Comparative Outcome Analysis of N-Butyl Cyanoacrylate Embolization of the False Lumen Versus Thoracic Endovascular Aortic Repair in Aortic Dissection

PurposeTo evaluate the feasibility, safety, and effectiveness of N-butyl cyanoacrylate (NBCA) embolization for the treatment of aortic dissection.Materials and MethodsIn this single-center retrospective study conducted from February 2003 to June 2019, NBCA embolization of an aortic false lumen was attempted in 12 patients (median age, 59 y; range, 41–68 y) and thoracic endovascular aortic repair (TEVAR) was performed in 53 patients (median age, 59 y; range, 37–70 y) for aortic dissection with one or more indications of persisting pain, malperfusion, rupture or impending rupture, maximal aortic diameter ≥ 55 mm, and/or rapid aortic enlargement. The main exclusion criterion for embolization was the presence of fast blood flow in the aortic false lumen on aortography. The efficacy of NBCA embolization and TEVAR was compared by evaluating technical and clinical outcomes, repeat intervention–free survival (RFS), and overall survival (OS).ResultsTechnical success was achieved in 11 of the 12 patients treated with NBCA embolization (91.7%), and clinical success was achieved in 9 of these 11 (81.8%). No significant difference was found between embolization and TEVAR in clinical success rates (embolization, 81.8%; TEVAR, 84.9%; P = .409) or procedure-related complications (embolization, 1 patient [8.3%]; TEVAR, 4 patients [7.5%]; P = .701). In addition, embolization showed comparable 5-y RFS (embolization, 82.5% ± 9.3; TEVAR, 85.5% ± 4.8; P = .641) and 5-y OS (embolization, 100%; TEVAR, 95.4% ± 3.2; P = .744) rates to TEVAR.ConclusionsNBCA embolization of the false lumen in aortic dissection seems to be a safe and effective treatment modality for the closure of false lumen in selected patients.     

前列腺癌早期诊断的研究进展北大核心

前列腺癌(prostate cancer, PCa)是中老年男性常见恶性肿瘤之一,目前尚缺乏有效的晚期癌症治疗方法,因此早期诊断对于降低PCa死亡率至关重要。近年来,较多研究开发出多种新型诊断方法以改善对PCa诊断的准确性,同时避免过度诊疗,但其有效性及实用性尚需进一步验证。本文对目前新型生物标志物、联合成像技术及风险预测模型等的早期诊断技术进行总结,以期为临床研究提供指导作用。     

蒙医用蒙药对新冠肺炎及疫病的的防治对策

介绍了蒙医药文献中对疫病的防治及现代蒙医对新冠肺炎的防治药物。     

对构建德智体美劳全面发展的新医科人才体系的思考

通过分析"新医科"发展趋势以及目前我国医疗供给侧改革的内在需求与人的全面发展之间的紧密联系,提出立德树人、以智启人、以体育人、以美成人、以劳塑人是"新医科"对医学人才培养的主要途径。在此要求之下,医学高等院校应适应全民健康的目标和社会保健服务的需求,坚持本科教育服务地方经济社会的理念,加强大健康教育与全面素质教育,着力培养符合社会需要的、全面发展的新医科人才。     

Vital and enchanted: Jane Bennett and new materialism for nursing philosophy and practice

Nursing theories are typically anthropocentric and emphasize caring for a person as a unitary whole. They maintain the dualisms of human–nonhuman, natural–social and material–ideal. Recent developments in nonhuman ontology question the utility of that approach. One important philosopher in this new materialism is political theorist Jane Bennett. In this paper, I explore Bennett's vital materialism and enchantment as two concepts arising from the nonhuman turn that should inform nursing philosophy. Vital materialism considers the lively power of matter to affect the world and be affected in relations. Enchantment refers to a sense of wonder and captivation with matter. While summarizing her important contributions, I also describe common criticisms and responses. I consider the human as an assemblage of matter as well as the agency or “thing power” of matter external to humans. This has implications for nursing thought and practice, and it can inform a more capacious research methodology. I also discuss how compassion fatigue or burnout and other professional issues may be seen as a form of disenchantment with the material world. I argue that embracing these and other elements of Bennett's new materialist philosophy can help nurses and other health professionals enrich their theories and practice to advance their disciplines and improve care for persons and populations.     

An evaluation of glasdegib for the treatment of acute myelogenous leukemia

ABSTRACT

Introduction

Despite recent advances in the treatment of adult acute myelogenous leukemia (AML), the overall outcome remains dismal especially in high-risk AML patients, including the elderly and the relapsed/refractory populations. In this setting, various clinical trials have recently explored novel therapeutic agents either used alone or in combination with intensive chemotherapy or low-intensity treatments.     

Development,implementation, and associated challenges of a new HDR brachytherapy program

Developing any new radiation oncology program requires planning and analysis of the current state of the facility and its capacity to take on another program. Staff must consider a large number of factors to establish a feasible, safe, and sustainable program. We present a simple and generic outline that lays out the process for developing and implementing a new HDR brachytherapy program in any setting, but with particular emphasis on challenges associated with starting the program in a limited resource setting. The sections include feasibility of a program, starting cases, machine and equipment selection, and quality and safety.     

新型管理模式在护理实习教学管理中的应用探讨

目的探讨在进行护理实习教学管理期间新型管理模式应用可行性。方法选择我院2018年1月-2019年2月102例实习护生作为试验对象;数字奇偶法分组后探究每组教学管理模式;对照组(51名):选择传统护理教学管理模式展开;试验组(51名):选择新型护理教学管理模式展开;比较两组护实习护生行为规范合格率、平均业务学习出勤率以及教学满意度评分结果。结果试验组实习护生规范合格率(98.04%)高于对照组(64.71%)(P<0.05);试验组实习护生平均业务学习出勤率(98.04%)高于对照组(62.75%)(P<0.05);试验组实习护生各项教学满意度评分均高于对照组(P<0.05)。结论医院实习护生在接受新型护理实习教学管理后,对于规范合格率的提升,平均业务学习出勤率的提升以及教学满意度评分的提升,均获得显著效果,最终为医院实习护生的学习效率以及护理安全提升奠定了基础。     

Cabozantinib for relapsed neuroblastoma: Single institution case series

Relapsed high‐risk neuroblastoma has few effective therapies currently available or in development. Cabozantinib is an Food and Drug Administration approved multitargeted tyrosine kinase inhibitor for select adult malignancies with preclinical data suggesting efficacy against neuroblastoma. A safe and tolerable dose has been identified for children, but its efficacy remains unknown. We describe four children with relapsed metastatic neuroblastoma treated with cabozantinib. All four patients had extended disease control (two complete responsesfor >12 months, 2 stable disease >6 months) with manageable predictable toxicities requiring dose reduction in two patients. We discuss the potential for the use of cabozantinib in neuroblastoma.