With the rapid advancement of hemodynamic indices and monitoring technologies, their classification methods and application processes have become increasingly complex. Currently, no unified standard hasbeen established, making it difficult to fully meet the clinical requirements for hemodynamic management. To assist in hemodynamic monitoring assessment and therapeutic decision-making in critically ill patients, the Critical Hemodynamic Therapy Collaborative Group, in conjunction with the Critical Ultrasound Study Group, has jointly developed the Standard for the Application of Hemodynamic Monitoring Techniques in Critical Care. The first part of this standard systematically categorizes hemodynamic indicators into flow indicators, pressure and its derivative indicators, and tissue perfusion indicators, while elaborating on the clinical application of each. The second part establishes a standardized clinical implementation pathway for hemodynamic monitoring. It proposes a tiered monitoring strategy-comprising basic, advanced, indication-specific, and special scenario monitoring-tailored to different clinical settings. It emphasizes the central role of critical care ultrasound across all levels of monitoring and establishes hemodynamic assessment standards for organs such as the brain, kidneys, and gastrointestinal tract. This standard aims to provide a unified framework for clinical practice, teaching, training, and research in critical care medicine, thereby promoting standardized development within the discipline.

Objective To explore the effect of autophagy and apoptosis on heart failure(HF)induced by pressure overload.Methods In the animal experiment,twenty C57/BL6J mice(aged 8-12 weeks)underwent transverse aortic constriction(TAC)to duplicate the model of pressure overload-induced HF.The mice were randomly divided into sham group(only threading was performed without ligation)and surgery group(TAC group).Four weeks after post-operation,echocardiography was used to assess cardiac function.Ratios of heart weight/body weight(HW/BW)and heart weight/tibia length(HW/TL)were calculated.Histopathological changes were assessed with Masson and WGA staining.Quantitative real-time PCR was used to quantify the mRNA levels of hypertrophy-related genes:ANP,BNP,and β-MHC.Western blot analysis was used to determine the expression of autophagy proteins(Beclin1,P62,LC3-Ⅱ/Ⅰ)and apoptosis proteins(BCL2,BAX,c-caspase-3).In the cell experiment,H9C2 cells were induced with angiotensin Ⅱ(Ang Ⅱ)to serve as an in vitro HF model.The H9C2 cells were divided into control(PBS group),Ang II group,PBS with chloroquine(PBS+CQ group),and Ang Ⅱ with chloroquine(Ang II+CQ group).After modeling,western blotting was used to assay apoptosis protein expression(Beclin1,P62,LC3-Ⅱ/Ⅰ,BAX,BCL2,c-caspase-3).Autophagy double-labeled lentivirus mRFP-eGFP-LC3 was used to detect autophagic flux.Results Compared with the control group,the TAC group enlarged mouse heart,significantly increased HW/BW and HW/TL values,and decreased ejection fraction(EF)and shortened fraction(FS)(P<0.001).Fibrosis and collagen deposition were aggravated,the cross-sectional area of cardiomyocytes increased(P<0.001),and the mRNA expression levels of myocardial hypertrophy markers ANP,BNP and β-MHC(P<0.001)were significantly increased,suggesting the successful construction of an understress-induced heart failure model in vivo.Compared to the control group,there was an upregulation of autophagy-related proteins Beclin1,P62,LC3-II/I(P<0.01)and apoptosis proteins BAX,c-caspase-3(P<0.01),while the expression of BCL-2(P<0.001)protein was reduced.In the cell experiments,in the in vitro heart failure model group,the autophagosomes were significantly increased,but there was no significant change in autophagic lysosomes,and autophagic flux was impaired.After blocking the autophagy process with chloroquine(CQ),the Ang II+CQ group showed further increased expression of the autophagic proteins Beclin 1,LC3-II/I,P62(P<0.05),and apoptosis proteins BAX and cleaved caspase-3(P<0.01)compared to the Ang II group,and a further decrease in protein levels of BCL-2(P<0.001).Additionally,CQ led to a significant increase in the number of autophagosomes,but there was no significant change in autophagic lysosomes,and autophagic flux was impaired.Conclusion Both autophagy and apoptosis are activated in pressure overload-induced heart failure,and impaired autophagic flux exacerbates apoptosis in this model.

Humans ; Erythema Infectiosum ; Lymphadenopathy

Objective:To investigate the correlations between level of serum heparin binding protein (HBP), procalcitonin (PCT), interleukin-18 (IL-18) and the severity of acute pancreatitis (AP).Methods:A total of 86 patients with AP admitted to the First Affiliated Hospital, University of Science and Technology of China from December 2017 to May 2019 were included and divided into mild AP group (MAP) with 36 cases, moderate AP group (MSAP) with 26 cases, and severe AP group (SAP) with 24 cases. There were 25 healthy subjects were chosen as the control group. Serum HBP, PCT, and IL-18 levels were dynamically monitored in all patients at 1, 3 and 7 days after admission. The Spearman correlation analysis was conducted to detect the correlation between the three indicators and inflammatory factors IL-6, IL-8, TNF-α, and APACHEII and Ranson score, and analyzed the early diagnostic value of HBP, PCT, and IL-18 in SAP patients.Results:In 86 AP patients, 53 were males and 33 were females, aged (48.3±8.0) years. In 25 healthy subjects, 15 were males and 10 were females, aged (40.5±5.9) years. Serum levels of HBP, PCT and IL-18 in AP patients were significantly higher than those of healthy control group at 1, 3 and 7 days after admission ( P<0.05), and the most significant increase was observed on the 1st day. At the meanwhile, HBP, PCT, and IL-18 were positively correlated with level of IL-6, IL-8, TNF-α, APACHEII and Ranson scores ( P<0.05). The AUC area of SAP diagnosis by using HBP, PCT or IL-18 alone was respectively 0.825, 0.896, 0.799, the Yoden index was respectively 0.605, 0.628, 0.583, the sensitivity and specificity were 75.3%, 76.2%, 74.8% and 85.2%, 86.6%, 83.5%. The AUC area, Yoden index, sensitivity and specificity of joint detection were 0.923, 0.787, 85.5%, 93.2%, and the positive predictive value and negative predictive value were also increased. Conclusion:Monitoring of serum HBP, PCT and IL-18 can predict the severity of AP patients, and it may serve as an early diagnostic marker for AP.

Objective: To explore the safety and efficacy of dezocine preemptive analgesia in the reconstruction of nasal bone fracture. Methods: From September 2016 to May 2018, 63 patients with simple nasal bone fracture admitted to the 908th Hospital of PLA Joint Logistics Support Force were selected in the study.The patients were divided into two groups by random number table method: dezocine group(n=32) and control group(n=31). The dezocine group was injected with dezocine before surgery, while the control group was injected with 0.9% sodium chloride solution.The differences of MAP, HR, SpO₂ at different time points between the two groups were observed.And the difference of VAS/RSS during operation and 2 hours after surgery were also observed. Results: There were no statistically significant differences in MAP, HR and SpO₂ between the two groups at different time points(10 min before and 10 min after intramuscular injection) (all P>0.05). During operation and 20 min after operation, the MAP values of the control group were (110.1±16.38)mmHg and (105.28±14.81)mmHg, respectively, which were higher than those of the dezocine group [(102.35±14.25)mmHg and (101.25±13.12)mmHg)], the differences were statistically significant(t=2.259, 2.153, all P<0.05). There were no statistically significant difference in HR between the two groups at 10 min before and 10 min after intramuscular injection(all P>0.05). The HR in the control group during operation and at 20min after operation were (90.81±19.52)times/min, (77.25±18.25)times/min, respectively, which were faster than those in the dezocine group [(85.16±17.25)times/min, (71.36±16.15)times/min], the differences were statistically significant(t=2.074, 2.047, all P<0.05). There were no statistically significant differences in SpO₂ between the two groups at different time points(all P>0.05). In the surgery, the RSS score of dezocine group[(4.3±0.6)points] was better than that in control group[(2.1±0.4)points], the difference was statistically significant(t=17.008, P<0.05). The VAS scores in the control group during operation and 20 min after operation were (2.3±0.5)points, (1.5±0.8)points, respectively, , which were lower than those in the control group [(5.5±0.7)points, (2.1±0.6)points](t=20.572, 3.277, all P<0.05). Conclusion Application of dezocine preemptive analgesia in the reconstruction of nasal bone fracture is effective and safe, the hemodynamics is stable and the analgesic effect is definite in the surgery.

In this paper, a new probe is proposed for the dielectric measurement of anisotropic tissue in radio frequency band, which could accomplish the dielectric measurement in perpendicular directions by one operation. The simulative studies are performed in the frequency range from 1-1 000 MHz in order to investigate the influence of probe dimension on the energy coupling and sensitivity of measurement. The suitable probe is designed and validated for the actual measurement in this frequency band. According to the simulation results, the energy coupling of the probe could be kept below -12 dB in the frequency range from 200-400 MHz with high sensitivity of measurement for the dielectric properties of anisotropic tissue. That indicates the new type of probe has the potential to achieve the dielectric measurement of anisotropic tissue in radio frequency band and could avoid the measurement error by multi-operations in the conventional method. This new type of probe could provide a new method for the dielectric measurement of anisotropic tissue in radio frequency band.

Objective To study the reason of concurrent styloid process syndrome after tonsillectomy and the clinical effect of styloidectomy.Methods Twelve patients with styloid process syndrome after tonsillectomy receiving styloidectomy were retrospectively analyzed.The clinical effect was evaluated.Results Ten patients were operated on unilateral styloid,two patient was operated on bilateral styloid.All patients were followed -up for 6 months to 5 years after operation.All of them were cured.Conclusion The mechanism of styloid process syndrome after tonsillectomy might be related to the stimulation of scar formation in the tonsillar fossa.Styloidectomy ia an effective method of treatment.

BACKGROUND:Acellular vascular matrix as vascular scaffold has following advantages:acellular vascular matrix possesses complicated three-dimensional structure of natural blood vessels. Growth factor and structural domain on the surface of acellular matrix helps for cell adhesion and infiltration.OBJECTIVE:To prepare acellular vascular matrix material and to evaluate its biocompatibility in vivo and in vitro.METHODS:Trypsin and Triton X-100 were used to gradually dispose pig carotid artery and to prepare acellular vascular matrix. The biocompstibility of the material was evaluated by implantation in muscle, acute toxicity experiment and cytotoxicity test in vitro.RESULTS AND CONCLUSION:The acallular vascular matrix material possessed good chemical stability and did not release harmful factors that produced destruction and dissolution in erythrocytes, without acute hemolytic reaction or toxic effects on cell growth. The acellular vascular matrix material showed lots of inflammatory cell infiltration in eady stage of implantation, and no significant inflammatory cell infiltration in late stage of observation. Fibroblasts were visible in the acellular matrix. In addition, the acellular matrix material did not exhibit toxic effects on surrounding tissues,showing wound stage I healing.Simultaneously,histological sections demonstrated that there were good compatibility of scaffold material and surrounding tissues, without rejection.These indicated that acellular matrix material presented good biocompatibility in animals.

Objective To review the clinical-pathological features, the tendency of incidence over 20 years, the predisposing factors, and the differences between the cases of cutaneous malignant melanoma from two hospitals. Methods A collection of 305 cases diagnosed as cutaneous malignant melanoma, among which 185 cases had complete clinical-pathological data, during 1981-2000 was analyzed. Results Acral malignant melanoma accounted for 63.3%, and the cases associated with congenital small nevi at the primary site accounted for 15.8% of 305 patients. During the period 1981-1990 and 1991-2000, cutaneous malignant melanoma constituted 0.053% and 0.094%, respectively, of all diagnoses with pathological sections, with an growth rate of 3.9% yearly. There was a tendency of the increased lesions located on face and neck, and decreased lesions on acra, over 20 years. Conclusion A rise of diagnosis of cutaneous malignant melanoma has been noticed from two hospitals over 20 years. Acra, especially planta, is the predominant anatomical site of cutaneous malignant melanoma.

Objective To investigate the expression of anti-apoptosis gene bag-1 and its relation to the differentiation of intrahepatic cholangiocarcinoma (ICC). Methods Immunohistochemical techniques were adopted to study the expression of bag-1 in ICC tissue ( n=48) and para-hepatocarcinoma bile duct ( control group, n=25). Results Expression of bag-1 in the ICC group was significantly higher than that in the control group. In the ICC group (P