Perioperative mechanical ventilation strategy for COVID-19 patients: Recommendation / 中国胸心血管外科临床杂志

@#Since December 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has gradually spread all over the world. With the implementation of class B infectious disease management policy for coronavirus disease 2019 (COVID-19), China has experienced a pandemic. For patients receiving a time-sensitive or emergency surgery, SARS-CoV-2 infection may increase the risk of postoperative pulmonary complications. An appropriate perioperative mechanical ventilation strategy, such as lung protective ventilation strategy, is particularly important for preventing postoperative pulmonary complications in patients undergoing general anesthesia. In addition, how to protect medical personnel from being infected is also the focus we need to pay attention to. This article will discuss the perioperative mechanical ventilation strategy for COVID-19 patients and the protection of medical personnel, in order to provide reference for the development of guidelines.

A consensus on the management of allergy in kindergartens and primary schools / 中国学校卫生

Abstract@#Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

Uridine diphosphate glucuronide transferase 1A1FNx0128 gene polymorphism and the toxicity of irinotecan in recurrent and refractory small cell lung cancer.

OBJECTIVE: The aim was to investigate the association between uridine diphosphate glucuronide transferase 1A1 (UGT1A1) gene promoter region polymorphism and irinotecan-related adverse effects and efficacy on recurrent and refractory small cell lung cancer (SCLC). MATERIALS AND METHODS: A total of 31 patients with recurrent and refractory SCLC were enrolled in this study from June 2012 to August 2013 and received at least two cycles of single-agent irinotecan chemotherapy. The efficacy and adverse effects of irinotecan were evaluated. DNA was extracted from peripheral blood and direct sequencing method was employed to test UGT1A1FNx0128 polymorphism, thus analyzing the correlation between UGT1A1FNx0128 polymorphism and irinotecan-related side-effects and efficacy. RESULTS: A total of 25 cases (80.6%) were UGT1A1FNx0128 wild-type (TA) 6 /(TA) 6 ; 6 cases (19.4%) were heterozygous mutant (TA) 6 /(TA) 7 , no homozygous mutant genotype (TA) 7 /(TA) 7 was found. The incidences of grade 3/4 neutropenia, diarrhea and thrombocytopenia were 35.5%, 25.8% and 22.6% in all the patients, respectively. The incidence of 3/4 adverse effects in patients with genotype (TA) 6 /(TA) 6 and heterozygous (TA) 6 /(TA) 7 had no statistical difference (P > 0.05 for all). The overall response rate (ORR) was 32.3%. Median progression free survival (PFS) and overall survival (OS) were 4 months and 7.5 months in all patients, respectively. There was no statistical difference in ORR, PFS and OS between genotype (TA) 6 /(TA) 6 patients and heterozygous (TA) 6 /(TA) 7 patients. CONCLUSION: Irinotecan showed efficacy in patients with recurrent and refractory SCLC; UGT1A1 FNx01 28 polymorphism failed to predict the incidence of serious adverse effects and efficacy of irinotecan.

The effect of selectively upward placement of acetabular implants on limb length and post-operative function of develop-mental dysplasia of the hip patients with shortened legs / 中华骨科杂志

Objective To investigate the effect of selectively upward placement of acetabular implants on limb length and post?operative function of developmental dysplasia of the hip patients with shortened legs during total hip arthroplasty (THA). Methods Twenty?six cases of developmental dysplasia of the hip received THA between January 2008 and December 2013, in?cluding 12 cases of Crowe typeⅠ, 8 of Crowe typeⅡ, 6 of Crowe typeⅢ. There were 5 males and 21 females with an average age of 62.7 years (range, 36-80 years). The left hip was involved in 9 cases and the right hip in 17 cases. The preoperative mean Har?ris score was 42.30±12.84, and the preoperative mean WOMAC score was 59.08±13.84 at the last follow?up. The anteroposterior X?ray films and CT scan of the pelvis, anteroposterior and lateral X?ray films of the femur, and TraumaCad analysis were conducted routinely preoperation. More than 70%of the bone?implant interface was covered by appropriate upward distance of acetabular im?plant. Results The follow?up time ranged from 6 to 73 months (mean, 36 months). The Harris score improved to 91.18±7.09, and WOMAC score reduced to 9.85±3.75. According to postoperative measurement, affected limb had been lengthened by 0-5 mm in 8 cases, 6-10 mm in 5 cases, 11-15 mm in 5 cases,>15 mm in 7 cases, and shortening increased 1 mm in 1 case, but the average lengthening was 9.23±7.54 mm. The upward distance of acetabular implant was 0-5 mm in 10 cases, 6-10 mm in 7 cases and>10 mm in 9 cases. The average lengthening was 6.60±6.72 mm in patients having 0-5 mm upward distance, 11.90±5.64 mm in patients having 6-10 mm upward distance and 10.11 ± 9.35 mm in patients having>15 mm upward distance, showing no significant differ?ence. The leg length discrepancy was-3.70±6.43 mm in patients having 0-5 mm upward distance, 1.71±6.24 mm in patients having 6-10 mm upward distance and 0.56 ± 7.70 mm in patients having>15 mm upward distance, showing no significant difference. Con?clusion The limb length could be improved by selectively upward placement of acetabular implants in developmental dysplasia of the hip patients with anatomically abnormal acetabulum during THA, with reasonable preoperative design and corrective operation.

Recent results of concurrent chemoradiotherapy with lobaplatin and paclitaxel in advanced esophageal carcinoma / 肿瘤研究与临床

ObjectiveTo investigate the recent treatment result and the toxic responses of chemoradiotherapy with lobaplatin and paclitaxel in advanced esophageal carcinoma. MethodsFrom April 2010 to May 2011, 26 initial treatment patients withadvanced esophageal carcinoma were enrolled. The chemotherapy consisted of paclitaxel (135 mg/m2) on day 1 and lobaplatin (35 mg/m2) on day 2,and one cycle continued 21 days. Radiotherapy started on the second day after the fist cycle of chemotherapy. The median total dose was 60 Gy (2 Gy/Fraction,30 fractions,completed in 6 weeks).ResultsThere were 52 cycles in all and mean 2 cycles per patient.CR occurred in 7 patients (26.9 ％),PR in 17 patients (65.4 ％) and SD in 2 patients (7.7 ％).The total effective rate was 92.3 ％ (CR+PR).The toxic responses mainly represented as following,myelotoxicity principally showed leucopenia at grade Ⅰ - Ⅱ occurred 46.1％ (12/26) and at grade Ⅲ-Ⅳ 46.1％ (12/26),thrombopenia at grade Ⅰ - Ⅱ occurred 30.8 ％ (8/26) and at grade Ⅲ-Ⅳ 7.7 ％ (2/26),hypohemoglobinemia at grade Ⅰ - Ⅱ occurred 42.3 ％ (11/26) and at grade Ⅲ 15.4 ％ (4/26).Baldness occurred 84.6 ％(22/26). Pain of muscles or arthralgia occurred 69.2 ％(18/26). Responses of gastrointestinal tract at grade Ⅰ - Ⅱ occurred 11.5 ％ (3/26).Radiation induced esophagitis occurred 88.5 ％ (23/26) and tracheitis 19.2 ％ (5/26).ConclusionThe toxic responses of concurrent chemoradiaotherapy with lobaplatin and paclitaxel in advanced esophageal carcinoma are tolerant, and the recent treatment result is good.Further study is needed.