Objective:To investigate the clinical characteristics, prognosis, and the impact of different secondary prevention strategies on stroke recurrence in patients with carotid web (CaW)-associated acute anterior circulation large vessel occlusion (LVO).Methods:A retrospective analysis was conducted on 401 patients with acute anterior circulation LVO who underwent mechanical thrombectomy at 2 advanced stroke centers, Xingtai Central Hospital and Xingtai People′s Hospital, from January 2018 to June 2024. CaW was identified using digital subtraction angiography (DSA) and other imaging modalities. Based on the presence of CaW, patients were divided into CaW group and non-CaW group. Differences between the 2 groups in baseline characteristics, clinical features, and clinical outcomes were compared, and long-term follow-up was conducted for the CaW group.Results:Among the 401 patients, the CaW group consisted of 16 patients (4.0%), while the non-CaW group included 385 patients (96.0%). Compared to the non-CaW group, patients in the CaW group were younger [53 (46, 58) years vs 65 (56, 76) years, Z=-3.811, P<0.001], had a higher proportion of M1 segment middle cerebral artery occlusion [13/16 vs 54.0% (208/385), χ2=4.602, P=0.032] and a lower proportion of internal carotid artery terminus occlusion [1/16 vs 40.0% (154/385), χ2=6.024, P=0.014]; the 90-day modified Rankin Scale (mRS) score was significantly lower in the CaW group [1.00 (0, 1.75) vs 3.00 (1.00, 4.00), Z=14.210, P<0.001], and the proportion of patients with favorable functional independence (mRS score 0-2) was significantly higher [15/16 vs 45.7% (176/385), χ2=12.350, P<0.001] in the CaW group; the incidence of pneumonia in the CaW group was significantly lower [2/16 vs 42.6% (164/385), χ2=4.562, P=0.033]. Among the 16 CaW patients, 10 received antiplatelet therapy, 4 underwent carotid artery stenting (CAS), and 2 underwent carotid endarterectomy (CEA). During a median follow-up of 29 months, patients who underwent CAS and CEA had no stroke recurrence, while 2 patients who received antiplatelet therapy had stroke recurrence and subsequently underwent CAS and CEA. Conclusions:The proportion of CaW among patients with acute anterior circulation LVO was 4.0%. The patients with CaW were younger and had a higher proportion of M1 segment middle cerebral artery occlusion. Following mechanical thrombectomy, patients in the CaW group had good functional outcomes. Simple drug therapy may be insufficient to prevent stroke recurrence in CaW patients, and CAS and CEA may be effective therapeutic options.

With the rapid development of neuroelectrophysiology, neuroimaging and other technologies, a large amount of evidence has shown that the occurrence and development of idiopathic generalized epilepsy (IGE) are closely related to the cortical-subcortical neural network. This article intends to review the relevant research on how the cerebral cortex and subcortical structures such as the thalamus, basal ganglia, and cerebellum are involved in the cognitive impairment of IGE, as well as the important subcortical neural nuclei targets currently targeted in the treatment of drug-resistant epilepsy by neuromodulation, to evaluate the feasibility of neuromodulation therapy in clinical practice.

The detection rate of carbapenem-resistant Enterobacter cloacae(CRECL)in clinical practice has risen steadily in recent years,and it has become one of the main pathogens of hospital-acquired infections.CRECL resistance is primarily driven by carbapenemase-encoding genes(CEG),which can spread through multiple mechanisms under the selective pressure of antibiotics and other environmental factors.This gene transfer significantly hampers antimicrobial treatment and infection control efforts.This review outlines the current understanding of CEG distribution in CRECL,key transmission pathways,and their public health im-plications.The findings aim to support the development of effective strategies for the prevention and manage-ment of CRECL infections.

Objective To observe the clinical efficacy of acupuncture combined with western medicine in the treatment of lumbar disc herniation(LDH)of qistagnation and blood stasis type.Methods A total of 62 cases of patients with LDH of qistagnation and blood stasis type were randomly divided into observation group and control group,with 31 cases in each group.The control group was given conventional western medicine for treatment,and the observation group was treated by acupuncture on the basis of the control group,the course of treatment covered three consecutive weeks.After three weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the Japanese Orthopedic Association(JOA)scores and Oswestry Disability Index(ODI)scores,as well as the Visual Analogue Scale(VAS)scores of pain,were observed before and after the treatment of the patients in the two groups.The changes in muscle tension,muscle hardness,and muscle elasticity of the multifidus muscle(MM)and lumbar multifidus muscle(LMM)before and after treatment were compared between the two groups.And the safety and the occurrence of adverse reactions in the two groups were evaluated.Results(1)The total effective rate was 96.77%(30/31)in the observation group and 74.19%(23/31)in the control group.The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the VAS,JOA,and ODI scores of the patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,with a statistically significant difference(P<0.01).(3)After treatment,the muscle tension,muscle hardness,and muscle elasticity of LMM and MM of patients in the two groups were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(4)The incidence rate of adverse reactions was 9.68%(3/31)in the observation group and 9.68%(3/31)in the control group;the intergroup comparison showed that there being no statistically significant difference(P>0.05).Conclusion Acupuncture combined with western medicine in the treatment of LDH of qistagnation and blood stasis type can significantly improve the lumbar function and clinical symptoms of the patients,and improve the muscular performance of the patients'LMM and MM,so as to enhance their quality of life.

Objective To construct a database for molecular mass spectra of toxins and drugs in order to facilitate the management and retrieval of mass spectra for nerve agents,metabolites and other small molecules.Methods Requirement analysis and functional design were performed using software engineering methods.The Spec2Vec algorithm was used for vector representation of mass spectra,while SMILES molecular structures were vectorized using the extended connectivity fingerprint(ECFP).A data storage model integrating structured information and vector representations was established using the Milvus database.Similarity search of mass spectra and molecular structures was conducted via vector similarity comparison and the FlashEntropySearch algorithm.Results The constructed database of mass spectra encompassed over 400,000 entries from such sources as OCAD,NIST,MASSBANK,metabolic products,and natural products of TCM,which was capable of searching for similarities in mass spectra and molecular structures.On a standard server,similarity search of mass spectra took no more than 5 seconds,while that of molecular structures took no more than 1 second.Conclusion The system enables efficient management of complex mass spectra and provides rapid retrieval and comparison of mass spectra-related information through advanced vector indexing technology,offering robust data support and research tools for toxicology and pharmacology.

Epilepsy is a chronic neurological disorder characterized by abnormal brain network function. The localization of the epileptogenic zone and feature analysis of the epileptic networks are key issues in clinical diagnosis and treatment as well as in research of disease mechanisms. In recent years, electroencephalography-functional magnetic resonance imaging (EEG-fMRI), by integrating the high temporal resolution of EEG and high spatial resolution of fMRI, has provided an important tool for localizing epileptogenic zones and researching epileptic networks. This article reviews the recent advance in EEG-fMRI in epilepsy, with a focus on its role in localizing the origin of epileptic seizures, exploring the epileptic networks of different modalities, analyzing the characteristics of epileptic networks, and studying the pathogenesis of epilepsy combined with cognitive impairment, in order to analyze pathophysiological mechanisms of epilepsy and provide new perspectives for clinical diagnosis and treatment.

Objective:To investigate the status quo of cognitive frailty in elderly patients with heart failure and analyze its influencing factors, so as to provide evidence for healthcare professionals to formulate effective intervention strategies.Methods:A total of 330 elderly patients with heart failure admitted to the First Affiliated Hospital of the University of South China and the Second Affiliated Hospital of the University of South China from October 2023 to January 2024 were selected as the study objects by convenience sampling method. General data questionnaire, Frailty Phenotype, Montreal Cognitive Assessment, Clinical Dementia Rating Scale, Geriatric Depression Scale-15 and Short Form Mini Nutritional Assessment were used for a sectional investigation. Random forest algorithm was used to rank the importance of variables and binary logistic regression was combined to explore the influencing factors of elderly patients with heart failure.Results:According to the evaluation criteria of cognitive frailty, 330 elderly patients with heart failure were divided into cognitive frailty group (124 cases) and non-cognitive frailty group (206 cases). The incidence of cognitive frailty was 37.6% (124/330). Among which, the median age of the cognitive frailty group was 73 years old, with 63 males and 61 females. The median age of the non-cognitive frailty group was 71 years old, with 117 males and 89 females. The random forest results showed that the top 7 variables in importance ranking were weekly intellectual activity, frequency of physical exercise, age, educational levels, depression status, cardiac function grade and risk of malnutrition. Binary logistic regression analysis showed that weekly intellectual activity ( OR=0.076, 95% CI 0.027-0.216), requency of physical exercise ( OR=0.184, 95% CI 0.079-0.430), age ( OR=1.173, 95% CI 1.077-1.277), educational levels ( OR=0.283, 95% CI 0.143-0.559), depression status ( OR=4.440, 95% CI 1.451-13.585), cardiac function grade ( OR=3.030, 95% CI 1.673-5.489) and risk of malnutrition ( OR=3.833, 95% CI 1.530-9.602) were the main influencing factors (all P<0.05). Conclusions:The incidence of cognitive frailty in elderly patients with heart failure is high. Healthcare professionals ought to focus on the screening and assessing of cognitive frailty in elderly patients with heart failure, and formulate effective intervention strategies by considering the above influencing factors to mitigate the occurrence of cognitive frailty.

Objective:To investigate the status quo of cognitive frailty in elderly patients with heart failure and analyze its influencing factors, so as to provide evidence for healthcare professionals to formulate effective intervention strategies.Methods:A total of 330 elderly patients with heart failure admitted to the First Affiliated Hospital of the University of South China and the Second Affiliated Hospital of the University of South China from October 2023 to January 2024 were selected as the study objects by convenience sampling method. General data questionnaire, Frailty Phenotype, Montreal Cognitive Assessment, Clinical Dementia Rating Scale, Geriatric Depression Scale-15 and Short Form Mini Nutritional Assessment were used for a sectional investigation. Random forest algorithm was used to rank the importance of variables and binary logistic regression was combined to explore the influencing factors of elderly patients with heart failure.Results:According to the evaluation criteria of cognitive frailty, 330 elderly patients with heart failure were divided into cognitive frailty group (124 cases) and non-cognitive frailty group (206 cases). The incidence of cognitive frailty was 37.6% (124/330). Among which, the median age of the cognitive frailty group was 73 years old, with 63 males and 61 females. The median age of the non-cognitive frailty group was 71 years old, with 117 males and 89 females. The random forest results showed that the top 7 variables in importance ranking were weekly intellectual activity, frequency of physical exercise, age, educational levels, depression status, cardiac function grade and risk of malnutrition. Binary logistic regression analysis showed that weekly intellectual activity ( OR=0.076, 95% CI 0.027-0.216), requency of physical exercise ( OR=0.184, 95% CI 0.079-0.430), age ( OR=1.173, 95% CI 1.077-1.277), educational levels ( OR=0.283, 95% CI 0.143-0.559), depression status ( OR=4.440, 95% CI 1.451-13.585), cardiac function grade ( OR=3.030, 95% CI 1.673-5.489) and risk of malnutrition ( OR=3.833, 95% CI 1.530-9.602) were the main influencing factors (all P<0.05). Conclusions:The incidence of cognitive frailty in elderly patients with heart failure is high. Healthcare professionals ought to focus on the screening and assessing of cognitive frailty in elderly patients with heart failure, and formulate effective intervention strategies by considering the above influencing factors to mitigate the occurrence of cognitive frailty.

Objective:To investigate the clinical characteristics, prognosis, and the impact of different secondary prevention strategies on stroke recurrence in patients with carotid web (CaW)-associated acute anterior circulation large vessel occlusion (LVO).Methods:A retrospective analysis was conducted on 401 patients with acute anterior circulation LVO who underwent mechanical thrombectomy at 2 advanced stroke centers, Xingtai Central Hospital and Xingtai People′s Hospital, from January 2018 to June 2024. CaW was identified using digital subtraction angiography (DSA) and other imaging modalities. Based on the presence of CaW, patients were divided into CaW group and non-CaW group. Differences between the 2 groups in baseline characteristics, clinical features, and clinical outcomes were compared, and long-term follow-up was conducted for the CaW group.Results:Among the 401 patients, the CaW group consisted of 16 patients (4.0%), while the non-CaW group included 385 patients (96.0%). Compared to the non-CaW group, patients in the CaW group were younger [53 (46, 58) years vs 65 (56, 76) years, Z=-3.811, P<0.001], had a higher proportion of M1 segment middle cerebral artery occlusion [13/16 vs 54.0% (208/385), χ2=4.602, P=0.032] and a lower proportion of internal carotid artery terminus occlusion [1/16 vs 40.0% (154/385), χ2=6.024, P=0.014]; the 90-day modified Rankin Scale (mRS) score was significantly lower in the CaW group [1.00 (0, 1.75) vs 3.00 (1.00, 4.00), Z=14.210, P<0.001], and the proportion of patients with favorable functional independence (mRS score 0-2) was significantly higher [15/16 vs 45.7% (176/385), χ2=12.350, P<0.001] in the CaW group; the incidence of pneumonia in the CaW group was significantly lower [2/16 vs 42.6% (164/385), χ2=4.562, P=0.033]. Among the 16 CaW patients, 10 received antiplatelet therapy, 4 underwent carotid artery stenting (CAS), and 2 underwent carotid endarterectomy (CEA). During a median follow-up of 29 months, patients who underwent CAS and CEA had no stroke recurrence, while 2 patients who received antiplatelet therapy had stroke recurrence and subsequently underwent CAS and CEA. Conclusions:The proportion of CaW among patients with acute anterior circulation LVO was 4.0%. The patients with CaW were younger and had a higher proportion of M1 segment middle cerebral artery occlusion. Following mechanical thrombectomy, patients in the CaW group had good functional outcomes. Simple drug therapy may be insufficient to prevent stroke recurrence in CaW patients, and CAS and CEA may be effective therapeutic options.

With the rapid development of neuroelectrophysiology, neuroimaging and other technologies, a large amount of evidence has shown that the occurrence and development of idiopathic generalized epilepsy (IGE) are closely related to the cortical-subcortical neural network. This article intends to review the relevant research on how the cerebral cortex and subcortical structures such as the thalamus, basal ganglia, and cerebellum are involved in the cognitive impairment of IGE, as well as the important subcortical neural nuclei targets currently targeted in the treatment of drug-resistant epilepsy by neuromodulation, to evaluate the feasibility of neuromodulation therapy in clinical practice.