Background:Lenvatinib is primarily utilized for the treatment of inoperable or advanced hepatocellular carcinoma,radioiodine-refractory differentiated thyroid cancer,and advanced renal cell carcinoma.Primary informati...Background:Lenvatinib is primarily utilized for the treatment of inoperable or advanced hepatocellular carcinoma,radioiodine-refractory differentiated thyroid cancer,and advanced renal cell carcinoma.Primary information about adverse reactions is principally derived from clinical trials;however,there is a notable dearth of substantial real-world studies.Methods:In this research,an examination of the U.S.Food and Drug Administration(FDA)Adverse Event Reporting System(FAERS)database was performed to evaluate the potential side effects of lenvatinib.The FAERS database revealed a total of 20,290 reported adverse events associated with lenvatinib.Different algorithms for repeated measure analysis were employed to ascertain the significance of these adverse reactions.Results:The study identified 170 instances of adverse events(AEs)induced by lenvatinib,incorporating several significant adverse reactions that the product label does not mention.The investigation also evaluated the onset periods of the adverse reactions,pinpointing a median time of 43 days.The majority of adverse reactions manifested within the initial month of lenvatinib use.Sex-specific analysis revealed disparities in high risk adverse reactions between females(vascular and lymphatic diseases,and neuronal organ diseases)and males(death and infectious diseases).Our data mining has unveiled adverse reactions beyond those mentioned within the instructions,such as osteonecrosis of the jaw,cholecystitis,cholangitis,dehydration,tumor lysis syndrome,type 1 diabetes,hyperammonemia,liver abscess,interstitial lung disease,pneumothorax,sudden death,and aortic dissection.Conclusion:The insights derived from these findings contribute significant nuances for optimizing lenvatinib use,enhancing its efficacy,and substantially mitigating potential side effects.These data elements will substantially enhance the implementation of the drug in a clinical environment.展开更多
BACKGROUND:Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well.We analyzed the database of the critical incident reporting system for prehosp...BACKGROUND:Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well.We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors.METHODS:Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure,non-verbal communication failure and missing communication at all.RESULTS:Between 2005 and 2015,845 reports were analyzed,of which 247 reports were considered to be related to communication failure.An arbitrary classifi cation resulted in six different kinds:1)no acknowledgement of a suggestion;2)medication error;3)miscommunication with dispatcher;4)utterance heard/understood improperly;5)missing information transfer between two persons;and 6)other communication failure.CONCLUSION:Communication defi cits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety.展开更多
The purpose of this paper is to deliver a better perception of the project success,and how reporting system might increase the probability of project success in construction projects in UAE.Further,it aims at explorin...The purpose of this paper is to deliver a better perception of the project success,and how reporting system might increase the probability of project success in construction projects in UAE.Further,it aims at exploring the relationship between effective reporting system in terms of the characteristic of its outputs(mainly effectiveness of financial reporting system)and project success.Semi-structured interviews with a number of interior auditors,accountants,and chief financial officers(CFOs)from different corporations in construction sector in UAE in order to recognize how effective reporting system in terms of the characteristic of its outputs(broad scope,timeliness,aggregation,and integration)might contribute to increase the probability of project success.There are several success factors in construction projects in UAE,thus it is very hard to capture all these factors in one paper.Hence,this paper is not considering all project success factors rather it focuses on the characteristic of outputs of the reporting system generally and the financial reporting system particularly(broad scope,timeliness,aggregation,and integration),as most of the studies in the literature considered the reporting system as a key factor of project success.This paper adds to both project management and accounting research by evidencing results from an exploration how effective reporting might impact the project success,with valuable implications for standard officials,customers,investors,stakeholders,sponsors,shareholders,CFOs,project developer,consultants,internal auditors,and accounting academics.The effective reporting system in United Arab Emirates(UAE)construction projects enables possessors,customers,and contractors of projects to get timely information about the progress of project in a brief and significant format which in turn improve the decision-making process and contribute to project success.This paper implies a contribution for both project management literature and accounting research by investigative the effectiveness of reporting system in project successes from historical point of view and contemporary point of view.展开更多
Coronary artery calcium data and reporting system(CAC-DRS)is a recently introduced standardized reporting system for calcium scoring on computed tomography.CAC-DRS provides four risk categories(0,1,2 and 3)along with ...Coronary artery calcium data and reporting system(CAC-DRS)is a recently introduced standardized reporting system for calcium scoring on computed tomography.CAC-DRS provides four risk categories(0,1,2 and 3)along with treatment recommendations for each category.As with any other new reporting platform,CAC-DRS has both advantages and disadvantages.Improved communication,better clarity of details,organized management recommendations and utility in future research and education are the major strengths of CAC-DRS.It has many limitations such as questionable need for a new system,few missing components,use of a less accurate visual method and treatment suggestions based on expert opinion instead of clinical trials.In this contemporary review,we discuss the new reporting system CAC-DRS,its application,strengths and limitations and conclude with some remarks for the future.展开更多
The purpose of this paper is to propose an innovation system of managerial accounting reports, which is actually on the basis of accounting objectives. On the one hand, as managerial accounting is one important branch...The purpose of this paper is to propose an innovation system of managerial accounting reports, which is actually on the basis of accounting objectives. On the one hand, as managerial accounting is one important branch of accounting(the other important branch is financial accounting), some of its characters should be closely connected with accounting. On the other hand, managers need managerial accounting information for enterprise operation(especially for internal management control) decisions, so, managerial accounting should also be in accordance with the enterprise's operation and its management control. Therefore, combined with the existed research of accounting(especially financial accounting research) and for the development requirement of Chinese enterprises, this paper will mainly discuss the relation between accounting objectives and managerial accounting's system and put forward an idea of constructing an applicable reporting system of managerial accounting based on the operation mode in Chinese modern enterprises. This study will develop the accounting reports research(including external reports and internal reports) both in the field of theory and that of practice.展开更多
AIM: To present a simple colonoscopy reporting system that can be checked easily the detection rate of colon polyps.METHODS: A simple colonoscopy reporting system Kosin Gastroenterology(KG quality reporting system) wa...AIM: To present a simple colonoscopy reporting system that can be checked easily the detection rate of colon polyps.METHODS: A simple colonoscopy reporting system Kosin Gastroenterology(KG quality reporting system) was developed. The polyp detection rate(PDR),adenoma detection rate(ADR),serrated polyp detection rate(SDR),and advanced adenoma detection rate(AADR) are easily calculated to use this system.RESULTS: In our gastroenterology center,the PDR,ADR,SDR,and AADR test results from each gastroenterologist were updated,every month. Between June 2014,when the program was started,and December 2014,the overall PDR and ADR in our center were 62.5% and 41.4%,respectively. And the overall SDR and AADR were 7.5% and 12.1%,respectively.CONCLUSION: We envision that KG quality reporting system can be applied to develop a comprehensive system to check colon polyp detection rates in other gastroenterology centers.展开更多
Spontaneous reporting system(SRS) is an important way to monitor the adverse drug reaction(ADR) and discover the ADR signal for marketed drugs. It can detect adverse reaction signals timely and effectively, and preven...Spontaneous reporting system(SRS) is an important way to monitor the adverse drug reaction(ADR) and discover the ADR signal for marketed drugs. It can detect adverse reaction signals timely and effectively, and prevent the occurrence of drug damage. Runzao Zhiyang Capsule is mainly composed of Radix Polygoni Multiflor, Radix Polygoni Multiflori Preparata, Radix Rehmanniae Recens, Radix Sophorae Flavescentis, Folium Mori and Urtica dentata Hand.-Mazz. It has the functions of nourishing blood, nourishing yin, expelling wind to relieve itching and moistening the intestines to relieve constipation. It is mainly used for skin itching, acne, constipation and other diseases caused by blood deficiency and wind dryness. The large, national SRS database of ADRs needs effective evaluation methods. We reported on the use of Bayesian confidence propagation neural network method(BCPNN) and reporting rate ratio method(PRR) with propensity score to control confounding variables. The tendency score method was used to control the hybrid bias produced by SRS data analysis. After the calculation of PRR and BCPNN, the score of "diarrhea", "rash" and "gastric dysfunction" showed that there was an early warning before and after matching. To sum up, it indicated that diarrhea, rash and gastric dysfunction were early warning signs.展开更多
Objective This study aimed to assess the local staging of bladder tumors in patients utilizing preoperative multiparametric MRI(mpMRI)and to demonstrate the clinical efficacy of this method through a comparative analy...Objective This study aimed to assess the local staging of bladder tumors in patients utilizing preoperative multiparametric MRI(mpMRI)and to demonstrate the clinical efficacy of this method through a comparative analysis with corresponding histopathological findings.Methods Between November 2020 and April 2022,63 patients with a planned cystoscopy and a preliminary or previous diagnosis of bladder tumor were included.All participants underwent mpMRI,and Vesical Imaging Reporting and Data System(VI-RADS)criteria were applied to assess the recorded images.Subsequently,obtained biopsies were histopathologically examined and compared with radiological findings.Results Of the 63 participants,60 were male,and three were female.Categorizing tumors with a VI-RADS score of>3 as muscle invasive,84%were radiologically classified as having an invasive bladder tumor.However,histopathological results indicated invasive bladder tumors in 52%of cases.Sensitivity of the VI-RADS score was 100%;specificity was 23%;the negative predictive value was 100%;and the positive predictive value was 62%.Conclusion The scoring system obtained through mpMRI,VI-RADS,proves to be a successful method,particularly in determining the absence of muscle invasion in bladder cancer.Its efficacy in detecting muscle invasion in bladder tumors could be further enhanced with additional studies,suggesting potential for increased diagnostic efficiency through ongoing research.The VI-RADS could enhance the selection of patients eligible for accurate diagnosis and treatment.展开更多
Our study describes the reported rate of the Institutional Review Board(IRB)approval,declaration of Helsinki(DoH),and informed consent in the case reports and case series and investigates factors associated with the e...Our study describes the reported rate of the Institutional Review Board(IRB)approval,declaration of Helsinki(DoH),and informed consent in the case reports and case series and investigates factors associated with the ethical approval report.We searched PubMed for case reports and case series from 2006 to 2017.Annually,we obtained the first 20 articles of a case report cluster from 20 distinct publications.This analysis initially contained at least 2400 papers,with 100 papers each study design and year.Only 26(5.4%)of 480 included studies reported IRB approval,DoH approval,and participant informed consent;58(12.1%)reported two out of three ethical statements(DoH,informed consent,IRB);and 151(31.5%)reported only one,leading to nearly 245 studies(51.0%)did not report any ethical approval item.Both clusters mentioned the DoH the least.Only years,ages,ethical item types,and cluster types were associated with ethical reporting practices.This study found the serious under‐reporting of ethical practices in both case reports and case series.展开更多
BACKGROUND Collision tumor are neoplasms,including two histologically distinct tumors that coexist in the same mass without histological admixture.The incidence of collision tumor is low and is rare clinically.AIM To ...BACKGROUND Collision tumor are neoplasms,including two histologically distinct tumors that coexist in the same mass without histological admixture.The incidence of collision tumor is low and is rare clinically.AIM To investigate ultrasound images and application of ovarian-adnexal reporting and data system(O-RADS)to evaluate the risk and pathological characteristics of ovarian collision tumor.METHODS This study retrospectively analyzed 17 cases of ovarian collision tumor diagnosed pathologically from January 2020 to December 2023.All clinical features,ultrasound images and histopathological features were collected and analyzed.The O-RADS score was used for classification.The O-RADS score was determined by two senior doctors in the gynecological ultrasound group.Lesions with O-RADS score of 1-3 were classified as benign tumors,and lesions with O-RADS score of 4 or 5 were classified as malignant tumors.RESULTS There were 17 collision tumors detected in 16 of 6274 patients who underwent gynecological surgery.The average age of 17 women with ovarian collision tumor was 36.7 years(range 20-68 years),in whom,one occurred bilaterally and the rest occurred unilaterally.The average tumor diameter was 10 cm,of which three were 2-5 cm,11 were 5-10 cm,and three were>10 cm.Five(29.4%)tumors with O-RADS score 3 were endometriotic cysts with fibroma/serous cystadenoma,and unilocular or multilocular cysts contained a small number of parenchymal components.Eleven(64.7%)tumors had an O-RADS score of 4,including two in category 4A,six in category 4B,and three in category 4C;all of which were multilocular cystic tumors with solid components or multiple papillary components.One(5.9%)tumor had an O-RADS score of 5.This case was a solid mass,and a small amount of pelvic effusion was detected under ultrasound.The pathology was high-grade serous cystic cancer combined with cystic mature teratoma.There were nine(52.9%)tumors with elevated serum carbohydrate antigen(CA)125 and two(11.8%)with elevated serum CA19-9.Histological and pathological results showed that epithelial-cell-derived tumors combined with other tumors were the most common,which was different from previous results.CONCLUSION The ultrasound images of ovarian collision tumor have certain specificity,but diagnosis by preoperative ultrasound is difficult.The combination of epithelial and mesenchymal cell tumors is one of the most common types of ovarian collision tumor.The O-RADS score of ovarian collision tumor is mostly≥4,which can sensitively detect malignant tumors.展开更多
BACKGROUND Thrombophilia contributes to a significant increased risk of venous thromboembolism and can be either inherited or acquired.Hereditary thrombophilia may arise from various gene mutations,some of which have ...BACKGROUND Thrombophilia contributes to a significant increased risk of venous thromboembolism and can be either inherited or acquired.Hereditary thrombophilia may arise from various gene mutations,some of which have not even been adequately reported or poorly understood.Previous studies reported a rare and novel missense mutation in the prothrombin gene(p.Arg596Gln),known as prothrombin Belgrade.The mechanisms and therapeutic strategies associated with prothrombin Belgrade mutation have not been fully elucidated.CASE SUMMARY We present the case of a 26-year-old woman with recurrent systemic thrombosis induced by prothrombin Belgrade mutation.The patient suffered from cerebral venous sinus thrombosis that rapidly progressed to systemic thrombosis,alongside a family history of cerebral thrombosis,and no traditional risk factors or abnormal coagulation function.Whole-genome sequencing detected a novel and rare heterozygous prothrombin missense mutation,c.1787G>T(p.Arg596Gln),which was responsible for the major etiology of the systemic thrombosis.CONCLUSION This case strengthens our understanding about hereditary basis of thrombophilia and provokes considerations for therapeutic options on prothrombin Belgrade mutation.展开更多
OBJECTIVE:In recent years,the number of clinical research reports on acupuncture and manipulation for the treatment of greater occipital neuralgia has gradually increased,but the quality is uneven.There is currently n...OBJECTIVE:In recent years,the number of clinical research reports on acupuncture and manipulation for the treatment of greater occipital neuralgia has gradually increased,but the quality is uneven.There is currently no literature evaluating the quality of published reports,which is not conducive to the promotion of clinical use of these therapies.Therefore,this article assessed the reporting quality of randomized controlled trials on acupuncture and manipulation for greater occipital neuralgia.METHODS:Cochrane Library,PubMed,Web of Science,Embase,China National Knowledge Infrastructure(CNKI),VIP,WanFang Data,and Chinese BioMedical Literature Database(CBM)from inception to May 20,2024 were searched.The reporting quality of included randomized controlled trials was independently evaluated by two investigators using the CONSORT statement,STRICTA checklist,and Cochrane bias of risk assessment tool.A third investigator resolved any disagreement.RESULTS:A total of 62 articles were included.Based on the CONSORT statement,59.46%(22/37)of all entries had a reporting rate of less than 50%,mainly including“Identification as a randomized trial in the title(1/62,1.61%),”“How sample size was determined(7/62,11.29%),”“Implementation(1/62,1.61%),”“Blinding(1/62,1.61%),”and“Reports of Funding(4/62,6.45%).”According to the STRICTA checklist,29.41%(5/17)of all entries had a reporting rate of less than 50%,mainly including“Details of other interventions(7/58,12.07%),”“Setting and context of treatment(0/58,0%),”and“Description of participating acupuncturists(0/58,0%).”CONCLUSION:The reporting quality of randomized controlled trials on acupuncture and manipulation therapy for greater occipital neuralgia remains low.Future researchers need to make greater efforts to strictly adhere to the CONSORT statement and STRICTA checklist during trial design,implementation,and reporting.This will facilitate the standardization of research in this field and enhance the reliability and reproducibility of the research results.展开更多
BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time ...BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time between injury and isolated meniscus repair on patient outcomes is not well described.Assessing this relationship is important as it may influence clinical decision-making and can add to the preoperative patient education process.We hypothesized that increasing the time from injury to meniscus surgery would worsen postoperative outcomes.AIM To investigate the current literature for data on the relationship between time between meniscus injury and repair on patient outcomes.METHODS PubMed,Academic Search Complete,MEDLINE,CINAHL,and SPORTDiscus were searched for studies published between January 1,1995 and July 13,2023 on isolated meniscus repair.Exclusion criteria included concomitant ligament surgery,incomplete outcomes or time to surgery data,and meniscectomies.Patient demographics,time to injury,and postoperative outcomes from each study were abstracted and analyzed.RESULTS Five studies met all inclusion and exclusion criteria.There were 204(121 male,83 female)patients included.Three of five(60%)studies determined that time between injury and surgery was not statistically significant for postoperative Lysholm scores(P=0.62),Tegner scores(P=0.46),failure rate(P=0.45,P=0.86),and International Knee Documentation Committee scores(P=0.65).Two of five(40%)studies found a statistically significant increase in Lysholm scores with shorter time to surgery(P=0.03)and a statistically significant association between progression of medial meniscus extrusion ratio(P=0.01)and increasing time to surgery.CONCLUSION Our results do not support the hypothesis that increased time from injury to isolated meniscus surgery worsens postoperative outcomes.Decision-making primarily based on injury interval is thus not recommended.展开更多
Sham acupuncture,as a control intervention in acupuncture studies,has been widely conducted to eval-uate the specific effect of acupuncture.However,there was no relevant particular reporting guideline,so the reporting...Sham acupuncture,as a control intervention in acupuncture studies,has been widely conducted to eval-uate the specific effect of acupuncture.However,there was no relevant particular reporting guideline,so the reporting quality of sham acupuncture was low,which could hinder the precise understanding and interpretation of details and implementation background of sham acupuncture by researchers.In order to standardize the reporting of sham acupuncture and improve its quality,SHam Acupuncture REporting guidelines and a checklist in clinical trials(SHARE)was developed by a research team from Beijing Univer-sity of Chinese Medicine.The SAHRE standardizes the reporting of sham acupuncture from 10 categories,including brief name,rationales,details of sham acupuncture,treatment regimen of sham acupuncture,the information informed or explained to patients,practitioner information,modifications of protocol,communication between practitioner and patient,practitioner adherence and blinding.This article elab-orates the development process and key content of SHARE in order to facilitate its application by re-searchers.展开更多
Objectives:This study aimed to investigate the dual mediating roles of psychological safety and reporting attitudes in the association between ethics-centered leadership and internal whistleblowing among nurses.Method...Objectives:This study aimed to investigate the dual mediating roles of psychological safety and reporting attitudes in the association between ethics-centered leadership and internal whistleblowing among nurses.Methods:A multicenter,cross-sectional study design was employed,involving a convenience sample of 273 nurses among five university hospitals from August to October 2024.Data were collected using a demographic questionnaire,Ethical Leadership Scale,Psychological Safety Scale,Positive Attitudes Toward Whistleblowing Scale,and Internal Whistleblowing Scale.Pearson correlation and structural equation model were conducted to test the hypothesized dual mediation model.Results:The average score of nurses for ethical leadership was 4.14±0.57,psychological safety was 3.80±0.64,reporting attitudes was 4.12±0.67,internal whistleblowing was 3.93±0.52.Ethical leadership had a significant effect on psychological safety(β=0.38,P<0.001),reporting attitudes(β=0.44,P<0.001),and internal whistleblowing(β=0.21,P=0.009).Furthermore,psychological safety(β=0.26,P<0.001)and reporting attitudes(β=0.27,P<0.001)significantly influenced internal whistleblowing among the nurses.The indirect effect of ethics-centered leadership on internal whistleblowing intermediated by psychological safety was significant(β=0.10,P<0.001).Similarly,reporting attitudes demonstrated a significant mediating effect(β=0.12,P=0.003).Conclusions:Ethical leadership encourages internal whistleblowing among nurses by fostering psychological safety and positive reporting attitudes.Therefore,healthcare managers should prioritize ethical leadership development,enhance psychological safety,and foster constructive reporting attitudes that enable nurses to report ethical violations confidently,without apprehension.展开更多
BACKGROUND Colonic diverticular bleeding is a significant cause of acute overt lower gastrointestinal hemorrhage.Colonoscopy is commonly performed in patients with colonic diverticular bleeding to identify and treat t...BACKGROUND Colonic diverticular bleeding is a significant cause of acute overt lower gastrointestinal hemorrhage.Colonoscopy is commonly performed in patients with colonic diverticular bleeding to identify and treat the source of bleeding,which is crucial for effective management.CASE SUMMARY We present the case of a 70-year-old male with acute painless hematochezia.Colonoscopy showed active bleeding originating from a diverticulum,and the EyeMax direct visualization system was used in the treatment of the colonic diverticular bleeding.No further evidence of bleeding was observed at the end of the procedure.The patient was discharged from hospital on the seventh day.CONCLUSION The EyeMax system proved advantageous in localizing the bleeding diverticulum,thereby facilitating successful hemostatic measures.展开更多
BACKGROUND Systemic lupus erythematosus(SLE)can affect multiple organs or systems.The involvement of the central nervous system can result in the manifestation of epilepsy,an acute confusional state,and other rare neu...BACKGROUND Systemic lupus erythematosus(SLE)can affect multiple organs or systems.The involvement of the central nervous system can result in the manifestation of epilepsy,an acute confusional state,and other rare neuropsychiatric presentations,such as catatonia.CASE SUMMARY We present a case of an adolescent male patient with first-onset SLE who presented with neuropsychiatric symptoms including epilepsy and delirium.The initial utilization of olanzapine to alleviate symptoms of agitation precipitated the emergence of catatonia,which was mitigated by discontinuing olanzapine and supplementing with lorazepam.In this case,whether the catatonia was secondary to the utilization of antipsychotics or to an organic disease is a question that warrants differential diagnosis.CONCLUSION Multidisciplinary collaborative management is the cornerstone for the successful management of severe cases of SLE.展开更多
BACKGROUND Recently,there has been a significant increase in the consumption of ultraprocessed foods worldwide.However,the association between the consumption of ultra-processed food,obesity,and the prevalence of colo...BACKGROUND Recently,there has been a significant increase in the consumption of ultraprocessed foods worldwide.However,the association between the consumption of ultra-processed food,obesity,and the prevalence of colon cancer remains controversial.AIM To find out the association between the consumption of ultra-processed food,obesity,and the prevalence of colon cancer.METHODS A comprehensive systematic literature search of PubMed,Scopus,Web of Science,and Google Scholar for grey literature was done for articles published before 8th March 2023.The search was done to retrieve potential peer-reviewed articles that explored the association between the consumption of ultra-processed food,obesity,and the prevalence of colon cancer.RESULTS Of the 246 potential articles assessed,17 met the inclusion criteria.Meta-analysis results demonstrated that high consumption of ultra-processed food is associated with an increased risk of obesity[odds ratio(OR):1.65;95%CI:1.07-2.45;P<0.05].Consequently,there is a positive association between obesity and an increased risk of colon cancer(OR 1.48;95%CI:0.77-2.87;P>0.05).CONCLUSION Consuming ultra-processed foods increases the risk of obesity and colon 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
BACKGROUND Liver cirrhosis patients can develop various complications including bacteremia as the intestinal flora is heterologous.In those with low immunity,trauma,or following surgery,etc.,the body is susceptible to...BACKGROUND Liver cirrhosis patients can develop various complications including bacteremia as the intestinal flora is heterologous.In those with low immunity,trauma,or following surgery,etc.,the body is susceptible to concurrent systemic or local infections.Under these circumstances,even minimally invasive treatment methods such as interventional therapy like transjugular intrahepatic portosystemic shunt(TIPS)for liver cirrhosis patients can also result in complications such as infections.CASE SUMMARY A male patient with decompensated cirrhosis experienced multiple episodes of gastrointestinal bleeding and hypersplenism.He was admitted to hospital due to voluntary remedial TIPS.The patient developed a numerous intrahepatic liver abscess postoperatively.Following initial conservative treatment with intravenous antibiotics and parenteral nutrition,three months after TIPS,the liver abscess had disappeared on imaging examination.At the 6-month postoperative follow-up,outpatient re-examination showed that the patient had recovered and the liver abscess had resolved.CONCLUSION Attention should be paid to decreased blood cell counts,especially low leukocyte levels in patients with liver cirrhosis as the presence of intestinal microbiota dysregulation and portal pyemia can result in liver abscess and sepsis during invasive diagnostic and therapeutic procedures like TIPS.The addition of probiotics might reduce the risk in such patients.展开更多
基金The 2022 Educational Teaching Reform and Research Project of Guangxi University of Traditional Chinese Medicine(2022C032).
文摘Background:Lenvatinib is primarily utilized for the treatment of inoperable or advanced hepatocellular carcinoma,radioiodine-refractory differentiated thyroid cancer,and advanced renal cell carcinoma.Primary information about adverse reactions is principally derived from clinical trials;however,there is a notable dearth of substantial real-world studies.Methods:In this research,an examination of the U.S.Food and Drug Administration(FDA)Adverse Event Reporting System(FAERS)database was performed to evaluate the potential side effects of lenvatinib.The FAERS database revealed a total of 20,290 reported adverse events associated with lenvatinib.Different algorithms for repeated measure analysis were employed to ascertain the significance of these adverse reactions.Results:The study identified 170 instances of adverse events(AEs)induced by lenvatinib,incorporating several significant adverse reactions that the product label does not mention.The investigation also evaluated the onset periods of the adverse reactions,pinpointing a median time of 43 days.The majority of adverse reactions manifested within the initial month of lenvatinib use.Sex-specific analysis revealed disparities in high risk adverse reactions between females(vascular and lymphatic diseases,and neuronal organ diseases)and males(death and infectious diseases).Our data mining has unveiled adverse reactions beyond those mentioned within the instructions,such as osteonecrosis of the jaw,cholecystitis,cholangitis,dehydration,tumor lysis syndrome,type 1 diabetes,hyperammonemia,liver abscess,interstitial lung disease,pneumothorax,sudden death,and aortic dissection.Conclusion:The insights derived from these findings contribute significant nuances for optimizing lenvatinib use,enhancing its efficacy,and substantially mitigating potential side effects.These data elements will substantially enhance the implementation of the drug in a clinical environment.
文摘BACKGROUND:Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well.We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors.METHODS:Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure,non-verbal communication failure and missing communication at all.RESULTS:Between 2005 and 2015,845 reports were analyzed,of which 247 reports were considered to be related to communication failure.An arbitrary classifi cation resulted in six different kinds:1)no acknowledgement of a suggestion;2)medication error;3)miscommunication with dispatcher;4)utterance heard/understood improperly;5)missing information transfer between two persons;and 6)other communication failure.CONCLUSION:Communication defi cits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety.
文摘The purpose of this paper is to deliver a better perception of the project success,and how reporting system might increase the probability of project success in construction projects in UAE.Further,it aims at exploring the relationship between effective reporting system in terms of the characteristic of its outputs(mainly effectiveness of financial reporting system)and project success.Semi-structured interviews with a number of interior auditors,accountants,and chief financial officers(CFOs)from different corporations in construction sector in UAE in order to recognize how effective reporting system in terms of the characteristic of its outputs(broad scope,timeliness,aggregation,and integration)might contribute to increase the probability of project success.There are several success factors in construction projects in UAE,thus it is very hard to capture all these factors in one paper.Hence,this paper is not considering all project success factors rather it focuses on the characteristic of outputs of the reporting system generally and the financial reporting system particularly(broad scope,timeliness,aggregation,and integration),as most of the studies in the literature considered the reporting system as a key factor of project success.This paper adds to both project management and accounting research by evidencing results from an exploration how effective reporting might impact the project success,with valuable implications for standard officials,customers,investors,stakeholders,sponsors,shareholders,CFOs,project developer,consultants,internal auditors,and accounting academics.The effective reporting system in United Arab Emirates(UAE)construction projects enables possessors,customers,and contractors of projects to get timely information about the progress of project in a brief and significant format which in turn improve the decision-making process and contribute to project success.This paper implies a contribution for both project management literature and accounting research by investigative the effectiveness of reporting system in project successes from historical point of view and contemporary point of view.
文摘Coronary artery calcium data and reporting system(CAC-DRS)is a recently introduced standardized reporting system for calcium scoring on computed tomography.CAC-DRS provides four risk categories(0,1,2 and 3)along with treatment recommendations for each category.As with any other new reporting platform,CAC-DRS has both advantages and disadvantages.Improved communication,better clarity of details,organized management recommendations and utility in future research and education are the major strengths of CAC-DRS.It has many limitations such as questionable need for a new system,few missing components,use of a less accurate visual method and treatment suggestions based on expert opinion instead of clinical trials.In this contemporary review,we discuss the new reporting system CAC-DRS,its application,strengths and limitations and conclude with some remarks for the future.
文摘The purpose of this paper is to propose an innovation system of managerial accounting reports, which is actually on the basis of accounting objectives. On the one hand, as managerial accounting is one important branch of accounting(the other important branch is financial accounting), some of its characters should be closely connected with accounting. On the other hand, managers need managerial accounting information for enterprise operation(especially for internal management control) decisions, so, managerial accounting should also be in accordance with the enterprise's operation and its management control. Therefore, combined with the existed research of accounting(especially financial accounting research) and for the development requirement of Chinese enterprises, this paper will mainly discuss the relation between accounting objectives and managerial accounting's system and put forward an idea of constructing an applicable reporting system of managerial accounting based on the operation mode in Chinese modern enterprises. This study will develop the accounting reports research(including external reports and internal reports) both in the field of theory and that of practice.
文摘AIM: To present a simple colonoscopy reporting system that can be checked easily the detection rate of colon polyps.METHODS: A simple colonoscopy reporting system Kosin Gastroenterology(KG quality reporting system) was developed. The polyp detection rate(PDR),adenoma detection rate(ADR),serrated polyp detection rate(SDR),and advanced adenoma detection rate(AADR) are easily calculated to use this system.RESULTS: In our gastroenterology center,the PDR,ADR,SDR,and AADR test results from each gastroenterologist were updated,every month. Between June 2014,when the program was started,and December 2014,the overall PDR and ADR in our center were 62.5% and 41.4%,respectively. And the overall SDR and AADR were 7.5% and 12.1%,respectively.CONCLUSION: We envision that KG quality reporting system can be applied to develop a comprehensive system to check colon polyp detection rates in other gastroenterology centers.
基金funded by National Science and Technology Major Project of New Important Drug Creation (2015ZX09501004-001-002)The National Natural Science Foundation of China (81473798):Study on allergic reaction mechanism of Chinese medicine injections with active monitoring and network target monitoring+1 种基金Project of "One Belt, One Road" for Traditional Chinese Medicine of China Academy of Chinese Medical Sciences (GH2017-04)Construction of China-US Major Disease Clinical Research Center (GH2017-04-01)
文摘Spontaneous reporting system(SRS) is an important way to monitor the adverse drug reaction(ADR) and discover the ADR signal for marketed drugs. It can detect adverse reaction signals timely and effectively, and prevent the occurrence of drug damage. Runzao Zhiyang Capsule is mainly composed of Radix Polygoni Multiflor, Radix Polygoni Multiflori Preparata, Radix Rehmanniae Recens, Radix Sophorae Flavescentis, Folium Mori and Urtica dentata Hand.-Mazz. It has the functions of nourishing blood, nourishing yin, expelling wind to relieve itching and moistening the intestines to relieve constipation. It is mainly used for skin itching, acne, constipation and other diseases caused by blood deficiency and wind dryness. The large, national SRS database of ADRs needs effective evaluation methods. We reported on the use of Bayesian confidence propagation neural network method(BCPNN) and reporting rate ratio method(PRR) with propensity score to control confounding variables. The tendency score method was used to control the hybrid bias produced by SRS data analysis. After the calculation of PRR and BCPNN, the score of "diarrhea", "rash" and "gastric dysfunction" showed that there was an early warning before and after matching. To sum up, it indicated that diarrhea, rash and gastric dysfunction were early warning signs.
文摘Objective This study aimed to assess the local staging of bladder tumors in patients utilizing preoperative multiparametric MRI(mpMRI)and to demonstrate the clinical efficacy of this method through a comparative analysis with corresponding histopathological findings.Methods Between November 2020 and April 2022,63 patients with a planned cystoscopy and a preliminary or previous diagnosis of bladder tumor were included.All participants underwent mpMRI,and Vesical Imaging Reporting and Data System(VI-RADS)criteria were applied to assess the recorded images.Subsequently,obtained biopsies were histopathologically examined and compared with radiological findings.Results Of the 63 participants,60 were male,and three were female.Categorizing tumors with a VI-RADS score of>3 as muscle invasive,84%were radiologically classified as having an invasive bladder tumor.However,histopathological results indicated invasive bladder tumors in 52%of cases.Sensitivity of the VI-RADS score was 100%;specificity was 23%;the negative predictive value was 100%;and the positive predictive value was 62%.Conclusion The scoring system obtained through mpMRI,VI-RADS,proves to be a successful method,particularly in determining the absence of muscle invasion in bladder cancer.Its efficacy in detecting muscle invasion in bladder tumors could be further enhanced with additional studies,suggesting potential for increased diagnostic efficiency through ongoing research.The VI-RADS could enhance the selection of patients eligible for accurate diagnosis and treatment.
文摘Our study describes the reported rate of the Institutional Review Board(IRB)approval,declaration of Helsinki(DoH),and informed consent in the case reports and case series and investigates factors associated with the ethical approval report.We searched PubMed for case reports and case series from 2006 to 2017.Annually,we obtained the first 20 articles of a case report cluster from 20 distinct publications.This analysis initially contained at least 2400 papers,with 100 papers each study design and year.Only 26(5.4%)of 480 included studies reported IRB approval,DoH approval,and participant informed consent;58(12.1%)reported two out of three ethical statements(DoH,informed consent,IRB);and 151(31.5%)reported only one,leading to nearly 245 studies(51.0%)did not report any ethical approval item.Both clusters mentioned the DoH the least.Only years,ages,ethical item types,and cluster types were associated with ethical reporting practices.This study found the serious under‐reporting of ethical practices in both case reports and case series.
基金Supported by Hunan Provincial Natural Science Foundation Regional Joint Fund,No.2023JJ50050.
文摘BACKGROUND Collision tumor are neoplasms,including two histologically distinct tumors that coexist in the same mass without histological admixture.The incidence of collision tumor is low and is rare clinically.AIM To investigate ultrasound images and application of ovarian-adnexal reporting and data system(O-RADS)to evaluate the risk and pathological characteristics of ovarian collision tumor.METHODS This study retrospectively analyzed 17 cases of ovarian collision tumor diagnosed pathologically from January 2020 to December 2023.All clinical features,ultrasound images and histopathological features were collected and analyzed.The O-RADS score was used for classification.The O-RADS score was determined by two senior doctors in the gynecological ultrasound group.Lesions with O-RADS score of 1-3 were classified as benign tumors,and lesions with O-RADS score of 4 or 5 were classified as malignant tumors.RESULTS There were 17 collision tumors detected in 16 of 6274 patients who underwent gynecological surgery.The average age of 17 women with ovarian collision tumor was 36.7 years(range 20-68 years),in whom,one occurred bilaterally and the rest occurred unilaterally.The average tumor diameter was 10 cm,of which three were 2-5 cm,11 were 5-10 cm,and three were>10 cm.Five(29.4%)tumors with O-RADS score 3 were endometriotic cysts with fibroma/serous cystadenoma,and unilocular or multilocular cysts contained a small number of parenchymal components.Eleven(64.7%)tumors had an O-RADS score of 4,including two in category 4A,six in category 4B,and three in category 4C;all of which were multilocular cystic tumors with solid components or multiple papillary components.One(5.9%)tumor had an O-RADS score of 5.This case was a solid mass,and a small amount of pelvic effusion was detected under ultrasound.The pathology was high-grade serous cystic cancer combined with cystic mature teratoma.There were nine(52.9%)tumors with elevated serum carbohydrate antigen(CA)125 and two(11.8%)with elevated serum CA19-9.Histological and pathological results showed that epithelial-cell-derived tumors combined with other tumors were the most common,which was different from previous results.CONCLUSION The ultrasound images of ovarian collision tumor have certain specificity,but diagnosis by preoperative ultrasound is difficult.The combination of epithelial and mesenchymal cell tumors is one of the most common types of ovarian collision tumor.The O-RADS score of ovarian collision tumor is mostly≥4,which can sensitively detect malignant tumors.
文摘BACKGROUND Thrombophilia contributes to a significant increased risk of venous thromboembolism and can be either inherited or acquired.Hereditary thrombophilia may arise from various gene mutations,some of which have not even been adequately reported or poorly understood.Previous studies reported a rare and novel missense mutation in the prothrombin gene(p.Arg596Gln),known as prothrombin Belgrade.The mechanisms and therapeutic strategies associated with prothrombin Belgrade mutation have not been fully elucidated.CASE SUMMARY We present the case of a 26-year-old woman with recurrent systemic thrombosis induced by prothrombin Belgrade mutation.The patient suffered from cerebral venous sinus thrombosis that rapidly progressed to systemic thrombosis,alongside a family history of cerebral thrombosis,and no traditional risk factors or abnormal coagulation function.Whole-genome sequencing detected a novel and rare heterozygous prothrombin missense mutation,c.1787G>T(p.Arg596Gln),which was responsible for the major etiology of the systemic thrombosis.CONCLUSION This case strengthens our understanding about hereditary basis of thrombophilia and provokes considerations for therapeutic options on prothrombin Belgrade mutation.
文摘OBJECTIVE:In recent years,the number of clinical research reports on acupuncture and manipulation for the treatment of greater occipital neuralgia has gradually increased,but the quality is uneven.There is currently no literature evaluating the quality of published reports,which is not conducive to the promotion of clinical use of these therapies.Therefore,this article assessed the reporting quality of randomized controlled trials on acupuncture and manipulation for greater occipital neuralgia.METHODS:Cochrane Library,PubMed,Web of Science,Embase,China National Knowledge Infrastructure(CNKI),VIP,WanFang Data,and Chinese BioMedical Literature Database(CBM)from inception to May 20,2024 were searched.The reporting quality of included randomized controlled trials was independently evaluated by two investigators using the CONSORT statement,STRICTA checklist,and Cochrane bias of risk assessment tool.A third investigator resolved any disagreement.RESULTS:A total of 62 articles were included.Based on the CONSORT statement,59.46%(22/37)of all entries had a reporting rate of less than 50%,mainly including“Identification as a randomized trial in the title(1/62,1.61%),”“How sample size was determined(7/62,11.29%),”“Implementation(1/62,1.61%),”“Blinding(1/62,1.61%),”and“Reports of Funding(4/62,6.45%).”According to the STRICTA checklist,29.41%(5/17)of all entries had a reporting rate of less than 50%,mainly including“Details of other interventions(7/58,12.07%),”“Setting and context of treatment(0/58,0%),”and“Description of participating acupuncturists(0/58,0%).”CONCLUSION:The reporting quality of randomized controlled trials on acupuncture and manipulation therapy for greater occipital neuralgia remains low.Future researchers need to make greater efforts to strictly adhere to the CONSORT statement and STRICTA checklist during trial design,implementation,and reporting.This will facilitate the standardization of research in this field and enhance the reliability and reproducibility of the research results.
文摘BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time between injury and isolated meniscus repair on patient outcomes is not well described.Assessing this relationship is important as it may influence clinical decision-making and can add to the preoperative patient education process.We hypothesized that increasing the time from injury to meniscus surgery would worsen postoperative outcomes.AIM To investigate the current literature for data on the relationship between time between meniscus injury and repair on patient outcomes.METHODS PubMed,Academic Search Complete,MEDLINE,CINAHL,and SPORTDiscus were searched for studies published between January 1,1995 and July 13,2023 on isolated meniscus repair.Exclusion criteria included concomitant ligament surgery,incomplete outcomes or time to surgery data,and meniscectomies.Patient demographics,time to injury,and postoperative outcomes from each study were abstracted and analyzed.RESULTS Five studies met all inclusion and exclusion criteria.There were 204(121 male,83 female)patients included.Three of five(60%)studies determined that time between injury and surgery was not statistically significant for postoperative Lysholm scores(P=0.62),Tegner scores(P=0.46),failure rate(P=0.45,P=0.86),and International Knee Documentation Committee scores(P=0.65).Two of five(40%)studies found a statistically significant increase in Lysholm scores with shorter time to surgery(P=0.03)and a statistically significant association between progression of medial meniscus extrusion ratio(P=0.01)and increasing time to surgery.CONCLUSION Our results do not support the hypothesis that increased time from injury to isolated meniscus surgery worsens postoperative outcomes.Decision-making primarily based on injury interval is thus not recommended.
文摘Sham acupuncture,as a control intervention in acupuncture studies,has been widely conducted to eval-uate the specific effect of acupuncture.However,there was no relevant particular reporting guideline,so the reporting quality of sham acupuncture was low,which could hinder the precise understanding and interpretation of details and implementation background of sham acupuncture by researchers.In order to standardize the reporting of sham acupuncture and improve its quality,SHam Acupuncture REporting guidelines and a checklist in clinical trials(SHARE)was developed by a research team from Beijing Univer-sity of Chinese Medicine.The SAHRE standardizes the reporting of sham acupuncture from 10 categories,including brief name,rationales,details of sham acupuncture,treatment regimen of sham acupuncture,the information informed or explained to patients,practitioner information,modifications of protocol,communication between practitioner and patient,practitioner adherence and blinding.This article elab-orates the development process and key content of SHARE in order to facilitate its application by re-searchers.
文摘Objectives:This study aimed to investigate the dual mediating roles of psychological safety and reporting attitudes in the association between ethics-centered leadership and internal whistleblowing among nurses.Methods:A multicenter,cross-sectional study design was employed,involving a convenience sample of 273 nurses among five university hospitals from August to October 2024.Data were collected using a demographic questionnaire,Ethical Leadership Scale,Psychological Safety Scale,Positive Attitudes Toward Whistleblowing Scale,and Internal Whistleblowing Scale.Pearson correlation and structural equation model were conducted to test the hypothesized dual mediation model.Results:The average score of nurses for ethical leadership was 4.14±0.57,psychological safety was 3.80±0.64,reporting attitudes was 4.12±0.67,internal whistleblowing was 3.93±0.52.Ethical leadership had a significant effect on psychological safety(β=0.38,P<0.001),reporting attitudes(β=0.44,P<0.001),and internal whistleblowing(β=0.21,P=0.009).Furthermore,psychological safety(β=0.26,P<0.001)and reporting attitudes(β=0.27,P<0.001)significantly influenced internal whistleblowing among the nurses.The indirect effect of ethics-centered leadership on internal whistleblowing intermediated by psychological safety was significant(β=0.10,P<0.001).Similarly,reporting attitudes demonstrated a significant mediating effect(β=0.12,P=0.003).Conclusions:Ethical leadership encourages internal whistleblowing among nurses by fostering psychological safety and positive reporting attitudes.Therefore,healthcare managers should prioritize ethical leadership development,enhance psychological safety,and foster constructive reporting attitudes that enable nurses to report ethical violations confidently,without apprehension.
文摘BACKGROUND Colonic diverticular bleeding is a significant cause of acute overt lower gastrointestinal hemorrhage.Colonoscopy is commonly performed in patients with colonic diverticular bleeding to identify and treat the source of bleeding,which is crucial for effective management.CASE SUMMARY We present the case of a 70-year-old male with acute painless hematochezia.Colonoscopy showed active bleeding originating from a diverticulum,and the EyeMax direct visualization system was used in the treatment of the colonic diverticular bleeding.No further evidence of bleeding was observed at the end of the procedure.The patient was discharged from hospital on the seventh day.CONCLUSION The EyeMax system proved advantageous in localizing the bleeding diverticulum,thereby facilitating successful hemostatic measures.
基金Supported by STI2030-Major Projects,No.2021ZD0202001Capital Funds for Health Improvement and Research,No.CFH 2022-2-4012.
文摘BACKGROUND Systemic lupus erythematosus(SLE)can affect multiple organs or systems.The involvement of the central nervous system can result in the manifestation of epilepsy,an acute confusional state,and other rare neuropsychiatric presentations,such as catatonia.CASE SUMMARY We present a case of an adolescent male patient with first-onset SLE who presented with neuropsychiatric symptoms including epilepsy and delirium.The initial utilization of olanzapine to alleviate symptoms of agitation precipitated the emergence of catatonia,which was mitigated by discontinuing olanzapine and supplementing with lorazepam.In this case,whether the catatonia was secondary to the utilization of antipsychotics or to an organic disease is a question that warrants differential diagnosis.CONCLUSION Multidisciplinary collaborative management is the cornerstone for the successful management of severe cases of SLE.
文摘BACKGROUND Recently,there has been a significant increase in the consumption of ultraprocessed foods worldwide.However,the association between the consumption of ultra-processed food,obesity,and the prevalence of colon cancer remains controversial.AIM To find out the association between the consumption of ultra-processed food,obesity,and the prevalence of colon cancer.METHODS A comprehensive systematic literature search of PubMed,Scopus,Web of Science,and Google Scholar for grey literature was done for articles published before 8th March 2023.The search was done to retrieve potential peer-reviewed articles that explored the association between the consumption of ultra-processed food,obesity,and the prevalence of colon cancer.RESULTS Of the 246 potential articles assessed,17 met the inclusion criteria.Meta-analysis results demonstrated that high consumption of ultra-processed food is associated with an increased risk of obesity[odds ratio(OR):1.65;95%CI:1.07-2.45;P<0.05].Consequently,there is a positive association between obesity and an increased risk of colon cancer(OR 1.48;95%CI:0.77-2.87;P>0.05).CONCLUSION Consuming ultra-processed foods increases the risk of obesity and colon 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BACKGROUND Liver cirrhosis patients can develop various complications including bacteremia as the intestinal flora is heterologous.In those with low immunity,trauma,or following surgery,etc.,the body is susceptible to concurrent systemic or local infections.Under these circumstances,even minimally invasive treatment methods such as interventional therapy like transjugular intrahepatic portosystemic shunt(TIPS)for liver cirrhosis patients can also result in complications such as infections.CASE SUMMARY A male patient with decompensated cirrhosis experienced multiple episodes of gastrointestinal bleeding and hypersplenism.He was admitted to hospital due to voluntary remedial TIPS.The patient developed a numerous intrahepatic liver abscess postoperatively.Following initial conservative treatment with intravenous antibiotics and parenteral nutrition,three months after TIPS,the liver abscess had disappeared on imaging examination.At the 6-month postoperative follow-up,outpatient re-examination showed that the patient had recovered and the liver abscess had resolved.CONCLUSION Attention should be paid to decreased blood cell counts,especially low leukocyte levels in patients with liver cirrhosis as the presence of intestinal microbiota dysregulation and portal pyemia can result in liver abscess and sepsis during invasive diagnostic and therapeutic procedures like TIPS.The addition of probiotics might reduce the risk in such patients.
