Successful resection of a huge retroperitoneal venous hemangioma:A case report

BACKGROUND Venous hemangioma is a benign and non-invasive type of tumor,which is rarely identified due to the absence of clinical manifestations.A retroperitoneal benign tumor is comparatively rare,and hemangioma is exceptional.Because of the different types and locations of hemangioma,presentations are varied;thus,establishing an accurate diagnosis before surgery is challenging.CASE SUMMARY A 45-year-old female patient visited our hospital with the complaint of a retroperitoneal mass without symptoms discovered during a medical examination.An abdominal and pelvic computed tomography(CT)revealed a giant hypodense mass that extended from the lower edge of the liver down to the right groin and showed no marked enhancement in the arterial phase of the enhanced CT.On magnetic resonance imaging,the retroperitoneal mass was hyperintense on the T2-weighted image and hypointense on the T1-weighted image.The mass was completely resected and confirmed as a venous hemangioma by pathology.CONCLUSION Venous hemangioma is rare in adults,and an accurate diagnosis before surgery is challenging.Surgery is the curative treatment for venous hemangioma,and the definitive diagnosis relies on pathology.

International normalized ratio and Model for End-stage Liver Disease score predict short-term outcome in cirrhotic patients after the resolution of hepatic encephalopathy

BACKGROUND In patients with cirrhosis,hepatic encephalopathy(HE)indicates a poor prognosis despite the use of artificial liver and liver transplantation,presenting as frequent hospitalizations and increased mortality rate.AIM To determine predictors of early readmission and mid-term mortality in cirrhotic patients discharged after the resolution of HE.METHODS From January to February 2018,213 patients were enrolled in this observational study assessing all the successive patients with cirrhosis discharged from Department of Gastroenterology and Department of Infectious and Liver Diseases,Second Affiliated Hospital of Chongqing Medical University after the resolution of HE.The patients were followed for 6 mo.For each subject,demographic,clinical,and laboratory variables were assessed at the time of diagnosis of HE,during hospital stay,at discharge,and during follow-up.The primary endpoints were incidence of early readmission and mid-term mortality.RESULTS During follow-up,65(31%)patients experienced an early readmission.International normalized ratio(INR)[odds ratio(OR)=2.40;P=0.003)at discharge independently predicted early readmission.The incidence of early readmission was significantly higher in patients with an INR>1.62 at discharge than in those with an INR≤1.62(44%vs 19%;P<0.001).Model for End-stage Liver Disease(MELD)score(OR=1.11;P=0.048)at discharge proved to be an independent predictor of early readmission caused by HE.Hemoglobin(OR=0.97;P=0.005)at discharge proved to be an independent predictor of non-early readmission.During 6 months of follow-up,34(16%)patients died.Artificial liver use(hazard ratio=6.67;P=0.021)during the first hospitalization independently predicted mid-term mortality.CONCLUSION INR could be applied to identify fragile cirrhotic patients,MELD score could be used to predict early relapse of HE,and anemia is a potential target for preventing early readmission.

Epstein-Barr virus-positive post-transplant lymphoproliferative disordepresenting as hematochezia and enterobrosis in renal transplant recipients in China: A report of two cases

BACKGROUND Post-transplant lymphoproliferative disorder(PTLD) is a rare severe complication after renal transplantation, with an incidence of approximately 0.3%-2.0% in patients undergoing renal transplantation. The clinical manifestations of PTLD are often nonspecific, leading to tremendous challenges in the clinical diagnosis and treatment of PTLD.CASE SUMMARY We report two Epstein-Barr virus(EBV)-positive PTLD cases whose main clinical manifestations were digestive tract symptoms. Both of them admitted to our hospital because of extranodal infiltration symptoms and we did not suspect of PTLD until the pathology confirmation. Luckily, they responded well to the treatment of rituximab. We also discuss the virological monitoring, clinical characteristics, diagnosis, and treatment of PTLD.CONCLUSION PTLD is a deceptive disease and difficult to diagnose. Once patients are confirmed with PTLD, immune suppressant dosage should be immediately reduced and rituximab should be used as first-line therapy.

Modulation of antiviral cytokine production and lung protection against influenza virus by the glycosides from Ligustrum purpurascens

Ligustrum purpurascens has been used as a traditional herb for over 2,000 years in China.This study was design to investigate the modulation of antiviral cytokines and reduction in lung inflammation of virus-infected mice by the glycosides isolated from Ligustrum purpurascens.Methods:Ligustrum purpurascens glycosides(LPG)were isolated from the leaves of Ligustrum purpurascens.Proliferation of spleen lymphocytes were investigated after LPG treatment.The in vitro and in vivo cytokine modulation of LPG was studied.Furthermore,the anti-inflammatory and antiviral activities of LPG,with the potential to reduce inflammatory lung disorders,were investigated by influenza A virus infected mice.Results:LPG could significantly promote the proliferation,and also could stimulate the production of IFN-γby spleen lymphocytes in a dose-dependent manner.IFN-γexpression level was increased significantly compared to the control and presented a dose-dependent manner in vitro.Furthermore,LPG inhibit the expression of TNF-αand IL-10,which return to normal level in the cyclophosphamide-induced mice model in vivo.Besides,the histopathological analysis indicated LPG reduced acute lung injury in mice infected with influenza virus.Conclusion:This study suggested that LPG could increase the exression of IFN-γ,immunoregulation and decrease lung inflammation of virus-infected mice.