The clinical data of 42 consecutive patients with extracranial carotid artery aneurysms (ECAA) who underwent surgical treatment in the Department of Vascular Surgery, the Second Affiliated Hospital of Nanchang University, from January 2012 to December 2024 were retrospectively collected. Based on the Attigah classification of aneurysms, while evaluating anatomical characteristics such as bifurcation involvement, proximal and distal landing zone conditions, and parent artery tortuosity, combined with etiological risks including infection, inflammation, or trauma, individualized treatment plans were formulated. Ultimately, 36 patients underwent endovascular treatment and 6 cases underwent open surgical treatment. In the perioperative period, immediate postoperative digital subtraction angiography (DSA) or postoperative computed tomography angiography (CTA) was used to evaluate aneurysm exclusion and parent-artery patency. The patients were aged (53.3±7.3) years, including 17 females and 25 males. Among them, there were 20 true aneurysms, 19 pseudoaneurysms, and 3 dissecting aneurysms. The surgical technical success rate was 97.6% (41/42). During the perioperative period, 1 (2.2%) patient developed cranial nerve injury after open surgery. The postoperative follow-up time was (18.5±4.6) months, no deaths occurred, and 2 (4.8%) patients developed in-stent restenosis at 6 months postoperatively. Treatment of ECAA should be individualized according to etiology and anatomic characteristics, and endovascular therapy represents a relatively straightforward, safe, and effective option for ECAA.

Objective: To investigate the impact of adding an early proactive telephone follow-up (2-4 weeks post-ablation) to routine follow-up on perioperative medication adherence, incidence of clinical outcome events, and re-consultation in patients with atrial fibrillation undergoing catheter ablation. Methods: This study employed a prospective cohort design. The intervention group included 554 patients who underwent catheter ablation for atrial fibrillation at our hospital in January 2025, receiving an additional telephone follow-up within 2-4 weeks post-ablation. The control group included 910 patients who underwent catheter ablation at our hospital in February 2025, receiving only routine first outpatient follow-up at 3 months post-ablation. The telephone follow-up content included verifying comprehension of medical orders, guiding medication administration, answering questions, assessing postoperative recovery, identifying abnormal symptoms, providing medical advice, and offering psychological support. The primary outcome measure was medication adherence at 3 months post-ablation. Secondary outcome measures included the incidence of thromboembolic events, bleeding events, and re-consultation within 3 months post-ablation. All data were statistically analyzed using SPSS 26.0; P-values<0.05 indicated statistical significance. Results: Baseline characteristics were comparable between the two groups (all P-values>0.05). Regarding medication adherence at 3 months post-ablation, the proportion of patients regularly taking anticoagulants in the intervention group (56.50%) was significantly higher than that in the control group (44.07%) (χ²=21.30, P<0.001); the proportion of patients who self-discontinued medication in the intervention group (27.26%) was significantly lower than that in the control group (41.87%) (χ²=31.78, P<0.001). For the incidence of thromboembolic and bleeding events, no statistically significant differences were observed between the two groups (all P-values>0.05). Specifically, the incidence of thromboembolic events was 1.08% (n=6) in the intervention group and 1.65% (n=15) in the control group (χ²=0.77, P=0.379); the incidence of bleeding events was 0.18% (n=1) and 0.22% (n=2), respectively (χ²=0.19, P=0.664). The overall incidence of any thromboembolic or bleeding event was 1.26% (n=7) and 1.76% (n=16), respectively, and this difference was not statistically significant (χ²=0.54, P=0.460). Regarding re-consultation, the incidence of outpatient visits due to cardiovascular disease was significantly lower in the intervention group (2.53%, n=14) than in the control group (6.81%, n=62) (χ²=12.84, P<0.001). No statistically significant differences were observed between the two groups for emergency visits due to cardiovascular disease (χ²<0.01,P=0.975), hospitalization due to cardiovascular disease (χ²<0.01,P=0.985), or re-consultation/hospitalization for any reason (χ²=0.95, P=0.329). Conclusion: Early proactive telephone follow-up can significantly improve perioperative medication adherence in patients with atrial fibrillation undergoing catheter ablation and effectively reduce postoperative outpatient visits. This simple and feasible intervention has positive clinical application value for improving short-term patient outcomes and optimizing medical resource allocation.

Objective: To analyze the diagnostic and therapeutic characteristics of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) with predominantly nasal symptoms. Methods: Clinical data of 10 patients (4 males and 6 females, aged 24-73 years) with AAV with predominantly nasal symptoms who were treated in the Second Hospital of Shanxi Medical University from January 2019 to January 2025 were collected and retrospectively analyzed with regard to clinical manifestations, endoscopy, imaging, laboratory examination, pathohistology, treatment and prognosis of the patients. Descriptive statistical methods were used for analysis. Results: Nasal symptoms such as nasal congestion, pus and dry crusts and pulmonary manifestations such as cough and pulmonary nodules were present in all 10 patients; most of them were accompanied by multifocal involvement of the head and neck (9/10) and systemic inflammatory prodromal manifestations such as intermittent fever and polyarticular pain (9/10). Nasal endoscopy showed congestion, erosion, and increased secretion of the nasal mucosa, and in severe cases, perforation of the nasal septum was seen (3/10). Sinus CT showed thickening of nasal and sinus mucosa, bone hyperplasia, and even progressive bone destruction and paranasal sinus granuloma formation (2/10). Laboratory tests showed ANCA positivity in 9 cases and negativity in 1. Six patients were treated with nasal surgery and 5 had postoperative outbreaks. Ten patients were treated with systemic glucocorticoid combined with immunosuppressant or monoclonal antibody after diagnosis, and all of them went into remission. During follow-up, 6 cases relapsed and all 10 cases survived. Conclusions: For patients with refractory nasal symptoms and inflammatory precursor manifestations (combined with other extra-nasal systems), who have poor responses to conventional treatment, AAV should be considered. Early ANCA testing, histopathological examination and multidisciplinary team combined diagnosis and treatment should be performed to improve patient prognosis.

As populations age and hypertension prevalence rises, the burden of hypertension-attributable chronic kidney disease (CKD) keeps aggregating and varies across regions. A systematic assessment of how disease burden and care quality change over time becomes a prerequisite for sound prevention and control policies.

To describe temporal changes and geographical distributions of hypertension-attributable CKD's burden and quality of care across countries, regions, and globally from 1990 to 2021.

Data were obtained from the Global Burden of Disease Study 2021. Temporal trends in disease burden and Quality of Care Index (QCI) were analyzed using the estimated annual percentage change (EAPC). Spearman correlation analysis and cross-national inequality analysis were conducted to explore QCI health inequality related to the Socio-demographic Index (SDI).

From 1990 to 2021, global age-standardized incidence and mortality rates of hypertension-attributable CKD increased by 22.30% and 29.21%, respectively. Age-standardized disability-adjusted life-years rate (ASDR) reached 128.41 per 100,000, up 19.15% over 31 years, whereas the QCI declined. Men had higher ASDR and QCI than women. SDI was negatively correlated with ASDR and positively correlated with QCI. Global health inequalities persisted: low-SDI regions (e.g., sub-Saharan Africa) faced heavier burdens and poorer care quality, whereas high-SDI regions such as Eastern Europe and High-income Asia Pacific displayed lower ASDR and higher QCI, indicating better disease management.

Global burden of hypertension-attributable CKD continues to rise while care quality declines, with low-SDI countries facing the greatest challenges. Enhanced hypertension prevention, improved CKD management, equitable resource allocation, and global health equity initiatives, with a focus on improving global quality of care, are needed.

To explore the feasibility of a novel multimodal executive function intervention in school-aged children with complex congenital heart disease (cCHD).

Single-centre, single-blinded, randomised-controlled 8-week multimodal personalised executive function intervention (E-Fit) study. Outcomes were measured throughout the intervention, post-intervention (T1) and at 4-month follow-up (T2).

Tertiary care centre between May 2022 and May 2024.

Children 10 to 12 years (M=11.0, SD=0.9) with cCHD without a genetic diagnosis with infant open-heart surgery and reported difficulties (T-scores ≥60) on any of the summary scales of the parent- or teacher-reported Behavior Rating Inventory for Executive Function (BRIEF).

Children with cCHD were randomly assigned to one of two groups: the intervention or the control group. The 8-week intervention was multimodal including three modalities: (1) computerised executive function (EF) training 3×20 min/week with CogniFit; (2) a weekly, remote standardised 1:1 individual EF strategy coaching; (3) analogue games played at convenience. The control group completed activity logs.

Acceptability: Acceptance and Feasibility Scale (AFS) and coach-rated engagement during coaching sessions. Demand: Number of completed computerised training, strategy coaching and analogue game sessions.

E-Fit Fidelity Measurement System, assessing adherence to core components. Practicality: Retention rate. Integration: AFS integration items. Exploratory efficacy: BRIEF, neuropsychological EF testing and psychosocial variables at baseline, post-intervention (8 weeks) and at 4-month follow-up.

We recruited 42 participants (N_female=20). Acceptability: The intervention was acceptable, with moderate observed engagement. Demand: median number of computerised training sessions completed was 16 of 24 sessions (67%, (IQR; 6 to 19)), all children attended all scheduled coaching sessions, analogue games were played in total a median of 9 times (IQR 4 to 14).

Coaching sessions could be implemented by the coaches as intended. Practicality: Overall retention rate was 90%. Integration: E-Fit was well integrable into the home setting. Exploratory efficacy favoured the intervention group with improvements in the parent-rated Behavioral Regulation Index of the BRIEF (adjusted Hedge's (g_A1) = -0.408 to -0.903) and in social responsiveness (g_A1 = -0.427 to -0.521) at T1 and at T2.

E-Fit is a feasible intervention suggesting EF and social responsiveness improvements in children with cCHD. Motivational strategies to improve adherence to computerised training should be refined before a full-scale efficacy trial.

NCT05198583.

To identify whether patients with arrhythmia, heart failure or ischaemic heart disease presenting with anxiety symptoms measured by the Hospital Anxiety and Depression Scale (HADS) have identifiable anxiety according to the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) and, if so, which type of anxiety disorder based on the SCID.

Initial screening data from the Heart and Mind randomised clinical trial.

Patients with arrhythmia, heart failure or ischaemic heart disease were screened using HADS, and patients with a HADS-anxiety (HADS-A) score≥8 were invited to participate. Participants were interviewed by trained cardiac nurses using the SCID to determine whether they met the criteria for anxiety and, if so, the type of anxiety disorder.

Of the 7816 patients who completed the HADS questionnaire, 1803 (23%) had a HADS-A score≥8. Among these, 398 (22%) agreed to the SCID interview, and 336 (84%) met the diagnostic criteria for an anxiety disorder. The mean age was 61 years, with 40% being female. The mean HADS-A score was 11.3 (SD=2.7). The most common types of anxiety were generalised anxiety disorder (61%), panic disorder (23%) and specific phobia (8%).

The majority of individuals identified by the instrument also met the diagnostic criteria for an anxiety disorder. Generalised anxiety disorder and panic disorder were the most prevalent subtypes. Anxiety was common across the cardiac population, underscoring the need for routine assessment and targeted intervention in clinical practice.

NCT04582734.

To review the literature reporting patient preferences for ambulatory heart rhythm monitoring (AHRM) and what factors affect experience and engagement.

The prevalence of arrhythmia continues to rise and contributes significantly to outpatient care burden. There is limited understanding of patient experience and compliance with monitoring. As innovative technologies are developed and healthcare strategies move towards surveillance and prevention, understanding this is key.

A scoping review was conducted using guidance from the Joanna Briggs Institute and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The review included studies of adults under investigation or surveillance for arrhythmia with a range of devices (Holter monitor, patch device, event recorder, mobile cardiac telemetry, external and implantable loop recorders, wearables and other implantable cardiac devices) in ambulatory care settings worldwide. The final search was conducted on 3 January 2026 across Medline (PubMed), Embase (Ovid), Web of Science (Clarivate Analytics), Cumulative Index to Nursing and Allied Health Literature (EBSCOhost), PsycINFO (Ovid) and Google Scholar. Quantitative, qualitative, mixed methods, multiple methods and any type of review articles were included.

54 studies were eligible for inclusion from the initial search that identified 1320 articles. Two overarching themes emerged from the quantitative and qualitative data: patient factors and device factors affecting experience and engagement. Patient factors included clinical and demographic factors, education and expectations, experience and preferences and impact on daily life and healthcare. Device factors could be common to several devices, for example, skin irritation or device specific, for example, the nature of activation.

Patient and device factors influence preferences for and experience and engagement with AHRM. While existing literature is incomplete and heterogeneous, it identifies key considerations that should be integrated into the development and testing of novel approaches for arrhythmia surveillance in healthcare contexts.

https://doi.org/10.17605/OSF.IO/6K3W8 (Open Science Framework).

To enhance venous thromboembolism (VTE) prevention and management in county-level hospitals, we developed a VTE quality control platform leveraging clinical databases and Clinician Workstations. The platform is characterised by simplified construction, cost-effectiveness and a user-friendly interface enabling precise real-time monitoring of VTE prevention measures in hospitalised patients. Comparative analysis of pre-implementation and post implementation data revealed significant improvements in key metrics: VTE bleeding risk assessment rate (1.33% vs 7.43%, p<0.001), basic prevention compliance (20.87% vs 50.38%, p<0.001), mechanical prevention utilisation (24.60% vs 27.37%, p=0.002) and appropriate prevention rate (11.67% vs 53.11%, p<0.001). The platform effectively optimised VTE prevention practices, demonstrating ease of deployment, affordability and operational efficiency-making it a scalable and practical solution for county-level hospitals in China.