The incidence of metabolic disorders is relatively high among transplant recipients and is closely related to the use of immunosuppressive agents. Metabolic diseases can trigger or accelerate the progression of cardiovascular conditions, becoming an important factor affecting long-term survival after transplantation. This article discusses the reasons for the high incidence of post-transplant metabolic disorders, and introduces the management strategies for post-transplant diabetes, dyslipidemia, and hyperuricemia, including early screening, timely diagnosis, and continuous management. It also highlights current challenges in the management of metabolic disorders after organ transplantation in China, such as insufficient interdisciplinary collaboration, lack of research data, and low awareness among recipients. It is recommended to establish a multidisciplinary follow-up system, improve the general medical capabilities of follow-up teams, and achieve precise management of transplant recipients.

Objective To investigate the association between early peripheral perfusion index (PPI) and acute kidney injury (AKI) in patients admitted to the intensive care unit (ICU) following major noncardiac surgery. Methods This retrospective cohort study was conducted at a single center. Adult patients consecutively enrolled were those admitted to the ICU after major noncardiac surgery. PPI measurements were collected within the first 6 hours post-surgery. The primary outcome assessed was the occurrence of AKI within 7 days after surgery. Multivariate logistic regression analysis was employed to adjust for confounding factors,while receiver operating characteristic (ROC) curve analysis determined the most predictive cutoff PPI. Results The study included a total of 444 patients who underwent noncardiac surgery. The incidences of postoperative AKI and severe AKI were 9.23％ and 1.13％,respectively. Early postoperative PPI levels exhibited a skewed distribution,with a median value of 3.02 (2.02,4.24). After adjusting for various perioperative variables,PPI was found to be indepen-dently correlated with the occurrence of postoperative AKI (OR=0.734,95％ CI:0.580～0.930,P=0.010),as indicated by an area under the ROC curve of 0.6802 (95％ CI:0.6022～0.7582,P<0.001). Using a cutoff value of ≤ 2 .04 for PPI,the sensitivity and specificity for predicting postoperative AKI were determined to be approximately at 53.7％ and 77.2％ respectively. Further analysis revealed that patients with PPI ≤ 2.04 had a higher incidence of severe postoperative complications as well as prolonged mechanical ventilation duration and hospital stay. Conclusions A prompt reduction in postoperative PPI usage was found to be linked with the inci-dence of AKI occurring within 7 days following major noncardiac surgery.

Peripheral perfusion index(PPI)is an objective and reliable parameter reflecting the peripheral micro-circulation through the ratio of local pulsatile to non-pulsatile blood flow.PPI is widely used in the early identifica-tion of hypotension,guiding volume management,assessing vascular tone,assisting mechanical ventilation settings,early identification of postoperative complications and poor prognosis of critically ill patients.

Pheochromocytoma and paraganglioma(PPGL)are rare neuroendocrine tumors characterized not only by hemodynamic instability but also by fluctuations in blood glucose levels during the perioperative period.These features are closely associated with significant variations in catechromamine secretion.Hypoglycemia is a common postoperative complication in patients with PPGL and is primarily attributed to rebound insulin secretion and enhanced insulin sensitivity following tumor resection.Postoperative hypoglycemia requires heightened clinical attention due to its often subtle presentation and potential for serious complications.Known risk factors include the presence of an epinephrine-secreting tumor,prolonged operative time,larger tumor size,and a history of end-stage renal disease.Therefore,it is essential to identify high-risk patients preoperatively,ensure meticulous intraopera-tive monitoring,and implement timely postoperative interventions.This article provides a comprehensive review of recent advances in the epidemiology,underlying mechanisms,clinical diagnosis,management strategies,and prognosis of postoperative hypoglycemia in PPGL.Importantly,it introduces novel research directions and concep-tual frameworks for the first time,including the optimal timing and dosage of α-receptor antagonists,potential ap-plications of micro-dose glucagon therapy,and molecular mechanisms with targeted interventions in glucose me-tabolism regulation.This review aims to address the current lack of standardized perioperative management proto-cols and to offer innovative and clinically relevant guidance for healthcare professionals.

Pheochromocytoma and paraganglioma(PPGL)are rare neuroendocrine tumors characterized not only by hemodynamic instability but also by fluctuations in blood glucose levels during the perioperative period.These features are closely associated with significant variations in catechromamine secretion.Hypoglycemia is a common postoperative complication in patients with PPGL and is primarily attributed to rebound insulin secretion and enhanced insulin sensitivity following tumor resection.Postoperative hypoglycemia requires heightened clinical attention due to its often subtle presentation and potential for serious complications.Known risk factors include the presence of an epinephrine-secreting tumor,prolonged operative time,larger tumor size,and a history of end-stage renal disease.Therefore,it is essential to identify high-risk patients preoperatively,ensure meticulous intraopera-tive monitoring,and implement timely postoperative interventions.This article provides a comprehensive review of recent advances in the epidemiology,underlying mechanisms,clinical diagnosis,management strategies,and prognosis of postoperative hypoglycemia in PPGL.Importantly,it introduces novel research directions and concep-tual frameworks for the first time,including the optimal timing and dosage of α-receptor antagonists,potential ap-plications of micro-dose glucagon therapy,and molecular mechanisms with targeted interventions in glucose me-tabolism regulation.This review aims to address the current lack of standardized perioperative management proto-cols and to offer innovative and clinically relevant guidance for healthcare professionals.

Objective To investigate the association between early peripheral perfusion index (PPI) and acute kidney injury (AKI) in patients admitted to the intensive care unit (ICU) following major noncardiac surgery. Methods This retrospective cohort study was conducted at a single center. Adult patients consecutively enrolled were those admitted to the ICU after major noncardiac surgery. PPI measurements were collected within the first 6 hours post-surgery. The primary outcome assessed was the occurrence of AKI within 7 days after surgery. Multivariate logistic regression analysis was employed to adjust for confounding factors,while receiver operating characteristic (ROC) curve analysis determined the most predictive cutoff PPI. Results The study included a total of 444 patients who underwent noncardiac surgery. The incidences of postoperative AKI and severe AKI were 9.23％ and 1.13％,respectively. Early postoperative PPI levels exhibited a skewed distribution,with a median value of 3.02 (2.02,4.24). After adjusting for various perioperative variables,PPI was found to be indepen-dently correlated with the occurrence of postoperative AKI (OR=0.734,95％ CI:0.580～0.930,P=0.010),as indicated by an area under the ROC curve of 0.6802 (95％ CI:0.6022～0.7582,P<0.001). Using a cutoff value of ≤ 2 .04 for PPI,the sensitivity and specificity for predicting postoperative AKI were determined to be approximately at 53.7％ and 77.2％ respectively. Further analysis revealed that patients with PPI ≤ 2.04 had a higher incidence of severe postoperative complications as well as prolonged mechanical ventilation duration and hospital stay. Conclusions A prompt reduction in postoperative PPI usage was found to be linked with the inci-dence of AKI occurring within 7 days following major noncardiac surgery.

The incidence of metabolic disorders is relatively high among transplant recipients and is closely related to the use of immunosuppressive agents. Metabolic diseases can trigger or accelerate the progression of cardiovascular conditions, becoming an important factor affecting long-term survival after transplantation. This article discusses the reasons for the high incidence of post-transplant metabolic disorders, and introduces the management strategies for post-transplant diabetes, dyslipidemia, and hyperuricemia, including early screening, timely diagnosis, and continuous management. It also highlights current challenges in the management of metabolic disorders after organ transplantation in China, such as insufficient interdisciplinary collaboration, lack of research data, and low awareness among recipients. It is recommended to establish a multidisciplinary follow-up system, improve the general medical capabilities of follow-up teams, and achieve precise management of transplant recipients.

OBJECTIVE To investigate the transfer and diffusion of berberine hydrochloride(BBH), the main active component of Coptis and Phellodenticum in the system of carboxymethyl chitosan(CMCS)-sodium alginate(SA). METHODS CMCS and SA were stirred in a certain proportion, and D-gluconolactone(GDL) was added to form polyelectrolyte hydrogel. Rheometer was used to study the rheological properties of CMCS-SA hydrogel, including the elastic modulus G′ and the viscous modulus G′′. A BBH diffusion model for CMCS-SA hydrogel was designed, and the relevant rules of BBH permeation through CMCS-SA polyelectrolyte hydrogel were observed by UV-VIS. RESULTS The elastic modulus G′ of the hydrogel was measured when the ratio of CMCS to SA was 3∶1, 2∶1, 1∶1, 1∶2, and 1∶3. When the ratio of CMCS to SA was 1∶1, G′ was the highest, and the crosslinking strength of the hydrogel was the highest. The cumulative amount of BBH transfer was measured by the BBH transfer model, and the diffusion of BBH in CMCS-SA hydrogel was fitted as the skeleton dissolution by Peppas equation, indicating that BBH dissociation and the transfer efficiency increased as the amino group of CMCS decreased or the carboxyl group of SA increased. The elastic modulus G′ of CMCS-SA hydrogel increased with the increase of GDL content. The reason was that the binding force between CMCS and SA molecules gradually increased with the decrease of pH, and the crosslinking degree of the hydrogel was enhanced. When ratio of fixed CMCS to SA was 1∶1 and the GDL content was 0.15 g·mL−1, the formability of CMCS-SA hydrogel was good. In addition, when BBH was transferred in hydrogel with different concentrations of GDL, the transfer efficiency increased with the increase of GDL content. When BBH was delivered in different thickness hydrogel, the delivery efficiency of CMCS-SA hydrogel increased with the decrease of thickness. CONCLUSION The CMCS-SA hydrogel system, as a potential drug carrier for traditional Chinese medicine extracts such as BBH, is expected to serve as a gel carrier for transdermal drug delivery.

BACKGROUND:Bone mineral density is the clinical gold standard for determining bone strength,but bone mineral density is less sensitive to changes in bone mass,with large changes in bone mineral density only occurring when bone mass is significantly reduced,so bone mineral density has limited ability to predict changes in bone strength and fracture risk. OBJECTIVE:A model of the normal and osteoporotic hip joint was developed to analyze the stresses and deformation in the hip of normal and osteoporotic patients under single-leg standing conditions. METHODS:A healthy adult female volunteer at the age of 36 years was selected as the study subject.The CT data of the hip joint of this volunteer were obtained and saved in DICOM format.The hip joint model was reconstructed in three dimensions,and the material properties were assigned by the gray value assignment method to obtain the normal and osteoporotic hip joint models according to the empirical formula.The same boundary conditions and loads were set to simulate the stresses and deformation in the normal and osteoporotic hip joints in the single-leg standing position. RESULTS AND CONCLUSION:(1)In the finite element model of the normal and osteoporotic hip,the stress distribution was more concentrated in the medial region of the femoral neck.(2)In the hip bone,the stress distribution was mainly concentrated in the upper part of the acetabulum.(3)The stress peaks in the medial femoral neck and upper acetabulum were larger in the normal hip model than in the osteoporotic hip model,probably due to the reduced bone strength of the osteoporotic bone.(4)The peak Von Mises of both normal and osteoporotic hip models were concentrated on the medial femoral neck,and the peak Von Mises of the hip bone was smaller,indicating that the overall effect of osteoporosis on hip bone stresses was relatively small.(5)In terms of deformation in the single-leg standing position,the maximum deformation in the normal hip model was located at the acetabulum and femoral head,and the maximum deformation was located at the upper part of the greater trochanter of the femur.(6)It is suggested that the finite element analysis method to model the values of parameters related to bone tissue in osteoporosis may improve clinical prediction of bone strength changes and fracture risk.It is explained from the biomechanical view that the intertrochanteric femur and femoral neck are good sites for osteoporotic hip fractures.

Objective To address the radioactive contamination of wounds caused by transuranic nuclides, wound radiation imaging based on coded aperture imaging technology was investigated. Methods By simulating multiple source terms using Monte Carlo method, the differences in imaging performance between two image reconstruction algorithms under near-field conditions were compared. The effects of detector pixels and detection plane pixels on image resolution were investigated. Results The imaging system was simulated based on the designed dimensions. The simulated imaging field of view was 89.4 mm × 89.4 mm and the simulated angular resolution was 1.98°. Based on the comparison of the average width at half height of the reconstructed point sources under different conditions, it was found that increasing the number of pixels in the detector and detection plane optimized the angular resolution but significantly prolonged the Monte Carlo simulation time. Conclusion According to the simulation results, the parameters of the imaging system can be used to effectively image radioactive contamination. Our results provide methodological support for the measurement of wound contamination caused by transuranic nuclides, and lay the foundation for the development of wound contamination imaging detection systems in the future.