Primary hepatic neuroendocrine tumor (PHNET) is an extremely rare subtype of neuroendocrine tumor (NET), accounting for approximately 0.3% - 4.0% of all NETs. This study reports a case of PHNET treated with ABO-incompatible liver transplantation. Intraoperatively, double filtration plasmapheresis was performed to remove antibodies. Postoperatively, the patient's blood concentrations of immunosuppressive drugs and liver function were closely monitored. The recipient maintained stable drug levels, with a gradual recovery of liver function. No acute rejection occurred, and the patient was successfully discharged.

Objective:To evaluate the treatment outcome of liver transplantation for patients with polycystic liver disease (PLD).Methods:Clinical data of 28 PLD patients admitted to the Affiliated Hospital of Qingdao University from May 2014 to November 2023 were retrospectively analyzed, including 10 males and 18 females, aged (50.4±6.6) years. Patients were divided into liver transplantation group ( n=15) and non-liver transplantation group ( n=13). In the liver transplantation group, we analyzed seve-ral critical parameters including methods of liver transplantation, intra-abdominal fluid volume, intraoperative blood loss, intraoperative red blood cell transfusion requirements, and postoperative complications. The prognosis of the two groups were also compared. Results:Among the 28 patients with PLD, 15 underwent liver transplantation, including 11 classic in situ liver transplantations, one modified back-to-back liver transplantation, and three liver-kidney combined transplantations. The 15 patients had 2 000 (300, 4 000) ml of abdominal fluid, 1 000 (600, 2 000) ml of intraoperative blood loss, and 8.0 (6.0, 17.0) U of red blood cells transfused during the operation. Postoperative complications occurred in eight cases, with four of which were managemed successfully, and the other four died. The 1-, 5-, and 10-year survival rates of after liver transplantation were 80.0%, 80.0%, and 73.3%, respectively. The 1-, 5-, and 10-year survival rates of patients with PLD without liver transplantation were 69.2%, 46.2%, and 38.5%, respectively. The difference between the two groups was statistically significant ( χ2=3.91, P=0.048). Conclusion:Liver transplantation is a treatment option for patients with PLD, with a better long-term survival compared to patients without liver transplantation.

Objective To conduct a multidimensional evaluation of brain cytoprotection agents used in the treatment of ischemic stroke,and to provide an evidence-based basis of medication selection and rational clinical use for medical institutions'decision-makers.Methods Based on the"Quick Guide to Drug Evaluation and Selection for Chinese Medical Institutions(Second Edition)"evaluation system,some scoring rules were adjusted.Referring to drug instructions,clinical guidelines,and rel-evant literature from databases such as China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database for Chinese Technical Periodicals(VIP),Pubmed,Embase,and Cochrane Library,seven brain cytoprotection agents were quantita-tively scored from five dimensions:pharmacological characteristics,effectiveness,safety,economic aspects,and other attributes(insurance coverage,essential drugs,manufacturing enterprises).Results Overall,the evaluated drugs received low scores.The top three drugs were edaravone and dexborneol injection(63.15 points),urinary kallidinogenase injection(62.20 points),and butylphthalide injection(62.04 points).Citicoline injection had the lowest score due to unclear effectiveness(37.07 points).Conclusions Based on guideline recommendations,edaravone and dexborneol,urinary kallidinogenase,and butylphthalide,which scored above 60,are weakly recommended when no alternative medications are available in medical institutions.This study can be used as a reference for the selection of therapeutic drugs for ischemic stroke in medical institutions and offer a basis for rational clinical medication use.

Objective:To explore the effects of adjuvant therapy by hyperbaric oxygen for high-energy lower limb fractures.Methods:This prospective case-control study enrolled the patients with high-energy lower extremity fracture who had been admitted to Department of Orthopaedics, Beijing Luhe Hospital, Capital Medical University from January 2021 to December 2022. Their fracture types included tibial plateau ones, pilon ones, ankle ones complicated with dislocation, and calcaneal ones. The patients were randomly divided into a control group receiving routine orthopedic treatment and a trial group receiving adjuvant therapy by hyperbaric oxygen in addition to routine orthopedic treatment using a random number table. The first adjuvant therapy by hyperbaric oxygen was conducted in the trial group within 48 h after injury before the timing for surgery was decided according to the soft tissue swelling at the affected limb. Follow-up was conducted until one year after surgery. The early and late wound complications, time from injury to surgery, and hospital stay were compared between the 2 groups.Results:A total of 160 patients with high-energy lower extremity fracture were enrolled in this study. Eventually, 7 patients were excluded, 72 patients [48 males and 24 females, with an age of (46.3±12.5) years] included in the trial group and 81 patients [61 males and 20 females, with an age of (47.8±13.4) years] in the control group. There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The incidence of early wound complications in the trial group was 5.6% (4/72), significantly lower than that in the control group [18.5% (15/81)] ( P<0.05). The incidences of late wound complications in the trial and control groups were 12.5% (9/72) and 9.9% (8/81) respectively, showing no statistically significant difference ( P>0.05). The time from admission to surgery was respectively 4 (2, 8) days and 4 (2, 6) days, and the hospital stay respectively 10 (7, 14) days and 9 (6, 12) days for the trial and control groups, showing no statistically significant differences between the 2 groups ( P>0.05). Conclusion:In the treatment of high-energy lower extremity fractures, adjuvant therapy by hyperbaric oxygen can reduce the incidence of early wound complications without increasing the hospital stay, but it does not reduce the incidence of late wound complications or shorten the preoperative waiting time.

Objective:To explore the effect of concomitant amiodarone on the bleeding risk in atrial fibrillation patients treated with dabigatran etexilate.Methods:This study was a retrospective cohort study. The clinical data of hospitalized patients with atrial fibrillation who took dabigatran etexilate in Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology from July 1, 2022 to June 30, 2023 were collected. Patients were divided into concomitant amiodarone group and non concomitant amiodarone group according to whether they were treated with oral amiodarone. Propensity score matching (PSM) was performed at a 1∶1 ratio in patients between the 2 groups according to patient's gender, age, main basic diseases and the number of basic diseases, baseline liver and kidney function, dosage of dabigatran etexilate, etc. The incidence of bleeding events was compared between the 2 groups.Results:A total of 878 patients were included in the study, including 568 males (64.7%) and 310 females (35.3%), with a age of 67 (59, 74) years. There were 252 patients (28.7%) in the concomitant amiodarone group and 626 patients (71.3%) in the non concomitant amiodarone group. Within 3 months of follow-up, the incidence of bleeding events in patients of concomitant and non concomitant amiodarone groups were 19.0% (48/252) and 21.2% (133/626), respectively, which were 19.0% (48/252) and 16.7% (40/239) after PSM, respectively, with no significant difference (all P>0.05). The main type of bleeding in patients of both groups was mild bleeding events [62.5% (30/48) vs. 67.5% (27/40)], and bleeding was more common in the gums, skin, and nose. There was no statistically significant difference in incidence of the bleeding types and bleeding sites of patients between the 2 groups (all P>0.05). Conclusions:Compared with patients with atrial fibrillation when treated with dabigatran etexilate and without concomitant amiodarone, the bleeding risk of patients with amiodarone did not significantly increased in the short term. The bleeding events during treatment of dabigatran etexilate were mainly mild bleeding, but clinical vigilance was still necessary.

Objective The multi-dimensional evaluation of hemocoagulase drugs was carried out to provide reference data for clinical drug use and drug selection in medical institutions.Methods According to the evaluation system established by the A Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions(the Second Edition),part of the scoring rules was adjusted,and relevant literatures from CNKI,Wanfang,VIP,PubMed,Embase,Cochrane Library and other databases were referred to.Four hemocoagulase drugs listed in China were quantitatively scored from five dimensions:pharmaceutical properties,effectiveness,safety,economy and other attributes(medical insurance,essential drugs,manufacturers,etc.).The recommendation levels were divided according to the scoring results.Results The quantified scoring results,in descending order,were ashaemocoagulaseagkistrodon(HCA)(68.50 points),hemocoagulaseagkistrodonhalys(HAH)(59.89 points),hemocoagulase injection(HI)(52.84 points)and hemocoagulasebothropsatrox(HBA)(49.31 points).Conclusions The overall score of hemocoagulase drugs is low,and other hemostatic drugs can be preferred when alternative drugs are available.Among them,the HCA is weakly recommended in medical institutions.This study can provide reference for the selection of hemocoagulase drugs in medical institutions,and also provide basis for clinical rational drug use.

Objective To conduct a multidimensional evaluation of brain cytoprotection agents used in the treatment of ischemic stroke,and to provide an evidence-based basis of medication selection and rational clinical use for medical institutions'decision-makers.Methods Based on the"Quick Guide to Drug Evaluation and Selection for Chinese Medical Institutions(Second Edition)"evaluation system,some scoring rules were adjusted.Referring to drug instructions,clinical guidelines,and rel-evant literature from databases such as China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database for Chinese Technical Periodicals(VIP),Pubmed,Embase,and Cochrane Library,seven brain cytoprotection agents were quantita-tively scored from five dimensions:pharmacological characteristics,effectiveness,safety,economic aspects,and other attributes(insurance coverage,essential drugs,manufacturing enterprises).Results Overall,the evaluated drugs received low scores.The top three drugs were edaravone and dexborneol injection(63.15 points),urinary kallidinogenase injection(62.20 points),and butylphthalide injection(62.04 points).Citicoline injection had the lowest score due to unclear effectiveness(37.07 points).Conclusions Based on guideline recommendations,edaravone and dexborneol,urinary kallidinogenase,and butylphthalide,which scored above 60,are weakly recommended when no alternative medications are available in medical institutions.This study can be used as a reference for the selection of therapeutic drugs for ischemic stroke in medical institutions and offer a basis for rational clinical medication use.

Objective:To evaluate the treatment outcome of liver transplantation for patients with polycystic liver disease (PLD).Methods:Clinical data of 28 PLD patients admitted to the Affiliated Hospital of Qingdao University from May 2014 to November 2023 were retrospectively analyzed, including 10 males and 18 females, aged (50.4±6.6) years. Patients were divided into liver transplantation group ( n=15) and non-liver transplantation group ( n=13). In the liver transplantation group, we analyzed seve-ral critical parameters including methods of liver transplantation, intra-abdominal fluid volume, intraoperative blood loss, intraoperative red blood cell transfusion requirements, and postoperative complications. The prognosis of the two groups were also compared. Results:Among the 28 patients with PLD, 15 underwent liver transplantation, including 11 classic in situ liver transplantations, one modified back-to-back liver transplantation, and three liver-kidney combined transplantations. The 15 patients had 2 000 (300, 4 000) ml of abdominal fluid, 1 000 (600, 2 000) ml of intraoperative blood loss, and 8.0 (6.0, 17.0) U of red blood cells transfused during the operation. Postoperative complications occurred in eight cases, with four of which were managemed successfully, and the other four died. The 1-, 5-, and 10-year survival rates of after liver transplantation were 80.0%, 80.0%, and 73.3%, respectively. The 1-, 5-, and 10-year survival rates of patients with PLD without liver transplantation were 69.2%, 46.2%, and 38.5%, respectively. The difference between the two groups was statistically significant ( χ2=3.91, P=0.048). Conclusion:Liver transplantation is a treatment option for patients with PLD, with a better long-term survival compared to patients without liver transplantation.

Objective:To explore the effect of concomitant amiodarone on the bleeding risk in atrial fibrillation patients treated with dabigatran etexilate.Methods:This study was a retrospective cohort study. The clinical data of hospitalized patients with atrial fibrillation who took dabigatran etexilate in Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology from July 1, 2022 to June 30, 2023 were collected. Patients were divided into concomitant amiodarone group and non concomitant amiodarone group according to whether they were treated with oral amiodarone. Propensity score matching (PSM) was performed at a 1∶1 ratio in patients between the 2 groups according to patient's gender, age, main basic diseases and the number of basic diseases, baseline liver and kidney function, dosage of dabigatran etexilate, etc. The incidence of bleeding events was compared between the 2 groups.Results:A total of 878 patients were included in the study, including 568 males (64.7%) and 310 females (35.3%), with a age of 67 (59, 74) years. There were 252 patients (28.7%) in the concomitant amiodarone group and 626 patients (71.3%) in the non concomitant amiodarone group. Within 3 months of follow-up, the incidence of bleeding events in patients of concomitant and non concomitant amiodarone groups were 19.0% (48/252) and 21.2% (133/626), respectively, which were 19.0% (48/252) and 16.7% (40/239) after PSM, respectively, with no significant difference (all P>0.05). The main type of bleeding in patients of both groups was mild bleeding events [62.5% (30/48) vs. 67.5% (27/40)], and bleeding was more common in the gums, skin, and nose. There was no statistically significant difference in incidence of the bleeding types and bleeding sites of patients between the 2 groups (all P>0.05). Conclusions:Compared with patients with atrial fibrillation when treated with dabigatran etexilate and without concomitant amiodarone, the bleeding risk of patients with amiodarone did not significantly increased in the short term. The bleeding events during treatment of dabigatran etexilate were mainly mild bleeding, but clinical vigilance was still necessary.

Objective The multi-dimensional evaluation of hemocoagulase drugs was carried out to provide reference data for clinical drug use and drug selection in medical institutions.Methods According to the evaluation system established by the A Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions(the Second Edition),part of the scoring rules was adjusted,and relevant literatures from CNKI,Wanfang,VIP,PubMed,Embase,Cochrane Library and other databases were referred to.Four hemocoagulase drugs listed in China were quantitatively scored from five dimensions:pharmaceutical properties,effectiveness,safety,economy and other attributes(medical insurance,essential drugs,manufacturers,etc.).The recommendation levels were divided according to the scoring results.Results The quantified scoring results,in descending order,were ashaemocoagulaseagkistrodon(HCA)(68.50 points),hemocoagulaseagkistrodonhalys(HAH)(59.89 points),hemocoagulase injection(HI)(52.84 points)and hemocoagulasebothropsatrox(HBA)(49.31 points).Conclusions The overall score of hemocoagulase drugs is low,and other hemostatic drugs can be preferred when alternative drugs are available.Among them,the HCA is weakly recommended in medical institutions.This study can provide reference for the selection of hemocoagulase drugs in medical institutions,and also provide basis for clinical rational drug use.