BACKGROUND Early renal artery thrombosis after kidney transplantation is rare but often leads to graft loss.Prompt diagnosis and intervention are essential,particularly in patients with inherited thrombophilias such a...BACKGROUND Early renal artery thrombosis after kidney transplantation is rare but often leads to graft loss.Prompt diagnosis and intervention are essential,particularly in patients with inherited thrombophilias such as factor V Leiden(FVL)mutation.CASE SUMMARY A kidney transplant recipient with FVL mutation developed an acute transplant renal artery thrombosis.The immediate post-operative Doppler ultrasonography revealed thrombosis of the main and inferior polar renal arteries.Emergent thrombectomy and separate arterial re-anastomoses were performed after cold perfusion with heparinized saline and vasodilator solution.Reperfusion was successful with immediate urine output and gradual improvement in renal function.The patient was discharged on direct oral anticoagulation therapy.CONCLUSION Early detection and surgical intervention can preserve graft function in posttransplant renal artery thrombosis even in patients at high risk.展开更多
Transcatheter intervention allows to deal with multiple cardiovascular diseases1 in patients with impaired clinical conditions and burdened with multiple comorbidities,both with the advantage of planning number and mo...Transcatheter intervention allows to deal with multiple cardiovascular diseases1 in patients with impaired clinical conditions and burdened with multiple comorbidities,both with the advantage of planning number and modalities of the interventions and deciding,where possible,to realize them in a single session.Here we describe the case of a patient affected by severe aortic stenosis and associated cardiac comorbidities(coronary artery disease,atrial fibrillation and left appendage thrombosis)that needed a multimodal clinical and interventional strategy to lead him to the best clinical condition for performing transcatheter aortic valve implantation(TAVI).展开更多
BACKGROUND Long-term chemotherapy for patients with gastric cancer(GC),facilitated by peripherally inserted central catheter(PICC)catheterization,reduces vascular damage and enhances drug delivery efficiency but carri...BACKGROUND Long-term chemotherapy for patients with gastric cancer(GC),facilitated by peripherally inserted central catheter(PICC)catheterization,reduces vascular damage and enhances drug delivery efficiency but carries risks of catheter-related complications.A combination of group psychological nursing and physical mo-vement care significantly mitigates the risk of venous thrombosis and improves psychological well-being,and enhances motor function,underscoring its clinical importance.AIM To assess group psychological and physical movement nursing in preventing venous thrombosis in patients with PICC GC.METHODS Sixty-five GC patients with PICC,admitted from January 2022 to January 2023,were randomly divided into two groups using the lottery method:A control group(n=35,routine nursing)and an observation group(n=30,routine nursing plus psychological nursing and physical movement nursing).Both groups re-ceived continuous care for 2 weeks.Pre-nursing and post-nursing data on psycho-logical state,physical function,chemotherapy-related thrombosis incidence,and cancer-related fatigue were analyzed using SPSS 26.0 and GraphPad Prism 8.0.RESULTS After nursing,both groups showed reduced Hamilton Anxiety Scale scores and increased General Perceived Self-Efficacy Scale scores,with the observation group performing better(P<0.05).The Functional Comprehensive Assessment score for the observation group after nursing was(65.42±2.35)points,lower than the control group’s(62.19±4.33)points(P<0.05).Although no significant difference was observed in the incidence of venous thrombosis between the two groups(χ2=0.815,P=0.367),the observation group had lower incidence.Both groups showed decreased Revised Piper Fatigue Scale scores,with the observation group scoring lower(P<0.05).CONCLUSION Group psychological and physical movement nursing for patients with PICC reduces venous thrombosis risk,improves psychological well-being,cancer-related fatigue,and physical function,making it highly promotable.展开更多
BACKGROUND Alagille syndrome is a multisystem disease that results in various vascular anomalies,commonly involving the cardiac and pulmonary systems.To the best of our knowledge,there is no literature regarding the c...BACKGROUND Alagille syndrome is a multisystem disease that results in various vascular anomalies,commonly involving the cardiac and pulmonary systems.To the best of our knowledge,there is no literature regarding the cardiovascular outcomes of these patients in association with coronavirus disease 2019(COVID-19).CASE SUMMARY A 34-year-old woman with a history of Alagille syndrome who underwent successful atrial septal defect with partial anomalous pulmonary veins and patent ductus arteriosus repair,as well as left pulmonary artery catheterization and stenting in childhood due to pulmonary stenosis.The patient was without any respiratory symptoms and was a dancer prior to contracting COVID-19.Several weeks after her COVID-19 infection,she developed left pulmonary artery stent thrombosis and subsequent symptomatic pulmonary hypertension.A treatment strategy of anticoagulation alongside pharmacological agents for pulmonary hypertension for 3 months followed by balloon pulmonary artery angioplasty to reopen the stenosis was unsuccessful.CONCLUSION In the era of COVID-19,patients with pulmonary vascular malformations and endovascular stents are at an increased risk for chronic thromboembolic disease.Patients may benefit from prophylactic antiplatelet or anticoagulation therapy.Stent thrombosis is a devastating phenomenon and should be treated urgently and aggressively with balloon pulmonary angioplasty,and/or a thrombolytic agent.展开更多
BACKGROUND Ovarian vein thrombosis(OVT)is a rare condition that most commonly affects postpartum women.It is particularly prevalent in the first 10 days postpartum,a period when women are more prone to developing this...BACKGROUND Ovarian vein thrombosis(OVT)is a rare condition that most commonly affects postpartum women.It is particularly prevalent in the first 10 days postpartum,a period when women are more prone to developing this condition.The right ovarian vein is often affected due to its tortuous nature and less competent valves.OVT presents similarly to acute abdominal conditions,such as acute appendicitis,especially when the right ovarian vein is involved.Given the overlap in clinical presentation,diagnosis requires high-quality imaging techniques and a high degree of suspicion.CASE SUMMARY Herein,we report a rare case of OVT in a young postpartum female who presented to the emergency department with signs and symptoms of acute abdomen.The patient had a history of pulmonary tuberculosis treatment.A provisional diagnosis of a perforated appendix was made,and a lower midline exploratory laparotomy was planned.During surgery,the appendix and inte-stines appeared normal,but a distended and thrombosed right ovarian vein was found.The affected ovarian vein was excised,and the patient was placed on anti-coagulants postoperatively.The recovery was unremarkable,and anticoagulants were continued for six months.CONCLUSION OVT is most commonly seen in the early postpartum period,especially within the first 10 days.Due to its anatomical characteristics,the right ovarian vein is more commonly involved.The clinical presentation of OVT can closely mimic acute abdomen or acute appendicitis,making diagnosis challenging.Accurate diagnosis requires a high index of suspicion and advanced imaging techniques to differentiate OVT from other conditions with similar presentations.展开更多
Portal vein thrombosis(PVT)is one of the most common serious complications in patients with liver cirrhosis.The occurrence of PVT not only aggravates the condition of liver cirrhosis but can also cause several serious...Portal vein thrombosis(PVT)is one of the most common serious complications in patients with liver cirrhosis.The occurrence of PVT not only aggravates the condition of liver cirrhosis but can also cause several serious complications,such as portal hypertension,esophagogastric variceal bleeding,and refractory ascites.All these factors have a serious impact on patients’quality of life and prognosis.This article evaluates the current evidence on the management of PVT in cirrhosis and explores the role of direct oral anticoagulants,but data on individualized anticoagulation strategies are limited and lacking for the treatment of PVT in cirrhosis,and it is hoped that it will inform a broad range of clinicians on the treatment of cirrhosis combined with PVT.展开更多
BACKGROUND Post-hepatectomy portal vein thrombosis(PH-PVT)is a life-threatening complication;however,the available literature on this topic is limited.AIM To examine the incidence,risk factors,and outcomes associated ...BACKGROUND Post-hepatectomy portal vein thrombosis(PH-PVT)is a life-threatening complication;however,the available literature on this topic is limited.AIM To examine the incidence,risk factors,and outcomes associated with PH-PVT.METHODS Medical records of patients who underwent hepatic resection for various diseases between February 2014 and December 2023 at Beijing Tsinghua Changgung Hospital affiliated with Tsinghua University(Beijing,China)were retrospectively reviewed.The patients were divided into a PH-PVT group and a non-PH-PVT group.Univariate and multivariate logistic regression analyses were performed to identify the risk factors for PH-PVT.RESULTS A total of 1064 patients were included in the study cohort,and the incidence and mortality rates of PH-PVT were 3.9%and 35.7%,respectively.The median time from hepatectomy to the diagnosis of PH-PVT was 6 days.Multivariate analysis revealed that hepatectomy combined with pancreaticoduodenectomy(HPD)[odds ratio(OR)=7.627(1.390-41.842),P=0.019],portal vein reconstruction[OR=6.119(2.636-14.203),P<0.001]and a postoperative portal vein angle<100°[OR=2.457(1.131-5.348),P=0.023]were independent risk factors for PH-PVT.Age≥60 years[OR=8.688(1.774-42.539),P=0.008]and portal vein reconstruction[OR=6.182(1.246-30.687),P=0.026]were independent risk factors for mortality in PH-PVT patients.CONCLUSION Portal vein reconstruction,a postoperative portal vein angle<100°and HPD were independent risk factors for PHPVT.Age≥60 years and portal vein reconstruction were independent risk factors for mortality in PH-PVT patients.展开更多
Non-tumoral portal vein thrombosis(PVT)is a frequent and challenging complication in liver transplant candidates.The prevalence reaches up to 26%in patients with cirrhosis on a transplant waiting list.Its severity inc...Non-tumoral portal vein thrombosis(PVT)is a frequent and challenging complication in liver transplant candidates.The prevalence reaches up to 26%in patients with cirrhosis on a transplant waiting list.Its severity increases with liver disease progression and significantly impacts post-transplant outcomes.Advanced PVT increases postoperative mortality to 30%.Effective management requires a multidisciplinary approach,especially in advanced cases.Preoperative strategies emphasize anticoagulation with low molecular weight heparin,while interventional radiology,including transjugular intrahepatic portosystemic shunts,offers alternatives in some cases.Intraoperatively,management is guided by PVT classification systems,ranging from thrombectomy and portal vein reconstruction to non-physiological reconstructions in complex cases.This manuscript explores the management of PVT in liver transplantation candidates,discusses strategies to optimize outcomes,and presents our institutional protocol for addressing this high-risk condition.展开更多
Objective:To systematically evaluate prediction models for postoperative deep vein thrombosis(DVT)in elderly hip fracture patients and assess their methodological quality and predictive performance.Methods:Following P...Objective:To systematically evaluate prediction models for postoperative deep vein thrombosis(DVT)in elderly hip fracture patients and assess their methodological quality and predictive performance.Methods:Following PRISMA guidelines,we searched eight databases(PubMed,Embase,Cochrane Library,Web of Science,CINAHL,CNKI,Wanfang,VIP)from inception to May 2025.Studies developing or validating DVT prediction models in elderly hip fracture patients were included.Two reviewers independently screened studies,extracted data,and assessed risk of bias and applicability using the PROBAST tool.Results:Eleven studies were included,all conducted in China between 2021 and 2025.Sample sizes ranged from 101 to 504 patients(total n=3,286).Models incorporated 3 to 9 predictors,with D-dimer,age,and time from injury to surgery being most common.All 11 studies(100%)were rated as high risk of bias,primarily due to small sample sizes,lack of validation,and inadequate missing data handling.Applicability concerns were low in 8 studies(72.7%).AUC values ranged from 0.648 to 0.967,with 10 studies(90.9%)reporting AUC>0.7.Meta-analysis identified time from injury to surgery(OR=4.63,95%CI:2.58–6.68),age(OR=1.99),D-dimer(OR=1.51),and Caprini score(OR=1.75)as significant predictors.Conclusion:Current DVT prediction models for elderly hip fracture patients demonstrate acceptable discrimination but are limited by high risk of bias and lack of external validation.Prospective,multicenter studies with rigorous validation are needed to develop clinically applicable models.展开更多
To build a thrombosis risk assessment model applicable to oxygenators and investigate the effects of oxygenator external configuration and membrane filaments macroscopic parameters on the performances of cylindrical o...To build a thrombosis risk assessment model applicable to oxygenators and investigate the effects of oxygenator external configuration and membrane filaments macroscopic parameters on the performances of cylindrical oxygenators.A thrombosis driven by surface contact,shear stress,and anticoagulant drugs,and considering the effects of these factors on platelet,coagulation factor,and hemostatic protein function risk model was developed and validated with clinical oxygenators.The thrombosis model combined with a pressure loss model and an oxygen partial pressure model was used to assess the effect of the external structure and macroscopic parameters of the membrane filaments(height and thickness)on the performance of the cylindrical oxygenator.The cylindrical oxygenator center circular inflow manner and tangential outflow manner from the middle region of the outside benefit the overall performance of the oxygenator(reduced pressure loss and thrombosis risk).Increasing the radial thickness of the oxygenator membrane filaments significantly increased the oxygen exchange ability of the oxygenator and reduced the thrombosis risk compared to increasing the axial height,but with a smaller increase in pressure loss.Contact activation leading to thrombin production contributes significantly to oxygenator thrombosis.The oxygenator has little effect on platelet receptor function.Thrombosis in cylindrical oxygenators tends to form in the flow-flow/border impingement regions because of the high concentration of coagulation factors and long residence times in these regions.A thrombosis risk assessment model applicable to oxygenators was developed.We disclosed the mechanism of the impact of oxygenator external configuration and membrane filaments macroscopic parameters on its internal flow fields,the risk of thrombosis,and the efficiency of gas exchange,which are useful for the design and optimization of cylindrical oxygenators.展开更多
Colorectal cancer(CRC),the third most prevalent cancer globally,exhibits a notable association with venous thromboembolism(VTE),significantly impacting patient morbidity and mortality.We delve into the complex pathoge...Colorectal cancer(CRC),the third most prevalent cancer globally,exhibits a notable association with venous thromboembolism(VTE),significantly impacting patient morbidity and mortality.We delve into the complex pathogenesis of cancer-associated thrombosis(CAT)in CRC,highlighting the interplay of clinical risk factors and tumor-specific mechanisms.Our comprehensive review synthesizes the current understanding of CRC’s pro-thrombotic tendencies,examining both general clinical factors(e.g.,age,gender,obesity,prior VTE history)and tumor-specific aspects(e.g.,tumor location,stage,targeted therapies).Key findings illustrate how CRC cells themselves actively contribute to coagulation cascade activation through various procoagulant elements such as tissue factor,cancer procoagulant,and extracellular vesicles.We also explore how CRC influences host cells to adopt a procoagulant phenotype,thereby exacerbating thrombotic risks.This review underscores the role of genetic mutations in CRC(e.g.,KRAS,p53)in modulating coagulation-related protein expression and thrombosis risks.An in-depth understanding of the genetic landscape specific to CRC subtypes is essential for developing targeted anticoagulation strategies and could significantly advance thrombosis prevention while improving the overall management of patients with CRC.This highlights the urgent need for precision in addressing CAT within clinical settings.展开更多
Objective:To explore the key points of holistic nursing for children with membranous nephropathy(MN)combined with cerebral venous thrombosis,providing a reference for similar cases.Methods:The course of illness data o...Objective:To explore the key points of holistic nursing for children with membranous nephropathy(MN)combined with cerebral venous thrombosis,providing a reference for similar cases.Methods:The course of illness data of an 8-year-old boy with MN in the recurrent phase complicated with cerebral venous sinus thrombosis(CVST)was retroactively analyzed.Systematic nursing was implemented based on evidence-based practices,including strict neurological monitoring,anticoagulation and thrombolysis medication nursing,fluid and electrolyte management,hypoalbuminemia and edema nursing,complication prevention,and mental health education.Results:After 16 days of continuous infusion of low molecular weight heparin and supportive treatment,the child’s symptoms,such as headache and vomiting,disappeared.The reexamination of MRV showed significant absorption of thrombosis,and there was no residual neurological deficit.During the 3-month follow-up,the anticoagulation compliance was good,and there was no recurrence.Conclusion:Early identification of hypercoagulability risk,strengthening dynamic evaluation of neurological signs and coagulation indicators,standardizing anticoagulation and thrombolysis nursing,and cooperating with continuous health management can significantly improve the prognosis of children with MN combined with CVST.展开更多
Case Letter Severe trauma has high morbidity and mortality rates,being the leading cause of death in young adults.Among all traumas,tra ffi c injuries are particularly lethal.^([1-2]) The injury severity score(ISS) ca...Case Letter Severe trauma has high morbidity and mortality rates,being the leading cause of death in young adults.Among all traumas,tra ffi c injuries are particularly lethal.^([1-2]) The injury severity score(ISS) can be used to assess trauma severity,with ISS of<9,9–15,16–24,and≥25 indicating minor,moderate,severe,and critical trauma,respectively.The ISS is correlated with mortality,morbidity,and hospitalization duration after injury.^([3-4]) Here,we report one patient who was admitted to our emergency intensive care unit(EICU) due to traumatic liver rupture and traumatic myocardial infarction complicated with inferior vena cava(IVC) thrombosis.展开更多
Thrombosis is a leading cause of mortality and morbidity in patients suffering from polycythemia vera(PV).Drug pair Salviae Miltiorrhizae Radix et Rhizoma(Danshen,DS)and Notoginseng Radix et Rhizoma(Sanqi,SQ)is common...Thrombosis is a leading cause of mortality and morbidity in patients suffering from polycythemia vera(PV).Drug pair Salviae Miltiorrhizae Radix et Rhizoma(Danshen,DS)and Notoginseng Radix et Rhizoma(Sanqi,SQ)is common traditional Chinese medicine(TCM)used in clinical practice to promote blood circulation and eliminate blood stasis.In this study,network pharmacology and molecular docking were used to analyze the potentially active ingredients and underlying mechanisms of drug pair DS-SQ against thrombosis after PV.These results show that 54 targets are related to both disease and the drug pair.Nineteen core targets,including IL-6 and AKT1,were screened.Luteolin and tanshinone IIa from DS as well as quercetin from SQ might be the major substances in the treatment of thrombosis after PV.KEGG enrichment analysis demonstrated that the lipid and atherosclerosis signaling pathway might play a significant role.These results provide valuable insights and a reference for the use of drug pair DS-SQ in management of thrombosis after PV and lay a foundation for further exploration of pharmacological effects.展开更多
Objective:To investigate the risk factors for deep vein thrombosis(DVT)following total hip arthroplasty in elderly patients with femoral neck fractures during the winter.Methods:A total of 162 patients who underwent t...Objective:To investigate the risk factors for deep vein thrombosis(DVT)following total hip arthroplasty in elderly patients with femoral neck fractures during the winter.Methods:A total of 162 patients who underwent total hip arthroplasty were categorized based on the development of DVT within 7 days postoperatively:28 patients formed the DVT group and 134 patients the non-DVT group.Collected data included age,gender,history of glucocorticoid use,diabetes,hypertension,body mass index(BMI),triglyceride(TG)levels,cholesterol(CHOL)levels at admission,operative time,and postoperative bed rest duration.D-dimer(D-D)and fibrinogen(Fg)levels,along with the D-D/Fg ratio,were recorded on the first postoperative day.Group comparisons were performed using t-tests.Logistic regression analysis was conducted to identify independent risk factors,and the predictive value of these factors was evaluated using receiver operating characteristic(ROC)curve analysis.Results:In the DVT group,18 patients had diabetes.Levels of TG(1.78±0.44 mmol/L),CHOL(4.70±1.84 mmol/L),D-D(0.40±0.17 mg/L),and the D-D/Fg ratio(0.24±0.07)were significantly higher than in the non-DVT group(P<0.05).Logistic regression identified TG,CHOL,D-D,and the D-D/Fg ratio as independent risk factors for DVT,with odds ratios of 0.987,2.395,0.8,4.992,and 9.004,respectively(P<0.05).ROC curve analysis yielded areas under the curve(AUCs)of 0.715,0.69,0.614,and 0.726 for TG,CHOL,D-D,and the D-D/Fg ratio,respectively.Sensitivities were 0.643,0.500,0.429,and 0.857,and specificities were 0.694,0.978,0.918,and 0.537,respectively.Conclusion:Elevated levels of TG,CHOL,D-D,and the D-D/Fg ratio are independent risk factors for DVT following total hip arthroplasty in elderly patients.Among these,the D-D/Fg ratio demonstrated the highest sensitivity and may serve as an effective marker for early-stage DVT screening.展开更多
Objective:To develop and validate a risk prediction model for catheter-related thrombosis(CRT)in pediatric patients with severe traumatic brain injury(sTBI).Methods:Using convenience sampling,216 pediatric patients wi...Objective:To develop and validate a risk prediction model for catheter-related thrombosis(CRT)in pediatric patients with severe traumatic brain injury(sTBI).Methods:Using convenience sampling,216 pediatric patients with sTBI admitted to the Surgical Intensive Care Unit of Kunming Children’s Hospital between June 2022 and May 2025 were enrolled and randomly divided into a training set of 151 cases and a validation set of 65 cases.Influencing factors were identified through univariate analysis and logistic regression analysis to construct the prediction model.The model’s discrimination and calibration were evaluated by the area under the receiver operating characteristic(ROC)curve(AUC)and the Hosmer–Lemeshow goodness-of-fit test.Results:Univariate analysis showed that admission GCS score,CVC insertion site,D-dimer level,and duration of mechanical ventilation were risk factors for CRT in children with sTBI(P<0.05).The logistic regression equation was constructed as follows:Logit(P)=2.74–1.95×GCS score+0.25×D-dimer(μg/mL)+0.02×duration of mechanical ventilation(h).Based on this model,the AUC was 0.87 in the training set and 0.88 in the validation set.The Hosmer–Lemeshow goodness-of-fit test indicated good agreement between the model’s calibration curve and the ideal curve.Conclusion:The developed prediction model demonstrates good predictive performance and can serve as a reference for the early clinical identification of CRT risk in pediatric patients with sTBI.展开更多
Objective:To explore the molecular mechanism of tissue factor-positive microparticles(TF-MPs)expression and deep venous thrombosis(DVT)in patients with cervical cancer.Methods:A total of 200 patients with cervical can...Objective:To explore the molecular mechanism of tissue factor-positive microparticles(TF-MPs)expression and deep venous thrombosis(DVT)in patients with cervical cancer.Methods:A total of 200 patients with cervical cancer and benign cervical diseases who were hospitalized in the First Department of Gynecologic Oncology of Gansu Provincial Cancer Hospital from January 2024 to December 2025 were selected,including 100 patients with benign cervical diseases as the control group and 100 patients with cervical cancer as the experimental group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression level of TF-MPs in peripheral blood samples from patients with cervical cancer and healthy controls.At the same time,real-time quantitative PCR was used to explore the molecular mechanism of TF-MPs promoting DVT formation.Finally,the formation of DVT in the two groups was observed and recorded,and the incidence of DVT was counted.Results:Experimental measurements showed that the expression levels of TF-MPs,coagulation factors FVII,FX,PT,and inflammatory factors IL-6 and TNF-a in the experimental group were significantly higher than those in the control group(P<0.01);the incidence of DVT in the experimental group was up to 38%,far exceeding the 6%in the control group(P<0.001).Conclusion:Abnormal expression of TF-MPs in patients with cervical cancer is an important risk factor for DVT.Through in-depth analysis of the molecular mechanism of TF-MPs promoting DVT formation,it provides a new perspective and theoretical basis for the prevention and treatment of DVT in patients with cervical cancer.In the future,intervention strategies targeting TF-MPs and their related molecular pathways are expected to become effective ways to reduce the incidence of DVT in patients with cervical cancer.展开更多
BACKGROUND The portal vein thrombosis(PVT)can exacerbate portal hypertension and lead to complications,increasing the risk of mortality.AIM To evaluate the predictive capacity of artificial neural networks(ANNs)in qua...BACKGROUND The portal vein thrombosis(PVT)can exacerbate portal hypertension and lead to complications,increasing the risk of mortality.AIM To evaluate the predictive capacity of artificial neural networks(ANNs)in quan-tifying the likelihood of developing PVT in individuals afflicted with hepatitis B-induced cirrhosis.METHODS A retrospective study was conducted at Beijing Ditan Hospital,affiliated with Capital Medical University,including 986 hospitalized patients.Patients admitted between January 2011 and December 2014 were assigned to the training set(685 cases),while those hospitalized from January 2015 to December 2016 were divided into the validation cohort(301 cases).Independent risk factors for PVT were identified using COX univariate analysis and used to construct an ANN model.Model performance was evaluated through metrics such as the area under the receiver operating characteristic curve(AUC)and concordance index.RESULTS In the training set,PVT occurred in 19.0%of patients within three years and 23.7%within five years.In the validation cohort,PVT developed in 16.7%of patients within three years and 24.0%within five years.The ANN model incorporated nine independent risk factors:Age,ascites,hepatic encephalopathy,gastrointestinal varices with bleeding,Child-Pugh classification,alanine aminotransferase levels,albumin levels,neutrophil-to-lymphocyte ratio,and platelet.The model achieved an AUC of 0.967(95%CI:0.960–0.974)at three years and 0.975(95%CI:0.955–0.992)at five years,significantly outperforming existing models such as model for end-stage liver disease and Child-Pugh-Turcotte(all P<0.001).CONCLUSION The ANN model demonstrated effective stratification of patients into high-and low-risk groups for PVT deve-lopment over three and five years.Validation in an independent cohort confirmed the model's predictive accuracy.展开更多
BACKGROUND About 35%-50%of patients with hepatocellular cancer(HCC)present with portal venous tumor thrombosis(PVTT).Stereotactic body radiation therapy(SBRT)offers a promising approach for locoregional treatment in p...BACKGROUND About 35%-50%of patients with hepatocellular cancer(HCC)present with portal venous tumor thrombosis(PVTT).Stereotactic body radiation therapy(SBRT)offers a promising approach for locoregional treatment in patients with HCC with PVTT.This study aimed to report the clinical characteristics and early outcomes of patients with unresectable HCC and PVTT treated with SBRT.AIM To report the clinical characteristics and early outcomes of patients with unresectable HCC and PVTT treated with SBRT.METHODS This retrospective,single-institution study included adult HCC patients with PVTT treated between March 2020 and December 2023.Eligibility criteria included Child-Pugh A-B liver function,serum bilirubin<3 mg/dL,Eastern Co-operative Oncology Group performance status 0-2,a normal liver volume>700 cc,and a tumor-lumen distance>5 mm.SBRT dose and fractionation were determined based on tumor volume and organ-at-risk constraints.Baseline clinical and dosimetric parameters were recorded.Survival analysis was performed using Kaplan-Meier curves,response was assessed at 3 months post-SBRT using the Revised Response Evaluation Criteria in Solid Tumors 1.1 criteria,and toxicity was graded per Common Terminology Criteria for Adverse Events 4.0.RESULTS Thirty patients(median age:65 years,90%male)were included.Sixteen(53.3%)were Child-Pugh A,and fourteen(46.6%)were Child-Pugh B.Sixty percent had VP4 disease.SBRT doses ranged from 30-50 Gy in 5-6 fractions.The median tumor diameter was 6.1 cm,and the median follow-up was 15 months.The overall response rate was 83.3%,with a median overall survival of 13 months and progression-free survival of 10.2 months.No grade 4 toxicities were observed.CONCLUSION SBRT has the potential to be an effective modality for locoregional control in patients with unresectable HCC with PVTT.展开更多
BACKGROUND Peripherally inserted central catheter(PICC)is the preferred intravenous route for chemotherapy in patients with cancer,but its complications,especially deep vein thrombosis(DVT),are becoming increasingly p...BACKGROUND Peripherally inserted central catheter(PICC)is the preferred intravenous route for chemotherapy in patients with cancer,but its complications,especially deep vein thrombosis(DVT),are becoming increasingly prevalent.Medical staff proficient in intubation and maintenance techniques can reduce complications.The multivariate integration teaching model applies the integration of“teaching learning application”to medical training,which helps shift the prevention of complications from“passive management of complications”to“active construction of risk immunity”,thereby ensuring foundational competency for PICC in patients with cancer.AIM To investigate the efficacy of the multivariate integration teaching model in patients with gastric cancer and concurrent DVT after PICC intubation and analyze its effect on patients’quality of life index(QLI)and satisfaction.METHODS A retrospective analysis of medical records of 100 patients with gastric cancer and PICC treated at Zhejiang Provincial People’s Hospital from May 2019 to November 2020 was conducted.According to the different treatment methods and teaching modes received by medical staff,they were divided into a control group and an experimental group,with 50 cases in each group.The routine clinical teaching model and the multivariate integration teaching model were administered to the medical staff for the control group and the experimental group,respectively,to compare the incidence rates of DVT and other adverse reactions,QLI scores,Karnofsky Performance Scale scores,Mental Status Scale in Non-Psychiatric Settings scores,patient satisfaction,medical staff’s test marks,and satisfaction evaluation of the teaching model.RESULTS Compared with the control group,the experimental group exhibited significantly lower incidence rates of DVT and other adverse reactions and MSSNS scores but significantly higher QLI scores,KPS scores,patient satisfaction,medical staff’s test marks,and their satisfaction evaluations of the teaching model(P<0.05).CONCLUSION In a single-center practice,performing the multivariate integration teaching model for medical staff may effectively improve the patients’QLI and satisfaction and may have certain application value in preventing DVT in patients with gastric cancer and PICC.展开更多
文摘BACKGROUND Early renal artery thrombosis after kidney transplantation is rare but often leads to graft loss.Prompt diagnosis and intervention are essential,particularly in patients with inherited thrombophilias such as factor V Leiden(FVL)mutation.CASE SUMMARY A kidney transplant recipient with FVL mutation developed an acute transplant renal artery thrombosis.The immediate post-operative Doppler ultrasonography revealed thrombosis of the main and inferior polar renal arteries.Emergent thrombectomy and separate arterial re-anastomoses were performed after cold perfusion with heparinized saline and vasodilator solution.Reperfusion was successful with immediate urine output and gradual improvement in renal function.The patient was discharged on direct oral anticoagulation therapy.CONCLUSION Early detection and surgical intervention can preserve graft function in posttransplant renal artery thrombosis even in patients at high risk.
文摘Transcatheter intervention allows to deal with multiple cardiovascular diseases1 in patients with impaired clinical conditions and burdened with multiple comorbidities,both with the advantage of planning number and modalities of the interventions and deciding,where possible,to realize them in a single session.Here we describe the case of a patient affected by severe aortic stenosis and associated cardiac comorbidities(coronary artery disease,atrial fibrillation and left appendage thrombosis)that needed a multimodal clinical and interventional strategy to lead him to the best clinical condition for performing transcatheter aortic valve implantation(TAVI).
文摘BACKGROUND Long-term chemotherapy for patients with gastric cancer(GC),facilitated by peripherally inserted central catheter(PICC)catheterization,reduces vascular damage and enhances drug delivery efficiency but carries risks of catheter-related complications.A combination of group psychological nursing and physical mo-vement care significantly mitigates the risk of venous thrombosis and improves psychological well-being,and enhances motor function,underscoring its clinical importance.AIM To assess group psychological and physical movement nursing in preventing venous thrombosis in patients with PICC GC.METHODS Sixty-five GC patients with PICC,admitted from January 2022 to January 2023,were randomly divided into two groups using the lottery method:A control group(n=35,routine nursing)and an observation group(n=30,routine nursing plus psychological nursing and physical movement nursing).Both groups re-ceived continuous care for 2 weeks.Pre-nursing and post-nursing data on psycho-logical state,physical function,chemotherapy-related thrombosis incidence,and cancer-related fatigue were analyzed using SPSS 26.0 and GraphPad Prism 8.0.RESULTS After nursing,both groups showed reduced Hamilton Anxiety Scale scores and increased General Perceived Self-Efficacy Scale scores,with the observation group performing better(P<0.05).The Functional Comprehensive Assessment score for the observation group after nursing was(65.42±2.35)points,lower than the control group’s(62.19±4.33)points(P<0.05).Although no significant difference was observed in the incidence of venous thrombosis between the two groups(χ2=0.815,P=0.367),the observation group had lower incidence.Both groups showed decreased Revised Piper Fatigue Scale scores,with the observation group scoring lower(P<0.05).CONCLUSION Group psychological and physical movement nursing for patients with PICC reduces venous thrombosis risk,improves psychological well-being,cancer-related fatigue,and physical function,making it highly promotable.
文摘BACKGROUND Alagille syndrome is a multisystem disease that results in various vascular anomalies,commonly involving the cardiac and pulmonary systems.To the best of our knowledge,there is no literature regarding the cardiovascular outcomes of these patients in association with coronavirus disease 2019(COVID-19).CASE SUMMARY A 34-year-old woman with a history of Alagille syndrome who underwent successful atrial septal defect with partial anomalous pulmonary veins and patent ductus arteriosus repair,as well as left pulmonary artery catheterization and stenting in childhood due to pulmonary stenosis.The patient was without any respiratory symptoms and was a dancer prior to contracting COVID-19.Several weeks after her COVID-19 infection,she developed left pulmonary artery stent thrombosis and subsequent symptomatic pulmonary hypertension.A treatment strategy of anticoagulation alongside pharmacological agents for pulmonary hypertension for 3 months followed by balloon pulmonary artery angioplasty to reopen the stenosis was unsuccessful.CONCLUSION In the era of COVID-19,patients with pulmonary vascular malformations and endovascular stents are at an increased risk for chronic thromboembolic disease.Patients may benefit from prophylactic antiplatelet or anticoagulation therapy.Stent thrombosis is a devastating phenomenon and should be treated urgently and aggressively with balloon pulmonary angioplasty,and/or a thrombolytic agent.
文摘BACKGROUND Ovarian vein thrombosis(OVT)is a rare condition that most commonly affects postpartum women.It is particularly prevalent in the first 10 days postpartum,a period when women are more prone to developing this condition.The right ovarian vein is often affected due to its tortuous nature and less competent valves.OVT presents similarly to acute abdominal conditions,such as acute appendicitis,especially when the right ovarian vein is involved.Given the overlap in clinical presentation,diagnosis requires high-quality imaging techniques and a high degree of suspicion.CASE SUMMARY Herein,we report a rare case of OVT in a young postpartum female who presented to the emergency department with signs and symptoms of acute abdomen.The patient had a history of pulmonary tuberculosis treatment.A provisional diagnosis of a perforated appendix was made,and a lower midline exploratory laparotomy was planned.During surgery,the appendix and inte-stines appeared normal,but a distended and thrombosed right ovarian vein was found.The affected ovarian vein was excised,and the patient was placed on anti-coagulants postoperatively.The recovery was unremarkable,and anticoagulants were continued for six months.CONCLUSION OVT is most commonly seen in the early postpartum period,especially within the first 10 days.Due to its anatomical characteristics,the right ovarian vein is more commonly involved.The clinical presentation of OVT can closely mimic acute abdomen or acute appendicitis,making diagnosis challenging.Accurate diagnosis requires a high index of suspicion and advanced imaging techniques to differentiate OVT from other conditions with similar presentations.
基金Supported by the Postgraduate Research and Practice Innovation Program of Jiangsu Province,No.SJCX24_2067Chen Xiao-Ping Foundation for the Development of Science and Technology of Hubei Province,No.CXPJJH123009-079.
文摘Portal vein thrombosis(PVT)is one of the most common serious complications in patients with liver cirrhosis.The occurrence of PVT not only aggravates the condition of liver cirrhosis but can also cause several serious complications,such as portal hypertension,esophagogastric variceal bleeding,and refractory ascites.All these factors have a serious impact on patients’quality of life and prognosis.This article evaluates the current evidence on the management of PVT in cirrhosis and explores the role of direct oral anticoagulants,but data on individualized anticoagulation strategies are limited and lacking for the treatment of PVT in cirrhosis,and it is hoped that it will inform a broad range of clinicians on the treatment of cirrhosis combined with PVT.
文摘BACKGROUND Post-hepatectomy portal vein thrombosis(PH-PVT)is a life-threatening complication;however,the available literature on this topic is limited.AIM To examine the incidence,risk factors,and outcomes associated with PH-PVT.METHODS Medical records of patients who underwent hepatic resection for various diseases between February 2014 and December 2023 at Beijing Tsinghua Changgung Hospital affiliated with Tsinghua University(Beijing,China)were retrospectively reviewed.The patients were divided into a PH-PVT group and a non-PH-PVT group.Univariate and multivariate logistic regression analyses were performed to identify the risk factors for PH-PVT.RESULTS A total of 1064 patients were included in the study cohort,and the incidence and mortality rates of PH-PVT were 3.9%and 35.7%,respectively.The median time from hepatectomy to the diagnosis of PH-PVT was 6 days.Multivariate analysis revealed that hepatectomy combined with pancreaticoduodenectomy(HPD)[odds ratio(OR)=7.627(1.390-41.842),P=0.019],portal vein reconstruction[OR=6.119(2.636-14.203),P<0.001]and a postoperative portal vein angle<100°[OR=2.457(1.131-5.348),P=0.023]were independent risk factors for PH-PVT.Age≥60 years[OR=8.688(1.774-42.539),P=0.008]and portal vein reconstruction[OR=6.182(1.246-30.687),P=0.026]were independent risk factors for mortality in PH-PVT patients.CONCLUSION Portal vein reconstruction,a postoperative portal vein angle<100°and HPD were independent risk factors for PHPVT.Age≥60 years and portal vein reconstruction were independent risk factors for mortality in PH-PVT patients.
文摘Non-tumoral portal vein thrombosis(PVT)is a frequent and challenging complication in liver transplant candidates.The prevalence reaches up to 26%in patients with cirrhosis on a transplant waiting list.Its severity increases with liver disease progression and significantly impacts post-transplant outcomes.Advanced PVT increases postoperative mortality to 30%.Effective management requires a multidisciplinary approach,especially in advanced cases.Preoperative strategies emphasize anticoagulation with low molecular weight heparin,while interventional radiology,including transjugular intrahepatic portosystemic shunts,offers alternatives in some cases.Intraoperatively,management is guided by PVT classification systems,ranging from thrombectomy and portal vein reconstruction to non-physiological reconstructions in complex cases.This manuscript explores the management of PVT in liver transplantation candidates,discusses strategies to optimize outcomes,and presents our institutional protocol for addressing this high-risk condition.
文摘Objective:To systematically evaluate prediction models for postoperative deep vein thrombosis(DVT)in elderly hip fracture patients and assess their methodological quality and predictive performance.Methods:Following PRISMA guidelines,we searched eight databases(PubMed,Embase,Cochrane Library,Web of Science,CINAHL,CNKI,Wanfang,VIP)from inception to May 2025.Studies developing or validating DVT prediction models in elderly hip fracture patients were included.Two reviewers independently screened studies,extracted data,and assessed risk of bias and applicability using the PROBAST tool.Results:Eleven studies were included,all conducted in China between 2021 and 2025.Sample sizes ranged from 101 to 504 patients(total n=3,286).Models incorporated 3 to 9 predictors,with D-dimer,age,and time from injury to surgery being most common.All 11 studies(100%)were rated as high risk of bias,primarily due to small sample sizes,lack of validation,and inadequate missing data handling.Applicability concerns were low in 8 studies(72.7%).AUC values ranged from 0.648 to 0.967,with 10 studies(90.9%)reporting AUC>0.7.Meta-analysis identified time from injury to surgery(OR=4.63,95%CI:2.58–6.68),age(OR=1.99),D-dimer(OR=1.51),and Caprini score(OR=1.75)as significant predictors.Conclusion:Current DVT prediction models for elderly hip fracture patients demonstrate acceptable discrimination but are limited by high risk of bias and lack of external validation.Prospective,multicenter studies with rigorous validation are needed to develop clinically applicable models.
基金supported by the National Key R&D Program of China(Grant Nos.2020YFC0862904,2020YFC0862900,and 2020YFC0862902)the National Natural Science Foundation of China(Grant Nos.12372300,U23A20486,and 32071311)the Fundamental Research Funds for the Central Universities,and the Academic Excellence Foundation of BUAA for PhD Students.
文摘To build a thrombosis risk assessment model applicable to oxygenators and investigate the effects of oxygenator external configuration and membrane filaments macroscopic parameters on the performances of cylindrical oxygenators.A thrombosis driven by surface contact,shear stress,and anticoagulant drugs,and considering the effects of these factors on platelet,coagulation factor,and hemostatic protein function risk model was developed and validated with clinical oxygenators.The thrombosis model combined with a pressure loss model and an oxygen partial pressure model was used to assess the effect of the external structure and macroscopic parameters of the membrane filaments(height and thickness)on the performance of the cylindrical oxygenator.The cylindrical oxygenator center circular inflow manner and tangential outflow manner from the middle region of the outside benefit the overall performance of the oxygenator(reduced pressure loss and thrombosis risk).Increasing the radial thickness of the oxygenator membrane filaments significantly increased the oxygen exchange ability of the oxygenator and reduced the thrombosis risk compared to increasing the axial height,but with a smaller increase in pressure loss.Contact activation leading to thrombin production contributes significantly to oxygenator thrombosis.The oxygenator has little effect on platelet receptor function.Thrombosis in cylindrical oxygenators tends to form in the flow-flow/border impingement regions because of the high concentration of coagulation factors and long residence times in these regions.A thrombosis risk assessment model applicable to oxygenators was developed.We disclosed the mechanism of the impact of oxygenator external configuration and membrane filaments macroscopic parameters on its internal flow fields,the risk of thrombosis,and the efficiency of gas exchange,which are useful for the design and optimization of cylindrical oxygenators.
文摘Colorectal cancer(CRC),the third most prevalent cancer globally,exhibits a notable association with venous thromboembolism(VTE),significantly impacting patient morbidity and mortality.We delve into the complex pathogenesis of cancer-associated thrombosis(CAT)in CRC,highlighting the interplay of clinical risk factors and tumor-specific mechanisms.Our comprehensive review synthesizes the current understanding of CRC’s pro-thrombotic tendencies,examining both general clinical factors(e.g.,age,gender,obesity,prior VTE history)and tumor-specific aspects(e.g.,tumor location,stage,targeted therapies).Key findings illustrate how CRC cells themselves actively contribute to coagulation cascade activation through various procoagulant elements such as tissue factor,cancer procoagulant,and extracellular vesicles.We also explore how CRC influences host cells to adopt a procoagulant phenotype,thereby exacerbating thrombotic risks.This review underscores the role of genetic mutations in CRC(e.g.,KRAS,p53)in modulating coagulation-related protein expression and thrombosis risks.An in-depth understanding of the genetic landscape specific to CRC subtypes is essential for developing targeted anticoagulation strategies and could significantly advance thrombosis prevention while improving the overall management of patients with CRC.This highlights the urgent need for precision in addressing CAT within clinical settings.
文摘Objective:To explore the key points of holistic nursing for children with membranous nephropathy(MN)combined with cerebral venous thrombosis,providing a reference for similar cases.Methods:The course of illness data of an 8-year-old boy with MN in the recurrent phase complicated with cerebral venous sinus thrombosis(CVST)was retroactively analyzed.Systematic nursing was implemented based on evidence-based practices,including strict neurological monitoring,anticoagulation and thrombolysis medication nursing,fluid and electrolyte management,hypoalbuminemia and edema nursing,complication prevention,and mental health education.Results:After 16 days of continuous infusion of low molecular weight heparin and supportive treatment,the child’s symptoms,such as headache and vomiting,disappeared.The reexamination of MRV showed significant absorption of thrombosis,and there was no residual neurological deficit.During the 3-month follow-up,the anticoagulation compliance was good,and there was no recurrence.Conclusion:Early identification of hypercoagulability risk,strengthening dynamic evaluation of neurological signs and coagulation indicators,standardizing anticoagulation and thrombolysis nursing,and cooperating with continuous health management can significantly improve the prognosis of children with MN combined with CVST.
文摘Case Letter Severe trauma has high morbidity and mortality rates,being the leading cause of death in young adults.Among all traumas,tra ffi c injuries are particularly lethal.^([1-2]) The injury severity score(ISS) can be used to assess trauma severity,with ISS of<9,9–15,16–24,and≥25 indicating minor,moderate,severe,and critical trauma,respectively.The ISS is correlated with mortality,morbidity,and hospitalization duration after injury.^([3-4]) Here,we report one patient who was admitted to our emergency intensive care unit(EICU) due to traumatic liver rupture and traumatic myocardial infarction complicated with inferior vena cava(IVC) thrombosis.
基金supported by grant from the Project of the National Natural Science Foundation of China(Grant No.82060028)funded by the Yunnan Blood Disease Clinical Medical Center(Grant No.2023YJZX-XY05)+2 种基金the Yunnan Health Commission(L2019003)to TSthe Yunnan Provincial Key Laboratory of Clinical Virology(Grant No.202205AG070005)the Yunnan Provincial Key Laboratory of Innovative Application of Traditional Chinese Medicine.
文摘Thrombosis is a leading cause of mortality and morbidity in patients suffering from polycythemia vera(PV).Drug pair Salviae Miltiorrhizae Radix et Rhizoma(Danshen,DS)and Notoginseng Radix et Rhizoma(Sanqi,SQ)is common traditional Chinese medicine(TCM)used in clinical practice to promote blood circulation and eliminate blood stasis.In this study,network pharmacology and molecular docking were used to analyze the potentially active ingredients and underlying mechanisms of drug pair DS-SQ against thrombosis after PV.These results show that 54 targets are related to both disease and the drug pair.Nineteen core targets,including IL-6 and AKT1,were screened.Luteolin and tanshinone IIa from DS as well as quercetin from SQ might be the major substances in the treatment of thrombosis after PV.KEGG enrichment analysis demonstrated that the lipid and atherosclerosis signaling pathway might play a significant role.These results provide valuable insights and a reference for the use of drug pair DS-SQ in management of thrombosis after PV and lay a foundation for further exploration of pharmacological effects.
基金supported by grants from the Youth TCM scientific research Project of Heilongjiang Province TCM Administration(ZHY2024-283)the Health and Family Planning Commission of Heilongjiang Province(20240404070039)+1 种基金Heilongjiang Postdoctoral Fund(NO.LBH-Z23257)the Innovative Science Research Fund of Harbin Medical University(also known as Heilongjiang Provincial University's Project of Graduate Scientific Research Business Fees)(2024,Xin Zhang)and the Postdoctoral Program of Heilongjiang Province(NO.LBH-Z23234).
文摘Objective:To investigate the risk factors for deep vein thrombosis(DVT)following total hip arthroplasty in elderly patients with femoral neck fractures during the winter.Methods:A total of 162 patients who underwent total hip arthroplasty were categorized based on the development of DVT within 7 days postoperatively:28 patients formed the DVT group and 134 patients the non-DVT group.Collected data included age,gender,history of glucocorticoid use,diabetes,hypertension,body mass index(BMI),triglyceride(TG)levels,cholesterol(CHOL)levels at admission,operative time,and postoperative bed rest duration.D-dimer(D-D)and fibrinogen(Fg)levels,along with the D-D/Fg ratio,were recorded on the first postoperative day.Group comparisons were performed using t-tests.Logistic regression analysis was conducted to identify independent risk factors,and the predictive value of these factors was evaluated using receiver operating characteristic(ROC)curve analysis.Results:In the DVT group,18 patients had diabetes.Levels of TG(1.78±0.44 mmol/L),CHOL(4.70±1.84 mmol/L),D-D(0.40±0.17 mg/L),and the D-D/Fg ratio(0.24±0.07)were significantly higher than in the non-DVT group(P<0.05).Logistic regression identified TG,CHOL,D-D,and the D-D/Fg ratio as independent risk factors for DVT,with odds ratios of 0.987,2.395,0.8,4.992,and 9.004,respectively(P<0.05).ROC curve analysis yielded areas under the curve(AUCs)of 0.715,0.69,0.614,and 0.726 for TG,CHOL,D-D,and the D-D/Fg ratio,respectively.Sensitivities were 0.643,0.500,0.429,and 0.857,and specificities were 0.694,0.978,0.918,and 0.537,respectively.Conclusion:Elevated levels of TG,CHOL,D-D,and the D-D/Fg ratio are independent risk factors for DVT following total hip arthroplasty in elderly patients.Among these,the D-D/Fg ratio demonstrated the highest sensitivity and may serve as an effective marker for early-stage DVT screening.
基金Health Science Research Project of Kunming Health Committee,Yunnan Province(Project No.:2023-14-04-008)。
文摘Objective:To develop and validate a risk prediction model for catheter-related thrombosis(CRT)in pediatric patients with severe traumatic brain injury(sTBI).Methods:Using convenience sampling,216 pediatric patients with sTBI admitted to the Surgical Intensive Care Unit of Kunming Children’s Hospital between June 2022 and May 2025 were enrolled and randomly divided into a training set of 151 cases and a validation set of 65 cases.Influencing factors were identified through univariate analysis and logistic regression analysis to construct the prediction model.The model’s discrimination and calibration were evaluated by the area under the receiver operating characteristic(ROC)curve(AUC)and the Hosmer–Lemeshow goodness-of-fit test.Results:Univariate analysis showed that admission GCS score,CVC insertion site,D-dimer level,and duration of mechanical ventilation were risk factors for CRT in children with sTBI(P<0.05).The logistic regression equation was constructed as follows:Logit(P)=2.74–1.95×GCS score+0.25×D-dimer(μg/mL)+0.02×duration of mechanical ventilation(h).Based on this model,the AUC was 0.87 in the training set and 0.88 in the validation set.The Hosmer–Lemeshow goodness-of-fit test indicated good agreement between the model’s calibration curve and the ideal curve.Conclusion:The developed prediction model demonstrates good predictive performance and can serve as a reference for the early clinical identification of CRT risk in pediatric patients with sTBI.
基金Correlation analysis between TF-MPs expression level and deep vein thrombosis in patients with cervical cancer(Project No.:2023-ZD-69)。
文摘Objective:To explore the molecular mechanism of tissue factor-positive microparticles(TF-MPs)expression and deep venous thrombosis(DVT)in patients with cervical cancer.Methods:A total of 200 patients with cervical cancer and benign cervical diseases who were hospitalized in the First Department of Gynecologic Oncology of Gansu Provincial Cancer Hospital from January 2024 to December 2025 were selected,including 100 patients with benign cervical diseases as the control group and 100 patients with cervical cancer as the experimental group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression level of TF-MPs in peripheral blood samples from patients with cervical cancer and healthy controls.At the same time,real-time quantitative PCR was used to explore the molecular mechanism of TF-MPs promoting DVT formation.Finally,the formation of DVT in the two groups was observed and recorded,and the incidence of DVT was counted.Results:Experimental measurements showed that the expression levels of TF-MPs,coagulation factors FVII,FX,PT,and inflammatory factors IL-6 and TNF-a in the experimental group were significantly higher than those in the control group(P<0.01);the incidence of DVT in the experimental group was up to 38%,far exceeding the 6%in the control group(P<0.001).Conclusion:Abnormal expression of TF-MPs in patients with cervical cancer is an important risk factor for DVT.Through in-depth analysis of the molecular mechanism of TF-MPs promoting DVT formation,it provides a new perspective and theoretical basis for the prevention and treatment of DVT in patients with cervical cancer.In the future,intervention strategies targeting TF-MPs and their related molecular pathways are expected to become effective ways to reduce the incidence of DVT in patients with cervical cancer.
基金Supported by The Beijing Hospitals Authority Youth Programme,No.QMl220201802.
文摘BACKGROUND The portal vein thrombosis(PVT)can exacerbate portal hypertension and lead to complications,increasing the risk of mortality.AIM To evaluate the predictive capacity of artificial neural networks(ANNs)in quan-tifying the likelihood of developing PVT in individuals afflicted with hepatitis B-induced cirrhosis.METHODS A retrospective study was conducted at Beijing Ditan Hospital,affiliated with Capital Medical University,including 986 hospitalized patients.Patients admitted between January 2011 and December 2014 were assigned to the training set(685 cases),while those hospitalized from January 2015 to December 2016 were divided into the validation cohort(301 cases).Independent risk factors for PVT were identified using COX univariate analysis and used to construct an ANN model.Model performance was evaluated through metrics such as the area under the receiver operating characteristic curve(AUC)and concordance index.RESULTS In the training set,PVT occurred in 19.0%of patients within three years and 23.7%within five years.In the validation cohort,PVT developed in 16.7%of patients within three years and 24.0%within five years.The ANN model incorporated nine independent risk factors:Age,ascites,hepatic encephalopathy,gastrointestinal varices with bleeding,Child-Pugh classification,alanine aminotransferase levels,albumin levels,neutrophil-to-lymphocyte ratio,and platelet.The model achieved an AUC of 0.967(95%CI:0.960–0.974)at three years and 0.975(95%CI:0.955–0.992)at five years,significantly outperforming existing models such as model for end-stage liver disease and Child-Pugh-Turcotte(all P<0.001).CONCLUSION The ANN model demonstrated effective stratification of patients into high-and low-risk groups for PVT deve-lopment over three and five years.Validation in an independent cohort confirmed the model's predictive accuracy.
文摘BACKGROUND About 35%-50%of patients with hepatocellular cancer(HCC)present with portal venous tumor thrombosis(PVTT).Stereotactic body radiation therapy(SBRT)offers a promising approach for locoregional treatment in patients with HCC with PVTT.This study aimed to report the clinical characteristics and early outcomes of patients with unresectable HCC and PVTT treated with SBRT.AIM To report the clinical characteristics and early outcomes of patients with unresectable HCC and PVTT treated with SBRT.METHODS This retrospective,single-institution study included adult HCC patients with PVTT treated between March 2020 and December 2023.Eligibility criteria included Child-Pugh A-B liver function,serum bilirubin<3 mg/dL,Eastern Co-operative Oncology Group performance status 0-2,a normal liver volume>700 cc,and a tumor-lumen distance>5 mm.SBRT dose and fractionation were determined based on tumor volume and organ-at-risk constraints.Baseline clinical and dosimetric parameters were recorded.Survival analysis was performed using Kaplan-Meier curves,response was assessed at 3 months post-SBRT using the Revised Response Evaluation Criteria in Solid Tumors 1.1 criteria,and toxicity was graded per Common Terminology Criteria for Adverse Events 4.0.RESULTS Thirty patients(median age:65 years,90%male)were included.Sixteen(53.3%)were Child-Pugh A,and fourteen(46.6%)were Child-Pugh B.Sixty percent had VP4 disease.SBRT doses ranged from 30-50 Gy in 5-6 fractions.The median tumor diameter was 6.1 cm,and the median follow-up was 15 months.The overall response rate was 83.3%,with a median overall survival of 13 months and progression-free survival of 10.2 months.No grade 4 toxicities were observed.CONCLUSION SBRT has the potential to be an effective modality for locoregional control in patients with unresectable HCC with PVTT.
文摘BACKGROUND Peripherally inserted central catheter(PICC)is the preferred intravenous route for chemotherapy in patients with cancer,but its complications,especially deep vein thrombosis(DVT),are becoming increasingly prevalent.Medical staff proficient in intubation and maintenance techniques can reduce complications.The multivariate integration teaching model applies the integration of“teaching learning application”to medical training,which helps shift the prevention of complications from“passive management of complications”to“active construction of risk immunity”,thereby ensuring foundational competency for PICC in patients with cancer.AIM To investigate the efficacy of the multivariate integration teaching model in patients with gastric cancer and concurrent DVT after PICC intubation and analyze its effect on patients’quality of life index(QLI)and satisfaction.METHODS A retrospective analysis of medical records of 100 patients with gastric cancer and PICC treated at Zhejiang Provincial People’s Hospital from May 2019 to November 2020 was conducted.According to the different treatment methods and teaching modes received by medical staff,they were divided into a control group and an experimental group,with 50 cases in each group.The routine clinical teaching model and the multivariate integration teaching model were administered to the medical staff for the control group and the experimental group,respectively,to compare the incidence rates of DVT and other adverse reactions,QLI scores,Karnofsky Performance Scale scores,Mental Status Scale in Non-Psychiatric Settings scores,patient satisfaction,medical staff’s test marks,and satisfaction evaluation of the teaching model.RESULTS Compared with the control group,the experimental group exhibited significantly lower incidence rates of DVT and other adverse reactions and MSSNS scores but significantly higher QLI scores,KPS scores,patient satisfaction,medical staff’s test marks,and their satisfaction evaluations of the teaching model(P<0.05).CONCLUSION In a single-center practice,performing the multivariate integration teaching model for medical staff may effectively improve the patients’QLI and satisfaction and may have certain application value in preventing DVT in patients with gastric cancer and PICC.
