ABSTRACT
@#Objective To evaluate the clinical effects of harmonic scalpel application in thoracoscopic surgery for lung cancer, which may guide its reasonable application. Methods We retrospectively analyzed the clinical data of 145 lung cancer patients receiving thoracoscopic surgery from January to March 2017 in our hospital. There were 57 patients with thoracoscopic pulmonary wedge resection, and harmonic scalpel was used in 34 patients (8 males, 26 females at age of 59.68±10.91 years), and was not used in 23 patients (13 males and 10 females at age of 59.13±11.21 years). There were 88 patients receiving thoracoscopic pulmonary lobectomy, among whom harmonic scalpel was used in 80 patients (36 males and 44 females at age of 59.68±10.91 years), and was not used in 8 patients (5 males, 3 females at age of 61.63±5.60 years). We recorded the perioperative outcomes of all patients. Results In the 34 patients undergoing thoracoscopic pulmonary wedge resection by harmonic scalpe, the operation time was 90.09±43.52 min, the blood loss was 21.32±12.75 ml, the number of lymph nodes resected was 5.12±4.26, duration of drainage was 3.15±1.16 d, volume of drainage was 535.00±291.69 ml, the length of postoperative hospital stay was 4.56±1.40 d, and no postoperative complication was observed. In the 80 patients receiving thoracoscopic pulmonary lobectomy by harmonic scalpel, operation time was 131.88±41.82 min, blood loss was 42.79±31.62 ml, the number of lymph nodes resected was 13.54±8.75, duration of thoracic drainage was 4.47±2.30 d, drainage volume was 872.09±585.24 ml, the length of postoperative hospital stay was 5.81±2.26 d, and 20 patients had postoperative complications. No complication occurred in the 8 patients without harmonic scalpel. Conclusion Harmonic scalpel showed satisfactory effectiveness and safety in lung cancer thoracoscopic surgery.
ABSTRACT
BACKGROUND: The development of clean or novel alternative energy has become a global trend that will shape the future of energy. In the present study, 3 microbial strains with different oxygen requirements, including Clostridium acetobutylicum ATCC 824, Enterobacter cloacae ATCC 13047 and Kluyveromyces marxianus 15D, were used to construct a hydrogen production system that was composed of a mixed aerobic-facultative anaerobic-anaerobic consortium. The effects of metal ions, organic acids and carbohydrate substrates on this system were analyzed and compared using electrochemical and kinetic assays. It was then tested using small-scale experiments to evaluate its ability to convert starch in 5 L of organic wastewater into hydrogen. For the one-step biohydrogen production experiment, H1 medium (nutrient broth and potato dextrose broth) was mixed directly with GAM broth to generate H2 medium (H1 medium and GAM broth). Finally, Clostridium acetobutylicum ATCC 824, Enterobacter cloacae ATCC 13047 and Kluyveromyces marxianus 15D of three species microbial co-culture to produce hydrogen under anaerobic conditions. For the two-step biohydrogen production experiment, the H1 medium, after cultured the microbial strains Enterobacter cloacae ATCC 13047 and Kluyveromyces marxianus 15D, was centrifuged to remove the microbial cells and then mixed with GAM broth (H2 medium). Afterward, the bacterial strain Clostridium acetobutylicum ATCC 824 was inoculated into the H2 medium to produce hydrogen by anaerobic fermentation. RESULTS: The experimental results demonstrated that the optimum conditions for the small-scale fermentative hydrogen production system were at pH 7.0, 35°C, a mixed medium, including H1 medium and H2 medium with 0.50 mol/L ferrous chloride, 0.50 mol/L magnesium sulfate, 0.50 mol/L potassium chloride, 1% w/v citric acid, 5% w/v fructose and 5% w/v glucose. The overall hydrogen production efficiency in the shake flask fermentation group was 33.7 mL/h-1.L-1, and those the two-step and the one-step processes of the small-scale fermentative hydrogen production system were 41.2 mLVh-1.L-1 and 35.1 mL/h-1.L-1, respectively. CONCLUSION: Therefore, the results indicate that the hydrogen production efficiency of the two-step process is higher than that of the one-step process.