Acute respiratory failure and sudden cardiac arrest caused by acute intrathoracic infection is a fatal clinical condition with a low resuscitation success rate. The present study describes the case of a patient with acute empyema secondary to an acute lung abscess rupture, complicated by acute respiratory failure and sudden cardiac arrest caused by severe hypoxemia. The patient recovered well through the administration of multiple therapeutic measures, including medication and closed chest drainage, cardiopulmonary resuscitation, extracorporeal membrane oxygenation combined with continuous renal replacement therapy, and minimally invasive surgical resection of the lung lesion with persistent alveolar fistula as the clinical manifestation. To the best of our knowledge, the treatment of such a severe condition combined with thoracoscopic surgery has rarely been reported before, and the present study may provide insight regarding therapeutic schedules for acute respiratory failure by intrathoracic infection, and excision of ruptured lung abscess.

目的 研究胸腔镜手术对非小细胞肺癌患者肺功能、疼痛应激指标及外周血T淋巴细胞亚群的影响.方法 分析本院 2017年 6 月至 2022 年 6 月收治的 100 例非小细胞肺癌患者,根据手术方法分为对照组、研究组,对照组行常规开胸手术,研究组行胸腔镜手术,比较两组患者肺功能、疼痛应激指标及外周血T淋巴细胞亚群指标.结果 两组患者术后肺功能各项指标均有下降,研究组总体下降指标低于对照组,差异有统计学意义(P<0.05).研究组VAS评分低于对照组,差异有统计学意义(P<0.05);与术前相比,两组术后第 1天,CD3+T、CD4+T、CD4+/CD8+、淋巴细胞总数较术前均降低,CD8+T水平升高(P<0.05);术后 7天,各项指标均有回升,恢复至术前水平,CD8+T下降(P>0.05);术后 21天,CD3+T、CD4+T、CD4+/CD8+水平较术前升高,淋巴细胞总数呈回升趋势,CD8+T显著降低(P<0.05).两组间指标比较差异无统计学意义(P>0.05).结论 胸腔镜手术可改善患者肺功能,降低疼痛应激指标,有助于患者术后细胞免疫功能恢复.

Metastasis, a major challenge during the treatment of lung cancer, causes deterioration in patient health outcomes. Thus, to address this problem, this study aimed to explore the role and contribution of Cholesterol 25-Hydroxylase (CH25H) as a potential diagnostic and prognostic marker in lung cancer. Online public databases were used to analyze the expression level, prognostic value, gene-pathway enrichment, and immune infiltration of CH25H in lung cancer patients. The Real-Time Quantitative Reverse Transcription PCR (qRT-PCR) was used to analyze and detect the CH25H expression levels in leukocytes from lung cancer patients. The expression level of CH25H was significantly reduced in lung adenocarcinoma (LUAD), which is associated with a higher disease stage, but not in lung squamous cell carcinoma (LUSC). Kaplan-Meier survival analysis indicated that LUAD patients with low CH25H expression had a worse prognosis. Mechanistically, our results showed that in LUAD, CH25H may be a regulatory factor affecting the immune cell infiltration level, and the resultant tumor development. Experimental data showed that low expression of CH25H in leukocytes was significantly associated with LUAD metastasis (P<0.01). Our study suggests that CH25H may function as a prognostic and risk stratification biomarker for LUAD.

目的 探讨动脉氧分压(PaO2)、一氧化氮合酶(NOS)水平对法洛四联症(TOF)患儿预后评估的价值.方法 选取2016年12月-2018年12月嘉兴市第二医院收治的TOF患儿52例作为研究组,根据预后分为生存组36例和死亡组16例,同期选择在本院体检的健康幼儿50例作为对照组,收集患儿入院当日和术后静脉血及健康儿童清晨空腹外周血,利用CIBA-CORNING238血气分析仪分析PaO2水平,采用分光光度计比色法检测PaO2、NOS水平,利用全自动化学发光分析仪检测血清中肌酸激酶同工酶(CK-MB)、血清肌钙蛋白(cTnI)水平,采用酶联免疫吸附(ELISA)法检测血清中神经组织蛋白质(S-100B)、神经元特异性烯醇化酶(NSE)的水平,应用多重线性回归分析各个因素对TOF患儿预后的影响.结果 研究组患儿PaO2水平明显低于对照组幼儿,NOS水平明显高于对照组幼儿,差异均有统计学意义(P＜0.05);两组NO水平比较差异无统计学意义(P＞0.05).生存组和死亡组性别、年龄差异无统计学意义(P＞0.05).死亡组CK-MB、cTnI、S-100Bβ、NSE、NOS及NO水平均明显高于生存组,PaO2水平低于生存组,差异均有统计学意义(P＜0.05),生存组与死亡组的主动脉阻隔时间差异有统计学意义(P＜0.05).多重线性回归分析结果显示,纳入模型的3个变量PaO2、NO及NOS对预测TOF患儿预后均有统计学意义(P＜0.05).结论 TOF患儿与健康儿童相比PaO2降低,NO及NOS水平升高;死亡组NOS、NO水平均明显高于生存组,PaO2水平低于生存组.提示PaO2、NO及NOS参与TOF的发生发展,可作为TOF患儿预后评估的潜在临床指标.

Objective: To investigate the expression of miRNA-483-5p in esophageal cancer and its correlation with clinicopathological features and prognosis. Methods: This studys 82 cases of esophageal cancer tissue were archived at the study hospital between March 2013 and May 2014. In addition, 28 cases of paracancerous tissue were archived. Real-time fluorescent quantitative polymerase chain reaction was used to detect the relative expression levels of microRNA-483-5p (miRNA-483-5p) in esophageal cancer and adjacent tissues. The relative expression level of miRNA-483-5p was analysed with clinicopathological parameters and prognosis of patients with esophageal cancer. Results: The relative expression of miRNA-483-5p in esophageal cancer was (3.25 +/- 1.25), and the relative expression of miRNA-483-5p in adjacent tissue was (0.99 +/- 0.71). The difference was significant (P<0.05). The expression level of miRNA-483-5p was not related to the esophageal cancer patients gender, age, or histological grade, nor to the depth of invasion of the tissue (P>0.05). It was related to lymph node metastasis and the TNM stage of the esophageal cancer patient (P<0.05). The five-year survival rate of patients with relatively high levels of expression of miRNA-483-5p was 43.90% (18/41), and the five-year survival rate of patients with relatively low levels of expression of miRNA-483-5p was 75.61% (31/41). There was a significant difference (P<0.05). Results from the COX proportional hazard regression model showed that miRNA-483-5p expression level, lymph node metastasis, and TNM stage were independent prognostic factors for patients with esophageal cancer. Conclusions: The expression levels of miRNA-483-5p are elevated in esophageal cancer tissues, and its expression is related to lymph node metastasis and TNM staging in patients with esophageal cancer. MicroRNA-483-5p could be used as an independent risk factor in the prognoses of patients with esophageal cancer, being that it is of great significance in the onset and progression of esophageal cancer; it can be expected to become a new target for clinical treatment of esophageal cancer.

目的: 观察高聚金葡素联合紫杉醇联合顺铂(TP方案)治疗中晚期非小细胞肺癌的临床疗效.方法: 64例患者随机分为对照组和实验组,对照组给予TP治疗方案,实验组给予TP治疗方案的基础上加用高聚金葡素.比较两组治疗前后的近期疗效 、不良反应和生活质量的改善情况.结果: 实验组近期疗效的有效率优于对照组,差异具有统计学意义.实验组的KPS评价与体质量改善方面显著优于对照组;差异具有统计学意义.对照组患者血清的TNF-α 和IL-6水平下降,实验组患者两指标显著升高.结论: 高聚金葡素联合TP方案在近期疗效的有效率,患者的生活质量与TP方案相比较有显著的改善.

目的 分析先天性心脏病孕妇的临床预后特点及结局.方法 选取2009年8月-2018年8月嘉兴市第二医院收治的175例先天性心脏病孕妇为研究对象,回顾性分析其临床资料.按照孕妇人院时美国纽约心脏病协会(NYHA)心功能分级将其分别纳入Ⅰ级组、Ⅱ级组、Ⅲ～Ⅳ级组,比较不同心功能分级对母婴结局的影响,总结临床处理体会.结果 Ⅱ级组孕周小于Ⅰ级组,剖宫产率、产钳助产率、心衰发生率及产褥感染发生率高于Ⅰ级组,差异均有统计学意义(均P＜0.05);Ⅲ～Ⅳ级组孕周小于Ⅱ级组,剖宫产率、产钳助产率、心衰发生率高于Ⅱ级组,差异均有统计学意义(均P＜0.05).Ⅲ～Ⅳ级组围生儿出生体质量、5 min Apgar评分低于Ⅰ级组、Ⅱ级组,早产率、胎儿生长受限(FGR)率及死亡率均高于Ⅰ级组、Ⅱ级组,差异均有统计学意义(均P＜0.05).结论 先天性心脏病孕妇的母婴结局与孕妇心功能分级密切相关,Ⅰ～Ⅱ级孕妇母婴结局普遍良好,临床处理应尽可能维持孕产妇心功能在Ⅰ～Ⅱ级.