Objective To evaluate the efficacy of intravascular intervention in the treatment of multiple intracranial aneurysms(MIAs).Methods The clinical data of MIAs patients,who were treated with intravascular intervention from December 2013 to December 2021 in Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,were collected and were analyzed by using statistical methods.Results A total of 105 MIAs patients were enrolled in this study,and among them 77 patients(73.3％)were complicated by subarachnoid haemorrhage.Intravascular intervention was performed for 192 of the 240(80.0％)intracranial aneurysms(I As),including 142 IAs receiving one-stage treatment and 50 IAs receiving multi-stage treatment.In 66 patients,all the IAs were treated.Simple spring coil embolization was performed for 84 IAs and stent-assisted spring coil embolization was carried out for 108 IAs.During the follow-up period,11 patients developed recurrent IAs,which received treatment again.There was no obvious statistical difference in the treatment results between the patients receiving one-stage treatment and the patients receiving multi-stage treatment(P＞0.05).There was also no obvious statistical difference in the follow-up findings and prognosis results between the patients receiving one-stage treatment and the patients receiving multi-stage treatment(P＞0.05).Conclusion For the treatment of MIAs,the clinical efficacy of one-stage intravascular treatment and multi-stage intravascular treatment is roughly the same.However,one-stage treatment should be adopted as far as possible when the technical conditions permit.

Objective:To investigate the clinical features and prognostic factors of newly-treated elderly acute myeloid leukemia (AML) patients with intermediate-risk karyotype.Methods:A retrospective case series study was conducted. A total of 87 newly-treated elderly AML patients with intermediate-risk karyotype in the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from January 2013 to December 2023 were selected. The clinical characteristics were summarized. The Kaplan-Meier method was used for survival analysis and Cox proportional hazards model was used to make univariate and multivariate analyses of prognostic factors.Results:The median age [ M ( Q1, Q3)] of 87 patients was 69 (60, 87) years. The patients with normal karyotype and abnormal karyotype accounted for 77.1% (67/87), 22.9% (20/87), respectively. A total of 74 patients (85.1%) had 1 or more gene mutations, of which FLT3-ITD, NPM1 mutation, CEBPA mutation and WT1 high expression accounted for 29.9% (26/87), 26.4% (23/87), 19.5% (17/87), and 65.5% (57/87), respectively; additionally, 44.7% (39/87) of patients had 2 or more gene mutations. The objective response rate of patients after induction therapy was 47.7% (41/87), while the relapse rate was 73.2% (30/41). The median progression-free survival (PFS) time was 7.8 months, and the median overall survival (OS) time was 12.1 months. Univariate analysis result revealed that age, FLT3-ITD, hypomethylating agents, and minimal residual disease complete remission (MDR-CR) were factors influencing the OS of newly-treated elderly AML patients with intermediate-risk karyotype (all P < 0.05). Multivariate analysis indicated that MDR-CR was an independent risk factor for OS (yes vs. no: HR = 0.27, 95% CI: 0.14-0.51, P < 0.001). Conclusions:Newly-treated elderly AML patients with intermediate-risk karyotype have a high relapse rate and poor prognosis, and MDR-CR is identified as an independent influencing factor for the prognosis of these patients.

Migraine is a common neurological disorder with a complex pathogenesis that is currently not fully understood;however,the role of mitochondrial function in migraine pathogenesis has recently attracted widespread attention.This review considers the latest research progress on the relationship between mitochondrial dysfunction and migraine,including mitochondrial energy metabolism,oxidative stress,calcium homeostasis,and neuroinflammation.We introduce the epidemiological and clinical characteristics of migraine,and provide a detailed exploration of the key role of mitochondria in these processes.Mitochondrial dysfunction may lead to increased neuronal excitability,abnormal vasoconstriction,and inflammatory responses,thereby inducing migraine.Based on the evidence of mitochondrial involvement in the pathogenesis of migraine,we propose future research directions and potential treatment strategies,with the aim of providing new ideas for the prevention and treatment of migraine.

Through reviewing literature on thyroid cancer management strategies, this article discusses the problems of active monitoring strategies, the real implementation status, and the hidden dangers of thermal ablation as a downgrade treatment. It points out that further research is needed to accurately identify low-risk PTMCs and implement active monitoring methods. The improvement in the 5-year survival rate of thyroid cancer is due to standardized diagnosis and treatment. At present, it is still too early to downgrade the diagnosis and treatment of thyroid cancer in China. The World Health Organization recommends the three early principles of early detection, early diagnosis, and early treatment for the treatment of malignant tumors as the fundamental principles of thyroid cancer diagnosis and treatment.

Objective To explore the impact and prevention strategies of medical device adverse events in a children's hospital,and to improve the monitoring and management capabilities of medical device adverse events.Methods We retrieved 367 medical device adverse events that occurred in a children's hospital from 2017 to 2022.Using Excel software,we analyzed,organized,and statistically summarized the annual reports of adverse events,the distribution of event grades,the age distribution of involved patients,and the main medical devices involved.Results The annual reports of medical device adverse events showed an overall upward trend.Grade Ⅲ and Ⅳ adverse events accounted for the majority,representing 97.28％of the total re-ports.The main age group affected was 0-3 years old,accounting for 43.60％of the total adverse event reports.Disposable ster-ile syringes,disposable vacuum blood collection tubes,disposable gastric tubes,disposable infusion sets(with needles),dispos-able intravenous catheters,and other polymer products accounted for a high proportion of adverse events.Adverse events related to infusion,nursing,and protective equipment also accounted for a high proportion.Conclusion Adopting measures such as continuous monitoring and analysis of medical device adverse event reports,improving the construction of adverse event systems,strengthening professional skill training for medical staff,and enhancing quality management are conducive to improving the man-agement level of medical device adverse events in hospitals and ensuring patient safety.

Through reviewing literature on thyroid cancer management strategies, this article discusses the problems of active monitoring strategies, the real implementation status, and the hidden dangers of thermal ablation as a downgrade treatment. It points out that further research is needed to accurately identify low-risk PTMCs and implement active monitoring methods. The improvement in the 5-year survival rate of thyroid cancer is due to standardized diagnosis and treatment. At present, it is still too early to downgrade the diagnosis and treatment of thyroid cancer in China. The World Health Organization recommends the three early principles of early detection, early diagnosis, and early treatment for the treatment of malignant tumors as the fundamental principles of thyroid cancer diagnosis and treatment.

Migraine is a common neurological disorder with a complex pathogenesis that is currently not fully understood;however,the role of mitochondrial function in migraine pathogenesis has recently attracted widespread attention.This review considers the latest research progress on the relationship between mitochondrial dysfunction and migraine,including mitochondrial energy metabolism,oxidative stress,calcium homeostasis,and neuroinflammation.We introduce the epidemiological and clinical characteristics of migraine,and provide a detailed exploration of the key role of mitochondria in these processes.Mitochondrial dysfunction may lead to increased neuronal excitability,abnormal vasoconstriction,and inflammatory responses,thereby inducing migraine.Based on the evidence of mitochondrial involvement in the pathogenesis of migraine,we propose future research directions and potential treatment strategies,with the aim of providing new ideas for the prevention and treatment of migraine.

Objective To explore the impact and prevention strategies of medical device adverse events in a children's hospital,and to improve the monitoring and management capabilities of medical device adverse events.Methods We retrieved 367 medical device adverse events that occurred in a children's hospital from 2017 to 2022.Using Excel software,we analyzed,organized,and statistically summarized the annual reports of adverse events,the distribution of event grades,the age distribution of involved patients,and the main medical devices involved.Results The annual reports of medical device adverse events showed an overall upward trend.Grade Ⅲ and Ⅳ adverse events accounted for the majority,representing 97.28％of the total re-ports.The main age group affected was 0-3 years old,accounting for 43.60％of the total adverse event reports.Disposable ster-ile syringes,disposable vacuum blood collection tubes,disposable gastric tubes,disposable infusion sets(with needles),dispos-able intravenous catheters,and other polymer products accounted for a high proportion of adverse events.Adverse events related to infusion,nursing,and protective equipment also accounted for a high proportion.Conclusion Adopting measures such as continuous monitoring and analysis of medical device adverse event reports,improving the construction of adverse event systems,strengthening professional skill training for medical staff,and enhancing quality management are conducive to improving the man-agement level of medical device adverse events in hospitals and ensuring patient safety.

Objective:To investigate the correlation between clinical phenotypes and genetic characteristics of children with ring chromosomes (RCs).Methods:Case series study.The clinical data of 11 434 children who received treatment and peripheral blood chromosome karyotype detection in Henan Children′s Hospital from October 2008 to October 2023 due to growth retardation, intellectual impairment or congenital malformation were analyzed retrospectively.A total of 25 children with RCs were selected.Their age at diagnosis, karyotype distribution, clinical manifestations, and genetic detection results were analyzed.Results:RCs were detected in 25 out of 11 434 children, with a detection rate of 0.21%.The genome-wide copy number variation (CNV) analysis was performed on 7 RCs cases, and it found that pathogenic variation existed in all of them.Among the 25 RC cases (11 males and 14 females of social gender), the age at diagnosis ranged from 2 months to 14 years; there were 20 autosomal rings and 5 sex chromosome rings; 13 cases had chimeric karyotypes, and 12 cases had non-chimeric karyotypes.Most of the 25 children showed clinical manifestations of mental or developmental retardation, and some also presented with specific clinical manifestations, such as short stature, congenital malformation, and epilepsy.Conclusions:The pathogenesis of RCs is complex.The clinical manifestations are determined by both RCs syndrome and specific phenotypes caused by the dose effect and exhibit high heterogeneity, so it is easy to miss or misdiagnose.The combined application of cellular and molecular genetic detection technology can facilitate early diagnosis and treatment of RCs, and the correlation analysis of phenotypes and genetic characteristics can provide guidance for genetic counseling.

BACKGROUND:The medial patellofemoral ligament reconstruction is the most commonly used method for the treatment of lateral dislocation of patella at present.The ultimate goal is to adjust the patella to the normal anatomical position and restore the patella track.Currently,the main core problem of medial patellofemoral ligament reconstruction is the selection of its femoral end fixation point. OBJECTIVE:Finite element method was used to analyze the limiting effect of the reconstructed medial patellofemoral ligament on the patella at different flexion angles of the knee joint,and to simulate the limiting effect of medial patellofemoral ligament reconstruction at different fixation points of the femoral end on the patellofemoral end,so as to provide help for the selection of fixation points of the femoral end during the reconstruction of the medial patellofemoral ligament. METHODS:A finite element model of knee including bone and soft tissue was established according to the extracted CT and MRI data of knee joint.When the knee flexion angle of 30° and 60° was simulated,the medial patellofemoral ligament was constructed by selecting different fixation points of femur end.The contact stress and contact area between patellofemoral joints at different points were compared,as well as the transverse binding force on patella.The equilength of the medial patellofemoral ligament constructed from the same fixation point of the femoral end at different flexion angles was verified to study the effect of various reconstruction positions of the medial patellofemoral ligament. RESULTS AND CONCLUSION:(1)A three-dimensional finite element model of the knee joint at 30° and 60° flexion angles was established to construct the medial patellofemoral ligament at different fixation points of the femur end.The medial patellofemoral ligament constructed at the same position of the femur end had usable isometric length at different flexion angles.(2)After the lateral displacement of the patella,in the transverse direction,the medial patellofemoral ligament constructed at different fixed points of the femur end produced different transverse binding force on the patella,and the transverse binding force was maximum at the anterior 10 mm and minimum at the proximal 5 mm.In the longitudinal direction,the location and size of stress concentration points on the patella cartilage were roughly the same,and the contact pressure did not change much.However,the contact area between the patella cartilage and the femoral cartilage was significantly different,with the maximum contact area at 10 mm at the front end and the minimum contact area at 5 mm at the proximal end.(3)The medial patellofemoral ligament constructed at the center of the saddle region has a good lateral restriction on the patella,but does not cause excessive restriction on the patella in the longitudinal restriction,and can achieve a good restriction on the patella.