With the rapid advancement of hemodynamic indices and monitoring technologies, their classification methods and application processes have become increasingly complex. Currently, no unified standard hasbeen established, making it difficult to fully meet the clinical requirements for hemodynamic management. To assist in hemodynamic monitoring assessment and therapeutic decision-making in critically ill patients, the Critical Hemodynamic Therapy Collaborative Group, in conjunction with the Critical Ultrasound Study Group, has jointly developed the Standard for the Application of Hemodynamic Monitoring Techniques in Critical Care. The first part of this standard systematically categorizes hemodynamic indicators into flow indicators, pressure and its derivative indicators, and tissue perfusion indicators, while elaborating on the clinical application of each. The second part establishes a standardized clinical implementation pathway for hemodynamic monitoring. It proposes a tiered monitoring strategy-comprising basic, advanced, indication-specific, and special scenario monitoring-tailored to different clinical settings. It emphasizes the central role of critical care ultrasound across all levels of monitoring and establishes hemodynamic assessment standards for organs such as the brain, kidneys, and gastrointestinal tract. This standard aims to provide a unified framework for clinical practice, teaching, training, and research in critical care medicine, thereby promoting standardized development within the discipline.

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.

Thyrotoxic periodic paralysis(TPP) is a rare but potentially life-threatening complication of thyrotoxicosis. TPP secondary to thyrotoxicosis factitia(TF) is exceptionally uncommon. Here, we report the case of a 31-year-old female who developed TF and subsequent TPP after taking laxatives containing unknown ingredients. The patient presented with acute onset of quadriplegia. Laboratory investigations revealed severe hypokalemia(serum potassium 1.47mmol/L), thyrotoxicosis[thyroid stimulating hormone(TSH)<0.005 mIU/L, free thyroxine(FT 4) 30.84 pmol/L, free triiodothyronine(FT 3) 7.71 pmol/L], and a decreased thyroglobulin level(3.08 ng/mL). The patient′s symptoms resolved rapidly following potassium supplementation, and thyroid function gradually normalized after discontinuation of the suspected medication. This case highlights the importance of considering TF in the differential diagnosis of TPP, particularly in patients with a history of unknown medication use. It also underscores the diagnostic value of thyroglobulin measurement in identifying TF and outlines clinical strategies for the management of TF-induced TPP.

OBJECTIVE To explore the diagnostic value of combined detection of droplet digital polymerase chain reaction(ddPCR),C-reactive protein(CRP),procalcitonin(PCT)and neutrophil-to-lymphocyte ratio(NLR)for bacterial bloodstream infections.METHODS Patients with suspected bloodstream infections admitted to Jiangbin Hospital of Guangxi Zhuang Autonomous Region from Jan.2023 to Jun.2024 were selected as the study subjects,with a total of 993 specimens from 543 patients included.Based on ddPCR and blood culture(BC)results,the pa-tients were divided into BC+and/or ddPCR+group(424 specimens)and ddPCR-/BC-group(569 specimens).The bacterial species detected by ddPCR were further classified into single infection group(258 speci-mens),mixed infection group(160 specimens)and ddPCR-group(575 specimens).The levels of CRP,PCT and NLR were compared among the groups.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic efficacy of ddPCR,CRP,PCT and NLR separately and in combination for bacterial bloodstream in-fections.RESULTS The levels of CRP,PCT and NLR in the BC+and/or ddPCR+group were 71.61(37.00,108.81)mg/L,1.74(0.47,7.93)ng/ml and 9.82(5.53,18.07),respectively,which were higher than those in the ddPCR-/BC-group(P＜0.001).I n the ddPCR mixed infection group,the levels of CRP and PCT were 88.02(42.90,112.39)mg/L and 2.83(0.89,12.35)ng/ml,respectively,which were higher than those in the single infection group(P＜0.05).The qualitative results of ddPCR were better at predicting bloodstream infec-tions(OR=15.279,95％CI:6.525～35.776,P＜0.001).According to ROC curve analysis,ddPCR had the lar-gest area under the curve(AUC)among the single detection indicator(0.759),followed by PCT(0.732).The AUC for the combination of ddPCR qualitative results with CRP,PCT and NLR was 0.830,indicating that the di-agnostic performance of the combined detection was better than that of any single indicator.CONCLUSIONS The combination of ddPCR with PCT,CRP and NLR can improve the accuracy of diagnosing bacterial bloodstream in-fections.Compared with BC,ddPCR has higher sensitivity and can quickly identify the types and concentrations of pathogens in bloodstream infections.

Objective:To explore the feasibility of selecting appropriate respiratory motion management strategies for patients undergoing stereotactic radiotherapy for liver cancer using chi-square feature testing and machine learning techniques.Methods:A retrospective analysis was conducted on 95 liver cancer patients who underwent respiratory motion evaluation at Xiangya Hospital of Central South University between March 2022 and August 2024. Chi-square testing was used to screen features related to respiratory motion evaluation in liver cancer patients. Based on these features, predictive models were constructed using 4 machine learning classification algorithms: support vector machine (SVM), random forest (RF), gradient boosting decision tree (GBDT), and adaptive boosting (AdaBoost). The predictive performance of these models was evaluated using accuracy, sensitivity, specificity, F1 value, and area under the curve (AUC).Results:The accuracy values for the SVM, RF, GBDT and AdaBoost models were 0.75, 0.75, 0.70, and 0.82, respectively. The sensitivity values were 0.82, 0.82, 0.64, and 0.82, respectively. The specificity values were 0.63, 0.63, 0.63, and 0.75, respectively. The F1 scores were 0.78, 0.78, 0.67, and 0.82, respectively. The AUC values were 0.85, 0.80, 0.76, and 0.85, respectively.Conclusions:The predictive models constructed by combining chi-square feature testing and machine learning methods can effectively predict the selection of respiratory motion management strategies. Among the models, the AdaBoost model demonstrated the best predictive performance for selecting respiratory motion management strategies.

Objective: To analyze the fluctuations of patient-reported outcomes (PROs) and their relationships with cytokines in the peripheral blood of patients undergoing chemotherapy for ovarian cancer (OC). Methods: PROs burden was prospectively measured by the M.D. Anderson Symptom Inventory-Ovarian Cancer (MDASI-OC) at baseline before chemotherapy, on a daily basis during and post-chemotherapy days (PCD) 7, 14, and 20. Cytokines were collected at baseline, days prior to hospital discharge and PCD 20. Pearson correlation was used to explore the associations between PROs and cytokines levels in peripheral blood. Results: The top 8 rated symptoms were compared between the neoadjuvant chemotherapy (NACT) group (n=20) and the postoperative adjuvant chemotherapy (PAC) group (n=7).Before chemotherapy, the mean scores of fatigue and lack of appetite in the NACT group were higher than those in the PAC group. After chemotherapy, pain, nausea, vomiting, disturbed sleep, lack of appetite, and constipation increased to peak during PCD 2–6; while, fatigue and numbness or tingling remained at high levels over PCD 2–13. By PCD 20, disturbed sleep and fatigue showed a significant increase in mean scores, particularly in the NACT group;while, other symptom scores decreased and returned to baseline levels. Additionally, the longitudinal fluctuations in pain, fatigue, and lack of appetite were positively associated with circulating levels of interleukin-6 and interferon gamma (p<0.05). Conclusion MDASI-OC was feasible and adaptable for demonstrating the fluctuations of symptom burden throughout chemotherapy course. Moreover, symptoms changing along with cytokines levels could provide clues for exploring mechanism underlying biochemical etiology.

Objective:To investigate the efficacy and toxicity of blinatumomab in the first-line and second-line treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL).Methods:A multi-center retrospective cohort study was conducted to analyze clinical data from 323 pediatric B-ALL patients treated with blinatumomab across 14 hospitals in China from May 2021 to July 2023. Patients were divided into four groups based on the treatment phase and disease status when blinatumomab was used: relapsed/refractory group, post-consolidation minimal residual disease (MRD)-positive group, early MRD-positive group, and MRD-negative group. Blinatumomab for the relapsed/refractory group was considered as second-line treatment, while the other 3 groups as first-line treatment. The MRD negativity rate after treatment, the survival rates and the incidence of severe adverse events were compared across these groups. Patients who received blinatumomab for more than 7 days were included in the efficacy analysis. Survival analysis was performed using the Kaplan-Meier method, and Log-Rank test was used to compare the survival rates among groups.Results:Among the 323 patients, 191 (59.1%) were male, with the age of 6.2 (3.9, 10.5) years. There were 117 patients in the relapsed/refractory group, 62 cases in the post-consolidation MRD-positive group, 43 cases in the early MRD-positive group, and 101 cases in the MRD negative group. In the relapsed/refractory group, the complete remission rate and MRD negativity rate after one course of blinatumomab were 71.4% (35/49) and 81.5% (75/92) for the 49 children without complete remission and the 92 children with flow cytometry-positive MRD, respectively. In the post-consolidation MRD-positive group, the MRD negativity rates after one course of blinatumomab were 100.0% (27/27), 12/16 and 9/19 for patients with MRD positivity detected by flow cytometry, polymerase chain reaction and next-generation sequencing, respectively. In the early MRD-positive group, the MRD negativity rates were 96.7% (29/30) and 9/9 for flow cytometry and next-generation sequencing, respectively. The 2-year overall survival rate and event-free survival rate for the 319 children evaluable for efficacy were (90.6±1.7)% and (87.6±1.9)%, respectively, with the relapsed/refractory group showing significantly lower overall survival rates and event-free survival rate compared to the other groups ( χ2=21.40, 26.21,both P<0.001). Grade 3 or higher adverse events occurred in 128 cases (39.6%), with hematological toxicity observed in 101 cases, while cytokine release syndrome (CRS), infection, and neurotoxicity occurred in 11, 26 and 8 cases, respectively. In addition, there were statistically significant differences in the grade 3 or higher CRS among the four groups ( χ2=8.03, P<0.05). Conclusion:Blinatumomab can clear MRD more effectively and achieve superior survival outcomes when used as first-line treatment for pediatric B-ALL, with less CRS.

Conventional surgical management of pelvic fractures entails incision and reduction with internal fixation, a procedure associated with significant bleeding, trauma, and a high surgical risk. The advent of advanced imaging techniques and sophisticated surgical instruments has led to a paradigm shift towards minimally invasive surgery as the prevailing treatment modality for such injuries. The efficacy of reduction is pivotal in determining the clinical prognosis of pelvic fractures, underscoring the importance of enhancing the quality of reduction in the minimally invasive surgery. The advent of 3D printing technology, intelligent orthopaedic surgical robots, mixed reality augmentation technology and high-precision optical localization tracking has catapulted minimally invasive pelvic fracture reduction to the forefront of research in the field of orthopaedics. Studies have demonstrated encouraging outcomes. This paper reviews relevant literature, mainly focusing on the evaluation and measurement, open reduction techniques, minimally invasive closed reduction techniques, and surgical robot assisted reduction techniques in treatment of pelvic fractures, to summarize the technical research progress in minimally invasive closed surgical reduction for pelvic fractures.

Pelvic fractures, the most severe bone trauma, account for approximately 3% of all fractures. As they are caused by high-energy injuries, their rates of mortality and disability are high. Over the past two centuries, the treatment strategies for these fractures have evolved from conservative therapy to open reduction and plate fixation, then to closed reduction and percutaneous screw fixation, and recently to screw fixation assisted by artificial intelligence. In the past 40 years, constant progress has been made in the treatment of pelvic fractures. It is generally acknowledged that a personalized treatment plan should be formulated based on each patient's age, fracture type, comorbidities, functional requirements and other factors when an appropriate treatment mode is chosen. The primary aim of treatment is to accelerate functional recovery, decrease the rate of disability after injury, and improve the quality of daily life of the patient. This paper reviews the treatment history of pelvic fractures, discusses the advantages and disadvantages of current treatment options, and looks ahead to future prospects, aiming to offer valuable references for related clinical practice.