bluuebunny/crossref_metadata_2025 huggingface dataset:
Advancements in the management of overactive bladder in women using nano-botulinum toxin type A: A narrative review
Authors: Zhou Yongheng , Liu Qinggang , Cong Huiling , Liao Limin
Published: January 2025

Intravesical injections of botulinum toxin type A (BTX-A) are effective for treating refractory overactive bladder (OAB) in women. However, the adverse effects linked to the injections, such as hematuria, pain, and infection, and need for repeated injections can lower patient compliance and make the treatment inconvenient. Hence, urologists are actively pursuing less invasive and more convenient methods for the intravesical delivery of BTX-A. Advances in nanotechnology have facilitated noninvasive intravesical drug delivery. Currently, liposomes, hydrogels, nanoparticles, and many other forms of carriers can be used to enhance bladder wall permeability. This facilitates the entry of BTX-A into the bladder wall, allowing it to exert its effects. In this review, the feasibility and efficacy of liposomes, thermosensitive hydrogels, and hyaluronic acid-phosphatidylethanolamine for the treatment of OAB in women are discussed along with recent animal experiments on the use of nanotechnology-delivered BTX-A for the treatment of OAB in female rat models. Although the clinical efficacy of nanocarrier-encapsulated BTX-A for the treatment of OAB in women has not yet matched that of direct urethral muscle injection of BTX-A, improvements in certain symptoms indicate the potential of bladder instillation of nanocarrier-encapsulated BTX-A for future clinical applications. Consequently, further research on nanomaterials is warranted to advance the development of nanocarriers for the noninvasive delivery of BTX-A in the bladder.
Evaluation of Scleral Thickness in Patients With Keratoconus
Authors: Ciftci Mukaddes Damla , Degirmenci Cumali , Palamar Melis
Published: January 2025

Objectives:

To evaluate scleral thickness of patients with keratoconus by anterior segment optical coherence tomography (AS-OCT).

Materials and methods:

Fifty-two eyes of 42 patients with keratoconus (group 1) and 42 right eyes of 42 healthy individuals (group 2) were included. Scleral thickness measurements were taken with AS-OCT 6, 4, and 2 mm behind the scleral spur in four gaze positions: superior, inferior, temporal, and nasal. The data including central corneal thickness (CCT) by Pentacam from patients with keratoconus was also analyzed and its relationship with scleral thickness was evaluated.

Results:

In group 1, mean scleral thickness from 6 mm posterior to scleral spur in superior, inferior, temporal, and nasal quadrants were 397±35.3 (320–482), 408±29.5 (341–467), 393±40.8 (297–469), and 403±35.8 (310–482) μm, respectively. In group 2, mean scleral thickness from 6 mm posterior to scleral spur in superior, inferior, temporal, and nasal quadrants were 440±42.2 (346–552), 461±33.9 (390–563), 451±46.6 (340–549) and 448±34.3 (350–521) μm, respectively. The mean scleral thickness in group 1 was significantly lower in all quadrants compared with group 2 (P<0.001). The mean CCT in group 1 was 478.22±87.55 (306–632) μm. Positive correlation was found between scleral thickness measurements taken at 4 mm (ϱ=0.312, P=0.037) and 2 mm (ϱ=0.308, P=0.039) posterior from the scleral spur in the inferior quadrant and CCT.

Conclusion:

Scleral thickness was significantly lower in patients with keratoconus. Scleral thickness and CCT were positively correlated in inferior quadrant. Even though it is not yet known whether scleral changes are progressive or not, scleral thickness measurement may also find a place in the diagnosis and follow-up of patients with keratoconus in the future.
Exploring auxiliary liver transplantation in the era of transplant oncology—A proposal for a new liver splitting program (ALERT-50)
Authors: Gringeri Enrico , Furlanetto Alessandro , Polacco Marina , Perin Luca , Nieddu Eleonora , Rosso Eugenia , De Nardi Clarissa , Ballo Mattia , De Feo Tullia , Trapani Silvia , Burra Patrizia , Spada Marco , Colledan Michele , Lauterio Andrea , Romagnoli Renato , Cardillo Massimo , Feltrin Giuseppe , De Carlis Luciano , Cillo Umberto
Published: January 2025

Total hepatectomy and liver transplantation have emerged as a game-changing strategy in the treatment of several liver-confined primary or metastatic tumors, opening a new era of transplant oncology. However, the expansion of indications is going to worsen the chronic scarcity of organs, and new strategies are needed to enlarge the donor pool. A possible source of organs could be developing split liver transplantation programs. We propose to refer donors aged 18–50 years unsuitable for pediatric patients and donors aged 50–60 years for split evaluation. This will generate new small left lateral grafts that can be used for resection and partial liver segment II-III transplantation with delayed total hepatectomy procedures, based on a national waiting list specifically for non-HCC oncologic patients. Centralized imaging review will streamline the donor-recipient matching process and address organizational challenges. Additionally, adopting an ex situ splitting technique during hypothermic oxygenated machine perfusion could further enhance logistical efficiency and improve graft viability. The proposed protocol (ALERT 50) will therefore promote the development of oncologic indications without affecting the standard waiting list and without competing with urgent or pediatric patients.
Osteosarcoma biomarker analysis and drug targeting prediction based on pyroptosis-related genes
Authors: Zhuang Yuxiang , Li Xiaofeng
Published: January 2025

Osteosarcoma is a malignant bone tumor originating from mesenchymal tissue. Recent studies have found that the tumor inflammatory microenvironment plays an important role in promoting the malignant characteristics and metastatic potential of malignant tumors. Pyroptosis, an inflammatory programmed cell death, elicits immune responses that exhibit anti-tumor effects through released factors and contents. Therefore, improving anti-tumor immunity by targeting osteosarcoma-related pyroptosis genes and pathways may be of great significance in delaying early metastasis of osteosarcoma and improving patient survival rate. The study aimed to identify pyroptosis-related genes and biomarkers in osteosarcoma, predicting therapeutic drugs targeting these genes. Gene expression profiles of osteosarcoma were retrieved from Gene Expression Omnibus and cross-referenced with GeneCards and Comparative Toxicogenomics Database to identify differentially expressed pyroptosis-related genes. We conducted enrichment analysis on intersecting genes to identify their biological processes and signaling pathways and assessed immune cell composition in the tumor microenvironment through immune infiltration analysis. In addition, we further utilized Cytoscape software to screen out the top 10 genes with Degree values among the intersected genes as hub genes and performed GSEA analysis and drug prediction based on the hub genes. A total of 22 differentially expressed pyroptosis-related genes were identified in osteosarcoma, with 10 of them (TP53, CYCS, IL-1A, IL-1B, IL-18, CASP-3, CASP-8, IL-6, TNF, CASP-1) pinpointed as hub genes. Enrichment analysis found that the 22 intersection genes are mainly associated with pyroptosis, apoptosis, immune regulation, and related biological processes. The results of data validation targeting hub genes suggest that IL-18, CASP-1, and CASP-8 may be key genes involved in the regulation of pyroptosis in osteosarcoma. Immune infiltration analysis shows statistical differences in the distribution of immune cells like naive B cells, monocytes, M2 macrophages, and dendritic/mast cells, suggesting they play a role in the osteosarcoma tumor microenvironment. Hub gene drug targets suggest Triethyl phosphate, Plinabulin, and Siltuximab as potential osteosarcoma treatments. Our findings suggest potential mechanisms of action for 22 pyroptosis-related genes in osteosarcoma and preliminarily predicted that the occurrence of osteosarcoma is closely related to pyroptosis, apoptosis, and immune regulation. Predicted Triethyl phosphate, Plinabulin, Siltuximab as potential osteosarcoma treatments.
A short-course of low-dose insulin detemir effectively decreases blood glucose levels in gestational diabetic women undergoing dexamethasone treatment to promote newborn lung maturity
Authors: Wu Wei-Zhen , Huang Fang-Ying , Li Si-Ying , Wang Yan , Chen Jia , Zeng Li-Zhu , Li Ying-Tao
Published: January 2025

Pregnant women with gestational diabetes mellitus undergoing glucocorticoid treatment to prevent neonatal respiratory distress syndrome could have increased glucose level. We performed a retrospective study and reviewed gestational diabetic women who received an intramuscular dexamethasone injection (6 mg, every 12 hours, 4 times) in our hospital between December 2018 and June 2020. Eligible pregnant women were assigned to the study group (with simultaneous subcutaneous insulin detemir injection, 2–4 units per day) or the control group (without insulin detemir injection). The fasting and 2-hour postprandial blood glucose levels were measured before and on days 1, 2, and 3 after the insulin detemir injection. The changes in their blood glucose levels were compared before and after the drug administrations as well as between the 2 groups. A total of 104 pregnant women were analyzed, including 48 women in the study group and 56 women in the control group. The blood glucose levels increased, with the peak levels occurring on the next day, after the dexamethasone administration in both groups. Compared with the control group, the study group had lower 2-hour postprandial blood glucose levels on days 2 and 3 after the insulin detemir injection (P < .05). There were no statistically significant differences in the fasting blood glucose levels between the 2 groups. Dexamethasone administration increased the blood glucose levels in the pregnant women with gestational diabetes mellitus. A short-course of low-dose insulin detemir administration effectively lowered the blood glucose levels in these women.
Diagnosis and treatment of COVID-19 complicated with liver abscess: A case report and literature review
Authors: Li Fan , Jiang Xueqiang , Liu Yanwei , Wang Wan , Zhang Congyu
Published: January 2025

Rationale:

Novel coronavirus pneumonia is spreading in many countries and regions. Coronavirus disease (COVID-19) is characterized by rapid onset, high infectivity, rapid progression, and variably effective treatment.

Patient concerns:

One 63-year-old woman presented to the fever clinic of our hospital on February 10, 2020, due to a fever for 12 days.

Diagnoses:

COVID-19 complicated with liver abscess.

Interventions:

A case report of a patient with COVID-19 complicated with liver abscess admitted to our hospital was used to explore the treatment methods for COVID-19 complicated with bacterial liver abscess. The sepsis caused by pulmonary viral infection and liver bacterial infection were correctly distinguished, and the patient was cured and discharged after targeted treatment, abscess, and pleural puncture and drainage.

Outcomes:

The patient was cured with a normal temperature is >3 days and coronavirus 3 consecutive negative nucleic acid detection.

Lessons:

COVID-19, elderly critically ill patients may be prone to rapid onset, complex disease, multiple organ damage, prolonged hospital stay, and high mortality. In the treatment of such COVID-19 patients, holistic thinking is required, pathology may not be limited to the lung, but may affect other organs, and treatment guidelines should not be blindly followed. Medication may need to be individualized for patients with COVID-19 complicated with liver abscess.
Analyzing gene-based apoptotic biomarkers in insomnia using bioinformatics
Authors: Zhu Wenwen , Yang Xingchun , Li Nanxi , Zhang Bin , Huang Lishan , Cheng Hanxing , Wu Xiao , Zhang Dechou , Li Sen , Xu Houping
Published: January 2025

Insomnia is increasingly common and poses significant health risks. The aims of this study are to identify apoptosis-related genes and potential biomarkers for insomnia and to find new therapeutic targets. Insomnia gene expression profiles were downloaded from the Gene Expression Omnibus database, and differentially expressed genes in normal and insomnia samples were identified by limma rapid differential analysis, and then the major modular genes with clinical relevance to insomnia were analyzed using the Weighted Gene Co-Expression Network Analysis, and intersections were obtained with the differentially expressed genes as well as with apoptotic gene databases. We validated apoptosis-related differentially expressed genes, enriched and analyzed the specific biological process of insomnia and related signaling pathways. In addition, we constructed a protein–protein interaction network and obtained Top10 hub genes using Cytoscape. We selected 3 of them as hub genes and compared their expression in normal hippocampal neuronal cells and hippocampal neuronal cells of the model group exposed to corticosterone induction by Western Blot and qRT-PCR experiments. A total of 190 differentially expressed apoptosis-related genes were identified in insomnia, and BCL2, SOCS3, and IL7R were identified as important hub genes. Enrichment analysis showed that the occurrence of apoptosis in insomnia was mainly related to “PI3K-Akt signaling pathway,” “JAK-STAT signaling pathway,” “P53 signaling pathway” and so on. GO analysis showed that apoptosis in insomnia was mainly related to “immune response,” “T cell differentiation in thymus,” and “positive regulation of MAPK cascade.” Western Blot and qRT-PCR experiments showed that BCL2, SOCS3, IL7R antiapoptotic indexes were under-expressed in modeled hippocampal neuronal cells compared to normal hippocampal neuronal cells. This study emphasizes the role of apoptosis-related genes in insomnia and preliminarily predicts that the occurrence of insomnia is closely related to apoptosis. Compared to the normal group, the antiapoptotic ability of hippocampal neurons in the model group is reduced. Although BCL2 has been studied in the context of sleep deprivation, SOCS3 and IL7R have not yet been explored in insomnia. Insomnia and sleep deprivation involve similar pathways, but due to different mechanisms and types of insomnia, gene expression may vary.
A narrative review of papilla preservation techniques in clinical dentistry
Authors: Fu Yinghua , Zhang Zhixin , Tang Xiaoping , Su Jiangling
Published: January 2025

The interdental papilla is closely associated with oral health and dental aesthetics. Interproximal papilla is an essential component of pink aesthetics as well as an indispensable prerequisite for the health of oral tissues. The loss of papillary height not only considerably affects final esthetic results, but also brings a series of periodontal complications. The deficiency of papilla can be induced by iatrogenic factors, particularly the flap technique, which is usually employed in oral surgeries. Therefore, preservation of the interdental papilla must be a consideration of flap designs. To avoid papilla defects secondary to conventional flaps, papilla-preserving flap designs have been widely studied in clinical practice. With numerous papilla preservation techniques (PPTs) increasingly being employed, not only is the postoperative pink aesthetic better maintained, but the predictability of surgical outcomes has been significantly enhanced. However, there is a lack of adequate literature that provides a comprehensive overview of PPTs in the field of dentistry. This review summarizes the latest developments in papilla preservation flap designs in the field of oral surgery, with a particular emphasis on their indications, limitations, incision characteristics, and clinical benefits. This review may provide optimal protocols for the personalized treatment.
Risk factors of nausea and vomiting in patients with breast cancer undergoing chemotherapy: A retrospective study
Authors: Jiang Ting , Wang Xinming , Zheng Lingli , Ren Tao , Li Yan , Li Jing
Published: January 2025

Chemotherapy is one of the main treatments for breast cancer patients. However, chemotherapy-related nausea and vomiting can significantly reduce patients’ quality of life and lead to electrolyte disturbance and metabolic imbalance in severe cases. Therefore, to identify the risk factors for nausea and vomiting during chemotherapy in these patients is very important. This retrospective study included 113 patients with breast cancer undergoing chemotherapy and used antiemetic drugs hospitalized in First Affiliated Hospital of Chengdu Medical College between January 1, 2021, and January 1, 2023. Of these, 26 (23.01%) patients developed nausea and vomiting. The univariate and multivariate logistics regression analyses showed that patients combined with diabetes, hypertension, chronic hepatitis B, >65 years of age, >8 cycles of chemotherapy, and had a history of nausea and vomiting are the risk factors for nausea and vomiting. However, due to the limited sample size and some risk factor data missing from this study, further prospective studies are needed to improve and verify.
Case series on 2 cases of macular damage caused by the novel coronavirus: A case report
Authors: Guo Yong , Guo Chenjun , Li Yan , Zhang Yongkang , Liu Xiaozhan , Liang Houcheng
Published: January 2025

Rationale:

Macular damage is a rare yet significant ocular complication of coronavirus disease 2019 (COVID-19) infection. This report highlights the clinical features, diagnosis, treatment, and outcomes in 2 cases of COVID-19-associated macular damage, contributing to the understanding of its pathophysiology and management.

Patient concerns:

Both patients presented with a sudden onset of visual impairment and black shadows in their central visual fields shortly after contracting COVID-19.

Diagnoses:

The first patient, a 15-year-old male, was diagnosed with acute macular neuroretinopathy, evidenced by optical coherence tomography (OCT) imaging showing high-density shadows in the macular area. The second patient, a 28-year-old female, presented with more extensive macular lesions, confirmed via fundus photography and OCT imaging.

Interventions:

Both patients received systemic corticosteroid therapy (oral prednisone acetate, 30 mg daily). The male patient was treated for 5 days, while the female patient underwent a 3-day treatment course.

Outcomes:

The male patient showed significant improvement in visual acuity, with OCT imaging revealing the resolution of high-density shadows but persistent disruption of the ellipsoid zone. The female patient demonstrated partial improvement in visual symptoms, though residual macular abnormalities remained evident on imaging.

Lessons:

COVID-19-associated macular damage appears to involve inflammatory and vascular mechanisms. Early systemic corticosteroid therapy may offer symptomatic relief and partially restore visual function. However, long-term monitoring is essential to address potential residual or progressive retinal damage.
Gut microbiota, immune cells, and chronic sinusitis: A Mendelian randomization analysis
Authors: Huang Junwei , Zhu Xiao , Yao Jingxin , Yang Weili , Zhu Zhenhua
Published: January 2025

Allergic rhinitis (AR) is a common allergic inflammatory disease that affects the upper respiratory tract. Although previous research suggests a potential association between gut microbiota alterations and AR, the causal relationship remains unclear. This study employs Mendelian randomization (MR) to reduce confounding factors and reverse causality. By using genetic variants as instrumental variables, the MR approach aims to provide more reliable causal evidence of the relationship between gut microbiota, immune-related antibodies, and AR. This study utilized large-scale genome-wide association study data from the FINRISK 2002 cohort and the UK Biobank to systematically investigate the causal relationships between gut microbiota, antibody immune responses, and AR through a 2-sample MR approach. We applied the inverse variance weighting method to assess the potential mediating role of antibody immune responses in the interaction between gut microbiota and AR. MR analysis identified 17 gut microbiomes significantly associated with chronic rhinosinusitis (CRS) risk. Specifically, increased abundances of the CAG-884 and UBA1407 species were linked to a higher CRS risk, while greater levels of Atopobiaceae and Bacteroides thetaiotaomicron were associated with a reduced risk. In addition, of the 29 immune cell types correlated with CRS, 12 were found to increase risk, while 17 reduced it. Notably, CAG-884 indirectly influenced CRS risk by affecting the proportion of TD double negative (CD4−CD8−) % T cells, with a mediating effect ratio of 36.4%. Our findings confirm a causal relationship between gut microbiota and immune cells in relation to CRS, underscoring the mediating role of immune cells in this interaction.
High prevalence of soil-transmitted helminths among primary students in Ha Giang, Vietnam: A descriptive cross-sectional study
Authors: Nhu Dang Duc , Ly Tran Thi , Canh Hoang Dinh , Dung Do Trung , Tinh Nguyen Luong , Da Pham Xuan , Nghia Nguyen Ngoc , Anh Nguyen Huynh Phuong , Trung Nguyen Thanh , Khoa Nguyen Trong , Luong Duong Huy , Thang Tran Quoc , Vinh Tran Vuong The , Ha Luong Thi Thu
Published: January 2025

Despite improvements in environmental sanitation and healthcare, the infection rate of soil-transmitted helminths (STHs) remains high in low socioeconomic regions of developing countries including Vietnam. This study aimed to determine the prevalence and intensity of STH infections among primary school children in Meo Vac, Ha Giang: a poor mountainous province in Vietnam. A descriptive cross-sectional study was conducted from October to November 2023, involving 400 participants. The Kato-Katz method was used to identify and quantify STH infections. Out of the 386 children assessed, 76.1% were infected with at least 1 type of STH. The most common infections were with Trichuris trichiura and Ascaris lumbricoides (47.0%). Mixed infections were identified in 121 children, with 77 cases of co-infection with A lumbricoides and T trichiura, 13 cases of A lumbricoides and hookworms, 8 cases of T trichiura and hookworms, and 23 cases involving all 3 STH types. Most infections were of light intensity, with a few moderate-intensity cases of A lumbricoides. Primary school students in Meo Vac, Ha Giang, Vietnam, continue to experience high infection rates of STHs in 2023. The majority of infections were of light intensity. To address this issue, government efforts should focus on educating the public about STH causes, transmission routes, and negative impacts. Improving personal and environmental hygiene and ensuring access to clean water are essential measures.
Newly developed DWI hyperintensities and changes in cerebral blood flow after carotid stent placement for unilateral symptomatic carotid artery stenosis
Authors: Zhang Feng , Shi Weiliang , Xi Zhenhua , Chu Lulu , Ma Xiaodong
Published: January 2025

This study aimed to evaluate changes in cerebral blood flow and perioperative outcomes in patients with unilateral symptomatic carotid artery stenosis before and after carotid artery stenting (CAS), providing insights to guide surgical decision-making. Ninety-six patients with moderate to severe unilateral symptomatic carotid artery stenosis (>50%) admitted to the Neurology Department of the Second Affiliated Hospital of Zhejiang University from June 2023 to April 2024 were included. All patients underwent CAS and magnetic resonance imaging, including diffusion-weighted imaging (DWI) and 3D quasi-continuous arterial spin-labeled perfusion imaging, within 3 days preoperatively and on the third postoperative day. Patients were categorized into microembolic and non-embolic groups based on the presence of new diffusion-weighted imaging hyperintensities. Newly developed diffusion-weighted imaging hyperintensities were detected in 68 patients (70.8%), with a total of 704 lesions, though only 4 cases exhibited symptoms. Most lesions were localized to the frontal–parietal cortex and subcortical areas on the affected side (60.8%) and were <3 mm in size (92.6%). Postoperatively, cerebral blood flow in the frontal–parietal lobe was significantly higher than in the temporal lobe on both the affected (50.49 ± 8.02 vs 47.94 ± 9.08, t = 2.179, P < .05) and healthy sides (50.16 ± 5.79 vs 48.00 ± 5.98, t = 3.835, P < .05). Additionally, cerebral blood flow in the affected frontal and temporal lobes significantly increased after surgery (P < .05). Preoperative frontal–parietal cerebral blood flow was lower in the microembolic group compared to the non-embolic group (P < .05). Microemboli are common after CAS but are unlikely to result from immediate hemodynamic changes. Instead, they appear to be associated with chronic preoperative hypoperfusion, which impairs cerebral blood flow regulation.
Iatrogenic diversion of inferior vena cava to the left atrium presented as persistent hypoxemia: Case series
Authors: Zhang Hanwen , Liu Qianqian , Meng Hong , Xiong Changming
Published: January 2025

Rationale:

The transcatheter closure and atrioseptopexy are the main treatment methods for atrial septal defect (ASD). However, persistent hypoxemia due to iatrogenic diversion of inferior vena cava (IVC) to the left atrium (LA) is reported as a rare complication after ASD closure. Contrast echocardiology is a reliable and powerful tool to detect iatrogenic diversion and identify the etiology accurately.

Patient concerns:

We reported 2 patients (a 11-year-old boy [Patient 1] and a 39-year-old female [Patient 2]) with persistent hypoxemia and exertional dyspnea after ASD transcatheter closure and robotic atrioseptopexy, respectively.

Diagnoses:

Contrast echocardiography confirmed the presence of a right-to-left shunt at the atrial level which was presented only in femoral venous contrast injection instead of upper extremity venous contrast injection.

Interventions and Outcomes:

Subsequent surgical exploration found that the occluder straddling the entry of IVC and the fibrous membrane proliferating along the lower edge of the occlude in the first patient, and the patch improperly linked to the Eustachian valve in the second patient. The misoperation led to IVC partially draining into LA. After the surgeries, both of them had their hypoxic symptoms relieved.

Lessons:

Persistent unexplained hypoxemia after ASD closure might be considered to result from a right-to-left shunt. An iatrogenic right-to-left shunt flow from the IVC to the LA was usually caused by the misplaced interatrial occluder or patch. Transthoracic agitated saline contrast echocardiography via combined peripheral venous access has the well-performed capability to hint some insidious right-to-left shunts and guides clinical therapy as soon as possible.
Functional neurological disorder treated with psychoeducation: A case report
Authors: Alhazmi Amal Yousef , Attar Ahmed Ahmed , Labban Suhail Ali , Felemban Reema Ghazi
Published: January 2025

Rationale:

Psychogenic tremor (PT) is the most common subtype of psychogenic movement disorder, characterized by involuntary movement, and is usually related to occupational injuries or accidents. Psychogenic movement disorder falls under the category of functional neurological disorders, which are diagnosed based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders.

Patient concerns:

A 25-year-old Saudi male with a history of recurrent superior ventricular tachycardia presented to the emergency department with tremors affecting all his extremities for 8 days. Tremors were nonrhythmic, continuous, and worsened over time and were exacerbated by reaching objects. There was no history of similar presentations or neurological diseases.

Diagnoses:

Examination revealed high-frequency, high-amplitude tremors and rigidity in all extremities, and hyperreflexia in the lower limbs. Laboratory findings were unremarkable; thus, the psychiatric team was consulted for possible PTs.

Interventions:

Psychiatric assessments showed no evidence of psychiatric disorders. The patient only received psychoeducation about his diagnosis.

Outcomes:

The tremor was completely resolved by the time of discharge.

Lessons:

In our case, the patient’s PT resolved entirely with education alone, differing from previous cases that included psychotherapy and medication, emphasizing the importance of the doctor–patient relationship and the need for future research on effective approaches to delivering diagnosis to patients.
A case series of ultrasound and pathological assessment of follicular thyroid tumors: Addressing indeterminate malignancy
Authors: Wang Xian , Zhou Hui , Iqbal Muhammad Asad , Pan Donggang , Zuo Junbo , Moazzam Nida Fatima , Zhang Jin , Sun Hui
Published: January 2025

Rationale:

Follicular tumors with uncertain malignant potential of the thyroid are a new classification of thyroid tumors in the World Health Organization (2017). Only a few cases of evaluating the value of ultrasound combined with pathological examination in diagnosing follicular tumors with uncertain malignant potential of the thyroid have been reported in recent decades.

Patient concerns:

A retrospective analysis was performed on 18 patients with follicular tumors with uncertain thyroid malignant potential who underwent preoperative ultrasonography and were confirmed by operation and pathology in our hospital from January 2019 to November 2024. Ultrasonic characteristics, histopathology, and immunohistology were recorded.

Diagnoses:

The patient was pathologically diagnosed as follicular tumor of uncertain malignant potential.

Interventions:

All the 18 patients underwent ultrasound, surgical treatment and immunohistochemical staining in our hospital.

Outcomes:

The patients underwent surgery. There was no complication or recurrence.

Lessons:

This case series indicates that the ultrasonographic manifestations of follicular tumors with uncertain thyroid malignant potential were regular and well-defined hypoechoic thyroid masses with an elastic grade of 2. The pathological characteristics were positive expression of P53, TG, CD56, Ki67, TTF-1, and Gal-3 mutations in most lesions.
To analyze the risk factors associated with mortality within 1 year after surgery in elderly patients with hip fracture and to assess the value of the age-corrected Charlson comorbidity index in predicting this mortality risk
Authors: Xiao Yu-Chen , Ailihemaiti Ayidan , Zheyiken Jiangannuer
Published: January 2025

To investigate the determining risk factors for 1-year postoperative mortality in elderly patients with hip fracture and to assess the efficacy of the age-adjusted Charlson comorbidity index (ACCI) in predicting the risk of death. This study adopted a retrospective analysis method to focus on 652 elderly patients who underwent hip fracture surgery between January 2018 and November 2022 in our hospital. By systematically combing the patients’ medical records, relevant data were collected and analyzed in depth for their association with morbidity and mortality rates within 1 year. In the 1-year follow-up for 652 elderly patients who underwent hip fracture surgery, the proportion of deaths due to disease amounted to 21.5% (140/652). Univariate analysis using the Cox proportional hazard model revealed that age, number of hospital days, ACCI, and the occurrence of postoperative pneumonia were significantly associated with the rate of morbidity and mortality within 1 year. Further multivariate Cox regression analysis confirmed that age (hazard ratio [HR], 1.087 [95% confidence interval [CI], 1.060–1.114]), ACCI (HR, 1.645 [95% CI, 1.548–1.747]), and postoperative pneumonia (HR, 2.353 [95% CI, 1.624–3.408]) served as independent risk factors that significantly influenced the patients’ 1-year survival. The ACCI excelled in predicting the risk of 1-year postoperative mortality, with an AUC of 0.912 for its prediction model and a specificity and sensitivity of 0.834 and 0.871, respectively, when the threshold was set at 5.5. The results of this study emphasize that age, ACCI, and postoperative pneumonia are key risk factors affecting the survival of elderly patients with hip fracture at 1-year postoperatively. ACCI, as an effective predictive tool, can provide an important reference for the clinical assessment of patients’ postoperative risk and help precision medical decision-making.
A brief examination of literature on adult cystic fibrosis: An emerging topic
Authors: Karcioglu Oguz , Sancar Elif Naz , Alkan Asli
Published: January 2025

Cystic fibrosis (CF), a historically fatal childhood disease, now became a manageable adulthood disease. The transition of the disease to adulthood and the patients to adult physicians raised a new question: What is the extent of adult physicians’ contributions to CF literature? We examined the data of all CF publications from Web of Sciences between 1945 and 2023. We determined the adult CF articles by searching for the term “adult” in titles. We analyzed the data in terms of publication years, study types, countries, and languages. A total of 30,944 articles examined. From 1945 to 2023, both the number of published articles (88–10,460), and the number of publishing journals (31–1770) on CF have increased. The number of articles on adult CF has also increased, from only 3 in the first 3 decades up to 716 between 2010 and 2019. While pediatrics was initially the leading journal with the highest number of articles published on CF, general medicine journals, and finally the Journal of Cystic Fibrosis became the leading publisher. The USA were the most productive country on behalf of publication on CF. The increasing number of annual publications clearly shows the growing interest in CF. The increase in the number of articles on adult CF along with the increase in publishing journals provide evidence that the disease is now acknowledged as a disease concerning adults.
Relationship between TyG-BMI index and glycemic index with diet quality, anthropometric indices, and blood pressure in patients with metabolic syndrome
Authors: Moulavi Paria , Ahmadi Afsane , Masoumi Seyed Jalil , Zare Morteza , Honardoust Mahdi , Ranjbar Rahil
Published: January 2025

A recently introduced metric for assessing metabolic syndrome (MetS) is the triglyceride glucose-body mass index (TyG-BMI). Additionally, the glycemic index (GI) is recognized as a significant measure for evaluating conditions associated with blood glucose. In this context, our research explores the correlation between TyG-BMI and GI in relation to diet quality, anthropometric measurements, and blood pressure among individuals diagnosed with MetS. A cross-sectional descriptive-analytical study was conducted on 431 employees with MetS at Shiraz University of Medical Sciences (SUMS). Anthropometric measurements of height, weight, waist circumference (WC), and hip circumference (HC) were taken according to Persian cohort protocols. BMI, C-index, visceral adiposity index (VAI), body adiposity index (BAI), body shape index (ABSI), abdominal volume index (AVI), potential renal acid load (PRAL), TyG-BMI and GI were calculated. A physician measured blood pressure, while the dietary inflammatory index was determined using guidelines. Biochemical parameters were analyzed using standard laboratory techniques. Data analysis was conducted using SPSS software version 21, with a significance threshold set at <.05. A significant correlation was identified between the TyG-BMI index and the PRAL index (β = 0.094, P-value = .026), WC (β = 0.627, P-value < .001), BAI (β = 0.396, P-value < .001), and blood pressure (β = 0.063, P-value = .002). Furthermore, the findings indicated a notable association between the GI and blood pressure (β = 0.610, P-value < .001). The results of this study suggest that managing the PRAL index, body weight, and blood pressure may be associated with an enhanced status of TyG-BMI. Additionally, appropriate GI may be linked to regulated blood pressure. These findings can inform health-related policy decisions for these patients.
Study on the clinical efficacy of soothing moisturizing repairing cream combined with desonide in the treatment of atopic dermatitis in children
Authors: Zhang Yuping , Chen Yueqing , Li Chen
Published: January 2025

This study evaluates the efficacy and safety of soothing moisturizing repairing cream combined with desonide in the treatment of atopic dermatitis (AD) in children in the real world. A total of 37 children with AD were randomly divided into experimental (17) and control (20) groups. For the experimental group, treated with moisturizing cream combined with desonide cream, the maintenance period was with moisturizer alone. For the control group, treated solely with desonide, the maintenance period was with nothing. Clinical assessments were made before and 1, 2, and 4 weeks after treatment. Efficacy indicators are compared between the 2 groups, and the relieving effect of moisturizer on the maintenance period of AD in children is observed. Adverse reactions are also recorded. After 4 weeks of treatment, the cure rate and effectiveness rate in the experimental group were 52.9% and 100%, respectively, compared to 0% and 60% in the control group; the estimated median maintenance time was 48 days for the control group and 73 days for the experimental group. The incidence of adverse reactions shows no statistical significance. The combination of moisturizing cream and desonide in the treatment of AD in children is highly effective and safe. It is worth promoting for clinical application due to its significant therapeutic effects and high safety profile.
The treatment of continuous double-level lumbar degenerated disease with PE-TLIF: A case report
Authors: Chen Yufeng , Jiang Weiwei , Ma Xiaoming
Published: January 2025

Rationale:

Percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) is a minimally invasive surgical approach for the treatment of lumbar degenerative diseases, Due to the high incidence of surgical complications and long operative time, the cases reported in previous literature were focused on single segment lumbar degenerative diseases. In our study, we present 2 patients who had continuous double-level lumbar degenerated disease.

Patient concerns:

A 71-year-old man with severe low back pain and right leg pain for 3 months, a 57-year-old woman with severe low back pain and bilateral leg pain for 6 months. Conservative treatment is ineffective for both of them.

Diagnoses:

Magnetic resonance imaging and physical examination show that the patients had 2 consecutive segments lumbar degenerated disease that required surgical treatment.

Interventions:

Considering the poor efficacy of conservative treatment, We performed PE-TLIF on 2 patients.

Outcomes:

Finally, both of 2 patients obtained a satisfactory short-term clinical efficacy, without any complications.What’s more, the most crucial thing is that average operative time is only 205 minutes.

Lessons:

The patients of continuous double-level lumbar degenerated disease treated with PE-TLIF may provide significant support in selecting the appropriate treatments for similar cases and increase the surgical indications for PE-TLIF.
Fatal complications of aortoesophageal fistula caused by pseudoaneurysm following esophageal stent placement: A case report
Authors: Liao Yiran , Yu Shishi , Shen Neng , Liao Zhongli , Wang Jiong
Published: January 2025

Rationale:

Aortoesophageal fistula (AEF) is an exceedingly rare yet critically life-threatening condition, with mortality rates nearing 100% if not addressed promptly. AEF often develops in the context of thoracic aortic aneurysms, esophageal malignancies, or as a complication of foreign body ingestion and prior thoracic aortic surgeries. This study reports an exceptionally severe and clinically rare case of AEF associated with a pseudaneurysm induced by esophageal stenting. By disseminating this case, we aim to heighten awareness of AEF and emphasize the necessity for meticulous decision-making during esophageal stent placement, along with the importance of vigilant postoperative monitoring to enable early intervention.

Patient concerns:

A 70-year-old male presented with “food obstruction” and was subsequently diagnosed with esophageal malignancy. To alleviate the obstruction, he underwent esophageal stenting. Fifty-five days postprocedure, he experienced a sudden onset of “chest pain, vomiting of dark red blood, and melena,” prompting hospitalization for “gastrointestinal bleeding.”

Diagnoses:

Urgent computed tomography angiography revealed the emergence of a new pseudaneurysm at the lateral aspect of the esophageal stent, with direct communication between the aneurysm and the adjacent esophagus, raising the suspicion of AEF.

Interventions:

An urgent multidisciplinary emergency team was convened to execute critical interventions, including endoluminal stenting of the esophagus and thoracic endovascular aortic repair.

Outcomes:

The patient suffered a sudden and massive hematemesis, estimated at approximately 3000 mL, leading to his subsequent demise.

Lessons:

AEF is a rare cause of upper gastrointestinal bleeding. For patients suspected of AEF, it is imperative to conduct prompt and thorough computed tomography angiography while initiating an emergency surgical alert. The proximity of esophageal stents to the aorta may significantly elevate the risk of AEF; thus, a comprehensive risk assessment should precede stent placement in cases involving tumors adjacent to the aorta. Furthermore, postoperative surveillance is crucial to monitor potential aortic invasion by the tumor or the development of an aneurysm near the esophagus, facilitating timely intervention.
Cardiac papillary fibroelastoma involving the mitral valve: A case report
Authors: An Yuqiong , Nie Fang
Published: January 2025

Rationale:

Cardiac papillary fibroelastoma (CPF) is a rare cardiac tumor that can lead to severe and potentially fatal complications such as stroke, myocardial infarction, and sudden cardiac death. The rarity of CPF makes it challenging for clinicians to diagnose and treat, highlighting the importance of timely and accurate diagnosis to prevent catastrophic outcomes. This case report aims to contribute to the clinical understanding of CPF involving the mitral valve (MV), providing insights into diagnosis and treatment strategies.

Patient concerns:

We present a case of CPF attached to the MV in a 69-year-old male patient with a 3-year history of syncope.

Diagnoses:

Echocardiography and computed tomography (CT) imaging confirmed a floating, round-shaped mass on the anterior leaflet MV, with pathological analysis supporting the diagnosis of CPF.

Interventions:

The patient underwent the tumor resection and valve repair operation.

Outcomes:

Postoperative recovery was favorable, with no evidence of recurrence or valve dysfunction at 1-year follow-up.

Lessons:

Echocardiography is a valuable diagnostic tool for identifying CPF and guide treatment decisions. This case emphasizes the importance of recognizing this rare valve tumor for timely clinical intervention.
Sub-coronary ROSS operation in a young man with quadricuspid aortic valve and anomalous aortic origin of the left coronary artery: A case report
Authors: Xu Li , Su Yueqiu , Leng Zhou
Published: January 2025

Rationale:

Quadricuspid aortic valve (QAV) is a rare condition with a very low incidence. Anomalous aortic origin of a coronary artery (AAOCA) is the most prevalent form of coronary anomaly. One variant of AAOCA is the anomalous aortic origin of the left coronary artery from the right coronary sinus (L-AAOCA). It is even rarer for QAV to occur in combination with AAOCA.

Patient concerns:

In this case report, we present a patient who was diagnosed with QAV and L-AAOCA using preoperative transesophageal echocardiography and 3-dimensional computed tomography (3D-CT).

Diagnoses:

Cardiac-enhanced CT showed an anomalous aortic origin of the left coronary artery from the right coronary sinus with an intramural course.

Interventions:

The patient underwent sub-coronary ROSS procedure along with the unroofing procedure.

Outcomes:

The timely diagnosis of this incorporated cardiac anomaly, or rather its accidental discovery, led to successful surgical correction, eliminating the future risk of cardiac ischemia or SCD.

Lessons:

The timely diagnosis of this incorporated cardiac anomaly, or rather its accidental discovery, led to successful surgical correction, eliminating the future risk of cardiac ischemia or SCD.
Effects of Shenmai Injection on proliferation, migration, invasion and angiogenesis of colorectal carcinoma vascular endothelial cells
Authors: Liu Xiangyu
Published: January 2025

Background:

Colorectal cancer, being 1 of the most significant malignant tumors globally, poses a substantial risk to human health. Unfortunately, its 5-year survival rate stands at a mere 65%. There remains an urgent need for the development of novel treatments to combat this detrimental malignancy effectively. The Shenmai Injection (SMI) is a Chinese medicine that has been proven to have significant clinical efficacy in the treatment of cardiovascular diseases. This study aimed to examine the impact of SMI on the proliferation, migration, invasion, and angiogenesis of tumor-derived endothelial cells (Td-EC).

Methods:

Human umbilical vein endothelial cells (HUVEC) induced Td-EC, and HUVEC were treated with conditioned media from the human colorectal carcinoma cells (HCT116). The effects of HCT116 on the proliferation, migration, and invasion of hepatocellular carcinoma cells after treatment of SMI were observed by MTS assay and Transwell techniques. Additionally, an angiogenesis experiment was used to investigate Td-EC tube formation capacity.

Results:

SMI had a significant inhibiting effect on the proliferation, migration, and invasion of HCT116. SMI was also able to inhibit the angiogenesis of Td-EC. Notably, SMI did not have any effect on the normal endothelium.

Conclusion:

SMI has obvious antiproliferation, migration, infiltration, and neogenesis effects on HCT116.
Prenatal diagnosis and treatment of fetal intestinal volvulus: A case report
Authors: Zeng Xiaoyan , Li Xiang , Mo Weinong , Zhu Xuefen
Published: January 2025

Rationale:

Fetal intestinal volvulus, a rare and severe disorder, poses significant diagnostic challenges prenatally and can lead to intrauterine death or adverse neonatal outcomes if untreated in a timely manner. This study reports a case of fetal intestinal volvulus confirmed postoperatively, providing insights into its clinical manifestations, diagnostic methods, and treatment outcomes, thereby enhancing understanding of this rare condition.

Patient concerns:

A Chinese gravida 2, para 1 female presented at 32 weeks and 5 days of gestation with decreased fetal movements. Fetal ultrasound and MRI revealed small intestinal torsion and obstruction. Due to fetal distress, an emergency cesarean section was performed, followed by an urgent laparotomy on the neonate to untwist the intestinal volvulus and resect the necrotic bowel segment.

Diagnosis:

Fetal intestinal volvulus

Interventions:

Following an emergency cesarean section, the neonate was promptly transferred to the surgical department for immediate surgical intervention. The procedure encompassed detorsion of the intestinal volvulus and resection of the necrotic bowel segment.

Outcomes:

The infant exhibited a satisfactory postoperative recovery, successfully transitioned to complete oral and gastrointestinal nutrition, and demonstrated normal physical growth and cognitive development during the ensuing follow-up period.

Lessons:

Fetal intestinal volvulus requires multidisciplinary collaboration for diagnosis and treatment. Early recognition, prompt delivery, and urgent surgical intervention are crucial for optimizing neonatal outcomes. By sharing this case, we hope to enhance the diagnostic and therapeutic capabilities of healthcare providers in managing this rare but severe condition.