Objective:To develop a formula correlating body weight and the insertion length of peripherally inserted central catheters (PICC) in very low birth weight infants (VLBWI) undergoing lower limb PICC placement, aiming to improve the success rate of one-time catheter placement.Methods:A prospective research method was adopted, 205 VLBWI patients who were hospitalized in the NICU of Shenzhen Maternal and Child Health Hospital from May 2023 to February 2024 and had indwelling PICC in the lower extremities were selected as the research subjects using the convenience sampling method. Data including gender, insertion vein, body weight on the day of catheterization, and the vertical distance from the puncture site to the first popliteal crease were collected. Pearson correlation analysis and linear regression analysis were used to construct a predictive formula for estimating the insertion length of PICC based on body weight. The Bland-Altman plot was applied to evaluate the consistency between the predicted insertion depth using the formula and the actual correct insertion length.Results:A total of 182 VLBWI were included in the study, comprising 102 male infants and 80 female infants. The catheterization sites were the right lower extremity in 166 cases and the left lower extremity in 16 cases. The body weight was (1.08 ± 0.26) kg. The vertical distance from the puncture site to the first popliteal crease was (5.58 ± 1.72) cm. The prediction formula for the length of lower extremity PICC catheterization was constructed through linear regression analysis: PICC insertion length = 8.013 + [5.194×body weight (kg)] ± vertical distance from the puncture site to the popliteal crease (cm). Consistency evaluation showed good agreement between the predicted insertion depth and the actual correct insertion length, with 95% of the measurement differences falling within the limits of agreement. The mean difference was 0.07 cm ( P > 0.05). Conclusions:The weight-based formula derived for VLBWI provides a basis for predicting the optimal insertion length of PICC in clinical practice.

Objective:To develop a formula correlating body weight and the insertion length of peripherally inserted central catheters (PICC) in very low birth weight infants (VLBWI) undergoing lower limb PICC placement, aiming to improve the success rate of one-time catheter placement.Methods:A prospective research method was adopted, 205 VLBWI patients who were hospitalized in the NICU of Shenzhen Maternal and Child Health Hospital from May 2023 to February 2024 and had indwelling PICC in the lower extremities were selected as the research subjects using the convenience sampling method. Data including gender, insertion vein, body weight on the day of catheterization, and the vertical distance from the puncture site to the first popliteal crease were collected. Pearson correlation analysis and linear regression analysis were used to construct a predictive formula for estimating the insertion length of PICC based on body weight. The Bland-Altman plot was applied to evaluate the consistency between the predicted insertion depth using the formula and the actual correct insertion length.Results:A total of 182 VLBWI were included in the study, comprising 102 male infants and 80 female infants. The catheterization sites were the right lower extremity in 166 cases and the left lower extremity in 16 cases. The body weight was (1.08 ± 0.26) kg. The vertical distance from the puncture site to the first popliteal crease was (5.58 ± 1.72) cm. The prediction formula for the length of lower extremity PICC catheterization was constructed through linear regression analysis: PICC insertion length = 8.013 + [5.194×body weight (kg)] ± vertical distance from the puncture site to the popliteal crease (cm). Consistency evaluation showed good agreement between the predicted insertion depth and the actual correct insertion length, with 95% of the measurement differences falling within the limits of agreement. The mean difference was 0.07 cm ( P > 0.05). Conclusions:The weight-based formula derived for VLBWI provides a basis for predicting the optimal insertion length of PICC in clinical practice.

This case report described the sucussful treatment of a male infant born at 21 weeks and 4 days through assisted reproductive technology. After prenatal consultation and with the strong desire of the parents, active resuscitation and treatment were performed. The infant received 52 days of mechanical ventilation and was extubated to non-invasive ventilation at a corrected gestational age of 28 weeks and 6 days. During hospitalization, no vasoactive drugs were used, and necrotizing enterocolitis did not occur. The gastric tube was removed at a corrected gestational age of 37 weeks and 4 days. At a corrected gestational age of 40 weeks, cranial MRI showed no abnormalities. The infant was discharged at a corrected gestational age of 42 weeks after 143 days of treatment, without the need for any respiratory support. Follow-up until a corrected age of 6 months showed good growth and development.

Objective:To observe the impacts of using heated and humidified gas sources for delivery room resuscitation on the short-term outcomes of extremely preterm infants.Methods:A retrospective study was conducted on 231 extremely preterm infants admitted to the neonatal intensive care unit of Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, from January 2020 to December 2022. The infants were divided into two groups based on whether heated and humidified gas sources were used during delivery room resuscitation: the heated and humidified group (103 cases) and the non-heated and humidified group (128 cases). Independent sample t-tests, Chi-square tests, and Mann-Whitney U tests were used to compare general conditions and short-term outcomes between the groups. Multivariate logistic regression analysis was used to assess the impact of using heated and humidified gas sources during delivery room resuscitation on the short-term outcomes of extremely preterm infants. Results:Compared to the non-heated and humidified group, the heated and humidified group had a lower incidence of intubation resuscitation [28.2% (29/103) vs. 41.4% (53/128), χ 2=4.38], moderate to severe bronchopulmonary dysplasia (BPD)/death [22.3% (23/103) vs. 39.1% (50/128), χ 2=7.39] and low rectal temperature upon admission (<36.7 ℃) [57.3% (59/103) vs. 79.7% (102/128), χ 2=13.57], while the rectal temperature upon admission was higher [36.3 ℃ (36.0-36.7 ℃) vs. 35.9 ℃ (35.5-36.3 ℃), U=－5.05], with all differences being statistically significant (all P<0.05). After adjusting for gender, gestational age, mode of delivery, amniotic fluid condition, weight on admission, maternal premature rupture of membranes, assisted reproductive technology, and full course of prenatal steroid use, multivariate logistic regression analysis showed that the use of heated and humidified gas sources during delivery room resuscitation could increase the hospital admission rectal temperature ( β=0.46, 95% CI: 0.28-0.64), and decrease the risks of severe BPD/death ( aOR=0.39, 95% CI: 0.20-0.75), and low rectal temperature upon admission ( aOR=0.29, 95% CI: 0.16-0.55)(all P<0.05). Compared to the non-heated and humidified group, the heated and humidified group showed no statistically significant differences in the use of pulmonary surfactant [37.9% (39/103) vs. 43.8% (56/128), χ 2=1.45], incidence of stage Ⅲ or higher necrotizing enterocolitis [2.0% (2/103) vs. 5.5% (7/128), χ 2=2.06], grade Ⅲ or higher intracranial hemorrhage [2.9% (3/103) vs. 3.9% (5/128), χ 2=0.22], and retinopathy of prematurity requiring surgical treatment [3.9% (4/103) vs. 10.2% (13/128), χ 2=3.60] (all P>0.05). Conclusion:The use of heated and humidified gas sources during resuscitation of extremely preterm infants can reduce the risk of moderate to severe BPD/death, help maintain warmth during resuscitation, and do not adversely affect other short-term outcomes.

Background and Aims:The Octoparms filter is a newly introduced domestically manufactured umbrella-shaped retrievable inferior vena cava (IVC) filter. A multicenter,parallel-controlled trial demonstrated its non-inferiority to the Celect filter. This study was performed to compare the clinical outcomes of the placement and retrieval of the Octoparms filter with those of the Denali filter to assess its safety and efficacy further.Methods:From May 2021 to May 2024,289 Denali filters (Denali group) and 78 Octoparms filters (Octoparms group) were placed and attempted to be retrieved at Beijing Shijitan Hospital,affiliated with Capital Medical University. After propensity score matching (PSM) of baseline characteristics,the incidence of filter tilt,wall apposition,vein wall penetration,retrieval success rates,and other relevant variables were compared between the two groups.Results:After PSM,77 patients were included in each group. Following matching,except for the significantly lower placement cost in the Octoparms group (P<0.05),all baseline characteristics (e.g.,gender,age,surgical indications,filter insertion route,IVC diameter,and angle) showed no statistically significant differences between the two groups (all P>0.05). The average indwelling time of the filter was longer in the Denali group compared to the Octoparms group (58 d vs. 47 d,P=0.004). There was no significant difference in the average filter tilt angle between the two groups (4.4° vs. 4.8°,P=0.71). While wall apposition or significant tilt was more frequent in the Octoparms group,the difference was not statistically significant (P>0.05). Both groups achieved a 100.0％ technical success rate for filter retrieval,with no complications such as filter fracture or vascular rupture during retrieval. Other retrieval-related variables (surgical approach,retrieval duration,retrieval techniques,and costs) also showed no significant differences between the two groups (all P>0.05).Conclusion:As a newly launched domestic filter,the Octoparms filter demonstrates comparable stability and retrieval rate to the Denali filter,and it is a safe and reliable choice.

Background and Aims:The Octoparms filter is a newly introduced domestically manufactured umbrella-shaped retrievable inferior vena cava (IVC) filter. A multicenter,parallel-controlled trial demonstrated its non-inferiority to the Celect filter. This study was performed to compare the clinical outcomes of the placement and retrieval of the Octoparms filter with those of the Denali filter to assess its safety and efficacy further.Methods:From May 2021 to May 2024,289 Denali filters (Denali group) and 78 Octoparms filters (Octoparms group) were placed and attempted to be retrieved at Beijing Shijitan Hospital,affiliated with Capital Medical University. After propensity score matching (PSM) of baseline characteristics,the incidence of filter tilt,wall apposition,vein wall penetration,retrieval success rates,and other relevant variables were compared between the two groups.Results:After PSM,77 patients were included in each group. Following matching,except for the significantly lower placement cost in the Octoparms group (P<0.05),all baseline characteristics (e.g.,gender,age,surgical indications,filter insertion route,IVC diameter,and angle) showed no statistically significant differences between the two groups (all P>0.05). The average indwelling time of the filter was longer in the Denali group compared to the Octoparms group (58 d vs. 47 d,P=0.004). There was no significant difference in the average filter tilt angle between the two groups (4.4° vs. 4.8°,P=0.71). While wall apposition or significant tilt was more frequent in the Octoparms group,the difference was not statistically significant (P>0.05). Both groups achieved a 100.0％ technical success rate for filter retrieval,with no complications such as filter fracture or vascular rupture during retrieval. Other retrieval-related variables (surgical approach,retrieval duration,retrieval techniques,and costs) also showed no significant differences between the two groups (all P>0.05).Conclusion:As a newly launched domestic filter,the Octoparms filter demonstrates comparable stability and retrieval rate to the Denali filter,and it is a safe and reliable choice.

【Objective】 To explore the expressions of PBRM1 and PD-L1 in renal cell carcinoma (RCC), and the molecular mechanism of PBRM1 regulating PD-L1, in order to provide experimental results for clinical immunotherapy. 【Methods】 The protein expressions of PBRM1 and PD-L1 were detected with immunohistochemistry, and their mRNA expressions were determined by analyzing TCGA database. Meanwhile, the relationship between overall survival and mRNA expressions of PBRM1 and PD-L1 were analyzed in TCGA database. The exosomes were extracted with exoEasy Maxi Kit. Expressions of exosomal biomarkers CD63 and CD9 were detected with Western blotting, and their morphology was observed with transmission electron microscope. PD-L1 expression after IFN-γ, IL-6 and TNF-α treatment was detected with Western blotting. 【Results】 The expression of PBRM1 was significantly lower in canver tissue than in paracancerous tissue (P<0.001). The loss rate of PBRM1 was up to 76.4%. PBRM1 expression was not correlated with PD-L1 expression. PBRM1 deletion activated TNF-α/exosome signaling pathway, leading to increase of PD-L1 secretion in exosomes, which was then transported to the outside of cells. 【Conclusion】 There is no relationship between PBRM1 and PD-L1 protein expressions in RCC. However, PBRM1 mutation can lead to inflammatory signaling pathway activation, inducing PD-L1 secretion, which is encapsulated in exosomes and transported to the outside of cells, and affects the response of immunotherapy.

Objective:To investigate the effect of ultrasound monitoring of inferior vena cava collapse index (IVC-CI) guiding fluid replacement on circulation in elderly patients during induction of general anesthesia.Methods:A total of 71 elderly patients who underwent elective surgery under general anesthesia and tracheal intubation at Hunan Provincial People′s Hospital from April 2021 to September 2022 were randomly divided into control group (35 cases) and observation group (36 cases) using a random number table method. Before anesthesia, both groups of patients underwent IVC ultrasound examination and calculated the IVC-CI value. For patients with IVC-CI≥40%, the observation group was given 8 ml/kg of crystal solution before anesthesia induction, while the control group was not treated. The incidence of hypotension, the use of vasoactive drugs, and the total infusion volume from anesthesia induction to skin incision were recorded in two groups. Mean arterial blood pressure (MBP), heart rate (HR), oxygen saturation (SpO 2), cardiac index (CI), and cardiac volume variability (SVV) before anesthesia (T 0), 5 min after induction (T 1), 1 min after tracheal intubation (T 2), 5 min after tracheal intubation (T 3), 10 min after tracheal intubation (T 4), and 1 min before skin incision (T 5) were recorded and compared between the two groups. Results:The incidence of hypotension (27.8% vs 60.0%) and utilization rate of vasoactive drugs (25.0% vs 48.6%) in the observation group were lower than those in the control group, and the total infusion volume during anesthesia induction was higher than that in the control group, with statistical significance (all P<0.05). SVV, CI and MBP at T 1, T 3, T 4 and T 5 were significantly different from those at T 0 in the control group ( F=3.85, 14.66, 3.96, all P<0.05). SVV, CI and MBP at T 1, T 3, T 4 and T 5 in the observation group were significantly different from those at T 0 ( F=3.51, 13.20, 4.35, all P<0.05). There was no significant difference in SVV, CI, MBP, HR and SpO 2 between 2 groups (all P>0.05). Conclusions:For the elderly patients with preoperative IVC-CI≥40%, pre-filling with 8ml/kg crystal solution before anesthesia induction can significantly reduce the incidence of hypotension and the utilization rate of vasoactive drugs in the elderly patients during anesthesia induction.

The 83rd American Diabetes Association(ADA) Academic Conference was held from 23 to 26 June, 2023 in San Diego, U. S.A, in a combined online and offline format. The conference featured various aspects, including diabetes epidemiology, diabetes complications, and advances in the treatment of diabetes and related metabolic diseases. This article provides an overview of Banting awards and research advancements in diabetes and other metabolic diseases.

Objective:To analyze the clinical adverse events of the first carbon ion therapy system in radiotherapy for cancer patients in China.Methods:A retrospective analysis was conducted on the clinical trial monitoring data of the carbon ion therapy system obtained by the Pharmacovigilance Center of Gansu Province. A descriptive study was conducted on the demographic characteristics, radiotherapy techniques, irradiation site and dose parameters, postoperative follow-up, and adverse event information of 46 tumor patients who received carbon ion therapy and participated in the clinical trial in Wuwei Cancer Hospital, Gansu Province from November 2018 to February 2019. Frequency and percentage were used to describe and analyze the occurrence of adverse events after carbon ion therapy for cancer patients in different groups. All subjects who received radiotherapy were grouped according to the treatment dose and fractionation method.Results:The median age of the 46 patients was 47 years old, and the male to female ratio was 30∶16. There were 15, 5, 8, 9, and 9 patients with head and neck, chest, abdomen, pelvic cavity, and limb spinal tumors, respectively. The total duration of radiotherapy was 2-4 weeks for 10-16 times. There were 246 adverse events in 45 cases, with an incidence of 98%. No severe adverse events occurred. The adverse events definitely related to carbon ion devices accounted for 19.1%, and no severe adverse events related to carbon ion devices occurred. According to the evaluation criteria of common terminology criteria for adverse events (CTCAE), the main adverse events were CTCAE grade 2 and below, with only 1 (2%) head and neck tumor patient (nasopharyngeal malignant tumor) experienced CTCAE grade 3 adverse events after treatment. In addition, 43 patients developed acute adverse reactions, with an incidence of 93%, mainly involving the skin, mucosa, eyes, ears, pharynx and esophagus, upper gastrointestinal tract, lower gastrointestinal tract (including pelvic cavity), lung, genitourinary tract, heart, central nervous system and hematology (white blood cells, platelets and neutrophils), etc. Conclusion:The adverse reactions of patients treated with the first carbon ion therapy system are mainly CTCAE grade 2 and below, and the clinical adverse events are mild and controllable.