L6.A longitudinal column of HRP-labeled motoneurons was found in the dorsolateral and mediolateral portions of the spinal cord,distributing in the lamina Ⅸ from the caudal L4 to the rostral L6.Additionally,the transganglionic HRP-labeled central projection axonal terminals were found to be dense in the central part of laminae Ⅰ-Ⅱ from L4 to the rostral L6,and to scatter in the central part of gracile nucleus.Conclusion HRP-labeled primary afferent and efferent innervating acupoint "Taixi"(KI 3) are DRGs of L4-L6,the dorsolateral and mediolateral motoneuron columns of L4-L6,and the centrally projecting axonal terminals of laminae Ⅰ-Ⅱ of the spinal cord and the gracile nucleus.

Esophagus ; pathology ; Gastroenterology ; trends ; Humans ; Stomach ; pathology

Objective To compare the safety and effectiveness of power peripherally inserted central catheters (Power PICC) and double cavity central venous catheter (CVC) application in intensive care unit (ICU). Methods 458 cases were reviewed during January to September in 2014 and divided into two groups: Power PICC group (245 cases) and CVC group (213 cases) , and average retention time, successful rate of inserting catheter and the incidence of complications were compared. Results The average retention time of Power PICC group was (21.6±5.8) days which was longer than (13.1±3.4) days of CVC group (t=2.234, P <0.05). No statistics difference of successful rate between two groups (P>0.05). No significant difference for the total incidence of complications between two groups as 14.69% (36/245) and 19.72%(42/213)(P>0.05). No significant difference for the total incidence of complications in the operation time between two groups as 5.31% (13/245) and 4.23% (9/213)(P>0.05). But rate of catheter malposition for Power PICC group [ 2.86% (7/245) ] was higher than CVC group 0 (X2=4.428, P <0.05). Rate of the total incidence of complications in the retention time Power PICC group [ 9.39%(23/245) ] was lower than CVC group [ 15.96%(33/213)(P<0.05). And rate of catheter related blood stream infection of CVC group [3.29%(7/213)] was much more higher than Power PICC group (0)(X2=6.139,P<0.05). Conclusions Power PICC and CVC are both applicable for ICU, and Power PICC has more advantage regarding safety and effectiveness than CVC and can be one replacement for CVC.

Objective To evaluate the role of three vessels and trachea view (3VT) in diagnosis of fetal heart disease and great artery abnormality.Methods 39 pregnant women undergoing fetal ultrasound scan and diagnosed with great artery abnormality were enrolled in this study.Then the image characteristics and significance of 3VT in these 39 cases were analyzed and evaluated.Results In these 39 cases proved by autopsy,persistent truncus arteriosus(7 cases),transposition of the great arteries(7 cases),coarctation of the aorta(5 cases),tetralogy of Fallot (4 cases),pulmonary stenosis (3 cases),hypoplastic left ventricle syndrome(2 cases),persistent left superior vena cava (2 cases),pulmonary valve stenosis with single ventricle(2 cases),Ebstein anomaly with pulmonary stenosis (1 case),interruption of the aortic arch( 1 case),hypoplastic right ventricle(1 case),dextroaortic arch (1 case),and ductus arteriosus stenosis( 1 case) were detected.All of them had anomalies performance on 3VT.While in the 2 cases of double outlet right ventricle,only one eoncurrenting with pulmonary artery stenosis showed reduced inner diameter of pulmonary artery on 3VT.According to the performance of 3VT in great artery abnormality,it could be divided into 4 categories:abnormal location,abnormal ratio,abnormal amount and abnormal blood direction of great artery.Conclusions 3VT is a useful supplement to the 4-chamber view,and has significant value in diagnosis of fetal heart and great arteries abnormities.

Objective:To explore the clinical characteristics, possible causes and treatment methods of anaphylactoid reactions related to PICC catheterization.Methods:A retrospective analysis of the data of 27 patients with anaphylactoid reactions in 3 933 PICC catheters from October 2018 to February 2020.Results:The incidence of anaphylactoid reactions was 0.69%(27/3 933), its clinical symptoms were mainly skin reactions, some of which were complicated with respiratory, digestive, cardiovascular system and other symptoms. There was no difference in the incidence of different genders, diagnosis, and history of allergy ( χ2 value was 2.233, 0.839, 0.027, P>0.05). The incidence of patients younger than 60 years old was higher than that of patients older than 60 ( χ2 value was 12.821, P<0.01); the incidence of two catheters with different coatings was higher than that of uncoated catheters ( χ2 value was 27.195, 84.203, P<0.01). Twenty six patients continued the catheterization after the symptoms relieved, and one patient stopped the catheterization. Conclusion:The incidence of anaphylactoid reactions related to PICC, which is more common in catheters or the stylet wire is coated. It is recommended to use a large amount of saline to flush the catheter to reduce or avoid coating materials into the blood, so as to effectively control the occurrence and severity of such complications.

A young man with a history of thrombocytopenia for seven years presented with splenomegaly and fever and rapidly evolved to disseminated intravascular coagulation (DIC) and hemorrhagic shock. Spontaneous rupture of the spleen was diagnosed. The critical patient underwent an emergency splenectomy. Pathological examination revealed splenic peliosis, an extremely rare disease with unknown etiology and pathogenesis. Despite the high mortality rate due to spontaneous splenic rupture with DIC, the patient was successfully treated and the details of the case are presented in this report.

Objective To detecte the neovascularizations in carotid plaques using contrast-enhanced ultrasound (CEUS) and explore the relationship between the neovascularizations and the peripheral leukocytes in the patients with acute cerebral infarction. Methods Sixty-two patients with large artery atherosclerosis cerebral infarction were selected as cerebral infarction group;and 54 age-and gender-matched patients with atherosclerosis and without cerebral cerebrovascular events were recruited control group.The dominant carotid artery plaques were performed by CEUS,the peak of time-intensity curve(TIC-P) and the mean of time-intensity curve (TIC-M) were measured by off-line quantitative analysis.The peak (FC-P), time to peak (FC-TP),sharpness (FC-S) and under the curve area (FC-AUC) were obtained from fitting curves of time-intensity. The correlations between parameters of contrast-enhanced ultrasound and leukocyte counts were analyzed by Pearson correlation analysis. Results ①In the cerebral infarction group, the total leukocytes and neutrophils were higher than those in the control group,while the number of lymphocytes was lower than that of the control group(all P <0.05). ②In the cerebral infarction group,the TIC-P and TIC-M values were greater than those in the control group ( P < 0.05).Compared with the control group,the FC-P,FC-S and FC-AUC values in the cerebral infarction group were increased (all P <0.05). ③There was a negative correlation between PIG-P,TIC-M of FC-P and lymphocytes( r = -0.291,-0.263 and -0.270;all P <0.05).FC-S and FC-AUC were positively correlated with neutrophils ( r =0.261,0.298;all P < 0.05). Conclusions Carotid plaque neovascularizations is related to peripheral leukocyte count.CEUS help us know more the vulnerability of plaque.

Objective:To investigate the stability of fat emulsions after the preparation of parenteral nutrient solution under different storage conditions.Methods:Standardized parenteral nutrient solution was used to prepare a total of 24 bags of nutrient solution with the same formula, except for that Group A (12 bags) contains 20% of medium and long chain fat emulsion (C6-24) while Group B contains 20% of C8-24. The preparations were stored under 2-8℃, 23-25℃, and 35-37℃ and were examined at 24h, 48h and 72h after preparation. The appearance, average size of fat particles, pH value of nutrient solution, and lipid peroxidation were investigated.Results:After storage at 4℃, 25℃ and 36℃ for 24h, 48h and 72h respectively, both groups of preparations showed no obvious change in appearance. There was no significant difference in pH ( P>0.05) nor lipid peroxidation ( P>0.05). Conclusion:Both kinds of fat emulsion are stable in terms of pH value, fat particle size and lipid peroxidation, and can be used for patients receiving intravenous nutrition support.

OBJECTIVETo explore the impacts on physical and mental health of the patients with polycystic ovary syndrome (PCOS) treated with electroacupuncture (EA) or Diane 35.

METHODSSeventy-two patients of PCOS were randomized into an acupuncture group and a western medication group, 36 cases in each group. In the acupuncture group, acupuncture was applied to relieving liver stagnation and regulatingactivity at Ganshu (BL 18), Danzhong (CV 17), Qimen (LR 14), Zhongwan (CV 4), Tianshu (ST 25), Guanyuan (CV 4), Zigong (EX-CA 1), Sanyinjiao (SP 6), Zusanli (ST 36) and Taichong (LR 3). Afterarrival, the electric stimulation was added for 30 min. Acupuncture treatment was given 3 times a week. In the western medication group, Diane 35 was taken since the 5th day of menstruation and lasted for 21 days. The cycle of treatment was 3 months in the two groups. Before treatment and at the end of treatment, the symptom scores were evaluated and the self-report symptom inventory, symptom checklist-90 (SCL-90) was used for the mental health evaluation and the comparison was made between the two groups.

RESULTSCompared with those before treatment in the same group, the symptom scores were reduced significantly after treatment in the two groups (both<0.01). After treatment, the symptom scores in the acupuncture group were reduced significantly as compared with those in the western medicationgroup (<0.01). After treatment, the scores of somatization, interpersonal sensitivity, depression, anxiety and hostility were reduced significantly as compared with those before treatment in the acupuncture group (all<0.05). After treatment, the scores of somatization, interpersonal sensitivity, depression, anxiety, hostility and phobic factor were lower significantly than those in the western medication group (all<0.05).

CONCLUSIONSEA with relieving liver stagnation and regulatingactivity reduces the symptom scores of PCOS and SCL-90 scores, acting on regulating both physical and mental conditions. The effects achieved with acupuncture are better than those with Diane 35.

Objective To investigate the appropriate venous access for obese patients undergoing metabolic and bariatric surgery by comparing the clinical outcomes of different lengths of peripheral intravenous catheters.Methods Inpatients who underwent bariatric surgery in a tertiary hospital in Zhejiang from August 2022 to December 2022 were selected as the study population using a fixed-point continuous convenience sampling method.A stratified block randomisation method was used to divide the group into an experimental group 1(mini-midline catheters),an experimental group 2(midline catheters)and a control group(short peripheral intravenous catheters,Short PIVCs).The incidence of catheter-related complications,the rate of extubation due to complications,the duration of catheter retention,the time to first catheter-related complication were compared in the 3 groups.Results A total of 186 patients were included,with 62 patients in each group.The overall incidence of catheter-related complications in experimental group 1,experimental group 2,and control group were 25.81％,8.06％,and 58.06％.The extubation rates due to complications were 19.35％,4.84％,and 41.94％,and the duration of catheter retention was 7.00(6.00,7.00)d,7.00(6.00,7.00)d,6.00(3.00,6.25)d.The differences were statistically different(P＜0.05)when comparing the 3 groups.Among them,the differences in the overall incidence of catheter-related complications and the rate of extubation due to complications were statistically significant when comparing experimental group 1 with the control group,experimental group 2 with the control group,and experimental group 1 with experimental group 2(P＜0.017);the duration of catheter retention in both experimental group 1 and experimental group 2 were higher than it in the control group,and the differences were statistically different(P＜0.017).Conclusion The complication rate of mini-midline catheters and midline catheters is lower than that of short ones,and the indwelling time is consistent with the perioperative period of metabolic and bariatric surgery,which is suitable for use in patients undergoing metabolic and bariatric surgery.