This was a single-center retrospective case series study. This study evaluated the efficacy and safety of percutaneous covered stent endovascular exclusion under digital subtraction angiography (DSA) for removing dialysis catheters misplaced in arteries. The clinical data from 7 patients treated in the First Affiliated Hospital of Zhejiang University School of Medicine from January 2012 to October 2023 were analyzed. All patients had dialysis catheters confirmed to be misplaced in arteries via chest CT, X-ray radiography or computed tomography angiography. Percutaneous covered stent endovascular exclusion under DSA was used to remove the catheters. The results showed that except for one elderly patient died during waiting for surgery, the remaining 6 patients achieved satisfactory outcomes with no postoperative bleeding. There was no related complication observed during a 6-month follow-up. Arterial misplacement of dialysis catheters is a serious complication requiring prompt removal. Percutaneous covered stent endovascular exclusion under DSA offers a minimally invasive, effective, and safe approach with a high technical success rate and a low complication rate, making it a viable surgical option for similar clinical cases.

This was a single-center retrospective case series study. This study evaluated the efficacy and safety of percutaneous covered stent endovascular exclusion under digital subtraction angiography (DSA) for removing dialysis catheters misplaced in arteries. The clinical data from 7 patients treated in the First Affiliated Hospital of Zhejiang University School of Medicine from January 2012 to October 2023 were analyzed. All patients had dialysis catheters confirmed to be misplaced in arteries via chest CT, X-ray radiography or computed tomography angiography. Percutaneous covered stent endovascular exclusion under DSA was used to remove the catheters. The results showed that except for one elderly patient died during waiting for surgery, the remaining 6 patients achieved satisfactory outcomes with no postoperative bleeding. There was no related complication observed during a 6-month follow-up. Arterial misplacement of dialysis catheters is a serious complication requiring prompt removal. Percutaneous covered stent endovascular exclusion under DSA offers a minimally invasive, effective, and safe approach with a high technical success rate and a low complication rate, making it a viable surgical option for similar clinical cases.

In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.

Macrophages are important cells of the immune system. Tumor-associated macrophages are enriched macrophages near tumor cells or tissues. Their role is mainly to promote the construction of tumor inflammatory microenvironment and inhibit tumor immune response. Cell co-culture system is a symbiotic culture system formed by mimicking the internal environment of the body in vitro. The co-culture condition is relatively consistent with the environment in vivo, enabling better information exchange and material exchange between cells, which is a supplement to the monolayer cell culture and animal experiments. Tumor-associated macrophages and tumor cells co-exist in the tumor microenvironment. Thus, constructing a co-culture system for tumor-associated macrophages and tumor cells would be conducive to studying the antitumor effect of tumor-associated macrophages and developing new immunotherapy drugs. The co-culture system would provide a new direction for treating malignant tumors. This article mainly reviewed the co-culture patterns of macrophages and the antitumor effects of different phenotypes of macrophages, and highlighted the importance of using immunotherapy to treat malignant tumors in the tumor microenvironment.

Klebsiella pneumoniae liver abscess accompanied by metastatic infectious complications was firstly reported in 1986. The pathogen was defined as Hypervirulent K. pneumoniae (hvKp) after a series of studies, which is an evolving pathotype and more virulent than classical K. pneumoniae (cKp). At present, it is difficult to distinguish hvKp and cKp in the clinical microbiology lab, which results in delay in early diagnosis and treatment on hvKp-related infections. Biliary tract diseases after cholangiojejunostomy, biliary interventional therapy and liver transplantation have become common causes of recurrent acute cholangitis. The incidence of bacterial liver abscess is on the rise, especially the infection caused by multidrug-resistant bacteria. This article reviews difficulties in the diagnosis and treatment of bacterial liver abscess.

OBJECTIVES: Thoracoabdominal aortic aneurysm (TAAA) prosthetic vessel replacement is one of the most complex operations in the field of cardiovascular surgery. The key to success of this operation is to prevent and avoid ischemia of important organs while repairing TAAA. This study aims to summarize and analyze the effect of prosthetic vessel replacement under left heart bypass in the treatment of TAAA. METHODS: Data of 15 patients with TAAA who underwent prosthetic vessel replacement under left heart bypass in Xiangya Hospital of Central South University were retrospectively analyzed. According to Crawford classification, there were 2 cases of type I, 8 cases of type II, 3 cases of type III, and 2 cases of type V. There were 14 cases of selective operation and 1 case of emergency operation. All operations were performed under left heart bypass, and cerebrospinal fluid drainage was performed before operation. Left heart bypass was established by intubation of left inferior pulmonary vein and distal abdominal aorta or left femoral artery. The thoracoabdominal aorta was replaced segment by segment. After aortic dissection, the kidneys were perfused with cold crystalloid renal protective solution, and the celiac trunk and superior mesenteric artery were perfused with warm blood. RESULTS: One patient with TAAA after aortic dissection of type A died. During the operation, straight blood vessels were used to repair TAAA, and the celiac artery branches were trimmed into island shape and anastomosed with prosthetic vessels. After the operation, massive bleeding occurred at the anastomotic stoma, then anaphylactic reaction occurred during massive blood transfusion, resulting in death. One patient suffered from paraplegia due to ischemic injury of spinal cord. The other patients recovered well and were discharged. The postoperative ventilation time was (16.5±13.8) h and the postoperative hospital stay was (10±4) d. The amount of red blood cell transfusion was (13±9) U. The patients were followed up for 2 months to 2 years, and the recovery was satisfactory. CONCLUSIONS The effect of prosthetic vessel replacement under left heart bypass in the treatment of TAAA is good, which is worthy of clinical promotion.
Aneurysm, Dissecting/surgery* ; Aortic Aneurysm, Thoracic/surgery* ; Blood Vessel Prosthesis Implantation ; Heart Bypass, Left ; Humans ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome

External cervical resorption (ECR) refers to a pathological state in which resorption tissues penetrate into the dentin at the cervical aspect of the root. Despite being latent in its initial phase, ECR could cause severe damage to mineralized dental tissue and even involve the pulp if not given timely diagnosis and treatment. Nevertheless, the etiology of ECR is still poorly understood, which adds to the difficulty in early diagnosis. ECR has received growing attention in recent years due to the increasing number of clinical cases. Several potential predisposing factors have been recognized in cross-sectional studies as well as case reports. In the meantime, studies on histopathology and pathogenesis have shed light on possible mechanisms of ECR. This review aims to summarize the latest findings in the pathogenesis and potential predisposing factors of ECR, so as to provide pragmatic reference for clinical practice.

Objective:To explore the feasibility and effect of establishing a hierarchical management model based on scientific research performance assessment.Methods:In our hospital, each department was classified as one of the four levels based on the scientific research performance: leading disciplines, dominant disciplines, backbone disciplines or developing disciplines.Continuing assessment was conducted to monitor the discipline development.Results:There were 41 departments in the hospital, including 5 leading disciplines, 9 dominant disciplines, 14 backbone disciplines and 7 developing disciplines. After two years of construction, more than 200 national-level projects have been funded, and the total funding number is nearly 200 million Yuan.30 national or provincial-level scientific and technological achievements awards have been awarded. 213 patents have been granted.More than 1 000 SCI papers were published. The number of major key projects has been continuously increased.Conclusions:Establishing a hierarchical management model based on scientific research performance assessment plays a positive role in scientific research.

Adult ; Endocarditis/surgery* ; Endocarditis, Bacterial/surgery* ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Young Adult

Objective:To explore the effect of network medication guidance on anticoagulation management of warfarin.Methods:The study was designed as the retrospective cohort study. Study subjects were selected from patients who underwent cardiac valve replacement during January 2018 and April 2019 in the Department of Cardiovascular Surgery of Xiangya Hospital, Central South University, and took oral warfarin for 3 months or more after operation. According to the mode of revisit, the patients were divided into 4 groups: 1-month post-operation network group (INR review results were uploaded online for more than 2 times within 1 month after operation), 1-month post-operation control group (INR was reviewed in Xiangya Hospital 1 month after the operation and INR data was recorded), 3-month post-operation network group (INR review results were uploaded online for more than 4 times within 3 months after operation), and 3-month post-operation control group (INR was reviewed in Xiangya Hospital 3 months after the operation and INR data was recorded). The gender and age distribution of patients in the network group and the control group, as well as INR and INR compliance rate at 1 or 3 months after operation were compared.Results:A total of 420 patients underwent cardiac valve replacement in Xiangya Hospital during the study period, and all of them were prescribed warfarin for anticoagulation. Among the 420 patients, 266 patients (63.3%) had network or Xiangya Hospital revisit records 1 month after operation, 71 of which were included in the 1-month post-operation network group and 178 of which in the 1-month post-operation control group; 132 (31.4%) patients had network or Xiangya Hospital revisit records 3 month after operation, 46 of which were included in the 3-month post-operation network group and 77 of which in the 3-month post-operation control group. Patients in the 1-month post-operation network group had lower age, higher INR compliance rate, and lower incidence of insufficient anticoagulation than those in the 1-month post-operation control group, and the differences were all statistically significant [(49±10) years vs. (53±11) years, P=0.009; 64.8%(46/71) vs. 45.5%(81/178), P=0.006; 21.1%(15/71) vs. 46.6%(83/178), P<0.001]. Patients in the 3-month post-operation network group had higher INR, higher INR compliance rate, and lower incidence of insufficient anticoagulation than those in the 3-month post-operation control group, and the differences were all statistically significant [(2.05±0.45) vs. (1.84±0.62), P=0.044; 67.4% (31/46) vs. 30.9% (30/97), P=0.002; 30.4% (14/46) vs. 54.5% (42/77), P=0.009]. Conclusions:Network medication guidance is helpful to improve the effect of warfarin anticoagulation management and improve the INR compliance rate of patients after cardiac valve replacement. The main manifestation of substandard anticoagulation is insufficient anticoagulation, which should be paid attention to.