Thrombus formation in the suprahepatic inferior vena cava after microwave ablation in patients with hepatic metastasis: a case report.

BACKGROUND: Microwave ablation (MWA) via ultrasound guidance is an important tool in the treatment of liver metastases. The most common postoperative complications are abdominal hemorrhage and bile leakage, whereas thrombosis in the suprahepatic inferior vena cava (IVC) is very rare, and clinical management is very difficult when the head end of the thrombus reaches the right atrium. CASE PRESENTATION: This is a case report of a 52-year-old man with hepatic metastasis 21 months after radical resection of rectal cancer. After chemotherapy combined with targeted therapy, metastasis in segment IV (S4) of the liver was treated with microwave ablation. Two months after treatment, the hepatic metastasis in S4 showed a microwave ablation zone on MRI.Enhanced MRI showed venous thrombosis located in the left hepatic vein and IVC, and the head of the thrombus reached the right atrium. After two weeks of anticoagulation and thrombolytic treatment, the follow-up MRI showed that the venous thrombus had nearly disappeared. CONCLUSION: When liver metastases are close to the hepatic vein, clinicians should pay attention to the occurrence of hepatic vein and IVC thrombosis following MWA; through early diagnosis and anticoagulation, pulmonary thromboembolism (PTE) can be minimized.

Recanalization of thrombosed aneurysmal hemodialysis arterovenous fistulas using a hybrid technique based on data from a single center.

OBJECTIVE: To explore the technical specifications and clinical outcomes of thrombosed aneurysmal haemodialysis arteriovenous fistula (AVF) treated with ultrasound-guided percutaneous transluminal angioplasty combined with minimal aneurysmotomy. METHODS: This case series study included 11 patients who had thrombosed aneurysmal AVF and underwent salvage procedures over a 13-month period. All procedures were performed under duplex guidance. Minimal aneurysmotomy was performed, along with manual thrombectomy and thrombolytic agent infusion, followed by angioplasty to macerate the thrombus and sufficiently dilate potential stenoses. A successful procedure was defined as immediate restoration of flow through the AVF. RESULTS: The 11 patients (four males and seven females) had a mean age of 49.6 years ± 11.9 years. Six patients (54.5%) had two or more aneurysms. The mean aneurysm maximal diameter was 21.5 mm (standard deviation: ± 5.0 mm), and the mean thrombus length was 12.9 cm (8-22 cm). Ten (83.3%) of the 12 procedures were technically successful. The mean duration of operation was 150.9 minutes (standard deviation: ± 34.2 minutes), and mean postoperative AVF blood flow was 728.6 ml/min (standard deviation: ± 53.7 mi/min). The resumption of hemodialysis was successful in all 11 cases, with a clinical success rate of 100%. The primary patency rates were 90.0% and 75.0% at three and four months over a mean follow-up time of 6.3 months (3-12 months). The secondary patency rates were 90.4% at three and four months. CONCLUSION: A hybrid approach combining ultrasound-guided percutaneous transluminal angioplasty and minimal aneurysmotomy might be a safe and effective method for thrombosed aneurysmal AVF salvage.

The direct effect of exercise on the mental health of scientific and technological professionals and the mediating effects of stress, resilience, and social support.

Background: High working pressure is one of the main causes of occupational sub-health problems in scientific and technological professionals. With the development of exercise psychology, an increasing number of scholars have begun to focus on the influence of exercise on mental health. However, a limited number of scholars have investigated the effects of exercise on mental health and related mechanisms among scientific and technological professionals. Thus, this study aimed to investigate the relationship between exercise and the mental health of scientific and technological professionals and the mediating roles of stress, resilience, and social support. Methods: The respondents in this study were recruited using snowball sampling techniques and finally collected a total of 1,248 valid responses. Questionnaires were distributed through "www.wjx.cn (An online questionnaire website in China, which provides similar functions with Amazon MTurk)" in Henan province from November to December 2021. Participants were asked to complete the Positive Mental Health Scale, the stress subscale of the Depression Anxiety and Stress Scale (21 items), the Connor-Davidson Resilience Scale, and the Perceived Social Support Scale. A total of 1,248 valid responses were obtained. Results: The mean exercise time of males was longer than that of females (t = 3.65, p < 0.01). Exercise and mental health were significantly associated with differences in age (F = -8.57, F = -4.66, p < 0.01) and educational background (F = 12.86, F = 7.14, p < 0.01). There were significant correlations among exercise, mental health, stress, resilience, and social support (p < 0.01). The direct effects of exercise on mental health were significant (ß = 0.271, t = 9.577, p < 0.001), and the mediating effects of stress, resilience, and social support were also significant (χ2/df = 4.72, CFI = 0.940, TLI = 0.935, SRMR = 0.048, RMSEA = 0.055). Conclusion: This study explored the effects of exercise on mental health and related mechanisms among scientific and technological professionals, which is beneficial to providing effective suggestions for managing and preventing the mental health of scientific and technological professionals. Future research should include a wider range of participants and adopt a longitudinal follow-up design to more deeply investigate the relationship between exercise and the mental health of scientific and technological professionals.