Objective To compare the clinical effect of video-assisted thoracoscopic surgery (VATS) and chest tube drainage combined with urokinase for the treatment of empyema after fibropurulent pneumonia, and to determine the best therapy for patients. Methods Patients were randomly divided into two groups according to inclusion and exclusion crite?ria:55 patients were selected as group VATS performed VATS;46 patients were selected as drainage group performed 12F catheter chest closed drainage by Seldinger technique under B ultrasound guidance. The 100 000 unit urokinase was inject?ed into chest, and open after 4-hour closed, once a day for three days. Values of white blood cell (WBC), pH, glucose, lactate dehydrogenase (LDH) and C reactive protein (CRP) of pleural effusion before treatment were recorded, and the duration of fe?ver after treatment, duration of chest-tube placement, antibiotic use, hospital stay, cure rate, complication and hospitaliza?tion expenses were also recorded. Results The duration of fever after treatment,, duration of chest-tube placement, antibiot?ic use and hospital stay were significantly lower in VATS group than those in drainage group. The cure rate was significantly higher in VATS group than that of drainage group (P<0.05). There were no significant differences in complication rates and hospitalization expenses between two groups. There was no death in both two groups. Conclusion VATS is more suitable for the treatment of empyema after fibropurulent pneumonia than chest tube drainage combined with urokinase, and which is worthy of clinical promotion for not adding complication rates and hospitalization expenses.

Objective To analyze the causes,cardiac function grading and drug application related to heart failure of the patients with chronic heart failure in Yongchuan district people's hospital.Methods The cases of chronic heart failure of department of cardiology in our hospital from January 1st,2012 to December 31st,2015 were counted and retrospectively analyzed.Results 3 320 cases of chronic heart failure in our hospital chosen from 8 126 medical records accounted for 40.86% of total discharged patients in the same period,including 2 262 cases of coronary disease (68.13%),353 cases of rheumatic heart disease (10.63%)and 265 cases of pulmonary heart disease (7.98%),who took up the top three in the spectrum of disease;2 683 cases of NYHA heart function Ⅲ magnitude accounted for 80.81%;The utilization rate of diuretic,digoxin,spironolactone,angiotensin -converting enzyme inhibi-tor,angiotonin receptor blocker,beta adrenergic receptor were 71.23%,27.23%,70.48%,30.75%,30.78%respectively.The statistical analysis showed that the differences were statistically significant between the patients using diuretics and the patients using spirolactone(χ2 =2.386,P <0.001),the patients with hypertension and the patients with no hypertension using ACEI /ARB(χ2 =2.727,P <0.001),and merged chronic bronchitis patients and the chro-nic bronchitis patients using beta -blocker(χ2 =61.807,P <0.001).Conclusion The patients with chronic heart failure takes up a higher portion among the inpatients in department of cardiology in the district level hospital.The heart function decreases significantly and the normative drug therapy needs to be improved.

Objective:To investigate the diagnosis and treatment value of intraoperative ultrasound (IOUS) in video-assisted thoracic surgery (VATS) of small solitary pulmonary nodule (SSPN).Methods:Of the 35 SSPN patients who received VATS in Tianjin Third Central Hospital from January 2016 to January 2020, the visual and touch examination (VTE) and IOUS method were used to locate pulmonary nodules during the operation. The differences between the two methods in the locating success rate and locating time were compared. The imaging findings of SSPN were classified and the sonographic characteristics of SSPN were summarized by univariate analysis.Results:The success rate of IOUS locating was 91.43%(32/35), which was higher than that of VTE 48.57%(17/35), and the difference was statistically significant (χ 2=15.310, P<0.001). The time of IOUS locating (6.23±1.93)min was shorter than that of VTE(9.98±1.56)min, and the difference was statistically significant ( t=6.940, P<0.001). The sonograms of 32 SSPN(17 malignancy and 15 benign) patients were all hypoechoic, univariate analysis showed that heterogeneous echo (χ 2=10.615, P=0.01) and unclear borderline (χ 2=10.041, P<0.001) were helpful to judge the benign or malignant. Conclusions:In video-assisted thoracic surgery, using IOUS could quickly and accurately locate and diagnose SSPN, which can shorten the operation time, improve the resection efficiency and guide the operation.

BACKGROUND: Non-small cell lung cancer (NSCLC) have the highest incidence of lung cancer which treatment principles are diagnosis and treatment as early as possible. Because of its insidious onset and lack of specific markers for early screening, most patients are at an advanced stage when diagnosed which results in a low 5-year survival rate and poor prognosis. Therefore Exploring a sensitive biomarker is the focus of current diagnosis and treatment of lung cancer. The aim of this study is to investigate the biological markers in serum of patients with I-IIb stage NSCLC by differential peptidomics analysis. METHODS: The serum peptidome was compared and analyzed among the groups of normal health controls, benign lung diseases and early stage NSCLC patients using a nano ultra-performance liquid chromatography combined with a quadrupole-orbitrap mass spectrometer. The differentially expressed polypeptides were identified and analyzed quantitatively to screen the tumor biomarkers for the early diagnosis of NSCLC patients. RESULTS: According to the Swiss-Prot database, a total of 545 polypeptides originated from 118 proteins were identified. The spectral numbers of serum polypeptides in each group were compared and a total of 201 polypeptides differentially expressed were found. Following a quantitative analysis of the above peptides, we found that there were 7 peptides with the coefficient of variation (CV) less than 30% and among them the peptide of QGAKIPKPEASFSPR from ITIH4 was down-regulated and the peptide of CDDYRLC from MGP was up-regulated in NSCLC group. CONCLUSIONS The tumor biomarkers obtained by serum peptidome technology can provide a new clue for early diagnosis of NSCLC and the specific peptides hydrolyzed from ITIH4 and MGP may be the serum biological markers for early NSCLC patients.
Adult ; Aged ; Amino Acid Sequence ; Biomarkers, Tumor ; blood ; chemistry ; Carcinoma, Non-Small-Cell Lung ; blood ; diagnosis ; Early Detection of Cancer ; Female ; Humans ; Lung ; pathology ; Lung Neoplasms ; blood ; diagnosis ; Male ; Middle Aged ; Neoplasm Staging ; Peptides ; blood ; chemistry ; Proteomics ; methods ; Sensitivity and Specificity ; Young Adult