Bethune International Peace Hospital

A teenage girl presented with sudden lower abdominal pain following exercise, prompting initial consideration of ovarian cyst rupture by the attending emergency physician. However, the presence of unilateral renal absence on Computed Tomography (CT) imaging strongly suggested a reproductive tract malformation, later confirmed by Magnetic Resonance Imaging (MRI). Surgical exploration during laparotomy revealed a functional non-communicating rudimentary horn with associated ovarian endometriosis, in the setting of chronic dysmenorrhea. This rare case underscores the essentiality of comprehensive preoperative assessment to identify anatomical variations, guide surgical decision-making, and prevent diagnostic errors. Subsequent literature review focused on the co-occurrence of endometriosis in rudimentary horns and congenital urinary system abnormalities.

BackgroundObstructive sleep apnea (OSA) frequently coexists with gastroesophageal reflux disease (GERD), yet the degree to which hypoxic burden contributes to reflux severity and whether symptoms improve with continuous positive airway pressure (CPAP) remains insufficiently defined. Objective: To investigate the cross-sectional associations of OSA severity and nocturnal hypoxic burden with GERD symptom presence and severity, and to evaluate longitudinal changes in reflux symptoms after CPAP therapy in a prospective follow-up cohort.MethodsIn a prospective cohort of adults undergoing polysomnography, 580 participants were evaluated at baseline and stratified by GERD status using the GERD-Q (≥8 indicating GERD). OSA severity (apnea–hypopnea index, AHI) and nocturnal hypoxemia burden (T90%, minimum SpO₂, oxygen desaturation index) were compared across reflux strata. Multivariable linear and logistic regression models assessed continuous associations between sleep parameters and GERD severity. A CPAP sub-cohort of moderate-to-severe OSA with concomitant reflux (n = 150; completed follow-up, n = 112) was monitored for GERD-Q changes at 3 and 6 months.ResultsGERD prevalence reached 29.0%. GERD-Q scores demonstrated dose–response escalation across both OSA severity and hypoxemia categories (p for trend <0.001). T90% and ODI showed stronger associations with reflux burden than AHI in fully adjusted models (T90% β = 0.81; ODI β = 0.44; both p < 0.001), while minimum SpO₂ remained inversely related (β = −0.18; p = 0.003). Logistic models confirmed increased GERD risk in moderate (OR = 1.87) and severe OSA (OR = 2.74), and in patients with marked nocturnal hypoxemia (T90 > 10%; OR = 3.42; all p < 0.001). CPAP therapy yielded progressive symptom reduction (GERD-Q − 1.92 at 3 months; −3.28 at 6 months), with clinically meaningful improvement in 69.6% at 6 months.ConclusionOSA severity and nocturnal desaturation jointly predict reflux symptom burden, with hypoxic load outperforming event frequency. CPAP produced sustained GERD symptom improvement over 6 months.

BACKGROUNDColorectal cancer (CRC) with liver metastasis remains a significant therapeutic challenge, particularly in cases of postoperative recurrence. While transarterial chemoembolization (TACE) and targeted therapies have shown promise individually, the efficacy combining these for treating postoperative recurrent CRC with liver metastasis requires further investigation.AIMTo evaluate the efficacy and safety of TACE combined with targeted therapies for postoperative recurrent CRC with liver metastasis.METHODSThis observational study enrolled 75 patients with postoperative recurrent CRC accompanied by liver metastasis between January 2020 and December 2023. All patients received combined treatment with TACE and targeted therapy: Bevacizumab (40 patients, 53.3%), cetuximab (25 patients, 33.3%), or panitumumab (10 patients, 13.3%). Treatment response was evaluated using the Response Evaluation Criteria in Solid Tumors 1.1 criteria, with overall survival (OS) and progression-free survival as the primary endpoints. Quality of life was assessed using the European Organization for Research and Treatment of Cancer quality of life questionnaire at baseline and after six months of treatment.RESULTSThe median OS was 28 months (95% confidence interval: 24-32 months), and the median progression-free survival was 12 months (95% confidence interval: 10-14 months). Patients treated with bevacizumab showed significantly better survival outcomes than those treated with cetuximab/panitumumab (median OS, 30 vs 24 months, P = 0.015). The overall response rate was 58.7%, with a disease control rate of 86.7%. Quality of life scores improved significantly across all domains, with greater improvements observed in the bevacizumab group. Treatment-related adverse events were manageable, with grade 3-4 events occurring in 13.3% of the patients and no treatment-related mortality.CONCLUSIONThe combination of TACE with targeted therapy, particularly bevacizumab, has demonstrated promising efficacy and acceptable safety for the treatment of postoperative recurrent CRC with liver metastasis. This multimodal approach not only improved survival outcomes but also enhanced the patients’ quality of life, suggesting its potential as a valuable treatment strategy for this challenging condition.

BackgroundWandering spleen is a rare disorder characterized by splenic displacement into the abdominal or pelvic cavity, predisposing to torsion and infarction. Congenital factors (long pedicle, lax ligaments) or acquired conditions (splenomegaly) are the usual causes.Case presentationA 17-year-old female presented with 5 days of escalating abdominal pain. Imaging (contrast-enhanced CT and ultrasound) revealed a pelvic spleen with 360° pedicle torsion and partial infarction. After multidisciplinary review, emergency laparotomy was performed and splenectomy was undertaken. Post-operatively, low-molecular-weight heparin followed by aspirin was prescribed to mitigate post-splenectomy thrombocytosis-related thrombosis. The patient was discharged on day 18 without complications and remained well at follow-up.ConclusionEarly recognition, prompt splenectomy, and individualized anticoagulation guided by hematology input are essential to prevent complications in acute splenic torsion.

Triple-negative breast cancer (TNBC) is characterised by an absence of the oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2), for which there are few therapeutic options and the prognosis is poor. This research sought to explore the particular function of the long non-coding RNA (lncRNA) LINC01232 in TNBC and its regulatory impacts on the miR-516a-5p/BCL9 pathway. In this study, quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to determine the expression level of LINC01232 in TNBC tissues. We also examined its regulatory influences on miR-516a-5p and BCL9 via cellular function tests and a luciferase reporter experiment. Evaluated the effect of LINC01232 silencing on proliferation, migration and invasion of breast cancer cells. Results showed that LINC01232 expression was abnormally high in TNBC tissues in comparison to normal tissues. Inhibition of LINC01232 expression markedly impeded breast cancer cell proliferation, clone formation, migration and invasion. We found that LINC01232 competes with miR-516a-5p for binding, thereby reducing its expression and subsequently increasing BCL9 expression. In conclusion, our results indicate that LINC01232 facilitates the malignant development of TNBC through the miR-516a-5p/BCL9 pathway, providing fresh perspectives on the pathogenesis of TNBC and pinpointing potential therapeutic targets.

Preoperative distinguishing between benign and malignant gastrointestinal stromal tumors (GISTs) poses a challenge. Ultrasound elastography has emerged as a promising diagnostic tool; however, further investigation is needed to assess its diagnostic accuracy in evaluating GISTs. To evaluate the accuracy of ultrasound elastography for differentiating between benign and malignant GISTs. This prospective study included 110 patients with 103 histopathologically confirmed GISTs between January 2021 and December 2023. All tumors underwent conventional ultrasound examination, strain elastography (SE), and shear-wave elastography (SWE) before surgical resection. The study evaluated elastographic parameters such as strain ratio, elastographic patterns, mean elastic modulus, and heterogeneity index. Diagnostic performance was evaluated using receiver operating characteristic curve analysis, with histopathological diagnosis as the reference standard. Of the 103 GISTs, 45 (43.7%) were benign and 58 (56.3%) were malignant based on modified National Institutes of Health criteria. Malignant GISTs exhibited significantly higher strain ratios (4.82 ± 1.73 vs 2.31 ± 0.89; P < 0.001) and mean elastic modulus values (45.6 ± 15.8 kPa vs 21.3 ± 8.4 kPa; P < 0.001) than benign tumors. The optimal cutoff values were 3.45 for the strain ratio (sensitivity: 84.5%, specificity: 86.7%) and 32.5 kPa for the mean elastic modulus (sensitivity: 87.9%, specificity: 88.9%). The areas under the curve were 0.892 and 0.918, respectively. Interobserver agreement was excellent for both SE [intraclass correlation coefficient (ICC) = 0.88] and SWE (ICC range: 0.85-0.93) measurements. Ultrasound elastography shows high diagnostic accuracy in distinguishing between benign and malignant GISTs. Combining SE and SWE provides complementary parameters for preoperative risk stratification.

BackgroundHip fractures in the elderly triggers a severe inflammatory immune response.MethodsPeripheral blood samples from 16 elderly hip fracture patients and 16 healthy controls were analysed for 92 inflammatory biomarkers using proximity extension assay (PEA) at different stages after trauma.ResultsDynamic trends in inflammatory proteins after surgery were assessed. Correlation analyses showed significant associations between inflammation-related proteins and clinical parameters. A prognostic risk score model was developed: on day 1, CCL19, FGF-19 and MCP-2 were significant; on day 3, TGF-α, FGF-5, CCL19, IL-22RA1 and IL-12B were included; and on day 7, IL-2RB, CCL19 and 4E-BP1 were significant. High-risk patients had a significantly lower rate of recovery compared with low-risk patients.ConclusionIn this study, we have highlighted the complex inflammatory response during fracture healing and emphasised the importance of long-term monitoring of protein dynamics.