This paper analyses the defects of bubble oxygen inhalators currently used, and investigates into their solutions for improvement.
Oxygen Inhalation Therapy ; instrumentation ; methods ; Oxygenators ; standards

Objective To evaluate the efficacy and feasibility of the coil-and-glue method for the reduction of lung volume in rabbit emphysema model.Methods Sixteen rabbits of emphysema model were divided into the occlusion group(n=10),in which both anterior bronchi were occluded using the coil-and- glue method,and the control group(n=6).The maximal static pressure of airway(P_(max)),peak expiratory flow(PEF),end-expiratory volume(EEV)and pressure of oxygen(PO_2)were measured at ante- emphysema,post-emphysema,1 week and 4 week after occlusion respectively.The expectoration(or migration)of coil and collapse of lung were also investigated.Results P_(max)was(20.0?1.3)and(17.1? 1.4)cm H_2O(1 cm H_2O=0.098 kPa)in the occlusion group at ante-emphysema and post-emphysema respectively.P_(max)was(19.2?1.4)cm H_2O in the occlusion group in the 1 week after the occlusion,while (17.1?1.5)cm H_2O in the control group(F=6.68,P

Objective To explore the perioperative efficiency and safety of different regimen of tranexamic acid (TXA) in total knee arthroplasty (TKA).Methods From February 2013 to May 2013,150 female patients with knee osteoarthritis underwent unilateral TKA were randomly divided into three groups,50 cases in each group.Patients received 10 mg/kg TXA by fast intravenous infusion before closing the wound in first group (single dose group),patients in second group received two doses of 10 mg/kg TXA before closing the wound and 3 hours postoperation (repeated dose group),patients in the third group didn't receive TXA (control group).The postoperative blood loss via drainage,the total blood loss,the hidden blood loss,the postoperative hemoglobin concentration at different times and the numher of patients need blood transfusion were recorded.All patients were observed for detecting deep vein thrombosis (DVT) by the color doppler ultrasonography within 5 days postoperation,and the symptomatic DVT and pulmonary embolism (PE) were observed within 90 days postoperation.Results The blood loss via drainage was significantly less in the single dose group (273.6±99.6 ml) and repeated dose group (168.5±80.8 ml) compared with the control group (447.2±101.9 ml),and it was significantly less in the repeated dose group than the single dose group; the total blood loss was significantly less in the single dose group (959.1±291.7 ml) and repeated dose group (818.7±206.9 ml) compared with the control group (1 100.8±288.3 ml),and it was significantly less in the repeated dose group than in the single dose group; there was no differ ences about the hidden blood loss among the three groups.The hemoglobin concentration was significantly higher in the single dose group and repeated dose group than in the control group in day 1,3 and 5 postoperation; and it was significantly higher in the repeated dose group compared with the single dose group.The ratio of transfusion was significantly less in the single and repeated dose groups than in the control group,but no differences exists between the single dose group and repeated dose group.There was no DVT in all of the three groups within 5 days postoperation,and there was no symptomatic DVT and PE in all of the three groups within 90 days.Conclusion 10 mg/kg of TXA infused intravenous before closing the wound is effective and safe in TKA,another dose 3 hours postoperation is much more effective and will not increase the danger of DVT and PE.

Objective To study osteoporosis in patients receiving androgen deprivation therapy (ADT) with prostate cancer, and determine whether once-weekly oral alendronate can prevent bone loss in men receiving ADT. Methods One hundred and twelve men with nonmetastatic prostate cancer receiving ADT were divided into two groups from April 2007 to April 2008, 56 cases in each group. Group A took alendronate (70 rng once-weekly orally) and calcium supplement, group B received calcium supplement only. Bone mineral density (BMD) were measured both before and 6 months, 12 months after treatment for both groups. Results There were no statistically differences in age, persistence time of castration, prostate specific antigen level and adverse effect between two groups(P＞ 0.05). At baseline, 39.3%(44/112) of men had osteoporosis and 51.8%(58/112) had low bone mass. After 12 months treatment, in group A, BMD increased 3.7% (95% CI 2.80% to 4.60% ,P＜0.01 ) at the spine,0.7%(95% CI 0.10% to 1.40% ,P=0.031)at the total hip and 1.6% (95% CI0.40% to 2.80%,P =0.008) at the femoral neck. In group B decreased 1.4% (95% CI-2.70% to -0.03%, P = 0.045 ) at the spine, 0.7% (95% CI - 1.50% to -0.01%,P = 0.052) at the total hip and 0.7% (95% CI -1.50% to 0.10%, P = 0.081 ) at the femoral neck. The estimated changes in BMD were significantly different between two groups (P ＜ 0.01 ). Conclusions It suggests that ADT induce bone loss which should be treated in early stage. Bone loss that occurred with ADT is prevented and improved with once-weekly oral alendronate.

Objective To explore the anatomical morphology of femoral trochlear groove and the difference between normal males and females.Methods Eighty healthy volunteers were recruited,including 42 males and 38 females with an average age of 36.2 years (range,21-55 years).All the volunteers without knee unstabilization,pain and wound.CT scan of right femurs were performed and 3-D model were reconstructed.The anatomical parameters of right femoral trochlear groove were measured,which included transepicondylar axis,medial and lateral length of trochlear groove,medial and lateral condylar height,sulcus angle,depth of trochlear groove,transcondylar axis,anterior femoral condylar angle,trochlear groove position,and then compared the morphologic difference of trochlear groove between males and females.Results The average width of transepicondylar axis was 79.21±3.80 mm for males and 70.73±2.91 mm for females (t=-53.40,P=0.00).The minimum sulcus angle was acquired at 45° flexion for males and 42° flexion for females.It was 133.92°±4.76° for males and 132.71°±4.36° for females.The maximum length of transepicondylar axis was acquired at 87° flexion for males and 90° flexion for females.It was 42.36±3.48 mm for males and 39.03 ±3.36 mm for females.The anterior femoral condylar angle decreased with the increasing flexion angle of knee (P＞0.05).The position of the trochlear groove moved laterally with the increasing flexion angle of knee (P＞0.05).Conclusion There is no significant difference between male and female in the geometry of femoral trochlear groove,however there is a significant difference in sizes.Therefore,during design the knee prosthesis,close approximation of size is essential,while gender differences in morphology need not be considered a factor.

Objective To evaluate the efficacy and safety of local infiltration analgesia in the multimodal analgesia protocol.Methods Sixty patients who were scheduled to undergo TKA were randomly divided two groups:local infiltration analgesia (LIA) group (n=30) or the non-local infiltration analgesia (N-LIA) group (n=30).All patients were given Celecoxib 200 mg bid,3 days preoperative,and a single-injection femoral nerve block (SFNB) half an hour before the surgery (ropivacaine 3.3 g/L,30 ml).The LIA group was given local infiltration analgesia with ropivacaine (2.5 g/L,60 ml) and 0.1 mg epinephrine before suture the operative incision.The N-LIA group didn't do the LIA.Both of the two groups didn't use the patient controlled analgesia.The VAS scores,the knee joint range of motion,the muscle strength of quadriceps femoris and the side effects and complications were recorded.Results The VAS scores were lower in LIA group than in the N-LIA group,these scores at 2 h to 48 h after surgery at rest and after 24 h at motion had statistical significance.The range of motion and the muscular strength of quadriceps femoris in the LIA group were better than in the N-LIA group.In the LIA group the use of opioids was less and the side effects were lower.The average length of hospital stay after the operation was shorter in the LIA group than the N-LIA group.Conclusion This multimodal perioperative analgesia protocol that include SFNB and LIA offered improved pain control and minimal side effects to patients undergoing TKA.

Objective To assess the clinical factors impacting on the effective time of endocrine therapy for patients with prostate cancer.Methods The chnical data of 432 patients with prostate cancer who accepted endocrine therapy were analyzed retrospectively.The endpoint of the study was failure of endocrine therapy which was defined as continuous elevation of prostate specific antigen (PSA) from nadir for 2 times and more than 0.2 μg/L.The clinical data such as age,clinical stage,lymph node metastasis,bone metastasis,Gleason score,initial PSA,and PSA nadir were collected and their rehtionship with the effective time of endocrine therapy were further assessed via COX regression model.Results Age of onset was 57-88(73.70 ± 7.28) years.Initial PSA was 10.30-588.10(27.15 ± 75.90) μ g/L.The effective time of endocrine therapy was 3-62 (27.01 ± 13.10) months.Univariate regression analysis showed that initial PSA,clinical stage,Gleason score,PSA nadir,lymph node metastasis,bone metastasis were correlated with the effective time of endocrine therapy (P ＜ 0.01).Multivariate regression analysis showed that only Gleason score was correlated with the effective time of endocrine therapy(P=0.001).Compared with patients with Gleason score equal to or less than 3+4,patients with Gleason score equal to or more than 4+3 showed 2.49 fold increased risk of therapy failure (OR =2.49,95％ CI 1.44-4.30).Conclusion Gleason score has close relationship with the effective time of endocrine therapy for patients with prostate cancer,Gleason score equal to or more than 4+3 is an indicator for poor response to endocrine therapy.

Objective To compare the clinical efficacy between continuous and intermittent androgen deprivation in high risk prostate cancer.Methods Sixty-four patients with high risk prostate cancer were treated from January 2008 to April 2009,36 cases who accepted goserelin and bicalutamide were taken as intermittent hormonal therapy (intermittent treatment group),while 28 cases who accepted bilateral orchiectomy in addition to flutamide were regarded as continuous hormonal therapy (continuous treatment group).The comparison of tumor specific mortality,time of prostate specific antigen (PSA) to nadir,tine to PSA recurrence,serum testerone and quality of life score were assessed between the two groups.Results In continuous treatment group and intermittent treatment group,follow-up period was (26.4 ± 10.3) and (28.1 ± 8.7) months,the time of PSA to nadir was (3.8 ± 2.1 ) and (4.0 ± 3.6) months,the time to PSA recurrence was (20.1 ± 12.3) and (24.5 ± 14.6) months,respectively.There was no significant difference between the two groups.At the time of 18,24 and 30 months after therapy,serum testerone was 0.85,0.88,0.89 μg/L in continuous treatment group,while 1.21,1.36,1.48 μg/L in intermittent treatment group,respectively (P ＜ 0.05 ).Similarly,quality of life score was 38.7,40.5,39.8 scores in continuous treatment group,while 49.2,51.4,52.3 scores in intermittent treatment group at the time of 12,18 and 30 months after therapy,respectively (P ＜ 0.05 ).Conclusions Clinical efficacy could not been found between continuous and intermittent endocrinic therapy of prostate cancer.During intermittent,quality of life seems to be better and increases in accordance with serum testerone recurrence at given time.

Objective Although minimally invasive thoracoscopic surgery has unique advantages, there are still some difficulties in the complete resection of the thymus.Video-assisted thoracoscopic surgery has made up for the lack of thoracoscopy.This article summarize and analyze the clinical effects of DaVinci robotic surgery and thoracic surgery in the treatment of thymic diseases.Methods 116 cases of patients with thymic lesion were included in the study.According to the different treatment methods, 65 cases were included in da Vinci robotic group and other 51 cases were thoracoscopic group.Comparison was made in operating time, time of chest tube extubation, bleeding volume during surgery and amount of drainage within 24h after the operation between two groups.Results There were no statistical differences between robot group and thoracoscopic group in operating time(P>0.05).The time of pulling out the chest tube in robot group, postoperative days in surgical intensive care unit (SICU), and postoperative hospitalization days were significantly shorter than those in thoracoscopic group ([2.54±0.32]d vs [2.87±0.49]d, [0.75±0.04]d vs [0.81±0.06]d, [5.17±0.15]d vs [5.50±0.23]d, P<0.05).The bleeding volume during surgery and amount of drainage within 24h after the operation in robot group had a significant advantage over those in thoracoscopic group ([125.7±7.5]mL vs [136.6±8.2]mL, [117.38±11.45]mL vs [122.41±13.14]mL, P<0.05).Conclusion The da Vinci robotic surgery has the advantages of minimal trauma and rapid recovery, which makes up for the deficiency of thoracoscopy to a certain extent.

Objective To investigate the MR imaging technique and features of acute radiation- induced hepatic injury with superparamagnetic iron oxide(SPIO)enhancement in a rabbit model.Methods On the 10th day after half-liver single 40 Gy X-ray irradiation,MR imaging before and after SPIO administration and pathologic study of 12 adult rabbits were performed.Results On the 10th post-irradiation day,TSE T_2 WI before SPIO enhancement,the irradiated liver of two rabbits showed relatively higher signal, and 1 showed slightly lower signal.With SPIO enhancement,the irradiated livers of 9 rabbits were found to be abnormal,manifesting as higher or slightly higher areas on multiple MR imaging sequences,especially the TFE T_1 WI sequence.Histological specimen with HE stain under light microscopy revealed occlusive injury of central veins(veno-occlusive disease,VOD)in each irradiated liver to some extent.Electron microscopy investigation of the irradiated liver disclosed intracellular edema,fibrin deposition,and widening of the Disse-space.Conclusion The early pathologic feature of the irradiated liver is occlusive injury of the central vein.MR imaging with SPIO enhancement is effective to valuate the early irradiation-induced liver injury.