Background: and Purpose In patients with large vessel occlusion (LVO), intravenous thrombolysis (IVT) frequently alters thrombus location; however, the clinical impact of this phenomenon remains unclear. We aimed to compare post-IVT thrombus dynamics between tenecteplase and alteplase and to evaluate the association between thrombus dynamics and 3-month outcomes. Methods: This retrospective study analyzed prospectively collected, multicenter data from consecutive patients with LVO who underwent bridging therapy between January 2022 and December 2024. Thrombus dynamics were classified as resolution, migration, or stability. Analyses incorporated propensity score matching with weighting to balance baseline characteristics. Results: Of the 806 initially included patients, 746 were included after matching (373 treated with tenecteplase and 373 treated with alteplase). The incidence of thrombus migration was significantly higher in the tenecteplase group than in the alteplase group (19.3% vs. 11.3%; odds ratio [OR]: 1.92; 95% confidence interval [CI] 1.27–2.91). The advantage of tenecteplase over alteplase was restricted to patients with an IVT-to-puncture time of <60 minutes (18.6% vs. 6.2%; p=0.001) and was no longer significant when the interval ≥60 minutes (19.7% vs. 15.0%; p=0.204; pinteraction=0.043). Additionally, thrombus migration was associated with a better functional outcome (OR: 1.62; 95% CI 1.04–2.53). Finally, tenecteplase was associated with improved functional independence compared with alteplase (OR: 1.43; 95% CI 1.04–1.95). Conclusions Tenecteplase demonstrated superior efficacy in inducing thrombus migration compared with alteplase, particularly within 60 minutes of IVT administration. Thrombus migration independently predicted improved functional independence. These findings support the preferential use of tenecteplase for bridging therapy in patients with LVO.

Objective To evaluate the clinical characteristics, diagnostic reasoning, and therapeutic strategies of prostatic paraganglioma (PPG) to provide an evidence-based foundation for early diagnosis and precision treatment of this rare malignancy. Methods The clinical data of a patient with PPG admitted to our hospital were retrospectively analyzed. Concurrently, a systematic search was conducted across domestic and international databases, including PubMed, CNKI, and Wanfang.Clinical manifestations, laboratory tests, pathological features, therapeutic modalities, and prognostic data of 24 cases reported between 1979 and 2025 were pooled with the institutional case for a comprehensive analysis (n=25). Results Epidemiological features: the age at onset ranged from 8 to 76 years, with a mean age of (44.6±15.2) years, predominantly affecting young and middle-aged adults (30-50 years).Notably, 20.0% (5/25) of the patients exhibited characteristic micturition-associated catecholamine release symptoms (e.g., post-micturition palpitations, transient hypertension).Laboratory findings: among the 19 patients who underwent catecholamine metabolite testing, 14 (73.7%) showed significant elevation in serum or urinary norepinephrine and methoxyadrenaline levels.Pathological and immunohistochemical features: the positivity rate for neuroendocrine markers (chromogranin A, synaptophysin, and neuron-specific enolase) was 100%, while the negativity rate for prostate-specific markers (prostate-specific antigen and prostate-specific acid phosphatase) was also 100%.Treatment and prognosis: surgical intervention was performed in 96.0% (24/25) of the patients, including radical prostatectomy (37.5%), precision tumor excision (25.0%), and transurethral resection (12.5%).Favorable outcomes without recurrence were observed in 89.5% (17/19) of the total cohort. Conclusion PPG is clinically exceedingly rare.The disease should be highly suspected in patients presenting with a prostatic mass, normal prostate-specific antigen level, and micturition-associated cardiovascular symptoms.Testing for catecholamine metabolites is the key screening tool.Robot-assisted surgery facilitates precise tumor excision while ensuring optimal functional preservation.Given the malignant potential and genetic correlations of PPG, lifelong follow-up is recommended.

To investigate the positivity rates of specific antibodies, including parietal cell antibody (PCA) and anti-inner factor antibody (IFA), in a community population in Xinjiang for autoimmune gastritis (AIG), determine the prevalence of AIG, and analyze the correlations of PCA and IFA with clinical characteristics, pepsinogen (PG), gastrin 17 (G17), and Helicobacter pylori antibody (Hp-Ab).

Objective: To establish a supply model for RhD-negative red blood cells that meets the clinical blood safety needs of Beijing, and to systematically address the challenges of timeliness and safety in rare blood type supply. Methods: Data on the distribution of RhD-negative red blood cells from 2021 to 2025 were retrieved from the management information system of Beijing Red Cross Blood Center. A retrospective analysis was conducted on supply-demand characteristics, blood type distribution, quarterly fluctuations and key difficulties. On this basis, a hierarchical supply mechanism covering demand assessment, appointment response, overall inventory planning and regional coordination was constructed and continuously optimized in practice. Results: A total of 15 295 units of RhD-negative red blood cells were distributed in the past five years, with an A∶B∶O∶AB ratio of approximately 3∶3∶3∶1. Quarterly demand for each blood type fluctuated significantly. Following the implementation of the hierarchical supply mechanism, the supply of RhDnegative red blood cells remained stable and orderly. The response time for massive emergency blood demand was significantly improved, and the fulfillment rate of non-emergency appointment demand remained high. Zero RhD conversion and zero blood wastage of RhD-negative red blood cells were achieved during the blood support for major events. Conclusion: The Beijing model effectively addresses the difficulties and risks associated with RhD-negative red blood cell supply in megacities with highly concentrated high-quality medical resources and provides a replicable practical reference for other major cities.

Objective To analyze the temporal trends of gout disezse burden in China from 1990 to 2021,and construct an age-period-cohort(APC)model to explore the independent effects of age,period,and birth cohort on epidemiological indicators,and predict the future burden of gout disease in China from 2022 to 2035.Methods Data on gout disease burden in China during 1990-2021 were extracted from the Global Burden of Disease(GBD)2021 database.Joinpoint regression analysis was used to assess temporal trends.The APC model was applied to evaluate the age,period and cohort effects on prevalence risk and disability-adjusted life years(DALYs).A Bayesian age-period-cohort(BAPC)model was employed to project the age-standardized prevalence rate(ASPR)and age-standardized DALY rate(ASDR)of gout in China from 2022 to 2035.Results From 1990 to 2021,the incidence,prevalence and DALYs of gout in China all increased substantially,with overall rising trends in the age-standardized incidence rate(ASIR),ASPR and ASDR.Compared with 1990,the incidence,prevalence and DALYs in 2021 increased by 160.45%,181.12%,and 175.93%,respectively,while their age-standardized rates increased by 23.74%,26.48%and 25.89%.Joinpoint regression analysis revealed that average annual percentage changes(AAPCs)of 0.73%for ASIR,0.82%for ASPR and 0.80%for ASDR during 1990-2021.In 2021,the number of cases and DALYs reached their peaks in males aged 55-59 years and females aged 65-69 years.Both prevalence and DALY rates increased steadily with age,with marked rises starting at age 30 in men and age 40 in women.Overall,males showed higher prevalence,DALYs and corresponding rates than those of females across all age groups.APC model results indicated that the age effect,period effect and cohort effects on prevalence and DALY rates presented an overall upward tread.Decomposition analysis showed that population aging contributed the most to the increase in incidence and DALYs from 1990 to 2021.BAPC projections suggested that by 2035,the ASPR and ASDR of gout in China reached 890.50 per 100,000 and 27.26 per 100,000,respectively.Conclusion The ASPR and ASDR of gout in China are projected to continue increasing from 2022 to 2035.Targeted public health strategies for high-risk populations are urgently needed to reduce the growing burden of gout.

In recent years, significant progress has been made in the treatment of chronic constipation, with high-quality studies emerging in areas such as fecal microbiota transplantation (FMT), sacral neuromodulation (SNM), acupuncture, and surgical techniques. The therapeutic approach is shifting from a traditional "medication and surgery" model toward an integrated strategy that includes dietary and defecation habit adjustment, FMT, SNM, acupuncture, pharmacotherapy, and surgery. Although FMT can partially improve stool frequency and consistency, its standardization and long-term efficacy require further validation. SNM demonstrates limited effectiveness in treating chronic constipation and is relatively cost-inefficient. Electroacupuncture remains controversial, though some studies support its value. Biofeedback therapy is recommended by multiple guidelines as the first-line treatment for dyssynergic defecation (DD), with portable home-based biofeedback systems showing considerable potential. For internal rectal prolapse (IRP) and rectocele (RC), various surgical options exist without a clear superiority, though laparoscopic ventral rectopexy (VMR) is increasingly favored due to its low recurrence rate and high patient satisfaction. In the surgical management of slow transit constipation (STC), total colectomy with ileorectal anastomosis remains the mainstream approach, while subtotal colectomy is gaining attention as an alternative.

Objective To analyze the temporal trends of gout disezse burden in China from 1990 to 2021,and construct an age-period-cohort(APC)model to explore the independent effects of age,period,and birth cohort on epidemiological indicators,and predict the future burden of gout disease in China from 2022 to 2035.Methods Data on gout disease burden in China during 1990-2021 were extracted from the Global Burden of Disease(GBD)2021 database.Joinpoint regression analysis was used to assess temporal trends.The APC model was applied to evaluate the age,period and cohort effects on prevalence risk and disability-adjusted life years(DALYs).A Bayesian age-period-cohort(BAPC)model was employed to project the age-standardized prevalence rate(ASPR)and age-standardized DALY rate(ASDR)of gout in China from 2022 to 2035.Results From 1990 to 2021,the incidence,prevalence and DALYs of gout in China all increased substantially,with overall rising trends in the age-standardized incidence rate(ASIR),ASPR and ASDR.Compared with 1990,the incidence,prevalence and DALYs in 2021 increased by 160.45%,181.12%,and 175.93%,respectively,while their age-standardized rates increased by 23.74%,26.48%and 25.89%.Joinpoint regression analysis revealed that average annual percentage changes(AAPCs)of 0.73%for ASIR,0.82%for ASPR and 0.80%for ASDR during 1990-2021.In 2021,the number of cases and DALYs reached their peaks in males aged 55-59 years and females aged 65-69 years.Both prevalence and DALY rates increased steadily with age,with marked rises starting at age 30 in men and age 40 in women.Overall,males showed higher prevalence,DALYs and corresponding rates than those of females across all age groups.APC model results indicated that the age effect,period effect and cohort effects on prevalence and DALY rates presented an overall upward tread.Decomposition analysis showed that population aging contributed the most to the increase in incidence and DALYs from 1990 to 2021.BAPC projections suggested that by 2035,the ASPR and ASDR of gout in China reached 890.50 per 100,000 and 27.26 per 100,000,respectively.Conclusion The ASPR and ASDR of gout in China are projected to continue increasing from 2022 to 2035.Targeted public health strategies for high-risk populations are urgently needed to reduce the growing burden of gout.

Objective:To analyze the guiding value of index of consciousness 1(IoC1) and index of consciousness 2(IoC2) in anesthesia management of laparoscopic surgery.Methods:A total of 100 elderly patients undergoing laparoscopic surgery under general anesthesia in the Beijing Coal Group General Hospital from June 2022 to October 2023 were prospectively selected as research objects, and they were divided into the observation group and the control group according to random number table method, with 50 cases in each group. The observation group used IoC1 and IoC2 to monitor and guide anesthesia management, while the control group used bispectral index (BIS) to monitor the depth of anesthesia, and combined with the experience of anesthesiologists to guide anesthesia management. The changes of vital signs of patients in the two groups were compared after calm entry (T 0), induction of anesthesia (T 1), implantation of laryngeal mask 1 min (T 2), carbon dioxide (CO 2) pneumoperitoneum 1 min (T 3), and removal of laryngeal mask 1 min (T 4). The time of resuscitation extubation, dosage of anesthetic drugs, dosage of vasoactive drugs, IoC1, IoC2 and BIS were compared between the two groups. Results:The pneumoperitoneum time and incidence of circulatory instability between the two groups had no statistical differences ( P>0.05). The time of resuscitation and extubation in the observation group was shorter than that in the control group : (8.16 ± 6.08) min vs. (13.10 ± 7.09) min, the dosage of propofol and remifentanil were lower than those in the control group : (382.10 ± 201.90) mg vs. (465.48 ± 213.51) mg, (0.81 ± 0.62) mg vs. (1.17 ± 0.55) mg, there were statistical differences ( P<0.05). The amount of ephedrine and atropine between the two groups had no statistical differences ( P>0.05). The dosage of norepinephrine in the observation group was lower than that in the control group: (106.42 ± 46.12) μg vs. (147.04 ± 51.38) μg, there was statistical difference ( P<0.05). The heart rate, mean arterial pressure (MAP) and IoC1/BIS between the two groups had no statistical differences ( P>0.05). The IoC2 values of T 0, T 1, T 2, T 3 and T 4 in the observation group were 97.46 ± 2.46, 45.28 ± 5.08, 48.64 ± 4.51, 50.44 ± 4.21 and 96.08 ± 2.69, respectively. The IoC2 value of T 3 was higher than that of T 1 and T 2 in the observation group, there were statistical differences ( P<0.05). Conclusions:The application of IoC1 and IoC2 to monitor and guide the anesthesia management of laparoscopic patients under general anesthesia makes the application of anesthetic drugs more quantitative and precise, the perioperative vital signs more stable, and the recovery time faster.

BACKGROUND:There are still great controversies in the etiology,clinical manifestations,diagnosis and treatment of pigmented villonodular synovitis.Bibliometric and visualization studies on pigmented villonodular synovitis can clarify the research development context and point out the direction for future research.OBJECTIVE:To analyze the global research status,hotspot,and trend of pigmented villonodular synovitis.METHODS:All publications related to pigmented villonodular synovitis from 1995 to 2023 were retrieved from Web of Science and CNKI.Citespace and bibliometrics were used to analyze the clustering,co-occurrence,and emergent words of all articles.The Web of Science database adopts subject headings plus free words for retrieval,while the CNKI database retrieves through subject headings.Finally,986 English articles and 599 Chinese articles were included.RESULTS AND CONCLUSION:(1)The United States has an absolute leading position in research in this field,ranking first in the number of published papers,H index,and cited times.China ranks the 4th in the total volume of published articles and 12th in the H index.The quality of published articles and international cooperation still need to be improved.(2)Cluster analysis of pigmented villonodular synovitis studies showed that the top five clusters were radiotherapy,soft tissue sarcoma,rheumatoid arthritis,magnetic resonance imaging,and diagnosis.(3)The key words that continued to emerge until 2023 were colony-stimulating factor 1,giant cell tumor of tendon sheath,case report,chromosome translocation,radiotherapy,expression,and kinase.(4)Based on keyword analysis and co-citation analysis,it is found that the research on the clinical characteristics of pigmented villonodular synovitis,the development of new colony-stimulating factor 1 inhibitors,and the application of colony-stimulating factor 1 inhibitors in the treatment process are current research hotspots.(5)Combining thematic evolution with the analysis of current research hotspots,based on clarifying the etiology,pathogenesis,and clinical characteristics of pigmented villonodular synovitis,improving the diagnostic accuracy of pigmented villonodular synovitis,enhancing the precision of treatment,and reducing the recurrence rate after treatment will be key issues that require focus in the future.

Objective To investigate the clinical efficacy of oblique lumbar interbody fusion(OLIF)combined with lateral plate fixation in the treatment of single-level adjacent segment disease(ASDis)following lumbar fusion surgery so as to evaluate the safety and effectiveness of this surgical approach.Methods A retrospective analysis was conducted on 46 patients with single-level ASDis after lumbar fusion surgery from August 2022 to October 2024.Twenty-three patients underwent OLIF combined with lateral plate fixation(OLIF group),while 23 patients received posterior lumbar interbody fusion(PLIF)(PLIF group).The following parameters were compared between the two groups:operative time,intraoperative blood loss,visual analogue scale(VAS)for pain,Oswestry disability index(ODI),disc height(DH),intervertebral foramen height(IFH),and interbody fusion status.Results All the 46 patients successfully completed surgery for single-level ASDis and were followed up for(13.7±1.1)months.The OLIF group had significantly shorter operative time[(70.7±4.6)min vs.(128.6±12.0)min]and less intraoperative blood loss[(58.6±5.7)mL vs.(313.3±47.5)mL]compared to the PLIF group(all P＜0.05).Both groups showed significant improvements in postoperative lumbar VAS and ODI scores at all follow-up time points compared to preoperative values(P＜0.05).The OLIF group exhibited significantly lower lumbar VAS scores at 3 days and 3 months postoperatively than those of the PLIF group(P＜0.05),and there was no statistical difference in VAS scores at the other follow-up time points(P＞0.05).There was no significant difference in postoperative ODI between OLIF group and PLIF group at each time point(P＞0.05).Postoperative DH and IFH were significantly improved in both groups compared to preoperative measurements(P＜0.05).In OLIF group,1 case of transient left thigh numbness resolved with conservative treatment within 2 weeks;1 case of cage subsidence was observed at 1 month postoperatively,achieving fusion without further displacement by 13 months.All the OLIF cases achieved complete fusion(fusion rate:100％).In PLIF group,2 cases of cerebrospinal fluid leakage healed with bed rest,1 case of wound exudation resolved with intensive dressing changes,and 1 case failed to achieve fusion(fusion rate:96％).Conclusion OLIF combined with lateral plate fixation demonstrates satisfactory early clinical outcomes for single-level ASDis after lumbar fusion,with significant advantages in operative efficiency(shorter time plus reduced blood loss)and short-term pain relief.Therefore,it is a safe and effective surgical approach.