ObjectiveTo summarize recent advances, clinical applications, and future directions of the portal vein iodine-125 (125I) irradiation stent in the treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). MethodsLiterature published over the past 15 years concerning 125I irradiation stents for HCC with PVTT treatment was retrieved. Studies focusing on stent design, radiation dosimetry, combination treatment strategies, and prognostic outcomes were systematically reviewed and analyzed. ResultsThe portal vein 125I irradiation stent provides dual therapeutic benefits: mechanical recanalization of the obstructed portal vein and continuous intraluminal low-dose γ-radiation, achieving high-dose, long-duration localized irradiation. Clinical evidences indicate superior outcomes in maintaining portal vein patency, controlling tumor thrombus progression, and improving overall survival as compared with transcatheter arterial chemoembolization (TACE) or systemic therapy alone. Moreover, combination approaches with TACE or targeted or immunotherapy further enhance tumor control and survival benefits, making it an integral part of multidisciplinary HCC management. ConclusionsAs an innovative integration of interventional and brachytherapy techniques, the 125I portal vein irradiation stent shows promising efficacy and safety in treating HCC with PVTT. Future developments should emphasize biomaterial optimization, image-guided precision implantation, and individualized dosimetry, supported by multicenter randomized controlled trials to establish standardized therapeutic protocols and advance precision oncology.
ObjectiveTo investigate the negative emotions of patients before cardiac surgery in West China Hospital in order to analyze the related factors.MethodsThe Huaxi emotional-distress index (HEI), a screening tool for mood disorders developed by the Mental Health Center of West China Hospital, was used for preoperative psychological evaluation of 1 968 adult patients hospitalized in cardiac surgery from March 2016 to July 2014. There were 835 males and 1 133 females at age of 49±13 years.Results Fifty-one patients (2.6%) had negative emotions, among whom 6 patients were screened for suicide risk. After intervention, none of them had serious consequences caused by adverse emotions, such as automatic discharge from hospital, avoidance of surgery and suicide.ConclusionThis study found that most of the cardiac surgery patients in West China Hospital have good psychological status before surgery, and a few suffered from negative emotions. “Huaxi emotional-distress index” is simple, effective and worth promoting.
Objectives To analyze the effect of sling exercise therapy on the walking ability of children with spastic hemiplegia and cerebral palsy, and to provide a scientific basis for clinical treatment. Methods Children with spastic hemiplegia and cerebral palsy who were treated in the Department of Rehabilitation of Children’s Hospital of Shanghai from July 2018 to July 2019 were selected as the research subjects. The children were divided into conventional treatment group and sling exercise therapy group by random number table method. The routine treatment group was given routine rehabilitation training, and the sling exercise therapy group was given combined sling exercise therapy on the basis of routine treatment. The Gross Motor Function Measure (GMFM)-88-item E functional area score, Clinical Spasticity Index (CSI) and Berg Balance Scale (BBS) score were compared between the two groups. Results A total of 36 children were included, with 18 cases in each group. There was no significant difference in gender, age and hemiplegia side between the two groups (P>0.05). All children completed the trial without adverse reactions. Before treatment, there was no significant difference in BBS, CSI and GMFM-88 E functional area scores between the two groups (P>0.05). After 3 months of treatment, the above scores of the two groups were improved compared with those before treatment (P<0.05). The improvement of the above scores in the sling exercise therapy group after treatment was better than that in the conventional treatment group. The difference of BBS, CSI, and GMFM-88 E functional area scores in the sling exercise therapy group before and after treatment was 8.94±4.15, 2.44±0.71, and 7.28±3.23, respectively, the difference of the above scores before and after treatment in the conventional treatment group was 4.50±4.15, 1.83±0.79, and 2.89±1.64, respectively, and the differences were statistically significant (P<0.05). Conclusion Combined use of sling exercise therapy can better improve the walking ability of children with spastic hemiplegia and cerebral palsy, which is worthy of clinical promotion and application.
為實現培養實用型與創新性相結合人才的教育目標,我們對傳統的預防醫學實驗教學模式進行了改革,包括實驗內容、考核方式、學生參與實驗準備等環節。通過改革,充分激發了學生的積極性和自主性,提高了學生的實際動手能力,增強了學生的團隊合作精神和創新意識,有利于學生綜合素質的提高。
Objective To explore the way of clinical pharmacists participating in formulating the chemotherapy regimen for cancer and pharmaceutical monitoring, through the practice of drug treatment in a patient with gestational trophoblastic neoplasia. Methods Clinical pharmacists participated in the treatment of one patient with low-risk gestational trophoblastic neoplasia in gynecological chemotherapy ward, from the first chemotherapy in January 2015 to the clinical cure. The countermeasures included designating chemotherapy regimen, monitoring clinical efficacy and adverse reactions, changing the chemotherapy regimen in time when the curative effect was poor, and coping with adverse reactions. Results Physicians adopted the suggestions from clinical pharmacists and the patient was clinically cured after standardized treatment. Conclusion Pharmaceutical care by clinical pharmacists can assist clinicians to ensure the safety and effectiveness of drug use.
目的 探討運用心臟臨時起搏器搶救嚴重心律失常、更換永久性心臟起搏器及心動過緩的外科手術患者圍手術期需用臨時起搏器保護的臨床效果及護理經驗。 方法 2008年8月－2011年7月，共對30例緩慢型心律失常者實施臨時心臟起搏術。術前做好患者的心理護理，做好器材及藥品準備；術中搶救器械、搶救藥品處于備用狀態，作好術中配合及病情觀察；術后護理，觀察生命體征及相關癥狀變化。 結果 安置心臟臨時起搏器患者共30例，除1例因合并下壁心肌梗死、嚴重心力衰竭搶救無效死亡外，其余均取得滿意的治療效果，術中、術后無并發癥發生，術后恢復良好，病情穩定出院。 結論 心臟臨時起博器運用于搶救嚴重心律失常患者、贏得進一步搶救時間，更換永久性心臟起博器患者的臨時保護，以及心動過緩的外科手術患者圍手術期保護，均是一種安全有效的治療方法。做好術前、術中及術后的護理是必要保證。Objective To investigate the clinical effects and nursing experiences of using temporary cardiac pacemaker in emergency rescue for patients with severe arrhythmia, in renewal of permanent cardiac pacemaker, or in peri-operative patients with bradycardia. Methods From August 2008 to July 2011, 30 patients with bradycardia arrhythmia underwent temporary cardiac pacemaker implantation surgery. We applied psychological nursing to the patients and made a good preparation of necessary equipments and medicine before operation. During the surgery, all required apparatuses and materials were ready at hand, and careful observation of conditions of the patients was carried out. After operation, the vital signs as well as the development of related symptoms in the patients were closely observed. Results There were 30 patients who had temporary cardiac pacemakers implanted. All got satisfying treatment effects except one who died from severe heart failure combined with inferior-wall myocardial infarction. No intraoperative or postoperative complications occurred, and the patients attained good postoperative recuperation before leaving hospital. Conclusion Temporary cardiac pacemaker is safe and effective in the emergency rescue of patients with severe arrhythmia, in temporary heart protection for patients undergoing renewal of permanent cardiac pacemaker, and in perioperative protection for patients with bradycardia. Good nursing before, during, and after the operation should be guaranteed.
Objective To review the recent advances in the application of graphene oxide (GO) for bone tissue engineering. Methods The latest literature at home and abroad on the GO used in the bone regeneration and repair was reviewed, including general properties of GO, degradation performance, biocompatibility, and application in bone tissue engineering. Results GO has an abundance of oxygen-containing functionalities, high surface area, and good biocompatibility. In addition, it can promote stem cell adhesion, proliferation, and differentiation. Moreover, GO has many advantages in the construction of new composite scaffolds and improvement of the performance of traditional scaffolds. Conclusion GO has been a hot topic in the field of bone tissue engineering due to its excellent physical and chemical properties. And many problems still need to be solved.
ObjectiveTo evaluate the effect of early preoperative mobilization on the rehabilitation of the elderly patients with hip fractures after operation.MethodsThe clinical data of 16 elderly patients with hip fractures between February 2017 and April 2018 who met the selection criteria was retrospectively analyzed. There were 8 males and 8 females, with an average age of 80.3 years (range, 69-90 years). There were 8 cases of intertrochanteric fracture and 8 cases of femoral neck fracture. The preoperative American Society of Anesthesiologists (ASA) scored 2.94±0.43. There were 3 cases of cardiovascular and cerebrovascular diseases, 6 cases of essential hypertension, 5 cases of respiratory diseases, 3 cases of diabetes, and 2 cases of other system diseases. The time from injury to admission was 4 hours to 14 days with an average of 39.5 hours. On the day of admission or on the first day after admission, the patient started to exercise on the floor underwent analgesia treatment. And the patients were treated with closed reduction (9 cases) or artificial hip arthroplasty (7 cases). The time from admission to operation was 4 to 25 days, with an average of 7.4 days. At the time of admission, after the first ground movement before operation, on the second day after operation, and at last follow-up, the Barthel Index was used to assess the patients’ self-care ability, and Barthel effectiveness (BE) was calculated. The complications were observed and recorded during follow-up.ResultsAll 16 patients underwent operation successfully. The hospital stay was 8 to 24 days, with an average of 14.1 days. All patients were followed up 2.5-16.0 months with an average of 6.5 months. One patient developed postoperative pulmonary infection; the remaining patients had no surgical-related complications. No patient died during the follow-up. The Barthel Index scored 30.63±5.56 at admission, 53.13±9.50 after the first ground movement before operation, 60.63±6.09 on the second day after operation, and 96.25±4.84 at last follow-up. There were significant differences in Barthel Index scores between different time points (P<0.05). The BE was 0.23±0.06 after the first ground movement before operation, 0.30±0.04 on the second day after operation, and 0.66±0.06 at last follow-up. There were significant differences in BE between different time points (P<0.05).ConclusionFor elderly patients with hip fractures who have long waiting time before operation, early preoperative mobilization has a positive impact on patients’ activities of daily living.
目的:評價國產腺苷臨床應用安全性及腺苷負荷心肌灌注顯像對冠心病的診斷價值。方法:對51例臨床疑診冠心病患者,分別靜脈注射腺苷,注射3min末,靜脈注射核素顯像劑99TcmMIBI 925 MBq,1～1.5h行心肌灌注斷層顯像,分析患者在腺苷注入后的血流動力學改變、副作用發生情況。經半年以上隨訪排除或確診冠心病,評價腺苷負荷心肌灌注顯像對冠心病的診斷價值。結果:腺苷輸注后,86.3%(44/51) 患者出現各種副作用,停藥后均很快緩解。腺苷負荷試驗心肌灌注顯像診斷冠心病的敏感性90.9%,特異性71.4%,準確性88.2%,陽性預測值95.2%,陰性預測值55.6%。結論:國產腺苷可安全地應用于負荷心肌灌注顯像。腺苷負荷心肌灌注顯像診斷冠心病敏感性較高,具有重要的臨床應用價值。
目的:為了提高漏出性胸腔積液的診斷率對其進行病因分析。方法:對54 例漏出性胸腔積液病例就不同年齡及病變部位進行分析。結果:50 歲以下以腎病綜合征居首位;50~ 60歲以歲慢性肺源性心臟病右心衰竭及肝硬化為主;60 歲以上歲以慢性肺源性心臟病右心衰竭居發病之首,其次為冠狀動脈粥樣硬化性心臟病。左側以心包積液為主。右側以慢性肺源性心臟病右心衰竭居發病之首,其次為冠狀動脈粥樣硬化性心臟病,肝硬化居第三。雙側以慢性肺源性心臟病右心衰竭居首位,其次為腎病綜合征,高血壓心臟病居第三。結論:漏出性胸腔積液的發病年齡,病變部位不同病因各異。