Since continuous renal replacement therapy(CRRT) is a continuous treatment,extracorporeal anticoagulation is an important measure to ensure the success of CRRT.We briefly describe the basic principles,modes and monitoring objectives of anticoagulation in CRRT.Besides,heparin anticoagulation,anticoagulation without heparin and regional citrate anticoagulation(RCA)are presented in details.We emphasize that anticoagulation mode should be individualized,and the correct selection of anticoagulation mode and intensive clinical monitor are essential to prevent complications.

To explore the analgesic effect of propofol combine with dezocine after painless abortion and the influence on stress hormone and hemodynamics of the patients. Methods:Totally 126 cases of patients with painless abortion in our hospital from March 2013 to March 2014 were randomly divided into the observation group and the control group with 63 ones in each. The observa-tion group was anesthetized with propofol combine with dezocine, while the control group was anesthetized only by propofol. The dosage of propofol, anesthesia effect and postoperative recovery of the patients in the two groups were compared, and the level of stress hor-mones and hemodynamic parameters before and after the surgery were also compared. Results: Compared with that in the control group, the dosage of dezocine and the score of VAS after the surgery was significantly reduced in the observation group with obviously better anesthesia effect, and the differences had statistical significance (P<0. 05). The level of Cor, NE and ACTH was significantly improved, and the level of A-I and A-II was reduced significantly in the observation group, and compared with that in the control group, the differences showed statistical significance(P<0. 05). Compared with those that in the control group, the levels of SBP, DBP and SpO2 were improved significantly and the level of HR was reduced significantly in the observation group during and after the surgery, and the differences showed statistical significance (P<0. 05). The incidence of adverse drug reactions in the observation group was significantly lower than that in the control group, and the difference had statistical significance (P<0. 05). Conclusion:Propofol combine with dezocine for the surgery of painless abortion can reduce the dosage of dezocine, improve the anesthesia effect and reduce the harem pain with lower stress hormone fluctuation, hemodynamic effect and incidence of adverse reactions.

Objective To summarize the diagnosis and treatment of urological trauma.Methods One hundred and sixty-two patients with trauma of kidney,ureter,bladder or urethra were treated between March 2002 and March 2012.The diagnosis,treatment and outcome were analyzed.Results All patients were discharged with improved condition.Of 62 patients with renal injury,45 were treated with conservative approach,9 were treated with superselective arterial embolization,and 8 were treated with nephrectomy.All the 62 patients had normal renal function during the follow-up period of 3 to 24 months.Of 2 patients with ureteral injury,one was treated with cystoscopic ureteral catheterization,and another one with ureteric reimplantation.Neither of the 2 patients developed hydronephrosis during the one year follow-up period.All 6 patients with vesical injury were treated with open surgery,and they all had normal urinary function during the follow-up period of 6 to 12 months.Of 92 patients with urethral injury,6 were treated with urethral catheterization,18 with urethral realignment,35 with cystoscopic urethral realignment,4 with urethral repairment,and 29 with end-to-end anastomotic urethroplasty; 29 (32％) patients suffered from urethral stricture during the follow-up period of 6 to 24 months,and they underwent further treatment.Conclusions Urological trauma is quite frequent,and early diagnosis and treatment is important.Good outcomes will be achieved in most of patients by suitable treatments,but complications which need further treatments may occur subsequently in part of the patients.

Cerebral small vessel diseases refer to small intracranial vascular lesions caused ischemic or hemorrhagic disease.Although researches have performed a large number of studies for its pathogenesis,it remains unclear now.This article reviews the pathogenesis of cerebral small vessel diseases from endothelial dysfunction,blood-brain barrier damage,ischemic and hypoperfusion,amyloid deposition,and genetic factor.

Clavicle ; injuries ; surgery ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans

OBJECTIVE:To determine the concentration of ozagrel in human plasma by RP-HPLC.METHODS:The sample separation was performed on a SinoChrom OPS-AP column.The mobile phase consisted of 0.025 mol?L-1 potassium dihydrogen phosphate buffer solution-acetonitrile(85∶15) with a flow rate of 0.8 mL?min-1 and a detection wavelength of 274 nm.The internal standard was levodropropizine.RESULTS:The linear range of ozagrel was 0.7～21.3 ?g?mL-1,(r=0.999 6).The extraction recovery of ozagrel was 83.78%～89.14% and the methodological recovery of it was 101.95%～106.68%.The intra-day RSD and inter-day RSD were 1.33%～3.27% and 2.72%～5.97%,respectively.CONCLUSION:This method is simple,rapid,accurate and reproducible,and it is applicable for the pharmacokinetic study of ozagrel in human plasma.

Objective To investigate the effect of tanshinone ⅡA on growth and apoptosis in human hepatoma cell line BEL 7402 in vitro . Methods The human hepatoma cell line BEL 7402 was treated with tanshinone ⅡA at various concentrations for 72 h. Cytotoxicity was evaluated by MTT assay, apoptosis related alterations in morphology ascertained by cytochemical staining(Hoechst 33258) and transmission electron microscopy(TEM). Apoptotic rate was quantified by flow cytometry (FCM). Results Tanshinone ⅡA inhibited the growth of hepatoma cells in a dose dependent manner, with IC 50 values of 6.28 ?g/ml. After treatment with 1～10 ?g/ml tanshinone ⅡA for 72 h, BEL 7402 cell apoptosis with nuclear chromatin concentration and fragmentation as well as cell shrinkage and the formation of apoptotic bodies were observed. FCM analysis showed hypodiploid peaks on histogram and the apoptotic rates at 5 ?g/ml concentration for 12, 24, 36, 48 and 72 h were (2.32?0.16)%, (3.01?0.35)%, (3.87? 0.43 )%, (6.73?0.58)% and (20.85?1.74)% respectively, which were all significantly higher than that of control group (1.07?0.13)%. Conclusion Tanshinone ⅡA can induce the apoptosis of human hepatoma cell line BEL 7402 in vitro , which may be related to the mechanism of growth inhibition of the human hepatoma cell line.

Objective To investigate the effect of low molecular weight heparin (LMWH) on the prevention of deep venous thrombosis in patients with lower limb fracture.Methods 213 cases of peripherally inserted central venous catheter after deep venous thrombosis of lower extremity fractures from February 2014 to October 2016 in our hospital orthopedic surgery were retrospectively analyzed,according to whether patients with low molecular weight heparin were divided into two groups,which did not use low molecular weight heparin in patients with 104 cases as control group,using the low molecular weight heparin in 109 patients as study group,with seven days of treatment as the observation period, the blood rheology indexes of the two groups of patients and the incidence of deep vein thrombosis were analyzed.Results After treatment, the blood viscosity, fibrinogen, and plasma D-dimer levels of the whole blood decreased in both groups, and the levels of plasma D-dimer were significantly lower in the study group than in the control group (P<0.05);the plasma viscosity of the study group was significantly lower than that of the control group (P <0.05).After treatment,the recurrence rate of deep venous thrombosis in the study group was significantly lower than that in the control group ( P<0.05 ); The effective rate of treatment group was 96.33%was significantly higher than the control group 76.92%(P<0.05);study group incidence of adverse reactions 1.83%was significantly lower than the control group 7.69%( P <0.05 ) .Conclusion Low molecular weight heparin can effectively improve the indexes of Hemorheology in patients with lower limb fracture after central venous catheter puncture, reduce the risk of deep vein thrombosis, and have a clear preventive effect.

ObjectiveTo derive and evaluate the formula of exactly calculating the contrast dosage used during pulmonary CT angiography ( CTPA ). Methods Time density curves in 27 patients who underwent CTPA were collected and analyzed,the formula for calculating contrast dosage during CTPA was derived.68 patients suspected of pulmonary embolism ( PE ) clinically but no PE on CTPA were divided randomly into group A,with bolus tracing technique ( n =26 ),and group B,with small dose injection contrast test (SDCT) (n =42).The CT values of the right main pulmonary artery (RMPA),right upper pulmonary vein ( RUPV),right posterior basal PA,right lower PV (RLPV) and the aorta were calculated.The total contrast dosage and the hard beam artifact in the SVC were compared between the two groups.Student's t test,Chi-square test and Mann-Whitney U test were used.ResultsThe ratio of the time from starting injection to enhancement peak of caudal end of SVC and the time to enhancement peak of the main pulmonary trunk was 0.65 ±0.09 (about 2/3),the formula for contrast dosage calculation was derived as (DTs/3 + STs/2) FR ml/s.The CT values of RMPA and RLPA between the two groups[ (301 ±117),(329 ± 122) and (283 ±95),(277 ±98) HU respectively] were not significantly different (t =1.060,P =0.292 ;t =2.056,P =0.044),but the differences of CT values in the paired PA and PV between the two groups (median were 22.5,58.0 and 170.5,166.5 HU respectively ) were significant (U =292,P =0.001 and U =325,P =0.005),contrast artifact of the SVC (grade 1-3) in group B ( n =34,7,1 respectively) was significantly less than in group A (n =11,10,5 respectively,x2 =10.714,P =0.002),the contrast dosage injected in group A was ( 87.6 ± 7.3 ) ml,and in group B was ( 40.0 ±5.4) ml (P ＜0.01 ).ConclusionCTPA with SDCT technique is superior to that with conventional bolus tracing technique regarding contrast dosage and contrast artifact in the SVC.

[Objective]To discuss the effective treatment of complicate intertrochanteric hip fracture.[Method]Thirty-five cases with complicate intertrochanteric hip fracture.The class of fracture,surgery method,operating time,complicatico,union rate of fracture were amounted statisti cally.[Result]All the 35 cases were surgical treated,l 4 cases with PFN(priemeral femur nail),21 cases with DHS(dynamic hip screw)with mean time of operation 1.8 h(1.5~3 h),mean amount of blood loss during operation 300 ml(150~500 ml),mean time in bed 2.4 monthes (1.2~3 monthes),mean following-up time 12 months(6~16months).Thirty-one cases got union,3 cases union time delayed,1 case nounion,union rate was 88.5%.Four cases suffered hip iversion( 11.4%),the screw in the neck removed in 6 cases(8.5%),5 cases feeled pain in hip( 14.2% ).[Conclusion]The complicate intertrochateric hip fracture is a kind of fracture which can not be treated easily.Using PFN and DHS can not control the stability effectively.Additional fixation of the greater trochantar fracture is necessary.Added out-fixation and avoid early bearing are useful.