Correlation Analysis Between Changes of D-Dimer Level and Rheumatoid Arthritis Complicated with Interstitial Lung Disease

Objective:To explore the correlation between the change of D-dimer level and rheumatoid arthritis complicated with interstitial lung disease.Methods:From January 2022 to February 2024,20 rheumatoid arthritis patients complicated with interstitial lung disease(interstitial lung disease group),20 rheumatoid arthritis patients without interstitial lung disease(without interstitial lung disease group),and 20 healthy people(control group)in Xijing Hospital were selected for this study.The fasting venous blood of the three groups of subjects was collected and their D-dimer,C-reactive protein(CRP),rheumatoid factor(RF),and erythrocyte sedimentation rate(ESR)were detected.Subsequently,the correlation between each index and rheumatoid arthritis complicated with interstitial lung disease was analyzed.Results:The D-dimer level of the interstitial lung disease group was significantly higher than the other two groups(P<0.05).The D-dimer level of the group without interstitial lung disease was significantly higher than the control group(P<0.05).CRP levels in the interstitial lung disease group and the group without interstitial lung disease were significantly higher than those of the control group(P<0.05).The ESR and RF levels of the interstitial lung disease group were significantly higher than the other two groups(P<0.05).The levels of ESR and RF levels of the group without interstitial lung disease were significantly higher than the control group(P<0.05).Conclusion:D-dimer levels of rheumatoid arthritis patients are higher than those of healthy individuals,and those complicated with interstitial lung disease present even higher levels.This finding shows that there is a correlation between D-dimer levels and rheumatoid arthritis with interstitial lung disease,which may facilitate the evaluation and diagnosis of this disease.

Mechanism of Gegen Qinlian Decoction in Treating Type 2 Diabetes Mellitus Complicated with NAFLD Based on Network Pharmacology

[Objectives]To explore the mechanism of Gegen Qinlian Decoction in treating type 2 diabetes mellitus(T2DM)complicated with non-alcoholic fatty liver disease(NAFLD)by analyzing the effective components of Gegen Qinlian Decoction.[Methods]TCMSP database was used to analyze the active components of Gegen Qinlian Decoction,and pubchem and Swiss ADME databases were also used to predict drug targets,extract T2DM complicated with NAFLD targets from OMIM and Genecards databases.Venny plot was drawn to obtain intersection targets,and finally Cytoscape was used to make core target maps and drug-target-disease network maps.Using DAVID and Metascape database to analyze the intersection targets,the gene ontology information of Go and KEGG was obtained.Microbial informatics technology was used to visualize GO,and Cytoscape was used to make drug-target-disease network map-enrichment pathway map.[Results]The network pharmacological analysis showed that Gegen Qinlian Decoction acted on the key targets of type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease,such as ALB and ALT1,through many components,and achieved the purpose of treating this disease.The chemical constituents of the drug include formononetin,5-hydroxyisomucronulatol-2,5-2-O-glucoside,cholesteryl laurate,isoliquiritigenin,etc.[Conclusions]This study provides a new idea and theoretical support for future drug research and clinical practice.

Protective effects of Zuogui Jiangtang Jieyu Formula on hippocampal neurons in rats of diabetes complicated with depression via the TRP/KYN metabolic pathway

Objective To explore the protective effects and mechanism of Zuogui Jiangtang Jieyu Formula(左归降糖解郁方,ZGJTJYF)on hippocampal neurons in rats of diabetes complicated with depression(DD)via the TRP/KYN metabolic pathway.Methods(i)In vivo experiments:60 specified pathogen free(SPF)grade male Sprague-Dawley(SD)rats were randomly divided into six groups with 10 rats in each groups:control,DD model,positive(1.8 mg/kg fluoxetine+0.18 g/kg metformin),high-dose ZGJTJYF(ZGJTJYFH,40.500 g/kg ZGJTJYF),middle-dose ZGJTJYF(ZGJTJYF-M,20.250 g/kg ZGJTJYF),and lowdose ZGJTJYF(ZGJTJYF-L,10.125 g/kg ZGJTJYF)groups.Except for the control group,other groups were established DD model by high-fat emulsion intake with single tail vein streptozotocin(STZ)and four weeks of chronic unpredictable mild stress(CUMS).All drug administration groups were treated by gavage during CUMS modeling,and the control and model groups were given equal amount of distilled water.After four weeks,the serum levels of blood glucose and glycosylated hemoglobin were measured to determine the hypoglycemic effect of ZGJTJYF.Moreover,the open field test and Morris water maze test were performed to evaluate the antidepressant effect of ZGJTJYF.Changes in 5-hydroxytryptamine(5-HT)level were detected via high-performance liquid chromatography with electrochemical detection(HPLC-ECD);the levels of tryptophan(TRP),kynurenine(KYN),and indoleamine 2,3-dioxygenase(IDO)in the hippocampus were detected using enzyme-linked immunosorbent assay(ELISA);the protein expression levels of synaptophysin(SYN)and postsynaptic density material-95(PSD-95)were detected via immunohistochemistry(IHC);and the protein expression levels of N-methyl-D-aspartate receptor(NR)2 A and NR2 B were detected using Western blot.(ii)In vitro experiments:five SPF grade SD pregnant rats(E16–18)were used to obtain primary hippocampal neurons(Ne),six SD new-born rats were used to collected primary astrocytes(As)and microglia(MG),and to establish a Ne-As-MG co-culture system.All co-culture systems were divided into six groups:control(PBS),model[150 mmol/L glucose+200μmol/L corticosterone(G&P)+PBS],blank(G&P+blank serum),positive(G&P+positive drug-containing serum),ZGJTJYF(G&P+ZGJTJYF serum),and 1-methyl-D-tryptophan(1-MT,IDO inhibitor)(G&P+1-MT)groups.After 18 h of intervention by corresponding treatment,immunofluorescence was used to analyze the protein expression levels of SYN,PSD-95,NR2 A,and NR2 B;ELISA was performed to measure the levels of interleukin(IL)-1β,IL-6,tumor necrosis factor(TNF)-α,and TRP/KYN metabolic pathway-related factors[TRP,KYN,kynurenine acid(KYNA),quinolinic acid(QUIN)].Results(i)In vivo experimental results showed that ZGJTJYF-M and ZGJTJYF-L significantly improved the elevated blood glucose state of DD rats(P<0.01 and P<0.05,respectively);ZGJTJYF-H,ZGJTJYF-M,and ZGJTJYF-L increased their autonomous activity,learning,and memory ability(P<0.01,P<0.01,and P<0.05,respectively).Moreover,the levels of 5-HT and TRP were significantly increased(P<0.01),and the levels of KYN and IDO were significantly decreased in the hippocampus(P<0.01)of rats after ZGJTJYF-M treatment.The protein expression levels of SYN and PSD-95 were significantly upregulated in hippocampal neurons(P<0.01),while the abnormal activation of NR2A and NR2B was markedly inhibited in hippocampus(P<0.05)of rats after ZGJTJYF-M treatment.(ii)In vitro experimental results showed that ZGJTJYF-containing serum significantly increased the protein expression levels of SYN and PSD-95 in hippocampal neurons(P<0.01),decreased the levels of IL-1β(P<0.01),IL-6(P<0.05),TNF-α(P<0.01),IDO(P<0.05),KYN(P<0.05),and QUIN(P<0.01),and increased the levels of TRP and KYNA(P<0.01)in the simulated DD state.ZGJTJYF also had an significantly inhibitory effect on the abnormal activation of NR2A and NR2B in neurons(P<0.05)in a stimulated DD state.Conclusion ZGJTJYF can effectively improve 5-HT deficiency in the hippocampus of rats by inhibiting IDO expression and regulating the TRP/KYN metabolic pathway,and it has a favorable protective effect on hippocampal neuron injury caused by DD.Therefore,ZGJTJYF is an effective potential therapeutic drug for the prevention and treatment of DD.

Mechanism of Wulan Shisanwei Decoction in Treating Hypertension Complicated with Hyperlipidemia Based on Network Pharmacology

[Objectives]To screen out the main effective components of Wulan Shisanwei Decoction in the treatment of hypertension complicated with hyperlipidemia based on the method of network pharmacology,predict the target and explore the possible mechanism.[Methods]13 components of Wulan Shisanwei Decoction were searched on the TCMSP data platform,the corresponding active components were found and the corresponding targets were searched in Pubchem database.GeneCards database was used to screen the corresponding targets of hypertension and hyperlipidemia.The core target PPI network of Wulan Shisanwei Decoction in the treatment of hypertension complicated with hyperlipidemia was constructed by processing in STRING database.The effective data were imported into Cytoscape 3.8.0 to analyze the network topology parameters,and they were screened according to the degree value greater than the average value.Finally,the relevant information about the core target of Wulan Shisanwei Decoction in the treatment of hypertension complicated with hyperlipidemia was obtained.GO enrichment analysis and KEGG pathway analysis were carried out for core targets in DAVID database.The visualization map of"drug-component-target-disease"was drawn by Cytoscape 3.8.0.[Results]A total of 85 active components were obtained from Wulan Shisanwei Decoction,and there were 1532 corresponding targets.A total of 303 key targets were obtained by intersecting corresponding drug targets with disease targets.3178 biological processes were obtained by GO analysis(P<0.05)and 192 signaling pathways were obtained by KEGG enrichment analysis(P<0.05).[Conclusions]It was predicted that the main active components of Wulan Shisanwei Decoction in the treatment of hypertension complicated with hyperlipidemia were stigmasterol,acacetin,pectolinarigenin,isorhamnetin,alizarin,quercetin,nordamnacanthal,kaempferol,luteolin,glyceollin,kushenol,t,3-methylkempferol,ellagic acid,etc.20 core targets were selected in the treatment of hypertension complicated with hyperlipidemia:SRC,STAT3,HSP90AA1,MAPK1,MAPK3,PIK3R1,HRAS,GRB2,PIK3CA,AKT1,PTPN11,ESR1,LCK,EGFR,FYN,EP300,RELA,JUN,LYN,RHOA.These targets were involved in PI3K-Akt signaling pathway,lipid and atherosclerosis,proteoglycan in cancer,Ras signaling pathway,etc.to exert a response to oxidative stress,cellular response to chemical stress,peptidyl-tyrosine phosphorylation and peptide tyrosine modification,and can intervene in the early stage of the disease.It may be the potential mechanism of Wulan Shisanwei Decoction in the treatment of hypertension complicated with hyperlipidemia.

Clinical Study on the Retention Enema with Modified Dahuang Mudan Decoction in Treating Lower-Jiao Obstruction Syndrome Caused by Severe Pneumonia Complicated with Heart Failure

[Objectives]To treat patients with Lower-Jiao Obstruction Syndrome caused by severe pneumonia complicated with heart failure using the retention enema with Modified Dahuang Mudan Decoction,and to observe the effect and safety of this treatment on inflammatory indicators,cardiac function,gastrointestinal function and multiple organ failure in patients with Lower-Jiao(lower energizer)Obstruction Syndrome caused by severe pneumonia complicated with heart failure.[Methods]54 patients with Lower-Jiao Obstruction Syndrome caused by severe pneumonia complicated with heart failure diagnosed in Nanchong Chinese Medicine Hospital from January 2020 to December 2021 were randomly divided into experimental group(n=27)and control group(n=27).The control group was given conventional treatment combined with 0.9%sodium chloride injection(100 mL)+glycerine enema(40 mL).The treatment group was treated with Modified Dahuang Mudan Decoction on the basis of conventional treatment for 7 d.The efficacy indicators and adverse events such as white blood count(WBC),C-reactive protein(CRP),procalcitonin(PCT),N-terminal pro-brain natriuretic peptide(NT-proBNP),Lausanne Intestinal Failure Estimation(LIFE)and multiple organ dysfunction score(MODS)were observed.[Results](i)There was no significant difference in WBC,PCT,CRP and NT-proBNP between the two groups before treatment.All indicators after treatment were significantly lower than those before treatment in both groups(P<0.05).The levels of WBC,PCT and CRP in the treatment group were lower than those in the control group after treatment(P<0.05),and there was no significant difference in NT-proBNP between the two groups after treatment(P>0.05),but the difference in NT-proBNP before and after treatment in the treatment group was higher than that in the control group.(ii)The LIFE of the two groups decreased significantly after treatment,and the improvement of LIFE of the treatment group was better than that of the control group(P<0.05).(iii)The MODS of the two groups decreased significantly after treatment(P<0.05),and the degree of decrease after treatment in the treatment group was higher than that in the control group(P<0.05).(iv)There was no significant difference in all-cause mortality between the two groups(P>0.05).(v)No serious adverse events were found in both groups during the treatment period.[Conclusions]The conventional treatment,combined with the retention enema with Modified Dahuang Mudan Decoction could further reduce the inflammatory indicators,improve cardiac function,improve intestinal function and organ function,and the safety was good.

ACUPUNCTURE TREATMENT OF FEMALE OBESITY COMPLICATED WITH PREMENSTRUAL TENSION SYNDROME

Objective： To explore mechanisms of acupuncture for the treatment of obesity complicated with prernenstrual tension syndrome （PTS）. Methods： By means of syndrome-differentiation, 45 female simple obese （SO） patients with PTS （SO＋ PTS group and 35 simple obesity patients （SO group） were treated with body acupuncture combined with ear acupuncture. Thirtythree normal women subjects were assigned to control group. Changes in symptoms, signs, obesity index, clinical indices of disease and syndrome, equilibrium index of the vegetative nervous system （Y value）, blood estradiol （E2）, progesterone （P）, aldosterone （Aid） and lipid levels were detected and compared before and after the treatment. Results： Before acupuncture treatmerit, the obesity index, clinical indices of disease and syndrome, Y value, E2/P ratio and Aid in these patients were obviously increased, and E2 and P levels decreased. After the treatment, the body weight of the patients was reduced, and the increased obesity index, clinical indices of diseases and syndromes, Y value, E2/P ratio and Aid were markedly lowered （P〈0.05, or P 〈 0.01）, and the decreased E2 and P levels elevated significantly （P〈 0.01）. Conclusion： Acupuncture exerts favorable regulative function on clinical indices of disease and syndrome, Y value, E2, P, Aid, lipid and E2/P in obese patients with PTS, which may be related to its resultant improvement of the functions of the hypothalamo-pituitary-gonedal axis, hypothalamo-pituitary-adrenal axis and the vegetative nervous system.

Study on treatment and nursing of elderly patients with gastric cancer complicated with diabetes

Objective To study and analyze the treatment and nursing of elderly patients with gastric cancer complicated with diabetes.Methods:different data were analyzed and summarized.Conclusion:the elderly patients with gastric cancer and diabetes can cooperate with the control of blood glucose during the surgical treatment,and strengthen the nursing before and after the operation.

Clinical Analysis of Placenta Previa Complicated with Previous Caesarean Section

Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period. Results There was no difference in the mean age (28.9±3.6 vs. 28.1±4.5 years) and the average gravidity (2.35±1.48 vs. 2.21±1.53) between RCS group and FCS group (all P>0.05). The RCS group had more preterm births (24.1% vs. 13.2%), complete placenta previa (55.2% vs. 4.9%), placenta accreta (34.5% vs. 2.5%), more blood loss during caesarean section (1412±602 vs. 648±265 mL), blood transfusion (51.7% vs. 4.9%), disseminated intravascular coagulation (13.8% vs. 2.1%), and obstetric hysterectomy (13.8% vs. 0.8%) than the FCS group (all P<0.05). The preterm infant rate (30.0% vs. 13.0%), neonatal asphyxia rate (10.0% vs. 4.9%), and perinatal mortality rate (6.7% vs. 0.4%) of the RCS group were higher than those of the FCS group (all P<0.05). Conclusions More patients had complete placenta previa and placenta accreta, postpartum hemorrhage, transfusion, uterine packing, obstetric hysterectomy, and perinatal morbidity in the placenta previa patients with previous caesarean section. The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.

Acute necrotizing pancreatitis complicated with pancreatic pseudoaneurysm of the superior mesenteric artery: A case report

Acute necrotizing pancreatitis complicated with pancreatic pseudoaneurysm is a rare emergency associated with high mortality that demands immediate treatment to save the patient’s life. We treated a 64-year-old man who presented with a bleeding pseudoaneurysm of the superior mesenteric artery caused by acute pancreatitis, using interventional embolizing therapy. In the present report we show that interventional treatment is an effective therapeutic modality for patients with acute necrotizing pancreatitis complicated with intra-abdominal bleeding.

Comparison of efficacy and safety between late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy for cervical cancer complicated with pelvic lymph node metastasis

Objective This study aimed to compare and analyze the clinical efficacy and safety of late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy(IMRT) for cervical cancer complicated with pelvic lymph node metastasis. Methods Sixty patients with cervical cancer complicated with pelvic lymph node metastasis who were admitted to our hospital from January 2013 to January 2015 were enrolled. The patients were randomly divided into the late-course dose-increasing IMRT group and the simultaneous integrated dose-increasing IMRT group, with 30 cases included in each group, respectively. All patients were concurrently treated with cisplatin. After treatment, the clinical outcomes of the two groups were compared. Results The remission rate of symptoms in the simultaneous integrated dose-increasing IMRT group was significantly higher than that in the late-course dose-increasing IMRT group(P < 0.05). The follow-up results showed that the overall survival time, progression-free survival time, and distant metastasis time of patients in the simultaneous integrated dose-increasing IMRT group were significantly longer than those in the late-course dose-increasing IMRT group(P < 0.05). The recurrent rate of lymph nodes in the radiation field in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in the incidence of cervical and vaginal recurrence and distant metastasis between the two groups(P > 0.05). The radiation doses of Dmax in the small intestine, D1 cc(the minimum dose to the 1 cc receiving the highest dose) in the bladder, and Dmax in the rectum in the simultaneous integrated dose-increasing IMRT group were significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in intestinal D2 cc(the minimum dose to the 2 cc receiving the highest dose) between the two groups(P > 0.05). The incidence of bone marrow suppression in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group.Conclusion The application of simultaneous integrated dose-increasing IMRT in the treatment of cervical cancer patients complicated with pelvic lymph node metastasis can significantly control tumor progression, improve the long-term survival time, and postpone distant metastasis time with high safety.

Effects of Progressive Muscle Relaxation Training Combined with Emotion Nursing of Traditional Chinese Medicine on Motor Function and Quality of Life in Patients with Cerebral Stroke Complicated with Hemiplegia

OBJECTIVE: To explore the effects of progressive muscle relaxation training combined with emotion nursing of traditional Chinese medicine(TCM) on the motor function and quality of life in patients with cerebral stroke complicated with hemiplegia. METHODS: A total of 100 cases of patients with cerebral stroke complicated with hemiplegia who were admitted to Rehabilitation Medicine Department of Suzhou Municipal Hospital from May 2016 to May 2017 were selected and randomly divided into study group(50 cases) and control group(50 cases), and they were nursed for 1 month. Control group was given routine nursing, and study group was given progressive muscle relaxation training combined with TCM emotion nursing on the basis of routine nursing. The scores of all items were obtained by nurses through questionnaires, and the motor function and quality of life were analyzed and compared between the 2 groups. RESULTS: After nursing, the scores of muscle strength, Barthel index(BI) and Fugl-Meyer motor function scales in study group were higher than those in control group(P < 0.05). The facing scores of coping style in study group were higher than those in control group, and the avoidance score and yielding score were lower than those in control group(P < 0.05). The scores of depression and anxiety in study group were lower than those in control group(P < 0.05). The scores of items in SF-36 life scale in study group were higher than those in control group(P < 0.05). CONCLUSION: Progressive muscle relaxation training combined with TCM emotion nursing is conducive to the recovery of motor function and improvement of quality of life in patients with cerebral stroke complicated with hemiplegia.

On-treatment isolated superior ophthalmic vein thrombosis complicated with carotid cavernous fistula: a case report

Dear Editor, We are writing this letter to present a case of ontreatment isolated superior ophthalmic vein thrombosis(SOVT) that progressed to cavernous sinus thrombosis(CST) and further complicated with carotid cavernous fistula(CCF). SOVT is a rare but potentially lethal illness. It is normally presented with orbital congestion syndrome with proptosis, ophthalmoplegia, diplopia, and high intraocular pressure(IOP)[1]. Late detection of this disease can lead to devastating complications such as optic nerve compression。

Clinical efficacy and significance of serum fibroblast growth factor-21 and ghrelin in the treatment of type 2 diabetes complicated with coronary heart disease with integrated traditional Chinese and western medicine

Objective: To treat the patients with type 2 diabetes mellitus complicated with coronary heart disease, to explore the clinical efficacy and mechanism of conventional western medicine combined with Yiqi Yangyin Huoxue herbs, and to detect the level of serum fibroblast growth factor-21 (FGF-21) and Ghrelin. Changes and significance. Methods: A randomized control method was used to collect 100 patients with type 2 diabetes mellitus complicated with coronary heart disease who were diagnosed and treated in our hospital from March 2015 to March 2018.They were randomly divided into two groups according to the random number table method: 50 patients separately. The patients in the control group were treated with conventional western medicine and basic treatment;the observation group was treated with the addition and subtraction of traditional Chinese medicine formulas on the basis of the control group;the clinical curative effect was evaluated after two months of treatment, and the treatment efficiency and scores of traditional Chinese medicine symptoms were observed in the two groups. Basic laboratory indicators were improved, and serum levels of FGF-21 and Ghrelin in patients were measured and the difference between the results of the tests was compared with the condition and efficacy. Results: After treatment, the total effective rate of the observation group (86.0%) was significantly higher than that of the control group (68.0%) (P<0.05), suggesting that the combination of Chinese and Western medicine treatment can significantly improve the clinical efficacy;before treatment,there is no difference between the two groups of Chinese medicine symptom scores (P>0.05). After treatment, the symptom scores of the two groups were significantly improved after treatment (P<0.05). The observation group was better among the two groups (P<0.05).After treatment, the basic biochemical indicators were improved. The observation group was better than the control group (P<0.05);Serum FGF-21 levels were significantly lower in both groups after treatment (P<0.05), and Ghrelin levels were significantly increased. There was a statistically significant difference between the two groups (P<0.05). Conclusion: The use of conventional western medicine in combination with Yiqi Yangyin Huoxue Chinese medicine for the treatment of type 2 diabetes mellitus patients with coronary heart disease can significantly improve the clinical efficacy, effectively promote the improvement of symptoms, and can be used in clinical work through serum FGF-21, Ghrelin levels combined detection of the value of Abnormal changes to predict the severity of type 2 diabetes mellitus with coronary heart disease severity and treatment effect should be widely used in clinical diagnosis and treatment.

Pulp health and calcific healing of a complicated crown–root fracture with additional root fracture in a maxillary incisor: A case report

BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and teenagers, but the maintenance of pulphealth and the calcific healing of multiple root fractures are rarely reported in theliterature.CASE SUMMARY This case reports healing of a permanent tooth with complicated crown–root andadditional root fractures, in which pulp health was maintained. A 10-year-old girlfell and fractured the root of her maxillary left central incisor at the cervical level.After the coronal fragment was repositioned, the tooth was splinted until thetooth was no longer mobile, 2 years later. Eight years after treatment, the toothhas remained asymptomatic with vital pulp and localized gingival overgrowth.Cone-beam computed tomography revealed not only calcified healing of the CRFbut also spontaneous healing in an additional undiagnosed root fracture. Thefracture line on the enamel could not be healed by hard tissue and formed agroove in the cervical crown. It was speculated that the groove was related to thelocalized gingival overgrowth.CONCLUSION This case provides a clinical perspective of the treatment of a tooth with acomplicated CRF and an additional root fracture.

Split liver transplantation with complicated portal vein variations in graft

To the Editor:Liver transplantation(LT)is the most effective method for endstage liver disease.Split liver transplantation(SLT)is an effective method to enlarge the number of liver grafts.However,because of the existence of portal vein variations,right hemi-grafts splitting and recipients’portal vein(PV)reconstruction might be more challenging[1,2].According to the origins of intrahepatic PV branches,Nakamura and his coworkers[3]classified PV variants into five classes(Fig.S1):type A to E.It is reported that the standard anatomy in PV branching pattern accounts for only 65%of investigated population,and that the most common anatomic variation of main portal vein(MPV)is trifurcation variation followed by right posterior portal vein(RpPV)as a first branch of MPV[4].Type C and D variations are the two most technique highly demanding types.The variation of PV in donated liver graft still challenges surgeons,especially in the field of SLT.There is still a lack of a common sense about the modality of complicated variations in PV reconstruction.Here,we presented two complicated SLT cases,existence of type C and D PV variations in grafts,respectively.

Pregnancy Complicated With a Giant Pancreatic Tumor and Decompensation of Liver Cirrhosis:A Case Report and Literature Review

Pregnancy with solid pseudopapillary tumor of the pancreas(SPTP)is rare.Because pregnancy hormones may cause tumor progression,the management and treatment of SPTP need to balance the safety of pregnant women and fetuses with surgical treatment.We reported a case of a giant pancreatic tumor diagnosed during pregnancy that was considered to be SPTP.Examinations also showed hepatitis B virus infection and severe decompensation of liver cirrhosis.Medical termination of pregnancy was performed.The patient has lived with the tumor until now without surgery.We retrieved the published case reports,summarized the clinical characteristics of pregnancy with SPTP,and explored its management during the perinatal period.Most patients with SPTP have a good prognosis with good maternal and fetal outcomes,and it is important to choose an appropriate treatment method and timing.However,pregnancy combined with decompensated liver cirrhosis needs to be terminated in a timely manner because of its high-risk status.

Risk factors related to death in patients with tuberculosis complicated with sepsis in an intensive care unit

Objective To explore the risk factors related to death in patients with tuberculosis complicated with sepsis in an intensive care unit,in order to provide reference for the clinical treatment of patients with tuberculosis complicated with sepsis.Methods A retrospective case-control study was conducted to collect the general clinical data of 384 patients with tuberculosis complicated with sepsis in intensive care unit of Public Health Clinical Center of Chengdu from March 2020 to November 2022.

Cauda equina syndrome with urinary retention as a postoperative complication of lumbar spine surgery:A case report

BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.

Association of stent thrombectomy and conventional treatment with neuroprotection, complications, anxiety, and depression in acute ischemic stroke patients

BACKGROUND Acute ischemic stroke(AIS)is an abrupt blood flow cessation to a specific brain region within a vascular zone,causing a subsequent decline in neurological capabilities.Stent thrombectomy is a recently established technique for treating AIS.It provides the benefits of being a relatively simple and safe procedure,capable of partially enhancing a patient’s condition.However,some patients may experience endothelial damage and recurrent thrombosis,with clinical outcomes that are not always satisfactory.Hence,the efficacy of this method remains unclear.AIM To survey the association of stent thrombectomy vs standard treatment with neurological function protection,complications,and short-term prognosis in patients diagnosed with AIS.METHODS This study assigned 90 patients with AIS to the observation and control groups(n=45 patients)from December 2020 to December 2022.Stent thrombectomy was conducted in the observation group,whereas routine treatment was provided to the control group.The study assessed the therapeutic outcomes of two groups,including a comparison of their neurological function,living ability,anxiety and depression status,plaque area,serum inflammatory factors,serum Smur100βprotein,neuron-specific enolase(NSE),homocysteine(Hcy),and vascular endo-thelial function.Additionally,the incidence of complications was calculated and analyzed for each group.RESULTS The total effective rate of treatment was 77.78%and 95.56%in the control and observation groups,respectively.After 8 weeks of treatment,the scores on the National Institutes of Health Stroke Scale,Hamilton Anxiety Scale,and Hamilton Depression Scale decreased remarkably;the Barthel index increased remarkably,with better improvement effects of the scores in the observation group(P<0.05);total cholesterol,triglyceride,C-reactive protein,and plaque area lessened remarkably,with fewer patients in the observation group(P<0.05);S-100βprotein,NSE,and Hcy levels lessened remarkably,with fewer patients in the observation group(P<0.05);serum vascular endothelial growth factor and nitric oxide synthase levels increased remarkably,whereas the endothelin-1 level decreased,with better improvement effect in the observation group(P<0.05).Complications occurred in 8.88%of patients in the observation group compared with 33.33%in the control group.CONCLUSION Stent thrombectomy appeared to provide more remarkable neuroprotective effects in patients with AIS compared to the intravenous thrombolysis regimen.Additionally,it has effectively improved the neurological function,daily activities,and vascular endothelial function of patients,while reducing the incidence of complications and improving short-term prognosis.

Therapeutic effect of taurine with hypertonic saline on rat hemorrhagic shock complicated with hypernatremia

Abstract Objective To investigate the therapeutic effect of hypertonic saline (HS) and hypertonic saline with taurine (HST) hemorrhagic shock and hemorrhagic shock with hypernatremia rats. Methods Hypernatremic dehydration and hemorrhagic shock models were produced by Trachtma's and Krausz's methods in Sprague Dawley rats. Hemorrhagic changes of mean arterial blood pressure (MABP), left ventricular end diastolic pressure (LVEDP), ±dp/dtmax and heart rate (HR) were registered on polygraph. Plasma Na +, urea lactate and taurine content were assayed. Results After treatment with HS, the hemodynamic changes of hemorrhagic shock rats were significantly alleviated, and tissue fluid redistributed. When the hemorrhagic shock animals were treated with HS containing taurine (HST), in comparison with HS treatment, the hemodynamic improvement and hemodilution were more obvious. When the hemorrhagic animals complicated with hypernatremia were treated with HS, the symptoms of dehydration and shock further deteriorated, when the hemorrhage with hypernatremia animals were treated with an infusion of HST, the symptoms of dehydration and shock were significantly ameliorated. Conclusion The therapeutic effect of HS with taurine is obviously better than HS alone. So when hemorrhagic shock was complicated with hypernatremia, HS with taurine is recommended in stead of HS alone.