SM Case Reports

Archive Articles

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Clinical Observation of Traditional Chinese Medicine in the Treatment of Diabetic Kidney Disease: A Clinical Case Series

Aim : Diabetic kidney disease (DKD) is a critical microvascular complication of diabetes and the main cause of in end-stage renal disease (ESRD). Conventional clinical treatments for blood glucose, blood pressure, and blood lipid control include ACEI/ARB drugs and other symptomatic treatments, which do not control disease progression. Therefore, in the present study, we assessed the effectiveness of a Chinese medicinal therapy for the treatment of DKD, ameliorating patients’ clinical symptoms, controlling proteinuria, delaying the progression of DKD, and protecting renal function.

Methods : From July 2007 to January 2018, we assessed five DKD patients. We collected data on these patients’ symptoms, physical examination findings, and physicochemical examination findings at multiple visits. Patient medical records were reviewed retrospectively. also improved.

Results : In the five cases reported, clinical symptoms such as edema and urine foam were obviously relieved or even resolved completely. Serum creatinine (Scr) decreased or was maintained, and the 24-hour urinary protein tended to decrease. In the course of treatment, not only were no adverse reactions observed, but patient renal functioning improved or remained stable. Patient quality of life  also improved.

Conclusion : Shenzhuo formula is a promising and safe method for the treatment of DKD and is thus worthy of further controlled clinical and mechanistic studies.

Lili Zhang1#, Jiang Ma2#, Yu Wei3#, Rumeng Tang3, Linhua Zhao1*, and Xiaolin Tong1*


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Critical Malfunction of Autonomous Surgical Table During Anesthesia Induction and Its Impact on AI in Medicine: Case Report

Background: Although rare, medical device failures during surgical procedures can result in severe outcomes, including fatalities. The increasing use of autonomous medical technologies introduces new risks, particularly if external control mechanisms fail during a malfunction.

Case presentation: A 54-year-old ASA I patient with obesity and a short neck was scheduled for elective facial plastic surgery under general anesthesia. During induction, the autonomous surgical table unexpectedly shifted into a Trendelenburg position and tilted laterally, placing the anesthetized patient at risk of falling. The surgical team promptly stabilized the patient and safely transferred them to another operating room. The procedure continued without further incident. Subsequent inspection by biomedical engineers revealed a malfunction in the table’s sealed integrated circuit, which caused the autonomous movements.

Discussion: This case highlights the intersection of patient safety, obesity-related anesthetic risk, and the emerging challenges of autonomous surgical systems. While AI integration in healthcare offers significant benefits, it also introduces new vulnerabilities. Device malfunction whether from design flaws, maintenance lapses, or software failure can pose immediate threats in high-stakes environments. As intelligent automation advances, robust safety protocols, human oversight, and ethical frameworks must evolve in parallel to mitigate risks and ensure patient-centered care.

Conclusion: This case underscores the critical need to reassess the safety protocols surrounding autonomous surgical devices. As AI technologies become more integrated into healthcare, even minor malfunctions can lead to significant perioperative risks. Ongoing vigilance, robust device management, and proactive safety frameworks are essential to mitigate hazards and uphold patient safety in an increasingly automated clinical environment.

Keywords: Surgical Table; Artificial Intelligence (AI); Surgical Tools.

Espinosa Jorge A*1, Juan Ochoa2, Rodríguez Fredy3 and Menjívar Gabriela4


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Non-selective Beta-Blockers in Retroperitoneal Fibrosis: Possible Role in Symptom Exacerbation – A Case Report

Introduction: Retroperitoneal fibrosis (RPF) is a rare fibroinflammatory disorder characterized by progressive deposition of dense collagenous tissue within the retroperitoneal space, encasing vascular and visceral structures. Although most cases are idiopathic, certain pharmacological agents have been implicated in symptom exacerbation. This case report describes an acute deterioration of gastrointestinal function following initiation of a non-selective beta-adrenergic blocker in a patient with otherwise stable disease.

Case Presentation: A 45-year-old Caucasian woman with dyslipidemia and chronic sinus tachycardia underwent exploratory laparotomy for suspected peritoneal malignancy. Histopathological examination confirmed extensive fibrotic deposition with chronic inflammatory infiltrates and excluded neoplasia, establishing a diagnosis of RPF. During three years of surveillance with serial laboratory testing and magnetic resonance imaging, the disease remained quiescent. To optimize heart rate control, therapy with a beta-1-selective antagonist was replaced by propranolol 40 mg twice daily, a non-selective beta-adrenergic blocker. Within days, she developed severe crampy abdominal pain, marked distension, and altered bowel habits, despite stable imaging findings. The close temporal relationship, together with the established role of beta-2 receptors in intestinal smooth muscle relaxation, implicated non-selective blockade in aggravating colonic dysmotility against a background of fibrotic compression. Dietary modifications and low-dose antispasmodics provided only marginal relief.

Conclusion: This case highlights that non-selective beta-blockers may exacerbate gastrointestinal symptoms in RPF by impairing smooth muscle relaxation. In patients with colonic involvement, beta-1-selective agents should be preferred, with careful consideration of cardiovascular benefits versus gastrointestinal risks.

Diletta Vittoria Carla Settimi*