Objective: To find out the application value of minimally invasive percutaneous dilational tracheostomy in critically ill patients in intensive care unit (ICU). Methods: One hundred and forty critically ill patients who underwent tracheostomy in ICU of our hospital were included in the study from August 2016 to December 2017. They were divided into an observation group and a control group by random number table method, 70 in each group. The control group received conventional tracheotomy, while the observation group received percutaneous dilational tracheostomy. The operation time, incision length, amount of intraoperative bleeding and healing time of incision were compared between the two groups, and the changes of vital signs and complications after operation were recorded. The family members of the patients signed the informed consent. Results: The operation time, healing time and incision length of the observation group were (9.92±4.13) min, (1.31±0.21) cm and (6.91±0.72) respectively, shorter than (24.09±6.82) min, (3.40±0.65) cm and (67.48±0.61) d in the control group, and the differences were statistically significant (P<0.05). The amount of intraoperative bleeding of the observation group was (7.81±1.83) mL, less than (16.34±2.83) mL in the control group; the difference was statistically significant (P<0.05). The heart rate and oxygen saturation of the observation group before and during the operation were not significantly different (P>0.05). The heart rate of the control group during the operation was significantly higher than that before the operation (P<0.05); the oxygen saturation of the control group before and during the operation had no significant difference (P>0.05). The incidence of complications in the observation group was 24.3%, which was significantly lower than that in the control group (55.7%, X2=8.279, P=0.014). Conclusion: Minimally invasive percutaneous dilational tracheostomy has advantages of small trauma, less infection and beautiful incision, and it will not increase postoperative complications. It is of great value in the treatment of ICU critical patients. doi: https://doi.org/10.12669/pjms.36.2.594 How to cite this:Gan H, Dong A, Xu H. Application value of minimally invasive percutaneous dilational tracheostomy for ICU critical patients. Pak J Med Sci. 2020;36(2):59-63. doi: https://doi.org/10.12669/pjms.36.2.594 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

在目前中石油各油田都自建很多专业数据库,各专业也开发了多个数据库,专业信息系统缺乏统一规划和建设,重复建设现象多,专业与专业之间无法共享信息数据和资源,内部信息孤岛严重,还给一线工程师带来了繁重的负担.文章通过井筒工程一体化数据库建立与应用实践,形成了跨专业数据库的整合与管理的方法,并提出了"大数据"在钻井工程中应用.大数据是未来石油信息技术发展的基础,也是川庆钻探公司向信息化、智能化管理转变的必经之路.文章提出的方法及应用对石油行业如何用好"大数据"具有一定的借鉴意义.

In the present study a eukaryotic expression vector of varicella zoster virus (VZV) glycoprotein E (gE) was constructed and enabled to express in COS7 cells. Furthermore, a specific immune response against the VZV gE eukaryotic expression plasmid was induced in BALB/c mice. The VZV gE gene was amplified using polymerase chain reaction (PCR) and cloned into a eukaryotic expression vector, pcDNA3.1. The recombinant vector was subsequently transfected into COS7 cells using a liposome transfection reagent. The recombinant protein was instantaneously expressed by the transfected cells, as detected by immunohistochemistry, and the recombinant pcDNA-VZV gE plasmid was subsequently used to immunize mice. Tissue expression levels were analyzed by reverse transcription-PCR. In addition, the levels of serum antibodies and spleen lymphocyte proliferation activity were investigated. The amplified target gene included the full-length gE gene (~2.7 kb), and the recombinant expression vector induced gE expression in COS7 cells. In addition, the expression plasmid induced sustained expression in vivo following immunization of mice. Furthermore, the plasmid was capable of inducing specific antibody production and effectively stimulating T cell proliferation. Effective humoral and cellular immunity was triggered in the mice immunized with the VZV gE eukaryotic expression vector. The results of the present study laid the foundation for future research into a VZV DNA vaccine.

Objective To investigate the efficacy of continuous blood purification(CBP) in the treatment of severe sepsis,and explore the related immune regulatory mechanisms.Methods Forty-eight patients with severe sepsis were randomly divided into a control group(n=23) and a CBP group(n=25).CD4+CD25+ regulatory T cells(Treg%) in peripheral blood and APACHEⅡ score were measured dynamically before treatment and 12,24,36,48,60,72 hours after treatment.Meanwhile the length of ICU stay,duration of mechanical ventilation,and 28 day mortality were determined.Results Compared with the control group,the length of ICU stay,ventilator time,incidence of multiple organ failure,and mortality decreased significantly in the CBP group(P0.05).And CBP also decreased Treg% and APACHEⅡ score significantly.There was a positive correlation between Treg% and APACHEⅡ score(r=0.804,P0.01).Conclusion Early CBP treatment can reduce Treg%,improve cellular immunity and improve the prognosis of sepsis.

Objective:To explore the application effect of early enteral nutrition in the treatment of patients with acute exacerbated chronic obstructive pulmonary disease(AECOPD) by applying mechanical ventilation.Methods:40 AECOPD patients with mechanical ventilation were randomly divided into nutrition group with nasointestinal tube(group A,n=15) and nutrition group with nasogastric tube(group B,n=14) and control group(group C,n=11).The patients in group A and group B were provided nutrition respectively by nasointestinal tube and nasogastric tube,and the patients in the control group received intravenous nutrition.The length of mechanical ventilation,incidence of complications and improvement of patient's nutrition were observed and compared among the 3 groups after treatment for 2 weeks.Results:The length of mechanical ventilation was shorter in the group A than that in the group B and C(P<0.05);abdominal distension and other complications and the frequency of hyperglycemia were less than the group B and C(P<0.05);the increasing amount of albumin in the group A was more than the group B and C(P<0.01).Conclusion:The application of early nutritional support can effectively reduce complications and improve the nutritional status of AECOPD patients with mechanical ventilation.

患者男,59岁.因无明显诱因咯血10余天于2010年8月9日入院,多为痰中带血,偶有咯血.无发热、胸痛,无心悸及心前区不适,无全身皮疹及疱疹,无鼻衄及牙龈出血,无呕血及黑便.患者饮食和睡眠、二便如常.

目的:探讨早期肠内营养在慢性阻塞性肺疾病急性加重期(AECOPD)机械通气患者中的应用效果.方法:将40例AECOPD机械通气患者随机分为鼻肠管组(A组)15例,鼻胃管组(B组)14例,对照组(C组)11例.A组、B组分别给予鼻肠管、鼻胃管鼻饲营养,对照组给予静脉营养,治疗2周后观察、比较三组机械通气时间、并发症发生情况及营养改善情况.结果:A组机械通气时间短于B组、C组(P<0.05),腹胀等并发症、高血糖发生次数均少于B组、C组(P<0.05);白蛋白增加量大于B组、C组(P<0.01).结论:AECOPD机械通气患者早期应用鼻肠管营养支持可缩短机械通气时间,且并发症少,营养改善佳.

Based on the PEBI grid numerical simulation meth-od ,the research on the optimization of the structure of herring-bone multilateral horizontal well and radial multilateral horizontal well in a five-spot pattern was performed,and the influence of branch num-ber,branch length and branch angle on multilateral horizontal wells productivity was also analyzed. It can be concluded that; more branch number of herring-bone multilateral horizontal well should be selected when branch length and branch angle are large,and vice versa. The branch angle of herring-bone multilateral horizontal well should be between 45 degree and 60 degree. The branch length of herring-bone multilateral horizontal well should be chosen carefully according to the area of the well pattern and the position of the multi-lateral horizontal well. Four branches should be taken for the radial multilateral horizontal in five-spot well pattern. At the same time,branch length should be long based on the drilling technology and drilling security.

The bottle-neck points of Sichuan drilling technology are low ROP,lost circulations,reservoir damage resulted from complicated geologic conditions.In recent years,gas drilling technology has been studied and tested;it shows good results,exhibiting technical advantages and bright development prospects.Up to now,we have developed technical specifications for gas drilling,and a series of technologies including straight gas drilling,mist drilling,foam drilling,fast deflection-minimized gas drilling,gas/liquid conversion,effective fluid drainage,gas coring,gas drilling equipment and tools,horizontal drilling with gas,and measures to solve gas drilling problems,etc.Field application shows that those technologies play important roles in ROP improvement,control of lost circulations,discovery and protection of reservoirs.Gas drilling is still a new technology in China,and it is recommended that study be conducted on the mechanism of BOP erosion to develop special well control equipment for gas drilling,and a set of data acquisition and remote control system be set up to improve reliability and safety of gas drilling.

The bottle-neck points of Sichuan drilling technology are low ROP,lost circulations,reservoir damage resulted from complicated geologic conditions.In recent years,gas drilling technology has been studied and tested;it shows good results,exhibiting technical advantages and bright development prospects.Up to now,we have developed technical specifications for gas drilling,and a series of technologies including straight gas drilling,mist drilling,foam drilling,fast deflection-minimized gas drilling,gas/liquid conversion,effective fluid drainage,gas coring,gas drilling equipment and tools,horizontal drilling with gas,and measures to solve gas drilling problems,etc.Field application shows that those technologies play important roles in ROP improvement,control of lost circulations,discovery and protection of reservoirs.Gas drilling is still a new technology in China,and it is recommended that study be conducted on the mechanism of BOP erosion to develop special well control equipment for gas drilling,and a set of data acquisition and remote control system be set up to improve reliability and safety of gas drilling.

In the past decades,electronic and network tax implication of China has formed its strong information foundation,which can promote revenue up to new steps.However,many problems arose in the actual operation,especially taxation inspection,the key one.This article summits some problems on taxation inspection in the construction of taxation information,through which the author make some resolution to these problems according to his own working experiences.There is benefitting by meaning especially for information constructing of the gold-taxation engineering and government of the taxation by the law.

In recent years, Northwest Sichuan Gas Mine of PCL Southwest Branch, performed the gas drilling for 5 wells such as Well Pingluo 19 etc. in the west Sichuan area. The data and results indicate the advantages of gas drilling sufficiently. The good exploration fruits are achieved. And several new records of gas drilling are created in China. The practice shows the gas drilling is not difficult, but necessary geological conditions must exist for it to be done and the working process schedule must be made carefully and performed correctly.