Objective To investigate the technique and effect of tunneled cuffed catheter as long-term hemodialysis access and the prevention of its related complications.Methods Permcath cuffed dual lumen catheter wag implanted in patients by the standard Seldinger technique,that a guidewire wss inserted into deep central vein, following by the insertion of the cuffed catheter through a peel-away sheath.The catheter related complications were observed.Urea reduce rate(URR),the Kt/V,the normalized protein catabolic rate(nPCR)and the time-averaged BUN concentration(TACurea)were measured as the index of the effect of hemodislysis.The effects were compared to those of arteriovenous fistula(AVF)within the same period(in 20 cases).Results In the total of 25 patients, 23 catheters were implanted in the internal jugular vein (21 cases at right,two at left side),one in the subclavian vein and one in the external jugular vein.Except for that one case died of cerebral infarction,all patients were using the catheter in well condition.Catheter related thrombosis or underfed occurred in 4 cases for 9 times, which became fluent after thrombolytic therapy or the adjustment of catheters.Catheter related infections occurred in 2 cases,and were successfully treated with anti-inflammation therapy.The average URR was 71.03%,Kt/V was 1.29,TAC urea was 12.74 mmol/L,and nPCR was 0.93 g/(kg·d)in all 25 patients,which was not significant different compared to patients with AVF((URR 72.46%,Kt/V 1.31,TACurea 12.86 mmol/L,nPCR 0.94 g/(kg·d)).Conclusions Cuffed dual lumen catheter for long-term aecegs in persistent hemodialysis has good effect on hemodialysis. Good catheter implanting technique and prevention of complications may improve the application of the catheter.

Objective To investigate the features of white matter impairment and its relationship with cognition in patients with amnestic mild cognitive impairment (aMCI).Methods Eighty-three cases of aMCI and 85 normal aging volunteers were scanned with diffusion tensor imaging (DTI) using MR system.All subjects completed the neuropsychological battery.We analyzed the differences between two groups using tract-based spatial statistics and the association between regions in difference and cognition using correlation analysis.Results There were significant differences between aMCI and normal control in the neuropsychological battery including the Mini-Mental State Examination(26.2 ± 2.6 vs 28.3 ± 1.3,F =43.224,P =0.000),Mattis Dementia Rating Scale-2 (131.4 ± 6.9 vs 138.0 ± 3.5,F =62.308,P =0.000),Auditory Verbal Learning Test-delayed recall(2.4 ± 1.6 vs 7.5 ± 2.0,F =324.018,P =0.000),Boston Naming Test(8.7 ± 1.4 vs 9.2 ± 1.0,F =6.821,P =0.010),Rey-Osterrich Complex Figure Test (12.1 ± 7.3 vs 18.5 ± 6.1,F =40.674,P =0.000),Symbol Digit Modulation Test (30.0 ± 10.1 vs 38.6 ± 9.8,F =30.786,P =0.000),Trail-Making Test Part B ((256.8 ± 124.5) s vs (178.1 ± 59.0) s,F =27.601,P =0.000).Significantly higher diffusivity indexes and radial diffusivity were also found in aMCI subjects compared to healthy elders in the parahippocampal,superior longitudinal fasciculus,inferior longitudinal fasciculus,superior fronto-occipital fasciculus,inferior fronto-occipital fasciculus,unciform fasciculus,corticospinal tract,corpus callosum,cingulum,corona radiate.We also found that axial diffusivity was significantly increased in the parahippocampal,superior longitudinal fasciculus,inferior longitudinal fasciculus,superior fronto-occipital fasciculus,inferior fronto-occipital fasciculus,unciform fasciculus,corticospinal tract and corpus callosum,whereas fractional anisotropy changes were not observed in aMCI.Diffusivity indexes values in bilateral frontal lobe (left r =0.67 ; right r =0.70),left cingulum (r =0.63),parietal white matter (r =0.69) and radial diffusivity values in left parietal (r =0.68) were significantly related to Trail Making Test A among aMCI (all P ＜ 0.05).Conclusions In aMCI patients,there was a wide range of white matter damage,with no brain region-specific.Executive function deficit was related to the white matter impairment in bilateral frontal lobe,left cingulate and parietal lobe.The specificity and sensitivity of four DTI parameters fordetecting white matter lesions are variant.Trial registration Clinical Research Center of Jiangsu Province (BL2013025)

Objective To investigate the role of NF-κB/survivin signal pathway in the intima hyperplasia of rat carotid balloon injury restenosis model.Methods NF-κB siRNA lentivirus vector(titer was 1 × 108 TU/ml)was established.Carotid balloon injury restenosis model was made in 33 SD rats.The rats were divided into 4 groups according to different processing methods,including negative control (NC) group (n =11),NF-κB siRNA group(n =11),NF-κB siRNA + YM155 (survivin inhibitor) (n =11),the uninjured carotid artery served as the normal control group(n =1 1).After 7 days,the carotid sample(n =5 each group)were harvested to detect the NF-κB and survivin mRNA expression by RT-PCR.The carotid sample were harvested on 28 days (n =6 each group) for HE staining and measuring intima hyperplasia.Immunohistochemical method was also used to detect the expression of intima proliferation cell nuclear antigen (PCNA) and media α-SM-actin.Results (1) After 7 days,NF-κB and survivin mRNA expression was significant higher in NC group than in normal control group (P ＜ 0.05),the NF-κB mRNA expression was significantly lower in NF-κB siRNA group than in NC group (P ＜ 0.05) and similar between NF-κB siRNA group and NF-κB siRNA + YM155 group.The survivin mRNA expression was significantly lower in NF-κB siRNA group compared to NC group (P ＜ 0.05) and significantly higher in NF-κB siRNA group than in NF-κB siRNA + YM155 group (P ＜0.05).(2) After 28 days,intima hyperplasia was observed in NC (0.13 ±0.01),NF-κB siRNA (0.11 ±0.01) and NF-κB siRNA +YM155 group(0.09 ±0.01)mm2(P ＜ 0.05).Media area was similar among NC group,NF-κB siRNA group and NF-κB siRNA + YM155 group (P ＞ 0.05).L/M ratio was gradually reduced among NC group(1.55 ± 0.07),NF-κB siRNA group(0.92 ± 0.08),NF-κB siRNA + YM155 group(0.76 ±0.06,all P ＜0.05).Similar results were found in the residual restenosis rate:NC group (58.71 ± 0.02) ％,NF-κB siRNA group (32.13 ± 0.05) ％,NF-κB siRNA + YM155 group (26.42 ± 0.03) ％ (all P ＜ 0.05) and expression of vascular smooth muscle cell PCNA:NC group(45.32 ± 7.21) ％,NF-κB siRNA group(36.54 ± 6.42) ％,NF-κB siRNA + YM155 group(28.57 ± 6.31)％ (all P ＜ 0.05).On the contrary,the IOD of α-SM-actin in media increased gradually:NC group (0.055 ± 0.006),NF-κB siRNA group (0.072 ± 0.011),NF-κB siRNA + YM155 group(0.084 ±0.008,all P ＜ 0.05).Conclusion Inhibiting NF-κB expression can significant decrease intima hyperplasia in this model,and this effect may be mediated by inhibiting survivin and reducing the proliferation of vascular smooth muscle cells.

Objective:To explore the application value of non-invasive prenatal testing (NIPT) technology in twin pregnancy.Methods:A total of 339 twin pregnant women who underwent NIPT at Dalian Municipal Women and Children′s Medical Center(Group), Dalian Jinpu New District Maternity and Child Health Hospital, and Dalian Lvshunkou District People′s Hospital from July 1, 2019 to June 30, 2021 were continuously retrospectively included. The clinical characteristics and test results of pregnant women with high-risk and low-risk were analyzed.Results:Among 339 pregnant women, 336 were successfully tested, with a success rate of 99.12%(336/339); 6 pregnant women were at high risk of NIPT, with a positive screening rate of 1.77%(6/339), including 1 case of high risk of trisomy 13, 2 cases of high risk of trisomy 18, and 3 cases of high risk of Trisomy 21; the results of amniocentesis for 2 high-risk pregnant women were not abnormal.Conclusions:NIPT technology is non-invasive, safe and efficient, and is suitable for large-scale prenatal screening. However, the detection accuracy of pregnant women with twin pregnancy needs to be improved.