Objective To analyze the occurrence of postoperative pneumonia(POP)in a tertiary general first-class hospital in Shanghai,and provide basis for strengthening the implementation of POP prevention and control meas-ures for the target population.Methods The real-time monitoring data of healthcare-associated infection(HAI)from 2017 to 2023 were retrospectively surveyed.The occurrence of POP in all surgical patients(including minimal-ly invasive interventional surgery)were analyzed.Results A total of 701 postoperative patients had POP.The inci-dence of POP was 0.30％.Incidence of POP was higher in male patients than in female patients(0.48％vs 0.15％),in 65-year-old-population than in＜65-year-old-population(0.58％vs 0.17％),and in elective surgery than in emergency surgery(0.35％vs 0.27％),differences were statistically significant(all P＜0.05).The inter-val from postoperative time to POP occurrence in 701 POP patients was 6(4,10)days,with emergency surgery pa-tients developing POP later than elective surgery(7[4,11]days vs 6[3,10]days),and difference was statistically significant(P＜0.05).The top five departments with higher incidences of POP were neurosurgery(5.84％),cardi-ac surgery(4.01％),thoracic surgery(1.92％),abdominal surgery(0.74％),and minimally invasive intervention(0.17％).Incidence of POP in emergency neurosurgery was higher than that in elective neurosurgery(9.71％vs 2.14％),while incidences of POP in elective cardiac surgery and thoracic surgery were both higher than emergency surgery(5.09％vs 2.93％,2.46％vs 0.58％,respectively),differences were all statistically significant(all P＜0.05).A total of 675 strains of pathogens were detected from 701 POP patients,with Gram-negative bacteria being the major pathogens(n=520,77.04％).The predominant detected pathogens were Acinetobacter baumannii(n=119),Pseudomonas aeruginosa(n=116),Staphylococcus aureus(n=108),Klebsiella pneumoniae(n=104),and Stenotrophomonas maltophilia(n=47).Conclusion In the prevention and control of perioperative infection,the key populations for POP prevention and control should be males and those aged ≥65 years old,and the key depart-ments should be neurosurgery,cardiac/thoracic surgery,and abdominal surgery.Minimal invasive surgery also has the risk of POP,which should be paid more attention.

Objective To explore the effect of Baofei Yiqi pill on immune function of patients with lung cancer.Methods A total of 100 patients with lung cancer diagnosed and treated in Leping Hospital of Traditional Chinese Medicine from September 2020 to September 2023 were selected and divided into experimental group and control group according to random number table method,with 50 cases in each group.The control group was treated with docetaxel combined with cisplatin,and the experimental group was treated with Baofei Yiqi pill on the basis of control group.Both groups were treated with 3 cycles of chemotherapy.The clinical efficacy,quality of life,changes in weight,immune function and adverse reactions were compared between two groups.Results The total response rate of experimental group was significantly higher than that of control group(x2=14.620,P＜0.001).After treatment,the Karnofsky performance status score and weight of experimental group were significantly higher than those of control group(P＜0.05),and the levels of CD3+,CD4+and CD4+/CD8+in experimental group were significantly higher than those in control group,and the levels of CD8+was significantly lower than than in control group(P＜0.05).The incidence of gastrointestinal reactions in experimental group was significantly lower than that in control group(P＜0.05).There was no significant difference in the incidence of abnormal renal function and liver function between two groups(P＞0.05).Conclusion Baofei Yiqi pill can effectively improve the immune function of patients with lung cancer,improve the quality of life of patients,reduce the adverse reactions of chemotherapy,and alleviate the disease of patients to a certain extent,which is worthy of promotion and application.

Objective To analyze the occurrence of postoperative pneumonia(POP)in a tertiary general first-class hospital in Shanghai,and provide basis for strengthening the implementation of POP prevention and control meas-ures for the target population.Methods The real-time monitoring data of healthcare-associated infection(HAI)from 2017 to 2023 were retrospectively surveyed.The occurrence of POP in all surgical patients(including minimal-ly invasive interventional surgery)were analyzed.Results A total of 701 postoperative patients had POP.The inci-dence of POP was 0.30％.Incidence of POP was higher in male patients than in female patients(0.48％vs 0.15％),in 65-year-old-population than in＜65-year-old-population(0.58％vs 0.17％),and in elective surgery than in emergency surgery(0.35％vs 0.27％),differences were statistically significant(all P＜0.05).The inter-val from postoperative time to POP occurrence in 701 POP patients was 6(4,10)days,with emergency surgery pa-tients developing POP later than elective surgery(7[4,11]days vs 6[3,10]days),and difference was statistically significant(P＜0.05).The top five departments with higher incidences of POP were neurosurgery(5.84％),cardi-ac surgery(4.01％),thoracic surgery(1.92％),abdominal surgery(0.74％),and minimally invasive intervention(0.17％).Incidence of POP in emergency neurosurgery was higher than that in elective neurosurgery(9.71％vs 2.14％),while incidences of POP in elective cardiac surgery and thoracic surgery were both higher than emergency surgery(5.09％vs 2.93％,2.46％vs 0.58％,respectively),differences were all statistically significant(all P＜0.05).A total of 675 strains of pathogens were detected from 701 POP patients,with Gram-negative bacteria being the major pathogens(n=520,77.04％).The predominant detected pathogens were Acinetobacter baumannii(n=119),Pseudomonas aeruginosa(n=116),Staphylococcus aureus(n=108),Klebsiella pneumoniae(n=104),and Stenotrophomonas maltophilia(n=47).Conclusion In the prevention and control of perioperative infection,the key populations for POP prevention and control should be males and those aged ≥65 years old,and the key depart-ments should be neurosurgery,cardiac/thoracic surgery,and abdominal surgery.Minimal invasive surgery also has the risk of POP,which should be paid more attention.

Objective To explore the effect of Baofei Yiqi pill on immune function of patients with lung cancer.Methods A total of 100 patients with lung cancer diagnosed and treated in Leping Hospital of Traditional Chinese Medicine from September 2020 to September 2023 were selected and divided into experimental group and control group according to random number table method,with 50 cases in each group.The control group was treated with docetaxel combined with cisplatin,and the experimental group was treated with Baofei Yiqi pill on the basis of control group.Both groups were treated with 3 cycles of chemotherapy.The clinical efficacy,quality of life,changes in weight,immune function and adverse reactions were compared between two groups.Results The total response rate of experimental group was significantly higher than that of control group(x2=14.620,P＜0.001).After treatment,the Karnofsky performance status score and weight of experimental group were significantly higher than those of control group(P＜0.05),and the levels of CD3+,CD4+and CD4+/CD8+in experimental group were significantly higher than those in control group,and the levels of CD8+was significantly lower than than in control group(P＜0.05).The incidence of gastrointestinal reactions in experimental group was significantly lower than that in control group(P＜0.05).There was no significant difference in the incidence of abnormal renal function and liver function between two groups(P＞0.05).Conclusion Baofei Yiqi pill can effectively improve the immune function of patients with lung cancer,improve the quality of life of patients,reduce the adverse reactions of chemotherapy,and alleviate the disease of patients to a certain extent,which is worthy of promotion and application.

Senior care workers specializing in traditional Chinese medicine (TCM) healthcare have become an indispensable force in institutional care, community care, and home care. The first Chinese nursing service team aimed to improve the health of the elderly by providing continuous services for physical and mental well-being, disease prevention, physical amelioration, and overall health enhancement using TCM concepts, methods, and technologies. The primary purpose of formulating this TCM health and elderly care worker service specification was to standardize services within the TCM elderly care industry, ensuring that the elderly receive better health and elderly care services supported by technical expertise. This specification outlined the basic requirements for TCM health and elderly care workers, including standards for service content, service quality control, service evaluation, and improvement. It primarily focused on the content and requirements of TCM health and elderly care services, such as constitution identification, life care, acupoint healthcare, and TCM auxiliary nursing for elderly individuals with chronic diseases. This specification is applicable to TCM health and elderly care personnel at various levels of hospitals and healthcare institutions and is noted for its strong applicability and effectiveness.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

Objective:To understand the factors hindering exercise rehabilitation in aged patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI) and provide a reference for clinical interventions.Methods:Aged CHD patients who underwent PCI in the Department of Cardiovascular Medicine at Hunan Provincial People's Hospital from January to June 2022 were selected by purposive sampling and underwent semi-structured interviews. Content analysis was employed for data analysis.Results:The factors hindering exercise rehabilitation in aged CHD patients after PCI can be categorized into two major groups: endogenous factors and exogenous factors. Endogenous factors were categorized into four themes: inadequate understanding, adverse disease experiences, weakness and physical dysfunction, and poor self-perception. Exogenous factors were categorized into four themes: lack of cardiac rehabilitation prescriptions and programs, social environmental barriers, insufficient family support, and restricted medical insurance coverage.Conclusions:The factors hindering exercise rehabilitation in aged CHD patients after PCI are diverse and complex. Prior to implementing exercise rehabilitation, healthcare professionals should thoroughly assess individuals' health conditions, rehabilitation needs, and limiting factors, and provide feasible rehabilitation content and formats.

Objective:To investigate the efficacy and adverse reactions of moderately hypofractionated intensity modulated radiation therapy (IMRT) combined with androgen deprivation therapy (ADT) for locally advanced prostate cancer (LAPC).Methods:This study retrospectively analyzed the medical records of 40 LAPC patients who were admitted in The Second Hospital of Dalian Medical University during 2014-2020. The planning gross target volume (PGTV) dose for prostate gland and seminal vesicle gland was 64.8-70.0 Gy/25-28 f, 2.4-2.8 Gy/f and the dose of PGTVnd in 20 cases with positive pelvic lymph nodes was 60.0-64.4 Gy/25-28 f, 2.3-2.4 Gy/f. The dose of planning target volume (PTV) for the drainage area of pelvic lymph nodes was 45.0-50.4 Gy/25-28 f. The enrolled patients were treated with long-term ADT, including neoadjuvant, simultaneous, and adjuvant therapies. The efficacy and adverse reactions were evaluated. The prognostic factors affecting the biochemical failure-free survival (BFFS) were analyzed.Results:The median follow-up time was 31 months. The 2- and 3-year overall survival (OS) rates were 100% and 96.9%, respectively. The 1-, 2-, and 3-year BFFS rates were 90%, 76.8% and 72%, respectively. The 1-, 2-, and 3-year distant metastasis-free survival (DMFS) rates were 92.2%, 82.8% and 75.1%, respectively. Gleason (GS) score ( χ2=10.00, P < 0.05) and adjacent tissue invasion ( χ2=8.85, P<0.05) were prognostic factors related to BFFS for LAPC. Adjacent tissue invasion and GS 9-10 were independent poor prognostic factors. The incidence of acute urinary adverse reaction and rectal injury (grade≥2) was 7.5% and 20%, respectively. The incidence of late urinary adverse reaction and rectal injury (grade≥2) was 12.5% and 17.5%, respectively. Adverse reactions at grade 3-4 did not occur. Conclusions:The moderately hypofractionated IMRT combined with ADT is feasible for LAPC treatment, achieving satisfactory survival effects. 70 Gy/25-28 f, 2.5-2.8 Gy/f is a safe and effective moderate hypofraction scheme. Adjacent tissue invasion and GS score are prognostic factors related to BFFS for LAPC.

Regenerative endodontic procedures (REPs) is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis. The ultimate objective of REPs is to regenerate the pulp-dentin complex, extend the tooth longevity and restore the normal function. Scientific evidence has demonstrated the efficacy of REPs in promotion of root development through case reports, case series, cohort studies, and randomized controlled studies. However, variations in clinical protocols for REPs exist due to the empirical nature of the original protocols and rapid advancements in the research field of regenerative endodontics. The heterogeneity in protocols may cause confusion among dental practitioners, thus guidelines and considerations of REPs should be explicated. This expert consensus mainly discusses the biological foundation, the available clinical protocols and current status of REPs in treating immature teeth with pulp necrosis, as well as the main complications of this treatment, aiming at refining the clinical management of REPs in accordance with the progress of basic researches and clinical studies, suggesting REPs may become a more consistently evidence-based option in dental treatment.
Humans ; Consensus ; Regenerative Endodontics ; Dental Pulp Necrosis/therapy* ; Dentists ; Professional Role ; Dental Care

Objective: To evaluate the therapeutic efficacy of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm (BEB). Methods: A prospective randomized controlled trial was performed. A total of 105 participants were randomized 1:1:1 into an acupuncture group, a herbal medicine group and an acupuncture plus herbal medicine group. Participants in the acupuncture group received manual acupuncture treatment, twice a week. Participants in the herbal medicine group received Dang Gui Bu Xue Qu Feng Tang, oral administration, once a day. Participants in the acupuncture plus herbal medicine group received both treatments. The therapeutic effects of the three groups were evaluated after four weeks of treatment. The primary outcome was the Jankovic rating scale (JRS) score, and the secondary outcome was the blepharospasm disability index (BSDI) score. Results: After four weeks of treatment, the JRS total scores significantly decreased in all three groups versus baseline (P<0.05). A greater reduction in the JRS total score was reported in participants in the acupuncture plus herbal medicine group (P<0.05), but there was no significant difference between the acupuncture group and the herbal medicine group (P>0.05). The acupuncture plus herbal medicine group had a greater decrease in the JRS severity score than the herbal medicine group (P<0.05). The reduction in the JRS frequency score was not significantly different among the three groups (P>0.05). The BSDI scores significantly decreased in all three groups versus baseline (P<0.05), but the reduction in the BSDI score was insignificantly different among the three groups (P>0.05). Conclusion: It is effective in the treatment of BEB either to use acupuncture and Dang Gui Bu Xue Qu Feng Tang alone or in combination. The combination therapy shows a more significant effect than either of the treatment alone.