To explore the effect and safety of no indwelling catheter after interventional therapy in patients with intracranial aneurysms.

A total of 173 patients with intracranial aneurysms hospitalized in our department from June 2022 to April 2023 were included. They were divided into two groups by natural grouping method, including 87 cases in the medical group A as the experimental group and 86 cases in the medical group B as the control group. The experimental group did not retain a catheter during the operation, while the control group retained a catheter during the operation and pulled it out in the next morning after the operation, according to the doctor's advice. The primary outcome was the incidence of postoperative urinary retention. The secondary outcomes were the incidence of urinary tract irritation, urinary tract infection, urethral injury, indwelling rate of catheter in the ward, unplanned extubation, postoperative agitation, aneurysm rupture, and hematoma/hemorrhage at puncture site. The Chi-square test was used to compare the differences in the above indexes between the two groups. Relative ratio (RR) was used to calculate the incidence ratio of the two groups.

Compared with the control group, the incidence of postoperative urinary retention in the experimental group decreased (5.62% vs 18.39%, χ²=6.830, P=0.009), which was only 0.309 times lower than that in the control group (RR=0.309, 95.0%CI: 1.241-8.446, P=0.016), and the incidence of urinary tract irritation in the experimental group was lower than that in the control group (0 vs 13.79%, χ²=14.829, P<0.001), which was 0.040 times lower than that in the control group (RR=0.040, 95%CI: 0.002-0.658, P=0.024). There was no significant difference in other complications and adverse events.

No indwelling catheter during operation can reduce the incidence of postoperative urinary retention and urinary tract irritation in patients with intracranial aneurysms undergoing interventional embolization, and does not increase the incidence of postoperative aneurysm rupture bleeding and hematoma/hemorrhage at the puncture site . It is safe, feasible, and worth promoting.

To investigate the influencing factors of pulmonary infection after hemorrhagic stroke.

A retrospective analysis was conducted on 144 patients with hemorrhagic stroke treated with craniotomy at the Neurosurgery Department of Zhongshan Hospital Affiliated to Xiamen University from June 2021 to March 2023. They were divided into the infected group and the non-infected group according to the diagnostic criteria for pulmonary infection. The infected group had 24 cases (16.67%) and the non-infected group had 120 cases (83.33%). The difference in general clinical data (age, gender, disease type, operation method, smoking history, GCS score, hypertension history, diabetes history, gastric tube retention, urinary tube retention, postoperative mechanical ventilation, NRS2002 score, general anesthesia, bed time) between the two groups was compared by χ² test, and the independent risk factors of postoperative pulmonary infection in patients with hemorrhagic stroke was analyzed by Logistic regression.

The univariate analyse showed that age (≥60 years old/<60 years old: 19/5 vs 6/114), hypertension (75.0% vs 51.7%), GCS score (≥9 points/<9 points: 15/9 vs 98/22), diabetes (54.2% vs 14.2%), indwelling gastric tube (83.3%% vs 10.8%), postoperative mechanical ventilation (62.5% vs 8.3%), NRS 2002 score ≥3 points (91.7% vs 8.3%) and bed rest time (≥3 weeks/<3 weeks: 14/10 vs 20/100) between the two groups showed statistically significant differences (χ²=71.598, 4.410, 4.349, 19.402, 55.477, 40.901, 11.118, 19.251; P<0.001, =0.036, =0.037, <0.001, <0.001, <0.001, =0.001, <0.001); Logistic regression analysis showed that age ≥ 60 years old (OR=1.394, 95%CI: 1.036-2.002, P<0.001), diabetes (OR=1.358, 95%CI: 1.008-1.692, P=0.004), postoperative mechanical ventilation (OR=1.485, 95%CI: 1.183-2.189, P<0.001), and indwelling gastric tube (OR=1.236, 95%CI: 0.993-1.838, P<0.001) were all independent influencing factors of postoperative pulmonary infection.

Patients with age ≥60 years, hypertension, GCS score<9 points, diabetes, postoperative mechanical ventilation, indwelling gastric tube, NRS2002 score ≥3 points, and bed rest time ≥3 weeks are prone to postoperative pulmonary infection after hemorrhagic stroke. In particular, attention should be paid to age, diabetes, postoperative mechanical ventilation, indwelling gastric tube.

To explore the clinical effect of microsurgical clipping via supraorbital keyhole approach of non-dominant feeder for ruptured anterior communicating artery aneurysms.

The clinical data of 69 patients with ruptured anterior communicating artery aneurysm who underwent microsurgery with supprorbital keyhole approach in the Second Affiliated Hospital of Soochow University from January 2016 to October 2020 were retrospectively analyzed. Among them, 32 patients underwent non-dominant feeder approach and 37 patients underwent dominant feeder approach. The operation duration, the rate of intraoperative aneurysm rupture, the number of intraoperative aneurysm clips, the resection rate of frontal gyrus, the rate of incomplete aneurysm clipping, the variation and torsion rates of anterior communicating artery aneurysm complex, and the good prognosis rate were compared between the two groups.

The operative time of the non-dominant feeder approach group and the dominant feeder approach group was (190±61) min and (204±55) min, respectively. Intraoperative aneurysm rupture occurred in 9 cases (24.3%) and 4 cases (12.5%) in the two groups, respectively. The number of intraoperative aneurysm clips were (1.38±0.61) and (1.35±0.63), the resection rate of frontal gyrus were 37.5% (12/32) and 48.6% (18/37), the rate of aneurysm occlusion was 3.1% (1/32) and 2.7% (1/37), and the variation and torsion rates of anterior communicating artery aneurysm complex were 16 cases (50.0%) and 14 cases (37.8%), respectively. The good prognosis rate of the two groups at discharge were 25 (78.1%) and 28 (75.7%), respectively, and the good prognosis rate at 1 month, 3 months, 6 months and 12 months after discharge were 25 (78.1%) and 27 (73.0%), respectively, with no statistical significance (all P>0.05).

Microsurgery through the supraorbital keyhole approach on the non-dominant feeder is safe and effective for the treatment of ruptured anterior communicating artery aneurysm.

To analyze the risk factors for 30-day mortality in patients with severe spontaneous intracerebral hemorrhage (SICH) and establish a risk prediction model.

Clinical data of severe SICH patients were extracted from the Medical Information Mart for Intensive Care-Ⅳ (MIMIC-Ⅳ). Lasso regression was used to screen potential risk factors for 30-day mortality. Logistic regression was used to construct a risk prediction model for 30-day mortality in patients with severe SICH, and the plot of the model was drawn. The prediction ability and clinical applicability of the model were evaluated by counting C-index, plotting the calibration curve of the model, and clinical decision curve.

There were significant differences between the death group and the non-death group in underlying diseases, vital signs, and test indicators. The C-index of the established model was 0.906, and after resampling, it was 0.867. The calibration curve of the model was consistent with the actual curve. In addition, the decision curve analysis showed that using this plot model could achieve positive clinical net benefits for patients.

The risk prediction model for 30-day mortality in patients with severe SICH on Logistic regression has good clinical applicability.

To investigate the application effects of pelvic floor myoelectric stimulation combined with biofeedback therapy on female post-stroke urinary incontinence patients.

A total of 71 female post-stroke urinary incontinence patients admitted to the Second Affiliated Hospital of Xinjiang Medical University from July 2021 to July 2022 were included. They were divided into the experimental group (35 cases) and the control group (36 cases) using a random number table. The control group underwent conventional treatment, while the experimental group received pelvic floor myoelectric stimulation combined with biofeedback therapy plus the conventional treatment. After undergoing the two different treatment methods, the surface electromyography values of pelvic floor muscles (baseline during quiet rest, maximum value during fast contraction, average value during endurance contraction), scores on the International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF), and General Self-Efficacy Scale (GSES) were compared between the two groups. For normally distributed data, t-tests were used; for non-normally distributed data, the Mann-Whitney U test was employed.

Compared with the control group, the experimental group had a lower pre-baseline mean value of surface electromyography of the pelvic floor muscles during the pre-resting phase [(5.22±2.76) μV vs (6.27±2.75) μV], a higher mean endurance contraction value during the slow twitch endurance contraction phase [(19.84±6.22) μV vs (14.90±5.00) μV], the differences were statistically significant (t=-3.124, 3.694, P=0.003, <0.001); however the maximum muscle contraction in the experimental group was significantly higher than that in the control group during the rapid contraction phase [(53.81±17.49) μV vs (45.16±17.70) μV], the difference was statistically significant (t=2.071, P=0.042). The GSES score in the experimental group was higher than that of the control group [23.00 (20.00,27.00) vs 17.00 (15.00, 21.00)], and the ICI-Q-SF assessment score in the experimental group was lower than that of the control group [8.00 (5.00,9.00) vs 9.00 (6.25, 11.00)], the differences were statistically significant (Z=-3.959, -1.974, P＜0.001, =0.048).

Pelvic floor myoelectric stimulation combined with biofeedback therapy can effectively alleviate the symptoms of urinary incontinence in female post-stroke patients.

To explore the value of acupuncture combined with repetitive transcranial magnetic stimulation (rTMS) in improving unilateral spatial neglect (USN) in stroke patients.

A prospective study was conducted on 90 post-stroke USN patients who visited the Rehabilitation Medicine Department and the Neurology Department of Chengdu Jinniu District People's Hospital from March 2022 to December 2022. They were randomly divided into three groups, with 30 patients in each group. Group A received rTMS treatment; Group B received acupuncture treatment; and Group C (the combined group) received rTMS plus acupuncture treatment; All three groups were treated continuously for 8 weeks. The differences of USN severity scores (clock drawing test, digital deletion test, line segment elimination test), Fugl-Meyer Assessment (FMA) scale, ability of daily living (ADL) score, simple mental state examination scale (MMSE) score, and hemorheology (whole blood viscosity, plasma viscosity, fibrinogen) of patients in the three groups were compared before and after treatment.

(1) After treatment, the scores of the three groups of clock drawing test, digital deletion test, and line segment elimination test were lower than those before treatment; the scores of the three items in the combined group were lower than those in Group A and Group B, and the scores of the three items in Group A were higher than those in Group B; the differences were statistically significant (P<0.05); (2) After treatment, the scores of FMA, ADL and MMSE in the three groups were improved compared with those before treatment, and the differences between the three groups were statistically significant. The scores of the three items in the combined group were higher than those in Group A and B, and the scores of the three items in Group A were higher than those in Group B; the differences were statistically significant (P<0.05); (3) After treatment, the whole blood viscosity, plasma viscosity, and fibrinogen raw water in the three groups were lower than those before treatment on average. The three levels in the combined group were lower than those in group A and B, and the plasma viscosity level in group A was lower than that in group B; the differences between the three groups were statistically significant (P<0.05).

Acupuncture combined with rTMS has an ideal effect on improving the USN of stroke patients, can significantly enhance the limb function, daily living ability, and mental state of patients, and regulate hemorheology.

To summarize the high-resolution magnetic resonance imaging (HR-MRI) features of stroke patients caused by cervical artery dissection (CAD).

Clinical and imaging data were collected from 6 patients admitted to Beijing Chao-Yang Hospital, Capital Medical University due to acute ischemic stroke caused by cervical artery dissection from December 2017 to June 2021. All patients were confirmed by HR-MRI and followed up with HR-MRI.

The patients were aged from 29 to 45 years, all males and acute onset, with obvious inducement in three among them. The clinical manifestations were dizziness in 4 cases, speech impairment in 3 cases, limb weakness in 2 cases, blurred vision, limb numbness, dysphagia, and neck pain in 1 case each. Imaging examination showed internal carotid artery dissection in 3 cases, with lesions located in the middle cerebral artery area, and vertebral artery dissection in another 3 cases, with lesions located in the cerebellum and thalamus. HR-MRI examination showed intramural high signal hematoma in all 6 cases, with 3 cases showed intimal flap or double lumen. Follow up HR-MRI showed complete absorption of the hematoma in 4 cases, organized in 1 case, and no absorption in 1 case. After treatment, all 6 patients had a good prognosis.

HR-MRI can visually display intramural hematoma and the visual signs of dissection. HR-MRI can be used for the diagnosis and follow-up of cervical arterial dissection.

To analyze the factors influencing middle-aged and young stroke patients' return to work and build a prediction model.

A total of 323 middle-aged and young stroke patients admitted to Hainan Cancer Hospital from May 2018 to April 2020 were included. The survey tools were the general questionnaire, the readiness for return-to-work scale (RRTW), and the general self-efficacy scale (GSES). A questionnaire survey was used to investigate the readiness of 323 middle-aged and young stroke patients, return to work. Lasso and Logistic regression were used to analyze the influencing factors of stroke in middle-aged and young patients, and a nomograph prediction model was constructed to verify its predictability and accuracy.

The average score of the intention dimension before the RRTW scale was (2.68±0.83) points; the average score of the intention dimension was (3.07±0.92) points; the average score of the action preparation self-assessment dimension was (2.62±0.78) points; and the action preparation behavior dimension was (2.57±0.72) points; the average score of the GSES scale was (13.25±3.54) points. Fifty-seven middle-aged and young stroke patients had high readiness to return to work, while 266 middle-aged and young stroke patients had low readiness to return to work; education level, adverse emotions, dysfunction, family monthly income per capita, family support, social support, and professional rehabilitation guidance training were the influencing factors for middle-aged and young stroke patients to return to work (P＜0.05); the C-index of the nomograph model for middle-aged and young stroke patients returning to work was 0.837 (95% CI: 0.810-0.865), and the predicted value was consistent with the measured value. The internal validation ROC curve showed an AUC of 0.808, and the decision curve showed a high net benefit value when the threshold probability was within the range of 1% to 88%.

Middle-aged and young stroke patients have low readiness to return to work, and education level, adverse emotions, dysfunction, family per capita monthly income, family support, social support, and professional rehabilitation guidance training are the influencing factors that affect the return to work of middle-aged and young stroke patients. Building a line graph model based on the influencing factors has a good predictive effect on patients' return to work intention .

To investigate the effect of neuronavigation combined with 3D reconstruction-guided neuroendoscopic hematoma removal on hypertensive intracerebral hemorrhage (HICH).

110 patients with hypertensive cerebral hemorrhage admitted to Gucheng County Hospital from January 2016 to January 2019 were included. According to different treatment methods, they were divided into the control group (general endoscopic treatment group, n=58) and the observation group (neuronavigation combined with 3D reconstruction technology-guided neuroendoscopic treatment group, n=52). The differences in therapeutic effect, postoperative complications, and prognosis between the two groups were compared.

The operative duration and the amount of bleeding in the observation group were significantly less than those in the control group, and the hematoma clearance rate in the observation group was higher than that in the control group, with significant differences [(1.97±0.21) h vs (2.13±0.32) h，t=3.130, P=0.002; (152.69±20.67) ml vs (165.48±23.28) ml，t=3.032, P=0.003; (89.75±3.86)% vs (70.35±7.06)%, t=17.592, P＜0.001]. The rates of gastrointestinal bleeding and the intracranial rebleeding in the observation group were significantly lower than those in the control group (5.77% vs 20.69%, χ²=3.993, P=0.046; 3.85% vs 20.69%, χ²=5.568, P=0.018). There was no statistically significant difference in mRS grading between the two groups (P＞0.05).

Neuronavigation combined with 3D reconstruction technology can significantly improve the cure rate of HICH patients and reduce complications.

To review the literature on the benefit finding of stroke caregivers in order to provide references for future studies.

Focusing on the benefit finding of stroke caregivers, the Chinese and English databases and grey databases were systematically searched using the scoping review method as the framework. The search time was from the establishment of the database to January 17, 2024. The included literatures were summarized, including extract benefit finding level, perception of benefit finding, assessment tools, influencing factors, intervention measures and so on.

A total of 22 literatures were included, and the results showed that the overall level of stroke caregivers' benefit finding was at the intermediate level. The perception of benefit finding mainly included five aspects: the improvement of personal ability, the change of mentality and behavior, the promotion of family relationships, the formation of new life belief, and the sublimation of self-value. There were two kinds of assessment tools: benefit finding scale and caregiver benefit finding questionnaire. The main influencing factors were demographic factors, disease factors, and other relevant factors, including social support. The primary interventions included mindfulness-based cognitive therapy, information-motivation-behavioral skill model intervention, focused problem-solving model intervention, and positive self-disclosure intervention.

Stroke caregivers need to be widely concerned by relevant personnel. Appropriate assessment tools should be selected to conduct in-depth discussions on the status quo, influencing factors and benefit experience of caregivers of stroke patients. Mature intervention programs for benefit finding at home and abroad should be referred to. To develop personalized intervention measures suitable for Chinese stroke caregivers in order to comprehensively understand the benefit finding of stroke caregivers and effectively improve the level of benefit finding of caregivers.

To construct a self-management intervention scheme for unruptured intracranial aneurysm interventional therapy, and provide references for clinical self-management intervention support.

According to the evidence-based method, the literature was systematically searched, and the best evidence was extracted and integrated. The first draft of a self-management intervention plan for patients with unruptured intracranial aneurysm was prepared with the guidance of the empowerment theory framework. Delphi method was used to conduct two rounds of expert correspondence consultation. The authority coefficient of experts and the degree of coordination of expert opinions (Kendall's W values and coefficient of variation) were evaluated, and the content of the program was revised after discussion by the research group.

Following a literature review, this study comprised 13 papers. The two rounds of expert letter consultation involved 15 experts totally, and the recovery rates were 100% (15/15) and 93.75% (15/16), respectively. Within the two expert rounds, the authority coefficients were 0.92 and 0.94, and the corresponding Kendall's W values were 0.30 and 0.23 (P<0.001). Besides, the coefficient of variation of each item was less than 0.25. After two rounds of expert consultation, the final draft of the intervention scheme was formed, including 5 first-level items, 15 second-level items, and 42 third-level items.

The self-management intervention program for unruptured intracranial aneurysm interventional therapy has good scientific, applicability, and feasibility, and can provide intervention guidance for patients' self-management practice.

To evaluate the application effect of the improved Peyton's teaching method in teaching clinical operation skills in Neurology Department.

A total of 54 clinical medical students of the eight-year program who participated in clinical practice in the Department of Neurology of Peking University Third Hospital were randomly divided into the experimental group (27 students) and the control group (27 students). The improved Peyton's teaching method, which adopted the standardized teaching process and role exchange model, and the traditional bedside teaching method were used to teach the physical examination of the nervous system, respectively. The physical examination scores and the results of a questionnaire of the two groups were compared with t-test and non-parametric test, respectively.

The physical examination scores of the experimental and control groups were 18.6±0.7 and 18.7±0.7, respectively. No significant differences were found between the two groups (t=0.707, P=0.483). The survey by questionnaire showed that most students in the experimental group gave a positive evaluation of the improved Peyton's teaching method, and 63.0% of students believed that it was necessary to apply the enhanced Peyton's teaching method in clinical operational skills teaching.

The teaching effect of the improved Peyton's teaching method is similar to that of the traditional teaching method, which is suitable for teaching operational skills in Neurology Department.