This Chinese expert consensus summarizes clinical practices, studies, and expert opinions on perioperative nursing for pediatric cardiovascular implantable electronic devices (CIEDs) to standardize care in China. It aims to optimize device function, ensure patient safety, reduce complications such as hemodynamic instability or arrhythmias, and enhance clinical outcomes and quality of life. The consensus covers CIED implantation techniques, medication management, perioperative nursing, complication prevention and management, and post-discharge follow-up to guide clinical practice.

To investigate the efficacy of Acostream thrombus aspiration device combined with catheter-directed thrombolysis in the treatment of acute/subacute lower extremity deep venous thrombosis(DVT).

Patients with acute/subacute lower extremity DVT treated at Nanjing First Hospital from March 2020 to November 2023 were enrolled. According to the treatment plan, they were divided into three groups: CDT alone (Group A, n=48), manual aspiration thrombectomy (MAT) + CDT (Group B, n=27), and AcoStream thrombus aspiration + CDT (Group C, n=27). Thrombus clearance rate, thrombolytic drug dosage, treatment duration, follow-up, and incidence of post-thrombotic syndrome (PTS) were compared and analyzed.

The immediate thrombus clearance rate in Group C (58.9%±12.7%) was higher than in Group B (35.1%±13.1%, P<0.001). At discharge, the thrombus clearance rate in Group C (75.1±15.3%) was higher than in Group B (57.9%±19.2%, P=0.005) and Group A (48.3%±16.6%, P<0.001), with statistically significant differences. The dosage of alteplase in Group C (38.9±18.9 mg) was lower than in Group A (73.1±34.2 mg, P<0.001) and Group B (59.6±30.2 mg, P=0.026). The thrombolytic duration in Group C (3.0±1.5 days) was shorter than in Group A (5.1±2.1 days, P<0.001) and Group B (4.5±2.1 days, P=0.031). The length of hospital stay in Group C (9.8±2.2 days) was shorter than in Group A (11.8±2.6 days, P=0.044) and Group B (11.9±4.7 days, P=0.011). The operation time in Group C (155.6±60.5 min) was longer than in Group A (88.4±34.4 min, P<0.001) and Group B (101.9±34.9 min, P=0.002). The treatment cost in Group C (CNY 81 000±20 000) was higher than in Group A (CNY 57 000±14 000, P<0.001) and Group B (CNY 69 000±23 000, P=0.019). Intraoperative blood loss in Group C (209.3±49.9 mL) was greater than in Group B (153.5±51.1 mL, P<0.001). The incidence of bleeding complications was 20.8% (10/48) in Group A, 11.1% (3/27) in Group B, and 14.8% (4/27) in Group C, with no significant difference among the groups (P=0.531). The average follow-up durations were 5.3±2.5 months, 5.1±2.5 months, and 4.9±2.3 months, respectively, with no significant difference (P=0.818). The incidences of PTS were 17.1% (7/41), 8.7% (2/23), and 12.5% (3/24), respectively, also with no significant difference (P=0.633).

AcoStream thrombus aspiration combined with CDT is safe and effective for the treatment of acute/subacute deep venous thrombosis. It improves thrombus clearance and reduces the dosage of thrombolytic drugs and thrombolysis duration. However, it is associated with longer operation time, greater intraoperative blood loss, and higher treatment costs.

To explore the prevalence and influencing factors of post-contrast acute kidney injury (PC-AKI) in patients with lower extremity arteriosclerosis obliterans (LEASO) after interventional therapy.

A retrospective analysis was conducted on 550 patients with LEASO who underwent interventional therapy at Zhejiang Provincial People's Hospital between January 1, 2023 and December 31, 2024. Patients were categorized into PC-AKI and non-PC-AKI groups based on the occurrence of PC-AKI. Clinical data were collected and compared. The Cochran-Armitage trend test was applied to assess the relationship between PC-AKI incidence and chronic kidney disease (CKD) stage. Multivariate logistic regression analysis was performed to identify independent predictors of PC-AKI.

PC-AKI occurred in 42 patients (7.64%). The incidence of PC-AKI increased significantly with advancing CKD stage (trend P<0.001). Multivariate logistic regression analysis identified heart failure (OR=5.63, 95% CI：1.58~20.00, P=0.008), acute limb ischemia (ALI) (OR=5.53, 95% CI：1.91~16.01, P=0.002), baseline eGFR<60 mL·min^-1·(1.73 m²)^-1 (OR=2.81, 95% CI：1.08~7.32, P=0.035), and a contrast medium volume-to-eGFR ratio (CGR)≥3 (OR=4.03, 95% CI：1.61~10.09, P=0.003) as independent factors associated with PC-AKI.

PC-AKI is a relatively common complication in LEASO patients after interventional therapy, with incidence increasing in parallel with CKD stage progression. Heart failure, ALI, impaired baseline renal function [eGFR< 60 mL/(min·1.73 m²)], and CGR≥3 are independent predictors of PC-AKI in this population.

To assess the effectiveness of traditional chinese medicine in the treament of post-ablation syndrome of hepatocarcinoma with the syndrome of liver stagnation and spleen deficiency, and analyze the changes in peripheral blood T cell subsets.

This multicenter, randomized, double-blind, placebo-controlled trial enrolled 120 patients with primary liver cancer and a diagnosis of liver depression and spleen deficiency. Patients were randomly assigned to either the treatment group or the control group. The treatment group received minimally invasive therapy combined with Chinese medicine granules (major Bupleurum decoction combined with six gentlemen decoction with modifications), while the control group received minimally invasive therapy plus placebo.

Compared with the control group, patients in the treatment group showed significant improvement in the incidence and severity of post-ablation symptoms by day 5 after ablation (P<0.05). The length of hospital stay was also significantly shorter in the treatment group (P=0.001). Furthermore, immune function, reflected by changes in T-cell subsets, improved significantly in the treatment group compared with the control group (P<0.05).

Traditional Chinese medicine aimed at regulating the liver and spleen can effectively alleviate post-ablation syndrome in HCC patients with liver depression and spleen deficiency, enhance recovery of immune function, and shorten hospitalization duration.

To evaluate the clinical efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) combined with portal vein endovascular brachytherapy stent implantation in patients with primary hepatocellular carcinoma (HCC) complicated by type Ⅲ portal vein tumor thrombus (PVTT).

We retrospectively analyzed 30 patients with type Ⅲ PVTT treated at the First Affiliated Hospital of Xinjiang Medical University between January 2021 and December 2024. Patients were assigned to an observation group (HAIC + portal vein endovascular brachytherapy stent, n=15) or a control group (HAIC alone, n=15). Treatment efficacy, liver function parameters, adverse events, progression-free survival (PFS), and overall survival (OS) were compared.

The disease control rate (DCR) was higher in the observation group than in the control group (86.7% [13/15] vs. 66.7% [10/15], P=0.031). Median PFS was significantly prolonged in the observation group (17.6 months, 95% CI: 14.8~20.4) compared with the control group (5.6 months, 95% CI: 4.7~6.5; log-rank P<0.001). Median OS was also longer in the observation group (18.1 months, 95% CI: 15.2~21.0) versus the control group (5.9 months, 95% CI: 5.1~6.9; log-rank P<0.001). Liver function recovery was better in the observation group, with lower post-treatment total bilirubin levels (23.87 ± 9.03 μmol/L vs. 45.94±24.46 μmol/L, P=0.015) and a higher proportion of patients maintaining ALBI grade 2 (93.3% vs. 46.7%, P=0.014). Most adverse events were grade I–II, and the overall incidence was similar between groups (26.7% vs. 20.0%, P=0.648). Cox regression analysis identified treatment group as an independent predictor of OS (HR 0.28, 95% CI: 0.10~0.75, P=0.011).

HAIC combined with portal vein endovascular brachytherapy stent implantation significantly improves disease control, liver function recovery, and survival compared to HAIC alone in PVTT type III HCC patients, with a favorable safety profile.

To evaluate the efficacy and safety of raltitrexed-eluting microspheres for transarterial chemoembolization (TACE) combined with systemic therapy in patients with advanced colorectal cancer with liver metastases.

Fifty patients with newly diagnosed, potentially resectable colorectal cancer with liver metastases were enrolled and randomly assigned to an experimental group (n=25) or a control group (n=25). The experimental group received systemic therapy (chemotherapy plus targeted drugs) combined with TACE using raltitrexed-eluting microspheres (CalliSpheres). The control group received systemic therapy alone (chemotherapy plus targeted drugs). Short-term efficacy, surgical resection conversion rates, and adverse events were compared between groups.

In the experimental group, the complete response (CR) rate was 8%, partial response (PR) rate 60%, stable disease (SD) rate 24%, progressive disease (PD) rate 8%, objective response rate (ORR) 68%, and disease control rate (DCR) 92%. In the control group, the CR rate was 4%, PR 36%, SD 20%, PD 40%, ORR 40%, and DCR 60%. The experimental group had significantly higher ORR and DCR (P<0.05). Surgical resection conversion rates were 40% in the experimental group and 8% in the control group (P<0.05). Adverse events, including elevated transaminases, leukopenia, neutropenia, anemia, thrombocytopenia, hyperbilirubinemia, nausea, vomiting, and elevated creatinine, showed no significant difference between groups (P>0.05). The experimental group had significantly higher 2-year overall survival (OS) and progression-free survival (PFS) at 3, 6, and 12 months compared to the control group (P<0.05).

In patients with advanced colorectal cancer with liver metastases, TACE using raltitrexed-eluting microspheres combined with systemic therapy significantly improves clinical efficacy, surgical resection conversion rates, 2-year OS, and short-term PFS without increasing adverse events compared to systemic therapy alone. This approach warrants broader clinical adoption.

The aim of this study was to evaluate the clinical efficacy and safety of multimodal-transcatheter arterial chemoembolization (M-TACE) in unresectable large hepatocellular carcinoma (HCC).

Seventeen patients with unresectable large hepatocellular carcinoma (HCC) treated with M-TACE at the interventional radiology department of Guangdong Provincial People's Hospital between March 2022 and May 2024 were retrospectively analysed. The number of treatments, tumour response at one-month follow-up, and adverse events of M-TACE were recorded.The observational indexes included objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS).

The number of M-TACE treatments ranged from 1 to 14, with a median number of 6. After one month of follow-up, 13 (76.5%) patients were rated as PR, 2 (11.8%) were rated as SD, 2 (11.8%) were rated as PD, and no patient achieved CR. The ORR was 76.5% and the DCR was 88.2%. Median OS was 28 months and median PFS was 7 months. Mild complications included fever in 8 cases (47.1%), abdominal pain in 11 cases (64.7%), abdominal distension in 4 cases (23.5%), vomiting in 5 cases (29.4%), diarrhoea in 2 cases (11.8%), haemorrhage in 1 case (5.9%), infection in 4 cases (23.5%), and 2 cases of serious complications were observed as liver abscesses (11.8%).

For patients with unresectable large hepatocellular carcinoma, M-TACE demonstrates promising therapeutic efficacy and warrants further investigation.

To identify predictive factors for successful endovascular recanalization in patients with symptomatic non-acute middle cerebral artery occlusion (SNMCAO) and provide a basis for selecting appropriate candidates for this treatment.

Clinical and imaging data of 47 SNMCAO patients who underwent endovascular recanalization at The Seventh Affiliated Hospital of Sun Yat-sen University and Tongji Hospital Affiliated Tongji University between January 2016 and October 2023 were retrospectively analyzed. Baseline characteristics, occlusion segment imaging features, perioperative outcomes, and 3-month follow-up results were collected. Binary Logistic regression analysis was used to determine independent predictors of recanalization success.

Of the 47 patients, 35 (74.5%) were male, with a mean age of 60±11 years. The median occlusion duration was 14.5 days. Univariate analysis revealed significant differences between the success and failure groups in occlusion duration, occlusion segment length, stump morphology, and presence of slow distal antegrade flow (SDAF). Multivariate logistic regression analysis identified occlusion duration ≤ 3 months (OR=35.828, 95% CI: 1.153~1113.800, P=0.041), occlusion segment length < 10 mm (OR=29.814, 95% CI: 1.745~509.480, P=0.019), and presence of SDAF (OR=18.376, 95% CI: 1.213~278.496, P=0.036) as independent predictive factors for successful recanalization.

Occlusion duration of ≤ 3 months, occlusion segment length of < 10 mm, and the presence of SDAF are independent predictors of successful endovascular recanalization in SNMCAO patients. These factors may assist in selecting patients most likely to benefit from this intervention.

To investigate the relationship between serum levels of neuron-specific enolase (NSE), S100 protein, and interleukin-1β (IL-1β) with the severity of brain injury and prognosis in patients after mechanical thrombectomy for cerebral infarction.

A total of 60 patients with acute cerebral infarction who underwent mechanical thrombectomy in the Emergency Department of the First Affiliated Hospital of Dalian Medical University between September 2023 and January 2025 were retrospectively analyzed. Clinical data collected included gender, age, CT imaging results, infarct location, serum levels of S100, NSE, IL-1β, and leukocyte count. Patients were followed up by telephone for 28 days after discharge. Group comparisons were performed using t-tests for normally distributed data and rank-sum tests for non-normally distributed data. One-way ANOVA was used for multi-group comparisons. Logistic regression was applied to identify risk factors for mortality. Receiver operating characteristic (ROC) curve analysis assessed the predictive performance of each biomarker for 28-day mortality. Spearman correlation analysis was used to evaluate associations between biomarker levels and infarct volume.

IL-1β, S100, and NSE levels were significantly higher in the death group compared with the survival group (P<0.05). Univariate logistic regression analysis showed that elevated IL-1β, S100, and NSE were significantly associated with 28-day mortality (P<0.05), with odds ratios greater than 1, indicating they were independent risk factors. ROC curve analysis demonstrated that IL-1β, S100, NSE, and their combination had predictive value for 28-day mortality, with favorable AUC values. Spearman correlation analysis indicated that serum IL-1β, S100, and NSE levels were positively correlated with infarct volume; higher levels corresponded to larger infarct size.

Serum IL-1β, NSE, and S100 are closely associated with short-term prognosis in patients after mechanical thrombectomy for acute cerebral infarction. Elevated levels predict higher 28-day mortality and larger infarct volume, suggesting their utility as biomarkers for early prognostic evaluation.

Cervical spondylosis is a common and frequently occurring disease. With lifestyle changes and poor posture, its incidence is on the rise. Currently, the main minimally invasive treatment methods include radiofrequency ablation, laser ablation, collagenase lysis, and other technologies. Among these, collagenase has demonstrated positive long-term effects. However, ensuring that a sufficient amount of the drug solution reaches the target site remains a clinical challenge. This paper presents a retrospective analysis of six cases using an anterior approach for collagenase injection into the anterior epidural space, directly targeting the protruding surface of the nucleus pulposus. This technique may enhance drug delivery to the lesion and provide a new therapeutic option for the treatment of cervical spondylosis.

The clinical experience of the anterior approach for targeted collagenase injection into cervical discs was retrospectively analyzed in six patients treated at the Department of Minimally Invasive Intervertebral Disc Intervention, Shaanxi Second People's Hospital, from August 2024 to September 2024. The key technical points of the procedure were summarized.

All six patients were successfully discharged after the procedure. No postoperative complications such as nausea, vomiting, headache, or dizziness occurred, and no severe adverse events such as bleeding or inadvertent drug entry into the subarachnoid space were observed.

The anterior approach of collagenase injection into the anterior epidural space appears to be a feasible, safe, and reliable technique for the treatment of cervical spondylosis.

To investigate preoperative anxiety levels and information needs in patients undergoing endovascular treatment for unruptured intracranial aneurysms and to analyze the factors influencing these outcomes.

A total of 190 patients scheduled for endovascular treatment of unruptured intracranial aneurysms at the First Affiliated Hospital of Nanjing Medical University were selected using a convenience sampling method. Data were collected using a self-designed general information questionnaire and the Amsterdam Preoperative Anxiety and Information Scale (APAIS).

The mean preoperative anxiety score was 10.12±2.63, with 31.58% (44/140) of patients scoring ≥12, indicating clinically significant anxiety. The mean information needs score was 6.62±1.52, with 62.63% (88/140) of patients scoring ≥5, reflecting a moderate or higher need for information. A significant positive correlation was found between preoperative anxiety and information needs (P<0.01). Multivariate linear regression analysis identified age, primary caregiver status (i.e., patients responsible for caregiving), and higher information needs as key factors influencing preoperative anxiety. Factors influencing information needs included medical costs, number of children, anesthesia classification, gender, preoperative sleep quality, and prior surgical experienc.

Patients undergoing endovascular treatment for unruptured intracranial aneurysms exhibit high levels of preoperative anxiety and information needs, with a significant positive correlation between the two. Analysis of influencing factors highlights the importance of tailored interventions. Healthcare providers should focus on enhanced information provision and psychological support, particularly for female patients, those with high information needs, poor preoperative sleep quality, and distressing prior surgical experiences, to reduce preoperative anxiety.

To analyze the effectiveness of combining vascular intervention simulation with staged goal teaching in neurointervention education.

Forty interns who rotated through our hospital from September 2024 to December 2024 were randomly divided into two groups (n=20 each). Both groups received vascular intervention simulator training. The control group was taught using conventional methods (multimedia courseware plus simulator practice), while the experiment group received staged goal teaching (progressive objectives and assessments in four stages) integrated with simulator training. After training, under the supervision of senior physicians, participants were evaluated through a neurointervention theory exam and cerebral angiography simulator-based skills assessment. Assessment scores, clinical competencies, and teaching evaluations were compared between groups.

The experiment group achieved significantly higher scores in both theoretical knowledge and practical skills compared with the control group (P<0.05). In addition, the experiment group demonstrated greater improvement in clinical reasoning, surgical decision-making ability, and overall teaching evaluation scores of resident physician competencies (P<0.05).

In neurointervention training, combining vascular intervention simulation with staged goal teaching is more effective than conventional simulation-based teaching alone. This approach enhances theoretical knowledge, procedural skills, clinical decision-making, and teaching evaluation outcomes, demonstrating an overall favorable application effect.

To compare the changes in the ablation zone of porcine lung tissue in vivo between low-power (40 W) and high-power (100 W) microwave ablation (MWA).

Microwave ablation was performed on porcine lungs in vivo. The ablation was divided into two groups based on power: 40 W and 100 W. Ablation times were set at 1 min, 3 min, 5 min, 8 min, and 10 min, with each group repeated three times, for a total of 30 ablations. The maximum long axis, short axis/thickness, volume, and aspect ratio of the ablation zone were recorded, and histological examination of the ablation zone was performed.

When the ablation power was constant, the long axis, short axis/thickness, and volume of the ablation zone increased gradually with time (all P<0.05). For the 40 W group with ablation times ranging from 1 to 10 minutes, the long axis of the ablation zone was 13.6±6.0 mm, the short axis/thickness was 10.4±3.8 mm, and the aspect ratio was 1.3±0.2. For the 100 W group with ablation times ranging from 1 to 10 minutes, the long axis of the ablation zone was 31.1±9.1 mm, the short axis/thickness was 19.9±6.5 mm, and the aspect ratio was 1.6±0.2. In the 40 W group, the increase in long axis, short axis/thickness, and volume of the ablation zone became stable at 8 min and 10 min of ablation, with neither long diameter nor short diameter/thickness exceeding 20 mm, and the aspect ratio remained between 1.3 and 1.4. In contrast, the long axis and short axis/thickness of the ablation zone in the 100 W group continued to increase within the same time frame, with the aspect ratio maintained between 1.4 and 1.5. Histologically, the ablation zone showed a coagulative necrosis zone at the center, surrounded by a zone of pulmonary tissue congestion, edema, and inflammatory cell infiltration, with visible inflammatory cell infiltration.

When the ablation time is the same, high-power (100 W) microwave ablation generates a larger ablation zone compared to low-power (40 W) microwave ablation and is more suitable for the ablation treatment of lesions with a diameter greater than 20 mm. Further investigation into its clinical application is warranted.

Hepatocellular carcinoma (HCC) ranks third in global cancer mortality, with a 5-year survival rate below 20%, making its diagnosis and treatment a global medical priority. Artificial intelligence (AI), particularly machine learning and deep learning, has advanced rapidly in medical applications. AI models integrate medical imaging and clinical data to extract and analyze features from radiological and pathological images, enabling rapid, non-invasive HCC diagnosis. Additionally, AI supports non-invasive pathological assessments and prognostic predictions using pre-treatment clinical data. These technologies aid treatment decisions and optimize therapies, potentially improving patient outcomes.

Stanford type B aortic dissection is a serious, life-threatening cardiovascular emergency, and thoracic endovascular aortic repair is the main treatment method. Effective self-management after surgery is crucial for improving prognosis and quality of life. This article aims to explore the current status and research progress on self-management in patients with type B aortic dissection following interventional therapy. It systematically reviews the harms of inadequate self-management, discusses aspects such as disease awareness, lifestyle, medication adherence, and related factors, and provides a reference for clinical staff in managing these patients after discharge to reduce complications.

On June 29, 2023, Tianjin People's Hospital admitted a female patient with advanced lung adenocarcinoma. The patient had undergone multiple lines of treatment，re-examination of the blood genetic test still indicated EGFR mutation, but targeted therapy was ineffective. The patient underwent another lung biopsy, which confirmed the pathology as small cell lung cancer. She received bronchial arterial infusion chemotherapy combined with molecular targeted therapy (Dacomitinib) and anti-angiogenesis therapy (Anlotinib), achieving partial response (PR) with a progression-free survival (PFS) of 4 months. During the treatment process, timely secondary biopsy indicated pathological transformation, and the combination of arterial infusion chemotherapy and targeted therapy successfully controlled the disease. This case may provide valuable insights for the treatment of transformed small cell lung cancer.

This paper reports the perioperative nursing care for a 9-day-old Neonate weighing 3.22 kg who underwent endovascular embolization for a dural arteriovenous fistula. Through systematic preoperative assessment and preparation, meticulous intraoperative monitoring and coordination, and seamless postoperative handover and transfer, the successful progression of the procedure was ensured. The patient's vital signs remained stable throughout the surgery, and no related complications occurred. This article summarizes key nursing strategies pertaining to temperature management, fluid balance, assistance during embolization, and monitoring of respiratory, circulatory, and cerebral functions. The aim is to provide a reference for nursing care in the interventional management of neonatal dural arteriovenous fistulas.

Persistent left superior vena cava (PLSVC) is one of the most common thoracic venous anatomical anomalies and poses challenges in establishing central venous access. This report describes a patient with advanced breast cancer complicated by type I PLSVC who successfully underwent venous access port implantation via the left subclavian vein under digital subtraction angiography (DSA) guidance. Intraoperative DSA clearly demonstrated the abnormal venous pathway, and electrocardiographic monitoring was combined to accurately position the catheter tip at the middle-to-lower third of the left superior vena cava, resulting in successful port implantation. After a 104-day follow-up period, the venous access port functioned well, and no catheter-related complications were observed. These findings indicate that DSA guidance allows real-time identification of venous anatomical variations and precise evaluation of catheter position, thereby improving the safety and success rate of venous access port implantation in patients with PLSVC and providing a reliable method for establishing long-term venous access in such patients.