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  • 1.
    Ultrasonographic features of carotid web
    Jie Yang, Yang Hua, Fubo Zhou, Xiaojie Tian, Ran Liu, Lingyun Jia
    Chinese Journal of Medical Ultrasound (Electronic Edition) 2020, 17 (07): 679-683. DOI: 10.3877/cma.j.issn.1672-6448.2020.07.017
    Abstract (523) HTML (3) PDF (716 KB) (192)
    Objective

    To evaluate the features of carotid web (CW) by ultrasonography.

    Methods

    A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

    Results

    Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

    Conclusion

    Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

  • 2.
    Different historical stages of elderly orthopaedic treatments--A retrospect and prospect analysis
    Yingze Zhang
    Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition) 2018, 04 (01): 1-3. DOI: 10.3877/cma.j.issn.2096-0263.2018.01.001
    Abstract (163) HTML (0) PDF (374 KB) (7)
  • 3.
    The effect of combining therapeutic ultrasound and sling exercise for lumbar disc herniation
    Weiwei Wu, Jianye Cao, Liwei Dong, Jing Zhang
    Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition) 2020, 06 (05): 291-296. DOI: 10.3877/cma.j.issn.2096-0263.2020.05.008
    Abstract (299) HTML (1) PDF (657 KB) (4)
    Objective

    The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

    Methods

    Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

    Results

    At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

    Conclusion

    All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

  • 4.
    Diagnosis and treatment of traumatic cerebral infarction in children
    Guiling Zhang, Huaiqiang Zhang, Hongsheng Wang, Yinchen Sun, Peilin Zhao, Zhiming Wang, Wenbo Meng
    Chinese Journal of Neurotraumatic Surgery(Electronic Edition) 2020, 06 (04): 229-232. DOI: 10.3877/cma.j.issn.2095-9141.2020.04.008
    Abstract (237) HTML (4) PDF (589 KB) (13)
    Objective

    To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

    Methods

    The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

    Results

    In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

    Conclusion

    It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

  • 5.
    Characterization of Patients with Supratentorial Hypertensive Intracerebral Hemorrhage in the Tibetan Plateau over an Altitude of 4000 meters
    Zhongzheng He, Jiankang Ma, Sang Gong, Gongsangmingjiu, Cidanzhaxi, Zhiyong Jin, Caihong Ran, Hong Wang, Yu Wang, Qianfa Long
    Chinese Journal of Cerebrovascular Diseases(Electronic Edition) 2020, 14 (02): 96-99. DOI: 10.11817/j.issn.1673-9248.2020.02.007
    Abstract (457) HTML (2) PDF (555 KB) (12)
    Objective

    To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

    Methods

    A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ2 test.

    Results

    The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P>0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

    Conclusion

    The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

  • 6.
    Multi-center study of electrospun composite biomaterial and SIS biological mesh in adult inguinal hernia surgery
    Shaojie Li, Jianxiong Tang, Hongbing Xiao, Lei Hua, Lei Huang, Ding Ping, Xianke Si, Xingchen Hu, Zhao Cai
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2020, 14 (04): 336-341. DOI: 10.3877/cma.j.issn.1674-392X.2020.04.004
    Abstract (246) HTML (7) PDF (882 KB) (27)
    Objective

    To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

    Methods

    A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

    Results

    172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

    Conclusion

    We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

  • 7.
    Key surgical techniques and notes of laparoscopic pancreaticoduodenectomy by using robotic surgery system
    Rong Liu, Jizhe Li
    Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) 2019, 13 (04): 336-339. DOI: 10.3877/cma.j.issn.1674-3946.2019.04.004
    Abstract (92) HTML (1) PDF (872 KB) (28)

    Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

  • 8.
    Refined management of COVID-19 prevention and control in medical ultrasound department during COVID-19 epidemic
    Zhang Zhang, Lü Lü, Meng Meng
    Chinese Journal of Medical Ultrasound (Electronic Edition) 2020, 17 (08): 787-790. DOI: 10.3877/cma.j.issn.1672-6448.2020.08.014
  • 9.
    Analysis of textbook outcomes and influencing factors in elderly patients after laparoscopic pancreaticoduodenectomy
    Wei Gong, Xin Deng, Shuai Xu, Bowen Wang, Jun Liu
    Chinese Journal of Laparoscopic Surgery(Electronic Edition) 2025, 18 (06): 329-336. DOI: 10.3877/cma.j.issn.1674-6899.2025.06.002
    Abstract (4) HTML (0) PDF (3226 KB) (1)
    Objective

    To explore the influencing factors for achieving textbook outcome (TO) after laparoscopic pancreaticoduodenectomy (LPD) in elderly patients with malignant tumors, and the relationship between TO and long-term prognosis.

    Methods

    A retrospective analysis was conducted on the clinicopathological data of elderly patients with malignant tumors who underwent LPD at our center between Mar. 2017 and Mar. 2025. Variables with a significance level of P<0.05 in the univariate analysis were included in a multivariate logistic regression analysis to identify independent risk factors for failure to achieve a TO postoperatively.

    Results

    This study included a total of 351 patients, among whom 215 achieved a TO, while 136 did not. The long-term prognosis of patients in the TO group was significantly better than that of the non-TO group(P<0.05). The multivariate logistic regression analysis revealed that preoperative BMI (OR 1.095; 95%CI: 1.016-1.180; P=0.018), firm pancreatic texture (OR 0.568; 95%CI: 0.367-0.934; P=0.025), main pancreatic duct diameter (OR 0.748; 95%CI: 0.616-0.909; P=0.003), and postoperative delayed gastric emptying (OR 5.036; 95%CI: 2.354-10.770; P<0.001) were independent risk factors for failure to achieve a TO.

    Conclusions

    High preoperative body mass index(BMI), soft pancreatic texture, narrow main pancreatic duct diameter, and postoperative delayed gastric emptying are independent risk factors for failure to achieve TO in elderly malignant tumor patients after LPD. TO is associated with long-term survival in these patients.

  • 10.
    Comparison of efficacy and safety between single-port and multi-port laparoscopy in the removal of large uterine fibroids
    Xiaoying Zhong, Yang Cao, Xin Yu, Honghui Shi, Haiyuan Liu
    Chinese Journal of Laparoscopic Surgery(Electronic Edition) 2025, 18 (06): 348-353. DOI: 10.3877/cma.j.issn.1674-6899.2025.06.005
    Abstract (3) HTML (0) PDF (2487 KB) (1)
    Objective

    To retrospectively analyzed the therapeutic efficacy and perioperative safety of single-port laparoscopic myomectomy (SPLM) versus multiport laparoscopic myomectomy (MPLM) for large uterine fibroids.

    Methods

    A retrospective analysis was conducted on the clinical data of 482 patients who underwent SPLM or MPLM at the General Gynecology Center of Peking Union Medical College Hospital between Aug. 2022 and Sep. 2024. Patients with a single uterine fibroid of maximum diameter ≥10 cm were selected, including 24 cases in the SPLM group and 64 cases in the MPLM group. Surgical outcomes were evaluated based on three main aspects: 1) surgical parameters (operative time, additional trocar use, postoperative hemoglobin decrease, frequency of blood transfusion, adjacent organ injury); 2) perioperative recovery and safety indicators (pain scores at 6 h, 24 h, and 48 h postoperatively, postoperative fever, hospital stay, hospitalization costs, perioperative complications); and 3) scar cosmesis assessed using a scar evaluation and rating scale. Statistical analysis was performed using SPSS 27.0 software, with a P-value<0.05 considered statistically significant.

    Results

    The operative time was 136.81±56.82 min for the SPLM group and 119.85±42.07 min for the MPLM group, with a significant difference between groups (P=0.025). The postoperative hemoglobin decrease was 18.26±8.01 g/L in the SPLM group and 17.04±7.70 g/L in the MPLM group (P=0.480). Postoperative VAS scores at 6 h, 24 h, and 48 h were significantly lower in the SPLM group compared to the MPLM group (3.88±1.14 vs. 4.51±1.15, 2.83±0.96 vs. 3.18±1.03, 1.57±0.83 vs. 1.83±0.90, respectively; all P<0.05). No statistically significant differences were found between the two groups regarding hospital stay or hospitalization costs. The total scar score was significantly lower in the SPLM group (1.21±1.18) compared to the MPLM group (5.36±2.45, P<0.001). Specifically, the SPLM group demonstrated superior outcomes in scar spread, erythema, pigmentation abnormality, suture marks, and hypertrophy/atrophy compared to the MPLM group (0.29±0.56 vs. 1.56±0.82, 0.04±0.20 vs. 0.89±0.69, 0.33±0.48 vs. 0.73±0.45, 0.21±0.41 vs. 0.98±0.13, 0.25±0.44 vs. 0.80±0.68, respectively; all P<0.001).

    Conclusion

    Single-port laparoscopic surgery is a safe and feasible treatment option for large uterine fibroids. It is superior to multiport laparoscopic surgery, particularly in terms of postoperative pain control and cosmetic outcomes.

  • 11.
    Clinical evaluation of hysteroscopic myomectomy with electrosection for FIGO type 3 uterine fibroids
    Yuanyuan He, Lingli Ju, Yunping Wang, Yihua Jin, Lingxia Li, Lu Bai, Na Zhuo, Li Wei
    Chinese Journal of Laparoscopic Surgery(Electronic Edition) 2025, 18 (06): 354-360. DOI: 10.3877/cma.j.issn.1674-6899.2025.06.006
    Abstract (3) HTML (0) PDF (3128 KB) (1)
    Objective

    To investigate the feasibility, safety, and clinical efficacy of transcervical resection of myoma (TCRM) in the management of International Federation of Gynecology and Obstetrics(FIGO) type 3 uterine fibroids.

    Methods

    A retrospective analysis was conducted on the clinical data of 42 patients with solitary FIGO type 3 uterine fibroids treated at XiJing Hospital, Air Force Medical University between Feb. 2021 and Feb. 2024. Perioperative parameters, surgical complications, improvement in menstrual symptoms, and postoperative reproductive outcomes were recorded and analyzed.

    Results

    The mean age of the 42 patients was 34.3±5.1 years, with a mean fibroid diameter of 4.6±1.8 cm. The primary procedure success rate was 85.7%(36/42). The mean operative time was 43±18 minutes, and the mean intraoperative blood loss was 26±16 ml. The shortest distance from the tumor cavity to the uterine serosa significantly increased from 3.1±1.3 mm preoperatively to 8.4±1.5 mm postoperatively. No severe complications, such as uterine perforation or major hemorrhage, occurred. Among the 35 patients with preoperative menorrhagia, the cure rate was 80.0%(28/35), resulting in a total effective rate of 97.1%(34/35). Among the 28 patients with fertility desires, the average follow-up duration was 16.2±7.3 months. The pregnancy rate within one year postoperatively was 78.5%(22/28). Seventeen patients have delivered (11 vaginal deliveries and 6 cesarean sections), with no cases of uterine rupture reported.

    Conclusion

    For FIGO type 3 uterine fibroids, hysteroscopic resection performed by experienced surgeons under ultrasonographic guidance is a safe and effective minimally invasive treatment. It significantly ameliorates menstrual symptoms and is associated with favorable reproductive outcomes.

  • 12.
    Clinical efficacy of axillary single-port endoscopic subcutaneous gland excision combined with immediate implant reconstruction
    Yuan Li, Dan Wang, Jian Zhu, Yixin Liu, Hai Yan, Meng Wang, Ziyu Fang, Qingqing He
    Chinese Journal of Laparoscopic Surgery(Electronic Edition) 2025, 18 (06): 361-368. DOI: 10.3877/cma.j.issn.1674-6899.2025.06.007
    Abstract (4) HTML (0) PDF (3391 KB) (1)
    Objective

    To evaluate the clinical efficacy, oncologic safety, and aesthetic outcomes of axillary single-port endoscopic subcutaneous glandular resection combined with immediate implant reconstruction in patients with breast cancer, and to provide evidence for optimizing surgical approach selection.

    Methods

    This retrospective comparative study included 129 female breast cancer patients who underwent subcutaneous glandular resection with immediate implant-based reconstruction at the 960th Hospital of the Joint Logistics Support Force from Jan. 2023 to May 2025. Patients were allocated to an endoscopic group (n=67) or an open surgery group (n=62) according to surgical approach. Baseline characteristics, perioperative parameters, postoperative complications, oncologic outcomes, and aesthetic satisfaction were systematically compared between groups.

    Results

    No significant differences were found between the two groups in baseline characteristics, including age, body mass index, smoking history, diabetes, tumor T/N stage, ER/PR/HER2 status, and perioperative treatments (all P>0.05). Intraoperative blood loss was significantly lower in the endoscopic group than in the open group (40.9±27.6 ml vs. 71.5±66.3 ml, P=0.001). The overall postoperative complication rates were 11.3% and 7.5% in the open and endoscopic groups, respectively, with no significant difference (P=0.550). The incidence of nipple-areolar complex (NAC) ischemia/necrosis was 3.2% versus 4.5%, also without a significant difference (P>0.05). Aesthetic evaluation showed higher BREAST-Q scores in the endoscopic group at 1 month and 3 months postoperatively (67.96±5.33 vs. 64.11±6.38, P=0.019; 76.19±4.47 vs. 67.46±6.41, P<0.001). The proportion of "excellent" Harris ratings was also higher in the endoscopic group (79.1% vs. 61.3%, P=0.034). During follow-up, one case of nipple Paget′s disease recurrence occurred in the endoscopic group, whereas no local recurrence was observed in the open group; no distant metastasis or death occurred in either group, and the between-group differences were not statistically significant.

    Conclusion

    Endoscopic nipple-sparing mastectomy with immediate implant reconstruction achieves comparable short-term oncologic safety and surgical efficacy to open surgery while reducing intraoperative trauma and significantly improving early aesthetic outcomes and patient satisfaction. Longer follow-up is warranted to confirm long-term efficacy and safety.

  • 13.
    The application of laparoscopy combined with ultrasound in the diagnosis and treatment of idiopathic retroperitoneal fibrosis
    Zhigang Ma, Yupeng Li, Maimaitinijati YusufuKadir, Jianhao Liang, Chao Ma, Jie Zhang, Yuan Meng, Xiong Chen
    Chinese Journal of Laparoscopic Surgery(Electronic Edition) 2025, 18 (06): 369-373. DOI: 10.3877/cma.j.issn.1674-6899.2025.06.008
    Abstract (4) HTML (0) PDF (2233 KB) (1)
    Objective

    To investigate the diagnostic value of laparoscopy combined with ultrasound technology in idiopathic retroperitoneal fibrosis(IRF) and summarize the clinical diagnostic and therapeutic characteristics of this disease.

    Methods

    Clinical data from 11 patients with pathologically confirmed IRF were collected. A retrospective analysis was conducted on their clinical manifestations, laboratory tests, and imaging features, with a detailed description of the method for obtaining pathological diagnosis using laparoscopy combined with ultrasound technology.

    Results

    The 11 patients had a mean age of 53.3±7.6 years, comprising 7 males and 4 females. The predominant clinical symptoms were abdominal and lumbar pain(8/11). The median disease duration was 5(3, 11) months. CT or MRI revealed a retroperitoneal soft tissue density, yet the diagnosis remained indeterminate (0/11). All 11 patients underwent laparoscopy combined with ultrasound-guided biopsy of retroperitoneal masses, which confirmed IRF. The treatment regimen included prednisone + tamoxifen + mycophenolate mofetil. All patients were followed up for a median duration of 21(13.5, 27) months, showing significant reduction in lesion size and effective treatment outcomes.

    Conclusion

    IRF presents with non-specific clinical manifestations and blood test results, and has a low diagnostic confirmation rate by imaging, making differential diagnosis from retroperitoneal tumors challenging. Laparoscopy combined with ultrasound-guided technology enables the acquisition of pathological tissue for definitive diagnosis, effectively avoiding missed or misdiagnoses, with minimal surgical trauma and proven safety and efficacy.

  • 14.
    Progress in the research of anastomotic leakage after radical surgery of esophageal cancer
    Ruiji Chen, Siyu Chen, Hong Ren, Bo Yang, Yang Liu
    Chinese Journal of Laparoscopic Surgery(Electronic Edition) 2025, 18 (06): 379-384. DOI: 10.3877/cma.j.issn.1674-6899.2025.06.010
    Abstract (3) HTML (0) PDF (2502 KB) (1)

    Esophageal cancer is a highly prevalent and specific malignant tumor of the digestive tract in China, and surgery is an important treatment for esophageal cancer. However, anastomotic leakage is a high incidence and serious postoperative complication, which adversely affects perioperative mortality and long-term survival. This article summarizes the clinical characteristics, high-risk factors, and progress of prevention and treatment of anastomotic leakage after radical surgery for esophageal cancer, with a view to providing future references for reducing the incidence of this complication and improving its treatment prognosis.

  • 15.
    Adhesion-associated glycosylphosphatidylinositol-anchored cell wall proteins in Candida albicans infection: regulatory mechanism and research progress
    Wenqin Yang, Jing Yang
    Chinese Journal of Clinicians(Electronic Edition) 2025, 19 (10): 786-792. DOI: 10.3877/cma.j.issn.1674-0785.2025.10.009
    Abstract (3) HTML (0) PDF (2660 KB) (1)

    Adhesion genes represent a crucial gene family in Candida albicans infection and biofilm formation, serving a dual functional role. On the one hand, they act as “initiators” for infection and colonisation; on the other hand, they function as “architects” of the drug-resistant microenvironment. During biofilm formation, the expression of adhesion genes facilitates the construction of complex biofilm structures, including extracellular matrix formation and hyphal differentiation. This review examines the pathogenicity and regulatory mechanisms of several adhesion-associated glycosylphosphatidylinositol-anchored cell wall proteins, providing insights for identifying novel antimicrobial drug targets and therapeutic approaches.

  • 16.
    Emerging insights into autophagy-mediated drug resistance in multiple myeloma
    Yitong Liu, Xin Tian
    Chinese Journal of Clinicians(Electronic Edition) 2025, 19 (10): 793-797. DOI: 10.3877/cma.j.issn.1674-0785.2025.10.010
    Abstract (1) HTML (0) PDF (2004 KB) (1)

    Over the past few decades, the use of novel therapeutics has significantly improved survival outcomes for patients with multiple myeloma (MM). However, most patients still experience disease recurrence or progression. Drug resistance remains the most pressing challenge in MM treatment. Recent studies have revealed that autophagy plays a pivotal role in drug resistance in MM. This review examines autophagy and its regulatory mechanisms; the interplay between autophagy and MM treatment, tumor microenvironment, and metabolic reprogramming; and autophagy-related therapeutic strategies for MM, aiming to provide novel insights for clinical diagnosis and treatment of MM.

  • 17.
    Relationship between PANoptosis and cancer: an update
    Hongji Ding, Guizhen Wang, Can Wang, Longlong Li
    Chinese Journal of Clinicians(Electronic Edition) 2025, 19 (10): 798-802. DOI: 10.3877/cma.j.issn.1674-0785.2025.10.011
    Abstract (1) HTML (0) PDF (1954 KB) (1)

    PANoptosis is a unique inflammatory cell death pattern newly discovered in recent years. It integrates the main features and interactions of apoptosis, pyroptosis, and necroptosis, initiated by innate immune sensors and driven by PANoptosome. As one of the most intricate forms of programmed cell death (PCD) identified to date, PANoptosis is closely related to the pathogenesis of various systemic diseases in humans, including infectious diseases, cancer, neurodegenerative disorders, and inflammatory conditions. Therefore, understanding the pathogenesis of PANoptosis is of great significance for providing a basis for the treatment of human diseases. The role of PANoptosis in tumor treatment is multi-faceted, including inhibiting tumor growth, enhancing chemotherapy sensitivity, predicting treatment response and prognosis, and promoting immune monitoring. Given the impact of PANoptosis across the entire disease spectrum, targeting its molecular components offers great potential for the treatment of diseases.

  • 18.
    Analysis of risk factors associated with portal vein thrombosis following liver transplantation in adult patients with liver cirrhosis
    Guisheng Ai, Junjie Li, Yan Xie, Jian Yang, Jian He, Lei Zhang, Wentao Jiang
    Chinese Journal of Transplantation(Electronic Edition) 2025, 19 (05): 344-350. DOI: 10.3877/cma.j.issn.1674-3903.2025.05.009
    Abstract (7) HTML (0) PDF (2927 KB) (1)
    Objective

    To investigate the risk factors and treatment methods of portal vein thrombosis (PVT) after liver transplantation (LT) in adult liver cirrhosis recipients.

    Methods

    The clinical data of 596 adult cirrhosis patients undergoing LT in the Organ transplantation Center of Tianjin First Central Hospital from January 2018 to June 2022 were analyzed, and the overall cases were divided into PVT group (32 cases) and non-PVT group (564 cases) according to postoperative PVT. Unvariate and multivariate analysis were used to screen risk factors for PVT formation after LT and to compare survival rates between the two groups.

    Results

    Out of the 596 LT recipients included in this study, the overall incidence of postoperative PVT was 5.37% (32/596). Multivariate analysis revealed that, the presence of large spontaneous portosystemic shunt (SPSS) (OR=6.716, 95%CI: 2.481-18.180), postoperative presence of portoshunt (OR=5.917, 95%CI: 1.785-19.615), preoperative grade Ⅲ-Ⅳ PVT (OR=8.368, 95%CI: 1.954-35.835) and cold ischemia time ≥10 h (OR=4.002, 95%CI: 1.183-13.537) were independent risk factors for PVT formation after LT(P<0.05). Among 32 recipients with PVT, 4 underwent surgical thrombectomy, 7 received interventional therapy, and 21 were treated with anticoagulant medications. After treatment, PVT resolved in 25 recipients, while 7 had stable PVT without clinical symptoms. A total of 5 deaths unrelated to PVT occurred. Survival analysis revealed that the 1-year, 2-year, and 3-year post-operative graft survival rates of the non-PVT group achieved 98.4%, 95.1%, and 93.6%, compared with 87.3%, 83.6%, and 78.4% in the PVT group. The difference was statistically significant (χ2=11.3, P<0.05).

    Conclusions

    The presence of large SPSS, grade Ⅲ-Ⅳ PVT, persistence of portosystemic shunt and cold ischemia time ≥10 h are independent risk factors for PVT formation after LT in adult patients with cirrhosis. For recipients of postoperative PVT formation, early diagnosis and treatment can achieve a better survival prognosis.

  • 19.
    Impact of downgrading therapy during liver transplant waiting period on prognosis in acute-on-chronic liver failure patients
    Zhaokai Zeng, Zhangzhengyi Fan, Ying Tong, Yongbing Qian, Hualian Hang
    Chinese Journal of Transplantation(Electronic Edition) 2025, 19 (05): 351-355. DOI: 10.3877/cma.j.issn.1674-3903.2025.05.010
    Abstract (5) HTML (0) PDF (2187 KB) (0)
    Objective

    To investigate the impact of downgrading therapy during liver transplant waiting period on the prognosis of patients with acute-on-chronic liver failure (ACLF).

    Methods

    A retrospective analysis was performed on 344 ACLF patients who were on the liver transplantation waiting list at the Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, from January 2018 to August 2024. The cohort included 102 patients who did not undergo transplantation and 242 patients who completed liver transplantation. Based on the Chinese Group on the Study of Severe Hepatitis B-ACLF guideline, ACLF was classified into grades 1 to 3. For the transplant group, the last examination prior to liver transplantation was used as the endpoint for scoring, while for the non-transplant group, the last examination before discharge or prior to death was used as the scoring endpoint. In addition to assessing changes in ACLF grades, an evaluation method based on "organ failure + organ injury" was incorporated. After downgrading therapy, patients were divided into a successful downgrading group and a failed downgrading group. Normally distributed continuous variables were compared using the independent-samples t-test; non-normally distributed continuous variables were compared using the Mann-Whitney U test. Categorical variables were compared using the chi-square test. Kaplan-Meier survival curves were constructed, and comparisons were made using the log-rank test. A P-value of <0.05 was considered statistically significant.

    Results

    The differences in γ-glutamyltransferase, serum glucose, prothrombin time, serum creatinine, the proportion of patients with renal failure, international normalized ratio, the proportion of patients with coagulopathy, and the model for end-stage liver disease score between the transplant and non-transplant groups were statistically significant (Z/χ2=-2.315, -2.260, -4.299, -2.434, 4.428, -5.263, 13.021, and -5.282, all P<0.05). At the time of outcome events, 225 patients achieved successful downgrading therapy (successful downgrading group), including 193 in the transplant group and 32 in the non-transplant group. A total of 119 patients experienced failure of downgrading therapy (failed downgrading group), including 49 cases in the transplant group and 70 cases in the non-transplant group. The 1-year cumulative survival rate of ACLF patients in the successful downgrading group (n=225) was higher than that in the failed downgrading group (n=119) (χ2=81.95, P<0.05). Further analysis showed that in the non-transplant group, the 1-year cumulative survival rate of ACLF patients in the successful downgrading group (n=32) was higher than that in the failed downgrading group (n=70) (χ2=4.28, P<0.05). However, in the transplant group, there was no statistically significant difference in the 1-year cumulative survival rate between the successful downgrading group (n=193) and the failed downgrading group (n=49) (χ2=2.62, P>0.05).

    Conclusion

    Successful downgrading can improve the overall short-term prognosis of all patients with ACLF and the survival rate of non-transplanted patients, and extend the liver transplant waiting period.

  • 20.
    Latent analysis of the lung transplant quality of life survey among lung transplant recipients
    Haiqin Zhou, Yinghua Cai, Yingxiang Zhang, Keyao Huang, Wanting Kou
    Chinese Journal of Transplantation(Electronic Edition) 2025, 19 (05): 356-361. DOI: 10.3877/cma.j.issn.1674-3903.2025.05.011
    Abstract (4) HTML (0) PDF (3345 KB) (0)
    Objective

    To explore the latent profiles of lung transplant recipients′ quality of life, as well as the traits and contributing variables of different quality of life categories.

    Methods

    The study included 300 lung transplant recipients who visited Wuxi People′s Hospital for follow-up outpatient visits between January and December 2022. The lung transplant quality of life survey (LT-QOL) and a general information questionnaire were used in the questionnaire surveys. The Kruskal-Wallis H test was used to compare groups for continuous data, while the chi-square test or Fisher′s exact probability test was used for comparison between groups for categorical data. The factor scores for every dimension were determined using the lavaan package. The mclust and tidyLPA programs were used to conduct latent profile analysis (LPA). The nnet software was used to perform logistic regression on factors with P<0.10 in univariate analysis. The threshold for statistical significance was set at P<0.05.

    Results

    A total of 300 questionnaires were distributed, with 5 invalid responses excluded, yielding a valid response rate of 98.3% (295/300). LPA was conducted based on factor scores across the LT-QOL′s 11 domains, the 295 recipients were categorised into high quality of life-quality of life satisfaction group (n=181), moderate quality of life-prominent diarrhoea symptoms group (n=34), moderate quality of life-prominent sexual function issues group (n=40), low quality of life-poor overall perception group (n=40). Univariate analysis revealed statistically significant differences in age, pathoglycemia, and dyslipidaemia among recipients in the above four groups (H/χ2=10.135, 15.599 and 14.527 respectively, all P<0.05). Multivariate logistic regression analysis revealed that the age, unplanned readmission frequency, pathoglycemia, and dyslipidaemia were statistically significant factors influencing quality of life categories among lung transplant recipients (all P<0.05).

    Conclusions

    Quality of life among lung transplant recipients exhibits marked heterogeneity. Nursing staff may develop targeted intervention strategies based on the characteristics of their respective quality of life categories to enhance their quality of life and overall health status.

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