Effects of Dezocine and Propofol Combination on Plasma 5-HT and ET Levels in Stroke Patients Undergoing Thrombolysis

Objective: To investigate the effect of dezocine combined with propofol on brain metabolism in patients undergoing cerebral thrombosis thrombolysis. Methods: A total of 86 stroke patients admitted between July 2022 and December 2023 were randomly divided into two groups: Group A (study group) and Group B (control group), with 43 patients in each group. Both groups underwent intra-arterial thrombolysis therapy. Group B received dezocine for anesthesia, while Group A received a combination of dezocine and propofol. Plasma concentrations of 5-hydroxytryptamine and endothelin, as well as brain metabolic indicators, were compared between the two groups immediately after anesthesia, at 1 hour post-reperfusion, and 3 hours post-reperfusion. Results: There were no significant differences in the levels of 5-hydroxytryptamine and endothelin between the two groups immediately after anesthesia and at 1 hour post-reperfusion (P > 0.05). However, at 3 hours post-reperfusion, the levels of 5-hydroxytryptamine and endothelin in Group A were significantly lower than those in Group B. Furthermore, in Group A, the levels of 5-hydroxytryptamine and endothelin at 3 hours post-reperfusion were lower compared to the levels at 1 hour post-reperfusion (P < 0.05). Conclusion: Dezocine combined with propofol can effectively improve the quality of anesthesia and has a minimal effect on brain metabolic indices, suggesting reduced damage to brain metabolism.

Comparison and Analysis of Clinical Characteristics of Common COVID-19 and NSIP Patients

Objective:To investigate the relationship between coronavirus disease 2019(COVID-19)and non-specific interstitial pneumonia(NSIP),with a focus on the clinical features of COVID-19 and NSIP,and the key points of differential diagnosis.Methods:The clinical data of 20 patients with common-type COVID-19 and NSIP admitted to Linyi People’s Hospital from January 21,2020,to June 21,2022,were retrospectively analyzed.Gender,age,history of residence in Hubei province,underlying diseases,clinical manifestations,laboratory test results(including blood routine indexes,inflammatory markers,liver function indexes,and coagulation indexes),and computed tomography(CT)scan images were compared between the two groups.Results:COVID-19 patients were younger than NSIP patients(P<0.05).Nine COVID-19 patients had a travel history to Hubei province,while none of the NSIP patients did(P<0.05).Eight COVID-19 patients had underlying chronic conditions,fewer than the NSIP group(12 patients;P<0.05).Both groups experienced symptoms such as shortness of breath,expectoration,fatigue,and runny nose,but fever and cough were more severe and more frequent in the COVID-19 group.Compared to normal reference ranges,both groups exhibited normal white blood cell counts(WBC)and liver function indexes,but elevated lymphocyte counts(LYMP),inflammatory markers,and coagulation indexes,with reduced neutrophil counts(NE).WBC and LYMP were higher in the COVID-19 group compared to the NSIP group.Male patients in the COVID-19 group had higher erythrocyte sedimentation rates and C-reactive protein values than those in the NSIP group,while procalcitonin levels were lower in the COVID-19 group,although the differences were not statistically significant(all P>0.05).The NE count in the COVID-19 group was significantly lower than in the NSIP group(P<0.05).Alanine aminotransferase,total bilirubin,and indirect bilirubin were significantly higher in the COVID-19 group compared to the NSIP group(P<0.05).Chest CT scans of both groups showed bilateral patchy ground-glass opacities,but the lesions in COVID-19 patients were scattered.NSIP patients’chest CTs showed diffuse lesions centered around the hilum or multiple lesions in both lungs,with pleural involvement being rare.Conclusion:While there are certain specific clinical,laboratory,and imaging findings in both COVID-19 and NSIP,the specificity of these features is not high.Differentiating the two requires careful consideration of epidemiological history,nucleic acid testing,and antigen-antibody levels.

Diffusion-weighted imaging and variable flip angle T1 mapping: a supplement for image-guided biopsy in follow-up analysis of liver fibrosis

Purpose To evaluate the performance of diffusion-weighted imaging(DWI) and variable flip angle(VFA) T1 mapping as a supplement to image-guided biopsy in follow-up analysis of liver fibrosis. Materials and Methods This prospective study was approved by the institution's committee on human research, and written informed consent was provided from the enrolled patients. We investigated five MRI parameters of DWI and VFA T1 mapping, collected from 11 patients who underwent serial ultrasound image-guided biopsy with follow-up MRI within 1.5 years after treatment for liver fibrosis/cirrhosis. For each patient, four consecutive MRI examinations were conducted, including baseline MRI before treatment and three follow-up MRI examinations after treatment at each 0.5-year interval. ADC values at four b values and T1 relaxation times were correlated to pathology-confirmed liver fibrosis stages, which were subsequently divided into two groups, stages F2–3 and F4. The receiver operating characteristic(ROC) analysis and repeated measurement analysis of variance were used for statistical analysis. Results Among these ADC parameters, ADC value(b = 500 s/mm^2) was the most consistent in differentiating between stage F2–3 and F4 liver fibrosis. Repeated measurement analysis showed that the intra-group and inter-group differences were 0.447 and 0.024, respectively. T1 relaxation time could not consistently differentiate between the F2–3 and F4 groups; however, it was repeatable, and the intra-group and inter-group differences were 0.410 and 0.042, respectively. Conclusion MRI-ADC value at a b value of 500 s/mm^2 can be a promising biomarker for differentiating stages F2–3 and F4 liver fibrosis. A combination of this biomarker with repeatable T1 relaxation time may function as a non-invasive tool for follow-up liver fibrosis in patients who reject repeated image-guided biopsy.

A 10-Year Retrospective Cohort Study of Real-World Effectiveness of Sofosbuvir-Based Regimens for Hepatitis C in a Single Center in China

This study aimed to review the trends of hepatitis C virus(HCV)treatment over the past decade and to analyze the effectiveness of sofosbuvir(SOF)–based direct-acting antiviral regimens in the heterogeneous population of patients with chronic hepatitis C(CHC)in clinical practice.This retrospective cohort study included CHC patients attending the Sir Run Run Shaw Hospital between January 1,2012,and December 31,2022.All of the 194 patients treatedwith SOF-based regimens completed 12weeks of treatment and were followed up for at least 12 weeks after completion of the therapy.Sustained virologic response(SVR)12 weeks after the end of treatment was the primary endpoint.A total of 194 patients treated with SOF-based regimens were included,among which 121,56,10 and 7 patients received SOF+velpatasvir±ribavirin,SOF+daclatasvir,SOF+ledipasvir or SOF+ribavirin,respectively.With 36.1%,HCV Genotype 1 predominated in CHC patients treated with SOF-based regimens,followed by Genotype 2a with 17.5%and Genotype 3 with 14.9%.Comorbidities among patients included hypertension(4.1%),diabetes(2.1%),depression(1.0%)and neoplastic disease(2.6%).All patients treated with SOF-based regimens achieved SVR.There was no association between SVR and factors such as HCV genotype,sex,age,presence of cirrhosis or previous treatment history.There were no reports of any serious adverse events in the study.This single-center retrospective study represented the latest 10-year treatment trends for HCV in real-world clinical practice and provided useful information on the excellent efficacy of SOF-based direct-acting antiviral regimens for treatment of CHC patients in Eastern China.

China Anti‑Cancer Association(CACA)guidelines for holistic integrative management of lymphoma(version 2022)Lymphoma,Guideline,Diagnosis,Treatment,Holistic integrative medicine

Purpose Lymphoma has become a major threat to human health.Fortunately,the diagnosis and treatment of lymphoma have developed rapidly,and research progress has emerged in an endless stream,with new drugs emerging one after another.These results are constantly rewriting guidelines changing clinical practice,need to be popularized and applied more widely.Methods This guideline has integrated consensuses reached by the Lymphoma Committee of China Anti-Cancer Association(CACA),based on China’s practice,tracking previous results of the most advanced clinical researches,absorbing the latest clinical evidence,and referring to domestic and international lymphoma guidelines.Results This holistic integrative guideline of lymphoma introduces the latest progress in the diagnosis and treatment of different subtypes of lymphoma,guide the clinical application of new drugs,standardized and precise management for lymphoma patients.Conclusions CACA guidelines for holistic integrative management of lymphoma(version 2022)enhance standardization and precision of the management for lymphoma patients in China.