Objective To investigate the clinical features of patients with liver cirrhosis complicated by portal vein thrombosis (PVT) and related risk factors.Methods A total of 65 patients with liver cirrhosis complicated by PVT who were diagnosed and treated from June 2013 to June 2015 were enrolled as PVT group,and 70 cirrhotic patients without PVT were enrolled as controls (non-PVT group).The data collected included general information,results of laboratory examination,imaging findings,clinical manifestations,and complications.The clinical features were compared between the two groups,and related risk factors were screened out.Results There were no significant differences between the PVT group and non-PVT group in age,sex,nation,etiology,white blood cell count,platelet count,international normalized ratio,activated partial thromboplastin time,fibrinogen,serum creatinine,total bilirubin,and the diameter of the splenic vein (allP ＞ 0.05),while between these two groups,there were significant differences in D-dimer (1.87±1.45 mg/ml vs 0.55±0.58mg/ml,P ＜ 0.05),fibrinogen degradation product (FDP) level (18.57±19.46 μg/ml vs 5.45±6.00 μg/ml,P ＜ 0.05),hemoglobin (99.32±26.73 g/L vs 112.64±25.03 g/L,P ＜ 0.05),albumin (28.51±5.19 g/L vs 33.07±7.94 g/L,P ＜0.05),the diameter of the portal vein (12.53±2.70 mm vs 11.17±1.79 mm,P ＜ 0.05),spleen thickness (5.12±0.95cm vs 4.56±0.83 cm,P ＜ 0.05),spleen length (15.35±3.21 cm vs 13.86±2.82 cm,P ＜ 0.05),and Child-Pugh score (7.66±2.06 vs 6.93±1.87,P ＜ 0.05).The two groups showed no significant differences in diarrhea,ileus,hepatorenal syndrome,and hepatic encephalopathy (P ＞ 0.05),but showed significant differences in abdominal pain (18 vs 7 cases,P ＜ 0.05),fever (17 vs 4 cases,P ＜ 0.05),esophageal variceal bleeding (22 vs 9 cases,P ＜0.05),and spontaneous peritonitis (24 vs 12 cases,P ＜ 0.05).D-dimer (OR =4.290,P ＜ 0.000) and mean platelet volume (OR =1.294,P =0.023) were independent risk factors for PVT in patients with liver cirrhosis.Conclusion Cirrhotic patients with a high degree of liver cirrhosis,high levels of D-dimer and FDP and a large diameter of the portal vein tend to have a high incidence rate of PVT.PVT can aggravate the clinical symptoms and significantly increase complications in patients with liver cirrhosis.An increased D-dimer level and a greater width of the main portal vein are independent risk factors for PVT in patients with liver cirrhosis.

Objective:To explore the structural alterations in functional brain areas of patients with diabetic peripheral neuropathy (DPN) using voxel-based morphometry (VBM), and to investigate the abnormal region of grey matter and its distribution in DPN.Methods:A total of 124 patients with DPN and 88 patients with type 2 diabetes without DPN (NDPN) diagnosed in Haikou Hospital and the First Affiliated Hospital of Guangdong Pharmaceutical University from June 2019 to December 2020 were selected as the study subjects, and 40 healthy volunteers matched with gender and age were included as the control group.All subjects underwent whole-brain MRI examination, and 3D-T1WI data were collected for post-processing and analysis based on voxel morphological analysis.Results:Compared with NDPN patients, decreased gray matter volume in DPN patients was observed in the bilateral anterior central gyrus and thalamus, with statistical signifcant difference ( P<0.05), and there was no significant difference between the two sides ( P>0.05). Compared with healthy control group, decreased gray matter volume in DPN was observed in the the bilateral anterior central gyrus, central posterior gyrus, superior frontal gyrus and thalamus, with statistical signifcant difference ( P<0.05) and there was no significant difference between the two sides ( P>0.05). Conclusions:DPN patients also have decreased volumes of the brain greymatter, suggesting that the occorrence of DPN patients may be caused by the of injury of central structure.

Objective To investigate the risk factors of progressive motor deficit (PMD) in patients with acute middle cerebral artery occlusion (MCAO) beyond thrombolysis time.Methods The clinical data of 123 patients with acute MCAO beyond thrombolysis time,admitted to our hospital from March 2015 to March 2017,were analyzed retrospectively.According to whether patients having National Institute of Health Stroke Scale (NIHSS) scores increased＞2 within 5 d of admission and continued for 24 h,these patients were divided into two groups:PMD group and non-PMD group.Single factor analysis was performed on all clinical parameters that might influence PMD;in addition,the influencing factors of PMD were analyzed by multiple factor Logistic regression analysis.Results Fifty-one patients (41.5％) had PMD and 72 patients (58.5％) did not have PMD.Single factor analysis showed that the differences of randomized blood glucose level,ratio of patients with PH2 type hemorrhagic transformation,intracurricular infarct pattern,radiation crown infarct and collateral circulation pathway between the PMD group and the non-PMD group were statistically significant (P＜0.05).Multiple factor Logistic regression analysis showed that ratio of patients with PH2 type hemorrhagic transformation,radiation infarct site,internal watershed infarct model and collateral circulation pathway were significantly correlated to PMD (OR=2.857,95％CI:1.037-7.869,P=0.042;OR=2.585,95％CI:1.219-5.481,P=0.013;OR=2.876,95％CI:1.327-6.232,P=0.007;OR=2.332,95％CI:1.120-4.867,P=).024).Conclusion PH2 type hemorrhagic transformation,corona radiate infarct,intemal watershed infarct model and insufficient collateral circulation pathway are the important risk factors of PMD in patients with acute MCAO beyond thrombolysis time.