ABSTRACT
@#Objective To evaluate the effect of perioperative nebulization of ipratropium bromide on preoperative pulmonary function and incidence of postoperative pulmonary complications as well as safety in chronic obstructive pulmonary disease (COPD) patients who underwent lung resection in thoracic surgery. Methods During November 18, 2013 to August 12, 2015, 192 COPD patients with a necessity of selective surgical procedures of lobectomy or right bilobectomy or segmentectomy under general anaesthesia in 10 centers were 1 : 1 randomized to an ipratropium bromide group (96 patients) and a placebo group (96 patients), to compare the effect on preoperative pulmonary function and incidence of postoperative pulmonary complications. The average age of treated patients was 62.90±6.50 years, with 168 male patients and 22 female patients. Results The demographic and baseline characteristics were well-balanced between the two groups. The adjusted mean increase of forced expiratory volume in one second (FEV1) in the ipratropium bromide group was significantly higher than that in the placebo group (169.90±29.07 mL vs. 15.00±29.35 mL, P<0.05). The perioperative use of ipratropium bromide significantly decreased incidence of postoperative pneumonia (2.6% vs. 14.1%, P<0.05). There was no ipratropium bromide related adverse event (AE) observed in this trial. Conclusion This trial indicates that perioperative nebulization of ipratropium bromide significantly improves preoperative lung function and reduces postoperative pneumonia in COPD patients undergoing lung resection in thoracic surgery, and has good safety profile.
ABSTRACT
Objective To evaluate the value of utility of bronchoscopy in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients with Bacteria sputum negative pulmonary tuberculosis.Methods Bronchoscopy was conducted to 65 AIDS patients with bacteria sputum negative pulmonary tuberculosis in the first hospital of Changsha. The patients’ bronchoalveolar lavage fluid through the electronic bronchoscopy, mycobacterium tuberculosis (MTB) culture, brushings and biopsy pathology were analyzed.Results 65 cases, bronchoscope alveolar lavage lfuid smear positive acid-fast stain 14 cases (21.54%), BAL mycobacterium tuberculosis culture positive 20 cases (30.76%), a bronchoscope brush positive 24 cases (36.92%), 35 cases of bronchoscopy biopsy, according to the performance under the bronchoscope positive 21 cases (60.00%), bronchoscopy combined different methods conifrmed 43 cases (66.15%).Conclusions Bronchoscopy in AIDS with bacteria sputum negative pulmonary tuberculosis diagnosis, it has important application value.
ABSTRACT
OBJECTIVE@#To determine the risk factors for mechanical ventilation offline in patients with severe pneumonia.@*METHODS@#Th e data of 59 patients, who were admitted to the First Hospital of Changsha because of severe pneumonia and required mechanical ventilation between June 2011 and December 2013, were reviewed retrospectively. The patients were divided into two groups: a successful weaned group (n=31) and a failure group (n=28). Th e patients' background, laboratory and bacteriological examinations at the beginning of mechanical ventilation were recorded. All the indexes were analyzed by univariate analysis and logistic regression analysis.@*RESULTS@#Univariate analysis showed that there was no significant difference in gender and age in the 2 groups (P>0.05). Smoker, APECHE II score, D-dimer and brain natriuretic peptide (BNP) concentration in the success weaned group were lower than those in the failure group. The difference between the 2 groups was significant (P<0.05). The serum albumin level in patients of the success weaned group at the time of entering respiratory intensive care unit was higher than that in the failure group, with significant difference (P<0.05). The logistic regression analysis showed that the high concentration of D-dimer, lung diseases based on thoracic CT and low serum albumin were independent risk factors for mechanical ventilation offline in severe pneumonia patients.@*CONCLUSION@#The severe pneumonia patients with low albumin, high concentration of D-dimer and lung diseases should be comprehensive evaluated and receive treatment, which is beneficial to the mechanical ventilation offline.
Subject(s)
Humans , Fibrin Fibrinogen Degradation Products , Intensive Care Units , Lung Diseases , Pneumonia , Therapeutics , Respiration, Artificial , Retrospective Studies , Risk Factors , Serum Albumin , Treatment FailureABSTRACT
Objective:To monitor the effects of asarone injections on the expression of IL-25, IL-27 and eosinophils cationic pro-tein ( ECP) in the serum of asthma patients. Methods:Totally 100 patients with bronchial asthma were randomly divided into the ob-servation group ( 55 cases ) and the control group ( 45 cases ) . The control group was treated with the conventional symptomatic treat-ment ( oxygen inhalation, spasmolysis and anti-asthma, and anti-infection, etc) . The observation group was given asarone injections 24 mg in 250 ml 0. 9% sodium chloride infusions, once a day for 14 days on the basis of the conventional therapy. The changes in symp-toms, and pulmonary function in the patients were observed with simultaneous detection of IL-25, ECP and IL-27 levels. Results:To-tal effective rate of the observation group was 92. 7%,which was higher than that of the control group (P<0. 05). Asarone injections could decrease IL-25, ECP and IL-27 levels in the observation group compared with those in the control group with statistically signifi-cant difference (P<0. 05 or 0. 01). Conclusion:Asarone injections can decrease the levels of IL-25, IL-27and ECP in the serum of asthma patients and inhibit the formation of inflammatory cells to alleviate the symptoms of airway inflammation.
ABSTRACT
<p><b>OBJECTIVE</b>To establish a stable and feasible rabbit model of cardiopulmonary bypass (CPB) in acute cerebral embolism phase for studying the effects of CPB on brain tissues and the timing of surgical intervention of acute cerebral embolism.</p><p><b>METHODS</b>Fifty-four rabbits were randomized into group A (n=18) to receive CPB without middle cerebral artery occlusion (MCAO) and group B to undergo CPB at 24 h (group B1, n=18) or 1 week (group B2, n=18) after MCAO. Through a supraorbital margin approach, electrocoagulation was carried out to occlude the main stem of the left MCA under direct vision to establish MCAO. Magnetic resonance imaging (MRI) was performed at both 24 h and 1 week after MCAO, and the severity of cerebral embolization was evaluated. CPB was established by cannulation of the ascending aorta and the right atrium through a median sternotomy incision. MRI was performed at 2 h after CPB to observe the brain tissues.</p><p><b>RESULTS</b>MCAO was successfully established in groups B1 and B2, and all the rabbits survived after MCAO. In both groups A and B, MRI examination detected no cerebral hemorrhage or new embolism 2 h after CPB.</p><p><b>CONCLUSIONS</b>We have established a stable and feasible CPB model in rabbits with acute cerebral embolism to allow study of the mechanisms of CPB-related organ damage and its interventions.</p>
Subject(s)
Animals , Female , Male , Rabbits , Cardiopulmonary Bypass , Disease Models, Animal , Electrocoagulation , Infarction, Middle Cerebral Artery , Magnetic Resonance Imaging , Middle Cerebral Artery , General Surgery , Random AllocationABSTRACT
<p><b>OBJECTIVE</b>To analyze the causes of failure of esophageal stent implantation and explore technical improvement of re-implantation of esophageal stent (RIES).</p><p><b>METHODS</b>According to the conditions of the failed stent implantation, 32 patients who required RIES underwent placement of more appropriate esophageal stents with an improved implantation technique. The patients were followed up for 6 months after the operation to evaluate the effects of RIES.</p><p><b>RESULTS</b>The success rate of the operation was 96.9% in these cases, and the esophageal conditions including stricture and fistula were effectively relieved. During the 6-month follow-up, stent migration occurred in 4 cases (12.5%), and esophageal fistula in the upper edge of the re-implanted stent occurred in 2 cases. No stent loss, bleeding, or stricture was found in these cases.</p><p><b>CONCLUSION</b>The improved technique is effective for stent re-implantation after failed esophageal stent implantation with reduced complications associated with esophageal stenting.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Esophageal Fistula , General Surgery , Esophageal Neoplasms , General Surgery , Esophageal Stenosis , General Surgery , Prosthesis Failure , Prosthesis Implantation , Reoperation , Stents , Treatment OutcomeABSTRACT
Objective To compare the effect of video-assisted minithoracotomy(VAMT)and video-assisted thoracoscopic surgery(VATS)for spontaneous pneumothorax.Methods 98 patiens with spontaneous pneumothorax allocated to VAMT or VATS were selected.The operation time,blood loss during operation,score of postoperative pain,time of postoperative drainage,postoperative hospital stay,surgery cost,rate of complication and recurrence were compared between the two groups.Results All patients were cured.The operation time,postoperative hospital stay and surgery cost were significantly different between VAMT and VATS groups(all P ＜0.05).The parameters of two groups were similar in score of postoperative pain,time of post-operative drainage,blood loss during operation,rate of complication and recurrence(all P ＞ 0.05).Conclusion VAMT was as effective as VATS,but the operation time,postoperative hospital stay and surgery cost was significantly better than VATS.
ABSTRACT
BACKGROUND: Silk fibroin film showed an anti-coagulated blood activity following sulfurous acid treatment; however, its flexibility and anti-tension were poor. If the silk flbroin film was coated on small-caliber expanded poly(tetrafiuoroethylene) (ePTFE) vascular grafts prior to surface sulfonation, the adverse effects were improved and the blood compatibility of ePTFE vascular grafts were remarkably enhanced. OBJECTIVE: To research the preparation of ePTFE vascular grafts applied by surface sulfonation of silk flbroin film by low temperature plasma treatment. METHODS: The ePTFE vascular grafts were treated with low temperature plasma and coated on the surface of silk fibroin. The compound was then sulfonated with low temperature plasma. The ePTFE vascular grafts were considered as the controls to detect contact angle and sulfonation. RESULTS AND CONCLUSION: The contact angle was decreased gradually form 87.7°to 65.1° following low temperature plasma treatment. Moreover, the contact angle was 106.2° following coating silk flbroin film and 92.9°following sulfonation. X-raylight-electron spectrometer demonstrated that percents of sulfur element on the surfaces of the combined blood vessel was 2.89%, respectively, while that of the control film was only 0.12%. The X-ray light-electron spectrometer also showed that most of the sulfur element were sulfonic group (-SO_3H). The results suggested the feasibility of the preparation of the combined blood vessel.