Background: Gastrointestinal involvement of Henoch-Sch(o)nlein purpura (HSP) lacks specific clinical manifestations, which makes it difficult to be diagnosed and easy to misdiagnose.Aims: To analyze the clinical characteristics and outcome of gastrointestinal involved HSP across all ages and provide evidence for early diagnosis and treatment of the disease.Methods: A retrospective analysis was conducted on 35 gastrointestinal involved HSP patients admitted to Shanghai Changzheng Hospital from Jan.2006 to Jan.2016.The clinical outcome was followed up by phone interview.Results: Of the 35 gastrointestinal involved HSP patients, 22 were male and 13 were female, with a mean age of disease onset at 33.6 years.The frequent disease onset seasons were winter and spring, and the most frequent precipitating events were eating foreign proteins and upper respiratory tract infection shortly before disease onset.Abdominal pain was the presenting manifestation in 35 patients (57.1%) and was most frequently at periumbilical area (42.9%), and 48.6% of the pain was of paroxysmal colicky pain.The abdominal signs were mild.Laboratory tests showed 57.1% of the patients had elevated leukocyte count and 25.0% had elevated serum IgA.Stomach, duodenum, rectum and colon were frequently involved endoscopically, and the endoscopic lesions included mucosal petechia, diffuse mucosal erythema, edema and erosion.Nonspecific inflammatory cells infiltration was demonstrated by biopsy pathology.The overall prognosis was good with a recurrence rate of 21.9%.Elevated serum fibrinogen degradation product (FDP) and D-dimer were found in all the recurrent patients at admission.Conclusions: Purpura rash usually appeared later than gastrointestinal symptoms in gastrointestinal involved HSP.Typical clinical manifestations and endoscopic appearances are helpful for early diagnosis and treatment.Elevated FDP and D-dimer might be the predictor of recurrence.

Objective To observe the effect of hot compress with medicinal salt pack in preventing PICC-associated mechanical phlebitis.Method Totally 200 inpatients undergone PICC intubation were randomized into a treatment group and a control group, 100 cases in each group. After PICC intubation, the treatment group was intervened by hot compress with medicinal salt pack, while the control group was by hot compress with warm wet towel. The occurrence of mechanical phlebitis was observed at different time points and compared between the two groups. Result The occurrence rate of mechanical phlebitis was 9.0% in the treatment group versus 26.0% in the control group, and the difference was statistically significant (P<0.05). In the treatment group, the occurrence rate of mechanical phlebitis was respectively 6.0% and 3.0% when treatment≤72 h and>72 h, versus 16.0% and 10.0% in the control group, and the differences were statistically significant (P<0.05). Conclusion Hot compress with medicinal salt pack can effectively reduce the occurrence of PICC-associated mechanical phlebitis.

Objective To investigate the reasons and nursing countermeasures of the discomfort of peripher-ally inserted central catheter(PICC)intubation patients in the process of placing tube.Methods 290 patients with PICC who were treated with PICC for the first time were summarized.Results 290 patients with PICC in catheter had not comfortable experience.The main reason of causing discomfort was psychological factors,accounted for 90.0%, catheter when the cold experience leads to the discomfort of 82.8%,catheter environmental factors accounted for 6 3 .8 % ,pain caused by discomfort accounted for 15.5% ,puncture posture factors leading to 13.1% .Conclusion The causes of discomfort in the process of PICC is more,strengthen preoperative health education and the operation of effective communication,to create a relaxed comfortable environment to help patients take comfortable posture,improve a catheter success rate,preventing catheter during cold and other measures can improve the patients'comfort.

Objective To investigate the therapeutic effect of injection of dexamethasone solution on the mechanical phlebitis induced by PICC through a syringe pump on intravenous branch of the PICC puncture point.Methods A total of 90 patients who met the criteria were divided randomly into experimental group (n=45) and control group (n=45). Patients in the experimental group were injected on the forearm below the PICC puncture point,where was with good elasticity and obvious exposure,without damage or inflammation,easily fixed,and away from joints or end of tendons. 40 ml of dexamethasone solution,with concentration of 0.125 mg/ml,was injected by a syringe pump with scalp needle 5.5#,with an infusion speed of 10 ml/h,1 time/day. For 3 days of continuous use,the needle was withdrawn once the infusion was done,and the injection location was different for each day. If the mechanical phlebitis was cured after 1 day or 2 days of medication,the injection stopped instantly. For patients in the control group,a wet hot towel was compressed above the PICC point, 3 times/day,20 mins/time. After the application,Hirudoid ointment was rubbed on the side of the upper arm where the catheter was injected,3 days of continuous use was conducted. Observation was conducted to both groups until the 7th day after intervention measures were taken.Results There were significant differences in terms of cure rate and cure time between the two groups (P<0.05) in the treatment of mechanical phlebitis. Conclusions It is highly effective to treat mechanical phlebitis induced by PICC by injection of dexamethasone solution through a syringe pump on intravenous branch of the PICC puncture point,which can relieve symptoms of patients,reduce their pain within a shorter time.