Objective To investigate the prevalence, characteristics and risk factors of superior vena cava and auxiliary branchs thrombosis in hemodialysis patients with internal jugular venous indwelling catheter. Methods A total of 43 cases on hemodialysis (HD) with indwelling short-term catheter in internal jugular vein from June to December in 2007 were enrolled in this study. The clinical data and biochemical indicators were collected to investigate the prevalence, characteristics and risk factors of venous thrombosis around indwelling catheter, such as, superior vena cava and auxiliary branehs in these patients. Results Short-term double Iumen internal jugular venous catheter were placed in 43 HD patients. Different degrees of central vein thrombosis were found in 21 of the 43 HD patients (48.8%). The ratio of thrombosis in jugular vein, brachiocephalic vein, subclavical vein and uperior vena cava was 100% (21/21), 28.6% (6/21), 23.8%(5/21) and 19.0%(4/21), respectively. Ten of the 21 HD patients (47.6%) with central vein thrombosis presented clinical symptoms. Five cases developed edema of the upper extremity, 2 cases had new-onset symptom's pulmonary embolism, and 3 eases developed blood overflowed from inlet port of circum-catheter. The ratio of diabetes mellitus, malignant tumor, the prevalence of increased level of serum lipoprotein a and plasma homocysteic acid were significantly higher in the HD patients with central vein thrombosis than that in those without central vein thrombosis. The odds ratio of diabetes mellitus, malignant tumor, high serum lipoprotein a and high plasma homocysteic acid was 5.758, 4.750, 6.967 and 8.533, respectively. Conclusions The prevalence of central vein thrombosis in HD patients with short-term indwelling catheter in internal jugular vein is quite high. Its clinical symptom is insidious but dangerous. Diabetes mellitus, malignant tumor, high serum lipoprotein a and high plasma homocysteic acid may be the important risk factors of central vein thrombosis in above HD patients.

Objective To study the effect of ro ta ry magnetic field on experimental myocardial ischemia caused by Pitui trin (Pit) injection in rats. MethodsThirty rats with experimental myocardial ischemia induced by intravenous injection of Pit (2U/kg) were divided into three groups: control group, ischemia g roup, rotary magnetic field group. The ST-segment elevated amplitude, T -wave amplitude of ECG, serum NO content, SOD activity and MAD content in the three groups were observed and compared. Results The 30 mT rotary magentic field for 30 min significantly increa sed SOD activity ( P

Objective The antioxidative activities of extracts from Undaria pinnatifida in vitrowere tested. Methods Using the assay system of peroxide value (POV), diphenyl picryl-hydrazyl (DPPH), the antioxidative activities of various extracts were studied and comparedwith VE and VC. Results Different extracts from Undaria pinnatifida showed antioxidativeactivities, and petroleum ether extract showed the highest free radical scavenging efficiency.Conclusion petroleum ether extract has stronger antioxidative effect than others.

Objective To summarize the prevention and treatment experience of complications of cardiac myxoma excision.Methods Cardiac myxoma excision were performed in 215 cases under general anesthesia,cardiopulmonary bypass and cardiac arrest condition.Results Two cases died from severe low cardiac output syndrome which eventually caused multiple organ failure.The remaining 213 cases were cured and discharged.Among 213 cases,low cardiac output syndrome occurred in 35 cases,re-open chest for bleeding was performed in 8 cases,30 cases in arrhythmia (including paroxysmal supraventricular tachycardia in 20 cases and ventricular premature in 10 cases),no vital organs embolism occurred.Follow-up was done to 200 patients for 1-8 years with a follow-up rate of 93.9％ (200/213).In 200 cases,1 case died from lung cancer,1 case recurred and was cured after re-operation.The remaining patients had no obvious abnormalities.Conclusion As the particularity of surgical treatment of cardiac myxoma,it is essential to take prevention measures to reduce complications of cardiac myxoma excision in perioperative periods.

Objective To build emergency specialist nurse training evaluation index system model.Methods By Delphi method,21 emergency care specialists participated in the consultation,using the Analytic Hierarchy Process (AHP)to build a hierarchical model,establishing judgment matrix,through statistical calculations to determine the indicators and weight coefficients of the index system of emergency specialist nurse training.Results Four first-level indicators,11 second-level indicators,31 third-level indicators emergency specialist nurse training evaluation system model were established.Conclusions Establishment of emergency nurse specialist training evaluation index system provides an effective method and reference to improve the overall capacity of the emergency specialist nursing team to ensure the quality of training of emergency nurse specialists.

Objective To investigate the potential contributing effects of fasting plasma glucose on cardiovascular events in diabetic patients treated with maintenance hemodialysis.Methods According to fasting plasma glucose,154 patients undergoing maintenance hemodialvsis in our department were assigned into group A (n =84) nondiabetic with normal fasting blood glucose,group B (n =41) diabetic with good control of fasting blood glucose,and group C (n =29) diabetic with poor control of fasting glucose.Anthropometric and laboratory data were collected,and the participants were followed up for 36 months.Cardiovascular events and hypoglycemia were recorded and analyzed.Results Highly-sensitive C reactive protein (hs-CRP),triglyceride,and waist circumference were significantly higher in group B and group C compared with group A.Bodv mass index in group C was the highest while high density lipoprotein-cholesterol and intact parathyroid hormone levels were the lowest among 3 groups (P＜0.05).During the 36 months follow-up,47 cases of cardiovascular events occurred.Kaplan-Meier curves showed that cumulative incidence of cardiovascular events was significantly higher in group C than group A and B (both P＜0.01),and no significant difference was found between group A and B.Cox regressive analysis revealed that fasting plasma glucose and hs-CRP were independant risk factors for cumulative incidence of cardiovascular events (P＜0.05 or P＜0.0l).Conclusions If fasting plasma glucose is contmlled within the range of 5.6 to 7.2 mmol/L,cardiovascular outcomes may be significantly ameliorated in diabetic patients treated with maintenance hemodialysis.

Objective To evaluate the efficacy and safety of permissive hypercapnia ventilation in mechanically ventilated newborns.Methods PubMed,Embase,the Cochrane Library,China National Knowledge Infrastructure (CKNI),Wanfang Data and Chinese BioMedical Literature Database (CBM) were searched up until March 31,2013.Randomized controlled trials (RCTs) comparing permissive hypercapnia (PHC) group with normocapnia (NC) group in mechanically ventilated newborns were included.The primary outcomes included the incidence of ventilator associated lung injury (VALI),bronchopulmonary dysplasia (BPD),intraventricular hemorrhage (IVH),periventricular leukomalacia (PVL),patent ductus arteriosus (PDA),neonatal necrotizing enterocolitis (NEC),neurodevelopmental injury and the mortality rate.Secondary outcomes included the duration of ventilatory support and the length of hospital stay.The Cochrane Handbook 5.1.0 was used to evaluate the methodological quality and RevMan 5.1 software from Cochrane Collaboration was used for meta-analysis.The fixed effects model or the random effects model was adopted according to the result of heterogeneity.Results (1) A total of 325 articles were searched,and eight RCTs involving 605 newborns (302 newborns in PHC group while 300 newborns in NC group) which met the inclusion criteria were selected.In seven studies,the partial pressure of carbon dioxide (PCO2) was controlled at ＜ 65 mmHg (1 mmHg=0.133 kPa) and pH at ≥ 7.2 in PHC group.In one study,PCO2 was ＞ 52 mmHg and pH＞7.2,without descripition of the upper limit of PCO2.(2) Four articles described the method of random allocation in detail; three described allocation concealment; all eight studies used blinding method for research subjects; two used blinding method for outcome assessment; all eight studies reported complete data; and three articles described the source of other bias.(3) All eight studies reported the incidence of VALI (I2=56％,P=0.03).The random effects model was used for the meta-analysis,and there was significant difference between PHC group and NC group (RR=0.52,95％CI:0.29-0.93,P=0.03).According to the gestational age,the eight studies were divided into two subgroups.One subgroup,including three studies with an average gestational age of 25 weeks (I2=0％,P=0.46),showed no significant difference in the incidence of VALI between PHC and NC group (RR=1.05,95％CI:0.72-1.54,P=0.78).The other subgroup,including five studies with gestational age of ＞27 weeks (I2=0％,P=0.68),showed significant difference in the incidence of VALI between the two groups (RR=0.27,95％CI:0.14-0.50,P＜0.01).The in-hospital mortality and duration of ventilation showed significant difference between the two groups (in-hospital mortality:RR=0.40,95％CI:0.22-0.74,P＜0.01; duration of ventilation:difference in means=-0.75,95％CI:-1.04--0.46,P＜0.01).There was no significant difference in the incidence of BPD,IVH,PVL,PDA,NEC and neurodevelopmental impairment between the two groups (all P＞0.05).Conclusions PHC ventilation in mechanically ventilated newborns can decrease the incidence of VALI,the in-hospital mortality and the duration of ventilation,while its protective efficacy against BPD is not remarkable.It does not increase the risk of IVH,PVL,PDA,NEC and neurodevelopmental injury,when the PCO2 is ＜ 65 mmHg and pH ≥ 7.2.

Objective To investigate the potential contributing effects of metabolic syndrome (MS) on cardiovascular events and mortality in maintenance hemodialysis (MHD) patients.Methods According to the diagnostic criteria for MS set by Chinese Diabetes Society,201 subjects undergoing MHD were assigned into MS group(n =78) or non-MS group (n =123),in August 2009.General and laboratory data were collected for cross-sectional analyses,and the participants were followed up for 36 months.Cardiovascular events,cause of death and time were recorded for longitudinal analyses.Results Prevalence of MS was 38.8％.Weight,waist circumference,triglyceride,total cholesterol,low density lipoprotein,fasting glucose level,uric acid and high-sensitivity C-reactive protein were significant higher in MS group compared to non-MS group,but duration of dialysis and high-density lipoprotein were lower (P ＜ 0.05).During the 36 months follow-up,cumulative incidence of cardiovascular events,cardiovascular and all-cause mortality were 41.0％ (32/78),19.2％ (15/78),28.2％ (22/78),in MS group respectively.Those of non-MS group were 22.8％ (28/123),10.6％ (13/123),17.1％ (21/123).There was significant difference between patients with and without MS in cumulative incidence of cardiovascular events (x2 =7.601,P =0.006).There was relationship between the number of metabolic syndrome parameters and cardiovascular events (r =0.236,P =0.001).Kaplan-Meier curves showed the relationship between two groups did not remained statistically significant in cardiovascular and all-cause mortality.Impaired glycometabolism in 5 parameters of MS was a cardiovascular mortality risk factor in MHD patients.Conclusions The prevalence of MS is high in MHD patients.MS is a risk factor of cardiovascular events,but it is not associated with cardiovascular and all-cause 3-year mortality in patients with MHD.

Objective To investigate the potential correlation between serum magnesium and malnutrition-inflammation-atherosclerosis (MIA) syndrome in maintenance hemodialysis (MHD) patients.Methods A total of 120 patients who received MHD in Department of Blood Purification of Beijing Chaoyang Hospital from March to August 2013 were enrolled.Anthropometric and laboratory data were collected for the analysis of correlation between serum magnesium and indicators relating to malnutrition,chronic inflammation,and atherosclerosis,and the analysis of relevant factors of MIA syndrome.Results In the 120 MHD patients,the mean serum magnesium level was (1.11 ±0.14) mmol/L.44 patients had malnutrition (36.7％),whose serum magnesium level was significantly lower than that of patients in normal nutritious status [(1.04 ±0.12) mmol/L vs.(1.14 ±0.15) mmol/L,t =3.576,P =0.001] ; 43 patients had chronic inflammation (35.8％),with serum magnesium level significantly lower than that of patients without inflammation [(1.07 ±0.13) mmol/L vs.(1.13 ±0.15) mmol/L,t =2.138,P =0.035]; 79 patients had atherosclerosis (65.8％),whose serum magnesium level was significantly lower than that of patients without atherosclerosis [(1.08 ±0.12) mmol/L vs.(1.15 ±0.08) mmol/L,t =0.385,P =0.019] ; and 26 patients had MIA syndrome (21.7％),whose serum magnesium level was significantly lower than that of non-MIA patients [(1.02 ± 0.10) mmol/L vs.(1.13 ± 0.14) mmol/L,t =3.534,P =0.001].Serum magnesium level was found negatively correlated with high-sensitivity C-reactive protein (hs-CRP,r =-0.237,P =0.010) and carotid intima-media thickness (IMT,r =-0.331,P =0.000),and positively correlated with serum albumin,blood urea nitrogen,serum creatinine,uric acid,serum potassium,triceps skin-fold thickness,mid-arm circumference,mid-arm muscle circumference and hemoglobin (r =0.191,P =0.037; r =0.345,P =0.000; r =0.242,P=0.008; r =0.282,P=0.002; r=0.254,P=0.005; r=0.265,P=0.011; r=0.233,P=0.018; r=0.282,P=0.007; r=0.374,P =0.000).Multivariate logistic regression analysis showed that age (OR =1.142,95％ CI =1.026-1.271,P=0.049),hs-CRP (OR=1.415,95％ CI=1.152-1.740,P=0.001),IMT (OR =1.386,95％ CI=1.009-1.904,P=0.044),serum albumin (OR =0.944,95％ CI=0.910-0.978,P=0.002) and serum magnesium (OR =0.886,95％ CI =0.788-0.996,P =0.042) were related factors of MIA syndrome.Conclusions Serum magnesium level is correlated to malnutrition,inflammation,atherosclerosis,and MIA syndrome in MHD patients.

Clinical data of 595 patients of stroke admitted to the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning were analyzed retrospectively, 310 (52. 1% ) of them with strokeassociated pneumonia (SAP). Early-onset pneumonia occurred in 225 patients (72.6%), and late-onset pneumonia in 85 (27.4%). Patients with length of hospital-stay equal to or more than two weeks accounted for (113 cases) 50. 3% of those with early-onset pneumonia, whereas patients with length of hospital-stay less than one week (60 cases) accounted for 70. 6% of those with late-onset pneumonia. Age above 65 years ( OR = 1. 037 ), diabetes ( OR = 1. 724), Glasgow coma scores equal to or less than eight ( OR = 0. 098 ),nasal feeding ( OR = 6. 640 ), administration of gastric mucosal protective drugs ( OR = 3. 581 ) and antibiotic prophylaxis ( OR = 2. 433) all were risk factors for SAP.