THERAPEUTICS AND CLINICAL RISK MANAGEMENT 是一本经过同行评审的国际临床治疗和风险管理期刊，专注于对所有治疗领域的临床研究、结果、安全性和有效、安全和持续使用药物的计划进行简明快速的报告，所有临床领域的治疗和手术干预。该杂志欢迎提交涵盖原始研究、临床和流行病学研究、评论、指南、专家意见和评论的投稿。该杂志将考虑案例报告，但前提是它们对文献做出了有价值的原创贡献。自 2019 年 3 月 18 日起，治疗学和临床风险管理将不再考虑发表荟萃分析。该杂志不接受研究方案、基于动物或基于细胞系的研究。

Therapeutics and Clinical Risk Management is a peer-reviewed international journal focused on clinical therapy and risk management. The journal aims to provide concise and rapid reports on clinical research, outcomes, safety, and the effective and sustained use of medications across all therapeutic areas. We welcome submissions that include original research, clinical and epidemiological studies, reviews, guidelines, expert opinions, and commentaries. While case reports will be considered, they must provide valuable original contributions to the existing literature. As of March 18, 2019, the journal will no longer consider the publication of meta-analyses. Additionally, we do not accept study protocols or research based on animals or cell lines.

《Therapeutics and Clinical Risk Management》是一本经过同行评审的国际期刊，专注于临床治疗和风险管理。该期刊致力于快速、简明地报告所有治疗领域的临床研究、结果、安全性以及药物的有效性和持续使用。我们欢迎提交涵盖原始研究、临床和流行病学研究、评论、指南、专家意见和评论的稿件。虽然我们会考虑案例报告，但前提是这些报告对现有文献做出了有价值的原创贡献。自2019年3月18日起，本期刊将不再考虑发表荟萃分析。同时，我们不接受研究方案、基于动物或细胞系的研究。

Therapeutics and Clinical Risk Management

Abstract: This review aimed to study the role of analgesia and sedation after coronary artery bypass graft (CABG) surgery, regarding pain management, assisted respiration, overall postoperative health care, and hospitalization. Data were collected from Pubmed, Scopus, and Cochrane databases. The following terms were used for the search: "analgesia", "sedation", "coronary artery bypass grafting", CABG", and "opioids". Articles between the years 1988 and 2018 were evaluated. Several opioid and non-opioid analgesics used to relieve surgical pain are regarded as critical risk factors for developing pulmonary and cardiovascular complications in all kinds of thoracic surgery, especially CABG procedures. Effective pain management in post-CABG patients is largely dependent on effective pain assessment, type of sedatives and analgesics administered, and evaluation of their effects on pain relief. A significant challenge is to determine adequate amounts of administered analgesics and sedatives for postoperative CABG patients, because patients often order more sedatives and analgesics than needed. The pain management process is deemed successful when patients feel comfortable after surgery, with no negative side effects. However, postoperative pain management patterns have not included many modern methods such as patient-controlled analgesia, and postoperative pain management drugs are still limited to a restricted range of opioid and non-opioid analgesics. Keywords: coronary artery bypass grafting (CABG), analgesia, sedation, opioids, ICU

Mansour Jannati

Armin Attar

&lt;p&gt;Analgesia and sedation post-coronary artery bypass graft surgery: a review of the literature&lt;/p&gt;

Background: Acute kidney injury (AKI) is prevalent in hospitalized patients with traumatic brain injury (TBI), and increases the risk of poor outcomes. We designed this study to develop a visual and convenient decision-tree-based model for predicting AKI in TBI patients. Methods: A total of 376 patients admitted to the emergency department of the West China Hospital for TBI between January 2015 and June 2019 were included. Demographic information, vital signs on admission, laboratory test results, radiological signs, surgical options, and medications were recorded as variables. AKI was confirmed since the second day after admission, based on the Kidney Disease Improving Global Outcomes criteria. We constructed two predictive models for AKI using least absolute shrinkage and selection operator (LASSO) regression and classification and regression tree (CART), respectively. Receiver operating characteristic (ROC) curves of these two predictive models were drawn, and the area under the ROC curve (AUC) was calculated to compare their predictive accuracy. Results: The incidence of AKI on the second day after admission was 10.4% among patients with TBI. Lasso regression identified five potent predictive factors for AKI: glucose, serum creatinine, cystatin C, serum uric acid, and fresh frozen plasma transfusions. The CART analysis showed that glucose, serum uric acid, and cystatin C ranked among the top three in terms of the feature importance of the decision tree model. The AUC value of the decision-tree predictive model was 0.892, which was higher than the 0.854 of the LASSO regression model, although the difference was not statistically significant. Conclusion: The decision tree model is valuable for predicting AKI among patients with TBI. This tree-based flowchart is convenient for physicians to identify patients with TBI who are at high risk of AKI and prompts them to develop suitable therapeutic strategies. Keywords: acute kidney injury, decision tree, traumatic brain injury, prediction, machine learning

Ruoran Wang

Jing Zhang

Min He

Jianguo Xu

Classification and Regression Tree Predictive Model for Acute Kidney Injury in Traumatic Brain Injury Patients

Abstract: Individuals with glioblastoma are often characterized by older age, advanced neurologic manifestations at the primary stage, and unresectable tumors, and these factors are associated with poor treatment outcomes. Administration of bevacizumab (BV, Avastin ® ) promotes tumor regression and improves cerebral edema, and is expected to improve neurologic findings in many patients with malignant gliomas, including glioblastoma. Although the addition of BV to the conventional standard therapy (chemoradiotherapy with temozolomide) for newly diagnosed glioblastoma prolonged the progression-free survival time and the performance status of patients, it failed to extend overall survival time. However, more than 50% of glioblastoma patients show Karnofsky performance status ≤70 at initial presentation; therefore, BV should be used to improve or maintain their performance status as an initial treatment. Most of the adverse events of BV, except hypertension and proteinuria, occur as complications of glioblastoma, and explanation of the advantages and disadvantages of BV administration to patients is important. Herein, the efficacy, safety, and challenges of using BV for treating glioblastoma were reviewed. Keywords: bevacizumab, glioblastoma, glioma, adverse events

Yoshitaka Narita

Bevacizumab for glioblastoma

贝伐珠单抗用于胶质母细胞瘤

Objective: This study aimed to evaluate the clinical efficacy of recombinant human growth hormone (rhGH) in the treatment of children with idiopathic short stature (ISS) and growth hormone deficiency (GHD) and to explore the related factors affecting treatment efficacy. Methods: The current research reflects a real-world study. A total of 79 patients with ISS and 95 patients with GHD (both groups pre-puberty) who had been treated with rhGH for more than one year from January 2010 to September 2019 were included in this study. The patients were divided into two groups, ie, an ISS and a GHD group, respectively. The growth indexes, such as chronological age (CA), bone age (BA), height standard deviation score (HtSDS), insulin-like growth factor-1 (IGF-1) SDS, and body mass index were recorded and compared between the two groups before and after treatment. The treatment efficacy was evaluated according to changes in HtSDS before and after treatment, and the influencing factors of clinical efficacy were analyzed using a multivariate regression model. Results: At the start of treatment, the differences in CA, BA, height, weight, sexual development stage, HtSDS, mid-parental height SDS, and IGF-1 SDS between the two groups were not statistically significant (P > 0.05). However, the initial dose of rhGH in the GHD group was significantly lower than in the ISS group (P < 0.001). Following rhGH treatment, the differences in CA, BA, BA/CA ratio, and IGF-1 SDS measured at 6, 12, 18, and 24 months between the ISS and GHD groups were not statistically significant, while the difference in HtSDS measured at 6 months was statistically significant. With the extension of rhGH treatment time, the annual growth rate (GV) gradually decreased, and the difference between HtSDS and the baseline gradually increased; however, the differences between the ISS and GHD groups were not statistically significant. The most important factor affecting the treatment efficacy for patients with ISS was age at the start of treatment; the most important factors affecting the treatment efficacy for patients with GHD were age and IGF-1 SDS. Conclusion: Recombinant human growth hormone treatment can significantly improve the height of patients with ISS and GHD. There was no significant difference in growth rate between patients with ISS and those with GHD at relatively high doses. The common factor affecting the treatment efficacy of the two groups was the age at the start of treatment. During treatment, monitored data indicated that rhGH treatment of GHD and ISS thyroid function showed a clinical phenomenon in the form of increased free triiodothyronine, rather than hypothyroidism, which was rarely reported in existing studies. Keywords: growth hormone deficiency, idiopathic short stature, recombinant human growth hormone, efficacy evaluation, multivariate analysis

Peng Gou

Xinran Cheng

Jie Leng

Na Su

A Real-World Study of Recombinant Human Growth Hormone in the Treatment of Idiopathic Short Stature and Growth Hormone Deficiency

重组人生长激素治疗特发性矮小症和生长激素缺乏症的现实世界研究

Ya-zhi Xi

Xue-lian Wei

Lei Xie

Xiao-yu Jia

Zhen-ping Li

Qing-he Zhou

Impact of Permissive Hypercapnia on Postoperative Early Plasma Neurofilament Light Chain in Elderly Patients Undergoing Laparoscopic Surgery: A Prospective, Randomized Controlled Trial

允许性高碳酸血症对老年患者腹腔镜手术后早期血浆神经丝轻链的影响：一项前瞻性随机对照试验

Purpose: We conducted a prospective, real-world study to evaluate the efficacy and safety of balanced propofol sedation (BPS) in bronchoscopy and identify an advantageous sedation regimen for such procedures. Patients and Methods: The participants were placed in four groups based on their sedation regimen (exposure factor): the M-S group (midazolam + sufentanil for traditional sedation), R-S group (remimazolam + sufentanil for traditional sedation), M-S-P group (midazolam + sufentanil + propofol for BPS), and R-S-P group (remimazolam + sufentanil + propofol for BPS). The primary outcomes included satisfaction metrics (satisfaction of the patients, endoscopic physicians, and nurses) and follow-up questionnaires. The secondary outcomes included time metrics (induction time, recovery time, and discharge time), dosage metrics (induction dose, maintenance dose, and total dose of each sedative), completion rate of sedation, intraprocedural dose, and frequency of lidocaine spray in the airway, and incidence of adverse reactions. Results: In total, 418 subjects were included in this study. Compared to traditional sedation, both BPS groups significantly increased the satisfaction of patients, endoscopic physicians, and nurses (P < 0.05) and reduced the incidence of intraprocedural wakefulness (P < 0.05). Additionally, induction and recovery of the BPS group were rapid, with high sedation completion rates and no increase in the incidence of intraprocedural and postprocedural adverse reactions (P < 0.05). The RSP group was better than the MSP group in terms of various time metrics and postprocedural adverse reactions. Conclusion: BPS can be safely and effectively applied during bronchoscopy, with remimazolam and sufentanil combined with a small dose of propofol being an optimal medication regimen. Keywords: balanced propofol sedation, bronchoscopy, remimazolam, midazolam, procedural sedation

Xinyu Wu

Lina Zhang

Zangong Zhou

Lijie Qi

Yinhuan Liu

Xuebin Du

Lixia Ma

Xiangyu Ji

The Efficacy and Safety Profile of Balanced Propofol Sedation for Bronchoscopy

平衡丙泊酚镇静在支气管镜检查中的疗效和安全性

Low cardiac output syndrome (LCOS) after pericardiectomy is associated with high morbidity and mortality. This study aimed to assess the effect of levosimendan on postoperative LCOS in the patients with constrictive pericarditis.

Likui Fang

Pengfei Zhu

Guocan Yu

Wang Lv

Jian Hu

Effect of Levosimendan on Low Cardiac Output Syndrome After Pericardiectomy

左西孟旦对心包切除术后低心排血量综合征的影响

Participants: This study enrolled 294 patients admitted to the Thyroid Surgery Department of the First Hospital of Shanxi Medical University between April and July 2024. Patients were randomly assigned to either the control group (145 patients) or the experimental group (149 patients). Interventions: The control group received traditional adhesive tape fixation for drains, while the experimental group utilized a newly developed fixation patch combined with a unique "C" and "S" fixation method. Both groups employed vertical negative pressure drainage. Specific Objectives or Hypotheses: The aim of this study was to assess the clinical effectiveness and patient satisfaction with a novel surgical drain fixation patch and method in the context of thyroid surgery. The hypothesis was that the novel fixation patch and method would reduce drain-related adverse events, improve patient comfort, and increase patient satisfaction. Outcomes: The experimental group exhibited significantly lower rates of drain-related adverse events, including displacement, infection, and leakage, compared to the control group (3.40% vs 53.10%, P < 0.05). Additionally, patients in the experimental group reported lower neck/throat pain scores (mean score: 0.84 vs 1.40 in the control group, P < 0.05) and experienced no drain pulling pain (0% vs 1.16% in the control group, P < 0.05). Furthermore, the need for patch replacements was virtually eliminated in the experimental group (0% vs 70.86% in the control group, P < 0.05). Patient satisfaction with the fixation method was significantly higher in the experimental group (83.3% vs 46.9% in the control group, P < 0.05). Randomization: Patients were randomly assigned to the control and experimental groups, ensuring the fairness and reliability of the study. Trial Registration: The study was retrospectively registered with the China Clinical Trial Registry (ChiCTR2400087677) on August 1, 2024. Keywords: anti-dislodgement fixation patch, cervical drains, thyroid surgery, nursing adverse events, patient's satisfaction

Caizhen Zhang

Weiping Mi

Yajun Zhu

Yonghao Li

Yifan Cao

Zhensu Li

Evaluation of the Effect of a New Surgical Medical Drain Anti-Dislodgement Fixation Patch and Fixation Method in Postoperative Thyroid Care: A Randomized Trial

新型外科医用引流防脱位固定贴及固定方法在术后甲状腺护理中的效果评估：一项随机试验

Background: Myoclonus is a common problem during induction of anesthesia with etomidate. A variety of agents, including opioids and lidocaine, reduced the incidence of myoclonus. However, there is no reported literature evaluating the effect of esketamine pretreatment on etomidate-induced myoclonus. We investigated the influence of pretreatment with esketamine on the incidence of etomidate-induced myoclonus. Methods: This is a prospective, double-blind, and randomized controlled trial. One hundred patients aged 18– 65 scheduled for elective surgery under general anesthesia (including urology surgery, gynaecology surgery, general surgery, and thoracic surgery) were randomly allocated into two groups, each consisting of 50 patients. Esketamine was pretreated with 0.1 mg/kg 60 s before the initiation of etomidate in Group ESK, while normal saline was administered as the placebo (Group C). During the first 1 minute after etomidate administration, myoclonus incidence and severity were assessed. In addition, we measured the hemodynamic changes and side effects of esketamine before administering etomidate. Results: In group ESK, 14 patients (28%) had myoclonus (degrees of myoclonus: mild 2, moderate 7, severe 5), and 32 patients (64%) in group C (mild 6, moderate 5, severe 21) ( P < 0.001). In group ESK, myoclonus incidence and severity were significantly lower than in group C ( P < 0.001). Conclusion: Esketamine 0.1mg/kg IV pretreatment significantly reduce the incidence and the severity of severe myoclonus of etomidate-induced myoclonus without significant adverse effects. Keywords: esketamine, etomidate, myoclonus, anesthesia induction

Jiang Wang

Mengmeng Zhu

Yuanyuan Cao

Lei Zhang

Lijian Chen

Pretreatment with Esketamine Reduces Etomidate-Induced Myoclonus During the Induction of Anesthesia: A Randomized Controlled Trial

预处理使用依他佐辛减少依托咪酯诱导麻醉期间的肌阵挛：一项随机对照试验

Purpose: Atrial fibrillation (AF) is classified into paroxysmal, persistent, long-term persistent, and permanent types. It is commonly treated by radiofrequency ablation (RFA), which is more successful than conventional anti-arrhythmic drugs, but it is still largely unknown whether these beneficial effects are equally present for all AF types. Here, we evaluated the impact that AF type has on post-RFA patient conditions and identified underlying factors affecting AF prognoses. Patients and Methods: Three hundred and twenty-nine AF patients who underwent RFA were retrospectively examined (221 paroxysmal, 56 persistent, 52 long-term persistent), during a post-RFA follow-up period, from 3-months to 2-years. Cardiac functional parameters, such as left atrial (LA), ventricular (LV), and pulmonary artery diameters, as well as ejection fraction (EF) and end-diastolic/systolic diameter ratio, were measured using echocardiography. Additionally, chronic kidney disease (CKD) was diagnosed among these AF patients, using the Modification of Diet in Renal Disease (MDRD) formula, and its impact on post-RFA patient outcomes was examined. Logistic regression analysis identified differences between AF and non-AF recurrence groups. Results: In terms of functional parameters, persistent AF had significantly smaller LA, and larger EF, compared to paroxysmal and long-term persistent groups, while paroxysmal had significantly larger LV versus persistent and long-term persistent after RFA. For post-RFA patient conditions, paroxysmal, compared to persistent and long-term persistent, had significantly lower AF recurrence (18.10% versus 30.36% and 36.54%) and re-hospitalization rates (6.79% versus 14.29% and 19.23%); however, no significant difference was present between the 3 groups in terms of post-operative stroke rates, as well as re-hospitalization duration. Additionally, CKD patients, versus non-CKD, were more prone to AF recurrence and re-hospitalization, being 3.268 times more likely. Conclusion: AF types and CKD were independent factors influencing AF recurrence, serving as highly sensitive predictors to monitor prognoses and guide treatments. Therefore, personalized treatment regimens should be recommended for different AF patients. Keywords: atrial fibrillation, radiofrequency ablation, chronic kidney disease

Pei Mo

Cheng Fan

Jiayuan Chen

Yu Wang

Wenhao Xiao

Zhiguo Peng

Xiao-Zhen Lin

Cheng-Feng Luo

Chongyu Zhang

Atrial Fibrillation Types and Chronic Kidney Disease are Independent Predictors of Atrial Fibrillation Recurrence After Radiofrequency Ablation

心房颤动类型和慢性肾脏疾病是射频消融后心房颤动复发的独立预测因素

Abbreviation	TCRM
Journal Impact	2.34
Quartiles(Global)	HEALTH CARE SCIENCES & SERVICES(Q2)

ISSN	1176-6336, 1178-203X
h-index	70

Publication Information	Publisher: Dove Medical Press Ltd，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2006，Proportion of original research papers: 65.98%，Self Citation Rate:0.00%， Gold OA Rate: 99.36%
Journal Fees	$3300Details
Average review cycle	网友分享经验：16 Weeks

Therapeutics and Clinical Risk Management

Journal Citation Format

A journal article with 1 author

A journal article with 2 authors

A journal article with 3 authors

A journal article with 5 or more authors

Books Citation Format

Thesis Citation Format

Web sites Citation Format

Patent Citation Format

Staying up late manually editing references? ivySCI automatically matches journals and helps you generate references with a single click.

Share Submission Experience

<p>Analgesia and sedation post-coronary artery bypass graft surgery: a review of the literature</p>