Stroke, a major cerebrovascular disease, has high morbidity and mortality. Effective methods to reduce the risk and improve the prognosis are lacking. Currently, uric acid (UA) is associated with the pathological mechanism, prognosis, and therapy of stroke. UA plays pro/anti-oxidative and pro-inflammatory roles in vivo. The specific role of UA in stroke, which may have both neuroprotective and damaging effects, remains unclear. There is a U-shaped association between serum uric acid (SUA) levels and ischemic stroke (IS). UA therapy provides neuroprotection during reperfusion therapy for acute ischemic stroke (AIS). Urate-lowering therapy (ULT) plays a protective role in IS with hyperuricemia or gout. SUA levels are associated with the cerebrovascular injury mechanism, risk, and outcomes of hemorrhagic stroke. In this review, we summarize the current research on the role of UA in stroke, providing potential targets for its prediction and treatment.
Humans ; Uric Acid/metabolism* ; Stroke/drug therapy* ; Animals ; Hyperuricemia/drug therapy* ; Ischemic Stroke/blood* ; Biomarkers/blood*

Primary liver cancer is one of the most common malignant tumors of the digestive system， and the “inflammation-to-cancer transformation” （ICT） of chronic hepatitis is the core pathological process of the progression of chronic hepatitis to liver cancer. Persistent and uncontrolled liver inflammation in patients with chronic hepatitis often leads to repeated liver tissue damage and repair， which gradually develops into liver fibrosis and cirrhosis， eventually leading to malignant transformation through the mechanisms such as gene mutation and microenvironment imbalance. ICT in chronic hepatitis is the key link between chronic hepatitis and liver cancer， and its dynamic evolution involves various pathogenic factors such as dampness， heat， deficiency， toxin， and stasis； among which damp-heat and vital energy deficiency are the initiating factors for ICT of chronic hepatitis， while intermingled stasis and toxin are the key pathological products that promote malignant transformation. Based on the concept of preventive treatment， traditional Chinese medicine can effectively delay and even block the ICT of chronic hepatitis by regulating inflammation， metabolism， and abnormal cell proliferation through multiple targets， which provides important strategies and research directions for the prevention and treatment of liver cancer.

Objective:To investigate the application and clinical efficacy of customized, 3D-printed femoral bone marrow stems in the revision of tumor prostheses.Methods:A retrospective analysis was performed for the data of 11 patients (7 males and 4 females) aged 53.1±11.7 years (range, 38-75 years), who underwent 3D-printed customized revision of femoral intramedullary stems due to loosening of femoral tumor prostheses at the 960th Hospital of the Joint Support Force of the PLA from June 2021 to June 2023. The pathological types of tumors associated with the initial surgeries included 4 cases of giant cell tumor of bone, 5 cases of osteosarcoma, 1 case of chondrosarcoma, and 1 case of plasma cell tumor. The tumor was located at the distal femur in 8 cases and the proximal femur in 3 cases. The procedures included 3 initial revisions, 7 secondary revisions, and 1 tertiary revision. The average limb shortening measured 4.6±2.2 cm (range, 2.5-9.0 cm). Prior to revision, all prostheses were fixed with bone cement, revealing enlargement of the femoral medullary cavity and cortical bone thinning. Among them, 5 cases had intramedullary stems permeabilizing the femoral cortex, and 1 case had femoral cleavage fractures. All 11 patients received personalized data for the design and 3D printing of femoral bone marrow stems.Results:The lengths and diameters of the 3D-printed porous femoral bone marrow stems ranged from 80 to 160 mm and 20 to 22 mm, respectively. Ten patients were fitted with cylindrical intramedullary handles, while one received a conical intramedullary handle. A successful revision with the 3D-printed stems was achieved in 10 patients; however, 1 case failed to accommodate the conical handle and was instead revised with a bone cement prosthesis. During the implantation of the intramedullary stems, three patients experienced minor cortical splitting, which was managed with bundling and fixation during the procedure. Immediate stability was attained for all prostheses during surgery, yet postoperative limb shortening did not undergo significant correction. All patients exhibited normal healing of their postoperative incisions. The visual analog scale for limb pain decreased significantly from 8.0±0.8 points before surgery to 1.0±0.4 points three months postoperatively ( t=25.957, P<0.001). By six months after the surgery, none of the patients reported any limb pain. Follow-up data for all 11 patients indicated an average follow-up duration of 25.2±7.5 months (range, 16-36 months), during which limb function improved satisfactorily. The Musculoskeletal Tumor Society (MSTS) score increased from 7.9±1.4 points preoperatively to 20.9±2.7 points at the last follow-up, with this change also being statistically significant ( t=14.229, P<0.001). Imaging evaluations revealed normal lower limb force lines, no rotation or longitudinal displacement of the prosthetic stem, and successful integration with the femur. Conclusion:Personalized intramedullary stems produced through 3D printing demonstrate significant clinical effectiveness in femoral tumor prosthesis revision surgery, making them a viable option for such procedures.

Objective:To investigate the application and clinical efficacy of customized, 3D-printed femoral bone marrow stems in the revision of tumor prostheses.Methods:A retrospective analysis was performed for the data of 11 patients (7 males and 4 females) aged 53.1±11.7 years (range, 38-75 years), who underwent 3D-printed customized revision of femoral intramedullary stems due to loosening of femoral tumor prostheses at the 960th Hospital of the Joint Support Force of the PLA from June 2021 to June 2023. The pathological types of tumors associated with the initial surgeries included 4 cases of giant cell tumor of bone, 5 cases of osteosarcoma, 1 case of chondrosarcoma, and 1 case of plasma cell tumor. The tumor was located at the distal femur in 8 cases and the proximal femur in 3 cases. The procedures included 3 initial revisions, 7 secondary revisions, and 1 tertiary revision. The average limb shortening measured 4.6±2.2 cm (range, 2.5-9.0 cm). Prior to revision, all prostheses were fixed with bone cement, revealing enlargement of the femoral medullary cavity and cortical bone thinning. Among them, 5 cases had intramedullary stems permeabilizing the femoral cortex, and 1 case had femoral cleavage fractures. All 11 patients received personalized data for the design and 3D printing of femoral bone marrow stems.Results:The lengths and diameters of the 3D-printed porous femoral bone marrow stems ranged from 80 to 160 mm and 20 to 22 mm, respectively. Ten patients were fitted with cylindrical intramedullary handles, while one received a conical intramedullary handle. A successful revision with the 3D-printed stems was achieved in 10 patients; however, 1 case failed to accommodate the conical handle and was instead revised with a bone cement prosthesis. During the implantation of the intramedullary stems, three patients experienced minor cortical splitting, which was managed with bundling and fixation during the procedure. Immediate stability was attained for all prostheses during surgery, yet postoperative limb shortening did not undergo significant correction. All patients exhibited normal healing of their postoperative incisions. The visual analog scale for limb pain decreased significantly from 8.0±0.8 points before surgery to 1.0±0.4 points three months postoperatively ( t=25.957, P<0.001). By six months after the surgery, none of the patients reported any limb pain. Follow-up data for all 11 patients indicated an average follow-up duration of 25.2±7.5 months (range, 16-36 months), during which limb function improved satisfactorily. The Musculoskeletal Tumor Society (MSTS) score increased from 7.9±1.4 points preoperatively to 20.9±2.7 points at the last follow-up, with this change also being statistically significant ( t=14.229, P<0.001). Imaging evaluations revealed normal lower limb force lines, no rotation or longitudinal displacement of the prosthetic stem, and successful integration with the femur. Conclusion:Personalized intramedullary stems produced through 3D printing demonstrate significant clinical effectiveness in femoral tumor prosthesis revision surgery, making them a viable option for such procedures.

Methods: Preoperatively, all 115 patients underwent BMD assessments using both CT-derived HUs and dual-energy X-ray absorptiometry and were administered multiple questionnaires, including the Pain Catastrophizing Scale (PCS), Beck Anxiety Inventory (BAI), and Beck Depression Index (BDI). Both pain intensity and pain-related disability were assessed before and after lumbar fusion surgery. Results: Postoperatively, 14 patients (14/115, 12.2%) experienced FBSS. Multivariate logistic regression was used to examine all preoperative covariates with significant differences between the patients with and without FBSS. The numeric rating pain scale score at rest, BAI score, PCS score, and HU value were found to be independently associated with FBSS (p<0.05). Conclusions This study revealed that preoperative BMD, as quantified by CT-derived HU values, may be associated with FBSS. Preoperative assessments of CT-derived HU values might provide additional details for identifying patients susceptible to FBSS, which could help prevent this complication.

Objective:The distribution characteristics of intrathecal drugs and the limitation of current catheterization techniques make traditional intrathecal analgesic treatment nearly useless for refractory craniofacial pain,such as trigemina neuralgia.This technical guideline aims to promote the widespread and standardize the application of intra-prepontine cisternal drug delivery via spinal puncture and catheterization. Methods:A modified Delphi approach was used to work for this guideline.On the issues related to the intra-prepontine cisternal targeted drug delivery technique,the working group consulted 10 experts from the field with 3 rounds of email feedback and 3 rounds of conference discussion. Results:For the efficacy and safety of the intra-prepontine cisternal targeted drug delivery technique,a consensus was formed on 7 topics(with an agreement rate of more than 80%),including the principles of the technique,indications and contraindications,patient preparation,surgical specifications for intra-prepontine cisternal catheter placement,analgesic dosage coordination,analgesic management,and prevention and treatment of complications. Conclusion:Utilizing the intra-prepontine cisternal drug infusion system to manage refractory craniofacial pain could provide advantages in terms of minimally invasive,secure,and effective treatment.This application can not only alleviate the suffering of individuals experiencing the prolonged pain but also support the maintenance of quality of life and dignity in their final moments,justifiing its widespread dissemination and standardized adoption in domestic and international professional fields.

Objective:To study the risk factors for acute kidney injury (AKI) after adult orthotopic liver transplantation.Methods:The clinical data of 232 recipients who underwent orthotopic liver transplantation at the First Affiliated Hospital of Zhengzhou University from January 2019 to April 2021 were retrospectively analyzed. There were 195 males and 37 females, aged (49.1±9.4) years old. The patients were divided into two groups according to whether AKI had occurred within 7 days of surgery into the AKI group ( n=112) and the non-AKI group ( n=120). Clinical data including basic information, preoperative hematological indexes, operation time and postoperative hospital stay were compared between the two groups. Factors associated with AKI after orthotopic liver transplantation were studied using univariate analysis and those factors with significant differences were included in multifactorial logistic regression analysis. Results:Among 232 patients who underwent orthotopic liver transplantation, 112 patients developed AKI after surgery, with an incidence of 48.3% (112/232). There were 64 patients with AKI stage 1 (57.1%, 64/112), 30 patients with AKI stage 2 (26.8%, 30/112), and 18 patients with AKI stage 3 (16.1%, 18/112). Logistic regression analysis showed that hypertension ( OR=5.874, 95% CI: 1.931-17.863, P=0.002) and high scores on the model for end-stage liver disease (MELD) ( OR=1.041, 95% CI: 1.010-1.074, P=0.010) were independent risk factors for AKI after orthotopic liver transplantation. Conclusion:Hypertension and MELD score were independent risk factors for postoperative AKI in orthotopic liver transplant recipients.

Objective:To investigate the value of real-time shear wave elastography (SWE) in the assessment of splenic congestion in patients with chronic right heart failure.Methods:Sixty patients with chronic right heart failure with cardiac function grade Ⅱ-Ⅳ of New York Heart Association (NYHA) treated in Lianyungang First People′s Hospital from March 2020 to February 2021 were collected as the study group, and 20 healthy subjects in the same period were selected as the control group. Routine echocardiography was performed on all subjects; spleen stiffness measurement (SSM) was detected by SWE, and blood biochemical indicators related to patients with right heart failure were detected and recorded. SSM and other related parameters between the two groups were analyzed; the SSM in patients of different cardiac function classifications and course of disease were compared; 60 patients were divided into low SSM group (SSM≤15.0 kPa), middle SSM group (15.0 kPa

BACKGROUND: Studies have shown that elevated serum lactate dehydrogenase (LDH) concentration can lead to poor prognosis in patients with small cell lung cancer and lung adenocarcinoma, but its relationship with the prognosis of patients with lung large-cell neuroendocrine carcinoma (L-LCNEC) is not clear. This study aims to explore the influence of L-LCNEC preoperative serum LDH concentration and postoperative LDH concentration change trend on the disease-free survival (DFS) of patients after surgery, so as to judge the clinical prognosis of L-LCNEC provides new ideas. METHODS: Collected the clinical data. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value, while the Kaplan-Meier and Cox proportional hazard model were used to analyze data. RESULTS: DFS was shortened in patients with high serum LDH concentration before operation and increased LDH concentration after operation (P<0.001, P<0.001). The preoperative LDH concentration and postoperative LDH concentration change trend were independent prognostic factors for patients (P<0.001, P=0.037). CONCLUSIONS Preoperative LDH concentration and its postoperative concentration change trend in patients with L-LCNEC are independent prognostic factors for DFS of patients.

Objective:To explore the effects of serum cystatin C (Cys C) and uric acid (UA) concentrations before treatment on the prognosis of small cell lung cancer (SCLC) patients.Methods:A total of 196 patients diagnosed with SCLC in Affiliated Hospital of Qingdao University from April 2015 to December 2018 were selected, and hematological indicators such as serum Cys C and UA before treatment were collected. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values of Cys C and UA. The Kaplan-Meier method was used for survival analysis. Cox proportional hazards model was used for univariate and multivariate analysis.Results:The optimal cut-off values of serum Cys C and UA before treatment were 0.775 mg/L and 296.45 μmol/L, respectively. Survival analysis showed that with the optimal cut-off value, the median progression-free survival (PFS) of patients with high concentrations of serum Cys C and UA (5.49 months vs. 8.57 months, χ2=35.943, P<0.001; 6.67 months vs. 8.20 months, χ2=8.047, P=0.005) and overall survival (OS) (13.37 months vs. 23.95 months, χ2=21.355, P<0.001; 14.13 months vs. 20.97 months, χ2=11.333, P=0.001) were shorter than those of patients with low concentrations. Univariate analysis showed that factors related to PFS were smoking history ( HR=0.707, 95% CI: 0.518-0.965, P=0.029), staging ( HR=1.776, 95% CI: 1.329-2.373, P<0.001), first-line medication ( HR=1.596, 95% CI: 1.072-2.376, P=0.021), chest radiotherapy ( HR=2.407, 95% CI: 1.803-3.214, P<0.001), Cys C ( HR=3.602, 95% CI: 1.716-7.561, P=0.001), UA ( HR=1.002, 95% CI: 1.000-1.003, P=0.036), and alkaline phosphatase ( HR=1.010, 95% CI: 1.004-1.016, P=0.001); factors related to OS included smoking history ( HR=0.577, 95% CI: 0.382-0.870, P=0.009), staging ( HR=1.846, 95% CI: 1.295-2.630, P=0.001), chest radiotherapy ( HR=2.041, 95% CI: 1.426-2.921, P<0.001), Cys C ( HR=9.506, 95% CI: 3.278-27.564, P<0.001) and UA ( HR=1.003, 95% CI: 1.001-1.005, P=0.006). Multivariate analysis showed that chest radiotherapy ( HR=2.553, 95% CI: 1.774-3.672, P<0.001), Cys C ( HR=4.538, 95% CI: 1.875-10.982, P=0.001) and alkaline phosphatase ( HR=1.011, 95% CI: 1.005-1.018, P=0.001) were independent prognostic factors for PFS; Cys C ( HR=9.028, 95% CI: 2.680-30.413, P<0.001) was an independent prognostic factor for OS. Conclusion:Both serum Cys C and UA concentrations before treatment in SCLC patients have a certain relationship with the prognosis of the patients. Those with elevated concentrations have shorter PFS and OS and poor prognosis. The high concentration of serum Cys C before treatment may indicate a rapid progression of the disease and a short survival time. It is necessary to pay attention to disease progression and recurrence.