Objective:To investigate the safety and efficacy of flow diverter (FD) in the treatment of middle cerebral artery (MCA) dissection aneurysms.Methods:Patients with MCA dissection aneurysm received FD treatment at the Department of Neurosurgery, Jinjiang Hospital and the Cerebrovascular Disease Center of the First Affiliated Hospital of Naval Medical University from January 2021 to December 2023 were included retrospectively. The success rate of procedure, incidence of complications, occlusion rate of aneurysms, and clinical outcome were evaluated.Results:A total of 23 patients were included, with a success rate of 100% for FD implantation and a periprocedural complication rate of 8.7%. Nineteen patients (82.6%) completed angiography follow-up within an average of 7.2 months, of which the aneurysms of 16 patients (84.2%) were completely occluded, 3 (15.8%) were partial occluded, and 2 (10.5%) experienced in-stent restenosis; 14 (73.7%) showed stenosis of covered branch openings, of which 2 (10.5%) had branch occlusions, with no relevant clinical symptoms. The median clinical follow-up time was 23.2 months, with 95.7% of patients achieving good outcome (modified Rankin scale score ≤2).Conclusion:FD is safe and effective in the treatment of MCA dissection aneurysms, and precise device selection and release is the key to improving procedural safety.

Graves'ophthalmopathy(GO),also known as thyroid-associated ophthalmopathy,is an organ-specific au-toimmune disease that ranks first in the incidence of adult orbital diseases.GO has complex clinical manifestations,and dry eyes are a common cause of eye discomfort in patients with this disease.The pathogenesis of concurrent dry eyes is still unclear.It is currently believed that ocular surface damage in patients with GO is a direct factor leading to the occurrence and development of dry eyes.In addition,immunity and inflammation,and intestinal flora imbalance also play a role.Mul-tiple factors interact to form a vicious cycle,which further aggravates dry eyes.This article reviews the research results re-lated to the pathogenesis of GO complicated by dry eyes,aiming to provide ideas for clinical treatment and further research in the field.

Objective To observe the value of ultrasound assessment of diaphragm function combined with the Medical Research Council(MRC)muscle strength score and acute physiology and chronic health Ⅱ(APACHE Ⅱ)score for predicting weaning outcome in severe pneumonia patients after mechanical ventilation.Methods Totally 102 patients with severe pneumonia who underwent mechanical ventilation were retrospectively enrolled.Spontaneous breathing trial(SBT)was performed,and diaphragmatic mobility and contraction velocity were measured before and after SBT to evaluate diaphragm function.All patients were divided into successful weaning(successful group,n=76)and failed weaning group(failure group,n=26)according to breathing condition after weaning.Univariate analysis and multivariate logistic regression were used to analyze clinical data,MRC and APACHE Ⅱ scores before SBT,as well as diaphragm function parameters before and after SBT,and the independent risk factors for weaning failure were screened,based which a combined regression model was established.The diagnostic efficacy of each independent risk factor and combined regression model was evaluated by receiver operating characteristic curve and the area under the curve(AUC).Results MRC and APACHE Ⅱ scores,diaphragmatic mobility and contraction velocity before SBT were all independent risk factors for weaning failure in severe pneumonia patients after mechanical ventilation(all P＜0.05),with AUC of 0.682,0.667,0.785 and 0.685,respectively.The AUC of combined regression model established with the above independent risk factors was 0.898,higher than that of each independent risk factor(all P＜0.05).Conclusion Ultrasound assessment of diaphragm function combined with MRC muscle strength and APACHE Ⅱ scores could effectively predict weaning outcome in severe pneumonia patients who underwent mechanical ventilation.

Objective:To investigate the value of a 5-point predictive score based on unenhanced CT combined with blood glucose detection for predicting short-term prognosis in patients with spontaneous cerebral hemorrhage.Methods:A total of 102 patients with spontaneous intracerebral hemorrhage who received treatment in Zhejiang Provincial People's Hospital from March 2020 to March 2022 were included in this study and analyzed retrospectively. Blood glucose level was measured and BAT score was used to evaluate hematoma enlargement. After 30 days, Glasgow Outcome Scale was used to evaluate the prognosis of patients. The relationships between blood glucose and BAT score, and between blood glucose and BAT score and prognosis were analyzed. The value of blood glucose and BAT score for predicting short-term prognosis was analyzed.Results:The Glasgow Outcome Scale results showed that among the 102 patients, 24 patients (23.53%) had poor prognosis. The BAT score and blood glucose level in patients with poor prognosis were (3.13 ± 0.68) points and (11.58 ± 2.30) mmol/L, respectively, which were significantly higher than (2.40 ± 0.59) points and (8.88 ± 1.71) mmol/L in patients with good prognosis ( t = 5.10, 5.30, both P < 0.05). Pearson correlation analysis showed that in patients with spontaneous intracerebral hemorrhage, blood glucose level was positively correlated with BAT score ( r = 0.43, P < 0.05). Spearman correlation analysis showed that in patients with spontaneous intracerebral hemorrhage, blood glucose level and BAT level were positively correlated with prognosis ( r = 0.42, 0.47, both P < 0.05). The receiver operating characteristic curve showed that the area under the curve plotted for BAT score combined with blood glucose level for predicting short-term prognosis was 0.874, which was significantly greater than the area under the curve plotted for BAT score alone for predicting short-term prognosis ( Z = 2.54, P < 0.05). Conclusion:A large proportion of patients with spontaneous intracerebral hemorrhage have a poor prognosis. The patients with a poor prognosis have higher blood glucose levels and BAT scores than those with good prognosis. Blood glucose and BAT score have a high value for predicting the prognosis of patients with spontaneous intracerebral hemorrhage.

Objective:To analyze the characteristics of adverse events of active medical devices in Shandong province, as well as the impact of device use duration on the risk rate of adverse events, for reference in improving the monitoring system of active medical device adverse events in China and the level of hospital medical quality management.Methods:The data came from the adverse event reporting data of active medical devices collected by Shandong Adverse Drug Reaction Monitoring Center from January 2019 to October 2021. The R software was used to analyze the distribution, cause and severity of adverse events, and a linear regression model of adverse event risk rate(Y) and adverse event time point(X) was established.Results:A total of 35 254 adverse events of active devices were included, of which 3 059 were serious injuries. The province/municipality with the largest number of reported adverse events was Shanghai(8 006 cases), and the least was Hainan province(4 cases); The majority of adverse events were reported by hospitals, with 34 056(96.60%). The medical devices reporting a higher number of adverse events were ventilators(688 cases), monitors(4 623 cases), infusion pumps(1 079 cases), syringe infusion pumps(1 995 cases), medical electron accelerators(529 cases)and infant incubators(513 cases). In the linear regression model, the risk rate of adverse events increased with the useduration of the device when 0.00%≤ X<14.14%; the risk rate of adverse events decreased with the increase of service time when 14.14%≤ X<100.00%. Conclusions:The number of adverse events reported in each province is different, and hospitals are the main reporting units.The causes of adverse events of different medical devices indicate different correlation strengths with the product itself. The use duration of medical devices poses a great impact on the risk rate of adverse events.

【Objective】 To establish a dry fluorescent luminescence method for the detection of antibodies to hepatitis C virus (HCV) and evaluate its clinical application. 【Methods】 Anti-HCV antibody was detected by double-antigen sandwich dry fluorescent luminescence method established using multi-epitope chimeric antigen. The established method was used to detect national reference samples(positive 20, negative 20), and a total of 349 clinical samples, including 108 HCV patients, 36 patients with other diseases and 205 healthy individuals, which were tested in parallel with enzyme-linked immunoassay (ELISA) to evaluate the performance of the established method. 【Results】 The concordance rate of positive and negative(each 20) reference samples were both 100% (20/20), and the CV of precision reference sample was 9.16%, which met the requirements of national reference samples. In clinical performance evaluation, the AUC value was 0.984, and the sensitivity and specificity of the dry fluorescent luminescence method were 96.30% (104/108) and 96.27% (233/241). The overall concordance rate between dry fluorescent luminescence method and ELISA was 97.71% (341/349) (Kappa=0.952). 【Conclusion】 The dry fluorescence luminescence method of HCV antibody is simple and rapid, with high sensitivity and high specificity, and can be used in clinical application.

Objective:To investigate the safety and efficacy of Tubridge flow diverter for the treatment of recurrent internal carotid blood blister-like aneurysms after stent-assisted embolization.Methods:From June 2018 to April 2021, patients with recurrent internal carotid blood blister-like aneurysms treated with Tubridge flow diverter in the Department of Neurosurgery, Changhai Hospital, Naval Medical University were enrolled retrospectively. The perioperative safety, immediate postoperative and follow-up results were analyzed.Results:A total of 6 patients with recurrent internal carotid blood blister-like aneurysm after stent-assisted embolization were enrolled. The time interval from the first stent-assisted embolization to Tubridge placement was 14 to 90 d. Tubridge implantation alone was used in 4 patients, and Tubridge was implanted in the other 2 patients after the coils were packed. There were no complications during the perioperative period, and no rebleeding was observed after clinical follow-up for 5 to 36 months. Five patients were followed up by angiography for 1-3 months, and the aneurysms disappeared completely.Conclusion:Tubridge flow diverter for the treatment of recurrent internal carotid blood blister-like aneurysms is safe and effective.

In addition to causing high disability and high fatality rates, ruptured intracranial aneurysms can also cause cognitive impairment. Although preventive surgical treatment can avoid intracranial aneurysm rupture and bleeding, patients may still have a certain degree of cognitive impairment, even in patients with good clinical recovery after surgery. There is no systematic review on the effect of different surgical methods on cognitive function, and the best surgical method is still inconclusive. This article reviews the cognitive impairment in patients with intracranial aneurysm, hoping to provide a basis for clinical treatment decisions.

Objective: To develop a method for rapid detection of influenza virus and its subtypes based on flow fluorescence technology, and then detect the clinical specimens by our established method . Methods: We designed degenerate primers and specific probes, synthesized plasmids, used Luminex platform to establish detection method and later detected 430 clinical specimens, and compared the result with those of Fujian Center for Disease Control and prevention. Results: A method for the simultaneous determination of influenza viruses A, B, C and its subtypes (H116, N19) was established. The time consumption was 3.5 hours, with good specificity, high sensitivity and feasible stability. The detection result of 430 clinical specimens showed high consistency with the result of Fujian Center for Disease Control and Prevention. Conclusions We established a method for simultaneous determination of influenza viruses and its subtypes, high sensitivity, specificity and stability.

Objective To examine the impact of case management on hospitalizations of the chronically and severely mentally ill patients in Zhongshan. Methods Patients with severe and chronic mental illness,aged ≥ 15 years and living in pilot area were divided into two groups naturally since the program of case management launched, 65 cases in the group of case management and 112 patients in the group of standard management. Hospitalizations of the two groups before and after case management were compared. Results Data were analysised with MIXED procedure. Length of stay in days per admission (LOS) of both groups decreased with time in years (F=11.02, P=0.001), and the decline in LOS of case management group was greater than that of standard management group (F=9.02, P=0.003). The average admissions of case management group was more than that of standard management group (F=4.98,P=0.03). There was no significant differences in average hospitalization incidents before and after case management in both groups(case management group 5.13%vs. 5.38%, standard management group 7.14%vs. 8.92%, P>0.05). Conclusions Case management was effective in reducing hospitalizations for a group of Chinese with chronic and severe mental illness, and may contribute to the balance on mental health resources between community and hospital.