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Objective To study the effect of chest drainage and injection of pleural adhesion agent in the treatment of the malignant pleural effusion (MPE),and to discuss the influences about it.Methods The data of the in-hospital patients with MPE who received thoracostomic drainage and pleural adhesions were retrospectively analyzed.11 factors were selected as research subjects,such as sex,age,KPS score,tissue origin of primary tumor,the position of hydrothorax,the cell number,the level of protein,the level of LDH in the effusion,species of sclerosant,the fluid volume of hydrothorax in 24 hours before using sclerosant,the duration between pleurodesis and removing the tude.Then,the factors that affected the effect of pleurodesis were analyzed.Results In total 196 cases,61 patients acquired significant efficacy,71 men achieved good result,and 64 people had no effect.The total effective rate was 67.3％.Univariate analysis showed that KPS score,tissue origin of primary tumor,the position of hydrothorax,the level of protein and LDH in the effusion,species of sclerosant,the fluid volumeof hydrothorax in 24 hours before using sclerosant were related to the effect.Multivariate Logistic regression analysis indicated that KPS score,tissue origin of primary tumor,the position of hydrothorax,the level of protein and LDH in the effusion,species of sclerosant,the fluid volume of hydrothorax in 24 hours before using sclerosant were indepent factors for efficacy of the pleurodesis.Conclusion It seems that good adhesion effect achieved in patients with MPE that KPS score ≥70,primary breast carcinoma,using sapylin as a sclerosant,the fluid volume of hydrothorax ≤ 200nmL in 24 hours before using sclerosant.
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ObjectiveTo investigate the diagnostic value of transbronchoscopic lung biopsy (TBLB) without X-ray fluoroscopy in patients with peripheral pulmonary lesions.Methods Fifty patients with peripheral and diffuse pulmonary lesions and without cavity lesions from January to December 2011 were selected and examined by conventional hronchoscopy.According to the anatomical orientation of CT image and bronchial tree path,TBLB was performed by electronic bronchoscope.ResultsThere were 63 cases of TBLB in 50 patients and 30 patients got confirmed diagnosis (60.0％),including 24 cases in 35patients with peripheral pulmonary lesions (68.6％),and 6 cases in 15 patients with diffuse pulmonary lesions (40.0％).There was no severe complication during and after electronic bronchoscopy.ConclusionsTBLB without X-ray fluoroscopy is a convenient,safe and repeatable operational method with fewer complications.It has higher clinic diagnostic value in pulmonary diseases.
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Objective To discuss the possible enteric nervous pathogenesis in gastritis related GI motor disorders on the expression changes of protein gene product9. 5 in neurons from the gastric walls of gastritis rat model. Methods 35 clean grade Wister rats were randomly divided into 3 groups, which included gastritis group A (n =10), gastritis group B(n =15) and control group(n =10). Rats in gastritis group A and B received gastric perfusion of HP and the mixture of 2% aspirin and 0. 6N hydrochloric acid respectively. The control group only received gastric perfusion of saline. All of the rats were killed and the gastric mucosal tissues were obtained for the pathological and HP examination. After immunohistochemical pretreatment, the tissues were stained with PGP9. 5 and at the same time the maximum diameter (Dmax, μm), mean area(μm2) and mean optical density (nm) of the neurons from the gastric walls were compared among the groups with Image-Pro Plus professional image analysis system. Results In gastric group A, HP could be found sparsely in the mucous layer or gastric pits, and all of the rapid urease tests were positive. In the other two groups, HP could not be found, and all of the rapid urease tests were negarive. In both gastric group A and B, different grades of inflammatory cell infiltration with active inflammation signs could be found in the deep layers of mucosa, while the control group was normal. The expression mean area, mean optical density of neurons from the gastric wall of rat in group A[(77. 10 ±48. 46) μm2, (53. 25 ±41.40) nm] or B [(73. 92 ± 39. 60) μm2, (45.33 ± 33.20) nm] was obvious lower than control group [(143.51 ± 29. 84) μm2, (85. 00 ± 14. 32) nm], while there was no significant difference between gastric group A and B (P ＞0. 05) (table 1). Conclusions Hp and NSAIDs might cause gastritis and decrease the PGP9. 5 expression of Neurous from gastric walls. The decrease of PGP9. 5 expression of neurons from the gastric wall might contribute to the pathogenesis of GI motor disorders or symptoms of functional dyspepsia.
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OBJECTIVE To investigate the distribution of acute appendicitis pathogens and their drug resistance,and to guide clinically the selection of reasonable antibiotics.METHODS Germicultures and drug sensitivity tests were conducted for the pus specimens from the 116 patients with acute appendicitis by ATB Expression bacteria(identifier).RESULTS Pathogens in 75 cases of 116 were found,with a positive rate of 64.7%,totally 85 strains of bacteria were isolated from clinical samples.Gram-negative bacilli had 72 strains,accounted for 84.7% and Gram-positives had 13 strains,(accounted) for 15.3%.The first three were Escherichia coli(54.1%),Pseudomonas aeruginosa(4.7%),and Klebsiella pneumoniae(4.7%).Sensitivity tests showed that resistance rates of E.coli to cefapirin,imipenem,compound(piperacillin),cefoxitin,and amikacin were 0,2.2%,10.9%,17.4%, and(23.9%).CONCLUSIONS Dominant pathogens in patients with acute(appendicitis) are intestinal bacilli,with(predominance) of E.coli;more emphasis should be placed on pathogen detections and drug sensitivity tests so that effective antibiotics could be selected and resistant bacteria be reduced and nosocomial infections be prevented.