To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To investigate the influence of different placental pathological sampling methods on the detection rate of uteroplacental vessels and the accuracy of placental pathological diagnosis.

(1) Based on the ultrasonic blood flow signals of different placental locations, a new placental sampling method was proposed (new method group) and compared with the conventional placental sampling method recommended by the Amsterdam Consensus (conventional method group), in terms of the detection rate of uteroplacental vessels and the accuracy of placental pathological diagnosis. (2) There were 176 patients in the new method group, 57 of whom were clinically diagnosed as hypertensive disorders of pregnancy (HDP); 129 patients in the conventional method group, 43 of whom were HDP. The detection rate of uteroplacental vessels and the diagnostic rate of placental maternal vascular malperfusion (MVM) were compared between the two groups.

(1) In the detection rate of uteroplacental vessels, comparison of HDP placentas showed that the new method group was significantly higher than the conventional method group (70.2% vs 39.5%, Z=-3.057, P=0.002). (2) Comparison of different placental positions showed that the detection rate of blood vessels located at the placental margin was the highest (54.4%, U=13.841, P=0.003). (3) The diagnostic rate of MVM of HDP in the new method group was higher than that in the conventional method group (59.6% vs 32.6%, Z=-2.671, P=0.008).

The new placental sampling method can obtain more uteroplacental vessels for histopathological evaluation and demonstrate more comprehensive lesion information, which improves the accuracy of placental pathological diagnosis and standardizes placental sampling criteria.

To investigate the relationship between the non-fasting triglyceride-glucose (TyG) index and macrosomia during the third trimester in pregnant women at high altitudes.

A retrospective study was conducted on singleton pregnant women who delivered at Chaya People's Hospital of Qamdo City, Xizang Autonomous Region, from January 2023 to April 2025. Participants were divided into a macrosomia group and a control group based on newborn birth weight. The non-fasting TyG index was calculated from non-fasting triglyceride (TG) and random plasma glucose (PG). Based on the tertiles of the non-fasting TyG index, participants were divided into three groups. The baseline clinical characteristics, lipid profiles, and the risk of macrosomia were compared among the three groups. Statistical analyses were performed using one-way ANOVA, Kruskal-Wallis H test, Chi-square test, or Fisher's exact test for multi-group comparisons. Multivariate logistic regression and restricted cubic spline (RCS) analyses were used to evaluate the correlation between the non-fasting TyG index and macrosomia. Subgroup analyses were also conducted.

(1) A total of 771 singleton pregnant women were included, with a mean age of 27.3±6.1 years, a proportion of 26.72% (206/771) primiparous women, a pre-pregnancy BMI of (25.1±2.3) kg/m^2, and a mean non-fasting TyG index of 9.1±0.4. Twenty-one pregnant women were diagnosed with macrosomia, with a detection rate of 2.72% (21/771). (2) Statistically significant differences in pre-pregnancy BMI, altitude, serum total cholesterol (TC), TG, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), PG, newborn birth weight, and the incidence of macrosomia were observed among the three non-fasting TyG groups (all P<0.05). Trend tests further revealed that TC, TG, LDL-C, PG, newborn birth weight, and macrosomia incidence all showed increasing trends with the elevation of the non-fasting TyG index (all P<0.001). (3) Multivariate logistic regression analysis demonstrated an independent positive association between the non-fasting TyG index and macrosomia (OR=6.64, 95%CI: 2.00-22.01, P=0.002), and the risk of macrosomia increased progressively with the non-fasting TyG index (P for trend <0.05). (4) Restricted cubic spline analysis showed a linear dose-response relationship between the non-fasting TyG index and macrosomia (P for non-linearity =0.355). (5) Subgroup analysis revealed no interaction between the non-fasting TyG index and hyperglycemia in pregnancy (HIP) in relation to macrosomia (P for interaction >0.05).

The non-fasting TyG index in the third trimester is an independent risk factor for macrosomia in singleton pregnant women at high altitudes, and the risk of macrosomia increases progressively with the elevation of the non-fasting TyG index.

To investigate the detection rate and risk factors of abnormal prethrombotic state and its association with pregnancy outcomes in pregnant women with fetal growth restriction.

A retrospective study was conducted on 182 pregnant women with FGR treated at our hospital from January to December 2024. Data collected included maternal age, pre-pregnancy body mass index (BMI), mode of conception, obstetric history, gestational age at first FGR diagnosis, gestational age at prethrombotic state testing, pregnancy complications and comorbidities, TORCH screening results, prenatal screening or diagnostic findings, medication during pregnancy, and pregnancy outcomes. Laboratory tests included antiphospholipid antibody profiles, antinuclear antibodies, protein C/S, antithrombin Ⅲ (AT-Ⅲ), and homocysteine levels. Patients were divided into an abnormal group (n=99) and a normal group (n=83) based on test results. Clinical characteristics and pregnancy outcomes were compared between the two groups.

Prethrombotic state abnormalities were detected in 54.3% of FGR pregnant women. Compared with the normal group, the abnormal group had significantly higher levels of anticardiolipin antibody IgM, anti-β2-glycoprotein I antibody IgM, lupus anticoagulant screening/confirmatory ratio, anti-phosphatidylserine/prothrombin antibody IgM, and antinuclear antibodies, along with significantly lower levels of AT-Ⅲ activity and protein S, with all differences being statistically significant (all P<0.05). Multivariate logistic regression analysis identified maternal age (OR=1.10, 95%CI: 1.01-1.20) and high pre-pregnancy BMI (OR=1.10, 95%CI: 1.00-1.22) as independent risk factors for prethrombotic state abnormalities.

Advanced maternal age and high pre-pregnancy BMI are independent risk factors for prethrombotic state abnormalities in pregnant women with FGR, with a high detection rate. Screening for prethrombotic state is recommended in FGR patients with these risk factors to improve pregnancy outcomes.

To analyze the uterine electromyography (EMG) characteristics of primiparous women with threatened preterm labor and to evaluate the value of uterine EMG combined with cervical length in predicting preterm birth.

This was a prospective observational cohort study. Primiparous women at 24-34 weeks of gestation with symptoms of threatened preterm labor who presented to the obstetrics clinic or emergency department of our hospital were enrolled. Uterine EMG and cervical length measurements were performed. Clinical characteristics, cervical length, pregnancy outcomes, and uterine EMG parameters including burst wave frequency (number of burst waves per 30 minutes), burst duration, maximum power density spectrum (PDS) frequency, and total power were recorded and analyzed. ROC curves for predicting delivery within 7 days were constructed using uterine EMG parameters and cervical length, alone and in combination.

A total of 209 pregnant women were included. Based on the time interval from enrollment to delivery, they were divided into three groups: delivery within 48 hours (n=20), delivery within 3-7 days (n=22), and delivery after more than 7 days (n=167). The total power of uterine EMG burst waves in the within-48-hours delivery group was significantly higher than that in the 3-7 days delivery group and the >7 days delivery group, with mean differences (I-J) of -3.13 and -4.47, respectively (both P<0.001). The total power in the 3-7 days delivery group was significantly higher than that in the >7 days delivery group, with a mean difference (I-J) of -1.34 (P<0.001). There were no statistically significant differences in the number of burst waves, burst duration, or maximum PDS among the three groups (all P>0.05). The AUC of total power for predicting delivery within 7 days was 0.88, with a sensitivity of 76.0% and a specificity of 86.2%. The AUC of cervical length for predicting delivery within 7 days was 0.71, with a sensitivity of 74.0% and a specificity of 63.0%. When uterine EMG total power was combined with cervical length, the AUC for predicting delivery within 7 days increased to 0.92, with a sensitivity of 81.0% and a specificity of 90.0%.

An increase in uterine EMG burst wave total power may indicate an increased risk of preterm birth. The combination of uterine EMG and cervical length can improve the accuracy of predicting delivery within 7 days in women with threatened preterm labor.

To explore the early identification, clinical characteristics, diagnosis and treatment, and pregnancy outcomes of pregnancy-related fulminant type 1 diabetes mellitus (FT1DM), in order to improve clinicians' diagnostic and therapeutic approach and increase maternal and fetal survival rates.

A retrospective analysis was conducted on the clinical data of 4 patients with pregnancy-related FT1DM. Additionally, a literature search was performed using the keyword " fulminant type 1 diabetes" in the China National Knowledge Infrastructure (CNKI) and Chinese Journal Full-text Database from January 2000 to December 2024. A total of 222 relevant articles and case reports were retrieved, including 423 patients with FT1DM. Among these, 100 cases of pregnancy-related FT1DM were further screened and analyzed.

All four patients presented with a typical acute onset, rapidly progressing from markedly elevated blood glucose (random blood glucose 18.75-38.69 mmol/L) to diabetic ketosis or ketoacidosis within a short period (1-5 days). They exhibited a " dissociation" phenomenon between extremely high random blood glucose and relatively mildly elevated glycated hemoglobin (6.1%-6.9%), with a PG/HbA1c ratio ≥3.3. Fasting serum C-peptide levels were all <100 pmol/L; pancreatic autoantibodies were negative in 3 patients and not tested in 1. Literature analysis of 100 pregnancy-related FT1DM cases showed that the condition was more common during pregnancy (96%, 96 cases), with acute onset (mean time approximately 3 days). The four patients presented with non-specific prodromal symptoms: gastrointestinal symptoms in 2 cases, respiratory symptoms in 1 case, and neurological symptoms in 1 case.Literature analysis of 100 pregnancy-related FT1DM cases showed that The most common prodromal symptoms were gastrointestinal symptoms (24%, 24 cases), followed by respiratory symptoms (16%, 16 cases). After multidisciplinary treatment, 3 neonates survived and 1 was stillborn. Literature analysis showed that the overall pregnancy outcomes were extremely poor, with a fetal loss rate as high as 60% (mainly stillbirths, accounting for 54%).

Pregnancy-related FT1DM has an acute onset and insidious symptoms, and leads to an extremely high rate of fetal loss. Clinicians should enhance their awareness and remain highly vigilant for any non-specific gastrointestinal or respiratory symptoms in pregnant women without a history of diabetes, considering them as possible prodromal signs of FT1DM. Random blood glucose, urine ketone bodies, and pancreatic function (C-peptide) should be tested immediately, and the key feature of " dissociation between blood glucose and glycated hemoglobin" should be used for early differentiation. Emergency protocols should be initiated, and multidisciplinary collaboration should be implemented to improve maternal and fetal survival.

To develop a multivariable model incorporating lipid profiles and endoscopic features of colorectal adenomatous polyps, and to validate its performance in predicting polyp recurrence risk and estimating polyp growth rate based on the surveillance interval.

A retrospective observational study was conducted, enrolling adult patients who had undergone adenomatous polypectomy and at least one follow-up colonoscopy at the Second Affiliated Hospital of Nanjing University of Chinese Medicine. Baseline and follow-up endoscopic data (polyp number, cumulative volume, maximum diameter, and surveillance interval) from the rectum and ascending colon were collected. Patients from the endoscopy center (n=795) and the colorectal surgery center (n=476) were assigned to the test group and validation group, respectively. Univariate and multivariate logistic regression were used to screen for independent predictors of recurrence and to construct a nomogram model. The discriminatory performance of the model was evaluated using the area under the receiver operating characteristic curve (AUC). Multiple linear regression, robust regression, and log-transformation models were employed to analyze the impact of various factors on the number, cumulative volume, and maximum diameter of polyps detected during follow-up.

A total of 1 271 patients were included (1 005 in the recurrence group and 266 in the non-recurrence group). Multivariate logistic regression showed that elevated total cholesterol (OR=2.51, 95% CI: 1.53~4.11), prolonged surveillance interval (OR=1.08, 95%CI: 1.04~1.12), and higher baseline polyp count (OR=1.15, 95%CI: 1.06~1.25) were independent risk factors for polyp recurrence, while decreased high-density lipoprotein cholesterol (OR=0.51, 95%CI: 0.27~0.95) was a protective factor. The nomogram model constructed based on these factors achieved AUCs of 0.736 and 0.710 in the training and validation sets, respectively. Multiple linear regression analysis further confirmed that the surveillance interval was a stable factor for predicting the number (β=0.13, P＜0.001), cumulative volume (β=2.94, P＜0.001), and maximum diameter (β=0.23, P＜0.001) of polyps at follow-up. The model predicted a median time of 25.08 months for the maximum polyp diameter to reach 10.0 mm. Subgroup analysis showed that the recurrence rates in the rectal group and the ascending colon group were 80.60% and 77.39%, respectively, with no statistically significant difference (P = 0.182). Polyp location was not identified as an independent predictor of recurrence (OR = 0.82, 95% CI: 0.61~1.08, P = 0.160).

The multivariable model prediction model, integrating lipid parameters with endoscopic features, has the potential to serve as an adjunctive tool for post-polypectomy recurrence risk assessment, providing a preliminary quantitative reference for individualizing surveillance intervals.

To compare the short-term clinical efficacy of robotic single-incision plus one-port total colectomy (TC) versus multi-port laparoscopic total colectomy in the treatment of slow transit constipation (STC).

A retrospective study with frequency matching was conducted. The clinical data of 50 patients diagnosed with STC who underwent surgical treatment in the First Affiliated Hospital of Soochow University from June 2021 to November 2025 were collected. According to the surgical method, the patients were divided into the robot-assisted single-incision plus one-port group (25 cases) and the laparoscopic multi-port group (25 cases). Baseline data and perioperative indicators were compared between the two groups, including operative duration, intraoperative blood loss, pain score, time to first ambulation, first oral feeding and first defecation, and length of hospital stay. Short-term postoperative follow-up indicators covered the Wexner Constipation Score (WCS), complete spontaneous bowel movements (CSBM), Gastrointestinal Quality of Life Index (GIQLI), Bristol Stool Form Scale (BSFS), and incision cosmetic satisfaction score.

There were no statistically significant differences between the two groups in baseline characteristics, including sex, body mass index (BMI), and American Society of Anesthesiologists (ASA) classification (P＞0.05); however, age differed to some extent between the groups (t=−2.025, P=0.048). All operations were completed successfully without conversion to open laparotomy or severe intraoperative complications. Compared with the multi-port laparoscopic group, the robotic-assisted single-incision plus one-port group required longer operative duration [(293.52±60.57) min vs.(235.56±56.31) min, t=3.504, P＜0.001]. However, the time to first defecation [(25.00±5.00) h vs.(28.92±6.94) h, t=−2.423, P=0.020], time to first ambulation [(42.52±12.43) h vs. (51.92±13.07) h, t=−2.606, P=0.012] and length of hospital stay [(9.08±1.91) d vs. (11.84±2.98) d, t=−3.895, P＜0.001] were shorter in the laparoscopic multi-port group. No statistically significant intergroup differences were observed in intraoperative blood loss, pain scores, WCS, CSBM and GIQLI scores at the 3-month postoperative follow-up, as well as overall postoperative complications (P＞0.05). The incision cosmetic satisfaction score showed a statistically significant difference between the two groups (Z=−3.830, P＜0.001).

Compared with laparoscopic multi-port group, robot-assisted single-incision plus one-port group for STC is equally safe and feasible, and has more advantages in postoperative rapid recovery and incision cosmesis, which can be used as one of the preferred options for individualized minimally invasive treatment of patients with STC.

Lymph node metastasis in rectal cancer, which is regulated by the tumor immune microenvironment (TIME), is closely correlated with patient prognosis. Nevertheless, the current accuracy in evaluating lymph node metastasis in rectal cancer patients is still less than satisfactory and needs further enhancement. This review clarifies the main mechanisms by which the immune microenvironment regulates lymph node metastasis in rectal cancer and summarizes the current state of research on imaging-based assessment of immune microenvironment heterogeneity, with a focus on MRI. The objective is to enhance the precision of preoperative diagnosis of lymph node metastasis, improve patient prognosis, and provide novel perspectives for individualized diagnosis and treatment.

Regulatory T cells (Tregs) are key immune components that mediate immunosuppression in the colorectal cancer tumor microenvironment (TME), facilitating tumor immune evasion and promoting tumor progression through various mechanisms. This article reviews the biological characteristics and intrinsic heterogeneity of Treg cells, as well as the mechanisms by which they mediate immunosuppression, including the secretion of inhibitory cytokines, nutrient competition, metabolic interference, and the formation of specific spatial niches. Furthermore, it summarizes the evolution and shift of Treg-targeted therapeutic strategies from simple depletion toward precise regulation, offering new directions for immunotherapy in colorectal cancer.

Necrotizing fasciitis (NF) is a rare, life-threatening acute critical illness in colorectal and anal surgery, characterized by insidious onset, rapid progression, extensive tissue destruction and high mortality. The infection can spread rapidly along fascial planes, involving the perianal region, perineum, pelvic floor, and even the retroperitoneal space. Traditional management has mainly focused on infection control and surgical debridement during the acute phase, while insufficient attention has been paid to functional preservation, staged reconstruction, and long-term rehabilitation in the later course of treatment. The concept of whole-course management emphasizes the establishment of a comprehensive care system spanning prevention, screening, diagnosis, treatment and rehabilitation. Through multidisciplinary collaboration and individualized decision-making, it integrates early recognition and differential diagnosis, imaging-based stratified assessment, thorough debridement and targeted antimicrobial therapy in the acute phase, staged wound management, functional reconstruction and long-term rehabilitation follow-up, thereby reducing gaps in care and optimizing overall prognosis. This review discusses the clinical application of the whole-course management concept for NF in colorectal and anal surgery, and its significance in improving treatment success rate and patients’ long-term quality of life.

To explore the predictive value of the cholesterol-high density lipoprotein cholesterol-glucose (CHG) index for outcomes in patients with acute basilar artery occlusion (aBAO) undergoing endovascular treatment (EVT).

Data were derived from the prospective BASILAR registry study. Patients were stratified into quartiles (Q1-Q4) based on the admission CHG index: Q1 (-0.25 to 3.68), Q2 (＞3.68 to 4.25), Q3 (＞4.25 to 4.82), and Q4 (＞4.82 to 7.91). The follow-up period was 1 year post-EVT. The primary outcome was favorable functional outcome at 1 year post-EVT, defined as a modified Rankin scale (mRS) score ≤3. Secondary outcomes included favorable functional outcome at 90-day after EVT. Safety endpoints comprised 90-day all-cause mortality, symptomatic intracranial hemorrhage within 48 hours, and procedure-related complications. Normally distributed continuous data were compared across groups using one-way ANOVA, whereas non-normally distributed data were analyzed using the Kruskal-Wallis H test. Categorical variables were compared using the χ² test or Fisher's exact test. Multivariate Logistic regression was used to analyze the association between the CHG index and poor functional outcome (mRS score ＞3) by odds ratios (OR) with 95% confidence intervals (CI).

A total of 396 aBAO patients treated with EVT were included, with 99 patients in each quartile. Significant differences were observed among the quartiles in age, smoking history, hypertension, type 2 diabetes, hyperlipidemia, uric acid, lipid profile, blood glucose, glycated hemoglobin, and coagulation indicators (all P＜0.05). Regarding clinical outcomes, both the successful recanalization rate [modified thrombolysis in cerebral infarction (mTICI) scale 2c-3: 68.69%, 68.69%, 57.58%, and 48.48% for Q1-Q4, respectively; χ²=11.905, P=0.008] and the rate of favorable functional outcome at 1 year (48.48%, 44.44%, 32.32%, and 31.31%; χ²=9.276, P=0.026) exhibited a significant decreasing trend with increasing CHG index. Multivariate logistic regression showed that each 1-standard-deviation increase in the CHG index was associated with a 41% increased risk of poor outcome (OR=1.41, 95%CI: 1.13-1.76, P=0.002).

An elevated CHG index may serve as an independent predictor of poor 1-year functional outcomes in aBAO patients undergoing EVT. Preoperative assessment of the CHG index might facilitate clinical risk stratification.