Efficacy of prone positioning ventilation in acute respiratory distress syndrome after acute Stanford type A aortic dissection surgery / 中国胸心血管外科临床杂志

@#Objective     To explore the efficacy of prone positioning ventilation in patients with acute respiratory distress syndrome (ARDS) after acute Stanford type A aortic dissection (STAAD) surgery. Methods     From November 2019 to September 2021, patients with ARDS who was placed prone position after STAAD surgery in the Xiamen Cardiovascular Hospital of Xiamen University were collected. Data such as the changes of blood gas, respiratory mechanics and hemodynamic indexes before and after prone positioning, complications and prognosis were collected for statistical analysis. Results    A total of 264 STAAD patients had surgical treatment, of whom 40 patients with postoperative ARDS were placed prone position. There were 37 males and 3 females with an average age of 49.88±11.46 years. The oxygen partial pressure, oxygenation index and peripheral blood oxygen saturation 4 hours and 12 hours after the prone positioning, and 2 hours and 6 hours after the end of the prone positioning were significantly improved compared with those before prone positioning ventilation (P<0.05). The oxygenation index 2 hours after the end of prone positioning which was less than 131.42 mm Hg, indicated that the patient might need ventilation two or more times of prone position. Conclusion     Prone position ventilation for patients with moderate to severe ARDS after STAAD surgery is a safe and effective way to improve the oxygenation.

Clinical effect of cross positioning method for correcting low and moderate astigmatism during small incision lenticule extraction / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the clinical outcomes of using the cross-positioning method for correcting low and moderate astigmatism during small incision lenticule extraction(SMILE)surgery with Alpins vector analysis.METHODS: A total of 50 patients(81 eyes)with low and moderate astigmatism with the rule ≤1.50 D who underwent SMILE surgery at the laser myopia treatment center of Xi'an No.1 Hospital from May 2022 to November 2022 were included in the prospective randomized controlled study, and they were divided into two groups according to the random table, with 25 case(41 eyes)in cross-positioning group and 25 cases(40 eyes)in control group. In the cross-positioning group, the patients' head position was adjusted based on the cross intersection lines before the standard SMILE procedure, aligning the lateral canthi with the horizontal line and the midpoint of the eyebrows and the nose bridge with the vertical line. Postoperative visual acuity and refractive results at 3 mo were observed in both groups, and astigmatic changes were analyzed and evaluated using the Alpins vector analysis method.RESULTS: During the follow-up period, 6 cases(11 eyes)in the cross-positioning group were lost to follow-up, while in the control group, 8 cases(14 eyes)were lost to follow-up, with 19 cases(30 eyes)and 17 cases(26 eyes)finally included in the cross-positioning group and the control group, respectively. At 3 mo postoperatively, the uncorrected visual acuity(UCVA)of both groups' operated eyes was ≥1.0, and no serious complications occurred, with no significant differences in UCVA, best corrected visual acuity(BCVA), spherical power, and spherical equivalent between the cross-positioning group and the control group(all P&#x0026;#x003E;0.05). The cylindrical power in the cross-positioning group was 0.00(0.00, 0.00)D, which was lower than -0.13(-0.50, 0.00)D in the control group(P=0.01). The vector analysis results showed that the difference vector(DV)in the cross-positioning group was lower than that in the control group [0.00(0.00, 0.00)vs 0.13(0.00, 0.50), P=0.01], and the index of success(IOS)was better than that of the control group [0.00(0.00, 0.00)vs 0.18(0.00, 0.77), P&#x0026;#x003C;0.01]. At 3 mo postoperatively, 26(87%)and 15(58%)eyes in the cross-positioning group and control groups achieved an angle of error(AE)within ±5°, respectively.CONCLUSION: The cross positioning method was used to calibrate the patients' head position during SMILE surgery, which reduced the axial position error and improved the accuracy of SMILE in correcting low and moderate astigmatism.

Precise Clinical Positioning of Chinese Patent Medicine in Paradigm of "Target Spectral Effect of Prescription"： A Case Study of Qizhi Tongluo Capsules / 中国实验方剂学杂志

The clinical value of Chinese patent medicine is the core direction of the development of the traditional Chinese medicine industry. The precise clinical positioning determines the way to prove the value of the drug， and is a key link to highlight the clinical value. This paper presented a case study of clinical positioning for Chinese patent medicine， namely Qizhi Tongluo capsules， and the key technical framework of precise clinical positioning of Chinese patent medicine， which was manifested as a comparison of prescription target spectral effect， discovery of core value of prescription， and confirmation of clinical positioning trial. The technical framework was designed to address a range of issues in the realm of precise clinical positioning. Before the clinical positioning trial， based on the multi-component， multi-target， and multi-phenotype data of prescription and clinical indication， the multi-omics network analysis technology was used to identify the core value of the traditional Chinese medicine varieties and predict the potential clinical advantages. Then， based on the predicted clinical advantages， reasonable efficacy indicators were selected， and the clinical efficacy was judged and verified by dynamic and flexible innovative clinical trials to improve the success rate of clinical positioning. This research paradigm integrates "omics technology" with "evidence-based" principles and follows the "precise evidence-based" concept. This research aims to provide a new strategy and method for the precise medication and positioning of Chinese patent medicine with traditional Chinese medicine characteristics after being put into the market and provide more technical thinking for traditional Chinese medicine to move towards precise medicine.

Clinical application of perforator vessel location guide plate for fibular musculocutaneous flaps / 口腔疾病防治

Objective@#Based on 3D printing technology, explore the precision of a perforator vessel location guide plate for fibular musculocutaneous flaps before the transplantation of fibular osteocutaneous flaps and evaluate its application effects.@*Methods@#This study was reviewed and approved by the ethics committee, and informed consent was obtained from the patients. From May 2019 to October 2022, 14 patients with jaw defects who needed to undergo fibular perforator flap transplantation at the First Affiliated Hospital of Xinjiang Medical University were selected. For the seven patients in the guide plate group, CTA was combined with Mimics software to reconstruct both lower limbs, and the perforator vessel positioning guide for locating perforator vessels was designed; the two ends of the guide plate were designed as fixed ends, with the upper end fixed to the knee joint and the lower end fixed to the ankle joint, and the guide plate was fabricated by a 3D printer. For the seven patients in the control group, a conventional handheld Doppler probe was used for perforator vessel location. The average operation time, bleeding volume, recovery time, deviation of perforator vessel location, postoperative flap-related complications, postoperative donor site shape satisfaction, and lower extremity functional scale (LEFS) score were recorded. SPSS 25.0 software was used for statistical analysis.@*Results@#The average operation time, bleeding volume, recovery time, deviation of perforator vessel location and postoperative donor site shape satisfaction were significantly better in the guide plate group than in the control group (P<0.05); moreover, the differences in postoperative flap-related complications and LEFS scores were not statistically significant (P>0.05).@*Conclusion@#Based on 3D printing technology, fibular musculocutaneous flap perforator vessels can be more accurately located using a guide plate and the knee and ankle as fixed points, and this method can effectively stabilize the guide position, prevent soft tissue offset, and improve positioning accuracy and thus deserves to be generalized.

Efficacy of bronchoalveolar lavage combined with prone positioning in children with Mycoplasma pneumoniae pneumonia and atelectasis: a prospective randomized controlled study / 中国当代儿科杂志

OBJECTIVES@#To study the efficacy of bronchoalveolar lavage (BAL) combined with prone positioning in children with Mycoplasma pneumoniae pneumonia (MPP) and atelectasis and its effect on pulmonary function.@*METHODS@#A prospective study was conducted on 94 children with MPP and atelectasis who were hospitalized in Ordos Central Hospital of Inner Mongolia from November 2020 to May 2023. The children were randomly divided into a treatment group and a control group, with 47 children in each group. The children in the treatment group were given conventional treatment, BAL, and prone positioning, and those in the control group were given conventional treatment and BAL. The two groups were compared in terms of fever, pulmonary signs, length of hospital stay, lung recruitment, and improvement in pulmonary function.@*RESULTS@#Compared with the control group, the treatment group had significantly shorter time to improvement in pulmonary signs and length of hospital stay and a significantly higher rate of lung recruitment on day 7 of hospitalization, on the day of discharge, and at 1 week after discharge (P<0.05). Compared with the control group, the treatment group had significantly higher levels of forced vital capacity (FVC) as a percentage of the predicted value, forced expiratory volume (FEV) in 1 second as a percentage of the predicted value, ratio of FEV in 1 second to FVC, forced expiratory flow at 50% of FVC as a percentage of the predicted value, forced expiratory flow at 75% of FVC as a percentage of the predicted value, and maximal mid-expiratory flow as a percentage of the predicted value on the day of discharge and at 1 week after discharge (P<0.05). There was no significant difference in the time for body temperature to return to normal between the two groups (P>0.05).@*CONCLUSIONS@#In the treatment of children with MPP and atelectasis, BAL combined with prone positioning can help to shorten the time to improvement in pulmonary signs and the length of hospital stay and promote lung recruitment and improvement in pulmonary function.

Risco de Desenvolvimento de Lesão em Decorrência de Posicionamento Cirúrgico: Estudo Observacional / Risk of Injury Development Due to Surgical Positioning: an Observational Study / Riesgo de Desarrollo de Lesiones Debido al Posicionamiento Quirúrgico: Estudio Observacional

Objetivo:Classificar o risco de desenvolvimento de lesão por posicionamento cirúrgico. Método: Estudo observacional, longitudinal, prospectivo, de abordagem quantitativa realizado em hospital público, com 135 pacientes submetidos à cirurgia eletiva. Utilizaram-se instrumentos contendo caracterização sociodemográfica, clínica e cirúrgica e escala de avaliação de risco para desenvolvimento de lesões decorrentes do posicionamento cirúrgico. Empregaram-se análise descritiva, teste exato de Fisher ou teste χ2 e a medida de associação odds ratio, conforme apropriado. Resultados: A maioria dos participantes era do sexo masculino (51,11%), adulta (52,59%) e foi classificada como maior risco para o desenvolvimento de lesões por posicionamento cirúrgico (51,85%). Ser idoso, hipertensão, diabetes mellitus e cirurgias urológicas foram estatisticamente significativos (p < 0,05) para maior risco de desenvolvimento de lesões. A incidência de lesão por pressão foi de 0,74%, com observação apenas na região sacra. Conclusão: Verificou-se maior risco para desenvolvimento de lesão em decorrência do posicionamento cirúrgico e baixa incidência de lesão por pressão. A enfermagem perioperatória deve incorporar à prática assistencial ferramentas validadas de mensuração de risco para um cuidado seguro, individualizado e de qualidade aos pacientes cirúrgicos.

Objective:To classify the risk of developing injury due to surgical positioning. Method: Observational, longitudinal, prospective study with a quantitative approach carried out in a public hospital, with 135 patients undergoing elective surgery. Instruments containing sociodemographic, clinical, and surgical characteristics and a risk assessment scale for the development of injuries due to surgical positioning were used. Descriptive analysis, Fisher's exact test or χ2 test and odds ratio association measure were used as appropriate. Results: Most participants were male (51.11%), adults (52.59%) and were classified as having a higher risk for developing injuries due to surgical positioning (51.85%). Elderly, hypertension, diabetes mellitus and urological surgeries were statistically significant (p < 0.05) for a higher risk of developing lesions. The incidence of pressure injuries was 0.74%, with observation only in the sacral region. Conclusion: There was a greater risk of developing lesions due to surgical positioning and low incidence of pressure injury. Perioperative nursing should incorporate validated risk measurement tools into care practice for safe, individualized and quality care for surgical patients,

Objetivo:Clasificar el riesgo de desarrollar lesión por posicionamiento quirúrgico. Método: Estudio observacional, longitudinal, prospectivo, con abordaje cuantitativo, realizado en un hospital público, con 135 pacientes sometidos a cirugía electiva. Se utilizaron instrumentos que contenían características sociodemográficas, clínicas y quirúrgicas y una Escala de Evaluación de Riesgo para el Desarrollo de Lesiones por Posicionamiento Quirúrgico. Se utilizó el análisis descriptivo, la prueba exacta de Fisher, o chi-cuadrado y la medida de asociación odds ratio, según corresponda. Resultados: La mayoría de los participantes eran hombres (51,11 %), adultos (52,59 %) y se clasificaron con mayor riesgo de desarrollar lesiones debido al posicionamiento quirúrgico (51,85 %). Ancianos, hipertensión, diabetes mellitus y cirugías urológicas fueron estadísticamente significativos (p ˂ 0,05) para mayor riesgo de desarrollar lesiones. La incidencia de lesiones por presión fue del 0,74%, observándose solo en la región sacra. Conclusión: Hubo un mayor riesgo de desarrollar lesiones debido al posicionamiento quirúrgico y una baja incidencia de lesión presión. La enfermería perioperatoria debe incorporar herramientas validadas de medición del riesgo en la práctica asistencial para una atención segura, individualizada y de calidad a los pacientes quirúrgicos.

Quem Pode Falar no Divã? Raça e Psicanálise Situada / Who can Speak on the Couch? Race and Situated Psychoanalysis / ¿Quién Puede Hablar en el Diván? Raza y Psicoanálisis Situado

Quem pode falar no divã? Como a inscrição do sujeito e do sujeito do inconsciente em relações sociais de poder de classe, gênero, sexualidade, raça, idade, validade, limita o acesso a uma elaboração analítica? O reconhecimento da colonialidade, como efeito de dominação e lugar de enunciação que persiste além da colonização, tornou possível a emergência de novas formas subjetivas, culturais e epistêmicas, incentivando a psicanálise a escutar de outra forma. Este artigo propõe se debruçar sobre a incidência da raça e da branquitude na psicanálise a partir das epistemologias do posicionamento e da epistemologia da ignorância. No contexto social francês, enquanto uma parte crescente da população francesa experimenta diariamente a discriminação racial, essa é veementemente negada por uma maioria de político·as e pesquisadore·as, que recusam até o uso da palavra "raça". A partir dessa negação oficial do racismo sistémico pelo poder político e por uma maioria de estudos acadêmicos, o artigo tenta analisar a epistemologia da ignorância que prevalece na postura clínica e teórica de uma psicanálise maioritária. Trata-se de estudar a forma como uma ignorância branca provoca uma desescuta das questões de raça no divã, produz efeitos transferenciais de silenciamento, e nega vivências particulares em nome do universalismo.

Who can speak on the couch? How does the inscription of the subject and the subject of the unconscious in class, gender, sexuality, race, age and validity social power relations limit access to a psychoanalytical elaboration? The recognition of coloniality as an effect of domination and a locus of enunciation that persists beyond colonisation has made it possible for new subjective, cultural and epistemic forms to emerge, encouraging psychoanalysis to listen differently. This article looks at the impact of race and whiteness on psychoanalysis through the perspective of the Standpoint Epistemologies and the Epistemology of Ignorance. In the French social context, while a growing part of the French population experiences racial discrimination on a daily basis, it is vehemently denied by a majority of politicians and researchers, who refuse to even use the word "race". Starting from this official denial of systemic racism by the political establishment and a majority of academic studies, the article seeks to analyse the epistemology of ignorance that prevails in the clinical and theoretical stance of a majoritian psychoanalysis. The aim is to study the way in which white ignorance causes race issues to be non-listened to on the couch produces silencing transferential effects, and denies particular experiences in the name of universalism.

¿Quién puede hablar en el diván? ¿Cómo la inscripción del sujeto y del sujeto del inconsciente en las relaciones sociales de poder de clase, género, sexualidad, raza, edad, validez, limitan el acceso a una elaboración analítica? El reconocimiento de la colonialidad como un efecto de dominación y un lugar de enunciación que persiste más allá de la colonización ha posibilitado la emergencia de nuevas formas subjetivas, culturales y epistémicas, impulsionando al psicoanálisis a escuchar de otra manera. Este artículo examina el impacto de la raza y la blanquitud en el psicoanálisis desde la perspectiva de las epistemologías del posicionamiento y la epistemología de la ignorancia. En el contexto social francés, mientras que una parte creciente de la población francesa experimenta a diario la discriminación racial, ésta es negada con vehemencia por una mayoría de políticos/as e investigadores/as, que se niegan incluso a utilizar la palabra "raza". Partiendo de esta negación oficial del racismo sistémico por parte del poder político y de una mayoría de estudios académicos, el artículo intenta analizar la epistemología de la ignorancia que prevalece en la postura clínica y teórica de un psicoanálisis mayoritario. El objetivo es estudiar el modo en que la ignorancia blanca hace que las cuestiones raciales sean des-escuchadas en el diván, produce efectos transferenciales de silenciamiento y niega las experiencias particulares en nombre del universalismo.

O efeito da polarização política na crença em notícias falsas / The effect of political polarization on belief in fake news

A polarização política pode ser entendida como o afastamento severo de grupos com pensamentos e sentimentos opostos aos do seu grupo político. No cenário brasileiro, a polarização está presente em diversos contextos, principalmente no contexto político e pode ser capaz de influenciar o endosso de notícias falsas. Buscando entender as fake news em um contexto de polarização política, o presente artigo buscou avaliar a relação entre a polarização política e a crença em notícias falsas, tanto de esquerda quanto de direita. Para tanto, 211 participantes responderam um questionário contendo quatro instrumentos distintos: termômetro de sentimentos; avaliação de notícias; posicionamento político; e suscetibilidade às notícias falsas. Os resultados indicaram que os indivíduos tendem a acreditar em notícias falsas do seu próprio grupo político, embora participantes de direita apresentem uma maior tendência de endossar fake news em comparação com participantes de esquerda. De maneira geral, verificou-se que a polarização política afeta o endosso de fake news. Implicações para compreensão e combate às fake news são discutidas.

Political polarization can be understood as the strong alienation of groups with thoughts and feelings opposite to those of their political group. In the Brazilian scenario, polarization is present in different contexts, especially in the political context and can influence the endorsement of fake news. Seeking to understand fake news in the context of political polarization, the present article sought to evaluate the relationship between political polarization and belief in fake news, both on the left and on the right. To this end, 211 participants completed a questionnaire that included four different instruments: mood thermometer; news rating; political positioning; and susceptibility to fake news. The results indicate that individuals tend to believe fake news from their own political group, although participants from the right-wing participants are more likely to endorse fake news than participants to left-wing participants. Overall, political polarization was found to affect the endorsement of fake news. Implications for understanding and combating fake news are discussed.

Nursing Care Related with Surgical Position / Cuidados de enfermería relacionados con la posición quirúrgica / Cuidados de enfermagem relacionados à posição cirúrgica

The patient's correct position is necessary to conduct a safe and effective surgical procedure. This position depends on the access route, duration of the procedure, kind of anesthesia, devices to use, among other factors. This procedure requires planning and effort by the surgical team where they share responsibility to establish and maintain the correct positions for patients. Each surgical position fulfills an objective and implies risks to patients, which is why nursing professionals must be very attentive to provide the necessary care and ensure reliable practices in each position during the perioperative, the importance of the documentation, and the NANDA, NIC, and NOC taxonomy to consider.

La correcta posición del paciente es necesaria para el desarrollo de un procedimiento quirúrgico seguro y eficaz. Esta posición depende de la vía de acceso, la duración del procedimiento, el tipo de anestesia, los dispositivos a utilizar entre otros factores. Este procedimiento requiere planeación y esfuerzo del equipo quirúrgico donde se comparten responsabilidad para establecer y mantener las posiciones correctas para los pacientes. Cada posición quirúrgica cumple un objetivo e implica un riesgo para el paciente, por lo que los profesionales de enfermería deben estar muy atentos para brindar los cuidados necesarios y asegurar prácticas confiables en cada posición durante el perioperatorio, la importancia de la documentación y la taxonomía NANDA, NIC y NOC a tener en cuenta.

A posição correta do paciente é necessária para o desenvolvimento de um procedimento cirúrgico seguro e eficaz. Essa posição depende da via de acesso, da duração do procedimento, do tipo de anestesia, dos aparelhos a serem utilizados, entre outros fatores. Este procedimento requer planejamento e esforço da equipe cirúrgica onde a responsabilidade é compartilhada para estabelecer e manter as posições corretas dos pacientes. Cada posição cirúrgica cumpre um objetivo e implica um risco para o paciente, por isso os profissionais de enfermagem devem estar muito atentos para prestar os cuidados necessários e garantir práticas confiáveis em cada posição durante o período perioperatório, a importância da documentação e taxonomia NANDA, NIC e NOC para levar em conta.

Distocia de hombros: propuestas de resolución de acuerdo con las diferentes posiciones de parto según la movilidad de la pelvis

Introducción. La distocia de hombros es una complicación del parto vaginal que se produce por dificultad en el parto de los hombros fetales. Puede desencadenarse en forma impredecible e imprevista, por lo que debería ser considerada como riesgo potencial de todo nacimiento. La mayoría de las recomendaciones sobre las maniobras de resolución de distocia de hombros lo hacen desde la posición de litotomía y sin considerar los movimientos intrínsecos de la pelvis durante el parto. Objetivos. Analizar las maniobras de resolución de distocia de hombros a partir del conocimiento de la biomecánica de la pelvis y su relación con los hombros fetales, teniendo en cuenta las diferentes posiciones de parto. Métodos. Revisión bibliográfica no sistematizada. Resultados. Ante la distocia del hombro anterior, si la gestante se encuentra en litotomía podría recomendarse la maniobra de McRoberts con presión suprapúbica seguida de la extracción del brazo posterior. Si la gestante se encuentra en posición vertical, se sugiere pasar a posición de cuatro apoyos y una variante original resultado del análisis de los movimientos de la pelvis llamada 'cuatro apoyos en asimetría'. Esta puede ser realizada desde cualquier posición, no es invasiva y requiere un mínimo de entrenamiento. Conclusiones. La resolución de distocia de hombros no posee un único algoritmo; dependerá del tipo de distocia, la posición de la gestante, el contexto y la mayor o menor habilidad de una maniobra sobre otra. La postura de Gaskin y cuatro apoyos en asimetría debería ser tenida en cuenta antes de realizar maniobras internas para la resolución de la distocia de hombros.

Introduction: Shoulder dystocia is a complication of vaginal delivery caused by a difficulty in delivering the fetal shoulders. It can be triggered in an unpredictable and unplanned manner, so it should be considered as a potential risk for every vaginal birth. Most of the recommendations on shoulder dystocia resolution maneuvers are made from the lithotomy position and without considering the intrinsic movements of the pelvis during labor. Objectives : To analyze the maneuvers for resolving shoulder dystocia based on knowledge of the biomechanics of the pelvis and its relationship with the fetal shoulders, considering the different birthing positions. Methods: Non-systematized bibliographic review. Results : In the case of anterior shoulder dystocia, the McRoberts maneuver with suprapubic pressure followed by extraction of the posterior arm could be recommended for a birthing woman in lithotomy position. If the birthing woman is in an upright position, it is suggested to move to the four-support position and an original variant resulting from the analysis of the biomechanics of the pelvis called 'four-lying in asymmetry'. These maneuvers are non-invasive techniques, require minimal training and resources, and can be performed from any childbirth position. Conclusions : The resolution of shoulder dystocia does not have a single algorithm; it will depend on the type of dystocia, the position of the birthing woman, the context, and the greater or lesser ability of one maneuver over another. Gaskin maneuver and four supports in asymmetry should be considered before performing internal maneuvers for the resolution of shoulder dystocia.

Analysis of accreditation results and development strategies of tertiary hospitals in Jiangsu province from 2018 to 2020 / 中华医院管理杂志

As an important measure starting for hospital management, hospital accreditation can effectively guide hospitals to improve their comprehensive service capabilities and management level. The accreditation results of 38 tertiary general hospitals in Jiangsu province from 2018 to 2020 showed that there were weaknesses existing in the development of hospitals, including the radiosity and influence of tertiary hospitals, patient service mode, construction of medical technology capabilities and disciplines, medical quality and safety, nursing quality management and specialized nursing, and information construction. The author suggested that hospitals should return to functional positioning, improve the service quality, strengthen construction of hospital disciplines and technical projects, consolidate the foundation of quality and safety management, improve the level of information technology construction, for references for promoting the high-quality sustainable development of tertiary general hospitals.

Pure single-port lumpectomy non-lipolysis breast-conserving surgery in the treatment of early-stage breast cancer / 中华内分泌外科杂志

Objective:To summarize the clinical data and experience of pure single-port lumpectomy non-lipolysis breast-conserving surgery (PSLN-BCS) in patients with early-stage breast cancer.Methods:A retrospective analysis was conducted on 400 patients who underwent breast-conserving surgery for early-stage breast cancer in the Second Department of Breast Surgery at Harbin Medical University Cancer Hospital from Jan. 2022 to Jan. 2023. Patients were divided into two groups: PSLN-BCS group ( n=200) and conventional breast-conserving surgery (C-BCS) group ( n=200). The surgical time, intraoperative blood loss, postoperative drainage within three days, and short-term (3 months to 6 months after surgery) complications, including the incidence of residual fluid after drain removal and incision infection were observed. Long-term (6 months after surgery) complications, including the incidence of skin and pectoralis major muscle adhesions in the surgical area and cosmetic results after breast-conserving surgery, were also evaluated. Statistical analysis was performed using R language, and quantitative data were expressed as mean ± standard deviation ( ± s) and analyzed using t-test, while count data were analyzed using χ2 test. A p-value less than 0.05 was considered statistically significant. Results:PSLN-BCS had a longer average surgical time than C-BCS (198.341min vs 62.961min, P<0.001, 95% CI:132.028 vs 138.732). PSLN-BCS had less intraoperative bleeding (18.824 ml vs 22.627 ml, P=0.003, 95% CI: -6.294 vs -1.311) and lower postoperative drainage volume (346.157 ml vs 406.191 ml, P<0.001, 95% CI: -70.571-a-49.496). There were no significant differences in short-term postoperative complications such as subcutaneous fluid accumulation ( χ2=2.33, P=0.127) or incisional infection ( χ2=0.14, P=0.708) between the two groups. The incidence of skin and muscle adhesions in the surgical area was lower in patients who underwent PSLN-BCS at 6 months postoperatively ( χ2=11.58, P<0.001). Patients who received PSLN-BCS achieved better cosmetic outcomes, with a statistically significant difference ( χ2=273.00, P<0.001) compared to those who received C-BCS. Conclusion:Pure single-port lumpectomy non-lipolysis breast-conserving surgery is a safe and effective treatment option for early-stage breast cancer and can be considered as a surgical option for patients with cosmetic requirements.

Analysis of the efficacy of 3D printing-assisted hematoma puncture and drainage in the treatment of hypertensive intracerebral hemorrhage and the factors of postoperative brain dysfunction / 国际外科学杂志

Objective:To observe the efficacy of 3D printing-assisted hematoma puncture and drainage in the treatment of hypertensive intracerebral hemorrhage and to explore the factors affecting postoperative brain dysfunction.Methods:A retrospective Case-control study was conducted to select 168 hypertensive intracerebral hemorrhage patients who were treated with 3D printing assisted hematoma puncture and drainage in the People′s Hospital of Yuechi County from January 2020 to September 2022 as the observation group, and 125 hypertensive intracerebral hemorrhage patients who were treated with CT guided hematoma puncture and drainage in the People′s Hospital of Yuechi County at the same time as the control group. The clinical efficacy of the two groups of patients was compared. According to the occurrence of postoperative brain dysfunction, the patients in the observation group were divided into normal brain function group ( n=121) and brain dysfunction group ( n=47). The clinical data of age, preoperative cerebral hernia, blood loss, ventilator-assisted ventilation, postoperative Glasgow coma index score (GCS) and postoperative complications were compared between the two groups. Multivariate Logistic regression was used to analyze the factors affecting postoperative brain dysfunction in the observation group, and a line chart model was constructed and its predictive efficiency was evaluated. The measurement data of normal distribution is expressed as mean ± standard deviation ( ± s), and independent sample t-test is used for inter group comparison. Chi-square test was used for comparison between count data groups. Results:The proportion of the drainage tube in the hematoma, hematoma clearance rate at 3 and 7 days after surgery, total effective rate of treatment, and GCS score at 1 week after surgery in the observation group were 88.69%(149/168), 54.17%(91/168), 96.43%(162/168), 92.86%(156/168), and 10.72±3.45, respectively, the control group was 75.20%(94/125), 36.80%(46/125), 81.60%(102/125), 76.80%(96/125), and 9.08±3.22, respectively, the difference between the two groups was statistically significant ( P<0.05). Advanced age ( OR=1.983, 95% CI: 1.169-2.732, P=0.017), preoperative cerebral hernia ( OR=1.532, 95% CI: 1.113-2.139, P=0.029), bleeding volume ≥ 50 mL ( OR=2.538, 95% CI: 1.802-3.347, P=0.003), postoperative GCS score 3-5 ( OR=2.874, 95% CI: 2.265-3.449, P<0.001), postoperative hypoxemia ( OR=2.251, 95% CI: 1.673-2.842, P=0.010) and postoperative chronic hydrocephalus ( OR=1.642, 95% CI: 1.214-2.021, P=0.022) were risk factors for postoperative brain dysfunction, while ventilator-assisted ventilation ( OR=0.656, 95% CI: 0.132-0.828, P=0.038) was protective factors. The internal verification of the line chart model by Bootstrap resampling method shows that the model has high differentiation, accuracy and validity. Conclusion:The application of 3D printing-assisted localization in hematoma puncture and drainage can improve the puncture condition and the hematoma clearance rate and clinical effect of patients with hypertensive intracerebral hemorrhage. Advanced age, preoperative cerebral hernia and bleeding volume are related to postoperative brain dysfunction. Clinical attention should be paid to patients with risk indicators of postoperative brain dysfunction.

Application of body surface markers localization in totally implantable venous access port implantation via internal jugular vein approach / 国际外科学杂志

Objective:To investigate the feasibility of using body surface marker localization method to determine the correct position of catheter tip (lower 1/3 of the superior vena cava or the junction of superior vena cava and right atrium) in totally implantable venous access port (TIVAP) implantation via internal jugular vein approach.Methods:The clinical data of 220 patients who underwent TIVAP implantation in Beijing Tongren Hospital, Capital Medical University from June 2019 to June 2021 were retrospectively analyzed. Among them, 168 patients used the internal jugular vein approach. According to the method implemented for determining the length of central venous catheter (CVC) during the operation, the patients were divided into two groups: 136 patients using the body surface marker localization method were defined as the study group; and the remaining 32 cases treated by the intraoperative X-ray fluoroscopic localization method were defined as the control group. The difference in the excellent or good rate of CVC tip position immediately after implantation and the time of implantation was compared between the two groups. In addition, the correlation between the length of CVC indwelling, height, age, and the distance between the catheter tip and tracheal carina was analyzed for the patients with right and left internal jugular vein catheterization. Kolmogorov-Smirnov test was used for statistical distribution of measurement data. Normal distribution of measurement data was expressed as mean ± standard deviation ( ± s), independent sample t-test was used for comparison between groups. Chi-square test was used for comparison between counting data. With TIVAP catheter indenture length as dependent variable and height as independent variable, Pearson correlation analysis was performed, the relationship equation between ideal catheter indenture length and patient height was analyzed by unitary linear regression. Results:When the CVC tip was located at the second intercostal space, the third sternocostal joint and the third intercostal space, the corresponding probability of being in the correct position was 34.8%, 83.3% and 95.0% respectively. The third sternocostal joint or the third intercostal space had a higher probability of correct CVC tip location than the second intercostal space, and the difference were statistically significant ( P<0.001). Furthermore, there was no significant difference in the possibility of the CVC tip located in the correct position between the third sternocostal joint and the third intercostal space ( P=0.149). Compared with the control group (before adjusting catheter position), the proportion of excellent or good CVC position in the study group was significantly improved (94.1% vs 46.9%), and the difference was statistically significant ( χ2=41.99, P<0.001); while the total operation time was significantly shortened [(33.04±6.69) min vs (42.50±5.54) min], and the difference was statistically significant ( P<0.05). There was a linear correlation between the length of CVC insertion and height. Indwelling catheter length via right internal jugular vein approach (cm) =0.159× height (cm)-1.284 ( r=0.597, r2=0.356, P<0.001); length of catheter indwelling through the left approach (cm) =0.097× height (cm) + 12.139 ( r=0.322, r2=0.104, P=0.020). Conclusions:The third sternocostal joint or the third intercostal space would be the corresponding correct surface landmark of the CVC tip when the body surface marker localization method was adopted during the TIVAP implantation via the internal jugular vein approach. Compared with the intraoperative X-ray fluoroscopy localization, the operation time is significantly shortened with the application of the body surface marker localization method. This technique is simple and easy to master and has high reliability in determining the length of catheter and the position of CVC tip.

Clinical application of a digital positioning guide template during the extraction of maxillary wholly impacted supernumerary teeth / 口腔疾病防治

Objective@#To evaluate the clinical efficacy of positioning guide templates for maxillary wholly impacted supernumerary teeth to provide technological solutions for clinical applications. @*Methods @#After approval by the hospital ethics committee and informed consent given by the patients. Data from 136 patients with maxillary wholly impacted supernumerary teeth from January 2016 to April 2022 were analyzed retrospectively. The patients were divided into two groups according to the usage of the positioning guide template. The experimental group included patients using the positioning guide template (71 cases), and the control group did not use the positioning guide template (65 cases). The operation time and complications were statistically analyzed to evaluate the clinical efficacy after surgery. @*Results @# All operations were successfully completed. The average operation time in the experimental group was (21.5 ± 3.4) min, significantly shorter than that in the control group (27.2 ± 4.9) min. There were statistically significant differences between the experimental and control groups (t = 7.599, P<0.001). One week after the operation, there were no complications in the experimental group, and there were 2 cases of adjacent tooth injury and 3 cases of gingival numbness in the control group.@* Conclusion @# A digital positioning guide template can effectively shorten the time of maxillary wholly impacted supernumerary teeth extraction and is an effective means to assist clinical maxillary wholly impacted supernumerary teeth extraction.

Theory and application of pulse diagnosis at Renying and Cunkou regions / 中国针灸

Renying and Cunkou pulse diagnostic method is one of the important parts of the pulse diagnosis in Huangdi Neijing (Inner Canon of Yellow Emperor) and has been controversial since its proposal. This article takes WANG Shu-he's diagnostic operation as the evidence, and is in reference of the statement, "Cun region (the region ahead of Guan region of Cunkou) determines the human life, that on the left hand refers to Renying, while on the right hand is Qikou". The pulse conditions on the left and right hands represent yin and yang. If Renying pulse on the left is greater, the diseases are in yang meridians, while if Cunkou pulse on the right is bustling, the diseases are in yin meridians. By comparing the pulse condition and strength, as well as the pulse beating (rapid and urgent) between Guan region and region ahead of Guan on the same side, the conditions of three yang and three yin meridians are detected. In treatment, based on the records of Renying and Cunkou pulse diagnosis in Huangdi Neijing, the principles are proposed for reinforcing and reducing methods on hand and foot meridians of yin and yang. Five-shu points and yuan-source points are taken as the main acupoints in acupuncture treatment. During treatment, the changes in pulse conditions should be emphasized specifically and those at Renying and Cunkou regions are the criteria for judging qi arrival and qi regulation.

Clinical Value Evaluation of DR Corneal Suture Ring Localization and CT 3D Reconstruction Localization of Orbital Foreign Body / 中山大学学报(医学科学版)

ObjectiveTo investigate the clinical value of DR corneal suture ring localization and CT 3D reconstruction localization of orbital foreign bodies. MethodsRetrospective analysis was performed on patients （51 cases） suspected of ocular foreign bodies admitted to our hospital from January 2016 to December 2020 At the same time， DR corneal suture ring localization and CT three-dimensional reconstruction localization of orbital foreign bodies were performed， and the detection rate of foreign bodies by the two methods was calculated to analyze the location of ocular foreign bodies. ResultsThere were 38 cases of intraorbital foreign body identified by DR corneal suture ring localization method， and 46 cases of intraorbital foreign body identified by CT three-dimensional reconstruction localization method. The accuracy of CT three-dimensional reconstruction localization method was 90.20%， which was higher than that of DR corneal suture ring localization method 74.51% （P<0.05）. Intraocular foreign bodies in 23 cases could be distinguished by DR corneal suture ring localization， and 25 cases by CT 3D reconstruction localization. The maximum diameter of intraocular foreign bodies that could be distinguished by CT 3D reconstruction localization was （2.65±0.14） mm. The diameter of intraspherical foreign body was （2.94±0.36） mm （P<0.05） lower than that which could be distinguished by DR corneal suture ring localization method. The results of DR corneal suture ring localization of orbital foreign body showed no difference compared with the results of CT 3D reconstruction localization （P>0.05）. Forty cases of high density images inside and outside the eye could be clearly distinguished by CT 3D reconstruction. By using DR corneal suture ring localization method， 23 cases were confirmed to be intraocular high-density shadows， and 15 cases could not be confirmed to be intraocular high-density shadows （P < 0.05）. ConclusionsFor the location of intraorbital foreign bodies， CT three-dimensional reconstruction can be used as a conventional method for locating ocular foreign bodies with high resolution and accuracy， and can detect fine metal particles inside the eyeball. Meanwhile， for a few small foreign bodies in the iris root， ciliary body and lateral suspension ligament， it is necessary to locate orbital foreign bodies with DR corneal suture ring.

Advances in the production of chemicals by organelle compartmentalization in Saccharomyces cerevisiae / 生物工程学报

As a generally-recognized-as-safe microorganism, Saccharomyces cerevisiae is a widely studied chassis cell for the production of high-value or bulk chemicals in the field of synthetic biology. In recent years, a large number of synthesis pathways of chemicals have been established and optimized in S. cerevisiae by various metabolic engineering strategies, and the production of some chemicals have shown the potential of commercialization. As a eukaryote, S. cerevisiae has a complete inner membrane system and complex organelle compartments, and these compartments generally have higher concentrations of the precursor substrates (such as acetyl-CoA in mitochondria), or have sufficient enzymes, cofactors and energy which are required for the synthesis of some chemicals. These features may provide a more suitable physical and chemical environment for the biosynthesis of the targeted chemicals. However, the structural features of different organelles hinder the synthesis of specific chemicals. In order to ameliorate the efficiency of product biosynthesis, researchers have carried out a number of targeted modifications to the organelles grounded on an in-depth analysis of the characteristics of different organelles and the suitability of the production of target chemicals biosynthesis pathway to the organelles. In this review, the reconstruction and optimization of the biosynthesis pathways for production of chemicals by organelle mitochondria, peroxisome, golgi apparatus, endoplasmic reticulum, lipid droplets and vacuole compartmentalization in S. cerevisiae are reviewed in-depth. Current difficulties, challenges and future perspectives are highlighted.

Clinical application of optical surface monitoring system in radiotherapy after radical mastectomy for left breast cancer / 中国辐射卫生

@#<b>Objective</b> To study the setup error under deep inspiration breath hold (DIBH) guided by optical surface monitoring system (OSMS) and free breathing (FB) FB1 and FB2 (without OSMS guidance, directly set up the body marker line by laser lamp) in radiotherapy after radical mastectomy for left breast cancer, and to provide a basis for individualized clinical target volume-planning target volume (CTV-PTV) expansion for the doctor in charge to delineate the target volume. <b>Methods</b> A total of 36 patients with left breast cancer after radical mastectomy were selected and divided into three groups, in which cone beam computed tomography (CBCT) images were taken in three states: DIBH, FB1, and FB2, respectively. CBCT and CT images were analyzed for registration; the absolute error data of linear displacement in the ventro-dorsal, cranio-caudal, and left-right directions were recorded, and the expanding margin was calculated. <b>Results</b> The translation errors in the ventro-dorsal, cranio-caudal, and left-right directions were (0.06 ± 0.22) cm, (0.05 ± 0.23) cm, and (0.01 ± 0.24) cm in the DIBH group, (0.07 ± 0.21) cm, (0.02 ± 0.23) cm, and (0.02 ± 0.21) cm in the FB1 group, and (0.07 ± 0.24) cm, (0.07 ± 0.34) cm, and (0.25 ± 0.09) cm in the FB2 group. The statistical results of the DIBH group and FB1 group in the ventro-dorsal, RTN, and ROLL directions were significantly different (<i>P</i> < 0.05). The statistical results of the FB1 group and FB2 group in the ventro-dorsal direction were significantly different. The relation of three groups in the value of margin of planning target volume was DIBH < FB1 < FB2 in the ventro-dorsal and cranio-caudal directions and FB1 < DIBH < FB2 in the left-right direction. <b>Conclusion</b> OSMS-guided DIBH radiotherapy in patients with left breast cancer after radical mastectomy can reduce the setup error and provide an important basis for individualized CTV-PTV expansion for the doctor in charge to delineate the target volume.

Development of Human Vital Signs and Body Posture Monitoring and Positioning Alarm Systems / 中国医疗器械杂志

In view of the high incidence of malignant diseases such as malignant arrhythmias in the elderly population, accidental injuries such as falls, and the problem of no witnesses when danger occurs, the study developed a human vital signs and body posture monitoring and positioning alarm system. Through the collection and analysis of electrocardiogram (ECG), respiration (RESP) and acceleration (ACC) signals, the system monitors human vital signs and body posture in real time, automatically judges critical states such as malignant arrhythmias and accidental falls on the local device side, and then issues alarm information, opens the positioning function, and uploads physiological information and patient location information through 4G communication. Experiments have shown that the system can accurately determine the occurrence of ventricular fibrillation and falls, and issue position and alarm information.