Objective To investigate the factors influencing the prognosis of complex intracranial aneurysms treated with pipeline flow-directed device(PED)and to develop a nomogram prediction model.Methods The clinical data of a total of 98 patients with complex intracranial aneurysm,who were admitted to the Anyue County People's Hospital or the Second Affiliated Hospital of Guilin Medical College of China from January 2021 to April 2023 to receive PED treatment,were retrospectively analyzed.The influencing factors that might affect the prognosis of patients with complex intracranial aneurysm were collected.According to the modified Rankin Scale(mRS)score,the patients were divided into good prognosis group(being defined as mRS ≤2 points)and poor prognosis group(being defined as mRS＞2 points).The clinical data were compared between the two groups,and a nomogram model was established and validated.Results In the 98 patients,poor prognosis was seen in 10(10.20％).The differences in age,history of hypertension,history of diabetes mellitus,clopidogrel resistance,Fisher classification,repeated aneurysm rupture,aneurysm location,aneurysm size,aneurysm neck,multiple lesions,and Hunt-Hess grade on admission between good prognosis group and poor prognosis group were statistically significant(all P＜0.05).Multivariate analysis revealed that history of hypertension,clopidogrel resistance,repeated aneurysm rupture,aneurysm location,multiple lesions,and Hunt-Hess grade were the independent factors influencing the prognosis of patients with complex intracranial aneurysm after receiving PED treatment.The AUC of the nomogram model in predicting the prognosis of PED for complex intracranial aneurysms was 0.849(95％CI=0.758-0.939).The predicted curves of the model group and validation group were basically fitted to the standard curves.The results of the decision curve analysis showed that the net benefit to patients was greater than 0 when the probability threshold of the nomogram model for predicting a poor prognosis of PED for complex intracranial aneurysms was 0.10-0.90.Conclusion The factors causing poor prognosis of PED for complex intracranial aneurysms mainly include history of hypertension,clopidogrel resistance,repeated aneurysm rupture,etc.The nomogram model established in this study can predict the risk of poor prognosis in patients with complicated intracranial aneurysm after receiving PED treatment.

Objective:To investigate any anti-aging effect of repeated transcranial magnetic stimulation (rTMS) and explore the relationship between the effect and relief of clinical symptoms in patients with Parkinson′s disease (PD).Methods:A total of 108 PD patients were randomly divided into an rTMS group and a control group, each of 54, while another 54 healthy counterparts were selected to form a normal group. In addition to anti-PD drug therapy, the rTMS group was given daily rTMS treatment, 5 days a week for 4 weeks, while the control group received sham rTMS treatment, with no treatment of the normal group. Before the treatment and after 4 weeks of treatment as well as and 1 month after the ending of the treatment, the subjects′ clinical exercise symptoms were evaluated using the Unified Parkinson′s Disease Rating Scale (UPDRS), a timed exercise test and the 10m re-entry exercise test. Non-exercise symptoms were assessed using the Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA) and the Mini-mental State Examination (MMSE). Fasting venous blood samples were analyzed to quantify the serum levels of tumor necrosis factor (TNF), interleukin-6 (IL-6), interleukin-1β (IL-1β) and matrix metalloproteinase-3 (MMP-3).Results:Four weeks and 1 month after the treatment, the average UPDRS scores, exercise test times and 10m re-entry exercise test results of the rTMS group were significantly better than those before treatment and significantly better than those of the control group at the same time point. The rTMS group′s average HAMA, HAMD and MMSE scores, as well as its average P300 latency and amplitude were also significantly better than those of the control group at the same time point and significantly better than those before treatment. After 4 weeks, the average MMP-3 content in the rTMS group was significantly lower than the control group′s average, and after a month the average levels of TNF, IL-6, IL-1β and MMP-3 of the rTMS group were all significantly different from those before treatment and those of the control group. The TNF, IL-6, IL-1β and MMP-3 levels were all positively correlated with the average UPDRS total score.Conclusion:High-frequency rTMS therapy can change the phenotypes related to cell senescence, and thus has good therapeutic effect on motor and non-motor symptoms of PD.

Objective:In the research, the traditional mercury sphygmomanometer was used to press the puncture point to evaluate the hemostatic effect.Methods:Eighty patients with acute cerebral infarction diagnosed clinically in Xuanwu Hospital of Capital Medical University from June 2018 to December 2019 were examined by magnetic resonance perfusion examination. The serial number of the patient was randomly divided into the group by random digital table, and the puncture point was pressed by mercury sphygmomanometer after needle extraction in the auxiliary pressing group, and the individual systolic blood pressure intensity was set as the pressing intensity, while the control group adopted independent vertical pressing technique. After examination, the puncture points of the two groups were qualitatively evaluated, such as secondary bleeding, hematoma, ecchymosis, normal and so on.Results:In the auxiliary compression group, there were 3 cases of secondary hemorrhage, 1 case of hematoma, 0 cases of ecchymosis and 36 cases of normal, while in the control group, there were 4 cases of bleeding, 2 case of hematoma, 1 case of ecchymosis and 33 cases of normal ( χ2value was 4.372-34.225, P<0.05). Conclusion:Traditional mercury sphygmomanometer-assisted pressing puncture point can make personalized nursing hemostasis plan for patients with acute cerebral infarction, reduce the phenomenon of puncture point bleeding, ecchymosis, and even subcutaneous hematoma caused by unstable pressing and unequal force, and practice high-quality nursing service.

Objective:To better promote the standardization of public health management in China, and provide evidence for the development and improvement of the standardization strategy and management system in public health field in China.Methods:This paper summarizes and analyzes the information about the standardized management mechanism collected from international organizations related with standardization in public health.Results:The standards in public health varied in different management systems of the international organizations, and there were great differences in organization nature, standard types, application, release, organization structure, standard development principles, advantages, transformation, promotion and implementation, and evaluation.Conclusion:China can benefit from the studying of the working mechanism of the international organization related with standardization in public health to facilitate its own standardization in public health.

To systematically analyze the status of the standardization of basic public health services, the project of basic public health service equalization and the first round of national pilot projects of the standardization of basic public services are carried out to provide support for the promotion of the standardization and equalization of basic public health services. The information about above-mentioned three aspects related to national basic public health services were collected, and a systematic comparison of standardization of basic public health services with the 14 specifications in the National Basic Public Health Service Specification ( the 3 th Edition ) and the 51 pilot projects in the Notice of Carrying Out the Pilot Work of National Basic Public Service Standardization was conducted. The current public health standards are basically in line with the requirement of the resident health record management service specifications. However, the public health standards related to public health projects in other 13 service specifications and national basic public health service standardization pilot projects are incomplete or absent. The current public health standards cannot fully meet the requirements of the implementation of national basic public health services. In the process of promoting the equalization of basic public health service, it is urgent to develop targeted public health standards in related fields.

Objective:To systematically analyze the basic characteristics and contents of the current health standards for infectious disease, environmental health, school health and disinfection in the context of COVID-19 prevention and control, and provide support for the further optimization of epidemic prevention and control guidelines and reference for the revision and improvement of related health standards.Methods:Public health standards used in COVID-19 prevention and control were selected for a systematic comparison with "The Plan of COVID19 Prevention and Control (the 6 th Edition)" and other epidemic prevention and control guidelines from the perspectives of application scope and technical elements. Results:The current standards of public health are with scientificity, timeliness and feasibility. The application scope and technical elements of the current public health standards basically meet the needs of the prevention and control of COVID-19 epidemic, but the public health standardization system still needs improvement, and some public health standards need to be revised.Conclusions:The implementation of current public health standards can provide strong technical support for the prevention and control of COVID-19 epidemic. The experience obtained from COVID-19 epidemic prevention and control might promote the further improvement of the health standardization system.

Objective:To compare the technical elements of health standards for nosocomial infection control, health protection, health information, and health emergency and biosafety in the context of the prevention and control of COVID-19, and provide support for the further optimization of the epidemic prevention and control guidelines.Methods:Above mentioned health standards used in COVID-19 prevention and control were collected for a systematic comparison with "Guidelines for Prevention and Control of COVID-19 in Medical Institutions" (the 1 st Edition) from the perspective of technical elements. Results:The application scope and technical elements of the current health standards basically meet the needs for the prevention and control of COVID-19 epidemic.Conclusions:The implementation of the current health standards can provide strong technical support for the prevention and control of COVID-19 epidemic. The experience obtained in the epidemic prevention and control can also contribute to the further revision and improvement of the health standards.

Objective To Observe and evaluate the effect of hyperbaric oxygen therapy for patients with tracheotomy using ventilator lengthening tube. Methods 75 patients with tracheotomy in our hospital from January 2017 to January 2018 were divided into the study group (n = 38 cases) and the control group (n = 37 cases) according to the random number method. The control group used conventional oxygen inhalation while the study group used the ventilator tube after prolonged special oxygen hyperbaric oxygen pipe three (built-in ventilation pipe check valve) and bellows connecting an oxygen supply device, compared two groups of patients with oxygen inhalation methods suction phlegm oxygen concentration times and cabin, every time when treating. Results The rate of oxygen inhalation in the study group was 97. 37％ (37/38) higher than that of the control group (81. 08％ (30/37)), and the difference was statistically significant (P＜0. 05). The number of sputum sucking in the study group was (1. 02 ± 0. 36) times less than that of the control group (2. 32 ± 0. 53), and the difference was statistically significant (P＜0. 05). The total time of hospitalization in the study group was (16. 4 ± 2. 4) d, and the total time of hospitalization in the control group was (21. 7 ± 3. 2) d, the difference was statistically significant(WTBX〗P＜0. 05). The score of GCS in the study group was higher than that of the control group, and the difference was statistically significant (P＜0. 01). Conclusion The ventilator extension tube for hyperbaric oxygen therapy in patients with tracheotomy improves the oxygen concentration, ensures the curative effect, reduces the oxygen concentration in the cabin and reduces security risks; the operation method is safe, simple and practical and convenient for clinical application.

Objective: To investigate the value of short tandem repeat (STR) genotyping in the diagnostic workup of molar and non-molar gestations with correlation of histological characteristics. Methods: Six hundred and fifty-six cases were selected based on clinically suspected hydropic abortion and/or molar pregnancy from July 2015 to September 2017 at Beijing Obstetrics and Gynecology Hospital. DNA was extracted from dissected chorionic villi and paired maternal endometrial FFPE tissue samples by Simplex OUP™ FFPE DNA Tissue Kit. STR genotyping was performed by PowerPlex 16 HS system. Results: DNA genotyping was informative in 649 of 656 cases, leading to identification of 215 hydatidiform mole gestations and 434 non-molar gestations. Most of non-molar gestations (375 cases, 86.4%) were diploid hydropic abortion. Various trisomy syndromes were found (53 cases, 12.2%), including trisomy 2, 3, 4, 7, 8, 13, 16 and 21. Only 2(0.5%) digynic triploid gestations were detected. Moreover, 4 cases (0.9%) of uniparental disomies (homologous or heterologous) were found. There were 196 cases with histologic diagnostic suspicious of hydatidiform moles were accurate sub-classified. Among them, 59 cases hydatidiform moles were under-diagnosed as diploid hydropic abortions, and 28 cases diploid hydropic abortions were over-diagnosed as hydatidiform moles.Compared with partial moles(PHM), there were no specific histomorphological features between the various types of non-molar gestations and partial moles for definitive diagnostic separation. There was no significant difference in the expression of p57^kip2 among PHM, trisomy and diploid hydropic abortions group (P=0.247). Conclusions STR genotyping can distinguish non-molar gestations from early hydatidiform moles, and efficiently avoid misdiagnosis based only on histological evaluation. Therefore, using STR genotyping, not only can the overdiagnosis of non-molar pregnancy be avoided, but also individualized management can be offered to patients including monitoring of serum hCG.

Objective To assess the therapeutic effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) combined with neuromuscular electrical stimulation (NMES) on poststroke dysphagia.Methods A total of 90 patients with poststroke dysphagia were enrolled.They were randomly divided into either a NMES + rTMS group or a NMES + sham rTMS group (n =45 in each group).The Kuhota water drinking test and Standardized Swallowing Assessment (SSA) were used to assess the swallowing function.Results The scores of Kuhota water drinking test (F=82.001,P＜0.001) and the SSA (F =33.743,P ＜0.001) before treatment,treatment of one course,treatment of two courses,and at 3 months after treatment in the NMES + rTMS group had significant differences.Compared with before treatment,they were improved significantly for treatment of one course (P ＜0.01 and P ＜0.05,respectively),two courses (all P＜0.01),and at 3 months (all P＜0.01) after treatment.The scores of Kuhota water drinking test (F =53.647,P＜0.001) and the SSA (F=19.178,P＜0.001) in the NMES + sham rTMS group also had significant difference.Compared with before treatment,they had significant improvement for treatment of one course (all P ＜0.05),two courses (P ＜0.05 and P ＜0.01,respectively) and at 3 months (all P＜0.01)after treatment.The scores of Kuhota water drinking test for treatment of one course,two courses,and at 3 months after treatment (treatment of one course:t=2.217,P=0.02;treatment of two courses:t =2.406,P =0.019;at 3 months after treatment:t =2.128,P =0.037) and the SSA (treatment of one course:t =2.196,P =0.030,treatment of two courses:t =2.425,P =0.016;at 3 months after treatment:t =2.512,P=0.013) in the NMES + rTMS group were significantly better than those in the NMES + sham rTMS group.Conclusions High-frequency rTMS combined with NMES may significantly improve the swallowing function in patients with stroke.Its efficacy is superior to NMES.