Peripherally inserted central catheter (PICC) has become internationally widespread in various healthcare settings (hospital, clinics ,homecare, et al), mainly used for administration of chemotherapy drugs, hypertonic parenteral nutrition solution and infusion therapy in two extreme age patients (neonates, especially in premature infants;elderly), which provides necessary vascular access for medium to longer term transfusion therapy. The risks of complications related with PICC are still existed, and PICC site with impaired skin integrity is prevalent, but described by only paucity of literature. International evidence-based guidelines provide little strategy. Our study was to review PICC site with skin injury in order to better understand the etiology, evolution and familiar with the international nursing dynamics, and identify directions for future research in this field, promote to overcome the nursing conundrum, and provide a basis for construction of guidelines for the skin management of PICC.

Objective To measure the prevalence and analyzed associated factors of medical adhesive-related skin injuries (MARSI) at PICC insertion site in patients with hematologic malignancies. Methods A cross- sectional observational study lasting two weeks was carried out in Department of Hematology. Skin assessment data and photographs of skin were collected during PICC maintenances by the same investigator. The related information was got out from the medical record. The observed skin injuries were classified by the dermatologist and PICC specialized nurse together. MARSI prevalence was calculated. The associated factors were analyzed statistically. Results All of the 153 patients with hematologic malignancies were included. The prevalence of total MARSI at PICC insertion site was 33.99%(52/153), including mechanical skin injury (22.87%,35/153), contact dermatitis (CD) ( 9.80%,15/153), moisture-associated skin damage (0.65%,1/153), folliculitis(0.65%,1/153), respectively. Multivariate analysis identified two independent risk factors for mechanical skin injury including age≥50 years old, P=0.016, odds ratio (OR)=5.919, 95%CI 1.389-25.220 and non-specialist nurses in PICC maintenance, P=0.013, OR=8.333,95%CI 1.566-44.360. History of skin allergies (P=0.000,OR=12.333,95%CI 3.669-41.454) and arsenic trioxide infusion through PICC(P=0.003,OR=4.565,95%CI 1.661-12.547) were associated with CD. Conclusions MARSI at PICC insertion site is a prevalent event in the patients with hematologic malignancies. Epidemiological data and independent risk factors are presented in our study, which provide a basis for future study in this area.

Objective To compare analgesic and anti-inflammatory effects of Gentianopsis Paludosa and Sophora Alopecuroide of different kinds of compatibility on the mice.Methods Mice were randomly divided into normal control group, positive medicine group, and different kinds of compatibility groups, 10 mice in each group. Mice received gavage for successive 7 days, once a day. Glacial acetic acid twist body method and hot board to pain method were used to observe and compare analgesic effects of different kinds of compatibility. Xylene to ear swelling method and agar to granulation swollen method were used to observe and compare inflammatory effects of different kinds of compatibility.Results Compared with normal group, compound Gentianopsis Paludosa had obvious analgesic and anti-inflammatory effects (P<0.01). When the ratio of Gentianopsis Paludosa and Sophora Alopecuroide was 20:0.6 and 20:0.9, the analgesic and anti-inflammatory effects were the best.Conclusion Gentianopsis Paludosa and Sophora Alopecuroide have good analgesic and anti-inflammatory effects, among which, when the ratio of Gentianopsis Paludosa and Sophora Alopecuroide is 20:0.6, the best effects show.

Objective To investigate the effect of serous amyloid P (SAP) component on serum paraoxonase 1 (PON1) activity, serum monocyte chemotactic protein 1 (MCP-1) expression and atherosclerosis progression in ApoE-/- mice, and explore the possible mechanisms thereof. Methods Six male C57/BL6 mice were fed with chow diet as normal control group. Twelve male ApoE-/- mice fed with western diet for 12 weeks were used to establish animal models of atherosclerosis, and then randomly divided into two groups (6 each): SAP and PBS group. Mice in SAP group were treated (i.p.) with SAP (6mg/g) every other day from day 0 to day 14. Mice in normal and PBS group were treated (i.p.) with PBS (same volume as SAP group) every other day from day 0 to day 14. The blood specimen and aorta vascular tissues were collected at the 16th week after the first immunization. Serum lipids and PON1 activity were assessed. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of serum SAP and MCP-1. Hematoxylin-eosin (HE) staining was used to observe the formation of atherosclerotic plaque. Oil red O staining was performed to observe the lipid accumulation, and immunohistochemical staining was performed to detect the SAP expression in the atherosclerotic plaque. Results Compared with the normal group, the serum PON1 activity reduced significantly while MCP-1 expression increased (P<0.01), and a large number of plaques formed in the blood vessels of mice in SAP and PBS group. Compered with PBS group, SAP treatment markedly improved the PON1 activity (P=0.046) and down-regulated MCP-1 expression (P=0.032). Furthermore, SAP treatment significantly reduced atherosclerotic plaque area (P=0.001) and oil red O positive area (P=0.03). Conclusion SAP could mitigate atherosclerotic lesion through improving the property of PON1 and down-regulating the level of MCP-1.

OBJECTIVETo evaluate the feasibility of retroperitoneal laparoscopic surgery combined with ureteroscopic lithotomy through the pelvis for treatment of renal and ureteral calculi.

METHODSIn February 2010, 2 patients with renal and ureteral calculi underwent retroperitoneal laparoscopic surgery combined with ureteroscopic lithotomy through the pelvis.

RESULTSThe operation time in these two cases was 70 and 80 min, and the volume of intraoperative blood loss was about 20 ml. The exposure was excellent, and the patient recovered rapidly without complications or residual calculi.

CONCLUSIONRetroperitoneal laparoscopic surgery combined with ureteroscopic lithotomy through the pelvis is feasible for treatment of renal and ureteral calculi.

Aged ; Female ; Humans ; Kidney Calculi ; complications ; surgery ; Kidney Pelvis ; Laparoscopy ; Male ; Treatment Outcome ; Ureteral Calculi ; complications ; surgery

OBJECTIVETo evaluate the clinical application of susceptibility-weighted magnetic resonance imaging (SWAN) in lacunar cerebral infarction imaging.

METHODSForty-two cases of lacunar cerebral infarction, including 18 complicated by high blood pressure, 4 by type 2 diabetes and 12 by both high blood pressure and type 2 diabetes, underwent examinations with SWAN and conventional MRI sequences (including GRE sequence T(1) and T(2), T(2) gradient echo, T(2) FLAIR, DWI). The imaging data were analyzed in comparison with the clinical data of the patients.

RESULTSIn 23 patients with lacunar cerebral infarction, intracerebral micro-hemorrhage displayed point-like, round and oval low signal on SWAN. A total of 123 lesions were identified, distributing from the cortical, subcortical, basal ganglia, thalamus, brain stem to the cerebellum. The conventional sequences were more sensitive in detecting the majority of lacunar cerebral infarction than SWAN, while the latter showed better performance in displaying cerebral micro-hemorrhage, tiny blood vessels and small vascular malformations as well as other small vascular diseases. SWAN was superior to other sequences in showing lacunar cerebral infarction complicated by cerebral micro-hemorrhages.

CONCLUSIONMRI SWAN can better display lacunar cerebral infarction associated with cerebral micro-hemorrhages and small veins in the infract region. Identification of the micro-hemorrhages in lacunar cerebral infarction can be critical in determining the proper treatments. Patients with lacunar cerebral infarction are likely to have cerebral micro-hemorrhages in close relation to the number of lacunar infarction sites. The cerebral micro-hemorrhages and lacunar cerebral infraction are both signs of micro-vessel damage of the brain.

Aged ; Cerebral Infarction ; classification ; complications ; diagnosis ; Diabetes Mellitus, Type 2 ; complications ; Female ; Humans ; Hypertension ; complications ; Magnetic Resonance Imaging ; methods ; Male ; Sensitivity and Specificity

OBJECTIVETo compare the value of apolipoprotein B (apoB) and low-density lipoprotein cholesterol (LDL-C) in assessing the risk of coronary heart disease in patients with inconsistent apoB and LDL-C levels.

METHODSIn a total of 603 patients undergoing coronary angiography, apoB and LDL-C levels were categorized into high and low levels relative to the median levels of apoB and LDL-C, based on which the patients were divided into 4 groups with low apoB/low LDL-C, low apoB/high LDL-C, high apoB/low LDL-C, or high apoB/high LDL-C. According to the results of coronary angiography, we evaluated the number of coronary artery branches with lesions and the severity of coronary artery stenosis in the 4 groups to assess the correlation of apoB and LDL-C with cardiovascular risks.

RESULTSWe found significant differences in the number of coronary artery branches with lesions and the severity of coronary artery stenosis among the 4 groups (P<0.05). The number of coronary artery branches involved and the severity of stenosis differed significantly between patients with consistently high and low apoB/LDL-C levels (P<0.005). Compared with those with low apoB/low LDL-C levels, the patients with high apoB/low LDL-C levels showed a significantly greater number of coronary artery branches with lesions (P=0.017) and more severe stenosis (P=0.034), but such differences were not found in patients with low apoB/high LDL-C levels. Pearson correlation analysis identified LDL-C and apoB as the risk factors for cardiovascular disease with areas under the ROC curve of 0.579 (P=0.014) and 0.589 (P=0.006), respectively.

CONCLUSIONSIn patients with inconsistent levels of apoB and LDL-C, apoB and LDL-C levels are both risk factors of coronary heart disease in close relation with the disease severity. LDL-C and apoB are comparable for their important values in predicting the risk of coronary heart disease.

Objective To investigate the mechanism of Gentianopsis paludosa xanthone(GPX)combined with probiotics in the intervention of colon inflammation-tumor transformation in rats by regulating TGF-β1/Smads pathway and inflammatory factors.Methods Ninety rats were divided into the normal group,the model group[drinking sodium dextran sulfate(DSS)for 3 days]and the intervention group by random number table method.The model group was subdivided into the inflammatory stage group,the pre-inflammatory cancer group(DMH injection for 4 weeks),the intermediate inflammatory cancer group(DMH injection for 13 weeks)and the advanced inflammatory cancer group(DMH injection for 21 weeks).The administration group was subdivided into the groups(after the first day of drinking DSS,drugs for each group were given by gavage once a day for 8 weeks)on the basis of the advanced inflammatory cancer group,including the GPX group(GPX 69.3 mg/kg),the probiotic group,the combined group(GPX+probiotics 400 mg/kg)and the thalidomide group(thalidomide 13.5 mg/kg).The disease activity index(DAI),colon length and wet mass index were compared between all groups.Characteristics of colon tumors were observed,and pathological changes of colon were observed by HE staining.The expression levels of transforming growth factor(TGF)-β1,Smad4,Smad7,interleukin(IL)-6 and tumor necrosis factor(TNF)-α were detected by Western blot assay and enzyme-linked immunosorbent assay,respectively.Results Compared with the advanced inflammatory cancer group,the administration groups showed an increase in colon length,the expression levels of TGF-β1 and Smad4 protein,a decrease in colon wall thickness,wet mass index,maximum tumor diameter,the levels of Smad7,IL-6,TNF-α,and DAI score decreased in the GPX group and the combined group(P＜0.05).The structure and morphology of intestinal mucosa were improved in the GPX group,the probiotic group and the combination group,and the structure of colonic crypt and goblet cell number were increased.Compared with the probiotic group and the GPX group,the colon wall thickness,colon wet mass index and tumor number were decreased,the protein expression levels of TGF-β1 and Smad4 were increased,and levels of IL-6 and TNF-α were decreased in the combination group(P＜0.05).Conclusion GPX combined with probiotics could inhibit the transformation of colon inflammation-tumor,and the mechanism may be related to the regulation of TGF-β1/Smads pathway and the inhibition of pro-inflammatory factors of IL-6 and TNF-α.