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Volume 41 ， Issue 1 ， 2026
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Risk Factors for Postoperative Pulmonary Complications Following Posterior Spinal Fusion in Adolescent Scoliosis: A Retrospective Cohort Study Enhanced Publication AI Introduction
Abstract：ObjectiveScoliosis is a prevalent spinal deformity that severely impacts the physical and psychological well-being of adolescents and often requires surgical correction. This study aimed to investigate the risk factors for postoperative pulmonary complications (PPCs) following posterior spinal fusion in adolescent scoliosis, with a specific focus on evaluating the predictive value of preoperative forced vital capacity (FVC) and etiological classification.MethodsThis retrospective cohort study enrolled adolescents who underwent posterior spinal fusion for scoliosis correction at Peking Union Medical College Hospital between January 2018 and December 2022. The baseline demographic, clinical, and perioperative variables were collected. The primary endpoint was the occurrence of PPCs prior to hospital discharge. Univariate and multivariable binary logistic regression analyses were conducted to identify independent risk factors.ResultsA total of 1,234 patients were included, of whom 29 (2.35%) developed PPCs and 1,205 did not. Univariate analysis revealed that 12 variables, including non-idiopathic scoliosis, a larger main thoracic curve, a decreased FVC% predicted, and increased perioperative blood transfusions, were significantly associated with PPCs (P < 0.05). Multivariable logistic regression model showed that non-idiopathic scoliosis emerged as the sole independent risk factor for PPCs [adjusted odds ratio (OR) = 5.478, 95% confidence interval: 2.017–19.148, P = 0.002]. Preoperative FVC% predicted (adjusted OR = 0.993, P = 0.497) and main thoracic curve (adjusted OR = 1.002, P = 0.736) did not demonstrate independent predictive value.ConclusionsNon-idiopathic scoliosis, rather than preoperative pulmonary function or curve severity, is an independent risk factor for PPCs following posterior spinal fusion in adolescents. During perioperative respiratory risk assessment, particular emphasis should be placed on the etiological classification of these patients.Keywords：scoliosis;adolescent;spinal fusion;postoperative complications;respiratory function tests;risk factors8|0|0Updated：2026-03-31 -
Teaching Neuraxial Ultrasonography with a Virtual Reality Simulator of Spine: A Randomized Controlled Study Enhanced Publication AI Introduction
Abstract：ObjectiveTo evaluate whether adjunctive virtual reality (VR) spine simulation in neuraxial ultrasound training improves performance competency among anesthesia residents compared with traditional didactic teaching alone.MethodsIn this single-center, randomized controlled trial, anesthesia residents from the Department of Anesthesiology, Peking Union Medical College Hospital were recruited and randomized (1:1, computer-generated) to receive either a traditional 30-minute didactic lecture of spine ultrasonography (control group) or an identical teaching session followed by 30-minute VR spine simulation (VR group). After the training, participants were required to perform a preprocedural spine ultrasound scan. The primary outcome was a composite learning score evaluating the theoretical knowledge, practical skills, self-assessed satisfaction, and willingness to apply the technique in future practice. The secondary outcomes included scanning time, score of anatomic structure recognition, and accuracy of depth measurement to the posterior complex.ResultsA total of 46 participants (23 per group) were enrolled. Compared to the control group, the VR group achieved significantly higher composite learning scores (0.80±0.05 vs 0.74±0.09, P = 0.01). The score of anatomic structure recognition (0.85±0.15 vs 0.72±0.20, P = 0.01) and the accuracy of depth measurement to the posterior complex (73.9% vs 43.5%, P = 0.03) were also significantly superior in the VR group.ConclusionAmong anesthesia residents, adjunctive VR simulator training improves the technical and cognitive performance in neuraxial ultrasound compared with traditional didactic teaching alone.Keywords：neuraxial ultrasonography;virtual reality;neuraxial anesthesia4|0|0Updated：2026-03-31
Research Article
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Time-Dependent Neuroprotection and Precision Interventions in Acute Ischemic Stroke in the Reperfusion Era AI Introduction
Abstract：Acute ischemic stroke ranks as the second leading cause of mortality among noncommunicable diseases globally. Although recent advancements in intravenous thrombolysis and endovascular thrombectomy have markedly increased recanalization rates in patients with large vessel occlusion, improvements in clinical outcomes have not been consistently observed. Accumulating evidence demonstrates that successful recanalization does not necessarily translate into effective tissue reperfusion. Accordingly, the concept of neuroprotection has evolved from a traditional focus on mitigating cellular necrosis toward a strategy aimed at delaying the progression of ischemic penumbra and preserving salvageable brain tissue. This review summarizes the dynamic processes underlying reperfusion injury, microcirculatory dysfunction, neurovascular unit disruption, and associated neuroprotective mechanisms. Particular emphasis is placed on reversible changes within penumbra, reperfusion-induced injury amplification, and emerging imaging-guided approaches and molecular biomarkers for precision interventions. These insights provide a framework for developing spatiotemporally coordinated, individualized neuroprotective strategies.Keywords：acute ischemic stroke;neuroprotection;reperfusion;penumbra;brain imaging technology;precision medicine37|114|0Updated：2026-03-31
Review Article
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Abstract：Life sciences have entered the era of big data, uncovering the complexity of human biological systems and advancing precision medicine and scientific wellness. In alignment with the Findable, Accessible, Interoperable, and Reusable (FAIR) principles, integrating population-level biological data resources from the academic and industrial sectors can substantially increase the efficiency of data utilization and foster innovative breakthroughs. Here, we introduce a novel framework for Good Data Governance Practice (GDGP) coupled with a grading initiative for the life sciences, focusing on traceability and openness. The GDGP framework systematically defines governance constraints, influencing factors, and functional capabilities to streamline data governance and management efficiency. This achievement lays the groundwork for compliant cross-institutional and cross-border data sharing and collaborative processing, poised to pave the way for standardized, ethical, and scalable data-driven research in precision medicine and beyond.Keywords：data governance;grading initiative;FAIR principles;biological data22|13|0Updated：2026-03-31
Think Tank Forum
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Emergency Management of Crushing Perineal Avulsion with Complete Urethral Disruption: A Case Report AI Introduction
Abstract：High-energy machinery entrapment can result in catastrophic perineal injuries involving complete urethral disruption, extensive soft tissue avulsion, and associated orthopedic trauma. We report a 24-year-old man who suffered a crushing roller injury, resulting in total perineal avulsion with bilateral testicular exposure, complete bulbar urethral transection, right pubo and ischial ramus avulsion, and an open ipsilateral tibiofibular fracture. Given the patient's hemodynamic stability following resuscitation and the intraoperative finding of cleanly transected urethral ends without rectal or bladder neck injuries, a single-stage surgical approach was pursued. Primary urethral anastomosis and in situ subcutaneous testicular burial were performed, with primary closure of the perineal wound. At 6 months postoperatively, debridement was repeated for non-healing wound secondary to infection, followed by regular dressing changes. Complete healing was achieved at 1 year postoperatively. At the 3-year follow-up, the patient could ambulate independently without assistance, void with a normal stream, and reported preserved erectile function. These favourable outcomes support the value of aggressive early single-stage reconstruction in carefully selected, hemodynamically stable patients sustaining devastating perineal avulsion injuries.Keywords：perineal avulsion;urethral disruption;genitourinary trauma;first aid;urethral reconstruction6|0|0Updated：2026-03-31 -
Endometrial Carcinoma Arising in Adenomyosis in the Myometrium with Uninvolved Endometrium: A Case Report AI Introduction
Abstract：Endometrial carcinoma arising in adenomyosis (EC-AIA) is a rare entity that originates deep within the myometrium and often spares the endometrial lining. We report a 53-year-old woman who presented with a vascularized uterine mass invading the bladder (International Federation of Gynecology and Obstetrics [FIGO] stage ⅢB2). Despite imaging findings suggesting malignancy, endometrial curettage yielded only atrophic cells, and hysterectomy confirmed a histologically normal endometrial cavity. Final pathology revealed endometrioid adenocarcinoma confined to adenomyotic lesions with lymph node involvement. This case underscores a critical diagnostic pitfall: negative endometrial sampling does not exclude EC-AIA. Moreover, applying current FIGO staging systems, designed for endometrial-origin tumors, to EC-AIA presents significant limitations, risking either underestimation of deep invasion or artificial upstaging.Keywords：endometrial cancer arising in adenomyosis;adenomyosis;endometrial neoplasm3|0|0Updated：2026-03-31
Case Report
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Abstract：This study focuses on eleven representative medical figures—including John Heng Liu and Robert K. S. Lim—to provide a historical account of their wartime service during the Chinese People's War of Resistance against Japanese Aggression. It reveals that the faculty and students of the Peking Union Medical College (PUMC) made distinguished contributions in three critical areas: battlefield medical relief, westward evacuation of the medical colleges and nursing school, and epidemic prevention research. Liu laid the groundwork for China's wartime medical system, while Lim organized and commanded the Medical Relief Corps of the Red Cross Society of China. Qizhen Shen established the Medical Division of the New Fourth Army, and James K. Shen oversaw the westward evacuation of the Central Hospital before serving on the Burma front. Shoukai Zhou drafted key health regulations. Together, these figures formed a wartime medical relief network spanning both the frontal battlefields and the resistance bases in enemy-occupied territories. In medical education, Xiaoqian Zhang led the westward evacuation of Hsiang-Ya Medical College, Zongen Li founded the National Guiyang Medical College, and Yuchan Nieh directed the evacuation of the PUMC School of Nursing—efforts that preserved the torch of medical education amid the flames of war. In scientific research, Feifan Tang overcame Western technological blockades to develop vaccines and penicillin; Wengui Chen exposed Japanese germ-warfare atrocities in his Changde Plague Report; and Dushan Rong supported battlefield medicine through radiological services. Through their scientific expertise and patriotic commitment, these medical figures embodied the collective awakening of PUMC faculty at a moment of existential national crisis. Their service provided indispensable medical support that contributed significantly to China's ultimate victory.Keywords：Chinese People's War of Resistance against Japanese Aggression;Peking Union Medical College;medical history;medical figures2|1|0Updated：2026-03-31
Historical Traces of Medicine
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