Objective To investigate the curative effect of interventional therapy on postoperative multiple metastases of breast cancer.Methods A total of 15 patients with multiple metastases after breast cancer surgery were treated with interventional therapy.After comprehensive evaluation,all patients were treated with chemoembolization.The therapeutic regimen was docetaxel loaded on drug-eluting bead(DEB)combined with carboplatin,once in 1 d for 21 d,2 times in total,and then the regimen was changed to docetaxel and carboplatin combined with ordinary embolization microspheres,once in 1 d for 21 d,4 times in total.CT/MRI was performed on every 2 cycles and 1,3,and 6 months after interventional therapy to evaluate its efficacy and record adverse reactions.Results The overall remission rate(ORR)at 3 months after treatment was 75％,and the disease control rate(DCR)was 91.7％.The ORR and DCR at 6 months after treatment were 50％and 83.3％,respectively.Most of the common adverse reactions were below grade Ⅲ.Conclusion Interventional therapy for multiple metastases of breast cancer after operation has a definite short-term effect,with little adverse reactions.It is worthy of further promotion in the comprehensive treatment of postoperative metastases of breast cancer.

Objective:To explore the clinical manifestations, diagnosis and treatment methods, and prognosis of hepatic portal venous gas (HPVG).Methods:Retrospective case analysis was used in the case data of 7 patients with HPVG, who were treated in Lishui Central Hospital from January 2017 to July 2024, including 5 males and 2 females. Age ranged from 46 to 90 years, with an average age of 69 years. Abdominal pain was the first manifestation in 6 cases, and septic shock occurred in 2 cases. The initial symptoms, primary diseases, comorbidities, laboratory results, imaging examinations, treatment plans, and prognosis were analyzed. Prognostic follow-up was conducted by telephone, with the focus on whether the patient had experienced HPVG recurrence and postoperative complications. The deadline for follow-up was July 31, 2024.Results:All patients had elevated white blood cells and C-reactive protein (CRP), and prothrombin time was prolonged in 4 patients. pH and base excess decreased in 4 cases, and lactic acid increased in 5 cases. Alanine aminotransferase increased in 2 cases, and total bilirubin increased in 3 cases. Blood culture was positive in 3 cases. Contrast-enhanced abdominal CT showed clear gas shadows in the portal vein and its branches in all 7 cases, which were confined to the left liver in 4 cases and distributed in both sides of the liver in 3 cases. The primary diseases were intestinal obstruction and necrosis in 4 cases, intestinal perforation and necrosis in 1 case, inflammatory bowel disease in 1 case, and acute pancreatitis in 1 case. Five patients were complicated with hypertension, diabetes and other diseases. Two patients received surgical treatment, and the average time from surgery to diagnosis was 6.8 h. Five cases received conservative treatment, 2 cases were cured and 3 cases died, with an average time from onset to death of 21.2 h.Conclusions:Contrast-enhanced abdominal CT should be the preferred method for the diagnosis of HPVG. The primary disease and its severity should be fully evaluated in the treatment of HPVG. Patients with intestinal necrosis should undergo laparotomy as soon as possible, and enterostomy should be performed during the operation. Clinicians should strengthen the awareness of HPVG in order to improve the prognosis of patients.

Objective:To explore the clinical manifestations, diagnosis and treatment methods, and prognosis of acute portal vein thrombosis after hepatectomy.Methods:Retrospective case analysis was used in the case data of 11 patients with acute portal vein thrombosis after hepatectomy, who were treated in Lishui Central Hospital of Zhejiang Province from January 2018 to August 2023, including their demographic characteristics, clinical manifestations, test results, imaging examinations, treatment plans, and prognosis.Results:The diagnostic time of PVT was 4-15 days after surgery. 5 cases were main portal vein thrombosis, including 2 cases who were accumulated splenic vein and superior mesenteric vein, and 6 cases were portal vein branch thrombosis. 2 cases had fever, 3 cases had abdominal distension, 3 cases had ascites, and 5 cases had no obvious clinical symptoms. Patients may experience elevated bilirubin, elevated transaminase, prolonged prothrombin time, and elevated D-2 dimer levels during PVT. 10 cases were diagnosed through CT enhancement, and 1 case was first diagnosed through ultrasound examination. 11 patients who diagnosed with PVT were received anticoagulant therapy, with 6 patients receiving a combination of circulatory improvement drugs. One patient progressed to liver failure, and 10 patients had thrombus disappearance, who were receivedsatisfactory clinical efficacy.Conclusions:Early detections and treatments are the key to treating the acute PVT after hepatectomy. If possible, anticoagulant therapy should be used as soon as possible after surgery. For main grade 3 portal vein thrombosis, early surgical thrombectomy should be considered. At present, there is a lack of effective prevention and prediction methods for acute PVTafter hepatectomy, and thefurther research and exploration are needed.

Lateral epicondylitis is a common clinical disease with characteristics of lateral elbow pain, insidious onset and easy recurrence, which can cause forearm pain and decreased wrist strength, seriously affecting patients′ daily life and work. Although there are various treatment methods for lateral epicondylitis with different effects, standard treatments are still lacking nowadays. Platelet-rich plasma (PRP) has good effects on bone and tendon repair, and is now widely used in the treatment of lateral epicondylitis. However, there is a lack of a unified understanding of the technology and specifications of PRP in the treatment of lateral epicondylitis. Therefore, the Sports Medicine Branch of the Chinese Medical Association and Physical Medicine and Rehabilitation Branch of the Chinese Medical Association organized experts in the fields of sports medicine and rehabilitation medicine in China to formulate the "clinical expert consensus on platelet-rich plasma treatment for lateral epicondylitis (2022 version)", and proposed suggestions based on evidence-based medicine mainly from the concept, epidemiology and pathophysiology of lateral epicondylitis, symptoms, signs and imaging manifestations of lateral epicondylitis, PRP concept and application component requirements, quality control of PRP preparation technology, indications and contraindications of PRP in the treatment of lateral epicondylitis, PRP injection in the treatment of lateral epicondylitis, application of PRP in the operation of lateral epicondylitis, related problems after PRP treatment of lateral epicondylitis, evaluation of the results after PRP treatment of lateral epicondylitis, and health and economic evaluation of PRP treatment of lateral epicondylitis, so as to provide guidance for clinical diagnosis and treatment.

Objective:To analyze the risk factors of stress perception in patients with systemic lupus erythematosus (SLE) , and construct and validate a risk prediction model for health risk stress perception in SLE patients.Methods:This study is a cross-sectional study. From October 2020 to March 2021, totals of 310 SLE inpatients and outpatients in the Department of Rheumatology and Immunology from 4 general hospitals in Anhui Province were selected as the modeling object. According to the patients' stress perception score, they were divided into the group with health risk stress ( n=132) and the group without health risk stress ( n=178) . The general data, SLE disease activity, general self-efficacy, emotional intelligence, resilience, sleep disturbance, anxiety, depression were compared between the two groups, and independent risk factors were screened out and Logistic regression was used to construct a risk prediction model. Hosmer-Lemeshow and receiver operator characteristic curve (ROC) area were used to test the fit and prediction effect of the model, respectively, and 206 patients were included for model validation. Results:Binary Logistic regression analysis showed that SLE disease activity, resilience, anxiety, payment type, and family monthly income were the influencing factors of stress perception in SLE patients, and the difference was statistically significant ( P<0.05) . Hosmer-Lemeshow fit test showed χ 2=6.123, P=0.633. Besides, the area under the ROC, maximum Youden index, predictive critical value, sensitivity and specificity were 0.903, 0.660, 0.497, 0.795 and 0.865 respectively. Conclusions:This study is based on five independent risk factors of SLE patients' stress perception, namely SLE disease activity, resilience, anxiety, payment type, and family monthly income. The risk prediction model has good sensitivity and specificity, which can provide a reference for clinical assessment of health risk stress perception in SLE patients.

Objective:To investigate the effects of poly (ADP-ribose) polymerase-1(PARP-1) in intestinal mucosal barrier injury in rat model with severe acute pancreatitis (SAP).Methods:Twenty healthy male Wistar rats were divided into four groups ( n=5 each group) using a random table method: control, SAP, 3-aminobenzamide (3-AB), and 3-AB control groups. The SAP model was induced by intraperitoneal injection of cerulean with lipopolysaccharide. At 30 min, the rats were treated with the PARP-1 inhibitor, 3-AB, or normal saline,separately. After 12 h, all rats were sacrificed to harvest pancreas tissues, intestines tissues, and blood from the hearts for index detection. Serum amylase (AMY) and interleukin (IL)-6 levels were measured using an automatic biochemical instrument and enzyme-linked immunosorbent assay (ELISA), respectively.The protein expression of PARP-1 and nuclear factor (NF-κB) were measured using Western blot and that of occludin was measured using an immunohistochemical test. One-way analysis of variance was used for comparison of multiple groups of variables. Non-parametric tests of rank conversion were used when variances were not uniform. A P <0.05 was considered statistically significant. Results:Compared to the control group, the following indexes in the SAP group were significantly increased: ascites (with serious hemorrhage and necrosis in the pancreas and disordered intestinal villi),serum AMY and IL-6 levels, and the expression of PARP-1 and NF-κB. However, Occludin expression was significantly decreased. There was no significant difference between 3-AB group and 3-AB control group. Compared to the SAP group, the severity of SAP and pancreatitis-associated intestinal injury was significantly attenuated with the administration of 3-AB. Serum AMY and IL-6 levels were significantly decreased (serum AMY: 1 879.25 ± 736.6 U/L vs 5 569.33 ± 1993.48 U/L; IL-6: 77.98 ± 20.65 pg/mL vs 209.14 ± 79.08 pg/mL, both P<0.05), but the expression of PARP-1 and NF-κB were significantly increased (PARP-1: 1.44 ± 0.09 vs 1.49 ± 0.13; NF-κB: 0.63 ± 0.09 vs 0.96±0.08, both P<0.05). Similarly, Occludin expression was significantly decreased (6.7±1.5 vs 3.2±1.1, P<0.05). Conclusions:Inhibition of PARP-1 has protective effects on SAP associated intestinal mucosal barrier damage. The mechanism may be related to the inhibition of NF-κB signaling pathway and increase intestinal mucosal Occludin protein expression.

Objective To evaluate the effect of Weisu granule combined with conventional therapy in treatment of chronic atrophic gastritis (CAG). Methods A total of 99 CAG patients who met the inclusion criteria were randomly divided into control group (49 cases) and observation group (50 cases) according to random number table method. The control group was treated with quadruple therapy, while the observation group was treated with Weisu granule on the basis of the control group. Both groups were treated for 90 days. Interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α) were detected by ELISA. The scores of TCM symptoms between the two groups before and after treatment were compared. Adverse reactions during treatment were observed and recorded. The eradication rate of H.pylori was measured by 14C urea breath test, and the clinical efficacy was evaluated. Results The total effective rate was 92.0% (46/50) in the observation group and 73.5% (36/49) in the control group. There were significant differences between the two groups (χ2=5.975, P=0.015). After treatment, the level of serum IL-6, hs-CRP and TNF-α in the observation group was significantly lower than those in the control group (t=7.112, 7.753, 9.310, respectively, all P<0.01). After treatment, the scores of symptoms such as abdominal distension and pain, emotional disturbance, hypochondrium pain and belching in both groups decreased (P<0.01), and those in the observation group was significantly lower than those in the control group (t=12.892, 12.451, 10.596, respectively, P<0.01). The eradication rate of H.pylori was 90.0% (45/50) in the observation group and 24.5% (12/49) in the control group. There was a significant difference between the two groups (χ2=43.381, P<0.01). Conclusions The Weisu granule combined with quadruple therapy has a definite theraputic effect. It can improve the clinical symptoms of patients, improve the clearance rate of H.pylori, and alleviate inflammation.

Objective To explore the effect of supplemental parenteral nutrition (SPN) combined with early enteral nutrition (EN) for enhanced recovery in postoperative liver cancer patients.Methods From June 2015 to June 2018,liver cancer patients admitted to our hospital were randomly divided into two groups with 47 patients receiving SPN combined with early EN in the study group and 45 patients receiving early EN in the control group.Results There were no significant difference in bilirubin recovery,liver enzyme recovery,postoperative exhaust and defecation time and complication rate between the two groups (P ＞ 0.05).In study group prealbumin (PAB) synthesis recovered faster (F =7.89,P =0.006),albumin use was significantly lower (t =-2.29,P =0.0024),and postoperative hospital stay was shorter (t =2.46,P =0.016).Conclusion In ERAS patients with liver cancer,the combination of SPN and early EN provide reasonable energy support to improve nutritional status and accelerate patient recovery.

Owing to its great medicinal and ornamental values, is frequently adulterated with other species on the market. Unfortunately, the utilization of the common DNA markers ITS, ITS2, and + is unable to distinguish from 5 closely related species of it (, , , and ). Here, we compared 63 plastomes comprising 40 newly sequenced plastomes of the 6 species and 23 previously published plastomes. The plastomes of and its closely related species were shown to have conserved genome structure and gene content. Comparative analyses revealed that small single copy region contained higher variation than large single copy and inverted repeat regions, which was mainly attributed to the loss/retention of genes. Furthermore, the intraspecific sequence variability among different species was shown to be diversified, which necessitates a cautious evaluation of genetic markers specific for different species. By evaluating the maximum likelihood trees inferred from different datasets, we found that the complete plastome sequence dataset had the highest discriminatory power for and its closely related species, indicating that complete plastome sequences can be used to accurately authenticate species.