Abstract:Objective To analyze the pregnancy outcomes and influencing factors after cardiac surgery under cardiopulmonary bypass in pregnancy.Methods The clinical data of 56 patients who underwent cardiac surgery under cardiopulmonary bypass(CPB)in pregnancy in Department of Cardiac Surgery,Guangdong Provincial People's Hospital from January 2010 to December 2023 were retrospectively analyzed.According to whether the fetuses survived 1 week after surgery,the patients were divided into fetal survival group(45 patients)and fetal death group(11 patients).The clinical data were compared between the two groups.Multivariate logistic regression was used to analyze the influencing factors of fetal death.Results There were no maternal deaths among the 56 patients.Among the 45 patients of the fetal survival group,1 case belonged to a twin pregnancy.There were 11 cases in the fetal death group,all of whom were singleton pregnancies.The fetal mortality rate was 19.30％(11/57).The proportion of patients receiving metoprolol treatment during pregnancy in the fetal survival group was higher than that in the fetal death group,and the duration of operation and duration of CPB in the fetal survival group were shorter than those in the fetal death group,and the intraoperative blood loss in the fetal survival group was less than that in the fetal death group,and the perioperative blood transfusion rate in the fetal survival group was lower than that in the fetal death group,and the proportion of patients receiving atosiban treatment during the perioperative period in the fetal survival group was higher than that in the fetal death group,with statistically significant differences between the two groups(P＜0.05).The results of multivariate logistic regression analysis showed that perioperative blood transfusion was an independent risk factor for fetal death,while receiving metoprolol treatment during pregnancy and receiving atosiban treatment during the perioperative period were independent protective factors for inhibiting fetal death(P＜0.05).Conclusion Cardiac surgery under CPB during pregnancy poses a greater threat to the fetuses than to their mothers.Perioperative blood transfusion is an independent risk factor for fetal death.Receiving metoprolol treatment during pregnancy and receiving atosiban treatment during the perioperative period are independent protective factors for inhibiting fetal death.

Abstract:Objective To observe the efficacy of the"peach-like"procedure combined with levonorgestrel-releasing intrauterine system(LNG-IUS)in treatment of adenomyosis.Methods A retrospective analysis was conducted on the clinical data of 60 patients with adenomyosis who were admitted to Henan Provincial People's Hospital from January 2023 to June 2024.Thirty patients who underwent the"peach-like"procedure combined with LNG-IUS for adenomyosis were selected as the observation group,and other 30 patients who underwent laparoscopic uterine lesion resection for adenomyosis were selected as the control group.The clinical therapeutic effects were compared between the two groups 3 months after the operation.Results Before the operation,there were no statistically significant differences in uterine volume,Visual Analogue Scale(VAS)scores and Pictorial Blood Loss Assessment Chart(PBAC)scores between the two groups(P＞0.05).Compared with those before the operation,the uterine volume,VAS scores and PBAC scores were decreased in the two groups 3 months after the operation,with statistically significant differences(P＜0.05).At 3 months after the operation,the uterine volume in the observation group was smaller than that in the control group,and the VAS scores and PBAC scores in the observation group were lower than those in the control group,with statistically significant differences between the two groups(P＜0.05).The duration of operation in the observation group was shorter than that in the control group,and the intraoperative blood loss in the observation group was less than that in the control group,with statistically significant differences between the two groups(P＜0.05).There was no statistically significant difference in the length of hospital stay between the two groups(P＞0.05).Conclusion Compared with laparoscopic uterine lesion resection,the"peach-like"procedure combined with LNG-IUS in treatment of adenomyosis can shorten surgical time,reduce blood loss,decrease postoperative uterine volume,increase menstrual blood volume and improve dysmenorrhea symptoms more significantly.The combination treatment is worthy of clinical recommendation.

Abstract:Objective To analyze the influencing factors of kinesiophobia in kidney transplant recipients by using a qualitative research method.Methods Fifteen recipients with kinesiophobia after kidney transplantation who were admitted to Department of Nephrology,the First Affiliated Hospital of Army Medical University from November 2024 to January 2025 were selected as the research subjects by using the purposive sampling method.Semi-structured interviews were conducted on them,and the interview data were analyzed and summarized by using the thematic analysis method,and the themes were extracted.Results Four major themes were extracted:physiological factors,psychological factors,social support factors and environmental factors.The physiological factors included 2 sub-themes:reduced tolerance of the body and increased sensitivity to postoperative physical discomfort.The psychological factors included 2 sub-themes:low self-efficacy in exercise and worry about injury to the transplanted kidney,as well as worry about secondary infection.The social support factors included 3 sub-themes:insufficient exercise guidance,lack of family companionship,and limited access to exercise information.The environmental factors included 1 sub-theme:weather condition.Conclusion Kinesiophobia in kidney transplant recipients is caused by internal and external factors.Doctors and nurses should promptly identify the relevant factors that lead to kinesiophobia in the recipients,scientifically alleviate their kinesiophobia,and encourage them to actively participate in exercise.

Abstract:Minimal change disease(MCD)is a glomerular disease characterized by mild glomerular lesions under light microscopy,often lacking immune complex deposition,but characterized by diffuse foot process fusion under electron microscopy.Previous studies have generally believed that this disease is closely related to T lymphocyte dysfunction.However,recent studies have found that the depletion agent of B lymphocytes,rituximab(RTX),can induce remission of MCD,suggesting that B lymphocytes may play an important role in the occurrence and development of MCD.In this paper,the research progress in involvement of B lymphocytes in pathogenesis of MCD is reviewed.

Abstract:Objective To observe the application effect of neurodevelopmental therapy combined with cognitive training in the family rehabilitation treatment for infants with global developmental delay(GDD).Methods Fifty infants with GDD who were admitted to the People's Hospital of Guangxi Zhuang Autonomous Region from January 2019 to December 2020 were recruited and divided into observation group(receiving neurodevelopmental therapy combined with cognitive training)and control group(receiving neurodevelopmental therapy)by random number table method,with 25 infants in each group.In the control group,3 infants were excluded due to their incomplete treatments,and finally 25 infants were included in the observation group and 22 infants in the control group.The development quotients(DQ)of the GDD infants'adaptation functional domain,gross motor functional domain,fine motor functional domain,language functional domain and personal social contact functional domain were evaluated by using Gesell Developmental Schedules before treatment,at 1 month of treatment and at 3 months of treatment,and comparisons were conducted between the two groups.Results There were no significant differences in the DQ of the adaptation functional domain,gross motor functional domain,fine motor functional domain,language functional domain and personal social contact functional domain between the two groups before treatment(P＞0.05).At 1 month and 3 months of treatment,the DQ of the adaptation functional domain,gross motor functional domain,fine motor functional domain and language functional domain in the two groups were significantly increased compared with those before treatment(P＜0.05),and the DQ of the4 functional domains in the observation group were higher than those in the control group at 3 months of treatment,and the differences were statistically significant(P＜0.05).At 3 months of treatment,the DQ of personal social contact functional domain in the two groups were significantly increased compared with those before treatment(P＜0.05),and the DQ in the observation group were higher than those in the control group at 3 months of treatment,and the differences were statistically significant(P＜0.05).Conclusion In family rehabilitation treatment,the application of neurodevelopmental therapy combined with cognitive training can improve the development levels of the cognitive,motor and language functional domains in GDD infants.

Abstract:Myasthenia gravis(MG)is an autoimmune disease caused by thymic abnormalities.Thymectomy is a core approach for treating MG,and its clinical value has been confirmed by landmark studies such as the Thymectomy Trial in Non-Thymomatous Myasthenia Gravis Patients Receiving Prednisone Therapy(MGTX).Thymectomy can significantly improve the clinical outcomes of patients with acetylcholine receptor antibody(AChR-Ab)-positive generalized MG,reduce their immunosuppressant dosages,and elevate their long-term remission rates.With the advancement of minimally invasive techniques such as thoracoscopy and robotics,thymectomy has entered a new stage of"minimally invasive and precise",which makes patients safer and enables them to recover faster.Early thymectomy is now the consensus recommendation for patients with early-onset and AChR-Ab-positive generalized MG.However,its applications in some special populations,including those with ocular MG and muscle-specific kinase(MuSK)antibody-positive MG,remain controversial and require individualized assessment.The future research direction lies in establishing precision decision-making models based on patient subtypes and biomarkers,and conducting large-scale studies to define its precise role across different MG subtypes,which will optimize surgical timing and screen beneficiary groups to achieve personalized treatments.

Abstract:Objective To explore the application value of time-lapse imaging technology in monitoring embryonic direct cleavage(DC)and evaluating embryonic developmental potential.Methods The clinical data of patients who received in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI)treatment in Reproductive Medicine and Genetics Center,the People's Hospital of Guangxi Zhuang Autonomous Region from July 2020 to February 2024 were retrospectively analyzed,with a total of 601 treatment cycles.The development process of embryos was monitored by using time-lapse imaging technology.According to the embryonic cleavage patterns,the embryos were divided into normal cleavage group and DC group.According to the periods of DC,the DC group was further divided into DC1 group(DC occurred in the first division of the fertilized eggs),DC2 group(DC occurred in the second division of the fertilized eggs)and DC3 group(DC occurred in the third division of the fertilized eggs).The indicators of embryonic developmental potential and pregnancy outcomes were compared among the groups.Results The monitoring results of time-lapse imaging showed that the incidence of DC in the embryos was 16.67%(822/4 932).The mean of blastomeres of D3 embryos in the DC group was significantly less than that in the normal cleavage group,and the rates of D3 high-quality embryos,D6 blastocysts formation,D6 high-quality blastocyst formation and D6 freezable blastocyst formation in the DC group were significantly lower than those in the normal cleavage group(P＜0.05).The D3 high-quality embryo rates in the DC1 group and the DC2 group were significantly lower than those in the normal cleavage group(P＜0.05).The D3 high-quality embryo rates in the DC1 group were significantly lower than those in the DC2 group and the DC3 group(P＜0.05).The D6 blastocyst formation rates in the DC1 group and the DC2 group were significantly lower than those in the normal cleavage group(P＜0.05).The D6 blastocyst formation rates in the DC1 group were significantly lower than those in the DC2 group and the DC3 group(P＜0.05).The D6 high-quality blastocyst formation rates in the DC1 group,the DC2 group and the DC3 group were significantly lower than those in the normal cleavage group(P＜0.05).The D6 high-quality blastocyst formation rates in the DC1 group were significantly lower than those in the DC2 group and the DC3 group(P＜0.05).Compared with those in the normal cleavage group,the biochemical pregnancy rate,clinical pregnancy rate,implantation rate and live birth rate in the DC1 group and the DC2/3 group were significantly decreased(P＜0.05).Conclusion DC can reduce the embryonic development potential,and the earlier DC occurs,the greater the negative impact on the embryonic development.Time-lapse imaging technology is an effective method to monitor the occurrence of DC in the embryos and evaluate the embryonic development potential.

Abstract:Objective To explore the incidence and independent risk factors of complications after tubeless thymoma resection,and to provide a reference basis for the clinical optimization of perioperative management.Methods A retrospective analysis was conducted on the clinical data of 80 patients who underwent tubeless thymoma resection in Nanxishan Hospital of Guangxi Zhuang Autonomous Region from January 2021 to July 2025.The patients'general data,surgical-related indicators and postoperative complications were recorded.Univariate analysis was used to screen for the risk factors,and multivariate Firth-corrected logistic regression was used to analyze the independent risk factors.Results In the 80 patients,11 patients had postoperative complications,among which arrhythmia and incision fat liquefaction were the most common.Univariate analysis showed that the maximum diameter of tumors,Masaoka-Koga stage,myasthenia gravis,surgical method,duration of operation,intraoperative blood loss and duration of artificial pneumothorax were associated with the occurrence of complications(P＜0.05).The analysis results of multivariate Firth-corrected logistic regression indicated that the longer maximum diameter of tumors,longer duration of operation and longer duration of artificial pneumothorax were independent risk factors for the occurrence of postoperative complications after tubeless thymoma resection(P＜0.05).Conclusion Tubeless thymoma resection is generally safe and feasible,but patients with longer maximum diameter of tumors,longer duration of operation and longer duration of artificial pneumothorax have a higher risk of complications.For the high-risk patients,preoperative assessment and perioperative management should be strengthened to reduce the incidence of postoperative complications.

Abstract:Objective To explore the diagnostic value of ultra-high b-value apparent diffusion coefficient(ADC)images combined with prostate-specific antigen density(PSAD)for lesions in the prostate central gland region.Methods A retrospective analysis was conducted on the clinical data of 106 patients with suspected prostate cancer(PCa)and undergoing routine magnetic resonance imaging(MRI)examination for the prostate and diffusion-weighted imaging(DWI)examination with a b-value of 3 000 s/mm2 from July 2023 to March 2025 in Nanping First Hospital Affiliated to Fujian Medical University.The lesions were located in the central gland region of the prostate and were scored 3-5 points according to the Prostate Imaging Reporting and Data System(PI-RADS)version 2.1.The mean ADC(ADCmean),minimum ADC(ADCmin),and relative deviation(RD)were obtained.The levels of prostate-specific antigen(PSA)were detected by using chemiluminescent immunoassay,and PSAD was calculated.Results Among the 106 patients,54 patients were diagnosed with central gland prostate cancer(CGPCa)(CGPCa group)by pathological examination,and 52 patients were diagnosed with benign prostatic hyperplasia(BPH)(BPH group)by pathological examination.The levels of ADCmin and ADCmean in the CGPCa group were lower than those in the BPH group,while the levels of RD,PSA and PSAD in the CGPCa group were higher than those in the BPH group,with statistically significant differences(P＜0.05).The results of receiver operating characteristic(ROC)curve analysis showed that ADCmin,ADCmean,RD,PSA and PSAD could effectively differentiate CGPCa from BPH(P＜0.05).The 3 indicators(ADCmin,RD and PSAD)having higher diagnostic efficiency were selected to construct a combined diagnostic model.The results of DeLong's test showed that the diagnostic efficiency of the combination of the three indicators was higher than that of a single indicator(Zthree-indicator combination-ADCmin=1.968,P=0.049;Zthree-indicator combination-PSAD=2.081,P=0.037;Zthree-indicator combination-RD=1.992,P=0.046),with a sensitivity of 74.07%and a specificity of 100.00%.Conclusion The diagnostic model constructed on basis of ADCmin,RD and PSAD exhibits significant advantages in differentiating CGPCa from BPH,enhancing the diagnostic efficiency for lesions in the central gland region of the prostate.This model provides a novel methodological strategy for accurately distinguishing CGPCa from BPH and has good clinical application value.

Abstract:Objective To analyze the clinical phenotypes and genetic variation characteristics of 21 pediatric patients with neonatal seizures of unknown causes.Methods A retrospective analysis was conducted on the clinical data of 21 pediatric patients with neonatal seizures of unknown causes who were admitted to Department of Neonatology,the First Affiliated Hospital of Xinxiang Medical University and Department of Neonatology,Luoyang Maternal and Child Health Hospital from September 2018 to October 2024.The results of blood tandem mass spectrometry,urine gas chromatography-mass spectrometry and whole exome gene detection were analyzed,and the clinical outcomes of the pediatric patients were summarized.Results In the 21 pediatric patients,7 pediatric patients were male and 14 pediatric patients were female.All of the pediatric patients presented with seizures as the initial manifestation.There were no abnormalities in the blood tandem mass spectrometry and urine gas chromatography-mass spectrometry.Head magnetic resonance imaging(MRI)indicated that there were no abnormalities or the abnormal results were not specific.The results of 24-hour video electroencephalography(EEG)in all the pediatric patients showed abnormalities,mainly including sharp waves,spike waves and slow waves,with a few abnormalities showing burst-inhibition.The genetic testing results in the 21 pediatric patients were positive.There were 7 cases of benign familial neonatal seizures caused by variations in KCNQ2,KCNQ3 and SCN2A genes,and 12 cases of developmental and epileptic encephalopathies caused by variations in KCNA2,KCNQ2,CNPY3,ATP6V1A and MT-ND3 genes.Two pediatric patients with variations in KCNQ2 gene were lost to follow-up and their clinical phenotypes could not be determined.The follow-up was conducted until April 2025.Two pediatric patients were lost to follow up.Seven pediatric patients died,all of whom were pediatric patients with developmental and epileptic encephalopathies.Conclusion Genetic testing is helpful for judging the prognosis of neonatal seizures.This study reveals that variations in CNPY3 and ATP6V1A genes lead to developmental and epileptic encephalopathies,which enriches the disease gene spectrum.

Abstract:Lung cancer is one of the leading causes of cancer deaths worldwide.Visceral pleural invasion(VPI)refers to the infiltration of tumor cells beyond the elastic fibrous layer of the pleura.VPI has significant effects on the clinical staging and survival prognosis of patients with early-stage lung cancer.Imaging examinations have the advantages of comprehensiveness,non-invasiveness and good repeatability,and have played an important role in the preoperative assessment of the VPI status of lung cancer.In this paper,the progress in imaging studies on VPI in lung cancer is reviewed.

Abstract:Objective To analyze the factors influencing poor clinical outcomes in patients with acute hypoxemic respiratory failure(AHRF)after Venturi mask oxygen therapy and to construct a nomogram model.Methods A retrospective analysis was conducted on the clinical data of 203 patients with AHRF who were admitted to Anqing Hospital of Chinese Medicine from November 2021 to April 2024.All these patients received Venturi mask oxygen therapy.According to the clinical outcomes of the patients after the therapy,they were divided into poor outcome group(57 patients)and good outcome group(146 patients).Multivariate logistic regression was used to analyze the factors influencing the clinical outcomes of patients with AHRF after Venturi mask oxygen therapy,and a nomogram model for predicting poor clinical outcomes of patients with AHRF after Venturi mask oxygen therapy was constructed based on the screened indicators.The predictive efficiency and application value of the constructed nomogram model were evaluated through receiver operating characteristic(ROC)curve,Hosmer-Lemeshow test,calibration curve and decision curve.Results In the 203 patients,57 patients(28.08%)hadpoor clinical outcomes.Amongthe57 patientswithpoor clinical outcomes,45 patientswere converted to mechanical ventilation,and 10 patients had deteriorated conditions leading to rescue,and 2 patients died.The results of multivariate logistic regression analysis showed that older age[OR(95%CI)=1.754(1.040-2.958)],higher Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)scores[OR(95%CI)=2.373(1.535-3.669)],fever[OR(95%CI)=2.274(1.170-4.419)]and concurrent multiple organ dysfunction syndrome(MODS)[OR(95%CI)=1.635(1.093-2.446)]were independent risk factors for poor clinical outcomes in patients with AHRF after Venturi mask oxygen therapy(P＜0.05).A high respiratory rate-oxygenation(ROX)index at 1 hour after treatment[OR(95%CI)=0.556(0.364-0.849)]was an independent protective factor for promoting good clinical outcomes in the patients(P＜0.05).A nomogram model for predicting poor clinical outcomes in patients with AHRF after Venturi mask oxygen therapy was constructed on basis of age,fever,concurrent MODS,APACHEⅡscores and ROX index at 1 hour after treatment.The results of ROC curve analysis showed that the nomogram model had good predictive efficiency[AUC(95%CI)=0.925(0.880-0.957),P＜0.001],with a sensitivity of 92.98%and a specificity of 85.62%.The results of Hosmer-Lemeshow test showed that there was no statistically significant difference between the probability of the patients'poor clinical outcomes predicted by the nomogram model and the actual probability(χ2=0.859,P=0.354).The calibration curve showed that the predicted probability of the nomogram model had a good consistency with the actual probability.The decision curve indicated that the nomogram model could be applied to the vast majority of clinical decision-making settings.Conclusion Age,fever,concurrent MODS,APACHEⅡscores,and the ROX index at 1 hour after treatment are the factors influencing the clinical outcomes of AHRF patients after Venturi mask oxygen therapy.The nomogram model constructed on basis of these indicators is helpful for rapid clinical decision-making,improves the patients'prognosis,and has good clinical application value.

Abstract:Objective To construct a nomogram model for predicting postoperative delirium(POD)in non-hyperlipidemia patients undergoing esophageal cancer resection based on plasma total cholesterol(TC)levels.Methods A retrospective analysis was conducted on the clinical data of 187 non-hyperlipidemia patients who underwent esophageal cancer resection in the 960th Hospital of the PLA Joint Logistics Support Force from January 2019 to December 2023.According to the occurrence of delirium within 1 week after the operation,the patients were divided into delirium group(24 patients)and non-delirium group(163 patients).Multivariate logistic regression was used to analyze factors influencing the incidence of POD in the patients undergoing esophageal cancer resection,and a nomogram prediction model was constructed.The predictive efficacy of the model was verified by using Hosmer-Lemeshow goodness-of-fit test,Bootstrap resampling method,receiver operating characteristic(ROC)curve and decision curve analysis(DCA).Results Compared with the non-delirium group,the delirium group was older,and had a lower proportion of patients receiving dexmedetomidine treatment,lower levels of intraoperative minimum mean arterial pressure(MAP)and total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C),longer duration of anesthesia and postoperative hospital stay,and a higher proportion of patients with coronary heart disease,a higher proportion of patients transferred to intensive care unit(ICU)after surgery and a higher proportion of patients who died within 30 days after surgery,with statistically significant differences(P＜0.05).The results of multivariate logistic regression analysis showed that a higher TC level,a higher intraoperative minimum MAP,and use of dexmedetomidine were independent protective factors for inhibiting the incidence of POD in the patients undergoing esophageal cancer resection(P＜0.05).A nomogram prediction model was constructed based on the above three influencing factors.The results of Hosmer-Lemeshow goodness-of-fit test showed that the model fitted well(χ2=3.763,P=0.878).The C-index value obtained by the Bootstrap resampling method was 0.897,indicating that the model had a relatively high prediction consistency.The ROC curve showed that area under the curve(AUC)(95%CI)of the model for predicting POD in patients undergoing esophageal cancer resection was 0.919(0.870-0.969),with specificity of 79.10%and sensitivity of 91.70%.The DCA curve showed that the net benefit of the model was relatively high and stable within the risk thresholds ranging from 0.05 to 0.85,indicating that the model had good clinical value.Conclusion Higher plasma TC level,higher intraoperative minimum MAP and use of dexmedetomidine are independent protective factors for inhibiting the incidence of POD in non-hyperlipidemic patients undergoing esophageal cancer resection.The nomogram prediction model constructed based on the above three factors has good predictive value for POD.

Abstract:Objective To study the mechanisms of long non-coding ribonucleic acid(RNA)(lncRNA)small nucleolar RNA host gene 16(SNHG16)promoting breast cancer radioresistance by binding to host cellular RNA binding protein Staufen 1(STAU1)to reduce the stability of Parkin RBR E3 ubiquitin protein ligase(PRKN)mRNA.Methods The expressions of lncRNA SNHG16 in breast cancer tissues were analyzed by using The Cancer Genome Atlas(TCGA)database and real-time quantitative polymerase chain reaction(RT-qPCR)was used to detect the expressions of lncRNA SNHG16 in breast cancer cells.MDA-MB-231 and MCF-7 cells with high expression of lncRNA SNHG16 were selected for transfection and were divided into si-NC group(control group)and si-SNHG16 group(experimental group).Cells in logarithmic growth phase were taken for experiment 48 hours after transfection.Cell proliferation was detected by using Cell Counting Kit-8(CCK-8)assay.Cell apoptosis was detected by using flow cytometry.Cell invasion was detected by using Transwell assay.Cell radiosensitivity was detected by using CCK-8 assay.Cellular glucose uptake was determined by using the glucose uptake colorimetric assay kit.The combination of RNA immunoprecipitation(RIP)detection with RNA stability experiment was used to verify the regulatory relationship among lncRNA SNHG16,STAU1 and PRKN.Results lncRNA SNHG16 was highly expressed in breast cancer tissues and cells.Knockdown of lncRNA SNHG16 expression reversed the proliferation,apoptosis,invasion and radioresistance of the breast cancer cells,and inhibited the reprogramming of glucose metabolism in breast cancer cells.The RIP experiment confirmed that there was an interaction between STAU1 and PRKN mRNA,whereas knockdown of lncRNA SNHG16 attenuated this interaction relationship,and knockdown of STAU1 expression also enhanced the stability of PRKN mRNA.Conclusion The highly expressing lncRNA SNHG16 in breast cancer cells binding to STAU1 reduces the stability of PRKN mRNA via a post-transcriptional modification pathway,thus affecting the reprogramming of glucose metabolism and promoting radioresistance in breast cancer.

Abstract:Chylous ascites is a rare but serious complication after lymph node resection for gynecological malignancies.Its occurrence is closely related to high-level para-aortic lymph node resection,laparoscopic operation and perioperative malnutrition.Clinical diagnosis of chylous ascites requires a combination of criteria such as a chylous fluid drainage volume≥200 mL/d and a triglyceride level exceeding 200 mg/dL in the fluid.A stepwise therapeutic approach is recommended:conservative management(dietary modification combined with pharmacological therapy)as the first-line treatment,followed by lymphangiography in or in no combination with embolization for the patients who have failed to respond to the conservative treatment,and surgical ligation or lymphovenous anastomosis for refractory cases.The consensus emphasizes preventing chylous ascites through comprehensive measures such as meticulous intraoperative operations,the application of biological agents,and delayed extubation after surgery.The formulation of this consensus provides an evidence-based foundation for the standardized clinical management of chylous ascites after lymphadenectomy for gynecological malignancies.

Abstract:This paper reports the diagnosis and treatment of pre-myasthenic crisis following thymoma resection with phrenic nerve sacrifice in a patient.

Abstract:Objective To observe the efficacy of integrated neuromuscular training(INT)in treatment of patients with spastic hemiplegia of lower limbs after stroke.Methods One hundred patients with spastic hemiplegia of lower limbs after stroke who were admitted to Chinese People's Liberation Army Marine Corps Hospital from January 2021 to December 2024 were selected.The patients were divided into control group and observation group by using random number table method,with 50 patients in each group.The control group received conventional rehabilitation training,while the observation group received INT.The training period was 12 weeks in both groups.The surface electromyography(sEMG)indicators of lower limbs,neurological function,lower limb motor function,psychological state and quality of life were observed,and the levels of serum gamma-aminobutyric acid(GABA),neuron-specific enolase(NSE)and glutamate(Glu)were detected before and after treatment.The clinical effects were compared between the two groups.Results After treatment,the root mean square(RMS)of electrical activity signals of muscles in electromyography,the National Institutes of Health Stroke Scale(NIHSS)scores,the Clinical Spasticity Index(CSI)scores,the Hospital Anxiety and Depression Scale(HADS)scores,GABA levels,NSE levels and Glu levels in both groups were significantly lower than those before treatment,and these indicators in the observation group were significantly lower than those in the control group after treatment(P＜0.05).After treatment,the time of 10-meter walk test in both groups was significantly shortened compared with that before treatment,and the time of 10-meter walk test in the observation group was significantly shorter than that in the control group after treatment(P＜0.05).After treatment,the intramuscular electromyography(iEMG),median frequency(MF),mean power frequency(MPF),Berg Balance Scale(BBS)scores,Fugl-Meyer Assessment(FMA)scale scores,Functional Independence Measure(FIM)scores and modified Barthel Index(MBI)in the two groups were significantly elevated than those before treatment,and these indicators in the observation group were significantly higher than those in the control group after treatment(P＜0.05).The total effective rate of the observation group was higher than that of the control group(96.00%vs82.00%,χ2=5.005,P=0.025).Conclusion INT is significantly effective in treatment of patients with spastic hemiplegia of lower limbs after stroke.INT can effectively improve the neurological function,lower limb motor function and psychological state of the patients.

Abstract:CO external fixation technique,an innovation based on the development of traditional Chinese orthopedics,demonstrates good clinical efficacy in treatment of limb fractures and aligns with the biomechanical principles of fracture healing.However,the molecular biological mechanisms by which CO external fixation technique promotes fracture healing remain unclear.This paper discusses the molecular biological mechanisms of CO external fixation technique in promoting osteogenic differentiation of bone marrow mesenchymal stem cells and vascularization of endothelial progenitor cells on the basis of traditional Chinese medicine theory and biomechanical principles of CO external fixation technique,and summarizes the signal pathways that may be involved in these molecular biological mechanisms,which will provide new ideas for the scientific treatment of fractures in traditional Chinese medicine and the experimental researches of CO external fixation technique.

Abstract:Objective To explore the safety and short-term efficacy of postoperative hyperthermic intrathoracic perfusion treatment(HITP)in patients with stagesⅢ-Ⅳthymoma who underwent tumor-reductive surgery to the most extent.Methods A retrospective analysis was conducted on the clinical data of 17 patients with stages Ⅲ-Ⅳ thymoma who were admitted to the University of Hong Kong-Shenzhen Hospital from June 2022 to July 2025.All the patients underwent tumor-reductive surgery to the most extent and received postoperative HITP(with normal saline at 46-48℃for 60 minutes,once every 24 hours with a total of 3-5 treatments).The patients'perioperative complications,adverse reactions and survival outcomes were recorded.The follow-up methods included outpatient re-examination,phone calls and WeChat communication.Results Among the 17 patients,16 patients were completed 3 to 5 times of HITP as planned,while 1 patient was only completed 1 time of HITP.One patient experienced unbearable significant chest tightness after surgery,and the major adverse reactions in the other 16 patients were mild chest tightness and discomfort.No severe complications such as severe arrhythmia,respiratory failure,major bleeding and anastomotic fistula were observed.No obvious impairments of heart,lung,liver and kidney functions occurred.During the follow-up period of 1-38 months,all the patients survived,and thoracic recurrence occurred in 2 patients with stage Ⅳ A thymoma.Conclusion The combined HITP demonstrates good safety and manageable adverse reactions in patients with stages Ⅲ-Ⅳ thymoma who underwent tumor-reductive surgery to the most extent.However,its long-term efficacy still needs further verification through prospective studies with large sample sizes and long-term follow-up.

Abstract:Objective To analyze the90%effective dose(ED90)of midazolam for oral mucosal administration for sedation during head magnetic resonance imaging(MRI)examination in infants weighing less than 5 kg.Methods The infants who underwent head MRI examination under sedation in Maternity and Child Health Care of Guangxi Zhuang Autonomous Region from March 2024 to October 2024 were recruited.Sedative intervention was conducted on the included infants in sequence using a biased-coin design method.The first infant received midazolam oral solution at a dose of 0.15 mg/kg through oral mucosal route of administration.The dose for each subsequent infant was determined based on the sedation outcome of the previous infant:(1)If the previous infant experienced sedation failure,the current infant received midazolam oral solution at a dose increased by1 unit(0.05 mg/kg)through oral mucosal route of administration compared to the previous dose given to the the previous infant.(2)If the previous infant achieved success of sedation,the dose for the current infant was either maintained(with 89%probability)or reduced by 1 unit(with 11%probability)using a biased-coin design method.The trial was terminated when the number of successful sedation cases reached 45.The ED90 was calculated,and isotonic regression with bootstrap resampling was employed to estimate the 95%effective dose(ED95)and the99%effectivedose(ED99).Results A total of 53 infants were included in this study,among whom 45 infants were successfully sedated and 8 infants failed to be sedated.The ED90 of midazolam administered via the oral mucosal route for sedation during MRI examination in the infants weighing less than 5 kg was 0.295 mg/kg(95%CI=0.236-0.335 mg/kg).After calculation using isotonic regression and bootstrap resampling,the ED95 was estimated to be 0.325 mg/kg(95%CI=0.289-0.345 mg/kg)and the ED99 was estimated to be 0.347 mg/kg(95%CI=0.340-0.364 mg/kg).Conclusion The ED90 of midazolam administered via oral mucosal route for sedation during head MRI examination in infants weighing less than 5 kg is 0.295 mg/kg(95%CI=0.236-0.335 mg/kg).