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Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.
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Objective To study the effect of external application of Wuwei Shuangbai Powder on relieving primary liver cancer pain and to observe its effect on hemorheology indexes.Methods A double-blind,randomized and controlled trial was carried out in 60 primary hepatocellular carcinoma patients with cancer pain.The patients were divided into control group and treatment group,30 cases in each group.The treatment group was given external application of Wuwei Shuangbai Powder and oral use of placebo capsules,and the control group was given external application of placebo powder and oral use of celecoxib capsules.The treatment for the two groups lasted for 7 days.Before and after treatment,pain was scored by Numeric Rating Scale (NRS),and the peripheral blood hemorheology indexes of both groups were observed.Results (1) After treatment,the NRS pain scores of both groups were decreased compared with those before treatment (P ＜ 0.05 or P ＜ 0.01),and the scores of the treatment group were significantly lower than those of the control group (P ＜ 0.05),indicating that the treatment group had better effect on relieving cancer pain.(2) After treatment,the indexes of hemorheology of treatment group were significantly higher than those of the control group,and the differences of the indexes except the hematocrit were significant between the two groups(P ＜ 0.05 or P ＜ 0.01).Conclusion Wuwei Shuangbai Powder is effective for the treatment of primary liver cancer pain.The mechanism may be related to the improvement of hemorheology of liver cancer patients.
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<p><b>OBJECTIVE</b>To investigate the effects of obstructive sleep apnea-hypopnea syndrome (OSAHS) and age on sleep architecture and the therapeutic effects of continuous positive airway pressure (CPAP).</p><p><b>METHODS</b>We retrospectively analyzed 222 subjects undergoing polysomnography (PSG) for snoring, who received CPAP under PSG on the next day following the initial PSG. The sleep architecture of the subjects in different age groups and in groups with different severities of OSAHS was analyzed before and after adjustment for apnea-hypopnea index (AHI) or age. The sleep architecture and ventilation function of the patients with OSAHS were also analyzed after CPAP.</p><p><b>RESULTS</b>N3 sleep showed the strongest correlation with AHI (r=-0.361), and REM sleep and wake after sleep onset (WASO) were the most strongly correlated with age (r=-0.211 and 0.216, respectively). The 4 age groups showed significant differences in sleep efficiency (P<0.001), N1 (P=0.015), N2 (P=0.013) and REM (P=0.030) sleeps, and WASO (P=0.001) but not in AHI (P=0.185). REM sleep decreased and WASO increased with an increasing age. The sleep efficiency and architecture were still significant different after adjustment for AHI. In 4 groups with different severity of OSAHS, N1, N2 and N3 sleeps were significant different after adjustment for age (P=0.011, 0.017, 0.001). In patients with moderate or severe OSAHS, N3 sleep increased with the increase of AHI. After CPAP for OSAHS, N1 and N2 sleeps significantly decreased, and N3 and REM sleeps increased (P<0.001).</p><p><b>CONCLUSION</b>Between OSAHS and age, REM sleep and WTSO are more importantly affected by age, while OSAHS more strongly affects N3 sleep. CPAP can improve the sleep quality of patients with OSAHS.</p>
Subject(s)
Humans , Age Factors , Continuous Positive Airway Pressure , Polysomnography , Retrospective Studies , Sleep Apnea, Obstructive , Sleep Stages , SnoringABSTRACT
BACKGROUND:The meningeal defect patients can be treated with artificial dural materials combined neurosurgical techniques which can protect the integrity of brain tissue. OBJECTIVE:To analyze the biocompatibility and application feasibility of various artificial dura mater materials. METHODS:The artificial dura materials were classified according to the different sources, and the biocompatible and application feasibility of various artificial dura mater materials were analyzed, as wel as the advantages and disadvantages of various materials. The anticoagulant and hemolytic properties of the materials were analyzed through recalcification test and hemolysis test. 100 patients receiving col agen membrane repair selected from Department of Neurosurgery, Dongfang Hospital of Beijing University of Chinese Medicine were observed. RESULTS AND CONCLUSION:The dural repair materials mainly include autologous material, al ograft materials, dissimilar materials, synthetic materials and natural materials. Each kind of material has its advantages and disadvantages. Meningeal defect complications include cerebrospinal fluid leakage, pseudo meninges, infection and arachnoiditis. There are many problems of artificial dural materials to be solved, and the novel biological dural materials and absorbable materials are the direction of dural material research.
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<p><b>OBJECTIVE</b>To explore the relationship of continuous positive airway pressure and pulmonary function in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and formulate the prediction equation for the effective therapeutic pressure.</p><p><b>METHODS</b>In a retrospective cross-sectional study of 48 patients with established OSAHS, all the patients were carefully examined for their medical history, and overnight sleep monitoring was carried out to measure the sleep apnea-hypopnea index, mean oxygen saturation, minimum oxygen saturation, and oxygen drop index. The data of manual pressure titration (effective pressure) and pulmonary function tests (tidal volume, one second forced expiratory volume, central airway resistance, and peripheral airway resistance were collected for multiple linear regression analysis.</p><p><b>RESULTS</b>The effective therapeutic pressure was not correlated with the indices of the pulmonary functions in the patients, but showed correlations with the neck circumference, abdominal circumference, apnea-hypopnea index, mean oxygen saturation, least oxygen saturation, and oxygen desaturation index. Multiple linear regression (α=0.05 test level) identified only oxygen desaturation index (P=0.012) and mean oxygen saturation (P=0.036) as the dependent variables of the effective therapeutic pressure. Linear regression analysis showed that the effective therapeutic pressure had a linear relationship with the oxygen drop index and mean oxygen saturation, and was inversely correlated with the mean oxygen saturation.</p><p><b>CONCLUSIONS</b>In patients with OSAHS, the pulmonary function indices are not correlated with the effective therapeutic pressure. In the absence of manual pressure titration, the effective therapeutic pressure can be predicted using the prediction equation: effective therapy pressure = 24.262+0.044×oxygen desaturation index -0.19×average oxygen saturation.</p>
Subject(s)
Adult , Aged , Humans , Middle Aged , Continuous Positive Airway Pressure , Forced Expiratory Volume , Polysomnography , Respiratory Function Tests , Retrospective Studies , Sleep Apnea, Obstructive , TherapeuticsABSTRACT
Objective To observe the therapeutic effect of Professor Deng's Jinfu An Decoction(JAD)on intermediate and advanced non-small cell lung cancer(NSCLC).Methods Ninety patients with intermediate and advanced NSCLC were equally randomized into 3 groups.GroupⅠreceived routine chemical therapy(CT), groupⅡreceived oral use of JAD,which is mainly composed of raw Arisaema cum Bile,raw Rhizoma Pinelliae, Radix Pseudostellariae,Culmus Phragmitis,Poria,Semen Persicae,Bulbus Fritillariae Thunbergii,Gekko Chinensis,Pseudobulbus Cremastrae seu Pleiones,Radix Salviae Mihiorrhizae,and groupⅢreceived JAD + CT. Three weeks constituted one phase,two phases constituted one treatment courses,and the treatment lasted 2 courses.The changes of clinical symptom and signs scoring,tumor mass,immune function,hemorrheological indexes,and quality of life(QOL)as well as body weight and toxic and side reactions were observed in the three groups.Results The symptom scores decreased in the 3 groups obviously(P0.05).Between the 3 groups,the improvement of QOL in groupsⅡandⅢdiffered from that in groupⅠ(P
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Acute respiratory failure (ARF) after operation for esophageal carcinoma is a serious challenge to medical management and usually accompanied by a high mortality rate. This paper present author's experience on the management of 10 such cases. It is emphasized that advanced age, long-history of smoking, COPD are predisposing factors and in-trathoracic surgery and its complication may trigger the ARF,which usually occurs within 48-72 hours after operation. Besides assist mechanical ventilation, thorough clearance of the secretion from the respiratory tract, control of pulmonary infection and early eradication of the intrathoracic complications are the key points of the successful treatment. Preoperative pulmonary functional studies with careful analysis in correlation with patients condition is mandatory especially in elderly patients. Prevention is more important and valuable than treatment for the patients with postoperative acute respiratory failure.