Objective To investigate the efficacy of lateral lung volume reduction with small incision and ligation for the treatment of serious chronic obstructive pulmonary disease(COPD).Methods From April 1994 to May 2006,36 patients suffering from serious COPD complicated with severe emphysema underwent lateral lung volume reduction in our hospital.Small incision and ligation were used during the operation.Results After the surgery,6 patients developed pulmonary air-leak,and were cured after 180-minute to 5-day treatments(mean,1.6 days).No perioperative death in this series.One year after the operation,the patient had significantly higher FEV1 and PaO2,and lower TLC and RV than those determined preoperation [(839.9?76.0)ml vs(589.0 ?80.5)ml,t=18.451;(72?10)mm Hg vs(62?8)mm Hg,t=4.686;(5167.6?639.9)ml vs(6725.8?976.6)ml,t=8.116;(3062.4?722.0)ml vs(4329.6?669.9)ml,t=7.720;all P=0.000].In addition,they had significantly longer 6MWT than that before the operation [(306.0?24.8)m vs(223.8?36.7)m,t=11.135,P=0.000].Conclusion For the patients with COPD who had indications for lateral lung volume deduction,resection of emphysemic tissues by the procedure using small incision and ligation can improve their symptoms and physiological conditions.

OBJECTIVE:To investigate the effect of different doses ambroxol hydrochloride on lung protection of patients in perioperative thoracotomy. METHODS:60 patients in perioperative thoracotomy were randomly divided into control group(30 cas-es)and observation group(30 cases). Control group received 30 mg Ambroxol hydrochloride injection from 1 week before surgery to 1 week after surgery,adding into 100 ml 0.9% Sodium chloride injection,intravenously,twice a day. Observation group re-ceived 300 mg Ambroxol hydrochloride injection from preoperative 1 week to postoperative 1 week,adding into 100 ml 0.9%Sodi-um chloride injection,intravenously,twice a day. All patients received the second-generation cephalosporin antimicrobial drugs for anti-infection after surgery. lung surfactant-associated protein A(SP-A),intercellular adhesion molecule(ICAM-1)levels preopera-tive 1 week and postoperative 1 week,and incidence of postoperative complications in 2 groups were observed. RESULTS:Preop-erative 1 week,there were no significant differences in the SP-A and ICAM-1 in 2 groups(P>0.05). Postoperative 1 week,SP-A and ICAM-1 in control group and ICAM-1 in observation group were significantly higher than preoperative 1 week,but SP-A and ICAM-1 in observation group were lower than control group,the differences were statistically significant(P<0.05),there were no significant differences in SP-A in preoperative 1 week and postoperative 1 week(P>0.05). The incidence of postoperative compli-cations in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). CON-CLUSIONS:The effect of high-doses ambroxol hydrochloride on lung protection of patients in perioperative thoracotomy is signifi-cantly superior to small dose,which can reduce the incidence of lung complications.

This study was aimed to explore the possibility of reducing postoperative inflammatory response and lung injury degree by observing the effect ofTan-Re-Qing(TRQ) Injection on perioperative period of lung cancer patients complicated with chronic obstructive pulmonary disease (COPD). A total of 39 lung cancer cases complicated with COPD (phlegm-heat obstructing the lung) were randomly divided into the tested group of 18 cases and the control group of 21 cases. All patients underwent small incision surgery with video-assisted thoracoscopic surgery (VATS). The control group was treated with routine western medicine. TRQ injection was added in the tested group. On the preoperative 1D (T1), 1D after operation (T2), 3D after operation (T3), 7D after operation (T4), serum samples were collected for the determination of serum concentrations of TNF-α, IL-6, IL-8 and IL-10. At T1 and T2 time, there were no significant differences on levels of TNF-α, IL-6, IL-8 and IL-10 between two groups of patients (P > 0.05). At T3 time, levels of TNF-α, IL-6, IL-8 of the tested group were lower than that of the control group with statistical significance (P < 0.05). The level of IL-10 in the tested group was higher than that of the control group with statistical significance (P < 0.05). At T4 time, the levels of TNF-α, IL-6 and IL-8 of the tested group were lower than that of the control group with statistical significance (P < 0.05). The levels of TNF-α, IL-6 and IL-8 of both groups gradually declined at T3 and T4 time, compared with T2 time level with statistical significant (P < 0.05). It was concluded that TRQ injection reduced the releasing of inflammatory cytokines during perioperative period, increased levels of anti-inflammatory cytokine, thereby reducing the degree of inflammatory reaction and relieving lung injury for the protection of lung function of lung cancer patients complicated with COPD.

Objective To explore the effect of chronic intermittent hypoxia(CIH)combined with high-fat diet(HFD)on gastroc-nemius muscle in mice and its possible mechanism.Methods A mouse model of obstructive sleep apnea hypopnea syndrome(OSAHS)combined with obesity was established by simulating CIH and HFD.Mice were divided into normal control group(NC),CIH group,HFD group,and CIH+HFD group.Hematoxylin-eosin(HE)staining was used to observe the structural changes of the gastrocnemius in each group of mice,and adenosine triphosphate(ATP)enzyme staining was used to analyze the changes in the types of muscle fibers in the gastrocnemius.Real-time quantitative polymerase chain reaction(RT-qPCR)was used to detect the mRNA expression level of MHC i-sotype genes(MHC1,MHC2),mitochondrial function related genes(Cs,Ant,NQO1,Hmox1,OGG1)gastrocnemius cells of mice;Western blot was used to detect the expression level of apoptosis-related proteins(cleaved-caspase-3),mitochondrial fusion proteins(Mfn1,Mfn2,OPA1)and mitochondrial division proteins(Drp1 Ser616,Fis1)in gastrocnemius cells of mice.Results Compared with the NC group,the gastrocnemius structure of the mice in the CIH+HFD group was significantly damaged.while the type Ⅰ muscle fibers in the gastrocnemius were decreased,the type Ⅱ muscle fibers in the gastrocnemius were increased.The expression level of MHC1mRNA in the gastrocnemius cells was decreased,and the expression level of MHC2mRNA was increased.In addition,the protein expressions of cleaved-caspase-3,mitochondrial division proteins(Drp1 Ser616 and Fis1)were significantly up-regulated in the CIH+HFD group.The mRNA or protein expressions of Cs,Ant,NQO1,Hmox1,OGG1,Mfn1 were down-regulated.Conclusion CIH combined with HFD can lead to structural and functional damage of gastrocnemius in mice,which may be related to mitochondrial dysfunction caused by mitochondrial dynamics disorder.

Objective To compare the safety and efficacy of direct thrombectomy versus bridging thrombectomy in the treatment of acute anterior circulation large vessel occlusion stroke under different collateral circulation statuses.Methods Totally 93 patients with acute anterior circulation ischemic stroke admitted to the First Affiliated Hospital of Xinxiang Medical University from September 2020 to March 2023 were selected as the research subjects.Patients were divided into direct throm-bectomy group(n=47)and bridging thrombectomy group(n=46)based on the type of thrombectomy.Patients in the direct thrombectomy group received direct intravascular thrombectomy,while patients in the bridging thrombectomy group received intravenous thrombolysis with alteplase combined with mechanical thrombectomy.According computed tomography angiography,the collateral circulation Tan classification was applied to divide the patients into good collateral circulation sub-group and poor collateral circulation sub-group.The modified thrombolysis in cerebral infarction grading(mTICI)was used to evaluate vessel recanalization.Head computed tomography plain scan was performed at 24-48 hours postoperatively to assess if there was hemorrhagic transformation,and modified Rankin Scale score was performed at 90 days postoperatively.Information such as imaging examination time,femoral artery puncture time,vessel recanalization time after thrombectomy,prognosis and spontaneous non-traumatic symptomatic intracerebral hemorrhage(SICH)were collected.Results The age,gender,baseline Alberta stroke program early computed tomography score,baseline national institutes of health stroke scale score,proportions of hypertension,diabetes and atrial fibrillation,baseline systolic pressure,creatinine,baseline blood glucose,platelet count,occlusion site,stroke etiologies and collateral circulation status of patients in the two groups were not statistically significantly different(P＞0.05).There were no significant differences in the post-admission imaging examination time,femoral artery puncture time,vessel recanalization time after thrombectomy,successful vascular reperfusion rate,good prognosis rate,mortality rate,and SICH incidence between the two groups(P＞0.05).The hemorrhagic transformation rate of patients in the direct thrombectomy group was significantly lower than that in the bridging thrombectomy group(P＜0.05).There were no significant differences in the post-admission imaging examination time,femoral artery puncture time,vessel recanalization time after thrombectomy,successful vascular reperfusion rate,good prognosis rate,mortality rate,and SICH incidence between patients with good collateral circulation and patients with poor collateral circulation in the two groups(P＞0.05).The hemorrhagic transformation rate of patients with good and poor collateral circulation in the direct thrombectomy group was significantly lower than that in the bridging thrombectomy group(P＜0.05).Conclusion Under different collateral circulation conditions,the safety and efficacy of direct thrombectomy and bridging thrombectomy in the treatment of acute anterior circulation large vessel occlusion stroke are similar,but bridging thrombectomy is more likely to result in cerebral hemorrhage transformation compared with direct thrombectomy.