Objective To investigate the value of video-assisted thoracoscopy in the diagnosis and treatment of pleural effusion with unknown causes.Methods Video-assisted thoracoscopic biopsy or pleurodesis was performed in 45 cases of pleural effusion unexplained by routine examinations from March 2002 to March 2005.Results The diagnosis was clarified in all the 45 cases.There were 3 cases of malignant effusion,38 cases of tuberculous pleurisy,3 cases of nonspecific effusion,and 1 case of idiopathic pleural effusion.No severe surgical complications occurred.Follow-up checkups for 2~36 months found no recurrence.Conclusions Video-assisted thoracoscopy is a safe,effective,and micro-traumatic approach for the diagnosis and treatment of pleural effusion.

Objective Summarize the experience of single port video-assisted thoracoscopic surgery (SPVATS).Evaluate the value of SPVATS for thoracic diseases.Methods 32 patients underwent SPVATS from March 2011 to May 2011,including 28 males and4 females,with an average age of (26.5 ±9.2) years (ranged 18-72 years).There were twenty-seven cases of spontaneous pneumothorax ( including 2 cases of single stage bilateral surgery),three cases of unknown pleural effusion,one case of bilateral pulmonary nodules,and one case of pulmonary metastasis tumor.Results All procedures were successfully accomplished without conversion to conventional multi-port VATS or open approach.There was no major complication or operative death.All procedures were using self-developed specialized surgical instruments and two-incision joint protection.The procedures inluded resection of lung bullae in 27 cases,purulent drainage fiber stripping pleural lavage in 3,parietal pleural biopsy in 1,and pulmonary wedge resection in 1.The operating time ranged from (22.0 ± 9.5 ) min.The average intraoperative blood loss was ( 14.5 ± 8.8 )ml.The mean chest tube duration was (3.1 ± 0.6 ) days.The average postoperative hospital stay was (6.8 ± 1.6 ) days.Conclusion SPVATS is a new approach for treatment of thoracic diseases.This technique is preferred as a minimally invasive and cosmetic procedure with decreased operative time,quickened postoperative recovery,few complications,and satisfactory short-term outcome.

OBJECTIVETo evaluate the feasibility of surgical management for patients with locally advanced carcinomas of uterine cervix after radical radiation therapy who were prone to develop central recurrence.

METHODSThese 40 patients were treated by combined pre-operative radiotherapy with dose at point A of > 70 Gy in 30 patients, 60 approximately 70 Gy in 7, 50 approximately 59 Gy in 2 and 44 Gy in 1. The interval between radiation and surgery was 1 - 6 weeks. Extrafascial hysterectomy was performed in 15 patients, subradical hysterectomy in 23 and radical hysterectomy with pelvic lymphadenectomy in 2 cases.

RESULTSThese patients have been followed up for 1 - 8 years with 2 died of other diseases and 12 died of cancer. Eighteen of the 26 survivors have been followed up for more than 5 years. The 3- and 5-year survival rates were 74.9% and 66.8%. Half of the death occurred within the first year after treatment. The 2-year death rate was 9/12 (75.0%). Three patients suffered from long term complications after the treatment, but all were cured by conservative management.

CONCLUSIONThe combination of hysterectomy performed shortly after radical radiotherapy, ie, for patients with locally poor prognostic cervical carcinoma is reasonable and feasible.

Adult ; Cervix Uteri ; Combined Modality Therapy ; Female ; Humans ; Hysterectomy ; Middle Aged ; Neoplasm Staging ; Survival Rate ; Uterine Cervical Neoplasms ; mortality ; radiotherapy ; surgery

In order to evaluate the moUuseicidal effect of 50% wettable power of niclosamide ethanolamine salt(WPN)combined with urea against Oncomelania snails in the field,4 g/m~2 WPN,4 g/m~2 WPN+20 g/m2 urea and 4 g/m~2 WPN+30 g/m~2 urea were used for mollusciciding with the spraying method.The results showed after 7 days,the mortality rates of snail were 74.43% for 4 g/m~2 WPN,90.32% for 4 g/m~2 WPN+20 g/m~2 urea and 94.83% for 4 g/m~2 WPN+30 g/m~2 urea,respectively.It is indicated that WPN combined with urea can improve the molluscieidal effect significantly.

OBJECTIVETo explore the relationship between nurse occupational stress and salivary alpha- amylase (SAA).

METHODSEvaluation of occupational stress was conducted in 131 nurses. The activity of SAA was determined using enzyme-linked immunosorbent assay (ELISA).

RESULTSThe activity of SAA in nurses varied with age and working years. The baseline, work period, recovery, average activities of >35 age group were less than those of ≤ 30 age group; work period, recovery, average activities of ≤ 10 years group were higher than other two groups; there was no statistical difference between SAA vitalities of different degree groups (P>0.05). In nurses with high scores for job demands, the activity of SAA in working period was significantly higher than that in nurses with low scores (P < 0.05). The baseline SAA activity in nurses with high scores for role conflict and ambiguity was significantly higherthan thatin nurses with low scores (P < 0.05). The baseline SAAactivity was positively correlated with workload, role conflict, and role ambiguity (P < 0.05). The activity of SAA in working period was negatively correlated with task control, decision control, and technology utilization (P < 0.05), and was positively correlated with quantitative load, load change, work monotony, and workload (P < 0.05). The activity of SAA in recovery period was negatively correlated with task control, decision control, resource control, and technology utilization (P < 0.01). The average activity of SAA was negatively correlated with task control, decision control, resource control, technology utilization, opportunity for participating in decision-making, and promotion (P < 0.05), and was positively correlated with quantitative load, load change, workload, and role ambiguity (P < 0.05).

CONCLUSIONThe occupational stress in 131 nurses is correlated with the activity of SAA, which can be used as an objective biomarker for identification and evaluation of occupational stress.

Biomarkers ; Humans ; Nurses ; psychology ; Occupational Diseases ; epidemiology ; Salivary alpha-Amylases ; analysis ; Stress, Psychological ; diagnosis ; epidemiology ; Work ; Workload

OBJECTIVETo investigate the effect of occupational stress on the oxidation/antioxidant capacity in nurses.

METHODSA total of 131 nurses were included as study subjects. The occupational health information collection system (based on the Internet of things) was used for measurement of occupational stress. Levels of hydroxyl free radicals and antioxidant enzymes were determined.

RESULTSThe serum level of superoxide dismutase (SOD) was the highest in nurses under the age of 30 and the lowest in those over 45 (P < 0.05). The serum levels of glutathione peroxidase (GSH-Px) and peroxidase (POD) were the highest in nurses of working age less than 5 years, followed by those of 5-15 years, and nurses with more than 25 years' working experience showed the lowest GSH-Px and POD levels (P < 0.05). Furthermore, nurses with a university (college) degree had a higher GSH-Px level and a lower POD level compared with those with junior and senior high school degrees (P < 0.05). Job prospects and job control were positive occupational stress factors for SOD. Job hazards were negative occupational stress factors for POD. Psychological satisfaction was negative occupational stress reaction for hydroxyl free radicals. Calmness was positive occupational stress reaction for SOD, and daily stress was a negative one. The positive occupational stress reactions for GSH-Px were psychological satisfaction and job satisfaction, and daily stress was negative reaction.

CONCLUSIONNurses with higher occupational stress have stronger oxidation and weaker antioxidant capacity, which intensifies oxidant-antioxidant imbalance and leads to oxidative stress damage.

Adult ; Glutathione Peroxidase ; blood ; Humans ; Malondialdehyde ; blood ; Middle Aged ; Nurses ; psychology ; Oxidative Stress ; Reactive Oxygen Species ; blood ; Stress, Psychological ; blood ; Superoxide Dismutase ; blood ; Surveys and Questionnaires

OBJECTIVETo investigate the impact of occupational stress on serum monoamine neurotransmitters in nurses.

METHODSA total of 131 nurses were included as study subjects by stratified cluster sampling. The occupational health information collection system (based on the Internet of things) was used to measure occupational stress. Serum levels of monoamine neurotransmitters were also measured.

RESULTSEpinephrine (E) was negatively correlated with superior support (P < 0.05) and colleague support (P < 0.05). Negative correlation was also found between dopamine (DA) and job prospect (P < 0.05). Level of 5-hydroxytryptamine was negatively correlated with promotion opportunities (P < 0.05). Norepinephrine (NE), E, and DA were all negatively correlated with work satisfaction (P < 0.05) and positively correlated with daily stress (P < 0.01). NE and E were negatively correlated with sufficient confidence (P < 0.05) and positively correlated with physical complaints (P < 0.01). There was a negative correlation between NE and psychological satisfaction (P < 0.05).

CONCLUSIONOccupational stress in nurses is correlated with serum monoamine neurotransmitters, and it may affect serum levels of monoamine neurotransmitters to a certain extent.

Adult ; Biogenic Monoamines ; blood ; Female ; Humans ; Job Satisfaction ; Middle Aged ; Neurotransmitter Agents ; blood ; Nurses ; psychology ; Stress, Psychological ; Surveys and Questionnaires

Objective To observe the clinical effect of the maintenance for the liver and kidney function by extra corporeal membrane oxygenation (ECMO) in brain death donor with severe hemodynamic instability.Methods Ninety-nine brain death donors maintained by ECMO were followed up.The criteria for using the ECMO to protect the organ function were as follow:cardiopulmonary resuscitation history (cardiac compression ＞ 20 min);mean arterial pressure (MAP),for Adult ＜60-70 mmHg,for child ＜50-60 mmHg,and for infant ＜40-50 mmHg;cardiac index ＜2 L/(m2 ·min) (3 h);Large doses of vasoactive drugs,for doparnine 20μg/(kg·min),for (norepinephrine) epinephrine 1.0 μg/(kg· min) (3 h),and for oliguria ＜0.5 mL/(kg · h);blood biochemical indexes,moderate,severe impairment on acute hepatic and renal function;others,ST-T significant changes in electrocardiogram,and difficult to correct the metabolic acidosis (3 h).The organs were evaluated during their retrieval and as well their evolution after transplantation was evaluated.Results ECMO allowed for the maintenance of hemodynamic stability before organ procurement.A total of 99 cases receiving ECMO maintenance were collected,equal to100 ％ of the total donation cases (100％).198 kidneys,and 99 livers were procured from these donors meanwhile 15 kidneys and 42 livers respectively were discarded as theywere shown in a macroscopic evaluation.177 of the procured kidneys were transplanted.DGF of kidney transplantation was observed in 20.9％of the cases.Acute rejection incidence was 12.99％.Transplanted kidneys and recipient survival rate was 96.1％/99.3％ for one year,94.7％/97.8％ for 3 years,and 93.6/97.8％ for 4 years,respectively.There was no significant difference in patient or graft survival between the group with ECMO and the group without ECMO.Conclusion ECMO in the brain dead donors with severe circulatory dysfunction allows to avoid organ donors loss and obtain good quality kidneys and livers with excellent graft survival after transplantation.

Objective By analyzing the perioperative management in our hospital to explore the clinical effect and safety of single kidney transplantation from deceased juveniles' donors.Methods We retrospectively analyze 86 cases of kidney transplantations from deceased juveniles' donors in our hospital from 2007 December to 2015 August.Results The success rate of the operations was 100％.The postoperative complications occurred as fellows:7 cases of acute rejection (8.14％);10 cases of drug intoxication (11.62％);21 cases of DGF (24.44％),4 cases of leakage of urine (4.65％),7 cases of lung infection (8.14％).Two cases (2.32％) died after the operation because of serious lung infection,and by corresponding treatment 47 cases recovered after 2-4 weeks.The creatinine level in 37 cases without any complications was 131.88 ± 44.20 μmol/L during discharge.Conclusion With strict selection,the organ from a deceased juvenile donor is safe and practicable.

Objective:To explore the incidence, clinical characteristics and prognosis of invasive pulmonary fungal infection(IPFI)in recipients of lung transplantation(LT)in southern China.Methods:From January 2003 to August 2019, retrospective analysis was performed for 300 recipients of lung transplantation at three hospitals in southern China. There were 254 males and 46 females with an average age of (54.98±14.2)years. Clinical data were collected from medical records, including symptoms and signs, imaging studies, bronchoscopy examination, pathogen separation and culture from deep sputum and bronchoalveolar lavage fluid(BALF), fungal-related laboratory tests and tissue pathology.Results:Among 300 cases, 93(31.0%)had at least one episode of IPFI. The most common pathogen was aspergillosis(60.2%), followed by candida(15 cases, 16.1%)and Pneumocystis jeroveci (13 cases, 14.0%). Kaplan Meier analysis indicated that all-cause mortality was significantly higher in IPFI group than that in non-IPFI(nIPFI)group with one-year mortality of 45.2% vs. 26.7% in IPFI and nIPFI groups respectively( P<0.05). Conclusions:IPFI is prevalent after LT in southern China. And aspergillosis is the most common pathogen and Candida comes the next. The median occurring time for aspergillosis is 6 months after LT. Candida infection occurs earlier at airway anastomosis. A higher incidence of invasive fungal disease(IFD)associated with a lower survival indicates that IPFI has a substantial mortality among recipients after LT. Prophylactic agents should be optimized based upon an epidemiologically likely pathogen.