Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoen-cephalopathy (CADASIL) is caused by NOTCH3 gene variants and is predominantly characterized by cerebral small vessel disease. Previous studies have suggested that CADASIL may also involve the macrovascular system. This study aimed to explore the association between rare NOTCH3 variants and macrovascular lesions.

BACKGROUND: Modern acupuncture anesthesia is a combination of Chinese and Western medicine that integrates the theories of acupuncture with anesthesia. However, some clinical studies of acupuncture anesthesia lack specific descriptions of randomization, allocation concealment, and blinding processes, with subsequent systematic reviews indicating a risk of bias. OBJECTIVE: Clinical trial registration is essential for the enhancement of the quality of clinical trials. This study aims to summarize the status of clinical trial registrations for acupuncture anesthesia listed on the World Health Organization International Clinical Trials Registry Platform (ICTRP). SEARCH STRATEGY: We searched the ICTRP for clinical trials related to acupuncture anesthesia registered between January 1, 2001 and May 31, 2023. Additionally, related publications were retrieved from PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Data. Registrations and publications were analyzed for consistency in trial design characteristics. INCLUSION CRITERIA: Clinical trials that utilized one of several acupuncture-related therapies in combination with pharmacological anesthesia during the perioperative period were eligible for this review. DATA EXTRACTION AND ANALYSIS: Data extracted from articles included type of surgical procedure, perioperative symptoms, study methodology, type of intervention, trial recruitment information, and publication information related to clinical enrollment. RESULTS: A total of 166 trials related to acupuncture anesthesia from 21 countries were included in the analysis. The commonly reported symptoms in the included studies were postoperative nausea and vomiting (19.9%) and postoperative pain (13.3%). The concordance between the publications and the trial protocols in the clinical registry records was poor, with only 31.7% of the studies being fully compatible. Inconsistency rates were high for sample size (39.0%, 16/41), blinding (36.6%, 15/41), and secondary outcome indicators (24.4%, 10/41). CONCLUSION The volume of acupuncture anesthesia clinical trials registered in international trial registries over the last 20 years is low, with insufficient disclosure of results. Postoperative nausea and vomiting as well as postoperative pain, are the most investigated for acupuncture intervention. Please cite this article as: Li Y, Liu YN, Guo Z, Gu ME, Wang WJ, Zhu Y, Zhuang XJ, Chen LM, Zhou J, Li J. Current situation of clinical trial registration in acupuncture anesthesia: A scoping review. J Integr Med. 2025; 23(3): 256-263.
Humans ; Acupuncture Analgesia ; Acupuncture Therapy ; Anesthesia ; Clinical Trials as Topic ; Registries

BACKGROUND: Postoperative pulmonary complications (PPCs) are major adverse events in neurosurgical patients. This study aimed to develop and validate machine learning models predicting PPCs after neurosurgery. METHODS: PPCs were defined according to the European Perioperative Clinical Outcome standards as occurring within 7 postoperative days. Data of cases meeting inclusion/exclusion criteria were extracted from the anesthesia information management system to create three datasets: The development (data of Huashan Hospital, Fudan University from 2018 to 2020), temporal validation (data of Huashan Hospital, Fudan University in 2021) and external validation (data of other three hospitals in 2023) datasets. Machine learning models of six algorithms were trained using either 35 retrievable and plausible features or the 11 features selected by Lasso regression. Temporal validation was conducted for all models and the 11-feature models were also externally validated. Independent risk factors were identified and feature importance in top models was analyzed. RESULTS: PPCs occurred in 712 of 7533 (9.5%), 258 of 2824 (9.1%), and 207 of 2300 (9.0%) patients in the development, temporal validation and external validation datasets, respectively. During cross-validation training, all models except Bayes demonstrated good discrimination with an area under the receiver operating characteristic curve (AUC) of 0.840. In temporal validation of full-feature models, deep neural network (DNN) performed the best with an AUC of 0.835 (95% confidence interval [CI]: 0.805-0.858) and a Brier score of 0.069, followed by Logistic regression (LR), random forest and XGBoost. The 11-feature models performed comparable to full-feature models with very close but statistically significantly lower AUCs, with the top models of DNN and LR in temporal and external validations. An 11-feature nomogram was drawn based on the LR algorithm and it outperformed the minimally modified Assess respiratory RIsk in Surgical patients in CATalonia (ARISCAT) and Laparoscopic Surgery Video Educational Guidelines (LAS VEGAS) scores with a higher AUC (LR: 0.824, ARISCAT: 0.672, LAS: 0.663). Independent risk factors based on multivariate LR mostly overlapped with Lasso-selected features, but lacked consistency with the important features using the Shapley additive explanation (SHAP) method of the LR model. CONCLUSIONS: The developed models, especially the DNN model and the nomogram, had good discrimination and calibration, and could be used for predicting PPCs in neurosurgical patients. The establishment of machine learning models and the ascertainment of risk factors might assist clinical decision support for improving surgical outcomes. TRIAL REGISTRATION ChiCTR 2100047474; https://www.chictr.org.cn/showproj.html?proj=128279 .
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Algorithms ; Lung Diseases/etiology* ; Machine Learning ; Neurosurgical Procedures/adverse effects* ; Postoperative Complications/diagnosis* ; Risk Factors ; ROC Curve

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.

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.

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*

Objective:To explore the efficacy and safety of combining minimally invasive hematoma puncture with urokinase irrigation and continuous drip drainage in patients with spontaneous intracerebral hemorrhage.Methods:A total of 22 patients with spontaneous intracerebral hemorrhage admitted to Department of Functional Neurosurgery, Zhujiang Hospital of Southern Medical University and Department of Neurosurgery of Yuebei People's Hospital from May 2023 to January 2024 were chosen. Using precise localization, a minimally invasive haematoma puncture was used to insert a balloon drainage catheter into the hematoma cord; urokinase irrigation was administered during the procedure, followed by continuous drip drainage postoperatively. A retrospective analysis was performed; their clinical data before and after the procedure were collected; and Glasgow Coma Scale (GCS) score, hematoma residual volume, hematoma evacuation rate and complications were analyzed.Results:In these 22 patients, the residual hematoma volume after intraoperative suction was (20.89±10.74) mL, with a residual rate of (51.86±14.88)%. After the 1 st urokinase injection for continuous drainage, the residual hematoma volume in the 22 patients was (12.72±7.92) mL, with a hematoma evacuation rate of (35.01±30.41)%. After the 2 nd injection, the residual hematoma volume in the 13 patients was (9.48±6.12) mL, with a hematoma evacuation rate of (42.03±20.89)%. After the 3 rd injection, the residual hematoma volume in the 7 patients was (5.84±2.84) mL, with a hematoma evacuation rate of (49.32±11.09)%. After the 4 th injection, the residual hematoma volume in the 3 patients was (3.67±3.79) mL, with a hematoma evacuation rate of (54.44±32.03)%. After the 5 th injection, the residual hematoma volume in the left 1 patient was 5 mL, with a hematoma evacuation rate of 37.50%. Before tube removal, the residual hematoma volume in these 22 patients was (6.73±5.01) mL, with a hematoma evacuation rate of (81.48±13.56)%. During hospitalization, 1 patient experienced postoperative hemorrhage and ultimately died of cardiac arrest; 1 patient developed pulmonary infection after surgery and cured with antibiotics. These patients had GCS scores of 12.23±3.16 at discharge, which was significantly increased than those at admission (9.45±3.19, P<0.05). Conclusion:Minimally invasive hematoma puncture combined with urokinase irrigation and continuous drip drainage is a safe and effective new treatment in spontaneous cerebral hemorrhage.

Objective:To explore the efficacy and safety of combining minimally invasive hematoma puncture with urokinase irrigation and continuous drip drainage in patients with spontaneous intracerebral hemorrhage.Methods:A total of 22 patients with spontaneous intracerebral hemorrhage admitted to Department of Functional Neurosurgery, Zhujiang Hospital of Southern Medical University and Department of Neurosurgery of Yuebei People's Hospital from May 2023 to January 2024 were chosen. Using precise localization, a minimally invasive haematoma puncture was used to insert a balloon drainage catheter into the hematoma cord; urokinase irrigation was administered during the procedure, followed by continuous drip drainage postoperatively. A retrospective analysis was performed; their clinical data before and after the procedure were collected; and Glasgow Coma Scale (GCS) score, hematoma residual volume, hematoma evacuation rate and complications were analyzed.Results:In these 22 patients, the residual hematoma volume after intraoperative suction was (20.89±10.74) mL, with a residual rate of (51.86±14.88)%. After the 1 st urokinase injection for continuous drainage, the residual hematoma volume in the 22 patients was (12.72±7.92) mL, with a hematoma evacuation rate of (35.01±30.41)%. After the 2 nd injection, the residual hematoma volume in the 13 patients was (9.48±6.12) mL, with a hematoma evacuation rate of (42.03±20.89)%. After the 3 rd injection, the residual hematoma volume in the 7 patients was (5.84±2.84) mL, with a hematoma evacuation rate of (49.32±11.09)%. After the 4 th injection, the residual hematoma volume in the 3 patients was (3.67±3.79) mL, with a hematoma evacuation rate of (54.44±32.03)%. After the 5 th injection, the residual hematoma volume in the left 1 patient was 5 mL, with a hematoma evacuation rate of 37.50%. Before tube removal, the residual hematoma volume in these 22 patients was (6.73±5.01) mL, with a hematoma evacuation rate of (81.48±13.56)%. During hospitalization, 1 patient experienced postoperative hemorrhage and ultimately died of cardiac arrest; 1 patient developed pulmonary infection after surgery and cured with antibiotics. These patients had GCS scores of 12.23±3.16 at discharge, which was significantly increased than those at admission (9.45±3.19, P<0.05). Conclusion:Minimally invasive hematoma puncture combined with urokinase irrigation and continuous drip drainage is a safe and effective new treatment in spontaneous cerebral hemorrhage.

Humans ; Multiple Myeloma/genetics* ; Neoplasm, Residual/diagnosis* ; Flow Cytometry ; High-Throughput Nucleotide Sequencing

Objectives: This study sought to describe our institutional experience of repeated percutaneous stellate ganglion blockade (R-SGB) as a treatment option for drug-refractory electrical storm in patients with nonischemic cardiomyopathy (NICM). Methods: This prospective observational study included 8 consecutive NICM patients who had drug-refractory electrical storm and underwent R-SGB between June 1, 2021 and January 31, 2022. Lidocaine (5 ml, 1%) was injected in the vicinity of the left stellate ganglion under the guidance of ultrasound, once per day for 7 days. Data including clinical characteristics, immediate and long-term outcomes, and procedure related complications were collected. Results: The mean age was (51.5±13.6) years. All patients were male. 5 patients were diagnosed as dilated cardiomyopathy, 2 patients as arrhythmogenic right ventricular cardiomyopathy and 1 patient as hypertrophic cardiomyopathy. The left ventricular ejection fraction was 37.8%±6.6%. After the treatment of R-SGB, 6 (75%) patients were free of electrical storm. 24 hours Holter monitoring showed significant reduction in ventricular tachycardia (VT) episodes from 43.0 (13.3, 276.3) to 1.0 (0.3, 34.0) on the first day following R-SGB (P<0.05) and 0.5 (0.0, 19.3) after whole R-SGB process (P<0.05). There were no procedure-related major complications. The mean follow-up was (4.8±1.1) months, and the median time of recurrent VT was 2 months. Conclusion: Minimally invasive R-SGB is a safe and effective method to treat electrical storm in patients with NICM.
Humans ; Male ; Adult ; Middle Aged ; Aged ; Female ; Stroke Volume ; Stellate Ganglion/surgery* ; Ventricular Function, Left ; Cardiomyopathies/complications* ; Tachycardia, Ventricular/therapy* ; Treatment Outcome ; Catheter Ablation