With the deep integration of tumor diagnosis and treatment technologies and critical care medicine, oncology critical care has emerged as an innovative interdisciplinary field, whose standardized development is crucial for improving the prognosis of cancer patients. Based on complex system theory and incorporating cutting-edge clinical practices, this paper systematically elaborates on five core principles for promoting the high-quality development of oncology critical care: complex system thinking, value-based healthcare, interdisciplinary integration, spatiotemporal holism, and humanistic experience. These five principles provide a top-level design framework for the discipline in terms of conceptual understanding, comprehensive management, developmental paradigms, clinical treatment, and service models. They aim to establish a patient-centered oncology critical care system that balances medical quality and efficiency, ultimately maximizing patient survival benefits across their entire life cycle.

BACKGROUND:High-frequency repetitive transcranial magnetic stimulation has garnered significant attention due to its potential non-invasive benefits in modulating brain function.However,no studies have comprehensively analyzed the current research landscape and development trends of this field from a macroscopic perspective.OBJECTIVE:To explore research hotspots,current trends,and emerging frontiers in the field of high-frequency repetitive transcranial magnetic stimulation through visualized analysis.METHODS:Data were collected from the Web of Science Core Collection database from January 1,2014 to November 15,2024.CiteSpace was used for analyzing publication volume,collaborations among countries/regions,institutions and authors,citation analysis of journals and co-cited literature,as well as disciplinary distribution.Additionally,keyword co-occurrence,clustering,and burst analyses were conducted,and visualized knowledge maps were generated.RESULTS AND CONCLUSION:A total of 860 articles were included.The publication volume of high-frequency repetitive transcranial magnetic stimulation showed an overall upward trend from 2014 to 2022,followed by a decline from 2022 to 2024.China had the highest publication volume,while Ghent University ranked as the most productive institution.Universities acted as the most high-output institutions.Chris Baeken from Ghent University was identified as the most prolific author.Collaboration among leading authors and institutions worldwide remained limited.The main research hotspots in this field were associated with keywords such as depression,stroke,neuropathic pain,and Parkinson's disease.Burst keywords focused on mild cognitive impairment,reflecting a diversification in research directions.The overall research activity in high-frequency repetitive transcranial magnetic stimulation continues to rise,with primary focuses on its clinical applications for psychiatric and neurological disorders,as well as explorations of its underlying mechanisms.Future research may focus on optimizing treatment parameters for targeting different brain regions in clinical applications and expanding its applications and mechanisms across various domains.

BACKGROUND:High-frequency repetitive transcranial magnetic stimulation has garnered significant attention due to its potential non-invasive benefits in modulating brain function.However,no studies have comprehensively analyzed the current research landscape and development trends of this field from a macroscopic perspective.OBJECTIVE:To explore research hotspots,current trends,and emerging frontiers in the field of high-frequency repetitive transcranial magnetic stimulation through visualized analysis.METHODS:Data were collected from the Web of Science Core Collection database from January 1,2014 to November 15,2024.CiteSpace was used for analyzing publication volume,collaborations among countries/regions,institutions and authors,citation analysis of journals and co-cited literature,as well as disciplinary distribution.Additionally,keyword co-occurrence,clustering,and burst analyses were conducted,and visualized knowledge maps were generated.RESULTS AND CONCLUSION:A total of 860 articles were included.The publication volume of high-frequency repetitive transcranial magnetic stimulation showed an overall upward trend from 2014 to 2022,followed by a decline from 2022 to 2024.China had the highest publication volume,while Ghent University ranked as the most productive institution.Universities acted as the most high-output institutions.Chris Baeken from Ghent University was identified as the most prolific author.Collaboration among leading authors and institutions worldwide remained limited.The main research hotspots in this field were associated with keywords such as depression,stroke,neuropathic pain,and Parkinson's disease.Burst keywords focused on mild cognitive impairment,reflecting a diversification in research directions.The overall research activity in high-frequency repetitive transcranial magnetic stimulation continues to rise,with primary focuses on its clinical applications for psychiatric and neurological disorders,as well as explorations of its underlying mechanisms.Future research may focus on optimizing treatment parameters for targeting different brain regions in clinical applications and expanding its applications and mechanisms across various domains.

In current clinical practice, various dermal templates and skin substitutes are used to enhance wound healing. However, the role of wound commensal microbiome in regulating scaffold performance and the healing process remains unclear. In this study, we investigated the influence of both natural and synthetic scaffolds on the wound commensal microbiome and wound repair in three distinct models including diabetic wounds, burn injuries, and germ-free (GF) wounds. Remarkably, synthetic electrospun polycaprolactone (PCL) scaffolds were observed to positively promote microbiome diversity, leading to enhanced diabetic wound healing compared to the natural scaffolds Integra® (INT) and MatriDerm® (MAD). In contrast, both natural and synthetic scaffolds exhibited comparable effects on the diversity of the microbiome and the healing of burn injuries. In GF wounds with no detectable microorganisms, a reversed healing rate was noted showing natural scaffold (MAD) accelerated wound repair compared to the open or the synthetic scaffold (PCL) treatment. Furthermore, the response of the wound commensal microbiome to PCL scaffolds appears pivotal in promoting anti-inflammatory factors during diabetic wound healing. Our results emphasize that the wound commensal microbiome, mediated by different scaffolds plays an important role in the wound healing process.

OBJECTIVE To explore the clinical characteristics of bronchial asthma with secondary pulmonary infec-tions in children and compare the expressions of transcriptomes in peripheral blood between the bronchial asthma with secondary pulmonary infections and the bronchial asthma without the secondary pulmonary infections.METHODS The clinical data were collected from 425 children with bronchial asthma who were treated in respirato-ry medicine department of Children's Hospital of Anhui Province from Apr.2022 to Feb.2025 and were retrospec-tively analyzed.The enrolled children were divided into the infection group with 60 cases and the non-infection group with 365 cases according to the status of complication with pulmonary infections.The clinical characteristics were compared between the infection group and the non-infection group.The gene expression profile sequencing was carried out for peripheral blood mononuclear cells by transcriptome high throughput technology,and the bio-logical information was analyzed.RESULTS There were significant differences in course of asthma,frequencies times of acute attack,complication with nasosinusitis or allergic rhinitis,standardized use of antibiotics and intra-venous use of glucocorticoids between the two groups of children(P＜0.05).Totally 60 children had secondary pulmonary infections,with the infection rate 14.12％.Totally 73 strains of pathogens were isolated,43.84％of which were gram-positive bacteria,and 56.16％were gram-negative bacteria.As compared with the non-infection group,there were 1578 genes with the changed expression in the infection group,and the expressions of the genes such as nuclear factor κB were upregulated.The differentially expressed genes were primarily enriched in immuno-regulation-related pathways,including proinflammatory factor signal transduction,interacted networks of cyto-kines and its receptors,T lymphocyte activation signal transduction and other biological processes.CONCLUSION The specific clinical characteristics and abnormal immune pathways may jointly result in the pulmonary infec-tions in children with the asthma and provide theoretical bases for early identification of the children at high risk of pneumonia and targeted intervention.

Objective:To evaluate the diagnostic efficacy of B-type natriuretic peptide(BNP)combined with the Evaluation of Guidelines in Syncope Study(EGSYS)score for cardiogenic syncope(CS), and to provide evidence for rapid clinical identification of high-risk patients.Methods:We retrospectively analyzed 366 patients with syncope hospitalized in the department of cardiovascular medicine of Beijing Hospital from January 1, 2016, to December 31, 2022.Based on the international guideline diagnostic criteria, the patients were categorized into four groups: neutrally mediated reflex syncope(NMS)group, orthostatic hypotension(OH)group, cardiogenic syncope(CS)group, and syncope of unknown origin(US)group.BNP levels were measured at admission and EGSYS scores were calculated.Receiver operating characteristic(ROC)curve analysis was performed to assess the diagnostic efficacy of individual and combined indices for CS.Results:A total of 366 syncope patients were included, among which 70 patients(19.1%)were diagnosed with NMS, 25 patients(6.8%)with OH, 44 patients(12.0%)with CS, and 227 patients(62.0%)with US.Patients in the CS group had significantly higher BNP levels and EGSYS scores compared to those in the NMS, OH, and US groups(all P<0.001). The AUC of EGSYS score for diagnosing CS was 0.783(95% CI: 0.711-0.855), while the AUC of BNP level for diagnosing CS was 0.805(95% CI: 0.727-0.884). When BNP level was combined with EGSYS score, diagnostic performance was significantly improved, with the AUC increasing to 0.855(95% CI: 0.792-0.918). Conclusions:The combination of BNP and EGSYS score significantly can improve the diagnostic accuracy of cardiogenic syncope, providing a practical diagnostic strategy for the early identification of high-risk syncope patients in clinical practice.

Objective To explore the mechanism of regulating miR-532-3p with Yiqi Huayu Decoction to improve adriamycin cardiotoxicity.Methods Totally 25 rats were randomly divided into control group,model group and Yiqi Huayu Decoction low-,medium-and high-dosage groups,with 5 rats in each group.Myocardial injury model was established by intraperitoneal injection of adriamycin 2.5 mg/kg once a week for 8 weeks in model group and Yiqi Huayu Decoction low-,medium-and high-dosage groups.At the same time,Yiqi Huayu Decoction low-,medium-and high-dosage groups were given 2,4,8 g/kg Yiqi Huayu Decoction by gavage respectively,once a day for consecutive 8 weeks.Cardiac function of rats was detected by echocardiography,serum NT-proBNP content was detected by ELISA,morphology of myocardial tissue were observed by HE staining,apoptosis of myocardial tissue was detected by TUNEL staining,miR-532-3p gene expression was detected by RT-qPCR,Western blot was used to detect the expressions of GATA4 and CARP protein.Results Compared with the control group,the left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD)of the model group increased significantly,the left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)significantly decreased(P＜0.05),and the serum NT-proBNP content significantly increased(P＜0.05),with severe hypertrophy and disordered arrangement of myocardial cells,fibroblast proliferation accompanied by necrosis,and significantly increased apoptosis rate of myocardial cells(P＜0.05),the expression of miR-532-3p gene in myocardial tissue significantly increased(P＜0.05),and the expressions of GATA4 and CARP proteins in myocardial tissue significantly increased(P＜0.05).Compared with the model group,Yiqi Huayu Decoction high-dosage group showed a significant decrease in LVESD and LVEDD(P＜0.05),with LVEF and LVFS significantly increased(P＜0.05),the content of serum NT-proBNP in Yiqi Huayu Decoction low-,medium-and high-dosage groups were significantly decreased(P＜0.05),and myocardial cell damage and fibrosis were improved to varying degrees,the apoptosis rate of myocardial cells was significantly decreased(P＜0.05),the expression of miR-532-3p gene in myocardial tissue decreased(P＜0.05),and the expressions of GATA4 and CARP proteins in myocardial tissue decreased(P＜0.05).Conclusion Yiqi Huayu Decoction can antagonize doxorubicin cardiotoxicity,and its possible mechanism may be related to regulating miR-532-3p to inhibit myocardial fibrosis.

Objective:To explore the safety and efficacy of intraosseous regional administration (IORA) of vancomycin for preventing infection in primary total knee arthroplasty (TKA).Methods:A total of 124 patients with knee osteoarthritis undergoing TKA between February 2024 and May 2024 at nine hospitals were enrolled. Preoperative infection prophylaxis involved either IORA (0.5 g vancomycin administered via intraosseous regional infusion before incision) or intravenous infusion (1 g vancomycin via peripheral vein). The IORA group included 15 males and 47 females with a median age of 66.5 years (range, 60.0-70.0 years), while the intravenous group included 14 males and 48 females with a median age of 66.0 years (range, 61.8-70.3 years) years. Intraoperative samples were collected including fat and synovium tissues after incision, before prosthesis placement, and after tourniquet release; distal femoral cancellous bone during femoral osteotomy; proximal tibial cancellous bone during tibial osteotomy; proximal intercondylar cancellous bone before prosthesis placement; and peripheral blood from non-infused arms at surgery initiation and after tourniquet release. Vancomycin concentrations were measured using liquid chromatography-tandem mass spectrometry. Vital sign changes were recorded from admission to 5~10 minutes post-IORA (IORA group) or post-incision (intravenous group). Follow-ups were conducted on postoperative day 1 and 3, and at 1 and 3 months, to document complications including IORA-related adverse events, periprosthetic joint infections, surgical site infections, red man syndrome, acute kidney injury, deep vein thrombosis and so on.Results:Vancomycin concentrations in bone, fat, and synovial tissue samples were significantly higher in the IORA group than in the intravenous group ( P<0.05), while vancomycin concentrations in blood samples were significantly lower in the IORA group than in the intravenous group ( P<0.05). Only 7.3%(41/558) of tissue samples in the IORA group had vancomycin concentrations below 2.0 μg/g (the minimum inhibitory concentration of vancomycin against coagulase-negative staphylococcus), compared to 59.3%(331/558) in the intravenous group (χ 2=11.285, P<0.001). In the intravenous group, 16.9%(21/124) of blood samples had vancomycin concentrations exceeding 15.0 mg/L (the threshold associated with a significantly increased risk of nephrotoxicity), while all concentrations in the IORA group were below this threshold, the difference was statistically significant (χ 2=22.943, P<0.001). There were no statistically significant difference ( P>0.05) in vital signs changes before and after vancomycin administration between the two groups. Two patients in the intravenous group experienced incision exudate, while no other related complications occurred in either group. Conclusions:Compared to the traditional intravenous infusion of 1 g vancomycin, intraosseous injection of a low dose (0.5 g) of vancomycin achieves higher local tissue concentrations in the knee joint with a lower incidence of adverse reactions and is safe for infection prophylaxis. Despite guidelines not recommending the routine use of vancomycin for preventing infection after primary TKA, intraosseous injection of 0.5 g vancomycin may be considered intraoperatively for primary TKA in the following scenarios: patients in medical institutions with a high prevalence of methicillin-resistant staphylococcus aureus (MRSA) infections, patients with potential preoperative MRSA colonization, or patients with cephalosporin allergy.

This report described the multidisciplinary management of a preterm infant with congenital tracheal agenesis (TA). The infant, delivered via cesarean section at 32 +5 weeks' gestation, had Apgar scores of 6 and 8 at 1 and 5 minutes, respectively. Although skin color improved after 30 seconds of bag-mask ventilation, the infant exhibited no cry, weak spontaneous breathing, and failed multiple intubation attempts. The patient was transferred to Anhui Children's Hospital of Fudan University under continuous bag-mask positive-pressure ventilation at 3 hours after birth (September 10, 2024). Combined imaging and fiberoptic bronchoscopy confirmed TA (Floyd type Ⅱ/Faro type C) with multiple anomalies, including duodenal atresia, aortic coarctation, and butterfly vertebrae. Whole-genome sequencing revealed a suspected mosaic SCN2A c.5317G>A variant (wild-type parents) and an ERCC5 c.2974C>T heterozygous variant inherited from the mother (homozygous). Following esophageal intubation, invasive mechanical ventilation, and continuous gastrointestinal decompression, respiratory distress significantly improved with a stabilized condition. The infant died 30 hours after birth following treatment withdrawal.

Objective To investigate the mechanism by which Yangmai Tongluo formula improves microcirculation disorders induced by high homocysteine(Hcy)levels via regulation of the acid sphingomyelinase(ASM)and endoplasmic reticulum(ER)stress pathways.Methods Fifty male C57BL/6J mice were divided randomly into a control group,Hcy model group,Yangmai Tongluo formula low-/high dose groups(5.3,10.4 g/kg,respectively),and a folic acid group(0.08 g/kg).Except for the control group,microcirculation disorders were induced in all mice using drinking water containing 1.8 g/L Hcy for 6 weeks.After modeling for 2 weeks,mice were administered the corresponding treatments by gavage for 4 weeks.Serum Hey concentrations and the blood perfusion volume of the lower extremity microvessels were measured.Protein expression levels of zonula occludens ZO-1,ZO-2,intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),ASM,glucose-regulated protein 78(GRP78),and C/EBP homologous protein(CHOP)in the cardiac microvascular endothelium were analyzed using immunofluorescence.Results Serum Hcy levels were significantly increased in the Hcy model group compared with the control group(P＜0.05).Yangmai Tongluo formula did not significantly reduce Hey levels compared with the Hey model group,but blood perfusion in the lower extremities was significantly increased(P＜0.01)and expression levels of ZO-1 and ZO-2 in the cardiac microvascular endothelium were restored(P＜0.001)in the Yangmai Tongluo formula high dose group.It also inhibited the expression of ICAM-1,VCAM-1,ASM,GRP78,and CHOP(P＜0.05),with comparable effects to folic acid.Conclusions Yangmai Tongluo formula improves Hcy-induced microcirculation disorders and endothelial dysfunction by inhibiting ASM activity and alleviating ER stress,via a mechanism closely related to the regulation of endothelial inflammation and barrier stability.These result provide experimental evidence to support the use of traditional Chinese medicine to treat microvascular diseases.