Objective To investigate the effect of positive airway pressure on catheterization of right internal jugular vein (IJV) in anesthetized patients. Methods One hundred and twenty-five ASA Ⅰ or Ⅱ patients aged 19-64 yr weighing 44-85 kg undergoing right IJV catheterization were randomly divided into 2 groups: control group (group C, n = 60) and positive airway pressure group (group P, n = 65). Anesthesia was induced with midazolam, sufentanil and etomidate. Tracheal intubation was facilitated with vecuronium. The patients were mechanically ventilated. Right IJV was catheterized under the guidance of ultrasound and was punctured at the plane of cricoid cartilage. IJV catheterization was performed when mechanical ventilation was suspended in group C and when airway pressure was maintained at 20 cm H2O in group P. The cross section area of right IJV, CVP, the shortest dislance between right IJV and the skin and the depth of needle insertion were measured. The number of attempts to puncture the vein was calculated and the easiness of withdrawing blood from the right IJV after being pierced was assessed. MAP and HR were measured before and after positive airway pressure. Results Positive airway pressure (20 cm H2O) significantly increased the cross section area of IJV, CVP, success rates of puncturing IJV at first attempt and within 30 seconds and easiness of withdrawing blood from IJV after being pierced and deceased the depth of needle insertion as compared with control group. Positive airway pressure (20 cm H2O) also significantly increased the incidence of bradycardia and hypotension. Conclusion Positive airway pressure is helpful for right IJV catheterization guided by ultrasound under general anesthesia.

Carbazoles ; therapeutic use ; Child, Preschool ; Heart Failure ; complications ; drug therapy ; Humans ; Male ; Propanolamines ; therapeutic use ; Takayasu Arteritis ; complications ; drug therapy ; Vasodilator Agents ; therapeutic use

Aortic Aneurysm ; diagnosis ; Aortic Aneurysm, Thoracic ; diagnosis ; Carotid Body Tumor ; diagnosis ; Diagnostic Errors ; Humans ; Male ; Middle Aged

Objective To investigate the pathological diagnosis of high-grade intraepithelial neoplasia in gastric biopsy.MethodsOne hundred and forty-three cases diagnosed by gastric biopsy as high-grade intraepithelial neoplasia were analyzed by light microscopy,and were compared with the pathological findings of surgical specimens in 60 cases and a second biopsy in 13 cases.Results Among the sixty cases treated surgically following the gastric biopsies,no carcinoma was found in 6,while the other 54 were diagnosed as gastric adenocarcinoma,27 in advanced stage and 27 in early stage,respectively.Fifteen cases were well-differentiated,24 moderately-differentiated,12 poorly-differentiated and 3 were of mucinous type.Four of the 13 cases with a second biopsy were diagnosed as well-differentiated adenocarcinoma,8 low-grade intraepithelial neoplasia and 1 chronic inflammation.The colorectal adenomas-like changes were morphologically found in 6 surgically-treated cases without carcinoma,5 of whom mucous muscles were not found by biopsy.Fibroblastic reactions were found in 9 cases,all of which were diagnosed as adenocarcinoma in surgical specimens.Conclusion Ninety percent of the cases who are diagnosed as high-grade intraepithelial neoplasia by biopsy may have already been complicated with adenocarcinoma.The location and depth of the specimen in gastric biopsy have a considerable influence on pathological diagnosis.The fibroblastic reaction may be considered as an important marker for gastric adenocarcinoma in pathological diagnosis of gastric biopsy.

Objective To explore the risk factors of prehypertension and the relationship between blood pressure and atherosclerosis.Methods The data of 456 cases in the Department of General Medicine were cross-sectional analyzed,including 174 subjects with normotension and 282 with prehypertension.The information was consisted of demographic characteristics,blood pressure,blood biochemical metabolism index,brachia-ankle pulse wave velocity (baPWV),ankle-brachial index (ABI) and carotid intima media thickness (CIMT).Results Compared to normotension group,the levels of systolic pressure,diastolic pressure,pulse pressure,body mass index,fasting blood glucose,glycosylated hemoglobin,triglyceride,uric acid,and C-reactive protein in prehypertension group were significantly increased (P ＜ 0.05) ; and high-density lipoprotein cholesterol was significantly decreased (P ＜0.05) ; the body mass index(OR =1.185),triglyceride(OR =1.302),and fasting blood sugar (OR =1.690) were the independent risk factors of prehypertension ; baPWV and CIMT in prehypertension group were higher,but ABI and artery atheromatous plaque rate were not obvious changed.When baPWV or CIMT were set as the dependent variables,multiple linear regression analysis showed that systolic blood pressure(β =0.226,P =0.007),fasting blood glucose(β =0.209,P =0.018),and age(β =0.279,P =0.002) were risk factors of baPWV;systolic blood pressure(β =0.118,P =0.015),body mass index(β =0.109,P =0.001),and age(β =0.396,P =0.001) were risk factors of CIMT.Conclusions Body mass index,triglycerides,and fasting blood sugar were the independent risk factors of prehypertension.The early subclinical damage of hardening of the arteries was occurred in the prehypertension cases,and systolic blood pressure was closely related with baPWV or CIMT.

Objective To investigate the imaging features of splenic littoral cell angioma (LCA)and correlate with pathological findings.Methods Ten patients of LCA with pathologically confirmed diagnosis were included in this study.A retrospective review of clinical data and imaging findings on CT and MRI was performed,along with review of the literature.Results Splenic littory cell angiomas presented with multiple nodules of varying sizes with a predoninance of small ones.Nine of 10 patients had clinical symptoms of splenomegalia and hypersplenia.MR T2WI and DWI showed masses with high-signalintensity.The CT and MRI enhancing pattern of LCA was similar to splenic hemangioma.There were many mammiliform structures pointing inside in the wall of the vascular channels,a hallmark feature allowing its differentiation from splenic hemangioma pathologically.Conclusion The CT and MRI findings of LCA can show some of its characteristic signs,especially on DWI,which can assist to identify LCA in clinical practice.

Objective:To observe the clinical efficacy of acupuncture plus umbilicus application with Chinese medicine for detrusor underactivity.Methods:A total of 46 male patients with detrusor underactivity who were admitted to our hospital between January and December 2017 were randomized into a control group and an observation group,with 23 cases in each group.The control group received intermittent catheterization and routine nursing,and the observation group was treated with acupuncture plus umbilicus application with Chinese medicine on the basis of the treatment of the control group.The comprehensive efficacy,the improvement of bladder urine residue and maximum flow rate of the two groups were observed.Results:No cases dropped out in the two groups.After the intervention,the total effective rate of the observation group was 78.3％,which was significantly higher than 52.2％ of the control group (P＜0.05).After intervention,the improvements of bladder urine residue and maximum flow rate in the observation group were statistically different from those in the control group (both P＜0.05).Conclusion:The combination of acupuncture and umbilicus application with Chinese medicine added on the basis of intermittent catheterization and routine nursing has a certain effect in treating male patients with detrusor underactivity,and is worth further clinical study.

Objective To observe the effect of meridian balancing on speech disorder in children with cerebral palsy. Methods 130 childrenaged 1.5~7 years old were divided into the control group (n=62) and treatment group (n=68). The control group received routine rehabilitationwhile the treatment group received meridian balancing in addition. Results The rate of improvement was 89.7% in treatmentgroup and 79% in control group (P<0.05). The rate was more for those with language retardation than with anarthria in the treatment group(P<0.01). Conclusion The meridian balancing is effective on speech disorder in children with cerebral palsy, especially for those with languageretardation.

OBJECTIVETo study the antalgic and antiphlogistic functions and mechanism of ronggudingtong (RGDT) plaster (traditional Chinese medicine).

METHODSThe painful models were established with hot plate test or acetic acid writhing and the inflammatory models were established with daubing dimethylbenzene on auricle or injecting formaldehyde in toe or synovial envelope to study the antalgic and antiphlogistic functions of RGDT Plaster. The total protein and leukotriene B4(LTB4) in inflammatory exudate were detected to investigate the antalgic and antiphlogistic mechanism of RGDT plaster. The mice were randomly divided into different groups (n = 11), on the basis of drug using, the indexes of pain threshold, swelling degree were observed. Sixty-six mice were used to establish gasbag synovitis model and randomly divided into normal control group,model control group, positive control group (Voltaren gel 0.8 mg/d)and low/medium/high dosage RGDT plaster treating groups(30 mg/d, 60 mg/d, 120 mg/d).

RESULTS30 mg/d, 60 mg/d,120 mg/d RGDT plaster could upgrade the pain thresholds, remit auricular and foot swelling (P < 0.05, P < 0.01), and degrade total protein and LTB4 in inflammatory exudates (P < 0.05, P < 0.01).

CONCLUSIONRGDT plaster has some antalgic and antiphlogistic functions, and one of the mechanisms is depressing synthesis of LTB4.

Analgesics ; pharmacology ; Animals ; Anti-Inflammatory Agents ; pharmacology ; Leukotriene B4 ; metabolism ; Medicine, Chinese Traditional ; Mice ; Pain ; drug therapy

Endoscopy ; Female ; Humans ; Middle Aged ; Nose ; surgery ; Oculomotor Muscles ; surgery