Patients requiring extracorporeal membrane oxygenation (ECMO) often need concurrent continuous renal replacement therapy (CRRT). At present, there are various connection methods between ECMO and CRRT circuits, among which in-series integration is the most common. However, ECMO blood flow and catheter type, pressure changes at the pre-pump, post-pump pre-oxygenator, and post-oxygenator segments frequently result in circuit pressures that exceed the alarm threshold of the device. Excessive negative or positive pressures may compromise blood withdrawal and return within the CRRT circuit, leading to frequent system alarms, interruptions in therapy, filter occlusion, and an increased risk of thrombus formation. To address this issue, the critical care nursing team of Zhongda Hospital Affiliated to Southeast University, developed a novel pressure-regulating clamp for CRRT vascular access in ECMO patient, which has been granted a National Utility Model Patent of China (patent number: ZL 2021 2 1496610.7). The device comprises opposing left and right clamp arms joined at the top by a flexible plastic bridge, with dual internal compression surfaces designed to fit CRRT tubing of various calibers. A locking mechanism and serrated strip at the base enable precise adjustment of the compression distance, thereby modulating the tubing's cross-sectional area. This configuration allows real-time regulation of blood flow and stabilization of pressures at blood withdrawal and return sites within the CRRT circuit. By reducing pressure-related alarms and extending filter life, the device may enhance the safety and efficiency of CRRT delivery during ECMO. It is user-friendly, cost-effective, and well-suited for broad clinical implementation, with the potential to alleviate the overall treatment burden on patients and their families.
Extracorporeal Membrane Oxygenation/instrumentation* ; Humans ; Continuous Renal Replacement Therapy/instrumentation* ; Equipment Design ; Pressure

Objective To investigate the impact of nociceptive level(NOL)index on cellular immunity and HIF-1α in patients with radical breast cancer.Methods A total of 80 patients undergoing radical mastectomy between December 2022 and December 2023 were randomly assigned into an experimental group and a control group using a random number table method.The NOL index in the experimental group was maintained within the range of 30 to 50,with corresponding adjustments made to achieve the target concentration of remifentanil.In contrast,the control group initially received remifentanil at a target controlled infusion rate of 4 ng/mL,which was adjusted based on hemodynamics.The average target concentration of remifentanil was recorded for both groups.Venous blood samples were collected from all participants one day before and one day after surgery to measure CD4+,CD8+cell counts,NK cell activity,as well as serum levels of HIF-1α.Results There were no significant differences observed in anesthesia time,operation time,intraoperative mean arterial pressure(MAP),heart rate(HR),and postoperative visual analog scale(VAS)scores between the two groups.The average target concentra-tion of remifentanil in the experimental group was significantly lower than that in the control group(P＜0.05).Moreover,the experimental group exhibited higher values of CD4+,CD4+/CD8+ratio,and NK cells compared to the control group,while demonstrating a lower level of HIF-1α expression(P＜0.05).In addition,within the experimental group,there was a decrease in CD4+count and CD4+/CD8+ratio one day after surgery compared to one day before surgery;meanwhile,HIF-1α expression increased significantly after surgery when compared to preoperative levels(P＜0.05).Similarly,within the control group,there was a decrease observed in CD4+,CD8+,CD4+/CD8+ratio as well as NK cell values one day after surgery when compared to preoperative levels;additionally,HIF-1α expression showed a significant increase after surgery when compared to preoperative levels(P＜0.05).Conclusion The implementation of NOL monitoring during radical mastectomy under general anes-thesia can effectively lower the required remifentanil concentration,thereby mitigating its suppressive effects on T lymphocytes,preserving NK cell activity,and reducing elevated levels of HIF-1α.Consequently,this approach exerts minimal impact on the tumor immune microenvironment(TIME)in patients.

Objective:To evaluate the effect of preemptive analgesia with ibuprofen on postoperative pain following single posterior tooth implantation, aiming to provide a clinical reference for its application.Methods:A multicenter, randomized, double-blind, placebo-controlled parallel-group trial was conducted. A total of 82 participants were included in the trial, meeting the eligibility criteria from April 2022 to April 2024 at the Capital Medical University School of Stomatology (40 cases), Beijing TianTan Hospital, Capital Medical University (22 cases), Beijing Chao-Yang Hospital, Capital Medical University (20 cases). Participants were randomly assigned in a 1∶1 ratio to either the ibuprofen group or the control group, with each group comprising 41 individuals. Participants in the ibuprofen group received 300 mg of sustained-release ibuprofen capsules orally 15 min before surgery, while the control group received a placebo. Both groups received the same postoperative analgesic regimen for 3 days. Pain scores were assessed using the numerical rating scale at 30 min, 4 h, 6 h, 8 h, 24 h, 48 h, and 72 h postoperatively, and the additional use of analgesic medication was recorded from days 4 to 6 postoperatively.Results:A total of 82 participants were initially enrolled in the study, with 7 dropouts (4 from the control group and 3 from the ibuprofen group), resulting in 75 participants (37 in the control group and 38 in the ibuprofen group) completing the trial. There were no reports of adverse events such as nausea or vomiting among the participants. The ibuprofen group exhibited significantly lower pain scores at 4 h, 6 h and 8 h [1.0 (0.0, 2.0), 1.0 (0.0, 2.0), 1.5 (0.0, 3.0) ] postoperatively compared to the control group 4 h, 6 h and 8 h [2.0 (1.0, 3.0), 3.0 (1.5, 4.0), 2.0 (1.0, 4.0)] ( Z=-1.99, P=0.047; Z=-3.01, P=0.003; Z=-2.10, P=0.036). The proportions of patients requiring additional analgesic medication between days 4 and 6 post-surgery were 18.4% (7/38) in the ibuprofen group and 27.0% (10/37) in the control group, with no significant difference (χ 2=0.79, P=0.373). The median additional medication usage postoperatively was [0.0 (0.0, 0.0) pills] in the ibuprofen group and [0.0 (0.0, 1.0) pills] in the control group, with no significant difference ( Z=-0.78, P=0.439). Conclusions:Preemptive analgesia with ibuprofen effectively reduces postoperative pain following tooth implantation, representing a safe and effective perioperative pain management strategy.

Objective To explore the true feelings and emotional needs of the patients with androgen insensitivity syndrome (AIS) during diagnosis and treatment. Methods In this qualitative study, the phenomenological research method was conducted among 9 patients with androgen insensitivity syndrome. The data were analyzed by using Colaizzi analysis method. Result The AIS patients during the diagnosis and treatment experienced six psychological feelings: eagerness to understand disease knowledge, gender cognition disorder inferiority, self-pity, anger and resentment, feeling at a loss about future, general symptoms, and anxiety for social acceptance. Conclusions Nurses should provide relevant information guidance and emotional support to alleviate patients'negative emotions and enhance their confidence in the treatment. The nurses should encourage family members of the patients to participate in psychological counselling, expand social support through multiple channels, correct patients'psychological biases, and restore their self-confidence.

AIM:To investigate the regulation of miR-222 on BCL2L13 gene and its effect on the growth and apoptosis of HBx-HepG2 cells, and to explore the underlying molecular mechanisms .METHODS:The expression level of miR-222 was detected by RT-qPCR.The HBx-HepG2 cell growth was examined by MTT and colony formation assays .The cell cycle and apoptosis were analyzed by flow cytometry .The recombination vector pmirGLO-BCL2L13 was constructed, and dual-luciferase reporter experiment was performed to validate the target of miR-222.RESULTS:The expression level of miR-222 in the HBx-HepG2 cells was significantly higher than that in the L 02 cells ( P<0.05 ) .Over-expression of miR-222 enhanced HBx-HepG2 cell growth, changed cell cycle, and inhibited apoptosis (P<0.05).Knockdown of miR-222 reduced HBx-HepG2 cell growth, changed cell cycle, and increased cell apoptotic rate (P<0.05).BCL2L13 was down-regulated in the HBx-HepG2 cells as compared with L02 cells (P<0.05), and knockdown of miR-222 in the HBx-HepG2 cells increased the expression level of BCL2L13 (P<0.05).The results of dual-luciferase reporter assay and re-store experiment showed that miR-222 negatively regulated the expression of BCL2L13 via targeting 3’ UTR of BCL2L13, resulting in the promotion of HBx-HepG2 cell growth .CONCLUSION: miR-222 enhances HBx-HepG2 cell growth via down-regulation of BCL2L13.

Objective To explore the characteristics of diagnosis a nd treatment of testicular trauma. Methods A retrospective study was done on 30 cases of testicular trauma. The treatment effects of non -operation and operation on different types of injuries were observed and com pared. Results Follow-up time ranged from two months to tw o years. There were three cases with testicular atrophy, one with chronic pain l asting for one year and eight with non-operation. All of 22 cases treated with surgical operation were good except for one with sperm disorder due to bilateral testicular trauma. Conclusions Testicular trauma is a speci al type of trauma. Ultrasound is an important diagnostic method for testicular trauma. Surgical exploration should be performed as soon as possible so as to a void testicular atrophy and sperm disorder.