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.

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.

Objective To summarize our experience and the early and midterm outcomes of stented elephant trunk procedure for right-sided aortic arch (RAA) with Kommerell's diverticulum (KD). Methods From April 2013 to July 2020, patients with RAA and KD who underwent stented elephant trunk procedure at our center were collected. Surgery was performed under moderate hypothermic circulatory arrest combined with selective antegrade cerebral perfusion via median sternotomy. Results A total of 8 patients were included, including 7 males and 1 female with a mean age of 51.88±9.61 years. All patients had an aneurysmal KD and aberrant left subclavian artery. Preoperative comorbidities included acute Stanford type B aortic dissection in 1 patient, aortic arch pseudoaneurysm in 1 patient, acute type B intramural hematoma in 2 patients, and coronary artery disease in 1 patient. Concomitant procedures included reconstruction of the left subclavian artery in all patients and coronary artery bypass grafting in 1 patient. The mean time of operation, cardiopulmonary bypass, aortic cross-clamping, and selective cerebral perfusion was 6.25±1.16 h, 157.75±40.07 min, 77.75±33.10 min, and 28.50±5.55 min, respectively. No intraoperative death occurred. There was 1 in-hospital death. Follow-up was completed in all patients with a mean period of 3.58±2.08 years. No late death occurred. A persistent anastomotic leak of the proximal arch was detected in 1 patient, but reintervention was not performed because neither aortic dilatation nor symptoms of tracheal and esophageal compression were observed during the follow-up. The remaining 6 patients showed positive aortic remodeling with complete thrombosis of the aneurysmal KD, and neither aortic event nor tracheal and esophageal compression occurred. Conclusion Stented elephant trunk procedure is a safe and feasible technique for selected patients with RAA and KD, which can achieve favorable early and midterm outcomes.

Objective To assess the clinical efficacy and safety of fire needling therapy for vitiligo. Method A self-control study was carried out. Fifty-six vitiligo patients with 124 skin lesions were allocated by long-axis random to two groups. The treatment group received fire needling therapy weekly for 12 times or until cure and the control group, no treatment as a blank control. The clinical efficacy and safety were assessed after the completion of treatment. Result The total efficacy rate of local fire needling therapy for vitiligo skin lesions was 79.8% and there was a statistically significant difference as compared with the control group (P<0.05). The therapeutic effect was better in patients with faciocervical skin lesions or short course of disease. The therapeutic effect increased with an increase in the course of treatment at the early stage of treatment but did not significantly increase after 8 weeks of treatment. Main adverse reactions were mild pain and skin infection. Conclusion Local fire needling has a definite therapeutic effect on vitiligo with high safety.

Atopic dermatitis (AD) is an inflammatory skin disease closely related to impairment of skin barrier function.Hereditary factors,life style and exposure to the environment all contribute to the occurrence of AD.Even though AD occurs mostly in infants,sometimes it may initially occur in adults,which is called adult-onset AD (AOAD).There are evident differences in types,immunological mechanisms and association with other diseases between childhood AD and AOAD.The lesional distribution of AOAD is similar to that of childhood AD,while AOAD is characterized by subacute and chronic dermatitis,and mainly manifests as dry hypertrophic lesions rarely complicated with exudation.Th1/Th2 imbalance and hyperfunction of antigen-presenting cells are immunological basis of AD occurrence.Moreover,FLG gene mutations are associated with the occurrence of AD.Acquired expression defect in the FLG gene induced by elevated levels of interleukin-13 (IL-13) only occurs in adults,suggesting that AOAD is different from AD that initially occurs during infancy and continues into adulthood.Infection,changes of bacterial flora in the skin and intestinal tract,and smoking are all important causative factors of AOAD,thus enquiries about histories of related diseases and smoking are helpful for the diagnosis of AOAD.

24 hours. Results There were totally 192 patients met the criteria for the investigation. Group A consisted of 76 patients, group B 116 patients. No significant differences between the two groups were found in terms of associated injury, ISS, ICU length of hospital stay,complication or mortality, while significant difference existed between two groups in terms of associated shock (?2=6.078,P