Objective:To analyze the clinical data of patients with severe fever with thrombocytopenia syndrome（SFTS）in Linyi city of Shandong province from 2023 to 2024，analyze the related factors affecting the prognosis，improve the understanding of the disease and reduce its mortality..Methods:The data of 36 SFTS patients diagnosed and admitted to Linyi People's Hospital from May 2023 to August 2024 were retrospectively analyzed. According to the clinical outcomes of the patients，they were divided into a survival group（n=30）and a death group（n=6）. The clinical data and laboratory test results of the two groups were analyzed to evaluate the risk factors related to prognosis.Results:The median age in the death group was 68.33 years old，and that in the survival group was 63.96 years old，with no statistically significant difference. All patients had fever，22 had fatigue and poor appetite，and 21 had muscle aches and other systemic symptoms. some were prone to general symptoms such as fatigue，poor appetite，and muscle soreness. All patients in the death group had neurological symptoms such as headache and consciousness disorders. The levels of serum potassium，CRP，PCT，IL-6，ALT，AST，CK，CK-MB，LDH，α-HBDH，APTT，D-D，and viral load in the death group were higher than those in the survival group，with statistically significant differences（ t=-3.344， P=0.002； Z=-2.195， P=0.028； Z=-3.648， P=0.000； Z=-3.641， P=0.000； Z=-2.241， P=0.025； Z=-2.288， P=0.022； Z=-2.427， P=0.015； Z=-2.007， P=0.045； Z=-3.127， P=0.002； Z=-2.404， P=0.016； Z=-2.755， P=0.006； Z=-3.081， P=0.002； P<0.05）. The platelet count in the death group was lower than that in the survival group，and the difference was statistically significant（ Z=-3.292， P=0.001， P<0.05）. Multivariate Logistic regression analysis showed that patients with increased AST，CK，IL-6，APTT，D-dimer and decreased platelet count had an increased risk of death. Fungal infections occurred in 15 cases，including 5 cases of Candida albicans，3 cases of Candida parapsilosis，and 7 cases of Aspergillus. All patients in the death group had fungal infections，all of whom had Aspergillus infections. Conclusion:SFTS patients often have fever，fatigue，and muscle soreness，and critically ill patients are prone to neurological symptoms. Patients with elevated AST，CK，IL-6，APTT，D-D，viral load，and decreased platelet count in the course of the disease often indicate poor prognosis and should be closely monitored. In addition，critically ill patients are prone to fungal infection.

Objective: To investigate the potential efficacy and safety of Lutai Danshen Baishao granules (LDBG) for treating female melasma associated with kidney deficiency and blood stasis patterns. Methods: A randomized, double-blind, placebo-controlled trial was conducted at the Third Central Hospital of Tianjin, China from March to December 2023. A total of 110 female patients with melasma linked to kidney deficiency and blood stasis were enrolled and treated with either LDBG or a placebo twice daily for 60 days. Efficacy was assessed through measures such as the total melasma area, reduced melasma area, reduction rate of melasma area, melasma color score, Melasma Area and Severity Index (MASI) score, and traditional Chinese medicine (TCM) symptom score scale. Safety assessments included routine blood and biochemical tests. Results: Participants in both groups were aged 52–63 years, with no significant differences. After the 2-month intervention, the total melasma area decreased in both groups; however, a greater reduction was observed in the test group [462.50 mm2 (12.81%) vs. 100.00 mm2 (3.11%), P < .001]. Moreover, LDBG treatment significantly reduced the MASI and melasma color scores in the test group (P < .05). The total TCM symptom evaluation score significantly decreased (test group: 6.00 vs. placebo group: 7.00, P = .001), with significant relief in symptoms such as improvement in dark lips, nails, and waist soreness in the test group, compared with that in the placebo group (P < .05). Within-group comparisons revealed that TCM syndrome was significantly alleviated in the test group (P < .05). Conclusion LDBG intervention shows promising effectiveness in reducing female melasma and alleviating TCM syndromes.

Objective:To compare the efficacy of hepatic artery infusion chemotherapy (HAIC) combined with targeted therapy and immunnotherapy and transarterial chemoembolization (TACE) combined with targeted therapy and immunnotherapy in the treatment of unresectable hepatocellular carcinoma HCC.Methods:We retrospectively analyzed the clinical data of 40 patients with unresectable HCC treated with HAIC combined with targeted therapy and immunnotherapy and TACE combined with targeted therapy and immunnotherapy in Tongde Hospital of Zhejiang Province and Zhejiang Provincial People's Hospital.The patients were divided into HAIC group ( n=14) and TACE group ( n=26) according to the different treatment methods. Baseline data, surgical conversion and intraoperative situation, tumor response, portal vein cancer thrombus control rate, leukocyte reduction rate, platelet reduction rate, incidence of liver function abnormalities, objective remission rate, and disease control rate were compared between the two groups. Results:The HAIC group had a later baseline tumor staging than the TACE group (higher percentage of portal vein cancer thrombus, CNLC stage Ⅲa).The surgical conversion rate of the HAIC and TACE groups were 28.6%(4/14) and 26.9%(7/26), respectively, with the difference of no statistical significance ( P>0.05);The operation time and intraoperative bleeding were (329.5±19.9) min vs.(413.4±26.4) min, (272.2±49.9) ml vs.(536.0±123.6) ml, and the differences were statistically significant ( P<0. 05); The maximum tumor diameter reduction rate [(30.7%±15.1%) vs.(7.2%±12.6%)] and portal vein cancer thrombus control rate [100% (12/12) vs. 64.3% (9/14)], the differences were statistically significant ( P<0.05);The incidences of leukocyte and platelet decrease in the two groups during the course of treatment were 71.4%(10/14) vs. 34.6%(9/26)、78.5%(11/14) vs. 38.5%(10/26), and the incidences of liver function abnormalities were 35.7%(5/14) vs. 69.2%(18/26), the differences were statistically significant ( P<0.05);The objective response rate and disease control rate were 57.1%(8/14) vs. 30.8% (8/26)、71.4% (10/14) vs. 53.8%(14/26), all statistically significant. Conclusion:HAIC combined with targeted therapy and immunnotherapy is a safe and effective treatment for middle and advanced HCC, especially suitable for patients with portal vein tumor thrombus(PVTT), large tumor, or poor liver function.

Objective:To analyze the clinical data of patients with severe fever with thrombocytopenia syndrome（SFTS）in Linyi city of Shandong province from 2023 to 2024，analyze the related factors affecting the prognosis，improve the understanding of the disease and reduce its mortality..Methods:The data of 36 SFTS patients diagnosed and admitted to Linyi People's Hospital from May 2023 to August 2024 were retrospectively analyzed. According to the clinical outcomes of the patients，they were divided into a survival group（n=30）and a death group（n=6）. The clinical data and laboratory test results of the two groups were analyzed to evaluate the risk factors related to prognosis.Results:The median age in the death group was 68.33 years old，and that in the survival group was 63.96 years old，with no statistically significant difference. All patients had fever，22 had fatigue and poor appetite，and 21 had muscle aches and other systemic symptoms. some were prone to general symptoms such as fatigue，poor appetite，and muscle soreness. All patients in the death group had neurological symptoms such as headache and consciousness disorders. The levels of serum potassium，CRP，PCT，IL-6，ALT，AST，CK，CK-MB，LDH，α-HBDH，APTT，D-D，and viral load in the death group were higher than those in the survival group，with statistically significant differences（ t=-3.344， P=0.002； Z=-2.195， P=0.028； Z=-3.648， P=0.000； Z=-3.641， P=0.000； Z=-2.241， P=0.025； Z=-2.288， P=0.022； Z=-2.427， P=0.015； Z=-2.007， P=0.045； Z=-3.127， P=0.002； Z=-2.404， P=0.016； Z=-2.755， P=0.006； Z=-3.081， P=0.002； P<0.05）. The platelet count in the death group was lower than that in the survival group，and the difference was statistically significant（ Z=-3.292， P=0.001， P<0.05）. Multivariate Logistic regression analysis showed that patients with increased AST，CK，IL-6，APTT，D-dimer and decreased platelet count had an increased risk of death. Fungal infections occurred in 15 cases，including 5 cases of Candida albicans，3 cases of Candida parapsilosis，and 7 cases of Aspergillus. All patients in the death group had fungal infections，all of whom had Aspergillus infections. Conclusion:SFTS patients often have fever，fatigue，and muscle soreness，and critically ill patients are prone to neurological symptoms. Patients with elevated AST，CK，IL-6，APTT，D-D，viral load，and decreased platelet count in the course of the disease often indicate poor prognosis and should be closely monitored. In addition，critically ill patients are prone to fungal infection.

Objective:To compare the efficacy of hepatic artery infusion chemotherapy (HAIC) combined with targeted therapy and immunnotherapy and transarterial chemoembolization (TACE) combined with targeted therapy and immunnotherapy in the treatment of unresectable hepatocellular carcinoma HCC.Methods:We retrospectively analyzed the clinical data of 40 patients with unresectable HCC treated with HAIC combined with targeted therapy and immunnotherapy and TACE combined with targeted therapy and immunnotherapy in Tongde Hospital of Zhejiang Province and Zhejiang Provincial People's Hospital.The patients were divided into HAIC group ( n=14) and TACE group ( n=26) according to the different treatment methods. Baseline data, surgical conversion and intraoperative situation, tumor response, portal vein cancer thrombus control rate, leukocyte reduction rate, platelet reduction rate, incidence of liver function abnormalities, objective remission rate, and disease control rate were compared between the two groups. Results:The HAIC group had a later baseline tumor staging than the TACE group (higher percentage of portal vein cancer thrombus, CNLC stage Ⅲa).The surgical conversion rate of the HAIC and TACE groups were 28.6%(4/14) and 26.9%(7/26), respectively, with the difference of no statistical significance ( P>0.05);The operation time and intraoperative bleeding were (329.5±19.9) min vs.(413.4±26.4) min, (272.2±49.9) ml vs.(536.0±123.6) ml, and the differences were statistically significant ( P<0. 05); The maximum tumor diameter reduction rate [(30.7%±15.1%) vs.(7.2%±12.6%)] and portal vein cancer thrombus control rate [100% (12/12) vs. 64.3% (9/14)], the differences were statistically significant ( P<0.05);The incidences of leukocyte and platelet decrease in the two groups during the course of treatment were 71.4%(10/14) vs. 34.6%(9/26)、78.5%(11/14) vs. 38.5%(10/26), and the incidences of liver function abnormalities were 35.7%(5/14) vs. 69.2%(18/26), the differences were statistically significant ( P<0.05);The objective response rate and disease control rate were 57.1%(8/14) vs. 30.8% (8/26)、71.4% (10/14) vs. 53.8%(14/26), all statistically significant. Conclusion:HAIC combined with targeted therapy and immunnotherapy is a safe and effective treatment for middle and advanced HCC, especially suitable for patients with portal vein tumor thrombus(PVTT), large tumor, or poor liver function.

Surgical resection is one of the important means to achieve long-term survival for patients with liver malignant tumor. However, most of the liver malignant tumor has been diagnosed in the middle and late stage, and lose the chance of surgical treatment. For these patients who have lost the chance of surgery, some surgeons have proposed the concept of planned liver resection, which is to reduce tumor stage and increase future liver remnant (FLR) in a planned way, so as to improve the safety of surgery and prolong the survival time of patients after surgery. For patients with FLR insufficiency after prior evaluation or/and treatment, the technique of hepatic hyperplasia is an important part of planned hepatectomy, that is, to effectively increase FLR in a short period of time by various means. Portal vein ligation (PVL) and portal vein embolization (PVE), associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and liver venous deprivation (LVD) are three main techniques for hepatic hyperplasia. This article reviews the principle, effect and safety of three liver augmentation techniques.

Malignant obstructive jaundice is caused by direct invasion or compression of the biliary tract by malignant tumors of the bile duct, pancreas and other systems. Patients are often accompanied by symptoms such as malnutrition, low immune function, and organ damage. The treatments of active preoperative biliary drainage and reasonable reinfusion combined with enteral nutrition can help improve the safety of patients during the perioperative period, reduce postoperative complications, and improve the life quality of patients. This article reviewed the research progress of preoperative biliary drainage, bile recycling methods and precautions in patients with malignant obstructive jaundice, aiming to provide reference for clinical diagnosis and treatment practice.

Objective:To evaluate the safety and clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with portal vein embolization (PVE) and percutaneous microwave ablation liver partition with PVE for planned hepatectomy in patients with hepatocellular carcinoma (HCC) with insu-fficient remnant liver volume.Methods:The clinical data of 51 patients with initially unresectable HCC due to insufficient remnant liver volume admitted to Zhejiang Provincial Tongde Hospital and Zhejiang Provincial People’s Hospital from January 2014 to December 2021 were retrospectively analyzed, including 37 males and 14 females, aged (56.7±11.2) years old. Patients were divided into two groups according to the treatment prior to hepatectomy: percutaneous microwave ablation liver partition combined with PVE (AP group, n=12) and TACE with PVE (TP group, n=39). Patients who successfully underwent planned hepatectomy in the above two groups were marked as resectable AP group ( n=10) and the resectable TP group ( n=29), respectively. Clinical data including the waiting time for surgery and the incidence of complications were analyzed. Patients were followed up by telephone or outpatient review. Kaplan-Meier and log-rank analysis were used for survival comparison. Results:The FLR growth rate was higher in AP group [76.5% (65.3%, 81.6%)] than that in TP group [31.4% (28.2%, 41.9%), P<0.01]. The waiting time for planned hepatectomy in the resectable AP group was 12.0 (11.3, 14.5) d, shorter than that in the resec-table TP group [21.0 (15.0, 29.0) d, P<0.05]. The incidence of postoperative complications was higher in the resectable AP group than that in the resectable TP group [80.0% (8/10) vs. 27.6% (8/29), P<0.05]. There was one perioperative death in the resectable AP group. The survival rate after PVE was lower in AP group than that in TP group, and the survival rate after hepatectomy was also lower in the resectable AP group than that in the resectable TP group (all P<0.05). Conclusion:For HCC patients with insufficient FLR, TACE combined with PVE is a safe and effective method for enlargement of liver remnant, whereas percutaneous microwave ablation liver partition with PVE showed a poor prognosis, despite the higher rate of FLR enlargement and shortened the waiting time for planned hepatectomy.

Objective:To investigate the clinical characteristics and prognosis of Philadelphia (Ph) chromosome-positive chronic myeloid leukemia (CML) patients with additional chromosomal abnormalities.Methods:The data of 351 CML patients with Ph-positive in the Affiliated Hospital of Qingdao University from January 2009 to January 2019 were retrospectively analyzed. The bone marrow chromosomal karyotype analysis of all patients was performed by using R-banding technique. The clinical characteristics and karyotype of Ph-positive CML patients with additional chromosomal abnormalities at initial diagnosis were summarized, and Kaplan-Meier was used to analyze the differences in overall survival (OS) of patients with different karyotypes.Results:Among 351 patients with Ph-positive CML, 32 (9.1%) cases had variant translocation. At initial diagnosis, 47 cases had additional chromosomal abnormalities including 29 cases in chronic phase accounting for 9.15% (29/317) of all patients in chronic phase, 3 cases in accelerated phase accounting for 25.00% (3/12) of all patients in accelerated phase, 15 cases in blast crisis accounting for 68.18% (15/22) of all patients in blast crisis; there was a statistically significant difference in the chromosomal abnormalities rate of all different phases ( χ2=50.799, P<0.05). Among 47 Ph-positive CML patients with additional chromosomal abnormalities, 13 patients had complex karyotypes with more than 3 additional chromosomal abnormalities, the proportion of complex karyotypes in chronic phase, accelerated phase and blast crisis was 13.79% (4/29), 33.33% (1/3) and 53.33% (8/15), respectively, and the difference was statistically significant ( χ2=9.26, P<0.05). The study showed that the most common additional chromosomal abnormalities in chronic phase were double Ph (48.28%, 14/29) and -Y (10.34%, 3/29), while the most common chromosomal abnormalities in the blast crisis were +8 (26.67%, 4/15) and double Ph (26.67%, 4/15). Kaplan-Meier survival analysis showed that at initial diagnosis the OS time of patients with additional chromosomal abnormalities was worse than that of those with the non-additional chromosomal abnormalities group ( χ2 = 61.138, P<0.05). The OS of patients with complex karyotypes for Ph - positive CML patients with additional chromosomal abnormalities at initial diagnosis was worse than that of patients with non-complex karyotypes, and the difference was significant ( χ2 = 4.945, P < 0.05). Conclusions:The additional chromosomal abnormalities is closely related to the progression of CML, and the prognosis of CML patients with additional chromosomal abnormalities is poorer than that of patients with only Ph translocation. Moreover, the more complex the additional chromosomes are, the more likely blastic changes are, and the poorer prognosis. And additional chromosomeal abnormalities during the treatment of CML patients may also lead to the progression of blastic changes.