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Background Arterial thrombosis of the lower extremities is a common emergency in vascular surgery that can easily lead to amputation due to acute limb ischemia if not managed promptly. Arterial thrombosis of lower extremities is often associated with atherosclerosis, but some rare conditions, such as polycythemia vera, can also induce thrombosis. Polycythemia vera is prone to thrombosis because of its special pathological features. In addition, the thrombus sites are common in brain blood vessels and coronary arteries. Conversely, thrombosis occurring in the lower limbs is rare. Case presentation: A 44-year-old man with an about 20 years history of hypertension and smoking presented to the emergency department and transferred to department of vascular surgery after low molecular weight heparin administered due to acute thrombosis of lower extremities in May 2019. Laboratory tests revealed that his hemoglobin and hematocrit levels elevated, and a diagnosis of chronic polycythemia was considered. At that time, the patient’s thrombosis was not connected to polycythemia. After discharge, the patient was advised to visit the hematology department for further diagnosis confirmation. However, the patient did not comply. In August 2019, the patient was admitted to the hospital for the second time due to arterial thromboembolism in the left lower limb. After discharge, the patient completed a bone marrow biopsy and genetic testing and was diagnosed with polycythemia vera. Unfortunately, the patient has suffered from arterial thrombosis of lower limbs in September 2019, November 2019, December 2019, and October 2022 because of the non-standard treatment. Conclusions It is important to determine the etiology of patients with arterial thrombosis of lower extremities especially recurrent thrombosis as well as pay attention to some rare causes that can induce thrombosis. Standard treatment is vital for patients to prevent recurrent thrombosis when there are some specific etiologies as in our present case.

Intramuscular ganglion cyst (IMGC) is a very rare lesion with an unidentified pathogeny that originates within the muscle. We encountered a case of 49-year-old man who complained of intermittent claudication in the right lower limb for 2 months. An intramuscular ganglion cyst in the biceps femoris muscle was diagnosed and located by Computed tomography angiography (CTA) and magnetic resonance imaging (MRI), which compressed the popliteal artery and resulted in ischemia in the right lower limb. Six months after surgical resection, there was no recurrence of the cyst and the popliteal artery was patency. We describe this case with a review of the relevant literature.

To investigate the association between HLA-DP gene polymorphism and the susceptibility to hepatitis B virus (HBV) infection in people in Buyi, Miao and Shui ethnic groups in Guizhou.A total of 256 patients with HBV infection, 142 HBV self-cleared patients and 135 controls were recruited from 3 ethnic groups for this case-control study. Genotypes of rs3077 and rs9277535 were determined by using real-time PCR with a TaqMan-MGB probe.Compared with healthy subjects and self-cleared subjects, the allele distribution of rs9277535 was significantly associated with chronic HBV infection (P0.05), no significant differences in rs3077 allele and genotype distributions were found among 3 groups (P0.05). Compared with the rs9277535 GG genotype, the AA and AG genotypes were protective factors against HBV infection in dominant model after adjustment for age and sex (OR=0.645, 95%CI: 0.421-0.988), and no significant difference in rs3077 locus was found in the same analysis (P0.05). For men, the rs3077 locus CC and CT genotypes were also protective factors against HBV infection (OR=0.493, 95%CI: 0.266-0.916), and there was no significant difference in rs9277535 locus compared the genotype distributions among 3 groups in dominant mode. Comparison of allele and genotype distribution in 3 ethnic groups showed that HLA-DP gene rs3077 genotype distributions had significant difference between the HBV infection group and the healthy control group in Buyi ethnic group (χ(2)=6.726, P=0.036).The presence of rs9277535A allele atHLA-DP gene polymorphisms might decrease the risk for HBV infection, the rs3077 C allele at HLA-DP gene polymorphisms might also confer protective effect against HBV infection in women. No significant correlation between HLA-DP gene rs3077 and rs9277535 locus polymorphism and HBV clearance was found in this study. The HLA-DP gene rs3077 genotype distribution of HBV-infected patients had significant differences among different ethnic groups.