Objective:To evaluate the effect of the integrated physician-nurse management model on postoperative care in preschool children undergoing laparoscopic appendectomy (LA) .Methods:A total of 64 preschool children who underwent LA were selected by convenience sampling from the pediatric surgery department of Xuzhou Children's Hospital Affiliated to Xuzhou Medical University between November 2023 and June 2024. They were randomly assigned to either the intervention group or the control group (32 cases in each). The control group received routine postoperative care, while the intervention group received additional care based on the integrated physician-nurse management model. Postoperative pain scores at 4, 8, 12, 24, and 36 hours after surgery, as well as parental satisfaction, were compared between the two groups.Results:A total of 60 children completed the study, with 30 in each group. Post-intervention, the intervention group had lower pain scores at all five postoperative time points (4, 8, 12, 24, and 36 hours) compared to the control group, and the differences were statistically significant ( P<0.05). Additionally, the parental satisfaction rate in the intervention group was higher than that in the control group with statistically significant difference (χ 2=6.667, P<0.05) . Conclusions:The integrated physician-nurse management model effectively reduces postoperative pain in preschool children undergoing LA and improves parental satisfaction, supporting its clinical promotion and application.

BACKGROUND:Current treatment strategies for chronic non-healing wounds have shown unsatisfactory results,necessitating the exploration of novel therapeutic approaches.Concentrated growth factors,rich in high-concentration growth factors and possessing a stable natural three-dimensional structure,have demonstrated significant application value in the treatment of chronic non-healing wounds.OBJECTIVE:To review the current status of concentrated growth factor application in chronic non-healing wounds,analyze the shortcomings of concentrated growth factor in clinical applications,and propose constructive suggestions and prospects.METHODS:CNKI,WanFang,and VIP databases were searched with the key words of"concentrated growth factor,platelet concentrate products,chronic wound,chronic ulcer,wound healing,platelet-rich plasma,platelet-rich fibrin"in Chinese.PubMed was searched with the key words of"CGF,concentrated growth factor,platelet concentrate products,chronic wound,chronic ulcer,wound healing,PRP,PRF,platelet-rich plasma,platelet-rich fibrin"in English.The articles published from 2000 to 2024 were searched and further analyzed and summarized after screening.RESULTS AND CONCLUSION:Concentrated growth factor,with its diverse application forms,high concentration of growth factors,natural three-dimensional structure,compatibility with various material technologies,relatively low cost,and ease of operation,has demonstrated significant clinical value in the treatment of chronic wounds.Numerous researchers have validated its positive effects in chronic wound therapy through clinical applications.However,there is currently no clear consensus on standardized concentrated growth factor application protocols,and certain deficiencies have been revealed in practical applications,including issues with dosage,centrifugation settngs,identification schemes,and preparation methods for different forms of concentrated growth factor.There is substantial room for research on concentrated growth factor,and it is believed that with a clear consensus on its application in the future,concentrated growth factor could play a significant role in clinical practice.

Objective To design a pairs of detection gloves for orthopedic manipulation to solve the problems of orthopedic manipulation in accurate,visual and quantitative description and reproduction in teaching.Methods The orthopedic manipulation detection gloves were mainly composed of a detection body worn on the hands,a main control module and a data visualization system.The detection body was made of multi-layer flexible materials such as rubber,cotton and non-woven fabrics,which integrated inertial sensors,pressure sensors and a data acquisition device;the main control module consisted of a filter circuit,an A/D converter(MCP3008)and a main controller(ARM-STM32 microcontroller);the data visualization system was designed based on the Unity 3D platform.Results The orthopedic manipulation detection gloves effectively detected the rotation angle of the knuckle during the orthopedic process with a high accuracy rate.Conclusion The orthopedic manipulation detection gloves can quantitatively display the abstract orthopedic manipulation,and can provide support for intelligent orthopedic teaching and orthopedic manipulation optimization.[Chinese Medical Equipment Journal,2025,46(7):27-33]

Objective To propose a image processing strategy based on salient object detection algorithm for optimizing the presentation of prosthetic visual information at a limited resolution level,aiming to detect and enhance the salient objects in the scene and remove the background information.Methods A salient object detection model combining CNN and Transformer was used to extract salient objects.On this basis,methods such as object magnification,contour enhancement and contrast enhancement were utilized to optimize the image information.Psychophysical experiments were carried out at 5 resolution levels(16×16,24×24,32×32,48×48 and 64×64).Results In the simulated prosthetic vision,this image processing strategy had a remarkable effect on improving the object recognition ability of the subjects.Regardless of the resolutions of 16×16,24×24,32×32,48×48 and 64×64,the proposed strategy achieved the highest recognition accuracies,specifically 34%±6%,56%±9%,72%±9%,89%±4%and 96%±2%.Conclusion Using the salient object detection method and image processing strategy to extract and enhance salient objects can help prosthesis implant recipients effectively improve their object recognition ability.

Objective:To explore the clinical effect of treating complex talar neck fractures with double-column fixation using plates and cannulated screws.Methods:A retrospective analysis was performed on the data of 13 patients with complex talar neck fractures treated with double-column fixation using plates and cannulated screws at Tianjin Hospital, Tianjin University from June 2019 to November 2023. There were 9 males and 4 females, with an age of 42.1±17.7 years (range, 15-66 years). There were 5 cases on the left and 8 cases on the right. Four cases were caused by traffic accidents, 8 by falling from a height, and 1 by a heavy object injury. According to the Hawkins classification, there were 12 cases of type II and 1 case of type III talar neck fractures. All the fractures were comminuted, including 12 cases of talar neck combined with talar body, and 3 cases combined with subluxation of subtalar joint. The time from injury to surgery was 3.3±1.6 d (range, 1-6 d). All patients were treated with anteromedial combined anterolateral approach, plate and cannulated screw double-column fixation pattern. The healing time of fractures and the occurrence of complications were recorded. Postoperative anteroposterior and lateral X-ray images were taken to assess the quality of fracture reduction based on the presence or absence of step-offs and angulation after reduction of fractures at the neck or body of the talus. The functional outcome was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale.Results:All 13 patients were followed up for 33.8±15.2 months (range, 12-53 months). All fractures healed, and the healing time was 17.2±2.8 weeks (range, 13-23 weeks). Postoperative X-ray evaluation showed that 10 cases had anatomical reduction and 3 cases had near-anatomical reduction. After operation, there was no loosening or breakage of implant, loss of fracture reduction, irritation of skin and soft tissue by internal fixation. The AOFAS score was 88.1±13.0 points (range, 48-100 points), with 9 excellent cases, 3 good cases, and 1 poor case. Superficial skin necrosis in one surgical incision healed after dressing exchange. At the 1-year follow-up after surgery, 1 case developed avascular necrosis of the talus without collapse. And at the last follow-up (postoperative 13 to 53 months), 5 cases developed post-traumatic arthritis.Conclusion:Plate and cannulated screw double-column fixation in the treatment of complex talar neck fractures can achieve satisfactory reduction and strong fixation effects, which is beneficial in reducing complications related to poor reduction.

Objective To propose a image processing strategy based on salient object detection algorithm for optimizing the presentation of prosthetic visual information at a limited resolution level,aiming to detect and enhance the salient objects in the scene and remove the background information.Methods A salient object detection model combining CNN and Transformer was used to extract salient objects.On this basis,methods such as object magnification,contour enhancement and contrast enhancement were utilized to optimize the image information.Psychophysical experiments were carried out at 5 resolution levels(16×16,24×24,32×32,48×48 and 64×64).Results In the simulated prosthetic vision,this image processing strategy had a remarkable effect on improving the object recognition ability of the subjects.Regardless of the resolutions of 16×16,24×24,32×32,48×48 and 64×64,the proposed strategy achieved the highest recognition accuracies,specifically 34%±6%,56%±9%,72%±9%,89%±4%and 96%±2%.Conclusion Using the salient object detection method and image processing strategy to extract and enhance salient objects can help prosthesis implant recipients effectively improve their object recognition ability.

Objective:To analyze the efficacy and safety of standard chemotherapy and immune checkpoint inhibitors (CI) combined with radiotherapy (RT) in driver-gene negative (wild-type) oligometastatic non-small cell lung cancer (NSCLC) patients with central nervous system involvement.Methods:In this multicenter retrospective cohort study, oligometastatic NSCLC patients receiving first-line chemo-immunotherapy-based therapy were analyzed. Between January 2017 and January 2023, a total of 98 eligible patients were enrolled from the National Cancer Center/Cancer Hospital (Beijing/Shenzhen) and Shanxi Province Cancer Hospital. All participants were divided into chemo-immunotherapy (CI) group (28.6%, n=28) and chemo-immuno-radiotherapy (CIR) group (71.4%, n=70) according to whether receiving radiotherapy. Baseline characteristics were well-balanced between two groups, with no statistically significant differences (all P>0.05). The primary endpoint of the study was overall survival (OS), while progression-free survival (PFS) was designated as a key secondary endpoint. Qualitative data were compared by Chi-square test. Survival analysis was conducted using Kaplan-Meier method, and prognostic analysis was performed by multivariate Cox regression models. Results:The median PFS in the CIR and CI groups was 21.8 and 11.5 months, respectively, and the difference was not statistically significant ( P=0.211). The median OS in the CIR group was significantly better ( P=0.036) than 25.3 months in the CI group. The median OS in the CIR group was not reached. The 2-year local regional control rates for the whole brain radiotherapy patients, stereotactic radiotherapy / stereotactic radiosurgery patients and CI groups were 33.3% ,100% and 83.4%, respectively. Multivariate analysis showed that brain radiotherapy was an independent protective factor for OS in patients with oligometastatic brain metastases at baseline ( HR=0.47, 95% CI=0.22-0.99, P=0.047). Subgroup analysis revealed that patients with 1-3 metastatic lesions benefited from radiotherapy (PFS: HR=0.47, 95% CI=0.22-1.03, P=0.060; OS: HR=0.34, 95% CI=0.12-0.98, P=0.046). Conclusions:For central nervous system involved oligometastatic NSCLC patients, the integration of chemo-immunotherapy with radiotherapy is well tolerated and can improve the efficacy, particularly among those with a limited number of metastatic lesions.

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

OBJECTIVE: To explore the potential effects and mechanisms of Liang-Ge-San (LGS) for the treatment of acute respiratory distress syndrome (ARDS) through network pharmacology analysis and to verify LGS activity through biological experiments. METHODS: The key ingredients of LGS and related targets were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform. ARDS-related targets were selected from GeneCards and DisGeNET databases. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed using the Metascape Database. Molecular docking analysis was used to confirm the binding affinity of the core compounds with key therapeutic targets. Finally, the effects of LGS on key signaling pathways and biological processes were determined by in vitro and in vivo experiments. RESULTS: A total of LGS-related targets and 496 ARDS-related targets were obtained from the databases. Network pharmacological analysis suggested that LGS could treat ARDS based on the following information: LGS ingredients luteolin, wogonin, and baicalein may be potential candidate agents. Mitogen-activated protein kinase 14 (MAPK14), recombinant V-Rel reticuloendotheliosis viral oncogene homolog A (RELA), and tumor necrosis factor alpha (TNF-α) may be potential therapeutic targets. Reactive oxygen species metabolic process and the apoptotic signaling pathway were the main biological processes. The p38MAPK/NF-κ B signaling pathway might be the key signaling pathway activated by LGS against ARDS. Moreover, molecular docking demonstrated that luteolin, wogonin, and baicalein had a good binding affinity with MAPK14, RELA, and TNF α. In vitro experiments, LGS inhibited the expression and entry of p38 and p65 into the nucleation in human bronchial epithelial cells (HBE) cells induced by LPS, inhibited the inflammatory response and oxidative stress response, and inhibited HBE cell apoptosis (P<0.05 or P<0.01). In vivo experiments, LGS improved lung injury caused by ligation and puncture, reduced inflammatory responses, and inhibited the activation of p38MAPK and p65 (P<0.05 or P<0.01). CONCLUSION LGS could reduce reactive oxygen species and inflammatory cytokine production by inhibiting p38MAPK/NF-κ B signaling pathway, thus reducing apoptosis and attenuating ARDS.
Drugs, Chinese Herbal/pharmacology* ; Respiratory Distress Syndrome/enzymology* ; p38 Mitogen-Activated Protein Kinases/metabolism* ; NF-kappa B/metabolism* ; Animals ; Signal Transduction/drug effects* ; Molecular Docking Simulation ; Humans ; Male ; Network Pharmacology ; Apoptosis/drug effects* ; Mice