Objective:To explore the mediation effect of personality between negative life events and risky mentation of university students.Methods:A cross sectional investigation was conducted among 8 379 freshmen with the adolescent self-rating life events check list (ASLEC), the prodromal questionnaire(PQ-16) and the Eysenck personality questionnaire (EPQ). The data were analyzed by SPSS 23.0 and AMOS 24.0.Results:The total score of negative life events scale((31.16±0.58) vs (15.19±0.15)), the scores of neuroticism((58.20±0.36) vs (41.59±0.13)) and psychoticism((53.07±0.29) vs (47.71±0.08)) in the risk psychological state group were significantly higher ( t=26.611, 42.270, 17.286, all P<0.01), and the score of introversion-extroversion factor was significantly lower((49.83±0.42) vs (55.88±0.13), t=-13.634, P<0.01) than those in the risk-free psychological state group. There was a positive correlation between the scores of risk psychological state and negative life events( r=0.290, 0.334, both P<0.01), and the scores of risk psychological state and negative life events were positively correlated with the scores of personality neuroticism and psychoticism ( r=0.139-0.469, all P<0.01) in both risk psychological state and risk-free psychological state group.The risk psychological state score of college students was negatively correlated with the inside and outside personality score( r=-0.070, P<0.01), and the score of negative life events was not correlated with introversion-extroversion personality score in the risk psychological state group, while the score of risk psychological state, negative life events and introversion-extroversion personality score were negatively correlated in the risk-free psychological state group ( r=-0.177, -0.080, P<0.01). The personality of college students played a complete mediating role between negative life events and risk psychological state in the risk psychological state group, while the personality of college students in the risk-free psychological state group played a partial mediating role between negative life events and risk psychological state, accounted for 71.43% of the total effect. Conclusion:Negative life events not only directly lead to the risky mentation of college students, but also affect the risky mentation of college students by the mediation effect of introverted and extroverted tendency and unstable emotion.

Objective:To study the feasibility of domestic flow diverter(TFD) for the treatment of unruptured internal carotid artery small- and medium-sized wide-neck aneurysms.Methods:This is a retrospective case series study.The study retrospectively evaluated consecutive 54 patients with unruptured intracranial small- and medium-sized wide-neck aneurysms treated with TFD in the Department of Cerebrovascular Disease,the Second Affiliated Hospital of Kunming Medical University between October 2019 and January 2024. There were 11 males and 43 females, and the age of patients was (54.9±9.6) years (range:36 to 74 years). There were 63 aneurysms in 54 patients,6 of which were tandem multiple small aneurysms. One case had saccular aneurysms of bilateral internal carotid artery. The maximum diameter of aneurysm was (4.1±0.8) mm (range: 1.5 to 10.0 mm).The ratio of the maximum diameter of the aneurysm to the neck width diameter was 1.3±0.4 (range:0.4 to 2.4). The surgical and follow-up data were collected. The aneurysm embolization rate at the immediate operation and follow-up,and the complications were analyzed. The degree of aneurysm embolization was evaluated using the O′Kelly-Marotta (OKM) grading system,with OKM grade D as complete occlusion and grade C and above (C1,C2,C3 and D) as successful occlusion. Clinical outcomes of all patients were evaluated by modified Rankin scale(mRS).Results:For 63 aneurysms, 48 aneurysms were treated with TFD alone,and 15 aneurysms were treated with a combination of TFD and coiling. The immediate postoperative successful occlusion rate was 14.3% (9/63) and the complete occlusion rate was 3.2% (2/63). Follow-up results were obtained for all of the patients. The follow-up time ( M(IQR)) was 124 (182) days (range: 85 to 754 days). The time to aneurysm successful occlusion was 140.5 (151.5) days (range: 85 to 308 days). At final follow-up,the successful aneurysm occlusion rate was 68.3% (43/63) and the complete occlusion rate was 58.7% (37/63). The complete occlusion rate of the TFD group was 50.0% (24/48) and the TFD+coiling group was 13/15. All patients had no aneurysm rupture,ischemic complications and no recurrence of the aneurysm needed to retreatment during the intraoperative and follow-up period. A total of 3 mild haemorrhagic complications which were related to dual-antiplatelet agents. Twelve patients had asymptomatic mild-moderate stent stenosis. TFD covered 66 branch vessels totally. Only 6 branches were affected by the time of the last follow-up and none of the patients had relevant ischaemic symptoms. All of 54 patients were evaluated as mRS score<2 points at the last follow-up. Conclusion:Using TFD to treat internal carotid artery unruptured small and medium-sized wide-neck aneurysms can simplify the surgical procedure with low complication rate, which is a clinically optional treatment approach.

Objective:To study the feasibility of domestic flow diverter(TFD) for the treatment of unruptured internal carotid artery small- and medium-sized wide-neck aneurysms.Methods:This is a retrospective case series study.The study retrospectively evaluated consecutive 54 patients with unruptured intracranial small- and medium-sized wide-neck aneurysms treated with TFD in the Department of Cerebrovascular Disease,the Second Affiliated Hospital of Kunming Medical University between October 2019 and January 2024. There were 11 males and 43 females, and the age of patients was (54.9±9.6) years (range:36 to 74 years). There were 63 aneurysms in 54 patients,6 of which were tandem multiple small aneurysms. One case had saccular aneurysms of bilateral internal carotid artery. The maximum diameter of aneurysm was (4.1±0.8) mm (range: 1.5 to 10.0 mm).The ratio of the maximum diameter of the aneurysm to the neck width diameter was 1.3±0.4 (range:0.4 to 2.4). The surgical and follow-up data were collected. The aneurysm embolization rate at the immediate operation and follow-up,and the complications were analyzed. The degree of aneurysm embolization was evaluated using the O′Kelly-Marotta (OKM) grading system,with OKM grade D as complete occlusion and grade C and above (C1,C2,C3 and D) as successful occlusion. Clinical outcomes of all patients were evaluated by modified Rankin scale(mRS).Results:For 63 aneurysms, 48 aneurysms were treated with TFD alone,and 15 aneurysms were treated with a combination of TFD and coiling. The immediate postoperative successful occlusion rate was 14.3% (9/63) and the complete occlusion rate was 3.2% (2/63). Follow-up results were obtained for all of the patients. The follow-up time ( M(IQR)) was 124 (182) days (range: 85 to 754 days). The time to aneurysm successful occlusion was 140.5 (151.5) days (range: 85 to 308 days). At final follow-up,the successful aneurysm occlusion rate was 68.3% (43/63) and the complete occlusion rate was 58.7% (37/63). The complete occlusion rate of the TFD group was 50.0% (24/48) and the TFD+coiling group was 13/15. All patients had no aneurysm rupture,ischemic complications and no recurrence of the aneurysm needed to retreatment during the intraoperative and follow-up period. A total of 3 mild haemorrhagic complications which were related to dual-antiplatelet agents. Twelve patients had asymptomatic mild-moderate stent stenosis. TFD covered 66 branch vessels totally. Only 6 branches were affected by the time of the last follow-up and none of the patients had relevant ischaemic symptoms. All of 54 patients were evaluated as mRS score<2 points at the last follow-up. Conclusion:Using TFD to treat internal carotid artery unruptured small and medium-sized wide-neck aneurysms can simplify the surgical procedure with low complication rate, which is a clinically optional treatment approach.

Objective:To analyze the safety and efficacy of endovascular treatment in fusiform aneurysms at V4 segment of vertebral artery.Methods:Twenty-five patients with fusiform aneurysms at V4 segment of vertebral artery, accepted endovascular treatment in Department of Cerebrovascular Diseases, Second Affiliated Hospital of Kunming Medical University from May 2016 to January 2022 were chosen; their clinical data were retrospectively analyzed. The short-term (within one month of surgery) and long-term (>8 months of surgery) complications were evaluated, including aneurysm re-bleeding and ischemic stroke. All patients were followed up for 3-21 months; aneurysm recurrence and parent arteries were evaluated by DSA. The prognosis of patients was evaluated by modified Rankin scale (mRS) at the last follow-up (mRS scores of 0-2 as good prognosis).Results:Twenty-six aneurysms involved in 25 patients, including 13 ruptured aneurysms and 13 un-ruptured aneurysms; 7 aneurysms were located at the dominant vertebral artery and 7 aneurysms involved in the origin of posterior inferior cerebellar artery (PICA). In these 13 ruptured aneurysms, 6 (46.15%) were treated with parent artery sacrifice and 7 (53.85%) were with stent-assisted coil embolization; in 13 un-ruptured aneurysms, 9 (69.23%) were treated with stent-assisted coil embolization and 4 (30.77%) were with flow diversion devices (Tubridge). Seven aneurysms (43.75%) used multi-stent in these 16 aneurysms accepted stent-assisted coil embolization. No short-term and long-term re-bleeding or ischemic stroke were noted in all patients. Twenty patients completed DSA follow-up, with a median follow-up time of 8 months; 3 patients had recurrent aneurysms and one had asymptomatic stent occlusion. All 25 patients completed the last follow-up (telephone or outpatient follow-up) in May 2022, and 24 had good prognosis.Conclusion:According to characteristics of dominant vertebral artery and relations between aneurysms and PICA, individualized endovascular treatment can be safe and effective in fusiform aneurysms at V4 segment of vertebral artery.