A comprehensive literature on the utility of ultrasound guidance for artery catheterization were searched. The research of the literature was divided to three parts:evaluation of radial artery, the process of puncture and the application progress. Ultrasound is a useful adjunct to arterial catheter insertion and increase the rate of success. During the process of ultrasound guidance, evaluation of radial artery, preparation, the way of poke and the direction of the needle were recommended.

Objective To study the effect of Shaoyaozhitong Mixture on stageⅢ-Ⅳendometriosis, and explore its mechanism. Methods Ninty-five cases of stageⅢ-Ⅳ endometriosis were randomly divided into three groups. The traditional Chinese medicine (TCM) group (31 cases) was treated with Shaoyaozhitong Mixture, the GnRHa group (31 cases) was treated with Triptorelin Acetate for Injection, while the expectant group (33 cases) received no medications. The changes of CA125, TNF-α and VEGF levels, visual pain score and SF-36 score, total effective rate, pregnancy and recurrence were compared. Results There were significant increases in CA125, TNF-α and VEGF levels, visual analogue pain score and SF-36 score in all the three groups after treatment (P<0.05). The decline of CA125, TNF-αand VEGF levels and visual analogue pain score in TCM group and GnRHa group was significantly faster and greater than that of the expectant group (P<0.05). The total effective rates of TCM group was 83.9%(26/31), GnRHa group was 87.1%(27/31), and expectant group was 60.6%(20/33), TCM group and GnRHa group were superior to the expectant group, respectively (P<0.05). The pregnancy rate was higher and recurrence rate was lower in TCM group and GnRHa group than that of expectant group, but there was no statistical difference (P>0.05). Conclusion Shaoyaozhitong Mixture is effective in treating endometriosis by inhibiting the growth of ectopic endometrium.

BACKGROUND:Abdominal incision healing is not only related with the patient’s own situation, but also closely related with the surgeon's suture technique, suture method, choice of stitches. ＜br> OBJECTIVE:To compare the absorbable sutures and silk sutures for abdominal incision. ＜br> METHODS:Total y 153 colorectal cancer patients, including 91 males and 62 females, aged 30-82 years, were randomly divided into observation group (n=78) and control group (n=75). An abdominal midline incision was made in al patients receiving radical surgery of colorectal cancer. The Vicryl suture and silk suture were respectively used in the observation and control groups for abdominal incision closure. Suturing time, length of hospital stay, incision infection, disruption of wound, fat liquefaction of wound and rejection were compared between two groups. ＜br> RESULTS AND CONCLUSION:The suturing time and length of hospital stay were less in the observation group than the control group (P＜0.05). In the observation group, there were three cases of incision infection, but no incision dehiscence and rejection occurred;in the control group, there were 10 cases of incision infection, 4 cases of incision dehiscence, and 5 cases of rejection. A significant difference was found in the incision infection, dehiscence and rejection between the two groups (P＜0.05). Hospitalization expenses and fat liquefaction of incision had no difference between the two groups. these findings indicate that the Vicryl plus as an absorbable suture is simple, effective and safe that can promote wound healing and reduce complications.

Objective: To evaluate the feasibility of ICU nurse-performed lung ultrasound in screening the reason of dyspnea in ICU patients, and to explore the effect on nursing decisions. Methods: ICU nurses trained on lung ultrasound with 16 hours performed point-of-care lung ultrasound in patient with acute respiratory failure to assess the condition of the patient′s lungs and screen for pleural effusion, atelectasis/lung consolidation. Etc; Repeated examinations by ICU physicians accredited by the International Critical Ultrasound Alliance to evaluate the accuracy of ICU nurse interpretation. Results: A total of 510 lung ultrasonographic examinations were performed in 51 patients. Compared with physicians, ICU nurses correctly interpreted 472 ultrasound signs, accounting for 92.53%. ICU nurses found that the sensitivity of the pleural effusion was 86.7%, the specificity was 95.2%, and the diagnostic accuracy rate was 90.2%, and Youden index was 81.9%. The ultrasonography revealed a sensitivity of 92.1% for atelectic/pulmonary consolidation and a specificity of 92.3.%, the diagnostic accuracy rate was 92.2% and Youden index was 84.4%. Conclusion ICU nurses who have undergone standardized training can correctly interpret lung ultrasound signs and have good diagnostic value for screening of pleural effusions and atelectasis/lung consolidation; they provide the basis for optimization of chest physiotherapy programs.

【Objective】 To explore the safety of transrectal ultrasound-guided transperineal injection of sodium hyaluronate to expand the Dirichlet gap in laparoscopic radical prostatectomy. 【Methods】 A total of 14 healthy male purebred beagle dogs were selected and randomly divided into 2 groups, with 7 in either group.The control group was treated with conventional laparoscopic radical prostatectomy, while the experimental group was treated with laparoscopic radical prostatectomy after 2.5 mL sodium hyaluronate was injected into the Dirichlet gap under the guidance of transrectal ultrasound.The total operation time, prostate separation time, intraoperative blood loss and rectal status of the 2 groups were observed. 【Results】 After the injection of sodium hyaluronate into the Dirichlet gap between the prostate and the rectum, no rectal tissue was found in the prostate, and no obvious damage was found in the posterior rectum in either groups.The postoperative hemoglobin (HGB) was [(118.70±2.56) g/L vs.(122.10±2.19) g/L, P=0.02]; the total operation time was [(141.40±9.80) min vs.(119.10±9.16) min, P<0.05]; the prostate separation time was [(24.99±1.75) min vs.(16.64±2.34) min, P<0.05]; the amount of bleeding was [(47.43±4.32) mL vs.(34.86±5.18) mL, P<0.05] in the control group and experimental group. 【Conclusion】 Laparoscopic radical prostatectomy performed after 2.5 mL of sodium hyaluronate injection into the Dirichlet gap under the guidance of transrectal ultrasound can shorten the total operation time, the separation and resection time of the prostate, and reduce the amount of bleeding, which can improve and reduce the incidence of rectal injury, and prove the feasibility of this approach for prostatic cancer.

OBJECTIVETo explore the effect difference between acupuncture combined with Chinese medicine of artificial cycle therapy on the basis of western medication and simple western medication for polycystic ovarian syndrome (PCOS) of phlegm damp type with insulin resistance, and to explore its mechanism.

METHODSSixty patients were randomly assigned into an observation group and a control group, 30 cases in each group. Patients of the control group began to take letrozole and metformin orally on the third menstrual day. Patients of the observation group were treated with acupuncture combined with Chinese medicine of artificial cycle therapy on the basis of the treatment of the control group. The main acupoints were Guanyuan (CV 4), Qihai (CV 6) and bilateral Zigong (EX-CA 1), Luanchao (Extra), Fenglong (ST 40), Yinlingquan (SP 9), Zusanli (ST 36), Sanyinjiao (SP 6). Dahe (KI 12) was matched in the follicular phase, and warm acupuncture was applied at Guanyuan (CV 4) and Qihai (CV 6); Zhongji (CV 3) and Xuehai (SP 10) were matched in the ovulatory phase, and electroacupuncture were used at Qihai (CV 6) and Zhongji (CV 3), Xuehai (SP 10) and Yinlingquan (SP 9), 2 Hz and continuous wave; The acupoints in the luteal phase were the above main acupoints, at the same time, moxibustion was used at Guanyuan (CV 4) and Qihai (CV 6), the treatment was given once every other day, 30 min a time. There was no treatment in the menstrual phase. Chinese medicine was applied for tonifying kidney and nourishing blood, strengthening spleen and eliminating phlegm. The patients of the two groups were treated for continuous three menstrual cycles. The indexes before and after treatment were detected, including serum microRNA-29 (miR-29) expression, TCM symptom score, insulin (INS), blood-sugar content and homeostasis model assessment-insulin resistance (HOMA-IR) index, the endocrine hormone values of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), LH/FSH ratio, prolactin (PRL). The pregnancy rates of the two groups were compared.

RESULTSAfter treatment the expressions of miR-29 and TCM symptom scores of the two groups were lower than those before treatment (<0.01,<0.05), with better results in the observation group (<0.01,<0.05). The levels of LH LH/FSH and T of the observation group were lower than those before treatment (<0.01,<0.05), and the T value in the control group decreased after treatment (<0.05). The changes of LH and LH/FSH in the observation group were better than those in the control group (both<0.05). After treatment, The INS, blood-sugar content and HOMA-IR were lower than those before treatment in the two groups (<0.05,<0.01), with better results for INS and HOMA-IR improvements in the observation group (both<0.05). The pregnancy rate in the observation group was 56.7% (17/30), which was significantly higher than 30.0% (9/30) in the control group (<0.05).

CONCLUSIONAcupuncture combined with Chinese medicine of artificial cycle therapy can improve the endocrine levels and insulin resistance of PCOS with phlegm damp type. At the same time, the pregnancy rate is improved. By the view of molecular biology, there may be a pathway trough changing serum miR-29 expression.

Objective: To establish a practical framework for critical ultrasonography to provide a basis for clinical practice. Methods: With reference to domestic and foreign literature, expert interviews and research groups developed a preliminary draft of the practice framework for critical ultrasonography, and conducted two rounds of consultation using the Delphi method. Results: A practical framework for critical ultrasonography was developed, including 5 primary indicators and 20 secondary indicators. In the two rounds of expert consultation, the expert′s positive coefficient was 100% and the authoritative coefficient was 0.836. Conclusions Expert opinion has good coordination and high authority, which can provide clinical basis for ICU nurses to carry out ultrasound examination.