Objective:To investigate the differences in respiratory work load and oxygenation index improvement between intermittent sighing and progressive lung retraction strategies in patients with acute respiratory distress syndrome(ARDS)related to lung collapse.Methods:Sixty patients with ARDS related to lung collapse admitted from January 2020 to January 2024 were selected and divided into intermittent sighing group(IS group,n=30)and progressive lung re-expansion group(PLR group,n=30)according to different treatment methods.The IS group used an intermittent sighing ventilation mode,while the PLR group adopted a progressive lung re-expansion strategy.The changes in respiratory work load indicators[including work of breathing(WOB),maximum inspiratory pressure(Pmax),transcutaneous oxygen saturation(SpO2)],oxygenation index(PaO2/FiO2),lung compliance(Cst),and mechanical ventilation-related parameters were compared before and after treatment in both groups.Results:After treatment,the respiratory work load was significantly reduced in both groups,with a more pronounced decrease in WOB in the PLR group(P＜0.05);both groups showed significant improvements in oxygenation index,but the degree of improvement was more marked in the PLR group(P＜0.01);lung compliance improved more markedly in the PLR group(P＜0.05);the PLR group had significantly shorter mechanical ventilation time and ICU stay compared to the IS group(P＜0.05).Conclusions:The progressive lung recruitment strategy is better than the intermittent sighing ventilation in improving the respiratory work load,oxygenation index and lung compliance of patients with ARDS related to lung collapse.It can shorten the mechanical ventilation time and ICU hospital stay more effectively,which is worth clinical promotion and application.

Objective:To investigate the differences in respiratory work load and oxygenation index improvement between intermittent sighing and progressive lung retraction strategies in patients with acute respiratory distress syndrome(ARDS)related to lung collapse.Methods:Sixty patients with ARDS related to lung collapse admitted from January 2020 to January 2024 were selected and divided into intermittent sighing group(IS group,n=30)and progressive lung re-expansion group(PLR group,n=30)according to different treatment methods.The IS group used an intermittent sighing ventilation mode,while the PLR group adopted a progressive lung re-expansion strategy.The changes in respiratory work load indicators[including work of breathing(WOB),maximum inspiratory pressure(Pmax),transcutaneous oxygen saturation(SpO2)],oxygenation index(PaO2/FiO2),lung compliance(Cst),and mechanical ventilation-related parameters were compared before and after treatment in both groups.Results:After treatment,the respiratory work load was significantly reduced in both groups,with a more pronounced decrease in WOB in the PLR group(P＜0.05);both groups showed significant improvements in oxygenation index,but the degree of improvement was more marked in the PLR group(P＜0.01);lung compliance improved more markedly in the PLR group(P＜0.05);the PLR group had significantly shorter mechanical ventilation time and ICU stay compared to the IS group(P＜0.05).Conclusions:The progressive lung recruitment strategy is better than the intermittent sighing ventilation in improving the respiratory work load,oxygenation index and lung compliance of patients with ARDS related to lung collapse.It can shorten the mechanical ventilation time and ICU hospital stay more effectively,which is worth clinical promotion and application.

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

OBJECTIVES: To investigate the risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture and establish a nomogram model for predicting the risk of neonatal asphyxia. METHODS: A retrospective study was conducted with 613 cases of neonatal asphyxia treated in 20 cooperative hospitals in Enshi Tujia and Miao Autonomous Prefecture from January to December 2019 as the asphyxia group, and 988 randomly selected non-asphyxia neonates born and admitted to the neonatology department of these hospitals during the same period as the control group. Univariate and multivariate analyses were used to identify risk factors for neonatal asphyxia. R software (4.2.2) was used to establish a nomogram model. Receiver operator characteristic curve, calibration curve, and decision curve analysis were used to assess the discrimination, calibration, and clinical usefulness of the model for predicting the risk of neonatal asphyxia, respectively. RESULTS: Multivariate logistic regression analysis showed that minority (Tujia), male sex, premature birth, congenital malformations, abnormal fetal position, intrauterine distress, maternal occupation as a farmer, education level below high school, fewer than 9 prenatal check-ups, threatened abortion, abnormal umbilical cord, abnormal amniotic fluid, placenta previa, abruptio placentae, emergency caesarean section, and assisted delivery were independent risk factors for neonatal asphyxia (P<0.05). The area under the curve of the model for predicting the risk of neonatal asphyxia based on these risk factors was 0.748 (95%CI: 0.723-0.772). The calibration curve indicated high accuracy of the model for predicting the risk of neonatal asphyxia. The decision curve analysis showed that the model could provide a higher net benefit for neonates at risk of asphyxia. CONCLUSIONS The risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture are multifactorial, and the nomogram model based on these factors has good value in predicting the risk of neonatal asphyxia, which can help clinicians identify neonates at high risk of asphyxia early, and reduce the incidence of neonatal asphyxia.
Infant, Newborn ; Humans ; Male ; Pregnancy ; Female ; Nomograms ; Retrospective Studies ; Cesarean Section ; Risk Factors ; Asphyxia Neonatorum/etiology*

Background:The Food and Drug Administration recently announced that the use of morcellation may cause fibroids or pelvic dissemination and metastasis of uterine sarcoma;therefore,the use of morcellation is limited in the USA.A large sample study is necessary to assess the proportion of uterine malignant tumors found in patients with laparoscopic myomectomy.Methods:A national multicenter study was performed in China.From 2002 to 2014,33,723 cases were retrospectively selected.We calculated the prevalence and recorded the clinical characteristics of the patients with malignancy after morcellation application.A total of 62 cases were finally pathologically confirmed as malignant postoperatively.Additionally,the medical records of the 62 patients were analyzed in details.Results:The proportion of postoperative malignancy after morcellation application was 0.18％ (62/33,723) for patients who underwent laparoscopic myomectomy.Nearly 62.9％ (39/62) of patients had demonstrated blood flow signals in the uterine fibroids before surgery.And,23 (37.1％) patients showed rapid growth at the final preoperative ultrasound.With respect to the pathological types,38 (61.3％) patients had detectable endometrial stromal sarcoma,13 (21.0％) had detectable uterine leiomyosarcoma,only 3 (3.2％) had detectable carcinosarcoma,and 5 (8.1％) patients with leiomyoma had an undetermined malignant potential.Conclusions:The proportion of malignancy is low after using morcellation in patients who undergo laparoscopic myomectomy.Patients with fast-growing uterine fibroids and abnormal ultrasonic tumor blood flow should be considered for malignant potential,and morcellation should be avoided.

OBJECTIVETo evaluate clinical characteristics, prognosis, prognostic factors, and the ideal treatment of the young patients with cervical malignant tumor.

METHODSWe analyzed retrospectively 52 cervical malignant tumor patients younger than 35 years (study group) and 45 cervical carcinoma patients older than 50 years (control group) who were admitted in Peking Union Medical College Hospital from 1985 to 2002. The data were analyzed statistically by SPSS10.0. The ovarian functions were evaluated by the questionnaire and the serum sex hormone assay.

RESULTSIn study group, the median age was (31.0 +/- 0.6) years old. The most common clinical symptoms were contact bleeding and irregular bleeding; 55.8% of patients had more than one symptom. HPV positive rate was 20.5%, which was higher than control group significantly (P < 0.05). The percentage of advanced stage (stage II b-stage IV b) of disease in study group and control group were 30.8% and 22.2%, respectively, the difference was significant (P < 0.05). The most common histological type was squamous cell carcinoma (71.2%) in study group, while the percentage of non-squamous cell carcinoma (43.8%) in patients younger than 30 years was much higher than control group (P < 0.05). All the histological type was non-squamous cell carcinoma in the patients younger than 25 years. Histological grade showed that G1, G2, and G3 were 21.2%, 54.5%, and 24.2% respectively in study group. The percentage of bulky cervix (tumor diameter > 4 cm) in study group and control group was 27.9% and 2.7% respectively (P < 0.005). The overall 5-year survival rates were 75.7% in study group, lower than control group (P < 0.05). The COX hazards regression model showed histological type (P = 0.003) and bulky cervix (P = 0.001) were of significant prognostic values.

CONCLUSIONSThere are more advanced stage carcinoma and non-squamous cell carcinoma patients with poor prognosis in study group. The treatment to younger patients should be concerned individually, as well as preservation of reproductive and female endocrine function should be considered.

Adenocarcinoma ; diagnosis ; surgery ; virology ; Adult ; Age Factors ; Carcinoma, Squamous Cell ; diagnosis ; surgery ; virology ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; Ovarian Function Tests ; Papillomaviridae ; isolation & purification ; Papillomavirus Infections ; Prognosis ; Regression Analysis ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms ; diagnosis ; surgery ; virology