The patient presented with dry cough, lending, fever and progressive dyspnea for two weeks. The patient had a prior respiratory infection history and the symptoms were not obvious, Early X-ray showed lung infection. Under the fibrolaryngoscope, the lingual surfaces of the epiglottis, epiglottic vallecula, and bilateral vocal cords were covered by yellow pseudomembrane. The motion of vocal cords was normal with poor glottic closure, and no ulcer was noted. Endotracheal mucosa was swelling and congested with an uneven surface, and purulent discharge and pseudomembrane was formed. Pathological examination revealed Aspergillus. The disease was diagnosed as Aspergillus laryngotracheobronchitis.
Adult ; Aspergillosis ; diagnosis ; physiopathology ; Aspergillus ; Bronchitis ; diagnosis ; microbiology ; physiopathology ; Humans ; Male

Objective To investigate the effect of stellate ganglion block(SGB)on heart mte variability (HRV)during thyroidectomy performed under cervical plexus block.Methods Forty-five ASA Ⅰ or Ⅱ pafients of both sexy8(8 males,37 females) aged 20-60 yr,weighing 40-70 kg undergoing elective thyroidectomy under cervical plexus block were randomly divided into 3 groups(n=15 each):group Ⅰ control,group Ⅱ left SGB and group Ⅲ right SGB.The parameters of HRV included low frequency(LF),high frequency(HF),LFnu,HFnu and LF/HF ratio.SBP,DBP,HB and HRV parameters were recorded before anesthesia(To,baseline),immediately(T1) and at 5 and 10 rain after cervical plexus block(T2,T3),at the beginning and end of operation (T4,T5).Results SBP and DBP were significantly increased at different time points after cervical plexus block in all 3 groups.Compared with the baseline at T0,LFnu and LF/HF ratio were significantly increased while HR,HF and HFnu decreased during operation in group Ⅰ,LF,HF and HFnu were significantly decreased while HR increased during operation in group Ⅲ(P<0.05),but no significant change in HRV parameters was found during operation in group Ⅱ(P>0.05).Compared with group Ⅰ,HR and LFnu were significantly decreased while HF and HFnu increased in group Ⅱ(P<0.05),but no significant change was found in the indexes mentioned abovein group Ⅲ (P>0.05).Conclusion SGB can adjust cervical plexus block-induced sympathetic excitability and maintain the balance between sympathetic and parasympathetic tension.Left SGB outweighs right SGB.

OBJECTIVE: To investigate the relationship between apoptosis of myocardial cells in spontaneously hypertensive rats (SHRs) and the expressions of Bcl-2 and Bax protein, and the protective effect of stellate ganglion block on apoptosis of myocardial cells. METHODS: A total of 32 ten-week-old male SHRs were assigned randomly into 4 groups: a left stellate ganglion block group (group LS), a right stellate ganglion block group (group RS), a captopril group (group D) and a control group (group C). The arterial systolic blood pressure was measured by ALC-NIBP system. After 10 weeks, all rats were anaesthetized by 3% pentobarbital sodium, cardiomyocyte apoptosis index of left ventricle was assessed by TUNEL, and the localization of myocardium Bcl-2, Bax was investigated by immunohistochemistry. RESULTS: Compared with group LS and C, the apoptotic index decreased (P<0.05). SHR myocardial expression of Bcl-2 significantly increased (P<0.05), Bax expression significantly decreased (P<0.05) and Bcl-2/Bax was significantly higher (P<0. 05) in group RS. CONCLUSION Bcl-2 and Bax play an important role in the apoptosis of myocardial cells in SHRs. Right stellate ganglion block can reduce the apoptosis of myocardial cells and reverse the reconstruction of the left ventricle in SHRs via regulation of apoptosis-related gene proteins.
Animals ; Apoptosis ; Autonomic Nerve Block ; Blood Pressure ; Heart Ventricles ; Male ; Myocardium ; Myocytes, Cardiac ; cytology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Inbred SHR ; Stellate Ganglion ; physiopathology ; bcl-2-Associated X Protein ; metabolism

OBJECTIVE: To determine the effect of stellate ganglion block on reconstruction of the left ventricle in spontaneously hypertensive rats (SHRs). METHODS: Thirty-two 10-week-old male SHRs were randomly assigned into 4 groups: a left stellate ganglion block group (group LS), a right stellate ganglion block group (group RS), a captopril group (group D) and a control group (group C). The arterial systolic blood pressure (SBP) was measured by ALC-NIBP measuring system. After 10 weeks, we observed the left ventricular mass index (LVMI), myocardial pathologic changes, and detected the endothelin (ET-1) and endothelial nitric oxide synthase (eNOS) level in the left ventricle by radioimmunoassay and the collagen protein level in the left ventricle by immunohistochemical method. RESULTS: Compared with group LS and group C, the LVMI in group RS was lowered most notably (P<0.05) and pathological changes were improved obviously. The expression of eNOS in group RS was significantly increased and ET-1 significantly decreased (P<0.05) compared with that in group C and group LS. The expression of type I collagen fibers in group RS was significantly lower and type III collagen fibers significantly higher (P<0.05) when compared with that in group C and LS. CONCLUSION Right stellate ganglion block can not only decrease the arterial pressure but also reverse the reconstruction of the left ventricle.
Animals ; Autonomic Nerve Block ; Hypertension ; physiopathology ; therapy ; Male ; Rats ; Rats, Inbred SHR ; Stellate Ganglion ; Ventricular Remodeling ; physiology

Objective:To analyze the X-ray imaging characteristics of calcaneus in adult patients with osteoarticular diseases and its impact on disease diagnosis.Methods:Totally 78 patients (156 ankle joints) with osteoarticular diseases admitted to the Affiliated Hospital of Jining Medical University from June 2019 to June 2022 were selected as research subjects, including 72 cases of osteoarthritis and 6 cases of Kashin-Beck disease. Another 50 volunteers who underwent health examination in this hospital during the same period were selected as control group, all of them underwent calcaneal X-ray examination. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of calcaneal X-ray parameters in predicting adult osteoarticular diseases.Results:Among 72 patients with osteoarthritis, 63 cases (87.50%) showed joint surface sclerosis in the calcaneal X-ray changes. Forty-seven cases (65.28%) had narrowing of the subtalar joint space; 14 cases showed disappearance of the subtalar joint space, accounting for 19.44%. Among the 6 patients with Kashin-Beck disease, the X-ray changes of the calcaneus showed joint surface sclerosis in 6 cases, narrowing of the subtalar joint space in 4 cases, and disappearance of the subtalar joint space in 2 cases. The length, height, Bohler angle, Gissane angle, and inclination angle of the calcaneus in patients with Kashin-Beck disease were all smaller than those in the osteoarthritis group and the control group, the height to length ratio of the calcaneus was higher than that in the osteoarthritis group and the control group, and the difference was statistically significant ( P < 0.05). The length, height, Bohler angle, Gissane angle, and inclination angle of the calcaneus in patients of the osteoarthritis group were all smaller than those in the control group, and the height to length ratio of the calcaneus was higher than that in control group, and the difference was statistically significant ( P < 0.05). ROC curve analysis showed that the sensitivity of Bohler angle, Gissane angle, and the height to length ratio of the calcaneus in predicting osteoarticular diseases (72 patients with osteoarthritis) were 92.5%, 87.6% and 80.4%, respectively, with specificity of 73.0%, 68.8% and 63.1%, respectively. Conclusion:The calcaneal X-ray manifestations of adult patients with osteoarticular diseases vary greatly, among which Bohler angle, Gissane angle, and height to length ratio of the calcaneus have certain accuracy in diagnosis of osteoarthritis.

Objective To investigate the safety and efficacy of fiber choledochoscope in the treatment of patients with biliary cast syndrome (BCS) after liver transplantation (LT).Methods Clinical data of 10 patients with BCS after LT treated with fiber choledochoscope in the Affiliated Hospital of Qingdao University between March 2014 and June 2016 were analyzed retrospectively. There were 8 males and 2 females, aged 46-66 years old and the median age was 50 years old. The primary diseases of the patients were primary liver cancer (n=6), biliary cirrhosis (n=1), hepatic cirrhosis after hepatitis B (n=2), and hepatic cirrhosis after hepatitis C (n=1). The informed consents of all patients were obtained and the local ethical committee approval was received. For patients with BCS in the early stage after LT, T tube was replaced. For patients in late stage after LT, T tube fistula dilatation was performed, then biliary cast (BC) was removed and the supporting drainage tube was placed.Results 2 cases received T tube replacement when in early stage after LT, 8 received T tube fistula dilatation when in late stage after LT. All 10 cases had BC removed successfully with fiber choledochoscope. Liver function of 8 cases returned to normal after surgery, and the biliary drainage tube was removed. 2 cases had BC again and recurrent biliary infection, and then received PTCD drainage. Conclusion Fiber choledochoscope is safe, effective and feasible for the treatment of BCS after LT.