Although low temperature plasma ablation technology has significant advantages in clinical applications,its poor stability,high power consumption and thermal injuries to the tissues are still key factors limiting its widespread use.To address these issues,a device that uses bipolar pulses to excite plasma is developed,and it can flexibly adjust its output voltage,frequency and duty cycle,effectively reducing breakdown voltage and power consumption.By conducting simulation and saltwater discharge experiments,the excitation process of plasma is elaborated in detail.Meanwhile,the effects of two different pulse excitation modes on plasma excitation are discussed and compared.The results show that the bipolar pulse excitation mode is advantageous in reducing discharge current and breakdown voltage,and shortening the formation time of the vapor layer,which effectively relieves thermal injuries to the tissues.Finally,the broad application potential of the plasma ablation device is demonstrated in plasma ablation experiments which are conducted at different voltages,with pork as the experimental material.The study provides a new theoretical basis and practical guidance for the application of plasma ablation technology in minimally invasive surgery.

Objective: To prospectively evaluate the feasibility, accuracy, and safety of multiparameter MRI-guided percutaneous biopsy using a 1T open MRI scanner for evaluating suspicious centrally located lung lesions with associated post-obstructive atelectasis. Materials and Methods: In this single-center study, MRI-guided percutaneous coaxial cutting biopsy was performed for 107 suspicious central lung lesions with associated post-obstructive atelectasis in 107 patients between July 2015 and December 2020. A fast T2-weighted imaging (T2WI)-turbo spin echo (TSE) sequence and an enhanced fast T1-weighted imaging (T1WI)-TSE sequence were used to identify, localize, and biopsy lung lesions, and diffusion-weighted imaging (DWI) was used as a supplementary sequence for identifying the lesion location. The final diagnosis was confirmed by surgical histopathology or clinical follow-up for a minimum of 24 months. The sensitivity, specificity, and accuracy for diagnosing lung malignancies were calculated, and the complications were recorded for each case. Results: Using multiparameter MRI, central lung lesions could be clearly distinguished from post-obstructive atelectasis in 96 patients (89.7%). The sensitivity, specificity, and accuracy of MRI-guided percutaneous biopsy for diagnosing lung malignancy was 97.0% (98/101), 100% (6/6), and 97.2% (104/107), respectively. Self-limited hemoptysis occurred in three patients. Pneumothorax occurred in five patients, of which none required pleural drainage. No serious procedure-related complications were observed. Conclusion As a technology that does not involve ionizing radiation, multiparameter MRI-guided percutaneous coaxial cutting biopsy is a safe and accurate diagnostic technique for evaluating centrally located lung lesions associated with post-obstructive atelectasis.

Objective: To prospectively evaluate the feasibility, accuracy, and safety of multiparameter MRI-guided percutaneous biopsy using a 1T open MRI scanner for evaluating suspicious centrally located lung lesions with associated post-obstructive atelectasis. Materials and Methods: In this single-center study, MRI-guided percutaneous coaxial cutting biopsy was performed for 107 suspicious central lung lesions with associated post-obstructive atelectasis in 107 patients between July 2015 and December 2020. A fast T2-weighted imaging (T2WI)-turbo spin echo (TSE) sequence and an enhanced fast T1-weighted imaging (T1WI)-TSE sequence were used to identify, localize, and biopsy lung lesions, and diffusion-weighted imaging (DWI) was used as a supplementary sequence for identifying the lesion location. The final diagnosis was confirmed by surgical histopathology or clinical follow-up for a minimum of 24 months. The sensitivity, specificity, and accuracy for diagnosing lung malignancies were calculated, and the complications were recorded for each case. Results: Using multiparameter MRI, central lung lesions could be clearly distinguished from post-obstructive atelectasis in 96 patients (89.7%). The sensitivity, specificity, and accuracy of MRI-guided percutaneous biopsy for diagnosing lung malignancy was 97.0% (98/101), 100% (6/6), and 97.2% (104/107), respectively. Self-limited hemoptysis occurred in three patients. Pneumothorax occurred in five patients, of which none required pleural drainage. No serious procedure-related complications were observed. Conclusion As a technology that does not involve ionizing radiation, multiparameter MRI-guided percutaneous coaxial cutting biopsy is a safe and accurate diagnostic technique for evaluating centrally located lung lesions associated with post-obstructive atelectasis.

Objective: To prospectively evaluate the feasibility, accuracy, and safety of multiparameter MRI-guided percutaneous biopsy using a 1T open MRI scanner for evaluating suspicious centrally located lung lesions with associated post-obstructive atelectasis. Materials and Methods: In this single-center study, MRI-guided percutaneous coaxial cutting biopsy was performed for 107 suspicious central lung lesions with associated post-obstructive atelectasis in 107 patients between July 2015 and December 2020. A fast T2-weighted imaging (T2WI)-turbo spin echo (TSE) sequence and an enhanced fast T1-weighted imaging (T1WI)-TSE sequence were used to identify, localize, and biopsy lung lesions, and diffusion-weighted imaging (DWI) was used as a supplementary sequence for identifying the lesion location. The final diagnosis was confirmed by surgical histopathology or clinical follow-up for a minimum of 24 months. The sensitivity, specificity, and accuracy for diagnosing lung malignancies were calculated, and the complications were recorded for each case. Results: Using multiparameter MRI, central lung lesions could be clearly distinguished from post-obstructive atelectasis in 96 patients (89.7%). The sensitivity, specificity, and accuracy of MRI-guided percutaneous biopsy for diagnosing lung malignancy was 97.0% (98/101), 100% (6/6), and 97.2% (104/107), respectively. Self-limited hemoptysis occurred in three patients. Pneumothorax occurred in five patients, of which none required pleural drainage. No serious procedure-related complications were observed. Conclusion As a technology that does not involve ionizing radiation, multiparameter MRI-guided percutaneous coaxial cutting biopsy is a safe and accurate diagnostic technique for evaluating centrally located lung lesions associated with post-obstructive atelectasis.

Objective: To prospectively evaluate the feasibility, accuracy, and safety of multiparameter MRI-guided percutaneous biopsy using a 1T open MRI scanner for evaluating suspicious centrally located lung lesions with associated post-obstructive atelectasis. Materials and Methods: In this single-center study, MRI-guided percutaneous coaxial cutting biopsy was performed for 107 suspicious central lung lesions with associated post-obstructive atelectasis in 107 patients between July 2015 and December 2020. A fast T2-weighted imaging (T2WI)-turbo spin echo (TSE) sequence and an enhanced fast T1-weighted imaging (T1WI)-TSE sequence were used to identify, localize, and biopsy lung lesions, and diffusion-weighted imaging (DWI) was used as a supplementary sequence for identifying the lesion location. The final diagnosis was confirmed by surgical histopathology or clinical follow-up for a minimum of 24 months. The sensitivity, specificity, and accuracy for diagnosing lung malignancies were calculated, and the complications were recorded for each case. Results: Using multiparameter MRI, central lung lesions could be clearly distinguished from post-obstructive atelectasis in 96 patients (89.7%). The sensitivity, specificity, and accuracy of MRI-guided percutaneous biopsy for diagnosing lung malignancy was 97.0% (98/101), 100% (6/6), and 97.2% (104/107), respectively. Self-limited hemoptysis occurred in three patients. Pneumothorax occurred in five patients, of which none required pleural drainage. No serious procedure-related complications were observed. Conclusion As a technology that does not involve ionizing radiation, multiparameter MRI-guided percutaneous coaxial cutting biopsy is a safe and accurate diagnostic technique for evaluating centrally located lung lesions associated with post-obstructive atelectasis.

With the increasing awareness of health among the public and the widespread use of low-dose spiral CT screening, the detection rate of pulmonary nodules has risen significantly.Notably, the incidence of pulmonary nodules is considerably higher among the elderly population, which presents unique challenges due to their specific physiological conditions.This article aims to review and explore the commonly employed treatment methods for pulmonary nodules, including surgical interventions, stereotactic radiation therapy, image-guided local ablation therapy, and systemic treatment strategies.We will analyze the clinical application status and technical characteristics of these various treatment modalities, with a particular focus on the current research hotspot of ground glass nodules(GGNs)within the context of pulmonary nodules.This analysis will provide insights for developing personalized treatment strategies tailored to elderly patients.Additionally, we will examine the role of multidisciplinary team(MDT)management and collaborative decision-making between doctors and patients in achieving precise and personalized diagnosis and treatment for individuals with pulmonary nodules.

Objective To analyze risk factors for poor postoperative wound healing in spinal tuberculo-sis patients and construct prediction models along with a risk scoring table using machine learning algorithms,providing references for early prevention and management.Methods Clinical data from 420 spinal tuberculo-sis patients treated at four tertiary hospitals in Guizhou Province between January 2017 and February 2024 were retrospectively analyzed.Risk factors were identified through univariate and multivariate analyses.Logis-tic regression,random forest,and support vector machine prediction models were constructed.Model perform-ance was evaluated using receiver operating characteristic(ROC)curves,precision,recall,accuracy,and F1-score.A risk prediction scoring table for poor postoperative wound healing was subsequently developed.Re-sults Among the 420 patients with spinal tuberculosis,132 experienced poor postoperative wound healing,with an incidence rate of 31.43%.Logistic regression analysis showed that BMI≤18.5 kg/m2,preoperative albumin≤30 g/L,combined surgical procedure,intraoperative blood loss>1 000 mL,direct bilirubin>8 μmol/L within 3 days after surgery,neutrophil count≤75×109/L within 3 days after surgery,and postopera-tive drainage volume>500 mL were risk factors for poor postoperative wound healing(P<0.05).In the comparison among the three risk prediction models constructed based on machine learning algorithms,the ran-dom forest model demonstrated the best predictive performance.A risk prediction scoring table was construc-ted based on the partial regression coefficients from the multivariate analysis,with a total score range from 0 to 11 points.A score>6 points indicated an increased risk of poor postoperative wound healing.The area un-der the ROC curve(AUC)for this risk prediction scoring table was 0.846(95%CI:0.769 to 0.923),indica-ting good predictive performance.Conclusion The random forest model based on machine learning algorithms and the risk prediction scoring table have certain predictive value for assessing the risk of poor postoperative wound healing in patients with spinal tuberculosis;they can assist healthcare professionals in early identifica-tion of high-risk patients.

Objective:To investigate the clinical effects of the anterolateral thigh perforator flaps transplantation in repairing the wounds after radical resection of skin malignant tumors in the head, face, and neck.Methods:This study was a retrospective observational study. From May 2020 to December 2023, 27 patients with skin malignant tumors in the head, face, and neck were admitted to the Department of Burns and Plastic Surgery of the First People's Hospital of Kashi Prefecture, including 19 males and 8 females, aged 53 to 89 years. There were 21 cases with squamous cell carcinoma and 6 cases with basal cell carcinoma. The wound area after radical resection of tumors was 9.0 cm×7.0 cm to 27.0 cm×21.5 cm. The wounds were repaired with the lobulated, combined, or various forms of combination of the anterolateral thigh perforator flaps, and the harvesting flap area in single donor site was 10.0 cm×8.0 cm to 27.0 cm×11.0 cm. The wounds in the flap donor sites were closed by suturing in 26 patients, while the wound in the flap donor site in 1 patient was repaired with medium-thickness skin graft in the lower leg. The survival of the flap, and the occurrence of vascular crisis and infection were observed after surgery. During follow-up after surgery, the tumor recurrence, shape and texture of the flaps, and the function and scar formation of the limbs where the donor site was located were observed.Results:Only one patient developed venous crisis of the flap 27 hours after surgery, and the flap survived after vascular exploration and reanastomosis of the vein; the flaps in the other patients survived after surgery. One patient had an infected effusion under the flap after surgery, which healed after dressing change. After 6-36 months of postoperative follow-up, no tumor recurrence was observed; the flap had good appearance, texture, and elasticity; the limb where the donor site was located functioned normally, with only linear scars left.Conclusions:For complex wounds after radical resection of skin malignant tumors in the head, face, and neck, different forms of anterolateral thigh perforator flaps can be used to repair the wounds according to the condition of the wounds, and the wounds in the recipient sites heal well after surgery, with minimal damage to the donor site.

Objective: To prospectively evaluate the feasibility, accuracy, and safety of multiparameter MRI-guided percutaneous biopsy using a 1T open MRI scanner for evaluating suspicious centrally located lung lesions with associated post-obstructive atelectasis. Materials and Methods: In this single-center study, MRI-guided percutaneous coaxial cutting biopsy was performed for 107 suspicious central lung lesions with associated post-obstructive atelectasis in 107 patients between July 2015 and December 2020. A fast T2-weighted imaging (T2WI)-turbo spin echo (TSE) sequence and an enhanced fast T1-weighted imaging (T1WI)-TSE sequence were used to identify, localize, and biopsy lung lesions, and diffusion-weighted imaging (DWI) was used as a supplementary sequence for identifying the lesion location. The final diagnosis was confirmed by surgical histopathology or clinical follow-up for a minimum of 24 months. The sensitivity, specificity, and accuracy for diagnosing lung malignancies were calculated, and the complications were recorded for each case. Results: Using multiparameter MRI, central lung lesions could be clearly distinguished from post-obstructive atelectasis in 96 patients (89.7%). The sensitivity, specificity, and accuracy of MRI-guided percutaneous biopsy for diagnosing lung malignancy was 97.0% (98/101), 100% (6/6), and 97.2% (104/107), respectively. Self-limited hemoptysis occurred in three patients. Pneumothorax occurred in five patients, of which none required pleural drainage. No serious procedure-related complications were observed. Conclusion As a technology that does not involve ionizing radiation, multiparameter MRI-guided percutaneous coaxial cutting biopsy is a safe and accurate diagnostic technique for evaluating centrally located lung lesions associated with post-obstructive atelectasis.

Allergen-specific immunotherapy（AIT） remains the only therapeutic approach with the potential to modify the natural course of allergic rhinitis（AR）. Nevertheless, considerable inter-individual variability exists in patients'responses to AIT. To facilitate more reliable assessment of treatment efficacy, the China Rhinopathy Research Cooperation Group（CRRCG） convened young and middle-aged nasal experts in China to formulate the present consensus. The recommended subjective outcome measures for AIT comprise symptom scores, medication scores, combined symptom and medication scores, quality-of-life assessments, evaluation of disease control, and assessment of comorbidities. Objective indicators may supplement these measures. Currently available objective approaches include skin prick testing, nasal provocation testing, and allergen exposure chambers. However, these methods remain constrained by practical limitations and are not yet appropriate for routine implementation in clinical efficacy evaluation. In addition, several biomarkers, including sIgE and the sIgE/tIgE ratio, sIgG4, serum IgE-blocking activity, IgA, cytokines and chemokines, as well as immune cell surface molecules and their functional activity, have been shown to have associations with AIT outcomes. While these biomarkers may complement subjective assessments, they are subject to significant limitations. Consequently, large-scale multicenter trials and real-world evidence are required to strengthen the evidence base. The present consensus underscores the necessity of integrating patients'subjective experiences with objective testing throughout the treatment process, thereby providing a more comprehensive and accurate framework for efficacy evaluation. Looking forward, future investigations should prioritize the incorporation of multi-omics data and artificial intelligence methodologies, which hold promise for overcoming current limitations in assessment strategies and for advancing both the standardization and personalization of AIT.
Humans ; Allergens/immunology* ; China ; Consensus ; Desensitization, Immunologic ; Immunoglobulin E ; Quality of Life ; Rhinitis, Allergic/therapy* ; Treatment Outcome ; East Asian People