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 evaluate the clinical efficacy of different frequencies of repetitive transcranial magnetic stimulation (rTMS) combined with lower-limb robotic training on cortical excitability and motor function in stroke patients.

Ninety patients with stroke hospitalized in the Affiliated Hospital of Jining Medical University from January 2024 to January 2025 were randomly assigned to Groups A (n=30), B (n=30) and C (n=30). All groups received conventional rehabilitation therapy. Concurrently, Group A underwent lower limb robotic training; Group B received low-frequency (1 Hz) rTMS combined with lower-limb robotic training; and Group C received high-frequency (10 Hz) rTMS combined with robotic training. The treatment cycle lasted four weeks. Cortical excitability was assessed before and after treatment by measuring motor evoked potential (MEP) latency and central motor conduction time (CMCT). Motor function was evaluated using the Berg balance scale (BBS), Pro-kin balance tester (measuring trajectory length and ellipse area), Fugl-Meyer assessment for lower extremity (FMA-LE), and functional ambulation category (FAC) scale. The one-way ANOVA and χ² test were used for intergroup comparisons.

(1) After 4 weeks of treatment, all three groups demonstrated significant improvements in MEP latency and CMCT compared to baseline (all P<0.05). Intergroup comparisons revealed that both Group B and Group C patients showed significantly better MEP latency and CMCT than Group A, while Group B patients exhibited significantly better MEP latency and CMCT than Group C. All differences were statistically significant (all P<0.05). (2) After 4 weeks of treatment, all three groups demonstrated significant improvements in motor function outcomes——BBS scores, gait path length, gait ellipse area, FMA-LE, and FAC compared to baseline (all P<0.05). Groups B and C showed significantly superior outcomes across these measures compared to Group A (all P<0.05), though no statistically significant differences were observed between Groups B and C in any motor function measure (all P>0.05).

The short-term efficacy of low-frequency and high-frequency rTMS combined with lower limb robotic therapy on motor function in stroke patients is comparable. However, low-frequency rTMS demonstrates more effective capacity than high-frequency rTMS in enhancing cortical excitability on the lesion side. Clinically, low-frequency rTMS combined with lower-limb robotic therapy is recommended for improving motor function in stroke patients.

To investigate the understanding of minor ischemic stroke (MIS) among clinicians involved in acute ischemic stroke (AIS) care in Beijing and to identify the key factors influencing their decision-making regarding intravenous thrombolysis (IVT) for these patients.

An online questionnaire survey was conducted among clinicians participating in AIS treatment in Beijing from April to June 2023 by SoJump. Statistical analysis was performed using SPSS 20.0 software, focusing on: 1) knowledge of MIS prevalence, definition, and classification; 2) guideline recommendations for IVT in MIS; 3) factors influencing IVT decision-making.

A total of 303 valid questionnaires were collected from 80 hospitals, with a valid questionnaire rate of 100%. The proportions of clinicians who believed that MIS accounted for less than 30%, 30%-<40% and 40%- <50% in AIS were 15.84%, 38.61% and 17.49%, respectively. Concerning guideline recommendation, 87.13% of clinicians approved of "thrombolytic therapy for mild disability patients", while only 48.51% of clinicians approved of "no thrombolysis for mild non-disabling patients". Among the factors considered by clinicians in supporting MIS IVT, from the patient's perspective, the top three in descending orders were "symptom disability" (95.38%), "gradual/rapid progression of symptoms "(94.06%) and "impact on daily work and life" (90.76%); From the perspective of clinicians themselves, the top three in descending orders were "possibility of worsening or progression of the condition" (97.03%), "disability of patient symptoms" (93.73%), and "low risk of MIS thrombolysis bleeding" (72.94%). Among the factors considered by clinicians who did not support MIS IVT, from the patient's perspective, they were "comorbidity with high-risk bleeding diseases" (90.10%), "patient and family members not actively/difficult to communicate" (86.14%), and "comorbidity with multiple other diseases" (81.52%). From the perspective of clinicians themselves, the following were: "patients had relative contraindications" (67.99%), "some patients were non-disabled" (56.44%), and "concerns about bleeding risk" (41.91%). The proportion of clinicians who believed that the risk of (syndrome intracerebral hemorrhage) sICH during MIS intravenous thrombolysis was <1.0%, 1.0%-<2.0%, 2.0%-<3.0%, 3.0%-<4.0% and 4.0%-<5.0% were 43.56%, 20.46%, 14.85%, 9.57%, 2.64%, and 8.91%, respectively.

"Symptom disability" was the primary factor motivating IVT use for MIS. Knowledge gaps exist among clinicians regarding MIS epidemiology, prognosis, and thrombolysis risks, with a tendency to overestimate sICH risk. Enhanced evidence-based guidance, academic training, and updated diagnostic and therapeutic concepts are needed to ensure appropriate MIS patients receive timely, scientific treatment.

To evaluate the safety and efficacy of endovascular treatment for patients with acute severe cerebral venous sinus thrombosis.

Clinical data were collected from 3 patients diagnosed with acute severe cerebral venous sinus thrombosis who underwent with endovascular treatment at the First Affiliated Hospital, Air Force Medical University from February 1 to June 1, 2024. A retrospective analysis was conducted on their clinical manifestations, imaging characteristics, surgical techniques and devices used, medication regimens, and follow-up outcomes, supplemented by a review of relevant literature.

The cohort consisted of two female patients (one in early pregnancy and one postpartum) and one male patient. All three exhibited clinical manifestations of intracranial hypertension and hemiplegia, with one case showing conscious disturbance and two experiencing epileptic seizures. Cranial imaging revealed venous cerebral infarction in all patients, involving the superior sagittal sinus and bilateral transverse sinuses, with two cases showing hemorrhagic transformation. All patients underwent thrombectomy using Solitaire (6 mm×30 mm) stents-retriever combined with intermediate catheter retrieval technique, achieving partial recanalization. Subsequent catheter-directed intravenous thrombolysis resulted in satisfactory recanalization outcomes and rapid clinical improvement.

Endovascular treatment demonstrates both safety and efficacy in the management of acute severe cerebral venous sinus thrombosis.

The brain extracellular space (ECS) is a crucial component of the brain, serving as the immediate environment supporting neuronal survival and function. However, its full significance—particularly in the context of cerebrovascular diseases—remains underexplored and underutilized. This review summarizes recent advances in brain ECS research, highlights current detection techniques, and explores its emerging applications in the diagnosis and treatment of cerebrovascular disorders. Notably, as research in this field deepens, Chinese scientists have begun to investigate innovative approaches, such as utilizing the ECS for drug delivery and enhancing metabolic waste clearance via surgical interventions. These developments offer promising avenues for advancing the management of cerebrovascular diseases in the future.

Cerebrovascular dysfunction serves as a critical pathological basis for cerebrovascular diseases, characterized by high disability and mortality rates. Astrocyte-derived extracellular vesicle (AC-EV), which mediate intercellular communication by transporting bioactive substances such as proteins and nucleic acids, play a pivotal role in regulating cerebrovascular function under both physiological and pathological conditions. Recent studies have revealed that AC-EV not only participate in cerebrovascular homeostasis but also exhibit altered composition and function closely linked to the pathogenesis and progression of multiple cerebrovascular disorders, including stroke, Alzheimer's disease, and Parkinson's disease. As a result, they have emerged as promising diagnostic and therapeutic targets. This review systematically summarizes the mechanisms by which AC-EV regulate cerebrovascular function and explores their clinical prospects in disease diagnosis and treatment, aiming to provide a theoretical foundation for developing precise intervention strategies against cerebrovascular dysfunction.

Nutcracker Syndrome (NCS) is a condition characterized by a variety of symptoms caused by the compression of the left renal vein by the angle between the abdominal aorta and the superior mesenteric artery or the spine. The clinical manifestations of NCS are diverse and lack specificity. Although advancements in the diagnosis and treatment of NCS, controversies remain regarding its diagnostic criteria, treatment approaches, and surgical indications. This article reviews recent progress in the diagnosis and treatment of NCS, highlights the role of advances in surgical techniques in providing more treatment options for patients, and serves as a reference for clinicians.

Percutaneous nephrolithotomy plays an important role in the treatment of upper urinary tract calculi. With the continuous development of technology, more and more scholars begin to pay attention to the influencing factors of renal function deterioration after percutaneous nephrolithotomy, including preoperative influencing factors: urinary tract infection, hypertension, diabetes, proteinuria, serum creatinine, etc; intraoperative influencing factors: channel size, number of channels, surgical time, intraoperative hypotension, etc; postoperative influencing factors: bleeding, etc. This review synthesizes current evidence on perioperative determinants of renal function deterioration after PCNL, aiming to provide guidance for clinical prevention and management of this complication.

The reported incidence of pleural effusion after percutaneous nephrolithotomy (PCNL) ranges from 2% to 16%, primarily attributed to pleural injury, extravasation of irrigation fluid, or absorption syndrome. Identified risk factors include renal pelvic pressure >40 cm H₂O during surgery, prolonged irrigation time, complex stones (multiple or large), supracostal access (particularly via the 11th or 12th intercostal space), medially or cranially located puncture sites, and a narrow costovertebral angle. Preventive strategies include maintaining low irrigation pressure (100-200 mmHg, equivalent to 136-270 cmH₂O), ensuring unobstructed outflow, selecting safer subcostal access routes (e.g., lateral to the scapular line, below the 10th rib), puncturing at end-expiration, intraoperative ultrasound guidance, and preoperative CT-based anatomical assessment. For treatment, conservative observation is appropriate for small effusions, moderate effusions may be managed by thoracentesis, and large or symptomatic effusions require closed thoracic drainage, with adjunctive human albumin administration if necessary to promote absorption.

Prostate cancer (PCa) is a malignant tumor with high incidence and mortality rates worldwide. Its insidious early symptoms make early screening and diagnosis crucial. This review systematically elaborates on the common methods and latest research advances in early screening for PCa. Traditional methods such as digital rectal examination (DRE) and prostate-specific antigen (PSA) testing, while widely used clinically, have limitations including high operator dependence and insufficient specificity, potentially leading to missed diagnoses or overdiagnosis. In recent years, significant progress has been made in imaging techniques. Multiparametric magnetic resonance imaging (mpMRI) has become a cornerstone for evaluating suspicious lesions and guiding targeted biopsies. Derived technologies of transrectal ultrasound (TRUS), such as superb microvascular imaging (SMI), contrast-enhanced ultrasound (CEUS), and elastography, have significantly improved diagnostic efficacy through multimodal fusion. Positron emission tomography/computed tomography (PET/CT), particularly prostate-specific membrane antigen (PSMA)-targeted PET/CT, shows great potential in precise staging and detection of metastatic lesions. Meanwhile, emerging biomarkers such as the prostate health index (PHI), 4Kscore, urinary non-coding RNAs (e.g., PCA3), and circulating tumor DNA (ctDNA) from liquid biopsies provide new avenues for non-invasive and precise risk stratification and personalized diagnosis and treatment. Furthermore, risk prediction models based on molecular characteristics and radiomics are advancing PCa management towards personalized medicine.

卵圆孔未闭（PFO）是一种常见的先天性心脏病，近年来研究发现其与多种非卒中性疾病存在关联，如偏头痛、减压病、斜卧呼吸-直立性低氧血症及非脑血管周围栓塞等。本文探讨了PFO相关非卒中性疾病的流行病学特征、病理生理机制、诊断与评估方法以及治疗策略等方面的最新进展，旨在为临床诊疗提供参考，并对未来研究方向进行展望。

心房颤动（房颤）和心力衰竭（心衰）息息相关，可通过不同的机制相互引起或加重。多项研究表明，导管消融治疗房颤合并心衰不仅可改善心功能（降低脑钠肽水平及纽约心脏学会心功能分级）、提高生活质量，还能改善临床预后、降低因心衰再住院率和全因死亡率。导管消融的时机把握也同样重要，在房颤患者出现心衰症状前或在心衰早期进行导管消融，可使患者获益更多。

心力衰竭（心衰）是多种心脏疾病的严重表现形式或晚期阶段。尽管现代医学在药物及器械治疗方面取得了显著进展，患者预后有所改善，但死亡率和再住院率仍居高不下。可溶性鸟苷酸环化酶（sGC）刺激剂作为一类新型药物，通过特异性激活一氧化氮-sGC-环磷酸鸟苷信号通路，在改善心室重构、内皮功能及心肌收缩力等方面展现出独特优势。本文旨在综述sGC刺激剂在心衰中的作用机制、临床研究现状及未来发展方向。