ObjectiveTo identify the multidimensional factors influencing balance dysfunction in middle-aged and older adults, providing evidence-based support for the precise identification of high-risk individuals and the formulation of fall prevention strategies. MethodsDrawing upon the 2015 follow-up data from the China Health and Retirement Longitudinal Study (CHARLS), participants aged ≥ 45 years were selected. Information on demographic characteristics, lifestyle habits, and health status was collected. Balance function was assessed using the full-tandem stance test. Logistic regression models were employed to analyze influencing factors and their correlation with Five Times Sit to Stand Test (FTSST) time. ResultsFemale (OR = 1.958, 95% CI: 1.706 to 2.247), age (OR = 1.035, 95% CI: 1.030 to 1.040), depressive state (OR = 1.151, 95% CI: 1.050 to 1.262), hypertension (OR = 1.115, 95% CI: 1.015 to 1.225), diabetes (OR = 1.587, 95% CI: 1.390 to 1.813), history of stroke (OR = 1.582, 95% CI 1.289 to 1.942), sarcopenia (OR = 1.273, 95% CI 1.080 to 1.500) and impaired activity daily living (OR = 1.306, 95% CI 1.142 to 1.493) were risk factors for balance function, while being able to complete FTSST (OR = 0.411, 95% CI 0.341 to 0.496) and having a high cognitive level (OR = 0.974, 95% CI 0.965 to 0.983) were protective factors for balance function. Among those able to complete the FTSST, longer FTSST completion time increased the risk of balance impairment after adjusting for confounding factors (Q2: OR = 1.287, 95%CI 1.116 to 1.485; Q3: OR = 1.517, 95%CI 1.321 to 1.745; Q4: OR = 1.857, 95%CI 1.615 to 2.137). ConclusionBalance function in middle-aged and older adults is influenced by multiple factors, with FTSST performance showing a significant negative correlation with balance impairment.

Objective:To explore the feasibility and preliminary efficacy of domestic single-port robotic surgical system in the surgical treatment of thyroid cancer. Methods:Thyroid cancer patients who underwent domestic single-port robotic surgery in the Department of Head and Neck Surgery of Sichuan Cancer Hospital from June 2024 to January 2025 were prospectively included. Clinical data, oncological characteristics, and perioperative indicators were systematically collected. Results:A total of 7 patients were included, including 3 males and 4 females, with an age of （34.57±10.26） years. All procedures were successfully completed without conversion to open surgery. Operative time was（180.00±30.41） minutes. Blood loss was（5.00[15.00 ]）mL. Postoperative drainage volume was （167.86±130.95） mL. The postoperative pathological results were all thyroid papillary carcinoma. There were no system failures, no device-related complications and adverse events were observed during the operation and perioperative period. No tumor recurrence or metastasis was observed during the follow-up period. Conclusion:Preliminary data indicate that the domestic single-port robotic surgical system is safe and feasible for the surgical treatment of thyroid cancer, providing a practical basis for subsequent multi-disease, multi-center, and large-sample studies.
Humans ; Thyroid Neoplasms/surgery* ; Robotic Surgical Procedures/instrumentation* ; Male ; Female ; Adult ; Thyroidectomy/methods* ; Operative Time ; Middle Aged ; Prospective Studies

OBJECTIVETo compare the model for end-stage liver disease (MELD), delta model for end-stage liver disease (deltaMELD), MELD and serum sodium (MELD-Na), MELD score to serum sodium ratio index (MESO), and integrated end-stage liver disease model (iMELD) scoring systems for their utility in evaluating medium-short term prognosis of cirrhotic patients who underwent the transjugular intrahepatic portosystemic shunt (TIPS) procedure.

METHODSA total of 101 patients with liver cirrhosis who underwent the TIPS procedure between January 2011 and May 2013 were enrolled and followed-up for 1, 3 and 6 months.The MELD, deltaMELD, MELD-Na, MESO, and iMELD scores were assessed for each patient, according to the clinical data.The accuracy of the five scoring systems for predicting prognosis was analyzed and compared by the area under the receiver operating characteristic (ROC) curve.

RESULTSScores according to the different systems, which were recorded up to the patients' follow-up cut-off times (without death) were:MELD:19.35 +/- 5.78, deltaMELD:2.47 +/- 1.38, MELD-Na:18.23 +/- 7.82, MESO:1.57 +/- 0.43, and iMELD:33.76 +/- 9.58).For the patients who died, the scores were:MELD:24.36 +/- 5.67, deltaMELD:4.35 +/- 1.61, MELDNa:28.54 +/- 8.06, MESO:2.16 +/- 0.59, and iMELD:48.05 +/- 12.64.The differences between these five scores in the death group showed statistical significance (all P less than 0.01).As the scores of MELD, deltaMELD, MELDNa, MESO and iMELD increased, the survival rate of the patients decreased correspondingly.The differences between the survival rate and survival curve of each group showed statistical significance (P less than 0.01).The area under the curve was 0.735 for MELD, 0.769 for deltaMELD, 0.803 for MELD-Na, 0.740 for MESO and 0.816 for iMELD, and the differences did not show statistical significance (P more than 0.05).

CONCLUSIONThe MELD and MELD-based scoring systems (deltaMELD, MELD-Na, MESO and iMELD), can all predict medium-short term prognosis well.These five scoring systems showed no statistically significant difference in their predictive value.

End Stage Liver Disease ; Humans ; Liver Cirrhosis ; Portasystemic Shunt, Transjugular Intrahepatic ; Prognosis ; ROC Curve ; Severity of Illness Index ; Sodium ; Survival Rate

Objective To explore the clinical safety and validity of Da Vinci surgical system in distal pancreatic tumor resection.Methods The clinical data of 14 patients with distal pancreatic tumor underwent robotic surgeries by using Da Vinci surgical system from January 2009 to June 2012 were retrospectively analyzed.Results The average operation time was 343.93 (170-575) min,average blood loss was 192.5 (10-700) ml,without blood trahsfusion.Pathologic examination showed:pancreatic ductal adenocarcinoma in 7 patients,pancreatic cystadenoma in 1 patient,mucous cystadenoma in 1 patient,cystadenocarcinoma in 1 patient,high levels of pancreatic ductal intraepithelial neoplasia in 1 patient,insulinoma in 1 patient,solid pseudo-papillary tumor in 2 patients.Two patients with pancreatic leaks after operation and then relieved after conservative medical therapy.Others were discharged from hospital without complications.The average hospital stay was 10.64 d.Conclusions Da Vinci surgical system is safe and effective in treatment for patients with distal pancreatic rumor with minimally invasive advantage.Because lack of surgical experience and small sample,a large sample with long term follow-up of high-quality clinical research is required and then update the system to evaluate the efficacy and safety.

OBJECTIVE: To present the experience of nasal reconstruction with forehead flap. METHOD: nasal reconstruction with forehead flap were applied in eight nasal carcinoma cases after operation and 5 nasal trauma cases with defects. RESULT: These forehead flaps were alive in all patients, all incision healed in I stage, no post operative complications were found. The shapes of nose were satisfactory, there were no recurrence of tumor during 1 to 17 year follow up. CONCLUSION The method can be clinically applied for its simple procedure, reliable flap's blood supply, high survival rate and satisfied result.
Adolescent ; Adult ; Aged ; Female ; Forehead ; surgery ; Humans ; Male ; Middle Aged ; Nose ; injuries ; surgery ; Rhinoplasty ; methods ; Skin Transplantation ; Surgical Flaps ; Young Adult