BACKGROUND: Traditional treatment includes conservative therapy and surgical treatment on bronchial pleural fistula. With the development of endoscopic therapy, a new safe and effective method is concerned. OBJECTIVE: To summarize the therapeutic effect of treating bronchopleural fistula using bronchoscopy-guided injection of fibrin sealant combined with gelatin sponge filled and microwave following after lung resection. METHODS: Totally 8 cases of bronchial fistula patients were received injection of fibrin sealant after microwave and gelatin sponge filled by bronchoscopy, including 6 males and 2 females, mean aged 53.8 years (39-73 year-old). Cases 1 and 2 received left upper pulmonary Iobectomy, cases 3 received left lower pulmonary Iobectorny, case 4 received right lower pulmonary Iobectomy, cases 5 and 6 received right upper pulmonary Iobectomy, and the cases 7 and 8 received pneumonectomy. bronchopleuralfistula occurred after postoperative Chemotherapy in cases 4 and 8. RESULTS AND CONCLUSION: The case 8 was failed to treatment due to the large orificium fistulae (> 5 mm) and disappointed results after 6 times plugging. The other 7 patients were cured successfully. The injection time was correlated to the size of orificium fistulae, and the plugging was successful for 4 patients with less than 3 mm orificium fistulae. However, a third or fifth plugging was performed for 3 cases with 3-5 rnm orificium fistulae. No surgery-related complications occurred in all patients. Bronchoscopy guided injection of fibrin sealant combined with gelatin sponge and microwave is a safe and effective method for bronchial fistula.

OBJECTIVETo investigate the effect of tumor necrosis factor-α (TNF-α) on nutritional status and proteolysis of respiratory muscle in a rat model of chronic obstructive pulmonary disease (COPD).

METHODSNinety healthy male adult Wistar rats were randomly divided into model group (A) and normal control group (B). COPD malnutrition rat models were established by cigarettes smoke and nutrient limitation and divided into normal nutrition COPD group (A(1)), malnutrition COPD group (A(2)), and malnutrition COPD intervention group (A(3)). In group A(3), the rats received intravenous injection of TNF-α mAb (0.1 mg/kg). TNF-α levels in the serum and respiratory muscle homogenates were measured using enzyme-linked immunosorbent assay (ELISA), and plasma levels of glucose, albumin, and triglyceride were measured with an automatic biochemistry analyzer. High-performance liquid chromatography was used to measure the contents of 3-methylhistidine and tyrosine in the respiratory muscle homogenates.

RESULTSThe serum TNF-α level and plasma levels of glucose and triglyceride were significantly higher but the plasma albumin level was significantly lower in group A(2) than in groups B, A(1), and A(3) (P<0.01). The contents of 3-MH and Tyr in the respiratory muscle homogenates were significantly higher in group A(2) than in the other 3 groups (P<0.01, P<0.01). TNF-α in the respiratory muscle showed a strong positive correlation to 3-MH and Tyr.

CONCLUSIONTNF-α is one of the causes of increased proteolysis of the respiratory muscle.

Animals ; Lung ; pathology ; Male ; Nutritional Status ; Proteolysis ; Pulmonary Disease, Chronic Obstructive ; metabolism ; pathology ; Rats ; Respiratory Muscles ; metabolism ; Tobacco Products ; Tumor Necrosis Factor-alpha ; pharmacology

Objective: To analyze the diagnosis and treatment of acute myeloid leukemia (AML) complicated with myeloid sarcoma (MS). Methods: The clinical features, diagnosis and therapy of 3 AML who were treated with routine regimen induction and consolidation therapy in Shanghai Beizhan Hospital and showed MS during the marrow remission stage were retrospectively analyzed. Results: Three female patients included 2 cases of CBFβ-MYH11 positive and 1 case of AML1-ETO positive. One patient occurred in the first complete remission(CR₁) and 2 patients occurred in CR₂. The involved sites included brain, vagina, and breast respectively. Three patients all received short efficacy after chemotherapy, including 1 patient in bone marrow remission stage, 1 patient died of after bone marrow relapse and 1 patient without follow-up. Conclusions For AML patients in remission with extramedullary lesions, pathological examination is warranted to confirm the diagnosis of the disease. Systemic chemotherapy is still the main treatment for MS. Central nervous system(CNS) leukemia treatment should be performed to the patients with CNS involved. Allogeneic hematopoietic stem cell transplantation may be the best option for the treatment of these patients.