Objective:To summarize and analyze the modalities and experience of retrograde distal perfusion with distal perfusion catheter (DPC) via cannulation of the posterior tibial artery in veno-arterial extracorporeal membrane oxygenation(V-A ECMO).Methods:The clinical data of 15 patients who were treated with V-A ECMO and underwent DPC placement via the posterior tibial artery in our hospital from January 2022 to June 2023 were retrospectively analyzed.Results:The V-A ECMO catheterization method in 15 patients was percutaneous puncture catheterization, and all of them underwent surgical incision to indwelling retrograde DPC through the posterior tibial artery: 6 cases of preventive catheterization, 9 cases of remedial catheterization, the success rate of one-time catheterization was 93.33%, and the type of catheter was mainly 6 F sheath (66.67%). There was no ALI in preventive catheterization, and one case of osteofascial compartment syndrome occurred in remedial catheterization, and the catheterization time was (20.73 ± 3.47) min.Conclusions:In V-A ECMO, placement of DPC via the posterior tibial artery for retrograde distal perfusion is perfectly feasible, and has a high success rate, which can prevent or treat lower extremity ischemia.

ObjectiveTo explore the distribution characteristics of traditional Chinese medicine （TCM） syndromes in postoperative gastric cancer patients， and to analyse the factors associated with yang deficiency syndrome and its severity. MethodsTotally， 173 patients who underwent postoperative gastric cancer surgery and were treated in four centers nationwide from February 22， 2022 to March 21， 2023， were enrolled. General information and TCM syndromes were collected， and Diagnostic Scale for Yang Deficiency Syndrome in Gastric Malignancies was filled in. The frequency of TCM syndromes after gastric cancer surgery was analyzed， and univariate analysis and multivariate logistic regression analysis were performed on the related factors of yang deficiency syndrome versus non-yang deficiency syndrome and between different severity of yang deficiency syndrome. ResultsThe most common syndrome after gastric cancer surgery was qi deficiency （95 cases， 54.91%）， followed by yang deficiency （87 cases， 50.29%）. Patients with yang deficiency syndrome were often suffered from qi deficiency， qi stagnation， and phlegm dampness syndrome. Comparing yang deficiency syndrome with non-yang deficiency syndrome， univariate analysis showed that history of alcohol consumption， pathological stage， degree of differentiation， Lauren grade， signet ring cell carcinoma， vascular cancer thrombus， and nerve invasion were statistically significant （P＜0.05）； and multivariate logistic regression analysis showed that history of alcohol consumption， signet ring cell carcinoma， pathological stage Ⅲ， Ⅳ， and vascular cancer thrombus may be correlated with yang deficiency syndrome in postoperative gastric cancer patients （P＜0.05）. The univariate analysis showed that age， pathological stage， precancerous lesions， and body mass index grade were significantly different when compared between mild and severe yang deficiency syndrome （P＜0.05）； multivariate logistic regression analysis showed that age， low body weight， and pathological stage Ⅲ and Ⅳ might be correlated with severe yang deficiency syndrome after gastric cancer surgery （P＜0.05）. ConclusionQi deficiency and yang deficiency are common TCM syndromes in postoperative patients with gastric cancer. Alcohol consumption history， pathological staging （stage Ⅲ and Ⅳ）， signet ring cell carcinoma， and the presence of vascular cancer thrombus may be correlated with the occurrence of yang deficiency syndrome， and higher age， low body weight， and pathological staging （stage Ⅲ and Ⅳ） may be the correlates of severe yang deficiency syndrome.

"Stagnation" is an important pathological state in the development and progression of malignant tumors. However， its intrinsic connection with different stages of tumor evolution has not been clearly elucidated in previous studies. Drawing on clinical practice， this paper proposes the theory of stagnant toxin， emphasizing stage-specific pathogenesis and differentiated treatment strategies for tumors based on the varying manifestations of stagnation at each phase. The theory interprets the pathogenesis of stagnant toxin across the stages of tumor development through the five elements "wood， fire， earth， metal， and water" corresponding respectively to wood stagnation in the precancerous stage， metal stagnation in the postoperative phase， fire stagnation during adjuvant therapy， earth stagnation in the progressive stage， and water stagnation in the advanced stage. Each type of stagnation reflects a distinct pathogenic mechanism， such as wood stagnation giving rise to disease， metal stagnation inducing residual symptoms， fire stagnation resulting in ulceration， earth stagnation spreading toxin transmission， and water stagnation leading to critical deterioration. Accordingly， the treatment principles include guiding wood stagnation with counterflow， dispersing metal stagnation to harmonize symptoms， venting fire stagnation to regress ulcers， depleting earth stagnation to block progression， and controlling water stagnation to preserve vitality. This theoretical framework offers a traditional Chinese medicine perspective for understanding and treating malignant tumors based on the concept of stagnant toxin.