Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

Public hospitals have formed a relatively perfect working foundation in the introduction and training of young talents,but the evaluation system of young talents is not perfect.Based on the requirements of high-quality development,grasp the principle of party management of talents,combine the talents development situation in Jiading District Maternal and Child Health Care Hospital,takes the special training of young talents in administration as the starting point,comprehensively uses the literature method,interview method and Delphi method to establish the index database,uses the exploratory factor analysis meth-od to calculate the index weight,and constructs the evaluation model of young talents in hospital administrative management,so as to help hospitals better screen and evaluate talents and give full play to the value and role of talents as the first resource.

Public hospitals have formed a relatively perfect working foundation in the introduction and training of young talents,but the evaluation system of young talents is not perfect.Based on the requirements of high-quality development,grasp the principle of party management of talents,combine the talents development situation in Jiading District Maternal and Child Health Care Hospital,takes the special training of young talents in administration as the starting point,comprehensively uses the literature method,interview method and Delphi method to establish the index database,uses the exploratory factor analysis meth-od to calculate the index weight,and constructs the evaluation model of young talents in hospital administrative management,so as to help hospitals better screen and evaluate talents and give full play to the value and role of talents as the first resource.

Objective This study aims to explore the collaborative governance model of medical and elderly care integra-tion to promote the participation of medical institutions in integrated services and provide policy recommendations.Methods Based on the perspective of welfare pluralism,combined with the practical experience of an A hospital-managed nursing home in Guangzhou,the roles of different welfare subjects such as the government,market,community,and family in the medical and elderly care integration service system were discussed.Results The integration of medical and elderly care faces issues such as inadequate government guarantees in terms of space and medical insurance,insufficient vitality of social capital participating in medical and elderly care integration in the market,weak linkage between integrated care institutions and community organizations,and heavy burden on elderly families in accessing integrated services.Conclusion The government should improve top-level insti-tutional design,the market needs to optimize the supply of medical and elderly care integration services,the community should play a pivotal role as a platform,and families should create a supportive environment for respecting and caring for the elderly.

Objective:To explore the influence and mechanism of perceived school climate on life satisfaction of junior high school students.Methods:From June to September 2022, students in sixth, seventh and eighth grade of junior high school were surveyed by the perceived school climate scale, the family cumulative risk-related questionnaire, the cognitive emotion regulation strategy questionnaire and the life satisfaction scale.SPSS 25.0 software was used to process data and the macro program PROCESS 4.1 was used for model testing.Results:(1) The total scores of perceived school climate, negative cognitive emotion regulation strategy, life satisfaction and family cumulative risk were 83.00(19.00), 21.00(8.00), 23.00(9.00) and 1.00(2.00), respectively.(2) Perceived school climate was significantly and negatively correlated with negative cognitive emotion regulation strategy and family cumulative risk( r=-0.30, -0.40, both P<0.01), while significantly and positively correlated with life satisfaction ( r=0.51, P<0.01).Negative cognitive emotion regulation strategy was significantly and negatively correlated with life satisfaction ( r=-0.37, P<0.01), while significantly and positively correlated with family cumulative risk ( r=0.29, P<0.01). Family cumulative risk was significantly and negatively correlated with life satisfaction ( r=-0.45, P<0.01). (3) Negative cognitive emotion regulation strategy played a mediating role between perceived school climate and life satisfaction, and the mediating effect accounted for 13.46%(0.07/0.52) of the total effect. (4) Family cumulative risk played a moderating role in the relationship between perceived school climate and life satisfaction, and between perceived school climate and negative cognitive emotion regulation strategy. Specifically, as the level of family cumulative risk decreased, the positive predictive effect of perceived school climate on life satisfaction significantly increased ( βsimple=0.42, P<0.001). Perceived school climate significantly and negatively predicted negative cognitive emotion regulation strategy under the condition of low level family cumulative risk ( βsimple=-0.30, P<0.001). Conclusion:Under the condition of low family cumulative risk in junior high school students, the perceived positive school climate can help reduce negative cognitive emotion regulation strategy, thereby improving life satisfaction.

Objective To investigate the correlation between indocyanine green(ICG)fluorescence imaging and lymph node metastasis of bladder cancer and its application value.Methods The clinicopathological data of 35 patients with bladder cancer(T1-T4aNxM0)treated in our hospital during Jun.2019 and Mar.2023 were collected.All patients underwent ICG submucous injection,and those with successful imaging received lymph node dissection under fluorescent guidance.After that,the remaining lymph tissue was cleared according to the standard lymph node dissection range,and the resected lymph tissue was subassembled for examination.Patients with non-imaging underwent standard pelvic lymph node dissection according to the routine procedure.Intraoperative lymph node imaging areas were recorded,and postoperative lymph node pathological data were collected.The correlation between fluorescence imaging patterns and lymph node metastasis in patients with different stages of bladder cancer was analyzed with correlation coefficients.Results The ICG fluorescence imaging rate was 91.43％(32/35),and there was no statistically significant difference in the imaging rate among patients with different stages of bladder cancer(P＞0.05).The fluorescence imaging range was significantly correlated with the stage(C=0.351,P=0.034).There was a significant correlation between the imaging range and lymph node metastasis in early-stage patients(C=0.619,P=0.022),but there was no significant difference in the lymph node metastasis rate in advanced patients with different imaging range(P＞0.05).In patients with full staging,the sensitivity of lymph nodes to predict metastasis was 60.00％(6/10),and the negative predictive value was 84.62％(22/26).In early-stage patients,the sensitivity and negative predictive value were 50.00％(1/2)and 93.75％(15/16),respectively.In advanced-stage patients,they were 62.50％(5/8)and 70.00％(7/10),respectively.Conclusion ICG fluorescence imaging rate of tracing lymph node metastasis is high,and the imaging range is significantly related to the tumor stage.For patients with early-stage(T1-T2)bladder cancer,the range of imaging helps to predict the risk of lymph node metastasis and guide the extent of lymph node dissection.Resection of multi-area imaged lymph nodes can comprehensively evaluate the lymphatic metastasis status of early-stage patients.

Objective:To study the effects of aluminum exposure on learning and memory and the expression of nerve growth factor(NGF)in the hippocampus of offspring rats,and to investigate the mechanism by which aluminum impairs learning and memory function.Methods:Forty pregnant Wistar rats were randomly assigned to the Control group(Control),low-dose Al group(Al-L),medium-dose Al group(Al-M)and high-dose Al group(Al-H).The off-spring rats were fed with Al through breast milk from birth to weaning,while the rats in the control group were fed with distilled water.The maternal rats Al-L,Al-M and Al-H groups drank distilled water solution containing 2.0,4.0 and 8.0 g/L AlCl3,respectively.After weaning,the offspring rats in the aluminum exposure group drank distilled water so-lution containing 2.0,4.0 and 8.0 g/L AlCl3 by themselves until the 90th day after birth to establish the offspring rat model of subchronic aluminum exposure.After aluminum exposure,the shuttle box test was used to detect the learning and memory ability of offspring rats,and the body weight of offspring rats and hippocampus were weighed to evaluate the effect of aluminum exposure.The expression of nerve growth factor(NGF)protein in hippocampus of offspring rats was detected by Western blot,and the expression of NGF mRNA in hippocampus of offspring rats was detected by real time RT-PCR.Results:The body weight of offspring rats in Al-H group was significantly lower than that in the other three dose groups.In the shuttle box test,compared with the control group,the active avoidance response and passive avoid-ance response of the offspring rats in the aluminum exposure group showed a downward trend with the increase of alumi-num exposure dose,indicating that the learning and memory ability of the offspring rats in the aluminum exposure group was impaired.Compared with the control group,the NGF protein content and NGF mRNA expression in the hippocam-pus of offspring rats in the aluminum exposure group were significantly decreased.Conclusion:Subchronic aluminum exposure down-regulates the expression of NGF in the hippocampus,which may cause learning and memory impairment in offspring rats.

Objective:To explore the influence and mechanism of perceived school climate on life satisfaction of junior high school students.Methods:From June to September 2022, students in sixth, seventh and eighth grade of junior high school were surveyed by the perceived school climate scale, the family cumulative risk-related questionnaire, the cognitive emotion regulation strategy questionnaire and the life satisfaction scale.SPSS 25.0 software was used to process data and the macro program PROCESS 4.1 was used for model testing.Results:(1) The total scores of perceived school climate, negative cognitive emotion regulation strategy, life satisfaction and family cumulative risk were 83.00(19.00), 21.00(8.00), 23.00(9.00) and 1.00(2.00), respectively.(2) Perceived school climate was significantly and negatively correlated with negative cognitive emotion regulation strategy and family cumulative risk( r=-0.30, -0.40, both P<0.01), while significantly and positively correlated with life satisfaction ( r=0.51, P<0.01).Negative cognitive emotion regulation strategy was significantly and negatively correlated with life satisfaction ( r=-0.37, P<0.01), while significantly and positively correlated with family cumulative risk ( r=0.29, P<0.01). Family cumulative risk was significantly and negatively correlated with life satisfaction ( r=-0.45, P<0.01). (3) Negative cognitive emotion regulation strategy played a mediating role between perceived school climate and life satisfaction, and the mediating effect accounted for 13.46%(0.07/0.52) of the total effect. (4) Family cumulative risk played a moderating role in the relationship between perceived school climate and life satisfaction, and between perceived school climate and negative cognitive emotion regulation strategy. Specifically, as the level of family cumulative risk decreased, the positive predictive effect of perceived school climate on life satisfaction significantly increased ( βsimple=0.42, P<0.001). Perceived school climate significantly and negatively predicted negative cognitive emotion regulation strategy under the condition of low level family cumulative risk ( βsimple=-0.30, P<0.001). Conclusion:Under the condition of low family cumulative risk in junior high school students, the perceived positive school climate can help reduce negative cognitive emotion regulation strategy, thereby improving life satisfaction.

Objective:To investigate the effectiveness of the Rain Classroom teaching model in the Functional Experiment Science.Methods:A total of 61 clinical medicine students from grade 2021 at a medical college were enrolled and divided into the control group(n=30)who received traditional experimental teaching,and the experimental group(n=31)who was taught using the Rain Classroom teaching model.Ultimately,the outcomes compared between the two groups included scores of experimental assignments,satisfaction with the teaching model,and the experimental group's supporting rate for the Rain Classroom teaching mode.Results:The experimental score in the experimental group was significantly higher than that in the control group(P＜0.05).Additionally,58.06%(18/31)of the experimental group supported the Rain Classroom model.Among the experimental group,77.42%(24/31)and 70.97%(22/31)of the students believed that the Rain Classroom teaching mode could enhance the awareness of autonomous learning and the mastery of key and difficult knowledge.Conclusion:Through the Rain Classroom teaching mode,students'experimental grades have been improved,and it also plays a certain role in promoting the enhancement of their self-study ability.

Viral myocarditis(VMC)is a type of myocarditis caused by Coxsackievirus B3(CVB3)infection.Its pathogenesis is complex that includes direct viral action,host immune and inflammatory response,myocardial structure and function remodeling.The therapeutic effect of single target drugs is limited,while traditional Chinese medicine not only has antiviral effects,but also demon-strates systematic advantages in intervening in VMC due to its"multi-component,multi-target,and multi-pathway"characteristics.This article reviews the pathogenic mechanisms of CVB3-induced VMC,clarifies the interaction between CVB3 and host cells,and ex-plores the intervention mechanisms and developments of traditional Chinese medicine interventions for CVB3-induced VMC.At the same time,the prospects of traditional Chinese medicine treatment for CVB3-induced VMC in this study suggest that future research should strengthen the analysis of multi-target synergistic mechanisms based on traditional Chinese medicine formulas,combine artifi-cial intelligence,genomics,and gene editing technologies to predict drug-target interaction networks,establish standardized and per-sonalized system for integrated traditional Chinese and Western medicine treatment plans,and provide more effective strategies for the prevention and treatment of VMC.