ABSTRACT
Objective To explore the clinical application of GlideScope video laryngoscope combined with fiberoptic bronchoscope for double-lumen endobronchial tube intubation in patients with difficult glottis exposure.Methods Forty patients undergoing scheduled for thoracic surgery (24 males,1 6 females,aged 24-78 years,falling into ASA Ⅰ or Ⅱ,Mallampati classification Ⅲ or Ⅳ, were randomly divided into two groups (n=20 each):GlideScope video laryngoscope combined with fiberoptic bronchoscope group (group GF)and Macintosh laryngoscope group (group M).In group GF,GlideScope video laryngoscopy combined with fiberoptic bronchoscope was used to guide the double-lumen tube bronchial intubation and then bronchoscope was used to check the placement of the tube.In group M,the double-lumen endobronchial tube was intubated with conventional macintosh laryngoscope,and then the placement of the tube was checked by bronchoscope.The results of the Cormack and Lehane grade measuring the degree of glottic opening during laryngoscopy,the intuba-tion time consumed,one-time intubation success rate,patients manoeuvre needed to aid tracheal intu-bation and endotracheal intubation related complications within 48 hours after operation were recorded and compared between the two groups.Results Compared with group M,the Cormack and Lehane grade was significantly better (P < 0.01 ), intubation time consumed was significantly shorter [(104.3±1 1.1)s vs.(138.6 ± 33.0)s](P < 0.01 ),one-time intubation success rate was higher (90% vs.55%)(P <0.05 ),fewer patients needed manoeuvre to aid tracheal intubation (20% vs. 90%)(P < 0.01 )and postoperative complications of hoarseness and pharyngalgia within 48 hours were significantly fewer (5% vs.35%,25% vs.75%)in group GF(P <0.05 ).Conclusion Com-pared with conventional method, GlideScope video laryngoscope combined with fiberoptic bronchoscope used to guide double-lumen endobronchial tube intubation in patients with difficult glottis exposure may improve the success rate of intubation,reduce the stress response of intubation and postoperative complications of hoarseness and pharyngalgia.
ABSTRACT
Objective To analyze the impact and quality of life of minimally invasive surgery combined with catheter attract surgery on patients with cerebral hemorrhage.Methods A total of 90 patients with cerebral hemorrhage in our department from February 2013 to De-cember 2014 were randomly divided into invasive group and the control group.Minimally invasive surgery group were given to cerebral hemor-rhage minimally invasive surgery combined with catheter attract surgery,the control group received traditional craniotomy.The postoperative recovery,nerve function scores,quality of life and morbidity between two groups were compared.Results The operation time and edema vol-ume of tissue postoperative 7 days in minimally invasive surgery group was significantly lower than those of the control group.The hematoma clearance rate 1 day after surgery was higher than that of control group,with statistically significant difference(P <0.05).NIHSS scores of two groups were gradually decreased 7 d,15 d,30 d after surgery(P <0.05).NIHSS scores of the minimally invasive surgery group 7 d,15 d, 30 d after surgery were lower than that of control group,with statistically significant difference(P <0.05).The scores of vitality,physiological function,physical function,general health,bodily pain,emotional function,social function,mental health after 6 months of the surgery in the min-imally invasive group was higher than those of control group,with statistically significant difference(P <0.05).The rate of postoperative pulmo-nary infection,electrolyte imbalance,gastrointestinal bleeding in MIS group were lower than those in the control group,with statistically signifi-cant difference(χ2 =5.400 0,4.405 7,4.615 4,P <0.05).Conclusion Minimally invasive surgery combined with catheter attract surgery can improve neurological function and quality of life for patients with intracerebral hemorrhage, and reduce the incidence of complications.
ABSTRACT
Objective To investigate the radiosensitization effect and underlying mechanism of Paeonol on human lung adenocarcinoma cell line A549 in vitro. Methods Cells were assigned to following groups:control,Paeonol alone,irradiation alone,Paeonol combined with irradiation.The effect of Paeonol on cell proliferation was evaluated by the MTT assay. Clonogenic assay was performed to measure the radiosensitization effect of Paeonol under three concentrations around 20％ IC50.Cell apoptosis was determined by TUNEL assay and flow cytometry (FCM).The expression of Survivin protein was analyzed by Western blot.Results Cell growth was inhibited by Paeonol in a dose-dependent manner and the IC50 of Paeonol was (25.2 ± 2.1 ) mg/L. Clonogenic assay showed that Paeonol could markedly enhance cell radiosensitivity and the sensitizing enhancement ratio (SER) was 1.29.After the pretreatment of Paeonol with different concentrations,radiation-induced apoptosis increased with the doses at 24,48,and 72 h post-irradiation ( t =4.95,3.03,3.78,4.59,2.88,3.70,5.54,P ＜ 0.05 ). Moreover,the protein expression of Survivin was obviously down-regulated by 22.6％ - 56.7％ ( t =4.15,7.30,13.47,P ＜0.05 ) due to the treatment of Paeonol.When the Paeonol-treated cells were further irradiated with 6 Gy X-rays,the expression of Survivin was reduced to 22.2％ - 69.4％ ( t =4.30,8.36,16.34,P ＜ 0.05 ).Conclusions Paeonol had radiosensitization effect on the human lung adenocarcinoma cell line A549 in vitro,where the down-regulated Survivin protein might be involved.