Abstract:Objective To investigate the clinical efficacy of a modified technique for transnasal ileus tube insertion and evaluate its feasibility and safety in clinical practice.Methods Clinical data were collected from patients admitted to the Second Affiliated Hospital of Kunming Medical University from August 2022 to December 2024,who underwent the modified intestinal obstruction catheterization procedure in the Interventional Radiology Department.The success rate,efficacy,and postoperative complication rate(2.7%)of the modified method were analyzed.Feasibility was evaluated based on first-attempt success rate and clinical effectiveness rate,while safety was assessed by the incidence of postoperative complications.Patients were categorized into significant efficacy,effective,and ineffective groups according to clinical outcomes.Results Among 113 procedures,108 were successfully performed(success rate:95.6%),with 96 cases achieving clinical effectiveness(84.9%)and 12 cases deemed ineffective(10.6%).Three patients experienced catheter blockage or displacement(2.7%).No severe complications,such as aspiration,asphyxia,gastrointestinal bleeding or intestinal perforation,were observed during hospitalization or follow-up.Conclusion The modified technique for transnasal intestinal obstruction catheterization demonstrates a high success rate,definite therapeutic efficacy for patients with simple small bowel obstruction,and a low incidence of postoperative complications,warranting broader clinical promotion.

Abstract:Thyroid nodules have a high incidence rate and are a common clinical disease,among which benign nodules account for the majority.In the case that conventional treatment has disadvantages,ultrasound guided radiofrequency ablation,as a kind of minimally invasive innovation,is emerging.It has the characteristics of high safety,less trauma and few side effects.In addition,Traditional Chinese Medicine also has its uniqueness in the treatment of benign thyroid nodules,which can better meet the needs of clinical treatment through the internal administration of traditional Chinese medicine and external treatment.This article mainly reviews the clinical application of radiofrequency ablation combined with Traditional Chinese Medicine in the treatment of benign thyroid nodules.

Abstract:Cardiac physiologic pacing(CPP)includes the cardiac resynchronization therapy(CRT)by biventricular pacing,and the conduction system pacing(CSP)of His bundle pacing(HBP)and left bundle branch pacing(LBBP).CSP has emerged as a new strategy to restore or preserve ventricular synchrony to treat and potentially prevent heart failure(HF).With growing clinical evidence,recent guidelines have increasingly emphasized the role of LBBP.This perspective provides an overview of the current applications of CPP and explores future directions,with a particular emphasis on LBBP.

Abstract:Acute ischemic stroke accounts for about 80%of all stroke cases.Among them,acute anterior circulation cerebral infarction,due to the blockage of the main blood supply arteries to the brain,leads to ischemia and hypoxia of brain tissue,with persistently high disability and mortality rates.The core of its treatment lies in the rapid opening of the occlusive blood vessels and the restoring of blood perfusion after the onset of the disease to rescue the ischemic penumbra.Endovascular treatment,as the preferred option for patients within 24 hours of onset,can effectively reduce the ischemia-reperfusion time of brain tissue and alleviate functional neurological damage.However,hemorrhagic transformation(HT)after endovascular treatment is a key factor affecting the prognosis of patients.Its occurrence is closely related to traditional factors such as age,early ASPECT score,and recanalization time.Moreover,recent studies have found that new factors such as magnetic resonance SWI manifestations,bridging thrombectomy strategies,intraoperative tirofiban and thrombolytic drug application,and TICI grading of vascular recanalization are also involved.This article systematically reviews the pathological mechanism,classification and related factors of hemorrhagic transformation after endovascular treatment of acute anterior circulation cerebral infarction,aiming to provide a reference for clinical screening of high-risk patients and for optimization of prevention and management strategies.

Abstract:Objective To analyze the application effect of AI-assisted diagnosis combined with low-dose CT thin-layer scanning in the detection of pulmonary nodules and the interpretation of benign and malignant conditions.Methods A total of 75 patients with pulmonary nodules admitted to Songyuan Hospital of Integrated Traditional Chinese and Western Medicine from April 2024 to April 2025 were selected and underwent low-dose CT thin-layer CT scanning or AI-assisted diagnosis combined with low-dose CT thin-layer scanning.Taking clinicopathological examination as the gold standard,the influence of simple low-dose CT thin-layer scanning and the use of AI-assisted diagnosis schemes on the diagnostic efficacy of benign and malignant pulmonary nodules were analyzed.Results Clinicopathological examination revealed that among the 75 patients with pulmonary nodules,41 were benign and 34 were malignant.Low-dose CT thin-layer scanning detected 33 benign cases and 27 malignant cases.AI-assisted diagnosis combined with low-dose CT thin-layer scanning detected 39 benign cases and 32 malignant cases.The results of Kappa consistency analysis showed that the kappa value of AI-assisted diagnosis combined with low-dose CT thin-layer scan was 0.774,which was higher than the 0.609 of low-dose CT thin-layer scan(P<0.05).The sensitivity of AI-assisted diagnosis combined with low-dose CT thin-layer scanning was 95.12%and the specificity was 94.12%,which were higher than those of low-dose CT thin-layer scanning.There was no significant difference in the data comparison(χ2=2.847,P=0.092;χ2=2.049,P=0.152).The accuracy of AI-assisted diagnosis combined with low-dose CT thin-layer scanning was 94.67%,which was higher than that of low-dose CT thin-layer scanning,with a significant difference(χ2=6.027,P=0.014).Conclusion Compared with simple low-dose CT thin-layer scanning,the use of AI-assisted diagnosis can further improve the diagnostic efficiency of benign and malignant pulmonary nodules.

Abstract:Objective To explore the psychological changes in acute ischemic stroke(AIS)patients during peri-thrombolysis period,providing evidence for optimizing stroke green channel process and developing individualized psychological intervention strategies.Methods A descriptive qualitative study was conducted using semi-structured interviews with 13 AIS patients receiving thrombolytic therapy.Content analysis was employed to categorize and identify themes from the interview data.Results Four main themes and ten sub-themes were identified,including emotional turmoil at symptom onset,psychological coping during treatment,psychological efficacy of support systems,and psychological adjustment during prognostic uncertainty.Conclusion AIS patients experience complex and diverse psychological changes during the peri-thrombolysis period.Enhancing stroke education programs,optimizing green channel process with trust-building measures,strengthening psychological support,and improving medical environments and services can significantly improve patient experiences.

Abstract:Objective To investigate the status of care readiness of family caregivers for patients with tracheotomy in neurosurgery and explore the related influencing factors.Methods From March 2022 to September 2024,by the cluster sampling,105 family caregivers of patients with tracheotomy in the Department of Neurosurgery of a tertiary hospital were investigated by the general information questionnaire and care readiness scale.Multiple linear regression was used to analyze the influencing factors for the readiness of the main caregivers of patients with tracheotomy.Results The total score for care readiness among primary caregivers of patients with tracheostomy was(12.65±2.85).Among the eight items,the highest score was observed for physiological needs readiness(2.11±0.51),while the lowest score was noted for readiness to cope with caregiving stress(0.93±0.71).The results demonstrated statistically significant differences in care readiness scores among primary caregivers based on age(F=4.130,P=0.019),educational level(F=11.640,P<0.001),relationship to the patient(F=16.092,P<0.001),presence of co-caregivers(t=-3.679,P<0.001),cohabitation status with the patient(t=-2.224,P=0.028),and patient age(F=11.784,P<0.001).Multiple linear regression analysis revealed that caregivers'educational level,presence of co-caregivers,and cohabitation with the patient were key factors influencing their care readiness(t=4.281,P<0.001;t=2.791,P=0.006;t=2.166,P=0.033,respectively),accounting for 34.0%of the total variance explained.Conclusion The level of care readiness of family caregivers for patients with tracheotomy in neurosurgery is low.Nurses should carry out individualized guidance and intervention according to the specific conditions of the caregivers to improve the care readiness.

Abstract:Objective To analyze the effect of high-power radiofrequency ablation in the treatment of paroxysmal atrial fibrillation patients on the stress factors and the ablation time.Methods 60 patients with paroxysmal atrial fibrillation treated in our hospital from January 2022 to December 2023 were selected as study subjects and divided into two groups by random number table,with 30 patients in each group.The control group received conventional radiofrequency ablation at 40 W,while the observation group underwent high-power radiofrequency ablation at 50 W.Operation time and ablation time,levels of stress factors before and after treatment,levels of cardiac ultrasound-related indicators,and follow-up outcomes 6 months after treatment were compared between the groups.Results The operation time and ablation time in the observation group were shorter than those in the control group(t=3.007,P=0.004;t=5.821,P<0.001,respectively).Before treatment,there were no significant differences in stress factor levels between the groups(P>0.05).After treatment the levels of all stress factors in the observation group were lower than those of the control group(P<0.05).The levels of cardiac ultrasound-related indicators between the groups before treatment were insignificant(P>0.05).After treatment LAFI and LAEF of the observation group were significantly higher than those in the control group(t=3.367,P<0.001;t=4.812,P<0.001,respectively),and LAVmax and LAVmin were lower than those of the control group(t=2.418,P=0.019;t=4.405,P<0.001,respectively).Six months after treatment,there were no significant differences in disease recurrence,atrial arrhythmia or sinus rhythm(P>0.05).Conclusion The application of high-power radiofrequency ablation in the treatment of patients with paroxysmal atrial fibrillation can effectively shorten the operation time and ablation time,reduce the level of patient stress factors,and improve the level of cardiac ultrasound-related indicators of patients,which has high clinical treatment reference value.

Abstract:Objective To compare and analyze the diagnostic efficacy of intracavity contrast-enhanced ultrasound(IC-CEUS)versus conventional ultrasound(C-US)in detecting drain tube blockage after percutaneous transhepatic cholangial drainage(PTCD).Methods A total of 66 patients suspected of drain tube blockage following percutaneous transhepatic cholangial drainage at our hospital from January 2024 to March 2025 were enrolled as the study subjects.All patients underwent both intracavity contrast-enhanced ultrasound and conventional ultrasound examinations.Using reintervention(guidewire recanalization or repeat PTCD)as the gold standard,the diagnostic effects of the two modalities for detecting drain tube blockage after percutaneous transhepatic cholangial drainage were compared.Results The detection rate of drain tube blockage by intracavity contrast-enhanced ultrasound was significantly higher than that by conventional ultrasound(positive predictive value:97.78%vs.84.21%,χ2=5.114,P=0.047;negative predictive value:85.71%vs.46.43%,χ2=7.224,P=0.007).The sensitivity,specificity and accuracy of intracavity contrast-enhanced ultrasound were 93.62%,94.74%and 93.94%,respectively.In contrast,the sensitivity,specificity and accuracy of conventional ultrasound were 68.09%,68.42%and 68.18%,respectively.The sensitivity,specificity and accuracy of intracavity contrast-enhanced ultrasound were all significantly superior to those of conventional ultrasound(P<0.05).Conclusion Intracavity contrast-enhanced ultrasound can accurately visualize the location of drain tube blockage,demonstrating significantly better performance than conventional ultrasound.It exhibits outstanding diagnostic efficacy and holds important clinical significance for assessing the drain tube patency in patients after percutaneous transhepatic cholangial drainage.

Abstract:Objective To investigate the clinical efficacy of repetitive functional magnetic stimulation(FMS)combined with electroacupuncture regulation of the sacral 3 nerve in patients with spinal cord injury(SCI)and detrusor overactivity.Methods A total of 66 patients with incomplete SCI and detrusor overactivity admitted to our hospital between December 2022 and December 2024 were included.They were divided into two groups(33 cases each)using the odd-even number method.Both groups received conventional interventions,including a hydration schedule,intermittent clean catheterization,and bladder function training.The control group underwent standard electroacupuncture regulation of the S3 nerve,while the intervention group received additional repetitive FMS targeting the S3 nerve root(15 Hz frequency,once daily for 20 minutes per session,five times per week for eight consecutive weeks).Maximum cystometric capacity(MCC),maximum detrusor pressure(MDP),and Incontinence Quality of Life Questionnaire(I-QOL)scores were assessed before treatment and after eight weeks.Results Pretreatment urodynamic parameters and quality of life scores showed no significant differences between the two groups.After treatment,both groups exhibited significant improvements in MCC,MDP,and I-QOL scores(P<0.05),with the intervention group demonstrating greater improvements compared with the control group(P<0.05).Conclusion The combination of repetitive FMS and electroacupuncture regulation of the sacral 3 nerve is significantly effective in treating SCI patients with detrusor overactivity.

Abstract:Spontaneous vertebrobasilar artery dissecting aneurysms are a significant cause of subarachnoid hemorrhage and posterior circulation ischemic strokes in young to middle-aged individuals.This paper reports a case of a recurrent vertebrobasilar junction dissecting aneurysm in a 63-year-old male patient.The patient successfully underwent Pipeline flow diverter-assisted coil embolization under local anesthesia.During the procedure,real-time communication with the patient confirmed his condition,and no neurological deficits or other complications were observed postoperatively.This case demonstrates the clinical feasibility of using Pipeline flow diverter-assisted coil embolization for the treatment of recurrent vertebrobasilar junction dissecting aneurysms under local anesthesia.This approach not only avoids the risks associated with general anesthesia but also allows for intraoperative real-time neurological monitoring,providing a novel clinical strategy for the individualized management of such complex cases.

Abstract:Drug-coated balloons(DCBs),as an implantation-free interventional strategy for coronary artery disease,have emerged as a novel therapeutic option.In recent years,the application of DCBs in de novo lesions of large coronary vessels(typically defined as reference vessels of diameter>2.75 mm)has expanded.However,further exploration and research into their safety and efficacy are still warranted.This article synthesizes and summarizes some key aspects,including the accurate dissection assessment,the adequate lesion preparation,the guidance by intravascular imaging,and the latest research progress on DCB treatment for coronary de novo lesions.

Abstract:Objective To investigate the efficacy and complications of plasma exchange(PE)combined with dual plasma molecular adsorption system(DPMAS)in elderly patients with acute liver failure.Methods A total of 52 elderly patients with acute liver failure treated with PE+DPMAS in our hospital were enrolled from June 2020 to May 2023.They were randomly divided into groups A and B.In group A patients were treated with DPMAS before PE.In group B patients were treated with PE before DPMAS.The condition improvement,complications and machine parameter alarms of the two groups were evaluated and compared.Results In both groups the levels of total bilirubin(TBil),alanine aminotransferase(ALT),aspartate aminotransferase(AST),plasma albumin(ALB),prothrombin time(PT)and prothrombin activity(PTA)were significantly improved(P<0.05).The difference of ALB before and after treatment in group A was(-2.94±1.81)g/L and was(-2.35±1.88)g/L in group B,and the difference of PTA before and after treatment was(-11.45±7.83)%in group A and was(-9.15±6.33)%in group B.The differences of ALB and PTA before and after treatment were significant different between the two groups(t=-2.00,P=0.047 and t=-2.03,P=0.044,respectively).Compared with group B,group A was more prone to hypotension(18.75%vs.6.41%,χ2=4.236,P=0.040).The incidence of allergic reaction in group B was higher than that in group A(11.54%vs.2.50%,χ2=4.336,P=0.037).Group B was more prone to PV alarm(16.67%vs.5.00%,χ2=4.571,P=0.034)and membrane rupture alarm(7.69%vs.1.25%,χ2=3.933,P=0.047),while the PA alarm rate of group A was higher(21.25%vs.7.69%,χ2=4.375,P=0.036).Conclusion PE+DPMAS with different successive sequences can significantly improve the condition of elderly patients with acute liver failure,and the improvement effects of TBIL and PTA in patients with DPMAS before PE are superior to those with PE before DPMAS.For the occurrence of complications and abnormal machine alarms during PE+DPMAS treatment with different successive sequences,prevention and treatment can be done in advance to ensure the treatment effect.

Abstract:Objective To conduct a comparative analysis of the therapeutic efficacy and safety profiles between endoscopic injection sclerotherapy(EIS)and endoscopic variceal ligation(EVL)in managing acute esophageal variceal bleeding(EVB)secondary to liver cirrhosis.Methods Chinical data of patients with EVB in the First People's Hospital of Lianyungang from March 2020 to February 2023 were collected and retrospectively analyzed.Each patient was followed-up for six month after endoscopic therapy.The treatment effects in two groups were compared from efficient rate,rebleeding rate,complications and so on.Results The clinical data of 86 patients who were treated with EIS(n=49)or EVL(n=37)were qualified.In EIS group,41 patients(83.6%)were effective and 8 cases(16.4%)were ineffective.In EVL group,30 patients(81.1%)were effective and 7 cases(18.9%)were ineffective.There was no significant difference in elimination of varices between EVL group and EIS group(χ2=1.052,P>0.05).The early rebleeding rate(8.2%)in the EIS group was higher than that in the EVL group(8.1%),and the forward rebleeding rate in the EIS group(26.5%)was higher than that in the EVL group(21.6%),but both differences had no statistical significance(χ2=0.634,P=0.49;χ2=1.347,P=0.21,respectively).Differences in complications of fever(EIS group:14.3%vs EVL group:16.2%),eating choking(EIS group:6.1%vs EVL group:8.1%),and retrosternal pain(EIS group:12.2%vs EVL group:10.8%)had no statistical significance(χ2=1.523,P=0.17;χ2=0.725,P=0.46;χ2=1.968,P=0.46,respectively).Conclusion Both EVL and EIS are effective methods for EVB treatment in patients with liver cirrhosis,with comparable efficacy and safety.

Abstract:In recent years,the gut microbiota metabolite trimethylamine N-oxide(TMAO)has been confirmed to be closely associated with the occurrence and development of cardiovascular diseases and ischemic stroke.Studies have shown that TMAO may exacerbate atherosclerosis by promoting endothelial dysfunction,foam cell formation,platelet hyperreactivity,and thrombosis,thereby increasing the risk of large artery atherosclerosis(LAA)stroke.At the same time,TMAO may be involved in the pathological process of cardioembolism(CE)by inducing cardiac fibrosis,susceptibility to atrial fibrillation,and thrombosis.In small artery occlusion(SAO)stroke,it may aggravate small vessel lesions by affecting glucose and lipid metabolism.Although previous studies have proposed methods,such as diet,probiotics,antibacterial drugs,and statins,to reduce TMAO levels,the clinical effects of these interventions are not yet fully clear.In particular,there is still controversy regarding the impact of TMAO on the efficacy of antiplatelet drugs.Future research should explore the causal relationship between TMAO and stroke subtypes and evaluate its potential for clinical intervention,with the aim of optimizing the prevention and treatment strategies for ischemic stroke.

Abstract:Atrial functional mitral regurgitation(AFMR)is a unique form of mitral regurgitation(MR).With the increasing aging of the population,the incidence of AFMR is on the rise.Studies have shown that mitral valve transcatheter edge-to-edge repair is effective and safe for AFMR treatment,with significant improvements in patients'symptoms and survival rates.However,AFMR treatment is still challenging,as prognosis is influenced by multiple factors.

Abstract:Benign breast tumors,such as fibroadenomas,are common conditions in women.Although many of them require no intervention,traditional surgical excision presents limitations such as trauma,scarring,and potential aesthetic concerns for patients with symptomatic,rapidly growing lesions or strong preferences for minimally invasive approaches.Ultrasound-guided percutaneous microwave ablation(MWA),an emerging thermal ablative technique,offers an ideal alternative by leveraging its advantages of minimal invasiveness,precision,high efficiency,and excellent cosmetic outcomes.This video submission systematically demonstrates the standardized procedural workflow,critical technical nuances,and immediate efficacy assessment of ultrasound-guided percutaneous MWA for benign breast tumors.

Abstract:Objective To explore the pathological targets and their mechanisms in post-stroke dementia(PSD)based on GEO database and bioinformatics.Methods The mRNA gene chip dataset GSE186798,including neuronal cells,astrocytes and endothelial cells from normal patients,PSD patients and post-stroke non-dementia(PSND)patients,was downloaded from the GEO database.Differential expression genes were screened using the criteria of|log Fold Change|>1 and P value<0.05.The differential expression genes were subjected to GO and KEGG enrichment analysis using the DAVID database.The protein-protein interaction(PPI)network was constructed using Cytoscape software,and core genes were screened.Core gene-related miRNAs were predicted using TargetScanHuman,miRTraBase,and miRWalk databases,and an mRNA-miRNA network was constructed.Results There were 468 differential expression genes in neuronal cells between PSND patients and PSD patients,including 306 up-regulated genes and 162 down-regulated genes.GO enrichment analysis showed that PSD was mainly related to such biological functions as neuronal migration,protein binding,nucleus,and enzyme activity.KEGG enrichment analysis indicated that PSD was closely associated with TNF signaling pathway and HIF-1 signaling pathway.Ten core genes were screened from the PPI network,including EP 300,H 2 AC 20,H 2 BC 14,H2 BC5,AGO4,RBBP5,H2 AC13,UIMC1,KMT5 A and BAZ2 A.Has-miR-124 was a common miRNA for the ten core genes.Conclusion The ten core mRNA targets and has-miR-124 miRNA may be the main lesion targets of PSD,and TNF and HIF-1 signaling pathways may be part of the mechanisms to treat PSD.This study reveals the pathogenesis of PSD,providing new directions for the clinical treatment of PSD.

Abstract:Neuroendocrine neoplasms(NENs)are a rare group of tumors that originated from peptidergic neurons and neuroendocrine cells,which has neuroendocrine differentiation characteristics and expresses neuroendocrine markers.NENs occur in all parts of the body,especially in lung,gastrointestinal tract and pancreas.Both domestic and foreign researches showed that the incidence of NENs is on the rise.NENs have high heterogeneity and can originate in multiple tissues and organs,including pituitary,thyroid,parathyroid,skin,bronchial lung and thymus,gastrointestinal tract and pancreas,adrenal glands,genitourinary organs,etc.At the same time,when the classification and grading of NENs originating from the same tissue or organ are different,they also have significantly different biological behaviors.The high heterogeneity of NENs determines the difficulty and complexity of its diagnosis.In addition to clinical symptoms,it also needs to include special biomarkers,endoscopy,ultrasound,computed tomography(CT),magnetic resonance imaging(MRI)and various functional imaging methods for integrated diagnosis.In addition,the treatment of NENs also covers endoscopic therapy,surgical treatment,interventional therapy,drug therapy,radiotherapy and peptide receptor radionuclide therapy(PRRT).The development of treatment strategies requires not only following guidelines,but also making individual choices on the basis of multidisciplinary team(MDT)collaboration and integrated diagnosis and treatment.In 2024,the Society of Neuroendocrine Neoplasm of China Anti-Cancer Association once again organized experts in relevant fields to formulate the"China Anti-Cancer Association guideline for diagnosis and treatment of neuroendocrine neoplasms(2025 edition)"on the basis of the"China Anti-Cancer Association guideline for diagnosis and treatment of neuroendocrine neoplasm(2022 edition)",domestic and international guidelines and consensus,as well as the latest clinical research results.The guideline had been registered on Practice guideline REgistration for transPAREncy(PREPARE)with the registration number PREPARE-2024 CN1158.The 2025 edition updated and revised the relevant content from the 2022 edition and further expanded recommendations beyond thoracic,gastrointestinal tract and pancreas NENs,including pituitary neuroendocrine tumors(PitNETs),medullary thyroid carcinoma(MTC),pheochromocytoma/paragangliomas(PPGLs)and Merkel cell carcinoma(MCC),with the expectation of providing references for clinical practitioners.