Objective:To analyze the effects of citric acid anticoagulation on coagulation function and inflammatory factors in patients with sepsis and high-risk bleeding treated with continuous renal replacement therapy (CRRT).Methods:A total of 80 patients with sepsis with high-risk bleeding who received CRRT treatment in the Affiliated Hospital of Jining Medical University from February 2018 to August 2023 were retrospectively selected as the study objects, 40 cases were treated with low molecular weight heparin (control group) and 40 cases were treated with citric acid (observation group).Both groups were treated continuously, and the anticoagulant effect, coagulation function, electrolyte and inflammatory factor levels of the two groups were compared 7 d after medication.Results:The total effective rate of anticoagulation in the observation group after treatment was higher than that in the control group: 97.50% (39/40) vs. 75.00% (30/40), there was statistical difference ( χ2 = 8.54, P<0.05). After treatment, the levels of activated partial thrombin time (APTT), thrombin time (TT) and prothrombin time (PT) in the observation group were lower than those in the control group: (31.08 ± 8.31) s vs. (41.76 ± 8.36) s, (23.41 ± 5.02) s vs. (29.05 ± 5.13) s, (15.47 ± 3.50) s vs. (19.96 ± 4.75) s, there were statistical differences ( P<0.05). There were no statistical differences in the levels of potassium, chloride, sodium and calcium between the two groups after treatment ( P>0.05). After treatment, the levels of C-reactive protein (CRP) and procalcitonin (PCT) in the observation group were lower than those in the control group :(2.60 ± 0.86) mg/L vs. (4.35 ± 1.12) mg/L, (0.11 ± 0.03) μg/L vs. (0.19 ± 0.05) μg/L, there were statistical differences ( P<0.05). Conclusions:The application of citric acid anticoagulant in patients with sepsis and high-risk bleeding treated with CRRT can achieve significant curative effect, which can not only improve the anticoagulant effect, stabilize coagulation function and electrolyte level, but also down-regulate the level of inflammatory factors.

Objective:To evaluate the clinical outcomes of a modified dual-plane implant augmentation mammoplasty via periareolar incision.Methods:The patients undergoing primary breast augmentation at Vcharm Plastic & Aesthetic Surgery Hospital of Chongqing from October 2018 to June 2023 were enrolled in this prospective cohort study. Participants were alternately assigned to Group A (traditional Tebbetts dual-plane implant augmentation mammoplasty) and Group B (modified dual-plane implant augmentation mammoplasty) based on admission sequence. The modified technique included sharp subfascial dissection above the 5th rib, oblique muscle dissection below the 5th rib to create a subpectoral pocket, and elevation of the serratus anterior and external oblique fascia to the newly defined inframammary fold. Implants were positioned with 70% in the subfascial plane superiorly and 30% in the submuscular-fascial plane inferiorly. Postoperative pain was assessed using the numerical rating scale (NRS, 0-10) during days 0-7. Patient satisfaction (breast morphology, breast softness in sitting and supine positions) and complications were evaluated at 12-month follow-up. Statistical analysis was performed using SPSS 24.0. The measurement data were expressed as Mean ± SD, and the inter-group comparisons were performed by t-test. The enumeration data were expressed as examples and (or) percentages, and the inter-group comparisons were performed by χ2 test or Fisher exact probability test. P<0.05 was considered to be statistically significant. Results:Forty-eight female patients were included in Group A with age of (34.0±5.0) years and body mass index of (20.6±3.1) kg/m 2. Forty-three cases were received anatomical implants, and 5 cases rough round implants. The volume of implants was (265.0±12.5) cc. Fifty female patients were included in Group B with age of (35.0±4.5) years and body mass index of (21.5±3.7) kg/m 2. Forty-two cases were received anatomical implants and 8 cases rough round implants. The volume of implants was (262.0±15.0) cc. Baseline characteristics (age, body mass index, implant type, volume) showed no intergroup differences ( P>0.05). Group B demonstrated significantly lower NRS scores than Group A at all timepoints ( P<0.05). The immediate postoperative scores were 8.0±1.6 vs. 4.8±0.8, decreasing to 4.4±0.7 vs. 2.2±0.3 on Day 7. At 12 months, satisfaction rates for breast morphology[91.7%(44/48) vs. 92.0%(46/50)] and breast softness in sitting position [85.4%(41/48) vs. 86.0%(43/50) ] were comparable (both P>0.05). However, superior breast softness satisfaction in supine position was achieved in Group B [64.0%(32/50) vs. 43.8%(21/48), P<0.01] and fewer patients reported marked softness deterioration in supine position [28.0%(14/50) vs. 54.2%(6/48), P<0.01]. No hematoma, infection, delayed wound healing, implant malposition or wavy breast occurred in two groups. Capsular contracture occurred in 1 case per group. The implant was easy to be touched in 5 and 6 cases of Groups A and B, respectively ( P>0.05), while dynamic distortion was observed only in Group A (1 vs. 0, P<0.01). Conclusion:The modified dual-plane implant augmentation mammoplasty via periareolar incision significantly reduces postoperative pain, enhances breast softness in supine position, and prevents dynamic distortion without increasing complication risks, representing an optimized approach for implant-based augmentation.

Objective:To analyze the effects of citric acid anticoagulation on coagulation function and inflammatory factors in patients with sepsis and high-risk bleeding treated with continuous renal replacement therapy (CRRT).Methods:A total of 80 patients with sepsis with high-risk bleeding who received CRRT treatment in the Affiliated Hospital of Jining Medical University from February 2018 to August 2023 were retrospectively selected as the study objects, 40 cases were treated with low molecular weight heparin (control group) and 40 cases were treated with citric acid (observation group).Both groups were treated continuously, and the anticoagulant effect, coagulation function, electrolyte and inflammatory factor levels of the two groups were compared 7 d after medication.Results:The total effective rate of anticoagulation in the observation group after treatment was higher than that in the control group: 97.50% (39/40) vs. 75.00% (30/40), there was statistical difference ( χ2 = 8.54, P<0.05). After treatment, the levels of activated partial thrombin time (APTT), thrombin time (TT) and prothrombin time (PT) in the observation group were lower than those in the control group: (31.08 ± 8.31) s vs. (41.76 ± 8.36) s, (23.41 ± 5.02) s vs. (29.05 ± 5.13) s, (15.47 ± 3.50) s vs. (19.96 ± 4.75) s, there were statistical differences ( P<0.05). There were no statistical differences in the levels of potassium, chloride, sodium and calcium between the two groups after treatment ( P>0.05). After treatment, the levels of C-reactive protein (CRP) and procalcitonin (PCT) in the observation group were lower than those in the control group :(2.60 ± 0.86) mg/L vs. (4.35 ± 1.12) mg/L, (0.11 ± 0.03) μg/L vs. (0.19 ± 0.05) μg/L, there were statistical differences ( P<0.05). Conclusions:The application of citric acid anticoagulant in patients with sepsis and high-risk bleeding treated with CRRT can achieve significant curative effect, which can not only improve the anticoagulant effect, stabilize coagulation function and electrolyte level, but also down-regulate the level of inflammatory factors.

Objective:To evaluate the clinical outcomes of a modified dual-plane implant augmentation mammoplasty via periareolar incision.Methods:The patients undergoing primary breast augmentation at Vcharm Plastic & Aesthetic Surgery Hospital of Chongqing from October 2018 to June 2023 were enrolled in this prospective cohort study. Participants were alternately assigned to Group A (traditional Tebbetts dual-plane implant augmentation mammoplasty) and Group B (modified dual-plane implant augmentation mammoplasty) based on admission sequence. The modified technique included sharp subfascial dissection above the 5th rib, oblique muscle dissection below the 5th rib to create a subpectoral pocket, and elevation of the serratus anterior and external oblique fascia to the newly defined inframammary fold. Implants were positioned with 70% in the subfascial plane superiorly and 30% in the submuscular-fascial plane inferiorly. Postoperative pain was assessed using the numerical rating scale (NRS, 0-10) during days 0-7. Patient satisfaction (breast morphology, breast softness in sitting and supine positions) and complications were evaluated at 12-month follow-up. Statistical analysis was performed using SPSS 24.0. The measurement data were expressed as Mean ± SD, and the inter-group comparisons were performed by t-test. The enumeration data were expressed as examples and (or) percentages, and the inter-group comparisons were performed by χ2 test or Fisher exact probability test. P<0.05 was considered to be statistically significant. Results:Forty-eight female patients were included in Group A with age of (34.0±5.0) years and body mass index of (20.6±3.1) kg/m 2. Forty-three cases were received anatomical implants, and 5 cases rough round implants. The volume of implants was (265.0±12.5) cc. Fifty female patients were included in Group B with age of (35.0±4.5) years and body mass index of (21.5±3.7) kg/m 2. Forty-two cases were received anatomical implants and 8 cases rough round implants. The volume of implants was (262.0±15.0) cc. Baseline characteristics (age, body mass index, implant type, volume) showed no intergroup differences ( P>0.05). Group B demonstrated significantly lower NRS scores than Group A at all timepoints ( P<0.05). The immediate postoperative scores were 8.0±1.6 vs. 4.8±0.8, decreasing to 4.4±0.7 vs. 2.2±0.3 on Day 7. At 12 months, satisfaction rates for breast morphology[91.7%(44/48) vs. 92.0%(46/50)] and breast softness in sitting position [85.4%(41/48) vs. 86.0%(43/50) ] were comparable (both P>0.05). However, superior breast softness satisfaction in supine position was achieved in Group B [64.0%(32/50) vs. 43.8%(21/48), P<0.01] and fewer patients reported marked softness deterioration in supine position [28.0%(14/50) vs. 54.2%(6/48), P<0.01]. No hematoma, infection, delayed wound healing, implant malposition or wavy breast occurred in two groups. Capsular contracture occurred in 1 case per group. The implant was easy to be touched in 5 and 6 cases of Groups A and B, respectively ( P>0.05), while dynamic distortion was observed only in Group A (1 vs. 0, P<0.01). Conclusion:The modified dual-plane implant augmentation mammoplasty via periareolar incision significantly reduces postoperative pain, enhances breast softness in supine position, and prevents dynamic distortion without increasing complication risks, representing an optimized approach for implant-based augmentation.

Metaverse is a reality-connected parallel universe created by human beings by the aid of various techniques including virtue reality, augmented reality, mixed reality, 5G, artificial intelligence, blockchain, and so on. It provides immersive user experience and brings disruptive changes to social networking, games, medicine, education, etc. The application of metaverse in radiation medicine has not been reported yet, but with the increasingly prominent role of radiation medicine in the fields of disease diagnosis and treatment, nuclear energy safety, and manned space exploration, it can be predicted that metaverse will promote the development of radiation medicine. This paper reviews the possible influence of metaverse on the development of radiation medicine field, and suggests China start the creation and application of radiomediverse, a metaverse for radiation medicine, as soon as possible.