Objective:To investigate the current application of blood purification in the treatment of acute poisoning within Jiangsu Province and to evaluate the impact of extracorporeal blood purification on the clinical outcomes of critically poisoned patients.Methods:This multicenter, cross-sectional real-world observational study followed patients presenting with poisoning to the emergency departments of nine hospitals in Jiangsu Province between June 2015 and May 2019. Data were collected on demographic characteristics, vital signs within the first hour of emergency presentation, treatment modalities, length of hospital stay, and survival outcomes. Clinical data from patients who underwent extracorporeal blood purification were compared with those who did not, using the Wilcoxon rank-sum test and Chi-square test.Results:A total of 4 178 poisoning cases were included between June 2015 and May 2019. Among them, 21.7% (908/4 178) received blood purification therapy, while 78.3% (3 270/4 178) did not. Hemoperfusion (90.4%) was the most frequently employed method, followed by continuous renal replacement therapy (CRRT) (4.4%). In combined blood purification modalities, 4.8% underwent hemoperfusion combined with CRRT, 0.1% received hemoperfusion with plasma exchange, and another 0.1% underwent hemoperfusion combined with both CRRT and plasma exchange. Among patients who underwent blood purification, pesticide poisoning was the most prevalent (76.3%), with the most common toxic agents being paraquat (23.7%), dichlorvos (8.7%), methamidophos (5.2%), omethoate (4.0%), and glyphosate (3.7%). Compared to the non-blood purification group, patients in the blood purification group were more likely to present within the first hour with a low Glasgow Coma Scale (GCS) score (3-8) (22.6% vs. 9.7%, P <0.05), low mean arterial pressure (8.0% vs. 3.2%, P <0.05), longer hospital stays [5(3,9) days vs. 2(1,4) days, P <0.05] and a higher in-hospital mortality rate (21.1% vs. 5.3%, P <0.05). Follow-up via telephone 28 days after discharge revealed a survival rate of 78.9%, with a mortality rate of 21.1% in the blood purification group. Conclusions:Hemoperfusion is the most commonly utilized blood purification technique for treating poisoning in Jiangsu Province, with pesticides being the primary toxic agents treated. Although the mortality rate is higher in the blood purification group, the intervention may still contribute to improved patient outcomes.

Objective::Patients with untreated severe aortic regurgitation (AR) have a high risk of mortality. Transfemoral transcatheter aortic valve replacement (TF-TAVR) is a treatment option for AR; however, the safety and efficacy of this technique have not been sufficiently established. This study aimed to evaluate the clinical and anatomical variables correlating with device success of TF-TAVR using a self-expanding valve system for pure AR.Methods::Patients with pure native severe AR who underwent TF-TAVR using a self-expanding valve system were registered at 5 Chinese centers. The primary endpoint was device success at 1 month after TAVR. The secondary endpoint was the composite of major adverse cardiovascular events (MACE) at 6 months, including all-cause death, ischemic stroke, emergency conversion to cardiac surgery, and permanent pacemaker implantation. Echocardiography was used to analyze the left ventricular function before the TAVR procedure and during follow-up. Multivariable logistic regression and Cox regression analyses were performed to find relevant independent risk factors.Results::Between September 2019 and February 2022, 79 patients with AR were enrolled in the study. At 1 month, device success was achieved in 60 (75.9%) patients. By 6 months, 29 (36.7%) patients had MACE. Echocardiography revealed improved left ventricular function after TAVR. Multivariate regression analysis demonstrated that the Society of Thoracic Surgeons risk score (odds ratio 0.760, 95% confidence interval (CI): 0.584-0.989; P = 0.041) and annulus perimeter (odds ratio 0.888, 95% CI: 0.796-0.992; P = 0.035) were 2 predictors of device success. Moreover, annulus perimeter (<80.2 mm), but not Society of Thoracic Surgeons risk score, was associated with a significant reduction in MACE at 6 months (hazard ratio 2.223, 95% CI: 1.060-4.659; P = 0.028). Conclusions::TF-TAVR using a self-expanding valve system appears to be a safe and feasible treatment for patients with pure native severe AR, particularly those with a less enlarged annulus.

Objective::Patients with untreated severe aortic regurgitation (AR) have a high risk of mortality. Transfemoral transcatheter aortic valve replacement (TF-TAVR) is a treatment option for AR; however, the safety and efficacy of this technique have not been sufficiently established. This study aimed to evaluate the clinical and anatomical variables correlating with device success of TF-TAVR using a self-expanding valve system for pure AR.Methods::Patients with pure native severe AR who underwent TF-TAVR using a self-expanding valve system were registered at 5 Chinese centers. The primary endpoint was device success at 1 month after TAVR. The secondary endpoint was the composite of major adverse cardiovascular events (MACE) at 6 months, including all-cause death, ischemic stroke, emergency conversion to cardiac surgery, and permanent pacemaker implantation. Echocardiography was used to analyze the left ventricular function before the TAVR procedure and during follow-up. Multivariable logistic regression and Cox regression analyses were performed to find relevant independent risk factors.Results::Between September 2019 and February 2022, 79 patients with AR were enrolled in the study. At 1 month, device success was achieved in 60 (75.9%) patients. By 6 months, 29 (36.7%) patients had MACE. Echocardiography revealed improved left ventricular function after TAVR. Multivariate regression analysis demonstrated that the Society of Thoracic Surgeons risk score (odds ratio 0.760, 95% confidence interval (CI): 0.584-0.989; P = 0.041) and annulus perimeter (odds ratio 0.888, 95% CI: 0.796-0.992; P = 0.035) were 2 predictors of device success. Moreover, annulus perimeter (<80.2 mm), but not Society of Thoracic Surgeons risk score, was associated with a significant reduction in MACE at 6 months (hazard ratio 2.223, 95% CI: 1.060-4.659; P = 0.028). Conclusions::TF-TAVR using a self-expanding valve system appears to be a safe and feasible treatment for patients with pure native severe AR, particularly those with a less enlarged annulus.

Background: Sarcomas, a heterogenous group of malignancies consisting of tumors, are rarely encountered in most general oncology clinics. As a result, most general oncologists have very little experience in dealing with these tumors and resulting in poorer treatment and survival outcomes. Having successful collaborative efforts in research, the Asian Sarcoma Consortium (ASC) pioneered a Sarcoma Preceptorship Program with its main goal of increasing awareness of the multidisciplinary approach in the management of sarcomas. Objective: The objective of this study is to evaluate the ASC Sarcoma Preceptorship Program using the first 2 levels of the Kirkpatrick Evaluation Model: Level 1) Reaction – through using satisfaction surveys; and Level 2) Knowledge – focusing on the amount of information gained from the activity evaluated by test-retest method. Methods: The 2-day preceptorship program held in Singapore utilized educational activities such as didactic lectures, multidisciplinary case discussions, and case presentations. The program was evaluated using: 1) pre-test and posttest; 2) satisfaction survey from ASC; and 3) satisfaction survey made by the sponsor, Novartis Pharma. Results: The preceptorship program enrolled 30 participants, most from the Asia-Pacific region. The overall results from the satisfaction surveys were generally optimistic, with results showing high levels of satisfaction with regard to the time allotment, scope of topics, and how helpful each session was. Test results showed that participants scored lower in post-test as compared to the pre-test. Computation of the Coefficient of Test reliability showed that although the pre-test was highly reliable, this was not true of the post-test. Conclusions Based on the Level 1 evaluation, the program was successful in terms of both participant and faculty satisfaction. However, certain areas for improvement were identified and recommendations were made in order to effect improvements for future iterations of this preceptorship.
soft tissue sarcoma ; clinical preceptorship

Head and neck squamous cell carcinoma (HNSCC), as the most common type (>90%) of head and neck cancer, includes various epithelial malignancies that arise in the nasal cavity, oral cavity, pharynx, and larynx. In 2020, approximately 878 ‍ 000 new cases and 444 000 deaths linked to HNSCC occurred worldwide (Sung et al., 2021). Due to the associated frequent recurrence and metastasis, HNSCC patients have poor prognosis with a five-year survival rate of 40%-50% (Jou and Hess, 2017). Therefore, novel prognostic biomarkers need to be developed to identify high-risk HNSCC patients and improve their disease outcomes.
Biomarkers, Tumor/genetics* ; Head and Neck Neoplasms/genetics* ; Humans ; Kaplan-Meier Estimate ; RNA ; Squamous Cell Carcinoma of Head and Neck ; Survival Analysis ; Survival Rate

Objective    To explore the efficacy of artificial intelligence (AI) detection on pulmonary nodule compared with multidisciplinary team (MDT) in regional medical center. Methods    We retrospectively analyzed the clinical data of 102 patients with lung nodules in the Xiamen Fifth Hospital from April to December 2020. There were 57 males and 45 females at age of 36-90 (48.8±11.6) years. The preoperative chest CT was imported into AI system to record the detected lung nodules. The detection rate of pulmonary nodules by AI system was calculated, and the sensitivity, specificity of AI in the different diagnosis of benign and malignant pulmonary was calculated and compared with manual film reading by MDT. Results    A total of 322 nodules were detected by AI software system, and 305 nodules were manually detected by physicians (P<0.05). Among them, 113 pulmonary nodules were diagnosed by pathologist. Thirty-eight of 40 lung cancer nodules were AI high-risk nodules, the sensitivity was 95.0%, and 25 of 73 benign nodules were AI high-risk nodules, the specificity was 65.8%. Lung cancer nodules were correctly diagnosed by MDT, but  benign nodules were still considered as  lung cancer at the first diagnosis in 10 patients. Conclusion    AI assisted diagnosis system has strong performance in the detection of pulmonary nodules, but it can not content itself with clinical needs in the differentiation of benign and malignant pulmonary nodules. The artificial intelligence system can be used as an auxiliary tool for MDT to detect pulmonary nodules in regional medical center.

Background: Sarcomas, a heterogenous group of malignancies consisting of tumors, are rarely encountered in most general oncology clinics. As a result, most general oncologists have very little experience in dealing with these tumors and resulting in poorer treatment and survival outcomes. Having successful collaborative efforts in research, the Asian Sarcoma Consortium (ASC) pioneered a Sarcoma Preceptorship Program with its main goal of increasing awareness of the multidisciplinary approach in the management of sarcomas. Objective: The objective of this study is to evaluate the ASC Sarcoma Preceptorship Program using the first 2 levels of the Kirkpatrick Evaluation Model: Level 1) Reaction – through using satisfaction surveys; and Level 2) Knowledge – focusing on the amount of information gained from the activity evaluated by test-retest method. Methods: The 2-day preceptorship program held in Singapore utilized educational activities such as didactic lectures, multidisciplinary case discussions, and case presentations. The program was evaluated using: 1) pre-test and posttest; 2) satisfaction survey from ASC; and 3) satisfaction survey made by the sponsor, Novartis Pharma. Results: The preceptorship program enrolled 30 participants, most from the Asia-Pacific region. The overall results from the satisfaction surveys were generally optimistic, with results showing high levels of satisfaction with regard to the time allotment, scope of topics, and how helpful each session was. Test results showed that participants scored lower in post-test as compared to the pre-test. Computation of the Coefficient of Test reliability showed that although the pre-test was highly reliable, this was not true of the post-test. Conclusions Based on the Level 1 evaluation, the program was successful in terms of both participant and faculty satisfaction. However, certain areas for improvement were identified and recommendations were made in order to effect improvements for future iterations of this preceptorship.
Sarcoma

High frequency ultrasound can clearly show the integrity of Achilles tendon and evaluate the site of the injuried tendon.What’more it can assess the separated and internal indications of the ruptured tendon.It has the advantages of noninvasive,economical and convenient.With all these advantages,high frequency ultrasound can be the first choice to evaluate the injured tendon among all the imaging techniques and provide reliable evidence for clinical diagnosis.

Objective To investigate the outcome of free posterolateral leg perforator flap in the reconstruction of soft tissue defects of oral and maxillofacial area.Methods From February,2014 to August,2016,16 patients were performed defect reconstruction following oral cancer ablation with free posterolateral leg perforator flap including 3 cases of sequamous cell carcinoma of the tongue,6 cases of carcinoma of the buccal mucosa,7 cases of sequamouse cell carcinoma of the floor of mouth.The flap ranged from 5.0 cm×3.0 cm to 13.0 cm ×9.0 cm in size,and were adjected to the soft tissue defects of oral and maxillofacial area.The outcome of reconstruction was evaluated by considering the facial appearance,the swallowing and the speach function,the ranges of mouth opening and patient prognosis.Results All 15 transplanted flaps survived well and only 1 survived after disposing in time,because of vascular crisis.The donor sites were closed directly without donor-site morbidity.All patients were satisfactory with their facial appearance,the ranges of mouth opening and swallowing and speech function.Conclusion The free posterolateral leg perforator was an ideal free tissue for repairing functionally oral and maxillofacial defects,sinceit including some beneficial characteristic such as constant blood vessel,flexible and divese design,abundant and position-latent donor site tissues,small operation loss,flexible preparation and loss of major vascular nerves.

OBJECTIVETo observe the distribution law and study the factors related to the femoral neck anteversion angle among the patients with developmental dysplasia of the hip of Hartofilakidis type I.

METHODSAmong the patients with hip dysplasia of Hartofilakidis type I who was admitted to Department of Orthopaedic Surgery, the First Affiliated Hospital of People's Liberation Army General Hospital from June 2010 to June 2013, a total of 340 hips (25 male and 161 female) were included in the study. The average age was 28.3 years, ranging from 13.5 to 49.9 years. The observation index included: femoral neck anteversion angle, lateral center-edge angle, acetabular index angle, lateral displacement of the femoral head, superior displacement of the femoral head, continuity of Shenton's line and Calve's line. The correlation between different factors was analyzed, and the factor closest to femoral neck anteversion angle was analyzed further by regression analysis.

RESULTSAmong the patients of developmental dysplasia of the hip of Hartofilakidis type I, the femoral neck anteversion angle increased, with an average of 28°±13°. Correlation and regression analysis showed significant negative correlation with treatment age (r=-0.158, P=0.003; t=-6.892, P=0.000); positive correlation with gender (r=0.332, P=0.000; t=-4.376, P=0.000); significant positive correlation with lateral displacement of the femoral head (r=0.092, P=0.000; t=3.766, P=0.000); significant negative correlation with central-edge angle (r=-0.122, P=0.024; t=2.031, P=0.043). The femoral neck anteversion angle showed correlation with acetabular index angle, continuity of Calve's line and superior displacement of the femoral head in correlation analysis, not in regression analysis, however, it did not show correlation with side and continuity of Shenton's line.

CONCLUSIONAmong the patients of developmental dysplasia of the hip of Hartofilakidis type I, the increasing of the femoral neck anteversion angle may not only lead to early onset and therefore early treatment of pain in the hip joint but also the lateral displacement of the femoral head that requires immediate medical attention.

Acetabulum ; Adolescent ; Adult ; Female ; Femur Head ; Femur Neck ; pathology ; Hip Dislocation, Congenital ; pathology ; surgery ; Hip Joint ; Humans ; Hyperplasia ; Male ; Middle Aged ; Orthopedic Procedures ; Orthopedics ; Regression Analysis ; Tomography, X-Ray Computed ; Young Adult