Objective To investigate the correlation of imaging parameters of CT perfusion scan-ning combined with serum suPAR and Mac-2BP with END and poor outcomes in patients with BAD.Methods A total of 176 BAD patients admitted to Department of Neurology of Zhengzhou People's Hospital from June 2019 to March 2024 were prospectively enrolled,and according to whether END occurred within 72 h after onset,they were divided into END group(42 cases)and non-END group(134 cases).Based on their outcomes at 90 d of follow-up,they were also assigned into good outcome group(129 cases)and poor outcome group(47 cases).The serum suPAR and Mac-2BP levels were compared between the END and non-END groups,as well as the good and poor outcome groups.ROC curves were plotted to analyze the accuracies of serum suPAR and Mac-2BP in predicting END and poor outcomes.Results The END group had significantly higher suPAR and Mac-2BP levels,longer MTT and TTP,and larger proportions of DWMH,basal gan-glia EPVS and cerebral perfusion impairment,but lower CBV and CBF when compared with the non-END group(P＜0.05,P＜0.01).Obviously higher suPAR and Mac-2BP levels,NIHSS score at END,longer MTT and TTP,and larger proportions of EDN,basal ganglia EPVS and cerebral perfusion impairment,but lower CBV and CBF were observed in the poor outcome group than the good outcome group(P＜0.05,P＜0.01).suPAR and Mac-2BP levels,cerebral perfusion impair-ment and DWMH were independent risk factors for END(P＜0.05,P＜0.01).suPAR,Mac-2BP,NIHSS score at END,END,cerebral perfusion impairment,and basal ganglia EPVS were inde-pendent risk factors for poor outcomes(P＜0.05,P＜0.01).The AUC value of combined suPAR and Mac-2BP in predicting END was 0.8844(95％CI:0.822-0.947),and the value in predicting poor outcomes was 0.8742(95％CI:0.810-0.938)in BAD patients.Conclusion Cerebral perfu-sion impairment,suPAR and Mac-2BP are independent risk factors for END and poor outcome at 90 d in BAD patients.Combined detection can is helpful in evaluating the patient's condition and predicting the prognosis.

Background and purpose:In breast cancer surgery,margin status assessment significantly impacts patient prognosis,with positive margins indicating higher recurrence and metastasis risks.Ensuring complete tumor resection is thus critical for surgical success.Indocyanine green(ICG)has garnered attention for its potential real-time imaging of breast cancer lesions under near-infrared light.This study employed ICG for intraoperative assessment of breast cancer lesion margin status and further explored the possibility of optimizing the safe margin distance surround the lesion in normal breast tissue.Methods:Clinical data of patients admitted to the Department of Thyroid and Breast Surgery,the Fourth Affiliated Hospital of Anhui Medical University(Affiliated Chaohu Hospital),from December 2021 to September 2022 were collected.A retrospective clinical study was conducted on breast cancer patients who were randomly assigned to either the ICG group or the conventional surgery group.Two to three hours before surgery,patients in the ICG group received a peripheral intravenous injection of 0.5 mg/kg ICG.Intraoperative fluorescence imaging was performed on the specimen before and after resection,as well as on the residual cavity.Near-infrared fluorescence imaging equipment was used to quantitatively measure fluorescence intensity of resected lesions at 4 directions(12,3,6,and 9 o'clock)and detect fluorescence in the residual cavity after lesion removal.Specimens were promptly sent to the pathology department for pathological examination,and safety margins of normal breast tissue in the 4 directions were recorded.The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)checklist was followed for this study.This study was approved by the Ethics Committee of the Fourth Affiliated Hospital of Anhui Medical University(Affiliated Chaohu Hospital)(No.KYXM-202310-46).Results:This study included 50 breast cancer patients,with 24 in the ICG group and 26 in the traditional surgery group.In the ICG group,fluorescence signals were detected at all lesion sites.Specifically,fluorescence density values at the lesion center,margin,and surrounding normal breast tissue were measured as 251.08±10.73,208.08±19.74,and 156.76±16.47,respectively,showing a gradual decrease from center outward with statistically significant differences(P＜0.05).Additionally,fluorescence ratios between the lesion center and margin,and center and surrounding normal tissue,were 1.22±0.13 and 1.62±0.19,respectively.After resection,abnormal fluorescence was observed in 2 of 24 cases in the residual cavity,with 1 case being invasive carcinoma with ductal carcinoma in situ and the other normal breast tissue.Ultimately,this study demonstrated that ICG achieved a sensitivity of 95.9%and a specificity of 97.9%in margin assessment.After specimen resection,the safety margins of normal glandular tissue surrounding the lesion were measured.The safety widths for the ICG group and the concurrent breast cancer surgery group were(8.36±6.42)mm and(15.08±4.75)mm,respectively.This difference was statistically significant(P＜0.05).Conclusion:ICG is a real-time,efficient,and cost-effective tracer that can be used to determine breast cancer margins,with excellent sensitivity and specificity.For early-stage breast cancer patients who are eligible for breast-conserving surgery,this tracer helps to reduce the amount of healthy breast tissue that is removed around the lesion.

Objective To investigate the correlation of imaging parameters of CT perfusion scan-ning combined with serum suPAR and Mac-2BP with END and poor outcomes in patients with BAD.Methods A total of 176 BAD patients admitted to Department of Neurology of Zhengzhou People's Hospital from June 2019 to March 2024 were prospectively enrolled,and according to whether END occurred within 72 h after onset,they were divided into END group(42 cases)and non-END group(134 cases).Based on their outcomes at 90 d of follow-up,they were also assigned into good outcome group(129 cases)and poor outcome group(47 cases).The serum suPAR and Mac-2BP levels were compared between the END and non-END groups,as well as the good and poor outcome groups.ROC curves were plotted to analyze the accuracies of serum suPAR and Mac-2BP in predicting END and poor outcomes.Results The END group had significantly higher suPAR and Mac-2BP levels,longer MTT and TTP,and larger proportions of DWMH,basal gan-glia EPVS and cerebral perfusion impairment,but lower CBV and CBF when compared with the non-END group(P＜0.05,P＜0.01).Obviously higher suPAR and Mac-2BP levels,NIHSS score at END,longer MTT and TTP,and larger proportions of EDN,basal ganglia EPVS and cerebral perfusion impairment,but lower CBV and CBF were observed in the poor outcome group than the good outcome group(P＜0.05,P＜0.01).suPAR and Mac-2BP levels,cerebral perfusion impair-ment and DWMH were independent risk factors for END(P＜0.05,P＜0.01).suPAR,Mac-2BP,NIHSS score at END,END,cerebral perfusion impairment,and basal ganglia EPVS were inde-pendent risk factors for poor outcomes(P＜0.05,P＜0.01).The AUC value of combined suPAR and Mac-2BP in predicting END was 0.8844(95％CI:0.822-0.947),and the value in predicting poor outcomes was 0.8742(95％CI:0.810-0.938)in BAD patients.Conclusion Cerebral perfu-sion impairment,suPAR and Mac-2BP are independent risk factors for END and poor outcome at 90 d in BAD patients.Combined detection can is helpful in evaluating the patient's condition and predicting the prognosis.

Background and purpose:In breast cancer surgery,margin status assessment significantly impacts patient prognosis,with positive margins indicating higher recurrence and metastasis risks.Ensuring complete tumor resection is thus critical for surgical success.Indocyanine green(ICG)has garnered attention for its potential real-time imaging of breast cancer lesions under near-infrared light.This study employed ICG for intraoperative assessment of breast cancer lesion margin status and further explored the possibility of optimizing the safe margin distance surround the lesion in normal breast tissue.Methods:Clinical data of patients admitted to the Department of Thyroid and Breast Surgery,the Fourth Affiliated Hospital of Anhui Medical University(Affiliated Chaohu Hospital),from December 2021 to September 2022 were collected.A retrospective clinical study was conducted on breast cancer patients who were randomly assigned to either the ICG group or the conventional surgery group.Two to three hours before surgery,patients in the ICG group received a peripheral intravenous injection of 0.5 mg/kg ICG.Intraoperative fluorescence imaging was performed on the specimen before and after resection,as well as on the residual cavity.Near-infrared fluorescence imaging equipment was used to quantitatively measure fluorescence intensity of resected lesions at 4 directions(12,3,6,and 9 o'clock)and detect fluorescence in the residual cavity after lesion removal.Specimens were promptly sent to the pathology department for pathological examination,and safety margins of normal breast tissue in the 4 directions were recorded.The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)checklist was followed for this study.This study was approved by the Ethics Committee of the Fourth Affiliated Hospital of Anhui Medical University(Affiliated Chaohu Hospital)(No.KYXM-202310-46).Results:This study included 50 breast cancer patients,with 24 in the ICG group and 26 in the traditional surgery group.In the ICG group,fluorescence signals were detected at all lesion sites.Specifically,fluorescence density values at the lesion center,margin,and surrounding normal breast tissue were measured as 251.08±10.73,208.08±19.74,and 156.76±16.47,respectively,showing a gradual decrease from center outward with statistically significant differences(P＜0.05).Additionally,fluorescence ratios between the lesion center and margin,and center and surrounding normal tissue,were 1.22±0.13 and 1.62±0.19,respectively.After resection,abnormal fluorescence was observed in 2 of 24 cases in the residual cavity,with 1 case being invasive carcinoma with ductal carcinoma in situ and the other normal breast tissue.Ultimately,this study demonstrated that ICG achieved a sensitivity of 95.9%and a specificity of 97.9%in margin assessment.After specimen resection,the safety margins of normal glandular tissue surrounding the lesion were measured.The safety widths for the ICG group and the concurrent breast cancer surgery group were(8.36±6.42)mm and(15.08±4.75)mm,respectively.This difference was statistically significant(P＜0.05).Conclusion:ICG is a real-time,efficient,and cost-effective tracer that can be used to determine breast cancer margins,with excellent sensitivity and specificity.For early-stage breast cancer patients who are eligible for breast-conserving surgery,this tracer helps to reduce the amount of healthy breast tissue that is removed around the lesion.

Objective To investigate the effects of cerebral microbleeds（CMB）on the prognosis of patients with acute cerebral infarction（ACI）treated with intravenous thrombolysis（IVT）or mechanical thrombectomy（MT）. Methods A total of 738 patients with ACI treated with IVT or MT who were hospitalized in People's Hospital of Zhengzhou from January 2015 to June 2022 were consecutively included. They were evaluated for CMB at admission and the modified Rankin Scale（mRS）score at 3 months. The effects of the presence，location，and load of CMB on the mRS score at 3 months were analyzed. Subgroup analyses were performed for patients with successful recanalization. Results For all patients，the presence or absence of CMB was not significantly associated with the 3-month prognosis（38.0% vs 44.2%，P=0.295），while for the patients with successful recanalization，those without CMB had a significantly higher percentage of a favorable prognosis than those with CMB（56.9% vs 35.8%，P=0.011）. The multivariable logistic regression analysis showed that for all patients，only high-load CMB was significantly associated with the prognosis at 3 months（odds ratio OR=0.017，95% confidence interval CI 0.112-0.808，P=0.017）；in the patients with successful recanalization，the presence of CMB（OR=0.422，95% CI 0.214-0.832，P=0.013），lobar CMB（OR=0.379，95% CI 0.157-0.920，P=0.032），and high-load CMB（OR=0.207，95% CI 0.056-0.760，P=0.018）were significantly associated with the 3-month prognosis. Conclusion The adverse effects of CMB for patients with successful recanalization are more marked as compared with patients with failed recanalization. The presence of CMB，lobar CMB，and high-load CMB are independent predictors of a poor outcome at 3 months in patients with successful recanalization.

With the rapid development of information technology, artificial intelligence technology (AI) and how to use it have become the focus of current researches. The application of AI in the field of TCM has shown its uniqueness. The combination of artificial intelligence technology and traditional Chinese medicine provides a new direction and idea for the development of TCM. This paper analyzes the strengths, weaknesses, opportunities and threats (SWOT) of TCM development against the background of AI technology in China by SWOT analysis method. Based on these analyses, this paper puts forward some counter measures such as protecting personal information, avoiding negative effects and medical regulations etc. In order to facilitate and guarantee the development of TCM, we should take advantage of the AI, and avoid its disadvantages.

Objective To explore clinical characteristics,diagnosis and treatment method after Peutz-Jeghers Syndrome (PJS) secondary malignant.Methods The clinical date of five cases with malignant tumors associated with Peutz-Jeghers syndrome from June 2014 to January 2017 were analyzed retrospectively in Beijing Friendship Hospital,Capital Medical University.The patients were followed up by phone,outpatient service,and hospitalization.The starting point of the follow-up was the visit date.The patient's death was the end point.The clinical and pathological features,therapy,and postoperative survival were observed.The follow-up deadline was May 2018.Results PJS secondary malignant patients lack clinical specificity.Two cases of five patients accepted endoscopic resection,three cases accepted surgery,and were treated with chemotherapy postoperatively,including 1 case died from tumor progression of 6 months after operation.Tumor recurrence was not found in the rest 4 cases till May 2018.Conclusions Part of the malignant polyp,endoscopic resection is feasible.When endoscopic resection is not feasible,operation treatment is needed;and postoperative adjuvant chemotherapy is needed to improve the long-term prognosis.

Objective To study the efficacies and adverse reactions of urapidil and nicardipine in the treatment of the chronic renal failure patients with hypertensive emergencies .Methods 59 chronic renal failure patients with hypertensive emer-gencies were randomly divided into nicardipine treatment group and urapidil treatment group .The patients in the nicardipine group were given a 1 mg nicardipine intravenous injection ,and 30-100 μg/min intravenous transfusion was given continuously . The patients in the urapidil group were given a 12 .5 mg urapidil intravenous injection ,and 150-500μg/min intravenous trans-fusion was given continuously .The dosage were changed according to the patients′blood pressure in both of the groups .The patients′blood pressure ,heart rate and adverse reactions were recorded .Results The patients′blood pressure in both of the groups were significantly lower after treatment (P<0 .05) .The SBP in nicardipine treatment group was significant lower than SBP in urapidil treatment group in the first hour after treatment (P<0 .05) .There was no significant difference in SBP be-tween the two groups 2 hours after treatment (P>0 .05) .There was no significant difference in DBP between the two groups after treatment (P>0 .05) .In the nicardipine group ,the heart rate rose after the treatment ,the difference was statistically significant (P<0 .05) .While in the urapidil group ,the heart rate went down after the treatment ,and the difference was statis-tically significant (P<0 .05) .There was no significant difference in adverse reactions between the two groups (P>0 .05) . Conclusion Both of nicardipine and urapidil were effective in the treatment of chronic renal failure patients with emergency hy-pertensive .Nicardipine was more effective in reducing the SBP in the first stage of treatment .

ObjectiveTo evaluate the therapeutic value of neoadjuvant chemotherapy for patients with stages Ⅱ and ⅢA(Only T3N1M0) breast cancer,and assess the relationship of the tumor size and pathologically complete response.MethodA total of 408 breast cancers patients at stages Ⅱ and ⅢA,were studied,which were divided into neoadjuvant chemotherapy group (group A) and control group (group B).All patients of group A received 2-4 cycles NAC with TE scheme in breast cancer.The impact of neoadjuvant chemotherapy on surgical methods choice,local control rate,5-year overall survival rate and 5-year disease free survival rate were analyzed.ResultsFor patients of stage Ⅱ,the rate of breast conservation significantly increased from 23.6％ to 49.1％ (P =0.000) and there was no significant difference between groups A and B ( P =0.939,0.858 ) in 5-year overall survival rate and disease free survival rate.For patients of stage ⅢA,the 5-year overall survival rate (59.8％ ) and disease free survival rate (51.8％) in group A were greatly higher than that in group B (35.7％ and 27.6％ ) (P =0.000,0.000).The 3-year local relapse and metastasis rate(7.9％ ) was lower than group B (18.4％)(P ＜ 0.05 ).The tumor less than 3.0 cm is easy to achieve pathological complete remission (P =0.001 ).ConclusionsThe neoadjuvant chemotherapy can improve potential rate of breast conservation,reduce the rate of local-regional recurrence rate for the patients with stage Ⅱ and ⅢA breast cancer,and also improve the 5-year survival rate for the patients of stage ⅢA.Patients with clinically complete response or PCR may have higher 5- year overall survival rate and disease free survival rate.Primary tumor size was found to be the significant predictive factor for pathologically complete response to neoadjuvant chemotherapy in patients with breast cancer,particularly,the small tumor is easy to reach pathologically complete response.

Objective To investigate the diagnosis and treatment of pancreatic cystic tumors. Methods The clinical data of 35 patients with pancreatic cystic tumors were retrospectively analyzed. Results The preoperative diagnosis rate was as follows: ultrasound was 28.6% ( 10/35 ), CT 44.4% ( 12/27 ), MRI 70% (7/10). Twenty-eight cases underwent operation and were diagnosed finally by postoperative pathology. Serous cystic neoplasm (SCN) was found in 2 cases, mucinous cystic neoplasm (MCN) in 9 cases,cystic adenocarcinoma in 7 cases, intraductal papillary mucinous neoplasm ( IPMN ) in 3 cases, solid pseudopapillary tumor (SPT) in 7 cases. Twenty-three cases were followed up successfully. The post-operative 5 years survival rate was 62.5% (5/8) in pancreatic cystic adenoma without recurrence. The longest survival time in cystic adenocarcinoma after complete resection was 5 years and 8 months, while in which after incomplete resection was 6 months. The 4 cases of SPT are all alive, and one of them has survived for 4 years as the longest one. Conclusions It is difficult to diagnose the pancreatic cystic neoplasm accurately before operation. CT and MRI may be helpful to make the diagnosis. Surgical resection is the most effective treatment. The enhancement of the communication and cooperation between the related departments, the early diagnosis, and the appropriate operation are needed to improve the diagnostic and therapeutic efficacy.