Placental transmogrification of the lung: two case report and systematic review of the literature / 中华胸心血管外科杂志

Objective Placental transmogrification of the lung(PTL) is rare;summarizes the reported cases and add our two cases, to explore the best diagnosis and treatment strategy.Methods Review of the cases reported in the literature, combined with the 2 cases described in this article, summarizes the characteristics of PTL and analyzed the best diagnosis and treatment strategy.Results We reported two cases of placental transmogrification of the lung, both presented in the right lower lobe, imaging performance as a giant bulla with a cystic nodule.VATS lobectomy was performed in both cases, no complication after operation.Combined with literature review of 34 cases of patients to analyze the best diagnosis and treatment strategy.Conclusion Grossly and microscopically, the lesion resembles placental tissue, with formation of placental villus-like papillary structures covered by epithelial cells.The most common imaging manifestation of PTL is a bullous emphysema pattern or with a mixed pattern of thin-walled cystic lesions and nodules.Early diagnosis and surgical operation should be performed as soon as possible, these lesions are best treated by minimally invasive surgery, leaving as much normal lung tissue and avoiding pneumonectomy if possible.Surgical treatment is usually curable and leads to successful improvement of symptoms and quality of life.

Acute hypervolemic hemodilution with hydroxyethyl starch 130/0.4-electrolyte injection versus hydroxyethyl starch 130/0.4-sodium chloride injection for blood-saving effect / 中华麻醉学杂志

Objective To compare the blood-saving effect when acute hypervolemic hemodilution (AHH) was performed with hydroxyethyl starch (HES) 130/0.4 dissolved in electrolyte injection (HES-E) and HES 130/0.4 in sodium chloride injection (HES-NaCl).Methods Thirty patients of both sexes,aged 18-60 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with body mass index of 18-25 kg/m2,hemoglobin (Hb) ＞100 g/L,hematocrit (Hct) ＞ 35％,scheduled for elective abdominal operations under general anesthesia,were randomly divided into HES-E group and HES-NaCl group using a random number table,with 15 patients in each group.AHH was performed after induction of anesthesia.In HES-E and HES-NaCl groups,HES-E and HES-NaCl 15 ml/kg were intravenously infused over 30 min,respectively,and the infusion was conpleted before skin incision.Immediately after onset of AHH (T1),at 2 h after the end of AHH (T2),and at the end of operation (T3),arterial blood samples were collected for blood gas analysis and blood routine test,and pH value,base excess,HCO3-,K+,Na+,Cl-,Ca2+,Hb and Hct were recorded.Venous blood samples were collected at T1 and T2 for measurement of blood coagulation parameters including prothrombin time,activated partial thromboplastin time and fibrinogen and thrombelastography parameters.The volume of liquid intake and output and requirement for allogeneic blood transfusion were recorded,and the blood volume expansion rate was calculated.Results Compared with group HES-NaCl,no significant changes were found in the total volume of liquid infused,requirement for allogeneic blood transfusion,blood volume expansion rate,blood coagulation parameters at each time point,Hb and Hct (P＞0.05),pH value,base excess,HCO3 and K+ were significantly increased,and Na+ and Cl-were significantly decreased in group HES-E (P＜0.01).Conclusion There is no significant difference in the blood-saving effect between AHH with HES-E and HES-NaCl clinically,but HES-E can maintain homeostasis better.

Report a case of congenital pulmonary lymphangiectasia with fetal pleural effusions / 临床儿科杂志

ObjectiveTo summarize and review the clinical characteristics of congenital pulmonary lymphangiectasia with fetal bilateral pleural effusions.MethodsThe clinical data of a newborn diagnosed as congenital pulmonary lymphangiec-tasia with bilateral pleural effusions in Obstetrics and Gynecology Hospital, was summarized. The clinical, radiographic features, treatment and prognosis of this case are discussed in the context of the literature review.ResultsThe premature infants present-ed with rapid progression bilateral pleural effusions, respiratory distress, chylothorax, hypoalbuminemia and persistent pulmo-nary hypertension at birth. The pulmonary surfactant was given and mechanical ventilation was used for respiratory support. NO was inhaled, high-frequency mechanical ventilation was applied and albumin was repeatedly administered. After treatment for 3 months in the NICU, the patient was discharged. After 10 days, the patient was administered to the PICU with severe pneumo-nia, chronic lung disease, mechanical ventilation and anti-infection treatments were applied for 2 months. After living for six months, the baby died.ConclusionsCongenital pulmonary lymphangiectasia is extremely rare and prenatal diagnosis was dif-ifcult. The disease should be considered in patients presented with progressive dyspnea, interstitial emphysema after birth. Lung tissue biopsy and radioisotope scanning should be performed in time to get diagnosis.

Effect of hyperbaric oxygen preconditioning on activation of plasma protein C in a rat model of asphyxial cardiac arrest-resuscitation / 中华麻醉学杂志

Objective To investigate the effect of hyperbaric oxygen ( HBO) preconditioning on activation of plasma protein C in a rat model of asphyxial cardiac arrest?resuscitation. Methods A total of 105 adult male Sprague?Dawley rats, aged 70-90 days, weighing 260-320 g, were randomly divided into 3 groups: cardiac arrest group ( group CA, n=5) , cardiac arrest?resuscitation group ( group CA∕R, n=50) , and hyperbaric oxygen preconditioning group ( group H, n=50 ) . Cardiac arrest was induced by campling the endotracheal tube at the end of expiration. The animals underwent HBO preconditioning once a day for 3 consecutive days before cardiac arrest was induced in group H. The rats were placed in the HBO chamber, 10 min later the pressure was increased at a constant rate until the hyperbaric oxygen reached 2 atmosphere absolute, and maintained at this level for 45 min, after the oxygen concentration>95%, and then the pressure was decreased at a constant rate ( within 20 min) until the normal pressure was reached. The rats underwent no resuscitation in group CA. Five rats were selected from CA∕R and H groups at 3, 6, 12 and 24 h after restoration of spontaneous circulation, and at 30 min of cardiac arrest in group CA, and blood samples were taken from the abdominal aorta for determination of the plasma activated protein C ( APC) concentrations. The time from asphyxia to cardiac arrest, time for spontaneous regular cardiac rhythm, and successful resuscitation were recorded. Results Compared with group CA, the plasma APC concentrations were significantly decreased at each time point after restoration of spontaneous circulation in CA∕R and H groups ( P<0.05) . Compared with group CA∕R, the time from asphyxia to cardiac arrest was significantly prolonged, the time for spontaneous regular cardiac rhythm was shortened, the success rate of resuscitation was increased, and the plasma APC concentrations were increased at each time point after restoration of spontaneous circulation in group H ( P<0. 05 ) . Conclusion HBO preconditioning can promote activation of plasma protein C after resuscitation in a rat model of asphyxial cardiac arrest, and is helpful in improving hypercoagulation.

Nursing of Integration of Traditional Chinese and Western Medicine for Acute Myocardium Infarction: 30 Cases Report / 中国康复理论与实践

@#Objective To observe the prognosis of acute myocardium infarction (AMI) patient accepted nursing of Integration of Traditional Chinese and Western Medicine. Methods 30 hospitalized AMI patients were reviewed. Results All the patients finished the rehabilitation program successfully and achieved satisfied outcome, except a patient dropped for severe respiratory failure after respiratory diseases. Conclusion Nursing of Integration of Traditional Chinese and Western Medicine is effective on acute myocardial infarction patients.

Expression and identification of PEBP-like gene from Saussurea involucrate Kar.er kir in Escherichia coli / 生物工程学报

This assay was designed to construct the prokaryotic expression vector, investigate the expression of PEBP-like in Escherichia coli and purify its product. The PEBP gene was inserted into the vector pET30a (+). The recombinant vector was transferred into E. coli BL21 (DE3)and induced the expression of protein by low concentration of IPTG and low temperature overnight. After purification, the supernatants were analyzed by SDS-PAGE and the results were identified by Western blotting. After IPTG induction, a new anticipating fusion protein of 28 kD appeared as an expected size, and its product was 26.8% in total protein, the fusion protein was positive by Western blotting. The prokaryotic expression system of PEBP-like is successfully constructed. It lays the foundation for the further application study on the antifreeze characters of the PEBP.

Death Causes of 16 Patients with Acute Myocardium Infarction / 中国康复理论与实践

@#ObjectiveTo analyze the death causes of acute myocardium infarction (AMI) and nursing measures.MethodsThe data of 16 AMI patients, 58～87 years old and died in the hospital, were analyzed for factors of direct death causes, inducement, death period.ResultsIn 16 patients, 13 cases died from heart reason, seven patients (43.75%) had inducements, 12 cases died in acute stege.ConclusionThe death cause of AMI is mainly heart reason, and related with basic disease and complication.