Case 1 A 68-year-old male patient presented with poor appetite persisting for over 2 months and had been diagnosed with liver cancer 7 days prior. He was admitted to Liaocheng Second People′s Hospital on October 17, 2017. On October 18, 2017, at 8:00, the patient underwent transcatheter arterial chemoembolization under local anesthesia. At 17:30, the patient developed a fever. At 20:00, "port wine-colored" urine was noted during catheterization, prompting transfer to the intensive care unit (ICU) for enhanced treatment. Case 2 A 67-year-old male patient with a previous diagnosis of hilar cholangiocarcinoma presented to the Emergency Department of Liaocheng Second People′s Hospital at 17:40 on March 25, 2025, due to "unconsciousness for one hour". Routine blood testing revealed significantly decreased white blood cells, red blood cells, and platelets. Considering the critical condition, the patient was transferred to the ICU. At 19:30, "port wine-colored" urine was observed in the urinary catheter. Both cases showed evident signs of hemolysis in blood samples, rapid disease progression, with fatal outcomes occurring within a short period. Blood cultures from both patients signaled positive in anaerobic bottles. Identification using the bioMérieux VITEK 2 COMPACT ANC card confirmed Clostridium perfringens. Bloodstream infections caused by Clostridium perfringens leading to such severe intravascular hemolysis are rare. The disease course is notoriously aggressive. In clinical practice, early recognition of this infection is paramount.

Case 1 A 68-year-old male patient presented with poor appetite persisting for over 2 months and had been diagnosed with liver cancer 7 days prior. He was admitted to Liaocheng Second People′s Hospital on October 17, 2017. On October 18, 2017, at 8:00, the patient underwent transcatheter arterial chemoembolization under local anesthesia. At 17:30, the patient developed a fever. At 20:00, "port wine-colored" urine was noted during catheterization, prompting transfer to the intensive care unit (ICU) for enhanced treatment. Case 2 A 67-year-old male patient with a previous diagnosis of hilar cholangiocarcinoma presented to the Emergency Department of Liaocheng Second People′s Hospital at 17:40 on March 25, 2025, due to "unconsciousness for one hour". Routine blood testing revealed significantly decreased white blood cells, red blood cells, and platelets. Considering the critical condition, the patient was transferred to the ICU. At 19:30, "port wine-colored" urine was observed in the urinary catheter. Both cases showed evident signs of hemolysis in blood samples, rapid disease progression, with fatal outcomes occurring within a short period. Blood cultures from both patients signaled positive in anaerobic bottles. Identification using the bioMérieux VITEK 2 COMPACT ANC card confirmed Clostridium perfringens. Bloodstream infections caused by Clostridium perfringens leading to such severe intravascular hemolysis are rare. The disease course is notoriously aggressive. In clinical practice, early recognition of this infection is paramount.

Objective To explore the clinical significance of changes in coagulation function related indexes in elderly patients with severe pneumonia.Methods A total of 127 elderly patients with severe pneumonia admitted to the Second People's Hospital of Liaocheng from January 2022 to December 2023 were included in observation group,and 135 patients with common pneumonia admitted during the same period were included in control group.The indexes of coagulation function[platelet(PLT),prothrombin time(PT),fibrinogen(FIB),activated partial thromboplastin time(APTT),thrombin time(TT),D-dimer(D-D)]within 24h after admission were compared between two groups.Results The age of patients in observation group was significantly higher than that in control group,and the proportion of smoking history,underlying disease and underlying disease≥2 was significantly higher than that in control group(P＜0.05).The positive rates of PT and D-D in observation group were significantly higher than those in control group(P＜0.05).PT and TT in observation group were significantly longer than control group,D-D level was significantly higher than that in control group,PLT level was significantly lower than that in control group(P＜0.05).Conclusion Patients with severe pneumonia often have abnormal coagulation function,and the detection of related indexes of coagulation function is of great significance to evaluate the condition of patients.

Objective To explore the clinical significance of changes in coagulation function related indexes in elderly patients with severe pneumonia.Methods A total of 127 elderly patients with severe pneumonia admitted to the Second People's Hospital of Liaocheng from January 2022 to December 2023 were included in observation group,and 135 patients with common pneumonia admitted during the same period were included in control group.The indexes of coagulation function[platelet(PLT),prothrombin time(PT),fibrinogen(FIB),activated partial thromboplastin time(APTT),thrombin time(TT),D-dimer(D-D)]within 24h after admission were compared between two groups.Results The age of patients in observation group was significantly higher than that in control group,and the proportion of smoking history,underlying disease and underlying disease≥2 was significantly higher than that in control group(P＜0.05).The positive rates of PT and D-D in observation group were significantly higher than those in control group(P＜0.05).PT and TT in observation group were significantly longer than control group,D-D level was significantly higher than that in control group,PLT level was significantly lower than that in control group(P＜0.05).Conclusion Patients with severe pneumonia often have abnormal coagulation function,and the detection of related indexes of coagulation function is of great significance to evaluate the condition of patients.

Objective To observe the expression of A kinase interacting protein 1(AKIP1)in cervical cancer and analyze the correlation between AKIP1 and clinicopathological features and prognosis.Methods A total of 88 patients with cervical cancer admitted to the Second People's Hospital of Liaocheng from January 2016 to December 2018 were selected for the study.The expression of AKIP1 was detected by immunohistochemical staining,and its expression was judged to be negative or positive according to the score of staining results.The relationship between AKIP1 expression and clinicopathological features was analyzed by x2test;Kaplan-Meier curve was used to analyze the effect of AKIP1 on the prognosis of cervical cancer.Results Compared with the para-cancer tissues,the expression of AKIP1 was significantly increased in cervical cancer(P＜0.05);Patients with tumor diameter ≥4 cm,low differentiation,lymph node metastasis and FIGO stageⅡ-Ⅲ,the positive rate of AKIP1 was significantly higher than that of patients with tumor diameter＜4 cm,high differentiation,no lymph node metastasis and FIGO stage I,the difference is statistically significant(P＜0.05);Kaplan-Meier analysis showed that the survival rate of AKIP1 positive patients was significantly lower than that of AKIP1 negative patients(x2=5.162,P＜0.05).Conclusion The expression of AKIP1 is correlated with poor clinicopathologic features in patients with cervical cancer,and may be a biological marker affecting the prognosis of patients with cervical cancer.

Objective:To monitor and evaluate in vivo dose changes of intensity-modulated radiotherapy (IMRT) in patients with cervical cancer in a real-time manner. Methods:Twelve patients with cervical cancer admitted to our hospital were enrolled in this study. The in vivo doses were monitored by PerFRACTION?. Electronic portal imaging device (EPID) were collected in each treatment fraction for two-dimensional in vivo dose verification[γ index and dose difference (DD) index]. Log files were recorded for three-dimensional in vivo dose verification (γ index). The correlation between in vivo dose and treatment duration was analyzed by Pearson correlation analysis. Results:A total of 206 sets of EPID images and corresponding Log files were collected. The three-dimensional in vivo dose verification γ 1%/1mm of all patients was not correlated with treatment fraction ( P>0.05). Among them, the absolute difference of γ 1%/1mm of 94.66% fractions was< 1%. The mean DD 3% of two-dimensional in vivo dose verification of all patients was negatively correlated with treatment fraction ( P<0.05). Among which, the average γ 3%/3mm of 9 patients was>89% in the treatment fractions, and the average γ 3%/3mm of 98.57% fractions of these 9 patients was>93%. The other 3 patients had an average γ 3%/3mm ranged from 38% to 100%. CBCT images showed that the bladder volume of these 3 patients was significantly decreased with the relative changes by 82.08%, 84.41% and 73.59%, respectively, and the target area was retracted significantly with the relative changes by 38.12%, 59.79% and 24.46%, respectively. Conclusion:Combined with γ index and DD index, PerFRACTION? can monitor the mechanical stability of accelerator and MU delivery accuracy during treatment fractions, and monitor the changes of in vivo dose in patients with cervical cancer, which can improve the safety and quality assurance of IMRT for cervical cancer patients and provide guidance for patients with adaptive radiotherapy.

A 29-year-old female patient took vitamins with minerals tablets (29) (each tablet contains 150 μg of iodine) for nearly one year because she was preparing for pregnancy. Abnormal thyroid function was found in pre-pregnancy examination. Her free thyroxine (FT 4) was 23.2 pmol/L, free triiodothyronine (FT 3) was 5.56 pmol/L, and thyroid stimulating hormone (TSH) was 0.10 mU/L. According to the doctor′s advice, she stopped taking vitamins with minerals tablets (29) immediately. Five days after discontinuation of the drug, her FT 4 was 21.2 pmol/L, FT 3 was 5.39 pmol/L, TSH was 0.08 mU/L, and thyrotropin receptor antibody was <0.3 U/L. The results of re-examination on day 59 after drug withdrawal showed FT 4 16.35 pmol/L, FT 3 4.97 pmol/L, and TSH 2.36 mU/L. It was considered that the patient′s thyroid dysfunction was caused by vitamins with minerals tablets (29).

A 26-year-old male patient with type 2 diabetes mellitus was given liraglutide (0.6 mg/d) on the basis of insulin combined with metformin because of the poor therapeutic effect. Four days later, the dose of liraglutide was doubled and empagliflozin (10 mg orally, once daily) was added. The next day, the patient developed nausea, vomiting, and abdominal pain accompanied by elevated serum amylase and lipase (peak levels were 1 048 U/L and 26 U/L, respectively). Acute pancreatitis was diagnosed, all hypoglycemic drugs were discontinued, and fasting, gastrointestinal decompression, intravenous fluid infusion, continuous infusion of low-dose insulin, and symptomatic treatments with lansoprazole and somatostatin were given. Three days later, the patient′s symptoms were relieved, and serum amylase and lipase levels returned to normal. Ten days later, the hypoglycemic drug was changed to subcutaneous injection of insulin aspart 30 injection (24 U in the morning and 16 U in the evening) before meals and oral metformin 0.5 g thrice daily. His blood glucose was controlled and no symptoms of pancreatitis recurred. Therefore, it was considered that the patients′ pancreatitis might be related to the combined use of liraglutide and empagliflozin.

A 29-year-old female patient took vitamins with minerals tablets (29) (each tablet contains 150 μg of iodine) for nearly one year because she was preparing for pregnancy. Abnormal thyroid function was found in pre-pregnancy examination. Her free thyroxine (FT 4) was 23.2 pmol/L, free triiodothyronine (FT 3) was 5.56 pmol/L, and thyroid stimulating hormone (TSH) was 0.10 mU/L. According to the doctor′s advice, she stopped taking vitamins with minerals tablets (29) immediately. Five days after discontinuation of the drug, her FT 4 was 21.2 pmol/L, FT 3 was 5.39 pmol/L, TSH was 0.08 mU/L, and thyrotropin receptor antibody was <0.3 U/L. The results of re-examination on day 59 after drug withdrawal showed FT 4 16.35 pmol/L, FT 3 4.97 pmol/L, and TSH 2.36 mU/L. It was considered that the patient′s thyroid dysfunction was caused by vitamins with minerals tablets (29).

A 26-year-old male patient with type 2 diabetes mellitus was given liraglutide (0.6 mg/d) on the basis of insulin combined with metformin because of the poor therapeutic effect. Four days later, the dose of liraglutide was doubled and empagliflozin (10 mg orally, once daily) was added. The next day, the patient developed nausea, vomiting, and abdominal pain accompanied by elevated serum amylase and lipase (peak levels were 1 048 U/L and 26 U/L, respectively). Acute pancreatitis was diagnosed, all hypoglycemic drugs were discontinued, and fasting, gastrointestinal decompression, intravenous fluid infusion, continuous infusion of low-dose insulin, and symptomatic treatments with lansoprazole and somatostatin were given. Three days later, the patient′s symptoms were relieved, and serum amylase and lipase levels returned to normal. Ten days later, the hypoglycemic drug was changed to subcutaneous injection of insulin aspart 30 injection (24 U in the morning and 16 U in the evening) before meals and oral metformin 0.5 g thrice daily. His blood glucose was controlled and no symptoms of pancreatitis recurred. Therefore, it was considered that the patients′ pancreatitis might be related to the combined use of liraglutide and empagliflozin.