Objective:To observe the efficacy of synchronous scalp acupuncture and rehabilitation training in the treatment of poststroke dysphagia.Methods:A total of 106 participants were divided into an observation group and a control group using the random number table method,with 53 cases in each group.The control group was treated with scalp acupuncture in addition to conventional rehabilitation training.The observation group was treated with synchronous scalp acupuncture and conventional rehabilitation training.Water swallowing test(WST),blood oxygen-saturation change amplitude,mini-mental state examination(MMSE),and standardized swallowing assessment(SSA)were assessed before treatment,after 2 weeks of treatment,and at follow-ups at week 4 and week 6.The effective rate was calculated based on the change in the WST grading after 2 weeks of treatment.Results:After 2 weeks of treatment,there was an insignificant difference in the total effective rate between the two groups(P>0.05),but the inter-group difference in the cured plus markedly effective rate was significant(P<0.01).The intra-group differences in the WST grading,blood oxygen-saturation change amplitude,and the scores of MMSE and SSA were significant among the 4 time points in the two groups(P<0.01).At follow-up at week 6,the WST grading and SSA score in the observation group were superior to those in the control group(P<0.01).Conclusion:Both intervention protocols can improve the swallowing function,physical function,and psychological status;the observation group's intervention is better than that of the control group in improving swallowing function.

Cancer patients often experience worsening pain due to the limitations of traditional pharmacological treatments. This paper explores the innovative application of multi-agent systems in this field. As a key component of artificial intelligence, multi-agent systems assist healthcare providers in making intelligent decisions and interventions based on patients' conditions, and can collaborate with other smart devices to provide personalized care. This review discusses the concept of multi-agent systems, their application in pain management, and the potential challenges and countermeasures, aiming to provide guidance for the intelligent management of cancer patient pain.

Objective:To observe the efficacy of synchronous scalp acupuncture and rehabilitation training in the treatment of poststroke dysphagia.Methods:A total of 106 participants were divided into an observation group and a control group using the random number table method,with 53 cases in each group.The control group was treated with scalp acupuncture in addition to conventional rehabilitation training.The observation group was treated with synchronous scalp acupuncture and conventional rehabilitation training.Water swallowing test(WST),blood oxygen-saturation change amplitude,mini-mental state examination(MMSE),and standardized swallowing assessment(SSA)were assessed before treatment,after 2 weeks of treatment,and at follow-ups at week 4 and week 6.The effective rate was calculated based on the change in the WST grading after 2 weeks of treatment.Results:After 2 weeks of treatment,there was an insignificant difference in the total effective rate between the two groups(P>0.05),but the inter-group difference in the cured plus markedly effective rate was significant(P<0.01).The intra-group differences in the WST grading,blood oxygen-saturation change amplitude,and the scores of MMSE and SSA were significant among the 4 time points in the two groups(P<0.01).At follow-up at week 6,the WST grading and SSA score in the observation group were superior to those in the control group(P<0.01).Conclusion:Both intervention protocols can improve the swallowing function,physical function,and psychological status;the observation group's intervention is better than that of the control group in improving swallowing function.

Cancer patients often experience worsening pain due to the limitations of traditional pharmacological treatments. This paper explores the innovative application of multi-agent systems in this field. As a key component of artificial intelligence, multi-agent systems assist healthcare providers in making intelligent decisions and interventions based on patients' conditions, and can collaborate with other smart devices to provide personalized care. This review discusses the concept of multi-agent systems, their application in pain management, and the potential challenges and countermeasures, aiming to provide guidance for the intelligent management of cancer patient pain.

Objective To investigate the diagnostic value Tamm-Horsfall protein(THP)and osteopontin(OPN)in serum and 24-hour urine for urolithiasis.Methods A total of 101 patients with urolithiasis who underwent flexible ureteroscopy lithotripsy at the Urology Department of Civil Aviation General Hospital from April 2020 to March 2023 were included as the stone group,and 50 healthy individuals were enrolled as the control group.The samples of serum and 24-hour urine samples were collected from both the groups,and the levels of THP and OPN were measured using enzyme-linked immunosorbent assay(ELISA).Logistic regression analysis was performed to evaluate the association between each biomarker and urolithiasis,and receiver operating characteristic(ROC)curves were plotted to assess their diagnostic value.Results The stone group showed significantly lower THP levels(20.13[13.12,26.03]mg/d)and OPN levels(51.24[36.72,101.37]μg/d)in 24-hour urine,and THP levels(182.01[160.91,209.20]ng/mL)and OPN lev-els(18.76[15.72,22.48]ng/mL)in serum compared to the control group(all the P＜0.001).Binary Logistic regression analysis re-vealed that THP(OR=0.736,95％CI:0.606-0.895),OPN(OR=0.975,95％CI:0.958-0.993)and citrate(OR=0.067,95％CI:0.012-0.376)in 24-hour urine,and THP(OR=0.946,95％CI:0.908-0.986)and OPN(OR=0.896,95％CI:0.803-0.999)in ser-um were the protective factors for urolithiasis,while calcium level(OR=2.125,95％CI:1.243-3.633)24-hour urine was a risk factor(all the P＜0.05).ROC curve analysis showed that the areas under the curve(AUCROC)for the individual diagnosis of urolithiasis were 0.846,0.809,0.786,0.823,0.748,and 0.755 for the above six biomarkers,respectively.The AUCROC for the combined diagnosis u-sing THP+OPN in serum,THP+OPN in 24-hour urine and all the six biomarkers were 0.882,0.920 and 0.984,respectively,indica-ting better diagnostic performance.Conclusion The combined detection of the THP and OPN levels in serum and 24-hour urine may have good diagnostic value for urolithiasis and serve as potential diagnostic biomarkers.

Objective Alzheimer disease(AD),a continuous disease spectrum,includes the symptomatic stages of the period of mild cognitive impairment(MCI)and the dementia period,also known as AD dementia.Focusing on MCI and AD dementia screening,i.e.,AD spectrum screening,we analyzed the value of plasma biomarkers for diagnosing cognitive dysfunction in the local populations of Deyang City,Sichuan Province,China to provide evidence for the early screening and diagnosis of cognitive dysfunction.Methods A questionnaire survey was conducted between August 2023 and October 2023 among people aged 50 years or older in Deyang City,Sichuan Province.The survey covered demographic information,information on medical history,and cognitive function assessment.Subjects with MCI were included in the MCI group,those with AD dementia were included in the AD group,and the others were included in the healthy controls(HC)group.A partial sample,including all patients with AD dementia and a randomized sample of MCI patients and HC,was drawn.Then,the plasma levels of four cognition-related biomarkers,including phosphorylated tau217(p-tau217),were measured using an ultrasensitive digital chip immunoassay technology independently developed in China.Amyloid beta(Aβ)deposition was determined by positron emission tomography(PET)using Aβ molecular probes in all AD dementia patients and some of the MCI patients.The diagnostic value of the plasma biomarkers for cognitive dysfunction was assessed.Results A total of 2833 subjects were investigated,including 30(1.1％)with AD dementia,437(15.4％)with MCI,and 2366(83.5％)with HC.We measured the plasma levels of 4 biomarkers of 30 AD dementia patients,50 MCI patients,and 35 HC.Plasma p-tau217 performed best in differentiating AD dementia from HC and MCI,with the area under the curve(AUC)of receiver operator characteristic curves being 0.96(95％CI:0.91-1.00)and 0.93(95％CI:0.87-0.98),respectively.Plasma p-tau217 levels in the AD dementia,MCI,and HC groups were(2.32±1.27),(0.54±0.45),and(0.42±0.19)pg/mL,respectively,and the difference was statistically significant(P＜0.000 1).A total of 36 patients underwent Aβ PET examination.Plasma p-tau217 showed the best performance in the diagnosis of Aβ deposition(AUC:0.99,95％CI:0.96-1.00).Plasma p-tau217 levels were higher in Aβ-deposition-positive patients([2.52±1.17]pg/mL)than those in Aβ-deposition-negative patients([0.53±0.19]pg/mL),and the difference was statistically significant(P＜0.000 1).Plasma p-tau217 levels were significantly and positively correlated with Aβ PET uptake values in multiple brain regions of the frontal,temporal,and occipital lobes(r＞0.70,P＜0.000 1).Conclusion Plasma biomarkers measured with a technology independently developed in China demonstrate good performance in diagnosing AD dementia.Plasma p-tau217,in particular,demonstrates the highest diagnostic value and can be used for AD dementia screening of large populations.

Objective:To investigate the treatment strategy for pediatric humeral supracondylar fractures with callus formation and displacement neglected for over 1 week.Methods:A retrospective analysis was made of the clinical data of 36 children who had been treated at Department of Pediatric Orthopaedics, Medical Center, The Second Affiliated Hospital, Inner Mongolia Medical University from January 2011 to January 2021 for humeral supracondylar fractures with callus formation and displacement neglected for over 1 week. There were 22 boys and 14 girls, with an age of (6.7±2.7) years (from 2.3 to 12.8 years). All fractures were Gartland type Ⅲ. The patients were divided into 2 groups according to their treatment methods: a closed reduction and percutaneous pinning (CRPP) group of 15 patients subjected to the CRPP treatment only, and a leverage group of 21 patients subjected to CRPP assisted by the "lever technique" with posterior elbow Kirschner wire prying and pulling. The 2 groups were compared in terms of operation time, fluoroscopy frequency, quality of reduction, and recovery time for elbow range of motion; the elbow range of motion, visual analogue scale (VAS), Mayo elbow performance score (MEPS) and complications were assessed at the last follow-up.Results:The 2 groups were comparable because there was no significant difference between them in the general information before operation ( P>0.05). All patients were followed up for (26.2±16.3) months (from 6 to 96 months). All the fractures obtained acceptable reduction and clinical union 4 to 6 weeks after operation. The operation time [(28.2±6.8) min] and fluoroscopy frequency [(27.0±6.0) times] in the leverage group were significantly less than those in the CRPP group [(40.8±10.8) min and (43.3±11.4) times] ( P<0.05). The CRPP group was significantly better than the leverage group in the intraoperative Baumann angle (78.1°±1.6° versus 73.7°±4.1°), lateral capitellohumeral angle (58.3°±2.6° versus 49.6°±5.2°) and horizontal rotation rate (109.5%±3.0% versus 103.2%±4.9%) ( P<0.05). The intraoperative reduction in the CRPP group was significantly closer to the normal mean value than that in the leverage group ( P<0.05). There was no significant difference in the recovery time for elbow range of motion between the CRPP and the leverage groups ( P>0.05). At the last follow-up, the Baumann angle (75.4°±2.8°) and the lateral capitellohumeral angle (53.2°±3.6°) in the leverage group were still significantly better than those in the CRPP group (78.3°±1.5° and 57.5°±2.3°) ( P<0.05). However, there was no significant difference in the elbow range of motion, VAS, MEPS or incidence of complications between the 2 groups ( P>0.05). Conclusion:To treat humeral supracondylar fractures with callus formation and displacement neglected for over 1 week in children, CRPP assisted by the "lever technique" with posterior elbow Kirschner wire prying and pulling is an efficient and accurate method, because it can lead to more satisfactory reduction than CRPP only.

Objective:To explore the application of the the anterolateral thigh flap (ALTF) with vascularized fascia lata in repairing large lower lip defects.Methods:From January 2013 to June 2020, the clinical data of the cases with large complex lower lip defect due to extensive resection of lip tumor treated in the Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. The patients were immediately reconstructed using ALTF with vascularized fascia lata. The flap was used for shape reconstruction, and the fascia lata with residual orbicularis muscle was used for functional reconstruction via simulating the "closed-loop structure" of orbicularis. All these patients were followed up by regular visit. The survival of flap, mouth opening and closing were recorded.Results:All the 4 patients were successfully repaired through the above methods. The ALTF area was 18 cm×7 cm-26 cm×8 cm, with (5-8) cm ×1 cm fascia lata at both sides of the flap. The survival rate of ALTF was 100%. After 6-80 months’ follow-up, the ALTF was in good shape, and the mouth opening degree was 2-3 fingers. When the mouth was closed, the upper and lower lip could be sealed completely, and the drinking water is basically watertight.Conclusions:The shape and dynamic reconstruction could be completed in large complex lower lip defects through ALTF with vascularized fascia lata. The clinical effects were satisfying, and it’s an ideal option for repairing large complex lower lip defects.

Objective:To explore the clinical effect of observation and psychological intervention, splint or brace fixation as well as surgical treatment on habitual dislocation of the hip (HDH) and to combine the authors' data with a compilation of the cases from the literature, evaluingating the epidemiological characteristics of HDH and the treatment scheme to maintain the stability of hip joint by systematic literature review in children.Methods:A retrospective analysis of the relevant data of 11 patients (12 hips) with HDH were treated from March 2007 to March 2021, including 2 boys and 9 girls. The age of the first dislocation was 2.25 (1.66, 3.75) years old and 4.33 (3.33, 6.17) years old at the age of diagnosis. At the same time, the relevant literature reports were searched from 1932 to 2022, and 24 HDH patients reports and clinical studies were confirmed to be included in this study according to the inclusion and exclusion criteria. The data of 33 patients (38 hips) with HDH who were obtained in the literature, including 5 boys and 28 girls. The age of the first dislocation was 2.00 (1.50, 2.00) years old and 4.00 (2.55, 5.00) years old at the age of diagnosis. A total of 44 patients (50 hips) with HDH who were analyzed, including gender, age of first dislocation, age of diagnosis, mode of stimulating dislocation, side and direction of dislocation, accompanying symptoms, family history, trauma history and imaging examination. The data of 41 patients with HDH (3 patients were excluded due to lack of treatment description) were treated with observation and psychological intervention in 19 patients, splint or brace fixation in 13 patients, and surgical treatment in 9 patients. The femoral neck-stem angle, acetabular index, central edge angle (CE angle) and Reimers instability index were measured by AutoCAD software, and the hip function was evaluated by Harris standard. Meantime, the disappearance time of dislocation was recorded.Results:The average follow-up time of 44 patients (50 hips) with HDH were 4.05±2.93 years old, and the time of disappearance of dislocation after treatment were 1.28±1.19 years old. Patients were diagnosed as 7 boys and 37 girls, 30 right and 8 left as well as 6 bilateral, the age of the first dislocation was 2.64±1.54 years old and 4.52±2.64 years old at the age of diagnosis. The data of 39 patients took hip flexion, adduction, internal rotation or hip flexion and adduction as the mode of stimulating dislocation. There were 43 patients with posterior dislocation, 41 patients with an audible "click" sound during dislocation, 36 patients with painless dislocation, and 37 patients with "vacuum phenomenon" were captured at the moment of dislocation. All patients with HDH had no specific family history and obvious history of trauma. There was no significant difference in general data between observation and psychological intervention group, splint or brace fixation group as well as surgical treatment group ( P>0.05). Harris standard to evaluate hip function, CE angle and Reimers instability index of the affected side were significantly different from those before and after treatment at the moment of dislocation ( H=127.51, P<0.001; H=55.70, P<0.001; H=54.69, P<0.001). Compared with the immediate disappearance of dislocation in the surgical treatment group, the disappearance time of dislocation in the observation and psychological intervention group and the splint or brace fixation group were significantly longer, and the difference was statistically significant ( H=20.83, P<0.001). Conclusion:Without specific family history and obvious trauma at young girls, painless posterior dislocation of hip with an audible "click" sound and "vacuum phenomenon" at the moment of dislocation are the significant epidemiological characteristics of HDH. Observation and psychological intervention, splint or brace fixation are recommended as the initial treatment scheme. When conservative treatment is ineffective, surgical treatment is needed to stabilize the hip joint quickly.

Objective:To explore the application of the the anterolateral thigh flap (ALTF) with vascularized fascia lata in repairing large lower lip defects.Methods:From January 2013 to June 2020, the clinical data of the cases with large complex lower lip defect due to extensive resection of lip tumor treated in the Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. The patients were immediately reconstructed using ALTF with vascularized fascia lata. The flap was used for shape reconstruction, and the fascia lata with residual orbicularis muscle was used for functional reconstruction via simulating the "closed-loop structure" of orbicularis. All these patients were followed up by regular visit. The survival of flap, mouth opening and closing were recorded.Results:All the 4 patients were successfully repaired through the above methods. The ALTF area was 18 cm×7 cm-26 cm×8 cm, with (5-8) cm ×1 cm fascia lata at both sides of the flap. The survival rate of ALTF was 100%. After 6-80 months’ follow-up, the ALTF was in good shape, and the mouth opening degree was 2-3 fingers. When the mouth was closed, the upper and lower lip could be sealed completely, and the drinking water is basically watertight.Conclusions:The shape and dynamic reconstruction could be completed in large complex lower lip defects through ALTF with vascularized fascia lata. The clinical effects were satisfying, and it’s an ideal option for repairing large complex lower lip defects.