Background: and Purpose Accurately predicting long-term functional outcomes of basilar artery occlusion (BAO) remains challenging. We compared the predictive performance of the baseline, 24-hour, and 72-hour National Institutes of Health Stroke Scale (NIHSS) scores for 90-day BAO functional outcomes using the Acute Basilar Artery Occlusion: Endovascular Thrombectomy versus Standard Medical Treatment (ATTENTION) trial data. We identified the optimal assessment time point, determined treatment-specific NIHSS cutoff values, and explored the role of early neurological function in treatment effects. Methods: This retrospective post hoc analysis included 324 patients with acute BAO with baseline NIHSS scores ≥10 and complete NIHSS assessments at each time point. The primary outcome was a favorable 90-day functional outcome (modified Rankin Scale score, 0–3). Receiver operating characteristic curve analysis was used to assess the predictive ability of NIHSS scores. The optimal 72-hour NIHSS predictive cutoff values were determined for the endovascular treatment (EVT) and best medical management (BMM) subgroups. Results: The 72-hour NIHSS score showed the highest predictive accuracy for the primary outcome (area under the receiver operating characteristic curve [AUC]: 0.954), outperforming the 24-hour (AUC: 0.903) and baseline (AUC: 0.688) scores; its optimal predictive cut-off value was ≤11 in the EVT group (sensitivity: 85.6%, specificity: 92.9%, positive predictive value [PPV]: 91.8%, negative predictive value [NPV]: 87.4%) and ≤9 in the BMM group (sensitivity: 84.6%, specificity: 95.1%, PPV: 84.6%, NPV: 95.1%). Conclusions The 72-hour NIHSS score outperformed the baseline and 24-hour scores in predicting 90-day functional outcomes and mediating the effects of EVT. Treatment-specific 72-hour NIHSS cut-off values may guide early risk stratification and prognostic assessments.

ObjectiveThis study aims to develop and validate a novel multimodal predictive model， termed criss-cross network（CCNet）-directed graph neural network（DGNN）（CGN）， for accurate assessment of pulmonary nodule progression in high-risk individuals for lung cancer， by integrating longitudinal chest computed tomography（CT） imaging with both traditional Chinese and western clinical evaluation data. MethodsA cohort of 4 432 patients with pulmonary nodules was retrospectively analyzed. A twin CCNet was employed to extract spatiotemporal representations from paired sequential CT scans. Structured clinical assessment and imaging-derived features were encoded via a multilayer perceptron， and a similarity-based alignment strategy was adopted to harmonize multimodal imaging features across temporal dimensions. Subsequently， a DGNN was constructed to integrate heterogeneous features， where nodes represented modality-specific embeddings and edges denoted inter-modal information flow. Finally， model optimization was performed using a joint loss function combining cross-entropy and cosine similarity loss， facilitating robust classification of nodule progression status. ResultsThe proposed CGN model demonstrated superior predictive performance on the held-out test set， achieving an area under the receiver operating characteristic curve（AUC） of 0.830， accuracy of 0.843， sensitivity of 0.657， specificity of 0.712， Cohen's Kappa of 0.417， and F₁ score of 0.544. Compared with unimodal baselines， the CGN model yielded a 36%-48% relative improvement in AUC. Ablation studies revealed a 2%-22% increase in AUC when compared to simplified architectures lacking key components， substantiating the efficacy of the proposed multimodal fusion strategy and modular design. Incorporation of traditional Chinese medicine （TCM）-specific symptomatology led to an additional 5% improvement in AUC， underscoring the complementary value of integrating TCM and western clinical data. Through gradient-weighted activation mapping visualization analysis， it was found that the model's attention predominantly focused on nodule regions and effectively captured dynamic associations between clinical data and imaging-derived features. ConclusionThe CGN model， by synergistically combining cross-attention encoding with directed graph-based feature integration， enables effective alignment and fusion of heterogeneous multimodal data. The incorporation of both TCM and western clinical information facilitates complementary feature enrichment， thereby enhancing predictive accuracy for pulmonary nodule progression. This approach holds significant potential for supporting intelligent risk stratification and personalized surveillance strategies in lung cancer prevention.

Electroencephalogram (EEG) is a non-invasive, high temporal-resolution technique for monitoring brain activity. However, affected by the volume conduction effect, EEG has a low spatial resolution and is difficult to locate brain neuronal activity precisely. The surface Laplacian (SL) technique obtains the Laplacian EEG (LEEG) by estimating the second-order spatial derivative of the scalp potential. LEEG can reflect the radial current activity under the scalp, with positive values indicating current flow from the brain to the scalp (“source”) and negative values indicating current flow from the scalp to the brain (“sink”). It attenuates signals from volume conduction, effectively improving the spatial resolution of EEG, and is expected to contribute to breakthroughs in neural engineering. This paper provides a systematic overview of the principles and development of SL technology. Currently, there are two implementation paths for SL technology: current source density algorithms (CSD) and concentric ring electrodes (CRE). CSD performs the Laplace transform of the EEG signals acquired by conventional disc electrodes to indirectly estimate the LEEG. It can be mainly classified into local methods, global methods, and realistic Laplacian methods. The global method is the most commonly used approach in CSD, which can achieve more accurate estimation compared with the local method, and it does not require additional imaging equipment compared with the realistic Laplacian method. CRE employs new concentric ring electrodes instead of the traditional disc electrodes, and measures the LEEG directly by differential acquisition of the multi-ring signals. Depending on the structure, it can be divided into bipolar CRE, quasi-bipolar CRE, tripolar CRE, and multi-pole CRE. The tripolar CRE is widely used due to its optimal detection performance. While ensuring the quality of signal acquisition, the complexity of its preamplifier is relatively acceptable. Here, this paper introduces the study of the SL technique in resting rhythms, visual-related potentials, movement-related potentials, and sensorimotor rhythms. These studies demonstrate that SL technology can improve signal quality and enhance signal characteristics, confirming its potential applications in neuroscientific research, disease diagnosis, visual pathway detection, and brain-computer interfaces. CSD is frequently utilized in applications such as neuroscientific research and disease detection, where high-precision estimation of LEEG is required. And CRE tends to be used in brain-computer interfaces, that have stringent requirements for real-time data processing. Finally, this paper summarizes the strengths and weaknesses of SL technology and envisages its future development. SL technology boasts advantages such as reference independence, high spatial resolution, high temporal resolution, enhanced source connectivity analysis, and noise suppression. However, it also has shortcomings that can be further improved. Theoretically, simulation experiments should be conducted to investigate the theoretical characteristics of SL technology. For CSD methods, the algorithm needs to be optimized to improve the precision of LEEG estimation, reduce dependence on the number of channels, and decrease computational complexity and time consumption. For CRE methods, the electrodes need to be designed with appropriate structures and sizes, and the low-noise, high common-mode rejection ratio preamplifier should be developed. We hope that this paper can promote the in-depth research and wide application of SL technology.

This case report presents a 16-year-old male patient with deficiency of adenosine deaminase 2(DADA2). The patient had a history of Raynaud′s phenomenon with digital ulcers since childhood. As the disease progressed, the patient developed retinal vasculitis, intracranial hemorrhage, skin necrosis, severe malnutrition, refractory hypertension, and gastrointestinal bleeding. Genetic testing revealed compound heterozygous mutations in the ADA2 gene (paternal c.1072G > A pathogenic mutation + maternal c.1065C > A variant of unknown clinical significance). ADA2 enzyme activity was significantly reduced (0.1 U/L). A multidisciplinary treatment team developed an individualized plan to address key issues, including nutritional support, blood pressure control, rehabilitation, pain management, and balancing anticoagulation/bleeding risks. After systematic intervention, the patient′s condition showed partial improvement. This case reveals clinical challenges such as anticoagulation decisions and nutritional support of DADA2. It also emphasizes the importance of early molecular diagnosis, tumor necrosis factor-α inhibitor targeted therapy, and multidisciplinary collaboration in management, underlining the core value of precision medicine in rare disease management.

Objective To construct a perioperative nursing intervention scheme for patients undergoing hepatic arterial infusion chemotherapy(HAIC)via brachial artery access and to discuss its clinical application.Methods By using systematic literature search method,a perioperative nursing intervention scheme was constructed.A total of 90 patients with confirmed hepatic malignancy,who were admitted to hospital to receive HAIC from February 2022 to August 2023,were collected to validate this perioperative nursing intervention scheme,and its clinical application effect was evaluated.Results Through two rounds of expert letter inquiry,a nursing intervention scheme containing five primary indicators and 16 secondary indicators was finally formulated.The clinical validation was conducted.After the implementation of this nursing intervention scheme,the incidences of phlebitis and limb swelling in the intervention group decreased from previous 17.78％ to post-intervention 2.22％ and from previous 33.33％ to post-intervention 8.89％,respectively.The patient's anxiety level and depressed mood were significantly improved;the HADS scores decreased by 35.2％and 36.6％,respectively;the EORTC QLQ-C30 scores in the dimensions of somatic,role,emotional,and social functioning were obviously improved and the quality of life was strikingly improved(all P＜0.05).Besides,in the patients of the intervention group the clinical symptoms(e.g.pain,nausea,etc.)were significant alleviated,and the severity of the symptoms as well as the degree of distress to the patients were significantly reduced,indicating that the nursing intervention plays an important role in relieving the symptoms,anxiety and depression of the patients.Conclusion The perioperative nursing intervention scheme constructed in this study for patients undergoing AIC via brachial artery access is scientific and practical,it provides an important reference basis for the therapeutic nursing care of patients with hepatic malignancy.

Objective:To investigate the long-term outcomes of using 3D-printed preformed titanium meshes in repair and reconstruction of orbital region.Methods:A retrospective analysis was conducted on patients with tumors invading the naso-orbito-maxillary region who underwent surgical resection and repair/reconstruction with 3D-printed preformed titanium meshes. The patients were collected at three medical centers (the Third Affiliated Hospital of Sun Yat-sen University, Xijing Hospital of Air Force Military Medical University, and Shenzhen Longgang District Ear, Nose and Throat Hospital) from 2016 to 2023. Tumor extent was evaluated radiologically, and the surgical approaches, reconstruction outcomes, surgical complications, and long-term follow-up results were analyzed.Results:A total of 46 patients from the three centers were included in this study, comprising 27 males and 19 females, with an average age of 51 years (range: from 13 to 86 years). Among them, 4 patients had benign tumors, while the remaining 42 had malignant tumors. The median follow-up duration was 60.7 months (range: from 19.0 to 75.0 months). Postoperatively, symmetrical globe position was achieved in 38 cases without significant diplopia; 4 cases exhibited enophthalmos without diplopia, and 4 cases had enophthalmos with diplopia. Twelve patients received preoperative radiotherapy, and 30 patients received postoperative radiotherapy. Six patients developed enophthalmos, and 6 experienced titanium mesh exposure after radiotherapy. Following treatment completion, 3 patients underwent repair using frontal flaps, 1 using a superficial temporal artery island flap, and 2 using free flaps. All remaining patients showed no postoperative infections, and their wounds healed normally.Conclusion:The application of 3D-printed preformed titanium mesh enables precise repair of postoperative defects in patients with naso-orbital tumors, facilitating reliable reconstruction of the orbital and facial contours with straightforward operation and dependable outcomes.

Objective This study aims to investigate the current status and potential profiles of emotional inhibition in stoma patients with colorectal cancer,to analyze the differences and influencing factors,and thereby provide a basis for the development of intervention strategies.Methods A convenience sample of 348 colorectal cancer patients with ostomies was recruited from colorectal surgery departments and ostomy outpatient clinics of a tertiary A hospital in Anhui Province.Data were collected using the General Information Questionnaire,Emotional Inhibition Scale,Chinese Perceived Stress Scale,10 item Conner Davidson Resilience Scale,and Family Care Index Questionnaire.Latent profile analysis was performed using Mplus 8.3,while univariate analysis and multivariate logistic regression analysis were conducted using SPSS 26.0.Results Valid questionnaires were collected from 336 participants(response rate 96.6％).Colorectal cancer patients with ostomies demonstrated a mean emotional inhibition score of 30.84±10.49.Latent profile analysis identified 3 distinct emotional inhibition patterns:high inhibition-suppressive type(31.25％),moderate inhibition-adaptive type(39.88％),and low inhibition-excessive type(28.87％).Gender,residential location,household income per capita,ostomy self-care proficiency,perceived stress levels,psychological resilience scores and family functioning status emerged as significant determinants of emotional inhibition heterogeneity among colorectal cancer patients with ostomies across distinct latent profiles(P＜0.05).Conclusion Colorectal cancer patients with ostomies exhibit significant heterogeneity in emotional inhibition profiles.Clinicians should conduct early identification of these latent classes through standardized assessments and develop tailored interventions to improve emotional inhibition outcomes in this clinical population.

Objective Exploring the effect of Bian-stone-based herbal heat therapy on herbal heat ironing in gastrointestinal reactions during the preconditioning period of hematopoietic stem cell transplantation patients.Methods Convenience sampling method was used to select 68 cases of hematopoietic stem cell transplantation patients who attended the hematology department of a tertiary-level Chinese medicine hospital in Hangzhou from October 2023 to April 2024 as the study subjects,and the SPSS 26.0 statistical software was used to generate a random number for grouping into an experimental and a control group,with 34 cases in each group.On the basis of intravenous antiemetic medication and routine,the experimental group implemented the Bian-stone-based herbal heat therapy on the basis of intravenous antiemetic medication and conventional nursing care.In the control group,intravenous antiemetic drugs and routine care were used,and the intervention duration of both groups was 14 d,of which 7 d was a course of treatment,with a total of 2 courses of treatment.The incidence of gastroin-testinal reactions,Gastrointestinal Symptom Rating Scale(GSRS)score,Pepsin Ⅰ(PG Ⅰ),Pepsin Ⅱ(PG Ⅱ),and the ratio of PG Ⅰ to PG Ⅱ(PGR)before and after the intervention were compared between the 2 groups.Results The final sample of 66 cases was collected in this study,and 1 patient was dislodged from each of the control group and the experimental group.The comparison of the incidence of gastrointestinal reactions between the 2 groups within 14 days showed that the incidences of nausea,vomiting,abdominal distension,and diarrhea were lower in the experimental group than those in the control group(P＜0.05).GSRS scores on days 1,8,and 14 of intervention were compared,and there were effects between groups in both groups(F=5.338,P=0.017).The levels of PG Ⅰ,PG Ⅱ in the experimental group on day 8 of the intervention were lower than those in the control group.The levels of PGR was higher than that in the control group(all P＜0.05).The safety of the 2 groups after treatment was evaluated,and the results showed that no serious adverse events occurred in the 2 groups.Conclusion Bian-stone-based herbal heat therapy can improve gastrointestinal reactions and reduce the incidence of gastrointestinal reactions during the preconditioning period of hematopoietic stem cell transplantation patients,which provides clinical guidance for the application of Bian-stone-based herbal heat therapy by nursing staff in the future.

Objective To explore and analyze the current situation of consumer health activation index and its influencing factors in hospitalized elderly patients with multiple chronic conditions,and to provide reference basis for clinical intervention.Methods Convenience sampling method was used to select 332 hospitalized elderly patients with multiple chronic conditions from a tertiary hospital in Hefei City from July to December 2024 as the study subjects,and general information questionnaire,Consumer Health Activation Index,Health Literacy Management Scale,Scale of the Elderly Self-neglcet(Rural),and Perceived Social Support Scale were used to investigate the current situation of consumer health activation index of hospitalized elderly patients with multiple chronic conditions.Univariate analysis and multiple linear regression analysis were employed to explore the influencing factors of consumer health activation index in patients with multiple chronic conditions.Results A total of 332 questionnaires were distributed,and 325 valid questionnaires were retrieved.The score of the consumer health activation index of hospitalized elderly patients with multiple chronic conditions was(61.68±15.12).The results of multiple linear regression showed that literacy,average monthly household income,number of chronic diseases,medication frequency,self-care ability,health literacy management,perceived social support and self-neglect were the influencing factors for the positivity of hospitalized elderly patients with multiple chronic conditions(P＜0.05),which could explain 59.9％of the variance of the consumer health activation index of hospitalized elderly patients with multiple chronic conditions.Conclusion The consumer health activation index of hospitalized elderly patients with multiple chronic conditions is at a low level.In the future,precise and systematic intervention measures for enhancing positive health status can be formulated by taking into account relevant influencing factors,in order to promote the transformation of patients from passive health to active health,and thereby facilitating positive aging.

Objective To explore the impact and threshold effect of productive engagement on the elderly patients with chronic diseases with demoralization syndrome,and to provide theoretical basis for further improving the elderly patients with chronic diseases with demoralization syndrome.Methods A total of 350 elderly patients with chronic diseases from July to December 2024 in a tertiary hospital in Hefei were selected as the research subjects by convenience sampling method,and the general information questionnaire,Productive Engagement Scale and Demoralization Scale-Ⅱ were used for investigation.Using multiple stratified regression analysis to explore the impact of participation in productive activities on dementia syndrome in elderly patients with chronic diseases,and conducting threshold effect analysis.Results 341 valid questionnaires were collected.The score of demoralization syndrome in elderly patients with chronic diseases was 14.00(11.00,17.00),and the score of productive engagement was 37.00(29.50,46.00).Stratified regression analysis showed that productive engagement could independently explain 8.7％of the variance(P＜0.05).Curve fitting and threshold effect analysis showed that the degree of demoralization syndrome was not affected when the score of productive engagement of elderly patients with chronic diseases was ≤27 points(P＞0.05),and it was decreased with the increasing of productive engagement score＞27 points(P＜0.001).Conclusion The demoralization syndrome of elderly patients with chronic diseases were in the middle level,and productive engagement is negatively correlated with demoralization syndrome.Healthcare professionals can improve the level of demoralization syndrome by encouraging elderly patients with chronic diseases to actively participate in productive engagement activities.