Therapeutic strategy of central vein perforation accompanied by a mediastinal lesion after catheterization.

Central vein perforation associated with a mediastinal lesion is a rare complication of catheterization. A 50-year-old woman was diagnosed with chronic kidney disease and required hemodialysis treatment. The patient developed central vein injury during attempted placement of a double-channel catheter. A computed tomographic scan and venography showed that the catheter had punctured the mediastinum from the central vein. After comprehensive assessment and multidisciplinary consultation, percutaneous catheter thrombin injection with follow-up balloon dilatation under fluoroscopy guidance successfully fixed the perforation. We summarize the therapeutic strategy of this complication and other treatment options, and discuss the related literature of central vein injury.

Functional network connectivity alterations in schizophrenia and depression.

There is a high degree of overlap between the symptoms of major depressive disorder (MDD) and schizophrenia, but it remains unclear whether the similar symptoms are derived from convergent alterations in functional network connectivity. In this study, we performed a group independent component analysis on resting-state functional MRI data from 20 MDD patients, 24 schizophrenia patients, and 43 matched healthy controls. The functional network connectivity analysis revealed that, compared to healthy controls, the MDD and schizophrenia patients exhibited convergent decreased positive connectivity between the left and right fronto-parietal control network and decreased negative connectivity between the left control and medial visual networks. Furthermore, the MDD patients showed decreased negative connectivity between the left control and auditory networks, and the schizophrenia patients showed decreased positive connectivity between the bilateral control and language networks and decreased negative connectivity between the right control and dorsal attention networks. The convergent network connectivity alterations may underlie the common primary control and regulation disorders, and the divergent connectivity alterations may enable the distinction between the two disorders. All of the convergent and divergent network connectivity alterations were relevant to the control network, suggesting an important role of the network in the pathophysiology of MDD and schizophrenia.

[Comparative study on different anti-adhesion agents in preventing tubal obstruction after interventional recanalization.].

OBJECTIVE: To study the efficacy of different anti-adhesion agents used in preventing tubal obstruction after recanalization. METHODS: Five hundred and eight patients with tubal obstruction were divided into 245 cases in control group, 108 cases in chitosan group; 113 cases in sodium hyaluronate group and 42 cases in lipiodol group. The patients in control group were injected with anti-inflammation agents after recanalization, while other groups were injected with chitosan, sodium hyaluronate or lipiodol at dose of 2 - 3 ml in every therapeutic group. The rate of location of tubal obstruction and tubal recanalization were recorded during operation. Then patients in every group were followed up on tubal patency after 3 months, and pregnancy rate after 12 months. RESULTS: Among 1016 fallopian tubes in 508 patients, there were 330 tubes occlusion at isthmus portion and 563 tubes occlusion at interstitial portion of fallopian tube. Thirty-seven fallopian tubes were ablated because of ectopic pregnancy, 86 fallopian tubes were unobstructed. (1) The recanalization rate were 95.7% (179/187) in chitosan group, 97.9% (191/195) in sodium hyaluronate group, 98.7% (75/76) in lipiodol group and 97.7% (425/435) in control group, which did not show statistical difference (P > 0.05). (2) The rates of tubal patency after 3 months of 91.7% (99/108) in chitosan group and 88.5% (100/113) in sodium hyaluronate group were significantly higher than 71.4% (30/42) in lipiodol group and 74.3% (182/245) in control group (P < 0.05). (3) The rates of intrauterine pregnancy after 12 months were 48.1% (52/108) in chitosan group and 41.6% (47/113) in sodium hyaluronate group, which were significantly higher than 23.8% (10/42) in lipiodol group and 24.1% (59/245) in control group (P < 0.05). CONCLUSION: Chitosan and sodium hyaluronate could be effective to prevent tubal obstruction after interventional recanalization and increase pregnancy rate.