Objective To investigate the effect of different sealing methods of urokinase plus heparin on long-term dialysis catheter thrombolysis.Methods63 patients were treated with maintenance hemodialysis from central venous catheters with catheter thrombosis as a clinical study.The patients were divided into observation group and control group by simple random method.In the observation group, 31 cases were treated with urokinase and heparin mixed solution from the ends of the arteriovenous catheter of permanent double-laryngeal dialysis tube for 24 hours for 3 consecutive days.32 patients in the control group, from the permanent dual-chamber dialysis catheter arterial and vein at both ends with a micro pump pumped urokinase, maintained for 2hours.ResultsThere was no significant difference in thrombolytic success rate between the two groups.The catheter retention time in the observation group was significantly longer than that in the control group, the dialysis blood flow rate, the solute clearance index and the urea clearance index were significantly higher than those in the control group.The incidence of venous pressure and hemorrhagic adverse events was significantly lower than that of the control group (P<0.05).ConclusionUrea kinase plus heparin mixture is simple and easy to operate, which avoids the risk of excessive localized or systemic hemorrhage caused by excessive urokinase into the blood circulation of patients.It is worthy of popularization.

Objective To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) in detecting small liver metastasis (SLM) from breast cancer. Methods A total of 92 cases diagnosed as breast cancer by surgical pathology and suspected SLM by conventional ultrasonography were included in this study. CEUS was used to check liver lesion in patients. The biopsy operation was used as the gold standard. The coincidence rate of benign and malignant pathology was used to compare the consistency between CEUS and biopsy pathology. Results In 92 cases suspected liver metastases of breast cancer by routine ultrasound, there were 54 cases were diagnosed as benign by pathology, and all 92 cases were diagnosed as benign by CEUS. Thirty-eight cases were diagnosed as metastasis by pathology, in which 36 cases were correctly diagnosed by CEUS. The sensitivity of CEUS for the diagnosis of liver metastases of breast cancer was 94.74%(36/38), specificity was 100%(54/54), positive predictive value (PPV) was 100%(36/36) and negative predictive value (NPV) was 96.43%(54/56). Conclusion CEUS has a higher diagnostic value in SLM of breast cancer, and has clinical practical value.

Cell-Free Nucleic Acids ; blood ; Female ; Humans ; Mosaicism ; Placenta ; Pregnancy

OBJECTIVE: To explore the cause for the failure of non-invasive prenatal testing (NIPT) and feasibility of repeated testing. METHODS: Clinical data, test results and pregnancy outcomes of 40 311 pregnant women who received NIPT test from January 2011 to December 2018 were reviewed. RESULTS: Among all the pregnant women, 1116 cases failed in the first test, 9 cases (0.81%) had fetal free DNA concentration lower than 4%, 663 cases (59.41%) were retested after the establishment of Z value gray area, and the remainder 444 cases (39.78%) needed to be retested after the blood collection due to the fetal free DNA concentration lower than 4%. After retesting, 1069 cases (95.78%) obtained effective NIPT results. The results showed that 53 cases were at high risk (6 cases for trisomy 21, 6 cases for trisomy 18, 13 cases for trisomy 13, 16 cases for sex chromosomal abnormality, 12 cases for chromosomal copy number variation). Forty-eight cases were selected for invasive prenatal diagnosis, and 2 cases of 47, XXY and 2 CNV were confirmed. A total of 47 cases (0.12%) did not obtain results because the concentration of fetal free DNA was lower than 4%. Only 16 cases (34%) chose invasive prenatal diagnosis. CONCLUSION Repeated detection of the gray area of Z value can reduce the false positive rate of NIPT and invasive prenatal diagnosis, and the feasibility of repeated detection is high. In the case of fetal free DNA concentration lower than 4%, the success rate of obtaining effective NIPT results by re-sampling and re-detection increases with the increase of gestational age, but may delay the diagnosis for fetal aneuploidies. Therefore, personalized estimation should be made according to gestational age and clinical indications. It is suggested that pregnant women should choose invasive prenatal diagnosis when they have failed in the retest.