Résumé
Objective To summarise the experience of surgical treatment of invasive pulmonary fungal infection in patients with hematologic malignancies.Methods From Jan.2000 to Dec.2012,78 hematologic patients with invasive pulmonary fungal infections,including 49 males and 29 females with average age of 29.6 years,underwent surgical treatment.Preoperatively,all patients with 1 to 3 courses of chemotherapy had received average 4 weeks antifungal treatment.There were 58 cases received conventional open thoracic surgery and 20 cases received VATS including lobectomy,segmentectomy,wedgectomy.Results The procedures were successful,the average operation time w as(125.3 ± 35.7) min and intraoperative blood loss was(253.1 ± 42.8) nl.There were no severe postoperative complications.The main complications were excessive effusion (10.2％) and persistence airleak (7.7％).The hospital days was(7.8 ± 2.5) days,no reoperation and death case in 30 days after operation.The follow-up was from 6 to 24 months,38 cases(48.7％) received prophylaetic antifungal treatment,no ease with fungi spread and recurrence.Conclusion The surgical treatment is safe and useful for the hematologic patients with invasive pulmonary fungal infections,when internal medicine conservative treatment is invalid.
Résumé
Objective To compare the efficacies of the treatment of sternal fracture with wire fixation and the titanium sternal fixation system. Methods Thirty patients with sternal fracture from May 2003 to July 2009 were followed up. Among them,there were 20 patients with wire fixation (wire fixation group), 10 patients with the titanium sternal fixation system (titanium sternal fixation system group). The conditions before, during and after operation,complications and effects were compared to evaluate the effieaeies of titanium sternal fixation system. Results The operative time of titanium sternal fixation system group and wire fixation group were (67.0 ± 7.9) min and (90.0 ± 8.6) min, the blood loss were (11.0 ± 5.4) ml and (48.0 ± 8.4)ml,the duration of drainage were (0.5 ± 0.4) days and (1.9 ± 0.7) days,the amount of drainage were (1.9 ± 1.3) ml and (19.0 ± 4.6) ml, the average hospitalized days were (2.3 ± 0.5) days and (6.9 ± 0.9) days, the duration of pain were (1.5 ± 0.5) days and (3.8 ± 1.1) days, there were all significant difference between two groups (P < 0.05). The rates of wound infection, delayed union or nonunion, re-fracture,plate fracture or plate shift of wire fixation group were 5% (1/20) ,5% (1/20) ,5% (1/20), 10% (2/20). But the rates of titanium sternal fixation system group were 0, there were all significant difference between two groups (P < 0.05). Conclusion The treatment of sternal fracture with titanium sternal fixation system is a simple and stable fixation,high bone union rate and few complications,especially for the sternal fracture.
Résumé
Objective To explore the significance of mediastinum drainage tube in prevention and treatment of intrathoracic anastomotic leak after esophagectomy. Methods The morbidity and prognosis of intrathoracic anas-tomotic leak after esophagectomy in 180 patients with esophageal or cardia carcinoma (group A) who used mediasti-num drainage tube in operation from 2006 to 2008 was studied retrospectively,and were compare with 154 patients (group B) without mediastinum drainage tube from 2004 to 2006. Results The morbidity of intrathoracic anasto-motic leak after esophagectomy was 1.67% (3/180) in group A,and 4.55% (7/154) in group B,but no difference between them(χ2=1.4807, P>0.05) were found. Compared to group B, the final diagnosis of anastomotic leak in group A was early [(6.7±0.6) vs (10.0±2.1) days after operation (t=2.62, P<0.05)] and the duration of fe-ver was short [(5.3±1.5)vs (43.0±20.9) hours (t=4.39, P<0.01)]. The prognosis of 3 cases in group A was well, who all recovered without operation and had shorten hospital days than group B [(23.7±5.9)d vs (45.3± 5.0)d,t=4.86,P<0.01)]. In 7 cases of group B,there were 5 cases underwent second operation,but only 3 cases recovered, the case fatality rate was 2.60% (4/154), higher than in group A (0, Fisher, P<0.05). Conclusions Although the mediastinum drainage tube used or not used in esophagectomy is unrelated with the occurrence of anas-tomotic leak, and the significance to use it is that it can help to discover anastomotic leak early, and control mediasti-num infection effectively without reoperation,and improve patients' prognosis.
Résumé
Purpose:To study the effects and overexpression of p21 WAF1/CIP1 gene (p21 gene) on the SGC 7901 cell line plus cisplatin. Methods:An adenovirus expression vector with full length cDNA of p21 gene insert was constructed (ad p21) and transferred into SGC 7901 cell line with p53 mutation, the effects of ad p21 on the growth of SGC 7901 cell line was examined in vitro and in vivo . Results:The expression of p21 gene in SGC 7901 cell was confirmed by FCM, The growth of the Ad p21 gene transfected SGC 7901 cells was significantly inhibited as compared to mock (Ad LacZ) transfected SGC 7901 in vitro and induced the transfected cells appearing apoptotic, Combined with chemotherapeutic agent cisplatin (DDP), it could more strongly inhibit SGC 7901 cell growths.Conclusions:p21 gene can inhibit SGC 7901 cells growth and shows enhanced therapeutic efficiency for SGC 7901 cells when combined with DDP, especially in vivo experiment. Its use for gene therapy of cancer, especially when combined with other apoptosis inducing agents is promising.
Résumé
Objective To understand the air pollution by microorganisms in the underground spaces. Methods 51 underground spaces were investigated, the impact and sedimentation sampling methods were employed and the total bacterial count, mycetes, streptococcus and anaerobes in air were determined. ELESA was used to detect aflatoxin B1 in aspergillus flavus isolated from air. Results The total bacterial count in the air in underground spaces accorded with the military health standard. In the semi-closed spaces,the mycetes counts were 5 950 cfu/m3 and 9 500 cfu/m3 in aisle and rooms respectively, significantly higher than those in control group (P
Résumé
Objective To observe the effect of air disinfection with chlorine dioxide(ClO2)in the saps and determine the concentration change in order to ensure the safety for people to enter the saps.Methods The disinfection was done at the concentration of 1 000 mg/L and the spray dose of 10 ml/m3 and then to count the total bacteria and fungi with the cascade impactors in the saps before and after air disinfection and to monitor the concentration of ClO2 with the air ClO2 monitor(iTX).Results The 94.6% of the total bacteria and 92.1% of the fungi died in 30 minutes after disinfection.The concentration of ClO2 in the air decreased from 10 mg/m3 to 0.8 mg/m3 81 minutes later and to 0.3 mg/m3 96 minutes later,after 120 minutes,it was 0 mg/m3.Conclusion The air disinfection effect of ClO2 used at the dose of 10 ml/m3 and the concentration of 1 000 mg/L is satisfactory.96 minutes after disinfection,the concentration of ClO2 is safe for human health.