Objective:To explore the impact of diabetes mellitus on perioperative myocardial injury and cardiac function recovery in patients undergoing off-pump coronary artery bypass grafting (CABG).Methods:The clinical data of 40 patients with coronary heart disease who underwent off-pump CABG in Changsha Central Hospital from 2015 to 2025 were retrospectively included. They were divided into the diabetes group (20 cases) and the control group (20 cases) according to whether they had type 2 diabetes mellitus. Myocardial injury markers (creatine kinase isoenzyme, troponin I, lactate dehydrogenase) before surgery, on the 1st and 3rd days after surgery and before discharge, as well as cardiac function indicators (B-type natriuretic peptide, left ventricular ejection fraction) before surgery and before discharge were compared between the two groups. The postoperative recovery speed (mechanical ventilation time, intensive care unit stay, vasoactive drug use time, postoperative hospital stay) was also compared between the two groups.Results:Before surgery, there were no statistically significant differences in myocardial injury markers and cardiac function indicators between the two groups (all P>0.05). On the 3rd day after surgery, lactate dehydrogenase in the diabetes group was significantly higher than that in the control group ( P<0.05), while there were no statistically significant differences in creatine kinase isoenzyme and troponin I between the two groups (all P>0.05). Before discharge, the levels of creatine kinase isoenzyme and B-type natriuretic peptide in the diabetes group were significantly higher than those in the control group (all P<0.05), and the left ventricular ejection fraction was significantly lower than that in the control group ( P<0.05). Compared with the control group, the diabetes group had significantly longer mechanical ventilation time, intensive care unit stay, and postoperative hospital stay (all P<0.05), but there was no statistically significant difference in the use time of vasoactive drugs ( P>0.05). Conclusions:For patients with coronary heart disease complicated with diabetes mellitus, their preoperative cardiac status is comparable to that of patients without diabetes mellitus, but they show a characteristic dynamic injury pattern after surgery: early elevation of lactate dehydrogenase suggests susceptibility to subcellular injury, and long-term abnormalities of creatine kinase isoenzyme, B-type natriuretic peptide, and decrease in left ventricular ejection fraction indicate myocardial repair disorders. Compared with patients without diabetes mellitus, those with diabetes mellitus require a longer recovery time after off-pump CABG, and targeted perioperative management strategies are urgently needed.

Objective To investigate the efficacy of voriconazole in the treatment of pulmonary tuberculosis complicated with chronic pulmonary aspergillosis(CPA)based on CYP2C19 gene polymorphism detection and examine the factors affecting the efficacy for improving targeted therapy in clinical practice.Methods A total of 207 patients with pulmonary tuberculosis complicated with CPA treated in the Third People's Hospital of Kunming from December 2018 to November 2022 were randomly assigned to an observation group(105 cases)or a control group(102 cases).The patients in the control group received standard voriconazole treatment,while the patients in the observation group had their voriconazole regimen tailored based on CYP2C19 genotyping results.Plasma drug concentration levels,efficacy,and safety were compared between the two groups and in terms of CYP2C19 genotypes.Logistic regression analysis was used to identify the factors affecting treatment efficacy.Results The observation group showed significantly higher plasma voriconazole concentrations and overall antifungal efficacy compared to the control group(P＜0.05).In the observation group,CYP2C19 genotyping identified 37 extensive metabolizers(EM),47 intermediate metabolizers(IM),and 21 poor metabolizers(PM).Plasma concentration of voriconazole did not show significant difference between EM and IM(P＞0.05),but both PM and IM were associated with significantly lower plasma concentration of voriconazole than PM(P＜0.05).The clinical efficacy rate was 100％for PM,91.5％for IM,and 83.8％for EM(P＜0.05).The incidence of adverse events did not show significant difference among the three genotypes(P＞0.05).Logistic regression analysis revealed that lung cavitation,hypoalbuminemia,and agranulosis were significantly correlated with therapeutic efficacy(P＜0.05).Conclusions CYP2C19 gene polymorphism detection is valuable in clinical practice.It can inform anti-aspergillus therapy with voriconazole to effectively improve symptoms and clinical efficacy in patients with pulmonary tuberculosis complicated with CPA.Meanwhile,clinicians should be aware of the factors such as hypoproteinemia,agranulocytosis,and lung cavitation that may affect the efficacy of voriconazole.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

The carbon ion proton therapy system,as one of the most advanced methods for treating solid tumors,has been unanimously recognized for its therapeutic effect.Its unique deep dose distribution and high relatively biological effects,which are outstanding advantages that conventional radiotherapy hardly matches,can provide important technical support for effectively increasing patients'5-year survival rate.Its industrial application and promotion are in line with the policy orientation of national scientific and technological innovation,and strategic emerging industries.This article established a preliminary framework for the standard system of operational services of carbon ion proton therapy system through analyzed the products'operation management,service requirements,and quality requirements in the field of operational services of carbon ion proton therapy system.It provided development direction for the formulation and revision of the standards in the field of operational services of carbon ion proton therapy system,and it contributed to promote products'popularization and industrial development.

Objective:To evaluate the imaging stability of a portable boom-type ophthalmic ultra-high-resolution optical coherence tomography (OCT) device in multiple application scenarios.Methods:The boom-type mode and handheld mode of the portable boom-type OCT and the desktop OCT were used to perform three-dimensional imaging tests on three healthy adults undergoing physical examinations at the Zhongshan Ophthalmic Center, Sun Yat-sen University as well as on OEMI-7 model eyes in a sitting position.The same two modes of the portable boom-type OCT were used to perform three-dimensional imaging on four awake non-sedated infants, two sedated infants and four healthy adults in the supine position.The obtained 3D imaging data were processed using a correlation analysis method between adjacent B-scans, and the offset of B-scan in the axial (z-axis) and the fast axis transverse (x-axis) were calculated.The procedures for in vivo human eye experiments followed the Declaration of Helsinki and were approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-sen University (No.2020 KYPJ154).All subjects and infant guardians signed the informed consent form. Results:Compared with the handheld imaging mode, the axial and fast axis lateral motion offsets of the model eye were significantly reduced in the boom-type imaging mode from (124.00±12.49)μm to (48.00±15.87)μm and from (24.00±1.00)μm to (2.67±0.57)μm, respectively ( t=2.932, 4.337; both P<0.001).In both human and model eyes, the axial and fast axis lateral motion offsets of the boom-type mode were significantly lower than in the traditional handheld operation mode (both P<0.001).The axial and lateral motion offsets between the boom-type mode and desk-top OCT imaging were comparable, without significant differences (both P>0.05).In both sedated and awake, non-sedated infants in the supine position, the axial offset of the portable boom-type OCT system was similar to that of the healthy adults, without significant difference in the overall comparison ( P=0.385), and the lateral offsets were higher than those of healthy adults, with statistically significant differences (both P=0.013).There was no significant difference in axial deviation between sedated and non-sedated infants ( P>0.05).The lateral deviation of non-sedated infants was higher than that of sedated infants, though the difference was not statistically significant ( P=0.247). Conclusions:The portable boom-type OCT system can maintain high-speed, high-resolution imaging performance while achieving imaging stability comparable to traditional desktop OCT systems.It is more suitable for bedside imaging of supine subjects, especially uncooperative infants, and has good clinical application prospects.

Objective To investigate the efficacy of voriconazole in the treatment of pulmonary tuberculosis complicated with chronic pulmonary aspergillosis(CPA)based on CYP2C19 gene polymorphism detection and examine the factors affecting the efficacy for improving targeted therapy in clinical practice.Methods A total of 207 patients with pulmonary tuberculosis complicated with CPA treated in the Third People's Hospital of Kunming from December 2018 to November 2022 were randomly assigned to an observation group(105 cases)or a control group(102 cases).The patients in the control group received standard voriconazole treatment,while the patients in the observation group had their voriconazole regimen tailored based on CYP2C19 genotyping results.Plasma drug concentration levels,efficacy,and safety were compared between the two groups and in terms of CYP2C19 genotypes.Logistic regression analysis was used to identify the factors affecting treatment efficacy.Results The observation group showed significantly higher plasma voriconazole concentrations and overall antifungal efficacy compared to the control group(P＜0.05).In the observation group,CYP2C19 genotyping identified 37 extensive metabolizers(EM),47 intermediate metabolizers(IM),and 21 poor metabolizers(PM).Plasma concentration of voriconazole did not show significant difference between EM and IM(P＞0.05),but both PM and IM were associated with significantly lower plasma concentration of voriconazole than PM(P＜0.05).The clinical efficacy rate was 100％for PM,91.5％for IM,and 83.8％for EM(P＜0.05).The incidence of adverse events did not show significant difference among the three genotypes(P＞0.05).Logistic regression analysis revealed that lung cavitation,hypoalbuminemia,and agranulosis were significantly correlated with therapeutic efficacy(P＜0.05).Conclusions CYP2C19 gene polymorphism detection is valuable in clinical practice.It can inform anti-aspergillus therapy with voriconazole to effectively improve symptoms and clinical efficacy in patients with pulmonary tuberculosis complicated with CPA.Meanwhile,clinicians should be aware of the factors such as hypoproteinemia,agranulocytosis,and lung cavitation that may affect the efficacy of voriconazole.

Neurogenic bladder(NB)is one of the most challenging urinary system disorders,with spinal cord injury(SCI)being an important etiological factor.Animal models provide crucial tools for investigating the pathogenesis,therapeutic strategies,and novel drug screening for NB subsequent to SCI.We reviewed and synthesized recent literature on NB animal models after SCI from both domestic and international sources.This review summarizes and analyzes research advancements using these models in terms of animal species,SCI segments,modeling techniques,and evaluation indicators,with the aim of offering insights and guidance for future experimental research based on animal models of NB following SCI.

Purpose To investigate the predictive value of MRI-based peritumoral edema(PE)of lymph node(LN)metastasis burden in patient with invasive breast cancer.Materials and Methods A total of 213 patients in Sichuan Cancer Hospital with invasive breast cancer confirmed by pathology after surgery were enrolled retrospectively from September 2017 to February 2019.Based on the status and number of LN metastases proved by axillary surgery pathology,all patients were divided into high-burden LN metastasis group(n=47 cases,total number of metastatic LN greater than 2)and low-burden LN metastasis group(n=166 cases,total number of metastatic LN less than or equal to 2).T2WI features,including PE type and PE degree,were analyzed.On DCE-MRI,MRI features of breast cancer were analyzed based on BI-RADS.The predictive value of T2WI features and MRI features for LN metastasis burden was assessed by univariate analysis,and the statistically significant features identified by univariate analysis were further subjected to multivariate Logistic regression analysis to establish a prediction model.The model's performance for LN metastasis burden prediction was evaluated via receiver operating characteristic curve,and the predictive metrics were calculated based on the Youden index.Results The rate of high-burden LN metastasis was 22.1%(47/213).The results of univariate analysis showed that PE degree(OR=18.70,P＜0.001),PE type(OR=16.00,P＜0.001),tumor maximum diameter(OR=1.40,P=0.025),and tumor minimum diameter(OR=2.01,P=0.003)were predictive features for high-burden LN metastasis.The multivariate regression analysis showed that the peritumoral edema features,including PE degree(OR=8.02,P＜0.001)and PE type(OR=5.53,P=0.001)were independent predictive features for high-burden LN metastasis.The area under the curve of the final predictive model was 0.842.The diagnostic sensitivity was 0.766,the specificity was 0.861,the positive predictive value was 0.610,and the negative predictive value was 0.929.Conclusion The PE on preoperative MRI have good predictive performance for LN metastasis burden prediction in patient with invasive breast cancer,particularly for low-burden LN metastasis.

Objective:To evaluate the imaging stability of a portable boom-type ophthalmic ultra-high-resolution optical coherence tomography (OCT) device in multiple application scenarios.Methods:The boom-type mode and handheld mode of the portable boom-type OCT and the desktop OCT were used to perform three-dimensional imaging tests on three healthy adults undergoing physical examinations at the Zhongshan Ophthalmic Center, Sun Yat-sen University as well as on OEMI-7 model eyes in a sitting position.The same two modes of the portable boom-type OCT were used to perform three-dimensional imaging on four awake non-sedated infants, two sedated infants and four healthy adults in the supine position.The obtained 3D imaging data were processed using a correlation analysis method between adjacent B-scans, and the offset of B-scan in the axial (z-axis) and the fast axis transverse (x-axis) were calculated.The procedures for in vivo human eye experiments followed the Declaration of Helsinki and were approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-sen University (No.2020 KYPJ154).All subjects and infant guardians signed the informed consent form. Results:Compared with the handheld imaging mode, the axial and fast axis lateral motion offsets of the model eye were significantly reduced in the boom-type imaging mode from (124.00±12.49)μm to (48.00±15.87)μm and from (24.00±1.00)μm to (2.67±0.57)μm, respectively ( t=2.932, 4.337; both P<0.001).In both human and model eyes, the axial and fast axis lateral motion offsets of the boom-type mode were significantly lower than in the traditional handheld operation mode (both P<0.001).The axial and lateral motion offsets between the boom-type mode and desk-top OCT imaging were comparable, without significant differences (both P>0.05).In both sedated and awake, non-sedated infants in the supine position, the axial offset of the portable boom-type OCT system was similar to that of the healthy adults, without significant difference in the overall comparison ( P=0.385), and the lateral offsets were higher than those of healthy adults, with statistically significant differences (both P=0.013).There was no significant difference in axial deviation between sedated and non-sedated infants ( P>0.05).The lateral deviation of non-sedated infants was higher than that of sedated infants, though the difference was not statistically significant ( P=0.247). Conclusions:The portable boom-type OCT system can maintain high-speed, high-resolution imaging performance while achieving imaging stability comparable to traditional desktop OCT systems.It is more suitable for bedside imaging of supine subjects, especially uncooperative infants, and has good clinical application prospects.