This study aimed to introduce a minimally invasive technique for maxillary sinus floor elevation using the lateral approach(lSFE)and to determine the factors that influence the stability of the grafted area in the sin...This study aimed to introduce a minimally invasive technique for maxillary sinus floor elevation using the lateral approach(lSFE)and to determine the factors that influence the stability of the grafted area in the sinus cavity.Thirty patients(30 implants)treated with lSFE using minimally invasive techniques from 2015 to 2019 were included in the study.Five aspects of the implant(central,mesial,distal,buccal,and palatal bone heights[BHs])were measured using cone-beam computed tomography(CBCT)before implant surgery,immediately after surgery(T0),6 months after surgery(T1),and at the last follow-up visit(T2).Patients’characteristics were collected.A small bone window(height,(4.40±0.74)mm;length,(6.26±1.03)mm)was prepared.No implant failed during the follow-up period(3.67±1.75)years.Three of the 30 implants exhibited perforations.Changes in BH of the five aspects of implants showed strong correlations with each other and BH decreased dramatically before second-stage surgery.Residual bone height(RBH)did not significantly influence BH changes,whereas smoking status and type of bone graft materials were the potentially influential factors.During the approximate three-year observation period,lSFE with a minimally invasive technique demonstrated high implant survival rate and limited bone reduction in grafted area.In conclusion,lSFE using minimally invasive techniques was a viable treatment option.Patients who were nonsmokers and whose sinus cavity was filled with deproteinized bovine bone mineral(DBBM)had significantly limited bone resorption in grafted area.展开更多
Pentalogy of Cantrell is a rare congenital abnormality.Even with high-quality medical care and staged corrective surgeries in professional hospitals,the mortality rate is still very high and long-term prognosis is poo...Pentalogy of Cantrell is a rare congenital abnormality.Even with high-quality medical care and staged corrective surgeries in professional hospitals,the mortality rate is still very high and long-term prognosis is poor.Survival is largely determined by the complexity and severity of cardiac abnormalities,the efficiency of abdominal wall closure and postoperative complications.A 24-year-old male patient with complete pentalogy of Cantrell was diagnosed.One-stage surgical repair of all abnormalities were completed.The patient recovered well and had been follow-up for 7 years.He has a good cosmetic outcome,with no signs of cardiac dysfunction.No complications were noted.展开更多
Security and safety remain paramount concerns for both governments and individuals worldwide.In today’s context,the frequency of crimes and terrorist attacks is alarmingly increasing,becoming increasingly intolerable...Security and safety remain paramount concerns for both governments and individuals worldwide.In today’s context,the frequency of crimes and terrorist attacks is alarmingly increasing,becoming increasingly intolerable to society.Consequently,there is a pressing need for swift identification of potential threats to preemptively alert law enforcement and security forces,thereby preventing potential attacks or violent incidents.Recent advancements in big data analytics and deep learning have significantly enhanced the capabilities of computer vision in object detection,particularly in identifying firearms.This paper introduces a novel automatic firearm detection surveillance system,utilizing a one-stage detection approach named MARIE(Mechanism for Realtime Identification of Firearms).MARIE incorporates the Single Shot Multibox Detector(SSD)model,which has been specifically optimized to balance the speed-accuracy trade-off critical in firearm detection applications.The SSD model was further refined by integrating MobileNetV2 and InceptionV2 architectures for superior feature extraction capabilities.The experimental results demonstrate that this modified SSD configuration provides highly satisfactory performance,surpassing existing methods trained on the same dataset in terms of the critical speedaccuracy trade-off.Through these innovations,MARIE sets a new standard in surveillance technology,offering a robust solution to enhance public safety effectively.展开更多
BACKGROUND The combined anterior/posterior approach appears to be capable of reconstructing spinal stability,correcting thoracolumbar deformity,and promoting neural recovery in severe thoracolumbar fracture dislocatio...BACKGROUND The combined anterior/posterior approach appears to be capable of reconstructing spinal stability,correcting thoracolumbar deformity,and promoting neural recovery in severe thoracolumbar fracture dislocation.However,this type of operation requires changing the body position during the procedure,resulting in a lengthy operation time.As a universal surgical robot,TINAVI robot has achieved good surgical results in clinical surgery.But to our knowledge,no reports describing TINAVI robot-assisted single lateral position anteroposterior surgery for thoracolumbar fracture dislocation.CASE SUMMARY We describe a case of a 16-year-old female patient with severe thoracolumbar fracture and dislocation underwent surgery assisted by the TINAVI robot.A onestage combined anterior and posterior operation was performed on a severe thoracolumbar fracture dislocation using the TINAVI robot,and the operation was completed in right lateral position.CONCLUSION The TINAVI robot-assisted one-stage anterior and posterior surgery in right lateral position for severe thoracolumbar fracture and dislocation is both safe and effective.展开更多
BACKGROUND Thoracolumbar fractures are generally combined with spinal cord injury to varying degrees,which may cause deterioration of the patients’condition and increase the difficulty of clinical treatment.At presen...BACKGROUND Thoracolumbar fractures are generally combined with spinal cord injury to varying degrees,which may cause deterioration of the patients’condition and increase the difficulty of clinical treatment.At present,anterior or combined anterior-posterior surgery is preferred for severe thoracolumbar fractures.AIM To investigate the effectiveness and postoperative rehabilitation of one-stage combined anterior-posterior surgery for severe thoracolumbar fractures with spinal cord injury.METHODS One-hundred-and-twenty patients who received surgery for severe thoracolumbar fractures with spinal cord injury at our hospital from February 2018 to February 2020 were randomly enrolled.They were randomly divided into group 1(one-stage combined anterior-posterior surgery,n=60)and group 2(onestage anterior-approach surgery,n=60).Treatment efficacy was compared between the two groups.RESULTS Blood loss was greater and the operation time was longer in group 1 than in group 2,and the differences were statistically significant(P<0.05).Incision length,intraoperative X-rays,and length of hospital stay were not significantly different between the two groups(P>0.05).Preoperative function of the affected vertebrae was not significantly different between the two groups(P>0.05).In each group,the patients showed significant improvement after surgery.The anterior vertebral height ratio and the posterior vertebral height ratio in group 1 after surgery were significantly higher than those in group 2.The Cobb angle after surgery was significantly lower in group 1 than in group 2(P<0.05).The canal-occupying ratio of the affected vertebrae was not significantly different between the two groups(P>0.05).Before surgery,there was no significant difference in the quality of life scores between the two groups(P>0.05).The above indicators were significantly improved after surgery compared with before surgery in each group.In addition,these indicators were markedly better in group 1 than in group 2 after surgery(P<0.05 for each).CONCLUSION One-stage combined anterior-posterior surgery effectively improves the function of the affected vertebrae and the life quality of patients with severe thoracolumbar fractures and spinal cord injury.This surgical approach is worthy of popularization in clinical use.展开更多
The development of pancreatic surgery in China has progressed remarkably over 7 decades.China initiated its pancreatic surgery journey in the 1950s,marked by the first pancreaticoduodenectomy performed by Zeng Xianjiu...The development of pancreatic surgery in China has progressed remarkably over 7 decades.China initiated its pancreatic surgery journey in the 1950s,marked by the first pancreaticoduodenectomy performed by Zeng Xianjiu in 1951.Early progress was hindered by technological limitations and fragmented practices,but the establishment of academic platforms such as the National Pancreatic Disease Symposia in the 1980s catalyzed standardized research and interdisciplinary collaboration.In 2006,Zhang Shengdao spearheaded China’s first Guidelines for the Diagnosis and Treatment of Severe Acute Pancreatitis.The 21st century has seen remarkable progress in pancreatic surgery,marked by the China-specific treatment guidelines,technological breakthroughs in laparoscopic and robotic surgical systems,and the increasing centralization of pancreatic surgery in high-volume medical centers.These synergistic advancements have collectively propelled a paradigm shift in contemporary cancer care.By 2022,China Pancreas Data Center reported a postoperative mortality rate of 0.4% and 3-year survival rates of 43% for resected pancreatic cancer,rivaling global benchmarks.China has also emerged as a leader in minimally invasive pancreatic surgery,with advancements in laparoscopic and robotic pancreatic surgery.Academic growth paralleled clinical progress:the Chinese Pancreatic Association,established in 2022,fosters global collaboration,evidenced by its 2024 annual conference attracting over 10,000 participants.Through technological innovation,centralized care models,and international partnerships,China continues to redefine its role in advancing pancreatic surgery.展开更多
The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which...The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which ranks in the second quartile in the surgery category.This remarkable achievement,which reflects LERS’s steadily increasing influencein the area of surgery,would not be possible without the peer reviewer’s invaluable contributions.On behalf of the Editorial Board and Editorial Office,we would express our sincere appreciation to the following reviewers,who reviewed at least one paper with rigorous and insightful comments.We sincerely hope to engage further with them,either as esteemed reviewers or outstanding authors,in 2026 and beyond.展开更多
Objective:To explore the relationship between anesthetic depth and surgical stress response in minimally invasive cardiothoracic surgery.Methods:A total of 89 patients who underwent thoracoscopic minimally invasive ca...Objective:To explore the relationship between anesthetic depth and surgical stress response in minimally invasive cardiothoracic surgery.Methods:A total of 89 patients who underwent thoracoscopic minimally invasive cardiothoracic surgery in our hospital from June 2024 to December 2024 were selected as the research objects.They were divided into the light anesthesia group(n=45)and the deep anesthesia group(n=44).The vital signs at different intraoperative nodes and perioperative stress status of the two groups were compared.Results:Before lesion resection and after surgery,the mean arterial pressure and heart rate of the deep anesthesia group were lower than those of the light anesthesia group,with statistically significant differences.Conclusion:In thoracoscopic minimally invasive cardiothoracic surgery,deep anesthesia can effectively control the patient’s surgical stress response,but the postoperative awakening time is longer;patients under light anesthesia have a shorter awakening time,but the intraoperative stress response is obvious.展开更多
With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Lap...With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery(LECSSNNS)has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation.However,robust evidence-based support for guiding clinical implementation remains limited.To address this gap,we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations.These included preoperative assessment,surgical techniques,intraoperative endoscopic procedures,pathological evaluation,postoperative care,and follow-up.This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS,thereby advancing precise,minimally invasive,and function-preserving treatment for EGC.展开更多
1Introduction A 25-year-old woman presented with a 3-month history of otalgia and aural fullness in the left ear,without associated otological or systemic symptoms.Her medical history was unremarkable,and she denied a...1Introduction A 25-year-old woman presented with a 3-month history of otalgia and aural fullness in the left ear,without associated otological or systemic symptoms.Her medical history was unremarkable,and she denied any history of hepatitis,hypertension,diabetes,cardiovascular disease,or other significant conditions.The patient was diagnosed with external auditory canal cholesteatoma and subsequently underwent canalplasty under general anesthesia.Routine anesthetic drugs,including 2%lidocaine,dexamethasone,propofol,sufentanil,rocuronium bromide,ondansetron,flurbiprofen axetil,neostigmine,and atropine,were used during surgery and anesthesia recovery.No significant events were noted,and the patient experienced only a blood loss of 10 mL.展开更多
Background Computed tomography(CT) and cone-beam computed tomography(CBCT) image registration play pivotal roles in computer-assisted navigation for orthopedic surgery. Traditional methods often apply uniform deformat...Background Computed tomography(CT) and cone-beam computed tomography(CBCT) image registration play pivotal roles in computer-assisted navigation for orthopedic surgery. Traditional methods often apply uniform deformation models, neglecting the biomechanical differences between rigid structures and soft tissues, which compromises registration accuracy, especially during significant bone displacements. Method To address this issue, we introduce RE-Reg, a rigid-elastic CT-CBCT image registration framework that jointly learns rigid bone motion and soft tissue deformation. RE-Reg incorporates a rigid alignment(RA) module to estimate global bone motion and an elastic deformation(ED) module to model soft tissue deformation, preserving bony structures through bone shape preservation(BSP) loss. Result Our comprehensive evaluation on publicly available datasets demonstrates that RE-Reg significantly outperforms existing methods in terms of registration accuracy and rigid bone structure preservation, achieving a 1.3% improvement in Dice similarity coefficient(DSC) and a 23% reduction in rigid bone deformation(%Δvol) compared with the best baseline. Conclusion This framework not only enhances anatomical fidelity but also ensures biomechanical plausibility and provides a valuable tool for image-guided orthopedic surgery. This code is available athttps://github.com/Zq-Huang/RE-Reg.展开更多
AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing techn...AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.METHODS:This study included 74 eyes from 37 patients,comprising 17 males and 20 females,with a mean age of 51.74±7.80 years.Using a coin toss method,one eye per patient was randomly selected for improved anterior capsular polishing,while the other eye received standard irrigation/aspiration(I/A)polishing.The polishing group consisted of 37 eyes,including 21 right and 16 left eyes,while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group.Visual acuity and quality of the patients were evaluated before surgery and at 1 wk,1,6,and 12 mo after surgery.The OPD-Scan III was utilized to assess high-order aberrations,while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff),Strehl ratio(SR),and objective scatter index(OSI)for the purpose of visual quality assessment.Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results,and the SNK-q post hoc test was applied to identify significant differences.RESULTS:The polishing group’s uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05).At 12-months,UDVA,UNVA,and corrected distant visual acuity(CDVA)were better than the control group(P<0.05).The MTF cutoff,SR,OSI,and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.展开更多
The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatme...The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatment at grassroots hospitals faces numerous challenges such as limited resources,high technical difficulty,and insufficient multidisciplinary collaboration.Therefore,DCS strategies need to be adapted to simplified processes to create conditions for subsequent treatment.This paper retrieves relevant literature to discuss the proposal,promotion,and application of the DCS concept,aiming to provide evidence-based basis for optimizing trauma treatment outcomes at grassroots hospitals.展开更多
Background:Pressure injury(PI)is a prevalent complication in pediatric cardiac surgery,with higher incidence than in general pediatric populations due to children’s thin skin,underdeveloped subcutaneous tissue,and pr...Background:Pressure injury(PI)is a prevalent complication in pediatric cardiac surgery,with higher incidence than in general pediatric populations due to children’s thin skin,underdeveloped subcutaneous tissue,and prolonged intraoperative pressure.Objective:To evaluate the effectiveness of the curvilinear supine position(CSP)in preventing PI among children undergoing congenital heart disease(CHD)surgery.Methods:Between October 2024 and February 2025,a single-center randomized controlled trial was conducted.Of the 80 children initially enrolled for congenital heart disease(CHD)surgery,77(aged 1 month to 14 years)completed the study and were included in the final analysis after 3 were excluded due to protocol violations.Participants were randomly assigned to the CSP group(n=38)or the conventional supine position group(n=39).Results:The incidence of PI was significantly lower in the CSP group(2.6%)compared to the control group(20.5%)(p=0.029).Postoperative LDH levels were also significantly reduced in the CSP group(422.67±86.52 U/L vs.592.92±215.71 U/L;p=0.031),while preoperative LDH and surgical variables(e.g.,cardiopulmonary bypass time)were comparable between groups.Although the CSP group had a shorter hospital stay(17.24 vs.22.51 days),the difference was not statistically significant(p=0.085).Caregiver satisfaction was significantly higher in the CSP group(100.0%vs.84.6%;p=0.025).Conclusion:CSP effectively reduces PI incidence,mitigates tissue injury,and enhances caregiver satisfaction in pediatric cardiac surgery,offering a safe and feasible strategy for perioperative PI prevention.展开更多
Objective:To analyze the impact of nursing interventions based on quantitative assessment using the Kano model on the quality of rehabilitation in patients with early-stage ovarian cancer following laparoscopic radica...Objective:To analyze the impact of nursing interventions based on quantitative assessment using the Kano model on the quality of rehabilitation in patients with early-stage ovarian cancer following laparoscopic radical surgery.Methods:A prospective clinical study was conducted involving 96 patients with newly diagnosed early-stage ovarian cancer who underwent laparoscopic radical surgery from December 2023 to December 2025.Patients were randomly assigned to groups using a random number table method before surgery.After surgery,the control group(n=48)received routine quantitative assessment nursing interventions,while the observation group(n=48)received nursing interventions based on quantitative assessment using the Kano model.Both groups received continuous nursing care until discharge.Differences between the groups were compared in terms of negative emotions,quality of life scores before and after postoperative intervention,postoperative recovery indicators,and nursing satisfaction evaluations on the day of discharge.Results:After intervention,the observation group had lower scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS),as well as shorter recovery times for gastrointestinal function and food intake,and a shorter hospital stay compared to the control group.Additionally,the observation group had higher scores on the Quality-of-Life Instrument for Cancer Patients-Ovarian Cancer(QLICP-OV)than the control group,with statistically significant differences(p<0.05).The overall satisfaction with nursing care in the observation group was also higher than that in the control group,with a statistically significant difference(p<0.05).Conclusion:Implementing quantitative evaluation nursing interventions based on the Kano model for patients with early-stage ovarian cancer after laparoscopic radical surgery can,by addressing their postoperative basic health,disease awareness,and other intervention content needs to a comprehensive degree,actively promote postoperative recovery and improve their mental health and quality of life.展开更多
BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and...BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.展开更多
With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative...With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.展开更多
BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investig...BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investigated rates of return to farming or other heavy labor that is of interest to patients in rural areas.AIM To evaluate the literature regarding RTW in farming or heavy labor after orthopedic hip,knee,or shoulder surgery.METHODS A search was performed in the PubMed and EMBASE databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Studies were included if they reported patients employed in farming or heavy labor,RTW rates after orthopedic surgery of the hip,knee,or shoulder,and had a minimum 6-month follow-up.A meta-analysis of proportions using a random-effects model was performed on three single-arm observational studies to estimate the pooled RTW rate following arthroscopic shoulder surgery.RESULTS Ten studies were included,and 101 farmers were identified among 440 total patients.One study involved hip surgery,two studies involved knee surgery,and seven studies involved shoulder surgery.RTW rates across studies varied by type of surgery and follow-up interval,ranging from 24%to 100%.The RTW rate was only 53.6%at 1 year following total hip arthroplasty.No studies investigated RTW in farmers following total knee arthroplasty.Among non-comparative studies,meta-analysis revealed a pooled RTW rate of 89%following arthroscopic shoulder surgery,with low heterogeneity(I^(2)=30.1%).Among comparative studies,one study reported significantly higher RTW odds for patients undergoing anatomic total shoulder arthroplasty compared to reverse shoulder arthroplasty(odds ratio=5.45).Overall,surgical intervention for shoulder pathology was associated with a high likelihood of RTW across multiple techniques,with particularly favorable outcomes for anatomic total shoulder arthroplasty.CONCLUSION This systematic review highlights the high rates of RTW in farmers and heavy laborers after shoulder surgery.However,our findings also underscore the need for more rural-specific research to guide patient counseling,rehabilitation expectations,and shared decision-making in this underserved population,particularly for orthopedic surgery of the hip and knee.展开更多
AIM:To establish and validate a multidimensional predictive model of postoperative visual recovery after idiopathic macular hole(IMH)surgery.METHODS:Retrospective cohort study.Examinations within a three-month period,...AIM:To establish and validate a multidimensional predictive model of postoperative visual recovery after idiopathic macular hole(IMH)surgery.METHODS:Retrospective cohort study.Examinations within a three-month period,both pre-and postoperative,included assessments of best corrected visual acuity(BCVA),intraocular pressure(IOP),and morphological parameters of IMH with optical coherence tomography(OCT).Then,a series of indices were derived,including the IMH index(MHI),diameter hole index(DHI),macular hole closure index(MHCI),hole form factor(HFF),and tractional hole index(THI).Subfoveal anatomical damage(macular hole inferior volume,Vi)was calculated based on the basal diameter(BD),minimum diameter(MD),and height at the narrowest point(HMD)of IMH.Pearson correlation analysis was utilized to discern significant correlations between postoperative BCVA and the multiple indices examined.A subsequent linear correlation analysis was performed.RESULTS:The study involved 51 eyes from 51 patients(mean age 66.90±6.07y)diagnosed with IMH.Preoperative BCVA was 1.22±0.76 logMAR and improved to 0.88±0.38 logMAR after surgery(P<0.001).The correlation analysis results showed significant correlations between postoperative BCVA and preoperative BCVA(P<0.001),BD(P=0.042),MD(P=0.001),MHI(P=0.047),THI(P=0.004),and Vi(P=0.007).The multidimensional model integrating THI,Vi,and preoperative BCVA significantly outperformed traditional predictors(MD,BD,and height)in terms of postoperative visual recovery prediction.THI,reflecting posterior vitreous traction mechanics,independently predicted anatomical reset potential(β=-0.06,P=0.022),while Vi,quantifying subfoveal photoreceptor disruption,was correlated with structural-functional recovery(β=0.01,P=0.046).Preoperative visual acuity served as a critical surrogate for retinal functional reserve(β=0.15,P=0.020).Redundant morphometric parameters(MHI,DHI,MHCI,HFF)were excluded,as their predictive contributions were subsumed by THI/Vi or mediated by preoperative vision.CONCLUSION:The combination of biomechanical traction(THI),subfoveal anatomical damage(Vi),and preoperative BCVA represents a clinically applicable framework for predicting postoperative visual recovery after IMH surgery.This model can be used as a practical tool to guide surgical planning,facilitating the identification of highrisk patients who may benefit from additional techniques(such as an internal limiting membrane flap)while optimizing resource allocation for standard cases.展开更多
Objective:Sepsis exhibits remarkable heterogeneity in disease progression trajectories,and accurate identificationof distinct trajectory-based phenotypes is critical for implementing personalized therapeutic strategie...Objective:Sepsis exhibits remarkable heterogeneity in disease progression trajectories,and accurate identificationof distinct trajectory-based phenotypes is critical for implementing personalized therapeutic strategies and prognostic assessment.However,trajectory clustering analysis of time-series clinical data poses substantial methodological challenges for researchers.This study provides a comprehensive tutorial framework demonstrating six trajectory modeling approaches integrated with proteomic analysis to guide researchers in identifying sepsis subtypes after laparoscopic surgery.Methods:This study employs simulated longitudinal data from 300 septic patients after laparoscopic surgery to demonstrate six trajectory modeling methods(group-based trajectory modeling,latent growth mixture modeling,latent transition analysis,time-varying effect modeling,K-means for longitudinal data,agglomerative hierarchical clustering)for identifying associations between predefinedsequential organ failure assessment trajectories and 25 proteomic biomarkers.Clustering performance was evaluated via multiple metrics,and a biomarker discovery pipeline integrating principal component analysis,random forests,feature selection,and receiver operating characteristic analysis was developed.Results:The six methods demonstrated varying performance in identifying trajectory structures,with each approach exhibiting distinct analytical characteristics.The performance metrics revealed differences across methods,which may inform context-specificmethod selection and interpretation strategies.Conclusion:This study illustrates practical implementations of trajectory modeling approaches under controlled conditions,facilitating informed method selection for clinical researchers.The inclusion of complete R code and integrated proteomics workflows offers a reproducible analytical framework connecting temporal pattern recognition to biomarker discovery.Beyond sepsis,this pipeline-oriented approach may be adapted to diverse clinical scenarios requiring longitudinal disease characterization and precision medicine applications.The comparative analysis reveals that each method has distinct strengths,providing a practical guide for clinical researchers in selecting appropriate methods based on their specificstudy goals and data characteristics.展开更多
基金supported by National Natural Science Foundation of China(81970986,81771125)Exploration and R&D Project of West China Hospital of Stomatology(LCYJ2020-DC-1)+1 种基金Sichuan University Postdoctoral Innovation Fund(2023SCU12040)China Postdoctoral Science Foundation funded project(2022TQ0222).
文摘This study aimed to introduce a minimally invasive technique for maxillary sinus floor elevation using the lateral approach(lSFE)and to determine the factors that influence the stability of the grafted area in the sinus cavity.Thirty patients(30 implants)treated with lSFE using minimally invasive techniques from 2015 to 2019 were included in the study.Five aspects of the implant(central,mesial,distal,buccal,and palatal bone heights[BHs])were measured using cone-beam computed tomography(CBCT)before implant surgery,immediately after surgery(T0),6 months after surgery(T1),and at the last follow-up visit(T2).Patients’characteristics were collected.A small bone window(height,(4.40±0.74)mm;length,(6.26±1.03)mm)was prepared.No implant failed during the follow-up period(3.67±1.75)years.Three of the 30 implants exhibited perforations.Changes in BH of the five aspects of implants showed strong correlations with each other and BH decreased dramatically before second-stage surgery.Residual bone height(RBH)did not significantly influence BH changes,whereas smoking status and type of bone graft materials were the potentially influential factors.During the approximate three-year observation period,lSFE with a minimally invasive technique demonstrated high implant survival rate and limited bone reduction in grafted area.In conclusion,lSFE using minimally invasive techniques was a viable treatment option.Patients who were nonsmokers and whose sinus cavity was filled with deproteinized bovine bone mineral(DBBM)had significantly limited bone resorption in grafted area.
基金Supported by grants from the National Natural Science Foundation of China(81873502 and 31330029)the Fundamental Research Funds for the Central Universities(2017KFYXJJ250)Scientific Research Fund of Union Hospital,Tongji Medical College,Huazhong University of Science and Technology(02.03.2017-307).
文摘Pentalogy of Cantrell is a rare congenital abnormality.Even with high-quality medical care and staged corrective surgeries in professional hospitals,the mortality rate is still very high and long-term prognosis is poor.Survival is largely determined by the complexity and severity of cardiac abnormalities,the efficiency of abdominal wall closure and postoperative complications.A 24-year-old male patient with complete pentalogy of Cantrell was diagnosed.One-stage surgical repair of all abnormalities were completed.The patient recovered well and had been follow-up for 7 years.He has a good cosmetic outcome,with no signs of cardiac dysfunction.No complications were noted.
文摘Security and safety remain paramount concerns for both governments and individuals worldwide.In today’s context,the frequency of crimes and terrorist attacks is alarmingly increasing,becoming increasingly intolerable to society.Consequently,there is a pressing need for swift identification of potential threats to preemptively alert law enforcement and security forces,thereby preventing potential attacks or violent incidents.Recent advancements in big data analytics and deep learning have significantly enhanced the capabilities of computer vision in object detection,particularly in identifying firearms.This paper introduces a novel automatic firearm detection surveillance system,utilizing a one-stage detection approach named MARIE(Mechanism for Realtime Identification of Firearms).MARIE incorporates the Single Shot Multibox Detector(SSD)model,which has been specifically optimized to balance the speed-accuracy trade-off critical in firearm detection applications.The SSD model was further refined by integrating MobileNetV2 and InceptionV2 architectures for superior feature extraction capabilities.The experimental results demonstrate that this modified SSD configuration provides highly satisfactory performance,surpassing existing methods trained on the same dataset in terms of the critical speedaccuracy trade-off.Through these innovations,MARIE sets a new standard in surveillance technology,offering a robust solution to enhance public safety effectively.
文摘BACKGROUND The combined anterior/posterior approach appears to be capable of reconstructing spinal stability,correcting thoracolumbar deformity,and promoting neural recovery in severe thoracolumbar fracture dislocation.However,this type of operation requires changing the body position during the procedure,resulting in a lengthy operation time.As a universal surgical robot,TINAVI robot has achieved good surgical results in clinical surgery.But to our knowledge,no reports describing TINAVI robot-assisted single lateral position anteroposterior surgery for thoracolumbar fracture dislocation.CASE SUMMARY We describe a case of a 16-year-old female patient with severe thoracolumbar fracture and dislocation underwent surgery assisted by the TINAVI robot.A onestage combined anterior and posterior operation was performed on a severe thoracolumbar fracture dislocation using the TINAVI robot,and the operation was completed in right lateral position.CONCLUSION The TINAVI robot-assisted one-stage anterior and posterior surgery in right lateral position for severe thoracolumbar fracture and dislocation is both safe and effective.
文摘BACKGROUND Thoracolumbar fractures are generally combined with spinal cord injury to varying degrees,which may cause deterioration of the patients’condition and increase the difficulty of clinical treatment.At present,anterior or combined anterior-posterior surgery is preferred for severe thoracolumbar fractures.AIM To investigate the effectiveness and postoperative rehabilitation of one-stage combined anterior-posterior surgery for severe thoracolumbar fractures with spinal cord injury.METHODS One-hundred-and-twenty patients who received surgery for severe thoracolumbar fractures with spinal cord injury at our hospital from February 2018 to February 2020 were randomly enrolled.They were randomly divided into group 1(one-stage combined anterior-posterior surgery,n=60)and group 2(onestage anterior-approach surgery,n=60).Treatment efficacy was compared between the two groups.RESULTS Blood loss was greater and the operation time was longer in group 1 than in group 2,and the differences were statistically significant(P<0.05).Incision length,intraoperative X-rays,and length of hospital stay were not significantly different between the two groups(P>0.05).Preoperative function of the affected vertebrae was not significantly different between the two groups(P>0.05).In each group,the patients showed significant improvement after surgery.The anterior vertebral height ratio and the posterior vertebral height ratio in group 1 after surgery were significantly higher than those in group 2.The Cobb angle after surgery was significantly lower in group 1 than in group 2(P<0.05).The canal-occupying ratio of the affected vertebrae was not significantly different between the two groups(P>0.05).Before surgery,there was no significant difference in the quality of life scores between the two groups(P>0.05).The above indicators were significantly improved after surgery compared with before surgery in each group.In addition,these indicators were markedly better in group 1 than in group 2 after surgery(P<0.05 for each).CONCLUSION One-stage combined anterior-posterior surgery effectively improves the function of the affected vertebrae and the life quality of patients with severe thoracolumbar fractures and spinal cord injury.This surgical approach is worthy of popularization in clinical use.
文摘The development of pancreatic surgery in China has progressed remarkably over 7 decades.China initiated its pancreatic surgery journey in the 1950s,marked by the first pancreaticoduodenectomy performed by Zeng Xianjiu in 1951.Early progress was hindered by technological limitations and fragmented practices,but the establishment of academic platforms such as the National Pancreatic Disease Symposia in the 1980s catalyzed standardized research and interdisciplinary collaboration.In 2006,Zhang Shengdao spearheaded China’s first Guidelines for the Diagnosis and Treatment of Severe Acute Pancreatitis.The 21st century has seen remarkable progress in pancreatic surgery,marked by the China-specific treatment guidelines,technological breakthroughs in laparoscopic and robotic surgical systems,and the increasing centralization of pancreatic surgery in high-volume medical centers.These synergistic advancements have collectively propelled a paradigm shift in contemporary cancer care.By 2022,China Pancreas Data Center reported a postoperative mortality rate of 0.4% and 3-year survival rates of 43% for resected pancreatic cancer,rivaling global benchmarks.China has also emerged as a leader in minimally invasive pancreatic surgery,with advancements in laparoscopic and robotic pancreatic surgery.Academic growth paralleled clinical progress:the Chinese Pancreatic Association,established in 2022,fosters global collaboration,evidenced by its 2024 annual conference attracting over 10,000 participants.Through technological innovation,centralized care models,and international partnerships,China continues to redefine its role in advancing pancreatic surgery.
文摘The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which ranks in the second quartile in the surgery category.This remarkable achievement,which reflects LERS’s steadily increasing influencein the area of surgery,would not be possible without the peer reviewer’s invaluable contributions.On behalf of the Editorial Board and Editorial Office,we would express our sincere appreciation to the following reviewers,who reviewed at least one paper with rigorous and insightful comments.We sincerely hope to engage further with them,either as esteemed reviewers or outstanding authors,in 2026 and beyond.
文摘Objective:To explore the relationship between anesthetic depth and surgical stress response in minimally invasive cardiothoracic surgery.Methods:A total of 89 patients who underwent thoracoscopic minimally invasive cardiothoracic surgery in our hospital from June 2024 to December 2024 were selected as the research objects.They were divided into the light anesthesia group(n=45)and the deep anesthesia group(n=44).The vital signs at different intraoperative nodes and perioperative stress status of the two groups were compared.Results:Before lesion resection and after surgery,the mean arterial pressure and heart rate of the deep anesthesia group were lower than those of the light anesthesia group,with statistically significant differences.Conclusion:In thoracoscopic minimally invasive cardiothoracic surgery,deep anesthesia can effectively control the patient’s surgical stress response,but the postoperative awakening time is longer;patients under light anesthesia have a shorter awakening time,but the intraoperative stress response is obvious.
基金supported by National Key Research and Development Program of China(No.2023YFC2507406)National Natural Science Foundation of China(No.82300646)+6 种基金Beijing Natural Science Foundation(No.7232334)Beijing Municipal Administration of Hospitals Incubating Program(No.PX2024002,PX2020001)Capital Fund for Health Development Scientific Research(No.2024-2-2028)Beijing Municipal Science&Technology Commission AI+Health Collaborative Innovation Cultivation Project(No.Z241100007724004)Research Ward Excellence Program of Beijing Municipal Health Commission(No.BRWEP2024W162020100,BRWEP2024W162020112,BRWEP2024W162020114)Excellent Plan for Capital Medicine Scientific and Technological Innovation Achievement Transformation Promotion Plan(No.YC202401QX0824)Clinical Scientific Research Fund of Beijing Integrated Medical Association[No.ZHKY-2025-1869(B012)]。
文摘With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery(LECSSNNS)has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation.However,robust evidence-based support for guiding clinical implementation remains limited.To address this gap,we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations.These included preoperative assessment,surgical techniques,intraoperative endoscopic procedures,pathological evaluation,postoperative care,and follow-up.This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS,thereby advancing precise,minimally invasive,and function-preserving treatment for EGC.
基金supported by grants from Young Scientists Fund of the National Natural Science Foundation of China(grant number.82301295).
文摘1Introduction A 25-year-old woman presented with a 3-month history of otalgia and aural fullness in the left ear,without associated otological or systemic symptoms.Her medical history was unremarkable,and she denied any history of hepatitis,hypertension,diabetes,cardiovascular disease,or other significant conditions.The patient was diagnosed with external auditory canal cholesteatoma and subsequently underwent canalplasty under general anesthesia.Routine anesthetic drugs,including 2%lidocaine,dexamethasone,propofol,sufentanil,rocuronium bromide,ondansetron,flurbiprofen axetil,neostigmine,and atropine,were used during surgery and anesthesia recovery.No significant events were noted,and the patient experienced only a blood loss of 10 mL.
基金Supported by the National Natural Science Foundation of China(Grant Nos.62025104,62331005,and U22A2052)the Beijing Natural Science Foundation(Grant No.L242100).
文摘Background Computed tomography(CT) and cone-beam computed tomography(CBCT) image registration play pivotal roles in computer-assisted navigation for orthopedic surgery. Traditional methods often apply uniform deformation models, neglecting the biomechanical differences between rigid structures and soft tissues, which compromises registration accuracy, especially during significant bone displacements. Method To address this issue, we introduce RE-Reg, a rigid-elastic CT-CBCT image registration framework that jointly learns rigid bone motion and soft tissue deformation. RE-Reg incorporates a rigid alignment(RA) module to estimate global bone motion and an elastic deformation(ED) module to model soft tissue deformation, preserving bony structures through bone shape preservation(BSP) loss. Result Our comprehensive evaluation on publicly available datasets demonstrates that RE-Reg significantly outperforms existing methods in terms of registration accuracy and rigid bone structure preservation, achieving a 1.3% improvement in Dice similarity coefficient(DSC) and a 23% reduction in rigid bone deformation(%Δvol) compared with the best baseline. Conclusion This framework not only enhances anatomical fidelity but also ensures biomechanical plausibility and provides a valuable tool for image-guided orthopedic surgery. This code is available athttps://github.com/Zq-Huang/RE-Reg.
文摘AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.METHODS:This study included 74 eyes from 37 patients,comprising 17 males and 20 females,with a mean age of 51.74±7.80 years.Using a coin toss method,one eye per patient was randomly selected for improved anterior capsular polishing,while the other eye received standard irrigation/aspiration(I/A)polishing.The polishing group consisted of 37 eyes,including 21 right and 16 left eyes,while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group.Visual acuity and quality of the patients were evaluated before surgery and at 1 wk,1,6,and 12 mo after surgery.The OPD-Scan III was utilized to assess high-order aberrations,while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff),Strehl ratio(SR),and objective scatter index(OSI)for the purpose of visual quality assessment.Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results,and the SNK-q post hoc test was applied to identify significant differences.RESULTS:The polishing group’s uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05).At 12-months,UDVA,UNVA,and corrected distant visual acuity(CDVA)were better than the control group(P<0.05).The MTF cutoff,SR,OSI,and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.
文摘The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatment at grassroots hospitals faces numerous challenges such as limited resources,high technical difficulty,and insufficient multidisciplinary collaboration.Therefore,DCS strategies need to be adapted to simplified processes to create conditions for subsequent treatment.This paper retrieves relevant literature to discuss the proposal,promotion,and application of the DCS concept,aiming to provide evidence-based basis for optimizing trauma treatment outcomes at grassroots hospitals.
文摘Background:Pressure injury(PI)is a prevalent complication in pediatric cardiac surgery,with higher incidence than in general pediatric populations due to children’s thin skin,underdeveloped subcutaneous tissue,and prolonged intraoperative pressure.Objective:To evaluate the effectiveness of the curvilinear supine position(CSP)in preventing PI among children undergoing congenital heart disease(CHD)surgery.Methods:Between October 2024 and February 2025,a single-center randomized controlled trial was conducted.Of the 80 children initially enrolled for congenital heart disease(CHD)surgery,77(aged 1 month to 14 years)completed the study and were included in the final analysis after 3 were excluded due to protocol violations.Participants were randomly assigned to the CSP group(n=38)or the conventional supine position group(n=39).Results:The incidence of PI was significantly lower in the CSP group(2.6%)compared to the control group(20.5%)(p=0.029).Postoperative LDH levels were also significantly reduced in the CSP group(422.67±86.52 U/L vs.592.92±215.71 U/L;p=0.031),while preoperative LDH and surgical variables(e.g.,cardiopulmonary bypass time)were comparable between groups.Although the CSP group had a shorter hospital stay(17.24 vs.22.51 days),the difference was not statistically significant(p=0.085).Caregiver satisfaction was significantly higher in the CSP group(100.0%vs.84.6%;p=0.025).Conclusion:CSP effectively reduces PI incidence,mitigates tissue injury,and enhances caregiver satisfaction in pediatric cardiac surgery,offering a safe and feasible strategy for perioperative PI prevention.
文摘Objective:To analyze the impact of nursing interventions based on quantitative assessment using the Kano model on the quality of rehabilitation in patients with early-stage ovarian cancer following laparoscopic radical surgery.Methods:A prospective clinical study was conducted involving 96 patients with newly diagnosed early-stage ovarian cancer who underwent laparoscopic radical surgery from December 2023 to December 2025.Patients were randomly assigned to groups using a random number table method before surgery.After surgery,the control group(n=48)received routine quantitative assessment nursing interventions,while the observation group(n=48)received nursing interventions based on quantitative assessment using the Kano model.Both groups received continuous nursing care until discharge.Differences between the groups were compared in terms of negative emotions,quality of life scores before and after postoperative intervention,postoperative recovery indicators,and nursing satisfaction evaluations on the day of discharge.Results:After intervention,the observation group had lower scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS),as well as shorter recovery times for gastrointestinal function and food intake,and a shorter hospital stay compared to the control group.Additionally,the observation group had higher scores on the Quality-of-Life Instrument for Cancer Patients-Ovarian Cancer(QLICP-OV)than the control group,with statistically significant differences(p<0.05).The overall satisfaction with nursing care in the observation group was also higher than that in the control group,with a statistically significant difference(p<0.05).Conclusion:Implementing quantitative evaluation nursing interventions based on the Kano model for patients with early-stage ovarian cancer after laparoscopic radical surgery can,by addressing their postoperative basic health,disease awareness,and other intervention content needs to a comprehensive degree,actively promote postoperative recovery and improve their mental health and quality of life.
基金Supported by 2025 Henan Medical Education Research Project,No.WJLX2025038.
文摘BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.
文摘With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.
文摘BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investigated rates of return to farming or other heavy labor that is of interest to patients in rural areas.AIM To evaluate the literature regarding RTW in farming or heavy labor after orthopedic hip,knee,or shoulder surgery.METHODS A search was performed in the PubMed and EMBASE databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Studies were included if they reported patients employed in farming or heavy labor,RTW rates after orthopedic surgery of the hip,knee,or shoulder,and had a minimum 6-month follow-up.A meta-analysis of proportions using a random-effects model was performed on three single-arm observational studies to estimate the pooled RTW rate following arthroscopic shoulder surgery.RESULTS Ten studies were included,and 101 farmers were identified among 440 total patients.One study involved hip surgery,two studies involved knee surgery,and seven studies involved shoulder surgery.RTW rates across studies varied by type of surgery and follow-up interval,ranging from 24%to 100%.The RTW rate was only 53.6%at 1 year following total hip arthroplasty.No studies investigated RTW in farmers following total knee arthroplasty.Among non-comparative studies,meta-analysis revealed a pooled RTW rate of 89%following arthroscopic shoulder surgery,with low heterogeneity(I^(2)=30.1%).Among comparative studies,one study reported significantly higher RTW odds for patients undergoing anatomic total shoulder arthroplasty compared to reverse shoulder arthroplasty(odds ratio=5.45).Overall,surgical intervention for shoulder pathology was associated with a high likelihood of RTW across multiple techniques,with particularly favorable outcomes for anatomic total shoulder arthroplasty.CONCLUSION This systematic review highlights the high rates of RTW in farmers and heavy laborers after shoulder surgery.However,our findings also underscore the need for more rural-specific research to guide patient counseling,rehabilitation expectations,and shared decision-making in this underserved population,particularly for orthopedic surgery of the hip and knee.
基金Supported by the Shaanxi Provincial Science and Technology Plan Project(No.2024SF-YBXM-333).
文摘AIM:To establish and validate a multidimensional predictive model of postoperative visual recovery after idiopathic macular hole(IMH)surgery.METHODS:Retrospective cohort study.Examinations within a three-month period,both pre-and postoperative,included assessments of best corrected visual acuity(BCVA),intraocular pressure(IOP),and morphological parameters of IMH with optical coherence tomography(OCT).Then,a series of indices were derived,including the IMH index(MHI),diameter hole index(DHI),macular hole closure index(MHCI),hole form factor(HFF),and tractional hole index(THI).Subfoveal anatomical damage(macular hole inferior volume,Vi)was calculated based on the basal diameter(BD),minimum diameter(MD),and height at the narrowest point(HMD)of IMH.Pearson correlation analysis was utilized to discern significant correlations between postoperative BCVA and the multiple indices examined.A subsequent linear correlation analysis was performed.RESULTS:The study involved 51 eyes from 51 patients(mean age 66.90±6.07y)diagnosed with IMH.Preoperative BCVA was 1.22±0.76 logMAR and improved to 0.88±0.38 logMAR after surgery(P<0.001).The correlation analysis results showed significant correlations between postoperative BCVA and preoperative BCVA(P<0.001),BD(P=0.042),MD(P=0.001),MHI(P=0.047),THI(P=0.004),and Vi(P=0.007).The multidimensional model integrating THI,Vi,and preoperative BCVA significantly outperformed traditional predictors(MD,BD,and height)in terms of postoperative visual recovery prediction.THI,reflecting posterior vitreous traction mechanics,independently predicted anatomical reset potential(β=-0.06,P=0.022),while Vi,quantifying subfoveal photoreceptor disruption,was correlated with structural-functional recovery(β=0.01,P=0.046).Preoperative visual acuity served as a critical surrogate for retinal functional reserve(β=0.15,P=0.020).Redundant morphometric parameters(MHI,DHI,MHCI,HFF)were excluded,as their predictive contributions were subsumed by THI/Vi or mediated by preoperative vision.CONCLUSION:The combination of biomechanical traction(THI),subfoveal anatomical damage(Vi),and preoperative BCVA represents a clinically applicable framework for predicting postoperative visual recovery after IMH surgery.This model can be used as a practical tool to guide surgical planning,facilitating the identification of highrisk patients who may benefit from additional techniques(such as an internal limiting membrane flap)while optimizing resource allocation for standard cases.
基金funding from the China National Key Research and Development Program(No.2023YFC3603104)the National Natural Science Foundation of China(Nos.82472243 and 82272180)+6 种基金the Fundamental Research Funds for the Central Universities(No.226-2025-00024)the Huadong Medicine Joint Funds of the Zhejiang Provincial Natural Science Foundation of China(No.LHDMD24H150001)the Key Research&Development Project of Zhejiang Province(No.2024C03240)a collaborative scientific project co-established by the Science and Technology Department of the National Administration of Traditional Chinese Medicine and the Zhejiang Provincial Administration of Traditional Chinese Medicine(No.GZY-ZJ-KJ-24082)he General Health Science and Technology Program of Zhejiang Province(No.2024KY1099)the Project of Zhejiang University Longquan Innovation Center(No.ZJDXLQCXZCJBGS2024016)Wu Jieping Medical Foundation Special Research Grant(No.320.6750.2024-23-07).
文摘Objective:Sepsis exhibits remarkable heterogeneity in disease progression trajectories,and accurate identificationof distinct trajectory-based phenotypes is critical for implementing personalized therapeutic strategies and prognostic assessment.However,trajectory clustering analysis of time-series clinical data poses substantial methodological challenges for researchers.This study provides a comprehensive tutorial framework demonstrating six trajectory modeling approaches integrated with proteomic analysis to guide researchers in identifying sepsis subtypes after laparoscopic surgery.Methods:This study employs simulated longitudinal data from 300 septic patients after laparoscopic surgery to demonstrate six trajectory modeling methods(group-based trajectory modeling,latent growth mixture modeling,latent transition analysis,time-varying effect modeling,K-means for longitudinal data,agglomerative hierarchical clustering)for identifying associations between predefinedsequential organ failure assessment trajectories and 25 proteomic biomarkers.Clustering performance was evaluated via multiple metrics,and a biomarker discovery pipeline integrating principal component analysis,random forests,feature selection,and receiver operating characteristic analysis was developed.Results:The six methods demonstrated varying performance in identifying trajectory structures,with each approach exhibiting distinct analytical characteristics.The performance metrics revealed differences across methods,which may inform context-specificmethod selection and interpretation strategies.Conclusion:This study illustrates practical implementations of trajectory modeling approaches under controlled conditions,facilitating informed method selection for clinical researchers.The inclusion of complete R code and integrated proteomics workflows offers a reproducible analytical framework connecting temporal pattern recognition to biomarker discovery.Beyond sepsis,this pipeline-oriented approach may be adapted to diverse clinical scenarios requiring longitudinal disease characterization and precision medicine applications.The comparative analysis reveals that each method has distinct strengths,providing a practical guide for clinical researchers in selecting appropriate methods based on their specificstudy goals and data characteristics.
