ABSTRACT
Objective:To explore the efficacy of tracheotomy and nasal intubation in airways management in treatment of patients with respiratory failure caused by severe tetanus.Methods:A respective case series study was conducted to analyze the data of 92 patients with respiratory failure caused by severe tetanus admitted to Jiangxi Chest Hospital from January 2012 to December 2019. There were 60 males and 32 females, aged 23-81 years [(47.5±14.1)years]. Overall 43 patients underwent tracheotomy (tracheotomy group), and 49 patients underwent nasal intubation (nasal intubation group). The blood gas related indexes (PaO 2, PaCO 2), catheter retention time, incidence of complications such as airway bleeding, nasosinusitis, catheter blockage and ventilator-associated pneumonia (VAP), and clinical outcome were compared between the two groups. Results:After mechanical ventilation, the PaO 2 and PaCO 2 in both groups were significantly improved ( P<0.01), with no significant difference between groups ( P>0.05). Both groups were similar regarding the catheter indwelling time, catheter blockage, airway bleeding and nasosinusitis ( P>0.05). The incidences of VAP and catheter blockage after extubation in tracheotomy group [12%(5/43), 12%(5/43)] were significantly different from those in nasal intubation group [0%(0/49), 31%(15/49)] ( P<0.05). There were 3 deaths in each group, with the mortality rate of 7% (3/43) in tracheotomy group and of 6% (3/49) in nasal intubation group ( P>0.05). Both groups of live tetanus patients were cured. After 3-month follow-up, the tetanus was cured in the two groups. Conclusions:The tracheotomy and transnasal tracheal intubation are optional for severe tetanus patients with respiratory failure. The former has airway and tissue trauma, but it is convenient for mechanical ventilation management, especially indicated for patients with severe convulsions, angular arch reflexes, poor sedation, and continuous application of muscle relaxants. Nasal intubation is relatively non-invasive, simple and fast method, but the prevention and monitoring of VAP requires higher requirements.
ABSTRACT
Objective To separate human γ-tubulin ring complexes (γTuRC) .Methods Cell lysates prepared from 293FT cells were separated using gel filtration chromatography .Then, the eluate fractions containing γTuRC or γ-tubulin small complexes (γTuSC ) were determined by immunoblotting .Results As the constitutive components of γTuRC,γ-tubulin,γ-tubulin complex protein 2 (GCP2), GCP3 and GCP4 were eluted and enriched in the fourth fraction .The molecular mass of eluates in the fourth fraction was about 2000 ×10 3 .Following γTuRC, the constitutive components ofγTuSC including γ-tubulin, GCP2 and GCP3 were eluted and enriched in the fourteenth fraction .The molecular mass of eluates in the fourteenth fraction was about 310 ×10 3 .Unassembled free components were washed out in the eighteenth and subsequent fractions .γTuRC could be detected in the corresponding fractions by negative-PAGE separation .ConclusionγTuRC and γTuSC were successfully separated from the unassembled free components in the fourth ( 4#) and fourteenth (14#) eluted fraction, respectively.The eluates containing ofγTuRC orγTuSC can be used for microtubule assembly research.