Objective To analyze the literature about Xiaoxianxiong Decoction based on the bibliometric method;To explore the research status and hotspots and trend of Xiaoxianxiong Decoction.Methods Relevant literature about Xiaoxianxiong Decoction was retrieved from CNKI,VIP,Wanfang Data and CBM from the establishment of the databases to January 26,2024.NoteExpress 3.5.0 and CiteSpace 6.1.R6 software were used to sort out the data related to authors,institutions and keywords,and draw maps for analysis.Results After screening,a total of 1 023 articles were included,and the number of publications is on the rise.The journal with the most articles was Journal of Sichuan Traditional Chinese Medicine(35 articles),Journal of New Chinese Medicine(32 articles),and Henan Traditional Chinese Medicine(30 articles).The literature type was the most with the number of clinical applications,accounting for 40.08%(410 articles).Totally 884 authors were included,and the authors with the most articles were Sun Qinguo(10 articles),Liu Yujie(10 articles)and Geng Yun(8 articles).A total of 782 institutions were included,and the institution with the most articles was Hubei University of Chinese Medicine(35 articles),Hunan University of Chinese Medicine(18 articles),Shandong University of Traditional Chinese Medicine(15 articles),etc.A total of 871 keywords were included,forming 10 clusters.The keywords with high frequency and betweeness centrality were"classic formulas","coronary heart disease","experience of famous doctors","angina"and"medical records".Conclusion The research on Xiaoxianxiong Decoction continues to gain popularity.Research hotspots include clinical applications,the experience of famous doctors,and basic research.It has a wide range of disease types,mainly focusing on syndrome differentiation and treatment of phlegm heat syndrome of coronary heart disease and angina pectoris.In recent years,it has gradually expanded to diabetes,gastric cancer and other diseases.

Objective To investigate the association between remnant cholesterol(RC)and clinicopatho-logical parameters in patients with IgA nephropathy(IgAN),and to assess the clinical significance of RC in the progression and management of IgAN.Methods A total of 366 patients with a biopsy-proven diagnosis of IgAN were consecutively enrolled in this retrospective study.Clinical and pathological data were systematically collected,and RC was calculated.Participants were stratified into two groups according to the median RC value.Baseline characteristics were compared between these groups.The association between RC and the presence of tubular atrophy/interstitial fibrosis(T1/2 lesions)in IgAN patients was evaluated using binary logistic regression,restricted cubic spline(RCS)analysis,receiver operating characteristic(ROC)curve analysis,and subgroup analyses.Results In this study,the high-RC group exhibited significantly higher levels of body weight,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),triglycerides(TG),total cholesterol(TC),non-high-density lipoprotein cholesterol(non-HDL-C),uric acid(UA),complement 3(C3),and 24-hour urinary protein,as well as lower levels of albumin(ALB),estimated glomerular filtration rate(eGFR),and high-density lipoprotein cholesterol(HDL-C),compared to the low-RC group.Patients with T1/2 lesions showed elevated levels of SBP,DBP,TC,non-HDL-C,UA,24-hour urinary protein,and RC,along with reduced levels of hemoglobin(Hb),ALB,and eGFR,relative to those with T0 lesions.Multivariate logistic regression analysis indicated that increased RC and decreased eGFR were independent risk factors for the presence of T1/2 lesions in patients with IgAN(P<0.05).RCS analysis revealed a linear association between RC and the likelihood of T1/2 lesions(non-linearity P=0.343).The area under the receiver operating characteristic curve(AUC)for a predictive model incorporating RC,Hb,UA,and eGFR was 0.833,indicating good discriminative ability.Subgroup analyses consistently demonstrated a significant associa-tion between RC and the risk of T1/2 lesions,with no statistically significant interactions observed across subgroups(all P>0.05).Conclusion RC can reflect the severity of both clinical and pathological manifestations in patients with IgAN,making RC monitoring a potentially valuable tool for assessing disease progression in clinical practice.

Objective To investigate the association between nutritional status and serum hepcidin and pentraxin 3(PTX3)levels in patients undergoing maintenance hemodialysis(MHD).Methods A total of 76 patients with MHD who met the inclusion criteria were recruited from the hemodialysis center at the Affiliated Hospital of Chengde Medical University.Nutritional status was assessed using the Subjective Global Assessment(SGA),which categorizes patients into three grades:SGA-A,SGA-B,and SGA-C.Serum levels of PTX3 and hepcidin were mea-sured by enzyme-linked immunosorbent assay(ELISA).Statistical analyses were conducted using SPSS software.One-way analysis of variance(ANOVA)was applied to compare differences across the three SGA groups.Logistic regression analysis was performed to identify influencing factors,and receiver operating characteristic(ROC)curve analysis was used to evaluate diagnostic value.Among the participants,45 patients were classified as malnourished based on SGA-B and SGA-C scores,while those with SGA-A constituted the well-nourished control group.Results Among the 76 MHD patients,59.2%were malnourished.We then compared clinical characteristics across the three groups.The results showed that the malnourished group was older and exhibited significantly higher levels of hs-CRP,PTX3,and hepcidin(P<0.05),while serum albumin,creatinine,and phosphorus levels were significantly lower(P<0.05).Pearson correlation analysis revealed positive correlations between SGA grades and hs-CRP,PTX3,and hepcidin levels(all P<0.05).Logistic regression analysis with"malnutrition"as the dependent variable indicated that elevated hs-CRP,PTX3,and hepcidin levels,along with age and male gender,were associated with increased risk of malnutrition in MHD patients,whereas higher serum phosphorus and creatinine levels were protec-tive factors.Further multivariate logistic regression analysis demonstrated that serum PTX3 level was an independent risk factor for malnutrition(P=0.032),while higher creatinine level was an independent protective factor(P=0.047).ROC curve analysis showed that the combination of serum PTX3 and creatinine levels had a high diagnostic value for identifying malnutrition in MHD patients,yielding an AUC of 0.789(P<0.001),a Youden index of 0.448,sensitivity of 77.8%,and specificity of 71.0%.Conclusions Elevated levels of PTX3 and hepcidin,along with reduced serum creatinine levels,are associated with an increased risk of malnutrition in patients undergoing MHD.Notably,elevated serum PTX3 and decreased serum creatinine independently predict malnutrition in this population and demonstrate high predictive value.

Objective To investigate the association between remnant cholesterol(RC)and clinicopatho-logical parameters in patients with IgA nephropathy(IgAN),and to assess the clinical significance of RC in the progression and management of IgAN.Methods A total of 366 patients with a biopsy-proven diagnosis of IgAN were consecutively enrolled in this retrospective study.Clinical and pathological data were systematically collected,and RC was calculated.Participants were stratified into two groups according to the median RC value.Baseline characteristics were compared between these groups.The association between RC and the presence of tubular atrophy/interstitial fibrosis(T1/2 lesions)in IgAN patients was evaluated using binary logistic regression,restricted cubic spline(RCS)analysis,receiver operating characteristic(ROC)curve analysis,and subgroup analyses.Results In this study,the high-RC group exhibited significantly higher levels of body weight,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),triglycerides(TG),total cholesterol(TC),non-high-density lipoprotein cholesterol(non-HDL-C),uric acid(UA),complement 3(C3),and 24-hour urinary protein,as well as lower levels of albumin(ALB),estimated glomerular filtration rate(eGFR),and high-density lipoprotein cholesterol(HDL-C),compared to the low-RC group.Patients with T1/2 lesions showed elevated levels of SBP,DBP,TC,non-HDL-C,UA,24-hour urinary protein,and RC,along with reduced levels of hemoglobin(Hb),ALB,and eGFR,relative to those with T0 lesions.Multivariate logistic regression analysis indicated that increased RC and decreased eGFR were independent risk factors for the presence of T1/2 lesions in patients with IgAN(P<0.05).RCS analysis revealed a linear association between RC and the likelihood of T1/2 lesions(non-linearity P=0.343).The area under the receiver operating characteristic curve(AUC)for a predictive model incorporating RC,Hb,UA,and eGFR was 0.833,indicating good discriminative ability.Subgroup analyses consistently demonstrated a significant associa-tion between RC and the risk of T1/2 lesions,with no statistically significant interactions observed across subgroups(all P>0.05).Conclusion RC can reflect the severity of both clinical and pathological manifestations in patients with IgAN,making RC monitoring a potentially valuable tool for assessing disease progression in clinical practice.

Objective To investigate the association between nutritional status and serum hepcidin and pentraxin 3(PTX3)levels in patients undergoing maintenance hemodialysis(MHD).Methods A total of 76 patients with MHD who met the inclusion criteria were recruited from the hemodialysis center at the Affiliated Hospital of Chengde Medical University.Nutritional status was assessed using the Subjective Global Assessment(SGA),which categorizes patients into three grades:SGA-A,SGA-B,and SGA-C.Serum levels of PTX3 and hepcidin were mea-sured by enzyme-linked immunosorbent assay(ELISA).Statistical analyses were conducted using SPSS software.One-way analysis of variance(ANOVA)was applied to compare differences across the three SGA groups.Logistic regression analysis was performed to identify influencing factors,and receiver operating characteristic(ROC)curve analysis was used to evaluate diagnostic value.Among the participants,45 patients were classified as malnourished based on SGA-B and SGA-C scores,while those with SGA-A constituted the well-nourished control group.Results Among the 76 MHD patients,59.2%were malnourished.We then compared clinical characteristics across the three groups.The results showed that the malnourished group was older and exhibited significantly higher levels of hs-CRP,PTX3,and hepcidin(P<0.05),while serum albumin,creatinine,and phosphorus levels were significantly lower(P<0.05).Pearson correlation analysis revealed positive correlations between SGA grades and hs-CRP,PTX3,and hepcidin levels(all P<0.05).Logistic regression analysis with"malnutrition"as the dependent variable indicated that elevated hs-CRP,PTX3,and hepcidin levels,along with age and male gender,were associated with increased risk of malnutrition in MHD patients,whereas higher serum phosphorus and creatinine levels were protec-tive factors.Further multivariate logistic regression analysis demonstrated that serum PTX3 level was an independent risk factor for malnutrition(P=0.032),while higher creatinine level was an independent protective factor(P=0.047).ROC curve analysis showed that the combination of serum PTX3 and creatinine levels had a high diagnostic value for identifying malnutrition in MHD patients,yielding an AUC of 0.789(P<0.001),a Youden index of 0.448,sensitivity of 77.8%,and specificity of 71.0%.Conclusions Elevated levels of PTX3 and hepcidin,along with reduced serum creatinine levels,are associated with an increased risk of malnutrition in patients undergoing MHD.Notably,elevated serum PTX3 and decreased serum creatinine independently predict malnutrition in this population and demonstrate high predictive value.

Objective To analyze the literature about Xiaoxianxiong Decoction based on the bibliometric method;To explore the research status and hotspots and trend of Xiaoxianxiong Decoction.Methods Relevant literature about Xiaoxianxiong Decoction was retrieved from CNKI,VIP,Wanfang Data and CBM from the establishment of the databases to January 26,2024.NoteExpress 3.5.0 and CiteSpace 6.1.R6 software were used to sort out the data related to authors,institutions and keywords,and draw maps for analysis.Results After screening,a total of 1 023 articles were included,and the number of publications is on the rise.The journal with the most articles was Journal of Sichuan Traditional Chinese Medicine(35 articles),Journal of New Chinese Medicine(32 articles),and Henan Traditional Chinese Medicine(30 articles).The literature type was the most with the number of clinical applications,accounting for 40.08%(410 articles).Totally 884 authors were included,and the authors with the most articles were Sun Qinguo(10 articles),Liu Yujie(10 articles)and Geng Yun(8 articles).A total of 782 institutions were included,and the institution with the most articles was Hubei University of Chinese Medicine(35 articles),Hunan University of Chinese Medicine(18 articles),Shandong University of Traditional Chinese Medicine(15 articles),etc.A total of 871 keywords were included,forming 10 clusters.The keywords with high frequency and betweeness centrality were"classic formulas","coronary heart disease","experience of famous doctors","angina"and"medical records".Conclusion The research on Xiaoxianxiong Decoction continues to gain popularity.Research hotspots include clinical applications,the experience of famous doctors,and basic research.It has a wide range of disease types,mainly focusing on syndrome differentiation and treatment of phlegm heat syndrome of coronary heart disease and angina pectoris.In recent years,it has gradually expanded to diabetes,gastric cancer and other diseases.

Objective:To evaluate the efficacy and safety of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of pseudomyxoma peritonei (PMP).Methods:In this descriptive case series study, we retrospective analyzed the records of PMP patients treated with CRS and HIPEC between January 2013 and June 2023 at Affiliated Cancer Hospital and Institute of Guangzhou Medical University. The inclusion criteria were as follows: (1) Aged 18 to 75 years and nonpregnant women. (2) Histologically confirmed diagnosis of pseudomyxoma peritonei. (3) Karnofsky Performance Scale (KPS)>70. (4) The functions of major organs such as the heart, liver, lungs, and kidneys can tolerate major surgery for long periods of time. (5) No evidence of extra-abdominal metastasis. Patients with extensive intra-abdominal adhesions or severe infectious diseases were excluded. The main outcomes were overall survival (OS) and postoperative major complications. The postoperative major complications were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0). We used the peritoneal cancer index (PCI) score to quantitatively assess the peritoneal metastases and the completeness of cytoreduction (CCR) score at the end of surgery (CCR-0 and CCR-1 considered to be complete CRS).Results:A total of the 186 PMP patients with a median age of 56 (interquartile range extremes (IQRE), 48-64) years were included, 65 (34.9%) males and 121 (65.1%) females. The median peritoneal cancer index (PCI) score was 28 (20-34). Appendiceal origin accounted for 91.4%. Histological types were low grade in 99 patients (53.2%), high grade in 57 patients (30.6%), and 55 patients (29.6%) received complete cytoreduction (CCR-0/1). The median operative duration was 300 (211-430) minutes for all patients. Treatment-related 30-day mortality was 2.7%; 90-day mortality 4.3%; reoperation 1.6%; and severe morbidity 43.0%. Within the entire series, anemia(27.4%), electrolyte disturbance(11.6%), and hypoalbuminemia(7.5%) were the most frequent major complications (grade 3-4). The incidences of gastrointestinal anastomotic leakage, abdominal bleeding, and abdominal infection were 2.2%, 2.2%, and 4.3%, respectively. After a median follow-up of 38.1 (95%CI:31.2-45.1) months, the 5-year OS was 50.3% (95%CI: 40.7%-59.9%) with a median survival time of 66.1 (95%CI: 43.1-89.1) months. The survival analysis showed that patients with pathological low grade, low PCI, and low CCR score had better survival with statistically significant differences (all P<0.05). Further stratified into complete and incomplete CRS subgroups, the 5-year OS of the CCR-0 and CCR-1 subgroups was 88.9% (95%CI: 68.3%-100.0%) and 77.6% (95%CI: 62.7%-92.5%), respectively; and 42.0% (95%CI: 29.5%-54.5%) in the CCR-2/3 subgroup. Conclusions:CRS and HIPEC may result in a long-term survival benefit for PMP patients with acceptable perioperative morbidity and mortality. This strategy, when complete CRS is possible, could significantly prolong survival for strictly selected patients at experienced centers.

Objective:To evaluate the efficacy and safety of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of pseudomyxoma peritonei (PMP).Methods:In this descriptive case series study, we retrospective analyzed the records of PMP patients treated with CRS and HIPEC between January 2013 and June 2023 at Affiliated Cancer Hospital and Institute of Guangzhou Medical University. The inclusion criteria were as follows: (1) Aged 18 to 75 years and nonpregnant women. (2) Histologically confirmed diagnosis of pseudomyxoma peritonei. (3) Karnofsky Performance Scale (KPS)>70. (4) The functions of major organs such as the heart, liver, lungs, and kidneys can tolerate major surgery for long periods of time. (5) No evidence of extra-abdominal metastasis. Patients with extensive intra-abdominal adhesions or severe infectious diseases were excluded. The main outcomes were overall survival (OS) and postoperative major complications. The postoperative major complications were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0). We used the peritoneal cancer index (PCI) score to quantitatively assess the peritoneal metastases and the completeness of cytoreduction (CCR) score at the end of surgery (CCR-0 and CCR-1 considered to be complete CRS).Results:A total of the 186 PMP patients with a median age of 56 (interquartile range extremes (IQRE), 48-64) years were included, 65 (34.9%) males and 121 (65.1%) females. The median peritoneal cancer index (PCI) score was 28 (20-34). Appendiceal origin accounted for 91.4%. Histological types were low grade in 99 patients (53.2%), high grade in 57 patients (30.6%), and 55 patients (29.6%) received complete cytoreduction (CCR-0/1). The median operative duration was 300 (211-430) minutes for all patients. Treatment-related 30-day mortality was 2.7%; 90-day mortality 4.3%; reoperation 1.6%; and severe morbidity 43.0%. Within the entire series, anemia(27.4%), electrolyte disturbance(11.6%), and hypoalbuminemia(7.5%) were the most frequent major complications (grade 3-4). The incidences of gastrointestinal anastomotic leakage, abdominal bleeding, and abdominal infection were 2.2%, 2.2%, and 4.3%, respectively. After a median follow-up of 38.1 (95%CI:31.2-45.1) months, the 5-year OS was 50.3% (95%CI: 40.7%-59.9%) with a median survival time of 66.1 (95%CI: 43.1-89.1) months. The survival analysis showed that patients with pathological low grade, low PCI, and low CCR score had better survival with statistically significant differences (all P<0.05). Further stratified into complete and incomplete CRS subgroups, the 5-year OS of the CCR-0 and CCR-1 subgroups was 88.9% (95%CI: 68.3%-100.0%) and 77.6% (95%CI: 62.7%-92.5%), respectively; and 42.0% (95%CI: 29.5%-54.5%) in the CCR-2/3 subgroup. Conclusions:CRS and HIPEC may result in a long-term survival benefit for PMP patients with acceptable perioperative morbidity and mortality. This strategy, when complete CRS is possible, could significantly prolong survival for strictly selected patients at experienced centers.

Uterus didelphys occurs in ~0.4% of females and is found in ~11%-20% of all uterus defects. It is a risk factor for cervical insufficiency, consequently contributing to late miscarriage or preterm birth. Thus far, only two prior cases of uterus didelphys accompanied by cervical insufficiency treated through laparoscopic cervical cerclage have been reported; however, livebirth only occurred in one hemiuterus. Herein, we report a case of uterus didelphys in a patient diagnosed with cervical insufficiency. Following the placement of a modified laparoscopic cervical cerclage, the patient had two successful livebirths through both hemiuteruses, respectively, with longer gestation age (ie, >36 weeks). The aim of this case report was to provide useful information for clinical practitioners to make better decisions on the management of cervical insufficiency in patients with uterus didelphys, and identify obstetric complications that clinicians should pay attention to during pregnancy.