Objeetlve To avoid inserting the tip of the central venous catheter into internal jugular vein (IJV) through subclavian vein under ultrasound guidance.Methods sixty breast cancel patients aged 28-63 yr weighing 41-70 kg who needed long-term intravenous infusion and chemotherapy through central venous catheter were randomly divided into 2 groups (n=30 each):control group (group C) and ultrasound group (group U).In group C the insertion of central venous catheter through subclavian vein was guided by pulsatile injection of ice-cold saline.In group U ultrasound detector (type HFL 38/13-6 MH,Sonosite Co,USA) was used to guide the insertion of tbe central vesons catheter.The position of the catheter tip was verified by X-ray radiography.The rate of successful placement at 1st attempt was calculated.Results The tip of the central venous catheter was correctly placed in the vena cava and right atrium in all patients in group U (success rate 100%),while in group C the tip was misplaced in IJV in 6 patients (success rate 80%) and had to be replaced.Conclusion Ultrasound guidance is effective for correct placement of the tip of central venous catheter in the vema cava and right atrium through subclavian vein.

Objective To investigate the expression and significance of endothelin-1 ET-1 in urothelial transitional cell carcinoma. Methods Immunohistochemistry was applied to detect ET-1 expression in 30 cases of urothelial transitional cell carcinoma and 20 cases of normal urothelial transitional cell samples, the results were analyzed in combination with clinical data. Results ET-1 expression in urothelial transitional cell carcinoma was 40.5%, which was significantly higher than that in normal urothelial transitional cell samples(P ＜0.05). ET-1 expression was correlated with grade and stage of urothelial transitional cell carcinoma (P ＜0.05). Conclusion The over expression of ET-1 in urothelial transitional cell carcinoma tissues correlates closely with cancer genesis progression and invasiveness, suggesting that ET-1 might be a biomarker and as a therapeutic target in human urothelial transitional cell carcinoma.

Objective:To study the short-term effect of early application of intestinal microecological therapy after gastric cancer surgery.Methods:A retrospective analysis was made on 96 patients with early and middle stage gastric cancer who underwent surgical treatment in the department of gastrointestinal surgery of Shulan (Hangzhou) Hospital from June 1, 2020 to May 31, 2021. Among them, 48 patients in the observation group were given enteral nutrition support treatment in the early stage after operation and intestinal microecological preparation, while the control group of 48 patients in the early postoperative were given enteral nutrition support. The serum total protein, albumin, prealbumin and other nutrition related indexes and immune related indexes such as CD4 + , CD8 + , CD4 + /CD8 + were detected before and 7 days after operation. The clinical indexes such as the time of first anal exhaust and the incidence of infectious complications were recorded. Results:There was no significant difference between the two groups in preoperative serum total protein, albumin, prealbumin and immune related indexes such as CD4 + , CD8 + , CD4 + /CD8 + ( P>0.05). 7 days after operation, the above indexes in the observation group were significantly higher than those in the control group (all P<0.05). The anal exhaust recovery time of observation group was faster ( P<0.05); There was no significant difference in the incidence of postoperative infectious complications between the two groups ( P>0.05). Conclusions:Early application of intestinal microecological agents in patients with gastric cancer after operation can significantly improve the nutritional status and immune function, promote the recovery of intestinal function, and will not increase the incidence of complications.