The peripherally inserted central catheter occlusion is not rare in adults.Its occurence is related with the catheter's tip position,catheter type and the skills of medical staff.Personnel training is particularly important in the prevention of occlusion.Urokinase and heparin can be used for thrombolysis.

Objective To summarize our experience in microsurgical treatment of dumbbell tumors. Methods The clinical features,surgical approaches,operative techniques and surgical results of 21 cases of dumbbell tumors were analyzed retrospectively.Four surgical approaches were adopted according to the size and location of tumors,including,posterior midline approach(in 7 cases),modified far lateral approach(in 5 cases),posterior midline supplied by anterior cervical approach(in 2 cases)and paramidline approach(in 7 cases). Results In this series,10 cases of tumors were situated in the cervical,6 in thoracic,4 in lumbar and 1 in sacral segment of the spine.Total removal were achieved in 95% (20/21),and subtotal removal in 5%(1/21).Postoperative pathological diagnosis revealed 15 neurinomas,5 spinal meningiomas and 1 metastatic adenocarcinoma.14 cases of meningiomas and 1 metastatic adenocarcinoma were followed up for 1 to 48 months.11 of the 14 patients recovered completely,with 3 of them living daily life independently,4 maintainly radical hypoesthesia,and one having decubital ulcer unhealed.No postoperative malformation and dysfunction of the disposed spine occurred in these patients.Magnetic resonance imaging scans in 11 of the 14 follow-up cases revealed no tumor recurrence,of which inhanced MRI scans were performed in 8 cases. Conclusions dumbbell tumors should be treated by one-stage operation.Microsurgical technique could improve the rate of total removal,and decrease postoperative complications.

Syndrome factors as refined diagnostic units are the base of syndrome differentiation,each syndrome factor has the relative symptom and sign.By way of epidemiology and documents investigation,as well as algorithm of double levels of frequency and weight,the symptom and sign for the syndrome factor of Qi-deficiency,Blood-deficiency,Yin-deficiency and Yang-deficiency respectively were extracted correctly,and the weight values of symptoms and signs to syndrome factors were established.

Cell Differentiation ; Humans ; Stem Cells ; Urine ; cytology

Objective To investigate the influence of intravenous infusion by double-lumen peripherally inserted central catheter (PICC)on continuous dynamic central venous pressure(CVP)monitoring.Methods In the patient undergoing the double-lemon PICC,continuous dynamic CVP monitoring was performed by a lumen and the intravenous infusion was conducted by another lu-men.Whether the simultaneous venous infusion affecting the values of continuous dynamic CVP monitoring was observed.Results Intravenous infusion through double-lumen PICC had no influence on simultaneously continuous dynamic CVP monitoring (P>0.05),which could influence the values of CVP monitoring when simultaneously using the intravenous infusion pump(P<0.05). The speed of pumping fluid had no influence in a shout time(10 min),with significant difference(P>0.05).The CVP values could recovered to the status before infusion when continuously infusing after stopping using the infusion pump.Compared with before in-fusion,the CVP values after stopping intravenous infusion had no obvious change(P>0.05).Conclusion Intravenous infusion by double-lumen PICC has no influence on continuous dynamic CVP monitoring.But simultaneously adding infusion pump has certain influence on the CVP monitoring values.

Differentiating syndrome factor and forming syndrome type according to symptoms and signs are the rules and processes of syndrome differentiation in traditional Chinese medicine (TCM). TCM syndrome differentiation is a nonlinear complex giant system. In order to solve the key problem of determination of diagnosing weight value for syndrome factor differentiation, a new algorithm of double levels of frequency and weight based on the analysis of frequency statistics was applied, and the accurate syndrome differentiation parameters were acquired. Therefore, based on the nonlinear and multivariate analysis, a new algorithm of calculating diagnostics for syndrome factor differentiation was established.

Objective To investigate the past participation and their future intention of donation after citizen death (DCD) work of attendees.Methods A questionnaire study was carried out in the 9th Chinese ICU annual congress and local workshops taken part in difference provinces and cities from May 2015 to July 2015.A 12-multiple self choice questionnaires,collecting the demographic data of attendees and analyzing the ratio of DCD awareness and participation,their attitude towards DCD,and future recommendation of DCD development,were facilitated and immediately collected back.Results A total of 512 questionnaires were collected and 489 were available.97.75％ of the attendees have been awareness of DCD and 62.37％ have ever participated in DCD activity.During the whole survey,85.07％ of them expressed their willingness of future DCD activities participation.The current fierce conflict between medical workers and patients was selected to the main barrier of DCD work.The enforcement of DCD population and organ donation law were most recommended to improve donation success.Conclusion It is the fifth year after DCD programme initiation and full implementation since last year.Despite the obvious raise of DCD recognition among ICU staff,there is still long way to go ahead to the era of satisfactory donation rate.The hostility between medical workers and patients is the main barrier for ICU workers for DCD promotion.

Objective To understand the ABO blood type distribution of Buyi and Shui ethnic populations in Libo county of Guizhou province .Methods Totally 726 Buyi and 163 Shui individuals who were unrelated within three generations were detected ABO blood stype with glass-clotted method .Results The ABO blood type distributions in the Buyi and Shui ethnic populations both were in line with the Hardy-Weinberg equilibrium .The Buyi ethnic population ABO phenotypic distribution and gene frequen-cies were O>B>A>AB and r>q>p (r=0 .676 9 ,q=0 .176 7 ,P=0 .146 4) and the national index was 0 .842;while the Shui eth-nic population ABO phenotypic distribution and gene frequencies were O>A>B>AB and r>p>q(r=0 .522 6 ,q=0 .104 0 ,P=0 .164 7) and the national index was 1 .529 .Conclusion The Buyi and Shui ethnic populations′ABO blood type distribution in Libo county of Guizhou province is basically consistent with that of the same ethnic populations in other regions of Guizhou Province of the same ethnic groups .The genetic distance analysis prompts that the regional and ethnic differences exist in ABO blood type dis-tribution .

Spontaneous complete thrombosis with parent artery occlusion of giant intracranial aneurysms is rare.We report a patient with a rare giant vertebral artery aneurysm with spontaneous complete thrombosis and parent artery occlusion,and review the related literature,discuss its incidence,clinical presentation,pathogenesis,diagnosis,and treatment.

Objective To investigate the autophagy and apoptosis in acute myelogenous leukemia U937 cell induced by Sirolimus.Methods U937 cells were subcultured, and blank control group(normal) and Sirolimus treated groups(12 h, 24 h,48 h) were established.The Sirolimus treated groups were treated by 2 μmol/L concentration of Sirolimus for 12 h,24 h and 48 h, respectively.The cell morphology of U937 cells treated by Sirolimus was observed after 12 h,24 h and 48 h.The survival rate of cells was detected by cell counting kit-8 method.Cell apoptosis was detected by flow cytometry using Annexin V-FITC/PI double labeled.Real-time PCR was used to detect the level of mRNA expression in autophagy specific protein maker mictotubule-associated protein light chain 3 (LC3)-Ⅱ in different treated times by Sirolimus.Sirolimus LC3 protein expression levels after treatment were detected by Western blot method.Results Under inverted microscope, the cell number of Sirolimus treatment group reduced gradually after 12 h ,24 h and 48 h culture, volume of cells became smaller, cells got ruptured, and the nucleus pycnosis and cellular debris increased.With the extension of time, U937 cells survival rate was falling, and there was statistical differences compared with those of the control group(P =0.031).With Sirolimus treatment, U937 cells after 12 h,24 h and 48 h, U937 cell apoptosis rate increased, and there were statistically significances, compared with those of the control group (P =0.027).With Sirolimus treatment U937 cells after 12 h,24 h and 48 h,LC3-Ⅱ mRNA expression and protein expression were down-regulated compared with those of the control group, and there were statistically significances (P =0.029).Conclusions Sirolimus can induce autophagy and apoptosis in U937 cells.Autophagy protein LC3-Ⅱ in gene and protein expression levels were lowered, and LC3-Ⅱ may play an important role in regulating the leukemia cell autophagy.