Sudden cardiac arrest is one of the critical clinical syndromes in emergency situations. A cardiopulmonary resuscitation (CPR) is a necessary curing means for those patients with sudden cardiac arrest. In order to simulate effectively the hemodynamic effects of human under AEI-CPR, which is active compression-decompression CPR coupled with enhanced external counter-pulsation and inspiratory impedance threshold valve, and research physiological parameters of each part of lower limbs in more detail, a CPR simulation model established by Babbs was refined. The part of lower limbs was divided into iliac, thigh and calf, which had 15 physiological parameters. Then, these 15 physiological parameters based on genetic algorithm were optimized, and ideal simulation results were obtained finally.
ObjectiveTo investigate the safety and efficacy of robot-assisted pulmonary lobectomy using da Vinci S System, and explore its advantages in minimally invasive surgery. MethodsFrom May 2009 to May 2013, 12 patients with suspected non-small cell lung cancer (NSCLC) underwent robot-assisted lobectomy using da Vinci S System in Shanghai Chest Hospital. There were 6 male and 6 female patients with their age of 40-61 (52±8) years. Robotic instruments were used through a 12-mm observation port, two 8-mm thoracoscopic ports and a 12 to 40 mm utility incision without rib spreading. Perioperative data of the patients were collected and analyzed. ResultsAll the 12 patients successfully received surgical resection. All types of lobectomy were performed, and all the procedures were radical resection. Each patient received 4 to 9 (5±1) stations of lymph node dissection. None of the patients underwent conversion to thoracotomy. There was no perioperative mortality or morbidity in this group. Chest drainage duration was 3-11 (8±7) days. Length of hospital stay was 6 to 18 (14±8) days. Operation time was 60 to 280 (185±78) minutes. Intraoperative blood loss was 20 to 200 (108±71) ml. There was no perioperative blood transfusion. ConclusionsRobot-assisted lobectomy is initially proven a safe and effective procedure with enhanced visualization and better dexterity and stability than video-assisted thoracopscopic surgery. Thus surgical indications for robot-assisted lobectomy can be widened. Robot-assisted lobectomy is an important choice in the new age of minimally invasive thoracic surgery.
ObjectiveTo study the effect of bacillus calmette-guerin(BCG) polysaccharides nucleic acid on humoral immunity, interleukin(IL)-8 and tumor necrosis factor(TNF)-αin patients with chronic obstructive pulmonary disease (COPD), and to provide theoretical basis for evaluation of its clinical effectiveness. MethodsThirty hospitalized elderly patients with AECOPD treated from March 2012 to February 2013 and 60 patients with stable COPD treated at the same time were randomly selected as the study subjects. At the same time, 60 healthy people from our physical examination center were also enrolled and divided into two groups:the elderly healthy group (n=30) and nonelderly healthy group (n=30). IL-8, TNF-α, IgA, IgG and IgM levels were determined. The stable COPD group was randomly divided into two groups:group A (n=30) and group B (n=30). Group A received only routine therapy; group B received both routine therapy and intramuscular injection of BCG polysaccharide nucleic acid (0.35 mg/day, three times a week). IL-8, TNF-α, IgA, IgG and IgM levels in peripheral blood were investigated before treatment and one month later. ResultsThere were no statistically significant differences in IL-8 and TNF-αlevels in peripheral blood between elderly healthy group and nonelderly healthy group (P > 0.05), but the IgA, IgG and IgM levels were lower in the nonelderly healthy group than in the elderly healthy group (P < 0.05). Compared with the elderly healthy grouping, IgG and IgM levels were significantly lower in AECOPD group and stable COPD group (P < 0.05), but IL-8 and TNF-αlevels were significantly higher (P > 0.05). There were statistically significant differences in TNF-α, IgA, IgG and IgM levels between group B before and after treatment (P > 0.05). ConclusionsHuman's humoral immunity decreases with age. Elderly COPD patients are at high risks of abnormal immunologic function, particularly in the acute exacerbation period. The BCG polysaccharides nucleic acid can strength patients' humoral immunity. The levels of inflammatory cytokines can be reduced using BCG polysaccharides nucleic acid.