[A prospective study of position selection combined with autologous blood intrathoracic infusion in the treatment of postoperative persistent air leakage with an unexpanded lung].

We prospectively studied 17 patients with spontaneous pneumothorax or giant emphysematous bulla at Rizhao Hospital of Traditional Chinese Medicine from October 2020 to March 2022. All patients underwent thoracoscopic interventional therapy, had experienced continued air leakage for 3 days with closed thoracic drainage postoperatively, had an unexpanded lung on CT, and/or failed to intervention with position selection combined with intra-pleural thrombin injection(referred to as "position plus1.0"). They were all treated with position selection combined with autologous blood (100 ml) and thrombin (5 000 U) intra-pleural injection(referred to as "position plus 2.0").The success rate of the "position plus 2.0" intervention was 16/17, and the recurrence rate was 3/17. There were four cases of fever, four cases of pleural effusion, one case of empyema, and no other adverse reactions. This study has shown that the "position plus 2.0" intervention is safe, effective, and simple for patient with persistent air leakage failed to intervention with"position plus 1.0" after thoracoscopic treatment of pulmonary and pleural diseases related to bulla.

[Efficacy and safety of position selection combined with intra-pleural thrombin injection in the treatment of postoperative persistent air leakage in bullous pulmonary-pleural diseases].

Objective: To explore the efficacy and safety of position selection in combination with intra-pleural thrombin injection in the treatment of persistent air leakage (PAL) after medical thoracoscopic treatment of bullous pulmonary-pleural diseases (e.g. spontaneous pneumothorax or giant emphysematous bulla). Methods: This was a prospective study conducted in Rizhao Hospital of Traditional Chinese Medicine from August 2018 to November 2020. Twenty patients(19 males,1 female) with a mean age of (62.3±8.1) years met the diagnostic criteria for PAL which was defined as the air leak persisted more than 3 days despite of the closed thoracic drainage after medical thoracoscopic treatment of bullous pulmonary-pleural diseases.They received the following treatment procedures (referred to as "position plus"):①Pleural cavity injection (50% glucose 20 ml+thrombin 5 000 U).②Changing the patient's position under continuous negative pressure suction to find the position causing the complete stop or significant reduction of air leakage, and keeping in the position for 24-48 hours.③If the PAL wasn't stopped 48 hours later, the procedures above would be repeated.The duration of air leakage after "position plus", times of pleural cavity injection, condition of lung re-expansion, recurrence of air leakage and complications during hospitalization were recorded. Descriptive statistics were used to summarize the results:¯x±s or M(P25, P75) for continuous variables; frequency and percentages for categoric variables. Results: A total of 20 patients were included. The average duration of air leakage after"position plus" was (1.32±0.97) days. The times of pleural cavity injection required were 1.0(1.0, 1.0).All the patients showed good lung re-expansion in review of imaging after PAL was stopped. One patient had recurrent air leakage during hospitalization. No serious complications occurred. Conclusion: The comprehensive "position plus" intervention method is effective, safe and easily operating for the treatment of PAL after medical thoracoscopic treatment of bullous pulmonary-pleural diseases.

[Efficacy and safety of argon plasma coagulation plus medical adhesive via thoracoscopy in the treatment of spontaneous pneumothorax with subpleural blebs].

Objective: To evaluate the preliminary efficacy and safety of argon plasma coagulation (APC) plus medical adhesive via thoracoscopy in the treatment of spontaneous pneumothorax caused by subpleural blebs. Methods: Data of totally 51 patients of spontaneous pneumothorax with subpleural blebs treated in Pneumology Department of Rizhao Hospital of Traditional Chinese Medicine from July 2015 to July 2017 were retrospectively analyzed. Among the 51 patients, 59 target bullae were found, 1.2 per patient on average, with the diameter ranging from 0.5 to 5 cm and an average diameter of 2.6 cm. A total of 21 patients were treated with APC, and the rest 30 were treated with APC plus partially sprayed medical adhesive (APC+ group). The rate of air leakage discontinuance within 24 hours after operation, the rate of air leakage discontinuance within one week after operation, the disappearance rate of target subpleural blebs on CT scans one week after operation, and the rate of significantly shrunken target subpleural blebs and wall thickness, as well as the incidence of postoperative complications, including fever, chest pain, pleural effusion, hemorrhage, and infection after operation were observed and compared between the two groups. Results: The air leakage discontinuance rate in APC+ group was significantly higher than that in APC group 24 hours after operation (90.0% vs 52.4%, P<0.05), and the rate in APC+ group was also significantly higher than that in APC group one week after operation (96.7% vs 66.8%, P<0.05). There was no significant difference in the disappearance rate of target subpleural blebs on CT scans one week after operation and the incidence of significantly shrunken target subpleural blebs and wall thickness (both P>0.05). There was no significant difference in the incidence of postoperative complications such as fever, chest pain and pleural effusion (all P>0.05). Conclusion: The treatment of spontaneous pneumothorax with subpleural blebs by APC plus medical adhesive is safe and effective.

[Effectiveness and safety of argon plasma coagulation via thoracoscopy on the treatment of spontaneous pneumothorax with subpleural bullae].

Objective: To evaluate the effectiveness and safety of argon plasma coagulation (APC) via thoracoscopy on the treatment of spontaneous pneumothorax with subpleural blebs. Methods: Thirty patients with spontaneous pneumothorax with subpleural blebs were retrospectively analyzed during the period of Nov, 2012 to June, 2015 in Rizhao Hospital of Traditional Chinese Medicine. According to the classification of pulmonary bullae through medical thoracoscopy by Reid, type Ⅱand partial type Ⅲ pulmonary bullae (2 cm ≤ diameter <5 cm) were coagulated by argon, and pleural adhesions were mutilated by high frequency electrocision. Two years' follow-up was carried out to observe short-term and long term effect. Results: Thirty-nine pulmonary bullae were found in thirty patients, mainly in the upper lung (28 cases, 71.8%), including 28 type Ⅱ bullae (71.8%), 11 type Ⅲ bullae (28.2%) and most of them were single transparent bullae (24/39, 61.5%). Follow-up of short-term (72 h) effective rate was 70.0% and long-term effective rate was 89.3%. Conclusion: The application of APC via thoracoscopy in the treatment of subpleural bullae is safe and effective.

Microencapsulation of lobster carotenoids within poly(vinyl alcohol) and poly(D,L-lactic acid) membranes.

The use of natural pigments such as lobster carotenoids in fish feed formulations offers advantages over the use of the synthetic alternatives. Microencapsulation of the pigments, with or without the addition of antioxidants to the formulation, may be of benefit in terms of stabilizing pigment colour. In the present study, lobster carotenoids were extracted from lobster shell into petroleum ether and microencapsulated by phase separation and salt coacervation within (poly vinyl alcohol) and poly(vinyl alcohol)/poly(D,L-lactic acid) membranes. Spherical microcapsules, with smooth, thin and resilient membranes were obtained with mean diameters ranging from 50 to 150 microns, depending on the membrane material, and source of pigment. The microcapsules were pink-orange in colour, and colour stability was followed spectrophotometrically. Enhanced stability was observed in both membrane materials, in comparison to the non-encapsulated control. Rates of discoloration were determined under a variety of storage conditions, including the absence of light, reduced temperatures and under nitrogen atmosphere. The best stability of lobster carotenoids was observed under a nitrogen atmosphere within PVA/PLA membranes, representing an 11-fold enhancement of pigment stability in comparison to the controls. Under ambient conditions, the enhancement in pigment stability was approximately 6-fold. The optimum concentration of PVA during microencapsulation was 3-4%, and the microencapsulated pigments appeared most stable under acidic conditions. The rate of discoloration appeared independent of pigment concentration.

Comparative efficacy and tolerance of erythromycin and josamycin in the prevention of bacteraemia following dental extraction.

The tolerance and pharmacokinetics of erythromycin stearate and josamycin base were compared in healthy dental students. The efficacy and tolerance of the two antibiotics were compared in the prevention of bacteraemia following dental extraction. Erythromycin achieved higher serum levels at the time of extraction in dental patients than did josamycin. Erythromycin was rapidly and better absorbed than josamycin in the student volunteers, but josamycin caused less gastrointestinal side effects than erythromycin. Both antibiotics were only marginally more effective than placebo in preventing bacteraemia following dental extraction.