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Catheterization via direct cannulation of superior vena cava for a hemodialysis patient with an originaldysfunctional catheter on the left internal jugular vein

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《医学前沿（英文）》 2017年 第11卷 第3期   页码 445-448 doi: 10.1007/s11684-017-0520-0

摘要：

Establishing a long-term vascular access in patients exhibiting vascular access exhaustion is challenging. In this study, we reported a case of a direct catheterization in the superior vena cava of a hemodialysis patient with vascular access exhaustion and original dysfunctional catheter inserted via the left internal jugular vein. The direct catheterization was performed with cuffed tunnel catheter (CUFF) and guided by digital subtraction angiography (DSA) and multidetector computed tomography venography (MDCTV). The DSA and MDCTV results revealed an occlusion in the right innominate vein and thromboses in the left innominate, right internal jugular, subclavian, and femoral veins. The distal end of the superior vena cava was localized clearly by the original CUFF under DSA. Directed at the distal end of the superior vena cava, a 0.5-cm secondary puncture was introduced below the lateral head of the sternocleidomastoid muscle via the right neck area. This study is one of the few reports regarding direct catheterization of CUFF via the superior vena cava of a patient with vascular access exhaustion and CUFF dysfunction on the left internal jugular vein. We believe that our study can provide a new alternative for inserting central venous catheter for such patient.

关键词： superior vena cava     intervention     vascular access exhaustion     catheterization     tunneled cuffed hemodialysis catheter    

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A pilot study on Paxlovid therapy for hemodialysis patients with severe acute respiratory syndrome coronavirus

《医学前沿（英文）》 doi: 10.1007/s11684-023-1011-0

摘要： We aimed to investigate the safety and efficacy of nirmatrelvir/ritonavir (Paxlovid) therapy for hemodialysis-dependent patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Thirteen hemodialysis patients infected with the Omicron variant of SARS-CoV-2 from April 3 to May 30, 2022, were recruited. Laboratory parameters and chest CT (computed tomography) imaging were analyzed. The treatment group included six patients who received 150 mg/100 mg of Paxlovid orally once daily for 5 days, whereas the control group included seven patients who received basic treatment. No serious adverse reactions or safety events were recorded. Four control patients progressed to moderate disease, and none in the treatment group showed progression of chest CT findings (P < 0.05). Paxlovid therapy tended toward early viral clearance and low viral load on Day 8. Moreover, 83.3% of the patients in the treatment group and 57.1% of the patients in the control group turned negative within 22 days. In the Paxlovid treatment group, we found significantly increased levels of lymphocytes (P=0.03) and eosinophils (P=0.02) and decreased levels of D-dimer on Day 8 compared with those on Day 1. Paxlovid therapy showed a potential therapeutic effect with good tolerance in hemodialysis patients. The optimal dose and effectiveness evaluation must be further investigated in a largeer cohort.

关键词： Paxlovid     hemodialysis     SARS-CoV-2     viral load     chest CT scan    

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opportunities in improving left ventricular remodelling and clinical outcome following surgical and trans-catheter

《医学前沿（英文）》 2021年 第15卷 第3期   页码 416-437 doi: 10.1007/s11684-021-0852-7

摘要： Over the last half century, surgical aortic valve replacement (SAVR) has evolved to offer a durable and efficient valve haemodynamically, with low procedural complications that allows favourable remodelling of left ventricular (LV) structure and function. The latter has become more challenging among elderly patients, particularly following trans-catheter aortic valve implantation (TAVI). Precise understanding of myocardial adaptation to pressure and volume overloading and its responses to valve surgery requires comprehensive assessments from aortic valve energy loss, valvular-vascular impedance to myocardial activation, force-velocity relationship, and myocardial strain. LV hypertrophy and myocardial fibrosis remains as the structural and morphological focus in this endeavour. Early intervention in asymptomatic aortic stenosis or regurgitation along with individualised management of hypertension and atrial fibrillation is likely to improve patient outcome. Physiological pacing via the His-Purkinje system for conduction abnormalities, further reduction in para-valvular aortic regurgitation along with therapy of angiotensin receptor blockade will improve patient outcome by facilitating hypertrophy regression, LV coordinate contraction, and global vascular function. TAVI leaflet thromboses require anticoagulation while impaired access to coronary ostia risks future TAVI-in-TAVI or coronary interventions. Until comparable long-term durability and the resolution of TAVI related complications become available, SAVR remains the first choice for lower risk younger patients.

关键词： surgical aortic valve replacement     trans-catheter aortic valve implantation     left ventricular hypertrophy and fibrosis     myocardial force-velocity relationship     His-Purkinje pacing     renin-angiotensin system inhibitors     coronary access impairment    

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Effect of renal function and hemodialysis on the serum tumor markers in patients with chronic kidney

YU Xiaofang, XU Xialian, YE Zhibin

《医学前沿（英文）》 2007年 第1卷 第3期   页码 308-311 doi: 10.1007/s11684-007-0059-6

摘要： In patients with chronic renal failure, whether they have had hemodialysis or not, the specificity of some of the serum tumor markers for the diagnosis of the corresponding tumors is decreased while others remain as valuable as they are in patients with normal kidney function. The detection of tumor markers is extensively used for the diagnosis of corresponding tumors. It has been recently shown that some tumor markers are higher in patients with chronic kidney disease (CKD) than in the normal population. The effects of renal function and hemodialysis were examined on serum levels of some of the tumor markers including CEA, CA, CA, AFP, CA, CA, CYFRA, NSE, SCC-Ag, PSA, and fPSA. The 232 non-dialysis patients with CKD and 37 chronic uremic patients treated with maintenance hemodialysis were enrolled in this study. The 232 non-dialysis patients were divided into three groups according to their Ccr. In group 1, Ccr was ≤25 mL/min. In group 2, Ccr was between 25 and 50 mL/min. In group 3, Ccr was ≥50 mL/min. The male patients were also divided into three groups to compare the serum levels of PSA and fPSA among the three groups. Nine tumor markers in 37 uremic patients were tested. For comparison, 37 non-dialysis patients with similar Ccr of the same age and gender served as controls. There existed significant differences in serum levels of CEA, CA, CYFRA, NSE, and SCC-Ag among different Ccr groups and the markers bore a negative correlation with Ccr. There were no significant differences among the three groups in the serum concentrations of CA, AFP, CA, CA, PSA and fPSA. The serum levels of CA and NSE were significantly higher (199, CYFRA, NSE, CA and SCC-Ag for the diagnosis of the corresponding tumors was decreased while serum AFP, CA, CA, PSA and fPSA were as valuable as they were in patients with normal kidney function. Hemodialysis further increased the serum level of CA and NSE.

关键词： CKD     non-dialysis     valuable     detection     chronic    

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致力于血管内光学相干成像术的Ni A微电机导管

Tianshi Wang, Gijs van Soest, Antonius F. W. van der Steen

《工程（英文）》 2015年 第1卷 第1期   页码 15-17 doi: 10.15302/J-ENG-2015018

摘要：

我们研发了一种新型的血管内光学相干成像术（IV-OCT），该技术能极其快速地实现冠状动脉成像，并通过消除心脏运动伪影和欠采样以实现图像的更高质量。它所依赖的成像探头包括一个直径为1.0 mm 且转速为5600 rev·s–1的同步微电机，使IV-OCT 的帧频达到5.6 kHz，并使用每秒产生280 万图像扫描线的波长扫描激光器。通过使用该设备，我们团队在设置速度为100 mm·s–1时实现了体外5600 fps 和体内4000 fps 的成像速度。由实验对象的心电图触发整个图像采集过程，当心脏在跳动过程中相对不强烈时扫描冠状动脉，因此该技术还有一个新名字，"心动光学相干成像术"（Heartbeat OCT）。

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光纤微针装置中增强对流药物输注的热强化表征 Article

R. Lyle Hood,Rudy T. Andriani,Tobias E. Ecker,John L. Robertson,Christopher G. Rylander

《工程（英文）》 2015年 第1卷 第3期   页码 344-350 doi: 10.15302/J-ENG-2015077

摘要：

增强对流输注 (CED) 是一项颇具前景的技术，其借助压力驱动流来增强输注药物进入细胞间隙的穿透力。为进一步提升CED的药物分布容积，笔者发明了一种可产生局部亚致死热量的光纤微针装置。本文试图在琼脂糖组织模型中对该技术进行定量表征。在15 °C、20 °C、25 °C和30 °C的恒温条件下，染料的输注在质量分数为0.6%的琼脂糖组织模型中进行分析。输注指标通过自定义阴影成像技术和图像处理算法进行定量。利用所获数据构建一个分布容积的经验预测时序模型作为组织模型温度的函数。接下来通过一组概念验证实验来评估液体输注时新型光纤装置产生局部光加热的能力。恒温输注显示温度和分布容积呈正相关，在100 min时，在30 °C恒温条件下体积扩散是在15 °C恒温条件下的7倍。在光加热 (1064 nm，500 mW) 过程中，输注呈现相似的效果：与对照组 (0 mW) 相比，输注体积在4 h时增大了3.5倍。本文的分析和结果为体积扩散的热介导增强提供了特征描述及新思路。

关键词： 近红外激光     热化学疗法     琼脂糖     光加热     微导管     恶性胶质瘤    

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标题 作者 时间 类型 操作

Catheterization via direct cannulation of superior vena cava for a hemodialysis patient with an originaldysfunctional catheter on the left internal jugular vein

null

期刊论文

A pilot study on Paxlovid therapy for hemodialysis patients with severe acute respiratory syndrome coronavirus

期刊论文

opportunities in improving left ventricular remodelling and clinical outcome following surgical and trans-catheter

期刊论文

Effect of renal function and hemodialysis on the serum tumor markers in patients with chronic kidney

YU Xiaofang, XU Xialian, YE Zhibin

期刊论文

致力于血管内光学相干成像术的Ni A微电机导管

Tianshi Wang, Gijs van Soest, Antonius F. W. van der Steen

期刊论文

光纤微针装置中增强对流药物输注的热强化表征

R. Lyle Hood,Rudy T. Andriani,Tobias E. Ecker,John L. Robertson,Christopher G. Rylander

期刊论文