BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complic...BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complication after ileostomy closure.AIM To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional SSI.METHODS This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December 2021.Patients were randomly allocated into an MPNPWT group and a control group.The MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure dressing.The surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)groups.Risk factors for incisional SSI were identified using logistic regression.RESULTS There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood loss.Postoperative hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and pain.MPNPWT also helped heal the infected incision.Our study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional SSI.CONCLUSION MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure.展开更多
Background/Aims: Inguinal incisions are a common route of access in vascular surgery. Due to anatomical challenges and a diverse bacterial flora in this area, surgical site infections (SSI) represent a common, debilit...Background/Aims: Inguinal incisions are a common route of access in vascular surgery. Due to anatomical challenges and a diverse bacterial flora in this area, surgical site infections (SSI) represent a common, debilitating and sometimes life-threatening complication. The INVIPS-Trial evaluates the role of Negative Pressure Wound Therapy (NPWT) on closed inguinal incisions in elective vascular surgery to prevent SSI and other wound complications. Methods: This randomized controlled trial (RCT) registered at ClinicalTrials.gov (Identifier: NCT01913132) compares the effects of a NPWT dressing (PICO, Smith & Nephew, UK) and the center’s standard wound dressing (Vitri Pad, ViTri Medical, Sweden) on postoperative wound complications, especially SSI. The study includes two distinct vascular procedures with different SSI risk profiles: endovascular aortic repair (EVAR) and open surgical approaches involving the common femoral artery (OPEN). Results: Four hundred ninety-five groin incisions in both treatment arms are anticipated to be included in the EVAR group and 147 inguinal incisions in both treatment arms in the OPEN group. Since a large percentage of inguinal vascular procedures in both groups but especially in the EVAR group are performed bilaterally, many patients can serve as their own control by randomly receiving NPWT on one and the standard dressing on the contralateral inguinal incision. Conclusions: This ongoing RCT attempts to elucidate the potential benefit of NPWT on closed inguinal incisions after different vascular procedures. Outcome and conclusions of this trial could have implications on postoperative wound care of patients in both vascular surgery and other surgical specialties.展开更多
BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus ...BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus in existing guidelines regarding the optimal tourniquet pressure,placement site,and duration of use.There is a paucity of data on the relationship between the site of a tourniquet and postoperative pain in foot and ankle surgery.AIM To explore the relationship between tourniquet site and intensity of post-operative pain scores in patients undergoing elective foot and ankle surgery.METHODS Retrospective analysis of prospectively collected data on 201 patients who underwent foot and ankle surgery in a single institution was undertaken.Intraoperative tourniquet duration,tourniquet pressure and site,and postoperative pain scores using Visual Analogue Score were collected in immediate recovery,at six hours and at 24 h post-op.Scatter plots were used to analyse the data and to assess for the statistical correlation between tourniquet pressure,duration,site,and pain scores using Pearson correlation coefficient.RESULTS All patients who underwent foot and ankle surgery had tourniquet pressure of 250 mmHg for ankle tourniquet and 300 mmHg for thigh.There was no correlation between the site of the tourniquet and pain scores in recovery,at six hours and after 24 h.There was a weak correlation between tourniquet time and Visual Analogue Score immediately post-op(r=0.14,P=0.04)but not at six or 24 h post-operatively.CONCLUSION This study shows that there was no statistically significant correlation between tourniquet pressure,site and postop pain in patients undergoing foot and ankle surgery.The choice of using a tourniquet is based on the surgeon's preference,with the goal of minimizing the duration of its application at the operative site.展开更多
The A-site ordered perovskite oxides with chemical formula AA＇3B4O（12）display many intriguing physical properties due to the introduction of transition metals at both A and B sites. Here, research on the recently d...The A-site ordered perovskite oxides with chemical formula AA＇3B4O（12）display many intriguing physical properties due to the introduction of transition metals at both A and B sites. Here, research on the recently discovered intermetallic charge transfer occurring between A-site Cu and B-site Fe ions in La Cu3Fe4O（12） and its analogues is reviewed, along with work on the magnetoelectric multiferroicity observed in La Mn3Cr4O（12） with cubic perovskite structure. The Cu–Fe intermetallic charge transfer（LaCu3（3＋）Fe4（3＋）O（12）→ LaCu3（2＋）Fe4（3.75＋）O（12）） leads to a first-order isostructural phase transition accompanied by drastic variations in magnetism and electrical transport properties. The La Mn3Cr4O（12） is a novel spindriven multiferroic system with strong magnetoelectric coupling effects. The compound is the first example of cubic perovskite multiferroics to be found. It opens up a new arena for studying unexpected multiferroic mechanisms.展开更多
A novel CaCu_3Cu_2Ir_2O_（12-δ） polycrystalline sample was synthesized at 8 GPa and 1373 K.Rietveld structural analysis shows that this compound crystallizes in an AA＇_3B_4O_（12）-type A-site ordered perovskite st...A novel CaCu_3Cu_2Ir_2O_（12-δ） polycrystalline sample was synthesized at 8 GPa and 1373 K.Rietveld structural analysis shows that this compound crystallizes in an AA＇_3B_4O_（12）-type A-site ordered perovskite structure with space group Im-3.Xray absorption spectra reveal a ＋2-charge state for both the square-planar and octahedral coordinated Cu ions,and the valence state of Ir is found to be about ＋5.Although the A-site Ca and the A＇-site Cu^（2＋） are 1：3 ordered at fixed atomic positions,the distribution of B-site Cu^（2＋） and Ir^（5＋） is disorderly.As a result,no long-range magnetic ordering is observed at temperatures down to 2 K.Electrical transport and heat capacity measurements demonstrate itinerant electronic behavior.The crystal structure is stable with pressure up to 35.7 GPa at room temperature.展开更多
目的探讨两种不同加压包扎方法在经外周置入中心静脉导管(peripherally inserted central catheter,PICC)后穿刺点应用的效果,为临床提供一种新的包扎方法。方法采用随机数字表法将本院416例乳腺癌PICC患者随机分为对照组与试验组,分别...目的探讨两种不同加压包扎方法在经外周置入中心静脉导管(peripherally inserted central catheter,PICC)后穿刺点应用的效果,为临床提供一种新的包扎方法。方法采用随机数字表法将本院416例乳腺癌PICC患者随机分为对照组与试验组,分别208例。对照组患者PICC置管后应用无菌纱布覆盖并加压包扎穿刺点,24h进行常规换药,试验组PICC置管后应用藻酸盐敷料覆盖穿刺点并加压包扎,在无局部渗血情况下置管后7d换药。比较两组患者置管后24h内穿刺点渗血发生率、患者舒适度、换药次数及费用与7d内感染情况。结果对照组205例完成研究,试验组208例完成研究。试验组患者置管后24h穿刺点渗血发生率低于对照组(试验组27.88%,对照组38.05%,χ^(2)=4.829,P=0.028),24h换药次数少于对照组(Z=205.235,P<0.001),换药费用低于对照组(对照组换药费用中位数56.94元,试验组换药费用中位数10.20元,Z=-8.990,P<0.001);试验组患者局部疼痛和瘙痒评分低于对照组(Z=-12.079,Z=-12.194,均P<0.001),组间比较,差异有统计学意义;两组患者均未发生穿刺点感染。结论乳腺癌患者PICC置管后应用藻酸盐敷料加压包扎穿刺点,可将24h穿刺点未发生渗血者首次换药时间延长至置管后7d,该方法减少了穿刺点渗血发生率,增加患者舒适度,同时减少换药次数和换药费用,从而减少护士工作量。展开更多
基金Supported by the Zhejiang Provincial Natural Science Foundation of China,No.LQ20H260002.
文摘BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complication after ileostomy closure.AIM To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional SSI.METHODS This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December 2021.Patients were randomly allocated into an MPNPWT group and a control group.The MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure dressing.The surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)groups.Risk factors for incisional SSI were identified using logistic regression.RESULTS There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood loss.Postoperative hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and pain.MPNPWT also helped heal the infected incision.Our study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional SSI.CONCLUSION MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure.
基金an unrestricted unconditional research grant 15,550 USD and donation of 100 PICO dressing kits from Smith and Nephew in 201312,900 USD from the Swedish SUS Stiftelser och Fonder:Grant-number 95407ClinicalTrials.gov(Identifier:NCT01913132).
文摘Background/Aims: Inguinal incisions are a common route of access in vascular surgery. Due to anatomical challenges and a diverse bacterial flora in this area, surgical site infections (SSI) represent a common, debilitating and sometimes life-threatening complication. The INVIPS-Trial evaluates the role of Negative Pressure Wound Therapy (NPWT) on closed inguinal incisions in elective vascular surgery to prevent SSI and other wound complications. Methods: This randomized controlled trial (RCT) registered at ClinicalTrials.gov (Identifier: NCT01913132) compares the effects of a NPWT dressing (PICO, Smith & Nephew, UK) and the center’s standard wound dressing (Vitri Pad, ViTri Medical, Sweden) on postoperative wound complications, especially SSI. The study includes two distinct vascular procedures with different SSI risk profiles: endovascular aortic repair (EVAR) and open surgical approaches involving the common femoral artery (OPEN). Results: Four hundred ninety-five groin incisions in both treatment arms are anticipated to be included in the EVAR group and 147 inguinal incisions in both treatment arms in the OPEN group. Since a large percentage of inguinal vascular procedures in both groups but especially in the EVAR group are performed bilaterally, many patients can serve as their own control by randomly receiving NPWT on one and the standard dressing on the contralateral inguinal incision. Conclusions: This ongoing RCT attempts to elucidate the potential benefit of NPWT on closed inguinal incisions after different vascular procedures. Outcome and conclusions of this trial could have implications on postoperative wound care of patients in both vascular surgery and other surgical specialties.
文摘BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus in existing guidelines regarding the optimal tourniquet pressure,placement site,and duration of use.There is a paucity of data on the relationship between the site of a tourniquet and postoperative pain in foot and ankle surgery.AIM To explore the relationship between tourniquet site and intensity of post-operative pain scores in patients undergoing elective foot and ankle surgery.METHODS Retrospective analysis of prospectively collected data on 201 patients who underwent foot and ankle surgery in a single institution was undertaken.Intraoperative tourniquet duration,tourniquet pressure and site,and postoperative pain scores using Visual Analogue Score were collected in immediate recovery,at six hours and at 24 h post-op.Scatter plots were used to analyse the data and to assess for the statistical correlation between tourniquet pressure,duration,site,and pain scores using Pearson correlation coefficient.RESULTS All patients who underwent foot and ankle surgery had tourniquet pressure of 250 mmHg for ankle tourniquet and 300 mmHg for thigh.There was no correlation between the site of the tourniquet and pain scores in recovery,at six hours and after 24 h.There was a weak correlation between tourniquet time and Visual Analogue Score immediately post-op(r=0.14,P=0.04)but not at six or 24 h post-operatively.CONCLUSION This study shows that there was no statistically significant correlation between tourniquet pressure,site and postop pain in patients undergoing foot and ankle surgery.The choice of using a tourniquet is based on the surgeon's preference,with the goal of minimizing the duration of its application at the operative site.
基金Project supported by the National Basic Research Program of China(Grant No.2014CB921500)the Strategic Priority Research Program of the Chinese Academy of Sciences(Grant No.XDB07030300)the National Natural Science Foundation of China(Grant No.11574378)
文摘The A-site ordered perovskite oxides with chemical formula AA＇3B4O（12）display many intriguing physical properties due to the introduction of transition metals at both A and B sites. Here, research on the recently discovered intermetallic charge transfer occurring between A-site Cu and B-site Fe ions in La Cu3Fe4O（12） and its analogues is reviewed, along with work on the magnetoelectric multiferroicity observed in La Mn3Cr4O（12） with cubic perovskite structure. The Cu–Fe intermetallic charge transfer（LaCu3（3＋）Fe4（3＋）O（12）→ LaCu3（2＋）Fe4（3.75＋）O（12）） leads to a first-order isostructural phase transition accompanied by drastic variations in magnetism and electrical transport properties. The La Mn3Cr4O（12） is a novel spindriven multiferroic system with strong magnetoelectric coupling effects. The compound is the first example of cubic perovskite multiferroics to be found. It opens up a new arena for studying unexpected multiferroic mechanisms.
基金Project supported by the National Basic Research Program of China(Grant No.2014CB921500)the Strategic Priority Research Program of the Chinese Academy of Sciences(Grant No.XDB07030300)the National Natural Science Foundation of China(Grant No.11574378)
文摘A novel CaCu_3Cu_2Ir_2O_（12-δ） polycrystalline sample was synthesized at 8 GPa and 1373 K.Rietveld structural analysis shows that this compound crystallizes in an AA＇_3B_4O_（12）-type A-site ordered perovskite structure with space group Im-3.Xray absorption spectra reveal a ＋2-charge state for both the square-planar and octahedral coordinated Cu ions,and the valence state of Ir is found to be about ＋5.Although the A-site Ca and the A＇-site Cu^（2＋） are 1：3 ordered at fixed atomic positions,the distribution of B-site Cu^（2＋） and Ir^（5＋） is disorderly.As a result,no long-range magnetic ordering is observed at temperatures down to 2 K.Electrical transport and heat capacity measurements demonstrate itinerant electronic behavior.The crystal structure is stable with pressure up to 35.7 GPa at room temperature.
文摘目的探讨两种不同加压包扎方法在经外周置入中心静脉导管(peripherally inserted central catheter,PICC)后穿刺点应用的效果,为临床提供一种新的包扎方法。方法采用随机数字表法将本院416例乳腺癌PICC患者随机分为对照组与试验组,分别208例。对照组患者PICC置管后应用无菌纱布覆盖并加压包扎穿刺点,24h进行常规换药,试验组PICC置管后应用藻酸盐敷料覆盖穿刺点并加压包扎,在无局部渗血情况下置管后7d换药。比较两组患者置管后24h内穿刺点渗血发生率、患者舒适度、换药次数及费用与7d内感染情况。结果对照组205例完成研究,试验组208例完成研究。试验组患者置管后24h穿刺点渗血发生率低于对照组(试验组27.88%,对照组38.05%,χ^(2)=4.829,P=0.028),24h换药次数少于对照组(Z=205.235,P<0.001),换药费用低于对照组(对照组换药费用中位数56.94元,试验组换药费用中位数10.20元,Z=-8.990,P<0.001);试验组患者局部疼痛和瘙痒评分低于对照组(Z=-12.079,Z=-12.194,均P<0.001),组间比较,差异有统计学意义;两组患者均未发生穿刺点感染。结论乳腺癌患者PICC置管后应用藻酸盐敷料加压包扎穿刺点,可将24h穿刺点未发生渗血者首次换药时间延长至置管后7d,该方法减少了穿刺点渗血发生率,增加患者舒适度,同时减少换药次数和换药费用,从而减少护士工作量。
