Effects of bronchofibroscopic bronchoalveolar lavage on serum inflammatory cytokines levels in patients with severe ventilator-associated pneumonia / 国际检验医学杂志

Objective To investigate the effect of bronchofibroscopic bronchoalveolar lavage on serum inflammatory cytokines in the patients with severe ventilator-associated pneumonia(VAP) .Methods 68 cases of severe VAP were divided into the control group and observation group according to the random number table method ,34 cases in each group .The control group used conventional alveolar lavage plus sputum suction treatment ,while the observation group adopted bronchofibroscopic bronchoalveolar lavage plus sputum suction treatment .The lung infection control time ,mechanical ventilation treatment time ,time of body temperature recovery to normal ,pulmonary infection score(CPIS) ,white blood cell(WBC) count ,respiratory function ,blood gas indexes and serum inflammatory factors levels were compared between the two groups .Results The lung infection control time ,mechanical ventilation treatment time ,recovery time of normal temperature ,blood gas indexes and serum inflammatory factors levels after treatment in the observation group were significantly superior to those in the control group (P＜0 .05) .Conclusion Bronchofibroscopic bronchoalveolar lavage can significantly improve the respiratory function and blood gas indexes ,reduces the serum inflammatory factors levels in the patients with severe VAP .

Application of flexible fiberoptic bronchoscopy for the critical patients with severe respiratory diseases in PICU / 中国小儿急救医学

Objective To explore the role of flexible fiberoptic bronchoscope(FFB) in the critical patients with severe respiratory diseases of PICU.Methods One hundred and eighty-nine cases of severe respiratory diseases had undergone FFB from Jul 2010 to Jan 2011.One hundred and fifty-seven (83.06％) cases were less than 3 years.FFB examinations were made through nose (226 times) and endotracheal intubation (25 times).Bronchoscopic lavage for bacterial culture was performed by injecting normal saline solution (NSS) via a syringe into the working channel of FFB.Results Of all 189 cases,bacteria were isolated from 80 cases (42.3％) for bacterial culture of bronchoscopic lavage fluid,which included G-bacilli in 51 cases,G + cocci in 21 cases,and fungi in 8 cases.Six cases with tracheobronchial foreign bodies and 31 cases with respiratory tract anatomical abnormalities were found through FFB.Forty cases of severe pneumonia complicated with respiratory failure underwent bronchoscopic lavage,which were effective in 35 cases,and ineffective in 5 cases.In 20 cases of severe pneumonia atelectasis,pulmonary reexpansion were found in 16 cases by bronchoscopic lavage,atomization inhalation,and systemic administration,4 cases improved.Tracheobronchial foreign bodies were removed in all 6 cases by FFB.During FFB,bradycardia was found in 1 cases.There was no FFBrelated death.Conclusion FFB is safe for severe patients with respiratory diseases in PICU.FFB play important role in diagnosis and treatment for children in PICU,including feasible intervention under bronchoscopy.

Manifestaciones clínicas y evaluación diagnóstica en el Sarcoma de Kaposi / Clinical features and diagnostic evaluation in Kaposi´s sarcoma

El Sarcoma de Kaposi (SK) es una causa de compromiso respiratorio en el VIH/SIDA, que clásicamente ha indicado un pronóstico desfavorable. Esta definición está modificándose,según la extensión y alcance de los tratamientos actuales con antiretrovirales (HAART). Se exponen los rasgos clínicos y los recursos diagnósticos empleados en dos pacientesasistidos en nuestro hospital universitario. Las lesiones mucocutáneas generalizadas, los patrones característicos de tomografía computada de alta resolución (TCAR) junto a los hallazgos fibrobroncoscópicos (FBC) son descriptos en ambos casos. Se discuten los diagnósticos diferenciales para neoplasias e infecciones oportunistas, con la correspondiente revisión bibliográfica.

Kaposi´s sarcoma (KS) is considered one of the most severe manifestations related to lung involvement in HIV/AIDS. Present therapy with HAART has modified the incidence and prognosis of Kaposi´s sarcoma. However, KS is still a prevalent condition in HIV/AIDS patients. Clinical features, diagnostic patterns from High Resolution Computed Tomography (HRCT), and bronchofibroscopy findings are described in two patients.Differential diagnosis for main conditions in the AIDS clinical context (malignant neoplasm, opportunistic infections) is discussed with a review of previous reports.

Diagnosis evaluation of single and consociation to drawing materials methods with bronchofibroscopy in pulmonary carcinoma / 中国实用内科杂志

Objective To evaluation the Diagnosis value of single and consociation to drawing materials methods with bronchofibroscopy in pulmonary carcinoma.Methods 481 diagnosed patients with pulmonary carcinoma by bronchofibroscopy during July 2000 to July 2006 were analyzed.Four different drawing materials method including clamping,brushing,needling and rinse checking were used to diagnose.The positive rates of these four methods were compared with single and consociation to drawing materials methods.Results The positive rate of clamping,brushing,needling and rinse checking were 83.9%,70%,59.1%and 35.9%respectively,and the total positive rate was 90.2%after being united.Conclusions Bronchofibroscopy is one of the most important methods in diagnosing pulmonary carcinoma. Using multiple drawing materials methods in bronchofibroscopy can improve the accuracy rate of diagnosis of lung cancer significantly.