Electrical impedance tomography (EIT) is a technique that uses an array of electrodes to deliver safe stimulating currents and measures the boundary voltages between adjacent electrode pairs in the array in sequence. Subsequently, it reconstructs the impedance distribution in all or part of the tissue using reconstruction algorithms to achieve structural and functional imaging. Lung EIT technology features continuity, being radiation-free and non-invasive, and it can be used for real-time dynamic monitoring of the lungs in critically ill patients. This paper introduces the basic principles of lung EIT, analyzes the research progress and existing problems of the technology from the perspectives of hardware systems, imaging algorithms, and clinical applications (such as lung ventilation, lung perfusion, and lung function assessment), and discusses the development direction to provide ideas for expanding the clinical application of lung EIT.
Electric Impedance ; Humans ; Tomography/methods* ; Lung Diseases/therapy* ; Algorithms

Objective:To evaluate the clinical efficacy of total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the concept of enhanced recovery after surgery (ERAS).Methods:Clinical data from the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2012 to January 2024 were collected and analyzed retrospectively. Patients were divided into the non-ERAS group (total thoracoscopic mitral valve surgery combined with beating-heart tricuspid annuloplasty without ERAS intervention) and the ERAS group (the same surgical procedures under the concept of ERAS). Propensity score matching (PSM) was used to reduce selection bias. Differences in perioperative blood transfusion, 24-hour postoperative drainage volume, incidence of severe postoperative complications [such as low cardiac output syndrome, liver failure, renal failure, stroke (ischemic/hemorrhagic), perivalvular leakage, re-thoracotomy during hospitalization, etc.], surgery and hospitalization-related indicators (operation time, cardiopulmonary bypass time, aortic cross-clamp time, length of hospital stay, etc.), and echocardiographic results at 1 month after surgery [mitral valve peak pressure difference, mitral valve peak flow velocity, mitral valve pressure half-time (PHT), tricuspid regurgitation area, right ventricular diameter, right atrial diameter] were compared between the two matched groups.Results:After PSM, the selection bias of covariates in the two groups was corrected. There were no statistically significant differences in operation time, cardiopulmonary bypass time, or aortic cross-clamp time between the two groups (all P>0.05). The ICU monitoring time, ventilator use time, and postoperative hospital stay in the ERAS group were significantly shorter than those in the non-ERAS group, with statistically significant differences (all P<0.05). There were no statistically significant differences in 24-hour postoperative drainage volume, perioperative red blood cell transfusion volume, plasma transfusion volume, or total hospitalization cost between the two groups (all P>0.05). Both the ERAS group and the non-ERAS group had 1 case of re-thoracotomy for hemostasis, and the non-ERAS group had 1 case of perivalvular leakage, with no statistically significant differences between the groups ( P>0.05). Echocardiographic results at 1 month after surgery showed that in the ERAS group, tricuspid regurgitation area, right atrial diameter, and right ventricular diameter were significantly improved compared with those before surgery (all P<0.05); in the non-ERAS group, tricuspid regurgitation area was improved compared with that before surgery, with a statistically significant difference ( P<0.05). There were statistically significant differences in the right ventricular diameter and right atrial diameter between the two groups one month after surgery (all P<0.05). Conclusions:Total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the intervention of the ERAS concept is safe and effective, but further confirmation from more large-sample clinical studies is needed.

Objective:To study the cardiac morphology and function of fetuses with different types of complete transposition of the great arteries（cTGA）by using fetal heart quantification（fetal HQ）.Methods:A retrospective study was conducted on 50 fetuses diagnosed with cTGA through fetal echocardiography at Sir Run Run Shaw Hospital，Zhejiang University School of Medicine from July 2020 to December 2024. These cases were categorized into simple cTGA group（ n=31）and complex cTGA group（ n=19）based on the presence of concomitant cardiac anomalies. A control group of 160 normal fetuses with matched gestational ages was selected for comparison. Utilizing fetal HQ technology，the cardiac longitudinal diameter，transverse diameter，area，global sphericity index（GSI），left and right ventricular end-diastolic area（LVEDA，RVEDA），left and right ventricular fractional area change（LVFAC，RVFAC），left and right ventricular global longitudinal strain（LVGLS，RVGLS），and segmental sphericity index of 24 segments for both left and right ventricles（LVSI，RVSI）were measured. The analysis focused on comparing the differences among the simple cTGA group，complex cTGA group，and the control group. Results:Compared to the control group，the simple cTGA group exhibited significantly lower fetal GSI，LVEDA，RVFAC，and RVGLS（all P<0.05）. Statistically significant differences were observed in LVSI segments 1-4 and 10-17，as well as RVSI segments 1-7，9，and 15-23 compared to the control group（all P<0.05）. In comparison with the control group，the complex cTGA group demonstrated significantly reduced fetal GSI，LVFAC，LVGLS，RVFAC，and RVGLS（all P<0.05）. Significant differences were noted in LVSI segments 5-8 and 10-14，along with RVSI segments 1-14 and 24 compared to the control group（all P<0.05）. When compared to the simple cTGA group，the complex cTGA group showed significantly lower LVFAC，LVGLS，RVFAC，and RVGLS（all P<0.05），while GSI and LVEDA were significantly higher（all P<0.05）. Statistically significant differences were observed in LVSI segments 3-4，6-8，and 17，as well as RVSI segments 10-19 between the complex cTGA group and the simple cTGA group（all P<0.05）. Conclusions:The comprehensive parameters provided by Fetal HQ facilitate the assessment of cardiac morphology and function in cTGA fetuses，enabling a deeper understanding of the alterations in cardiac structure and function across different types of cTGA. This advanced analysis offers valuable reference information for clinical guidance during pregnancy.

Objective:To study the cardiac morphology and function of fetuses with different types of complete transposition of the great arteries（cTGA）by using fetal heart quantification（fetal HQ）.Methods:A retrospective study was conducted on 50 fetuses diagnosed with cTGA through fetal echocardiography at Sir Run Run Shaw Hospital，Zhejiang University School of Medicine from July 2020 to December 2024. These cases were categorized into simple cTGA group（ n=31）and complex cTGA group（ n=19）based on the presence of concomitant cardiac anomalies. A control group of 160 normal fetuses with matched gestational ages was selected for comparison. Utilizing fetal HQ technology，the cardiac longitudinal diameter，transverse diameter，area，global sphericity index（GSI），left and right ventricular end-diastolic area（LVEDA，RVEDA），left and right ventricular fractional area change（LVFAC，RVFAC），left and right ventricular global longitudinal strain（LVGLS，RVGLS），and segmental sphericity index of 24 segments for both left and right ventricles（LVSI，RVSI）were measured. The analysis focused on comparing the differences among the simple cTGA group，complex cTGA group，and the control group. Results:Compared to the control group，the simple cTGA group exhibited significantly lower fetal GSI，LVEDA，RVFAC，and RVGLS（all P<0.05）. Statistically significant differences were observed in LVSI segments 1-4 and 10-17，as well as RVSI segments 1-7，9，and 15-23 compared to the control group（all P<0.05）. In comparison with the control group，the complex cTGA group demonstrated significantly reduced fetal GSI，LVFAC，LVGLS，RVFAC，and RVGLS（all P<0.05）. Significant differences were noted in LVSI segments 5-8 and 10-14，along with RVSI segments 1-14 and 24 compared to the control group（all P<0.05）. When compared to the simple cTGA group，the complex cTGA group showed significantly lower LVFAC，LVGLS，RVFAC，and RVGLS（all P<0.05），while GSI and LVEDA were significantly higher（all P<0.05）. Statistically significant differences were observed in LVSI segments 3-4，6-8，and 17，as well as RVSI segments 10-19 between the complex cTGA group and the simple cTGA group（all P<0.05）. Conclusions:The comprehensive parameters provided by Fetal HQ facilitate the assessment of cardiac morphology and function in cTGA fetuses，enabling a deeper understanding of the alterations in cardiac structure and function across different types of cTGA. This advanced analysis offers valuable reference information for clinical guidance during pregnancy.

Objective:To evaluate the clinical efficacy of total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the concept of enhanced recovery after surgery (ERAS).Methods:Clinical data from the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2012 to January 2024 were collected and analyzed retrospectively. Patients were divided into the non-ERAS group (total thoracoscopic mitral valve surgery combined with beating-heart tricuspid annuloplasty without ERAS intervention) and the ERAS group (the same surgical procedures under the concept of ERAS). Propensity score matching (PSM) was used to reduce selection bias. Differences in perioperative blood transfusion, 24-hour postoperative drainage volume, incidence of severe postoperative complications [such as low cardiac output syndrome, liver failure, renal failure, stroke (ischemic/hemorrhagic), perivalvular leakage, re-thoracotomy during hospitalization, etc.], surgery and hospitalization-related indicators (operation time, cardiopulmonary bypass time, aortic cross-clamp time, length of hospital stay, etc.), and echocardiographic results at 1 month after surgery [mitral valve peak pressure difference, mitral valve peak flow velocity, mitral valve pressure half-time (PHT), tricuspid regurgitation area, right ventricular diameter, right atrial diameter] were compared between the two matched groups.Results:After PSM, the selection bias of covariates in the two groups was corrected. There were no statistically significant differences in operation time, cardiopulmonary bypass time, or aortic cross-clamp time between the two groups (all P>0.05). The ICU monitoring time, ventilator use time, and postoperative hospital stay in the ERAS group were significantly shorter than those in the non-ERAS group, with statistically significant differences (all P<0.05). There were no statistically significant differences in 24-hour postoperative drainage volume, perioperative red blood cell transfusion volume, plasma transfusion volume, or total hospitalization cost between the two groups (all P>0.05). Both the ERAS group and the non-ERAS group had 1 case of re-thoracotomy for hemostasis, and the non-ERAS group had 1 case of perivalvular leakage, with no statistically significant differences between the groups ( P>0.05). Echocardiographic results at 1 month after surgery showed that in the ERAS group, tricuspid regurgitation area, right atrial diameter, and right ventricular diameter were significantly improved compared with those before surgery (all P<0.05); in the non-ERAS group, tricuspid regurgitation area was improved compared with that before surgery, with a statistically significant difference ( P<0.05). There were statistically significant differences in the right ventricular diameter and right atrial diameter between the two groups one month after surgery (all P<0.05). Conclusions:Total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the intervention of the ERAS concept is safe and effective, but further confirmation from more large-sample clinical studies is needed.

Epidural labor analgesia aims to provide effective medical services to alleviate labor pain in parturients, while adhering to the principles of voluntary participation and clinical safety. In 2018, Peking Union Medical College Hospital(PUMCH)became one of the first pilot units for labor analgesia in China, and has achieved satisfactory results in high-quality development of labor analgesia. This article mainly introduces the achievements and experience of labor analgesia at PUMCH, including: (1) prioritizing maternal and infant safety, arranging personnel rationally, and developing standardized treatment processes through multidisciplinary collaboration to ensure safe and comfortable childbirth; (2) leveraging the hospital's comprehensive capabilities in emergency treatment, and improving collaborative rescue plans for critically ill parturients and newborns; (3) implementing advanced teaching methods to effectively train and conduct simulated drills for labor analgesia and rescue of critically ill parturients; (4) conducting patient education and informative lectures to help parturients acquire a scientific understanding of labor analgesia. We hope that this experience can provide reference and inspiration for other hospitals.

Central post-stroke pain (CPSP), a neuropathic pain syndrome occurring after a cerebrovascular accident, is characterized by pain or paraesthesia in the part of the body dominated by the area of the brain where blood vessels are injured. CPSP patients are often accompanied by anxiety, depression and other emotional disorders, which have a serious negative impact on patients' quality of life. However, the pathogenesis of CPSP has not been fully elucidated, the clinical diagnosis rate is not high, and the commonly used treatment methods are not effective. This article reviews the clinical features, epidemiology, pathogenesis and treatment of CPSP in order to provide reference for the elucidation of CPSP mechanism and effective treatment.

ObjectiveTo investigate the value of biliary score and hepatic signal intensity-to-muscle signal intensity ratio （HMR） obtained by multiphase contrast-enhanced MRI scan using Gd-EOB-DTPA in evaluating the pathological grade of liver fibrosis. MethodsA retrospective analysis was performed for the MRI and clinical data of 51 patients with chronic hepatitis B liver fibrosis in Wuming Hospital Affiliated to Guangxi Medical University from January 2020 to May 2023. The 51 patients with liver fibrosis were divided into low-grade group （S1-S2） and high-grade group （S3-S4）. GE Architact 3.0T MR scanner was used to perform MRI scans， including routine plain scan and contrast-enhanced scan at arterial phase， portal venous phase， delayed phase， hepatobiliary phase， and excretory phase， and biliary score and HMR were measured for the patients with different grades of liver fibrosis. The t-test was used for comparison of continuous data between groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The receiver operating characteristic （ROC） curve was plotted to evaluate the value of MRI indicators in determining the pathological grade of liver fibrosis. ResultsAmong the 51 patients with liver fibrosis， there were 30 patients in the low-grade group and 21 in the high-grade group. Compared with the high-grade group， the low-grade group had significantly higher biliary score （3.67±0.55 vs 2.57±0.75， t=6.05， P<0.001） and HMR at portal venous phase （2.38±0.76 vs 1.97±0.18， t=2.41， P=0.020）， delayed phase （2.48±0.70 vs 1.99±0.27， t=3.09， P=0.003）， and hepatobiliary phase （4.10±0.63 vs 3.16±0.47， t=5.81， P<0.001）. The above indicators had an area under the ROC curve （AUC） of 0.86， 0.79， 0.82， and 0.88， respectively， in distinguishing low- and high-grade liver fibrosis， with a positive rate of 70%， 63.3%， 83.3%， and 96.7%， respectively， and a negative rate of 90%， 95.2%， 74.1%， and 100%， respectively， in the diagnosis of high-grade liver fibrosis. Biliary score combined HMR had an AUC of 0.95， with a positive rate of 85.7% and a negative rate of 96.7%. ConclusionBiliary score and HMR at hepatobiliary phase obtained by multiphase contrast-enhanced MRI scan using Gd-EOB-DTPA has a relatively high diagnostic efficacy in distinguishing between low- and high-grade liver fibrosis and a certain guiding value for the diagnosis and treatment of liver fibrosis in clinical practice.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

Hepatic fibrosis is a pathological process of chronic liver injury. Without timely intervention and treatment， liver fibrosis may eventually lead to liver cirrhosis and cancer. Janus kinase （JAK）/signal transducer and activator of transcription （STAT） signaling pathway is closely associated with the occurrence and development of liver fibrosis. Based on this， this paper summarized and analyzed the mechanism and effects of active ingredients and compounds of traditional Chinese medicine improving liver fibrosis based on JAK/STAT signaling pathway. It is found that the active ingredients and compounds of traditional Chinese medicine that promote blood circulation and remove blood stasis （ingredients such as ethanol extract of Euonymus alatus and paclitaxel， as well as compounds such as Ershiwuwei songshi pill and Ganfukang）， clear away heat and toxic material （ingredients such as betulinic acid， total flavonoids from Persicaria perfoliata， as well as compounds such as Pianzaihuang and Kehuang capsules）， and sooth the liver and promote qi circulation （ingredients such as fraxetin and cucurbitacin B， as well as compounds such as Chaihu shugan powder and Xiaochaihu decoction） can all relieve liver fibrosis by inhibiting the activity of the JAK/STAT signaling pathway， reducing inflammatory reactions， and inhibiting the proliferation of hepatic stellate cells.