Objective To compare the safety and effectiveness of power peripherally inserted central catheters (Power PICC) and double cavity central venous catheter (CVC) application in intensive care unit (ICU). Methods 458 cases were reviewed during January to September in 2014 and divided into two groups: Power PICC group (245 cases) and CVC group (213 cases) , and average retention time, successful rate of inserting catheter and the incidence of complications were compared. Results The average retention time of Power PICC group was (21.6±5.8) days which was longer than (13.1±3.4) days of CVC group (t=2.234, P <0.05). No statistics difference of successful rate between two groups (P>0.05). No significant difference for the total incidence of complications between two groups as 14.69% (36/245) and 19.72%(42/213)(P>0.05). No significant difference for the total incidence of complications in the operation time between two groups as 5.31% (13/245) and 4.23% (9/213)(P>0.05). But rate of catheter malposition for Power PICC group [ 2.86% (7/245) ] was higher than CVC group 0 (X2=4.428, P <0.05). Rate of the total incidence of complications in the retention time Power PICC group [ 9.39%(23/245) ] was lower than CVC group [ 15.96%(33/213)(P<0.05). And rate of catheter related blood stream infection of CVC group [3.29%(7/213)] was much more higher than Power PICC group (0)(X2=6.139,P<0.05). Conclusions Power PICC and CVC are both applicable for ICU, and Power PICC has more advantage regarding safety and effectiveness than CVC and can be one replacement for CVC.

Objective To establish a fast and accurate technique of identifying the pachytene spermatocytes,round spermatids and elongating and condensing spermatids during STA-PUT velocity sedimentation.Methods Using STA-PUT velocity sedimentation method to isolate the pachytene spermatocytes, round spermatids and elongating and condensing spermatids from mouse testes.To determine the cell populations` distribution,each tube of cell fraction was then partially transfered to the 96 plate well,and each well was added with acridine orange dye.Then each well was analyzed using fluorescence microscopy.Results Three types of spermatogenic cells can be identified quickly and accurately by it`s specific cytoplasm/nucleus character using the acridine orange dye staining under fluorescence detection.Conclusions A rubust method to quickly and accurately determine the pachytene spermatocytes,round spermatids and elongating and condensing spermatids during STA-PUT velocity sedimentation is successfully developed.

The clinical data and findings in MRI enhanced scanning of 16 patients with meningeal carcinomatosis were analyzed retrospectively.Meningeal carcinomatosis with subacute- or chronic-onset deteriorated progressively presenting the characteristics of intracranial hypertension and meningeal irritation.Fourteen out of 16 patients showed abnormal linear and strip signal enhancement of meninges by enhancement scanning.Meningeal carcinomatosis presented in diversified patterns and contrast-enhanced MRI is of referential value for the diagnosis of the disease.

Objective To discuss the curative effect of unremitting pump infusion of microdose urokinase(100 000 u/24 h)into the cerebral venous sinus in treating thrombosis in cerebral venous sinus which had anatomical variation. Methods Mechanical disruption of the thrombus and unremitting pump infusion of microdose urokinase(100 000 u/24 h)into the cerebral venous sinus for 48-96 hours were employed in 9 patients with thrombosis in anatomically varied cerebral venous sinus.After the procedure the original disorder was actively treated and the anticoagulant therapy was continued for 6 months.A follow-up of 6-12 months(mean 10 months) was conducted. Results Recanalization of the previously occluded cerebral venous sinus was obtained in all 9 patients.The dose of urokinase was 100 000 u/24 h in 8 patients.For the remaining one patient the dose of urokinase was 100 000 u/24 h in the first 48 hours,then the dose Was increased to 250 000u/24 h. Excellent result was obtained in all patients.Conclusion Unremitting pump infusion of microdose urokinase into the cerebral venous sinus can effectively treat the thrombosis in anatomically varied cerebral venous sinus.

Objective To explore the feasibility and safety of cotransplantation of autologous bone marrow-derived mesenehymal stem cells (MSCs) and peripheral blood stem cells in hematological malignant diseases and to observe its effect on hematopoietic reconstruction after cotransplantation. Methods Adult human MSCs were isolated from the healthy bone marrow of the patient himself with Percoll (1. 073 g/ml) and cultured in Dulbecco's modified Eagle's medium with low glucose containing 10% AB type human serum. After conditioning regimen of high-dose chemotherapy and radiotherapy, cotransplantation of autologous bone marrow-derived MSCs and peripheral blood stem cells was done in five patients with hematological malignant diseases. Results The process of the infusion was safe and there were no adverse reactions or other toxicities related to the infustion of MSCs. The median time to achieve neutrophil counts greater than 0. 5 × 109/L was 9.4 days ( ranging from 8 to 11 days) after cotransplantation and platelet counts greater than 20 × 109/L 12. 2 days (ranging from 10 to 14 days). Conclusion Cotransplantation of autologous bone marrow-derived MSCs and peripheral blood stem cells in hematological malignant diseases is feasible and safe. The rapid hematopoietic reconstruction after cotransplantation shows that MSCs have an effect on hematopeiesis, but the mechanism is still to be investigated.

Objective To explore the effects and indications of physical cooling in fever patients after bone fracture surgery.Methods 450 fever patients after bone fracture surgery were selected.They were divided into different groups according to ~e main influencing factors which affected the effect of physical cooling,including the temperature of sponge bathing,the degree of fever,clinical phases of fever.The influence of above factors on physical cooling was observed.Results The temperature for sponge bathing maintaining at 38～40 ℃(the experimental group) achieved better results than that at 32～34 ℃(the control group).Physical cooling at constant peak period of fever had better effect than that during the fervescence period,and the effect of sponge bathing treatment was better in mild fever patients than in high fever patients.Conclusions The single physical hypothermia only fit the patients following bone fracture surgery who had a fever below 38.5 ℃.Patients who had an infectious high fever should receive drug combination.Temperature of sponge bathing maintaining at 38～40 ℃,bathing timing at constant peak period of fever may get best cooling effect.

Objective:To explore the clinical characteristics, possible causes and treatment methods of anaphylactoid reactions related to PICC catheterization.Methods:A retrospective analysis of the data of 27 patients with anaphylactoid reactions in 3 933 PICC catheters from October 2018 to February 2020.Results:The incidence of anaphylactoid reactions was 0.69%(27/3 933), its clinical symptoms were mainly skin reactions, some of which were complicated with respiratory, digestive, cardiovascular system and other symptoms. There was no difference in the incidence of different genders, diagnosis, and history of allergy ( χ2 value was 2.233, 0.839, 0.027, P>0.05). The incidence of patients younger than 60 years old was higher than that of patients older than 60 ( χ2 value was 12.821, P<0.01); the incidence of two catheters with different coatings was higher than that of uncoated catheters ( χ2 value was 27.195, 84.203, P<0.01). Twenty six patients continued the catheterization after the symptoms relieved, and one patient stopped the catheterization. Conclusion:The incidence of anaphylactoid reactions related to PICC, which is more common in catheters or the stylet wire is coated. It is recommended to use a large amount of saline to flush the catheter to reduce or avoid coating materials into the blood, so as to effectively control the occurrence and severity of such complications.

Objective:To evaluate the objective imaging markers of cognitive impairment in patients with end-stage renal disease by MRI intravoxel incoherent motion.Methods:A total of 40 patients with ESRD were enrolled in the Department of Nephrology, Changzhou Second Hospital Affiliated to Nanjing Medical University from January 2019 to August 2020, and 24 healthy controls were prospectively enrolled at the same time.All subjects performed with MRI scan were collected, and the slow apparent diffusion coefficient (ADC slow) of the corresponding brain regions were obtained .The cognitive function was evaluated by the Montreal cognitive assessment scale (MoCA). Two-sample t test was used to analyze the difference of ADC slow and cognitive score between the two groups.Pearson correlation analysis was performed among the cognitive function score of end-stage renal disease and ADC slow value. Results:(1) The score of the intelligence test scale in the ESRD group (23.30±1.76) was significantly lower than that of the healthy control group (27.92±1.00) ( P<0.01). The ADC slow values of bilateral frontal lobe, hippocampus, and insula brain areas (respectively(0.648±0.035), (0.633±0.043), (0.762±0.043), (0.756±0.042), (0.792±0.048), (0.776±0.054))in the ESRD group were significantly higher than those in the healthy control group ((0.600±0.039), 0.610±0.037, (0.725±0.059), (0.711±0.054), (0.740±0.063), (0.716±0.051)) ( P<0.01). (2) Pearson correlation analysis showed that the ADC slow values of bilateral insula and right hippocampus in the ESRD group were negatively correlated with MoCA scales ( r=-0.38, -0.38, -0.66, all P<0.05). Conclusion:ADC slow value in IVIM can better reflect the changes of cognitive function impairment in ESRD patients.

Nursing plays an irreplaceable role in the process of artificial liver treatment. Giving standardized nursing operation, timely finding and correctly handling the problems in the course of treatment are the key to the success of the treatment. Based on the theory of three-dimensional quality structure, this paper summarizes the influencing factors of nursing quality control in the process of artificial liver treatment, in order to improve nursing quality, control the incidence of adverse events of nursing, and ensure the safety of patients′ lives.

Objective:To construct a postoperative exercise management program for elderly patients with lung cancer based on social cognitive theory, and to provide guidance for improving the postoperative exercise ability of elderly patients with lung cancer.Methods:Systematically searched UpToDate, PubMed, Web of Science, Cochrane Library, Medlive, Wanfang, CNKI and other databases for relevant literature on postoperative rehabilitation exercise for elderly patients with lung cancer, with the search time from the establishment of the database to February 13, 2023. Guided by social cognitive theory, a preliminary draft of the postoperative exercise management program for elderly patients with lung cancer was prepared based on the literature research, and the final draft was formed after revising the program content through expert meeting method.Results:The questionnaire recovery rate of expert meeting method was 12/12; the expert authority coefficient was 0.892; the importance coefficient of variation of each item was 0-0.150; the Kendall coordination coefficient was 0.262 ( P<0.001); the final exercise management program included 5 first-level items, 18 second-level items and 42 third-level items. Conclusions:The process of constructing the postoperative exercise management program for elderly patients with lung cancer has scientificity and reliability, and the content has rationality and comprehensiveness, which can provide guidance for improving the postoperative exercise rehabilitation of elderly patients with lung cancer.