1.Advances in perioperative nutritional management for patients with esophageal cancer
Zuyu ZHANG ; Bo YANG ; Rong NIU ; Jijun XUE ; Jian CHEN ; Dong LI ; Wentao ZHAO ; Wenfeng HAN ; Yue BAI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(01):157-162
Esophageal cancer is a prevalent malignant tumor of the digestive tract in China, and radical surgery remains the cornerstone of its comprehensive treatment. However, multifactorial challenges such as postoperative gastrointestinal tract reconstruction, traumatic stress, and tumor-related metabolic disturbances render esophageal cancer patients highly susceptible to malnutrition. Perioperative nutritional support therapy plays a crucial role in enhancing surgical safety, improving clinical outcomes, and elevating patients' quality of life by regulating metabolic homeostasis, preserving organ function, and optimizing the immune microenvironment. This article reviews the mechanisms underlying malnutrition in esophageal cancer, methods for nutritional status assessment, and precision intervention pathways based on multi-omics evaluations. The aim is to strengthen clinicians' awareness of standardized perioperative nutritional management for esophageal cancer patients and promote its clinical implementation, thereby facilitating postoperative recovery and improving long-term quality of life.
2.Clinical and Neuroelectrophysiological Features of Autoimmune Nodopathy
Hongfei TAI ; Xunyan HUANG ; Songtao NIU ; Bin CHEN ; Yuzhi SHI ; Xingao WANG ; Fan JIAN ; Hua PAN ; Zaiqiang ZHANG
JOURNAL OF RARE DISEASES 2026;5(2):191-199
To summarize the clinical characteristics, antibody spectrum and neuroelectrophysiological features of autoimmune nodopathy(AN), and to explore the phenotypic differences among different antibody-positive subgroups. The clinical and electrophysiological data of patients definitely diagnosed with AN in Beijing Tiantan Hospital, Capital Medical University, from October 2018 to January 2026 were retrospectively analyzed. A total of 33 patients with AN were included. Antibody examination results showed that, anti-neurofascin(NF)155 antibody was the most prevalent, detected in 17 patients(51.50%), followed by anti-contactin-1(CNTN1) antibody in 8 patients(24.24%). Anti-NF186 antibody(4 cases, 12.12%), anti-contactin-associated protein 1(Caspr1) antibody(2 cases, 6.06%) and dual-target antibody positivity(2 cases, 6.06%) were relatively uncommon. The main clinical manifestations of AN patients included symmetric distal paresthesia of the extremities(32 cases, 96.97%), limb weakness(31 cases, 93.93%) and sensory ataxia(25 cases, 75.76%). Different antibody-positive subgroups presented distinct phenotypic features: patients with positive anti-NF155 antibody had a relatively younger age of onset, chronic onset and a high incidence of tremor, which was dominated by immunoglobulin(Ig)G4 subclass antibodies; patients with positive anti-CNTN1 antibody had a relatively advanced age of onset, mostly presented with acute or subacute onset, and were prone to complicated nephrotic syndrome; patients with positive anti-NF186 antibody had relatively mild nerve conduction damage; patients with anti-Caspr1 antibody manifested acute or subacute onset, with relatively elevated cerebrospinal fluid protein level and 24-h intrathecal IgG synthesis rate. The prominent neuroelectrophysiological manifestations of AN included decreased motor and sensory nerve conduction velocities, prolonged distal latency, frequent non-compressive conduction block and abnormal temporal dispersion. Definite sensory nerve action potentials could not be elicited in more than half of the patients. Patients with AN show high heterogeneity in clinical and neuroelectrophysiological characteristics, and different antibody-positive subgroups correspond to specific clinical and neuroelectrophysiological phenotypes.
3.Transthoracic Echocardiography-guided Double Cavity Permanent Pacemaker Implantation in Pregnant Women:Two Cases Report
Huayuan YUAN ; Mingpeng FU ; Yulong GUO ; Jian LI ; Zhiling LUO ; Yu QIAO ; Guodong NIU ; Tao GUO
Chinese Circulation Journal 2025;40(9):922-925
X-ray is usually used to determine anatomy and localization during conventional permanent pacemaker implantation.But X-ray exposure might induce radiation injury to fetus.In this paper,we reported 2 cases successful double cavity permanent pacemaker implantation in pregnant women woman at 13 weeks of gestation under the guidance of transthoracic echocardiography.The postoperative pacing parameters were good,the whole process was finished with zero radiation,and there were complications during pregnancy.Both cases resulted in full-term pregnancies and the natural delivery of healthy newborns.Pacemaker electrodes were in normal position as confirmed by post-delivery X-ray examinations.
4.Combined cricopharyngeal myotomy and autologous fat injection laryngoplasty: an effective surgery for dysphagia following glossopharyngeal and vagal nerve injury
Yanyan NIU ; Wei GU ; Xiaofeng JIN ; Tingting CUI ; Hong HUO ; Jian WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(11):1357-1362
Objective:To evaluate the efficacy of combined cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) in the management of dysphagia secondary to glossopharyngeal and vagal nerve injury.Methods:This retrospective cohort study collected the clinical data of 18 patients with persistent dysphagia due to glossopharyngeal and vagus nerve injuries, who underwent concurrent cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) at the Department of Otolaryngology, Peking Union Medical College Hospital, from January 2017 to December 2024. Pre-and postoperative assessments included electronic flexible laryngoscope, the Chinese version of Swallow Quality-of-Life Questionnaire (CSWAL-QOL), videofluoroscopic swallowing study (VFSS), body weight changes, and nasogastric tube (NGT) removal status with routine follow-up. The comparison of swallowing function before and after surgery was conducted using paired samples t-test and χ2 test. Results:The study cohort comprised 10 male and 8 female patients, with ages ranging from 33 to 70 years (mean±SD: 53.8±10.5). All surgical procedures were completed successfully without complications. During the 6-to 24-month follow-up period, 10 of the 13 patients who were initially nasogastric tube-dependent achieved successful decannulation. Compared with preoperative values, postoperative measurements demonstrated statistically significant improvements across all parameters: mean body weight increased from (56.95±9.14) kg to (59.22±8.72) kg ( t=3.689 , P<0.01), CSWAL-QOL scores improved from 91.89±17.81 to 130.83±25.42 ( t=6.921 , P<0.01), while, both VFSS scales showed marked reductions (VFSS-SWAL: 6.78±1.40 to 3.39±1.61, t=-8.001, P<0.01; PAS: 6.56±1.15 to 2.94±1.26, t=-10.114, P<0.01). Conclusions:Combined CPM and AFIL represents an effective surgical approach for dysphagia following glossopharyngeal and vagal nerve injury, thereby demonstrating significant improvements in both swallowing function and quality of life.
5.Risk analysis for coil adverse events based on FDA MAUDE database
Jian-wei YANG ; Lin HUANG ; Yu-juan ZHAO ; Yi XUAN ; Jian-jun CAO ; Chang-qing LIU ; Hui-fang NIU ; Xia LI
Chinese Medical Equipment Journal 2025;46(6):83-87
The coil adverse events in the U.S.Food and Drug Administration Manufacturer and User Facility Device Experience(MAUDE)database from January 2021 to June 2024 were analyzed retrospectively.The risks of coils during the clinical application and their causes were explored with hospital survey and expert demonstration in Shandong Province.Some improving measures were put forward for the safe use of coils,including implementing the main responsibility of the registrant,enhancing the professional skills of the using institutions and strengthening the supervision of the supervisory authorities.[Chinese Medical Equipment Journal,2025,46(6):83-87]
6.Risk analysis for coil adverse events based on FDA MAUDE database
Jian-wei YANG ; Lin HUANG ; Yu-juan ZHAO ; Yi XUAN ; Jian-jun CAO ; Chang-qing LIU ; Hui-fang NIU ; Xia LI
Chinese Medical Equipment Journal 2025;46(6):83-87
The coil adverse events in the U.S.Food and Drug Administration Manufacturer and User Facility Device Experience(MAUDE)database from January 2021 to June 2024 were analyzed retrospectively.The risks of coils during the clinical application and their causes were explored with hospital survey and expert demonstration in Shandong Province.Some improving measures were put forward for the safe use of coils,including implementing the main responsibility of the registrant,enhancing the professional skills of the using institutions and strengthening the supervision of the supervisory authorities.[Chinese Medical Equipment Journal,2025,46(6):83-87]
7.Effect of the axial position of posterior chamber phakic intraocular lens on the early postoperative vault changes
Yi-lin XU ; Qian JIAN ; Xun CHEN ; Yin-jie JIANG ; Ling-ling NIU ; Xiao-ying WANG
Fudan University Journal of Medical Sciences 2025;52(1):83-90
Objective To observe the early changes of vault after implantation of posterior chamber phakic intraocular lens implantable collamer lens(ICL),and investigate the effect of different implantation axes on the early vault changes.Methods A prospective,parallel cohort study was performed,enrolling a total of 124 eyes of who underwent ICL(V4c)implantation in the refractive clinic.The changes of vault were observed by scheimpflug tomography(Pentacam)and anterior segment optical coherence tomography(CASIA2)at 1 day,1 week and 1 month after surgery.Results The ICL vault declined significantly by approximately(108.2±82.4)μm 1 week after surgery with the proportion of 16.6%±12.1%compared with the values 1 day after surgery(P<0.001),and then remained stable.Within 1 month after surgery,excluding the difference in vault baseline at 1 day after surgery,the proportion of vault decline in the middle vault group(250-749 μm)and the high vault group(≥750 μm)was similar,and there was no statistically significant difference.We analyzed the relationship between ICL axial directions and vault and found that the vault decline of the horizontal ICL group stabilized quickly at 1 week after surgery,and the vault decline of the vertical ICL group was more significant within 1 month after surgery(P<0.05).Conclusion The vault of the ICL shows a downward trend in the early stage after implantation.The middle vault group and ICL in the horizontal position stabilizes faster,and the downward trend of the high vault group or ICL in the vertical position is more obvious.
8.Construction and evaluation of automatic measurement model of panoramic ultrasound biomicroscopy images based on deep learning
Jian ZHU ; Yulin YAN ; Weiyan JIANG ; Shaowei ZHANG ; Xiaoguang NIU ; Xiao HU ; Biqing ZHENG ; Yanning YANG
Chinese Journal of Experimental Ophthalmology 2025;43(6):513-521
Objective:To develop and evaluate a deep learning-based automatic measurement model for panoramic ultrasound biomicroscopy (UBM) images.Methods:A diagnostic test study was conducted.Preoperative UBM examination results of 372 patients who underwent implantable collamer lens (ICL) implantation were collected at the Eye Center of Renmin Hospital of Wuhan University between February 2021 and March 2023.A total of 1 368 panoramic UBM images were obtained to establish an image database.The dataset was divided into a training set (760 images), a validation set (86 images) and an internal test set (522 images).An expert panel consisting of three ophthalmologists annotated the images.The UNet+ + network was used to automatically segment anterior segment tissues, such as the cornea, lens and iris.In addition, image processing techniques and geometric localization algorithms were developed to automatically identify the anatomical landmarks of pupil diameter (PD), anterior chamber depth (ACD), angle-to-angle distance (ATA) and sulcus-to-sulcus distance (STS) to complete the measurement of these parameters.Additionally, 480 panoramic UBM images of 135 patients (240 eyes) from Aier Eye Hospital of Wuhan University were used as an external test set to further evaluate the performance of the model in different centers.The consistency between the measurements from the model and expert panel, the Pentacam system was assessed.Finally, 150 images were randomly selected from the external test set for a human-machine comparison to further evaluate the model's performance.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Renmin Hospital of Wuhan University (No.WDRY-2022-K109) and Aier eye Hospital of Wuhan University (No.2023IRBKY120903).Written informed consent was obtained from each subject.Results:In the internal test dataset and external test dataset, with manual labeling as the reference standard, the model achieved a mean Dice coefficient of not less than 0.882.At least 95.65% of the anatomical landmark localization results had Euclidean distance differences within 250 μm.The intraclass correlation coefficients (ICCs) for the measurements of PD, ACD, angle-to-angle ATA, and STS were at least 0.958, with mean relative errors not exceeding 2.407%.With the Pentacam measurements as the reference standard, the ICCs for PD in the internal and external test sets were 0.540 and 0.466, respectively, while the ICCs for ACD were 0.946 and 0.908, respectively.In the human-machine comparison, the ICCs between the model's measurements and those of senior experts were all not lower than 0.969.Conclusions:The deep learning-based model can automatically measure anterior segment parameters from preoperative panoramic UBM images of patients undergoing ICL surgery.The model demonstrates a consistency comparable to that of senior experts, while providing higher efficiency.In terms of ACD measurement, the model shows good agreement between the measurements obtained from the model and Pentacam system.
9.Transthoracic Echocardiography-guided Double Cavity Permanent Pacemaker Implantation in Pregnant Women:Two Cases Report
Huayuan YUAN ; Mingpeng FU ; Yulong GUO ; Jian LI ; Zhiling LUO ; Yu QIAO ; Guodong NIU ; Tao GUO
Chinese Circulation Journal 2025;40(9):922-925
X-ray is usually used to determine anatomy and localization during conventional permanent pacemaker implantation.But X-ray exposure might induce radiation injury to fetus.In this paper,we reported 2 cases successful double cavity permanent pacemaker implantation in pregnant women woman at 13 weeks of gestation under the guidance of transthoracic echocardiography.The postoperative pacing parameters were good,the whole process was finished with zero radiation,and there were complications during pregnancy.Both cases resulted in full-term pregnancies and the natural delivery of healthy newborns.Pacemaker electrodes were in normal position as confirmed by post-delivery X-ray examinations.
10.Effects of data-centric multi-task learning with larger patch sizes on pulmonary nodule segmentation performance
Jian LIU ; Zheng ZHANG ; Bing NIU ; Shuai KANG ; Juan REN ; Lei WANG ; Kai XU
Chinese Journal of Medical Physics 2025;42(10):1306-1320
Given the lack of annotations for key lung organs and tissues in existing public datasets,this study collected 863 cases of chest CT scan images and constructed the first comprehensive dataset containing annotations of pulmonary vessels,airways,and nodules using a semi-automated method that combines computer vision algorithms with manual corrections by radiologists.On this basis,a lung nodule segmentation model based on multi-task learning is proposed.By incorporating annotations of pulmonary vessels(pulmonary arteries and veins)and the trachea to enhance model's ability to learn lung features,the proposed model reduces the false discovery rate in lung nodule detection,and improves generalization ability.Additionally,the use of larger image patches further optimizes model performance.The trained VAAN_128 model achieves the best performance,with a Dice coefficient of 0.694 and a false discovery rate of 0.210 for lung nodule segmentation.Moreover,it simultaneously provides accurate segmentation results of pulmonary vessels and the trachea,assisting in the formulation of more precise diagnosis and treatment plans.Based on the VAAN_128 model,a software system for navigation and localization in biopsy procedures is developed.In clinical practice,this system can assist physicians in accurately locating lung nodules,distinguishing critical tissues,and improving preoperative planning efficiency.This provides precise and efficient technical support for early diagnosis and disease monitoring of lung diseases,and is of great significance for path planning in clinical navigation system and future lung imaging research.

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