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Objective:To explore the application value of virtual reality technology in thoracoscopic anatomical segmentectomy.Methods:Eighty-four patients with early stage non-small cell lung cancer admitted to the First Hospital of Jiaxing from December 2017 to December 2018 were enrolled in the study.They were divided into observation group and control group according to the random digital table method, with 42 cases in each group.The observation group used virtual reality technology to construct a three-dimensional digital model, and performed preoperative evaluation and simulated surgical drills and intraoperative navigation on the three-dimensional digital model, based on the preoperative evaluation and simulated surgical drill results, combined with the specific actual situation during the operation, developed and implemented individualized thoracoscopic anatomical segmentectomy.Thoracoscopy anatomical segmentectomy was routinely performed in the control group.The operation time, intraoperative blood loss, intraoperative lymph node dissection number, intraoperative lymph node dissection, postoperative hospital stay, postoperative thoracic closed drainage tube, total postoperative drainage, total hospitalization, cost and incidence of postoperative complications were compared between the two groups.Results:The operation of both two groups was successfully completed, and no intraoperative thoracic surgery was performed during the operation.There was no perioperative death.The operation time, intraoperative blood loss, intraoperative lymph node dissection number, intraoperative lymph node dissection, postoperative hospital stay, postoperative thoracic closed drainage tube, total postoperative drainage, total hospitalization cost and the incidence of postoperative complications in the observation group were (100.98±26.51)min, (67.98±32.96)mL, (7.79±1.32), (11.98±4.69), (4.60±1.43)d, (2.86±0.81)d, (437.14±193.86)mL, (3.76±0.31)million, 9.52%(4/42), respectively, which in the control group were (114.88±24.26)min, (104.52±52.37)mL, (6.45±0.3), (8.31±1.94), (6.50±2.55)d, (4.00±2.25)d, (667.26±415.01)mL, (4.20±0.65)million, 26.19%(11/42), respectively, the differences between the two groups were statistically significant ( t=-2.208, -3.328, 5.916, 4.678, -4.221, -3.993, -3.265, -3.968, χ 2=3.977, all P<0.05). No local recurrence or distant metastasis was found during the follow-up period. Conclusion:Virtual reality technology can provide preoperative evaluation and simulated surgical exercises and intraoperative navigation for thoracoscopic anatomical segmentectomy, which can reduce the difficulty of surgery and improve the accuracy and safety of the operation.
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Objective To investigate the clinical efficacy of thiophene tiotropium powder inhaler for postop-erative lung function recovery in lung cancer patients.Methods 80 patients of thoracic surgery lobectomy who had lung cancer were selected as research subjects.The patients were randomly divided into two groups.The observation group received tiotropium bromide powder for inhalation therapy,the control group was inhaled salmeterol /fluticasone propionate powder for inhalation therapy.Before treatment,after treatment,2d,6d of CRP,absolute neutrophil ANC, tumor necrosis factor α(TNF -α) were observed.Before treatment,after treatment 4 weeks,8 weeks of forced vital capacity (FVC),within one second force expiratory volume in FEV1 ,FEV1 percent predicted (FEV1%),FEV1 /FVC, PaO2 ,PaCO3 were detected.Results Before treatment,CRP,AND,TNF -αhad no significant differences between the two groups (all P >0.05).Postoperative 2d,CRP,ANC,TNF -αof the two groups were all increased.Postopera-tive 6d,the above indicators of the two groups were declined,and the decline of the observation group was significantly lower than the control group (t =3.163 4,3.651 8,4.025 3,all P 0.05).4 weeks,8 weeks af-ter treatment,FVC,FEV1%,FEV1 /FVC,PaO2 of the observation group were significantly higher than the control group (t =2.041 8,4.116 7;2.043 1,3.722 8;3.056 2,4.138 6;3.227 6,5.161 9;all P <0.05),FEV1 ,PaCO3 were significantly lower than the control group (t =1.523 7,3.427 6;3.439 2,4.521 7;all P <0.05).Conclusion Tiotropium bromide inhalation powder agents has certain effect on lung function recovery for lung cancer patients after surgery,it is worthy of clinical application.
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To analysis the reason of the arguments of “Sexual hallucinations” or “Sexual harassment”between clinicians and patients,and find out how to prevent its happening.Methods:Base on clinical case about patients complaints that clinicians sexually assault,review and analysis the prtinent literatures.Results:Sexual hallucinations is a complication following anesthesia with psychotropic drugs,it 's easy to be misunderstand as Sexual harassment and result in allegations of sexual misconduct between patient and clinician.Conclusion:Clinicians need to be aware that sexual hallucinations to occur during sedation or after anesthesia,to protect themselves against the accusations of sexual harassment,the practitioner should never be unchaperoned with a patient of the opposite sex during sedation or anesthesia.