Objective:To compare the efficacy and safety of flow diverter (FD) implantation versus stent-assisted coil embolization (SACE) in unruptured saccular aneurysms located at distal segments of the Willis circle.Methods:A retrospective study was performed; 119 patients with unruptured saccular aneurysms located at distal segments of the Willis circle who received FD implantation or SACE in Department of Neurosurgery, Guangdong Provincial People's Hospital, Southern Medical University and Department of Cerebrovascular Surgery, Neurosurgery Center, Southern Medical University from January 2018 to May 2025 were selected. According to different surgical methods, they were divided into a FD group ( n=60) and a SACE group ( n=59). These patients were subjected to propensity score matching (PSM) using 1:1 nearest neighbor matching method to eliminate confounding factors such as gender, age, aneurysm location, and aneurysm diameter (maximum diameter); and then, differences in neurological functional prognosis (good prognosis: modified Rankin scale scores of 0-2), complete aneurysm occlusion rate (O'Kelly-Marotta grade D or Raymond occlusion classification class I), and overall (perioperative and follow-up) complications were compared between the two groups. Results:After PSM, there were 43 patients in both FD group and SACE group. No significant difference was found in clinical and imaging follow-ups (12[6, 19] months vs. 10[6, 15] months, 10[5, 19] months vs. 9[2, 15] months) between the FD group and SACE group ( P>0.05). At the last imaging follow-up, the complete aneurysm occlusion rate in the FD group (65.1%[28/43]) was significantly lower than that in the SACE group (76.7%[33/43], P<0.05). At the last clinical follow-up, no significant difference was noted in good prognosis rate (95.3%[41/43] vs. 97.7%[42/43]) and overall complication rate (30.2%[13/43] vs. 18.6%[8/43]) between the FD group and SACE group ( P>0.05). Conclusion:Both FD implantation and SACE are safe and effective for unruptured saccular aneurysms located at distal segments of the Willis circle; the complete aneurysm occlusion rate within 1 year of FD implantation is relatively low.

Objective:To study the clinical efficacy and impact on quality of life of the first administration of different doses of 131iodine ( 131I) therapy in patients with differentiated thyroid cancer (DTC) after surgical resection. Methods:A total of 97 DTC patients who underwent elective surgical resection at Hongqi Hospital Affiliated to Mudanjiang Medical University from June 2022 to June 2024 were selected and divided into a high-dose group ( n = 49) and a low-dose group ( n = 48) based on their first postoperative treatment with different doses of 131I. All patients underwent DTC endoscopic thyroidectomy. The high-dose group received > 150 - 200 mCi 131I treatment after surgery, while the low-dose group received 100 - 150 mCi 131I treatment after surgery. Both groups of DTC patients were followed up for 12 months. A comparison was conducted between the two groups regarding the success rate of clearing residual thyroid tissue (referred to as thyroid clearance), disease-free survival rate, recurrence rate, incidence of adverse reactions, and changes in quality of life before and after treatment. Results:There was no statistically significant difference in the success rate of thyroid clearance between the two groups of DTC patients (χ 2 = 1.43, P = 0.232). The disease-free survival rate of DTC patients in the low-dose group was higher than that in the high-dose group (χ 2 = 4.86, P = 0.027), and the recurrence rate was lower than that in the high-dose group (χ 2 = 4.86, P = 0.027). The incidence of adverse reactions in DTC patients in the low-dose group was lower than that in the high-dose group (χ 2 = 4.59, P = 0.032). The scores of the short form 36 health survey (SF-36) of both groups of DTC patients after treatment were higher than those before treatment ( P < 0.05), and the SF-36 scores of DTC patients in the low-dose group were higher than those in the high-dose group after treatment ( P < 0.001). The scores of the thyroid cancer specific quality of life (THYCA-QoL) of both groups of DTC patients after treatment were lower than those before treatment ( P < 0.05), and the THYCA-QoL scores of DTC patients in the low-dose group were lower than those in the high-dose group after treatment ( t = 4.48, P < 0.001). Conclusions:The initial treatment effect of different doses of 131I after DTC surgical resection is comparable, but the low-dose 131I can improve the disease-free survival rate, reduce adverse reactions, and improve the quality of life of patients, which is worthy of clinical practice.

Objective:To study the clinical efficacy and impact on quality of life of the first administration of different doses of 131iodine ( 131I) therapy in patients with differentiated thyroid cancer (DTC) after surgical resection. Methods:A total of 97 DTC patients who underwent elective surgical resection at Hongqi Hospital Affiliated to Mudanjiang Medical University from June 2022 to June 2024 were selected and divided into a high-dose group ( n = 49) and a low-dose group ( n = 48) based on their first postoperative treatment with different doses of 131I. All patients underwent DTC endoscopic thyroidectomy. The high-dose group received > 150 - 200 mCi 131I treatment after surgery, while the low-dose group received 100 - 150 mCi 131I treatment after surgery. Both groups of DTC patients were followed up for 12 months. A comparison was conducted between the two groups regarding the success rate of clearing residual thyroid tissue (referred to as thyroid clearance), disease-free survival rate, recurrence rate, incidence of adverse reactions, and changes in quality of life before and after treatment. Results:There was no statistically significant difference in the success rate of thyroid clearance between the two groups of DTC patients (χ 2 = 1.43, P = 0.232). The disease-free survival rate of DTC patients in the low-dose group was higher than that in the high-dose group (χ 2 = 4.86, P = 0.027), and the recurrence rate was lower than that in the high-dose group (χ 2 = 4.86, P = 0.027). The incidence of adverse reactions in DTC patients in the low-dose group was lower than that in the high-dose group (χ 2 = 4.59, P = 0.032). The scores of the short form 36 health survey (SF-36) of both groups of DTC patients after treatment were higher than those before treatment ( P < 0.05), and the SF-36 scores of DTC patients in the low-dose group were higher than those in the high-dose group after treatment ( P < 0.001). The scores of the thyroid cancer specific quality of life (THYCA-QoL) of both groups of DTC patients after treatment were lower than those before treatment ( P < 0.05), and the THYCA-QoL scores of DTC patients in the low-dose group were lower than those in the high-dose group after treatment ( t = 4.48, P < 0.001). Conclusions:The initial treatment effect of different doses of 131I after DTC surgical resection is comparable, but the low-dose 131I can improve the disease-free survival rate, reduce adverse reactions, and improve the quality of life of patients, which is worthy of clinical practice.

Objective:To compare the efficacy and safety of flow diverter (FD) implantation versus stent-assisted coil embolization (SACE) in unruptured saccular aneurysms located at distal segments of the Willis circle.Methods:A retrospective study was performed; 119 patients with unruptured saccular aneurysms located at distal segments of the Willis circle who received FD implantation or SACE in Department of Neurosurgery, Guangdong Provincial People's Hospital, Southern Medical University and Department of Cerebrovascular Surgery, Neurosurgery Center, Southern Medical University from January 2018 to May 2025 were selected. According to different surgical methods, they were divided into a FD group ( n=60) and a SACE group ( n=59). These patients were subjected to propensity score matching (PSM) using 1:1 nearest neighbor matching method to eliminate confounding factors such as gender, age, aneurysm location, and aneurysm diameter (maximum diameter); and then, differences in neurological functional prognosis (good prognosis: modified Rankin scale scores of 0-2), complete aneurysm occlusion rate (O'Kelly-Marotta grade D or Raymond occlusion classification class I), and overall (perioperative and follow-up) complications were compared between the two groups. Results:After PSM, there were 43 patients in both FD group and SACE group. No significant difference was found in clinical and imaging follow-ups (12[6, 19] months vs. 10[6, 15] months, 10[5, 19] months vs. 9[2, 15] months) between the FD group and SACE group ( P>0.05). At the last imaging follow-up, the complete aneurysm occlusion rate in the FD group (65.1%[28/43]) was significantly lower than that in the SACE group (76.7%[33/43], P<0.05). At the last clinical follow-up, no significant difference was noted in good prognosis rate (95.3%[41/43] vs. 97.7%[42/43]) and overall complication rate (30.2%[13/43] vs. 18.6%[8/43]) between the FD group and SACE group ( P>0.05). Conclusion:Both FD implantation and SACE are safe and effective for unruptured saccular aneurysms located at distal segments of the Willis circle; the complete aneurysm occlusion rate within 1 year of FD implantation is relatively low.

Objective:To understand the prevalence of arboviruses in mosquito samples in Xichang City, Sichuan Province, and enrich the data of arbovirus activity and genetic characteristics in southwestern Sichuan Province.Methods:In June 2018, the nucleic acid was extracted from Culex tritaeniorhynchus mosquitoes collected from different pigsties in three villages and suburbs of Xichang City. The specific primers of Yunnan orbivirus, Banna virus, Tibet orbivirus (S7, S10), Flavivirus and alphavirus were used for quantitative polymerase chain reaction examination, and the positive product was cloned for sequencing analysis. Results:A total of 9 012 mosquitoes were collected, of which Cx. tritaeniorhynchus was the dominant species. A number of 88 batches of these mosquitoes were amplified, and 2 strains of Japanese encephalitis virus (JEV), 7 strains of Banna virus (BAV), 7 strains of Tibet orbivirus (TIBOV) and 1 strain of Yunnan orbivirus virus (YOUV) were detected, respectively. By the results of cluster analysis and evolutionary tree analysis, the 17 newly found virus strains were close to the Yunnan isolates, and 2 JEV strains were located in the GI-b clade. The other 7 strains of BAV were A2 evolutionary clades. Of the 7 TIBOV plants, 6 were located in the same clade. One TOUV was in the same clade as the Yunnan strain. Conclusions:Culex tritaeniorhynchus mosquitoes in Xichang city might carry JEV, BAV, YOUV and TIBOV, among them JEV was GI-b type and BAV was A2 type. The results provide data supporting the detection and analysis of arboviruses in Xichang city.

Objective:To explore the clinical application of portable head and neck magnetic resonance imaging (MRI) device in neurosurgery.Methods:A total of 213 patients with brain diseases who were scanned by portable head and neck MRI device in Center of Neurosurgery, Zhujiang Hospital, Southern Medical University from June to September 2022 were selected. The portable head and neck MRI images and 3.0T conventional MRI images of 10 randomly selected patients were compared; the differences in signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of different sequences were analyzed. Thirty-one patients accepted tracheal intubation/tracheotomy, or ventilator-assisted breathing were selected as special patient group, and another 30 patients were as general patient group; the differences in comprehensive diagnostic scores of portable head and neck MRI images were compared. Noise intensity differences in different sequences between 3.0T conventional MRI and portable head and neck MRI were statistically compared. Twenty hospitalized volunteers with normal hearing in our center from July to August 2022 were selected, conventional 3.0T MRI and portable head and neck MRI were performed successively, and the noise intensity of different sequences in them was evaluated by using a 5-point system.Results:Compared with those in 3.0T conventional MRI images, the SNR and CNR of T1WI, T2WI, and Liquid attenuated reverse recovery sequence (FLAIR) sequences in portable head and neck MRI images were significantly lower ( P<0.05). No significant difference was noted in the comprehensive diagnostic scores of portable head and neck MRI images between special patients and general patients ( P>0.05). Compared with that in the 3.0T conventional MRI, the noise intensity of different sequences in portable head and neck MRI was significantly reduced ( P<0.05). These volunteers had significantly reduced noise intensity scores of different sequences in portable head and neck MRI compared with that in conventional 3.0T MRI ( P<0.05). Conclusion:Portable head and neck MRI device is easy to use, enjoying high safety, imaging quality and suitability, which meets the clinical needs for neurosurgery patients.

Objective To analyze the hemodynamic parameters of anomalous origin of the right coronary artery from the left coronary artery sinus (AORL) based on computational fluid dynamics (CFD), so as to make an evaluation of the disease. Methods A normal right coronary artery (RCA) case and an AORL case were selected. Two models were reconstructed in Mimics software and imported into ANSYS CFX software for hemodynamics simulation. The hemodynamics of normal RCA model and AORL model were compared. Results AORL model had a smaller volume flow (9.35 cm3/s), which might lead to insufficient blood supply downstream of the RCA; the pressure at the acute corner of AORL model (13.78 kPa) was lower than normal RCA model (14.9 kPa); the wall shear stress (WSS) of AORL model (12.83 Pa) was larger than that of normal RCA model (9.74 Pa); the total deformation of AORL model was relatively large. Conclusions The entrance velocity and pressure of AORL were lower than those of normal RCA, which might lead to ischemic symptoms. The research findings are of theoretical significance for the effective evaluation of ischemia and other diseases in clinic.

Objective To investigate the association between RNF213 rs6565666 polymorphisms and intracranial cystic aneurysms in patients from Guangdong province. Methods Two hundred and fifty patients with intracranial cystic aneurysms, admitted to and conformed by digital substraction angiography (DSA) in our hospital from February 2016 to October 2018, were selected as experimental group; and 250 patients without intracranial aneurysms conformed by DSA, CT angiography or magnetic resonance angiography at the same time period were used as control group. The genotypes of rs6565666 locus of RNF213 gene were detected by polymerase chain reaction-ligase detection reaction (PCR-LDR). Results As compared with those in the control group, percentages of AG and AA genotypes were significantly higher and percentage of GG genotype was statistically higher at rs6565666 locus of patients from the experimental group (P<0.05). The proportion of allele A at rs6565666 locus in the experimental group was statistically higher as compared with that in the control group (P<0.05). In the experimental group, 112 patients had ruptured aneurysms and 138 patients did not have ruptured aneurysms; there was no statistically significant difference in the genotype distribution of rs6565666 between the ruptured group and the non-ruptured group (P>0.05). Conclusion RNF213 gene rs6565666 polymorphism is associated with intracranial cystic aneurysms in patients from Guangdong province.

Objective To explore the effect of Willis circle variation and hemodynamic forces alteration arised from vascular structural abnormity on intracranial aneurysm (IA) rupture using 3D-digital subtraction angiography (DSA) and transcranial color Doppler (TCCD) detection.Methods Two hundred and twenty-three patients with IA,admitted to and conformed by DSA in our hospital from November 2010 to November 2011,were divided into ruptured IA group (n=182) and un-ruptured IA group (n=41).The 3D-DSA was applied in all patients to carefully evaluate the aneurysm sizes,locations,and morphous features,and to confirm the presence of A1 dominance and Willis circle variation.Moreover,aneurysmal neck area,diameter of parent artery,angle between A2 segments of bilateral anterior cerebral artery,angle between aneurysmal longitudinal axis and parent artery,aortic diameter (AD) and aspect ratio (AR) were measured with assistance of 3D-DSA images.Besides,TCCD was applied to all patients,and the hemodynamic parameters were recorded to calculate wall shear stress (WSS) and mechanical stretch.The risk factors of IA rupture were analyzed by receiver operating characteristic (ROC) curve and multivariate Logistic regression with emphasis on Willis circle variation and hemodynamic forces alteration.Results Whether it was in ruptured IA group or in un-ruptured IA group,the incidence rate of variation of anterior Willis circle was higher than that of variation of posterior Willis circle.A1 dominance on the left side was the most common asymmetry.As compared with those in un-ruptured IA group,statistically elder age,smaller AD,larger angle between aneurysmal longitudinal axis and parent artery,decreased WSS and increased mechanical stretch in the ruptured IA group were noted (P＜0.05).ROC curve indicated that angle between aneurysmal longitudinal axis and parent artery,AD,WSS and mechanical stretch could be used to evaluate IA rupture (area under the curve:0.606、0.618、0.396、0.637).Age (OR=8.618,95％CI:2.866-25.917,P=0.000),hypertension (grade Ⅲ OR=16.320,95％CI:1.628-163.556,P=0.018),angle between aneurysmal longitudinal axis and parent artery (OR=3.053,95％CI:1.131-8.242,P=0.028),AD (OR=5.638,95％CI:1.507-20.251,P=0.008) and mechanical stretch (OR=4.230,95％CI:1.554-11.516,P=0.000) were risk factors of IA rupture.A1 dominance (OR=0.242,95％CI:0.074-0.785,P=0.018),small aneurysms (2-5 mm,OR=0.207,95％CI:0.054-0.788,P=0.002) and WSS (OR=0.021,95％CI:0.060-0.672,P=0.009) were identified as protective factors.Conclusions Willis circle variation exists in IA patients.Age,hypertension (grade ⅢD,angle between aneurysmal longitudinal axis and parent artery,AD and mechanical stretch are risk factors of IA rupture,while A1 dominance,small aneurysm (2-5 mm) and WSS are identified as protective factors.Accurate assessment of these factors is of great clinical significance for the prevention and treatment of IA in the future.

BACKGROUND:Reducing blood loss could help to prevent the complications of total knee arthroplasty, relieve the swelling and discomfort postoperatively and accelerate the rehabilitation. OBJECTIVE:To explore the methods for reducing blood loss during total knee arthroplasty. METHODS:Totally 63 patients undergoing primary unilateral total knee arthroplasty were divided into two groups. Group 1 included 27 patients who received the conventional surgical techniques using tourniquet during the whole procedure with wound drainage, as control group. Group 2 included 36 patients who received the modified procedure only using tourniquet during prosthesis implantation without wound drainage, as experimental group. In the experimental group, we stitched the capsule closely. The preoperative and postoperative hemoglobin, decrease of hemoglobin, knee pain score, range of motion blood transfusion rate and wound healing were compared between the two groups. RESULTS AND CONCLUSION:(1) There was no significant difference in preoperative hemoglobin between the two groups. At 1, 4 and 7 days postoperatively, the hemoglobins were significantly lower in the control group than in the experimental group, and the decreases of hemoglobins were significantly lower in the control group than in the experimental group. (2) Knee pain score was not significantly different between the two groups. (3) The range of motion of the knee was significantly larger in the experimental group than in the control group at 7 days. (4) Blood transfusion rate was 18.5%in the control group, and wound healing was poor in one patient. There was no transfused case and wound problem in the experimental group. All wounds were healed normally. (5) There was no infection or hematoma in two groups. (6) With the modified procedure, we could reduce blood loss during total knee arthroplasty without blood transfusion after surgery, which was helpful to postoperative rehabilitation.