This paper reviewed the development history of doctor-patient shared decision-making （SDM） at home and abroad， emphasizing the importance of cross-cultural analysis in constructing a Chinese doctor-patient SDM model. It also delved into the relationship between Western “individualistic” sociocultural values and doctor-patient SDM， as well as the influence of China’s “collectivist” sociocultural values on doctor-patient SDM， revealing significant disparities in doctor-patient SDM models under distinct sociocultural contexts. Although the doctor-patient SDM theory in China originated from the West， this theory requires profound “collision” and adaptation with local Chinese culture to form a localized theory suited to China’s national conditions. Through cross-cultural adaptation and integrating China’s familism tradition and medical ethics concepts， the future construction of the doctor-patient SDM model in China should emphasize family members’ involvement and seek cultural balance to facilitate its widespread application in clinical practice.

Peripheral nerve injury refers to the impairment that occurs when the sens-ory nerves and motor nerves are damaged.Professor Zhang Hong has unique insights into the treatment of neurologically diseases in children.Based on the different manifestations of the disease,it is categorized under the traditional Chinese medicine concepts of"atro-phy syndrome","muscle injury"and"Bi syndrome".Professor Zhang believes that the disease is fundamentally rooted in the liver and kidneys,and that treatment should notonly address the acquired symptoms but also nurture the innate foundation.This article a-nalyze and summarize professor Zhang's clinical experience in using acupuncture,electroa-cupuncture,moving cupping,and moxibustion in the comprehensive treatment of peripheral nerve injury,providing a reference for clinical treatment of peripheral neuropathy in chil-dren.

Objective:To analyze the factors associated with long-term survival after radical resection of hepatitis B virus(HBV)-associated hepatocellular carcinoma(HCC),and to construct random forest and Cox regression models,to evaluate the two models.Methods:A total of 368 patients with HBV-infected HCC who underwent radical resection were selected retrospectively.These patients were categorized as having a good prognosis(n=266)or a poor prognosis(n=102)based on their survival and mortality status.Univariate and Cox regression analysis were used to identify fac-tors that predict poor prognosis in HCC patients after surgery,and Cox regression and random forest prediction models were constructed and evaluated.Results:There were significant differences in smoking history,Child-Pugh classifica-tion,cirrhosis,microvascular invasion,TNM staging,tumor capsule integrity,platelet-to-lymphocyte ratio(PLR),regular antiviral therapy,HBV-DNA load,alpha-fetoprotein(AFP),neutrophil-to-lymphocyte ratio(NLR),systemic immune in-flammatory index(SII),and albumin-to-globulin ratio(AGR)between the two groups(P<0.05);Cox regression showed that cirrhosis,microvascular invasion,regular antiviral treatment,HBV-DNA load,NLR,PLR,SII,and AGR were related factors that negatively affected the prognosis of patients with HBV-infected HCC after surgery(P<0.05),with an AUC of 0.870 for predicting prognosis;the importance ranking obtained by the random forest model was HBV-DNA load,cirrho-sis,regular antiviral therapy,microvascular invasion,NLR,PLR,AGR,and SII,with an AUC of 0.926 for predicting prog-nosis;the AUC predicted by the random forest model was greater than that predicted by the Cox regression model(Z=2.411,P=0.016).Conclusion:HBV-DNA load,cirrhosis,regular antiviral therapy,microvascular invasion,NLR,PLR,AGR,and SII are factors that affect the poor prognosis of patients with HBV-related HCC after surgery.The random for-est prediction model constructed based on these factors has high predictive value and is superior to the Cox regression prediction model.

Peripheral nerve injury refers to the impairment that occurs when the sens-ory nerves and motor nerves are damaged.Professor Zhang Hong has unique insights into the treatment of neurologically diseases in children.Based on the different manifestations of the disease,it is categorized under the traditional Chinese medicine concepts of"atro-phy syndrome","muscle injury"and"Bi syndrome".Professor Zhang believes that the disease is fundamentally rooted in the liver and kidneys,and that treatment should notonly address the acquired symptoms but also nurture the innate foundation.This article a-nalyze and summarize professor Zhang's clinical experience in using acupuncture,electroa-cupuncture,moving cupping,and moxibustion in the comprehensive treatment of peripheral nerve injury,providing a reference for clinical treatment of peripheral neuropathy in chil-dren.

With the rapid development of deep learning(DL)technology,its potential applications in the medical field have become increasingly prominent.As a refractory disease,osteonecrosis of the femoral head(ONFH)has certain limitations in traditional diagnostic and therapeutic approaches.The application of DL technology is expected to overcome these limitations and improve diagnosis and treatment outcomes.At present,the applications of DL models-including enhancing image clarity,improving diagnostic accuracy and efficiency,conducting prognostic evaluations,optimizing preoperative planning,assisting intraoperative imaging,and customizing personalized treatment plans-have fully demonstrated their tremendous potential in the diagnosis and treatment of ONFH.This review summarizes the current application status of DL in ONFH diagnosis and treatment,aiming to provide references and insights for future related research.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Objective To analyze the microanatomical characteristics of the internal carotid artery(ICA)bifurcation through the lateral orbital keyhole(LOK)approach,thereby providing anatomical support for clipping the ICA bifurcation aneurysm.Methods A total of 15 cases(30 sides)of frozen cadaveric head specimens fixed with 10%formaldehyde and infused with red and blue latexes were selected.Craniotomy was performed by simulated LOK approach.The structure,and the course and quantity of the surrounding major perforator vessels of the ICA bifurcation were observed under the microscope,and the relevant data were recorded.Results The terminal diameter of ICA was(5.40±0.65)mm,and the length of ICA above the optic nerve plane was(11.99±1.86)mm.The proximal diameter of A1 was(1.85±0.26)mm,and the length of A1 was(12.90±3.13)mm;meanwhile,the proximal diameter of M1 was(3.64±0.64)mm,and the length of M1 was(15.54±2.10)mm.There were significant differences in the proximal diameter and length between A1 and M1(P<0.05).The angle between A1 and ICA was(77.61±19.43)°,while the angle between M1 and ICA was(137.93±10.31)°,and the difference between the two was statistically significant(P<0.001).There was no obvious linear relationship between the diameter ratio of A1 and ICA and the angle between A1 and ICA,and there was no obvious linear relationship between the diameter ratio of M1 and ICA and the angle between M1 and ICA.The peripheral perforator branches mainly consisted of 8.50(5.00,12.00)branches deriving from the proximal end of A1,0.50(0,3.25)branch deriving from the proximal end of M1,0(0,0.25)branch deriving from the distal end of ICA,(8.80±2.40)branches deriving from the posterior communicating artery,and(9.60±3.80)branches deriving from the anterior choroidal artery.The recurrent artery of Heubner was found in 28 sides,its main body could be the single trunk(30.00%),double trunk(43.00%),and triple trunk(20.00%).Conclusion The main structure and perforator branches of the ICA bifurcation can be clearly exposed through the LOK approach.When applying the LOK approach,it should be combined with the bifurcation angle,perforator branches distribution,and vascular variation characteristics of ICA bifurcation to optimize the aneurysm clipping plan,thereby thoroughly treating the lesion and minimizing the injury risk of perforator branches.

OBJECTIVE: To explore the safety and efficacy of high-dose etoposide (VP-16) combined with recombinant human granulocyte colony-stimulating factor (rhG-CSF) as salvage mobilization for peripheral blood stem cells (PBSC) in newly diagnosed multiple myeloma (NDMM) patients. METHODS: From April 2021 to May 2023, eight NDMM patients who had failed to yield sufficient PBSC during initial mobilization with high-dose cyclophosphamide (CTX) combined with rhG-CSF underwent salvage mobilization with 1.2 g/m2 etoposide combined with rhG-CSF 10 μg/(kg·d). The effects and adverse reactions of initial mobilization and salvage mobilization were analyzed. RESULTS: For salvage mobilization and initial mobilization, the numbers of PBSC collections were 16 and 18, respectively. The mean value of total collected CD34⁺ cells were (11.90±5.75)×10⁶/kg and (1.67±0.75)×10⁶/kg (P =0.0010) in salvage mobilization group and initial mobilization group, respectively. The proportion of patients with a total collection of CD34⁺ cell count≥2×10⁶/kg were 100% and 37.5% (P =0.0625), and the proportion of patients with a total collection of CD34⁺ cell count≥5×10⁶/kg were 87.5% and 0% (P =0.0156) in salvage mobilization group and initial mobilization group, respectively. For five patients who underwent high-dose CTX initial mobilization but had a total CD34⁺ cell count < 2×10⁶/kg, successful collection was achieved through salvage mobilization with high-dose VP-16. Salvage mobilization with high-dose VP-16 was scheduled 2-3 weeks after failure of CTX mobilization. Adverse reactions of high-dose VP-16 mobilization did not increase compared to the initial mobilization with high-dose CTX. CONCLUSION As a salvage mobilization regimen, VP-16 1.2 g/m² combined with rhG-CSF is safe and highly effective in NDMM patients who failed to initial mobilization with high-dose CTX combined with rhG-CSF.
Humans ; Multiple Myeloma/therapy* ; Etoposide/therapeutic use* ; Hematopoietic Stem Cell Mobilization/methods* ; Cyclophosphamide/therapeutic use* ; Granulocyte Colony-Stimulating Factor ; Salvage Therapy ; Peripheral Blood Stem Cells ; Male ; Middle Aged ; Female ; Peripheral Blood Stem Cell Transplantation

Objective To analyze the microanatomical characteristics of the internal carotid artery(ICA)bifurcation through the lateral orbital keyhole(LOK)approach,thereby providing anatomical support for clipping the ICA bifurcation aneurysm.Methods A total of 15 cases(30 sides)of frozen cadaveric head specimens fixed with 10%formaldehyde and infused with red and blue latexes were selected.Craniotomy was performed by simulated LOK approach.The structure,and the course and quantity of the surrounding major perforator vessels of the ICA bifurcation were observed under the microscope,and the relevant data were recorded.Results The terminal diameter of ICA was(5.40±0.65)mm,and the length of ICA above the optic nerve plane was(11.99±1.86)mm.The proximal diameter of A1 was(1.85±0.26)mm,and the length of A1 was(12.90±3.13)mm;meanwhile,the proximal diameter of M1 was(3.64±0.64)mm,and the length of M1 was(15.54±2.10)mm.There were significant differences in the proximal diameter and length between A1 and M1(P<0.05).The angle between A1 and ICA was(77.61±19.43)°,while the angle between M1 and ICA was(137.93±10.31)°,and the difference between the two was statistically significant(P<0.001).There was no obvious linear relationship between the diameter ratio of A1 and ICA and the angle between A1 and ICA,and there was no obvious linear relationship between the diameter ratio of M1 and ICA and the angle between M1 and ICA.The peripheral perforator branches mainly consisted of 8.50(5.00,12.00)branches deriving from the proximal end of A1,0.50(0,3.25)branch deriving from the proximal end of M1,0(0,0.25)branch deriving from the distal end of ICA,(8.80±2.40)branches deriving from the posterior communicating artery,and(9.60±3.80)branches deriving from the anterior choroidal artery.The recurrent artery of Heubner was found in 28 sides,its main body could be the single trunk(30.00%),double trunk(43.00%),and triple trunk(20.00%).Conclusion The main structure and perforator branches of the ICA bifurcation can be clearly exposed through the LOK approach.When applying the LOK approach,it should be combined with the bifurcation angle,perforator branches distribution,and vascular variation characteristics of ICA bifurcation to optimize the aneurysm clipping plan,thereby thoroughly treating the lesion and minimizing the injury risk of perforator branches.