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31 December 2025, Volume 25 Issue 2
    

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    Clinical Study

  • Comparative analysis of HLA-G expression in pathological tissues of endometrial hyperplasia and endometrial cancer

    JIAN Yan Sen, WEI Jie Zhen, SONG Yue Ling, HONG Yu, LI Chun Ke, LIANG Hai Qi, CHEN Qing Ye, LV Pei Ling
    Medical Journal of Kiang Wu. 2025, 25(2): 5-8. https://doi.org/10.12408/j.issn2223-4462.2025.02.001
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    Objective To explore the difference of HLA-G expression in pathological tissues of endometrial hyperplasia and endometrial cancer. Methods From September 2020 to November 2024, patients who underwent hysteroscopy in the Obstetrics and Gynecology department of Kiang Wu Hospital, Macau were enrolled in this case control study. According to the pathological results, they were divided into normal endometrial group, endometrial hyperplasia group, and endometrial cancer group. HLA-G expression in pathological tissues were measured by method of immunohistochemistry in all participants. Results Three groups included 78, 37, and 88 patients, respectively. The positive rates of HLA-G expression in the normal group, hyperplasia group, and endometrial cancer group were 14.1%, 29.7%, and 48.9%, respectively, showing an increasing trend. In the endometrial cancer group, there were 81 patients with endometrioid adenocarcinoma and 7 patients with non-endometrioid cancer with positive rates of HLA-G expression of 46.9% and 71.4%, respectively. The positive rates of HLA-G expression in both endometrial cancer and hyperplasia groups were significantly higher than that in the normal group (P<0.05); Moreover, the positive rate of HLA-G expression in the endometrial cancer group was significantly higher than that in the hyperplasia group (P<0.05). Conclusion Compared with normal endometrium, the expression of HLA-G was significantly increased in endometrial hyperplasia tissue, and even more significantly in endometrial cancer tissue.

  • Analysis of clinical characteristics and related factors of death risk of new coronavirus infection in hemodialysis patients

    HUN Wai Chan, TOU Tou, WU Jian Xun, WONG Wai Weng, TANG Jing
    Medical Journal of Kiang Wu. 2025, 25(2): 9-12. https://doi.org/10.12408/j.issn2223-4462.2025.02.002
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    Objective To analyze and understand the clinical characteristics and prognosis of maintenance hemodialysis patients during the COVID-19 epidemic in our center and to discuss morbidity, survival, mortality at that time. Provide for clinical diagnosis and treatment. Methods The clinical data of chronic dialysis patients diagnosed with COVID-19 infection from December 01, 2022, to February 28, 2023, in the hemodialysis center of a hospital in Macau were collected. Compared the age, gender, dialysis age, vaccination, comorbidities of the survival group and the death group, and understood the high-risk factors for death of patients. Results A total of 443 patients were positive for COVID-19 during the study period, with an average age of 69.26±12.47 years. A total of 43 patients died from COVID-19 infection, with a mortality rate of 9.7%. In the death group, the average age was 75.98±9.72 years . The age of the death group was higher than the survivor group (P<0.05).The vaccination rate in the death group was lower than that in the survival group (P<0.05). In multivariate logistic regression, male patients had an increased risk of death from COVID-19 [OR=3.78, 95% C.I. 1.61-9.70]. Older patients had an increased risk of death from COVID-19 [OR=1.06, 95% C.I. 1.02-1.1]. The single factor analysis of death showed that age were significantly related to death (P<0.001), and vaccination had a protective effect (P=0.001). Conclusion Among maintenance hemodialysis patients with Covid-19 infection who were male, older had an increased risk of death. Vaccination is protective against death. It is recommended that hemodialysis patients be vaccinated against the corona-virus vaccine in time, which can effectively reduce the mortality.
  • Application of BI-RADS microcalcification distribution patterns in mammography for breast cancer diagnosis
    TAN Lei, ZHU Hai Shan, HONG ShaoMei, LI Jun
    Medical Journal of Kiang Wu. 2025, 25(2): 13-17. https://doi.org/10.12408/j.issn2223-4462.2025.02.003
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    Objective To explore the correlation between microcalcification distribution patterns (based on BI-RADS classification) on mammography and the pathological types/molecular subtypes of breast cancer, and to evaluate their diagnostic value in malignant lesions. Methods A retrospective analysis of cases with microcalcifications on mammographic images from 2017 to 2020. Microcalcifications were classified into five distribution patterns(diffuse, regional, clustered, segmental, linear) according to BIRADS 5th edition. Statistical correlations were analyzed with histopathological types, molecular subtypes (ER, PR, HER-2),Ki67, and ultrasonographic findings. Results A total of 216 cases were included in the study, the five microcalcification distribution patterns showed statistically significant differences in breast cancer diagnosis(χ2 =22.4518, P<0.05 ). Clustered and regional distributions were strongly associated with invasive ductal carcinoma ( P<0.05 ), while segmental and clustered distributions exhibited higher correlations with ductal carcinoma in situ (DCIS) compared to other patterns. Regarding molecular subtypes, clustered distribution was predominant in hormone receptor-positive cancers(χ2 =15.2, P<0.00 ), whereas regional distribution correlated with HER-2-positive and triple-negative breast cancer (TNBC)(χ2 =21.4, P<0.00 ). Regional calcifications tend to exhibit high expression of Ki67. There was a significant association between the five types of microcalcification distribution patterns and ultrasonographic features(χ2 =68.489, P<0.05 ). The combination of mammography and ultrasound improved the diagnostic accuracy for breast cancer. Conclusion BI-RADS microcalcification distribution patterns provide critical guidance for breast cancer diagnosis and differentiation between benign and malignant lesions. These patterns can serve as a crucial basis for imaging diagnosis, clinical treatment planning, and prognosis evaluation in breast cancer management.
  • Analysis of the relationship between PD-L1 expression and tumor infiltrating lymphocytes in breast cancer
    WAI Kit Cheng, SIN Lai Fong, CHAN Kin Iong, WONG Heong Ting, LAM Man Wa, XIAO Gang, WEN Jian Ming
    Medical Journal of Kiang Wu. 2025, 25(2): 18-22. https://doi.org/10.12408/j.issn2223-4462.2025.02.004
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    Objective To investigate the relationship between the expression of programmed cell death ligand 1 (PD-L1) and cytotoxic T cells (CTL), helper T cells (Th), regulatory T cells (Treg), and natural killer cells (NK) in the immune microenvironment of breast cancer. Methods A total of 136 breast cancer specimens were collected from the Department of Pathology of Kiang Wu Hospital from January 2008 to June 2018. According to the molecular classification of breast cancer, they were divided into triple-negative breast cancer (TNBC), luminal A, luminal B and HER2 breast cancer. Immunohistochemical staining was used to detect the expression of PD-L1 (SP142), CD4, CD8, CD25 and CD56 in various types of breast cancer, and the relationship between them was analyzed. Results The expression of PD-L1 (SP142) in breast cancer was correlated with the number of infiltrating T lymphocytes ≥200/HPF, CTLs ≥200/HPF, helper T cells ≥200/HPF, and Treg cells ≥100/HPF in the immune microenvironment (P<0.05), but was not related to whether the T lymphocytes were mainly CTLs or located in the center of the tumor (P>0.05). The CTLs, helper T cells and Treg cells in the immune microenvironment of TNBC are more than those in other molecular types of breast cancer, while the luminal A type has the least. The expression of PD-L1 (SP142) in four different molecular types of breast cancer was correlated with the infiltration numbers of CTL and helper T cells (P<0.05). Except for luminal B breast cancer, the expression of PD-L1 (SP142) in TNBC, luminal A and HER2 breast cancer was correlated with the number of Treg cell infiltration (P<0.05). Conclusion The immune microenvironment of TNBC and HER2-type breast cancer is rich in CTLs, Th cells, and Treg cells, which are positively correlated with PD-L1 (SP142) expression. Increasing Treg cell numbers and restoring NK cell cytotoxicity are promising new therapeutic targets. Abnormal CD8 expression is associated with PD-L1 positivity, but its clinical significance requires further investigation.
  • Clinical study on monitoring the diagnostic effect of central precocious puberty in girls using pelvic ultrasound
    LAI Hai Rong, LIN Ning, LI Jun, LIU Zi Yi
    Medical Journal of Kiang Wu. 2025, 25(2): 23-25. https://doi.org/10.12408/j.issn2223-4462.2025.02.005
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    Objective To evaluate the clinical application value of pelvic ultrasound in monitoring the diagnostic efficacy of central precocious puberty (CPP) in girls, providing an objective tool to enhance clinical decision-making and treatment outcomes. Methods Pelvic ultrasound was used to measure uterine and ovarian parameters. Serum levels of estradiol (E2), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were assessed, followed by statistical analysis. Results Uterine and ovarian parameters in the CPP group were significantly larger than those in the control group (P<0.05). Serum E2, FSH, and LH levels were elevated in the CPP group (P<0.001). ROC analysis revealed that ovarian area was the most accurate diagnostic marker (AUC=0.829, P<0.001), with a threshold of 1.19 cm² yielding a specificity of 93.19% and sensitivity of 83.68%. Conclusion Pelvic ultrasound combined with serum sex hormone levels is a valuable non-invasive method that enhances the diagnostic accuracy of CPP and provides reliable data to optimize treatment strategies.
  • Efficacy Analysis of Conbercept For Neovascular Age-Related Macular Degeneration
    HONG Sin U
    Medical Journal of Kiang Wu. 2025, 25(2): 26-28. https://doi.org/10.12408/j.issn2223-4462.2025.02.006
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    Objective To assess the effects of intravitreal Conbercept injections on visual acuity and macular anatomical structure in patients with neovascular age-related macular degeneration (nAMD), and to evaluate the cumulative efficacy and safety of multiple injections. Methods A retrospective analysis was conducted on 9 patients (10 eyes) diagnosed with nAMD who completed three Conbercept injections between April 2023 to March 2025 in the Department of Ophthalmology of Kiang Wu Hospital Macau. Baseline and post-injection data (on the day of injection, 1 week, and 1 month after each injection) for best corrected visual acuity(BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were collected. Repeated-measures analysis of variance (RM-ANOVA) was used to evaluate longitudinal efficacy, and paired t-tests were employed to analyze single-injection effects. Results Baseline BCVA (LogMAR) was 1.03±0.68, and CMT was 352±194 μm. At 1 month after the third injection, CMT significantly decreased to 234±103μm (P<0.001), BCVA (LogMAR) improved to 0.72±0.54(P=0.02), and total macular volume reduced from 7.4±1.3mm³ to 6.8±1.1mm³ (P=0.03). Adverse events included only one case of iridocyclitis. Conclusion Conbercept rapidly reduces macular edema in nAMD patients, demonstrates cumulative efficacy with multiple injections, and exhibits a favorable safety profile.
    • Clinical Experience
  • Ultrasonographic diagnosis of hepatic abscess and analysis of misdiagnosis and missed diagnosis
    LIN Ning, CAI Yue Chang, LIANG Ji Fei, LAI Hai Rong
    Medical Journal of Kiang Wu. 2025, 25(2): 29-31. https://doi.org/10.12408/j.issn2223-4462.2025.02.007
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    Objective To investigate the application value of ultrasonography in the diagnosis of hepatic abscess, aiming to improve diagnostic accuracy and reduce the rates of misdiagnosis and missed diagnosis. and identify the causes of misdiagnosis. Methods To collect cases of hepatic abscess diagnosed by ultrasonography between 2022 and 2024. Ultrasonographic features were analyzed to summarize the sonographic manifestations of hepatic abscess and identify causes of misdiagnosis. Results Among the 27 cases, ultrasound correctly diagnosed 22 cases. The echogenicity of the lesions primarily manifested as: (1) Solid flaky hypoechoic areas or masses: 5 cases (22.7%), 1 of which exhibited gas-like hyperechoic foci; (2) Complex echogenicity lesions (mixed cystic-solid): 15 cases (68.2%), 1 of which exhibited gas-like hyperechoic foci; (3) Cystic lesions: 2 cases (9.1%); (4) Color Doppler ultrasound revealed punctate or linear flow signals within the lesion in 5 cases (22.7%). All lesions had poorly defined boundaries, with a peripheral hyperechoic halo observed in 3 cases (13.6%). Five misdiagnosed cases (22.7% of the ultrasound-diagnosed group) included 4 liver tumors (predominantly solid hypoechoic lesions) and 1 subphrenic encapsulated effusion. Conclusion Hepatic abscess exhibits characteristic ultrasonographic features. Comprehensive analysis of its two-dimensional and color Doppler manifestations contributes to improved diagnostic accuracy and reduced misdiagnosis.
  • The efficiency of speech training with intensive feedback in children with functional articulation disorder
    TAN Jia Sheng, DANG Chi Ting, LAO Chong Leong
    Medical Journal of Kiang Wu. 2025, 25(2): 32-34. https://doi.org/10.12408/j.issn2223-4462.2025.02.008
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    Objective To investigate the effects of speech training with intensive feedback in functional articulation disorder(FAD)children to improve their articulation abilities. Methods 22 children with FAD who were retrospectively studied were divided in traditional training group with 10 and experimental group with 12 children. The control group was accepted general articulation training, while the experiment group was accepted intensive feedback during the training. Before and after the trainings they were tested by the Cantonese articulation scale. Results In nonstimulability words, the effects of improving articulation ability in two groups were statistically different (P<0.05). In unaspiration disorder, the therapeutic effects in two groups were statistically different (P<0.05). Conclusion Speech training with intensive feedback can improve articulation ability in FAD children, and its improvement is better than traditional training.
  • The Effect of Neonatal Birth Support Protocol on Newborn Outcomes
    IEONG Weng San, YE Yi Lian, KAN Pui Kuan, CHAN Un Kei
    Medical Journal of Kiang Wu. 2025, 25(2): 35-36. https://doi.org/10.12408/j.issn2223-4462.2025.02.009
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    Objective To evaluate the influence of neonatal birth support protocols on newborn outcomes. Methods Newborns from 2015 to 2022 were used as the research subjects. The newborns in this group were implemented according to the neonatal birth support protocols established by both obstetric and pediatric team. Newborns in our hospital from 2007 to 2014 were used as the control group. The newborn outcomes including neonatal mortality, severe neonatal asphyxia and hypoxic ischemic encephalopathy between the two groups were compared, to understand the effect of this protocol. Results The incidence of neonatal mortality, severe neonatal asphyxia and hypoxic ischemic encephalopathy were significantly lower than that in the control group, and the difference was statistically significant (P <0.05). Conclusion Our neonatal birth support protocol have positive effect in clinical quality improvement.
  • Clinical pathological analysis of solid papillary carcinoma of the breast
    XIAO Gang, WAI Kit Cheng, SIN Lai Fong, YIP Yuk Ching
    Medical Journal of Kiang Wu. 2025, 25(2): 37-38. https://doi.org/10.12408/j.issn2223-4462.2025.02.010
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    Objective To investigate the clinicopathological characteristics and diagnostic points of solid papillary carcinoma (SPC) of the breast in order to reduce misdiagnosis. Methods A retrospective analysis of SPC cases from Kiang Wu Hospital in Macau, and diagnostic criteria were summarized in combination with HE staining, immunohistochemical analysis, and literature data. Results All 12 patients were female, with an average age of 67 years, presenting unilateral breast masses. Breast-conserving surgery was performed in 11 cases and modified radical mastectomy in 1 case. Sentinel lymph node biopsy showed no metastatic carcinoma. The tumors had clear boundaries and showed solid nodules with a fibrous vascular core under the microscope, with low to moderate cellular atypia. Immunohistochemical phenotype: diffuse strong positivity for ER, positivity for Syn and CgA, negativity for CK5/6 and C-erb B2, and absence of myoepithelial cells within the tumor; 11 cases were in situ SPC, and 1 case was in situ SPC with invasive ductal carcinoma. Conclusion SPC is a rare tumor that predominantly affects elderly women. It has special pathological morphology and immunohistochemical phenotype.
  • Analysis of the efficacy of meniscal suture versus meniscectomy under knee arthroscopy
    CHANG Wun Fong, WONG Hong Meng, ZHANG Yu, TANG Kuong Fai, CHAN Chi Kit
    Medical Journal of Kiang Wu. 2025, 25(2): 39-42. https://doi.org/10.12408/j.issn2223-4462.2025.02.011
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    Objective To analyze the efficacy of suture and resection of meniscus injury under knee arthroscopy. Methods A retrospective analysis was performed with unilateral grade 3 meniscal injuries treated in the Department of Orthopedics at Kiang Wu Hospital, Macau, from January 2021 to December 2023. Based on the surgical technique, the patients were divided into two groups: meniscal suture and meniscectomy. All patients were followed up for at least one year. Parameters including operative duration, hospital stay, time to return to work, postoperative complications (such as osteoarthritis, deep vein thrombosis, and hemarthrosis), visual analog scale (VAS) for pain, and Lysholm Knee Score (LKS) were recorded and statistically analyzed to evaluate therapeutic outcomes. Results 62 cases were followed up for at least one year postoperatively. The operative duration for meniscal suture group was significantly longer than meniscectomy group. No significant differences were observed between the two groups regarding the proportion of patients requiring postoperative physical therapy. None of the cases developed knee joint cysts or quadriceps atrophy. The incidence of joint stiffness and cartilage damage showed no intergroup differences; however, the meniscal suture group exhibited a lower rate of postoperative synovitis. At three months postoperatively, the Visual Analog Scale (VAS) pain scores were comparable between the two groups. Still, the suture group demonstrated significantly lower pain scores at the one-year follow-up. Preoperative and three-month postoperative Lysholm scores were similar in both groups, while the suture group achieved superior Lysholm total scores one year postoperatively. Conclusion Compared with meniscectomy, meniscal suture repair demonstrated comparable short-term outcomes but superior longterm effectiveness, enhanced pain relief, and fewer complications. Although it requires a longer operative time, this technique remains a preferred clinical option and merits wider adoption.
  • Effect of pulsed radiofrequency treatment via the transforaminal approach for cervical spondylotic radiculopathy
    WONG Kai Leong, CHENG Pui Him, CHIN Hiu Fai
    Medical Journal of Kiang Wu. 2025, 25(2): 43-46. https://doi.org/10.12408/j.issn2223-4462.2025.02.012
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    Objective To observe the short-term efficacy of transforaminal pulsed radiofrequency (PRF) of spinal nerve roots in the treatment of cervical radiculopathy. Methods A retrospective analysis was conducted on the clinical data with cervical radiculopathy who received DSA-guided transforaminal cervical spinal nerve root PRF in our hospital from January 2023 to December 2024. The Visual Analog Scale (VAS) scores and Neck Disability Index (NDI) scores of each patient were recorded and analyzed before surgery, as well as at 1 week, 1 month, 2 months, and 3 months after surgery. Additionally, the occurrence of surgery-related complications was documented. Results A total of 24 cases, compared with the pre-operative scores, the VAS and NDI results showed significant improvements at 1 week, 1 month, 2 months, and 3 months post-operatively, with statistically significant differences (P<0.01). When comparing the post-operative observation time points:The VAS results at 1 week, 1 month, 2 months, and 3 months post-operatively were similar, with no statistically significant differences (P>0.05).The NDI improvement was most significant at 1 week post-operatively, with lower scores than those at 1 month, 2 months, and 3 months post-operatively, and the differences were statistically significant (P<0.05). However, the NDI results among 1 month, 2 months, and 3 months post-operatively were comparable, with no statistically significant differences (P>0.05). Only 3 out of the 24 patients developed mild complications, which were relieved after symptomatic treatment. Conclusion Pulsed radiofrequency treatment via the transforaminal approach for cervical spondylotic radiculopathy has a definite short-term curative effect, can significantly relieve pain, improve the quality of life, and has high safety, showing clinical application value.
  • Accuracy analysis of Barrett Universal II formula in predicting refractive outcomes for Mini 4 Ready intraocular lens
    HO Chi Man, FONG Sao Nok, UN Sok Man, TANG Lai In
    Medical Journal of Kiang Wu. 2025, 25(2): 47-49. https://doi.org/10.12408/j.issn2223-4462.2025.02.013
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    Objective To evaluate the accuracy of the Barrett Universal II formula in predicting postoperative refraction for the Mini 4 Ready intraocular lens (IOL) (SIFI S.p.A., Catania, Italy) across different axial lengths, and to assess its clinical applicability. Methods A retrospective study underwent cataract phacoemulsification with implantation of the Mini 4 Ready IOL between January and December 2024. Eyes were categorized into short (<22.5mm), normal (22.5-25.5mm), and long (>25.5mm) axial length groups. The Barrett Universal II formula was used to predict postoperative refraction. At 1 month post-surgery, the spherical equivalent was measured as the actual refraction. Prediction error (PE) and absolute error (AE) were calculated, with ±0.50D as the acceptable range. Results Total 60 eyes, the short axial length group showed the highest accuracy, with 100% of cases having AE<0.50D (mean PE=0.13±0.24D). In the normal axial length group, 80.85% had AE<0.50D but exhibited a significant myopic shift (mean PE=-0.19±0.41D, P<0.05). The long axial length group had 75% with AE<0.50D, with more scattered errors (mean PE=-0.22±0.47D, P>0.05). Overall, prediction accuracy was 85.28% for AE<0.50D and 98.58% for AE<1.00D. Conclusion The Barrett Universal II formula demonstrates comparable overall accuracy for the Mini 4 Ready IOL to other IOL studies. The short axial length group performed best, while the normal axial length group requires parameter adjustments to reduce myopic bias. The long axial length group needs further validation with a larger sample. Adjusting formula parameters for different axial lengths is recommended to optimize clinical outcomes.
    • Case Report
  • Fetomaternal hemorrhage: a case report
    LIANG Jian Ming, WONG Fong Fong, NG Si Man, YU Anagelina
    Medical Journal of Kiang Wu. 2025, 25(2): 50-51. https://doi.org/10.12408/j.issn2223-4462.2025.02.014
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    Fetomaternal hemorrhage (FMH) is a rare pregnancy-related condition in which various causes lead to disruption of the placental barrier, allowing fetal blood to enter the maternal circulation. This results in a spectrum of clinical manifestations, including fetal anemia and hemolytic transfusion reactions in the mother. In 1955, Chown and colleagues first confirmed the presence of fetal red blood cells in the maternal circulation. The exact pathogenesis of FMH remains unclear, and there is currently no specific diagnostic standard. The incidence of FMH with typical clinical symptoms is estimated to be approximately 1 in 1,000 to 1 in 3,000 pregnancies.
  • X-linked agammaglobulinemia presented with recurrent infections and eczema: a case report with genetic diagnosis
    LEI Cheng, VONG Kit Hing, MIO In
    Medical Journal of Kiang Wu. 2025, 25(2): 52-53. https://doi.org/10.12408/j.issn2223-4462.2025.02.015
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    X‑linked agammaglobulinemia (XLA) is the most common form of antibody immunodeficiency, accounting for approximately 85% of congenital agammaglobulinemia cases. Patients typically present with persistently low serum immunoglobulin levels and recurrent bacterial infections, with onset most often occurring during infancy. Here, we report one case of XLA diagnosed and treated in our hospital, accompanied by a review of the relevant literature, in order to enhance clinicians’ understanding of this condition.
  • 18F-FDG PET/CT diagnosis of primary multiple hepatic angiosarcoma
    YANG Bo
    Medical Journal of Kiang Wu. 2025, 25(2): 54. https://doi.org/10.12408/j.issn2223-4462.2025.02.016
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    Primary hepatic angiosarcoma (PHA) is an extremely rare malignancy, accounting for approximately 2% of primary hepatic cancers and representing the most common primary malignant mesenchymal tumor of the liver. The imaging features of PHA lack specificity, and definitive diagnosis relies on pathological confirmation; biopsy should be performed with caution due to the risk of bleeding. This article presents a retrospective analysis of the imaging characteristics of a case of multifocal PHA treated at our hospital, providing a reference for future diagnostic practice.
  • A case report of perioperative amniotic fluid embolism
    CHAN Meng Fa
    Medical Journal of Kiang Wu. 2025, 25(2): 55. https://doi.org/10.12408/j.issn2223-4462.2025.02.017
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    Background: Amniotic fluid embolism is a serious complication during childbirth in pregnant women, with a rare occurrence but high mortality rate. At present, amniotic fluid embolism cannot be prevented, and only early detection and early treatment can improve the chances of successful treatment of pregnant women with amniotic fluid embolism.

    Case summary: A full-term pregnant woman was admitted to the hospital and needed emergency cesarean section, and amniotic fluid embolism occurred during subarachnoid anesthesia, the live fetus was delivered as soon as possible under endotracheal general anesthesia, and the MET team in the hospital was notified to collaborate to rescue the patient. The patient was received vasoactive drugs to maintain blood pressure, Hydrocortisone to anti-sensitization, blood transfusion, anti-infection, gastric protection and symptomatic supportive treatment. The patient was successfully discharged from the hospital.

    Conclusion: By reporting this case, we aim to enhance readers to understand the diagnosis and management of amniotic fluid embolism during the perioperative period.

  • Two cases of segmental vitiligo treated with fractional CO₂ laser combined with topical ruxolitinib
    IEONG Seng Hin
    Medical Journal of Kiang Wu. 2025, 25(2): 56. https://doi.org/10.12408/j.issn2223-4462.2025.02.018
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    The global prevalence of vitiligo is estimated to be 0.2–2%. Traditional phototherapy for stable-stage vitiligo—including narrowband UVB (NB‑UVB) and 308‑nm excimer laser—has been shown to achieve better repigmentation on the face and neck than on the extremities. Phototherapy is often combined with topical medications, and recent studies suggest that combining topical agents with fractional carbon dioxide laser may enhance drug efficacy.
  • A case report of superficial angiomyxoma
    KU Kit Meng
    Medical Journal of Kiang Wu. 2025, 25(2): 57. https://doi.org/10.12408/j.issn2223-4462.2025.02.019
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    Superficial angiomyxoma is a rare benign cutaneous tumor that commonly occurs on the head and neck, trunk, lower extremities, and external genital region. Clinically, it presents as a slowly growing polypoid, papular, or nodular skin lesion. Histologically, it is characterized by poorly circumscribed nodules separated by delicate fibrous septa, with spindle‑shaped or stellate cells embedded in a myxoid stroma. Surgical excision is the treatment of choice, and the prognosis is generally favorable; however, incomplete excision may lead to local recurrence. We report one such case below.
  • Right bundle branch block affected acute myocardial infarction ECG analysi
    LIU Shu Lei, O U Fan, LIU Hong
    Medical Journal of Kiang Wu. 2025, 25(2): 58-59. https://doi.org/10.12408/j.issn2223-4462.2025.02.020
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    The occurrence of right bundle branch block (RBBB) on electrocardiography in patients with acute myocardial infarction is relatively uncommon and may interfere with ECG interpretation, increasing the risk of delayed diagnosis and treatment. This article reports a case of such a patient.
    • Traditional Chinese Medicine
  • Advances in clinical application and safety research of external preparations containing toxic chinese medicinals
    KOU Seng Ka, LI Jian Heng, SHEN Jian
    Medical Journal of Kiang Wu. 2025, 25(2): 60-64. https://doi.org/10.12408/j.issn2223-4462.2025.02.021
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    Objective To systematically review the clinical application status, toxicity profiles, safety research advancements, and risk control strategies of topical formulations containing toxic Chinese herbal medicines (CHMs) over the past five years, providing evidence for their rational utilization and enhanced safety. Methods Relevant literature published within the last five years on topical formulations of toxic CHMs was retrieved from major Chinese databases (CNKI, Wanfang, and VIP). Studies were screened and synthesized, with analysis focusing on formulation types, administration routes, clinical applications, adverse reactions, and detoxification methods. Results Topical formulations of toxic CHMs exhibit diverse forms and broad clinical utility, demonstrating significant efficacy in treating conditions such as periarthritis of the shoulder, arthritis, and dermatological disorders. Adverse reactions are predominantly localized irritation and allergic responses, with systemic toxicity incidence rates remaining below 1%. Risk mitigation can be effectively achieved through measures including precise dosage control, optimized treatment duration, pharmaceutical processing for detoxification, formulation refinement, and technological improvements. Nevertheless, current research is limited by insufficient long-term toxicity data, inadequately defined protocols for special populations, and the absence of an established toxicity biomarker monitoring system. Conclusion Topical formulations of toxic CHMs present an overall controllable safety profile when used according to established guidelines, holding substantial clinical value. Future efforts should integrate multidisciplinary approaches-such as transdermal pharmacokinetics and metabolomics-to elucidate the mechanisms of dermal penetration by toxic constituents, establish comprehensive toxicity surveillance systems, and advance the development and implementation of technical standards. This integrated strategy is essential for achieving the precision dosing goal of optimal efficacy-toxicity balance.
  • A case of idiopathic pulmonary fibrosis and pneumonia treated with integrated traditional Chinese and Western medicine
    HO Cheng Hang, WONG Cheok Kin, SIN Wai Ma
    Medical Journal of Kiang Wu. 2025, 25(2): 65-66. https://doi.org/10.12408/j.issn2223-4462.2025.02.022
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    Idiopathic pulmonary fibrosis (IPF) is a chronic, fibrosing interstitial pneumonia of unknown etiology, often resulting in irreversible damage to lung function. Traditional Chinese Medicine considers IPF a type of pulmonary wasting, a late-stage disease characterized by coughing and spitting of turbid saliva. This article reports a case of idiopathic pulmonary fibrosis complicated by severe pneumonia.
    • Nursing Practice
  • Analysis of the influencing factors of uremic pruritus and its influence on quality of life among hemodialysis patients
    ZHANG Ying Hong, ZHUANG Yao Zhen
    Medical Journal of Kiang Wu. 2025, 25(2): 67-70. https://doi.org/10.12408/j.issn2223-4462.2025.02.023
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    Objective To explore the impact of uremic itching on the quality of life of hemodialysis patients. Methods this cross-sectional study, 5-D Itching Scale and the Quality of Life Scale for Kidney Disease Patients (KDQOL-36) were adopted to evaluate the prevalence of uremic pruritus and the quality of lifeamoung maintenance hemodialysis patients at a hospital hemodialysis center in Macau. Results The study enrolled 158 maintenance hemodialysis patients and all participants were divided into two groups according to the scoring of 5-D itch scale: 113 cases (71.5%) for the itch group and 45 cases (28.5%) for the non-itch group. The degree of itching is classified as mild itching (20.2%), moderate itching (26.6%), severe itching (17.7%), and serious itching (6.9%). There were statistically significant differences in the factors related to itching between the two groups of patients in terms of educational level (P=0.032), dialysis age (P=0.029), urea clearance index (Kt/v) (P=0.042), and blood phosphorus (P=0.048). In regardto quality of life, non-itching patients scored higher than those with itching, and the severer the itching, the lower the score of quality of life. Conclusion The incidence of uremia among maintenance hemodialysis patients in the study hospital is 71.5%. Educational level, dialysis age, urea clearance index,and blood phosphorus are factors related to uremic itching. Uremic itching is negatively correlated with quality of life.
  • The effectiveness of prewarming measures in improving the body temperature of patients undergoing cesarean section during perioperative period
    LOU Kin Chong, IEONG Ka Hou
    Medical Journal of Kiang Wu. 2025, 25(2): 71-73. https://doi.org/10.12408/j.issn2223-4462.2025.02.024
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    Objective To investigate the efficacy of prewarming measures in improving perioperative body temperature in patients undergoing cesarean section. Methods Patients who were scheduled cesarean section from June 2020 to December 2022 were recruited and divided into an experimental group or a control group based on the time of surgery. The experimental group received prewarming measures before the surgery, while the control group received routine warming measures. The tympanic temperature of all the patients was recorded at the following time points: before the surgery, upon arrival at the post-anesthesia care unit (PACU), after 30 minutes in the PACU, 30 minutes after the subarachnoid anesthesia, at the end of surgery (in the operating room), and 1 hour after returning to the ward. Cold perception and shivering were assessed upon arrival at the PACU, 30 minutes after the subarachnoid anesthesia, and 1 hour after returning to the ward. Differences in body temperature, cold perception and shivering between the two groups were analyzed. Results A total of 120 undergoing cesarean section completed the study. The experimental group showed significantly better body temperature maintenance and reduced cold perception compared to the control group (P<0.05).There was no significant difference in the degree of shivering between the two groups. Conclusion Prewarming measures can effectively prevent perioperative hypothermia in patients undergoing cesarean section and anesthesia.
    • Equipment and Technology
  • Design and implementation of a shared intelligent follow-up system for multiple chronic diseases
    PENG Li, LAI Chon Sang, ZHANG Jin Wen, PENG Hong Quan, LU Yan, WU Pei Shan, WU Shi Jue, LI Dan, CHEUAG ChunWing
    Medical Journal of Kiang Wu. 2025, 25(2): 74-77. https://doi.org/10.12408/j.issn2223-4462.2025.02.025
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    Objective To develop an intelligent shared follow-up system for pulmonary nodules, colorectal polyps, and chronic kidney disease (CKD), providing a scientifically robust and efficient technical solution for chronic disease follow-up management. Methods The system was constructed through three key approaches: 1.Systematically analyzing critical components of chronic disease follow-up workflows and establishing standardized management modules based on clinical practice guidelines; 2.Integrating internet technologies with lightweight artificial intelligence (AI) algorithms to build a distributed architecture supporting real-time data processing; 3.Developing an extensible follow-up management system adaptable to multiple chronic diseases. Results The system was successfully constructed and integrated nine core functions: 1.Intelligent screening of follow-up cohorts; 2.Disease risk assessment; 3.Automated generation of personalized follow-up plans; 4.Smart generation and automatic sending of test/examination request form; 5.Integrated online payment and appointment services; 6.Abnormal result alerts; 7.Physician-patient interaction platform; 8.Targeted health education system; 9.Automated follow-up data analysis and visualization. Conclusion This multi-disease shared follow-up system provides patients with comprehensive, full-cycle, and multidimensional intelligent management services. Its modular design ensures excellent extensibility, offering a replicable technical paradigm for other chronic disease management systems.
    • Medical education
  • My memory about my teacher ZHANG Can Jia
    WANG Li Heng, LI Xue Jun
    Medical Journal of Kiang Wu. 2025, 25(2): 78-79. https://doi.org/10.12408/j.issn2223-4462.2025.02.026
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    NA
  • On the neutrality of doctor
    LI Wei Ping
    Medical Journal of Kiang Wu. 2025, 25(2): 80-81. https://doi.org/10.12408/j.issn2223-4462.2025.02.027
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    The neutrality of physicians is a crucial safeguard for medical quality and patient safety. In modern healthcare systems, physicians’ decisions are often influenced by various factors, including administrative pressures, economic interests, and social relationships. To maintain physician neutrality, efforts are needed on multiple fronts: strengthening medical ethics education, improving healthcare management systems, establishing independent decision‑support mechanisms, enhancing legal and policy protections, raising public health literacy, and developing professional protection frameworks. Only by ensuring the neutrality of physicians can the true mission of medicine be fulfilled and patients’ lives and health be effectively protected.
    • Reveiw
  • Application of biomaterials in VPT of mature permanent teeth
    ZHANG Si Mai, NIE Li Huan, LIU Qi
    Medical Journal of Kiang Wu. 2025, 25(2): 82-84. https://doi.org/10.12408/j.issn2223-4462.2025.02.028
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    Vital pulp therapy (VPT) is a dental treatment approach aimed at preserving and restoring infected or damaged pulp tissue. The primary goal of this therapy is to maintain and recover the vitality and function of the dental pulp through various techniques and interventions. Specifically, VPT seeks to effectively remove sources of infection and damaged tissue within the pulp chamber, and to apply appropriate biomaterials that promote pulp regeneration and repair, thereby ensuring that the tooth can continue to function normally in terms of mastication and aesthetics.

    This treatment is particularly important for patients with mild to moderate structural damage to the tooth, as it helps maintain long‑term dental health and function while avoiding the complex procedures associated with conventional root canal therapy. Through accurate diagnosis and individualized treatment planning, VPT aims to maximize the preservation of pulp tissue, improve long‑term prognosis, and enhance patients’ quality of life.

  • New progress in medical dressing research
    WANG Xiao Ou, HE Cheng Bang
    Medical Journal of Kiang Wu. 2025, 25(2): 85-88. https://doi.org/10.12408/j.issn2223-4462.2025.02.029
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    Objective Skin or tissues will form wounds under the action of various external forces ( surgery , force , heat , hypothermia , electricity , chemical substances , etc .) and internal factors ( blood supply disorders , etc .). Selection and use of appropriate dressing is one of the essential parts in wound repair , which can not only protect the wound , but also can prevent the infection of the wound , relieve the pain of dressing change for patients , and even have a positive effect on wound healing . In recent years , the rapidly developing material science and industrial science has resulted in a variety of dressings with various functions and structures . Therefore , it has become a difficult task for clinicians to choose the appropriate wound dressing in clinical treatment .This paper reviews the current research progress and future development prospects of wound dressings.
    • This Special Issue
  • Study on the current situation and countermeasures of the integrated medical, rehabilitation and care services for elderly families in Zhuhai City
    AI Yan, ZHU Hua, ZHAN Xue Jun, JIANG Run Ping, XIAO Ying
    Medical Journal of Kiang Wu. 2025, 25(2): 89-92. https://doi.org/10.12408/j.issn2223-4462.2025.02.030
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    This report aims to deeply explore the integrated "medical care, rehabilitation and elderly care" services for the elderly in urban areas of Zhuhai City, and to sort out the current relevant policies and practical models in Zhuhai City. Research has found that Zhuhai has initially formed a home-based, community-based, institution supplemented, and medical care integrated elderly care service system. However, there are still problems such as fragmented service content, lack of professional talents, inadequate payment mechanisms, and insufficient intelligent applications in the integration of home-based medical and health care services. Based on demand side analysis, the report constructs a core service content system covering five dimensions: "medical support, rehabilitation promotion, life care, spiritual comfort, and smart empowerment", and proposes specific countermeasures and suggestions such as improving policy coordination, cultivating professional teams, innovating financing models, and deepening scientific and technological applications, in order to provide decision-making references for building a high-quality and sustainable family elderly care service system.
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