进展

订阅

MedSci主页 / 所有栏目 / 进展

盘点：NEJM 12月原始研究第二期汇总

2017-12-14 MedSci MedSci原创

关注

【1】印度基于辅导的WHO安全分娩清单项目的结局DOI：10.1056/NEJMoa1701075http://www.nejm.org/doi/full/10.1056/NEJMoa1701075尽管在过去的二十年间里，资源匮乏地区在医疗机构分娩的情况有了极大的改善，但是护理质量差距仍然存在，死亡率仍然很高。WHO安全分娩清单是一项质量改善工具，可提高助产人员对改善分娩结局的护理操作的总体依从性

【1】印度基于辅导的WHO安全分娩清单项目的结局


DOI：10.1056/NEJMoa1701075

尽管在过去的二十年间里，资源匮乏地区在医疗机构分娩的情况有了极大的改善，但是护理质量差距仍然存在，死亡率仍然很高。WHO安全分娩清单是一项质量改善工具，可提高助产人员对改善分娩结局的护理操作的总体依从性。研究人员在印度北方邦24个县的120家医疗机构内进行了一项配对设计的整群随机对照试验，测试了优生计划对分娩后7天内围生期死亡率、产妇死亡率或产妇重度并发症发生率的复合结局的影响。此外，研究人员还在启动干预后2个月和12个月时，比较了15组配对的医疗机构内助产人员对18项关键性分娩实践操作规范的依从性。结果表明，实施了安全分娩清单计划的医疗机构内，助产人员对于关键性分娩操作的依从性高于未实施安全分娩清单计划的机构，但是两组间的产妇和围生期死亡率，以及产妇发病率均无显著差异。

【2】无创性心脏放射消融术治疗室性心动过速的效果

DOI：10.1056/NEJMoa1613773

最新进展已经使心脏心律失常与心电图成像的无创性绘图成为可能，并可使用立体定向放射治疗（SBRT）实现无创性精确传送消融放射。我们将这些技术结合对室性心动过速实施无导管的、电生理学引导的无创性心脏放射消融术。通过植入型心律转复除颤器诱发室性心动过速，再将心动过速期间的解剖学影像和无创性心电图成像相结合，靶向致心律失常性瘢痕区。SBRT模拟、设计和治疗均采用标准技术。在患者清醒状态采用 25 Gy剂量的单次治疗。2015年的4月至11月，有5例难治性室性心动过速高危患者接受了治疗。结果表明，电生理引导下的无创性心脏放射消融治疗明显降低了室性心动过速的负荷。

【3】1型糖尿病患者胰岛素治疗中加用sotagliflozin的效果

DOI：DOI: 10.1056/NEJMoa1708337

大多数的1型糖尿病患者单纯使用胰岛素治疗难以达到充分的血糖控制。Sotagliflozin是一种口服钠-葡萄糖协同转运蛋白1和2的抑制剂，近期，一项三期双盲临床试验评价了1型糖尿病患者中胰岛素和sotagliflozin联用的安全性和疗效。研究共纳入了1402名正在接受任何形式胰岛素治疗的1型糖尿病患者，随机分配分别接受sotagliflozin（每日400mg）或安慰剂治疗24周。结果表明，在使用胰岛素治疗的1型糖尿病患者中，接受sotagliflozin治疗者达到糖化血红蛋白小于7.0%同时无严重低血糖或酮症酸中毒的比例高于接受安慰剂者。但是，sotagliflozin组有较高的糖尿病酮症酸中毒的发生率。

【4】青少年和青年接种的二价乙型脑膜炎球菌疫苗的研制

MenB-FHbp是一种获得许可的靶向H因子结合蛋白的乙型脑膜炎球菌疫苗。两项3期研究已评估了该疫苗的安全性及其对不同株的乙型脑膜炎球菌的免疫原性。新的研究中，研究人员随机分配了3596位青少年（10-18岁）在基线、2个月、6个月时接受MenB-FHbp疫苗或甲型肝炎病毒疫苗和生理盐水。使用包含人类补体的血清杀菌检测评估免疫原性。结果表明，在接受第二剂和第三剂后，MenB-FHbp疫苗引起了针对不同乙型脑膜炎球菌菌株的杀菌反应，并且在注射部位产生的反应比在甲肝病毒疫苗和盐水强。

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=271858, encodeId=57d62e1858d3, content=学习.了解.了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/07/d51783575d8d90eaa8b668d568aa6e50.jpg, createdBy=909f109204, createdName=liuweigang, createdTime=Sat Dec 23 14:36:27 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271276, encodeId=ce2c2e127623, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Thu Dec 21 19:14:13 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271229, encodeId=11242e1229cf, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Thu Dec 21 12:51:58 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=269750, encodeId=1f6b269e5057, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Dec 16 06:57:08 CST 2017, time=2017-12-16, status=1, ipAttribution=)]
    2017-12-23 liuweigang

    学习.了解.了解

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=271858, encodeId=57d62e1858d3, content=学习.了解.了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/07/d51783575d8d90eaa8b668d568aa6e50.jpg, createdBy=909f109204, createdName=liuweigang, createdTime=Sat Dec 23 14:36:27 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271276, encodeId=ce2c2e127623, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Thu Dec 21 19:14:13 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271229, encodeId=11242e1229cf, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Thu Dec 21 12:51:58 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=269750, encodeId=1f6b269e5057, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Dec 16 06:57:08 CST 2017, time=2017-12-16, status=1, ipAttribution=)]
    2017-12-21 三生有幸9135

    学习一下谢谢分享

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=271858, encodeId=57d62e1858d3, content=学习.了解.了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/07/d51783575d8d90eaa8b668d568aa6e50.jpg, createdBy=909f109204, createdName=liuweigang, createdTime=Sat Dec 23 14:36:27 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271276, encodeId=ce2c2e127623, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Thu Dec 21 19:14:13 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271229, encodeId=11242e1229cf, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Thu Dec 21 12:51:58 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=269750, encodeId=1f6b269e5057, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Dec 16 06:57:08 CST 2017, time=2017-12-16, status=1, ipAttribution=)]
    2017-12-21 1e0f8808m18(暂无匿称)

    学习了.谢谢分享.

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=271858, encodeId=57d62e1858d3, content=学习.了解.了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/07/d51783575d8d90eaa8b668d568aa6e50.jpg, createdBy=909f109204, createdName=liuweigang, createdTime=Sat Dec 23 14:36:27 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271276, encodeId=ce2c2e127623, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Thu Dec 21 19:14:13 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271229, encodeId=11242e1229cf, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Thu Dec 21 12:51:58 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=269750, encodeId=1f6b269e5057, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Dec 16 06:57:08 CST 2017, time=2017-12-16, status=1, ipAttribution=)]
    2017-12-16 1e0f8808m18(暂无匿称)

    学习了.谢谢分享

    0