World Journal of Clinical Cases最新文献

{"title":"Clinical efficacy, bone density, and follow-up in implant and orthodontic treatment for inclined adjacent teeth.","authors":"Yi Yang, Shun-Cheng Zhou, Yi-Hui Ma, Xiang Wang, Qing-Shan Dong","doi":"10.12998/wjcc.v12.i24.5542","DOIUrl":"10.12998/wjcc.v12.i24.5542","url":null,"abstract":"<p><strong>Background: </strong>Tooth defects can cause elongation of occlusal teeth, leading to insufficient repair space. The combination of dental implant restoration and orthodontic treatment of oblique adjacent teeth has a significant therapeutic effect.</p><p><strong>Aim: </strong>To explore clinical efficacy, bone density, and follow-up of implant and orthodontic treatment for patients with inclined adjacent teeth.</p><p><strong>Methods: </strong>In total, 98 patients with oblique adjacent teeth were randomly assigned to implant restoration combined with orthodontic treatment (group A, <i>n</i> = 49) or to receive implant restoration alone (group B, <i>n</i> = 49). Changes in alveolar ridge bone density and apical bone density were observed before and after treatment in the two groups. Changes in chewing function and language function were compared between the two groups of patients. Follow-up lasted for 12 mo after repair to observe any adverse reactions in the oral cavity.</p><p><strong>Results: </strong>The clinical effective rates of group A and group B were 97.96% and 85.71%, respectively, with group A having a higher clinical effective rate than group B. After treatment, the bone density of the alveolar ridge and apical bone in both groups decreased compared to before treatment, while the chewing and language functions improved. The changes in various indicators in group A were more significant. After treatment, the satisfaction rate of group A (97.96%) was higher than that of group B (79.59%). The incidence of adverse reactions in group A (2.04%) was lower than that in group B (24.49%).</p><p><strong>Conclusion: </strong>The amalgamation of implant restoration and orthodontic treatment for adjacent tilted teeth demonstrates notable clinical efficacy, diminishes alveolar bone resorption, and fosters patient functional rehabilitation while exhibiting negligible adverse reactions.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography-based radiomics predicts the fibroblast-related gene <i>EZH2</i> expression level and survival of hepatocellular carcinoma.","authors":"Ting-Yu Yu, Ze-Juan Zhan, Qi Lin, Zhen-Huan Huang","doi":"10.12998/wjcc.v12.i24.5568","DOIUrl":"10.12998/wjcc.v12.i24.5568","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is the most common subtype of liver cancer. The primary treatment strategies for HCC currently include liver transplantation and surgical resection. However, these methods often yield unsatisfactory outcomes, leading to a poor prognosis for many patients. This underscores the urgent need to identify and evaluate novel therapeutic targets that can improve the prognosis and survival rate of HCC patients.</p><p><strong>Aim: </strong>To construct a radiomics model that can accurately predict the <i>EZH2</i> expression in HCC.</p><p><strong>Methods: </strong>Gene expression, clinical parameters, HCC-related radiomics, and fibroblast-related genes were acquired from public databases. A gene model was developed, and its clinical efficacy was assessed statistically. Drug sensitivity analysis was conducted with identified hub genes. Radiomics features were extracted and machine learning algorithms were employed to generate a radiomics model related to the hub genes. A nomogram was used to illustrate the prognostic significance of the computed Radscore and the hub genes in the context of HCC patient outcomes.</p><p><strong>Results: </strong><i>EZH2</i> and <i>NRAS</i> were independent predictors for prognosis of HCC and were utilized to construct a predictive gene model. This model demonstrated robust performance in diagnosing HCC and predicted an unfavorable prognosis. A negative correlation was observed between <i>EZH2</i> expression and drug sensitivity. Elevated <i>EZH2</i> expression was linked to poorer prognosis, and its diagnostic value in HCC surpassed that of the risk model. A radiomics model, developed using a logistic algorithm, also showed superior efficiency in predicting <i>EZH2</i> expression. The Radscore was higher in the group with high <i>EZH2</i> expression. A nomogram was constructed to visually demonstrate the significant roles of the radiomics model and <i>EZH2</i> expression in predicting the overall survival of HCC patients.</p><p><strong>Conclusion: </strong><i>EZH2</i> plays significant roles in diagnosing HCC and therapeutic efficacy. A radiomics model, developed using a logistic algorithm, efficiently predicted <i>EZH2</i> expression and exhibited strong correlation with HCC prognosis.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Keyboard sign\" and \"coffee bean sign\" in the prenatal diagnosis of ileal atresia: A case report.","authors":"Zhi-Hui Fei, Qi-Yi Zhou, Ling Fan, Chan Yin","doi":"10.12998/wjcc.v12.i24.5622","DOIUrl":"10.12998/wjcc.v12.i24.5622","url":null,"abstract":"<p><strong>Background: </strong>Ileal atresia is a congenital abnormality where there is significant stenosis or complete absence of a portion of the ileum. The overall diagnostic accuracy of prenatal ultrasound in detecting jejunal and ileal atresia is low. We report a case of ileal atresia diagnosed prenatally by ultrasound examination with the \"keyboard sign\" and \"coffee bean sign\".</p><p><strong>Case summary: </strong>We report a case of ileal atresia diagnosed in utero at 31 weeks' of gestation. Prenatal ultrasound examination revealed two rows of intestines arranged in an 'S' shape in the middle abdomen. The inner diameters were 1.7 cm and 1.6 cm, respectively. A typical \"keyboard sign\" was observed. The intestine canal behind the \"keyboard sign\" showed an irregular strong echo. There was no normal intestinal wall structure, showing a typical \"coffee bean sign\". Termination of the pregnancy and autopsy findings confirmed the diagnosis.</p><p><strong>Conclusion: </strong>The prenatal diagnosis of ileal atresia is difficult. The sonographic features of the \"keyboard sign\" and \"coffee bean sign\" are helpful in diagnosing the location of congenital jejunal and ileal atresia.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of humanistic care-based operating room nursing on safety, recovery, and satisfaction after radical surgery for colorectal carcinoma.","authors":"Xian-Pu Wang, Min Niu","doi":"10.12998/wjcc.v12.i24.5483","DOIUrl":"10.12998/wjcc.v12.i24.5483","url":null,"abstract":"<p><strong>Background: </strong>Radical surgery is a preferred treatment for colorectal carcinoma, wherein nursing intervention is essential for postoperative recovery and prevention of complications. Recently, the application of humanistic care in medical care has attracted attention. Humanistic care emphasizes comprehensive care, with importance attached to patients' physical needs as well as psychological and emotional support to provide more humane and personalized care services. However, no clinical reports have examined the use of humanistic care in patients undergoing radical surgery for colorectal carcinoma.</p><p><strong>Aim: </strong>To investigate the influence of humanistic care-based operating room nursing on the safety, postoperative recovery, and nursing satisfaction of patients who have undergone radical surgery for colorectal carcinoma.</p><p><strong>Methods: </strong>In total, 120 patients with rectal cancer who underwent surgery in Zhongnan Hospital of Wuhan University between August 2023 and March 2024 were selected and grouped based on the nursing methods employed. Of these patients, 55 were treated with routine nursing intervention (control group) and 65 were provided humanistic care-based operating room nursing (research group). The patients' vital signs were recorded, including systolic/diastolic blood pressure (SBP/DBP) and heart beats per minute (BPM), as well as serum stress indices, including norepinephrine (NE), adrenal hormone (AD), and cortisol (Cor). Postoperative recovery and complications were also recorded. Patients' negative emotions, life hope, and nursing satisfaction were evaluated using the Self-rating Depression/Anxiety Scale (SDS/SAS), Herth Hope Index (HHI), and self-developed nursing satisfaction questionnaire, respectively.</p><p><strong>Results: </strong>During emergence from anesthesia, SBP, DBP, and BPM levels were found to be lower in the research group than those in the control group, also serum Cor, AD, and NE levels were lower. In addition, the research group had shorter operative, awakening, anal exhaust, first postoperative ambulation, drainage tube removal, intestinal recovery, and hospital times. The total complication rate and the SDS and SAS scores were lower in the research group than those in the control group. The HHI and nursing satisfaction scores were higher in the research group.</p><p><strong>Conclusion: </strong>Humanistic care-based operating room nursing can mitigate physiological stress responses, reduce postoperative complications, promote postoperative recovery, relieve adverse psychological emotions, and enhance life hope and nursing satisfaction in patients undergoing radical surgery for colorectal carcinoma, which can be popularized in clinical practice.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information-motivation-behavioral guided nursing for stroke patients with pulmonary dysfunction: A randomized controlled trial.","authors":"Xia Peng, Hui-Qin Ni, Yong-Mei Liu, Jin-Ling Zhu, Yu-Ting Bai","doi":"10.12998/wjcc.v12.i24.5549","DOIUrl":"10.12998/wjcc.v12.i24.5549","url":null,"abstract":"<p><strong>Background: </strong>Patients with stroke frequently experience pulmonary dysfunction.</p><p><strong>Aim: </strong>To explore the effects of information-motivation-behavioral (IMB) skills model-based nursing care on pulmonary function, blood gas indices, complication rates, and quality of life (QoL) in stroke patients with pulmonary dysfunction.</p><p><strong>Methods: </strong>We conducted a controlled study involving 120 stroke patients with pulmonary dysfunction. The control group received routine care, whereas the intervention group received IMB-model-based nursing care. Various parameters including pulmonary function, blood gas indices, complication rates, and QoL were assessed before and after the intervention.</p><p><strong>Results: </strong>Baseline data of the control and intervention groups were comparable. Post-intervention, the IMB model-based care group showed significant improvements in pulmonary function indicators, forced expiratory volume in 1 sec, forced vital capacity, and peak expiratory flow compared with the control group. Blood gas indices, such as arterial oxygen pressure and arterial oxygen saturation, increased significantly, and arterial carbon dioxide partial. pressure decreased significantly in the IMB model-based care group compared with the control group. The intervention group also had a lower complication rate (6.67% <i>vs</i> 23.33%) and higher QoL scores across all domains than the control group.</p><p><strong>Conclusion: </strong>IMB model-based nursing care significantly enhanced pulmonary function, improved blood gas indices, reduced complication rates, and improved the QoL of stroke patients with pulmonary dysfunction. Further research is needed to validate these results and to assess the long-term efficacy and broader applicability of the model.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating treatment resistance: Janus kinase inhibitors for ulcerative colitis.","authors":"Jonathan Soldera","doi":"10.12998/wjcc.v12.i24.5468","DOIUrl":"10.12998/wjcc.v12.i24.5468","url":null,"abstract":"<p><p>The management of refractory ulcerative colitis (UC) and acute severe UC (ASUC) is challenging due to the lack of standardized approaches in cases resistant to multiple treatments. In this editorial, I investigate the efficacy and safety of Janus kinase inhibitors, particularly upadacitinib and tofacitinib, in controlling severe and refractory disease. I highlight a notable case report by Xu <i>et al</i>, which explores the case of a patient with primary nonresponse to two classes of biologics and two fecal microbiota transplants who exhibited a remarkable response to upadacitinib. Furthermore, I discuss the use of tofacitinib in refractory UC and ASUC, either as monotherapy or in combination with biologics, which has shown promising response rates. Additionally, emerging evidence of upadacitinib efficacy in ASUC is presented. Overall, these cases emphasize the complex nature of managing refractory ASUC and the potential of small-molecule therapies to achieve remission. Further research is needed to refine treatment strategies for patients with treatment-resistant UC.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are case reports valuable? Exploring their role in evidence based medicine and patient care.","authors":"Tarun Kumar Suvvari","doi":"10.12998/wjcc.v12.i24.5452","DOIUrl":"10.12998/wjcc.v12.i24.5452","url":null,"abstract":"<p><p>Case reports, often overlooked in evidence-based medicine (EBM), play a pivotal role in healthcare research. They provide unique insights into rare conditions, novel treatments, and adverse effects, serving as valuable educational tools and generating new hypothesis. Despite their limitations in generalizability, case reports contribute significantly to evidence-based practice by offering detailed clinical information and fostering critical thinking among healthcare professionals. By acknowledging their limitations and adhering to reporting guidelines, case reports can contribute significantly to medical knowledge and patient care within the evolving landscape of EBM. This editorial explores the intrinsic value of case reports in EBM and patient care.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application value of machine learning models in predicting intraoperative hypothermia in laparoscopic surgery for polytrauma patients.","authors":"Kun Zhu, Zi-Xuan Zhang, Miao Zhang","doi":"10.12998/wjcc.v12.i24.5513","DOIUrl":"10.12998/wjcc.v12.i24.5513","url":null,"abstract":"<p><strong>Background: </strong>Hypothermia during laparoscopic surgery in patients with multiple trauma is a significant concern owing to its potential complications. Machine learning models offer a promising approach to predict the occurrence of intraoperative hypothermia.</p><p><strong>Aim: </strong>To investigate the value of machine learning model to predict hypothermia during laparoscopic surgery in patients with multiple trauma.</p><p><strong>Methods: </strong>This retrospective study enrolled 220 patients who were admitted with multiple injuries between June 2018 and December 2023. Of these, 154 patients were allocated to a training set and the remaining 66 were allocated to a validation set in a 7:3 ratio. In the training set, 53 cases experienced intraoperative hypothermia and 101 did not. Logistic regression analysis was used to construct a predictive model of intraoperative hypothermia in patients with polytrauma undergoing laparoscopic surgery. The area under the curve (AUC), sensitivity, and specificity were calculated.</p><p><strong>Results: </strong>Comparison of the hypothermia and non-hypothermia groups found significant differences in sex, age, baseline temperature, intraoperative temperature, duration of anesthesia, duration of surgery, intraoperative fluid infusion, crystalloid infusion, colloid infusion, and pneumoperitoneum volume (<i>P</i> < 0.05). Differences between other characteristics were not significant (<i>P</i> > 0.05). The results of the logistic regression analysis showed that age, baseline temperature, intraoperative temperature, duration of anesthesia, and duration of surgery were independent influencing factors for intraoperative hypothermia during laparoscopic surgery (<i>P</i> < 0.05). Calibration curve analysis showed good consistency between the predicted occurrence of intraoperative hypothermia and the actual occurrence (<i>P</i> > 0.05). The predictive model had AUCs of 0.850 and 0.829 for the training and validation sets, respectively.</p><p><strong>Conclusion: </strong>Machine learning effectively predicted intraoperative hypothermia in polytrauma patients undergoing laparoscopic surgery, which improved surgical safety and patient recovery.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clues for diagnosing misplaced central venous catheter in the right ascending lumbar vein during right femoral venous access.","authors":"Joho Tokumine, Kiyoshi Moriyama, Tomoko Yorozu","doi":"10.12998/wjcc.v12.i24.5473","DOIUrl":"10.12998/wjcc.v12.i24.5473","url":null,"abstract":"<p><p>The right ascending lumbar vein is difficult to detect on anteroposterior abdominal radiographs because it overlaps with the inferior vena cava on anteroposterior radiographs. Intensive observation by medical providers may be a cue for diagnosis. However, knowledge of catheter misplacement of the right ascending lumbar vein is also necessary, because misplacement cannot be suspected without that awareness.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic challenges from conflicting results of tests and imaging.","authors":"Run Yu","doi":"10.12998/wjcc.v12.i24.5448","DOIUrl":"10.12998/wjcc.v12.i24.5448","url":null,"abstract":"<p><p>Accurate diagnosis is the foundation of clinical care but accurate diagnosis is not easily reached in some cases. In rare instances, even a sophisticated multidisciplinary team at an academic medical center cannot reliably reach an accurate diagnosis after extensive testing and imaging, and has to wait until histological diagnosis or even autopsy results are available. The underlying reason of challenging diagnoses is mostly conflicting data from history, tests, and imaging that point to different diagnoses. In this issue of <i>World Journal of Clinical Cases</i>, Huffaker <i>et al</i> reported such a challenging case of a tricuspid mass in a patient with Li-Fraumeni syndrome. The case by Huffaker <i>et al</i> powerfully illustrates the occasional diagnostic challenges inherent in our current diagnostic approach and the current technology. Clinicians should realize that in rare situations, agnosticism in diagnosis is unavoidable but a treatment has to be initiated so long as the principle of <i>primum non nocere</i> is upheld.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}