BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pa...BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pain control after operation for femoral bone fracture and decreases the complications induced by systemic analgesic drugs. The severity of postoperative pain is affected by genetics, cultural and social factors across the world. In this study we assessed the efficacy of fascia iliaca compartment nerve block when it is used as part of multimodal analgesia after surgery for femoral bone fracture.METHODS: An institution-based case control study was conducted from September, 2013 to May, 2014. All patients who had been operated on under spinal anesthesia for femoral bone fracture were included. The patients divided into a FICNB group(n=20) and a control group(n=20). The FICNB group was given 30 mL of 0.25% bupivacaine at the end of the operation. Postoperative pain was assessed within the f irst 24 hours, i.e. at 15 minutes, 2 hours, 6 hours, 12 hours and 24 hours using 100 mm visual analogue scale(VAS), total analgesic consumption, and the time for the f irst analgesic request.RESULTS: VAS pain scores were reduced within the f irst 24 hours after operation in the FICNB group compared wtih the control group. VAS scores at 2 hours were taken as median values(IQR) 0.00(0.00) vs.18.00(30.00), P=0.001; at 6 hours 0.00(0.00) vs. 34.00(20.75), P=0.000; at 24 hours 12.50(10.00) vs. 31.50(20.75), P=0.004; and at 12 hours(17.80±12.45) vs.(29.95±12.40), P=0.004, respectively. The total analgesic consumption of diclofenac at 12 and 24 hours was reduced in the FICNB group, and the time for the fi rst analgesic request was signifi cantly prolonged(417.50 vs. 139.25 minutes, P=0.000).CONCLUSIONS: A single injection for FICNB could lead to postoperative pain relief, reduction of total analgesic consumption and prolonged time for the fi rst analgesic request in the FICNB group after surgery for femoral bone fracture. We recommend FICNB for analgesia after surgery for femoral bone fracture and for patients with femoral bone fracture at the emergency department.展开更多
Objective To explore a new method for the therapy of avascular necrosis of the femoral head. Method The recombinant plasmid pCD-rbFGF was mixed with collagen and was implanted in the necrotic femoral head. Expression ...Objective To explore a new method for the therapy of avascular necrosis of the femoral head. Method The recombinant plasmid pCD-rbFGF was mixed with collagen and was implanted in the necrotic femoral head. Expression of basic fibroblast growth factor (bFGF) was examined by RT-PCR and immunohistochemical method. Re-pair of the femoral head was observed by histological and histomorphometric analysis. Result Expression of bFGF was detected in the femoral head transfected with bFGF gene, indicating significant increase of angiogenesis 2 weeks after gene transfection and increased new bone formation 8 weeks after gene transfection on histom-orphometric analysis (P< 0.01). Conclusion Transfection of bFGF gene enhances bone tissue angiogenesis. Repair in osteonecrosis would be accelerated accordingly.展开更多
Objective: To explore the pathogenesis of avascular necrosis of femoral head (ANFH), the early diagnosis index and the treatment effective index of ANFH in clinical practice. Methods: Twenty-four Japanese rabbits were...Objective: To explore the pathogenesis of avascular necrosis of femoral head (ANFH), the early diagnosis index and the treatment effective index of ANFH in clinical practice. Methods: Twenty-four Japanese rabbits were divided into 2 groups: model group and control group. ANFH models were produced by intramuscular injection of large dosage of steroid to rabbits for 8 weeks. On the 4 th, 8 th week after the injection, two rabbits each time from each group were taken to observe the structure of femoral head by light microscope and scanning electron microscope. Four other stomach-empty rabbits from each group were also used to test the contents of Nitric Oxide (NO), contents of the hemorheology indexes. Results: Compared with the control group, the rabbits in the model group exhibited osteoporosis of femoral head and more bone lacuna and more fat cells through light microscope. Through scanning electron microscope observation bone trabecula were broken and sunk, and collagen fibers on the surface of bone matrix became loosen and broken, more osteocyte had pyknosis, adipocyte in the medullary cavity were enlarged and subchondral arterioles and capillaries of the femoral head were pressed by adipocyte. Compared with the control group, the model rabbits contained less NO and obvious increase of the plasma viscosity (PV), low blood viscosity (LBV), erythrocyte hematocrit (HCT), indices of erythrocyte rigidity (TK) and indices of erythrocyte aggregation (AI), plasma fibrin level (PFL) (P<0. 01) and an increase of erythrocyte electrophoresis rate (ERT) (P< 0.05). High blood viscosity (HBV), and erythrocyte sedimentation rate (ESR) were unchanged. Conclusion: The steroid-induced ANFH might be related to less NO and the abnormal hemorheology; and NO and hemorheology should be considered as an early diagnosis index for ANFH in clinical practice.展开更多
Fifteen cases,27 hips,of idiopathic necrosis of the femoral head (INFH) were included iour series.The role of radiography,isotopic bone scanning,intraosseous pressure measure-ment and intraosseous venography in the di...Fifteen cases,27 hips,of idiopathic necrosis of the femoral head (INFH) were included iour series.The role of radiography,isotopic bone scanning,intraosseous pressure measure-ment and intraosseous venography in the diagnosis of INFH were evaluated.Radiologicalexamination could not reveal early cases,while isotopic bone scanning was more sensitive.There was an increase of intraosseous pressure in most of the diseased hips.and intraos-seous venography showed abnormalities in all examined hips.The latter two tests couldtherefore detect early INFH.Core decompression was performed in 23 hips,21 of whichwere followed for 7 to 27 months.Functional evaluation was good or excellent in 18 hips.Radiological re-examination remained unchanged in 19 hips.Postoperative intraosseouspressure measurement and intraosseous venography revealed a decrease of intraosseous pres-sure and improvement of venous drainage.Core decompression is therefore an ideal methodof treatment for early INFH.展开更多
This paper presents the development of the blood flow simulation in two dimensions over the real geometry of the femoral artery. The Navier-Stokes equations are solved using the finite element method, to obtain the di...This paper presents the development of the blood flow simulation in two dimensions over the real geometry of the femoral artery. The Navier-Stokes equations are solved using the finite element method, to obtain the distributions of the blood pressure and flow velocity in multiple instants of time and different places of the femoral artery and thus determine the current condition of the blood vessels. The velocity field shows a laminar behavior,where, the velocity is higher in the center of the artery and decreases as the blood flow approaches artery walls. In spite of all artery and blood flow properties not being considered, the values of pressure and velocity obtained are within the normal ranges. Finally the model is used to verify if there exist irregularities in the blood flow in both healthy subjects and sick patients.展开更多
Osteonecrosis of the femoral head (ONFH) is a disabling pathology influencing the population averagely aged 33-38 years. It is characterized by a compromised subchondral microcirculation, especially in the small retin...Osteonecrosis of the femoral head (ONFH) is a disabling pathology influencing the population averagely aged 33-38 years. It is characterized by a compromised subchondral microcirculation, especially in the small retinacular vessels. The prevalence of ONFH is relatively high in China. At present, the surgery is the optimal treatment modality for ONFH, but it still can result in many complications. In recent years, traditional Chinese Medicine (TCM) has shown unique advantages in ONFH, including internal application and external application of Chinese herbs, TCM fumigation, TCM iontophoresis, TCM Tazi and so on. This article primarily investigated the key points of common syndromes, TCM nursing methods and healthy guidance of ONFH in adults, aiming at maintaining and developing the strengths of TCM, improving its efficacy and standardizing its behavior.展开更多
To investigate hip morphology in ischiofemoral impingement(IFI)patients and explore correlations between IFI and female pelvis morphology.Three-dimensional models based on DICOM data from 211 symptomatic(diagnosed wit...To investigate hip morphology in ischiofemoral impingement(IFI)patients and explore correlations between IFI and female pelvis morphology.Three-dimensional models based on DICOM data from 211 symptomatic(diagnosed with IFI)and 224 asymptomatic(without pain or hip surgery history)hips were reconstructed to compare morphological parameters among symptomatic and asy mptomatic participants.展开更多
Objective:To appraise the clinic effect of hemiarthroplasty for treating the femoral neck fracture.Methods: 65 elderly cases of femoral neck fracture were operated on with hemiarthroplasty from January, 1988 to May,20...Objective:To appraise the clinic effect of hemiarthroplasty for treating the femoral neck fracture.Methods: 65 elderly cases of femoral neck fracture were operated on with hemiarthroplasty from January, 1988 to May,2000. Results: 61 patients were followed up for an average period of about 2 years and 5 months. According to Harris evaluation method, the excellent or good results of unipolar hemiarthroplasty appeared in 88% of the patients, that of bipolar hemiarthoplasty in 94.4 % of the patients. By x2 test, there was no significant difference between the two operative results. ( P ＞ 0.05). Conclusion: The method is a fairly good one for the treatment of elderly patients with femoral neck fracture, in which early operation is important.展开更多
BACKGROUND:Catheter-related infection(CRI)of the central vein is a common cause of nosocomial infection.This study was undertaken to investigate the pathogen culturing and risk factors of CRI in emergency intensive ca...BACKGROUND:Catheter-related infection(CRI)of the central vein is a common cause of nosocomial infection.This study was undertaken to investigate the pathogen culturing and risk factors of CRI in emergency intensive care unit(EICU)in order to provide the beneficial reference.METHODS:From January 2008 to December 2010,a total of 1 363 patients were subjected to catheterization.In these patients,the peak CRI rate of the patients was determined by bacterial cultivation and blood bacterial cultivation.RESULTS:CRI happened in 147 of the 1 363 patients using the central venous catheter.The peak rate of CRI was 10.79%,with an incidence of 3.05 episodes per 1 000 catheter days.Of the147 patients,46.94%had gram-negative bacilli,40.14%had gram-positive cocci,and 12.92%had fungi.Unconditional logistic regression analysis suggests that multiple catheterization,femoral vein catheterization,the application of multicavity catheter,and the duration of catheterization were the independent risk factors for CRI.CONCLUSION:The risk factors for catheter-related infections should be controlled to prevent the occurrence of nosocomial infection.展开更多
Background and Objective The frequency of multifocal atherosclerosis (MFA) in patients with coronary heart disease (CHD) has not been thoroughly studied. The purpose of our study was to perform ultrasound screening fo...Background and Objective The frequency of multifocal atherosclerosis (MFA) in patients with coronary heart disease (CHD) has not been thoroughly studied. The purpose of our study was to perform ultrasound screening for MFA in patients with coronary atherosclerosis and make evaluation of the sensitivity and significance of different atherosclerosis markers. Methods Using Color Dupplex Ultrasound (CDU), we studied 32 clinically healthy persons and 87 patients of the city of B with clinical data for CHD where we also performed coronarography. Results In patients with coronary atherosclerosis we found high frequency of carotid atherosclerosis (93%) and peripheral artery disease (PAD) (81%). We established verifiable thickening of the intima-media (IMT) of the common carotid artery (CCA) and common femoral artery (CFA) in patients with CHD. There is a correlation between the frequency of carotid and femoral stenoses and CHD proven by coronarography. Patients with CHD had a high relative risk to develop carotid (RR = 5) and peripheral atherosclerosis (RR=3.5) and high frequency of asymptomatic stenoses and thromboses of the internal carotid artery (86.9%) and femoral artery (78.3%), as well as aneurisms of the abdominal aorta (8.1%). Markers for CAD with high sensitivity were the atherosclerotic plaques of ICA (0.93) and CFA (0.81) as well as IMT of the CFA (0.84). Conclusions MFA are common among patients with CHD. Ultrasound diagnosis is the method of choice for simultaneous non-invasive screening of carotid, peripheral and MFA and provides sensitive markers for coronary atherosclerosis. The most sensitive and specific markers for CHD are the combination of the IMT and atherosclerotic plaques of CCA, ICA and CFA (100% sensitivity and 0.92 specificity).展开更多
Background Transradial access for coronary catheterization is more technically challenging compared to the traditional transfemoral approach and radial access failure is quite common. The aim of this study is to descr...Background Transradial access for coronary catheterization is more technically challenging compared to the traditional transfemoral approach and radial access failure is quite common. The aim of this study is to describe the additional steps after initial radial access site failure in a high specialized forearm approach center. Methods A retrospective evaluation of all coronary catheterizations performed in our Department between January 2016 and December 2016 was performed, with focus on arterial access. Results One thousand three hundred forty six procedures were evaluated. The initial access site used was right radial [1173 procedures （87.1%）], left radial [120 procedures （8.9%）], fight ulnar [7 procedures （0.5%）], left ulnar [40 procedures （2.9%）] and femoral approach [6 procedures （0.4%）]. Radial artery can- nulation failure was observed in 37 procedures （2.9% of 1293 procedures with initial radial approach）. Failure of procedure completion after successful radial sheath insertion was observed in 46 procedures （3.6%）. The alternative access site after initial radial approach failure was contralateral radial [43 procedures （51.8%）], ipsilateral ulnar [22 procedures （26.5%）, contralateral ulnar [12 patients （14.5%）] and femoral approach [6 procedures （7.2%）]. Conclusion Forearm arteries can be used as alternative access site after initial radial approach failure in order to reduce the use of femoral approach during cardiac catheterization.展开更多
Objective: To study the effect of CO2 pneumoperitoneum and the special 30 degree head-down tilt position on the venous hemodynamics in the lower extremity. Methods: Color doplex ultrasound was adopted to evaluate the ...Objective: To study the effect of CO2 pneumoperitoneum and the special 30 degree head-down tilt position on the venous hemodynamics in the lower extremity. Methods: Color doplex ultrasound was adopted to evaluate the diameter and blood flow velocity of the right femoral vein of 18 patients undergoing gynecologic laparoscopy under the same pressure of pneumoperitoneum of 12 mmHg. The diameter of femoral vein and the flow velocity were measured; the blood flow volume was calculated based on the equation of Q = vπr2 . Result: After establishment of pneumoperitoneum, the dilation of the femoral vein and the decrease in the velocity and volume can be observed (P < 0.05). And the 30 degree head-down position could increase the flow velocity and volume of the femoral vein and decrease the diameter of the vessel ( P < 0.05). At 30 minutes of the 30 degree head-down tilt position, the blood flow ameliorated compared with that in prone position after the establishment of pneumoperitoneum. After deflation of pneumoperitoneum, the femoral vein remained dilated( P < 0. 05). Conclusion: During laparoscopy, CO2 pneumoperitoneum may result in the dilation of the vein in lower extremity and retar dance of blood flow. The 30 degree Trendlenburg position can ameliorate the blood flow in the lower extremity. The deflation of the pneumoperitoneum cannot eliminate the effect of CO2 pneumoperitoneum on the lower extremity veins, which may predispose deep venous thrombosis after laparoscopy.展开更多
Legg-Calvé-Perthes disease(LCPD),a historically-considered osteochondrosis,is now being diagnosed as an idiopathic avascularnecrosis of the femoral head in children.At present,the treatment for LCPD mainly focuse...Legg-Calvé-Perthes disease(LCPD),a historically-considered osteochondrosis,is now being diagnosed as an idiopathic avascularnecrosis of the femoral head in children.At present,the treatment for LCPD mainly focuses on the preservation orrecovery of the arthrogenic component of the femoral head.The currently-available surgical methods are various,most of which can obtain bettertherapeutic effects in LCPD.Nerveless,these surgeries are not universally acknowledged,and may have some limitations like increased articularand vascularinjury.In recent years,Traditional Chinese Medicine(TCM)has been shown a certain advantage in LCPD.This article primarily investigated the key points of common syndromes,TCM nursing methods and healthy guidance of LCPD,aiming at maintaining and developing the strengths of TCM,improving its efficacy and standardizing its behavior.展开更多
To investigate the effects of high flow shear stress on the smooth muscle of the collateral vessels of hind limbs in aged rats using a collateral vessel growth model of femoral artery ligation plus femoral arter ioven...To investigate the effects of high flow shear stress on the smooth muscle of the collateral vessels of hind limbs in aged rats using a collateral vessel growth model of femoral artery ligation plus femoral arter iovenous anastomosis and femoral artery ligation alone.10 adult rats and 15 old rats were divided into adult sham group,adult femoral artery ligation group,aged sham group,aged femoral artery ligation group and aged femoral artery liga tion with femoral arteriovenous shunt group.F emoral artery ligation group was performed with two knots.F emoral art eriovenous shunt group was created a sideto-side anastomosis between the distal stump of the occluded femoral artery and the accompanying vein,The rats survived for 1 week after surgery,collateral vessel growth was examined by imm unofluorescence.展开更多
文摘BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pain control after operation for femoral bone fracture and decreases the complications induced by systemic analgesic drugs. The severity of postoperative pain is affected by genetics, cultural and social factors across the world. In this study we assessed the efficacy of fascia iliaca compartment nerve block when it is used as part of multimodal analgesia after surgery for femoral bone fracture.METHODS: An institution-based case control study was conducted from September, 2013 to May, 2014. All patients who had been operated on under spinal anesthesia for femoral bone fracture were included. The patients divided into a FICNB group(n=20) and a control group(n=20). The FICNB group was given 30 mL of 0.25% bupivacaine at the end of the operation. Postoperative pain was assessed within the f irst 24 hours, i.e. at 15 minutes, 2 hours, 6 hours, 12 hours and 24 hours using 100 mm visual analogue scale(VAS), total analgesic consumption, and the time for the f irst analgesic request.RESULTS: VAS pain scores were reduced within the f irst 24 hours after operation in the FICNB group compared wtih the control group. VAS scores at 2 hours were taken as median values(IQR) 0.00(0.00) vs.18.00(30.00), P=0.001; at 6 hours 0.00(0.00) vs. 34.00(20.75), P=0.000; at 24 hours 12.50(10.00) vs. 31.50(20.75), P=0.004; and at 12 hours(17.80±12.45) vs.(29.95±12.40), P=0.004, respectively. The total analgesic consumption of diclofenac at 12 and 24 hours was reduced in the FICNB group, and the time for the fi rst analgesic request was signifi cantly prolonged(417.50 vs. 139.25 minutes, P=0.000).CONCLUSIONS: A single injection for FICNB could lead to postoperative pain relief, reduction of total analgesic consumption and prolonged time for the fi rst analgesic request in the FICNB group after surgery for femoral bone fracture. We recommend FICNB for analgesia after surgery for femoral bone fracture and for patients with femoral bone fracture at the emergency department.
基金Supported by the National Natural Sciences Foundation of China(30170945).
文摘Objective To explore a new method for the therapy of avascular necrosis of the femoral head. Method The recombinant plasmid pCD-rbFGF was mixed with collagen and was implanted in the necrotic femoral head. Expression of basic fibroblast growth factor (bFGF) was examined by RT-PCR and immunohistochemical method. Re-pair of the femoral head was observed by histological and histomorphometric analysis. Result Expression of bFGF was detected in the femoral head transfected with bFGF gene, indicating significant increase of angiogenesis 2 weeks after gene transfection and increased new bone formation 8 weeks after gene transfection on histom-orphometric analysis (P< 0.01). Conclusion Transfection of bFGF gene enhances bone tissue angiogenesis. Repair in osteonecrosis would be accelerated accordingly.
文摘Objective: To explore the pathogenesis of avascular necrosis of femoral head (ANFH), the early diagnosis index and the treatment effective index of ANFH in clinical practice. Methods: Twenty-four Japanese rabbits were divided into 2 groups: model group and control group. ANFH models were produced by intramuscular injection of large dosage of steroid to rabbits for 8 weeks. On the 4 th, 8 th week after the injection, two rabbits each time from each group were taken to observe the structure of femoral head by light microscope and scanning electron microscope. Four other stomach-empty rabbits from each group were also used to test the contents of Nitric Oxide (NO), contents of the hemorheology indexes. Results: Compared with the control group, the rabbits in the model group exhibited osteoporosis of femoral head and more bone lacuna and more fat cells through light microscope. Through scanning electron microscope observation bone trabecula were broken and sunk, and collagen fibers on the surface of bone matrix became loosen and broken, more osteocyte had pyknosis, adipocyte in the medullary cavity were enlarged and subchondral arterioles and capillaries of the femoral head were pressed by adipocyte. Compared with the control group, the model rabbits contained less NO and obvious increase of the plasma viscosity (PV), low blood viscosity (LBV), erythrocyte hematocrit (HCT), indices of erythrocyte rigidity (TK) and indices of erythrocyte aggregation (AI), plasma fibrin level (PFL) (P<0. 01) and an increase of erythrocyte electrophoresis rate (ERT) (P< 0.05). High blood viscosity (HBV), and erythrocyte sedimentation rate (ESR) were unchanged. Conclusion: The steroid-induced ANFH might be related to less NO and the abnormal hemorheology; and NO and hemorheology should be considered as an early diagnosis index for ANFH in clinical practice.
文摘Fifteen cases,27 hips,of idiopathic necrosis of the femoral head (INFH) were included iour series.The role of radiography,isotopic bone scanning,intraosseous pressure measure-ment and intraosseous venography in the diagnosis of INFH were evaluated.Radiologicalexamination could not reveal early cases,while isotopic bone scanning was more sensitive.There was an increase of intraosseous pressure in most of the diseased hips.and intraos-seous venography showed abnormalities in all examined hips.The latter two tests couldtherefore detect early INFH.Core decompression was performed in 23 hips,21 of whichwere followed for 7 to 27 months.Functional evaluation was good or excellent in 18 hips.Radiological re-examination remained unchanged in 19 hips.Postoperative intraosseouspressure measurement and intraosseous venography revealed a decrease of intraosseous pres-sure and improvement of venous drainage.Core decompression is therefore an ideal methodof treatment for early INFH.
文摘This paper presents the development of the blood flow simulation in two dimensions over the real geometry of the femoral artery. The Navier-Stokes equations are solved using the finite element method, to obtain the distributions of the blood pressure and flow velocity in multiple instants of time and different places of the femoral artery and thus determine the current condition of the blood vessels. The velocity field shows a laminar behavior,where, the velocity is higher in the center of the artery and decreases as the blood flow approaches artery walls. In spite of all artery and blood flow properties not being considered, the values of pressure and velocity obtained are within the normal ranges. Finally the model is used to verify if there exist irregularities in the blood flow in both healthy subjects and sick patients.
文摘Osteonecrosis of the femoral head (ONFH) is a disabling pathology influencing the population averagely aged 33-38 years. It is characterized by a compromised subchondral microcirculation, especially in the small retinacular vessels. The prevalence of ONFH is relatively high in China. At present, the surgery is the optimal treatment modality for ONFH, but it still can result in many complications. In recent years, traditional Chinese Medicine (TCM) has shown unique advantages in ONFH, including internal application and external application of Chinese herbs, TCM fumigation, TCM iontophoresis, TCM Tazi and so on. This article primarily investigated the key points of common syndromes, TCM nursing methods and healthy guidance of ONFH in adults, aiming at maintaining and developing the strengths of TCM, improving its efficacy and standardizing its behavior.
文摘To investigate hip morphology in ischiofemoral impingement(IFI)patients and explore correlations between IFI and female pelvis morphology.Three-dimensional models based on DICOM data from 211 symptomatic(diagnosed with IFI)and 224 asymptomatic(without pain or hip surgery history)hips were reconstructed to compare morphological parameters among symptomatic and asy mptomatic participants.
文摘Objective:To appraise the clinic effect of hemiarthroplasty for treating the femoral neck fracture.Methods: 65 elderly cases of femoral neck fracture were operated on with hemiarthroplasty from January, 1988 to May,2000. Results: 61 patients were followed up for an average period of about 2 years and 5 months. According to Harris evaluation method, the excellent or good results of unipolar hemiarthroplasty appeared in 88% of the patients, that of bipolar hemiarthoplasty in 94.4 % of the patients. By x2 test, there was no significant difference between the two operative results. ( P ＞ 0.05). Conclusion: The method is a fairly good one for the treatment of elderly patients with femoral neck fracture, in which early operation is important.
文摘BACKGROUND:Catheter-related infection(CRI)of the central vein is a common cause of nosocomial infection.This study was undertaken to investigate the pathogen culturing and risk factors of CRI in emergency intensive care unit(EICU)in order to provide the beneficial reference.METHODS:From January 2008 to December 2010,a total of 1 363 patients were subjected to catheterization.In these patients,the peak CRI rate of the patients was determined by bacterial cultivation and blood bacterial cultivation.RESULTS:CRI happened in 147 of the 1 363 patients using the central venous catheter.The peak rate of CRI was 10.79%,with an incidence of 3.05 episodes per 1 000 catheter days.Of the147 patients,46.94%had gram-negative bacilli,40.14%had gram-positive cocci,and 12.92%had fungi.Unconditional logistic regression analysis suggests that multiple catheterization,femoral vein catheterization,the application of multicavity catheter,and the duration of catheterization were the independent risk factors for CRI.CONCLUSION:The risk factors for catheter-related infections should be controlled to prevent the occurrence of nosocomial infection.
文摘Background and Objective The frequency of multifocal atherosclerosis (MFA) in patients with coronary heart disease (CHD) has not been thoroughly studied. The purpose of our study was to perform ultrasound screening for MFA in patients with coronary atherosclerosis and make evaluation of the sensitivity and significance of different atherosclerosis markers. Methods Using Color Dupplex Ultrasound (CDU), we studied 32 clinically healthy persons and 87 patients of the city of B with clinical data for CHD where we also performed coronarography. Results In patients with coronary atherosclerosis we found high frequency of carotid atherosclerosis (93%) and peripheral artery disease (PAD) (81%). We established verifiable thickening of the intima-media (IMT) of the common carotid artery (CCA) and common femoral artery (CFA) in patients with CHD. There is a correlation between the frequency of carotid and femoral stenoses and CHD proven by coronarography. Patients with CHD had a high relative risk to develop carotid (RR = 5) and peripheral atherosclerosis (RR=3.5) and high frequency of asymptomatic stenoses and thromboses of the internal carotid artery (86.9%) and femoral artery (78.3%), as well as aneurisms of the abdominal aorta (8.1%). Markers for CAD with high sensitivity were the atherosclerotic plaques of ICA (0.93) and CFA (0.81) as well as IMT of the CFA (0.84). Conclusions MFA are common among patients with CHD. Ultrasound diagnosis is the method of choice for simultaneous non-invasive screening of carotid, peripheral and MFA and provides sensitive markers for coronary atherosclerosis. The most sensitive and specific markers for CHD are the combination of the IMT and atherosclerotic plaques of CCA, ICA and CFA (100% sensitivity and 0.92 specificity).
文摘Background Transradial access for coronary catheterization is more technically challenging compared to the traditional transfemoral approach and radial access failure is quite common. The aim of this study is to describe the additional steps after initial radial access site failure in a high specialized forearm approach center. Methods A retrospective evaluation of all coronary catheterizations performed in our Department between January 2016 and December 2016 was performed, with focus on arterial access. Results One thousand three hundred forty six procedures were evaluated. The initial access site used was right radial [1173 procedures （87.1%）], left radial [120 procedures （8.9%）], fight ulnar [7 procedures （0.5%）], left ulnar [40 procedures （2.9%）] and femoral approach [6 procedures （0.4%）]. Radial artery can- nulation failure was observed in 37 procedures （2.9% of 1293 procedures with initial radial approach）. Failure of procedure completion after successful radial sheath insertion was observed in 46 procedures （3.6%）. The alternative access site after initial radial approach failure was contralateral radial [43 procedures （51.8%）], ipsilateral ulnar [22 procedures （26.5%）, contralateral ulnar [12 patients （14.5%）] and femoral approach [6 procedures （7.2%）]. Conclusion Forearm arteries can be used as alternative access site after initial radial approach failure in order to reduce the use of femoral approach during cardiac catheterization.
文摘Objective: To study the effect of CO2 pneumoperitoneum and the special 30 degree head-down tilt position on the venous hemodynamics in the lower extremity. Methods: Color doplex ultrasound was adopted to evaluate the diameter and blood flow velocity of the right femoral vein of 18 patients undergoing gynecologic laparoscopy under the same pressure of pneumoperitoneum of 12 mmHg. The diameter of femoral vein and the flow velocity were measured; the blood flow volume was calculated based on the equation of Q = vπr2 . Result: After establishment of pneumoperitoneum, the dilation of the femoral vein and the decrease in the velocity and volume can be observed (P < 0.05). And the 30 degree head-down position could increase the flow velocity and volume of the femoral vein and decrease the diameter of the vessel ( P < 0.05). At 30 minutes of the 30 degree head-down tilt position, the blood flow ameliorated compared with that in prone position after the establishment of pneumoperitoneum. After deflation of pneumoperitoneum, the femoral vein remained dilated( P < 0. 05). Conclusion: During laparoscopy, CO2 pneumoperitoneum may result in the dilation of the vein in lower extremity and retar dance of blood flow. The 30 degree Trendlenburg position can ameliorate the blood flow in the lower extremity. The deflation of the pneumoperitoneum cannot eliminate the effect of CO2 pneumoperitoneum on the lower extremity veins, which may predispose deep venous thrombosis after laparoscopy.
文摘Legg-Calvé-Perthes disease(LCPD),a historically-considered osteochondrosis,is now being diagnosed as an idiopathic avascularnecrosis of the femoral head in children.At present,the treatment for LCPD mainly focuses on the preservation orrecovery of the arthrogenic component of the femoral head.The currently-available surgical methods are various,most of which can obtain bettertherapeutic effects in LCPD.Nerveless,these surgeries are not universally acknowledged,and may have some limitations like increased articularand vascularinjury.In recent years,Traditional Chinese Medicine(TCM)has been shown a certain advantage in LCPD.This article primarily investigated the key points of common syndromes,TCM nursing methods and healthy guidance of LCPD,aiming at maintaining and developing the strengths of TCM,improving its efficacy and standardizing its behavior.
文摘To investigate the effects of high flow shear stress on the smooth muscle of the collateral vessels of hind limbs in aged rats using a collateral vessel growth model of femoral artery ligation plus femoral arter iovenous anastomosis and femoral artery ligation alone.10 adult rats and 15 old rats were divided into adult sham group,adult femoral artery ligation group,aged sham group,aged femoral artery ligation group and aged femoral artery liga tion with femoral arteriovenous shunt group.F emoral artery ligation group was performed with two knots.F emoral art eriovenous shunt group was created a sideto-side anastomosis between the distal stump of the occluded femoral artery and the accompanying vein,The rats survived for 1 week after surgery,collateral vessel growth was examined by imm unofluorescence.
