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.
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.
Objective To evaluate the effect of prophylactic removal of asymptomatic impacted wisdom teeth in adolescents and adults compared with the retention of these wisdom teeth. Methods We searched the Cochrane Oral Health Group Trials Register （to 4 August, 2004）, the Cochrane Central Register of Controlled Trials （CENTRAL）, PubMed （1966 to 4 August, 2004）, EMBASE （1974 to 4 August, 2004）. There was no restriction to publication of language. Key journals were handsearched. An attempt was made to identify ongoing and unpublished trials. All randomised or controlled clinical trials （KCTs/CCTs） comparing the effect of prophylactic removal of asymptomatic impacted wisdom teeth with no-treatment （retention） were included. Assessment of relevance ,validity and data extraction were conducted in duplicate by three independent reviewers. Where uncertainty existed, authors were contacted for additional information about randomisation and withdrawals. The quality assessments of the trials were carried out. Results Only three trials were identified to fulfill the selection criteria. Two complete RCTs assessed the influence of prophylactic removal on late incisor crowding in adolescents. One ongoing RCT was identified, but the researchers were unable to provide any data and intended to publish in the near future. Although both complete trials met the inclusion criteria, different outcome measures were prevented us from pooling data. Conclusions No evidence has been found to support or refute routine prophylactic removal of asymptomatic impacted wisdom teeth in adults. There is some reliableevidence that suggests that the prophylactic removal of asymptomatic impacted wisdom teeth in adolescents neither reduces nor prevents late incisor crowding.
Cardiac implantable electronic device (CIED) is commonly used to treat arrhythmias. The amount of CIED implantation has increased year by year since its first application in 1958. At the same time, the CIED infection rate also increases significantly. Although the infection rate is very low for the primary implantation, the consequences of CIED infection are serious, and it is often necessary to remove the equipment for treatment. The mortality rate in patients with CIED infections is high, and the economic burden is huge. In this paper, the epidemiology, pathogenesis and pathogen, manifestations and diagnosis, risk factors, treatment and preventive measures of CIED infection were systematically described based on the recently published guidelines and international consensus literature, so as to provide theoretical guidance for the prevention of CIED infections.
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.
ObjectiveTo investigate the reason, prevention, and treatment measures of gastrointestinal unplanned reoperation. MethodsClinical data of 21 patients who carried out gastrointestinal unplanned reoperation for various reasons from Jun. 2012 to Jun. 2013 in our hospital were retrospectively analyzed. ResultsTwenty-one of 2 492 patients with gastrointestinal tract surgery carried out gastrointestinal unplanned reoperation, and the incidence of reoperation was 0.8%. The causes of reoperation were intra-abdominal hemorrhage in 10 cases, gastrointestinal fistula in 7 cases, inflammatory intestinal obstruction with peritonitis in 1 case, and incision dehiscence in 3 cases. After undergoing suture hemostasis, colostomy, anastomotic fistula repair, debridement, and suture,20 cases were cured or improved, and 1 case died. The median of hospitalization expense was 76 000 yuan(46 000-116 000 yuan), and the median of hospital stay was 25-day(16-49 days). ConclusionsGastrointestinal unplanned reoperation can cause more serious economic and emotional burden to patients, standardizing surgical procedure and enhancing perioperative monitoring can reduce the incidence of unplanned reoperation. In addition, grasp legitimately the indications of reoperation, implement timely, and effective reoperation can avoid further deterioration of the disease.
Objective To analysis the common reasons for failure in orthotopic liver transplantation during preliminary experiment and propose the preventive. Methods One hundred and twenty cases in preliminary experiment using modified Kamada “two-cuff” method of orthotopic liver transplantation were retrospectively analyzed. Results The causes of failure included： lengthening of anhepatic phase (66 cases)， failed anastomosis of suprahepatic inferior vena cava (61 cases)， failed anastomosis of infrahepatic inferior vena cava (17 cases), failed anastomosis of portal vein (12 cases), unsatisfied anesthesia (8 cases). Succeed in 21 cases (17.50%, 21/120). Conclusion Improve the microsurgical operation techniques, particularly the anastomosis of suprahepatic inferior vena cava, can increase the success rate in orthotopic liver transplantation.
目的 探讨胰性脑病的可能的发病机制、发病情况及防治措施.方法 计算机检索中文科技期刊全文数据库(1989～2004),收集有关胰性脑病的临床研究,并进行统计分析.结果 共纳入43篇文献,435例患者.胰性脑病在重症急性胰腺炎中的发病率远高于轻症急性胰腺炎;发病年龄趋向中、老年;病死率为43.67%;病因仍以胆系疾病为主;伴发低氧的几率不高于未并发胰性脑病患者.结论 胰性脑病的发生可能是多因素共同作用的结果,仍需进一步探讨其发病机制.血清髓鞘碱性蛋白有望成为有价值的诊断指标.防治以治疗原发病急性胰腺炎为主,重在预防.胰酶抑制剂和早期营养支持有一定预防作用.