Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

Background: and Purpose Ruptured intracranial aneurysms (RIA) are associated with a mortality rate of up to 40% in the Chinese population, highlighting the critical need for targeted treatment interventions for at-risk individuals. Although the impact of aldehyde dehydrogenase 2 (ALDH2) gene mutations on susceptibility to intracranial aneurysms (IA) is well documented, the potential connection between ALDH2 rs671 single-nucleotide polymorphism (SNP) and RIA remains unexplored. Given the increased prevalence of ALDH2 gene mutations among Chinese Han individuals, it is clinically relevant to investigate the link between ALDH2 rs671 SNP and IA rupture. Methods: A prospective study was conducted on 546 patients diagnosed with IA to investigate the association between ALDH2 rs671 SNP and the risk of IA rupture. Results: The ALDH2 rs671 SNP (ALDH2*2) was significantly more prevalent in patients with unruptured IA (UIA) than in those with RIA (32.56% vs. 18.58%, P=0.004). Multivariate logistic regression analysis revealed that people with the ALDH2 mutation (ALDH2*1/*2 and ALDH2*2/*2 gene type) had a significantly reduced odds ratio (OR=0.49; 95% confidence level [CI] 0.27–0.88; P=0.018) for RIAs. Age-specific subgroup analysis indicated that the ALDH2 mutation provided a stronger protective effect in individuals aged 60 years and above with IA compared to those under 60 years old (OR=0.38 vs. OR=0.52, both P<0.05). Conclusion The incidence of RIA was significantly higher in individuals with a normal ALDH2 gene (ALDH2*1/*1) than in those with an ALDH2 rs671 SNP (ALDH2*1/*2 or ALDH2*2/*2). ALDH2 rs671 SNP may serve as a protective factor against RIA in the Chinese Han population.

Background: and Purpose Ruptured intracranial aneurysms (RIA) are associated with a mortality rate of up to 40% in the Chinese population, highlighting the critical need for targeted treatment interventions for at-risk individuals. Although the impact of aldehyde dehydrogenase 2 (ALDH2) gene mutations on susceptibility to intracranial aneurysms (IA) is well documented, the potential connection between ALDH2 rs671 single-nucleotide polymorphism (SNP) and RIA remains unexplored. Given the increased prevalence of ALDH2 gene mutations among Chinese Han individuals, it is clinically relevant to investigate the link between ALDH2 rs671 SNP and IA rupture. Methods: A prospective study was conducted on 546 patients diagnosed with IA to investigate the association between ALDH2 rs671 SNP and the risk of IA rupture. Results: The ALDH2 rs671 SNP (ALDH2*2) was significantly more prevalent in patients with unruptured IA (UIA) than in those with RIA (32.56% vs. 18.58%, P=0.004). Multivariate logistic regression analysis revealed that people with the ALDH2 mutation (ALDH2*1/*2 and ALDH2*2/*2 gene type) had a significantly reduced odds ratio (OR=0.49; 95% confidence level [CI] 0.27–0.88; P=0.018) for RIAs. Age-specific subgroup analysis indicated that the ALDH2 mutation provided a stronger protective effect in individuals aged 60 years and above with IA compared to those under 60 years old (OR=0.38 vs. OR=0.52, both P<0.05). Conclusion The incidence of RIA was significantly higher in individuals with a normal ALDH2 gene (ALDH2*1/*1) than in those with an ALDH2 rs671 SNP (ALDH2*1/*2 or ALDH2*2/*2). ALDH2 rs671 SNP may serve as a protective factor against RIA in the Chinese Han population.

Background: and Purpose Ruptured intracranial aneurysms (RIA) are associated with a mortality rate of up to 40% in the Chinese population, highlighting the critical need for targeted treatment interventions for at-risk individuals. Although the impact of aldehyde dehydrogenase 2 (ALDH2) gene mutations on susceptibility to intracranial aneurysms (IA) is well documented, the potential connection between ALDH2 rs671 single-nucleotide polymorphism (SNP) and RIA remains unexplored. Given the increased prevalence of ALDH2 gene mutations among Chinese Han individuals, it is clinically relevant to investigate the link between ALDH2 rs671 SNP and IA rupture. Methods: A prospective study was conducted on 546 patients diagnosed with IA to investigate the association between ALDH2 rs671 SNP and the risk of IA rupture. Results: The ALDH2 rs671 SNP (ALDH2*2) was significantly more prevalent in patients with unruptured IA (UIA) than in those with RIA (32.56% vs. 18.58%, P=0.004). Multivariate logistic regression analysis revealed that people with the ALDH2 mutation (ALDH2*1/*2 and ALDH2*2/*2 gene type) had a significantly reduced odds ratio (OR=0.49; 95% confidence level [CI] 0.27–0.88; P=0.018) for RIAs. Age-specific subgroup analysis indicated that the ALDH2 mutation provided a stronger protective effect in individuals aged 60 years and above with IA compared to those under 60 years old (OR=0.38 vs. OR=0.52, both P<0.05). Conclusion The incidence of RIA was significantly higher in individuals with a normal ALDH2 gene (ALDH2*1/*1) than in those with an ALDH2 rs671 SNP (ALDH2*1/*2 or ALDH2*2/*2). ALDH2 rs671 SNP may serve as a protective factor against RIA in the Chinese Han population.

Objective: To explore the correlation between traditional Chinese medicine (TCM) constitution and depressive symptom among school aged children and adolescents, so as to provide evidences for informing constitution based regulation and prevention of depressive symptom. Methods: From June to December 2024, a total of 4 729 students aged 6-14 were recruited by cluster random sampling from 10 primary schools in Baoding (Hebei Province), Heze and Liaocheng (Shandong Province). General information, TCM constitution and depressive symptom were collected. Restricted cubic spline (RCS) models were used to analyze related factors and threshold effects of depressive symptom. Binary Logistic regression was applied to examine the association between depressive symptom and TCM constitution, with subgroup analyses conducted. Results: The detection rate of depressive symptom among the included children and adolescents was 25.82%. RCS analyses indicated non linear associations between depressive symptom and age (inflection point at 10 years old), bedtime (inflection point at 22:00), and wake up time (inflection point at 6:30 ) (all P non linearity <0.01). Linear associations were observed with body mass index (BMI) and sleep duration (all P non linearity > 0.05 ). After adjusting for covariates such as age, BMI and sleep status, binary Logistic regression analyses showed that Yin deficient constitution ( OR =1.26, 95% CI =1.09-1.45) and Phlegm-dampness constitution ( OR =1.42, 95% CI =1.11-1.82) were significantly associated with depressive symptom among children and adolescents (all P <0.05). Conclusions Depressive symptom among school aged children and adolescents is primarily associated with Yin deficiency and Phlegm dampness constitutions in TCM constitution. Active attention should be paid to susceptible TCM constitution among children and adolescents. Targeted health guidance and interventions should be implemented to improve TCM constitution health status for preventing the occurrence of depressive symptom.

Objective:To analyze the correlation of perifollicular blood flow parameters with follicle development, embryo quality and pregnancy outcome in in vitro fertilization and embryo transfer (IVF-ET). Methods:A retrospective case-control study was conducted to analyze the data of 112 infertile patients who underwent IVF-ET admitted to the Department of Reproductive Medicine of Zhumadian Central Hospital from October 2020 to October 2022. Perifollicular blood flow parameters [peak systolic velocity/end diastolic velocity (S/D), resistance index (RI), pulsatility index (PI) and peak systolic velocity (PSV)] were measured by vaginal color doppler ultrasound. A total of 1 156 follicles were extracted, they were divided into high-quality follicle group ( n=208), and non-high-quality follicle group ( n=948) according to follicle development, high-quality embryo group ( n=161) and non-high-quality embryo group ( n=995) according to embryo quality, pregnant group ( n=37) and non-pregnant group ( n=75) according to pregnancy outcome. The S/D, RI, PI and PSV of the groups were compared. The correlation indexes of PSV peak velocity among different perifollicular blood flow were compared, and the correlation between PSV and follicle development and embryo quality in non-high-quality follicle group, non-high-quality embryo group and non-pregnant group was analyzed by Pearson method. Results:PSV in high-quality follicle group [(11.26±0.94) cm/s] was significantly higher than that in non-high-quality follicle group [(10.31±0.78) cm/s, P<0.001], but there were no significant differences in S/D, RI and PI between high-quality follicle group and non-high-quality follicle group (all P>0.05). PSV was significantly higher in the high-quality embryo group [(13.38±1.19) cm/s] than in the non-high-quality embryo group [(12.02±0.85) cm/s, P<0.001], but there were no significant differences in S/D, RI and PI between high-quality embryo group and non-high-quality embryo group (all P>0.05). PSV of pregnant group [(15.14±1.25) cm/s] was significantly higher than that of non-pregnant group [(8.27±0.75) cm/s, P<0.001], and there were no significant differences in S/D, RI and PI between pregnant group and non-pregnant group (all P>0.05). There were no statistically significant differences in age, infertility duration, body mass index, basal follicle-stimulating hormone level, total dosage and duration of gonadotropin used among different perifollicular blood flow PSV peak velocity (all P>0.05), but there were statistically significant differences in the number of high-quality follicles, the number of high-quality embryos and the level of β-human chorionic gonadotropin (β-hCG) [<9 cm/s: 1.05±0.23, 0.73±0.14, (3.05±0.61) U/L;9-10 cm/s: 1.35±0.35, 0.85±0.16, (22.14±5.78) U/L; >10 cm/s: 2.01±0.41, 1.12±0.20, (71.33±8.63) U/L; all P<0.001]. Pearson correlation analysis showed that PSV was positively correlated with follicle diameter, embryo quality score and blood β-hCG level ( r=0.767, P<0.001; r=0.750, P<0.001; r=0.700, P<0.001) in non-high-quality follicle group, non-high-quality embryo group,non-pregnant group. Conclusion:Perifollicular blood flow parameter PSV is correlated with IVF-ET follicle development, embryo quality and pregnancy outcome, which can provide an important reference for clinical evaluation of follicle development, embryo quality and pregnancy outcome.

Objective:To analyze the correlation of perifollicular blood flow parameters with follicle development, embryo quality and pregnancy outcome in in vitro fertilization and embryo transfer (IVF-ET). Methods:A retrospective case-control study was conducted to analyze the data of 112 infertile patients who underwent IVF-ET admitted to the Department of Reproductive Medicine of Zhumadian Central Hospital from October 2020 to October 2022. Perifollicular blood flow parameters [peak systolic velocity/end diastolic velocity (S/D), resistance index (RI), pulsatility index (PI) and peak systolic velocity (PSV)] were measured by vaginal color doppler ultrasound. A total of 1 156 follicles were extracted, they were divided into high-quality follicle group ( n=208), and non-high-quality follicle group ( n=948) according to follicle development, high-quality embryo group ( n=161) and non-high-quality embryo group ( n=995) according to embryo quality, pregnant group ( n=37) and non-pregnant group ( n=75) according to pregnancy outcome. The S/D, RI, PI and PSV of the groups were compared. The correlation indexes of PSV peak velocity among different perifollicular blood flow were compared, and the correlation between PSV and follicle development and embryo quality in non-high-quality follicle group, non-high-quality embryo group and non-pregnant group was analyzed by Pearson method. Results:PSV in high-quality follicle group [(11.26±0.94) cm/s] was significantly higher than that in non-high-quality follicle group [(10.31±0.78) cm/s, P<0.001], but there were no significant differences in S/D, RI and PI between high-quality follicle group and non-high-quality follicle group (all P>0.05). PSV was significantly higher in the high-quality embryo group [(13.38±1.19) cm/s] than in the non-high-quality embryo group [(12.02±0.85) cm/s, P<0.001], but there were no significant differences in S/D, RI and PI between high-quality embryo group and non-high-quality embryo group (all P>0.05). PSV of pregnant group [(15.14±1.25) cm/s] was significantly higher than that of non-pregnant group [(8.27±0.75) cm/s, P<0.001], and there were no significant differences in S/D, RI and PI between pregnant group and non-pregnant group (all P>0.05). There were no statistically significant differences in age, infertility duration, body mass index, basal follicle-stimulating hormone level, total dosage and duration of gonadotropin used among different perifollicular blood flow PSV peak velocity (all P>0.05), but there were statistically significant differences in the number of high-quality follicles, the number of high-quality embryos and the level of β-human chorionic gonadotropin (β-hCG) [<9 cm/s: 1.05±0.23, 0.73±0.14, (3.05±0.61) U/L;9-10 cm/s: 1.35±0.35, 0.85±0.16, (22.14±5.78) U/L; >10 cm/s: 2.01±0.41, 1.12±0.20, (71.33±8.63) U/L; all P<0.001]. Pearson correlation analysis showed that PSV was positively correlated with follicle diameter, embryo quality score and blood β-hCG level ( r=0.767, P<0.001; r=0.750, P<0.001; r=0.700, P<0.001) in non-high-quality follicle group, non-high-quality embryo group,non-pregnant group. Conclusion:Perifollicular blood flow parameter PSV is correlated with IVF-ET follicle development, embryo quality and pregnancy outcome, which can provide an important reference for clinical evaluation of follicle development, embryo quality and pregnancy outcome.

Objective:To observe preventive effect of intestinal stent against anastomotic leakage after rectal cancer operation.Methods:A retrospective cohort study was carried out. Clinical data of 107 patients with low rectal cancer undergoing laparoscopic radical resection from January 2015 to August 2019 were retrospectively analyzed. Intestinal stent was placed intraoperatively in 48 cases and was not placed in 59 cases. Postoperative Wexner score for anal function and incidence of anastomotic leakage were compared between patients with and without intstinal stent.Results:There was no significant differences in age, distance between tumor and the anal verge, operative time and postoperative Wexner score for anal function between the two groups (all P>0.05). After a month of follow-up, the incidence of anastomotic leakage was 16.9% (10/59) in the non-stent group, while no anastomotic leakage was found in the stent group ( P=0.002). Conclusion:Placement of intestinal stent can effectively prevent anastomotic leakage after low rectal cancer surgery.

Objective:To observe preventive effect of intestinal stent against anastomotic leakage after rectal cancer operation.Methods:A retrospective cohort study was carried out. Clinical data of 107 patients with low rectal cancer undergoing laparoscopic radical resection from January 2015 to August 2019 were retrospectively analyzed. Intestinal stent was placed intraoperatively in 48 cases and was not placed in 59 cases. Postoperative Wexner score for anal function and incidence of anastomotic leakage were compared between patients with and without intstinal stent.Results:There was no significant differences in age, distance between tumor and the anal verge, operative time and postoperative Wexner score for anal function between the two groups (all P>0.05). After a month of follow-up, the incidence of anastomotic leakage was 16.9% (10/59) in the non-stent group, while no anastomotic leakage was found in the stent group ( P=0.002). Conclusion:Placement of intestinal stent can effectively prevent anastomotic leakage after low rectal cancer surgery.