Haemodialysis Cost Reduction by Artificial Kidney Storage: A Simple Effective Technique for Re-use of Coil Kidneys

A simple method of storing and re-using coil dialysers was used in over 700 dialysers without serious complications but mantaining the efficiency of the dialyser. The method can reduce the expense of coil and tubing by as much as 70%, while the total cost of home or hospital dialysis can be reduced by as much as 15 to 25% even when the coil is re-used only once. Coils were re-used as many as 14 times, making the potential reduction in cost much larger. This technique deserves further evaluation in both hospital and home dialysis programmes.     

Femoral Arterial and Venous Catheterization for Blood Sampling,Drug Administration and Conscious Blood Pressure and Heart Rate Measurements

In multiple fields of study, access to the circulatory system in laboratory studies is necessary. Pharmacological studies in rats using chronically implanted catheters permit a researcher to effectively and humanely administer substances, perform repeated blood sampling and assists in conscious direct measurements of blood pressure and heart rate. Once the catheter is implanted long-term sampling is possible. Patency and catheter life depends on multiple factors including the lock solution used, flushing regimen and catheter material. This video will demonstrate the methodology of femoral artery and venous catheterization of the rat. In addition the video will demonstrate the use of the femoral venous and arterial catheters for blood sampling, drug administration and use of the arterial catheter in taking measurements of blood pressure and heart rate in a conscious freely-moving rat. A tether and harness attached to a swivel system will allow the animal to be housed and have samples taken by the researcher with minimal disruption to the animal. To maintain patency of the catheter, careful daily maintenance of the catheter is required using lock solution (100 U/ml heparinized saline), machine-ground blunt tip syringe needles and the use of syringe filters to minimize potential contamination. With careful aseptic surgical techniques, proper catheter materials and careful catheter maintenance techniques, it is possible to sustain patent catheters and healthy animals for long periods of time (several weeks).     

Role of Venous Needle Hub in Extracorporeal Pressure Changes during Haemodialysis

Certain types of stainless steel needles with metal hubs, and also a fistula set with projecting internal edges, were used at the venous end of the haemodialysis circuit and found to be associated with undesirable rises in extracorporeal pressure in 56 to 64% of dialyses. These increases in pressure are likely to be the result of platelet thrombus formation at the hub of the needle brought about by turbulent flow. The use of a plastic cannula and a stainless steel needle with a plastic hub, both of which have smooth internal surfaces, resulted in increases in pressure in only 4 to 12% of dialyses.     

食蟹猴经股静脉导管长期给药方法的建立

目的建立一种可靠的食蟹猴经股静脉导管长期给药的方法.方法选取20只雄性食蟹猴,麻醉后经股静脉造口,插入静脉导管,将植入式通道与导管连接并将其埋植于背部皮下,通过与植入式通道相连的输液泵进行给药.分别于术前1周、术后1周及术后2周测定血常规、血凝、生化等值.结果全部动物都能完成为期3个月的给药,手术感染率、导管堵塞率较低,分别为10%和5%.术后两周89.5%的生理指标与术前相比,差异无统计学意义(P>0.05).结论该实验采用的食蟹猴经股静脉插管并通过输液泵进行长期给药是一种安全、有效的方法,可广泛用于药理学及毒理学实验.     

Venous Drainage of the Femoral Neck in Legg Perthes Disease and in Hip Dysplasia

Three clinical cases of canine avascular femoral head necrosis and 4 cases of hip dysplasia were examined using intraosseus femoral neck venography. The contrast medium passed initio the diaphyseal bone marrow in all cases. Three growing dogs and 7 growing pigs were examined with the same method, before and after experimental ligation of the femoral veins. Before the venous tamponade, no contrast medium was visible in the femoral neck. The venography performed immediately after ligation showed contrast flow into the femoral neck similar to that seen in the clinical cases of Legg Perthes disease or hip dysplasia. However, a collateral circulation developed within 7 weeks. No more contrast-flow into the diaphysis was observed after that time. Although osteomedullography shows that both in Perthes disease and in hip dysplasia venous drainage has failed, venous tamponade may not induce the onset of the disease.     

血管回声跟踪技术评价慢性肾功能衰竭患者股总动脉内皮功能

目的：应用血管回声跟踪技术（echo-tracking,ET）评价慢性肾功能衰竭患者股总动脉内皮功能,并探讨该技术治疗慢性肾衰患者心血管并发症的临床意义。方法：选择2012年1月至12月在我院就诊的82例慢性肾功能衰竭患者为观察组,另选47例健康体检者为对照组。应用ET技术检测两组患者的左右侧股总动脉血管弹性指标,包括压力应变弹性系数（Ep）,脉搏波传导速度（PWVβ）,增大指数（AI）,硬度指数（β）和脉顺应性（AC）。观察两组患者的检测结果并进行比较。结果：观察组中,压力应变弹性系数（Ep）,脉搏波传导速度（PWVβ）,增大指数（AI）和硬度指数（β）均高于对照组所对应的值;而脉顺应性（AC）值低于对照组,两组差异有统计学意义（P〈0.05）。观察组中,需要透析的患者组β、PWVβ、Ep和AI的值均高于非透析患者组对应的值,AC值低于非透析患者组的值,差异有统计学意义（P〈0.05）。结论：ET对慢性肾功能衰竭患者心血管并发症的早期治疗,改善患者的愈后具有一定的临床指导意义。     

Simultaneous Recordings of Human Microsaccades and Drifts with a Contemporary Video Eye Tracker and the Search Coil Technique

Human eyes move continuously, even during visual fixation. These “fixational eye movements” (FEMs) include microsaccades, intersaccadic drift and oculomotor tremor. Research in human FEMs has grown considerably in the last decade, facilitated by the manufacture of noninvasive, high-resolution/speed video-oculography eye trackers. Due to the small magnitude of FEMs, obtaining reliable data can be challenging, however, and depends critically on the sensitivity and precision of the eye tracking system. Yet, no study has conducted an in-depth comparison of human FEM recordings obtained with the search coil (considered the gold standard for measuring microsaccades and drift) and with contemporary, state-of-the art video trackers. Here we measured human microsaccades and drift simultaneously with the search coil and a popular state-of-the-art video tracker. We found that 95% of microsaccades detected with the search coil were also detected with the video tracker, and 95% of microsaccades detected with video tracking were also detected with the search coil, indicating substantial agreement between the two systems. Peak/mean velocities and main sequence slopes of microsaccades detected with video tracking were significantly higher than those of the same microsaccades detected with the search coil, however. Ocular drift was significantly correlated between the two systems, but drift speeds were higher with video tracking than with the search coil. Overall, our combined results suggest that contemporary video tracking now approaches the search coil for measuring FEMs.     

Association of Versican Turnover with All-Cause Mortality in Patients on Haemodialysis

Objective

Cardiovascular diseases are among the most common causes of mortality in renal failure patients undergoing haemodialysis. A high turnover rate of the proteoglycan versican, represented by the increased presence of its fragmentation products in plasma, has previously been associated with cardiovascular diseases. The objective of the study was to investigate the association of versican turnover assessed in plasma with survival in haemodialysis patients.

Methods

A specific matrix metalloproteinase-generated neo-epitope fragment of versican (VCANM) was measured in plasma of 364 haemodialysis patients with a 5-years follow-up, using a robust competitive enzyme-linked immunosorbent assays. Association between VCANM plasma concentration and survival was assessed by Kaplan-Meier analysis and adjusted Cox model.

Results

Haemodialysis patients with plasma VCANM concentrations in the lowest quartile had increased risk of death (odds ratio, as compared to the highest quartile: 7.1, p<0.001), with a reduced survival of 152 days compared to 1295 days for patients with plasma VCANM in the highest quartile. Multivariate analysis showed that low VCANM (p<0.001) and older age (p<0.001) predicted death in haemodialysis patients.

Conclusions

Low concentrations of the versican fragment VCANM in plasma were associated with higher risk of death among haemodialysis patients. A possible protective role for the examined versican fragment is suggested.     

股神经阻滞和收肌管阻滞对全膝关节置换术后下肢静脉血栓形成的影响

目的:探究股神经阻滞(femoral nerve block,FNB)和收肌管阻滞(adductor canal block,ACB)对全膝关节置换术(total knee arthroplasty,TKA)后下肢静脉血栓形成的影响。方法:将2019年3月-2019年4月拟在全身麻醉下行全膝关节置换术的40例患者随机分为FNB组和ACB组,所有患者均给予超声引导下单次注射,术后均给予标准化抗凝治疗。术后评估两组患者不同时间节点的疼痛评分、股四头肌肌力及术后下肢静脉血栓形成情况。结果:两组患者术后2、6、12、24、48、72 h患肢术区局部疼痛的VAS评分差异无统计学意义(P0.05)。ACB组患者术后2、6、12、24、48 h股四头肌肌力均明显高于FNB组(P0.05),术后72 h两组患者股四头肌肌力无明显差异(P0.05)。ACB组在术后患者首次直腿抬高时间(4.5±4.6)h,显著低于FNB组在术后患者首次直腿抬高时间(25.6±12.6)h,两组对比差异有统计学意义(P0.05)。术后72 h给予两组患者复查双下肢血管超声,复查结果显示,FNB组19例患者中共有2例出现下肢静脉血栓,均为肌间隙静脉血栓形成;ACB组20例患者中无患者出现下肢静脉血栓形成,差异无有统计学意义(P0.05)。结论:FNB与ACB在全膝关节置换术后镇痛方面无明显差异,但ACB组较好的保留患者术后早期股四头肌肌力,对于术后功能锻炼和快速康复有较积极的作用,两种神经阻滞方式对患者VTE风险的影响相同。     

Comparison of the Association of Sac Growth and Coil Compaction with Recurrence in Coil Embolized Cerebral Aneurysms

Background and Purpose

In recurrent cerebral aneurysms treated by coil embolization, coil compaction is regarded as the presumptive mechanism. We test the hypothesis that aneurysm growth is the primary recurrence mechanism. We also test the hypothesis that the coil mass will translate a measurable extent when recurrence occurs.

Methods

An objective, quantitative image analysis protocol was developed to determine the volumes of aneurysms and coil masses during initial and follow-up visits from 3D rotational angiograms. The population consisted of 15 recurrence and 12 non-recurrence control aneurysms initially completely coiled at a single center. An investigator sensitivity study was performed to assess the objectivity of the methods. Paired Wilcoxon tests (p<0.05, one-tailed) were performed to assess for aneurysm and coil growth. The translation of the coil mass center at follow-up was computed. A Mann Whitney U-Test (p<0.05, one-tailed) was used to compare translation of coil mass centers between recurrence and control subjects.

Results

Image analysis protocol was found to be insensitive to the investigator. Aneurysm growth was evident in the recurrence cohort (p=0.003) but not the control (p=0.136). There was no evidence of coil compaction in either the recurrence or control cohorts (recurrence: p=0.339; control: p=0.429). The translation of the coil mass centers was found to be significantly larger in the recurrence cohort than the control cohort (p=0.047).

Conclusion

Aneurysm sac growth, not coil compaction, was the primary mechanism of recurrence following successful coil embolization. The coil mass likely translates to a measurable extent when recurrence occurs and has the potential to serve as a non-angiographic recurrence marker.     

超声定位腔镜深筋膜下交通支离断术联合湿性换药技术治疗下肢静脉性溃疡

目的:探讨彩超定位下的腔镜深筋膜下交通支离断术(SEPS)联合湿性换药技术治疗下肢静脉性溃疡(VU)的方法及效果。方法:回顾性分析了8例VU患者共8条C6级下肢SEPS手术联合湿性换药技术的方法和效果。术前用彩色多普勒超声对功能不全交通支(ICPV)行体表定位,进行SEPS+大隐静脉高位结扎剥脱术+硬化剂注射术,术后湿性换药技术溃疡换药。结果:超声准确定位下SEPS联合湿性换药术后所有C6级患肢VU均在短期内愈合,随访期间无溃疡复发。结论:SEPS联合湿性换药技术治疗VU术后安全,疗效确切,并发症少。     

Catheterization of pulmonary artery in rats with an ultraminiature catheter pressure transducer

Utilizing new materials and miniaturization techniques, an ultraminiature catheter pressure transducer for catheterization of the pulmonary artery (PA) has been developed and applied in intact, spontaneously breathing, anesthetized rats. The catheter arrangement consists of three components: 1) an SPR-671 ultraminiature pressure transducer (measuring catheter), 2) a plastic introducer (sheath) that is slipped over the measuring catheter, and 3) an external wire mounted on the outside of the introducer for bending its tip. The measuring catheter is first inserted through the right jugular vein into the right ventricle. The introducer is then slipped over it. The tip of the introducer is bent so that there is an angle of approximately 90 degrees or less to the shaft. The measuring catheter is advanced across the pulmonary valve into the PA. Measurements of pulmonary arterial pressure were made in five male Long Evans (364 +/- 7 g body wt) and five female Sprague-Dawley (244 +/- 7 g body wt) rats under control conditions. The effects of infusion of norepinephrine (0.1 mg.kg(-1).h(-1) iv for 20-min duration) were tested in Long Evans rats. Pulmonary arterial systolic pressure measurements were 34.0 +/- 0.8 and 29.5 +/- 0.4 mmHg, and diastolic pressure values were 23.6 +/- 0.8 and 18.1 +/- 0.6 mmHg in male Long Evans and female Sprague-Dawley rats, respectively. Norepinephrine induced an increase in pulmonary arterial systolic (40.8 +/- 0.1 mmHg) and diastolic (28.6 +/- 0.4 mmHg) pressures and an elevation in pulmonary vascular resistance from a control value of 0.093 +/- 0.003 to 0.103 +/- 0.004 mmHg.kg.min.ml(-1).     

颅内静脉系统血栓形成6例临床分析

目的：探讨颅内静脉系统血栓形成（CVT）的临床表现、影像学特征以及治疗方法对临床诊断的意义。方法：回顾性分析首都医科大学宣武医院收治的6例CVT患者的临床表现及影像学特征与治疗方法。结果：6例临床表现无特殊,4例经MRI＋MRV确诊,3例DSA检查确诊,1例介入治疗,4例抗凝治疗,2例保守,无死亡患者。结论：静脉系统血栓形成临床症状缺乏特异性,临床遇到急性起病的头痛、呕吐,伴或不伴有局灶性神经功能缺损或癫痫发作、意识障碍的青中年人,应高度怀疑CVT。早期应用抗凝、溶栓等治疗方法,对改善预后具有较高的临床应用价值。