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Intracoronary thrombolysis combined with drug balloon angioplasty in a young ST-segment elevation myocardial infarction patient:A case report

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World Journal of Cardiology 2024年第9期16卷 531-541页

作者： Li-Qiong She De-Kui Gao Le Hong Yin Tian Hui-Zhen Wang Sheng Huang department of Critical Care Medicine Jiangyou Second People's HospitalJiangyou 621701Sichuan ProvinceChina department of Cardiology Jiangyou Second People's HospitalJiangyou 621701Sichuan ProvinceChina department of interventional Medicine Jiangyou Second People's HospitalJiangyou 621701Sichuan ProvinceChina

BACKGROUND The combination of acute ST-segment elevation myocardial infarction(STEMI)and gastric ulcers poses a challenge to primary percutaneous coronary intervention(PPCI),particularly for young *** role of drug-coated balloons(DCBs)in the treatment of de novo coronary artery lesions in large vessels remains unclear,especially for patients with *** strategy is to implement drug balloon angioplasty following the intracoronary administration of low-dose prourokinase and adequate *** SUMMARY A 54-year-old male patient presented to the emergency department due to chest pain on June 24,*** the first 3 minutes of the initial assessment in the emergency room,the electrocardiogram(ECG)showed significant *** was atrial fibrillation with ST-segment ***,atrial fibrillation terminated spontaneously and reverted to sinus *** after,the patient experienced *** ECG revealed torsades de pointes ventricular tachycardia.A few seconds later,it returned to sinus ***-sensitivity tropon in I was *** diagnosis was acute *** coronary angiography revealed subtotal occlusion with thrombus formation in the proximal segment of the left anterior descending *** the patient's age and history of peptic ulcer disease,after the intracoronary injection of prourokinase,percutaneous transluminal coronary angioplasty and cutting balloon angioplasty were conducted for thorough preconditioning,and paclitaxel drug-eluting balloon angioplasty was performed without any stents,achieving favorable *** A PPCI without stents may be a viable treatment strategy for select patients with STEMI,and further research is warranted.

关键词： STsegment elevation myocardial infarction Recombinant human prourokinase De novo coronary lesion Large vessels Drug-eluting balloon angioplasty Case report

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Perforated gastric ulcer causing mediastinal emphysema: A case report

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World Journal of Clinical Cases 2024年第4期12卷 859-864页

作者： Zhi-Cheng Dai Xun-Wu Gui Feng-He Yang Hao-Yuan Zhang Wen-Feng Zhang department of General Surgery Mengcheng County First People's HospitalMengcheng 233500Anhui ProvinceChina department of Medical imaging Mengcheng County First People's HospitalMengcheng 233500Anhui ProvinceChina

BACKGROUND Mediastinal emphysema is a condition in which air enters the mediastinum between the connective tissue spaces within the pleura for a variety of *** can be spontaneous or secondary to chest trauma,esophageal perforation,medi-cally induced factors,*** common symptoms are chest pain,tightness in the chest,and respiratory *** mediastinal emphysema patients have mild symptoms,but severe mediastinal emphysema can cause respiratory and circulatory failure,resulting in serious *** SUMMARY A 75-year-old man,living alone,presented with sudden onset of severe epigastric pain with chest tightness after drinking *** to the remoteness of his residence and lack of neighbors,the patient was found by his nephew and brought to the hospital the next morning after the disease *** tomography(CT)showed free gas in the abdominal cavity,mediastinal emph-ysema,and subcutaneous *** gastrointestinal angiography showed that the esophageal mucosa was intact and the gastric antrum was ***,we chose to perform open gastric perforation repair on the patient under thoracic epidural anesthesia combined with intravenous *** operative incision of the muscle layer of the patient's abdominal wall was made,and a large amount of subperitoneal gas was *** a continued incision of the peritoneum revealed the presence of a perforation of approx-imately 0.5 cm in the gastric antrum,which we repaired after pathological ***,the patient received high-flow oxygen and cough *** CT was performed on the first and sixth postoperative days,and the mediastinal and subcutaneous gas was gradually *** After gastric perforation,a large amount of free gas in the abdominal cavity can reach the mediastinum through the loose connective tissue at the esophageal hiatus of the diaphragm,and upper gastrointestinal angiography can clarify the site of *** pat

关键词： Gastric ulcer Perforated Mediastinal emphysema Case report

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A novel neuroprotective method against ischemic stroke by accelerating the drainage of brain interstitial fluid

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Science China Life Sciences 2024年第10期67卷 2213-2223页

作者： Jingge Lian Liu Yang Hanbo Tan Shaoyi Su Leonor Serrano Lopes Fangxiao Cheng Junhao Yan Yu Fu Wanyi Fu Zhaoheng Xie Jianfei Sun Jicong Zhang Zhiqian Tong Yajuan Gao Hongbin Han department of Radiology Peking University Third Hospital Beijing Key Laboratory of Magnetic Resonance imaging Technology Institute of Medical Technology Peking University Health Science Center department of Informatics Technical University of Munich department of Anatomy and Histology School of Basic Medical SciencesPeking University department of Neurology Peking University Third Hospital department of Electronic Engineering Tsinghua University State Key Laboratory of Bioelectronics School of Biological Science and Medical EngineeringSoutheast University School of Biological Science and Medical Engineering Beihang University Key Laboratory of Alzheimer's Disease of Zhejiang Province Institute of AgingSchool of Mental HealthWenzhou Medical University NMPA Key Laboratory for Evaluation of Medical imaging Equipment and Technique

Ischemic stroke is a leading cause of death and disability worldwide. Inflammatory response after stroke determines the outcome of ischemic injury. A recent study has reported an efficient method, epidural arterial implantation(EAI), for accelerating interstitial fluid(ISF)drainage, which provides a promising strategy to clear pro-inflammatory cytokines in the brain extracellular space(ECS). In this study, the method of EAI was modified(m-EAI) to control its function of accelerating the ISF drainage at different time points following ischemic attack. The neuroprotective effect of m-EAI on ischemic stroke was evaluated with the transient middle cerebral artery occlusion(tMCAO)rat model. The results demonstrated the accumulation of IL-1β, IL-6, and TNF-α was significantly decreased by activating m-EAI at 7 d before and immediately after ischemic attack in tMCAO rats, accompanied with decreased infarct volume and improved neurological function. This study consolidates the hypothesis of exacerbated ischemic damage by inflammatory response and provides a new perspective to treat encephalopathy via brain ECS. Further research is essential to investigate whether m-EAI combined with neuroprotective drugs could enhance the therapeutic effect on ischemic stroke.

关键词： ischemic stroke brain extracellular space interstitial fluid modified epidural arterial implantation

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Thoracic spine infection caused by Pseudomonas fluorescens:A case report and review of literature

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World Journal of Clinical Cases 2024年第12期12卷 2099-2108页

作者： Liang Li Bao-Hua Zhang Jin-Feng Cao Li-Jin Zhang Ling-Ling Guo department of Traditional Chinese Medicine Zibo Central HospitalZibo 255000Shandong ProvinceChina department of Pathology Zibo Central HospitalZibo 255000Shandong ProvinceChina department of Medical imaging Zibo Central HospitalZibo 255000Shandong ProvinceChina

BACKGROUND The clinical incidence of spinal infection is gradually increasing,and its onset is insidious,easily leading to missed diagnosis and misdiagnosis,which may lead to serious complications such as nervous system dysfunction,spinal instability and/or deformity,and cause a huge burden on society and *** identification of the causative agent and precision medicine will greatly reduce the suffering of *** present,the main pathogenic bacteria that cause spinal infection are Staphylococcus aureus,Streptococcus,Pneumococcus,Escherichia coli,and *** are no reports of spinal infection caused by Pseudomonas *** SUMMARY We report a 32-year-old female patient with spinal *** presented with flank pain,initially thought to be bone metastases or bone tuberculosis,and had a family background of *** clinical features and changes in imaging and laboratory tests led to the suspicion of thoracic spine *** of the lesion showed inflammation,tissue culture of the lesion was negative several times,and the possible pathogen-Pseudomonas fluorescens was found after gene sequencing of the *** patient recovered completely after a full course of antibiotic *** This report increases the range of pathogens involved in spinal infections,highlights the unique advantages of gene sequencing technology in difficult-todiagnose diseases,and validates conservative treatment with a full course of antibiotics for spinal infections without complications.

关键词： Thoracic spine infection Pseudomonas fluorescens Spinal infection Case report

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Strain-dependent alpha-synuclein spreading in Parkinson's disease and multiple system atrophy

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Neural Regeneration Research 2024年第12期19卷 2581-2582页

作者： Shuyu Zhang Paul Lingor department of Neurology School of MedicineUniversity Hospital rechts der IsarTechnical University of MunichMunichGermany department of Neurology University Medical Center GöttingenGöttingenGermany Center for Biostructural imaging of Neurodegeneration University Medical Center GöttingenGöttingenGermany

Parkinson's disease(PD) and atypical Parkinsonian syndromes,such as multiple system atrophy(MSA) and Dementia with Lewy bodies,are neurodegenerative movement disorders characterized by the accumulation of alphasynuclein(a-syn) *** a-syn aggregates propagate throughout the brain in a prion-like manner,where pathological a-syn recruits endogenous a-syn to form insoluble *** forms representing intermediates on the way to insoluble aggregates result in the most pronounced neurotoxic effects.

关键词： atrophy endogenous atypical

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Spontaneous intra-abdominal hematomas in a hepatocellular carcinoma patient treated with lenvatinib:a case report

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Oncology and Translational Medicine 2024年第2期10卷 99-102页

作者： Hong Ma Jun-Feng Li An-Rong Wang Yong Tan Guang-Jin Yuan department of Oncology the People's Hospital of Dianjiang ChongqingChina department of interventional Therapy the People's Hospital of Dianjiang ChongqingChina

A 44-year-old patient was admitted with tumor rupture in the left hepatic lateral lobe,and he underwent emergent exploratory laparotomy and proceeded for hepatic left lateral lobectomy on September 19,*** final diagnosis of hepatocellular carcinoma was confirmed by histopathological examination of the surgical ***,the patient received hepatic arterial infusion chemotherapy with FOLFOX(oxaliplatin,fluorouracil,and leucovorin)for 5 ***,recurrence of the hepatocellular carcinoma was diagnosed in the abdominal *** patient was then treated with *** less than 1 month of the treatment with lenvatinib,the patient was admitted to the emergency room on June 2,2022,because of acute intra-abdominal bleeding(hematomas).Percutaneous intra-abdominal angiography found that the bleeding vessels were the right gastroepiploic artery and left gastric *** patient was stabilized after arterial embolization using gelatin *** diagnosis and management of spontaneous intra-abdominal hematomas are discussed.

关键词： Arterial embolization Hematomas Hepatocellular carcinoma Lenvatinib

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Ultrasound of the Rotator Cuff in Non-Fractured Shoulder Trauma: 30 Cases at the Yalgado Ouedraogo University Hospital of Ouagadougou (Burkina Faso)

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Open Journal of Medical imaging 2024年第2期14卷 64-71页

作者： Milckisédek Judicaël Marouruana Some Aïda Ida Tankoano Pakisba Ali Ouedraogo Ladouon Sylvie Simboro Bassirou Kindo Siaka Ben Aziz Dao Rabiou Cisse department of Medical imaging The Ouahigouya Regional University Hospital University of Ouahigouya Ouahigouya Burkina Faso department of Medical imaging Souro Sanou University Hospital Nazi Boni University Bobo Dioulasso Burkina Faso department of Medical imaging Workers Health Office Ouagadougou Burkina Faso department of Medical imaging Yalgado Oudraogo University Hospital Joseph Ki Zerbo University Ouagadougou Burkina Faso

Introduction: Ultrasound is the imaging technique of choice for the study of rotator cuff lesions. However, in the case of shoulder trauma, it is rarely requested in our context. This study aimed to show ultrasound lesions of the rotator cuff in cases of non-fracture shoulder trauma at the CHUYO in Ouagadougou. Methodology: This was a prospective descriptive cross-sectional study running from August 1 to November 30, 2017, in the medical imaging department of CHUYO. The study population consisted of patients received in the department for ultrasound in the context of non-fracture shoulder trauma. Results: We collected 20 cases (66.67%) of rotator cuff lesions out of 30 non-fracture shoulder injuries. The mean age of the patients was 27.6 years. Road traffic accidents accounted for 60% of injuries, sports accidents for 30%, and domestic accidents for 10%. Ultrasound lesions were mainly tendon ruptures (36.67%) and tendinitis (23.33%). Ruptures were non-transfixing in 90.90% of cases. The supraspinatus was the most affected (81.81%). Conclusion: Ultrasound can help diagnose rotator cuff injuries, particularly in non-fractured shoulder trauma.

关键词： Traumatic Shoulder Rotator Cuff Ultrasound

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Preliminary clinical application of total free-breathing cardiac MR examination

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中国医学影像技术 2024年第8期40卷 1183-1188页

作者： YANG Kai YIN Gang AN Jing YANG Xinling LAN Tian ZHAO Shihua LU Minjie department of Magnetic Resonance imaging Fuwai HospitalNational Center for Cardiovascular DiseasesPeking Union Medical College and Chinese Academy of Medical SciencesBeijing 100037China Siemens Shenzhen Magnetic Resonance Ltd. Shenzhen 518057China Key Laboratory of Cardiovascular imaging Chinese Academy of Medical SciencesBeijing 100730China

Objective To observe the clinical application value of total free-breathing cardiac MR(CMR)examination *** Two patients who underwent CMR scanning under free-breathing state,including cine,motion correction T1 and T2 mapping,blood flow imaging,and late gadolinium enhancement scanning were retrospectively enrolled,and the qualities of the above images were evaluated and compared with that of conventional CMR images under breath-holding *** No significant difference of imaging quality was found between total free-breathing and conventional breath-holding *** differences of left ventricular ejection fraction,cardiac output,left ventricular end-diastolic volume index and left ventricular mass measured based on CMR images under different breath conditions were *** Total free-breathing CMR was feasible in clinical practice,which could provide"one-stop"evaluation of cardiac structure,function and myocardial histological characteristics,hence having promising clinical prospects.

关键词： heart magnetic resonance imaging respiratory motion motion correction

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Dynamics of glutamine synthetase expression in hepatic ischemiareperfusion injury: Implications for therapeutic interventions

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World Journal of Hepatology 2024年第8期16卷 1177-1184页

作者： Zhi-Hao Huang Meng-Qi Dong Feng-Yong Liu Wei-Jie Zhou State Key Laboratory of Organ Failure Research Department of General SurgeryGuangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal TumorNanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina department of interventional Radiology Senior Department of OncologyFifth Medical Center of PLA General HospitalBeijing 100853China

BACKGROUND Hepatic ischemia-reperfusion injury(IRI)poses a great challenge in liver surgery and transplantation because of oxidative stress and inflammatory *** changes in glutamine synthetase(GS)expression during hepatic IRI remain *** To investigate the dynamic expression of GS during hepatic *** Following hepatic ischemia for 1 h and reperfusion,liver tissue samples were collected at 0.5,6,and 24 hours postreperfusion for fixation,embedding,*** and eosin staining and GS staining were *** GS expression rapidly decreases in hepatocytes around the central vein after IRI,reaching its lowest point at 6 hours postreperfusion,and then gradually *** GS is highly sensitive to IRI,highlighting its potential role as an indicator of liver injury states and a target for therapeutic intervention.

关键词： Hepatic ischemia-reperfusion Glutamine synthetase Central vein Liver Injury repair

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Generative pretrained transformer 4:an innovative approach to facilitate value-based healthcare

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Intelligent Medicine 2024年第1期4卷 10-15页

作者： Han Lyu Zhixiang Wang Jia Li Jing Sun Xinghao Wang Pengling Ren Linkun Cai Zhenchang Wang Max Wintermark department of Radiology Capital Medical University Affiliated Beijing Friendship HospitalBeijing 100050China department of Medical imaging Capital Medical University Affiliated Beijing Friendship HospitalBeijing 100050China School of Biological Science and Medical Engineering Beihang UniversityBeijing 100191China department of Neuroradiology University of Texas MD Anderson CenterHoustonTX 77030USA

Objective Appropriate medical imaging is important for value-based *** aim to evaluate the performance of generative pretrained transformer 4(GPT-4),an innovative natural language processing model,providing appropriate medical imaging automatically in different clinical *** Institutional Review Boards(IRB)approval was not required due to the use of nonidentifiable ***,we used 112 questions from the American College of Radiology(ACR)Radiology-TEACHES Program as prompts,which is an open-sourced question and answer program to guide appropriate medical *** included 69 free-text case vignettes and 43 simplified *** the performance evaluation of GPT-4 and GPT-3.5,we considered the recommendations of ACR guidelines as the gold standard,and then three radiologists analyzed the consistency of the responses from the GPT models with those of the *** set a five-score criterion for the evaluation of the consistency.A paired t-test was applied to assess the statistical significance of the *** For the performance of the GPT models in free-text case vignettes,the accuracy of GPT-4 was 92.9%,whereas the accuracy of GPT-3.5 was just 78.3%.GPT-4 can provide more appropriate suggestions to reduce the overutilization of medical imaging than GPT-3.5(t=3.429,P=0.001).For the performance of the GPT models in simplified scenarios,the accuracy of GPT-4 and GPT-3.5 was 66.5%and 60.0%,*** differences were not statistically significant(t=1.858,P=0.070).GPT-4 was characterized by longer reaction times(27.1 s in average)and extensive responses(137.1 words on average)than *** As an advanced tool for improving value-based healthcare in clinics,GPT-4 may guide appropriate medical imaging accurately and efficiently。

关键词： Generative pretrained transformer 4 model Natural language processing Medical imaging Appropriateness

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