After decades of development,ventricular assist devices(VADs)have evolved into the current generation of magnetically levitated blood pumps,achieving revolutionary progress in terms of implantation into the chest and large-scale clinical application.VADs have become an effective means of treating heart failure,which is a major global public health challenge.Despite these achievements,up to 89％of patients are readmitted within five years due to complications such as gastrointestinal bleeding,stroke,infection,and blood pump malfunction.Therefore,it is necessary to further study the mechanisms of blood damage of various blood components;to further develop and comprehensively utilize numerical simulations,in vitro bench testing,animal experiments,and other methods to more comprehensively evaluate blood pump performance.Innovative designs of VADs are also needed to improve blood compatibility,meet the needs of different patient groups,and improve patients'quality of life.In this review,the research progress on evaluation and design methods of VADs in 2024 both domestically and internationally is summarized,including advances in the study of blood damage mechanisms;the use of numerical simulations,in vitro bench testing,and animal experiments to evaluate blood pump performance;the progress in design and optimization of blood pump,new concept blood pump,and bio-coatings.The aim is to support the development of VADs and further improve their clinical therapeutic benefits.

After decades of development,ventricular assist devices(VADs)have evolved into the current generation of magnetically levitated blood pumps,achieving revolutionary progress in terms of implantation into the chest and large-scale clinical application.VADs have become an effective means of treating heart failure,which is a major global public health challenge.Despite these achievements,up to 89％of patients are readmitted within five years due to complications such as gastrointestinal bleeding,stroke,infection,and blood pump malfunction.Therefore,it is necessary to further study the mechanisms of blood damage of various blood components;to further develop and comprehensively utilize numerical simulations,in vitro bench testing,animal experiments,and other methods to more comprehensively evaluate blood pump performance.Innovative designs of VADs are also needed to improve blood compatibility,meet the needs of different patient groups,and improve patients'quality of life.In this review,the research progress on evaluation and design methods of VADs in 2024 both domestically and internationally is summarized,including advances in the study of blood damage mechanisms;the use of numerical simulations,in vitro bench testing,and animal experiments to evaluate blood pump performance;the progress in design and optimization of blood pump,new concept blood pump,and bio-coatings.The aim is to support the development of VADs and further improve their clinical therapeutic benefits.

Objective:To investigate the mechanism of dexmetomidine (DEX) in improving lung injury in septic mice.Methods:Male C57BL/6 mice were randomly assigned to the blank group (NC), sham operation group (sham), cecal ligation and puncture group (CLP), and Dex treatment group (CLP+DEX), 36 mice per group. Mice in the CLP group were intraperitoneally injected with 1 mL sterile saline 15 min before CLP, and mice in the CLP + DEX group were intraperitoneally injected with 50 μg/kg DEX 15 min before CLP. The survival rate was recorded within 24 h after CLP. The mice were sacrificed at 0, 3, 6, 12, and 24 h after CLP, and lung tissues were collected. The expression levels of cytokines (IL-6, IL-1β, TNF-α) and lncRNA-HOTAIR in the lung of mice were detected by qPCR. RAW264.7 cell were cultured in vitro, LPS (100 ng/mL) and DEX (1 μ mol/L) were used to establish a cell model for studying the mechanism of Dex, and the expression of cytokines (IL-6, IL-1β, TNF-α) and lncRNA-HOTAIR in RAW264.7 cell model were detected by qPCR. In addition, the effect of lncRNA-HOTAIR on sepsis was explored in vivo and in vitro by knockdown or overexpression of HOTAIR.Results:The survival rate of the CLP+DEX group was higher than that of the CLP group within 24 h after surgery, and the levels of IL-6, IL-1β, and TNF-α in the lungs were significantly lower than those in the CLP group at 6, 12, and 24 h after surgery ( P<0.05). In addition, the level of lncRNA HOTAIR showed that the expression level of lncRNA HOTAIR in the lungs of mice were decreased after Dex treatment, and were decreased 1.1 times ( P<0.05), 4.0 times ( P<0.01) and 3.8 times ( P<0.01) at 6, 12, and 24 h, respectively. Compared with the NC group, knockdown of HOTAIR significantly decreased the levels of IL-1β, IL-6, and TNF-α in septic mice ( P<0.05), and overexpression of HOTAIR significantly increased the levels of IL-1β, IL-6, and TNF-α in septic mice ( P<0.01). Conclusions:DEX can reduce the production of inflammatory factors in the lungs of septic mice and improve the survival rate of septic mice. The mechanism may be related to the inhibition of HOTAIR expression.

Neonatal necrotizing enterocolitis (NEC) is one of common gastrointestinal critical diseases in the neonatal medical center,with high morbidity and mortality.The pathophysiological mechanism of the NEC is still unclear so far.Thus,the treatment of NEC is currently mainly limited to the symptomatic treatment in clinic.In the recent years,the studies on the pathogenesis of NEC have been increasing.This artical clarified the pathogenesis of NEC in six aspects:the pathogeny of intestinal immune function,gut microbiome,oxidative stress reaction,breastfeeding,blood transfusion and inflammatory mediators,to provide a new detection in prevention,diagnosis and treatment of NEC.

Objective To explore the clinical value of early fluid resuscitation guided by passive leg-raising test (PLR) combined with transthoracic echocardiography (TTE) in patients with septic shock. Methods A prospective randomized controlled trial (RCT) was conducted. Seventy-four patients with septic shock admitted to China-Japan Friendship Hospital from January 2017 to October 2018 were enrolled. The patients were randomly divided into control group and experimental group with 37 patients in each group. Both groups of patients were treated with broad-spectrum antibiotics empirically, while received fluid resuscitation via the subclavian vein catheter. The patients of control group were given rapid fluid replacement, and those of experimental group received fluid replacement according to result of PLR combined with TTE. The stroke volume (SV) was measured by TTE before and after PLR, volumetric response of patients was judged by stroke volume variation (SVV). If the SVV≥15%, it was considered that there was a volume responsiveness, and fluid loading was given. If SVV﹤15%, it was considered that there was no volume shortage, and the restrictive fluid replacement was given. The goal of fluid resuscitation in both groups were to simultaneously meet the central venous pressure (CVP) of 8-12 mmHg (1 mmHg = 0.133 kPa), mean arterial pressure (MAP) ≥65 mmHg, urine volume ≥ 0.5 mL·kg-1·h-1, and central venous blood oxygen saturation (ScvO2) ≥ 0.70 within 6 hours. Vasoactive drugs were used when the patients could not achieve the treatment goals. The MAP, lactic acid (Lac), oxygenation index (PaO2/FiO2) and ScvO2 of the patients were determined at 6 hours of treatment, and serum C-reactive protein (CRP) and chest CT were reviewed at 48 hours of treatment, and compared with those before treatment. The total hospital stay and the mortality were recorded. Results There was no significant difference in gender, age, body weight and etiological structure between the two groups, which indicated that the baseline data were generally balanced. There was no statistical difference in MAP, Lac, PaO2/FiO2, ScvO2 and CRP before infusion between the two groups. After 6 hours of treatment, the MAP, Lac, PaO2/FiO2 and ScvO2 of the two groups were all better than those before infusion. Except for the difference in MAP between the experimental group and the control group (mmHg: 78.76±5.22 vs. 76.35±6.66, P > 0.05), the other three parameters in the experimental group were significantly better than those in the control group [Lac (mmol/L): 2.52±1.15 vs. 3.89±1.42, PaO2/FiO2 (mmHg):338.14±27.47 vs. 303.35±22.52, ScvO2: 0.70±0.04 vs. 0.63±0.05, all P < 0.01]. After 48 hours of treatment, CRP levels of both groups were lower than those before infusion, and the experimental group was better than the control group (mg/L: 110.12±39.80 vs. 137.98±31.23, P < 0.01). Chest CT showed that the incidence of pulmonary edema in the experimental group was significantly lower than that in the control group [13.5% (5/37) vs. 37.8% (14/37), P < 0.01]. The hospital stay of the experimental group was shorter than that of the control group (days: 21.47±5.58 vs. 28.33±4.93, P < 0.01), but no significant difference in mortality was found between the two groups [18.9% (7/37) vs. 18.9% (7/37), P > 0.05]. Conclusion Compared with the traditional rapid fluid replacement, early fluid resuscitation treatment strategies guided by the PLR combined with TTE, could better improve perfusion and oxygenation level of tissues and organs, avoid pulmonary edema caused by rapid fluid replacement, shorten the hospital stay in patients with septic shock, but had no significant effect on hospital mortality.

Objective To investigate whether specific cellular uptake of 99Tcm-survivin-ASODN in nude mice bearing human HCC is influenced by its cytosine content.Methods Three kinds(A1,A2,A3) of synthesized survivin ASODN with three cytosine contents(10％,20％,30％),20 bases per single-strand were prepared.They were labeled with 99Tcm by conjugating with a bifunctional chelator HYNIC,purified through Cellufine GH-25 and then encapsulated with liposome.Antisense gene imaging and the biodistribution of 99Tcm-HYNIC-survivin ASODN in nude mice bearing HCC were performed.The data were analysed by Kruskal-Wallis H test.Results At 4 h post injection,all the 3 labelled compounds showed increased uptake by tumor,liver and kidney.With increase in cytosine content,the uptake increased in kidney (％ID/g:1.50±0.06,2.80±0.09 and 3.96±0.03),and decreased in tumor (％ID/g:2.08±0.08,1.69±0.01 and 1.20±0.09).T/NT in imaging (4.49-4.93,4.12-4.21,3.35-3.85;H=12.50,P＜0.05) and in biodistribution (4.08-4.94,4.02-4.18,3.66-3.85;H=10.82,P＜0.05) were all significantly different.Conclusion ASODN with lower cytosine content shows higher uptake by HCC tumor cells and less stasis in kidneys,thus providing better quality in antisense gene imaging.

OBJECTIVESTo investigate the feasibility of establishing an individualized navigation template for occipital condyle screws insertion using a fused deposition modeling based three-dimensional printing forming technique, and to evaluate the accuracy and safety of template-assisted condyle screw insertion.

METHODSThirty adult occipitocervical specimens were selected to take a CT-scan. After original Dicom data imported into the Mimics software, the craniocervical junction models were created, which were used to evaluate anatomic structures and define the screw-related parameters. Design and generate the cavity models of the occipital condyle based on a three-dimensional printing forming technique. After using a free-hand procedure to create a navigation template with a well-established screw path, finish bilateral condyle screws insertion assisted by the navigation template. Anatomy study and CT-scan were taken postoperatively to access the position of the screws.

RESULTSSixty condyle screws were implanted assisted by 30 individualized navigation templates with an average time cost of (91.4 ± 8.2) s. The axial medial angle, sagittal cranial angle and distance between the entry point to atlantooccipital joint surface were (33.2 ± 6.4)°, (8.9 ± 3.4)°, (3.9 ± 0.9) mm, respectively. The variations due to different sex and sides resulted in a statistically insignificant difference of the parameters. Anatomy study and CT-scan indicated no intrusion of the vertebral artery, hypoglossal canal, condyle emissary vein canal or atlantooccipital joint. Fifty-nine condyle screws were completely contained within the condyle, while only 1 screw perforated lateral condyle wall.

CONCLUSIONSUsing the Mimics software for establishing the occipital condyle and related cavity model based on CT-scan images proves to be a feasible and precise method.Occipital condyle screws insertion assisted by a three-dimensional printing model is highly accurate and simple, which could be a new alternative to conventional technique.

Adult ; Aged ; Bone Screws ; Cadaver ; Female ; Humans ; Male ; Middle Aged ; Occipital Bone ; surgery ; Printing, Three-Dimensional ; Surgery, Computer-Assisted

Objective According to the infrared spectrum of renal stone composition analysis,discuss the relationship between gender,age and kidney stone.Methods Kidney stone composition analysis of 408 cases had been done in our hospital from the 2002 to 2011 by using Fourier transform infrared spectroscopy.There were 271 males (66.4％) and 137 females (33.6％).Results There were 359 cases with calcium stones,accounting for 88.0％ (359/408); 197 cases with calcium oxalate stones alone,accounting for 48.3％; 180 cases with phosphate stones,accounting for 44.1％; 211 cases with mixed composition stones,accounting for 51.7％.Main chemical composition of the stones were:calcium oxalate 48.3％,carbonate apatite 34.8％,urates 5.4％,ammonium magnesium phosphate 4.4％,ammonium carbonate eutectic 3.4％,brushite 1.5％,cystine 2.0％ and protein 0.3％.Male patients accounted for 66.4％ of all cases and the peak onset age was 30-59 years; Female patient accounted for 33.6％ of all cases and the peak onset age was 50-59 years.Conclusions Calcium oxalate and phosphate are the most common components of kidney stones.Males age between 30-59 years and females age between 50-59 years may suffer from of kidney stone formation.

Objective To investigate the clinical characteristics of laminar shelling decompression for the treatment of thoracic spinal stenosis.Methods One hundred and twenty-one patients with thoracic spinal stenosis were reviewed.Ages of these 51 male and 70 female patients ranged from 45 to 71 years (mean 54.8 years).There were 72 patients with thoracic ossification of ligamentum flavum(OLF),21 patients with thoracic ossification of posterior longimental ligament(OPLL)and 28 patients with thoracic OLF and OPLL.The lesion segmentum,kyphosis angle of thoracic vertebra and residual area of vertebral canal(RAVC)were measured.All these patients were treated with laminar shelling decompression.Preoperative and postoperative functional statuses were evaluated using a Japanese Orthopaedic Association(JOA)score.Results Thoracic OLF were found between T7 to T12 in 77.0% of the lesions;thoracic OPLL were found between T1 to T6 in 81.1% of the lesions.Of the 121 patients,the mean kyphosis angle was 31.5°±6.8° in upper thoracic spine and,9.4°±3.5° in lower thoracic spine.In patients whose RAVC were more than 80%,the pre- and postoperative mean JOA score was 7.7±1.4 and 9.5±1.6 respectively;RAVC more than 50%,5.2±1.8 and 8.6±2.1 respectively;RAVC less than 5%,4.8±1.4,and 5.6±1.3 respectively.Conclusion Thoracic OLF mostly occurred in lower thoracic spine,while thoracic OPLL mostly occurred in upper thoracic spine.The RAVC is a significant factor to the prognosis of thoracic spinal stenosis.As long as the clinical symptoms correspond with imaging findings,it is better to resect the whole ossification part as much as possible.Thoracic spinal stenosis often recurs after surgery.More attention to decompression ranges and decompression skills shoud be paied during revision surgery.