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Objective@#To identify the anatomical positional relation of the internal jugular vein and the common carotid artery, and investigate the predictive factors associated with the stenosis rate of the internal jugular vein after catheterization in hemodialysis patients.@*Methods@#A single-center cross-sectional survey study of 235 patients from the Department of Nephrology, Guangdong Provincial People's Hospital between August 2017 and June 2018 was performed. According to whether received hemodialysis treatment, The patients were divided into dialysis group (n=187) and control group (chronic kidney disease non-dialysis patients, n=48). Clinical data such as age, primary disease, history of deep vein catheterization, catheter indwelling time and dialysis age were collected. The positional relationship between the internal jugular vein and the common carotid artery was examined by Doppler ultrasound. Measure the cross-sectional area of the internal jugular vein in different neck anatomical planes and analyse of the incidence of internal jugular vein stenosis in the dialysis group. Chi-square test was used to compare the differences in the incidence of internal jugular vein stenosis between subgroups of different ages, with or without catheter retention, catheter indwelling time, dialysis age and presence or absence of diabetic nephropathy.@*Results@#Doppler ultrasonography showed that in the 235 patients, there were four types of anatomical relationship between the internal jugular vein and the common carotid artery in the plane of the flat thyroid cartilage and the apex plane of the upper clavicle. The internal jugular vein was located on the lateral, anterolateral, anterior and medial sides of the common carotid artery, accounting for 16.23%, 36.52%, 41.11% and 3.14% respectively. There were significant differences in the anatomical relationship between the internal jugular vein and the common carotid artery between the left and right sides, different anatomical planes and patients of different ages (P<0.05). The rate of internal jugular vein stenosis in 187 hemodialysis patients was 47.1%. The right internal jugular vein stenosis rate was 66.4% and 44.1% in the age<65 years old group (n=128) and age≥65 years old group (n=59), respectively (P=0.004). The rate of internal jugular vein stenosis was 49.0% and 32.8% (P=0.018) in the catheter placement group (n=151) and the catheterless retention group (n=36), respectively. Two variables including age and history of catheterization were included in the logistic regression equation. The results showed that the history of catheterization was a risk factor for internal jugular vein stenosis (OR=1.668, 95% CI 1.083-2.568, P=0.020).@*Conclusions@#There is variability in the anatomical relationship between the internal jugular vein and the common carotid artery. Internal jugular vein stenosis is a common complication after indwelling catheters in hemodialysis patients. The history of internal jugular vein catheterization is a risk factor affecting internal jugular vein stenosis.
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Objective To identify the anatomical positional relation of the internal jugular vein and the common carotid artery, and investigate the predictive factors associated with the stenosis rate of the internal jugular vein after catheterization in hemodialysis patients. Methods A single-center cross-sectional survey study of 235 patients from the Department of Nephrology, Guangdong Provincial People's Hospital between August 2017 and June 2018 was performed. According to whether received hemodialysis treatment, The patients were divided into dialysis group (n=187) and control group (chronic kidney disease non-dialysis patients, n=48). Clinical data such as age, primary disease, history of deep vein catheterization, catheter indwelling time and dialysis age were collected. The positional relationship between the internal jugular vein and the common carotid artery was examined by Doppler ultrasound. Measure the cross-sectional area of the internal jugular vein in different neck anatomical planes and analyse of the incidence of internal jugular vein stenosis in the dialysis group. Chi-square test was used to compare the differences in the incidence of internal jugular vein stenosis between subgroups of different ages, with or without catheter retention, catheter indwelling time, dialysis age and presence or absence of diabetic nephropathy. Results Doppler ultrasonography showed that in the 235 patients, there were four types of anatomical relationship between the internal jugular vein and the common carotid artery in the plane of the flat thyroid cartilage and the apex plane of the upper clavicle. The internal jugular vein was located on the lateral, anterolateral, anterior and medial sides of the common carotid artery, accounting for 16.23％, 36.52％, 41.11％ and 3.14％respectively. There were significant differences in the anatomical relationship between the internal jugular vein and the common carotid artery between the left and right sides, different anatomical planes and patients of different ages (P﹤0.05). The rate of internal jugular vein stenosis in 187 hemodialysis patients was 47.1％. The right internal jugular vein stenosis rate was 66.4％and 44.1％in the age﹤65 years old group (n=128) and age≥65 years old group (n=59), respectively (P=0.004). The rate of internal jugular vein stenosis was 49.0％and 32.8％(P=0.018) in the catheter placement group (n=151) and the catheterless retention group (n=36), respectively. Two variables including age and history of catheterization were included in the logistic regression equation. The results showed that the history of catheterization was a risk factor for internal jugular vein stenosis (OR=1.668, 95％ CI 1.083-2.568, P=0.020). Conclusions There is variability in the anatomical relationship between the internal jugular vein and the common carotid artery. Internal jugular vein stenosis is a common complication after indwelling catheters in hemodialysis patients. The history of internal jugular vein catheterization is a risk factor affecting internal jugular vein stenosis.
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Objective To study the effects and mechanism of Xuling-Jiangu formula on bone mineral density in the osteoporosis model rats.Methods According to the random number table method,50 SD female rats were randomly divided into the sham group,the model group,the low dose group of Xuling-Jiangu formula group,the medium dose group and the high dose of group.In addition to the sham group,the other groups were osteoporosis model.After 30 days,low dose group received intragastric Xuling-Jiangu formula solution 7.5 g/kg;medium dose group and high dose group received 15 and 30 g/kg,respectively.And the sham group and the model group received normal saline 10 ml/kg.After 12 weeks treatment,the bone mineral density of the left tibia was measured by double energy X ray.Estrone,osteocalcin in serum had been detected by Enzyme linked immunosorbent assay (ELISA).The mRNA expression of osteoprotegerin (OPG),receptor activator of nuclear factor κB ligand (RANKL) in lumbar were measured by quantitative real-time PCR.Results The bone mineral density (0.215 ± 0.010 g/cm2,0.222 ± 0.013 g/cm2 vs.0.196 ± 0.016 g/cm2) of the Xuling-Jiangu formula group were significantly higher than that of the model group (P＜0.01 or P＜0.05).The estrone in low,middle and high dose groups showed an upward trend,but there was no significant difference compared with the model group.The OC (87.0 ± 8.9 ng/L vs.100.5 ± 16.8 ng/L) of high dose group was significantly lower than that of the model group (P＜0.05).Compare with the model group,OPG mRNA level (0.97 ± 0.23 vs.0.78 ± 0.17) in high dose group increased (P＜0.05),the RANKL mRNA level decreased significantly (1.12 ± 0.17,0.97 ± 0.38,1.04 ± 0.29 vs.1.31 ± 0.18) in three Xuling-Jiangu formula groups (P＜0.05).Conclusions The bone mineral density of rats with osteoporosis can be improved by treating Xuling-Jiangu formula.It may be related to the increase of mRNA expression of OPG,and the reduction of RANKL.
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Objective To explore the mechanism of Liver-soothing therapy on the Luteotropic hormone receptor (LHR) and Follicle stimulating hormone receptor (FSHR) in Perimenopausal Syndrome (PMS). Methods A total of 30 nature aging rats (13-month-old) were randomly assigned into three groups;PMS Liver-qi stagnation model (n=8), PMS Liver-qi stagnation model (n=8) treated with Chaihu-Shugan powder (4.0 g/kg?d) and PMS Liver-qi stagnation model (n=8) treated with Danzhi-Xiaoyao powder (4.0 g/kg?d). The PMS Liver-qi stagnation syndrome rat model were established by immobilizing the nature aging rats. Twelve-week-old female rats (n=8) were used as normal controls. Water decoctions of Chaihu-Shugan powder or Danzhi-Xiaoyao powder were administered respectively for 3 weeks while the rat models established. The serum E2, FSH, LH level were measured by radioimmunoassay. The LHR, FSHR in ovary were measured by quantitative real-time PCR. Results Compared with Liver-qi stagnation syndrome rat model, FSH in the Chaihu-Shugan powder group (4.32 ± 0.33 mIU/ml vs. 5.24 ± 0.45 mIU/ml) decreased (P<0.01), and LH in the Danzhi-Xiaoyao powder group (6.76 ± 0.52 mIU/ml vs. 8.08 ± 0.59 mIU/ml) decreased (P<0.01). Compared with normal controls, LHR mRNA, FSHR mRNA level increased in PMS Liver-qi stagnation model. Compared with Liver-qi stagnation syndrome rat model, LHR mRNA, FSHR mRNA level decreased (7.42 ± 2.54,4.91 ± 1.76 vs. 3.80 ± 1.36) in the ovary of Danzhi-Xiaoyao powder group (P<0.01), but there was no remarkable FHR, LHR expression changes in Chaihu-Shugan powder group. Conclusions The mechanism of Liver-soothing therapy may be related to the regulation of endocrine and decrease of LHR, FSHR.
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Objective To explore the effect of liver-soothing therapy on the expression of estrogen receptors mRNA in perimenopausal syndrome (PMS) rats with liver qi stagnation. Methods A total of 30 nature aging rats are assigned into control groups (n=8), model groups (n=8),Chaihu-Shugan San (CHSGS group,n=8) andDanzhi-Xiaoyao San (DZXYS group, n=8), according to the random number table. The PMS liver-Qi stagnation syndrome rat models were established by the methods of isolation raised and chronic bondage in all the groups except the control group. CHSGS group were administered 4.0 g/kg water decoctions ofChaihu ShuganSan, and DZXYS group 4.9 g/kg water decoctions ofDanzhi XiaoyaoSan respectively for 3 weeks after the rat models established. The model group and control group were administered with equal volume of normal saline. The open field test was used for the behavior test. The serum E2, FSH, LH level were measured by radioimmunoassay. The ERα, ERβ in ovary were measured by quantitative real-time PCR. Results Compared with model group on the 21st days, the CHSGS and DZXYS groups showed a significantly increase in crossings (49.6 ± 6.0, 51.6 ± 5.8vs. 40.0 ± 4.6,P0.05) increaed in the DZXYS group, but there was no remarkable difference. Conclusion The Liver-soothing therapy can improve the behavior of PMS rats with liver-Qi stagnation, and the mechanism may be related to the regulation of endocrine and ovarian estrogen receptors.