OBJECTIVE: To investigate short-term effectiveness of robot-assisted fracture reduction and fixation combined with arthroscopic exploration for posterolateral depressed tibial plateau fractures. METHODS: Between January 2022 and January 2024, 8 patients with posterolateral depressed tibial plateau fractures (Schatzker type Ⅲ) were treated using robot-assisted fracture reduction and fixation combined with arthroscopic exploration, with simultaneous treatment of concomitant ligament or meniscus tears. There were 3 males and 5 females with an average age of 54.1 years (range, 42-68 years). Injury mechanisms included traffic accidents (3 cases) and falls (5 cases). The time from injury to operation ranged from 2 to 4 days (mean, 3.1 days). Operation time, intraoperative blood loss, hospital stay duration, visual analogue scale (VAS) score for pain, and complications were recorded. Fracture healing and knee Rasmussen scores were assessed radiographically, while knee function was evaluated using range of motion and Hospital for Special Surgery (HSS) scores. RESULTS: All operations were successfully completed. The operation time was 108-129 minutes (mean, 120.1 minutes). The intraoperative blood loss was 10-100 mL (mean, 41.3 mL). The hospital stay duration was 4-7 days (mean, 5.6 days). All incisions healed by first intention without complication such as peroneal nerve injury, vascular damage, or infection. All patients were followed up 32-48 weeks (mean, 40 weeks). Radiographic follow-up confirmed that the knee Rasmussen scores rated as excellent in 8 patients and all fractures healed with the healing time of 12-16 weeks (mean, 13.5 weeks). The VAS score for pain was 2-4 (mean, 2.8) at discharge and improved to 0 at 1 month after operation. The knee range of motion was 80°-110° (mean, 96.1°) at discharge and increased to 135°-140° (mean, 137.9°) at 1 month after operation. At 3 months after operation, the HSS score was 91-94 (mean, 92.8), all graded as excellent. No severe complication, including implant failure, occurred during follow-up. CONCLUSION For posterolateral depressed tibial plateau fractures, the minimally invasive approach combining robot-assisted fracture reduction and fixation with arthroscopic exploration demonstrates multiple advantages, including shorter operation time, reduced intraoperative blood loss, excellent wound healing, fewer complications, and rapid recovery of knee function. This technique achieves satisfactory short-term effectiveness, while its long-term effectiveness requires further evaluation.
Humans ; Male ; Tibial Fractures/surgery* ; Female ; Middle Aged ; Adult ; Arthroscopy/methods* ; Minimally Invasive Surgical Procedures/methods* ; Fracture Fixation, Internal/methods* ; Aged ; Treatment Outcome ; Robotic Surgical Procedures/methods* ; Operative Time ; Range of Motion, Articular ; Fracture Healing ; Length of Stay ; Tibial Plateau Fractures

Objective: To develop an assessment tool for risky road behavior tendencies among middle school students in western China, as well as to determine the relevant indices and their weights, so as to provide the reference for road safety prevention and control for middle school students in western China. Methods: A Delphi study was employed to construct the assessment tool for risky road behavior tendencies among middle school students in western China. In August 2023, eighteen experts in related fields such as traffic safety, education, and healthcare were invited to achieve Delphi consensus. The final indices were initially selected based on the consulting results,followed by the determination of their individual and combined weights using the analytic hierarchy process. Results: The finalized assessment tool comprised 3 primary indicators, 13 secondary indicators, and 100 tertiary indicators. The positivity coefficient of experts was 100%, accompanied by the authority coefficient 0.90. The mean importance scores for the three primary indicators varied from 4.67 to 4.78, while those for the 13 secondary indicators ranged from 4.22 to 4.89. The Kendall coefficient W was statistically significant at 0.32 ( χ 2=96.83, P <0.05). The weights assigned to the three primary indicators were:ability (0.329 4), opportunity (0.337 3), and motivation (0.333 3). The secondary indicators with the top three highest combined weights were social influence (0.027 4), knowledge (0.027 3), and skills (0.026 7). Conclusions The assessment tool for risky road behavior tendencies among middle school students in western China demonstrates high expert consensus, with balanced weighting of primary and secondary indicators. Expanded use of the assessment tool would provide the data support for intervention work.

Objective To understand the serotype, drug resistance and pulsed field gel electrophoresis (PFGE) typing of Salmonella isolated from meat products in Hengyang from 2020 to 2022, so as to provide scientific data for the prevention and control of food-borne Salmonella infection in our city. Methods All 101 Salmonella isolated from meat products were serotyped, drug sensitivity tests were performed with micro broth dilution method, molecular typing was performed using PFGE, clustering analysis was performed with BioNumerics software, and statistical analysis was performed using SPSS 18.0 software. Results The total detection rate of Salmonella from meat sources in Hengyang City from 2020 to 2022 was 38.55% (101/262). Totally 23 different serotypes were detected in the 101 strains of Salmonella among which S. London (21.78%, 22/101),was the dominant serotypes. Seventy nine Salmonella strains showed different levels of drug resistance, with a multi drug resistance rate of 42.57% (43/101). Eighty nine different PFGE bands were found in the 101 strains of Salmonella, with a similarity of approximately 55% to 100%. Conclusion Different Salmonella Serotype are widely distributed, and the antibiotic resistance rate is very high. The PFGE map are polymorphic, and the homology of PFGE bands in Salmonella from different sources is relatively low.

With the development of information technology, the massive growth of pharmaceutical electronic data and the significant increase in the reports of drug adverse event reports have brought great challenges to pharmacovigilance research. Data mining techniques can automatically extract the risk signals of adverse drug reaction from real-world data. Therefore, efficient data mining of massive adverse event reporting is a necessary measure to realize the automatic detection of adverse drug reactions. By introducing the current major large-scale adverse drug event reporting databases and related data mining methods, this study reviews the application and limitations of adverse drug reaction data mining technology in pharmacovigilance, which provides reference for pharmacovigilance-related institutions and researchers.

Objective To observe the value of CT radiomics-based nomogram for predicting difference of Lauren types of gastric cancers between endoscopic biopsy and postoperative pathology.Methods Totally 126 patients with gastric cancer diagnosed by surgical pathology were retrospectively analyzed.The patients were divided into concordant group(n=77)and inconsistent group(n=49)according to the concordance between endoscopic biopsy and postoperative pathology results or not,also divided into training set and validation set at the ratio of 2∶1.Clinical predictors were screened,then a clinical prediction model was constructed.Radiomics features were extracted based on venous-phase CT images and screened using L1 regularization.Radiomics models were constructed using 3 machine learning(ML)algorithms,i.e.decision trees,random forests and logistic regression.The nomogram based on clinical and the best ML radiomics model was constructed,and the efficacy and clinical utility of the above models and nomogram for predicting inconsistency of Lauren types of gastric cancers between endoscopic biopsy and postoperative pathology were evaluated.Results Patients'age,platelet count,and arterial-phase CT values of tumors were all independent predictors of inconsistency between endoscopic biopsy and postoperative pathology of Lauren types of gastric cancer.CT radiomics model using random forests algorithm showed better predictive efficacy among 3 ML models,with the area under the curve(AUC)of 0.835 in training set and 0.724 in validation set,respectively.The AUC of clinical model,radiomics model and the nomogram in training set was 0.764,0.835 and 0.884,while was 0.760,0.724 and 0.841 in validation set,respectively.In both training set and validation set,the nomogram showed a good fit and considerable clinical utility.Conclusion CT radiomics-based nomogram had potential clinical application value for predicting inconsistency of Lauren types of gastric cancers between endoscopic biopsy and postoperative pathology.

Objective To observe the value of spectral CT multi-parameter imaging for preoperative predicting lymph node metastasis(LNM)of gastric cancer.Methods Totally 136 patients with gastric adenocarcinoma were retrospectively enrolled.The patients were further divided into LNM group(n=74)and non-LNM group(n=62)according to postoperative pathological findings of lymph nodes status.Clinical data,conventional CT findings and spectral CT parameters were compared between groups.Factors being significant different between groups were included in multivariate logistic regression analysis to screen independent predictors of gastric cancer LNM.Clinical+conventional CT model(model 1),spectrum CT model(model 2)and combined model(model 3)were constructed based on the above independent predictors,respectively.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of each model for preoperative predicting LNM of gastric cancer.Results CT-N stage,CT-T stage,70,100 and 140 keV CT valuestumor at arterial phase(AP),arterial enhancement fraction(AEF)and normalized iodine concentration at venous phase(NICVP)were all independent predictors of gastric cancer LNM(all P＜0.05).AUC of model 3 was 0.846,higher than that of model 1 and model 2(AUC=0.767,0.774,Z=-0.368,-2.373,both P＜0.05)for preoperative predicting LNM of gastric cancer,while the latter two were not significantly different(Z=-0.152,P=0.879).Conclusion Spectral CT multi-parameter imaging could effectively predict LNM of gastric cancer preoperatively.

Purpose/Significance To explore the changes,challenges,key application scenarios and future development directions of generative artificial intelligence(AI)represented by ChatGPT in the field of hospital management,and to provide references for the ap-plication of AI natural language processing(NLP)technology in the field of hospital management in China.Method/Process Through literature review and analysis,the changes and challenges brought about by the rapid development of generative AI in the field of hospital management are sorted out,its key application scenarios and future development directions in the field of hospital management are empha-sized and explored.Result/Conclusion AI has broad application prospects in the field of hospital management,and it should focus on exploring its practical application scenarios and strategic directions to provide reference and guidance for promoting the high-quality de-velopment of public hospitals.

Objective To investigate the clinical features,diagnosis and treatment of congenital epulis,to provide a reference for clinical diagnosis and treatment.Methods Two cases of congenital epulis in the mandible and maxilla of a newborn were reported,and the boundary and size of the tumor were determined by ultrasonography and MRI.The tu-mor was resected under general anesthesia.The previous literature on congenital epulis was reviewed and analyzed.Results Patient 1(male)had a hard mass of approximately 20 mm×15 mm×10 mm in the right mandible immedi-ately after birth.MRI was performed,and the mass was removed.In Patient 2(female),a mass approximately 24 mm×23 mm×20 mm in the oral cavity of the anterior maxillary region was shown on ultrasound at 29 gestational weeks,and the mass grew rapidly in the last trimester.The mass was removed after birth.Postoperative pathological examination re-vealed congenital epulis.The results of the literature review showed that the incidence of congenital epulis is greater in females than in males,and it mainly occurs in the maxillary incisor area.Congenital epulis does not invade bone and does not affect tooth development.When a mass affects a child's breathing or swallowing,it must be surgically removed in a timely manner.Recent studies have shown that there is no evidence of recurrence after surgical resection.The histo-logical origin and etiology of the disease are not clear.Clinically,it is often necessary to distinguish between teratomas and congenital epulis.Regarding the clinical manifestations,teratomas and congenital epulis are similar in appearance,and the main distinguishing point lies in pathological manifestations.Under the microscope,teratomas are observed as mature or immature tissue from various embryonic layers,while congenital epulis involves tightly arranged,homoge-neous,polygonal to microspindle-shaped,medium to large cell compositions of nest-like and ribbon-like cells.Conclu-sion Congenital epulis is a rare oral tumor in neonates.The diagnosis should be based on the location,age,clinical manifestations,and imaging findings.The final diagnosis depends on pathological examination.When congenital epulis tumors affect children's breathing and eating,they should be surgically removed as soon as possible,and there is al-most no recurrence after surgery.

Objective Evaluation of Chinese-thyroid imaging reporting and data system(C-TIRADS)combined with contrast-enhanced ultrasound(CEUS)for the assessment of category 4 nodules in the setting of Hashimoto's thyroiditis.Methods Retrospective analysis of 120 C-TIRADS category 4 thyroid nodules from 79 patients with confirmed Hashimoto's thyroiditis who attended the Yiyang Central Hospital from June to December 2022.Thyroid nodules exhibiting one or more benign or malignant features that were suspicious on CEUS were treated as downgraded or upgraded one level.Using the final surgical pathology results as the gold standard,working characteristic(ROC)curves of subjects based on C-TIRADS grading before and after CEUS adjustment were plotted to compare diagnostic efficacy.Results The sensitivity,specificity,and accuracy of the CEUS-adjusted C-TIRADS were 93.0％,87.8％and 90.8％,respectively(P<0.05).The area under the ROC curve was 0.811 and 0.904,respectively(P<0.05).Conclusion C-TIRADS combined with CEUS has better diagnostic efficacy in evaluating category 4 nodules in Hashimoto's thyroiditis.