OBJECTIVES: Oblique lateral interbody fusion (OLIF) has become a well-established treatment for lumbar spinal stenosis (LSS) due to its advantages of being minimally invasive, effective, and associated with fewer complications. However, relying solely on lateral fixation provides limited strength and uneven load distribution. Conventional posterior bilateral fixation after OLIF typically requires intraoperative repositioning, increases fluoroscopy frequency, and involves extensive dissection of posterior muscles and soft tissues, resulting in greater trauma, blood loss, and risks of dural tear, nerve root injury, and persistent postoperative low back pain. This study aims to compare the clinical efficacy of robot-assisted single-position OLIF with lateral plating and posterior unilateral fixation, OLIF with lateral fixation alone, and OLIF combined with posterior bilateral fixation for treating single-segment LSS, and to explore how to enhance fixation stability, reduce trauma, and achieve precise minimally invasive outcomes without changing patient positioning. METHODS: A retrospective analysis was conducted on the clinical data from patients treated for single-segment LSS between January 2020 and June 2023 at the First Affiliated Hospital of Kunming Medical University. Patients were divided into 3 groups: Robot group (robot-assisted single-position OLIF with lateral plate and posterior unilateral fixation, 33 cases), lateral group (OLIF with lateral fixation alone, 52 cases), and combined group (OLIF with posterior bilateral fixation, 45 cases). Surgical time, intraoperative blood loss, fluoroscopy frequency, hospital stay, pedicle screw placement accuracy, and complication rates were recorded. Pain visual analogue scale (VAS) scores and Oswestry disability index (ODI) scores were assessed preoperatively, postoperatively, and at the final follow-up. Radiological evaluations (X-ray, computed tomography, and magnetic resonance imaging) measured interbody disc height (IDH), intervertebral foraminal height (IFH), and cross-sectional area (CSA) of the dural sac. Differences between pre- and postoperative imaging indices were statistically analyzed, and complication rates, fusion rates, and cage subsidence rates were recorded. RESULTS: All patients exhibited good positioning of internal fixation devices and cages, with significant symptom relief and no cases of spinal cord injury or symptom worsening. The follow-up time was (15.2±3.6) months. The operation time of the robot group was (70.62±8.99) min, which was longer than that of the lateral group (45.90±6.09) min and shorter than that of the combined group (110.12±8.44) min. The intraoperative blood loss of the robot group was (44.27±6.87) mL, which was more than that of the lateral group (33.58±9.73) mL and less than that of the combined group (79.19±10.35) mL. The number of intraoperative fluoroscopy times of the robot group was (9.49±2.25), which was comparable to that of the lateral group (7.45±2.02) but less than that of the combined group (12.24±4.25). The hospital stay of the robot group was (9.28±2.10) days, which was longer than that of the lateral group (7.95±1.91) days and shorter than that of the combined group (12.49±5.07) days. The screw placement accuracy of the robot group was 98.48%, which was higher than that of the combined group (90.55%). Postoperative and final follow-up VAS and ODI scores were significantly lower than preoperative scores in all 3 groups (all P<0.05), and there were no significant differences in preoperative VAS and ODI scores among the groups (all P>0.05). Radiologically, IDH, IFH, and CSA at the surgical segment were significantly increased postoperatively and at final follow-up compared to preoperatively and at final follow-up compared to preoperative values (all P<0.05), with no significant differences among the groups postoperatively (all P>0.05). Internal fixation remained stable during the follow-up period, and all cages achieved fusion at final follow-up. The intervertebral fusion rate of the robot-assisted group was 93.40%, which was similar to that of the combined group (95.56%) and higher than that of the lateral approach group (90.34%). The complication rate of the robot-assisted group was 6.1%, which was comparable to that of the combined group (8.9%) and lower than that of the lateral approach group (15.4%) (P<0.05). No cases of fixation loosening or breakage were observed throughout the follow-up period. CONCLUSIONS Robot-assisted single-position OLIF with lateral plate combined with posterior unilateral fixation effectively achieves indirect decompression and excellent spinal stability without the need for intraoperative repositioning. It provides high pedicle screw accuracy, reduces intraoperative blood loss, fluoroscopy times, and complication rates, offering a fully minimally invasive new treatment option for single-segment LSS.
Humans ; Spinal Stenosis/surgery* ; Robotic Surgical Procedures/methods* ; Lumbar Vertebrae/surgery* ; Spinal Fusion/instrumentation* ; Male ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Treatment Outcome ; Bone Plates ; Minimally Invasive Surgical Procedures/methods* ; Adult

Objective To construct a mammography image classification assistant system suitable for Chinese population,and explore the potential of artificial intelligence technology to assist early screening of breast cancer in China.Methods Curated breast imaging subset of digital database for screening mammography(CBIS-DDSM),Mammographic image analysis society database(MIAS)and other international open datasets were used to conduct model training respectively in order to reproduce the mainstream in-depth learning methods in the current literature.The model was also tested on the Chinese breast mammography database(CBMD)provided by Huajiao Technology Co.,Ltd,and the performance was compared.Aiming at the problem that the Chinese population data are not ideal in the performance test of the open dataset training model,an optimization strategy based on the sliding window adjustment mechanism was implemented in combination with the characteristics of Chinese population data.Then a two-stage migration learning method was designed to improve the overall performance of the model,and then development of our system was carried out.Results With the sliding window adjustment mechanism and the CBMD training model after two-stage transfer learning,the accuracy of our developed system was improved from 0.50 of the open datasets to 0.80,precision from 0.54 to 0.82,sensitivity from 0.52 to 0.80,F1 value from 0.52 to 0.80,and AUC value from 0.51 to 0.89 based on the Chinese population dataset as the test set.Conclusion Through the introduction of sliding window adjustment mechanism and two-stage migration learning strategy,the performance of the breast molybdenum target image classification model has been significantly improved in the Chinese population dataset,and our system primarily achieves the purpose of assisting the classification of breast molybdenum target images for the Chinese population.

Objective To evaluate the feasibility of early postoperative bathing within the framework of Enhanced recovery after surgery(ERAS)perioperative management.Methods A total of 156 patients who underwent laparoscopic appendectomy or cholecystectomy in the Department of General Surgery between December 2024 and May 2025 were included in the study.Based on the postoperative bathing protocol selected 24 hours after surgery,patients were randomly assigned to one of three groups:the early bathing-exposed group,the early bathing-covered group,or the control group.In the early bathing-exposed group,patients were permitted to bathe with the surgical incision uncovered 24 hours postoperatively.In the early bathing-covered group,sterile,waterproof dressings were applied to the incision site during bathing to maintain aseptic conditions.The control group followed conventional postoperative care guidelines,which restricted bathing until at least three days after suture removal.The outcomes,including the incidence of surgical site infection,postoperative complications,length of hospital stay,and follow-up data,were systematically recorded and analyzed across all three groups.Results Finally,54 patients were included in the early bathing-exposed group,52 in the early bathing-covered group,and 50 in the control group.No statistically significant differences were observed among the three groups in terms of baseline clinical characteristics,including gender,age,primary disease,comorbidities,body mass index(BMI),surgical procedure,operative duration,or incision classification(all P>0.05).Similarly,postoperative comparisons of time to first bathing,incisional infection rates,complication incidence,and length of hospital stay showed no significant intergroup differences(all P>0.05).However,with respect to patient satisfaction during hospitalization,both early bathing groups reported significantly higher satisfaction scores compared to the control group,and these differences were statistically significant(all P<0.05).Conclusions Compared with the conventional principle of postoperative water restriction,early bathing does not increase the incidence of surgical site infection and contributes to improved patient satisfaction during hospitalization.This approach broadens the scope of early postoperative interventions within the ERAS protocol and warrants further clinical implementation.

Objective To construct a transparent and visualized bionic model of human utricle and explore the biomechanical response of the utricle to linear acceleration.Methods Using three-dimensioanl(3D)printing technology and PVA-gelatin composite hydrogel fabrication method,a visual physical model of the utricle with a ratio of 10∶1 to the human body was successfully prepared.The biomechanical response of the utricle macula was investigated by varying acceleration and direction stimulation experiments.Results Under 1-5 Hz sinusoidal reciprocating linear excitation,the response amplitude of the bionic macula increased from 4.11 μm to 48.82 μm.The response amplitude of the bionic macula increased linearly with the acceleration.In addition,the macula showed deformation differences in response to acceleration in a specific direction.Conclusions The bionic utricle model prepared in this study can accurately simulate the working mechanism of human utricle,which is expected to provide a new way for the pathological study of vestibular dysfunction and expand a new direction for the application of bionic technology in the field of biomedical engineering.

Objective To construct a transparent and visualized bionic model of human utricle and explore the biomechanical response of the utricle to linear acceleration.Methods Using three-dimensioanl(3D)printing technology and PVA-gelatin composite hydrogel fabrication method,a visual physical model of the utricle with a ratio of 10∶1 to the human body was successfully prepared.The biomechanical response of the utricle macula was investigated by varying acceleration and direction stimulation experiments.Results Under 1-5 Hz sinusoidal reciprocating linear excitation,the response amplitude of the bionic macula increased from 4.11 μm to 48.82 μm.The response amplitude of the bionic macula increased linearly with the acceleration.In addition,the macula showed deformation differences in response to acceleration in a specific direction.Conclusions The bionic utricle model prepared in this study can accurately simulate the working mechanism of human utricle,which is expected to provide a new way for the pathological study of vestibular dysfunction and expand a new direction for the application of bionic technology in the field of biomedical engineering.

Objective To evaluate the feasibility of early postoperative bathing within the framework of Enhanced recovery after surgery(ERAS)perioperative management.Methods A total of 156 patients who underwent laparoscopic appendectomy or cholecystectomy in the Department of General Surgery between December 2024 and May 2025 were included in the study.Based on the postoperative bathing protocol selected 24 hours after surgery,patients were randomly assigned to one of three groups:the early bathing-exposed group,the early bathing-covered group,or the control group.In the early bathing-exposed group,patients were permitted to bathe with the surgical incision uncovered 24 hours postoperatively.In the early bathing-covered group,sterile,waterproof dressings were applied to the incision site during bathing to maintain aseptic conditions.The control group followed conventional postoperative care guidelines,which restricted bathing until at least three days after suture removal.The outcomes,including the incidence of surgical site infection,postoperative complications,length of hospital stay,and follow-up data,were systematically recorded and analyzed across all three groups.Results Finally,54 patients were included in the early bathing-exposed group,52 in the early bathing-covered group,and 50 in the control group.No statistically significant differences were observed among the three groups in terms of baseline clinical characteristics,including gender,age,primary disease,comorbidities,body mass index(BMI),surgical procedure,operative duration,or incision classification(all P>0.05).Similarly,postoperative comparisons of time to first bathing,incisional infection rates,complication incidence,and length of hospital stay showed no significant intergroup differences(all P>0.05).However,with respect to patient satisfaction during hospitalization,both early bathing groups reported significantly higher satisfaction scores compared to the control group,and these differences were statistically significant(all P<0.05).Conclusions Compared with the conventional principle of postoperative water restriction,early bathing does not increase the incidence of surgical site infection and contributes to improved patient satisfaction during hospitalization.This approach broadens the scope of early postoperative interventions within the ERAS protocol and warrants further clinical implementation.

In recent years, the application of minimal residual disease (MRD) in solid tumors has gained widespread attention. MRD typically refers to the presence of residual cancer cells that remain undetectable by imaging after curative treatments, such as surgical resection. The presence of MRD post-surgery is significantly associated with an increased risk of tumor recurrence. In colorectal cancer, circulating tumor DNA (ctDNA) serves as an effective marker for assessing MRD, particularly in non-metastatic (stages I-III) colorectal cancer. As a real-time, accurate, and convenient biomarker, ctDNA can effectively predict tumor recurrence, guide postoperative adjuvant chemotherapy decisions, and provide crucial information for recurrence monitoring. The application prospects of ctDNA detection technology are vast, promising more precise and individualized treatment plans for colorectal cancer patients. This article comprehensively analyzes the progress in the application of ctDNA for detecting MRD in non-metastatic colorectal cancer patients, elaborates on its guiding role in clinical treatment decisions, and envisions the future development directions in this field.

In recent years, the application of minimal residual disease (MRD) in solid tumors has gained widespread attention. MRD typically refers to the presence of residual cancer cells that remain undetectable by imaging after curative treatments, such as surgical resection. The presence of MRD post-surgery is significantly associated with an increased risk of tumor recurrence. In colorectal cancer, circulating tumor DNA (ctDNA) serves as an effective marker for assessing MRD, particularly in non-metastatic (stages I-III) colorectal cancer. As a real-time, accurate, and convenient biomarker, ctDNA can effectively predict tumor recurrence, guide postoperative adjuvant chemotherapy decisions, and provide crucial information for recurrence monitoring. The application prospects of ctDNA detection technology are vast, promising more precise and individualized treatment plans for colorectal cancer patients. This article comprehensively analyzes the progress in the application of ctDNA for detecting MRD in non-metastatic colorectal cancer patients, elaborates on its guiding role in clinical treatment decisions, and envisions the future development directions in this field.

Objective:To characterize clinical and neuroimaging features, etiologies, and mechanisms of bilateral middle cerebellar peduncle (MCP) infarctions.Methods:Consecutive patients with bilateral MCP infarctions treated in the Beijing Tiantan Hospital, Capital Medical University between January 1, 2020 and April 30, 2022 were enrolled in this retrospective study. The demographic data, vascular risk factors, clincial manifestations and the National Institutes of Health Stroke Scale (NIHSS) scores were collected. Brain diffusion-weighted imaging was used to assess the regions of cerebral infarction, and the extracranial and intracranial segments of the vertebrobasilar artery were evaluated using magnetic resonance angiography, or computed tomography angiography. The stroke etiology and underlying mechanism were evaluated according to the Chinese Ischemic Stroke Subclassification.Results:Ten patients with bilateral MCP infarctions (8 men and 2 women) were analyzed ultimately. The onset age were 51.0-86.0 (64.8±11.4) years. NIHSS scores were 2.0-12.0 (4.9±2.9) points at admission. All patients had vascular risk factors, most of which were hypertension (10 cases) and dyslipoproteinemia (8 cases). The most common clinical manifestations were vertigo (10 cases), followed by ataxia (9 cases) and dysarthria (8 cases). Four cases were isolated bilateral MCP infarctions, while 6 patients were combined with other vertebrobasilar artery infarctions, 4 of which were combined with cerebellar hemisphere infarctions, consistent with the clinical symptoms. The etiology in all patients was large atherosclerosis (severe stenosis or occlusion of V4 segment of vertebral artery and anterior inferior cerebellar artery; 9 cases). Five patients were classified as hypoperfusion/impaired emboli clearance, while 4 patients were considered as artery-to-artery embolism, and 1 was considered as the parent artery (plaque or thrombosis) occluding penetrating artery.Conclusions:Bilateral MCP infarctions are an extremely rare cerebrovascular disease characterized by vertigo, ataxia, and dysarthria. Cerebral infarction can be isolated or often combined with cerebellar hemisphere infarction. The etiology was mostly stenosis or occlusion of V4 segment of vertebral artery and anterior inferior cerebellar artery.

Objective:To investigate the application effect of Mini-Clinical Evaluation Exercise (Mini-CEX) combined with direct observation of procedural skills (DOPS) in standardized training of emergency medicine guided by professional physician qualification examination.Methods:Based on the time of emergency medicine teaching reform in Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, 32 standardized training residents in Emergency Department before September 2020 were included as control group and were given traditional teaching, and 32 standardized training residents after September 2020 were included as observation group and were given Mini-CEX combined with DOPS teaching under the guidance of professional physician qualification examination. The two groups were compared in terms of Mini-CEX score, DOPS score, assessment score of comprehensive emergency skills, pass rate of professional physician qualification examination, and comprehensive teaching quality. SPSS 25.00 was used to perform the t-test and the chi-square test. Results:Compared with the control group after training, the observation group had significantly higher scores of Mini-CEX, DOPS, and comprehensive emergency skill assessment ( P<0.05). There were no significant differences between the two groups in the pass rates of theoretical and practical examinations in professional physician qualification examination, and the observation group had a significantly higher total pass rate than the control group ( P<0.05). The observation group had significantly higher comprehensive teaching quality scores than the control group ( P<0.05). Conclusion:Mini-CEX combined with DOPS guided by professional physician qualification examination can help to improve the teaching effectiveness of standardized training residents in emergency, enhance their comprehensive skills and emergency professional skills, achieve a relatively high pass rate of professional physician qualification examination, and improve their post competency, and thus it holds promise for clinical application.