BACKGROUND Massive pulmonary haemorrhage can spoil the entire lung and block the airway in a short period of time due to severe bleeding,which quickly leads to death.Alveolar lavage is an effective method for haemosta...BACKGROUND Massive pulmonary haemorrhage can spoil the entire lung and block the airway in a short period of time due to severe bleeding,which quickly leads to death.Alveolar lavage is an effective method for haemostasis and airway maintenance.However,patients often cannot tolerate alveolar lavage due to severe hypoxia.We used extracorporeal membrane oxygenation(ECMO)to overcome this limitation in a patient with massive pulmonary haemorrhage due to severe trauma and succeeded in saving the life by repeated alveolar lavage.CASE SUMMARY A 22-year-old man sustained multiple injuries in a motor vehicle accident and was transferred to our emergency department.On admission,he had a slight cough and a small amount of bloody sputum;computed tomography revealed multiple fractures and mild pulmonary contusion.At 37 h after admission,he developed severe chest tightness,chest pain,dizziness and haemoptysis.His oxygen saturation was 68%.Emergency endotracheal intubation was performed,and a large amount of bloody sputum was suctioned.After transfer to the intensive care unit,he developed refractory hypoxemia and heparin-free venovenous ECMO was initiated.Fibreoptic bronchoscopy revealed diffuse and profuse blood in all bronchopulmonary segment.Bleeding was observed in the trachea and right bronchus,and repeated alveolar lavage was performed.On day 3,the patient’s haemoptysis ceased,and ECMO support was terminated 10 d later.Tracheostomy was performed on day 15,and the patient was weaned from the ventilator on day 21.CONCLUSION Alveolar lavage combined with ECMO can control bleeding in trauma-induced massive pulmonary haemorrhage,is safe and can be performed bedside.展开更多
Ceramic capillary membrane has received much attention due to its relatively high pack density and favorable mechanical strength.However,it is difficult to prepare capillary membrane on its thin support by a dip-coati...Ceramic capillary membrane has received much attention due to its relatively high pack density and favorable mechanical strength.However,it is difficult to prepare capillary membrane on its thin support by a dip-coating method.In this study,alumina microfiltration membranes were prepared on the inner surface of alumina capillary support(outer diameter 4 mm,inner diameter 2.5 mm)by a dip-coating method.Scanning electron microscopy(SEM)observation,gas bubble pressure(GBP)method and membrane permeation test were carried out to evaluate membrane performance.Two major effects in preparation of crack-free membrane,capillary filtration and film-coating,upon the thin support were studied.The as-prepared crack-free membrane presents a narrow pore size distribution,a mean pore size of about 0.6μm and a high pure water flux of 86000 L·m -2 ·h -1 ·MPa.It is proved that the membrane thickness should be sufficiently large to overcome the defects of support surface,but it is only one of the prerequisites for the formation of crack-free membrane.Furthermore,it is demonstrated that the capillary filtration effect is greatly restricted for thin capillary support with the dip-coating method and the film-coating effect plays a crucial role in the formation of crack-free membrane.展开更多
BACKGROUND Capillary leak syndrome(CLS)is characterized by the leakage of large amounts of fluid and plasma proteins into the interstitial space,resulting in hypoalbuminemia,hypovolemic shock,elevated blood concentrat...BACKGROUND Capillary leak syndrome(CLS)is characterized by the leakage of large amounts of fluid and plasma proteins into the interstitial space,resulting in hypoalbuminemia,hypovolemic shock,elevated blood concentration,systemic progressive edema,and multiple serosal cavity effusion.Clinical syndromes such as cavity effusion pose a grave threat to the life and health of the patient.CASE SUMMARY A 58-year-old female patient was admitted to the hospital after being in a coma for 6 h following accidental ingestion of a pesticide.She was treated with phencyclidine hydrochloride and pralidoxime iodide for detoxification,mechanical ventilation to maintain oxygen supply,continuous renal replacement therapy to maintain the internal environment,and hemoperfusion to promote the excretion of toxins.She also received a transfusion of red blood cells and massive fluid resuscitation.However,her blood pressure was not maintained.The patient was diagnosed with CLS due to pesticide poisoning.Oxygenation was difficult to maintain under full ventilator support;therefore,veno-venous-extracorporeal membrane oxygenation(VV-ECMO)treatment was given 13 h after admission.Her oxygenation level improved,but a large amount of ascites and pleural effusion soon became apparent.We continued drainage with an indwelling drainage tube,and the ECMO flow stabilized.The leakage gradually decreased,and ECMO was discontinued 3 d later.On the 6th day,the patient recovered from unconsciousness,but on gastroscopic evaluation,severe erosions were found in her entire stomach.With the family’s consent,treatment was stopped,and the patient was discharged from the hospital on the 7th day.CONCLUSION ECMO,liquid resuscitation and management,and improvement in plasma colloidal osmotic pressure,circulation,and tissue oxygen supply are crucial in treating CLS.展开更多
Alveolar macrophages (AM) from BCG activated Wistar rat were irradiated with different doses of Gamma rays in vitro. The effects of radiation on their immunological functions and membrane damage were studied. The non-...Alveolar macrophages (AM) from BCG activated Wistar rat were irradiated with different doses of Gamma rays in vitro. The effects of radiation on their immunological functions and membrane damage were studied. The non-specific cytotoxicity and specific phagocytosis of AM irradiated with dose of 0, 100, 300 and 500 Gy decreased with the increase in dose. The relative fractions of Lactate Dehydrogenase and Beta-glucuronidase (β-glu) activity in supernatant increased with the increase in dose. There was a correlation between the suppression of immunological functions and the degree of damage of cytoplasmic and lysosomal membranes of AM after irradiation. Na2SeO3, a protective agent of cell membranes, alleviated this effect on the suppressive cytotoxicity indices of irradiated AM.展开更多
Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is a rare, fatal developmental lung disorder of neonates and infants, associated with severe persistent pulmonary hypertension unresponsive t...Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is a rare, fatal developmental lung disorder of neonates and infants, associated with severe persistent pulmonary hypertension unresponsive to treatment. We reported the case of a term newborn with delayed presentation of ACD/MPV and a novel mutation of FOXF1 gene that received supportive cardiopulmonary treatments, inhaled nitric oxide, oral sildenafil and nebulized iloprost with no clinical improvement. DNA sequence analysis of FOXF1 gene identified a novel heterozygous variant c.257G > C;p.R86P, in exon 1. At autopsy, lung histology showed the characteristic features of ACD/MPV. FOXF1 has been identified as one of the genes responsible for ACD/MPV associated with multiple congenital malformations. This is a report of a novel heterozygous variant c.257G > C;p.R86P, in the first exon of FOXF1, in a patient with delayed presentation of ACD/MPV.展开更多
A novel capillary electrophoresis method coupled with on-line microdialysis using an attachable electrode has been developed to study the interaction of macromolecule with small molecule. The binding constants of bovi...A novel capillary electrophoresis method coupled with on-line microdialysis using an attachable electrode has been developed to study the interaction of macromolecule with small molecule. The binding constants of bovine serum album (BSA) with D,L-tryptophan (Trp), sulfamethoxazole (SMZ) with trypsin and chymotrypsin were determined. These values are 2.3 x 10(4)L/mol for BSA-L-Trp; 1.77 x 10(3) L/mol for BSA-D-Trp in pH 7.4, 50 mmol/ L phosphate; 1.4 x 10(4) L/mol for SMZ- trypsin and 6.0 x 10(3) L/mol for SMZ-chymotrypsin in pH 6.5, 25 mmol/L Tris buffer. The proposed method has merits of speed, low sample consumption and readily available to be performed in desired physiological conditions.展开更多
Capillary leak syndrome(CLS)is a rare clinical syndrome associated with significant morbidity and mortality.Intensive care and supportive therapy constitute the mainstay of the treatment,along with judicious use of cr...Capillary leak syndrome(CLS)is a rare clinical syndrome associated with significant morbidity and mortality.Intensive care and supportive therapy constitute the mainstay of the treatment,along with judicious use of crystalloids and colloids such as dextran and starch during the leak phase.The advantages of proning,steroids,and intravenous immunoglobins are worth contemplating in patients with such a presentation.Extracorporeal membrane oxygenation appears to be an excellent strategy to surmount the impediments of the leak and post leak phase of CLS,especially in patients with severe or refractory hypoxemia.展开更多
The alveolar antral artery resides lateral to the maxillary sinus and can lead to complications in sinus lift surgery. Traditional approaches that decrease intraoperative bleeding into the surgical field include vesse...The alveolar antral artery resides lateral to the maxillary sinus and can lead to complications in sinus lift surgery. Traditional approaches that decrease intraoperative bleeding into the surgical field include vessel preservation using multiple bony windows or neutralizing the vessel at the surgical site. Unfortunately, these methods are technique sensitive, time intensive, and may lead to hemosinus and graft loss. The variable distance from the crest of the alveolar ridge and vessel diameter further complicates pre-operative planning. This paper discusses the anatomical features of the alveolar antral artery, techniques for clinical assessment, and current management strategies. We then describe a novel protocol to manage the alveolar antral artery in sinus lift procedures via tamponade of the vessel at a proximal site. This method is faster than those described in the literature, does not require any additional equipment or expertise, and aims to improve long-term graft predictability by decreasing the risk of sinus membrane perforation. The alveolar antral artery is an under-reported source of surgical complications and warrants further research.展开更多
目的:在颊侧袋形瓣引导性骨再生手术基础上,探讨放置可吸收胶原膜是否有利于维持术后牙槽嵴轮廓稳定。方法:收集2019年6月至2023年6月因单颗后牙缺失采用种植体植入同期进行颊侧袋形瓣引导性骨再生手术患者,根据骨粉表面是否覆盖胶原膜...目的:在颊侧袋形瓣引导性骨再生手术基础上,探讨放置可吸收胶原膜是否有利于维持术后牙槽嵴轮廓稳定。方法:收集2019年6月至2023年6月因单颗后牙缺失采用种植体植入同期进行颊侧袋形瓣引导性骨再生手术患者,根据骨粉表面是否覆盖胶原膜分为胶原膜覆盖组和无覆盖组。术前(T0)、术后即刻(T1)和术后3~7个月(T2)拍摄锥形束CT,利用Mimics软件测量种植体光滑-粗糙交界面下不同水平(0、2、4和6 mm)处颊侧骨板厚度(thickness of the buccal bone plate,BBT,分别表示为BBT-0、-2、-4、-6)。结果:收集胶原膜覆盖组15例,无胶原膜覆盖组14例,共计29例患者进行统计分析。在T0、T1和T2三个时间点,不同水平的BBT在两组间差异均无统计学意义(P>0.05)。T2时,BBT-0在胶原膜覆盖组和无覆盖组分别为(1.22±0.55)mm和(1.70±0.97)mm,相应的BBT-2分别为(2.32±0.94)mm和(2.57±1.26)mm。T1~T2愈合阶段不同水平处颊侧骨板吸收的绝对值[(0.47±0.54)~(1.33±0.75)mm]和百分数[(10.04%±24.81%)~(48.43%±18.32%)],以及T0~T2阶段颊侧骨板新骨形成厚度[(1.27±1.09)~(2.75±2.15)mm]在两组间差异均无统计学意义。结论:颊侧袋形瓣引导骨再生手术无论是否使用胶原膜均可有效修复种植体颈部颊侧骨缺损。与无胶原膜覆盖相比,胶原膜覆盖植骨材料不能提高术后牙槽嵴轮廓的稳定性。展开更多
By introducing cell membrane into electrophoretic buffer as pseudo-stationary phase,a novel capillary electrophoresis method was established to explore the interaction between drugs and cell membrane,where the interac...By introducing cell membrane into electrophoretic buffer as pseudo-stationary phase,a novel capillary electrophoresis method was established to explore the interaction between drugs and cell membrane,where the interaction between citalopram and rabbit red blood cell membrane was used as an example. A series of concentrations of cell membrane were suspended into the running buffer by peak-shift method. The binding constant of citalopram to rabbit red blood cell membrane of 0.977 g-1·L was obtained after treatment of Scatchard plot. This method could provide not only a new way for the investigation on the interactions between drugs and cell membrane,but also a new approach for high throughput screening of the drug membrane permeability,biological activity,and evaluating drugs in vivo.展开更多
文摘BACKGROUND Massive pulmonary haemorrhage can spoil the entire lung and block the airway in a short period of time due to severe bleeding,which quickly leads to death.Alveolar lavage is an effective method for haemostasis and airway maintenance.However,patients often cannot tolerate alveolar lavage due to severe hypoxia.We used extracorporeal membrane oxygenation(ECMO)to overcome this limitation in a patient with massive pulmonary haemorrhage due to severe trauma and succeeded in saving the life by repeated alveolar lavage.CASE SUMMARY A 22-year-old man sustained multiple injuries in a motor vehicle accident and was transferred to our emergency department.On admission,he had a slight cough and a small amount of bloody sputum;computed tomography revealed multiple fractures and mild pulmonary contusion.At 37 h after admission,he developed severe chest tightness,chest pain,dizziness and haemoptysis.His oxygen saturation was 68%.Emergency endotracheal intubation was performed,and a large amount of bloody sputum was suctioned.After transfer to the intensive care unit,he developed refractory hypoxemia and heparin-free venovenous ECMO was initiated.Fibreoptic bronchoscopy revealed diffuse and profuse blood in all bronchopulmonary segment.Bleeding was observed in the trachea and right bronchus,and repeated alveolar lavage was performed.On day 3,the patient’s haemoptysis ceased,and ECMO support was terminated 10 d later.Tracheostomy was performed on day 15,and the patient was weaned from the ventilator on day 21.CONCLUSION Alveolar lavage combined with ECMO can control bleeding in trauma-induced massive pulmonary haemorrhage,is safe and can be performed bedside.
基金Supported by the National High Technology Research and Development Program of China （2007AA030303）, the National Basic Research Program of China （2009CB623400） and the National Natural Science Foundation of China （20776067）.
文摘Ceramic capillary membrane has received much attention due to its relatively high pack density and favorable mechanical strength.However,it is difficult to prepare capillary membrane on its thin support by a dip-coating method.In this study,alumina microfiltration membranes were prepared on the inner surface of alumina capillary support(outer diameter 4 mm,inner diameter 2.5 mm)by a dip-coating method.Scanning electron microscopy(SEM)observation,gas bubble pressure(GBP)method and membrane permeation test were carried out to evaluate membrane performance.Two major effects in preparation of crack-free membrane,capillary filtration and film-coating,upon the thin support were studied.The as-prepared crack-free membrane presents a narrow pore size distribution,a mean pore size of about 0.6μm and a high pure water flux of 86000 L·m -2 ·h -1 ·MPa.It is proved that the membrane thickness should be sufficiently large to overcome the defects of support surface,but it is only one of the prerequisites for the formation of crack-free membrane.Furthermore,it is demonstrated that the capillary filtration effect is greatly restricted for thin capillary support with the dip-coating method and the film-coating effect plays a crucial role in the formation of crack-free membrane.
文摘BACKGROUND Capillary leak syndrome(CLS)is characterized by the leakage of large amounts of fluid and plasma proteins into the interstitial space,resulting in hypoalbuminemia,hypovolemic shock,elevated blood concentration,systemic progressive edema,and multiple serosal cavity effusion.Clinical syndromes such as cavity effusion pose a grave threat to the life and health of the patient.CASE SUMMARY A 58-year-old female patient was admitted to the hospital after being in a coma for 6 h following accidental ingestion of a pesticide.She was treated with phencyclidine hydrochloride and pralidoxime iodide for detoxification,mechanical ventilation to maintain oxygen supply,continuous renal replacement therapy to maintain the internal environment,and hemoperfusion to promote the excretion of toxins.She also received a transfusion of red blood cells and massive fluid resuscitation.However,her blood pressure was not maintained.The patient was diagnosed with CLS due to pesticide poisoning.Oxygenation was difficult to maintain under full ventilator support;therefore,veno-venous-extracorporeal membrane oxygenation(VV-ECMO)treatment was given 13 h after admission.Her oxygenation level improved,but a large amount of ascites and pleural effusion soon became apparent.We continued drainage with an indwelling drainage tube,and the ECMO flow stabilized.The leakage gradually decreased,and ECMO was discontinued 3 d later.On the 6th day,the patient recovered from unconsciousness,but on gastroscopic evaluation,severe erosions were found in her entire stomach.With the family’s consent,treatment was stopped,and the patient was discharged from the hospital on the 7th day.CONCLUSION ECMO,liquid resuscitation and management,and improvement in plasma colloidal osmotic pressure,circulation,and tissue oxygen supply are crucial in treating CLS.
文摘Alveolar macrophages (AM) from BCG activated Wistar rat were irradiated with different doses of Gamma rays in vitro. The effects of radiation on their immunological functions and membrane damage were studied. The non-specific cytotoxicity and specific phagocytosis of AM irradiated with dose of 0, 100, 300 and 500 Gy decreased with the increase in dose. The relative fractions of Lactate Dehydrogenase and Beta-glucuronidase (β-glu) activity in supernatant increased with the increase in dose. There was a correlation between the suppression of immunological functions and the degree of damage of cytoplasmic and lysosomal membranes of AM after irradiation. Na2SeO3, a protective agent of cell membranes, alleviated this effect on the suppressive cytotoxicity indices of irradiated AM.
文摘Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is a rare, fatal developmental lung disorder of neonates and infants, associated with severe persistent pulmonary hypertension unresponsive to treatment. We reported the case of a term newborn with delayed presentation of ACD/MPV and a novel mutation of FOXF1 gene that received supportive cardiopulmonary treatments, inhaled nitric oxide, oral sildenafil and nebulized iloprost with no clinical improvement. DNA sequence analysis of FOXF1 gene identified a novel heterozygous variant c.257G > C;p.R86P, in exon 1. At autopsy, lung histology showed the characteristic features of ACD/MPV. FOXF1 has been identified as one of the genes responsible for ACD/MPV associated with multiple congenital malformations. This is a report of a novel heterozygous variant c.257G > C;p.R86P, in the first exon of FOXF1, in a patient with delayed presentation of ACD/MPV.
文摘A novel capillary electrophoresis method coupled with on-line microdialysis using an attachable electrode has been developed to study the interaction of macromolecule with small molecule. The binding constants of bovine serum album (BSA) with D,L-tryptophan (Trp), sulfamethoxazole (SMZ) with trypsin and chymotrypsin were determined. These values are 2.3 x 10(4)L/mol for BSA-L-Trp; 1.77 x 10(3) L/mol for BSA-D-Trp in pH 7.4, 50 mmol/ L phosphate; 1.4 x 10(4) L/mol for SMZ- trypsin and 6.0 x 10(3) L/mol for SMZ-chymotrypsin in pH 6.5, 25 mmol/L Tris buffer. The proposed method has merits of speed, low sample consumption and readily available to be performed in desired physiological conditions.
文摘Capillary leak syndrome(CLS)is a rare clinical syndrome associated with significant morbidity and mortality.Intensive care and supportive therapy constitute the mainstay of the treatment,along with judicious use of crystalloids and colloids such as dextran and starch during the leak phase.The advantages of proning,steroids,and intravenous immunoglobins are worth contemplating in patients with such a presentation.Extracorporeal membrane oxygenation appears to be an excellent strategy to surmount the impediments of the leak and post leak phase of CLS,especially in patients with severe or refractory hypoxemia.
文摘The alveolar antral artery resides lateral to the maxillary sinus and can lead to complications in sinus lift surgery. Traditional approaches that decrease intraoperative bleeding into the surgical field include vessel preservation using multiple bony windows or neutralizing the vessel at the surgical site. Unfortunately, these methods are technique sensitive, time intensive, and may lead to hemosinus and graft loss. The variable distance from the crest of the alveolar ridge and vessel diameter further complicates pre-operative planning. This paper discusses the anatomical features of the alveolar antral artery, techniques for clinical assessment, and current management strategies. We then describe a novel protocol to manage the alveolar antral artery in sinus lift procedures via tamponade of the vessel at a proximal site. This method is faster than those described in the literature, does not require any additional equipment or expertise, and aims to improve long-term graft predictability by decreasing the risk of sinus membrane perforation. The alveolar antral artery is an under-reported source of surgical complications and warrants further research.
文摘目的:在颊侧袋形瓣引导性骨再生手术基础上,探讨放置可吸收胶原膜是否有利于维持术后牙槽嵴轮廓稳定。方法:收集2019年6月至2023年6月因单颗后牙缺失采用种植体植入同期进行颊侧袋形瓣引导性骨再生手术患者,根据骨粉表面是否覆盖胶原膜分为胶原膜覆盖组和无覆盖组。术前(T0)、术后即刻(T1)和术后3~7个月(T2)拍摄锥形束CT,利用Mimics软件测量种植体光滑-粗糙交界面下不同水平(0、2、4和6 mm)处颊侧骨板厚度(thickness of the buccal bone plate,BBT,分别表示为BBT-0、-2、-4、-6)。结果:收集胶原膜覆盖组15例,无胶原膜覆盖组14例,共计29例患者进行统计分析。在T0、T1和T2三个时间点,不同水平的BBT在两组间差异均无统计学意义(P>0.05)。T2时,BBT-0在胶原膜覆盖组和无覆盖组分别为(1.22±0.55)mm和(1.70±0.97)mm,相应的BBT-2分别为(2.32±0.94)mm和(2.57±1.26)mm。T1~T2愈合阶段不同水平处颊侧骨板吸收的绝对值[(0.47±0.54)~(1.33±0.75)mm]和百分数[(10.04%±24.81%)~(48.43%±18.32%)],以及T0~T2阶段颊侧骨板新骨形成厚度[(1.27±1.09)~(2.75±2.15)mm]在两组间差异均无统计学意义。结论:颊侧袋形瓣引导骨再生手术无论是否使用胶原膜均可有效修复种植体颈部颊侧骨缺损。与无胶原膜覆盖相比,胶原膜覆盖植骨材料不能提高术后牙槽嵴轮廓的稳定性。
基金Supported by the National Natural Science Foundation of China (Grant No. 20775096)the Natural Science Foundation of Chongqing (Grant No. 2006BB5177)
文摘By introducing cell membrane into electrophoretic buffer as pseudo-stationary phase,a novel capillary electrophoresis method was established to explore the interaction between drugs and cell membrane,where the interaction between citalopram and rabbit red blood cell membrane was used as an example. A series of concentrations of cell membrane were suspended into the running buffer by peak-shift method. The binding constant of citalopram to rabbit red blood cell membrane of 0.977 g-1·L was obtained after treatment of Scatchard plot. This method could provide not only a new way for the investigation on the interactions between drugs and cell membrane,but also a new approach for high throughput screening of the drug membrane permeability,biological activity,and evaluating drugs in vivo.
