Objective:To analyze the clinical efficacy of three-dimensional(3D) reconstruction guided uniportal fluorescence thoracoscopic subsegmentectomy for the pulmonary nodules.Methods:We retrospectively analyzed 50 patients with nodules who underwent uniportal fluorescence thoracoscopic subsegmentectomy from December 2021 to February 2024. All patients underwent thin-slice CT scanning and 3D reconstruction preoperatively. 12 patients were given CT-guided hookwire localization preoperatively.The intersegmental plane was identified by fluorescence method.Results:One patient was converted to right upper lobectomy due to no lesion found in S1b. The mean blood loss was(23.4±16.5)ml and the mean operative time was(126.5±38.5)min. The mean duration of postoperative drainage was(2.6±0.8)days. Mean postoperative hospitalization was(4.8±1.8)days. There were 2 cases with postoperative pulmonary infections, including one with encapsulated pleural effusion. There was no air leakage over 3 days, and no death within 30 days after surgery.Conclusion:3D reconstruction guided uniportal fluorescence thoracoscopic subsegmentectomy is a safe and feasible technique for resection of pulmonary nodules in lung subsegments, and surgical indications must be strictly controlled.

Objective    To summarize the clinical experience of thoracoscopic combined subsegmentectomy (CSS). Methods    The clinical data of 76 patients who underwent thoracoscopic CSS in Anqing Municipal Hospital from May 2018 to July 2022 were retrospectively analyzed, including 22 males and 54 females, aged 27.0-76.0 (54.3±10.5) years. All patients underwent preoperative three-dimensional computed tomography bronchography and angiography using dual source CT. The modified inflation-deflation technique or indocyanine green was used to identify the intersubsegmental border. Results    A total of 86 pulmonary nodules were resected in 76 patients. One patient of left upper lobe S1+2c+S4a, 1 patient of right upper lobe S2b+S3a and 1 patient of right upper lobe S1b+S3b were further performed lobectomy due to insufficient margin. One patient of left upper lobe S1+2+S3a was further performed left upper division segmentectomy due to residual atelectasis. One patient of left upper lobe S1+2c+S3a was further performed left upper division segmentectomy due to B3b+c injury, and the rest completed planned surgeries successfully. The operative time was 90.0-350.0 (174.9±53.2) min. The operative hemorrhage volume was 50.0 (20.0, 50.0) mL. The postoperative hospital stay time was 6.0 (5.0, 7.0) d. Postoperative complications included pulmonary infection in 9 patients, hemoptysis in 3 patients, persistent pulmonary leakage>3 d in 4 patients, pneumothorax in 1 patient, pleural effusion in 1 patient, and myocardial infarction in 1 patient. All of the patients were cured and discharged without perioperative death. Conclusion    Thoracoscopic CSS is relatively complex. Preoperative planning under three-dimensional reconstruction and intraoperative fine operation are helpful for safe completion.

Objective    To explore the clinical issues associated with video-assisted pulmonary segmentectomy and to provide reference for better implementation of thoracoscopic pulmonary segmentectomy and reduction of perioperative complications through analyzing the clinical results of thoracoscopic segmentectomy. Methods    The clinical data of 90 patients who planned to undergo thoracoscopic segmentectomy in our department from October 2017 to December 2019 were retrospectively analyzed, including 35 males with an average age of 60.34±9.40 years and 55 females with an average age of 56.09±12.11 years. The data including lung nodule number, benign or malignant, preoperative location by Hookwire, preoperative planning and actual implementation, operation time, intraoperative blood loss, postoperative drainage volume and time of drainage tube removal, postoperative hospital stay and complications were collected and analyzed. Results    Among the 90 patients, 38 were preoperatively positioned by Hook-wire, 52 were directly operated on; 87 were completed under thoracoscopic surgery among whom 3 underwent passive lobectomy after segmentectomy under thoracoscopic surgery, and 3 were converted to thoracotomy among whom 1 underwent lobectomy. Operation time was 198.58±56.42 min, intraoperative blood loss was 129.78±67.51 mL, lymph node samples were 6.43±1.41, drainage time was 2.98±1.25 d, the amount of postoperation drainage was 480.00±262.00 mL, hospital stay was 7.60±2.38 d. In all patients, 73 had single nodules and 17 had multiple nodules. Totally 113 pulmonary nodules were resected, 14 (12.39%) were benign nodules and 99 (87.61%) were malignant nodules. There was no perioperative death or serious complications. Conclusion    For those pulmonary parenchymal nodules which meet the  indications, it is feasible to perform thoracoscopic anatomic pulmonary segmentectomy according to preoperative thin-slice CT and three-dimensional computed tomography-bronchography and angiography (3D-CTBA) reconstruction results. Preoperative Hookwire localization can ensure effective edge resection and reduce unplanned lobotomy for intersegmental nodules and non-palpable peripheral pure ground-glass nodules.

OBJECTIVE： To investigate the formulation of therapy plan and pharmaceutical care for a penicillin allergic patient with necrotizing fasciitis combined with diabetes mellitus. METHODS： A penicillin allergic patient with necrotizing fasciitis combined with diabetes mellitus was admitted to Ordos central hospital on March 30， 2018. According to the disease characteristics of the patient， clinical pharmacists conducted pharmaceutical care during the treatment process from the aspects of antiinfective drugs selection， monitoring points of necrotizing fasciitis， blood glucose monitoring， effects of hypoproteinemia on antibiotic pharmacokinetics-pharmacodynamics， and assisted the physician to develop a more reasonable and effective individualized therapentic regimen. RESULTS： For diabetes mellitus， the patient adjusted Insulin lispro injection （insulin pump）， Acarbose tablets， Metformin hydrochloride tablets and Glimepiride tablets successively. For rapid atrial fibrillation with intraventricular differential conduction and ST-T changes， Metoprolol tartrate tablets were used to reduce heart rate. For necrotizing fasciitis， when choosing drugs to ensure the anti-infective effect， considering that the patient had penicillin allergic and hypoproteinemia， clinical pharmacists chose drugs with low protein binding rates and different from the mother nucleus and side chain of penicillin. Imipenem cilastatin for injection， Aztreonam for injection， Levofloxacin lactate and sodium chloride injection were used successively. Voriconazole for injection was adopted for anti-fungal treatment. Physicians adopted the suggestions of clinical pharmacists. Debridement through early thorough drainage and rational drug use， the patient’s condition was effectively controlled. CONCLUSIONS： Clinical pharmacists assist physicians to formulate and optimize whole course therapentic regimen so as to improve the safety and effectiveness of drug treatment.

（《》）was written in 1827 and the author is unknown. The book has only one version which is collected by the National Library of Vietnam. The book contains one volume and includes contraindication of acupuncture and moxibustion, meridian points, point locations, indications and the therapeutic methods at extraordinary points. They are mainly cited from(《》) by,(《》) byand(《》) byin theDynasty. In the paper, in view of the characteristics of version and compilation, the hand-coped book was introduced. It was explored that Vietnam acupuncture absorbed Chinese medicine and emphasized clinical practice rather than theoretic statement.

To investigate hemodynamic parameters in 2 anatomical segments (S1 and S2) of anterior cerebral artery (ACA) in normal pregnancy during the second and third trimester of gestation.
 Methods: The peak systolic velocity (PSV), end diastolic velocity (EDV), time-average maximum velocity (TAMAXV), peak systolic velocity/end diastolic velocity (S/D), resistance index (RI), and pulsation index (PI) in S1 and S2 of fetal anterior cerebral artery (ACA) in 288 normal pregnant women were detected by power Doppler and pulsed Doppler. Multiple regression models were fitted to estimate the relation between Doppler variables and gestational age. The differences of hemodynamic parameters between ACAS1 and ACAS2 were compared.
 Results: The PSV, EDV, and TAMAXV of ACAS1 and ACAS2 were positively correlated with the weeks of pregnancy (P<0.001), all fitted with the cubic curve. The S/D, PI, and RI values of ACAS1 and ACAS2 were not correlated with gestational ages (P>0.05). The PSV, TAMAXV, S/D, PI, and RI of ACAS1 were significantly higher than those of ACAS2, while EDV in ACAS1 was lower than that in ACAS2 (P<0.05).
 Conclusion: The velocity parameters (PSV, EDV, TAMAXV) of the 2 anatomical segments (ACAS1 and ACAS2) are increased with the increase of gestational age in normal pregnant fetus during the second and third trimester of gestation, and the resistance parameters (S/D, PI, RI) are not significantly correlated with gestational age. Distribution of blood flow is different in the blood supply territory between ACAS1 and ACAS2.
Anterior Cerebral Artery ; physiology ; Blood Flow Velocity ; Female ; Fetus ; blood supply ; Hemodynamics ; Humans ; Pregnancy ; Pregnancy Trimester, Third ; Ultrasonography, Prenatal

UNLABELLEDObjective To explore the effects of sperm DNA integrity rate, acrosome integrity rate and acrosome reaction rate on the outcomes of rescue intracytoplasmic sperm injection (ICSI).

METHODSThis retrospective analysis was conducted among 97 infertile couples receiving rescue ICSI due to failure of in vitro fertilization procedures in our Reproductive Medicine Center. Of these 97 women, 41 had clinical pregnancy and 56 did not, and the effects of sperm DNA integrity rate (estimated by DNA fragmentation index, DFI), acrosome integrity rate and acrosome reaction rate on rescue ICSI outcomes were analyzed.

RESULTSNo significant difference was found in paternal age, testosterone value, testicular volume, FSH, female patient' age or the number of eggs retrieved between the two groups (P>0.05), but the infertility years was significantly shorter in the pregnancy group than in the non-pregnancy group (P<0.05). The fertilization rate and cleavage rate were similar between the two groups (P>0.05), but the good embryo rate was significantly higher in the pregnancy group (P<0.05). The sperm DNA integrity or acrosome reaction rate did not differ significantly between the two groups (P>0.05), but the acrosome integrity rate was significantly higher in the pregnancy group (P<0.05). The sperm DNA integrity rate, acrosome integrity or acrosome reaction rate were not correlated with the fertilization rate, cleavage rate or good embryo rate (P>0.05). The pregnancy rate, twin and single fetus rates were 42.3%, 10.3% and 32.0% in this cohort after recue ICSI, respectively.

CONCLUSIONRescue ICSI is an effective treatment after failed in vitro fertilization procedure, and sperm acrosome integrity rate is associated with the outcome of rescue ICSI.

Acrosome ; pathology ; Acrosome Reaction ; DNA Fragmentation ; Female ; Fertilization ; Fertilization in Vitro ; Humans ; Infertility ; Male ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic

Objective To comparative analysis the intracytoplasmic sperm injection (ICSI)result and rate of sperm DNA in-tegrity (DNA fragmentation index,DFI)about testicular and epididymis sperm.Methods Totally 183 obstructed azoospermia pa-tients were choosed to use ICSI.80 cycles by PESA and 103 cycles by TESA,compared two groups of sperm DNA integrity rate and ICSI outcome.Results Sperm DNA integrity rate,fertilization rate,cleavage rate,good-qualityembryo rate and pregnancy rate com-pared with no difference by ICSI(P >0.05).Conclusion DNA integrity rate and ICSI outcomes of the testis and epididymis sperm have no significant differences,clinicians can be based on personal experiences or patients,wills to select sperm for ICSI.

Extra-nodal malignant lymphoma is often characterized by a lack of typical symptoms and positive results of auxiliary examinations, which make diagnosis difficult. In some cases, fever can be the only clinical manifestation. For the lymphoma patients presenting with persistent fever with a duration over 3 weeks, characteristics of fever including time of fever attack, fever type and effects of drugs may have significant value in the diagnosis, especially in the early stage of the disease or in rare cases.
Fever of Unknown Origin ; Humans ; Lymphoma ; diagnosis ; Muscles ; pathology

Pathological neural activity in subthalamic nucleus (STN) is closely related to the symptoms of Parkinson' s disease. Local field potentials (LFPs) recordings from subthalamic nucleus show that power spectral peaks exist at tremor, double tremor and tripble tremor frequencies, respectively. The interaction between these components in the multi-frequency tremor may be related to the generation of tremor. To study the linear and nonlinear relationship between those components, we analyzed STN LFPs from 9 Parkinson's disease patients using time frequency, cross correlation, Granger casuality and bi-spectral analysis. Results of the time-frequency analysis and cross-frequency correlation analysis demonstrated that the power density of those components significantly decreased as the alleviation of tremor and cross-correlation (0.18-0.50) exists during tremor period. Granger causality of the time-variant amplitude showed stronger contribution from tremor to double tremor components, and contributions from both tremor and double tremor components to triple tremor component. Quadratic phase couplings among these three components were detected by the bispectral approaches. The linear and nonlinear relationships existed among the multi-components and certainly confirmed that the dependence cross those frequencies and neurological mechanism of tremor involved complicate neural processes.
Action Potentials ; Electromyography ; Humans ; Parkinson Disease ; physiopathology ; Subthalamic Nucleus ; physiopathology ; Tremor ; physiopathology