目的:探讨纤维支气管镜(简称纤支镜)肺泡灌洗术在治疗肺部感染性疾病的疗效。方法:共从内科系统中入选社区获得性肺炎和医院获得性肺炎患者122例,将其分为二组,治疗组:传统治疗加纤支镜肺泡灌洗术治疗肺部感染,共52例;对照组:传统方法治疗肺部感染,共70例。结果:两组病例在发热时间,咳嗽,咳痰及肺部罗音消失时间,住院日,抗生素使用时间,治愈率和死亡率方面对比均有显著性差异(Plt;0.05)。结论:纤支镜肺泡灌洗术在治疗肺部感染性疾病的疗效确切,且术中危险性小,值得推广。
ObjectiveTo review the progress of cell sheet technology (CST) and its application in bone tissue engineering. MethodsThe literature concerning CST and its application was extensively reviewed and analyzed. ResultsCST using temperature-responsive culture dishes is applied to avoid the shortcomings of traditional tissue engineering. All cultured cells are harvested as intact sheets along with their deposited extracellular matrix. Avoiding the use of proteolytic enzymes, cell sheet composed of the cells and extracellular matrix derived from the cells, and remained the relative protein and biological activity factors. Consequently, cell sheet can provide a suitable microenvironment for the bone regeneration in vivo. With CST, cell sheet engineering is allowed for tissue regeneration by the creation of three-dimensional structures via the layering of individual cell sheets, be created by wrapping scaffold with cell sheets, or be created by folding the cell sheets, showing great potential in tissue engineered bone. ConclusionConstructing tissue engineered bone using CST and traditional method of bone tissue engineering will promote the development of the bone tissue engineering.
目的:为了探讨肝硬化放腹水后应用右旋糖酐40代替人血白蛋白治疗顽固性腹水的临床疗效及其经济性。方法:将216例肝硬化顽固性腹水患者随机分为A,B,C三组。A组:定期放腹水后应用右旋糖酐40;B组:定期放腹水后应用人血白蛋白或血浆;C组:传统治疗方法,限钠和不断增加利尿剂用量。结果:A组分别与B组,C组相比较,其腹水消退时间,ALT复常率,输血不良反应,住院费用,平均住院日,好转治愈率,死亡率,以上各项对比均有显著性差异(Plt;0.05)。血清蛋白量的对比无显著性差异(Pgt;0.05)。结论:肝硬化放腹水后应用右旋糖酐40治疗顽固性腹水,能缩短病程,减少住院日,降低医疗费用,降低死亡率。
Objective To explore the clinical application value of electrical impedance tomography (EIT) individualized adjustment of positive end-expiratory pressure (PEEP) in patients with acute respiratory distress syndrome (ARDS). Methods The ARDS patients requiring mechanical ventilation who admitted between April 2019 and March 2022 were recruited in the study. They were randomly divided into 3 groups with 12 cases in each group. Optimal PEEP was set using ARDSnet method (a control group), lung ultrasound scoring method (LUS group) and EIT adjustment method (EIT group). The changes of hemodynamics, blood gas analysis, respiratory mechanics, extravascular lung water index and other indicators of the patients were recorded at each time point. Results There was no significant difference in PEEP between the EIT group and the LUS group, but PEEP in both the EIT group and the LUS group was significantly higher than the control group (P<0.05). After 12 hours of treatment, the dynamic lung compliance of the control group did not change significantly, while the dynamic lung compliance ventilation of the LUS group and the EIT group was significantly improved for 12 hours, and the improvement in the EIT group was significantly better than that in the control group (P<0.05). After treatment, the oxygenation index in the three groups was significantly increased, and the oxygenation index in the EIT group was significantly higher than that in the control group (P<0.05). There was no significant difference in hemodynamics between the three groups before and after treatment (P>0.05). The extravascular lung water index of the three groups after treatment was significantly decreased, and the LUS group and the EIT group decreased more significantly than the control group (P<0.05). Conclusion In the PEEP setting of ARDS patients, the use of EIT personalized adjustment method can effectively improve the patient’s lung compliance and oxygenation index, and reduce extravascular lung water, without affecting hemodynamics.
ObjectiveTo explore the distribution pattern of respiratory symptoms and relevant factors in patients with pulmonary nodules. MethodsDemographic and clinical information were collected from patients who visited the Thoracic Surgery Outpatient Clinic of Guangdong Provincial People’s Hospital from January 2021 to January 2022. Hospital Anxiety and Depression Scale (HADS) was used to assess their anxiety and depression level. ResultsA total of 1173 patients were enrolled, including 449 males and 724 females, with an average age of 46.94±11.43 years. Among the patients with pulmonary nodules, 37.7% of them had at least one respiratory symptom; 24.4% had cough, 14.0% had expectoration, 1.3% had hemoptysis and 14.9% had chest pain. Old age, male, exposure to second-hand smoking or environmental smoke, hair coloring and history of tuberculosis were major risk factors for respiratory symptoms (P<0.05). Middle age, old age, male, exposure to environmental smoke were major risk factors for cough (P<0.05); old age, smoking, larger maximum nodules diameters, exposure to environmental smoke and history of pneumonia were major risk factors for expectoration (P<0.05); male, multiple nodules, hair coloring, exposure to second-hand smoking and history of tuberculosis were major risk factors for chest pain (P<0.05). Symptomatic patients showed generally higher HADS scores than asymptomatic patients (P<0.001). ConclusionCough, expectoration and chest pain are the predominant respiratory symptoms for patients with pulmonary nodules. The presentation of respiratory symptoms increases patients' anxiety and depression.