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Objective:To investigate the effect of ultrasound-guided midline catheter placement on the incidence of catheter-related bloodstream infection (CRBSI) in severe emergency patients.Methods:Five hundred and twenty-nine patients were chosen as the research objects from March 2018 to December 2019 at Emergency Intensive Care Unit, which was divided into the experimental group ( n=278) and the control group ( n=251). In the experimental group, ultrasound-guided midline catheter was used as central venous catheter (CVC) removal method of sequential, and in the control group, peripheral venous indwelling needle was used as sequential method after removal of CVC. CVC, midline catheter and the indwelling time of indwelling needle were counted. The utilization rate of CVC was compared between the two groups. Kaplan-Meier survival curve was plotted to describe the CVC indwelling time of the two groups and log-rank test was performed. Cox regression analysis was performed to analyze the influencing factors of CVC indwelling time and compare the incidence of CRBSI and other catheter-related complications. Results:The CVC indwelling time of the experimental group was significantly shorter than that of the control group (8 d vs. 13 d, P=0.000). The CVC utilization rate of the experimental group was significantly lower than that of the control group (49.83% vs. 80.45%, P=0.000). Multivariate Cox regression analysis showed that difficult intravenous access, length of ICU stay, the site of catheter placement, and midline catheter implantation without ultrasound-guidance were independent risk factors for prolonged CVC indwelling time ( P=0.000). The CRBSI rate of the experimental group was significantly lower than that of the control group (0.571‰ vs. 3.802‰, P=0.038). There was no significant difference in the incidence of other catheter-related complications between the two groups ( P=0.403). Conclusions:Ultrasound-guided midline catheter implantation can shorten the indwelling time of CVC, reduce the utilization rate of CVC, and reduce the incidence of CRBSI, which is worthy of clinical promotion.
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Objective To explore the status of emotional-social loneliness including emotional isolation,social isolation,emotional and social loneliness in patients with acute cerebral infraction,and to analyze the related factors.Methods A total of 122 patients with acute cerebral infraction admitted to the neurology department of 5 third-grade class-A hospitals from Jan.2017 to Oct.2017 were enrolled.Data was collected by self-reported questionnaires including patients' general data and the emotional-social loneliness questionnaire data.Results Among 122 patients with acute cerebral infraction,emotional isolation,social isolation,emotional loneliness and social loneliness were found in 48 cases(39.3％),60 cases(49.2％),40 cases(32.8％)and 36 cases(29.5％),respectively.The total average score for emotional isolation,social isolation,emotional loneliness and social loneliness were 8.3 ± 5.2,8.6 ± 5.1,7.5 ± 6.1,and 7.4 ± 5.5,respectively.The scores for emotional-social loneliness were associated with education level,monthly family income,occupations and the emotion state before disease,and were not associated with gender,marriage status and stroke history.Conclusions The prevalence of emotional-social loneliness is high in patients with acute cerebral infraction.Especially careful attention should be paid to patients with higher education level and retired with monthly family income ≥5 000 RMB.
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Objective To investigate the effect of dexmedetomidine (Dex)on long-term cogni-tive function after partial hepatectomy (PH)in mice.Methods Forty adult male C57BL/6J mice were randomly divided into control group (group C),group PH,normal saline group (group NS)and group Dex,10 mice per each group.At 2 days after PH,the mice of group C and group PH under-went Morris water maze test,four times per day and a total of 4 days.The mice were euthanized and hippocampi tissue was immediately excised for determination of wet hippocampi weight to dry hipp-ocampi weight (W/D)and total hippocampi water content (TWC).The expression levels of cycteinyl aspirate-specific protease 12 (caspase-12)mRNA and protein of hippocampi tissue were detected re-spectively by reverse transcription-polymerase chain reaction (RT-PCR)and Western blot.Apoptosis index (AI)of hippocampi tissue was determined by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL)assay.After the mice regained consciousness after operation,animals re-ceived intraperitoneally Dex at a dose of 25 μg·kg-1 ·d-1 for 30 consecutive days in group Dex.Ani-mals of group NS were given intraperitoneally with the same volume of normal saline.After treatment for 30 consecutive days,the mice of group Dex and group NS underwent Morris water maze test,four times per day and a total of 4 days.The mice were euthanized and hippocampi tissue was immediately excised for determination of W/D and TWC.The expression levels of caspase-12 mRNA and protein of hippocampi tissue were detected respectively by RT-PCR and Western blot.AI of hippocampi tissue was determined by TUNEL assay.Results Compared with the first day,the escape latency at the third day,the fourth day and swimming distance were shortened in groups C,NS and Dex (P <0.05);Compared with group C,the escape latency at the third day,the fourth day and swimming distance were prolonged (P < 0.05 ), W/D,TWC and AI were higher (P < 0.05 ), and the expression levels of caspase-12 mRNA and protein of hippocampi tissue were significantly higher (P<0.05)in group PH.Compared with group NS,the escape latency at the third day,the fourth day and swimming distance were shortened (P <0.05),W/D,TWC and AI were lower (P <0.05)and the expression levels of caspase-12 mRNA and protein of hippocampi tissue were significantly lower (P <0.05)in group Dex.Conclusion The treatment of Dex could improve the long-term cognitive function after PH in mice,and the mechanism may be to lighten apoptosis mediated by caspase-12 in hippocampi tissue.
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Objective To explore the carotid intima-media thickness and the value of uric acid in predicting the prognosis of coronary heart disease patients.Methods Using the random number table method,182 patients diagnosed with coronary heart disease were divided into two groups:group A was 92 cases of acute coronary syndrome (ACS),groups B was 90 cases of chronic stable angina,healthy check-up 90 cases as control group (group C),fasting blood test blood uric acid (UA),application of color Doppler ultrasound measurement carotid intima-media thick ness (IMT).Results Acute coronary syndrome (ACS) set of uric acid,IMT,plaque index were (428.5 ± 70.3) mmol/L,(1.58 ± 0.92) mm,(3.24 ± 1.81) and those in stable angina group were (356.4 ± 68.2) mmol/L,(1.32 ± 0.86) mm,(3.08 ± 1.62) and those of the control group were (251.2 ± 65.4) mmol/L,(0.92 ± 0.41) ram,(2.80 ± 1.18) to compare the difference was statistically significant(group A compared with group B(t =4.47,3.26,5.21,all P ＜ 0.05),group A compared with group C (t =8.23,9.36,7.48,all P ＜ 0.01);group SAP compared with control group the difference was statistically significant (t =6.34,5.26,7.12,all P ＜ 0.05);Linear correlation analysis showed that uric acid and carotid intima-media thickness were positively correlated,r value was 0.67.The ACS group soft carotid atherosclerosis plaque detection rate was 60.9％,SAP group was 26.7％ and the control group was 8.9％,the difference was statistically significant (x2 =21.60,P ＜ 0.05;x2 =69.11,P ＜ 0.01),group SAP compared with the control group,the difference was statistically significant (x2 =39.84,P ＜ 0.01).Conclusion Uric acid levels and carotid artery atherosclerosis and coronary artery disease are closely related,which can provide theoretical basis for the risk assessment and prognosis of coronary heart disease.Early intervention can prevent the occurrence of serious cardiovascular events.
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<p><b>OBJECTIVE</b>To analyze interpersonal sensitivity level and influencing factors among patients in methadone maintenance treatment.</p><p><b>METHODS</b>From 2010 June to 2011 June, the research was performed in Center of Methadone Maintenance Treatment of Nanjing Baixia District Hospital. A total of 272 methadone maintenance treatment was studied using a self-designed questionnaire, interpersonal sensitivity scale in symptom check list (SCL-90), self-rating depression scale (SDS), self-rating anxiety scale (SAS). If interpersonal sensitivity level ≥ 2 points, it was positive. In this study, through independent sample t test, analysis of the social demographic characteristics, depression and anxiety, interpersonal sensitivity level. Non conditional logistic regression analysis was used to explore a variety of factors, and the relationship of these factors with interpersonal sensitivity.</p><p><b>RESULTS</b>The depression score, the anxiety score and the level of interpersonal relationship sensitivity in 272 methadone maintenance treatment (1.65 ± 0.51, 47.66 ± 8.58, 42.38 ± 9.40) was higher than the national norm (1.65 ± 0.51, 41.88 ± 10.57, 29.78 ± 0.46) (t values were 8.23, 17.63 and 22.27, respectively; all P values < 0.001). In 272 methadone maintenance treatment, the percentage of men was 75.0% (204/272) and the percentage of women was 25.0% (68/272). SDS score of male and female was (48.38 ± 8.30) and (45.90 ± 9.34) points (t = 5.67, P = 0.037); Aged 20-29, 30-39, 40-49 and ≥ 50 years old group, SDS scores were (48.26 ± 7.59), (47.73 ± 8.38), (47.79 ± 9.22) and (48.09 ± 6.33) points (F = 3.90, P = 0.046); According to the drug's time, divided into 1-3, 4-6 and ≥ 7 years group, SDS scores were (45.92 ± 7.47), (47.41 ± 7.57) and (48.07 ± 8.57) points (F = 4.49, = 0.039). SAS score of male and female was (41.21 ± 9.53) and (42.91 ± 9.42) points (t = 2.23, P = 0.043). The positive rate of interpersonal sensitivity was 47.1% (128/272). Multivariate analysis showed that, with SDS and SAS scores increased by 1, respectively, interpersonal sensitivity increased 23.23 (8.62-96.68) and 11.97 (6.42-19.27) points.</p><p><b>CONCLUSION</b>Interpersonal sensitivity level in methadone maintenance treatment was higher than normal and depression; anxiety and depression both were the risk factors of interpersonal sensitivity level.</p>
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Anxiety , Depression , Interpersonal Relations , Methadone , Therapeutic Uses , Opiate Substitution Treatment , Psychology , Risk Factors , Surveys and QuestionnairesABSTRACT
Objective To study hyperbaric oxygen on left ventricular ejection fraction preserved by the influence of left ventricular remodeling in patients with heart failure. Methods A total of 110 patients with heart failure and normal ejection fraction were randomly allocated into the control group (n=55) and the HBO group (n=55). The control group were given the routine therapy, the HBO group were treated with hyperbaric oxygen on the basis of conventional drug. The application of color doppler ultrasound before and after treatment for 3 months left ventricular structure indicators. Results Left ventricular structure indicators were significantly decreased (LVDd、IVSD、LVPWD、LVMI)(P<0.01). Compared with the control group the difference was statistically significant (P<0.05). Follow-up of 3 months, The treatment group composite cardiovascular events was fewer than the control group and had significant difference (P<0.05). Conclusion Hyperbaric oxygen therapy can significantly improve left ventricular ejection fraction preserved by heart failure of left ventricular diastolic and systolic function and reverse left ventricular remodeling,And can reduce the happening of cardiovascular events.
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Objective To study the effects of hyperbaric oxygen on the diastolic heart failure in hypertensive patients. Methods 60 hypertensive patients with diastolic heart failure were randomly divided into treatment group and control group. Conventional therapies were given to patients of both groups. In addition, hyperbaric oxygen therapy was applied to those of treatment group. After 3 months, Doppler ultrasound recordings were obtained from all patients to determine the left ventricular diastolic function. Results The indexes of left ventricular diastolic function were im-proved after treatment in both groups(P < 0.01) ,and treatment group was better than control group(P < 0. 05). Conclusion For hypertensive patients with diastolic heart failure, hyperbaric oxygen can improve heart diastolic function.
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Objective To study the effects of enhanced external counterpulsation (EECP) on the diastolic heart failure in hypertensive patients.Methods 104 hypertensive patients with diastolic heart failure were randomly divided into treatment group and control group,52 patients were given 36 hours of treatment EECP.After 6 months,Doppler ultrasound recordings were obtained from all patients to determine the left ventrlcular diastolic function.Resuits Left ventricular diastolic function index and the left ventrich mass weight index (LVMI) wero impmved after treatment in both groups(P＜0.01),and EECP treated group was better than control group(P＜0.05).Conduslon For hypertensive patients with diastolic heart failure,EECP could not only improve heart diastolic function,but also reverse reconstruction of the left ventricuhr.
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Objective To investigate the methodology and feasibility of bedside temporary cardiac pacing with balloon-tipped floating catheter by femoral vein approach.Methods 86 patients in this study were treated with bedside temporary cardiac pacing by femoral vein for arrhythmias.A balloon-tipped floating catheter was inserted through the femoral vein in right ventricle,guided by the length of catheter in body and the QRS morphology of pacing electrocardiogram(ECG).After that,the pacing site was identified by X-ray fluoroscopy.Then,the feasibility and successful rate of this bedside temporary cardiac pacing,and the causes for failure were analyzed.Results Guided by the length of catheter and the QRS morphology of pacing ECG,the succesful rate of balloon-tipped floating catheter putted into right ventricle was 98.8%.The most successful pacing sites were located at the right ventricular apex(RVA) and right ventricular out-flow tract(RVOT).The lengths of catheter from the puncture sites to RVA and RVOT were (57.2?3.2)cm and (54.3?3.1)cm,respectively.Incidence of undersensing in RVOT pacing group was significantly higher than that in RVA pacing group(P
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Objective To investigate the relationship between resting heart rate(RHR) and prognosis of acute coronary syndromes without ST-segment elevation.Methods 167 patients of ACS without ST-segment elevation admitted to hospitals consecutively from Oct. 2001 to Oct. 2004 were divided into five groups according to the levels of RHR[RHR 1 group:RHR
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BACKGROUND: New-type tissue engineering materials and post-proliferation Schwann cells are implanted into biosynthesis tube for repairing peripheral nerve defect, which are two great developments in the field of artificial biomaterial tube.OBJECTIVE: Taking chitosan-collagen as scaffold, activated Schwann cells as seed cells, we are in attempt to observe the affinity between them as well as growth rule of activated Schwann cells on Chitosan-collagen, so as to provide basis for pre-construction of artificial nerve.DESIGN: Open experiment.SETTING: Department of Hand Surgery, Huashan Hospital Affiliated to Fudan University.MATERIALS: This experiment was conducted at the Key Laboratory of Hand Function Reconstruction, Ministry of Public Health from July 2003 to December 2003. Four male SD rats, of clean degree, were used in this experiment. Chitosan-collagen film was made in Qisheng Biomaterial Technique Institute, Shanghai, Schwann cells activator solution was made in our laboratory (self-made).METHODS: After rats were anaesthenia, the sciatic nerve was cut off to perform predegeneration for 7 days. Another anaesthenia later, the rats were euthanized. Both sides of sorciatic nerves were cut off quickly and put in the D-HANK's solution containing penicillin and streptomycin.Epineurium was eliminated and chipped into 1 mm pieces, then put in the centrifuge tube containing 5 g/L trypsinase and 0.6 g/L collagenase. 0.5 mL activator solution every 2 mL liquid was added and the activated Schwann cells were harvested with the way of two-step enzymolysis. 2×107 L-1 activated Schwann cells in 200 μL were inoculated to Chitosan-collagen film and Petri dish . Two weeks later, cellular growth was observed under phase contrast microscope and scanning electron microscope. Cellular purity was identified with S-100 staining.MAIN OUTCOME MEASURES: ① Drawing cell growth curve and confirming in vitro doubling time. ②Observation of activated Schwanri cells under an inverted phase contrast microscope. ③ Observation of activated Schwann cells inoculated on Chitosan-collagen film under scanning electron microscope.RESULTS: ① Confirmation of in vitro doubling time: Concentration of activated Schwann cells inoculated on both Chitosan-collagen and Petri dish was 2×107 L-1, the final concentration was up to 3.0×108 L-1 and 2.0×108 L-1 respectively 2 weeks later. Doubling time of activated Schwann cells cultured on Chitosan-collagen film was 4 days calculated according to DT=(t-t0) lg2/(lgn-lgn0). ②Observation of activated Schwanncells under an inverted microscope: 24 hours later, the activated Schwann cells inoculated to Petri dish mostly changed from spherical to long shuttle-shape,mutation appeared and most were two-pole shape, fewer were three-pole shape; Morphologically, there was no significant difference between activated Schwann cells inoculated on Chitosan-collagen film and on Petri dish. Activated Schwann cells inoculated to Chitosan-collagen film were like "words cayed on the sand" under phase contrast microscope and the purity was over 95%. ③ Observation of activated Schwann cells inoculated to Chitosan-collagen under scanning electron microscope: Most of activated Schwann cells grew in the introcession of Chitosan-collagen or closely to surface of Chitosan-collagen, presenting regular head-to-end connection and adhesion to Chitosan-collagen film. The cell body was fusiform,with diameter of 4-6 μm, 60-80 μm in length. Cells were shuttle-shape with some small branches. Morphology of Chitosan-collagen film was still complete at week 1.CONCLUSION: There exists great affinity between Chitosan-collagen film and high-purity activated Schwann cell; so tissue-engineering scaffold made of the two components probably promote peripheral nerve regeneration.
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Purpose To study the relationship between sympathetic nerve and the branches of primary sensory neurons in dominating cervical zygapophyseal joints with the HRP retrograde tracing methods.To explore the mechanism of the external intervertebral foramen's cryical nerve compression syndrome with neck-shoulder pain and the symptom of head and face regions. Methods 8 Wistar rats were used with the right side as experimental side and the left side as control side.5 μl of 30% HRP solution was injected into the C5/C6 cervical zygapophyseal joint capsule of the right side by microinjection syringe and 5 μl of 0.9% normal saline was injected into the left side as control.The animals survived for 48 hours and were killed by perfusing through ascending aorta.The C1-T1 DRG,cervical sympathetic ganglia and trigeminal ganglia on both sides were sectioned by frozen section method,and treated with TMB method.The HRP labeled cells in sections were observed under optical microscope.The classification and count of HRP labeled cells in DRG and cervical sympathetic ganglia on experimental sides were analysed by image pattern analysis system. Results There were HRP labeled cells in middle cervical ganglia,inferior cervical ganglia (stellate ganglia) and C5-C7 DRG on experimental sides after HRP injection.Most of the labeled cells were small or middle size.The sum of mean area and the mean optical density of HRP labeled cells were larger in the middle cervical ganglia and C6 DRG than that in inferior cervical ganglia(stellate ganglia) and C5 or C7 DRG separately (P<0.01).There wasn't any HRP labeled cell in C1-T1 DRG of control side and in trigeminal ganglia. Conclusions The cervical zygapophyseal joint mainly dominated by the sensory branches of the three cervical nerves next to it and by the branches of the sympathetic nerves.It may be related to the causing of neck-shoulder pain and the symptoms of head and face regions of patients with the external intervertebral foramen's cervical nerve compression
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Purpose To observe exogenous epidermal growth factor (EGF) influence upon sensory neurons axotomy-induced and change ultra-structure of sensory. Methods Eighteen male Sprague-Dawely rats weighing 180-200 g(8-9 weeks of age)were randomly divided into two groups.One as control,the other was treated with EGF.Sciatic nerve injury model was set up by transecting left side sciatic nerve at 0.5 cm away from performed muscle.The proximal stump of sciatic nerve was ligated to inhibit nerve regeneration.Then 5 μl of normal saline in the control groups and an equal volume of EGF solution (containing 10 μg EGF) in the EGF treated groups were injected into the proximal of ligated nerve.The rats were sacrificed in 7,14,28 days of operative intervals respectively and transcardialy perfused with 4% para-fromaladehyde.The L5 dorsal root ganglion(DRG) were harvested.Eletromicroscope technique was used to observe the changes of L5 DRG sensory neurons axotomy-induced. Results A series of changes happened in the control group.The size of the nucles decreased.Nucleoplasm was scattered.The nucleolus was pale.Edema,loss of crest and matrix was found in the mitochondria. Satellite cells detached from the soma.The ultrastructure of L5 DRG sensory neurons in EGF groups get near to normal following nerve injury. Conclusions EGF could protect sensory neurons.
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The principle of corresponding analysis was introduced.The relationship between the content of trace elements and the efficacy of eleven kinds of Chinese materia medica(CMM) was analyzed by the corresponding analysis.The result showed that the corresponding analysis could reveal the relationship between the efficacy of eleven kinds of CMM and the trace elements content that they contain.According to the analysis,the efficacy of CMM was classified.The result shows that the corresponding analysis is a good method for the efficacy analysis of CMM.
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Objective: To observe the influence on curative effect of aescine in curing Lumbar intervertebral disc prolapse(LIDP) before and after operation. Methods: 184 cases of patients with LIDP were divided into two groups. 96 cases in curative group began to be used 10mg of aescin by adding to infusion of iv drip bid 3 days before the operation, and contie for 6-8 days it. 88 cases in control group were only operated.Results: Curative group was superior to control group in lysis of pain, postoperative La feeling and improvement of muscle strength. The excellent and better rates in two groups are 72.91%, 91.67% and 43.18%, 85.22%. The excellent rate of curative group is higher than that of control group( P 0.05). There is no serious bad reaction of drug in curative group.Conclusion: Aescin used before and after operation is good to recovery of nervous function after LIDP operation.
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To find immunomorphologic evidence of interregulation between neuroendocrine system and immune system by detecting 5-HT in human normal lymph-node and lymphoma.Methods:Immunohistochemical SABC method and statistics analysis.Results:Thirty-three cases of lymph-nodes showd 5-HT positive expression.The positive rate of lymphoma is lower than that of normal lymph-node.The differences between human normal lymph-nodes and lymphoma are significant( P