Evidence serves as the driving force shifting medical practice from empirical medicine towards evidence-based medicine. In the current era of information explosion, it is challenging for clinical surgeons to extract evidence from the vast pool of primary research literature to address clinical issues. Literature reviews, as a form of synthesized evidence, are particularly crucial for precise and efficient evidence utilization. A new form of review within the framework of evidence-based medicine, systematic reviews, also has widespread application in the surgical domain. With the development of methodological approaches in evidence-based medicine, the types of systematic reviews continue to diversify. This paper outlines and summarizes the common types and methodologies of systematic reviews in the surgical field, aiming to provide a clear framework for surgical practitioners to select evidence for both confirming and innovating clinical practices in specific clinical challenges.

Head and neck squamous cell carcinoma(HNSCC)is characterized by high recurrence or distant metastases rate and the prognosis is challenging.There is mounting evidence that tumor-infiltrating B cells(TIL-Bs)have a crucial,synergistic role in tumor control.However,little is known about the role TIL-Bs play in immune microenvironment and the way TIL-Bs affect the outcome of immune checkpoint blockade.Using single-cell RNA sequencing(scRNA-seq)data from the Gene Expression Omnibus(GEO)database,the study identified distinct gene expression patterns in TIL-Bs.HNSCC samples were categorized into TIL-Bs inhibition and TIL-Bs activation groups using unsupervised clustering.This classification was further validated with TCGA HNSCC data,correlating with patient prognosis,immune cell infiltration,and response to immunotherapy.We found that the B cells activation group exhibited a better prognosis,higher immune cell infiltration,and distinct immune checkpoint levels,including elevated PD-L1.A prognostic model was also developed and validated,highlighting four genes as potential biomarkers for predicting survival outcomes in HNSCC patients.Overall,this study provides a foundational approach for B cells-based tumor classification in HNSCC,offering insights into targeted treatment and immunotherapy strategies.

Animals ; Humans ; Thymic Stromal Lymphopoietin ; Pyroglyphidae/metabolism* ; Cytokines/metabolism* ; Asthma/metabolism* ; Respiratory System ; Epithelial Cells/metabolism*

Liver cancer is the fourth most prevalent and the second most lethal cancer in China. Hepatitis B virus (HBV) infection represents a major risk factor for hepatocellular carcinoma (HCC). Liver ultrasonography plus alpha-fetoprotein every 6 months continues to be the predominant surveillance modality. The age-Male-ALBI-Platelets score was recommended in the recent 2022 Chinese guidelines to predict HCC occurrence. The Chinese liver cancer (CNLC) staging system proposed in the 2017 guidelines continues to be the standard model for staging with modifications in the treatment allocations. Considering the aggressive nature of HBV-associated HCC, multimodal and high-intensity strategies like the addition of immunotherapy-based systemic treatment to local therapies, including resection, ablation, and intra-arterial therapies, have been adopted in real-life practices in China. The latest Chinese guidelines recommend atezolizumab plus bevacizumab, suntilimab plus a bevacizumab analog, lenvatinib, sorafenib, donafenib, and FOLFOX (folinic acid, fluorouracil, and oxaliplatin) chemotherapy as first-line treatment without priority. Regorafenib, apatinib, camrelizumab, and tislelizumab have been added as second-line systemic therapies for patients who progressed on sorafenib. Systemic therapies adopted in real-life practice are sophisticated with various combination modalities and different sequences.

In recent years, as a new treatment method developed on the basis of traditional acupuncture, electrical stimulation, including electroacupuncture and transcutaneous electrical acustimulation, has shown great potential in the treatment of various gastrointestinal diseases. Because of the characteristics of family therapy, it can greatly reduce the cost of treatment and has a comparative advantage over drug therapy, however, it has not been widely used in clinical practice. This article reviewed the advantages and disadvantages of electrical stimulation, stimulation parameters, mechanism, and research progress of the treatment.

Objective To compare three-dimensional contrast-enhanced ultrasound ( 3DCEUS) fusion imaging and computed tomography ( CT ) fusion imaging in evaluating ablation margin ( AM ) after radiofrequency ablation ( RFA) for hepatocellular carcinoma ( HCC) . Methods The 3DCEUS images of 60 patients before and after RFA were collected . The AM was evaluated by the self-developed 3DCEUS fusion imaging technique . The consistency of AM evaluation was compared between 3DCEUS and CT fusion imaging . The risk factors of local tumor progression ( LTP) including AM were analyzed . Results The registration success rate of 3DCEUS fusion imaging was 96 .7％ ( 58/60) . Thirty-one cases were in the AM<5 mm group ,and 27 cases were in the AM ≥5 mm group . The consistency of AM evaluation between 3DCEUS and CT fusion imaging was good ( Kappa coefficient = 0 .895 , P < 0 .001) . During a follow-up period ranging 4 .2 to 18 months ,LTP was identified in 5 tumors (8 .6％ ,5/58) .The incidence of LTP with the AM<5 mm was higher than that with the AM ≥5 mm ( P =0 .033) . Conclusions 3DCEUS fusion imaging is feasible for AM evaluation immediately after RFA with high consistency with CT fusion imaging . AM<5 mm evaluated on 3DCEUS fusion immediately after RFA is a risk factor for LTP .

Objective To explore the effect of risk assessment tracking management in reducing unplanned extubation in patients with tracheal intubation.Methods From January to December 2015,120 patients with tracheal intubation in ICU were selected as the control group with routine nursing care of indwelling endotracheal intubation.From January to November 2016,120 patients with tracheal intubation were selected as the observation group,where the risk assessment and risk management were done on the basis of routine nursing as in the control group.The two groups were compared in terms of tracheal intubation and unplanned extubation related knowledge,the implementation of the risk assessment,the accuracy in risk assessment and the incidence of unplanned extubation.Result The tracheal intubation and unplanned extubation related knowledge in the observation group was lower than that of the control group (P＜0.001),The implementation rate of the risk assessment and the accuracy in risk assessment in the observation group were significantly higher than the control group,and the rate of unplanned extubation in the observation group was significantly lower than in the control group (all P＜0.01).Conclusion The implementation on risk assessment and extubation-preventing nursing quality tracing management can enhance the awareness and knowledge of preventing trachea cannula exodus,improve the quality of nursing and reduce the rate of unplanned extubation.

Objective To study influences of intervention in pregnant women with positive thyroid autoantibodies on the thyroid function of babies. Methods A total of 55 pregnant women were enrolled with positive thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) during prenatal checkup. They were randomly divided into two groups: intervening group( n= 36, newborn group A) was treated with levothyroxine ( L-T4 ), and non-intervening group ( n= 19, newborn group B) was not treated. 30 cases of pregnant women with negative thyroid autoantibodies served as a normal population control group (newborn group N). Serum TSH, TPOAb, TgAb, TT3, TT4, FT3 and FT4 were measured by high-sensitive immunochemiluminescent assay ,and urinary iodine was also examined in the pregnant women. Fetal plasma TSH, TT3, TT4, FT3, and FT4 levels were measured after cutting the umbilical cord from placenta, and repeated measurements were made by 3-4 weeks and 8-10 weeks postpartum. Results At baseline, serum TSH levels of the pregnant women in intervening and nonintervening groups were significantly higher than that in control group ( P＜0.05 ). Non-intervening group had higher TSH and lower TT3, TT4, FT4 compared with the other two groups (P＜0. 05 or P＜0.01 ). The cord blood TSH levels of the neonates in both group B [(7.06 ± 1.31 ) mIU/L] and group A [(6.23 ± 1.26 ) mIU/L] were significantly higher than that of group N [(5.48±1. 17) mIU/L, P＜0.01 and 0. 05]. By 3-4 weeks postpartum,the serum TSH level [(3.21±0.70)mIU/L] in group B was significantly higher than those in group N [(2.72±0.51)mIU/L] and group A [(2.78±0.42) mIU/L, all P＜0.05]. The serum TSH level in group B [(2.99±0.57) mIU/L] was still higher than those in group N [(2.48±0.68) mIU/L] by 8 to 10 weeks postpartum (P＜0.05 ). Multiple stepwise regression analysis revealed that TSH, TPOAb, and urine iodine levels of mothers were independently related to TSH of their infants. Conclusion When differences in thyroid function exist in pregnant women, these differences also reside in their offspring. The thyroid function in neonates correlates with both the thyroid autoantibodies and thyroid function of their mothers.