Extracorporeal membrane oxygenation (ECMO) is primarily used in clinical practice to provide continuous extracorporeal respiratory and circulatory support for patients with severe heart and lung failure, thereby sustaining life. It is a key technology for managing severe heart failure and respiratory failure that are difficult to control. With the accumulation of clinical experience in ECMO for circulatory and/or respiratory support, as well as advancements in biomedical engineering technology, more portable and stable ECMO devices have been introduced into clinical use, benefiting an increasing number of critically ill patients. Although ECMO technology has become relatively mature, the timing of ECMO initiation, management of sudden complications, and monitoring and early warning of physiological indicators are critical factors that greatly affect the therapeutic outcomes of ECMO. This article reviews traditional methods and artificial intelligence techniques used in risk assessment related to ECMO, including the latest achievements and research hotspots. Additionally, it discusses future trends in ECMO risk management, focusing on six key areas: multi-center and prospective studies, external validation and standardization of model performance, long-term prognosis considerations, integration of innovative technologies, enhancing model interpretability, and economic cost-effectiveness analysis. This provides a reference for future researchers to build models and explore new research directions.
Extracorporeal Membrane Oxygenation ; Humans ; Artificial Intelligence ; Risk Assessment ; Respiratory Insufficiency/therapy* ; Heart Failure/therapy*

AIM: To explore the neuro-ophthalmological characteristics of acute macular neuroretinopathy(AMN)after SARS-CoV-2 infection.METHODS: A total of 8 patients(14 eyes), including 6 females and 2 males, who were diagnosed with AMN in the neuro-ophthalmology department of Xi'an No.1 Hospital(The First Affiliated Hospital of Northwest University)from December 27, 2022 to February 1, 2023 were included in the study. All patients had a history of SARS-CoV-2 infection before the disease, and the results of best corrected visual acuity(BCVA), non-contact indirect intraocular pressure measurement, fundus color photography, near infrared(IR), spectral-domain optical coherence tomography(SD-OCT), OCT angiography(OCTA), fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA), visual field, visual evoked potential(VEP), and electroretinogram(ERG)were collected. Furthermore, the neuro-opthalmology characteristics of the included patients were analyzed and summarized.RESULTS: The included 8 patients aged from 20 to 43, with an average age of(30±6.63)years old. The patients had a history of SARS-CoV-2 infection 3 to 11(mean 5±3.51)d before the disease, and 6 out of 8 patients developed visual symptoms within 5 d of infection with SARS-CoV-2, with manifestated with decreased vision or visual scotoma. The visual acuity varied from 0.08 to 1.0, with visual field defect characterized by central, paracentral or peripheral scotoma. VEP showed prolongation latency of P100 or P2, and ERG revealed impaired function of retinal photoreceptor cell. In the early stage of the disease, the size and shape of early visual acuity, visual field, and extraretinal lesions in patients with AMN associated with SARS-CoV-2 infection may not match, and the lower the visual acuity, the later the VEP peaks.CONCLUSION: The neuro-ophthalmic features of SARS-CoV-2 infection-associated AMN require the attention of clinicians. In addition to multi-mode fundus imaging, clinicians should use a variety of methods to comprehensively evaluate visual function and prognosis of patients.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

Objective:To study the maximum volume of oral cavity (MVOC) of the young adults with normal occlusion and to explore the correlation of MOVC with the height,weight,mouth opening degree and masticatory efficiency.Methods:100 volunteers with normal occlusion(50 for each sex) were enrolled.MVOC was measured by the maximum water capacity method,the height,weight,degree of mouth opening and masticatory efficiency value of the subjects were measured.Results:The average values of MVOC of the male and female were (117.63±15.31) ml and (92.08±14.06) ml respectively(P<0.01).MVOC was positively correlation with the height(r=0.67,P<0.01),weight(r=0.63,P<0.01),degree of mouth opening(r=0.47,P<0.01) and masticatory efficiency(r=0.45,P<0.01).Conclusion:MVOC is moderate-positively correlated and low-positively correlated with mouth opening degree and masticatory efficiency.

BACKGROUNDIn March 2013, human cases of infection with a novel A (H7N9) influenza virus emerged in China. The epidemic spread quickly and as of 6 May 2013, there were 129 confirmed cases. The purpose of this study was to analyze the epidemiology of the confirmed cases, determine the impacts of bird migration and temperature changes on the H7N9 epidemic, predict the future trends of the epidemic, explore the response patterns of the government and propose preventive suggestions.

METHODSThe geographic, temporal and population distribution of all cases reported up to 6 May 2013 were described from available records. Risk assessment standard was established by analysing the temperature and relative humidity records during the period of extensive outbreak in three epidemic regions in eastern China, including Shanghai, Zhejiang and Jiangsu provinces. Risk assessment maps were created by combining the bird migration routes in eastern China with the monthly average temperatures from May 1993 to December 2012 nationwide.

RESULTSAmong the confirmed cases, there were more men than women, and 50.4% were elderly adults (age >61 years). The major demographic groups were retirees and farmers. The temperature on the days of disease onset was concentrated in the range of 9°C-19°C; we defined 9°C-19°C as the high-risk temperature range, 0°C-9°C or 19°C-25°C as medium risk and <0°C or >25°C as low risk. The relative humidity on the days of disease onset ranged widely from 25% to 99%, but did not correlate with the incidence of infection. Based on the temperature analysis and the eastern bird migration routes, we predicted that after May, the high-risk region would move to the northeast and inland, while after September, it would move back to north China.

CONCLUSIONSTemperature and bird migration strongly influence the spread of the H7N9 virus. In order to control the H7N9 epidemic effectively, Chinese authorities should strengthen the surveillance of migrating birds, increase poultry and environmental sampling, improve live poultry selling and husbandry patterns and move from a "passive response pattern" to an "active response pattern" in focused preventive measures.

Objective To investigate the clinical value of endoscopic biliary stent drainage for obstructive jaundice due to hepatic portal metastatic carcinoma. Methods Patients with obstructive jaundice arising from hepatic portal metastatic carcinoma were selected and treated with consent by plastic endoscopic bile duct stents since 2006. Success rate and survival were evaluated. A total of 38 patients with obstructive jaundice were treated and analyzed. Hepatic portal metastatic carcinoma included 13 cases of liver cancer, 3gallbladder carcinoma, 14 gastric carcinoma, 2 esophageal carcinoma, 1 ileum adenocarcinoma and 5 pancreatic carcinoma. Results Stents were successfully placed in all patients and jaundice rapidly subsided after the endoscopic procedure. Follow-up life span was 92-521 days, mean 264. 42 ± 104. 41 days. During follow-up, biliary stents were replaced in 5 patients in 3-14 months ( mean 8. 6 ± 4. 1 months) because of stent displacment in 1 case, biliary stone obstruction in 2 cases and carcinomatous obstruction in 2 others.Conclusion For patients with obstructive jaundice arising from hepatic portal metastatic carcinoma, endoscopic biliary stent drainage is effective and can prolong life span to some degree.

Objective To evaluate the diagnostic and therapeutic effects of endoscopic retrograde cholangiopancreatography (ERCP) in biliary papillomatosis. Methods Data of 6 patients, who underwent ERCP and diagnosed as biliary papillomatosis from 2000 to 2008, were retrospectively analyzed. Results There were 3 males and 3 females, with the mean age of onset at 72.8 years (range 52-83 years). Recurrent cholangitis and jaundice were common presentations in all patients, with 5 patients having right upper abdominal pain and 3 others exhiting fever and algor. History of partial hepatectomy was observed in 2 patients. Endoscopic findings included dilated papillary orifice with mucin discharge in 5 patients and papillary-occupying lesion in 1 patient. Multiple filling defects in the lumen of the biliary system in dilated common bile duct were detected in all patients, accompanied with extra-hepatic ducts dilatation in 3, right intra-hepatic duct dilatation in 1, and major pancreatic duct dilation in 1. Of 6 patients, 5 underwent multiple ERCP, inclucling stents and endoscopic nasobiliary drainage (ENBD), and have survived for 10-30 months. Another 83-year-old patient underwent palliative endoscopic treatment with balloons, baskets and ENBD, but died of cholangitis 10 days after the procedure. Conclusion This case series reports the typical endoscopic findings of biliary papiliomatosis. For inoperable or postoperative recurrent patients, endoscopic palliative treatment is a safe, convenient and effective procedure.

Objective To evaluate the clinical value of endoscopic palliative stents drainage in patients with unresectable carcinoma at pancreas head.Methods Endoscopic stents placement was Derformed in 197 patients with unresectable pancreas head carcinoma,from August 2003 to August 2007,and the clinieal data was studied retrospectively.Results Bile duct obstruction was present in all patients.in which 126 were accompanied with dilation of distal pancreatic duct,91 with atrophy of pancrea body and tail. Stent placement in pancreatic duct Was performed in 108 patients with a Success rate of 96.4%,and placement in bile duct was performed in all patients with a success rate of 99.0%.In 195 patients with successful stent placement,jaundice dissolved after the procedure.Of 101 patients who had abdominal pain,complete pain alleviation Was achieved in 98,partially alleviation achieved in 3. Serum amylase level increased after the operation in 24 cases,which resumed tO normal value after corresponding managements.All Datients received a lifelong follow-up at mean duration of 373.57±157.35 days,with a longest survival time of 842 days.Conclusion Endoscopic palliative stents drainage is safe and effective in patients with unresectable Dancre.atie carcer,which miight increase survival rate and improve life quality.

Objective To investigate the efficacy, technical tip, safety and complication prevention of combining Neuroform stents and Guglielmi detachable coils for treating acute ruptured giant intracranial aneurysms. Methods Among 10 cases who were diagnosed with giant intracranial aneurysms,Neuroform stents were released for supporting the neck of aneurysms, then micro-catheters were inserted into aneurysms through lumina of stents and coils were implanted. Results All the operations were completed successfully. There was no complication in these cases. The aneurysms were packed totally in 9 cases and partly in 1 case.Eight postoperative cases were followed up by 6 to 17 months. Neither bleeding nor thrombus was found, and all the patients recovered well. Conclusion Combining Neuroform stents and Guglielmi detachable coils for treating acute ruptured giant intracranial aneurysms is a safe and effective method.

OBJECTIVETo study the relationship among p16, genesis, and development of brain gliomas.

METHODSWe detected the deletion and point mutation of p16 exon 2 by PCR-TGGE. Methylation sensitivity ristriction enzyme polymerase chain reaction was used to detect whether methylation is correlated with happening of glioma.

RESULTSp16 homozygous deletion was detected in 14 of 48 gliomas. No deletions were found in low grade gliomas. Of the 48 gliomas, 5 anaplastic gliomas (WHO grade III) and 9 glioblastomas (WHO grade IV) showed homozygous deletion of exon 2 with a deletion rate of 33.33% (5/15) and 50.00% (9/18) respectively. The mutations of 34 gliomas with p16 positive amplification were detected point mutations in two gliomas, in which one was anaplatic glioma and the other was glioblastoma. Six of the 48 gliomas (12.5%) showed exon1 methylations.

CONCLUSIONSp16 may play an important role in genesis of brain glioma. The main alteration of p16 in brain gliomas was homozygous deletion of exon 2, the methylation of p16 exon 1 was subcardinal, however, point mutation was rare. The deletion of p16 was found especially in high grade gliomas, so we could propose that it may be the late event of tumor occurrence.