Objective:To explore the predictive factors for extubation in the operating room after single lung transplantation without the assistance of extracorporeal membrane oxygenation (ECMO) in adult patients with end-stage interstitial lung disease (ILD), as well as their short-term (1-year postoperative) prognosis.Methods:A retrospective analysis was conducted on the clinical data of 78 adult ILD recipients who underwent single lung transplantation without ECMO assistance at the First Affiliated Hospital of Guangzhou Medical University from June 2018 to June 2023. Based on whether extubation was completed in the operating room (OR), patients were divided into the OR group (19 cases) and ICU group (59 cases). Baseline characteristics of donors and recipients, as well as intraoperative events, were compared between the two groups. Univariate logistic regression analysis was used to identify potential predictors, and variables with P<0.2 were included in multivariate logistic regression to determine independent predictors for OR extubation. Receiver operating characteristic (ROC) curves were plotted to evaluate predictive performance. The Kaplan-Meier method was used to analyze survival, and short-term prognosis between groups was compared. Results:The rate of OR extubation after single lung transplantation in ILD recipients was 24%(19/78). Compared with the ICU group, the OR group had shorter operation times, lower fluid volumes, reduced transfusions of red blood cells and plasma, less intraoperative bleeding, and lower lactate levels 15 minutes after pulmonary artery reperfusion (all P<0.05). Univariate logistic regression analysis identified the following factors as significantly associated with OR extubation: recipient age ( P=0.100), operative time ( P=0.001), fluid infusion volume ( P=0.005), red blood cell transfusion volume ( P=0.037), plasma transfusion volume ( P=0.039), blood loss ( P=0.004), oxygenation index at 15 minutes after reperfusion ( P=0.174), and blood lactate at 15 minutes after reperfusion ( P=0.041). Multivariate analysis revealed that intraoperative blood loss was an independent predictor of OR extubation ( OR=0.993, 95% CI: 0.986 - 0.999, P=0.026). ROC curve analysis showed that blood loss had an area under the curve (AUC) of 0.822 in predicting OR extubation, with a sensitivity of 64.4% and specificity of 89.5%. Postoperatively, patients in the OR group had significantly shorter durations of mechanical ventilation [0 vs 5 (3,11) days, P<0.001], ICU stay [7(4,8) vs 9(6,20) days, P=0.012], and overall postoperative hospitalization [19 (15,23) vs 25 (19,39) days, P=0.015]. Within one year after surgery, 2 patients (11%) in the OR group and 19 patients (32%) in the ICU group had died, but the difference in 1-year survival rates between the two groups was not statistically significant. Conclusions:Intraoperative blood loss is an independent predictor of extubation in the operating room. Early extubation in non-ECMO-assisted single lung transplantation for ILD patients is associated with improved short-term outcomes.

Objective:To explore the predictive factors for extubation in the operating room after single lung transplantation without the assistance of extracorporeal membrane oxygenation (ECMO) in adult patients with end-stage interstitial lung disease (ILD), as well as their short-term (1-year postoperative) prognosis.Methods:A retrospective analysis was conducted on the clinical data of 78 adult ILD recipients who underwent single lung transplantation without ECMO assistance at the First Affiliated Hospital of Guangzhou Medical University from June 2018 to June 2023. Based on whether extubation was completed in the operating room (OR), patients were divided into the OR group (19 cases) and ICU group (59 cases). Baseline characteristics of donors and recipients, as well as intraoperative events, were compared between the two groups. Univariate logistic regression analysis was used to identify potential predictors, and variables with P<0.2 were included in multivariate logistic regression to determine independent predictors for OR extubation. Receiver operating characteristic (ROC) curves were plotted to evaluate predictive performance. The Kaplan-Meier method was used to analyze survival, and short-term prognosis between groups was compared. Results:The rate of OR extubation after single lung transplantation in ILD recipients was 24%(19/78). Compared with the ICU group, the OR group had shorter operation times, lower fluid volumes, reduced transfusions of red blood cells and plasma, less intraoperative bleeding, and lower lactate levels 15 minutes after pulmonary artery reperfusion (all P<0.05). Univariate logistic regression analysis identified the following factors as significantly associated with OR extubation: recipient age ( P=0.100), operative time ( P=0.001), fluid infusion volume ( P=0.005), red blood cell transfusion volume ( P=0.037), plasma transfusion volume ( P=0.039), blood loss ( P=0.004), oxygenation index at 15 minutes after reperfusion ( P=0.174), and blood lactate at 15 minutes after reperfusion ( P=0.041). Multivariate analysis revealed that intraoperative blood loss was an independent predictor of OR extubation ( OR=0.993, 95% CI: 0.986 - 0.999, P=0.026). ROC curve analysis showed that blood loss had an area under the curve (AUC) of 0.822 in predicting OR extubation, with a sensitivity of 64.4% and specificity of 89.5%. Postoperatively, patients in the OR group had significantly shorter durations of mechanical ventilation [0 vs 5 (3,11) days, P<0.001], ICU stay [7(4,8) vs 9(6,20) days, P=0.012], and overall postoperative hospitalization [19 (15,23) vs 25 (19,39) days, P=0.015]. Within one year after surgery, 2 patients (11%) in the OR group and 19 patients (32%) in the ICU group had died, but the difference in 1-year survival rates between the two groups was not statistically significant. Conclusions:Intraoperative blood loss is an independent predictor of extubation in the operating room. Early extubation in non-ECMO-assisted single lung transplantation for ILD patients is associated with improved short-term outcomes.

Objective: To achieve intelligent access to normal training or individual soldier signs information during the war, establish individual soldier health intelligent interactive regulation and health system platform of IOT, realized digitalization, information management mode. Methods: Using the communication network, intelligent call, vital signs monitoring technology, to design intelligent signs monitoring system. Results:This system is mainly for the automatic sense of individual signs in the training or war, to understand the individual activity, get the sign data, which can send information through a call or intelligent system, based on the identification and location, medical personnel to care and treatment in the shortest time, construction of intelligent information. Conclusion: Through the use of intelligent detection system to Individual life signs in training or in wartime, the system can always grasp of individual soldier signs, and realizing a complete coverage of all of the intelligent health monitoring system, to provide effective guarantee for wartime workers health.

Objective: The mobile medical collaborative service platform can realize mobile nursing informatization, which will bring new changes to the nursing work, and work flow is optimized. The construction of mobile nursing system is the trend of development in informatization, in order to better service to patients, realize full nursing work informatization. Methods: Based on wireless dynamic environment, and three subsystems including nursing collaboration portal, intelligent mobile terminal application system, the message engine service system, it adopts hierarchical architecture design, based on SOA structure mode, whose modules are loosely coupled, and platform core includes: the message engine subsystem, the medical task analysis engine subsystem, WEB middleware subsystem and the client subsystem,in order to realize the service management of mobile medical collaboration. Results: According to the actual situation of nursing work in hospitals, construction of mobile nursing system by the stage of application, to meet the core work of nursing, and then realize the basic nursing work, the construction of digital implementation of nursing information, to realize the informatization construction of digital care. Conclusion: Application of the system to achieve the whole informatization of the nursing management, through access to health services, cloud services center, to share resources, to achieve full coverage of all aspects of smart care management for people's health to provide effective protection.

Objective: To design device to measure D/T index which is used for evaluation of arteriosclerosis. Methods:By calculating the detected date of blood pressure values, pulse pressure, pulse rate, pulse patterns and SpO2 on the extremities, we get a set of analytical data in the system in order to analyze the arteriosclerosis situations. Results: The device use the ECG signal as it based and modulated signal, the computer process the date of blood pressure and SpO2, then output the result by the display and printing systems. Conclusion:The device provides an effective noninvasive detection means for extremity vascular.

Mobile X-ray system is a very important equipment in hospital,but it's difficult to protect the user from the exposure of the X-ray while the equipment is in use.This paper introduces a circuit that is able to control the exposure by remote controller and it can solve the problem of the protection better.The efficiency is proved to be good by experiments.

Accompanied with the application of CT,MRI and DSA in hospital,the digital radiography is gradually instead of the general radiography.The digital radiography system is more advantage in the field of the image collection,display,procession,management and transmission compared with the general radiography.

OBJECTIVESTo analyze the technical aspects of uterine artery embolization with dextran microspheres and to evaluate the effectiveness of this technique as the primary treatment of uterine fibroids in a series of 38 patients.

METHODSThirty-eight volunteers (age range, 24-48 years; mean, 37.2 years) with symptoms caused by uterine fibroids (menorrhagia, mass-related symptoms, and pelvic pain) were randomly included in this study. The fibroids were single in 32 patients and multiple in 6 patients. According to the tumor location, subserous fibroids were found in 4 patients and interstitial or submucosal fibroids in 34. Tumor size was from 2 to 10.9 cm in diameter. We performed embolization with a single Headhunter catheter using the right-femoral artery approach, injection of dextran microspheres (225-450 micro m), and an absorbable gelatin sponge. Follow-up included clinical and sonographic examinations at one-month intervals for 6 months.

RESULTSEmbolization was successfully performed in all patients. Post-procedural pain control was good in 35 (92%) patients. In most patients, symptoms were improved at 3 months (36/38, 95%). Clinical failure of the treatment occurred in only 2 patients (2/38, 5%). Progressive reduction in leiomyoma size was revealed during sonographic follow-up, and the reduction rate at the sixth month after embolization was 68%. The tumor had vanished in five submucosal fibroid patients. Histopathological tests showed that the tumor was degenerative as fibrosis and hyalinosis.

CONCLUSIONSUterine artery embolization with dextran microspheres is a micro-invasive method for the treatment of uterine fibroids. It is clinically effective in most patients and induces a progressive reduction in the size of fibroids. Based on this study, we believe that this new technique is much more suitable for submucosal fibroids with massive menorrhagia.

Adult ; Dextrans ; administration & dosage ; Embolization, Therapeutic ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Leiomyoma ; therapy ; Middle Aged ; Uterine Neoplasms ; therapy ; Uterus ; blood supply