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Application of fiberoptic bronchscopy in patients with acute exacerbations of chronic obstructive pulmonary disease during sequential weaning of invasive-noninvasive mechanical ventilation

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World Journal of Emergency Medicine 2012年第1期3卷 29-34页

作者： Rong-rong Song Yan-ping Qiu Yong-ju Chen Yong Ji Department of Intensive Care Unit Tongzhou People's HospitalNantong

BACKGROUND:Early withdrawal of invasive mechanical ventilation(IMV) followed by noninvasive MV(NIMV) is a new strategy for changing modes of treatment in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD) with acute respiratory failure(ARF).Using pulmonary infection control window(PIC window) as the switch point for transferring from invasive to noninvasive MV,the time for early extubation can be more accurately judged,and therapy efficacy can be *** study aimed to prospectively investigate the clinical effectiveness of fiberoptic bronchscopy(FOB) in patients with AECOPD during sequential weaning of invasive-noninvasive ***:Since July 2006 to January 2011,106 AECOPD patients with ARF were treated with comprehensive medication and IMV after *** were randomly divided into two groups according to whether fiberoptic bronchoscope is used(group A,n=54) or not(group B,n=52) during sequential weaning from invasive to noninvasive *** group A,for sputum suction and bronchoalveolar lavage(BAL),a fiberoptic bronchoscope was put into the airway from the outside of an endotracheal tube,which was accompanied with uninterrupted use of a *** achieving PIC window,patients of both groups changed to NIMV mode,and weaned from *** following listed indices were used to compare between the groups after treatment:1) the occurrence time of PIC,the duration of MV,the length of ICU stay,the success rate of weaning from MV for the first time,the rate of reventilatJon and the occurrence rate of ventilator-associated pneumonia(VAP);2) the convenience and safety of FOB *** results were compared using Student's f test and the Chi-square ***:The occurrence time of PIC was(5.01 ±1.49) d,(5.87±1.87) d in groups A and B,respectively(P<0.05);the duration of MV was(6.98±1.84) d,(8.69±2.41) d in groups A and B,respectively(P<0.01);the length of ICU stay was(9.25±1.84) d,(11.10±2.63) d in

关键词： Acute exacerbations of chronic obstructive pulmonary disease Acute respiratory failure Mechanical ventilation Sequential weaning of invasive-noninvasive ventilation Fiberoptic bronchscopy Bronchoalveolar lavage Pulmonary infection control window Side effect success rate

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Lumbar-Sacral Plexus Block Anesthesia versus General Anesthesia for Total Hip Arthroplasty: Case Control Study

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Open Journal of Anesthesiology 2021年第9期11卷 259-268页

作者： Perales Caldera Eduardo González Lumbreras Aniza Surinam Uribe Campo Giselle Andrea Fernández Soto José Rodrigo Medina de la Rosa Edoardo Díaz Borjón Efraín Bravo Reyna Carlos César Department of Anesthesiology Hospital ángeles Lomas México City Mexico Department of Orthopaedics Hospital ángeles Lomas México City Mexico Department of Experimental Surgery Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán México City Mexico

Background: Peripheral block techniques for total hip arthroplasty have been used as an analgesic strategy, only a few studies described it as an anesthetic technique, so the perioperative performance and safety are poorly studied. Methods: 78 total hip arthroplasties were prospectively observed in our hospital. Divided into 2 groups: 1) General anesthesia;and 2) Lumbar sacral plexus block anesthesia. Variables measured in both groups were: demographics, conversion to general anesthesia, total opioid doses, surgical time, blood loss, postoperative pain, use and total dose of vasopressors drugs, transfusion and ICU transfer needs, postoperative ambulation time, and length of hospital stay. T student and chi-square tests were used upon the case. A significant difference was considered when a value of p Results: 3 patients (7.3%) anesthetized with combined lumbar sacral plexus block were converted to general anesthesia. When comparing peripheral nerve block and general anesthesia, less intraoperative (p = 0.000) and postoperative (p = 0.002) opioid consumption were noted, less postoperative pain in PACU (p = 0.002) and in the first 24 hours (p = 0.005), as well as earlier onset of ambulation (p = 0.008) and shorter hospital stay (p = 0.031). Conclusions: In our study, the lumbar and sacral plexus block anesthesia technique provided anesthetic conditions to perform hip joint arthroplasty and it was proved to be advantageous in comparison to general anesthesia.

关键词： Anesthetic Technique Conversion Opioids Requirements General Anesthesia Regional Anesthesia Lumbar Plexus Block Sacral Plexus Block Lumbar Sacral Plexus Anesthesia success rate

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A systematic review of pre-hospital shoulder reduction techniques for anterior shoulder dislocation and the effect on patient return to function

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Chinese Journal of Traumatology 2020年第5期23卷 295-301页

作者： Joseph T.Fennelly Lysander Gourbault Gregory Neal-Smith Akhilesh Pradhan Venkat Gade Jonathan A.Baxter Trauma and Orthopaedics Stoke Mandeville HospitalAylesburyHP218ALUK Trauma and Orthopaedics Royal United HospitalBathBA13NGUK

Purpose:The majority of acute anterior shoulder dislocations are sustained during sports and wilderness *** management of acute dislocations in the pre-hospital setting is currently without guidelines based on the *** study aims to assess the risk of acute complications in pre-hospital shoulder reduction and identify which pre-hospital reduction technique has the highest success rate in the published ***:The involved databases were Allied and Complementary Medicine,CENTRAL,CINAHL,Cochrane Database of Systematic Reviews,Embase,Europe PMC,Ovid MEDLINE®,Pedro,Proquest,Trip,and World Health Organization International Clinical Trials Registry *** original research of high methodological quality was included,which was defined by the recently developed assessment tooleassessing the methodological quality of published papers(AMQPP)and investigated the management of acute anterior shoulder dislocations in the pre-hospital ***:Two hundred and ninety-eight articles were identified and screened.A full text review was performed on 40 *** articles published between 2015 and 2018 met the inclusion criteria.A total of 181 patients were included with the study duration ranging from 6 to 60 *** studies reported zero immediate complication following pre-hospital reduction and there were no documented subsequent adverse events regardless of the technique *** resolution of neurological symptoms was observed following the early and successful pre-hospital *** attempt success rate,when performed by skilled practitioners,ranged from 72.3%to 94.9%.Conclusion:Pre-hospital shoulder reduction appears to be a safe and feasible option when carried out with the appropriate expertise.A novel reduction technique adapted from the mountain medicine diploma course at the University of Paris North was found to have the highest first attempt reduction success rate of 94.9%.Other techniques described in the lite

关键词： Should dislocation Pre-hospital reduction success rate Imaging

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Effects of Bovine Embryos at Different Developmental Stages on Bisection Effect

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Agricultural Biotechnology 2021年第5期10卷 60-62页

作者： Guizhi TONG Yongsheng HAN Hongbao WANG Xintao LI Weixia WANG Xueying SONG Branch of Animal Husbandry and Veterinary Heilongjiang Academy of Agricultural SciencesQiqihar 161005China Jilin Academy of Agricultural Sciences Changchun 136100China

[Objectives]This study was conducted to explore the effects of embryos at different developmental stages on the bisection effect of embryos,improve the efficiency of bovine embryo bisection,and facilitate the application of embryo bisection technology in cattle breeding.[Methods]The effects of two different bisection solutions on the bisection of morulae and blastocysts in vitro were *** morulae and blastocysts produced in vitro from cattle that developed to the 6th to 8th d were bisected by hands,and demi-embryos were cultured in *** development was observed.[Results]Morulae were bisected in PBS solution and PBS+0.2 mol/L sucrose,and the success rates of bisection were 50%and 95.2%,*** success rate of bisecting morulae in PBS+0.2 mol/L sucrose was significantly higher than that in PBS(Prate of the bisected demi-embryos had no significant difference between the two(53.3%,52.4%)(P>0.05).The success rates of blastocyst bisection in PBS solution and PBS+0.2 mol/L sucrose were 51.6%and 95.1%,*** success rate of blastocyst bisection in PBS+0.2 mol/L sucrose was significantly higher than that in PBS(Prate of the bisected demi-embryos had no significant difference between the two(50.0%,56.4%)(P>0.05).[Conclusions]There were no significant differences between the success rates of bisecting bovine morulae and blastocysts in PBS+0.2 mol/L sucrose,which were both significantly better than those in pure PBS bisection solution,proving that PBS+0.2 mol/L sucrose bisection solution is suitable for bovine embryo bisection.

关键词： Cattle Embryo division success rate Development rate Morula Blastocyst

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