OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

Objective To explore the correlation between central venous oxygen saturation(ScvO2)-re-lated indexes at different time points and the occurrence of low cardiac output syndrome(LCOS)after con-genital heart disease(CHD)correction surgery.Methods A total of 73 children who underwent CHD correc-tion surgery in this hospital from July 1st,2021 to July 1st,2024 were selected as the research subjects.The clinical data,preoperative conditions,and postoperative conditions of the children were collected.The ScvO2 and arterial lactate(Lac)levels of the children at different time points(the 1st,6th,12th,and 24th hours after surgery)were monitored,and the ScvO2/Lac at different time points and the change rate of ScvO2 in different time periods were calculated.The correlation between ScvO2-related indexes and LCOS after CHD correction surgery was analyzed.Results ScvO2 at the 6th hour after surgery,ScvO2 at the 12th hour after surgery,Sc-vO2/Lac at the 12th hour after surgery,the change rate of ScvO2 from the 1st to the 24th hour after surgery,the change rate of ScvO2 from the 6th to the 12th hour after surgery,and the change rate of ScvO2 from the 12th to the 24th hour after surgery were independent influencing factors of LCOS occurrence after CHD cor-rection surgery(P＜0.05).There was a negative correlation between ScvO2 at the 12th hour after surgery,ScvO2/Lac and LCOS occurrence after CHD correction surgery(r=-0.543,-0.523,P＜0.05).The area under the curve(AUC)of ScvO2 at the 12th hour after surgery for predicting LCOS occurrence after CHD correction surgery was 0.938(95％CI:0.865-1.000);the AUC of ScvO2/Lac at the 12th hour after surgery for predicting LCOS occurrence after CHD correction surgery was 0.922(95％CI:0.851-0.994).Conclusion ScvO2 and ScvO2/Lac at the 12th hour after surgery have good predictive potential for LCOS occurrence af-ter CHD correction surgery.

Objective:To evaluate the efficacy and safety of regional citrate anticoagulation (RCA) during plasma exchange (PE) in pediatric patients.Methods:We conducted a retrospective analysis of 12 critically ill children admitted to the Pediatric Intensive Care Unit (PICU) of Jinan Children's Hospital, who underwent 28 PE sessions with RCA between December 2023 and August 2024. Clinical records were reviewed to assess bleeding events, extracorporeal circuit performance, and changes in arterial blood gas parameters, serum total calcium (Ca tot), and activated clotting time before and after treatment. Results:No patients exhibited signs of increased bleeding. In one case, the procedure was discontinued prematurely due to elevated venous pressure. A significant decrease in ionized calcium (Ca ion) was observed 0.5 hours post-treatment. At the end of PE, pH, HCO 3?, base excess (BE), lactate, PaCO 2, Ca tot, and Na + levels increased, while K + and Ca ion levels decreased, with all changes being statistically significant. Four hours post-treatment, pH, HCO 3?, BE, PaCO 2, and Na + remained elevated, whereas Ca ion, lactate, and K + returned to baseline. By 12–15 hours post-treatment, all parameters—including pH, HCO 3?, BE, PaCO 2, Na +, K +, Ca ion, and lactate—had normalized, showing no significant differences from pre-treatment levels. Conclusions:RCA provides effective extracorporeal anticoagulation during pediatric PE without increasing bleeding risk. However, metabolic complications—primarily metabolic alkalosis—are common. These disturbances typically resolve spontaneously and do not lead to severe adverse events. While no ideal anticoagulant for PE has yet been established, RCA remains a safe and effective option, particularly for pediatric patients at higher risk of bleeding.

Childhood is an important period for individual health. In order to provide community child health services, Zhoujiaqiao Community Health Service Center of Shanghai Changning District has opened a pediatric clinic since July 2017. Through equipping basic facilities, personnel training, extending service items and service time, allocating resources with cooperative hospitals, optimizing internal system management and other methods, the community pediatric service under the family physician team model has been initially constructed. The article summarizes experiences in the construction and operation of community pediatric services and child health care, to provide reference for the development of a replicable and promotable urban community pediatric service system under the contracted family physician team model.

OBJECTIVE To analyze the compositional differences between Fructus Tritici Levis and Triticum aestivum， and to provide reference for identification and quality control of both. METHODS Twenty batches of Fructus Tritici Levis and three batches of T. aestivum were collected， and their fingerprints were acquired by high-performance liquid chromatography and the similarities were evaluated by the Evaluation System of Similarity of Chromatographic Fingerprints of Traditional Chinese Medicine （2012 version）. Cluster analysis （CA）， principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA） were performed to analyze the difference of Fructus Tritici Levis and T. aestivum from different regions， and the differential components were screened. The contents of the six identified components in Fructus Tritici Levis and T. aestivum were determined. RESULTS The similarities of the fingerprints of Fructus Tritici Levis ranged from 0.928 to 0.996， and the relative similarities of T. aestivum with Fructus Tritici Levis ranged from 0.761 to 0.773. A total of 19 common peaks were calibrated， and six components including linolenic acid， linoleic acid， 5-heptadecylresorcinol， 5-nonadodecylresorcinol， 5- heneicosylresorcinol， and 5-tricosylresorcinol were identified. The results of CA and PCA showed that Fructus Tritici Levis and T. aestivum could be clearly distinguished； the distribution of Fructus Tritici Levis from Anhui province was relatively concentrated. The results of OPLS-DA showed that linolenic acid， linoleic acid， and other six unknown compounds were the differential components between Fructus Tritici Levis and T. aestivum. The average contents of the six identified components in Fructus Tritici Levis were 0.100 9， 1.094 0， 0.005 1， 0.030 9， 0.098 2，and 0.024 8 mg/g， respectively； the contents of linolenic acid and linoleic acid in Fructus Tritici Levis were significantly higher than those in T. aestivum （P＜0.05）.CONCLUSIONS The established qualitative and quantitative methods are simple and reliable， and can be used for the identification and quality evaluation of Fructus Tritici Levis and T. aestivum. The identified differential components， such as linolenic acid and linoleic acid， can also provide clues for the differentiation and pharmacological study of Fructus Tritici Levis and T. aestivum.

OBJECTIVE To analyze the compositional differences between Fructus Tritici Levis and Triticum aestivum， and to provide reference for identification and quality control of both. METHODS Twenty batches of Fructus Tritici Levis and three batches of T. aestivum were collected， and their fingerprints were acquired by high-performance liquid chromatography and the similarities were evaluated by the Evaluation System of Similarity of Chromatographic Fingerprints of Traditional Chinese Medicine （2012 version）. Cluster analysis （CA）， principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA） were performed to analyze the difference of Fructus Tritici Levis and T. aestivum from different regions， and the differential components were screened. The contents of the six identified components in Fructus Tritici Levis and T. aestivum were determined. RESULTS The similarities of the fingerprints of Fructus Tritici Levis ranged from 0.928 to 0.996， and the relative similarities of T. aestivum with Fructus Tritici Levis ranged from 0.761 to 0.773. A total of 19 common peaks were calibrated， and six components including linolenic acid， linoleic acid， 5-heptadecylresorcinol， 5-nonadodecylresorcinol， 5- heneicosylresorcinol， and 5-tricosylresorcinol were identified. The results of CA and PCA showed that Fructus Tritici Levis and T. aestivum could be clearly distinguished； the distribution of Fructus Tritici Levis from Anhui province was relatively concentrated. The results of OPLS-DA showed that linolenic acid， linoleic acid， and other six unknown compounds were the differential components between Fructus Tritici Levis and T. aestivum. The average contents of the six identified components in Fructus Tritici Levis were 0.100 9， 1.094 0， 0.005 1， 0.030 9， 0.098 2，and 0.024 8 mg/g， respectively； the contents of linolenic acid and linoleic acid in Fructus Tritici Levis were significantly higher than those in T. aestivum （P＜0.05）.CONCLUSIONS The established qualitative and quantitative methods are simple and reliable， and can be used for the identification and quality evaluation of Fructus Tritici Levis and T. aestivum. The identified differential components， such as linolenic acid and linoleic acid， can also provide clues for the differentiation and pharmacological study of Fructus Tritici Levis and T. aestivum.

Objective:To evaluate the clinical value of intraoperative sliding CT in deep brain stimulation (DBS) for Parkinson's disease (PD).Methods:A total of 117 PD patients accepted DBS in Department of Neurosurgery, First Affiliated Hospital of Zhengzhou University from May 2019 to May 2023 were chosen; 46 patients had local anesthesia and 71 had general anesthesia. Bilateral subthalamic nucleus (STN) DBS was performed in 73 patients, bilateral medial globus pallidus (GPi) DBS was performed in 43 patients, and right GPi and left STN DBS was performed in 1 patient. Preoperative/intraoperative sliding CT images and preoperative MRI images were fused to calculate the spatial distance between the preoperative planned target and actual target (adjusting electrode position timely in case of spatial distance greater than 2 mm [electrode displacement]). Differences of spatial distance between preoperative planned target and actual target in patients accepted different types of anesthesia and surgical modalities were compared.Results:All 117 patients were successfully operated and 234 electrodes were implanted. No patients needed a second operation for misalignment of electrodes or poor efficacy. During CT scan, neither anesthesia extubation or mechanical collision nor intracranial hemorrhage complications occurred. Spatial distance between the preoperative planned target and actual target was (1.35±0.50) mm in 117 patients. Displacement was noted in 4 electrodes and immediately adjusted during the operation; and CT re-examination confirmed good electrode position. No statistical significance in spatial distance between the preoperative planned target and actual target was noted between the general anesthesia group and local anesthesia group, and between the STN group and GPi group ( P>0.05). Conclusion:Intraoperative sliding CT is simple, safe and effective, which helps to timely adjust the electrode position during operation, avoids second operation and complications, and improves the safety and efficacy of DBS.

ObjectiveTo realize the automatic recognition of the slicing angles of Fritillariae Thunbergii Bulbus （FTB） based on the improved YOLOv7-tiny algorithm. MethodFirstly， a diverse dataset of FTB images， totaling 16 000 pictures， with various angles was constructed. Furthermore， improvements were made to YOLOv7-tiny by replacing standard convolutions with ghost convolution （GhostConv）， incorporating the coordinate attention （CA） mechanism as a preferred addition， substituting some activation functions with HardSwish function for decreasing the floating point operations. Additionally， a penalty term for angle recognition error was integrated into the loss function， and modifications were made to the non-maximum suppression （NMS） strategy to address cases where multiple detection results were associated with the same target. In order to verify the effectiveness of different improvement points on the optimization of the algorithm model， ablation experiments were carried out on all the improvement points， and the effectiveness of the improvement points was proved by comparing the prediction results before and after the addition of a certain improvement point on the basis of the original model or the model with the addition of an improvement point that has been verified to be effective， in order to evaluate the improvement of the indexes. ResultThe number of parameters required for the improved slicing angle recognition algorithm of FTB was about 55.4% of the original algorithm， and the amount of computation was about 59.4% of the original algorithm. The mAP@0.5［mean average precision at an intersection over union（IoU） of 0.5］ increased by 12.2%， the mean absolute error（MAE） of the recognized angle was 5.02°， representing a reduction of 4.58° compared to the original algorithm. In the experimental environment of this paper， the average recognition time per image was as low as 8.7 ms， significantly faster than the average human reaction time. ConclusionThis study， by utilizing the improved YOLOv7-tiny algorithm， achieves effective slicing angle recognition of FTB with high accuracy and more lightweight， which provides a novel approach for stable and precise automated slicing of FTB， thereby providing valuable insights into the automation of processing other traditional Chinese medicines.

Objective To analyze the factors affecting the risk of hepatocellular carcinoma(HCC)in patients with chronic hepatitis B-associated cirrhosis(CHB-Cir)complicated by essential hypertension(EH)and explore the impact of EH on HCC risk in patients with CHB-Cir.Methods This study was conducted among the patients with CHB-Cir with or without EH received antiviral therapy in the Infectious Disease Department,Third Affiliated Hospital of Xinxiang Medical University from January,2017 to January,2024.The cases with insufficient follow-up time or missing data were excluded.The patients were subjected to propensity score matching in a 1:1 ratio to form an EH group and a non-EH group.The Kaplan-Meier method was used to compare the cumulative incidence of HCC between the two groups,and the Cox proportional hazards regression model was used to analyze the risk of HCC and the factors affecting HCC risk.Results A total of 390 CHB-Cir patients(274 male and 116 female patients)were enrolled in this study,including 195 with EH and 195 without EH.In these patients,EH was significantly correlated with the occurrence of HCC(HR=1.69,P=0.002).Multivariate analysis suggested that the male gender(HR=1.73,P=0.005),a family history of liver cancer(HR=2.23,P<0.001),elevated alpha-fetoprotein(HR=2.83,P=0.001),elevated glutathione reductase(HR=1.53,P=0.046),reduced high-density lipoprotein(HR=1.46,P=0.027),and elevated low-density lipoprotein(HR=2.29,P=0.003)were all significantly correlated with HCC occurrence,while elevated triglycerides(HR=0.37,P<0.001)was a protective factor against HCC.In the EH group,treatment with non-RASIs drugs(HR=2.77,P=0.021)and no treatment/diuretic treatment(HR=7.18,P<0.001)were significantly correlated with HCC occurrence.Conclusion Hypertension increases the risk of HCC in patients with CHB-Cir,suggesting the importance of controlling hypertension in these patients.

Bone and soft tissue tumors occur in the musculoskeletal system, and malignant bone tumors of bone and soft tissue account for 0.2% of all human malignant tumors, and if not diagnosed and treated in a timely manner, patients may be at risk of a poor prognosis. Image interpretation plays an increasingly important role in the diagnosis of bone and soft tissue tumors. Artificial intelligence (AI) can be applied in clinical treatment to integrate large amounts of multidimensional data, derive models, predict outcomes, and improve treatment decisions. Among these methods, deep learning is a widely employed technique in AI that predominantly utilizes convolutional neural networks (CNN). The network is implemented through repeated training of datasets and iterative parameter adjustments. Deep learning-based AI models have successfully been applied to various aspects of bone and soft tissue tumors, encompassing but not limiting in image segmentation, tumor detection, classification, grading and staging, chemotherapy effect evaluation, recurrence and prognosis prediction. This paper provides a comprehensive review of the principles and current state of AI in the medical image diagnosis and treatment of bone and soft tissue tumors. Additionally, it explores the present challenges and future prospects in this field.