bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficient formation route of the prebiotic molecule formamide on interstellar dust grains
Authors: Dulieu F , Nguyen T , Congiu E , Baouche S , Taquet V
Published: January 2019

Interstellar complex organic molecules are thought to be the building blocks of more complex prebiotic compounds. In particular, formamide (or methanimide, NH2CHO), is presented as a multifunctional prebiotic precursor, the starting point of both pre-genetic and pre-metabolic species. NH2CHO is widely observed in different astrophysical media as well as in comets that may have had a crucial role in the delivery of exogenous material to Earth. In star-forming regions, gas phase synthesis of formamide is possible, even if it is still debated. In this paper we present laboratory experiments demonstrating formamide formation in interstellar ice analogues at astronomically relevant temperatures via simultaneous hydrogenation of NO and H2CO, two abundant molecules in star-forming regions. Inclusion of the experimental results in an astrochemical gas-grain model confirms the importance of the investigated solid-state reaction channel leading a high yield of formamide in dark interstellar clouds, and adds a valuable perspective about the way this refractory molecule may have been part of the prebiotic molecular building blocks delivered to the young Earth.
Incidence of Spontaneous Obliteration in Untreated Brain Arteriovenous Malformations
Authors: Liew Jason A , Yang Wuyang , Mashouf Leila A , Li Sean , Caplan Justin M , Tamargo Rafael J , Huang Judy
Published: January 2019

BACKGROUND

Spontaneous obliteration (SpO) of untreated arteriovenous malformations (AVMs) is rare with fewer than 100 cases reported. The incidence and predisposing factors of SpO remain unclear, impeding our understanding of lesion progression in untreated patients.

OBJECTIVE

To determine the incidence rate and predisposing factors of SpO in a North American cohort.

METHODS

AVMs were retrospectively evaluated at our institution for over 25 yr. Untreated AVMs were divided into 2 groups: SpO-AVMs and non-SpO-AVMs. All statistical results were based on univariate analyses. Incidence was generated from counts of SpO over the untreated interval in patient years from birth until obliteration, treatment, or last follow-up.

RESULTS

One hundred fifty-four patients had untreated AVMs; SpO was observed in 4. Average ages were 49.0 ± 23.6 and 48.7 ± 20.4 yr in the SpO-AVM and non-SpO-AVM group, respectively (P = .98). Average AVM sizes were 2.0 ± 1.8 cm (SpO-AVMs) and 3.7 ± 2.6 cm (non-SpO-AVMs, P = .25). All SpO-AVMs and 40 (27.0%) non-SpO-AVMs had a ruptured presentation (P = .006). A single draining vein was observed in all SpO-AVMs and 39 (32.8%) non-SpO-AVMs (P = .01). Deep venous drainage was not observed in any SpO-AVMs, but in 81 (57.9%) non-SpO-AVMs (P = .04). Mean follow-up time was 37.0 ± 42.6 and 75.6 ± 161.7 mo in SpO-AVM and non-SpO-AVMs patients, respectively. Of the 2 SpO-AVM patients with postobliteration follow-up, 1 experienced recanalization. From a 672-patient cohort, the incidence of SpO over 28 961 patient years was 0.014%.

CONCLUSION

SpO-AVMs have an annual incidence rate of approximately 0.014% and tend to present with rupture, a single draining vein, and superficial venous drainage. Expectation of SpO for untreated AVMs is not justified, and patients should anticipate life-long hemorrhagic risk for untreated AVMs.
Interest Rates and Inflation Revisited
Authors: Fama Eugene F
Published: January 2019

The continuously compounded (CC) interest rate on a one-month Treasury bill observed at the end of month t–1 is the sum of a CC expected real return and a CC expected inflation rate, Rt–1 = Et–1(rt) + Et–1(It). Two approaches are used to split Rt–1 between its two components. In the first, models for rt produce estimates of Et–1(rt), which are used to infer Et–1(It) as Rt–1 – Et–1(rt). The second approach models It to produce estimates of Et–1(It) and infer Et–1(rt) as Rt–1 – Et–1(It). By design, the estimates of Et–1(rt) and Et–1(It) from both approaches have the properties implied by rational bill prices.

Received October 10, 2018; Editorial decision December 31, 2018 By Editor Jeffrey Pontiff
Noncognitive Abilities and Financial Distress: Evidence from a Representative Household Panel
Authors: Parise Gianpaolo , Peijnenburg Kim
Published: January 2019

This paper provides evidence of how noncognitive abilities affect financial distress. In a representative panel of households, we find that people in the bottom quintile of noncognitive abilities are 10 times more likely to experience financial distress than those in the top quintile. We provide evidence that this relation largely arises from worse financial choices and lack of financial insight by low-ability individuals and reflects differential exposure to income shocks only to a lesser degree. We mitigate endogeneity concerns using an IV approach and an extensive set of controls. Implications for policy and finance research are discussed.

Received September 24, 2017; editorial decision September 26, 2018 by Editor Stijn Van Nieuwerburgh. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Cash Transfers, Microentrepreneurial Activity, and Child Work: Evidence from Malawi and Zambia
Authors: de Hoop Jacobus , Groppo Valeria , Handa Sudhanshu
Published: January 2019

Cash transfer programs are rapidly becoming a key component of the social safety net of many countries in Sub-Saharan Africa. The primary aim of these programs is to help households improve their food security and to smooth consumption during periods of economic duress. However, beneficiary households have also been shown to use these programs to expand their microentrepreneurial activities. Cluster-randomized trials carried out during the rollout of large-scale programs in Malawi and Zambia show that children may increase their work in the household enterprise through such programs. Both programs increased forms of work that may be detrimental to children, such as activities that expose children to hazards in Malawi and excessive working hours in Zambia. However, both programs also induced positive changes in other child well-being domains, such as school attendance and material well-being, leading to a mixed and inconclusive picture of the implications of these programs for children.
Nurse Influence in Meeting Compliance With the Centers for Medicare and Medicaid Services Quality Measure
Authors: Jorgensen Ann L.
Published: January 2019

Increased mortality has been identified as the sepsis cascade progresses from sepsis to severe sepsis to septic shock. Estimates reflect sepsis death rates ranging from 10% to 20%, severe sepsis death rates of 20% to 50%, and septic shock fatality rates of 40% to 80%. The high rates of morbidity, mortality, and Medicare costs prompted the Centers for Medicare and Medicaid Services to implement bundled care and public reporting of the Early Management Bundle, Severe Sepsis/Septic Shock (SEP-1) quality measure in 2015. Sepsis care bundles were identified to be beneficial since the 1990s as the bundle facilitates efficient, effective, and timely delivery of care to support quality improvement. The SEP-1 measure can be challenging and requires the nurse's active participation. Nurses need increased knowledge of the sepsis cascade and treatments as defined in the SEP-1 quality measure. Increased knowledge and application of bundle elements are lifesaving and can influence postdischarge outcomes. This article discusses the nurse's role in meeting the specific elements of each bundle and strategies to improve bundle compliance.
Effect of Dahuang Danpi Decoction on Lactobacillus bulgaricus growth and metabolism
Authors: Li Chaoqun , Zhang Jiayu , Xu Hua , Chen Yabin , Gao Shuoshuo , Guo Shu-ning , Huang Bang , Gao Ruyi , Long Zhicheng , Jiang Meirong
Published: January 2019

Gut flora plays an essential role in disease and health. A traditional Chinese herb formula, Dahuang Danpi Decoction (DDD) can alleviate several gastrointestinal diseases.

In the present study, we assessed the effect of DDD on the growth and metabolism of Lactobacillus bulgaricus. L bulgaricus was cultured in MRS with 40 mg/ml (high), 10 mg/ml (medium), and 2.5 mg/ml (low) of DDD, Ceftriaxone and blank (control). The growth of L bulgaricus was measured by optical density. The levels of L-lactic acid and D-lactic acid were also measured.

Compared to the control group, the concentrations of L bulgaricus in the medium and the high concentrations DDD groups were significantly higher (P < .001 for all), while the concentrations of L bulgaricus in the ceftriaxone groups were significantly lower. In the 3 DDD groups, the L- lactic acid levels were significantly higher than those in the control group and the ceftriaxone groups (P < .001 for all), and the L-lactic acid level was the highest in the high DDD group. Similarly, the D-lactic acid level in the high concentration DDD group was significantly higher than those in the medium and low concentration DDD groups, the control group and the ceftriaxone groups. Both the L-lactic acid and D-lactic acid levels were lower than those in the control group and the DDD groups.

DDD could dose-dependently promote the growth of L bulgaricus and enhance the secretion of L-lactic acid and D-lactic acid, which suggests DDD may be able to interact with the probiotics, improve the gut microbiota, and serve in the prevention and treatment of dysbiosis.
Cytokines concentrations in aqueous humor of eyes with uveal melanoma
Authors: Cheng Yong , Feng Jing , Zhu Xuemei , Liang Jianhong
Published: January 2019

Uveal melanoma (UM) is the major intraocular malignancy in adults, of which the molecular biology is still unknown. Therefore, this study was designed to determine the aqueous concentrations of angiogenic, inflammatory, and chemotactic cytokines in eyes with UM.

Aqueous humor samples were collected from 38 patients with UM and 22 patients undergoing cataract surgery. Interleukin 6, 8 (IL-6, IL-8, respectively), interferon-inducible protein-10 (IP-10), placental growth factor1 (PIGF1), regulated on activation, normal T Cell expressed and secreted (RANTES), monocyte chemoattractant protein-1 (MCP-1), nerve growth factor-beta (NGF-β), epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), and vascular endothelia growth factor A (VEGF-A) were assessed by multiplex bead assay.

In the study group, significantly higher concentrations of IL-6 (P = .006), IL-8 (P = .018), IP-10 (P = .004), RANTES (P = .008), MCP-1 (P = .02), NGF-β (P = .013), EGF (P < .001), PIGF1 (P = .01), bFGF (P = .016), and VEGF (P = .017) were measured, when compared with the control group.

Several angiogenic, inflammatory, and chemotactic cytokines are highly expressed in the aqueous humor of the UM eyes, which provides new insights into the pathophysiology of UM and could be potential targets for treatment.
Association of serum leptin with breast cancer
Authors: Gu Li , Wang Cheng-Di , Cao Chang , Cai Lin-Rui , Li De-Hua , Zheng Yu-Zhen
Published: January 2019

Background:

Accumulating evidence has demonstrated that leptin is associated to the tumorigenesis and progression of breast cancer (BC). However, these studies remain inconsistent. Thus, a meta-analysis was conducted to investigate the role of leptin in the patients with BC.

Method:

A systematic search in PubMed, Embase, ISI Web of Science, and Chinese National Knowledge Infrastructure (CNKI) databases was conducted up to September 1, 2017. The standardized mean difference (SMD) with 95% confidence interval (CI) was applied to pool the effect size. A funnel plot and Egger test were used to evaluate publication bias.

Results:

Finally, 43 eligible studies were included in the current meta-analysis. Overall, serum leptin levels in BC cases were significantly higher compared with the controls (SMD = 0.61, P <.0001). When subgroup analyses were restricted to ethnicity and menstrual status, higher serum leptin concentration was also detected in patients with BC. Moreover, BC cases with body mass index (BMI) >25 indicated significantly higher serum leptin levels (SMD = 1.48, P = .034). Furthermore, the BC cases with lymph node metastases showed significantly higher serum leptin concentration (SMD = 0.53, P = .015).

Conclusion:

The present meta-analysis suggests that the serum leptin may profiles as a pivotal role in the pathogenesis and metastasis of BC. In addition, leptin will provide useful information for a therapeutic target to treat BC.
Malignant melanoma with indiscoverable skin manifestations presenting with paresis and refractory hypercalcemia
Authors: Wang Pei-pei , Zhou Xi , Chen Xi , Wang Li-wen , Liu Yong
Published: January 2019

Rationale:

Malignant melanoma with indiscoverable skin manifestations is unusual and refractory hypercalcemia with high metabolic signal of the rectum as initial manifestation is very rare.

Patient concerns:

We present a case that presented with paresis, nausea, and vomiting.

Diagnoses:

Malignant melanoma with spinal metastasis.

Interventions and outcomes:

The patient underwent posterior decompression, partial tumor resection, bone cement reconstruction, and internal fixation. The patient's hypercalcemia was controlled and muscle strength was partially recovered. The immunohistochemical stainings showed Melan-A (+), HMB45 (+), s-100 (+), Vimentin (+), and AE1/AE3 (−).

Lessons:

We emphasize the necessity of screening potential existence of neoplasms for the patients with hypercalcemia. Surgical treatment is still necessary for patients with spinal metastasis.
Relationship between β-defensin-1 gene polymorphism and susceptibility and prognosis of acute respiratory distress syndrome
Authors: Feng Qijia , Liu Nan , Song Shuping , Ma Yufei
Published: January 2019

Objective:

The 1st exon 5′ noncoding region rs1799946 (-52A/G), rs1800972 (-44C/G), rs11362 (-20A/G) 3 single-nucleotide polymorphisms (SNPs) on human β-defensin-1 (HBD-1) gene affect its transcription and posttranscriptional mRNA stability then affect the activity of HBD-1. This study was to investigate the effects of HBD-1 gene rs1799946, rs1800972, and rs11362 locus SNPs on genetic susceptibility and prognosis of acute respiratory distress syndrome (ARDS).

Methods:

A total of 300 patients with ARDS (ARDS group) and 240 patients who were admitted to the intensive care unit and had a high risk of ARDS but did not progress to ARDS (control group) were included in this study. The genotypes of HBD-1 gene rs1799946, rs1800972, and rs11362 locus and serum HBD-1 were detected. Patients were followed for 60 days with development of ARDS as a primary outcome, ARDS-related mortality and organ dysfunction were secondary outcomes.

Results:

HBD-1 gene rs1799946 and rs11362 gene mutations were not risk factors for ARDS (P > .05). Mutation allele G of rs1800972 locus in HBD-1 gene was a risk factor for ARDS. There was no significant difference in serum HBD-1 levels between patients with different genotypes of rs1799946 and rs11362 locus in the HBD-1 gene (P > .05). HBD-1 gene rs1800972 locus wild type, heterozygous, and mutant homozygous serum levels of HBD-1 gradually decreased, the difference was statistically significant (P < .001). The 60-day survival rate of subjects with wild type, heterozygous, and mutant homozygote at the rs1800972 locus of HBD-1 gene decreased sequentially (81.7%, 48.9%, and 39.7%), and the difference was statistically significant (P < .05).

Conclusion:

The SNP of rs1800972 (-44C/G) in HBD-1 gene is associated with the risk of ARDS. The rs1800972 locus G allele carriers are more likely to develop ARDS and have a poor prognosis.
Herbal medicine (Hyeolbuchukeo-tang or Xuefu Zhuyu decoction) for treating primary dysmenorrhea
Authors: Leem Jungtae , Jo Junyoung , Kwon Chan-Young , Lee Hojung , Park Kyoung Sun , Lee Jin Moo
Published: January 2019

Background:

Primary dysmenorrhea is a condition characterized by painful menstrual cramps that usually occurs in the absence of any identifiable pathological condition among menstruating women, with the prevalence estimates varying between 45% and 95%. Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered as a standard treatment for primary dysmenorrhea; however, the failure rate of NSAIDs is often 20% to 25% and these drugs commonly cause adverse effects. In this review, we investigated the current evidence related to the effectiveness of Xuefu Zhuyu decoction (XZD) or Hyeolbuchukeo-tang, a traditional herbal formula, as a treatment for primary dysmenorrhea.

Methods:

Literature search was conducted about randomized controlled trials (RCTs) for XZD on primary dysmenorrhea. PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure Database, Oriental Medicine Advanced Searching Integrated System, and other Chinese, Korean, Japanese databases were searched up to December 20, 2017. Two independent reviewers extracted and assessed the data. The main outcome domains were visual analogue scale (VAS) score and response rate.

Results:

Among 475 publications, 8 RCTs involving 1048 patients were finally included. Methodological quality of included RCTs was relatively low. In 4 add-on design studies, XZD plus western medication (WM) group showed better response rate as compared to the WM sole therapy (relative risk 1.18, 95% confidence interval [1.11, 1.25], P < .01). VAS score after the 3rd month of treatment in the XZD plus WM group was also lower than that in the WM group (mean difference –0.45, 95% confidence interval [–0.79, –0.12], P < .01). In 4 XZD versus WM design studies, XZD sole therapy showed better response rate than did WM sole therapy (relative risk 1.26, 95% confidence interval [1.06, 1.49], P < .01).

Conclusion:

The existing trials showed a favorable effect of XZD for the management of primary dysmenorrhea. However, the efficacy of XZD on primary dysmenorrhea is not conclusive owing to the small number of studies and the high risk of bias. Large-scale, long-term RCTs with rigorous methodological input are needed to clarify the role of XZD for the management of primary dysmenorrhea.

Trial registration number:

CRD42016050447 in PROSPERO 2016
Rheumatoid factor as predictor of response to treatment with anti-TNF alpha drugs in patients with rheumatoid arthritis
Authors: Santos-Moreno Pedro , Sánchez Guillermo , Castro Carlos
Published: January 2019

We determined whether rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) can predict remission or severe disability in rheumatoid arthritis (RA) patients treated with anti-tumor necrosis factor (TNF) alpha drugs.

We performed a cohort study based on the clinical data from a referral center for the treatment of RA in Bogotá, Colombia, were included patients aged ≥18 years with diagnosis of RA with an active disease and for whom a treatment scheme was begun with anti-TNF alpha medication, with a minimum follow-up time of 12 months. Disease activity of Rheumatoid Arthritis was assessed through measurement of RF, ACPA, disease activity score (DAS28), and health assessment questionnaire (HAQ). We calculated the incidence rates (IRs) for remission and severe disability. We also calculated the incidence rate ratio (IRR) for each outcome by adjusting for possible confounders using the Poisson regression method. The hypothesis was tested with a P value of <.05. Statistical analysis was performed in Stata 15.

We included 400 patients receiving an anti-TNF alpha agent. Median age was 60 years, and 322 patients were women (80.5%). RF was positive in 357 patients (89%), ACPA in 348 patients (87%), and co-positivity in 324 patients (81%). Median follow-up was 41 months (range, 12–79 months). The IR for remission was 23 per 100 person-years in RF-negative patients and 16 per 100 person-years in RF-positive patients. The adjusted IRR (age sex, treatment, and ACPA) was 1.51 (95%CI, 1.05–2.18). The IR for severe disability was 10.8 per 100 person-years in the RF-positive cohort and 2.3 per 100 person-years in the RF-negative cohort. The IRR adjusted for these factors was 4.37 (95%CI, 1.6–12). Co-positivity had a similar behavior to RF. No differences were recorded in the rates of remission or disability in ACPA-positive and ACPA-negative patients.

Our findings suggest that remission is less frequent and severe disability more frequent in RF-positive patients treated with anti-TNF alpha agents than in RF-negative patients.
Challenges in diagnosis of spinal epidural abscess
Authors: Yang Xiaowei , Guo Runsheng , Lv Xin , Lai Qi , Xie Banglin , Jiang Xiaozhen , Dai Min , Zhang Bin
Published: January 2019

Rationale:

Spinal epidural abscess (SEA) is a rare condition that shows a high prevalence in immunocompromised patients. The clinical presentation of SEA includes the “classic triad” of pain, fever, and neurological dysfunction. However, these nonspecific features can lead to a high rate of misdiagnosis. SEA may lead to paralysis or even death; thus, prognosis of these patients remains unfavorable.

Patient concerns:

We report a case of a multilevel (T6–T12) SEA in a 22-year-old woman.

Diagnosis:

The patient was initially diagnosed with spinal tuberculosis at a local hospital based on a history of tuberculosis exposure, as well as radiography and computed tomography. Histopathological examination of the tissue resected during laminectomy confirmed the diagnosis of SEA in this patient.

Interventions:

The patient underwent multilevel laminectomy combined with long-term antibiotic therapy.

Outcomes:

Physical examination performed 16 months postoperatively revealed that superficial and deep sensation was restored to normal levels in the lower extremities with improvement in the patient's motor function (muscle strength 2/5).

Lessons:

This case report indicates that whole spine magnetic resonance imaging is warranted in patients with SEA and that prompt surgical intervention is important at symptom onset. Long-term antibiotic therapy is also essential postoperatively.
Corneal aberrations after small-incision lenticule extraction versus Q value-guided laser-assisted in situ keratomileusis
Authors: Zhang Jun , Zheng Li , Zhao Xia , Sun Yi , Feng Wei , Yuan Minhui
Published: January 2019

Previous studies compared ocular aberration and visual quality after small-incision lenticule extraction (SMILE) and Q value-guided femtosecond laser-assisted in situ keratomileusis (Q-FS-LASIK), but anterior corneal surface aberration properties are poorly known. This study aimed to compare the changes in anterior corneal surface aberration after SMILE versus Q-FS-LASIK.

This was a prospective, observational cohort study. Patients with myopia and myopic astigmatism underwent SMILE or Q-FS-LASIK at Hangzhou MSK Eye Hospital between January 2015 and November 2015. High order aberration (HOA), primary spherical aberration (PSA), primary coma aberration (PCA), primary vertical coma aberration (PVCA), and primary horizontal coma aberration (PHCA) were assessed using pre- and postoperative Sirius scanning.

Both surgery were associated with significant increases in postoperative HOA, PSA, and PCA (both groups P < .01). In the SMILE group (n = 51), the variations in HOA, PSA, and PCA were no longer significant after postoperative week 2 (P > .05). In the Q-FS-LASIK group (n = 73), the variations in HOA and PCA were no longer significant after postoperative day 1 (P > .05). In the SMILE group, the 3-month changes in PCA were not correlated with spherical, spherical equivalent (SE), and spherical plus cylinder measurements. Cylinder measurements were not correlated with HOA, PSA, and PCA. In the Q-FS-LASIK group, the 3-month changes in PCA correlated with spherical, SE, and spherical plus cylinder measurements.

Both SMILE and Q-FS-LASIK resulted in an increase in HOA, PSA, and PCA at postoperative day 1, but Q-FS-LASIK introduced lower HOA and showed better stability. Spherical measurement was related to PSA.
Changes in blood flow distribution after hypogastric artery embolization and the ischaemic tolerance of the pelvic circulation
Authors: Nitta Jun , Hoshina Katsuyuki , Isaji Toshihiko
Published: January 2019

This study aimed to compare the pelvic cavity vasculature before and after the interventional occlusion of a hypogastric artery (IOHA) and to reveal the protective mechanism of the collateral vessels against pelvic ischaemia.

Sixty-nine patients with abdominal aortic or aortoiliac aneurysms who underwent endovascular aneurysm repair accompanied with IOHA were retrospectively analysed. Patients were divided into those who complained of buttock claudication (BC) group and asymptomatic patients (non-BC group).

Two analyses were performed. In Study 1, the factors associated with postoperative BC were evaluated in patients who underwent IOHA using only 0.035 Tornade embolization coils. In Study 2, the pelvic arterial volume (PAV) was assessed in patients with both pre- and postoperative multidetector computed tomography images. PAV was calculated by subtracting the aortoiliac artery volume from the total PAV. The PAV ratio was defined as the postoperative PAV divided by preoperative PAV and represented collateral development in the pelvis.

In Study 1, BC occurred in 16 patients (BC group) and did not occur in 25 patients (non-BC group). Significantly more coils were used in the BC group than in the non-BC group (8.6 ± 1.0 vs 5.6 ± 0.83, P = .013). Study 2 had 24 patients in the BC group and 31 patients in the non-BC group. The PAV ratio was significantly higher in the BC group than in the non-BC group (0.93 ± 0.05 vs 0.62 ± 0.04, P<.0001).

The use of more coils in IOHA is associated with BC. In addition, volumetric analysis revealed that less collateral vessel development occurred in the non-BC group than in the BC group, which might reflect a potential reservation capacity of non-BC patients for acute pelvic ischaemia.
Risk of massive blood product requirement in cardiac surgery
Authors: Huang Dou , Chen Changwei , Ming Yue , Liu Jing , Zhou Li , Zhang Fengjiang , Yan Min , Du Lei
Published: January 2019

Cardiac surgery under cardiopulmonary bypass (CPB) accounts for most consumption of red blood cells (RBCs). Identifying risk factors for massive red blood cell transfusion (MRT) in cardiac surgery may help to reduce this consumption.

We retrospectively analyzed 8238 patients who underwent valve surgery and/or coronary artery bypass grafting (CABG) under CPB at 2 major heart centers in China. Uni- and multivariate logistic regression was carried out to assess whether risk factors for MRT (defined as receiving at least 4 units RBCs) varied with type of cardiac surgery.

A total of 1691 patients (21%) received at least 4 units RBCs (6.77 ± 4.78 units per person). This MRT group consumed 70% of the total units of allogeneic RBCs in the study. MRT incidence was 2-fold higher among patients undergoing CABG with or without valve surgery than among patients undergoing valve surgery alone. Multivariate logistic analysis identified the following MRT risk factors common to valve surgery alone, CABG alone, and their combination: female sex, older age, renal dysfunction, lower body mass index, lower preoperative hemoglobin, and longer CPB. Several independent MRT risk factors were also identified specific to valve surgery: active endocarditis, nonatrial fibrillation, smaller left atrium diameter, abnormal international normalized ratio, and repeat surgery.

Different types of cardiac surgery share several, but not all, MRT risk factors. This study may help guide the prediction and management of patients at higher MRT risk.
Efficacy of sorafenib adjuvant therapy in northwestern Chinese patients with non-metastatic renal-cell carcinoma after nephrectomy
Authors: Wei Di , Wu Guojun , Zheng Yu , Chen Fubao , Lu Jingyi , Wang Yangmin , He Dalin , Wang He , Wang Zhiping , Chen Peng , Wang Yujie , Wang Zhiyong , Ye Yongli , Zhu Zheng , Yuan Jianlin
Published: January 2019

Recent studies have confirmed the efficacy of sorafenib for patients with advanced renal cell carcinoma; however, its efficacy and safety as an adjuvant therapy in patients with non-metastatic and loco-regional renal cell carcinoma after surgery remains controversial. Thus, the aim of the present retrospective study was to evaluate the efficacy of adjuvant sorafenib therapy in such patients from 8 centers in northwestern China that were treated from August 2009 to December 2016.

After surgery, the patients (n = 48) received oral sorafenib for 3 months. The control group (n = 48) comprised patients that underwent the same surgery from December 2009 to June 2016 but without adjuvant therapy who were matched 1:1 with the sorafenib group with respect to sex, age, pathological findings, disease stage and grade, operation time, and surgical procedure. The primary outcome compared between the groups was disease-free survival. Adverse events were also recorded to evaluate the safety of sorafenib. The influence of patients’ characteristics and laboratory tests on recurrence was analyzed using unconditional logistic regression.

Overall, the demographic characteristics of the 2 groups were similar. There was no significant difference in the rate of recurrence (8.3% for sorafenib patients and 6.2% for the matched patients, P = .66) or median disease-free survival between the 2 groups (hazard ratio = 1.561, 95% confidence interval = 0.349–6.987, P = .56). In multiple logistic regression analysis, increased blood urea nitrogen (BUN) emerged as an independent predictor of recurrence risk (P = .02).

These results indicate that postoperative sorafenib adjuvant therapy did not achieve the expected beneficial effect, pointing to the need for further studies to evaluate its utility in such cases.
Pectoralis major tendon transfer for recurrent anterior shoulder dislocation after primary surgery in an elderly patient
Authors: Kim Jun Bum , Hong Sijohn , Wang Soon Do , Kim Chang Hyun
Published: January 2019

Rationale:

Adequate stability of traumatic anterior shoulder dislocation without any obvious damage to the anterior capsulolabral structure in elderly patients can be achieved by treating the associated rotator cuff injuries. However, in case of recurrent shoulder dislocation despite rotator cuff repair, the repaired rotator cuff may be weakened or reruptured and is often impossible to repair again. Therefore, the role of the rotator cuff as a shoulder stabilizer cannot be expected. Even if the anterior joint capsule is left, it is too weak to imbrication either. An additional anterior structural reconstruction that can replace the rotator cuff and capsule is needed to prevent recurrence.

Patient concerns:

A 59-year-old man visited our clinic because of traumatic anterior dislocation of the right shoulder combined with anterior–superior rotator cuff tear. Because there was no obvious anterior capsulolabral injury, he underwent arthroscopic rotator cuff repair only. Postoperative rehabilitation was maintained; however, anterior shoulder dislocation recurred 10 months postoperatively.

Diagnosis:

Physical examination revealed anterior instability in abduction and external rotation of the shoulder joint. Magnetic resonance imaging suggested retear of the repaired anterior–superior rotator cuff and Hill–Sachs lesion of the humeral head.

Interventions:

Diagnostic arthroscopy was performed. The reruptured rotator cuff seemed impossible to repair; thus, arthroscopic remplissage procedure was performed for engaging the Hill–Sachs lesion. In addition, open pectoralis major tendon transfer for anterior stabilization was performed via the deltopectoral approach.

Outcomes:

At the 12-month follow-up, the patient showed good clinical outcomes, including internal rotation of the shoulder joint without recurrent instability.

Lesson:

Recurrent anterior shoulder dislocation after primary surgery in the elderly may be a challenging situation for surgeons. In patients with irreparable anterior rotator cuff tear and for whom reconstruction of the anterior glenoid is not indicated, pectoralis major tendon transfer is a good treatment option for satisfactory clinical outcomes without recurrence.
A left femoral artery to right femoral vein bypass graft for hemodialysis access
Authors: Wang Jian , Li Jie , Sun Jinhong , Xin Jun , Lei W-H.
Published: January 2019

Rationale:

As survival prospects improve for long-term patients with hemodialysis, it is common for patients to exhaust all upper extremity access options before other avenues need exploration. The purpose of this case report was to describe our experience in creating a prosthetic graft between left femoral artery and right femoral vein in a patient with history of central venous occlusion and bilateral femoral neck fracture.

Patient concerns:

A female patient with hemodialysis exhausted all upper extremity access options along with bilateral femoral neck fracture.

Diagnoses:

Patients with end-stage renal disease exhausted all upper extremity access options.

Interventions:

We performed a left femoral artery to right femoral vein dialysis access utilizing a prosthetic graft and autologous cephalic vein.

Outcome:

The graft was used for hemodialysis 3 weeks after the operation. There was no edema of the lower extremity through the immediate postoperative period as well as at follow up. The patient has been using the access for 9 months with no complication of thrombosis, infection, or bleeding.

Lessons:

Prosthetic graft between the left femoral artery and right femoral vein is a simple, safe and novel approach to creating lower extremity access. This method could be a viable means of hemodialysis access in selected patients.
Identification of risk factors affecting bone formation in gradual ulnar lengthening in children with hereditary multiple exostoses
Authors: Li Yuchan , Han Bingqiang , Tang Jingyan , Chen Mu , Wang Zhigang
Published: January 2019

The forearm deformity classified by Masada is a characteristic trait of patients with hereditary multiple exostoses (HME). Ulnar gradual lengthening, which was considered to be a safe and reliable procedure, was popular in treating these difficult deformities, however, delayed consolidation of the callus is uncommon but not rare in literature review. The purpose of this study was to try to identify the risk factors influencing bone healing in gradual ulnar lengthening in HME.

We retrospectively reviewed patients with HME-induced forearm deformity who underwent gradual ulnar lengthening at our hospital from 2010 to 2016. Patients’ demographic data, forearm deformity of Masada type, surgical procedure, ulnar diameter of osteotomy site, and external fixator type were recorded. We also reviewed radiographical data included gained length, axis deviation, callus form. Clinical outcome was assessed by the bone healing index (HI). Multiple linear regression was used to analyze the relationships between diffident parameters and the HI, the level of significance was set P <.05.

Thirty-three patients were included in this study. The mean follow-up period was 1.5 (range 0.5–8) years. Circular external fixators were used in 5 patients and monolateral external fixators were used in 28 patients. The mean achieved length was 4.24 cm. The mean HI was 50.3 (range 26.6–99.3) days/cm. In patient with monolateral external fixator, patient's age was positively correlated with the bone HI (P = .001), while diameter and body mass index (BMI) were negatively correlated with the HI (P = .040, .018, respectively). Patient's sex, removal of distal ulnar exostoses, lengthening percentage, and axis deviation were non-significant in the regression model.

When using monolateral external fixator for ulnar lengthening, patient's age, diameter of osteotomy site, and BMI are the most important risk factors related to bone formation. Pediatric orthopedic surgeons should consider these variables in order to avoid delayed union.
Association of transcription factor 7-like 2 (TCF7L2) gene polymorphism with type 2 diabetes mellitus in Chinese Korean ethnicity population
Authors: Zhou Kui-Chen , Liu Hong-Wei , Wang Chen , Fu Yan-Jun , Jin Feng
Published: January 2019

Presently, data on the type 2 diabetes mellitus (T2DM) in Chinese Korean ethnicity are very scarce. This study aimed to explore the relationship between the transcription factor 7-like 2 (TCF7L2) and T2DM in Chinese Korean ethnicity population. This case-control study involved 43 T2DM Chinese Korean ethnicity patients (T2DM group) and 43 healthy Chinese Korean ethnicity normoglycemic subjects as controls (Control group). All included participants aged from 40 to 75 years old. Clinical and biological data were collected to determine the phenotypic traits. The restriction fragment length polymorphism-polymerase chain reaction was used to analyze the TCF7L2 by genotyping for rs7903146 (C/T). Spectrophotometer with Chronolab kits was used to conduct the biochemical analyses. TCF7L2 was associated with T2DM in the Chinese Korean ethnicity population (P < .01 for alleles, and P < .05 for genotypes). Significant differences were found 2 groups regarding the T allele (37.2% T2DM patients vs 15.1% healthy subjects, P < .01), and G allele (62.8% T2DM patients vs 84.9% healthy subjects, P < .01). The risk genotypes were GG (83.7% T2DM patients, vs 44.2% healthy control, P < .01), GT (4.7% T2DM patients, vs 20.9% healthy control, P = .04), and TT (11.6% T2DM patients, vs 34.9% healthy control, P = .01). The results of this study demonstrated that TCF7L2 is associated with T2DM in the Chinese Korean ethnicity population, which is an important risk factor for T2DM in this population.
Cyclophosphamide for the treatment of acute lymphoblastic leukemia
Authors: Zhao Yue-rong , Song Hong-mei , Ni Lei
Published: January 2019

Background:

Previous clinical trials have reported that cyclophosphamide can be used for the treatment of acute lymphoblastic leukemia (ALL). However, its efficacy is still unclear. In this systematic review study, we aim to evaluate its efficacy and safety for ALL.

Methods:

The following 9 databases will be searched from their inception to the present: Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), and four Chinese databases. The randomized controlled trials or case control studies of cyclophosphamide that assess the clinical efficacy and safety in patients with ALL are included. The methodological quality of all eligible included studies will be assessed by the Cochrane risk of bias tool.

The primary outcome measurement will be all-cause mortality at the period of treatment and follow-up. The secondary outcome measurements will include the health-related quality of life (HRQL), postinduction complete remission (CR) rate, event-free survival (EFS), relapse rate, and adverse events. Two authors will independently select eligible studies, exact data, and assess the methodological quality of included studies. RevMan 5.3 software will be used to synthesize the data. Reporting bias will be evaluated by the funnel plots, Begg, and Egger tests.

Results:

This systematic review will evaluate the clinical efficacy and safety of cyclophosphamide for ALL.

Dissemination and ethics:

The findings of this review will summarize the present evidence of cyclophosphamide for ALL, and may provide guidance for clinical practice of cyclophosphamide for ALL. Its results will be published through peer-reviewed journals. This study does not need ethic approval, because it will not involve the individual data.

Systematic review registration:

PROSPERO CRD42018119333.
How international are the editorial boards of leading spine journals? A STROBE-compliant study
Authors: Xu Bin , Meng Hongyu , Qin Shiji , Liu Yueju , Li Zhiyong , Cao Junming , Lin Yongsheng , Zhang Yingze , Wang Zhihong
Published: January 2019

Low- and middle-income countries contribute to only a small percentage of publications in multiple medical fields. Editorial bias was reported to be an important reason for this. However, whether this trend exists in leading spine journals remains unclear. This study determined the composition of the editorial boards of leading spine journals and analyzed the international representation of editorial boards.

The editorial board members of four leading subspecialty spine journals, including The Spine Journal, Journal of Neurosurgery: Spine, European Spine Journal, and Spine were identified from the journals’ websites. The countries of editorial board members were identified and analyzed according to the continent and country income categories classified by the World Bank.

A total of 608 editorial board members were identified from the four leading spine journals. The majority (91.4%) of editorial board members were from high-income countries, followed by upper-middle income countries (7.2%), and lower-middle income countries (1.3%). No editorial board members were from low-income countries. Regarding the continent of residence, 46.5% of the editorial board members were from North America, followed by Europe (38.5%), Asia (9.9%), South America (2.8%), Oceania (1.6%), and Africa (0.7%). The editorial board members came from 40 different countries, which were concentrated in North America, Western Europe, and East Asia. The largest number of editorial board members came from the United States (42.3%), followed by Germany (6.9%), the United Kingdom (6.7%), Switzerland (5.8%), and Italy (5.1%).

A lack of international representation on editorial boards exists in leading spine journals. Editorial board members from high-income countries are substantially overrepresented, while editorial board members from low- and middle-income countries are severely underrepresented. The United States is the most represented country on the editorial boards of leading spine journals.
Pharyngeal hairy polyps
Authors: Teng Yishu , Xian Zhixiong , Han Saihong , Liang Zhenjiang , Pan Hongguang , Li Lan
Published: January 2019

It was aimed to report 5 cases of pharyngeal hairy polyps, and to summarize the characteristics combined with literature review.

Five cases with pathological diagnosis of pharyngeal hair polyps were diagnosed and treated in our department from June, 2006 to October, 2016, and retrospective analysis of their clinical data was performed. Among the 5 cases, there were 1 male and 4 female, with the age of 2 days to 26 months old. After birth, these patients were accompanied by stridor, difficulty breathing, snoring, feeding difficulties, and slow weight gain.

Gray mass in the stem original from the pharynx was found in all 5 cases, with the surface hair-covering. The polyp resections were performed under general anesthesia, with the complete removal of polyp along the pars basilaris during surgery smoothly. The operation during was 5 to 20 minute, with an average of 12 minute, and there was little hemorrhage during operation. Symptoms disappeared completely after the surgery, and follow-up was performed for 1 year without recurrence shown.

Pharyngeal hairy polyp is a rare non-malignant clinical disease, mainly caused by symptoms in respiratory tract obstruction. Complete removal of polyps along the pars basilaris is an effective treatment, with no recurrence case reported after surgery.
Solitary renal metastasis from squamous cell carcinoma of the lung
Authors: Wang Jiantao , Wang Li , Long Lang , Tao Qing , Xu Feng , Luo Feng
Published: January 2019

Rationale:

Non-small cell cancer with isolated unilateral renal metastasis is rare, and the role of radical nephrectomy has not been determined. In the present study, a case of a patient with solitary kidney metastasis from squamous cell lung cancer who underwent radical nephrectomy is reported.

Patient concerns:

A 74-year-old patient diagnosed with pulmonary squamous cell lung cancer who had undergone radical pulmonary lobectomy and mediastinal lymph node dissection revealed a solitary mass in the right kidney during the follow-up.

Diagnoses:

Unilateral isolated kidney metastasis originated from squamous cell lung cancer.

Interventions:

The patient underwent radical right nephrectomy and squamous cell cancer metastasis was confirmed by the postoperative pathology results.

Outcome:

Lung cancer relapse was diagnosed and the patient died of cancer progression 10 months after the right nephrectomy.

Lessons:

Solitary renal metastasis is rare and squamous cell lung cancer might be the primary disease. Abdominal computed tomography (CT) is important in detecting solitary kidney metastasis during the follow up of patients with squamous cell lung cancer. Due to the rareness of isolated renal metastasis, the role of radical nephrectomy needs to be further investigated.
Long-term survival of an elderly female with metastatic colon cancer after treated with capecitabine monotherapy
Authors: Liu Jin , Wang Yao , Jiang Haiping , Yu Xiongfei , Xu Nong
Published: January 2019

Rationale:

Colorectal cancer (CRC) is one of the most common cancers all over the world, and approximately 70% of the newly diagnosed patients are over 65 years old. Due to the aging of society, there will be more and more elderly patients of CRC in the future. Treatment of CRC in elderly patients is much more challenging thanks to multiple factors including disabling comorbidities as well as declines in organs function, especially in advanced or metastatic settings.

Patient concerns:

An 82-year-old female without history of disease was admitted to the emergency room because of abdominal pain in December 2009. A computed tomography (CT) scan of the abdomen was performed immediately, which revealed bowel obstruction.

Diagnoses:

The histopathological examination of the resected specimen confirmed well-to-moderately differentiated colonic adenocarcinoma with a stage of IIIB (T3N1M0) based on the NCCN tumor-node-metastasis (TNM) classification system.

Interventions:

The patient underwent emergency surgery and rejected adjuvant chemotherapy, but was diagnosed with multiple liver metastases 3 months later. Then she received capecitabine monotherapy as first-line treatment.

Outcomes:

The efficacy achieved complete response (CR) when 8 cycles were completed and the agent was continued as maintenance treatment until totally 16 cycles were completed. Up to the latest follow-up, the disease remained CR and the progression-free survival (PFS) has achieved approximately 87 months. She is still alive and has good quality of life.

Lessons:

Capecitabine monotherapy may be an effective treatment in advanced or metastatic colorectal cancer (mCRC) for elderly patients.
Intramuscular hemangioma within the biceps brachii causing the limitations of elbow extension and forearm pronation
Authors: Liu Yang , Li Ruijun , Liu Zhigang , Wang Shuang , Lu Laijin
Published: January 2019

Rationale:

Intramuscular hemangiomas are rare benign vascular neoplasms, merely accounting for 0.8% of all hemangiomas. Moreover, there are few case reports of intramuscular hemangiomas in the upper extremities.

Patient concerns:

A 24-year-old male patient presented with a 5-year history of intermittent pain of the right elbow joint. He had observed a swelling of the right cubital fossa over the past 2 years, leading to the limitations of elbow extension and forearm pronation.

Diagnosis:

The patient was diagnosed with intramuscular hemangioma of the biceps brachii.

Interventions:

Surgical excision of the tumor was performed for this patient and postoperative early functional exercises were permitted.

Outcomes:

The movements of the right elbow and forearm reached the normal range of motion at 5 weeks after surgery. There was no evidence of recurrence during the 5-month follow-up.

Lessons:

Optimal management of intramuscular hemangioma is critical, including precise evaluation, good microsurgical technique and early functional exercises, which may result in a satisfying outcome.