Objective To investigate the application effect of nasal gastrointestinal double lumen catheter tube placement with air insufflation in mechanically ventilated patients with intra-abdominal hypertension.Methods A total of 20 patients with intra-abdominal hypertension were randomly divided into control group and observation group (n=10 in each group).Patients in control group received indwelling nasogastric tube for decompression and indwelling nasal intestine tube by air insufflation for enteral nutrition support .Patients in observation group received the dual lumen gastrointestinal tube for decompression and enteral nutrition support.The time required for catheterization,changes in intra-abdominal pressure before and after air insufflation,catheter success rate at one attempt,pain scores of patients to catheter operation, duration of decompression,enteral nutrition start time and the duration of mechanical ventilation were compared between two groups.Results The time required for catheterization,catheter air insufflation volume in observation group were significantly lower than those in control group (P <0.01);pain scores of patients to catheter operation were significantly lower in observation group than those in control group (P <0.01);There was no significantly difference in once catheter success rate,changes in intra-abdominal pressure before and after catheterization,abdominal high pressure relief time ,enteral feeding start time, and duration of mechanical ventilation between the two groups (P >0.05 ).Conclusions The technique of air insufflation has higher success rate for Indwelling nasal intestine tube in mechanically ventilated patients with intra-abdominal hypertension,and this method is safe and reliable,dual lumen gastrointestinal tube can improve patients'comfort,shorter catheterization time and reduce catheter air insufflation volume.

Objective To investigate the relationship between the evaluation of cerebral perfusion with CT perfusion (CTP)imaging and cognitive impairment in patients with asymptomatic severe internal carotid stenosis. Methods A total of 104 patients with asymptomatic severe unilateral internal carotid artery origin stenosis (the unilateral stenosis rate ≥70% and the contralateral stenosis rate < 30%)were enrolled respectively. After conducting Montreal Cognitive Assessment (MoCA)scores,they were divided into a non-cognitive impairment group (n = 24;MoCA ≥26)and a cognitive impairment group (n = 80;MoCA <26). All patients were performed digital subtraction angiography (DSA)and / or CT angiography (CTA)examinations. Their unilateral severe stenosis was confirmed,and they underwent brain CTP examinations. The relative cerebral blood flow (rCBF),relative cerebral blood volume (rCBV),relative mean transit time (rMTT),and relative time to peak (rTTP)were calculate by CTP. The presence rate of collateral circulation in 96 patients was calculated by DSA. The presence rate of collateral circulation,and relative perfusion parameters of the 2 groups were compared. Results (1)The MoCA score in patients of the non-cognitive impairment group was 27. 8 ± 1. 7,and the MoCA score in patients of the cognitive impairment group was 21. 4 ± 3. 1. There was significant difference between the 2 groups (t = 17. 959, P <0. 05). (2)The rate of 96 patients having collateral circulation was 68. 4% (52 / 76)in the cognitive impairment group,and in the non-cognitive impairment group was 60. 0% (12/ 20). There was no significant difference (P >0. 05). The CTP parameters rMTT,rTTP,rCBV,and rCBF in the non-cognitive impairment group were 1. 074 ± 0. 066,1. 103 ± 0. 032,1. 045 ± 0. 021 and 1. 066 ± 0. 040,respectively;the CTP parameters rMTT,rTTP,rCBV,and rCBF in the cognitive impairment group were 1. 241 ± 0. 169, 1. 328 ± 0. 248,1. 046 ± 0. 030,and 1. 093 ± 0. 058,respectively. The rTTP and rMTT of the cognitive impairment were longer than those of the non-cognitive impairment group. There were significant differences in rTTP and rMTT between the 2 groups (P < 0. 05),but there were no significant differences in rCBF and rCBV between the 2 groups (P >0.05). Conclusion Most of the patients with asymptomatic severe internal carotid stenosis has cognitive impairment,and cerebral perfusion caused by stenosis is significantly slower in patients with cognitive impairment than in those with noncognitive impairment.

Gene-edited mice are the most ideal laboratory animals for studying human gene functions, exploring disease mechanisms, and developing new drugs. Strain resulting from low fertility, aging, illness, etc. can cause irreversible losses to scientific research, so strain rescues of genetically engineering mice require different measures accordingly. Meanwhile, cost control is another key point when a specific technology is applied. First of all, when the only remaining gene-edited mouse in reproductive age suddenly dies, the dead male mouse can be rescued by in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), while the female mouse can be saved by ovarian transplantation, etc. Secondly, due to aging or diseases, mice can be saved through IVF-embryo transfer (ET) and unilateral epididymal tail assisted reproduction. Thirdly, round sperm injection (ROSI) and ovarian transplantation can be used to save endangered mice before sexual maturity with poor life status. This paper reviews rescue techniques of common endangered mice and their applications, which provides a reference for relevant practitioners to better maintain gene-edited mouse strains.

In order to avoid the intra- and post-operative risks caused by massive blood loss, there are various clinical methods for evaluating the blood supply of the tumor and the distribution of blood vessels around the tumor before surgery, such as dynamic enhanced CT, dynamic enhanced magnetic resonance imaging, digital subtraction angiography, etc. And there are a variety of pre- and intra-operative methods to reduce tumor bleeding, such as transarterial vertebral tumor embolization, percutaneous or transpedicular injection of Onyx/NBCA, antifibrinolytic drugs, controlled deliberate hypotension, etc. This article reviews on spinal tumor blood supply assessment and the methods to reduce the amount of surgical bleeding.

Bone defect repairing and reconstruction has been a hot research topic in orthopedics for a long time. Tissue engineering and stem cell technology have made a series of important achievements in promoting bone regeneration to treat bone defect. In recent years, 3D bio-printing, which combining with 3D printing, tissue engineering and stem cell technology, has significant advantages in optimizing the geometry, mechanical properties and biological functions of repairing tissue for bone defect by accurately controlling the shape and internal structure of scaffolds, and printing biomaterials, stem cells and (or) cells into three-dimensional biological functional structures. A series of important progress has been achieved. The common printing methods for bio-printing related to orthopedic include: Inkjet 3D bioprinting; microextrusion 3D bioprinting; laser-assisted 3D bioprinting; stereolithography; microvalve based 3D bioprinting. Various printing methods and principles are not the same, and each has advantages and disadvantages, and the applicable "bio ink" is also different. The key technologies of orthopedic bio-3D printing include: the methods of image data acquisition and 3D structure design; development and application of composite bio-scaffold materials suitable for 3D printing, tissue engineering and bone-enhancing effect; stem cell selection for ensuring graft biological performance and induced pluripotent stem cell technology; in vitro bioreactor technology for improving the maturity and biocharacterization of bioprinted tissues. The literature published in the field of biological 3D printing research has continued to grow at a high rate since 2008. Using the bibliometric analysis software VOSviewer to create a co-word matrix for high-frequency keywords and to draw a keyword co-occurrence network map analysis, biological 3D printing research hotspots are the use of tissue engineering methods to 3D printed tissue scaffolds, while studying cell survival and drug effects. The instruments and methods of bio-3D printing are also one of the research hotspots.

AIM: To analyze the abnormal refractive status of infants and young children aged 6 to 48 months, and to provide basis for the correction of ametropia and the early prevention and treatment of amblyopia.METHODS: Infants and young children aged 6 to 48 months were examined for refraction by Spot vision screener for natural optometry. Clinical data of infants and young children with refractive abnormalities were collected, Ciliary muscle paralysis agent was used for retinoscopy and optometry, and the results were statistically analyzed.RESULTS: A total of 168 cases(336 eyes)with abnormal Spot refractive outcomes were collected, with a high proportion of hyperopia and astigmatism abnormalities, 38.4% and 28.6%, respectively, while the proportion of myopia was low(12.2%). There were 90 cases of anisometropia(≥1.00 D), among which 41 cases(45.6%)were astigmatic anisometropia, 33 cases(36.7%)were hyperopic anisometropia, and 16 cases(17.8%)were myopic anisometropia, accounting for the least proportion. A total of 109 infants and young children with Spot refractive abnormalities completed ciliary muscle paralysis retinal optometry. The analysis of the difference and correlation between Spot diopter and post ciliary muscle paralysis optometry results showed that the difference in astigmatism was 0.34±0.64 D(P<0.001), the difference in hyperopia was -2.10±1.27 D(P<0.001), and the difference in myopia was -0.43±0.91 D(P=0.023). Although there was a statistical difference between the two results, astigmatism, hyperopia, and myopia were highly positively correlated, respectively(r=0.694, 0.762, 0.909).CONCLUSION: The main refractive abnormalities in infants and young children aged 6 to 48 months are astigmatism, hyperopia, and anisometropia, with fewer abnormalities in myopia. For screening abnormalities, further ciliary muscle paralysis agent retinoscopy and optometry should be performed, and glasses correction should be given to effectively prevent refractive amblyopia in infants and young children.

The adjacent anatomy of the pelvis is complicated, with digestive, urinary, reproductive and other organs as well as important blood vessels and nerves. Therefore, accurate resection of pelvic tumors and precise reconstruction of defects after resection are extremely difficult. The development of medical 3D printing technology provides new ideas for precise resection and personalized reconstruction of pelvic tumors. The “triune” application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis in pelvic tumor limb salvage reconstruction treatment has achieved good clinical results. However, the current lack of normative guidance standards such as preparation and application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis restricts its promotion and application. The formulation of this consensus provides normative guidance for 3D printing personalized pelvic tumor limb salvage reconstruction treatment.