الملخص
Objective To compare the clinical application value of medical glue and a new-type medical anchor positioning needle in thoracoscopic resection of pulmonary nodules.Methods A total of 182 patients with pulmonary nodules,who received video-assisted thoracic surgery(VATS)at the Department of Thoracic Surgery of Affiliated Hospital of Shaoxing University of China between January 2020 and December 2022,were enrolled in this study.Preoperative CT-guided localization of the pulmonary nodule was performed in all patients,including medical glue positioning in 89 patients(medical glue group)and anchor needle positioning in 93 patients(anchor needle group).The incidences of pneumothorax and bleeding,the time spent for positioning,the interval between localization and operation,the time spent for operation,and the radiation dose during localization process were recorded and the data were statistically analyzed.Results The success rate of positioning was 100％(93/93)in the anchor needle group and 96.7％(86/89)in the medical glue group.There was no statistically significant difference between the two groups(P>0.05).The incidence of bleeding was 31.2％(29/93)in the anchor needle group and 15.7％(14/89)in the medical glue group,and the difference between the two groups was statistically significant(P<0.05).The incidence of pneumothorax was 30.1％(28/93)in the anchor needle group and 20.2％(18/89)in the medical glue group,and there was no significant difference between the two groups(P>0.05).No statistically significant difference in the time spent for operation existed between the two groups(P>0.05).The time spent for positioning and the interval between localization and operation in the medical glue group were longer than those in the anchor needle group,and the radiation dose in the medical glue group was higher than that in the anchor needle group,and the differences between the two groups were statistically significant(P<0.05).Conclusion For the preoperative localization of ground glass opacity(GGO)or solitary pulmonary nodule(SPN),both medical glue positioning method and anchor needle positioning method have high clinical application value.The clinical and interventional physicians should adopt appropriate positioning method according to the patient's condition.
الملخص
OBJECTIVE:To investigate the effects of different doses of tanshinone ⅡAon hemodynamics in patients underwent non-extracorporeal circulation coronary artery bypass grafting(NECCABG). METHODS:A total of 66 patients underwent selective NECCABG during Nov. 2016-Apr. 2017 were selected and divided into control group(33 cases)and observation group(33 cases) according to random number tablet. Both groups were given Tanshinone ⅡAsodium sulfonate injection with loading dose of 0.4 μg/kg for 10 min at the beginning of surgery. Control group was given Tanshinone ⅡAsodium sulfonate injection 0.2 μg/(kg·h) continuously till the end of surgery;observation group was given 0.4 μg/(kg·h)continuously till the end of surgery. HR,MAP, central venous pressure(CVP),mean pulmonary arterial pressure(MPAP),pulmonary capillary wedge pressure(PCWP),cardiac index(CI),systemic vascular resistance index(SVRI),pulmonary circulation resistance index(PVRI)and the occurrence of ADR were observed in 2 groups before anesthesia induction(T0),5 min after tracheal intubation(T1),at the moment of sternum cut(T2),at the end of anastomosis of anterior descending branch(T3),at the end of anastomosis of right coronary artery(T4),at the end of operation(T5). RESULTS:At T0,there was no statistical significance in HR,MAP,CVP,MPAP,PCWP, CI,SVRI or PVRI between 2 groups(P>0.05). At T1-T5, HR,MAP,CVP,MPAP,PCWP,SVRI and PVRI of control group were significantly higher than at T0,with statistical significance(P<0.05). There was no statistical significance in CI of control group among at T1-T5and with at T0;there was no statistical significance in HR,MAP,CVP,MPAP,PCWP,SVRI or PVRI of observation group between at T1-T5with at T0 (P>0.05). At T1-T5,CI of observation group was significantly higher than at T0and than control group;HR,MAP,CVP, MPAP,PCWP,SVRI and PVRI were significantly lower than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during medication. CONCLUSIONS:Tanshinone ⅡA0.4 μg/(kg·h)is helpful to keep hemodynamics stable and improve heart function in patients with NECCABG with good safety.
الملخص
Objective To observe the effect of Dachengqi decoction combined with β-aescine on pulmonary function in patients with acute lung injury (ALI) after chest trauma.Methods Ninety-five patients with ALI after chest trauma admitted to the Department of Thoracic Cardiothoracic Surgery of Dingxi People's Hospital of Gansu from April 2013 to May 2016 were enrolled, and they were divided into a Dachengqi decoction group (47 patients) and a control group (48 patients) by random number table. The control group patients were treated with conventional therapy and β-aescine 0.4 mg/kg+ 10% Glucose (250 mL) intravenous drip, while the Dachengqi decoction group patients were additionally treated with Dachengqi decoction on the treatment of the control group (rhubarb 12 g, magnolia officinalis 24 g, fructus aurantii immaturus 12 g, mirabilite 9 g), one dose daily, taken twice in a day, once in the morning and once in the evening orally, both groups were treated for one week. Before and after treatment, the changes of esophageal pressure, respiratory dynamics, the indexes of pulmonary function and blood gas analysis were observed. Results Compared with those before treatment, the levels of plateau pressure (Pplat), mean airway pressure (mPaw), airway resistance (Raw) and arterial partial pressure of carbon dioxide (PaCO2) of the two groups after treatment were significantly reduced, but the levels of lower esophageal sphincter pressure (LESP), peak airway pressure (PIP), the first second forced expiratory volume (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEF), the mean maximum expiratory flow (MMEF), pulse oxygen saturation (SpO2), arterial partial pressure of oxygen (PaO2), oxygenation index (PaO2/FiO2) were all increased significantly; the changes of the above indexes in the Dachengqi decoction group were more significant than those in the control group [LESP (mmHg, 1 mmHg = 0.133 kPa):18.64±2.79 vs. 15.46±3.09, Pplat (cmH2O, 1 cmH2O = 0.098 kPa): 14.27±1.68 vs. 16.00±1.87, PIP (cmH2O): 40.23±5.03 vs. 32.19±4.45, mPaw (cmH2O): 8.57±0.67 vs. 9.41±1.23, Raw (cmH2O·L-1·s-1): 6.76±1.01 vs. 9.31±1.43, FEV1 (L): 1.73±0.27 vs. 1.46±0.25, FVC: (3.95±0.51)% vs. (3.30±0.46)%, PEF (L/s): 3.81±0.47 vs. 3.11±0.38, MMEF (L/s): 0.93±0.16 vs. 0.77±0.12, SpO2: 0.96±0.06 vs. 0.91±0.05, PaO2 (mmHg): 97.82±10.13 vs. 74.73±8.02, PaCO2 (mmHg): 36.49±4.28 vs. 47.13±5.46, PaO2/FiO2 (mmHg): 362.47±20.82 vs. 259.79±17.61, allP < 0.05]. Conclusion Dachengqi decoction combined with β-aescine can reduce the respiratory intensity of patients with ALI after chest trauma and improve the lung function and blood oxygen level.
الملخص
Objective To explore the effect of analgesia management on the analgesic effect and the quality of delivery of labor analgesia. Methods The 80 cases were divided into two groups according to the odd number of labor analgesia, the control group without anesthesia nurse labor analgesia, only the anesthesiologist operation, given routine obstetric care. Anesthesia nursing group for labor analgesia by anesthesiologists and nurse by anesthesia on maternal perinatal period health education and pain management, pain score was compared between the two groups (at full dilatation), mode of delivery, postpartum hemorrhage, neonatal asphyxia. Results The total score of pain in the nursing group was 3.9±0.2, while that of the control group was 8.4±0.8, and the difference was statistically significant (t=-38.5872,P=0.000); anesthesia nursing group cesarean delivery, delivery, were 1 cases, 27 cases, 12 cases; the control group were 9 cases, 21 cases, 10 cases, the difference was statistically significant (χ2=7.31, P0.05). Conclusions During the perinatal period, the labor management and nursing intervention of the parturient women with labor analgesia are significantly reduced, the cesarean section rate is significantly reduced, and the complication rate is reduced.
الملخص
Objective To observe the protective effect of propofol on hematopoietic system injury in mice with total body irra?diation(TBI). Method Three different radiation doses were used in the experiments:7.5 Gy TBI in 30 day-survival experiment,6Gy TBI in colony-forming unit spleen(CFU-S)experiment and 2Gy TBI in the other experiment;mice were divided into 4 groups in a 30 day-survival experiment,including 7.5Gy TBI group,7.5 Gy TBI+5 mg/kg propofol group,7.5 Gy TBI+10 mg/kg propofol group and 7.5 Gy TBI + 20 mg/kg propofol group. For the other experiments,mice were divided into 4 groups:control group,propofol group,TBI(2 or 6 Gy)group,and TBI+20 mg/kg propofol group. Propofol of 20 mg/kg were administered to mice 1 d before TBI,30 mins before TBI and once each day within the following 7 days after TBI. Mice were euthanized on the ninth day after TBI,the number of CFU-S,peripheral blood parameters and bone marrow cells per femur were measured in this experiment. Results Propofol im?proved the 30 day-survival of lethally irradiated mice. There were increases in number of CFU-S,white blood cells,red blood cells, hemoglobin in peripheral blood and bone marrow cells per femur in 2 Gy TBI+20 mg/kg propofol group compared to 2 Gy TBI group (P<0.05). Conclusion Propofol exhibits a promising protective effect on TBI-induced hematopoietic system injury;further study should be focused on the related mechanisms.
الملخص
OBJECTIVE:To provide reference for the establishment of coordinative mechanism among different interest groups during the implementation of essential drug system. METHODS:Based on game theory,game behaviors of various interest groups were studied with public medical institution as study core. Behavior relationships among various interest groups were ensured to find out equilibrium point of interests. RESULTS & CONCLUSIONS:In the implementation process of National Essential Drug System,great importance should be attached to the study on game phenomena and behavior among various interest groups to make sure implementation of National Essential Drug System.