ObjectiveTo review the progress of treatment and prevention of breast cancer related lymphedema. MethodsThe recent literature concerning treatment and prevention of breast cancer related lymphedema was extensively consulted and reviewed. ResultsThe treatment of lymphedema is now based on complete decongestive therapy, supplemented with medicine and surgery. Those procedures have been proved to be safe and effective. Sentinel lymph node biopsy, axillary reverse mapping, and lymphaticovenous anastomoses have been used to decrease the incidence of lymphedema. They show promising effectiveness in short term, but the long-term effectiveness needs further tests. ConclusionIn clinical practice, many treatment methods are used to decrease lymphedema, and lymphedema prevention is playing an increasingly important role. Lymphaticovenous anastomoses shows a promising effectiveness in reducing lymphedema.
ObjectiveTo investigate the effectiveness of hydrocolloid dressing in preventing peripheral phlebitis due to intravenous infusions. MethodsFrom April 1st to October 30th, 2014, 320 patients admitted in the Biliary Department of West China Hospital for parenteral nutrition were collected along with their clinical data and were randomly divided into control group and intervention group. A total of 160 patients who were allocated in the control group accepted simple dressing with 3M adhesive tape (6 cm×7 cm) at the intravenous catheter site. In contrast, hydrocolloid dressing (5 cm×7 cm) was applied at the intravenous catheter site and then covered with 3M adhesive tape (6 cm×7 cm) for the patients in the intervention group. ResultsPhlebitis rate was significantly higher in the control group (115 patients) than that in the interventions group (64 patients) (χ2=32.978, P<0.001). In addition, the severity of phlebitis was higher in the control group than that in the intervention group (Z=-4.466, P<0.001). Statistically significant difference was noted. ConclusionHydrocolloid dressing is effective in preventing and delaying the occurrence of peripheral phlebitis due to intravenous infusions.
ObjectiveTo analyze the common reasons of anastomotic leakage following sphincter preservation for rectal cancer, and to explore the better prevention and treatment strategies. MethodThe related literatures of the definition, common causes, and prevention and treatment status of anastomotic leakage were reviewed. ResultsCurrently rectal cancer was one of common malignant tumors, including about 2/3 low rectal cancer.Recently, sphincter preserving surgery had become the preferred surgical procedure.However, the incidence of anastomotic leakage keeping in higher was still the most serious and common complications.Through improving the general condition of the patients, improving surgical techniques, and standardized treatment could effectively reduce the incidence of anastomotic leakage. ConclusionReasonable preoperative assessment for the basic situation of patients with rectal cancer, standardized and individualized treatments, contribute to reduce incidence of anastomotic leakage and improve clinical outcomes in patients with low rectal cancer.
【Abstract】Objective To study the mechanisms of enhancing effect of mild hypothermia (MH) to ischemic preconditioning (IP) on hepatic ischemiareperfusion (I-R) injury. Methods To observe the content of the marker enzymes of liver damage (ALT,AST,LDH) and malondialdehyde (MDA), and activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSHPX), total antioxidase (TAX) in inferior vena cava blood above liver in nonischemic control group (n=6), I-R group (n=6), IP group (n=6) and mild hypothermic ischemic preconditioning (MHIP) group (n=6). Results After I-R the content of ALT,AST, LDH and MDA were significantly elevated (P＜0.01), SOD,CAT,GSH-PX,ACT activities were declined obviously (P＜0.01). The content of ALT,AST,LDH and MDA were significantly lower in IP group than those in I-R group, and in MHIP group than those in IP group (P＜0.01,P＜0.05), and the content of SOD, CAT,GSH-PX, ACT activities were significantly higher in IP group than those in I-R group, and in MHIP group than those in IP group (P＜0.01,P＜0.05). Conclusion Ischemic preconditioning may enhance the oxidation-resistance of liver, and reduce the oxygen free radical injury to liver after ischemia-reperfusion. Mild hypothermia may enhance the protective effect of IP on hepatic ischemiareperfusion injury.
Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is defined as an acute and clinically significant respiratory deterioration characterized by evidence of new, widespread alveolar abnormality. In the past, AE-IPF was considered to be idiopathic, which was hard to be prevented and its prognosis was hard to be obviously improved; the latest researches have shown that AE-IPF can be triggered by known causes, including pulmonary infection, aspiration, etc. This review summarizes the etiology or risk factors, treatment and prevention of AE-IPF according to the latest researches.
Abstract： Air leak is still a common postoperative complication after selective lobectomy. The majority of patients undergoing lobectomy have some risk factors of postoperative air leak or persistent air leak. Nowadays，preventive measures of postoperative air leak mainly include preoperative, intraoperative （surgical technique，reinforcement material，pleural cavity reduction），and postoperative （pleurodesis，chest drainage management） strategies. Many of these new measures have been applied in clinical practice with satisfactory outcomes.
Objective To study the effect of the allogeneic bone sheet that has been treated by the freezedrying and radiation sterilization in preventing the epidural adhesion after laminectomy in sheep. Methods Laminectomy was performed on L3,4and L4,5 of 12 adult male sheep. Afteroperation, one site of L3,4 or L4,5was covered by the allogeneicbone sheet in “H” shape after the freeze-drying and radiation sterilization treatment; and the other site was used as a control. The sheep were killed and the specimens were retrieved at 4，8，12，16，20 and 24 weeks after operation to observe the scar formation process. X-ray andCT scan were performed in the segments of L3,4and L4,5at 4 and 24weeks. Results Four weeks after operation, the position and the shape of the allogeneic bone sheet were good in condition, and no lumbar spinal stenosis or compression of the dura was found in the experimental sections. Twentyfour weeks after operation theexamination on the experimental sections revealed that the vertebral canal reconstruction was completed, the allograft was absorbed almost completely, and inosculation with the lamina of the vertebra and the shape of the lumbar spine were good, with no fibroid tissues found in the epidural area. Compared with the control segment, the dura adhesion degree in the laminoplasty segment was significantly decreased (Plt;0.01), and the dura sac remained in a good shape. There was no obvious compression on the dura. Conclusion The allogeneic bone sheet after the treatment of freeze-drying and radiation sterilization can effectively reduce the scar formation after laminectomy and prevent postoperative recurrence of the spinal stenosis.
To analyse the causes of biliary injuries and summuarize the experience of prevention of biliary injury during laparoscopic cholecystectomy (LC). Twenty-three patients with biliary duct injury were diagnosed and treated at our center between September 1992 and August 1998. The main causes were either misidentification of the bile duct or aberrant right duct as the cystic or injudicious use of thermal energy (cautery) to dissect, control bleeding, or divide tissue. Conclusion: The causes of biliary duct injury are complex. Training and experience of sugeon, the meticulous dissection of the calot′s triangle and preoperative or operative cholangiography are three key factors in prevention of biliary duct injury during LC.