Objective:To explore the effect of ultrasound-guided stellate ganglion block (SGB) combined with cognitive behavioral therapy for insomnia (CBT-I) in the treatment of chronic insomnia.Methods:A total of 69 patients with chronic insomnia admitted to the Nanjing First Hospital from January 2023 to February 2024 were selected and randomly divided into the CBT-I alone group (simple group, 34 cases) and the SGB combined with CBT-I group (combined group, 35 cases) using a random number table. Both groups received treatment for 8 weeks. The simple group was treated with CBT-I twice a week, 1 hour each time. The combined group, on the basis of the simple group, received ultrasound-guided SGB with 4 ml of 1% lidocaine, which was performed once a day, alternately on the left and right sides, for 7 consecutive days each time, with a total of 14 injections in the 1st and 5th weeks. One week before treatment and 8 weeks after treatment, the Pittsburgh Sleep Quality Index (PSQI) and sleep diary were used to record patients′ subjective sleep quality; Actigraph was used to record objective sleep status; the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to assess patients′ emotional status. Adverse reactions such as hoarseness, pneumothorax, bleeding, and infection were recorded.Results:After 8 weeks of treatment, the effective rate was 76.5%(26/34) in the simple group and 94.3%(33/35) in the combined group, with a statistically significant difference (χ 2=8.433, P<0.05). Before treatment, there was no significant difference in PSQI scores between the two groups ( P>0.05). After 8 weeks of treatment, the PSQI scores of both groups were lower than those before treatment, and the PSQI score of the combined group was lower than that of the simple group, with a statistically significant difference ( P<0.05). Before treatment, there were no significant differences in sleep parameters from sleep diaries and Actigraph between the two groups (all P>0.05). Compared with before treatment, after treatment, the total sleep time and time in bed were prolonged, and sleep efficiency, the proportion of deep sleep, and the proportion of rapid eye movement sleep were increased in both groups; these indicators in the combined group were better than those in the simple group, with statistically significant differences (all P<0.05). Compared with before treatment, the sleep onset latency was shortened and the number of awakenings was reduced in both groups after treatment, and the combined group was better than the simple group, with statistically significant differences (all P<0.05). Before treatment, there were no significant differences in SAS and SDS scores between the two groups (all P>0.05). After treatment, the SAS and SDS scores of both groups were lower than those before treatment, and the SAS and SDS scores of the combined group were lower than those of the simple group, with statistically significant differences (all P<0.05). During treatment, 2 cases in the combined group developed hoarseness, which relieved spontaneously after 2 hours, and no other complications occurred. Conclusions:Ultrasound-guided SGB combined with CBT-I can significantly improve the nighttime sleep quality of patients with chronic insomnia.

Background and Aims:Spontaneous isolated superior mesenteric artery dissection(SISMAD)is a relatively common type of visceral artery dissection,typically presenting with acute abdominal pain.In severe cases,it may lead to intestinal ischemia or even necrosis.With the widespread use of imaging techniques such as CT angiography(CTA),the detection rate of SISMAD has significantly increased.However,there is still controversy regarding its optimal treatment strategy,especially in choosing between conservative management and endovascular intervention,as no unified standard currently exists.This study aimed to compare the short-and medium-term outcomes of the two treatment modalities by retrospectively analyzing the clinical data of SISMAD patients treated at our center in order to provide evidence for individualized treatment decisions.Methods:A retrospective analysis was conducted on 174 patients diagnosed with SISMAD at Ningbo Second Hospital between January 2018 and December 2023.Among them,30 patients received conservative treatment,and 144 underwent endovascular intervention(including stent implantation alone or in combination with coil embolization of the false lumen).All patients were diagnosed using CTA or superior mesenteric artery angiography and classified accordingly.Patients were followed up at 1 month and 1 year after treatment to assess clinical symptom relief and radiological outcomes,including dissection remodeling and stent patency.Results:In the conservative group,the symptom relief rate was 90.0%at 1 month and 92.8%at 1 year;in the interventional group,the corresponding rates were 99.3%and 98.6%.The difference in symptom relief at 1 month was statistically significant(P=0.016),while the difference at 1 year was not(P>0.05).Subgroup analysis by classification showed that the interventional group generally had higher symptom relief rates than the conservative group across all types.However,none of the differences reached statistical significance(all P>0.05).The conservative group showed poorer symptom control in type Ⅲpatients,including one death.The technical success rate of endovascular treatment was 99.3%,with no cases of stent displacement or occlusion within 1 year.The complete remodeling rate was 86.8%,and the stent patency rate was 100.0%.Some patients had minor mural thrombus formation within the stent without evidence of flow obstruction.Conclusion:Endovascular intervention offers a high technical success rate and favorable short-and medium-term efficacy in SISMAD patients,particularly for type Ⅱ and Ⅲ cases with compromised true lumen perfusion.Treatment strategies should be tailored based on the dissection type and the degree of true lumen compression to improve clinical outcomes and reduce associated risks.

Objective:To investigate the effect of extracorporeal membrane oxygenation (ECMO) in assisting neonates with complex congenital heart diseases (CHD) and the survival rate of the patients.Methods:A retrospective case-control study was made on 22 newborns with complex CHD assisted by ECMO during the perioperative period in Fuwai Central China Cardiovascular Hospital from January 2018 to June 2024.There were 19 males and 3 females in the newborns included, with an average age of (10.4±8.7) days (range: 1-26 days) and an average weight of (3.1±0.3) kg.Complex CHD included total anomalous pulmonary venous connection in 9 cases (40.9%), interrupted aortic arch and coarctation in 8 cases (36.4%), transposition of great arteries in 3 cases (13.6%), double outlet right ventricle in 1 case (4.5%) and cardiac tumor in 1 case (4.5%).The patients were divided into the <5 d group, 5-12 d group, and >12 d group according to the duration of ECMO support.Data were compared using the t-test or χ2 test. Results:There were 8 cases (36.4%) successfully weaned from ECMO support and 6 cases (27.3%) survived.ECMO support was used routinely in 15 cases (68.2%), and for extracorporeal cardiopulmonary resuscitation in 7 cases (31.8%).The duration of ECMO support was (5.9±3.7) days.There were no statistically differences in age, weight, gender, disease composition, operation time, cardiopulmonary bypass time, cross-clamp time, assistant time, blood routine, liver and kidney function and other biochemical indicators, preoperative cardiac ejection fraction value, procalcitonin, C-reactive protein and other infection indicators between the death group and the survival group (all P>0.05).The highest lactate values 24 hours before [(8.1±5.4) mmol/L] and after ECMO support [(10.5±7.1) mmol/L] in the survival group were significantly lower than those in the death group [(18.7±9.2) mmol/L, (21.3±8.6) mmol/L] ( t=2.606, P=0.018; t=2.729, P=0.013).It was found that the survival rate was 0/9 (0) in the <5 d group, 6/12 (50.0%) in the 5-12 d group, and 0/1 (0) in the >12 d group.The survival rate of the 5-12 d group was the highest, which was significantly higher than that of the <5 d group ( χ2=6.300, P=0.012). Conclusions:ECMO support is an effective treatment for severe circulatory failure in neonates with complex CHD in the perioperative period.The highest lactate levels 24 hours before and after ECMO support affect the survival rate.Patients receiving 5-12 d ECMO support can achieve the highest survival rate.

Background and Aims:Spontaneous isolated superior mesenteric artery dissection(SISMAD)is a relatively common type of visceral artery dissection,typically presenting with acute abdominal pain.In severe cases,it may lead to intestinal ischemia or even necrosis.With the widespread use of imaging techniques such as CT angiography(CTA),the detection rate of SISMAD has significantly increased.However,there is still controversy regarding its optimal treatment strategy,especially in choosing between conservative management and endovascular intervention,as no unified standard currently exists.This study aimed to compare the short-and medium-term outcomes of the two treatment modalities by retrospectively analyzing the clinical data of SISMAD patients treated at our center in order to provide evidence for individualized treatment decisions.Methods:A retrospective analysis was conducted on 174 patients diagnosed with SISMAD at Ningbo Second Hospital between January 2018 and December 2023.Among them,30 patients received conservative treatment,and 144 underwent endovascular intervention(including stent implantation alone or in combination with coil embolization of the false lumen).All patients were diagnosed using CTA or superior mesenteric artery angiography and classified accordingly.Patients were followed up at 1 month and 1 year after treatment to assess clinical symptom relief and radiological outcomes,including dissection remodeling and stent patency.Results:In the conservative group,the symptom relief rate was 90.0%at 1 month and 92.8%at 1 year;in the interventional group,the corresponding rates were 99.3%and 98.6%.The difference in symptom relief at 1 month was statistically significant(P=0.016),while the difference at 1 year was not(P>0.05).Subgroup analysis by classification showed that the interventional group generally had higher symptom relief rates than the conservative group across all types.However,none of the differences reached statistical significance(all P>0.05).The conservative group showed poorer symptom control in type Ⅲpatients,including one death.The technical success rate of endovascular treatment was 99.3%,with no cases of stent displacement or occlusion within 1 year.The complete remodeling rate was 86.8%,and the stent patency rate was 100.0%.Some patients had minor mural thrombus formation within the stent without evidence of flow obstruction.Conclusion:Endovascular intervention offers a high technical success rate and favorable short-and medium-term efficacy in SISMAD patients,particularly for type Ⅱ and Ⅲ cases with compromised true lumen perfusion.Treatment strategies should be tailored based on the dissection type and the degree of true lumen compression to improve clinical outcomes and reduce associated risks.

Objective:To investigate the effect of extracorporeal membrane oxygenation (ECMO) in assisting neonates with complex congenital heart diseases (CHD) and the survival rate of the patients.Methods:A retrospective case-control study was made on 22 newborns with complex CHD assisted by ECMO during the perioperative period in Fuwai Central China Cardiovascular Hospital from January 2018 to June 2024.There were 19 males and 3 females in the newborns included, with an average age of (10.4±8.7) days (range: 1-26 days) and an average weight of (3.1±0.3) kg.Complex CHD included total anomalous pulmonary venous connection in 9 cases (40.9%), interrupted aortic arch and coarctation in 8 cases (36.4%), transposition of great arteries in 3 cases (13.6%), double outlet right ventricle in 1 case (4.5%) and cardiac tumor in 1 case (4.5%).The patients were divided into the <5 d group, 5-12 d group, and >12 d group according to the duration of ECMO support.Data were compared using the t-test or χ2 test. Results:There were 8 cases (36.4%) successfully weaned from ECMO support and 6 cases (27.3%) survived.ECMO support was used routinely in 15 cases (68.2%), and for extracorporeal cardiopulmonary resuscitation in 7 cases (31.8%).The duration of ECMO support was (5.9±3.7) days.There were no statistically differences in age, weight, gender, disease composition, operation time, cardiopulmonary bypass time, cross-clamp time, assistant time, blood routine, liver and kidney function and other biochemical indicators, preoperative cardiac ejection fraction value, procalcitonin, C-reactive protein and other infection indicators between the death group and the survival group (all P>0.05).The highest lactate values 24 hours before [(8.1±5.4) mmol/L] and after ECMO support [(10.5±7.1) mmol/L] in the survival group were significantly lower than those in the death group [(18.7±9.2) mmol/L, (21.3±8.6) mmol/L] ( t=2.606, P=0.018; t=2.729, P=0.013).It was found that the survival rate was 0/9 (0) in the <5 d group, 6/12 (50.0%) in the 5-12 d group, and 0/1 (0) in the >12 d group.The survival rate of the 5-12 d group was the highest, which was significantly higher than that of the <5 d group ( χ2=6.300, P=0.012). Conclusions:ECMO support is an effective treatment for severe circulatory failure in neonates with complex CHD in the perioperative period.The highest lactate levels 24 hours before and after ECMO support affect the survival rate.Patients receiving 5-12 d ECMO support can achieve the highest survival rate.

Objective:To explore the effect of ultrasound-guided stellate ganglion block (SGB) combined with cognitive behavioral therapy for insomnia (CBT-I) in the treatment of chronic insomnia.Methods:A total of 69 patients with chronic insomnia admitted to the Nanjing First Hospital from January 2023 to February 2024 were selected and randomly divided into the CBT-I alone group (simple group, 34 cases) and the SGB combined with CBT-I group (combined group, 35 cases) using a random number table. Both groups received treatment for 8 weeks. The simple group was treated with CBT-I twice a week, 1 hour each time. The combined group, on the basis of the simple group, received ultrasound-guided SGB with 4 ml of 1% lidocaine, which was performed once a day, alternately on the left and right sides, for 7 consecutive days each time, with a total of 14 injections in the 1st and 5th weeks. One week before treatment and 8 weeks after treatment, the Pittsburgh Sleep Quality Index (PSQI) and sleep diary were used to record patients′ subjective sleep quality; Actigraph was used to record objective sleep status; the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to assess patients′ emotional status. Adverse reactions such as hoarseness, pneumothorax, bleeding, and infection were recorded.Results:After 8 weeks of treatment, the effective rate was 76.5%(26/34) in the simple group and 94.3%(33/35) in the combined group, with a statistically significant difference (χ 2=8.433, P<0.05). Before treatment, there was no significant difference in PSQI scores between the two groups ( P>0.05). After 8 weeks of treatment, the PSQI scores of both groups were lower than those before treatment, and the PSQI score of the combined group was lower than that of the simple group, with a statistically significant difference ( P<0.05). Before treatment, there were no significant differences in sleep parameters from sleep diaries and Actigraph between the two groups (all P>0.05). Compared with before treatment, after treatment, the total sleep time and time in bed were prolonged, and sleep efficiency, the proportion of deep sleep, and the proportion of rapid eye movement sleep were increased in both groups; these indicators in the combined group were better than those in the simple group, with statistically significant differences (all P<0.05). Compared with before treatment, the sleep onset latency was shortened and the number of awakenings was reduced in both groups after treatment, and the combined group was better than the simple group, with statistically significant differences (all P<0.05). Before treatment, there were no significant differences in SAS and SDS scores between the two groups (all P>0.05). After treatment, the SAS and SDS scores of both groups were lower than those before treatment, and the SAS and SDS scores of the combined group were lower than those of the simple group, with statistically significant differences (all P<0.05). During treatment, 2 cases in the combined group developed hoarseness, which relieved spontaneously after 2 hours, and no other complications occurred. Conclusions:Ultrasound-guided SGB combined with CBT-I can significantly improve the nighttime sleep quality of patients with chronic insomnia.

Non-tuberculosis mycobacterium (NTM) refers to a general term for a large group of mycobacteria, excluding the mycobacterium tuberculosis and mycobacterium leprae, which is an opportunistic pathogen. NTM pulmonary disease and pulmonary tuberculosis have very similar clinical and imaging manifestations. Ordinary sputum tests can not distinguish between mycobacterium tuberculosis and NTM accurately, and it needs to be differentiated through detection methods such as mycobacterium culture medium, high-performance liquid chromatography, and molecular biology. During the diagnosis of occupational pneumoconiosis, a sandblasting and polishing worker's lung CT showed dynamic changes in infiltrating shadows and cavities in the right lung. A sputum drug sensitivity test showed NTM infection, but the patient refused treatment. After 20 months, the CT examination of the lung showed further enlargement of infiltrating shadows and cavities, and NTM bacterial identification showed intracellular mycobacterial infection. Amikacin, moxifloxacin, azithromycin, and ethambutol combined antibacterial treatment were given. Currently, the patient is still under treatment.

At present, China has not yet established a comprehensive standard and evaluation system specifically for occupational health engineering ventilation inspection. In order to meet the requirements for the design of occupational-disease-prevention facilities, the evaluation of occupational disease hazard control effectiveness, and the protective facilities, the Guangdong Provincial Occupational Health Technical Quality Control Center developed the Guangdong Province Occupational Health Engineering Ventilation Inspection Work Specification (Trial) by referring domestic and international standards and norms related to occupational health engineering, industrial ventilation design manuals and professional literature, using brainstorming and experience-based methods. The work specification covers the key detection indicators of ventilation systems, and comprehensively covers the core links of occupational health engineering ventilation testing. The relevant indicators mainly include: detection of air velocity control; wind speed and air volume of exhaust hoods and exhaust vents of ventilation facilities; detection of wind pressure, wind speed and air volume inside the ventilation duct; fresh air volume detection; and calculation and evaluation of ventilation frequency. The specification is highly practical, indicting scientific and advanced principles, and ensures the fairness and reliability of the testing process and results. Its implementation will effectively promote the standardization and professionalism of occupational health engineering ventilation testing, providing robust technical support for safeguarding workers' health.

Objective To analyze the implementation effect of quality control on the homepage of inpatient medical re-cords based on the background of Disease Diagnosis Related Groups(DRG).Methods A retrospective study was conducted,including a total of 20,000 medical records from Dongguan People's Hospital from 2018 to 2022.Among them,10,000 medical records from January to December 2018,before the implementation of DRG-based quality control,were included as the control group;10,000 medical records from January to December 2022,after the implementation of DRG-based quality control,were in-cluded as the observation group.The implementation effect of quality control of hospital admission medical records among different groups based on DRG was explored.Results In the control group,there were 1,943 medical records with defects,accounting for 19.43％,which affected DRG grouping in 1,000 cases(51.47％)and did not affect DRG grouping in 943 cases(48.53％).In the observation group,there were 1,316 medical records with defects,accounting for 13.16％,among which 643 cases(48.86％)affected DRG grouping and 673 cases(51.14％)did not affect DRG grouping.The difference in the number of defective medical records between the groups was statistically significant(χ2=144.11,P<0.05).The missing rates of diagnos-tic and treatment information and cost information in the observation group were lower than those in the control group(P<0.05).The completeness and accuracy rates of diagnosis and surgical information in the observation group were higher than those in the control group(P<0.05).Conclusion The implementation of quality control of hospital admission medical records based on DRG can significantly improve the quality of medical records,increase the accuracy of diagnosis and surgical information in medi-cal records,and have higher comprehensive quality control value.It is recommended for clinical promotion and use.

Background: SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood. Methods: We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival. Results: Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity. Conclusions The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.