bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of dezocine patient-controlled epidural analgesia in postoperative analgesia in patients with total myomectomy
Authors: Ning Feng-Feng , Yao Ting-Ting , Wang Xiao-Xia 
Published: June 2024

BACKGROUND
Uterine fibroids are common benign gynecological conditions. Patients who experience excessive menstruation, anemia, and pressure symptoms should be administered medication, and severe cases require a total hysterectomy. This procedure is invasive and causes severe postoperative pain, which can affect the patient’s postoperative sleep quality and, thus, the recovery process.
AIM
To evaluate use of dezocine in patient-controlled epidural analgesia (PCEA) for postoperative pain management in patients undergoing total myomectomy.
METHODS
We selected 100 patients undergoing total abdominal hysterectomy for uterine fibroids and randomized them into two groups: a control group receiving 0.2% ropivacaine plus 0.06 mg/mL of morphine and an observation group receiving 0.2% ropivacaine plus 0.3 mg/mL of diazoxide in their PCEA. Outcomes assessed included pain levels, sedation, recovery indices, PCEA usage, stress factors, and sleep quality.
RESULTS
The observation group showed lower visual analog scale scores, shorter postoperative recovery indices, fewer mean PCEA compressions, lower cortisol and blood glucose levels, and better polysomnographic parameters compared to the control group (P < 0.05). The cumulative incidence of adverse reactions was lower in the observation group than in the control group (P < 0.05).
CONCLUSION
Dezocine PCEA can effectively control the pain associated with total myomectomy, reduce the negative impact of stress factors, and have less impact on patients’ sleep, consequently resulting in fewer adverse effects.
Treatment refractory mast cell leukemia with dominant gastrointestinal manifestation and concomitant skin symptoms: A case report
Authors: Wysocki Maciej Tomasz , Gonciarz Maciej , Puła Bartosz 
Published: June 2024

BACKGROUND
Mast cell leukemia (MCL), a subtype of systemic mastocytosis (SM), is an extremely rare clinical entity characterized by a very poor prognosis. Chemotherapy, tyrosine kinase inhibitors, and allogeneic hematopoietic cell transplantation are the only treatment options, but they cannot provide the desired outcomes in most cases of MCL. However, other types of SM can be successfully treated. The disease has no specific manifestation, but gastroenterological symptoms are present in most cases.
CASE SUMMARY
The authors, hereby, report a case of a 46-year-old female patient diagnosed with MCL-the rarest subtype of SM. The patient presented to the gastroenterology clinic with multiple, various, and unspecific gastroenterological symptoms. Concomitance of skin lesions significantly contributed to a relatively prompt diagnosis. The serum tryptase level was extremely high and bone the marrow aspirate showed an infiltration of atypical mast cells. The disease was rapidly progressive and primary refractory to chemotherapy and the patient succumbed to the illness about a month after the initiation of treatment.
CONCLUSION
Despite its “hematological nature”, MCL, in most cases presents dominantly with unspecific gastroenterological symptoms. Thus, a high disease awareness among physicians other than hematologists is necessary to improve treatment outcomes. Serum tryptase level, due to its non-invasive nature and easy access, may serve as an initial step to estimate the probability of mastocytosis.
Rectus sheath hematoma combined with COVID-19: A case report
Authors: Wang Wei , Duan Jie 
Published: June 2024

BACKGROUND
Rectus sheath hematoma (RSH) is uncommon, and because people have limited knowledge about it, it is difficult to recognize the symptoms in time, often de-laying optimal treatment.
CASE SUMMARY
Herein, we report a case of a 77-year-old female with RSH. The patient was treated at our hospital for coronavirus disease 2019. Anticoagulant treatment was administered during this period because of thrombosis. On the 8th d of treatment, the patient complained of abdominal pain. Ultrasonography revealed a solid cystic mass in the pelvic cavity. An emergency laparotomy was performed, and a huge hematoma was found in the deep layer of the rectus abdominis muscle. We used anticoagulants with caution based on the patient’s condition.
CONCLUSION
Optimal management of patients with RSH s depends on timely diagnosis and when to reintroduce anticoagulants.
Nasal congestion caused by long-term retention of a nasal foreign body near the orbit: A case report
Authors: Wang Dan , Liu Qing , Liu Hui , Wei Jia-Sha 
Published: June 2024

BACKGROUND
Nasal trauma presents a risk of foreign body invasion into the nasal cavity. However, in the early treatment stage of nasal trauma, patients and doctors are not always aware of possible foreign body invasion, resulting in delayed detection. We describe the case of an adult patient admitted to the hospital due to left nasal congestion accompanied by yellow, purulent, and bloody discharge.
CASE SUMMARY
Consultation with the patient revealed a history of nasal trauma 30 years prior that did not receive thorough examinations and imaging during treatment, resulting in a glass fragment retained in the nasal cavity adjacent to the orbit. After admission, computerized tomography (CT) confirmed the presence of the foreign body in the patient’s left nasal–maxillary sinus. The nasal foreign body led to symptoms such as chronic sinusitis, nasal polyps, fungal infection, and deviated nasal septum. The foreign body was successfully removed by nasal endoscopy, polypectomy, sinus fungal removal, left middle turbinate conchoplasty, fenestration via the right inferior meatus, nasal endoscopic maxillary sinus cystectomy, and septolplasty. The operation was successful and without any complications.
CONCLUSION
CT scans should be performed in addition to necessary debridement sutures to avoid possible foreign body invasion during nasal trauma. Surgical planning should be tailored to the patient’s specific situation. The surgical method should be carefully selected, and sufficient preparation should be undertaken before the surgery to avoid possible displacement of the nasal foreign body.
An unusual etiology of subarachnoid hemorrhage, basilar artery perforator aneurysms, in Macao: Three case reports and review of literature
Authors: Man Ieong-Chon , Pan Tam-Man , U Kuok-Cheong 
Published: June 2024

BACKGROUND
Subarachnoid hemorrhage is a severe neurological condition that requires prompt and appropriate treatment to prevent complications. Aneurysms are the most common cause of spontaneous subarachnoid hemorrhage. Conversely, basilar artery perforator aneurysms (BAPAs) are a rare etiology. There is no consensus on the optimal management of ruptured BAPAs in the acute setting.
CASE SUMMARY
We present a case series of 3 patients with ruptured BAPAs who were treated at our institution. Two patients had a modified Fisher grade of I, and one had a grade of IV on initial presentation. The aneurysms were detected by computed tomography angiography in two cases and conventional angiography in one case. The 3 patients underwent endovascular treatment with Guglielmi detachable coils. Post-treatment, the patients had good clinical outcomes, and follow-up brain computed tomography scans showed reduced subarachnoid hemorrhage without any new hemorrhage. However, one patient experienced a cerebral infarction 2 months later and eventually succumbed to the condition. The other 2 patients showed progressive recovery, and no aneurysm recurrence was observed at the 2-year follow-up.
CONCLUSION
Endovascular treatment may be a preferable approach for managing ruptured BAPAs compared with surgical intervention or conservative management. Early detection and prompt treatment is important to achieve favorable patient outcomes.
Atypical Guillain-Barré syndrome with positive anti-sulfatide, anti-GT1b, and anti-GT1a antibodies: A case report
Authors: Tan Fei-Fei , Liu He-Xu , Huang Xue-Yan , Yu Chang-Yin , Yang Xiao-Yan 
Published: June 2024

BACKGROUND
The role of diverse antibodies in mediating peripheral nerve injury in Guillain-Barré syndrome (GBS) is becoming clearer, but positivity for multiple antibodies in one case is uncommon. To our knowledge, this is the first case involving GBS with positive anti-sulfatide, anti-GT1a, and anti-GT1b antibodies.
CASE SUMMARY
A 20-year-old female patient was admitted to the hospital due to weakness of limbs for 5 d, and deterioration of the weakness and muscle aches for 1 d. The patient's limbs were weak, but the tendon reflexes in the part of the limbs were normal. There was no comorbid peripheral nociception or deep sensory dysfunction. She was diagnosed with GBS and was discharged after receiving intravenous human immunoglobulin pulse therapy.
CONCLUSION
In this article, the clinical manifestations, neurophysiological examination, and auxiliary examination findings of a GBS patient positive for multiple antibodies were analyzed to improve the identification of the disease by clinical physicians at an early stage.
Misdiagnosed Meckel's diverticulum with internal hernia mimicking appendicitis: A case report
Authors: Zhang Qi , Xu Xiu-Juan , Ma Jun , Zhang Ya-Ming 
Published: June 2024

BACKGROUND
Meckel's diverticulum is a common congenital anomaly of the gastrointestinal tract, with a higher incidence rate in children under 7 years old. The condition is characteristically asymptomatic but may become a clinical concern when complications such as intestinal obstruction, bleeding, perforation, or diverticulitis precipitate acute abdominal presentations.
CASE SUMMARY
This report describes the case of a middle-aged man initially suspected of having acute appendicitis, which rapidly progressed to acute peritonitis with concomitant intestinal obstruction observed during preoperative assessment. Surgical exploration confirmed the diagnosis of Meckel's diverticulum-induced internal hernia, accompanied by intestinal obstruction and necrosis. In addition, the hernial ring base exhibited entrapment resembling a surgical knot.
CONCLUSION
Meckel's diverticulum is a rare cause of small bowel obstruction in adults, and it should be considered in a differential diagnosis.
Ischemic stroke with concomitant clear cell carcinoma of the ovary: A case report and review of literature
Authors: Siu Wing Yu Sharon , Ding Dah-Ching 
Published: June 2024

BACKGROUND
Ischemic stroke is a rare event associated with an elevated risk of blood clot formation owing to an underlying malignancy. Herein, we present a case of ovarian carcinoma that led to cerebral infarction.
CASE SUMMARY
A 43-year-old woman experienced sudden onset right-sided paralysis and difficulty speaking two days after discovery of a large ovarian tumor measuring approximately 14 cm, which was suspected to be malignant. Further examination revealed left middle cerebral artery infarction. The patient had a history of hypertension and adenomyosis. Following stabilization with heparin treatment and vital signs management, the patient underwent debulking surgery, including total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and bilateral pelvic and para-aortic lymph node dissection. The final diagnosis was clear cell carcinoma of the right ovary (stage IA). Subsequently, the patient completed six rounds of adjuvant chemotherapy while simultaneously undergoing rehabilitation. Presently, the patient is able to walk independently, although she still experiences aphasia.
CONCLUSION
Prompt medical intervention and interdisciplinary care are crucial in the setting of incidental findings such as a large ovarian tumor.
Ipsilateral retroperitoneal papillary renal cell carcinoma 27 years after simple nephrectomy for a renal abscess: A case report
Authors: Kim Tae Nam , Kim Ahrong , Kim Kyung Bin , Lee Chang Hun 
Published: June 2024

BACKGROUND
Cases of severe inflammatory renal disease and renal cell carcinoma (RCC) that occur simultaneously in the same kidney have been occasionally reported. However, extrarenal RCC that does not originate from the native kidney has rarely been reported. To our knowledge, this is the first reported case of RCC developing in the ipsilateral retroperitoneal space after a simple nephrectomy (SN) for inflammatory renal disease.
CASE SUMMARY
A 63-year-old woman was referred to our hospital following the incidental discovery of a left retroperitoneal mass without specific symptoms. Her medical history revealed a left SN 27 years ago due to a renal abscess. Magnetic resonance imaging of the abdomen revealed three oval masses in the left retroperitoneum. The masses were successfully excised, and subsequent pathology confirmed papillary RCC. After surgery, the patient remained disease-free for 11 years without adjuvant therapy.
CONCLUSION
Clinicians should be vigilant of RCC in patients with retroperitoneal masses, especially after SN for inflammatory renal disease.
Treatment of a patient with severe cerebral malaria during the COVID-19 pandemic in China: A case report
Authors: Zhu Yan-Fang , Xia Wen-Jing , Liu Wei , Xie Ju-Min 
Published: June 2024

BACKGROUND
On June 30, 2021, China received certification from the World Health Organization for malaria elimination. However, this certification does not signify the absence of malaria within China. Due to the increasing frequency of international exchanges and collaborations, the threat of imported malaria persists in China. Consequently, the prevention and control of imported malaria have become a primary focus for our country to maintain its malaria elimination status.
CASE SUMMARY
Herein, we present a case report of a 53-year-old Chinese man who worked in Africa for nearly two years. He was diagnosed with malaria in the Democratic Republic of the Congo between November 19 and November 23, 2022. After receiving effective treatment with oral antimalarial drugs, his condition improved, allowing him to return to China. He was later admitted to our hospital on January 12, 2023, during the coronavirus disease 2019 pandemic in Huangshi, China. Through a thorough evaluation of the patient's symptoms, clinical signs, imaging and laboratory test results, and epidemiological data, he was rapidly diagnosed with severe cerebral malaria. The patient underwent successful treatment through a series of intensive care unit interventions.
CONCLUSION
The successful treatment of this imported case of severe cerebral malaria provides a valuable reference for managing patients with similar malaria infections and has significant clinical implications.
Ear keloid and epidermal cyst following auricular cartilage harvest for rhinoplasty: A case report
Authors: Kim Jun Mo , Cheon Ji Seon , Choi Woo Young 
Published: June 2024

BACKGROUND
This case report highlights a rare instance of concurrent keloid and epidermal cyst development at an ear cartilage harvest site following rhinoplasty in a 25-year-old woman. Both conditions, which typically stem from skin trauma, seldom occur together, demonstrating the exceptional characteristics of this case.
CASE SUMMARY
The patient underwent successful surgical removal of both the keloid and the epidermal cyst. Postoperative treatment included the use of silicone sheets, gel, and oral tranilast to reduce scarring. No recurrence was observed over a 6-mo follow-up period, indicating effective management of the condition.
CONCLUSION
The effective management of complex skin trauma cases underscores the need for individualized treatment strategies in plastic surgery.
Temporal lobe malacia as a rare cause of gelastic seizure: A case report
Authors: Liao Yuan-Sheng , Gao Li-Li , Lin Min , Wu Cheng-Han 
Published: June 2024

BACKGROUND
Gelastic seizure (GS) is a rare type of epilepsy that most commonly appears in patients with hypothalamic hamartoma. It is rarely associated with other types of brain damage. This particular type of epilepsy is relatively rare and has few links to other brain lesions. Temporal lobe malacia is mostly caused by cerebral infarction or cerebral hemorrhage, which can lead to seizures. We report a case of GS in a woman with temporal lobe malacia which was reported for the first time in the literature.
CASE SUMMARY
A 73-year-old female, diagnosed case of GS, presented with repetitive stereotyped laughter a month prior to presentation, happening multiple times daily and with each time lasting for 5-15s. Electroencephalogram displayed a focal seizure seen in the right temporal region. Magnetic resonance imaging head with contrast showed a right temporal lobe malacia. The patient was started on levetiracetam daily. The patient indicated that they had fully recovered and were not experiencing any recurrent or stereotyped laughter during their daily routines. These results remained consistent even after a one-year follow-up period.
CONCLUSION
GS can be caused by temporal lobe malacia, which is an uncommon but potentially grave condition. The outcome of this present case exhibited the importance of the temporal lobe in the genesis of GS.
Predictive model for postpartum hemorrhage requiring hysterectomy in a minority ethnic region
Authors: Wang Ling , Pan Jun-Yu 
Published: June 2024

BACKGROUND
Postpartum hemorrhage (PPH) is a leading cause of maternal mortality, and hysterectomy is an important intervention for managing intractable PPH. Accurately predicting the need for hysterectomy and taking proactive emergency measures is crucial for reducing mortality rates.
AIM
To develop a risk prediction model for PPH requiring hysterectomy in the ethnic minority regions of Qiandongnan, China, to help guide clinical decision-making.
METHODS
The study included 23490 patients, with 1050 having experienced PPH and 74 who underwent hysterectomies. The independent risk factors closely associated with the necessity for hysterectomy were analyzed to construct a risk prediction model, and its predictive efficacy was subsequently evaluated.
RESULTS
The proportion of hysterectomies among the included patients was 0.32% (74/23490), representing 7.05% (74/1050) of PPH cases. The number of deliveries, history of cesarean section, placenta previa, uterine atony, and placenta accreta were identified in this population as independent risk factors for requiring a hysterectomy. Receiver operating characteristic curve analysis of the prediction model showed an area under the curve of 0.953 (95% confidence interval: 0.928-0.978) with a sensitivity of 90.50% and a specificity of 90.70%.
CONCLUSION
The model demonstrates excellent predictive power and is effective in guiding clinical decisions regarding PPH in the ethnic minority regions of Qiandongnan, China.
Establishment of a nomogram model for predicting therapy complications in patients with polycythemia and deep venous thrombosis
Authors: Zhao Ming-Xian , Li Guo-Jie 
Published: June 2024

BACKGROUND
Patients with deep venous thrombosis (DVT) residing at high altitudes can only rely on anticoagulation therapy, missing the optimal window for surgery or thrombolysis. Concurrently, under these conditions, patient outcomes can be easily complicated by high-altitude polycythemia (HAPC), which increases the difficulty of treatment and the risk of recurrent thrombosis. To prevent reaching this point, effective screening and targeted interventions are crucial. Thus, this study analyzes and provides a reference for the clinical prediction of thrombosis recurrence in patients with lower-extremity DVT combined with HAPC.
AIM
To apply the nomogram model in the evaluation of complications in patients with HAPC and DVT who underwent anticoagulation therapy.
METHODS
A total of 123 patients with HAPC complicated by lower-extremity DVT were followed up for 6-12 months and divided into recurrence and non-recurrence groups according to whether they experienced recurrence of lower-extremity DVT. Clinical data and laboratory indices were compared between the groups to determine the influencing factors of thrombosis recurrence in patients with lower-extremity DVT and HAPC. This study aimed to establish and verify the value of a nomogram model for predicting the risk of thrombus recurrence.
RESULTS
Logistic regression analysis showed that age, immobilization during follow-up, medication compliance, compliance with wearing elastic stockings, and peripheral blood D-dimer and fibrin degradation product levels were indepen- dent risk factors for thrombosis recurrence in patients with HAPC complicated by DVT. A Hosmer-Lemeshow goodness-of-fit test demonstrated that the nomogram model established based on the results of multivariate logistic regression analysis was effective in predicting the risk of thrombosis recurrence in patients with lower-extremity DVT complicated by HAPC (χ 2 = 0.873; P > 0.05). The consistency index of the model was 0.802 (95%CI: 0.799-0.997), indicating its good accuracy and discrimination.
CONCLUSION
The column chart model for the personalized prediction of thrombotic recurrence risk has good application value in predicting thrombotic recurrence in patients with lower-limb DVT combined with HAPC after discharge.
Effect of bivalirudin on myocardial microcirculation and adverse events after interventional therapy in older patients with acute coronary syndrome
Authors: Du Ya-Kun , Cui Li-Jun , Gao Hong-Bo 
Published: June 2024

BACKGROUND
Bivalirudin, a direct thrombin inhibitor, is used in anticoagulation therapies as a substitute for heparin, especially during cardiovascular procedures such as percutaneous coronary intervention.
AIM
To explore the effect of bivalirudin on myocardial microcirculation following an intervention and its influence on adverse cardiac events in elderly patients with acute coronary syndrome (ACS).
METHODS
In total, 165 patients diagnosed with acute myocardial at our hospital between June 2020 and June 2022 were enrolled in this study. From June 2020 to June 2022, elderly patients with ACS with complete data were selected and treated with interventional therapy. The study cohort was randomly divided into a study group (n = 80, administered bivalirudin) and a control group (n = 85, administered unfractionated heparin). Over a 6-mo follow-up period, differences in emergency processing times, including coronary intervention, cardiac function indicators, occurrence of cardiovascular events, and recurrence rates, were analyzed.
RESULTS
Significant differences were observed between the study cohorts, with the observation group showing shorter emergency process times across all stages: Emergency classification; diagnostic testing; implementation of coronary intervention; and conclusion of emergency treatment (P < 0.05). Furthermore, the left ventricular ejection fraction in the observation group was significantly higher (P < 0.05), and the creatine kinase-MB and New York Heart Association scores were notably lower than those in the control group (P < 0.05).
CONCLUSION
In elderly patients receiving interventional therapy for ACS, bivalirudin administration led to increased activated clotting time achievement rates, enhanced myocardial reperfusion, and reduced incidence of bleeding complications and adverse cardiac events.