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.

Background and Aims:Ruptured abdominal aortic aneurysm (rAAA) is the most severe complication of abdominal aortic aneurysms,characterized by rapid progression and high mortality. Timely diagnosis and treatment are critical,with endovascular aneurysm repair (EVAR) currently serving as the first-line treatment. This study was conducted to evaluate the safety,efficacy,and short-to mid-term outcomes of EVAR for rAAA under standardized emergency protocols.Methods:The clinical data of 22 patients with rAAA who underwent EVAR at Yunnan Fuwai Cardiovascular Hospital from January 2018 to October 2024 were retrospectively analyzed. The cohort included 16 males and 6 females,with a mean age of (67.2±10) years. The mean maximum aneurysm diameter was (70.6±9.2) mm,and all cases were infrarenal rAAA with a mean aneurysm neck angle of (107.9±54.3)° . All patients were diagnosed preoperatively via total aortic and coronary computed tomography angiography (CTA) and treated with EVAR under standardized emergency protocols. Perioperative clinical data,along with follow-up CTA findings at 1 week,1 month,6 months,12 months,and annually thereafter,were collected. Outcome measures included aneurysm sac thrombosis rate,stent morphology,type and incidence of endoleaks,and iliac branch patency rate.Results:The procedural success rate was 100％. Intraoperative angiography revealed type I endoleak in 6 cases,which were successfully managed using balloon dilation,short stent implantation,or a combination of coil embolization and biologic glue to seal the aneurysm sac. Post-treatment angiography showed resolution or significant reduction of the endoleak. The mean operative time was (162.1±63.6) min,with an average transfusion of (736.4±532.3) mL of packed red blood cells. After operation,the average stay in the SICU was (8.76±1.0) h,and the mean hospital stay was (8.1±4.5) d. There were 6 deaths within 30 d after operation. Two patients had minor type Ⅱ endoleak detected on CTA at 1 week,which required no special intervention;these endoleaks reduced by 1 month and resolved by 3-6 months. One patient developed a type Ib endoleak at 2 years after operation,which was successfully managed with reintervention. The remaining patients had no endoleaks,no iliac branch occlusions,and satisfactory aneurysm sac thrombosis.Conclusion:EVAR under standardized emergency protocols is safe and effective for treating rAAA,with satisfactory short-and mid-term outcomes. Type Ⅰ endoleak can be reliably managed using techniques such as balloon dilation,short stent implantation,and coil embolization with biologic glue,demonstrating a safe and effective treatment approach.

Background and Aims:Ruptured abdominal aortic aneurysm (rAAA) is the most severe complication of abdominal aortic aneurysms,characterized by rapid progression and high mortality. Timely diagnosis and treatment are critical,with endovascular aneurysm repair (EVAR) currently serving as the first-line treatment. This study was conducted to evaluate the safety,efficacy,and short-to mid-term outcomes of EVAR for rAAA under standardized emergency protocols.Methods:The clinical data of 22 patients with rAAA who underwent EVAR at Yunnan Fuwai Cardiovascular Hospital from January 2018 to October 2024 were retrospectively analyzed. The cohort included 16 males and 6 females,with a mean age of (67.2±10) years. The mean maximum aneurysm diameter was (70.6±9.2) mm,and all cases were infrarenal rAAA with a mean aneurysm neck angle of (107.9±54.3)° . All patients were diagnosed preoperatively via total aortic and coronary computed tomography angiography (CTA) and treated with EVAR under standardized emergency protocols. Perioperative clinical data,along with follow-up CTA findings at 1 week,1 month,6 months,12 months,and annually thereafter,were collected. Outcome measures included aneurysm sac thrombosis rate,stent morphology,type and incidence of endoleaks,and iliac branch patency rate.Results:The procedural success rate was 100％. Intraoperative angiography revealed type I endoleak in 6 cases,which were successfully managed using balloon dilation,short stent implantation,or a combination of coil embolization and biologic glue to seal the aneurysm sac. Post-treatment angiography showed resolution or significant reduction of the endoleak. The mean operative time was (162.1±63.6) min,with an average transfusion of (736.4±532.3) mL of packed red blood cells. After operation,the average stay in the SICU was (8.76±1.0) h,and the mean hospital stay was (8.1±4.5) d. There were 6 deaths within 30 d after operation. Two patients had minor type Ⅱ endoleak detected on CTA at 1 week,which required no special intervention;these endoleaks reduced by 1 month and resolved by 3-6 months. One patient developed a type Ib endoleak at 2 years after operation,which was successfully managed with reintervention. The remaining patients had no endoleaks,no iliac branch occlusions,and satisfactory aneurysm sac thrombosis.Conclusion:EVAR under standardized emergency protocols is safe and effective for treating rAAA,with satisfactory short-and mid-term outcomes. Type Ⅰ endoleak can be reliably managed using techniques such as balloon dilation,short stent implantation,and coil embolization with biologic glue,demonstrating a safe and effective treatment approach.

Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.

Objective:To analyze the preliminary explorations and practical effects of strengthening the process management of nursing special projects in a tertiary general hospital, so as to explore the refined management strategy of hospital projects and provide reference for improving the management level of the research project.Methods:This article takes a series of refined measures taken by the hospital in the process management of nursing special projects from August 2016 to August 2021 as the research example, including setting up subject directions around key disciplines, setting application conditions at different levels, standardizing selection procedures, strengthening mid-term assessments, strictly controlling final acceptance, establishing integrity files, and promoting the transformation of scientific achievements, etc. and these measures are deeply analyzed and discussed.Results:Through a series of measures, the hospital nursing team has significantly improved in terms of research paper publication, patent authorization, approval of projects above the bureau level, and nursing specialties ranking of Chinese hospital Science and Technology Evaluation Metrics (STEM) in the past six years.Conclusions:By strengthening the process management of nursing special research project, the construction level of nursing disciplines has been significantly improved, and the development of nursing disciplines has been greatly promoted.

Objective:According to the requirements of high-quality development of public hospitals, to explore the innovative incentive path for medical youth based on the two-factor theory, and provide a reference for promoting the high-quality development of public hospitals.Methods:Using the literature analysis method, the two-factor theory, hospital scientific research incentive mechanism, and scientific research incentive mechanism for young talents were investigated. Meanwhile, combining the two-factor theory and practical experience, the problems that existed in the innovation incentive policy of public hospitals for young medical talents were analyzed, and the corresponding countermeasures were proposed to build the innovation incentive path of young medical talents under the two-factor theory.Results:Based on analyzing the demand characteristics of young medical talents, managers should distinguish health care factors and incentive factors, and implement incentives from both aspects. Provide incentives through improving the personal sense of achievement, creating a personal growth environment, and promoting professional titles to stimulate young talents' innovation motivation; implement health care factors from aspects of working conditions, material benefits, salary levels, etc.Conclusions:As a new concept of development, high-quality development is not only reflected in scientific and technological innovation-driven, but also in the innovation of management mechanisms so that institutional innovation becomes the driving force for high-quality development.

Objective:Established a Super-DEA model to calculate the efficiency of scientific research work of the hospital departments, statistically compared it with the evaluation results of scientific research work in discipline construction, and proposed improvement suggestions.Methods:Considering the characteristics of the input and output indicators, non-radial super-SBM model from the DEA methods was established to calculate the scientific research efficiency of 47 departments of the hospital in 2019, two independent sample t-tests were used to compare the differences in subject construction scores between effective and ineffective departments with super-efficiency values.Results:The average scientific research efficiency of 47 departments in the hospital was 0.70, with the highest efficiency being the scientific research department and the lowest being the internal medicine department; there were 18 DEA-effective departments and 29 DEA-ineffective departments; among the DEA-ineffective departments, the average human resource input was 1.13 people, the redundant scientific research funds is 854, 800 yuan on average; compared with the evaluation results of scientific research work in the discipline construction in 2019, the ranking of the same discipline is significantly different, the t-test results showed that there was no significant difference in the subject construction scores between DEA effective and ineffective departments. Using this model to calculate the data in 2021, the results show that DEAs in 21 departments are effective, with an effective rate of 42.86%.Conclusions:There is a big difference in the scientific research efficiency of the hospital departments, and the overall efficiency need to be improved; it should be improved according to the reasons for the lack of scientific research efficiency; the discipline construction evaluation system has not considered the input and other deficiencies, it is recommended to optimize the evaluation system to improve fairness and rationality. The results preliminarily show that the model can play a positive guiding role in the scientific research work of the department.

Objective:To establish the high-level clinical research platform to promote scientific and technological innovation ability in hospitals.Methods:Summarize and share the practical experience of integrating and optimizing the construction of scientific research platform in our hospital, this paper aimed to illustrate the important role of scientific research platform in promoting the innovation ability of science and technology in hospital.Results:According to the construction practice of clinical research platform in our hospital, the planning of clinical research platform should be guided by clinical needs and application. At the same time, having better understandings of relevant national policies, as well as the overall national development strategy layout play important roles in establishing a high-starting point clinical research platform from the very beginning.Conclusions:Accordingly, the key factors to improve the hospital's scientific and technological innovation ability mainly include the construction of scientific research platform, the cultivation of dominant and characteristic disciplines, the cultivation of innovative talents, the cross-disciplinary cooperation, the transformation of innovative achievements and the innovative management mechanism, among which the construction of high-level scientific research platform is the most basic guarantee to enhance the scientific and technological innovation ability.

Objective Discipline construction is the core for the development of a hospital and international cooperation and exchange play an important role in promoting discipline construction.This paper summarized the experiences of carrying out international cooperation and exchange in the hospital discipline construction.Methods Analyzed the exploration,practice and its effect in promotion of hospital discipline construction regarding to international cooperation in recent years.Results The international cooperation and exchange have effectively promoted the development of hospital disciplines,for instance,introduction and training of talents,organizing and holding of high-level international conferences,establishment of international academic journals and the joint construction of academic platforms.Conclusions In accordance with the requirements of discipline development strategy,the hospital can improve the overall level of discipline construction rapidly by carrying out all-dimensional cooperation with international top medical institutions.

Recently, traditional Chinese medicine (TCM) researches on diabetic peripheral neuropathy made great progress. It is found that theetiology and pathogenesis was the deficiency in origin and the ecessive in superficialty. The deficiencyincluded Yin deficiency, Qi deficiency, blood deficiency, deficiency of both Qi and Yin, Yang deficiency, while the ecessive in superficialty included blood stasis, stasis of phlegm and blood. Thus, the principles of treatment were supplementing Qi and nourishing Yin, warming Yang, promoting blood and removing blood stasis, and smooth Luo, all of which showed the characteristics of TCM treatment were combination of inside and outside, and multi-target effects. This paper reviewed the progress of clinical and experimental studies on the TCM for diabetic peripheral neuropathy.