OBJECTIVE To develop technique of central vein catheterization by external jugular vein puncture under ultrasound guidance.METHODS A total of 224 patients with central vein catheterization by external jugular vein puncture were randomized into two groups: the control group was treated by routine manipulation and observed blood vessels by macroscopic observation;the patients from the observation group were placed catheters with the assist of ultrasound techniques.To record the one time achievement ratio of catheterization and incidence of phlebitis and thrombus.RESULTS Comparing the two groups,we found the observation group had higher one time achievement ratio of catheterization and lower incidence of phlebitis and thrombus than that of the control group.And there were statistical significances between the two groups(P

Objective To compare the effects and complications of lumboperitoneal shunt ( LP ) and ventriculoperitoneal shunt ( VP ) in the treatment of post?traumatic hydrocephalus. Methods Eighty patients with post?traumatic hydrocephalus treated in the neurosurgery department of Zhangjiagang Hospital of Traditional Chinese Medicine from March 2014 to March 2010 were retrospectively analyzed. The patients were randomly divided into two groups,40 patients treated with LP were assigned into the LP group and 40 patients undergone VP treatment were seen as the VP group. All patients were followed up for 1 year to investigate and compare the symptom improvement rate,neurological deficit score and the incidence of complication of the two groups. Results The total effective rate of hydrocephalus disappearance in the LP group was 41. 50% ( 37/40) and 87. 50%( 35/40) in the VP group. The difference between the two groups was not statistically significant (χ2=0. 556,P=0. 456);the neurological deficit scores before treatment in the LP group and VP group were (28. 35±8. 64) points and (29. 13±7. 98) points,there was no significant difference between the two groups (t=0. 419,P=0. 676) . The difference in the scores of neurological deficit after treatment in the LP and VP group was not statistically significant ( (19. 32±5. 34) points vs. (21. 62±4. 86) points,t=1. 480,P=0. 143),the average scores of neurological deficits in the two groups were significantly better than those before treatment ( t=5. 623, 5. 084,P<0. 001 ) . There was no significant difference in the average score of improvement of urinary incontinence between the two groups before and after treatment ( t=0. 376,1. 265,P>0. 05) ,the average score of urinary incontinence improvement after treatment in both groups were better than those before treatment ( t=4. 891,5. 370,P<0. 001) . In the LP group,the incidence of bleeding,infection,shunt related complications and shunt abnormality were all 2. 50% ( 1/40 ) , the overall complication rate was 10. 00%, the incidence of bleeding,infection,shunt related complications and shunt abnormality in the VP group were 7. 50% (3/40), 10% ( 4/40 ) , 5% ( 2/40 ) 10%, ( 4/40 ) , the overall complication rate was 32. 50%, there was significant difference between the two groups (χ2=6. 050,P=0. 014) . Conclusion LP and VP have significant curative effect on the treatment of post?traumatic hydrocephalus,but the overall incidence of LP complication after 1 year is significantly lower than that of VP,and is worth popularizing widely in clinical practice

Objective:To explore the clinical characteristics of Haff disease in our hospital,be familiar with the disease and provide some experience in diagnosis and treatment.Methods:Inpatients with Haff disease in our Kidney disease center between July and August 2016 were retrospectively analyzed.The clinical data of patients was collected and statistically analyzed.Results:There were 66 patients (28 of male and 38 of female) in total with Haff disease between July and August 2016 in our ward.The average onset age was 35.5 years old (18-76 years old) and the average latency period was 5.6 hours (1-24 hours).All the patients had crayfish before the onset of the disease.The initial symptoms included muscle pain and concentrated brown urine (19 cases,28.8％).Laboratory tests suggested that transaminase and myotropin were increased significantly (alanine aminotransferase,aspartate aminotransferase,lactate dehydrogenase,creatine kinase,myoglobin and creatine kinase isoenzyme).A trace of blood (45％) and protein (16.7％) was present in some patients' urine test.After treatment,muscle pain was alleviated and urine color turned to clear in all patients.All the transaminase and muscle enzymes were significantly decreased (P＜0.05).No blood or protein was detected in the urine test.Conclusions:The epidemiology of Haffdisease in summer at Nanjing was related to the intake of crayfish.The latency period was short and the initial symptoms were mostly muscle soreness,with or without myoglobinuria.Laboratory tests showed serum creatine phosphokinase,myoglobin,creatine kinase isoenzymes were increased significantly.The treatment period was short with good prognosis.Generally no sequelae was observed.

Objective:To preliminarily study the characteristics of ventricular synchronicity in patients of idiopathic pulmonary arterial hypertension (IPAH) with different heart function.
Methods:Our research included in 2 groups:IPAH group, n=40 patients intermittently collected in our hospital from 2010-10 to 2014-12 and Control group, n=23 normal subjects from the same period of time. Tissue Doppler echocardiography was conducted to compare interventricular systolic and diastolic time to peak (Ts and Te), their differences (Te-Ts) and (Te-Ts) of left ventricle (LV), right ventricle (RV), interventricular septum (IVS) between 2 groups.
Results:Ts and Te of RV were longer than Ts and Te of LV and IVS in both groups, P<0.05. Compared with Control group, by heart function reducing, IPAH group showed different Ts and Te of LV and IVS, P<0.05 and Ts was gradually prolonged, Te was gradually shorter;while Te of RV became longer firs tand then became shorter thereafter. In IPAH group, the patients with heart function grade IV had the longer Ts of LV and IVS than those with heart functionII, III;the patients with heart function IV had the shorter Te of LV, RV and IVS than those with heart function II, III, all P<0.05. In IPAH group with different heart function, Te between RV-IVS and RV-LV were different from Control group, all P<0.05;Te between LV-IVS in heart function IV patients had the largest difference from Control group, P<0.05. Compared with Control group, IPAH group had gradually decreased Te-Ts of LV and IVS by heart function reducing asgrade II>III>IV, all differences had statistic meaning.
Conclusion:IPAH patients with different right heart function may have interventricular systolic and diastolic de-synchronicity;by reduced heart function, interventricular Te-Ts could be specifically shortened.