ObjectiveTo understand the current research status of conservative mastectomy with breast reconstruction for breast cancer, so as to provide a reference for surgeons and patients with breast cancer to choose surgical method. MethodThe recently domestic and foreign literature on the research of conservative mastectomy with breast reconstruction for breast cancer was reviewed and summarized. ResultsAt present, conservative mastectomy mainly included nipple sparing mastectomy, skin sparing mastectomy, and skin reduction mastectomy. All three surgical methods were safe and effective in the treatment of breast cancer, and the complications could be controlled. When combined with breast reconstruction, the better cosmetic effect could be obtained, and the postoperative satisfaction and quality of life of patients were markedly improved. ConclusionsAfter comprehensively preoperative evaluation for patients with breast cancer, conservative mastectomy provides a treatment choice for them. After conservative mastectomy, individualized reconstruction scheme is formulated according to size and sagging degree of breast, as well as individual expectations of patients, which can obtain a higher quality of life while treating diseases for patients with breast cancer.
Objective To assess the global situation of off-label drug use in outpatient children.Methods A search was conducted in PubMed, EMbase, CBM, CNKI and VIP for collecting studies on off-label drug use in outpatient children aged 0 to 18 years, and the publication language was limited to English and Chinese. The quality assessment was based on Crombie Criteria for cross-sectional studies, and the descriptive analysis was performed to analyze the incidence of off-label drug use at all levels of medical institutes and different age groups, the common types of off-label used drugs, and the constitution ratio of off-label use drugs. Results A total of 20 cross-sectional studies were included, involving 1 933 760 children and 5 262 573 prescriptions. The results of descriptive analysis showed: a) The incidence of off-label drug use in outpatient children in primary care and tertiary care institutes were 19.5% (IQR 13.5%, 24.5%) and 26.0% (IQR 24.0%, 35.0%), respectively; b) The primary studies reported that neonate, infant and adolescent had the highest incidence of off-label drug use, while the other children had the lowest incidence; c) Drugs for respiratory system, anti-infection, sensory organs, and dermatosis were listed as the top 5 frequently used off-label drugs by more than half of the studies; d) The studies with issue of “lack of instruction for children” showed it was exactly the type with highest incidence of off-label use, while other studies without that issue showed the highest incidence was over aged off-label use. Conclusion a) Off-label drug use is common in outpatient children. The incidence of off-label drug use may be higher in tertiary care institutes than primary care institutes, and it is higher in neonate, infant and adolescent rather than other age groups of children; b) Incidence of off-label use may be higher in inpatient children than outpatient ones; c) Drugs for respiratory system, anti-infection, sensory organs, and dermatosis were most common types of off-label use; and d) Off-label use due to both “lack of instruction for children” and “over aged use” is more common. So it suggests that further studies trials should focus on fields in which clinical trials of drugs are totally absent.
This article aims to review the recall of refecoxib which increases the incidence of cardiovascular and cerebrovascular diseases and to find the methods to solve problems in post marked monitoring of drug safety.
Advancing patient safety is one of the most important strategies developed by WHO and patients must be in the center of advancing patient safety activities. This paper outlined the importance of partnership between health professionals and patients in patient safety activities in the WHO global patient safety challenges “Safe surgery saves lives”.
Objective
To evaluate the effects of neoadjuvant long-course chemoradiotherapy (CRT), neoadjuvant short-course radiotherapy (SCRT), and total neoadjuvant treatment (TNT) on chemoradiotherapy related complications and perioperative safety in mid-low rectal cancer patients.
Methods
The clinical data of 63 rectal cancer patients who received neoadjuvant (chemo) radiotherapies and surgery treatment in West China Hospital from Jul. 2014 to Feb. 2016 were retrospectively analyzed. According to the neoadjuvant regimen, the patients were divided into CRT group (n=15), SCRT group (n=30), and TNT group (n=18), and then the effects of these 3 kinds of neoadjuvant regimen on chemoradiotherapy related complications and perioperative safety were compared.
Results
① Chemoradiotherapy related complications: among all the included 63 patients, 29 patients (46.0%) occurred chemoradiotherapy related complications, including radiation enteritis in 9 patients and bone marrow suppression in 25 patients. There were significant differences in the overall incidence of chemoradiotherapy related complications, incidence of radiation enteritis and bone marrow suppression (P≤0.001). The overall incidence of chemoradiotherapy related complications and incidence of bone marrow suppression of SCRT group were lower. ② Perioperative safety: no significant differences were found in the incidence of surgical complications, incidence of specific surgical complication, operation duration, intraoperative blood loss, and postoperative flatus time (P<0.05), but there was significant difference in the postoperative hospital stay among 3 groups (P=0.033), the postoperative hospital stay of SCRT group was shorter.
Conclusion
CRT, SCRT, and TNT have similar effect on the safety in the mid-low rectal cancer patients, which suggests that SCRT is worthy of further research and promotion.
Inflammatory bowel disease (IBD) is a group of chronic, recurrent, and non-specific intestinal inflammatory diseases. It usually occurs between 20 and 40 years old, overlapping with the patient’s childbearing age. Active IBD may lead to decreased fertility and adverse pregnancy outcomes, and pregnancy may also lead to recurrence of IBD. Through studying domestic and foreign related literature on pregnancy and IBD, this article elaborates on the guidance and management of IBD before pregnancy, the disease management of IBD during pregnancy, the disease management of IBD during lactation, and the current status and prospects of traditional Chinese medicine treatment. It aims to provide references for patients and clinicians to have a more scientific understanding of pregnancy with IBD.
Background Hepatitis B is one of the major infectious diseases of mankind, and up to now, there is no effective way to handle it. Recent clinical trials have shown the potential advantages of Kurorinone an extract of Chinese herb, in treament of chronic HBV infection. Objectives Systermically review the safety and efficacy of Kurorinone in treatment of chronic HBV infection. Search strategy With the searching terms including Kurorinone, its products’ name, hepatitis B and chronic carrier status, the trials registers of the Cochrane Hepato- Biliary Group, the Cochrane Complementary Medicine Field, and the central database of the Cochrane Library as well as MEDILINE, EMBASE and Chinese Biomedical CD Database were searched from their date of inception onward. 20 Chinese medical journals and relevant academic conference proceedings have been searched by hand. The reference lists of identified documents were checked as the complementary search. Inclusion Criteria All RCTs that tested Kurorinone for chronic HBV infection were included in this review. Method of the review According the demand of Cochrane systematic review, selection of trial for inclusion, assessment of methodological quality, data extraction and data syntheses would be conducted for each included trial.
To attend the Patient Safety Summit of UK Presidency of the EU 2005, learn and share ideas with each other, participate in discussing and developing the vision and mission as well as goals for patients for patient safety program, seek the common interest for further cooperation so as to help promote the activities on patient safety in healthcare in China.
ObjectiveTo compare the early effectiveness and safety of simultaneous bilateral and staged bilateral unicompartmental knee arthroplasty (UKA) in treatment of anteromedial compartment osteoarthritis.MethodsThe clinical data of 31 patients with bilateral anteromedial compartment osteoarthritis who underwent bilateral UKAs between January 2015 and January 2017 was retrospectively analyzed. Of them, 17 patients were treated with simultaneous bilateral UKAs (simultaneous group) and 14 patients with staged bilateral UKAs (staged group). There was no significant difference in gender, age, body mass index, osteoarthritis grading, and preoperative hip-knee-ankle angle, knee society score (KSS), visual analogue scale (VAS) score, and range of motion (ROM) of knee between the two groups (P>0.05). The operation time, blood loss, hospitalization stay, minimum hemoglobin value during 10 days after operation, and hospitalization cost were recorded. The staged group was compared by the sum of two operations. The effectiveness was evaluated by KSS score, VAS score, ROM at 3, 6, 12 months after operation, and patient satisfaction scores were recorded at 12 months after operation.ResultsThe operation time, hospitalization stay, and hospitalization cost of the simultaneous group were significantly lower than those of the staged group (P<0.05). There was no significant difference in blood loss and the minimum hemoglobin value during 10 days after operation between the two groups (P>0.05). Superficial infection occurred in 1 side of 1 case (7.1%) in staged group. Postoperative delirium occurred in 1 case (5.9%) in simultaneous group. There was no significant difference in incidence of postoperative complications between the two groups (P=1.000). Patients in both groups were followed up 12-32 months (mean, 24.7 months). There was no significant difference in KSS score between the two groups at 3 months after operation (t=0.896, P=0.392). KSS scores were significanly higher in simultaneous group than in staged group at 6 and 12 months after operation (P<0.05). There was no significant difference in ROM and VAS scores between the two groups at 3, 6, and 12 months after operation (P>0.05). At 12 months after operation, the patient satisfaction scores were significantly higher in simultaneous group than in staged group (P<0.05). X-ray films showed no loosening of the prosthesis in the two groups.ConclusionSimultaneous bilateral UKAs has the same security as staged bilateral UKAs. Meanwhile knee function recovery was better, hospitalization stay and hospitalization cost reduced, and patient satisfaction was higher in simultaneous bilateral UKAs.
ObjectiveTo evaluate the safety and efficacy of microwave ablation (MWA) in the treatment of lung tumors.MethodsThe clinical data of 31 patients with lung neoplasms treated with MWA from January 2019 to August 2020 in a single center were retrospectively analyzed. There were 17 males and 14 females at an age of 63.4±10.4 years. The characteristics of the lesions, technical success rate, technical efficiency, local progression rate, adverse reactions and complications were recorded in detail.ResultsThere were 39 target lesions with an average diameter of 20.2±10.6 mm. A total of 36 MWA procedures were completed. The initial technical success rate was 84.6% (33/39), and the technical efficiency was 92.3% (36/39). The median postprocedure hospital stay was 2.0 (2.0, 3.0) d. A total of 12.9% (4/31) of the patients had local progression, and the local control rate was 87.1%. The main adverse reactions were pain (12/36, 33.3%), cough (6/36, 16.7%), post-ablation syndrome (6/36, 16.7%) and pleural effusion (3/36, 8.3%). The main complications were pneumothorax (11/36, 30.6%), hemorrhage (8/36, 22.2%), cavitation (2/36, 5.6%) and pulmonary infection (1/36, 2.8%). The median follow-up time was 13.0 (8.0, 18.0) months. No patient died during the follow-up.ConclusionMWA is safe and effective in the treatment of lung tumors with controllable complications. Successive researches with large sample, and medium and long-term follow-ups are needed to explore the significance of combined therapies.
