BACKGROUND Solitary fibrous tumors(SFT)are rare spindle cell tumors that are usually benign.A total of 10 cases of SFTs in the upper esophagus have ever been reported.Here,we report the anesthetic management of a pati...BACKGROUND Solitary fibrous tumors(SFT)are rare spindle cell tumors that are usually benign.A total of 10 cases of SFTs in the upper esophagus have ever been reported.Here,we report the anesthetic management of a patient with a large isolated fibrous tumor of the upper esophagus compressing the tracheal membrane.We also provide a literature review of the current research.CASE SUMMARY We report the case of a 49 year old male with“cough aggravation and wheezing after exercise”,who underwent esophagectomy for a large isolated fibrous tumor compressing the tracheal membrane in the upper esophagus.We advise the use of a single-lumen tube with a blocker in patients with difficult airways to reduce the incidence of airway injury and fibrinoscopy at all stages of the perioperative period to guide airway management.This case study is the first report of the anesthetic management of a large,isolated fibrous tumor compressing the tracheal membrane in the upper esophagus.CONCLUSION This rare case emphasizes the importance of perioperative management of anesthesia in patients with large isolated fibrous tumors of the upper esophagus that compress the tracheal membrane.The use of blocker reduce the incidence of airway injury and fibrinoscopy at the perioperative period to guide airway mana-gement.展开更多
BACKGROUND Chronic obstructive pulmonary disease(COPD)is associated with high morbidity and mortality rates worldwide.Older patients have a degenerative cardiopulmonary function,weak compensatory capacity,and poor sur...BACKGROUND Chronic obstructive pulmonary disease(COPD)is associated with high morbidity and mortality rates worldwide.Older patients have a degenerative cardiopulmonary function,weak compensatory capacity,and poor surgical tolerance.Therefore,the mode of anesthesia must be optimized.Remimazolam is a new ultrashort-acting benzodiazepine with a rapid onset of action,rapid metabolism,and mild effects on pulmonary circulation.Remimazolam sedation combined with an epidural block has not been reported in hypertensive older adults with severe COPD and inguinal mass resection.CASE SUMMARY We report the case of a 73-year-old man with hypertension and severe COPD,who underwent resection of an enlarged inguinal mass that he had noticed more than 7 mo before presentation.The patient presented with a“right inguinal mass”and was recommended to undergo an enlarged inguinal mass resection.Surgery was relatively challenging,due to the large mass(13 cm×8 cm×7 cm),hard texture,and poor mobility.Considering the advanced age of the patient,gradeⅢhypertension,and severe COPD,we administered remimazolam combined with an epidural block for anesthesia to ensure perioperative safety and careful consideration.The anesthetic effect was precise;the procedure was performed smoothly without any complications,and the patient was successfully anesthetized.However,anesthetic management in such cases has not yet been reported by previous studies.CONCLUSION Remimazolam sedation combined with an epidural block is safe and effective in older patients with hypertension and severe COPD.展开更多
The Xinlong gold deposit is located in Niyma County,Naqu area of Tibet and was discovered by the Institute of Mineral Resources,Chinese Academy of Geological Sciences through the 1∶50000 mineral geological survey.The...The Xinlong gold deposit is located in Niyma County,Naqu area of Tibet and was discovered by the Institute of Mineral Resources,Chinese Academy of Geological Sciences through the 1∶50000 mineral geological survey.The ore bodies occur in the Zenong Group volcanic rocks in the middle section of the central Lhasa subterrane and are structurally controlled by the NNW-striking faults.Four ore bodies have been found,exhibiting cloddy,dense-sparse,disseminated,and breccia structures.The ore minerals are mainly tetrahedrite group minerals,and other ore minerals include pyrite,chalcopyrite,nevskite,bornite,anglesite,native gold,and silver-gold bearing selenide,etc.The types of alteration are dominated by silicification,as well as middle-and high-graded argillization.The alteration mineral assemblages contain quzrtz,pyrophyllite,and kaolinite.The Zaliela Formation volcanic rocks of Zenong Group are silicified by later hydrothermal fluid with vuggy quartz in some fractured zones.The middle-and high-graded argillization are characterized by pyrophyllitization and kaolinization.The Xinlong gold deposit shows great metallogenetic potentiality and has been revealed by 1∶10000 geological mapping,IP sounding,and trial trenching in the mining area.Combined with the regional metallogenic geological setting,we suppose that a potential epithermal gold belt probably exists in the middle of the Lhasa terrane.The discovery of the Xinlong gold deposit opens a new chapter for the gold prospecting in Northern Tibet.展开更多
BACKGROUND Intraoperative hyperlactatemia often affects circulatory stability,vital organ function,and postoperative recovery,poses a serious prognostic risk,and requires considerable attention from anesthesiologists....BACKGROUND Intraoperative hyperlactatemia often affects circulatory stability,vital organ function,and postoperative recovery,poses a serious prognostic risk,and requires considerable attention from anesthesiologists.Here,we describe a case of hyperlactatemia during the postoperative resection of liver metastases after chemotherapy for sigmoid colon cancer.This did not affect the patient's circulatory stability or quality of awakening,which is rarely reported in clinical practice.We present our management experience with the aim of providing a reference for future studies and clinical practice.CASE SUMMARY A 70-year-old female patient was diagnosed with postoperative liver metastasis following chemotherapy for sigmoid colon cancer.Laparoscopic right hemicolectomy and cholecystectomy under general anesthesia were required.Metabolic disorders,primarily hyperlactatemia,often occur intraoperatively.After treatment,other indices quickly returned to normal,lactate levels decreased slowly,and hyperlactatemia persisted during the awakening period.However,this did not affect the patient's circulatory stability or awakening quality.This condition has rarely been clinically reported.Therefore,we report our management experience in order to guide clinical practice in this regard.Hyperlactatemia did not affect circulatory stability or the quality of awakening.We considered that active intraoperative rehydration avoided serious harm to the organism caused by hyperlactatemia due to insufficient tissue perfusion,while hyperlactatemia caused by decreased lactate clearance due to impaired liver function associated with surgical resection had a mild effect on the function of important organs.CONCLUSION Active intraoperative rehydration avoided serious harm to the organism caused by hyperlactatemia.Strengthening body temperature protection could improve lactate circulation.展开更多
文摘BACKGROUND Solitary fibrous tumors(SFT)are rare spindle cell tumors that are usually benign.A total of 10 cases of SFTs in the upper esophagus have ever been reported.Here,we report the anesthetic management of a patient with a large isolated fibrous tumor of the upper esophagus compressing the tracheal membrane.We also provide a literature review of the current research.CASE SUMMARY We report the case of a 49 year old male with“cough aggravation and wheezing after exercise”,who underwent esophagectomy for a large isolated fibrous tumor compressing the tracheal membrane in the upper esophagus.We advise the use of a single-lumen tube with a blocker in patients with difficult airways to reduce the incidence of airway injury and fibrinoscopy at all stages of the perioperative period to guide airway management.This case study is the first report of the anesthetic management of a large,isolated fibrous tumor compressing the tracheal membrane in the upper esophagus.CONCLUSION This rare case emphasizes the importance of perioperative management of anesthesia in patients with large isolated fibrous tumors of the upper esophagus that compress the tracheal membrane.The use of blocker reduce the incidence of airway injury and fibrinoscopy at the perioperative period to guide airway mana-gement.
文摘BACKGROUND Chronic obstructive pulmonary disease(COPD)is associated with high morbidity and mortality rates worldwide.Older patients have a degenerative cardiopulmonary function,weak compensatory capacity,and poor surgical tolerance.Therefore,the mode of anesthesia must be optimized.Remimazolam is a new ultrashort-acting benzodiazepine with a rapid onset of action,rapid metabolism,and mild effects on pulmonary circulation.Remimazolam sedation combined with an epidural block has not been reported in hypertensive older adults with severe COPD and inguinal mass resection.CASE SUMMARY We report the case of a 73-year-old man with hypertension and severe COPD,who underwent resection of an enlarged inguinal mass that he had noticed more than 7 mo before presentation.The patient presented with a“right inguinal mass”and was recommended to undergo an enlarged inguinal mass resection.Surgery was relatively challenging,due to the large mass(13 cm×8 cm×7 cm),hard texture,and poor mobility.Considering the advanced age of the patient,gradeⅢhypertension,and severe COPD,we administered remimazolam combined with an epidural block for anesthesia to ensure perioperative safety and careful consideration.The anesthetic effect was precise;the procedure was performed smoothly without any complications,and the patient was successfully anesthetized.However,anesthetic management in such cases has not yet been reported by previous studies.CONCLUSION Remimazolam sedation combined with an epidural block is safe and effective in older patients with hypertension and severe COPD.
基金funded by the National Natural Science Foundation of China(41902099)the China Geological Survey Project(DD20230054)Fundamental Research Funds from the Institute of Mineral Resources and Chinese Academy of Geological Sciences(No.KK2215).
文摘The Xinlong gold deposit is located in Niyma County,Naqu area of Tibet and was discovered by the Institute of Mineral Resources,Chinese Academy of Geological Sciences through the 1∶50000 mineral geological survey.The ore bodies occur in the Zenong Group volcanic rocks in the middle section of the central Lhasa subterrane and are structurally controlled by the NNW-striking faults.Four ore bodies have been found,exhibiting cloddy,dense-sparse,disseminated,and breccia structures.The ore minerals are mainly tetrahedrite group minerals,and other ore minerals include pyrite,chalcopyrite,nevskite,bornite,anglesite,native gold,and silver-gold bearing selenide,etc.The types of alteration are dominated by silicification,as well as middle-and high-graded argillization.The alteration mineral assemblages contain quzrtz,pyrophyllite,and kaolinite.The Zaliela Formation volcanic rocks of Zenong Group are silicified by later hydrothermal fluid with vuggy quartz in some fractured zones.The middle-and high-graded argillization are characterized by pyrophyllitization and kaolinization.The Xinlong gold deposit shows great metallogenetic potentiality and has been revealed by 1∶10000 geological mapping,IP sounding,and trial trenching in the mining area.Combined with the regional metallogenic geological setting,we suppose that a potential epithermal gold belt probably exists in the middle of the Lhasa terrane.The discovery of the Xinlong gold deposit opens a new chapter for the gold prospecting in Northern Tibet.
文摘BACKGROUND Intraoperative hyperlactatemia often affects circulatory stability,vital organ function,and postoperative recovery,poses a serious prognostic risk,and requires considerable attention from anesthesiologists.Here,we describe a case of hyperlactatemia during the postoperative resection of liver metastases after chemotherapy for sigmoid colon cancer.This did not affect the patient's circulatory stability or quality of awakening,which is rarely reported in clinical practice.We present our management experience with the aim of providing a reference for future studies and clinical practice.CASE SUMMARY A 70-year-old female patient was diagnosed with postoperative liver metastasis following chemotherapy for sigmoid colon cancer.Laparoscopic right hemicolectomy and cholecystectomy under general anesthesia were required.Metabolic disorders,primarily hyperlactatemia,often occur intraoperatively.After treatment,other indices quickly returned to normal,lactate levels decreased slowly,and hyperlactatemia persisted during the awakening period.However,this did not affect the patient's circulatory stability or awakening quality.This condition has rarely been clinically reported.Therefore,we report our management experience in order to guide clinical practice in this regard.Hyperlactatemia did not affect circulatory stability or the quality of awakening.We considered that active intraoperative rehydration avoided serious harm to the organism caused by hyperlactatemia due to insufficient tissue perfusion,while hyperlactatemia caused by decreased lactate clearance due to impaired liver function associated with surgical resection had a mild effect on the function of important organs.CONCLUSION Active intraoperative rehydration avoided serious harm to the organism caused by hyperlactatemia.Strengthening body temperature protection could improve lactate circulation.
