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 explore the practical value of integrating the dynamic indicator limits derived from national clinical laboratory quality specifications with Six Sigma in driving the continuous improvement of quality indicators across the total testing process in medical laboratories.

Data of 15 quality indicators from the clinical laboratory of a tertiary hospital between 2023 and 2025 were analyzed. Using the 2023 national quality specifications as the baseline and the 2025 specifications as the evaluation standard, 8 quality indicators requiring improvement were included. Based on the root causes of errors, they were divided into process-dependent (n=5) and operation-dependent (n=3) indicators. A dynamic benchmarking management strategy was adopted to implement a stepwise PDCA cycle of "benchmarking, reaching the standard, and setting a new standard," and the improvement effects during 2023 to 2025 were evaluated.

By 2025, the process-dependent indicators improved significantly: Error rates for specimen type, container, and collection volume decreased substantially, with corresponding σ values increasing to 5.4σ (P＜0.01)、5.3σ (P＜0.001)、5.3σ (P＜0.01), respectively. The σ value for the IQC CV failure rate rose to 6.0σ (P＜0.001), and the σ value for the incorrect laboratory report rate increased to 5.3σ (P＜0.001). Among the operation-dependent indicators, the σ values for the blood culture contamination rate and specimen hemolysis rate improved to 4.6σ (P＜0.001) and 4.7σ (P＜0.05), respectively, while the improvement in the anticoagulated specimen coagulation rate was not statistically significant.

The dynamic benchmarking management strategy combined with Six Sigma metrics, through stepwise goal setting and focusing on indicators requiring improvement, can significantly enhance the quality level of the total testing process, with the intervention effect on process-dependent indicators.

To investigate the association of serum interleukin-1 (IL-1), platelet activating factor (PAF), and poor prognosis in patients with acute massive hemorrhage complicated with transfusion-related acute lung injury (TRALI).

Clinical data of 108 patients with acute massive hemorrhage complicated with TRALI treated at the Tianmen First People's Hospital and Jingmen People's Hospital from June 2021 to August 2024 were retrospectively collected. Based on survival status within 7 days after TRALI, patients were divided into a good prognosis group (88 cases, 81.48%) and a poor prognosis group (20 cases, 18.52%). The levels of serum IL-1 and PAF detected at the time of diagnosis of TRALI were collected. The relationship between the levels of serum IL-1 and PAF and the poor prognosis of patients with acute massive hemorrhage complicated with TRALI were explored through statistical methods such as t-test, receiver operating characteristic curve (ROC curve), logistic regression analysis, and interaction.

The proportion of patients with a history of blood transfusion and smoking in the poor prognosis group was significantly higher than that in the good prognosis group(P＜0.05). The serum levels of IL-1 and PAF in the poor prognosis group were higher than those in the good prognosis group(P＜0.05). Logistic regression analysis showed that after adjusting for confounding factors, serum IL-1 and PAF remained poor prognostic factors in acute massive hemorrhage complicated with TRALI (P＜0.05). The ROC curves were plotted, indicating that the area under the curve (AUC) values of serum IL-1 alone and PAF in combination for predicting poor prognosis in patients with acute massive hemorrhage complicated with TRALI were 0.774, 0.824, and 0.891, respectively. The combined prediction had the highest value, among which the cutoff value of serum IL-1 was 111.900 pg/ml. The cut-off value of PAF was 99.950 μg/L. Serum IL-1 and PAF had a positive interaction effect on poor prognosis in patients with acute massive hemorrhage complicated with TRALI. When both of them were highly expressed, the risk of poor prognosis was 53.200 times and 43.908 times higher than that when both of them were low expressed and other location factors, respectively. The synergistic effect was 6.300 times greater than the sum of the effect of the two alone. Among the co-occurrence risks, 82.53% were caused by their interaction.

There is a close correlation between serum IL-1 and PAF levels and poor prognosis in patients with acute hemorrhage complicated with TRALI. When serum IL-1 levels are greater than 111.900 pg/ml and PAF levels are greater than 99.950 μg/L, the risk of poor prognosis in patients with acute hemorrhage complicated with TRALI is higher.

To explore a risk management framework based on ISO 15189 and biosafety to enhance risk management capabilities in biochemical testing.

According to CLSI QMS03 requirements, a risk management practice framework was constructed, including standardized online theoretical training, nonconformity management practices based on ISO 15189 and WS/T 442, and digital intelligence-based practices following the ISO 22367 risk management process. In 2025, 42 trainees were enrolled to validate the training effectiveness of this framework by assessing their mastery level (5-point scale) and theoretical assessment results (100-point scale), while evaluating risk management practices and risk priority numbers (RPN) in biochemical testing.

Trainees achieved a mastery level of 4.50±0.27 for risk management practices, and theoretical assessment scores significantly increased from 61±15 to 91±11 after training (P＜0.001). Established A general laboratory risk source database containing 122 items was established and 30 potential risk points specific to biochemical testing were identified, including 27 low-risk, 2 medium-risk, and 1 high-risk point. For the three medium- and high- risk points, quality control monitoring throughout the process (RPN 48), handling of infectious specimens (RPN 24), and delayed critical value reporting (RPN 24), corresponding risk control measures were implemented, reducing the risks to acceptable levels, and these were incorporated into the risk monitoring list.

An effective risk management framework has been established, integrating theoretical learning, contextualized practice, and risk assessment tools, thereby enhancing risk management capabilities and practical proficiency.

The long-term management of chronic hepatitis B (CHB) involves multiple steps, including screening, diagnosis, disease staging, monitoring of antiviral therapy, assessment of treatment discontinuation and risk of relapse, and surveillance for cirrhosis and hepatocellular carcinoma. Laboratory biomarkers are central to clinical evaluation and decision-making in CHB. With advances in hepatitis B virus (HBV) research and diagnostic technologies, laboratory biomarkers for CHB have evolved from conventional serologic and virologic markers to newer markers that reflect viral transcriptional activity, antigen expression characteristics, and the status of the viral reservoir. While improving diagnosis and treatment rates remains a fundamental goal in CHB care, the recognition of functional cure as an important therapeutic endpoint has further increased the need for biomarkers that can assess residual viral activity, stratify relapse risk after treatment withdrawal, and guide long-term follow-up strategies. In this review, we summarize the evidence base and clinical application characteristics of conventional and novel laboratory biomarkers in CHB, and further discuss the roles of reflex testing and laboratory test utilization management in optimizing clinical pathways for CHB. Overall, the optimization of laboratory testing in CHB should not depend on simply increasing the number of assays, but rather on the rational integration of biomarkers according to specific clinical questions, so as to improve diagnostic and management efficiency, reduce unnecessary testing, and better support stratified management, long-term follow-up, and the assessment of functional cure.

In the diagnosis, disease monitoring, and prognosis evaluation of autoimmune diseases, laboratory markers such as autoantibodies hold significant value. However, traditional testing practices face challenges including suboptimal strategies, low positive predictive value, and wastage of medical resources. Evidence-based medicine emphasizes guiding clinical decisions based on the best available research evidence, while machine learning, with its powerful data mining and analytical capabilities, provides robust support for the management and selection of clinical laboratory tests. This article explores the value of a novel strategy for autoimmune disease testing project selection, grounded in evidence-based medicine and machine learning, in disease diagnosis, stratified management, and prognosis evaluation. Using systemic lupus erythematosus as an example, a novel test pannel strategy for autoimmune disease testing panels is constructed. This novel strategy demonstrates significant potential in enhancing diagnostic efficacy, strengthening dynamic management, and optimizing the allocation of medical resources. However, its clinical implementation still faces multiple challenges, including standardization of testing platforms, quality of training data, and integration with healthcare information systems. In the future, through the accumulation of multi-center data and deep integration with clinical decision support systems, it is expected to establish a novel strategy for autoimmune disease testing panel selection that optimizes quality, efficiency, and cost.

Residual risk is the risk that remains and cannot be completely eliminated after risk control and management measures have been implemented. This review summarizes the current status and progress of residual risk management in medical laboratories. It outlines the current application of commonly used risk management tools in clinical and transfusion laboratories for residual risk identification, reassessment, continuous monitoring, and improvement, and further reviews recent advances in disease-related residual risk in clinical laboratory testing and transfusion-related residual risk in transfusion safety. Available evidence suggests that residual risk management facilitates the ongoing identification of weaknesses in existing technologies and workflows, and promotes an expansion of risk management from internal laboratory control to patient safety and clinical decision support, thereby contributing to improved laboratory quality and transfusion safety.

Embolization is a cornerstone of modern interventional radiology, offering minimally invasive treatments for hemorrhages, tumors, and vascular malformations. Clinical success depends on the strategic selection of agents based on vascular anatomy and therapeutic goals. This review comprehensively explores the transition from traditional materials to advanced biomaterials designed for specific clinical scenarios. Temporary strategies utilize gelatin sponge particles and resorbable microspheres to provide transient occlusion, with recent focus on quick soluble versions that prevent long term ischemic injury. Permanent embolization has evolved from metallic coils and polyvinyl alcohol particles to sophisticated microsphere platforms, including drug eluting and radiopaque beads. Liquid embolic systems, such as N butyl cyanoacrylate and ethylene vinyl alcohol copolymers, represent a significant paradigm shift by offering superior penetration into distal microvascular beds without the limitations of solid particles. Furthermore, ethanol remains a critical chemical sclerosant for definitive obliteration by inducing immediate endothelial destruction. Innovations like second generation hydrogel coated coils and bioabsorbable filaments further enhance procedural safety and predictability. As endovascular therapy moves toward high precision interventions, understanding these diverse temporary and permanent materials is essential for optimizing patient outcomes and minimizing complications in complex vascular landscapes.

The global disease burden of cirrhosis is heavy, with portal hypertension being one of the most common complications of decompensated cirrhosis, severely affecting the quality of patient survival. While relieving portal pressure, transjugular intrahepatic portosystemic shunt (TIPS) also brings enterogenous toxins into the body circulation, with a consequent rapid increase in blood ammonia levels, which induces hepatic encephalopathy, severely limiting the promotion of this technique in the clinic. This study will explore the differences between transjugular intrahepatic portosystemic shunt–associated hepatic encephalopathy (TIPS-HE) and conventional hepatic encephalopathy from the aspects of pathophysiologic mechanism, disease diagnosis and postoperative management, providing a new perspective for the precise prevention and treatment of TIPS-HE.

Knee Osteoarthritis (KOA), characterized by significant and persistent pain and functional impairment, has emerged as a major global cause of disability. The core mechanism underlying its pain involves mechanical injury and joint degeneration triggering a vicious cycle of "synovitis-vascular proliferation-aberrant innervation-sensitization". Conventional conservative treatments (such as NSAIDs and intra-articular injections) offer limited efficacy, while Total Knee Arthroplasty (TKA) is constrained by its high-risk profile and prolonged recovery period. Genicular Artery Embolization (GAE), an emerging minimally invasive interventional therapy, aims to alleviate pain by selectively embolizing abnormal neovessels within the knee joint. This targeted approach disrupts the neurovascular coupling pathway mediated by synovial inflammation. This article systematically reviews the current evidence-based basis regarding the pathophysiology of KOA pain, GAE's clinical efficacy, safety profile, and key ongoing deliberations. It evaluates the potential value and positioning of GAE within the stepwise treatment framework for KOA and explores future research directions.

To evaluate the efficacy and safety of an ethanol–iohexol mixture (EIM) as an endovascular embolic agent in a rabbit renal artery embolization model and compare it with an ethanol–lipiodol suspension (ELS).

Forty-five rabbits were randomly divided into a control group, an EIM group, and an ELS group (n=15 each). All underwent transcatheter renal angiography and embolization with 1 mL of either EIM or ELS. Post-embolization vessel occlusion was assessed using digital subtraction angiography (DSA) and graded via the Thrombolysis in Cerebral Infarction (TICI) scale.

Both EIM and ELS achieved complete and persistent occlusion (TICI 0) without recanalization or collateral formation. EIM, being water-soluble with lower viscosity, was easier to inject and showed rapid intravascular diffusion, enabling faster visualization of embolization. ELS was more viscous, difficult to inject, and exhibited phase separation within one minute. Histopathology confirmed comparable thrombus formation in both groups. Transient elevations in hepatic and renal biomarkers were observed but returned to baseline by 1 and 2 weeks, respectively.

EIM and ELS both provided effective, durable renal artery embolization with minimal systemic toxicity. EIM offered superior injectability and handling, while overall efficacy and safety were similar.【Keywords】Ethanol-iohexol mixture; Ethanol-iodized oil suspension; Alcohol;Interventional embolization

To assess the clinical efficacy and safety of transarterial chemoembolization (TACE) combined with cone-beam computed tomography (CBCT)–guided percutaneous ethanol injection (PEI) performed simultaneously for small hepatocellular carcinomas (HCCs) located in high-risk areas.

A retrospective study was conducted on 61 patients (64 lesions) with high-risk HCC who underwent simultaneous CBCT-guided TACE and PEI at the Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, between January 2019 and December 2023. Follow-up evaluations were performed at 1, 3, 6, and 12 months after treatment. Complete ablation was determined based on the absence of arterial enhancement according to mRECIST criteria. The initial complete ablation rate, secondary complete ablation rate, and final complete ablation rate were calculated. Recurrence-free survival (RFS), local tumor progression (LTP), and adverse events were also analyzed.

The technical success rate was 100%. The initial complete ablation rate was 93.8% (60/64). Four lesions did not achieve complete ablation after the initial treatment; all subsequently achieved complete ablation following additional PEI, resulting in a final complete ablation rate of 100%. At the end of follow-up, among 61 patients (64 lesions), the overall tumor recurrence rate was 44.3% (27/61), and the incidence of LTP was 19.7% (12/61). The mean RFS was 34.75 months (95% CI: 28.99–40.50), and the mean time to LTP was 45.33 months (95% CI: 39.51–51.15). Both univariate and multivariate analyses demonstrated that maximum tumor diameter (≥2 cm and <3 cm) was an independent risk factor for RFS (P < 0.001). No severe treatment-related adverse events occurred during or after the procedure.

Simultaneous TACE combined with CBCT-guided PEI is a safe and effective therapeutic approach for small HCCs in high-risk anatomical locations, achieving excellent tumor control with minimal complications.

This study sought to construct a predictive model for the short-term efficacy of transarterial chemoembolization (TACE) combined with targeted-immunotherapy in hepatocellular carcinoma (HCC) patients residing in high-altitude regions, offering a reliable quantifiable tool for clinical efficacy assessment.

A total of 101 eligible HCC patients were retrospectively included. Clinical and imaging data were collected, and independent predictive factors were identified via univariate and multivariate logistic regression analyses. A nomogram model was established, with internal validation performed using 1 000 bootstrap resamplings. Model performance was evaluated by receiver operating characteristic (ROC) curve, calibrated area under the curve (AUC), calibration curves, and decision curve analysis.

Maximum tumor diameter (OR=1.598, 95% CI: 1.265-2.017, P<0.05), lack of tumor pseudocapsule (OR=12.588, 95% CI: 2.356-67.238, P<0.05), and lower minimum apparent diffusion coefficient (ADCmin, OR=0.333，95% CI: 0.194-0.569, P<0.05) were identified as independent predictors of short-term treatment response. After bootstrap validation, the model's calibrated AUC reached 0.953 (95% CI: 0.919-0.993), and a visualized nomogram was generated accordingly.

This predictive model serves as a reliable quantifiable tool for efficacy evaluation and personalized treatment decision-making in HCC patients from high-altitude regions.