Abstract:Acute ischemic stroke has a sudden onset,and the mortality and disability rates remain high for a long time,which seriously threatens the life health and the quality of life of patients.After mechanical thrombectomy for patients with acute ischemic stroke,there are still problems,such as insufficient postoperative brain tissue protection measures.Reasonable sedation treatment is a commonly used intervention after surgery,which has achieved remarkable outcomes in reducing the mortality of acute ischemic stroke and promoting early postoperative rehabilitation.However,there is no uniform standard for the optimal sedation time after acute ischemic stroke.In view of this,this article intends to systematically review the theoretical basis and the optimal time of sedation after interventional therapy for acute ischemic stroke,and to provide theoretical reference and practical basis for clinical optimization of postoperative management strategies.

Abstract:Venous malformation(VM)is the most common type of congenital vascular anomaly,characterized by a lifelong progressive course that poses significant threats to patients'physical and mental health.In terms of treatment,the innovative application of radiofrequency ablation(RFA)to VM has emerged as a reliable therapeutic option,demonstrating definitive clinical efficacy while offering advantages such as safety,minimal invasiveness,shorter hospital stays,and lower cost.Nevertheless,there is still no authoritative guideline or consensus,either from domestic or international sources,that provides standardized recommendations for RFA in the treatment of VM.To fill this void,the Emergency Medicine Branch of the Chinese Medical Association and the Interventional Physicians Branch of the Chinese Medical Doctor Association convened a multidisciplinary panel of experts from various fields that include vascular tumor surgery,vascular surgery,plastic surgery,interventional radiology,diagnostic imaging,emergency medicine,general surgery,and internal medicine.Drawing upon both domestic and international research,the panel reviewed and discussed recent advances and the clinical significance of RFA in VM treatment.As a result,they developed and refined the Expert consensus on radiofrequency ablation treatment for venous malformation(2025 version).This consensus includes 20 expert recommendations covering indications,ablation strategies,perioperative management,and approaches to the prevention and management of related complications.The aim is to enhance clinicians'understanding and practical skills in the standardized application of RFA for VM,thereby ensuring its safety and effectiveness in clinical practice.

Abstract:Coronary Artery Ectasia(CAE)is defined as a localized or diffuse dilation of the coronary artery lumen,with a diameter exceeding 1.5 times the adjacent normal vessel segment.The prevalence of CAE among patients undergoing coronary angiography ranges from 0.3%to 8.0%,and it is more commonly observed in middle-aged and older adults,males and smokers.The pathophysiological mechanisms of CAE are complex,involving inflammatory responses,increased matrix metalloproteinase activity,genetic factors,among others.Its clinical manifestations are diverse,ranging from asymptomatic cases to symptoms such as angina and myocardial infarction.Its diagnosis relies primarily on imaging techniques,including coronary angiography and computed tomography angiography.Given the complexity of CAE pathophysiology and its varied clinical presentations,the treatment strategies encompass pharmacological approaches(e.g.,antiplatelet anticoagulant,and lipid-lowering therapies),interventional procedures,and surgical treatments.However,the unified and standardized treatment protocols remain lacking.This expert consensus summarizes the current understanding of CAE,including its epidemiology,pathophysiology,clinical manifestations,diagnostic methods,and therapeutic strategies,to enhance CAE awareness,optimize diagnostic and treatment processes and improve the clinical outcomes.

Abstract:Objective To evaluate the clinical application value,technical nuances,efficacy and safety of the dual-microcatheter technique for the endovascular treatment of ruptured intracranial aneurysms,with a focus on ultra-early intervention.Methods A retrospective analysis was conducted on 36 patients with ruptured intracranial aneurysms treated with the dual-microcatheter coiling technique in our institution from August 2022 to August 2024.All procedures were performed in the ultra-early phase after rupture.The cohort included 13 males and 23 females,with a mean age of(56.35±8.16)years.Aneurysm locations were as follows:posterior communicating artery(16 cases),anterior communicating artery(12 cases),middle cerebral artery(4 cases),and other locations(4 cases).According to the Hunt-Hess scale,19 cases were grade Ⅰ,9 were grade Ⅱ,and 8 were grade Ⅲ.Technical details,immediate angiographic outcomes(assessed by the Raymond-Roy Occlusion Classification),periprocedural complications,clinical prognosis(evaluated by the modified Rankin Scale(mRS)),and follow-up results over 6-24 months were analyzed.Results The technical success rate was 100％.Immediate embolization results were Raymond-Roy Class Ⅰ in 30 cases(83.3％)and Ⅱ in 6 cases(16.7％),with no Class Ⅲ outcomes.Stent assistance was required in 8 cases(22.2％)with wide-neck aneurysm.No postoperative rebleeding or symptomatic large-territory cerebral infarction occurred.Asymptomatic small-sized infarctions were observed in 3 patients(8.3％),which resolved without neurological deficits after treatment.At the last follow-up,mRS scores were 0 in 28 cases(77.8％),1 in 6 cases(16.7％),and 2 in 2 cases(5.6％),and no patient had poor outcomes(mRS≥3).Aneurysm recurrence was noted in 3 cases(8.3％)during follow-up:one was treated with a flow-diverting stent,another received additional coiling,and the third was under continued observation.Conclusion The dual-microcatheter technique is a safe and effective treatment for ruptured intracranial aneurysms.Ultra-early intervention can effectively prevent rebleeding.Through meticulous intra-aneurysmal microcatheter positioning,strategic coil selection,and alternate packing,this technique can achieve a high rate of complete occlusion while avoiding or minimizing the need for stent placement,thereby improving patient prognosis.Meticulous attention to procedural details is paramount for enhancing the safety and efficacy of this technique.

Abstract:Objective To evaluate the application value of the third-party witness model in the informed consent process for high-risk interventional procedures and to establish a standardized operational pathway.Methods A retrospective cohort study was conducted,involving 156 patients who underwent high-risk interventional procedures in the First People's Hospital of Lianyungang from August 2024 to August 2025.Participants were divided into a third-party witness group(n=78)and a conventional control group(n=78).The incidence of medical disputes,completeness of informed consent documentation,patient understanding,and satisfaction scores were compared between the two groups.Results The incidence of medical disputes in the witness group was 1.28%(1/78),significantly lower than that in the control group(11.54%,9/78)(P<0.05).The completeness rate of informed consent documentation in the witness group(98.72%)was significantly higher than that in the control group(82.05%)(P<0.05).The understanding score of patients'families in the witness group(4.65±0.48)was significantly higher than that in the control group(3.82±0.76)(P<0.05).Conclusion The third-party witness mechanism can effectively improve the quality of informed consent,and mitigate medical disputes.The standardization pathway established in this study holds significant clinical promotion value.

Abstract:Objective To examine the risk factors associated with acute kidney injury(AKI)following acute ischemic stroke(AIS)in young patients who were admitted to the emergency department,and to propose intervention strategies.Methods A total of 167 young patients with acute ischemic stroke were selected from the Emergency Department of the Affiliated Lianyungang Hospital of Xuzhou Medical University from October 2021 to October 2023.These patients were divided into two groups based on the occurrence of acute kidney injury:the AKI group(comprising 42 cases)and the non-AKI group(comprising 125 cases).Results The risk factors of AKI in young AIS patients were analyzed and the intervention strategies were developed.Young AIS patients had higher risk for AKI if they had elevated NIHSS scores,higher serum creatinine levels,decreased low density lipoprotein cholesterol levels,or higher homocysteine levels(P<0.05).Conclusion Low density lipoprotein cholesterol,NIHSS score,homocysteine and serum creatinine are independent risk factors for AKI after AIS in young patients.AKI is extremely harmful to the prognosis and mortality of AIS patients.Young people are the backbone of social development.Strengthening early warning management of AKI in young AIS patients,and forming and implementing intervention measures based on risk factors should be done.

Abstract:Objective To explore the association and diagnostic value of symptomatic complaints for radial artery occlusion(RAO)in patients undergoing transradial coronary catheterization(TRC).Methods The study data were derived from a prospective cohort study,which enrolled 449 patients suspected or confirmed of coronary heart disease who underwent either elective coronary angiography(CAG)or percutaneous coronary intervention(PCI)via radial artery at the Department of Cardiology,First Affiliated Hospital of Nanjing Medical University,from January 2021 to October 2022.Any reported pain,paresthesia or weakness in the forearm on the surgical side was defined as a symptomatic complaint,and patients were divided into an asymptomatic complaint group(348 cases)and a symptomatic complaint group(101 cases).An independent ultrasound sonographer performed radial artery ultrasound examinations on patients both preoperatively and 12-24 hours post-TRC.The absence of radial artery antegrade blood flow observed using color Doppler mode was defined as RAO.The RAO incidence was compared between two groups and the association between symptomatic complaints and RAO was analyzed.Univariate and multivariate logistic regression analyses were used to explore the influencing factors for RAO in patients undergoing TRC.ROC curves were drawn to evaluate the diagnostic value of symptomatic complaints for RAO in patients undergoing TRC.Results Compared with the asymptomatic complaint group,the symptomatic complaint group showed a significantly higher incidence of RAO(26.7％vs.4.9％,P<0.001).Univariate and multivariate logistic regression analyses showed that symptomatic complaints[OR=6.453,95％CI(2.858-14.567)]and the sheath-to-artery(S/A)ratio[OR=16.272,95％CI(3.025-87.544)]were independent predictors for RAO post-TRC(P<0.05).ROC curve analysis showed that the AUCs of symptomatic complaints,S/A ratio,and their combination for predicting RAO in post-TRC patients were 0.715[95％CI(0.628-0.803)],0.691[95％CI(0.596-0.785)],and 0.769[95％CI(0.686-0.853)],respectively.Conclusion Presence of symptomatic complaints is an independent risk factor for RAO post-TRC,and the risk of RAO in patients with symptomatic complaints is 5.45 times higher than that in asymptomatic complaint patients.The symptomatic complaints and S/A ratio both show certain diagnostic value for RAO post-TRC,and the diagnostic value of their combination is higher,providing references for early detection of high-risk patients and for optimization of clinical practice and nursing strategy.

Abstract:In response to the"Healthy China 2030"strategy,the General Surgery Quality Control Center of Sichuan Province and the Thyroid Surgery Innovation and Transformation Branch of Sichuan Medical Science and Technology Innovation Association,jointly established 18 quality control(QC)nodes.This framework integrates evidence from many major domestic and international guidelines/consensus and regional clinical QC practices in Western China.The system encompasses three core dimensions:diagnostic logic accuracy(e.g.,TQC-01 for targeted screening to avoid over diagnosis by specifying high-risk ultrasonography indications);evidence-based treatment hierarchy(e.g.,TQC-06/TQC-08 standardizing staging protocols for surgical indications);treatment outcome optimization(e.g.,TQC-17 for longterm quality-of-life tracking).A four-phase closed-loop management structure is implemented.Screening intervention:imaging restricted to high-risk populations.Standardized diagnosis:initial nodule evaluation with serological testing(TQC-02)and pathological verification(TQC-04).Treatment protocolization:stratified execution of surgery/ablation indications(TQC-10).Dynamic prognosis monitoring:10-year survival tracking post-differentiated thyroid cancer surgery(TQC-17)and multidimensional ablation efficacy assessment(TQC-16).Under the collaborative governance of regional leading institutions,this framework has demonstrated significant impact:reduction of low-value care(e.g.,avoidance of non-indicated biopsy for suspicious lesion<1 cm),elimination of critical process omissions(including mandatory TNM staging compliance),and advancement toward regional healthcare quality homogenization.These contributions establish a replicable paradigm for enhancing China's national thyroid disease clinical quality ecosystem.

Abstract:Objective To investigate the effect of microwave physiotherapy combined with phased rehabilitation exercise nursing intervention on the rehabilitation outcomes of postoperative patients with malignant tumors.Methods A randomized controlled study was conducted,including 124 postoperative patients with malignant tumors admitted from January 2023 to June 2025,who were divided into the observation group(62 cases,conventional care+microwave physiotherapy and phased rehabilitation exercise)and the control group(62 cases,conventional care).The first time getting out of bed after surgery,incision healing time,hospitalization period,incidence of complications,and quality of life were compared between the two groups.Results The first time getting out of bed[(24.00±5.00)h vs.(192.00±20.00)h,t=18.367,P<0.001],incision healing time[(10.26±2.50)d vs.(16.33±3.21)d,t=10.861,P<0.001],and hospitalization period[(15.38±2.61)d vs.(22.42±4.50)d,t=9.652,P<0.001]in the observation group were significantly shorter than those in the control group.The total incidence of complications in the observation group was significantly reduced(3.23%vs.11.29%,χ2=3.075,P=0.036)compared with the control group,and the quality of life scores(physical function,emotional state,social function and symptom control)were significantly better than those in the control group(P<0.05).Conclusion Microwave physiotherapy combined with phased rehabilitation exercise can accelerate postoperative functional recovery,reduce the risk of complications,and improve the quality of life of cancer patients,which has clinical application value.

Abstract:Objective To explore the optimization effect of a modified sputum aspiration method on the detection of respiratory tract pathogenic bacteria in ICU patients with pulmonary infection.Methods A total of 90 patients with pulmonary infection admitted to ICU of the First People's Hospital of Lianyungang from January 2023 to December 2023 were selected and randomly divided into an observation group and a control group.The observation group adopted the modified sputum aspiration method,while the control group adopted the conventional sputum aspiration method.The pathogen DNA concentration and positive detection rate in sputum specimens,and the patients'blood gas analysis indicators,changes in blood oxygen saturation,incidence of adverse reactions,length of hospital stay and sputum aspiration time were compared between the two groups.Results The DNA concentration of pathogenic bacteria in the observation group[(103.44±20.81)μg/ml vs.(94.07±19.54)μg/ml,P<0.05]and the positive detection rate(77.78%vs.55.56%,P<0.05)were significantly higher than those in the control group.After sputum specimens were collected,PaO2 and PaCO2 in the observation group were better than those in the control group(P<0.05).The rate of decrease in blood oxygen saturation in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The incidence of respiratory mucosal bleeding in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The hospitalization time of the observation group was shorter than that of the control group[(10.26±6.58)d vs.(14.13±7.26)d,P<0.05].The single sputum aspiration time of the observation group was shorter than that of the control group,but the difference was not statistically significant(P>0.05).Conclusion The modified sputum aspiration method can improve the quality of sputum specimens,optimize the detection efficiency for pathogenic bacteria,and provide basis for precise clinical diagnosis and treatment.

Abstract:Objective To explore the effect of whole pathway nursing combined with nutritional support in patients after interventional surgery for liver cancer.Methods From January 2024 to May 2025,a total of 110 patients who underwent interventional surgery for liver cancer admitted to Huaihua Central Hospital were included as research subjects,and were randomly divided into a control group(n=55 cases)and a research group(n=55 cases).The control group was given routine nursing intervention for liver cancer interventional surgery,and the research group was given whoe pathway nursing combined with nutritional support intervention on the basis of the control group.Both interventions lasted for 4 weeks.Before and after the intervention,the serum nutritional indicators[albumin(ALB),total protein(TP),prealbumin(PA)],liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST)]and quality of life(EORTC QLQ-C30)scores were compared between the two groups,and the incidence of complications during the intervention period was also calculated.Results Before intervention,there were no statistically significant differences in EORTC QLQ-C30 scores and serum ALB,TP,PA,ALT and AST levels between the two groups(all P>0.05).After intervention,the EORTC QLQ-C30 score(t=8.593,P<0.05)and serum ALB(t=4.997,P<0.05),TP(t=8.394,P<0.05)and PA(t=8.315,P<0.05)levels of the research group were higher than those of the control group,while ALT(t=4.719,P<0.05)and AST(t=6.936,P<0.05)levels were lower than those of the control group,and the differences were statistically significant(P<0.05).The total postoperative complication rate in the research group was lower than that in the control group(14.55%vs.34.55%,χ2=5.939,P<0.05).Conclusion Whole pathway care combined with nutritional support can help improve liver function and nutritional status in patients undergoing interventional surgery for liver cancer,reduce the incidence of postoperative complications,and improve the quality of life,which is worthy of reference.

Abstract:Hepatocellular carcinoma(HCC)is one of the most common malignant tumors in China.Surgical resection remains the primary radical treatment.However,due to the lack of typical clinical symptoms in its early stages,it is often diagnosed at an intermediate or advanced stage,missing the optimal treatment window.Conversion therapy for unresectable hepatocellular carcinoma(uHCC)can effectively improve patient prognosis.In this case,the carcinoma was initially assessed as unresectable.After receiving tumor conversion therapy through transarterial chemoembolization(TACE)and surgical conversion via portal vein embolization(PVE),the patient was eventually qualified for radical surgery under this"dual conversion"strategy.Postoperative pathology confirmed a pathological complete response.During the follow-up period of approximately four years,no tumor recurrence has been observed,indicating clinical cure.Therefore,developing individualized conversion therapy regimens for patients with unresectable hepatocellular carcinoma may significantly improve their prognosis.

Abstract:The"Report on Cardiovascular Health and Diseases in China"is compiled by the National Center for Cardiovascular Diseases under the guidance of the National Health Commission.Since its inception in 2005,the report has spanned two decades.It has consistently adhered to the principles of professionalism,cutting-edge insights,representativeness,and authority.By continuously collecting,analyzing,and disseminating data on changes in cardiovascular health-related factors and disease trends,the report serves as a critical reference for policymakers in formulating public health strategies,identifying priority intervention areas,evaluating the effectiveness of prevention and control measures,and optimizing resource allocation.Cardiovascular diseases(CVD)remain the leading cause of death among urban and rural residents in China,accounting for 48.98%of rural deaths and 47.35%of urban deaths in 2021,and 2 out of every 5 deaths were CVD related.The Healthy China 2030 initiative includes a dedicated"Cardiovascular and Cerebrovascular Disease Prevention and Control Action"among its 15 key campaigns,setting a clear target:reducing CVD mortality to 190.7 per 100 000 or lower by 2030.To achieve this goal,more refined action plans and high-quality multidimensional data are needed to track the CVD prevention progress.This includes not only monitoring and reporting CVD incidence,prevalence,mortality,disease burden,and healthcare quality but also actively promoting and tracking improvements in cardiovascular health indicators,such as tobacco consumption,diet,physical activity,sleep,body mass index(BMI),blood pressure,cholesterol,blood glucose,and environmental factors.

Abstract:Intracranial bifurcation wide-necked aneurysms are a difficult problem in the treatment of intracranial aneurysms and are often a challenge in endovascular interventional treatment.Traditional interventional treatment mainly uses stents combined with spring coils,but the operation is complex,and the risk for ischemic complications and post-operation recurrence is high.With the emergence of the intrasaccular flow disruption device Woven EndoBridge(WEB),its advantages over traditional interventional treatments have gradually manifested.With continuous research on WEB,WEB is no longer limited to bifurcation aneurysms,and its application scope has also been gradually expanded.This article discusses the WEB device and its clinical application scope,WEB device implantation procedure,device size selection and perioperative antiplatelet regimen,postoperative follow-up and embolization effect evaluation methods,clinical outcomes of WEB treatment,complications occurrence and treatment,and off-label use of WEB.The current status and advances in these areas are reviewed.

Abstract:Objective To study the application effect of quality control management measures based on SHEL accident analysis in pre-hospital emergency care for patients with acute myocardial infarction.Methods A total of 96 patients with acute myocardial infarction admitted to the Emergency Medicine Department of our hospital from December 2023 to December 2024 were selected and divided into Group A(48 cases from December 2023 to May 2024)and Group B(48 cases from June 2023 to December 2024)based on the admission time.There was no statistically significant difference in the general data between the two groups of patients(P>0.05).In group A the conventional pre-hospital emergency care was implemented,and in group B the quality control management measures based on the SHEL accident analysis method was applied in addition to the emergency care in group A.The two groups were compared in terms of the pre-hospital ambulance care effect after the intervention(response time,pre-hospital emergency time,first electrocardiogram time),the total incidence of errors and accidents during the intervention period,as well as the quality of nursing care and patients'satisfaction with nursing care after the intervention.Results Compared with group A after the intervention,group B had shorter response time[(1.78±0.52)min vs.(2.45±0.57)min,t=6.016,P<0.05],pre-hospital emergency time[(25.76±5.64)min vs.(34.25±5.59)min,t=7.407,P<0.05],and first electrocardiogram time[(14.74±3.48)min vs.(18.36±4.23)min,t=7.407,P<0.05](all P<0.05).During the intervention period,the total incidence of errors and accidents in group B was lower than that of Group A(20.83%vs.6.25%,χ2=4.360,P<0.05).And after the intervention period,the quality of care and satisfaction with care of group B were both higher than those of Group A(both P<0.05).Conclusion The quality control management intervention based on SHEL accident analysis method is beneficial to improve the pre-hospital emergency care effect of patients with acute myocardial infarction,reduce the occurrence of errors and accidents during the intervention period,and improve the quality of care and the patients'satisfaction,which is worthy of reference.

Abstract:Objective To understand the level of supportive care needs in breast cancer patients undergoing endocrine therapy and analyze the characteristics of these needs among patients with different clinical profiles.Methods A convenience sampling method was used to select 135 breast cancer patients receiving endocrine therapy at the Breast Surgery Outpatient Department of a tertiary hospital in Lianyungang City from July 2024 to September 2024.Data were collected using a general information questionnaire and the Supportive Care Needs Survey short-form(SCNS-SF34).One-way ANOVA was employed to compare differences across clinical characteristics,with pairwise comparisons conducted using the LSD test.Results Data from 132 patients were included(3 invalid questionnaires excluded).Patients during endocrine therapy for breast cancer exhibited high supportive care needs,particularly in the domains of physical and daily living needs,health information needs,and psychological needs.Higher need scores were associated with shorter postoperative duration,more advanced pathological stage,older age,lower education level,and lower monthly household income.Conclusion Patients undergoing endocrine therapy still have multiple unmet needs.Current health information provided by clinical practitioners remains insufficient,highlighting the necessity to strengthen community collaboration,leverage science popularization and online platforms,and better address patients'needs during home-based care.Additionally,attention to patients'psychological well-being is critical to mitigate the impact of negative emotions on disease outcomes.

Abstract:Objective To explore the clinical efficacy and safety of oxiracetam in the treatment of patients with hypertensive intracerebral hemorrhage.Methods A total of 100 patients with hypertensive intracerebral hemorrhage admitted from March 2023 to March 2025 were selected as the research subjects and divided into the observation group(n=50)and the control group(n=50)according to the random number table method.The control group was given conventional antihypertensive,dehydration,hemostasis and symptomatic supportive treatments.The observation group was additionally treated with oxiracetam on this basis.The clinical efficacy was compared between the two groups of patients,including the NIHSS score,GCS score,and ADL score before and after treatment,and the incidence of adverse reactions was recorded.Result The total effective rate of treatment in the observation group was 98.0%,and that in the control group was 86.0%.Through comparison,the treatment effect of the observation group was higher(χ2=4.891,P<0.05).The NIHSS score in the observation group decreased,while the GCS score and ADL score were higher than those in the control group(all P<0.05).The levels of IL-6,CRP and NSE in the observation group were all lower than those in the control group(all P<0.05).The incidences of adverse reactions in the two groups of patients were similar(χ2=0.210,P>0.05).Conclusion Oxiractam can significantly improve the neurological deficits and activities of daily living in patients with hypertensive intracerebral hemorrhage,reduce the levels of neurological injury markers,and has good safety.It is worthy of clinical promotion.