Objective:To study the optimal anastomotic angle of end-to-side anastomosis autogenous arteriovenous fistula (AVF).Methods:A case-report and case-series design was used to obtain clinical data on 10 patients with diabetic nephropathy from Department of Nephrology, the 905th Hospital of the Chinese People′s Liberation Army Navy from June 2024 to February 2025. The models of "radial artery-cephalic vein" end-to-side anastomosis in the forearm with anastomotic angles of 30°, 40°and 50°were established. Numerical simulation was used to analyze the blood flow in the model, and to study the effect of different anastomotic angles on blood flow. Wall shear stress (WSS), cross section flow velocity and flow rate, and relative residence time (RRT) were studied in the model. The Whitney test with Holm correction was used to evaluate the difference in the median RRT between the three angle models.Results:At the moment of 0.65 s, the area fraction of low wall shear stress (LWSS) in the 30° model was 7.7%, which was reduced by 2.4% and 3.7% compared to the 40°and 50°models, respectively. At the time of 0.2 s, the area proportions of high wall shear stress (HWSS) in the 30°, 40°and 50°models were 54.4%, 43.9% and 37.4%, respectively. At 0.2 s, the maximum cross section flow velocity reached 4.07, 3.84 and 3.67 m/s for the 30°, 40°and 50°models, respectively. In the cycle, the maximum mean flow velocity for the 30°model reached 1.20 m/s. The mean flow rates of the 30°, 40°and 50°models in the J-5 cross section were 349, 316, and 328 ml/min, respectivly. For patient 6, the area proportions of the RRT>1 region were 11.97%, 14.84% and 15.22% for the 30°, 40°and 50°models, respectively.Conclusions:The optimal anastomotic angle of "radial artery-cephalic vein" for end-to-side anastomosis AVF surgery in patients with diabetic nephropathy is 40°.

ObjectiveTo study the relationship between qi stagnation constitution and suboptimal health status (SHS) or lifestyle.MethodsFrom 2012 to 2013, we conducted a cross-sectional survey of 24 159 Chinese individuals aged 12–80 years. The qi stagnation constitution was assessed using the Constitution in Chinese Medicine Questionnaire. Health status was evaluated through medical records and the Subhealth Measurement Scale V1.0 (SHMS V1.0). Health-promoting lifestyles were measured using the Health-Promoting Lifestyle Profile II (HPLP-II).ResultsOf the 24 159 participants, 16.1% and 15.2% were classified as “always” and “sometimes” having the qi stagnation constitution, respectively. Those classified as “rarely” having the qi stagnation constitution scored higher on both the HPLP-II and SHMS V1.0. The participants classified as “always” having the qi stagnation constitution showed a significant association with SHS or disease compared to other imbalanced constitutions. Those in the “always” category were approximately 21 times more likely to be classified as having SHS (odds ratio [OR]: 21.17, 95% confidence interval [CI]: 15.74–28.45), whereas those in the “sometimes” category were approximately six times more likely (OR: 5.89, 95% CI: 5.04–6.90). Accordingly, the qi stagnation constitution score was significantly associated with the diagnosis of SHS, with an area under the curve of 0.77 (P .001). A score of 18.75 yielded the highest Youden Index (0.407), with a sensitivity of 60.5% and a specificity of 80.3%. Significant associations were observed between health-promoting lifestyles and qi stagnation constitution severity in an ordinal regression analysis (P .001). Protective factors included stress management (OR: 1.59), self-actualization (OR: 1.57), and exercise (OR: 1.36). In contrast, poorer interpersonal relationships (OR: 0.79), greater health responsibilities (OR: 0.86), and poorer nutrition (OR: 0.91) were associated with increased severity.ConclusionModulating the qi stagnation constitution through lifestyle interventions may help prevent the progression of SHS to disease, which aligns with core preventive principles in traditional Chinese medicine.

Objective To design and verify an implantable dialysis port that enables the central venous catheter to no longer be placed on the body surface,and to study the effect of the central venous catheter's structural design on its performance.Methods The feasibility of the dialysis port was verified by flow and pressure experiments.Four representative catheter structures were analyzed by finite element method.The recirculation rate,flow rate-pressure ratio and proportion of indwelling particles were recorded,and performance differences were analyzed.An experimental platform was built to verify the simulation conclusion,and the fluid flow direction of the arteriovenous cavity was quantified by the salinity measurement method.Results The dialysis port could reach the flow requirement of 300 mL/min under the 45 kPa pressure.The recirculation rate of the measured central venous catheter was between 10.7％and 23.5％,and the residual value of heparin was between 2.3％and 2.8％.The performance of the catheter with bundle mouth,positive position and side hole structure was better.Conclusions The implantable dialysis port can potentially cooperate with central venous catheters to establish a new vascular access approach.The structure of the central venous catheter should adopt the design of bundle mouth,positive position and side hole,which has better recirculation rate and heparin locking performance with low flow rate-pressure ratio.This study provides a theoretical and experimental basis for structural design and clinical selection of the central venous catheter.

Objective To design and verify an implantable dialysis port that enables the central venous catheter to no longer be placed on the body surface,and to study the effect of the central venous catheter's structural design on its performance.Methods The feasibility of the dialysis port was verified by flow and pressure experiments.Four representative catheter structures were analyzed by finite element method.The recirculation rate,flow rate-pressure ratio and proportion of indwelling particles were recorded,and performance differences were analyzed.An experimental platform was built to verify the simulation conclusion,and the fluid flow direction of the arteriovenous cavity was quantified by the salinity measurement method.Results The dialysis port could reach the flow requirement of 300 mL/min under the 45 kPa pressure.The recirculation rate of the measured central venous catheter was between 10.7％and 23.5％,and the residual value of heparin was between 2.3％and 2.8％.The performance of the catheter with bundle mouth,positive position and side hole structure was better.Conclusions The implantable dialysis port can potentially cooperate with central venous catheters to establish a new vascular access approach.The structure of the central venous catheter should adopt the design of bundle mouth,positive position and side hole,which has better recirculation rate and heparin locking performance with low flow rate-pressure ratio.This study provides a theoretical and experimental basis for structural design and clinical selection of the central venous catheter.

Objective:To design a single-line low-temperature plasma ablation electrode, aiming to solve the problem of uniform, continuous and stable microbubbles generated by conventional electrodes, and improve the ablation and cutting effect of low-temperature plasma.Methods:The structures of low temperature plasma three-wire electrode and single-line electrode were modeled in SolidWorks 2021 3D modeling software, and the prototype was made by 3D printing. The finite element analysis of electric field and temperature field of the two kinds of electrode ablation process was carried out by COMSOL Multiphysics 6.1 software, and the validity and correctness of the finite element simulation model were verified by temperature test experiment, and the ablation effect and plasma excitation process of the two kinds of electrode were compared by tissue ablation experiment and low temperature plasma excitation experiment.Results:The results of finite element analysis showed that the maximum surface temperature of three-wire electrode and single-wire electrode were 70.2 and 63.3 ℃, respectively, and the surface temperature of single-wire electrode was more ideal, and the maximum electric field intensity of the two electrodes was more than 1.0 × 10 7 V/m, which met the electric field condition of microbubble breakdown. The electric field intensity of the two ends of the three-wire electrode was much higher than that of the other regions, while the electric field intensity of the single-wire electrode had no obvious sudden change and fluctuation. The experimental values of the temperature at the electrode surface and a distance of 1 cm on the electrode surface were basically consistent with the simulation values, the degree of fit was good, and the relative error was 3.2%. The highest ablation temperature of single linear electrode on pig fat was 46.8 ℃. After ablation, there was no coking area in morphology, and the tissue cutting depth of 0.5 mm could be reached in 1 s. When connected to the energy platform, microbubbles would occur on the working electrode surface of the single-wire electrode; when 6 ms was electrified, the working electrode surface was completely covered by microbubbles; when 9 ms was energized, the low-temperature plasma was excited and the blue-purple plasma could be seen; when 25 ms was energized, the microbubbles were still regular and stable. Conclusions:A kind of single-line low-temperature plasma ablation electrode is designed, which can produce uniform, continuous and stable microbubbles and achieve better ablation and cutting effect than the traditional electrode.

Objective:To study the effects of various parameters in the structural design and usage methods of insulin pen needles on their performance.Methods:Twenty-one conventional needles and five self-destructive needles were selected. A testing machine was used to clamp the needle and make it vertically puncture the test material with a constant speed of 50, 100, 150, 200, and 250 mm/min, respectively. The influence of the needle insertion speed on the puncture force was analyzed. The deformation of the needle on the small contact surface and the large contact surface at 4 N was recorded by a Photron high-speed digital camera. The penetration depth at 1 N and 3 N was measured by an indirect measurement and a direct measurement method, respectively, and the maximum damage width of the damage area was recorded. The tilt resistance of the needle at 6°, 9° and 12° under 2 N pressure was obtained by the testing machine. SPSS 27.0 software was used for statistical analysis of the experimental data, and the LSD multiple comparison method was used for one-way analysis of variance.Results:The difference in puncture force between the needle insertion speed of 50 mm/min and the other four needle insertion speeds was statistically significant (all P < 0.05), while the differences between the other groups were not statistically significant (all P > 0.05). The small contact surface needle was significantly deformed, with a large penetration depth, a large maximum damage width, and low anti-tilting resistance. The large contact surface needle was deformed slightly, with a smaller penetration depth, a smaller maximum damage width, and greater resistance to tilting. Conclusions:The influence of the usage method on the large contact surface of the needle is relatively small. The hexagonal and cross-shaped needle seats have stronger anti-tilt ability than the circular needle seat. The hexagonal needle seat is not easy to change with the rotation axis, and the performance is optimal. In the structural design, the size of the connection part should be reduced, and the appropriate shape of the needle base should be selected.

Humans ; Herpesvirus 3, Human ; Myelitis, Transverse/complications* ; Guillain-Barre Syndrome/complications* ; Herpes Zoster/complications* ; Varicella Zoster Virus Infection/complications*

Osteoarthritis (OA) is one of the most common chronic diseases in the world. However, current treatment modalities mainly relieve pain and inhibit cartilage degradation, but do not promote cartilage regeneration. In this study, we show that G protein-coupled receptor class C group 5 member B (GPRC5B), an orphan G-protein-couple receptor, not only inhibits cartilage degradation, but also increases cartilage regeneration and thereby is protective against OA. We observed that Gprc5b deficient chondrocytes had an upregulation of cartilage catabolic gene expression, along with downregulation of anabolic genes in vitro. Furthermore, mice deficient in Gprc5b displayed a more severe OA phenotype in the destabilization of the medial meniscus (DMM) induced OA mouse model, with upregulation of cartilage catabolic factors and downregulation of anabolic factors, consistent with our in vitro findings. Overexpression of Gprc5b by lentiviral vectors alleviated the cartilage degeneration in DMM-induced OA mouse model by inhibiting cartilage degradation and promoting regeneration. We also assessed the molecular mechanisms downstream of Gprc5b that may mediate these observed effects and identify the role of protein kinase B (AKT)-mammalian target of rapamycin (mTOR)-autophagy signaling pathway. Thus, we demonstrate an integral role of GPRC5B in OA pathogenesis, and activation of GPRC5B has the potential in preventing the progression of OA.

Objective:To investigate the clinical characteristics and prognosis of acute myeloid leukemia (AML) patients with positive TLS-ERG fusion gene.Methods:The clinical data of 9 AML patients with positive TLS-ERG fusion gene in the First Hospital of Jilin University from June 2013 to August 2020 were retrospectively analyzed, and the relevant literature was reviewed.Results:Among 9 patients with positive TLS-ERG fusion gene, there were 5 males and 4 females, with a median age of 16 years old (6-40 years old). Five patients received chemotherapy alone, 3 patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT), and 1 patient did not receive systematic treatment. Among 8 patients with systematic treatment, 1 patient had complete remission after the first induction chemotherapy and 5 patients had complete remission after induction therapy. The median overall survival time of 5 patients with chemotherapy alone was 1.5 months (1-11 months), of which 3 patients did not respond to the first course of treatment and died of infection, and 2 patients died after relapse. The median overall survival time of 3 patients with allo-HSCT was 16 months (13-17 months), of which 2 patients died after relapse and 1 patient had sustained molecular complete remission by the end of follow-up.Conclusions:AML with positive TLS-ERG fusion gene has low incidence rate and poor induction efficacy. Hematopoietic stem cell transplantation may partially improve the survival prognosis of patients, but it cannot overcome the adverse effect of positive TLS-ERG fusion gene on prognosis.