Heat stroke is a life-threatening emergency characterized by a rapid elevation in core body temperature(typically>40℃)and central nervous system dysfunction(e.g.,delirium,seizures or coma),often accompanied by systemic inflammatory response,coagulation disorders,and multiple organ failure,with an extremely high mortality rate.Among the multiple organ injuries caused by heat stroke,the liver,as the core organ for metabolism and detoxification in the body,is one of the targets that are vulnerable to high temperatures.If not intervened promptly and effectively,acute liver injury(ALI)can rapidly evolve into acute liver failure(ALF),significantly increasing the complexity of clinical treatment and the risk of patient death.In recent years,with the frequent occurrence of heat wave events worldwide,the pathological mechanisms and prevention strategies of heat stroke and its related liver injuries have received increasingly widespread attention.Although basic and clinical studies have made certain progress,revealing key pathological changes such as hepatocyte necrosis,excessive inflammatory response and coagulopathy,there is still a lack of unified and standardized consensus guidelines for the clinical evaluation,diagnosis and systematic treatment of heat stroke combined with liver failure.Therefore,this article aims to systematically review and summarize the pathogenesis,clinical presentation,diagnostic approaches,and treatment strategies of current liver failure related to heat stroke,in order to provide clear diagnostic and treatment ideas and practical references for clinical workers,and thereby provide theoretical basis and clinical guidance for improving the prognosis of critically ill patients with heat stroke liver failure.

In recent years, the incidence of heat stroke has increased annually due to global climate warming and frequent extreme high-temperature events. Although medical staff's awareness of heat stroke has been improving, there are still many controversies regarding its diagnosis, pathogenesis, treatment, and prognosis. This article reviews the latest developments in the diagnosis and treatment of heat stroke based on both domestic and international research, and summarizes and discusses the issues that healthcare providers should focus on during the diagnosis and treatment process. The goal is to improve the level of diagnosis and treatment of heat stroke and to enhance patient prognosis.

In recent years, the incidence of heat stroke has increased annually due to global climate warming and frequent extreme high-temperature events. Although medical staff's awareness of heat stroke has been improving, there are still many controversies regarding its diagnosis, pathogenesis, treatment, and prognosis. This article reviews the latest developments in the diagnosis and treatment of heat stroke based on both domestic and international research, and summarizes and discusses the issues that healthcare providers should focus on during the diagnosis and treatment process. The goal is to improve the level of diagnosis and treatment of heat stroke and to enhance patient prognosis.

Heat stroke is a life-threatening emergency characterized by a rapid elevation in core body temperature(typically>40℃)and central nervous system dysfunction(e.g.,delirium,seizures or coma),often accompanied by systemic inflammatory response,coagulation disorders,and multiple organ failure,with an extremely high mortality rate.Among the multiple organ injuries caused by heat stroke,the liver,as the core organ for metabolism and detoxification in the body,is one of the targets that are vulnerable to high temperatures.If not intervened promptly and effectively,acute liver injury(ALI)can rapidly evolve into acute liver failure(ALF),significantly increasing the complexity of clinical treatment and the risk of patient death.In recent years,with the frequent occurrence of heat wave events worldwide,the pathological mechanisms and prevention strategies of heat stroke and its related liver injuries have received increasingly widespread attention.Although basic and clinical studies have made certain progress,revealing key pathological changes such as hepatocyte necrosis,excessive inflammatory response and coagulopathy,there is still a lack of unified and standardized consensus guidelines for the clinical evaluation,diagnosis and systematic treatment of heat stroke combined with liver failure.Therefore,this article aims to systematically review and summarize the pathogenesis,clinical presentation,diagnostic approaches,and treatment strategies of current liver failure related to heat stroke,in order to provide clear diagnostic and treatment ideas and practical references for clinical workers,and thereby provide theoretical basis and clinical guidance for improving the prognosis of critically ill patients with heat stroke liver failure.

Objective:To evaluate the incidence, clinical significance and influencing factors on in-stent stenosis(ISS) after treatment of intracranial aneurysms by Pipeline embolization device(PED).Methods:A retrospective analysis was conducted on the clinical data of 161 patients with intracranial aneurysms treated with PED at the Department of Interventional Radiology of the First Affiliated Hospital of Zhengzhou University from April 2015 to July 2021. PED was implanted into the parent artery through the femoral artery approach after general anesthesia. The first DSA follow-up duration time and imaging data were collected, and the patients were divided into ISS group and non-ISS group accordingly. The degree of aneurysm occlusion was evaluated by O′Kelly-Marotta(OKM) grading scale. Univariate and multivariate logistic regression analysis were applied to identify the factors related to ISS.Results:A total of 179 PED were employed in 161 patients with 168 aneurysms. Eighty-eight (52.38%) aneurysms were treated by PED only, and 80 (47.62%) aneurysms by PED combined with coiling. After a median follow-up of 6 (5, 7) months, 31(18.45%) aneurysms had ISS within the PED, of which 16(9.52%) cases were with mild stenosis (<50%), 13 (7.74%) were with moderate stenosis (50%-75%), and 2(1.19%) were with severe stenosis (>75%). All patients with ISS showed no relevant clinical symptoms. One (0.60%) patient with ISS underwent balloon angioplasty. Univariate analysis showed that the stent diameter, aneurysm location, triglyceride level, the diameter of distal parent artery, and the diameter of proximal parent artery were associated to ISS. Further multivariate logistic regression analysis showed the stent diameter (OR=0.332, 95%CI 0.191-0.578, P<0.001) and triglyceride level (OR=1.641, 95%CI 1.034-2.605, P=0.036) were independent factors of ISS. Conclusions:ISS is a common benign complication after PED treatment. The current results suggest that small stent diameter and high triglyceride level are independent factors of ISS.