Peripherally inserted central catheter(PICC)is extensively used in critical care settings,because it plays a vital role in providing safe central venous entry.However,PICC is associated with several complications,whic...Peripherally inserted central catheter(PICC)is extensively used in critical care settings,because it plays a vital role in providing safe central venous entry.However,PICC is associated with several complications,which should be detected to shorten the duration of patients'improvement,reduce health care cost,and lessen the incidence of various PICC-related complications.Therefore,this study aimed to outline current literature on PICC procedures,potential complications,and measures for prevention.Understanding evidence-based guidelines regarding insertion technique,early detection of complications,and care bundle of PICC is significant in complication prevention.Implementation of education,training,and appropriate multidisciplinary approaches on PICC care among nurses and caregivers is the key to preventing complications.Thus,the strict care of indwelling PICC lines,the targeted and reasonable PICCassociated complication prevention,and nursing care have a major clinical significance in reducing the occurrence of potential PICC complications.展开更多
Acupuncture induced pneumothorax is a rarely seen clinical accident. In the present paper, the authors analyze its causes of onset, clinical manifestations and measures for prevention and management.
Iatrogenic tumor implantation is a condition that results from various medical procedures used during diagnosis or treatment of a malignancy.It involves desquamation and dissemination of tumor cells that develop into ...Iatrogenic tumor implantation is a condition that results from various medical procedures used during diagnosis or treatment of a malignancy.It involves desquamation and dissemination of tumor cells that develop into a local recurrence or distant metastasis from the tumor under treatment.The main clinical feature of the condition is nodules at the operation's porous channel or incision,which is easily diagnosed in accordance with the case history.Final diagnosis can be made based on pathological examination.Tumor implantation may occur in various puncturing porous channels,including a laparoscopic port,abdominal wall incision,and perineal incision,etc.Besides a malignant tumor, implantation potential exists with diseases,such as a borderline tumor and endometriosis etc.Once a tumor implantation is diagnosed,or suspected,surgical resection is usually conducted. During the diagnosis and treatment of diseases,avoiding and reducing iatrogenic implantation and dissemination has been regarded as an important principle for surgical treatment of tumors.In a clinical practice setting,if possible,excisional biopsy should be employed,if a biopsy is needed.Repeated puncturing should be avoided during a paracentesis.In a laparoscopic procedure,the tissue is first put into a sample bag and then is taken out from the point of incision.After a laparoscopic procedure,the peritoneum,abdominal muscular fasciae,and skin should be carefully closed,and/or the punctured porous channel be excised.In addition,the sample/tissue should be rinsed with distilled water before surgical closure of the abdominal cavity, allowing the exfoliated tumor cells to swell and rupture in the hypo-osmolar solution.Then surgical closure can be conducted following a change of gloves and equipment.The extent of hysteromyomectomy should as far as possible be away from the uterine cavity.The purpose of this study is to make clinicians aware of the possibility of tumor implantation and to give special attention to avoid,or reduce iatrogenic implantation during a surgical procedure.展开更多
Nephroprevention strategies are crucial for handling chronic kidney disease(CKD) complications, and slowing its progression. However, these preventative measures should be guided by major geriatrics principles in orde...Nephroprevention strategies are crucial for handling chronic kidney disease(CKD) complications, and slowing its progression. However, these preventative measures should be guided by major geriatrics principles in order to help nephrologists to adequately handle the oldest old with CKD. These geriatric concepts consist of taking into account the relevance of choosing an individualized therapy, handling clinical frailty, and keeping a geriatric perspective which means that a good quality of life is sometimes a more important therapeutic objective inoctogenarians than merely prolonging life. Even though nephroprevention strategies for treating the oldest old with CKD are basically similar to those applied to younger patients such as low sodium and protein diet, optimized hemoglobin levels, blood pressure and metabolic control, the treating physician or care provider must at all times be ready to make fundamental adjustments and tweak patient care paradigms and objectives if and when the initial therapeutic options applied have caused unintended clinical consequences and complications. Additionally, the sarcopenia status should also be evaluated and treated in very old CKD patients.展开更多
Complications occur frequently after surgical treatment of scoliosis.In order to prevent from them effectively,101 cases with failure and postoperative complications were analysed.They included ...Complications occur frequently after surgical treatment of scoliosis.In order to prevent from them effectively,101 cases with failure and postoperative complications were analysed.They included rod fracture in 22 cases(15 Harrington rods,4 Zielke rods,and 3 Luque rods);recurrence of curve severity in 12 cases;broken or loossened luque wires in 15 cases;loss of thoracic kyphosis(flat back) in 6 cases;progressive kyphosis with or without paraplegia following incorrect posterior decompression in 5 cases;and increased unbalance of shoulders after instrumentation in 2 cases due to neglect of the tilting of the first thoracic vertebra.Infection occurred in 8 cases(incision infection 7 cases,deep wound infection in 1 case);and pneumothorax in 1 case.They were induced by biomechanical factors in 23 cases(22 8%),incorrect selections of indications in 29 cases(28 7%),operational mistakes in 37 cases(36 6%),internal fixation factors in 15 cases(14 9%).The authors hold that there are quite a lot of factors leading to occurrence of complications and the effective way for prevention from them is to understand the factors and main technical points related to internal fixation.展开更多
Cancer is the major cause of death worldwide and in the local community. Due to the aging population and changes in lifestyle of the citizens, it is expected that the incidence of cancer will continue to increase. In ...Cancer is the major cause of death worldwide and in the local community. Due to the aging population and changes in lifestyle of the citizens, it is expected that the incidence of cancer will continue to increase. In fact, according to the World Health Organization, about 30% of cancer death can be prevented. The fight against cancer relies on support from the government, together with collaborations with the policymakers, healthcare professionals, and the public. Legislation can act as a tool for cancer prevention. The purpose of this paper is to provide an overview of the global cancer burden and to describe how cancer legislation acts as a tool for cancer prevention in the Hong Kong region.展开更多
Chemotherapy and chemoprevention have been two of the most important means to control cancer incidence and mortality, and the cellular defensive machinery against oxidative/electrophilic stresses plays significant rol...Chemotherapy and chemoprevention have been two of the most important means to control cancer incidence and mortality, and the cellular defensive machinery against oxidative/electrophilic stresses plays significant roles in both means. This defensive system is composed of cytoprotective enzymes that metabolize and eliminate oxidative/electrophitic species. The transcription factor nuclear factor erythroid 2-related factor 2 （Nrf2） controls the basal and inducible expression of many cytoprotective genes, and plays a pivotal role in coordinating cellular defensive responses. Under basal conditions, the activity of Nrf2 is inhibited by binding to Kelch-like ECH-associated protein 1 （Keap 1）, which is capable of sensing oxidative/electrophilic signals. Upon oxidative/electrophilic stresses, the binding of Nrf2 to Keapl is disrupted, leading to activation of Nrf2 and induction of cytoprotective enzymes. Thus, Nrf2 has emerged as an important target of chemopreventive drugs. However, activation of Nrf2 could lead to very different outcomes depending on the cellular context. The indiscriminative protective effects of Nrf2 lead to its undesired functions in carcinogenesis and chemoresistance of cancer cells. Activation of Nrf2 provides neoplastic cells with growth advantages and protects cancer cells from chemotherapeutic drugs, resulting in poor clinical outcomes. In this means, inhibitors of Nrf2 signaling can enhance the efficacy of chemotherapeutic drugs and deserve further development. A better understanding of the regulation and functions of Nrf2 would be helpful for researches in both chemoprevention and chemotherapy of cancer.展开更多
Objective: To compare the various methods for prevention of peridural adhesion. Methods: Laminectomy was performed in lumbar 1, 3 and 5 segments in 30 adult rabbits that were divided into 5 groups. A 10 mm×5 mm d...Objective: To compare the various methods for prevention of peridural adhesion. Methods: Laminectomy was performed in lumbar 1, 3 and 5 segments in 30 adult rabbits that were divided into 5 groups. A 10 mm×5 mm dura was exposed, and then covered with autogenou purifieds pearl fat (APPF) mixed with basic fibroblast growth factor (bFGF) in Group A, with APPF treated with insulin in Group B, with APPF in Group C, with 2% sodium hyaluronate (SHA) in Group D, and uncovered in Group E. The slide sections for histological study were observed at 2, 4, 6, 8 and 12 weeks postoperatively. The specimens were observed with a computed imaging analysis system at 4 and 8 weeks postoperatively. Results: Severe peridural adhesions were formed in Groups B, C, D and E after laminectomy. But no adhesion was formed in the Group A at all time points. bFGF could stimulate pearl fat revascularization, increase the number of newly formed vessels and contribute to the survival of pearl fat. However, insulin had no certain effect in preventing degradation and deterioration of pearl fat. SHA had some effect in prevention of peridural adhesions only in the early stage, which was weakened with the lapse of time. Conclusions: APPF implantation mixed with bFGF provides a potential new approach to improving fat survival and preventing peridural adhesion postlaminectomy.展开更多
文摘Peripherally inserted central catheter(PICC)is extensively used in critical care settings,because it plays a vital role in providing safe central venous entry.However,PICC is associated with several complications,which should be detected to shorten the duration of patients'improvement,reduce health care cost,and lessen the incidence of various PICC-related complications.Therefore,this study aimed to outline current literature on PICC procedures,potential complications,and measures for prevention.Understanding evidence-based guidelines regarding insertion technique,early detection of complications,and care bundle of PICC is significant in complication prevention.Implementation of education,training,and appropriate multidisciplinary approaches on PICC care among nurses and caregivers is the key to preventing complications.Thus,the strict care of indwelling PICC lines,the targeted and reasonable PICCassociated complication prevention,and nursing care have a major clinical significance in reducing the occurrence of potential PICC complications.
文摘Acupuncture induced pneumothorax is a rarely seen clinical accident. In the present paper, the authors analyze its causes of onset, clinical manifestations and measures for prevention and management.
文摘Iatrogenic tumor implantation is a condition that results from various medical procedures used during diagnosis or treatment of a malignancy.It involves desquamation and dissemination of tumor cells that develop into a local recurrence or distant metastasis from the tumor under treatment.The main clinical feature of the condition is nodules at the operation's porous channel or incision,which is easily diagnosed in accordance with the case history.Final diagnosis can be made based on pathological examination.Tumor implantation may occur in various puncturing porous channels,including a laparoscopic port,abdominal wall incision,and perineal incision,etc.Besides a malignant tumor, implantation potential exists with diseases,such as a borderline tumor and endometriosis etc.Once a tumor implantation is diagnosed,or suspected,surgical resection is usually conducted. During the diagnosis and treatment of diseases,avoiding and reducing iatrogenic implantation and dissemination has been regarded as an important principle for surgical treatment of tumors.In a clinical practice setting,if possible,excisional biopsy should be employed,if a biopsy is needed.Repeated puncturing should be avoided during a paracentesis.In a laparoscopic procedure,the tissue is first put into a sample bag and then is taken out from the point of incision.After a laparoscopic procedure,the peritoneum,abdominal muscular fasciae,and skin should be carefully closed,and/or the punctured porous channel be excised.In addition,the sample/tissue should be rinsed with distilled water before surgical closure of the abdominal cavity, allowing the exfoliated tumor cells to swell and rupture in the hypo-osmolar solution.Then surgical closure can be conducted following a change of gloves and equipment.The extent of hysteromyomectomy should as far as possible be away from the uterine cavity.The purpose of this study is to make clinicians aware of the possibility of tumor implantation and to give special attention to avoid,or reduce iatrogenic implantation during a surgical procedure.
文摘Nephroprevention strategies are crucial for handling chronic kidney disease(CKD) complications, and slowing its progression. However, these preventative measures should be guided by major geriatrics principles in order to help nephrologists to adequately handle the oldest old with CKD. These geriatric concepts consist of taking into account the relevance of choosing an individualized therapy, handling clinical frailty, and keeping a geriatric perspective which means that a good quality of life is sometimes a more important therapeutic objective inoctogenarians than merely prolonging life. Even though nephroprevention strategies for treating the oldest old with CKD are basically similar to those applied to younger patients such as low sodium and protein diet, optimized hemoglobin levels, blood pressure and metabolic control, the treating physician or care provider must at all times be ready to make fundamental adjustments and tweak patient care paradigms and objectives if and when the initial therapeutic options applied have caused unintended clinical consequences and complications. Additionally, the sarcopenia status should also be evaluated and treated in very old CKD patients.
文摘Complications occur frequently after surgical treatment of scoliosis.In order to prevent from them effectively,101 cases with failure and postoperative complications were analysed.They included rod fracture in 22 cases(15 Harrington rods,4 Zielke rods,and 3 Luque rods);recurrence of curve severity in 12 cases;broken or loossened luque wires in 15 cases;loss of thoracic kyphosis(flat back) in 6 cases;progressive kyphosis with or without paraplegia following incorrect posterior decompression in 5 cases;and increased unbalance of shoulders after instrumentation in 2 cases due to neglect of the tilting of the first thoracic vertebra.Infection occurred in 8 cases(incision infection 7 cases,deep wound infection in 1 case);and pneumothorax in 1 case.They were induced by biomechanical factors in 23 cases(22 8%),incorrect selections of indications in 29 cases(28 7%),operational mistakes in 37 cases(36 6%),internal fixation factors in 15 cases(14 9%).The authors hold that there are quite a lot of factors leading to occurrence of complications and the effective way for prevention from them is to understand the factors and main technical points related to internal fixation.
文摘Cancer is the major cause of death worldwide and in the local community. Due to the aging population and changes in lifestyle of the citizens, it is expected that the incidence of cancer will continue to increase. In fact, according to the World Health Organization, about 30% of cancer death can be prevented. The fight against cancer relies on support from the government, together with collaborations with the policymakers, healthcare professionals, and the public. Legislation can act as a tool for cancer prevention. The purpose of this paper is to provide an overview of the global cancer burden and to describe how cancer legislation acts as a tool for cancer prevention in the Hong Kong region.
基金Ministry of Science and Technology of China (The National Basic research Program of China, Grant No. 2009CB526509)supported by Peking University Health Science Center (bmu2009138-121)
文摘Chemotherapy and chemoprevention have been two of the most important means to control cancer incidence and mortality, and the cellular defensive machinery against oxidative/electrophilic stresses plays significant roles in both means. This defensive system is composed of cytoprotective enzymes that metabolize and eliminate oxidative/electrophitic species. The transcription factor nuclear factor erythroid 2-related factor 2 （Nrf2） controls the basal and inducible expression of many cytoprotective genes, and plays a pivotal role in coordinating cellular defensive responses. Under basal conditions, the activity of Nrf2 is inhibited by binding to Kelch-like ECH-associated protein 1 （Keap 1）, which is capable of sensing oxidative/electrophilic signals. Upon oxidative/electrophilic stresses, the binding of Nrf2 to Keapl is disrupted, leading to activation of Nrf2 and induction of cytoprotective enzymes. Thus, Nrf2 has emerged as an important target of chemopreventive drugs. However, activation of Nrf2 could lead to very different outcomes depending on the cellular context. The indiscriminative protective effects of Nrf2 lead to its undesired functions in carcinogenesis and chemoresistance of cancer cells. Activation of Nrf2 provides neoplastic cells with growth advantages and protects cancer cells from chemotherapeutic drugs, resulting in poor clinical outcomes. In this means, inhibitors of Nrf2 signaling can enhance the efficacy of chemotherapeutic drugs and deserve further development. A better understanding of the regulation and functions of Nrf2 would be helpful for researches in both chemoprevention and chemotherapy of cancer.
文摘Objective: To compare the various methods for prevention of peridural adhesion. Methods: Laminectomy was performed in lumbar 1, 3 and 5 segments in 30 adult rabbits that were divided into 5 groups. A 10 mm×5 mm dura was exposed, and then covered with autogenou purifieds pearl fat (APPF) mixed with basic fibroblast growth factor (bFGF) in Group A, with APPF treated with insulin in Group B, with APPF in Group C, with 2% sodium hyaluronate (SHA) in Group D, and uncovered in Group E. The slide sections for histological study were observed at 2, 4, 6, 8 and 12 weeks postoperatively. The specimens were observed with a computed imaging analysis system at 4 and 8 weeks postoperatively. Results: Severe peridural adhesions were formed in Groups B, C, D and E after laminectomy. But no adhesion was formed in the Group A at all time points. bFGF could stimulate pearl fat revascularization, increase the number of newly formed vessels and contribute to the survival of pearl fat. However, insulin had no certain effect in preventing degradation and deterioration of pearl fat. SHA had some effect in prevention of peridural adhesions only in the early stage, which was weakened with the lapse of time. Conclusions: APPF implantation mixed with bFGF provides a potential new approach to improving fat survival and preventing peridural adhesion postlaminectomy.
