The in-depth research of artificial intelligence in the medical field has greatly improved the workflow and diagnostic ability of diagnostic radiology.This article focuses on artificial intelligence technology in the field of interventional medicine,and enumerates its potential application scenarios,including improving image analysis capabilities to assist diagnosis and predict treatment response.It also describes the challenges that need to be overcome for practical application.Finally,with the continuous development of artificial intelligence in interventional medicine,artificial intelligence will further optimize the channels of interventional medicine and bring revolutionary changes to the clinical practice of interventional medicine.

Objective:To search for and screen evidence related to perioperative nutrition management in cardiac surgery patients and summarize the best available evidence.Methods:Computerized searches were conducted in BMJ Best Practice, UpToDate, Guidelines International Network, National Institute for Health and Care Excellence website, National Guideline Clearinghouse, Scottish Intercollegiate Guideline Network, Registered Nurses' Association of Ontario, Canadian Medical Association Clinical Practice Guidelines Library, Medlive, Joanna Briggs Institute (JBI) Evidence-Based Health Care Centre Database, Cochrane Library, American College of Physicians Journal Club, PubMed, Web of Science, Embase, China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Data, VIP and other database and professional association websites for literature related to perioperative nutrition management in cardiac surgery patients. The search time limit is from the establishment of the database to April 30, 2024. Two researchers independently screened the literature based on quality standards, performed quality assessments, and extracted and synthesized the evidence.Results:A total of 17 articles were included, including four clinical decisions, five guidelines, five expert consensuses, two systematic reviews, and one randomized controlled trial. The final best evidence was summarized into 35 key recommendations across eight areas: multidisciplinary team formation, nutritional assessment and monitoring, dietary management, caloric requirements, nutrient intake, preoperative nutritional support therapy, postoperative nutritional support therapy, and health education.Conclusions:The best evidence summarized in this study for perioperative nutrition management in cardiac surgery patients is scientifically rigorous and comprehensive. It provides evidence-based support and decision-making guidance for clinical healthcare providers in managing perioperative nutrition for cardiac surgery patients.

Objective:To search for and screen evidence related to perioperative nutrition management in cardiac surgery patients and summarize the best available evidence.Methods:Computerized searches were conducted in BMJ Best Practice, UpToDate, Guidelines International Network, National Institute for Health and Care Excellence website, National Guideline Clearinghouse, Scottish Intercollegiate Guideline Network, Registered Nurses' Association of Ontario, Canadian Medical Association Clinical Practice Guidelines Library, Medlive, Joanna Briggs Institute (JBI) Evidence-Based Health Care Centre Database, Cochrane Library, American College of Physicians Journal Club, PubMed, Web of Science, Embase, China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Data, VIP and other database and professional association websites for literature related to perioperative nutrition management in cardiac surgery patients. The search time limit is from the establishment of the database to April 30, 2024. Two researchers independently screened the literature based on quality standards, performed quality assessments, and extracted and synthesized the evidence.Results:A total of 17 articles were included, including four clinical decisions, five guidelines, five expert consensuses, two systematic reviews, and one randomized controlled trial. The final best evidence was summarized into 35 key recommendations across eight areas: multidisciplinary team formation, nutritional assessment and monitoring, dietary management, caloric requirements, nutrient intake, preoperative nutritional support therapy, postoperative nutritional support therapy, and health education.Conclusions:The best evidence summarized in this study for perioperative nutrition management in cardiac surgery patients is scientifically rigorous and comprehensive. It provides evidence-based support and decision-making guidance for clinical healthcare providers in managing perioperative nutrition for cardiac surgery patients.

Microcephaly is a common pediatric neurodevelopmental disorder with complex etiology. In recent years, with the development of brain organoid technology, there has been rapid progress in understanding the pathogenesis and treatment strategies of microcephaly using this technology. This article elucidates the advantages of brain organoids over traditional experimental models, reviews the research progress of brain organoid technology in disease modeling and drug screening for various causes of microcephaly, and discusses the limitations and future prospects of brain organoids.

Objective:To investigate the risk factors of long-term shoulder imbalance in patients presented postoperative shoulder imbalance who underwent single segment hemivertebra resection, and the role of postoperative trunk shift in shoulder imbalance.Methods:All of 30 patients who presented shoulder imbalance after hemivertebrae resection and short fusion from July 2006 to December 2018 were reviewed in this study, including 16 males and 14 females, aged 4.53±2.05 years (range, 2-8 years). Among them, 10 cases were thoracic hemivertebra, 12 thoracolumbar hemivertebra and 8 lumbar hemivertebra. According to the vertical height difference at the highest point of soft tissue shadows on both shoulders in the final follow-up upright posteroanterior radiograph, which was shoulder imbalance (SI), they were divided into two groups: Group B (balance, shoulder imbalance less than 10 mm) and Group IB (imbalance, shoulder imbalance more than 10 mm). Several radiographic parameters were measured preoperatively, 3 months after surgery and at the final follow-up, such as SI, distance between C 7 plumbline and center sacral vertical line (C 7PL-CSVL), Cobb angle of main curve, cobb angle of proximal curve (CAPC), Cobb angle of distal curve (CADC), upper instrumented vertebra offset (UO), lower instrumented vertebra offset (LO), upper instrumented vertebra slope (US), lower instrumented vertebra slope (LS), T1 tilt and sagittal vertical axis (SVA). Results:The mean follow-up period was 54.3±33.7 months (range, 24-132 months). A mean of 3.1 segments were fused. 7 cases (70%) of thoracic, 6 cases (50%) of thoracolumbar and 3 cases of lumbar hemivertebrae (37.5%) with shoulder imbalance at 3 months after surgery remained imbalanced at the last follow-up. Thirteen cases presented coronal imbalance postoperative (C 7PL-CSVL>2 cm), among 6 cases whose trunk shafted to the side of the higher shoulder postoperatively, 5 cases presented aggravated SI at final follow-up, and among 7 cases whose trunk shafted to the side of the lower shoulder postoperatively, 6 cases presented aggravated SI at final follow-up, while the difference had statistical significance ( P=0.029). The static analysis indicated that postoperative and long-term C 7PL-CSVL, long-term lowest instrumented vertebra and long-term T 1 tilt were risk factors of shoulder imbalance at final follow-up. Conclusion:A proportion of congenital scoliosis patients who presented shoulder imbalance after hemivertebra resection plus short fusion are less likely to achieve shoulder balance at the final follow-up. Long-term shoulder imbalance is often presented in the patients whose trunk shafted to the side of the higher shoulder postoperatively.

Objective:To explore the efficacy and correction mechanism of posterior column osteotomy for treatment of "Lenke 5-like" lumbar congenital scoliosis.Methods:From April 2008 to September 2019, 16 patients with lumbar congenital scoliosis underwent posterior column osteotomy were retrospectively reviewed including 6 males and 10 females, aged 23.9±11.7 years (range, 14-48 years). Among them, 8 cases were unsegmentation, 5 malformation and 3 mixed type. The average segments of PCO were 5.3. Posterior column osteotomy was adapted after the insertion of pedicle screws, then removed spinous process, ligaments, superior and inferior facet and corrected the deformity with the rods. The pre- and post-operative and last follow-up radiographic parameters were measured: Cobb angle of lumbar curve, distance between C 7 plumbline and center sacral vertical line (C7PL-CSVL), deformity angle (DA), disc correction angle (DCA) of instrumented segments, disc angle above upper instrumented vertebra (DAAU), lower instrumented vertebra disc angle (LDA), upper instrumented vertebra slope (US), lower instrumented vertebra slope (LS), lower instrumented vertebra offset (LO) and sagittal parameters such as thoracic kyphosis (TK), lumbar lordosis(LL) and thoracic junctional kyphosis (TJK). The Scoliosis Research Society-22 questionnaire (SRS-22) were conducted at preoperation and the final follow up to evaluate the clinical outcomes. Results:The mean follow-up period was 16.69±7.65 months (range, 12-36 months). The coronal DA was 26.74°±10.59° while the sagittal DA was 14.70°±11.63°. The pre- and post-operative Cobb angle were 51.19°±12.91° and 23.25°±12.86° while the correction rate was 57.17%±16.31% and reached 24.26°±13.19° in the last follow-up. The improvement of DAAU, LDA, US, LS, and LO pre- and post-operative had statistical significance ( P<0.001). The pre- and post-operative and the last follow-up C 7PL-CSVL were 27.13±17.08 mm, 21.81±12.80 mm and 20.24±15.02 mm. The pre-operative, postoperative and last follow-up DAAU were -4.35°±2.12°, 1.36°±2.34° and 1.60°±2.45°. The pre- and post-operative LDA were -7.03°±4.40° and 2.42°±3.39°, and the last follow-up LDA was 2.81°±2.98°. US and LS decreased from pre-operative 12.01°±8.33° and 21.46°±5.79° to 2.84°±7.52° and 11.64°±6.06°. The mean US and LS were 4.22°±6.56° and 11.56°±6.02° in the last follow-up. LO decreased after surgery and keep unchanged in the last follow-up, which were 12.71°±6.43°, 6.31°±5.17° and 7.01°±4.73°, respectively. For the sagittal plane parameters, the changes of TK, LL, and TJK reached statistical significance through the surgery. LL increased from 33.69°±14.01° to 44.28°±10.07° through the surgery and reached 41.97°±6.69° at the last follow-up while TK increased from 13.41°±12.37° to 23.52°±8.10°, TJK decreased from 29.02°±20.74° to 16.20°±12.62° after the surgery and reached 16.07°±13.33° at the last follow-up. The pre-operative, post-operative and last follow-up thoracic kyphosis were 13.41°±12.37°, 23.52°± 8.10°, and 24.21°±7.39°. There was no statistical significance of the change of C 7PL-CSVL, SVA, SSA and PI-LL through the surgery ( P>0.05). At the final follow-up, the self-image and psychologic status scores of SRS-22 were significantly higher than that before surgery ( t=15.457, P<0.001; t=14.726, P<0.001), and there was no significant difference in the rest of the domain ( P>0.05). Conclusion:"Lenke5-like" lumbar congenital scoliosis could obtain satisfactory correction of coronal and sagittal deformities with the treatment of posterior column osteotomy, while there was no significant loss of correction during follow-up. The incidence of surgical complications is low.

Objective:To assess the association of time interval with surgical repair effects for patients with ventricular septal defect(VSD) following acute myocardial infarction(AMI).Methods:From January 2010 to December 2017, 14 patients with VSD induced by AMI have received surgical therapy in our department. The age of the entire group was (65.5±3.3) years with male percentage of 78.6%(11/14). VSDs were anterior apical in 10(71.4%) and posterior inferior in 4(28.6%) patients. Average size of VSD was(15.8±5.8)mm. We retrospectively reviewed the patients' clinical manifestations, surgical methods and outcomes. According to the time interval from AMI onset and operation, patients were divided into two groups, Group 1(9 cases) as more than one week and Group 2(5 cases) as less than one week. Comparing study was done and differences were analyzed.Results:All patients underwent concomitant coronary artery bypass graft surgery. The cardiopulmonary bypass time and aortic clamp time was(203.9±52.3)min and(152.4±44.8)min. The mortality rate was 14.3%(2/14), higher in Group 2 but no significant differences(20.0% vs 11.1%, P=1.000). Mechanical support(IABP and ECMO) were more common in Group 2, both in preoperative(IABP 80.0% vs 22.2%, P=0.091; ECMO 20.0% vs. 0, P=0.357) and intraoperative period(IABP 60.0% vs. 0, P=0.027; ECMO 40.0% vs. 0, P=0.110). Compared with Group 1, Group 2 revealed worse left ventricular function(LVEF 0.304±0.023 vs. 0.408±0.103, P=0.035), higher rate of urgent procedure(100% vs. 11.1%, P=0.003). No resistant shunt and death was found during follow-up. Conclusion:Surgery is an effective way to treat AMI with VSD. When the time from onset to surgery exceeds one week, the patient's hemodynamic condition is more stable and the operation is safer. Patients undergoing surgery within one week show more unstable hemodynamic status, and mechanical assistance supports can correct the hemodynamic status and improve perioperative success rate.

Objective: To investigate the prevalence of autonomic dysfunction and its influencing factors in the elderly in Jizhou community of Tianjin. Methods: By using a cross-sectional study, a questionnaire survey was conducted in the elderly in order to investigate the prevalence of autonomic dysfunction and its influencing factors. Results: A total of 1 292 elderly patients were enrolled.Of them, 196 cases had autonomic dysfunction(15.2%, 196/1 292). The main symptoms of autonomic dysfunction were frequent urination, urination urgency, urination incontinence(19.7%, 255/1 292)and constipation(15.9%, 205/1 292). Multivariate Logistic regression analysis showed that women(OR=1.808, 95%CI: 1.253~2.607), 75-85 years of age(OR=1.573, 95%CI: 1.109~2.232), general anesthesia history(OR=1.552, 95%CI: 1.044~2.307), sleep disorders(OR=2.906, 95%CI: 1.506~2.916), diabetes(OR=1.791, 95%CI: 1.197~2.678)and headache(OR=2.589, 95%CI: 1.482~4.520)were risk factors for autonomic dysfunction. Conclusions The prevalence of autonomic dysfunction is high in the elderly in Jizhou community of Tianjin city.It is necessary to pay great attention to potential risk factors of autonomic dysfunction in the elderly.And the autonomic dysfunction symptoms should be diagnosed and treated as early as possible.

Objective: To investigate the current status of professional identity among the undergraduates majoring in public affairs management and the related influence factors. Methods: A stratified cluster sampling method was used to conduct a questionnaire survey among the 115 undergraduates majoring in public affairs management in a medical university in Harbin, China, and the contents of the questionnaires included general status and professional identity. The t-test, one-way analysis of variance, and multiple linear regression analysis were used to analyze the influencing factors of professional identity. In-depth interviews were conducted for some students to explore the profound influencing factors for professional identity among the students majoring in public affairs management. Results: The overall level of professional identity was low among the undergraduates majoring in public affairs management in the medical university in Harbin, and the score of professional identity was 3.25±0.56. The scores of cognitive dimension, emotional dimension, behavioral dimension, and applicable dimension were 3.41±0.69, 3.21±0.78, 3.24±0.71, and 3.13±0.72, respectively. The multivariate analysis showed that grade, academic performance, major selection, and children number in family had significant influence on their professional identity. The students who were at grade four, who had high academic record (b=-0.276, P<0.01), who chose this major independently (b=-0.277, P<0.01), and who were the only child (b=-0.233, P<0.05) had a high score of professional identity. As for the undergraduates at different grades, the undergraduates at grades two and three had a significantly lower score of professional identity than those at grade four (b=-0.296 and -0.369, P<0.05), while there was no significant difference between the undergraduates at grades one and four (b=-0.008, P>0.05). Furthermore, the students with a high score of professional identity had higher possibility to pursue the job related to this major than those with a low score (3.39±0.53 vs. 2.92±0.49, t=4.414, P<0.01). Conclusion Universities should strengthen the publicity of the major of public affairs management, optimize the curriculum, and add job experience, so as to enhance professional identity among students with this major and provide talent for the field of public health management.

Objective To evaluate the safety and feasibility of extra-anatomic bypass in the treatment of complex aorta coarctation concomitant with cardiac lesions,multiple stenosis of aorta or severe stenosis.Methods Complex aorta coarctation include a combination of heart disease (valve disease,coronary artery disease,ect.),or multiple constrictive lesions of the thoracic abdominal aorta or an aneurysm due to constriction of the arch,which are all difficult by interventional surgery or open thoracotomy surgery.From October 2016 to October 2017,6 patients with complex aorta coarctation have received surgical therapy in our department,including 3 males and 3 females,with the average age(50.0-± 17.9) years old.One-staged extra-anatomic bypass was used to establish an ascending aorta to the distal aorta bypass,4 patients underwent median thoracotomy and bypass surgery with thoracic aorta from the posterior inferior pericardium,1 patient underwent bypass surgery with abdominal aorta through thoracoabdominal incision,and 1 patient underwent bypass surgery with bilateral femoral artery from bilateral inguinal incision and guiding with laparoscopic through peritoneal cavity.Among them,3 patients underwent valve surgery in the same period,and 1 patient underwent coronary artery bypass surgery.Results No patient died.The mean cardiopulmonary bypass time was 273.8 minutes and the average aorta blocking time was 216.0 minutes.Pulse pressure of extremities blood pressure was significantly reduced compared with preoperative,and the clinical symptoms were significantly alleviation.During follow-up,6 patients presented with patent artificial blood vessels and alleviated symptoms.Conclusion Extra-anatomic bypass is a safe and effective method for the treatment of complex vasoconstriction without increasing the risk of surgery.