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Closed thoracic drainage in elderly patients with chronic obstructive pulmonary disease complicated with spontaneous pneumothorax:A retrospective study

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世界临床病例杂志 2023年第27期11卷 6415-6423页

作者： Wei Wang Dong-Ning Zhu Shan-Shan Shao Jun Bao Department of respiratory and Critical Care Medicine The People’s Hospital of ShexianHuangshan 242700Anhui ProvinceChina

BACKGROUND Chronic obstructive pulmonary disease(COPD)combined with spontaneous pneumothorax,is characterized by significant decline in lung function,and even cause cardiopulmonary failure and *** To evaluate the clinical effectiveness of central venous catheters and indwelling pleural catheters(IPC)in managing closed thoracic drainage in patients diagnosed with COPD with concomitant by spontaneous *** Retrospective analysis was conducted on the clinical information of 60 elderly patients with COPD complicated by spontaneous pneumothorax admitted to the Shexian Branch of the second affiliated hospital of Zhejiang university school of medicine between March 2020 and March *** clinical efficacy,complications,hospitalization duration,and costs were compared between patients with an indwelling thoracic catheter and those with a central venous *** logistic regression was used to analyze the causes of catheter *** According to our findings,there were significant differences in the IPC group’s clinical efficacy,catheter operation time,and lung recruitment time(P<0.05).Comparing the complications after catheter treatment between the two groups revealed statistically significant variations in the incidence of postoperative analgesics,catheter abscission,catheter blockage,and subcutaneous emphysema in the IPC group(P<0.05).Univariate analysis demonstrated significant differences between patients with and without catheter dislodgement regarding duty nurse’s working years(less than three),Acute Physiology and Chronic Health Evaluation II(APACHE II)scores(less than 15),lack of catheter suture fixation,and the proportion of catheters not fixed twice(P<0.05).CONCLUSION Our results demonstrated that when treating elderly COPD patients with spontaneous pneumothorax,indwelling thoracic catheters are more effective than the central venous catheter ***’catheter shedding is influenced by the primary nurse’s workin

关键词： Indwelling thoracic catheter Central venous catheter Chronic obstructive pulmonary disease Pneumothorax Catheter detached

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clinical Course of Lung Cancer Patients with Subcutaneously Implanted Central Venous Access Device Ports from the Time of Receiving Chemotherapy to the Endpoint of Cancer

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Journal of Cancer Therapy 2016年第7期7卷 519-529页

作者： Tomonori Hirashima Teppei Tsumori Kenichi Sakai Makoto Fujishima Yukie Yamakawa Noriko Ryouta Masumi Sandoh Takayuki Shiroyama Motohiro Tamiya Naoko Morishita Hidekazu Suzuki Norio Okamoto Sho Goya Hironori Shigeoka Departments of Thoracic Malignancy Osaka Prefectural Medical Center for respiratory and Allergic Diseases Osaka Japan Departments of Palliative Medicine Osaka Prefectural Medical Center for respiratory and Allergic Diseases Osaka Japan Tsumori clinic Osaka Japan Departments of Gastroenterological and Breast Surgery Osaka Prefectural Medical Center for respiratory and Allergic Diseases Osaka Japan Departments of Nursing Osaka Prefectural Medical Center for respiratory and Allergic Diseases Osaka Japan Departments of Pharmacy Osaka Prefectural Medical Center for respiratory and Allergic Diseases Osaka Japan

Background: As the prognosis of lung cancer (LC) patients improves, subcutaneously implanted central venous access device ports (CV-ports) have frequently been used for continuing chemotherapy (CC) or palliative care (PC). In this study, we examined the clinical course of LC patients with subcutaneously implanted CV-ports from the time of receiving chemotherapy to the endpoint of cancer. Materials and Methods: We retrospectively reviewed the clinical data and treatment history of LC patients with subcutaneously implanted CV-ports between June 2008 and November 2013 using clinical records and a pharmacy database. Results: Of the 132 LC patients with subcutaneously implanted CV-ports, 79 (59.8%) had CV-ports for CC (the CC group) and 53 (40.2%) had CV-ports for PC (the PC group). After CV-port implantation, LC patients in the CC group received a median of two regimens with a median of 6 cycles. The median survival time of patients in the CC and PC groups was 457 and 44 days, respectively. In the CC group, the median survival time of small cell and non-small cell LC patients was 342 (95% confidence interval, 235 - 627) and 563 (95% confidence interval, 368 - 728) days, respectively. Nine patients (6.8%) had their CV-ports removed due to complications. Forty (30.3%) of the 132 enrolled patients were referred for at-home PC. The at-home death rate observed among these 40 patients was 30.0% (N = 12). Conclusion: CV-ports may contribute to seamless oncological care.

关键词： clinical Course At-Home Death Rate Implanted Central Venous Access Device Port Lung Cancer Seamless Oncological Care

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A comparison of artificial urinary sphincter outcomes after primary implantation and first revision surgery

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Asian Journal of Urology 2021年第3期8卷 298-302页

作者： Kevin J.Hebert Brian J.Linder Griffin T.Morrisson Laureano Rangel Latuche Daniel S.Elliott Department of Urology Mayo ClinicRochesterMNUSA Department of Health Sciences Research Mayo ClinicRochesterMNUSA

Objective:The artificial urinary sphincter(AUS)is the gold standard for severe male stress urinary incontinence,though evaluations of specific predictors for device outcomes are *** sought to compare outcomes between primary and revision AUS surgery for non-infectious ***:We identified 2045 consecutive AUS surgeries at Mayo clinic(Rochester,MN,USA)from 1983 to *** these,1079 were primary AUS implantations and 281 were initial revision surgeries,which comprised our study *** survival rates,including overall and specific rates for device infection/erosion,urethral atrophy and mechanical failure,were compared between primary AUS placements versus revision *** follow-up was obtained through office examination,written correspondence,or telephone ***:During the study period,1079(79.3%)patients had a primary AUS placement and 281(20.7%)patients underwent a first revision surgery for mechanical failure or urethral *** undergoing revision surgery were found to have adverse 1-and 5-year AUS device survival on Kaplan-Meier analysis,90%vs.85% and 74%vs.61%,respectively(pfailure(p=0.43)and urethral atrophy(p=0.77).Conclusions:Our findings suggest a significantly higher rate of overall device failure following revision AUS surgery,which is likely secondary to an increased rate of infection/urethral erosion events.

关键词： Artificial urinary sphincter Outcomes Revision Urinary incontinence Urethra Post prostatectomy incontinence

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Post-liver transplant biliary complications:Current knowledge and therapeutic advances

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World Journal of Hepatology 2021年第1期13卷 66-79页

作者： Irina Boeva Petko Ivanov Karagyozov Ivan Tishkov Department of Interventional Gastroenterology Acibadem City Clinic Tokuda HospitalSofia 1407Bulgaria Department of Interventional Gastroenterology Clinic of GastroenterologyAcibadem City Clinic Tokuda HospitalSofia 1407Bulgaria

Liver transplantation is the current standard of care for end-stage liver disease and an accepted therapeutic option for acute liver failure and primary liver *** the remarkable advances in the surgical techniques and immunosuppressive therapy,the postoperative morbidity and mortality still remain high and the leading causes are biliary complications,which affect up to one quarter of *** most common biliary complications are anastomotic and non-anastomotic biliary strictures,leaks,bile duct stones,sludge and *** the absence of a recommended treatment algorithm many options are available,such as surgery,percutaneous techniques and interventional *** the last few years,endoscopic techniques have widely replaced the more aggressive percutaneous and surgical *** retrograde cholangiography is the preferred technique when duct-to-duct anastomosis has been ***,new devices and techniques have been developed and this has led to a remarkable increase in the success rate of minimally invasive *** the mechanisms of biliary complications helps in their early recognition which is the prerequisite for successful *** endoscopic therapy is essential for the reduction of morbidity and mortality in these *** article focuses on the common post-transplant biliary complications and the available interventional treatment modalities.

关键词： Post-transplant biliary complications Endoscopic retrograde cholangiopancreatography Cholangioscopy Percutaneous biliary interventions Liver transplantation Living-donor liver transplantation

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COVID-19 vaccination produces exercise-responsive SARS-CoV-2 specific T-cells regardless of infection history

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Journal of Sport and Health Science 2024年第1期13卷 99-107页

作者： Kyle A.Smith Tiffany M.Zúñiga Forrest L.Baker Helena Batatinha Charles R.Pedlar Shane C.Burgess Michael P.Gustafson Emmanuel Katsanis Richard J.Simpson School of Nutritional Sciences and Wellness The University of ArizonaTucsonAZ 85721USA Department of Pediatrics The University of ArizonaTucsonAZ 85724USA Faculty of Sport Allied Health and Performance ScienceSt.Mary's UniversityTwickenham TW14SXUK Institute of Sport Exercise and Health University College LondonLondon WC1E 7HUUK Department of Animal and Comparative Biomedical Sciences The University of ArizonaTucsonAZ 85721USA The University of Arizona Cancer Center The University of ArizonaTucsonAZ 85719USA Laboratory Medicine and Pathology Mayo Clinic ArizonaPhoenixAZ 85054USA Department of Immunobiology The University of ArizonaTucsonAZ 85724USA Department of Medicine The University of ArizonaTucsonAZ 85724USA Department of Pathology The University of ArizonaTucsonAZ 85724USA

Background:The mobilization and redistribution of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)specific T-cells and neutralizing antibodies(nAbs)during exercise is purported to increase immune surveillance and protect against severe coronavirus disease 2019(COVID-19).We sought to determine if COVID-19 vaccination would elicit exercise-responsive SARS-CoV-2 T-cells and transiently alter nAb ***:Eighteen healthy participants completed a 20-min bout of graded cycling exercise before and/or after receiving a COVID-19 *** major leukocyte subtypes were enumerated before,during,and after exercise by flow cytometry,and immune responses to SARS-CoV-2 were determined using whole blood peptide stimulation assays,T-cell receptor(TCR)-βsequencing,and SARS-CoV-2 nAb ***:COVID-19 vaccination had no effect on the mobilization or egress of major leukocyte subsets in response to intensity-controlled graded ***,non-infected participants had a significantly reduced mobilization of CD4+and CD8+naive T-cells,as well as CD4+central memory T-cells,after vaccination(synthetic immunity group);this was not seen after vaccination in those with prior SARS-CoV-2 infection(hybrid immunity group).Acute exercise after vaccination robustly mobilized SARS-CoV-2 specific T-cells to blood in an intensity-dependent *** groups mobilized T-cells that reacted to spike protein;however,only the hybrid immunity group mobilized T-cells that reacted to membrane and nucleocapsid *** increased significantly during exercise only in the hybrid immunity ***:These data indicate that acute exercise mobilizes SARS-CoV-2 specific T-cells that recognize spike protein and increases the redistribution of nAbs in individuals with hybrid immunity.

关键词： Anti-viral COVID-19 Exercise immunology SARS-CoV-2 T-Cells Vaccine

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SARS-CoV-2 non-structural protein 13 (nspl3) hijacks host deubiquitinase USP13 and counteracts host antiviral immune response

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Signal Transduction and Targeted Therapy 2021年第4期6卷 1107-1109页

作者： Guijie Guo Ming Gao Xiaochen Gao Bibo Zhu Jinzhou Huang Kuntian Luo Yong Zhang Jie Sun Min Deng Zhenkun Lou Department of Molecular Pharmacology and Experimental Therapeutics Mayo ClinicRochesterMNUSA Department of Oncology Mayo ClinicRochesterMNUSA Thoracic Diseases Research Unit Division of Pulmonary and Critical Care MedicineDepartment of MedicineMayo Clinic College of Medicine and ScienceRochesterMNUSA Department of Immunology Mayo Clinic College of Medicine and ScienceRochesterMNUSA

Dear Editor,COVID-19(Coronavirus Disease-2019),a respiratory disease caused by the novel virus strain,SARS-CoV-2(severe acute respiratory syndrome coronavirus 2),an enveloped,positive-sense,single-stranded RNA betacoronavirus of the family Corona-viridae,has spread worldwide.1 Notably,SARS-CoV-2 infection led to poor induction of typeⅠ interferon response,and the impaired type Ⅰ IFN responses have been shown to be associated with severe COVID-19 disease.2 However,molecular mechanisms by which SARS-CoV-2 suppresses type Ⅰ IFN production,and how host cells respond to the inhibition of type Ⅰ IFN response during SARS-CoV-2 infection,remain largely unknown.

关键词： impaired respiratory interferon

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Rutaecarpine attenuates monocrotaline-induced pulmonary arterial hypertension in a Sprague-Dawley rat model

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Traditional Medicine Research 2023年第1期8卷 26-35页

作者： Xiao-Wei Gong Yan-Ling Sheng Shi-Wei Kang Bo-Yun Yuan Ya-Dong Yuan Department of respiratory and Critical Care Medicine The Second Hospital of Hebei Medical UniversityShijiazhuang 050000China Department of respiratory and Critical Care Medicine Huabei Petroleum Administration Bureau General HospitalRenqiu 062550China.

Background:Pulmonary arterial hypertension presents with obliterative remodeling of the pulmonary arteries and progressive elevation of pulmonary vascular resistance,which increase the risk of right ventricular failure and *** has been reported in previous studies that rutaecarpine plays a crucial role in anti-inflammatory and antioxidant activities,which may help regulate cell apoptosis and cell *** purpose of this study was to determine the effects of rutaecarpine in the rat model of monocrotaline-induced pulmonary ***:We induced pulmonary arterial hypertension in adult Sprague-Dawley rats by injecting monocrotaline(60 mg/kg)and then treated with rutaecarpine(40 mg/kg·d)or sildenafil(30 mg/kg·d)(positive control).Subsequently,pulmonary function,inflammation,cytokines and pulmonary vascular remodeling or proliferation were ***:Rutaecarpine was found to improve monocrotaline-induced mean pulmonary artery pressure,cardiac index,right heart index,right ventricular hypertrophy index,pulmonary artery remodeling and pulmonary *** transcription-quantitative polymerase chain reaction demonstrated a decrease in tumor necrosis factor-α,interleukin-6 and interleukin-1β,whereas western blots a significantly decrease in the expression of nuclear factor kappa-B,endothelin-1,extracellular signal-regulated kinases 1/2,B cell lymphoma-2,Beclin1 and microtubule-associated protein1 light chain 3-II protein,and increase in the expression of Bax,caspase-3 and p62 ***:Rutaecarpine attenuated pulmonary arterial hypertension by inhibiting inflammation,oxidative stress,cell proliferation and autophagy,while promoting apoptosis.

关键词： rutaecarpine pulmonary arterial hypertension inflammatory response oxidative stress vascular proliferation

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Manifestation of severe pneumonia in anti-PL-7 antisynthetase syndrome and B cell lymphoma:A case report

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World Journal of clinical Cases 2021年第22期9卷 6435-6442页

作者： Xuan-Li Xu Ru-Hui Zhang Yue-Hong Wang Jian-Ying Zhou Department of respiratory and Critical Care Medicine The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Antisynthetase syndrome(ASS)is characterized by the presence of antisynthetase antibodies coupled with clinical findings such as fever,polymyositis-dermatomyositis and interstitial lung *** is,however,rare to observe ASS association with B cell lymphoma presenting severe pneumonia as the first clinical *** SUMMARY We evaluated a 59-year-old male patient who presented with cough with sputum,shortness of breath and fever for 13 d.A chest computed tomography radiograph revealed bilateral diffuse ground-glass infiltrates in both upper fields,left lingual lobe and right middle ***,the patient was diagnosed with severe community-acquired pneumonia and respiratory *** was empirically treated with broad-spectrum antibiotics,without *** analysis showed an ASS panel with anti-PL7 ***,electromyography evaluation demonstrated a manifestation of myogenic damage,while deltoid muscle biopsy showed irregular muscle fiber bundles especially abnormal lymphocyte *** addition,bone marrow biopsy revealed high invasive B cell ***,the patient was diagnosed with a relatively rare anti–PL7 antibody positive ASS associated with B cell *** This case highlights that rapidly progressive lung lesions and acute hypoxemic respiratory failure associated with heliotrope rash and extremely high lactate dehydrogenase level should be considered as the characteristics of non-infectious diseases,especially ASS and B cell lymphoma.

关键词： Antisynthetase syndrome PL7 B cell lymphoma Severe pneumonia Case

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A rare but potentially lethal complication of dengue

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Asian Pacific Journal of Tropical Medicine 2013年第6期6卷 500-501页

作者： Yingjuan Mok Jessica Quah Chuin Siau Department of respiratory and Critical Care Medicine Changi General HospitalSingapore Department of General Medicine Changi General HospitalSingapore

Severe rhabdomyolysis is an uncommon but potentially fatal complication of dengue fever that is not well characterised and may be *** the resurgence and continued rise of dengue cases worldwide,physicians must be aware of the less common but serious complications of ***,we report a patient who presented with severe rhabdomyolysis secondary to dengue fever with a serum creatine kinase of 742 900

关键词： Dengue Rhabdomyolysis Acute renal failure Shock

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Diagnosis and treatment of gallbladder perforation

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World Journal of Gastroenterology 2006年第48期12卷 7832-7836页

作者： Hayrullah Derici Cemal Kara Ali Dogan Bozdag Okay Nazli Tugrul Tansug Esra Akca Third Surgical clinic of Atatürk Training and Research Hospital Izmir 35360 Turkey

AIM： To present our clinical experience with gallbladder perforation cases.METHODS： Records of 332 patients who received medical and/or surgical treatment with the diagnosis of acute cholecystitis in our clinic between 1997 and 2006 were reviewed retrospectively. Sixteen （4.8%） of those patients had gallbladder perforation. The parameters including age, gender, time from the onset of symptoms to the time of surgery, diagnostic procedures, surgical treatment, morbidity, and mortality were evaluated.RESULTS： Seven patients had type I gallbladder perforation, 7 type I gallbladder perforation, and 2 type m gallbladder perforation according to Niemeier＇ s classification. The patients underwent surgery after administration of intravenous electrolyte solutions, and were treated with analgesics and antibiotics within the first 36 h （mean 9 h） after admission. Two patients died of sepsis and multiple organ failure in the early postoperative period. Subhepatic abscess, pelvic abscess, pneumonia, pancreatitis, and acute renal failure were found in 6 patients.CONCLUSION： Early diagnosis and emergency surgical treatment of gallbladder perforation are of crucial importance. Upper abdominal computerized tomography for acute cholecystitis patients may contribute to the preoperative diagnosis of gallbladder perforation.

关键词： Acute cholecystitis Gallbladder perforation Early diagnosis Computed tomography Emergencysurgery

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