[Pulmonary artery stenting in chronic thromboembolic pulmonary hypertension: a report of 2 cases].

Chronic thromboembolic pulmonary hypertension (CTEPH) is a pulmonary vascular disease characterized by an insidious onset, progressive deterioration, and poor prognosis. It is distinguished by the thrombotic organization within the pulmonary arteries, leading to vascular stenosis or occlusion. This results in a progressive increase in pulmonary vascular resistance and pulmonary arterial pressure, ultimately leading to right heart failure. In recent years, balloon pulmonary angioplasty (BPA) has emerged as an effective treatment option for patients ineligible for pulmonary endarterectomy (PEA). However, the use of stents in patients with suboptimal balloon dilation remains controversial. This article describes two cases of chronic thromboembolic pulmonary hypertension (CTEPH) in which balloon angioplasty yielded unsatisfactory results, subsequently leading to stent placement. Following stent implantation, there was improved blood flow, significant reduction in pulmonary arterial pressure, and notable alleviation of patient symptoms. One-year follow-up showed no recurrence of stenosis within the stent, suggesting potential guidance for the use of pulmonary artery stenting as a treatment modality for CTEPH. This report provided new insights into the therapeutic approach for CTEPH.

[Reassessment of practice of Chinese surgeons since introduction of the watch and wait strategy after neoadjuvant therapy for rectal cancer].

Objective: To investigate perspectives and changes in treatment selection by Chinese surgeons since introduction of the watch-and-wait approach after neoadjuvant therapy for rectal cancer. Methods: A cross-sectional survey was conducted using a questionnaire distributed through the "Wenjuanxing" online survey platform. The survey focused on the recognition and practices of Chinese surgeons regarding the strategy of watch-and-wait after neoadjuvant therapy for rectal cancer and was disseminated within the China Watch-and-Wait Database (CWWD) WeChat group. This group targets surgeons of deputy chief physician level and above in surgical, radiotherapy, or internal medicine departments of nationally accredited tumor-specialist or comprehensive hospitals (at provincial or municipal levels) who are involved in colorectal cancer diagnosis and treatment. From 13 to 16 December 2023, 321 questionnaires were sent with questionnaire links in the CWWD WeChat group. The questionnaires comprised 32 questions encompassing: (1) basic physician characteristics (including surgical volume); (2) assessment methods and criteria for clinical complete response (cCR); (3) patients eligible for watch-and-wait; (4) neoadjuvant therapies and other measures for achieving cCR; (5) willingness to implement watch-and-wait and factors influencing that willingness; (6) risks and monitoring of watch-and-wait; (7) subsequent treatment and follow-up post watch-and-wait; (8) suggestions for development of the CWWD. Descriptive statistics were employed for data analysis, with intergroup comparisons conducted using the χ2 or Fisher's exact probability tests. Results: The response rate was 31.5%, comprising 101 responses from the 321 individuals in the WeChat group. Respondents comprised 101 physicians from 70 centers across 23 provinces, municipalities, and autonomous regions nationwide, 85.1% (86/101) of whom represented provincial tertiary hospitals. Among the respondents, 87.1% (88/101) had implemented the watch-and-wait strategy. The approval rate (65.6%, 21/32) and proportion of patients often informed (68.8%, 22/32) were both significantly higher for doctors in oncology hospitals than for those in general hospitals (27.7%, 18/65; 32.4%, 22/68) (χ2=12.83, P<0.001; χ2=11.70, P=0.001, respectively). The most used methods for diagnosing cCR were digital rectal examination (90.1%, 91/101), colonoscopy (91.1%, 92/101), and rectal T2-weighted magnetic resonance imaging (86.1%, 87/101). Criteria used to identify cCR comprised absence of a palpable mass on digital rectal examination (87.1%, 88/101), flat white scars or new capillaries on colonoscopy (77.2%, 78/101), absence of evident tumor signals on rectal T2-weighted sequences or T2WI low signals or signals equivalent to the intestinal wall (83.2%, 84/101), and absence of tumor hyperintensity on diffusion-weighted imaging with no corresponding hypointensity on apparent diffusion coefficient maps (66.3%, 67/101). As for selection of neoadjuvant regimen and assessment of cCR, 57.4% (58/101) of physicians preferred a long course of radiotherapy with or without induction and/or consolidation capecitabine + oxaliplatin, whereas 25.7% (26/101) preferred immunotherapy in combination with chemotherapy and concurrent radiotherapy. Most (96.0%, 97/101) physicians believed that the primary lesion should be assessed ≤12 weeks after completion of radiotherapy. Patients were frequently informed about the possibility of achieving cCR after neoadjuvant therapy and the strategy of watch-and-wait by 43.6% (44/101) of the responding physicians and 38.6% (39/101) preferred watch-and-wait for patients who achieved cCR or near cCR after neoadjuvant therapy for rectal cancer. Capability for multiple follow-up evaluations (70.3%, 71/101) was a crucial factor influencing physicians' choice of watch-and-wait after cCR. The proportion who patients who did not achieve cCR and underwent surgical treatment was lower in provincial tertiary hospitals (74.2%, 23/31) than in provincial general hospitals (94.5%, 52/55) and municipal hospitals (12/15); these differences are statistically significant (χ2=7.43, P=0.020). The difference between local recurrence and local regrowth was understood by 88.1% (89/101) of respondents and 87.2% (88/101) agreed with monitoring every 3 months for 5 years. An increase in local excision or puncture rates to reduce organ resections in patients with pCR was proposed by 64.4% (65/101) of respondents. Conclusion: Compared with the results of a previous survey, Chinese surgeons' awareness of the watch-and-wait concept has improved significantly. Oncologists in oncology hospitals are more aware of the concept of watch-and-wait.

Hepatitis C virus genotype diversity in Ningxia Hui autonomous region, Northwestern China / Diversidade genética do vírus da hepatite C na região autônoma de Ningxia Hui

Hepatitis C virus (HCV) genotypes vary greatly in different regions. The aim of this study is to investigate the distribution of HCV genotypes in HCV infected patients, in Ningxia Hui Autonomous Region. Nucleic acid extraction and amplification were performed with test kits on 153 HCV infected patients serum samples. The HCV viral load was measured using reverse transcriptase PCR (RT-PCR) and HCV genotypes were determined. Among the 153 HCV-infected patients, 56 had genotype (GT)1b (36.60%), 45 had GT2a (29.40%), 23 had GT3a (15.00%), 14 had GT3b (9.20%),13 had GT6a (8.50%), 1 had GT1g (0.70%), 1 had GT6xa (0.70%). In GT1b, 21.40% were female and 78.60% were male; in GT2a, 42.20% were female and 57.80% were male;Males were most prevalent in genotypes 1b(39.30%), while female were most prevalent in genotype 2a(46.30%). Rare GT1g and GT6xa were also detected in males. The 41-50 year age group had the highest HCV prevalence of 32.00%. HCV GT1b is the predominant HCV genotype in Ningxia Hui Autonomous Region.

Os genótipos do vírus da hepatite C (HCV) variam muito de acordo com a região. O objetivo deste estudo é investigar a distribuição do genótipo do vírus da hepatite C em pessoas infectadas pelo vírus na região autônoma de Ningxia Hui. A extração de ácido nucleico e a expansão de amostras séricas em 153 pacientes infectados com HCV foram realizadas utilizando kits de ensaio. A capacidade do vírus HCV foi medida pela reação em cadeia da polimerase retrotranscrição (RT-PCR) e o genótipo HCV foi determinado. Os genótipos (Gt) tiveram a seguinte distribuição entre os 153 casos de infecção HCV: 56 Gt 1-B (36, 60%), 45 Gt 2-A (29, 40%), 23 Gt 3-A (15, 00%), 14 Gt 3-B (9, 20%), 13 Gt 6-A (8, 50%), 1 Gt 1-G (0, 70%) e 1 Gt 6-Xa (0, 70%). Já o sexo dos indivíduos teve a seguinte distribuição: Gt 1-B, 21, 40% mulheres e 78, 60% homens; Gt 2-A, 42, 20% mulheres e 57, 80% homens. A presença de homens é mais comum no genótipo 1-B (39, 30%), enquanto as mulheres ocorrem mais comumente no genótipo 2-A (46, 30%). Gt 1-G e Gt 6-Xa raros também foram detectados em homens. A taxa de infecção com HCV para grupos etários de 41 a 50 anos é a mais alta, com 32,00%. HCV Gt 1-B é o genótipo dominante do HCV na região autônoma de Ningxia Hui.

Effects of dietary crude protein on the growth performance, carcass characteristics and serum biochemical indexes of Lueyang black-boned chickens from seven to twelve weeks of age

This study was undertaken to assess dietary crude protein (CP) concentration for optimum growth performance and carcass characteristics of Lueyang black-boned chicken. In total, six hundred 42-day-old Lueyang black-boned chicks were randomly assigned to five treatments, each with six replicate pens with ten males and ten females. The birds fed experimental diets with different levels of protein concentration of 120, 140, 160, 180 and 200 g kg-1 from seven to twelve weeks of age respectively. On day of 84, weight gain, feed intake, and feed:gain ratio were measured, and two chickens (one male and one female) close to the average weight of all birds in each treatment were selected from each pen and sacrificed to evaluate carcass traits and selected serum biochemical indexes. Dietary CP concentration did not have any significant influence on feed intake (p>0.05). The birds fed the diet with 180 or 160 g kg-1 CP concentration exhibited greater (p< 0.05) growth rate, better feed conversion ratio, relative breast weight and albumin concentration in serum than that of those fed other dietary CP concentrations. According to the results of regression analysis, the CP requirements of Lueyang black-boned chicken from seven to twelve weeks of age for optimal weight gain and feed:gain ratio were 174 and 170 g kg-1, respectively.

Effects of dietary crude protein on the growth performance, carcass characteristics and serum biochemical indexes of Lueyang black-boned chickens from seven to twelve weeks of age

This study was undertaken to assess dietary crude protein (CP) concentration for optimum growth performance and carcass characteristics of Lueyang black-boned chicken. In total, six hundred 42-day-old Lueyang black-boned chicks were randomly assigned to five treatments, each with six replicate pens with ten males and ten females. The birds fed experimental diets with different levels of protein concentration of 120, 140, 160, 180 and 200 g kg-1 from seven to twelve weeks of age respectively. On day of 84, weight gain, feed intake, and feed:gain ratio were measured, and two chickens (one male and one female) close to the average weight of all birds in each treatment were selected from each pen and sacrificed to evaluate carcass traits and selected serum biochemical indexes. Dietary CP concentration did not have any significant influence on feed intake (p>0.05). The birds fed the diet with 180 or 160 g kg-1 CP concentration exhibited greater (p< 0.05) growth rate, better feed conversion ratio, relative breast weight and albumin concentration in serum than that of those fed other dietary CP concentrations. According to the results of regression analysis, the CP requirements of Lueyang black-boned chicken from seven to twelve weeks of age for optimal weight gain and feed:gain ratio were 174 and 170 g kg-1, respectively.(AU)