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Objective To investigate the expression levels of tumor necrosis factor alpha (TNF-α),interleukin-6(IL-6) and the change of serum ferritin in patients with intracranial aneurysm and its clinical significance.Methods 22 patients with intracranial aneurysm and 16 cases of traumatic brain injury who recevied operation in Department of Neurosurgery in Quzhou People's Hospital from Jan.2014 to Jan.2015 were enrolled as observation group and control group.The intracranial aneurysm tissues and normal cerebral vascular tissues were collected respectively to detect the situation of inflammatory cell infiltration,and the expression of TNF-α and IL-6 was detected by HE staining and immunohistochemical staining.The serum was collected on hospitalized,postoperative 3 days and postoperative 7 days to detect serum ferritin.Results The positive cells were observed in the observation group after immunohistochemical staining,in which the expression levels of TNF-α [(0.194 ± 0.074) vs.(0.135 ± 0.047),t =2.799] and IL-6 [(0.152 ± 0.057) vs.(0.103 ± 0.028),t =3.494] were significantly higher than those in the control group(P =0.008,0.001).The serum ferritin level in the observation group was significantly higher than that in the control group at postoperative 3d [(232.25 ± 105.26) ng/mL vs.(169.51 ± 66.24) ng/mL,t =2.097] and postoperative 7d[(263.39 ± 114.73) ng/mL vs.(166.57 ± 73.71) ng/mL,t =2.955] (P =0.043,0.005).The difference of serum ferritin on different day in the observation group also was statistically significant(F =8.625,P =0.003).Conclusion The expression levels of TNF-α and IL-6 in intracranial aneurysms were high,which may be one of the important factors in the formation of intracranial aneurysms,and it provides an important reference of early prevention and drug treatment for patients with intracranial aneurysm.The serum ferritin is related to the rupture and hemorrhage of intracranial aneurysm,which can be used to judge prognosis and guide rational treatment,and worth further study to confirm.
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Objective To evaluate the clinical effects of thoracic close drainage with thin drainage tube assisted to thick drainage tube after video-assisted thoracic surgery(VATS)lobectomy. Methods We ret-rospectively reviewed 89 patients received VATS lobectomy in Chinese PLA General Hospital from January 2014 to September 2014. The patients with non-small cell lung cancer were divided into two groups:treatment group (50 patients)and control group(39 patients). Treatment group took thin tube assisted to thick tube of thoracic close drainage and control group took general thoracic closed drainage tube. We studied the operation time,the bleeding of operation,the number of lymph node dissection,time of first activity out of bed,the hospitalization time of post-operation,post-operative complications,the days of post-operative drainage,drainage volume,the effect of drainage,the VAS evaluation score of post-operative pain in the two groups. Results Compared with control group,there was no statistical significance in the differences of the time of operation[(2. 58 ± 0. 57)h vs(2. 57 ± 0. 50)h;t = 0. 127,P = 0. 681],bleeding of operation[(108. 00 ± 52. 84)ml vs(114. 10 ± 107. 18)ml;t = 0. 352,P = 0. 334],the number of lymph node dissection[(14. 20 ± 5. 95)vs(11. 21 ± 4. 71);t = 2. 576,P = 0. 068)],the staying time of drainage[(5. 66 ± 2. 53)d vs(5. 82 ± 2. 02)d;t =0. 324,P = 0. 219],the postoperative drainage volume[(1 141. 76 ± 819. 26)ml vs(1 022. 95 ± 464. 84) ml;t = 0. 889,P = 0. 367]and the occurrences of the post-operative complications(8. 00% vs 10. 25% ;χ2 =1. 750,P = 0. 726). There was statistical significance in the differences of the post-operative time of off-bed [(11. 28 ± 8. 78)h vs(13. 97 ± 7. 83)h;t = 4. 027,P = 0. 045],the time from surgery to discharge [(8. 36 ± 2. 63)d vs(9. 56 ± 2. 89)d;t = 2. 952,P = 0. 043]and the drainage effect(costophrenic angle sharp:72. 0% vs 46. 2% ;χ2 = 5. 329,P = 0. 017). In the two groups,there were statistical significance differences in scores of VAS for the 24 to 72 hours resting and coughing of post-operation:24 h[(2. 78 ± 1. 13)vs(3. 74 ± 1. 68);t = 3. 226,P < 0. 001)],48 h[(1. 98 ± 0. 59)vs(3. 33 ± 1. 72);t = 5. 189,P <0. 001)],72 h[(1. 94 ± 0. 55)vs(3. 15 ± 1. 60);t = 5. 010,P < 0. 001)],coughing[(3. 64 ± 1. 23)vs (5. 33 ± 1. 95);t = 5. 005,P < 0. 001)]. Conclusion The thin drainage tube assisted to thick drainage tube for thoracic close drainage make the drainage more effective,release the pain,shorten the hopital stay;moreo-ver,it is simple and safe for operation and easy to popularize with high modified value.
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Objective To summarize the clinical characteristics, diagnosis and surgical management experiences of 51 cases of pulmonary fungal infections. Methods The clinical data of 51pulmonary fungal infection patients hospitalized in department of thoracic surgery of PLA General Hospital from 1981 to 2008 were retrospectively analyzed. Results The recruited cases included three cases of Candida albicans, 22 of Aspergillus, and 26 of Cryptococcus. The clinical symptoms included cough, hemoptysis, fever, chest tightness, chest pain and asthma. Twenty cases were identified through routine healthy examination. Of chest X-ray and computed tomograply scan, 29 cases presented with solid nodules in the lung, some of which had burrs and spikes; 13 presented with pulmonary cavity with even wall thickness and smooth inner wall including 7 with aspergillar glomera.Forty-eight cases underwent standard thoracotomy operations and 3 cases underwent thoracoscope or thoracoscopy-assisted minithoracotomy. Seventeen underwent pulmonary lobectomies, and 34 wedge resections. There was no operative mortality in the 51 patients. All diagnoses were confirmed by postoperative pathology. There was no relapse during 3- 10 years of follow-up. Conclusions Primary pulmonary fungal infections lack characteristic presentations in clinical manifestations and imaging examinations. Pathology is the evidence for definite diagnosis. Surgical intervention is an effective tool for diagnose and treatment of this disease.
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Objective To summarize the prevention and management of common intraoperative complications during thoracoscopic lobectomy. Methods During June 2007 to December 2009, 96 patients received thoracoscopic lobectomy through 3 mini-incisons, including right upper lobectomy in 28 cases, right middle lobectomy in 7, right middle and lower lobectomy in 3, right lower lobectomy in 28, left upper lobectomy in 12, and left lower lobectomy in 27. Results All procedure were carried out safely. No severe complications or perioperative death occurred in all cases. The common intraoperative compliations during the surgery included: the bleeding of wounds and vessels, thoracic cavity extensive adhesion, and air leak of bronchus stumps. There were four patients conversed to open thoracotomy. The mean operation time was ( 180 ±59) minutes (range,90 - 360 minutes), and the mean blood loss was ( 191 ± 92 ) ml ( range,50 - 700 ml ), including 2 cases blood transfusio(n). The chest drainage lasted (4.6 ± 2.4 ) days, the average length of stay after operation was ( 8.0 ± 3.2 ) days. Pathological diagnosis included primary lung cancer in 85 cases, sclerosing hemangioma in 3, bronchiectasis in 3, tuberculoma in 2, pulmonary sequestration in 2, and fungus ball in 1. Conclusion It is helpful to master the prevention and management of common intraoperative complications for thoracoscopic lobectomy.
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@#Objective To investigate the effect of median nerve electrical stimulation on the activity, speech and quality of life in patients after severe traumatic brain injury. Methods 60 patients with severe traumatic brain injury were divided into 2 groups: the control group (A) and the treated group (B). The patients in Group A were treated with the routine medicine and rehabilitation. Based on the routine therapy, the patients in Group B were treated with the right median nerve electrical stimulation. Their outcome, activity, speech and quality of life were assessed. Results The scores of Glasgow Outcome Scale (GOS), speech assessment, and the quality of life in Group B improved compared with that in Group A (P<0.05), the activity seemed to improve, but not significantly. Conclusion The right median nerve electrical stimulation is effective to promote the recovery of neurological function and improve the quality of life in patients with severe traumatic brain injury.
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The equipment development for emergency medical aid station of the Armed Police applies modern medical science and technology as well as management system.Based on the functional necessity,it accords with the theory of wartime health service support and draws on the experience of anti-terrorism struggle in foreign countries.It realizes serialization,modularizaion and motorization.This paper mainly introduces the development background,systematical structure and functional characteristics of the equipment for the emergency medical aid station.
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<p><b>OBJECTIVE</b>To study the clinical therapeutic effect of anisodamine on respiratory function after severe brain injury.</p><p><b>METHODS</b>Ninety patients with respiratory dysfunction following severe brain injury were divided into two groups: a treatment group (n = 45, treated with routine therapy plus anisodamine) and a control group (n = 45, treated with routine therapy only). The pulmonary ventilation function and oxygenation function were compared between the two groups.</p><p><b>RESULTS</b>In the treatment group, 12 hours after treatment the respiratory rate reduced, the partial pressure of carbon dioxide (PCO(2)), the partial pressure of oxygen in arterial blood (PaO(2)) and oxygenation exponent increased, the dead space ventilation dose and the pulmonary alveolus-partial pressure of arterial oxygen difference decreased, and the ventilation function of the respiratory tract and pulmonary oxygenation function improved. There was a significant difference between the two groups (P < 0.01). No side-effect was found except a slight increase of intracranial pressure and heart rate.</p><p><b>CONCLUSIONS</b>Anisodamine can improve pulmonary ventilation function and oxygenation function and decrease the incidence of hypoxemia markedly. It is effective in treating respiratory dysfunction after severe brain injury.</p>
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Brain Injuries , Diagnosis , Mortality , Dose-Response Relationship, Drug , Drug Administration Schedule , Follow-Up Studies , Infusions, Intravenous , Injury Severity Score , Primary Prevention , Methods , Probability , Pulmonary Gas Exchange , Reference Values , Respiratory Function Tests , Respiratory Insufficiency , Mortality , Solanaceous Alkaloids , Survival Rate , Treatment OutcomeABSTRACT
Objectives:To research the relation of high blood glucose,GCS and prognosis after craniocerebal injury. Methods:63 patients were divided into three groups,“GCS” 3～8,“GCS” 9～12,and GCS 13～15.Blood glucose of these groups were tested at admission of all patients and one week after hosptialization. Results:The level of blood glucose and the mortality in GCS 3～8 group were significantly high than those in the other two groups. Conclusions:After cranidcerebral injury,the blood glucose is an index of the injury degree.We should try to control the blood glucose in normal levels to improve the prognosis of patients with craniocerebral injury.
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Objectives:To research the relation of high blood glucose,GCS and prognosis after craniocerebal injury. Methods:63 patients were divided into three groups,“GCS” 3~8,“GCS” 9~12,and GCS 13~15.Blood glucose of these groups were tested at admission of all patients and one week after hosptialization. Results:The level of blood glucose and the mortality in GCS 3~8 group were significantly high than those in the other two groups. Conclusions:After cranidcerebral injury,the blood glucose is an index of the injury degree.We should try to control the blood glucose in normal levels to improve the prognosis of patients with craniocerebral injury.