Acute Transverse Myelitis in Pregnancy—A Case Report and a Literature Review

Purpose: This case report highlights a rare instance of a 26-week pregnant woman presenting with limb numbness, diagnosed with acute transverse myelitis (ATM) following COVID-19 vaccination. Notably, she tested positive for neuromyelitis optica (NMO) but did not exhibit the typical symptoms of blurred vision. Methods: Data were collected from I Seha in governmental hospitals in Bahrain, providing a comprehensive overview of the patient’s clinical journey. Results: The patient was treated with carbamazepine, steroids, and clexane, leading to the successful delivery of a healthy baby at 34 weeks. However, two years postpartum, she reported new episodes of blurred vision and numbness. Subsequent treatment with Rituximab resulted in significant improvement, with a diagnosis of Devic’s disease established. Conclusion: Acute transverse myelitis is a rare condition, particularly during pregnancy, and in this case, symptoms of Devic’s disease were masked by the absence of blurred vision. This condition predominantly affects females in their 20s during childbearing years and can lead to complications such as premature delivery. Effective management includes steroids and antiepileptic drugs, with clexane playing a crucial role in preventing embolisms. A delivery mode may vary based on obstetric factors, and MRI remains the gold standard for diagnosis. Close follow-up is essential for optimal patient outcomes.

Correlation between serum uric acid levels and clinical characteristics in patients with longitudinally extensive transverse myelitis A case-control study

Uric acid is reduced in demyelinating diseases, including multiple sclerosis and neuromyelitis optica （NMO）. Longitudinally extensive transverse myelitis （LETM） is often an early manifestation of NMO. Whether uric acid levels are reduced at presentation of LETM remains unknown. The present study investigated serum uric acid levels by evaluating 35 patients with LETM, 64 with NMO, 62 with multiple sclerosis, 63 with other neurological diseases and 65 healthy controls. In addition, we tested the correlation between serum uric acid and the clinical characteristics of LETM. All patients were in the acute phase, defined as less than 1 month from onset or relapse. The results revealed that serum uric acid levels in LETM were significantly lower than in multiple sclerosis, other neurological diseases and healthy controls, but no difference was found between LETM and NMO. A negative correlation between uric acid levels and Expanded Disability Status Scale scores was found in LETM patients （r = -0.545, P 〈 0.05）. The results suggest that uric acid levels are reduced in patients with LETM, raising the possibility that lower uric acid levels are an indicator of disease disability. Moreover, reduced uric acid levels may be a risk factor in NMO.

Concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis:A case report

BACKGROUND Tuberculous myelitis is a rare manifestation of tuberculosis(TB)that is usually caused by hematogenous spread of Mycobacterium tuberculosis(MTB).Neurosyphilis is a neurological disease that occurs when Treponema pallidum invades the brain or the spinal cord.Individually,these two diseases involving the spinal cord are rare and cases of concurrent tuberculous transverse myelitis and asymptomatic neurosyphilis have seldom been reported.CASE SUMMARY A 56-year-old man presented with numbness and pain of both lower limbs for 2 wk and dysuria for 1 wk.Syphilis serology and cerebrospinal fluid(CSF)analysis supported the diagnosis of neurosyphilis and the patient was treated with intravenous ceftriaxone at first,but symptoms still progressed.Then,magnetic resonance images revealed multiple lesions along the cervicothoracic junction,and chest computed tomography showed a typical TB lesion.MTB DNA was detected in the CSF sample by metagenomic next-generation sequencing.Eventually the patient was diagnosed with tuberculous myelitis combined with asymptomatic neurosyphilis.Subsequently,quadruple anti-TB drug standardized therapy was empirically used and his neurological symptoms improved gradually.CONCLUSION Patients can have coinfection with tuberculous transverse myelitis and asymptomatic neurosyphilis.Patients with neurosyphilis should be examined for other pathogens.

Transverse myelitis caused by herpes zoster following COVID-19 vaccination:A case report

BACKGROUND Transverse myelitis(TM)is characterized by sudden lower extremity progressive weakness and sensory impairment,and most patients have a history of advanced viral infection symptoms.A variety of disorders can cause TM in association with viral or nonviral infection,vascular,neoplasia,collagen vascular,and iatrogenic,such as vaccination.Vaccination has become common through the global implementation against coronavirus disease 2019(COVID-19)and reported complications like herpes zoster(HZ)activation has increased.CASE SUMMARY This is a 68-year-old woman who developed multiple pustules and scabs at the T6-T9 dermatome site 1 wk after vaccination with the COVID-19 vaccine(Oxford/AstraZeneca([ChAdOx1S{recombinant}]).The patient had a paraplegia aggravation 3 wk after HZ symptoms started.Spinal magnetic resonance imaging(MRI)showed transverse myelitis at the T6–T9 Level.Treatment was acyclovir with steroids combined with physical therapy.Her neurological function was slowly restored by Day 17.CONCLUSION HZ developed after COVID-19 vaccination,which may lead to more severe complications.Therefore,HZ treatment itself should not be delayed.If neurological complications worsen after appropriate management,an immediate diagnostic procedure,such as magnetic resonance imaging and laboratory tests,will start and should treat the neurological complications.

Cytomegalovirus Transverse Myelitis Secondary to Influenza Infection and Early Recovery:A Case Report

Immunosuppression can lead to opportunistic infections in a host.The evidence of viral infections causing immunosuppression in a host for a transient period is gaining attention.In order to prolong their stay in the human body,viruses affect the human immune systemin various ways.Common viral infections such as influenza can lead to transient lymphocytopenia,which lays the groundwork for more dangerous opportunistic infections.Cytomegalovirus(CMV)infection is a rare cause of inflammatory myelopathy.We present the case of a patient with an influenza infection who progressed to severe acute respiratory distress syndrome,methicillin-resistant Staphylococcus aureus necrotizing pneumonia,and idiopathic lymphocytopenia with a CD4 count of 61 perμL on arrival.After 2 weeks,the patient developed complete flaccid paralysis with sensory and autonomic dysfunction.Because his polymerase chain reaction results of cerebrospinal fluid and blood test were positive for CMV infection,he was treated with high doses of steroids and ganciclovir intravenously.Due to early diagnosis and intervention,the patient was able to recover in 2 months with only minimal residual weakness.Thus,this case stresses on the importance of looking out for opportunistic infections in patients affected by severe viral infections for their early recovery.

Impact of tibial transverse transport in tissue regeneration and wound healing with perspective on diabetic foot ulcers

In this editorial,we comment on an article by Liao et al published in the current issue of the World Journal of Diabetes.We focus on the clinical significance of tibial transverse transport(TTT)as an effective treatment for patients with diabetic foot ulcers(DFU).TTT has been associated with tissue regeneration,improved blood circulation,reduced amputation rates,and increased expression of early angiogenic factors.Mechanistically,TTT can influence macrophage polarization and growth factor upregulation.Despite this potential,the limitations and conflicting results of existing studies justify the need for further research into its optimal application and development.These clinical implications highlight the efficacy of TTT in recalcitrant DFU and provide lasting stimuli for tissue re-generation,and blood vessel and bone marrow improvement.Immunomodu-lation via systemic responses contributes to its therapeutic potential.Future studies should investigate the underlying molecular mechanisms to enhance our understanding and the efficacy of TTT.This manuscript emphasizes the potential of TTT in limb preservation and diabetic wound healing and suggests avenues for preventive measures against limb amputation in diabetes and peripheral artery disease.Here,we highlight the clinical significance of the TTT and its importance in healing DFU to promote the use of this technique in tissue regeneration.

Midpoint transverse process to pleura block for postoperative analgesia following laparoscopic renal cyst decortication:Two case reports

BACKGROUND The midpoint transverse process to pleura(MTP)block,a novel technique for thoracic paravertebral block(TPVB),was first employed in laparoscopic renal cyst decortication.CASE SUMMARY Thoracic paravertebral nerve block is frequently employed for perioperative analgesia during laparoscopic cyst decortication.To address safety concerns associated with TPVBs,we administered MTP blocks in two patients prior to administering general anesthesia for laparoscopic cyst decortication.The MTP block was performed at the T9 level under ultrasound guidance,with 20 mL of 0.5%ropivacaine injected.Reduced sensation to cold and pinprick was observed from the T8 to T11 dermatome levels.Immediately postoperative Numeric Pain Rating Scale scores were 0/10 at rest and on movement,with none exceeding a mean 24 h numeric rating scale>3.CONCLUSION MTP block was effective technique for providing postoperative analgesia for patients undergoing laparoscopic renal cyst decortication.

Winding Function Model-based Performance Evaluation of a PM Transverse Flux Generator for Applications in Direct-drive Systems

The magnetic flux in a permanent magnet transverse flux generator(PMTFG) is three-dimensional(3D), therefore, its efficacy is evaluated using 3D magnetic field analysis. Although the 3D finite-element method(FEM) is highly accurate and reliable for machine simulation, it requires a long computation time, which is crucial when it is to be used in an iterative optimization process. Therefore, an alternative to 3DFEM is required as a rapid and accurate analytical technique. This paper presents an analytical model for PMTFG analysis using winding function method. To obtain the air gap MMF distribution, the excitation magneto-motive force(MMF) and the turn function are determined based on certain assumptions. The magnetizing inductance, flux density, and back-electro-magnetomotive force of the winding are then determined. To assess the accuracy of the proposed method, the analytically calculated parameters of the generator are compared to those obtained by a 3D-FEM. The presented method requires significantly shorter computation time than the 3D-FEM with comparable accuracy.

Evaluation of the Clinical Advantages of Laparoscopic Transverse Abdominal Wall Suspension in the Treatment of Pelvic Organ Prolapse

Objective:To evaluate the clinical advantages of laparoscopic transverse abdominal wall suspension in treating pelvic organ prolapse.Methods:Sixty patients diagnosed with moderate to severe pelvic organ prolapse and underwent surgical treatment in our hospital between January 2022 and December 2023 were selected.According to different surgical methods,they were divided into an observation group(given laparoscopic transverse abdominal wall suspension)and a control group(given transvaginal mesh implantation),with 30 subjects/group.The data on perioperative-related indicators,quality of life scores,postoperative recurrence,and complications of the two groups of patients were collected.Results:The postoperative hospitalization days and intraoperative bleeding volume of the observation group were significantly lower than those of the control group,but had longer operation time than that of the control group(P<0.05).The differences between the two groups were statistically significant 6 months after surgery,and the Pelvic Floor Disease Quality of Life Impact Questionnaire(PFIQ-7)score of the observation group was significantly higher than the control group(P<0.05).Both groups of patients completed 12 months of follow-up without any postoperative recurrence.The number of complications in the observation group was slightly lower than that of the control group(P>0.05).Conclusion:Laparoscopic transverse abdominal wall suspension was more effective in treating pelvic organ prolapse and is an ideal surgical procedure.

Analytical solution for the effective elastic properties of rocks with the tilted penny-shaped cracks in the transversely isotropic background

Seismic prediction of cracks is of great significance in many disciplines,for which the rock physics model is indispensable.However,up to now,multitudinous analytical models focus primarily on the cracked rock with the isotropic background,while the explicit model for the cracked rock with the anisotropic background is rarely investigated in spite of such case being often encountered in the earth.Hence,we first studied dependences of the crack opening displacement tensors on the crack dip angle in the coordinate systems formed by symmetry planes of the crack and the background anisotropy,respectively,by forty groups of numerical experiments.Based on the conclusion from the experiments,the analytical solution was derived for the effective elastic properties of the rock with the inclined penny-shaped cracks in the transversely isotropic background.Further,we comprehensively analyzed,according to the developed model,effects of the crack dip angle,background anisotropy,filling fluid and crack density on the effective elastic properties of the cracked rock.The analysis results indicate that the dip angle and background anisotropy can significantly either enhance or weaken the anisotropy degrees of the P-and SH-wave velocities,whereas they have relatively small effects on the SV-wave velocity anisotropy.Moreover,the filling fluid can increase the stiffness coefficients related to the compressional modulus by reducing crack compliance parameters,while its effects on shear coefficients depend on the crack dip angle.The increasing crack density reduces velocities of the dry rock,and decreasing rates of the velocities are affected by the crack dip angle.By comparing with exact numerical results and experimental data,it was demonstrated that the proposed model can achieve high-precision estimations of stiffness coefficients.Moreover,the assumption of the weakly anisotropic background results in the consistency between the proposed model and Hudson's published theory for the orthorhombic rock.

Suppression of stimulated Brillouin and Raman scatterings using an alternating frequency laser and transverse magnetic fields

A novel scheme to suppress both stimulated Brillouin scattering(SBS) and stimulated Raman scattering(SRS) by combining an alternating frequency(AF) laser and a transverse magnetic field is proposed. The AF laser allows the laser frequency to change discretely and alternately over time. The suppression of SBS is significant as long as the AF difference is greater than the linear growth rate of SBS or the alternating time of the laser frequency is shorter than the linear growth time of SBS. However, the AF laser proves ineffective in suppressing SRS, which usually has a much higher linear growth rate than SBS. To remedy that, a transverse magnetic field is included to suppress the SRS instability. The electrons trapped in the electron plasma waves(EPWs) of SRS can be accelerated by the surfatron mechanism in a transverse magnetic field and eventually detrapped. While continuously extracting energy from EPWs, the EPWs are dissipated and the kinetic inflation of SRS is suppressed. The one-dimensional particle-in-cell simulation results show that both SBS and SRS can be effectively suppressed by combining the AF laser with a transverse magnetic field with tens of Tesla. The total reflectivity can be dramatically reduced by more than one order of magnitude. These results provide a potential reference for controlling SBS and SRS under the related parameters of inertial confinement fusion.

The Effect of Transverse Tibial Bone Transfer in the Treatment of Diabetic Foot

To analyse the effectiveness of performing a transverse tibial bone graft in the treatment of patients with diabetic foot. We retrospectively analysed the clinical details of 51 diabetic foot patients in our hospital from February 2023 to February 2024 and divided them into two groups according to the different treatment modalities, in which the control group received open debridement and the treatment group received transverse tibial bone transfer and compared the differences between the two groups. There were large differences in VAS score, Toronto Clinical Symptom Score, quality of life score, internal lumen diameter, blood flow velocity in the affected limb, perfusion volume, vascular endothelial growth factor, epidermal growth factor and CRP between the two groups after surgery (P < 0.05). Patients with diabetic foot should be treated with transverse tibial bone grafting, which is safer and more effective and can have a significant impact on improving the status of the affected limb, the inflammation and the patient’s quality of life.

Determining beam transverse absolute position by triangulation of multi-electrode signal phase differences

Accurate measurement of the transverse position of a beam is crucial in particle accelerators because it plays a key role in determining the beam parameters.Existing methods for beam-position measurement rely on the detection of image currents induced on electrodes or narrow-band wake field induced by a beam passing through a cavity-type structure.However,these methods have limitations.The indirect measurement of multiple parameters is computationally complex,requiring external calibration to determine the system parameters in advance.Furthermore,the utilization of the beam signal information is incomplete.Hence,this study proposes a novel method for measuring the absolute electron beam transverse position.By utilizing the geometric relationship between the center position of the measured electron beam and multiple detection electrodes and by analyzing the differences in the arrival times of the beam signals detected by these electrodes,the absolute transverse position of the electron beam crossing the electrode plane can be calculated.This method features absolute position measurement,a position sensitivity coefficient independent of vacuum chamber apertures,and no requirement for a symmetrical detector electrode layout.The feasibility of this method is validated through numerical simulations and beam experiments.

Early postoperative complications after transverse colostomy closure,a retrospective study

BACKGROUND Ostomy is a common surgery usually performed to protect patients from clinical symptoms caused by distal anastomotic leakage after colorectal cancer(CRC)surgery and perforation or to relieve intestinal obstruction.AIM To analyze the complications after transverse colostomy closure.METHODS Patients who underwent transverse colostomy closure from Jan 2015 to Jan 2022 were retrospectively enrolled in a single clinical center.The differences between the complication group and the no complication group were compared.Logistic regression analyses were conducted to find independent factors for overall complications or incision infection.RESULTS A total of 102 patients who underwent transverse colostomy closure were enrolled in the current study.Seventy(68.6%)patients underwent transverse colostomy because of CRC related causes.Postoperative complications occurred in 30(29.4%)patients and the most frequent complication occurring after transverse colostomy closure was incision infection(46.7%).The complication group had longer hospital stays(P<0.01).However,no potential risk factors were identified for overall complications and incision infection.CONCLUSION The most frequent complication occurring after transverse colostomy closure surgery in our center was incision infection.The operation time,interval from transverse colostomy to reversal,and method of anastomosis might have no impact on the postoperative complications.Surgeons should pay more attention to aseptic techniques.

Laminated Solid Timber Slab with Transverse Prestressing Using the Strategy of Interleaved Vertical Displacement of Lamellae

This article presents a study on the structural behavior of transversely prestressed laminated timber slabs,focusing on an innovative approach:vertically misaligned lamellae.This misalignment,achieved by sliding vertically the wooden lamellae rather than aligning them,enhances the slab’s cross-section moment of inertia,thereby improving load-bearing capacity and stiffness.Testing involved two groups of structural size specimens:one with vertically aligned lamellae(control group)and the other with misaligned lamellae(study group).Results showed the study group exhibited 42%superior stiffness and 10%less load capacity compared to the control.Failures typically occurred individually in the lamellae,particularly in those with defects or lower modulus of elasticity,concentrated in the middle third of the slabs’free span where tensile stresses peak.Despite a higher number of failed lamellae,the study group demonstrated promising performance.Analysis of prestressing bar indicated no damage at all in the thread,suggesting potential for reducing bar diameter.These findings offer crucial insights into applying these slabs in timber construction as well as to any kind of construction.

Analyzing the Form-Finding of a Large-Span Transversely Stiffened Suspended Cable System: A Method Considering Construction Processes

The precise control of the shape of transversely stiffened suspended cable systems is crucial. However, existing form-finding methods primarily rely on iterative calculations that treat loads as fixed known conditions. These methods are inefficient and fail to accurately control shape results. In this study, we propose a form-finding method that analyzes the load response of models under different sag and stress levels, taking into account the construction process. To analyze the system, a structural finite element model was established in ANSYS, and geometric nonlinear analysis was conducted using the Newton-Raphson method. The form-finding analysis results demonstrate that the proposed method achieves precise control of shape, with a maximum shape error ranging from 0.33% to 0.98%. Furthermore, the relationships between loads and tension forces are influenced by the deformed shape of the structures, exhibiting significant geometric nonlinear characteristics. Meanwhile, the load response analysis reveals that the stress level of the self-equilibrium state in the transversely stiffened suspended cable system is primarily governed by strength criteria, while shape is predominantly controlled by stiffness criteria. Importantly, by simulating the initial tensioning process as an initial condition, this method solves for a counterweight that satisfies the requirements and achieves a self-equilibrium state with the desired shape. The shape of the self-equilibrium state is precisely controlled by simulating the construction process. Overall, this work presents a new method for analyzing the form-finding process of large-span transversely stiffened suspended cable system, considering the construction process which was often overlooked in previous studies.

Transverse myelitis after infection with varicella zoster virus in patient with normal immunity: A case report

BACKGROUND Varicella zoster virus(VZV)is a human neurotropic and double-stranded DNA alpha-herpes virus.Primary infection with VZV usually occurs during childhood,manifesting as chickenpox.Reactivation of latent VZV can lead to various neurological complications,including transverse myelitis(TM);although cases of the latter are very rare,particularly in newly active VZV infection.CASE SUMMARY We report here an unusual case of TM in a middle-aged adult immunocompetent patient that developed concomitant to an active VZV infection.The 46-year-old male presented with painful vesicular eruption on his left chest that had steadily progressed to involvement of his back over a 3-d period.Cerebrospinal fluid testing was denied,but findings from magnetic resonance imaging and collective symptomology indicated TM.He was administered antiviral drugs and corticosteroids immediately but his symptom improvement waxed and waned,necessitating multiple hospital admissions.After about a month of repeated treatments,he was deemed sufficiently improved for hospital discharge to home.CONCLUSION VZV myelitis should be suspected when a patient visits the outpatient pain clinic with herpes zoster showing neurological symptoms.

Influence of ganglioside combined with methylprednisolone sodium succinate on efficacy and neurological function in patients with acute myelitis

BACKGROUND Acute myelitis(AM)can lead to sudden sensory,motor and autonomic nervous dysfunction,which negatively affects their daily activities and quality of life,so it is necessary to explore optimization from a therapeutic perspective to curb the progression of the disease.AIM To investigate the effect of ganglioside(GM)combined with methylprednisolone sodium succinate(MPSS)on the curative effect and neurological function of patients with AM.METHODS First,we selected 108 AM patients visited between September 2019 and September 2022 and grouped them based on treatment modality,with 52 patients receiving gamma globulin(GG)+MPSS and 56 patients receiving GM+MPSS,assigned to the control group(Con)and observation group(Obs),respectively.The therapeutic effect,neurological function(sensory and motor function scores),adverse events(AEs),recovery(time to sphincter function recovery,time to limb muscle strength recovery above grade 2,and time to ambulation),inflammatory factors(IFs)[interleukin(IL)-6,C-reactive protein(CRP),and tumor necrosis factor(TNF)-α]and other data of the two groups were collected for evaluation and comparison.RESULTS The Obs had:(1)A significantly higher response rate of treatment than the Con;(2)Higher scores of sensory and motor functions after treatment that were higher than the baseline(before treatment)and higher than the Con levels;(3)Lower incidence rates of skin rash,gastrointestinal discomfort,dyslipidemia,osteoporosis and other AEs;(4)Faster posttreatment recovery of sphincter function,limb muscle strength and ambulation;and(5)Markedly lower posttreatment IL-6,CRP and TNF-αlevels than the baseline and the Con levels.CONCLUSION From the above,it can be seen that GM+MPSS is highly effective in treating AM,with a favorable safety profile comparable to that of GG+MPSS.It can significantly improve patients’neurological function,speed up their recovery and inhibit serum IFs.

Early hemodynamics after tibial transverse transport in patients with nonarterial stenosis and arterial stenosis diabetic foot

BACKGROUND The diagnosis of peripheral arteriopathy in the diabetic foot is complicated by diabetes and its advanced complications.It has been found that diabetic foot can be categorized into arterial stenosis and non-arterial stenosis,both of which have significant differences in hemodynamic characteristics.AIM To evaluate the early hemodynamic changes in diabetic foot patients with nonarterial stenosis and arterial stenosis treated by tibial transverse transport(TTT)using high-frequency color Doppler ultrasonography(HFCDU)and a laser Doppler flowmeter.METHODS Twenty-five patients with Wagner grades 3-5 diabetic foot ulcers were treated with TTT,and the wound healing time and rate were recorded.Patients were grouped according to the results of preoperative lower-extremity ultrasonography.Cases with≥50%stenosis in any of the femoral,popliteal,posterior tibial,anterior tibial,and peroneal arteries of the affected limb were classified as the arterial stenosis group(n=16);otherwise,they were classified as the nonarterial stenosis group(n=9).Before and one month after surgery,HFCDU was used to evaluate the degree of lower limb artery lesions and hemodynamic changes in patients.The degree of femoral-popliteal atherosclerotic stenosis,the degree of vascular stenosis and occlusion of the lower-knee outflow tract,and the degree of medial arterial calcification were scored;the three scores were added together to obtain the total score of lower extremity arteriopathy.PeriScanPIM3,a laser Doppler flowmeter system,was used to detect alterations in plantar microcirculation before and 1 mo after surgery.Wound healing and hemodynamic indices were compared between the two groups.RESULTS The wound healing time of the diabetic foot was significantly shorter in the nonarterial stenosis group than in the arterial stenosis group(47.8±13 vs 85.8±26,P<0.05),and the wound healing rate of both groups was 100%.The preoperative total lower extremity arteriopathy scores were lower in the nonarterial stenosis group than those in the arterial stenosis group(18.89±8.87 vs 24.63±3.52,P<0.05).The nonarterial stenosis group showed higher preoperative popliteal artery(POA)blood flow than the arterial stenosis group(204.89±80.76 cc/min vs 76.75±48.49 cc/min,P<0.05).Compared with the baseline(before surgery),the postoperative POA blood flow of the affected limb in the nonarterial stenosis group decreased one month after surgery(134.11±47.84 cc/min vs 204.89±80.76 cc/min,P<0.05),while that in the arterial stenosis group increased(98.44±30.73 cc/min vs 61.69±21.70 cc/min,P<0.05).Although the POA blood flow in the arterial stenosis group was obviously improved one month after surgery,it was still lower than that in the nonarterial stenosis group(98.44±30.73 cc/min vs 134.11±47.84 cc/min,P<0.05).The nonarterial stenosis group had higher preoperative plantar microcirculation than the arterial stenosis group(56.1±9.2 vs 33.2±7.5,P<0.05);compared with the baseline,the plantar microcirculation in the arterial stenosis group was significantly improved one month after surgery(51.9±7.2,P<0.05),while that in the nonarterial stenosis group was reduced(35.9±7.2,P<0.05).CONCLUSION Based on preoperative HFCDU findings,diabetic foot patients can be divided into two categories:Those with nonarterial stenosis and those with arterial stenosis,with obvious differences in hemodynamic changes in the early postoperative period between them.In the early stage after TTT,the blood flow volume and velocity and the plantar microcirculation perfusion of the affected limb of the diabetic foot with nonarterial stenosis decreased compared with the baseline,while those of the diabetic foot with arterial stenosis improved significantly compared with the baseline,although both had smoothly healed diabetic foot ulcers.

A Case of Acute Upper Gastrointestinal Bleeding in Liver Cirrhosis Complicated by Acute Cerebral Infarction and Acute Myelitis

Background: Acute upper gastrointestinal bleeding in liver cirrhosis combined with acute cerebral infarction is uncommon in clinical work, and then combined with acute myelitis is even rarer and more complex, which poses a greater challenge to clinical diagnosis and treatment. This paper reports a case of acute upper gastrointestinal bleeding in liver cirrhosis complicated by acute cerebral infarction and acute myelitis, which be hoped to provide a reference for clinical work. Methods: We retrospectively evaluated the clinical information of a 68-year-old female admitted to the Digestive Medical Department with acute gastrointestinal bleeding and appeared limb movement disorder on the third day. Results: The patient was eventually diagnosed with acute upper gastrointestinal bleeding in liver cirrhosis complicated by acute cerebral infarction and acute myelitis. Conclusions: When patients with liver cirrhosis have abnormal neurological symptoms, in addition to liver cirrhosis-related complications, doctors need to consider cerebrovascular diseases and myelitis.