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case report:simultaneous femtosecond laser astigmatic keratotomy and toric intraocular lens implantation in femtosecond laser-assisted cataract surgery in a patient with surgically induced high corneal astigmatism

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Annals of Eye Science 2022年第4期7卷 69-76页

作者： Yan Guo Heather Edwards Mark Woodward Tyrone Curtis Gresham Kayla Morgan Hampton Roads Eye Associates Riverside Medical GroupHamptonVAUSA Hampton Surgical Center Riverside Medical GroupHamptonVAUSA

Background:Femtosecond laser astigmatic keratotomy(FSAK)and toric intraocular lens(IOL)implantation have been studied individually for comparison to treat astigmatism at cataract surgery.We report a case of surgically induced high corneal astigmatism by laser thermal keratoplasty(LTK)in a patient with cataract who was successfully treated with simultaneous combination of FSAK and toric IOL implantation with femtosecond laser-assisted cataract surgery(FLACS).This is the first report of both procedures combined simultaneously,with or without history of LTK.case Description:A 68-year-old male presented with a history of LTK with two enhancements each eye in 2004,with subsequent surgically induced high corneal astigmatism,and with age-related nuclear cataract of both eyes.IOL master demonstrated+7.71 diopters of astigmatism at 163 degree right eye and+3.29 diopters of astigmatism at 4 degree left eye.After extensive discussion of the risks and benefits,the patient agreed to undergo FLACS with FSAK with two 61 degrees of relaxation incisions(RIs)and toric IOL(Alcon SN6AT9)right eye;FLACS with toric IOL(Alcon SN6AT7)alone left eye.At 2-year follow-up,uncorrected visual acuity was 20/30 right eye,20/25 left eye.His best corrected visual acuity was 20/25(+0.25+1.00 axis 21)right eye and 20/20(plano+0.25 axis 90)left eye;his best corrected near visual acuity was J1+with add+2.50 diopters right eye and left eye.Conclusions:Patients with age-related cataract and LTK induced high corneal astigmatism can hardly be sufficiently treated with FSAK or toric IOL alone at the time of cataract surgery.An effective way is to combine large FSAK and toric IOL of the highest cylindrical power of T9,in our case,simultaneously,which can achieve an excellent long term visual outcome.

关键词： High corneal astigmatism[induced by laser thermal keratoplasty(LTK)] femtosecond laser astigmatic keratotomy(FSAK) toric intraocular lens implantation(IOL implantation) femtosecond laser-assisted cataract surgery(FLACS) case report

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Intestinal microecological transplantation for a patient with chronic radiation enteritis:A case report

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World Journal of Gastroenterology 2024年第19期30卷 2603-2611页

作者： Lin Wang Yan Li Yu-Jing Zhang Li-Hua Peng Department of Gastroenterology and Hepatology The First Medical CenterChinese PLA General HospitalBeijing 100853China Department of Gastroenterology and Hepatology Chinese PLA Medical SchoolBeijing 100853China

BACKGROUND The gut microbiota is strongly associated with radiation-induced gut damage.This study aimed to assess the effectiveness and safety of intestinal microecological transplantation for treating patients with chronic radiation enteritis.case SUMMARY A 64-year-old female with cervical cancer developed abdominal pain,diarrhea,and blood in the stool 1 year after radiotherapy.An electronic colonoscopy was performed to diagnose chronic radiation enteritis.Two courses of intestinal microecological transplantation and full-length 16S rRNA microbiological analysis were performed.The patient experienced short-and long-term relief from symptoms without adverse effects.Whole 16S rRNA sequencing revealed significant differences in the intestinal flora’s composition between patient and healthy donors.Pathogenic bacteria,such as Escherichia fergusonii and Romboutsia timonensis,were more in the patient.Beneficial bacteria such as Faecalibacterium prausnitzii,Fusicatenibacter saccharivorans,Ruminococcus bromii,and Bifidobacterium longum were more in the healthy donors.Intestinal microbiota transplantation resulted in a significant change in the patient's intestinal flora composition.The composition converged with the donor's flora,with an increase in core beneficial intestinal bacteria,such as Eubacterium rectale,and a decrease in pathogenic bacteria.Changes in the intestinal flora corresponded with the patients'alleviating clinical symptoms.CONCLUSION Intestinal microecological transplantation is an effective treatment for relieving the clinical symptoms of chronic radiation enteritis by altering the composition of the intestinal flora.This study provides a new approach for treating patients with chronic radiation enteritis.

关键词： Chronic radiation enteritis Gut microbial transplantation Intestinal microecology Cancer Quality of life case report

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case report of Esophageal Rupture, Empyema, and Aortic Dissection Potentially Caused by Severe Vomiting

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Cardiology Discovery 2022年第2期2卷 127-130页

作者： Jiawen Huang Chengfeng Huang Zhaoming Lin Huanan Liu Xiaoshen Zhang Department of Pharmacy First Affiliated HospitalJinan UniversityGuangzhouGuangdong 510630China Department of Cardiovascular Surgery First Affiliated HospitalJinan UniversityGuangzhouGuangdong 510630China.

Both empyema and type A aortic dissection are life-threatening conditions.The combination,though rare,can cause serious complications and death.There have been rare cases of empyema caused by a co-infection with a Gram-positive bacterium,Granulicatella adiacens,which is difficult to identify,and a Gram-negative bacterium,Escherichia coli.In this case,a 50-year-old man was referred to the emergency department due to sudden chest pain and a suspected diagnosis of type A aortic dissection.The patient was subsequently found to have co-morbid empyema and a fissure in the esophagus when the cause of the disease was investigated.Considering the possibility that the patient’s infection was of digestive origin,a combination of Gram-positive and Gram-negative antibiotics was given immediately.Etiological examination later confirmed the presence of Granulicatella adiacens and Escherichia coli in chest drainage fluid,and the patient was successfully treated with antimicrobial therapy and conservative treatment.

关键词： case report Empyema Escherichia coli Granulicatella adiacens Acute aortic dissection

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Primary pancreatic peripheral T-cell lymphoma:A case report

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1668-1675页

作者： Yan-Liang Bai Li-Jie Wang Hui Luo Ya-Bin Cui Jin-Hui Xu Hui-Jie Nan Pei-Yao Yang Jun-Wei Niu Ming-Yue Shi Department of Hematology Zhengzhou University People's Hospital and Henan Provincial People's HospitalZhengzhou 450003Henan ProvinceChina Department of Hematology Henan University People's Hospital and Henan Provincial People's HospitalZhengzhou 450003Henan ProvinceChina Department of Radiation Oncology The Affiliated Cancer Hospital of Zhengzhou UniversityZhengzhou 450008Henan ProvinceChina

BACKGROUND Primary pancreatic lymphoma(PPL)is an exceedingly rare tumor with limited mention in scientific literature.The clinical manifestations of PPL are often nonspecific,making it challenging to distinguish this disease from other panc-reatic-related diseases.Chemotherapy remains the primary treatment for these individuals.case SUMMARY In this case study,we present the clinical details of a 62-year-old woman who initially presented with vomiting,abdominal pain,and dorsal pain.On further evaluation through positron emission tomography-computed tomography,the patient was considered to have a pancreatic head mass.However,subsequent endoscopic ultrasonography-guided fine needle aspiration(EUS-FNA)revealed that the patient had pancreatic peripheral T-cell lymphoma,not otherwise specified(PTCL-NOS).There was a substantial decrease in the size of the pancreatic mass after the patient underwent a cycle of chemotherapy comprised of brentuximab vedotin,decitabine,and oxaliplatin(brentuximab vedotin and Gemox).The patient had significant improvement in radiological findings at the end of the first cycle.CONCLUSION Primary pancreatic PTCL-NOS is a malignant and heterogeneous lymphoma,in which the clinical manifestations are often nonspecific.It is difficult to diagnose,and the prognosis is poor.Imaging can only be used for auxiliary diagnosis of other diseases.With the help of immunostaining,EUS-FNA could be used to aid in the diagnosis of PPL.After a clear diagnosis,chemotherapy is still the first-line treatment for such patients,and surgical resection is not recommended.A large number of recent studies have shown that the CD30 antibody drug has potential as a therapy for several types of lymphoma.However,identifying new CD30-targeted therapies for different types of lymphoma is urgently needed.In the future,further research on antitumor therapy should be carried out to improve the survival prognosis of such patients.

关键词： Pancreatic cancer Lymphoma Chemotherapy Primary pancreatic lymphoma case report

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Acute penetrating injury of the spinal cord by a wooden spike with delayed surgery:a case report

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Neural Regeneration Research 2023年第12期18卷 2781-2784页

作者： James D.Guest Zhuojing Luo Yansheng Liu Hongkun Gao Dianchun Wang Xiao-Ming Xu Hui Zhu Neurological Surgery and the Miami Project to Cure ParalysisMiller School of MedicineUniversity of MiamiMiamiFLUSA Kunming International Spine and Spinal Cord Injury Treatment CenterKunming Tongren HospitalKunmingYunnan ProvinceChina Department of Orthopedic Spinal Surgery Xijing HospitalThe Fourth Military Medical UniversityXi’anShaanxi ProvinceChina Department of Neurosurgery Kunming Tongren HospitalKunmingYunnan ProvinceChina Indiana University School of Medicine Stark Neurosciences Research InstituteIndianapolisINUSA

Rarely,penetrating injuries to the spinal cord result from wooden objects,creating unique challenges to mitigate neurological injury and high rates of infection and foreign body reactions.We report a man who sustained a penetrating cervical spinal cord injury from a sharpened stick.While initially tetraparetic,he rapidly recovered function.The risks of neurological deterioration during surgical removal made the patient reluctant to consent to surgery despite the impalement of the spinal cord.A repeat MRI on day 3 showed an extension of edema indicating progressive inflammation.On the 7~(th)day after injury,fever and paresthesias occurred with a large increase in serum inflammatory indicators,and the patient agreed to undergo surgical removal of the wooden object.We discuss the management nuances related to wood,the longitudinal evolution of MRI findings,infection risk,surgical risk mitigation and technique,an inflammatory marker profile,long-term recovery,and the surprisingly minimal neurological deficits associated with low-velocity midline spinal cord injuries.The patient had an excellent clinical outcome.The main lessons are that a wooden penetrating central nervous system injury has a high risk for infection,and that surgical removal from the spinal cord should be performed soon after injury and under direct visualization.

关键词： case report interleukin-6 magnetic resonance imaging penetrating spinal cord injury wood

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Clinical pathological characteristics of“crawling-type”gastric adenocarcinoma cancer:A case report

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1660-1667页

作者： Yong-Wei Xu Yan Song Jun Tian Ba-Cui Zhang Yu-Sheng Yang Jing Wang Department of Gastroenterology Songjiang HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai 201600China Department of Pathology Songjiang HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai 201600China

BACKGROUND Gastric cancer(GC)is a significant health problem worldwide,and early detection and accurate diagnosis are crucial for improving patient outcomes.Crawling-type gastric adenocarcinoma is a rare subtype of GC that has unique histopathological and clinical characteristics,and its diagnosis and management can be challenging.This pathological type of GC is also rare.case SUMMARY Here,we report the case of a patient who underwent ordinary endoscopy,na-rrow-band imaging,and endoscopic ultrasonography intending to determine the extent of tumor invasion and upper abdominal enhanced computed tomography and whether there was tumor metastasis.Then,endoscopic submucosal dissection was performed.After pathological and immunohistochemical examination,the pathological diagnosis was crawling-type gastric adenocarcinoma.This is a very rare and special pathological type of tumor.This case highlights the importance of using advanced endoscopic techniques and pathological examination in diagnosing and managing gastric crawling-type adenocarcinoma.Moreover,the findings underscore the need for continued research and clinical experience in this rare subtype of GC to improve patient outcomes.CONCLUSION The“crawling-type”GC is a rare and specific tumor pathology.It is difficult to identify and diagnose gliomas via endoscopy.The tumor is ill-defined,with a flat appearance and indistinct borders due to the lack of contrast against the background mucosa.Pathology revealed that the tumor cells were hand-like,so the patient has diagnosed with“crawling-type”gastric adenocarcinoma.

关键词： Clinicopathological Crawling-type gastric Pathology Gastric cancer Gastric adenocarcinoma cancer case report

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Successfully treated recalcitrant atopic eczema with acupoint autohemotherapy:A case report and hypothesized mechanism of the therapy

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Journal of Integrative Medicine 2022年第2期20卷 182-186页

作者： Bin Zhao Yong Chen Shi-min Liao Jian-ying Zheng Shi-hua Yan Dong-shu Zhang Department of Acupuncture Nanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of Acupuncture College of Traditional Chinese MedicineSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of Rheumatology and Immunology Shenzhen People’s Hospitalthe Second Clinical Medical College of Jinan UniversityShenzhen 518020Guangdong ProvinceChina

Acupoint autohemotherapy at bilateral Zusanli(ST36)and Xuehai(SP10)was used to treat a 26-year-old female patient who had suffered from recalcitrant atopic eczema(AE)for five years.The treatment was applied at a frequency of once per week for the first month,followed by a three-month period of once every other week.At the end of treatment,the patient’s AE symptoms were entirely resolved,and by the end of a six-month follow-up her immunoglobulin E level had returned to the normal range.Further,there was no relapse of AE symptoms during the six-month follow-up.Therefore,we hypothesized that after the repeated treatments the local inflammatory reaction induced by autologous blood injection triggered a local immune response,followed by a systemic immune response after the repeated treatment,finally leading to the anti-inflammation and immunomodulation effects.This case suggests that acupoint autohemotherapy could be used as an effective complementary treatment for recalcitrant AE,especially in cases where other treatments have failed.Further comparative studies are needed to corroborate the value and mechanisms of this therapy.

关键词： Acupuncture therapy Autohemotherapy Eczema case report Mechanism

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Myocardial metastasis from ZEB1-and TWIST-positive spindle cell carcinoma of the esophagus:A case report

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World Journal of Gastroenterology 2024年第11期30卷 1636-1643页

作者： Yoshihiro Shibata Hirofumi Ohmura Kazuki Komatsu Kosuke Sagara Atsuji Matsuyama Ryuji Nakano Eishi Baba Department of Medical Oncology Fukuoka Wajiro HospitalFukuoka 811-0213Japan Department of Oncology and Social Medicine Kyushu University Graduate School of Medical SciencesFukuoka 812-8582Japan Department of Pathology and Oncology University of Occupational and Environmental HealthKitakyushu 807-8555Japan Department of Diagnostic Pathology Fukuoka Wajiro HospitalFukuoka 811-0213Japan

BACKGROUND Metastatic cardiac tumors are known to occur more frequently than primary cardiac tumors,however,they often remain asymptomatic and are commonly dis-covered on autopsy.Malignant tumors with a relatively high frequency of cardiac metastasis include mesothelioma,melanoma,lung cancer,and breast cancer,whereas reports of esophageal cancer with cardiac metastasis are rare.case SUMMARY The case of a 60-year-old man who complained of dysphagia is presented.Upper gastrointestinal endoscopy showed a submucosal tumor-like elevated lesion in the esophagus causing stenosis.Contrast-enhanced computed tomography showed left atrial compression due to the esophageal tumor,multiple liver and lung metastases,and a left pleural effusion.Pathological examination of a biopsy speci-men from the esophageal tumor showed spindle-shaped cells,raising suspicion of esophageal sarcoma.The disease progressed rapidly,and systemic chemotherapy was deemed necessary,however,due to his poor general condition,adminis-tration of cytotoxic agents was considered difficult.Given his high Combined Positive Score,nivolumab was administered,however,the patient soon died from the disease.The autopsy confirmed spindle cell carcinoma(SCC)of the esophagus and cardiac metastasis with similar histological features.Cancer stem cell markers,ZEB1 and TWIST,were positive in both the primary tumor and the cardiac metastasis.CONCLUSION To the best of our knowledge,there have been no prior reports of cardiac metastasis of esophageal SCC.This case highlights our experience with a patient with esophageal SCC who progressed rapidly and died from the disease,with the autopsy examination showing cardiac metastasis.

关键词： Spindle cell carcinoma Esophagus Myocardial metastasis Epithelial-mesenchymal transition case report

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Multiple portions enteral nutrition and chyme reinfusion of a blunt bowel injury patient with hyperbilirubinemia undergoing open abdomen:A case report

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Chinese Journal of Traumatology 2023年第4期26卷 236-243页

作者： Kai Wang Yun-Xuan Deng Kai-Wei Li Xin-Yu Wang Chao Yang Wei-Wei Ding Division of Trauma and Surgical Intensive Care Unit Research Insttute of General SurgeryAffliated jinling HospitalMedical Schoolof Nanjing UniversityNanjing20002China The First School of Clinical Medicine Southern Medical UniversityNanjing210002China

Blunt bowel injury(BBI)is relatively rare but life-threatening when delayed in surgical repair or anas-tomosis.Providing enteral nutrition(EN)in BBI patients with open abdomen after damage control surgery is challenging,especially for those with discontinuity of the bowel.Here,we report a 47-year-old male driver who was involved in a motor vehicle collision and developed ascites on post-trauma day 3.Emergency exploratory laparotomy at a local hospital revealed a complete rupture of the jejunum and then primary anastomosis was performed.Postoperatively,the patient was transferred to our trauma center for septic shock and hyperbilirubinemia.Following salvage resuscitation,damage control lapa-rotomy with open abdomen was performed for abdominal sepsis,and a temporary double enterostomy(TDE)was created where the anastomosis was ruptured.Given the TDE and high risk of malnutrition,multiple portions EN were performed,including a proximal portion EN support through a nasogastric tube and a distal portion EN via a jejunal feeding tube.Besides,chyme delivered from the proximal portion of TDE was injected into the distal portion of TDE via a jejunal feeding tube.Hyperbilirubinemia was alleviated with the increase in chyme reinfusion.After 6 months of home EN and chyme reinfusion,the patient finally underwent TDE reversal and abdominal wall reconstruction and was discharged with a regular diet.For BBI patients with postoperative hyperbilirubinemia who underwent open abdomen,the combination of multiple portions EN and chyme reinfusion may be a feasible and safe option.

关键词： Blunt bowel injury Open abdomen Enteral nutrition Chyme reinfusion Hyperbilirubinemia case report

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Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy:A case report and review of literature

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1647-1659页

作者： Ju-Hang Chu Lu-Yao Huang Ya-Ru Wang Jun Li Shi-Long Han Hao Xi Wen-Xue Gao Ying-Yu Cui Ming-Ping Qian Department of General Surgery Shanghai Tenth People's HospitalSchool of MedicineTongji UniversityShanghai 200072China Department of Interventional and Vascular Surgery Shanghai Tenth People's HospitalSchool of MedicineTongji UniversityShanghai 200072China Department of Pathology Shanghai Tenth People's HospitalSchool of MedicineTongji UniversityShanghai 200072China Clinical Research Management Office Shanghai Tenth People’s HospitalShanghai 200072China Department of Cell Biology Institute of Medical GeneticsState Key Laboratory of CardiologyTongji University School of MedicineShanghai 200331China

BACKGROUND Hepatocellular carcinoma(HCC)is one of the leading causes of death due to its complexity,heterogeneity,rapid metastasis and easy recurrence after surgical resection.We demonstrated that combination therapy with transcatheter arterial chemoembolization(TACE),hepatic arterial infusion chemotherapy(HAIC),Epclusa,Lenvatinib and Sintilimab is useful for patients with advanced HCC.case SUMMARY A 69-year-old man who was infected with hepatitis C virus(HCV)30 years previously was admitted to the hospital with abdominal pain.Enhanced computed tomography(CT)revealed a low-density mass in the right lobe of the liver,with a volume of 12.9 cm×9.4 cm×15 cm,and the mass exhibited a“fast-in/fast-out”pattern,with extensive filling defect areas in the right branch of the portal vein and an alpha-fetoprotein level as high as 657 ng/mL.Therefore,he was judged to have advanced HCC.During treatment,the patient received three months of Epclusa,three TACE treatments,two HAIC treatments,three courses of sintilimab,and twenty-one months of lenvatinib.In the third month of treatment,the patient developed severe side effects and had to stop immunotherapy,and the Lenvatinib dose had to be halved.Postoperative pathological diagnosis indicated a complete response.The patient recovered well after the operation,and no tumor recurrence was found.CONCLUSION Multidisciplinary conversion therapy for advanced enormous HCC caused by HCV infection has a significant effect.Individualized drug adjustments should be made during any treatment according to the patient's tolerance to treatment.

关键词： Hepatocellular therapy Conversion hepatectomy Interventional therapy Epclusa Lenvatinib Sintilimab case report

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