Objective: To study relationship among ambulatory pulse pressure (PP), pulse pressure index (PPI) and carotid intima-media thickness (IMT) in aged patients with hypertension. Methods: The 24h ambulatory blood pressures of 159 subjects were measured, and their ambulatory PP [(mean systolic blood pressure (SBP) - mean diastolic blood pressure (DBP)] and ambulatory PPI (ambulatory PP/mean SBP) were calculated. Color Doppler ultrasonography was used to measure carotid IMT. Relationship between ambulatory PPI and carotid IMT was analyzed. Results: Pearson correlation analysis indicated that carotid IMT was correlated with age (r=0.353), mean SBP (r=0.594), mean DBP (r=-0.355), ambulatory PP (r=0.855) and ambulatory PPI (r=0.883), P<0.001 all. Multivariant gradual regressive analysis indicated that carotid IMT possessed significant linear correlation with ambulatory PP and ambulatory PPI (R2=0.789), and standardized regression coefficient β of ambulatory PPI (β=0.621) was higher than that of ambulatory PP (β=0.284). Conclusion: Ambulatory pulse pressure index and ambulatory pulse pressure are good indicators for evaluation of carotid arteriosclerosis, and value of ambulatory pulse pressure index is more than.

Objective To explore the clinical application value of the continuous blood purification (CBP) technology in pediatric intensive care unit (ICU). Methods A retrospective study was conducted. All CBP patients admitted to pediatric ICU of Children's Hospital of Nanjing Medical University from 2015 to 2017 were enrolled. The disease diagnosis, CBP treatment mode, catheter placement, anticoagulation way, treatment time and adverse reactions were summarized and analyzed. Results ① A total of 203 children were included, male accounted for 59.1%; age 37 days to 14 years old, with an average of (4.52±3.60) years old; weight 3.3-68.0 kg, with an average of (21.38±13.77) kg.② There were a total of 660 CBP treatments, with an average of 3.25 times per person. The main treatment modes of CBP were plasma exchange (PE, 38.64%), and followed by continuous veno-venous hemodiafiltration (CVVHDF, 38.64%), hemoperfusion (HP, 16.51%) and continuous veno-venous hemofiltration (CVVH, 6.21%).③ Central venous catheterization was mainly placed in the right internal jugular vein (90.64%), followed by the right femoral vein (5.42%) and the left femoral vein (3.94%).④ Heparin sodium was the main anticoagulant in pipeline filters (84.73%), followed by low molecular weight heparin calcium (11.33%), sodium citrate and non-anticoagulant (both 1.97%). Mixed anticoagulants were used 21 children. ⑤ Primary diseases included poisoning (26.11%), liver failure (25.62%), sepsis (12.32%), shock after cardiopulmonary resuscitation (11.82%), acute respiratory distress syndrome (ARDS, 8.37%), central nervous system diseases (5.41%) and metabolic diseases (4.93%). The lowest efficacy of CBP was metabolic diseases, with mortality rate of 60.00%; followed by ARDS, shock after cardiopulmonary resuscitation, sepsis and liver failure, with mortality was 58.82%, 41.67%, 36.00% and 32.69%, respectively. The length of hospitalization stay of children with central nervous system diseases was (30.89±15.13) days.⑥ Adverse events of CBP treatment included uncontrollable restlessness (2.88%), hypotension (1.82%), allergic rash (1.21%), catheterization and pipeline coagulation (1.21%), filter coagulation (1.06%), decreased heart rate and oxygen saturation (0.76%); CBP was stopped in 8 children due to cardiac arrest during the treatment. Conclusion At present, the application of CBP technology in pediatric ICU is universal, and it is an important way to rescue critical illness.