Objective: To evaluate the clinical efficacy of a novel autologous blood recovery device during the weaning process from extracorporeal membrane oxygenation (ECMO). Methods: A total of 16 patients who received ECMO support and underwent blood recovery during the weaning process from January 2022 to September 2024 at our hospital were included in the experimental group. In contrast, 58 patients who did not receive blood recovery during the weaning process were assigned to the control group. Transfusion components, costs, and changes in routine blood tests and coagulation functions were compared between the two groups from the day of weaning until 48 hours post-weaning. Results: Significant differences were observed in the volumes of red blood cell transfusions, plasma transfusions, and transfusion costs between the two groups from the day of weaning to 48 hours post-weaning (P<0.05). Additionally, in the experimental group, significant differences were noted in hemoglobin (Hb), platelet (Plt), and activated partial thromboplastin time (APTT) results when comparing values before and after extubation (P<0.05). Conclusion: The application of a novel autologous blood recovery device during ECMO weaning reduces patient costs, minimizes wastage of autologous blood, decreases reliance on exogenous blood transfusions, and mitigates the risks associated with allogeneic blood transfusion. This approach merits further promotion for clinical use.

Objective To compare the clinical efficacy of three-dimensional (3D) and two-dimensional (2D) laparoscopic repairs of gastroduodenal perforation.Methods The retrospective cohort study was conducted.The clinicopathological data of 92 patients who underwent laparoscppic repair of gastroduodenal perforation from July 2014 to December 2017 in the Ganzhou People's Hospital were collected.Forty-four patients undergoing 3D laparoscopic repair and 48 patients undergoing 2D laparoscopic repair were respectively allocated into the 3D and 2D groups.Observation indicators:(1) comparisons of intra-and post-operative recovery;(2) postoperative drug sensitivity test and pathological examination;(3) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect complications after discharging from hospital up to August 2018.Measurement data with normal distribution were represented as x-±s and comparison between groups was analyzed using t test.Measurement data with skewed distribution were described as M (range).Comparison between groups of count data was analyzed using the chi-square test.Results (1) Comparison of intra-and post-operative recovery:92 patients underwent successfully laparoscopic gastroduodenal perforation,without conversion to open surgery or perioperative death.The operation time,time of pathological tissue extract at the perforation,time of perforation repair,volume of intraoperative blood loss and time of initial anal exsufflation were respectively (60± 8)minutes,(36± 6) seconds,(137±12)seconds,(9.0±2.2)mL,(23.8±2.8)hours in the 3D group and (70±9)minutes,(39±6) seconds,(143±14) seconds,(10.3±2.5) mL,(25.9±4.8) hours in the 2D group,with statistically significant differences between groups (t =5.795,2.779,2.215,7.740,2.570,P＜0.05).Three patients in the 3D group were complicated with pulmonary infection,localized atelectasis and delirium.Two patients in the 2D group were complicated with pulmonary infection and heart failure.Patients with complications between groups were improved by symptomatic and supporting treatment.There was no statistically significant difference in cases with postoperative complications between groups (x2 =0.010,P＞ 0.05).(2) Postoperative drug sensitivity test and pathological examination:the ascites culture of peritoneal effusion in the 2 groups was positive,and drug susceptibility results were obtained.No malignant cells at the perforation were found in pathological examination.(3) Follow-up:84 patients were followed up for 1-12 months,with a median time of 3 months.There was no related complication after discharging from hospital.Conclusion Compared with 2D laparoscopic repair of gastroduodenal perforation,3D laparoscopic repair of gastroduodenal perforation not only is safe and feasible,but also has advantages of shorter operation time,perforation repair time and time of pathological tissue extract at the perforation,less volume of intraoperative blood loss and shorter time of initial anal exsufflation.

Objective To investigate the changes and significance of serum C reactive protein (CRP) and calcitonin (PCT) levels in the elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods One hundred and twenty elderly patients with AECOPD in the respiration deplartment of our hospital from January 2013 to study One hundred and twenty elderly patients with AECOPD in our hospital from January 2013 to June 2015 were selected to conduct the study and performed the subgroup analysis according to the BODE index (body weight,dyspnea,airflow,motor function index),times of acute exacerbation within 1 year after treatment and recurrence time,and other 40 healthy subjects in the outpatient department were selected as the control group.The serum PCT and CRP levels were compared among various groups.Results Serum CRP and PCT levels in AECOPD patients with grade 1-4 of BODE index were significantly higher than those in the control group (P＜0.05),moreover in the intra-group comparison of serum CRP and PCT,the grade l＜grade 2＜grade 3＜grade 4,the differences were statistically significant (P＜0.05).Serum CRP and PCT had the significantly positive correlation with the grades of BODE index in AECOPD patients (r=0.482,0.317,P＜0.05).After treatment,serum CRP and PCT levels in AECOPD patients with recurrence occurred more than 3 months were significantly lower than those in the patients with recurrence occurred within 3 months,the difference was statistically significant (P＜0.05);serum CRP and PCT levels in the patients with more than once recurrence at 1 year after discharge from hospital were significantly higher than those in the patients with recurrence ≤once,the difference were statistically significant (P＜0.05).Conclusion The serum levels of CRP and PCT in the patients with AECOPD can reflect dyspnea,airflow limitation and motor function ability,and conducts the preliminary assessment on the patient's prognosis.