bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multisite distribution of fibrillary inclusions in a patient with light chain proximal tubulopathy: A case report
Authors: Wang Yingying , Chen Kai , Zhou Shengguo , Zhang Wei 
Published: August 2024

Rationale:
Light chain proximal tubulopathy (LCPT) is a rare form of renal impairment associated with multiple myeloma (MM). LCPT is caused by inclusions formed of free light chains that are typically crystalline, but can also be noncrystalline structures.

Patient concerns:
A 62-year-old man was hospitalized for the investigation of abnormal urine test results lasting for 1 year and kidney-function abnormalities persisting for more than 1 month.

Diagnoses:
Noncrystalline LCPT and MM.

Interventions:
The patient was treated with the lenalidomide, bortezomib, and dexamethasone and pomalidomide, bortezomib, and dexamethasone chemotherapy regimens.

Outcomes:
Complete remission of MM was achieved, and the patient’s renal function returned to normal.

Lessons:
This case report highlights the importance of renal pathology in the diagnosis of patients with unexplained chronic kidney disease and proteinuria.
The clinical, economic, and humanistic burden of treatments for exocrine pancreatic insufficiency and cost-effectiveness of treatments: A systematic literature review
Authors: Chu Paula , Mioc Jasmina , Henry Owen , O’Donovan Peter 
Published: August 2024

Background:
To examine the burden of exocrine pancreatic insufficiency (EPI), specifically the clinical impact of EPI on patients, their quality of life (QoL) and the cost-effectiveness of existing treatments.

Methods:
A systematic literature review was conducted using key search terms for the clinical, economic, and humanistic burden. Databases were searched from 2010 to 2022, with articles screened independently by 2 reviewers at abstract and full-text stage against pre-defined eligibility criteria.

Results:
Seventy-one publications were identified that reported relevant clinical, humanistic, and economic data. Prevalence and incidence of EPI varied across identified studies; EPI appears to be especially prevalent as a comorbid condition in patients with cystic fibrosis. EPI has a large impact on QoL, with lower QoL scores in patients with EPI compared with those without EPI. The instruments used to assess QoL, however, were inconsistent across studies. Where reported, economic burden studies highlighted that patients with EPI have higher healthcare resource utilization compared with those without, with costs increasing with disease severity.

Conclusion:
This systematic literature review highlights that patients with EPI have higher treatment costs and lower QoL scores than patients without EPI. The prevalence of EPI as a comorbid condition is high, particularly in patients with cystic fibrosis.
Association between the triglyceride–glucose index and mortality in critically ill patients: A meta-analysis
Authors: Nie Mengzhen , Jiang Biantong , Xu Yu 
Published: August 2024

Background:
To further identify the association of the triglyceride–glucose (TyG) index with the risk of mortality among critically ill patients admitted to the intensive care unit (ICU).

Methods:
The PubMed, Web of Science, and EMBASE databases were searched for relevant studies up to February 2, 2024. The primary outcomes were in-hospital mortality and ICU mortality. The secondary outcomes were 30-day mortality, 90-day mortality, and 1-year mortality. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined to evaluate the associations between the TyG index and the above endpoints. All the statistical analyses were performed with STATA 15.0 software.

Results:
Ten studies involving 22,694 patients were included. The pooled results demonstrated that an elevated TyG index indicated an increased risk of in-hospital mortality (HR = 1.76, 95% CI: 1.41–2.18, P < .001), ICU mortality (HR = 1.52, 95% CI: 1.33–1.74, P < .001), 30-day mortality (HR = 1.50, 95% CI: 1.02–2.19, P = .037), 90-day mortality (HR = 1.42, 95% CI: 1.01–2.00, P = .043), and 1-year mortality (HR = 1.19, 95% CI: 1.11–1.28, P < .001). Subgroup analysis for in-hospital mortality and ICU mortality based on sex, age, body mass index and hypertension showed similar results. However, subgroup analysis stratified by diabetes mellitus (DM) revealed that the associations of the TyG index with in-hospital mortality (HR = 2.21, 95% CI: 1.30–3.78, P = .004) and ICU mortality (HR = 1.93, 95% CI: 0.95–3.94, P = .070) were observed only among patients without DM.

Conclusion:
The TyG index was significantly associated with mortality among critically ill patients without DM, and an elevated TyG index predicted an increased risk of mortality.
Novel GJB2 mutation c.188delT compound with c.235delC causing non-syndromic hearing loss in a Chinese family: A case report
Authors: Tao Yilun , Hu Zhipeng , Han Dong , Song Wenxia , Wang Lihong , Wang Haiwei , Li Xiaoze 
Published: August 2024

Rationale:
Congenital sensorineural hearing loss is a significant global health issue, primarily driven by genetic factors, such as mutations in the GJB2 gene. This report presents a Chinese girl with congenital deafness and a novel mutation of the GJB2 gene.

Patient Concerns:
A newborn Chinese girl exhibited signs of congenital deafness.

Diagnosis:
Congenital deafness was confirmed through comprehensive newborn hearing screenings that included otologic, audiologic, and physical examinations. Genetic analysis revealed a compound heterozygous mutation involving c.188delT and c.235delC in the GJB2 gene, indicating a genetic basis for her hearing loss.

Interventions:
The patient underwent cochlear implantation, which resulted in stable auditory outcomes.

Outcomes:
Despite follow-up difficulties, stable auditory outcomes were achieved post-cochlear implantation, highlighting the potential efficacy of this intervention in GJB2-related hearing loss.

Lessons:
This case study enriches our understanding of GJB2 mutations and underscores the critical role of genetic testing in diagnosing congenital sensorineural hearing loss. It emphasizes the necessity for early intervention and sustained interdisciplinary care to enhance the quality of life for patients with genetic hearing impairment.
A case report: Treatment of a patient with ruptured middle cerebral aneurysm in the second trimester of pregnancy
Authors: Li Wei , Liu Yang , Chu Fudi , Li Mingjian , Wang Jinpeng 
Published: August 2024

Background:
To summarize the clinical experience of intracranial aneurysm clipping in the treatment of ruptured intracranial aneurysms in the second trimester of pregnancy.

Methods:
A case of ruptured middle cerebral aneurysm in the second trimester of pregnancy was reported. Craniotomy and aneurysm clipping were performed at 24 weeks of pregnancy, and fetal preservation was continued after the operation.

Results:
The prognosis of the parturient was good and the skull was missing on the operative side. A healthy baby boy was delivered by cesarean section 2 months after the operation, and skull repair was performed 4 months after the operation. During the follow-up for 1 year, the mother and son were healthy and no obvious sequelae were found.

Conclusion:
Ruptured intracranial aneurysm hemorrhage in mid-pregnancy is a rare and critical case. Summarizing the corresponding clinical experience will help to have a reference plan for the next time when facing a similar situation, and it will help to treat critically ill patients. The treatment of ruptured intracranial aneurysm in mid-pregnancy requires multidisciplinary collaboration, and cranial aneurysm clamping + fertility preservation can reduce the impact of radiation on the fetus and improve the prognosis for both the mother and the fetus.
Infectious wrist arthritis complicating acute carpal tunnel syndrome in a child: A CARE-compliant case report
Authors: Huang Jihui , Li Jun , Li Ruichen , Wu Xing , Lei Yuanxue , Zhou Zhiguo 
Published: August 2024

Introduction:
The objective of this case report is to provide clinical evidence that acute infectious wrist arthritis in children can lead to the rare condition of acute carpal tunnel syndrome (ACTS). This article discusses in detail the characteristics of infectious wrist arthritis complicating ACTS in children in terms of etiology, pathogenic bacteria, treatment modalities, and sequelae to improve the understanding of this disease.

Patient concerns:
A 10-year-old male child presented with a 15-day history of swelling and pain in the left forearm, wrist, and hand.

Diagnoses:
Left-sided infected wrist arthritis complicating ACTS.

Interventions:
The child received emergency surgery and anti-infective treatment combined with regular rehabilitation.

Outcomes:
During the treatment period, the child’s wrist pain and swelling gradually improved, and wrist movement was restored compared with the preoperative period. At 6-month follow-up, the activities of the metacarpophalangeal joints of the left hand were close to normal, and the flexion of the left wrist joint was slightly limited.

Conclusion:
In infectious wrist arthritis in children, ACTS is a serious complication that requires aggressive surgical carpal tunnel release to avoid median nerve injury in addition to anti-infective therapy.
Rupture of intrahepatic bile duct after ERCP for common bile duct stone: A case report of rare complications
Authors: Ly Tuan Huu , Pham Quang Tien , Tran Loc Huynh , Tran Ha Nhat , Tran Phuoc Duy , Nguyen Khoa Hoang Anh , Le Truc Huynh Thanh , Pham Trung Quoc 
Published: August 2024

Rationale:
Complications after endoscopic retrograde cholangiopancreatography (ERCP) are diverse and usually treated with nonoperative management or percutaneous drainage; however, there are still some rare, life-threatening complications. This is an extremely rare case of biliary peritonitis caused by rupture of the intrahepatic bile duct after ERCP.

Patient concerns:
A 63-year-old male underwent ERCP for common bile duct stones. On the second day after the procedure, the patient developed sepsis and abdominal distention. Contrast-enhanced computed tomography revealed a subcapsular hepatic fluid collection attached to the bile duct of segment VII.

Diagnoses:
Sepsis resulted in liver parenchyma rupture and intrahepatic bile duct injury after ERCP. Intraoperative cholangiography revealed a connection between a hole in the liver parenchymal surface and the intrahepatic bile duct.

Interventions:
Surgeons performed the cholecystectomy, inserted a T-tube into the common bile duct stones, sutured the defect, and put 2 drainage tubes around the lesion.

Outcomes:
Postoperative recovery was uneventful, and the patient was discharged on the 17th postoperative day.

Lessons:
Intrahepatic bile duct perforation after ERCP can lead to rupture of the liver parenchyma, biloma, or abdominal peritonitis. Multidisciplinary management is necessary to achieve favorable outcomes.
Pulmonary adverse reaction caused by furazolidone: Two case reports and a literature review
Authors: Zheng Cong , Cheng Yao , Huang Ping , Zhang Miaomiao , Ren Zhuochao , Zheng Xiaochun , Xuan Zixue , Shen Bin , Yang Xiuli 
Published: August 2024

Rationale:
As one of the drugs used to treat Helicobacter pylori, furazolidone has been reported to cause gastrointestinal reactions, allergies, dizziness, and more. However, its related drug-induced lung injury has been rarely reported. Furthermore, there have been no reports of the timing for initiating hormone therapy when a pulmonary adverse reaction occurs.

Patient concerns:
We report 2 cases, both of them showed interlobular septal thickening and nodules on the chest computed tomography. One had more discomfort symptoms and had a higher eosinophil count than the normal range, while the other only had fever symptoms and had an eosinophil count within the normal range.

Diagnoses:
Pulmonary adverse reaction caused by furazolidone was diagnosed.

Interventions:
Furazolidone was discontinued, and the person with increased eosinophils received hormone therapy, while the other person did not.

Outcomes:
After discontinuation of medication and treatment, the symptoms of the 2 patients gradually improved.

Lessons:
This report suggests that furazolidone may cause pulmonary adverse reactions to raise clinical awareness, and for the first time indicates that hormone therapy is needed for patients whose eosinophils continue to increase after discontinuation.
Construction and verification of rehabilitation nursing program for shoulder and neck discomfort after thyroid cancer surgery: A pilot randomized controlled trial
Authors: Xu Qiuqin , Jiang Hongzhan , Li Yuanchan , Qi Xiushan , Chen Lijuan 
Published: August 2024

Background:
To develop a nursing program for the prevention and rehabilitation of shoulder and neck discomfort after thyroid cancer surgery based on the empowerment theory, and to evaluate the application effect of the program.

Methods:
The prevention and rehabilitation nursing program for shoulder and neck discomfort after thyroid cancer surgery was established by literature review and the Delphi method. Between July 2022 and January 2023, a total of 62 postoperative thyroid cancer patients were recruited and randomly allocated to either the intervention group (n = 31) or the control group (n = 31) in this randomized controlled trial. Comparisons of shoulder and neck function, self-efficacy, and quality of life between the 2 groups were performed using a 2-sample independent t test, Wilcoxon rank-sum test, and repeated-measures analysis of variance.

Results:
At the end of the study, the control group and intervention group were 30 cases each completed the study. After the intervention, the self-efficacy score of the intervention group was higher than the control group (P < .05), and the score of emotional function, cognitive function, and overall health dimension of the intervention group was higher than the control group (P < .05). The pain dimension score of the intervention group was lower than the control group (P < .05). There were significant differences in the group and time effects of the total shoulder joint scores between the 2 groups (P < .05).

Conclusion:
This study demonstrated that the shoulder and neck rehabilitation nursing program can alleviate the symptoms of shoulder and neck discomfort and improve patients’ self-efficacy and quality of life.
The allocation and utilization efficiency of hospital beds in Sichuan Province, China
Authors: Zhou Minghua 
Published: August 2024

Objective:
To analyze the allocation and utilization efficiency of hospital beds in Sichuan Province, China, and to provide a scientific basis for improving the rational allocation and efficient utilization.

Methods:
The supply and demand balance method, health resource agglomeration degree (HRAD), bed efficiency index and bed utilization model were used to evaluate the allocation and utilization efficiency of hospital beds in Sichuan Province from 2017 to 2021.

Results:
The number of hospital beds per 1000 population in Sichuan Province increased from 4.97 in 2017 to 5.94 in 2021. The overall supply and demand ratio of hospital beds in Sichuan Province is between 0.85 and 1.01, and the supply and demand situation is a basically balanced situation. The HRAD of hospital beds in Ya’an, Aba, Ganzi and Liangshan is <1, indicating that the equity of hospital beds by geography in these regions is low. The difference between HRAD and population agglomeration degree (PAD) in 9 regions, including Deyang, Aba, Ganzi and Liangshan, is <0, indicating that there are insufficient hospital beds in these areas relative to the agglomerated population. The bed efficiency index of hospital beds in 17 regions, including Chengdu, Zigong, Aba and Ganzi, are all <1, which means that hospital beds are operating with low efficiency. The bed utilization model of Panzhihua is efficiency type, that of Zigong, Deyang and Ziyang is pressure bed type, and that of Nanchong and Ya’an is idle type.

Conclusion:
The hospital bed allocation in Sichuan Province is relatively good, and the supply and demand situation is in a basically balanced situation. The hospital bed allocation in Aba, Ganzi and Liangshan is insufficient by geography and population. The overall operational efficiency of hospital beds is low, and there are more idle and pressure bed utilization models.
Simultaneous occurrence of papillary thyroid carcinoma, medullary thyroid carcinoma, and lymphoma: A case report
Authors: Hao Zengfang , Cui Hanjing , Li Yuehong , Wu Wenxin , Wang Yuan , Dan Haijun , Lou Lei , Wang Hengshu , Zhao Pengxin 
Published: August 2024

Background:
Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, the coexistence of PTC and medullary thyroid carcinoma (MTC) is uncommon. While the simultaneous occurrence of both cancers with small lymphocytic lymphoma (SLL) in lymph nodes with PTC metastasis is very rare. This study presents a unique case of concurrent PTC, MTC, and SLL, highlighting the exceptional rarity of these coexisting tumors.

Methods:
A 75-year-old female with a thyroid tumor underwent total thyroidectomy, bilateral central neck lymph node dissection, and right radical neck lymph node dissection. Histopathological examination revealed a low-grade medullary thyroid carcinoma (MTC) in the left lobe and classical papillary thyroid carcinoma (PTC) in the right lobe, with PTC metastasis in the cervical lymph nodes and concurrent SLL in the affected lymph nodes.

Results:
Coexistence of PTC, MTC and SLL in the same patient is rare, there are currently no standardized treatment guidelines due to the limited literature. However, it is essential to consider not only the treatment for each type of tumor but also the potential risks or conflicts associated with the treatments. In the case reported in this paper, the papillary carcinoma invaded the capsule of the right lobe of the thyroid and metastasized to the cervical lymph nodes, warranting radioactive iodine therapy. However, considering the potential negative impact of radioactive iodine on the pre-existing lymphoma, the radioactive iodine therapy was postponed. Meanwhile, constant monitoring of calcitonin and thyroid globulin should be performed to monitor tumor recurrence as was performed in the present case.

Conclusion:
Since MTC, PTC, and SLL may coexist, patients with PTC deserve careful surveillance for the other disease entities. This case underscores the need for heightened awareness among clinicians, radiologists, and pathologists regarding the possibility of concurrent thyroid tumors and abnormal lymph nodes, guiding comprehensive pre-operative evaluations and postoperative monitoring strategies. This study aims to provide a warning for routine pathological diagnosis and contribute data for related research.
Cholecystopleural fistula: A case report and literature review
Authors: Yang Yong , Chen Qian , Hu Yi , Zhao Liangsong , Cai Pengcheng , Guo Suqi 
Published: August 2024

Introduction:
Gallstone with acute cholecystitis is one of the most common diseases in the clinic. If the disease is serious, gallbladder gangrene, perforation, and sepsis may be caused. Gallbladder diseases rarely cause thoracic-related complications, especially pleural fistula, which is very rare in clinical practice.

Patient concerns:
A 52-year-old male patient was admitted to the emergency department for 1 month with recurrent right middle and upper abdominal pain.

Diagnosis:
Computed tomography diagnosis: cholecystitis and peri-inflammation, small abscess around the base of the gallbladder, local peritonitis, and bilateral pleural effusion.

Interventions:
After admission, conservative treatment was given. On the 4th day of admission, the symptoms worsened, and an emergency catheter drainage was performed on the right thoracic cavity to extract 900 mL of dark yellow effusion. After the operation, a large amount of bili-like fluid was continuously drained from the thoracic drainage tube. After the iatrogenic biliary fistula caused by thoracic puncture was excluded, cholecystopleural fistula was considered to be cholecystopleural fistula. On the 6th day of admission, endoscopic retrograde cholangiopancreatography (ERCP) + cholecystography + Oddi sphincterotomy + laminating biliary stent was performed in the emergency department, and cholecystopleural fistula was confirmed during the operation.

Outcomes:
The patient recovered well after surgery, computed tomography examination on the 20th day after surgery indicated that pleural effusion was significantly reduced, and the patient was cured and discharged. The patient returned to the hospital 8 months after the ERCP operation to pull out the bile duct–covered stent. The patient did not complain of any discomfort after the postoperative follow-up for 3 years, and no recurrence of stones, empyema, and other conditions was found.

Conclusion:
Cholecystopleural fistula is one of the serious complications of acute cholecystitis, which is easy to misdiagnose clinically. If the gallbladder inflammation is severe, accompanied by pleural effusion, the pleural effusion is bili-like liquid, or the content of bilirubin is abnormally elevated, the existence of the disease should be considered. Once the diagnosis is clear, active surgical intervention is needed to reduce the occurrence of complications. Endoscopic therapy (ERCP) can be used as both a diagnostic method and an important minimally invasive treatment.
Successful preoperative diagnosis and laparoscopic management of primary small bowel volvulus: A case report and literature review
Authors: Shimizu Seito , Hara Hitoshi , Muto Yasuhide , Kido Tomoki , Miyata Ryohei 
Published: August 2024

Rationale:
Small bowel volvulus (SBV) is a rare cause of acute abdominal pain in adults, which requires surgical intervention to prevent small bowel necrosis. Primary SBV is rare, and its preoperative diagnosis is challenging. This report describes a case of primary SBV diagnosed preoperatively and treated laparoscopically.

Patient concerns:
A 56-year-old man presented complaining of sudden-onset abdominal pain of 3-hour duration. Physical examination revealed tenderness in periumbilical and upper abdominal regions with no signs of peritonitis.

Diagnosis:
Contrast-enhanced computed tomography revealed a 360°-clockwise rotation of the small intestine when viewed caudally at the mesenteric base. At this region, the superior mesenteric vein was interrupted. Although no dilation of the small intestine was observed, increased density in the mesentery of the affected area was observed. Minimal ascites was observed in the pelvic cavity. No evidence of congenital or secondary SBV was observed, supporting the diagnosis of primary SBV.

Interventions:
Laparoscopic detorsion of the SBV was performed approximately 6 hours after the onset of symptoms. No signs of bowel necrosis were observed, and the procedure was concluded after releasing the torsion.

Outcomes:
Severe abdominal pain disappeared immediately after surgery. The postoperative course was uneventful, and the patient was discharged on the 8th postoperative day.

Lessons:
This case highlights the importance of preoperatively diagnosing SBV, which enables early laparoscopic devolvulation without bowel resection.