Zhonghua yi xue za zhi最新文献

The deep integration of artificial intelligence (AI) is driving a profound transformation in the research paradigm of sports medicine. This article systematically reviewed the primary models of AI-sports medicine integration, including intelligent early warning for sports injury risks, intelligent diagnosis of musculoskeletal health issues, intelligent assistance of surgeries, and intelligent prediction of patient prognosis. It further analyzed the key challenges hindering deep integration, covering technical bottlenecks and data barriers, patient privacy and health equity risks, as well as the lack of regulatory and health insurance mechanisms. On this basis, systematic pathways for promoting high-quality development were proposed, including strengthening a clinical value-oriented technology research and development and transformation system, building a full-cycle data security and ethical governance framework for technologies, and improving value-based payment mechanisms and policy support environments. Through multi-dimensional and coordinated advancement, the potential of AI-sports medicine integration could be fully unleashed, achieving a leap from technological empowerment to health value creation, thereby providing robust support for the implementation of the"Healthy China 2030"strategy.

A retrospective analysis was conducted on the clinical data of patients with giant refractory gastric bezoars treated at Zhongda Hospital of Southeast University between January 2019 and May 2025. All patients underwent modified endoscopic holmium laser-yellow zebra guidewire loop combined lithotripsy. Follow-up gastroscopy was performed 4 weeks postoperatively to analyze the efficacy of this combined technique in treating giant refractory gastric bezoars. A total of 38 patients were included, including 14 males and 24 females, aged (66±12) years (44-88 years). Thirty-five patients successfully achieved bezoar removal after a single treatment session, with a single-session success rate of 92.1% (35/38). Postoperative complications, such as nausea, vomiting, gastric mucosal injury, or pain, occurred in 4 patients (10.5%). At the 4-week follow-up gastroscopy, the complete ulcer healing rate was 87.0% (20/23). The modified endoscopic holmium laser-yellow zebra guidewire loop combined lithotripsy is a safe and effective treatment for giant refractory gastric bezoars.

The incidence of osteoporosis increases significantly with age. When elderly patients require internal fixation due to degenerative changes or trauma in the thoracolumbar spine, concomitant osteoporosis considerably elevates surgical difficulty and risk. Common complications include screw loosening, internal fixation failure, and nonunion of bone grafts, posing substantial challenges to spine surgeons. Currently, there is a lack of relevant clinical standards or guidelines for the application of thoracolumbar internal fixation in elderly patients with osteoporosis. To address this gap, based on the principles of evidence-based medicine, integrating scientific rigor with practicality, conducting a systematic review and analysis of relevant literature, the Innovation and Transformation Group of the Chinese Orthopaedic Association and the Spine Trauma Group of the Chinese Association of Orthopaedic Surgeons and the Orthopedic Minimally Invasive Injury Professional Committee of Shaanxi Province Association of Orthopedic Surgeons jointly led an expert initiative leading to the development of this guideline. Recommendations are proposed primarily covering preoperative education, surgical strategies, intraoperative considerations, and postoperative rehabilitation, aiming to standardize the clinical application of this technique.

More and more studies have confirmed that robotic-assisted total knee arthroplasty (RATKA) can improve surgical accuracy and has a user-friendly learning curve. However, most current studies evaluating the learning curve use operative time as the standard of assessment, although proficiency does not equate to complete mastery of RATKA surgical techniques. This article will summarize experience from two perspectives: surgical technical pitfalls and non-surgical technical adverse events in RATKA. Regarding surgical techniques, it is essential to fully understand the differences in workflow and principles between RATKA and traditional total knee arthroplasty to avoid the occurrence of"unsatisfactory cases". At the non-surgical technical level, a comprehensive understanding of the various new complications that may arise during RATKA is necessary in order to consciously prevent adverse events. Ultimately, the robot will become a powerful tool for surgeons.

Objective: To quantitatively evaluate the efficacy, precision, and reproducibility of the surgical navigation module of a novel robotic-assisted anterior cruciate ligament reconstruction (ACLR) system during bone tunnel drilling using in vitro models. Methods: Thirty 3D-printed knee models were randomized into a robotic group (n=15) and a conventional group (n=15) using a random number table. Both groups utilized the same individualized surgical plans generated by the system's preoperative planning module. In the robotic group, bone tunnel drilling was guided by the system's mechanical arm; in the conventional group, drilling was performed manually by senior sports medicine surgeons using traditional instrumentation. Operative time was recorded. Postoperative bone tunnel lengths and tunnel exit positions in both groups were compared with the preoperative planning values among the three groups. Results: The total operative time was significantly longer in the robotic group [(25.83±2.20) vs (15.55±1.96) min, P<0.001], whereas the robotic group achieved a significantly shorter duration for the core bone tunnel drilling phase [6.08 (5.72, 6.75) vs 7.60 (6.80, 8.52) min, P=0.003]. There were no statistically significant differences among the three groups regarding the numerical values of the three length indicators (femoral and tibial tunnel lengths, intra-articular distance) or the four tunnel exit position dimensions (deep-shallow, high-low, anterior-posterior, medial-lateral) within the Bernard quadrant (all P>0.05). However, the variance in all positioning dimensions was significantly lower in the robotic group compared to the conventional group (all P<0.05), particularly in the femoral high-low and tibial anterior-posterior directions (both P<0.001), indicating superior consistency in robot-assisted operation. Conclusions: Robot-assisted ACLR technology improves efficiency during the critical drilling phase and significantly minimizes manual operational variability. These findings provide experimental evidence supporting the application of high-precision surgical navigation in ACLR.

The rapid advancement of artificial intelligence (AI) technologies, particularly deep learning algorithms and hardware devices, has profoundly transformed diagnostic and therapeutic paradigms in sports medicine. This article reviews the applications and recent progress of AI across multiple domains in the field, including the use of deep learning and machine learning models for injury risk prediction and early screening; the application of computer vision techniques in imaging diagnosis; the integration of intelligent algorithms into surgical planning and intraoperative assistance; the dynamic monitoring of rehabilitation processes; and the deployment of large language models to support patient education and consultation. The deep integration of sports medicine and AI requires interdisciplinary collaboration across clinical medicine, sports science, materials science, and computer science. This article highlights the current applications, discusses existing challenges and potential risks, and provides an outlook on future development trends.

Neutropenia is one of the most common hematologic toxicities during the treatment of hematologic malignancies. It can lead to delays in subsequent treatments, dose reduction of chemotherapeutic agents, or even treatment discontinuation. Furthermore, neutropenia increases the risk of febrile neutropenia and severe infections, which adversely affect patient prognosis. Pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) is effective in preventing and treating neutropenia, and is widely used in the treatment of hematologic malignancies and hematopoietic stem cell transplantation (HSCT). To further promote the standardized application of PEG-rhG-CSF in hematological malignancies, the Hematology Oncology Committee of China Anti-Cancer Association organized domestic experts in the related fields, based on current evidence-based medical data and clinical practice, to focus on the clinical application of PEG-rhG-CSF in hematologic malignancies, hematopoietic stem cell mobilization and hematopoietic function reconstitution after HSCT. Eight recommendation opinions were finally proposed to guide the standardized use of drugs in clinical practice.

With the rapid aging of the population, disability and dementia have become major public health challenges affecting the health and quality of life of the elderly in the community. The multidisciplinary collaborative intervention model for the risk of disability and dementia in the elderly, covering key areas such as clinical medicine, public health and social support systems, has become a current research focus. This expert consensus concentrates on eight core functional dimensions-mobility, cognition, emotion, vision, hearing, excretion, swallowing, and comorbidity management-and the corresponding modifiable risk factors. It systematically reviews the clinical evidence and latest advances in relevant interventions in China and abroad. By integrating opinions from multidisciplinary experts through the Delphi method, the consensus ultimately formulates 15 intervention strategies and recommendations across these eight dimensions for the elderly in the community, with the aim of establishing effective approaches to delay the progression of disability and dementia, providing evidence-based support for primary health-care services, and promoting healthy ageing in China.