The peripherally inserted central catheter occlusion is not rare in adults.Its occurence is related with the catheter's tip position,catheter type and the skills of medical staff.Personnel training is particularly important in the prevention of occlusion.Urokinase and heparin can be used for thrombolysis.

Objective To evaluate the effectiveness, the influence on cellular immune function and the side-effect of bacillus of Calmette-Guerin polysaccharide nucleic acid(BCG-PSN)combined with antituberculous chemotherapy in the treatment of pulmonary tuberculosis. Methods A total of 60 pulmonary tuberculosis patients were divided into treatment group(30 patients)and control group(30 patients)by random digits table. All patients accepted the same standard antituberculous chemotherapy, meanwhile patients in treatment group were injected with BCG-PSN. Observed and compared the clinical symptom,the size of the focas nidus,the change of toxic response and immunity. Results The symptoms were significantly relieved in both groups after treatment(P＜0.05), but it was significantly better in treatment group(P＜0.05), the effective rate and control rate in treatment group[36.7%(11/30),96.7%(29/30)]were significantly higher than those in control group[23.3%(7/30), 86.7%(26/30)](P ＜ 0.05). After treatment,the levels of CD3,CD4 and IL-2 were higher, and the level of CD8 was lower, but the treatment group improved significantly better than control group(P ＜ 0.05). The rate of leukopenia was lower in treatment group than that in control group[10.0%(3/30)vs. 33.3%(10/30),P ＜0.05]. As to the safety,no other toxicities were observed in the treatment group. Conclusions BCG-PSN combined with antituberculous chemotherapy in the treatment of pulmonary tuberculosis contributes to relieve the symptom, reduce size of the nidus, decrease leukopenia incidence and enhance the cell immunity. It is safe.

Objective To investigate the nasal endoscope Television Co-line self-retaining laryngoscope vo-cal polyps surgery treatment. Methods 121 cases diagnosed of vocal cord polyp (of which 54 cases of bilateral, u-nilateral 67 cases), in the serf-retaining laryngoscope and surveillance camera system of vocal cord polyp removed and opened Lacunar Reinke and will preoperative laryngoscopy and laryngoscopy after surgery and review the results of the video and retain. Results 4 weeks to review 70° nasal endoscope, and 116 cases of vocal sounds close to nor-mal, the cure rate reached 95.9 percent, and the remaining five cases because of vocal hypertrophy or incomplete closure of the vocal cords, sounds worse than normal shoots. Follow-up 3～18 months without recurrence, no serious complications. Conclusion The nasal endoscope and television surveillance camera system of amplification, in par-ticular, Reinke Lacunar throat image more clearly, so that lesions can be completely removed, and the vocal cords can be a very good organization had to protect, and by retaining the video can be pre-operative, during and after vo-cal dynamic comparative situation.

Objective To investigate the molecular mechanisms of beta3 adrenoceptor subtypes mediating rat detrusor relaxation. Methods Cyclic adenosine monophosphate(cAMP) was detected by radioimmunoassay, the effects of the cyclic AMP inhibitor SQ 22,536 and the cyclic AMP dependent protein kinase inhibitor H 89 on the relaxation elicited by ISO and BRL37344A in the rat ditrusor were investigated based on pharmacological evaluations. Results After the stimulating of ? AR by ISO, the levels of intracellular cAMP was increased, and the relaxation mediated via ISO could be partly inhibited by SQ 22,536 or H 89 The concentrations of intracellular cAMP had no changes in the presence of SQ 22,536 or H 89, and the relaxant responses to BRL37344A was not affected by SQ 22,536 or H 89. Conclusion The effects of ISO via? AR on relaxant responses to detrusor was mediated mainly by the cyclic AMP independent pathway and in part by the cyclic AMP dependent pathway, but cAMP PKA pathway were not involved in the beta3 adrenoceptor signaling pathway

Objective To determine the in vitro antifungal effects of closantel against Candida albicans.Methods A microdilution method was used to determine the minimum inhibitory concentration (MIC)of fluconazole alone and in combination with closantel against Candida albicans standard strain CAF-2.Ten strains of Candida albicans were cultured in RPMI-1640 liquid culture containing 10％ calf serum with or without the presence of closantel at 16 mg/L,followed by the observation of hypha formation.Transmission electron microscopy (TEM) and scanning electron microscopy (SEM) were performed to observe the ultrastructure of Candida albicans CAF-2 strain after exposure to closantel at 16 mg/L for 24 hours.Results Closantel could inhibit the growth of Candida albicans,and enhance the antifungal effect of fluconazole against Candida albicans in vitro.The percentage of Candida albicans forming hypha was 91.2％ ± 3.9％ in untreated Candida albicans,significantly higher than that in closantel-treated Candida albicans (29.8％ ± 5.1％,t =30.24,P ＜ 0.05).As TEM showed,closantel-treated Candida albicans gave a round,oval or pleomorphic appearance,with an irregular budding from the cell surface.Further more,the electron dense layer in the outer layer of cell wall was absent or unevenly distributed,the transparent layer was irregularly thickened,some cell membrane was locally disrupted or collapsed,and intracellular vacuoles increased after closantel treatment.Scanning microscopy revealed a rough surface,sparse and irregular budding of Candida albicans after treatment with closantel.Conclusion Closantel exhibits a promising anti-Candida albicans property in vitro.

Objective To compare magnetic resonance spectroscopy (MRS) characteristics and changes before and after 5-Fu interventional thermochemotherapy (ITC) as well as to analyze the correlation of Cho/Lip and apoptosis index (AI) in hepatic VX2 carcinoma animal model.Methods 20 rabbit models of hepatic VX2 carcinoma were implanted successfully.Ten days later,as tumor diameter≥ 10 mm,routine scan and 1H-MRS were performed before one day and after 14 days on all of rabbits by Philips 1.5T MR scanner.The changes of Cho peak,Lip peak and the ratio of Cho/Lip before and after the treatment were analyzed.Specimens of AI were examined and compared with the ratio of Cho/Lip.Results The Cho peak and Lip peak were increased before ITC.After ITC,the Cho peak and the ratio of Cho/Lip decreased than before.The Lip peak was further increased than that of before.AI was correlated negatively with the ratio of Cho/Lip (r =-0.56,P =0.02).Conclusions The metabolites of different ROI are matched with the levels and scopes of AI.1H-MRS can be used to evaluate tumor cell apoptosis and energy metabolism changes of the rabbit models of hepatic VX2 carcinoma with the treatment.

Objective To investigate the influence of intravenous infusion by double-lumen peripherally inserted central catheter (PICC)on continuous dynamic central venous pressure(CVP)monitoring.Methods In the patient undergoing the double-lemon PICC,continuous dynamic CVP monitoring was performed by a lumen and the intravenous infusion was conducted by another lu-men.Whether the simultaneous venous infusion affecting the values of continuous dynamic CVP monitoring was observed.Results Intravenous infusion through double-lumen PICC had no influence on simultaneously continuous dynamic CVP monitoring (P>0.05),which could influence the values of CVP monitoring when simultaneously using the intravenous infusion pump(P<0.05). The speed of pumping fluid had no influence in a shout time(10 min),with significant difference(P>0.05).The CVP values could recovered to the status before infusion when continuously infusing after stopping using the infusion pump.Compared with before in-fusion,the CVP values after stopping intravenous infusion had no obvious change(P>0.05).Conclusion Intravenous infusion by double-lumen PICC has no influence on continuous dynamic CVP monitoring.But simultaneously adding infusion pump has certain influence on the CVP monitoring values.

Objective This study investigates the relationship of serum irfflammatory cytokine levels with intracranial pressure (ICP) in patients with severe traumatic brain injury (TBI) after surgery.Methods A total of 32 cases with severe TBI and placement of ICP monitor were prospectively enrolled.Serum was collected before surgery and every 12 h after surgery.Cytokines levels of interleukin (IL)-1β,IL-8,and tumor necrosis factor (TNF)-α were analyzed and compared with outcome of patients.Hourly values of ICP were recorded.The degree of ICP above treatment threshold (20 mm Hg) were calculated every 12 h as pressure times time dose(PTD-ICP20),which was compared with serum cytokine levels before (Pre) and after (Post) the 12-hour time period using linear regression method.Results Serum IL-1β (P＜0.05),IL-8 (P＜0.01) and TNF-a (P＜0.01) levels elevated dramatically after severe TBI and were significantly associated with outcome of patients.Mean PTD-ICP20 was (42.9 ± 60.2)mm Hg/h and was correlated with increased Pre-IL-8 (r=0.554,P＜0.001),Pre-TNF-α (r=0.597,P＜0.001),Post-IL-8 (r=0.629,P＜0.001) and Post-TNF-α (r=0.538,P＜0.001) levels.Conclusion Serum IL-8 and TNF-α demonstrated the most promising candidate bio.rnarkers of impending ICP elevation in this study.These findings indicate a feasible way of monitoring patients with severe TBI.

A retrospective analysis was carried out in 36 patients with blunt diaphragmatic rupture during March 1991 and March 2006. Twenty-two diagnoses were confirmed preoperatively, and the rest 14were confirmed perioperatively. Three patients underwent surgical treatment after no response to conservative therapy. Thoracotomy was performed in 21 patients, laparotomy in 9, thoracotomy plus laparotomy in 5 and combined thoraco-laparotomy in 1. Most diaphragmatic rupture may be caused by blunt collision and could lead to thoracoabdominal injury. In spite of high mortality rate, the condition is usually under diagnosed. Definite diagnosis and timely operation are important to increase survival rate and reduce mortality.

Objective To explore methods of quickly identifying loopholes in medical quality management and to improve medical quality by means of analyzing low-risk death cases.Methods Two rounds of analysis of 1 14 low-risk death cases of hospitals in Beijing in 2012 in terms of data quality and medical procedures,in an effort to identify problems and to verify the feasibility and accuracy of the method through interaction with other data.Results Totally 585 760 inpatients were discharged in 2012 from 21 hospitals,of whom 1 5 1 1 93 being low-risk cases.Such cases included 1 14 low-risk death cases, accounting for 0.01 9% of the total discharged,and 0.075% of low-risk discharged cases.Analysis of these medical records found 50 cases of problematic diagnosis (43.86%),45 cases of possible defects in diagnosis and treatment (39.47%),39 cases of missing items of secondary diagnosis (34.21%),and 28 cases of missing items of surgery/operation (24.56%). Some of the abovementioned cases had overlapping mistakes.Conclusion Analysis of low-risk death cases can help focus among massive data of medical records,problems of diagnostic and therapeutic insufficiency,pinpointing common problems in medical service and improving medical quality and fine management of hospitals.