1.Effect of different dose of propofol compounding with epidural anesthesia on oxygenation and shunt fraction during one-lung ventilation
Liwen WU ; Miansheng CHEN ; Liangjie ZHENG
Chinese Journal of Primary Medicine and Pharmacy 2005;0(02):-
Objective To study the effect of different dose of propofol compounding with epidural anesthesia on oxygenation and shunt fraction during one-lung ventilation(OVL).Methods Forty patients with esophageal carcinoma undergoing thoracotomy were randomly divided into group Ⅰ and Ⅱ.After placing epidural tube at T_(6~7) for epidural anesthesia,the patients group Ⅰ were received propofol 5mg?kg~(-1)?h~(-1) and 10mg?kg~(-1)?h~(-1) in group Ⅱ.Taking the blood sample from arter for blood-gases measurement at beginning of operation,30min after OVL and 60min after OVL.Results At 30min after OVL,the shunt fraction(Qs/Qt) value of group Ⅰ and Ⅱ was(11.35?3.6) and(15.6?5.41);PaO_2 was (36.12?10.23) and(31.05?9.36).At 60min,the Qs/Qt was(13.9?3.7) and(18.5?2.1);PaO_2 was(34.87?15.42) and(26.97?11.35).There was significantly difference between two groups(P
2.Bronchial Intubation of General Anesthesia and Lower Respiratory Tract Infection: An Exploration of Their Relationship
Liwen WU ; Miansheng CHEN ; Liangjie ZHENG ; Yongjian KE ; Huifang XIE
Chinese Journal of Nosocomiology 2006;0(05):-
OBJECTIVE To explore the relationship between intubation of general anesthesia and lower respiratory tract infection.METHODS Totally 947 cases were divided into bronchial intubation group(groupⅠ,541 cases) and(tracheal) intubation group(groupⅡ,406 cases) for a retrospective analysis about lower respiratory tract(infection).The(sputum) samples of(infected) patients were took germiculture and antibiotic susceptibility.RESULTS There were 26 cases arisen lower respiratory tract infection in group Ⅰ and there were 18 in group Ⅱ.The(incidence) was 4.81% and 4.43%,respectively.86.36% pathogens of sputum samples were non-zymophytes,it was a direct proportion between high(antimicrobial) resistance rate and lower respiratory tract infection rate.The infection rate of 60-70 years old and under 49 years patients was 9.56% and 2.04%,respectively.The infection rate of(patients) undergoing anesthesia less 3h and over 3h was 3.26% and 6.14%,respectively,with significant(differences)(P
3.Clinical features and survival analysis of light-chain amyloidosis associated renal disease
Hehua WANG ; Wenfang CHEN ; Xiuzhen TONG ; Miansheng YAN ; Duorong XU ; Juan LI
Chinese Journal of Postgraduates of Medicine 2010;33(31):7-10
Objective To analyze the clinical pathology features of light-chain amyloidosis associated renal disease,and investigate the survival influential factors. Method From January 1998 to March 2009,25 patients with light-chain amyloidosis associated renal disease were reviewed and followed up.Results Of the 25 patients with light-chain amyloidosis associated renal disease,median age was 57(37-69) years old and lamda light-chain predominated (88% ,22/25). Heavy proteinuria and nephrotic syndrome with peripheral edema were typical clinical presentations. Renal biopsy showed that amyloid deposition of light-chain amyloidosis associated renal disease involved the glomeruh mostly, with mesangial area widening. Median survival of all patients was 24.4 months after diagnosis. The estimated 1,2,3 year survival rate was (65 ± 10 )%, (46 ± 12 )% and (15 ± 12 )% respectively. There was significant difference in median survival between the two groups (24.7 months in the group of 14 patients with isolated kidney affected,16.4 months in the group of 11 patients with kidney and other organs involved,P = 0.03). By univariate analysis, kidney associated with other organs amyloidosis and renal dysfunction were relevant to prognosis (P < 0.05) and heart involvement was probably relevant (P = 0.06),whereas sex,age,plasma cell ratio,serum albumin level and hemoglobin level had no relation(P> 0.05 ). Multivariate analysis revealed that renal dysfunction at the time of diagnosis was a significant and independent prognostic factor for survival (P <0.05). Conclusions Renal dysfunction at the time of diagnosis is the best predictor of survival. The presence of amyloidosis in organs other than the kidney, such as advanced cardiac amyloidosis, predicts a poor survival.