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OBJECTIVE@#To investigate the effect of inverse ratio ventilation (IRV) combined with positive end-expiratory pressure (PEEP) in infants undergoing thoracoscopic surgery with single lung ventilation (OLV) for lung cystadenomas.@*METHODS@#A total of 66 infants undergoing thoracoscopic surgery with OLV for lung cystadenomas in our hospital from February, 2018 to February, 2019 were randomized into conventional ventilation groups (group N, =33) and inverse ventilation group (group R, =33). Hemodynamics and respiratory parameters of the infants were recorded and arterial blood gas analysis was performed at 15 min after two lung ventilation (TLV) (T), OLV30 min (T), OLV60 min (T), and 15 min after recovery of TLV (T). Bronchoalveolar lavage fluid was collected before and after surgery to detect the expression level of advanced glycation end product receptor (RAGE).@*RESULTS@#Sixty-three infants were finally included in this study. At T and T, Cdyn, PaO and OI in group R were significantly higher ( < 0.05) and Ppeak, PaCO and PA-aO were significantly lower than those in group N ( < 0.05). There was no significant difference in HR or MAP between the two groups at T and T ( > 0.05). The level of RAGE significantly increased after the surgery in both groups ( < 0.05), and was significantly lower in R group than in N group ( < 0.05).@*CONCLUSIONS@#In infants undergoing thoracoscopic surgery with OLV for pulmonary cystadenoma, appropriate IRV combined with PEEP does not affect hemodynamic stability and can increases pulmonary compliance, reduce the peak pressure, and improve oxygenation to provide pulmonary protection.
Subject(s)
Humans , Infant , Cystadenoma , Therapeutics , Lung , One-Lung Ventilation , Positive-Pressure Respiration , ThoracoscopyABSTRACT
OBJECTIVE@#To investigate the effect of inverse ratio ventilation (IRV) combined with positive end-expiratory pressure (PEEP) in infants undergoing thoracoscopic surgery with single lung ventilation (OLV) for lung cystadenomas.@*METHODS@#A total of 66 infants undergoing thoracoscopic surgery with OLV for lung cystadenomas in our hospital from February, 2018 to February, 2019 were randomized into conventional ventilation groups (group N, =33) and inverse ventilation group (group R, =33). Hemodynamics and respiratory parameters of the infants were recorded and arterial blood gas analysis was performed at 15 min after two lung ventilation (TLV) (T), OLV30 min (T), OLV60 min (T), and 15 min after recovery of TLV (T). Bronchoalveolar lavage fluid was collected before and after surgery to detect the expression level of advanced glycation end product receptor (RAGE).@*RESULTS@#Sixty-three infants were finally included in this study. At T and T, Cdyn, PaO and OI in group R were significantly higher ( < 0.05) and Ppeak, PaCO and PA-aO were significantly lower than those in group N ( < 0.05). There was no significant difference in HR or MAP between the two groups at T and T ( > 0.05). The level of RAGE significantly increased after the surgery in both groups ( < 0.05), and was significantly lower in R group than in N group ( < 0.05).@*CONCLUSIONS@#In infants undergoing thoracoscopic surgery with OLV for pulmonary cystadenoma, appropriate IRV combined with PEEP does not affect hemodynamic stability and can increases pulmonary compliance, reduce the peak pressure, and improve oxygenation to provide pulmonary protection.
Subject(s)
Humans , Infant , Cystadenoma , General Surgery , Lung , General Surgery , One-Lung Ventilation , Positive-Pressure Respiration , Thoracoscopy , Treatment OutcomeABSTRACT
Objective@#To explore the factors, characteristics and imaging manifestations of ankle joint injury in amateur marathoners (no formal training and no marathon career).@*Methods@#From December 2018 to March 2019, the amateur marathon runners in Guangdong Zhuhai had been recruited as research subjects according to the study inclusion and exclusion criteria. The questionnaires were used to collect relevant data, and the subjects underwent MRI scans of the ankle joint. The ankle joint special phased array coils were used to perform fast spin echo sequence (TSE) coronal T1WI and proton density-weighted fat-suppression sequence (PDWI-FS). Axial, coronal and sagittal scans, three-dimensional-double echo steady-state sequence (3D-DESS) and three-dimensional variable flip angle fast spin echo sequence (3D-SPACE) scans were also acquired. The results of the examination were independently analyzed by two radiologists (5 and 17 years of work experience, respectively) on the ligament, tendon, bone marrow and ankle joint injuries. When they had inconsistent views, the diagnosis provided by the third radiologist (27 years of work experience) was considered a final diagnosis. The relationship between ankle injury and different running postures, the number of participating in marathons and training intensity was analyzed, and the independent sample χ2 was used for statistical analysis. The consistency of two radiologists was tested by Kappa test.@*Results@#According to the inclusion and exclusion criteria, 39 subjects were included, with 64 ankles totally, 35 right ankles and 29 left ankles. MRI showed that (1) Ligament injuries: 28 ankles were anterior talofibular ligament injuriy;50 ankles were posterior talofibular ligament injury; 60 ankles the calcaneofibular ligament injuries and 54 ankles were deltoid ligament injuries, without complete injury. (2) Tendon sheath effusion and injuries: peritendinous effusion was common, with 47 flexor hallucis longus tenosynovitis, 49 posterior tibialis tenosynovitis, 37 flexor digitorum longus tenosynovitis, 7 peroneus longus tenosynovitis and 5 peroneus brevis tenosynovitis. (3) Synovitis effusion: 43 posterior ankle synovitis and local effusion. (4) Others: cartilage injury in 2 ankles, bone marrow edema in 8 ankles, and among them stress fracture in 2 ankles. The two radiologists had good consistency with the Kappa value of 0.91. Regarding the running posture, the incidence of ligaments injuries was obviously higher in those who landed on the hind foot than in those landed on front and middle foot,and the difference was statistically significant(P=0.013, χ2 value was 6.191).The incidence of tendon injuries was higher in those who landed on the front middle foot than in those landed on the hind foot, and the difference was statistically significant (P=0.029, χ2 value was 4.775). Those with larger training (training running ≥300 km/month) had significant ankle injury (P=0.005, χ2 value was 7.844).@*Conclusion@#The MRI features of ankle joint injuries in amateur marathon volunteers are related to different running postures and training intensity.
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Objective To explore the factors, characteristics and imaging manifestations of ankle joint injury in amateur marathoners (no formal training and no marathon career). Methods From December 2018 to March 2019, the amateur marathon runners in Guangdong Zhuhai had been recruited as research subjects according to the study inclusion and exclusion criteria. The questionnaires were used to collect relevant data, and the subjects underwent MRI scans of the ankle joint. The ankle joint special phased array coils were used to perform fast spin echo sequence (TSE) coronal T1WI and proton density?weighted fat?suppression sequence (PDWI?FS). Axial, coronal and sagittal scans, three?dimensional?double echo steady?state sequence (3D?DESS) and three?dimensional variable flip angle fast spin echo sequence (3D?SPACE) scans were also acquired. The results of the examination were independently analyzed by two radiologists (5 and 17 years of work experience, respectively) on the ligament, tendon, bone marrow and ankle joint injuries. When they had inconsistent views, the diagnosis provided by the third radiologist (27 years of work experience) was considered a final diagnosis. The relationship between ankle injury and different running postures, the number of participating in marathons and training intensity was analyzed, and the independent sample χ2 was used for statistical analysis. The consistency of two radiologists was tested by Kappa test. Results According to the inclusion and exclusion criteria, 39 subjects were included, with 64 ankles totally, 35 right ankles and 29 left ankles. MRI showed that (1) Ligament injuries: 28 ankles were anterior talofibular ligament injuriy;50 ankles were posterior talofibular ligament injury; 60 ankles the calcaneofibular ligament injuries and 54 ankles were deltoid ligament injuries, without complete injury. (2) Tendon sheath effusion and injuries: peritendinous effusion was common, with 47 flexor hallucis longus tenosynovitis, 49 posterior tibialis tenosynovitis, 37 flexor digitorum longus tenosynovitis, 7 peroneus longus tenosynovitis and 5 peroneus brevis tenosynovitis. (3) Synovitis effusion: 43 posterior ankle synovitis and local effusion. (4) Others: cartilage injury in 2 ankles, bone marrow edema in 8 ankles, and among them stress fracture in 2 ankles. The two radiologists had good consistency with the Kappa value of 0.91. Regarding the running posture, the incidence of ligaments injuries was obviously higher in those who landed on the hind foot than in those landed on front and middle foot,and the difference was statistically significant(P=0.013, χ2 value was 6.191).The incidence of tendon injuries was higher in those who landed on the front middle foot than in those landed on the hind foot, and the difference was statistically significant (P=0.029, χ2 value was 4.775). Those with larger training (training running ≥300 km/month) had significant ankle injury (P=0.005, χ2 value was 7.844). Conclusion The MRI features of ankle joint injuries in amateur marathon volunteers are related to different running postures and training intensity.
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Objective To investigate the protective effect of permissive hypercapnia in infants undergoing one-lung ventilation(OLV). Methods A total of 64 infants were randomly divided into Group N(normocapnia group,n=32)and Group H(hypercapnia group,n=32).Arterial blood gas samples were collected at four differ-ent time points:10 minutes after intubation(T1),30 and 60 minutes after artificial pneumothorax(T2,T3),and 30 minutes after being sent to post anesthesia care unit(T4)while vital signs(HR,MAP,SpO2and temperature) and ventilation parameters(Ppeak,Vt,PEEP,RR,MVV,and FiO2)were recorded simultaneously;OI was calcu-lated by corresponding equation. Bronchoalveolar lavage fluid(BALF)was collected before and after surgery for the measurement of RAGE. Results Compared with those at T1,MAP and PaO2were significantly lower but Ppeak was obviously higher in group N,while HR,Ppeakas well as PaCO2were increased(P<0.05)and Vt,MVV,pH, PaO2as well as lactic acid were decreased in group H(P < 0.05)at T2and T3. Compared with those in group N, MAP,HR as well as PaCO2were higher while Ppeak,Vt,MVV,pH,and lactic acid were lower in group H at T2 and T3(P<0.05).There was a significant increase of RAGE in both groups after surgery and it was much higher in group N when compared with that in group H after surgery(P<0.05). Conclusion PHC not only has advantages in improving tissue oxygenation,but also has the potential of lung protection for infants undergoing OLV.
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Objective To explore the value of preoperative spleen-liver volume ratio for predicting recurrence of primary liver cancer after hepatectomy.Methods Clinical data of 75 cases of hepatocellular carcinoma undergoing hepatectomy were analyzed retrospectively.According to the preoperative spleen-liver volume ratio,these patients were divided into 2 groups:those with spleen-liver volume ratio ＜ 0.8,and spleen-liver volume ratio≥0.8.Patients were followed-up until March 2014.Cox ratio risk pattern analysis was used for the recurrent correlative factors.Results Univariate analysis showed that preoperative AFPL3％ ≥ 10％,the maximum diameter of the tumor ＞ 5 cm,the number of tumor ＞ 3,spleen-liver volume ratio ≥0.8,vascular invasion,positive resection margin and hepatic or portal vein tumor thrombus were all risk factors of poor disease-free survival (P ＜ 0.05).Cox regression analysis revealed that spleen-liver volume ratio ≥0.8,AFP-L3％ ≥10％,the maximum diameter of the tumor ＞5 cm and hepatic or portal vein tumor thrombus were independent predictors of poor disease-free survival after hepatectomy for hepatocellular carcinoma(P ＜ 0.05).Conclusions Preoperative spleen-liver volume ratio ≥0.8 was an independent adverse predictor of poor disease-free survival.
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This study examined the value of volume rendering (VR) interpretation in assessing the growth of pulmonary nodular ground-glass opacity (nGGO). A total of 47 nGGOs (average size, 9.5 mm; range, 5.7-20.6 mm) were observed by CT scanning at different time under identical parameter settings. The growth of nGGO was analyzed by three radiologists by comparing the thin slice (TS) CT images of initial and repeat scans with side-by-side cine mode. One week later synchronized VR images of the two scans were compared by side-by-side cine mode to evaluate the nGGO growth. The nodule growth was rated on a 5-degree scale: notable growth, slight growth, dubious growth, stagnant growth, shrinkage. Growth standard was defined as: Density increase ≥ 30 HU and (or) diameter increase (by 20% in nodules ≥10 mm, 30% in nodules of 5-9 mm). Receiver operating characteristic (ROC) was performed. The results showed that 32 nGGOs met the growth criteria (29 nGGOs showed an increase in density; 1 nGGO showed an increase in diameter; 2 nGGOs showed an increase in both diameter and density). Area under ROC curve revealed that the performance with VR interpretation was better than that with TS interpretation (P<0.01, P<0.05 and P<0.05 for observers A, B and C respectively). Consistency between different observers was excellent with both VR interpretation (κ=0.89 for observers A&C, A&B, B&C) and TS interpretation (κ=0.71 for A&B, κ=0.68 for A&C, κ= 0.74 for B&C), but time spending was less with VR interpretation than with TS interpretation (P<0.0001, P<0.0001 and P<0.05 for observers A, B and C, respectively). It was concluded that VR is a useful technique for evaluating the growth of nGGO.
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Objective To study the effect of Chinese Herb of Yigan Granules in different dosages on bile secretion in rats.Methods The rats were randomly divided into 5 groups: blank control group,positive control group and high,mod erate,low dosages of Yigan Granules groups.The medicines were administered thr ough duodenal intubation for the rats.Then the volume of bile were gathered by common bile duct intubations in different time,and the volume of bile and the contents of bilirubin in bile were tested before and after given drugs.Results Yigan Granules increased the bile secretion in a dose-dependent manner and promote the secretion of bilirubin.Conclusion Chinese Herb of Yigan granules has a choleretic effect.