Objective:To examine the clinical effect of endovascular treatment for patients with non-acute symptomatic anterior circulation distal medium artery disease (aDMAD).Methods:This is a retrospective case series study.Retrospective analysis was conducted on the clinical data of 28 patients(29 lesions) with non-acute symptomatic aDMAD who underwent endovascular treatment at the Department of Neurosurgery,Beijing Hospital from May 2018 to March 2024. There were 15 males and 13 females,with an age of (63.4±10.2) years (range:36 to 82 years). The course of disease were more than 72 hours of all the patients. Confirmed by digital subtraction angiography,the lesion was located in distal anterior circulation and (or) medium arteries. Among them, 21 lesions (72.4%) located at middle cerebral artery and 8 lesions (27.6%) located at anterior cerebral artery.The median degree of stenosis before surgery ( M(IQR)) was 90%(23%) (range:70% to 100%).After standardized drug treatment,there was still a transient ischemic attack or cerebral infarction in the vascular related area.The therapeutic effects and complications were analyzed,and the differences in the occurrence of target vessel restenosis under different interventional treatment methods were collected. Results:A total of 28 patients with 29 lesions underwent endovascular treatment, with a treatment success rate of 96.6% (28/29). The course of disease was 60(66)days (range:9 to 210 days). Simple plain balloon angioplasty was performed in 12 cases (13 lesions), drug-coated balloon (DCB) angioplasty in 7 cases (7 lesions), and stent placement in 9 cases (9 lesions). The median degree of stenosis after surgery was 20%(39%) (range:0 to 50%). There was no new cerebral infarctions,cerebral hemorrhages,or other complications during the perioperative period.Imaging follow-up was conducted on 23 lesions for 12(15)months(range:3 to 34 months),with 10 cases (43.5%) of restenosis,3 cases (13.0%) of symptomatic restenosis,and 4 cases (17.4%) of re-treatment. There were no new cases of cerebral hemorrhage or death during the follow-up process.The restenosis rate was 6/10 for the conventional balloon group,1/6 for the DCB group, and 3/7 for the stent group; the rate of symptomatic restenosis was 1/10 for the conventional balloon group,0/6 for the DCB group, and 2/7 for the stent group.Conclusions:Endovascular treatment for non-acute symptomatic aDMAD is relatively effective,but there is a high rate of restenosis postoperatively. DCB may reduce the occurrence of postoperative restenosis.

Objective:To examine the clinical effect of endovascular treatment for patients with non-acute symptomatic anterior circulation distal medium artery disease (aDMAD).Methods:This is a retrospective case series study.Retrospective analysis was conducted on the clinical data of 28 patients(29 lesions) with non-acute symptomatic aDMAD who underwent endovascular treatment at the Department of Neurosurgery,Beijing Hospital from May 2018 to March 2024. There were 15 males and 13 females,with an age of (63.4±10.2) years (range:36 to 82 years). The course of disease were more than 72 hours of all the patients. Confirmed by digital subtraction angiography,the lesion was located in distal anterior circulation and (or) medium arteries. Among them, 21 lesions (72.4%) located at middle cerebral artery and 8 lesions (27.6%) located at anterior cerebral artery.The median degree of stenosis before surgery ( M(IQR)) was 90%(23%) (range:70% to 100%).After standardized drug treatment,there was still a transient ischemic attack or cerebral infarction in the vascular related area.The therapeutic effects and complications were analyzed,and the differences in the occurrence of target vessel restenosis under different interventional treatment methods were collected. Results:A total of 28 patients with 29 lesions underwent endovascular treatment, with a treatment success rate of 96.6% (28/29). The course of disease was 60(66)days (range:9 to 210 days). Simple plain balloon angioplasty was performed in 12 cases (13 lesions), drug-coated balloon (DCB) angioplasty in 7 cases (7 lesions), and stent placement in 9 cases (9 lesions). The median degree of stenosis after surgery was 20%(39%) (range:0 to 50%). There was no new cerebral infarctions,cerebral hemorrhages,or other complications during the perioperative period.Imaging follow-up was conducted on 23 lesions for 12(15)months(range:3 to 34 months),with 10 cases (43.5%) of restenosis,3 cases (13.0%) of symptomatic restenosis,and 4 cases (17.4%) of re-treatment. There were no new cases of cerebral hemorrhage or death during the follow-up process.The restenosis rate was 6/10 for the conventional balloon group,1/6 for the DCB group, and 3/7 for the stent group; the rate of symptomatic restenosis was 1/10 for the conventional balloon group,0/6 for the DCB group, and 2/7 for the stent group.Conclusions:Endovascular treatment for non-acute symptomatic aDMAD is relatively effective,but there is a high rate of restenosis postoperatively. DCB may reduce the occurrence of postoperative restenosis.

Objectives:The purpose of this study was to investigate the clinical efficacy of percutaneous endoscopic transforaminal lumbar interbody fusion(PE-TLIF)in patients with single-segment lumbar spinal stenosis and explore the changes of paraspinal muscles and adjacent segmental facet joints of operative segement after PE-TLIF.Methods:28 patients with L4/5 lumbar spinal stenosis treated with PE-TLIF in Beijing Chaoyang Hospital from March 2017 to March 2019 were analyzed retrospectively.The patients consisted of 12 males and 16 females with an average age of 58.0±8.7 years(41-79 years)and were followed up for 40.7±3.6 months(36-58 months).The visual analogue scale(VAS)of low back pain(VAS-LBP)and VAS of leg pain(VAS-LP)were collected at pre-operation,postoperative 1-week follow-up,3-month follow-up,12-month follow-up and the final follow-up;Oswestry disability index(ODI)was evaluated at pre-operation,post-operative 3-month follow-up,12-month follow-up and the final follow-up.CT examination was performed at pre-operation,postoperative 12-month follow-up,24-month follow-up and the final follow-up,the cross-sec-tional area(CSA)and fat infiltration(FI)score of multifidus(MF)were measured,and the degeneration degree of adjacent segmental facet joints was evaluated according to the score of facet joint degeneration.The differ-ences of MF CSA and FI score,as well as adjacent segmental facet joint degeneration were compared be-tween preoperation and postoperation.Results:The VAS-LBP score was 3(2,3)at 1-week follow-up,1(1,2)at 3-month follow-up,1(0,2)at 12-month follow-up,and 1(0,1)at the final follow-up,which was signif-icantly improved compared with the preoperative score of 7(7,8)(P＜0.05);the VAS-LP score was 2(1,3)at 1-week follow-up,1(1,2)at 3-month follow-up,1(0,1)at 12-month follow-up,and 0(0,1)at the final fol-low-up,which were significantly improved compared with the preoperative score of 6(5,7)(P＜0.05);The ODI at 3-month follow-up was 23％(19％,31％),at 12-month follow-up was 12％(8.5％,17.5％),and at the final follow-up was 7％(4％,15.6％),all significantly improved compared with the ODI before operation of 61％(55％,67％)(P＜0.05).The postoperative MF CSAs of 547.12±53.31mm2(12-month follow-up),558.35±52.37mm2(24-month follow-up),and 531.21±56.12mm2(final follow-up)were not significantly changed from the preoper-ative MF CSA of 557.06±46.72mm2(P＞0.05).There was no significant difference in FI score between pre-op-eration of 2(2,3)and 12-month follow-up of 3(2,3),24-month follow-up of 3(2,3)and the final follow-up of 3(3,3)(P＞0.05).The postoperative facet joint degeneration scores of upper segment facet joint(USFJ)of 5(4,6)at 12-month follow-up,5(4,5)at 24-month follow-up,and 5(4,6)at final follow-up were not signifi-cantly changed from the preoperative 5(4,6)(P＞0.05).And there was no significant difference either in facet joint degeneration score of lower segment facet joint(LSFJ)between pre-operation of 5(4,6)and 12-month follow-up of 5(4,5),24-month follow-up of 5(4,6)and the final follow-up of 5(4,7)(P＞0.05).Conclusions:PE-TLIF can achieve satisfactory clinical outcomes in the treatment of single-segment lumbar spinal stenosis,which has no significant effect on multifidus in the surgical segment and adjacent segmental facet joints in the mid-to long-term.

Objectives:To compare the clinical outcomes of posterior lumbar interbody fusion(PLIF)and per-cutaneous endoscopic transforaminal lumbar interbody fusion(PE-TLIF)in treating single-segment lumbar spinal stenosis and their effects on the paraspinal muscles.Methods:This prospective study included 52 patients with L4/5 lumbar spinal stenosis treated in our hospital between January 2019 and January 2022.Among the patients,22 were in the PLIF group(10 females,12 males,aged 60.2±10.3 years old)and 30 were in the PE-TLIF group(14 females,16 males,aged 60.4±12.3 years old).The two groups were compared of the peri-operative indicators including operative time,intraoperative blood loss,postoperative drainage volume,and postoperative bed rest time;And paraspinal muscles related indicators such as creatine kinase(CK)before op-eration and at postoperative 1d and 1 week,and multifidus muscle(MF)cross-sectional area(CSA),fatty infil-tration(FI)score,and muscle CT density before operation and at postoperative 6 and 12 months;Preoperative,postoperative 1d,1 week,6 months and 12 months'visual analogue scale on low back pain(VAS-LBP),visual analogue scale on leg pain(VAS-LP),and 0swestry disability index(0DI).The complications of the two groups were analyzed and compared,and at 12 months after operation,the fusion rate was evaluated and compared according to the Bridwell criteria.Results:PE-TLIF group was different from PLIF group significantly in op-erative time(211.2±38.5min vs 98.9±31.6min,P=0.000),postoperative bed rest time(25.9±8.3h vs 52.4±14.8h,P=0.001),intraoperative blood loss(112.8±79.6mL vs 232.5±122.5mL,P=0.002),and postoperative drainage vol-ume(46.5±28.2mL vs 283.6±142.1mL,P=0.000).The MF CSA before operation,at 6 and 12 months after op-eration was not significantly different between PE-TLIF group and PLIF group(P＞0.05),and there was no sta-tistical difference between pre-operation MF CSA and MF CSA 6 months and 12 months after surgery within either group(P＞0.05).The PE-TLIF group was not significantly different from the PLIF group in MF FI score before operation and at 6 months after operation(P＞0.05),while at 12 months after operation,the PE-TLIF group was lower than the PLIF group[3.0(2.8,3.0)vs 3.0(3.0,4.0),P=0.031].There was no statistical differ-ence in MF FI score between pre-operation,6 months after surgery and 12 months after surgery within the PE-TLIF group(P＞0.05).And,there was no statistical difference in MF FI score between pre-operation and 6 months after surgery in the PLIF group(P＞0.05),while statistically significant difference was found between pre-operation and 12 months after surgery in the PLIF group[3.0(2.0,3.3)vs 3.0(3.0,4.0),P=0.016].The dif-ference in preoperative MF CT density and MF CT density 6 months after operation between the two groups was not statistically significant(P＞0.05).At the 12-month follow-up,MF CT density in the PLIF group was significantly lower than that in the PE-TLIF group[30.5(28.5,32.1)HU vs 34.2(31.8,36.9)HU,P=0.000].There was no significant difference in MF density between pre-operation,and 6 months after surgery or 12 months after surgery within the PE-TLIF group(P＞0.05).And there was no statistically significant difference in MF density between pre-operation and 6 months after surgery in the PLIF group(P=0.516),but there was a statis-tical difference between pre-operation and 12 months after surgery within the PLIF group[34.6(30.5,36.4)HU vs 30.5(28.5,32.5)HU,P=0.017).The PE-TLIF group and PLIF group was not significantly different in pre-operative CK(P=0.712),while the PE-TLIF group was lower on Id and 7d after operation(P＜0.05).VAS-LBP,VAS-LP,and 0DI at all follow-up time points after surgery of both groups were better compared to those before surgery(P＜0.05).The VAS-LBP of the PE-TLIF group was better than that of the PLIF group at 1d and 1 week after surgery(P＜0.05).There was no statistical difference in VAS-LBP between the PLIF and PE-TLIF at 6 months or 12 months after surgery.There was no statistical difference in VAS-LP or ODI between the PLIF and PE-TLIF at any follow-up time point(P＞0.05).There was no significant difference in the inci-dence of postoperative complications between the two groups(P=0.379).And there was no significant difference in the fusion rate between the two groups(P=0.877).Conclusions:PE-TLIF can achieve similar clinical out comes as traditional PLIF in the treatment of single-segment lumbar spinal stenosis,which reduces effects on paraspinal muscles and alleviate operative trauma.

Objective:To investigate grey matter volume changes and their correlation with the severity of anxiety in adolescents with major depressive disorder (MDD) accompanied by anxious distress specifier (ADS).Methods:From June 2022 to June 2023, totally 71 inpatients with MDD in the child and adolescent psychiatry department of Anhui Mental Health Center were included. According to the definition of ADS in the DSM-5, MDD adolescents were divided into the group with anxious distress (MDD/ADS+ group, n=44) and the group without anxious distress (MDD/ADS- group, n=27). Healthy adolescents matched in terms of gender, age, education level were recruited as the control group (HC group, n=19). Voxel-based morphometry (VBM) was used to compare changes in grey matter volume among the three groups.Grey matter volume values of brain regions with significant differences between the MDD/ADS+ group and MDD/ADS- group were collected, and their correlation with Hamilton anxiety rating scale (HAMA) score were analyzed by Pearson correlation analysis using SPSS 26.0 software. Results:Compared to the MDD/ADS- group, the MDD/ADS+ group showed a significant decrease in grey matter volume in the right dorsolateral prefrontal cortex (MNI: x=16.5, y=34.5, z=52.5, t=4.48, P<0.05) and the right cerebellum (MNI: x=49.5, y=-69.0, z=-24.0, t=5.18, P<0.05). In MDD adolescents, the grey matter volumes of the right dorsolateral prefrontal cortex and the right cerebellum were negatively correlated with HAMA score ( r=-0.249, -0.491, both P<0.05). Conclusion:In adolescents with MDD accompanied by ADS, a decrease in gray matter volume is observed in the right dorsolateral prefrontal cortex and the right superior cerebellum. These brain regions may serve as potential biological markers for the severity of anxiety in adolescents with MDD.

Objective:To explore the benefits of transradial diagnostic cerebral angiography in elderly patients and its correlation with morphometric parameters of the aortic arch.Methods:Clinical data and aortic arch CTA imaging parameters of patients who underwent cerebral angiography at the Department of Neurosurgery, Beijing Hospital, between May 2022 and April 2023 were retrospectively analyzed.The study aimed to compare the time taken for angiography via radial artery access in elderly patients versus younger patients, as well as via femoral artery access, and to evaluate the associated aortic arch morphology parameters.Results:A total of 101 patients' data were analyzed, with 67 males(66.3%)and an average age of 63.4±12.0 years.Among them, 69 patients(68.3%)were aged 60 and above.The arterial approach for 44 patients(43.6%)was radial, while 57 cases(56.4%)used the femoral artery approach.In the elderly group, 14 cases(20.6%), 31 cases(45.6%), and 23 cases(33.8%)had type Ⅲ aortic arch, respectively.For younger patients, 17 cases(53.1%), 12 cases(37.5%), and 3 cases(9.4%)fell into these categories.The distribution difference was statistically significant( χ2=12.765, P=0.002).Elderly patients had a larger aortic arch width angle compared to younger patients(106°±12°and 100°±12°, t=2.334, P=0.022).The time for whole-brain angiography via radial artery was shorter for elderly patients than via femoral artery(39.8±29.5 minutes and 52.2±28.4 minutes, respectively, t=1.845, P=0.070).In young patients, there was no significant time difference between the two approaches(42.3±30.4 minutes for radial artery and 34.6±11.2 minutes for femoral artery, t=1.026, P=0.313).In the type Ⅱ aortic arch group, the average times for transradial and transfemoral approaches were 38.1±21.7 minutes and 46.7±32.2 minutes, respectively( t=1.020, P=0.314).The average times for the type Ⅲ aortic arch group were 41.9±37.3 minutes and 48.9±20.7 minutes, respectively.Correlation analysis revealed a significant negative correlation between the duration of radial artery access and the distance from the origin of the innominate artery to the left subclavian artery(Pearson correlation coefficien( r=-0.372, P=0.014). Conclusions:In elderly patients, particularly those with type Ⅱ or Ⅲ aortic arch or a wide aortic arch, diagnostic cerebral angiography using transradial access is preferable to femoral access.The distance between the innominate artery and the left subclavian artery origin could impact the duration of the procedure.

The twenty-first century has already recorded more than ten major epidemics or pandemics of viral disease, including the devastating COVID-19. Novel effective antivirals with broad-spectrum coverage are urgently needed. Herein, we reported a novel broad-spectrum antiviral compound PAC5. Oral administration of PAC5 eliminated HBV cccDNA and reduced the large antigen load in distinct mouse models of HBV infection. Strikingly, oral administration of PAC5 in a hamster model of SARS-CoV-2 omicron (BA.1) infection significantly decreases viral loads and attenuates lung inflammation. Mechanistically, PAC5 binds to a pocket near Asp49 in the RNA recognition motif of hnRNPA2B1. PAC5-bound hnRNPA2B1 is extensively activated and translocated to the cytoplasm where it initiates the TBK1-IRF3 pathway, leading to the production of type I IFNs with antiviral activity. Our results indicate that PAC5 is a novel small-molecule agonist of hnRNPA2B1, which may have a role in dealing with emerging infectious diseases now and in the future.
Animals ; Mice ; Antiviral Agents/pharmacology* ; COVID-19 ; Hepatitis B virus ; Interferon Type I/metabolism* ; SARS-CoV-2/drug effects* ; Heterogeneous-Nuclear Ribonucleoprotein Group A-B/antagonists & inhibitors*

The transportation of electron is inseparable from vacuum environment. The maintenance of the vacuum system of Elekta linear accelerator depends on two sputtering ionic pumps at the gun end and the target end. The traveling wave acceleration were used in Elekta linear accelerators. And the design of the electron gun filament is detachable. Because of these two reasons, the vacuum stability is relatively weak. Only two vacuum values are used to reflect the operation state of the whole vacuum system, which causes a few failures but will not trigger a the machine interlock. Considering the complexity of whole vacuum system, the problem of vacuum caused by the failure of various components in vacuum system is analyzed in this paper. It is hoped that some useful repairing experience and suggestions for the maintenance engineers of linear accelerator to solve the vacuum fault and rebuild the vacuum can be provided quickly.
Electrons ; Particle Accelerators ; Radiotherapy Dosage ; Vacuum

Objective:To explore whether endoscopic surgery can achieve the same effect on thyroid cancer as open surgery.Method:44 cases were selected to endoscopic thyroidectomy with breast areola approach, who were prepared to accept the surgical treatment of thyroid cancer with cT1N0 stages, female, ≤60 years old, no history of neck surgery and beauty desire. Fifty patients with the same conditions undergoing thyroid open surgery were as the control group.Results:Operative time of endoscopic group[ (170.0±28.0) min] was longer than that of the open operation group[ (90.0±21.0) min ( t=15.610, P=0.000) ]. There was no significant difference between the two groups in surgical complications ( P>0.05) . There was no statistical difference between the number of paratracheal and anterior tracheal lymph nodes of endoscopic group (6.0 ±4.2) and open surgery group (5.5 ±3.7) ( t=0.692, P>0.05) . There was no statistical difference between the number of anterior laryngeal lymph nodes of endoscopic group (0.7 ±1.1) and open surgery group (0.5 ±0.9) ( t=1.186, P>0.05) . Conclusion:The breast areola approach endoscopic thyroidectomy is safe and reliable in treatment of thyroid cancer, and the central cervical lymph node dissection is sufficient, which can be used as the choice of operation mode for thyroid cancer patients in cT1N0 stage.

Objective:To explore the application of panoramic teaching in clinical practice.Methods:From October 2017 to October 2018, 40 clinical undergraduate interns were collected into the experimental group (panoramic teaching group, n=20) and the control group (traditional teaching group, n=20). The experimental group received panoramic teaching including case teaching, scenario design, and situational simulation, while the control group adopted traditional teaching mode. After the internship, theoretical and operational examinations, and questionnaire survey were conducted to evaluate the teaching effects of the two teaching modes. The data were collected and analyzed by t test using SPSS 16.0 software. Results:The results showed that theoretical examination [(85.4±3.3) vs. (82.5±2.5)] and clinical operational examination [(31.5±3.5) vs. (27.6±2.2)] scores in the panoramic teaching group were significantly higher than that in the traditional teaching group. The questionnaire survey on the satisfactions with teaching mode showed that the panoramic teaching group was significantly better than the traditional teaching group in theory learning [(7.7±0.9) vs. (6.8±0.7)], clinical practice[(7.8±0.9) vs. (6.7±0.7)], learning interest [(8.1±0.7) vs. (6.9±0.7)], self-learning ability [(7.7±0.7) vs. (7.1±0.6)], teacher-student communication ability [(7.6±0.8) vs. (6.8±0.7)], doctor-patient communication ability [(7.5±0.6) vs. (7.0±0.8)], medical humanistic spirit [(7.9±0.7) vs. (6.8±0.7)], group working [(8.2±0.6) vs. (6.5±0.5)], humanistic concern [(8.4±0.5) vs. (7.4±0.7)], and total satisfactions [(8.4±0.5) vs. (7.4±0.7)].Conclusion:Panoramic teaching can significantly improve the theoretical and operational performance of family practice interns, enhance the effect of clinical teaching of family practice, and increase students’ interest and satisfaction in clinical teaching.