Objective To compare and analyze the application value of domestic Octoparms and imported Celect inferior vena cava filter(IVCF)in the interventional treatment of venous thromboembolism(VTE).Methods Forty patients with VTE were randomly divided into Octoparms group(experimental group)and Celect group(control group)according to the double-blinded method of the central random system.All the patients underwent filter placement,catheter-directed thrombolysis and filter retrieval.The primary end point was the success of filter placement and retrieval,and the secondary end point included indwelling complications such as the occurrence of pulmonary embolism(PE)and filter tilt and migration.Results Forty patients were enrolled in this study,22 patients and 18 patients were divided into the experimental group and the control group,respectively.Among them,11 cases were identified with right lower extremity deep vein thrombosis,29 cases with left lower extremity deep vein thrombosis,17 cases with PE,and 6 cases with inferior vena cava thrombosis.The success rate of IVCF placement was 100%in all participants.Immediately after filter place-ment,the angle of filter tilt was(3.8±2.3)° in the experimental group and(4.9±2.8)° in the control group(t=1.44,P=0.16).Filter retrieval was successful in 21 cases(21/22,95.5%)of the experimental group and 17 cases(17/18,95.5%)of the control group.There was no significant difference between the two groups(t=0.14,P=0.89).The mean indwelling time of filter was(8.0±2.1)days in the experimental group and(9.7±3.1)days in the control group(t=0.73,P=0.47).The angle of filter tilt was(5.3±3.4)° in the experimental group and(5.7±7.7)° in the control group(t=0.19,P=0.85).There was no significant difference for filter placement and retrieval between the two groups(t=0.48 and 2.00,P=0.06 and 0.64,respectively).There were no complications of filter migration,strut penetration or new PE in both groups.Conclusion The application value of domestic Octoparms and impor-ted Celect IVCF is similar in interventional treatment of VTE.

Objective:To investigate the feasibility and safety of distal radial artery approach in emergency percutaneous coronary intervention(PCI) of elderly ST-segment elevation myocardial infarction(STEMI) patients.Methods:This study is a cross-sectional study. Elderly patients with acute myocardial infarction who received emergency PCI at the Third Central Hospital of Tianjin from January 2020 to December 2022 were selected. They were divided into the distal radial artery group and the classic radial artery group based on the puncture location. The success rate, puncture time, surgical success rate, and surgical time of the two groups were observed; The incidence of complications in patients, including radial artery occlusion rate, radial artery spasm rate, local hematoma rate, aneurysm incidence rate were recorded.Results:There were 70 cases in the distal radial artery group, including 33 males (47.1%), aged (65.6±6.7) years old; There were 70 cases in the classic radial artery group, including 35 males (50.0%), aged (66.4±6.9) years old. There was no statistically significant difference in puncture success rate, puncture time, surgical success rate, and surgical time between the distal radial artery group and the classical radial artery group ( P>0.05). The incidence of radial artery occlusion in the distal radial artery group was significantly lower than that in the classical radial artery group (1.4% vs. 8.6%, P=0.024). The postoperative compression time in the distal radial artery group was significantly shorter than that in the classical radial artery group ((291.6±10.5) min vs. (343.5±9.8) min, P=0.047). There was no statistically significant difference in the incidence of radial artery spasm, local hematoma, and aneurysm between the two groups ( P>0.05). Conclusions:The distal radial artery approach has a lower radial artery occlusion rate, shorter compression time, and better safety. It can be used as a new approach for emergency PCI in elderly patients with STEMI for clinical application.

Objective To determine the effect of thrombus aspiration combined with intracoronary injection of recombinant human TNK tissue type plasminogen activator(rhTNK-tPA)on micro-circulation and cardiac function during primary PCI in elderly patients with acute myocardial in-farction(AMI).Methods A retrospective study was conducted on 90 elderly patients with STEMI undergoing primary PCI in Tianjin Third Central Hospital from January 2021 to October 2023.According to their treatment strategies,they were divided into simple suction group(n=46)and combination group(n=44).The suction group received a suction catheter for thrombus aspiration within the coronary artery,while the combined group got a suction catheter for thrombus aspira-tion within the infarct related blood vessels,and then received a local injection of rhTNK-tPA into the lesion through the suction catheter.Their general data,proportion of ST segment resolution(STR)≥70％at 90 min after surgery,postoperative TIMI blood flow grade,postoperative TIMI myocardial perfusion grade(TMPG),corrected TIMI frame count(CTFC)and cardiac ultrasound indicators as well as the incidence of adverse cardiac events during hospitalization were compared between the two groups.Results Larger proportions of postoperative STR ≥70％,postoperative TIMI blood flow grade 3 and TMPG grade 3,and lower CTFC were observed in the combination group than the suction group(P＜0.05).In 1 week after surgery,the simple suction group had lower left ventricular ejection fraction[LVEF,(52.5±6.2)％vs(58.3±6.4)％,P＜0.05],but larger left ventricular diameter(LVD,44.1±3.9 mm vs 51.9±2.5 mm,P＜0.05)than the com-bined group.The incidence of MACE during hospitalization was obviously lower in the combined group than the suction group(20.5％vs 37.0％,P＜0.05).Conclusion Combined intracoronary injection of rhTNK-tPA based on thrombotic aspiration can effectively reduce the coronary thrombus burden,improve myocardial microcirculation perfusion,reduce the incidence of MACE during hospitalization,and not increase the risk of bleeding in elderly STEMI patients.

Objective To investigate the impact of a peer support model on the mental health of caregivers and the perceived social support and psychiatric symptoms of the mental disorder patients under their care. Methods Patients with mental disorders undergoing long-term community-based rehabilitation and their primary caregivers were recruited for this study. A total of 44 pairs of eligible patients and caregivers were selected based on a 1∶1 matching ratio. Systematic peer support activities were conducted exclusively for the caregivers. The General Health Questionnaire (GHQ) and the Symptom Checklist-90 (SCL-90) were administered before and after the intervention to assess the mental health status of caregivers. The Perceived Social Support Scale (PSSS) and the Brief Psychiatric Rating Scale (BPRS) were employed to evaluate the patients' perceived social support and psychiatric conditions before and after the intervention. Results A total of 44 valid questionnaires from caregivers and 42 from patients were collected. The GHQ score and the total scores, the number of positive item, positive total scores, and positive mean scores of and SCL-90 of caregivers were significantly lower after the intervention compared to pre-intervention (P < 0.05 or P < 0.001). For patients, the family support score, extracurricular support score, and total score of the PSSS were significantly higher post-intervention compared to pre-intervention (P < 0.05 or P < 0.001). Compared to pre-intervention, patients'scores on anxiety and depression, lack of energy, thought disturbance, activation, hostility and suspicion, and the total score on the BPRS were significantly lower after the caregiver peer support intervention (P < 0.001). Conclusion The peer support model contributes to improving the mental health of caregivers for patients with mental disorders and enhancing the patients'psychiatric conditions.

Objective:To investigate the changes of liver volume and liver function in patients with extensive hepatic vein occluded Budd-Chiari syndrome (BCS) treated with transjugular intrahepatic portosystem shunt (TIPS).Methods:The clinical data of 29 BCS patients from Affiliated Hospital of Xuzhou Medical University during March 2016 to June 2019 were retrospectively collected and analyzed. The BCS was caused by extensive hepatic vein occlusion and patients were treated with TIPS. Pre- and postoperative abdominal CT/MRI images were collected and analyzed, and hepatic volume was measured with 3D-reconstruction. The liver volume and liver function during before and post the surgery were also collected and analyzed with preoperative value.Results:Patients including 8 males and 21 females, aged (33.3±6.3) years, were enrolled in this study. TIPS was successfully performed in all patients, with a technical success rate 100%. No serious complications related to TIPS occurred. Patients were followed up for 12-33 months (median, 16 months). Compared with preoperative [(2 124.6±420.9) cm 3] , the hepatic volume of time points after operation [1 week: (1 926.3±372.3) cm 3; 3 months: (1 480.6±183.1) cm 3; 6 months: (1 461.9±153.0) cm 3; 12 months: (1 469.3±148.5) cm 3] were all significantly reduced, and the differences were statistically significant ( P<0.05). Compared with preoperative values, the hepatic function indexes at each time point after operation were significantly improved ( P<0.05). The complete remission rate of ascites was 96.4% (27/28), 100.0% (28/28) and 100.0% (28/28) at 3, 6 and 12 months, respectively. Conclusion:The extensive hepatic vein occlusive BCS patients were benefit from TIPS therapy. Six months after operation, the hepatic volume and the hepatic function returned to normal level.

Repetitive transcranial magnetic stimulation(rTMS) is a painless and non-invasive method for stimulation and modulation in the field of cognitive neuroscience research and clinical neurological regulation. In this paper, adult Wistar rats were divided into the rTMS group and control group randomly. Rats in the rTMS group were stimulated with 5 Hz rTMS for 14 days, while the rats in the control group did not accept any stimulation. Then, the behavior and local field potentials (LFPs) were recorded synchronously when the rats perform a working memory (WM) task with T-maze. Finally, the time-frequency distribution and coherence characteristics of the LFPs signal in the prefrontal cortex (PFC) during working memory task were analyzed. The results showed that the rats in the rTMS group needed less training days to reach the task correction criterion than the control group (
Animals ; Memory, Short-Term ; Neurons ; Prefrontal Cortex ; Rats ; Rats, Wistar ; Transcranial Magnetic Stimulation

The precise resection and suture of bronchia, vascular and pulmonary tissue are the key techniques in thoracic surgery. Mechanical suture technique has gradually become a routine operation in thoracic surgery. However, at present, there is still a lack of consensus and guidelines on the application of this technique in thoracic surgery, neither strong evidence-based medical support. In this study, we discuss the application standard of mechanical suture technique in thoracoscopic surgery, irregular treatment techniques, intraoperative complications, and management principles to promote the standardized application of mechanical suture technique. We also explain the shortcomings of the technique in order to promote the further improvement and perfection.

The quality control of lung transplantation involves many aspects, such as team building, selection of recipients, preoperative diagnosis and evaluation of recipients, maintenance of brain-dead donors, evaluation and acquisition of donors, surgical operation, postoperative management and postoperative follow-up. Precision management is the core concept of operation quality control. Only by normalizing the operation quality control of lung transplantation to provide basic guarantee for multi-team cooperation and development of lung transplantation management in the future, building a complete lung transplantation database to excavate data resources and improve the quality of transplanta-tion, and comprehensively building a Chinese lung transplantation quality control system with multi-team participation and cooperation, can we improve the overall level of surgical diagnosis and treatment of lung transplantation in China.

Objective: To analyze effects of cooperation between physicians in department of burn surgery and department of intensive care medicine on rescue and treatment of severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident. Methods: On August 2nd, 2014, 15 extremely severe burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident were admitted to temporary burn treatment center established in Department of Critical Care Medicine of the Second Affiliated Hospital of Soochow University. The 15 patients were equally divided into 3 groups, with 5 patients in each group. Fifteen surgeons and 30 nurses from department of burn surgery and 15 physicians and 30 nurses from department of intensive care medicine from different hospitals in China were divided into 3 groups, with 5 physicians and 10 nurses from department of burn surgery and 5 physicians and 10 nurses from department of intensive care medicine in each group. Each group of physicians and nurses were responsible for treatment of 5 patients. Treatment of patients was leaded by surgeons from department of burn surgery, who were responsible for wound dealing and operation. Physicians from department of intensive care medicine were responsible for systemic treatment and adjustment of relevant equipment's parameters. Volume of fluid infusion and urine output in shock period, severe systemic complication during period of treatment, using time and kind of antibiotics, death in 1 month after admission, length of hospital stay, and survival of patients were monitored. Results: Volume of fluid infusion of 15 extremely severe burn patients within the first 24 hours post injury was 10 360-17 162 (12 998±1 811) mL, including (1.62±0.23) mL·% total body surface area (TBSA)^-1·kg^-1 electrolyte and colloid and (2 850±232) mL glucose, with electrolyte and colloid ratio of (1.76±0.23)∶1.00. Volume of urine output within the first 24 hours post injury was (2 384±1 242) mL, with (99±52) mL in each hour. Volume of fluid infusion of 15 extremely severe burn patients within the second 24 hours post injury was 8 720-11 616 (9 406±1 277) mL, including (1.04±0.22) mL·%TBSA^-1·kg^-1 electrolyte and colloid and (2 910±187) mL glucose, with electrolyte and colloid ratio of (1.53±0.31)∶1.00. Volume of urine output within the second 24 hours post injury of patients was (2 299±1 362) mL , with (108±61) mL in each hour. One patient had pulmonary infection, and 7 patients had fungal infection, and no patient had gut microbiota dysbiosis. Patients were treated with combined 2 kinds of antibiotics for 21-85 (50±16) d. No patient died within 1 month after admission. The length of hospital stay was 53-132 (98±44) d. Ten patients survived finally. Conclusions After being treated by cooperation between physicians in department of burn surgery and department of intensive care medicine, severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident had hemodynamic stability and could stably experience shock period, with less complication, shorter length of hospital stay, no death within 1 month after admission, more survived patients, which can provide reference for rescue and treatment of severe mass burn patients.

Objective To evaluate the clinical effect of reduced glutathione in protecting the liver function for patients with hepatocellular carcinoma (HCC) after receiving international therapy.Methods The clinical data of 110 HCC patients,who were admitted to authors' hospital during the period from January 2010 to June 2013,were retrospectively analyzed.According to the random number table method the patients were divided into the control group (n=50) and the treatment group (n=60),and transcatheter arterial chemoembolzation (TACE) and transcatheter arterial infusion (TAI) were carried out in all patients.After the treatment,intravenous infusion of 2.0 g vitamin C,0.2 g vitamin B6,2.0 g inosine,and 250 ml branched chain amino acid was employed per day for one week for the patients of both groups,and additional intravenous dripping of 1.8 g reduced glutathione (added in 250 ml of 5％ glucose solution) was adopted for the patients of the treatment group.Various liver function indexes were tested before and one week after the treatment,the results were compared between the two groups.Results Before the treatment,no obvious differences in the hepatic functions and in the clinical condition existed between the two groups.One week after the treatment,in both groups the aminotransferase (ALT and AST) and total bilirubin (TBIL) were significantly increased when compared with the preoperative data (P＜0.05),while the serum pre-albumin (PA) was remarkably decreased when compared with the preoperative data (P＜0.05);these changes of various indexes in the treatment group were apparently better than those in the control group (P＜0.05).Conclusion The use of reduced glutathione can effectively relieve the liver function damage caused by interventional therapy in HCC patients,therefore,reduced glutathione has a very good clinical application value.