OBJECTIVE:Anterior cervical decompression and fusion is a classic surgical method for the treatment of degenerative cervical spondylosis.The use of nail plates increases the fusion rate and stability and indirectly leads to adjacent vertebral degeneration and postoperative dysphagia.In this paper,the clinical results and complications of ROI-CTM self-locking system and traditional cage combined with screw-plate internal fixation in the treatment of degenerative cervical spondylosis were compared by meta-analysis to provide evidence-based support for the selection of internal fixation methods in anterior cervical decompression and fusion. METHODS:CNKI,WanFang,VIP,PubMed,Cochrane Library,Web of Science,and Embase databases were searched for Chinese and English literature on the application of ROI-CTM self-locking system and fusion cage combined with screw plate internal fixation in the treatment of degenerative cervical spondylosis.The retrieval time range was from inception to July 2023.Two researchers selected the literature strictly according to the inclusion and exclusion criteria.The Cochrane bias risk tool was used to evaluate the quality of randomized controlled trials.Newcastle-Ottawa Scale was used to assess the quality of cohort studies.Meta-analysis was performed using RevMan 5.4 software.Outcome indicators included operation time,intraoperative blood loss,Japanese Orthopaedic Association score,Neck Disability Index,C2-C7 Cobb angle,fusion rate,incidence of adjacent vertebral degeneration,cage subsidence rate,and incidence of dysphagia. RESULTS:Thirteen articles were included,including eleven retrospective cohort studies and two randomized controlled trials,with 1 136 patients,569 in the ROI-C group,and 567 in the cage combined with the nail plate group.Meta-analysis results showed that the operation time(MD=-15.52,95%CI:-18.62 to-12.42,P<0.000 01)and intraoperative blood loss(MD=-24.53,95%CI:-32.46 to-16.61,P<0.000 01)in the ROI-C group and the fusion device combined with nail plate group.Postoperative adjacent segment degeneration rate(RR=0.40,95%CI:0.27-0.60,P<0.000 01)and postoperative total dysphagia rate(RR=0.18,95%CI:0.13-0.26),P<0.000 01)were statistically different.The two groups had no significant difference in Japanese Orthopaedic Association score,Neck Disability Index,C2-C7 Cobb angle,fusion rate,or cage subsidence rate(P≥0.05). CONCLUSION:Applying an ROI-CTM self-locking system and traditional cage combined with plate internal fixation in anterior cervical decompression and fusion can achieve satisfactory clinical results in treating degenerative cervical spondylosis.The operation of the ROI-CTM self-locking system is more straightforward.Compared with a cage combined with plate internal fixation,the ROI-CTM self-locking system can significantly reduce the operation time and intraoperative blood loss and has obvious advantages in reducing the incidence of postoperative dysphagia and adjacent segment degeneration.The ROI-CTM self-locking system is recommended for patients with skip cervical spondylosis and adjacent vertebral disease.However,given its possible high settlement rate,using a fusion cage combined with screw-plate internal fixation is still recommended for patients with degenerative cervical spondylosis with multiple segments and high-risk factors of fusion cage settlement,such as osteoporosis and vertebral endplate damage.

Objective To investigate the efficacy and safety of transcatheter arterial chemoembolization(TACE)for the treatment of locally recurrent breast cancer.Methods The clinical data of 57 patients with locally recurrent breast cancer from January 2018 to December 2020 were retrospectively analyzed.Twenty-four patients(group A)received TACE using adriamycin 12 mg/m2 and paclitaxel 45 mg/m2,which was accomplished by local perfusion into the tumor target blood vessels with microcatheter catheterization,the embolization material was Embosphere microspheres,and the embolization endpoint was occlusion of the main stem of the target vessel.Other 33 patients who received systemic chemotherapy using adriamycin 40 mg/m2 and paclitaxel 135 mg/m2 in the same period were collected as group B.The 6-month disease control rate(DCR),progression-free survival(PFS)and overall survival(OS)were compared between the two groups.Results Successful TACE was accomplished in all the 24 patients of group A,with a technical success rate of 100％.In group A,the 6-month DCR was 87.50％,the median PFS was 12 months,and the median OS was 22 months.In group B,the 6-month DCR was 63.63％,the median PFS was 9 months,and the median OS was 20 months.The differences in the 6-month DCR and the median PFS between the two groups were statistically significant(P=0.04 and P=0.03 respectively),while no statistically significant difference in the median OS existed between the two groups(P=0.21).The incidence of post-embolization syndrome in group A was 75％(18/24),the clinical symptoms included chest wall pain and mild fever,which disappeared 3 days after symptomatic treatment such as pain-relief and antipyretic medication,and no TACE-related serious complications such as target vessel injury,ectopic embolization of embolization materials or chest wall necrosis occurred in all patients.All patients were followed up for a mean period of(19.47±4.96)months(range of 8-24 months)Conclusion For the treatment of locally recurrent breast cancer,TACE is superior to systemic chemotherapy in short-term efficacy.TACE carries no intervention-related serious complications.However,more studies need to be conducted before its long-term efficacy and safety can be clarified.(J Intervent Radiol,2024,33:280-284)

【Objective】 To explore the risk factors of severe postoperative hemorrhage in patients with staghorn renal calculi treated with mini-percutaneous nephrolithotomy (M-PCNL), and to construct a Bayesian network model to predict postoperative hemorrhage. 【Methods】 A retrospective analysis was conducted on 160 patients with staghorn renal calculi who were treated with M-PCNL by surgeons with equivalent qualifications at the First Affiliated Hospital of Xinxiang Medical College during Jan. 2020 and Jan. 2022.A computer-generated random number method was used to divide them into a modeling group (120 cases) and a validation group (40 cases).Patients in the modeling group were divided into severe bleeding group (38 cases) and non-severe bleeding group (82 cases).The general information of the two groups was compared, and the independent risk factors of severe postoperative hemorrhage were analyzed.A Bayesian network model was constructed using R software, the inference prediction was conducted using Netica software, and the performance of the model was evaluated with receiver operating characteristic (ROC) curve. 【Results】 Multivariate logistic regression analysis showed that renal insufficiency (OR: 2.845, 95%CI: 1.563-6.515), mixmum diameter of stones ≥2 cm (OR: 2.063, 95%CI: 1.824-4.555), operation time ≥90 minutes (OR: 3.632, 95%CI: 2.365-7.11), one-stage operation (OR: 2.321, 95%CI: 1.874-6.332), and multi-channel stone removal (OR: 1.842, 95%CI: 1.366-3.687) were independent risk factors of postoperative severe hemorrhage (P<0.05).Based on the above parameters, a Bayesian network model was established, which was then evaluated with the modeling and validation groups internally and externally.The AUC of the modeling group was 0.879 (95%CI: 0.804-0.931, P<0.001), with sensitivity and specificity being 87.68% and 89.63%, respectively.The AUC of the validation group was 0.875(95%CI: 0.818-0.908, P<0.001), with sensitivity and specificity being 87.55% and 89.40%, respectively.The model showed good discrimination. 【Conclusion】 Renal dysfunction, mixmum diameter of stones ≥2 cm, operation time ≥90 minutes, one-stage operation, and multi-channel stone removal are risk factors of severe hemorrhage in patients after M-PCNL.The prediction model has good predictive ability and can effectively describe the complex mechanism between diseases and risk factors.

Sepsis-induced thrombocytopenia-associated multiple organ failure（TAMOF）is a severe subtype of sepsis-related organ dysfunctions，which has high mortality and poor prognosis.The main clinical characteristics are thrombocytopenia caused by infection and multiple organ dysfunction.However，the exact molecular mechanism of TAMOF remains unclear.The current studies have shown ADAMTS-13，which is a von Willebrand factor lyase，plays an important role during the disease.Plasma exchange could be a treatment method，but still need more large-scale randomized controlled trials to verify.In the future，von Willebrand factor and ADAMTS-13 could become the therapeutic targets for new drug development.

Objective:To analyze the research progress of family psychological education in schizophrenia population, in order to understand the elements and current situation of family psychological education application, and provide guidance for future research in this field.Methods:According to the basic idea of scoping review, research on family psychological education for schizophrenia patients was systematically searched in PubMed, Embase, CINAHL, Web of Science, Cochrane Library, China National Knowledge Infrastructure, WanFang Data, and China Biology Medicine. The search period was from database establishment to March 15, 2023.Results:A total of 15 articles were included, including 11 completely randomized controlled trials, 2 semi-randomized controlled trials, and 2 follow-up studies. The content consisted of the evaluation and intervention forms of family psychological education, and the development and implementation of specific intervention plans.Conclusions:There is limited research on family psychological education for patients with schizophrenia, and the implementation efforts around the world are insufficient. In the future, relevant research can be conducted to develop cost-effective education programs that are in line with China's culture and environment, so that schizophrenia patients and their families can receive evidence-based treatment to improve patient and family outcomes.

Objective:To translate the English version of the Beliefs Toward Mental Illness Scale (BTMI) into Chinese and test the reliability and validity of the Chinese version in college students.Methods:According to the Beaton cross-cultural adaptation guideline, the Chinese version of BTMI was formed. From April to May 2023, a questionnaire survey was conducted on 915 university students from 171 universities in 26 provinces, autonomous regions, and municipalities across China using convenience sampling, to analyze the reliability and validity of the scale.Results:A total of 915 questionnaires were distributed, and 814 valid questionnaires were collected, with an effective recovery rate of 88.96% (814/915). The Chinese version of BTMI had a total of 21 items. The Cronbach's α coefficient of the total scale was 0.922, and the Cronbach's α coefficients of each dimension were 0.745 to 0.921. The half reliability coefficient of the total scale was 0.797, and the retest reliability coefficient of the total scale was 0.903 ( P<0.01). Exploratory factor analysis extracted four common factors, namely social function, risk, incurability, and awkwardness, with a cumulative variance contribution rate of 62.29%. Confirmatory factor analysis showed that all important fitting indicators were greater than 0.900, indicating a good overall model fit. Conclusions:The Chinese version of BTMI has good reliability and validity, which can be used to evaluate the beliefs of Chinese university students about mental illness.

Objective:To analyze and elaborate on the concept and connotation of elder self-neglect, so as to provide reference for nursing practice.Methods:Literature on elder self-neglect was systematically searched on China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc, PubMed, Web of Science, and CINAHL. The search period was from database establishment to July 5, 2023. The literature was analyzed using Rodgers' evolutionary concept analysis as the theoretical framework.Results:A total of 63 articles were included. Elder self-neglect consisted of four defining attributes of disorder, danger, concealment, and closure. Antecedents contained physiological, psychological, social environment, and other factors. Consequences included the impact on the elderly themselves as well as the impact on others and the society.Conclusions:Elder self-neglect has a profound impact on individuals and society. By analyzing the concept of elder self-neglect and clarifying its conceptual attributes, researchers can conduct in-depth and comprehensive research on it, promoting the development of healthy aging.

Objective To investigate the effect of green laser anatomical vaporization on patients with benign prostatic hyperplasia(BPH)and type 2 diabetes mellitus(T2DM),as well as its impact on inflammatory factors,quality of life,and urethral stricture.Methods A total of 120 patients with BPH and T2DM who were treated at the First Affiliated Hospital of Xinxiang Medical University from March 2021 to August 2022 were selected as the research subjects.The patients were divided into a control group and an observation group according to the surgical approach,with 60 cases in each group.Patients in the control group underwent green laser selective photovaporization,while patients in the observation group were treated with green laser anatomical vaporization.The intraoperative and postoperative recovery indicators such as operation time,intraoperative blood loss,prostate resection quality,catheter indwelling time,bladder irrigation time,and hospitalization time of patients between the two groups were compared.The serum levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected by using enzyme-linked immunosorbent assay,and the serum levels of malondialdehyde(MDA)and lipid peroxide(LPO)were detected by using immunofluorescence assay before surgery,3 days after surgery,and 7 days after surgery.The international prostate symptom score(IPSS)was used to assess prostate symptoms,the urinary symptom distress score(USDS)was used to assess urinary symptoms,the dynamic urodynamic monitor was used to measure urodynamics[maximum flow rate(Qmax),residual urine volume(RUV)],the enzyme-linked immunosorbent assay was used to detect the serum level of total prostate specific antigen(tPSA),the international index of erectile function-5(IIEF-5)was used to assess erectile function,and the BPH quality of life(BPH-QOL)scale was used to assess quality of life before surgery,3 months after surgery,and 6 months after surgery.The incidence of complications such as urethral stricture,urinary tract irritation,bladder neck contracture,urinary retention,and secondary bleeding was compared between the two groups.Results The operation time of patients in the observation group was significantly longer than that in the control group,the intraoperative blood loss was significantly less than that in the control group,and the bladder irrigation time,catheter indwelling time,and hospitalization time were significantly shorter than those in the control group(P＜0.05).There was no statistically significant difference in the quality of prostatectomy between the two groups of patients(P＞0.05).Before surgery,there was no statistically significant difference in the levels of serum TNF-α,IL-6,MDA,and LPO between the two groups of patients(P＞0.05).On postoperative days 3 and 7,the levels of serum TNF-α,IL-6,MDA,and LPO in both groups were significantly higher than those before surgery,and the levels of serum TNF-α,IL-6,MDA,and LPO in the observation group were significantly lower than those in the control group(P＜0.05).Before surgery,there was no statistically significant difference in the IPSS and USDS scores between the two groups of patients(P＞0.05).At 3 and 6 months after surgery,the IPSS and USDS scores of patients in both groups were significantly lower than those before surgery,and the IPSS and USDS scores of patients in the observation group were significantly lower than those in the control group(P＜0.05).Before surgery,there was no statistically significant difference in RUV,Qmax,and serum tPSA levels between the two groups of patients(P＞0.05).At 3 and 6 months after surgery,the RUV and serum tPSA levels of patients in both groups were significantly lower than those before surgery,while the Qmax was signifi-cantly higher than that before surgery(P＜0.05).The RUV and serum tPSA levels of patients in the observation group were significantly lower than those in the control group,while the Qmax was significantly higher than that in the control group(P＜0.05).Before surgery,there was no statistically significant difference in the IIEF-5 and BPH-QOL scores of patients between the two groups(P＞0.05).At 3 and 6 months after surgery,the IIEF-5 scores of patients in both groups were significantly lower than those before surgery,while the BPH-QOL scores were significantly higher than those before surgery(P＜0.05).The IIEF-5 and BPH-QOL scores of patients in the observation group were significantly higher than those in the control group(P＜0.05).The total incidence of complications in the control group and the observation group was 16.67％(10/60)and 5.00％(3/60),respectively,and the total incidence of complications in the observation group was significantly lower than that in the control group(x2=4.227,P＜0.05).Conclusion Green laser anatomical vaporization in the treatment of BPH patients with T2DM can optimize the surgical process,reduce inflammatory stress and the risk of complications,promote early postoperative recovery,improve urodynamics and sexual function,relieve symptoms,and enhance quality of life.

Objective To explore the clinical effect of personalized pars plana vitrectomy(PPV)for proliferative di-abetic retinopathy(PDR).Methods In this retrospective case study,76 patients(86 eyes)diagnosed with PDR and re-ceiving PPV in the Department of Ophthalmology of Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine,from October 2019 to November 2022,were divided into the observation group(40 patients,46 eyes)and the control group(36 patients,40 eyes).Patients in the obseration group were treated with personalized PPV,while patients in the control group were treated with conventional PPV,After treatment,all patients were followed up for 12 months.The operation time,intraoperative use of heavy water and silicone oil,incidence of iatrogenic retinal tears and heavy water resi-dues,proportion of scleral buckling,preoperative and postoperative best corrected visual acuity(BCVA)and intraocular pressure(IOP),retinal reattachment rate at 12 months after surgery,and the incidence of post-vitrectomy vitreous hemor-rhage(PVH),diabetic macular edema(DME)and neovascular glaucoma(NVG)were compared between the two groups.Results The operation time of patients in the observation group was shorter than that in the control group(P＜0.05).Intraoperative use of heavy water and silicone oil in the observation group was lower than that in the control group(both P＜0.05).The incidence of iatrogenic retinal tears and heavy water residues and the proportion of scleral buckling showed no statistically significant difference between the two groups(all P＞0.05).There was no statistically significant difference between the two groups in BCVA preoperatively,3,6 and 12 months postoperatively(all P＞0.05).BCVA in the observa-tion group was better than that in the control group at 1 day,1 week and 1 month after surgery(all P＜0.05).Compared with the preoperative value,BCVA increased in the observation group at 1 day,1 week,1 month,3 months,6 months,and 12 months after surgery(all P＜0.05);in the control group,BCVA increased slightly at 1 day and 1 week(both P＞0.05)and then increased significantly at 1 month,3 months,6 months,and 12 months after surgery(all P＜0.05).The two groups showed no statistically significant difference in IOP at 1 day,1 week,1 month,3 months,6 months,and 12 months postoperatively(all P＞0.05).There was no statistically significant difference in the retinal reattachment rate and the inci-dence of complications such as PVH,DME,and NVG between the two groups at 12 months postoperatively(all P＞0.05).Conclusion Personalized PPV can shorten the operation time,reduce the intraoperative use of heavy water and silicone oil,enhance the efficiency of the operation,and rapidly improve the visual acuity of PDR patients.

Objective:To investigate respiratory virus infection in children with septic shock in pediatric care units (PICU) in China and its influence on clinical outcomes.Methods:The clinical data of children with septic shock in children′s PICU from January 2018 to December 2019 in 10 Chinese hospitals were retrospectively collected. They were divided into the pre-COVID-19 and post-COVID-19 groups according to the onset of disease, and the characteristics and composition of respiratory virus in the 2 groups were compared. Matching age, malignant underlying diseases, bacteria, fungi and other viruses, a new database was generated using 1∶1 propensity score matching method. The children were divided into the respiratory virus group and non-respiratory virus group according to the presence or absence of respiratory virus infection; their clinical characteristics, diagnosis, and treatment were compared by t-test, rank sum test and Chi-square test. The correlation between respiratory virus infection and the clinical outcomes was analyzed by logistic regression. Results:A total of 1 247 children with septic shock were included in the study, of them 748 were male; the age was 37 (11, 105) months. In the pre-and post-COVID-19 groups, there were 530 and 717 cases of septic shock, respectively; the positive rate of respiratory virus was 14.9% (79 cases) and 9.8% (70 cases); the seasonal distribution of septic shock was 28.9% (153/530) and 25.9% (185/717) in autumn, and 30.3% (161/530) and 28.3% (203/717) in winter, respectively, and the corresponding positive rates of respiratory viruses were 19.6% (30/153) and 15.7% (29/185) in autumn, and 21.1% (34/161) and 15.3% (31/203) in winter, respectively. The positive rates of influenza virus and adenovirus in the post-COVID-19 group were lower than those in the pre-COVID-19 group (2.1% (15/717) vs. 7.5% (40/530), and 0.7% (5/717) vs. 3.2% (17/530), χ2=21.51 and 11.08, respectively; all P<0.05). Rhinovirus virus were higher than those in the pre-Covid-19 group (1.7% (12/717) vs. 0.2% (1/530), χ2=6.51, P=0.011). After propensity score matching, there were 147 cases in both the respiratory virus group and the non-respiratory virus group. Rate of respiratory failure, acute respiratory distress, rate of disseminated coagulation dysfunction, and immunoglobulin usage of the respiratory virus group were higher than those of non-respiratory virus group (77.6% (114/147) vs. 59.2% (87/147), 17.7% (26/147) vs. 4.1% (6/147), 15.6% (25/147) vs. 4.1% (7/147), and 35.4% (52/147) vs. 21.4% (32/147); χ2=11.07, 14.02, 11.06 and 6.67, all P<0.05); and PICU hospitalization of the former was longer than that of the later (7 (3, 16) vs. 3 (1, 7)d, Z=5.01, P<0.001). Univariate logistic regression analysis showed that the presence of respiratory viral infection was associated with respiratory failure, disseminated coagulation dysfunction, the use of mechanical ventilation, and the use of immunoglobulin and anti-respiratory viral drugs ( OR=2.42, 0.22, 0.25, 0.56 and 1.12, all P<0.05). Conclusions:The composition of respiratory virus infection in children with septic shock is different between pre and post-COVID-19. Respiratory viral infection is associated with organ dysfunction in children with septic shock. Decreasing respiratory viral infection through respiratory protection may improve the clinical outcome of these children.