Objective To explore the application and nursing of retention central vein catheter in hemodialy- sis.Methods Blood vessel path was established by inserted central vein catheter on 96 patients who needed hemodialysis treatment.Results Only one patient needed to tease tube for complication.Conclusion It's safe and effective to insert central vein catheter in hemodialysis.Applying and attending exactly can extend service life of catheter and prevent complication.

ObjectiveTo understand the marriage status marriage quality and marriage adaptation of inpatients with depression.Methods 100 inpatients with depression met the diagnostic criterion of major depression of CCMD-3 and 100 health people were recruited,and investigated by using the self-developed marriage status questionnaire,Olson's marriage quality questionnaire,Loche Wallace marriage adaptation scale and HAMD.Results ( 1 ) The marriage and remarriage rates of the depressive inpatients in female were significant higher than those in male(P＜ 0.05).(2) The score of ENRICH in the depressive inpatients group was significant lower than that in the health control group(P＜ 0.01 ).(3)The rate of the well adaptation of marriage in the depressive inpatients group was 32.0％,which was lower than that in the control group(P＜ 0.01 ).(4) The total score of the EN-RICH was negative correlation with the total score of HAMD( r=- 0.419,P＜ 0.01 ).ConclusionThe marriage status of the depressive inpatients is not fine and maladatative,which is influenced by the depressive symptoms.

Objective To systematically review findings on the effectiveness and safety of transcranial magnetic stimulation (TMS) for treating Parkinson's disease. Methods Foreign and Chinese databases were searched to find relevant trials. The searches were supplemented by searching the reference lists of the published trials. The studies were separated into two groups: those applying TMS at frequencies higher than 1 Hz, and those at 1 Hz or lower. Meta-analysis was performed with the aid of RevMan 5.0 software. Results Both low-frequency and highfrequency TMS can significantly reduce total scores on the Unified Parkinson's Disease Rating Scale (UPDRS) compared with sham stimulations. High-frequency TMS can significantly reduce UPDRS motor scores compared with sham stimulations. On the other hand, low-frequency TMS studies showed no significant overall improvement in motor scores, mental scores or in the activities of daily living (ADL) UPDRS scores. Low-frequency and high-frequency TMS studies also showed no significant overall improvement in Schwab and England ADL scores. Conclusions TMS therapy is safe and partially effective for treating Parkinson's disease.

Objective To investigate the expression of endocytic receptor megalin and cubilinin in the developing mouse kidneys, and the correlation between the expression and the development of the renal tubules. Methods Expression of megalin and cubilin in developing mouse kidneys was examined at different embryonic days (E) using immunohistochemistry. Meanwhile, the ultrastructure of developing proximal tubules related to endocytosis was observed at transimission electron microscope level. Results At E9.5, megalin and cubilin were co-expressed in apical plasma membrane of the mesonephric ducts and mesonephric tubules. From E11 to E18, in the metanephros, the expression of both receptors were seen at the free surface and apical plasma of uretic bud, but weakly in all renal tubules of S shaped body at early differentiatial stage. With the mature of proximal tubule development, they were both confined to the brush border and the apical plasma of the proximal tubules in juxtamedullary cortex.Conclusion The endocytic receptors, megalin and cubilin are expressed in apical part of nearly all renal tubule epithelia in early development, and confined to free surface of mature proximal tubules, suggesting that with the mature of proximal tubules, the two receptors are generally involved in collaborating to facilitate, the reabsorption of ultrafiltration.

Objective To study the relationship between calcitonin gene related peptide(CGRP)and enhanced osteogencsis after brain injury by investigating the expression of CGRP in callas and the level of CGRP in serum of rats with brain injury and femoral fracture.Method The experiment was conducted in the Laboratory of Surgery,Affiliated Hospital of North Claim Coal Medical College.Totally 56 male Sprague-Dawley(SD)rats were divided randomly into 3 groups:fracture group(n=24),fracture with brain injury group(n=24)and normal control group(n=8).The parietal skull revealed,the bone windowwas opened,rats models of brain injury were established by falling freely,and rats models of fracture were established by cutting the right middle femur.The rats in normal control group were killed at the 21 days after operation,the rats in other two groups were killed at 7,14and 21 days after operation,respectively.The X-ray of femoral fracture was obtained,the CGRP concentration in serum was detected by mdioimmunoassay,and tissues at 5mm above and below the fracture were stained by HE and SP immtmohistochemistry to observe the expressions of CGRP and the fracture healing.The data were expressed as mean±SEM and ahalyzed with student't t test with SPSS,Results The serum levels of CGRP in fracture group were(91.58±28.67)ng/L,(102.46±27.95)ng/L,(86.54±24.13)ng/L at 7,14,21 days after operation,respectively,which were significantly higher than that in the control group.In fracture with brain injury group,the serum levels of CGRP(165.49±43.28)ng/L significantly increased at 7 days after operation,and compared with fracttwe group,there was significant difference.The serum levels of CGRP decreased at 14,21 days after operation,with 104.72±31.36)ng/L,(74.93±21.57)ng/L,respectively,and compared with fracture group,there was significant difference at 21 days.The mean optical density in callus of the fracture in brain injury group (0.496±0.108)were higher than that in the fracture group[(0.348±0.076)]at 7 days after operation(P＜0.01),but there were no significant difference on the 14 and 21 days.Conclusions CGRP may play a role in osteogenesis after brain injury.

BACKGROUND: Biliary tract complications are one of the most common postoperative problems after liver transplantation.Balloon dilation and percutaneous transhepatic biliary drainage (PTBD) has become an effective method to improve biliary complication after orthotopic liver transplantation (OLT).OBJECTIVE: To evaluate the balloon dilation and PTBD in the treatment of biliary stricture after OLT through case follow up.DESIGN, TIME AND SETTING: A total of 53 consecutive patients underwent interventional procedures to treat biliary stricture after OLT in the Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University from July 1999 to March 2007 and were recruited for this study. The series included 46 men and 7 women, with 17-64 years of age. After OLT transplantation, all patients had abnormally elevated serum bilirubin level, and confirmed to suffer from obstruction of biliary tract by CT or MRI examinations.METHODS: Of 50 patients who received PTBD treatment, 36 underwent PTBD through right bile duct, 14 underwent bilateral (right bile duct and left bile duct) PTBD with 6 patients through left bile duct in the second treatment. A total of 13 underwent balloon dilation, and 3 were subjected to balloon dilation alone.MAIN OUTCOME MEASURES: An averaged 9.6 months of follow up was performed in 53 patients to observe obstructive jaundice recurrence induced by abnormally elevated serum bilirubin level after percutaneous transhepatic biliary interventional procedures.RESULTS: Follow up results showed satisfactory clinical outcome with obstructive jaundice resolved in all patients, except one patient, who received treatment with T tube, died of acute rejection at month 1 during the follow up, and one patient with liver failure had extremely poor prognosis after discharge at month 1 during the follow up. Obstructive jaundice was recovered even healed and serum bilirubin level was decreased to normal level in 51 patients at the end of follow-up. Primary success rate was 79% (42 in 53 cases), and assisted success rate was 21%. The first interventional procedure failed to treat obstructive jaundice in 5 patients. Obstructive jaundice recurred after primary percutaneous procedure in other 6 cases. No procedure related severe complications happened.CONCLUSION: Balloon dilation and PTBD are safe to treat biliary tract complication after OLT, without complication.

Objective To discuss the feasibility of constructing the system of traditional Chinese medicine nursing diagnosis.Methods Based on the theoretical analysis and status quo analysis,the feasibility of constructing the system of TCM nursing diagnosis was discussed,and the achievements and problems waiting for settlement were also narrated.Resuts It has the foundation of constructing the system of TCM nursing diagnosis,but some problems still need to be solved.Conclusions It is feasible for building TCM nursing diagnosis system,and the TCM nursing diagnosis system does not conflict with NANDA-I.

Objective To analyze the occurrence of infections relative to percutanous biliary drainage(PTBD)or stenting for malignant obstructive jaundice and explore the therapy and prevention. Methods 181 patients(130 male and 51 female; median age 64.5 years old)with malignant biliary obstructive jaundice were investigated including 81 hepatobiliary cancers,42 pancreatico-ampullae tumors,58 gestro-intestinal portal lymphatic metastasis. All cases accepted PTBD or placement of metallic stents and the perioperative complications were recorded and analysed including the occurance and treatment. Results All cases accepted PTBD or stenting successfully. The perioperative biliary infection was the major complication including 50 out of 62 preoperative infected cases(34.25%). 18 cases(15.13%)suffered from biliary infection after operation with 13 under control,5 without control,4 complicated with pulmonary infection and 17(9.39%)died of serious biliary infections. Gram-negative bacilli and endotoxin were the main cause of the severe biliary infection. Postoperative mild pancreatitis occurred in 65 cases(35.91%)without severe necrotic changes and were cured after anti-inflammatory treatment. Hepatic abscess due to biliary leak occurred in 1 case(0.55%),and was cured by CT-guided drainage. Conclusion Biliary infection is the most common complication after interventional therapy and should be promptly under control for preventing mortality and prolonging survival. Simultaneously,acute pancreatitis should also be on alert but good prognosis would be obtained with apt therapy.(J Intervent Radiol,2007,16: 693-695)

In this paper,we analyzed one case of primary multifocal extranodal non-Hodgkin's lymphoma and reviewed the related literatures.We investigated the clinical data of this case with primary multifocal extranodal lymphoma and retrospected the related references.The key words,primary extranodal lymphoma and multifocal,were used to search Pubmed and Wanfang Database,and finally only three cases were found.The 68-yea-old woman was confirmatively diagnosed as primary multifocal extranodal B cell non-Hodgkin's lymphoma.The positron emission tomography/computed tomography (PET/CT) scan showed multiple hypermetabolic lesions in the left humerus,both kidneys and ileum.The confirmative diagnosis was based on clinical manifestations and serological tests,imaging features of CT and PET/CT,and especially on the histopathological and immunohistochemical studies.After one cycle chemotherapy (rituximab,Vincristine and prednisone) and another cycle (rituximab,Vincristine,cyclophosphamide and prednisone),a repeat PET/CT scan showed a complete metabolic resolution of the lesions in the kidneys and ileum,and a partial metabolic resolution of the left humerus.After four cycles of chemotherapy,there were new extensive involvements of the right supraclavicular and intrapulmonary lymph nodes,bilateral pleural and pericardium,and the patient gave up chemotherapy.This case demonstrated the imaging findings of an uncommon primary multifocal extranodal lymphoma in left humerus,both kidneys and ileum,and highlighted the usefulness of CT and PET/CT scan in identifying the extent of disease involvement,in guiding a biopsy,and in assessing the treatment response of lymphoma.It is essential to differentiate between primary multifocal extranodal lymphoma and lymphoma extensive metastases.

Pediatric surgery is the important part of the paediatrics,and the complicated content,limited time and many difficulties are the main problems of pediatric surgery teaching. The multimedia courseware is used in teaching of pediatric surgery,which is convenient for teachers'preparing lessons and teaching and is beneficial to students'review and summary. After the technique is used,the teaching efficiency and the quality are obviously improved.