Résumé
To compare the performance of self-inflating bag (SIB) with T-piece resuscitator (TPR) in neonatal resuscitation.Methods:This study involved the trainees participating in a Neonatal Resuscitation Simulation Camp (NRSC) organized by Shanghai First Maternity and Infant Hospital in December 2019. They were trained to provide positive pressure ventilation with the two devices on artificial lungs. Ventilation parameters including peak inspiratory pressure (PIP), positive end-expiratory pressure (PEEP), PIP in pulmonary alveoli (PIP alv), mean airway pressure (MAP), frequency, inspiratory time (Ti), tidal volume and minute ventilation volume were recorded and analyzed by independent sample t-test or rank sum test. Results:The PIP alv, PIP, oxygen flow rate, tidal volume and minute ventilation volume delivered by TPR were significantly lower than those by SIB [(17.18±1.61) vs (24.05±4.29) cmH 2O (1 cmH 2O=0.098 kPa), t=－6.87; (17.91±1.35) vs (29.97±4.50) cmH 2O, t=－14.06; (3.65±0.25) vs (6.88±1.59) L/min, t=－11.33; (15.90±1.81) vs (24.02±4.29) ml/min, t=－10.99; (664.71±88.94) vs (1 069.49±205.68) ml/min, t=－9.89; all P<0.001]. However, compared with SIB, the PEEP in pulmonary alveoli, Ti, duration of ventilation, inspiratory to expiratory ratio were increased when using TPR [(4.76(4.69-5.57) vs 0.19(0.12-4.10) cmH 2O, T=1 190.00; (0.59±0.15) vs (0.43±0.09) s, t=5.01; (1.46±0.23) vs (1.36±0.11) s, t=2.15; 0.71±0.22 vs 0.47±0.13, t=5.14; all P<0.05]. Conclusion:TPR could deliver more stable and safer PIP, PEEP and tidal volume than SIB and keeping MAP at a stable level during positive pressure ventilation on artificial lungs.
Résumé
Objective To compare the toxicity between different dose fractionation regimens in postoperative radiotherapy for prostate cancer. Methods Patients with prostate cancer who received postoperative radiotherapy with moderate hypo-fractionation ( 62. 75 Gy in 25 fractions, 2. 51 Gy per fraction) or conventional fractionation (72 Gy in 36 fractions, 2 Gy per fractions) in our hospital from 2011 to 2017 were enrolled as subjects.All patients received intensity-modulated radiotherapy and daily cone-beam computed tomography image-guided radiotherapy. According to the propensity score matching ( PSM ) method, 35 patients treated with moderately hypo-fractionated radiotherapy were matched to 35 patients treated with conventionally fractionated radiotherapy based on age, irradiated volume, hormonal therapy, interval between surgery and radiotherapy, and comorbidities ( diabetes and hypertension). Toxicity was evaluated according to Radiation Therapy Oncology Group criteria. Comparison was made by the Fisher's exact probability test. Results One hundred and thirteen patients, consisting of forty-one in moderate hypo-fractionation group and seventy-two in conventional fractionation group, were enrolled as subjects. The median follow-up time in the two groups was 5. 6 and 45. 0 months, respectively. There were no significant differences in incidence rates of grade 2 acute gastrointestinal (GI) or genitourinary (GU) toxicity between the two groups ( 7% vs. 7%, P＝ 1. 000; 15% vs. 17%, P＝ 0. 847). After PSM, there were still no significant differences in incidence rates of grade 2 acute GI or GU toxicity between the two groups (9% vs. 11%, P＝0. 814; 14% vs. 11%, P＝ 0. 670). None of patients reported ≥grade 3 GI or GU toxicity. Conclusions Preliminary results show that moderate hypo-fractionation, compared with conventional fractionation, does not increase the risk of acute GI or GU toxicity in patients undergoing postoperative radiotherapy for prostate cancer.
Résumé
OBJECTIVE To investigate the distribution of Pseudomonas aeruginosa and its antibiotic resistance in(emergency) intensive care unit(EICU) patients with lower respiratory infections.METHODS The data of the pathogens isolated in sputum from the 25 patients with lower respiratory infections admitted to EICU from(Aug) 2005 to Feb 2006 were collected and analyzed.RESULTS Eighty-one bacteria strains were found in these 25 EICU cases.The Gram-negative bacteria were the main pathogens of infection(43.2%),after them were Gram-positive bacteria(32.1%),and fungi(24.7%).The percentage of P.aeruginosa infection was 13.6% of all(patients).The antibiotic resistance for P.aeruginosa was found to the antibiotics,such as cefotaxime,gentamicin,(SMZ-TMP),minocycline,levofloxacin,and gatifloxacin.CONCLUSIONS The P.aeruginosa infection and its(antibiotic) resistance should be paid more attention in the treatment of the lower respiratory infection patients in EICU.