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.

Objective To observe the surgical outcomes and complications of transforaminal endoscopic lumbar discectomy(TELD)and interlaminar endoscopic lumbar discectomy(IELD)in the treatment of lumbar disc herniation(LDH)with prolapse type at the L4/5 segment using full-endoscopic spine surgery.Methods A retrospective analysis was conducted on the clinical data of 75 patients with L4/5 segmental prolapse type LDH who underwent spinal endoscopic surgery from November 2020 to November 2022.Among them,53 patients underwent TELD(TELD group)and 22 patients underwent IELD(IELD group).The surgical outcomes and postoperative therapeutic effect of the two groups were compared.Results Compared with the TELD group,the IELD group had significantly shorter operation time and fewer intraoperative fluoroscopy times,the differences were statistically significant(P<0.05);There were no statistically significant in the length of hospital stay and the incidence of complications between the two groups(P>0.05).All patients were followed up for 12 to 19 months after surgery.The visual analogue scale(VAS)score and Oswestry disability index(ODI)at the last follow-up in both groups were significantly lower than those before surgery,and the IELD group was significantly lower than the TELD group,the differences were statistically significant(P<0.05).Further analysis based on the location of the herniation and nerve roots revealed that,compared with preoperative values,the VAS scores and ODI at the last follow-up were significantly reduced in both groups of patients with shoulder-upper type herniation(10 cases in the TELD group and 6 cases in the IELD group),and the VAS score in the IELD group at the last follow-up was significantly lower than that in the TELD group,the differences were statistically significant(P<0.05).Similarly,both groups of patients with axillary type herniation(8 cases in the TELD group and 16 cases in the IELD group)exhibited significantly reduced VAS score and ODI at the last follow-up than those before operation,with significantly lower in the IELD group compared to the TELD group,the differences were statistically significant(P<0.05).Among the 35 patients with anterior-shoulder type herniation who underwent TELD,the VAS score and ODI at the last follow-up were also significantly lower than those before surgery,the difference was statistically significant(P<0.05).Further analysis based on the Lee classification of herniations revealed that,compared with preoperative values,the VAS score and ODI at the last follow-up were significantly reduced in both groups of patients with herniations in Lee zone Ⅲ(44 cases in the TELD group and 10 cases in the IELD group),and the ODI in the IELD group was significantly lower than that in the TELD group,the differences were statistically significant(P<0.05).Similarly,both groups of patients with LDH in Lee zone Ⅳ(9 cases in the TELD group and 12 cases in the IELD group)exhibited significantly reduced VAS score and ODI at the last follow-up,with significantly lower in the IELD group compared to the TELD group(P<0.05).Conclusion Both TELD and IELD can achieve satisfactory decompression effects in the treatment of LDH with prolapse type at the L4/5 segment.However,IELD offers a relatively shorter operative time,requires fewer X-ray fluoroscopies,and demonstrates superior decompression effects for shoulder-type,axillary-type,Lee Ⅲ and Lee Ⅳ.

Objective To explore the effect of young plasma intraperitoneal injection on the fertility and ovarian function of aging mice and analyze its potential molecular mechanism.Methods Fifty-four-week-old female C57BL/6 mice and 8-week-old male C57BL/6 mice were selected.Among them,the female mice were randomly divided into three groups:the young plasma group,the aging plasma group and the normal saline group.The young plasma group and the aging plasma group received intraperitoneal injection of plasma from young(25-29 years old)and elderly(45-49 years old)female donors,respectively.Each injection was 500 μL,administered every other day for 2 weeks.The saline group received an equal volume of saline.After the last injection,mating experiments were conducted to evaluate fertility.Ovarian histopathological changes were observed by HE staining.Oocytes and fertilized eggs were collected after superovulation and cultured in vitro to assess oocyte quality and embryo developmental potential.Transcriptomic analysis of ovarian tissue was performed,followed by KEGG and GO enrichment analysis.Results Compared with the normal saline group and the aging plasma group,the number of offspring increased in the young plasma group,which reflected higher extrusion rate of first polar body(PB1),decreased fragmentation rate of oocytes and increased conversion rate of two-cell embryos and increased formation rate of blastocysts.There were no significant differences in these indicators between the aging plasma group and the normal saline group.Transcriptomic sequencing revealed that the differentially expressed genes in ovarian tissue of the young plasma group were mainly involved in steroid biosynthesis and metabolic pathways.Among them,the expression level of steroid sulfatase protein was significantly upregulated.Conclusion Systemic infusion of young plasma enhances the reproductive potential of aging ovaries in elderly mice.The sulfated steroid metabolites in plasma may be key substances in restoring ovarian function and delaying the process of ovarian aging.

To analyze the standard establishment approach and compilation rationale for metallic pharmaceutical packaging standard development in the 2025 edition of the Pharmacopeia of the People's Republic of China.This article systematically explained the background and process of establishing the guiding principles for metallic materials and containers used in pharmaceutical packaging in the Chinese Pharmacopoeia through basic information,relevant domestic and international standards,the establishment of key quality attributes of metallic pharmaceutical packaging materials,and the construction of metallic pharmaceutical packaging material standards.The newly established guidelines,the Pharmacopeia of the People's Republic of China 9625,prioritized product critical quality attributes(CQAs)and real-world applicability.This dual emphasis on rigidity and adaptability enhances drug safety,meets the regulatory requirements,and promotes the globalization and scientific advancement of China's pharmaceutical packaging industry.

Objective To observe the surgical outcomes and complications of transforaminal endoscopic lumbar discectomy(TELD)and interlaminar endoscopic lumbar discectomy(IELD)in the treatment of lumbar disc herniation(LDH)with prolapse type at the L4/5 segment using full-endoscopic spine surgery.Methods A retrospective analysis was conducted on the clinical data of 75 patients with L4/5 segmental prolapse type LDH who underwent spinal endoscopic surgery from November 2020 to November 2022.Among them,53 patients underwent TELD(TELD group)and 22 patients underwent IELD(IELD group).The surgical outcomes and postoperative therapeutic effect of the two groups were compared.Results Compared with the TELD group,the IELD group had significantly shorter operation time and fewer intraoperative fluoroscopy times,the differences were statistically significant(P<0.05);There were no statistically significant in the length of hospital stay and the incidence of complications between the two groups(P>0.05).All patients were followed up for 12 to 19 months after surgery.The visual analogue scale(VAS)score and Oswestry disability index(ODI)at the last follow-up in both groups were significantly lower than those before surgery,and the IELD group was significantly lower than the TELD group,the differences were statistically significant(P<0.05).Further analysis based on the location of the herniation and nerve roots revealed that,compared with preoperative values,the VAS scores and ODI at the last follow-up were significantly reduced in both groups of patients with shoulder-upper type herniation(10 cases in the TELD group and 6 cases in the IELD group),and the VAS score in the IELD group at the last follow-up was significantly lower than that in the TELD group,the differences were statistically significant(P<0.05).Similarly,both groups of patients with axillary type herniation(8 cases in the TELD group and 16 cases in the IELD group)exhibited significantly reduced VAS score and ODI at the last follow-up than those before operation,with significantly lower in the IELD group compared to the TELD group,the differences were statistically significant(P<0.05).Among the 35 patients with anterior-shoulder type herniation who underwent TELD,the VAS score and ODI at the last follow-up were also significantly lower than those before surgery,the difference was statistically significant(P<0.05).Further analysis based on the Lee classification of herniations revealed that,compared with preoperative values,the VAS score and ODI at the last follow-up were significantly reduced in both groups of patients with herniations in Lee zone Ⅲ(44 cases in the TELD group and 10 cases in the IELD group),and the ODI in the IELD group was significantly lower than that in the TELD group,the differences were statistically significant(P<0.05).Similarly,both groups of patients with LDH in Lee zone Ⅳ(9 cases in the TELD group and 12 cases in the IELD group)exhibited significantly reduced VAS score and ODI at the last follow-up,with significantly lower in the IELD group compared to the TELD group(P<0.05).Conclusion Both TELD and IELD can achieve satisfactory decompression effects in the treatment of LDH with prolapse type at the L4/5 segment.However,IELD offers a relatively shorter operative time,requires fewer X-ray fluoroscopies,and demonstrates superior decompression effects for shoulder-type,axillary-type,Lee Ⅲ and Lee Ⅳ.

Objective To explore the effect of young plasma intraperitoneal injection on the fertility and ovarian function of aging mice and analyze its potential molecular mechanism.Methods Fifty-four-week-old female C57BL/6 mice and 8-week-old male C57BL/6 mice were selected.Among them,the female mice were randomly divided into three groups:the young plasma group,the aging plasma group and the normal saline group.The young plasma group and the aging plasma group received intraperitoneal injection of plasma from young(25-29 years old)and elderly(45-49 years old)female donors,respectively.Each injection was 500 μL,administered every other day for 2 weeks.The saline group received an equal volume of saline.After the last injection,mating experiments were conducted to evaluate fertility.Ovarian histopathological changes were observed by HE staining.Oocytes and fertilized eggs were collected after superovulation and cultured in vitro to assess oocyte quality and embryo developmental potential.Transcriptomic analysis of ovarian tissue was performed,followed by KEGG and GO enrichment analysis.Results Compared with the normal saline group and the aging plasma group,the number of offspring increased in the young plasma group,which reflected higher extrusion rate of first polar body(PB1),decreased fragmentation rate of oocytes and increased conversion rate of two-cell embryos and increased formation rate of blastocysts.There were no significant differences in these indicators between the aging plasma group and the normal saline group.Transcriptomic sequencing revealed that the differentially expressed genes in ovarian tissue of the young plasma group were mainly involved in steroid biosynthesis and metabolic pathways.Among them,the expression level of steroid sulfatase protein was significantly upregulated.Conclusion Systemic infusion of young plasma enhances the reproductive potential of aging ovaries in elderly mice.The sulfated steroid metabolites in plasma may be key substances in restoring ovarian function and delaying the process of ovarian aging.

To analyze the standard establishment approach and compilation rationale for metallic pharmaceutical packaging standard development in the 2025 edition of the Pharmacopeia of the People's Republic of China.This article systematically explained the background and process of establishing the guiding principles for metallic materials and containers used in pharmaceutical packaging in the Chinese Pharmacopoeia through basic information,relevant domestic and international standards,the establishment of key quality attributes of metallic pharmaceutical packaging materials,and the construction of metallic pharmaceutical packaging material standards.The newly established guidelines,the Pharmacopeia of the People's Republic of China 9625,prioritized product critical quality attributes(CQAs)and real-world applicability.This dual emphasis on rigidity and adaptability enhances drug safety,meets the regulatory requirements,and promotes the globalization and scientific advancement of China's pharmaceutical packaging industry.

Background Work-related musculoskeletal disorders (WMSDs) are one of the major occupational health problems faced by bus drivers and should receive special attention. Objective To explore the associations of weekly working hours and sleep quality with neck and lower back WMSDs among bus drivers, as well as assess the potential mediating role of sleep quality. Methods From June to December 2022, we recruited bus drivers from 5 subsidiaries of the Shenzhen Bus Group by convenient sampling method. Demographic characteristics, lifestyles, and work-related features of the bus drivers were collected through a questionnaire survey. The Pittsburgh Sleep Quality Index (PSQI) scale and the Musculoskeletal Disorders Survey Questionnaire were used to assess sleep quality and WMSDs respectively. Logistic regression models were applied to analyze the associations of weekly working hours and sleep quality with WMSDs in neck and lower back. Furthermore, mediation analysis was performed to investigate the role of sleep quality in the associations between weekly work hours and neck and lower back WMSDs. Results A total of 1792 valid questionnaires were collected, with a response rate of 95.07%. Among these, 89.3% of the bus drivers worked more than 40 h per week, and the positive rate of poor sleep quality was 28.2%. The overall positive rate of WMSDs within one year before the survey was 69.12%. Among different body regions, the leading positive rates were identified in neck and lower back regions, at 55.92% and 53.68%, respectively. The logistic regression model showed that compared to the bus drivers with weekly work hours ≤40 h, those weekly worked (40~48] h (OR=1.43, 95%CI: 1.02, 2.01; OR=1.65, 95%CI: 1.17, 2.34), (48~56] h (OR=2.69, 95%CI: 1.89, 3.83; OR=2.30, 95%CI: 1.62, 3.29) and ＞56 h (OR=2.63, 95%CI: 1.86, 3.74; OR=3.23, 95%CI: 2.27, 4.62) had significantly increased risk of WMSDs in neck and lower back. Additionally, when compared to those with good sleep quality, bus drivers with poor sleep quality had higher risks of both neck and lower back WMSDs (OR=4.08, 95%CI: 3.20, 5.23; OR=4.15, 95%CI: 3.26, 5.30, respectively). Further mediation analysis indicated that sleep quality partially mediated the associations between weekly working hours and both neck and lower back WMSDs, with 36.15% and 33.68% as the respective proportion of mediation. Conclusion The positive rate of WMSDs is high among bus drivers, and the most common WMSDs occur in neck and lower back. Long working hours and poor sleep quality are significantly associated with increased risks of neck and lower back WMSDs. Sleep quality may mediate the associations of weekly working hours with neck and lower back WMSDs.

Acute large-vessel occlusive ischemic stroke has high disability and mortality rates，causing a great burden to social economy and health care system. Mechanical thrombectomy has become the standard treatment method for this disease，but some patients still have poor prognosis after successful recanalization of blood vessels，and therefore，it is important to explore the factors that can be used to judge the poor prognosis of patients. Quantitative electroencephalography can quantify and objectively assess the changing process of brain function in patients，and RAPID perfusion parameters based on brain CTP can rapidly quantify the local blood perfusion of brain tissue. This combination of perfusion neuroimaging and electrophysiological activity can quantify the severity of ischemia associated with cerebral infarction and functional damage to neurons. This article reviews the application value of these two methods in the prognostic evaluation of stroke.

Interleukin-17 (IL-17) and its receptor family members are involved in a variety of pathophysiological processes.Studies have shown that the IL-17 family may be closely related to the occurrence and development of interstitial cystitis/ bladder pain syndrome (IC/BPS).This paper explores the relationship between the IL-17 family and IC/BPS, introduces the members and structures of the IL-17 family, their value in inflammatory diseases, and discusses in depth the IL-17 pathways in IC/BPS and the latest research progress.Research has found that the IL-17 family is upregulated in IC/BPS, related to the exacerbation of pathological inflammatory reactions, and responsible for maintaining the chronic inflammatory state of IC/BPS patients.In addition, IL-17 is also associated with neuroinflammation, pain, and other biological effects in IC/BPS.This review aims to deepen the understanding of the mechanisms underlying IC/BPS and to provide references for the development of new therapeutic strategies.