ObjectiveTo summarize the influence of dietary factors on the risk of pancreatic cancer and its possible mechanism. MethodThe literatures relevant to studies of the influence of dietary factors on the risk of pancreatic cancer were collected and reviewed. ResultsThe total intakes of carbohydrate, fatty acid, protein, and vitamin affected the risk of pancreatic cancer, and the different substances belonging to the same nutrients had different effects on the risk of pancreatic cancer. In addition to nutrients, the popular beverages and different dietary patterns in recent years also affected the risk of pancreatic cancer through certain mechanisms. ConclusionDietary factors can affect risk of pancreatic cancer through a variety of mechanisms, and it might decrease risk of pancreatic cancer by intervening in dietary factors in daily life for healthy people.
摘要:目的：评价围手术期预防性应用抗菌药物现状及合理性。方法：采用回顾性调查的方法，随机抽查2009年度Ⅰ类切口手术围手术期病案500份，设计外科围手术期预防性应用抗生素调查表，对预防用药的适应证、用药种类、联合用药、给药时机及持续时间进行统计分析。结果：未使用抗生素5例，预防性使用抗生素495例，其中不合理80例（16.00％）。预防性使用抗生素总品规数为540，其中头孢菌素类453例（83.89%），青霉素类（包括加酶抑制剂）26例（4.81%），喹诺酮类44例（8.15%）。选用头孢唑啉钠178例（32.96%）居第一位，头孢替唑钠第二，151例（2796%）。结论：Ⅰ类切口手术患者围手术期预防性使用抗菌药物较为合理，但仍存在用药指征把握不严，抗菌药物的选择、抗菌药物使用时间较长等问题，有待进一步规范化管理。Abstract: Objective: To understand the current application of perioperative preventive antibiotics, and their rationality. Methods: Five hundred perioperative records of patients with incision Ⅰ were randomly chosen and surveyed in 2009. A questionnaire for prophylactic use of antimicrobial was designed. The indication of antimicrobial use, the species, combination, timing and drug duration were analyzed. Results: Our of 500, 495 used antimicrobial and 80 were unreasonable; 540 kinds of antimicrobial were used, included cephalosporin 453 cases (83.89%), penicillin class (including plus enzyme inhibitors) in 26 cases (4.81%), quinolone 44 cases (8.15%). Cefazolin sodium (178 patients, 32.96%) ranked first, second was cefazolin sodium (151, 27.96%). Conclusion: Perioperative use of antimicrobial prophylaxis in patients with incision Ⅰ is reasonable, but standardization management should be strengthened in the indication, species, and duration.
How to accurately identify factors of cancer occurrence and to provide intervention early are the key issues that urgently need to be addressed in cancer prevention and treatment. Mendelian randomization (MR) analysis uses genetic variants as instrument variables for exposures of interest, which compensates the shortcomings of traditional observational studies and clinical trials. This review introduced the current application status of MR analysis in cancer etiology and treatment researches in details, including assessment of cancer risk factors, exploration of cancer treatment targets, and evaluation of drug efficiency and adverse reactions. The scopes and dimensions of cancer etiology and treatment researches are greatly expanded because of various MR designs and abundant high-level omics data. As well, it provides a practical and feasible method for constructing cancer etiology networks and drug targeted databases, which are promising for supporting the development of precision cancer prevention and treatment.
Exercise intervention is an important non-pharmacological intervention for various diseases, and establishing precise exercise load assessment techniques can improve the quality of exercise intervention and the efficiency of disease prevention and control. Based on data collection from wearable devices, this study conducts nonlinear optimization and empirical verification of the original "Fitness-Fatigue Model". By constructing a time-varying attenuation function and specific coefficients, this study develops an optimized mathematical model that reflects the nonlinear characteristics of training responses. Thirteen participants underwent 12 weeks of moderate-intensity continuous cycling, three times per week. For each training session, external load (actual work done) and internal load (heart rate variability index) data were collected for each individual to conduct a performance comparison between the optimized model and the original model. The results show that the optimized model demonstrates a significantly improved overall goodness of fit and superior predictive ability. In summary, the findings of this study can support dynamic adjustments to participants' training programs and aid in the prevention and control of chronic diseases.
ObjectiveTo summarize the prevention and treatment of iatrogenic medial collateral ligament (MCL) injuries in total knee arthroplasty (TKA).MethodsThe relevant literature about iatrogenic MCL injuries in TKA was summarized, and the symptoms, causes, preventions, and treatments were analyzed.ResultsPreventions on the iatrogenic MCL injuries in TKA is significantly promoted. With the occurrence of MCL injuries, the femoral avulsion can be fixed with the screw and washer or the suture anchors; the tibial avulsion can be treated with the suture anchors fixation, bone staples fixation, or conservative treatment; the mid-substance laceration can be repaired directly; the autologous quadriceps tendon, semitendinosus tendon, or artificial ligament can be used for the patients with poor tissue conditions or obvious residual gap between the ligament ends; the use of implant with greater constraint can be the last alternative method.ConclusionNo consensus has been reached to the management of iatrogenic MCL injuries in TKA. Different solutions and strategies can be integrated and adopted flexibly by surgeons according to the specific situation.
ObjectiveTo evaluate efficacy and safety of early anticoagulation therapy with low molecular weight heparin (LMWH) in prevention of venous thromboembolism (VTE) after pancreatoduodenectomy (PD).MethodsThe patients who received PD in our hospital from January 2017 to December 2018 were collected retrospectively, then were divided into the anticoagulant group and the non-anticoagulant group. The operation time, intraoperative blood loss, tumor property, coagulation function indexes such as prothrombin time (PT), PT activity (PTA), fibrinogen (FIB), activated partial thromboplastin time (APTT), thrombin time (TT), and D-dimer (DD), platelet (PLT), VTE, bleeding related complications etc. were compared between the two groups.ResultsA total of 103 patients underwent PD were included in this study, including 52 patients in the anticoagulant group and 51 patients in the non-anticoagulant group. There were no significant differences in the baseline data such as the gender, age, and preoperative coagulation function indexes, etc. between the two groups (P>0.05). The incidence of VTE in the anticoagulant group was lower than that in the non-anticoagulant group (13.5% versus 47.1%, P<0.001). There was no significant difference in the incidence of bleeding between the anticoagulant group and the non-anticoagulant group (9.6% versus 7.8%, P>0.05). There were no statistically significant differences in the coagulation indexes between the two groups before operation and day 1 after operation (P>0.05). On day 8 after operation, the FIB and DD values of the anticoagulant group were significantly lower than those of the non-anticoagulant group (P values were 0.040 and 0.002, respectively). A comparison of different phases in the same group on coagulation indexes between day 8 and day 1 after surgery showed that there were statistically significant differences (P<0.05), the changes of all indexes were within the normal range.ConclusionThe results of this study indicate that LMWH administered at 24 h after PD could decrease incidence of VTE and don’t increase risk of bleeding.
For the purposes of promoting the effect of secondary prevention of myocardial infarction, and improving the compliance with myocardial infarction (MI) secondary prevention, a guideline for strengthening patients self-management on non-pharmacological secondary prevention was produced by an multidiscipline team leaded by Chinese Association of Integrative Medicine clinical cardiovascular branch, Lanzhou University Evidence-Based Medicine Center, Peking University School of Nursing, Tianjin University of Traditional Chinese Medicine and Beijing University of Chinese Medicine. This is the first version of patient guideline in China. This paper introduces the main methods, processes and characteristics of the patient guideline development. It will provide reference to future researchers to the development of the patient guideline.
摘要:目的: 探讨传染病医院工作人员对甲型H1N1流感医院感染控制知识的认知程度。 方法 :选择救治甲型H1N1流感期间传染病医院不同岗位工作人员进行无记名自填式调查问卷。 结果 :全院对甲型H1N1流感医院感染控制认知总体情况良好,认知的薄弱环节是对防护措施,尤其是一级防护和三级防护的认知;不同工作岗位的工作人员对甲型H1N1流感医院感染控制认知程度不同,与甲型H1N1流感有接触的工作人员认知度高于其他工作人员,中高级职称、高年龄段(35岁以上)的医务人员认知度高于初级职称及低年龄段(35岁以下)的医务人员。 结论 :针对薄弱环节,进一步加强全员医院感染控制知识、技能的培训考核。Abstract: Objective: To explore the knowledge about the Influenza A (H1N1) of Chengdu Hospital for Infectious Diseases ‘s staff. Methods : Different medical staff of the infectious Disease Hospital during the influenza A (H1N1) treatment in Chinese mainland was selected to fill in anonymous questionnaire. Results : The awareness of the hospital is well about the hospital infection control to Influenza A (H1N1). Preventive measure is weak, especially about the primary barriers and the third barriers. The different position awareness is different. The staff who is in touch with Influenza A (H1N1) is more awareness than the others, the senior and intermediate title is more awareness than the Junior Title, the high ages group(over 35 ages) is more awareness than the low ages group (under 35 ages). Conclusion : For the weak link, further strengthens the entire hospital infection control knowledge, skills training and examination.
ObjectiveTo understand the related factors and prevention and treatment of anastomotic leakage after colorectal cancer operation.MethodThe literatures on the studies of colorectal anastomotic leakage in recent years were reviewed and analyzed.ResultsThe occurrence of postoperative anastomotic leakage of colorectal cancer was usually related to many factors, besides the patients’ nutritional status, body mass index, gender, smoking and drinking history, preoperative radiotherapy and chemotherapy, etc., as well as the distance between the anastomotic stoma and the anal margin and the ligation of the left colonic artery. The monitors of albumin, prealbumin, C-reactive protein, procalcitonin and other indicators might be better for early prediction of anastomotic leakage. The use of oral antibiotics while mechanical bowel preparation, intraoperative ICG fluorescence angiography, single-layer intestinal anastomosis, reducing the number of staplers, preserving the left colon artery, placing drainage tube through anus, and minimally invasive colorectal cancer resection might have some advantages in reducing the incidence of postoperative anastomotic leakage.ConclusionsAs a surgeon, risk factors associated with anastomotic leakage should be fully understood. It is of great significance to use related markers to identify early anastomotic leakage and timely intervene, and use of more accurate surgical procedures to reduce occurrence of anastomotic leakage.
Objective To summarize the research progress of anterior cutaneous nerve injury and repair in knee arthroplasty. Methods The relevant literature at home and abroad in recent years was reviewed and summarized from the anatomy of anterior cutaneous nerve, nerve injury grade, clinical manifestations, prevention and treatment of anterior cutaneous nerve. Results The anterior cutaneous nerve injury is a common complication of knee arthroplasty. Because the anterior cutaneous nerve branches are many and thin, and mainly run between the first and second layers of fascia, this level is often ignored during surgical exposure. In addition, the knee arthroplasty does not routinely perform the exploration and repair of the cutaneous nerve. So the anterior cutaneous nerve injury is difficult to avoid, and can lead to postoperative skin numbness and knee pain. At present, studies have explored the feasibility of preventing its occurrence from the aspects of improved incision and intraoperative separation of protective nerve. There is no effective prevention and treatment measures for this complication. For patients with skin numbness after knee arthroplasty, the effectiveness of drug treatment is not clear. Local nerve block or nerve excision can be used to treat patients with painful symptoms after knee arthroplasty considering cutaneous pseudoneuroma. ConclusionKnee arthroplasty is widely used and anterior cutaneous nerve injury is common in clinic. In the future, more high-quality clinical studies are needed to further explore the prevention and treatment measures of this complication and evaluate the clinical benefits obtained.