Objective:To evaluate the value of ultrasonography in evaluating the influential factors of early insufficient flow after central venous catheter placement in dialysis patients.Methods:Three hundred and twenty seven hemodialysis patients who underwent central venous catheterization at the Affiliated Hospital of Chengde Medical College from May 2016 to June 2019 were selected. According to the catheter flow, the patients were divided into the low catheter flow group(43 cases) and the normal catheter flow group(284 cases). The distribution variance of clinical features(age, gender, blood pressure) were compared and whether some ultrasonic parameters(position of catheter tip, left ventricular ejection fraction, left atrial end-systolic diameter, left ventricular end-diastolic diameter, distance from the catheter tip to superior vena cava beyond right atrial opening) had influence on the insufficient catheter flow in the early stage between the two groups were analyzed.Results:The differences of left ventricular ejection fraction, left atrial end-systolic diameter and position of catheter tip between the two groups were statistically different( P<0.05). However, univariate and multivariate analyses showed that there were significant differences in catheter tip approaches and touches the wall of right atrium( OR=5.393, 95% CI=2.039-14.263, P=0.001), increased left atrial end-systolic diameter( OR=0.321, 95% CI=0.124-0.827, P=0.019), left ventricular ejection fraction in critical range( OR=2.953, 95% CI=1.113-7.835, P=0.030) and decreased left ventricular ejection fraction( OR=5.828, 95% CI=1.869-18.174, P=0.002) were the independent risk factors of early insufficient catheter flow. Conclusions:Insufficient catheter flow after central venous catheterization is related to catheter position, left atrial end-systolic diameter and left ventricular ejection fraction. Ultrasonography evaluation is a primary method to observe the position of the catheter tip in dialysis patients and diagnose the early insufficient catheter flow after central venous catheterization.

Objective To study the effect of Sinisan on the ultra structure of hippo-campus to the intervention in rats with post-traumatic stress disorder(PTSD).Methods SD rats were divided equally into 5 groups,each group had ten rats:blank control group,model group,negative control group,positive control group and experimental group.The blank control group did not copy the model,the normal feeding.Model group,repetitive post-traumatic stress disorder model was induced by current stimulation,but not treated.Negative control group,equal volume of 0.9％ NaC1.Positive control group (paroxetine hydrochloride 0.42 mg · mL-1) and experimentalgroup (Sinisan,containing crude drug 0.24 g · mL-1).It given to drugs 1 h before the model establishment.The rats were administered with 10 mL · kg-1,once a day,for a total of 7 d.In each group,rats was cardiac perfusion and the hippo-campus tissue was collected.The changes of ultra structure of CA1 and CA3 area in hippo-campus with rats were observed by transmission electron microscope.Results In the blank control group,the CA1 and CA3 neurons in the hippocampus were rich in cytoplasmic organelles,and the mitochondria were round or long,the structure of the mitochondrial cristae was clear,the rough endoplasmic reticulum was like a cord like distribution,and the ribosome was abundant.Compared with the blank control group,the organelle of CA1 and CA3 area in hippo-campus of the model group were significantly damaged,the cytoplasm was open,the mitochondria were swollen,the mitochondrial membrane and cristae disappeared,and the rough endoplasmic reticulum was dilated.The results showed that the damage of the organelles in the hippocampal neurons of rats was induced by the electric shock.The model group was similar to the negative control group,which indicated that there was no significant effect on the stress of rats after intragastric administration.The intracellular organelles in the CA1 and CA3 neurons in the hippocampus of the positive control group and the experimental group were significantly recovered,and the changes in the two groups were similar.These results suggest that both paroxetine hydrochloride and Sinisan can significantly improve the structure of CA1 and CA3 neurons in the hippocampus of PTSD rats.Conclusion Snisan as traditional Chinese medicine compound can significantly improve the hippocampus of rats with PTSD CA1 and CA3 neurons.

Objective To study on intervene function of Sinisan with the ultra structure of hippo-campus in rats with sleep disorder induced by post traumatic stress disorder.Methods Fifty SD rats were divided equally into five groups:blank control group,model group,negative control group,positive control group and experimental group.The control blank group did not copy the model,do not receive drugs,the normal feeding.Model group,repetitive post-traumatic stress disorder model was induced by current stimulation,but not receive drugs.Negative control group,equal volume of 0.9％ NaCl.Positive control group (paroxetine hydrochloride 0.42 mg ·mL-1) and experimental group (Sinisan,containing crude drug 0.24 g · mL-1).It given to drugs 1 h before the model establishment.The rats were administered with 10 mL · kg-1,once a day,for a total of 7 d.The changes of ultra structure of CA1 and CA3 area in hippo-campus with rats were observed by transmission electronmicroscope.Results In the blank control group,the hippocampal neurons were clearly defined,and the synaptic space was obvious in the CA1 and CA3 area.Compared with the blank control group,in the model group,the synaptic structure of hippocampal neurons was significantly changed,the synaptic vesicles were reduced and the synaptic structure was not clear in the CA1 and CA3 area.Compared with the model group,the negative control group was same too,which indicated that there was no significant stress effect on the rats after intragastric administration of saline.Compared with the negative control group,positive control group and experimental group hippocampal neurons synapse structure was restored,and the two groups were similar in the CA1 and CA3 area.Conclusion Transmission electronmicroscope was used to study the ultra structure of CA1 and CA3 in rats hippo-campus with characteristic difference.

Objective To study the effects of sleep latency to the intervention of Sinisan in rats with post-traumatic stress and sleep disorder (PTSD).Methods Fifty SD rats were divided equally into 5 groups:sham operation group,model group,negative control group group,positive control group and experimental group.PTSD model was made by claustrophobia,but not in sham operation group.The model group was not given the drug,the negative control group was given equal volume 0.9％ NaC1,and the positive control group was given paroxetine hydrochloride 0.42 mg · mL-1.The experimental group was perfused with the decoction of Sinisan (containing 0.24 g · mL-1) 10 mL · kg-1.The drug was administered 1 h before the stress model was administered once a day for a total of 7 d.After intervention on the 7th day,nonrapid eye movements sleep (NREMS) and eye movements sleep (REMS) were detected.Results The REMS and NREMS of sham operation group and model group were respectively (8.66 ± 3.04),(23.27 t 10.15) min;(65.90 ± 25.08),(109.36 ± 43.43) min,the differences between groups were statistically significant(all P ＜ 0.01);the result suggest that difficulty in falling asleep appears in rats after modeling.The REMS and NREMS of the positive control group and the experimental group were respectively (8.17 ±2.29),(6.83 ±2.84) min;(162.29 ±46.19),(195.24 ±67.96) min.Comparison between the drugs groups and model group,the difference was statistically significant (P ＜0.05,P ＜0.01).These Results suggested that both paroxetine hydrochloride and Sinisan can significantly promote the sleep of rats.Conclusion Traditional Chinese medicine compound Sinisan can obviously promote the rats with sleep disorder caused by PTSD.

OBJECTIVE: To investigate the pathogen composition and clinical features of preterm infants with sepsis, and to provide a basis for early identification and treatment of sepsis in preterm infants. METHODS: A retrospective analysis was performed for the clinical data of 371 preterm infants with sepsis who had a positive blood culture between January 2014 and May 2018. According to the time of onset, the preterm infants were divided into an early-onset group (an age of onset of <7 days) with 73 preterm infants and a late-onset group (an age of onset of ≥7 days) with 298 preterm infants. The two groups were compared in terms of pathogen composition and clinical features (initial symptoms, laboratory examination results at the time of onset, comorbidities, and prognosis). RESULTS: There was a higher proportion of infants with Klebsiella pneumoniae infection in the late-onset group (P<0.05), while there was a higher proportion of infants with Escherichia coli, Streptococcus agalactiae or Listeria infection in the early-onset group (P<0.05). The early-onset group had a significantly higher proportion of infants with dyspnea than the late-onset group (P<0.05). Compared with the late-onset group, the early-onset group had significantly shorter time to negative conversion of blood culture, duration of antibiotic use before infection, and indwelling time of deep venous catheterization (P<0.05), and the late-onset group had a significantly higher incidence rate of neonatal necrotizing enterocolitis than the early-onset group (P<0.05). The early-onset group had a significantly higher rate of treatment withdrawal than the late-onset group (P<0.05). CONCLUSIONS Preterm infants with sepsis lack typical clinical manifestations and laboratory examination results at the time of onset. There are certain differences in pathogen composition and clinical features between preterm infants with early- and late-onset sepsis. Possible pathogens for sepsis should be considered based on age in days at the time of onset and related clinical features.
Enterocolitis, Necrotizing ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Retrospective Studies ; Sepsis ; Streptococcus agalactiae

Objective To establish a sensitive and specific high per-formance liquid chromatography ( HPLC ) method for similarity analysis of Sinisan lyophilized power in rats serum.Methods HPLC method was applied.The chromatographic conditions were as following: Column:Kromasil C18 column ( 4.6 mm ×250 mm, 5 μm );flow -rate:1.0 mL? min -1;column temperature:30 ℃.The mobile phase:acetonitrile ( A) and H2 O ( acidified to pH=3 with phosphoric acid) ( B) with a gra-dient elution.The concentration of solvent A was from 10% to 90% in 150 min.Ten batches Sinisan lyophilized powder samples in serum were analyzed by HPLC fingerprint.Results The HPLC chromatographic fingerprin-ting of Sinisan showed 8 characteristic peaks compared with that of blank serum, they were absorbed into blood.The result of sim-ilarity analysis was over 0.99. Conclusion The chromatographic fingerprinting of Sinisan lyophizied power had high specificity and characteristic.

Objective To study the influence of Sinisan on hippocampal CA1 and CA3 neuron spatiotemporal characteristics in rats with post-traumatic stress disorder(PTSD).Methods SD rats were divided into five groups:normal group,blank group,model group,control group,experimental group.Except for normal group and blank group,the rats in other groups were stimulated by the current stimulation plus dark claustrophobic method to replicate the posttraumatic stress disorder (PTSD) model.The blank group and model group were given 0.9％ NaCl 10 mL · kg-1 at 1 h before making the model.The control group and experimental group was given paroxetine hydrochloride 0.42 mg · mL-1 and Sinisan(containing crude drug 0.24 g · mL-1) by intragastric administration,respectively.The model replicated 7 d,and each electric shock was 30 min every morning and afternoon.The neural coding on amplitude in hippocampal CA1 and CA3 were detected by the M-NEMEA after administration,and the spectral density spectrum was obtained from Neuro explorer neural data analysis software.Results The power spectral densities of CA1 and CA3 in hippocampus of rats were determined,they were (-109.08 ± 15.41) and (-108.46 ± 13.16)dB in normal group,(-110.17 ± 14.30)and (-109.54 ± 14.16)dB in blank group,and the differences were not statistically significant (all P ＞ 0.05).Compared with the blank group,the power spectral densities of hippocampus in the model group decreased significantly,which were (-117.39 ± 14.97),(-122.51 ± 16.42) dB,and the differences were statistically significant (all P ＜0.01).Compared with the model group,the power spectral densities of the experimental group in hippocampus were significantly higher (P＜0.01),which were (-110.83 ±11.40),(-110.36 ±10.87)dB.Conclusion The Sinisanhas significant positive effect on hippocampal neuron signal intensity.

Objective To study the function mechanism of the Sinisan on hippocampal neuron discharge amplitude in rats with post-traumatic stress disorder and sleep disorder.Methods Fifty SD rats were divided into blank group,model group,negative control group,positive control group and experimental group.The blank group did not copy the model,did not receive treatment,the normal feeding.The repetitive post-traumatic stress disorder model was induced by current stimulation in model group,but not treated.Negative control group was given equal volume of 0.9％ NaC1.Positive control group was given paroxetine hydrochloride 0.42 mg · mL-1 and experimental group was given Sinisan,containing crude drug 0.24 g · mL-1.The rats were administered with 10 mL · kg-1,once a day,for 7 d.Theneural coding on amplitude in hippocampal CA1/CA3 were detected by M-NEMEA after the treatment.Results The amplitude of the wave amplitude in model group were 63.73 ± 5.80,63.24 ± 6.29,significantly lower than those of negative control group,which were 90.95 ± 5.94,91.16 ± 8.18 (P ＜ 0.01).And the wave amplitude in positive control group were 87.12 ± 8.14,87.21 ± 7.94,and were 91.63 ± 7.30,91.39 ± 7.64 in experimental group,had significant difference with those in model group (P ＜ 0.01).Conclusion The Sinisan have significant positive effect on hippocampal neuron discharge amplitude.

The tracheal aspirates and serum samples of a suspected human case of high-pathogenic avian influenza (firstly found in Shenzhen, China) were collected and tested by a series of assays. The results showed that the RNA extracted from the tracheal aspirate specimens of the patient was confirmed positive for H5N1 avian influenza virus by Real-time PCR. The H5N1 avian influenza virus was isolated from patient's tracheal aspirates on MDCK cell and was named A/Guangdong/2/06(H5N1). The viral load of tracheal aspirates collected at different time points were detected by Real-time PCR. The virus microneutralization and the antigenic ratio of human H5N1 isolated were also assayed. It was found that when the virus load decreased gradually after the disease onset, the serum neutralizing antibody titer in the patient increased to 1 : 160 and subsequently decreased gradually. By molecular analysis, the eight gene segments of A/Guangdong/2/06 revealed to be similar to that of H5N1 avian influenza viruses isolated from south China in 2005-2006. However, there were obvious differences in the gene sequence of the detected H5N1 viral RNA as compared with that of the strains isolated from Vietnam, Thailand and Indonesia.
Adult ; Amino Acid Sequence ; Antibodies, Viral ; blood ; Humans ; Influenza A Virus, H5N1 Subtype ; genetics ; immunology ; isolation & purification ; Influenza, Human ; diagnosis ; virology ; Male ; Molecular Sequence Data ; Mutation ; Neutralization Tests ; RNA, Viral ; blood

BACKGROUND: Heterotopic ossification (HO) is a known complication of hip arthroscopy. We investigated incidence of HO after hip arthroscopy and determined whether revision for HO improved outcome. METHODS: A retrospective study was conducted on 242 patients (140 men and 102 women, mean age: 36.2 ± 9.5 years) who underwent hip arthroscopy for femoroacetabular impingement (FAI) between January 2016 and January 2018. The average follow-up period was 22.88 ± 11.74 months (range: 11-34 months). Thirteen (5.37%) cases of HO (six men and seven women, five left hips and eight right hips; mean age: 37.5 ± 4.7 years) were observed. Among them, four cases with HO with obvious pain symptoms and persistent non-remission underwent revision surgery to remove HO. Monthly follow-up was conducted. Visual analog scale (VAS), modified Harris Hip Score (mHHS), and non-Arthritis Hip Score (NAHS) were evaluated and compared between HO and non-HO patients. Independent sample t test, Mann-Whitney U test and the Chi-square test were used for inter-group comparisons. HO degree was evaluated using Brooker classification. Symptoms and function were evaluated before and after revision. RESULTS: A total of 242 patients were involved in this study. Thirteen cases (5.4%) had imaging evidence of HO. Nine (9/13) were classified as Brooker stage I, three (3/13) Brooker stage II, and one (1/13) Brooker stage III. HO was detected by ultrasonography as early as 3 weeks after operation. After primary surgery, the mHHS of the HO group and non-HO group increased by 13.00 (8.50, 25.50) and 24.00 (14.00, 34.50) points (Z = -1.80, P = 0.08), NAHS increased by 18.00 (9.50, 31.50) and 26.00 (13.50, 36.00) points (Z = -1.34, P = 0.18), and VAS decreased by 3.00 (2.00, 4.00) and 4.00 (3.00, 4.50) points (Z = -1.55, P = 0.12). Average follow-up time after revision was 9.00 ± 2.94 months; mHHS increased by 34.75 points (t = -55.23, P < 0.01) and NAHS by 28.75 points (t = -6.03, P < 0.01), and VAS decreased by 4 points (t = 9.80, P < 0.01). HO and non-HO patients were similar for demographic and surgical data, and clinical and functional scores. CONCLUSION HO incidence after arthroscopic treatment of FAI is similar to that found in previous studies. Most HO have no effect on clinical symptoms. Patients who undergo revision HO resection show improvement in pain and joint function.
Adult ; Arthroscopy ; adverse effects ; Female ; Femoracetabular Impingement ; surgery ; Hip Joint ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Ossification, Heterotopic ; diagnosis ; etiology ; Retrospective Studies ; Treatment Outcome