面差异均有统计学意义(均P<0.01),联合组临床疗效总有效率为97.50%,明显优于针刀组(92.10%)和手法组(75.00%),差异有统计学意义(P<0.05)。结论:针刀联合Mulligan手法治疗中度膝骨关节炎,在改善患者关节疼痛、僵硬和活动不利等症状在近期与远期疗效方面均效果显著,值得临床推广应用。 展开更多
关键词 膝骨关节炎 针刀疗法 Mulligan手法 调衡筋骨 视觉模拟评分 西安大略和麦克马斯特大学骨关节炎指数 5次坐立试验 临床观察
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院前急救在高危胸痛患者救治中的应用效果分析
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作者 谢立志 陈秋虾 《中华灾害救援医学》 2024年第7期800-802,共3页
目的探索院前急救方案在高危胸痛急救过程中的应用效果。方法将2021年6月至2023年6月由漳州市急救中心收治的90例高危胸痛患者,采用随机数字表法分为观察组与对照组,每组各45例。观察组采取院前急救服务,对照组采取常规急救,对比两组患... 目的探索院前急救方案在高危胸痛急救过程中的应用效果。方法将2021年6月至2023年6月由漳州市急救中心收治的90例高危胸痛患者,采用随机数字表法分为观察组与对照组,每组各45例。观察组采取院前急救服务,对照组采取常规急救,对比两组患者的抢救时间、不良结局及临床疗效。结果观察组发病到急诊时间、发病到病情确诊时间、平均住院时间均显著短于对照组(P值均<0.001)。观察组并发症发生率为24.44%,死亡率为8.89%,对照组的并发症发生率为48.89%,死亡率为33.33%,观察组的并发症发生率及死亡率均显著低于对照组(P<0.005)。观察组的临床有效率为97.78%,显著高于对照组的82.22%,差异有统计学意义(P=0.014)。结论院前急救服务可有效缩短高危胸痛患者急救时间,降低不良结局的发生率,提高抢救的有效率。 展开更多
关键词 急救医疗服务 胸痛 临床方案
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卵泡期长效长方案与黄体期短效长方案的临床结局比较
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作者 孙雪艳 张爱玉 王辉 《国际医药卫生导报》 2024年第9期1473-1477,共5页
比较体外受精-胚胎移植(IVF-ET)卵泡期长效长方案与黄体期短效长方案新鲜移植周期的临床结局。方法回顾性分析2018年1月至2022年12月在烟台市烟台山医院生殖医学中心行IVF-ET助孕的313例患者(313个周期)资料,根据其促排卵方案分成两组... 比较体外受精-胚胎移植(IVF-ET)卵泡期长效长方案与黄体期短效长方案新鲜移植周期的临床结局。方法回顾性分析2018年1月至2022年12月在烟台市烟台山医院生殖医学中心行IVF-ET助孕的313例患者(313个周期)资料,根据其促排卵方案分成两组。卵泡期长效长方案组(A组,141个周期),年龄(31.59±3.00)岁,不孕年限(3.48±2.38)年;黄体期短效长方案组(B组,172个周期),年龄(31.42±3.03)岁,不孕年限(3.38±2.38)年。应用t检验及χ^(2)检验比较两种方案的临床结局。结果A组总促性腺激素(Gn)用量、Gn天数、人绒毛膜促性腺激素(HCG)日内膜厚度均高于B组[(29.53±11.18)支比(23.83±7.03)支、(9.61±1.80)d比(8.44±1.26)d、(1.13±0.23)cm比(1.06±0.26)cm],差异均有统计学意义(t=5.49、6.75、2.44,均P<0.05);A组HCG日雌二醇(E2)、HCG日黄体生成素(LH)水平、获卵率、优胚率均低于B组[(2255.00±1417.75)ng/L比(2787.01±1285.11)ng/L、(1.56±1.34)mIU/ml D0I:10.3765.2024.09.015比(2.12±1.02)mIU/ml、81.00%(1522/1879)比84.74%(2043/2411)、38.31%(344/898)比48.22%(597/1238)],差异均有统计学意义(t=3.44、4.14,χ^(2)=10.50、20.76,均P<0.05);A组临床妊娠率、胚胎着床率高于B组[59.65%(68/114)比43.88%(43/98)、44.39%(87/196)比31.82%(56/176)],差异均有统计学意义(χ^(2)=5.26、6.19,均P<0.05)。结论卵泡期长效长方案新鲜移植周期临床妊娠率和胚胎着床率均高于黄体期短效长方案。 展开更多
关键词 体外受精-胚胎移植 卵泡期长效长方案 黄体期短效长方案 临床妊娠率 胚胎着床率
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