Objective:To compare the differences in clinical characteristics among the patients at clinical high risk for bipolar disorder(CHR-BD),the patients with bipolar disorder(BD),and the healthy controls(HC)at low risk,and to provide the basis for the diognasis and treatment of CHR-BD.Methods:For the first time,the BD risk criteria and prospective structured assessment tools were jointly used in outpatients aged 16-30 years,and 43 CHR-BD patients were included to ensure the accuracy of the assessment.Meanwhile,33 BD patients and 32 HC subjects were also enrolled.The clinical symptoms,neurocognitive function,and global functional levels of the subjects in the three groups were evaluated using observer-rated and self-rated tools.The CHR-BD and BD groups were combined,and Logistic regression analysis was used to identify the independent influencing factors related to diagnostic status;Pearson or Spearman correlation analysis was used to analyze the correlations between the global functional levels and the symptoms or neurocognitive characteristics of the patients in CHR-BD and BD groups.Results:There were statistically significant differences in the scores of symptom and global functional level scales among HC,CHR-BD,and BD groups(P<0.05).Compared with HC group,the scores of mood symptoms(anxiety,depression,and mania/hypomania),psychotic symptoms,total affective temperament questionnaire scores,and some dimensions(cyclothymic,depressive,irritable,and anxious temperaments)in CHR-BD and BD groups were significantly increased(P<0.001),while the global functional levels were significantly decreased(P<0.001).Compared with BD group,the lowest global functional level score in the past year in CHR-BD group was significantly increased(P=0.022),while the current global functional level score was significantly decreased(P=0.005).No significant differences were observed in neurocognitive function scores among the three groups(P>0.05).The lowest global functional level score in the past year was an independent influencing factor for BD diagnosis[odds ratio(OR)=0.952,95%confidence interval(CI):0.917-0.988,P=0.010].In both CHR-BD and BD patients,the current global functional levels were negatively correlated with depressive(r=-0.417,P=0.005;r=-0.617,P<0.001)and anxiety symptoms(r=-0.360,P=0.018;r=-0.506,P=0.003).In BD patients,the current global functional level was negatively correlated with lifetime manic/hypomanic symptoms(r=-0.360,P=0.039),psychotic symptoms(r=-0.502,P=0.003),and affective temperament scores(r=-0.479,P=0.005),while the lowest global functional level in the past year was negatively correlated with lifetime manic/hypomanic symptoms(r=-0.391,P=0.024).Conclusion:CHR-BD patients share similar mood symptom characteristics with BD patients,and their global functional levels are negatively correlated with depressive and anxiety symptoms.BD patients exhibit worse lowest global functional levels in the past year,and their global functional levels are negatively correlated with manic/hypomanic symptoms.

Objective:To compare the efficacy and safety of flow diverter (FD) implantation versus stent-assisted coil embolization (SACE) in unruptured saccular aneurysms located at distal segments of the Willis circle.Methods:A retrospective study was performed; 119 patients with unruptured saccular aneurysms located at distal segments of the Willis circle who received FD implantation or SACE in Department of Neurosurgery, Guangdong Provincial People's Hospital, Southern Medical University and Department of Cerebrovascular Surgery, Neurosurgery Center, Southern Medical University from January 2018 to May 2025 were selected. According to different surgical methods, they were divided into a FD group ( n=60) and a SACE group ( n=59). These patients were subjected to propensity score matching (PSM) using 1:1 nearest neighbor matching method to eliminate confounding factors such as gender, age, aneurysm location, and aneurysm diameter (maximum diameter); and then, differences in neurological functional prognosis (good prognosis: modified Rankin scale scores of 0-2), complete aneurysm occlusion rate (O'Kelly-Marotta grade D or Raymond occlusion classification class I), and overall (perioperative and follow-up) complications were compared between the two groups. Results:After PSM, there were 43 patients in both FD group and SACE group. No significant difference was found in clinical and imaging follow-ups (12[6, 19] months vs. 10[6, 15] months, 10[5, 19] months vs. 9[2, 15] months) between the FD group and SACE group ( P>0.05). At the last imaging follow-up, the complete aneurysm occlusion rate in the FD group (65.1%[28/43]) was significantly lower than that in the SACE group (76.7%[33/43], P<0.05). At the last clinical follow-up, no significant difference was noted in good prognosis rate (95.3%[41/43] vs. 97.7%[42/43]) and overall complication rate (30.2%[13/43] vs. 18.6%[8/43]) between the FD group and SACE group ( P>0.05). Conclusion:Both FD implantation and SACE are safe and effective for unruptured saccular aneurysms located at distal segments of the Willis circle; the complete aneurysm occlusion rate within 1 year of FD implantation is relatively low.

Objective To investigate the in vitro antibacterial effect of Radix Sophorae Flavescentis on tigecycline-resistant carbapenem-resistant Klebsiella pneumonia(CRKP)and elucidate how Radix Sophorae Flavescentis restores the sensitivity of CRKP to tigecycline through the efflux pump pathway.Methods The CRKP standard strain BAA1705 was induced to be tigecycline-resistant using the microdilution broth method,and the expression of efflux pumps was verified by efflux pump inhibitors.The fractional inhibitory concentration index(FIC)was calculated using the microdilution checkerboard method to determine the minimum inhibitory concertration(MIC)of the two drugs in combination.Fluorescent real-time quantitative PCR(qRT-PCR)was used to analyze the expression of the AcrB gene before and after Radix Sophorae Flavescentis treatment,and the e?ux pump activity was validated by the Rhodamine 6G e?ux assay.Results The e?ux pump inhibition experiment on the artificially induced T-BAA1705 strain showed overexpression of e?ux pumps.The combined antibacterial test results indicated synergy between Radix Sophorae Flavescentis and tigecycline(FIC=0.375 2).The qRT-PCR results showed that the AcrB levels in the Radix Sophorae Flavescentis monotherapy group were lower than in the untreated group(0.018±0.002 vs 0.040±0.001),and the AcrB levels(0.009±0.001),RamA levels(0.184±0.003)and MarA(0.013±0.001)levels in the combination therapy group were all lower than in the untreated group(0.040±0.001,0.387±0.016,0.125±0.007),while the AcrR level was higher than in the untreated group(0.388±0.001 vs 0.288±0.001),and the differences were statistical significance(t=12.28～47.12,all P<0.05);the e?ux pump activity in the Radix Sophorae Flavescentis monotherapy group and the combination therapy group was lower than in the untreated T-BAA1705(60.667±0.448,60.267±0.376,65.133±0.296),and the differences were statistical significance(t=8.31,10.17,all P<0.05).Conclusion Radix Sophorae Flavescentis can restore the sensitivity of tigecycline-resistant CRKP to tigecycline and effectively inhibit bacterial growth when used in combination with tigecycline.The mechanism may involve Radix Sophorae Flavescentis inhibiting the expression of the AcrAB-TolC e?ux pump.

Objective To investigate the in vitro antibacterial effect of Radix Sophorae Flavescentis on tigecycline-resistant carbapenem-resistant Klebsiella pneumonia(CRKP)and elucidate how Radix Sophorae Flavescentis restores the sensitivity of CRKP to tigecycline through the efflux pump pathway.Methods The CRKP standard strain BAA1705 was induced to be tigecycline-resistant using the microdilution broth method,and the expression of efflux pumps was verified by efflux pump inhibitors.The fractional inhibitory concentration index(FIC)was calculated using the microdilution checkerboard method to determine the minimum inhibitory concertration(MIC)of the two drugs in combination.Fluorescent real-time quantitative PCR(qRT-PCR)was used to analyze the expression of the AcrB gene before and after Radix Sophorae Flavescentis treatment,and the e?ux pump activity was validated by the Rhodamine 6G e?ux assay.Results The e?ux pump inhibition experiment on the artificially induced T-BAA1705 strain showed overexpression of e?ux pumps.The combined antibacterial test results indicated synergy between Radix Sophorae Flavescentis and tigecycline(FIC=0.375 2).The qRT-PCR results showed that the AcrB levels in the Radix Sophorae Flavescentis monotherapy group were lower than in the untreated group(0.018±0.002 vs 0.040±0.001),and the AcrB levels(0.009±0.001),RamA levels(0.184±0.003)and MarA(0.013±0.001)levels in the combination therapy group were all lower than in the untreated group(0.040±0.001,0.387±0.016,0.125±0.007),while the AcrR level was higher than in the untreated group(0.388±0.001 vs 0.288±0.001),and the differences were statistical significance(t=12.28～47.12,all P<0.05);the e?ux pump activity in the Radix Sophorae Flavescentis monotherapy group and the combination therapy group was lower than in the untreated T-BAA1705(60.667±0.448,60.267±0.376,65.133±0.296),and the differences were statistical significance(t=8.31,10.17,all P<0.05).Conclusion Radix Sophorae Flavescentis can restore the sensitivity of tigecycline-resistant CRKP to tigecycline and effectively inhibit bacterial growth when used in combination with tigecycline.The mechanism may involve Radix Sophorae Flavescentis inhibiting the expression of the AcrAB-TolC e?ux pump.

Objective:To compare the efficacy and safety of flow diverter (FD) implantation versus stent-assisted coil embolization (SACE) in unruptured saccular aneurysms located at distal segments of the Willis circle.Methods:A retrospective study was performed; 119 patients with unruptured saccular aneurysms located at distal segments of the Willis circle who received FD implantation or SACE in Department of Neurosurgery, Guangdong Provincial People's Hospital, Southern Medical University and Department of Cerebrovascular Surgery, Neurosurgery Center, Southern Medical University from January 2018 to May 2025 were selected. According to different surgical methods, they were divided into a FD group ( n=60) and a SACE group ( n=59). These patients were subjected to propensity score matching (PSM) using 1:1 nearest neighbor matching method to eliminate confounding factors such as gender, age, aneurysm location, and aneurysm diameter (maximum diameter); and then, differences in neurological functional prognosis (good prognosis: modified Rankin scale scores of 0-2), complete aneurysm occlusion rate (O'Kelly-Marotta grade D or Raymond occlusion classification class I), and overall (perioperative and follow-up) complications were compared between the two groups. Results:After PSM, there were 43 patients in both FD group and SACE group. No significant difference was found in clinical and imaging follow-ups (12[6, 19] months vs. 10[6, 15] months, 10[5, 19] months vs. 9[2, 15] months) between the FD group and SACE group ( P>0.05). At the last imaging follow-up, the complete aneurysm occlusion rate in the FD group (65.1%[28/43]) was significantly lower than that in the SACE group (76.7%[33/43], P<0.05). At the last clinical follow-up, no significant difference was noted in good prognosis rate (95.3%[41/43] vs. 97.7%[42/43]) and overall complication rate (30.2%[13/43] vs. 18.6%[8/43]) between the FD group and SACE group ( P>0.05). Conclusion:Both FD implantation and SACE are safe and effective for unruptured saccular aneurysms located at distal segments of the Willis circle; the complete aneurysm occlusion rate within 1 year of FD implantation is relatively low.

Objective To assess the reinforcing effect and operability of DNV-1929 in canine lungs so as to provide scientific basis for its clinical application by observing its characterisation during surgical resection.Methods Fifteen Beagles of 10-to 15-month-old,randomly assigned to three experimental groups,were used in this study for implantation experiments with DNV-1929 and negative control material.The experimental animals were housed in a defined environment and detailed clinical observations were made before and after the experiments.By using specific surgical techniques,the materials were implanted into different parts of the left lung of the dogs and their pressure resistance was assessed by airway pressure tests.The handling properties of the implanted materials were also evaluated.At weeks 2 and 4 after implantation,macroscopic visual observations and pathological examinations were performed on three sites of the canine left lung,the posterior anterior anterior lobe,the anterior posterior lobe,and and the posterior posterior lobe,in order to compare the tissue response of DNV-1929 with that of the negative control material.In addition,all experimental animals were evaluated for safety,including monitoring of clinical signs,food intake,and body weight.Results At airway pressure levels up to 35 hPa,both DNV-1929 and the negative control material showed similar pressure resistance with no gas leakage at the implantation site.During the procedure,DNV-1929 showed similar manoeuvrability to the negative control material,with no significant abnormalities observed.As seen by visual pathological observation after 2 and 4 weeks of implantation,both materials formed an encapsulation around the implantation site and underwent different degrees of adhesion with the thoracic organs,but the difference was not statistically significant(P＞0.05).There were more residual implants in the DNV-1929 group at 2 weeks and almost disappeared at 4 weeks of implantation,whereas a small amount of implanted material was still present in the negative control group,but residual material did not differ significantly between the two groups(P＞0.05).Histological evaluation showed that the subtotal score of inflammatory condition of DNV-1929 in the 2-week implantation group was slightly higher than that of the negative control substance(P=0.016),while the subtotal score of inflammatory condition in the 4-week implantation group was not statistically different compared with that of the negative control substance(P＞0.05).In terms of safety evaluation,the experimental dogs did not show any clinical abnormality or reduction in food intake during the study period,and there was no death on the day of implantation of DNV-1929 and the negative control substance.There was no significant change in body weight of the experimental dogs during the study cycle(P＞0.05).Conclusion DNV-1929 demonstrated a strengthening effect and good manoeuvrability in canine lungs with no toxic effects on surrounding tissues.This provides preliminary evidence for the use of DNV-1929 in surgical treatment of the lung,establishes scientific basis for its use in clinical practice,and demonstrates its potential value.

Objective:To investigate the effect of pretreatment with butorphanol on perineal discomfort caused by intravenous injection of dexamethasone sodium phosphate.Methods:Using the method of prospective study, ninety patients undergoing elective gynecological surgery in Dalian Women And Children′s Medical Group from June to December 2021 were randomly divided into three groups: butorphanol 0.5 mg pretreatment group (group B1), butorphanol 1.0 mg pretreatment group (group B2) and normal saline control group (group C), with 30 cases in each group. Patients in groups B1 and B2 were given butorphanol 0.5 mg and 1.0 mg intravenously, respectively, prior to induction of anesthesia, while those in group C were given 0.9% sodium chloride injection. 3 minutes later, all patients in the three groups were given dexamethasone sodium phosphate injection 10 mg, and the incidence, grade and adverse reactions of their perineal discomfort symptoms were recorded.Results:The incidence of perineal discomfort and moderate perineal discomfort of patients in group B1 and group B2 was lower than that in group C: 20.00%(6/30)and 10.00%(3/30)vs. 60.00%(18/30), 3.33%(1/30)and 3.33(1/30)vs. 30.00%(10/30), with a statistically significant differences ( P<0.05). The incidence of adverse reactions such as dizziness was increased in the group B2:26.67%(8/30)and 10.00%(3/30)vs. 40.00%(12/30), with a statistically significant difference ( χ2 = 7.13, P = 0.028). Conclusions:Butorphanol 0.5 mg and 1.0 mg pretreatments are touted as effective in inhibiting perineal discomfort caused by intravenous injection of dexamethasone sodium phosphate. However, the butorphanol 0.5 mg pretreatment group have fewer adverse reactions.

Objective To compare the safety and efficacy of direct and remedial rotational atherectomy in the treatment of heavily calcified coronary artery lesions.Methods We retrospectively reviewed 58 patients admitted in the Shanghai Chest Hospital and Liaocheng People Hospital from May 2012 to July 2015 who had received stent implantation and rotational atherectomy.The 58 patients were divided into two groups which were the direct atherectomy group (n =27) and the remedial atherectomy group (n =31).General clinical date,lesion and procedural characteristics,intraoperative complications,in-hospital and follow-up MACCE were compared between the two groups.Results There were no differences between the two groups in general clinical date intraoperative complications,amount of contrast agent used,proceduraltime,rates of in-hospital and follow-up MACCE.Nevertheless,compared with the direct artherectomy group,the remedial group had more number of balloon dilations during procedure [3 (1,5) vs.2 (1,2),P ＜ 0.001] and higher peak cardiac troponin levels [1.1 (0.3,3.0) μg/L vs.0.5 (0.1,2.3) μg/L,P =0.032].Conclusions Remedial rotational atherectomy with drug-eluting stent had the same safety and efficacy as direct atheretomy with drug-eluting stent in treating patients with heavily calcified coronary lesions.It is reasonable and safe to transform routine PCI to remedial rotational atherectomy when the 2.0 mm semi compliant balloon or/and 2.5 mm non-compliant balloon cannot pass through or dilate the lesions.

Objective To explore the diagnosis and treatment of increased intracranial pressure caused by temporal muscle swelling after decompressive craniectomy in patients with severe traumatic brain injury.Methods A retrospective analysis was performed on 46 patients with increased intracranial pressure caused by temporal muscle swelling after decompressive craniectomy,admitted to our hospital from January 2004 and January 2012.Among them,22 were treated with conservative therapy,and the other 24 were treated with operative therapy.Results Based on Glascow Outcome Scale scores,23 recovered well,12 had moderate disability,8 had severe disability,3 were at vegetative state and no death was noted.Conclusions Temporal muscle swelling after decompressive craniectomy may cause secondary increased intracranial pressure,and this will lead a negative effect on recovery of patients with severe traumatic brain injury.Early prophylaxis,early diagnosis and early treatment are necessary for these patients.

Objective To detect the effect of deep hypothermia on the function of mitochondria in hippocampus after global ischemia in rats and to explore the protection mechanism. Methods The animal model of cardiopulmonary bypass (CPB) was established in rats that were then randomly divided into three groups,ie,control group,normothermia ischemia group and hypothermia ischemia group,eight rats per group.The mitochondria was extracted from the hippocampus of each rats for observing the mitochondrial respiratory function,the activities of succinate dehydrogenase (SDH),the cytochrome oxidese(CCO),the lnembrane fluidity and the content of intramitochondria free calcium and MDA. Resuits The content of intramitochondria free calcium and MDA in the normothermia ischemia group was increased significantly compared to the control group and that in the hypothermia ischemia group wag decreased significantly compared with the normothermia ischemia group(P<0.05).Respiratory state Ⅲ (R3),respiratory state IV(R4),P/O ratio and oxidative phosphorylation (OPR) in the normothermia ischemia group were decreased significantly compared to the control group (P<0.05).R3,R4,P/O ratio and OPR in the hypothermia ischemia group were increased significantly compared with the normothermia ischemia group (P<0.05).Membrane fluidity in the normothermia ischemia group wag decreased significantly compared to the control group (P<0.01),while that in the hypothermia ischemia group was increased significantly compared with the normothermia ischemia group(P<0.05).The activities of SDH and CCO in the normothermia ischemia group were decreased significantly compared to the control group (P<0.01),while those in the hypothermia ischemia group were increased significantly compared with the normothermia ischemia group (P<0.05). Conclusion Profound hypothermia exerts a protective effect on the function of mitochondria in the hippocampus after global ischemia in rats.