Risk prediction models for postoperative pulmonary complications (PPCs) can assist healthcare professionals in assessing the likelihood of PPCs occurring after surgery, thereby supporting rapid decision-making. This study evaluated the merits, limitations, and challenges of these models, focusing on model types, construction methods, performance, and clinical applications. The findings indicate that current risk prediction models for PPCs following lung cancer surgery demonstrate a certain level of predictive effectiveness. However, there are notable deficiencies in study design, clinical implementation, and reporting transparency. Future research should prioritize large-scale, prospective, multi-center studies that utilize multiomics approaches to ensure robust data for accurate predictions, ultimately facilitating clinical translation, adoption, and promotion.

ObjectiveTo assess the microstructural involvement of gray matter in recovered COVID-19 patients using Synthetic MRI. MethodsThis study was conducted in 29 recovered COVID-19 patients， including severe group （SG， n=11） and ordinary group （OG， n=18）. Healthy volunteers matched by age， sex， BMI and years of education were selected as a healthy control group （HC=23 cases）. Each subject underwent synthetic MRI to generate quantitative T₁ and T₂ maps， and the T₁ and T₂ maps were segmented into 90 regions of interest （ROIs） using automatic anatomical labeling （AAL） mapping. T₁ and T₂ values for each ROI were obtained by averaging all voxels within the ROIs. The T₁ and T₂ values of the 90 brain regions between the three groups were compared. ResultsRelative to HC， the SG had significantly higher T2 values in bilateral orbital superior frontal gyrus， bilateral parahippocampal gyrus， bilateral putamen， bilateral middle temporal gyrus， bilateral Inferior temporal gyrus， left orbital superior frontal gyrus， left orbital inferior frontal gyrus， left gyrus rectus， left anterior cingulate and paracingulate gyri， right median cingulate and paracingulate gyri， left posterior cingulate gyrus， and left supramarginal gyrus （P＜0.05）； Relative to OG， SG showed significantly increased T₂ values in the left rectus gyrus， left parahippocampal gyrus， bilateral middle temporal gyrus， and bilateral inferior temporal gyrus （P＜0.05）. Relative to HC， the T₁ values of SG were significantly increased in bilateral orbital superior frontal gyrus， left rectus gyrus， left anterior cingulate and paracingulate gyri， right posterior cingulate gyrus， left parahippocampal gyrus， left lingual gyrus， left putamen， left thalamus（P＜0.05）； Relative to OG， the T₁ values of SG were significantly higher in the right posterior cingulate gyrus， right calcarine fissure and surrounding cortex， and left putamen （P＜0.05）. ConclusionsEven after recovering from COVID-19， patients may still have persistent or delayed damage to their brain gray matter structure， which is correlated with the severity of the condition. SyMRI can serve as a sensitive tool to assess the extent of microstructural damage to the central nervous system， aiding in early diagnosis of the disease.

Objective: To evaluate the influence of electronic sports games on children s acquisition of basic motor skills, so as to provide assistance for childrens acquisition of basic motor skills in the context of digital society. Methods: Computer searches were conducted on CNKI, Web of Science, Cochrane Library and PubMed databases from March 2012 to March 2022. Methodological quality of included studies was evaluated using the Cochrane bias risk assessment tool RoB 2 and the extension tools RoB 2 Cluster and ROBINS-I. Publication bias assessment, heterogeneity test, subgroup analysis and Meta analysis were performed using RevMan 5.3. Results: A total of 12 studies included 897 participants, 7 randomized controlled trials, 2 cohort randomized controlled trials and 3 non randomized trials. Among them, 2 items had a low risk of bias, 8 items had certain risks and 2 items had a high risk of bias. Measures of basic motor skills in children from 12 studies included object control skills, motor skills, coordination, agility and balance. The results of Meta analysis showed that electronic sports games had a positive effect on children s acquisition of basic motor skills ( SMD=0.81, 95%CI=0.46-1.17, P <0.05). Conclusion Children can generate positive interactive communication behavior through physical activity and digital screen, and then promote the development of basic motor skills.

Objective To investigate the effect of osimertinib combined with aspirin on the survival pe-riod of the advanced lung adenocarcinoma patients with epidermal growth factor receptor(EGFR)mutation.Methods Sixty lung adenocarcinoma patients with EGFR mutation in advanced non-small cell lung cancer(NSCLC)first diagnosed in Banan District Second People's Hospital of from August 2020 to October 2021 were selected as the study subjects and divided into the observation group and control group by the random number table method,30 cases in each group.The observation group adopted osimertinib combined with aspi-rin,and the control used osimertinib merely.The overall response rate(ORR),disease control rate(DCR),progression-free survival(PFS),overall survival(OS)and the adverse reactions occurrence were compared between the two groups.Results ORR and DCR after 3,6,12 months medication in the observation group were higher than those in the control group,but the differences were not statistically significant(P＞0.05).Compared with the control group,PFS and OS in the observation group were longer,and the differences were statistically significant[14.9(11.8,17.2)m vs.10.5(8.9,12.5)m;24.1(19.5,27.4)m vs.18.1(16.1,21.1)m,P＜0.05].In addition,PFS and OS in male and female patients with brain metastasis,EGER19 and 21 ex-on mutation in the observation group were longer than those in the control group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in overall and≥Ⅲ degree adverse reactions between the two groups(P＞0.05).Conclusion Osimertinib combined with aspirin could prolong PFS and OS of the advanced lung adenocarcinoma patients with EGFR mutation without increasing the risk of adverse reactions.

Objective To explore the value of quantitative CT(QCT)for assessing complications of type 2 diabetes mellitus(T2DM).Methods Totally 220 T2DM patients were included and divided into uncomplicated group(n=40),mono-complicated group(n=84)and multi-complicated group(n=96).Bone mineral density(BMD)of L2—L4,as well as visceral adipose tissue(VAT)and subcutaneous adipose tissue(SAT)area were collected using QCT and compared among groups.The operator characteristic curves were drawn,and the area under the curves(AUC)were calculated to observe the value of QCT indicators and comprehensive model based on clinical indicators and QCT indicators for evaluating complications of T2DM.Decision curve analysis(DCA)and clinical impact curve(CIC)analysis were used to analyze the clinical application value of the comprehensive model.Results Significant differences of patients’age,lumbar BMDs and areas of VAT were found among 3 groups(all P＜0.05).The AUC of comprehensive model for differentiating uncomplicated group from mono-complicated group,uncomplicated group from multi-complicated group and mono-complicated group from multi-complicated group was 0.753,0.865,and 0.761,respectively,higher than that of BMD,VAT and SAT area(all P＜0.05).DCA and CIC analyses showed that comprehensive model yielded clinical benefits and had good clinical applicability for assessing complications of T2DM.Conclusion QCT was valuable for assessing complications of T2DM.

Percutaneous vertebroplasty is the main surgical therapeutic procedure for vertebral fractures and osteolytic metastases.Although the technique has been widely used clinically,recent studies have reported an increasing number of complications.Heart rupture and pulmonary embolism caused by bone cement leakage are the extremely rare and serious complications.We herein present a case of cardiac rupture and pulmonary embolism caused by bone cement after percutaneous vertebroplasty.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To evaluate the effect of preoperative pulmonary artery pressure on perioperative prognosis of the recipients with end-stage heart failure undergoing heart transplantation. Methods Clinical data of 105 recipients receiving heart transplantation were retrospectively analyzed. The mean pulmonary artery pressure (mPAP) was used as the diagnostic criterion. The optimal cut-off value of mPAP for predicting perioperative prognosis of heart transplant recipients was determined. According to the optimal cut-off value of mPAP, all recipients were divided into the low mPAP group (n=66) and high mPAP group (n=39). Intraoperative indexes (cardiopulmonary bypass time, aortic occlusion time, assisted circulation time and cold ischemia time of donor heart) and postoperative indexes [intra-aortic balloon pump (IABP) support rate, IABP support time, extracorporeal membrane oxygenation (ECMO) support rate, ECMO support time, mechanical ventilation time, length of ICU stay, incidence of moderate and severe tricuspid regurgitation and perioperative mortality rate] were compared between the low and high mPAP groups. The prognosis of the two groups was compared. Results The optimal cut-off value of mPAP in predicting clinical prognosis of heart transplant recipients was 30.5 mmHg. In the high mPAP group, the ECMO support rate and perioperative mortality rate were higher than those in the low mPAP group (both P < 0.05). No significant differences were observed in the cardiopulmonary bypass time, aortic occlusion time, assisted circulation time, cold ischemia time of donor heart, IABP support rate, IABP support time, ECMO support time, mechanical ventilation time, length of ICU stay and incidence of moderate and severe tricuspid regurgitation between two groups (all P > 0.05). No significant differences were noted in the 1-, 2-, 3- and 4- survival rates between two groups (all P > 0.05). Conclusions Preoperative mPAP in patients with end-stage heart failure is intimately correlated with perioperative prognosis of heart transplant recipients. The optimal cut-off value of mPAP in predicting perioperative prognosis of heart transplant recipients is 30.5 mmHg. In the high mPAP group, perioperative ECMO support rate and perioperative mortality rate are high, which do not affect the medium and long-term prognosis of the recipients undergoing heart transplantation.

Objective To apply the personal digital assistant(PDA)scanning positioning two-dimensional code recognition technology in writing nursing records in patients with acute ischemic stroke treated with intravenous thrombolysis,and to evaluate the application effect.Methods The quasi-experimental design was conducted.The nursing records routinely written by emergency nurses using mobile nursing cart for 58 patients with acute ischemic stroke treated with intravenous thrombolysis admitted to department of emergency of Zhejiang Hospital from September 2021 to February 2022 was taken as the control group,and the nursing records written by emergency nurses using PDA for 51 patients with acute ischemic stroke treated with intravenous thrombolysis from March 2022 to August 2022 through scanning positioning two-dimensional code recognition technology was used as the observation group.The differences of time required for writing nursing records and the incidence of errors in nursing records were compared between the two groups,and the satisfaction of emergency nurses in the observation group using PDA scanning positioning two-dimensional code to write nursing records was evaluated.Results The time required for writing nursing records in the observation group was significantly shorter than that in the control group[seconds:137(109,192)vs.480(436,604),P<0.05],the incidence of inadequate records of the first course of specialist assessment[3.92％(2/51)vs.20.69％(12/58)],and the incidence of insufficiently detailed records of thrombolytic observations[7.84％(4/51)vs.43.10％(25/58)]were significantly lower than the control group(both P<0.05).The differences between the observation group and the control group were not statistically significant when comparing the incidence of irregularities in thrombolytic drug pump records[0％(0/51)vs.1.72％(1/58)],incidence of irregularities in muscle strength assessment records[1.96％(1/51)vs.5.17％(3/58)],and the occurrence of typos in the nursing records[0％(0/51)vs.3.44％(2/58),all P>0.05].In addition,the overall satisfaction of emergency nurses in the observation group using PDA scanning positioning two-dimensional code to write nursing records was 92.94％(2 844/3 060),and the average score of each item in the synchronous nursing record of the positioning two-dimensional code was>4.5 points,among which the satisfaction score of ease of operation was(4.78±0.50),the acceptance of emergency nurses using PDA scanning positioning two-dimensional code to write nursing records was good,and could meet the clinical needs.Conclusion Using PDA scanning positioning two-dimensional code assists the writing of nursing records in the stroke treatment process,shortens the time required for writing nursing records of emergency nurses,reduces the incidence of errors in nursing records,and improves the quality of nursing records;At the same time,for emergency nurses,it can effectively reduce the burden of writing nursing records and improve their satisfaction with nursing records,which is worthy of clinical promotion.

Objective:To explore the value of ultra-short echo time magnetization transfer (UTE-MT) techniques for quantitatively dynamic monitoring of anterior patellar tendon (patellar tendon, quadriceps tendon) changes in amateur marathon runners before and after competition.Methods:Between October 2020 and January 2021, 23 amateur marathoners in Zhuhai, aged 28-50 (40±6) years, were prospectively recruited. Three-dimensional UTE-MT and dual-echo UTE-T 2* sequence scans of bilateral knee joints were performed before, 48 hours and 4 weeks after the marathon running, respectively. Another 5 non-running volunteers were recruited for verification of sequence stability. UTE-magnetization transfer ratio (MTR) and UTE-T 2* value of the patellar tendon, quadriceps tendon, and 3 tendon-bone insertion points (patellar tendon-tibial insertion point, patellar tendon-patellar insertion point, and quadriceps tendon-patellar insertion point) were measured independently on sagittal images of the knee joint by 2 radiologists. The stability of the 2 serial measurements and consistency tests between the 2 radiologists were assessed with a two-way mixed intraclass correlation coefficient (ICC). Repeated-measures analysis of variance was used to compare the differences in UTE-MTR and UTE-T 2* values of the prepatellar tendon before and after the marathon running. Results:Both UTE-MT and dual-echo UTE-T 2* sequence measurements had good stability, with ICC values of 0.98 and 0.92, respectively. Measurements of UTE-MTR and UTE-T 2* value of the patellar tendon, quadriceps tendon, and the 3 tendon-bone insertion points by the 2 radiologists were in good agreement (ICC>0.80). Forty-eight hours after the marathon running, the UTE-MTR of the patellar tendon, quadriceps tendon, and the 3 tendon-bone insertion points decreased, and UTE-MTR of the patellar tendon continued to decrease 4 weeks after the race, while UTE-MTR of other regions increased. Only the difference in UTE-MTR for the patellar tendon was statistically significant ( F=7.46, P=0.001) among pre-marathon (0.34±0.04), 48 h after the race (0.32±0.04), and 4 weeks after the race (0.31±0.04). UTE-T 2* value was mildly elevated in all regions at 48 h after the marathon running, but the differences among the three points were not statistically significant ( P>0.05). Conclusion:The UTE-MT has better reproducibility and inter-rater reliability. The UTE-MT can be used to monitor the dynamic changes of the prepatellar tendon before and after marathon exercise, where the UTE-MTR of the patellar tendon consistently decreases after marathon exercise.