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Objective To investigate the reasons of tracheobronchial tuberculosis misdiagnosis and its clinical charac?teristics as well as the diagnostic value of bronchoscope. Methods Clinical data of 92 cases of misdiagnosis of tracheobron?chial tuberculosis by electronic bronchoscopy in our department from January 2006 to January 2012 were analyzed retrospec?tively. Bronchoscopy, endoscopic biopsy, brushing, lavage and radiological images were all compared. Results Clinical symptoms and laboratory tests showed no specificity in diagnostic value;Chest X-ray was not typical. Bronchial stenosis was seen in 45 cases(48.9%)and bronchial obstruction was seen in 6 cases(6.5%)as shown in chest CT while no abnormality in the bronchus was seen in 41 cases(44.6%). Bronchoscopy revealed 28 cases (30.4%) of inflammatory infiltration, 14 cas?es (15.2%) of necrotizing ulceration, 35 cases (38.0%) of granulation hyperplasia and 15 cases (16.3%) of Scar stricture. En?doscopic biopsy confirmed 56 cases (60.9%), while bronchoscopic brushing and examination of acid-fast bacillus approved 32 cases (34.8%). Then, bronchoscopic lavage of acid-fast bacillus verified 39 cases (42.4%). Lastly, tuberculosis bacterium culture ascertained 75 cases (81.5%). Conclusion Bronchoscopy of local lesion with brush, lavage and biopsy is the most sensitive and specific diagnostic method to diagnose tracheobronchial tuberculosis. It has great clinical value in preventing tracheobronchial tuberculosis misdiagnosis.
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Objective:To summarize the clinical characteristics of 7 sporadic cases in children of influenza A (H1N1)broken out in Tianjin,and to provide clinical experience and prognosis factors for the diagnosis and prevention of this disease.Methods:The clinical data and protective measures were retrospectively analyzed in 7 children with H1N1 confirmed by Tianjin Haihe Hospital from June 9,2009 to September 21,2009,and the related literatures were reviewed.Results:There were six imported cases of H1N1 and one second-generation case.Fever and cough were the main symptom in children.There were 5 children with hyperpyrexia.Three were with expectoration.Other symptoms included anergy,dizziness,headache,nasal discharge,sneeze and pharyngalgia.Two of these children were with leukocytosis decrease,two were with infection of leukocytosis,and others were normal.Five of these children were with normal chest X-ray,one with texture disorder, and one with bilateral multiple infiltrating image.The positive influenza A virus result was detected by real-time PCR and sequencing comparison in the throat swab samples taken within 2 days from the seven children,and became negative after 5-9 days in the course of this disease.Six patients were accepted osehamivir treatment for 5 days.One was treated only with anti-virus mixture.The average length of hospital stay was 7.9 days.When the children were discharged from hospital,all the symptoms were disappeared.All the patients'families,doctors and nurses were not infected in non-directly exposed to the disease.Conclusion:The seven child patients showed mainly symptoms of fever and cough.The average course was 9.1 days,and they were all cured.Therefore,influenza A(H1N1)is preventable and curable.
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In order to simplify the technique of extracorporeal membrane oxygenation (ECMO) and apply extracorporeal life support ( ECLS) broadly for assisting the treatment of severe respiratory failure patients, we have developed a blood-gas exchanger (BGE) with the characteristics of small volume and simple structure. The exchange between blood and gas of BGE adopts cross-flowing model; blood flows along the outer hollow fiber and gas flows in the inner hollow fiber with the reverse direction of blood flowing. The interface of blood flow in and out was designed as the internal spiral, and the caliber of BGE is matched with the blood interface of dialysis. Thus it may successfully make single-use spiral connectors link up mutually in the extracorporeal blood circulation of dialysis, may help clinical operations become safe, convenient and easily-controlled, and may simplify the technique of EGMO.