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[Summary] This paper reported a patient suffering from hemorrhage after percutaneous liver biopsy treated by contrast enhanced ultrasound-guided percutaneous injection of thrombin in June 2015.Firstly,we performed contrast-enhanced ultrasound examination to find the position of active bleeding.And then,percutaneous injection of thrombin was performed under the guidance of ultrasonography.The active bleeding was stopped successfully.
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Objective To investigate the effect of three blood purification techniques on minerals disorder in maintenance hemodialysis patients,and provide clinical guidance for patients to choice the blood purification techniques.Methods Eighty-eight maintenance hemodialysis patients were divided into three groups according to the blood purification techniques:hemodialysis (HD) group (30 cases),hemodiafiltration (HDF) group (30 cases),and hemoperfusion (HP) group (28 cases).Serum urea nitrogen,creatinine,calcium,phosphorus,intact parathyroid hormone (iPTH),ftbroblast growth factor (FGF)-23 and so on before and after treatment were measured and compared among the groups.Results The serum phosphorus in HD group,HDF group and HP group before treatment were (1.93 ±0.44),(2.11 ±0.54) and (2.17 ±0.59)mmol/L,and after treatment were (1.01 ±0.23),(0.84 ±0.19),(0.99 ±0.27) mmol/L.There were significant differences in serum phosphorus level after treatment compared with that before treatment in the three groups (P ＜0.05).There were no significant differences in the descend rate of serum phosphorus among the three groups (P ＞0.05).There were no significant differences in clearance index of serum phosphorus among the three groups (P ＞ 0.05).The serum iPTH in HD group before treatment was (48.8 ± 42.9) pmol/L,and after treatment was (49.9 ± 42.9) pmol/L.The serum iPTH in HDF group and HP group before treatment were (64.7 ± 45.4) and (50.4 ± 45.9) pmol/L,after treatment was (46.2 ± 37.8) and (35.8 ± 36.5) pmol/L.There were significant differences in serum iPTH level after treatment compared with that before treatment (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum iPTH in HDF group and HP group (P ＞ 0.05).There was no significant difference in serum FGF-23 in HD group before and after treatment (P＞ 0.05).The serum FGF-23 in HDF group and HP group before treatment were (782.5 ± 105.8) and (879.5 ±97.2) ng/L,after treatment were (712.0 ±98.1),(823.5 ± 89.1) ng/L.There were significant differences in serum iPTH level after treatment compared with that before treatment in HDF group and HP group (P ＜ 0.05).The descend rate of serum FGF-23 in HD group,HDF group and HP group were (5.7 ±2.8)％,(12.3 ±6.2)％ and (9.1 ±4.6)％,and there was significant difference among the three groups (P ＜0.05).The clearance index of serum FGF-23 in HD group,HD F group and HP group were 0.06 ± 0.05,0.19 ± 0.11 and 0.12 ± 0.08,and there were significant differences among the three groups (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum urea among the three groups (P ＞ 0.05).Conclusions HD can only clear serum phosphorus.HDF and HP can clear serum phosphorus,iPTH and FGF-23 effectively,while HDF has better clearance effect on FGF-23.The HDF and HP blood purification can reduce minerals disorder in maintenance hemodialysis patients and has important clinical significance in improving the long-term prognosis of the patients.
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The present residents training for ultrasound departments depends mostly on poorlyscheduled rotation and clinical clerkship,with repeated and obsolete subjects in their training.The authors identified these setbacks and such characteristics as complication of ultrasound medicine,complex and variable ultrasonic scan technique,and the high threshold for beginners.In view of this,the authors adopted the tutorial system training mode for cultivating the residents in their medical care,teaching,research and foreign language competencies.A questionnaire survey of 44 residents so trained evaluated outcomes of the mode,with constructive suggestions raised on expansion of the training base,improvement of teachers’competency and reduction of trainees' workload.
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ObjectiveTo discuss the effects of adsorption(AP) combined with continuous venovenous hemofiltration(CVVH) on the serum inflammatory mediators levels in systemic inflammatory response syndrome (SIRS) patients.Methods Sixty-three SIRS patients were divided into treatment group (31 cases,AP combined with CVVH ) and control group (32 cases,CVVH ) by random digits table method.The changes of the serum tumor necrosis factor-alpha (TNF-α ),C-reactive protein (CRP),interleukin (IL)-1,IL-6 and IL-10 before and after treatment were compared in two groups.ResultsThere was no significant difference in the serum TNF-α,CRP,IL-1,IL-6,IL-10 before treatment between two groups (P ＞ 0.05 ).The serum TNF- α,CRP,IL- 1,IL-6,IL- 10 decreased after 2,26 and 50 h treatment compared with those before treatment in treatment group[after 2 h treatment:(226.4 ± 27.6) ng/L,(70.4 ± 22.1 ) mg/L,(30.1 ±2.9) ng/L,(227.5 ± 13.2) ng/L,(40.0 ±5.2) ng/L; after 26 h treatment:(165.3 ±24.5) ng/L,(58.2 ±25.1) mg/L,(18.2 ±2.7) ng/L,(82.4 ±7.2) ng/L,(26.2 ±4.3) ng/L; after 50 h treatment:( 120.6 ± 19.2) ng/L,(46.2 ± 24.6) mg/L,( 12.4 ± 2.3 ) ng/L,(38.1 ± 4.4 ) ng/L,( 15.2 ± 2.1 ) ng/L; before treatment:(350.8 ± 40.2) ng/L,( 126.4 ± 34.6) mg/L,(38.2 ± 3.6) ng/L,(307.7 ± 15.1 ) ng/L,(60.2 ± 9.3)ng/L,P ＜0.05].The serum TNF-α,CRP,IL-1,IL-6,IL-10 decreased after 26 and 50 h treatment compared with those before treatment in control group [after 26 h treatment:(262.7 ± 29.4) ng/L,(86.4 ±23.7) mg/L,(29.6 ± 3.1) ng/L,( 175.0 ± 10.6) ng/L,(42.7 ± 5.4) ng/L; after 50 h treatment:(219.3 ±25.6 ) ng/L,(75.6 ± 24.0) mg/L,(23.5 ± 2.8 ) ng/L,(99.0 ± 8.2 ) ng/L,(29.3 ± 4.8 ) ng/L; before treatment:(352.5 ± 40.4) ng/L,( 123.2 ± 35.2) mg/L,(37.5 ± 3.8) ng/L,(308.2 ± 15.3) ng/L,(58.4 ± 8.8) ng/L,P ＜0.05].There were significant differences in the serum TNF- α,CRP,IL-1,IL-6,IL-10 after 2,26 and 50 h treatment between two groups (P ＜ 0.05).ConclusionAP combined with CVVH can effectively decrease the serum inflammatory mediators in SIRS patients and it's therapeutic effect is superior to mere CVVH.
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Objective To investigate the clear effect of different blood purification techniques on the serum beta2-microglobulin ( β2-MG) of chronic renal failure maintenance hemodialysis patients.Methods Forty chronic renal failure maintenance hemedialysis patients were randomly divided into four groups: hemodialysis group (HD group), high flux dialysis group (HFD group), hemodiafiltration group (H D F group), hemodialysis and absorption group (HD+AP group). The serum β2-MG levels of the four groups were determined and compared before with after the therapy. Results The difference between the serum β2-MG in HD group detected at the first day before and after the therapy was insignificant difference [( 53.49±1.15 ) mg/L vs (49.10±2.31 ) mg/L ] (P > 0.05 ). The difference between the serum β2-MG in HD group detected at the first day before and after the therapy six months later [(55.63±1.30) mg/L] was significant difference (P <0.05). The serum levels at the first day and six months later after the therapy detected in HFD group, HDF group and HD+AP group were significantly decreased compared with those of the first day before the therapy (P < 0.05 ). Furthermore,the serum β2-MG level decreased in HD+AP group was more significant than HFD group and HDF group at six months later (P <0.05). Conclusions Hemodialysis can not clear the serum β2-MG. High flux dialysis, hemodiafiltration and resin absorptive devices associated hemedialysis can clear β2-MG effectively, while resin absorptive devices associated hemodialysis has the better effection after six months.
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50% in 7 patients and
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Objective To evaluate the usefulness of ultrasound during the operation of 125 I permanent brachytherapy for pancreas carcinoma.Methods According to the mass size,the total radiation dosage and the amount of radioactive seeds were calculated before operation.Then all needles were inserted evenly in the mass and radioactive seeds were implanted through the needles under ultrasonic guidance during the operation. At the end of operation,ultrasonography and/or abdominal radiography were applied to examine the distribution of seeds and to find if any place was left out. Results Thirteen patients were operated on successfully and the mass was displayed clearly with ultrasonography. Under the guidance of ultrasound,needles were exactly inserted in the mass and the whole process of implantment was easily observed. Locations were proved exactly by ultrasonography and abdominal radiography after operation. Conclusions Ultrasound has some important values in this procedure,such as precise orientation,real-time monitoring,follow-up evaluation,etc. Application of ultrasonography has the broad prospect in this field.