Over the years immunotherapy has demonstrably improved the field of cancer treatment.However,achieving long-term survival for colorectal cancer(CRC)patients remains a significant unmet need.Combination immunotherapies...Over the years immunotherapy has demonstrably improved the field of cancer treatment.However,achieving long-term survival for colorectal cancer(CRC)patients remains a significant unmet need.Combination immunotherapies incor-porating targeted drugs like MEK or multi-kinase inhibitors have offered some palliative benefit.Nevertheless,substantial gaps remain in the current therapeutic armamentarium for CRC.In recent years,there has been a surge of interest in exploring novel treatment strategies,including the application of light-activated drugs in conjunction with optical devices.This approach holds promise for achie-ving localized and targeted delivery of cytotoxic agents,such as microtubule-targeting drugs,directly to cancerous cells within the colon.展开更多
The Journal of Human Rights publishes original works in law,philosophy,political science and other disciplines which deal with concepts,measurement tools and policy alternatives from human rights perspectives.Please s...The Journal of Human Rights publishes original works in law,philosophy,political science and other disciplines which deal with concepts,measurement tools and policy alternatives from human rights perspectives.Please submit your manuscripts to the following e-mail address:JHRsubmissions@cupl.edu.cn.展开更多
A textbook, Economic, Social and Cultural Rights (second revised edition), has been translated into Chinese under the sponsorship of the China Society for Human Rights Studies and published by the Sichuan People’s Pu...A textbook, Economic, Social and Cultural Rights (second revised edition), has been translated into Chinese under the sponsorship of the China Society for Human Rights Studies and published by the Sichuan People’s Publishing House.展开更多
BACKGROUND Hypertrophic scars(HSs)formation is a complication that occurs after wounds heal with secondary intention and sometimes after clean surgical incisions.Many treatments are in vogue now with varying successes...BACKGROUND Hypertrophic scars(HSs)formation is a complication that occurs after wounds heal with secondary intention and sometimes after clean surgical incisions.Many treatments are in vogue now with varying successes.Although the mechanism or mechanisms that cause a HS to form are not clearly understood,one thing that is clear is that once scar tissue matures,any intervention will not be successful.In this paper,we report on a case where a patient who was known to develop HS was treated with a new combination of ingredients(Phyto-chemicals+Silicone JUMI)to suppress HS formation.CASE SUMMARY A 68-year-old female of African descent presented a severe HS post total knee replacement(TKR),which the patient describes as itchy and painful.Due to complications caused by the scar,she was apprehensive about undergoing TKR on her other knee.However,after the TKR of the contralateral side post-removal of skin clips,JUMI anti-scar cream(JASC)was used to suppress excessive scar formation.CONCLUSION JASC appears potent and efficacious at suppressing excessive scar formation.We believe that this warrants further studies on larger patient groups and on different surgical sites.展开更多
BACKGROUND Inflammatory pseudotumor(IPT)is a rare and benign lesion that mimics malignancy and can develop in any part of the body.The pathophysiology and etiology of these quasineoplastic lesions remain unclear.CASE ...BACKGROUND Inflammatory pseudotumor(IPT)is a rare and benign lesion that mimics malignancy and can develop in any part of the body.The pathophysiology and etiology of these quasineoplastic lesions remain unclear.CASE SUMMARY We report a case of a 65-year-old male who presented with fevers,night sweats,and unintentional weight loss following an influenza infection and was found to have multiple hepatic IPT’s following an extensive work up.CONCLUSION Our case highlights the importance of considering hepatic IPT’s in the differential in a patient who presents with symptoms and imaging findings mimicking malignancy shortly following a viral infection.展开更多
Periprosthetic joint infection(PJI)following total knee arthroplasty is one of the most catastrophic and costly complications that carries significant patient wellness as well as economic burdens.The road to efficient...Periprosthetic joint infection(PJI)following total knee arthroplasty is one of the most catastrophic and costly complications that carries significant patient wellness as well as economic burdens.The road to efficiently diagnosing and treating PJI is challenging,as there is still no gold standard method to reach the diagnosis as early as desired.There are also international controversies with respect to the best approach to manage PJI cases.In this review,we highlight recent advances in managing PJI following knee arthroplasty surgery and discuss in depth the two-stage revision method.展开更多
BACKGROUND Gastrointestinal stromal tumors(GISTs)are the most frequent mesenchymal tumors of gastrointestinal tract.The most common sites of metastases are the liver and the peritoneum,whereas breast metastases from G...BACKGROUND Gastrointestinal stromal tumors(GISTs)are the most frequent mesenchymal tumors of gastrointestinal tract.The most common sites of metastases are the liver and the peritoneum,whereas breast metastases from GIST are extremely rare.We present a second case of GIST breast metastasis.CASE SUMMARY We found a case of breast metastasis from rectum GIST.A 55-year-old female patient presented with rectum tumor with multiply liver lesions and metastasis in the right breast.Abdominal-perineal extirpation of rectum was performed,histology and immunohistochemistry study showed GIST,mixed type with CD117 and DOG-1 positive staining.The patient was taking imatinib 400 mg for 22 mo with stable disease.Because of growth of the breast metastasis the treatment was changed twice:The dose of imatinib was doubled with further progression in the breast lesion and then the patient was receiving sunitinib for 26 mo with partial response in the right breast and stable disease in the liver lesions.The breast lesion increased and right breast resection was done–surgery on local progression,the liver metastases were stable.Histology and immunohistochemistry studies revealed GIST metastasis,CD 117 and DOG 1 positive with KIT exon 11 mutation.After surgery the patient resumed imatinib.Until now the patient has been taking imatinib 400 mg for 19 mo without progression,last follow up was in November 2022.CONCLUSION GISTs breast metastases are extremely rare,we described the second case.At the same time second primary tumors have been reported frequently in patients diagnosed with GISTs and breast cancer is one of the most common second primary tumors in patients with GISTs.That is why it is very important to distinguish primary from metastatic breast lesions.Surgery on local progression made it possible to resume less toxic treatment.展开更多
BACKGROUND Congenital transverse deficiencies are horizontal deficiencies of the long bones that occur with a reported incidence as high 0.38%.They can occur alone or represent a manifestation of a various clinical sy...BACKGROUND Congenital transverse deficiencies are horizontal deficiencies of the long bones that occur with a reported incidence as high 0.38%.They can occur alone or represent a manifestation of a various clinical syndromes.Diagnosis has tradi-tionally comprised of conventional radiography and prenatal imaging studies.There has been much advancement regarding prenatal imaging modalities to allow for early diagnosis and appropriate treatment.AIM To summarize the current state of knowledge on congenital transverse limb deficiencies and to provide an update regarding the radiographic evaluation of congenital transverse limb deficiencies.METHODS This IRB-exempt scoping review followed the PRISMA-ScR checklist for scoping reviews strictly.Five search engines were searched for a total of 265 publications.Four authors reviewed these during the screening process.Of these,51 studies were included in our article.Prenatal magnetic resonance imaging(MRI),3D Ultrasound,and multidetector Computed tomography(CT)exist are emerging modalities that have the potential to improve diagnosis.RESULTS Use of the appropriate classification system,three-dimensional ultrasonography with a maximum intensity projection,and appropriate use of prenatal MRI and prenatal CT can improve diagnosis and inter-provider communication.CONCLUSION Further scholarly efforts are required to develop improve standardized guidelines regarding the pre-natal radiographic evaluation of congenital limb deficiencies.展开更多
Melatonin is widely available as a supplement,usually for sleep disorders.The consumption of melatonin supplements has increased considerably in recent years.An overlooked aspect of melatonin’s administration is the ...Melatonin is widely available as a supplement,usually for sleep disorders.The consumption of melatonin supplements has increased considerably in recent years.An overlooked aspect of melatonin’s administration is the resulting increase in prolactin secretion,via its action on hypothalamic dopaminergic neurons.We believe that since the effect of melatonin on prolactin is tangible,the laboratory finding of hyperprolactinemia could be encountered more often,given the increase in melatonin’s use.This is an issue that merits further study.展开更多
BACKGROUND Spilled gallstones from previous cholecystectomy is not an uncommon situation.It may further mimic neoplastic disease and can be misled by fluorine 18 fluorodeoxyglucose position emission tomography with co...BACKGROUND Spilled gallstones from previous cholecystectomy is not an uncommon situation.It may further mimic neoplastic disease and can be misled by fluorine 18 fluorodeoxyglucose position emission tomography with computed tomography([18F]FDG PET/CT).CASE SUMMARY A 63 year-old patient was diagnosed with a cancer of the cervix.Pretreatment[18F]FDG PET/CT showed a peritoneal lesion suspicious for metastasis.Surgical exploration and histologic examination revealed the lesion to be a spilled gallstone from a previous cholecystectomy.CONCLUSION[18F]FDG PET/CT carries pitfalls since benign conditions such as intraperitoneal gallstones may be confused as malignant lesions.This case highlights the importance to be aware of the possible implications of dropped gallstones for the future,minimize its occurrence,and make all efforts to properly evaluate cancer staging,particularly for the cervix cancer.展开更多
BACKGROUND Bibliometric analysis can be used to assess the current state of the literature and publication trends on a given topic.There has not been a review of this kind on prostatic artery embolization(PAE)for beni...BACKGROUND Bibliometric analysis can be used to assess the current state of the literature and publication trends on a given topic.There has not been a review of this kind on prostatic artery embolization(PAE)for benign prostatic hyperplasia(BPH).PAE is a relatively new and somewhat controversial treatment option for BPH.Given the novelty and controversy,there has been much research published on the topic recently.AIM To survey the current state of research on PAE for BPH by using bibliometric analysis to analyze the top 50 most highly cited articles.METHODS A cross-sectional study was performed using the Web of Science database to identify the most cited articles published on PAE for BPH as of June 2022.Articles that did not primarily focus on PAE or BPH as an indication were eliminated.The 50 most cited articles were carried forward for analysis.RESULTS All but 6 articles were published in the last decade with contributions from 15 countries.Fifty-two percent of the studies had a C level of evidence.The majority were published in the Journal of Vascular and Interventional Radiology and Cardiovascular and Interventional Radiology.Twenty percent(n=10)of the articles were published in urologic journals.On average,articles published in urologic journals tended to be more recent.The mean year of publication for an article in a urological journal was 2016.6 compared to 2013.9 in a non-urologic journal(P=0.02).Seventy percent of the articles focused on clinical outcomes,while only 2%focused on practice guidelines.Self-citations accounted for 11.4 citations perarticle on average,corresponding to 14.7%of all citations analyzed.CONCLUSION The most influential papers on this topic represent a fairly recent body of work with contributions from a wide variety of countries and journals.The fact that articles in urologic journals were published significantly more recently than articles on the list in non-urologic journals may suggest that the field of urology is starting to accept PAE for a wider range of indications.Finally,while there has been much high-quality research published,more influential studies on practice guidelines and technique may be beneficial.展开更多
Hematopoietic stem cell transplantation(HSCT)becomes a standard form of cellular therapy for patients with malignant diseases.HSCT is the first-choice of immunotherapy,although HSCT can be associated with many complic...Hematopoietic stem cell transplantation(HSCT)becomes a standard form of cellular therapy for patients with malignant diseases.HSCT is the first-choice of immunotherapy,although HSCT can be associated with many complications such as graft-versus-host disease(GVHD)which is a major cause of morbidity and mortality after allogeneic HSCT.It has been shown that certain gut microbiota could exert protective and/or regenerative immunomodulatory effects by the production of short-chain fatty acids(SCFAs)such as butyrate in the experimental models of GVHD after allogeneic HSCT.Loss of gut commensal bacteria which can produce SCFAs may worsen dysbiosis,increasing the risk of GVHD.Expression of G-protein coupled receptors such as GPR41 seems to be upre-gulated in the presence of commensal bacteria,which might be associated with the biology of regulatory T cells(Tregs).Treg cells are a suppressive subset of CD4 positive T lymphocytes implicated in the prevention of GVHD after allogeneic HSCT.Here,we discuss the current findings of the relationship between the modification of gut microbiota and the GVHD-related immunity,which suggested that tactics with certain probiotics for the beneficial symbiosis in gut-immune axis might lead to the elevation of safety in the allogeneic HSCT.展开更多
BACKGROUND Pulsatile tinnitus(PT)is a potentially disabling symptom that has received increasing attention.Multiple causes of PT have been confirmed by targeted treatment.However,dynamic changes of related structures ...BACKGROUND Pulsatile tinnitus(PT)is a potentially disabling symptom that has received increasing attention.Multiple causes of PT have been confirmed by targeted treatment.However,dynamic changes of related structures in PT patients with multiple causes after stenting for ipsilateral transverse sinus stenosis(TSS)have not been previously reported.We report such a case and present postoperative computed tomography venography(CTV)follow-up findings to demonstrate the decreased sigmoid sinus diverticulum and bone remodeling.CASE SUMMARY A 45-year-old man suffered from left-sided PT for 15 years that was occasionally accompanied by headache and dizziness.Pre-operative CTV revealed left-sided sigmoid sinus wall anomalies(SSWAs),TSS,outflow dominance,large posterior condylar emissary vein,and an empty sella turcica.A cerebrospinal fluid pressure of 270 mmH2O was further detected.The sound disappeared immediately after stenting for ipsilateral TSS,with no recurrence during 2 years of follow-up.After the procedure,the patient underwent four consecutive CTV examinations.The diverticulum decreased 6 mo after the procedure with new bone remodeling.The density of the remodeled bone was further increased 1 year later,and a hardened edge was formed 2 years later.CONCLUSION PT associated with SSWAs,TSS,and idiopathic intracranial hypertension can be cured by stenting for TSS alone.And bone remodeling around SSWAs is a more significant finding.展开更多
BACKGROUND Hepatitis B e antigen-negative chronic hepatitis B patients under nucleos(t)ids analogues(NAs)rarely achieve hepatitis B surface antigen(HBsAg)loss.AIM To evaluate if the addition of pegylated interferon(Pe...BACKGROUND Hepatitis B e antigen-negative chronic hepatitis B patients under nucleos(t)ids analogues(NAs)rarely achieve hepatitis B surface antigen(HBsAg)loss.AIM To evaluate if the addition of pegylated interferon(Peg-IFN)could decrease HBsAg and hepatitis B core-related antigen(HBcrAg)levels and increase HBsAg loss rate in patients under NAs therapy.METHODS Prospective,non-randomized,open-label trial evaluating the combination of Peg-IFN 180μg/week plus NAs during forty-eight weeks vs NAs in monotherapy.Hepatitis B e antigen-negative non-cirrhotic chronic hepatitis B patients of a tertiary hospital,under NAs therapy for at least 2 years and with undetectable viral load,were eligible.Patients with hepatitis C virus,hepatitis D virus or human immunodeficiency virus co-infection and liver transplanted patients were excluded.HBsAg and HBcrAg levels(log10 U/mL)were measured at baseline and during ninety-six weeks.HBsAg loss rate was evaluated in both groups.Adverse events were recorded in both groups.The kinetic of HBsAg for each treatment group was evaluated from baseline to weeks 24 and 48 by the slope of the HBsAg decline(log10 IU/mL/week)using a linear regression model.RESULTS Sixty-five patients were enrolled,61%receiving tenofovir and 33%entecavir.Thirty-six(55%)were included in Peg-IFN-NA group and 29(44%)in NA group.After matching by age and treatment duration,baseline HBsAg levels were comparable between groups(3.1 vs 3.2)(P=0.25).HBsAg levels at weeks 24,48 and 96 declined in Peg-IFN-NA group(-0.26,-0.40 and-0.44)and remained stable in NA group(-0.10,-0.10 and-0.10)(P<0.05).The slope of HBsAg decline in Peg-IFN-NA group(-0.02)was higher than in NA group(-0.00)(P=0.015).HBcrAg levels did not change.Eight(22%)patients discontinued Peg-IFN due to adverse events.The HBsAg loss was achieved in 3(8.3%)patients of the Peg-IFN-NA group and 0(0%)of the NA group.CONCLUSION The addition of Peg-IFN to NAs caused a greater and faster decrease of HBsAg levels compared to NA therapy.Side effects of Peg-IFN can limit its use in clinical practice.展开更多
BACKGROUND Atrial fibrillation(AF)is one of the most common arrhythmias,and radiofrequency catheter ablation is the most effective treatment strategy.The inferior vena cava(IVC)is a common approach for radiofrequency ...BACKGROUND Atrial fibrillation(AF)is one of the most common arrhythmias,and radiofrequency catheter ablation is the most effective treatment strategy.The inferior vena cava(IVC)is a common approach for radiofrequency ablation of AF.However,this approach may not be applied to some cases such as chronic venous occlusions,surgical ligation of the IVC,and heterotaxy syndrome(HS).CASE SUMMARY A 68-year-old man with HS suffered from severely symptomatic persistent AF for 9 years,and we successfully ablated by percutaneous transhepatic access.CONCLUSION In patients without femoral vein access,the use of the hepatic vein for pulmonary vein isolation is a viable alternative for invasive electrophysiology procedures.展开更多
In the 1930s and 1940s,Thomas Chao,an internationally-renowned Chinese journalist,influenced Chinese journalists’way of covering and writing news with his own prominent experience in international news reporting.Base...In the 1930s and 1940s,Thomas Chao,an internationally-renowned Chinese journalist,influenced Chinese journalists’way of covering and writing news with his own prominent experience in international news reporting.Based on his long-term news practice,Chao analyzed the differences between Chinese and Western press and explored the way for improvement.He called on the government to set up a national news agency so as to establish itself in the field of international communication,and helped the Central News Agency to take back Reuters’right to publish in China.Chao also actively promoted the exchange and cooperation between Chinese newspapers and news agencies and foreign press in international communication activities,striving to increase China’s voice worldwide.展开更多
BACKGROUND Gastric cancer (GC) with bone metastasis is rare, and rib metastasis is even lesscommon. The clinical prognosis of GC with bone metastasis is poor given the lackof an effective treatment.CASE SUMMARY A 70 y...BACKGROUND Gastric cancer (GC) with bone metastasis is rare, and rib metastasis is even lesscommon. The clinical prognosis of GC with bone metastasis is poor given the lackof an effective treatment.CASE SUMMARY A 70 year old man was referred to Shaoxing People’s Hospital with left chest painand slight dyspnea. Chest computed tomography (CT) revealed a metastaticlesion in the left 3rd rib. Esophagogastroduodenoscopy revealed several ulcers inthe angle and antrum of the stomach, and tumor biomarkers including CEA andCA-199 were clearly increased. In addition, lymph node metastasis in the lessercurvature of the stomach was identified by positron emission tomography/CTscanning. Further pathological examination confirmed metastatic adenocarcinomain the rib and medium-low differentiated adenocarcinoma in the gastric space.The patient had GC with rib metastasis, and was clinically staged as T3NxM1 (IVB).Based on multidisciplinary team opinions, the patient received five courses ofchemotherapy (CAPOX plus aptinib), and then underwent rib resection andlaparoscopic radical distal gastrectomy. The patient started four courses ofchemotherapy after surgery, and then capecitabine and aptinib were administeredorally for 3 mo. Follow-up was performed on an outpatient basis usingabdominal/chest CT and tumor biomarkers. The patient exhibited an overallsurvival greater than 2 years, and the disease-free survival was approximately 18mo. His adverse events were tolerable.CONCLUSION The incidence of GC with rib metastases is extremely low, and patients can obtainmore benefits from individualized treatment formulated by multidisciplinaryteam. Chemotherapy plus surgery might represent an alternative option for GCwith rib metastasis.展开更多
BACKGROUND Penial incarceration(PI)is a rare situation.It is usually caused by a foreign object which strangulates at the base of the penis.PI may derive from pranks,sexual demand,mental disease,or intention to prohib...BACKGROUND Penial incarceration(PI)is a rare situation.It is usually caused by a foreign object which strangulates at the base of the penis.PI may derive from pranks,sexual demand,mental disease,or intention to prohibit urinary disease.Generally,these situations are emergent and immediate treatments are needed.Cases of chronic PI are less reported,and their treating methods are yet to be discussed.CASE SUMMARY We reported a case on treating a 73-year-old male who had PI with a metallic hoop for three months.After multidisciplinary consultation,the operation was performed successfully with the help of a fretsaw.Despite the chronic strangulation,the prognosis of the patient was satisfying.To the best of our knowledge,this case was rare and precious as it featured the longest strangulating time,which might enlighten the treating process of future PI cases.Also,we have reviewed and summarized major published cases to encapsulate appropriate approaches when facing diverse strangulation situations.CONCLUSION The selection of surgical tools depends on the material of the strangulating objects,the availability of equipment,and the severity of the penial damage.The urination function may not be affected after three months of incarceration as in our case,whilst prudent preoperative measures and multidisciplinary evaluations are always essential.Although using a fretsaw is comparatively slow,it is safe and feasible to treat metallic penial incarceration.展开更多
BACKGROUND Cardiac arrest after noncardiac surgery is a dangerous complication that may contribute to mortality.Because of the high mortality rate and many complications of cardiac arrest,it is very important to ident...BACKGROUND Cardiac arrest after noncardiac surgery is a dangerous complication that may contribute to mortality.Because of the high mortality rate and many complications of cardiac arrest,it is very important to identify and correct a reversible etiology early.By reporting the treatment process of this case,we aimed to broaden the diagnosis and treatment of cardiac arrest after noncardiac surgery and describe how cardiopulmonary resuscitation using extracorporeal membrane oxygenation(ECMO)can improve a patient’s chance of survival.CASE SUMMARY A 69-year-old man visited our hospital complaining of low back pain on July 12,2021.Magnetic resonance imaging showed lumbar disc herniation.Two hours after lumbar disc herniation surgery,the patient developed cardiac arrest.Cardiopulmonary resuscitation was performed,and ECMO was started 60 min after the initiation of cardiopulmonary resuscitation.Regarding the etiology of early cardiac arrest after surgery,acute myocardial infarction and pulmonary embolism were considered first.Based on ultrasound evaluation,acute myocardial infarction appeared more likely.Coronary angiography confirmed occlusion of the left anterior descending branch,and coronary artery stenting was performed.Pulmonary artery angiography was performed to exclude pulmonary embolism.Due to heparinization during ECMO and coronary angiography,there was a large amount of oozing blood in the surgical incision.Therefore,heparinfree ECMO was performed in the early stage,and routine heparinized ECMO was performed after hemorrhage stabilization.Eventually,the patient was discharged and made a full neurologic recovery.CONCLUSION For early postoperative cardiac arrest,acute myocardial infarction should be considered first,and heparin should be used with caution.展开更多
文摘Over the years immunotherapy has demonstrably improved the field of cancer treatment.However,achieving long-term survival for colorectal cancer(CRC)patients remains a significant unmet need.Combination immunotherapies incor-porating targeted drugs like MEK or multi-kinase inhibitors have offered some palliative benefit.Nevertheless,substantial gaps remain in the current therapeutic armamentarium for CRC.In recent years,there has been a surge of interest in exploring novel treatment strategies,including the application of light-activated drugs in conjunction with optical devices.This approach holds promise for achie-ving localized and targeted delivery of cytotoxic agents,such as microtubule-targeting drugs,directly to cancerous cells within the colon.
文摘The Journal of Human Rights publishes original works in law,philosophy,political science and other disciplines which deal with concepts,measurement tools and policy alternatives from human rights perspectives.Please submit your manuscripts to the following e-mail address:JHRsubmissions@cupl.edu.cn.
文摘A textbook, Economic, Social and Cultural Rights (second revised edition), has been translated into Chinese under the sponsorship of the China Society for Human Rights Studies and published by the Sichuan People’s Publishing House.
文摘BACKGROUND Hypertrophic scars(HSs)formation is a complication that occurs after wounds heal with secondary intention and sometimes after clean surgical incisions.Many treatments are in vogue now with varying successes.Although the mechanism or mechanisms that cause a HS to form are not clearly understood,one thing that is clear is that once scar tissue matures,any intervention will not be successful.In this paper,we report on a case where a patient who was known to develop HS was treated with a new combination of ingredients(Phyto-chemicals+Silicone JUMI)to suppress HS formation.CASE SUMMARY A 68-year-old female of African descent presented a severe HS post total knee replacement(TKR),which the patient describes as itchy and painful.Due to complications caused by the scar,she was apprehensive about undergoing TKR on her other knee.However,after the TKR of the contralateral side post-removal of skin clips,JUMI anti-scar cream(JASC)was used to suppress excessive scar formation.CONCLUSION JASC appears potent and efficacious at suppressing excessive scar formation.We believe that this warrants further studies on larger patient groups and on different surgical sites.
文摘BACKGROUND Inflammatory pseudotumor(IPT)is a rare and benign lesion that mimics malignancy and can develop in any part of the body.The pathophysiology and etiology of these quasineoplastic lesions remain unclear.CASE SUMMARY We report a case of a 65-year-old male who presented with fevers,night sweats,and unintentional weight loss following an influenza infection and was found to have multiple hepatic IPT’s following an extensive work up.CONCLUSION Our case highlights the importance of considering hepatic IPT’s in the differential in a patient who presents with symptoms and imaging findings mimicking malignancy shortly following a viral infection.
文摘Periprosthetic joint infection(PJI)following total knee arthroplasty is one of the most catastrophic and costly complications that carries significant patient wellness as well as economic burdens.The road to efficiently diagnosing and treating PJI is challenging,as there is still no gold standard method to reach the diagnosis as early as desired.There are also international controversies with respect to the best approach to manage PJI cases.In this review,we highlight recent advances in managing PJI following knee arthroplasty surgery and discuss in depth the two-stage revision method.
文摘BACKGROUND Gastrointestinal stromal tumors(GISTs)are the most frequent mesenchymal tumors of gastrointestinal tract.The most common sites of metastases are the liver and the peritoneum,whereas breast metastases from GIST are extremely rare.We present a second case of GIST breast metastasis.CASE SUMMARY We found a case of breast metastasis from rectum GIST.A 55-year-old female patient presented with rectum tumor with multiply liver lesions and metastasis in the right breast.Abdominal-perineal extirpation of rectum was performed,histology and immunohistochemistry study showed GIST,mixed type with CD117 and DOG-1 positive staining.The patient was taking imatinib 400 mg for 22 mo with stable disease.Because of growth of the breast metastasis the treatment was changed twice:The dose of imatinib was doubled with further progression in the breast lesion and then the patient was receiving sunitinib for 26 mo with partial response in the right breast and stable disease in the liver lesions.The breast lesion increased and right breast resection was done–surgery on local progression,the liver metastases were stable.Histology and immunohistochemistry studies revealed GIST metastasis,CD 117 and DOG 1 positive with KIT exon 11 mutation.After surgery the patient resumed imatinib.Until now the patient has been taking imatinib 400 mg for 19 mo without progression,last follow up was in November 2022.CONCLUSION GISTs breast metastases are extremely rare,we described the second case.At the same time second primary tumors have been reported frequently in patients diagnosed with GISTs and breast cancer is one of the most common second primary tumors in patients with GISTs.That is why it is very important to distinguish primary from metastatic breast lesions.Surgery on local progression made it possible to resume less toxic treatment.
文摘BACKGROUND Congenital transverse deficiencies are horizontal deficiencies of the long bones that occur with a reported incidence as high 0.38%.They can occur alone or represent a manifestation of a various clinical syndromes.Diagnosis has tradi-tionally comprised of conventional radiography and prenatal imaging studies.There has been much advancement regarding prenatal imaging modalities to allow for early diagnosis and appropriate treatment.AIM To summarize the current state of knowledge on congenital transverse limb deficiencies and to provide an update regarding the radiographic evaluation of congenital transverse limb deficiencies.METHODS This IRB-exempt scoping review followed the PRISMA-ScR checklist for scoping reviews strictly.Five search engines were searched for a total of 265 publications.Four authors reviewed these during the screening process.Of these,51 studies were included in our article.Prenatal magnetic resonance imaging(MRI),3D Ultrasound,and multidetector Computed tomography(CT)exist are emerging modalities that have the potential to improve diagnosis.RESULTS Use of the appropriate classification system,three-dimensional ultrasonography with a maximum intensity projection,and appropriate use of prenatal MRI and prenatal CT can improve diagnosis and inter-provider communication.CONCLUSION Further scholarly efforts are required to develop improve standardized guidelines regarding the pre-natal radiographic evaluation of congenital limb deficiencies.
文摘Melatonin is widely available as a supplement,usually for sleep disorders.The consumption of melatonin supplements has increased considerably in recent years.An overlooked aspect of melatonin’s administration is the resulting increase in prolactin secretion,via its action on hypothalamic dopaminergic neurons.We believe that since the effect of melatonin on prolactin is tangible,the laboratory finding of hyperprolactinemia could be encountered more often,given the increase in melatonin’s use.This is an issue that merits further study.
文摘BACKGROUND Spilled gallstones from previous cholecystectomy is not an uncommon situation.It may further mimic neoplastic disease and can be misled by fluorine 18 fluorodeoxyglucose position emission tomography with computed tomography([18F]FDG PET/CT).CASE SUMMARY A 63 year-old patient was diagnosed with a cancer of the cervix.Pretreatment[18F]FDG PET/CT showed a peritoneal lesion suspicious for metastasis.Surgical exploration and histologic examination revealed the lesion to be a spilled gallstone from a previous cholecystectomy.CONCLUSION[18F]FDG PET/CT carries pitfalls since benign conditions such as intraperitoneal gallstones may be confused as malignant lesions.This case highlights the importance to be aware of the possible implications of dropped gallstones for the future,minimize its occurrence,and make all efforts to properly evaluate cancer staging,particularly for the cervix cancer.
文摘BACKGROUND Bibliometric analysis can be used to assess the current state of the literature and publication trends on a given topic.There has not been a review of this kind on prostatic artery embolization(PAE)for benign prostatic hyperplasia(BPH).PAE is a relatively new and somewhat controversial treatment option for BPH.Given the novelty and controversy,there has been much research published on the topic recently.AIM To survey the current state of research on PAE for BPH by using bibliometric analysis to analyze the top 50 most highly cited articles.METHODS A cross-sectional study was performed using the Web of Science database to identify the most cited articles published on PAE for BPH as of June 2022.Articles that did not primarily focus on PAE or BPH as an indication were eliminated.The 50 most cited articles were carried forward for analysis.RESULTS All but 6 articles were published in the last decade with contributions from 15 countries.Fifty-two percent of the studies had a C level of evidence.The majority were published in the Journal of Vascular and Interventional Radiology and Cardiovascular and Interventional Radiology.Twenty percent(n=10)of the articles were published in urologic journals.On average,articles published in urologic journals tended to be more recent.The mean year of publication for an article in a urological journal was 2016.6 compared to 2013.9 in a non-urologic journal(P=0.02).Seventy percent of the articles focused on clinical outcomes,while only 2%focused on practice guidelines.Self-citations accounted for 11.4 citations perarticle on average,corresponding to 14.7%of all citations analyzed.CONCLUSION The most influential papers on this topic represent a fairly recent body of work with contributions from a wide variety of countries and journals.The fact that articles in urologic journals were published significantly more recently than articles on the list in non-urologic journals may suggest that the field of urology is starting to accept PAE for a wider range of indications.Finally,while there has been much high-quality research published,more influential studies on practice guidelines and technique may be beneficial.
文摘Hematopoietic stem cell transplantation(HSCT)becomes a standard form of cellular therapy for patients with malignant diseases.HSCT is the first-choice of immunotherapy,although HSCT can be associated with many complications such as graft-versus-host disease(GVHD)which is a major cause of morbidity and mortality after allogeneic HSCT.It has been shown that certain gut microbiota could exert protective and/or regenerative immunomodulatory effects by the production of short-chain fatty acids(SCFAs)such as butyrate in the experimental models of GVHD after allogeneic HSCT.Loss of gut commensal bacteria which can produce SCFAs may worsen dysbiosis,increasing the risk of GVHD.Expression of G-protein coupled receptors such as GPR41 seems to be upre-gulated in the presence of commensal bacteria,which might be associated with the biology of regulatory T cells(Tregs).Treg cells are a suppressive subset of CD4 positive T lymphocytes implicated in the prevention of GVHD after allogeneic HSCT.Here,we discuss the current findings of the relationship between the modification of gut microbiota and the GVHD-related immunity,which suggested that tactics with certain probiotics for the beneficial symbiosis in gut-immune axis might lead to the elevation of safety in the allogeneic HSCT.
基金The Beijing Scholar 2015and the National Natural Science Foundation of China,No.61931013,No.81701644,and No.61801311.
文摘BACKGROUND Pulsatile tinnitus(PT)is a potentially disabling symptom that has received increasing attention.Multiple causes of PT have been confirmed by targeted treatment.However,dynamic changes of related structures in PT patients with multiple causes after stenting for ipsilateral transverse sinus stenosis(TSS)have not been previously reported.We report such a case and present postoperative computed tomography venography(CTV)follow-up findings to demonstrate the decreased sigmoid sinus diverticulum and bone remodeling.CASE SUMMARY A 45-year-old man suffered from left-sided PT for 15 years that was occasionally accompanied by headache and dizziness.Pre-operative CTV revealed left-sided sigmoid sinus wall anomalies(SSWAs),TSS,outflow dominance,large posterior condylar emissary vein,and an empty sella turcica.A cerebrospinal fluid pressure of 270 mmH2O was further detected.The sound disappeared immediately after stenting for ipsilateral TSS,with no recurrence during 2 years of follow-up.After the procedure,the patient underwent four consecutive CTV examinations.The diverticulum decreased 6 mo after the procedure with new bone remodeling.The density of the remodeled bone was further increased 1 year later,and a hardened edge was formed 2 years later.CONCLUSION PT associated with SSWAs,TSS,and idiopathic intracranial hypertension can be cured by stenting for TSS alone.And bone remodeling around SSWAs is a more significant finding.
文摘BACKGROUND Hepatitis B e antigen-negative chronic hepatitis B patients under nucleos(t)ids analogues(NAs)rarely achieve hepatitis B surface antigen(HBsAg)loss.AIM To evaluate if the addition of pegylated interferon(Peg-IFN)could decrease HBsAg and hepatitis B core-related antigen(HBcrAg)levels and increase HBsAg loss rate in patients under NAs therapy.METHODS Prospective,non-randomized,open-label trial evaluating the combination of Peg-IFN 180μg/week plus NAs during forty-eight weeks vs NAs in monotherapy.Hepatitis B e antigen-negative non-cirrhotic chronic hepatitis B patients of a tertiary hospital,under NAs therapy for at least 2 years and with undetectable viral load,were eligible.Patients with hepatitis C virus,hepatitis D virus or human immunodeficiency virus co-infection and liver transplanted patients were excluded.HBsAg and HBcrAg levels(log10 U/mL)were measured at baseline and during ninety-six weeks.HBsAg loss rate was evaluated in both groups.Adverse events were recorded in both groups.The kinetic of HBsAg for each treatment group was evaluated from baseline to weeks 24 and 48 by the slope of the HBsAg decline(log10 IU/mL/week)using a linear regression model.RESULTS Sixty-five patients were enrolled,61%receiving tenofovir and 33%entecavir.Thirty-six(55%)were included in Peg-IFN-NA group and 29(44%)in NA group.After matching by age and treatment duration,baseline HBsAg levels were comparable between groups(3.1 vs 3.2)(P=0.25).HBsAg levels at weeks 24,48 and 96 declined in Peg-IFN-NA group(-0.26,-0.40 and-0.44)and remained stable in NA group(-0.10,-0.10 and-0.10)(P<0.05).The slope of HBsAg decline in Peg-IFN-NA group(-0.02)was higher than in NA group(-0.00)(P=0.015).HBcrAg levels did not change.Eight(22%)patients discontinued Peg-IFN due to adverse events.The HBsAg loss was achieved in 3(8.3%)patients of the Peg-IFN-NA group and 0(0%)of the NA group.CONCLUSION The addition of Peg-IFN to NAs caused a greater and faster decrease of HBsAg levels compared to NA therapy.Side effects of Peg-IFN can limit its use in clinical practice.
基金Supported by Shanxi Provincial Health Commission “Four batch” Science and Technology Innovation Project of Medical Development,No. 2021XM45 (to Dr. Wang HX)Academic promotion plan of Shanxi Cardiovascular Hospital,No. XYS20180102 (to Dr. Wang HX)+1 种基金Natural Science Foundation of Shanxi Province,No. 20210302123346 (to Dr. Wang HX)and Scientific Research Incentive Fund of Shanxi Cardiovascular Hospital,No. XYS20190206 (to Dr. Li N)
文摘BACKGROUND Atrial fibrillation(AF)is one of the most common arrhythmias,and radiofrequency catheter ablation is the most effective treatment strategy.The inferior vena cava(IVC)is a common approach for radiofrequency ablation of AF.However,this approach may not be applied to some cases such as chronic venous occlusions,surgical ligation of the IVC,and heterotaxy syndrome(HS).CASE SUMMARY A 68-year-old man with HS suffered from severely symptomatic persistent AF for 9 years,and we successfully ablated by percutaneous transhepatic access.CONCLUSION In patients without femoral vein access,the use of the hepatic vein for pulmonary vein isolation is a viable alternative for invasive electrophysiology procedures.
文摘In the 1930s and 1940s,Thomas Chao,an internationally-renowned Chinese journalist,influenced Chinese journalists’way of covering and writing news with his own prominent experience in international news reporting.Based on his long-term news practice,Chao analyzed the differences between Chinese and Western press and explored the way for improvement.He called on the government to set up a national news agency so as to establish itself in the field of international communication,and helped the Central News Agency to take back Reuters’right to publish in China.Chao also actively promoted the exchange and cooperation between Chinese newspapers and news agencies and foreign press in international communication activities,striving to increase China’s voice worldwide.
文摘BACKGROUND Gastric cancer (GC) with bone metastasis is rare, and rib metastasis is even lesscommon. The clinical prognosis of GC with bone metastasis is poor given the lackof an effective treatment.CASE SUMMARY A 70 year old man was referred to Shaoxing People’s Hospital with left chest painand slight dyspnea. Chest computed tomography (CT) revealed a metastaticlesion in the left 3rd rib. Esophagogastroduodenoscopy revealed several ulcers inthe angle and antrum of the stomach, and tumor biomarkers including CEA andCA-199 were clearly increased. In addition, lymph node metastasis in the lessercurvature of the stomach was identified by positron emission tomography/CTscanning. Further pathological examination confirmed metastatic adenocarcinomain the rib and medium-low differentiated adenocarcinoma in the gastric space.The patient had GC with rib metastasis, and was clinically staged as T3NxM1 (IVB).Based on multidisciplinary team opinions, the patient received five courses ofchemotherapy (CAPOX plus aptinib), and then underwent rib resection andlaparoscopic radical distal gastrectomy. The patient started four courses ofchemotherapy after surgery, and then capecitabine and aptinib were administeredorally for 3 mo. Follow-up was performed on an outpatient basis usingabdominal/chest CT and tumor biomarkers. The patient exhibited an overallsurvival greater than 2 years, and the disease-free survival was approximately 18mo. His adverse events were tolerable.CONCLUSION The incidence of GC with rib metastases is extremely low, and patients can obtainmore benefits from individualized treatment formulated by multidisciplinaryteam. Chemotherapy plus surgery might represent an alternative option for GCwith rib metastasis.
文摘BACKGROUND Penial incarceration(PI)is a rare situation.It is usually caused by a foreign object which strangulates at the base of the penis.PI may derive from pranks,sexual demand,mental disease,or intention to prohibit urinary disease.Generally,these situations are emergent and immediate treatments are needed.Cases of chronic PI are less reported,and their treating methods are yet to be discussed.CASE SUMMARY We reported a case on treating a 73-year-old male who had PI with a metallic hoop for three months.After multidisciplinary consultation,the operation was performed successfully with the help of a fretsaw.Despite the chronic strangulation,the prognosis of the patient was satisfying.To the best of our knowledge,this case was rare and precious as it featured the longest strangulating time,which might enlighten the treating process of future PI cases.Also,we have reviewed and summarized major published cases to encapsulate appropriate approaches when facing diverse strangulation situations.CONCLUSION The selection of surgical tools depends on the material of the strangulating objects,the availability of equipment,and the severity of the penial damage.The urination function may not be affected after three months of incarceration as in our case,whilst prudent preoperative measures and multidisciplinary evaluations are always essential.Although using a fretsaw is comparatively slow,it is safe and feasible to treat metallic penial incarceration.
基金Supported by The Science and Technology Project of Jiaxing,No.2020AD30047 and No.2019AD32231The Key Medical Disciplines of Jiaxing,No.04-Z-08The Key Research Project of Zhejiang Science and Technology Department,No.2020C03019.
文摘BACKGROUND Cardiac arrest after noncardiac surgery is a dangerous complication that may contribute to mortality.Because of the high mortality rate and many complications of cardiac arrest,it is very important to identify and correct a reversible etiology early.By reporting the treatment process of this case,we aimed to broaden the diagnosis and treatment of cardiac arrest after noncardiac surgery and describe how cardiopulmonary resuscitation using extracorporeal membrane oxygenation(ECMO)can improve a patient’s chance of survival.CASE SUMMARY A 69-year-old man visited our hospital complaining of low back pain on July 12,2021.Magnetic resonance imaging showed lumbar disc herniation.Two hours after lumbar disc herniation surgery,the patient developed cardiac arrest.Cardiopulmonary resuscitation was performed,and ECMO was started 60 min after the initiation of cardiopulmonary resuscitation.Regarding the etiology of early cardiac arrest after surgery,acute myocardial infarction and pulmonary embolism were considered first.Based on ultrasound evaluation,acute myocardial infarction appeared more likely.Coronary angiography confirmed occlusion of the left anterior descending branch,and coronary artery stenting was performed.Pulmonary artery angiography was performed to exclude pulmonary embolism.Due to heparinization during ECMO and coronary angiography,there was a large amount of oozing blood in the surgical incision.Therefore,heparinfree ECMO was performed in the early stage,and routine heparinized ECMO was performed after hemorrhage stabilization.Eventually,the patient was discharged and made a full neurologic recovery.CONCLUSION For early postoperative cardiac arrest,acute myocardial infarction should be considered first,and heparin should be used with caution.
