The learning and inferencing capabilities of large language models(LLMs)that underlie generative artificial intelligence(GenAI)can be exploited to optimize cancer treatments and improve patient outcomes.The ability of...The learning and inferencing capabilities of large language models(LLMs)that underlie generative artificial intelligence(GenAI)can be exploited to optimize cancer treatments and improve patient outcomes.The ability of these models to learn from large amounts of clinical,molecular,and radiomic data on cancer patients and their treatments is driving research interest in their application to treatment decision-making.The learning and predictive power of LLMs make them uniquely suitable for supporting adaptive cancer therapy.However,the clinical validation of GenAI support for clinical decisions in oncology needs to address the complexity and unique challenges of GenAI clinical interventions.The United States Food and Drug Administration(FDA)guidelines on the clinical evaluation of software as a medical device(SaMD)are explored as a basis for the clinical evaluation of GenAI-assisted adaptive cancer therapy.Metrics are proposed to address clinical associations and analytical validation along with an outlook on randomized clinical trials.This article provides a much-needed and timely perspective on the clinical evaluation of GenAI-assisted cancer treatments and provides insights into overcoming the inherent challenges of GenAI in its acceptance and adoption in real-world clinical settings.展开更多
Objective To investigate the prevalence and clinical significance of the centromere protein-F-like(CENP-F-like)immunofluorescence staining pattern in a large patient cohort and through literature review.Methods We ret...Objective To investigate the prevalence and clinical significance of the centromere protein-F-like(CENP-F-like)immunofluorescence staining pattern in a large patient cohort and through literature review.Methods We retrospectively analyzed antinuclear antibody(ANA)immunofluorescence assay results from 191274 patients at West China Hospital of Sichuan University between March 2018 and November 2020.Specific immunological markers were tested in sera with CENP-F-like patterns.Additionally,a narrative review of seven relevant studies was performed for comparison.Results In Southwest China,ANA positivity was found in 32.09%of patients,with the CENP-F-like pattern detected in 0.015%of all cases and 0.05%of ANA-positive individuals.The CENP-F-like pattern appeared predominantly at titers≥1∶320,most often in isolation(68.97%),but also mixed with cytoplasmic speckled patterns.Patients with cancers accounted for the highest proportion(31.03%),including solid tumors and hematologic malignancies.Metastasis was observed in patients with solid tumors,while graft-versus-host disease(GVHD)occurred in those with hematologic malignancies post-transplantation.Autoimmune diseases(AIDs)were diagnosed in 20.69%of cases,all showing disease-specific autoantibodies.These findings were broadly consistent with previous reports and suggest a possible association between the CENP-F-like pattern and malignancies.Conclusion The CENP-F-like pattern is rare in ANA tests but may be associated with clinically important conditions,particularly cancers and AIDs.The occurrence of metastasis and GVHD in patients with this pattern highlights its potential clinical relevance,and concurrent autoantibodies may assist in diagnosing AIDs.展开更多
Objectives This study aimed to analyse the benefits of a gamified clinical supervision strategy during hospital-based training,particularly regarding the development of critical and reflective thinking among undergrad...Objectives This study aimed to analyse the benefits of a gamified clinical supervision strategy during hospital-based training,particularly regarding the development of critical and reflective thinking among undergraduate nursing students.Methods From April to July 2023,second-year nursing students who undertaking a nine-week clinical placement in a cardiology ward in northern Portugal were selected.Following a two-week diagnostic phase,students participated in a six-week gamified supervision programme comprising weekly 60-min sessions:infection-control decision-making;technical-procedural reasoning;guided emotional and ethical reflection;and clinical reasoning quiz on cardiology topics.Students completed weekly Structured Reflection Guide entries;supervisors recorded structured field notes after each session;and,after the intervention,students answered a post-intervention questionnaire and participated in focus groups.Qualitative data(reflections,field notes,open-ended questionnaire items,and focus-group transcripts)were analyzed using Bardin’s content analysis;quantitative questionnaire items were summarized descriptively.Results All seven students completed the six gamified sessions and submitted weekly reflection entries.Five students(71.4%)completed the questionnaire.Across data sources,students reported that gamified activities supported knowledge consolidation,teamwork,and clinical reasoning.Questionnaire data showed that all respondents(n=5,100%)strongly agreed that gamification enhanced their learning and should be maintained in clinical training.Reflections and focus groups revealed recurring themes related to emotional expression,sense of belonging,and difficulties using structured reflection tools,particularly in terms of comprehension and timing.Conclusion The gamified supervision strategy integrated into clinical training provided structured opportunities for practical engagement,collaborative work,and guided reflection.These findings suggest that gamification may support the development of reflective and critical-thinking processes in authentic clinical environments.展开更多
Objective:For patients with hypertension complicated with diabetes mellitus,their health risks are not a simple sum but present complex interactive effects.Clarifying the clinical characteristics of such patients is t...Objective:For patients with hypertension complicated with diabetes mellitus,their health risks are not a simple sum but present complex interactive effects.Clarifying the clinical characteristics of such patients is the key to solving this medical problem.Methods:From June 2023 to June 2024,this study conducted a comparative study on 100 patients with hypertension complicated with diabetes mellitus and 100 patients with hypertension alone.By retrospectively analyzing clinical data of patients,the differences in disease manifestations,complication occurrence,and treatment effects between the two groups were explored in depth,and the unique challenges and treatment difficulties faced by patients with hypertension complicated with diabetes mellitus were identified.Results:Hypertensive patients with concurrent diabetes had more difficult blood glucose and blood pressure control,and were more prone to severe complications such as cardiovascular lesions and renal damage.Conclusion:The clinical characteristics and treatment needs of patients with hypertension complicated with diabetes mellitus are different from those with hypertension alone,and disease management should be more refined and personalized.展开更多
Background:Artificial intelligence medical diagnostic devices(AIMDDs)show strong potential but face barriers to clinical use,emphasizing the need for rigorous clinical research.Objective:We assessed current AIMDD rese...Background:Artificial intelligence medical diagnostic devices(AIMDDs)show strong potential but face barriers to clinical use,emphasizing the need for rigorous clinical research.Objective:We assessed current AIMDD research,key challenges,and future directions.Methods:A scoping review followed Arksey and O'Malley's methodological framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.PubMed,Web of Science Core Collection,and the Cochrane Database of Systematic Reviews(January 2020-December 2024)were searched on AIMDD design,implementation,and evaluation.Two independent researchers screened and extracted data from the literature using predefined criteria.Results:Ninety-seven articles met the inclusion criteria.Machine learning and deep learning approaches dominated across diverse disease fields,with oncology being the most frequent(41%).The key challenges identified include insufficient quantity,quality,representativeness,and diversity of data;research designs that do not adequately address clinical needs;poor patient selection;poorly defined gold standards;lack of external and prospective validation;and a disconnect between validation strategies and clinical practice.Additionally,issues such as the“black box”phenomenon,overfitting,and data privacy concerns hinder clinical translation.Completeness and standardization of reporting were also found to be lacking.Conclusions:Significant challenges remain in the development and clinical application of AIMDD.To facilitate their clinical translation,improvements are needed in dataset optimization,clinically driven research design,development of evaluation frameworks,enhanced interpretability,and standardized reporting and validation of algorithms.展开更多
Portable ratiometric fluorescent platforms have emerged as promising tools for multifarious detection,yet remain unexplored for point-of-care monitoring doxorubicin(DOX),one of clinically antineoplastic drugs.To this ...Portable ratiometric fluorescent platforms have emerged as promising tools for multifarious detection,yet remain unexplored for point-of-care monitoring doxorubicin(DOX),one of clinically antineoplastic drugs.To this end,we herein develop a portable self-calibrating platform namely carbon dots(C-dots)-embedded hydrogel sensors with a smartphone-assisted high-throughput imaging device,for DOX sensing.The prepared green-emitting(λ_(em)=508 nm)and negatively-charged C-dots(−11.40±1.21 mV),which have sufficient spectral overlap with the absorption band of DOX(∼500 nm),can strongly bind with positively-charged DOX molecules by electrostatic attraction effects.As a result,DOX molecules are selectively and rapid(20 s)determined with a detection limit of 10.26 nmol/L via Förster resonance energy transfer processes,demonstrating a remarkably chromatic shift from green to red.Further integrated with a 3D-printed smartphone-assisted device,the platform enabled high-throughput quantification,achieving recoveries of 96.40%-101.85%in human urine/serum(RSDs<2.94%,n=3).Notably,the dual linear detection ranges of the platform align with the reported clinical DOX concentrations in urine and plasma(0-4 h post-administration),validating their capability for direct quantification of DOX in clinical samples without special pre-treatment processes.By virtue of attractive analytical performances and robust feasibility,this platform bridges laboratory precision and point-of-care testing needs,offering promising potential for personalized chemotherapy and multiplexed analyte screening.展开更多
[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to t...[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to two tertiary hospitals in Jingzhou City between March and August 2024 were collected.Patients were randomly divided into three groups:<3-year-old,3—17-year-old,and≥18-year-old.A retrospective analysis was performed on their clinical features(including laboratory findings,disease course,and imaging characteristics)and epidemiological characteristics.[Results]In the<3-year-old group,28 cases(36.4%)were unvaccinated and 22 cases(28.6%)had received only one dose of the pertussis vaccine.In the 3—17-year-old group,91 cases(94.8%)had received four doses.Vaccination history was unknown for the≥18-year-old adult group.The<3-year-old group exhibited significantly higher incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the 3—17-year-old and≥18-year-old groups.Post-tussive vomiting was less frequent in the<3-year-old group than in the 3—17-year-old group but more frequent than in the≥18-year-old group;these differences were statistically significant(P<0.05).The≥18-year-old group had significantly lower incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the<3-year-old and 3—17-year-old groups(P<0.05).The proportion of cases with pneumonia and increased lung markings was higher in the<3-year-old group than in the 3—17-year-old group but lower than in the≥18-year-old group,showing statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was lower in the<3-year-old group than in both the 3—17-year-old and≥18-year-old groups,and these differences were also statistically significant(P<0.05).The proportion of pneumonia cases in the 3—17-year-old group was lower than in both the<3-year-old and≥18-year-old groups.The proportion of cases with increased lung markings was lower than in the<3-year-old group but higher than in the≥18-year-old group;these differences were statistically significant(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci in the 3—17-year-old group was higher than in the<3-year-old group but lower than in the≥18-year-old group,with statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was higher in the≥18-year-old group than in both the<3-year-old and 3—17-year-old groups,and these differences were also statistically significant(P<0.05).[Conclusions]Analysis of the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City contributes to enhancing the prevention and control of pertussis within the city.展开更多
The convergence of artificial intelligence(AI)and big data is reshaping contemporary oncology by enabling the integration of multimodal information across imaging,pathology,genomics,and clinical records.From a physici...The convergence of artificial intelligence(AI)and big data is reshaping contemporary oncology by enabling the integration of multimodal information across imaging,pathology,genomics,and clinical records.From a physician-centered perspective,these technologies can potentially be used to improve diagnostic precision,support individualized treatment planning,enhance longitudinal patient management,and accelerate both clinical and translational research.In this review,we synthesize the core AI methodologies most relevant to oncology-machine learning,deep learning,and large language models-and examine how they interact with established and emerging oncology data platforms.We further highlight practical use cases in clinical workflows and research pipelines,emphasizing opportunities for advancing precision cancer care while also addressing challenges associated with data heterogeneity,model generalizability,privacy protection,and real-world implementation.By underscoring the synergistic value of AI and big data,this review aims to inform the development of clinically meaningful,context-adapted strategies that promote translational innovation in both global and locally resourced healthcare environments.展开更多
While conventional FISH and IHC methods struggle to decode complex tissue heterogeneity and comprehensive molecular diagnosis due to low-throughput spatial information,spatial omics technologies enable high-throughput...While conventional FISH and IHC methods struggle to decode complex tissue heterogeneity and comprehensive molecular diagnosis due to low-throughput spatial information,spatial omics technologies enable high-throughput molecular mapping across tissue microenvironments.These technologies are emerging as transformative tools in molecular diagnostics and medical research.By integrating histopathological morphology with spatial multi-omics profiling(genome,transcriptome,epigenome,and proteome),spatial omics technologies open an avenue for understanding disease progression,therapeutic resistance mechanisms,and precise diagnosis.It particularly enhances tumor microenvironment analysis by mapping immune cell distributions and functional states,which may greatly facilitate tumor molecular subtyping,prognostic assessment,and prediction of the radiotherapy and chemotherapy efficacy.Despite the substantial advancements in spatial omics,the translation of spatial omics into clinical applications remains challenging due to robustness,efficacy,clinical validation,and cost constraints.In this review,we summarize the current progress and prospects of spatial omics technologies,particularly in medical research and diagnostic applications.展开更多
Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate...Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate diagnosis difficult in routine clinical practice.Misdiagnosis may lead to inappropriate treatment strategies,increased psychological and physical burdens,reduced quality of life,and impaired social functioning.Genetic overlap may partially explain the clinical similarities between MDD and BD-Ⅱ,and biomarkers along with neuroimaging techniques are receiving increasing attention as tools to aid in diagnosis.For example,electroencephalography has been shown to effectively distinguish between unipolar depression and bipolar depression;serum levels of glycogen synthase kinase-3 have also been investigated as a potential tool for differentiating between the two disorders.A comprehensive assessment integrating clinical characteristics,genetic basis research,and multimodal evaluations using neuroimaging and biomarkers through a multidisciplinary approach will help enhance clinicians'ability to distinguish between MDD and BD-Ⅱ.By improving diagnostic accuracy,more personalized and effective treatment strategies can be developed,ultimately improving patients'health outcomes and quality of life.展开更多
Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was ...Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was conducted with 190 clinical nurses recruited from an oncology hospital in Central Vietnam.The self-administered Evidence-Based Practice Questionnaire(EBPQ)was employed to assess the nurses'knowledge/skills,attitudes,and implementation of EBP.Data analysis utilized descriptive statistics,the Mann-Whitney test,the Kruskal-Wallis test,and Spearman's rho correlation.Results:The mean total score for EBP implementation among the nurses was 29.52(SD=7.14)out of 42 scores.The most frequently undertaken activity was sharing evidence with colleagues,whereas finding relevant evidence was the least performed.The level of EBP implementation significantly varied based on the nurses'role types and their participation in related courses(P<0.05).Moreover,a strong positive correlation was observed between EBP implementation and both knowledge/skills(r=0.703,P<0.001)and attitudes toward EBP(r=0.536,P<0.001).Conclusions:The implementation of EBP by oncology nurses is generally moderate and is significantly positively correlated with their knowledge/skills and attitudes toward EBP.These findings underscore the importance of enhancing educational programs and facilitating suppor tive institutional policies to fur ther encourage the adoption of EBP among nurses.展开更多
AIM:To investigate the clinical features and prognosis of patients with orbital inflammatory myofibroblastic tumor(IMT).METHODS:This retrospective study collected clinical data from 22 patients diagnosed with orbital ...AIM:To investigate the clinical features and prognosis of patients with orbital inflammatory myofibroblastic tumor(IMT).METHODS:This retrospective study collected clinical data from 22 patients diagnosed with orbital IMT based on histopathological examination.The patients were followed up to assess their prognosis.Clinical data from patients,including age,gender,course of disease,past medical history,primary symptoms,ophthalmologic examination findings,general condition,as well as imaging,laboratory,histopathological,and immunohistochemical results from digital records were collected.Orbital magnetic resonance imaging(MRI)and(or)computed tomography(CT)scans were performed to assess bone destruction of the mass,invasion of surrounding tissues,and any inflammatory changes in periorbital areas.RESULTS:The mean age of patients with orbital IMT was 28.24±3.30y,with a male-to-female ratio of 1.2:1.Main clinical manifestations were proptosis,blurred vision,palpable mass,and pain.Bone destruction and surrounding tissue invasion occurred in 72.73%and 54.55%of cases,respectively.Inflammatory changes in the periorbital site were observed in 77.27%of the patients.Hematoxylin and eosin staining showed proliferation of fibroblasts and myofibroblasts,accompanied by infiltration of lymphocytes and plasma cells.Immunohistochemical staining revealed that smooth muscle actin(SMA)and vimentin were positive in 100%of cases,while anaplastic lymphoma kinase(ALK)showed positivity in 47.37%.The recurrence rate of orbital IMT was 27.27%,and sarcomatous degeneration could occur.There were no significant correlations between recurrence and factors such as age,gender,laterality,duration of the disease,periorbital tissue invasion,bone destruction,periorbital inflammation,tumor size,fever,leukocytosis,or treatment(P>0.05).However,lymphadenopathy and a Ki-67 index of 10%or higher may be risk factors for recurrence(P=0.046;P=0.023).CONCLUSION:Orbital IMT is a locally invasive disease that may recur or lead to sarcomatoid degeneration,primarily affecting young and middle-aged patients.The presence of lymphadenopathy and a Ki-67 index of 10%or higher may signify a poor prognosis.展开更多
“By successfully integrating artificial intelligence(AI)into research workflows,researchers could substantially increase scientific productivity”[1].In biofabrication,AI is dr iving a paradigm shift from empiricism ...“By successfully integrating artificial intelligence(AI)into research workflows,researchers could substantially increase scientific productivity”[1].In biofabrication,AI is dr iving a paradigm shift from empiricism toward intelligen t,data centric manufacturing[2].By integrating computation,automation,and biology,AI gives rise to self-evolving,adaptive systems that learn from data,predict complex behaviors,and autonomously optimize fabrication outcomes.Such systems translate experimental insights into patient-specific and clinically relevant solutions,bridging laboratory research and regenerative therapies[3].This emerging frontier is rapidly advancing from concept to application.This Special Column highlights how AI-driven advanc es in materials,design,and manufacturing are reshaping biof abrication for regenerative medicine and clinical translation.展开更多
Dear Editor,The National Health Commission(NHC)of China has championed the creation of weight management clinics to confront the growing crisis of overweight and obesity.Forecasts indicate that by 2030,the prevalence ...Dear Editor,The National Health Commission(NHC)of China has championed the creation of weight management clinics to confront the growing crisis of overweight and obesity.Forecasts indicate that by 2030,the prevalence of these conditions among Chinese adults and children could climb to 70.5%and 31.8%,respectively[1].This troubling trajectory,alongside an increasing burden of chronic illnesses such as diabetes,hypertension,and cardiovascular diseases,underscores the need for immediate action.Instead of focusing solely on weight management clinics,we propose that medical institutions prioritize the establishment of comprehensive chronic disease management clinics,building upon the foundation of weight management clinics to holistically address obesity,aging,and healthcare system challenges.展开更多
Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal ...Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.展开更多
Due to the special anatomical location,complex functions,and significant impact on patients’appearance and psychology,the treatment of oral and maxillofacial tumors has always been a key and difficult issue in the fi...Due to the special anatomical location,complex functions,and significant impact on patients’appearance and psychology,the treatment of oral and maxillofacial tumors has always been a key and difficult issue in the field of head and neck surgery.With the rapid development of surgical technology,microsurgical reconstruction technology,perioperative management,and multidisciplinary treatment models,surgical treatment has occupied a core position in the comprehensive treatment system of oral and maxillofacial tumors.Based on this,this paper conducts research on the clinical outcomes of surgical treatment for patients with oral and maxillofacial tumors,expounds the optimization strategies of surgical treatment,and analyzes the clinical effects of the optimized surgical treatment,aiming to provide a reference for the clinical treatment of oral and maxillofacial tumors.展开更多
Iron deficiency anemia affects approximately 1.62 billion people worldwide,yet traditional iron supplements present bioavailability limitations and gastrointestinal side effects.This randomized,double-blind clinical t...Iron deficiency anemia affects approximately 1.62 billion people worldwide,yet traditional iron supplements present bioavailability limitations and gastrointestinal side effects.This randomized,double-blind clinical trial investigated a novel Auricularia auricula polysaccharide-iron complex(AAPIC)compared with heme iron and ferrous glycinate in 180 iron-deficient adults receiving 30 mg elemental iron daily for 12 weeks.AAPIC achieved comparable hemoglobin improvements(from 98.3±8.7 to 126.5±9.2 g/L)to heme iron(from 97.8±9.1 to 128.3±8.6 g/L)and was significantly superior to ferrous glycinate(from 98.6±8.9 to 119.7±10.3 g/L;p<0.001).Iron absorption efficiency showed AAPIC at 23.7±4.2%,heme iron at 25.1±3.8%,and ferrous glycinate at 18.4±5.1%.Toxicological assessments revealed no hepatotoxicity,nephrotoxicity,or mutagenicity.Gastrointestinal adverse events occurred in 8.3%of AAPIC recipients versus 15.0%with ferrous glycinate and 10.0%with heme iron.The polysaccharide component facilitates iron transport through enhanced intestinal uptake mechanisms.AAPIC represents a promising,well-tolerated alternative with clinical efficacy comparable to established iron formulations.展开更多
BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges f...BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges from nonoperative methods to surgical interventions such as intramedullary K-wires,which promote faster rehabilitation and improved elbow mobility.AIM To evaluate the outcomes of managing humeral shaft fractures using closed reduction and internal fixation with flexible intramedullary K-wires.METHODS This was a retrospective cohort study analyzing the medical records of patients with humeral shaft fractures managed with flexible intramedullary K-wires at King Abdulaziz Medical City,using non-random sampling and descriptive analysis for outcome evaluation.RESULTS This study assessed the clinical outcomes of 20 patients treated for humeral shaft fractures with intramedullary K-wires.Patients were predominantly male(n=16,80%),had an average age of 39.2 years,and a mean body mass index of 29.5 kg/m^(2).The fractures most frequently occurred in the middle third of the humerus(n=14,70%),with oblique fractures being the most common type(n=7,35%).All surgeries used general anesthesia and a posterior approach,with no intraoperative complications reported.Postoperatively,all patients achieved clinical and radiological union(n=20,100%),and the majority(n=13,65%)reached an elbow range of motion from 0 to 150 degrees.CONCLUSION These results suggest that intramedullary K-wire fixation may be an effective option for treating humeral shaft fractures,with favorable outcomes in range of motion recovery,fracture union,and a low rate of intraoperative complications.展开更多
Ganmai Dazao Decoction,originating from“Jin Gui Yao Lue”(Synopsis of the Golden Chamber),is a classical prescription for treating visceral agitation.Composed of three medicinal and edible substances-licorice(Gancao)...Ganmai Dazao Decoction,originating from“Jin Gui Yao Lue”(Synopsis of the Golden Chamber),is a classical prescription for treating visceral agitation.Composed of three medicinal and edible substances-licorice(Gancao),wheat(Xiaomai),and jujube(Dazao),it functions to nourish the heart and calm the mind,harmonize the middle burner and regulate Qi,and alleviate urgency and restlessness.As its clinical application has expanded from traditional emotional disorders to neurological,endocrine,and various psychosomatic diseases,establishing a scientifically precise quality control system and deeply elucidating its pharmacodynamic material basis and mechanism of action have become critical tasks.Modern analytical methods,typified by chromatography,spectroscopy,and their hyphenated techniques,with their high sensitivity,high resolution,and powerful substance characterization capabilities,have become the core driving force for standardizing the quality control and modernizing the clinical application research of this formula.This paper systematically reviews the progress of the aforementioned analytical techniques and chemometrics in interpreting the chemical composition,establishing fingerprint profiles,controlling process quality,and researching the pharmacodynamic material basis of Ganmai Dazao Decoction.Furthermore,it discusses integrated approaches combining analytical techniques with pharmacology and clinical medicine to reveal mechanisms of action and explore therapeutic biomarkers.Finally,it provides an outlook on future directions and challenges,including technological integration and innovation,standardization of whole-process quality control systems,and evidence-based research aimed at internationalization.展开更多
文摘The learning and inferencing capabilities of large language models(LLMs)that underlie generative artificial intelligence(GenAI)can be exploited to optimize cancer treatments and improve patient outcomes.The ability of these models to learn from large amounts of clinical,molecular,and radiomic data on cancer patients and their treatments is driving research interest in their application to treatment decision-making.The learning and predictive power of LLMs make them uniquely suitable for supporting adaptive cancer therapy.However,the clinical validation of GenAI support for clinical decisions in oncology needs to address the complexity and unique challenges of GenAI clinical interventions.The United States Food and Drug Administration(FDA)guidelines on the clinical evaluation of software as a medical device(SaMD)are explored as a basis for the clinical evaluation of GenAI-assisted adaptive cancer therapy.Metrics are proposed to address clinical associations and analytical validation along with an outlook on randomized clinical trials.This article provides a much-needed and timely perspective on the clinical evaluation of GenAI-assisted cancer treatments and provides insights into overcoming the inherent challenges of GenAI in its acceptance and adoption in real-world clinical settings.
文摘Objective To investigate the prevalence and clinical significance of the centromere protein-F-like(CENP-F-like)immunofluorescence staining pattern in a large patient cohort and through literature review.Methods We retrospectively analyzed antinuclear antibody(ANA)immunofluorescence assay results from 191274 patients at West China Hospital of Sichuan University between March 2018 and November 2020.Specific immunological markers were tested in sera with CENP-F-like patterns.Additionally,a narrative review of seven relevant studies was performed for comparison.Results In Southwest China,ANA positivity was found in 32.09%of patients,with the CENP-F-like pattern detected in 0.015%of all cases and 0.05%of ANA-positive individuals.The CENP-F-like pattern appeared predominantly at titers≥1∶320,most often in isolation(68.97%),but also mixed with cytoplasmic speckled patterns.Patients with cancers accounted for the highest proportion(31.03%),including solid tumors and hematologic malignancies.Metastasis was observed in patients with solid tumors,while graft-versus-host disease(GVHD)occurred in those with hematologic malignancies post-transplantation.Autoimmune diseases(AIDs)were diagnosed in 20.69%of cases,all showing disease-specific autoantibodies.These findings were broadly consistent with previous reports and suggest a possible association between the CENP-F-like pattern and malignancies.Conclusion The CENP-F-like pattern is rare in ANA tests but may be associated with clinically important conditions,particularly cancers and AIDs.The occurrence of metastasis and GVHD in patients with this pattern highlights its potential clinical relevance,and concurrent autoantibodies may assist in diagnosing AIDs.
文摘Objectives This study aimed to analyse the benefits of a gamified clinical supervision strategy during hospital-based training,particularly regarding the development of critical and reflective thinking among undergraduate nursing students.Methods From April to July 2023,second-year nursing students who undertaking a nine-week clinical placement in a cardiology ward in northern Portugal were selected.Following a two-week diagnostic phase,students participated in a six-week gamified supervision programme comprising weekly 60-min sessions:infection-control decision-making;technical-procedural reasoning;guided emotional and ethical reflection;and clinical reasoning quiz on cardiology topics.Students completed weekly Structured Reflection Guide entries;supervisors recorded structured field notes after each session;and,after the intervention,students answered a post-intervention questionnaire and participated in focus groups.Qualitative data(reflections,field notes,open-ended questionnaire items,and focus-group transcripts)were analyzed using Bardin’s content analysis;quantitative questionnaire items were summarized descriptively.Results All seven students completed the six gamified sessions and submitted weekly reflection entries.Five students(71.4%)completed the questionnaire.Across data sources,students reported that gamified activities supported knowledge consolidation,teamwork,and clinical reasoning.Questionnaire data showed that all respondents(n=5,100%)strongly agreed that gamification enhanced their learning and should be maintained in clinical training.Reflections and focus groups revealed recurring themes related to emotional expression,sense of belonging,and difficulties using structured reflection tools,particularly in terms of comprehension and timing.Conclusion The gamified supervision strategy integrated into clinical training provided structured opportunities for practical engagement,collaborative work,and guided reflection.These findings suggest that gamification may support the development of reflective and critical-thinking processes in authentic clinical environments.
文摘Objective:For patients with hypertension complicated with diabetes mellitus,their health risks are not a simple sum but present complex interactive effects.Clarifying the clinical characteristics of such patients is the key to solving this medical problem.Methods:From June 2023 to June 2024,this study conducted a comparative study on 100 patients with hypertension complicated with diabetes mellitus and 100 patients with hypertension alone.By retrospectively analyzing clinical data of patients,the differences in disease manifestations,complication occurrence,and treatment effects between the two groups were explored in depth,and the unique challenges and treatment difficulties faced by patients with hypertension complicated with diabetes mellitus were identified.Results:Hypertensive patients with concurrent diabetes had more difficult blood glucose and blood pressure control,and were more prone to severe complications such as cardiovascular lesions and renal damage.Conclusion:The clinical characteristics and treatment needs of patients with hypertension complicated with diabetes mellitus are different from those with hypertension alone,and disease management should be more refined and personalized.
基金supported by the National Key R&D Program of China(2022YFC3501000,2022YFC3502300)National Natural Science Foundation of China(82374627)+2 种基金Fundamental Research Funds for the Central public welfare research institutes(Z0876)Fundamental Research Funds for the Central Universities(2024-JYB-KYPT-01)Beijing Municipal Science and Technology Commission(Z241100007724010).
文摘Background:Artificial intelligence medical diagnostic devices(AIMDDs)show strong potential but face barriers to clinical use,emphasizing the need for rigorous clinical research.Objective:We assessed current AIMDD research,key challenges,and future directions.Methods:A scoping review followed Arksey and O'Malley's methodological framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.PubMed,Web of Science Core Collection,and the Cochrane Database of Systematic Reviews(January 2020-December 2024)were searched on AIMDD design,implementation,and evaluation.Two independent researchers screened and extracted data from the literature using predefined criteria.Results:Ninety-seven articles met the inclusion criteria.Machine learning and deep learning approaches dominated across diverse disease fields,with oncology being the most frequent(41%).The key challenges identified include insufficient quantity,quality,representativeness,and diversity of data;research designs that do not adequately address clinical needs;poor patient selection;poorly defined gold standards;lack of external and prospective validation;and a disconnect between validation strategies and clinical practice.Additionally,issues such as the“black box”phenomenon,overfitting,and data privacy concerns hinder clinical translation.Completeness and standardization of reporting were also found to be lacking.Conclusions:Significant challenges remain in the development and clinical application of AIMDD.To facilitate their clinical translation,improvements are needed in dataset optimization,clinically driven research design,development of evaluation frameworks,enhanced interpretability,and standardized reporting and validation of algorithms.
基金supported by the National NaturalScience Foundation of China(No.22274001)the Key Project of Natural Science Research of the Education Department of Anhui Province(No.2022AH051032)the Excellent Research and Innovation Team of Universities in Anhui Province(No.2024AH010016).
文摘Portable ratiometric fluorescent platforms have emerged as promising tools for multifarious detection,yet remain unexplored for point-of-care monitoring doxorubicin(DOX),one of clinically antineoplastic drugs.To this end,we herein develop a portable self-calibrating platform namely carbon dots(C-dots)-embedded hydrogel sensors with a smartphone-assisted high-throughput imaging device,for DOX sensing.The prepared green-emitting(λ_(em)=508 nm)and negatively-charged C-dots(−11.40±1.21 mV),which have sufficient spectral overlap with the absorption band of DOX(∼500 nm),can strongly bind with positively-charged DOX molecules by electrostatic attraction effects.As a result,DOX molecules are selectively and rapid(20 s)determined with a detection limit of 10.26 nmol/L via Förster resonance energy transfer processes,demonstrating a remarkably chromatic shift from green to red.Further integrated with a 3D-printed smartphone-assisted device,the platform enabled high-throughput quantification,achieving recoveries of 96.40%-101.85%in human urine/serum(RSDs<2.94%,n=3).Notably,the dual linear detection ranges of the platform align with the reported clinical DOX concentrations in urine and plasma(0-4 h post-administration),validating their capability for direct quantification of DOX in clinical samples without special pre-treatment processes.By virtue of attractive analytical performances and robust feasibility,this platform bridges laboratory precision and point-of-care testing needs,offering promising potential for personalized chemotherapy and multiplexed analyte screening.
文摘[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to two tertiary hospitals in Jingzhou City between March and August 2024 were collected.Patients were randomly divided into three groups:<3-year-old,3—17-year-old,and≥18-year-old.A retrospective analysis was performed on their clinical features(including laboratory findings,disease course,and imaging characteristics)and epidemiological characteristics.[Results]In the<3-year-old group,28 cases(36.4%)were unvaccinated and 22 cases(28.6%)had received only one dose of the pertussis vaccine.In the 3—17-year-old group,91 cases(94.8%)had received four doses.Vaccination history was unknown for the≥18-year-old adult group.The<3-year-old group exhibited significantly higher incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the 3—17-year-old and≥18-year-old groups.Post-tussive vomiting was less frequent in the<3-year-old group than in the 3—17-year-old group but more frequent than in the≥18-year-old group;these differences were statistically significant(P<0.05).The≥18-year-old group had significantly lower incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the<3-year-old and 3—17-year-old groups(P<0.05).The proportion of cases with pneumonia and increased lung markings was higher in the<3-year-old group than in the 3—17-year-old group but lower than in the≥18-year-old group,showing statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was lower in the<3-year-old group than in both the 3—17-year-old and≥18-year-old groups,and these differences were also statistically significant(P<0.05).The proportion of pneumonia cases in the 3—17-year-old group was lower than in both the<3-year-old and≥18-year-old groups.The proportion of cases with increased lung markings was lower than in the<3-year-old group but higher than in the≥18-year-old group;these differences were statistically significant(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci in the 3—17-year-old group was higher than in the<3-year-old group but lower than in the≥18-year-old group,with statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was higher in the≥18-year-old group than in both the<3-year-old and 3—17-year-old groups,and these differences were also statistically significant(P<0.05).[Conclusions]Analysis of the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City contributes to enhancing the prevention and control of pertussis within the city.
基金Hunan Provincial Natural Science Foundation of China,Grant/Award Numbers:2024JJ6289,2023JJ60464,2023JJ60334Changsha City Technology Program,Grant/Award Number:kq2403120+1 种基金Climb Plan of Hunan Cancer Hospital,Grant/Award Numbers:ZX2021005,QH2023006High-Level Talent Support Program of Hunan Cancer Hospital,Grant/Award Number:20250731-1050。
文摘The convergence of artificial intelligence(AI)and big data is reshaping contemporary oncology by enabling the integration of multimodal information across imaging,pathology,genomics,and clinical records.From a physician-centered perspective,these technologies can potentially be used to improve diagnostic precision,support individualized treatment planning,enhance longitudinal patient management,and accelerate both clinical and translational research.In this review,we synthesize the core AI methodologies most relevant to oncology-machine learning,deep learning,and large language models-and examine how they interact with established and emerging oncology data platforms.We further highlight practical use cases in clinical workflows and research pipelines,emphasizing opportunities for advancing precision cancer care while also addressing challenges associated with data heterogeneity,model generalizability,privacy protection,and real-world implementation.By underscoring the synergistic value of AI and big data,this review aims to inform the development of clinically meaningful,context-adapted strategies that promote translational innovation in both global and locally resourced healthcare environments.
基金supported by the National Natural Science Foundation of China(32171022,32221005,and 32401246).
文摘While conventional FISH and IHC methods struggle to decode complex tissue heterogeneity and comprehensive molecular diagnosis due to low-throughput spatial information,spatial omics technologies enable high-throughput molecular mapping across tissue microenvironments.These technologies are emerging as transformative tools in molecular diagnostics and medical research.By integrating histopathological morphology with spatial multi-omics profiling(genome,transcriptome,epigenome,and proteome),spatial omics technologies open an avenue for understanding disease progression,therapeutic resistance mechanisms,and precise diagnosis.It particularly enhances tumor microenvironment analysis by mapping immune cell distributions and functional states,which may greatly facilitate tumor molecular subtyping,prognostic assessment,and prediction of the radiotherapy and chemotherapy efficacy.Despite the substantial advancements in spatial omics,the translation of spatial omics into clinical applications remains challenging due to robustness,efficacy,clinical validation,and cost constraints.In this review,we summarize the current progress and prospects of spatial omics technologies,particularly in medical research and diagnostic applications.
文摘Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate diagnosis difficult in routine clinical practice.Misdiagnosis may lead to inappropriate treatment strategies,increased psychological and physical burdens,reduced quality of life,and impaired social functioning.Genetic overlap may partially explain the clinical similarities between MDD and BD-Ⅱ,and biomarkers along with neuroimaging techniques are receiving increasing attention as tools to aid in diagnosis.For example,electroencephalography has been shown to effectively distinguish between unipolar depression and bipolar depression;serum levels of glycogen synthase kinase-3 have also been investigated as a potential tool for differentiating between the two disorders.A comprehensive assessment integrating clinical characteristics,genetic basis research,and multimodal evaluations using neuroimaging and biomarkers through a multidisciplinary approach will help enhance clinicians'ability to distinguish between MDD and BD-Ⅱ.By improving diagnostic accuracy,more personalized and effective treatment strategies can be developed,ultimately improving patients'health outcomes and quality of life.
文摘Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was conducted with 190 clinical nurses recruited from an oncology hospital in Central Vietnam.The self-administered Evidence-Based Practice Questionnaire(EBPQ)was employed to assess the nurses'knowledge/skills,attitudes,and implementation of EBP.Data analysis utilized descriptive statistics,the Mann-Whitney test,the Kruskal-Wallis test,and Spearman's rho correlation.Results:The mean total score for EBP implementation among the nurses was 29.52(SD=7.14)out of 42 scores.The most frequently undertaken activity was sharing evidence with colleagues,whereas finding relevant evidence was the least performed.The level of EBP implementation significantly varied based on the nurses'role types and their participation in related courses(P<0.05).Moreover,a strong positive correlation was observed between EBP implementation and both knowledge/skills(r=0.703,P<0.001)and attitudes toward EBP(r=0.536,P<0.001).Conclusions:The implementation of EBP by oncology nurses is generally moderate and is significantly positively correlated with their knowledge/skills and attitudes toward EBP.These findings underscore the importance of enhancing educational programs and facilitating suppor tive institutional policies to fur ther encourage the adoption of EBP among nurses.
基金Supported by the National Key R&D Program of China(No.2023YFC2410203)Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(No.ZLRK202503).
文摘AIM:To investigate the clinical features and prognosis of patients with orbital inflammatory myofibroblastic tumor(IMT).METHODS:This retrospective study collected clinical data from 22 patients diagnosed with orbital IMT based on histopathological examination.The patients were followed up to assess their prognosis.Clinical data from patients,including age,gender,course of disease,past medical history,primary symptoms,ophthalmologic examination findings,general condition,as well as imaging,laboratory,histopathological,and immunohistochemical results from digital records were collected.Orbital magnetic resonance imaging(MRI)and(or)computed tomography(CT)scans were performed to assess bone destruction of the mass,invasion of surrounding tissues,and any inflammatory changes in periorbital areas.RESULTS:The mean age of patients with orbital IMT was 28.24±3.30y,with a male-to-female ratio of 1.2:1.Main clinical manifestations were proptosis,blurred vision,palpable mass,and pain.Bone destruction and surrounding tissue invasion occurred in 72.73%and 54.55%of cases,respectively.Inflammatory changes in the periorbital site were observed in 77.27%of the patients.Hematoxylin and eosin staining showed proliferation of fibroblasts and myofibroblasts,accompanied by infiltration of lymphocytes and plasma cells.Immunohistochemical staining revealed that smooth muscle actin(SMA)and vimentin were positive in 100%of cases,while anaplastic lymphoma kinase(ALK)showed positivity in 47.37%.The recurrence rate of orbital IMT was 27.27%,and sarcomatous degeneration could occur.There were no significant correlations between recurrence and factors such as age,gender,laterality,duration of the disease,periorbital tissue invasion,bone destruction,periorbital inflammation,tumor size,fever,leukocytosis,or treatment(P>0.05).However,lymphadenopathy and a Ki-67 index of 10%or higher may be risk factors for recurrence(P=0.046;P=0.023).CONCLUSION:Orbital IMT is a locally invasive disease that may recur or lead to sarcomatoid degeneration,primarily affecting young and middle-aged patients.The presence of lymphadenopathy and a Ki-67 index of 10%or higher may signify a poor prognosis.
文摘“By successfully integrating artificial intelligence(AI)into research workflows,researchers could substantially increase scientific productivity”[1].In biofabrication,AI is dr iving a paradigm shift from empiricism toward intelligen t,data centric manufacturing[2].By integrating computation,automation,and biology,AI gives rise to self-evolving,adaptive systems that learn from data,predict complex behaviors,and autonomously optimize fabrication outcomes.Such systems translate experimental insights into patient-specific and clinically relevant solutions,bridging laboratory research and regenerative therapies[3].This emerging frontier is rapidly advancing from concept to application.This Special Column highlights how AI-driven advanc es in materials,design,and manufacturing are reshaping biof abrication for regenerative medicine and clinical translation.
基金supported by the Beijing Natural Science Foundation-Xiaomi Innovation Joint Fund(L233009).
文摘Dear Editor,The National Health Commission(NHC)of China has championed the creation of weight management clinics to confront the growing crisis of overweight and obesity.Forecasts indicate that by 2030,the prevalence of these conditions among Chinese adults and children could climb to 70.5%and 31.8%,respectively[1].This troubling trajectory,alongside an increasing burden of chronic illnesses such as diabetes,hypertension,and cardiovascular diseases,underscores the need for immediate action.Instead of focusing solely on weight management clinics,we propose that medical institutions prioritize the establishment of comprehensive chronic disease management clinics,building upon the foundation of weight management clinics to holistically address obesity,aging,and healthcare system challenges.
基金supported by the Innovative Team Project of Ordinary Universities in Guangdong Province(No.2022KCXTD016).
文摘Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.
文摘Due to the special anatomical location,complex functions,and significant impact on patients’appearance and psychology,the treatment of oral and maxillofacial tumors has always been a key and difficult issue in the field of head and neck surgery.With the rapid development of surgical technology,microsurgical reconstruction technology,perioperative management,and multidisciplinary treatment models,surgical treatment has occupied a core position in the comprehensive treatment system of oral and maxillofacial tumors.Based on this,this paper conducts research on the clinical outcomes of surgical treatment for patients with oral and maxillofacial tumors,expounds the optimization strategies of surgical treatment,and analyzes the clinical effects of the optimized surgical treatment,aiming to provide a reference for the clinical treatment of oral and maxillofacial tumors.
文摘Iron deficiency anemia affects approximately 1.62 billion people worldwide,yet traditional iron supplements present bioavailability limitations and gastrointestinal side effects.This randomized,double-blind clinical trial investigated a novel Auricularia auricula polysaccharide-iron complex(AAPIC)compared with heme iron and ferrous glycinate in 180 iron-deficient adults receiving 30 mg elemental iron daily for 12 weeks.AAPIC achieved comparable hemoglobin improvements(from 98.3±8.7 to 126.5±9.2 g/L)to heme iron(from 97.8±9.1 to 128.3±8.6 g/L)and was significantly superior to ferrous glycinate(from 98.6±8.9 to 119.7±10.3 g/L;p<0.001).Iron absorption efficiency showed AAPIC at 23.7±4.2%,heme iron at 25.1±3.8%,and ferrous glycinate at 18.4±5.1%.Toxicological assessments revealed no hepatotoxicity,nephrotoxicity,or mutagenicity.Gastrointestinal adverse events occurred in 8.3%of AAPIC recipients versus 15.0%with ferrous glycinate and 10.0%with heme iron.The polysaccharide component facilitates iron transport through enhanced intestinal uptake mechanisms.AAPIC represents a promising,well-tolerated alternative with clinical efficacy comparable to established iron formulations.
基金approved by King Abdullah International Medical Research Center Ethics Committee(approval No.0000074524).
文摘BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges from nonoperative methods to surgical interventions such as intramedullary K-wires,which promote faster rehabilitation and improved elbow mobility.AIM To evaluate the outcomes of managing humeral shaft fractures using closed reduction and internal fixation with flexible intramedullary K-wires.METHODS This was a retrospective cohort study analyzing the medical records of patients with humeral shaft fractures managed with flexible intramedullary K-wires at King Abdulaziz Medical City,using non-random sampling and descriptive analysis for outcome evaluation.RESULTS This study assessed the clinical outcomes of 20 patients treated for humeral shaft fractures with intramedullary K-wires.Patients were predominantly male(n=16,80%),had an average age of 39.2 years,and a mean body mass index of 29.5 kg/m^(2).The fractures most frequently occurred in the middle third of the humerus(n=14,70%),with oblique fractures being the most common type(n=7,35%).All surgeries used general anesthesia and a posterior approach,with no intraoperative complications reported.Postoperatively,all patients achieved clinical and radiological union(n=20,100%),and the majority(n=13,65%)reached an elbow range of motion from 0 to 150 degrees.CONCLUSION These results suggest that intramedullary K-wire fixation may be an effective option for treating humeral shaft fractures,with favorable outcomes in range of motion recovery,fracture union,and a low rate of intraoperative complications.
文摘Ganmai Dazao Decoction,originating from“Jin Gui Yao Lue”(Synopsis of the Golden Chamber),is a classical prescription for treating visceral agitation.Composed of three medicinal and edible substances-licorice(Gancao),wheat(Xiaomai),and jujube(Dazao),it functions to nourish the heart and calm the mind,harmonize the middle burner and regulate Qi,and alleviate urgency and restlessness.As its clinical application has expanded from traditional emotional disorders to neurological,endocrine,and various psychosomatic diseases,establishing a scientifically precise quality control system and deeply elucidating its pharmacodynamic material basis and mechanism of action have become critical tasks.Modern analytical methods,typified by chromatography,spectroscopy,and their hyphenated techniques,with their high sensitivity,high resolution,and powerful substance characterization capabilities,have become the core driving force for standardizing the quality control and modernizing the clinical application research of this formula.This paper systematically reviews the progress of the aforementioned analytical techniques and chemometrics in interpreting the chemical composition,establishing fingerprint profiles,controlling process quality,and researching the pharmacodynamic material basis of Ganmai Dazao Decoction.Furthermore,it discusses integrated approaches combining analytical techniques with pharmacology and clinical medicine to reveal mechanisms of action and explore therapeutic biomarkers.Finally,it provides an outlook on future directions and challenges,including technological integration and innovation,standardization of whole-process quality control systems,and evidence-based research aimed at internationalization.
