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

BACKGROUND Chronic obstructive pulmonary disease(COPD)combined with spontaneous pneumothorax,is characterized by significant decline in lung function,and even cause cardiopulmonary failure and hypoxia.AIM 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 pneumothorax.METHODS 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 2023.The clinical efficacy,complications,hospitalization duration,and costs were compared between patients with an indwelling thoracic catheter and those with a central venous catheter.Univariate logistic regression was used to analyze the causes of catheter displacement.RESULTS 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 group.Patients’catheter shedding is influenced by the primary nurse’s working years,APACHE II scores,and catheter fixation technique.

Role of exosome-associated microRNA in diagnostic and therapeutic applications to metabolic disorders

Metabolic disorders are classified clinically as a complex and varied group of diseases including metabolic syndrome,obesity,and diabetes mellitus.Fat toxicity,chronic inflammation,and oxidative stress,which may change cellular functions,are considered to play an essential role in the pathogenetic progress of metabolic disorders.Recent studies have found that cells secrete nanoscale vesicles containing proteins,lipids,nucleic acids,and membrane receptors,which mediate signal transduction and material transport to neighboring and distant cells.Exosomes,one type of such vesicles,are reported to participate in multiple pathological processes including tumor metastasis,atherosclerosis,chronic inflammation,and insulin resistance.Research on exosomes has focused mainly on the proteins they contain,but recently the function of exosome-associated microR NA has drawn a lot of attention.Exosomeassociated microR NAs regulate the physiological function and pathological processes of metabolic disorders.They may also be useful as novel diagnostics and therapeutics given their special features of non-immunogenicity and quick extraction.In this paper,we summarize the structure,content,and functions of exosomes and the potential diagnostic and therapeutic applications of exosome-associated micro RNAs in the treatment of metabolic disorders.