1-year follow-up

1 年随访
  • 文章类型: Journal Article
    幽门螺杆菌的复发率(H.成功根除后的pylori)感染得到了关注。本研究旨在评估中国南部沿海省份成功根除幽门螺杆菌后的复发率,并分析其影响因素。
    975例使用13C或14C-尿素呼气试验(UBT)诊断为幽门螺杆菌感染的上消化道症状患者在2021年8月至2022年12月之间接受了根除治疗。八到十二周后,重复进行UBT。此外,成功根除的824例患者在一年后通过填写问卷进行了重复UBT。计算1年复发率,并根据基线数据分析差异,社会学特征,和生活方式。
    共有734名患者完成了为期1年的随访,其中26例(3.5%)患者出现幽门螺杆菌感染复发。其他感染幽门螺杆菌的个体暴露(χ2=12.852,P<0.001),外出就餐场所卫生条件差(χ2=6.839,P=0.009),经常外出就餐(χ2=24.315,P<0.001),吸烟(χ2=7.510,P=0.006),非纯净水消耗量(χ2=16.437,P<0.001),腌制食品的消费量(χ2=5.682,P=0.017),饮食不规律(χ2=16.877,P<0.001)和年龄(χ2=9.195,P=0.010)是幽门螺杆菌感染复发的重要因素。暴露于感染幽门螺杆菌的其他个体,外出就餐的卫生条件差,消耗非纯净水,频繁外出就餐和不规律进餐模式是独立危险因素(P=0.022,0.016,0.002,<0.001,<0.001;95%CI0.146-0.861,0.121-0.806,1.715-10.845,0.085-0.521,2.291-14.556)。
    中国南部沿海省份根除幽门螺杆菌感染后一年复发率为3.5%。与感染者接触,餐饮场所卫生条件差,消耗非纯净水,经常外出就餐,和不规则膳食模式被确定为影响幽门螺杆菌复发的显著独立因素。
    UNASSIGNED: Recurrence rate of Helicobacter pylori (H. pylori) infection after successful eradication have gained attention. This study was to assess the recurrence rate of H. pylori infection after successful eradication in the southern coastal provinces of China and to analyze its factors.
    UNASSIGNED: 975 patients with upper gastrointestinal symptoms who were diagnosed with H. pylori infection using the 13C or 14C-urea breath test (UBT) underwent eradication treatment between August 2021 and December 2022. After eight to twelve weeks, repeat UBT was performed. Besides, 824 patients with successful eradication underwent a repeat UBT by completing questionnaires after a year. The 1-year recurrence rate was calculated, and the differences were analyzed based on baseline data, sociological characteristics, and lifestyle.
    UNASSIGNED: A total of 734 patients completed the 1-year follow-up, out of which 26 (3.5%) patients experienced a recurrence of H. pylori infection. Exposure to other individuals infected with H. pylori (χ2=12.852, P<0.001), poor hygiene conditions at dining out places (χ2=6.839, P=0.009), frequent dining out (χ2=24.315, P<0.001), smoking (χ2=7.510, P=0.006), consumption of non-purified water (χ2=16.437, P<0.001), consumption of pickled foods (χ2=5.682, P=0.017), irregular meal patterns (χ2=16.877, P<0.001) and age (χ2=9.195, P=0.010) were significant factors for H. pylori infection recurrence. Exposure to other individuals infected with H. pylori, poor hygiene conditions at dining out places, consumption of non-purified water, frequent dining out and irregular meal patterns were independent risk factors (P=0.022, 0.016, 0.002, <0.001, <0.001; 95% CI 0.146-0.861, 0.121-0.806, 1.715-10.845, 0.085-0.521, 2.291-14.556).
    UNASSIGNED: The one-year recurrence rate of H. pylori infection post-eradication in the southern coastal provinces of China is 3.5%. Contacting with infected individuals, poor hygiene in dining places, consumption of non-purified water, frequent dining out, and irregular meal patterns were identified as significant independent factors influencing H. pylori recurrence.
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  • 文章类型: Case Reports
    三尖瓣生物假体结构瓣膜变性(SVD)患者常表现为右心室扩大和严重功能障碍,导致重做心脏手术的风险更高。2019年,我们的中心创新使用J型瓣膜系统进行瓣膜-瓣膜(ViV)植入治疗三尖瓣生物假体SVD。目的总结随访1年后的临床疗效。
    从2019年4月至2019年10月,用J瓣系统治疗了两例三尖瓣生物假体功能障碍。两个病人都是男性,46岁和67岁,分别。术前评估显示,常规重做心脏直视手术的风险较高。两种情况下的J瓣植入均成功。一名患者在手术过程中取出转运器时瓣膜轻微移位,在理想位置植入了第二个J型瓣膜.没有死亡,无延迟阀门位移,在12个月的随访期内没有再入院。在这两种情况下,没有微量三尖瓣返流。华法林抗凝6个月后,患者转为长期阿司匹林治疗.
    使用J型瓣膜的ViV技术治疗高危患者的三尖瓣生物假体SVD是可行和有效的,避免体外循环和传统开胸手术损伤。
    UNASSIGNED: Patients with tricuspid bioprosthetic structural valve degeneration (SVD) often present with right ventricular enlargement and severe dysfunction, which cause a higher risk for redo cardiac surgery. In 2019, our center innovated using the J-valve system for valve-in-valve (ViV) implantation to treat tricuspid bioprosthetic SVD. The purpose of this study was to summarize the clinical effect after 1-year follow-up.
    UNASSIGNED: From April 2019 to October 2019, two cases of tricuspid bioprosthetic dysfunction were treated with the J-valve system. Both patients were male, aged 46 and 67 years, respectively. The preoperative evaluation showed that the risk of conventional redo open heart surgery was high. The J-valve implantation was successful in both cases. One patient had slight valve displacement when the transporter was withdrawn during the operation, and a second J-valve was implanted in an ideal position. There was no death, no delayed valve displacement, and no readmission during the follow-up period of 12 months. In both cases, there was an absence of trace tricuspid regurgitation. After 6 months of anticoagulation with warfarin, the patients were converted to long-term aspirin treatment.
    UNASSIGNED: The ViV technique with J-valve is feasible and effective in treating tricuspid bioprosthetic SVD in high-risk patients, avoiding cardiopulmonary bypass and conventional thoracotomy injury.
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  • 文章类型: Journal Article
    目的:最近的研究表明,通过心理干预可以改变人格特质。然而,尚不清楚这些预期的人格变化是否可以维持或仅仅反映短暂的变化。
    方法:本研究报告了3个月数字干预对人格特质变化的1年随访效果。在干预前测量人格特质(预测试:N=1523),直接在干预后(后测:n=554),干预结束后3个月(随访1:n=437)和1年(随访2:n=157)。
    结果:磨耗分析表明,完成1年随访的参与者对经验的开放程度更高(d=0.19),神经质较少(d=0.20),与未完成1年随访的参与者相比,他们更同意(d=0.35)和更认真(d=0.27).此外,直到1年的随访,获得的人格特质变化保持稳定(对于那些想要增加外向性和责任心的人),甚至朝着期望的方向进一步变化(对于那些想要减少神经质的人)。
    结论:这些结果表明,由于有针对性的干预而导致的人格特质的变化不仅仅是短暂的变化,甚至可以持续。
    OBJECTIVE: Recent research suggests that personality traits can be changed by psychological interventions. However, it is unclear whether these intended personality changes can be maintained or merely reflect ephemeral shifts.
    METHODS: The present study reports 1-year follow-up effects of a 3-month digital intervention for personality trait change. Personality traits were measured before the intervention (pretest: N = 1523), directly after the intervention (posttest: n = 554), and 3 months (follow-up 1: n = 437) and 1 year (follow-up 2: n = 157) after the end of the intervention.
    RESULTS: Attrition analyses suggest that participants who completed the 1-year follow-up were significantly more open to experience (d = 0.19), less neurotic (d = 0.20), more agreeable (d = 0.35) and more conscientious (d = 0.27) than participants who did not complete the 1-year follow-up. Also, until the 1-year follow-up, personality trait changes achieved remained stable (for those who wanted to increase in extraversion and conscientiousness) or even changed further in the desired direction (for those who wanted to decrease in neuroticism).
    CONCLUSIONS: These results suggest that changes in personality traits due to a targeted intervention are not just ephemeral shifts and can even continue.
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  • 文章类型: Journal Article
    2019年冠状病毒病(COVID-19)是由SARS-CoV-2引起的。我们调查了针对SARS-CoV-2的抗体反应,直到症状发作后1年。
    我们收集了97例COVID-19患者的314份血清样本。使用间接免疫荧光测定(IFA)测试抗体反应,酶联免疫吸附测定(ELISA),和斑块减少中和试验(PRNT)检测特异性中和抗体。
    在1:10滴度截止时,中和抗体的阳性率在1周时为58.1%,4周时97.8%,症状发作后1年为78%(无症状患者为53.8%,有症状患者为89.3%)。IFA和抗S1ELISAIgG结果与中和抗体滴度显著相关。危重/致命病例的抗体滴度明显高于无症状或轻度至中度疾病组。尽管如此,在无症状和有症状的患者中,中和抗体血清转换的中位天数为10和15,分别。无症状组的中和效能指数明显高于轻度至重度疾病组。
    中和抗体对应于较早的血清转换,但在无症状组比有症状组短,在严重/致命病例中症状发作后1年仍存在。
    Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2. We investigated the antibody response against SARS-CoV-2 until 1 year after symptom onset.
    We collected 314 serum samples from 97 patients with COVID-19. Antibody responses were tested using an indirect immunofluorescence assay (IFA), enzyme-linked immunosorbent assay (ELISA), and plaque reduction neutralization test (PRNT) to detect specific neutralizing antibodies.
    The positivity rates for neutralizing antibodies at a 1:10 titer cutoff were 58.1% at 1 week, 97.8% at 4 weeks, and 78% at 1 year after symptom onset (53.8% in asymptomatic patients and 89.3% in symptomatic patients). The IFA and anti-S1 ELISA IgG results significantly correlated with neutralizing antibody titers. Critical/fatal cases showed significantly higher antibody titers than the asymptomatic or mild-to-moderate illness groups. Nonetheless, the median number of days to the seroconversion of neutralizing antibodies was 10 and 15 in asymptomatic and symptomatic patients, respectively. The asymptomatic group had a significantly higher neutralizing potency index than the mild-to-severe illness groups.
    Neutralizing antibodies corresponded to earlier seroconversion but had a shorter presence in the asymptomatic group than in the symptomatic group and were still present 1 year after symptom onset in critical/fatal cases.
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  • 文章类型: Journal Article
    背景:冠状病毒病(COVID-19)住院与创伤后应激障碍(PTSD)有关。现有信息受到随访不足和缺乏纵向研究的限制。基线因素(例如,性;肥胖)与创伤后应激障碍有关,但住院后因素尚未研究。目的:本研究旨在分析患病率,基线,COVID-19住院后PTSD的出院后因素和可能的临床病程。方法:109例患者(占原始样本的94.7%)在住院后的一年内完成了一项由三个随访电话评估的计划。数据包括临床和社会人口统计学因素以及评估PTSD的心理测量工具,社会支持,和对生命威胁的感知(PTL)。进行混合模型分析以研究PTSD症状的纵向过程。还分析了慢性(>6个月)PTSD预测因子。结果:1年PTSD患病率为23.9%,6个月时达到峰值;11%的患者患有慢性PTSD。住院前后因素影响PTSD的发病和病程。这些包括工作状态,PTL,缺乏社会支持。有趣的是,肥胖,肺部疾病和家族聚集性感染似乎与COVID-19后的PTSD特别相关。相反,临床干预措施,年龄较大和男性性别是保护性的。结论:COVID-19住院后PTSD很常见。分析的人口统计,社会,临床,随着时间的推移,心理因素可以预测PTSD症状,并可以改变慢性病程的几率。临床医生可以更好地识别有慢性PTSD病程风险的病例。最后,照常治疗似乎与更好的结果相关,应建议PTSD患者使用。
    Background: Coronavirus disease (COVID-19) hospitalization has been related to Post-Traumatic Stress Disorder (PTSD). Available information is limited by insufficient follow-up and lack of longitudinal studies. Baseline factors (e.g., sex; obesity) have been related to PTSD, but post-hospitalization factors have not been studied. Objective: This study aimed to analyse prevalence, baseline, post-discharge factors and possible clinical courses of PTSD after hospitalization for COVID-19. Method: 109 patients (94.7% of the original sample) completed a programme of three follow-up telephone assessments during the year following hospitalization. Data included clinical and sociodemographic factors as well as psychometric tools assessing PTSD, social support, and perception of threat to life (PTL). Mixture model analysis was performed to study the longitudinal course of PTSD symptoms. Chronic (>6 months) PTSD predictors were also analysed. Results: 1-year PTSD period prevalence was 23.9%, peaking at six months; 11% of the patients suffered chronic PTSD. Pre- and post-hospitalization factors influenced the onset and course of PTSD over time. These included working status, PTL, and lack of social support. Interestingly, obesity, pulmonary diseases and family cluster infection seem specifically related to PTSD following COVID-19. Inversely, clinical interventions, older age and male gender were protective. Conclusions: PTSD following COVID-19 hospitalization is common. The analysed demographic, social, clinical, and psychological factors predict PTSD symptomatology over time and can modify odds of a chronic course. Clinicians could better identify cases at risk of a chronic PTSD course. Finally, treatment as usual appeared related to a better outcome and should be proposed to patients with PTSD.
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  • 文章类型: Journal Article
    新型冠状病毒仍在变异,大流行仍在继续。同时,许多COVID-19幸存者有残留的感染后临床表现。人脐带间充质干细胞(hUC-MSCs)已被证明在COVID-19的早期阶段是有效的。
    这项研究的目的是研究接受hUC-MSCs治疗的重症COVID-19患者的长期安全性和有效性。
    对25例重度COVID-19出院患者(包括标准治疗组和标准治疗加hUC-MSCs组)进行1年随访。评估认为不良反应(包括对肝肾功能的影响,凝血,心电图,肿瘤标志物,等等),肺功能,圣乔治呼吸问卷(SGRQ),感染后后遗症和KrebsvondenLungen-6(KL-6)的血清浓度,丙二醛(MDA),H2S,肉碱,和N-6长链多不饱和脂肪酸(N-6LC-PUFA)。
    hUC-MSCs组及对照组随访1年肺通气功能均较随访3个月明显改善(P<0.01)。在1年的随访中,疲劳(60%[15/25])仍然是最常见的症状。与对照组(76.5%[13/17])相比,hUC-MSCs组(25%[2/8])的疲劳缓解率显著降低(P=0.028)。hUC-MSCs组KL-6水平(2585.5±186.5U/ml)显著低于对照组(3120.7±158.3U/ml)(P<0.001)。与对照组相比,hUC-MSCs组MDA水平较低(9.27±0.54vs.9.91±0.72nmol/ml,P=0.036)。hUC-MSCs治疗组出院后1年未见明显不良反应。
    静脉移植hUC-MSCs是治疗重症COVID-19患者的长期安全方法。此外,hUC-MSCs对COVID-19幸存者感染后后遗症有积极作用。
    中国临床试验注册;ChiCTR2000031494;注册2020年4月2日-回顾性注册,http://www。medresman.org.
    The novel coronavirus is still mutating, and the pandemic continues. Meanwhile, many COVID-19 survivors have residual postinfection clinical manifestations. Human umbilical cord mesenchymal stem cells (hUC-MSCs) have been shown to be effective in the early stages of COVID-19.
    The aim of this study was to investigate long-term safety and efficacy of treatment in patients with severe COVID-19 patients who had received hUC-MSCs therapy.
    Twenty-five discharged patients who had severe COVID-19 (including the standard treatment group and the standard treatment plus hUC-MSCs group) were enrolled in a 1-year follow-up. The assessment considered adverse effects (including effects on liver and kidney function, coagulation, ECG, tumor marker, and so on), pulmonary function, St George\'s Respiratory Questionnaire (SGRQ), postinfection sequelae and serum concentration of Krebs von den Lungen-6 (KL-6), malondialdehyde (MDA), H2S, carnitine, and N-6 long-chain polyunsaturated fatty acids (N-6 LC-PUFAs).
    Pulmonary ventilation function had significantly improved at the 1-year follow-up in both the hUC-MSCs group and the control group compared with the 3-month follow-up (P < 0.01). Fatigue (60% [15/25]) remained the most common symptom at the 1-year follow-up. The rate of fatigue relief was significantly reduced in the hUC-MSCs group (25% [2/8]) compared to the control group (76.5% [13/17]) (P = 0.028). The level of KL-6 was significantly lower in the hUC-MSCs group (2585.5 ± 186.5 U/ml) than in the control group (3120.7 ± 158.3 U/ml) (P < 0.001). Compared with the control group, the hUC-MSCs group had a lower level of MDA (9.27 ± 0.54 vs. 9.91 ± 0.72 nmol/ml, P = 0.036). No obvious adverse effects were observed in the hUC-MSCs treatment group at 1 year after discharge.
    Intravenous transplantation of hUC-MSCs was a safe approach in the long term in the treatment of patients with severe COVID-19. In addition, hUC-MSCs had a positive effect on postinfection sequelae in COVID-19 survivors.
    Chinese Clinical Trial Registration; ChiCTR2000031494; Registered 02 April 2020-Retrospectively registered, http://www.medresman.org.
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  • 文章类型: Case Reports
    液泡,E1酶,X-linked,自身炎症,体细胞(VEXAS)综合征是由UBA1基因的体细胞变异引起的自身炎症性疾病,可导致严重的全身性炎症和骨髓增生异常综合征。虽然目前还没有建立标准的治疗方法,据报道,阿扎胞苷和骨髓移植是有希望的可能性;然而,这些治疗的适应症是有问题的,不一定适用于所有患者。我们先前报道了3例VEXAS综合征患者接受托珠单抗(TCZ)和糖皮质激素短期治疗的结果。在本文中,我们报道,TCZ和糖皮质激素的联合治疗使患者能够继续治疗至少1年,而无明显疾病进展.糖皮质激素能够从TCZ开始减少。不良事件是带状疱疹,蜂窝织炎后的皮肤溃疡,血细胞计数减少。结果表明,这种疗法作为未来疗法发展的桥梁疗法具有重要意义。
    Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome is an autoinflammatory disease caused by somatic variants in the UBA1 gene that lead to severe systemic inflammation and myelodysplastic syndrome. Although no standard therapy has been established yet, azacitidine and bone marrow transplantation have been reported to be promising possibilities; however, the indications for these treatments are problematic and not necessarily applicable to all patients. We previously reported the results of short-term treatment with tocilizumab (TCZ) and glucocorticoids in three patients with VEXAS syndrome. In this paper, we report that the combination of TCZ and glucocorticoids allowed the patients to continue treatment for at least one year without significant disease progression. Glucocorticoids were able to be reduced from the start of TCZ. Adverse events were herpes zoster, skin ulceration after cellulitis, and decreased blood counts. The results suggest the significance of this treatment as a bridge therapy for the development of future therapies.
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  • 文章类型: Journal Article
    未经证实:COVID-19以内皮功能障碍为特征,推测有长期心血管后遗症。在这项横断面研究中,我们旨在探讨出院后1年从COVID-19中康复的患者的血清内皮生物标志物水平.
    未经证实:在这项临床随访研究中,345名来自黄冈的COVID-19幸存者,湖北,纳入119名年龄和性别匹配的医务人员作为健康对照.进行了标准化症状问卷,而下肢的心电图和多普勒超声,血常规检查,生化和免疫学测试,血清可溶性血管细胞粘附分子-1(VCAM-1),细胞间粘附分子-1(ICAM-1),P-选择素,和fractalkine通过酶联免疫吸附测定(ELISA)进行测量。
    UNASSIGNED:出院后一年,39%的康复者患有后COVID综合征,而少数有异常的心电图表现,在所有筛选的幸存者中均未发现深静脉血栓形成.循环炎症标志物(白细胞,中性粒细胞,淋巴细胞,C反应蛋白和白细胞介素-6),丙氨酸氨基转移酶,估计肾小球滤过率,葡萄糖,甘油三酯,在先前轻度或重度感染的健康对照中观察到的总胆固醇和D-二聚体。此外,血清VCAM-1,ICAM-1,P-选择素,和fractalkine在幸存者和健康对照之间没有显着差异。
    未经评估:SARS-CoV-2感染可能不会增加发生长期心血管事件的风险,即使是那些从严重疾病中康复的人。
    UNASSIGNED: COVID-19 is characterized by endothelial dysfunction and is presumed to have long-term cardiovascular sequelae. In this cross-sectional study, we aimed to explore the serum levels of endothelial biomarkers in patients who recovered from COVID-19 one year after hospital discharge.
    UNASSIGNED: In this clinical follow-up study, 345 COVID-19 survivors from Huanggang, Hubei, and 119 age and gender-matched medical staff as healthy controls were enrolled. A standardized symptom questionnaire was performed, while electrocardiogram and Doppler ultrasound of lower extremities, routine blood tests, biochemical and immunological tests, serum soluble vascular cell adhesion molecule-1(VCAM-1), intercellular cell adhesion molecule-1(ICAM-1), P-selectin, and fractalkine were measured by enzyme-linked immunosorbent assays (ELISA).
    UNASSIGNED: At one year after discharge, 39% of recovers possessed post-COVID syndromes, while a few had abnormal electrocardiogram manifestations, and no deep vein thrombosis was detected in all screened survivors. There were no significant differences in circulatory inflammatory markers (leukocytes, neutrophils, lymphocytes, C-reactive protein and interleukin-6), alanine aminotransferase, estimated glomerular filtration rate, glucose, triglycerides, total cholesterol and D-dimer observed among healthy controls with previously mild or severe infected. Furthermore, serum levels of VCAM-1, ICAM-1, P-selectin, and fractalkine do not significantly differ between survivors and healthy controls.
    UNASSIGNED: SARS-CoV-2 infection may not impose a higher risk of developing long-term cardiovascular events, even for those recovering from severe illness.
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  • 文章类型: Journal Article
    更大的药物依从性和持久性与2型糖尿病患者的血糖控制改善相关。这项研究比较了依从性,持久性,在6个月(6M)和12个月(12M)的随访期内,未对胰高血糖素样肽1受体激动剂开始每周一次的杜拉鲁肽与司马鲁肽注射治疗的患者的治疗模式。
    这次回顾展,观察性队列研究使用来自三个IBMMarketScan研究数据库的行政索赔数据.数据来自2018年1月至2020年1月期间新开始使用杜拉鲁肽或司马鲁肽治疗的成年2型糖尿病患者(指标日期定义为最早填写日期),在6M基线期没有胰高血糖素样肽1受体激动剂使用的证据,纳入6M基线和6M或12M随访期的连续入组.杜拉鲁肽的发起者倾向得分匹配,以1:1的比例,每个6M和12M随访队列中的司马鲁肽发起者(26,284和13,837对,分别)。
    在匹配的队列中,基线特征平衡;平均年龄为53岁,50%的患者是女性。与司马鲁肽引发剂相比,杜拉鲁肽引发剂更粘附(6M,63.4%对47.8%;12M,54.4%vs43.3%;两者,P<0.0001),更持久的治疗(6M,72%vs62%,12M,55.5%vs45.3%,两者,P<0.001),并且平均持续天数更多(6M,145vs132,12M,254.3vs220.7;两者,P<0.001)。
    在6M和12M随访时,与匹配的赛马鲁肽引发剂相比,杜拉鲁肽引发剂具有更大的粘附性和更高的持久性。
    Greater medication adherence and persistence have been associated with improved glycemic control in patients with type 2 diabetes mellitus. This study compared adherence, persistence, and treatment patterns among patients naïve to glucagon-like peptide 1 receptor agonists initiating once-weekly injectable treatment with dulaglutide versus semaglutide over 6-month (6M) and 12-month (12M) follow-up periods.
    This retrospective, observational cohort study used administrative claims data from three IBM MarketScan research databases. Data from adult patients with type 2 diabetes newly initiating treatment with dulaglutide or semaglutide between January 2018 and January 2020 (index date was defined as the earliest fill date), without evidence of glucagon-like peptide 1 receptor agonist use in the 6M baseline period, and with continuous enrollment in the 6M baseline and 6M or 12M follow-up period were included. Dulaglutide initiators were propensity score-matched, in a 1:1 ratio, to semaglutide initiators in each 6M and 12M follow-up cohort (26,284 and 13,837 pairs, respectively).
    In the matched cohorts, baseline characteristics were balanced; the mean age was 53 years, and 50% of patients were women. Compared to semaglutide initiators, dulaglutide initiators were more adherent (6M, 63.4% vs 47.8%; 12M, 54.4% vs 43.3%; both, P < 0.0001), more persistent on therapy (6M, 72% vs 62%, 12M, 55.5% vs 45.3%, both, P < 0.001), and had more mean days of persistence (6M, 145 vs 132, 12M, 254.3 vs 220.7; both, P < 0.001).
    At both 6M and 12M follow-up, dulaglutide initiators had significantly greater adherence and greater persistence compared with matched semaglutide initiators.
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  • 文章类型: Journal Article
    背景:在2020年批准Sapien瓣膜之前,没有商业上可用的短框架瓣膜用于经心尖二尖瓣瓣膜(MVIV)植入。2019年1月,我们首次尝试反向安装的J形瓣膜用于经心尖MVIV植入,取得了良好的临床效果。本研究旨在探讨将J型瓣膜反向安装在输送系统上的经心尖MVIV植入的安全性和有效性。
    方法:从2019年1月至2020年12月,对使用J瓣进行经心尖MVIV植入的患者进行了分析,并进行了1年的随访。在程序之前,计算机断层扫描(CT)血管造影数据分析,以确定内径,左心室流出道(LVOT),和共轴天使。根据原始二尖瓣生物假体的扫描内径,使用5-10%的超大比例选择J瓣。在手术过程中,在回波和透视辅助下,3个U形抓紧器与3个组织瓣膜支柱一对一扣紧.植入到左心房的深度是J形瓣膜的0-20%部分,然后在快速起搏下释放瓣膜。在需要时使用球囊后扩张。
    结果:19例患者(平均年龄70.05±11.19岁),胸外科医师协会平均得分为8.01%±4.20%,包括在内。通过经食管超声心动图,我们发现平均跨瓣梯度为6.21±2.63mmHg.平均随访时间为20.31±7.23个月,末次随访生存率为94.74%。经瓣膜梯度从基础的15.06±3.00mmHg下降至1年随访的7.13±2.28mmHg(P<0.001)。随访1年,左心室射血分数(LVEF)由60.31%±7.30%上升至59.94%±7.72%(P=0.863)。13例(81.25%)患者无瓣周漏或有微量瓣周漏(PVL),两名(12.50%)患者有轻微PVL,1例(6.25%)患者有中度PVL,1年经胸超声心动图(TTE)检查结果无严重反流病例。
    结论:反向安装在输送系统上的J瓣可用于经心尖MVIV植入,手术发病率较低,预后良好。
    BACKGROUND: Prior to the approval of the Sapien valve in 2020, there were no commercially available short-frame valves for transapical mitral valve-in-valve (MVIV) implantation. In January 2019, we first attempted the reverse mounted J-valve for transapical MVIV implantation with good clinical results. The present study aimed to explore the safety and effectiveness of transapical MVIV implantation with the J-valve reversely mounted on the delivery system.
    METHODS: Patients who underwent transapical MVIV implantation using the J-valve were analyzed from January 2019 to December 2020 with a 1-year follow-up. Before the procedure, computed tomography (CT) angiography data were analyzed to determine the inner diameter, left ventricular outflow tract (LVOT), and coaxial angel. An oversize rate of 5-10% was used to select the J-valve depending on the scanned inner diameter of the original mitral bioprosthesis. During the procedure, the three U-shape graspers were one-to-one buckled with the three tissue valve struts with the assist of echo and fluoroscopy. The implant depth into the left atrium was a 0-20% part of the J-valve, and the valve was then released under rapid pacing. Post-balloon dilatation was used when needed.
    RESULTS: Nineteen patients (mean age 70.05±11.19 years), with a mean Society of Thoracic Surgeons score of 8.01%±4.20%, were included. By transesophageal echocardiography, we found that the mean transvalvular gradient was 6.21±2.63 mmHg. The mean follow-up time was 20.31±7.23 months, and the survival rate was 94.74% at the last follow-up. The transvalvular gradient decreased from 15.06±3.00 mmHg at basal to 7.13±2.28 mmHg at the 1-year follow-up (P<0.001). The left ventricular ejection fractions (LVEF) increased from 60.31%±7.30% to 59.94%±7.72% at the 1-year follow-up (P=0.863). Thirteen (81.25%) patients had no or trace paravalvular leak (PVL), two (12.50%) patients had minor PVL, one (6.25%) patient had moderate PVL, and there were no cases of major regurgitation at the 1-year transthoracic echocardiography (TTE) examination results.
    CONCLUSIONS: The J-valve reversely mounted on the delivery system can be used for transapical MVIV implantation with less operative morbidity and favourable outcomes.
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