bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of acute ischemic stroke on mortality in gastrointestinal malignancies: A nationwide analysis.
Authors: Polpichai Natchaya , Saowapa Sakditad , Wattanachayakul Phuuwadith , Danpanichkul Pojsakorn , Fangsaard Panisara , Chan Shu-Yen , Chaisrimaneepan Nattanicha , Sirachainan Ekaphop
Published: July 2024

e16372

Background: Acute ischemic stroke, marked by a sudden loss of brain blood supply, carries potential life-threatening consequences. The impact on individuals with pre-existing gastrointestinal (GI) malignancies, coupled with ensuing complex medical complications affecting morbidity and mortality, remains inadequately understood. This study aims to assess the influence of acute ischemic stroke on in-hospital mortality in GI cancer patients in the United States. Methods: This retrospective analysis utilized the 2016-2020 National Inpatient Survey (NIS) database. Adults aged 18 and above with esophageal, gastric, colon, cholangiocarcinoma, hepatocellular carcinoma, and pancreatic cancers were identified using the International Classification of Disease-10 (ICD-10) code. The cohort was stratified into patients with and without acute ischemic stroke. Hospital mortality was analyzed using STATA 18, adjusted for age, gender, race, insurance, Charlson’s index, baseline hospital characteristics, and comorbidities. Multivariate logistic regression analysis was performed, with all P values ≤ 0.05 considered statistically significant. Results: Among 2,133,465 adults with GI malignancies, 28,394 were hospitalized with acute ischemic stroke. Patients with acute ischemic stroke were older (mean age 71.19 vs. 67.01 years; P < 0.001), more likely to be male (55.47%, P = 0.002), Caucasian (67.96%, P < 0.001), from urban teaching hospitals (76.83%, P = 0.011), and had Medicare insurance (70.50%, P < 0.001). Acute ischemic stroke was most associated with pancreatic cancer (39.81%), colon cancer (30.13%), and esophageal cancer (9.86%). Within the cohort of patients with acute ischemic stroke, esophageal cancer patients had the highest mortality rates of 20%. After adjusting for potential confounders, patients with colon cancer, esophageal cancer, gastric cancer, pancreatic cancer, cholangiocarcinoma, and hepatocellular carcinoma had significantly higher odds of in-hospital mortality of 2.91, 2.50, 2.31, 2.22, 1.65, and 1.51, respectively. Conclusions: This study reveals an association between outcomes in hospitalized GI cancer patients and acute ischemic stroke, leading to increased mortality despite adjusting for potential confounders. The impact of anticancer therapies on the vascular system may influence the risk and severity of ischemic events. Further studies are needed to develop tailored prevention, diagnosis, and management strategies to reduce disease complications and the overall healthcare burden of cerebrovascular events.
Effect of NIR-II on cancer nanocomposite vaccines for lymph node targeted delivery and enhanced immunotherapy.
Authors: Zhou HaiYu , Huang YuCheng , Xu Bin , Hou HengLiang
Published: July 2024

e20506

Background: Cancervaccines have become one of the hot areas of research in recent years. However, different types of tumors and the tumor tissue itself are heterogeneous. Some cancervaccines contain a single epitope and have weak immunogenicity. The antigen-presenting cells cannot adequately absorb and present the antigen peptide contained in the vaccine. As a result, the body fails to elicit an effective immune response, which greatly limits the therapeutic effect of the cancervaccine. In situ cancervaccines composed of antigens and adjuvants are a promising cancer treatment modality; however, convenient manufacturing of vaccines in vivo and their efficient delivery to lymph nodes (LNs) remain a significant challenge. In this study, we outline a facile approach to simultaneously achieve in situ programming of vaccines via two synergistic nanomedicines to generate robust immune responses. Methods: We first prepared two synergistic nanocomposite systems: Gold nanorods, amphiphilic polymer polyphosphate mPEG- b-PHEP encapsulating the immune adjuvant R848, and nanoparticles doped with cationic liposomes DOTAP. Two nanomedicines were characterized and the efficacy of the nanovaccine was verified at the Cellular Experiments. At the animal level, the lymph node targeting of the nanoparticles was demonstrated through IVIS. We also constructed distant model and lung metastasis model to verify the nanovaccine's effect on enhancing systemic immunotherapy. Results: We used amphiphilic polymer polyphosphate mPEG- b-PHEP to encapsulate TLR7/8 agonist R848 to obtain VNPR848 nanoparticles. Gold nanorods (~ 100nm) can produce a strong photothermal effect mediated by NIR-II, killing tumor cells and releasing abundant antigens at the same time. The small size of VNPR848 (~ 30nm) is beneficial to the enrichment of lymph nodes. After capturing the antigens produced by photothermal, nanoparticles will be targeted and delivered to the tumor draining lymph nodes together with R848, and will be effectively absorbed by DC cells. This in situ tumor vaccine with the ability of targeted delivery of lymph nodes can trigger a strong anti-tumor immune response. This therapy can completely inhibit distant tumors in some mice and produce a long-term immune memory effect on NSCLC metastasis. Conclusions: We propose a simple personalized in situ cancervaccine strategy, which uses nanotechnology to remove tumors in situ and release antigens. Antigens and immune adjuvants are simultaneously delivered to the draining lymph nodes to initiate the antigen presentation function of DC cells, resulting in an anti-tumor immune response to inhibit tumor recurrence and metastasis. The nano-vaccine based on powerful therapeutic effect provides an attractive technology for in situ programming of personalized cancervaccine and an effective strategy for the development of cancervaccine.
Analysis of the LIPI score as a prognostic factor in advanced non-small cell lung cancer.
Authors: Richardet Eduardo , Perea Pablo , Molina Matias , Magi Ignacio , Depetris Santos , Richardet Martin Eduardo
Published: July 2024

e20612

Background: A field of interest is the search for new biomarkers within which inflammatory/immunological ones have taken on special relevance. The LIPI Score (Lung Immune Prognostic Index) that combines derived Neutrophil -Lymphocyte Ratio (dNRL) and LDH shows growing evidence in favor of its use. End Point: Primary: Evaluate the relationship of LIPI Score with Progression Free Survival (PFS) in advanced non-small cell lung cancer (NSCLC) treated with immunotherapy (IO) alone or in combinationwtih Chemotherapy(CT) in the first line. Secondary: Evaluate the relationship of the LIPI Score and Objective Response Rate (ORR) and the relationship of the LIPI Score and PFS at 6 months. Methods: Metastatic NSCLC , treated first-line with IO alone or in combination between January 2018 and July 2023 at our institution, were included . The LIPI Score has 3 prognosis categories: Good (RNLd < 3 and LDH < upper limit of normal (ULN) ); Intermediate (RNLd > 3 or LDH > upper limit of normal (ULN), Poor (RNLd > 3 and LDH > upper limit of normal (ULN) Results: 67 patients were analyzed, the overall PFS was 8.58 months. Of these, 22 had a good LIPI Score, 24 had an intermediate LIPI Score and 21 had a poor LIPI Score. The PFS per group was 21.56, 8.71 and 3.18 months respectively (p < 0.01). The ORR was 27% in the general population and by groups: 45%, 29%, 5% respectively (p = 0.01). The 6-month PFS was 86%, 83% and 29%, respectively, by subgroup. Conclusions: We consider that the LIPI Score is a very useful tool due to its simplicity, low cost and accessibility that allows us to understand the behavior of the disease in our patients early. It is necessary to continue researching to determine what is the best therapeutic strategy for these patients based on their prognosis.
Implementation of hematology oncology lecture series for nursing staff.
Authors: Eng Shirley , Steinberg Amir S. , Quintas Joseph , Moussly Sammy , Sweeney Richard , Trias Juan , Sauerland Carmel , Kretschmer Patricia , Wantroba Cynthia
Published: July 2024

e21005

Background: Westchester Medical Center has an oncology unit that provides care for hundreds of patients annually. Inpatient cancer patients often have especially complex medical treatment plans that require interdisciplinary collaboration and specialized knowledge of oncologic conditions. There is a need to implement formal teaching tailored to nursing staff devoted to topics in hematology and oncology. Our goal was to develop a monthly lecture series for nursing that deepened their understanding of cancer treatments, enabling them to assess and monitor patients with greater expertise. Methods: Topics were chosen based on relevance and are listed in the table. Speakers included full-time faculty, fellows and residents, pharmacists, and medical students. Ten lectures were completed and scheduled approximately once monthly in the mornings just prior to sign out for nursing shift change. Nursing staff were asked to complete a set of questions prior to each lecture (Pre-Test) They were given the same set of questions after each lecture (Post-Test) to determine whether there was an improvement in understanding of the topic. Informational handouts were distributed at the end of each lecture to provide participants with a summary of key points. A survey administered at the conclusion of the lecture series was collected to assess attitudes towards the lectures. Results: Overall test scores improved after each lecture was given, as demonstrated in the table: Pre and Post Lecture Test Scores. Additionally, feedback regarding the lectures was positive. 100% agreed that they gained a better understanding of topics related to hematology oncology and 92% agreed that participation in these lectures has improved their ability to function collaboratively on interprofessional healthcare teams. Conclusions: A didactic lecture series is a valuable component of hematology oncology education for nursing staff and will improve quality of care of the oncology service. Some limitations of this lecture series concerned nursing staff scheduling conflicts and their availability for lecture attendance. Possible interventions in the future may include setting aside time dedicated for monthly lectures and scheduling lectures for afternoons to avoid conflicts with shift changes and morning rounds. Nevertheless, our findings highlight the value of continued education in empowering nursing staff to deliver quality care to hematology oncology patients.[Table: see text]
A phase II randomized control trial of triapine plus lutetium 177 DOTATATE versus lutetium 177 DOTATATE alone for well-differentiated somatostatin receptor-positive neuroendocrine tumors.
Authors: Chauhan Aman , Kunos Charles , Arnold Susanne M. , Weiss Heidi , Ivy S. Percy , Gore Steven , Rubinstein Lawrence , Pelosof Lorraine , Beumer Jan Hendrik , Kolesar Jill , Carson William Edgar , Kohn Elise C. , Anthony Lowell Brian
Published: July 2024

TPS4202

Background: Radiolabeled somatostatin analogues provide a means of delivering targeted radiation with a high therapeutic index to NETs that express somatostatin receptors (SSTRs). Radiolabeled somatostatin analogue Lutetium 177 DOTATATE (Lutathera) is a beta-emitting radionuclide, FDA approved for use in SSTR positive gastroenteropancreatic neuroendocrine tumors (GEPNETS) in the US based on the NETTER-1 Phase III trial. Despite favorable PFS and safety profile, the drug has limited cytoreductive capability with a 14% ORR. Peptide receptor radionuclide therapy (PRRT) also doesn’t seem to be very effective in treating peritoneal disease. We hypothesize that addition of an effective radiation sensitizer could help improve antitumor activity of Lutathera. Radiation is a potent inducer of DNA double-strand breaks, and ribonucleotide reductase (RNR) is the rate-limiting enzyme in the synthesis and repair of DNA, making RNR-targeted therapy a rationale therapeutic strategy for radiosensitization. ETCTN 10388 (NCT04234568) evaluated safety and efficacy of the combination of lutetium 177 DOTATATE, a beta-emitting radionuclide in combination with triapine, a ribonucleotide reductase (RNR) inhibitor. The combination of triapine and Lu-177 DOTATATE was safe with preliminary efficacy signals. Methods: This study is an investigator initiated, NCI sponsored, multicenter randomized phase 2 trial of triapine and lutetium Lu 177 DOTATATE in well-differentiated somatostatin receptor-positive neuroendocrine tumor. A total of 94 patients will be equally randomized to either Lu-177 dotatate or Triapine + Lu-177 dotatate arm. The study will be open through the NCI ETCTN (National Cancer Institute Experimental Therapeutics Clinical Trials Network) program. Triapine will be administered orally from D1-14 with each dose of PRRT [200 mCi]. Primary endpoint is to evaluate overall response rate (ORR). Secondary endpoint is to evaluate median PFS. We are also evaluating triapine PK, plasma deoxyribonucleosides, circulating DNA and plasma hPG80, a novel blood based diagnostic biomarker. Clinical trial information: 05724108.
Electronic Medical Record–Based Nudge Intervention to Increase Comprehensive Molecular Genotyping in Patients With Metastatic Non–Small Cell Lung Cancer: Results From a Prospective Clinical Trial
Authors: Marmarelis Melina E. , Scholes Dylan G. , McWilliams Tara L. , Hwang Wei-Ting , Kosteva John , Costello Michael R. , Sun Lova , Singh Aditi P. , Lau-Min Kelsey S. , Doucette Abigail , Gabriel Peter E. , Martella Anthony O. , Roy Megan A. , Thompson Jeffrey C. , Cohen Roger B. , Dougherty David W. , Shulman Lawrence N. , Langer Corey J. , Bekelman Justin E. , Carpenter Erica L. , Aggarwal Charu
Published: July 2024

PURPOSE

Less than half of the patients with newly diagnosed metastatic non–small cell lung cancer (NSCLC) undergo comprehensive molecular testing. We designed an electronic medical record (EMR)–based “nudge intervention” to prompt plasma-based molecular testing at the time of initial medical oncology consultation.

METHODS

A nonrandomized prospective trial was conducted at the University of Pennsylvania's academic practice and two affiliated community practices. Molecular genotyping was performed by tissue- and/or plasma-based next generation sequencing methods. Comprehensive testing was defined as testing for
EGFR
,
ALK
,
BRAF
,
ROS1
,
MET
,
RET
,
KRAS
, and
NTRK
. Guideline-concordant treatment was defined as the use of the appropriate first-line (1L) therapy as per the National Comprehensive Cancer Network (NCCN) guidelines. Proportion of patients with comprehensive molecular genotyping results available at any time, molecular results available before 1L therapy, and guideline-concordant 1L treatment were compared between the preintervention and postintervention cohorts using Fisher's exact test or Pearson's chi-squared test.

RESULTS

Five hundred and thirty-three patients were included, 376 in the preintervention cohort and 157 in the postintervention cohort. After implementation of the EMR-based nudge, a higher proportion of patients underwent comprehensive molecular testing in the postintervention versus the preintervention cohort (100%
v
88%,
P
= <.001), had results of comprehensive molecular testing available before initiating 1L treatment (97.3%
v
91.6%,
P
= .026), and received NCCN guideline-concordant care (89.8%
v
78.2%,
P
= .035).

CONCLUSION

Across three practice sites in a large health system, implementation of a provider team–focused EMR-based nudge intervention was feasible, and led to a higher number of patients with NSCLC undergoing comprehensive molecular genotyping. These findings demonstrate that behavioral nudges can promote molecular testing and should be studied further as a tool to improve guideline-concordant care in both community and academic sites.
Działalność Klubu „Prometeusz” oraz relacje polsko-ukraińskie w Harbinie w latach 1931–1936
Authors: Lakh Roman
Published: July 2024

Tematem artykułu jest historia próby polsko-ukraińskiego porozumienia w Harbinie, opartego na koncepcji prometeizmu. Tekst ma na celu przedstawienie historii Klubu „Prometeusz” i specyfiki jego działalności w Mandżurii przeciwko Rosji: organizowania wydarzeń kulturalnych i edukacyjnych oraz popularyzacji i publikacji artykułów w czasopismach. Przeanalizowano tu dokumenty polskiego wywiadu dotyczące kwestii polsko-ukraińskiej na Dalekim Wschodzie.
Jak rządzić wielką fortuną? (na przykładzie dóbr książąt Olelkowiczów)
Authors: Skiepjan Anastazja
Published: July 2024

Celem artykułu jest analiza metod i warunków administrowania wielkimi dobrami ziemskimi w Wielkim Księstwie Litewskim na przykładzie posiadłości książąt Olelkowiczów od drugiej połowy wieku XVI do trzeciej dekady stulecia następnego. W wyniku prowadzonych badań stwierdzono, że na przełomie XVI i XVII w. w większości latyfundiów przeprowadzono zmiany w zarządzaniu polegające na rozdzieleniu funkcji urzędników i stworzeniu dodatkowego systemu kontroli i nadzoru.
Health education intervention and its impact on patients with unilateral vestibular dysfunction: An information-motivation-behavioral model approach
Authors: Musharaf Imshaal , Nashwan Abdulqadir J
Published: June 2024

Unilateral vestibular dysfunction is a one-sided impairment of vestibular function in one ear. Incorporating health education in treatment and rehabilitation plans can improve vestibular function, keep negative emotions at bay, and reduce the extent of the condition. This letter investigates the impact of the information-motivation-behavioral skills model as a medium for health education on patient outcomes. While offering encouraging observations, there are certain limitations, such as the study’s retrospective design, small sample size, use of subjective measures, and lack of longer follow-ups that challenge the cogency of the study. The study is a step toward transforming vestibular dysfunction treatment through health education.
Risk factors and management countermeasures for obstructive sleep apnea hypoventilation syndrome in children
Authors: He Wen , Cheng Qi
Published: June 2024

BACKGROUND

Obstructive sleep apnea hypoventilation syndrome (OSAHS) in children is a sleep respiratory disorder characterized by a series of pathophysiologic changes. Statistics in recent years have demonstrated an increasing yearly incidence.

AIM

To investigate the risk factors for OSAHS in children and propose appropriate management measures.

METHODS

This study had a case–control study design. Altogether, 85 children with OSAHS comprised the case group, and healthy children of the same age and sex were matched at 1:1 as the control group. Basic information, including age, sex, height, weight and family history, and medical history data of all study participants were collected. Polysomnography was used to detect at least 8 h of nocturnal sleep. All participants were clinically examined for the presence of adenoids, enlarged tonsils, sinusitis, and rhinitis.

RESULTS

The analysis of variance revealed that the case group had a higher proportion of factors such as adenoid grading, tonsil indexing, sinusitis, and rhinitis than the control group.

CONCLUSION

A regression model was established, and glandular pattern grading, tonsil indexing, sinusitis, and pharyngitis were identified as independent risk factors affecting OSAHS development.
Effect of a comprehensive geriatric assessment nursing intervention model on older patients with diabetes and hypertension
Authors: Bao Dong-Ying , Wu Lin-Yan , Cheng Qi-Yan
Published: June 2024

BACKGROUND

The Comprehensive Geriatric Assessment (CGA) was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings. However, there are few reports on its application in hospitalized patients, especially older patients with diabetes and hypertension.

AIM

To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension.

METHODS

We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022. Among the 80 patients included, 40 received CGA nursing interventions (study group), while the remaining 40 received routine nursing care (control group). The study group's comprehensive approach included creating personalized CGA profiles, multidisciplinary assessments, and targeted interventions in areas, such as nutrition, medication adherence, exercise, and mental health. However, the control group received standard nursing care, including general and medical history collection, fall prevention measures, and regular patient monitoring. After 6 months of nursing care implementation, we evaluated the effectiveness of the interventions, including assessments of blood glucose levels fasting blood glucose, 2-h postprandial blood glucose, and glycated hemoglobin, type A1c (HbA1c); blood pressure indicators such as diastolic blood pressure (DBP) and systolic blood pressure (SBP); quality of life as measured by the 36-item Short Form Survey (SF-36) questionnaire; and treatment adherence.

RESULTS

After 6 months, the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators, such as fasting blood glucose, 2-h postprandial blood glucose, and HbA1c, as well as blood pressure indicators, including DBP and SBP, compared with the control group (P < 0.05). Quality of life assessments, including physical health, emotion, physical function, overall health, and mental health, showed marked improvements compared to the control group (P < 0.05). In the study group, 38 patients adhered to the clinical treatment requirements, whereas only 32 in the control group adhered to the clinical treatment requirements. The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care (95% vs 80%, P < 0.05).

CONCLUSION

The CGA nursing intervention significantly improved glycemic control, blood pressure management, and quality of life in hospitalized older patients with diabetes and hypertension, compared to routine care.
Quality of life and survival analyses of breast cancer cases treated with integrated traditional Chinese and Western medicine
Authors: Wang Yu-Kun , Zhu Rong-Wei , Gao Zhi-Peng , Tao Yi
Published: June 2024

BACKGROUND

Breast cancer (BC) is the second leading cause of tumor-related mortality after lung cancer. Chemotherapy resistance remains a major challenge to progress in BC treatment, warranting further exploration of feasible and effective alternative therapies.

AIM

To analyzed the quality of life (QoL) and survival of patients with BC treated with integrated traditional Chinese and Western medicine (TCM-WM).

METHODS

This study included 226 patients with BC admitted to the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine between February 2018 and February 2023, including 100 who received conventional Western medicine treatment (control group) and 126 who received TCM-WM treatment (research group). The total effective rate, side effects (alopecia, nausea and vomiting, hepatorenal toxicity, and myelosuppression), QoL assessed using the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30), 1-year overall survival (OS), recurrence and metastasis rates, and serum inflammatory factors [interleukin (IL)-6, IL-10, and tumor necrosis factor alpha] were comparatively analyzed.

RESULTS

The research group showed statistically better overall efficacy, EORTC QoL-C30 scores, and 1-year OS than the control group, with markedly lower side effects and 1-year recurrence and metastasis rates. Moreover, the posttreatment levels of serum inflammatory in the research group were significantly lower than the baseline and those in the control group.

CONCLUSION

Overall, TCM-WM demonstrated significantly improved therapeutic efficacy while ensuring drug safety in BC, which not only improved patients’ QoL and prolonged survival, but also significantly inhibited the inflammatory response.
Correlation analysis of human papillomavirus E6/E7 mRNA detection with diagnosis, prognosis and recurrence risk in patients with cervical epithelioma
Authors: Zhang Ling-Li , Du Ming-Yan , Du Xin , Duan Jie , Yao Dong-Mei , Jing Jing , Feng Chun , Song Lin
Published: June 2024

BACKGROUND

Cervical intraepithelial neoplasia (CIN) is an important precursor of cervical cancer. Early detection and treatment can reduce the incidence of cervical cancer.

AIM

To investigate the detection rate of human papillomavirus (HPV) E6/E7 mRNA in cervical tissue of patients with different types of epithelial cell neoplasia (CIN) and its relationship with CIN progression and diagnosis.

METHODS

One hundred women with HPV infection detected by cervical exfoliation cytology between January 2022 and January 2023 were retrospectively selected. These patients were graded CIN based on colposcopy and cervical pathology. The positive expression rates of HPV E6/E7 mRNA and HPV [polymerase chain reaction (PCR)-reverse dot crossing] were compared among all groups. Patients with HPV E6/E7 mRNA expression in the grade 1 CIN group were followed up for 1 yr. The relationship between atypical squamous epithelium and high malignant epithelial neoplasia was investigated by univariate and multivariate analysis.

RESULTS

The diagnostic sensitivity, specificity, and sensitivity of PCR-reverse point hybridization technology for secondary CIN were 70.41%, 70.66%, and 0.714, respectively. Sensitivity and specificity for secondary CIN were 752% and 7853%, respectively, the area under the curve value was 0.789. Logistic Multifactorial model analysis revealed that the HPV positive rates and the HPV E6/E7 mRNA positive rates were independent risk factors of CIN grade I (P < 0.05). In CIN grade I patients with positive for HPV E6/E7 mRNA, in its orientation to grade CIN patients, in its orientation to grade CIN patients, at 69.2%, compared with patients negative for HPV E6/E7 mRNA (30.8%), significant difference (P < 0.05).

CONCLUSION

HPV E6/E7 mRNA and HPV (PCR-reverse dot hybrid) positive expression have a close relationship with CIN-grade disease progression and is an independent risk factor for high-grade CIN lesions.
Effects of nursing team communication and collaboration on treatment outcomes in intensive care unit patients with severe pneumonia
Authors: Wei Xi-Fang , Zhu Ting , Xia Qiao
Published: June 2024

BACKGROUND

Severe pneumonia is a common severe respiratory infection worldwide, and its treatment is challenging, especially for patients in the intensive care unit (ICU).

AIM

To explore the effect of communication and collaboration between nursing teams on the treatment outcomes of patients with severe pneumonia in ICU.

METHODS

We retrospectively analyzed 60 patients with severe pneumonia who were treated at the ICU of the hospital between January 1, 2021 and December 31, 2023. We compared and analyzed the respiratory mechanical indexes [airway resistance (Raw), mean airway pressure (mPaw), peak pressure (PIP)], blood gas analysis indexes (arterial oxygen saturation, arterial oxygen partial pressure, and oxygenation index), and serum inflammatory factor levels [C-reactive protein (CRP), procalcitonin (PCT), cortisol (COR), and high mobility group protein B1 (HMGB1)] of all patients before and after treatment.

RESULTS

Before treatment, there was no significant difference in respiratory mechanics index and blood gas analysis index between 2 groups (P > 0.05). However, after treatment, the respiratory mechanical indexes of patients in both groups were significantly improved, and the improvement of Raw, mPaw, plateau pressure, PIP and other indexes in the combined group after communication and collaboration with the nursing team was significantly better than that in the single care group (P < 0.05). The serum CRP and PCT levels of patients were significantly decreased, and the difference was statistically significant compared with that of nursing group alone (P < 0.05). The levels of serum COR and HMGB1 before and after treatment were also significantly decreased between the two groups.

CONCLUSION

The communication and collaboration of the nursing team have a significant positive impact on respiratory mechanics indicators, blood gas analysis indicators and serum inflammatory factor levels in the treatment of severe pneumonia patients in ICU.
Impact of a 12-wk physical conditioning program on the aerobic capacity of aviation cadets
Authors: Luo Hao , Zhao Ding-Yu , Li Juan
Published: June 2024

BACKGROUND

Flight cadets need to have good physical fitness to cope with the challenges of flying missions. The continuous development of science and technology has led to the constant upgrading of fighter jets and the improvement of their performance, which has resulted in new and higher requirements for the physical fitness of flight personnel. The traditional physical training mode, method, and assessment have been used for many years and do not meet current fitness needs.

AIM

To investigate the impact of a 12-wk comprehensive anti-G fitness training program on the aerobic capacity of aviation cadets and to evaluate its effectiveness.

METHODS

Fifty-five cadets were randomly assigned to control and experimental groups using a randomized, single-blind design. The control group maintained their existing training regimen, while the experimental group participated in a 12-wk comprehensive training intervention. The training program comprised strength training twice per week, high-intensity interval training three times per week, and supplemental nutritional and psychological support. Maximal oxygen uptake (VO2max), lower limb strength, and hemoglobin levels were measured at baseline, at 6 wk and 12 wk post-intervention.

RESULTS

Repeated measures analysis of variance revealed significant differences of both VO2max and relative VO2 in both groups across time points (P < 0.05). However, no significant time-group interaction was observed (P > 0.05). Paired t -tests comparing baseline and 12-wk results showed that VO2max and relative VO2 were significantly higher in the experimental group than the control group (P < 0.05). This suggests that the training program effectively enhanced the aerobic capacity of the experimental group. Key indicators of aerobic capacity, bilateral lower limb strength and hemoglobin levels, were also significantly different over time and between groups (P < 0.05). No significant differences were noted in heart-rate metrics (P > 0.05).

CONCLUSION

A 12-wk comprehensive anti-G fitness training program significantly improved the aerobic capacity of aviation cadets, thereby enhancing their overall capacity and laying a physiological foundation for enduring high-G flights.
Effects of respiratory muscle training on post-stroke rehabilitation: A systematic review and meta-analysis
Authors: Liu Yong-Tao , Liu Xiao-Xin , Liu Yi-Qing , Zhang Lei , Zhang Lin-Jing , Wang Jian-Hua , Shi Yan , Xie Qing-Fan
Published: June 2024

BACKGROUND

Stroke often results in significant respiratory dysfunction in patients. Respiratory muscle training (RMT) has been proposed as a rehabilitative intervention to address these challenges, but its effectiveness compared to routine training remains debated. This systematic review and meta-analysis aim to evaluate the effects of RMT on exercise tolerance, muscle strength, and pulmonary function in post-stroke patients.

AIM

To systematically assess the efficacy of RMT in improving exercise tolerance, respiratory muscle strength, and pulmonary function in patients recovering from a stroke, and to evaluate whether RMT offers a significant advantage over routine training modalities in enhancing these critical health outcomes in the post-stroke population.

METHODS

Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, a comprehensive search across PubMed, Embase, Web of Science, and the Cochrane Library was conducted on October 19, 2023, without temporal restrictions. Studies were selected based on the predefined inclusion and exclusion criteria focusing on various forms of RMT, control groups, and outcome measures [including forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), maximal voluntary ventilation (MVV), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and 6-min walking test (6MWT)]. Only randomized controlled trials (RCTs) were included. Data extraction and quality assessment were conducted independently by two reviewers using the Cochrane Collaboration's risk of bias tool. Statistical analyses, including those using the fixed-effect and random-effects models, sensitivity analysis, and publication bias assessment, were performed using Review Manager software.

RESULTS

A total of 15 RCTs were included. Results indicated significant improvements in MIP (12.51 cmH2O increase), MEP (6.24 cmH2O increase), and various pulmonary function parameters (including FEV1, FVC, MVV, and PEF). A substantial increase in 6MWT distance (22.26 meters) was also noted. However, the heterogeneity among studies was variable, and no significant publication bias was detected.

CONCLUSION

RMT significantly enhances walking ability, respiratory muscle strength (MIP and MEP), and key pulmonary function parameters (FEV1, FVC, MVV, and PEF) in post-stroke patients. These findings support the incorporation of RMT into post-stroke rehabilitative protocols.
Analysis of articles on hepatitis C by scientific mapping: 1989-2022
Authors: Tok Duran
Published: June 2024

BACKGROUND

Hepatitis C virus (HCV) poses a significant quandary about public health. It is challenging to study the literature in a particular discipline comprehensively today. One solution is bibliometric analysis, which is often used to track the attributes and evolutionary trajectories of scientific outputs.

AIM

To examine the 35-year scientific evolution of articles focused on HCV.

METHODS

This study examined the 35-year scientific evolution of articles focused on HCV. Our study utilized the Web of Science database. The study encompassed a total of 11930 articles.

RESULTS

Regarding the cumulative count of articles, the leading countries are the United States, Japan, and Italy. Rice CM is the author with the highest recorded H-index and G-index values. The journal with the highest recorded H-index and G-index values is the Journal of Virology . The Journal of Viral Hepatitis contributed 10.94% of the articles, whereas the Journal of Virology published 9.68%. According to the strategic diagram, the keywords most frequently used in 2020-2022 are HCV, epidemiology, and sofosbuvir.

CONCLUSION

This study provides valuable information about 40 years of academic knowledge on HCV.
Pulsatile gonadotropin-releasing hormone therapy induces spermatogenesis in pituitary stalk interruption syndrome: A case report and review of the literature
Authors: Xie Jin-Long , Zhu Hai-Ying , Dong Yang , Sun Ping-Ping , Qi Dan-Dan , Luan Su-Xian , Zhang Yan , Ma Hua-Gang
Published: June 2024

BACKGROUND

Pituitary stalk interruption syndrome (PSIS) is a rare anatomical defect of the pituitary gland falling under the spectrum of holoprosencephaly phenotypes. It is characterized by a deficiency in anterior pituitary hormones, such as growth hormone, gonadotropins, and thyroid hormones. Due to the syndrome's rarity and nonspecific manifestations, there is a lack of standardized treatment strategies. Consequently, early diagnosis through imaging and on-time intervention are crucial for improving patients’ outcomes.

CASE SUMMARY

A 30-year-old man presented with absent secondary sexual characteristics and azoospermia. Laboratory evaluation revealed a deficiency in gonadotropins, while thyroid function was mostly within normal ranges. Magnetic resonance imaging of the pituitary gland showed pituitary stalk agenesis, hypoplasia of the anterior pituitary, and ectopic posterior pituitary, leading to the diagnosis of PSIS. Initially, the patient underwent 6 mo of gonadotropin therapy without significant changes in hormone levels and secondary sexual characteristics. Pulsatile gonadotropin-releasing hormone therapy was then administered, resulting in the detection of sperm in the semen analysis within 3 mo. After 6 mo, routine semen tests showed normal semen quality. The couple faced challenges in conceiving due to abstinence and underwent three cycles of artificial insemination, which was unsuccessful. They also attempted in vitro fertilization, but unfortunately, the woman experienced a miscarriage 10 wk after the embryo transfer.

CONCLUSION

Early detection, accurate diagnosis, and timely treatment are crucial in improving the quality of life and fertility of PSIS patients.
Lithium carbonate-induced giant goiter and subclinical hyperthyroidism in a patient with schizophrenia: A case report and review of literature
Authors: Chen Xing-Ming , Jiang Zhi-Li , Wu Xiang , Li Xu-Guang
Published: June 2024

BACKGROUND

Lithium carbonate is used to manage various mood disorders, but it can cause thyroid abnormalities, including goiter, hypothyroidism, and hyperthyroidism. In rare cases, it can lead to giant goiter and subclinical hyperthyroidism, which may require surgical intervention in severe cases.

CASE SUMMARY

This case represents a rare development of giant goiter and subclinical hyperthyroidism in a schizophrenia patient who was subjected to prolonged lithium carbonate treatment. The enlarged thyroid gland caused pressure on the airway and recurrent laryngeal nerve, which led to respiratory distress, hoarseness, and dysphagia. The immediate danger of suffocation required urgent surgical intervention. In this report, we describe the case of a 41-year-old Chinese woman. This sheds light on the etiology and challenges associated with managing a giant goiter. The patient underwent a subtotal thyroidectomy to relieve airway compression and facilitate airway expansion. Prior to the procedure, the patient was given iodine to prepare. Concurrently, changes were made to the psychiatric medication regimen. Following surgery, the patient's respiratory function and vocal cord functionality improved significantly, and her mental state remained stable.

CONCLUSION

It is essential to monitor thyroid function, test thyroid antibody levels, and perform thyroid ultrasounds consistently in all patients undergoing long-term lithium carbonate treatment. This vigilance helps prevent severe and potentially life-threatening thyroid enlargement.
New application of intestinal obstruction catheter in enterocutaneous fistula: A case report
Authors: Wang Xiao-Tong , Wang Long , Liu An-Lin , Huang Jing-Le , Li Lei , Lu Zhi-Xing , Mai Wei
Published: June 2024

BACKGROUND

Enterocutaneous fistula (ECF) is an abnormal connection between the gastrointestinal tract and the skin. ECF can lead to massive body fluid loss, hypercatabolism, and malnutrition. Therefore, nutritional support plays a crucial role in managing ECFs and promoting the healing of fistulas. For nutritional support, enteral nutrition (EN) is the preferred method when gastrointestinal function is recovering. Currently, various EN approaches have been applied for different anatomical positions of the ECF. However, the effectiveness of administering EN support for treating lower ECFs still needs further exploration and improvement.

CASE SUMMARY

We present the case of a 46-year-old male who underwent gastrointestinal stromal tumour resection. Six days after the surgery, the patient presented with fever, fatigue, severe upper abdominal pain, and septic shock. Subsequently, lower ECFs were diagnosed through laboratory and imaging examinations. In addition to symptomatic treatment for homeostasis, total parenteral nutrition support was administered in the first 72 h due to dysfunction of the intestine. After that, we gradually provided EN support through the intestinal obstruction catheter in consideration of the specific anatomic position of the fistula instead of using the nasal jejunal tube. Ultimately, the patient could receive optimal EN support via the catheter, and no complications were found during the treatment.

CONCLUSION

Nutritional support is a crucial element in ECF management, and intestinal obstruction catheters could be used for early EN administration.
Central nervous injury risk factors after endovascular repair of a thoracic aortic aneurysm with type B aortic dissection
Authors: Liang Feng , Su Jie-Qiong
Published: June 2024

BACKGROUND

Aortic dissection is the deadliest disease of the cardiovascular system. Type B aortic dissection accounts for 30%-60% of aortic dissections and is mainly treated by endovascular repair of thoracic endovascular aneurysm repair (TEVAR). However, patients are prone to various complications after surgery, with central nervous system injury being the most common, which seriously affects their prognosis and increases the risk of disability and death. Therefore, exploring the risk factors of central nervous system injury after TEVAR can provide a basis for its prevention and control.

AIM

To investigate the risk factors for central nervous system injury after the repair of a thoracic endovascular aneurysm with type B aortic dissection.

METHODS

We enrolled 306 patients with type B aortic dissection who underwent TEVAR at our hospital between December 2019 and October 2022. The patients were categorized into injury (n = 159) and non-injury (n = 147) groups based on central nervous system injury following surgery. The risk factors for central nervous system injury after TEVAR for type B aortic dissection were screened by comparing the two groups. Multivariate logistic regression analysis was performed.

RESULTS

The Association between age, history of hypertension, blood pH value, surgery, mechanical ventilation, intensive care unit stay, postoperative recovery times on the first day after surgery, and arterial partial pressure of oxygen on the first day after surgery differed substantially (P < 0.05). Multivariate logistic regression analysis indicated that age, surgery time, history of hypertension, duration of mechanical ventilation, and intensive care unit stay were independent risk factors for central nervous system injury after TEVAR of type B aortic dissection (P < 0.05).

CONCLUSION

For high-risk patients with central nervous system injury after TEVAR of type B aortic dissection, early intervention measures should be implemented to lower the risk of neurological discomfort following surgery in high-risk patients with central nervous system injury after TEVAR for type B aortic dissection.
Study on the efficacy of early treatment with pirfenidone on the lung function of patients with idiopathic pulmonary fibrosis
Authors: Lei Ying , Sheng Jian-Hui , Jin Xu-Ru , Liu Xian-Bing , Zheng Xiao-Yan , Xu Xiao-Hua
Published: June 2024

BACKGROUND

Idiopathic pulmonary fibrosis (IPF) is classified under fibrotic interstitial pneumonia, characterized by a chronic and progressive course. The predominant clinical features of IPF include dyspnea and pulmonary dysfunction.

AIM

To assess the effects of pirfenidone in the early treatment of IPF on lung function in patients.

METHODS

A retrospective analysis was performed on 113 patients with IPF who were treated in our hospital from November 2017 to January 2023. These patients were divided into two groups: control group (n = 53) and observation group (n = 60). In the control group, patients received routine therapy in combination with methylprednisolone tablets, while those in the observation group received routine therapy together with pirfenidone. After applying these distinct treatment approaches to the two groups, we assessed several parameters, including the overall effectiveness of clinical therapy, the occurrence of adverse reactions (e.g., nausea, vomiting, and anorexia), symptom severity scores, pulmonary function index levels, inflammatory marker levels, and the 6-min walk distance before and after treatment in both groups.

RESULTS

The observation group exhibited significantly higher rates than the control group after therapy, with a clear distinction (P < 0.05). After treatment, the observation group experienced significantly fewer adverse reactions than the control group, with a noticeable difference (P < 0.05). When analyzing the symptom severity scores between the two groups of patients after treatment, the observation group had significantly lower scores than the control group, with a distinct difference (P < 0.05). When comparing the pulmonary function index levels between the two groups of patients after therapy, the observation group displayed significantly higher levels than the control group, with a noticeable difference (P < 0.05). Evaluating the inflammatory marker data (C-reactive protein, interleukin-2 [IL-2], and IL-8) between the two groups of patients after therapy, the observation group exhibited significantly lower levels than the control group, with significant disparities (P < 0.05). Comparison of the 6-min walking distance data between the two groups of patients after treatment showed that the observation group achieved significantly greater distances than the control group, with a marked difference (P < 0.05).

CONCLUSION

Prompt initiation of pirfenidone treatment in individuals diagnosed with IPF can enhance pulmonary function, elevate inflammatory factor levels, and increase the distance covered in the 6-min walk test. This intervention is conducive to effectively decreasing the occurrence of adverse reactions in patients.
Serum inflammatory markers in children with Mycoplasma pneumoniae pneumonia and their predictive value for mycoplasma severity
Authors: Wang Li-Ping , Hu Zhong-Hua , Jiang Jun-Sheng , Jin Jie
Published: June 2024

BACKGROUND

Mycoplasma pneumoniae pneumonia (MPP) significantly impacts pediatric health, necessitating markers for early severe disease identification.

AIM

To investigate the correlation between serum inflammatory marker and the severity of MPP in children.

METHODS

A prospective study was carried out from January 2023 to November 2023. A total of 160 children with MPP who underwent treatment were selected: 80 had severe MPP and 80 had mild MPP. Clinical and laboratory data were collected at the time of hospital admission and during hospitalization. Receiver operating characteristic curves were utilized to assess the diagnostic and prognostic for severe MPP.

RESULTS

Fever duration and length of hospitalization in pediatric patients with severe MPP exceeded those with mild MPP. The incidence of pleural effusion, lung consolidation, and bronchopneumonia on imaging was markedly elevated in the severe MPP cohort compared to the mild MPP cohort. In contrast to the mild cohort, there was a notable increase in C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate, lactic dehydrogenase, D-dimer, and inflammatory cytokines [interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor (TNF)-α] in the severe MPP group were significantly higher.

CONCLUSION

Serum inflammatory markers (CRP, PCT, IL-6, D-dimer, IL-10 and TNF-α) were considered as predictors in children with severe MPP.