Objective To investigate the risk factors for mortality and bleeding complications in extracorporeal membrane oxygenation(ECMO)treated patients and to evaluate the impact of thrombocytopenia severity on the prognosis of ECMO therapy.Methods A total of 153 patients who received ECMO treatment at Peking University Third Hospital between January 2013 and September 2024 were en-rolled in this study.The patients were divided into death group(n=97)and recovery group(n=56)based on their final outcomes.Additionally,the patients were categorized into bleeding group(n=104)and non-bleeding group(n=49)based on the occurrence of bleeding complications during ECMO.Clinical baseline characteristics and extreme laboratory values during ECMO were compared be-tween groups.Logistic regression was used to analyze the risk factors for mortality and bleeding.The patients were further divided,based on the initial platelet(PLT)values on the day of catheter placement and the lowest platelet count during ECMO,into normal group(PLT≥ 100× 109/L),moderate reduction group[PLT=(50～99)× 109/L],and severe reduction group(PLT＜50× 109/L).Kaplan-Meier analysis was used to compare survival rates among these groups.The patients in the moderate and severe reduction groups were further divided into a platelet transfusion group and a non-transfusion group,and the outcomes and complication rates were com-pared.Results The recovery group had a higher proportion of myocarditis,higher minimum values of PLT,Hb,and Fib,and higher initial PLT values,while the maximum values of lactic dehydrogenase(LDH),total bilirubin(T-Bil),prothrombin time(PT),and procalcitonin(PCT)were lower(all P＜0.05)with significant differences.Logistic regression showed that age and maximum PCT were independent risk factors for mortality(OR=1.025 and 1.015 respectively,all P＜0.05).The bleeding group had longer ECMO dura-tions,more plasma transfusions,lower minimum Hb values,and higher maximum values of WBC,neutrophils(Neu),and APTT(all P＜0.05)with statistical differences.The minimum PLT value,maximum WBC value,and maximum APTT value were independent risk factors for bleeding complications(OR=0.986,1.062,and 1.004 respectively,all P＜0.05).Kaplan-Meier analysis showed that the patients in the severe reduction group had lower survival rates,regardless of whether the grouping was based on initial or minimum platelet counts(all P＜0.05).Platelet transfusion improved the mortality in the severe reduction group(P＜0.05)but had no effect on the moderate reduction group.Conclusion Age and peak value of PCT are the risk factors for mortality in ECMO patients,while mini-mum PLT count,peak value of WBC and APTT are the risk factors for bleeding complications.Early intervention for infection and in-flammation during ECMO may improve the outcome of patients.Severe thrombocytopenia during ECMO therapy increased the risk of mortality,and targeted platelet transfusion may improve the survival of these patients.

Objective To investigate the risk factors for mortality and bleeding complications in extracorporeal membrane oxygenation(ECMO)treated patients and to evaluate the impact of thrombocytopenia severity on the prognosis of ECMO therapy.Methods A total of 153 patients who received ECMO treatment at Peking University Third Hospital between January 2013 and September 2024 were en-rolled in this study.The patients were divided into death group(n=97)and recovery group(n=56)based on their final outcomes.Additionally,the patients were categorized into bleeding group(n=104)and non-bleeding group(n=49)based on the occurrence of bleeding complications during ECMO.Clinical baseline characteristics and extreme laboratory values during ECMO were compared be-tween groups.Logistic regression was used to analyze the risk factors for mortality and bleeding.The patients were further divided,based on the initial platelet(PLT)values on the day of catheter placement and the lowest platelet count during ECMO,into normal group(PLT≥ 100× 109/L),moderate reduction group[PLT=(50～99)× 109/L],and severe reduction group(PLT＜50× 109/L).Kaplan-Meier analysis was used to compare survival rates among these groups.The patients in the moderate and severe reduction groups were further divided into a platelet transfusion group and a non-transfusion group,and the outcomes and complication rates were com-pared.Results The recovery group had a higher proportion of myocarditis,higher minimum values of PLT,Hb,and Fib,and higher initial PLT values,while the maximum values of lactic dehydrogenase(LDH),total bilirubin(T-Bil),prothrombin time(PT),and procalcitonin(PCT)were lower(all P＜0.05)with significant differences.Logistic regression showed that age and maximum PCT were independent risk factors for mortality(OR=1.025 and 1.015 respectively,all P＜0.05).The bleeding group had longer ECMO dura-tions,more plasma transfusions,lower minimum Hb values,and higher maximum values of WBC,neutrophils(Neu),and APTT(all P＜0.05)with statistical differences.The minimum PLT value,maximum WBC value,and maximum APTT value were independent risk factors for bleeding complications(OR=0.986,1.062,and 1.004 respectively,all P＜0.05).Kaplan-Meier analysis showed that the patients in the severe reduction group had lower survival rates,regardless of whether the grouping was based on initial or minimum platelet counts(all P＜0.05).Platelet transfusion improved the mortality in the severe reduction group(P＜0.05)but had no effect on the moderate reduction group.Conclusion Age and peak value of PCT are the risk factors for mortality in ECMO patients,while mini-mum PLT count,peak value of WBC and APTT are the risk factors for bleeding complications.Early intervention for infection and in-flammation during ECMO may improve the outcome of patients.Severe thrombocytopenia during ECMO therapy increased the risk of mortality,and targeted platelet transfusion may improve the survival of these patients.

BACKGROUND:The definitive cause of adolescent idiopathic scoliosis is not yet known.The search for a clinical approach to address adolescent idiopathic scoliosis is imminent.OBJECTIVE:To investigate the effect of Schroth therapy combined with core strength training on mild adolescent idiopathic scoliosis and to provide more bases for the clinical treatment of mild adolescent idiopathic scoliosis.METHODS:110 patients with mild adolescent idiopathic scoliosis attending the Department of Rehabilitation Medicine and Department of Spine Surgery of Affiliated Hospital of Nantong University from July 2022 to January 2024 were selected as the study subjects.They were divided into the trial group and the control group according to the wishes of the patients and their parents,with 55 cases in each group.The control group was observed and followed up,and the trial group underwent Schroth therapy combined with core strength training for 45 minutes a day for 24 weeks.The differences in imaging parameters,body surface indexes,three-dimensional ultrasound imaging angle,and quality of life were compared between the two groups before and after treatment.RESULTS AND CONCLUSION:(1)At 24 weeks after treatment,major curve Cobb,apical vertebral translation,and cervical lordosis were significantly improved in the trial group(P＜0.05),while there was no significant difference in the control group(P＞0.05).Major curve Cobb and apical vertebral translation in the trial group were significantly better than those in the control group(P＜0.05).(2)At 24 weeks after treatment,angle of trunk rotation in the trial group was significantly lower than that before treatment(P＜0.05),while there was no significant difference between before and after treatment in the control group(P＞0.05),and angle of trunk rotation in the trial group was significantly lower than that of the control group(P＜0.05).(3)At 24 weeks after treatment,the center of laminae angle of three-dimensional ultrasound imaging was significantly reduced in the trial group(P＜0.05),while there was no significant difference in the control group before and after treatment(P＞0.05).The center of laminae angle of three-dimensional ultrasound imaging was smaller in the trial group than that in the control group(P＜0.05).(4)At 24 weeks after treatment,in terms of the quality of life,pain dimension score in the trial group was significantly increased(P＜0.05).Both trial and control groups showed significantly higher scores in the self-image dimension compared with that before treatment(P＜0.05).Both groups had significantly lower scores in the mental health dimension compared with that before treatment(P＜0.05).In the dimensions of pain,self-image,mental health,and satisfaction,the trial group was significantly higher than the control group(P＜0.05).(5)It is indicated that Schroth therapy combined with core strength training can improve the major curve Cobb,apical vertebral translation,and cervical lordosis angle,reduce the angle of trunk rotation,decrease the center of laminae angle of three-dimensional ultrasound imaging,and improve the quality of life,and it is effective in the treatment of mild adolescent idiopathic scoliosis.

BACKGROUND:The definitive cause of adolescent idiopathic scoliosis is not yet known.The search for a clinical approach to address adolescent idiopathic scoliosis is imminent.OBJECTIVE:To investigate the effect of Schroth therapy combined with core strength training on mild adolescent idiopathic scoliosis and to provide more bases for the clinical treatment of mild adolescent idiopathic scoliosis.METHODS:110 patients with mild adolescent idiopathic scoliosis attending the Department of Rehabilitation Medicine and Department of Spine Surgery of Affiliated Hospital of Nantong University from July 2022 to January 2024 were selected as the study subjects.They were divided into the trial group and the control group according to the wishes of the patients and their parents,with 55 cases in each group.The control group was observed and followed up,and the trial group underwent Schroth therapy combined with core strength training for 45 minutes a day for 24 weeks.The differences in imaging parameters,body surface indexes,three-dimensional ultrasound imaging angle,and quality of life were compared between the two groups before and after treatment.RESULTS AND CONCLUSION:(1)At 24 weeks after treatment,major curve Cobb,apical vertebral translation,and cervical lordosis were significantly improved in the trial group(P＜0.05),while there was no significant difference in the control group(P＞0.05).Major curve Cobb and apical vertebral translation in the trial group were significantly better than those in the control group(P＜0.05).(2)At 24 weeks after treatment,angle of trunk rotation in the trial group was significantly lower than that before treatment(P＜0.05),while there was no significant difference between before and after treatment in the control group(P＞0.05),and angle of trunk rotation in the trial group was significantly lower than that of the control group(P＜0.05).(3)At 24 weeks after treatment,the center of laminae angle of three-dimensional ultrasound imaging was significantly reduced in the trial group(P＜0.05),while there was no significant difference in the control group before and after treatment(P＞0.05).The center of laminae angle of three-dimensional ultrasound imaging was smaller in the trial group than that in the control group(P＜0.05).(4)At 24 weeks after treatment,in terms of the quality of life,pain dimension score in the trial group was significantly increased(P＜0.05).Both trial and control groups showed significantly higher scores in the self-image dimension compared with that before treatment(P＜0.05).Both groups had significantly lower scores in the mental health dimension compared with that before treatment(P＜0.05).In the dimensions of pain,self-image,mental health,and satisfaction,the trial group was significantly higher than the control group(P＜0.05).(5)It is indicated that Schroth therapy combined with core strength training can improve the major curve Cobb,apical vertebral translation,and cervical lordosis angle,reduce the angle of trunk rotation,decrease the center of laminae angle of three-dimensional ultrasound imaging,and improve the quality of life,and it is effective in the treatment of mild adolescent idiopathic scoliosis.

Transbronchil biopsy has the characteristic of less trauma and quick recovery compared to percutaneous aspiration biopsy. In order to automate this procedure, it requires the development of a robotic surgical system that combines electromagnetic navigation and flexible endoscope. The robotic surgical system introduced herein consists of flexible endoscope, remote-control handle, electromagnetic navigation and dexterous manipulators. The robotic system supports lung bronchial model segmentation and reconstruction, automatic bronchial path planning, real-time navigation and visual biopsy. In the control of the endoscopic catheter, an elasticity compensation algorithm was proposed to improve the location accuracy of the catheter and operational efficiency. Clinical trials proved that the robotic system had high positioning accuracy, was intuitive to operate, and could improve the biopsy efficiency, shorten the learning time, reduce the burden of surgical operations, and lower radiation exposure and infection rate.
Catheters ; Robotic Surgical Procedures ; Endoscopy ; Bronchoscopy

Deep brain disease stimulation (DBS) is commonly used to treat movement disorders such as Parkinson disease,and current evidence suggests that DBS may also be useful for refractory epilepsy and is affected by a variety of factors.Studies show that stimulation of the anterior nucleus of the thalamus and hippocampus may decrease the frequency of refractory seizures.The efficacy of stimulating other targets remains inconclusive.An absence of structural abnormality on imaging and electrode position are associated with stimulation efficacy.Certain seizure types may respond more favorably to specific targets.There are several factors that potentially predict seizure outcome following DBS,but more large-scale clinical trials are needed.

Objective To evaluate the effects of facial nerve reconstruction surgery by reviewing the clinical information and follow-up results of 42 cases.Methods The clinical data of 42 patients who were diagnosed as facial schwannoma and received tumor resection and facial nerve reconstruction simultaneously from January 2004 to December 2015 in our department were studied.The surgeries included anastomosis between the two faical nerves(3 cases), facial nerve transplantation(4 cases), Hypoglossal/masseteric-facial nerve anastomosis(27 cases) and cross-facial nerve graft(8 cases).We evaluated the facial nerve function using H-B grade and Fisch score post-operation (1 week, 3 months,6 months and 1 year after surgery).Results The Fisch scores were significantly different between 1 week and 3 months, 3 months and 6 months post-operation for patients received cross-facial nerve graft.The facial nerve function became better as time went by.While there were no difference between 6 months and 1 year post-operation.On the other hand, the scores were significantly different between 6 months and 1 year post-operation for patients received hypoglossal/masseteric facial nerve anastomosis.Conclusion Most patients received tumor section and facial nerve reconstruction simultaneously could gain good results, it took a long time for the facial nerve function to return to a stable state and some of them were still in recovering 1 year after surgery.

Objective To analyze the TCM principles of herbal prescriptions given by professor Zhang Shishun for esophageal cancer by using traditional Chinese medicine inheritance support system (V2.0). Methods The herbal prescriptions from professor Zhang were collected and used for esophageal cancer, and then were recorded into the traditional Chinese medicine inheritance support system. The date mining methods were used such as principle analysis and revised mutual information. Results A total of 166 prescriptions for esophageal cancer were collected, which involved 316 Chinese medicines. The medicines with high frequency were Ganoderma, Caulis Marsdeniae Tenacissimae, Fructus Trichosanthis, Herba Rabdosiae Rubescentis, and Agaricus Blazei Murrill. The combinations of medicines included Ganoderma and Ramulus Juglandis, Radix et Rhizoma Sophorae Tonkinensis and Caulis Marsdeniae Tenacissimae, and Herba Rabdosiae Rubescentis and Caulis Marsdeniae Tenacissimae. The prescription rules of drug combination mode were obtained. Conclusions The Professor Zhang advocated the theory of determination of treatment based on pathogenesis through differentiation of symptoms and signs, patho-examination, patho-location. He also stressed on the therapy of relieving both primary and secondary symptoms. The Ganoderma, Ramulus Juglandis and Agaricus Blazei Murril were used to strengthen the body resistance. Radix et Rhizoma Sophorae Tonkinensis, Caulis Marsdeniae Tenacissimae and Herba Rabdosiae Rubescentis were used to eliminate pathogenesis. The Endothelium Corneum Gigeriae Galli, Fructus Crataegi Praeparata, Massa Medicata Fermentata Praeparata were used to protect stomach-qi. The Fructus Trichosanthis, Bulbus Allii Macrostemonis and Folium Ginkgo wereused to dilate the esophagus. The Fructus Trichosanthis was often combined with Radix Scutellariae to serve all medicines on the esophagus.

Objective To evaluate the inter -list equivalency of the disyllabic materials for Mandarin speech perception test (MSP) by measuring the speech recognition score of patients with cochlear implant (CI) .Methods According to Latin -square design ,disyllabic recognition scores (quiet background) were measured for each of the 10 phonemically balanced lists in 50 Mandarin-speaking CI users(aged 30 .44 ± 12 .71 years)in sound field .RM -ANOVA was administered to confirm the list equivalency .Results The sentence recognition scores were 59 .26% ± 23 .49% ,64 .31% ± 23 .35% ,59 .97% ± 23 .07% ,62 .40% ± 25 .16% ,62 .75% ± 24 .47% ,62 .29% ± 23 .55% , 62 .85% ± 24 .60% ,61 .35% ± 23 .73% ,61 .82% ± 25 .28% ,58 .83% ± 25 .13% ,respectively for the 10 lists .There was no significance difference in sentence recognition scores across the 10 disyllabic lists [F(9 ,490)=0 .255 ,P=0 .986>0 .05] .Conclusion The good inter -list equivalency of the disyllabic materials for Mandarin speech perception test (MSP) has been proved to be useful for assessing speech recognition performance of Mandarin -speaking CI users .

BACKGROUNDCochlear implant surgery is widely practiced. Minimal incision cochlear implant surgery has been developed with the aims of reducing the impact of surgery on the patient and improving cosmesis while maintaining the low morbidity of conventional wider access approaches. This study aimed to assess the surgical technique and complication rate of minimal incision cochlear implantation (MICI) for children and adults.

METHODSData for this study were obtained via a retrospective analysis. Totally 378 patients were included in the study. All patients received minimal incision cochlear implantation, using the skin protector during the process of the operation. The surgical complications of MICI were recorded in a spreadsheet format. The incidence of major and minor complication were analyzed, and appropriate treatment was provided.

RESULTSA total of 40 (10.5%) complications were noted in the study. There were 0 life-threatening, 9 major, and 31 minor complications. Of the nine major complications, five were device failures, one developed infection and extrusion, and three required receiver-stimulator repositioning.

CONCLUSIONSMICI is as safe as standard cochlear implantation (SCI) and affords with it other benefits. Eliminating the scalp flap avoids devascularization and minimizes the opportunity of flap infection or necrosis. Complications not related to the flap are similar to SCI.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cochlear Implantation ; methods ; Female ; Humans ; Infant ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Retrospective Studies ; Young Adult