Effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries

BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries.METHODS We selected 97 patients with rotator cuff injuries treated in the People's Hospital of Yuhuan from February 2020 to May 2023.Patients were grouped using the envelope method.RESULTS After treatment,the study group’s treatment effective rate was 94.90%(46/49 patients),significantly higher than that in the control group(79.17%,38/48 cases;P<0.05).Before treatment,there was no difference in Constant Murley Score(CMS)scores,shoulder mobility,or 36-Item Short Form Health Survey(SF-36)scale scores(P>0.05).Compared with those before treatment,the CMS scores(including pain,daily living ability,shoulder mobility,and muscle strength),all aspects of shoulder mobility(forward flexion,posterior extension,external rotation,internal rotation),and SF-36 scale scores(including physiological,psychological,emotional,physical,vitality,and health status)were higher in both groups after treatment and significantly higher in the study group(P<0.05).There was no difference in the occurrence of complications between the two treatment groups(P>0.05).CONCLUSION Electroacupuncture combined with rehabilitation techniques has a good treatment effect on patients with rotator cuff injuries,helps accelerate the recovery of shoulder function,improves the quality of life,and is highly safe.

Stem cell therapy for central nerve system injuries: glial cells hold the key

Mammalian adult central nerve system （CNS） injuries are devastating because of the intrinsic difficulties for effective neuronal regeneration. The greatest problem to be overcome for CNS recovery is the poor regeneration of neurons and myelin-forming cells, oligodendrocytes. Endogenous neural progenitors and transplanted exogenous neuronal stem cells can be the source for neuronal regeneration. However, because of the harsh local microenvironment, they usually have very low efficacy for functional neural regeneration which cannot compensate for the loss of neurons and oligodendrocytes. Glial cells （including astrocytes, microglia, oligodendrocytes and NG2 glia） are the majority of cells in CNS that provide support and protection for neurons. Inside the local microenvironment, glial cells largely influence local and transplanted neural stem cells survival and fates. This review critically analyzes current finding of the roles of glial cells in CNS regeneration, and highlights strategies for regulating glial cells＇ behavior to create a permissive microenvironment for neuronal stem cells.

Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture?

Cold therapy has been used regularly as an immediate treatment to induce analgesia following acute soft-tissue injuries,however,a prolonged ice application has proved to delay the start of the healing and lengthen the recovery process.Hyperbaric gaseous cryotherapy,also known as neurocryostimulation,has shown the ability to overcome most of the limitations of traditional cold therapy,and meanwhile promotes the analgesic and anti-inflammatory effects well,but the current existing studies have shown conflicting results on its effects.Traditional cold therapy still has beneficial effect especially when injuries are severe and swelling is the limiting factor for recovery after soft-tissue injuries,and therefore no need to be entirely put out to pasture in the rehabilitation practice.Strong randomized controlled trials with good methodological quality are still needed in the future to evaluate the effects of different cryotherapy modalities.

Prospects for the use of olfactory mucosa cells in bioprinting for the treatment of spinal cord injuries

The review focuses on the most important areas of cell therapy for spinal cord injuries.Olfactory mucosa cells are promising for transplantation.Obtaining these cells is safe for patients.The use of olfactory mucosa cells is effective in restoring motor function due to the remyelination and regeneration of axons after spinal cord injuries.These cells express neurotrophic factors that play an important role in the functional recovery of nerve tissue after spinal cord injuries.In addition,it is possible to increase the content of neurotrophic factors,at the site of injury,exogenously by the direct injection of neurotrophic factors or their delivery using gene therapy.The advantages of olfactory mucosa cells,in combination with neurotrophic factors,open up wide possibilities for their application in threedimensional and four-dimensional bioprinting technology treating spinal cord injuries.

Managing facial infiltrating lipomatosis associated with PIK3CA mutation:From surgery to targeted therapy

Facial infiltrating lipomatosis(FIL)is a congenital asymmetrical deformity of the maxillofacial region that can significantly affect a patient’s facial appearance and function.With the development of sequencing technologies,PIK3CA mutations are considered among the potential etiologies of FIL.The management and treatment of FIL involves plastic surgery;more recently,an improved understanding of its pathogenesis has given rise to new treatment options,including targeted therapy.Here we report the clinical data of two patients diagnosed with FIL and present current curative concepts.

New insight into curcumin-based therapy in spinal cord injuries： CISD2 regulation

Multiple protective effects of curcumin in cases of spinal cord injuries（SCIs）：Curcumin[1,7-bis（4-hydroxy-3-methoxyphenyl）-1,6-heptadiene-3,5-dione]is a nonsteroidal,naturally occurring compound commonly utilized as a dietary pigment as well as a spice in India.It is obtained from curcuma longa in.

Treatment of spinal cord injury with biomaterials and stem cell therapy in non-human primates and humans

Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical disability.Thus,in the search for more effective treatments than those already applied for years,which are not entirely efficient,researches have been able to demonstrate the potential of biological strategies using biomaterials to tissue manufacturing through bioengineering and stem cell therapy as a neuroregenerative approach,seeking to promote neuronal recovery after spinal cord injury.Each of these strategies has been developed and meticulously evaluated in several animal models with the aim of analyzing the potential of interventions for neuronal repair and,consequently,boosting functional recovery.Although the majority of experimental research has been conducted in rodents,there is increasing recognition of the importance,and need,of evaluating the safety and efficacy of these interventions in non-human primates before moving to clinical trials involving therapies potentially promising in humans.This article is a literature review from databases(PubMed,Science Direct,Elsevier,Scielo,Redalyc,Cochrane,and NCBI)from 10 years ago to date,using keywords(spinal cord injury,cell therapy,non-human primates,humans,and bioengineering in spinal cord injury).From 110 retrieved articles,after two selection rounds based on inclusion and exclusion criteria,21 articles were analyzed.Thus,this review arises from the need to recognize the experimental therapeutic advances applied in non-human primates and even humans,aimed at deepening these strategies and identifying the advantages and influence of the results on extrapolation for clinical applicability in humans.

Advances in extracellular vesicle-based combination therapies for spinal cord injury

Spinal cord injury is a severe insult to the central nervous system that causes persisting neurological deficits.The currently available treatments involve surgical,medical,and rehabilitative strategies.However,none of these techniques can markedly reverse neurological deficits.Recently,extracellular vesicles from various cell sources have been applied to different models of spinal cord injury,thereby generating new cell-free therapies for the treatment of spinal cord injury.However,the use of extracellular vesicles alone is still associated with some notable shortcomings,such as their uncertainty in targeting damaged spinal cord tissues and inability to provide structural support to damaged axons.Therefore,this paper reviews the latest combined strategies for the use of extracellular vesicle-based technology for spinal cord injury,including the combination of extracellular vesicles with nanoparticles,exogenous drugs and/or biological scaffold materials,which facilitate the targeting ability of extracellular vesicles and the combinatorial effects with extracellular vesicles.We also highlight issues relating to the clinical transformation of these extracellular vesicle-based combination strategies for the treatment of spinal cord injury.

Preventable head and facial injuries by providing free bicycle helmets and education to preschool children in a head start program

The objectives of the study were to determine helmet use rates, incidence rates (IRs) of head and facial injuries for population attributable fraction (PAF) estimation, and to elucidate the magnitude of and changes in PAFs as the result of helmet use changes among preschool children. A study consisting of cross-sectional (survey) and longitudinal (follow-up) component was designed by including a randomly selected group of participants (n = 322) from 10 Head Start sites provided with free bicycle helmets along with a subgroup of prior helmet owners (n = 68) from the other random group (n = 285). All participants received bicycle helmet education. Helmet use surveys were conducted in May (1st Survey) and November 2008 (2nd Survey). The helmet owners were followed up to determine IRs, and incidence rate ratios (IRRs) for head and facial injuries. PAFs were computed using IRs as well as helmet use rates and IRRs. Helmet use rates increased significantly from the 1st to the 2nd Survey. The mean follow-up person-time was 5 months. The IRs for head, face (all portions), and face (upper/mid portions) injuries were higher in non-helmeted than helmeted riders. By using IRs, PAFs for the 3 injuries among the riders in both groups of helmet owners were 77%, 22%, and 32% respectively. The PAFs for each of the above injuries decreased by about 10% as helmet use rates increased. The magnitude of and changes in preventable head and facial injuries following free bicycle helmet distribution and education among helmeted riders was elucidated in this Head Start preschool children population.

Risk Factors for Gastrointestinal Injuries in Acute Coronary Syndrome Patients with Double Antiplatelet Therapy in One-Year Follow-Up

Background: The goal is to determine the incidence of symptomatic gastrointestinal (GI) injuries in acute coronary syndrome (ACS) patients receiving double antiplatelet therapy (DAPT). The risk factors for serious GI complications are also evaluated. Methods: 603 eligible patients from the Department of Cardiology at Zhongda Hospital between January 2014 and August 2015 were enrolled and the occurrence of GI injuries within one year assessed. The risk factors for serious GI complications were identified using cox regression analysis. Results: After one-year follow-up, 108 (17.9%) out of 603 patients developed symptomatic GI injuries: 22 (3.65%) with serious GI complications and 86 (14.2%) with GI symptoms. Drinking habit (95% CI: 1.512 - 8.796;P = 0.004) and previous peptic injury (95% CI: 2.307 - 18.080;P = 0.001) are independent predictors of serious GI complications, while proton pump inhibitor (PPI) was protective (95% CI: 0.120 - 0.699;P = 0.006) per cox regression analysis. Additionally, GI injuries of both serious GI complications and GI symptoms peaked in the first three months. Conclusions: Symptomatic GI injuries were relatively common in ACS patients with DAPT, especially in the first three months. Previous peptic injury and drinking habit were significant independent risk factors for serious GI complications, while PPI played a protective role in ACS with DAPT.

Timing of Continuous Renal Replacement Therapy Initiation in Sepsis-Associated Acute Kidney Injury: A Comprehensive Review and Future Directions

This review examines the application of continuous renal replacement therapy(CRRT)in patients with sepsis-associated acute kidney injury(S-AKI),with a particular focus on the timing of CRRT initiation.This review addresses the controversy surrounding initiation timing and proposes future research directions.Through a systematic review of recent literature on CRRT for S-AKI,working principles,therapeutic mechanisms,initiation timing of CRRT,and related meta-analyses were summarized.Current studies indicate that the optimal timing for CRRT initiation in S-AKI patients remains inconclusive,with ongoing debate regarding whether early initiation significantly improves patient survival and renal function.This lack of consensus reflects the heterogeneity of the S-AKI patient population and the limitations of existing research methodologies.Future studies should focus on advancing the application of precision medicine in S-AKI and developing individualized treatment strategies by integrating multidimensional information to optimize CRRT utilization and improve patient outcomes.

Prevalence of musculoskeletal injuries and a proposal for neuromuscular training to prevent lower limb injuries in Brazilian Army soldiers:an observational study

Background: The activities carried out by soldiers in the army involve great physical demands and require intense trainings to perform combat-specific tasks. Musculoskeletal injury is a potential threat to the health and physical integrity of the soldier. This study aimed to evaluate the prevalence of lower limb musculoskeletal injuries among soldiers and to propose a training protocol to prevent the most frequent injuries.Methods: This observational(cross-sectional) study recruited a sample of 103 soldiers who required medical attention,from a total 202 new battalion soldiers. The medical records(paper and online) had a form of running text. All data collected were recorded by the registered physicians of the battalion medical post. The records were analyzed by the following variables: medical diagnosis, injury site, mechanism, type of treatment, time loss, existence of previous injury,and recurring injury.Results: A total of 112 musculoskeletal injuries were diagnosed in 71 soldiers, and other types of diseases/injuries were diagnosed in the other soldiers. Joint pain accounted for 55.4% of the diagnoses. The knee was the most affected site, while trauma and overload were the most common mechanisms of injury. Drug treatment was used most frequently, accounting for 58% of the cases. The majority of the sample obtained a temporary leave of absence for1 to 6 days or not at all. Previous injuries and recurrence were not presented as risk factors for injury. With the data received, a protocol for the prevention of injuries to the lower limbs was proposed.Conclusions: This study indicated that the most frequent site of injury is the knee, and joint pain is the most common diagnosis. These results may support the necessity to develop a neuromuscular training protocol to prevent lower limb injuries, which we suggest to be applied in future studies.

A 2-year follow-up survey of 523 cases with peripheral nerve injuries caused by the earthquake in Wenchuan, China

We performed a 2-year follow-up survey of 523 patients with peripheral nerve injuries caused by the earthquake in Wenchuan, Sichuan Province, China. Nerve injuries were classiifed into three types： type I injuries were nerve transection injuries, type II injuries were nerve compression injuries, and type III injuries displayed no direct neurological dysfunction due to trauma. In this study, 31 patients had type I injuries involving 41 nerves, 419 had type II injuries involving 823 nerves, and 73 had type III injuries involving 150 nerves. Twenty-two patients had open tran-section nerve injury. The restoration of peripheral nerve function after different treatments was evaluated. Surgical decompression favorably affected nerve recovery. Physiotherapy was effective for type I and type II nerve injuries, but not substantially for type III nerve injury. Pharmaco-therapy had little effect on type II or type III nerve injuries. Targeted decompression surgery and physiotherapy contributed to the effective treatment of nerve transection and compression injuries. The Louisiana State University Health Sciences Center score for nerve injury severity de-clined with increasing duration of being trapped. In the ifrst year after treatment, the Louisiana State University Health Sciences Center score for grades 3 to 5 nerve injury increased by 28.2% to 81.8%. If scores were still poor （0 or 1） after a 1-year period of treatment, further treatment was not effective.

Brain and spinal cord trauma:what we know about the therapeutic potential of insulin growth factor 1 gene therapy

Although little attention has been paid to cognitive and emotional dysfunctions observed in patients after spinal co rd injury,several reports have described impairments in cognitive abilities.Our group also has contributed significantly to the study of cognitive impairments in a rat model of spinal co rd injury.These findings are very significant because they demonstrate that cognitive and mood deficits are not induced by lifestyle changes,drugs of abuse,and combined medication.They are related to changes in brain structures involved in cognition and emotion,such as the hippocampus.Chronic spinal cord injury decreases neurogenesis,enhances glial reactivity leading to hippocampal neuroinflammation,and trigge rs cognitive deficits.These brain distal abnormalities are recently called te rtiary damage.Given that there is no treatment for Tertiary Damage,insulin growth factor 1 gene therapy emerges as a good candidate.Insulin growth factor 1 gene thera py recove rs neurogenesis and induces the polarization from pro-inflammato ry towards anti-inflammatory microglial phenotypes,which represents a potential strategy to treat the neuroinflammation that supports te rtiary damage.Insulin growth factor 1 gene therapy can be extended to other central nervous system pathologies such as traumatic brain injury where the neuroinflammatory component is crucial.Insulin growth factor 1 gene therapy could emerge as a new therapeutic strategy for treating traumatic brain injury and spinal cord injury.

Pediatric Head Injury: The Incidence of Multiple Injuries

Objectives: Concomitant injuries play an important role when it comes to clinical management of traumatic brain injury (TBI). We examined the incidence of concomitant injuries and their relevance with respect to hospitalization. Methods: Children aged between 0 - 18 years hospitalized for treatment of TBI (ICD 10;S06.0 - 9) during 2010-2011 were included. The data relating to concomitant injuries and the course of treatment were evaluated. Statistical analysis included multivariate regressions at a level of significance of p ≤ 0.05. Results: 794 children were treated for head injury in our hospital. Head injury with other associated injuries had been sustained by 158 (19.9%) children. The face and the extremities were the areas of the body most often affected (p = 0.001). Boys represent the majority within the cohort of multiple injured children (p = 0.0001). The older the child, the higher the percentage of children with concomitant injuries (r = 0.27;p = 0.034). There was a significant correlation between the severity of the head injury and the occurrence of concomitant injuries (r = 0.19;p = 0.046). Children with concomitant injuries were found to suffer significantly more falls (N = 82;51.9%) than road traffic accidents (N = 68;43%) (p = 0.0001). A comparison of different variables revealed that age (7 to 10 years), severity of head injury (mild TBI), and trauma mechanism (fall) were most influential (KB = ?1.55;p = 0.023) for concomitant injuries. Children with concomitant injuries have a significant longer stay in hospital than those without: mean stay 2.5 to 4.5 days (p = 0.0001). Conclusion: Concomitant injuries are hints for more severe head injuries and children should be examined with special care.

Devastating complication of negative pressure wound therapy after deep inferior epigastric perforator free flap surgery:A case report

BACKGROUND Thermal injuries on free transferred or replanted tissues resulting from loss of sensibility are an infrequent occurrence.They require immediate and appropriate management before they progress to an irreversible condition.Although negative pressure wound therapy(NPWT)can prevent wound progression by increasing microcirculation,the inappropriate application of NPWT on complicationthreatened transferred and replanted tissues can induce an adverse effect.CASE SUMMARY A 48-year-old woman who underwent immediate breast reconstruction with a deep inferior epigastric artery perforator free flap.While applying a heating pad directly to the flap site,she sustained a deep second to third-degree contact burn over 30%of the transferred flap on postoperative 7 d.As the necrotic changes had progressed,we applied an NPWT dressing over the burned area after en-bloc debridement of the transferred tissues on postoperative 21 d.After 4 d of NPWT application,the exposed fatty tissues of the flap changed to dry and browncolored necrotic tissues.Upon further debridement,we noted that the wound gradually reached total necrosis with a collapsed vascular pedicle of deep inferior epigastric artery.CONCLUSION Although NPWT has been shown to be successful for treating various wound types,the significant risk of NPWT application in short-lasting reconstructed flap wounds after thermal injury should be reminded.

Eff ects of continuous renal replacement therapy on infl ammation-related anemia, iron metabolism and prognosis in sepsis patients with acute kidney injury

BACKGROUND:This study aims to evaluate the eff ect of continuous renal replacement therapy(CRRT)on inflammation-related anemia,iron metabolism,and the prognosis in sepsis patients with acute kidney injury(AKI).METHODS:Sepsis patients with AKI were prospectively enrolled and randomized into the CRRT and control groups.The clinical and laboratory data on days 1,3 and 7 after intensive care unit(ICU)admission were collected.The serum interleukin(IL)-6,hepcidin,erythropoietin,ferritin,and soluble transferrin receptor(sTfR)were determined by enzyme-linked immunosorbent assay.The Sequential Organ Failure Assessment(SOFA)score and 28-day mortality were recorded.Data were analyzed using Pearson’s Chi-square test or Fisher’s exact test(categorical variables),and Mann-Whitney U-test or t-test(continuous variables).RESULTS:The hemoglobin and serum erythropoietin levels did not signifi cantly diff er between the CRRT and control groups though gradually decreased within the first week of ICU admission.On days 3 and 7,the serum IL-6,hepcidin,ferritin,and red blood cell distribution width significantly decreased in the CRRT group compared to the control group(all P<0.05).On day 7,the serum iron was significantly elevated in the CRRT group compared to the control group(P<0.05).However,the serum sTfR did not signifi cantly diff er between the groups over time.In addition,the SOFA scores were signifi cantly lower in the CRRT group compared to the control group on day 7.The 28-day mortality did not signifi cantly diff er between the control and CRRT groups(38.0%vs.28.2%,P=0.332).CONCLUSION:CRRT might have beneficial effects on the improvement in inflammationrelated iron metabolism and disease severity during the fi rst week of ICU admission but not anemia and 28-day mortality in sepsis patients with AKI.

针刺联合艾灸治疗急性期周围性面瘫的疗效观察

目的 观察针刺联合艾灸治疗急性期周围性面瘫的临床疗效。方法 将60例急性期周围性面瘫患者随机分为治疗组和对照组,每组30例。对照组采用针刺联合药物治疗,治疗组在此基础上采用按摩灸治疗。观察两组治疗前后面部House-Brackmann(H-B)面神经功能分级、肌电图、面部残疾指数(facial disability index,FDI)量表评分变化,比较两组治疗前后炎性因子[超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞(white blood cell, WBC)计数、中性粒细胞与淋巴细胞的比值(neutrophil-to-lymphocyte ratio, NLR)和血小板与淋巴细胞的比值(platelet-to-lymphoccyte ratio, PLR)]变化,并比较两组临床疗效。结果 治疗组总有效率为96.7%,对照组总有效率为86.7%,两组比较差异有统计学意义(P<0.01)。两组治疗后H-B面神经功能分级优于治疗前(P<0.05),且治疗组的H-B面神经功能分级优于对照组(P<0.05)。两组治疗后口轮匝肌、眼轮匝肌、额肌肌电图潜伏期明显低于治疗前(P<0.05),治疗组低于对照组(P<0.01)。两组治疗后口轮匝肌、眼轮匝肌、额肌患健侧肌电图波幅比值高于治疗前(P<0.01),治疗组高于对照组(P<0.01)。两组治疗后FDI躯体功能评分(facial disability index physical function,FDIP)和社会功能评分(facial disability index social function, FDIS)评分优于治疗前(P<0.01),治疗组优于对照组(P<0.01)。两组治疗后炎性因子水平低于治疗前(P<0.05),治疗组低于对照组(P<0.05)。结论 在药物治疗的基础上,针刺联合艾灸可有效促进急性期周围性面瘫患者面神经功能和社会功能的恢复,疗效优于单纯针刺治疗,其机制可能与改善急性期面神经炎症反应有关。

Modified constraint-induced movement therapy enhances cortical plasticity in a rat model of traumatic brain injury:a resting-state functional MRI study

Modified constraint-induced movement therapy(mCIMT)has shown beneficial effects on motor function improvement after brain injury,but the exact mechanism remains unclear.In this study,amplitude of low frequency fluctuation(ALFF)metrics measured by resting-state functional magnetic resonance imaging was obtained to investigate the efficacy and mechanism of mCIMT in a control co rtical impact(CCI)rat model simulating traumatic brain injury.At 3 days after control co rtical impact model establishment,we found that the mean ALFF(mALFF)signals were decreased in the left motor cortex,somatosensory co rtex,insula cortex and the right motor co rtex,and were increased in the right corpus callosum.After 3 weeks of an 8-hour daily mClMT treatment,the mALFF values were significantly increased in the bilateral hemispheres compared with those at 3 days postoperatively.The mALFF signal valu es of left corpus callosum,left somatosensory cortex,right medial prefro ntal cortex,right motor co rtex,left postero dorsal hippocampus,left motor cortex,right corpus callosum,and right somatosensory cortex were increased in the mCIMT group compared with the control cortical impact group.Finally,we identified brain regions with significantly decreased mALFF valu es at 3 days postoperatively.Pearson correlation coefficients with the right forelimb sliding score indicated that the improvement in motor function of the affected upper limb was associated with an increase in mALFF values in these brain regions.Our findings suggest that functional co rtical plasticity changes after brain injury,and that mCIMT is an effective method to improve affected upper limb motor function by promoting bilateral hemispheric co rtical remodeling.mALFF values correlate with behavio ral changes and can potentially be used as biomarkers to assess dynamic cortical plasticity after traumatic brain injury.

俯卧位通气相关面部压力性损伤危险因素分析及最佳建模方法选择

背景面部压力性损伤是俯卧位通气患者常见并发症,创面局部暴露可增加全身感染风险,影响俯卧位通气治疗效果,甚至造成局部组织永久性功能损害。探讨其危险因素并构建预测模型对于预防俯卧位通气相关面部压力性损伤具有重要临床意义。目的探讨俯卧位通气相关面部压力性损伤的危险因素及其最佳建模方法。方法选择2020年6月—2023年3月入住新疆医科大学第一附属医院重症医学科的159例接受俯卧位通气的患者为研究对象,根据是否发生面部压力性损伤分为压力性损伤组(n=22)和非压力性损伤组(n=137),收集患者的一般信息、疾病诊断、治疗措施、实验室检查。分别使用逐步Logistic回归模型、全变量Logistic回归模型及Lasso-Logistic回归模型筛选面部压力性损伤危险因素并建立预测模型,应用受试者工作特征曲线下面积(AUC)评价模型区分度;应用赤池信息准则(AIC)、贝叶斯信息准则(BIC)及校准曲线评价模型校准度;应用决策曲线评价模型临床应用价值。通过比较三种Logistic回归模型预测效能和临床应用差异选择最佳建模方法。结果逐步Logistic回归模型结果显示,面部压力性损伤的影响因素为年龄(OR=39.041)、糖尿病(OR=7.256)和单次俯卧位通气时间(OR=6.705);全变量Logistic回归模型结果显示,面部压力性损伤的影响因素为年龄(OR=26.882)、糖尿病(OR=1.770)、ICU住院时间(OR=2.610)和单次俯卧位通气时间(OR=5.340);Lasso-Logistic回归结果显示,面部压力性损伤的影响因素为年龄(OR=38.256)、糖尿病(OR=1.094)、单次俯卧位通气时间(OR=5.738)和Richmond躁动镇静评分(OR=1.179)。Lasso-Logistic回归模型预测俯卧位通气相关面部压力性损伤的AUC、灵敏度和特异度分别为0.855、0.959和0.750,优于逐步和全变量Logistic回归模型;AIC和BIC分别为44.634和55.745,低于逐步和全变量Logistic回归模型;校准曲线显示Lasso-Logistic回归模型预测概率与实际概率拟合效果最佳。决策曲线显示Lasso-Logistic回归模型获得临床收益对应风险阈值为0.01~0.98,优于逐步和全变量Logistic回归模型。结论年龄、糖尿病、单次俯卧位通气时长和Richmond躁动镇静评分是俯卧位通气相关面部压力性损伤的危险因素,Lasso-Logistic回归模型预测效能和临床应用价值优于逐步Logistic回归模型和全变量Logistic回归模型,是最佳建模方法。