To explore the role of the "Clinical Practice Guidelines" column and others in the Medical Joumnal of Peking Union Medical College Hospital (Med J PUMCH) in promoting diseiplinary development.

Objective:We summarize the clinical characteristics of surgeries in which the thyroid lobe is used as a transfer flap to treat early pharyngeal fistula following total laryngectomy.We also provide useful data for improving the diagnosis and management of this condition.Methods:Retrospective analysis was conducted on data from 8 patients with pharyngocutaneous fistulas after total laryngectomy for laryn-geal and pharyngeal cancer patients admitted to Hunan Provincial People's Hospital(The First Hospital Affiliated to Hunan Normal University)between October 2016 and October 2023.The surgeons performed a double-layer repair technique that included local inversion and a purse-string suture of the fistula using the thyroid lobe as a transfer flap.Clinical data were collected to analyze postoperative outcomes.Results:All eight patients experienced successful pharyngeal fistula repair.Postoperatively,these patients were managed with nasogastric tube feed-ing,liquid diet,and prophylactic antibiotics to prevent infection.After 10 days,their diet was changed to oral liquids,and their nasogastric tubes were removed.All patients were discharged after complete recovery.Conclusions:Use of the thyroid lobe as a transfer flap in a double-layer repair technique involving local inversion of the fistula is an effective method for repairing early pharyngeal fistula after total laryngectomy.This approach offers several advantages,including ease of flap harvesting,shortened operation time,reduced patient discom-fort,high transfer flap survival rate,and rapid postoperative recovery.The clinical efficacy of this technique is well-supported,making it a re-liable option for the management of early pharyngeal leaks.

Objective To investigate the MRI manifestations of ovarian tumors and their diagnostic value.Methods The MRI images from patients who underwent pelvic MRI examination,and who had ovarian space-occupying lesions confirmed by postoperative pathology were retrospectively collected.The diagnostic efficacy of MRI examination was compared.Results Pathological examination results showed that among the 208 patients with ovarian tumors,198 benign tumors were detected,including 35 cases of ovarian cysts,20 cases of mucinous cystadenomas,22 cases of plasma cystadenomas,41 cases of cystic/maturity teratomas,24 cases of fibromas/follicular membranous fibromas,and 56 cases of endometriotic cysts.The 10 malignant tumors included 5 cases of plasma cystadenocarcinoma,1 case of mucinous cystadenocarcinomas,1 case of sarcoma,and 3 cases of metastatic carcinoma.MRI was concordant with pathology in 197 cases,190 benign tumors were detected,31 cases of ovarian cysts,20 cases of mucinous cystadenomas,20 cases of plasma cystadenomas,41 cases of cystic/maturity teratomas,22 cases of fibromas/follicular membranous fibromas,and 56 cases of endometriotic cysts,and 7 malignant tumors(ovarian cancer)were detected.The MRI detection rate was 94.71％with a Kappa value of 0.869,which was in good agreement with the pathologic examination.The MRI examination demonstrated high diagnostic efficacy,with a sensitivity of 95.96％,an accuracy of 94.71％,and a positive predictive value of 98.45％,all of which in strong agreement with pathological examination results.Conclusion MRI examination and pathological examination have high concordance and high diagnostic accuracy in the diagnosis of ovarian tumors,providing imaging support for clinical identification of ovarian tumor types,and for doctors to provide diagnosis and treatment options.

Objective To investigate the current status of knowledge,attitude,and practice(KAP)re-garding the clinical application of graduated compression stockings(GCS)for preventing venous thromboem-bolism(VTE)among medical staff and analyze its influencing factors.Methods Through convenience sam-pling,5 706 medical staff from 85 hospitals in Chongqing were surveyed using the"Questionnaire on KAP of Clinical Application of GCS for VTE Prevention"between March 16 and 30,2024.Univariate and multiple lin-ear stepwise regression analyses were conducted to explore influencing factors.Results The scores for knowl-edge,attitude,and practice in the clinical application of GCS for VTE prevention among healthcare workers were(37.77±10.56),(16.85±3.05),and(24.85±7.51),respectively.Age,highest education level,seniori-ty,department,whether they had received GCS application training,hospital level,whether the hospital passed the national venous thrombosis prevention center certification,and GCS procurement channels were influen-cing factors for knowledge scores.Professional title,whether they had received GCS application training,hos-pital level,and whether the hospital passed the national venous thrombosis prevention center certification were influencing factors for attitude scores.Gender,age,highest education level,seniority,department,whether they had received GCS application training,hospital level,whether the hospital passed the national venous thrombo-sis prevention center certification,and GCS procurement channels were influencing factors for behavior scores.Conclusion Healthcare workers'knowledge of clinical application of GCS for VTE prevention is at a medium level,their attitude toward clinical application is positive,and practical behaviors are basically in compliance with standards.Hospital managers should emphasize training and assessment on clinical application of GCS for healthcare workers,strengthen quality control in practical implementation,and ensure patients receive stand-ardized mechanical VTE prevention.

Objective:We summarize the clinical characteristics of surgeries in which the thyroid lobe is used as a transfer flap to treat early pharyngeal fistula following total laryngectomy.We also provide useful data for improving the diagnosis and management of this condition.Methods:Retrospective analysis was conducted on data from 8 patients with pharyngocutaneous fistulas after total laryngectomy for laryn-geal and pharyngeal cancer patients admitted to Hunan Provincial People's Hospital(The First Hospital Affiliated to Hunan Normal University)between October 2016 and October 2023.The surgeons performed a double-layer repair technique that included local inversion and a purse-string suture of the fistula using the thyroid lobe as a transfer flap.Clinical data were collected to analyze postoperative outcomes.Results:All eight patients experienced successful pharyngeal fistula repair.Postoperatively,these patients were managed with nasogastric tube feed-ing,liquid diet,and prophylactic antibiotics to prevent infection.After 10 days,their diet was changed to oral liquids,and their nasogastric tubes were removed.All patients were discharged after complete recovery.Conclusions:Use of the thyroid lobe as a transfer flap in a double-layer repair technique involving local inversion of the fistula is an effective method for repairing early pharyngeal fistula after total laryngectomy.This approach offers several advantages,including ease of flap harvesting,shortened operation time,reduced patient discom-fort,high transfer flap survival rate,and rapid postoperative recovery.The clinical efficacy of this technique is well-supported,making it a re-liable option for the management of early pharyngeal leaks.

Sympathectomy, as an emerging treatment method for cardiovascular diseases, has received extensive attention in recent years. Stereotactic radiotherapy (SRT), a precise and noninvasive therapeutic technique, has gradually been introduced into interventions targeting the sympathetic nervous system and has shown promising prospects in the management of cardiovascular conditions. Using three-dimensional imaging, SRT can accurately localize sympathetic ganglia and deliver high-energy radiation to disrupt nerve fibers, thereby achieving effects similar to conventional sympathectomy while reducing surgery-related complications and shortening recovery time. It also offers the advantages of being noninvasive and causing fewer adverse effects, and thus holds potential as an alternative to traditional approaches in the future. The integration of SRT with sympathectomy opens new avenues for the treatment of cardiovascular diseases and presents broad clinical application prospects.
Radiosurgery/methods* ; Cardiovascular Diseases/radiotherapy* ; Humans ; Imaging, Three-Dimensional ; Ganglionectomy/methods* ; Ganglia, Sympathetic/radiation effects* ; Blood Vessels/physiopathology* ; Heart/physiopathology*

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Objective To investigate the MRI manifestations of ovarian tumors and their diagnostic value.Methods The MRI images from patients who underwent pelvic MRI examination,and who had ovarian space-occupying lesions confirmed by postoperative pathology were retrospectively collected.The diagnostic efficacy of MRI examination was compared.Results Pathological examination results showed that among the 208 patients with ovarian tumors,198 benign tumors were detected,including 35 cases of ovarian cysts,20 cases of mucinous cystadenomas,22 cases of plasma cystadenomas,41 cases of cystic/maturity teratomas,24 cases of fibromas/follicular membranous fibromas,and 56 cases of endometriotic cysts.The 10 malignant tumors included 5 cases of plasma cystadenocarcinoma,1 case of mucinous cystadenocarcinomas,1 case of sarcoma,and 3 cases of metastatic carcinoma.MRI was concordant with pathology in 197 cases,190 benign tumors were detected,31 cases of ovarian cysts,20 cases of mucinous cystadenomas,20 cases of plasma cystadenomas,41 cases of cystic/maturity teratomas,22 cases of fibromas/follicular membranous fibromas,and 56 cases of endometriotic cysts,and 7 malignant tumors(ovarian cancer)were detected.The MRI detection rate was 94.71％with a Kappa value of 0.869,which was in good agreement with the pathologic examination.The MRI examination demonstrated high diagnostic efficacy,with a sensitivity of 95.96％,an accuracy of 94.71％,and a positive predictive value of 98.45％,all of which in strong agreement with pathological examination results.Conclusion MRI examination and pathological examination have high concordance and high diagnostic accuracy in the diagnosis of ovarian tumors,providing imaging support for clinical identification of ovarian tumor types,and for doctors to provide diagnosis and treatment options.

Objective:To investigate the concern about pollen broadcasting in Chinese population from multiple dimensions and to understand the information about allergic rhinitis (AR) in China by analyzing related factors.Methods:From March 1 to September 30, 2022, a large-scale multi-center cross-sectional survey was conducted based on the Questionnaire Star platform in 21 Chinese hospitals. A total of 7 056 subjects from 7 regions in China: Northeast, North, East, Central, South, Southwest, and Northwest China were included. Basic characteristics (including social demographic characteristics and disease characteristics of AR patients), concern about pollen broadcasting, the willingness of pollen-induced AR (PiAR) patients to receive pollen broadcasting, and the treatment satisfaction rate of AR patients were collected. The chi-square test, multivariate linear regression model, and Logistic regression analysis were used to analyze the concern about pollen broadcasting in the Chinese population and related factors from multiple dimensions.Results:Among 7 056 subjects, 23.02% were concerned about pollen broadcasting. Among 3 176 self-reported AR and 1 019 PiAR patients, 25.60% and 39.16% were concerned about pollen broadcasting, respectively, which was higher than that of non-AR or non-PiAR subjects ( χ2 value was 21.74 and 175.11, respectively, both P<0.001). Among AR patients, the proportion of spring and autumn allergen-positive patients concerned about pollen broadcasting was higher than that in perennial allergen-positive patients ( χ2 value was 20.90 and 19.51, respectively, both P<0.001). The proportion of AR patients with asthma, sinusitis, allergic conjunctivitis, and cardiovascular and cerebrovascular diseases was higher than those without complications ( χ2 value was 50.83, 21.97, 56.78, 7.62, respectively, all P<0.05). The proportion of AR patients in North China who could find pollen broadcasting locally was 31.01%, significantly higher than those in other regions (all P<0.05). Multivariate linear regression model analysis showed that among PiAR patients, those with higher per capita household income and higher AR disease cognition levels had been concerned about pollen broadcasting in the past, and those complicated with allergic conjunctivitis had stronger intention to receive pollen broadcasting (B value was 0.24, 0.13, 0.66, 0.47, respectively, all P<0.05). The higher the disease cognition level of PiAR patients, the stronger their willingness to actively participate in treatment ( R2=0.72, P<0.001). Only 18.89% of AR patients felt satisfied with the treatment effect. Logistic regression analysis showed that in AR patients, the treatment satisfaction rate was significantly higher among those concerned about pollen broadcasting compared to those who were not ( OR=1.83, P<0.001). Conclusions:Currently, the dissemination of pollen broadcasting in China is hindered by various factors such as disease cognition level. The treatment satisfaction among AR patients remains unsatisfactory.

Objective To discover new-structure active molecules in order to provide candidate compounds for anti-radiation drug research.Methods Conformational fixation and functional group conversion strategies were used to modify the structure of Ex-RAD before substituted 2H-benzopyran-3-formylaniline compounds were designed and synthesized.The anti-radiation activities of the synthesized compounds were screened via irradiated cell survival models and the cytotoxicity of the active compounds was examined.Western blotting assay was used to investigate the effects of the optimal compound on the expressions of apoptosis related proteins in irradiated cells.The anti-radiation activity of the optimal compound was evaluated through irradiated mice models.Results Twenty-one target compounds were synthesized,eight of which were found to significantly improve the survival of irradiated cells.Four compounds were selected for re-screening and cytotoxicity evaluation.Compound D19 was determined as the optimal compound that could affect the expressions of apoptosis related proteins in irradiated AHH-1 cells by Western blotting assay.Compared with the radiation group,the 30-day survival rate of D19 treated mice irradiated with 8.6 Gy of whole-body radiation increased by 70%.D19 showed protective effect on the blood system of non-lethal dose irradiated mice.Conclusion The novel compound D19 has shown strong anti-radiation activity and deserves more research.