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.

ObjectiveTo investigate the intervention effects of modified Linggui Zhugan Tang （LGZGT） on patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） of the spleen deficiency and dampness obstruction with blood stasis type， reveal its possible mechanisms， and provide a theoretical basis for the clinical treatment of OSAHS with traditional Chinese medicine （TCM）. MethodsEighty OSAHS patients with spleen deficiency and dampness obstruction with blood stasis were randomly assigned to a control group and an observation group （1∶1） using a random number table， with 40 patients in each group. The control group received standard basic treatment combined with oral Doxofylline tablets， while the observation group received standard basic treatment combined with modified LGZGT. Serum levels of macrophage migration inhibitory factor （MIF）， microRNA-223 （miR-223）， and interleukin-18 （IL-18） were measured by enzyme-linked immunosorbent assay （ELISA）， and the mRNA expression levels of MIF， miR-223， and IL-18 were measured by real-time quantitative polymerase chain reaction （Real-time PCR）. After two months of treatment， the total clinical efficacy， apnea-hypopnea index （AHI）， lowest nocturnal oxygen saturation （LSpO₂）， body mass index （BMI）， TCM syndrome scores， and expression levels of MIF， miR-223， and IL-18 before and after treatment were compared between the two groups. Correlations between MIF， miR-223， IL-18 and AHI and LSpO₂ were also analyzed. ResultsCompared with the control group， the observation group showed a significantly higher total clinical effective rate （P<0.01， Z=-3.49）. Within the control group， no significant changes were observed in AHI， LSpO₂， BMI， TCM syndrome scores， or MIF， miR-223， IL-18 levels and their mRNAs after treatment. In the observation group， AHI， BMI， TCM syndrome scores， and MIF and IL-18 levels and their mRNAs decreased significantly， while LSpO₂ increased significantly （P<0.01）. After treatment， compared with the control group， the observation group exhibited significantly lower AHI， BMI， TCM syndrome scores， and MIF and IL-18 levels and their mRNAs， and significantly higher LSpO₂ （P<0.01）. Correlation analysis showed that MIF and IL-18 were positively correlated with AHI （P<0.01） and negatively correlated with LSpO₂ （P<0.01）， whereas miR-223 was negatively correlated with AHI （P<0.01） and positively correlated with LSpO₂ （P<0.01）. ConclusionModified LGZGT may improve OSAHS of the spleen deficiency and dampness obstruction with blood stasis type by reducing airway inflammatory factors， alleviating airway inflammation， relieving airway edema and stenosis， and improving airway obstruction.

ObjectiveOxygen partial pressure (pO₂) is a critical indicator of the tumor microenvironment and plays an essential role in regulating tumor progression and therapeutic response, particularly for oxygen-dependent treatments such as photodynamic therapy (PDT). Although photoacoustic imaging (PAI) has shown great potential for functional and molecular imaging, conventional oxygenation imaging approaches based on hemoglobin absorption mainly provide relative oxygen saturation information and cannot directly quantify tissue oxygen partial pressure. Therefore, this study aimed to develop a fast laser sequence-based pump-probe photoacoustic tomography (PP-PAT) system for quantitative, non-invasive, and dynamic monitoring of oxygen partial pressure in tumor tissues. MethodsThe proposed PP-PAT system was developed based on the oxygen-sensitive triplet-state lifetime characteristics of methylene blue (MB). Upon optical excitation, MB molecules undergo transitions from the ground state to an excited state and subsequently form metastable triplet states through intersystem crossing. The lifetime of the triplet state is strongly affected by surrounding oxygen concentration due to dynamic oxygen quenching, providing a direct correlation between triplet-state kinetics and local oxygen partial pressure. A dual-wavelength pump-probe excitation scheme was implemented to selectively interrogate MB triplet-state dynamics. The pump pulse was used to initiate the triplet-state population, while the delayed probe pulse was applied to detect the transient triplet-state response. By optimizing the temporal interval between the pump and probe pulses, transient triplet-state differential (TTD) signals were extracted to enhance the specificity of oxygen-dependent molecular information and suppress background interference from conventional photoacoustic signals. The performance of the PP-PAT system was systematically evaluated through phantom and in vivo experiments. First, a single-tube phantom containing MB solution was used to investigate signal stability, reproducibility, and the influence of signal averaging on imaging quality. Subsequently, a dual-tube phantom model was established to simulate oxygen consumption during PDT, where one MB-containing tube was exposed to laser irradiation and the other served as a control. Finally, in vivo experiments were performed using a subcutaneous tumor model in nude mice. MB was locally injected into the tumor region before imaging to evaluate the feasibility of tumor oxygen partial pressure mapping using the proposed PP-PAT system. ResultsPhantom experiments demonstrated that the extracted TTD signals exhibited high stability and effectively reflected MB triplet-state dynamics while reducing non-specific background contributions. Signal averaging significantly improved the signal-to-noise ratio, and 50 repeated acquisitions provided an optimal compromise between image quality and acquisition efficiency. In the dual-tube phantom experiments, continuous PDT irradiation induced progressive oxygen depletion in the treated sample. The corresponding TTD decay rate gradually decreased, accompanied by an increase in the calculated triplet-state lifetime, indicating reduced oxygen quenching and decreased oxygen partial pressure. In contrast, the control sample showed relatively stable TTD kinetics and oxygenation levels during the same period. These results demonstrated that PP-PAT could quantitatively characterize oxygen consumption dynamics associated with photochemical reactions. In vivo experiments further demonstrated the capability of PP-PAT for spatially resolved oxygen partial pressure imaging in MB-injected tumor tissues. The reconstructed pO₂ maps revealed heterogeneous oxygen distributions within tumors, showing relatively hypoxic regions in the tumor core and higher oxygenation levels near the tumor boundary. This spatial oxygen distribution pattern was consistent with the typical physiological characteristics of solid tumors, where abnormal vascular structures and limited oxygen diffusion result in intratumoral oxygen gradients. ConclusionThis study presents a fast laser sequence-based PP-PAT system capable of quantitative and non-invasive imaging of tissue oxygen partial pressure. By utilizing the oxygen-dependent triplet-state lifetime of MB and extracting TTD signals, the proposed method provides molecularly specific information related to oxygen dynamics beyond conventional photoacoustic oxygenation imaging. The system enables dynamic monitoring of oxygen consumption during PDT and reveals spatial oxygen heterogeneity within tumors. This technique provides a promising imaging approach for tumor hypoxia characterization, evaluation of oxygen-dependent therapeutic responses, and precision-guided cancer treatment.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

The telomere structure in the cell nucleus is crucial for maintaining the stability and functions of chromosomes.Telomerase is a ribonucleoprotein reverse transcriptase,which catalyzes the elongation of telomeres using its own RNA as a template,thereby counteracting the shortening of telomeres caused by chromosome replication and cell division.Due to its overexpression in over 85％of malignant tumor cells,telomerase has emerged as a highly promising biomarker and a novel target for cancer therapy.In recent years,given the importance of precise quantification of telomerase activity in guiding medical diagnosis and treatment strategies,researchers have developed various high-performance telomerase detection techniques.Among these,electrochemical biosensing technique has cause much attention due to its high sensitivity,operational convenience,rapid response,and ease of miniaturization.This paper focused on the latest advances in electrochemical sensing technique for detection of telomerase activity,aiming to provide inspiration for designing novel telomerase activity detection strategies by elucidating three unique properties of telomerase primer extension products.

Detection of poor-water-soluble substances typically requires an organic solvent containing solution,and therefore,the biosensors that can operate in such conditions are highly promising for practical applications.However,most existing biosensors have been developed in aqueous solution and it is hard to work effectively in organic solvent systems.In this work,we uncovered that the G-quadruplex(G4)/hemin DNAzyme(G4HD)could be strongly reactivated by NH4 in organic solvents at concentration up to 30％,and the activity was significantly higher than that in aqueous solutions containing K+.Based on this discovery,a biosensing system was developed for small molecule in 40％methanol by coupling G4HD with our previously identified RNA-cleaving DNAzyme(E3).This system comprised an ATP-activated aptazyme that was made of E3 and a G4HD that was activated by the cleavage product of the aptazyme.By using a manmade pipette tip filter to separate the reaction products,the subsequent colorimetric reaction of the G4HD could be triggered.This biosensing system enabled the visualization of target molecules in organic cosolvents without any other instruments.The activable DNAzyme-cascade sensing system had potential in point-of-care detection of poor-water-soluble pollutants,thereby enhancing the practical values of functional nucleic acid-based biosensors in real-world detection conditions.

A highly efficient oxidase-mimetic silver phosphate/nickel hydroxystannate(Ag3PO4/NiSn(OH)6)composite was synthesized via a precipitation method using nickel hydroxystannate(NiSn(OH)6)as the support.The abundant hydroxyl groups(—OH)on NiSn(OH)6 not only provided nucleation sites for Ag3PO4 nanoparticles but also improved their dispersion and overall material stability.Based on oxidase-like activity of Ag3PO4/NiSn(OH)6 and inhibitory effect of sodium dodecylbenzenesulfonate(SDBS)on this catalytic activity,a novel colorimetric sensing method for SDBS detection was developed.Under optimized experimental conditions,the method exhibited a linear range of 3.69-42.7 μmol/L,with a detection limit of 0.135 μmol/L(S/N=3).The regression equation was ΔA652=0.01125C(μmol/L)+0.1498,with a correlation coefficient(R2)of 0.992.Practical application in dishwashing liquid analysis achieved satisfactory recoveries of 96.9%-106.4%,demonstrating the method's reliability for real sample detection.

Forensic medicine has been designated as a first-level discipline,presenting new opportunities and challenges for the development of forensic medicine.Since the 1980s,the establishment of foren-sic medicine discipline and the cultivation of high-level forensic talents have become hot topics in the development of forensic medicine in China.Since the 13th Five-Year Plan,the forensic team of Shanxi Medical University has been aiming at the forefront,proposing the development goals of"Five First-class"and the discipline development path"Six Major Achievements".It has selected benchmark disci-plines,identified gaps in disciplinary development,unified thoughts,formulated completion timelines,concentrated superior resources,assigned tasks to individuals,and created an"Organized Fill-in-the-Blank Format"forensic medicine discipline construction model with the characteristics of the new era.The construction model of forensic medicine has achieved good results in the goals,discipline frame-work,scientific research,talent cultivation,discipline team and platform construction,forming a rela-tively complete discipline construction and management system,and accumulating valuable experience for the construction of first-level discipline and high-level talent cultivation of forensic medicine.

PURPOSE: The rate of complications among patients undergoing surgery has increased due to infection with SARS-CoV-2 and other variants of concern. However, Omicron has shown decreased pathogenicity, raising questions about the risk of postoperative complications among patients who are infected with this variant. This study aimed to investigate complications and related factors among patients with recent Omicron infection prior to undergoing orthopedic surgery. METHODS: A historical control study was conducted. Data were collected from all patients who underwent surgery during 2 distinct periods: (1) between Dec 12, 2022 and Jan 31, 2023 (COVID-19 positive group), (2) between Dec 12, 2021 and Jan 31, 2022 (COVID-19 negative control group). The patients were at least 18 years old. Patients who received conservative treatment after admission or had high-risk diseases or special circumstances (use of anticoagulants before surgery) were excluded from the study. The study outcomes were the total complication rate and related factors. Binary logistic regression analysis was used to identify related factors, and odds ratio (OR) and 95% confidence interval (CI) were calculated to assess the impact of COVID-19 infection on complications. RESULTS: In the analysis, a total of 847 patients who underwent surgery were included, with 275 of these patients testing positive for COVID-19 and 572 testing negative. The COVID-19-positive group had a significantly higher rate of total complications (11.27%) than the control group (4.90%, p < 0.001). After adjusting for relevant factors, the OR was 3.08 (95% CI: 1.45-6.53). Patients who were diagnosed with COVID-19 at 3-4 weeks (OR = 0.20 (95% CI: 0.06-0.59), p = 0.005), 5-6 weeks (OR = 0.16 (95% CI: 0.04-0.59), p = 0.010), or ≥7 weeks (OR = 0.26 (95% CI: 0.06-1.02), p = 0.069) prior to surgery had a lower risk of complications than those who were diagnosed at 0-2 weeks prior to surgery. Seven factors (age, indications for surgery, time of operation, time of COVID-19 diagnosis prior to surgery, C-reactive protein levels, alanine transaminase levels, and aspartate aminotransferase levels) were found to be associated with complications; thus, these factors were used to create a nomogram. CONCLUSION Omicron continues to be a significant factor in the incidence of postoperative complications among patients undergoing orthopedic surgery. By identifying the factors associated with these complications, we can determine the optimal surgical timing, provide more accurate prognostic information, and offer appropriate consultation for orthopedic surgery patients who have been infected with Omicron.
Humans ; COVID-19/complications* ; Male ; Female ; Middle Aged ; Postoperative Complications/epidemiology* ; SARS-CoV-2 ; Orthopedic Procedures/adverse effects* ; Aged ; Nomograms ; Adult ; Retrospective Studies ; Risk Factors