bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of specialized nursing interventions for patients with Parkinson disease
Authors: Chen Yi , Lu Ting , Jiang Xiaoyan , Huang Xinyue
Published: January 2021

Background:

The purpose of this experiment is to evaluate the impact of the care of Parkinson disease nurse specialist on improving motor symptoms and life quality for patients with Parkinson disease (PD).

Method:

This is a randomized controlled research, and it will be conducted from April 2021 to October 2021 at Sichuan Provincial People's Hospital. The experiment was granted through the Research Ethics Committee of Sichuan Provincial People's Hospital (004510293). All the patients suffer from PD, age 18 years or older, both female and male, regardless of the duration or severity of this disease are eligible. The exclusion criteria contains: lack sufficient knowledge to complete questionnaires, serious physical comorbidities or refuse to take part in the program. In our experiment, the major result measures are motor symptoms and life quality. For the measurement of life quality, we will utilize Parkinson disease Questionnaire-39, the most extensively utilized the scale of life quality in PD. The evaluation of motor symptoms severity is carried out with the revision of Unified Parkinson Disease Rating Scale sponsored by Movement Disorder Society.

Results:

Table 1 indicates clinical outcomes at different time points.

Conclusion:

The Parkinson's disease nurse specialist care may promote the life quality in the PD patients.

Trial registration number:

researchregistry 6284.
The risk factors for cognitive dysfunction in elderly patients after laparoscopic surgery
Authors: Fan Yan , Liu Xinru , Wu Shanshan , Liu Yan
Published: January 2021

Postoperative cognitive dysfunction (POCD) is very common in clinical settings, it is necessary to analyze the risk factors for POCD in elderly patients after laparoscopic surgery to provide insights into clinical surgery management.

Elderly patients undergone laparoscopy between September 1, 2018 and March 31, 2020 were included. The mini-mental state examination (MMSE) scale was used to evaluate the POCD, and the characteristics and clinical data of patients with and without POCD were collected and compared. Logistic regression was used to analyze the potential influencing factors.

A total of 572 patients with laparoscopic surgery were included. The incidence of POCD was 11.89%. There were significant differences in the history of cerebral infarction, preemptive analgesia, preoperative use of dexmedetomidine, general anesthesia combined with continuous epidural block, duration of surgery, low SpO2 during anesthesia induction, PaCO2 after pneumoperitoneum, postoperative PCEA and VAS score at the third day after operation (all P < .05). Logistic regression analysis revealed that history of cerebral infarction (OR3.12, 1.02∼5.13), low SpO2 during anesthesia induction (OR2.03, 1.19∼4.47), Longer duration of surgery (OR1.82, 1.01∼3.16) were risk factors for POCD in elderly patients with laparoscopic surgery, while postoperative PCEA (OR0.43, 0.01∼0.91), General anesthesia combined with continuous epidural block (OR0.59, 0.04∼0.87), preoperative use of dexmedetomidine (OR0.70, 0.08∼0.94) and preemptive analgesia (OR0.75, 0.13–0.90) were the protective factors for POCD in elderly patients with laparoscopic surgery.

For the elderly patients undergoing laparoscopic surgery, the health care providers should be fully alert to the POCD based on those relevant factors.
The risk factors for acute respiratory distress syndrome in patients with severe acute pancreatitis
Authors: Zhang Weiwei , Zhang Min , Kuang Zhiming , Huang Zhenfei , Gao Lin , Zhu Jianlong
Published: January 2021

Acute respiratory distress syndrome (ARDS) is very common in patients with severe acute pancreatitis (SAP), the early interventions are essential to the prognosis of SAP patients. We aimed to evaluate the risk factors for ARDS in SAP patients, to provide insights into the management of SAP.

SAP patients treated in our hospital from June 1, 2018 to May 31, 2020 were included. The characteristics and lab test results were collected and compared, and we conducted the logistic regression analyses were conducted to identify the potential risk factors for ARDS in patients with SAP.

A total of 281 SAP patients were included finally, the incidence of ARDS in patients with SAP was 30.60%. There were significant differences on the respiratory rate, heart rate, APACHE II and Ranson score between 2 groups (allP < .05). And there were significant differences on the polymorphonuclear, procalcitonin, C-reactive protein, serum creatinine, albumin and PO2/FiO2between 2 groups (allP < .05), and no significant differences on the K+, Na+, Ca+, white blood cell, neutrophils, urine and blood amylase, trypsin, lipase, alanine aminotransferase, aspartate aminotransferase, total bilirubin, triglyceride, total cholesterol, total bilirubin, fasting blood glucose, and pH were found (allP > .05). Respiratory rate >30/min (odds ratio [OR]: 2.405, 95% confidence interval[CI]: 1.163–4.642), APACHE II score >11 (OR: 1.639, 95% CI: 1.078–2.454), Ranson score >5 (OR: 1.473, 95% CI: 1.145–2.359), polymorphonuclear >14 × 109/L (OR: 1.316, 95% CI: 1.073–2.328), C-reactive protein >150 mg/L (OR: 1.127, 95% CI: 1.002–1.534), albumin ≤30 g/L (OR: 1.113, 95% CI: 1.005–1.489) were the independent risk factors for ARDS in patients with SAP (allP < .05).

The incidence of ARDS in SAP patients is relatively high, and it is necessary to carry out targeted early prevention and treatment for the above risk factors.
Complications and feasibility analysis of ambulatory surgery for gynecological diseases in China
Authors: Yan Li , Rong Fengnian , Gao Mei , Chen Guoqiang , Su Yanfei , Xing Lumen , Xu Min
Published: January 2021

The Chinese government is attaching great importance to the development of ambulatory surgery in order to optimize the healthcare system in China. The study aims to examine the complications and quality indicators of patients who underwent gynecological ambulatory surgery at a tertiary hospital in China.

This was a retrospective study of patients who underwent ambulatory surgery between July and September 2019 at the Department of Gynecology of the First Affiliated Hospital of Shandong First Medical University. The patients were followed by phone at 30 days after discharge. The postoperative complications, mortality, unplanned re-operation, delayed discharge, unplanned re-hospitalization, and patient satisfaction were collected. The patients who underwent conventional hysteroscopic resection of uterine lesions during the same period were collected as controls for the economics analysis.

A total of 392 patients who underwent ambulatory gynecological surgery were included. Fifteen patients had postoperative complications, and the total complication rate was 3.8% (15/392). Eight (8/392, 2.0%) patients had delayed discharge. There were no unplanned re-operations and deaths. There were two (2/392, 0.5%) cases of unplanned re-hospitalization. At 30 days after discharge, two patients were dissatisfied, and 390 cases were satisfied, for an overall satisfaction rate of 99.5%. Compared with conventional hysteroscopic resection of uterine lesions, ambulatory hysteroscopic surgery had a shorter hospital stay and lower total costs (P < .05) but similar surgery-related costs.

Ambulatory gynecological surgery is feasible in China, with an acceptable complication profile and obvious economic and social benefits. Nevertheless, hospital management shall be reinforced.
Solitary adrenal metastasis from salivary duct carcinoma of the parotid gland successfully treated by surgery
Authors: Amano Yusuke , Tsuji Kentaro , Kihara Atshushi , Matsubara Daisuke , Fukushima Noriyoshi , Nishino Hiroshi , Niki Toshiro
Published: January 2021

Rationale:

Salivary duct carcinoma (SDC) is a rare and highly aggressive cancer with a poor prognosis. SDC demonstrates a potential for invasive growth with early regional and distant metastasis to organs, such as bone, lung, liver, and brain. Because, adrenal gland metastasis from SDC is rare, its treatment options are not well established. Herein, we report a case of SDC metastasis from the parotid gland to the adrenal gland, which was successfully treated by surgery.

Patient concerns:

The patient had an abnormal but painless lump on the right parotid gland. The size of the mass had increased over a period of 3 years. The patient underwent complete removal of the right parotid gland and radical neck dissection followed by adjuvant radiotherapy and chemotherapy. Two years later, a mass was identified in the left adrenal gland by computed tomography. As no local recurrence or metastasis to other organs was observed, the patient underwent adrenalectomy.

Diagnoses:

Metastasis of SDC in the adrenal gland was confirmed by histopathological examination of the adrenalectomized specimen.

Interventions:

After adrenalectomy, the patient was followed-up without adjuvant therapy.

Outcomes:

The patient was well and alive during the 13-month postoperative follow-up period without any complications.

Lessons:

Surgical resection of solitary metastatic lesion may show a survival benefit with metastatic SDC.
Efficacy and safety evaluation of acupuncture therapy for patients with salpingitis in IVF-ET
Authors: Li Sixuan , Ye Ying , Chen Zhaoxing , Zhao Mao , Jiang Yuchang , Wang Zhaodi , Jiang Yong
Published: January 2021

Background:

As an alternative for salpingitis in IVF-ET, acupuncture has gradually attracted the attention of clinicians based on the theory of syndrome differentiation and treatment of Chinese traditional medicine. However, due to the lack of evidence-based medical evidence, the author designed the program to evaluate the effectiveness and safety of acupuncture.

Methods:

From the beginning to August 2020, 7 electronic databases will be searched. Two of our researchers will independently conduct research selection, data extraction, and risk assessment of bias. We will use Review Manager 5.3 software for meta-analysis and heterogeneity assessment. In addition, we will use the grading of recommendations assessment, development, and evaluation to evaluate the evidence quality.

Results:

This study will demonstrate an evidence-based review of acupuncture for salpingitis in IVF-ET.

Conclusion:

The study will provide clear evidence to assess the effectiveness and side effects of acupuncture for salpingitis in IVF-ET.

Trial registration number:

INPLASY2020110125.
Early path nursing improves neurological function recovery in patients with intracerebral hemorrhage
Authors: Yang Yan , Mu Aiping , Wang Yuwen
Published: January 2021

Background:

To explore the influence of the early path nursing on life quality and the neurological function recovery in the intracerebral hemorrhage (ICH) patients.

Methods:

The experiment was implemented from January 2018 to October 2020 at the First Affiliated Hospital of Soochow University. The experiment was granted through the Research Ethics Committee of the First Affiliated Hospital of Soochow University (2017033). In this experiment, the criteria for inclusion includes: hemorrhagic stroke diagnosed via the MRI or head CT; over 18 years of age; patients with motor dysfunction; The Glasgow Coma Scale > 12. The patients with these symptoms will be excluded: severe cognitive impairment; ischemic stroke; onset time > 3 days; and severe complications. The scale used for the evaluation the neurological function is the American Stroke Scale. This scale contains a total of eleven items, that is, the movements of upper and lower limb, the consciousness level, gaze, visual field, etc. Other outcomes include patient satisfaction and complications.

Results:

Evaluation the neurological function and quality of life will be shown in Table 1.

Conclusion:

The early path nursing can promote the neurological function recovery in the ICH patients.

Trial registration number:

researchregistry6327
Cardiorespiratory arrest after iso-osmolar iodinated contrast injection
Authors: Yao Li-Ding , Zhu Xiu-Liang , Yang Run-Lin , Zhang Min-Ming
Published: January 2021

Rationale:

Contrast-induced encephalopathy (CIE) is a rare complication caused by administration of intravascular contrast media and characterized by acute reversible neurological disturbance. Most of the CIE cases are reported after arterial administration of contrast media such as during cerebral or coronary angiographies, yet only a few articles have reported CIE secondary to intravenous contrast. A case of CIE secondary to intravenous contrast administration is reported here.

Patient concerns:

A 68-year-old man was admitted to our hospital for contrast-enhanced chest computed-tomography (CT) examination due to suspected pulmonary nodules. After CT examination, the patient lost consciousness and experienced a cardiorespiratory arrest. An emergency plain brain CT was done immediately which showed abnormal cortical contrast enhancement and cerebral sulci hyperdensity.

Diagnoses:

After excluding other differential diagnoses such as electrolytes imbalance, hypo/hyperglycemia, cardiogenic pathologies and other neurological emergencies such as cerebral hemorrhage, cerebral infarction, the final diagnosis of CIE was made.

Interventions:

The patient was admitted to the intensive care unit for further management. A series of supportive treatments were arranged.

Outcomes:

Follow-up visits at the outpatient clinic showed no lasting neurological deficits.

Lessons:

CIE should be considered as 1 of the differential diagnoses for a patient with acute neurologic symptoms after iodinate contrast administration. Neuroradiological imaging examinations are essential to rule out other etiologies such as acute cerebral infarction or intracranial hemorrhage.
Underwater endoscopic mucosal resection of an incompletely resected superficial non-ampullary duodenal epithelial neoplasm using the loop-and-let-go technique
Authors: Kim Dong Hyun , Park Seon-Young , Cho Eunae , Park Chang Hwan , Kim Hyun Soo , Choi Sung Kyu , Rew Jong Sun
Published: January 2021

Rationale:

Endoscopic resection of superficial non-ampullary duodenal epithelial neoplasm (SNADEN) is a challenging procedure owing to the high recurrence rate and considerable incidence rate of adverse events.

Patient concerns:

SNADEN accidentally found during a medical examination in a 56-year-old man

Diagnosis:

The patient was diagnosed as having a 20-mm-sized flat elevated SNADEN at the superior duodenal angle.

Interventions:

First, we tried to perform conventional EMR (CEMR). However, the submucosal injection interrupted the endoscopic view and did not provide enough space for CEMR because of its angulated location. Therefore, we chose to perform endoscopic resection using the “loop-and-let-go” technique. Follow-up duodenoscopy after 2 days revealed post CEMR ulcer with suspicious remnant lesion. Underwater endoscopic mucosal resection (UEMR) was successfully performed 3 months after the first session of endoscopic resection.

Outcomes:

Complete endoscopic en bloc resection and histological complete resection were achieved with UEMR. Follow-up duodenoscopy revealed no recurrence.

Lessons:

Step-by-step endoscopic treatment with UEMR following loop-and-let-go technique may be a good strategy for SNADEN over 20-mm in diameter.
Management of magnetic foreign body ingestion in children
Authors: Zhang Shuhao , Zhang Lifeng , Chen Qingjiang , Zhang Yuebin , Cai Duote , Luo Wenjuan , Chen Ken , Pan Tao , Gao Zhigang
Published: January 2021

Magnetic foreign bodies ingestion is a special cause for attending emergency department. Here, we aim to analyze the characteristics and treatments of children who ingested magnetic foreign bodies (Buckyballs). Data were collected from children who ingested Buckyballs between February 2017 and October 2019. A retrospective analysis was performed to summarize the experiences of conservative treatment, gastroscopy and surgery when dealing with Buckyballs ingestion.

A total of 49 patients with buckyballs ingestion were identified, of whom 11 underwent conservative treatments, 6 underwent gastroscopy, and 32 underwent surgery. Among such individuals, eight patients (72.7%) had a successful conservative treatment (number of Buckyballs [NB]: 3.5[IQR: 2.0–4.0]); four patients (66.7%) had Buckyballs successfully removed by gastroscopy (NB: 3.5[IQR: 3.0–5.5]); 16 asymptomatic (50%) patients (NB: 4.0[IQR: 3.0–8.0]) and 16 symptomatic (50%) patients (NB: 8.5 [IQR: 6.25–11.75]) received emergency surgery. Compared to patients who received conservative treatment, the number of ingested Buckyballs was significantly higher in patients who received surgery or gastroscopy (7.0 [IQR: 3.0–10.75] vs 3.5 [IQR: 2.0–4.0], P < .05). The risk of intestinal perforation was significantly higher in symptomatic patients (P < .05) compared to asymptomatic patients.

Gastroscopy is recommended when Buckyballs are in the stomach or esophagus. In asymptomatic patients, conservative treatment can be considered for 4 to 6 days. Patients failing conservative treatment, or those who are symptomatic should undergo emergency surgery.
Does rifaximin offer any promise in Crohn's disease in remission and concurrent irritable bowel syndrome-like symptoms?
Authors: Tocia Cristina , Dumitru Irina Magdalena , Alexandrescu Luana , Petcu Lucian Cristian , Dumitru Eugen
Published: January 2021

Microbiota plays an important role in many diseases including inflammatory bowel diseases. Inflammatory bowel disease patients can have concurrent irritable bowel syndrome symptoms similar to those associated with a flare. The potential role of gut dysbiosis in the pathogenesis of inflammatory bowel disease provides a rationale for treating such patients with rifaximin. This study aimed to assess the efficacy of rifaximin in the management of irritable bowel syndrome-like symptoms (bloating, abdominal pain, stool consistency) and quality of life in patients with Crohn's disease in remission.

The present study included 86 patients with Crohn's disease in remission (fecal calprotectin <50 μg/g, C-reactive protein <0.5 mg/dL, simple endoscopic score for Crohn's disease <2) and associated irritable bowel syndrome-like symptoms (bloating, abdominal pain, diarrhea). These patients were randomly assigned to rifaximin treatment group (44 patients) and the control group (42 patients). Besides the baseline inflammatory bowel disease treatment and antispasmodics (as needed), patients in the rifaximin treatment group received 3 repeated courses of treatment, each course being represented by 1200 mg/d of rifaximin for 10 days and 20 days free of treatment (3 months consecutively); patients in the control group also received antispamodics as needed and were observed for 3 months.

Monthly analyses of bloating score, abdominal pain score, stool consistency score, and quality of life score showed significant improvement after treatment in the rifaximin group in contrast with control group. Significantly more patients in the rifaximin group than in the control group met the criteria for adequate improvement of bloating score after 3 months of treatment (59.09% vs 19.04%, P = .01), adequate improvement of abdominal pain score (54.5% vs 21.4%, P = .04), stool consistency score (34.09% vs 14.2%, P = .03), and quality of life score (70.4% vs 21.4%, P < .001).

Rifaximin in a dose of 1200 mg/d, 10 d/mo, 3 months consecutively is an effective medication for concurrent irritable bowel syndrome-like symptoms in patients with Crohn's disease in remission.
Molecular profiling of the colon cancer in South-Eastern Romania
Authors: Popescu Razvan Catalin , Tocia Cristina , Brînzan Costel , Cozaru Georgeta Camelia , Deacu Mariana , Dumitru Andrei , Leopa Nicoleta , Mitroi Anca Florentina , Nicolau Anca , Dumitru Eugen
Published: January 2021

Colorectal cancer is a heterogeneous disease with multiple epigenetic alterations and different molecular features. The molecular classification is based on 2 major distinct pathways: microsatellite stable pathway and the microsatellite instability pathway. Molecular profiling of colorectal cancer provides important information regarding treatment and prognosis. Aim of the study was to assess the frequency of microsatellite instability in colon cancer and the clinicopathological characteristics of the tumors with high level of microsatellite instability (MSI-H) in our region. The secondary outcome was to assess the frequency of v-raf murine sarcoma viral oncogene homolog B1 (BRAF) mutations in colon cancer.

The study included 129 patients with colon cancer fit for surgery. Demographic data, clinical and pathological data, immunohistochemistry staining pattern (4 mismatch repair proteins were investigated), and BRAF gene mutations were assessed. According to microsatellite instability status by polymerase chain reaction, patients were divided into 3 groups: microsatellite stable (MSS) = 108 patients, high level of microsatellite instability (MSI-H) = 15 patients and low level of microsatellite instability (MSI-L) = 6 patients. Different clinicopathological comparisons between MSS and MSI-H patients, and between MSS and MSI-L patients were performed.

Microsatellite instability was found in 16.3% patients: 11.6% had MSI-H and 4.7% had MSI-L. Significantly more patients in the MSI-H group than in the MSS group were female (P = .01) and had a family history of colon cancer (P < .001). MSI-H and MSI-L groups were associated with the ascending colon location of the tumors, were mostly type G3, T2, and stage I whereas MSS tumors were mostly G2, pT3, and stage III. Overall, BRAF mutations were identified in 18/129 patients (13.9%). BRAF mutant tumors were predominantly associated with MSI-H and MSI-L tumors. Immunohistochemistry had a sensitivity of 76% and a specificity of 89% in detecting MSI tumors and an accuracy of 87.6%.

The frequency of microsatellite instability in our study was 16.3%. MSI-H is a distinct molecular phenotype of colon cancer with particular features: female gender, family history of colorectal cancer, a predilection for the ascending colon, poorly differentiated, predominantly T2, and stage I. The frequency of BRAF mutations was 13.9% and mutations were more often present in the MSI tumors.
Coronary artery size as a predictor of Y-graft patency following coronary artery bypass surgery
Authors: Limanto Danang Himawan , Chang Hyoung Woo , Kim Dong Jung , Kim Jun Sung , Park Kay-Hyun , Lim Cheong
Published: January 2021

This study aims to evaluate the association between target vessel size and graft patency in the right IMA–right coronary territory anastomosis.

A total of 402 patients who underwent CABG between 2005 and 2016 using the right IMA Y-graft to the posterolateral branch or posterior descending artery were enrolled. Preoperative coronary angiography was utilized to measure the size of the target coronary arteries in the right territory. Follow-up angiography and computed tomography at 6 to 12 months were used to determine graft patency.

Thirty patients (7.5%) were found to have occluded graft. Larger target vessel size was associated with lower risk of graft occlusion (OR: 0.18, 95% CI:0.05–0.62, P = .007). The receiver operating characteristic (ROC) curve showed that the cutoff-value of 1.93 mm was found to have the maximum sum of sensitivity and specificity for graft patency (Area under the curve (AUC): 0.65, P = .01). Excluding patients with right coronary artery total occlusion, the discriminative performance of target vessel size became more prominent (AUC: 0.76, P < .01), with same cutoff value.

In the setting of bilateral IMA composite grafting, the patency of right IMA to right coronary territory was influenced by the size of the target coronary artery. The influence of target coronary artery size was prominent in non-total occlusion patients. Careful selection of a target anastomosis site is recommended.
Clinical significance of performing Sonazoid-based contrast-enhanced ultrasonography before ablation of uterine fibroids by high-intensity focused ultrasound
Authors: Zhang Lu , Kim Tae Hee , Zhou Kun , Ran Lifeng , Yang Wei , Zhu Hui
Published: January 2021

High-intensity focused ultrasound (HIFU) is effective for the ablation of uterine fibroids. However, no research has indicated whether HIFU ablation of uterine fibroids might be improved by application of contrast-enhanced ultrasonography (CEUS) with Sonazoid as a contrast agent. This study aimed to assess the clinical significance of Sonazoid-based CEUS 30 minute before HIFU ablation of uterine fibroids.

This retrospective cohort study included Asian patients with solitary uterine fibroids who were treated with HIFU at Seoul HICARE Clinic (South Korea; n = 34) and the Second Affiliated Hospital of Chongqing Medical University (China; n = 30) between August 1, 2017, and October 31, 2017. The patients in Seoul underwent Sonazoid-based CEUS 30 minute before HIFU. All the patients received contrast-enhanced magnetic resonance imaging to diagnose uterine fibroids. The ablation results were evaluated 1 day after HIFU by contrast-enhanced magnetic resonance imaging or Sonazoid-based CEUS.

All the patients were successfully treated with HIFU. The CEUS+HIFU group had lower values for sonication power, treatment time, sonication time, total energy applied, and energy efficiency factor compared with HIFU alone group (P < .001). There were no major adverse events after ablation therapy in either group. The incidence of post-procedure sacrococcygeal pain was lower in the CEUS+HIFU group than that in the HIFU alone group (P = .045), while the incidences of all other intraoperative and postoperative adverse events were similar between the 2 groups.

Our findings suggest that Sonazoid-based CEUS before HIFU may enhance the ablation of uterine fibroids.
Impact of binocular integrated visual field defects on healthy related quality of life in glaucoma
Authors: Zhao Can , Li Jiao , Cun Qing , Tao Yijin , Yang Wenyan , Tighe Sean , Zhu Yingting , Zhong Hua
Published: January 2021

To investigate the impact of different types of binocular integrated visual field defects on the quality of life in glaucoma.

Ninety-six patients with primary glaucoma were divided into 5 groups with 25, 24, 11, 15, and 21 patients according to types of the binocular integrated visual field (BVF) defects. The criteria for BVF grouping included mild visual field defect in binocular eyes, mild visual field defect in 1 eye and moderate or advanced defect in the other, moderate and non-overlapping visual field defect in both eyes, overlapping and moderate visual field defect in binocular eyes, and severe defect in both eyes, respectively. The visual field (VF) evaluation was based on H-P-A visual field grading system. Visual acuity, visual field tests and Glaucoma Quality of Life-15 Questionnaire (GQL-15) were performed for enrolled patients, and binocular visual field results were integrated. The changes and correlations of the Visual field index values and quality of life scores were compared among the 5 groups. The main factors affecting the quality of life in glaucoma were analyzed by multiple regression analysis.

The best binocular integrated visual field index (BVFI) and optimal quality of life were observed in group A. The BVFI of group B was better than that of group C or group D, but the peripheral vision glare and dark adaptation were worse. No significant difference was noted between group C and group D in terms of BVFI. However, the glare and dark adaptation in group C were better than that in group D. The BVFI was the lowest and the quality of life was the worst in group E. In all, BVFI and decibels (dB) values were negatively correlated with GQL-15 scores and positively correlated with patients’ quality of life.

Binocular integrated visual field accurately reflects the visual function in glaucoma. Higher binocular integrated visual field indices represent a better quality of life for patients with glaucoma. Mild to moderate synchronous or complementary binocular VF defects had a slight effect on the quality of life, while severe and non-compensated VF loss significantly impacts on quality of life in glaucoma patients.
Postoperative outcomes of free myocutaneous flap and pedicled myocutaneous flap for reconstruction in locally invasive thyroid carcinoma
Authors: Li Linke , Wang Jing , Deng Di , Shen Tian , Gan Weigang , Xu Feng , Liu Jifeng , Lv Dan , Li Bo , Wang Ji , Wang Jun , Chen Fei , Liu Jun
Published: January 2021

Locally invasive thyroid carcinoma (TC) often involves trachea. In such patients, the trachea needs to be reconstructed after surgery. We discuss the postoperative outcome and complications after trachea reconstruction by free myocutaneous flap (FMF) and pedicled myocutaneous flap (PMF).

From January 2009 to September 2019, the clinical data of 38 patients with TC were retrospectively analyzed. Demographics, pathologic results, neoplasm staging, surgical protocol, decannulation, subjective speech function, and complications were documented.

A total of 38 patients were analyzed (22 FMFs and 16 PMFs). Of the 38 patients, there is a similar rate of decannulation (81.8% in FMF and 75% in PMF), subjective speech function and complications.

The FMF reconstruction and the PMF reconstruction have a similar result in terms of postoperative outcome and complications.
A novel immunogenomic prognostic signature in lung squamous carcinoma
Authors: Hou Jili , Zhong Qiuying
Published: January 2021

Lung squamous carcinoma (LUSC) is a common subtype of lung cancer with limited available therapy and is thus associated with poor survival. Immune infiltrating cells and immune-related genes (IRGs) play a key role in the clinical outcomes of LUSC. In the present study, we aimed to develop a potential immunogenomic prognostic signature for patients with LUSC. The transcriptional profiles of 501 LUSC samples from The Cancer Genome Atlas (TCGA) and 2498 IRGs from the ImmPort database were used to develop the signature by Cox regression analysis. Ten differentially expressed and survival-associated IRGs were used to develop the risk signature, which could serve as an independent prognostic and predictive factor for patients with LUSC. Furthermore, this risk signature correlated with overall survival and clinical features, including age, in patients with LUSC. In addition, we identified 25 transcription factors that may regulate 15 survival-associated IRGs, using a regulatory network. Collectively, this immunogenomic signature could be a robust prognostic tool for patients with LUSC and holds great promise as individualized immunotherapy for LUSC.
The prognosis of early-stage breast cancer in extremely young female patients
Authors: Chung Wei-Pang , Lee Kuo-Ting , Chen Ya-Ping , Hsu Ya-Ting , Loh Zhu-Jun , Huang Chien-Chang , Hsu Hui-Ping
Published: January 2021

Breast cancer at a young age is associated with poor outcomes. However, few reports have compared the outcomes of breast cancer between extremely young patients and elderly patients.

We retrospectively collected information on patients diagnosed with breast cancer before 30 years of age. This case-control study employed matched operative methods, stage, and subtypes with a case-to-control ratio of 1:3. The primary endpoint was disease-free survival, and the secondary endpoint was overall survival. We analyzed potential prognostic factors in univariate and multivariate analyses.

This analysis included 18 patients in the young group with a median age of 28.5 years and 54 patients in the control group with a median age of 71 years. The 5-year disease-free survival rate was 68.8% in the former group and 84.6% in the latter group (P = .080). The 5-year overall survival was 87.1% and 91.2% in the young and old groups, respectively (P = .483). Multivariate analysis showed that tumor size and triple-negative breast cancer was major prognostic factors of poorer disease-free survival in the young group.

Extremely young breast cancer patients had a trend to develop a poorer disease-free survival than old patients, but not a poorer overall survival. Aggressive treatment for young patients at early stages of disease would improve survival.
Effectiveness comparisons of acupuncture treatments for vascular dementia
Authors: Guan Xiuju , Zhang Lijuan , Li Xinqin , Hou Hanru , Bi Shuyue , Wang Kangfeng
Published: January 2021

Background:

Vascular dementia (VD) is the second most common form of dementia in the world. Acupuncture therapy has been widely used in clinical treatment. Based on the available evidence, we will rank different acupuncture therapy to determine the most effective acupuncture therapy.

Methods:

We will search the following database, including PubMed, Embase, Cochrane, Web of Science, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database and Chinese Scientific Journals Database database, in order to collect randomized controlled trials on acupuncture in the treatment of VD. We will use Stata 14.2 and WinBUGS 1.4.3 software for Bayesian network meta-analysis and finally evaluated the level of evidence of the results.

Results:

This study will compare and rank the effectiveness of acupuncture in the treatment of vascular dementia. Outcome indicators included Alzheimer Disease Assessment Scale-Cognitive section and Mini-mental State Examination, Activity of Daily Living, Blessed dementia scale, Hastgawa Dementia Scale, and adverse events.

Conclusion:

Our study will provide support for clinical practice.

INPLASY registration number:

INPLASY2020110088.
Traditional Chinese medicine on treating splenomegaly due to portal hypertension in cirrhosis
Authors: Wang Zhaodi , Chen Zhaoxing , Fan Zhipeng , Jiang Yong
Published: January 2021

Background:

Liver cirrhosis is a common clinical chronic progressive disease. Due to the obstruction of blood flow after cirrhosis, it leads to long-term congestion of splenic sinus, hyperplasia of fibrous tissue and proliferation of splenic myeloid cells, resulting in hepatocirrhosis and splenomegaly. At present, western medicine still uses splenectomy and interventional therapy are the main treatment, but the adverse reactions are more and the curative effect is not good. Many clinical trials have proved that Traditional Chinese medicine has a great therapeutic effect on Hepatocirrhosis with splenomegaly, which can effectively delay the development of the disease and improve the survival rate of patients. This systematic review aims to evaluate the efficacy and safety of Traditional Chinese medicine in the treatment of hepatocirrhosis with splenomegaly.

Methods:

The databases of Pubmed, CENTRAL (The Cochrane Central Register of Controlled Trials), China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (WANFANG Data), Weipu Information Chinese Periodical Service Platform (VIP), and China Biomedical Literature Service System (SinoMed) will be searched online to collect randomized controlled trials related to the treatment of hepatocirrhosis with splenomegaly with Traditional Chinese medicine The time is limited from the construction of the library to November 2020. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the Revman 5.3 and Stata 13.0 software so as to systematically review the effectiveness of Traditional Chinese medicine for hepatocirrhosis with splenomegaly.

Ethics and dissemination:

This systematic review will evaluate the efficacy and safety of Traditional Chinese medicine for hepatocirrhosis with splenomegaly. Because all data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. In addition, all data will be analyzed anonymously during the review process.

Results:

In this study, we will evaluate the efficacy of Traditional Chinese medicine in the treatment of cirrhosis with splenomegaly.

Conclusion:

The conclusion of this study will be evidence to ensure the efficacy of Traditional Chinese medicine© in the treatment of cirrhosis with splenomegaly and provide guidance for its treatment.

Trial registration number:

INPLASY2020110121.
Pediatric blunt abdominal trauma with horizontal duodenal injury in school baseball
Authors: Tokumaru Teppei , Eifuku Ryozo , Sai Kenichi , Kurata Hideaki , Hata Michiaki , Tomioka Joji
Published: January 2021

Rationale:

Pediatric sports injuries, including those from baseball, most often are musculoskeletal injuries and rarely include blunt abdominal injuries. Duodenal injury is rare and often associated with other organ injuries. Because it has a relatively high mortality, early recognition and timely treatment are needed. Here, we report a case of successful treatment of a pediatric patient with duodenal injury incurred in the context of school baseball.

Patient concerns:

A 13-year-old boy suffered blunt abdominal trauma and a right-hand injury caused by beating his abdomen strongly with his own right knuckle after he performed a diving catch during a baseball game. On the following day, the abdominal pain had worsened.

Diagnoses:

Computed tomography led to a suspicion of injury to the horizontal part of the duodenum.

Interventions:

The duodenal injuries were repaired by simple closure. On the 10th post-operative day, an abscess formed in the retroperitoneal cavity because of an occult pancreatic injury. Ultrasound-guided percutaneous drainage of the cavity was performed.

Outcomes:

The post-operative course of the abscess drainage was uneventful. The patient was discharged from our hospital on day 72 after admission and was in good health at the 9-month follow-up.

Lessons:

Regardless of the type of injury, we must assess the life-threatening conditions that can be expected based on the mechanism of the injury. In duodenal injuries, it is critical to perform surgical procedures and post-operative management based on the assumption of injuries to other organs.
Gastrointestinal Henoch–Schönlein purpura successfully treated with Mycophenolate Mofetil
Authors: Gicchino Maria Francesca , Iafusco Dario , Marrapodi Maria Maddalena , Melone Rosa , Cuomo Giovanna , Zanfardino Angela , del Giudice Emanuele Miraglia , Olivieri Alma Nunzia
Published: January 2021

Rationale:

Henoch–Schönlein Purpura (HSP) is an acute small vessel vasculitis. It is the most common vasculitis in children. In majority of the cases, the disease is self-limited. Relapses can occur, in particular during the first year of the disease. There is no consensus on a specific treatment. The efficacy and safety of steroidal treatment in treating HSP is still controversial. Immunosuppressive treatment of HSP nephritis is used in patients with severe renal involvement (nephrotic range proteinuria and/or progressive renal impairment). The literature on immunosuppressive treatment of severe HSP without kidney involvement is scanty.

Patients concerns:

We report 2 case reports of 2 adolescents affected from Henoch–Schönlein Purpura and severe gastrointestinal involvement. Both patients presented a poor response to steroids treatment.

Diagnoses:

The diagnosis of HSP was made according to the diagnostic criteria published by European League against Rheumatism and Pediatric Rheumatology European Society in 2006

Interventions:

In consideration of the recurrence of the Henoch Schönlein Purpura and the gastrointestinal involvement, we decided to start Mycophenolate Mofetil treatment.

Outcomes:

In both patients all clinical manifestations resolved in few days.

Lessons:

In our cases of HSP with gastrointestinal involvement Mycophenolate Mofetil treatment has been very effective. This experience teaches us that immunosuppressive agents may be very useful to induce and maintain remission not only in renal involvement, but in all cases of persistent, recurrent, or complicated Henoch Schönlein Purpura in children.
Effectiveness of intraoperative radiotherapy vs hypofractionated postmastectomy radiotherapy for early stage breast cancer
Authors: Feng Jiang-Yi , Li Ge , Guo Yi , Gao Yun-Han , Ma Sha-Ying
Published: January 2021

Background:

Radiotherapy is one of the essential components of breast cancer treatment. It destroys the remaining cells in the chest area after breast cancer surgery and is useful for reducing the necessity of mastectomies. As a single dose of radiation at the time of breast conserving surgery, intraoperative radiotherapy delivers radiotherapy directly and accurately to the tumor itself or the tumor bed whilst delivering minimal dose to the surrounding normal tissues. Hypofractionated postmastectomy radiotherapy with shorter and more convenient hypofractionated dose schedules might help to treat more patients and reduce cost. We will conduct a comprehensive systematic review and meta-analysis to compare the effectiveness of these 2 therapies in the management of early stage breast cancer.

Methods:

Four English databases (PubMed, Embase, Cochrane Library, and Web of Science) and 3 Chinese databases (China National Knowledge Infrastructure, China Science and Technology Journal Database, and Chinese Biomedical Literature Database) will be searched from inception of databases to December 2020 without language limitation. Two reviewers will independently conduct selection of studies, data extraction and management, and assessment of risk of bias. Any disagreement will be resolved by the third reviewer. Review Manager 5.3 (The Cochrane Collaboration, Software Update, Oxford, UK) will be used for data synthesis. Cochrane risk of bias assessment tool will be used to assess the risk of bias.

Results:

This study will provide a systematic synthesis of current published data to compare the effectiveness of intraoperative radiotherapy vs hypofractionated postmastectomy radiotherapy for early stage breast cancer.

Conclusions:

This systematic review and meta-analysis will provide clinical evidence for the effectiveness of intraoperative radiotherapy vs hypofractionated postmastectomy radiotherapy for early stage breast cancer, and inform our understanding of the value of intraoperative radiotherapy and hypofractionated postmastectomy radiotherapy for early stage breast cancer.

Study registration number:

INPLASY2020110115.
Effect of sodium-dependent glucose transporter inhibitors on glycated hemoglobin A1c after 24 weeks in patients with diabetes mellitus
Authors: Chen Mao-Bing , Wang Hua , Zheng Qi-Han , Xu Hua-Lan , Cui Wei-Yan
Published: January 2021

Background:

To evaluate dapagliflozin, canagliflozin, empagliflozin, ertugliflozin, and sotagliflozin according to their effect on the glycated hemoglobin A1c (HbA1c) level in patients with type 2 diabetes mellitus.

Methods:

The Web of Science, PubMed, Cochrane Library, EMBASE, and Clinical Trials databases were electronically searched to collect randomized controlled trials of patients with type 2 diabetes mellitus through June 2020. Two researchers independently screened and evaluated the obtained studies and extracted the outcome indexes. RevMan 5.3 software was used to perform the meta-analysis and to create plots.

Results:

Finally, 27 studies were selected and included in this study. The meta-analysis results showed that sodium-dependent glucose transporter (SGLT) inhibitors significantly reduced the HbA1c level in patients with type 2 diabetes mellitus. However, these results were highly heterogeneous, so we conducted a subgroup analysis. The results of the subgroup analysis suggested that by dividing populations into different subgroups, the heterogeneity of each group could be reduced.

Conclusions:

SGLT inhibitors had a good effect on the HbA1c level in patients with type 2 diabetes mellitus, but there might be differences in the efficacy of SGLT inhibitors in different populations. It is hoped that more studies will be conducted to evaluate the efficacy and safety of SGLT inhibitors in different populations.

Registration Number:

CRD42020185025.
Banxia Xiexin Decoction in the treatment of Hp-associated peptic ulcer
Authors: Zhu Weikai , Li Jiyan , Shen Hui
Published: January 2021

Background:

Studies suggested Banxia Xiexin Decoction is effective in the treatment of helicobacter pylori (HP) positive peptic ulcer. The present meta-analysis aimed at evaluating the efficacy and safety of Banxia Xiexin decoction in the treatment HP positive peptic ulcer.

Methods:

We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the November 30th, 2020. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software will be used for data analysis.

Results:

This systematic review will determine the efficacy and safety of Banxia Xiexin decoction in the treatment HP positive peptic ulcer.

Conclusion:

Its findings will provide helpful evidence for the efficacy and safety of Banxia Xiexin decoction in the treatment HP positive peptic ulcer.

Systematic review registration:

INPLASY2020120002.
Clinical symptoms of COVID-19 pneumonia in children
Authors: Tang Zhengwu , Li Muzhe , Chen Wei , Ran Xun , Li Huiyun , Chen Zhiwei
Published: January 2021

Background:

This meta-analysis aimed to compare the clinical symptoms of COVID-19 pneumonia in children.

Methods and analysis:

Electronic databases including PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI) database, Wanfang Database, and Chinese Biomedical Literature Database (CBM) were searched from its inception to June 21, 2020. We only included studies that reported clinical symptoms of COVID pneumonia in children. Quality of the included studies was assessed by 2 authors. Pooled results were summarized by STATA 12.0 software.

The heterogeneity was measured by I
2 tests (I
2 < 50 indicates little heterogeneity, I
2≥50 indicates high heterogeneity). Publication bias was performed by funnel plot and statistically assessed by Begg test (P > .05 as no publication bias).

Results:

Results will be shown as figures or tables.

Conclusion:

Our study aims to systematically present the clinical symptoms of COVID-19 pneumonia patients in children, so as to further provide guidance for clinical management.
Limbus-centered marking technique-assisted continuous circular capsulorhexis
Authors: Wang Xiaogang , Dong Jing , Deng Minghui
Published: January 2021

To introduce a limbus-centered continuous circular capsulorhexis (CCC) marking technique.

Compared with traditional capsulotomy diameter mark technique, a self-designed limbus-centered capsulotomy mark (LCM) was used to perform the routine cataract surgery in this observational study. Ten eyes were included in each group. The area outer/inner 5.5-mm CCC ring, the furthest/nearest distance from the capsule margin to the intraocular lens (IOL) margin, the CCC total coverage IOL area were measured and compared between this 2 groups.

No significant differences were found for all the comparison parameters between the 2 groups (all P > .05). However, the capsule total coverage area, area inner 5.5-mm ring was lower in the LCM group, which demonstrated advantage of LCM.

The limbus-centered capsulotomy diameter mark, as an inexpensive and convenient method, helps to perform limbus-centered capsulorhexis with not only a 360° overlapping capsular edge but also well-centered IOL optics.