Objective To work out a flowchart for putting normal saline column by gravity drip via Groshong PICCs to guide intracavitary ECG and investigate the effect. Methods We developed the flowchart and trained the nurses to use it. Then the flowchart was used in catheteration of Groshong PICC to guide intracavitary ECG for 30 patients. Results The normal target rate was 93.3%(28/30) and the optimal tip target rate was 90.0%(27/30). The score on the flowchart by the nurses was (4.8 ± 0.4), indicating they were satisfied with it. Conclusion The flowchart for pushing normal saline column with gravity drip method via Groshong PICCs to guide intracavitary ECG provides an operational standard, enhancing the operational quality.

Objective To evaluate the effect of mild hypothermia on acute cerebrovascular diseases. Methods Sixty-two cases of severe cerebrovascular diseases were randomized into hypothermia group and control group. In hypothermia group the patients were cooled to 34～35℃ for 48h ,while the patients in the control group treated by routine methods. Median nerve short latency somatosensory evoked potentials (SLSEP) and brain-stem auditory evoked potentials (BAEP) were recorded before cooling and 30 minutes, 24, 72, and 120 hours after cooling. The changes of EP were analyzed statistically. Results After treatment with mild hypothermia, the N13-N20 interpeak latency (IPL) of SLSEP and I-V IPL of BAEP were significantly reduced as compared with those of the control group ( P

BACKGROUND: With the deep investigations of pathophysiological mechanism of acute cerebral infarction, it is discovered that inflammation occupies an important stance in the ischemic injuries of central nervous system ( CNS ), in which tumor necrosis factor-αt (TNF-α), interleukin- 1β(IL-1β), and soluble intercellular adhesion molecule(sICAM-1) become hotspots in the researches.OBJECTIVE: To investigate the relationship between the levels of serous inflammatory cell factors and the course of the disease, the severity of the situation in patients with ischemic stroke.DESIGN: A case-control study based on patients and healthy individuals.SETTING: Department of neurology in a university hospital.PARTICIPANTS: Fifty ischemic stroke patients including 23 males and 27 females with an average age of(60.26 ± 8.77) years old were selected from the outpatient and inpatient Departments of Neurology of the Renmin Hospital of Wuhan University between January 2001 and December 2003. Forty healthy controls including 18 males and 22 females with an average age of (61.05 ± 8.09) years old were selected from the subjects who had physical check up at outpatient department during corresponding period.INTERVENTIONS: Serous TNF-α, IL-1 β and sICAM-1 levels were detected by double-antibody-ELISA.MAIN OUTCOME MEASURES: Serous levels of TNF-α, IL-1β and sICAM-1 in patients with ischemic stroke of different stage, with different infarction volume and different neural functional defects.RESULTS: Serous TNF-α, IL-1β and sICAM-1 levels of patients with cerebral infarction during acute phase and convalescence were significant higher than that of control group( P ＜ 0.01 ), and the levels was significantly higher in acute phase than convalescence ( P ＜ 0.05 ) . The elevation was closely correlated with the degree of neural functional defect and the size of infarction volume, and furthermore, the serous content of TNF-α was also correlated with IL-1β and sICAM-1 levels.CONCLUSION: TNF-α, IL-1β and sICAM-1 interact and participate in the inflammation and reperfusion injury of acute cerebral infarction. Surveillance on them can provide experimental indicators for early clinical therapy and rehabilitative intervention, which is good for the control of the development and recurrence of stroke.

AIM: To evaluate the influences of triptolide on serum cytokines, symptoms and pulmonary function in patients with steroid - resistant asthma, so as to investigate if there is therapeutic effect of triptolide on these patients. METHODS: Sixteen patients with steroid - resistant asthma were randomly divided into two groups (A and B, n =8 for each group). All of the patients took procaterol (50 - 100 μg/d) and theophylline (400 mg/d) orally as baseline treatment. Additionally, triptolide was prescribed for group A (33 μg, orally, three times per day for 4 weeks). Asthmatic symptom score calculation, serum cytokines ( interferon - γ, IFN - γ; interleukin - 4, IL - 4; and interleukin - 5, IL - 5)determination and pulmonary function test (FVC%, FEV1%, PEF%, V50% and V25% ) were undertaken before and at the end of the study. RESULTS: At baseline, no significant difference was found between group A and group B with respect to the above mentioned indices. Following the administration of triptolide, group A had significantly increased serum IFN -γlevel, FVC%, FEV1%, PEF%, V50% and V25%, and significantly decreased asthmatic symptom score and serum IL-4, IL-5 levels (P＜0.01 compared with baseline in the same group, and P＜0.05 compared with group B at the end of the study). Compared with baseline, no significant change was observed for group B regarding all the indices at the end of the study. CONCLUSION: Triptolide in combination with procaterol and theophylline may be a novel and effective strategy for the treatment of steroid - resistant asthma.

s of catheter,and extend the service life of a catheter.

Objective To investigate the effect of m il d hypothermia on the content of Ca 2+、Mg 2+、EAA in rat brain tissue and ET in plasma after acute cerebral infarction. Methods Forty-eight Sprague-Dawley rats were randomly assigned into trial group and control group. Using the method of reformed line-thrombosis,the cerebral in farction models were established. The rats in the trial-group were cooled by mi ld hypothermia for half an hour, while those in the control group were subjected to no disposal. Every group was divided into 4 sub-groups according to the pos t-infarction disposal time. Every sub-group was composed of 6 SD rats and kill ed at the time points of 1 hour,2 hour,4 hour and 8 hour after infarction, respe ctively. Then the content of Ca 2+、Mg 2+、EAA in rat brain tissue an d ET in plasma were measured. ResultsThe post-infar ction content of Ca 2+、EAA and ET of trial-group increased mildly and Mg 2+ reduced very little. There was a significant statistical difference bet ween the trial group and the control group. Conclusion Mild hypothermia may significantly reverse the increase of the content of Ca 2+ and EAA and the fall of Mg 2+ and the increment of ET in plasma as well after acute cerebral infarction in experimental animals. So as a result, m ild hypothermia possesses protective effect on brain.

AIM: To study the language characteristics and origins of subcortical aphasia. METHODS: One hundred and five patients with unilateral subcortical lesions were confirmed by CT scans. Aphasia examinations, brain electrical activity mapping (BEAM) and CT image standardization were performed at the end of two weeks, one month and two months after onset. RESULTS: Most aphasia patients had lesions in the lateral, front and upper part of basal ganglion. BEAM is largely abnormal in the aphasia patients of lateral type and thalamic aphasia who had serious auditory comprehension disturbance. Prominent dysarthria and dysprosody occurred in aphasia patients with lesions in caudate nucleus. CONCLUSION: Subcortical aphasia has its language characteristics. It is mostly due to the damage of language related zone of hemisphere caused directly or indirectly by subcortical lesions. Thalamus serves as a subcortical center in controlling language and its disturbance causes aphasia in some patients.

AIM: To evaluate the pulmonary function in patients with type 2 diabetes mellitus in order to identify whether the lung is a target organ of chronic pathologic changes in diabetes mellitus. METHODS: Pulmonary ventilation function and diffusion capacity were studied in 107 patients with type 2 diabetes mellitus and 61 healthy subjects matched for age and sex. Glycosylated hemoglobin (HbA1c), urine albumin excretion rate (AER), fundus examination and nerve conduction velocity were included as parameters of glycemic control and diabetic microangiopathies. RESULTS: Pulmonary ventilation function was similar in type 2 diabetic group and the control. Compared with the control, carbon monoxide diffusion capacity (DLCO) and DLCO corrected by alveolar volume (DLCO/VA) were significantly lower in type 2 diabetic group (P<0.05). DLCO and DLCO/VA were inversely correlated with microangiopathy score (r: -0.291, -0.324, respectively, P<0.01). Furthermore, DLCO/VA was negatively correlated with age and duration of diabetes mellitus (r: -0.269, -0.236, respectively, P<0.05). CONCLUSIONS: Pulmonary ventilation function is normal in patients with type 2 diabetes mellitus, but their diffusion capacity is impaired. It suggests that the lung may also be the target organ of the chronic pathologic changes of diabetes mellitus.

0.05,respectively).Plasma Mg2+,intracellular Mg2+,the beta 2-AR mRNA and protein in lung tissue in group C at 21st d and 34th d were significantly higher than those in group A at 21st d and 34th d 21st d:(0.84?0.09)mmol/L vs 0.57?0.10)mmol/L,(2.39?0.14)mmol/L vs(2.11?0.08)mmol/L,(0.75?0.09)pmol/g vs(0.59?0.06)pmol/g,(88.50?8.50)pmol/g vs(60.10?7.70)pmol/g,P

Objective:To investigate the influencing factors for the number of lymph node harvested after Da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer.Methods:The retrospective case-control study was conducted. The clinicopathological data of 1 396 patients who underwent Da Vinci robotic or laparoscopic radical gastrectomy for gastric cancer in the First Affiliated Hospital of Nanchang University from December 2014 to July 2019 were collected. There were 991 males and 405 females, aged (60±11) years. Surgery using Da Vinci robotic system or laparoscopic system was completed according to patients' wishes. Cases with early gastric cancer underwent D 1+ lymphadenectomy and cases with advanced gastric cancer underwent standard D 2 lymphadenectomy. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) influencing factors for the number of lymph node harvested after radical gastrectomy for gastric cancer; (4) follow-up and survival. Follow-up using outpatient examination or telephone interview was performed to detect survival of patients up to October 2020. Measurement data with normal distribution were represented as Mean± SD. Univariate analysis was done using the chi-square test or Fisher exact probability. Multivariate analysis was performed using Logistic regression model. The survival rate was calculated by Kaplan-Meier method. Results:(1) Intraoperative situations: all the 1 396 patients underwent radical gastrectomy, including 415 cases undergoing Da Vinci robotic radical gastrectomy and 981 cases undergoing laparoscopic radical gastrectomy. Thirty-five of the 1 396 patients were converted to open surgery, including 5 cases undergoing Da Vinci robotic radical gastrectomy and 30 cases undergoing laparoscopic radical gastrectomy. Of the 1 396 patients, 983 cases underwent distal gastrectomy, 400 cases underwent total gastrectomy and 13 cases underwent proximal gastrectomy, among which 597 cases underwent Billroth Ⅰ anastomosis, 385 cases underwent Billroth Ⅱ anastomosis, 401 cases underwent Roux-en-Y anastomosis and 13 cases underwent residual stomach-esophagus anastomosis. The operation time, volume of intraoperative blood loss and cases with intraoperative blood transfusion were (221±51)minutes, (201±81)mL, 24 of 415 cases undergoing Da Vinci robotic radical gastrectomy, and (196±42)minutes, (232±76)mL, 75 of 981 cases undergoing laparoscopic radical gastrectomy, respectively. (2) Postoperative situations: the time to postoperative first flatus, time to postoperative initial liquid food intake and duration of postoperative hospital stay of the 1 396 patients were (3.0±1.0) days, (4.2±1.5) days and (9.0±3.8) days, respectively. Two hundred and ten of the 1 396 patients had postoperative complications including 170 cases with grade Ⅰ-Ⅱ complications and 40 cases with grade Ⅲ-Ⅴ complications. Eight of the 210 patients with postoperative complications died of serious complica-tions and the other 202 cases were cured after symptomatic treatment. Results of postoperative histopathological examination showed that there were 958 cases of adenocarcinoma, 220 cases of mucinous adenocarcinoma, and 218 cases of signet ring cell carcinoma. The number of lymph node harvested and the number of positive lymph node of the 1 396 patients were 26.0±8.3 and 3.6±0.9, respectively, and cases with the number of lymph node harvested ≥16 or <16 were 1 312 and 84. (3) Influencing factors for the number of lymph node harvested after radical gastrectomy for gastric cancer: results of univariate analysis showed that the operating surgeon, operation method, range of gastric resection, nerve invasion, degree of tumor invasion and tumor pathological N stage were related factors influencing the number of lymph node harvested after Da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer ( χ2=13.167, 6.029, 15.686, 5.573, 9.402, 17.139, P<0.05). Results of multivariate analysis showed that the operating surgeon, operation method, range of gastric resection and tumor pathological N stage were independent factors influencing the number of lymph node harvested after Da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer ( odds ratio=1.589, 2.018, 1.787, 0.267, 95% confidence interval as 1.221?2.068, 1.140?3.570, 1.066?2.994, 0.103?0.689, P<0.05). (4) Follow-up and survival: of the 1 396 patients, 1 256 cases were followed up for 2 to 70 months, with a median follow-up time of 27 months. The 3-year cumulative survival rate of the 1 256 cases was 70.2%. Conclusion:The operating surgeon, operation method, range of gastric resection and tumor pathological N stage are independent factors influencing the number of lymph node harvested after Da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer.