ObjectiveTo analyze the research hotspots and development trends in the field of spinal cord stimulation (SCS) for spinal cord injury (SCI). MethodsLiterature about SCS for SCI was retrieve from the Web of Science (WOS) Core Collection database, with a time range from January, 1999 to July, 2025. VOSviewer 1.6.20 and CiteSpace 6.4.R2 were used to analyze the annual publication volume, countries, authors, institutions, journals and keywords. ResultsA total of 636 literatures were included. From 1999 to 2025, the overall publication trend in this field showed an upward trajectory, with recent years fluctuating but tending to stabilize. The country with the most publications was the United States (429 papers), followed by Russia (98 papers) and China (70 papers). The institution with the highest number of publications was the University of California, Los Angeles (76 papers), the author with the most publications was V. Reggie Edgerton (70 papers), and the journal with the most publications was Journal of Clinical Medicine (31 papers). The most frequently cited study focused on exploring the combination of epidural spinal cord stimulation with task-specific training to restore motor function in patients with complete SCI. Keyword analysis showed that the research hotspots in this field were mainly focused on neuroregulation mechanisms, recovery of motor and autonomic nervous dysfunction, artificial intelligence, closed-loop stimulation and brain-computer interface technology innovations. In recent years, the research focus gradually shifted from basic mechanisms to personalized and precise multifunctional rehabilitation strategies. ConclusionThe field of SCS for SCI has undergone phases of basic mechanism exploration and clinical application expansion. Current research hotspots and future trends focus primarily on the development of new stimulation paradigms and combined innovative technologies.

ObjectiveTo investigate the independent risk factors for decompensation in patients with liver cirrhosis， to construct a nomogram-based risk assessment model， and to assess its risk assessment performance and clinical value by comparing it with Model for End-Stage Liver Disease （MELD）， MELD combined with serum sodium concentration （MELD-Na）， and MELD 3.0 scoring system. MethodsA retrospective analysis was performed for 514 patients with liver cirrhosis who attended The First Hospital of Shanxi Medical University from January 2020 to May 2025， and related data were collected， including demographic data and laboratory markers. According to the presence or absence of decompensation， the patients were divided into compensation group with 275 patients and decompensation group with 239 patients. The Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. The least absolute shrinkage and selection operator regression analysis was used for screening of variables， and the multivariate logistic regression analysis was used to identify independent risk factors for decompensated liver cirrhosis and construct a nomogram model. The receiver operating characteristic （ROC） curve， calibration curve， and decision curve analysis were used to assess the discriminatory ability， calibration， and net clinical benefit of the model. ResultsThe multivariate logistic regression analysis showed that low hemoglobin （odds ratio ［OR］=0.984， 95% confidence interval ［CI］： 0.969　—　0.999， P<0.05）， low lymphocytes （OR=0.564， 95%CI： 0.383　—　0.830， P<0.05）， high international normalized ratio （OR=3.131， 95%CI： 1.242　—　7.891， P<0.05）， and low serum sodium （OR=0.922， 95%CI： 0.872　—　0.975， P<0.05） were independent risk factors for decompensation events in patients with liver cirrhosis. Construct the prediction model equation： Logit（P）=intercept value－0.016×hemoglobin－0.573×lymphocytes+1.141×INR－0.081×serum sodium. The nomogram constructed based on these factors had a good discriminatory ability， with an area under the ROC curve （AUC） of 0.787， a specificity of 77.8%， and a sensitivity of 67.4%， and it had significantly better predictive performance than MELD score （AUC=0.718）， MELD-Na score （AUC=0.719）， and MELD 3.0 score （AUC=0.725）. The calibration curve showed good consistency between the probability of risk assessed by the model and the observed probability. The decision curve analysis showed that compared with the MELD-based scores， this model provided higher net clinical benefit across a wide range of risk thresholds. ConclusionThis study successfully constructed and validated a nomogram risk assessment model incorporating hemoglobin， international normalized ratio， lymphocytes， and serum sodium. This model has good clinical practicability and can help to achieve early identification of high-risk patients with decompensated liver cirrhosis and optimize intervention strategies in clinical practice.

Objective To explore the application of cognitive interview in the development of Experience Scale of Patient Sense of Gain.Methods Purposive sampling method were used to select 13 inpatients of a tertiary grade A hospital in Xi'an,14 outpatients from a community health service center in Guangzhou,and 14 inpatients of a tertiary hospital in Guangzhong from February to April 2023 as the interviewees.The measurement tool was the preliminary version of Experience Scale of Patient Sense of Gain which was preliminary phase of research results of the group.Three rounds of cognitive interviews were conducted to explore the respondent'sunderstanding towards the items of the scale.The collected data were analyzed by thematic coding and the items of the scale were revised by the results of interviews and group discussion.Results After the first round of interviews,eight doubtful items were discussed and revised;after the second round of interviews,three doubtful entries were discussed and revised;and after the third round of interviews,all the interviewees were able to correctly understand the scale.Conclusion Cognitive interviews can provide insights into the target population's understanding of Experience Scale of Patient Sense of Gain,effectively addressing the problems of understanding differences between the developer and respondent in the process of the scale development,thus improving the accuracy of the scale.

Objective To explore the constituent elements of patients'sense of gain experience and provide theoretical insights for improving patient satisfaction with healthcare services.Methods Purposive sampling and convenience sampling were employed to select 46 experts in health management from universities,hospitals,government agencies,and academic societies across China for semi-structured interviews.Qualitative analysis of the interview data was conducted using grounded theory.Results Through three-level coding,159 initial concepts,19 categories,7 main categories,and 2 core categories were identified.A conceptual framework for the constituent elements of patients'sense of gain experience was constructed,centered on two core dimensions:micro-level experience and macro-level acquisition.Conclusion The concept of"patients'sense of gain experience"enriches the theoretical framework of"sense of gain"and breaks through the unidimensional approach to evaluating medical service quality.Its enhancement requires collaborative efforts from multiple stakeholders,including medical institutions,governments,policymakers,and other actors.

Objective To compare the dosimetric differences between volumetric modulated arc therapy(VMAT)and intensity modulated radiation therapy(IMRT)in the irradiation of chest wall and upper and lower clavicle regions after radical mastectomy for breast cancer.Methods A total of 100 patients who were scheduled to receive radiotherapy after radical mastectomy were included and selected as research subjects.Patients were divided into the VMAT group and the IMRT group by random number table method,with 50 cases in each group.The target dose parameters,exposure dose of organs at risk,monitor unit(MU)and treatment time were compared between the two groups.Results There were no statistical differences in V95 and V110 between the VMAT group and the IMRT group(P＞0.05).The D2%in the VMAT group was lower than that of the IMRT group,while D98%and D50%were higher in the VMAT group than those in the IMRT group(P＜0.05).Target area uniformity and target area conformity were better in the VMAT group than those in the IMRT group(P＜0.05).There were no significant differences in mean cardiac dose(Dmean)and ipsilateral lung V5 and V10 between the VMAT group and the IMRT group(P＞0.05).The heart V20 and V30,contralateral lung Dmean,maximum spinal cord dose(Dmax),contralateral breast Dmean,ipsilateral lung Dmean,V20,V30 and mean MU were lower in the VMAT group than those in the IMRT group,and the treatment time was shorter than that in the IMRT group(P＜0.05).Conclusion In the irradiation treatment of chest wall and upper and lower clavicle regions after radical mastectomy,VMAT demonstrates superior dosimetric characteristics and higher treatment efficiency compared with IMRT,particularly in terms of target area uniformity,target area conformity and exposure doses to organs at risk.

Objective:To assess the clinicopathological characteristics of non-muscle-invasive bladder cancers (NMIBC) with high expression of human epidermal growth factor receptor 2 (HER2) and to examine the prognostic values of HER2 expression in NMIBC patients with intravesical anthracycline instillation.Methods:A total of 221 NMIBC samples diagnosed between January 1, 2017 and April 15, 2024 were collected. Their clinical, diagnostic and treatment features were analyzed. The expression of HER2 protein and the Ki-67 proliferation index were assessed using immunohistochemistry (IHC). For the patients with HER2 high-expression (IHC 3+), the clinical pathological features (age, gender, tumor grade, Ki-67 expression level, tumor size, and tumor number) were compared with those without (i.e., HER2 IHC 0/1+/2+). The impact of HER2 expression on the recurrence-free survival (RFS) of patients with intravesical anthracycline (epirubicin or pirarubicin) instillation after transurethral resection of bladder tumor (TURBT) was evaluated.Results:Among the 221 NMIBC patients, 30 (13.6%) were HER2 IHC 3+, 142 (64.3%) HER 2+, 46 (20.8%) HER2 1+, and 3 (1.4%) HER2 IHC 0. The proportion of high-grade tumors in patients with HER2 high-expression was higher than that in patients without (83.3% versus 44.5%, P<0.001). Additionally, a high Ki-67 index (≥20%) was more commonly noted in HER2 high-expression tumors ( P=0.003). In the patients treated with intravesical anthracycline instillation, HER2 high-expression was associated with a shorter RFS ( P<0.001). Conclusion:HER2 high-expression seems to be not only associated with worse clinicopathological features of NMIBC but also a poor RFS in NMIBC patients treated with anthracycline instillation after TURBT.

Objective To analyze the application effects of laryngeal mask airway(LMA)general anesthesia versus endotracheal intubation(ETI)general anesthesia in Parkinson's disease(PD)patients undergoing deep brain stimulation(DBS)implantable pulse generator(IPG)surgery.Methods A retrospective analysis was conducted on 164 PD patients who underwent IPG surgery at our hospital from August 2020 to February 2021.Patients were divided into two groups based on airway management:LMA group(n=61)and ETI group(n=103).Perioperative hemodynamic parameters,including mean arterial pressure(MAP)and heart rate(HR),were observed at five time points:pre-induction(T0),post-induction(T1),skin incision(T2),extubation(T3),and post-anesthesia care unit(PACU)admission(T4).Key outcomes,such as extubation time,intraoperative hypoxia events,LMA-to-ETI conversion rate,and postoperative complications(respiratory depression,pneumonia),were compared between the two groups.Results The LMA group had a significantly lower body mass index than the ETI group[(22.75±3.11)kg/m2 vs(23.85±3.49)kg/m2,P=0.039],while the other baseline characteristics were comparable.After induction,the LMA group exhibited a less decrease in MAP[(85.46±11.63)mmHg vs(74.13±11.78)mmHg in the ETI group,P<0.001].At extubation,the ETI group showed higher MAP[(98.27±13.78)mmHg vs(89.66±10.50)mmHg in the LMA group,P<0.001].The intraoperative use of vasoactive drugs was significantly lower in the LMA group(3.3%)than that in the ETI group(13.6%,P=0.032).The mean extubation time was shorter in the LMA group[(8.43±5.25)min vs(14.28±7.66)min in the ETI group,P<0.001].No intraoperative hypoxia or LMA-to-ETI conversion events occurred in either group.Postoperative respiratory depression and pneumonia rates showed no statistically significant differences between the groups.Conclusion LMA general anesthesia can be safely applied in PD patients undergoing DBS IPG implantation.It shortens extubation time,reduces the use of vasoactive drugs,and does not increase the risk of intubation-related complications.

Objective To compare the dosimetric differences between volumetric modulated arc therapy(VMAT)and intensity modulated radiation therapy(IMRT)in the irradiation of chest wall and upper and lower clavicle regions after radical mastectomy for breast cancer.Methods A total of 100 patients who were scheduled to receive radiotherapy after radical mastectomy were included and selected as research subjects.Patients were divided into the VMAT group and the IMRT group by random number table method,with 50 cases in each group.The target dose parameters,exposure dose of organs at risk,monitor unit(MU)and treatment time were compared between the two groups.Results There were no statistical differences in V95 and V110 between the VMAT group and the IMRT group(P＞0.05).The D2%in the VMAT group was lower than that of the IMRT group,while D98%and D50%were higher in the VMAT group than those in the IMRT group(P＜0.05).Target area uniformity and target area conformity were better in the VMAT group than those in the IMRT group(P＜0.05).There were no significant differences in mean cardiac dose(Dmean)and ipsilateral lung V5 and V10 between the VMAT group and the IMRT group(P＞0.05).The heart V20 and V30,contralateral lung Dmean,maximum spinal cord dose(Dmax),contralateral breast Dmean,ipsilateral lung Dmean,V20,V30 and mean MU were lower in the VMAT group than those in the IMRT group,and the treatment time was shorter than that in the IMRT group(P＜0.05).Conclusion In the irradiation treatment of chest wall and upper and lower clavicle regions after radical mastectomy,VMAT demonstrates superior dosimetric characteristics and higher treatment efficiency compared with IMRT,particularly in terms of target area uniformity,target area conformity and exposure doses to organs at risk.

Objective To explore the application of cognitive interview in the development of Experience Scale of Patient Sense of Gain.Methods Purposive sampling method were used to select 13 inpatients of a tertiary grade A hospital in Xi'an,14 outpatients from a community health service center in Guangzhou,and 14 inpatients of a tertiary hospital in Guangzhong from February to April 2023 as the interviewees.The measurement tool was the preliminary version of Experience Scale of Patient Sense of Gain which was preliminary phase of research results of the group.Three rounds of cognitive interviews were conducted to explore the respondent'sunderstanding towards the items of the scale.The collected data were analyzed by thematic coding and the items of the scale were revised by the results of interviews and group discussion.Results After the first round of interviews,eight doubtful items were discussed and revised;after the second round of interviews,three doubtful entries were discussed and revised;and after the third round of interviews,all the interviewees were able to correctly understand the scale.Conclusion Cognitive interviews can provide insights into the target population's understanding of Experience Scale of Patient Sense of Gain,effectively addressing the problems of understanding differences between the developer and respondent in the process of the scale development,thus improving the accuracy of the scale.

OBJECTIVE To analyze the clinical characteristics and the correlation between laboratory indicators and prognosis of severe Mycoplasma pneumoniae pneumonia(SMPP)in children.METHODS A total of 85 children with SMPP admitted to Anhui Provincial Children's Hospital from Nov.2021 to May 2024 were selected as the study subjects.Based on clinical typing at admission,they were divided into a high-risk group(n=59)and a low-risk group(n=26).The clinical manifestations,laboratory indicators and outcomes at 28 days of treatment were compared between the two groups.RESULTS The duration of fever and cough before admission in the high-risk group was(7.17±1.09)days and(6.79±1.25)days,respectively,which was longer than that in the low-risk group(P＜0.05).There were no statistically significant differences in pulmonary auscultation(wheezing rales,moist rales)and extrapulmonary complications between the two groups.The levels of C-reactive protein(CRP),serum amyloid A(SAA),platelets(PLT),fibrinogen(FIB),D-dimer(DD)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in the high-risk group were(11.62±1.45)mg/L,(226.88±36.83)mg/L,(3 18.57±39.82)×109/L,(4.28±0.74)g/L,(0.81±0.12)μg/ml and(2 295.48±413.75)pg/ml,respectively,all of which were higher than those in the low-risk group(P＜0.05).Within 28 days after treatment of children in both groups,one patient in the high-risk group died.CONCLUSIONS Compared with children with SMPP in the low-risk group,those in the high-risk group have a higher risk of prognostic mor-tality,suggesting a correlation between the children's blood CRP,SAA,PLT,FIB,DD and NT-proBNP levels and the prognosis of children with SMPP.