Objective:To analyze the research and development of control system for airbag pressure of intelligent tracheal catheter,and its application effect in clinical practice.Methods:The hospital designed an intelligent self-adaptive control system for cuff pressure of tracheal catheter,which can rationally apply main components such as single chip microcomputer,display screen,control panel,pressure monitoring module,inflation device and solenoid valve,etc..This control system connected the measuring module of pressure through single chip microcomputer,so as to continuously detect the airbag pressure of tracheal catheter.An inflation and deflation algorithm was independently researched and developed to control air pump or solenoid valve to inject or release part of the gas to the airbag,so as to achieve intelligent control for the pressure of airbag.Sixty patients underwent endotracheal intubation who admitted to the department of general surgery of Wuhan Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were selected as the study objects,and they were divided into control group(n=30)and observation group(n=30)according to random number table method.The cuff pressure of endotracheal intubation of patients in control group were managed by conventional method.The intelligent adaptive control system was adopted to manage the cuff pressure of endotracheal intubation for patients in the observation group.The complications,compliance rate of airbag pressure,the instantaneous maximum value of airbag pressure during sputum aspiration,insertion of gastric tube,and turning over of body were compared between the two groups after intubation.Results:The incidence of complication included cough,trachyphonia,dysphagia and bloody sputum after tracheal intubation in the observation group were 6.66%,which was significantly lower than 33.33%in the control group,and the difference was statistically significant(x2=6.667,P<0.05).The compliance rate of the pressure(25-30cmH2O)of airbag in the control group was 92.83%,which was significantly lower than 97.78%in the observation group,and the difference was statistically significant(x2=14.698,P<0.05).The instantaneous maximum values of airbag pressure during sputum aspiration,insertion of gastric tube and turning over were(28.24±3.65)cmH2O,(27.98±4.25)cmH2O and(28.65±4.87)cmH2O in observation group,respectively,which were significantly lower than those in control group,and the differences were significant(t=17.930,19.208,16.485,P<0.05).Conclusion:The application of intelligent adaptive control system for cuff pressure of tracheal catheter can maintain the airbag pressure of tracheal catheter at normal level(20-30 cmH2O),and reduce complications,and improve the compliance rate of airbag pressure.

Objective:To investigate the treatment regimens, therapeutic effects, and adverse events of immune checkpoint inhibitors (ICI) in the treatment of progressive multifocal leukoencephalopathy (PML).Methods:A retrospective analysis was performed on patients with PML who received ICI treatment at the Department of Neurology of Peking Union Medical College Hospital from October 2020 to September 2024. The patients′ demographic characteristics, baseline immune status, clinical manifestations, laboratory tests, treatment regimens, and clinical outcomes were analyzed.Results:A total of 2 male patients with PML, aged 40 and 59 years, received ICI treatment. One patient had underlying combined immunodeficiency, while the other had acute myeloid leukemia subtype M2 and had previously undergone umbilical cord blood stem cell transplantation. Both patients were treated with pembrolizumab (dosage range: 2-3 mg/kg, administered every 3-4 weeks), receiving a total of 2-4 courses of treatment. In terms of therapeutic effects, both patients showed significant improvement. Regarding adverse events, 1 patient experienced immune-related adverse event (irAE) of immune-related pneumonia combined with immune-related hypophysitis.Conclusions:ICI may be an effective treatment option for PML. However, the use of ICI may be accompanied by the occurrence of irAE, necessitating close monitoring during treatment.

Wound cleansing is an essential step in skin wound management. It can prevent local infection and optimize healing micro-environment by removing necrotic tissue and foreign matter, reducing microbial load, breaking bacterial biofilm formation and so on. Many randomized controlled trials and meta-analysis abroad have concluded that there is no significant difference in the incidence of wound infection and healing rate between the wounds irrigated with tap water and with sterile normal saline for skin wound cleansing. Considering the current requirements of medical fee policies in China, we recommend the use of tap water instead of saline or other wound cleansing solutions for cleansing skin wounds.

Objective:To analyze the research and development of control system for airbag pressure of intelligent tracheal catheter,and its application effect in clinical practice.Methods:The hospital designed an intelligent self-adaptive control system for cuff pressure of tracheal catheter,which can rationally apply main components such as single chip microcomputer,display screen,control panel,pressure monitoring module,inflation device and solenoid valve,etc..This control system connected the measuring module of pressure through single chip microcomputer,so as to continuously detect the airbag pressure of tracheal catheter.An inflation and deflation algorithm was independently researched and developed to control air pump or solenoid valve to inject or release part of the gas to the airbag,so as to achieve intelligent control for the pressure of airbag.Sixty patients underwent endotracheal intubation who admitted to the department of general surgery of Wuhan Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were selected as the study objects,and they were divided into control group(n=30)and observation group(n=30)according to random number table method.The cuff pressure of endotracheal intubation of patients in control group were managed by conventional method.The intelligent adaptive control system was adopted to manage the cuff pressure of endotracheal intubation for patients in the observation group.The complications,compliance rate of airbag pressure,the instantaneous maximum value of airbag pressure during sputum aspiration,insertion of gastric tube,and turning over of body were compared between the two groups after intubation.Results:The incidence of complication included cough,trachyphonia,dysphagia and bloody sputum after tracheal intubation in the observation group were 6.66%,which was significantly lower than 33.33%in the control group,and the difference was statistically significant(x2=6.667,P<0.05).The compliance rate of the pressure(25-30cmH2O)of airbag in the control group was 92.83%,which was significantly lower than 97.78%in the observation group,and the difference was statistically significant(x2=14.698,P<0.05).The instantaneous maximum values of airbag pressure during sputum aspiration,insertion of gastric tube and turning over were(28.24±3.65)cmH2O,(27.98±4.25)cmH2O and(28.65±4.87)cmH2O in observation group,respectively,which were significantly lower than those in control group,and the differences were significant(t=17.930,19.208,16.485,P<0.05).Conclusion:The application of intelligent adaptive control system for cuff pressure of tracheal catheter can maintain the airbag pressure of tracheal catheter at normal level(20-30 cmH2O),and reduce complications,and improve the compliance rate of airbag pressure.

Objective:To investigate the treatment regimens, therapeutic effects, and adverse events of immune checkpoint inhibitors (ICI) in the treatment of progressive multifocal leukoencephalopathy (PML).Methods:A retrospective analysis was performed on patients with PML who received ICI treatment at the Department of Neurology of Peking Union Medical College Hospital from October 2020 to September 2024. The patients′ demographic characteristics, baseline immune status, clinical manifestations, laboratory tests, treatment regimens, and clinical outcomes were analyzed.Results:A total of 2 male patients with PML, aged 40 and 59 years, received ICI treatment. One patient had underlying combined immunodeficiency, while the other had acute myeloid leukemia subtype M2 and had previously undergone umbilical cord blood stem cell transplantation. Both patients were treated with pembrolizumab (dosage range: 2-3 mg/kg, administered every 3-4 weeks), receiving a total of 2-4 courses of treatment. In terms of therapeutic effects, both patients showed significant improvement. Regarding adverse events, 1 patient experienced immune-related adverse event (irAE) of immune-related pneumonia combined with immune-related hypophysitis.Conclusions:ICI may be an effective treatment option for PML. However, the use of ICI may be accompanied by the occurrence of irAE, necessitating close monitoring during treatment.

Wound cleansing is an essential step in skin wound management. It can prevent local infection and optimize healing micro-environment by removing necrotic tissue and foreign matter, reducing microbial load, breaking bacterial biofilm formation and so on. Many randomized controlled trials and meta-analysis abroad have concluded that there is no significant difference in the incidence of wound infection and healing rate between the wounds irrigated with tap water and with sterile normal saline for skin wound cleansing. Considering the current requirements of medical fee policies in China, we recommend the use of tap water instead of saline or other wound cleansing solutions for cleansing skin wounds.

Objective To study the changes and mechanism of skin stem cells in microgravity.Methods The skin stem cells of SD rats were used to establish a suspension culture system and compare the proliferation of skin stem cells with 1G gravity.Results The simulated microgravity significantly affected the velocity of skin stem cell sphere proliferation in suspension culture,which was about 12%higher than the 1G gravity group.Transcriptome sequencing showed that 1673 genes were up-regulated and 1409 genes were downregulated;Calcium signaling;cytokine-cytokine receptor interaction and PPAR pathway were different in the two environments.Conclusion Simulation of microgravity can affect the proliferation behavior of skin stem cells in suspension culture by regulating the expression of key signaling pathways,which provides an experimental basis for further research in spatial microgravity environ ment.

Advance care planning(ACP)is designed to ensure that patients lacking autonomous decision-making capacity receive medical services in accordance with their expectations and preferences.Individuals with advanced cancer are a crucial target for ACP implementation.However,the current practice of ACP in this group in China is suboptimal,demanding high-quality implementation evidence to strengthen ACP in the clinical practice of patients with advanced cancer.The existing literature can be summarized into 27 pieces of evidence across 7 dimensions,including initiation time,intervention content,intervention providers,intervention modalities,communication skills,outcome indicators,and environmental support.The aforementioned evidence could provide crucial support for improving ACP implementation for patients with advanced cancer.Subsequent research efforts should integrate patient preferences and explore the most suitable implementation strategies for ACP in the Chinese population with advanced cancer,considering diverse aspects such as traditional culture,ACP education and training,legislative support,and healthcare system refinement.

Oral squamous cell carcinoma (OSCC) develops on the mucosal epithelium of the oral cavity. It accounts for approximately 90% of oral malignancies and impairs appearance, pronunciation, swallowing, and flavor perception. In 2020, 377,713 OSCC cases were reported globally. According to the Global Cancer Observatory (GCO), the incidence of OSCC will rise by approximately 40% by 2040, accompanied by a growth in mortality. Persistent exposure to various risk factors, including tobacco, alcohol, betel quid (BQ), and human papillomavirus (HPV), will lead to the development of oral potentially malignant disorders (OPMDs), which are oral mucosal lesions with an increased risk of developing into OSCC. Complex and multifactorial, the oncogenesis process involves genetic alteration, epigenetic modification, and a dysregulated tumor microenvironment. Although various therapeutic interventions, such as chemotherapy, radiation, immunotherapy, and nanomedicine, have been proposed to prevent or treat OSCC and OPMDs, understanding the mechanism of malignancies will facilitate the identification of therapeutic and prognostic factors, thereby improving the efficacy of treatment for OSCC patients. This review summarizes the mechanisms involved in OSCC. Moreover, the current therapeutic interventions and prognostic methods for OSCC and OPMDs are discussed to facilitate comprehension and provide several prospective outlooks for the fields.
Humans ; Carcinoma, Squamous Cell/therapy* ; Squamous Cell Carcinoma of Head and Neck ; Mouth Neoplasms/therapy* ; Head and Neck Neoplasms ; Tumor Microenvironment

Objective To establish a preliminary evaluation system for gastrointestinal qi stagnation syndrome.Methods On the basis of the systematic evaluation of medical literature in the early stage of the research group,24 high-frequency items were subjected to Delphi method,the item indexes were determined through three rounds of expert consultation,and the proportion value of the indexes was determined by AHP,and the evaluation system of gastrointestinal qi stagnation syndrome was initially constructed.Results A total of 84 valid questionnaires were collected by three rounds of Delphi method,including 15 in the first round,32 in the second round and 37 in the third round.According to the statistics,16 items including distention(stuffy)or distending pain or moving pain(epigastric,abdominal,etc.),belching,borborygmus,flatus,etc.were selected.The order of the proportion of the first level indexes obtained by the analytic hierarchy process from high to low is:clinical symptoms,pulse,tongue;The proportion of secondary indicators from high to low is as follows:distention(stuffy)or distending pain or moving pain(epigastric,abdominal,etc.),pulse string,greasy fur,thin white fur,slippery pulse string,pulse sinking string,light red tongue,flatus,borborygmus,belching,induced or aggravated in case of emotional distress,hiccup,abdominal mass,anorexia,vomiting,belching and swallowing acid.Conclusion Delphi method and analytic hierarchy process have been used to study gastrointestinal qi stagnation syndrome,and an evaluation system has been preliminarily formed.The index structure is reasonable,targeted and has strong clinical practicability.