Objective:To investigate the effects of one-lung ventilation with a laryngeal mask airway combined with a bronchial blocker on respiratory function in older adult patients undergoing thoracoscopic surgery.Methods:Sixty older adult patients who underwent thoracoscopic surgery in Zhejiang Veteran Hospital from January 2019 to December 2020 were included in this study. They were randomly divided into a single group (a simple bronchial blocker) and a combined group (a bronchial blocker combined with a laryngeal mask airway), with 30 patients in each group. Awakening (time to extubation, spontaneous respiration and eye opening), respiratory function [peripheral oxygen saturation, vital capacity, maximum voluntary ventilation measured before and 3 days after surgery], hemodynamics [heart rate and mean arterial pressure were recorded before (T 1) and immediately after placement of a bronchial blocker or a laryngeal mask (T 2) and at the time of removal of a bronchial block or a laryngeal mask (T 3)], and adverse events (hoarseness, throat pain, dysphagia and choking) were recorded. Results:Time to extubation, time to spontaneous respiration, and time to eye opening in the combined group were (5.62 ± 1.23) minutes, (6.85 ± 1.34) minutes, and (7.34 ± 1.52) minutes, respectively, which were significantly shorter than (8.62 ± 1.55) minutes, (10.25 ± 1.78) minutes, (11.38 ± 1.85) minutes in the single group ( t = 9.94, 10.00, 11.06, all P < 0.05). At 3 days after surgery, peripheral oxygen saturation, vital capacity, and maximum voluntary ventilation in the combined group were (98.23 ± 1.05)%, (2.18 ± 0.60) L, (54.23 ± 5.36) L, respectively, which were significantly higher than (96.23 ± 1.01)%, (1.82 ± 0.50) L, (48.12 ± 4.23) L in the single group ( t = 7.51, 2.52, 4.90, all P < 0.05). Mean arterial pressure measured at T 3 was significantly lower in the combined group than that in the single group [(98.25 ± 2.32) mmHg vs. (93.35 ± 2.48) mmHg, t = 7.90, P < 0.05]. The incidences of hoarseness, throat pain and choking in the combined group were 6.66% (2/30), 10.00% (3/30), 6.66% (2/30), respectively , which were significantly lower than 33.33% (10/30), 43.33% (13/30), 43.33% (13/30) in the single group (χ 2 = 6.66, 8.52, 10.75, all P < 0.05). There was no significant difference in the incidence of dysphagia between the two groups ( P > 0.05). Conclusion:Use of a laryngeal mask airway combined with a bronchial blocker during thoracoscopic surgery in older adult patients facilitates postoperative recovery, has little impact on hemodynamics, and is highly safe.

The chemical extraction method was used to prepare the rat uterine decellularized scaffolds, and to investigate the feasibility of preparing the extracellular matrix (ECM) hydrogel. The rat uterus were collected and extracted by 1%sodium dodecyl sulfate (SDS), 3% TritonX-100 and 4% sodium deoxycholate (SDC) in sequence. Scanning electron microscopy, histochemical staining and immunohistochemistry was used to assess the degree of decellularization of rat uterine scaffold. The prepared decellularized scaffold was digested with pepsin to obtain a uterine ECM hydrogel, and the protein content of ECM was determined by specific ELISA kit. Meanwhile, the mechanical characteristic of ECM hydrogel was measured. The results showed that the chemical extraction method can effectively remove the cells effectively in the rat uterine decellularized scaffold, with the ECM composition preserved completely. ECM hydrogel contains a large amount of ECM protein and shows a good stability, which provides a suitable supporting material for the reconstruction of endometrium .

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.