0.05).Phlebitis occurred in 3 cases(4.2%) in PICC group,pneumothorax happened in 2 cases in CVC group.Calhelerization failure in CVC group was 7 cases who then received PICC successfully.No deep vein thrombosis occurred in either group. Conclusions:PICC has no possible severe complications of central venous access such as pneumothorax.The new method provides a safe,reliable and effective venous access for mid and long term usage in old patients.

Animals ; Dependovirus ; genetics ; immunology ; Gene Transfer Techniques ; instrumentation ; Genetic Therapy ; instrumentation ; Genetic Vectors ; genetics ; immunology ; Humans

Objective To investigate the causes of success or failure of natural orifice translumenal endoscopic surgery(NOTES)in animals.Methods Data were collected from animal studies of NOTES carried out between August 2007 and September 2009.The studies were divided into acute phase and survival phase.In the studies,simple NOTES and laparoscopic-assisted NOTES were performed on female miniswines or adult mongrel dogs.Diagnostic abdominal exploration,liver biopsy,cholecystectomy,tubal ligation,oophorectomy,gastrojejunal anastomosis,and splenectomy were made in the animals.The intra-and post-operative complications and technical difficulties were recorded during the procedures.Results Totally 37 miniswines and 16 mongrel dogs were enrolled in the studies of NOTES procedures(91 procedures),including 22 acute experiments and 31 survival experiments.Simple NOTES was conducted through the transgastric route in 25 cases,transcolonic route in 8 cases,and combinations of transgastric and transcolonic routes in 16 cases,and combinations of transgastric and transvaginal routes in 6.In Laparoscopic-assisted cases,36 animals were treated via the transgastric route by traditional(26 cases)or single-port transumbilical laparoscopy(10 cases).Diagnostic exploration was carried out in 33 cases,liver biopsy was done in 11 cases,tubal ligation was made in 11,and oophorectomy was performed on 6;the procedures were all completed in these cases showing a success rate of 100%.Cholecystectomy was completed in 27 cases with a success rate of 44.4%(12/27).One case of splenectomy,and two cases of gastrojejunal anastomosis failed.The totally complication rate in the studies were 39.6%(21/53).The complications included perforation(8 cases),organ injury(5 cases),bleeding(4 cases),infection(3 cases)and pneumoperitoneum with hypertonia(1 case).Conclusions NOTES is feasible,safe and effective in diagnostic abdominal exploration and simple abdominal surgeries,but does not suit difficult abdominal surgeries.By using laparoscopy,the technique may be further developed and used in the future.

Objective To investigate the risk factors for the prognosis of radical resection in elderly patients with colorectal cancer.Methods A total of 416 patients with colorectal cancer aged over 65 years were analyzed retrospectively,who came from Peking University First Hospital and Beijing Hospital from July 2008 to July 2011.Survival analysis was conducted by Kaplan-Meier and the survival rate was compared by Log-rank method.Multivariate analysis was conducted to analyze the prognostic factors by Cox regression.Results In this group of patients,the age was(74.3 ±5.4)years,and the post operative 5-year survival rate were 84.5％,77.3％,48.2％ respectively for staging Ⅰ,Ⅱ,Ⅲ patients.Univariate analysis showed that age,ASA score,co morbidity,preoperative hypohemia,preoperative hypoalbuminemia,postoperative complications,elevated preoperative carcinoembryonic antigen (CEA),intraoperative blood loss,perioperative blood transfusion,vascular cancer embolus,nerve invasion,depth of invasion,lymph node metastasis,tumor TNM stage and adjuvant therapy were correlated with the prognosis.Multivariate analysis showed that age ≥75 years,co morbidity,postoperative complications,preoperative albumin＜30 g/ L,depth of invasion,and lymph node metastasis,tumor TNM stage and adjuvant therapy were the independent risk factors for prognosis.Conclusions The risk factors for prognosis after radical resection in elderly patients with colorectal cancer include age≥75 years,co-morbidity,postoperative complications,preoperative albumin ＜30 g/L,depth of invasion,and lymph node metastasis,tumor TNM stage and adjuvant therapy.

AIM: To study the effect of tissue kallikrein gene (HK) treatment on blood pressure in type 2 diabetic rats and its mechanism. METHODS: Male Wistar rats were injected with low dose streptozotocin and fed with diets enriched in fat and sugar to form type 2 diabetic model. Recombinant adeno-associated viral vectors (rAAV)-mediated HK gene (HK group) or LacZ gene (LacZ group) was introduced to the diabetic rats. The systolic blood pressure was measured every 2 weeks. The acetylcholine (Ach)-dependent vasodilation response, the synthesis of nitric oxide (NO), the expression of endothelin-1 (ET-1) and endothelin-A receptor (ET_A-R) in the aorta were detected. RESULTS: (1) Systolic blood pressure was significantly higher in diabetic rats than that in normal control rats. In HK group, systolic blood pressure was significantly reduced within 2 weeks after injection with rAAV?HK, reached near normal levels at 4 weeks and kept until the experiments ended (16 weeks). (2) In LacZ group, Ach-dependent vasodilation response of isolated aorta was markedly decreased than that in HK group (P

This paper introduces a method for feature extraction of surface EMG signal with fuzzy wavelet packet and classification with C4.5 decision tree. The application of the method to the classification of four action EMG signals proves its effectivity and high recognition rate.

Objective To Summary the first 40 cases underwent robotic atrial septal defect (ASD) closure or atrial septal defect closure combined bicuspid valve plasty (TVP) using da Vinci S surgical System on beating heart. Methods 40 cases of atrial septal defect or combined sever tricuspid valve regurgitation were repaired using da Vinic S surgical system on beating heart from March 2009 to December 2010 in cardiovascular department of PLA general hospital. The average age was (38 ± 13) yeas old. 23 cases were female and 17 cases were male. All patients were ostium atrial septal defect with or without pulmonary hypertension. The atrial defect diameter was 1.5 -3.5 cm, and the mean diameter was(2. 8 ±1.3)cm. 9 patients had sever tricuspid valve regurgitation. Without sternotomy, the extracorporeal circulation was established through groin artery,groin vein and internal jugular vein cannulation with the guidance of transeophageal echocardiography. 3 ports of 8 mm and 1 working port of 2 cm were made in the right chest wall. After da Vinci S syetem was set up, with the assistant of bed-side surgeon, the surgeon completed the atrial septal defect closure or combined tricuspid valve plasty in the surgeon console with three dimensions visualization. During the operation, without cardioplegia administrated and aortic occlusion, the procedure was completed through right atriotomy. The pleural space was insufflated with carbon dioxide to avoid the air embolism. The direct suturing was used in 22 cases and pericardial patch were used in 18 cases. 9 patients accepted concurrent De Vega tricuspid valve plasty. The transesophageal echocardiography were used to evaluate the result of atrial defect closure or tricuspid valve repair. The operation time, robotic using time and cardiopulmonary time were compared with totally robotic atrial defect repair in arrested heart. Results All cases were accomplished successfully without complication. There was no residual shunt and air embolism. The operation time, robotic using time and cardiopulmonary time were less than the arrested group. Conclusion Robotic atrial septal defect closure or combined tricuspid valve repair on beating heart can avoid aortic ocllusion and can be utilized effectively and safely.

Background Spectral-domain optical coherence tomography (SD-OCT) can quantitatively analyze some ocular parameters in vivo.Although human ocular parameters have been obtained by SD-OCT,few studies were performed in animal experiment.Objective This study was to investigate the anterior and posterior segment parameters of C57BL/6 mice and pigmented rabbits using SD-OCT in vivo.Methods Some anterior and posterior segment ocular parameters,including the central corneal thickness (CCT),anterior chamber depth (ACD),white-to-white (WTW),optic nerve head (ONH) depth/width and retinal thickness,were measured in 8 eyes of 4 health SPF C57BL/6 mice and 12 eyes of 6 health SPF pigmented rabbits using SD-OCT.Results For C57BL/6 mice,Cornea,iris,lens in pupil area were clearly exhibited by SD-OCT.Mean CCT,ACD and WTW were (96±9)μm,(460±8) μm and (2.86 ± 0.41) mm pre-mydriasis,respectively,the corresponding values of post-mydriasis were (96±8) μm,(356±20)μm and (2.87±0.62)mm.There were no statistical differences of CCT and WTW between pre-and post-mydriasis (t =0.478,P =0.647 ; t =-0.737,P =0.485).ACD of post-mydriasis was significantly shallower than that of baseline (t =-13.022,P＜0.001).For the pigmented rabbits,the thickness of corneal thinnest point,retinal thickness,ONH depth and width were (370 ± 10) μm,(175 ± 4) μm,(1.35 ± 0.51) mm and (4.52±0.82) mm,respectively.Conclusions As a non-contact and non-invasive technology,SD-OCT can provide not only high resolution cross-sectional ocular images,but also high precise quantitative parameters for both C57BL/6 mouse and pigmented rabbit in vivo.

Objective To study the effect of trachea intubation and mechanical ventilation on the prognosis and discharge rate of patients with successful cardiac-pulmonary resuscitation.Method The clinical data of 389 patients,who were admitted from January 2005 to February 2007,were retrospectively analyzed.The relation between trachea intubation time and discharge rate was studied.According to the time from cardiac arrest to finishing trachea intubation,patients were divided into group A (within 3 minutes,n=209) and group B (over 3 minutes,n=143);according to the time from reaching emergency medicine department to finishing trachea intubation,the rest patients were divided into group C (within 5 minutes,n=9) and group D (over 5 minutes, n=38) minutes.The discharge rate was calculated between groups.The software of SPSS 11.0 was used for statistical analysis.Results The successful rate was 9.75% (389/3988),and 59 patients were discharged, with discharge rate 1.48% (59/3988).The discharge rate of group A was 19.62% (41/209),and was significantly higher than that of group B 6.99 % (10/143) (P