Acute ischemic stroke (AIS) is a cerebrovascular disease characterized by high morbidity, disability, and mortality, posing a significant threat to human health. Endovascular treatment has now been established as a key method for AIS management, in which stent retrievers that can mechanically remove blood clots play a key role in this technique. In recent years, stent retrievers have evolved in complexity and functionality to improve the ability of clot removing and surgical safety. However, the present instruments still have limitations on treatment efficiency, vascular adaptability, and operational precision, posing an urgent need for innovation in the design of stent retrievers. This paper systematically reviewed the structural features and working principles of AIS stent retrievers from the perspective of efficacy evaluation metrics, historical development, recent advancements in stent retrieval technology, and future prospects.
Humans ; Ischemic Stroke/surgery* ; Stents ; Endovascular Procedures/methods* ; Thrombectomy/methods* ; Device Removal/methods*

OBJECTIVES: This study aimed to explore the clinical efficacy of severe early childhood caries (SECC) treatment combined with local anesthesia under general anesthesia. METHODS: A total of 108 children under 6 years old who underwent SECC dental treatment under general anesthesia at the Department of Pediatric Dentistry, Third Affiliated Hospital of Air Force Medical University from March to December 2023 were selected as the study subjects, with American Society of Anesthesiologists (ASA) classification of classⅠor Ⅱ. The study subjects were divided into a control group (n=54) and an experimental group (n=54) by retrieving intraoperative cases and postoperative follow-up records. The control group was given general anesthesia through inhalation combined with nasotracheal intubation, whereas the experimental group was given local anesthesia with 2% lidocaine on each treated tooth on the basis of general anesthesia. The basic information, preoperative anesthesia depth, hemodynamic changes during different surgical procedures, postoperative pain, and adverse reactions in the two groups were recorded and analyzed. RESULTS: No statistically significant difference was found in the basic information and preoperative anesthesia depth between the two groups (P>0.05). Among the three procedures (pulpotomy, root canal treatment, and tooth extraction), the three observed indicators in the experimental group were significantly lower than those in the control group (P<0.05). The proportion of patients in the experimental group who needed to take analgesic measures in accordance with the modified facial pain scale (FPS-R) score was significantly lower than that in the control group at postoperative wakefulness and 2 h after surgery (P<0.05). Meanwhile, no statistically significant difference was observed between the groups at 24 h after surgery (P>0.05). The proportion of patients in the experimental group who needed to take analgesic measures on the basis of the parent posto-perative pain measurement (PPPM) score was significantly lower than that in the control group when they were awake after surgery (P<0.05). No statistically significant difference was found between the groups at 2 and 24 h after surgery (P>0.05). Moreover, no statistically significant difference was observed in the incidence of adverse reactions between the two groups at 24 h after surgery (P>0.05). CONCLUSIONS The combination of local anesthesia during SECC dental treatment under general anesthesia results in minimal changes in intraoperative hemodynamics and mild postoperative pain response, hence worthy of clinical promotion.
Humans ; Anesthesia, General ; Child, Preschool ; Dental Caries/therapy* ; Pain, Postoperative/prevention & control* ; Anesthesia, Local/methods* ; Male ; Hemodynamics ; Female ; Lidocaine/administration & dosage* ; Child ; Anesthetics, Local/administration & dosage* ; Anesthesia, Dental/methods*

Objective To explore the relationship between triglyceride-glucose index(TyG)and acute ischemic stroke with large vessel occlusion(AIS-LVO)of anterior circulation.Methods A retrospective study was conducted on patients with anterior circulation AIS-LVO who underwent emergency endovascular thrombectomy at Neurovascular Center of The First Affiliated Hospital of Naval Medical University from Jan.2018 to Dec.2019.According to modified Rankin scale(mRS)score 90 d after operation,the patients were assigned to favorable outcome group(mRS score 0-2)or unfavorable outcome group(mRS score 3-6),and the TyG was compared.According to the median of TyG,the patients were assigned to low-TyG group(TyG＜8.57)or high-TyG group(TyG ≥8.57),and the clinical data,laboratory indexes,and imaging characteristics were compared.Receiver operating characteristic curve was used to evaluate the predictive value of TyG for poor prognosis.Results A total of 135 patients were enrolled,with 72 in the favorable outcome group and 63 in the unfavorable outcome group.The TyG of the unfavorable outcome group was significantly higher than that of the favorable outcome group(8.82+0.63 vs 8.43+0.60,P＜0.001).There were 67 patients in the low-TyG group and 68 in the high-TyG group.Compared with the low-TyG group,the proportion of patients with hyperlipidemia history(P=0.003),systolic blood pressure at admission(P=0.018),fasting blood glucose level(P＜0.001),and triglyceride level(P＜0.001)were significantly higher in the high-TyG group,the infarct core volume was significantly larger(P=0.025),the high density lipoprotein-cholesterol level was significantly lower(P=0.013),and the mRS score 90 d after operation was significantly higher(3[1,5]vs 1[0,5],P=0.049).The TyG had certain predictive value for poor prognosis in anterior circulation AIS-LVO patients(area under curve value=0.662,95％confidence interval 0.571-0.753).Conclusion TyG is elevated in anterior circulation AIS-LVO patients with poor prognosis,and may be a potential prognostic indicator for anterior circulation AIS-LVO patients.

Objective : To assess and to compare the diagnostic performance of cervical ultrasound and 18F fluorodeoxyglucose(18F-FDG PET/CT) in identifying cervical lymph node metastases in patients with differentiated thyroid cancer(DTC) following total thyroidectomy, focusing on both early and delayed imaging phases. Methods : A retrospective review was performed on 83 DTC patients with DTC who had undergone total thyroidectomy. A total of 143 cervical lymph nodes, comprising both metastatic and non-metastatic nodes, were evaluated using 18F-FDG PET/CT and ultrasound. Sensitivity, specificity, and overall diagnostic accuracy were calculated for each imaging modality. Differences in lymph node detection rates across cervical regions using ultrasound were analyzed, along with nodal size parameters(long and short axis diameters), to investigate potential limitations of ultrasound in this context. Additionally, PET/CT parameters including axial ratio, early and delayed maximum standardized uptake values(SUVmax), and changes in SUVmax between imaging timepoints(ΔSUVmax) were compared between metastatic and non-metastatic lymph nodes to evaluate the diagnostic value and underlying mechanisms of PET/CT in this clinical setting. Results : 18 F-FDG PET/CT demonstrated a sensitivity of 91 . 58% (98/107) , a specificity of 72. 22% (26/36) , and an overall diagnostic accuracy of 86. 71% (124/143) in identifying cervical lymph node metastases post-total thyroidectomy in DTC patients . In comparison , ultrasound showed a lower sensitivity of 50. 47% (54/107) , but a higher specificity of 97. 22% (35/36) , with an overall accuracy of 62. 24% (89/ 143) . Notably , ultrasound exhibited a significantly higher false-negative rate in the first cervical lymph node group compared to the second group [56. 6% (30/53 ) vs 43 . 4% (23/53 ) ; χ2 = 20. 396 , P < 0. 001] . In delayed PET/CT imaging , metastatic lymph nodes showed a significantly increased SUV max compared to early-phase imaging (Z = - 8. 147 , P < 0. 001) . Using an SUV max threshold of 2. 5 , delayed imaging identified a greater number of positive lymph nodes than early imaging ( χ2 = 18. 127 , P < 0. 001) . Furthermore , metastatic lymph nodes exhibi- ted a significantly lower axial ratio than non-metastatic nodes (Z = - 4. 529 , P < 0. 001) . Both early and delayed SUV max values were significantly higher in malignant nodes compared to benign ones (Z = - 3 . 689 , P < 0. 001 and Z = - 4. 550 , P < 0. 001 , respectively) . Additionally , ΔSUV max was markedly elevated in metastatic lymph nodes (Z = - 4. 189 , P < 0. 001) . Conclusion Dual-phase 18 F-FDG PET/CT proves to be superior to ultrasound in di- agnosing cervical lymph node metastasis in patients with differentiated thyroid cancer (DTC) following total thyroid- ectomy . Delayed-phase imaging offers higher tumor-to-background ratio , which enhances the visibility of metastatic lymph nodes . In addition , dual-phase 18 F-FDG PET/CT plays greater advantages in the differential diagnosis be- tween metastatic lymph nodes and non-metastatic lymph nodes .

[Objective]To summarize and analyze the research progress of flavonoids in the prevention and treatment of diabetes mellitus and its complications.[Methods]The role of flavonoids in diabetes mellitus and diabetic complications was summarized by searching the databases of Web of Science,PubMed,China National Knowledge Infrastructure,VIP,Wanfang and others for the reports of flavonoids and diabetes mellitus and diabetic complications from January 2013 to December 2022,and the role of flavonoids in diabetes mellitus and diabetic complications was summarized.[Results]Studies have confirmed that flavonoids(herbal flavonoid extracts,naringenin,galangal,kaempferol,etc.)are effective in preventing and treating diabetes and diabetes-induced retinopathy,nephropathy,cardiomyopathy,osteoporosis and diabetic foot.Overall regulation and comprehensive treatment are the characteristics of flavonoid components,which can inhibit inflammation,reduce oxidative stress,repair mitochondrial function,lower blood glucose,relieve insulin resistance and are able to influence the expression of related factors from multiple signaling pathways,thus treating diabetes and its complications.[Conclusion]The elaboration of the pharmacodynamic material basis,mechanism of action and constitutive relationship of Chinese medicine flavonoids against diabetes mellitus and its complications in multiple ways and at multiple levels are key issues to be solved in the development of flavonoids and an important direction for future research.

Improving the entire outpatient clinic experience is an important measure in the new era to enhance patients'sense of gain from medical treatment.Beijing Tongren Hospital Affiliated to Capital Medical University explores the establishment of a full-process outpatient service management system based on continuous improvement of medical services.Through the concept of forward service,it focuses on the patient's pre-diagnosis experience;the process is simplified and intelligently guided to optimize the patient's in-diagnosis experience;and continuous diagnosis and treatment Model innovation improves patients'post-diagnosis experience and creates a Chinese-style modern outpatient medical service model to continuously meet the people's growing needs for a better life.

Improving the entire outpatient clinic experience is an important measure in the new era to enhance patients'sense of gain from medical treatment.Beijing Tongren Hospital Affiliated to Capital Medical University explores the establishment of a full-process outpatient service management system based on continuous improvement of medical services.Through the concept of forward service,it focuses on the patient's pre-diagnosis experience;the process is simplified and intelligently guided to optimize the patient's in-diagnosis experience;and continuous diagnosis and treatment Model innovation improves patients'post-diagnosis experience and creates a Chinese-style modern outpatient medical service model to continuously meet the people's growing needs for a better life.

OBJECTIVE To explore the protective effect and mechanism of Longshengzhi capsules on cerebral ischemia- reperfusion injury in rats. METHODS The model of middle cerebral artery occlusion （MCAO） was established by using the improved thread occlusion method. The experiment was divided into six groups： sham surgery group （only separating blood vessels without inserting thread plugs， given the same volume of normal saline）， model group （modeling， given the same volume of normal saline）， nimodipine group （positive control， modeling， dose of 20 mg/kg）， and low-dose， medium-dose， and high-dose groups of Longshengzhi capsules （modeling， doses of 0.72， 1.44 and 2.88 g/kg， respectively）， with 10 mice in each group. Each group was given corresponding medication solution/normal saline by gavage， once a day， for 7 consecutive days. One hour after the last administration， the Zea Longa scoring method was used to score the neurological deficits in each group of rats， and the ABC enzyme-linked immunosorbent assay was used to detect the serum levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in rats； TTC staining was used to observe the volume of cerebral infarction in rats and calculate the cerebral infarction volume ratio. Hematoxylin eosin staining was used to observe the pathological changes in the brain tissue of rats. Immunohistochemical staining was used to detect the positive expression of NLRP3 protein in the brain tissue of rats. Real-time fluorescence quantitative PCR was used to detect mRNA relative expressions of Toll-like receptor 4 （TLR4） and nuclear factor-κB （NF-κB） in the brain tissue of rats. Western blot assay was adopted to detect the relative expressions of TLR4， NLRP3 and phosphorylated NF-κB （p-NF-κB） protein in the brain tissue of rats and its intracellular NF-κB protein. RESULTS Compared with the sham surgery group， the neural dysfunction score， serum levels of TNF-α and IL-6， cerebral infarction volume ratio， relative expression levels of NF-κB and TLR4 mRNA， as well as protein relative expressions of TLR4， NLRP3 and p-NF-κB in the brain tissue， and relative protein expression of intracellular NF-κB were increased significantly in the model group （P＜0.01）； the enlarged gap and significant edema were observed in cortical nerve cells of brain tissue in rats， with a large amount of inflammatory cell infiltration； the positive expression of NLRP3 protein in brain tissue of rats obviously increased. Compared with the model group， the levels of the above indicators in the medium-dose and high-dose groups of Longshengzhi capsules， as well as the Nimodipine group， were reversed to varying degrees， and most differences were statistically significant （P＜0.05 or P＜0.01）； the pathological morphology observation showed a significant improvement， and the positive expression of NLRP3 protein in the brain tissue of rats was obviously reduced. CONCLUSIONS Longshengzhi capsules may inhibit TLR4/NF-κB/NLRP3 signaling pathway and neuroinflammatory response， thereby achieving a protective effect against cerebral ischemia-reperfusion injury in rats.

Improving the entire outpatient clinic experience is an important measure in the new era to enhance patients'sense of gain from medical treatment.Beijing Tongren Hospital Affiliated to Capital Medical University explores the establishment of a full-process outpatient service management system based on continuous improvement of medical services.Through the concept of forward service,it focuses on the patient's pre-diagnosis experience;the process is simplified and intelligently guided to optimize the patient's in-diagnosis experience;and continuous diagnosis and treatment Model innovation improves patients'post-diagnosis experience and creates a Chinese-style modern outpatient medical service model to continuously meet the people's growing needs for a better life.

Improving the entire outpatient clinic experience is an important measure in the new era to enhance patients'sense of gain from medical treatment.Beijing Tongren Hospital Affiliated to Capital Medical University explores the establishment of a full-process outpatient service management system based on continuous improvement of medical services.Through the concept of forward service,it focuses on the patient's pre-diagnosis experience;the process is simplified and intelligently guided to optimize the patient's in-diagnosis experience;and continuous diagnosis and treatment Model innovation improves patients'post-diagnosis experience and creates a Chinese-style modern outpatient medical service model to continuously meet the people's growing needs for a better life.