Background: and Purpose In patients with large vessel occlusion (LVO), intravenous thrombolysis (IVT) frequently alters thrombus location; however, the clinical impact of this phenomenon remains unclear. We aimed to compare post-IVT thrombus dynamics between tenecteplase and alteplase and to evaluate the association between thrombus dynamics and 3-month outcomes. Methods: This retrospective study analyzed prospectively collected, multicenter data from consecutive patients with LVO who underwent bridging therapy between January 2022 and December 2024. Thrombus dynamics were classified as resolution, migration, or stability. Analyses incorporated propensity score matching with weighting to balance baseline characteristics. Results: Of the 806 initially included patients, 746 were included after matching (373 treated with tenecteplase and 373 treated with alteplase). The incidence of thrombus migration was significantly higher in the tenecteplase group than in the alteplase group (19.3% vs. 11.3%; odds ratio [OR]: 1.92; 95% confidence interval [CI] 1.27–2.91). The advantage of tenecteplase over alteplase was restricted to patients with an IVT-to-puncture time of <60 minutes (18.6% vs. 6.2%; p=0.001) and was no longer significant when the interval ≥60 minutes (19.7% vs. 15.0%; p=0.204; pinteraction=0.043). Additionally, thrombus migration was associated with a better functional outcome (OR: 1.62; 95% CI 1.04–2.53). Finally, tenecteplase was associated with improved functional independence compared with alteplase (OR: 1.43; 95% CI 1.04–1.95). Conclusions Tenecteplase demonstrated superior efficacy in inducing thrombus migration compared with alteplase, particularly within 60 minutes of IVT administration. Thrombus migration independently predicted improved functional independence. These findings support the preferential use of tenecteplase for bridging therapy in patients with LVO.

Objective To preoperatively predict microvascular invasion(MVI)in intrahepatic cholangiocarcinoma(ICC)using clinical data and computed tomography(CT)signs.Methods A retrospective analysis was conducted on the preoperative clinical data and CT images of 173 ICC patients with complete surgical pathological results.Among them,102 were MVI-negative and 71 were MVI-positive.Results Statistically significant differences were observed between the MVI-positive and MVI-negative groups in liver cirrhosis,alpha-fetoprotein,alanine aminotransferase(ALT),margin,and capsule(P<0.05).Univariate analysis identified liver cirrhosis(OR=0.530,95%CI:0.286-0.983,P=0.044),unsmooth tumor margin(OR=19.362,95%CI:5.717-65.575,P<0.001),and incomplete capsule(OR=2.983,95%CI:1.544-5.760,P=0.001)as risk factors for predicting MVI.Multivariate analysis revealed that elevated ALT(OR=0.164,95%CI:0.030-0.884,P=0.035),unsmooth tumor margin(OR=35.816,95%CI:7.486-171.36,P<0.001),and incomplete capsule(OR=4.234,95%CI:1.211-14.801,P=0.024)were independent predictors of MVI.Conclusion Elevated ALT,unsmooth tumor margin,and incomplete capsule are highly correlated with MVI in ICC patients.

Solitary fibrous tumors（SFT）is rare Mesenchymal tissue tumor，originally identified and usually found in the pleura，but the incidence of SFT in the spermatic cord is particularly rare.This article reported a case of a 37-year-old patient who was admitted for a right inguinal mass over the past 2 years. Preoperative MR examination showed a right spermatic cord-derived mass. Under spinal anesthesia，excision of the right spermatic cord mass was performed. Postoperative pathological diagnosis was spermatic cord solitary fibrous tumor. Twelve months of follow-up revealed no metastasis and recurrence on imaging examination. Solitary fibrous tumors of the spermatic cord are rare and require a combination of pathological examination and immunohistochemistry to confirm the diagnosis. Once the diagnosis is confirmed，tumor resection should be performed as soon as possible，and benign lesions are also at risk of recurrence，and long-term follow-up is required after surgery.

This article reports a case of a 55-year-old patient who was admitted to the hospital due to an 8-year history of a right epididymal mass and intermittent right scrotal heaviness for 1 month. Preoperative ultrasound examination revealed a right epididymal cyst and right testicular hydrocele. Under general anesthesia, a right epididymal mass resection and right testicular tunica vaginalis inversion procedure were performed. Postoperative pathological diagnosis was epididymal papillary cystadenoma. The patient has been followed up for 1 year with no recurrence and malignancy. Epididymal papillary cystadenoma, a rare benign tumor, lacks specific clinical and imaging features, often leading to misdiagnosis as seminal vesicle cysts or malignant tumors. If associated with von Hippel-Lindau syndrome, bilateral occurrence should be considered to prevent missed diagnosis and treatment delay.

This article reports a case of a 55-year-old patient who was admitted to the hospital due to an 8-year history of a right epididymal mass and intermittent right scrotal heaviness for 1 month. Preoperative ultrasound examination revealed a right epididymal cyst and right testicular hydrocele. Under general anesthesia, a right epididymal mass resection and right testicular tunica vaginalis inversion procedure were performed. Postoperative pathological diagnosis was epididymal papillary cystadenoma. The patient has been followed up for 1 year with no recurrence and malignancy. Epididymal papillary cystadenoma, a rare benign tumor, lacks specific clinical and imaging features, often leading to misdiagnosis as seminal vesicle cysts or malignant tumors. If associated with von Hippel-Lindau syndrome, bilateral occurrence should be considered to prevent missed diagnosis and treatment delay.

Objective To preoperatively predict microvascular invasion(MVI)in intrahepatic cholangiocarcinoma(ICC)using clinical data and computed tomography(CT)signs.Methods A retrospective analysis was conducted on the preoperative clinical data and CT images of 173 ICC patients with complete surgical pathological results.Among them,102 were MVI-negative and 71 were MVI-positive.Results Statistically significant differences were observed between the MVI-positive and MVI-negative groups in liver cirrhosis,alpha-fetoprotein,alanine aminotransferase(ALT),margin,and capsule(P<0.05).Univariate analysis identified liver cirrhosis(OR=0.530,95%CI:0.286-0.983,P=0.044),unsmooth tumor margin(OR=19.362,95%CI:5.717-65.575,P<0.001),and incomplete capsule(OR=2.983,95%CI:1.544-5.760,P=0.001)as risk factors for predicting MVI.Multivariate analysis revealed that elevated ALT(OR=0.164,95%CI:0.030-0.884,P=0.035),unsmooth tumor margin(OR=35.816,95%CI:7.486-171.36,P<0.001),and incomplete capsule(OR=4.234,95%CI:1.211-14.801,P=0.024)were independent predictors of MVI.Conclusion Elevated ALT,unsmooth tumor margin,and incomplete capsule are highly correlated with MVI in ICC patients.

Solitary fibrous tumors（SFT）is rare Mesenchymal tissue tumor，originally identified and usually found in the pleura，but the incidence of SFT in the spermatic cord is particularly rare.This article reported a case of a 37-year-old patient who was admitted for a right inguinal mass over the past 2 years. Preoperative MR examination showed a right spermatic cord-derived mass. Under spinal anesthesia，excision of the right spermatic cord mass was performed. Postoperative pathological diagnosis was spermatic cord solitary fibrous tumor. Twelve months of follow-up revealed no metastasis and recurrence on imaging examination. Solitary fibrous tumors of the spermatic cord are rare and require a combination of pathological examination and immunohistochemistry to confirm the diagnosis. Once the diagnosis is confirmed，tumor resection should be performed as soon as possible，and benign lesions are also at risk of recurrence，and long-term follow-up is required after surgery.

Objective To establish a canine model of intervertebral disc extrusion by surgery and observe the histological and microcirculatory changes of the spinal cord , in order to accumulate data for studies on the pathology and mechanism of treatment for intervertebral disc extrusion .Methods Normal healthy adult dogs were divided randomly into two groups:normal control group and model group .To simulate the intervertebral disc extrusion caused by spinal cord compression, 6Fr double lumen catheter with ballon was inserted into the spinal cord T 12-T13 and filled with about 5 mL Iohexol after the exposure of spinal cord L 1 by hemilaminectomy .The spinal cord blood flow ( SCBF) at the L1 level before and after compression was measured by laser-Doppler flowmetry .Morphological changes of the compressed spinal cord at 14 days after compression was examined by histopathology .Results The ( Texas spinal cord injury score ) ( TSCIS) scores of the motor function of bilateral hind limbs were highly significantly decreased (P<0.01).The blood flow of spinal cord at the L1 level was significantly decreased (P<0.05) after compression than that before .Compared with the normal control group, the model group showed abnormal vacuolization in the white matter and the number of normal neurons in the ventral horn of gray matter was significantly lower ( P<0.01 ) .Conclusions Our findings demonstrate that canine models of intervertebral disc extrusion can be successfully established by balloon catheter compression , showing local impairment of microcirculation and histological changes in the spinal cord .This canine model may provide a useful model for evaluation of therapeutic effects of acupuncture and for mechanism studies .

Objective To explore the feasibility,the safety,D2 lymph node dissection and clinical outcomes of laparoscope-assisted radical gastrectomy lot advanced gastric cancer.Methods The clinica data of 47 cases with advanced gastric treated with laparoscope-assisted radical gastrectomy were analyzed retrospectively.Results Laparoscope-assisted radical gastrectomy,proximal gastrectomy in 25 cases,distalgastrectomy in 11 cases,total gastrectomy in 10 cases;46 were performed Laparoscope-assisted surgery radical gastrectomy successfuly,and the other one was converted to abdominal opening.The average operative time for proximal gastrectomy,distal gastrectomy,and total gastrectomy was(220±55)min,(284±37)min,and (330±50)min,respectivel.The average blood loss in proximal gastrectomy,distal gastrectomy,and total gastrectomy was(150±87)ml,(120±70)ml,and(330±50)ml respectively.The average time of proximal gastrectomy for gastrointestinal function recovery,for the patients to stand up,and for the postoperative hospital stay was(5.1±0.5)d,(3.2±0.8)d and(9.0±1.5)d.The average time of distal gastrectomy for gastrointestinal function recovery,for the patients to stand up,and for the postoperative hospital stay was (4.0±0.8)d,(3.2±1.5)d and(9.0±2.0)d.The average time of total gastrectomy for gastrointestinal function recovery,for the patients to stand up,and for the postoperative hospital stay was(4.1±0.8)d,(3.2±0.8)d and(9.5±2.0)d.The mean total number of retrieved lymph nodes was(21.95±9.88),and the lengths of proximal and distal margins to the tumor were(6.41±2.13)cm and(6.22±1.98)cm respectively.No postoperative deaths or anastomtic fistulas were found.Its short-term outcomes were satisfactory.Conclusion Laparoscope-assisted radical gastrectomy with D2 lymphadenectomy is safe,feasible,which achieves adequate cancer clearance,but the long-term outcome is needed to be observed.

ObjectiveTo observe the effect of immunoloregulation induced by tripterygium glycosides on experimental IgA nephropathy in rats.MethodsRat model of IgA nephropathy was established with bovine serum albumin and staphylococcal enterotoxins compound immunization.The urine erythrocyte,urine protein in 24 h,renal function,erythrocyte C3b receptor rosette rate and kidney constitution pathology alteration among the normal control group,model group and tripterygium glycosides group were compared.ResultsCompared with the model group,urine erythrocyte,urine protein,serum Cr and BUN reduced( P<0.05),erythrocyte C3b receptor rosette rate was higher(P<0.05),IgA depositing on glomerular mesangial region was less and renal function improved in rats of the tripterygium glycosides group.ConclusionTripterygium glycosides have better therapeutic effect and adjusting action for immune disturbance.