OBJECTIVETo observe the clinical effect of central venous catheter in the treatment of refractory pleural effusion and pneumothorax.

METHODSPatients with coal workers' pneumoconiosis-tuberculosis complicated by pleural effusion or pneumothorax were randomly divided into central venous catheter group (48 cases, treated by chest drainage using a peripherally inserted central catheter) and conventional puncture group (56 cases, treated by conventional pleural puncture). Chemotherapy (DOTS strategy) was fully supervised, and both groups used 3HRZE/6HR (H, isoniazid; R, rifampicin; Z, pyrazinamide; E, ethambutol).

RESULTSIn the central venous catheter group, catheterization in the thoracic cavity was performed once in all cases, without fall-off; the mean total volume of pumped effusion was 3932±4430 ml; the time to disappearance of pleural effusion and pneumatosis was 10±2 d; 40 (83.33%) of the 48 cases were cured. In the conventional puncture group, the volume of pumped effusion was 2753±315 ml; the time to disappearance of pleural effusion and pneumatosis was 18±6 d; pleural puncture was performed twice in 4 cases, 3-4 times in 38 cases, and over 5 times in 10 cases, with an average of 3.8 times; 26 (46.43%) of the 56 cases were cured. The cure rate was significantly higher in the central venous catheter group than in the conventional puncture group (χ(2) = 7.59, P < 0.01).

CONCLUSIONFor pleural effusion and pneumothorax, PICC can be used instead of closed thoracic drainage and pleural puncture, and it has good clinical effect, causes little pain, and is easy to operate.

Anthracosis ; Catheterization ; Central Venous Catheters ; Drainage ; Humans ; Pleural Effusion ; complications ; therapy ; Pneumothorax ; complications ; therapy

OBJECTIVETo introduce the early clinical features and the main points of diagnosis and treatment of children with pancreatic pleural fistula presenting massive bloody pleural effusion.

METHODThe clinical data of symptoms, signs, laboratory examination, diagnosis and treatment methods of pancreatic pleural fistula in a child are presented.

RESULTA 4-year-old boy presented with one month history of intermittent fever, cough, chest tightness and chest pain. His pleural effusion collected from three thoracic closed drainage was hemorrhagic. He had no positive abdominal signs. His abdominal B-mode ultrasonography showed rough pancreatic echo. The levels of amylase in blood and pleural fluid were 495 U/L and 35 938 U/L, respectively. There was a fistulous tract from the thoracic cavity leading to the pancreas at thoracic surgical exploration. The child was cured by total parenteral nutrition, intravenous infusion of somatostatin and a stent placed in the pancreatic duct by endoscopic retrograde cholangiopancreatography (ERCP).

CONCLUSIONThe child with pancreatic pleural fistula in early stage mainly present respiratory symptoms and lack abdominal symptoms, so the diagnosis and treatment is often delayed. Significant increase of pancreatic amylase level in pleural effusion can be an important clue and basis for the diagnosis. If conservative therapy fails, the examination and treatment with ERCP should be considered.

Child, Preschool ; Humans ; Male ; Pancreatic Fistula ; complications ; diagnosis ; therapy ; Pleural Effusion ; diagnosis ; etiology ; therapy ; Recurrence

Fibrinolytic Agents ; therapeutic use ; Humans ; Lung Neoplasms ; complications ; Mesothelioma ; complications ; Pleural Effusion, Malignant ; drug therapy ; Streptokinase ; therapeutic use

Aged ; Anthracosis ; complications ; Catheterization ; Drainage ; methods ; Humans ; Male ; Middle Aged ; Pleural Effusion ; etiology ; therapy ; Pneumothorax ; etiology ; therapy ; Retrospective Studies

Lung cancer is the most commonly diagnosed cancer worldwide. Malignant pleural effusion (MPE) caused by advanced lung cancer seriously affect the patients' quality of life and prognosis. The management of MPE includes thoracentesis, pleurodesis, indwelling pleural catheters and drug perfusion in pleural cavity. Vascular endothelial growth factor (VEGF) and its receptor are a group of important ligands and receptors that affect angiogenesis. They are the main factors controlling angiogenesis, and they play an important role in the formation of MPE. Bevacizumab is a recombinant humanized VEGF monoclonal antibody, competitively binding to endogenous VEGF receptor. Bevacizumab can inhibit new blood vessel formation, reduce vascular permeability, prevent pleural effusion accumulation and slow the growth of cancers. This review aims to discuss the progress of bevacizumab in the treatment of MPE caused by non-small cell lung cancer (NSCLC), and explore the clinical application, efficacy, safety and future direction of bevacizumab.
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Antineoplastic Agents ; therapeutic use ; Antineoplastic Agents, Immunological ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; complications ; pathology ; Humans ; Pleural Effusion, Malignant ; drug therapy ; Pleural Neoplasms ; drug therapy ; secondary

OBJECTIVETo evaluate the clinical effect of Xuefu Zhuyu Decoction (XFZYD) on the incidence of complications of rib fracture in patients with blunt chest injury.

METHODSOne hundred and twenty patients with rib fracture stratified according to the AIS scale in three layers (1-3) were equally assigned to two groups, the treated group and the control group, all received conventional treatment, but XFZYD was administered to patients in the treated group additionally. The incidence of complications in patients, including atelectasis, pleural effusion, pulmonary contusion, pleurocentesis and closed thoracic drainage, were observed.

RESULTSThe incidence of pleural effusion in patients of AIS-1 and -2 in the treated group was 20% and 45% respectively, which was remarkable lower than that in the control group (55% and 85%) respectively (P < 0.05); in the treated group, 10% patients of AIS-3, for whom close thoracic drainage was applied, while in the control group, the percentage reached 60%, showing significant difference between groups (P < 0.05).

CONCLUSIONXFZYD could reduce the incidence of pleural effusion in patients with blunt chest injured rib fracture of AIS-1 or -2, and reduce the utilization of close thoracic drainage in those of AIS-3, so it is good for clinical practice.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Pleural Effusion ; etiology ; prevention & control ; Rib Fractures ; complications ; drug therapy ; Thoracic Injuries ; complications ; Wounds, Nonpenetrating ; complications

OBJECTIVETo evaluate the clinical efficacy of Xiaoshui Powder as auxiliary with chemotherapy for treatment of tuberculous remnant pleural effusion.

METHODSSixty patients were assigned to the treated group and the control group, 30 in each group. All were given conventional treatment but those in the treated group were given Xiaoshui Powder additionally. The hydrothorax disappearance time, and change of vital capacity of lung and immune function in patients were observed.

RESULTSHydrothorax disappearance time in all the 30 patients of the treated group was 26.0 +/- 3.8 days in average, while in the control group, it only disappeared in 23 with the mean disappearance time prolonged to 42.0 +/- 1.2 days, showing significant difference between the two groups (P<0.05). The improvement of pulmonary vital capacity and immune function in the treated group were superior to those in the control group (P <0.05).

CONCLUSIONXiaoshui Powder has definitely curative effect for auxiliary treatment of tuberculous remnant pleural effusion.

Adolescent ; Adult ; Aged ; Antitubercular Agents ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Pleural Effusion ; drug therapy ; etiology ; Treatment Outcome ; Tuberculosis, Pleural ; complications ; drug therapy ; Young Adult

While pleural effusion in multiple myeloma is relatively infrequent, myelomatous pleural effusion is extremely rare. We experienced a 61-year-old woman with IgD-lambda multiple myeloma and pleural effusion. The diagnosis was made originally by pleural biopsy, pleural fluid cytology and immunoelectropheresis of pleural fluid. Transient improvement of the pleural effusion was observed after administration of combination chemotherapy of vincristine, melphalan, cyclophosphamide, prednisone (VMCP)/vincristine, cyclophosphamide, adriamycin, prednisone (VCAP). Two months later, myelomatous pleural effusion recurred and no response to salvage therapy was observed. We reviewed the clinical feature of this case and literature concerning myelomatous pleural effusion.
Antineoplastic Agents, Combined/administration & dosage* ; Case Report ; Cyclophosphamide/administration & dosage ; Female ; Human ; Melphalan/administration & dosage ; Middle Age ; Multiple Myeloma/pathology ; Multiple Myeloma/drug therapy* ; Multiple Myeloma/complications* ; Plasma Cells/pathology ; Pleural Effusion/radiography ; Pleural Effusion/pathology ; Pleural Effusion/etiology* ; Prednisone/administration & dosage ; Tomography, X-Ray Computed ; Vincristine/administration & dosage

While pleural effusion in multiple myeloma is relatively infrequent, myelomatous pleural effusion is extremely rare. We experienced a 61-year-old woman with IgD-lambda multiple myeloma and pleural effusion. The diagnosis was made originally by pleural biopsy, pleural fluid cytology and immunoelectropheresis of pleural fluid. Transient improvement of the pleural effusion was observed after administration of combination chemotherapy of vincristine, melphalan, cyclophosphamide, prednisone (VMCP)/vincristine, cyclophosphamide, adriamycin, prednisone (VCAP). Two months later, myelomatous pleural effusion recurred and no response to salvage therapy was observed. We reviewed the clinical feature of this case and literature concerning myelomatous pleural effusion.
Antineoplastic Agents, Combined/administration & dosage* ; Case Report ; Cyclophosphamide/administration & dosage ; Female ; Human ; Melphalan/administration & dosage ; Middle Age ; Multiple Myeloma/pathology ; Multiple Myeloma/drug therapy* ; Multiple Myeloma/complications* ; Plasma Cells/pathology ; Pleural Effusion/radiography ; Pleural Effusion/pathology ; Pleural Effusion/etiology* ; Prednisone/administration & dosage ; Tomography, X-Ray Computed ; Vincristine/administration & dosage

PURPOSE: We evaluated the clinical characteristics and courses of patients with congenital cystic adenomatoid malformation (CCAM) complicated by pneumonia. MATERIALS AND METHODS: We retrospectively reviewed the records of 19 adult patients with surgically confirmed CCAM between March 2005 and July 2013. RESULTS: Eighteen of nineteen patients presented with acute pneumonia symptoms and signs, and inflammatory markers were elevated. On chest computed tomography, all 18 patients had parenchymal infiltration around cystic lesions, 17 (94%) had an air-fluid level, and 2 (11%) had pleural effusion. After antibiotics treatment for a median of 22 days prior to surgery, all acute pneumonia symptoms and signs disappeared in 17 (94%) patients at a median of 10 days. Improvements and normalization of inflammatory marker levels, occurred in 17 (94%) and 9 (50%) patients at medians of 8 and 17 days, respectively. Radiological improvement was evident in 11 (61%) patients, at a median of 18 days, of these patients, partial radiological improvement occurred in 10 (56%) and complete radiological resolution in only 1 (6%). One patient (6%) did not improve in terms of clinical, laboratory, or radiological findings despite antibiotic treatment for 13 days. Consequently, after 17 (94%) elective and 1 (6%) emergency surgeries, all patients improved without development of complications. CONCLUSION: We described the clinical characteristics and courses of patients with CCAM complicated by pneumonia, and showed that surgery may be performed safely after clinicolaboratory improvement is attained upon antibiotic treatment, even in the absence of complete radiological resolution.
Adult ; Cystic Adenomatoid Malformation of Lung, Congenital/*diagnosis/*surgery/therapy ; Female ; Humans ; Male ; Physical Examination ; Pleural Effusion ; Pneumonia/complications/*radiography ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome