BACKGROUND:Compared with conventional repetitive transcranial magnetic stimulation,Theta burst transcranial magnetic stimulation(TBS)has attracted extensive attention from scholars in various fields due to its advantages of short stimulation time,high efficiency,good safety and long-lasting effect,and the research popularity continues to rise.OBJECTIVE:Through the visual bibliometrics analysis of international TBS research in the past 20 years,to sort out the development context of TBS research,summarize the research status,reveal research hotspots and development trends,and provide reference for subsequent research.METHODS:Relevant studies on TBS from January 2005 to June 2024 were searched in the Web of Science Core Collection database.CiteSpace software was used to perform annual publication volume analysis,co-occurrence analysis of countries,institutions and authors,and co-citation analysis of references,journals and authors,keywords co-occurrence,clustering,time evolution and emergence analysis,and so on,and draw the visual knowledge map.RESULTS AND CONCLUSION:(1)After screening,a total of 1914 papers were included in the study,and the amount of TBS research has shown an overall increasing trend over the past 20 years,and it is expected to continue to be a hot topic of research in the future.(2)The top three countries in terms of number of publications are the United States,China and Italy,and the top three institutions are the University of Toronto,the University of London and Harvard Medical School.Pascual-leone Alvaro from Harvard Medical School has the most research achievements,and HUANG YZ from Chang Gung University has the most citations.NEURON is the most influential core journal.(3)Analyses of high-frequency keywords,highly cited references and clustering topics showed that the research hotspots of TBS in the past 20 years mainly focus on the mechanism of TBS on synaptic plasticity and neurophysiological activity,the effect of TBS on stimulating targets in different brain regions(including the motor cortex,dorsolateral prefrontal cortex,anterior cingulate cortex and cerebellum,etc.),and the therapeutic effect of TBS on neurological and psychiatric diseases(including depression,Parkinson's disease movement disorder,post-stroke movement disorder and cognitive impairment,and Alzheimer's disease memory disorders).(4)Keyword burst,literature emergence and keyword temporal evolution analyses showed that"major depression,application guidelines,rating scale,efficacy,disorder,refractory depression,meta-analysis,etc."are not only current research hotspots,but also future research trends.(5)In the future,TBS research should strengthen the regional cooperation of core authors and institutions,explore the clinical application in the treatment of refractory diseases,and realize the precision,personalization and optimization of TBS application by combining cutting-edge technologies and optimizing stimulus parameters,so as to solve more clinical problems.

Objective:To construct a performance assessment system based on the supply chain operations reference(SCOR)model for medical consumables,and explore its application effect in management for medical consumables of hospital.Methods:Based on the SCOR framework,the performance indicators such as cost,management for asset,flexibility,reliability and response speed were selected to construct a performance assessment system based on SCOR for medical consumables.A total of 585 batches of medical consumables that were used clinically in our hospital from November 2022 to October 2024 were selected,and 268 batches of them that were used during November 2022 to October 2023 were managed by using conventional management mode(conventional management mode)for medical consumables,and 317 batches of them that were used during November 2023 to October 2024 were managed by using the management mode with performance assessment system(performance management mode)based on SCOR for medical consumables.The management efficiency and the score of management quality of two management modes for medical consumables were compared.Results:The review duration,average turnover efficiency in hospital,average turnover efficiency out of hospital,average occupancy rate of inventory capital,and the number of monthly average rush order of adopting performance management mode were respectively(0.89±0.26)d,(0.83±0.32)%,(0.76±0.17)%,(0.23±0.03)%and(3.58±0.89)times,all of which were lower than those of conventional management mode,and the differences were significant(t=17.139,34.836,42.851,29.747,27.878,P<0.05).The scores in different dimensions included management methods,counting and transportation for medical consumables,and management contents and forms for medical consumables of adopting performance management mode were significantly higher than those of adopting conventional management mode,and the differences were significant(t=14.629,11.239,10.891,12.696,10.830,P<0.05).Conclusion:The performance assessment system based on SCOR for medical consumables can improve the efficiency and quality of management for medical consumables,and reduce occupation for capital,and promote sustainable economic development of hospitals.

Objective:To investigate the effect of the embryo cryopreservation duration on pregnancy and obstetric outcome.Methods:A retrospective cohort study of 2 662 frozen-thawed embyro tranfer (FET) cycles was conducted in the Reproductive Medicine Center, Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital from January 2016 to December 2020. According to embryo cryopreservation duration, the patients were divided into group A (≤1 year, n=2 115), group B (>1 years and ≤3 years, n=319), group C (>3 years and ≤6 years, n=174), and group D (>6 years, n=54). We used the propensity score matching (PSM) to match the baseline data of oocyte retrieval age of the other three groups according to group D at a ratio of 1∶3. Clinical and obstetric outcomes were compared among the four groups. Multiple logistic regression analysis was used to analyze the effect of oocyte retrieval age, embryo transfer age, the duration of embryo cryopreservation, endometrial preparation scheme, endometrial thickness, the number of transferred embryos and the number of high-quality embryos on pregnancy and live birth outcome. Results:1) Before PSM, there were significant differences in the maternal age at oocyte retrieval and embryo transfer and duration of embryo cryopreservation among the four groups(all P<0.001). 2) After PSM, the baseline characteristics of oocyte retrieval age reached a balance among the four groups. There were no statistical differences in the number of embryos transfer, the number of high-quality embryos, the transferred embryo stage, the endometrial regimen among the groups (all P>0.05). The clinical pregnancy rate [37.04% (20/54)] and the live birth rate [33.33% (18/54)] in group D were lower than those in group A [51.57% (82/159), 40.88% (65/159)], group B [50.00% (65/130), 40.77% (53/130)] and group C [49.59% (61/123), 39.02% (48/123)], but the difference was not statistically significant between the four groups ( P=0.310, P=0.781). There were no statistical differences among the four groups in the ratio of male to female newborns, gestational age, birth weight, preterm delivery rate, low birth weight rate, macrosomia rate, birth defects, and premature repture of membranes (all P>0.05). 3) Multiple logistic regression analysis showed that the number of high-quality embryos transferred affected the clinical pregnancy outcome (before PSM, OR=2.614, 95% CI: 2.168-3.151, P<0.001; after PSM, OR=1.984, 95% CI: 1.406-2.800, P<0.001) and live birth (before PSM, OR=2.708, 95% CI: 2.198-3.336, P<0.001; after PSM, OR=2.122, 95% CI: 1.474-3.053, P<0.001). The duration of embryo cryopreservation does not affect the clinical outcome and live birth (all P>0.05). Conclusion:The duration of embryo cryopreservation does not affect the clinical outcome and live birth, but large sample data are still needed to support this conclusion in the future.

Objective:To investigate the effect of the embryo cryopreservation duration on pregnancy and obstetric outcome.Methods:A retrospective cohort study of 2 662 frozen-thawed embyro tranfer (FET) cycles was conducted in the Reproductive Medicine Center, Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital from January 2016 to December 2020. According to embryo cryopreservation duration, the patients were divided into group A (≤1 year, n=2 115), group B (>1 years and ≤3 years, n=319), group C (>3 years and ≤6 years, n=174), and group D (>6 years, n=54). We used the propensity score matching (PSM) to match the baseline data of oocyte retrieval age of the other three groups according to group D at a ratio of 1∶3. Clinical and obstetric outcomes were compared among the four groups. Multiple logistic regression analysis was used to analyze the effect of oocyte retrieval age, embryo transfer age, the duration of embryo cryopreservation, endometrial preparation scheme, endometrial thickness, the number of transferred embryos and the number of high-quality embryos on pregnancy and live birth outcome. Results:1) Before PSM, there were significant differences in the maternal age at oocyte retrieval and embryo transfer and duration of embryo cryopreservation among the four groups(all P<0.001). 2) After PSM, the baseline characteristics of oocyte retrieval age reached a balance among the four groups. There were no statistical differences in the number of embryos transfer, the number of high-quality embryos, the transferred embryo stage, the endometrial regimen among the groups (all P>0.05). The clinical pregnancy rate [37.04% (20/54)] and the live birth rate [33.33% (18/54)] in group D were lower than those in group A [51.57% (82/159), 40.88% (65/159)], group B [50.00% (65/130), 40.77% (53/130)] and group C [49.59% (61/123), 39.02% (48/123)], but the difference was not statistically significant between the four groups ( P=0.310, P=0.781). There were no statistical differences among the four groups in the ratio of male to female newborns, gestational age, birth weight, preterm delivery rate, low birth weight rate, macrosomia rate, birth defects, and premature repture of membranes (all P>0.05). 3) Multiple logistic regression analysis showed that the number of high-quality embryos transferred affected the clinical pregnancy outcome (before PSM, OR=2.614, 95% CI: 2.168-3.151, P<0.001; after PSM, OR=1.984, 95% CI: 1.406-2.800, P<0.001) and live birth (before PSM, OR=2.708, 95% CI: 2.198-3.336, P<0.001; after PSM, OR=2.122, 95% CI: 1.474-3.053, P<0.001). The duration of embryo cryopreservation does not affect the clinical outcome and live birth (all P>0.05). Conclusion:The duration of embryo cryopreservation does not affect the clinical outcome and live birth, but large sample data are still needed to support this conclusion in the future.

BACKGROUND:Compared with conventional repetitive transcranial magnetic stimulation,Theta burst transcranial magnetic stimulation(TBS)has attracted extensive attention from scholars in various fields due to its advantages of short stimulation time,high efficiency,good safety and long-lasting effect,and the research popularity continues to rise.OBJECTIVE:Through the visual bibliometrics analysis of international TBS research in the past 20 years,to sort out the development context of TBS research,summarize the research status,reveal research hotspots and development trends,and provide reference for subsequent research.METHODS:Relevant studies on TBS from January 2005 to June 2024 were searched in the Web of Science Core Collection database.CiteSpace software was used to perform annual publication volume analysis,co-occurrence analysis of countries,institutions and authors,and co-citation analysis of references,journals and authors,keywords co-occurrence,clustering,time evolution and emergence analysis,and so on,and draw the visual knowledge map.RESULTS AND CONCLUSION:(1)After screening,a total of 1914 papers were included in the study,and the amount of TBS research has shown an overall increasing trend over the past 20 years,and it is expected to continue to be a hot topic of research in the future.(2)The top three countries in terms of number of publications are the United States,China and Italy,and the top three institutions are the University of Toronto,the University of London and Harvard Medical School.Pascual-leone Alvaro from Harvard Medical School has the most research achievements,and HUANG YZ from Chang Gung University has the most citations.NEURON is the most influential core journal.(3)Analyses of high-frequency keywords,highly cited references and clustering topics showed that the research hotspots of TBS in the past 20 years mainly focus on the mechanism of TBS on synaptic plasticity and neurophysiological activity,the effect of TBS on stimulating targets in different brain regions(including the motor cortex,dorsolateral prefrontal cortex,anterior cingulate cortex and cerebellum,etc.),and the therapeutic effect of TBS on neurological and psychiatric diseases(including depression,Parkinson's disease movement disorder,post-stroke movement disorder and cognitive impairment,and Alzheimer's disease memory disorders).(4)Keyword burst,literature emergence and keyword temporal evolution analyses showed that"major depression,application guidelines,rating scale,efficacy,disorder,refractory depression,meta-analysis,etc."are not only current research hotspots,but also future research trends.(5)In the future,TBS research should strengthen the regional cooperation of core authors and institutions,explore the clinical application in the treatment of refractory diseases,and realize the precision,personalization and optimization of TBS application by combining cutting-edge technologies and optimizing stimulus parameters,so as to solve more clinical problems.

Objective:To construct a performance assessment system based on the supply chain operations reference(SCOR)model for medical consumables,and explore its application effect in management for medical consumables of hospital.Methods:Based on the SCOR framework,the performance indicators such as cost,management for asset,flexibility,reliability and response speed were selected to construct a performance assessment system based on SCOR for medical consumables.A total of 585 batches of medical consumables that were used clinically in our hospital from November 2022 to October 2024 were selected,and 268 batches of them that were used during November 2022 to October 2023 were managed by using conventional management mode(conventional management mode)for medical consumables,and 317 batches of them that were used during November 2023 to October 2024 were managed by using the management mode with performance assessment system(performance management mode)based on SCOR for medical consumables.The management efficiency and the score of management quality of two management modes for medical consumables were compared.Results:The review duration,average turnover efficiency in hospital,average turnover efficiency out of hospital,average occupancy rate of inventory capital,and the number of monthly average rush order of adopting performance management mode were respectively(0.89±0.26)d,(0.83±0.32)%,(0.76±0.17)%,(0.23±0.03)%and(3.58±0.89)times,all of which were lower than those of conventional management mode,and the differences were significant(t=17.139,34.836,42.851,29.747,27.878,P<0.05).The scores in different dimensions included management methods,counting and transportation for medical consumables,and management contents and forms for medical consumables of adopting performance management mode were significantly higher than those of adopting conventional management mode,and the differences were significant(t=14.629,11.239,10.891,12.696,10.830,P<0.05).Conclusion:The performance assessment system based on SCOR for medical consumables can improve the efficiency and quality of management for medical consumables,and reduce occupation for capital,and promote sustainable economic development of hospitals.

Objective:To analyze the reproductive outcomes of the subsequent embryo transfer (ET) cycles in women with repeated implantation failure (RIF) after the management of uterine cavity abnormalities.Methods:This was a retrospective case-control study. The clinical data of 89 patients with repeated implantation failure who underwent hysteroscopy at Reproductive Medicine Center of the Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital from January 1, 2017 to March 31, 2021 were analyzed. The patients were assigned to a normal uterine cavity (UC) group ( n=38) and an abnormal UC group ( n=51) according to hysteroscopic examination and endometrial biopsy results. Women in the abnormal UC group received relevant treatments, and all patients received the embryo transfer again. The reproductive outcomes were compared between the two groups in the subsequent ET cycles. Results:The prevalence of uterine abnormalities was 57.30% (51/89) in women with RIF. Chronic endometritis accounted for the highest incidence 39.33% (35/89). Among 38 women in normal UC group, 16 women got clinical pregnancy in the subsequent ET cycles, and 24 women in 51 got clinical pregnancy in the abnormal UC group. There were no differences in the implantation rate, the clinical pregnancy rate, and the ectopic pregnancy rate between the two groups (all P>0.05). The early abortion rate was significantly higher in the normal UC group [37.50% (6/16)] than in the abnormal UC group [8.33% (2/24), P=0.042]. Conclusion:The uterine abnormalities mainly occurred in women with primary infertility. The clinical pregnancy rate of women after correction of uterine abnormalities was similar to those women with normal UC. Hysteroscopy was advised to performed routinely to evaluate the uterine environment in women with RIF.

Objective:To analyze the reproductive outcomes of the subsequent embryo transfer (ET) cycles in women with repeated implantation failure (RIF) after the management of uterine cavity abnormalities.Methods:This was a retrospective case-control study. The clinical data of 89 patients with repeated implantation failure who underwent hysteroscopy at Reproductive Medicine Center of the Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital from January 1, 2017 to March 31, 2021 were analyzed. The patients were assigned to a normal uterine cavity (UC) group ( n=38) and an abnormal UC group ( n=51) according to hysteroscopic examination and endometrial biopsy results. Women in the abnormal UC group received relevant treatments, and all patients received the embryo transfer again. The reproductive outcomes were compared between the two groups in the subsequent ET cycles. Results:The prevalence of uterine abnormalities was 57.30% (51/89) in women with RIF. Chronic endometritis accounted for the highest incidence 39.33% (35/89). Among 38 women in normal UC group, 16 women got clinical pregnancy in the subsequent ET cycles, and 24 women in 51 got clinical pregnancy in the abnormal UC group. There were no differences in the implantation rate, the clinical pregnancy rate, and the ectopic pregnancy rate between the two groups (all P>0.05). The early abortion rate was significantly higher in the normal UC group [37.50% (6/16)] than in the abnormal UC group [8.33% (2/24), P=0.042]. Conclusion:The uterine abnormalities mainly occurred in women with primary infertility. The clinical pregnancy rate of women after correction of uterine abnormalities was similar to those women with normal UC. Hysteroscopy was advised to performed routinely to evaluate the uterine environment in women with RIF.

This paper introduced a liver normothermic machine perfusion repair and assessment system. This system consists of a liver normothermic machine perfusion device, a fluorescence imaging system and a tissue oxygen detector. The normothermic machine perfusion device can continuously perfuse the donor liver and monitor and control the perfusion parameters in real time. The fluorescence imaging system can detect the indocyanine green metabolized by the liver to evaluate the microcirculation and the metabolism function of hepatocytes. The tissue oxygen detector can monitor the change of oxygen partial pressure of liver tissue in real time to evaluate the state of cell oxygen consumption.
Humans ; Liver ; Liver Transplantation ; Living Donors ; Organ Preservation ; Perfusion

It is intractable to Complex biliary stricture therapy after liver transplantation and other biliary operations is intractable.The routine therapies are to place stents with ERCP or do choledochojejunostomy.The former,however,is of little effect for patients with complex biliary stricture or completed obstruction.And the latter is more difficult and is with high rate postoperative complications due to the previous operation history.The application of magnetic compression offers a new direction of minimally invasive therapy of complex biliary structure.This article summarizes the current situation of the therapy of complex biliary structure with magnetic compression and the existing obstacles.