One patient,two malpositioned hemodialysis catheters, (hepatic vein and ascending lumbar vein), no fluoroscopy

Cuffed-tunneled hemodialysis catheter (CTHC) application via the femoral vein is a safe and effective alternative when peripheral vascular routes are exhausted for hemodialysis in patients with end-stage renal disease. Also, imaging methods have become more important for the diagnosis or prevention of the possible complications that may develop during or after catheter placements. Here, we present a case of hemodialysis catheter dysfunction due to the insertion of a CTHC tip into the hepatic vein, and into the left ascending lumbar vein at the next attempt. We think that the use of fluoroscopy, whether in the first catheter intervention or catheter change, is extremely important in preventing possible complications that may develop, or detecting them as soon as possible.     

Precise Regulation of Inflammation and Oxidative Stress by ROS-Responsive Prodrug Coated Balloon for Preventing Vascular Restenosis

Vascular restenosis after balloon dilation is largely caused by the over-proliferation of smooth muscle cells, which is triggered and exacerbated by local excessive inflammation and oxidative stress. The excessive inflammatory and oxidative stress cause tissue/cell damage, hamper endothelial functions, and worsen intimal hyperplasia and restenosis. A high level of reactive oxygen species (ROS) overproduction is regarded as the main culprit. Therefore, efficiently inhibiting ROS over-production or weightily depleting them is of great significance. Herein, a “ROS-responsive/scavenging prodrug” is introduced into balloon coating for the treatment of vascular restenosis. A reversible phenylboronic ester-bearing caffeic acid (CA) macromolecular prodrug (PBC) is designed for the controlled and on-demand dual-drug release triggered by the local high ROS level; the released CA and 4-hydroxybenzyl alcohol exhibit efficient antioxidant and anti-inflammatory effects by scavenging ROS, thereby regulating vascular microenvironment and protecting endothelium functions. To accelerate endothelium regeneration, pro-endothelial microRNA-126 is further introduced. The ROS-responsive/scavenging prodrug/miRNA balloon coating efficiently prevents intimal hyperplasia, alleviates local inflammation, and improves endothelium healing in a rat abdominal aorta restenosis model, which may provide applicative perspectives for next-generation drug-coated balloons and other cardiovascular diseases treatment.     

品管圈活动在降低新生儿 PICC 置管非计划性拔管发生率的应用

目的：探讨品管圈活动在降低新生儿 PICC 置管非计划性拔管（UEX）发生率的应用效果。方法随机抽取南昌大学第一附属医院新生儿科2012年1—8月行 PICC 置管患儿60例作为对照组，2012年9月至2013年5月行 PICC 置管患儿60例作为观察组。对照组采用常规护理方法，观察组在此基础上同时开展品管圈活动。结果与对照组比较，观察组患儿穿刺点红肿、静脉炎、导管堵塞的发生率均降低（均 P ＜0．05）；UEX 的发生率显著降低（P ＜0．01）。结论品管圈活动有效降低了新生儿 PICC 导管穿刺点红肿、静脉炎、导管堵塞和 UEX 的发生率，避免了患儿再次穿刺的痛苦，保证了治疗的连续性。