Risk Factors for Intraoperative Pressure Injury in Aortic Surgery:A Nested Case-Control Study

Aims and Objectives:The aim of this study was to identify risk factors associated with an increased risk of intraoperative pressure injury in patients undergoing aortic surgery.Background:Intraoperative pressure injuries are some of the most signifi cant health problems in clinical practice.According to previous studies,patients undergoing aortic surgery are at high risk of developing an intraoperative pressure injury,with an incidence much higher than that associated with other types of cardiac surgery.Design:This was a nested case-control study.Methods:Following the STROBE checklist,a nested case-control approach was adopted in this study.A patient cohort was selected on the basis of inclusion and exclusion criteria from patients undergoing aortic surgery.Data were collected from these patients by means of a tailored questionnaire designed in-house.Patients with intraoperative pressure injury at the end of surgery were identifi ed as the case group,while the control group consisted of patients without intraoperative pressure injury.Patients in the groups underwent 1:1 matching based on age and sex.Initially,a single-factor analysis was conducted between the two groups.Subsequently,risk factors for intraoperative pressure injury were identifi ed through conditional logistic regression analysis with use of the variables that exhibited statistically signifi cant differences in the single-factor analysis.Results:A total of 400 patients were selected.Among these,167 patients experienced intraoperative pressure injury at an incidence rate of 41.8%.Strict preoperative bed confi nement,deep hypothermic circulatory arrest during surgery,application of norepinephrine or dopamine during surgery,and intraoperative skin wetting were associated with the occurrence of intraoperative pressure injury in patients undergoing aortic surgery.Conclusions:Nurses should thoroughly assess the risk of intraoperative pressure injury and implement appropriate preventative interventions,particularly in high-risk patients undergoing aortic surgery.

Clinical practice guideline on bladder cancer(Part Ⅰ)

Bladder cancer represents one of the most prevalent malignant tumors affecting the urinary system.As per data disclosed by the National Cancer Registration Center of China in 2019,the incidence of bladder cancer was 5.80 per 100,000 in 2015,placing it as the thirteenth most common systemic malignancy.Bladder cancer poses a substantial threat to public health in China,underlining the critical importance of standardizing diagnosis and treatment to enhance clinical outcomes.This clinical practice guideline for bladder cancer centers on the etiologies,clinical presentations,and diagnostic procedures for suspected bladder cancer,in addition to the histopathology and staging of urothelial bladder cancer.

Clinical practice guideline on bladder cancer(Part Ⅲ)

Bladder cancer(BC)has become a significantly prevalent disease in China,with an incidence rate of 5.80 per 100000 in 2015,ranking it as the thirteenth most common type of cancer within the nation.This illness presents a serious public health concern,highlighting the imperative need to unify the standards for diagnosis and treatment to improve patient outcomes.The section of the clinical practice guideline in question is dedicated to addressing muscle-invasive bladder cancer(MIBC)and metastatic BC.The primary treatment strategies for MIBC are well-defined:preoperative(neoadjuvant)chemotherapy combined with radical cystectomy stands as the conventional treatment protocol.For patients with locally advanced MIBC,integrating systemic and local therapies is advocated to enhance treatment effectiveness.In cases of metastatic BC,the focus shifts to systemic treatment supplemented by supportive care measures.The guideline also succinctly presents the pros and cons of various urinary diversion surgeries,which are critical considerations following radical cystectomy.It provides an in-depth exploration of the treatment modalities for metastatic urothelial carcinoma of the bladder.Additionally,this part delves into the integrated approach to treatment and the use of radiotherapy in bladder preservation for localized disease.Moreover,it offers a concise overview of the classification,diagnosis,and therapeutic approaches for nonurothelial carcinoma of the bladder.Lastly,this part emphasizes the importance of recommended posttreatment follow-up for MIBC patients to ensure comprehensive and ongoing care management.

Clinical practice guideline on bladder cancer(PartⅡ)

Bladder cancer(BC)is an increasingly common malignancy in China,with an incidence rate of 5.80 per 100000 in 2015,making it the thirteenth most common cancer in the country.This trend underscores the urgent need for standardized diagnosis and treatment protocols.In terms of treatment,approaches for bladder cancer vary based on the cancer's stage and pathology,as well as the patient's overall health.Notably,non-muscleinvasive BC(NMIBC)confined to the mucosa(Ta)and lamina propria(T1)without invading the muscle represents about 75%of all BC cases.Succeeding the first part of the guideline,this part of the clinical practice guideline focuses on NMIBC.It details risk classifications and treatment options,including both surgical procedures and posttransurethral resection of the bladder tumor intravesical instillations.Special attention is given to the treatment strategies for carcinoma in situ.The guideline also covers the recommended follow-up procedures for patients with NMIBC,underscoring the need for thorough and continuous care management.

Cardiopulmonary resuscitation in China, 2002-2012

In the last decade, the 2000, 2005 and 2010 American Heart Association Guidelines for CardiopulmonaryResuscitation （CPR） and Emergency Cardiovascular Care were issued based on an increasing amount of basic and clinical research. The issue and promotion of the new guidelines have caused worldwide discussion, as well as controversy. These guidelines have greatly changed clinicians＇ understanding of CPR and also promoted further research and development of CPR in China.