Transarterial radioembolization (TARE) is a widely utilized therapeutic approach for hepatocellular carcinoma (HCC), however, the clinical implementation is constrained by the stringent preparation conditions of radioembolization agents. Herein, we incorporated the superstable homogeneous iodinated formulation technology (SHIFT), simultaneously utilizing an enhanced solvent form in a carbon dioxide supercritical fluid environment, to encapsulate radionuclides (such as ¹³¹I,¹⁷⁷Lu, or ¹⁸F) with lipiodol for the preparation of radiolipiodol. The resulting radiolipiodol exhibited exceptional stability and ultra-high labeling efficiency (≥99%) and displayed notable intratumoral radionuclide retention and in vivo stability more than 2 weeks following locoregional injection in subcutaneous tumors in mice and orthotopic liver tumors in rats and rabbits. Given these encouraging findings, ¹⁸F was authorized as a radiotracer in radiolipiodol for clinical trials in HCC patients, and showed a favorable tumor accumulation, with a tumor-to-liver uptake ratio of ≥50 and minimal radionuclide leakage, confirming the feasibility of SHIFT for TARE applications. In the context of transforming from preclinical to clinical screening, the preparation of radiolipiodol by SHIFT represents an innovative physical strategy for radionuclide encapsulation. Hence, this work offers a reliable and efficient approach for TARE in HCC, showing considerable promise for clinical application (ChiCTR2400087731).

Objective A new type fighter pilot's helmet comfort was investigated to provide basis for generalization and popularization.Methods A quantitative questionnaire was designed to evaluate the comfort of current helmets and new helmets by pilots of series A and B fighters,and compare the new helmets with the current helmets.Thirdly,quantitative statistics of questionnaires were carried out to analyze the pilot's opinions on current helmets and new helmets.Based on the structure and quality characteristics of current helmets and new helmets,the investigation results were analyzed and discussed.Results A total of 167 pilots from series A and B fighter aircraft participated in trial wear and questionnaire investigation of new helmets.Among them,103 pilots from series A fighters and 64 pilots from series B fighters.Compared with the pilot's current helmet,the new helmet is lightweight and comfortable.Among them,92.2%of the pilots of the series A believe that the new helmet is more comfortable than the current helmet,and 90.3%of pilots think it is necessary to replace the current helmet with the new helmet.90.6%of the pilots of the Series B think the new helmet is more comfortable than the current helmet,and 92.2%of pilots think it is necessary to replace the current helmet with the new helmet.Conclusion The new fighter pilot's helmet is light and comfortable,and has been widely praised by pilots.The research results provide data support and decision-making basis for its universalization and popularization.

ObjectiveTo investigate a suspected outbreak of healthcare-associated infection with carbapenem-resistant Klebsiella pneumoniae (CRKP) in a geriatric emergency ward, and to provide references for the prevention and control of multidrug-resistant bacteria in a hospital in Shanghai. MethodsOn-site epidemiological investigation, combined with environmental hygiene monitoring and pulsed field gel electrophoresis (PFGE) molecular typing method, were adopted to investigate a suspected outbreak of CRKP infection in the geriatric emergency ward of a hospital from October to November 2022, aiming at finding out factors caused the outbreak before taking corresponding control measures. ResultsA total of 3 cases of healthcare-associated CRKP infection were identified, of which 2 cases were homologous to a previous case of community-associated CRKP infection. What’s more, the 2 cases lived in the same ward with the latter and with adjacent beds, but the third case was non-homologous to the community-associated infection case. A total of 46 samples were collected from the environmental surfaces and the hands of healthcare workers, of which 7 samples tested positive for CRKP and were identical to the strains from the 2 healthcare-associated infection cases and the 1 community-associated infection case, originating from the bedrails, bedside tables, surface of non-invasive ventilator, bed curtains and panels of monitoring equipment, with a detection rate of 15.22%. But none of the 11 samples from the hands of healthcare workers tested positive for CRKP. The outbreak was effectively controlled after taking specific prevention and control measures such as strengthening personnel management, intensifying environmental cleaning and disinfection and strictly enforcing hand hygiene among healthcare workers. Subsequently, no similar new cases were reported during the 14-day follow-up period. ConclusionIncomplete environmental cleaning and disinfection, as well as inadequate enforcement of hand hygiene among heatheare workers may have contributed to the suspected outbreak of CRKP in the geriatric emergency ward. Early warning and timely investigation of suspected outbreaks of multidrug-resistant bacteria are crucial for preventing and controlling such outbreaks in hospitals.

Objective:To investigate the safety and feasibility of the domestic single-port serpentine-arm robotic surgical system for pyeloplasty in children with congenital ureteropelvic junction obstruction(UPJO).Methods:Data of UPJO patients who underwent pyeloplasty using a domestic single-port ser-pentine-arm robotic surgical system(Beijing Surgerii Robotics Co.,Ltd.)in Beijing Children's Hospital from November 2023 to February 2024 were retrospectively collected.The patients who were not receiving surgical treatment for the first time,had hydronephrosis caused by other reasons(such as ureterovesical junction obstruction,posterior urethral valve,urinary tract stones,vesicoureteral reflux,ureterocele,etc.),had other urinary tract malformations(such as duplicated kidneys,congenital renal dysplasia,etc.),had severe atrophy of the affected kidney,severe urinary tract infection or severe renal insufficien-cy were excluded.All the surgeries were performed through the umbilicus and abdominal cavity,and the operation time,number of intraoperative incisions,incision size,intraoperative blood loss,and peri-operative complications were recorded.Statistical analysis was performed to compare changes in the an-teroposterior pelvic diameter(APD)and renal cortical thickness before surgery and 6 months postopera-tively.Results:A total of 10 patients were included(8 males and 2 females),with an average age of(10.20±3.12)years.Nine patients were on the left side and one patient was on the right side.The average height was(142.0±17.8)cm and the average weight was(37.6±17.9)kg.All the patients underwent surgery using the domestic single-port robotic surgery system,and no patient was converted to open pyeloplasty.The total operation time was(237±96)min,and the operation time on the operating table was(162.0±69.3)min.The intraoperative blood loss was 5.00(2.25,5.00)mL.No compli-cations,such as bleeding,urine extravasation,fever,and poor wound healing occurred during the perioperative period.Compared with the preoperative measurements,the APD was significantly shortened postoperatively(P=0.005),and the renal cortical thickness significantly increased(P=0.011).Con-clusion:The domestic single-port serpentine arm robotic surgical system is safe and feasible for UPJO pyeloplasty in children,with good surgical results,and can be promoted and applied in most domestic medical centers.

Objective:To investigate the safety and feasibility of the domestic single-port serpentine-arm robotic surgical system for pyeloplasty in children with congenital ureteropelvic junction obstruction(UPJO).Methods:Data of UPJO patients who underwent pyeloplasty using a domestic single-port ser-pentine-arm robotic surgical system(Beijing Surgerii Robotics Co.,Ltd.)in Beijing Children's Hospital from November 2023 to February 2024 were retrospectively collected.The patients who were not receiving surgical treatment for the first time,had hydronephrosis caused by other reasons(such as ureterovesical junction obstruction,posterior urethral valve,urinary tract stones,vesicoureteral reflux,ureterocele,etc.),had other urinary tract malformations(such as duplicated kidneys,congenital renal dysplasia,etc.),had severe atrophy of the affected kidney,severe urinary tract infection or severe renal insufficien-cy were excluded.All the surgeries were performed through the umbilicus and abdominal cavity,and the operation time,number of intraoperative incisions,incision size,intraoperative blood loss,and peri-operative complications were recorded.Statistical analysis was performed to compare changes in the an-teroposterior pelvic diameter(APD)and renal cortical thickness before surgery and 6 months postopera-tively.Results:A total of 10 patients were included(8 males and 2 females),with an average age of(10.20±3.12)years.Nine patients were on the left side and one patient was on the right side.The average height was(142.0±17.8)cm and the average weight was(37.6±17.9)kg.All the patients underwent surgery using the domestic single-port robotic surgery system,and no patient was converted to open pyeloplasty.The total operation time was(237±96)min,and the operation time on the operating table was(162.0±69.3)min.The intraoperative blood loss was 5.00(2.25,5.00)mL.No compli-cations,such as bleeding,urine extravasation,fever,and poor wound healing occurred during the perioperative period.Compared with the preoperative measurements,the APD was significantly shortened postoperatively(P=0.005),and the renal cortical thickness significantly increased(P=0.011).Con-clusion:The domestic single-port serpentine arm robotic surgical system is safe and feasible for UPJO pyeloplasty in children,with good surgical results,and can be promoted and applied in most domestic medical centers.

Aim To develop and validate a dynamic nomogram to predict the risk of no-reflow phenomenon(NRP)after percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STE-MI)by constructing HALP based on haemoglobin(Hb),albumin(Alb),lymphocytes(LYM),and platelets(PLT).Methods A retrospective analysis of 449 STEMI patients admitted to Nanyang Central Hospital from January 2022 to Janu-ary 2024 was divided into 145 cases in the NRP group and 304 cases in the normal reflow group according to whether the patients developed NRP after surgery.HALP was calculated based on Hb,Alb,LYM and PLT observations.Independ-ent influences on NRP risk were determined by multivariate Logistic regression analysis.Dynamic nomogram of NRP risk after PCI in STEMI patients were developed using the R language correlation software package.Results The incidence of NRP was 32.3％(145/449)among 449 patients with NRP.The HALP of patients in the NRP group was lower than that of patients in the normal reflow group(P＜0.05).The area under the curve(AUC)of HALP for diagno-sis of NRP was 0.880(0.847-0.909),and the Kappa coefficient of its optimal cutoff value ≤3.04 versus patients with accurate diagnosis of NRP was 0.612.The results of multivariate Logistic regression analysis showed that age,diabetes mellitus,and high sensitivity C-reactive protein(hs-CRP)were independent risk factors for NRP after PCI in STEMI pa-tients(P＜0.05),and left ventricular ejection fraction(LVEF)and HALP were independent protective factors(P＜0.05).A dynamic nomogram(https://xz0311.shinyapps.io/DynNamicNRP/)based on HALP combined with age,di-abetes,LVEF,and hs-CRP was effective in predicting the risk of post-PCI NRP in STEM1 patients.Conclusion HALP is more effective than traditional risk factors in predicting NRP risk in STEMI patients after PCI,and the dynamic nomogram developed based on HALP will help develop personalized treatment strategies for patients with high NRP risk.

To examine the global research trends and emerging focal points in the field ofgeriatric interdisciplinary team (GIT) from 2000 to 2023, so as to offer insights and reference for related research in China.

To investigate the collective influence of sarcopenia on the extended prognosis of hospitalized elderly individuals with type 2 diabetes mellitus(T2DM).

To improve the current situation of multiple preoperative visits and evaluations for elderly patients and other patients with complex conditions, in December 2022, Peking Union Medical College Hospital established preoperative multidisciplinary evaluation clinic (shorted as joint clinic). The joint clinic established a multidisciplinary team, clarified service targets, and developed standardized clinic workflows to provide patients with a " one-stop" preoperative assessment(physical fitness assessment, nutritional assessment, and frailty assessment, etc.), nutritional optimization intervention, and prerehabilitation education and guidance services. This practice strengthened preoperative risk management, improved preoperative assessment efficiency, and ensured the safety of patients during the perioperative period. As of September 2023, the joint clinic had received a total of 128 patients, of which 86 underwent surgery after preoperative evaluation and prehabilitation optimization. The obesity rate, smoking rate, and number of frailty cases of these patients had decreased from 13.96%, 11.63%, and 18 at the time of visit to 9.30%, 4.65%, and 14 on the day before surgery, respectively. They had recovered well after surgery. This practice had improved the preoperative status of patients and created conditions for high-risk patients to undergo surgery smoothly, so as to provide references for other hospitals to carry out multidisciplinary collaborative preoperative evaluation works.

Objective To investigate the long-term incidence of in-stent stenosis(ISS)in patients with intracranial aneurysms receiving pipeline embolization device(PED)who showed no ISS at short-to-medium term follow-up examination.Methods The clinical data of patients,who received PED treatment at the Department of Neurointervention,First Affiliated Hospital of Zhengzhou University of China between April 2015 and June 2022,were retrospectively collected.The patients with intracranial aneurysms,who showed no ISS at the initial follow-up with DS A and completed＞12 months long-term follow-up check after treatment at the same hospital,were screened out,and their relevant clinical data and imaging materials were collected.The incidence of ISS occurring in postoperative＞12 months long-term follow-up was calculated.The ISS was defined as a＞25％lumen loss of the parent artery when compared with its lumen size measured immediately after PED implantation.Results A total of 57 patients with 61 aneurysms were enrolled in this study,and a total of 68 PEDs were implanted.Forty-one(67.21％)aneurysms were treated by PED implantation only,and 20(32.79％)aneurysms by PED plus spring coils.The median initial follow-up time was 184.0 days(119.0,212.5).At postoperative＞12 months long-term follow-up visit,DSA was employed for 35(57.38％)aneurysms,CTA was adopted for 22(36.07％)aneurysms,and 3D-SPACE sequence MR scan was performed in 4(6.56％)aneurysms.The median follow-up time was 538.0 days(407.5,678.0),and the incidence of ISS was 0％.No ISS-related neurological symptoms occurred in all patients.Conclusion In treating intracranial aneurysms with PED,the postoperative incidence of ISS is low.No ISS is found during the short-term follow-up period,and long-term follow-up results tend to indicate that no ISS events have occurred.