The principle of temperature control in operating room air decontamination system and the main reasons with difficulties of regulating temperature in transformation period of spring and autumn are analyzed. The reconstructed approaches of circulating water line on surface cooler are adopted appropriately, not only to solve the question of long temperature decreasing response time in operating room but also to save substantially a lot of expenditures and reduce the running loss.

Objective To determine the influencing factors on informed consent associated with decline or delay of primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods This study was conducted in Peking University People′s Hospital from 1 August, 2014 to 31 March, 2016, with 229 consecutive cases of acute STEMI enrolled in the study.Data were collected by reviewing medical records and STEMI treatment time records.180 patients with ischemic symptoms ≤12 hours were included in the final analysis.Patients were divided into the consent group and the refusal group according to the final decision.For patients who received primary PCI, they were further categorized into two groups based on the 30min cut-off time.Results Among the 180 STEMI patients reviewed, 139 patients agreed to primary PCI and the remaining 41 patients refused primary PCI.Multivariate logistic analysis showed that symptom relief (OR 5.532, 95% CI 1.165-26.278, P=0.031) and history of chronic kidney disease (OR 4.786, 95% CI 1.346-17.011, P=0.016) were predictors of dissent of primary PCI.Self-rated symptoms severity (OR 0.094, 95% CI 0.034-0.260, P<0.001)was predictor of consent to primary PCI.106 patients had complete time point records of informed consent in the consent group (n=139).Among these patients, the median informed consent delay was 24 min.64 patients made a decision within 30 minutes, and the other 42 patients had their decision made beyond 30 minutes.Symptom-to-door time ≥4 hours (OR 4.563,95% CI 1.682-12.385, P=0.003) was independent predictor of informed consent delay.Conclusions Patients with resolved symptoms, self-rated mild symptoms or renal insufficiency were more inclined to refuse primary PCI.For patients who eventually received primary PCI, symptom-to-door time ≥4 hours was the independent predictor of informed consent delay.

Objective To evaluate the clinical effect of ultrasound - guided sclerosing agent lauromacrogol injection in treating lymph leakage. Methods A total of 31 patients with postoperative lymph leakage were selected for this study. Of the 31 patients, successful conservative oppression treatment was accomplished in 16, and lauromacrogol injection had to be carried out in 15 as conservative oppression treatment failed. The patients were followed up and the results were analyzed. Results In 15 patients receiving lauromacrogol injection treatment, complete cure of lymph leak was obtained in 14 with a success rate of 93.33%. Among the 14 cases, the second lauromacrogol injection was employed in 3 at one week after the first injection. Infection occurred in another case one day after the injection , which was cured after dressing change for 15 days. Conclusion For the treatment of lymph leakage, ultrasound-guided sclerosing agent lauromacrogol injection is effective and safe.

Objective To explore the correlation between up-regulation of cyclooxygenase-2(COX-2) (expression) and hepatocellular carcinoma(HCC) angiogenesis.Methods The expression of COX-2,vascular endothelial growth factor(VEGF)、basic fibroblast growth factor(bFGF) and angiopoientin-2(Ang-2) were examined in eighty matched sets of HCC specimens using immunohistochemistry and reverse (transcription-polymerase) chain reaction(RT-PCR).Results In HCC,the expression rate of COX-2,VEGF,bFGF and Ang-2 was 75.0%,62.5%,60.0% and 61.25%,respectively.(Immunohistochemical) staining scores of VEGF、bFGF and Ang-2 were 5.98?1.16,4.57?0.26 and(5.87)?0.12,respectively in strongly postive group of COX-2;and were 3.30?0.22,2.61?0.16 and 2.63?0.13,respectively in moderately weak postive group of COX-2.The expression rates of VEGF,(bFGF) and Ang-2 were 100.0%(95/95),94.29%(33/35) and 97.14%(34/35),respectively in strongly postive group of COX-2;and were 60.0%(15/25),60.0%(15/25) and 60.0%(15/25),respectively in moderately weak postive group of COX-2.There was significant difference in HCC(angiogenesis) between the two groups(P

Objective To investigate the influence of exogenous p53mut, p53wt and p16 on the expression of Smad4 in lung cancer H1299 cells. Methods Target genes (p53mut, p53wtand p16) were amplified by PCR and inserted into effective eukaryotic expression vector pIRES2-EGFP, respectively. These recombinant plasmids were transfected into H1299 cells by lipofectamine. The fluorescence microscope was employed to observe the transfected cells and the expression of EGFP. RT-PCR was used to validate the transfection efficiency. Western blot assay was used to detect the change of the Smad4 expression in H1299, Results Green fluorescence was observed under fluorescence microscope in the transfected H1299 cells at 72 hour post transfection. RT-PCR indicated that p53mut, p53wt and p16 genes were highly expressed in H1299 cell. There was no significant difference in Samd4 expression between the empty plasmid group and control group(P＞0.05). But the expression of Samd4 in p53mut transfected group was decreased(P＜0.05). On the contrary, the expression of Smad4 was increased in the p53wt transfected group and P53wt and p16 co-transfected group. Moreover, the increase was more obvious in the P53wt and p16 cotransfected group(P＜ 0.05). Conclusion P53mut gene transfection reduces the expression of Smad4 and P53wt. The co-infection of p53mut and p16 increases the expression of Smad4 in the H1299 cells. The tumor promoting effect of p53mut and the antitumor effect of p53^ and p16 may be related to the signal pathway of TGF-β/Smad4.

Objective To examine the feasibility and early effects of unilateral pedicle screw fixation in combination with contralateral translaminar facet screw fixation plus interbody fusion through the channel-assisted muscle-splitting approach for the treatment of degenerative lumbar spine diseases in elderly patients.Methods A total of 82 elderly patients with degenerative lumbar spine diseases received treatment between January 2015 and June 2016.Of these patients,25 had lumbar spinal stenosis,42 had degenerative lumbar instability,13 had giant lumbar disc herniation,and two had recurrent lumbar disc herniation;There were 69 cases of single segment and 13 cases of double segment lesions.Perioperative evaluation,imaging evaluation,and clinical evaluation were performed,and surgical complications were analyzed.Results The average length of incision was (2.6 ± 0.4) cm in cases of single segment lesions and (4.4±0.5) cm in cases of two segment lesions.The mean operation time was (98.3±19.6) minutes and peri-operation blood loss was (232.2±25.8) ml.The post-operation height of the intervertebral disc space significantly increased at the last follow-up(P ＜ 0.05);the height of the intervertebral disc space was restored and well maintained with internal fixation showing no loosening,breakage or Cage shift.The post-operation lumbar coronal Cobb angle decreased(P＜0.05)while the sagittal Cobb angle increased(P＜0.05)at the last follow-up.There was no significant difference in the area and grade of the multifidus muscle on MRI 12 months after operation.Seventy-two patients were followed up for 12-18 months (mean =16.8 months),and there were 67 cases of intervertebral fusion (93.1％).The last follow-up showed a Japanese Orthopaedic Association(JOA) score of (25.8 ± 1.7),which was significantly higher than the pre-operation score (10.6±1.3),with an excellence rate of 88.9 ％.The Oswestry Disability Index score was significantly reduced,from (50.9±21.6) at pre-operation to (9.6± 4.8) at the last follow-up.There were 78 patients with primary wound healing,three cases of superficial wound necrosis,one case of dural tear,and one case of nerve root injury.No cardiovascular or cerebrovascular incident was observed during or after operation.Conclusions Combined pedicle/facet screw fixation plus interbody fusion through the channel-assisted muscle-splitting approach shows satisfactory short-term effects when used for the treatment of degenerative lumbar spine diseases in the elderly and possesses advantages such as minimal invasiveness,limited bleeding,quick recovery,high fusion rates and significantly improved clinical outcomes.However,further clinical studies are required to assess its medium-and long-term efficacy.

Objective To analyze the hemodynamic parameters of Stanford type B aortic dissection based on computational fluid dynamics (CFD), so as to make a thorough evaluation of the disease.Methods Based on CTA images of a patient with complex Stanford type B aortic dissection, the three-dimensional model and hemodynamic numerical simulation were carried out to analyze the velocity distribution of flow field and intersecting fracture profile, as well as the wall shear stress. Results The maximum velocity of blood flow at the entry tear and re-entry tear could reach 1.2 m/s and 2 m/s, respectively, providing references for further evaluation on aortic rupture position and prediction of aortic rupture risk. An obvious low wall shear stress zone was formed on false lumen wall near the entry tear, which was consistent with the thrombus position in the patient. Conclusions CFD could effectively analyze the hemodynamic characteristics of complex aortic dissection, obtain the correlation between aortic dissection and wall shear stress at aorta arch and descending aorta, which contributed to guiding clinical assessment of aortic function for preventing the diseases.

Corona virus disease 2019 (COVID-19) has been the focus of global attention since its outbreak. With the rapid spreading of COVID-19, serious challenges including medical management system, medical resources, emergency response, medical devices and instruments gradually occur, revealing many shortcomings among these aspects. Herein, through the principles, viewpoints and methods of biomechanics, this article recognizes and analyzes the existing problems that are urgently needed to be solved, such as the study of in-vitro viability of the virus, the biomechanics of aerosol, the fluid mechanics in public transportation and places, the relationship between respiratory diseases and cardiovascular diseases, the improvement of medical devices, with an objective of taking advantages of biomechanics in epidemic prevention and control, so as to promote the development of biomechanics.

It has been found that the incidence of cardiovascular disease in patients with lower limb amputation is significantly higher than that in normal individuals, but the relationship between lower limb amputation and the episodes of cardiovascular disease has not been studied from the perspective of hemodynamics. In this paper, numerical simulation was used to study the effects of amputation on aortic hemodynamics by changing peripheral impedance and capacitance. The final results showed that after amputation, the aortic blood pressure increased, the time averaged wall shear stress of the infrarenal abdominal aorta decreased and the oscillatory shear index of the left and right sides was asymmetrically distributed, while the time averaged wall shear stress of the iliac artery decreased and the oscillatory shear index increased. The changes above were more significant with the increase of amputation level, which will result in a higher incidence of atherosclerosis and abdominal aortic aneurysm. These findings preliminarily revealed the influence of lower limb amputation on the occurrence of cardiovascular diseases, and provided theoretical guidance for the design of rehabilitation training and the optimization of cardiovascular diseases treatment.
Amputation ; Aorta, Abdominal/surgery* ; Aortic Aneurysm, Abdominal/surgery* ; Blood Flow Velocity/physiology* ; Hemodynamics/physiology* ; Humans ; Lower Extremity ; Models, Cardiovascular ; Stress, Mechanical

Vascular injury resulting from lower limb amputation leads to the redistribution of blood flow and changes in vascular terminal resistance, which can affect the cardiovascular system. However, there was no clear understanding of how different amputation levels affect the cardiovascular system in animal experiments. Therefore, this study established two animal models of above-knee amputation (AKA) and below-knee amputation (BKA) to explore the effects of different amputation levels on the cardiovascular system through blood and histopathological examinations. The results showed that amputation caused pathological changes in the cardiovascular system of animals, including endothelial injury, inflammation, and angiosclerosis. The degree of cardiovascular injury was higher in the AKA group than in the BKA group. This study sheds light on the internal mechanisms of amputation's impact on the cardiovascular system. Based on the amputation level of patients, the findings recommend more comprehensive and targeted monitoring after surgery and necessary interventions to prevent cardiovascular diseases.
Animals ; Animal Experimentation ; Cardiovascular System ; Cardiovascular Diseases ; Hypertension ; Amputation, Surgical