Background and Aims:Totally implantable venous access port(TIVAP)are widely used for chemotherapy,blood transfusion,and nutritional support in patients with malignancies.Among them,upper arm port(UAP)are increasingly recommended in clinical practice due to their advantages in avoiding thoracic complications and providing more concealed incisions.Currently,two main implantation techniques are used for UAP:the tunnel needle-transverse incision technique and the puncture point-transverse incision technique.This study aims to compare the clinical outcomes of these two techniques in patients with hematological malignancies,focusing on safety and cosmetic appearance,to provide evidence for clinical decision-making.Methods:A retrospective analysis was conducted on 412 patients with hematological malignancies who underwent UAP implantation at Xiangya Hospital of Central South University between December 2021 and December 2024.Based on the implantation method,patients were divided into the tunnel needle-transverse incision group(n=200)and the puncture point-transverse incision group(n=212).Intraoperative variables(operative time,intraoperative pain score,catheter kinking at the pocket,intraoperative blood loss)and postoperative indicators(incidence of complications and incision aesthetic satisfaction)were compared between the two groups.Results:There were no significant differences in baseline characteristics between the two groups(all P>0.05),indicating comparability.The puncture point-transverse incision group showed superior performance in operative time[(32.99±4.91)min vs.(41.42±5.35)min],catheter kinking rate(1.4％vs.8.5％),and incision aesthetic satisfaction(7.99±0.58 vs.6.26±0.86)compared with the tunnel needle-transverse incision group(all P<0.05).Although the puncture point group had slightly more intraoperative bleeding[(4.52±1.02)mL vs.(4.16±0.83)mL],the difference,while statistically significant,was of limited clinical relevance.No significant differences were observed between the two groups in intraoperative pain scores or incidence of postoperative complications(both P>0.05).Conclusion:The puncture point-transverse incision technique offers significant advantages in terms of operative efficiency,reduced catheter kinking,and improved incision aesthetics,without compromising safety.It represents a promising alternative to the traditional tunnel needle-transverse incision method and has strong potential for broader clinical adoption.The puncture point-transverse incision technique offers advantages such as shorter operative time,lower catheter kinking rate,and higher incision aesthetic satisfaction.It is a promising alternative to the traditional tunnel needle-transverse incision technique and has good potential for clinical application and promotion.

Background and Aims:Totally implantable venous access ports(TIVAP)are widely used in patients requiring long-term intravenous therapy.Traditional butterfly needle puncture fixation methods have limitations,including low success rates,increased pain,and risk of needle-stick injury.This study aimed to design an adjustable puncture protection kit for butterfly needles and evaluate its clinical utility using a simulated device.Methods:A prospective randomized controlled trial was conducted with 70 patients implanted with upper arm ports in the Hematology Department of Xiangya Hospital,Central South University,from January to December 2024.The patients were divided into a study group and a control group,with 35 cases in each,using a randomized block design.The study group underwent puncture with the simulated adjustable protection kit,while the control group used the traditional finger fixation method.Outcomes compared included first-attempt success rate,vertical puncture rate,pain score,puncture time,and complication rate.Results:The baseline characteristics of the two groups were balanced.The study group had significantly higher first-attempt puncture success rate and vertical puncture rate than the control group(94.3%vs.77.1%;91.4%vs.57.1%,both P<0.05).In the experimental group compared with the control group,pain scores were lower(1.80±1.13 vs.2.94±1.33,P<0.05),and puncture time was shorter[(31.31±9.05)s vs.(41.80±23.97)s,P<0.05].There was no significant difference in the incidence of puncture-related complications between the two groups(2.9%vs.14.3%,P>0.05).Conclusion:The simulated adjustable butterfly needle puncture protection kit effectively improves puncture success,enhances efficiency,reduces patient pain,and demonstrates good clinical safety.This innovative design provides a promising solution for reducing needle-stick injury risks and optimizing port puncture procedures,although larger,multicenter,and long-term studies are warranted.

Background and Aims:Totally implantable venous access ports(TIVAP)are widely used in patients requiring long-term intravenous therapy.Traditional butterfly needle puncture fixation methods have limitations,including low success rates,increased pain,and risk of needle-stick injury.This study aimed to design an adjustable puncture protection kit for butterfly needles and evaluate its clinical utility using a simulated device.Methods:A prospective randomized controlled trial was conducted with 70 patients implanted with upper arm ports in the Hematology Department of Xiangya Hospital,Central South University,from January to December 2024.The patients were divided into a study group and a control group,with 35 cases in each,using a randomized block design.The study group underwent puncture with the simulated adjustable protection kit,while the control group used the traditional finger fixation method.Outcomes compared included first-attempt success rate,vertical puncture rate,pain score,puncture time,and complication rate.Results:The baseline characteristics of the two groups were balanced.The study group had significantly higher first-attempt puncture success rate and vertical puncture rate than the control group(94.3%vs.77.1%;91.4%vs.57.1%,both P<0.05).In the experimental group compared with the control group,pain scores were lower(1.80±1.13 vs.2.94±1.33,P<0.05),and puncture time was shorter[(31.31±9.05)s vs.(41.80±23.97)s,P<0.05].There was no significant difference in the incidence of puncture-related complications between the two groups(2.9%vs.14.3%,P>0.05).Conclusion:The simulated adjustable butterfly needle puncture protection kit effectively improves puncture success,enhances efficiency,reduces patient pain,and demonstrates good clinical safety.This innovative design provides a promising solution for reducing needle-stick injury risks and optimizing port puncture procedures,although larger,multicenter,and long-term studies are warranted.

External apical root resorption(EARR)is one of the most common side effects of orthodontic treatment.Contact with sur-rounding anatomical structures during tooth movement is a significant cause for EARR.However,a comprehensive review of factors leading to EARR due to direct contact of surrounding anatomical structures with the root apex during orthodontic treatment is still lac-king.This review summarizes the anatomical structures related to EARR,including alveolar bone,incisive canal,maxillary sinus,ad-jacent teeth,and bone islands.Alveolar bone,incisive canal,and adjacent teeth can directly cause EARR during orthodontic treat-ment,while the impact of the maxillary sinus and bone islands on EARR has not been discovered so far.Analyzing the anatomical structures around the tooth roots can help develop more effective methods to prevent or reduce the occurrence of EARR during orthodon-tic treatment.

External apical root resorption(EARR)is one of the most common side effects of orthodontic treatment.Contact with sur-rounding anatomical structures during tooth movement is a significant cause for EARR.However,a comprehensive review of factors leading to EARR due to direct contact of surrounding anatomical structures with the root apex during orthodontic treatment is still lac-king.This review summarizes the anatomical structures related to EARR,including alveolar bone,incisive canal,maxillary sinus,ad-jacent teeth,and bone islands.Alveolar bone,incisive canal,and adjacent teeth can directly cause EARR during orthodontic treat-ment,while the impact of the maxillary sinus and bone islands on EARR has not been discovered so far.Analyzing the anatomical structures around the tooth roots can help develop more effective methods to prevent or reduce the occurrence of EARR during orthodon-tic treatment.

Background and Aims:Totally implantable venous access port(TIVAP)are widely used for chemotherapy,blood transfusion,and nutritional support in patients with malignancies.Among them,upper arm port(UAP)are increasingly recommended in clinical practice due to their advantages in avoiding thoracic complications and providing more concealed incisions.Currently,two main implantation techniques are used for UAP:the tunnel needle-transverse incision technique and the puncture point-transverse incision technique.This study aims to compare the clinical outcomes of these two techniques in patients with hematological malignancies,focusing on safety and cosmetic appearance,to provide evidence for clinical decision-making.Methods:A retrospective analysis was conducted on 412 patients with hematological malignancies who underwent UAP implantation at Xiangya Hospital of Central South University between December 2021 and December 2024.Based on the implantation method,patients were divided into the tunnel needle-transverse incision group(n=200)and the puncture point-transverse incision group(n=212).Intraoperative variables(operative time,intraoperative pain score,catheter kinking at the pocket,intraoperative blood loss)and postoperative indicators(incidence of complications and incision aesthetic satisfaction)were compared between the two groups.Results:There were no significant differences in baseline characteristics between the two groups(all P>0.05),indicating comparability.The puncture point-transverse incision group showed superior performance in operative time[(32.99±4.91)min vs.(41.42±5.35)min],catheter kinking rate(1.4％vs.8.5％),and incision aesthetic satisfaction(7.99±0.58 vs.6.26±0.86)compared with the tunnel needle-transverse incision group(all P<0.05).Although the puncture point group had slightly more intraoperative bleeding[(4.52±1.02)mL vs.(4.16±0.83)mL],the difference,while statistically significant,was of limited clinical relevance.No significant differences were observed between the two groups in intraoperative pain scores or incidence of postoperative complications(both P>0.05).Conclusion:The puncture point-transverse incision technique offers significant advantages in terms of operative efficiency,reduced catheter kinking,and improved incision aesthetics,without compromising safety.It represents a promising alternative to the traditional tunnel needle-transverse incision method and has strong potential for broader clinical adoption.The puncture point-transverse incision technique offers advantages such as shorter operative time,lower catheter kinking rate,and higher incision aesthetic satisfaction.It is a promising alternative to the traditional tunnel needle-transverse incision technique and has good potential for clinical application and promotion.

Objective To analyze the current cultural state of the hospital culture with multiple campuses,identify fac-tors influencing its development,and propose targeted strategies for integration and harmonization of culture across the hospital's branches.Methods The Cite Space was employed for the annual literature statistics and knowledge mapping of hospital culture of multiple campuses.A survey with a questionnaire was then conducted among 110 employees of a public dental hospital in Zhe-jiang Province.The factors influencing the development of culture were investigated.Results The volume of research literature on multi-campus hospital culture was observed to have been upsurge since 2020,with a rapid increase in the publications from 2020 to 2022.The knowledge map of keywords indicated a diversification in the research focuses on multi-campus public hospi-tals,with"cultural construction"emerging prominently between 2019 and 2020,with a burst strength of 1.47.Cultural construc-tion became a focal keyword in multi-campus hospital research.Pearson correlation analysis revealed multi-campus hospital cul-ture was significantly positively correlated with healthcare services,Party and group organization construction,image promotion,and human resource distribution across campuses(P＜0.01).Conclusion Research on the construction of culture in multi-campus hospital is gaining momentum.As hospitals continue to expand in scale,there is a need to strengthen the Party-led gov-ernance,diversify cultural construction efforts,strategically plan disciplines,manage medical quality through homogenized ap-proaches,accommodate differences within the cultural system,and establish a unified brand image.

Objective To investigate the effects of genistein on genioglossus muscle function and nuclear factor erythroid 2 related factor 2(Nrf-2)/antioxidant responsive element(ARE) signaling pathway in rats under chronic intermittent hypoxia(CIH) condition in order to find medication treatment of obstructive sleep apnea/hyponea syndrome.Methods Thirty female Sprague-Dawley(SD) rats (8 weeks old) were randomly(random number table) divided into three groups 1 week after ovariectomy: control group(NC group), CIH group, and CIH+genistein treatment group(T group).Rats in the latter two groups were exposed to CIH for 8 h/d for 5 weeks.Electrophysiological method was used to detect the change of genioglossus muscle function, and real-time reverse transcription(RT)-PCR and Western blotting were used to determine the level of Nrf-2 gene and protein.Results Compared to NC group, the contractive properties of genioglossus muscle fatigue test at every time set was significantly decreased in CIH group(P＜0.05).Compared to CIH group, the contractive properties was significantly increased in T group(P＜0.05).The level of Nrf-2 gene and protein were less in CIH group(0.54±0.11 and 0.35±0.13) than in NC group(1.00±0.00 和 1.00±0.00)(P＜0.05).Compared to CIH group the level of Nrf-2 gene and protein were increased in T group (0.76 ± 0.16 and 0.63 ± 0.14)(P＜0.05), however, it was still less than the level in NC group(P＜0.05).Conclusions CIH attenuates genioglossus muscle fatigue resistance under chronic intermittent hypoxia through Nrf-2/ARE signaling pathway.Genistein protects genioglossus muscle function through up-regulation of the level of Nrf-2 gene and protein.