Video-assisted thoracic surgery drainage is feasible and safe for acute necrotizing mediastinitis: a retrospective cohort study.

Background: Acute necrotizing mediastinitis (ANM) is a severe infection of the mediastinal loose connective tissue. Traditionally, it has been treated with thoracotomy, but video-assisted thoracic surgery (VATS) is been increasingly used in patients with this condition. This study aimed to compare the outcomes of VATS and open thoracotomy in treating ANM. Methods: The medical records of patients with ANM who underwent surgery between March 2012 and April 2021 were retrieved. A retrospective screening was conducted based on clinical characteristics, bacterial pathogens, surgical approach, and outcomes. The patients were divided into a VATS group and an open thoracotomy (Open) group. The patient characteristics and surgical outcomes of the two groups were summarized and compared. Results: A total of 64 cases were enrolled in this study, including 48 in the VATS group (75%) and 16 in the Open group (25%). The most common site of infection was the neck (n=26, 40.6%). Streptococcus constellatus and Acinetobacter baumannii (A. baumannii) were the most frequently found pathogens in secretion culture. In sputum culture, the most common pathogens were Klebsiella pneumonia and A. baumannii. Postoperative outcomes, including blood transfusion (33.3% vs. 43.8%; P=0.45), duration of postoperative drainage {14 [1-47] vs. 17 [4-54] days; P=0.15}, length of antibiotic medication {14.5 [1-54] vs. 18 [4-54] days; P=0.29}, admission to intensive care unit (ICU) (87.5% vs. 75.0%; P=0.43), length of ICU stay {5 [1-58] vs. 8.5 [1-37] days; P=0.20}, postoperative hospital stay {17 [2-61] vs. 21 [5-56] days; P=0.22}, reoperation rate (12.5% vs. 6.25%; P=0.82), and mortality rate (14.6% vs. 12.5%; P>0.99) were comparable between the two groups. Conclusions: ANM treated by both the VATS and open approach had comparable outcomes. Therefore, VATS is a viable option for patients with ANM.

Improving Pretrained Language Model Fine-Tuning With Noise Stability Regularization.

The advent of large-scale pretrained language models (PLMs) has contributed greatly to the progress in natural language processing (NLP). Despite its recent success and wide adoption, fine-tuning a PLM often suffers from overfitting, which leads to poor generalizability due to the extremely high complexity of the model and the limited training samples from downstream tasks. To address this problem, we propose a novel and effective fine-tuning framework, named layerwise noise stability regularization (LNSR). Specifically, our method perturbs the input of neural networks with the standard Gaussian or in-manifold noise in the representation space and regularizes each layer's output of the language model. We provide theoretical and experimental analyses to prove the effectiveness of our method. The empirical results show that our proposed method outperforms several state-of-the-art algorithms, such as [Formula: see text] norm and start point (L2-SP), Mixout, FreeLB, and smoothness inducing adversarial regularization and Bregman proximal point optimization (SMART). In addition to evaluating the proposed method on relatively simple text classification tasks, similar to the prior works, we further evaluate the effectiveness of our method on more challenging question-answering (QA) tasks. These tasks present a higher level of difficulty, and they provide a larger amount of training examples for tuning a well-generalized model. Furthermore, the empirical results indicate that our proposed method can improve the ability of language models to domain generalization.

Analyzing public opinion on COVID-19 through different perspectives and stages.

In recent months, COVID-19 has become a global pandemic and had a huge impact on the world. People under different conditions have very different attitudes toward the epidemic. Due to the real-time and large-scale nature of social media, we can continuously obtain a massive amount of public opinion information related to the epidemic from social media. In particular, researchers may ask questions such as "how is the public reacting to COVID-19 in China during different stages of the pandemic?", "what factors affect the public opinion orientation in China?", and so on. To answer such questions, we analyze the pandemic-related public opinion information on Weibo, China's largest social media platform. Specifically, we have first collected a large amount of COVID-19-related public opinion microblogs. We then use a sentiment classifier to recognize and analyze different groups of users' opinions. In the collected sentiment-orientated microblogs, we try to track the public opinion through different stages of the COVID-19 pandemic. Furthermore, we analyze more key factors that might have an impact on the public opinion of COVID-19 (e.g. users in different provinces or users with different education levels). Empirical results show that the public opinions vary along with the key factors of COVID-19. Furthermore, we analyze the public attitudes on different public-concerning topics, such as staying at home and quarantine. In summary, we uncover interesting patterns of users and events as an insight into the world through the lens of a major crisis.

Intranasally Administered Adjunctive Dexmedetomidine Reduces Perioperative Anesthetic Requirements in General Anesthesia

PURPOSE: Intranasal dexmedetomidine is an effective sedative for premedication and is regularly used to reduce preoperative tension and anxiety in children. This study aimed to assess the effect of intranasally adjunctive dexmedetomidine on perioperative sedative and analgesic requirements in adults. MATERIALS AND METHODS: Patients were randomly divided into four groups to receive preoperative administration of saline, intranasal dexmedetomidine 1 µg/kg and 2 µg/kg, and intravenous dexmedetomidine 1 µg/kg, respectively. Propofol and remifentanil were target-controlled infused to maintain intraoperative bispectral index at 45-55 and blood pressure at baseline value±20%. Sufentanil was administered to maintain postoperative visual analogue scale ≤3. Perioperative anesthetics requirements were compared using nonparametric tests. RESULTS: Intranasal dexmedetomidine significantly attenuated propofol requirements for anesthesia induction and maintenance in a dose-dependent manner. Patients given intranasal dexmedetomidine 2 µg/kg required less remifentanil for anesthesia maintenance. The first postoperative request for sufentanil analgesia was delayed in patients given intranasal dexmedetomidine 2 µg/kg. The anesthetics-sparing effect of intranasal dexmedetomidine was significantly weaker than intravenous dexmedetomidine at the same dose of 1 µg/kg. The incidences of adverse events, including hemodynamic instability and delayed recovery, were comparable with and without intranasal dexmedetomidine. CONCLUSION: Intranasal administration of dexmedetomidine can reduce perioperative anesthetic requirements, and a dose of dexmedetomidine 2 µg/kg produces a better effect in adults. The anesthetics-sparing effect of intranasal dexmedetomidine 1 µg/kg is less than that with the same intravenous dose of dexmedetomidine.

Correlative factors for organic psychotic symptoms in patients following traumatic brain injury / 法医学杂志

OBJECTIVE@#To investigate the correlative factors for organic psychotic symptoms following traumatic brain injury (TBI).@*METHODS@#In the current study, 391 subjects who had undergone forensic identification of the organic mental disorders due to TBI were included, both the demographic and post-traumatic information collected. The relevant data were statistically analyzed in those confirmed as organic psychotic syndrome according to Chinese Classification of Mental Disorders 3rd version (CCMD-3).@*RESULTS@#Fifty-two subjects (13.3%) were identified as organic psychotic symptoms. The chi-square test showed that the detectable organic psychotic symptoms were associated with the marriage status, damage nature, injury severity and treatment, and the multivariate logistic regression analysis revealed good fitness of treatment and injury severity with the regression model (OR = 0.044, 95% CI: 0.017-0.114; OR = 2.145, 95% CI: 1.201-3.832, respectively).@*CONCLUSION@#The risks of organic psychotic symptoms following TBI can be involved in the alternative of craniotomy for the cases with trauma and moderate brain injury.

Evaluating on recognition impairment after traumatic brain injury with WCST / 法医学杂志

OBJECTIVE@#To explore the value of Wisconsin Card Sorting Test (WCST) in evaluating the recognition impairment after traumatic brain injury (TB1).@*METHODS@#WCST and Wechsler Adult Intelligence Scale Revised in China (WAIS-RC) were adopted to assess the cognitive function in 186 patients with brain injury (experimental group) and 180 healthy volunteers (control group), respectively. The cognition between the experimental group and the control group was compared. The correlation between WCST and IQ was analyzed. The correlation between age, education level, the severity of TBI and the executive function were also analyzed.@*RESULTS@#(1) The performances of WAIS-RC and WCST in the experimental group were significantly worse than that of the control group. (2) There were significantly negative correlation between the performance of total errors, percentage of preservative errors, percentage of random errors, response number on first category and IQ (P < 0.05). While there were significantly positive correlation between the categories completed, percentage of conceptual level and IQ (P < 0.05). (3) There was significantly negative correlation between percentage of conceptual level and the severity of TBI. While there were significantly positive correlation between percentage of preservative errors, percentage of random errors, response number on first category and the severity of TBI.@*CONCLUSION@#WCST could be an important method in evaluating cognition of patients with brain injury.

Clinical and pathological characteristics of intracranial haemangioblastoma / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze and summarize the clinical and pathological characteristics of intracranial haemangioblastoma and to improve surgery effect.</p><p><b>METHOD</b>Seventy-two patients with intracranial haemangioblastoma who were proven by operation and pathology from 1970 to 1988 were analyzed retrospectively.</p><p><b>RESULTS</b>Intracranial haemangioblastoma tends to occur in the hemisphere of cerebellum (83 tumours, 87%) and the age of them ranged from 20 to 40 years (47 cases, 58.3%) mostly. The ratio of men (46 cases) was higher than women (26 cases). The diagnosis of the disease depends on CT and MR substantive haemangioblastoma. The most effective and reliable treatment of intracranial haemangioblastoma is surgical resection.</p><p><b>CONCLUSION</b>Intracranial haemangioblastoma is benign tumour which can be, cured by total surgical resection. The key recurrence factors include the young age of initial onset, mistaken exploration and incomplete extirpation of tumour.</p>