Objective To analyze the characteristics of adverse events of disposable hemoperfusion devices in real-world clinical practice using multicenter data,and to investigate the influencing factors of hypotension,providing evidence for the safe clinical use of these devices.Methods An observational study was conducted involving patients who received disposable hemoperfusion therapy across 17 sentinel hospitals in China from June 2022 to July 2024.Device-related adverse events were monitored and analyzed.Descriptive statistics,Firth's Logistic regression model,and balanced random forest model were applied to systematically evaluate the manifestations of adverse events and the risk factors for the occurrence of hypotension.Results A total of 17,824 usage records were included.In the sentinel hospital data,hypotension[0.19％,95％CI(0.14％,0.27％)]and hemoperfusion occlusion[0.13％,95％CI(0.09％,0.19％)]occupied the highest incidence rate.The Firth's Logistic regression analysis revealed that end-stage renal disease with comorbidities significantly increased hypotension risk(OR=77.324),while no prior medical history was protective(OR=0.061).Stepwise blood purification modalities(hemoperfusion alone or sequential hemoperfusion-hemodialysis)significantly reduced the hypotension risk compared with simultaneous hemoperfusion and hemodialysis(OR=0.003).The random forest model further confirmed that blood purification modality was the strongest influencing factor for hypotension.Conclusion In real-world clinical settings,hypotension and device occlusion were the predominant adverse events,with blood purification modality critically influencing hypotension risk.Stepwise blood purification is recommended to mitigate this risk.Enhancing clinical operating procedures and device design is essential to improve overall treatment safety.

Objective To analyze the characteristics of adverse events of disposable hemoperfusion devices in real-world clinical practice using multicenter data,and to investigate the influencing factors of hypotension,providing evidence for the safe clinical use of these devices.Methods An observational study was conducted involving patients who received disposable hemoperfusion therapy across 17 sentinel hospitals in China from June 2022 to July 2024.Device-related adverse events were monitored and analyzed.Descriptive statistics,Firth's Logistic regression model,and balanced random forest model were applied to systematically evaluate the manifestations of adverse events and the risk factors for the occurrence of hypotension.Results A total of 17,824 usage records were included.In the sentinel hospital data,hypotension[0.19％,95％CI(0.14％,0.27％)]and hemoperfusion occlusion[0.13％,95％CI(0.09％,0.19％)]occupied the highest incidence rate.The Firth's Logistic regression analysis revealed that end-stage renal disease with comorbidities significantly increased hypotension risk(OR=77.324),while no prior medical history was protective(OR=0.061).Stepwise blood purification modalities(hemoperfusion alone or sequential hemoperfusion-hemodialysis)significantly reduced the hypotension risk compared with simultaneous hemoperfusion and hemodialysis(OR=0.003).The random forest model further confirmed that blood purification modality was the strongest influencing factor for hypotension.Conclusion In real-world clinical settings,hypotension and device occlusion were the predominant adverse events,with blood purification modality critically influencing hypotension risk.Stepwise blood purification is recommended to mitigate this risk.Enhancing clinical operating procedures and device design is essential to improve overall treatment safety.

Objective:To investigate the efficacy and safety of combined catheter-directed thrombolysis and anticoagulation for acute pulmonary embolism combined with lower limb deep vein thrombosis.Methods:A retrospective analysis was conducted using a case-control study approach on the clinical data of 58 patients with acute pulmonary embolism who received treatment at the Inner Mongolia Autonomous Region People's Hospital from August 2021 to August 2023. These patients were categorized into two groups based on whether they had lower-limb deep vein thrombosis or not. The group with pulmonary embolism alone ( n = 14) underwent targeted catheter thrombolysis in combination with anticoagulation treatment using low molecular-weight heparin. The group with both pulmonary embolism and deep vein thrombosis in the lower limbs (combined group, n = 44) received inferior vena cava filter placement, along with targeted catheter thrombolysis and anticoagulation treatment with low-molecular weight heparin. The improvement in pulmonary circulation was observed before and after the surgical interventions in both groups. A comparison was made regarding the improvement in indicators including arterial oxygen pressure, fingertip oxygen saturation, the proportion of pulmonary artery trunk thrombosis area to pulmonary artery trunk area, and respiratory rate, both before and after pulmonary artery catheterization and thrombolysis in both groups. Results:The surgery was successful for all patients. The symptom of shortness of breath was obviously relieved after surgery. After surgery, in the pulmonary embolism alone group, the respiratory rate was (22.75 ± 4.38) beats/min, the mean pulmonary artery pressure was (32.53 ± 3.63) mmHg (1 mmHg = 0.133 kPa), the arterial oxygen partial pressure was (81.46 ± 7.24) mmHg, and the fingertip oxygen saturation was (90.53 ± 4.57)%, respectively. In the combined group, the respiratory rate, mean pulmonary artery pressure, arterial oxygen partial pressure, and fingertip oxygen saturation were (23.35 ± 5.8) beats/min, (31.34 ± 4.53) mmHg, (82.34 ± 4.62) mmHg, and (92.57 ± 3.45)%, respectively. After surgery, the respiratory rate, pulmonary artery pressure, arterial oxygen partial pressure, and fingertip oxygen saturation in each group were significantly higher compared with the corresponding levels before surgery ( t = 6.33, 12.12, 17.32, 8.13, 6.86, 13.02, 15.52, 7.20, all P < 0.001). The proportion of pulmonary artery trunk thrombosis area to pulmonary artery trunk area in the group with pulmonary embolism alone was (19.56 ± 7.53)%, while in the combined group, it was (20.63 ± 4.83)%. After surgery, the proportion of pulmonary artery trunk thrombosis area to pulmonary artery trunk area in each group decreased compared with the corresponding value before surgery ( t = 19.36, 18.23, both P < 0.001). Conclusion:The surgical method combining catheter-directed thrombolysis with inferior vena cava filter placement is effective and safe for the treatment of acute pulmonary embolism combined with deep vein thrombosis in the lower limbs.

Objective To evaluate the efficacy and safety of polyene phosphatidylcholine injection in the treatment of liver disease.Methods Pubmed,Embase,The Cochrane Library,ClinicalTrial.gov,CNKI,SinoMed,VIP,and WanFang Data were electronically searched to collect randomized controlled trials(RCTs)of polyene phosphatidylcholine injection in the treatment of liver disease from inception to December 31st,2022.Two researchers independently screened literature,extracted data and assessed the risk of bias of the included studies.The Meta-analysis was performed using Stata 17.0 software.Results A total of 10 RCTs were included,including 809 patients.Meta-analysis showed that the effective rate in the polyene phosphatidylcholine injection group was higher than that in the control group(RR=1.12,95％CI 1.04 to 1.20,P=0.003 8).Compared with the control group,polyene phosphatidylcholine injection could decrease ALT level(MD=-18.92 U/L,95％CI-27.75 to-10.09,P＜0.001),AST level(MD=-31.19 U/L,95％CI-46.27 to-16.11,P=0.000 1),TBiL level(MD=-7.31 μmol/L,95％CI-10.75 to-3.88,P＜0.001),and GGT levels(MD=-48.93 U/L,95％CI-54.64 to-43.21,P＜0.001).Only one study reported mild adverse events,and six studies reported no severe adverse events in patients.Conclusion Current evidence shows that polyene phosphatidylcholine injection in the treatment of alcoholic liver disease can increase the effective rate,improve the levels of liver function indicators(ALT,AST,TBiL,and GGT),and has less adverse events.Due to the limited number and quality of included studies,the above conclusions need to be verified by more high-quality studies.

Clinical characteristics, treatments and prognosis of 10 primary Sj?gren syndrome (pSS) patients with lymphoma were retrospectively analyzed. All 10 patients were female. Dry mouth, dry eyes and lymph node enlargement were common. Laboratory tests showed positive antinuclear antibody(ANA), anti-SSA antibody, anti-SSB antibody and rheumatoid factor(RF); lower lymphocyte counts and high IgG level. All patients were not treated regularly after pSS was diagnosed; 9 cases of non-Hodgkin lymphoma (NHL) and 1 case of Hodgkin lymphoma (HL) were finally diagnosed. The main histological types of NHL were mucosa-associated lymphoid tissue marginal zone lymphoma (MALT) and diffuse large B cell lymphoma (DLBCL). Both intranodal and extranodal involvement was common. Patients were followed up for 1-144 months, 8 patients were treated with R-CHOP regime, CHOP regime or rituximab; 5 patients were stable, 4 patients died, and 1 case lost to follow up. Patients with pSS are closely associated with an enhanced risk of lymphoma, especially NHL. The clinical manifestations were complicated and varied.

Objective To study effect of a novel schiff base ruthenium coordination compound on cell proliferation and apoptosis of gastric cancer SGC-7901 cell.Method Gastric cancer SGC-7901 cell were divided into four groups according to different treatment of novel schiff base ruthenium coordination compound (concentration of 10, 30, 50μmol/L) and blank group with DMSO.Cell proliferation was detected by MTT assay, cell apoptosis and cell cycle were analysed by flow cytometry.ResuIts MTT results showed the inhibitory effect of novel schiff base ruthenium coordination compound on SGC-7901 cell enhanced with the increase of its concentration, and inhibitory rates were higher than that of blank group at 24, 48, 72 h.Flow cytometry results showed the apoptosis rate of novel ruthenium coordination compound groups of 10, 30, 50μmol/L were (17.64 ±1.21)%, (26.47 ± 0.61)%, (55.63 ±1.49)%, respectively, all higher than that of blank group (P<0.05).The cell proportion of G1 phase increased with the increasing of the novel schiff base ruthenium coordination.ConcIusion A novel schiff base ruthenium coordination compound could inhibit the growth of gastric cancer SGC-7901 cells, promote apoptosis and arrest gastric cancer SGC-7901 cells at G1.

Objective To investigate the effect of fish oil parenteral supplementation on monocyte function in gastrointestinal cancer patients.Methods Sixty-four gastrointestinal cancer volunteers were equally randomized into study group and control group.Both groups received conventional lipid emulsion,and the study group was added with fish oil parenteral supplementation for 5 days.Blood samples were collected on the 1st,3rd,and 6th post-operative days to detect the interleukin (IL)-1β,IL-10,IL-6,tumor necrosis factor-α,and human leukocyte antigen-DR.Results After 5 days of continuous management,the IL-1β,IL-6,and tumor necrosis factor-o levels in the study group became significantly lower than those in the control group [(1 818 ± 213)pg/Lvs (2292 ±289)pg/L,P=0.027; (415 ±71)pg/Lvs (791±163)pg/L,P=0.001; (2 194± 350) pg/L vs (2 509 ± 507)pg/L,P =0.036,respectively),whereas the level of IL-10 by mononuclear leukocytes in two groups showed no significant difference.The expression of human leukocyte antigen-DR was significantly increased in both groups,but was significantly higher in the study group than in the control group [(76.6±15.2)％ vs (62.3±16.8)％,P=0.029].Conclusion Fish oil helps improve postoperative monocyte function in patients with gastrointestinal tumor.

Objective To investigate the voicing acoustic characteristics of sulcus vocalis patients with mini-mum glottal area(MGA) .Methods 60 normal subjects (30 male ,30 female) ,and 62 subjects with sulcus vocalis (33 male and 29 female)were recruited .They all had stroboscopic laryngoscopy ,and had MGA measured when say-ing /i:/using software supporting KIPS .The acoustic parameters consisted of vocal cord fundamental frequency (F0) ,jitter and shimmer ,normalized noise energy ( NNE) ,harmony to noise ratio (HNR) and signal noise ratio (SNR) ,maximum phonation time(MPT) and respectively make correlation analysis with voice MGA .Results The voicing MGA of male patients with sulcus vocalis was 434 .74 ± 112 .83 ,larger than the males with normal vocalis 298 .25 ± 93 .63 .This was statistically significant (P<0 .05) .The voicing MGA of females with sulcus vocalis was (484 .75 ± 143 .91) ,significantly larger than those of females with normal vocalis (293 .43 ± 93 .73) and the differ-ence was statistically significant (P<0 .05) .The voicing MGA on both males and females with sulcus vocalis was noticeably relation to the F0 (r=0 .972 ,P<0 .05) and (r=0 .928 ,P<0 .05) ,Jitter (r=0 .978 ,P<0 .05) and (r=0 .910 ,P<0 .910) and Shimmer (r=0 .973 ,P<0 .05) and (r=0 .921 ,P<0 .05) ,normalized noise energy(r=0 .883 ,P<0 .05) and (r=0 .960 ,P<0 .05) ;and negative relation to the signal noise ratio (r= -0 .947 ,P<0 .05) and (r = -0 .957 ,P<0 .05) ,signal noise ratio (r= -0 .959 ,P<0 .05) and (r= -0 .944 ,P<0 .05) ,max-imum phonation time (r= -0 .891 ,P<0 .05) and (r= -0 .936 ,P<0 .05) .Conclusion Patients with pathological sulcus vocalis have glottal areas larger than normal .Acoustic analysis of the voices of the sulcus vocalis can be used as an objective laboratory examination .

Objective To investigate the effect of porous silk fibroin scaffolds (PSFSs) combined with chondroitinase ABC (ChABC)for treatment of rats with spinal cord injury (SCI).Methods After exposed to T9 spinal cord transection injury,96 SD rats were divided into control group,PSFSs group,ChABC group,and PSFSs plus ChABC group according to random number table.BBB scoring system was used to evaluate hindlimb motor function in rats.Immunohistochemistry and Western blot analysis were performed to detect expression levels of neurofilament-200 (NF-200),glial fibrillary acidic protein (GFAP),and growth associated protein-43 (GAP-43) of the injured spinal cord.Immuno-fluorescence staining was carried out to evaluate regeneration of nerve fiber.Results BBB score improved in PSFSs group (8.1 ± 0.8),ChABC group (9.0 ± 1.1),and PSFSs plus ChABC group (13.7 ± 1.3) compared with control group 4 weeks after injury (5.3 ±0.7,P ＜0.05).Immunohistochemistry showed higher integral absorbance (IA) values of NF-200 and GAP-43 in those treatment groups,but smaller GFAP-positive area was observed compared with control group (P ＜ 0.05).Immuno-fluorescence staining indicated more GAP-43 growth at injury sites in PSFSs plus ChABC group in contrast with other 3 groups.Western blotting showed levels of NF-200,GFAP,and GAP-43 differed among groups (P ＜ 0.05).Conclusion PSFSs combined with chondroitinase ABC transplantation can enhance axonal regeneration,inhibit glial scar proliferation and hence promote motor function recovery.