Real-time ultrasound guided placement of permanent internal jugular vein catheters in maintenance hemodialysis patients / 中南大学学报(医学版)

OBJECTIVE@#To investigate the value of real-time ultrasound guided placement of permanent internal jugular vein (IJV) catheterization in maintenance hemodialysis patients, and analyze its technical success and complication rate.@*METHODS@#We prospectively analyzed 63 patients (39 males, 24 females) who underwent permanent IJV cannulation with real-time ultrasound guidance from January to October in 2012. Under the real-time guidance of Logiq 5 color Doppler, we placed the tunneled cuffed catheters into the jugular vein by Seldinger technique. The number of needle punctures, technical success, the operation time, and complications were recorded. The patients were divided into a normal-risk group and a high-risk group: those who suffered multiple catheter insertions, previous difficulties during catheterization, poor compliance, obesity, impaired consciousness, skeletal deformity, disorder of haemostasis were regarded as high-risk patients.@*RESULTS@#Cannulation of IJV was done in all patients. Of the 63 catheters, 20 (31.7%) were placed in the high-risk patients; 60 (95.2%) were successfully placed at the first attempt, with the average number of punctures of (1.23±0.21) (range 1-3); Only 3 immediate complications (4.7%) developed; 3 (4.7%) catheter infections occurred in the course of using. Cannulation of IJV took longer time in the high-risk group than that in the normal-risk group [(30.6±0.11) min vs (19.1±0.09) min, P<0.05]. The number of needle punctures, percent of successful cannulation, and the frequency of immediate complications were similar in the high- and normal-risk groups. It was more likely to form catheter thrombosis during long-term use in the high-risk group (4/20, 20%) which might cause poor blood flow.@*CONCLUSION@#Permanent IJV cannulation under real-time ultrasound guidance is very safe with high success rates. Nephrologists can use this technique with ease and with minimal complications in both normal- and high-risk patients.

Basic experimental and clinical research on peritoneal dialysis in the past 16 years / 中南大学学报(医学版)

To summarized the experiences from our basic experimental and clinical research on peritoneal dialysis. In the past 16 years, peritoneal fibrosis rat models and rabbit models of peritonitis were first established successfully in our laboratory in China. Peritoneal mesothelial cells were also separated and identificated. Besides, we assessed the biocompatibility of peritoneal dialysis fluid and analyzed the molecular mechanism of peritoneal mesothelial cell injury. We demonstrated the key role of transforming growth factor-beta1 (TGF-beta1), connective tissue growth factor (CTGF) and peroxisome proliferative activated receptor-gamma (PPAR-gamma) in the pathogenesis of peritoneal fibrosis, as well as their regulation of molecular mechanism. Furthermore, we transfected the plasmids encoding TGF-beta1-shRNA or pCTGF-shRNA into peritoneal cells and tissues by nanocarrier technologies. In clinical research, the positioning of peritoneal dialysis catheters, peritoneal dialysis treatment modalities and the prevention and treatment of its complications were studied. The characteristics and mechanism of solute transport in peritoneal dialysis was also explored.

An analysis of the sleep condition and its influence factors in old patients with hypertension / 中国实用护理杂志

Objective To investigate the sleep condition and its influence factors in old patients with hypertension. Methods A total of 100 old patients with hypertension were investigated by Pitts-burgh sleep quality index (PSQI) and serf-designed questionnaire of influence factors. Results 76 per-cents of the old patients with hypertension had sleep disorders.The total score of PSQI,sleep quality,time take to fall asleep,hours of sleep,sleep effficiency,sleep disorders,hypnotic drugs and every score of daytime dysfunction were significantly higher than domestic norm(P<0.01).Surroundings(strange circumstances or noisiness), physio-pathology (disease distress or high frequency of going to toilet during nighttime),psycho-logical situations(the fear to the disease or worrying about medical fees) and drags(use of diuretics or the adverse effects of some antihypertensive agents) were the important factors affecting sleep quality. Con-clusions Old patients with hypertension have poor sleep quality,which relates with multiple factors.Valid nursing interventions should be adopted in order to control the various factors which affect sleep quality to improve patients' sleep quality.

Immuno-histo-chemical and Pathological Studies on Post - hepatitic Liver Cirrhosis Treated with Peach - kernel Extract Plus Cordicep Hypha, / 中医杂志

Based on the idea that the pathogenic-etiologic mechanism is the " blockadeof liver channels, blood stasis and Qi stagnation resulting in malnutrition of liver due to iack of blood supply", the treating principle of " e-liminating stasis and supporting body resistance" was established with the combined use of extracts from peach -kernel plus cordicep hypha. 6 cases were thus treated. All of them received laparoscopy , and liver biopsy before and after the treatment. The gross appearance, histology and ultra. - microscopic structure and irnmuno - histo - chemistry were examined. Results showed that most of the activatedfat - storage cells after treatment were silent the I, III types of collagen depo - sited among the spaces of peri - sinusoid and liver cells and FN, LM weredecreased in part of the patient, resulting in less intrahepatic fibrosis, degradation of collagen fibres deposited in inter hepatic cellular spaces, inhibition and reversion of capillariza-tion oi liver sinusoid, hence, improvement of degener-ation of liver cells in most cases. The texture of the liver were turning normal with amelioration of portal hypertension and decrease of varicose mesenteric ves-seis. The liver turned red, swelling of falciform lig(?)-ment disappeared, and ascitis subsided.