The Bulong Gold Deposit-a Quartz-Barite Vein Type Gold Deposit in Xinjiang:Geological Characteristics and S, He and Ar Isotopic Compositions

The Bulong gold deposit, located in the southwest Tianshan in China, occurs in the Upper Devonian finegrained clastic rocks. The gold orebodies are controlled by an gently inclined interlayer fractured zone. They are hosted only in quartz-barite veins though there are barite veins and quartz veins in the ore district. The δ34S values of pyrite in the ores range from 14.6‰ to 19.2‰ and those of barite from 35.0‰ to 39.6‰, indicating that the sulfur was derived from the strata. 3He/4He ratios of fluid inclusions in pyrite are 0.24-0.82 R/Ra, approximating to that of the crust. The 40Ar/39Ar ratios range from 338 to 471, slightly higher than that of the atmosphere. 40Ar /4He ratios of ore fluids range from 0.015 to 0.412 with a mean of 0.153. Helium and argon isotope compositions of fluid inclusions show that the ore fluids of the Bulong gold deposit were mainly derived from the crust.

Isotopic Chronological Study of the Huangsha-Tieshanlong Quartz Vein-Type Tungsten Deposit and Timescale of Molybdenum Mineralization in Southern Jiangxi Province,China

The Huangsha-Tieshanlong quartz-vein tungsten polymetallic ore deposit, located in the northern Pangushan-Tieshanlong tungsten ore field in eastern Ganxian-Yudu prospecting areas of the Yushan metallogenic belt, is a well-known tungsten deposit in southern Jiangxi province, China. SHRIMP-determined dating of zircons from the Tieshanlong granite yields ages of 168.1±2.1 Ma （n=11, MSWD-1.3）. Rhenium and osmium isotopic dating of molybdenite from the Huangsha quartz-vein tungsten deposit determined by ICP-MS yields a weighted average ages of 153-3 Ma and model ages of 150.22.1 Ma - 155.4-2.3 Ma. The age of the Huangsha tungsten deposit is 10 to 15 Ma later than the Tieshanlong granite, which shows that there might have been another early Late Jurassic magmatic activity between 150 and 160 Ma, a process which is closely related with tungsten mineralization in this area. The Tieshanlong granite, the Hnangsha tungsten deposit and the Pangushan-Tieshanlong ore field were all formed around 150-170 Ma, belonging to products of a Mesozoic second large-scale mineralization. According to the collected molybdenite Re-Os dating results in southern Jiangxi province, the timescale of the associated molybdenum mineralization is 2-6 Ma in the tungsten deposit and the timescale of independent molybdenum mineralization is 1-4 Ma, implying the complexity of tungsten mineralization. Times of molybdenum mineralization are mainly concentrated in the Yanshanian, which includes three stages of 133-135 Ma, 150-162 Ma, and 166-170 Ma, respectively. The 150-162 Ma-stage is in accordance with ages of large-scale WoSn mineralization, which is mainly molybdenum mineralization characterized by associated molybdenum mineralization with development of an even greater-intensity independent molybdenum mineralization. Independent molybdenum mineralization occurred before and after large-scale W-Sn mineralization, which indicates that favorable prospecting period for molybdenum may be in Cretaceous and early late Jurassic.

Experimental Study of Tissue-type Plasminogen Activator Gene to Prevent Vein Grafts Stenosis

The effects of in vivo local expression of recombined human tissue-type plasminogen activator （t-PA） gene on the thrombosis and neointima formation of vein grafts were explored. Jugular vein-to-artery bypass grafting was performed on 72 New Zealand white rabbits. The rabbits were divided into 3 groups according to the different processing methods： transfected t-PA gene group （n = 24）, vector group （n= 24） and blank control group （n = 24）. Samples of vein grafts were harvested at different time points after surgery. The expression of t-PA gene in vein graft was detected by RT-PCR and the synthesis of t-PA protein by Western-Blot assay. The t-PA activity was measured by chromogenic substrate assay. The Cr51 labeled platelets accumulation in vein grafts was counted. The histopathological changes were compared in intima hyperplasia index among the three groups after operation. The results showed that at the 2^nd , 5^th , 14^th and 28^th day after operation, RT-PCR and Western-blot confirmed the expression of t-PA mRNA and protein at the site of gene transfer. The t-PA activity detected on the 2^nd, 5^th, 14^th and 28^th day in experimental group was 370. 63±59. 44, 344. 13±48. 47, 252.87±51.80 and 161.75±68. 94 U/g respectively, and disappeared on the 60^th day and undetected in the control groups. The number of platelets accumulated in the vein grafts in gene group, vector group and blank control group was （85. 04 ± 21.58） 10s, （225.87±85.13） 10^6 and （211.57±78.02） 10^6 respectively. The number of platelets accumulated in gene group was significantly fewer than that in the control groups. Morphometric analysis revealed that intimal hyperplasia was markedly reduced in the t-PA gene group as compared with that in the control groups. It was suggested that the local expression of t-PA gene in vein graft significantly inhibited the accumulation of platelets, thrombosis and concomitant intimal hyperplasia, by which stenosis of bypass graft could be prevented effectively.

Ore-forming fluid characteristics and genesis of vein-type lead-zinc mineralization of Xiaohongshilazi deposit,Jilin Province, China

The Xiaohongshilazi mineral deposit in Jilin Province,China,is located in the accretion zone in the northern margin of the North China Block. The deposit contains two types of ore bodies: layered Pb-Zn ore bodies in volcanic rock and vein-hosted Pb-Zn ore bodies controlled by fractures. The vein Pb-Zn ore bodies are strictly controlled by tectonic fracture zones trending in S-N direction,which comprise sulfide veins or sulfidebearing quartz veins distributed along faults or structural fissures. The ores mainly appear mesh-vein and vein structures,and also show solid-solution separation and metasomatic textures. The metal minerals are mainly sphalerite,galena,and pyrite,etc. Wall-rock alteration includes mainly sericitization,chloritization,silicification and carbonatization,etc. Microscope observations and Raman spectroscopy analyses indicate that the oreforming fluid of the vein Pb-Zn ore bodies was mainly magmatic water with low temperature,low salinity,and a shallow depth of metallogenesis( ~ 1.5 km). Sulfur and lead isotope analyses indicate that the sulfide source is mainly formation sulfur or biogenic sulfur,which is similar to the sulfur source of hydrothermal deposit( negative( δ^(34) S values),while the main Pb source was the upper crust with some mantle input. This article argues that the vein Pb-Zn ore body of the Xiaohongshilazi deposit is a low-to medium-temperature hydrothermal vein type related to the formation of a shallow magma chamber.

辽东半岛五龙金矿外围电性特征及找矿意义

辽东五龙金矿经过80余年的开采,矿山资源储备严重下滑,后备资源不足问题日益突出,亟需查明矿区深部和外围矿产资源。通过在v163号脉西北和东南两侧以及100号断裂南侧开展瞬变电磁法测量工作,构建了相应的二维和三维地电模型,分析了矿区低阻异常特征;结合前人研究成果,推断出金矿成因类型和下一步找矿方向。研究结果表明:v163号脉西北方向P0剖面上低阻区是由包括163号脉西北段的细粒闪长岩脉群引起的,属于石英脉型成矿的可能性较大;100号断裂南侧三维地电模型中的低阻区域与大孤顶子金矿矿化点相对应,该低阻区向北侧深部规模增大,异常未封闭,表明该区域北侧深部具有良好的找矿前景,值得进一步开展研究工作;v163号脉东南方向的三维地电模型中,低阻异常值在数量级上明显低于前二者,推测为蚀变带引起,后经工程验证孔揭露,该区域纵向存在多层不连续的硅化蚀变岩,最大厚度为41m,蚀变类型有硅化、绢云母化、绿泥石化以及不同程度的黄铁矿化。研究表明,五龙金矿不仅存在石英脉型金矿体,还有蚀变岩型金矿体,后者可能是该矿区下一个找矿的主要方向。

利伐沙班对氧化型低密度脂蛋白诱导的人脐静脉内皮细胞功能的影响

目的探讨利伐沙班(RIV)对氧化型低密度脂蛋白(Ox-LDL)诱导的人脐静脉内皮细胞(HUVEC)功能损伤的影响。方法根据干预措施,将实验分为空白对照组(A组,常规培养液),Ox-LDL组(B组,100μg/mL Ox-LDL的培养液),Ox-LDL+RIV125组(C1组,100μg/mL Ox-LDL和125 ng/mL RIV的培养液),Ox-LDL+RIV250组(C2组,100μg/mL Ox-LDL和250 ng/mL RIV的培养液)和Ox-LDL+RIV500组(C3组,100μg/mL Ox-LDL和500 ng/mLRIV的培养液),各组细胞均处理48 h。采用CCK-8法检测各组细胞存活率的变化,采用流式细胞术检测细胞凋亡情况,采用酶联免疫吸附试验(ELISA)检测白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,采用免疫印迹(Western blot)法检测细胞核因子-κB(NF-κB)和尿激酶型纤溶酶原激活因子受体(uPAR)蛋白表达水平。结果与B组比较,C1组、C2组、C3组细胞存活率显著升高(P<0.05),细胞凋亡率和uPAR表达水平均显著降低(P<0.05);C3组IL-1β,TNF-α,IL-6水平和p-NF-κB p65表达水平显著降低(P<0.05)。结论RIV能显著恢复细胞活力、减少细胞凋亡和由Ox-LDL引起的炎性反应,可能通过NF-κB和uPAR的调节而发挥作用。

肝移植围手术期门静脉血栓管理的研究进展

门静脉血栓是肝硬化的常见并发症之一,其发生率随着疾病的发展而增加。门静脉血栓的发生发展与多种因素有关,抗凝治疗的指征仍需进一步研究探索。门静脉血栓目前已不再认为是肝移植手术的禁忌,但是复杂的门静脉血栓会增加肝移植围手术期风险,如何恢复门静脉系统血流是临床手术方案决策的难点,合理的术前分型、手术规划和门静脉重建方式是保障肝移植受者远期良好预后的关键。本文就门静脉血栓的流行病学现状、危险因素、分型与鉴别,肝移植术前门静脉血栓管理和术中处理,以及门静脉血栓对肝移植结局的影响进行综述,为肝移植围手术期门静脉血栓的管理提供参考。

湖南柿竹园矿田柴山石英脉型钨矿体的发现及其深部勘查指示

湖南柿竹园矿田以矽卡岩型钨锡多金属矿床集中产出而闻名。近期在柴山矿区坑探新揭露了一组石英脉型钨矿体,该组矿体穿切早期矽卡岩,成矿明显较晚,这不仅为柿竹园深部找矿增添了新的线索,也为研究区内矽卡岩型钨矿与石英脉型钨矿的成因联系问题提供了理想场地。文章以柴山石英脉型钨矿为研究对象,对其中黑钨矿、白钨矿和石英开展了矿物地球化学和流体包裹体研究。结果显示:柴山黑钨矿表现为明显负Eu异常的左倾型稀土元素配分模式,与瑶岗仙黑钨矿类似;石英脉中白钨矿则表现为负Eu异常的平坦型稀土元素配分模式,这与区内矽卡岩型白钨矿类似,但分馏效应不明显,Mo含量也明显偏低;同一矿体中白钨矿的Y/Ho比值(6.21~22.35)明显高于黑钨矿的Y/Ho比值(4.61~5.95),这可能与晚期萤石的晶出有关。白钨矿和石英流体包裹体温度和盐度明显低于矽卡岩型钨矿,显示出中高温、中低盐度成矿流体特征。结合矿物学和流体包裹体的研究成果及矿体产出特征,指示柴山石英脉型钨矿与矽卡岩型钨矿为不同源、不同期次的岩浆热液产物,石英脉型钨矿的成矿流体可能源自柿竹园矿田千里山黑云母花岗岩主体侵位之后的更晚一期花岗质岩浆活动,并由此推测矿区南段深部存在一期更晚的岩浆成矿作用,成因上与石英脉型钨矿化相关,预测柿竹园矿田柴山矽卡岩型矿体之深部仍存“第二找矿空间”。

腹腔镜下子宫深静脉入路C型宫颈癌根治术的疗效

目的探讨腹腔镜下子宫深静脉入路C型宫颈癌根治术治疗宫颈癌的疗效。方法2021年1月~2022年12月我院采用腹腔镜下子宫深静脉入路C型宫颈癌根治术+盆腔淋巴结清扫术±腹主动脉旁淋巴结切除术治疗58例宫颈癌。建立通道后,在阔韧带后叶定位输尿管,分离输尿管后暴露子宫动脉,沿子宫动静脉背侧分离结缔组织,逐渐暴露子宫深静脉。将包绕子宫深静脉周围的宫旁淋巴结切除,单独送病理检查。继续向膀胱方向追踪子宫深静脉,游离其属支,血管夹双重夹闭。结果手术时间(307.2±54.1)min,出血量中位数50(20,100)ml,淋巴结清扫(26.3±6.9)枚,留置导尿管时间(20.6±4.7)d,拔除腹腔引流管时间(9.4±4.1)d,肛门排气时间(36.7±4.1)h,抗生素使用时间(9.2±4.2)d,住院时间(13.4±2.6)d。术后并发症发生率3.4%(2/58)。术后病理分期升级率为22.4%(13/58)。术后欧洲癌症研究治疗组织(European Organization of Research and Treatment of Cancer,EORTC)生活质量核心30问卷(Quality of Life Questionnaire-Core 30,QLQ-C30)评分较术前显著升高[(78.6±10.7)分vs.(47.1±7.6)分,t=17.177,P=0.000]。58例随访4~25个月,(13.5±6.2)月,无复发。结论腹腔镜下子宫深静脉入路C型宫颈癌根治术疗效确切、安全可靠。

高精度磁测在柴达木盆地北缘三角顶金矿床找矿中的应用

三角顶金矿床位于柴北缘结合带滩间山岩浆弧,是区域造山型金矿成矿事件响应的产物;研究区主要出露寒武系—奥陶系滩间山群火山岩组,岩性主要为玄武岩、硅质岩等;岩浆活动强烈,主要为晚泥盆世花岗闪长岩、二长花岗岩等,岩体中发育辉绿岩脉、石英脉等;基性—酸性岩中磁性由强变弱,其中辉长岩、二长花岗岩磁化率最高分别为8815.6×10^(-6)×4π·SI、5992.4×10^(-6)×4π·SI,可能由磁铁矿化、黄铁矿化引起强磁化率;磁异常呈锯齿状不规则跳跃,强度中等,梯度变化大,幅值为-733~820 nT;高精度磁法测量对与金矿成矿关系密切的断裂构造、破碎蚀变带等地质体有较好的分辨效果,经高精度磁法探测出局部异常呈串珠状分布,沿异常轴部存在断裂构造。经部分工程验证,在区内圈定构造蚀变带12条、金矿体7条、金矿化体40余条,M18-2异常与区内化探异常、深部工程验证等找矿信息相吻合,为区内进一步金矿找矿方向提供了依据。

双重阻断式程序护理在预防剖宫产术后深静脉血栓形成中的作用

目的:分析双重阻断式程序护理在预防剖宫产术后深静脉血栓形成(deep vein thrombosis,DVT)中的作用。方法:选取2022年2月—2023年5月南通市妇幼保健院收治的120例剖宫产产妇作为研究对象,采用随机数表法将产妇分为对照组和研究组,各60例。对照组实施常规护理,研究组实施双重阻断式程序护理。对比两组DVT发生情况、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、血浆凝血酶原时间(prothrombin time,PT)、纤维蛋白原(fibrinogen,FIB)水平,股总静脉、胭静脉、髂静脉血液流速。结果:研究组DVT发生率低于对照组,差异有统计学意义(P<0.05);术后2 d,研究组APTT、PT水平高于对照组,FIB水平低于对照组,差异有统计学意义(P<0.05);术后2 d,研究组股总静脉、胭静脉、髂静脉血液流速高于对照组,差异有统计学意义(P<0.05)。结论:双重阻断式程序护理在产妇剖宫产术后的应用,可减小对产妇术后凝血指标、静脉血液流速的影响,有效降低DVT的发生风险。

妇科恶性肿瘤患者术后下肢深静脉血栓形成的中医证型分布及风险预测

目的分析妇科恶性肿瘤患者术后下肢深静脉血栓(DVT)的中医证型分布及风险预测。方法收集2019年1月至2022年9月于广州中医药大学第一附属医院行妇科恶性肿瘤手术的279例患者的临床资料进行回顾性分析,根据术后是否发生DVT分为血栓组(40例)和非血栓组(239例),分析两组中医证型分布情况及DVT相关危险因素。结果妇科恶性肿瘤术后DVT的发生率为14.34%,血栓组气滞血瘀证占比最大(40.0%)。多因素分析提示,年龄、既往无手术史、术后3 d D-二聚体(DD)水平是妇科恶性肿瘤术后DVT的独立危险因素(P<0.05)。三指标联合的受试者工作特征曲线下面积为0.776(95%CI:0.697~0.855),经Hosmer-Lemeshow检验该模型准确性良好。结论妇科恶性肿瘤术后DVT以气滞血瘀证最为常见,高龄、既往无手术史、术后3 d DD高水平是该病的独立危险因素,三指标联合有较好的预测效率。临床应重视术后及时检测相关指标,以预防妇科恶性肿瘤术后DVT。

瑶岗仙钨矿床两类白钨矿地质特征对比研究

瑶岗仙矿床是南岭地区典型的石英脉型黑钨矿床,并伴生石英脉型和矽卡岩型两类白钨矿化。经过野外地质现象系统的观察以及精细的镜下矿物学研究,厘定了两种类型白钨矿化的成矿阶段,对不同类型白钨矿进行了宏观和微观地质特征对比。结果表明,石英脉型和矽卡岩型白钨矿的成矿环境、成矿规模、显微组构等有着明显区别。通过对比两种矿体白钨矿的岩相学特征,约束不同类型白钨矿的成矿过程与成矿作用。

庄河市新房金矿区找矿方向探讨

庄河市新房金矿区为辽南地区新发现的大型矿床,属庄河-桓仁断裂构造体系,区内褶皱构造发育程度一般,断裂构造较为发育,庄凤构造虽然为区域内规模最大构造,但属导矿构造,其次级构造燕山期构造为成矿期控矿构造,矿体多而分散,研究区域成矿规律对找矿突破有着重要指导意义。通过分析该矿区区的地质特征、矿体特征、矿床成因。明确了该矿床以充填、交代为主,属于中-低温热液交代充填型成因。含金地质体赋存于太古界鞍山群变片麻岩地层内,具明显层控性,主要为石英脉、硅钾蚀变岩二类含金地质体,两者呈迭加过渡关系或单独产出,属石英脉和硅钾蚀变岩型金矿,指出元古代盖层与太古代基底接触带部位是找矿有利靶区。

内镜下组织胶“三明治”联合套扎术治疗2型胃底静脉曲张的研究

目的探讨内镜下组织胶“三明治”联合套扎术治疗2型胃底静脉曲张(GOV2)的临床疗效。方法选取2020年5月至2021年5月赣州市第五人民医院接诊的50例GOV2患者作为研究对象,根据治疗方法不同分为研究组与对照组,每组25例。研究组采用内镜下组织胶“三明治”联合套扎术,对照组采用内镜下组织胶+聚桂醇“三明治”夹心法。比较两组临床疗效、治疗前后门静脉血流动力学指标、术后并发症发生情况。结果两组治疗总有效率比较差异无统计学意义。治疗后,两组门静脉内径(PVD)、门静脉血流量(PBF)、胃左静脉(LGV)及脾静脉内径(SVD)均大于治疗前,门静脉血流速度(PVV)快于治疗前,门静脉压(PVP)低于治疗前,且研究组PVD、PBF、LGV及SVD均大于对照组,PVV快于对照组,PVP低于对照组,差异有统计学意义(P<0.05)。研究组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论内镜下组织胶“三明治”联合套扎术可有效改善GOV2患者血流动力学变化,减少术后并发症发生,值得临床推广应用。

某石英脉型含金矿石工艺矿物学研究

针对某石英脉型含金矿石进行了详细的工艺矿物学研究,并在此基础上开展了重选—重尾浮选试验及金流失状态考查。研究结果表明:金为唯一有价回收元素,金品位为1.78 g/t。金矿物主要以自然金、银金矿形式存在,以包裹金(占45.33%)形式嵌布。粒度主要集中在-0.037 mm,占78.98%。采用重选—重尾浮选工艺,总金回收率为94.80%,浮选尾矿中流失的金矿物主要以脉石矿物包裹金形式存在,目的矿物浸出效果良好,金流失特征符合工艺矿物学研究结果。

伴自发性门静脉分流孤立性静脉曲张破裂出血患者临床特点

目的了解伴自发性门静脉分流(SPSS)的孤立性静脉曲张(IGV-1)破裂出血患者的临床特点。方法回顾性分析伴SPSS的IGV-1破裂出血患者,记录不同的类型的SPSS患者门静脉直径、门静脉压力梯度(HVPG)、门静脉有无血栓、Child-Pugh评分、Meld评分、治疗方式,随访3年,记录术后再出血次数及生存情况。结果纳入IGV-1破裂出血患者37例,15例存在脾肾分流道,14例存在胃肾分流道,8例同时存在脾肾分流和胃肾分流。18例进行TIPS治疗,随访中出现再出血4例,肝性脑病4例;胃冠状静脉栓塞术联合部分脾栓塞术治疗6例,随访中再出血4例,死亡1例。内镜治疗患者9例,随访中再出血3例,肝性脑病1例,死亡1例。单因素Cox回归发现门静脉血栓(PVT)和HVPG是影响患者再出血的危险因素。结论伴SPSS的IGV-1患者再出血、腹水和PVT发生率较高,同时PVT和HVPG是再出血的危险因素,分流形式对IGV-1治疗方案的选择有重要价值。

U-Pb SHRIMP Dating of Zircon from Quartz Veins of the Yangshan Gold Deposit in Gansu Province and Its Geological Significance

The Yangshan gold deposit is a super-large fine-grained disseminated gold deposit located in southern Gansu Province. Its metallogenic age has been determined by using the cathodoluminescence image and ion probe U-Pb dating techniques. It is found that zircons from quartz veinlet of the fine-grained disseminated gold ore show characters of magmatic origin with prism idiomorphism, oscillatory zoning and dominant Th/U ratios of 0.5-1.5. Three main populations of zircons are obtained, giving average 206Pb/238U ages of 197.6±1.7 Ma, 126.9±3.2 Ma and 51.2±1.3 Ma respectively. The first age corresponds to the K-Ar age of the plagiogranite dike, while the latter two ages indicate that buried Cretaceous and Tertiary intrusives exist in the orefield, suggesting that the Yangshan gold deposit was genetically related to the three magmatic hydrothermal activities. By contrast, zircons from coarse gold-bearing quartz vein in the mining area are much older than the host rock, indicating that the vein was formed earlier and was not contaminated by later magmatic fluids. It is concluded that the coupling of multiperiodic hydrothermal activities in the mining area has contributed a lot to mineralization of the Yangshan gold deposit.

A new type U-Th-REE-Nb mineralization related to albitite:A case study from the Chachaxiangka deposit in the northeastern Qaidam Basin of China

The U-Th-REE-Nb(Ta)-polymetallic mineralization is generally related to either the silica-undersaturated syenites,the silica-oversaturated alkaline/peralkaline granites or igneous carbonatites.In this study,the authors report a new mineralization type,which is related to the magmatic-hydrothermal albitite(with mineral assemblage predominated by albite with volume content>90%),as exemplified by the Chachaxiangka deposit in Qinghai Province of China.The Chachaxiangka deposit is the first albititerelated U-Th-REE-Nb deposit recognized in China and the mineralization can be divided into 3 types:the vein-type,the disseminated veinlet type and breccia type,of which the former 2 are predominant.Three mineralization stages can be identified according to the detailed mineralogical analyses,including the magmatic stage,main hydrothermal mineralization stage and post-ore stage.By comprehensive analyses of the mineralogical,major and trace element compositions,the authors suggest that the albitite vein is magmatic-hydrothermal in origin and both the magmatic evolution and overprint of the hydrothermal fluids play important roles in the formation of the albitite and related polymetallic mineralization.Phase separation between the silicate melt and carbonate/phosphate melt might take place in the magmatic stage,yet the immiscibility between the silicate melt and chloride-dominated fluids is the most important mechanism for the REE mineralization and also causes the Nb-Th re-mobilization and enrichment.The red color of the albitite aplite vein is an eye-catching prospecting mark in the field and more mineralization can be expected at depth and in the surrounding areas.The discovery of the new albitite type U-Th-REENb mineralization give rise to new ideas during future U-Th-REE-Nb exploration,not only in the Qaidam-Altun belt,but also other areas across China.

A New Type of Double-Lumen Catheter to Replace Current One in RCA

Objective: To replace the peripheral venous puncture for blood sampling with taking blood samples extracorporally from arterial line before predilution during RCA-CRRT performed. Methods: A new type of double-lumen femoral catheter was used instead of the current tubes. The new type of double-lumen tube had a greater distance from the inner venous ports to the inner arterial ports than current tubes. The minimum distance from the venous port to the arterial port was greatly lengthened. Replacement solution contained citrate, zero Ca2+, zero bicarbonate, low Na+. Blood samples were synchronously collected from the arterial line before the infusion of citrate replacement fluid and from the peripheral vein. The iCa concentration data of two groups were analyzed to observe the difference between iCa concentration levels in the arterial line and in peripheral vein;the anticoagulant effect of RCA and possible complications were observed, such as bleeding, clottings and hypocalcaemia. Results: 28 times of RCA-CRRT were performed on17 AKI and CRF patients with active bleeding or at the high risk of bleeding;336 blood samples were collected. Statistics showed that the difference of iCa concentration between arterial line group and the peripheral vein group was not significant (P = 0.9), there is a high degree of similarity between the iCa concentration of arterial line blood and the peripheral venous blood. None of the patients developed citrate toxicity or metabolic alkalosis. None induced bleeding, or bleeding aggravated. No obvious clotting occurred. Systemic calcium concentration was achieved in the ideal range. Conclusion: In clinical practice, the data of iCa concentration from arterial line can be used to replace that from peripheral vein when the new type of double-lumen femoral catheter is placed in femoral vein. RCA-CRRT therapy is safe and effective.