Despite advancements in neuroimaging,false positive diagnoses of intracranial aneurysms remain a significant concern.This article examines the causes,prevalence,and implications of such false-positive diagnoses.We dis...Despite advancements in neuroimaging,false positive diagnoses of intracranial aneurysms remain a significant concern.This article examines the causes,prevalence,and implications of such false-positive diagnoses.We discuss how conditions like arterial occlusion with vascular stump formation and infundibular widening can mimic aneurysms,particularly in the anterior circulation.The article compares various imaging modalities,including computer tomography angiogram,magnetic resonance imaging/angiography,and digital subtraction angiogram,highlighting their strengths and limitations.We emphasize the im-portance of accurate differentiation to avoid unnecessary surgical interventions.The potential of emerging technologies,such as high-resolution vessel wall ima-ging and deep neural networks for automated detection,is explored as promising avenues for improving diagnostic accuracy.This manuscript underscores the need for continued research and clinical vigilance in the diagnosis of intracranial aneurysms.展开更多
False aneurysm occurring after replacement of ascending aorta by a vascular prosthesis is a rare, but life-threatening complication. In spite of advances in endovascular techniques, surgery remains the treatment of ch...False aneurysm occurring after replacement of ascending aorta by a vascular prosthesis is a rare, but life-threatening complication. In spite of advances in endovascular techniques, surgery remains the treatment of choice in the majority of cases. We report the case of a huge pseudoaneurysm caused by late dehiscence of the right coronary ostium-aortic tubular graft anastomosis, occurred 30 years after replacement of aortic valve and ascending aorta by classical Bentall operation. A fistula originating from the aneurysmal sac extended across the sternum into the thoracic subcutaneous soft tissues and gave rise to a pulsatile mass well appreciable on the anterior chest wall. The surgical treatment, consisting of partial resection of the aortic tubular graft and sternal reconstruction was effective and uneventful.展开更多
The Kakinuma et al’s case report shows that non-pregnancy-related arterial pseudoaneurysm is a relatively rare,little known by some gynecologists,endo-scopists,surgeons or radiologists,which can cause massive bleedin...The Kakinuma et al’s case report shows that non-pregnancy-related arterial pseudoaneurysm is a relatively rare,little known by some gynecologists,endo-scopists,surgeons or radiologists,which can cause massive bleeding.Arterial pseudoaneurysm is a condition in which the wall of a blood vessel collapses due to some invasive event,and the resulting leaked blood is engulfed by soft tissues,forming a cavity that is in communication with the vessel.It is a potentially life-threatening complication that could occurs after some deliveries and some gynecological invasive procedures.Remarkably,an undetermined percentage of pseudoaneurysms are asymptomatic,and in an asymptomatic patient it is difficult to predict the risk of haemorrhage and the attitude to follow,which depends on several factors,such as,the size and location of the vessel involved,changes in the size of the pseudoaneurysm,or the available therapeutic resources to be offered to patients,among others circumstances.The management of abdominal arterial pseudoaneurysm does not have consistent scientific evidence,but it seems that,regardless of the associated circumstances,the pseudoaneurysm could be treated at least initially,and mainly,through endovascular procedures,as done by Kakinuma et al.展开更多
The incidence of saphenous vein graft aneurysms(SVGAs)after coronary artery bypass grafting(CABG)is approximately 0.07%;[1]however,the true incidence is likely underreported because of their frequent incidental discov...The incidence of saphenous vein graft aneurysms(SVGAs)after coronary artery bypass grafting(CABG)is approximately 0.07%;[1]however,the true incidence is likely underreported because of their frequent incidental discovery.[2]Due to its rarity,knowledge mainly comes from case reports and small case series,though some decision algorithms have been proposed in systematic reviews.展开更多
BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated wit...BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated with false-positive and false-negative FIT results.METHODS This retrospective study was based on the database of the Tianjin Colorectal Cancer Screening Program from 2012 to 2020.A total of 4129947 residents aged 40-74 years completed at least one FIT.Of these,24890 asymptomatic participants who underwent colonoscopy examinations and completed lifestyle questionnaires were included in the analysis.Multivariable logistic regression was performed to identify the factors associated with false FIT results.RESULTS Among the overall screening population,88687(2.15%)participants tested positive for FIT.The sensitivity,specificity,positive predictive value,and negative predictive value of FIT for advanced neoplasms were 58.2%,44.8%,9.7%,and 91.3%,respectively.Older age,female sex,smoking,alcohol consumption,higher body mass index,and hemorrhoids were significantly associated with increased odds of false-positive and lower odds of falsenegative FIT results.Moreover,features of high-grade dysplasia or villous for advanced adenoma and the presence of cancer were also associated with lower odds of false-negative results,while irregular exercise and diverticulum were associated with higher odds of false-positive results.CONCLUSION FIT results may be inaccurate in certain subgroups.Our results provide important evidence for further individualization of screening strategies.展开更多
Dear Editor,We extend our academic appreciation to the contributors of this pioneering study,1 which leverages Mendelian Randomization(MR)to investigate the causal relationship between immune cell phenotypes and intra...Dear Editor,We extend our academic appreciation to the contributors of this pioneering study,1 which leverages Mendelian Randomization(MR)to investigate the causal relationship between immune cell phenotypes and intracranial aneurysms(IAs),demonstrating a certain level of innovation.By extracting 731 immunophenotypes from publicly available genetic databases and conducting large-scale analyses,the study comprehensively evaluates the impact of immune cell traits on IAs.Moreover,multivariable MR analysis was employed to adjust for interactions between different immune phenotypes,providing a novel perspective on the interplay between the immune system and IAs.展开更多
The chronic occlusion of intracranial arteries generally has no or mild clinical symptoms,and the clinical symptoms of acute cerebral artery occlusion are mostly manifested as severe cerebral infarction symptoms,which...The chronic occlusion of intracranial arteries generally has no or mild clinical symptoms,and the clinical symptoms of acute cerebral artery occlusion are mostly manifested as severe cerebral infarction symptoms,which often make early diagnosis difficult,thus losing the best treatment opportunity.Once cerebral infarction occurs,the consequences are difficult to recover.This is also an important reason for the high misdiagnosis rate and mortality of this disease.In this paper,the characteristics of the disease were analyzed to provide clinical reference.展开更多
BACKGROUND Abdominal aortic aneurysm(AAA)repair often involves significant postoperative pain,traditionally managed with systemic opioids,which can cause undesirable side effects.This case report explores the novel us...BACKGROUND Abdominal aortic aneurysm(AAA)repair often involves significant postoperative pain,traditionally managed with systemic opioids,which can cause undesirable side effects.This case report explores the novel use of a surgically-initiated rectus sheath block with a catheter-over-needle assembly for pain management in AAA repair.CASE SUMMARY A 67-year-old female with hypertension and previous aortic dissection underwent elective open repair of an infrarenal AAA,which had grown from 3.4 cm to 4.3 cm over 14 months.A rectus sheath block was initiated surgically for postoperative pain control.The patient reported low pain scores and did not require systemic intravenous opioids,enabling early ambulation and discharge on postoperative day seven without complications.By preventing complications of systemic opi-oids,the method indicating a promising direction for postoperative pain management in major vascular surgeries.CONCLUSION Surgically-initiated rectus sheath block as a valuable tool for managing postoperative pain in AAA repair.展开更多
Vocal cord paralysis that presents as hoarseness due to an underlying cardiovascular pathology is a rare clinical entity known as Ortner’s syndrome(OS).The syndrome was first described in 1897 by Norbert Ortner in a ...Vocal cord paralysis that presents as hoarseness due to an underlying cardiovascular pathology is a rare clinical entity known as Ortner’s syndrome(OS).The syndrome was first described in 1897 by Norbert Ortner in a report of three patients with severe mitral stenosis.[1]Notably,a review of published cases showed that between 1955 and 1990,mitral stenosis was the primary cause of OS.However,since the 1990s,vascular lesions(especially thoracic aortic aneurysms)have become the most common cause of OS.[2]This epidemiologic shift may be due to improved early detection and treatment of mitral stenosis.展开更多
Pedestrian detection has been a hot spot in computer vision over the past decades due to the wide spectrum of promising applications,and the major challenge is false positives that occur during pedestrian detection.Th...Pedestrian detection has been a hot spot in computer vision over the past decades due to the wide spectrum of promising applications,and the major challenge is false positives that occur during pedestrian detection.The emergence of various Convolutional Neural Network-based detection strategies substantially enhances pedestrian detection accuracy but still does not solve this problem well.This paper deeply analyzes the detection framework of the two-stage CNN detection methods and finds out false positives in detection results are due to its training strategy misclassifying some false proposals,thus weakening the classification capability of the following subnetwork and hardly suppressing false ones.To solve this problem,this paper proposes a pedestrian-sensitive training algorithm to help two-stage CNN detection methods effectively learn to distinguish the pedestrian and non-pedestrian samples and suppress the false positives in the final detection results.The core of the proposed algorithm is to redesign the training proposal generating scheme for the two-stage CNN detection methods,which can avoid a certain number of false ones that mislead its training process.With the help of the proposed algorithm,the detection accuracy of the MetroNext,a smaller and more accurate metro passenger detector,is further improved,which further decreases false ones in its metro passenger detection results.Based on various challenging benchmark datasets,experiment results have demonstrated that the feasibility of the proposed algorithm is effective in improving pedestrian detection accuracy by removing false positives.Compared with the existing state-of-the-art detection networks,PSTNet demonstrates better overall prediction performance in accuracy,total number of parameters,and inference time;thus,it can become a practical solution for hunting pedestrians on various hardware platforms,especially for mobile and edge devices.展开更多
The earthquake early warning system is an effective means of disaster reduction to reduce losses caused by earthquakes,it can release earthquake warning information to the public before destructive seismic waves reach...The earthquake early warning system is an effective means of disaster reduction to reduce losses caused by earthquakes,it can release earthquake warning information to the public before destructive seismic waves reach the warning target area,and carry out automatic disposal of lifeline engineering facilities.Through the construction of the National Earthquake Intensity Rapid Reporting and Early Warning Project,an earthquake early warning network consisting of over 1900 monitoring stations has been established in the Beijing-Tianjin-Hebei Urban Agglomeration.The early warning system has achieved second level earthquake warning and minute level intensity rapid reporting.The implementation of these functions relies on the system's ability to timely,accurately,and reliably identify seismic waves.But with the development of social economy,the background noise of earthquake observation environment is becoming increasingly complex,which brings certain challenges to earthquake wave recognition,some interference events have the risk of triggering the earthquake warning system incorrectly.Therefore,this article focuses on seismic wave recognition in complex noise environments and proposes a seismic wave detection method based on triangulation to enhance the antiinterference ability and recognition accuracy of early warning systems.展开更多
Intracranial aneurysm(IA)is a prevalent cerebrovascular disease associated with high mortality and disability rates upon rupture.The hemodynamics of IA,which are significantly influenced by geometric parameters,direct...Intracranial aneurysm(IA)is a prevalent cerebrovascular disease associated with high mortality and disability rates upon rupture.The hemodynamics of IA,which are significantly influenced by geometric parameters,directly impact its rupture.This study focuses on investigating the transient flow characteristics in saccular IA models fabricated using a water droplet-based method,specifically examining the influence of neck widths.Particle image velocimetry technique and numerical simulation were employed to investigate the dynamic evolution of flow structures within three IA models.The results reveal that neck width(W)has a substantial effect on flow characteristics in the neck region,subsequently impacting the deep flow inside the sac.Three distinct patterns were observed during flow evolution inside the sac:for W=2 mm,two vortices occur and then disappear with relatively low average flow velocity;for W=4 mm,enhanced effects of a high-speed jet result in periodic pulsatile flow velocity distribution while maintaining stable vortex core position;for W=6 mm,significant changes in flow velocity occur due to size expansion and intensity increase of vortices.These findings demonstrate that neck widths play a complex role in influencing transient flow characteristics within IAs.Overall,this research contributes to further understanding transient flow behaviors in IAs.展开更多
BACKGROUND Aneurysmal subarachnoid hemorrhage(aSAH),a particularly devastating subtype of stroke,is associated with substantial rates of mortality and long-term functional impairment.Despite notable progress in therap...BACKGROUND Aneurysmal subarachnoid hemorrhage(aSAH),a particularly devastating subtype of stroke,is associated with substantial rates of mortality and long-term functional impairment.Despite notable progress in therapeutic strategies,a considerable proportion of aSAH survivors continue to suffer from neuropsychiatric complications,most commonly anxiety and depression,which detrimentally impact their overall quality of life.AIM To investigate the prevalence of anxiety and depressive symptoms in patients with aSAH and to identify associated clinical risk factors.METHODS Clinical records of 1268 consecutive patients diagnosed with aSAH and treated between 2016 and 2022 were retrospectively reviewed.At follow-up,psychological assessments were performed using the Hospital Anxiety and Depression Scale to quantify symptoms of anxiety and depression.To identify independent predictors associated with these psychological outcomes post-aSAH,both univariate and multivariate statistical analyses were employed.RESULTS Among the studied cohort,34.9%of patients presented with anxiety symptoms,while 31.8%demonstrated depressive features.Multivariate analysis identified female sex,presence of multiple aneurysms,a positive family history of cerebral hemorrhage,and receiving surgical clipping as independent predictors of anxiety.In contrast,significant predictors of depression included female sex,multiplicity of aneurysms,posterior circulation aneurysm localization,and poor clinical outcome.Notably,age above 60 years and documented functional recovery were associated with a reduced risk of depression.CONCLUSION Anxiety and depression are common neuropsychiatric sequelae in survivors of aSAH,each associated with a distinct set of risk factors.Early identification and targeted management of these risk profiles may facilitate more effective intervention strategies for psychological comorbidities,ultimately contributing to improved long-term patient outcomes.展开更多
Left atrial aneurysm is an exceptionally rare condition,particularly in the pediatric population,and even more so as a sequela of bacterial pericarditis.We present the case of a 16-month-old girl who developed a left ...Left atrial aneurysm is an exceptionally rare condition,particularly in the pediatric population,and even more so as a sequela of bacterial pericarditis.We present the case of a 16-month-old girl who developed a left atrial aneurysm following isolated Staphylococcus aureus pericarditis.She initially presented in decompensated shock and was later diagnosed with constrictive pericarditis.Despite undergoing pericardiectomy,she subsequently developed a left atrial aneurysm,necessitating surgical closure.This case highlights the aggressive nature of bacterial pericarditis and its potential to cause rare structural cardiac complications.展开更多
Background Abdominal aortic aneurysm(AAA)is a life-threatening vascular disease associated with endothelial cell senescence.Resveratrol(RSV),a natural polyphenol,exerts potent anti-senescent and anti-inflammatory effe...Background Abdominal aortic aneurysm(AAA)is a life-threatening vascular disease associated with endothelial cell senescence.Resveratrol(RSV),a natural polyphenol,exerts potent anti-senescent and anti-inflammatory effects.However,its molecular mechanism in treating AAA remains unclear.Methods An AAA model was established in mice via angiotensin Ⅱ(AngⅡ)infusion[1000 ng/(kg·min)],with a subset receiving RSV treatment[100 mg/(kg·day)by gavage].Aortic diameter was measured,and histopathological changes were assessed by Hematoxylin-Eosin(HE)and Elastica Van Gieson(EVG)staining.Vascular aging was evaluated by senescence-associatedβ-galactosidase(SA-β-gal)activity and pulse wave velocity(PWV).In vitro,human umbilical vein endothelial cells(HUVECs)were treated with AngⅡ(10-6 M)with or without RSV(40μM)and/or the sirtuin 1(SIRT1)inhibitor EX527(10μM).Senescence markers,senescence-associated secretory phenotype(SASP)factor expression[interleukin-1 beta(IL-1β),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α)],and SIRT1/p21 pathway proteins were analyzed.Results In vivo,RSV significantly attenuated Ang Ⅱ-induced AAA formation,reducing aortic diameter,preserving elastic fiber integrity,and suppressing vascular senescence and stiffness.In HUVECs,Ang Ⅱ-induced senescence and SASP expression were markedly inhibited by RSV.However,these protective effects were abolished by EX527.Mechanistically,RSV reversed the Ang Ⅱ-induced downregulation of SIRT1 and upregulation of p21,which was also blocked by SIRT1 inhibition.Conclusions RSV effectively prevented experimental AAA formation by alleviating vascular aging and endothelial cell senescence.This protective effect was abrogated by the SIRT1 inhibitor EX527,confirming that RSV mitigated AAA development and vascular senescence through the SIRT1/p21 signaling pathway.These findings highlighted RSV as a promising therapeutic candidate for AAA treatment.展开更多
Objective:To summarize the nursing experience of a patient with intracranial aneurysm rupture and hemorrhage who developed pulmonary embolism after clipping surgery.Methods:A patient in our hospital,who had intracrani...Objective:To summarize the nursing experience of a patient with intracranial aneurysm rupture and hemorrhage who developed pulmonary embolism after clipping surgery.Methods:A patient in our hospital,who had intracranial aneurysm rupture and hemorrhage and developed pulmonary embolism after clipping surgery,was selected as the research subject.Through multidisciplinary collaboration,standardized assessment and dynamic condition observation,various risks were identified early.Combined with the patient’s individual characteristics,a personalized nursing plan was formulated.During the treatment process,emphasis was placed on strengthening the patient’s airway management,closely monitoring various indicators,and preventing postoperative complications.Targeted nursing measures were adopted:reasonable airway humidification and effective lung care were used to gradually control the patient’s pulmonary infection;fluid balance management and individualized care were implemented to ensure the patient’s normal circulating blood volume,thereby optimizing cerebral perfusion and cerebral oxygenation.Since the patient had overlapping risk factors for bleeding and thromboembolic events,evidence-based nursing principles were followed for thromboembolism prevention,and anticoagulation strategies and nursing plans were dynamically adjusted to reduce the occurrence of postoperative complications.Results:The patient’s condition improved and was successfully discharged on the 22^(nd) day after surgery,and then transferred to a local rehabilitation hospital for further treatment.At the 1-month follow-up after discharge,the patient recovered well;at the 3-month follow-up after discharge,the patient had recovered and returned home.Conclusion:The results show that standardized assessment and condition observation,multidisciplinary collaboration,and personalized nursing plans can significantly reduce the occurrence of postoperative complications and improve the patient’s prognosis.This nursing experience provides a reference for the nursing of similar patients in the future.展开更多
BACKGROUND Aneurysmal bone cysts(ABCs)are usually treated with curettage or various minimally invasive percutaneous procedures.Patient refractory to these treatments,as well as those with locally advanced or unresecta...BACKGROUND Aneurysmal bone cysts(ABCs)are usually treated with curettage or various minimally invasive percutaneous procedures.Patient refractory to these treatments,as well as those with locally advanced or unresectable tumors,present a challenge for orthopedic surgeons and require new treatment approaches.Antiresorptive drugs inhibit osteoclastic resorption and increase intralesional osteogenesis.Denosumab induces tumor ossification,but this effect may disappear after drug withdrawal due to limited impact on neoplastic cells.Bisphosphonates(BPs)may induce apoptosis of tumor cells and allow for long-term local control.We hypothesized that after denosumab treatment,BPs would better accumulate in the tumor and exert an irreversible antitumor effect.AIM To test the hypothesis that the sequential use of BPs after denosumab induction improves treatment outcomes in surgically unsalvageable ABCs.METHODS Using data from five electronic databases(Scopus,MEDLINE,EMBASE,PubMed,Web of Science),we aimed to identify all patients who received denosumab therapy(DT)for unresectable ABCs.Among published case reports and case series,we identified patients who discontinued denosumab for various reasons and divided them into two groups:Group 1 included 31 patients without further anti-resorptive therapy and Group 2 included 12 patients who received BPs in the context of rebound hypercalcemia.Local control rates in both groups were analyzed.RESULTS As of December 2024,43 patients have been reported in the literature who received DT for locally advanced/unresectable ABCs.There were 27 males and 16 females with a mean age of 15.8 years.At a median follow-up time of 15.5 months,there were 10 confirmed and two pathologically unconfirmed relapses after denosumab discontinuation.All 10 relapses occurred in patients in Group 1 at a median time of 13.5 months.Among patients in Group 2,with a median follow-up time of 12.5 months after completion of therapy,no local relapses were observed.The difference between local recurrence rates(32%vs 0%)is statistically significant(P value=0.02).Kaplan-Meier estimates show the same trend with marginal statistical significance(P value=0.085).Here we put forward a novel treatment algorithm.CONCLUSION BPs used in post-denosumab ossifying ABCs appear to improve treatment outcomes,presumably by targeting residual tumor cells.Prospective clinical studies are warranted to validate this promising two-stage conceptual strategy in difficult-to-treat ABC.展开更多
BACKGROUND Splenic artery aneurysm(SAA)rupture is a rare,life-threatening condition characterized by acute intra-abdominal hemorrhage and hemodynamic instability.Ruptured SAAs may exhibit a biphasic and relatively slo...BACKGROUND Splenic artery aneurysm(SAA)rupture is a rare,life-threatening condition characterized by acute intra-abdominal hemorrhage and hemodynamic instability.Ruptured SAAs may exhibit a biphasic and relatively slow clinical progression,commonly referred to as the“double-rupture phenomenon”.The reported incidence of the double-rupture phenomenon ranges 12%-21%in patients with ruptured SAAs,potentially due to variations in intra-abdominal pressure.Following anesthesia induction,muscle relaxation can decrease intra-abdominal pressure,potentially triggering the double-rupture phenomenon and leading to circulatory collapse.CASE SUMMARY A 61-year-old female presented to the Department of Emergency with upper abdominal pain,abdominal distension,dizziness,and vomiting.Her vital signs were initially stable.Physical examination revealed abdominal tenderness and positive-shifting dullness.Abdominal contrast-enhanced computed tomography revealed cirrhosis,severe portal hypertension,and splenomegaly.Acute rupture was suggested by a hematoma on the upper left side outside the SAA.Surgeons deemed intravascular intervention challenging and open splenectomy inevitable.Circulatory collapse occurred after anesthesia induction,likely due to a double rupture of the SAA.This double-rupture phenomenon may have resulted from an initial rupture of the SAA into the omental bursa,forming a hematoma that exerted a tamponade effect.A second rupture into the peritoneal cavity may have been triggered by decreased intra-abdominal pressure following anesthesia induction.The patient’s life was saved through early,coordinated,multidisciplinary significant postoperative bleeding or hypoxic encephalopathy.CONCLUSION Anesthesia-induced pressure reduction may trigger a second SAA rupture,causing collapse.Early diagnosis and multidisciplinary teamwork improve outcomes.This is a rare and life-threatening case of SAA rupture,which is of great significance to the medical community for understanding and handling such emergencies.展开更多
The mortality rate of patients with abdominal aortic aneurysm(AAA) after rupture is extremely high,and this disease has become an important disease endangering the health of the Chinese population.Methods used to mode...The mortality rate of patients with abdominal aortic aneurysm(AAA) after rupture is extremely high,and this disease has become an important disease endangering the health of the Chinese population.Methods used to model AAA include intraluminal pressurized elastase infusion,chronic infusion of angiotensin Ⅱ(Ang Ⅱ) via an osmotic pump,periarterial application of calcium chloride,vascular grafting,and gene modification.AAA models induced by elastase and Ang Ⅱ are the two most widely used animal models.In the elastase-induced model,because intraluminal infusion is transient,with the cessation of initial stimulation,the aneurysm lesion tends to be stable and rarely ruptures.The model induced by Ang Ⅱ infusion often presents with a typical aortic dissection with a false lumen,whereas clinical AAA patients do not necessarily have dissection.Currently,the treatment of AAA in clinical practice remains endovascular,and there is a lack of pharmacological therapy,which is also related to the fact that the pathogenic mechanism has not been fully elucidated.Smoking,old age,male sex,and hypertension are the main risk factors for AAA,but these risk factors have not been fully investigated in the current modeling methods,which may affect the clinical translational application of research results based on animal models.Therefore,this article reviews the most commonly used AAA modeling methods,comments on their applications and limitations,and provides a perspective on the development of novel animal models.展开更多
False Data Injection Attacks(FDIAs)pose a critical security threat to modern power grids,corrupting state estimation and enabling malicious control actions that can lead to severe consequences,including cascading fail...False Data Injection Attacks(FDIAs)pose a critical security threat to modern power grids,corrupting state estimation and enabling malicious control actions that can lead to severe consequences,including cascading failures,large-scale blackouts,and significant economic losses.While detecting attacks is important,accurately localizing compromised nodes or measurements is even more critical,as it enables timely mitigation,targeted response,and enhanced system resilience beyond what detection alone can offer.Existing research typically models topological features using fixed structures,which can introduce irrelevant information and affect the effectiveness of feature extraction.To address this limitation,this paper proposes an FDIA localization model with adaptive neighborhood selection,which dynamically captures spatial dependencies of the power grid by adjusting node relationships based on data-driven similarities.The improved Transformer is employed to pre-fuse global spatial features of the graph,enriching the feature representation.To improve spatio-temporal correlation extraction for FDIA localization,the proposed model employs dilated causal convolution with a gating mechanism combined with graph convolution to capture and fuse long-range temporal features and adaptive topological features.This fully exploits the temporal dynamics and spatial dependencies inherent in the power grid.Finally,multi-source information is integrated to generate highly robust node embeddings,enhancing FDIA detection and localization.Experiments are conducted on IEEE 14,57,and 118-bus systems,and the results demonstrate that the proposed model substantially improves the accuracy of FDIA localization.Additional experiments are conducted to verify the effectiveness and robustness of the proposed model.展开更多
文摘Despite advancements in neuroimaging,false positive diagnoses of intracranial aneurysms remain a significant concern.This article examines the causes,prevalence,and implications of such false-positive diagnoses.We discuss how conditions like arterial occlusion with vascular stump formation and infundibular widening can mimic aneurysms,particularly in the anterior circulation.The article compares various imaging modalities,including computer tomography angiogram,magnetic resonance imaging/angiography,and digital subtraction angiogram,highlighting their strengths and limitations.We emphasize the im-portance of accurate differentiation to avoid unnecessary surgical interventions.The potential of emerging technologies,such as high-resolution vessel wall ima-ging and deep neural networks for automated detection,is explored as promising avenues for improving diagnostic accuracy.This manuscript underscores the need for continued research and clinical vigilance in the diagnosis of intracranial aneurysms.
文摘False aneurysm occurring after replacement of ascending aorta by a vascular prosthesis is a rare, but life-threatening complication. In spite of advances in endovascular techniques, surgery remains the treatment of choice in the majority of cases. We report the case of a huge pseudoaneurysm caused by late dehiscence of the right coronary ostium-aortic tubular graft anastomosis, occurred 30 years after replacement of aortic valve and ascending aorta by classical Bentall operation. A fistula originating from the aneurysmal sac extended across the sternum into the thoracic subcutaneous soft tissues and gave rise to a pulsatile mass well appreciable on the anterior chest wall. The surgical treatment, consisting of partial resection of the aortic tubular graft and sternal reconstruction was effective and uneventful.
文摘The Kakinuma et al’s case report shows that non-pregnancy-related arterial pseudoaneurysm is a relatively rare,little known by some gynecologists,endo-scopists,surgeons or radiologists,which can cause massive bleeding.Arterial pseudoaneurysm is a condition in which the wall of a blood vessel collapses due to some invasive event,and the resulting leaked blood is engulfed by soft tissues,forming a cavity that is in communication with the vessel.It is a potentially life-threatening complication that could occurs after some deliveries and some gynecological invasive procedures.Remarkably,an undetermined percentage of pseudoaneurysms are asymptomatic,and in an asymptomatic patient it is difficult to predict the risk of haemorrhage and the attitude to follow,which depends on several factors,such as,the size and location of the vessel involved,changes in the size of the pseudoaneurysm,or the available therapeutic resources to be offered to patients,among others circumstances.The management of abdominal arterial pseudoaneurysm does not have consistent scientific evidence,but it seems that,regardless of the associated circumstances,the pseudoaneurysm could be treated at least initially,and mainly,through endovascular procedures,as done by Kakinuma et al.
文摘The incidence of saphenous vein graft aneurysms(SVGAs)after coronary artery bypass grafting(CABG)is approximately 0.07%;[1]however,the true incidence is likely underreported because of their frequent incidental discovery.[2]Due to its rarity,knowledge mainly comes from case reports and small case series,though some decision algorithms have been proposed in systematic reviews.
基金Supported by Natural Science Foundation of Tianjin,No.21JCZDJC00060 and No.21JCYBJC00180Tianjin Health and Medical Science and Technology Project,No.TJWJ2023QN040National Key Research and Development Program,No.2017YFC1700606 and No.2017YFC1700604.
文摘BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated with false-positive and false-negative FIT results.METHODS This retrospective study was based on the database of the Tianjin Colorectal Cancer Screening Program from 2012 to 2020.A total of 4129947 residents aged 40-74 years completed at least one FIT.Of these,24890 asymptomatic participants who underwent colonoscopy examinations and completed lifestyle questionnaires were included in the analysis.Multivariable logistic regression was performed to identify the factors associated with false FIT results.RESULTS Among the overall screening population,88687(2.15%)participants tested positive for FIT.The sensitivity,specificity,positive predictive value,and negative predictive value of FIT for advanced neoplasms were 58.2%,44.8%,9.7%,and 91.3%,respectively.Older age,female sex,smoking,alcohol consumption,higher body mass index,and hemorrhoids were significantly associated with increased odds of false-positive and lower odds of falsenegative FIT results.Moreover,features of high-grade dysplasia or villous for advanced adenoma and the presence of cancer were also associated with lower odds of false-negative results,while irregular exercise and diverticulum were associated with higher odds of false-positive results.CONCLUSION FIT results may be inaccurate in certain subgroups.Our results provide important evidence for further individualization of screening strategies.
文摘Dear Editor,We extend our academic appreciation to the contributors of this pioneering study,1 which leverages Mendelian Randomization(MR)to investigate the causal relationship between immune cell phenotypes and intracranial aneurysms(IAs),demonstrating a certain level of innovation.By extracting 731 immunophenotypes from publicly available genetic databases and conducting large-scale analyses,the study comprehensively evaluates the impact of immune cell traits on IAs.Moreover,multivariable MR analysis was employed to adjust for interactions between different immune phenotypes,providing a novel perspective on the interplay between the immune system and IAs.
基金Supported by the Science and Technology Program of Nantong Health Committee,No.MA2019003 and No.MA2021017Kangda College of Nanjing Medical University,No.KD2021JYYJYB025,No.KD2022KYJJZD019,and No.KD2022KYJJZD022+1 种基金Research Project of Nantong Health and Health Commission,No.MS2023041the Science and Technology Program of Nantong City,No.Key003 and No.JCZ2022040.
文摘The chronic occlusion of intracranial arteries generally has no or mild clinical symptoms,and the clinical symptoms of acute cerebral artery occlusion are mostly manifested as severe cerebral infarction symptoms,which often make early diagnosis difficult,thus losing the best treatment opportunity.Once cerebral infarction occurs,the consequences are difficult to recover.This is also an important reason for the high misdiagnosis rate and mortality of this disease.In this paper,the characteristics of the disease were analyzed to provide clinical reference.
基金Supported by the Taichung Veterans General Hospital,No.TCVGH-1125401B.
文摘BACKGROUND Abdominal aortic aneurysm(AAA)repair often involves significant postoperative pain,traditionally managed with systemic opioids,which can cause undesirable side effects.This case report explores the novel use of a surgically-initiated rectus sheath block with a catheter-over-needle assembly for pain management in AAA repair.CASE SUMMARY A 67-year-old female with hypertension and previous aortic dissection underwent elective open repair of an infrarenal AAA,which had grown from 3.4 cm to 4.3 cm over 14 months.A rectus sheath block was initiated surgically for postoperative pain control.The patient reported low pain scores and did not require systemic intravenous opioids,enabling early ambulation and discharge on postoperative day seven without complications.By preventing complications of systemic opi-oids,the method indicating a promising direction for postoperative pain management in major vascular surgeries.CONCLUSION Surgically-initiated rectus sheath block as a valuable tool for managing postoperative pain in AAA repair.
文摘Vocal cord paralysis that presents as hoarseness due to an underlying cardiovascular pathology is a rare clinical entity known as Ortner’s syndrome(OS).The syndrome was first described in 1897 by Norbert Ortner in a report of three patients with severe mitral stenosis.[1]Notably,a review of published cases showed that between 1955 and 1990,mitral stenosis was the primary cause of OS.However,since the 1990s,vascular lesions(especially thoracic aortic aneurysms)have become the most common cause of OS.[2]This epidemiologic shift may be due to improved early detection and treatment of mitral stenosis.
文摘Pedestrian detection has been a hot spot in computer vision over the past decades due to the wide spectrum of promising applications,and the major challenge is false positives that occur during pedestrian detection.The emergence of various Convolutional Neural Network-based detection strategies substantially enhances pedestrian detection accuracy but still does not solve this problem well.This paper deeply analyzes the detection framework of the two-stage CNN detection methods and finds out false positives in detection results are due to its training strategy misclassifying some false proposals,thus weakening the classification capability of the following subnetwork and hardly suppressing false ones.To solve this problem,this paper proposes a pedestrian-sensitive training algorithm to help two-stage CNN detection methods effectively learn to distinguish the pedestrian and non-pedestrian samples and suppress the false positives in the final detection results.The core of the proposed algorithm is to redesign the training proposal generating scheme for the two-stage CNN detection methods,which can avoid a certain number of false ones that mislead its training process.With the help of the proposed algorithm,the detection accuracy of the MetroNext,a smaller and more accurate metro passenger detector,is further improved,which further decreases false ones in its metro passenger detection results.Based on various challenging benchmark datasets,experiment results have demonstrated that the feasibility of the proposed algorithm is effective in improving pedestrian detection accuracy by removing false positives.Compared with the existing state-of-the-art detection networks,PSTNet demonstrates better overall prediction performance in accuracy,total number of parameters,and inference time;thus,it can become a practical solution for hunting pedestrians on various hardware platforms,especially for mobile and edge devices.
基金supported by the Spark Program of Earthquake Science and Technology(No.XH23003C)。
文摘The earthquake early warning system is an effective means of disaster reduction to reduce losses caused by earthquakes,it can release earthquake warning information to the public before destructive seismic waves reach the warning target area,and carry out automatic disposal of lifeline engineering facilities.Through the construction of the National Earthquake Intensity Rapid Reporting and Early Warning Project,an earthquake early warning network consisting of over 1900 monitoring stations has been established in the Beijing-Tianjin-Hebei Urban Agglomeration.The early warning system has achieved second level earthquake warning and minute level intensity rapid reporting.The implementation of these functions relies on the system's ability to timely,accurately,and reliably identify seismic waves.But with the development of social economy,the background noise of earthquake observation environment is becoming increasingly complex,which brings certain challenges to earthquake wave recognition,some interference events have the risk of triggering the earthquake warning system incorrectly.Therefore,this article focuses on seismic wave recognition in complex noise environments and proposes a seismic wave detection method based on triangulation to enhance the antiinterference ability and recognition accuracy of early warning systems.
基金supported by the National Natural Science Foundation of China(Grant Nos.12172017 and 11872083)Project of Beijing Municipal Education Commission(Grant Nos.KZ202210005006 and KZ202110005007).
文摘Intracranial aneurysm(IA)is a prevalent cerebrovascular disease associated with high mortality and disability rates upon rupture.The hemodynamics of IA,which are significantly influenced by geometric parameters,directly impact its rupture.This study focuses on investigating the transient flow characteristics in saccular IA models fabricated using a water droplet-based method,specifically examining the influence of neck widths.Particle image velocimetry technique and numerical simulation were employed to investigate the dynamic evolution of flow structures within three IA models.The results reveal that neck width(W)has a substantial effect on flow characteristics in the neck region,subsequently impacting the deep flow inside the sac.Three distinct patterns were observed during flow evolution inside the sac:for W=2 mm,two vortices occur and then disappear with relatively low average flow velocity;for W=4 mm,enhanced effects of a high-speed jet result in periodic pulsatile flow velocity distribution while maintaining stable vortex core position;for W=6 mm,significant changes in flow velocity occur due to size expansion and intensity increase of vortices.These findings demonstrate that neck widths play a complex role in influencing transient flow characteristics within IAs.Overall,this research contributes to further understanding transient flow behaviors in IAs.
基金Supported by Shenzhen Medical Academy of Research and Translation Program,No.A2302031.
文摘BACKGROUND Aneurysmal subarachnoid hemorrhage(aSAH),a particularly devastating subtype of stroke,is associated with substantial rates of mortality and long-term functional impairment.Despite notable progress in therapeutic strategies,a considerable proportion of aSAH survivors continue to suffer from neuropsychiatric complications,most commonly anxiety and depression,which detrimentally impact their overall quality of life.AIM To investigate the prevalence of anxiety and depressive symptoms in patients with aSAH and to identify associated clinical risk factors.METHODS Clinical records of 1268 consecutive patients diagnosed with aSAH and treated between 2016 and 2022 were retrospectively reviewed.At follow-up,psychological assessments were performed using the Hospital Anxiety and Depression Scale to quantify symptoms of anxiety and depression.To identify independent predictors associated with these psychological outcomes post-aSAH,both univariate and multivariate statistical analyses were employed.RESULTS Among the studied cohort,34.9%of patients presented with anxiety symptoms,while 31.8%demonstrated depressive features.Multivariate analysis identified female sex,presence of multiple aneurysms,a positive family history of cerebral hemorrhage,and receiving surgical clipping as independent predictors of anxiety.In contrast,significant predictors of depression included female sex,multiplicity of aneurysms,posterior circulation aneurysm localization,and poor clinical outcome.Notably,age above 60 years and documented functional recovery were associated with a reduced risk of depression.CONCLUSION Anxiety and depression are common neuropsychiatric sequelae in survivors of aSAH,each associated with a distinct set of risk factors.Early identification and targeted management of these risk profiles may facilitate more effective intervention strategies for psychological comorbidities,ultimately contributing to improved long-term patient outcomes.
文摘Left atrial aneurysm is an exceptionally rare condition,particularly in the pediatric population,and even more so as a sequela of bacterial pericarditis.We present the case of a 16-month-old girl who developed a left atrial aneurysm following isolated Staphylococcus aureus pericarditis.She initially presented in decompensated shock and was later diagnosed with constrictive pericarditis.Despite undergoing pericardiectomy,she subsequently developed a left atrial aneurysm,necessitating surgical closure.This case highlights the aggressive nature of bacterial pericarditis and its potential to cause rare structural cardiac complications.
基金supported by the grant from the Fujian Province Natural Science Foundation(No.2024J01608)。
文摘Background Abdominal aortic aneurysm(AAA)is a life-threatening vascular disease associated with endothelial cell senescence.Resveratrol(RSV),a natural polyphenol,exerts potent anti-senescent and anti-inflammatory effects.However,its molecular mechanism in treating AAA remains unclear.Methods An AAA model was established in mice via angiotensin Ⅱ(AngⅡ)infusion[1000 ng/(kg·min)],with a subset receiving RSV treatment[100 mg/(kg·day)by gavage].Aortic diameter was measured,and histopathological changes were assessed by Hematoxylin-Eosin(HE)and Elastica Van Gieson(EVG)staining.Vascular aging was evaluated by senescence-associatedβ-galactosidase(SA-β-gal)activity and pulse wave velocity(PWV).In vitro,human umbilical vein endothelial cells(HUVECs)were treated with AngⅡ(10-6 M)with or without RSV(40μM)and/or the sirtuin 1(SIRT1)inhibitor EX527(10μM).Senescence markers,senescence-associated secretory phenotype(SASP)factor expression[interleukin-1 beta(IL-1β),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α)],and SIRT1/p21 pathway proteins were analyzed.Results In vivo,RSV significantly attenuated Ang Ⅱ-induced AAA formation,reducing aortic diameter,preserving elastic fiber integrity,and suppressing vascular senescence and stiffness.In HUVECs,Ang Ⅱ-induced senescence and SASP expression were markedly inhibited by RSV.However,these protective effects were abolished by EX527.Mechanistically,RSV reversed the Ang Ⅱ-induced downregulation of SIRT1 and upregulation of p21,which was also blocked by SIRT1 inhibition.Conclusions RSV effectively prevented experimental AAA formation by alleviating vascular aging and endothelial cell senescence.This protective effect was abrogated by the SIRT1 inhibitor EX527,confirming that RSV mitigated AAA development and vascular senescence through the SIRT1/p21 signaling pathway.These findings highlighted RSV as a promising therapeutic candidate for AAA treatment.
文摘Objective:To summarize the nursing experience of a patient with intracranial aneurysm rupture and hemorrhage who developed pulmonary embolism after clipping surgery.Methods:A patient in our hospital,who had intracranial aneurysm rupture and hemorrhage and developed pulmonary embolism after clipping surgery,was selected as the research subject.Through multidisciplinary collaboration,standardized assessment and dynamic condition observation,various risks were identified early.Combined with the patient’s individual characteristics,a personalized nursing plan was formulated.During the treatment process,emphasis was placed on strengthening the patient’s airway management,closely monitoring various indicators,and preventing postoperative complications.Targeted nursing measures were adopted:reasonable airway humidification and effective lung care were used to gradually control the patient’s pulmonary infection;fluid balance management and individualized care were implemented to ensure the patient’s normal circulating blood volume,thereby optimizing cerebral perfusion and cerebral oxygenation.Since the patient had overlapping risk factors for bleeding and thromboembolic events,evidence-based nursing principles were followed for thromboembolism prevention,and anticoagulation strategies and nursing plans were dynamically adjusted to reduce the occurrence of postoperative complications.Results:The patient’s condition improved and was successfully discharged on the 22^(nd) day after surgery,and then transferred to a local rehabilitation hospital for further treatment.At the 1-month follow-up after discharge,the patient recovered well;at the 3-month follow-up after discharge,the patient had recovered and returned home.Conclusion:The results show that standardized assessment and condition observation,multidisciplinary collaboration,and personalized nursing plans can significantly reduce the occurrence of postoperative complications and improve the patient’s prognosis.This nursing experience provides a reference for the nursing of similar patients in the future.
文摘BACKGROUND Aneurysmal bone cysts(ABCs)are usually treated with curettage or various minimally invasive percutaneous procedures.Patient refractory to these treatments,as well as those with locally advanced or unresectable tumors,present a challenge for orthopedic surgeons and require new treatment approaches.Antiresorptive drugs inhibit osteoclastic resorption and increase intralesional osteogenesis.Denosumab induces tumor ossification,but this effect may disappear after drug withdrawal due to limited impact on neoplastic cells.Bisphosphonates(BPs)may induce apoptosis of tumor cells and allow for long-term local control.We hypothesized that after denosumab treatment,BPs would better accumulate in the tumor and exert an irreversible antitumor effect.AIM To test the hypothesis that the sequential use of BPs after denosumab induction improves treatment outcomes in surgically unsalvageable ABCs.METHODS Using data from five electronic databases(Scopus,MEDLINE,EMBASE,PubMed,Web of Science),we aimed to identify all patients who received denosumab therapy(DT)for unresectable ABCs.Among published case reports and case series,we identified patients who discontinued denosumab for various reasons and divided them into two groups:Group 1 included 31 patients without further anti-resorptive therapy and Group 2 included 12 patients who received BPs in the context of rebound hypercalcemia.Local control rates in both groups were analyzed.RESULTS As of December 2024,43 patients have been reported in the literature who received DT for locally advanced/unresectable ABCs.There were 27 males and 16 females with a mean age of 15.8 years.At a median follow-up time of 15.5 months,there were 10 confirmed and two pathologically unconfirmed relapses after denosumab discontinuation.All 10 relapses occurred in patients in Group 1 at a median time of 13.5 months.Among patients in Group 2,with a median follow-up time of 12.5 months after completion of therapy,no local relapses were observed.The difference between local recurrence rates(32%vs 0%)is statistically significant(P value=0.02).Kaplan-Meier estimates show the same trend with marginal statistical significance(P value=0.085).Here we put forward a novel treatment algorithm.CONCLUSION BPs used in post-denosumab ossifying ABCs appear to improve treatment outcomes,presumably by targeting residual tumor cells.Prospective clinical studies are warranted to validate this promising two-stage conceptual strategy in difficult-to-treat ABC.
基金Supported by National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-119.
文摘BACKGROUND Splenic artery aneurysm(SAA)rupture is a rare,life-threatening condition characterized by acute intra-abdominal hemorrhage and hemodynamic instability.Ruptured SAAs may exhibit a biphasic and relatively slow clinical progression,commonly referred to as the“double-rupture phenomenon”.The reported incidence of the double-rupture phenomenon ranges 12%-21%in patients with ruptured SAAs,potentially due to variations in intra-abdominal pressure.Following anesthesia induction,muscle relaxation can decrease intra-abdominal pressure,potentially triggering the double-rupture phenomenon and leading to circulatory collapse.CASE SUMMARY A 61-year-old female presented to the Department of Emergency with upper abdominal pain,abdominal distension,dizziness,and vomiting.Her vital signs were initially stable.Physical examination revealed abdominal tenderness and positive-shifting dullness.Abdominal contrast-enhanced computed tomography revealed cirrhosis,severe portal hypertension,and splenomegaly.Acute rupture was suggested by a hematoma on the upper left side outside the SAA.Surgeons deemed intravascular intervention challenging and open splenectomy inevitable.Circulatory collapse occurred after anesthesia induction,likely due to a double rupture of the SAA.This double-rupture phenomenon may have resulted from an initial rupture of the SAA into the omental bursa,forming a hematoma that exerted a tamponade effect.A second rupture into the peritoneal cavity may have been triggered by decreased intra-abdominal pressure following anesthesia induction.The patient’s life was saved through early,coordinated,multidisciplinary significant postoperative bleeding or hypoxic encephalopathy.CONCLUSION Anesthesia-induced pressure reduction may trigger a second SAA rupture,causing collapse.Early diagnosis and multidisciplinary teamwork improve outcomes.This is a rare and life-threatening case of SAA rupture,which is of great significance to the medical community for understanding and handling such emergencies.
基金Natural Science Foundation of Shaanxi Province,Grant/Award Number:2023-CX-PT-17General Project of Natural Science Research in Luoyang Polytechnic College,Grant/Award Number:2024B01。
文摘The mortality rate of patients with abdominal aortic aneurysm(AAA) after rupture is extremely high,and this disease has become an important disease endangering the health of the Chinese population.Methods used to model AAA include intraluminal pressurized elastase infusion,chronic infusion of angiotensin Ⅱ(Ang Ⅱ) via an osmotic pump,periarterial application of calcium chloride,vascular grafting,and gene modification.AAA models induced by elastase and Ang Ⅱ are the two most widely used animal models.In the elastase-induced model,because intraluminal infusion is transient,with the cessation of initial stimulation,the aneurysm lesion tends to be stable and rarely ruptures.The model induced by Ang Ⅱ infusion often presents with a typical aortic dissection with a false lumen,whereas clinical AAA patients do not necessarily have dissection.Currently,the treatment of AAA in clinical practice remains endovascular,and there is a lack of pharmacological therapy,which is also related to the fact that the pathogenic mechanism has not been fully elucidated.Smoking,old age,male sex,and hypertension are the main risk factors for AAA,but these risk factors have not been fully investigated in the current modeling methods,which may affect the clinical translational application of research results based on animal models.Therefore,this article reviews the most commonly used AAA modeling methods,comments on their applications and limitations,and provides a perspective on the development of novel animal models.
基金supported by National Key Research and Development Plan of China(No.2022YFB3103304).
文摘False Data Injection Attacks(FDIAs)pose a critical security threat to modern power grids,corrupting state estimation and enabling malicious control actions that can lead to severe consequences,including cascading failures,large-scale blackouts,and significant economic losses.While detecting attacks is important,accurately localizing compromised nodes or measurements is even more critical,as it enables timely mitigation,targeted response,and enhanced system resilience beyond what detection alone can offer.Existing research typically models topological features using fixed structures,which can introduce irrelevant information and affect the effectiveness of feature extraction.To address this limitation,this paper proposes an FDIA localization model with adaptive neighborhood selection,which dynamically captures spatial dependencies of the power grid by adjusting node relationships based on data-driven similarities.The improved Transformer is employed to pre-fuse global spatial features of the graph,enriching the feature representation.To improve spatio-temporal correlation extraction for FDIA localization,the proposed model employs dilated causal convolution with a gating mechanism combined with graph convolution to capture and fuse long-range temporal features and adaptive topological features.This fully exploits the temporal dynamics and spatial dependencies inherent in the power grid.Finally,multi-source information is integrated to generate highly robust node embeddings,enhancing FDIA detection and localization.Experiments are conducted on IEEE 14,57,and 118-bus systems,and the results demonstrate that the proposed model substantially improves the accuracy of FDIA localization.Additional experiments are conducted to verify the effectiveness and robustness of the proposed model.
