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Objective To evaluate the curative effect of sedation on broncholiths through bronchoscope with holmi-um laser. Methods From Jan.2008 to Dec. 2015, 12 cases with broncholiths through bronchoscope with holmium laser, male 7, female 5; the age from 35 to 64.12 cases visit a doctor when they cough, panting, haemoptysis and cough out stones. The predilection sites of bronchinal calculus: left main bronchus in 6, right middle bronchus in 4, main bronchus in 2. Thoracic computerized tomography was performed in 12 patients, which showed bronchial intra-luminal high-density shadow with distal bronchial stenosis, bronchiectasis, COPD, hilar calcifications, or mediastinal lymph node calcifications. Through bronchoscopy examination was performed in 12 cases, Broncholiths were found in 9 patients and granulomatous lesion wrapping hard lesions in 3 patients.12 cases were treated by using Dexmedeto-midine combined with Sufentanil for sedation through of bronchoscope with holmiun laser. Results All the operations were successful, the operation time 45~90 min, average 60 min . During the surgery, the patient have stable heart rate, oxygen saturation without falling, blood pressure is stable, stable hemodynamics, the patients did not complain of discomfort, without obvious heart and lung failure and other complications occurred, the operation without bleed-ing, pneumothorax, complications. All cases of postoperative respiratory system were improved after operation. The average time stay in hospital was (2.5 ± 1.4) days. Follow-up for 1~24 months (mean, 6 months) in 12 cases found no recurrence of stones and serious respiratory tract infection. Conclusions The method of Dexmedetomidine com-bined with Sufentanil for sedation on broncholiths through of bronchoscope with holmiun laser is safey, feasible and therapeutic effects were clearly, which provides a new method for the clinical on Broncholiths.
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BACKGROUND:Periprosthetic infection after artificial joint replacement is a disastrous complication for a patient. Currently, during treating for the periprosthetic infection, most of patients need two-stage revision, which bring about enormous physical and psychological pain for patients, and a heavy burden for the families and society. To make matters worse, the effect is not very perfect, and some of these cases require multi-stage revision, even amputation. OBJECTIVE:To investigate the therapeutic effect of vacuum sealing drainage combined with iodophor douche for the infection after artificial joint replacement. METHODS:Nine cases (six knees and three hips) of infection after artificial joint replacement were col ected, with an average age of 63.4 years. Infection occurred at 7 days-14 months, and a median time of 1 month after replacement. Al patients suffered from purulent or purulent blood secretion. Fistula formed in two cases and incision and drainage sites were not healed in one case. According to the bacterial culture results, above symptoms were accorded with clinical diagnosis of prosthesis infection. The prosthesis was remained for debridement. Vacuum sealing drainage was performed. Iodophor douche (30-50 mL) was conducted every day. The drainage tube at proximal end was occluded for 30 minutes, and then vacuum sealing drainage was performed. Al patients were regularly fol owed up to assess the therapeutic effects of vacuum sealing drainage combined with prosthesis infection after replacement. RESULTS AND CONCLUSION:(1) Except that one case was stil in treatment, one case was dead, and one case of tumor prosthesis was failure and final y amputated, the remaining six patients were healed. (2) The time of vacuum sealing drainage and iodophor douche was 10 to 84 days, with the median time of 57 days. No adverse reactions or complications occurred. Al healed patients were fol owed up for 12-60 months, without recurrence. (3) These results indicated that vacuum sealing drainage combined with iodophor douche retained the prosthesis to the greatest degree, is simple, safe, and effective for the infection after artificial joint replacement, needs a low cost, and is a kind of therapy for prosthesis infection after artificial joint replacement.
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Objective To understand clinical characteristics of primary pulmonary cryptococcosis (PPC),so as to provide reference for clinical diagnosis and treatment.Methods Clinical data of 32 patients who were confirmed PPC by pathological diagnosis in a hospital from January 2008 to June 2014 were analyzed retrospectively. Results All 32 cases were community-acquired infection ,26 male and 6 female (age between 17 and 62 years old, the average age was (35.53 ± 11 .29).Among 32 patients,8 had underlying diseases,2 were parturients,4 were carpenters,5 were pigeon keepers,3 were seafood transport drivers,and 10 lived in humid environment.Imaging findings:Solitary or multiple nodules and cluster shape(n=21),lobar consolidation(n=2),diffuse patchy shadow on bilateral lung (n=5),pulmonary cavity(n=3),and diffuse and mixed lesions (n=1).Pathological confirmation:di-agnosis through percutaneous lung biopsy(n=23),thoracoscopic surgery(n=7),and thoracotomy(n=2).Progno-sis:30 were cured,and 2 had marked effect.Conclusion PPC is commonly occurs in young and middle-aged immu-nocompetent persons,the onset is occult,clinical manifestations and imaging features lack specificity,can be easily misdiagnosed or omitted diagnosis,diagnosis is difficult,lack rapid diagnostic method in clinical practice,invasive pathological biopsy can be used as the basis of diagnosis;there is a controversy on therapy,adverse reaction of flu-conazol is mild,and has good therapeutic effect.
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BACKGROUND:Adipose-derived stem cels are a kind of mesenchyam stem cels with multipotent differentiation capacity, which have more advantages than bone marrow mesenchymal stem cels in tissue engineering research. OBJECTIVE: To establish a method to isolate and purify adipose-derived stem cels from human subcutaneous adipose tissues folowed byin vitro amplification and osteoblastic/adipogenic differentiation. METHODS: Adipose-derived stem cels were isolated from human subcutaneous adipose tissue and cultured by density gradient centrifugation and adherent culture. Cel morphology and growth features were observed under inverted microscope. Adipose-derived stem cels at passages 2 and 5 were selected for viability measurement using cel counting kit-8 method, and then cel growth curves were drawn. The immunophenotype identification was analyzed by flow cytometry. Passage 5 cels underwent osteoblastic/adipogenic induction to confirm the multi-differentiation potential. RESULTS AND CONCLUSION: (1) Using density gradient centrifugation and adherent culture method, high-purity human adipose-derived stem cels can be successfuly isolated from human adipose tissues. (2) The growth process of human adipose-derived stem cels includes stagnant phase, logarithmic phase and plateau phase, which meets the growth rhythm of normal cels. Moreover, the population doubling time is shorter. (3). Human adipose-derived stem cels are positive for stem cel-related antigens, with low immunogenicity and the multi-differentiation potential. (4) Labeling human adipose-derived stem cels with DAPI is a simple efficient labeled method, and the labeling rate is high but the cytotoxicity is low