AIM: To investigate the current incidence of retinopathy of prematurity(ROP)in Sichuan Province and analyze its risk factors, providing a scientific basis for establishing and improving the regional ROP screening and prevention system.METHODS: A retrospective study was conducted on premature infants who underwent fundus screening at the Departments of Ophthalmology and Neonatology of Sichuan Provincial Maternity and Child Health Care Hospital from January 20, 2017 to February 10, 2025. The incidence of ROP was calculated. The patients were divided into ROP group and non-ROP group according to whether ROP occurred, and the clinical characteristics of the two groups were compared. Multivariate Logistic regression was used to analyze risk factors for ROP.RESULTS:This study included a total of 861 premature infants, with 445 males(51.7%)and 416 females(48.3%).ROP occurred in 166 cases, with an incidence rate of 19.3%, and the non-ROP group consisted of 695 cases. The mean gestational age of the ROP and non-ROP groups was 30.24±2.20 and 33.06±1.90 wk(P<0.01), while the mean birth weight was 1438.94±389.66 and 1977.32±438.68 g(P<0.01). By comparing the clinical data of the two groups of preterm infants, the following factors were found to be associated with the occurrence of ROP: younger gestational age, low birth weight, history of oxygen therapy, respiratory distress syndrome, intracranial hemorrhage, neonatal anemia, bronchopulmonary dysplasia, patent ductus arteriosus, and sepsis(all P<0.01). Multivariate Logistic regression analysis revealed that gestational age(OR=0.685,95%CI:0.592-0.792,P<0.01), birth weight(OR=0.999,95%CI:0.998-0.999,P<0.01), and respiratory distress syndrome(OR=2.312,95%CI:1.313-4.070,P<0.01)were risk factors for ROP. Gestational age had the greatest impact.The younger the gestational age at birth, the higher the risk of ROP.CONCLUSION:The incidence of ROP in Sichuan Province is relatively high compared to multicenter results from China. Significant risk factors include younger gestational age, low birth weight, and respiratory distress syndrome. Screening criteria should be formulated based on the local incidence of ROP, and a screening, prevention, and treatment system for ROP should be established and improved.

Objective:To summarize the consultation data from the department of rheumatology and clinical immunology of Peking Union Medical College Hospital, and to describe the distribution of consultation needs of different rheumatic and immunologic diseases (RID) in each unit.Methods:To collect and analyze the data of patients who accepted the consultations of rheumatology and clinical immunology of Peking Union Medical College Hospital from January 1, 2021 to December 31, 2021.Results:A total of 1 640 consultations were executed. The ratio of male-to-female was 556∶1 084, with an average age of (44.5±16.0)years. The proportion of single consultation was 57.26% (939/1 640) while that of twice and multiple consultation was 42.74% (701/1 640). Among the consultations, 87.56% (1 436/1 640) were routine ones, especially from emergency 25.21% (362/1 436), department of infectious diseases 12.88% (185/1 436) and cardiology 12.47% (179/1 436). The other 12.44% (204/1 640) were multi-disciplinary treatment (MDT), mainly in department of general internal medicine, emergency and obstetrics. Main purposes of consultation included 52.66% (514/976) for RID condition assessment/medication adjustment and 47.34% (462/976) for etiological diagnosis in internal medicine unit; while 55.77% (58/104) for guidance for perioperative RID treatment in surgery. In Obstetrics and Gynecology, the majority purposes were RID condition assessment/medication adjustment 36.36% (12/33), perioperative treatment guidance 27.27% (9/33) and surgical risk/timing assessment 27.27% (9/33). Most consultations were focused on SLE, UCTD, SS, RA and TA.Conclusion:Requested as MDT and multiple repeat,consultation needs for department of rheumatology and clinical immunology are great, especially from emergency and infectious disease unit. It may improve the efficacy of consultation by popularizing the meaning of autoantibodies and enhancing the awarness of common RID and its complications, as well as the awareness of perioperative and prenatel periods.

Objective:To summarize the consultation data from the department of rheumatology and clinical immunology of Peking Union Medical College Hospital, and to describe the distribution of consultation needs of different rheumatic and immunologic diseases (RID) in each unit.Methods:To collect and analyze the data of patients who accepted the consultations of rheumatology and clinical immunology of Peking Union Medical College Hospital from January 1, 2021 to December 31, 2021.Results:A total of 1 640 consultations were executed. The ratio of male-to-female was 556∶1 084, with an average age of (44.5±16.0)years. The proportion of single consultation was 57.26% (939/1 640) while that of twice and multiple consultation was 42.74% (701/1 640). Among the consultations, 87.56% (1 436/1 640) were routine ones, especially from emergency 25.21% (362/1 436), department of infectious diseases 12.88% (185/1 436) and cardiology 12.47% (179/1 436). The other 12.44% (204/1 640) were multi-disciplinary treatment (MDT), mainly in department of general internal medicine, emergency and obstetrics. Main purposes of consultation included 52.66% (514/976) for RID condition assessment/medication adjustment and 47.34% (462/976) for etiological diagnosis in internal medicine unit; while 55.77% (58/104) for guidance for perioperative RID treatment in surgery. In Obstetrics and Gynecology, the majority purposes were RID condition assessment/medication adjustment 36.36% (12/33), perioperative treatment guidance 27.27% (9/33) and surgical risk/timing assessment 27.27% (9/33). Most consultations were focused on SLE, UCTD, SS, RA and TA.Conclusion:Requested as MDT and multiple repeat,consultation needs for department of rheumatology and clinical immunology are great, especially from emergency and infectious disease unit. It may improve the efficacy of consultation by popularizing the meaning of autoantibodies and enhancing the awarness of common RID and its complications, as well as the awareness of perioperative and prenatel periods.

Objective:To study the clinical results of robot-assisted laparoscopic resection for choledochal cysts.Methods:From October 2020 to June 2022, clinical data on 20 patients who underwent choledochal da Vinci robot-assisted laparoscopic choledochal cyst resection at Fujian Provincial Hospital were retrospectively analyzed. Forty-two children with choledochal cysts were included in this study. There were 16 males and 26 females, aged 25 (range 15.0 to 45.0) months. The operations were carried out by the same team of surgeons. These patients were divided into two groups based on the surgical methods: children who underwent da Vinci robot-assisted laparoscopic surgery were in the robotic group ( n=20) and children who underwent single-port (transumbilical) laparoscopic surgery were in the laparoscopic group ( n=22). The general clinical data, operation time, intraoperative blood loss, fasting time, hospital stay, total medical costs and complications were collectd and analysed. Follow-up was performed in outpatient visits. Results:Both the 2 groups underwent surgery successfully, and no patient was converted to laparotomy. When compared with the laparoscopic group, intraoperative blood loss [(10.65±3.75) vs. (14.86±3.75) ml], indwelling time of abdominal drainage tube [(5.45±2.21) vs. (7.05±1.94) d] and fasting time [(4.00±1.49) vs. (6.05±1.43) d] in the robotic group were significantly less, while the operation time [394(299, 422) vs. 351(269, 380) min] and hospitalization cost [(79 200±4 000) vs. (31 100±3 000) yuan] were significantly increased (all P<0.05). The differences in postoperative complication rates and pain score between the two groups showed no significant differences (all P>0.05). On follow-up, no patients developed complications such as cholangitis, jaundice, intestinal obstruction and cholangiocarcinoma, except for one patient in the laparoscopic group who developed cholangitis after surgery. Conclusion:Robot-assisted laparoscopic choledochal cystectomy was effective and safe in treatment of children with choledochal cysts.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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Objective:To investigate the clinical characteristics and outcomes in patients with wake-up stroke.Methods:From January 2019 to December 2019, consecutive patients with acute ischemic stroke admitted to the Department of Neurology, Huizhou Municipal Central Hospital were enrolled retrospectively. The modified Rankin Scale was used to evaluate the outcome of patients at 90 d after the onset. 0 to 2 was defined as a good outcome, and >2 was defined as a poor outcome. Multivariate logistic regression analysis was used to determine the factors affecting the poor outcome of patients with wake-up stroke. Results:A total of 356 patients with acute ischemic stroke were enrolled, including 97 (27.2%) wake-up stroke, and 259 (72.8%) non-wake-up stroke. The National Institutes of Health Stroke Scale (NIHSS) score at admission and the proportion of patients with atrial fibrillation, moderate to severe stroke and cardiogenic embolism in the wake-up stroke group were significantly higher than those of the non-wake-up stroke group, and the proportion of patients with small artery occlusion was significantly lower than that in the non-wake-up stroke group (all P<0.05). Moreover, the proportion of patients with poor outcome in the wake-up stroke group was significantly higher than that in the non-wake-up stroke group (36.1% vs. 24.7%; χ2=4.546, P=0.033). In the wake-up stroke group, 62 patients (63.9%) had a good outcome, and 35 (36.1%) had a poor outcome. The NIHSS score at admission and the proportion of patients with atrial fibrillation and moderate to severe stroke in the subgroup with poor outcome were significantly higher than those in the subgroup with good outcome, and the proportion of patients receiving intravenous thrombolysis and mechanical thrombectomy was significantly lower than those in the good outcome subgroup (all P<0.05). Multivariate logistic regression analysis showed that moderate to severe stroke (odds ratio [ OR] 6.674, 95% confidence interval [ CI] 2.223-20.034; P=0.001) was independently associated with the poor outcome in patients with wake-up stroke, while intravenous thrombolysis ( OR 0.102, 95% CI 0.017-0.630; P=0.014) and endovascular mechanical thrombectomy ( OR 0.108, 95% CI 0.023-0.506; P=0.005) were independently associated with the good outcome of patients with wake-up stroke. Conclusions:In patients with wake-up stroke, the proportion of cardioembolism is higher, the clinical symptoms are more serious and the incidence of poor outcome is higher. The severity of stroke at admission is associated with poor short-term outcome, and intravenous thrombolysis and endovascular mechanical thrombectomy can improve the outcome in patients with wake-up stroke.

Objective:To compare the consistency in diagnosing and staging acute kidney injury (AKI) in children with chronic kidney disease (CKD) according to three criterias.Methods:Children with CKD hospitalized in the First Affiliated Hospital of Sun Yat sen University from January 2013 to December 2019 were analyzed retrospectively. These patients underwent serum creatinine examination more than twice during hospitalization. The AKI diagnosis and staging were performed for each patient according to the 2007 pRIFLE, 2012 KDIGO and 2018 pROCK criteria respectively. All the children were followed up for 1 year after discharge through outpatient visit, re-hospitalization or online consultation. The clinical characteristics and prognosis of CKD children with or without AKI that were diagnosed by 3 criteria were compared. Analysis of variance and chi-squared tests were used for the comparison among groups. Concordance between the different diagnostic criteria was evaluated using Cohen′s kappa coefficient.Result:A total of 2 551 children with CKD were included in this study, with an age of (8±4) years. There were 1 628 boys and 923 girls. Nephrotic syndrome was the most prevalent primary disease (55.4%), followed by lupus nephritis (11.2%) and purpura nephritis (8.2%). Among all stages of CKD, CKD category G1 was the most common type (2 146 cases, 84.1%), followed by CKD category G2 (221 cases, 8.7%). AKI occurence rates according to pRIFLE, KDIGO and pROCK criteria were 33.9% (866/2 551), 26.2%(669/2 551) and 19.5% (498/2 551) respectively (χ2=136.3, P<0.01). The diagnostic consistency within three criteria for AKI was high in children with CKD ( κ=0.702), but AKI staging consistency was low ( κ=0.329). Both the diagnosis and staging consistency of three AKI criteria were poor in children with CKD category G5 (all κ<0.400). The length of hospital stay (LOS), hospitalization costs, the occurence of intensive care unit (ICU) admission and in-hospital mortality were significantly higher in children with AKI diagnosed by different criteria ( P<0.05). After 1-year follow-up, the repeated admission rate and CKD staging progress significantly increased in children with AKI ( P<0.05). In children with baseline serum creatinine≥200 μmol/L, compared with children who did not experience AKI during hospitalization, the LOS and the hospitalization costs in children who were diagnosed AKI according to pRIFLE or pROCK criteria was significantly higher ( P<0.05). However, there was no significant difference in the LOS and hospitalization costs between children with or without AKI who were diagnosed according to KDIGO criteria (all P>0.05). Conclusions:AKI diagnosed by all of the three criteria (pRIFLE, KDIGO and pROCK criteria) was associated with the poor prognosis in children with CKD. However, in those whose baseline serum creatinine≥ 200 μmol/L, AKI diagnosed by pRIFLE and pROCK criteria could better reflect the poor outcomes than by KDIGO criteria.

Objective To summarize and analyze the perioperative complications of irreversible electroporation (IRE) ablation in treating tumors at different locations and to discuss their managements. Methods A total of 200 patients with tumors, including pancreatic tumor (n=71), liver tumor (n=64) and other tumors (n =65), were enrolled in this study. All patients received IRE ablation treatment. The perioperative complications were recorded and the data were statistically analyzed. The causes of severe complications and the treatment of complications were discussed. Results None of the patients died during the course of IRE ablation procedure. Severe postoperative complications occurred in the patients with pancreatic tumor or liver tumor, including duodenal artery bleeding in 3 patients with pancreatic tumor, which occurred at 10 days, 11 days and 15 days after IRE ablation respectively, and gastrointestinal bleeding (n =1) and biliary septic shock (n=1) in 2 patients with liver tumor, which occurred at 9 days after IRE ablation, the clinical symptoms were controlled after interventional embolization and/or vascular ligation together with anti-infective therapy. All minor complications were relieved after symptomatic treatment within 14 days. Conclusion IRE ablation has less systemic inflammatory response, and both the intraoperative and postoperative adverse reactions can be easily controlled, besides, IRE ablation has higher clinical safety. Although IRE ablation procedure may damage the internal or peripheral vessels of the pancreatic tumor, this severe complications can be effectively avoided if proper measures are adopted based on the causes of complications. (J Intervent Radiol, 2018, 27: 223-227)

The incidence of liver cancer has been increasing year by year.In China,the incidence of liver cancer is 25.7/10 million.However,when the important organs have been involved or when the malignant liver tumors are located adjacent to the hepatic portal vital organs,the lesions are usually difficult to be surgically removed,and the curative results of chemotherapy and radiotherapy for such lesions are often poor.In recent years,along with the gradual rise of ablation techniques,the irreversible electroporation (IRE),regarded as a new ablation method that uses non-thermal energy,has been widely employed in clinical practice.Through generating instantaneous high voltage electrical pulses,IRE produces irreversible nanoscale damage to the cell membrane.Both domestic and foreign researches have indicated that for the treatment of inoperable primary or metastatic liver tumors IRE can effectively inactivate the tumor tissue while the lumen architecture of the vessels can be preserved and large vessel or bile duct will not be damaged.This paper aims to make a comprehensive review about IRE device structure,mechanism of therapeutic action,preclinical studies,clinical application methods and clinical efficacy in order to provide reference for the application of this technology in clinical practice.(J Intervent Radiol,2017,26:285-289)

Objective To discuss the clinical value of magnetic resonance diffusion-weighted imaging (MR-DWI) in distinguishing tumor remnants from tumor necrosis of pancreatic carcinoma after cryoablation treatment.Methods Conventional MRI T1WI,T2WI scan,DWI sequence and dynamic enhanced MRI scan were performed in 26 patients with pancreatic carcinoma who were received cryoablation treatment.The changes in MRI signals after cryoablation treatment were recorded.The apparent diffusion coefficient (ADC) values of the normal pancreas,preoperative tumor tissue,postoperative remnants and necrosis tissue were calculated,and the results were compared.The correlation between the ADC values and the size of the tumor was evaluated,and the differences in ADC values among the tumors that had different diameter,location and staging were statistically analyzed.Results Of the 26 patients,complete necrosis of tumor was obtained in 16.The necrotic tumor tissue displayed low-signal on T1WI,high-signal on T2WI and low-signal on DWI,with no enhancement on dynamic enhanced imaging.Active residual tumor tissue was detected in 9 patients,among them the residual tumor diameter ＞5 cm was seen in 7 patients;the residual rate was 34.6％.ADC values of the following tissue,from low to high in order,were preoperative pancreatic tumor tissue (1.022± 0.126)x10-3 mm2/s,postoperative residual tumor tissue (1.130±0.155)x10-3 mm2/s,normal pancreatic tissue (1.924±-0.124)×10-3 mm2/s and postoperative necrosis tissue (2.312-±0.214)×10-3 mm2/s.No statistically significant difference in ADC values existed between preoperative pancreatic tumor tissue and postoperative residual tumor tissue (P=0.452),while statistically significant difference in ADC values existed between normal pancreatic tissue and postoperative necrosis tissue (P＜0.001).The ADC values of pancreatic tumor tissue bore a negative correlation with the tumor size (R=-0.43,P=0.027 2),while the ADC values lacked the relationship to the tumor location as well as to the tumor staging (P=0.738 8 and P=0.089 5 respectively).Conclusion MR-DWI can effectively distinguish the residual tumor tissue from the necrotic tumor tissue of pancreatic carcinoma after cryoablation treatment,which provides reliable basis for further clinical diagnosis and treatment.