Background: Inferior vena cava filters are typically retrieved using endovascular procedures. However, in cases where complications related to the filter arise or when endovascular retrieval becomes challenging, open surgery could be considered. Case presentation: A 65-year-old woman underwent inferior vena cava filter placement surgery for progressive venous thrombosis embolism (VTE). Following an unsuccessful endovascular retrieval attempt at an external hospital two months later, she experienced abdominal pain and was transferred to our facility for further treatment. Examination revealed that she was encountered a complication where the inferior vena cava filter penetrated both the vena cava and the duodenum post-implantation. But fortunately, the patient's blood test results were within normal range. Ultimately, our institution successfully removed the filter through open surgery and the patient was discharged without any complications. Conclusions: This case, along with our literature review, illustrates the viability and safety of duodenal-penetrated filter removal via open surgery, resulting in favorable outcomes and a promising prognosis for the patient.

患者男，38岁。因“左下肢肿痛1 d”就诊。患者2周前高处坠落伤伴多发骨折和腹膜后血肿于外院行抗感染、扩容补液等保守治疗。1 d前患者自觉左下肢肿痛，不伴咳嗽、胸闷、胸痛等不适。入院后左下肢血管超声检查：腔静脉节段血流通畅，下段管腔受血肿压迫；左侧髂总、髂外静脉节段血栓形成；左侧深、浅静脉血栓形成。上腹部增强CT检查：腹膜后血肿；左侧腰大肌损伤；骶骨骨折。行下腔静脉造影+下腔静脉滤器（inferior vena cava filter，IVCF）置入术，术中造影发现滤器展开故障，尝试腔内回收滤器失败，确定滤器不在下腔静脉内（图1A），随即释放第二枚滤器（图1B）。术后第14天行剖腹探查，见下腔静脉后壁滤器外露呈部分展开状态，予以丝线捆绑滤器防止二次组织损伤（图2A），并试图拔除异常滤器失败。充分暴露滤器头端回收钩（图2B），并予以鹅颈抓捕器成功抓取异常滤器，并见到其内包裹结缔组织（图2C），术中未见到明显活动性出血灶，术后1周出院，3个月后取出第二枚正常解剖位滤器。

OBJECTIVE: The prognosis of COVID-19 is related to thrombotic events. This study investigated prognostic risk factors, anticoagulant therapy effects, and potential instruction of treatment or prognostic with D-dimer in patients with severe COVID-19 receiving anticoagulant therapy. MATERIALS AND METHODS: We undertook a retrospective study of 87 severe COVID-19 patients who had prophylactic low-molecular-weight heparin (LMWH) therapy. Patients were divided into two groups according to whether high-flow oxygen therapy was required during hospitalization: Better and poor prognoses. RESULTS: Multivariate logistic regression using risk factors measured before LMWH therapy revealed that older age (P < 0.035) and higher C-reactive protein (CRP) levels (P = 0.002) had a prognostic value. Anticoagulant therapy yielded significant changes in CRP levels (P < 0.001), white blood cell counts (P = 0.001), neutrophil counts (P < 0.001), neutrophil/lymphocyte ratios (P < 0.001), eosinophil counts (P = 0.031), and D-dimer levels (P < 0.001) in the better prognosis group and in D-dimer levels (P = 0.043) only in the poor prognosis group. Prognoses at different D-dimer levels at anticoagulant therapy initiation varied. Among 47 and 40 patients with D-dimer levels ≤4 and >4 μg/ml fibrin equivalent unit (FEU), 33 (70.6%) and 18 (45%) had better prognosis (P = 0.012), respectively. CONCLUSION: Anticoagulant therapy reduced inflammation in patients with better prognosis; conversely, minimal effect was observed in those with poor prognosis. During LMWH therapy patients with D-dimer levels, patients receiving anticoagulant therapy at D-dimer levels ≤4 μg/ml FEU had a better prognosis than those at >4 μg/ml FEU.

Objective:To summarize the experience of anticoagulant therapy in patients with COVID-19.Methods:The clinical data of 3 special patients confirmed COVID-19 in January and February 2020 in Union Hospital of Tongji Medical College, Huazhong University of Science and Technology were analyzed. All the three patients had worsened condition, worsened respiratory symptoms and significantly increased plasma D-dimer level (>20 mg/L) within one week of hospitalization. Two male patients were treated with enoxaparin sodium. Another female was treated with low molecular weight heparin sodium, followed by enoxaparin sodium.Results:Respiratory symptoms were relieved after prophylactic anticoagulation treatment. And no thrombotic events occurred.Conclusions:Patients with COVID-19 are associated with high risk factors for venous thromboembolism. Prophylactic anticoagulation may not only prevent thrombosis, but also improve the prognosis of patients.

目的 分析2008—2017年湖北省流感监测结果,初步探究湖北省流感流行规律,为湖北省流感防控提供科学依据.方法 收集2008—2017年中国疾病预防控制信息系统和突发公共卫生事件监测系统上流行性感冒突发事件进行分析.结果 2008—2017年度8、9、11月为流感高发月份,6岁以下的学龄前儿童发病率最高,职业以学生、散居儿童最高.流行性感冒突发事件主要集中在9、11月.结论 2008—2017年度流感总体呈上升趋势,某些年份可能病例突然增多,要注意加强监测和防范.尤其是每年9、11月要加强对学校学生和散居儿童的监测.