ObjectiveTo summarize the effect of staged operations strategy for delayed spontaneous rupture of esophagus with empyema.MethodsThree patients in the department of thoracic surgery of the second affiliated hospital of Guangzhou medical university underwent staged operative treatment for delayed spontaneous rupture of esophagus with empyema.The primary operative procedure consisted of removal of empyema sac,T-tube drainage and jejunostomies.The second operative procedure included alimentary reconstruction with thoracic esophageal resection and exclusion,or with esophageal resection and exclusion later.ResultsAll cases were cured with mean hospitalization of 78.7 days.None of them had any dysphagia at followup of 5-14 months.ConclusionDelayed spontaneous rupture of esophagus with empyema can be managed safely and effectively through staged operations strategy.

Objective To explore the effect of nuclear factor-kappa B (NF-κB) decoy oligode-oxynucleotides (ODN) on respiratory function and expressions of IL-1β and IL-13 in serum following se-vere lung contusion in rabbits. Methods A total of 40 New-Zealand rabbits were randomly divided into four groups, ie, severe lung contusion group (Group A, n=12), severe lung contusion with NF-κB scrambled decoy ODN intervention group (Group B, n=12), severe lung contusion with sense NF- B de-coy ODN intervention group (Group C, n=12) and normal control group (Group D, n =4). After the contusion model was set up, the sense and scrambled NF-κB decoy ODN were infused into the rabbits via the jugular veins in different groups, with 20 g per experimental rabbit. After contusion, respiratory fre-quency, tidal volume, airway pressure, respiration flow rate curve and end expiration nitric oxide concen-tration were detected at 1, 2, 3 and 4 hours. The expressions of IL-1β and IL-13 in serum were observed by means of ELISA. Results After sense NF-κB decoy ODN intervention, alveolar ventilation, arteri-al PO_2 and pulmonary compliance were improved, compared with Group A and Group B, with statistical difference (P<0.01). The expression of IL-1β was decreased and that of IL-13 increased after sense NF-κB decoy ODN intervention to the severe lung contusion, compared with Groups A and B, with statis-tical difference (P <0.01). The expression of IL-1β was increased to peak level at 1 hour after contu-sion, which continued to the end of the experiment. While expression of IL-13 was decreased at 1 hour af-ter contusion and reached the minimum level at 4 hours. With intervention with sense decoy ODN, the in-creased expression of IL-1β was down-regulated, but expression of IL-13 remained at high level, with sta-tistical difference compared with Group A and Group B (P < 0.01). Conclusions Intervention with sense NF-κB decoy ODN can significantly protect the respiratory function, reduce the expression of IL-1β and increase expression of IL-13 after severe lung contusion.

Objective To discuss the value of video -assisted thoracoscope technology in diagnosis and treatment of thoracic trauma .Methods Form January 2009 to December 2013, a retrospective analysis was carried out on 43 patients with thoracic trauma .All the patients were treated with video -assisted thoracoscope technology . Results The procedure were successful and all the patients were cured out of hospital .Conclusion It is wide oper-ation indication, little harm, definite treapeutic effect, little complication and fast recovered to treat the patient with thoracic trauma using video -assisted thoracoscope technology , and it is a good choice for diagnosis and treatment in thoracic trauma.

Objective To investigate the changes of serum TNF-α,IL-1β,IL-10,IL-13,lung ultrastructure and respiratory function in the early stage of pulmonary contusion. Method 16 white rabbits were randomly assigned to lung contusion group and control group. Pulmonary contusion was established. Serum TNF-α,IL-1β, IL-10 and IL-13 level at 1 ,2 ,3 and 4 h after contusion were tested. Respiratory function data was obtained and ultrastructure was observed. Results In the early phase after pulmonary contusion ,the expression of IL-1β and TNF-αincreased while IL-10 and IL-13 decreased continuously. Lung ultrastructure changes included alveolar dam-age and massive erythrocyte sedimentation and inflammatory cell exudation in alveolar cavity. Alveolar ventilation and PO2 decreased significantly,P-AO2 increased continuously and lung compliance reduced. Conclusions In the early phase after pulmonary contusion ,the expression of IL-1β and TNF-α increases while IL-10 and IL-13 de-creases,lung ultrastructure is progressively destructed and lung function is severely damaged.

Objective To explore the reasons and countermeasures for neonatal PICC abnormal extubation.Methods Retrospective research method was used to count and analyze the risk factors of eighty six cases with neonatal PICC abnormal extubation.Results Among clinical research participates, there were thirteen cases of abnormal tube drawing, accounted for 15.12% (13/86), among which ectopic catheter accounted for 46.15% (6/13), tube plugging 15.38%(2/13),Catheter Related Blood Stream Infection (CRBSI) 15.38%(2/13), phlebitis 7.69%(1/13), catheter prolapse 7.69% (1/13) and catheter fracture 7.69%(1/13).Conclusions The main reasons of neonatal PICC abnormal exbutation are catheter ectopia and indwelling complications.Therefore, clinical nurses should pay more attention to preventing high risks and regulating nursing care for the reduction of abnormal exbutation.

Objective:Evidence on potential cardiovascular benefits of personal-level intervention among the elderly exposed to high levels of particulate matter(PM)remains limited.We aimed to assess improvements in surrogate markers of cardiovascular injury in vulnerable populations at risks by using indoor air filtration units.Methods:We conducted a randomized crossover trial for 2 separate 2-week air filtration interventions in 20 households of patients with stable chronic obstructive pulmonary disease and their partners in the winter of 2013,with concurrent measurements of indoor PM.The changes in biomarkers indicative of cardiac injury,atherosclerosis progression and systemic inflammation following intervention were evaluated using linear mixed-effect models.Results:In the analysis,average levels of indoor PM with aerodynamic diameters＜2.5 μm(PM2.5)decreased significantly by 59.2％(from 59.6 to 24.3 μg/m3,P＜0.001)during the active air filtration.The reduction was accompanied by improvements in levels of high-sensitivity cardiac troponin I by-84.6％(95％confidence interval[CI]:-90.7 to-78.6),growth differentiation factor-15 by-48.1％(95％CI:-31.2 to-25.6),osteoprotegerin by-65.4％(95％CI:-56.5 to-18.7),interleukin-4 by-46.6％(95％CI:-62.3 to-31.0)and myeloperoxidase by-60.3％(95％CI:-83.7 to-3.0),respectively.Conclusion:Indoor air filtration intervention may provide potential cardiovascular benefits in vulnerable popu-lations at risks.