Objective:To explore the feasibility and safety of sodium bicarbonate solution for flushing in preventing fibrin sheath occlusion in peripherally inserted central catheters (PICC), providing a reference for PICC maintenance.Methods:A randomized controlled study was conducted from June 2022 to September 2023. Convenience sampling was used to select 96 patients who underwent PICC at the Affiliated Tumor Hospital of Guangxi Medical University. The patients were randomly divided into a control group and an observation group. Both groups performed grip strength exercises using a grip ball on the catheterized upper limb. During catheter maintenance, both groups used 10 ml of 0.9% sodium chloride solution for pulsed flushing. The control group used 10 ml of 0.9% sodium chloride solution for positive pressure flushing, while the observation group used 3 ml of 5% sodium bicarbonate solution for positive pressure flushing. The incidence of "mechanical valve" and catheter occlusion, as well as blood bicarbonate concentration and interleukin-6 (IL-6) levels, were recorded on the first day and at 1, 2, 3, 4, and 5 months after catheterization.Results:A total of 92 PICC patients were included, with 45 in the control group, 28 males and 17 females, aged (43.80 ± 2.21) years old, and 47 in the observation group, 29 males and 18 females, aged (43.80 ± 2.25) years old. The total incidence of "mechanical valve" in the observation group was 2.1% (1/47), lower than the control group′s 26.7% (12/45), the difference was statistically significant ( χ2=11.41, P<0.05). The incidence of catheter occlusion in the observation group was 2.1% (1/47), lower than the control group's 15.5% (7/45), the difference was statistically significant ( χ2=5.22, P<0.05). The IL-6 levels in the observation group at 2, 3, 4, and 5 months after catheterization were (4.53 ± 0.62), (4.68 ± 0.59), (4.76 ± 0.57), and (4.83 ± 0.53) ng/L, respectively, lower than the control group (4.83 ± 0.59), (4.95 ± 0.54), (5.21 ± 0.48), and (5.63 ± 0.57) ng/L, the differences were statistically significant ( t values were 2.26-6.86, all P<0.05). There were no significant differences in blood bicarbonate concentration between the two groups at different time points (all P>0.05). Conclusions:Sodium bicarbonate solution for flushing can effectively prevent fibrin sheath blockage of PICC and reduce serum IL-6 levels, making it a safe and effective flushing method.

Objective:To explore the feasibility and safety of sodium bicarbonate solution for flushing in preventing fibrin sheath occlusion in peripherally inserted central catheters (PICC), providing a reference for PICC maintenance.Methods:A randomized controlled study was conducted from June 2022 to September 2023. Convenience sampling was used to select 96 patients who underwent PICC at the Affiliated Tumor Hospital of Guangxi Medical University. The patients were randomly divided into a control group and an observation group. Both groups performed grip strength exercises using a grip ball on the catheterized upper limb. During catheter maintenance, both groups used 10 ml of 0.9% sodium chloride solution for pulsed flushing. The control group used 10 ml of 0.9% sodium chloride solution for positive pressure flushing, while the observation group used 3 ml of 5% sodium bicarbonate solution for positive pressure flushing. The incidence of "mechanical valve" and catheter occlusion, as well as blood bicarbonate concentration and interleukin-6 (IL-6) levels, were recorded on the first day and at 1, 2, 3, 4, and 5 months after catheterization.Results:A total of 92 PICC patients were included, with 45 in the control group, 28 males and 17 females, aged (43.80 ± 2.21) years old, and 47 in the observation group, 29 males and 18 females, aged (43.80 ± 2.25) years old. The total incidence of "mechanical valve" in the observation group was 2.1% (1/47), lower than the control group′s 26.7% (12/45), the difference was statistically significant ( χ2=11.41, P<0.05). The incidence of catheter occlusion in the observation group was 2.1% (1/47), lower than the control group's 15.5% (7/45), the difference was statistically significant ( χ2=5.22, P<0.05). The IL-6 levels in the observation group at 2, 3, 4, and 5 months after catheterization were (4.53 ± 0.62), (4.68 ± 0.59), (4.76 ± 0.57), and (4.83 ± 0.53) ng/L, respectively, lower than the control group (4.83 ± 0.59), (4.95 ± 0.54), (5.21 ± 0.48), and (5.63 ± 0.57) ng/L, the differences were statistically significant ( t values were 2.26-6.86, all P<0.05). There were no significant differences in blood bicarbonate concentration between the two groups at different time points (all P>0.05). Conclusions:Sodium bicarbonate solution for flushing can effectively prevent fibrin sheath blockage of PICC and reduce serum IL-6 levels, making it a safe and effective flushing method.

Objective The effect of lunar dust adhesion performance by fiber surface characteristics were investigated for the lunar dust adhesion mitigation of spacesuits.Methods In this research,an adhesion test method under ultraviolet ray radiation in vacuum was developed to measure the adhesion quantity of simulated lunar dust on fiber materials.Based on the microscopic image of the fiber sample after test,the influence of conductive and surface energy characteristics of the fiber materials on the lunar dust adhesion performance was studied.Results The simulated lunar dust were activated under ultraviolet ray radiation,which induced an increase of the adhesion quantity of simulated lunar dust on fiber materials;Lower surface energy or higher conductive characteristics of the fiber was both beneficial to reduce the adhesion quantity of simulated lunar dust.Conclusion The static electric forces were likely to be the major forces between the fiber and the lunar dust under ultraviolet ray radiation in vacuum.In addition to reducing surface energy,improving conductive characteristics of the fiber was more beneficial to reduce the adhesion quantity of simulated lunar dust.

Clinically,the incidence of portal vein thrombosis(PVT)in patients with cirrhosis can be up to 10％-23％.When PVT is not treated promptly,it may develop to cavernous transformation of the portal vein(CTPV).CTPV can aggravate portal hypertension,accelerate the progression of esophagogastric varices bleeding,refractory ascites,refractory peritonitis,biliary tract diseases,and hepatic insufficiency.At present,noninvasive imaging techniques such as portal vein reconstruction,enhanced CT and ultrasound are mostly used to make the diagnosis and evaluation of CTPV.It is rather difficult to perform portosystemic shunt surgery in patients with CTPV complicated by portal hypertension,which was once regarded as a contraindication for interventional portosystemic shunt procedures.With the improvement of related technologies and surgical instruments,the transjugular intrahepatic portosystemic shunt(TIPS)has become an important treatment for CTPV.This paper aims to make a comprehensive review about the relevant researches concerning the portosystemic shunt surgery in patients with CTPV so as to clarify the importance of TIPS in the treatment of CTPV.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To introduce a surgical technique utilizing suture plate fixation for the treatment of elbow "terrible triad" injuries and to evaluate its clinical outcomes.Methods:A retrospective analysis was conducted on 11 patients (9 males and 2 females; mean age: 40.5±9.0 years, range: 26-53 years) with elbow terrible triad injuries who underwent treatment via a single lateral approach (Kaplan approach) combined with loop plate fixation at the Trauma Emergency Center of the Third Hospital of Hebei Medical University between January 2018 and July 2022. During surgery, coronoid process fractures were stabilized using loop plates. Among the radial head fractures, 7 cases were fixed with headless compression screws, while 4 cases underwent radial head prosthetic replacement. Additionally, the lateral collateral ligament complex and common extensor tendon origin were repaired using one suture anchor in all cases. Postoperative evaluations included elbow range of motion (ROM), encompassing flexion-extension and forearm pronation-supination. Radiographic assessments were performed to evaluate the alignment of the humeroradial and humeroulnar joints, degenerative changes, and heterotopic ossification. Functional outcomes were assessed using the Mayo elbow performance score (MEPS) during follow-up.Results:All surgeries were successfully completed without intraoperative complications such as neurovascular injuries. Primary wound healing was achieved in all cases, with no instances of infection or other early complications. The mean follow-up duration was 15.55±3.78 months (range, 12-24 months). At 2 weeks postoperatively, the mean flexion-extension ROM was 66.82°±6.69°, forearm rotation ROM was 132.55°±10.61°, and MEPS was 62.73±3.44 points. By 3 months postoperatively, these values improved to 99.27°±10.82°, 159.18°±9.18°, and 83.18±10.31 points, respectively. At the final follow-up, further improvements were observed, with flexion-extension ROM reaching 115.18°±4.29°, forearm rotation ROM 164.73°±8.71°, and MEPS 95.45±7.89 points. Statistical analysis revealed significant increases in flexion-extension ROM ( F=268.014, P<0.001), forearm rotation ROM ( F=67.621, P<0.001), and MEPS ( F= 63.100, P<0.001) over time. At the final follow-up, MEPS outcomes were rated as excellent in 9 cases and good in 2 cases, yielding an excellent-to-good rate of 100%. Radiographic evaluation confirmed satisfactory joint alignment and bony union in all patients, with no reports of significant pain, elbow instability, or neurological deficits. Mild heterotopic ossification was observed in 2 cases but did not impair daily activities or necessitate additional treatment. Conclusion:The suture plate technique significantly reduced operative time, minimized surgical trauma, and lowered the risks of elbow infection and stiffness, demonstrating favorable clinical outcomes.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To introduce a surgical technique utilizing suture plate fixation for the treatment of elbow "terrible triad" injuries and to evaluate its clinical outcomes.Methods:A retrospective analysis was conducted on 11 patients (9 males and 2 females; mean age: 40.5±9.0 years, range: 26-53 years) with elbow terrible triad injuries who underwent treatment via a single lateral approach (Kaplan approach) combined with loop plate fixation at the Trauma Emergency Center of the Third Hospital of Hebei Medical University between January 2018 and July 2022. During surgery, coronoid process fractures were stabilized using loop plates. Among the radial head fractures, 7 cases were fixed with headless compression screws, while 4 cases underwent radial head prosthetic replacement. Additionally, the lateral collateral ligament complex and common extensor tendon origin were repaired using one suture anchor in all cases. Postoperative evaluations included elbow range of motion (ROM), encompassing flexion-extension and forearm pronation-supination. Radiographic assessments were performed to evaluate the alignment of the humeroradial and humeroulnar joints, degenerative changes, and heterotopic ossification. Functional outcomes were assessed using the Mayo elbow performance score (MEPS) during follow-up.Results:All surgeries were successfully completed without intraoperative complications such as neurovascular injuries. Primary wound healing was achieved in all cases, with no instances of infection or other early complications. The mean follow-up duration was 15.55±3.78 months (range, 12-24 months). At 2 weeks postoperatively, the mean flexion-extension ROM was 66.82°±6.69°, forearm rotation ROM was 132.55°±10.61°, and MEPS was 62.73±3.44 points. By 3 months postoperatively, these values improved to 99.27°±10.82°, 159.18°±9.18°, and 83.18±10.31 points, respectively. At the final follow-up, further improvements were observed, with flexion-extension ROM reaching 115.18°±4.29°, forearm rotation ROM 164.73°±8.71°, and MEPS 95.45±7.89 points. Statistical analysis revealed significant increases in flexion-extension ROM ( F=268.014, P<0.001), forearm rotation ROM ( F=67.621, P<0.001), and MEPS ( F= 63.100, P<0.001) over time. At the final follow-up, MEPS outcomes were rated as excellent in 9 cases and good in 2 cases, yielding an excellent-to-good rate of 100%. Radiographic evaluation confirmed satisfactory joint alignment and bony union in all patients, with no reports of significant pain, elbow instability, or neurological deficits. Mild heterotopic ossification was observed in 2 cases but did not impair daily activities or necessitate additional treatment. Conclusion:The suture plate technique significantly reduced operative time, minimized surgical trauma, and lowered the risks of elbow infection and stiffness, demonstrating favorable clinical outcomes.

Objective To observe the feasibility of 5.0T MR for cardiac imaging.Methods Three patients with heart diseases and 17 healthy volunteers were prospectively enrolled.Cardiac MR(CMR)cine sequence and black blood sequence imaging were performed using 5.0T and 3.0T MR scanner,respectively.The image quality and artifacts degrees were compared between 5.0T and 3.0T CMR images,and the consistency of left ventricular parameters obtained using 5.0T and 3.0T scanners was analyzed.Results No significant difference of image quality nor artifacts degrees was found between 5.0T and 3.0T CMR images(all P＞0.05).The left ventricular end diastolic volume(EDV),end systolic volume(ESV),ejection fraction(EF),stroke volume(SV)and end diastolic mass(EDM)derived from cine images acquired at different fields were in a good agreement(all ICC＞0.75,all P＜0.001).Conclusion 5.0T MR could be used for cardiac imaging,with image quality of cine and black blood sequences comparable to that of 3.0T MR.

Objective Screening for sensitive biomarkers for predicting and analyzing drug-induced renal toxicity,accelerates drug early development.Methods Focuses on epithelial cells of proximal convoluted tubules in human renal cortex(human kidney-2,HK-2)cells as the research object,screening for highly sensitive biomarkers using three nephrotoxic drugs(cisplatin,gentamicin,and aristolochic acid Ⅰ).Results The sensitivity of biomarkers in intracellular fluid is higher than in extracellular fluid,compared to detecting a single biomarker in the intracellular fluid.The combined detection of β2-microglobulin(β2-MG)and neutrophil gelatinase-associated lipocalin(NGAL)improved the accuracy of renal toxicity evaluation.Conclusion Based on the HK-2 cell model,the combined detection of β2-MG and NGAL in intracellular fluid can be used to predict renal toxicity in the drug's early development stage.