Endovascular aneurysm repair(EVAR)is the most common treatment for abdominal aortic aneurysm.However,when the common iliac artery has expansion or aneurysm,there may be internal leakage at the distal end of the stent.In this case,the ideal endovascular repair should ensure the pelvic blood supply on the premise of complete exclu-sion of the aneurysm.It is feasible and safe to use iliac branch devices(IBD)to preserve unilateral or bilateral internal iliac arteries,and its technology and clinical results are equivalent to standard EVAR.But IBD has certain anatomical a-daptability.In this paper,the current status of preservation of internal iliac artery with IBD is systematically reviewed.

Objective:To explore the effects of essential tremor(ET)on the mitochondrial morphology of GABAer-gic and glutamatergic neurons in the inferior olive(IO).Methods:The ET mouse model was established via intraper-itoneal injection of harmaline.Twelve 8-week-old male C57BL/6J mice were randomly divided into saline control group and harmaline treatment group(HA).Behavioral tests,including open field test,rotarod test,balance beam test,and tremor scoring,were conducted to assess the behavior of mice.Using genetic engineering technology and the CRISPR/Cas9 system,we designed and generated 6 male GAD2-Mito-GFP mice and 6 male VGLUT2-Mito-GFP mice,all being 8-week-old.The mice of each transgenic line were randomly divided into Control and HA group.Immunofluorescence staining was used to analyze the expression of c-FOS positive cells in the IO of both the Control and HA groups,and to classify different types of neurons.Mitochondrial network analysis(MiNA)was performed to quantitatively analyze the area,mean aspect ratio,branch length,and other of mitochondria in different types of neurons in the IO under ET con-ditions.Results:Compared to the Control group,the HA group exhibited motor abnormalities and significant tremors.Immunofluorescence results showed a significant increase in the number of c-FOS positive cells in the IO,primarily in GABAergic neurons.MiNA results revealed that the mitochondria of GABAergic neurons showed increased area,branch length diameter,demonstrating irregular morphology.Conclusion:ET induces activation of GABAergic neurons in the IO and leads to more prominent mitochondrial morphological changes.This provides a new perspective for further inves-tigation of the pathogenesis of essential tremor and its relationship with mitochondrial.

"When warm evil is received,it first attacks the lungs and then spread to the pericardium reversely"is the general rule of warm diseases.Doctors of different dynasties have different views on the phrase"reverse spread to the pericardium",especially the word"reverse".Professor Tong Xiaolin proposed that the heart governs the mind,the pericardium and the heart are connected in qi,and when the heart is affected by evil,the pericardium instead suffers from the evil.The"reverse spread to the pericardium"proposed by Ye Tianshi is actually the spread of warm evil to the brain.Taking meningococcal meningitis as the basic disease,it can be matched one by one with the typical stages of the transmission of Wei-Qi-Ying-Xue.Combined with the theory of Dingjiao,it is believed that the function of"the heart governing the mind"focuses more on the brain in the modern anatomical sense.Combining traditional Chinese medicine's ideas on diagnosis and treatment of warm diseases with modern medicine,revealing the essence of the disease,grasping the core of the pathogenesis,analyzing the word"reverse"from a new perspective,and exploring its true meaning,is of great significance for clarifying its connotation,exploring the development laws of warm diseases,and guiding the diagnosis and treatment of warm disea-ses.

Objective:To explore the impact of a comprehensive intervention program that integrates transitional care with personalized discharge preparation services on discharge preparedness on the growth, development, and motor development in premature infants, providing guidance and reference for clinical practice.Methods:The 90 pairs of premature infants and their main caregivers who were treated in the neonatal department, Children ′s Hospital, Quanzhou Maternal and Child Health Hospital were studied from February 2023 to February 2024 by randomized control method. Used the table of random numbers, they were divided into the control group and the observation group, with 45 pairs in each group. The control group routinely administered care, while the observation group was implemented a transitional care combined with personalized discharge preparation services. The discharge preparedness, growth and motor development, and the disease uncertainty of caregivers were observed between the 2 groups. Results:There were 27 males and 18 females of the 45 preterm infants,with gestational age of 30.86 (29.36, 31.50) weeks in the control group, 24 males and 21 females with gestational age of 30.29(29.00, 31.07) weeks in the observation group. The main caregiver identities 43 were mothers and 2 were other identities in the control group, 42 were mothers and 3 were other identities in the observation group, with them being 31.00(28.00, 35.00) years old. There were 97.78% (44 /45) caregivers who thought the child was ready to go home in the observation group, while the control group were 84.44% (38 /45), these differences were statistically significant ( χ2=4.88, P<0.05). The total score of discharge readiness in the observation group were 240.00(237.00, 242.50) points, higher than in the control group 226.00(219.00, 229.50) points, these differences were statistically significant ( Z=-6.23, P<0.05). The head circumference and body weight of the observation group were (34.82 ± 1.14) cm and (3.60 ± 0.55) kg, while the control group were (34.25 ± 1.22) cm and (3.35 ± 0.53) kg, there were statistically significant between the two groups ( t=-2.29, -2.22, all P<0.05). The Test of Infant Motor Performance score in the observation group was 50.00(46.00, 52.00) points, while the control group was 45.00(42.00, 48.00) points, there were statistically significant between the two groups ( Z=-3.65, P<0.05). The total score of disease uncertainty in the observation was 52.00(45.50, 60.00) points, while the control group was 61.00(58.50, 65.00) points, there was statistically significant between the two groups ( Z=-4.62, P<0.05). Conclusions:The discharge preparedness of the caregivers of preterm infants was improved because of the use of transitional care combined with personalized discharge preparation services, and the growth and motor development of preterm infants were promoted, and the uncertainty of the family caregivers of preterm infants about the disease was reduced.

Objective:To explore the effects of essential tremor(ET)on the mitochondrial morphology of GABAer-gic and glutamatergic neurons in the inferior olive(IO).Methods:The ET mouse model was established via intraper-itoneal injection of harmaline.Twelve 8-week-old male C57BL/6J mice were randomly divided into saline control group and harmaline treatment group(HA).Behavioral tests,including open field test,rotarod test,balance beam test,and tremor scoring,were conducted to assess the behavior of mice.Using genetic engineering technology and the CRISPR/Cas9 system,we designed and generated 6 male GAD2-Mito-GFP mice and 6 male VGLUT2-Mito-GFP mice,all being 8-week-old.The mice of each transgenic line were randomly divided into Control and HA group.Immunofluorescence staining was used to analyze the expression of c-FOS positive cells in the IO of both the Control and HA groups,and to classify different types of neurons.Mitochondrial network analysis(MiNA)was performed to quantitatively analyze the area,mean aspect ratio,branch length,and other of mitochondria in different types of neurons in the IO under ET con-ditions.Results:Compared to the Control group,the HA group exhibited motor abnormalities and significant tremors.Immunofluorescence results showed a significant increase in the number of c-FOS positive cells in the IO,primarily in GABAergic neurons.MiNA results revealed that the mitochondria of GABAergic neurons showed increased area,branch length diameter,demonstrating irregular morphology.Conclusion:ET induces activation of GABAergic neurons in the IO and leads to more prominent mitochondrial morphological changes.This provides a new perspective for further inves-tigation of the pathogenesis of essential tremor and its relationship with mitochondrial.

"When warm evil is received,it first attacks the lungs and then spread to the pericardium reversely"is the general rule of warm diseases.Doctors of different dynasties have different views on the phrase"reverse spread to the pericardium",especially the word"reverse".Professor Tong Xiaolin proposed that the heart governs the mind,the pericardium and the heart are connected in qi,and when the heart is affected by evil,the pericardium instead suffers from the evil.The"reverse spread to the pericardium"proposed by Ye Tianshi is actually the spread of warm evil to the brain.Taking meningococcal meningitis as the basic disease,it can be matched one by one with the typical stages of the transmission of Wei-Qi-Ying-Xue.Combined with the theory of Dingjiao,it is believed that the function of"the heart governing the mind"focuses more on the brain in the modern anatomical sense.Combining traditional Chinese medicine's ideas on diagnosis and treatment of warm diseases with modern medicine,revealing the essence of the disease,grasping the core of the pathogenesis,analyzing the word"reverse"from a new perspective,and exploring its true meaning,is of great significance for clarifying its connotation,exploring the development laws of warm diseases,and guiding the diagnosis and treatment of warm disea-ses.

Objective To compare the clinical efficacy of intraoperative intravenous tirofiban versus preoperative loading dose dual antiplatelet therapy in the acute phase LVIS stent-assisted coil embolization treatment for ruptured wide-necked intracranial aneurysms.Methods Patients with acutely ruptured,wide-neck intracranial aneurysms underwent LVIS stent-assisted coil embolization in the Department of Neurosurgery at Heze Municipal Hospital were retrospectively and consecutively enrolled from January 2017 to June 2023.According to the Chinese expert consensus on antiplatelet therapy for intracranial aneurysms,patients were divided into two groups based on the types of antiplatelet therapy they received:the loading-dose dual antiplatelet therapy(DAPT)group and the tirofiban group.Baseline and clinical data were collected and compared between the two groups,including age,sex,hypertension,diabetes mellitus,coronary artery disease,history of cerebral hemorrhage,preoperative Hunt-Hess grade,maximum aneurysm diameter,aneurysm neck width,and aneurysm location.Perioperative ischemic and hemorrhagic complications were collected and compared between the two groups.Perioperative ischemic complications included:intraoperative stent thrombosis(defined as filling defects in the parent artery,and,occlusion of the parent artery or stented branch during the procedure),and symptomatic ischemic infarction within 24 h postoperatively(confirmed by imaging with corresponding neurological deficits).Perioperative hemorrhagic complications included:intraoperative rupture of the target aneurysm(contrast extravasation or acute hemorrhage during embolization)and intracranial hemorrhage within 24 h postoperatively(new or worsened subarachnoid hemorrhage or intraparenchymal hemorrhage on CT).Clinical outcomes at 90 days were collected via telephone or outpatient follow-up,and evaluated using favorable prognosis defined as modified Rankin scale(mRS).A mRS score of 0-2 were defined as favorable prognosis and 3-6 as poor prognosis.Six-month postoperative imaging follow-up were collected,angiographic outcomes were categorized into four groups based on comparison with immediate post-embolization results:complete occlusion,total absence of contrast filling in the aneurysm sac;improved,reduced contrast filling;stable,unchanged contrast filling;and,recurrence,increased contrast filling.Results Totals of 108 patients with intracranial aneurysms treated by LVIS stent-assisted coiling were enrolled,with 30 males and 78females,aged32-75years(median age63[50,66]years).Among the108cases,55cases were assigned into the DAPT group,and 53 cases were included in the tirofiban group.(1)No statistically significant differences were observed between the tirofiban group and the DAPT group in baseline and clinical characteristics(all P＞0.05).(2)All patients underwent successful LVIS stent-assisted coiling,with a technical success rate of 100%.The total perioperative ischemic complications were 12.0%(13/108),including 4.6%(5/108)intraoperative stent thrombosis and 7.4%(8/108)symptomatic ischemic infarction within 24h after surgery.The total perioperative hemorrhagic complications rate was 1.9%(2/108),including 1 case of intraoperative aneurysm rupture and 1 case of postoperative intracranial hemorrhage within24h.92.6%(100/108)of the patients exhibited favorable prognosis and 7.4%(8/108)showed poor prognosis at the 90-day follow-ups.78.7%(85/108)of the patients accomplished at 6-month imaging follow-ups,the complete occlusion ratio was 94.1%(80/85)and the recurrence ratio was 2.4%(2/85).(3)The overall perioperative ischemic complication rates were 13.2%(7/53)in the tirofiban group and 10.9%(6/55)in the DAPT group,with no statistically significant difference(P=0.720).Intraoperative stent thrombosis occurred more frequently in the DAPT group(9.1%[5/55]vs.0,P=0.025),while symptomatic ischemic infarction within 24 h post-procedure was lower in the DAPT group(1.8%[1/55]vs.13.2%[7/53],P=0.028).The hemorrhagic complications occurred only in the DAPT group,with a rate of 3.6%(2/55),while no events observed in the tirofiban group.At the 90-day follow-up,the proportion of patients with favorable outcomes was 94.3%(50/53)in the tirofiban group and 90.9%(50/55)in the DAPT group,with no statistically significant difference between the groups(P=0.754).Conclusions Both intraoperative intravenous tirofiban and preoperative loading-dose DAPT demonstrated comparable safety profile and favorable clinical efficacy in the acute-phase treatment of ruptured wide-necked intracranial aneurysms with LVIS stent-assisted coil embolization.The results require further validation through large-scale prospective studies.

Objective To analyze the predictive value of CT cerebral perfusion(CTP)combined with CT angiography(CTA)for the prognosis of patients with large atherosclerotic cerebral infarction.Methods A retrospective study was performed in 98 patients with large atherosclerotic cerebral infarction who were admitted to Haian People's Hospital from January 2021 to November 2024.There were 63 males and 56 females with a mean age of(57.26±5.03)years.The mean time from onset to admission was(4.89±0.69)h.There were 20 patients with a history of smoking.After admission,CTP and CTA were performed to evaluate relative cerebral blood volume(rCBV),relative cerebral blood flow(rCBF),relative mean transit time(rMTT),relative time to peak(rTTP),and CTA score.The prognosis was evaluated according to the modified Rankin scale(mRS)3 months after intravenous thrombolysis.Then the patients were assigned to good prognosis group(0-2 points)or poor prognosis group(3-6 points).The basic data and the parameters of CTP and CTA were compared between the two groups.The receiver operating characteristic(ROC)curve was used to analyze the CTP-and CTA-related influencing factors of poor prognosis in patients with large atherosclerotic cerebral infarction.Results During 3-month follow-up,poor prognosis was found in 30 patients(25.21%).The rCBV,rCBF and CTA scores of the poor prognosis group were significantly lower than those of the good prognosis group,while the National Institutes of Health stroke scale(NIHSS)score,rMTT and rTTP at admission in the good prognosis group were significantly higher than those in the good prognosis group(P<0.05).Logistic regression equation analysis(introduction level 0.05,exclusion level 0.10)showed that NIHSS score(OR=1.622,95%CI:1.258 to 2.093),rMTT level(OR=10.757,95%CI:2.847 to 40.640)and rTTP level(OR=14.774,95%CI:3.280 to 66.558)at admission were risk factors for poor prognosis in patients with large atherosclerotic cerebral infarction(P<0.05),while CTA score(OR=0.315,95%CI:0.163 to 0.608),rCBF level(OR=0.008,95%CI:0.001 to 0.109),and rCBV level(OR=0.016,95%CI:0.002 to 0.155)were protective factors for poor prognosis in these patients(P<0.05).ROC curve analysis showed that the sensitivities of CTA score,rCBF,rCBV,rMTT,and rTTP in predicting poor prognosis in patients with large atherosclerotic cerebral infarction were 79.2%,75.0%,70.8%,58.3%,and 83.3%,respectively;the specificities were 62.2%,64.9%,70.3%,72.0%,and 70.3%,respectively;their combination had a relatively high predictive value for poor prognosis(area under the curve was 0.863).Conclusion The combination of CTP and CTA has a relatively high value in predicting the prognosis of patients with large atherosclerotic cerebral infarction.

Endovascular aneurysm repair(EVAR)is the most common treatment for abdominal aortic aneurysm.However,when the common iliac artery has expansion or aneurysm,there may be internal leakage at the distal end of the stent.In this case,the ideal endovascular repair should ensure the pelvic blood supply on the premise of complete exclu-sion of the aneurysm.It is feasible and safe to use iliac branch devices(IBD)to preserve unilateral or bilateral internal iliac arteries,and its technology and clinical results are equivalent to standard EVAR.But IBD has certain anatomical a-daptability.In this paper,the current status of preservation of internal iliac artery with IBD is systematically reviewed.

Objective:To explore the effects of peripheral nerve injury(PNI)on neuropathic pain(NP)and memo-ry function in mice,as well as the activation of neurons in the paraventricular nucleus(PVT)of the thalamus,so as to provide a basis for studying the relationship between NP and memory impairment.Methods:Twenty one 8-week-old male C57 BL/6J mice were randomly divided into sham group and experimental group,and the routine spared nerve inju-ry(SNI)was constructed in the mice of experimental group.The pain behavior and memory impairment of mice after SNI were evaluated with hot plate and eight-arm maze behavioral tests.Pearson correlation analysis was performed to an-alyze the correlation between pain behavior and memory impairment.The c-FOS expression in PVT was detected with immuno-staining.Results:Compared with the sham group,the heat pain threshold of mice in the experimental group was significantly reduced(P＜0.001).The results of the eight-arm maze test showed that the total rest time was signifi-cantly increased(P＜0.001),and the working memory error was increased from 1 to 4 days after SNI(P＜0.01).Correlation analysis indicated that early working memory errors were negatively correlated with heat pain threshold after SNI(P＜0.001).The immunofluorescence revealed that the number of c-FOS positive cells in PVT increased signifi-cantly(P＜0.001).Conclusion:SNI can cause abnormal pain behavior and memory impairment in mice,and cause neuronal activation in PVT.This study provides a basis for neurons in PVT to participate in the regulation of memory impairment in the context of NP.