2025年 · 第63卷第08期

The Chinese Medical Association has worked hard for 100 years, witnessing and leading the development of surgery in China. Standing on the historical coordinates of the new era, these accumulations are not only precious experience wealth, but also the cornerstone of future development.

This year marks the 110th anniversary of the founding of the Chinese Medical Association. As an important participant and witness of the development of China's medical cause, I am deeply honored. Invited by the editorial department, I briefly reviewed my medical history: from studying on the banks of Qiantang River to exploring under the shadowless lamp, from studying under Professor Yu Wenguang to cultivating the disciples of "Peng Jiajun", every step embodies the teachings of my predecessors, the support of my fellow peers and the inheritance of my juniors. At this special moment, I write this journey in writing, which is both a summary of the past and an expectation for the future.

On the occasion of the establishment of the Chinese Medical Association, I would like to review some of my work experiences in the Chinese Medical Association and share them with you!

peripheral inserted central catheter (PICC) can place the tip of the catheter in the middle and lower 1/3 of the superior vena cava. Compared with the traditional central venus catheter (CVC) catheterization, PICC has the advantages of high safety, long indwelling time and fewer complications, and is widely used in tumor chemotherapy, parenteral nutrition support and intensive care^{［1, 2］}。 However, it has been reported in the literature that the incidence of catheter ectopia during PICC catheterization is 5.0% ~56.1%^{［3, 4, 5, 6］}。 PICC catheter placement is too shallow, which will increase the risk of catheter blockage, fibrin sheath, venous thrombosis, etc. If the catheter is inserted too deeply, it may cause serious adverse events such as arrhythmia and pericardial tamponade. In order to ensure that the tip of PICC catheter is in the best position, although some researchers conducted catheter placement under the guidance of ultrasound combined with electrocardiogram positioning technology, it was still unable to monitor the catheter position in real time and reduce the positioning error^［7］。 The magnetic navigation tracer positioning technology has visualization, real-time tracking and tip positioning capabilities, allowing the operator to track the movement path of the catheter in the vessel and verify the tip position^［8］； Some research results show that this technology has advantages in PICC positioning accuracy and safety^［9］。 This research team began to introduce this technology into PICC catheterization in January 2025 to observe and verify the effectiveness and feasibility of this technology, and provide a reference for further popularization and application.

The patient, a 39-year-old male from Madagascar, was seen in the surgical department of the Central Hospital of Andrui District of China Medical Team in Madagascar on September 23, 2024 due to "bleeding in the chest and left upper limb caused by gunshot wound, accompanied by dyspnea for 10 min". The patient was hit by a shotgun, and the bullet penetrated the left upper limb and then penetrated the left anterior chest. The entrance of the chest ballistic trajectory was located in the fourth intercostal area of the midaxillary line, and the exit was in the fifth intercostal area of the left sternum. The ballistic area was bleeding and dyspnea. He was admitted to the hospital by a passerby. The past medical history is unknown.