ABSTRACT
@#Objective To analyze a new classification of the left apicoposterior segmental bronchus and summarize its clinical significance. Methods We accessed the computed tomography imaging data of the inpatients treated in the Department of Thoracic Surgery, Henan Provincial People's Hospital between January and November 2021. We observed and classified the branching pattern of the left apicoposterior segmental bronchus (B1+2) using three-dimensional computed tomography bronchography and angiography (3D-CTBA) technique. And we filtered out the patients who underwent thoracoscopic left apicoposterior segmentectomy and analyzed their clinical data retrospectively to summarize the instructing significance of different bronchial classification in the accurate and safe operation of left apicoposterior segmentectomy. Results Finally 240 patients were collected, including 131 males and 109 females with a median age of 51.0 (19.0-77.0) years. The anatomical pattern of the left apicoposterior segmental bronchus was divided into four main types based on the branching pattern of the outer subsegmental bronchi (B1+2c): type Ⅰ 10% (24 patients), type Ⅱ 54% (130 patients) , type Ⅲ 17% (40 patients) , type Ⅳ 18% (43 patients) and other variations 1% (3 patients). Thirty-two patients smoothly underwent thoracoscopic left apicoposterior segmentectomy, including 23 patients of type Ⅰ and type Ⅱ receiving LS1+2 resection, the other 9 patients of type Ⅲ and type Ⅳ receiving LS1+2 resection (3 patients), LS1+2c resection (4 patients) and LS1+2(a+b) resection (2 patients). Conclusion This new classification systematically and concisely elucidates the branching characteristics of the left apicoposterior bronchus. Different branching types are instructive to the left apicoposterior segmentectomy.
ABSTRACT
Objective To summarize the value of early mechanical ventilation plus continuous vacuum suction in treatment of serious pulmonary contusion.Methods Forty-eight cases of severe pulmonary contusion were assigned to mechanical ventilation plus continuous vacuum suction (observation group,n =20) and mechanical ventilation plus discontinuous vacuum suction (control group,n =28)according to the random number table.Modes of mechanical ventilation were synchronized intermittent mandatory ventilation (SIMV),pressure support ventilation (PSV),and positive and expiratory pressure (PEEP).Changes in blood gas analysis,mechanical ventilation time,and associated complications were compared between groups.Results At ventilation time of 6 and 24 hours,PaO2 in observation group was (100.36 ± 5.90) mmHg and (105.34 ± 7.40) mmHg respectively,with significant differences from (75.36 ± 8.95) mmHg and (76.36 ± 8.35) mmHg in control group (P ＜ 0.01).At ventilation time of 24 hours,PaO2/FiO2 was (283.50 ± 15.20) mmHg in observation group and (201.50 ± 10.20) mmHg in control group (P ＜0.01).Mechanical ventilation time and PEEP at ventilation time of 48 hours in observation group was (3.2 ± 1.1) days and (4.5 ± 2.3) cmH2 O,with significant differences from (6.5 ± 2.8) days and (8.5 ± 2.5) cmH2O in control group (P ＜ 0.01).Associated complications of the two groups revealed no significant difference (P ＞ 0.05).Conclusion Early mechanical ventilation with sustained vacuum suction is effective to keep airway clear,improve oxygenation index,decrease PEEP level,and control the duration of mechanical ventilation,but may not lower the risks of ventilator-associated pneumonia and pulmonary atelectasis.
ABSTRACT
BACKGROUND:Autologous peripheral blood hematopoietic stem cell transplantation,as the current latest therapy is widely used in the treatment of autoimmune diseases,however,the treatment on myasthenia gravis is still in the primary stage.OBJECTIVE:To create the model of myasthenia gravis with autologous peripheral blood hematopoietic stem cell transplantation in rats and to observe clinical manifestation,attenuation rate of repetitive nerve electric stimulation action potential and titer of serum acetylcholine receptor Ab in the models.DESIGN,TIME AND SETTING:The randomized control animal experiment was performed at the Human Anatomy Laboratory,Medical College of Zhengzhou University between July and December 2007.MATERIALS:Totally 50 female Wistar rats were randomly assigned into four groups,a normal group(n=10),an adjuvant control group(n=10),a stem cell transplantation group(n=15),and a model control group(n=15).METHODS:Rats in the normal group were intact.Rats in the adjuvant group were subjected to the same volume of saline and cyclophosphamide.Rats in the stem cell transplantation group were used to make experimental autoimmune myasthenia gravis by intraperitoneally infusing with serum of myasthenia gravis patients.Bone marrow stem cells were mobilized by granulocyte colony-stimulating factor.Autologous peripheral blood stem cells were collected and then were transplanted via tail vein injection after the pretreatment regimen of cyclophosphamide.Rats in the model control group were treated with an equal volume of peripheral blood,and with other procedures as the stem cell transplantation group.MAIN OUTCOME MEASURES:Swimming time and survival rate of rats from each group after stem cell transplantation;attenuation rate of repetitive nerve electric stimulation action potential and titer of serum acetylcholine receptor Ab were measured at 4 and 9 weeks after stem cell transplantation.RESULTS:The survival rate was higher in the stem cell transplantation group than in the model control group(P