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@#Management of complicated massive infective endocarditis (IE) in patients who are contraindicated for surgical valve replacement has long been a dilemma for many clinicians. Studies have shown that massive IE patients who were treated conservatively generally result in poorer prognosis. We report two cases of massive native valve infective endocarditis with severe mitral valve regurgitation and septic emboli that has been successfully treated conservatively. Interestingly, despite having a large vegetation and multiple septic emboli complications, none of these two cases had any positive culture or serology. Managing culture negative IE without surgical intervention pose an even greater challenge to the choice and duration of antibiotics with further long-term plans. We hope to share these case series to aid in the management dilemma of similar cases in the future.
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Objective: To explore the safety, feasibility and clinical value of Da Vinci robot system-assisted pulmonary surgery. Methods: The clinical data of Da Vinci robot system-assisted pulmonary surgery in our department were collected retrospectively and analyzed. Results: From March 2016 to November 2017, we enrolled 58 patients (42 males and 16 females, mean age 59±11 years) for the robotic system-assisted pulmonary surgery at our hospital. All surgeries were successfully completed, which consisted of lobectomy in 41 cases, segmentectomy in 7 cases, pulmonary wedge-shaped resection in 6 cases, pulmonary sleeve resection in 2 cases, combined resection in 1 case, and wedge-shaped resection & segmentectomy in 1 case. The postoperative diagnosis was benign lesions in 17 cases, and lung cancer in 41 cases. The average operation time was 169.93±66.88 mins for lobectomy and 165.43±56.37 mins for segmentectomy. The lymph node resection ranged from 5 to 26 pieces (mean of 15.1±8.7 pieces). The postoperative drainage time ranged from 2 to 15 days (mean of 6.0±2.6 days) and hospitalization time was 2 to 21 days (mean of 7.95±3.23 days). All but one patient recovered smoothly and were discharged with the total cost ranging from 32 015.57 to 127 087.89 yuan (mean of 78 483.19±15 925.18 yuan). The patient with bronchopleural fistula after resection was successfully treated with lobectomy. Conclusion: Da Vinci robotic system-assisted pulmonary surgery can be performed successfully in a center with extensive experience in thoracoscopic surgery. It is safe, feasible and advantageous in some complex operations, but the relatively expensive cost is an important factor that affects its wide application.
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<p><b>OBJECTIVE</b>To study the electrochemical corrosion behavior of Co-Cr, Ni-Cr and Ni-Cr-Be based porcelain alloys in NaCl solution.</p><p><b>METHODS</b>Five samples of each alloy were made respectively, electric polarization curve of each alloy was obtained using potentiodynamic polarization technique. Self-corrosion potential (E(corr)), self-corrosion current density (I(corr), passive region and transpassivation potential were tested. Microstructure and constituent was examined using scanning electron microscopy and energy dispersive spectroscopy.</p><p><b>RESULTS</b>Co-Cr alloy possessed the most desirable corrosion resistance because of its integrated, homogeneous and compact passive film. The poor compactness of Ni-Cr alloy's passive film decreased its corrosion resistance. Ni-Cr-Be alloy exhibited the worst corrosion resistance due to the Cr and Mo depleted Ni-Be eutectic phases in the alloy.</p><p><b>CONCLUSION</b>Taking biological security into consideration, it is necessary to avoid the application of porcelain alloys with Be element. Co-Cr alloy with better biocompatibility possesses much broader prospect in the field of dental restoration.</p>