Objective: To understand the current status of neglect among rural preschool children in Xi an under the multi child policy and the association with family characteristics, so as to provide a reference for preventing and reducing the occurrence of child neglect. Methods: A total of 7 052 parents of preschool children were selected using stratified cluster sampling across 9 suburban counties/districts in Xi an from March to April 2025. A questionnaire survey was administered using the Chinese Norm Scale for Neglect Assessment of Rural(Preschool) Children Aged 3-6. The t-test, Chi-quare test, and analysis of variance (ANOVA) were used for inter group comparisons. Results: The overall prevalence rate and mean score of neglect among rural preschool aged children in Xi an were 32.4% and 38.27±6.70, respectively. Statistically significant differences were detected in neglect rates and neglect degrees among preschool children of different genders and grade levels ( χ 2=30.41, 15.15, t/F =4.92,7.03, all P <0.05). Statistically significant differences were also detected in neglect rates and neglect degrees among preschool children from whether only one child, different family structures, numbers of children in a family and families with different annual incomes ( χ 2=29.22, 10.41 , 31.99, 186.47, t/F =-9.96, 5.50, 33.57, 68.63, all P <0.05). In multi child families, there was a statistically significant difference in neglect degree among children with different birth orders ( F =4.25, P <0.05), but there was no statistically significant difference in neglect rate ( χ 2=5.73, P >0.05). Among all subgroups, the highest neglect rates and neglect degrees were observed in children from multi child families(35.0%,39.00±6.71), other family types(50.0%，42.38±12.34) and families with three children(39.9%，39.50±7.43). Lower annual family income was associated with higher neglect rates and neglect degrees among preschool children( χ 2 trend =186.47， F =270.68，both P <0.05). Conclusions Under the multiple child policy, the neglect of preschool children in rural areas of Xi an is quite severe, particularly in families with multiple children and low income households. Targeted interventions should be implemented for high risk groups.

Hepatocellular carcinoma(HCC)is one of the most prevalent malignancies worldwide,and accurate prognostic assessment and treatment planning are vital for improving patient outcomes.Conventional prognostic models,which rely on limited clinicopathological parameters,often fail to capture the profound heterogeneity of HCC.In recent years,artificial intelligence(AI)-particularly machine learning and deep learning-has driven a paradigm shift in precision oncology by leveraging its powerful capabilities in data mining and pattern recognition.This review provides a comprehensive overview of recent advances in AI for prognostic assessment and treatment optimization in HCC,with an emphasis on key methodologies such as radiomics and multi-modal data integration.It further discusses the clinical potential and challenges of AI in predicting postoperative recurrence,evaluating therapeutic response,and supporting individualized treatment decisions,while also outlining future directions in this rapidly evolving field.The review aims to inform and facilitate the clinical translation of AI technologies into the management of HCC.

Hepatocellular carcinoma(HCC)is one of the most prevalent malignancies worldwide,and accurate prognostic assessment and treatment planning are vital for improving patient outcomes.Conventional prognostic models,which rely on limited clinicopathological parameters,often fail to capture the profound heterogeneity of HCC.In recent years,artificial intelligence(AI)-particularly machine learning and deep learning-has driven a paradigm shift in precision oncology by leveraging its powerful capabilities in data mining and pattern recognition.This review provides a comprehensive overview of recent advances in AI for prognostic assessment and treatment optimization in HCC,with an emphasis on key methodologies such as radiomics and multi-modal data integration.It further discusses the clinical potential and challenges of AI in predicting postoperative recurrence,evaluating therapeutic response,and supporting individualized treatment decisions,while also outlining future directions in this rapidly evolving field.The review aims to inform and facilitate the clinical translation of AI technologies into the management of HCC.

[Objective] To evaluate the efficacy and safety of sacral neuromodulation (SNM) in the treatment of patients with benign prostatic hyperplasia (BPH) complicated with underactive bladder (UAB) who respond poorly to transurethral resection of the prostate (TURP). [Methods] A retrospective analysis was performed on 10 patients with BPH and UAB treated with TURP by the same surgeon in Zhongda Hospital Southeast University during Jan.2018 and Jan.2023.The residual urine volume was not significantly relieved after operation, and the maximum urine flow rate and urine volume per discharge were not significantly improved.All patients underwent phase I SNM, and urinary diaries were recorded before and after surgery to observe the average daily frequency of urination, volume per urination, maximum urine flow rate, and residual urine volume. [Results] The operation time was (97.6±11.2) min.During the postoperative test of 2-4 weeks, if the residual urine volume reduction by more than 50% was deemed as effective, SNM was effective in 6 patients (60.0%). Compared with preoperative results, the daily frequency of urination [(20.2±3.8) times vs. (13.2±3.2) times], volume per urination [(119.2±56.7) mL vs. (246.5±59.2) mL], maximum urine flow rate [(8.7±1.5) mL/s vs. (16.5±2.6) mL/s], and residual urine volume [(222.5±55.0) mL vs. (80.8±16.0) mL] were significantly improved, with statistical significance (P<0.05). There were no complications such as bleeding, infection, fever or pain.The 6 patients who had effective outcomes successfully completed phase II surgery, and the fistula was removed.During the follow-up of 1 year, the curative effect was stable, and there were no complications such as electrode displacement, incision infection, or pain in the irritation sites.The residual urine volume of the other 4 unsuccessful patients did not improve significantly, and the electrodes were removed and the vesicostomy tube was retained. [Conclusion] SNM is safe and effective in the treatment of BPH with UAB patients with poor curative effects after TURP.

Nutritional support therapy is one of the extremely important treatment methods for patients in the intensive care unit. Timely and effective nutritional support regimens can improve patients' immune function, reduce complications, and optimize clinical outcomes. Energy expenditure is influenced by multiple factors, including patients' baseline characteristics (such as physical condition, gender, age) and dynamic changes in indicators (such as body temperature, nutritional support regimens, and therapeutic interventions). The currently recognized "gold standard" for accurately assessing energy metabolism in clinical practice is the indirect calorimetry system, also known as the metabolic cart. This device monitors carbon dioxide production and oxygen consumption in real time and uses specific algorithms to estimate the metabolic proportions of the three major nutrients (carbohydrates, fats, and proteins) in energy expenditure. An appropriate nutrient ratio helps maintain the balance between supply and demand in the body's nutritional metabolism. In the management of critically ill patients, the application of the metabolic cart enables personalized nutritional therapy, avoiding over- or under-supply of energy and optimizing the use of medical resources. Furthermore, with real-time, quantitative data support from the energy metabolism monitoring system, clinicians can develop more precise nutritional intervention strategies, thereby improving patient prognosis. This article provides a systematic review of the technical features of the metabolic cart and its application value in various critical care scenarios, aiming to offer a reference for indirect calorimetry in clinical practice.
Humans ; Critical Illness/therapy* ; Nutritional Support ; Energy Metabolism ; Calorimetry, Indirect

ObjectiveTo compare the clinical features of patients with hepatitis B virus （HBV）-related early-onset liver cancer and those with late-onset liver cancer， to assess the severity of the disease， and to provide a theoretical basis for the early diagnosis and treatment of liver cancer. MethodsA retrospective analysis was performed for 695 patients who were diagnosed with HBV-related liver cancer for the first time in Guangzhou Eighth People’s Hospital， Guangzhou Medical University， from January 2019 to August 2023， among whom 93 had early-onset liver cancer （defined as an age of50 years for female patients and40 years for male patients） and 602 had late-onset liver cancer （defined as an age of ≥50 years for female patients and ≥40 years for male patients）. Related clinical data were collected， including demographic data， clinical symptoms at initial diagnosis， comorbidities， smoking history， drinking history， family history， routine blood test results， biochemical parameters of liver function， serum alpha-fetoprotein（AFP）， virological indicators， coagulation function， and imaging findings. The pan-inflammatory indices neutrophil-to-lymphocyte ratio （NLR）， platelet-to-lymphocyte ratio （PLR）， and lymphocyte-to-monocyte ratio （LMR） were calculated， as well as FIB-4 index， aspartate aminotransferase-to-platelet ratio index （APRI）， S index， Model for End-Stage Liver Disease （MELD） score， Child-Turcotte-Pugh （CTP） score， albumin-bilirubin （AIBL） grade， and Barcelona Clinic Liver Cancer （BCLC） stage. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or Fisher’s exact test were used for comparison of categorical data between two groups. ResultsThere were significant differences between the two groups in the proportion of male patients and the incidence rates of diabetes， hypertension， and fatty liver disease （χ²=6.357， 15.230， 11.467， and 14.204， all P0.05）， and compared with the late-onset liver cancer group， the early-onset liver cancer group had a significantly higher proportion of patients progressing to liver cancer without underlying cirrhosis （χ²=24.657， P0.001） and a significantly higher proportion of patients with advanced BCLC stage （χ²=6.172， P=0.046）. For the overall population， the most common clinical symptoms included abdominal distension， abdominal pain， poor appetite， weakness， a reduction in body weight， edema of both lower limbs， jaundice， yellow urine， and nausea， and 55 patients （7.9%） had no obvious symptoms at the time of diagnosis and were found to have liver cancer by routine reexamination， physical examination suggesting an increase in AFP， or radiological examination indicating hepatic space-occupying lesion； compared with the late-onset liver cancer group， the patients in the early-onset liver cancer group were more likely to have the symptoms of abdominal distension， abdominal pain， and jaundice （all P0.05）. Compared with the late-onset liver cancer group， the early-onset liver cancer group had a significantly larger tumor diameter （Z=2.845， P=0.034）， with higher prevalence rates of multiple tumors and intrahepatic， perihepatic， or distant metastasis （χ²=5.889 and 4.079， both P0.05）， and there were significant differences between the two groups in tumor location and size （χ²=3.948 and 11.317， both P0.05）. Compared with the late-onset liver cancer group， the early-onset liver cancer group had significantly lower FIB-4 index， proportion of patients with HBsAg ≤1 500 IU/mL， and levels of LMR and Cr （all P0.05）， as well as significantly higher positive rate of HBeAg and levels of log₁₀ HBV DNA， AFP， WBC， Hb， PLT， NLR， PLR， TBil， ALT， Alb， and TC （all P0.05）. ConclusionCompared with late-onset liver cancer， patients with early-onset liver cancer tend to develop liver cancer without liver cirrhosis and have multiple tumors， obvious clinical symptoms， and advanced BCLC stage， which indicates a poor prognosis.

Objective:A novel grass-root community screening and management model of hepatitis B was developed in order to improve the diagnosis and treatment rate of hepatitis B in Guangzhou city.Methods:A three-tier collaborative framework［tertiary hospitals-center for disease control and prevention（CDC）-primary care clinics］implemented dual-track screening（fixed-site+mobile units）using rapid hepatitis B surface antigen（HBsAg）testing and structured surveys. Digital closed-loop management integrated screening，referral，and follow-up. Data were analyzed via SPSS 26.0.Results:Among 30 012 community-dwelling adults screened（Male∶Female=1∶1.68），overall HBsAg positive rate was 5.21%（1 565/30 012），peaking in the 50-59-year cohort（ χ2=271.80， P<0.001）. Hepatitis B knowledge awareness was critically low（39.24%）. Of 140 referred HBsAg-positive individuals，15 chronic carriers required no immediate antiviral therapy per guidelines. Treatment linkage surged from 32.8%（41/125）to 86.4%（108/125）post-intervention. aMAP hepatocellular carcinoma（HCC）risk stratification（n=82）revealed low（36.6%），intermediate（32.9%），and high-risk（30.5%）profiles. Conclusions:This coordinated，digitally-enhanced strategy significantly improved hepatitis B detection and treatment access. However，persistent knowledge gaps underscore the imperative for targeted community education and adherence support.

Objective:A novel grass-root community screening and management model of hepatitis B was developed in order to improve the diagnosis and treatment rate of hepatitis B in Guangzhou city.Methods:A three-tier collaborative framework［tertiary hospitals-center for disease control and prevention（CDC）-primary care clinics］implemented dual-track screening（fixed-site+mobile units）using rapid hepatitis B surface antigen（HBsAg）testing and structured surveys. Digital closed-loop management integrated screening，referral，and follow-up. Data were analyzed via SPSS 26.0.Results:Among 30 012 community-dwelling adults screened（Male∶Female=1∶1.68），overall HBsAg positive rate was 5.21%（1 565/30 012），peaking in the 50-59-year cohort（ χ2=271.80， P<0.001）. Hepatitis B knowledge awareness was critically low（39.24%）. Of 140 referred HBsAg-positive individuals，15 chronic carriers required no immediate antiviral therapy per guidelines. Treatment linkage surged from 32.8%（41/125）to 86.4%（108/125）post-intervention. aMAP hepatocellular carcinoma（HCC）risk stratification（n=82）revealed low（36.6%），intermediate（32.9%），and high-risk（30.5%）profiles. Conclusions:This coordinated，digitally-enhanced strategy significantly improved hepatitis B detection and treatment access. However，persistent knowledge gaps underscore the imperative for targeted community education and adherence support.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the significance of alkaline phosphatase to albumin ratio(APAR)in the diagnosis and prognosis evaluation of trauma sepsis in patients with multiple trauma.Methods A total of 130 patients with multiple trauma treated in this hospital from January 2021 to October 2023 were selected as subjects.According to the presence or absence of trauma sepsis,they were divided into sepsis group(82 cases)and non-sepsis group(48 cases).The patients with traumatic sepsis were followed up for 28 d and divided into survival group(67 cases)and death group(15 cases)according to the prognosis.The levels of alkaline phos-phatase and albumin in peripheral blood were detected by automatic biochemical analyzer,and APAR was cal-culated.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of alkaline phosphatase,albumin,and APAR for trauma sepsis in patients with multiple trauma.Multivariate Logistic re-gression analysis was used to explore the influencing factors of the prognosis of trauma sepsis in patients with multiple trauma.Results The levels of alkaline phosphatase and APAR in sepsis group were higher than those in non-sepsis group,and the level of albumin was lower than that in non-sepsis group(P＜0.05).The area under the curve(95％CI)of alkaline phosphatase,albumin,and APAR for predicting traumatic sepsis in patients with multiple trauma were 0.753(0.702-0.801),0.849(0.798-0.900),and 0.901(0.850-0.952),respectively.The cut-off values were 142.12 U/L,27.89 g/L and 5.24,the specificity were 55.24％,66.16％and 85.43％,and the sensitivity were 91.67％,91.67％and 84.12％,respectively.The levels of alka-line phosphatase and APAR in the death group were higher than those in the survival group,and the level of albumin was lower than that in the survival group(P＜0.05).Compared with the survival group,the death group had significantly higher proportion of patients aged ≥ 60 years,sequential organ failure score,acute physiology and chronic health evaluation Ⅰ(APACHEⅡ)score,and levels of C-reactive protein,blood lactic acid,and serum creatinine(P＜0.05).Multivariate Logistic regression analysis showed that old age(OR=2.330,95％CI 1.568-3.462),high APACHE Ⅱ score(OR=2.056,95％CI 1.448-2.921),high expression of alkaline phosphatase(OR=2.479,95％CI 1.652-3.720),low expression of albumin(OR=2.525,95％CI 1.543-3.288),and high APAR(OR=2.849,95％CI 1.848-4.394)were the influencing factors of the prog-nosis of trauma sepsis in patients with multiple trauma(P＜0.05).Conclusion APAR can be used as a bio-logical index to predict trauma sepsis in patients with multiple trauma,and the abnormal increase of APAR is associated with the prognosis of trauma sepsis.