Objective:To investigate the diagnosis, treatment, and prognosis of primary pancreatic signet-ring cell carcinoma (SRCC).Methods:A retrospective analysis was conducted on clinical data of 11 patients with pathologically confirmed SRCC treated at the Women and Children's Hospital Affiliated to Qingdao University and the Affiliated Hospital of Qingdao University between 2002 and 2024. The cohort included 10 male and 1 female patients, aged (65.6±9.2) years. Data on gender, age, clinical manifestations, biochemical markers, tumor biomarkers, surgical approaches, postoperative pathology, adjuvant the-rapy, and treatment outcomes were recorded. Postoperative survival was assessed via outpatient records and telephone follow-ups.Results:Among the 11 patients, all 10 male patients had a long-term smoking his-tory. Initial symptoms included epigastric pain (5 cases), jaundice (2 cases), postprandial upper abdominal discomfort (3 cases), and persistent hyperglycemia (1 case). Elevated total bilirubin with increased alanine transaminase and aspartate transaminase was observed in 4 cases, while 7 cases had normal liver function. Tumor biomarker profiles showed elevated carcinoembryonic antigen (CEA) alone in 2 cases, elevated carbohydrate antigen 19-9(CA 19-9) alone in 6 cases, concurrent elevation of CEA and CA19-9 in 2 cases, and normal tumor markers in 1 case. Tumor locations included the pancreatic head (8 cases) and pancreatic body/tail (3 cases). All patients underwent radical resection without major perioperative complications. Immunohistochemistry revealed perineural invasion (+ ) in 10 cases and Ki-67 ≥ 50% in 9 cases. Six patients received postoperative adjuvant therapy. The median disease-free survival was 14 months, and the median overall survival was 18 months.Conclusion:SRCC lacks specific clinical manifestations and carries a poor prognosis. Radical surgical resection remains the cornerstone of treatment, while adjuvant therapy may improve survival outcomes.

Objective To study the safety of amlodipine post-marketing and to mine the potential adverse drug event(ADE)signals,and to construct an intelligent query platform for ADE signals that can be popularized and applied to a variety of drugs.Methods The data from the first quarter of 2004 to the fourth quarter of 2024 were retrieved from the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database.A variety of disproportionality methods were used,including the reporting odds ratio(ROR)method,the United Kingdom Medicines and Healthcare products Regulatory Agency(MHRA)comprehensive standard method,Bayesian confidence propagation neural network(BCPNN)method,and the multi-item Gamma-Poisson shrinker(MGPS)method,to mine the signals of ADEs related to amlodipine.At the same time,a general query platform for mining ADE signals was developed based on the DeepSeek AI model to achieve the monitoring and analysis of the safety of various drugs.Results A total of 51,166 ADE reports were obtained,in which amlodipine was the primary suspected drug.Through the combined screening of the four algorithms,multiple potential ADE signals which had not been mentioned in the existing package inserts were found,including diseases of the ear and labyrinth(such as sensorineural hearing loss),diseases of the respiratory system,thorax and mediastinum(such as non-cardiogenic pulmonary edema),mental disorders(such as completed suicide),etc.The constructed digital intelligent platform had achieved the automated processing and monitoring of ADE data,providing a rapid access for clinicians and regulatory authorities to obtain drug safety information.Conclusion This study reveals potential safety risks associated with the use of amlodipine through real-world data mining.A risk assessment of patients' medication should be carried out before clinical use.In addition to paying attention to known ADEs,newly discovered potential risk signals should also be closely monitored.The construction of the digital intelligent platform provides an efficient tool for pharmacovigilance work.It can be popularized and applied to the safety monitoring of a variety of drugs,which is of great significance for improving the level of pharmacovigilance and the safety of medication.

Objective To study the safety of amlodipine post-marketing and to mine the potential adverse drug event(ADE)signals,and to construct an intelligent query platform for ADE signals that can be popularized and applied to a variety of drugs.Methods The data from the first quarter of 2004 to the fourth quarter of 2024 were retrieved from the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database.A variety of disproportionality methods were used,including the reporting odds ratio(ROR)method,the United Kingdom Medicines and Healthcare products Regulatory Agency(MHRA)comprehensive standard method,Bayesian confidence propagation neural network(BCPNN)method,and the multi-item Gamma-Poisson shrinker(MGPS)method,to mine the signals of ADEs related to amlodipine.At the same time,a general query platform for mining ADE signals was developed based on the DeepSeek AI model to achieve the monitoring and analysis of the safety of various drugs.Results A total of 51,166 ADE reports were obtained,in which amlodipine was the primary suspected drug.Through the combined screening of the four algorithms,multiple potential ADE signals which had not been mentioned in the existing package inserts were found,including diseases of the ear and labyrinth(such as sensorineural hearing loss),diseases of the respiratory system,thorax and mediastinum(such as non-cardiogenic pulmonary edema),mental disorders(such as completed suicide),etc.The constructed digital intelligent platform had achieved the automated processing and monitoring of ADE data,providing a rapid access for clinicians and regulatory authorities to obtain drug safety information.Conclusion This study reveals potential safety risks associated with the use of amlodipine through real-world data mining.A risk assessment of patients' medication should be carried out before clinical use.In addition to paying attention to known ADEs,newly discovered potential risk signals should also be closely monitored.The construction of the digital intelligent platform provides an efficient tool for pharmacovigilance work.It can be popularized and applied to the safety monitoring of a variety of drugs,which is of great significance for improving the level of pharmacovigilance and the safety of medication.

Objective:To investigate the diagnosis, treatment, and prognosis of primary pancreatic signet-ring cell carcinoma (SRCC).Methods:A retrospective analysis was conducted on clinical data of 11 patients with pathologically confirmed SRCC treated at the Women and Children's Hospital Affiliated to Qingdao University and the Affiliated Hospital of Qingdao University between 2002 and 2024. The cohort included 10 male and 1 female patients, aged (65.6±9.2) years. Data on gender, age, clinical manifestations, biochemical markers, tumor biomarkers, surgical approaches, postoperative pathology, adjuvant the-rapy, and treatment outcomes were recorded. Postoperative survival was assessed via outpatient records and telephone follow-ups.Results:Among the 11 patients, all 10 male patients had a long-term smoking his-tory. Initial symptoms included epigastric pain (5 cases), jaundice (2 cases), postprandial upper abdominal discomfort (3 cases), and persistent hyperglycemia (1 case). Elevated total bilirubin with increased alanine transaminase and aspartate transaminase was observed in 4 cases, while 7 cases had normal liver function. Tumor biomarker profiles showed elevated carcinoembryonic antigen (CEA) alone in 2 cases, elevated carbohydrate antigen 19-9(CA 19-9) alone in 6 cases, concurrent elevation of CEA and CA19-9 in 2 cases, and normal tumor markers in 1 case. Tumor locations included the pancreatic head (8 cases) and pancreatic body/tail (3 cases). All patients underwent radical resection without major perioperative complications. Immunohistochemistry revealed perineural invasion (+ ) in 10 cases and Ki-67 ≥ 50% in 9 cases. Six patients received postoperative adjuvant therapy. The median disease-free survival was 14 months, and the median overall survival was 18 months.Conclusion:SRCC lacks specific clinical manifestations and carries a poor prognosis. Radical surgical resection remains the cornerstone of treatment, while adjuvant therapy may improve survival outcomes.

Objective To observe the value of ultrasound vector flow imaging(VFI)combined with singular value decomposition(SVD)filtering for depicting deep microvasculature flow velocity of liver.Methods Grayscale ultrasound,CDFI and contrast-enhanced ultrasound(CEUS)were prospectively performed in a patient with suspected liver hemangioma.Images of CEUS were dealt with SVD filtering.Cross-correlation algorithm was used to obtain images of VFI based on grayscale ultrasound,original CEUS and SVD filtered CEUS,respectively,and the ability of the above images for depicting liver microvascular flow direction and velocity were compared.Results The signal-to-noise ratio(SNR)of liver grayscale ultrasound,original CEUS and SVD filtered CEUS images was 7.56,17.65 and 22.43 dB,respectively,while their contrast-to-issue ratio(CTR)was 1.12,7.56 and 16.34 dB,respectively.Compared with VFI based on grayscale ultrasound and original CEUS,VFI based on SVD filtered CEUS could display faster velocity and more uniform direction of blood flow.Before and after SVD filtering,liver microvascular flow velocity measured with VFI was 1.91(0.81,4.11)and 6.83(4.25,9.41)mm/s,respectively,which were significantly different(Z=-10.671,P＜0.001).Conclusion Combined with SVD filtering could significantly improve the efficiency of VFI for depicting liver deep microvasculature flow velocity.

Objective To investigate the effectiveness and safety of EVT in mild stroke patients with ALVO.Methods A total of 124 mild stroke patients with ALVO treated in our hospital were enrolled and randomly divided into control group(n=64)and observation group(n=60).The control group was given routine treatment,while the observation group received EVT treat-ment besides routine treatment.NIHSS score,BI score,and mRS score were compared between the two groups to evaluate the postoperative safety of EVT treatment.Results The NIHSS scores on the 7th and 14th days,and at discharge were significantly lower in the observation group and control group than those at admission(P＜0.05),and those of the former group were obvi-ously decreased than those of the latter group at the corresponding time points(P＜0.01).On the 7th,14th,and discharge days,the BI score of both groups were significantly increased compared to those at admission(P＜0.05),with the scores in the observation group higher than those of the control group at above time points(P＜0.01).The ratio of the patients having mRS score ≤2 point was larger in the observation group than the control group(96.67％vs 84.38％,P＜0.05).One case in the observation group experienced asymptomatic intracranial hemorrhage,and no oth-er adverse events were observed.Conclusion EVT can improve the prognosis of mild stroke pa-tients with ALVO,but does not significantly increases the incidence of adverse events.

Objective:To evaluate the auxiliary diagnosis value of bacterial culture, polymerase chain reaction (PCR) and serum anti-pertussis toxin immunoglobulin G (AntiPT-IgG) level detection in suspected pertussis.Methods:A total of 110 suspected cases of pertussis treated in the Department of Pediatrics of Wuhu No.1 People′s Hospital from June 2018 to May 2019 were recruited for the study.The nasopharyngeal swabs of all cases were collected for Bordetella pertussis culture and specific nucleic acid PCR detection.Serum samples of 78 cases were collected for the detection of AntiPT-IgG level by enzyme linked immunosorbent assays.Results:The positive rates of bacterial culture group and PCR group were 21.8% and 30.0%, respectively, with no statistically significant difference ( χ2=1.198, P>0.05). The culture positive rate of cases with the duration of cough<2 weeks was 32.1%, which was signi-ficantly higher than that of cases with the duration of cough about 2-4 weeks (14.3%) or >4 weeks (9.1%) ( χ2=6.522, P<0.05). The PCR positive rate of cases with the duration of cough <2 weeks was 39.6%, which was also significantly higher than that of cases with the duration of cough about 2-4 weeks (25.7%) or > 4 weeks (13.6%) ( χ2=6.126, P<0.05). The mean value for serum AntiPT-IgG level of 78 cases was (75.727±78.454) IU/mL, the median AntiPT-IgG levels of cases with the duration of cough<2 weeks and about 2-4 weeks were 5.909 IU/mL and 20.948 IU/mL, respectively, and the positive rates were 14.7% and 38.1%, respectively.The AntiPT-IgG level of cases with the duration of cough> 4 weeks and that at convalescent stage were (79.281±68.254) IU/mL and (107.242±75.750) IU/mL, and the positive rates were 39.1% and 57.1%, respectively. Conclusions:In the vaccine era, the results of pathogenic and serological tests should be combined to assist the clinical diagnosis of pertussis.The positive rate of bacterial culture and specific nucleic acid pathogen detection in children with cough duration less than 2 weeks is high, and the serological diagnosis is more effective after the duration of cough is over 4 weeks.

Objective:To analyze the clinical efficacy and safety of stent implantation combined with drug therapy and drug therapy alone in patients with vertebral artery initial stenosis.Methods:A total of 112 patients with vertebral artery initial stenosis who were treated in Wuzhou Workers′ Hospital from January 2016 to June 2018 were selected and divided into drug group and stent + drug group according to random number table method, with 56 patients in each group. The drug group received drug therapy alone, and stent + drug group received stent implantation combined with drug therapy. The incidence of ischemic events in posterior circulation, the improvement of vascular stenosis rate and the improvement of neurological function injury were observed in the two groups after 12 months of treatment.Results:The success rate in the stent + drug group was 100.0%(56/56). The rate of vascular stenosis in the stent + drug group was lower than that in the drug group: (15.21 ± 3.74)% vs. (18.62 ± 4.27)% ; but the incidence of restenosis was higher than that in the drug group:26.79%(15/56) vs. 7.14%(4/56), the differences were statistically significant ( P<0.05). The total incidence of ischemic events in the posterior circulation after treatment in the stent + drug group was lower than that in the drug group: 8.93%(5/56) vs. 28.57%(16/56), and the difference was statistically significant ( χ2 = 7.092, P = 0.008). After treatment, the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) in the stent + drug group were lower than those in the drug group: (2.30 ± 0.36) scores vs. (3.75 ± 0.52) scores, (4.11 ± 0.51) scores vs.(6.14 ± 0.57) scores, and the differences were statistically significant ( P<0.05). Conclusions:The application of stent implantation combined with drug regimen in the treatment of patients with vertebral artery initial stenosis can effectively reduce the neurological damage of patients, andimprove the total effective rate, which is conductive to the improvement of patients′ quality of life, but the rate of stent restenosis is high.

Acute Stanford type A aortic dissection with important branches involved is more complex, could lead to organ malperfusion syndrome even organ failure. The understanding of pathological anatomy, classification, staging, and the pathophysiological change has increasingly mature, but not complete. In addition, the treatment strategy for complex lesions is diversified, some questions may not reach consensus. Fully understanding of the anatomical and pathophysiology is very important for surgeons to choose reasonable treatment strategy. As the rapid development of the basic research, imaging techniques and the concept of surgery procedures, the manage technique of Stanfrod type A dissection and branch vessels at the same time is getting seriously, the related issues also need further discussions.

A 3-year-old girl received phenobarbital 20 mg thrice daily for the prophylaxis of febrile seizure at the beginning of each fever. Twelve hours after the first oral administration,the patient developed red spots on her perioral skin. About 1 hour after the second oral therapy,the patient developed the same rash on her perioral skin and right upper limb. The same symptoms occurred three times in succession after each dose. About one hour after treatment with phenobarbital again,the patient developed the same rash on her perioral skin,right upper limb and bilateral buttocks. The patient was diagnosed as fixed drug eruption induced by phenobarbital. Phenobarbital was stopped and the oral diazepam 1.25 mg thrice daily was given in order to prevent febrile convulsions. All above mentioned symptoms did not recur.