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        find Keyword "外周" 107 results
        • EFFECT OF RECOMBINANT ADENOVIRUS-BONE MORPHOGENETIC PROTEIN 12 TRANSFECTION ON DIFFERENTIATION OF PERIPHERAL BLOOD MESENCHYMAL STEM CELLS INTO TENDON/LIGAMENT CELLS

          ObjectiveTo research the effect of recombinant adenovirus-bone morphogenetic protein 12 (Ad-BMP-12) transfection on the differentiation of peripheral blood mesenchymal stem cells (MSCs) into tendon/ligament cells. MethodsPeripheral blood MSCs were isolated from New Zealand rabbits (3-4 months old) and cultured in vitro until passage 3. The recombinant adenoviral vector system was prepared using AdEasy system, then transfected into MSCs at passage 3 (transfected group); untransfected MSCs served as control (untransfected group). The morphological characteristics and growth of transfected cells were observed under inverted phase contrast microscope. The transfection efficiency and green fluorescent protein (GFP) expression were detected by flow cytometry (FCM) and fluorescence microscopy. After cultured for 14 days in vitro, the expressions of tendon/ligament-specific markers were determined by immunohistochemistry and real-time fluorescent quantitative PCR. ResultsGFP expression could be observed in peripheral blood MSCs at 8 hours after transfection. At 24 hours after transfection, the cells had clear morphology and grew slowly under inverted phase contrast microscope and almost all expressed GFP at the same field under fluorescence microscopy. FCM analysis showed that the transfection efficiency of the transfected group was 99.57%, while it was 2.46% in the untransfected group. The immunohistochemistry showed that the expression of collagen type Ι gradually increased with culture time in vitro. Real-time fluorescent quantitative PCR results showed that the mRNA expressions of the tendon/ligament-specific genes (Tenomodulin, Tenascin-C, and Decorin) in the transfected group were significantly higher than those in untransfected group (0.061±0.013 vs. 0.004±0.002, t=-7.700, P=0.031; 0.029±0.008 vs. 0.003±0.001, t=-5.741, P=0.020; 0.679±0.067 vs. 0.142±0.024, t=-12.998, P=0.000). ConclusionAd-BMP-12 can significantly promote differentiation of peripheral blood MSCs into tendon/ligament fibroblasts and enhance the expressions of tendon/ligament-specific phenotypic differentiation, which would provide the evidence for peripheral blood MSCs applied for tendon/ligament regeneration.

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        • Establishment of risk factors and risk nomogram model for unplanned extubation during peripherally inserted central catheter retention in cancer patients

          ObjectiveTo retrospectively analyze the causes and risk factors of unplanned extubation (UE) in cancer patients during peripherally inserted central catheter (PICC) retention, so as to provide references for effectively predicting the occurrence of UE. Methods27 998 cancer patients who underwent PICC insertion, maintenance and removal in the vascular access nursing center of our hospital from January 2016 to June 2023 were retrospectively analyzed. General information, catheterization information, and maintenance information were collected. The Chi-squared test was used for univariate analysis, multivariate analysis was used by binary unconditional logistic regression. They were randomly divided into modeling group and internal validation group according to the ratio of 7∶3. The related nomogram prediction model and internal validation were established. ResultsThe incidence of UE during PICC retention in tumor patients was 2.80% (784/27 998 cases). Univariate analysis showed that age, gender, diagnosis, catheter retention time, catheter slipping, catheter related infection, catheter related thrombosis, secondary catheter misplacement, dermatitis, and catheter blockage had an impact on UE (P<0.05). Age, diagnosis, catheter retention time, catheter slipping, catheter related infection, catheter related thrombosis, secondary catheter misplacement, and catheter blockage are independent risk factors for UE (P<0.05). Based on the above 8 independent risk factors, a nomogram model was established to predict the risk of UE during PICC retention in tumor patients. The ROC area under the predicted nomogram was 0.90 (95%CI 0.89 to 0.92) in the modeling group, and the calibration curve showed good predictive consistency. Internal validation showed that the area under the ROC curve of the prediction model was 0.91 (95%CI 0.89 to 0.94), and the trend of the prediction curve was close to the standard curve. ConclusionPatients aged ≥60 years, non chest tumor patients, catheter retention time (≤6 months), catheter slipping, catheter related infections, catheter related thrombosis, secondary catheter misplacement, and catheter blockage increase the risk of UE. The nomogram model established in this study has good predictive ability and discrimination, which is beneficial for clinical screening of patients with different degrees of risk, in order to timely implement targeted prevention and effective treatment measures, and ultimately reduce the occurrence of UE.

          Release date:2025-01-21 09:54 Export PDF Favorites Scan
        • The role of NLRP3 inflammasome in inflammatory response in patients with chronic obstructive pulmonary disease

          Objective To study the expression of NLRP3 inflammasome and its downstream inflammatory factors in patients with chronic obstructive pulmonary disease (COPD) and healthy controls, and to reveal the effect and significance of NLRP3 inflammasome in the pathogenesis of COPD. Methods Forty patients with acute exacerbation COPD (AECOPD) who were hospitalized from November 2016 to May 2017 were recruited in the AECOPD group, and recruited in the stable COPD group when they entered the stable stage. Forty healthy individuals were recruited in the control group. General information and peripheral blood were collected from each subject. The levels of NLRP3 mRNA and caspase-1 mRNA in peripheral blood mononuclear cells were measured by real-time PCR. The levels of IL-18 and IL-1β were measured by enzyme-linked immunosorbent assay. Results The levels of NLRP3 mRNA, IL-18 and IL-1β in the AECOPD patients were significantly higher than those in the stable COPD group [2.11±0.77, 12.79 (7.10, 43.13) pg/ml, 17.02 (8.36, 52.21) pg/ml vs. 1.60±0.44, 10.66 (6.32, 18.59) pg/ml, 13.34 (7.07, 16.89) pg/ml, all P<0.05] . The levels of NLRP3 mRNA, IL-18 and IL-1β in the AECOPD patients were significantly higher than those in the control group [2.11±0.77, 12.79 (7.10, 43.13) pg/ml, 17.02 (8.36, 52.21) pg/mlvs. 1.00±0.49, 6.29 (4.73, 7.93) pg/ml, 5.93 (4.81, 9.67) pg/ml, all P<0.05]. The levels of NLRP3 mRNA, IL-18 and IL-1β were significantly higher in the stable COPD group than the control group [1.60±0.44, 10.66 (6.32, 18.59) pg/ml, 13.34 (7.07, 16.89) pg/mlvs. (1.00±0.49, 6.29 (4.73, 7.93) pg/ml, 5.93 (4.81, 9.67) pg/ml, all P<0.05]. Correlation analysis showed that the plasma IL-18 level was positive correlated with leukocyte count and neutrophil percentage in the AECOPD group (r=0.372, P<0.05;r=0.386, P<0.05). The expression of NLRP3 mRNA in the AECOPD group and stable COPD group were positively correlated with the CAT score (r=0.387, P<0.05;r=0.399, P<0.05) . Conclusion NLRP3 inflammasome is involved in the inflammatory response in COPD patients.

          Release date:2018-03-29 03:32 Export PDF Favorites Scan
        • 超聲技術聯合經外周靜脈置入中心靜脈導管支撐導絲頭端退出法在導管多次異位頸內靜脈復位中的應用

          目的探討經外周靜脈置入中心靜脈導管(PICC)置管時導管頭端多次異位到頸內靜脈時的有效復位方法。 方法收集2014年3月-12月在血管超聲引導下行PICC置管時,導管頭端異位到頸內靜脈3次以上的患者17例,對其首先按常規復位法復位3次,仍不能成功復位,則采用支撐導絲頭端退出法,以利用血液流向和重力作用,將異位的導管調整至正常位置。 結果17例患者先采用常規復位法復位3次,均不成功。改用支撐導絲頭端退出法進行復位,一次復位成功16例,成功率為94.11%;二次復位成功率達100%。 結論PICC置管聯合血管超聲,能及時發現導管是否異位頸內靜脈,采用常規復位方法3次,均不能成功復位時,采用支撐導絲頭端退出法,可有效糾正導管頭端異位,提高置管成功率,減少反復送管所致靜脈并發癥。

          Release date:2016-11-23 05:46 Export PDF Favorites Scan
        • 運用改良塞丁格技術經外周靜脈置入中心靜脈導管臨床應用實踐

          目的 總結運用改良塞丁格技術實現經外周靜脈置入中心靜脈導管(PICC)的方法與經驗。 方法 2009年11月-2012年3月對51例腫瘤患者應用改良塞丁格技術置入PICC,其中10例在超聲引導下施行。 結果 50例首次操作置管成功,1例首次置管失敗,1周后再次置入成功,無重要并發癥。 結論 改良塞丁格技術行PICC 置管具有良好的臨床實用性、安全性和可靠性。

          Release date:2016-09-07 02:34 Export PDF Favorites Scan
        • Ultrasonographic Characteristics of Peripheral Vascular Arteriovenous Fistula

          【摘要】 目的 探討外周血管動靜脈瘺的超聲特征及其鑒別診斷。 方法 回顧性分析2003年1月-2010年3月間收治的36例先天性及后天性動靜脈瘺患者的臨床資料,使用彩色超聲診斷儀觀察受累血管的內徑、血管壁的連續性,根據血流動力學變化尋找瘺口;對受累血管血流頻譜進行分析,并與健側對照。 結果 18例先天性動靜脈瘺查見紆曲擴張的血管網,無法辨認瘺口;18例后天性動靜脈瘺全部可顯示瘺口,2例合并靜脈破裂的為囊瘤型,其余后天性動靜脈瘺均為洞口型。受累動脈近心端血流為高速低阻型,全部患者受累靜脈出現動脈樣血流,近心端靜脈呈高速低阻型頻譜;10例患者遠心端靜脈內出現逆向離心血流。 結論 引流靜脈出現高速、動脈樣血流頻譜是動靜脈瘺的特征性表現;先天性動靜脈瘺可見異常血管網,不能辨認瘺口;后天性動靜脈瘺均可顯示瘺口。彩色超聲多普勒檢查對動靜脈瘺能夠正確診斷及鑒別診斷。【Abstract】 Objective To observe characteristic imaging of arteriovenous fistulas (AVF) of periphery vessel, and to evaluate the differential diagnosis of AVF by ultrasonography. Methods Thirty-six patients suffering from congenital and acquired AVF in this hospital from January 2003 to March 2010 were selected to undergo Doppler ultrasonography. The blood flow of arteriovenous fistulas, diameter, morphology and blood flow characters of affected vessels were observed. Spectral of fistula and affected vessels were analyzed and compared with the healthy side. Results Deformed vascular net was observed, and the localization of arteriovenous fistulas was not observed directly in 18 congenital AVF patients.Inversely the localization of arteriovenous fistulas was observed directly in 18 acquired AVF patients.Two acquired AVF patients with venous rupture belonged to kystoma form, and others acquired AVF patients belonged to orifice form.Spectral analysis of proximal arteries of the fistula revealed high velocity and low resistance.Arterialized flow pattern was observed in affected veins.Proximal veins of the fistula revealed arterialized spectral with high velocity and low resistance.Reversed blood flow was observed in the distal veins of the fistulas in 10 patients. Conclusion Arterialized flow with high velocity in veins are characteristic signs of AVF.Deformed vascular net is observed, and the localization of arteriovenous fistulas in not observed directly in congenital AVF patients, but the localization of arteriovenous fistulas is observed directly in acquired AVF patients.Color Doppler ultrasonography has great value in confirming diagnosis and differential diagnosis of AVF.

          Release date:2016-09-08 09:50 Export PDF Favorites Scan
        • 重癥醫學科構建外周靜脈置入中心靜脈導管醫護一體的工作模式探討

          目的在重癥醫學科(ICU)開展外周靜脈置入中心靜脈導管(PICC)醫護一體合作的工作模式,以提高PICC置管的成功率,解決重癥患者置管的相關問題,降低導管相關性血流感染(CRBSI)發生率。 方法選擇2010年4月-2012年3月入住ICU的置入PICC的患者229例,按照入住日期單雙數分為對照組和試驗組,比較兩組CRBSI的發生率和PICC置管成功率。 結果試驗組CRBSI發生率明顯低于對照組;且試驗組的PICC置管成功率明顯高于對照組,差異均有統計學意義(P<0.01)。 結論ICU構建PICC醫護一體的工作模式,能顯著提高重癥患者PICC置管成功率和安全性,降低CRBSI發生率,減少了重癥患者反復靜脈穿刺的痛苦,保護患者外周靜脈,提高護理質量及工作效率。

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        • 110例新生兒外周動靜脈同步換血術的護理

          目的探討新生兒換血術中常見的護理問題及護理措施,為新生兒換血護理提供參考。 方法回顧性分析2014年12月1日-2015年5月31日收治的110例行動靜脈同步換血術的新生兒的臨床資料,總結在新生兒外周同步動靜脈換血術中常見的護理問題,并探討相應的臨床護理措施。 結果①換血前患兒總膽紅素為194.7~918.0 μmol/L,換血后總膽紅素為125.7~335.9 μmol/L;2次換血者6例。②動脈一次穿刺成功者101例,成功率91.82%。9例穿刺失敗后給予第2次穿刺成功。③動脈放血不暢者8例,發生率為7.27%。④換血過程中煩躁者98例,給予安撫后安靜者18例,使用藥物鎮靜者80例。⑤所有患者兒均未發生感染、低體溫、動脈排出端堵塞等并發癥。 結論新生兒換血過程中常見的護理問題包括動脈穿刺困難、動脈放血不暢、煩躁、感染、低體溫以及動脈排出端堵塞,護士要熟練掌握動脈穿刺方法和技巧,換血過程中保持患兒安靜,做好感染防護措施,防止低體溫發生及動脈排出端堵塞;密切監測生命體征及血清膽紅素的變化等,保證新生兒換血過程順利完成。

          Release date:2016-11-23 05:46 Export PDF Favorites Scan
        • Improve The Survival and Function of Islets by Combined Transplantation of Human Endothelial Cells in Peripheral Blood and Islet of Rats

          ObjectiveTo explore the endothelial cells from human peripheral blood and islet of rat co-transplantation under the renal capsule of diabetic nude mice to improve the survival and function of transplanted islet. MethodsThe endothelial cells from human peripheral blood(5×105)and freshly isolated rat islet cells were co-transplanted under the renal capsule of diabetic nude mice model, then the fasting blood glucose, body weight, peripheral blood C-peptide level, and intraperitoneal glucose tolerance test(IPGTT) were measured to evaluated the islet graft survival and function. ResultsCompared with the control group, the fasting blood glucose level significantly decreased(P < 0.01), peripheral blood C-peptide level rised(P < 0.01), and body weight increased(P < 0.01) of receptor nude mice in experience group, the IPGTT also improved. ConclusionThe endothelial cells from human peripheral blood and islet of rat co-transplan-tation can obviously improve the survival and function of transplanted islet of nude mice.

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        • Expression of CK20 mRNA in Peripheral Blood of Patients with Colorectal Cancer and Its Clinical Significance

          Objective To detect expression of CK20 mRNA in peripheral blood of patients with colorectal carcinoma and its clinical significance. Methods Using the reverse transcriptase-polymerase chain reaction (RT-PCR),CK20 mRNA expression was examined in peripheral blood from 42 patients with colorectal carcinoma before and after operation, 20 healthy volunteers, 20 fresh colorectal carcinoma samples. Results The positive expression rates of CK20 mRNA were 45.24%(19/42) and 33.33%(14/42) before and after operation in 42 colorectal carcinoma patients respectively. All 20 fresh colorectal carcinoma samples revealed expression of CK20 mRNA, but the 20 normal blood samples did not. Conclusion The detection of CK20 mRNA in peripheral blood is helpful to early diagnose, assess the prognosis and make a correct treatment of colorectal carcinoma.

          Release date:2016-08-28 04:43 Export PDF Favorites Scan
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