Endovascular aneurysm repair (EVAR) has increasingly replaced traditional open surgery for abdominal aortic aneurysms due to its minimally invasive adventure; however, postoperative circulatory management plays a critical role in patient outcomes. This review systematically examines three core strategies in post-EVAR care. Firstly, hemodynamic management requires precise regulation of blood pressure and cardiac output to prevent hypertension-induced stent graft migration or aneurysm sac expansion, while avoiding hypotension-related visceral hypoperfusion. Secondly, fluid balance optimization emphasizes individualized adjustment of crystalloid-to-colloid ratios through dynamic monitoring, aiming to maintain organ perfusion while protecting cardiopulmonary function. Thirdly, anticoagulation and thrombosis prevention strategies must balance the intensity of low molecular weight heparin or direct oral anticoagulants against bleeding risks, incorporating mechanical prophylaxis to further reduce thrombotic events.

Endovascular aneurysm repair (EVAR) has increasingly replaced traditional open surgery for abdominal aortic aneurysms due to its minimally invasive adventure; however, postoperative circulatory management plays a critical role in patient outcomes. This review systematically examines three core strategies in post-EVAR care. Firstly, hemodynamic management requires precise regulation of blood pressure and cardiac output to prevent hypertension-induced stent graft migration or aneurysm sac expansion, while avoiding hypotension-related visceral hypoperfusion. Secondly, fluid balance optimization emphasizes individualized adjustment of crystalloid-to-colloid ratios through dynamic monitoring, aiming to maintain organ perfusion while protecting cardiopulmonary function. Thirdly, anticoagulation and thrombosis prevention strategies must balance the intensity of low molecular weight heparin or direct oral anticoagulants against bleeding risks, incorporating mechanical prophylaxis to further reduce thrombotic events.

Objective To study the medication law of postoperative treatment of colorectal cancer by national TCM doctor Professor Piao Bingkui.Methods Professor Piao Bingkui's electronic medical records and paper medical records of colorectal cancer postoperative patients at Guang'anmen Hospital,China Academy of Chinese Medical Sciences and Beijing Yiqingtang Chinese Medicine Clinic were collected and organized from their outpatients from January 1st,2002 to February 28th,2022.R4.2.1 was used to study the prescriptions,including high-frequency drugs,drug types,properties of Chinese materia medica,yin yang and five elements and dosage of drugs,as well as the law of multi-drug association in postoperative patients with colorectal cancer.Results Totally 642 colorectal postoperative cancer patients were included,involving 2 226 prescriptions,180 kinds of Chinese materia medica,and a total frequency of 39 988 times.The high-frequency drugs were Astragali Radix,fried Aurantii Fructus with wheat bran,Dioscoreae Rhizoma,etc.The main drugs in terms of efficacy were tonics for tonifying deficiency,disinfectants,etc.;the main properties were warm and neutral,the main tastes were sweet,pungent and bitter,and the main meridians were spleen meridians and stomach meridians.Ascending medicines were often used,and the drug were basically non-toxic.The frequency of using yang tonifying medicine was high,and the five elements were commonly used as local medicines;the dosage was mostly 10,15 and 20 g.The complex network analysis and clustering analysis of the association between multiple drugs found that Professor Piao Bingkui's basic prescription for treating colorectal cancer included Astragali Radix,fried Aurantii Fructus with wheat bran,Dioscoreae Rhizoma,salt Alpiniae Oxyphyllae Fructus,Citri Reticulatae Pericarpium,Smilacis Glabrae Rhizoma,Pseudostellariae Radix,and fried Atractylodis Macrocephalae Rhizoma with wheat bran.Conclusion In the treatment of colorectal cancer,Professor Piao Bingkui focuses on reinforcing the healthy qi,nourishing spleen and stomach function,combined with detoxication method and clearing heat,expelling phlegm and dampness,guiding stagnation and dispelling stasis methods,making syndrome differentiation as well as tonifying and benefiting qi,regulating qi movement,so as to realize the"treating middle-energizer as balance"and achieve mild level when treating colorectal cancer.

Objective:To construct and implement a multidisciplinary pain management model during the perioperative period based on the project-achieving quality control circle, so as to improve the quality of patient pain management during the perioperative period.Methods:Using the convenient sampling, 310 surgical patients from the Department of Gastrointestinal Surgery, Hepatobiliary Surgery, Thoracic Surgery, Urology Surgery and Joint Surgery of Liaocheng People's Hospital from June to July 2020 were taken as the pre-improvement group, and the routine perioperative pain management model was implemented. Starting from August 2020, a project-achieving quality control circle was carried out, following the steps of theme selection, topic clarification, goal setting, formulation of strategies, investigation of the best strategies, implementation of strategies, and confirmation of effectiveness, to implement a multidisciplinary pain management model during the perioperative period. A total of 310 surgical patients admitted to 5 departments from February to March 2021 were included in the improvement group.Results:The implementation rate of multidisciplinary pain management plan, the rate of out-of-bed activity within 24 hours after surgery, the rate of excellent postoperative rehabilitation compliance, and the average sleep score of patients in the improvement group all increased, with statistical differences ( P<0.05). After improvement, the awareness rate of pain knowledge among medical and nursing staff, the accuracy rate of nurses' rest and active pain assessment records, and the score of nurse pain knowledge all increased, and the differences were statistically significant ( P<0.05) . Conclusions:The construction and implementation of a multidisciplinary pain management model during the perioperative period based on the project-achieving quality control circle can effectively improve the quality of pain management for surgical patients, accelerate patient recovery, and improve the pain management of medical and nursing staff.

Objective:To explore the effects of prenatal dexamethasone (DEX), postnatal pulmonary surfactant (PS) and respiratory support on the lung fluid clearance in premature rabbits at gestational age (GA) of 25-28 d (full term: 31 d) and their relationship with dynamic compliance of respiratory system (Cdyn), pulmonary morphology and other parameters.Methods:In our previous publications, premature rabbits were divided into four groups according to the intervention strategy: control group, PS-only group, DEX-only group and DEX+PS group in which data of several parameters including wet-to-dry lung weight ratio (W/D), Cdyn and volume density of alveoli (Vv) were retrieved and the lung tissue sections were scanned to recalculate the ratio of perivascular sheath to vascular sectional area (S/V) and lung injury scores-edema (LIS-E). W/D, LIS-E, S/V and Vv were adjusted for birth weight (BW) (divided by BW, represented as W/D/BW, LIS-E/BW, S/V/BW and Vv/BW) and mean Cdyn (Cdyn-m) was adopted. Based on the grouping of previous studies, the intervention groups in this study were divided as DEX group and non-DEX group, and PS group and non-PS group to analyze the influence of DEX and PS on the above parameters. Two independent samples t-test, one-way analysis of variance, LSD test, Kruskal-Wallis H test, Mann-Whitney U test and Pearson correlation analysis were used for statistical analysis. Results:A total of 196 newborn rabbits receiving mechanical ventilation after birth were included in this study. (1) Effects of DEX: compared with the non-DEX group, the DEX group showed increased W/D/BW (489±69 vs 421±113, t=－2.09), LIS-E/BW (188±57 vs 138±55, t=－2.61) and Vv/BW (20.1±4.9 vs 14.2±4.7, t=－3.60), but decreased S/V (0.33±0.23 vs 0.51±0.25, t=2.23) and S/V/W/D (0.05±0.03 vs 0.07±0.04, t=2.22) at 25 d of gestation; at 26 d of gestation, W/D/BW (472±76 vs 303±44, t=－8.75), LIS-E/BW (189±63 vs 106±36, t=－5.23), Cdyn-m [(0.16±0.07) vs (0.05±0.03) ml/(kg?cmH 2O), 1 cmH 2O=0.098 kPa; t=－7.29] and Vv/BW increased (22.4±5.0 vs 12.2±3.8, t=－7.46), while S/V (0.23±0.19 vs 0.62±0.38, t=4.10), S/V/BW (15.7±12.4 vs 25.7±17.3, t=2.20), S/V/W/D (0.03±0.03 vs 0.08±0.05, t=3.92) and propensity scores decreased [(12.5±1.2) vs (15.1±1.2) scores, t=7.00]; at 27 d of gestation, Cdyn-m increased [(0.23±0.12) vs (0.16±0.07) ml/(kg?cmH 2O), t=－2.43], but S/V (0.32±0.23 vs 0.57±0.39, t=2.57) and S/V/W/D decreased (0.05±0.04 vs 0.09±0.06, t=2.55); at 28 d of gestation, W/D/BW (270±64 vs 162±33, t=－8.09), LIS-E/BW (72±32 vs 35±20, t=－5.17), S/V (0.90±0.60 vs 0.59±0.48, t=－2.81), S/V/BW (34.0±23.6 vs 15.2±12.7, t=－3.77) and Vv/BW increased (16.9±4.3 vs 9.2±2.9, t=－8.04); the differences were all statistically significant (all P<0.05). (2) Effects of PS: compared with the non-PS group, the PS group had decreased LIS-E/BW at 25, 26 and 27 d of gestation, increased Cdyn-m and Vv/BW at 25 and 27 d of gestation and higher propensity scores at 25 d of gestation (all P<0.05). (3) The correlation between gestational age and each index: gestational age was positively correlated with S/V ( r=0.31, P<0.05), but negatively correlated with W/D/BW and LIS-E/BW ( r=－0.73 and－0.63, both P<0.05). Conclusions:The pharmacological action of prenatal DEX on lung fluid clearance is mainly confined to preterm rabbits at the GA of 28 d which is supported by mechanical ventilation. Prenatal treatment with DEX and/or postnatal PS can improve the early respiratory function in preterm rabbits between GA of 25-27 d, but had no substantial impact on lung fluid clearance. The GA-related lung maturation appears to play a crucial role, in comparison with medications, in lung fluid clearance.

Bezlotoxumab is a human monoclonal antibody that can bind to C. difficile toxin B and neutralize its effects. In October 2016, bezlotoxumab was approved by the food and drug administration(FDA) to reduce the recurrence of Clostridium difficile infection (CDI) in the patients aged equal or above 18 years who are receiving antibacterial therapy. This paper introduced the pharmacology, pharmacokinetics,clinical studies,adverse reactions,interactions and medication attentions of bezlotoxumab.