Fractal characters and fractal dimension of time series created by repeller in complicated system were studied and the time series were reconstructed by applying the theory of phase space reconstruction for chaotic ti...Fractal characters and fractal dimension of time series created by repeller in complicated system were studied and the time series were reconstructed by applying the theory of phase space reconstruction for chaotic time series. The influence of zero_mean treatment, Fourier filter on prediction for time series were studied. The choice of prediction sample affects the relative error and the prediction length which were also under good concern. The results show that the model provided here are practical for the modeling and prediction of time series created by chaotic repellers. Zero_mean treatment has changed prediction result quantitatively for chaotic repeller sample data. But using Fourier filter may decrease the prediction precision. This is theoretical and practical for study on chaotic repeller in complicated system.展开更多
The paper analyzed characters of complicated system and discussed the reason of comprehensive evaluation, realization of flexible comprehensive evaluation was researched from prospect of dynamic measure selection of e...The paper analyzed characters of complicated system and discussed the reason of comprehensive evaluation, realization of flexible comprehensive evaluation was researched from prospect of dynamic measure selection of evaluation, balance of functionality and harmony, uncertainty factor. In the end, multistage flexible comprehensive evaluation of complicated system was applied to performance evaluation of firm.展开更多
Based on the work discussed on the former study, this article first starts from the mathematical model of a kind of complicated financial system, and analyses all possible things that the model shows in the operation ...Based on the work discussed on the former study, this article first starts from the mathematical model of a kind of complicated financial system, and analyses all possible things that the model shows in the operation of our country's macro_financial system: balance, stable periodic, fractal, Hopf_bifurcation, the relationship between parameters and Hopf_bifurcation, and chaotic motion etc. By the changes of parameters of all economic meanings, the conditions on which the complicated behaviors occur in such a financial system, and the influence of the adjustment of the macro_economic policies and adjustment of some parameter on the whole financial system behavior have been analyzed. This study will deepen people's understanding of the lever function of all kinds of financial policies.展开更多
Based on the work discussed on the former study, this article first starts from the mathematical model of a kind of complicated financial system, and analyses all possible things that the model shows in the operation ...Based on the work discussed on the former study, this article first starts from the mathematical model of a kind of complicated financial system, and analyses all possible things that the model shows in the operation of our country's macro_financial system: balance, stable periodic, fractal, Hopf_bifurcation, the relationship between parameters and Hopf_bifurcation, and chaotic motion etc. By the changes of parameters of all economic meanings, the conditions on which the complicated behaviors occur in such a financial system, and the influence of the adjustment of the macro_economic policies and adjustment of some parameter on the whole financial system behavior have been analyzed. This study will deepen people's understanding of the lever function of all kinds of financial policies.展开更多
This paper is a further study of reference [1]. In this paper, we mainly discuss the complicated dynamical behaviors resulting from a simple one-dimensional model of nonlinear ecosystems: fixed point motion, periodic ...This paper is a further study of reference [1]. In this paper, we mainly discuss the complicated dynamical behaviors resulting from a simple one-dimensional model of nonlinear ecosystems: fixed point motion, periodic motion and chaotic motion etc., and briefly discuss the universality of the complicated dynamical behaviors, which can be described by the first and the second M. Feigenbaun. constants. At last, we discuss the 'one-side lowering phenomenon' due to near unstabilization when the nonlinear ecosystem approaches bifurcation points from unbifurcation side. It is of important theoretical and practical meanings both in the development and utilization of ecological resources ar.d in the design and management of artifilial ecosystems.展开更多
Aiming at the problem of reliability allocation for a complicated largesystem, a new thought is brought up. Reliability allocation should be a kind of decision-makingbehavior; therefore the more information is used wh...Aiming at the problem of reliability allocation for a complicated largesystem, a new thought is brought up. Reliability allocation should be a kind of decision-makingbehavior; therefore the more information is used when apportioning a reliability index, the morereasonable an allocation is obtained. Reliability allocation for a complicated large system consistsof two processes, the first one is a reliability information reporting process from bottom to top,and the other one is a reliability index apportioning process from top to bottom. By a typicalexample, we illustrate the concrete process of reliability allocation algorithms.展开更多
BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and te...BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and teenagers, but the maintenance of pulphealth and the calcific healing of multiple root fractures are rarely reported in theliterature.CASE SUMMARY This case reports healing of a permanent tooth with complicated crown–root andadditional root fractures, in which pulp health was maintained. A 10-year-old girlfell and fractured the root of her maxillary left central incisor at the cervical level.After the coronal fragment was repositioned, the tooth was splinted until thetooth was no longer mobile, 2 years later. Eight years after treatment, the toothhas remained asymptomatic with vital pulp and localized gingival overgrowth.Cone-beam computed tomography revealed not only calcified healing of the CRFbut also spontaneous healing in an additional undiagnosed root fracture. Thefracture line on the enamel could not be healed by hard tissue and formed agroove in the cervical crown. It was speculated that the groove was related to thelocalized gingival overgrowth.CONCLUSION This case provides a clinical perspective of the treatment of a tooth with acomplicated CRF and an additional root fracture.展开更多
BACKGROUND Distribution of the colonic diverticula differs in different populations,and rightsided colon diverticulitis(RCD)and left-sided colon diverticulitis(LCD)manifest distinct clinical features.Complicated diver...BACKGROUND Distribution of the colonic diverticula differs in different populations,and rightsided colon diverticulitis(RCD)and left-sided colon diverticulitis(LCD)manifest distinct clinical features.Complicated diverticulitis(CD)mostly requires hospitalization and can be treated within a spectrum from observation to surgery.Treatment choice is formed depending on the patient’s general condition,the presence of diffuse peritonitis,the localization of diverticulitis,Hinchey stage,and responsiveness to the prior treatment.Clinical disparities regarding right and LCD also led to the differences in the incidences of both emergency surgery and future elective surgery.AIM To evaluate the clinical features of CD,display the differences according to colonic localizations,and present treatment approaches.METHODS This was a retrospective study from a single centre analysing data from a prospective database.The 253 patients with history of hospitalization for CD were included and divided into two groups:RCD and LCD.To compare the differences between the two groups,the Student’s t-test was used when the parametric test prerequisites were fulfilled,and the Mann-Whitney U test was used when such requirements were not fulfilled.RESULTS The 208(82.2%)patients were found to have LCD,and 45(17.8%)had RCD.The majority of the patients had Hinchey 1A diverticulitis(49.8%).Male gender was significantly more common in patients who underwent surgery for LCD.While persistent abdominal pain was the main prior finding in the conservative treatment of both localizations,surgery was most performed due to abscess in RCD and perforation in LCD.The presence of an accompanying malignancy during colonoscopy was significantly more common in LCD cases who underwent surgery.Hartmann’s procedure was the most performed technique in emergency settings(56.3%),while laparoscopic colectomy with anastomosis was in elective settings(53.9%).In addition,surgery was found to prolong the mean length of hospital stay in LCD patients.CONCLUSION Although diverticulitis is a benign condition,the need for an individualized and evidence-based approach makes management challenging.Localization of the disease has an important role in determining the appropriate treatment.展开更多
BACKGROUND Ventriculoperitoneal shunt(VPS)catheter insertion is one of the most widely accepted surgical procedures for hydrocephalus.Migration of the end of the distal VPS catheter into the scrotum is one of the rare...BACKGROUND Ventriculoperitoneal shunt(VPS)catheter insertion is one of the most widely accepted surgical procedures for hydrocephalus.Migration of the end of the distal VPS catheter into the scrotum is one of the rare complications of VPS catheter insertion.METHODS This is a systematic review of the published cases,and the literature search was performed from 1974 to June 30,2024,to retrieve the relevant manuscripts.The cases were grouped into two.Group A included cases of migration of the distal VPS catheter into the scrotum,detected in children.Group B included the cases of migration of the distal VPS catheter into the scrotum,which was detected in adults and older people.RESULTS One hundred-twenty cases of migration of the distal end of VPS catheter into the scrotum were included in this study,a systematic literature review.Group A included n=112 cases,and group B included n=8 cases only.Three-fourths of the cases involved the right scrotum.Bilateral involvement was rare.The indication for initial VPS insertion was congenital hydrocephalus in four-fifths of the group A cases.The majority were infants at the time of initial shunt insertion.Four-fifths of the group A cases were 24 months-old or younger at the time of clinical diagnosis and treatment was provided for migration of the distal VPS catheter into the scrotum.In children,the interval from VPS insertion or shunt revision if any,to the diagnosis of the complication mentioned above was 12 months or less in four-fifths of the cases.The repositioning of migrated distal VPS catheter into the peritoneal cavity and herniotomy was preferred for the surgical procedure,and it was performed for two-thirds of group A cases.CONCLUSION Migration of the distal part of the VPS catheter into the scrotum is a rare complication of cerebrospinal fluid diversion via VPS catheter insertion.It was most frequent in children,and the right side of the scrotum was most often involved.展开更多
Background In recent years,the incidence of coronary heart disease(CHD)has continued to rise,and its comorbidity with hyperlipidemia significantly increases the mortality risk in patients.Statin monotherapy faces limi...Background In recent years,the incidence of coronary heart disease(CHD)has continued to rise,and its comorbidity with hyperlipidemia significantly increases the mortality risk in patients.Statin monotherapy faces limitations in efficacy for some patients and raises potential safety concerns.Ezetimibe,as a novel lipid-modulating agent,exhibits potential advantages in the treatment of hyperlipidemia.Based on this,the present study investigated the therapeutic efficacy of ezetimibe in CHD patients with hyperlipidemia,as well as its effects on lipid metabolism and the amelioration of atherosclerosis.Methods In this study,150 clinical cases with CHD and hyperlipidemia admitted in our hospital from July 2022 to July 2024 were collected for retrospective analysis.According to different treatment methods,they were randomly divided into the Atorvastatin group(control group,n=75)and the Atorvastatin+Ezetimibe group(experimental group,n=75).Control group received atorvastatin monotherapy,while experimental group were administered additional ezetimibe as an adjunct to the atorvastatin-based treatment regimen.The clinical efficacy of the two treatment groups was analyzed,including cardiac function-related parameters such as the cardiac index(CI),cardiac output(CO),left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)before and after treatment.The observed indicators encompassed coronary angiography findings,the Gensini score for assessing coronary stenosis severity,the inflammatory marker high-sensitivity C-reactive protein(hs-CRP),and lipid profile parameters including total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C).Additionally,the occurrence of adverse reactions during treatment was monitored.Results After treatment,the total effective rate in experimental group was significantly higher than that in control group,with a statistically significant difference(P<0.05).In the comparison of the baseline data,both groups showed marked improvements in CI,CO,LVEF,and HDL-C.However,at the same time points,the experimental group demonstrated significantly better results in these parameters than control group(P<0.05).Additionally,LVEDD,LDL-C,hs-CRP and Gensini scores were significantly reduced after treatment in both groups compared to pretreatment levels.Moreover,at identical time points,the aforementioned parameters in the experimental group demonstrated significantly greater reductions compared to control group(P<0.05).Regarding safety assessment,comparative analysis of adverse drug reaction(ADR)incidence rates between the two treatment groups revealed no statistically significant difference(P>0.05).Conclusions In patients with CHD complicated by hyperlipidemia,ezetimibe demonstrates significant therapeutic advantages.It effectively enhances treatment efficacy,regulates lipid profiles,improves cardiac function,and mitigates the progression of atherosclerosis.This regimen exhibits a favorable safety profile and holds substantial clinical value for both therapeutic processes and rehabilitation outcomes in this patient population.展开更多
BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related co...BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related complications in colorectal cancer patients who underwent stoma creation.METHODS Patients with stoma was prospectively recorded in the established stoma system.Data was collected from this stoma management system from November 2021 through May 2024.The rates of stoma-related complications were assessed,and potential risk factors were analyzed using univariate and multivariate logistic regression models.RESULTS A total of 734 patients were included in the analysis.The results showed that 12.3%of patients experienced stoma-related complications,with mucocutaneous separation,edema,and skin excoriation being the most common complications.The majority(90%)of complications were classified as grade 2 according to the Clavien-Dindo classification.Surgical factors,such as blood loss volume greater than 500 mL and open surgery,were significantly associated with stoma complications.Additionally,stoma features like location,shape,color,height,and edema were important factors in the association with complications.Body mass index over 30 kg/m²was also found to be a significant risk factor.CONCLUSION These findings highlight the need for a holistic approach to preventing and managing stoma complications,considering both patient-related and surgical factors.展开更多
Objective:To evaluate the efficacy and safety of traditional Chinese exercises(TCE)in patients with diabetic peripheral neuropathy(DPN)and to recommend best practices for using TCE to improve neurological function,gly...Objective:To evaluate the efficacy and safety of traditional Chinese exercises(TCE)in patients with diabetic peripheral neuropathy(DPN)and to recommend best practices for using TCE to improve neurological function,glycemic control,and psychological well-being.Methods:Nine databases were searched from the inception to October 2024.Effect relationships were assessed using meta-analysis with Stata 17,and the methodological quality and certainty of the evidence were evaluated using standard tools.Results:Twelve studies comprising three study designs(nine randomized controlled,one quasi-exper-imental controlled,and two single-arm clinical trials),were identified.Compared with usual care,TCE improved various indicators and enhanced the nerve conduction velocities of the peroneal motor(mean difference[MD]=3.86 m/s,95%confidence interval[CI]:0.38 to 7.34,P=0.03),sural sensory(MD=4.15 m/s,95%CI:0.68 to 7.63,P=0.02),median motor(MD=3.84 m/s,95%CI:2.14 to 5.54,P<.001),and median sensory nerves(MD=6.14 m/s,95%CI:4.54 to 7.74,P<.001).TCE practices also reduced glycosylated hemoglobin level(MD=-0.59%,95%CI:-0.91 to-0.27,P<.001)and fasting blood glucose(standardized mean difference[SMD]=-1.08,95%CI:-1.79 to-0.37,P<.001).The overall quality of evidence was very low.Conclusion:The results indicate that TCE therapy improves certain outcomes in patients with DPN.Although the optimal type,intensity,frequency,and duration of TCE interventions are uncertain,these preliminary findings suggest that TCE should be further studied as a potentially affordable and effective treatment for DPN.展开更多
BACKGROUND Gastric and oesophageal cancers are among the leading causes of cancer-related mortality globally.Treatment in the form of surgical resection and neoadjuvant therapy is considered the gold standard;however,...BACKGROUND Gastric and oesophageal cancers are among the leading causes of cancer-related mortality globally.Treatment in the form of surgical resection and neoadjuvant therapy is considered the gold standard;however,these procedures are associated with significant postoperative morbidity and prolonged recovery times.Prehabilitation aims to combat this by physically and psychologically optimising patients preoperatively to handle the stress of surgery and improve postoperative outcomes.AIM To evaluate the effectiveness of prehabilitation in patients undergoing gastric or oesophageal cancer resections.METHODS Standard medical databases such as MEDLINE,EMBASE,PubMed,and Cochrane Library were searched to find randomised,controlled trials comparing prehabilitation vs no-prehabilitation in patients undergoing gastric or oesophageal cancer resections.All data were analysed using Review Manager Software 5.4,and the meta-analysis was performed with a random-effect model analysis.RESULTS A total of 16 studies were included(n=1479),recruiting adult patients undergoing gastric or oesophageal cancer resections.In the random effect model analysis,prehabilitation was associated with fewer postoperative complications compared to no prehabilitation(Odds ratio:0.43,95%CI:0.31-0.58,Z=25.28,P<0.00001).Additionally,prehabilitation was associated with a lower postoperative readmission rate(risk ratio:0.58,95%CI:0.35-0.96,Z=2.10,P=0.04)and a shorter length of stay[standardised mean difference(SMD):-0.19,95%CI:-0.37 to-0.02,Z=2.21,P=0.03]compared to no-prehabilitation.Prehabilitation was also found to improve preoperative 6-minute walking distance(6-MWD)compared to no-prehabilitation(SMD:0.72,95%CI:0.21-1.23,Z=2.75,P=0.006).No statistical difference was found in postoperative 6-MWD,mortality,and severe complications.CONCLUSION Prehabilitation was found to be effective in reducing postoperative morbidity and improving preoperative physical health in patients undergoing gastric or oesophageal cancer resections.展开更多
BACKGROUND Colon cancer is one of the most common malignancies of the digestive tract,often complicated by intestinal obstruction,which can significantly impact patient outcomes.While traditional laparotomy is the sta...BACKGROUND Colon cancer is one of the most common malignancies of the digestive tract,often complicated by intestinal obstruction,which can significantly impact patient outcomes.While traditional laparotomy is the standard treatment,it is associated with large wounds,slower recovery,and higher complication rates.Laparoscopic surgery,a minimally invasive approach,may offer better outcomes for these patients.AIM To evaluate the clinical effects and prognosis of laparoscopic surgery in patients with colon cancer complicated by intestinal obstruction compared to traditional laparotomy.METHODS A retrospective analysis was conducted on 100 patients diagnosed with colon cancer and intestinal obstruction who underwent surgical treatment between January 2020 and December 2022.Patients were divided into two groups:The control group(CG),treated with traditional laparotomy,and the observation group(OG),treated with laparoscopic surgery.Clinical effects,surgical indicators,postoperative pain,inflammatory response,complication rates,quality of life,and prognosis were assessed and compared between the two groups.RESULTS The OG showed superior clinical outcomes compared to the CG(P<0.05).Patients in the OG had shorter operation times,reduced intraoperative blood loss,faster recovery of intestinal function,earlier mobilization,and shorter hospital stays(P<0.05).Postoperative pain(numerical rating scale scores)and inflam-matory markers[tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]were lower in the OG(P<0.05).The incidence of complic-ations was significantly reduced in the OG(6.00%vs 22.00%,P<0.05).Quality of life scores,including physical function,psychological state,social communication,and self-care ability,were significantly higher in the OG(P<0.05).There were no significant differences between groups in abdominal drainage volume,1-year tumor recurrence or metastasis rates,or 1-and 3-year survival rates(P>0.05).CONCLUSION The OG showed superior clinical outcomes compared to the CG(P<0.05).Patients in the OG had shorter operation times,reduced intraoperative blood loss,faster recovery of intestinal function,earlier mobilization,and shorter hospital stays(P<0.05).Postoperative pain(NRS scores)and inflammatory markers(TNF-α,IL-6,CRP)were lower in the OG(P<0.05).The incidence of complications was significantly reduced in the OG(6.00%vs 22.00%,P<0.05).Quality of life scores,including physical function,psychological state,social communication,and self-care ability,were significantly higher in the OG(P<0.05).There were no significant differences between groups in abdominal drainage volume,1-year tumor recurrence or metastasis rates,or 1-and 3-year survival rates(P>0.05).展开更多
BACKGROUND Hepatobiliary and pancreatic cancers are often associated with high morbidity and mortality.Surgical intervention remains the cornerstone for curative treatment.However,Due to the complexity of these proced...BACKGROUND Hepatobiliary and pancreatic cancers are often associated with high morbidity and mortality.Surgical intervention remains the cornerstone for curative treatment.However,Due to the complexity of these procedures,patients often experience postoperative complications.Prehabilitation has been suggested as a tool to decrease postoperative morbidity and improve recovery by optimising patients preoperatively to handle the stress of surgery.AIM To evaluate the effectiveness of prehabilitation in patients undergoing hepatobiliary and pancreatic cancer resections.METHODS Standard medical databases such as MEDLINE,EMBASE,PubMed,and Cochrane Library were searched to find randomised,controlled trials comparing prehabilitation vs no-prehabilitation before hepatic,biliary,or pancreatic cancer resections.All data were analysed using Review Manager Software 5.4,and the metaanalysis was performed with a random-effect model analysis.RESULTS A total of 8 studies were included(n=568),recruiting adult patients undergoing hepatic,biliary,or pancreatic cancer resections.In the random effect model analysis,prehabilitation was associated with fewer postoperative complications compared to no prehabilitation[risk ratio(RR):0.79,95%CI:0.66-0.95,Z=2.52,P=0.01].No statistically significant difference was found in postoperative readmission rate(RR:1.31,95%CI:0.79-2.17,Z=1.05,P=0.29),major complications(RR:1.08;95%CI:0.61-1.92,Z=0.28,P=0.78),length of stay(standardised mean difference:-0.11,95%CI:-0.31 to 0.1,Z=1.05,P=0.29),or mortality(RR:0.28,95%CI:0.01-6.51,Z=0.79,P=0.43).CONCLUSION Prehabilitation was found to be effective in reducing postoperative complications following surgical intervention for hepatobiliary or pancreatic cancer.展开更多
BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a highly effective treat-ment for complications associated with portal hypertension.However,stent fracture,although extremely rare,represents a potentia...BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a highly effective treat-ment for complications associated with portal hypertension.However,stent fracture,although extremely rare,represents a potentially serious complication following TIPS creation.Timely identification and management are crucial for preventing further adverse events.CASE SUMMARY We report a 56-year-old male patient who underwent a TIPS procedure for re-current melena caused by portal hypertension secondary to hepatitis B and experienced a stent fracture 15 months post-procedure.He was readmitted 30 months after the initial TIPS due to recurrent esophagogastric variceal bleeding and ascites.An attempt to revise the dysfunctional shunt via a stent-in-stent approach was unsuccessful.Consequently,a parallel TIPS procedure was success-fully performed via the proximal end of the fractured stent to decompress the portal venous system.At the 1-month follow-up,the patient exhibited no recur-rent variceal bleeding,and his ascites had significantly decreased.Twelve-month postoperative monitoring revealed no hepatic encephalopathy and no recurrence of bleeding or ascites.Additionally,we review the existing literature on post-TIPS stent fractures to explore the underlying mechanisms contributing to this com-plication.CONCLUSION Early recognition and prompt intervention are essential in managing stent fractures after TIPS creation to mitigate potential risks and ensure optimal patient outcomes.展开更多
Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities.Patients often experience a range of complications,including cardiovascular,renal,hematological,and metabolic abnorma...Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities.Patients often experience a range of complications,including cardiovascular,renal,hematological,and metabolic abnormalities,which can significantly affect treatment outcomes and quality of life.This article emphasizes the integration of multidisciplinary strategies and artificial intelligence-driven diagnostics,which have the potential to improve patient outcomes by optimizing early detection and targeted management of these complications.A recent study on 60 liver cancer patients undergoing interventional therapy highlighted the importance of recognizing and managing these complications.This article offers an overview of systemic complications in liver cancer,focusing on pathophysiological mechanisms,risk factors,and strategies to improve care.By addressing gaps in the existing literature and proposing future research directions,it underscores the importance of comprehensive,patient-centered approaches to refine therapeutic strategies.展开更多
BACKGROUND Urolithiasisposes challenges in patients with chronic kidney disease(CKD),necessitating careful consideration of surgical interventions due to potential complications.AIM To assess the safety,feasibility,an...BACKGROUND Urolithiasisposes challenges in patients with chronic kidney disease(CKD),necessitating careful consideration of surgical interventions due to potential complications.AIM To assess the safety,feasibility,and efficacy of surgical interventions for urolithiasis in CKD patients.METHODS Systematic review adhering to PRISMA guidelines.Comprehensive searches of PubMed,Scopus,Cochrane Library,Web of Science,and Embase were conducted for studies published from January 2014 to June 2024.Studies involving adult patients(≥18 years)with CKD undergoing surgical interventions for urolithiasis,including randomized controlled trials,cohort studies,case-control studies,and observational studies.Studies involving pediatric patients,those not specifically addressing CKD patients,review articles,commentaries,and editorials.Despite an extensive search,only six studies met the strict inclusion criteria,reflecting the limited available data on this topic.This limitation has been acknowledged and discussed.RESULTS A total of 6 studies met the inclusion criteria,encompassing a diverse range of surgical interventions such as percutaneous nephrolithotomy(PCNL),ureteroscopy(URS),and extracorporeal shock wave lithotripsy(ESWL).Perioperative and postoperative complications varied across studies,with bleeding,infection,and acute kidney injury being the most common.The risk of complications was higher in patients with advanced CKD.Technical success rates were generally high,but feasibility was influenced by patientspecific factors such as CKD stage and comorbidities.Modifications to standard surgical techniques were often necessary.Stone-free rates and recurrence rates varied,with PCNL generally achieving higher stone-free rates compared to URS and ESWL.Long-term outcomes on renal function were inconsistent,highlighting the need for individualized treatment plans.CONCLUSION Surgical interventions for urolithiasis in CKD patients are associated with significant risks but can be effective in achieving stone clearance and symptom relief.The safety,feasibility,and efficacy of these interventions depend on patient-specific factors,necessitating a tailored approach.Further high-quality studies are needed to develop standardized guidelines and improve clinical outcomes in this complex patient population.展开更多
BACKGROUND Colorectal cancer(CRC)is a common malignant tumor of the digestive system that poses a serious threat to human health.During the perioperative period,patients with CRC are prone to nutritional risks and mal...BACKGROUND Colorectal cancer(CRC)is a common malignant tumor of the digestive system that poses a serious threat to human health.During the perioperative period,patients with CRC are prone to nutritional risks and malnutrition.Compared with traditional nutritional support,immunostimulatory nutrients,including glutamine(Gln),have attracted increasing attention.Although many previous studies have reported that perioperative Gln supplementation can improve short-term clinical outcomes in patients with CRC,some studies have not demonstrated a benefit.Resolution of Gln supplementation value thus requires further exploration.AIM To clarify the influence of perioperative Gln-enhanced nutritional support on postoperative outcomes including nutritional status,immune function,inflammation levels,morbidity due to complications,and length of hospital stay(LOS).METHODS A comprehensive literature search was conducted(inception to June 2025).PubMed,EMBASE,Web of Science,Cochrane Library,China Biomedical Database,CNKI,VIP,and the Wanfang Electronic Database were searched.This meta-analysis ultimately included 27 studies with a total of 1643 patients;827 patients received perioperative Gln treatment and 816 received conventional nutritional therapy.A random-effects model was used to pool relative risks(RR)and mean differences(MD)with 95%confidence intervals(CI).RESULTS Pooled analysis showed that Gln intervention reduced morbidity associated with postoperative infectious complications(RR=0.36;95%CI:0.24-0.54)and non-infectious complications(RR=0.32;95%CI:0.19-0.55)and shortened the LOS by 2.31 days(MD=-2.31;95%CI:-3.21 to-1.41)in CRC patients.Gln supplementation also increased serum albumin,prealbumin,peripheral blood lymphocyte count,and nitrogen balance levels and improved humoral and cellular immune function.We also found that postoperative tumor necrosis factor-αand C-reactive protein levels were lower in Gln-supplemented patients.By contrast,Gln supplementation did not improve CD8+and CD4+/CD8+levels.CONCLUSION Gln supplementation effectively improved short-term clinical outcomes in patients with CRC.展开更多
Dear Editor,For the past few decades,mosquito-borne orthoflaviviruses,such as dengue virus,Zika virus,and West Nile virus(WNV),have posed significant threats to global public health.The Orthoflavivirus genus comprises...Dear Editor,For the past few decades,mosquito-borne orthoflaviviruses,such as dengue virus,Zika virus,and West Nile virus(WNV),have posed significant threats to global public health.The Orthoflavivirus genus comprises more than 70 viruses,many of which are responsible for a wide range of diseases in humans and animals,including febrile illnesses,encephalitis,and hemorrhagic febrile illness.These viruses are associated with approximately 400 million infections and 100 million symptomatic cases worldwide each year(Van Leur et al.,2021).Among them,Usutu virus(USUV)is an emerging pathogen classified alongside WNV within the Japanese encephalitis virus(JEV)serogroup of the Orthoflavivirus genus,the Flaviviridae family.USUV has spread from Africa to Europe since the late 20th century.It primarily causes central nervous system disorders in birds,with several large-scale mortality events recorded in Europe.USUV can also infect humans,it typically leads to neurological complications in rare cases(Roesch et al.,2019).展开更多
文摘Fractal characters and fractal dimension of time series created by repeller in complicated system were studied and the time series were reconstructed by applying the theory of phase space reconstruction for chaotic time series. The influence of zero_mean treatment, Fourier filter on prediction for time series were studied. The choice of prediction sample affects the relative error and the prediction length which were also under good concern. The results show that the model provided here are practical for the modeling and prediction of time series created by chaotic repellers. Zero_mean treatment has changed prediction result quantitatively for chaotic repeller sample data. But using Fourier filter may decrease the prediction precision. This is theoretical and practical for study on chaotic repeller in complicated system.
文摘The paper analyzed characters of complicated system and discussed the reason of comprehensive evaluation, realization of flexible comprehensive evaluation was researched from prospect of dynamic measure selection of evaluation, balance of functionality and harmony, uncertainty factor. In the end, multistage flexible comprehensive evaluation of complicated system was applied to performance evaluation of firm.
文摘Based on the work discussed on the former study, this article first starts from the mathematical model of a kind of complicated financial system, and analyses all possible things that the model shows in the operation of our country's macro_financial system: balance, stable periodic, fractal, Hopf_bifurcation, the relationship between parameters and Hopf_bifurcation, and chaotic motion etc. By the changes of parameters of all economic meanings, the conditions on which the complicated behaviors occur in such a financial system, and the influence of the adjustment of the macro_economic policies and adjustment of some parameter on the whole financial system behavior have been analyzed. This study will deepen people's understanding of the lever function of all kinds of financial policies.
文摘Based on the work discussed on the former study, this article first starts from the mathematical model of a kind of complicated financial system, and analyses all possible things that the model shows in the operation of our country's macro_financial system: balance, stable periodic, fractal, Hopf_bifurcation, the relationship between parameters and Hopf_bifurcation, and chaotic motion etc. By the changes of parameters of all economic meanings, the conditions on which the complicated behaviors occur in such a financial system, and the influence of the adjustment of the macro_economic policies and adjustment of some parameter on the whole financial system behavior have been analyzed. This study will deepen people's understanding of the lever function of all kinds of financial policies.
基金Supported by the Youth Science Fundation of Chinese Academia SinicaYouth Fundation of Lanzhou Unviersity
文摘This paper is a further study of reference [1]. In this paper, we mainly discuss the complicated dynamical behaviors resulting from a simple one-dimensional model of nonlinear ecosystems: fixed point motion, periodic motion and chaotic motion etc., and briefly discuss the universality of the complicated dynamical behaviors, which can be described by the first and the second M. Feigenbaun. constants. At last, we discuss the 'one-side lowering phenomenon' due to near unstabilization when the nonlinear ecosystem approaches bifurcation points from unbifurcation side. It is of important theoretical and practical meanings both in the development and utilization of ecological resources ar.d in the design and management of artifilial ecosystems.
文摘Aiming at the problem of reliability allocation for a complicated largesystem, a new thought is brought up. Reliability allocation should be a kind of decision-makingbehavior; therefore the more information is used when apportioning a reliability index, the morereasonable an allocation is obtained. Reliability allocation for a complicated large system consistsof two processes, the first one is a reliability information reporting process from bottom to top,and the other one is a reliability index apportioning process from top to bottom. By a typicalexample, we illustrate the concrete process of reliability allocation algorithms.
基金Supported by 2021 Disciplinary Construction Project in School of Dentistry,Anhui Medical University,No.2021kqxkFY05.
文摘BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and teenagers, but the maintenance of pulphealth and the calcific healing of multiple root fractures are rarely reported in theliterature.CASE SUMMARY This case reports healing of a permanent tooth with complicated crown–root andadditional root fractures, in which pulp health was maintained. A 10-year-old girlfell and fractured the root of her maxillary left central incisor at the cervical level.After the coronal fragment was repositioned, the tooth was splinted until thetooth was no longer mobile, 2 years later. Eight years after treatment, the toothhas remained asymptomatic with vital pulp and localized gingival overgrowth.Cone-beam computed tomography revealed not only calcified healing of the CRFbut also spontaneous healing in an additional undiagnosed root fracture. Thefracture line on the enamel could not be healed by hard tissue and formed agroove in the cervical crown. It was speculated that the groove was related to thelocalized gingival overgrowth.CONCLUSION This case provides a clinical perspective of the treatment of a tooth with acomplicated CRF and an additional root fracture.
文摘BACKGROUND Distribution of the colonic diverticula differs in different populations,and rightsided colon diverticulitis(RCD)and left-sided colon diverticulitis(LCD)manifest distinct clinical features.Complicated diverticulitis(CD)mostly requires hospitalization and can be treated within a spectrum from observation to surgery.Treatment choice is formed depending on the patient’s general condition,the presence of diffuse peritonitis,the localization of diverticulitis,Hinchey stage,and responsiveness to the prior treatment.Clinical disparities regarding right and LCD also led to the differences in the incidences of both emergency surgery and future elective surgery.AIM To evaluate the clinical features of CD,display the differences according to colonic localizations,and present treatment approaches.METHODS This was a retrospective study from a single centre analysing data from a prospective database.The 253 patients with history of hospitalization for CD were included and divided into two groups:RCD and LCD.To compare the differences between the two groups,the Student’s t-test was used when the parametric test prerequisites were fulfilled,and the Mann-Whitney U test was used when such requirements were not fulfilled.RESULTS The 208(82.2%)patients were found to have LCD,and 45(17.8%)had RCD.The majority of the patients had Hinchey 1A diverticulitis(49.8%).Male gender was significantly more common in patients who underwent surgery for LCD.While persistent abdominal pain was the main prior finding in the conservative treatment of both localizations,surgery was most performed due to abscess in RCD and perforation in LCD.The presence of an accompanying malignancy during colonoscopy was significantly more common in LCD cases who underwent surgery.Hartmann’s procedure was the most performed technique in emergency settings(56.3%),while laparoscopic colectomy with anastomosis was in elective settings(53.9%).In addition,surgery was found to prolong the mean length of hospital stay in LCD patients.CONCLUSION Although diverticulitis is a benign condition,the need for an individualized and evidence-based approach makes management challenging.Localization of the disease has an important role in determining the appropriate treatment.
文摘BACKGROUND Ventriculoperitoneal shunt(VPS)catheter insertion is one of the most widely accepted surgical procedures for hydrocephalus.Migration of the end of the distal VPS catheter into the scrotum is one of the rare complications of VPS catheter insertion.METHODS This is a systematic review of the published cases,and the literature search was performed from 1974 to June 30,2024,to retrieve the relevant manuscripts.The cases were grouped into two.Group A included cases of migration of the distal VPS catheter into the scrotum,detected in children.Group B included the cases of migration of the distal VPS catheter into the scrotum,which was detected in adults and older people.RESULTS One hundred-twenty cases of migration of the distal end of VPS catheter into the scrotum were included in this study,a systematic literature review.Group A included n=112 cases,and group B included n=8 cases only.Three-fourths of the cases involved the right scrotum.Bilateral involvement was rare.The indication for initial VPS insertion was congenital hydrocephalus in four-fifths of the group A cases.The majority were infants at the time of initial shunt insertion.Four-fifths of the group A cases were 24 months-old or younger at the time of clinical diagnosis and treatment was provided for migration of the distal VPS catheter into the scrotum.In children,the interval from VPS insertion or shunt revision if any,to the diagnosis of the complication mentioned above was 12 months or less in four-fifths of the cases.The repositioning of migrated distal VPS catheter into the peritoneal cavity and herniotomy was preferred for the surgical procedure,and it was performed for two-thirds of group A cases.CONCLUSION Migration of the distal part of the VPS catheter into the scrotum is a rare complication of cerebrospinal fluid diversion via VPS catheter insertion.It was most frequent in children,and the right side of the scrotum was most often involved.
文摘Background In recent years,the incidence of coronary heart disease(CHD)has continued to rise,and its comorbidity with hyperlipidemia significantly increases the mortality risk in patients.Statin monotherapy faces limitations in efficacy for some patients and raises potential safety concerns.Ezetimibe,as a novel lipid-modulating agent,exhibits potential advantages in the treatment of hyperlipidemia.Based on this,the present study investigated the therapeutic efficacy of ezetimibe in CHD patients with hyperlipidemia,as well as its effects on lipid metabolism and the amelioration of atherosclerosis.Methods In this study,150 clinical cases with CHD and hyperlipidemia admitted in our hospital from July 2022 to July 2024 were collected for retrospective analysis.According to different treatment methods,they were randomly divided into the Atorvastatin group(control group,n=75)and the Atorvastatin+Ezetimibe group(experimental group,n=75).Control group received atorvastatin monotherapy,while experimental group were administered additional ezetimibe as an adjunct to the atorvastatin-based treatment regimen.The clinical efficacy of the two treatment groups was analyzed,including cardiac function-related parameters such as the cardiac index(CI),cardiac output(CO),left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)before and after treatment.The observed indicators encompassed coronary angiography findings,the Gensini score for assessing coronary stenosis severity,the inflammatory marker high-sensitivity C-reactive protein(hs-CRP),and lipid profile parameters including total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C).Additionally,the occurrence of adverse reactions during treatment was monitored.Results After treatment,the total effective rate in experimental group was significantly higher than that in control group,with a statistically significant difference(P<0.05).In the comparison of the baseline data,both groups showed marked improvements in CI,CO,LVEF,and HDL-C.However,at the same time points,the experimental group demonstrated significantly better results in these parameters than control group(P<0.05).Additionally,LVEDD,LDL-C,hs-CRP and Gensini scores were significantly reduced after treatment in both groups compared to pretreatment levels.Moreover,at identical time points,the aforementioned parameters in the experimental group demonstrated significantly greater reductions compared to control group(P<0.05).Regarding safety assessment,comparative analysis of adverse drug reaction(ADR)incidence rates between the two treatment groups revealed no statistically significant difference(P>0.05).Conclusions In patients with CHD complicated by hyperlipidemia,ezetimibe demonstrates significant therapeutic advantages.It effectively enhances treatment efficacy,regulates lipid profiles,improves cardiac function,and mitigates the progression of atherosclerosis.This regimen exhibits a favorable safety profile and holds substantial clinical value for both therapeutic processes and rehabilitation outcomes in this patient population.
基金Beijing Municipal Administration of Hospitals Incubating Program,No.PZ20200272018 Beijing Talent Incubating Funding,No.2018-4+3 种基金National Natural Science Foundation of China,No.81773214Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support,No.ZYLX202116the National Key R&D Program of China,No.2021YFF1201104Science Foundation of Peking University Cancer Hospital-2023,No.JC202310.
文摘BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related complications in colorectal cancer patients who underwent stoma creation.METHODS Patients with stoma was prospectively recorded in the established stoma system.Data was collected from this stoma management system from November 2021 through May 2024.The rates of stoma-related complications were assessed,and potential risk factors were analyzed using univariate and multivariate logistic regression models.RESULTS A total of 734 patients were included in the analysis.The results showed that 12.3%of patients experienced stoma-related complications,with mucocutaneous separation,edema,and skin excoriation being the most common complications.The majority(90%)of complications were classified as grade 2 according to the Clavien-Dindo classification.Surgical factors,such as blood loss volume greater than 500 mL and open surgery,were significantly associated with stoma complications.Additionally,stoma features like location,shape,color,height,and edema were important factors in the association with complications.Body mass index over 30 kg/m²was also found to be a significant risk factor.CONCLUSION These findings highlight the need for a holistic approach to preventing and managing stoma complications,considering both patient-related and surgical factors.
基金funded by the Seed Funding of the Beijing University of Chinese Medicine(90011451310034).
文摘Objective:To evaluate the efficacy and safety of traditional Chinese exercises(TCE)in patients with diabetic peripheral neuropathy(DPN)and to recommend best practices for using TCE to improve neurological function,glycemic control,and psychological well-being.Methods:Nine databases were searched from the inception to October 2024.Effect relationships were assessed using meta-analysis with Stata 17,and the methodological quality and certainty of the evidence were evaluated using standard tools.Results:Twelve studies comprising three study designs(nine randomized controlled,one quasi-exper-imental controlled,and two single-arm clinical trials),were identified.Compared with usual care,TCE improved various indicators and enhanced the nerve conduction velocities of the peroneal motor(mean difference[MD]=3.86 m/s,95%confidence interval[CI]:0.38 to 7.34,P=0.03),sural sensory(MD=4.15 m/s,95%CI:0.68 to 7.63,P=0.02),median motor(MD=3.84 m/s,95%CI:2.14 to 5.54,P<.001),and median sensory nerves(MD=6.14 m/s,95%CI:4.54 to 7.74,P<.001).TCE practices also reduced glycosylated hemoglobin level(MD=-0.59%,95%CI:-0.91 to-0.27,P<.001)and fasting blood glucose(standardized mean difference[SMD]=-1.08,95%CI:-1.79 to-0.37,P<.001).The overall quality of evidence was very low.Conclusion:The results indicate that TCE therapy improves certain outcomes in patients with DPN.Although the optimal type,intensity,frequency,and duration of TCE interventions are uncertain,these preliminary findings suggest that TCE should be further studied as a potentially affordable and effective treatment for DPN.
文摘BACKGROUND Gastric and oesophageal cancers are among the leading causes of cancer-related mortality globally.Treatment in the form of surgical resection and neoadjuvant therapy is considered the gold standard;however,these procedures are associated with significant postoperative morbidity and prolonged recovery times.Prehabilitation aims to combat this by physically and psychologically optimising patients preoperatively to handle the stress of surgery and improve postoperative outcomes.AIM To evaluate the effectiveness of prehabilitation in patients undergoing gastric or oesophageal cancer resections.METHODS Standard medical databases such as MEDLINE,EMBASE,PubMed,and Cochrane Library were searched to find randomised,controlled trials comparing prehabilitation vs no-prehabilitation in patients undergoing gastric or oesophageal cancer resections.All data were analysed using Review Manager Software 5.4,and the meta-analysis was performed with a random-effect model analysis.RESULTS A total of 16 studies were included(n=1479),recruiting adult patients undergoing gastric or oesophageal cancer resections.In the random effect model analysis,prehabilitation was associated with fewer postoperative complications compared to no prehabilitation(Odds ratio:0.43,95%CI:0.31-0.58,Z=25.28,P<0.00001).Additionally,prehabilitation was associated with a lower postoperative readmission rate(risk ratio:0.58,95%CI:0.35-0.96,Z=2.10,P=0.04)and a shorter length of stay[standardised mean difference(SMD):-0.19,95%CI:-0.37 to-0.02,Z=2.21,P=0.03]compared to no-prehabilitation.Prehabilitation was also found to improve preoperative 6-minute walking distance(6-MWD)compared to no-prehabilitation(SMD:0.72,95%CI:0.21-1.23,Z=2.75,P=0.006).No statistical difference was found in postoperative 6-MWD,mortality,and severe complications.CONCLUSION Prehabilitation was found to be effective in reducing postoperative morbidity and improving preoperative physical health in patients undergoing gastric or oesophageal cancer resections.
文摘BACKGROUND Colon cancer is one of the most common malignancies of the digestive tract,often complicated by intestinal obstruction,which can significantly impact patient outcomes.While traditional laparotomy is the standard treatment,it is associated with large wounds,slower recovery,and higher complication rates.Laparoscopic surgery,a minimally invasive approach,may offer better outcomes for these patients.AIM To evaluate the clinical effects and prognosis of laparoscopic surgery in patients with colon cancer complicated by intestinal obstruction compared to traditional laparotomy.METHODS A retrospective analysis was conducted on 100 patients diagnosed with colon cancer and intestinal obstruction who underwent surgical treatment between January 2020 and December 2022.Patients were divided into two groups:The control group(CG),treated with traditional laparotomy,and the observation group(OG),treated with laparoscopic surgery.Clinical effects,surgical indicators,postoperative pain,inflammatory response,complication rates,quality of life,and prognosis were assessed and compared between the two groups.RESULTS The OG showed superior clinical outcomes compared to the CG(P<0.05).Patients in the OG had shorter operation times,reduced intraoperative blood loss,faster recovery of intestinal function,earlier mobilization,and shorter hospital stays(P<0.05).Postoperative pain(numerical rating scale scores)and inflam-matory markers[tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]were lower in the OG(P<0.05).The incidence of complic-ations was significantly reduced in the OG(6.00%vs 22.00%,P<0.05).Quality of life scores,including physical function,psychological state,social communication,and self-care ability,were significantly higher in the OG(P<0.05).There were no significant differences between groups in abdominal drainage volume,1-year tumor recurrence or metastasis rates,or 1-and 3-year survival rates(P>0.05).CONCLUSION The OG showed superior clinical outcomes compared to the CG(P<0.05).Patients in the OG had shorter operation times,reduced intraoperative blood loss,faster recovery of intestinal function,earlier mobilization,and shorter hospital stays(P<0.05).Postoperative pain(NRS scores)and inflammatory markers(TNF-α,IL-6,CRP)were lower in the OG(P<0.05).The incidence of complications was significantly reduced in the OG(6.00%vs 22.00%,P<0.05).Quality of life scores,including physical function,psychological state,social communication,and self-care ability,were significantly higher in the OG(P<0.05).There were no significant differences between groups in abdominal drainage volume,1-year tumor recurrence or metastasis rates,or 1-and 3-year survival rates(P>0.05).
文摘BACKGROUND Hepatobiliary and pancreatic cancers are often associated with high morbidity and mortality.Surgical intervention remains the cornerstone for curative treatment.However,Due to the complexity of these procedures,patients often experience postoperative complications.Prehabilitation has been suggested as a tool to decrease postoperative morbidity and improve recovery by optimising patients preoperatively to handle the stress of surgery.AIM To evaluate the effectiveness of prehabilitation in patients undergoing hepatobiliary and pancreatic cancer resections.METHODS Standard medical databases such as MEDLINE,EMBASE,PubMed,and Cochrane Library were searched to find randomised,controlled trials comparing prehabilitation vs no-prehabilitation before hepatic,biliary,or pancreatic cancer resections.All data were analysed using Review Manager Software 5.4,and the metaanalysis was performed with a random-effect model analysis.RESULTS A total of 8 studies were included(n=568),recruiting adult patients undergoing hepatic,biliary,or pancreatic cancer resections.In the random effect model analysis,prehabilitation was associated with fewer postoperative complications compared to no prehabilitation[risk ratio(RR):0.79,95%CI:0.66-0.95,Z=2.52,P=0.01].No statistically significant difference was found in postoperative readmission rate(RR:1.31,95%CI:0.79-2.17,Z=1.05,P=0.29),major complications(RR:1.08;95%CI:0.61-1.92,Z=0.28,P=0.78),length of stay(standardised mean difference:-0.11,95%CI:-0.31 to 0.1,Z=1.05,P=0.29),or mortality(RR:0.28,95%CI:0.01-6.51,Z=0.79,P=0.43).CONCLUSION Prehabilitation was found to be effective in reducing postoperative complications following surgical intervention for hepatobiliary or pancreatic cancer.
文摘BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a highly effective treat-ment for complications associated with portal hypertension.However,stent fracture,although extremely rare,represents a potentially serious complication following TIPS creation.Timely identification and management are crucial for preventing further adverse events.CASE SUMMARY We report a 56-year-old male patient who underwent a TIPS procedure for re-current melena caused by portal hypertension secondary to hepatitis B and experienced a stent fracture 15 months post-procedure.He was readmitted 30 months after the initial TIPS due to recurrent esophagogastric variceal bleeding and ascites.An attempt to revise the dysfunctional shunt via a stent-in-stent approach was unsuccessful.Consequently,a parallel TIPS procedure was success-fully performed via the proximal end of the fractured stent to decompress the portal venous system.At the 1-month follow-up,the patient exhibited no recur-rent variceal bleeding,and his ascites had significantly decreased.Twelve-month postoperative monitoring revealed no hepatic encephalopathy and no recurrence of bleeding or ascites.Additionally,we review the existing literature on post-TIPS stent fractures to explore the underlying mechanisms contributing to this com-plication.CONCLUSION Early recognition and prompt intervention are essential in managing stent fractures after TIPS creation to mitigate potential risks and ensure optimal patient outcomes.
文摘Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities.Patients often experience a range of complications,including cardiovascular,renal,hematological,and metabolic abnormalities,which can significantly affect treatment outcomes and quality of life.This article emphasizes the integration of multidisciplinary strategies and artificial intelligence-driven diagnostics,which have the potential to improve patient outcomes by optimizing early detection and targeted management of these complications.A recent study on 60 liver cancer patients undergoing interventional therapy highlighted the importance of recognizing and managing these complications.This article offers an overview of systemic complications in liver cancer,focusing on pathophysiological mechanisms,risk factors,and strategies to improve care.By addressing gaps in the existing literature and proposing future research directions,it underscores the importance of comprehensive,patient-centered approaches to refine therapeutic strategies.
文摘BACKGROUND Urolithiasisposes challenges in patients with chronic kidney disease(CKD),necessitating careful consideration of surgical interventions due to potential complications.AIM To assess the safety,feasibility,and efficacy of surgical interventions for urolithiasis in CKD patients.METHODS Systematic review adhering to PRISMA guidelines.Comprehensive searches of PubMed,Scopus,Cochrane Library,Web of Science,and Embase were conducted for studies published from January 2014 to June 2024.Studies involving adult patients(≥18 years)with CKD undergoing surgical interventions for urolithiasis,including randomized controlled trials,cohort studies,case-control studies,and observational studies.Studies involving pediatric patients,those not specifically addressing CKD patients,review articles,commentaries,and editorials.Despite an extensive search,only six studies met the strict inclusion criteria,reflecting the limited available data on this topic.This limitation has been acknowledged and discussed.RESULTS A total of 6 studies met the inclusion criteria,encompassing a diverse range of surgical interventions such as percutaneous nephrolithotomy(PCNL),ureteroscopy(URS),and extracorporeal shock wave lithotripsy(ESWL).Perioperative and postoperative complications varied across studies,with bleeding,infection,and acute kidney injury being the most common.The risk of complications was higher in patients with advanced CKD.Technical success rates were generally high,but feasibility was influenced by patientspecific factors such as CKD stage and comorbidities.Modifications to standard surgical techniques were often necessary.Stone-free rates and recurrence rates varied,with PCNL generally achieving higher stone-free rates compared to URS and ESWL.Long-term outcomes on renal function were inconsistent,highlighting the need for individualized treatment plans.CONCLUSION Surgical interventions for urolithiasis in CKD patients are associated with significant risks but can be effective in achieving stone clearance and symptom relief.The safety,feasibility,and efficacy of these interventions depend on patient-specific factors,necessitating a tailored approach.Further high-quality studies are needed to develop standardized guidelines and improve clinical outcomes in this complex patient population.
基金Supported by National Natural Science Foundation of China,No.81960105Medical Research Union Fund for High-quality Health Development of Guizhou Province,No.2024GZYXKYJJXM0155.
文摘BACKGROUND Colorectal cancer(CRC)is a common malignant tumor of the digestive system that poses a serious threat to human health.During the perioperative period,patients with CRC are prone to nutritional risks and malnutrition.Compared with traditional nutritional support,immunostimulatory nutrients,including glutamine(Gln),have attracted increasing attention.Although many previous studies have reported that perioperative Gln supplementation can improve short-term clinical outcomes in patients with CRC,some studies have not demonstrated a benefit.Resolution of Gln supplementation value thus requires further exploration.AIM To clarify the influence of perioperative Gln-enhanced nutritional support on postoperative outcomes including nutritional status,immune function,inflammation levels,morbidity due to complications,and length of hospital stay(LOS).METHODS A comprehensive literature search was conducted(inception to June 2025).PubMed,EMBASE,Web of Science,Cochrane Library,China Biomedical Database,CNKI,VIP,and the Wanfang Electronic Database were searched.This meta-analysis ultimately included 27 studies with a total of 1643 patients;827 patients received perioperative Gln treatment and 816 received conventional nutritional therapy.A random-effects model was used to pool relative risks(RR)and mean differences(MD)with 95%confidence intervals(CI).RESULTS Pooled analysis showed that Gln intervention reduced morbidity associated with postoperative infectious complications(RR=0.36;95%CI:0.24-0.54)and non-infectious complications(RR=0.32;95%CI:0.19-0.55)and shortened the LOS by 2.31 days(MD=-2.31;95%CI:-3.21 to-1.41)in CRC patients.Gln supplementation also increased serum albumin,prealbumin,peripheral blood lymphocyte count,and nitrogen balance levels and improved humoral and cellular immune function.We also found that postoperative tumor necrosis factor-αand C-reactive protein levels were lower in Gln-supplemented patients.By contrast,Gln supplementation did not improve CD8+and CD4+/CD8+levels.CONCLUSION Gln supplementation effectively improved short-term clinical outcomes in patients with CRC.
基金funded by grants from the National Key Research and Development Program of China(2022YFD1801900)National Natural Science Foundation of China(32272976&32302848)+3 种基金Sichuan Provincial Department of Science and Technology international scientific and technological innovation cooperation(2022YFH0026)the earmarked fund for China Agricultural Research System(CARS-42-17)Program Sichuan Veterinary Medicine and Drug Innovation Group of China Agricultural Research System(SCCXTD-2021-18)the Innovation and Demonstration of Industry and Education Integration in Feed Industrial Chain Transformation and Upgradation,Sichuan Province,China.
文摘Dear Editor,For the past few decades,mosquito-borne orthoflaviviruses,such as dengue virus,Zika virus,and West Nile virus(WNV),have posed significant threats to global public health.The Orthoflavivirus genus comprises more than 70 viruses,many of which are responsible for a wide range of diseases in humans and animals,including febrile illnesses,encephalitis,and hemorrhagic febrile illness.These viruses are associated with approximately 400 million infections and 100 million symptomatic cases worldwide each year(Van Leur et al.,2021).Among them,Usutu virus(USUV)is an emerging pathogen classified alongside WNV within the Japanese encephalitis virus(JEV)serogroup of the Orthoflavivirus genus,the Flaviviridae family.USUV has spread from Africa to Europe since the late 20th century.It primarily causes central nervous system disorders in birds,with several large-scale mortality events recorded in Europe.USUV can also infect humans,it typically leads to neurological complications in rare cases(Roesch et al.,2019).
