Objective To explore the difference in balance ability and motor control between the elder and the young.Methods From July,2022 to February,2025,30 older adults(older group)and 30 young individuals(young group)were recruited in Huadong Hospital.Both groups underwent sensory organization test using a computerized dynamic posture recording system.Balance scores under six conditions,composite equilibrium score and strategy scores were recorded.The contributions of vision,somatosensation and vestibular function to balance under different stance conditions were analyzed.Results The balance scores were lower in the older group than in the young group under the conditions of eyes open/un-stable surface,eyes closed/unstable surface,and visual conflict/unstable surface(t>3.887,P<0.05),as well as the composite equilibrium score(t=5.603,P<0.05),visual and vestibular scores(t>3.815,P<0.05),and strat-egy scores under all six conditions(t>2.496,P<0.05).Conclusion Posture control ability decreases in older adults,mainly for decreasing visual and vestibular inputs and im-pairing in ankle and hip strategies.

Objective To explore the difference in balance ability and motor control between the elder and the young.Methods From July,2022 to February,2025,30 older adults(older group)and 30 young individuals(young group)were recruited in Huadong Hospital.Both groups underwent sensory organization test using a computerized dynamic posture recording system.Balance scores under six conditions,composite equilibrium score and strategy scores were recorded.The contributions of vision,somatosensation and vestibular function to balance under different stance conditions were analyzed.Results The balance scores were lower in the older group than in the young group under the conditions of eyes open/un-stable surface,eyes closed/unstable surface,and visual conflict/unstable surface(t>3.887,P<0.05),as well as the composite equilibrium score(t=5.603,P<0.05),visual and vestibular scores(t>3.815,P<0.05),and strat-egy scores under all six conditions(t>2.496,P<0.05).Conclusion Posture control ability decreases in older adults,mainly for decreasing visual and vestibular inputs and im-pairing in ankle and hip strategies.

Objective:To explore the application selection of preputial circular flap pedicle in the treatment of complex long segment urethral stricture.Methods:The data of 11 patients who underwent surgical reconstruction of the urethra for complex long segment urethral stricture between October 2019 and November 2022 in Xinhua Hospital Affiliated to Shanghai Jiaotong University, School of Medicine were retrospectively analyzed. The patients’ average age was 46(range 40-66) years old, with average urethral stricture length of 7 (range 6-13) cm and average maximum preoperative urinary flow rate of 5 (range 3-7) ml/s. They had a history of recurrent urinary tract infections and endoscopic treatment for urinary tract stones. Among the 11 cases, one patient had necrotizing fasciitis of the scrotum with complete destruction and loss of the scrotal urethra. This patient received acute bladder diversion, surgical debridement, vacuum sealing drainage, and negative pressure suction during the acute phase. And six months later, a circular preputial pedicle flap was used to reconstruct a 12 cm urethral defect in the scrotal region. The remaining 10 patients underwent preputial circular flap pedicle onlay urethral reconstruction. The changes in the patient's maximum urinary flow rate, and the signs of restenosis, urinary fistula, or urethral diverticulum were analyzed.Results:All 11 patients who underwent preputial circular flap pedicle urethral reconstruction had unobstructed urination after surgery. Surgical time ranged from 96 to 246 min, with an average of 121 min. The intraoperative blood loss ranged from 10 to 200 ml, with an average of 46 ml. The hospital stay ranged from 6 to 13 d, with an average of 9 d. The indwelling catheterisation time ranged from 18 to 28 d, with an average of 20 d. The patients were followed-up for 9 to 32 months, with an average of 24 months. All 11 cases had smooth urinary flow after surgery, and the maximum urinary flow rate ranged from 16.1 to 24.2 ml/s, with an average of 17.6 ml/s, which was significantly higher than that before surgery. Two patients had post-void dribbling after four weeks, and imaging showed the formation of a diverticulum in the reconstructed segment of the urethra.Conclusions:Urethral reconstruction with preputial circular flap pedicle is a viable treatment option for complex long segment urethral stricture. The surgical outcomes are satisfactory, and the choice of treatment should be based on the patient's own conditions and the surgeon's technical expertise.

Malocclusion,identified by the World Health Organization(WHO)as one of three major oral diseases,profoundly impacts the dental-maxillofacial functions,facial esthetics,and long-term development of～260 million children in China.Beyond its physical manifestations,malocclusion also significantly influences the psycho-social well-being of these children.Timely intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition,by mitigating the negative impact of abnormal environmental influences on the growth.Early orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development,ranging from fetal stages to the early permanent dentition phase.From an economic and societal standpoint,the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated,underlining its profound practical and social importance.This consensus paper discusses the characteristics and the detrimental effects of malocclusion in children,emphasizing critical need for early treatment.It elaborates on corresponding core principles and fundamental approaches in early orthodontics,proposing comprehensive guidance for preventive and interceptive orthodontic treatment,serving as a reference for clinicians engaged in early orthodontic treatment.

Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

Purpose/Significance To explore the research status,research hotspots and frontiers in the field of clinical decision sup-port based on electronic medical records(EMR).Method/Process The bibliometric method and CiteSpace 6.2.R2 software are used to draw scientific knowledge graph of country/region distribution,author cooperation,institutional cooperation,keyword co-occurrence and clustering for visualized comparative analysis.Python is used for clustering hotspot mining and analysis.Result/Conclusion The field of clinical decision support based on EMR data shows a rapid development trend,with the United States and China as the main research countries and strong cooperation between domestic and foreign institutions.The keywords mainly involve EMR,artificial intelligence(AI),etc.

Recently, malaria incidence has sharply resurgence in the border area of northern Myanmar, with the parasite incidence rate in 2023 being 21.47 times (95% CI: 18.84-24.48) that of 2019 in Kachin State's Razan and nearby areas. This resurgence caused the number of imported malaria cases to increase from 188 in 2019 to 398 in 2023 in Yunnan Province. In addition to the impact of military conflict, the border malaria joint prevention and control cooperation mechanism and malaria control measures established between China and Myanmar have failed to be implemented effectively due to the impact of the international COVID-19 epidemic. Hence, it is recommended that relevant departments evaluate the quality and effectiveness of the current cross-border transmission measures for malaria in the China-Myanmar border area from a technical perspective, and provide a large demand for primaquine, which can block the spread of malaria and cure vivax malaria, in response to the current prevalent characteristics of vivax malaria predominating in northern Myanmar. Moreover, to effectively reduce the mortality of imported malaria patients and prevent re-importation and transmission, it is necessary to enhance clinical physicians' knowledge, awareness, and vigilance regarding malaria diagnosis and treatment in the Yunnan border region, as well as China's ability and quality of appropriate response to imported malaria.

Clinical cases of necrotizing fasciitis and complete urethral defects in the scrotal region are rare. The diagnosis and treatment are very challenging. This article reports one case. The patient was admitted to the hospital after 1 week of poor urination and 2 days of scrotal swelling, and then underwent bladder diversion, surgical debridement, vacuum-sealing drainage, and wound closure. After four weeks, the wound healed and the patient was discharged. Six months later after surgery, scrotal urethral reconstruction was performed using a circular phimosis pedicled skin flap graft to repair the 12 cm urethral defect. The urethral catheter was removed after three weeks. The bladder fistula tube was removed after 5 weeks. During the follow-up of one year, there was no occurrence of urinary fistula and urinary obstruction.

Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

Objective:To explore the application selection of preputial circular flap pedicle in the treatment of complex long segment urethral stricture.Methods:The data of 11 patients who underwent surgical reconstruction of the urethra for complex long segment urethral stricture between October 2019 and November 2022 in Xinhua Hospital Affiliated to Shanghai Jiaotong University, School of Medicine were retrospectively analyzed. The patients’ average age was 46(range 40-66) years old, with average urethral stricture length of 7 (range 6-13) cm and average maximum preoperative urinary flow rate of 5 (range 3-7) ml/s. They had a history of recurrent urinary tract infections and endoscopic treatment for urinary tract stones. Among the 11 cases, one patient had necrotizing fasciitis of the scrotum with complete destruction and loss of the scrotal urethra. This patient received acute bladder diversion, surgical debridement, vacuum sealing drainage, and negative pressure suction during the acute phase. And six months later, a circular preputial pedicle flap was used to reconstruct a 12 cm urethral defect in the scrotal region. The remaining 10 patients underwent preputial circular flap pedicle onlay urethral reconstruction. The changes in the patient's maximum urinary flow rate, and the signs of restenosis, urinary fistula, or urethral diverticulum were analyzed.Results:All 11 patients who underwent preputial circular flap pedicle urethral reconstruction had unobstructed urination after surgery. Surgical time ranged from 96 to 246 min, with an average of 121 min. The intraoperative blood loss ranged from 10 to 200 ml, with an average of 46 ml. The hospital stay ranged from 6 to 13 d, with an average of 9 d. The indwelling catheterisation time ranged from 18 to 28 d, with an average of 20 d. The patients were followed-up for 9 to 32 months, with an average of 24 months. All 11 cases had smooth urinary flow after surgery, and the maximum urinary flow rate ranged from 16.1 to 24.2 ml/s, with an average of 17.6 ml/s, which was significantly higher than that before surgery. Two patients had post-void dribbling after four weeks, and imaging showed the formation of a diverticulum in the reconstructed segment of the urethra.Conclusions:Urethral reconstruction with preputial circular flap pedicle is a viable treatment option for complex long segment urethral stricture. The surgical outcomes are satisfactory, and the choice of treatment should be based on the patient's own conditions and the surgeon's technical expertise.