1.Retrospective evaluation of the pharmaceutical pathway for prophylactic use of antibiotics during the perioperative period of class Ⅰ neurosurgery incisions
Jinping WANG ; Jie ZHAO ; Chunyan YANG ; Xiaomin LAI ; Yunteng ZHU ; Zhi’ang WU
China Pharmacy 2024;35(17):2147-2151
OBJECTIVE To explore the practicality of the pharmaceutical pathway for prophylactic use of antibiotics during the perioperative period of class Ⅰ neurosurgery incisions. METHODS The previously established pharmaceutical pathway for the prophylactic use of antibiotics in the perioperative period of class Ⅰ neurosurgery incisions was used to retrospectively evaluate the prophylactic use of antibiotics in 127 cases. The “antibiotics prophylactic use scoring system” in the pharmaceutical pathway was used to conduct preoperative scoring, and the patient’s actual antibiotics use was compared and analyzed in combination with existing Guiding Principles for Clinical Application of Antibiotics (2015 Edition) (hereinafter referred to as the Guiding Principles). The pharmaceutical pathway also innovatively proposes key points for improvement in terms of the frequency of adding antibiotics during surgery and the duration of prophylactic use of antibiotics after surgery. By comparing with the actual medication situation of patients, the direction for updating the Guiding Principles was explored. RESULTS According to the retrospective analysis results, for neurosurgery class Ⅰ incision surgery, in addition to the preoperative prophylactic use of antibacterial drugs for skull mass resection and carotid endarterectomy recommended in the guidelines, endoscopic trigeminal microvascular decompression, arthroscopy and other specific joint examinations, spinal nerve Radical decompression, endoscopic lumbar nucleectomy, dural repair, and spinal canal decompression can also be further explored about the situation of not using antibacterial prophylaxis before surgery; at the same time, for the patients undergoing class Ⅰ neurosurgery incisions, the use of antibiotics during and after surgery may be considered for a second addition of antibiotics, taking into account the surgical time. If cerebrospinal fluid leakage occurred after surgery, it is recommended to extend the duration of prophylactic use of antibiotics appropriately. CONCLUSIONS The application of pharmaceutical pathways can provide more targeted analysis of key points in the prevention of antibiotic use, which promotes the transformation of perioperative antibiotics management for class Ⅰ incisions from “qualitative, empirical” management to “quantitative, scientific” management.
2.Expert consensus on cryoablation therapy of oral mucosal melanoma
Guoxin REN ; Moyi SUN ; Zhangui TANG ; Longjiang LI ; Jian MENG ; Zhijun SUN ; Shaoyan LIU ; Yue HE ; Wei SHANG ; Gang LI ; Jie ZHNAG ; Heming WU ; Yi LI ; Shaohui HUANG ; Shizhou ZHANG ; Zhongcheng GONG ; Jun WANG ; Anxun WANG ; Zhiyong LI ; Zhiquan HUNAG ; Tong SU ; Jichen LI ; Kai YANG ; Weizhong LI ; Weihong XIE ; Qing XI ; Ke ZHAO ; Yunze XUAN ; Li HUANG ; Chuanzheng SUN ; Bing HAN ; Yanping CHEN ; Wenge CHEN ; Yunteng WU ; Dongliang WEI ; Wei GUO
Journal of Practical Stomatology 2024;40(2):149-155
Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.