Objective To analyze the difference of the venous port access (VPA) and peripherally inserted central catheter (PICC) in cancer chemotherapy.Methods All eligible studies on VPA and PICC were searched in the databases of PubMed,China National Knowledge Internet (CNKI),Chinese Biomedical Database (CBM),WANFANG Database and VIP Database.Literatures screening,quality evaluation and data extraction were conducted according to Cochrane Handbook;Meta-analysis was calculated by using RevMan 5.2.Results Twenty-nine studies with a total of 4 449 cases of patients were included in this Meta-analysis,with 1 912 cases in experimental group which adopted VPA and 2 537 cases in controlled group which adopted PICC.Experimental group had advantages in the average catheter retention time (SMD=3.36,95％CI 2.51-4.21) and quality of life (RR=1.61,95％CI 1.15-2.24) compared with controlled group.The overall complication rate (RR=0.26,95％CI 0.20-0.34,P＜0.01),phlebitis incidence (RR=0.08,95％CI 0.04-0.16,P＜0.01),catheter infection incidence (RR=0.32,95％CI 0.23-0.44,P＜0.01),catheter obstruction incidence (RR=0.32,95％CI 0.22-0.48,P＜0.01),catheter dystopy incidence (RR=0.18,95％CI 0.09-0.37,P＜0.01) in experimental group were remarkably lower than that in controlled group.However,no significant difference was found between the two groups in the incidence of the puncture success rate for the first time,errhysis or hematoncus,thrombus and catheter leakage (P ＞0.05).Conclusions Compared with PICC,VPA had advantages in a long retention time,fewer complications and few influence on quality of life.Therefore,VPA should be widely used in cancer chemotherapy.

ed in vitro and in vivo,which was inhibited by aspirin treatment.

Objective To evaluate the application value of superb micro-vascular imaging (SMI) technology in gastric cancer.Methods Data of color Doppler flow imaging (CDFI) and SMI of 69 patients with gastric cancer confirmed by pathology were analyzed retrospectively.The positive rate in displaying the blood flow,the thickness of gastric carcer lesion with blood flow signal and the grade of blood flow obtained with CDFI and SMI were compared.Results The positive rate of blood flow was 75.36％ (52/69) of CDFI and 95.65％ (66/69) of SMI,respectively.The difference of positive rate between the two methods was statistically significant (x2 =11.461,P=0.001).The thickness of gastric cancer lesion with blood flow signal measured with CDFI was (19.92±4.54)mm,and that measured with SMI was (16.92±5.77)mm (t=2.048,P=0.043).There was statistical difference of the grades of blood flow between SMI and CDFI (Z=5.354,P＜ 0.001).Conclusion SMI technology is more sensitive for the low flow velocity of micro vessels signal in gastric carcinomas compared with CDFI,which can provide valuable reference for clinic.

Objective: To investigate the clinical features, treatment and prognosis of the children with malignancy-associated hemophagocytic syndrome (MAHS) in Beijing in recent decade. Methods: The clinical data of the patients with MAHS under 18 years old from July 2007 to February 2018 collected by the Society of Beijing hemophagocytic syndrome were analyzed retrospectively. Results: There were 46 patients under 18 years old with MAHS in all(male 27, female 19). The patients with MAHS took up 8.9% of the patients with hemophagocytic lymphohistiocytosis (HLH)(46/519 cases) from the area during that period.The median age of onset had 13.5 years (0.9-18.0 years). Thirty-five patients had lymphoma (76.0%), 9 cases had leukemia (19.6%), 1 case had myelodysplastic syndrome with refractory anemia with excess blast(RAEB-T), and 1 case had Epstein-Barr virus(EBV) associated lymphoproliferative disease (borderline tumor stage). All the patients had a fever.A half of them suffered from hepatosplenomegaly and 7 patients(15.2%) had neurological symptoms.The common laboratory abnormalities included cytopenias, hemophagocytosis in bone marrow (81.8%, 36/44 cases), elevated serum ferritin (87.8%, 36/41 cases), and elevated sCD₂₅ (100.0%, 15/15 cases), decreased nature killer(NK) activity (61.1%, 11/18 cases), and plasma EBV-DNA positive (57.9%). Four patients did not receive treatment, the rest were treated by several chemotherapy protocols including the HLH-94/2004 protocol.Five patients (10.8%) received the allogeneic hematopoietic stem cell transplantation, and 1 case received the splenectomy therapy.The mortality was 58.7%.Four heterozygous mutations of SH2D1A, UNC13D and PRF1 genes were found in 2 patients. Conclusions MAHS in children progresses rapidly, with poor prognosis, and it is often complicated with EBV infection.The children with MAHS may develop genetic defects similar to primary hemophagocytic syndrome.Nowadays, there is no standard treatment for MAHS, so the individualized treatment is to be explored.

OBJECTIVE: To assess the effect of transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) on gastric insufflation during general anesthesia induction in obese patients. METHODS: Ninety obese patients (BMI 30-39.9 kg/m RESULTS: The incidence of gastric insufflation was significantly higher in Group M and Group M+T than in Group T ( CONCLUSIONS Ultrasound monitoring of the comet tail sign and the changes of CSA-GA in the gastric antrum is feasible and reliable for detecting gastrointestinal airflow, and in obese patients, the application of THRIVE for induction of anesthesia can ensure the oxygenation level without further increasing gastric insufflation.
Anesthesia, General ; Humans ; Insufflation ; Intubation, Intratracheal ; Masks ; Obesity