For first-aided surgery, tracheal intubation is an important step to keep patients breathing. In order to solve problems of traditional intubation instrument, such as non-portable, expertise requirement and secondary injury caused by rigid structure, a kind of pneumatic actuator based tracheal intubation system is proposed in this paper. The instrument hardware includes tongue depressor, feeding mechanism and steering mechanism. Pneumatic actuators made of soft material are applied in the instrument. System's software includes pneumatic controller and teleoperation controller. Medical experts can control the intubation system to operate first-aided intubation surgery remotely, helping to reduce mortality of asphyxia patients. The results of simulation and manikin experiments show that the tracheal intubation system meets the requirements of first-aided intubation surgery.
The occurrence of foreign body is uncommon in youths and adults. We report here a case of 16-year-old boy who inhaled a foreign body which was overlooked for 6 months. The patient suffered productive cough and received antibiotic treatment for 10 days. But the symptoms did not improve. Chest radiography and CT scan revealed a 1-cm-long needle-like foreign object in the right inferior lobar bronchus. Wedge resection of lung was finally performed because of severe hemorrhage caused by prior bronchoscopy.
Background The University of Wisconsin colloid based preserving solution (UW solution) is the most efficient preserving solution for multiorgan transplantation. Unfortunately, unavailability of delayed organ preserving solutions hindered further progression of cardinal organ transplantation in China. In this study, we validated an organ preserving Changzheng Organ Preserving Solution (CZ-1 solution) and compared it with UW solution. Methods A series of studies were conducted on how and how long CZ-1 solution could preserve the kidneys, livers, hearts, lungs and pancreas of New Zealand rabbits and SD rats. Morphology of transplanted organs was studied by visible microscopy and electron microscopy; biochemical and physiological functions and the survival rate of the organs during prolonged cold storage were studied. Results There was no significant difference between CZ-1 and UW solutions in preserving the kidneys, livers, hearts or lungs of rabbits; kidneys, livers, intestinal mucosa or pancreases of SD rats or five deceased donors’ testicles. In some aspects, such as preserving rabbits’ hearts, rats’ intestinal mucosa and pancreases, the effect of CZ-1 solution was superior to UW solution. CZ-1 could safely preserve kidneys for 72 hours, livers for 24 hours, hearts for 18 hours and lungs for 8 hours for SD rats. Twelve kidneys preserved in cold CZ-1 solution for 22–31 hours were transplanted successfully and the mean renal function recovery time was (3.83±1.68) days. Conclusions CZ-1 solution is as effective as UW solution for organ preservation. The development of CZ-1 solution not only reduces costs and improves preservation of organs, but also promotes future development of organ transplantation in China. Chin Med J 2008;121(10):904–909
Objective To compare the outcomes of traumatic flail chest with multiple injuries treated by operative fixation versus conservative approach. Methods The clinical data of 60 patients with traumatic flail chest with multiple injuries were retrospectively analysed, and the outcomes between operation group (treated by operative fixation, n=32)and non-operation group (treated by conservative approach, n=28) were compared. Results The mean time of hospital stay, ICU stay and mechanical ventilation was significantly shorter, and the prevalences of chest wall deformity, pulmonary infection, pulmonary atelectasis and respiratory failure were significantly lower in operation group than those in non-operation group (P0.05). Six months after discharge, the pulmonary function parameters such as inspiratory capacity, forced vital capacity, forced expiratory volume in one second, peak expiratory flow, total lung capacity and maximal midexpiratory flow were significantly higher in operation group than those in non-operation group (P0.05). Conclusion Traumatic flail chest with multiple injuries treated by operative fixation may lead to less flail chest associated complications. Operative fixation has short- and long-term benefits to flail chest.
Hemopneumothorax is a common sequelae of traumatic thoracic injury. The most effective treatment of this condition is thoracic drainage. Despite the common occurrence of this condition, available instruments are difficult to use emergently, particularly when large amounts of patients need to be drained. In the present experiment, a newly designed chest tube and thoracic closed drainage package is described and preliminarily evaluated with the goal to improve the treatment of traumatic hemopneumothorax.Twenty canines were divided into two groups. In one group, the newly designed thoracic closed drainage package was used, whereas in the other group a currently available chest tube and bottle were used. Drainage test, ultrasound examination, flushing test, and tension test were performed to evaluate the effectiveness of the drainage package.We found that the newly-designed drainage tube is as effective as the common tube when evaluated using all of the chosen methods. In addition, the package is very lightweight and portable.The newly-designed thoracic drainage package is very effective in the emergency treatment of thoracic trauma and may be more suitable for the emergency treatment of hemopneumothorax.
Abstract Objectives Our study aimed to evaluate the effect of cordycepin on human lung cancer cell lines A549 and NCI-H460. Methods Human lung cancer A549 cells and NCI-H460 cells were treated with different concentrations of cordycepin for different times. Cells incubated without cordycepin were defined as a control. The cell proliferation, migration and apoptosis were, respectively, determined by MTT assay, transwell migration assay and flow cytometry. Additionally, the expression levels of related proteins associated with cell cycle, epithelial–mesenchymal transition (EMT) and apoptosis were examined. Key findings The survival rate of A549 cells and NCI-H460 cells treated with cordycepin significantly decreased compared with untreated cells in a concentration-dependent manner, while the apoptosis rate increased. The migration number of cells treated with cordycepin significantly decreased as the increase in concentration. qRT-PCR and Western blot analysis showed that the aberrant expression of related molecules associated with cell cycle, migration and apoptosis was observed in the lung cancer cells, such as cyclin B, cyclin E, MMP-9, caspase-3 and Bcl-2. Conclusions Cordycepin may exert inhibitory effects on the development of human lung cancer via inhibiting cell proliferation, suppressing migration and inducing apoptosis, suggesting that cordycepin may have therapeutic potential for the treatment of this disease.
Research into robotic systems for single port surgery (SPS) has become widespread around the world in recent years. A new robot arm system for SPS was developed, but its positioning platform and other hardware components were not efficient. Special features of the developed surgical robot system make good teleoperation with safety and efficiency difficult.A robot arm is combined and used as new positioning platform, and the remote center motion is realized by a new method using active motion control. A new mapping strategy based on kinematics computation and a novel optimal coordinated control strategy based on real-time approaching to a defined anthropopathic criterion configuration that is referred to the customary ease state of human arms and especially the configuration of boxers' habitual preparation posture are developed.The hardware components, control architecture, control system, and mapping strategy of the robotic system has been updated. A novel optimal coordinated control strategy is proposed and tested.The new robot system can be more dexterous, intelligent, convenient and safer for preoperative positioning and intraoperative adjustment. The mapping strategy can achieve good following and representation for the slave manipulator arms. And the proposed novel control strategy can enable them to complete tasks with higher maneuverability, lower possibility of self-interference and singularity free while teleoperating.
Objective To investigate the relationship between the size of primary tumor, pathologic classification, cell differentiation or location of tumor and lymph node metastasis in lung cancer. Methods Three hundred and thirty-two patients with lung cancer underwent pulmonectomy plus extensive dissection of hilar and mediastinal nodes. The law of lymph node metastasis was analyzed. Results A total of 3 280 lymph nodes were removed. Metastatic rates of N1 and N2 were 29.9% and 22.4% respectively. The total lymph node metastatic rates of T1, T2, and T3 diseases were 8.5%, 27.4% and 61.2% respectively ( P < 0.005). No lymphatic metastasis was observed in well-differentiated squamous cell carcinoma, however, the lymph node metastatic rates in moderate- and poor-differentiated squamous cell carcinoma were 16.8% and 19.6% respectively. The lymph node metastatic rates were 27.5% and 71.6% in moderate- and poor-differentiated adenocarcinoma respectively ( P < 0.005). The total lymph node metastatic rates in central and peripheral squamous cell carcinoma were 19.6% and 11.7% respectively ( P < 0.005), while in adenocarcinoma, the rates were 57.9% and 24.0% respectively ( P < 0.005). The N2 metastatic rates in central and peripheral squamous cell carcinoma were 10.9% and 2.9% respectively ( P < 0.005), while in adenocarcinoma, the rates were 47.5% and 17.8% respectively ( P < 0.005 ). Under the same T status, cell differentiation or location of tumor, the metastatic rate of adenocarcinoma was much higher than that of squamous cell carcinoma ( P < 0.005 ). Conclusion The frequency of lymph node metastasis significantly correlate with size of primary tumor, pathological classification, cell differentiation and location of tumor.
DOI: 10.3779/j.issn.1009-3419.2004.04.23
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