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Respiratory failure in the hematopoietic stem cell transplant recipient

World Journal of Critical Care Medicine 2018年第5期7卷 62-72页

作者： Patrick M Wieruszewski Svetlana Herasevich Ognjen Gajic hemang yadav Department of Pharmacy Mayo Clinic Multidisciplinary Epidemiology and Translational Research in Intensive Care Group Mayo Clinic Department of Anesthesiology Mayo Clinic Division of Pulmonary and Critical Care Medicine Mayo Clinic

The number of patients receiving hematopoietic stem cell transplantation(HSCT) is rapidly rising worldwide. Despite substantial improvements in peri-transplant care, pulmonary complications resulting in respiratory failure remain a major contributor to morbidity and mortality in the post-transplant period, and represent a major barrier to the overall success of HSCT. Infectious complications include pneumonia due to bacteria, viruses, and fungi, and most commonly occur during neutropenia in the early post-transplant period. Non-infectious complications include idiopathic pneumonia syndrome, periengraftment respiratory distress syndrome, diffuse alveolar hemorrhage, pulmonary veno-occlusive disease, delayed pulmonary toxicity syndrome, cryptogenic organizing pneumonia, bronchiolitis obliterans syndrome, and post-transplant lymphoproliferative disorder. These complications have distinct clinical features and risk factors, occur at differing times following transplant, and contribute to morbidity and mortality.

关键词： Respiratory failure Pulmonary complications Hematopoietic stem cell transplantation Stem cell transplant Immunocompromised host

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Surgical Excision of Clivus Chordoma with the Use of Coblator—A Case Report

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第3期4卷 211-214页

作者： Saloni Shah Roma Gandh hemang Brahmbahtt Rajesh Viswakarma B.J. Medical College Civil Hospital Ahmedabad India ENT Department Civil Hospital Ahmedabad India

Chordomas are dysembryogenic tumors originating from the notochordal process [1] [2]. They are aggressive tumours with unique diagnostic and management challenges. Primary therapy is complete surgical removal of the tumour as much as possible. The likelihood of recurrence is high in spite of complete surgical resection. A 52-year-old female patient presented with complaints of decreased vision in right eye, nasal bleeding, nasal blockage and difficulties in swallowing. CT scan and nasal biopsy were performed which confirmed the diagnosis of clivus chordoma. The CT scan showed extension into nasopharynx, nasal cavity and oropharynx pushing onto the soft palate. Surgical excision of the mass was performed with coblator by both intraoral and intra nasal approach [3]. On follow-up, nasal endoscopy and CT were done;the patient was relieved of the symptoms and was clinically better.

关键词： Chordoma Clivus Nasopharynx Oropharynx Endoscopic Excision Coblator

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Effects of structural modification of anti-inflammatory steroidal antedrug on pro-inflammatory mediators and inhibitory cytokines in human alveolar epithelial cells

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Health 2009年第3期1卷 127-133页

作者： Gui-Fang Wang Soonjo Kwon Rakesh Sharma hemang Patel Henry J. Lee 不详

The anti-inflammatory effects of the new ster-oidal antedrug, 21-acetyloxy-9α-fluoro-11β-hy-droxyl-3, 20-dioxo-1, 4-pregnadieno-[16α, 17α-d] isoxazoline (FP-ISO-21AC), on nitric oxide (NO) and interleukin 8 (IL-8) production, were inves-tigated together with its parent steroid predni-solone (PRED). PRED is one of the anti-in-flammatory steroids but has systemic side ef-fects which limit the use of it. PRED was modi-fied with ‘antedrug concept’ to create safer drugs that attack problems such as inflamma-tion, then quickly become inactive before they can cause systemic side effect. We had a test about the effect of the modified anti-inflamma-tory steroidal antedrug on anti-inflammatory activity. The present study evaluated their ability to inhibit cytokine-induced NO and IL-8 produc-tion in human alveolar epithelial cells. We also investigated their ability to enhance the expres-sion of inhibitory cytokine receptor, interleukin 22 receptor (IL-22R) in human alveolar epithelial cells. Our results showed that FP-ISO-21AC sh- owed higher ability to inhibit the cytokine - in-duced production of NO than PRED. Exogenous IL-22 was added to the media of both human alveolar epithelial cells (A549) and human lung fibroblast (HLF-1). In the presence of the ex-ogenous inhibitory cytokine IL-22, further re-duction of NO production was observed in A549 cells, which express IL-22R, but not in HLF1, which does not express IL-22R. These data suggested that the steroidal antedrugs en-hanced the expression of IL-22R. FP-ISO- 21AC showed higher potency than PRED to restore the expression of IL-22R. FP-ISO-21AC further reduced NO production to 27% and PRED further reduced NO production to 39%. In con-clusion, a synthesized steroidal antedrug FP- ISO-21AC showed higher anti-inflammatory ef-fects than PRED by inhibiting the expression of pro-inflammatory mediator NO and stimulating the expression of IL-22R.

关键词： Steroidal Antedrug NO Production IL-8 Production Anti-Inflammatory Cytokine Receptor IL-22 Receptor

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Supreme 喉罩在腹腔镜胆囊切除术麻醉中的应用

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中国基层医药 2014年第15期21卷 2321-2322页

作者：姜慧王纯辉马国强阿卜拉江阿布都热合曼艾力江新疆维吾尔自治区皮山县人民医院麻醉科 845150

目的：探讨Supreme喉罩在腹腔镜胆囊切除手术麻醉中应用的安全性及可行性。方法选择择期腹腔镜胆囊切除术患者30例，ASAⅠ～Ⅱ级，常规监测EKG、BP、HR、SpO2，记录置入喉罩前后以及拔出喉罩后的BP、HR、SpO2变化，记录通气效果及并发... 详细信息

目的：探讨Supreme喉罩在腹腔镜胆囊切除手术麻醉中应用的安全性及可行性。方法选择择期腹腔镜胆囊切除术患者30例，ASAⅠ～Ⅱ级，常规监测EKG、BP、HR、SpO2，记录置入喉罩前后以及拔出喉罩后的BP、HR、SpO2变化，记录通气效果及并发症发生情况。结果与置入喉罩前比较，置入喉罩后1 min、3 min患者BP、HR、SpO2差异无统计学意义（均P＞0．05），与拔管前比较，拔管后患者BP、HR、SpO2差异无统计学意义（均P＞0．05），30例患者均首次置入成功，术中患者通气效果良好。结论 Supreme喉罩可安全、有效应用于腹腔镜胆囊切除手术，且具有操作简单、并发症少等优点。

关键词：喉面罩麻醉全身胆囊切除术,腹腔镜

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