Pregnancy with chronic kidney disease (CKD), particularly in stages 4-5, carries high risks of adverse outcomes including maternal renal failure, preeclampsia/eclampsia, fetal growth restriction, and preterm birth. This report described a 26-year-old woman with congenital solitary kidney, polycystic ovaries, and uterine septum due to PAX2 gene variant, complicated by CKD stage 4. Through multidisciplinary team precision management and individualized treatment strategies, including timely initiation of dialysis, the patient successfully maintained pregnancy until 34 +1 weeks and delivered a female infant via cesarean section. This case summarizes key management experiences for end-stage renal disease in pregnancy, highlighting early risk assessment, precise nutritional management, hemodialysis protocol optimization, and the crucial role of multidisciplinary collaboration, providing valuable references for managing CKD-complicated pregnancies.

Objective To investigate the value of ultrasound for differentiating pancreatoblastoma(PB)and solid pseudopapillary tumor of pancreas(SPT)in children.Methods Data of 7 children with PB(PB group)and 22 with SPT(SPT group)were retrospectively analyzed.The clinical data and lesion's ultrasonic manifestations were compared between groups.Receiver operating characteristic(ROC)curves of clinical and ultrasound related parameters being significantly different between groups showed by univariate analysis were draw,and the area under the curve(AUC)were calculated to evaluate their efficacy for differentiating PB and SPT.Ultrasound parameters with P＜0.05 in univariate analysis were incorporated into binary logistic analysis,and a ultrasound regression model was constructed to distinguish PB and SPT,and its diagnostic efficacy was evaluated.Results Significant differences of children'age,gender,serum alpha fetoprotein level,and the shape,maximum diameter,texture,calcification and local invasion of lesions were found between groups(all P＜0.05).AUC of single serum alpha fetoprotein level,the shape,maximum diameter,texture,calcification and local invasion of lesion for differentiating PB and SPT was 1.000,0.766,0.854,0.776,0.789 and 0.714,respectively(all P＜0.05).The shape(OR=8.704,P=0.075)and maximum diameter of lesions(OR=1.695,P=0.042)showed with ultrasound were both important differentiating factors for PB and SPT,and AUC of the ultrasound regression model constructed based on them was 0.886.Conclusion Ultrasound could effectively differentiate PB and SPT in children.

Background:Obesity has been confirmed as one of the risk factors for gastric cancer.Obesity can affect hormone levels,but studies on the impact of obesity-related hormones on gastric cancer are limited in China.Aims:To investigate the effects of obesity-related hormones on cardia gastric cancer(CGC)and non-cardia gastric cancer(NCGC).Methods:This case-control study included 316 patients diagnosed with gastric cancer at the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from July 2021 to June 2024,while 632 individuals who underwent physical examination during the same period were enrolled as the control group.According to the location of cancer,gastric cancer patients were divided into CGC and NCGC groups.General data and obesity-related hormone levels were compared among the three groups.Multivariate Logistic regression analysis was used to identify the risk factors for CGC and NCGC stratified by gender.Results:Compared with the control group,the levels of C-peptide and insulin-like growth factor-1(IGF-1)in both CGC and NCGC groups were significantly increased(all P<0.05),while the dehydroepiandrosterone(DHEA)level was significantly decreased(all P<0.05).The levels of leptin and sex hormone binding globulin(SHBG)in CGC group were significantly higher than those in the control group(all P<0.05).Compared with NCGC group,CGC group showed significantly higher levels of C-peptide,IGF-1,leptin and SHBG(all P<0.05),and significantly lower level of DHEA(P<0.05).Risk factors for male CGC included obesity,history of digestive system diseases,family history of gastric cancer,irregular meals,consumption of pickled food≥3 times/week,consumption of hot food≥3 times/week,smoking,Helicobacter pylori(Hp)infection,IGF-1≥250 ng/mL,leptin≥7 μg/L,DHEA<15 nmol/L,and SHBG≥80 mmol/L(all P<0.05),while education duration≥9 years was a protective factor(P<0.05).For female CGC,risk factors were history of digestive system diseases,family history of gastric cancer,irregular meals,consumption of pickled food≥3 times/week,smoking,Hp infection,C-peptide≥400 pmol/L,and IGF-1≥250 ng/mL(all P<0.05),while consumption of vegetables≥1 time/day and fruits≥3 times/week were protective factors(all P<0.05).For male NCGC,risk factors included history of mental illness,family history of gastric cancer,meat consumption≥3 times/week,smoking,alcohol drinking,Hp infection,and IGF-1≥250 ng/mL(all P<0.05),while education duration≥9 years and preference for light taste were protective factors(all P<0.05).For female NCGC,risk factors included family history of gastric cancer,irregular meals,consumption of fried food≥3 times/week,Hp infection,and C-peptide≥400 pmol/L(all P<0.05),while vegetables consumption≥1 time/day,fruits consumption≥3 times/week,and tea drinking were protective factors(all P<0.05).Conclusions:Some obesity-related hormones might have significant effects on the development of gastric cancer.

Background:Obesity has been confirmed as one of the risk factors for gastric cancer.Obesity can affect hormone levels,but studies on the impact of obesity-related hormones on gastric cancer are limited in China.Aims:To investigate the effects of obesity-related hormones on cardia gastric cancer(CGC)and non-cardia gastric cancer(NCGC).Methods:This case-control study included 316 patients diagnosed with gastric cancer at the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from July 2021 to June 2024,while 632 individuals who underwent physical examination during the same period were enrolled as the control group.According to the location of cancer,gastric cancer patients were divided into CGC and NCGC groups.General data and obesity-related hormone levels were compared among the three groups.Multivariate Logistic regression analysis was used to identify the risk factors for CGC and NCGC stratified by gender.Results:Compared with the control group,the levels of C-peptide and insulin-like growth factor-1(IGF-1)in both CGC and NCGC groups were significantly increased(all P<0.05),while the dehydroepiandrosterone(DHEA)level was significantly decreased(all P<0.05).The levels of leptin and sex hormone binding globulin(SHBG)in CGC group were significantly higher than those in the control group(all P<0.05).Compared with NCGC group,CGC group showed significantly higher levels of C-peptide,IGF-1,leptin and SHBG(all P<0.05),and significantly lower level of DHEA(P<0.05).Risk factors for male CGC included obesity,history of digestive system diseases,family history of gastric cancer,irregular meals,consumption of pickled food≥3 times/week,consumption of hot food≥3 times/week,smoking,Helicobacter pylori(Hp)infection,IGF-1≥250 ng/mL,leptin≥7 μg/L,DHEA<15 nmol/L,and SHBG≥80 mmol/L(all P<0.05),while education duration≥9 years was a protective factor(P<0.05).For female CGC,risk factors were history of digestive system diseases,family history of gastric cancer,irregular meals,consumption of pickled food≥3 times/week,smoking,Hp infection,C-peptide≥400 pmol/L,and IGF-1≥250 ng/mL(all P<0.05),while consumption of vegetables≥1 time/day and fruits≥3 times/week were protective factors(all P<0.05).For male NCGC,risk factors included history of mental illness,family history of gastric cancer,meat consumption≥3 times/week,smoking,alcohol drinking,Hp infection,and IGF-1≥250 ng/mL(all P<0.05),while education duration≥9 years and preference for light taste were protective factors(all P<0.05).For female NCGC,risk factors included family history of gastric cancer,irregular meals,consumption of fried food≥3 times/week,Hp infection,and C-peptide≥400 pmol/L(all P<0.05),while vegetables consumption≥1 time/day,fruits consumption≥3 times/week,and tea drinking were protective factors(all P<0.05).Conclusions:Some obesity-related hormones might have significant effects on the development of gastric cancer.

Objective To investigate the value of ultrasound for differentiating pancreatoblastoma(PB)and solid pseudopapillary tumor of pancreas(SPT)in children.Methods Data of 7 children with PB(PB group)and 22 with SPT(SPT group)were retrospectively analyzed.The clinical data and lesion's ultrasonic manifestations were compared between groups.Receiver operating characteristic(ROC)curves of clinical and ultrasound related parameters being significantly different between groups showed by univariate analysis were draw,and the area under the curve(AUC)were calculated to evaluate their efficacy for differentiating PB and SPT.Ultrasound parameters with P＜0.05 in univariate analysis were incorporated into binary logistic analysis,and a ultrasound regression model was constructed to distinguish PB and SPT,and its diagnostic efficacy was evaluated.Results Significant differences of children'age,gender,serum alpha fetoprotein level,and the shape,maximum diameter,texture,calcification and local invasion of lesions were found between groups(all P＜0.05).AUC of single serum alpha fetoprotein level,the shape,maximum diameter,texture,calcification and local invasion of lesion for differentiating PB and SPT was 1.000,0.766,0.854,0.776,0.789 and 0.714,respectively(all P＜0.05).The shape(OR=8.704,P=0.075)and maximum diameter of lesions(OR=1.695,P=0.042)showed with ultrasound were both important differentiating factors for PB and SPT,and AUC of the ultrasound regression model constructed based on them was 0.886.Conclusion Ultrasound could effectively differentiate PB and SPT in children.

Pregnancy with chronic kidney disease (CKD), particularly in stages 4-5, carries high risks of adverse outcomes including maternal renal failure, preeclampsia/eclampsia, fetal growth restriction, and preterm birth. This report described a 26-year-old woman with congenital solitary kidney, polycystic ovaries, and uterine septum due to PAX2 gene variant, complicated by CKD stage 4. Through multidisciplinary team precision management and individualized treatment strategies, including timely initiation of dialysis, the patient successfully maintained pregnancy until 34 +1 weeks and delivered a female infant via cesarean section. This case summarizes key management experiences for end-stage renal disease in pregnancy, highlighting early risk assessment, precise nutritional management, hemodialysis protocol optimization, and the crucial role of multidisciplinary collaboration, providing valuable references for managing CKD-complicated pregnancies.

Objective To analyze the research status,hot directions and frontier trends of traditional Chinese medicine in the prevention and treatment of diseases by regulating Wnt signaling pathway based on bibliometrics.Methods Based on Citespace and Vosviewer bibliometric software,the literature on the regulation of Wnt signaling pathway by traditional Chinese medicine in CNKI and WoSCC was visually analyzed.Results As of April 2023,607 and 257 related literatures were published in Chinese and English respectively.Since 2008,the number of literatures published in this field has shown a fluctuating increasing trend.China is the country with the most publications;guangzhou University of Traditional Chinese Medicine and Hunan University of Traditional Chinese Medicine were the institutions with the most publications in the Chinese database,and Shanghai University of Traditional Chinese Medicine was the institution with the most publications in the English literature database.Combined with the research direction of each research team and keyword clustering and burst analysis,the research hotspots of traditional Chinese medicine regulating Wnt signaling pathway are focused on osteoporosis,osteoarthritis and renal fibrosis.Diseases such as gastric cancer and breast cancer have become emerging research directions in recent years.Electroacupuncture therapy to promote stem cell proliferation and treat neurological diseases is one of the frontier research trends in this field.The mechanism of traditional Chinese medicine regulating the interaction between Wnt and NF-kappaB signaling pathway to prevent and treat diseases has great research potential.Conclusion In recent years,the prevention and treatment of diseases by traditional Chinese medicine targeting Wnt signaling pathway has developed rapidly.Various expert teams have obtained rich research results,and the research hotspots show a diversified trend.In-depth exploration of this can provide strong evidence for the molecular mechanism of traditional Chinese medicine in the treatment of various diseases.

Pregnancy with solid pseudopapillary tumor of the pancreas (SPTP) is rare. Because pregnancy hormones may cause tumor progression, the management and treatment of SPTP need to balance the safety of pregnant women and fetuses with surgical treatment. We reported a case of a giant pancreatic tumor diagnosed during pregnancy that was considered to be SPTP. Examinations also showed hepatitis B virus infection and severe decompensation of liver cirrhosis. Medical termination of pregnancy was performed. The patient has lived with the tumor until now without surgery. We retrieved the published case reports, summarized the clinical characteristics of pregnancy with SPTP, and explored its management during the perinatal period. Most patients with SPTP have a good prognosis with good maternal and fetal outcomes, and it is important to choose an appropriate treatment method and timing. However, pregnancy combined with decompensated liver cirrhosis needs to be terminated in a timely manner because of its high-risk status.

Pregnancy with solid pseudopapillary tumor of the pancreas (SPTP) is rare. Because pregnancy hormones may cause tumor progression, the management and treatment of SPTP need to balance the safety of pregnant women and fetuses with surgical treatment. We reported a case of a giant pancreatic tumor diagnosed during pregnancy that was considered to be SPTP. Examinations also showed hepatitis B virus infection and severe decompensation of liver cirrhosis. Medical termination of pregnancy was performed. The patient has lived with the tumor until now without surgery. We retrieved the published case reports, summarized the clinical characteristics of pregnancy with SPTP, and explored its management during the perinatal period. Most patients with SPTP have a good prognosis with good maternal and fetal outcomes, and it is important to choose an appropriate treatment method and timing. However, pregnancy combined with decompensated liver cirrhosis needs to be terminated in a timely manner because of its high-risk status.

Objective:To investigate the effects of Tiaogan Lifei Decoction on the level of symptom control in patients with bronchial asthma (asthma) treated with moderate and high dosage inhaled glucocorticoids (ICS).Methods:Randomized double-blind placebo controlled prospective study was used. Totally 90 patients with asthma (liver lung disharmony, wind phlegm blocking collateral syndrome) using moderate and high dosage ICS who met the inclusion criteria from January 2020 to December 2021 in Chaoyang District Hospital of Traditional Chinese Medicine in Beijing were divided into two groups according to random number table method, with 45 cases in each group. On the basis of using the original dosage of ICS, the treatment group used Tiaogan Lifei Decoction, while the control group used Tiaogan Lifei Decoction simulant. The course of treatment was 12 weeks. TCM symptom score of both group before and after the treatment was detected; asthma control test (ACT) was used to assess the effects of asthma on the patients; St George's Hospital Respiratory Questionnaire (SGRQ) was used to assess patients' quality of life; the peak expiratory flow rate (PEF) was measured with a peak expiratory flow meter. 2 ml of venous blood was collected for eosinophil (EOS) detection, and the serum allergen specific IgE level was determined by ELISA. The adverse reactions were observed during the treatment and the clinical efficacy was evaluated.Results:During the test, 3 cases and 2 cases in the treatment group and control group lost prevention respectively. 3 cases in the treatment group and 6 cases in the control group withdrew from the trial because of the aggravation of symptoms and the need to increase the dosage of ICS. The total effective rate in the treatment group was 78.6% (33/42), and that in the control group was 55.8% (24/43), with statistical significance ( χ2=4.98, P=0.026). After treatment, the scores of daily activities, early awakening, control and total scores in the treatment group were higher than those in the control group ( t values were 1.76, 1.99, 2.00, 2.69, respectively, P<0.01 or P<0.05); after treatment, the scores of cough, chest tightness, active wheezing, upset, pharyngeal itch and total score in the treatment group were lower than those in the control group ( t values were -5.89, -6.01, -5.66, -4.27, -6.67, -9.05, respectively, P<0.01); SGRQ score in the treatment group was lower than that of the control group ( t=-7.19, P<0.01). No serious adverse reactions occurred during treatment in the two groups. Conclusion:Tiaogan Lifei Decoction is helpful to improve the symptom control level of asthma patients who are using ICS, and effectively improve the quality of life of patients with asthma of liver lung disharmony and wind phlegm obstructing collaterals syndrome.