analysis on 103 cases of spontaneous pneumothorax patients between September, 2012 and December,2014. Then the patients were randomly divided into two groups according to the different therapies on pulmonary bulla, 52 in GIA surgical stapler group and 51 in ligature group. Comparison: The postoperative situations of the two groups.Results: The operation time and intraoperative bleeding volume of observation group are obvious less than control group(t=7.58,t=16.87;P<0.01), but oxygen saturation of observation group is obvious higher than control group(t=1.34,P<0.01). The operation fee of observation group is obvious higher than control group(t=38.26, P<0.01).2 cases of postoperative recurrence in observation group(3.84%), but 10 cases in control group(19.60%).The two recurrence rates have statistical significance(x2=4.77,P<0.05). The postoperative complications incidence is 5.77% in observation group,but 21.56% in control group.The two The postoperative complications incidences have statistical significance(x2=5.47,P<0.05).Conclusion: As opposed to ligature, under the therapy for spontaneous pneumothorax with GIA surgical stapler by thoracoscopy, the operation time is shorter, intraoperative bleeding volume is less, and recurrence rate is lower in 2 years. Ligature fits the sporadic pulmonary bulla patients.

Objective To evaluate the application of the LMA CTrach for airway management during cervical spine surgery.Methods A total of 80 patients received cervical spine surgery under general anesthesia. During the operation, the LMA CTrach was used for ventilation and insertion of endotracheal tube. The authors recorded the time of laryngeal mask insertion, the success rate of ventilation, the success rate of the first attempt of endotracheal intubation, the number of attempts of endotracheal intubation, the time from insertion of the LMA CTrach to the completion of tracheal intubation. Results The LMA CTrach insertion was successfully completed in all but 2 patients. In 78 patients with good ventilation, the first attempt of endotracheal intubation failed in 5 patients. Except for unsuccessful ventilation in 2 patients and intubation failure for 3 times in 3 patients, the endotracheal intubation by using the LMA CTrach was accomplished in 75 patients. The mean time from insertion of the LMA CTrach to the completion of tracheal intubation was 192 s (range, 156～273 s). Conclusions The LMA CTrach system has the ability to align the LMA outlet with the larynx under direct view, and can increase the success rate of intubation and avoid some unnecessary injuries, giving certain advantages for airway management during cervical spine surgery.

0.05).Various degrees of pharyngalgia and hoarseness occurred in 2 patients in the Group Ⅰ,3 patients in the Group Ⅱ,and 2 in the Group Ⅲ,the incidence of complications being not statistically different(?2=0.323,P=0.851).Conclusions Compared with local anesthesia or endotracheal intubation,percutaneous dilational tracheostomy under laryngeal mask airway ventilation offers more stable circulation,higher reliability,and less influence to tracheostomy.This technique may give certain protection against cervical spinal cord injury during anesthetic induction.

Setting up the innovative and entrepreneurship education and teaching system is the important content of the current university education reform. Through the idea of leading innovation with entrepreneurial practice, we have implemented a series of education reforms in the students of medical laboratory technology, reformed the teaching methods and content, set up the tutors for undergraduates and improved the scientific research ability of students. The results show that the education reforms have enhanced the ability and sense of innovation, providing a good reference for the reform of innovation and entrepreneurship education in medical laboratory technology.

This paper reviews the mechanisms and properties of different absorbable hemostatic agents. The development tendency of absorbable hemostatic agent is forecasted. Its' qualities of being useful to surgeons are introduced and are embodied in surgeon's comprehending of the hemostatic characteristic of absorbable hemostatic agents as well as in their clinical use of such agents accurately. At the same time, the researchers in pursuit of the medical materials can work with reference to the data herein presented.
Absorption ; Animals ; Blood Loss, Surgical ; prevention & control ; Cellulose, Oxidized ; administration & dosage ; pharmacology ; Chitosan ; administration & dosage ; pharmacology ; Fibrin Tissue Adhesive ; administration & dosage ; pharmacology ; Gelatin Sponge, Absorbable ; administration & dosage ; pharmacology ; Hemostatics ; administration & dosage ; pharmacology ; Humans

OBJECTIVETo investigate cell apoptosis, mitochondrial membrane potential, cytochrome C and mechanisms of mitochondria in lymphocyte apoptosis of sepsis.

METHODSIn the research, female C57BL/6 mice whose body weight ranged from 17 to 25 grams were utilized and assigned randomly to two groups: sham operated group (Control), cecal ligation and puncture group (CLP). The present study was undertaken by using the mice splenic lymphocyte to investigate cell apoptosis, mitochondrial membrane potential, cytochrome C. The apoptosis alteration was evaluated by Annexin V-FITC/PI double staining with flow cytometry. The alteration of mitochondrial membrane potential was investigated by Rhodamine-123 staining of cells. Cytochrome C of mitochondria and cytosol was investigated by Western blot methods. Statistical analysis was performed using SPSS 11.5 for Windows software. Experiment data was indicated with mean ± standard.

RESULTSThe splenic lymphocyte apoptosis was significantly accelerated in the CLP group when compared with that in control group (17.3% ± 2.2% vs. 3.5% ± 0.5%, P < 0.05). The Rhodamine-123 fluorescent intensity in splenic lymphocyte apoptosis was reduced in CLP group (76.2% ± 1.6%). Comparison between sham group (99.6% ± 0.4%) and CLP group had statistical significance (P < 0.05). Apoptosis could induce mitochondrial cytochrome C release into cytoplasm. In the CLP group, elevation of cytochrome C in cytosol was concurrently in accordance with decline in mitochondrial cytochrome C content.

CONCLUSIONThese data suggest that mitochondria and mitochondria signal pathway play an important role in lymphocyte apoptosis of sepsis.

Animals ; Apoptosis ; Cells, Cultured ; Cytochromes c ; metabolism ; Disease Models, Animal ; Female ; Lymphocytes ; metabolism ; pathology ; Mice ; Mice, Inbred C57BL ; Mitochondria ; metabolism ; physiology ; Sepsis ; metabolism ; pathology

BACKGROUNDIntermittent hypoxia (IH) is a key element of obstructive sleep apnea (OSA) that can lead to disorders in the liver. In this study, IH was established in a rat model to examine its effects on the expression of hepatic cytochrome P450 (CYP) and CYP regulators, including nuclear receptors.

METHODSHematoxylin and eosin staining was conducted to analyze the general pathology of the liver of rats exposed to IH. The messenger RNA (mRNA) expression levels of inflammatory cytokines, CYPs, nuclear factor-κB (NF-κB), and nuclear factors in the liver were measured by quantitative reverse transcription polymerase chain reaction.

RESULTSWe found inflammatory infiltrates in the liver of rats exposed to IH. The mRNA expression level of interleukin-1beta was increased in the liver of the IH-exposed rats (0.005 ± 0.001 vs. 0.038 ± 0.008, P = 0.042), whereas the mRNA expression level of Cyp1a2 was downregulated (0.022 ± 0.002 vs. 0.0050 ± 0.0002, P = 0.029). The hepatic level of transcription factor NF-κB was also reduced in the IH group relative to that in the control group, but the difference was not statistically significant and was parallel to the expression of the pregnane X receptor and constitutive androstane receptor. However, the decreased expression of the glucocorticoid receptor upon IH treatment was statistically significant (0.056 ± 0.012 vs. 0.032 ± 0.005, P = 0.035).

CONCLUSIONSThese results indicate a decrease in expression of hepatic CYPs and their regulator GR in rats exposed to IH. Therefore, this should be noted for patients on medication, especially those on drugs metabolized via the hepatic system, and close attention should be paid to the liver function of patients with OSA-associated IH.

Objective: This study aimed to determine the efficacy of dose-enhanced immunochemotherapy followed by autologous peripheral blood stem cell transplantation (ASCT) in young patients with newly diagnosed high-risk aggressive B-cell lymphoma. Methods: A retrospective study was conducted to examine the clinical and survival data of young patients with high-risk aggressive B-cell lymphoma who received dose-enhanced immunochemotherapy and ASCT as first-line treatment between January 2011 and December 2018 in Blood Diseases Hospital. Results: A total of 63 patients were included in the study. The median age range was 40 (14-63) years old. In terms of the induction therapy regimen, 52 cases received R-DA-EP (D) OCH, and the remaining 11 received R-HyperCVAD/R-MA. Sixteen (25.4% ) patients achieved partial response in the mid-term efficacy assessment, and ten of them were evaluated as complete response after transplantation. The median follow-up was 50 (8-112) months, and the 3-year progression-free survival (PFS) rate and overall survival (OS) rate were (83.9±4.7) % and (90.4±3.7) % , respectively. Univariate analysis demonstrated that age-adjusted international prognostic index ≥2 scores was a negative prognostic factor for OS (P=0.039) , and bone marrow involvement (BMI) was an adverse prognostic factor for OS (P<0.001) and PFS (P=0.001) . However, multivariate analysis confirmed that BMI was the only independent negative predictor of OS (P=0.016) and PFS (P=0.001) . Conclusions: The use of dose-enhanced immunochemotherapy in combination with ASCT as first-line therapy in the treatment of young, high-risk aggressive B-cell lymphoma results in good long-term outcomes, and BMI remains an adverse prognostic factor.
Adult ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Disease-Free Survival ; Hematopoietic Stem Cell Transplantation ; Humans ; Lymphoma, B-Cell ; Peripheral Blood Stem Cell Transplantation ; Prognosis ; Retrospective Studies ; Stem Cell Transplantation ; Transplantation, Autologous

Aged ; Antifungal Agents ; therapeutic use ; Bronchiectasis ; diagnosis ; drug therapy ; Female ; Humans ; Pulmonary Aspergillosis ; diagnosis ; drug therapy ; Tomography, X-Ray Computed ; Voriconazole ; therapeutic use

BACKGROUNDThe aim of this research was to evaluate long-term pulmonary sequelae on paired inspiration-expiration thin-section computed tomography (CT) scans 3 years after influenza A (H1N1) virus-associated pneumonia, and to analyze the affecting factors on pulmonary fibrosis.

METHODSTwenty-four patients hospitalized with H1N1 virus-associated pneumonia at our hospital between September 2009 and January 2010 were included. The patients underwent thin-section CT 3 years after recovery. Abnormal pulmonary lesion patterns (ground-glass opacity, consolidation, parenchymal bands, air trapping, and reticulation) and evidence of fibrosis (architectural distortion, traction bronchiectasis, or honeycombing) were evaluated on follow-up thin-section CT. Patients were assigned to Group 1 (with CT evidence of fibrosis) and Group 2 (without CT evidence of fibrosis). Demographics, rate of mechanical ventilation therapy, rate of intensive care unit admission, cumulative prednisolone-equivalent dose, laboratory tests results (maximum levels of alanine aminotransferase, aspartate transaminase [AST], lactate dehydrogenase [LDH], and creatine kinase [CK]), and peak radiographic opacification of 24 patients during the course of their illness in the hospital were compared between two groups.

RESULTSParenchymal abnormality was present in 17 of 24 (70.8%) patients and fibrosis occurred in 10 of 24 (41.7%) patients. Patients in Group 1 (10/24; 41.7%) had a higher rate of mechanical ventilation therapy (Z = -2.340, P = 0.019), higher number of doses of cumulative prednisolone-equivalent (Z = -2.579, P = 0.010), higher maximum level of laboratory tests results (AST [Z = -2.140, P = 0.032], LDH [Z = -3.227, P = 0.001], and CK [Z = -3.345, P = 0.019]), and higher peak opacification on chest radiographs (Z = -2.743, P = 0.006) than patients in group 2 (14/24; 58.3%).

CONCLUSIONSH1N1 virus-associated pneumonia frequently is followed by long-term pulmonary sequelae, including fibrotic changes, in lung parenchyma. Patients who need more steroid therapy, need more mechanical ventilation therapy, had higher laboratory tests results (maximum levels of AST, LDH, and CK), and had higher peak opacification on chest radiographs during treatment are more likely to develop lung fibrosis.

Adult ; Female ; Humans ; Influenza A Virus, H1N1 Subtype ; pathogenicity ; Influenza, Human ; complications ; virology ; Lung ; diagnostic imaging ; pathology ; virology ; Male ; Middle Aged ; Pneumonia ; complications ; diagnostic imaging ; microbiology ; Tomography, X-Ray Computed ; methods