Abstract:Objective To explore the effectiveness of a nursing intervention combining the Siebens Domain Management Model(SDMM)based on nursing quality feedback with the Attitude-Definition-Open mind-Planning-Try it out(ADOPT)model in patients with cerebral hemorrhage.Methods A total of 120 eligible cerebral hemorrhage cases were enrolled from patients admitted to our hospital from June 2022 to June 2025.Participants were randomly assigned via a random number table,with 60 cases in the observation group receiving the novel nursing intervention(SDMM combined with ADOPT)and the remaining 60 cases in the control group receiving conventional nursing care.Outcomes were compared in terms of motor function,activities of daily living,self-management ability,psychological state,and quality of life.Results Pre-intervention assessments showed no statistically significant differences in all observed indicators between the two groups(P>0.05).After 2 months of intervention,the observation group scored significantly higher than the control group in motor function,activities of daily living,self-care ability,and quality of life scales,while demonstrating significantly lower scores in negative emotions(anxiety and depression)(P<0.05).Conclusion The SDMM nursing intervention based on nursing quality feedback combined with the ADOPT model can effectively improve motor function and daily activity abilities in cerebral hemorrhage patients,enhance self-management,alleviate adverse psychological states,and elevate quality of life.

Abstract:Objective To explore the clinical efficacy of tenecplase and alteplase in the treatment of acute ischemic stroke within 4.5 hours after onset.Methods This study enrolled 50 patients with acute ischemic stroke who visited our hospital from June 2023 to June 2025.The patients were randomly divided into two groups,respectively receiving tenecteplase and alteplase for treatment,with 25 cases in each group.All eligible patients received corresponding intravenous thrombolysis within the 4.5-hour time window after onset.The primary objective of the study was to systematically compare and evaluate the efficacy of the two treatment regimens..Results Significantly more patients were effectively treated in the tenecteplase group than in the alteplase group(P<0.05).Both groups demonstrated reduced NIHSS scores at 24 hours and 7 days after treatment,with a more pronounced decrease in tenecteplase group(P<0.05).At 90 days,there was 1 death in tenecteplase group,and 4 in alteplase group.Both groups showed decreased mRS scores,with a more pronounced decrease in the tenecteplase group(t=13.628,P<0.05).At 24 hours post-treatment,coagulation function improved in both groups,with more significant enhancement in the tenecteplase group(P<0.05).At 7 days post-treatment,both groups showed improvement in coagulation function compared to baseline,though the inter-group difference was not statistically significant(P>0.05).There was no significant difference in the occurrence of adverse reactions between groups(χ2=0.136,P>0.05).Follow-up calls at 90 days post-treatment revealed 1 case of recurrence in tenecteplase group,and 7 in alteplase group(4.00%vs 28.00%,χ2=5.357,P<0.05).Conclusion Both tenecplase and alteplase have certain clinical efficacy in the treatment of acute ischemic stroke within 4.5 hours after onset.However,tenecplase is superior to alteplase in improving coagulation function and neurological function,and can effectively reduce the recurrence rate.Its safety is comparable to that of alteplase.Therefore,it can be used as the preferred drug for the treatment of acute ischemic stroke.

Abstract:China is among the countries with a high incidence of cholangiocarcinoma(CCA),and its incidence has been increasing annually.CCA arising at different anatomical sites presents distinct clinical features and requires differentiated diagnostic and therapeutic approaches.In 2015,the Chinese Chapter of the International Hepato-Pancreato-Biliary Association and the Hepatic Surgery Group of Surgical Branch of Chinese Medical Association jointly developed the"Diagnosis and treatment of cholangiocarcinoma:surgical expert consensus".Over the past decade,substantial progress has been made in the diagnosis and management of CCA.To better guide clinicians in addressing the challenges of CCA,the Chinese Chapter of the International Hepato-Pancreato-Biliary Association and the Hepatic Surgery Group of Surgical Branch of Chinese Medical Association convened a multidisciplinary committee of experts from different fields to revise and update the 2015 consensus,resulting in the present consensus.

Abstract:At present,radical surgery and individualized multidisciplinary comprehensive treatment based on surgery are the mainstream treatment models and effective methods for esophageal cancer.Surgery(radical resection),internal medicine(chemotherapy/immunotherapy/radiotherapy)as adjunctive therapy and interventional medicine as combination therapy are the three pillars of comprehensive treatment for esophageal cancer.Among them,interventional therapy is an emerging minimally invasive treatment technology.Reasonable combination application can help improve the resection rate,enhance the quality of life of patients,prolong survival,and improve the overall efficacy of esophageal cancer treatment.This article provides an overview and evaluation of the current status of interventional medical application in the comprehensive surgical treatment of esophageal cancer in China.

Abstract:Objective To explore the diagnostic value of ultrasound-guided biopsy combined with multimodal ultrasound for breast cancer.Methods A total of 90 patients(90 breast lesions)with suspected malignant breast masses,who were diagnosed and treated in the First Affiliated Hospital of Anhui Medical University and its Dongcheng Campus from December 2024 to September 2025,were selected as the research subjects.All of them underwent conventional ultrasound,shear wave elastography(SWE),contrast-enhanced ultrasound(CEUS),and preoperative ultrasound-guided biopsy.Taking the postoperative pathological diagnosis results as the"gold standard",the research subjects were divided into the malignant mass group(n=32)and the benign mass group(n=58).The conventional two-dimensional ultrasound and CEUS characteristics of the two groups were compared,and the diagnostic values of preoperative ultrasound-guided puncture,SWE,and CEUS alone and in combination for breast cancer were analyzed.Results In terms of conventional ultrasound imaging features,the mass diameter,shape,aspect ratio,internal echo,marginal crab-foot or spicule-like changes,microcalcification,hyperechoic halo near the margin,and the abnormal features of axillary lymph nodes in the malignant mass group all showed greater changes than those in the benign mass group(all P<0.05).In terms of CEUS characteristics,there were greater proportions of centripetal enhancement,hyperenhancement,lesion enlargement after enhancement,and disordered vascular course within and around the lesion in the malignant mass group than in the benign mass group(all P<0.05).Compared with the single examination method,the combined examination had higher sensitivity,specificity,positive predictive value,negative predictive value and accuracy rate(all P<0.05),which were 96.88%,96.55%,93.93%,98.25%and 96.67%respectively.Conclusion Ultrasound-guided biopsy combined with SWE and CEUS can significantly improve the sensitivity and specificity of breast cancer diagnosis and has high clinical application value.

Abstract:This article is an excerpt from the second section"Epidemiological Status of Cardiovascular Diseases and Their Risk Factors"of"Report on cardiovascular health and diseases in China 2024".It provides adetailed account of the incidence and mortality of cardiovascular and cerebrovascular diseases in China,as well as the epidemiological status and trends of risk factors such as smoking,overweight and obesity,hypertension,dyslipidemia,diabetes,and chronic kidney disease.Compiled by the National Center for Cardiovascular Diseases,the report covers cardiovascular impact factors,risk factors,diagnosis,treatment and epidemiological trends ofcardiovascular diseases,rehabilitation,basic research and development,and economic burden and evaluation.It iscurrently the most comprehensive and representative comprehensive compilation of practices and researchachievements in cardiovascular disease prevention and treatment in the industry.

Abstract:Objective To explore and evaluate the efficacy of drug-coated balloon(DCB)versus non-drug-coated balloon(NDCB)in side branch protection during coronary intervention.Methods Databases including PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Database,and Chinese Biomedical Literature Database(CBM)were searched,and relevant cardiovascular professional websites were also reviewed.The retrieval time was from the establishment of each database to June 2024 for relevant clinical studies.Literatures were screened according to the inclusion and exclusion criteria.Randomized controlled studies were evaluated using the Cochrane Risk of Bias Tool,and non-randomized controlled studies were evaluated using the Newcastle-Ottawa Scale.Relevant data were extracted,and statistical analysis was performed using RevMan 5.3.Results A total of 10 articles were included,among which 4 were randomized controlled studies and 6 were non-randomized controlled studies,with a total of 1 720 cases.The results of meta-analysis showed that compared with the NDCB group,the DCB group had lower late luminal loss of side branch vessels(MD=-0.17,95%CI:-0.26--0.08,P<0.01),while there were no statistically significant differences in target lesion revascularization(TLR),non-fatal myocardial infarction,and major adverse cardiovascular events(MACE).Subgroup analysis of non-randomized controlled studies showed that compared with the NDCB group,the DCB group was superior in terms of late luminal loss of side branch vessels(MD=-0.20,95%CI:-0.31--0.09,P<0.01),TLR(OR=0.44,95%CI:0.24-0.81,P<0.01),and MACE(OR=0.47,95%CI:0.27-0.79,P<0.01).Conclusion In the interventional treatment of primary coronary bifurcation lesions,compared with NDCB,DCB may improve late luminal loss and reduce the incidence of TLR and MACE.However,more large-sample randomized controlled studies are still needed for verification.

Abstract:Objective To explore the current situation of exercise prehabilitation adherence and its influencing factors in elderly patients with lung cancer,and to provide a basis for optimizing perioperative rehabilitation intervention strategies.Methods A single-center cross-sectional study was conducted,enrolling 123 lung cancer patients who underwent radical surgery from June 2023 to March 2025.Patients were divided into two groups based on exercise prehabilitation adherence:the high-adherence group(adherence rate≥75%)and the low-adherence group(adherence rate<75%).A multidisciplinary team developed personalized exercise programs,which were implemented in combination with supervision measures and psychological interventions.The patients'functional status,psychological characteristics,and postoperative clinical outcomes were evaluated.Univariate analysis and multivariate logistic regression analysis were used to explore the influencing factors of adherence.Results The overall exercise prehabilitation adherence rate of the patients was 82.45%,in which the adherence rate to breathing training was the highest(98.05%),and to aerobic exercise was the lowest(69.25%).Advanced age,frailty,preoperative anxiety,long prehabilitation period,and family support level were independent risk factors for reduced adherence(P<0.05).The postoperative hospital stay in the high-adherence group was significantly shorter than that in the low-adherence group(P=0.002),but there were no significant differences in other clinical outcome indicators such as complication rate between the two groups(all P>0.05).Conclusion The exercise prehabilitation adherence of lung cancer patients is affected by multiple factors including age,frailty,anxiety,and rehabilitation period.Individualized intervention strategies should be developed for elderly,frail and anxious patients,the prehabilitation period design should be optimized,and psychological support should be strengthened,so as to improve rehabilitation participation and surgical prognosis.

Abstract:Objective To investigate the clinical efficacy of ultrasound-guided foam sclerotherapy combined with percutaneous high ligation of the great saphenous vein(GSV)trunk in treating primary GSV varicosities.Methods The study was conducted on 60 patients with unilateral primary GSV varicosities.They were randomly divided into an observation group and a control group,each comprising 30 patients.The observation group underwent polidocanol foam sclerotherapy combined with ultrasound-guided percutaneous high ligation of the GSV trunk.The control group underwent high ligation of the GSV and intravenous injection of polidocanol foam sclerosant.Surgical efficacy indicators(trunk closure rate,symptom relief rate),safety indicators(operative time,complications,intraoperative blood loss,postoperative Visual Analogue Scale(VAS)score),and health economics indicators(hospitalization duration and costs)were compared between groups.Results Regarding efficacy,the observation group demonstrated a 6-month trunk closure rate of 80.00%(24/30)and a symptom relief rate of 96.67%(29/30),while the control group had a 6-month trunk closure rate of 100.00%(30/30)and a symptom relief rate of 93.33%(28/30).Differences in trunk closure rate and symptom relief rate between groups were not statistically significant(P>0.05).Regarding safety,the observation group demonstrated significantly reduced operative time[45.50(40.00,45.00)min vs 62.5(60.00,71.25)min,Z=3.22,P<0.001],intraoperative blood loss[10.00(5.00,10.00)ml vs 20.00(10.00,40.00)ml,Z=2.71,P<0.001],and postoperative complication rate(13.30%vs 60.00%,χ2=14.07,P<0.001)compared with the control group.However,postoperative VAS scores showed no statistically significant difference between groups(P>0.05).In terms of health economics indicators,the observation group exhibited shorter hospitalization duration[50.00(47.75,52.25)h vs 143.00(124.75,145.00)h,Z=3.87,P<0.001]and lower hospitalization costs[4 677.99(4 200.61,4 848.77)Yuan vs 5 455.59(4 779.96,5 906.83)Yuan,Z=2.45,P<0.001]than the control group.Conclusion Ultrasound-guided percutaneous suturing combined with sclerotherapy demonstrates reliable efficacy in treating GSV varicosities.This approach offers both minimally invasive and cost-effective advantages,making it particularly suitable for implementation in primary care hospitals.

Abstract:Objective To explore the clinical characteristics,diagnosis,and treatment plan of arrhythmogenic right ventricular cardiomyopathy through a typical case and in combination with diagnostic and therapeutic guidelines.Methods The clinical data of one case of arrhythmogenic right ventricular cardiomyopathy in our hospital were retrospectively analyzed and discussed in conjunction with relevant literature.Results The patient underwent successful implantable cardioverter defibrillator(ICD)surgery treatment.After surgery,the patient perceived one discharge of the ICD and electrocardiogram was performed,which showed ventricular tachycardia.Symptomatic treatment was given and ICD related parameters were adjusted.After nearly 5 years of follow-up,the patient did not experience any further episodes of palpitations or chest tightness,and the ICD did not discharge.The patient was able to participate in daily work normally.Conclusion The clinical characteristics of arrhythmogenic right ventricular cardiomyopathy are non-specific,and its diagnosis often requires a combination of clinical symptoms,signs,imaging examinations,and other diagnostic methods for it to be confirmed.ICD implantation is of great significance for patients with arrhythmogenic right ventricular cardiomyopathy who meet the indications for ICD implantation.

Abstract:Objective To observe the therapeutic effect of closed-loop repetitive transcranial magnetic stimulation(rTMS)combined with electroacupuncture in patients with neurogenic bladder(NB)after spinal cord injury.Methods A total of 40 patients with neurogenic bladder after spinal cord injury who were admitted to the Department of Rehabilitation Medicine of The First People's Hospital of Lianyungang from March 2024 to June 2025 were selected and randomly divided into a control group and an observation group,with 20 patients in each group.The control group was given electroacupuncture treatment on the basis of conventional rehabilitation treatment,while the observation group was treated with closed-loop repetitive transcranial magnetic stimulation combined with electroacupuncture on the basis of conventional rehabilitation treatment.The treatment was conducted 5 times a week for a total of 8 weeks.Urodynamic indexes(maximum bladder capacity,detrusor pressure during urination,residual urine volume),voiding diary parameters(average daily catheterization frequency,urine volume per catheterization)and Neurogenic Bladder Symptom Score(NBSS)of the two groups were compared before and after 8 weeks of treatment.Results Intragroup comparison showed that after treatment,the maximum bladder capacity,detrusor pressure during urination,residual urine volume,urine volume per catheterization and NBSS score in both groups were improved compared with those before treatment(P<0.05).The average daily catheterization frequency in the observation group was improved compared with that before treatment(P<0.05),while no significant improvement was found in the average daily catheterization frequency in the control group(P>0.05).Intergroup comparison after treatment revealed that the urodynamic indexes,voiding diary parameters and NBSS score in the observation group were superior to those in the control group(P<0.05).Conclusion Closed-loop repetitive transcranial magnetic stimulation combined with electroacupuncture can improve the urodynamic indexes and urination function of NB patients after spinal cord injury,and can promote the recovery of bladder function.Its efficacy is better than that of electroacupuncture alone.

Abstract:Objective To identify peri-operative factors associated with post-procedural nausea and vomiting(PONV)after percutaneous coronary intervention(PCI)and to develop a rigorously validated prediction system.Methods Clinical data of 250 patients who underwent PCI at The First People's Hospital of Lianyungang from September 2023 to August 2025 were retrospectively collected.A comprehensive model and a predictive evaluation framework were implemented in Python.In the model construction process,five machine learning methods were employed,namely Support Vector Machine(SVM),Decision Tree(DT),Random Forest(RF),Logistic Regression(LR),and Adaptive Boosting(Adaboost).The dataset was split so that 90％of observations were randomly allocated to the training set and the remaining 10％constituted the independent validation set.Model performance was evaluated by ten-fold cross-validation,with the area under the receiver-operating characteristic curve(AUC)serving as the primary metric.Results Seventy of the 250 patients(28.0％)developed PONV within 24 h after PCI.Univariable analysis revealed significant between-group differences(all P<0.05)in sex,smoking history,prior motion sickness or PONV,contrast volume>100 mL,procedure duration>120 min,intra-procedural hypotension,post-procedural pain score>3 on the FPS scale,and comorbidity count>3.Among the five algorithms,the LR-based model achieved the highest discriminative accuracy(mean AUC=0.871).Conclusion The LR model demonstrates superior predictive performance for post-PCI PONV.Integrating this model into user-friendly clinical software may facilitate individualized risk stratification and guide targeted prophylactic strategies to reduce the incidence of PONV.

Abstract:Objective To evaluate the clinical efficacy of drug coated balloon(DCB)in primary percutaneous coronary intervention(PPCI)based on optical coherence tomography(OCT).Methods We retrospectively analyzed data from patients who underwent PPCI with intraoperative OCT examination from February 2022 to December 2024.They were divided into the DCB group(n=15)and the drug-eluting stent(DES)group(n=40)according to the interventional treatment received.Relevant clinical data,coronary angiography,and OCT images were collected.Major adverse cardiovascular events(MACE)during the follow-up period were recorded,including cardiac death,recurrent acute myocardial infarction,target vessel revascularization,and bleeding events.Results There were no statistically significant differences in baseline clinical data between the DCB group and the DES group(P>0.05).Coronary angiography showed no significant differences in target vessels,preoperative and postoperative TIMI flow grades,thrombus aspiration,coronary thrombolysis,as well as device diameter and length between the two groups(P>0.05).Regarding coronary angiography parameters of target vessels,there were no statistically significant differences in preoperative reference vessel diameter,lesion length,or stenosis degree between the two groups(P>0.05).After PCI,the OCT minimum lumen area in the DCB group was smaller than that in the DES group,and the residual thrombus burden and incidence of dissection in the DCB group were higher than those in the DES group(P<0.05).The follow-up period was 28.0(18.0,29.5)months in the DCB group and 22.5(9.0,30.0)months in the DES group.During the follow-up period,1 patient in the DCB group had recurrent myocardial infarction and underwent target vessel revascularization,while 4 patients in the DES group underwent target vessel revascularization.Compared with patients without MACE,patients with MACE had higher postoperative residual thrombus burden,as well as higher incidences of dissection and intramural hematoma(P<0.05).Conclusion DCB can be safely and effectively used in PPCI for the treatment of lesions after adequate pretreatment,and OCT is helpful for identifying imaging features associated with postoperative MACE.

Abstract:Objective To explore the effect of comprehensive nursing intervention on reducing the incidence of malnutrition in patients after interventional therapy for esophageal cancer.Methods A total of 120 patients with esophageal cancer who received interventional therapy in our hospital from January 2021 to October 2025 were selected for the study.They were randomly divided into an observation group and a control group,with 60 cases in each group.The control group received routine nursing,while the observation group was given comprehensive nursing measures(including individualized nutritional support,swallowing function training,and digestive tract symptom management)on the basis of routine nursing.At 3 months after the intervention,the incidence of malnutrition,nutritional indicators,digestive tract symptoms,and quality of life were evaluated.Results Three months after the intervention,the total incidence of malnutrition in the observation group was 35.0%,which was significantly lower than the 65.0%in the control group(χ2=12.345,P<0.001).The body mass index[(20.5±2.3)kg/m2 vs(18.8±2.0)kg/m2 t=4.328,P<0.05],serum albumin[(38.2±3.5)g/L vs(34.1±3.2)g/L t=6.792,P<0.05],and hemoglobin[(120.5±13.1)g/L vs(110.3±12.8)g/L t=4.316,P<0.05]in the observation group were significantly higher than those in the control group(all P<0.001).The total incidence of digestive tract symptoms in the observation group was 25.0%,which was lower than the 50.0%in the control group(χ2=9.231,P=0.002),and the total score of the Esophageal Cancer Quality of Life Scale in the observation group[(65.0±7.4)points vs(55.0±7.4)points t=7.390,P<0.05]was significantly higher than that in the control group.All the above differences were statistically significant(P<0.05).Conclusion Comprehensive nursing intervention can effectively reduce the incidence of malnutrition in patients after interventional therapy for esophageal cancer,and improve their nutritional status and quality of life.

Abstract:Objective To develop and apply a self-management support system for cancer pain patients based on the O2 O(online-to-offline)model,aiming to improve healthcare professionals'work efficiency and provide reference for enhancing patients'home-based pain management.Methods Using convenience sampling,120 cancer pain patients hospitalized in the Oncology Department of the First People's Hospital of Lianyungang from June 2024 to December 2024 were selected as study participants.They were randomly divided into an observation group and a control group using a random number table,with 60 patients in each group.The observation group received the out-of-hospital health management with a self-management support system for cancer pain patients based on the O2 O model in addition to conventional out-of-hospital health management,while the control group received only conventional out-of-hospital health management.After 12 weeks of intervention,comparisons were made between the two groups regarding the case management completion rate for cancer pain,pain control status,self-management ability,and quality of life.Results After the system was promoted and applied,the case management completion rate for cancer pain was 97.2%in the observation group and 94.9%in the control group,indicating a statistically significant improvement in the completion rate after system application(P<0.001).The effective days of pain control were(50.05±2.43)days in the observation group and(37.23±2.33)days in the control group,and the average daily frequency of breakthrough pain episodes was(2.95±0.50)times per day in the observation group and(4.10±0.51)times per day in the control group,both with statistically significant differences(P<0.001).All self-management ability scores in the observation group were higher than those in the control group,with statistically significant differences(P<0.001).Except for bodily pain,all quality of life domain scores in the observation group were higher than those in the control group,with statistically significant differences(P<0.001).Conclusion The application of the self-management support system for cancer pain patients can effectively improve the case management completion rate for cancer pain,enhance patients'pain control status,improve their quality of life,and promote home-based management of cancer pain.

Abstract:Objective To explore the risk factors for puncture site complications after radiofrequency catheter ablation(RFCA)in patients with tachyarrhythmias and to propose corresponding strategies for early identification and risk reduction.Methods A total of 669 patients who underwent RFCA in our department from January 2017 to June 2023 were enrolled.Among them,23 cases had puncture site complications.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors by comparing clinical data between the complication and non-complication groups.Results The overall incidence of puncture site complications was 3.4％.The incidence was significantly higher in the atrial arrhythmia group than in the supraventricular(6.8％vs 1.1％,P<0.05)and ventricular arrhythmia groups(6.8％vs 0.9％,P<0.05).Hematoma formation was strongly associated with the type of procedure(P<0.05).Multivariate analysis identified atrial arrhythmias(OR=4.92,95％CI:1.98-12.23,P<0.05)and a history of hypertension(OR=2.45,95％CI:1.04-5.78,P<0.05)as independent risk factors for puncture site complications.Conclusion Ablation for atrial arrhythmias(especially atrial fibrillation)and a history of hypertension are independent risk factors for puncture site complications.Preoperative identification of high-risk patients,standardized intraoperative techniques with ultrasound guidance when necessary,and close postoperative monitoring are crucial for minimizing complications.

Abstract:Objective To construct an interventional room nosocomial infection prevention and control management model adapted to the"one hospital with multiple campuses"mode,and to resolve the contradiction between unified standards and decentralized management across multiple campuses.Methods Taking the three campuses of Guangzhou Medical University Affiliated Women and Children's Medical Center as research subjects,a closed-loop management model was established,which included risk assessment,process standardization,information management framework,implementation monitoring,and continuous improvement.Innovative measures,such as the formulation of unified standards,hierarchical management,cross-inspection,and a data sharing platform,were adopted to achieve collaborative management across multiple campuses.Results After implementation of the management model for 12 months,the consistency of infection prevention and control standards across all hospital campuses increased from 68.5%to 95.2%(t=78.42,P<0.01),the pass rate of training assessment rose from 82.2%to 97.8%(χ2=6.35,P<0.05),the hand hygiene compliance increased from 82.7%to 95%(χ2=517.63,P<0.01),the qualification rate for equipment disinfection rose from 93.3%to 98.9%,the incidence of adverse events related to hospital infections dropped from 3.2 ‰ to 0.8 ‰(χ2=11.26,P<0.05).Compared with before implementation,the incidence of occupational exposure decreased by 66.7%,the variation coefficient of hand hygiene compliance decreased by 72.2%,and the variation coefficient of the qualification rate for equipment disinfection decreased by 75.0%.Conclusion This management model can effectively address the management challenges in hospital infection prevention and control for interventional rooms in multi-campus hospitals,such as uneven capabilities among positions and across campuses,and insufficient job homogenization.It significantly improves the quality of prevention and control as well as management efficiency,providing a replicable innovative management model for multi-campus hospitals.

Abstract:A 65-year-old male presented with sudden onset of unconsciousness for one hour.His medical history included 30 years of hypertension,10 years of arrhythmia(treated with metoprolol),and severe stenosis of the right internal carotid artery at the ophthalmic segment with prior ischemic stroke.On admission,the patient was unconscious with right gaze deviation and left sided hemiplegia.Imaging examination revealed a large right hemispheric infarction and the occlusion of right internal carotid artery,initially suggesting thrombotic occlusion.Intravenous thrombolysis and endovascular intervention were performed,but intraoperative findings showed significantly reduced blood pressure on the right side compared to the left.Post procedural CT confirmed type A aortic dissection involving the right common carotid artery.Due to the extensive dissection and high surgical risk,the family opted for conservative treatment.The patient succumbed to cardiac tamponade and pump failure caused by aortic dissection extension to the aortic valve,9 hours post-onset.This case highlights the need for vigilance regarding aortic dissection in acute stroke patients,emphasizes the importance of comprehensive assessment and management,and underscores the critical impact of inadequate longterm blood pressure control on aortic diseases.

Abstract:Objective To evaluate the safety and efficacy of the Indigo large-lumen catheter in the treatment of high-and intermediate-risk pulmonary embolism(PE).Methods A retrospective analysis was conducted on 65 patients with high-and intermediate-risk PE admitted to our center from October 2023 to April 2025.All patients underwent mechanical thrombectomy using the Indigo large-lumen catheter.Patient baseline characteristics,procedural parameters,safety and efficacy indicators,and follow-up outcomes were collected and analyzed.Results Compared with preoperative measurements,at 48 hours postoperation the right ventricle/left ventricle diameter ratio(RV/LV)decreased[(1.02±0.15)vs.(0.78±0.08),P<0.001],and the pulmonary artery systolic pressure decreased[(59.6±18.4)mmHg vs.(49.0±16.7)mmHg,P<0.001].The rate of major adverse events was 1.5％(1/65),consisting of one case of pulmonary hemorrhage.No all-cause mortality or symptomatic PE recurrence occurred during the 30-day follow-up period.Conclusion Mechanical thrombectomy using the Indigo large-lumen catheter is a safe and effective treatment for high-and intermediate-risk PE.It can significantly improve patients'physiological parameters,providing a new therapeutic option for PE.