Rethinking the diagnosis and treatment of renal anastomotic hemangioma after partial nephrectomy

Renal anastomotic hemangioma(AH)is a rare,benign vascular tumor with unique histopathological features,a disease that is clinically rare,and existing clinical cases offer different treatment options.As reported in the text,this is a very unusual case of renal AH with AH secondary to residual renal tissue after renal clear cell carcinoma,describing a rare renal AH and a history of renal clear cell carcinoma,including ultrasound,computed tomography and magnetic re-sonance imaging.However,the available imaging data and the literature do not provide an effective basis for the diagnosis of the disease,raising the lack of un-derstanding and misdiagnosis,where the patient eventually underwent neph-rectomy,but the author is not the most appropriate surgical treatment.The po-stoperative pathological results of the patient are benign lesions,and it is unde-niable that nephrectomy is suspected to be overtreated.By reading the literature,we provide different insights into the treatment of the patient,and we hope that this paper can provide some help for the future clinical diagnosis and treatment.

Artificial intelligence-based comprehensive analysis of immune-stemness-tumor budding profile to predict survival of patients with pancreatic adenocarcinoma

Objective:Pancreatic ductal adenocarcinoma(PDAC)is an aggressive malignancy.CD8^(+)T cells,cancer stem cells(CSCs),and tumor budding(TB)have been significantly correlated with the outcome of patients with PDAC,but the correlations have been independently reported.In addition,no integrated immune-CSC-TB profile for predicting survival in patients with PDAC has been established.Methods:Multiplexed immunofluorescence and artificial intelligence(AI)-based comprehensive analyses were used for quantification and spatial distribution analysis of CD8^(+)T cells,CD133^(+)CSCs,and TB.In vivo humanized patient-derived xenograft(PDX)models were established.Nomogram analysis,calibration curve,time-dependent receiver operating characteristic curve,and decision curve analyses were performed using R software.Results:The established‘anti-/pro-tumor’models showed that the CD8^(+)T cell/TB,CD8^(+)T cell/CD133^(+)CSC,TB-adjacent CD8^(+)T cell,and CD133^(+)CSC-adjacent CD8^(+)T cell indices were positively associated with survival of patients with PDAC.These findings were validated using PDX-transplanted humanized mouse models.An integrated nomogram-based immune-CSC-TB profile that included the CD8^(+)T cell/TB and CD8^(+)T cell/CD133^(+)CSC indices was established and shown to be superior to the tumor-nodemetastasis stage model in predicting survival of patients with PDAC.Conclusions:‘Anti-/pro-tumor’models and the spatial relationship among CD8^(+)T cells,CSCs,and TB within the tumor microenvironment were investigated.Novel strategies to predict the prognosis of patients with PDAC were established using AI-based comprehensive analysis and machine learning workflow.The nomogram-based immune-CSC-TB profile can provide accurate prognosis prediction for patients with PDAC.

Early intravenous administration of tirofiban is recommended in patients with acute ischemic stroke treated with alteplase:a meta-analysis

Background:The occurrence of early neurological deterioration following intravenous thrombolysis(IVT)is considered a particularly ominous clinical event and is strongly correlated with poor outcomes.Initiating tirofiban within 24 h after IVT has been suggested as a better treatment option to achieve long-term functional outcomes.However,the rationality of this remedy is a controversial.The purpose of the study was to evaluate the safety and efficacy of early intravenous tirofiban administration after IVT in patients with acute ischemic stroke(AIS).Methods:Databases including PubMed,EMBASE,Cochrane Library,and Web of Science were searched for clinical trials on early tirofiban implementation after IVT in patients with AIS from inception to September 2022.Odds ratios(ORs)were generated for dichotomous variants via meta-analysis using STATA 17.0 MP.Results:Five clinical trials with 725 patients were eligible.The study outcomes demonstrated that early tirofiban administration after IVT was not associated with symptomatic intracranial hemorrhage(OR,0.78;95%confidence interval(CI),0.22–2.74;P=0.70),asymptomatic intracranial hemorrhage(OR,1.11;95%CI,0.52–2.37;P=0.80),systemic bleeding(OR,0.97;95%CI,0.42–2.23;P=0.94),and death(OR,1.05;95%CI,0.47–2.31;P=0.91),but may reduce the incidence of early neurological deterioration(OR,0.09;95%CI,0.02–0.50;P=0.01),and was significantly associated with 90-day excellent(modified Rankin scale score 0–1)(OR,2.01;95%CI,1.35–3.02;P=0.00)and favorable(modified Rankin scale score 0–2)(OR,2.30;95%CI,1.63–3.23;P=0.00)functional outcomes.Conclusion:The early intravenous administration of tirofiban after IVT in patients with AIS may be a safe and effective treatment strategy that improves long-term neurological functional outcomes without increasing the risk of adverse events.

Dancing bubble sonoluminescence in phosphoric acid solution

Sonoluminescence is more distinctly observed in phosphoric and sulfuric acid,which exhibit high viscosity and lower vapor pressures relative to water.Within an 85-wt%phosphoric acid solution saturated with argon(Ar),variations in the light-emitting regimes of bubbles were noted to correspond with increments in the driving acoustic intensity.Specifically,the bubbles were observed to perform a dance-like motion 2 cm below the multi-bubble sonoluminescence(MBSL)cluster,traversing a 25-mm^(2) grid during the camera exposure period.Spectral analysis conducted at the beginning of the experiment showed a gradual attenuation of CN(B^(2)Σ–X^(2)Σ)emission concurrent with a strengthening of Ar(4p–4s)atom emission lines.The application of a theoretical temperature model to the spectral data revealed that the internal temperature of the bubbles escalates swiftly upon their implosion.This study is instrumental in advancing the comprehension of the underlying mechanisms of sonoluminescence and in the formulation of a dynamic model for the behavior of the bubbles.

Integral Inequalities of Hermite-Hadamard Type for Functions Whose 3rd Derivatives Are <i>s</i>-Convex

In the paper, the authors find some new inequalities of Hermite-Hadamard type for functions whose third derivatives are s-convex and apply these inequalities to discover inequalities for special means.

Serum cystatin C levels are negatively correlated with post-stroke cognitive dysfunction

Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor in animal studies.However,the relationship between CysC levels and cognitive dysfunction in previous studies has revealed different results.This prospective observational study investigated the correlation between serum CysC levels and post-stroke cognitive dysfunction at 3 months.Data from 638 patients were obtained from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS).Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE) at 3 months after stroke.According to the MMSE score,308 patients (52.9%) had post-stroke cognitive dysfunction.After adjusting for potential confounding factors,the odds ratio (95% CI) of post-stroke cognitive dysfunction for the highest quartile of serum CysC levels was 0.54 (0.30–0.98),compared with the lowest quartile.The correlation between serum CysC and cognitive dysfunction was modified by renal function status.We observed a negative linear dose-response correlation between CysC and cognitive dysfunction in patients with normal renal function (Plinearity = 0.044),but not in those with abnormal renal function.Elevated serum CysC levels were correlated with a low risk of 3-month cognitive dysfunction in patients with acute ischemic stroke,especially in those with normal renal function.The current results suggest that CysC is a protective factor for post-stroke cognitive dysfunction,and could be used to treat post-stroke cognitive dysfunction.The CATIS study was approved by the Institutional Review Boards at Soochow University from China (approval No.2012-02) on December 30,2012,and was registered at ClinicalTrials.gov (identifier No.NCT01840072) on April 25,2013.

Bladder malacoplakia: A case report

BACKGROUND Bladder malacoplakia is a rare chronic granulomatous disease.The most common site of the malacoplakia is the urinary system.The etiology of bladder malacoplakia is complex,with its clinical misdiagnosis rate is high.Therefore,exposure to more clinical cases is necessary to improve the diagnosis and treatment of this condition.CASE SUMMARY A 65-year-old woman was admitted to our hospital because of dysuria.She presented with dysuria,frequent urination,urgency,pain,and absence of hematuria and pyuria.After the examination,bladder tumor electrocision was performed under combined intravenous and inhalation anesthesia on September 6,2021.During the operation,electrotomy and electrocoagulation were performed.The operation was then followed by anti-infection treatment,and the patient recovered well.The postoperative pathology was diagnosed as bladder malacoplakia by light and electron microscopic analyses.On a follow-up after 4 mo,no significant difference between electrotomy and electrocoagulation was found,with both achieving a curative effect.CONCLUSION Diagnosing bladder malacoplakia depends on histopathological examination.Antibiotic treatment with bladder tumor resection or electrocoagulation provides better therapeutic effect.

Research Progress on the Relationship Between White Matter Lesions and Vascular Cognitive Impairment

As the incidence of cerebrovascular disease increases,the incidence of white matter lesions (WMLs) and vascular cognitive impairment (VCI) also increases.Ischemic WMLs is directly related to VCI,especially non-dementia VCI.Early symptoms of non-dementia VCI are hidden and difficult to identify.About 50% of patients develop dementia.This article reviews the correlation between WMLs and VCI in terms of etiology,risk factors,pathogenesis and imaging manifestations.It provides scientific basis or ideas for clinical diagnosis and treatment for WMLs and VCI.

Metabonomics study of liver and kidney subacute toxicity induced by garidi-5 in rats

Objective:Metabonomics was used to analyze and explore the biomarkers and possible mechanisms of liver and kidney subacute toxicity induced by garidi-5 in rats.Methods:Taking garidi-5 as the target drug and SD rats as the research objects,each administration group except the normal group was intragastric administration of the corresponding drug solution for28 d.The serum,liver and kidney samples of rats were detected by metabolomics and characterized by principal component analysis(PCA)and partial least squares discriminant analysis(PLS-DA)to identify the sensitive markers and metabolic pathways of liver and kidney subacute toxicity.Results:Metabolomics analysis showed that compared with the normal group(Z),the 52,64 and 54 different metabolites were identified in the serum,liver and kidney samples of garidi-5 high dose group(GG),which were mainly enriched in ABC transporters,arginine and proline metabolism,nicotinate and nicotinamide metabolism,central carbon metabolism in cancer pathways.Conclusion:The preliminarily suggested that garidi-5 can damage the liver and kidney by affecting the ABC transporters,arginine and proline metabolism,nicotinate and nicotinamide metabolism pathways,etc.Trimethylamine N-oxide,L-pyroglutamic acid,glycine-betaine,xanthine,glutathione,L-leucine,cytidine,L-arginine,spermidine,urea,5-aminovaleric acid,creatine,L-glutamic acid,1-methylnicotinamide and S-adenosyl-L-methionine can be used as potential biomarkers of liver and kidney toxicity sensitivity.

Research on Materia Medica of Mongolian and Tibetan Medicinal Herb Caomaoxing

[Objectives] To investigate the basic source of the traditional Mongolian and Tibetan herb Caomaoxing. [Methods] The basic source of materia medica of Mongolian and Tibetan herb Caomaoxing was investigated through the collection of ancient books and modern literature about Mongolian and Tibetan medicine,combined with the current situation of clinical application. [Results] Through careful collection of literature and data,Caomaoxing recorded in Mongolian and Tibetan Meteria Medica is the red xylem heartwood of Caragana jubata( Pall.)Poir. [Conclusions] Through investigation of the basic source of Caomaoxing recorded in Mongolian and Tibetan Meteria Medica,this study is expected to provide literature reference for further research and development of Caomaoxing.

Synthesis, Crystal Structure and Anti-breast Cancer Activity of ((3S,5R)-5-((1H-1,2,4-triazol-1-yl)methyl)-5-(2,4-difluorophenyl)tetrahydrofuran-3-yl)methyl 4-Methylbenzenesulfonate

The new heterocycle compound ((3S,5R)-5-((1H-1,2,4-triazol-1-yl)methyl)-5-(2,4-difluorophenyl)tetrahydrofuran-3-yl)methyl 4-methylbenzenesulfonate (1), designed using((3R,5S)-5-(2,4-difluorophenyl)-5-iodotetrahydrofuran-3-yl)methyl isobutyrate(2) as the start material, was successfully obtained via multiple synthesis route and finally characterized by IR, ~1H NMR, and single-crystal X-ray crystallography. In addition, the in vitro anticancer activities of the newly synthesized complex 1 have been emulated against three human breast cancer cell lines BT474, MCF7 and MB.

Contrast-induced Encephalopathy after Endovascular Embolization of an Anterior Communicating Artery Aneurysm:Case Report and Literature Review

We report a case of contrast-induced encephalopathy after endovascular embolization of an anterior communicating artery aneurysm.A 59-year-old woman was admitted to Tongliao Hospital for neurointerventional treatment due to a left anterior communicating artery aneurysm.She had a history of hypertension,which was controlled by regular medication.The contraindications were eliminated following a preoperative examination,and head computed tomography(CT)showed no abnormalities.After evaluation,interventional embolization was performed.Three hours postoperatively,the patient complained of a headache on the right side,which was accompanied by frequent nausea.Emergency head CT showed no intracranial hemorrhage,obvious brain tissue edema in the right cerebral hemisphere,blurred sulcus/gyrus,or metal artifacts(spring coils)in the left frontal lobe.The patient was diagnosed with contrast-induced encephalopathy(CIE).This patient achieved good prognosis through timely and reasonable treatment.CIE is very rare clinically,improper treatment may lead to irreversible clinical outcomes;it should cause alarm to doctors.

Document Analysis of Correlation between Climate and Stroke

Aim: The aim of the research is to determine characteristic of the correlation between climate and stroke through the analysis of relevant documents. Methods: We found 115 researches of temperature and season on stroke mortality/incidence and these were categorized according to location, meteorology, date span, data source and research sites’ latitudes. We divided the globe into 5 temperature zones based on latitude ranges: 0 - 10, 10 - 23.5, 23.5 - 40, 40 - 50, and >50 degrees, and allotted a zone to each country. Stroke mortality by five temperature zones was calculated per 100,000 people. Results: 70% of the researches came from latitudes greater than 40 degrees with 92% of researches located in Europe, USA, and Asia. The mortality range was 42 - 63 per 105 individuals within latitudes 0 - 40 degrees. In latitudes 40 - 66.5 degrees, a linear upward trend (y = 69.82x &#8722;22.823, R2 = 0.99) was noticed. More than 75% of the research reports indicated a negative correlation between climate and stroke, and the proportion was almost 6 and 7 times greater than that of the fluctuation and non-correlation, respectively. The most frequently used research methods were regression analysis and time series analysis. Conclusion: All of the research results confirmed that lower temperature is associated with higher mortality and incidence of stroke, while higher latitude is correlated with higher stroke mortality, consistent with the temperature zones.

Neuroprotective effects of ischemic adaptation on cognitive dysfunction in mice with cerebral ischemia-reperfusion injury

Objective: To observe the effects of remote ischemia on cognitive function and neuronal pathological damage in rats with cognitive impairment induced by bilateral common carotid artery occlusion(BCAO).Methods:Male SD rats were selected to establish the cognitive impairment model induced by cerebral ischemia reperfusion caused by BCAO.The tests included three groups of rats:a sham group,a model group with vascular cognitive impairment (VCI) , and a remote ischemic conditioning (RIC) group (VCI + RIC group). From 24 h after operation, both hind limbs of rats in VCI + RIC group were treated with RIC. After 28 d, Morris water maze test and HE staining was used to observe the pathological changes of white matter and hippocampus in each group.Results: After 3 d mice in VCI group began to improve gradually. The recovery of rats in the VCI + RIC group was relatively slow,but they started to recover rapidly 2 d after the operation.Morris water maze test showed that the escape latency of rats in VCI group and VCI+RIC group was longer than that in the sham group, and the score of VCI+RIC group was better than that of the VCI group, but there was a significant difference between the two groups(P<0.05).The space exploration experiment was performed at 7 d and 28 d after the operation;the VCI+RIC group outperformed the VCI group in both trials;the difference between the two groups was statistically significant (P<0.05).In the target quadrant exploration time, the difference between the VCI group (33.5±11.3 s) and the VCI+RIC group (41.2±9.7 s) was statistically significant (P<0.05).Results from the hematoxylin and eosin(HE)staining showed that compared with VCI group, cortical cells in VCI + RIC group had loose stroma, thinner nerve fibers, fewer broken cells, and slightly shrunken cells. Compared with VCI group, neurons in VCI + RIC group had a little vacuolar degenera-tion and slightly shrunken cell volume.Conclusion:Cerebral ischemia-reperfusion injury can cause learning and memory impairment in rats, leading to VCI. RIC can significantly improve VCI and play a neuroprotective role.

Research progress of perioperative stroke

Perioperative stroke is one of the serious complications in perioperative patients,and its incidence is related to the risk factors of stroke,surgical methods,anesthesia,and surgical complexity.This article reviews the definition,incidence,risk factors,preventive measures,and management of perioperative patients of perioperative stroke,to provide a theoretical basis for clinical work,to reduce the incidence of perioperative stroke.

Clinical Effect Analysis of Small and Medium Doses of Betaloc Combined with Amiodarone in the Treatment of Ventricular Arrhythmia

Objective:To explore and analyze the clinical effect of small and medium doses of Betaloc combined with amiodarone in the treatment of ventricular arrhythmia.Methods:60 patients with ventricular arrhythmia that were treated in the Department of Cardiology of our hospital from May 2018-May 2023 were selected for this study,and they were divided into a research group(n=30)and a reference group(n=30).The study group was treated with small doses of Betaloc and amiodarone,while the reference group was treated with conventional treatment.The total efficacy of medication,QRS interval,standard deviation of normal-to-normal(NN)intervals(SDNN),root mean square of successive differences between normal heartbeats(RMSSD),standard deviation of the average NN intervals(SDANN),and incidence of adverse reactions were compared between the groups.Results:The effectiveness of medication in the study group was significantly higher than that in the reference group(P<0.05).Besides,there was no statistically significant difference(P>0.05)in the QRS interval and SDNN between the two groups before treatment.After treatment,the QRS interval and SDNN of the study group were significantly lower than those of the reference group(P<0.05).Before treatment,there was no significant difference in RMSSD and SDANN between groups(P>0.05).After treatment,RMSSD and SDANN in the study group were significantly better than those in the reference group(P<0.05),and the difference was statistically significant.The incidence of adverse reactions in the study group was significantly lower than that in the reference group(P<0.05),and the difference was statistically significant.Conclusion:Small doses of Betoprolol and amiodarone is more effective in the treatment of ventricular arrhythmia,which has the value of popularization and application.

Fibrous histiocytoma of the spermatic cord 1 case and review of the literature

Objective:The diagnosis and treatment of this disease were discussed based on the relevant literature and the clinical data of spermatic fibrous histiocytoma in our hospital.Methods:The clinical data of 1 case of spermatic cord fibrous histiocytoma admitted to urology department were retrospectively analyzed,combined with relevant literature review and discussion.Results:After surgical radical treatment,the pathological result was fibrous histiocytoma.Conclusion:Spermatic cord fibrous histiocytoma is a rare tumor of genitourinary system.The diagnosis is mainly based on pathological results.Surgery is the first choice for treatment.Adjuvant radiotherapy and chemotherapy are not effective and the prognosis is poor.Regular postoperative review is required.

Different strategies for ultra-early reperfusion therapy in anterior circulation acute ischemic stroke safety and effectiveness of the comparative observation

Background:To compare the safety and effectiveness of direct mechanical thrombectomy and bridging therapy for stroke with acute anterior circulation large vessel occlusion within 4.5 hours of onset.Methods:Retrospectively collected from 66 patients with acute ischemic stroke admitted to the Department of Neurology of Tongliao Hospital and Xuanwu Hospital from August 2019 to November 2021 within 4.5 hours.According to the different recanalization methods,30 patients were assigned to the direct thrombectomy treatment group,and 36 patients in the bridging treatment group(i.e.,the intravenous thrombolysis bridging mechanical thrombectomy treatment group).The primary outcome measure was the neurological outcome at the onset of 90d.Secondary outcome measures were intraoperative vascular recanalization and reperfusion,and the US National Institute of Health Stroke Scale score at 24 hours after surgery.The primary safety indicators are intracranial hemorrhage,including symptomatic intracranial hemorrhage and non-symptomatic intracranial hemorrhage,and 90d mortality.Results:The direct thrombectomy group had lower body mass index,hypertension and baseline Alberta early computed tomography score than the bridging treatment group,and longer time from onset to visit than the bridging group(206.5(119.5,256.25)min vs.150.5(25.205,212.75)min),the above difference were statistically significant(P<0.05).There were no significant differences in successful vascular reperfusion(93%vs.89%),24 hours postoperative National Institute of Health Stroke Scale score(11(5,18)vs.11(5,20)),intracranial hemorrhage(11%vs.14%),symptomatic intracranial hemorrhage(7%vs.17%),90d mRS0 to 2 points(43%vs.36%)and 90d mortality(23%vs.22%)(P>0.05).Conclusion:Similar clinical efficacy and safety of direct mechanical thrombectomy and bridging therapy for acute anterior circulation large vessel occlusive stroke within 4.5 hours of onset,direct thrombectomy can be used as an alternative scheme for acute anterior circulation intracranial large artery occlusive stroke.

A Case of Brucellosis Concomitant with Severe Fever with Thrombocytopenia Syndrome—Weifang City,Shandong Province,China,2023

Summary What is already known about this topic?Brucellosis and severe fever with thrombocytopenia syndrome(SFTS)are neglected zoonoses,attributable respectively to Brucella and the SFTS virus(SFTSV).While the incidence of these diseases has been rising,instances of co-infection remain uncommon.What is added by this report?This represents the first documented case of a rare coinfection involving Brucella and SFTSV.