Extracorporeal membrane oxygenation (ECMO) is a key continuous extracorporeal life support technology that can partially or completely replace a patient's cardiopulmonary function, thereby winning valuable time for the diagnosis and treatment of the primary disease. With the widespread application of ECMO, the need for transport has increased. However, during transfers, the standard heater unit is often large and inconvenient to carry, while alternative warming measures tend to be ineffective. This frequently leads to complications such as hypothermia or the inability to maintain body temperature, which can seriously affect the patient's prognosis. In response to this challenge, the medical and nursing staff of the critical care medicine department at Zhongda Hospital Affiliated to Southeast University jointly designed an insulation device for ECMO transport pipelines. The device was successfully granted a National Utility Model Patent of China (patent number: ZL 2021 2 0653569.3). It primarily consists of key components such as a heating pad, velcro straps, a cover layer, a backing layer, an electric heating layer, and a wiring plug. Its advantages include portability, the ability to effectively wrap around and warm the ECMO circuit during transit, and a reduction in the incidence of hypothermia-related complications. Furthermore, its transparent material design allows for real-time monitoring of the ECMO system's status, making it both economical and practical.
Extracorporeal Membrane Oxygenation/instrumentation* ; Humans ; Equipment Design

Objective: To investigate the efficacy and incidence of adverse reactions of therapeutic erythrocytapheresis in high altitude polycythemia (HAPC) population. Methods: A retrospective study was conducted on 243 HAPC patients who were either native residents or long-term workers in Xizang and underwent therapeutic erythrocytapheresis in the Chengdu Office Hospital of the People's Government of Xizang Autonomous Region from 2021 to 2023. A comparative study was carried out on the changes in blood routine, vital signs, skin color, serum iron metabolism data, and the incidence of adverse reactions before and after the procedure. Results: After erythrocytapheresis, significant decreases were observed in red blood cell (RBC) count (7.06±0.89×10 vs 6.08±0.93×10 /L, P<0.001], hemoglobin (HGB, 211.59±17.99 vs 182.76±19.83 g/L, P<0.001), hematocrit (Hct) [(65.30±6.45)% vs (55.56±8.12)%, P<0.001], serum iron (14.46±4.38 vs 11.77±3.78 μmol/L, P=0.003), total iron-binding capacity (126.62±4.47 vs 123.73±3.77 μmol/L, P=0.002), transferrin (1.88±0.41 vs 1.77±0.12 g/L, P=0.023), transferrin saturation [(11.32±3.11)% vs (9.43±2.78)%, P=0.004], serum ferritin (832.4±295.6 vs 665.3±249.2 ng/mL, P<0.001), systolic blood pressure (123.86±14.43 vs 118.51±13.68 mmHg, P<0.001) and diastolic blood pressure (81.68±9.54 vs 74.28±7.61 mmHg, P<0.001). In contrast, platelet count (Plt, 137.21±46.21 ×10 vs 147.94±50.66 ×10 /L, P<0.001) and oxygen saturation [(93.97±3.29)% vs (95.84±2.27)%, P<0.001] increased. No significant differences were found in white blood cell (WBC) count [5.35 (4.59, 6.44)×10 /L vs 5.43 (4.54, 6.53) ×10 /L, P=0.690], unsaturated iron-binding capacity (112.15±0.50 vs 111.96±0.25 μmol/L, P=0.074) and pulse rate (73.42±11.28 vs 73.19±7.18 beats/min, P=0.750). Furthermore, skin color of the face (conjunctiva, lips) and palms mitigated after therapeutic erythrocytapheresis, changing from purplish-red to red. The total incidence of adverse reactions during erythrocytapheresis was 13.98% (34/243), including citrate toxicity 12.75% (31/243), puncture site hematoma 0.82% (2/243) and blood volume imbalance 0.41% (1/243). Conclusion: Therapeutic erythrocytapheresis could rapidly decrease HCT, Hb, serum iron, transferrin and transferrin saturation levels in HAPC patients, with a low incidence of adverse reactions. Therefore, therapeutic erythrocytapheresis has broad clinical application prospects in Xizang Autonomous Region.

Objective:To observe the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) at different frequencies on cognitive impairment due to high-altitude hypoxia.Methods:Sixty officers and soldiers displaying cognitive impairment in a hypoxic high-altitude environment were randomly divided into 15Hz, 20Hz and 25Hz groups, each of 20. They were given rTMS at those frequencies for 30 days. Before the stimulation and after 15 and 30 days, event-related potentials, latencies of mismatched negativity (MMN) and P300 signals were recorded. The participants′ cognition was also evaluated using the Montreal Cognitive Assessment Scale (MoCA). Correlation between the electrophysiological indexes and the MoCA scores was computed.Results:After 15 days, all had shorter MMN latencies, higher total MoCA scores and better memory scores. The only significant difference among the three groups was in the average memory scores. After 15 days, MMN latency was significantly negatively correlated with the memory scores in all three groups ( r=0.44 to -0.54). Conclusions:rTMS at frequencies above 15Hz can effectively relieve cognitive impairment, especially memory dysfunction, resulting from high-altitude hypoxia.

Objective:To observe the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) at different frequencies on cognitive impairment due to high-altitude hypoxia.Methods:Sixty officers and soldiers displaying cognitive impairment in a hypoxic high-altitude environment were randomly divided into 15Hz, 20Hz and 25Hz groups, each of 20. They were given rTMS at those frequencies for 30 days. Before the stimulation and after 15 and 30 days, event-related potentials, latencies of mismatched negativity (MMN) and P300 signals were recorded. The participants′ cognition was also evaluated using the Montreal Cognitive Assessment Scale (MoCA). Correlation between the electrophysiological indexes and the MoCA scores was computed.Results:After 15 days, all had shorter MMN latencies, higher total MoCA scores and better memory scores. The only significant difference among the three groups was in the average memory scores. After 15 days, MMN latency was significantly negatively correlated with the memory scores in all three groups ( r=0.44 to -0.54). Conclusions:rTMS at frequencies above 15Hz can effectively relieve cognitive impairment, especially memory dysfunction, resulting from high-altitude hypoxia.

Objective To investigate the difference of spontaneous hemorrhagic transformation(HT)in enlarged perivascular space(EPVS)of different site and various dilation in patients with acute ischemic stroke.Methods A total of 595 patients admitted to our department acute ischemic stroke from January 2021 to June 2024 were recruited in this study.Brain magnetic resonance ima-ging was conducted in all of them within 72 h after admission,and their EPVS status was collect-ed.According to the results of brain MRI,they were divided into EPVS(384 cases)and non-EPVS(211 cases)groups.Based on EPVS site,the EPVS group was further assigned into basal ganglia(135 cases),centrum semiovale(132 cases),and midbrain(117 cases)subgroups,and based on the severity,the group was also into mild(155 cases)and severe(229 cases)subgroups.Brain CT or MRI examination was re-performed on the 7th to 10th day during hospitalization to investigate the intracranial condition,and then spontaneous HT was evaluated.The incidence of spontaneous HT in the EPVS patients of different sites and severity was analyzed and compared.Results The incidence of spontaneous HT was significantly higher in the EPVS group than the non-EPVS group(27.08％vs 8.53％,P＜0.01),and the incidence of spontaneous HT was also obviously higher in the basal ganglia subgroup than the centrum semiovale subgroup and then the midbrain subgroup(40.00％vs 21.97％vs 17.95％,P＜0.01).What's more,the severe subgroup had nota-bly higher incidence of spontaneous HT than the mild subgroup(33.19％vs 18.06％,P＜0.01).Conclusion There is difference in spontaneous HT among acute ischemic stroke patients with EPVS of different site and severity.EPVS in the basal ganglia and of severe level indicates a high-er risk of spontaneous HT,and the two features can better predict the incidence of spontaneous HT.

Objective To investigate the difference of spontaneous hemorrhagic transformation(HT)in enlarged perivascular space(EPVS)of different site and various dilation in patients with acute ischemic stroke.Methods A total of 595 patients admitted to our department acute ischemic stroke from January 2021 to June 2024 were recruited in this study.Brain magnetic resonance ima-ging was conducted in all of them within 72 h after admission,and their EPVS status was collect-ed.According to the results of brain MRI,they were divided into EPVS(384 cases)and non-EPVS(211 cases)groups.Based on EPVS site,the EPVS group was further assigned into basal ganglia(135 cases),centrum semiovale(132 cases),and midbrain(117 cases)subgroups,and based on the severity,the group was also into mild(155 cases)and severe(229 cases)subgroups.Brain CT or MRI examination was re-performed on the 7th to 10th day during hospitalization to investigate the intracranial condition,and then spontaneous HT was evaluated.The incidence of spontaneous HT in the EPVS patients of different sites and severity was analyzed and compared.Results The incidence of spontaneous HT was significantly higher in the EPVS group than the non-EPVS group(27.08％vs 8.53％,P＜0.01),and the incidence of spontaneous HT was also obviously higher in the basal ganglia subgroup than the centrum semiovale subgroup and then the midbrain subgroup(40.00％vs 21.97％vs 17.95％,P＜0.01).What's more,the severe subgroup had nota-bly higher incidence of spontaneous HT than the mild subgroup(33.19％vs 18.06％,P＜0.01).Conclusion There is difference in spontaneous HT among acute ischemic stroke patients with EPVS of different site and severity.EPVS in the basal ganglia and of severe level indicates a high-er risk of spontaneous HT,and the two features can better predict the incidence of spontaneous HT.

OBJECTIVE To explore the effect and potential mechanism of the compatibility of Astragali Radix-Puerariae Lobatae Radix on ferroptosis of liver cells in type 2 diabetes mellitus (T2DM) insulin resistance (IR) rats.METHODS Sixty male SD rats were randomly divided into control group (12 rats) and modeling group (48 rats).The modeling group was fed with a high-fat diet for 4 consecutive weeks and then given a one-time tail vein injection of 1％ streptozotocin to establish T2DM IR model.The model rats were randomly divided into model group,the compatibility of Astragali Radix-Puerariae Lobatae Radix group[QG group,4.05 g/(kg·d),intragastric administration],ferroptosis inhibitor ferrostatin-1 group[Fer-1 group,5 mg/kg by intraperitoneal injection,once every other day],the compatibility of Astragali Radix-Puerariae Lobatae Radix+ferroptosis inducer erastin group[QG+erastin group,4.05 g/(kg·d) by intragastric administration+erastin 10 mg/(kg·d),intraperitoneal injection].After 4 weeks of intervention,serum fasting blood glucose (FBG) and fasting insulin (FINS) were measured in each group of rats,and homeostasis model assessment of insulin resistance (HOMA-IR) and the natural logarithm of insulin action index(IAI) were calculated;the serum levels of total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),aspartate transaminase (AST) and alanine transaminase (ALT),Fe2+and Fe content,glutathione (GSH),malondialdehyde (MDA) and superoxide dismutase (SOD) levels,NADP+/NADPH ratio and reactive oxygen species (ROS) were determined.The pathological morphology of its liver tissue was observed;the protein expressions of glutathione peroxidase 4 (GPX4),ferritin heavy chain 1 (FTH1),long-chain acyl-CoA synthetase 3 (ACSL3),ACSL4,ferritin mitochondrial (FTMT),and cystine/glutamate anti-porter (xCT) in the liver tissue of rats were detected.RESULTS Compared with control group,the liver cells in the model group of rats showed disordered arrangement,swelling,deepened nuclear staining,and more infiltration of inflammatory cells,as well as a large number of hepatocyte vacuoles and steatosis;FBG (after medication),the levels of TC,TG,LDL-C,AST,ALT,FINS,MDA and ROS,HOMA-IR,Fe2+and Fe content,NADP+/NADPH ratio and protein expression of ACSL4 were significantly increased or up-regulated,while the levels of HDL-C,GSH and SOD,IAI,protein expressions of GPX4,FTH1,ACSL3,FTMT and xCT were significantly reduced or down-regulated (P<0.01).Compared with the model group,both QG group and Fer-1 group showed varying degrees of improvement in pathological damage of liver tissue and the levels of the above indicators,the differences in the changes of most indicators were statistically significant (P<0.01 or P<0.05).Compared with QG group,the improvement of the above indexes of QG+erastin group had been reversed significantly (P<0.01).CONCLUSIONS The compatibility decoction of Astragali Radix-Puerariae Lobatae Radix can reduce the level of FBG in T2DM IR rats,and alleviate IR degree,ion overload and pathological damage of liver tissue.The above effects are related to the inhibition of ferroptosis.

To summarize the nursing experience of 5 patients with severe ARDS complicated with hypercapnia who underwent extracorporeal carbon dioxide removal(ECCO2R).Key points of nursing care included:establishing a rapid emergency response nursing team for ECCO2R;PETCO2 real-time monitoring to grasp the timing of the machine;ensuring continuity of treatment and improving the removal efficiency;respiratory-related monitoring;prevention of complications of blood coagulation and hypothermia;and weaning from extracorporeal carbon dioxide removal.After careful treatment and care,all the 5 patients were successfully removed from ECCO2R treatment.

Objective:To analyze the effects of low-dose methimazole treatment on thyroid volume and calcitonin levels in patients with hyperthyroidism.Methods:A total of 100 hyperthyroidism patients who were treated at the Mianyang Central Hospital from January to June 2019 were selected and randomly divided into a control group (50 cases) and an observation group (50 cases) using a random number table method. The control group was treated with once a day and 30 mg/dose of methimazole, while the observation group was treated with twice a day and 10 mg/dose of methimazole. Thyroid volume, and thyroid function [Thyroid growth hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone receptor antibody (TRAb)] before and after treatment in two groups of patients, the changes in serum levels of calcitonin (CT), visfatin, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were compared. The clinical efficacy of two groups were also compared.Results:The total clinical effective rate of the observation group was higher than that of the control group ( P<0.05). After treatment, the thyroid volume in the observation group was significantly smaller than that in the control group, and the CT level was significantly lower than that in the control group (all P<0.05). After treatment, the TSH level in the observation group was significantly higher than that in the control group, while the levels of FT3, FT4, and TRAb were significantly lower than those in the control group (all P<0.05). After treatment, the levels of Visfatin, TNF-α, and IL-6 in the observation group were significantly lower than those in the control group (all P<0.05). Conclusions:Low dose methimazole can improve thyroid function, reduce thyroid volume, lower body CT and inflammation levels in patients with hyperthyroidism, and has a better therapeutic effect.

【Objective】 To investigate whether the blood donors' coagulation status may lead to apheresis platelet aggregation in vitro. 【Methods】 Thirty blood donors with aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times previously and occurred when the last time of apheresis donation were observed in aggregated group (referred to as the experimental group); Thirty donors without aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times were observed in the control group simultaneously. The basic platelet parameters in the two groups, including Plt, MPV, PDW, Pet, P-LCR were detected by automatic blood cell analyzer (BC-3000Plus), and thromboelastogram indexes including reaction time(R), kinetics time(K), kinetics of clot development(α), maximum amplitude (MA) and coagulation index(CI) were tested by Thrombosis elastography (TEG) before collection. With SPSS24.0 software, t test was used to compare the differences between the two groups. 【Results】 The CI value in experimental group was significantly different from that of the control group (0.48± 1.00 vs -0.99 ±1.96, P< 0.05), and there was no significant difference in all above basic platelet parameters and other TEG parameters (P>0.05 ) . 【Conclusion】 The coagulation status of blood donors may be an independent risk factor for the in vitro aggregation of apheresis platelets.