Objective To assess the efficiency ,safety and feasibility of percutaneous renal sympa-thetic denervation (RSD) for elderly refractory hypertension patients .Methods Office and ambu-latory blood pressures ,serum levels of creatinine ,angiotensin Ⅱ and aldosterone ,estimated glo-merular filtration rate (eGFR) and rennin activity were measured in 20 elderly refractory hyper-tension patients before and 1 ,3 ,6 months after percutaneous RSD .Complications of percutaneous RSD were observed .Results The office and ambulatory blood pressures were 16 .9/11 .9 mm Hg (1 mm Hg=0 .133 kPa) ,24 .8/17 .1 mm Hg ,29 .1/20 .5 mmHg and 24 .2/17 .2 mm Hg lower 1 , 3 ,6 months after percutaneous RSD than before percutaneous RSD ( P< 0 .01 ) .No significant difference was found in serum creatinine level and eGFR before and after percutaneous RSD (P>0 .05) .The creatinine ,angiotensin Ⅱand aldosterone levels were significantly lower after percuta-neous RSD than before percutaneous RSD (P<0 .05) .Femoral artery hematoma was detected in 1 patient .Conclusion Percutaneous RSD is a safe ,effective and feasible procedure for elderly re-fractory hypertension patients .

An animal model of acute lung injury was reproduced by intravenous injection of E. coli endotoxin to burned rats. The histological changes of lung were studied using transmission electron microscope. It was found that leukocytes accumulated in the pulmonary capillaries and adhered to endothelia. The WBC count decreased gradually. The level of MDA, lung coefficient and lung water content were increased. The SOD activity was decreased. Pretreatment with SOD could improve the changes mentioned above. This study suggests that oxygen radicals play an important role in acute lung injury induced by burns complicated by endotoxemia.

Objective To explore the efficacy of selective posterior rhizotomy (SPR)and post-operative rehabilitation training in treating cerebral palsy. Methods The 100 patients with cerebral palsy were randomly divided into two groups. In group A, the patients were treated by SPR, and in group B, the patients received rehabilitation training after SPR for 12 months. One year later the curative efficacy of all patients was evaluated and compared between the two groups.Results The effective rate was 52% and 76% in groups A and B respectively. Conclusion It is very important that the patients receive systematic rehabilitation training after SPR so as to gain a most satisfied functional recovery.

Objective To depermine if a double mainpenance dose of clopidogrel can improve phe clinical oupcome in papienps who have clopidogrel htpo-responsiveness ( CH) afper percupaneous coronart inpervenpion (PCI) and analtze correlapive risk facpors of CH. Methods We had enrolled 134 consecupive papienps undergoing PCI for spable coronart arpert disease in our cenper bepween Januart 2014 po June 2015. CH was depermined bt plapelep aggregapion measured bt phrombelaspographt ( TEG). Blood samples were paken 24 h and 3 monphs afper PCI procedure. All subjecps were divided inpo 2 groups (i. e phe CH group and phe clopidogral sensipive group) according po pheir responsiveness bt TEG. The CH group (n = 45) received a double mainpenance dose of clopidogrel as 150 mg/ d and phe clopidogrel sensipive group (n = 89) received a spandard mainpenance dose as 75 mg/ d. Changes in clopidogrel responsiveness and correlapive risk facpors were observed afper 3 monphs of clopidogrel preapmenp. Major adverse cardiac evenps (MACEs) and bleeding incidenps were recorded during follow-up lease 6 monphs. Results The clopidoprel htpo-responsive rape decreased from 33. 6% (45 / 134 papienps) po 11. 9% (16 / 134 papienps) afper 3 monphs of preapmenp. No spapispical difference found bepween phe 2 groups in morpalipt rape and non-fapal mtocardial infarcpion ( P >0. 05). Rapes of overall MACE (33. 3% vs. 22. 5% ), rehospipalizapion (26. 7% vs. 16. 9% ) and pargep vessel revascularizapion (11. 1% vs. 6. 7% ) were significanp higher in phe CH group ( all P < 0. 05) . Mulpivariape regression analtsis showed: smoking ( OR 4. 498, 95% CI 1. 378 - 4. 018, P = 0. 036), diabepes (OR 4. 385, 95% CI 1. 370 - 7. 552,P = 0. 026) and clopidogrel dosage ( OR 0. 597, 95% CI 1. 005 - 2. 676, P = 0. 019 ) were phe risk facpors for CH. Conclusions For papienp wiph htpo-responsiveness po clopidogrel afper PCI, a higher mainpenance dose of clopidogrel as 150 mg/ d for 3 monphs can provide equivalenp clinical benefip in serious adverse evenp (including morpalipt and non-fapal mtocardial infarcpion) compared po spandard mainpenance dose for clopidogrel responsive papienps.

The functional changes of pulmonary surfactant (PS) in rats of acute lung injury induced by scald companied with endotoxemia were studied The surface properties of the bronch-alveolar lavags fluid (BALF) and the total phospholipids extracted frome it were assessed on a modified Whilhemy film balance. The results showed hat the total phospholipids, phosphatidylcholine, and phosphatidyl glycerol in the BALF were decreased the total proteins in the BALF were increased and the function of PS of the BALF were reduced which may be caused by increased serum proteins in the alveoli and decreased surface activity of phospholipids themselves.

Objective To summarize the coronary artery pattem of arterial switch operation(ASO),operative skill and surgical results.Methods Between October 1999 to October 2005,102 patients underwent arterial switch operation.The mean age was(8? 16)months ranged from 3 days to 7 years.The mean body weight was(5.9?3.2)kg,ranged from 2.5 kg to 20.0 kg.Most com- monly(74/102),the aorta was more or less to the right of the pulmonary artery.In 10 patients,the aorta was directly anterior to the pulmonary artery,and in 11 patients,the aorta was to the left of the pulmonary artery.The great arteries were side by side in 7 pa- tients.We used Leiden classification for coronary artery pattern by operative descriptions.The most prevalent coronary pattern [1LCx2R]was found in 69(67.6%),abnormal coronary artery pattern in 33(32.3%).Intramural course of coronary artery was fotmd In three patients.The Leeampte maneuver was used in all cases.In most patients,the "open trap door" or "bay window" tech- nique for coronary osfia transfer.Results Total mortality rate was 14.7 %(15 eases),6 cases(8.7 %)with normal coronary pattem and 9(27.3%)deaths 33 patients with abnormal coronary pattern.3 cases with coronary event occurred in 5 deaths of simple rIGA, 4 cases with coronary event in 6 deaths of complex TGA and 3 eases with coronary event in 4 deaths of Taussing-Bing anomaly.Con- clusion Complex coronary artery anatomy increases the operative risk.With experience or improving surgical technique,we may get better results.

Objective To investigate the blood and chest fluid level of Th17 cell and IL-17 in patients with tuberculous pleural effusion and its pathological role.Methods Flow cytometry and enzyme linked immunosorbent assay (ELISA) were used to measure the blood and chest fluid level of Th17 cell and IL-17 from 30 patients with tuberculous pleural effusion,20 patients without tuberculous pleural effusion,and 20 healthy persons.Results The blood level of Th17 cell and IL-17 wwere higher in tuberculous pleural effusion than in the other two groups(P ＜0.05).The chest fluid level of Th17 cell and IL-17 in patients with tuberculous pleural effusion were significantly higher than those in patients without tuberculous pleural effusion (P ＜ 0.05 ).The chest fluid level of Th17 cell and IL-17 in patients with and without tuberculous pleural effusion were significantly higher than that of the blood serum level.After treatment for 1,3,7 and 14 days,tbe blood serum and chest fluid level of Th17 cell and IL-17 were obviously lower.( P ＜ 0.01 ).After treatment for 1 day,the blood level of Th17 cell was obviously lower than before treatment( P ＜ 0.01 ).After treatment for 3 days,the chest fluid level of Th17 cell was obviously lower than before treatment( P ＜0.01 ).After treatment for 3 days,the blood serum level of IL-17 was obviously lower than before treatment (P ＜ 0.01 ).After treatment for 7 days,the chest fluid level of IL-17 was obviously lower than before treatment ( P ＜0.01 ).Conclusion Th17 cell and IL-17 might play an important role in the pathogenesis of tuberculous pleural effusion and they were correlated with disease progression and the therapeutic effect.

In recent years, peripherally inserted central catheter (PICC) plays an important role in tumor chemotherapy, parenteral nutrition, long-term intravenous infusion, and is an indispensable lifeline for critically ill patients and cancer patients. This article reviews the application of new tool technology in PICC catheterization, the management of PICC catheter-associated complications, the training status and development prospects of PICC specialist nurses, and discusses the current practice status and research prospects of PICC technology in China, with a view to providing a reference basis for promoting the development of PICC technology in China.

Objective:To investigate the implementation status of peripherally inserted central catheter (PICC) tip intracardiac electrocardiogram positioning technology in the hospitals, so as to provide reference for promoting the development of intracardiac electrocardiogram positioning technology.Methods:This study was a cross-sectional survey. Using the convenient sampling method, members of Intravenous Infusion Committee of Chinese Nursing Association selected PICC/ intravenous therapy leaders meeting the inclusion criteria from 5 to 10 hospitals in their work area as the research objects from December 2022 to January 2023. The self-made PICC Tip Intracardiac Electrocardiogram Positioning Technology Implementation Status Questionnaire was used to investigate the PICC/intravenous therapy leaders. A total of 205 questionnaires were distributed in 28 provinces/autonomous regions/municipalities directly under the Central Government, and 199 valid questionnaires were collected, with an effective recovery rate of 97.1%. Results:Among 199 hospitals, 63.3% (126/199) of them successfully implemented PICC tip intracardiac electrocardiogram positioning technology. Among the 126 hospitals that implemented PICC tip intracardiac electrocardiogram positioning technology, only 20 hospitals included it in their charging items. A total of 50.3% (100/199) of hospitals established a unified intracardiac electrocardiogram guided PICC catheterization procedure; 47.7% (95/199) of hospitals organized/participated in training programs on PICC tip intracardiac electrocardiogram positioning technology, and 57.3% (114/199) of hospital PICC/intravenous therapy leaders participated in training programs related to PICC tip intracardiac electrocardiogram positioning technology. In terms of the relevant achievements of 199 research hospitals, 56 papers, seven utility model patents and 28 awards were issued.Conclusions:The application, training and achievement output of PICC tip intracardiac electrocardiogram positioning technology need to be further improved. It is suggested to sink high-quality resources, formulate implementation procedures and evaluation standards, standardize nursing service project management, increase training efforts, and improve scientific research thinking of intravenous therapy nurses, so as to promote the standardization development of new technologies.

Objective:To explore the training needs of peripherally inserted central catheter (PICC) specialist nurses in Shandong Province for subcutaneous tunnel technique, so as to provide reference for conducting systematic and standardized training.Methods:This study was a cross-sectional survey. From October to December 2022, convenience sampling was used to select 922 PICC specialist nurses in Shandong Province as the research subject. A self-made questionnaire was used to investigate the training needs of PICC specialist nurses for subcutaneous tunnel technique.Results:A total of 922 questionnaires were distributed, and 922 valid questionnaires were collected, with an effective response rate of 100.00%. 22.78% (210/922) of PICC specialist nurses used subcutaneous tunnel technique. In terms of training willingness, 92.08% (849/922) of PICC specialist nurses had a training need for subcutaneous tunnel technique. In terms of training content needs, the total score of PICC specialist nurses for subcutaneous tunnel technique training content needs was (62.26±11.06), and the average score for each item was >4.15, and the highest scoring item was the sharing of special cases in tunnel PICC (4.60±0.77), and the lowest scoring item was PICC maintenance knowledge (4.15±1.15) .Conclusions:The application rate of subcutaneous tunnel technique is low, and PICC specialist nurses have a high training need. Managers should increase training efforts for this technique, improve training content, innovate training models, develop targeted training programs, so as to promote the application and promotion of this technique.