Objective To explore the treatment effects of one-way valve lung volume reduction surgery for heterogeneous emphysema.Methods Seven heterogeneous emphysema Beagle dogs were each implanted in right lung2-4 pieces ofbronchial one-way valve.The animals were sacrificed two months later.Macro- and microscopic pathology changes of the lungs were observed.Results Of 21 valves implanted，2 were expectorated，and 19 were in normal position.The dogs did not have obvious adverse reactions.Generally specimens of the occluded lobes had different levels of lung volume decrease，such as texture stiffened，focal scar formation，atelectasis，pulmonary fibrosis.Pathological biopsy showed moderate alveolitis and pulmonary interstitial fibrosis.Conclusion One-way valve lung volume reduction is effective for heterogeneous emphysema
0bjective To investigate the prevalence of gastroesophageal reflux(GER)in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and to explore the influence of GER on the acidity of airway and pulmonary ventilation function in AECOPD patients．Methods Sixty-five hospitalized AECOPD patients and 20 healthy volunteers were enrolled in this study．According to “GER survey”questionnaire，AECOPD patients were allocated into GER group and non-GER group and expired breath condensate(EBC)pH and pulmonary ventilation function were detected．Breath condensate samples were collected using a specially designed condensing chamber(EcoScreen，Germany)．Results About 30.8％ (20／65)AECOPD patients were complicated with GER．EBC pH was lowest in GER group，middle in non-GER group and highest in the control group[6.oo±0.75 VS 6.76±0.77 and 7.97±0.12，both Plt;0.05)．The pulmonary ventilation function(FEV1、FEV1％pred)in AECOPD patients with GER were lower than those without GER(both Plt;0.05)．Conclusions There iS a high prevalence of GER in AECOPD patients．And the airway pH is reduced in AECOPD patients，especially when complicated with GER，which may play an important role in the development of COPD．
ObjectiveTo review antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants, so as to provide reference for subsequent research. MethodsThe related research literature on antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants in recent years was reviewed, and the research progress was summarized based on different kinds of antibacterial substances and osteogenic active substances. ResultsAt present, the antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants includes: ① Combined coating strategy of antibiotics and osteogenic active substances. It is characterized in that antibiotics can be directly released around titanium-based implants, which can improve the bioavailability of drugs and reduce systemic toxicity. ② Combined coating strategy of antimicrobial peptides and osteogenic active substances. The antibacterial peptides have a wide antibacterial spectrum, and bacteria are not easy to produce drug resistance to them. ③ Combined coating strategy of inorganic antibacterial agent and osteogenic active substances. Metal ions or metal nanoparticles antibacterial agents have broad-spectrum antibacterial properties and various antibacterial mechanisms, but their high-dose application usually has cytotoxicity, so they are often combined with substances that osteogenic activity to reduce or eliminate cytotoxicity. In addition, inorganic coatings such as silicon nitride, calcium silicate, and graphene also have good antibacterial and osteogenic properties. ④ Combined coating strategy of metal organic frameworks/osteogenic active substances. The high specific surface area and porosity of metal organic frameworks can effectively package and transport antibacterial substances and bioactive molecules. ⑤ Combined coating strategy of organic substances/osteogenic active substancecs. Quaternary ammonium compounds, polyethylene glycol, N-haloamine, and other organic compounds have good antibacterial properties, and are often combined with hydroxyapatite and other substances that osteogenic activity. ConclusionThe factors that affect the antibacterial and osteogenesis properties of titanium-based implants mainly include the structure and types of antibacterial substances, the structure and types of osteogenesis substances, and the coating process. At present, there is a lack of clinical verification of various strategies for antibacterial/osteogenesis dual-functional surface modification of titanium-based implants. The optimal combination, ratio, dose-effect mechanism, and corresponding coating preparation process of antibacterial substances and bone-active substances are needed to be constantly studied and improved.
Objective To explore the therapeutic effect of mild hypothermia on the inflammatory response, organ function and outcome in perioperative patients with acute Stanford type A aortic dissection (AAAD). Methods From February 2017 to February 2018, 56 patients with AAAD admitted in our department were enrolled and randomly allocated into two groups including a control group and an experimental group. After deep hypothermia circulatory arrest during operation, in the control group (n=28), the patients were rewarmed to normal body temperatures (36 to 37 centigrade degree), and which would be maintained for 24 hours after operation. While in the experimental group (n=28), the patients were rewarmed to mild hypothermia (34 to 35 centigrade degree), and the rest steps were the same to the control group. The thoracic drainage volume and the incidence of shivering at the first 24 hours after operation, inflammatory indicators and organ function during perioperation, and outcomes were compared between the two groups. There were 20 males and 8 females at age of 51.5±8.7 years in the control group, 24 males and 4 females at age of 53.3±11.2 years in the experimental group.Results There was no obvious difference in the basic information and operation information in patients between the two groups. Compared to the control group, at the 24th hour after operation, the level of peripheral blood matrix metalloproteinases (MMPs) was lower than that in the experimental group (P=0.008). In the experimental group, after operation, the awakening time was much shorter (P=0.008), the incidence of bloodstream infection was much lower (P=0.019). While the incidence of delirium, acute kidney injury (AKI), hepatic insufficiency, mechanical ventilation duration, intensive care unit (ICU) stays, or hospital mortality rate showed no statistical difference. And at the first 24 hours after operation, there was no difference in the thoracic drainage volume between the two groups, and no patient suffered from shivering. Conclusion The mild hypothermia therapy is able to shorten the awakening time and reduce the incidence of bloodstream infection after operation in the patients with AAAD, and does not cause the increase of thoracic drainage volume or shivering.