Objective To analyze the changes in serum levels of Krüppel-like transcription factors(KLF11)and long non-coding RNA small nucleolar RNA host gene 12(lncRNA SNHG12)in patients with intracranial aneurysm(IA),and their predictive value for prognosis.Methods A retrospective analysis was performed on 132 IA patients(IA group)who underwent interventional embolization for IA rupture and bleeding from February 2019 to February 2023,and 60 healthy people who underwent outpatient physical examination during the same period were selected as the control group.Serum levels of KLF11 was detected by enzyme-linked immunosorbent assay(ELISA),the level of lncRNA SNHG12 was detected by real-time fluorescence quantitative PCR(qRT-PCR).According to the modified Rankin scale(MRS)score,IA patients were divided into a good prognosis group(n=98,MRS score 0～2)and poor prognosis group(n=34,MRS score 3～6).Pearson correlation analysis was used to analyze the correlation between serum KLF11,lncRNA SNHG12 and cerebral hemodynamic parameters.Logistic regression analysis was used to analyze the factors affecting the prognosis of IA patients.The receiver operating characteristic curve was used to analyze the prognostic value of serum KLF11 and lncRNA SNHG12 in IA patients.Results The serum KLF11(47.12±6.58ng/L)and lncRNA SNHG12(1.89±0.36)in the IA group were lower than those in the control group(113.89±19.35ng/L,3.24±0.58),and the differences were statistically significant(t=19.695,35.476,all P<0.05).The levels of serum KLF11 and lncRNA SNHG12 in IA group were positively correlated with cerebral blood flow,cerebral blood volume and mean transit time(rKLF11=0.722,0.627,0.752;rlncRNA SNHG12=0.630,0.714,0.766,all P<0.05),and negatively correlated with intracranial pressure(r=-0.658,-0.599,all P<0.05).The proportion of CT Fisher grade 3～4 in IA patients in the poor prognosis group was higher than that in the good prognosis group,and the postoperative complication rate was higher than that in the good prognosis group,the serum KLF11(35.98±6.11 ng/L)and lncRNA SNHG12(1.12±0.30)levels were lower than those in the good prognosis group(50.98±6.90ng/L,2.16±0.39),and the differences were statistically significant(t=4.630～14.151,all P<0.05).CT Fisher grade 3～4,postoperative complications were risk factors for poor prognosis of IA patients(Wald χ2=8.403,12.049,all P<0.001),serum KLF11,lncRNA SNHG12 were protective factors(Wald χ2=5.550,7.904,all P<0.001).The AUC(95%CI)for predicting the prognosis of IA patients with the combination of serum KLF11 and lncRNA SNHG12 was 0.921(0.889～0.942),which was higher than the single detection of serum KLF11 and lncRNA SNHG12 at 0.848(0.805～0.886)and 0.810(0.767～0.852),and the differences were statistically significant(Z=5.886,4.367,all P<0.001).Conclusion The levels of serum KLF11 and lncRNA SNHG12 in IA patients are decreased,which are related to cerebral hemodynamic parameters.The combined detection has a high evaluation value for the prognosis of IA patients.

Objective To investigate the DSA imaging characteristics and efficacy of interventional treatment for post-pancreaticoduodenectomy hemorrhage(PPH),and to analyze the factors influencing recurrent bleeding following successful interventional hemostasis.Methods Clinical data of patients who underwent interventional treatment for PPH between January 2013 and December 2022 were retrospectively analyzed.All patients underwent DSA examination,and interventional therapy was the primary treatment option for patients with positive findings.Statistical analysis was performed on DSA angiography manifestations,bleeding sites,success rate of interventional treatment and hemostasis effectiveness.Univariate and multivariate logistic regression analysis were used to analyze the independent risk factors for rebleeding after interventional treatment for PPH.Results A total of 139 patients with PPH were included in this study.All 139 patients underwent DSA examination,with a positive rate of 82.01％(114/139)in the first examination.Major angiographic manifestations included contrast agent extravasation,pseudoaneurysm,and disrupted vascular architecture;bleeding sites included gastroduodenal artery in 45 cases(39.47％),hepatic artery in 22 cases(19.30％),and superior mesenteric artery in 32 cases(28.07％).107 patients underwent interventional treatment(81 embolization and 26 stenting),with a success rate of 91.59％(98/107).The independent risk factors for recurrent bleeding after interventional treatment in patients with PPH included preoperative bleeding(P＜0.001)and pancreatic fistula(P=0.041).Conclusion Interventional procedures for PPH can be efficient in diagnosis and treatment,with a high success rate and effective hemostasis.However,it should be noted that some patients remain at risk of recurrent bleeding after successful interventional hemostasis.

Objective To analyze the changes in serum levels of Krüppel-like transcription factors(KLF11)and long non-coding RNA small nucleolar RNA host gene 12(lncRNA SNHG12)in patients with intracranial aneurysm(IA),and their predictive value for prognosis.Methods A retrospective analysis was performed on 132 IA patients(IA group)who underwent interventional embolization for IA rupture and bleeding from February 2019 to February 2023,and 60 healthy people who underwent outpatient physical examination during the same period were selected as the control group.Serum levels of KLF11 was detected by enzyme-linked immunosorbent assay(ELISA),the level of lncRNA SNHG12 was detected by real-time fluorescence quantitative PCR(qRT-PCR).According to the modified Rankin scale(MRS)score,IA patients were divided into a good prognosis group(n=98,MRS score 0～2)and poor prognosis group(n=34,MRS score 3～6).Pearson correlation analysis was used to analyze the correlation between serum KLF11,lncRNA SNHG12 and cerebral hemodynamic parameters.Logistic regression analysis was used to analyze the factors affecting the prognosis of IA patients.The receiver operating characteristic curve was used to analyze the prognostic value of serum KLF11 and lncRNA SNHG12 in IA patients.Results The serum KLF11(47.12±6.58ng/L)and lncRNA SNHG12(1.89±0.36)in the IA group were lower than those in the control group(113.89±19.35ng/L,3.24±0.58),and the differences were statistically significant(t=19.695,35.476,all P<0.05).The levels of serum KLF11 and lncRNA SNHG12 in IA group were positively correlated with cerebral blood flow,cerebral blood volume and mean transit time(rKLF11=0.722,0.627,0.752;rlncRNA SNHG12=0.630,0.714,0.766,all P<0.05),and negatively correlated with intracranial pressure(r=-0.658,-0.599,all P<0.05).The proportion of CT Fisher grade 3～4 in IA patients in the poor prognosis group was higher than that in the good prognosis group,and the postoperative complication rate was higher than that in the good prognosis group,the serum KLF11(35.98±6.11 ng/L)and lncRNA SNHG12(1.12±0.30)levels were lower than those in the good prognosis group(50.98±6.90ng/L,2.16±0.39),and the differences were statistically significant(t=4.630～14.151,all P<0.05).CT Fisher grade 3～4,postoperative complications were risk factors for poor prognosis of IA patients(Wald χ2=8.403,12.049,all P<0.001),serum KLF11,lncRNA SNHG12 were protective factors(Wald χ2=5.550,7.904,all P<0.001).The AUC(95%CI)for predicting the prognosis of IA patients with the combination of serum KLF11 and lncRNA SNHG12 was 0.921(0.889～0.942),which was higher than the single detection of serum KLF11 and lncRNA SNHG12 at 0.848(0.805～0.886)and 0.810(0.767～0.852),and the differences were statistically significant(Z=5.886,4.367,all P<0.001).Conclusion The levels of serum KLF11 and lncRNA SNHG12 in IA patients are decreased,which are related to cerebral hemodynamic parameters.The combined detection has a high evaluation value for the prognosis of IA patients.

Objective:To evaluate the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) combined with lenvatinib and tislelizumab in the treatment of unresectable intrahepatic cholangiocarcinoma (ICC).Methods:The clinical data of 12 patients with unresectable ICC who received HAIC combined with lenvatinib and tislelizumab in the First Affliated Hospital of Soochow University from October 2021 to April 2023 were retrospectively analyzed. HAIC included gemcitabine plus oxaliplatin; this regimen was combined with lenvatinib and tislelizumab within 3-7 days after its initial administration. Relevant laboratory examinations were performed before each cycle of HAIC, and enhanced computed tomography/magnetic resonance imaging examinations were performed every 6-9 weeks. Tumor response to treatment was evaluated using the modified Response Evaluation Criteria in Solid Tumors. The objective response rate, disease control rate, progression-free survival, overall survival, and treatment-related adverse reactions of patients with ICC were statistically analyzed.Results:The objective response rate to HAIC combined with lenvatinib and tislelizumab was 6/12; the disease control rate was 8/12; the median progression-free survival was 11.8 months; and the median overall survival was 14.2 months. Three patients had grade Ⅳ adverse reactions (increased alanine aminotransferase and aspartate aminotransferase thrombocytopenia), while three patients had grade Ⅲ adverse reactions (increased total bilirubin, alanine aminotransferase, and aspartate aminotransferase). The remaining patients had grade Ⅰ-Ⅱ adverse reactions. There were no serious complications related to interventional surgery.Conclusions:Use of HAIC (gemcitabine plus oxaliplatin) combined with lenvatinib and tislelizumab in the treatment of unresectable ICC may be safe and feasible. Preliminary clinical studies have shown that this combination can improve the survival and prognosis of patients with ICC.

OBJECTIVE To explore the systemic prevention messures of ventilator-associated pneumonia(VAP).METHODS Mesures were taken to 54 patients to prevent infection in 54 from 2006 to 2008 and 52 patients with similar symptoms at the same interval time were chosed as control.RESULTS In the test group VAP occurred in 14.81%,with(11.11%) of mortality.In control group VAP accounted for 42.31%,with(26.92%) of mortality.CONCLUSIONS Systemic prevention messures can decrease VAP occurrance.