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Herbs & Plants

Trichosanthes kirilowii

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Botanical Name :Trichosanthes kirilowii
Family: Cucurbitaceae
Genus: Trichosanthes
Species:T. kirilowii
Kingdom:Plantae
Order:Cucurbitales

Common Names:  Chinese cucumber in English. And Chinese snake gourd.

Habitat :Trichosanthes kirilowii found particularly in Henan, Shandong, Hebei, Shanxi, and Shaanxi. It is one of the 50 fundamental herbs used in traditional Chinese medicine.

OIt often grows at an altitude of 200-1800m hillside forest, thickets, meadows and Cunpang Tanabe, or in the natural distribution area of bone, widely cultivated. Most parts of China are distributed, located in North, South, East and Liaoning, Shaanxi, Gansu, Sichuan, Guizhou and Yunnan. Most of the country has produced. The main production Shandong, Anhui, Henan and other places.

Description:
Trichosanthes kirilowii is a flowering plant.A Climber,length up to 10m. Tubers cylindrical , fleshy , rich in starch. Stems thick, much branched , with longitudinal ribs and grooves are white stretch pubescent. Leaves alternate ; petiole length 3-10cm, with vertical stripes, is of pubescent ; tendrils 3-7 differences pubescent ; leaves low-quality , contour nearly round or nearly heart-shaped , length and width are about 5-20cm, often 3-5 ( -7 ) lobed to the crack, split or dilute parted and only ranging from large coarse teeth , diamond-shaped lobes obovate , oblong , apex obtuse, acute, often re- lobed edges , base heart-shaped , curved lack of deep 3-4cm, surface dark green , rough, back of the green, on both sides along the veins villous hairy hirsute , basal palmate veins 5 , veinlets reticulate. Dioecious ; male racemes solitary or with a single flower and students, or those in the upper branches solitary, too inflorescence total length 10-20cm, stout, with longitudinal ridges and grooves , puberulent , the top 5 -8 flower, single flower stalk about 15cm, pedicel about 3mm, small bracts obovate or broadly ovate, 1.5-2.5 (-3) cm, width 1-2cm, the upper coarsely toothed , base with handle , pubescent ; calyx tube cylindrical , long 2-4cm, apex expanded diameter of about 10mm, the lower diameter of about 5mm, pubescent , lobes lanceolate, length 10-15cm, width 3-5mm, entire; Corolla white , lobes obovate , about 20mm, width 18mm, with a central green tip apex sides fringed with filaments , pubescent ; anther connivent , about 2mm, diameter of about 4mm, filaments separated , stout, villous ; female flowers solitary, stalk length 7.5cm, pubescent ; calyx tube oblong, 2.5cm, diameter 1.2cm, with male and corolla lobes ; ovary oval, green , long- 2cm, style long 2cm, stigma 3. Fruit oval, flattened , long 11-16mm, width 7-12mm, light brown, almost at the edge of a ridge . Flowering from May to August , the fruit of August to October……CLICK & SEE THE PICTURES

Cultivation:
Requires a rich well-drained soil and plenty of moisture in the growing season. Sometimes cultivated in China for its edible fruit and medicinal uses. Male plants are favoured for root production. This species is not winter hardy in Britain and usually requires greenhouse cultivation. However, it may be possible to grow it as an annual in a very warm sheltered bed outdoors. A climbing plant, supporting itself by means of tendrils. Dioecious, male and female plants must be grown if seed is required.

Propagation:
Seed – sow March in pots in a warm greenhouse in a rich soil. Sow 2 – 3 seeds per pot and thin to the strongest plant. Grow them on fast and plant out after the last expected frosts. Give some protection, such as a frame or cloche, until the plants are growing away well.

Edible Uses:
Edible Parts: Fruit; Leaves; Oil; Oil; Root…….click & see

Fruit. The young fruits are pickled. The pulp of older fruits is eaten. Mature fruits are about 10cm long. Leaves and young shoots – cooked and used as a vegetable. An edible starch is obtained from the root. It requires leeching, which probably means that it has a bitter flavour. The root is harvested in the autumn, cut into thick slices, soaked for 4 – 5 days in water, changing the water daily until the root disintegrates and can be mashed into a fine pulp. It is then steamed into cakes or used for making dumplings. An edible oil is obtained from the seed.

Chemical components: The plant is a source of the toxic anti-HIV type I ribosome-inactiving lectin trichosanthin

Medicinal Uses:
Trichosanthes kirilowii is commonly used in Chinese herbalism, where it is considered to be one of the 50 fundamental herbs. Recent research has isolated a protein called “trichosanthin” in the roots and this is undergoing trials as a possible remedy for AIDS. Skin, vulnerary. The leaf and the stem are febrifuge. The fruit is antibacterial, anticholesterolemic, antifungal, depurative, emollient, expectorant and laxative. It is used in the treatment of pulmonary infections with yellow and thick sputum, chest pains, stuffy feelings in the chest, constipation and dry stool. It has an antibacterial action against E. coli, Bacillus dysenteriae, B. typhi, B. paratyphi, Pseudomonas, Vibrio cholerae, V. Proteus etc. The fruit is traditionally prepared as a winter soup to ward off colds and influenza. The fruit is harvested in the autumn and dried for later use. The rind of the fruit is used to treat a number of ailments, including cancer, jaundice, retained placenta, bronchial infections with thick phlegm and sore throat. The seed is antitussive, emollient and expectorant. The root is antibiotic, anti-inflammatory, febrifuge, galactogogue, laxative, oxytocic, sialagogue and uterine tonic. The fresh root has been noted for centuries as an abortifacient – a sponge soaked in its juice was placed in the vagina and induced an abortion in the second trimester of pregnancy. The root is taken internally in the treatment of diabetes, dry coughs, and to assist in the second stage of labour. The root is harvested in the autumn and dried for later use. The root and/or the seed is powdered and used in the treatment of mammary cancer.

Other Uses:
Oil; ……..An oil from the seed is used for lighting.
Known Hazards: Root extracts are extremely toxic. Intravenous administration can cause pulmonary oedema, cerebral oedema, cerebral haemorrhage and myocardial damage. Seizures and fever in HIV patients with parenteral administration. Self-medication of root not advised
Resources:
http://en.wikipedia.org/wiki/Trichosanthes_kirilowii
http://www.mdidea.com/products/new/new05602.html
http://www.naturalmedicinalherbs.net/herbs/t/trichosanthes-kirilowii=chinese-cucumber.php
http://www.pfaf.org/user/Plant.aspx?LatinName=Trichosanthes+kirilowii

Categories
Diagnonistic Test News on Health & Science

Video-Asisted Thoracic Surgery (VATS)

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Introduction:
Video-assisted thoracic surgery (VATS) is a recently developed type of surgery that enables doctors to view the inside of the chest cavity after making only very small incisions. It allows surgeons to remove masses close to the outside edges of the lung and to test them for cancer using a much smaller surgery than doctors needed to use in the past. It is also useful for diagnosing certain pneumonia infections, diagnosing infections or tumors of the chest wall, and treating repeatedly collapsing lungs. Doctors are continuing to develop other uses for VATS.
..VATS->…  CLICK & SEE
When compared with a traditional open chest procedure, VATS has reduced the amount of chest wall trauma, deformity, and post-operative pain. While an open procedure generally requires a 30-40 cm incision, video-assisted biopsies can be performed through three 1 cm ports , and a VATS lobectomy, a resection of one lobe of the lung, is performed using a 5-8 cm incision.

How do you prepare for the test?
Discuss the specific procedures planned during your chest surgery ahead of time with your doctor. VATS is done by either a surgeon or a trained pulmonary specialist. You will need to sign a consent form giving the surgeon permission to perform this test. Talk to your doctor about whether you will stay in the hospital for any time after the procedure, so that you can plan for this.

You may need to have tests called pulmonary function tests (see page 33) before this surgery, to make sure that you can recover well.

If you are taking insulin, discuss this with your doctor before the test. If you take aspirin, nonsteroidal anti-inflammatory drugs, or other medicines that affect blood clotting, talk with your doctor. It may be necessary to stop or adjust the dose of these medicines before your test.

You will be told not to eat anything for at least eight hours before the surgery. An empty stomach helps prevent the nausea that can be a side effect of anesthesia medicines.

Before the surgery (sometimes on the same day), you will meet with an anesthesiologist to go over your medical history (including medicines and allergies) and to discuss the anesthesia.

What happens when the test is performed?

VATS is done in an operating room. You wear a hospital gown and have an IV (intravenous) line placed in your arm so that you can receive medicines through it.

VATS is usually done with general anesthesia, which puts you to sleep so you are unconscious during the procedure. General anesthesia is administered by an anesthesiologist, who asks you to breathe a mixture of gases through a mask. After the anesthetic takes effect, a tube is put down your throat to help you breathe. Your anesthesiologist can use this tube to make you breathe using only one of your lungs. This way the other lung can be completely deflated and allow the surgeon a full view of your chest cavity on that side during the procedure.

If VATS is being used only to evaluate a problem on the inside of the ribcage (not the lung itself), then it can sometimes be done using regional anesthesia. With regional anesthesia, you are not asleep during the surgery, but are given medicines that make you very groggy and that keep you from feeling pain in the chest. This is done with either a spinal block or an epidural block, in which an anesthesiologist injects the anesthetic through a needle or tube in your back or neck. You do your own breathing with this type of anesthesia, but one of your lungs will be partly collapsed to allow the doctors to move instruments between the lung and the chest wall.

When you meet with the thoracic surgeon, a physical exam will be performed and your treatment options will be discussed. The thoracic surgeon will discuss the benefits and potential risks of the surgical procedure that is recommended for you.

In general, preoperative tests include: (links will open in a new window)

*Blood tests
*Pulmonary function test (breathing test)
*CT scan
*Electrocardiogram

Your surgeon will determine if any additional preoperative tests are needed, based on the type of procedure that will be performed. If a cardiac (heart) evaluation is necessary, a consultation with a cardiologist will be scheduled in our internationally-renowned Miller Family Heart & Vascular Institute.

As part of your preoperative evaluation, you will meet with an anesthesiologist who will discuss anesthesia and post-operative pain control.

The thoracic surgery scheduler will schedule any additional tests and consultations that have been requested by your surgeon. In general, after your first meeting with your surgeon, all tests are scheduled on a single returning visit for your convenience.

You spend the surgery lying on your side. A very small incision (less than an inch long) is made, usually between your seventh and eighth ribs. Carbon dioxide gas is allowed to flow into your chest through this opening, while your lung on that side is made to partly or completely collapse. A tiny camera on a tube, called a thoracoscope, is then inserted through the opening. Your doctor can see the work he or she is doing by watching a video screen.

If you are having a procedure more complicated than inspection of the chest and lung, the doctor makes one or two other small incisions to allow additional instruments to reach into your chest. These additional incisions are usually made in a curving line along your lower ribcage. A wide variety of instruments are useful in VATS. These include instruments that can cut away a section of your lung and seal the hole left in your lung using small staples, instruments that can burn away scar tissue, and tools to remove small biopsy samples such as lymph nodes from your chest.

At the end of your surgery, the instruments are removed, the lung is reinflated, and all but one of the small incisions are stitched closed. For most patients, a tube (called a chest tube) is placed through the remaining opening to help drain any leaking air or fluid that collects after the surgery.

If you are having general anesthesia, it is stopped so that you can wake up within a few minutes of your VATS being finished, although you will remain drowsy for a while afterward.

How long will you stay in the hospital after thoracoscopic surgery?
The length of your hospital stay will vary, depending on the procedure that is performed. In general, patients who have thoracoscopic lung biopsies or wedge resections are able to go home the day after surgery. Patients who have a VATS lobectomy are usually able to go home 3 to 4 days after surgery.
Risk Factors:
It is easier for patients to recover from VATS compared with regular chest surgery (often called “open” surgery) because the wounds from the incisions are much smaller. You will have a small straight scar (less than an inch long) wherever the instruments were inserted. There are some potentially serious risks from VATS surgery. Air leaks from the lung that don’t heal up quickly can keep you in the hospital a longer time and occasionally require additional treatment. About 1% of patients have significant bleeding requiring a transfusion or larger operation.

Sometimes, especially if cancer is diagnosed, your doctors will decide that you need a larger surgery to treat your problem in the safest manner possible. Your doctors might discuss this option with you ahead of time. That way, if necessary, the doctors can change over to a larger incision and do open chest surgery while you are still under anesthesia. Death from complications of VATS surgery does occur in rare cases, but less frequently than with open chest surgery.

General anesthesia is safe for most patients, but it is estimated to result in major or minor complications in 3%-10% of people having surgery of all types. These complications are mostly heart and lung problems and infections.

Irritation of the diaphragm and chest wall can cause pain in the chest or shoulder for a few days. Some patients experience some nausea from medicines used for anesthesia or anxiety.

What will happen after your thoracoscopic surgery?
Your thoracic surgery team, including your surgeon, surgical residents and fellows, surgical nurse clinicians, social workers and anesthesiologist, will help you recovery as quickly as possible. During your recovery, you and your family will receive updates about your progress so you’ll know when you can go home.

Your health care team will provide specific instructions for your recovery and return to work, including guidelines for activity, driving, incision care and diet.

Most patients stay in the hospital for at least one day after a VATS procedure to recover from the surgery. Most patients have a chest tube left in the chest for a few days, to help drain out leaking air or collections of fluid. You should notify your doctor if you experience fever, shortness of breath, or chest pain.

Follow-Up Appointment: A follow-up appointment will be scheduled 7 to 10 days after your surgery. Your surgeon will assess the wound sites and your recovery at your follow-up appointment and provide guidelines about your activities and return to work.

Most people who undergo minimally invasive thoracic surgery can return to work within 3 to 4 weeks.

How long is it before the result of the test is known?
Your doctor can tell you how the surgery went as soon as it is finished. If biopsy samples were taken, these often require several days to be examined.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/video-assisted-thoracic-surgery.shtml
http://www.cancernews.com/data/Article/242.asp
http://my.clevelandclinic.org/thoracic/services/video_assisted.aspx

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