Clinical Treatment Methods Research Articles

The Progress in Treatment of β-Thalassemia and Research on Animal Models of the Disease

β-thalassemia is one of the most prevalent single-gene recessive disorders worldwide, characterized by the impaired synthesis of β-globin chains, which leads to ineffective erythropoiesis and results in anemia and iron overload, along with various complications. Therefore, establishing animal models that closely resemble β-thalassemia is essential for studying the pathogenesis and treatment of this disease. This article reviews the molecular mechanisms underlying β-thalassemia; highlights the research advancements of several common clinical treatment methods; and provides a summary of prevalent animal models of β-thalassemia, including mice, rabbits, and cynomolgus monkeys. Although the mouse model reproduces certain pathological characteristics of β-thalassemia, it is limited in its ability to correct specific gene mutations, making it less effective for certain aspects of the disease. In contrast, the rabbit model, which more closely resembles human physiology, offers an improved approximation. Furthermore, the cynomolgus monkey model outperforms both the mouse and rabbit models in exhibiting the severe phenotype of β-thalassemia, thanks to its notable genetic and physiological similarities to humans. This article aims to provide a comprehensive reference for researchers conducting animal experimental studies in relation to β-thalassemia.

Radiomics Analysis of Different Machine Learning Models based on Multiparametric MRI to Identify Benign and Malignant Testicular Lesions.

To develop and validate a machine learning-based prediction model for the use of multiparametric magnetic resonance imaging(MRI) to predict benign and malignant lesions in the testis. The study retrospectively enrolled 148 patients with pathologically confirmed benign and malignant testicular lesions, dividing them into: training set (n=103) and validation set (n=45). Radiomics characteristics were derived from T2-weighted(T2WI)、contrast-enhanced T1-weighted(CE-T1WI)、diffusion-weighted imaging(DWI) and Apparent diffusion coefficient(ADC) MRI images, followed by feature selection. A machine learning-based combined model was developed by incorporating radiomics scores (rad scores) from the optimal radiomics model along with clinical predictors. Draw the receiver operating characteristic (ROC) curve and use the area under the curve (AUC) to evaluate and compare the predictive performance of each model. The diagnostic efficacy of the various machine learning models was evaluated using the Delong test. Radiomics features were extracted from four sequence-based groups(CE-T1WI+DWI+ADC+T2WI), and the model that combined Logistic Regression(LR) machine learning showed the best performance in the radiomics model. The clinical model identified one independent predictors. The combined clinical-radiomics model showed the best performance, whose AUC value was 0.932(95% confidence intervals(CI)0.868-0.978), sensitivity was 0.875, specificity was 0.871 and accuracy was 0.884 in validation set. The combined clinical-radiomics model can be used as a reliable tool to predict benign and malignant testicular lesions and provide a reference for clinical treatment method decisions.

Guillain–Barré syndrome in children: clinical and diagnostic features

Introduction. In 2025, we will commemorate the 100th anniversary of the first pediatric case of Guillain–Barré Syndrome (GBS), initially documented by M. Monnier-Vinard. This significant milestone invites a reevaluation of our contemporary understanding of GBS in children. While the original description of GBS was thorough, the categorization has expanded over time to include a wider array of conditions, resulting in the term applied to various acute demyelinating polyneuropathies. The atypical forms of GBS present notable diagnostic challenges for healthcare providers. Objective. To analyze the demographic and clinical characteristics, treatment methods, and prognosis of GBS in children in Russia. Materials and methods. The study included fifty 6 months – 15 years patients with typical and atypical forms of Guillain-Barré syndrome (GBS). Neurological status was assessed using the Medical Research Council sum score and the Hughes disability scale. Additionally, data from cerebrospinal fluid analysis, nerve conduction study, magnetic resonance imaging of the spine, and peripheral nerves ultrasound was evaluated. Results. The classic ascending subtype of GBS was diagnosed in 30 (60%) patients, while atypical manifestations were observed in 17 (34%). Three (6%) patients had an overlap syndrome: GBS with acute myelitis. The median age of the patients was 7 [5.0; 11.0] years. Two peaks of GBS incidence associated with respiratory and gastrointestinal infections were identified. The most common initial symptoms were pain (80%), weakness in the legs (64%), and difficulty walking (54%). All 26 (100%) GBS patients were followed for 12 months from the onset of the disease regained the ability to walk. Conclusion. Both typical and atypical forms of GBS can occur in children. Overlap syndrome (GBS with acute myelitis) is a rare complication following COVID-19 and may go undiagnosed. With appropriate therapy the prognosis for both typical and atypical forms of GBS is generally favourable.

Late-onset hypogonadism: current methods of clinical diagnosis and treatment in Japan.

Testosterone affects several organs in the body and is very important for male well-being. Aging men with late-onset hypogonadism (LOH) experience physiologic, psychiatric, and sexual symptoms related to a decline in the serum concentration of testosterone with age. However, it is well-known that the extent of the decline in testosterone concentration does not correlate with the severity of LOH-related symptoms. Therefore, it is difficult to diagnose and treat patients with LOH. In addition, the symptoms, response to testosterone replacement therapy (TRT), and medical insurance coverage differ among ethnicities and countries. The evaluation of testosterone is essential for the diagnosis and treatment of LOH. The effects of testosterone are determined not only by the serum testosterone concentration but also by the androgen receptor sensitivity. A low number of glutamine repeats is indicative of high androgenic activity, and the number shows ethnicity-related differences (fewer in African American than in Caucasian people and more in East Asian people). The diagnosis of LOH is typically made using subjective symptoms and the serum testosterone concentration. The Aging Male Symptoms scale is widely used to evaluate the symptoms. The normal range of total testosterone concentration varies around the world; therefore, clinicians should follow the guidelines of their regional academic society. The principal treatment for LOH is TRT. There are many types of TRT and other treatment strategies are also available. Thus, physicians should treat LOH according to each patient's situation, considering related disorders, such as diabetes, osteoporosis, metabolic syndrome, and depression.

Advances in human umbilical cord mesenchymal stem cells-derived extracellular vesicles and biomaterial assemblies for endometrial injury treatment.

Endometrial injury caused by repeated uterine procedures, infections, inflammation, or uterine artery dysfunction can deplete endometrial stem/progenitor cells and impair regeneration, thereby diminishing endometrial receptivity and evidently lowering the live birth, clinical pregnancy, and embryo implantation rates. Currently, safe and effective clinical treatment methods or gene-targeted therapies are unavailable, especially for severe endometrial injury. Umbilical cord mesenchymal stem cells and their extracellular vesicles are characterized by their simple collection, rapid proliferation, low immunogenicity, and tumorigenicity, along with their involvement in regulating angiogenesis, immune response, cell apoptosis and proliferation, inflammatory response, and fibrosis, Therefore, these cells and vesicles hold broad potential for application in endometrial repair. This article reviewed recent research on human umbilical cord mesenchymal stem cells as well as their extracellular vesicles in repairing endometrial injury.

The efficacy of resveratrol supplementation on inflammation and oxidative stress in type-2 diabetes mellitus patients: randomized double-blind placebo meta-analysis.

The effects of resveratrol supplementation on inflammation and oxidative stress in patients with type 2 diabetes mellitus (T2DM) were controversial. A meta-analysis was performed to assess the changes in levels of inflammation and oxidative stress in patients with T2DM. Relevant literatures before November 6, 2024 were screened through Web of Science,Embase,the Cochrane Library and other sources (ClinicalTrials, ProQuest Dissertations and Theses). The quality of the literature was evaluated according to the Cochrane Handbook of Systematic Reviews. The study quality was assessed using the risk-of-bias 2 tool and the Grading of Recommendations Assessment,Development and Evaluation (GRADE) system. Review Manager 5.3 conducted meta-analysis of the data included in the literature. This meta-analysis was conducted in six randomized controlled trials involving 533 participants. Our results showed that supplementation with resveratrol significantly reduced C-reactive protein levels(SMD = -1.40, 95%CI(-2.60, -0.21), P = 0.02; Level of evidence: low), lipid peroxide levels (SMD = -0.99, 95%CI(-1.36, -0.61), P < 0.00001; Level of evidence: low), 8-isoprostanes(SMD = -0.79, 95%CI(-1.16, -0.42), P < 0.0001; Level of evidence: low) and oxidative stress score (SMD = -1.62, 95%CI(-2.49, -0.75), P = 0.0003; Level of evidence: very low). In addition, compared to placebo, Supplementation with resveratrol significantly increased glutathione peroxidase levels (SMD = 0.38, 95%CI(0.03, 0.74), P = 0.04; Level of evidence:low) and catalase levels (SMD = 0.33, 95%CI(0.03, 0.63), P = 0.03; Level of evidence: low). However, no significant difference was observed in improving interleukin-6 levels (SMD = -1.35, 95%CI(-2.75, -0.05), P = 0.06; Level of evidence: very low), tumor necrosis factor α levels (SMD = -3.30, 95%CI(-7.47, 0.87), P = 0.12; Level of evidence: very low), superoxide dismutase levels (SMD = 0.39, 95%CI(-0.26, 1.04), P = 0.24; Level of evidence: very low), total antioxidant capacity levels (SMD = 0.39, 95%CI(-0.23, 1.00), P = 0.21; Level of evidence: very low) and malondialdehyde levels (SMD = -3.36, 95%CI(-10.30, 3.09), P = 0.29; Level of evidence: very low). Resveratrol improved inflammation and oxidative stress in T2DM patients to some extent. This provides a new idea and method for clinical treatment. However, due to the limitations of the study, more large-sample, multi-center clinical studies are needed to verify this conclusion.

Inhibitory Effects of Different Doses of Matrine on Breast Cancer and Its Relationship with miR-188

Background Malignant tumors represented by breast cancer still have limitations in clinical treatment methods. Matrine is a compound with anticancer activity, but its inhibitory effect on breast cancer and its mechanism for regulating miR-188 are still unclear. Purpose Therefore, it is necessary to explore more effective breast cancer treatment methods and understand the intervention mechanism of matrine and its effect on miR-188. Methods A nude mouse model of breast cancer was in this study constructed and divided into a model group, 4 mg/kg group, 8 mg/kg group, drug group, and miR-188 mimic group. Different concentrations of matrine were administered intragastrically, and cell proliferation and apoptosis were observed. At the same time, a specific mechanism for miR-188 in the anti-breast cancer effect of matrine was explored by overexpressing miR-188. Results It was found that matrine inhibited the proliferation of breast cancer cells and caused cancer cell apoptosis. In addition, it inhibited cell migration in a dose-dependent manner. At the same time, miR-188 was lowly expressed in breast cancer and significantly increased after matrine treatment. Overexpression of miR-188 enhanced the antitumor effect of matrine. Phosphatase and tensin homolog (PTEN) was also activated in the surface by matrine, and expressions of matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase-2 (MMP-2) were inhibited. This study shows that matrine has a significant inhibitory effect on breast cancer, and its mechanism is related to upregulation of miR-188, activation of PTEN, and inhibition of MMP-9 and MMP-2 expressions. Conclusion miR-188 is involved in the anti-breast cancer process, which can be used as the theoretical basis of matrine potential drugs for breast cancer treatment. Meanwhile, miR-188 and matrine will also have great potential in developing new breast cancer treatment methods, which can provide ideas and a basis for further development of related studies.

Insights into laryngeal Castleman disease: A comprehensive scoping review with a case study focus.

Castleman disease (CD) refers to a heterogeneous group of lymphoproliferative disorders, which rarely involves the larynx. Our goal in this study is to elucidate the clinical presentation, diagnostic techniques, and treatment methods of laryngeal CD through a scoping review and the addition of a new case. Due to limited existing literature, we employed a mixed methodology for review. First, we searched Google Scholar using terms related to laryngeal CD. Subsequently, we screened abstracts using Covidence, drawing from databases such as PubMed, Science Direct, ProQuest, and EMBASE. We shortlisted studies for data extraction, focusing on clinical presentations, diagnostics, and treatment methodologies. Finally, we described our additional case. Scoping review revealed five qualifying laryngeal CD articles. Presenting symptoms included dysphagia, hoarseness, and dyspnea. Diagnosis was always established through histopathologic analysis. Management included local excision or radiotherapy. In our additional case, a 71-year-old male with known CD presented with neck swelling, dysphagia, and dysphonia. Exam revealed lymphoid laryngeal and supraglottic hyperplasia and edema. Laryngeal symptoms improved with medical management of CD. Given the rarity of laryngeal CD, its identification and management can be a challenge. Practitioners should be aware of characteristic points in a CD patient's history, physical exam, imaging, and biopsies. Local excision of obstructive lymphoid tissue and radiation are the best-supported therapies. This study aims to build toward improvements in accurate diagnosis and appropriate treatment for laryngeal CD.

Resveratrol loaded microglia-derived exosomes attenuate astrogliasis by restoring mitochondrial function to reduce spinal cord injury.

The activation of astrocytes in the injured lesion induces the progression of spinal cord injury (SCI). However, adverse side-effects during systemic administration have limited applications. Exosomes (Exos) are an emerging clinical treatment method that exerts anti-inflammatory effects by reducing pro-inflammatory factors and promoting functional recovery. Exosomes exhibit great potential as carriers of traditional Chinese medicine, attributed to their high delivery efficiency to internalized and targeted accumulation in inflammatory tissues. Herein, We synthesized resveratrol loaded microglia-derived exosomes (R-MDEs) for highly efficient accumulation and infiltration in the injured spinal cord. In vitro and in vivo experiments suggested that R-MDEs effectively accumulated in A1 astrocytes, inhibited reactive oxygen species (ROS) and glial scar formation by reprogramming the metabolic astrocytes. R-MDEs achieve a synergistic therapeutic effect of immunomodulation and neuroprotection, thereby shedding new light on the application of Exos and provides great potential for SCI.

A chitosan/acellular matrix-based neural graft carrying mesenchymal stem cells to promote peripheral nerve repair

BackgroundTreatment of peripheral nerve defects is a major concern in regenerative medicine. This study therefore aimed to explore the efficacy of a neural graft constructed using adipose mesenchymal stem cells (ADSC), acellular microtissues (MTs), and chitosan in the treatment of peripheral nerve defects.MethodsStem cell therapy with acellular MTs provided a suitable microenvironment for axonal regeneration, and compensated for the lack of repair cells in the neural ducts of male 8-week-old Sprague Dawley rats.ResultsIn vitro, acellular MTs retained the intrinsic extracellular matrix and improved the narrow microstructure of acellular nerves, thereby enhancing cell functionality. In vivo neuroelectrophysiological studies, gait analysis, and sciatic nerve histology demonstrated the regenerative effects of active acellular MT. The Chitosan + Acellular-MT + ADSC group exhibited superior myelin sheath quality and improved neurological and motor function recovery.ConclusionsActive acellular-MTs precellularized with ADSC hold promise as a safe and effective clinical treatment method for peripheral nerve defects.Graphical abstract

Varicella cellulitis in children (personal experience)

Annotation. The frequency of complications with varicella is 5-30%, and their level is much higher in patients with immunodeficiencies. In 8-50% of hospitalized children with varicella virus infection develop skin and soft tissue complications such as cellulitis, lymphadenitis, abscess, hysteria, toxicoderma. They are located on vulnerable parts of the body against the background of a state of anergy in a sick child, which is caused by the varicella virus. The aim is highlight clinical and diagnostic features and methods of treatment of varicella virus cellulitis in children based on own experience and according to literature sources. The high frequency of complications is associated with untimely detection of signs of inflammation and untimely treatment in case of secondary flora joining. The main etiological factors of superinfection are β-hemolytic streptococcus group A and staphylococcus aureus. Recently, cellulitis of the subcutaneous tissue is one of the most serious complications in patients with varicella virus infection. The clinical picture of this complication includes local and general manifestations. Local symptoms are accompanied by pronounced redness in the affected area, a significant increase in tissue volume due to swelling, intense, throbbing pain that worsens with touch or movement, the presence of purulent secretions from the affected area, compaction or softening of tissues at the site of the lesion, local hyperthermia. Treatment of varicella cellulitis involves a wide range of measures, which include: antibiotic therapy, drainage of purulent foci, symptomatic treatment, local treatment, supportive therapy, physiotherapy, observation and control. Before determining the optimal antibiotic, it is important to take into account the regional characteristics of the resistance of microorganisms and information about the typical causative agents of varicella cellulitis. Broad-spectrum antibiotics such as amoxicillin with clavulanic acid, ceftriaxone, clindamycin, or vancomycin are usually used for treatment. So, the main etiological factors causing complications in the form of necrotic cellulitis on the background of varicella virus are β-hemolytic streptococcus group A and Staphylococcus aureus. Diagnosis of varicella cellulitis includes a set of examination methods to confirm the diagnosis: daily examination of the child's body surface for inflammatory foci. The optimal treatment tactic is combined therapy (surgical and conservative treatment). Vaccination is recommended for children who are in risk groups – patients with oncology who receive cytostatics, corticosteroids; children with congenital and acquired immunodeficiencies.

DERMATOLOGICAL ASPECTS OF DIABETES MELLITUS

The article presents the pathogenetic mechanisms of the development of skin diseases in patients with carbohydrate metabolism disorders, describes their clinical manifestations and treatment methods. Dermatoses in patients with diabetes mellitus are based on metabolic disorders and its complications in the form of neuropathies and angiopathy, consequences of the introduction of medical drugs into the skin, disruption of microbiota against the background of reduced bactericidal function of the skin. The prevalence of skin lesions directly depends on the duration and severity of diabetes mellitus and existing complications.

Radiation-induced nasopharyngeal necrosis combined with local recurrence in nasopharyngeal carcinoma: diagnosis and treatment strategies

ABSTRACT Background To identify the diagnosis and treatment strategies by analyzing the clinical characteristics and treatment methods of RNNCLR. Methods A total of 210 patients pathologically diagnosed with RNNCLR were retrospectively included. Clinical characteristics, MRI features, treatment methods, and survival outcomes were analyzed. Propensity score matching (PSM) analysis was performed to adjust the surgical benefit. Results Ninety-one patients (43.3%) took a single biopsy, 67 patients (31.9%) underwent repeated biopsies and 52 patients (24.8%) received endoscopic surgery to obtain pathological positive tissues. RNNCLR had characteristic imaging features distinguished from pure radiation necrosis. The interval from the previous radiotherapy was 13.2 (7.0, 23.3) months. The 1-year, 3-year, and 5-year overall survival rates were 59.6%, 32.3%, and 14.6%. Patients with reirradiation, detectable EBV-DNA level, or ICA exposure had a worse prognosis. Overall survival was significantly higher in the endoscopic surgery group than in nonsurgery group after PSM (3-year OS rates, 44.5% vs. 23.9%, p = 0.011). Conclusions Histopathological diagnosis of RNNCLR needs repeated biopsies or even surgery. Careful analysis of MRI images, correlation with interval time from last radiation, and short-term follow-up may solve the diagnostic dilemmas. Endoscopic surgery results in a survival benefit by completely resecting lesions or removing necrotic tissue to reduce necrosis-related complications.

Global research progress of nanomedicine and colorectal cancer: a bibliometrics and visualization analysis.

Surgery and chemoradiotherapy are the main clinical treatment methods for colorectal cancer (CRC), but the prognosis is poor. The emergence of nanomedicine brings bright light to the treatment of CRC. However, there has not been a comprehensive and systematic analysis of CRC and nanomedicine by bibliometrics. We searched the Web of Science Core Collection database (WOSCC) for relevant literature published from 2011 to 2024. We used VOSviewer and Citespace to analyze countries, institutions, authors, keywords, highly cited references, and co-cited references. 3105 pieces of literatures were included in the research analysis, and PEOPLES R CHINA and the USA took the leading position in the number of papers published and had academic influence. The Chinese Academy of Sciences posted the most papers. The most prolific scholar was Abnous Khalil. The level of economic development is inversely proportional to the number of cases and deaths of colorectal cancer. Nanoparticles (NPs), the nanomedical drug delivery system (NDDS) is a hot topic in the field. Photodynamic therapy (PDT), immunogenic cell death (ICD), tumor microenvironment (TEM), folic acid, and pH are the cutting edge of the field. This paper introduces the research hotspot, emphasis, and frontier of CRC and nanomedicine, and points out the direction for this field.

Advances in Understanding Drug Resistance Mechanisms and Innovative Clinical Treatments for Melanoma.

Melanoma, a highly invasive skin cancer resulting from melanocyte malignant transformation, is the third most common skin malignancy. Despite accounting for only 4% to 5% of all skin malignancies, it is responsible for 80% of skin cancer-related deaths. Targeted therapies and immune checkpoint inhibitors have improved survival rates, yet drug resistance remains a major challenge. In this review, I explore the latest research progress on melanoma drug resistance mechanisms and clinical treatment methods. This aims to provide insights for more effective treatment strategies and improve patient prognosis and quality of life. I also discuss potential strategies to overcome drug resistance based on the latest scientific findings, with a particular focus on the complex and multi-factorial drug resistance mechanisms of melanomas, including genetic mutations, epigenetic changes, and tumor microenvironment factors. Understanding these mechanisms is crucial for developing new drugs and combination therapies targeting drug-resistant tumors. Analyzing complex drug resistance pathways paves the way for personalized medical approaches, which is expected to provide enlightenment on breaking through drug resistance barriers and enhancing the effectiveness of melanoma treatment.

Bionic model of blood cell segmentation based on impulse image transformation

Abstract Introduction: The relevance of the proposed topic is determined by the high incidence of hematopoietic system diseases and the lack of a clear understanding at the cytological level of their mechanisms and correction methods. The purpose of the article is to create images of blood cells using mathematical modelling. Materials and Methods: To achieve the defined goal, fundamental research methods were utilized, among which the method of mathematical modelling played a significant role, employed in creating a bionic model of blood cells. Results: The results of this study have indicated that the task of recognizing blood cells in complex images poses a significant challenge in the field of medicine. Such tasks are complicated by the transparency of cells compared to the buffer solution, uneven thickness of the blood smear, and varying staining of the smear. Therefore, there is a need to improve the segmentation algorithm of the bionic model and develop new, more efficient methods and models for image recognition. The algorithm for constructing the bionic model segmentation consists of four main steps. Conclusion: The practical significance of this research lies in the possibility of using the obtained results in the further development of clinical correction and treatment methods for diseases such as anaemia, thrombocytopenia, and neoplastic processes.

Application Value of 3D Printing Technology in Breast Cancer Treatment

Breast cancer, the most prevalent malignant tumor among women, has shown a rising incidence rate in recent years. Personalized and precise comprehensive treatment is currently considered the optimal approach for breast cancer management. The application of 3D printing technology in the medical field has been expanding, covering areas such as medical devices, anatomical models, tissue engineering scaffolds, tumor models, and drug formulation, drawing significant attention in the field of oncology. This article explores the application value of 3D printing technology in breast cancer treatment, including preoperative planning, radiotherapy, postoperative rehabilitation and adjuvant therapy, and scientific research, aiming to provide new perspectives and methods for clinical breast cancer treatment.

NF-κB Signaling Pathway in Rheumatoid Arthritis: Mechanisms and Therapeutic Potential.

Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disease that imposes a heavy economic burden on patients and society. Bone and cartilage destruction is considered an important factor leading to RA, and inflammation, oxidative stress, and mitochondrial dysfunction are closely related to bone erosion and cartilage destruction in RA. Currently, there are limitations in the clinical treatment methods for RA, which urgently necessitates finding new effective treatments for patients. Nuclear transcription factor-κB (NF-κB) is a signaling transcription factor that is widely present in various cells. It plays an important role as a stress source in the cellular environment and regulates gene expression in processes such as immunity, inflammation, cell proliferation, and apoptosis. NF-κB has long been recognized as a pathogenic factor of RA, and its activation can exacerbate RA by promoting inflammation, oxidative stress, mitochondrial dysfunction, and bone destruction. Conversely, inhibiting the activity of the NF-κB pathway effectively inhibits these pathological processes, thereby alleviating RA. Therefore, NF-κB may be a potential therapeutic target for RA. This article describes the physiological structure of NF-κB and its important role in RA through the regulation of oxidative stress, inflammatory response, mitochondrial function, and bone destruction. Meanwhile, we also summarized the impact of NF-κB crosstalk with other signaling pathways on RA and the effect of related drugs or inhibitors targeting NF-κB on RA. The purpose of this article is to provide evidence for the role of NF-κB in RA and to emphasize its significant role in RA by elucidating the mechanisms, so as to provide a theoretical basis for targeting the NF-κB pathway as a treatment for RA.

Клінічна характеристика та особливості хірургічного лікування пацієнтів із простими кістами нирок

Simple renal cysts are quite common in adults with an incidence that increases with age. Renal cysts are composed of enclosed liquid or semisolid fluid and are commonly identified through abdominal imaging. The purpose of this study was to compare the clinical and laboratory characteristics of patients with simple renal cysts who underwent aspiration sclerotherapy or laparoscopic resection and establish the association between these parameters. The research was conduc­ted on the basis of the urology department of the St. Panteleimon Hospital between 2021 and 2023, 46 patients who underwent surgical removal of a renal cysts were analyzed. The main methods of treating kidney cysts were aspiration sclerotherapy and laparoscopic unroofing. Patients were divided into groups depending on the treatment method (aspiration sclerothe­rapy or laparoscopic unroofing). In order to establish the differences, a comparative analysis was carried out by age, sex, results of clinical parameters, cyst localization and recurren­ces. The association between clinical parameters and treatment methods was assessed using Pearson’s χ2 test. Statistical analysis of the obtained data was carried out with the help of software packages SPSS v. 25.0 and EXCEL. There were 13 men (62 %) and 8 women (38 %) among patients who underwent lapa­roscopic unroofing. Right renal cysts were found in 8 patients (38 %), and left renal cysts were found in 13 patients (62 %). The mean age of the patients was 56±2.6 years. Among the patients undergoing aspiration sclerotherapy, there were 11 men (44 %) and 14 women (56 %). The right kidney cyst was found in 14 patients (56 %), and the left kidney cyst was found in 11 patients (44 %). The mean age of the patients was 63±2.2 years. The mean size of kidney cysts in patients who underwent laparoscopic unroofing was 70±3.6 mm. In patients undergoing aspiration sclerotherapy, the size of kidney cysts was 72±5.4 mm. There was no statistically significant difference in age, sex, and size of kidney cysts in patients who underwent aspiration sclerotherapy and laparoscopic unroofing. It was established that there was no statistically significant difference in age, sex, or size of renal cysts in patients undergoing surgical treatment. In patients after laparoscopic unroofing, relapses have not been established in the clinic. However, the frequency of recurrence in patients after aspiration sclerotherapy is 74±9 % of the total number of patients, which is a fairly high rate of recurrence of renal cysts. We found that laparoscopic unroofing was associated with a lower recurrence rate compared with aspiration sclerotherapy. It should be noted that laparoscopic unroofing is a more effective method of treatment compared to aspiration sclerotherapy. We emphasize that laparoscopy is a modern approach to renal cyst surgery, which not only reduces trauma, shortens the recovery time of patients, but also ensures high accuracy and efficiency of treatment.

Study on the clinical characteristics, treatment, and outcome influencing factors of severe pneumonia complicated with ARDS.

To investigate the clinical characteristics, treatment methods, and factors influencing the prognosis of patients with severe pneumonia complicated by Acute Respiratory Distress Syndrome (ARDS), aiming to provide references for clinical decision-making and improve patient outcomes. A retrospective analysis was conducted on 118 patients with severe pneumonia complicated by ARDS treated at our hospital from June 2018 to December 2022. Based on treatment outcomes, patients were divided into a death group (n = 75) and a survival group (n = 43). General data and clinical laboratory indicators, including blood urea nitrogen, serum creatinine, C-reactive protein, procalcitonin, arterial partial pressure of oxygen, and arterial partial pressure of carbon dioxide, were collected and compared between the 2 groups to identify independent factors affecting prognosis. Among the 118 patients, the mortality rate was 63.56%. Patients in the death group had a significantly higher average age (57.15 ± 13.38 years) and a higher proportion of severe ARDS (66.67%) compared to the survival group (40.02 ± 11.41 years, 30.23%, P < .001). The death group had significantly lower white blood cell counts (8.10 ± 1.64 × 109/L), oxygenation index (19.82 ± 2.29), and duration of mechanical ventilation (7.79 ± 2.11 days) compared to the Survival group (8.92 ± 1.22 × 109/L, 13.42 ± 1.82, 12.23 ± 3.05 days, P < .05). Conversely, the death group had significantly higher levels of blood urea nitrogen (6.87 ± 1.80 mmol/L), C-reactive protein (130.55 ± 50.28 mg/L), procalcitonin (5.50 ± 2.11 ng/mL), arterial partial pressure of carbon dioxide (41.12 ± 5.56 mm Hg), and a higher proportion of viral infections (48.00%) compared to the survival group (5.90 ± 1.72 mmol/L, 101.77 ± 55.56 mg/L, 3.98 ± 1.15 ng/mL, 35.59 ± 6.22 mm Hg, 27.91%, P < .05). Logistic regression analysis revealed that age (odds ratios [OR] = 1.990, 95% confidence interval [CI]: 1.306-3.033, P < .001), oxygenation index (OR = 1.426, 95% CI: 1.123-1.649, P < .001), and duration of mechanical ventilation (OR = 0.694, 95% CI: 0.557-0.864, P < .001) were independent factors influencing patient prognosis. This indicates that an increase in age and a decrease in oxygenation index are associated with a significantly higher risk of mortality, while shorter mechanical ventilation duration is related to poorer prognosis. Advanced age, lower oxygenation index, and shorter duration of mechanical ventilation are unfavorable prognostic factors in patients with severe pneumonia complicated by ARDS. These findings aid clinicians in identifying high-risk patients, optimizing treatment plans, and improving patient prognosis.