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 correlation between low adjusted body mass index (BMI) and the prognosis of patients with portal hypertension undergoing transjugular intrahepatic portosystemic shunt (TIPS).

A retrospective analysis was conducted on 157 patients with portal hypertension who underwent TIPS at the First Affiliated Hospital of University of Science and Technology of China from March 2019 to December 2022. Based on pre-procedure BMI adjusted for ascites (mild: -5%, moderate: -10%, severe: -15%, plus an additional -5% for peripheral edema), patients were divided into a malnutrition group (M group, adjusted BMI < 18.5 kg/m², n=79) and a non-malnutrition group (nM group, n=78). Postoperative incidence of hepatic encephalopathy (HE) and survival rates were compared. The median follow-up was 39 months (range: 15–60 months).

Within one year after TIPS, the M group showed a significantly higher incidence of overall HE (43.00% vs. 21.80%, χ²= 8.864, P=0.003) and overt HE (25.30% vs. 9.60%, χ²= 6.305, P=0.012) compared to the nM group. No significant difference was found in the incidence of covert HE (22.80% vs. 13.30%, P=0.098). At the end of follow-up, the survival rate in the M group was significantly lower than in the nM group (77.60% vs. 80.80%, χ²= 4.706, P=0.030).

Malnutrition, defined by adjusted BMI<18.5 kg/m², occurred in 50.32% of patients undergoing TIPS for portal hypertension. Malnutrition could increase the risk of post-procedure HE and reduce survival, serving as an independent risk factor for TIPS prognosis.

To analyze the impact of glycemic control levels on post-interventional coagulation function and the risk of post-procedure recurrence in patients with diabetes-induced lower extremity arteriosclerosis obliterans (DLASO) on the coagulation function after vascular interventional therapy and the risk of postoperative recurrence.

A total of 124 patients with DLASO treated from October 2021 to October 2024 were enrolled. Patients were divided into a recurrence group (n=46) and a non-recurrence group (n=78) based on clinical outcomes. Baseline data and post-procedure coagulation function indices were compared. Pearson correlation was used to analyze the relationship between blood glucose levels and coagulation function. Risk factors for recurrence were identified using the Least Absolute Shrinkage and Selection Operator (LASSO) and multivariate logistic regression. The dose-response relationship between coagulation function and recurrence was assessed via restricted cubic splines (RCS). A mediation effect model was employed to evaluate the mediating role of coagulation function in the relationship between glycemic control and recurrence.

The recurrence group had significantly higher proportions of patients with HbA1c ≥7.0% and FIB >4 g/L, as well as higher levels of blood lipids, hemorheology indices, VEGF, and endothelin-1, while PT, APTT, and TT levels were significantly lower compared to the non-recurrence group (P<0.05). Post-procedure PT, APTT, and TT at one week were negatively correlated with HbA1c levels (P<0.05). Multivariate analysis identified one-week post-procedure HbA1c, FIB, VEGF, and APTT as independent influencing factors for recurrence (P<0.05). There was a nonlinear dose-response relationship between one-week post-procedure PT, APTT, TT and recurrence (P<0.05). Coagulation function indicators at one week post-procedure mediated the relationship between HbA1c levels and recurrence (P<0.05).

Blood glucose control level is correlated with coagulation function, and both are independent influencing factors for recurrence after endovascular intervention in DLASO patients. These findings provide a reference for the early clinical identification of patients at high risk of recurrence.

To analyze the predictive value of serum intercellular adhesion molecule-1 (ICAM-1) levels for postoperative restenosis in patients with lower extremity arteriosclerosis obliterans (ASO).

A total of 94 ASO patients admitted between July 2021 and July 2023 were enrolled. Based on the occurrence of restenosis within one year postoperatively, patients were divided into a restenosis group (n=37) and a patency group (n=57). Multivariate logistic regression and interaction analyses were used to evaluate the impact of ICAM-1 and other indicators on restenosis.

Multivariate logistic regression analysis showed that infrapopliteal lesions, diabetes, hyperlipidemia, and elevated preoperative levels of C-reactive protein, interleukin-6, tumor necrosis factor-α, plasma viscosity, whole blood viscosity (high/low shear), and ICAM-1 were independent risk factors for postoperative restenosis (P<0.05). Interaction analysis revealed that preoperative ICAM-1 significantly interacted with endothelin and vascular endothelial growth factor to influence restenosis risk.

ICAM-1 levels are closely correlated with postoperative restenosis in ASO patients and serve as a significant predictor for the risk of re-obstruction.

The optimal treatment strategy for basilar artery trunk aneurysms (BATA) remains controversial. This study aimed to evaluate the safety and efficacy of endovascular treatment for BATA.

A retrospective analysis was performed on 40 BATA patients (41 aneurysms in total) who underwent endovascular treatment in our institute between October 2018 and December 2024. Based on digital subtraction angiography (DSA) findings, aneurysms were categorized into saccular, classic, segmental dilatation, and dolichoestasia types. Perioperative cerebrovascular complications were recorded. Immediate and 6-month embolization degrees were assessed with the Raymond scale, while clinical outcomes were evaluated with modified Rankin Scale (mRS) scores at 3-month follow-up.

Among the 41 aneurysms, 9 were saccular (22.0%), 18 classic (43.9%), 5 segmental dilatation (12.2%), and 9 dolichoestasia (22.0%). All aneurysms were successfully treated with stent-assisted coiling (SAC), including single-stent SAC in 11 cases (27.5%), overlapping-stent SAC in 26 cases (65.0%), and flow diverters in 3 cases (7.5%). Immediate postprocedural Raymond grades were Ⅰ in 13 (31.7%), Ⅱ in 16 (39.0%), and Ⅲ in 12 (29.3%) cases. Perioperative complications included: 1 (2.5%) intraoperative re-rupture of classic dissecting aneurysm, 1 (2.5%) acute stent thrombosis in dolichoestasia aneurysm (no improvement after tirofiban infusion). Postprocedurally acute ischemic events occurred in 1 saccular aneurysm case (2.5%), and the patient was left with left-sided hemiplegia at discharge. Two dolichoestasia cases (5.0%) developed acute ischemic events after the procedure but showed no significant disability at discharge (mRS: 2). At 3-month follow-up, 33 patients (82.5%) achieved favorable outcomes (mRS 0-2). Among 31 cases with 6-month DSA follow-up, 24 (77.4%) achieved complete occlusion (Raymond I).

For saccular and classic dissecting BATAs, conventional stent-assisted coiling is technically feasible and safe, with a high occlusion rate and an acceptable recurrence rate. Despite the occurrence of periprocedural ischemic events, overlapping large woven stents techniques and flow diverters can further improve treatment outcomes for segmental dilatation and dolichoestasia aneurysms.

To explore the symptom experience and psychological perceptions of patients with primary liver cancer during combined treatment with transarterial chemoembolization (TACE), targeted therapy, and immunotherapy, providing a basis for improved symptom management.

Using a phenomenological approach, semi-structured interviews were conducted with 15 patients receiving the combined therapy. Data were analyzed using Colaizzi's seven-step method.

Four main themes were identified: (1) physical symptoms, including post-embolization syndrome, sleep disturbances, and treatment-related adverse reactions; (2) psychological distress, involving fear of side effects and anxiety regarding recurrence; (3) social and family impact, including role conflicts, social withdrawal, and changes in work patterns; and (4) coping strategies, encompassing both active and passive modes.

Patients face multifaceted and interconnected symptoms. Healthcare professionals should implement dynamic assessments and integrated management, emphasizing psychological support and fostering family/social networks to improve patient adaptation and the overall care experience.

This study aims to explore the depression level, social support status and caregiver preparedness of the main caregivers of stroke patients undergoing interventional treatment, analyze their interrelationships, and investigate the mediating effect of social support between depression and caregiver preparedness, providing a theoretical basis for improving postoperative care quality and promoting the mental health of caregivers.

Convenience sampling was used to select stroke patients and their main caregivers who received interventional surgery in a tertiary hospital in Jiangsu Province as the research subjects. The Hamilton Depression Scale (HAMD), Social Support Rating Scale (SSRS), and Caregiver Preparedness Scale (CPS) were used for the investigation. Multiple linear regression and mediation effect analysis were used to explore the interrelationships among depression, social support, and caregiver preparedness.

A total of 217 valid samples were included. The results showed that the depression level of the main caregivers was significantly negatively correlated with caregiver preparedness (P<0.01), while the social support score was significantly positively correlated with caregiver preparedness (P<0.001). Univariate analysis revealed that main caregivers with different occupational backgrounds, place of residence, availability of assistance from others, and prior caregiving experience were significantly associated with preparedness scores (P<0.05). Multiple regression analysis revealed that higher caregiving preparedness was significantly predicted by the following factors: the stroke patient being female (β=2.252), having a higher level of education (high school and college/university or above; β=2.784 and 5.104, respectively), and the primary caregiver being unmarried or divorced/widowed (β=5.171). Mediation effect analysis showed that subjective support played a partial mediating role between the depression of main caregivers and caregiver preparedness. After including the basic characteristics of caregivers as covariates, the mediating effect of social support remained significant (P<0.01).

The marital status of main caregivers and the educational level of stroke patients are important factors affecting caregiver preparedness. The depression of main caregivers is significantly negatively correlated with caregiver preparedness, while social support is significantly positively correlated. Further analysis revealed that social support, especially subjective support, plays a mediating role in the path by which depression affects the preparedness of main caregivers.

To investigate the analgesic efficacy of preemptive analgesia in the perioperative period of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) patients.

36 cases of patients undergoing TACE from May 2023 to September 2023 admitted to the Department of Interventional Radiology at Jiangning Hospital were allocated into control group and received routine pain management and psychological intervention. From October 2023 to March 2024, 47 cases of patients undergoing TACE were managed with preemptive analgesia on the basis of the control group as the observation group. The Numeric Rating Scale (NRS) scores during surgery, at 6 h and 24 h after intervention, postoperative additional analgesic requirements, and perioperative comfort levels (Bruggrmann Comfort Scale, BCS) were compared between the two groups.

In the observation group the NRS score were lower than those of control group during surgery, at 6 h and 24 h after intervention (P<0.05). The proportion of patients requiring additional analgesics within 24 h postoperatively was 29.8% in the observation group, significantly lower than that of the control group (77.8%). The BCS scores of the observation group were higher than those of the control group during surgery and at 6 h postoperatively (P<0.05), while no significant difference was observed at 24 h postoperatively (P>0.05).

Preemptive analgesia effectively reduces pain intensity in patients undergoing TACE, decreases postoperative analgesic consumption, and enhances comfort during the early perioperative period. Therefore, preemptive analgesia is worthy of clinical promotion and application.

To evaluate the feasibility and clinical potential of deep learning–based cerebral artery reconstruction from non-contrast CT(NCCT).

Paired NCCT/CTA data from two stroke centers were retrospectively analyzed. An internal dataset of 140 patients without large vessel occlusion was split into training(n=100), validation(n=20),and test(n=20)sets, with 20 additional cases for external validation. CTA-derived segmentations served as reference.nnU-Net 3D-fullres, 3D cascade U-Net, and 2D U-Net were compared using DSC, ASSD, and HD95.

nnU-Net 3D-fullres achieved the best performance(DSC 0.78±0.04, 0.75±0.04, and 0.73±0.06 across validation, test, and external sets), with consistent trends in ASSD and HD95.

Deep learning enables accurate,contrast-free reconstruction of cerebral arteries from NCCT and may support path planning for mechanical thrombectomy.

To evaluate the predictive value of serum lactate dehydrogenase (LDH) levels and C-reactive protein to albumin ratio (CAR) for survival outcomes in hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE).

A retrospective analysis was conducted on 148 HCC patients who received at least three TACE sessions between January 2017 and December 2024. According to the Modified Response Evaluation Criteria in Solid Tumors (mRECIST), patients were divided into the poor prognosis group (n=65) and the good prognosis group (n=83). Relevant indicators were analyzed using Kaplan-Meier method, Cox proportional hazards regression model and receiver operating characteristic curve.

Kaplan-Meier analysis revealed that the median overall survival (OS) of patients in the poor prognosis group was 24 months, which was significantly shorter than 37 months in the good prognosis group (P<0.001). The median OS of the group with LDH≤250 U/L (34 months) was significantly better than that of the group with LDH>250 U/L (16 months; P<0.001). The median OS of the low-CAR group was significantly longer than that of the high-CAR group (P=0.004). Multivariate Cox regression analysis confirmed that Barcelona Clinic Liver Cancer (BCLC) stage, elevated LDH and elevated CAR were independent risk factors for shortened OS (all P<0.05).

Serum LDH and CAR levels can serve as effective prognostic predictors for HCC patients after TACE. These biomarkers are easy to detect and cost-effective, and have important clinical application value.

Peripheral artery disease (PAD) is an atherosclerotic disorder characterized by lower extremity arterial stenosis or occlusion, leading to symptoms such as intermittent claudication and rest pain. Its incidence has been rising globally year by year and is associated with a high prevalence of cardiovascular events. The pathogenesis of PAD is closely linked to systemic inflammatory responses. Various inflammatory biomarkers, including C-reactive protein, white blood cells, interleukins, and others, not only contribute to the development and progression of PAD but also serve as potential biomarkers for predicting disease prognosis and treatment outcomes. This review systematically summarizes the associations between multiple inflammatory markers and PAD, as well as the latest research advances in anti-inflammatory therapeutic strategies, aiming to provide a theoretical basis for the diagnosis and management of PAD.

Cerebral ischemia-reperfusion injury (CIRI) is a pathological phenomenon characterized by functional impairment and cellular damage that occurs following the restoration of blood flow after an ischemic event. During CIRI, mitophagy contributes to cellular homeostasis by selectively targeting and degrading damaged or dysfunctional mitochondria via autophagic mechanisms, thereby reducing excessive reactive oxygen species (ROS) generation and attenuating cell death. This review comprehensively summarizes the signaling pathways, pathological mechanisms, and neuroprotective roles of mitophagy in CIRI. Additionally, it examines the dual regulatory functions of mitophagy and highlights the critical importance of its precise modulation. The current challenges in clinical translation of these findings are also discussed, with the aim of facilitating the development of novel therapeutic strategies for the prevention and treatment of cerebral ischemia.

To construct a prediction model of high load axillary lymph node metastasis (ALNM) in breast cancer based on multiple ultrasound characteristic parameters.

According to the inclusion and exclusion criteria, a retrospective study was conducted on the clinical data of 250 patients with breast cancer who underwent preoperative ultrasound examinations (conventional ultrasound, acoustic radiation force impulse imaging, automated breast volume scanner, and contrast-enhanced ultrasound) in the Longyan First Hospital between January 2020 and June 2024. The patients were divided into a training group (n=175) and a validation group (n=75) at a ratio of 7∶3. The risk factors of high load ALNM in breast cancer patients of the training group were analyzed by univariate and multivariate logistic regression analyses. The prediction model was constructed accordingly and the nomogram was drawn. Receiver operating characteristic curve (ROC) and Hosmer-Lemeshow test were used to evaluate the discrimination degree and calibration degree of the model. Clinical decision curve analysis (DCA) was used to evaluate the clinical net benefit. The model was verified by the data of the validation group.

Multivariate logistic regression analysis revealed that lesion edge maximum shear wave velocity (SWV_max) (OR=2.742, 95%CI: 1.175-6.399) , lymphatic contrast-enhanced ultrasound (LCEUS) enhancement type (Ⅲ-Ⅳ type) (OR=11.993, 95%CI: 4.407-32.632) , intravenous contrast-enhanced ultrasound (ICEUS) enhancement type (concentric/mixed type) (OR=10.424, 95%CI: 3.583-30.326) , portal structure disappearance of sentinel lymph node (SLN) (OR=12.305, 95%CI: 2.758-54.901) , and blood flow of SLN edge (OR=5.280, 95%CI: 1.852-15.050) were predictive factors of high load ALNM in the training group. Based on this, a nomogram model was constructed and the model formula was as follow: Logit (P) =1 009×lesion edge SWV_max+1.664×blood flow of SLN edge flow+2.510×SLN portal structure disappearance+2.344×ICEUS enhancement type (concentric/mixed type) +2.484×LCEUS enhancement type (Ⅲ-Ⅳ type) -7.276. In the training group, the area under the ROC curve (AUC) of the prediction model was 0.920 (95%CI: 0.878-0.962), and the Hosmer-Lemeshow test revealed a chi-square value of 6.951 (P=0.542) . In the validation group, the AUC was 0.907 (95%CI: 0.842-0.973), and the Hosmer-Lemeshow test manifested a chi-square value of 8.965 (P=0.345). DCA results showed that when the threshold probabilities were 3%-97% and 8%-95% in the training group and validation group, the model could be used as a reference to obtain net benefits.

The prediction model based on lesion edge SWV_max, LCEUS enhancement type (Ⅲ-Ⅳ type) , ICEUS enhancement type (concentric/mixed type) , SLN portal structure disappearance and blood flow of SLN edge has a high predictive ability for high load ALNM in breast cancer patients.