Objective:To compare the clinical efficacy of catheter-directed thrombolysis (CDT) via the contralateral femoral vein approach (CFVA-CDT) and the calf deep vein approach (CVA-CDT) in the treatment of acute mixed-type lower extremity deep vein thrombosis (DVT).Methods:Patients treated with CFVA-CDT and CVA-CDT for acute mixed-type DVT were retrospectively collected from January 2018 to December 2021, totaling 49 and 32 patients, respectively. The relevant technical indicators, thrombolysis rates in the iliac-femoral vein segment and femoral-popliteal vein segment, clinical efficacy, and the incidence of lower extremity deep vein patency, venous valve insufficiency, and post-thrombotic syndrome (PTS), as well as the severity of chronic venous disease in the affected limb (VCSS score) during a 2-year follow-up period were retrospectively compared between the two venous access CDT groups. The t-test was used for comparing quantitative data, while the chi-square test or Fisher′s exact test was used for categorical data.Results:During CFVA-CDT procedure, 6-8 F vascular sheaths were used, and balloon dilation of 2~6 mm was more frequently employed (65.31%, 32/49) to expand venous stenosis/occlusion segments before successful sheath placement compared to the CVA-CDT group (37.50%, 12/32), and the difference was statistically significant ( P=0.014). In the CVA-CDT group, 31.25% (10/32) of patients had a maximum sheath size of 6 F, while the remainder used 4 or 5 F sheaths. Among them, 34.38% (11/32) of patients required re-puncture of the popliteal or femoral vein for larger sheaths (≥8 F) for thrombus aspiration and subsequent endovascular treatment during or after thrombolysis. The effective thrombolysis rates (≥50%) in the iliac-femoral vein segment were not significantly different between the two groups ( P=0.778). The effective thrombolysis rate of the femoral-popliteal venous segment is related to the presence or absence of popliteal vein opacification on lower extremity venous antegrade venography. There was no significant difference between the groups when the popliteal vein was visualized ( P=1.000). While the popliteal vein was not visualized, the CVA-CDT group (75.0%, 15/20) was significantly better than the CFVA-CDT group (34.38%, 11/32), and the difference was statistically significant ( P=0.004). There was no significant difference in clinical efficacy between the two groups ( P=0.819). During follow-up, the femoral-popliteal vein patency rate in the CVA-CDT group (87.50%, 28/32) was significantly higher than in the CFVA-CDT group (44.90%, 22/49), the difference was statistically significant ( P<0.001). Conclusions:Successful CFVA-CDT requires the assistance of more ancillary devices, while the use of larger sheaths is more limited in CVA-CDT due to the smaller caliber of the calf deep veins. The presence or absence of popliteal vein opacification on lower extremity venous antegrade venography may influence the effective thrombolysis of the femoral-popliteal venous segment thrombus in patients with acute mixed deep vein thrombosis (DVT) treated with CFVA-CDT and CVA-CDT. Compared to CFVA-CDT, CVA-CDT can improve the patency rate of the femoral-popliteal venous segment.

Medical ultrasound technology is widely used for diagnosis and therapy in clinical practice.Ultrasound probes,which are directly contact with patients,pose a potential risk of pathogen transmission.This expert consen-sus was developed by a multidisciplinary team based on international guidelines,standards in China,and the results of a national survey,aiming to reduce the risk of healthcare-associated infection through standardizing reprocessing of medical ultrasound probes,and formulating consensus recommendations with the Delphi method.The consensus clarifies the reprocessing principles for three types of ultrasound probes of different infection risks:external-use ul-trasound probes,interventional percutaneous ultrasound probes,and internal-use ultrasound probes,puts forward systematic suggestions on the reprocessing standards and disinfection levels of ultrasound probe isolation covers and coupling agents,the reprocessing procedures and methods of ultrasound probes,as well as architectural layout and management of reprocessing,so as to provide a scientific prevention and control framework for ensuring ultrasound diagnosis and therapy safety.

Based on the practical experience of the Human Sperm Bank, Obstetrics and Gynecology Hospital, Fudan University, this paper explores the necessity, core content, process, and common challenges of genetic counseling for sperm donors, while proposing optimization strategies. Genetic counseling for sperm donors employs methods such as family history investigation, karyotype analysis, high-throughput gene sequencing, and genetic matching to effectively identify and mitigate hereditary risks in donor-conceived offspring, thereby enhancing the scientific rigor and operability of sperm bank quality control systems. Addressing challenges such as donor acceptance, technological limitations, the complexity of genetic matching, ethical issues and privacy protection, and long-term health monitoring, this paper suggests strategies including optimizing genetic screening protocols, establishing intelligent genetic matching systems, strengthening privacy protection mechanisms, and improving long-term health management. The aim of this paper is to provide a scientific and practical reference for professionals to optimize genetic counseling management in sperm banks, ensuring sperm donor quality and the safety of assisted reproduction.

Objectives:To investigate the relationship between locations of ventricular septal perforation and 30-day prognosis in patients with acute myocardial infarction complicated by ventricular septal perforation.Methods:Clinical data of 150 acute myocardial infarction patients with ventricular septal perforation admitted to Fuwai Hospital of Chinese Academy of Medical Sciences and People's Hospital of Xinjiang Uygur Autonomous Region from January 2009 to October 2023 were retrospectively analyzed.Kaplan-Meier method was used to compare the difference in 30-day survival rate among patients with different sites of ventricular septal perforation.The impact of locations of ventricular septal perforation on 30-day prognosis of acute myocardial infarction patients was evaluated by multivariate Cox regression analysis(forward stepwise).Results:In acute myocardial infarction patients,the occurrence of anterior ventricular septal perforation was higher than that of posterior ventricular septal perforation(79.5%vs.20.5%,P<0.001).In the anterior ventricular septal perforation patients,females were more common(50.0%vs.22.6%,P=0.006),the blood glucose level was higher([10.51±5.99]mmol/L vs.[8.02±2.81]mmol/L,P=0.026),the left ventricular end-diastolic diameter was smaller([50.7±6.1]mm vs.[55.1±5.0]mm,P<0.001),the ventricular septal aperture was also smaller([9.8±4.6]mm vs.[12.6±5.4]mm,P=0.004),30-day mortality was higher(55.8%vs.35.5%,P=0.043)compared with posterior ventricular septal perforation patients.Multivariate Cox regression analysis(forward stepwise)showed that no transthoracic surgery or transcatheter closure(HR=26.344,95%CI:8.261-84.009,P<0.001)and anterior ventricular septal perforation(HR=2.432,95%CI:1.281-4.619,P=0.007)were associated with increased risk of 30-day all-cause mortality in patients with acute myocardial infarction complicated by ventricular septal perforation.Conclusions:In patients with acute myocardial infarction complicated by ventricular septal perforation,the incidence of anterior ventricular septal perforation is higher than posterior ventricular septal perforation and the 30-day all-cause mortality of anterior ventricular septal perforation patients is also higher.No transthoracic surgery or transcatheter closure and anterior ventricular septal perforation are the independent influential factors of 30-day all-cause mortality in patients with acute myocardial infarction and ventricular septal perforation.

Objective To analyze and summarize the MRI findings and clinical features of focal periphyseal edema(FOPE)in adolescents.Methods A retrospective analysis was conducted on the MRI and clinical data from 25 patients(29 knee joints)diagnosed with FOPE.All patients had no history of trauma.The MRI imaging features were analyzed by two senior musculoskeletal radiologists,and the diagnostic value and clinical significance of MRI were summarized.Results In 25 patients,34 lesions were found in 29 knee joints,including 20 in the femoral periphyseal plate region and 14 in the tibial periphyseal plate region.30 lesions were located in the central 2/3 area of the periphyseal plate and 4 were located in the peripheral 1/3 area of the periphyseal plate.On MRI,the lesions appeared as patchy areas of low signal on T1WI and high signal on fat suppression proton density weighted imaging(PDWI),extending from the periphyseal plate to the epiphysis and metaphyseal side with ill-defined borders.The longitudinal diameter of the lesions ranged from 0.4-1.7 cm,and the transverse diameter ranged from 0.3-1.7 cm.Apart from the FOPE,no other abnormal positive findings were observed on MRI of the knee joints in all patients.Conclusion FOPE in adolescents exhibits characteristic MRI findings,which may be related to closure of the periphyseal plate and knee joint pain in adolescents.

Based on the practical experience of the Human Sperm Bank, Obstetrics and Gynecology Hospital, Fudan University, this paper explores the necessity, core content, process, and common challenges of genetic counseling for sperm donors, while proposing optimization strategies. Genetic counseling for sperm donors employs methods such as family history investigation, karyotype analysis, high-throughput gene sequencing, and genetic matching to effectively identify and mitigate hereditary risks in donor-conceived offspring, thereby enhancing the scientific rigor and operability of sperm bank quality control systems. Addressing challenges such as donor acceptance, technological limitations, the complexity of genetic matching, ethical issues and privacy protection, and long-term health monitoring, this paper suggests strategies including optimizing genetic screening protocols, establishing intelligent genetic matching systems, strengthening privacy protection mechanisms, and improving long-term health management. The aim of this paper is to provide a scientific and practical reference for professionals to optimize genetic counseling management in sperm banks, ensuring sperm donor quality and the safety of assisted reproduction.

Objective:To investigate the therapeutic effects of adeno-associated virus vector 5 (AAV5)-mediated hepatic lipoprotein lipase (LPL) expression on serum triglyceride (TG) metabolism and hypertriglyceridemic acute pancreatitis (HTG-AP) in mice.Methods:Ten male C57BL/6 Lpl+/- mice were randomly divided into two groups by a random number table: the Lpl+/- control group and the Lpl+/- gene therapy group, with five mice in each group. The Lpl+/- control group received a tail vein injection of AAV5 vector carrying the enhanced green fluorescent protein (EGFP) gene (AAV5-EGFP), while the Lpl+/- gene therapy group received a tail vein injection of AAV5 vector carrying the human LPLS447X gene (AAV5-LPLS447X). Oral fat tolerance tests were performed at 14, 28, and 56 days post-injection. Twenty wild-type ICR mice were randomly divided into a control group and a gene therapy group, with ten mice in each group. The ICR control group was injected with AAV5-EGFP, and the ICR gene therapy group was injected with AAV5-LPLS447X. Fourteen days after injection, the mice underwent intraperitoneal injection of P407 solution (0.5 g/kg) and caerulein (200 μg/kg) to induce HTG-AP. Serum TG, total cholesterol (TC), amylase, lipase levels, and plasma LPL activity after heparin injection were measured by microplate reader. Plasma LPL concentration was measured using an enzyme-linked immunosorbent assay (ELISA). LPL mRNA expression levels in the liver, heart, and adipose tissue of Lpl+/- mice were determined by quantitative reverse-transcription polymerase chain reaction (qRT-PCR). LPL protein expression in the liver tissue of ICR mice was detected by immunohistochemistry at 28 days after gene therapy. Histopathological changes in the pancreas were observed using hematoxylin-eosin staining. Results:Compared to the Lpl+/- control group, the Lpl+/- gene therapy group showed a significant decrease in serum TG levels starting from day 21. After oral administration of olive oil, the increase and peak of serum TG levels were significantly lower than those in the control group. Furthermore, hepatic LPL mRNA expression levels were significantly higher (1.96±0.11 vs 1.02±0.12) with statistical significance ( P<0.05). Compared to the ICR control group, the ICR gene therapy group showed a significant decrease in serum TG and TC levels, and plasma LPL activity (0.17±0.05 mEq/L·h -1vs 0.06±0.02 mEq/L·h -1) was significantly higher at 28 days after heparin injection with statistical significance (all P value <0.05). Immunohistochemical results showed high expression of LPL protein on the hepatocyte membrane in the liver of ICR gene therapy group mice. Moreover, pancreatic edema, inflammatory infiltration, and acinar cell necrosis were significantly alleviated compared to the control group. Conclusions:LPLS447X treatment can promote LPL expression in the liver of mice, significantly reduce TG levels, and alleviate the severity of HTG-AP.

Objective:To investigate the correlation between the set mechanical angle(MA)by using an auxiliary photography device and the actual knee flexion angle(FA)in axial X-ray imaging for patellofemoral joint,so as to provide a theoretical basis for applying a self-developed dynamic adjustment device to achieve precisely dynamic radiography for patellofemoral joint,and to optimize diagnostic protocols of imaging for patellar dislocation,subluxation,etc..Methods:A prospective experimental design was adopted,which enrolled 96 healthy volunteers(40 males,56 females)whose age was 18-65 years old(mean age:32.6 years old).Using a self-developed dynamically auxiliary radiography device for axial position of patellofemoral joint,and the MA was set at 90°,120°,135°,150°,and 160°,and the corresponding FA was measured.At the same time,the gender,age,body mass index(BMI),thigh circumference,and calf circumference were also recorded.Statistical analysis was performed using SPSS 25.0 software.One-sample t-test was applied to analyze the difference value between MA and FA(MA-FA).Pearson correlation analysis and multiple linear regression analysis were conducted to conduct correlation analysis for the distribution characteristics of FA under different MA values,the FA and each anthropometric indicator.Results:FA showed a linear relationship with MA,BMI,thigh circumference,calf circumference,and gender.The regression equation was:FA=62.031+0.511×MA+0.489×BMI+0.189×thigh circumference-0.445×calf circumference+4.67×gender(R2=0.82,P<0.001).When MA was set at 90°,The actual FA was(112.21±4.7)° that was significantly larger than MA(90°),and the difference was significant(t=46.26,P<0.001).When MA was set at 120°,the actual FA was(126.19±6.43°),which was significantly greater than MA(120°)(t=9.42,P<0.001).When MA was set at 135°,there was not significant difference between FA and MA(P>0.05).When MA was set at 150°,the actual FA was(141.44±4.42°)that was significantly smaller than MA(150°),and the difference was significant(t=-18.97,P<0.001).When MA was set at 160°,the actual FA was(148.55±5.33°)that was significantly smaller than MA(160°),and the difference was significant(t=-21.03,P<0.001).BMI,thigh circumference,and calf circumference were the main factors of influencing the difference between MA and FA.Conclusion:Using the self-developed dynamic auxiliary radiography device for axial position of patellofemoral joint can construct a mathematical model to accurately predict,regulate and control the knee flexion angle,which can realize standardization for dynamic radiography on patellofemoral joint,and has significant clinical value in improving the diagnostic accuracy for imaging of patellar dislocation and subluxation.

Objectives:To investigate the relationship between locations of ventricular septal perforation and 30-day prognosis in patients with acute myocardial infarction complicated by ventricular septal perforation.Methods:Clinical data of 150 acute myocardial infarction patients with ventricular septal perforation admitted to Fuwai Hospital of Chinese Academy of Medical Sciences and People's Hospital of Xinjiang Uygur Autonomous Region from January 2009 to October 2023 were retrospectively analyzed.Kaplan-Meier method was used to compare the difference in 30-day survival rate among patients with different sites of ventricular septal perforation.The impact of locations of ventricular septal perforation on 30-day prognosis of acute myocardial infarction patients was evaluated by multivariate Cox regression analysis(forward stepwise).Results:In acute myocardial infarction patients,the occurrence of anterior ventricular septal perforation was higher than that of posterior ventricular septal perforation(79.5%vs.20.5%,P<0.001).In the anterior ventricular septal perforation patients,females were more common(50.0%vs.22.6%,P=0.006),the blood glucose level was higher([10.51±5.99]mmol/L vs.[8.02±2.81]mmol/L,P=0.026),the left ventricular end-diastolic diameter was smaller([50.7±6.1]mm vs.[55.1±5.0]mm,P<0.001),the ventricular septal aperture was also smaller([9.8±4.6]mm vs.[12.6±5.4]mm,P=0.004),30-day mortality was higher(55.8%vs.35.5%,P=0.043)compared with posterior ventricular septal perforation patients.Multivariate Cox regression analysis(forward stepwise)showed that no transthoracic surgery or transcatheter closure(HR=26.344,95%CI:8.261-84.009,P<0.001)and anterior ventricular septal perforation(HR=2.432,95%CI:1.281-4.619,P=0.007)were associated with increased risk of 30-day all-cause mortality in patients with acute myocardial infarction complicated by ventricular septal perforation.Conclusions:In patients with acute myocardial infarction complicated by ventricular septal perforation,the incidence of anterior ventricular septal perforation is higher than posterior ventricular septal perforation and the 30-day all-cause mortality of anterior ventricular septal perforation patients is also higher.No transthoracic surgery or transcatheter closure and anterior ventricular septal perforation are the independent influential factors of 30-day all-cause mortality in patients with acute myocardial infarction and ventricular septal perforation.

Objective:To investigate the measurement differences between mainstream and sidestream partial pressure of end tidal carbon dioxide(PetCO2)monitoring techniques in mechanically ventilated patients,as well as the correlation with partial pressure of arterial blood carbon dioxide(PaCO2)and clinical applicability,and to provide a basis for the rational selection of monitoring methods in the clinic.Methods:A total of 169 patients who underwent invasive mechanical ventilation in the operating room of the First Affiliated Hospital of Bengbu Medical University from August to November 2024 were selected to be monitored by three monitoring techniques of mainstream PetCO2,sidestream PetCO2 and PaCO2,respectively,and the 243 sets of valid pairwise data monitored by the three monitoring techniques were recorded,analyzed for correlation and deviation,and performed PaCO2 and PetCO2 were stratified and analyzed.Likert scales were used to analyze the subjective ratings of the 3 monitoring techniques of mainstream PetCO2,sidestream PetCO2,and PaCO2 by the 31 health care professionals who used the study.Results:Both mainstream and sidestream PetCO2 correlated with PaCO2(r=0.554,0.515,P<0.05),and mainstream PetCO2 correlated better than sidestream;mainstream PetCO2 was lower than the concurrent PaCO2 by 6.00 mmHg,and the 95%limit of agreement(95%LoA)was±6.28 mmHg,both lower than that of sidestream by 8.24 mmHg and±7.41 mmHg.8.24 mmHg and±7.41 mmHg.The dispersion of sidestream PetCO2 monitoring values was greater,especially at high PaCO2 levels.Mainstream method PetCO2 had the highest correlation with PaCO2 in gynecologic patients(r=0.820,P<0.05),and sidestream method PetCO2 underestimated PaCO2 more markedly in gastrointestinal and hepato-biliary-pancreatic surgery patients.The deviation of oxygenation index≤300 mmHg was significantly greater than that of patients with oxygenation index>300 mmHg,and the tendency of underestimation was more significant at high PaCO2.31 healthcare experts evaluated that the mainstream PetCO2 monitoring method was outstanding in terms of accuracy and real-time,and that the sidestream method of PetCO2 monitoring was advantageous in terms of ease of operation and management of consumables.Conclusion:In patients who receive mechanical ventilation,the precision,accuracy and real-time of mainstream PetCO2 monitoring are better,which is suitable for patients with rapid changes in disease condition or patients at risk of hypercapnia.The sidestream method is suitable for non-intubated or transported patients,but it is easy to be underestimated at high PaCO2,and it needs to be corrected regularly in combination with arterial blood gas.The clinical application should rationally choose monitoring method after a comprehensive assessment based on the patient's disease condition,oxygenation status,and the scenario of use.