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Objective To analyze the feasibility of using minimally invasive thoracoscopic surgery to treat stage Ⅲ silicosis complicated by pulmonary tuberculosis and secondary pneumothorax. Methods This study retrospectively analyzed the clinical data of a patient with stage Ⅲ silicosis complicated by pulmonary tuberculosis and secondary pneumothorax. Results The patient had stage Ⅲ silicosis complicated with active pulmonary tuberculosis for 1.5 years. In March 2021, a left-sided pneumothorax occurred and was conservatively treated with closed chest drainage. In April 2022, the patient was admitted with sudden frequent coughing and left-sided chest discomfort. Based on occupational history, dust exposure history, high-kilovolt anterior-posterior chest radiography, chest computed tomography, and sputum smear results, the diagnosis was "stage Ⅲ silicosis; active tuberculosis (positive for acid-fast bacilli in sputum smear); left-sided pleural effusion, pulmonary bulla rupture; secondary pneumothorax (recurrent tension type in left, encapsulated in right); left pleural adhesion". On the second day of admission, left-sided closed chest drainage was performed with poor outcome. On the fifth day of admission, minimally invasive thoracoscopic treatment was performed, including left lung volume reduction, pleural adhesion cauterization, and pleural fixation. Postoperative anti-inflammation, anti-tuberculosis, and symptomatic supportive treatments were administered. Due to the patient's severe underlying disease, wound healing was slow postoperatively, but no serious complications occurred. The pneumothorax completely absorbed and recovered in 17.0 days. Conclusion Minimally invasive thoracoscopic surgery is an effective treatment for silicosis complicated with pulmonary tuberculosis and secondary pneumothorax, and it is worth promoting.
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Objective:To evaluate the value of visual analysis and standardized uptake value ratio (SUVR) during 18F-florbetapir (AV45) PET/CT brain imaging in diagnosis of β-amyloid (Aβ) deposition in patients with mild cognitive impairment (MCI) and Alzheimer′s disease (AD), and to explore the clinical ancillary value of the two indexes. Methods:From December 2018 to July 2019, a total of 47 subjects, including 5 (3 males, 2 females, age (58±13) years) normal controls (NC), 8 (2 males, 6 females, age (66±10) years) patients with AD and 34 (16 males, 18 females, age (70±7) years) patients with MCI were enrolled. All subjects underwent 18F-AV45 PET/CT scan. All images were evaluated by visual analysis and SUVR were calculated. The diagnostic efficiencies of visual analysis and SUVR were compared by McNemar test and Kappa test. One-way analysis of variance and Welch test were used to compare data differences. The best threshold value of SUVR was obtained by receiver operating characteristic (ROC) curve analysis. Results:The positive rate of Aβ deposition for all subjects was 46.81%(22/47) by SUVR analysis, and 38.30%(18/47) by visual analysis. There was no significant difference between the two methods ( χ2=33.15, P>0.05), and the consistency was good ( Kappa=0.83). Considering the clinical diagnosis as the"gold standard", the Aβ deposition obtained by visual analysis and SUVR analysis can effectively distinguish AD from NC, and the sensitivities were 7/8 vs 8/8, respectively, both specificities were 5/5( χ2=9.48, P>0.05), with good consistency ( Kappa=0.84). SUVR quantitative analysis could distinguish AD from NC, AD from MCI ( F values: 3.99-8.79, all P<0.01), but could not distinguish NC from MCI (all P>0.05). ROC curve analysis showed that the best threshold value of precuneus′ SUVR was 1.08 for the differential diagnosis of AD and NC; for the differential diagnosis of AD and MCI, the best threshold value of lateral temporal′s SUVR was 1.06. Conclusion:Visual analysis was consistent with SUVR′s qualitative determination during 18F-AV45 PET/CT imaging for brain Aβ deposition, while SUVR quantitative analysis could assist in the differential diagnosis of AD and NC, AD and MCI.
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Objective To observe the proliferation ability of cocultured dendritic cells(DCs)loaded with tumor antigen and cytokine-induced killer cells( CIKs)and its killing effect on hepatocarcinoma cells HepG2. Methods The antigen of hepatocarcinoma cells HepG2 was prepared by repeated freezing and thawing of liquid nitrogen. Peripheral blood mononuclear cells(PBMNCs)were isolated from healthy donors by blood cell separator,then DCs and CIKs were induced. Ag-DCs were obtained by impinging DCs with tumor antigens. CIKs were divided into three groups:the first group was CIKs alone,the second group was mixed in the propor-tion of DCs : CIKs = 1 : 5,and the third group was mixed in the proportion of Ag-DCs : CIKs = 1 : 5. The three groups of cells were recorded as CIK group,DC-CIK group and Ag-DC-CIK group. The proliferation and cell phenotype of the three groups of cells were observed and the killing effects on hepatocarcinoma cells HepG2 were detected by methyl thiazolyl tetrazolium(MTT)assay. Results The proliferation multiples of the three groups of cells were gradually increased with the prolongation of culture time,and the proliferation rates of Ag-DC-CIK on the 9th day(61. 32 ± 1. 72),the 12th day(190. 83 ± 3. 53)and the 15th day(399. 09 ± 5. 60) were significantly higher than those of CIK group(22. 47 ± 2. 07,55. 91 ± 1. 81,83. 20 ± 2. 34)and DC-CIK group(40. 26 ±2. 49,125. 03 ±4. 16,251. 55 ±3. 25),and the difference between the three group was statisti-cally significant(F =185. 78,P =0. 033;F = 297. 35,P = 0. 018;F = 455. 37,P < 0. 001),in addition,the differences between each two groups were statistically significant(all P <0. 05). The cytotoxicity of Ag-DC-CIK to HepG2 cells at the effective target ratios of 5 : 1(31. 71％ ±0. 29％ ),10 : 1(42. 43％ ±1. 86％ )and 20 : 1 (57. 69％ ±1. 11％ )were significantly higher than those of CIK group(12. 11％ ±1. 14％ ,21. 30％ ±0. 52％ , 30. 71％ ±1. 26％ )and DC-CIK group(20. 06％ ± 0. 67％ ,29. 89％ ± 1. 37％ ,39. 11％ ± 0. 92％ ),and the difference between the three group was statistically significant(F =159. 64,P =0. 037;F =199. 36,P =0. 025;F =302. 08,P <0. 001),in addition,the differences between each two groups were statistically significant(all P <0. 05). On the 15th day of cell culture,the flow cytometry analysis showed that all the three groups were expressed CD3 + CD8 + ,CD3 + CD56 + double positive cells,the contents of CD3 + CD8 + 、CD3 + CD56 + double positive cells in the Ag-DC-CIK group(88. 12％ ± 1. 24％ ,61. 35％ ± 2. 63％ )were significantly higher than those in the CIK group(54. 37％ ± 3. 08％ ,18. 22％ ± 1. 83％ )and DC-CIK group(69. 80％ ± 1. 46％ , 39. 51％ ±2. 17％ ),and the difference between the three group was statistically significant(F = 414. 32,P <0. 001;F =378. 60,P <0. 001),in addition,the differences between each two groups were statistically signifi-cant(all P <0. 001). Conclusion The proliferation ability and killing effect of Ag-DC-CIK that obtained from antigen-pulsed DCs co-cultured with CIKs are significantly higher than those of CIKs and DC-CIKs.
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Purpose To investigate the clinicopathological features,diagnosis and differential diagnosis,and genetic alteration of lung cribriform adenocarcinoma (LCA).Methods Clinicopathological features and immunophenotype were retrospectively evaluated in twenty LCA cases collected from Fujian Provincial Hospital,combined with genetic mutation analysis of EGFR.Results The tumors occurred in 5 women and 15 men aged from 39 to 74 years (median =59.25).Diameter of masses ranged from 1.5-5.5 cm (median =3.265).Histologically,the tumors were unencapsulated and were divided by fibrous septa into lobules.Major parts of the lesions were composed of areas with solid and microcystic growth patterns.The most striking cytological feature was that the tumor cell nuclei were pale staining with a ground glass feature,and they often appeared to overlap.Immunephenotypically,the tumor cells were positive for TTF-1(20/20),Napsin A (18/20),SPB(19/20),CK7(20/20),CD56 (2/20),EGFR (7/20),β-catenin (4/20),ALK (2/20).Tg,CDX-2,Syn,CgA,S-100 and SMA were negative.Gene mutation detection confirmed that EGFR genes were mutating in nine cases,and eleven cases were wild type.The twenty cases were all performed for the completely surgical resection.20 cases accepted chemotherapy,and 4 cases unaccepted chemotherapy.Conclusion LCA is a rare tumor with distinct morphologic feature.Clinically and pathologically,it needs to differentiate from alveolus adenocarcinoma,adenoid cystic carcinoma and papillary carcinoma of the thyroid,and so on.The primary treatment for LCA is completely surgical excision and chemotherapy.Otherwise its prognosis is poor.
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Objective To explore the clinical application and complication management of ultrasound-guided implantation of venous access port via axillary vein in breast cancer patients with chemotherapy.Methods From Sep.2016 to Jan.2017,50 breast cancer patients were implanted implantable venous access ports via the axillary vein under ultrasound guidance in the First Affiliated Hospital of Chongqing Medical University,among whom 25 cases with the left-side breast cancer,the other cases with right-side breast cancer.The effects of the application of implantation method and complication management were observed.Results The success rate of venous access ports via the axillary vein under ultrasound guidance was 98％(49/50).The operation time was (26±4) mins.The number of puncture ≤ 2 times was 96％ (48/50).The incidence of intraoperative complications including pneumothorax (0％,0/50),error arterial puncture rate 4％ (2/50),catheter ectopic incidence 2％(1/50),and intraoperative blood loss 2％(1/50).The long-term postoperative included pinch-off syndrome (POS) (0％,0/50),thromboembolism (2 ％,1/50),infection (2％,1/50) and catheter detachment (0％,0/50).Conclusion Ultrasound-guided implantation of venous access port via axillary vein has features of high success ratio,high safety,and low complication rate,which provides additional venous channel selection of port implantation.
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Objective To study the influence of isoniazid on lymphocyte factor expression and macrophage function of rats.Methods Healthy male SD rats were randomly divided into three groups,which was treated for one month,three months and withdrawal for one month after treated for three months,and each group was randomly divided into isoniazid group and control group.The isoniazid groups were ig with isoniazid at dose of 120 mg/kg every other day and control groups were fed on normal saline.At the corresponding time points,the level of interleukin-12 (IL-12) and interferon-γ (IFN-γ) was detected with ELISA method,detected serum lysozyme content by agar plate method,and Comori method was used for the detection of acid phosphatase levels in peritoneal fluid.Results At all the time points,levels of IL-12,IFN-γ and lysozyme in isoniazid group were not significantly different compared with control group.There were statistically significant differences in acid phosphatase between isoniazid group and control group after treated for one month (P ＜ 0.05),but the significant differences disappeared at the next two time points.Conclusion Isoniazid of 120 mg/kg may have no obvious influence on the immune function of rat.We don't detect the immune injury.
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According to the professional characteristics of the operating room,on the basis of basic principles of hierarchical management and post management of nursing department,taking clinical needs as guiding ideology,combined with the development needs of surgical departments,we developed the operating room nursing staff management model,and set up 23 jobs.We adjusted it accordingly in practice,and constantly optimized nurses' career plan by providing clinical,teaching,research,management and other multi-channel development direction,meanwhile provided better quality care for patients.
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Objective To design a channel in the mobile hospital to solve the existing problems.Methods The technical form and characteristics of the existing channel were analyzed,and the requirements of the mobile hospital and channel shelter were considered comprehensively,then the selection of technical form and structure design of the channel shelter was explored from the aspects of airtightness,heat preservation and etc.The feasibility was verified by trial-manufacture and test.Results A shelter-tent channel was designed and the experiments showed its effectiveness when fulfilling the requirements of the mobile hospital.Conclusion The channel gains reasonable and feasible design,and has its performances meeting the desired requirements.
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Objective To study the influence of isoniazid on lymphocyte factor expression and macrophage function of rats.Methods Healthy male SD rats were randomly divided into three groups,which was treated for one month,three months and withdrawal for one month after treated for three months,and each group was randomly divided into isoniazid group and control group.The isoniazid groups were ig with isoniazid at dose of 120 mg/kg every other day and control groups were fed on normal saline.At the corresponding time points,the level of interleukin-12 (IL-12) and interferon-γ (IFN-γ) was detected with ELISA method,detected serum lysozyme content by agar plate method,and Comori method was used for the detection of acid phosphatase levels in peritoneal fluid.Results At all the time points,levels of IL-12,IFN-γ and lysozyme in isoniazid group were not significantly different compared with control group.There were statistically significant differences in acid phosphatase between isoniazid group and control group after treated for one month (P ＜ 0.05),but the significant differences disappeared at the next two time points.Conclusion Isoniazid of 120 mg/kg may have no obvious influence on the immune function of rat.We don't detect the immune injury.
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According to the professional characteristics of the operating room,on the basis of basic principles of hierarchical management and post management of nursing department,taking clinical needs as guiding ideology,combined with the development needs of surgical departments,we developed the operating room nursing staff management model,and set up 23 jobs.We adjusted it accordingly in practice,and constantly optimized nurses' career plan by providing clinical,teaching,research,management and other multi-channel development direction,meanwhile provided better quality care for patients.
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Objective To design a channel in the mobile hospital to solve the existing problems.Methods The technical form and characteristics of the existing channel were analyzed,and the requirements of the mobile hospital and channel shelter were considered comprehensively,then the selection of technical form and structure design of the channel shelter was explored from the aspects of airtightness,heat preservation and etc.The feasibility was verified by trial-manufacture and test.Results A shelter-tent channel was designed and the experiments showed its effectiveness when fulfilling the requirements of the mobile hospital.Conclusion The channel gains reasonable and feasible design,and has its performances meeting the desired requirements.