Objective To investigate whether embolization surgery can improve mid-to-long-term outcomes related to quality of life,anxiety and depression in patients with unruptured intracranial aneurysms(UIA).Methods This prospective study included patients diagnosed with UIA within 30 days.Patients were divided into two groups based on treatment:the embolization group and the conservative group.The assessments of quality of life,depression,and anxiety were conducted using the medical outcome study short form-36(SF-36),self-rating depression scale(SDS),and self-rating anxiety scale(SAS)at baseline,3 months,and 5 years after treatment.In the embolization group,psychological trauma was assessed using the impact of event scale-revised(IES-R)at 3 months and 5 years post-surgery.Results A total of 113 patients were involved in the analysis including 76 in the embolization group and 37 in the conservative group.Compared to the conservative group,SF-36 data showed that the embolization group had a lower physical function(80.3±16.4 vs.86.1±12.8,P=0.046)and role-physical(47.37±43.32 vs.67.57±34.29,P=0.015)scores at 3 months,but a higher mental health score(68.16±18.80 vs.61.62±14.62,P=0.048).At 5 years,all dimensions of SF-36 improved significantly compared to baseline(all P<0.05).The SDS and SAS scores in the embolization group were significantly lower at both 3 months and 5 years compared to baseline(both P<0.05).The decrease in SDS(-2.8±10.6 vs.0.5±6.5)and SAS(-2.7±11.8 vs.1.2±5.4)scores in the embolization group at 3 months was greater than in the conservative group(both P<0.05).Subgroup analysis showed that patients with depression or anxiety at baseline in the embolization group experienced a significant decrease in SDS and SAS scores at 3 months and 5 years compared to baseline(both P<0.05).Additionally,in the embolization group,the IES-R score at 3 months was 37.5±13.8,which was significantly higher than the critical threshold(P=0.005),but decreased to 33.8±13.3 at 5 years post-surgery.Conclusions Patients with unruptured intracranial aneurysms experienced long-term improvements in quality of life after embolization surgery.Embolization surgery also helped alleviate depression and anxiety.

Objective:To investigate the clinical characteristics and prognosis of cytomegalovirus-sepsis-like syndrome (CMV-SLS) in premature infants, and to provide the evidence for early clinical identification and treatment.Methods:Premature infants with CMV-SLS admitted to Children′s Hospital Affiliated of Zhengzhou University from January 1, 2019 to December 31, 2022 were selected as the research subjects, and their clinical characteristics, treatment, and prognosis were retrospectively analyzed.Results:A total of seven cases of CMV-SLS were included, with a gestational age of (26.8±1.2) weeks and a birth weight of (890±121) g. The age of disease onset was 55(45, 60) days, and the age of diagnosis was 67(56, 71) days. All the seven cases were exclusively breast feeding after birth, and cytomegalovirus (CMV) DNA was detected positive in their breast milk when diagnosed with CMV-SLS. The common clinical features were fever, abdominal distension, liver function damage, decreased neutrophil and platelet counts. Pneumonia, neonatal necrotizing enterocolitis, hearing loss, and chorioretinitis were common. After the diagnosis was confirmed, all the seven cases were given intravenous treatment of ganciclovir and followed by oral formulations, with a course of treatment ranging from five to seven weeks. Two cases were treated with intravitreal injection of ganciclovir for chorioretinitis. All the seven cases survived. During the follow-up with a corrected gestational age of 12 months, one case had delayed intellectual and motor development, two cases had delayed motor development, and the remaining cases had normal development.Conclusions:CMV-SLS in premature infants mainly occurs in extremely low birth weight infants, with atypical clinical manifestations and may be misdiagnosed easily. If extremely low birth weight infants who receive CMV DNA positive breast feeding show sepsis-like symptoms, the possibility of CMV infection should be considered, and early diagnosis and treatment should be carried out to prevent adverse outcomes.

Objective: To investigate the mortality and disease burden of diabetes in Hangzhou City from 2013 to 2021, so as to provide insights into improving diabetes prevention and control strategies. Methods: Data on morbidity and mortality of diabetes in Hangzhou City from 2013 to 2021 were collected through the Chronic Disease and Death Cause Monitoring System of Hangzhou Center for Disease Control and Prevention, and the crude and age-standardized mortality (standardized by the population of the Seventh National Population Census in China in 2020) were calculated. Data on the prevalence of diabetes were collected from the China Chronic Disease and Risk Factors Surveillance (CCDRFS), and the burden of disease was evaluated by calculating years of life lost (YLL), years lived with disability (YLD) and disability-adjusted years (DALY) with reference to the methodology of the Global Burden of Disease Study (GBD). The trends in mortality and disease burden of diabetes were evaluated with the average annual percent change (AAPC). Results: There were 8 686 deaths of diabetes in Hangzhou City from 2013 to 2021, with the average annual crude mortality of 13.17/105 and age-standardized mortality of 10.89/105. The crude mortality of diabetes showed a tendency towards a rise (AAPC=2.62%, P<0.05), while the trend in age-standardized mortality was not significant (P>0.05). The crude and age-standardized mortality of diabetes were higher in women than in men (14.11/105 vs. 12.21/105, 12.16/105 vs. 9.71/105; both P<0.05); however, the crude mortality in men increased more rapidly (men: AAPC=4.46%, P<0.05; women: AAPC=1.09%, P>0.05). The YLL, YLD and DALY of diabetes were 155.42, 1 246.73 and 1 402.15 thousand person-years, and the rates of YLL, YLD and DALY were 2.36, 18.90 and 21.25 person-years per thousand, respectively. The rates of YLL, YLD and DALY appeared a tendency towards a rise (AAPC=1.57%, 6.03% and 7.11%, all P<0.05). Higher rates of DALY and more remarkable increase were seen in men than in women (P<0.05; AAPC=8.37%, 5.54%, both P<0.05). Conclusions The mortality of diabetes in Hangzhou City from 2013 to 2021 is high, and the burden of disease, especially disability, is growing rapidly, with the burden of disease being more serious in men.

In recent years, the research of spatiotemporal clustering of disease is attracting more and more attention, which plays an important role in understanding the temporal and spatial distribution characteristics of diseases, and can provide references for the etiology exploration and prevention and control of diseases. In order to better understand the research methods of spatiotemporal clustering of diseases and its application progress, this paper summarizes the statistical methods commonly used in relevant researches at demestic and abroad from three aspects of temporal clustering, spatial clustering and spatiotemporal clustering of diseases.

Objective To investigate pediatric hemoptysis recurrence related to vascular malforma-tions after transcatheter occlusion and offer suitable preventive actions for reducing the rate of hemoptysis recurrence.Methods The clinical data of 27 children,collected form Department of Cardiology,Children's Hospital of Chongqing Medical University between June 2012 and April 2017,with hemoptysis related to vascular malformations were retrospectively analyzed.The clinical manifestation,image feature and occlusion program of children with hemoptysis recurrence were re-analyzed and evaluated. Results All 27 children with hemoptysis received transcatheter occlusion, whose vascular malformations included bronchial-pulmonary artery fistula (24 cases,88.9%) and pulmonary arteriovenous fistulas (3 cases,11.1%) by angiography. Six cases,approximately 26.1%,suffered from recurrent hemoptysis after therapy,and the interval time of hemoptysis recurrence was roughly (5.6 ± 2.3)months.It indicated mycoplasma pneumonia infection in all children with hemoptysis recurrence, and re-angiography showed that more abnormal vessels were found, other minor vessels except for vessels occluded grew thick and large,vessels except for vessels occluded were recanalization in children with recurrent hemoptysis.Conclusion Recurrence is the common complication of hemoptysis related to vascular malformations in children,and bronchial-pulmonary artery fistula is the most common type with hemoptysis recurrence. The main causes of hemoptysis recurrence include mycoplasma pneumonia infection,vessels without occlusion enlargement and recanalization.

Objective To investigate the relationship of ELK-3 and epithelial-mesenchymal transition ( EMT) for ex-ploring its possible mechanism .Methods The human hepatocellular carcinoma cells ( HCC) were divided into small interference RNA transfection group and Ras-ELK-3 pathway inhibitor group .The protein level of ELK-3 target gene EGR-1 E-cadherin ,vimentin and p38 in HCC were determined by Western blot analysis .Results The protein level of ELK-3 and its target gene EGR-1 in treated human hepatocellular carcinoma cells significantly decreased as compared with the negative control group (P<0.01).The protein level of E-cadherin was significantly increased (P<0.01), while vimentin and p38 were decreased in HCC cells with ELK-3 interference (P<0.01).Conclusions ELK-3 in-terference can inhibit the epithelial-mesenchymal transition of HCC cells by down-regulating p38.

Objective The present study was to investigate the feasibility of use of high resolution magnetic reso?nance vessel wall imaging(HR-VWI)in evaluation of intracranial aneurysms. Methods We prospectively collected data from patients who had intracranial aneurysms and received HR-VWI scan before surgical treatment or conservative treatment. Aneurysms were divided into ruptured group (n=12) and unruptured group (n=88). Aneurysm site, size, neck, aspect ratio(AR), daughter sac and aneurysmal wall enhancement scale were analyzed in both groups. Univariate and multivariate Logistic regression were performed to evaluate the risk factors of aneurysm rupture. Subgroup analysis was also performed to study symptomatic and asymptomatic unruptured aneurysms. Results Aneurysm size(t=2.187,P=0.031),AR(t=3.164,P=0.002),incidence of daughter sac(P=0.012) and aneurysmal wall enhancement scale(P<0.001)were higher in ruptured aneurysm group. Multivariate Logistic regression showed that aneurysmal wall enhance?ment scale was the only independent risk factor of ruptured aneurysms(P=0.002). Subgroup analysis showed aneurysm wall enhancement scale(P<0.001) and AR(t=3.939,P<0.001) were higher in symptomatic unruptured aneurysms. Conclusion Aneurysm wall enhancement on HR-VWI is more frequently seen in ruptured aneurysms and symptomatic unruptured aneurysms. Histological study is needed for better understanding of the mechanism of aneurysm wall enhance?ment.

Objective We evaluate if supplementary grading system can refine patient selection and accurately predict neurological outcome in BAVM. Methods We retrospectively study 221 BAVM patients who were treated micro?surgically by our hospital. The score of pre and post operation mRS and relative clinical, radiology data were collected. Two different logistic models (Spetzler-Martin, Supplementary Spetzler-Martin grading model) were constructed to com?pare the area under ROC. Results Some factors are significant different between worse outcome patients and good out?come patients:Non-hemorrhagic presentations prior surgery, AVM bigger than 3cm, diffuse shape of AVM and the elder patients. Predictive accuracy was higher for the supplementary model (ROC area, 0.91), than the Spetzler-Martin model (ROC area, 0.774). So the predictive accuracy of supplementary model was significantly better than that of the Spet?zler-Martin model (P=0.0362). Conclusions Supplementary Spetzler-Martin model can improve preoperative risk pre?diction and subgroup the patients more efficiently. When the score less than 5(including 5) in supplementary Spet?zler-Martin patients seem to have lower risk relative to surgery.

Objective To analyze the clinical features of severe pneumonia complicated with congenital heart disease (CHD) . Methods The clinical data of 270 children patients with severe pneumonia complicated with CHD (CHD group) were collected to analyze the relative medical history ,etiology ,bacterial drug resistance and clinical outcomes .Moreover ,636 age-matched children pa-tients with pure severe pneumonia were selected as the control group .Results In the CHD group ,250 cases were infants and 35 ca-ses suffered from repeated pneumonia .Compared with the control group ,the CHD group was earlier in onset and more prone to re-peated pneumonia .Among 270 cases ,totally 220 cases were checked out the pathogens ,but no statistically significant difference in the detection rates of pathogens between the CHD group and the control group was found (P>0 .05);179 cases were infected by bacteria ,in which 126 cases were Gram-negative bacteria ,the positive rate of bacterial infection and the detection rate of Gram-nega-tive bacterial were relatively higher than those in the control group ,the difference was statistically significant (P<0 .05);95 cases were infected by virus ,with respiratory syncytial virus being the most common pathogen ,30 cases were infected by fungi ,with Can-dida albicans being predominant ,the infection rates of virus and fungus had no statistical difference between two groups (P>0 .05);in the drug sensitive test ,the detection rate of extended spectrum beta lactamase (ESBLs)-producing positive bacteria in the CHD group was higher than that in the control group ,the difference was statistically significant (P<0 .05) .Main Gram-negative bacteria Pneumonia klebsiella pneumonia subspecies ,Escherichia coli and haemophilus inf luenzae were highly sensitive to imipenem ,mero-penem ,levofloxacin and ciprofloxacin ;main Gram-positive bacteria Staphylococcus aureus and streptococcus pneumoniae were highly sensitive to vancomycin and gentamicin .Especially ,pneumonia klebsiella pneumonia subspecies ,Escherichia coli and haemophilus influenzaewere100% resistanttopenicillin.TheaveragelengthofhospitalstayintheCHDgroupwas (20.9±12.5)d,207cases developed the respiratory failure ,88 cases appeared the heart failure and 205 cases were effective in treatment ;compared with the control group ,the CHD group had a longer length of hospital stay ,higher occurrence rate of heart and respiratory failure and lower treatment effective rate (P<0 .05) .Conclusion Because of the earlier onset ,more prone to repeated pneumonia ,more sensitive to bacterial infection ,esp .Gram-negative bacteria ,more ESBLs production ,longer hospital stay and more prone to complications ,com-pared with the control group ,children with severe pneumonia complicated with CHD require active treatment .

Objective T0 investigate the effects of transforming growth factorβ1 ( TGFβ1 ) and its receptorβ2 (TGFβR2) gene single nucleotide polymorphisms on the risk of intracranial hemorrhage in patients with brain arteriovenous malformation (BAVM).Methods Fifty-three BAVM patients of both sexes aged 18-64 yr who were genetically unrelated native HAN of Guangdong province were divided into 2 groups:patients with and without intracranial hemorrhage ( n =30:23).Venous blood samples were collected and anti-coagulated with ethylene diaminetetraacetic acid for genomic DNA extraction.TGFβ1-509C/T (rs1800469) and TGFβR2 875A/G (rs3087465) gene SNPs were genotyped by using PCR-RFLP.Results There were no significant differences in genotype and frequency between the 2 groups.The G carrier frequency of the TGFβR2 genotype was significantly higher in patients with intracranial hemorrhage than in patients without intracranial hemonrhage.The G carrier of the TGFβR2 genotype was associated with intrarcranial hemorrhage in patients with BAVM.Conclusion TGFβ1 gene polymorphism is not relevant to the intracranial hemorrhage in patients with BAVM,but polymorphisms of TGFβR2 could be a risk factor.