Pulmonary artery thrombectomy is an important method for treatment of acute pulmonary embolism(PE),and its successful implementation relies on the close collaboration of a multidisciplinary team.This article explores the indications,surgical strategies and key links of multidisciplinary treatment(MDT)for pulmonary artery thrombectomy through the diagnosis and treatment process of a patient with acute pulmonary embolism.The patient sought medical attention due to wheezing and was diagnosed with pulmonary embolism through imaging,with a risk stratification of medium to high risk.With the collaboration of multiple disciplines including respiratory medicine department,cardiology department,cardiac surgery department,radiology department and ultrasound department,percutaneous mechanical thrombectomy was successfully performed.After the surgery,the patient's blood flow was restored,symptoms were significantly relieved,and no serious complications occurred.This article aims to provide a reference framework for MDT in pulmonary artery thrombectomy for clinical doctors,optimize the treatment process for patients with pulmonary embolism,and provide reference for case selection and diagnosis and treatment strategies of thrombectomy treatment of pulmonary embolism.

Pulmonary artery thrombectomy is an important method for treatment of acute pulmonary embolism(PE),and its successful implementation relies on the close collaboration of a multidisciplinary team.This article explores the indications,surgical strategies and key links of multidisciplinary treatment(MDT)for pulmonary artery thrombectomy through the diagnosis and treatment process of a patient with acute pulmonary embolism.The patient sought medical attention due to wheezing and was diagnosed with pulmonary embolism through imaging,with a risk stratification of medium to high risk.With the collaboration of multiple disciplines including respiratory medicine department,cardiology department,cardiac surgery department,radiology department and ultrasound department,percutaneous mechanical thrombectomy was successfully performed.After the surgery,the patient's blood flow was restored,symptoms were significantly relieved,and no serious complications occurred.This article aims to provide a reference framework for MDT in pulmonary artery thrombectomy for clinical doctors,optimize the treatment process for patients with pulmonary embolism,and provide reference for case selection and diagnosis and treatment strategies of thrombectomy treatment of pulmonary embolism.

Objective:To explore the value of cardiodynamicsgram (CDG) obtained from electrocardiogram (ECG) data by radial basis functionradial basis function (RBF) neural network in early diagnosis of patients with acute coronary syndrome (ACS).Methods:Retrospective analysis method was used. Patients with chest pain as the main initial symptom in the emergency department of Baoan District People's Hospital of Shenzhen from October 2021 to September 2022 were enrolled. Baseline data were collected, including gender, age, smoking history, family history of coronary heart disease and history of hypertension, diabetes, hyperlipidemia, and atherosclerosis. The first 12-lead ECG was recorded after admission to the emergency department, and electrocardiodynamics analysis was performed to generate CDG. Receiver operator characteristic curve (ROC curve) was plotted to analyze the value of CDG and ECG in the early diagnosis of ACS and non-ST segment elevation ACS (NSTE-ACS). Sensitivity, specificity, area under the ROC curve (AUC), and 95% confidence interval (95% CI) were calculated. CDG and coronary angiography results of 3 patients with ACS with normal ECG were observed and analyzed. Non-ACS patients with normal ECG but positive CDG were followed for 30 days for adverse cardiovascular events. Results:A total of 384 patients with chest pain were included, including 169 patients with ACS and 215 patients without ACS. The proportion of male (87.0% vs. 53.0%), smoking history (37.9% vs. 12.1%), hypertension (46.2% vs. 22.3%), diabetes (24.3% vs. 7.9%), hyperlipidemia (55.0% vs. 14.0%) and history of atherosclerosis (22.5% vs. 2.3%) in ACS group were significantly higher than those in non-ACS group (all P < 0.05). The ROC curve showed that the AUC of CDG diagnosis of ACS was higher than that of ECG [AUC (95% CI): 0.88 (0.66-0.76) vs. 0.71 (0.84-0.92)], the sensitivity was 92.8%, 78.6%, and the specificity was 83.3%, 64.2%, respectively. The AUC of CDG diagnosis of NSTE-ACS was higher than that of ECG [AUC (95% CI): 0.85 (0.80-0.90) vs. 0.63 (0.56-0.69)], the sensitivity was 87.1%, 61.3%, and the specificity was 83.3%, 64.2%, respectively. CDG of 3 patients with ACS with normal ECG showed disordered state, and coronary angiography showed ≥70% stenosis of major coronary branches. Of 215 non-ACS patients, 20 had a normal ECG but positive CDG, and 3 developed ST segment elevation myocardial infarction (STEMI) within 30 days, and 2 developed unstable angina (UA) within 30 days. Conclusion:CDG has high value in early diagnosis of ACS patients and is expected to become an important means of early diagnosis of ACS in emergency.

Objective:To analyze the hotspots and frontiers of hyperbaric oxygen（HBO）research in and out of China.Methods:HBO-related articles published on CNKI and Web of Science from January 1，2010 to December 31，2020 were analyzed by CiteSpace from the following aspects such as the country，institution，author，and high-frequency key words，etc.Results:The study included 9，911 Chinese and 5，193 English literature. The knowledge mapping analysis showed that the HBO departments in Chinese hospitals were currently the main institutions in contributing Chinese articles on HBO，with few close collaborations among them；there were three relatively large HBO research teams in China，and the co-authorship within each team was common，while the cooperation between teams was not so close. The US had the most HBO-related articles published in English，followed by China and Turkey，and the articles published in the US had the strongest centrality in the map. The authors of English articles mainly came from five research teams，with relatively close cooperation within and among the teams. Key words co-occurrence and cluster analyses of Chinese articles showed that the research hotspot was applied research on the therapeutic evaluation of HBO in the treatment of various diseases，such as CO poisoning，sudden deafness，cerebral infarction，severe craniocerebral injury，delayed encephalopathy，cerebral hemorrhage，diabetic foot，hypoxic-ischemic encephalopathy，brain edema，etc. Key words co-occurrence and cluster analyses of English articles showed that the hot topics included basic experimental research on HBO mechanism，such as oxidative stress，expression，and apoptosis，and research on clinical application of HBO therapy in radiation injuries from cancer treatment，cerebral ischemia，decompression sickness，CO poisoning，traumatic brain injury，stroke，and diabetic foot ulcer，etc.Conclusion:Research focuses of HBO in and out of China were not completely same. In China，researchers focus on clinical application of HBO，while out of China，basic experimental research on HBO receives more attention.

Objective:To explore the automated external defibrillator (AED) configuration optimization strategy in line with the characteristics of the rapidly developing cities by analyzing the actual coverage of AED in Bao'an District based on the real world data of out-of-hospital cardiac arrest (OHCA) in Bao'an District, Shenzhen City.Methods:The data of cardiac arrest database registered in Bao'an District of Shenzhen City from March 1, 2019 to February 29, 2020 were included in a retrospective observational study. The AED coverage of public and non-public areas was analyzed by calculating the minimum distance between the occurrence place of each OHCA event and the nearest AED. The minimum distance ≤100 m was set as AED coverage, and the minimum distance > 100 m was set as non-AED coverage. It was assumed that one AED was configured for each OHCA hotspot area, then the AED coverage changes were analyzed. Based on the actual situation that the AED in schools, governments, sports venues, subways, tourist attractions and parks of public areas in Bao'an District could not be obtained at any time within 24 hours, it was assumed that all AED in the public areas could be obtained at any time within 24 hours, the impact of AED available at any time on AED coverage was analyzed.Results:A total of 525 cases of OHCA were enrolled. The highest incidence of OHCA was found in residential and industrial areas [54.5% (286/525) and 14.3% (75/525), respectively]. There were 252 AED in Bao'an District, Shenzhen, and 115 OHCA events occurred within the coverage area of AED. Even if all AED met the ideal state that could be obtained at any time within 24 hours, the coverage rate was only 21.9% (115/525). The AED coverage rate of the public areas and non-public areas was 31.6% (37/117) and 19.1% (78/408) respectively, with uneven distribution, and the AED coverage rate of non-public areas was low. Assuming that the residential community and industrial zone with more than 2 OHCA cases were respectively equipped with one AED, the coverage rate of AED in the non-public areas increased from 19.1% (78/408) to 28.2% (115/408), basically meeting the requirement that AED could be obtained at any time when OHCA events occurred. Some AED in the public areas of Bao'an District were not available at any time within 24 hours. If the ideal state that all AED in the public area could be obtained at any time within 24 hours could be achieved, the AED coverage rate of all regions increased from 16.8% (88/525) to 21.9% (115/525), the AED coverage rate of the public areas increased from 29.1% (34/117) to 31.6% (37/117), the AED coverage rate of the non-public areas increased from 13.2% (54/408) to 19.1% (78/408).Conclusions:AED configuration in Bao'an District was unevenly distributed, and the coverage rate of AED in non-public areas was low. The allocation strategy for AED in fast-growing cities like Shenzhen should be as follows: on the premise of ensuring AED availability for 24 hours, priority should be given to covering the number of AED in the non-public areas including residential communities and industrial zones; AED is available in the public areas for 24 hours.

Objective:To analyze the hotspots and frontiers of hyperbaric oxygen（HBO）research in and out of China.Methods:HBO-related articles published on CNKI and Web of Science from January 1，2010 to December 31，2020 were analyzed by CiteSpace from the following aspects such as the country，institution，author，and high-frequency key words，etc.Results:The study included 9，911 Chinese and 5，193 English literature. The knowledge mapping analysis showed that the HBO departments in Chinese hospitals were currently the main institutions in contributing Chinese articles on HBO，with few close collaborations among them；there were three relatively large HBO research teams in China，and the co-authorship within each team was common，while the cooperation between teams was not so close. The US had the most HBO-related articles published in English，followed by China and Turkey，and the articles published in the US had the strongest centrality in the map. The authors of English articles mainly came from five research teams，with relatively close cooperation within and among the teams. Key words co-occurrence and cluster analyses of Chinese articles showed that the research hotspot was applied research on the therapeutic evaluation of HBO in the treatment of various diseases，such as CO poisoning，sudden deafness，cerebral infarction，severe craniocerebral injury，delayed encephalopathy，cerebral hemorrhage，diabetic foot，hypoxic-ischemic encephalopathy，brain edema，etc. Key words co-occurrence and cluster analyses of English articles showed that the hot topics included basic experimental research on HBO mechanism，such as oxidative stress，expression，and apoptosis，and research on clinical application of HBO therapy in radiation injuries from cancer treatment，cerebral ischemia，decompression sickness，CO poisoning，traumatic brain injury，stroke，and diabetic foot ulcer，etc.Conclusion:Research focuses of HBO in and out of China were not completely same. In China，researchers focus on clinical application of HBO，while out of China，basic experimental research on HBO receives more attention.

Objective:To evaluate the clinical efficacy of hyperbaric oxygen as adjunctive therapy for neurological tinnitus (NT).Methods:Relevant clinical studies in eight databases (PubMed, Embase, Cochrane library, Web of Science, CBM, Cqvip, Wanfang data, and CNKI) were systematically searched, and data from the relevant studies were extracted based on inclusion and exclusion criteria. The methodological quality assessment of the data was conducted by using the Cochrane Collaboration’s tool for assessing risk of bias, the data analysis was conducted by using RevMan 5.3, and the sensitivity analysis of publication bias detection was conducted by using Stata 15.Results:A total of 12 randomized controlled trials (RCTs) were included. The results of meta-analysis showed that hyperbaric oxygen therapy had sound clinical efficacy in treating NT [ OR=4.10, 95% CI (2.81, 5.98), P<0.01]. It also reduced the scores of tinnitus severity index [ WMD=11.38, 95% CI (10.53, 12.23), P<0.01]. There was obvious asymmetry in the funnel diagram, and Egger’s test results ( t=2.96, P<0.05) indicated publication bias. Conclusion:Hyperbaric oxygen as adjunctive therapy for neurological tinnitus can effectively reduce tinnitus severity, which is superior to conventional treatment alone.

With the rapid development of nanotechnology, the research and development of nanomedicine has become one of the current development directions of drug innovation. The pharmacokinetic characteristics of nanomedicine are significantly different from general drugs because of the scale effect based on nanostructures, and pharmacokinetics studies of nanomedicine may be different from the general drugs. This article focuses on the research strategies and considerations on non-clinical pharmacokinetics of nanomedicine, including test agents, in vivo/in vitro assays, biological sample analysis, data evaluation and analysis etc., providing references for developers.

Objective:To evaluate the clinical efficacy of hyperbaric oxygen as adjunctive therapy for neurological tinnitus (NT).Methods:Relevant clinical studies in eight databases (PubMed, Embase, Cochrane library, Web of Science, CBM, Cqvip, Wanfang data, and CNKI) were systematically searched, and data from the relevant studies were extracted based on inclusion and exclusion criteria. The methodological quality assessment of the data was conducted by using the Cochrane Collaboration’s tool for assessing risk of bias, the data analysis was conducted by using RevMan 5.3, and the sensitivity analysis of publication bias detection was conducted by using Stata 15.Results:A total of 12 randomized controlled trials (RCTs) were included. The results of meta-analysis showed that hyperbaric oxygen therapy had sound clinical efficacy in treating NT [ OR=4.10, 95% CI (2.81, 5.98), P<0.01]. It also reduced the scores of tinnitus severity index [ WMD=11.38, 95% CI (10.53, 12.23), P<0.01]. There was obvious asymmetry in the funnel diagram, and Egger’s test results ( t=2.96, P<0.05) indicated publication bias. Conclusion:Hyperbaric oxygen as adjunctive therapy for neurological tinnitus can effectively reduce tinnitus severity, which is superior to conventional treatment alone.

Objective To discuss the influence of two recombinant hemoglobin (rHb1.1 and rHb2.0) and human serum albumin (HSA) on oxygen supply and demand balance in rat with coronary heart disease (CHD). Methods Male Wistar rats were randomly divided into normal control group, CHD model group, HSA treatment group, rHb1.1 treatment group and rHb2.0 treatment group, 20 rats in each group. Rat model of CHD was established by high fat diet combined with pituitrin injection. The mean arterial pressure (MAP) decreased to 40 mmHg (1 mmHg = 0.133 kPa) after femoral arterial blood was drawn from the femoral arteries, and the rats were resuscitated with 13.4% HSA, rHb1.1 and rHb2.0, respectively, at the rate of 60 mL·kg-1·h-1 (20 mL/kg). The changes of electrocardiogram (ECG) ST-segment were calculated before model reproduction and at 12 hours after the last time injection of pituitrin. MAP, heart rate (HR), superior mesenteric artery blood flow (QSMA) and arterial blood gas analysis were recorded at 0, 30, 60, 90 and 120 minutes after the administration. The blood was collected after 12-hour fasting, and serum total cholesterol (TC) and triglyceride (TG) were determined by enzymatic method. The pathological changes in cardiac tissue were observed with light microscope. Results Compared with the normal control group, the changes of ECG ST-segment and TC, TG of model group were significantly increased. Compared with the model group, rHb can significantly reduce the value of ST segment changes, and HSA has no such effect; rHb short-term infusion has no significant effect on blood lipids, but can reduce myocardial pathological changes. Compared with the normal control group, the MAP of the model group decreased significantly, the HR was increased, the QSMA was slowed down, the pH value, the residual alkali (BE), the arterial carbon dioxide partial pressure (PaCO2) and HCO3- were decreased significantly. MAP in rHb1.1 group and rHb2.0 group were significantly higher than those in HSA group. Values of MAP were significantly higher in rHb2.0 group than those in rHb1.1 group at 90 minutes and 120 minutes (mmHg: 80.9±3.3 vs. 69.4±4.9, 79.2±4.0 vs. 69.1±3.7, both P < 0.05). The HR of HSA, rHb1.1 and rHb2.0 decreased to normal in 30 minutes after administration, significantly lower than those in the model group (bpm: 534±46, 518±28, 526±37 vs. 609±52, all P < 0.05). In the rHb2.0 group, the QSMA increased significantly at 60, 90 and 120 minutes compared with the model group (qv·mL-1·min-1: 5.6±0.4 vs. 3.9±0.6, 6.2±0.6 vs. 4.1±0.4, 6.9±0.7 vs. 4.0±0.3, all P < 0.05), but there was no significant difference between the HSA group and the rHb1.1 group. The pH, BE, PaCO2 did not return to the normal level after administration of HSA; pH, PaCO2 and HCO3- in the rHb1.1 group returned to normal level at 60 minutes after administration, and BE returned to normal level at 90 minutes after administration. Each index in rHb2.0 group can restore to normal levels 30 minutes ahead of. Conclusion Recombinant hemoglobin can significantly improve the oxygen supply and demand balance of rats with CHD model, can quickly and effectively correct the hypoxic state of blood metabolic acidosis, and rHb2.0 has better effect than rHb1.1.