bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of Bacillus coagulans LBSC in irritable bowel syndrome
Authors: Gupta Anil Kumar , Maity Chiranjit
Published: January 2021

Goals:

To evaluate safety and efficacy of Bacillus coagulans LBSC [DSM17654] in irritable bowel syndrome (IBS) through a prospective, interventional, randomized, double-blind, and placebo-controlled, CONSORT compliant clinical trial.

Background:

Bacteriotherapy shows promising impact on alleviating clinical conditions of IBS and associated functional gastrointestinal disorders. B coagulans LBSC is a genetically and phenotypically safe probiotic strain used in this study to study its impact on ameliorating IBS symptoms and improving quality of life.

Methods:

In this interventional, randomized, double-blind, placebo-controlled clinical study, total 40 subjects (18–65 years) were screened through Rome IV criteria and randomized into 2 groups, that is, interventional and placebo arm (n = 20/arm). Similar dosages were received by both the arm, that is, placebo (vehicle) and interventional arm (B coagulans LBSC, 6 billion/d) for a period of 80 days. Study completed with per protocol subjects (n = 38) and results were considered to evaluate the primary and secondary endpoints.

Results:

Assessment through Digestive Symptom Frequency Questionnaire 5 point Likert scale showed significant improvement in interventional arm compared to placebo on symptoms such as bloating/cramping, abdominal pain, diarrhea, constipation, stomach rumbling, nausea, vomiting, headache, and anxiety. Maximum of “no symptoms” cases and mild to moderate gastrointestinal symptoms along with improved stool consistency were from interventional arm tested following IBS severity scoring system and Bristol stool form scale. Upper gastrointestinal endoscopy revealed no clinical difference of gastrointestinal mucosa between both the arms. B coagulans LBSC was well tolerated with no serious adverse events.

Conclusions:

B coagulans LBSC was safe for human consumption and efficacious in alleviating overall pathophysiological symptoms of IBS and thereby improving inclusive quality of life evaluated.
The effect of pestle acupuncture for patients with lactation insufficiency after cesarean section
Authors: Li Dongshuang , Jiang Yunlan , Ma Xiaoqing , Li Qing , Chu Xin , Zhong Wei , Deng Xiaochun , Yang Xiaolian
Published: January 2021

Introduction:

Cesarean section is a common operation in obstetrics, and the incidence of insufficient breast milk is high in parturients undergoing cesarean section. Studies have shown that acupuncture or massage at related acupoints can promote the secretion and excretion of milk. These external treatments are quick, safe, and effective. On the other hand, they can avoid the potential risk of changes in milk composition that may be caused by the use of drugs. Pestle needle therapy is a new branch of traditional acupuncture, and pestle needle operation does not need to break the skin. The pestle needle has good clinical efficacy and safety in cervical spondylosis, insomnia, fatigue, depression, and so on, but few studies have focused on the effect of pestle acupuncture for patients with lactation insufficiency after cesarean section. This study aims to determine whether pestle needle therapy is effective and safe in the treatment of postpartum milk deficiency.

Methods:

This is a 2 parallel-group, assessor-blinded, randomized controlled trial.128 patients with lactation insufficient after cesarean section will be recruited and randomly divided into control group and the pestle needle group in a 1:1 ratio. The control group will receive routine nursing care of milk deficiency. In the pestle needle group, pestle needles will be used to operate on the acupoints such as bilateral Shao ze (S11), bilateral Ru gen (ST18), Dan zhong (DU14), 8 array acupoints of Shen dao (DU11) and so on. It will be operated once a day for 5 days. The primary outcomes are milk yield, degree of breastfilling, degree of milk siltation and other milk deficiency symptom, and serum prolactin. Secondary outcomes include syndrome of traditional Chinese medicine, such as facial expression, fatigue, loss of appetite, and so on.

Discussion:

Pestle needle therapy based on acupoint and meridian theory may increase milk secretion and excretion, which will provide a new intervention means to promote breastfeeding and have great significance to guide clinical treatment.

Trial registration number:

ChiCTR2000039752.
Factors associated with hyperhomocysteinemia in relatively healthy Taiwanese adults
Authors: Chen Po-Ju , Lu Yueh-Chien , Wang Pei-Ming , Huang Chih-Fang , Loke Song-Seng
Published: January 2021

Elevated homocysteine levels have been proposed as a risk factor for cardiovascular disease. The aim of this study was to evaluate factors associated with hyperhomocysteinemia in relatively healthy Taiwanese adults.

A retrospective cross-sectional study was conducted using data from the health examination database in a medical center located in southern Taiwan. Hyperhomocysteinemia was defined as a plasma homocysteinemia level >15 μmol/L. Factors associated with hyperhomocysteinemia were evaluated using univariate and multiple stepwise logistic regression analyses.

A total of 817 adults with a mean age of 55.5 years were included in the present study, and of them, 67 (8.2%) had hyperhomocysteinemia. Results from multiple logistic regression analysis showed that male sex (Odd ratio [OR] = 12.28, 95% CI = 2.94–51.27, P 
= .001), advanced age (OR = 1.37 per 10 years, 95% CI = 1.06–1.77, P = .017), triglycerides (OR = 1.02 per 10 mg/dL, 95% CI = 1.01–1.04, P = .010), and uric acid (OR = 1.27, 95% CI = 1.09–1.49, P = .004) were significantly and independently associated with hyperhomocysteinemia.

In this retrospective medical record study, male sex, advanced age, higher plasma level of triglyceride, and uric acid were significantly associated with hyperhomocysteinemia in relatively healthy Taiwanese adults.
Lipi Guben decoction in treating diarrheal irritable bowel syndrome
Authors: Yang Hongmei , Liu Xin , Peng Wei , Chen Rong , Chen Yang
Published: January 2021

Background:

Irritable bowel syndrome (IBS) is a common functional bowel disorder. The global incidence of IBS is as high as 9% to 23%, accounting for about 50% of outpatients in gastroenterology, and the new case detection rate is 0.2% every year. IBS has become a global gastrointestinal functional disease. Although IBS is not a life-threatening disease, it seriously affects the quality of life of patients, causing huge economic and mental burden to individuals, society and families. Lipi Guben decoction (LPGBD) is an important auxiliary treatment for IBS, but lack of robust Evidence-based medicine evidence proving its efficacy. Therefore, we designed a randomized controlled trial to evaluate the efficacy and safety of LPGBD in the treatment of IBS.

Methods:

In this randomized controlled trial, a total of 100 eligible patients will be allocated to the blank control group or LPGBD group in a ratio of 1:1. The treatment period was 12 weeks. The primary outcome measure will be the total clinical effective rate. The Secondary outcomes will include IBS clinical symptom scores, IBS-Severity Scoring System, IBS-Quality of life, Hamilton Rating Scale for Anxiety, Hamilton Rating Scale for Depression, and Bristol Stool Form Scale. The safety outcome will include Echocardiogram, blood examination (including blood routine test, liver function test, and renal function test), urine routine test and stool routine test. The evaluation indicators and all safety results will be performed at baseline, week 4, week 8 and week 12.

Results:

This study will be helpful to evaluate the efficacy and safety of LPGBD in the treatment of IBS.

Conclusion:

LPGBD may improve the clinical efficacy of patients with IBS, which has important value in practical application

Trial registration:

Chictr20000039617, registration time: November 3, 2020
The association between rs1800872 polymorphism in interleukin-10 and risk of cervical cancer
Authors: Wang Kexin , Jiao Zhen , Chen Hongxiang , Liu Xiaowan , Lu Jing , Liu Xuli , Li Jinming , Wang Lin
Published: January 2021

Background:

In recent years, several reports have tried to prove this connection between rs1800872 polymorphism in interleukin-10 and cervical cancer among different populations, but the results are debatable. Thus, we collected all the published literature and conducted an integrated meta-analysis, which provided better evidence-based medicine for the relationship between rs1800872 polymorphism in interleukin-10 and risk of cervical cancer.

Methods:

We systematically performed our search on PubMed, EMBASE, Web of Science, WanFang database, and CNKI for all papers related to this research, published up to August 1, 2020. Summary odds ratios (OR) with 95% confidence interval (95% CI) were calculated in allelic, homozygous, heterozygous, dominant, and recessive model to appraise the association.

Results:

The meta-analysis included 8 studies containing 1393 cervical cancer cases and 1307 controls. The aggregate data under heterozygous model and dominant inheritance model (OR = 0.66, 95% CI: 0.55--0.80) indicated a significant association between rs1800872 and the low risk of cervical cancer in the entire population. And the aggregated data under the dominant inheritance model shows that rs1800872 is significantly associated with the reduction in the risk of cervical tumors in the entire population.

Conclusion:

Our conclusion is that the AC/AA + AC variant of Rs1800872 indicates a protective effect in the development of cervical cancer.
Efficacy and safety of Chinese medicine for obstructive sleep apnea
Authors: Bao Jun-Li , Xinyuan-Gao  , Han Yu-Bo , Zhang Ke , Liu Li
Published: January 2021

Background:

Obstructive sleep apnea (OSA) is significant public concern. Clinical practice indicates that Chinese medicine has certain therapeutic advantages, while there is a lack of evidence-based medicine support. The aim of this study is to synthesize related data to explore efficacy and safety of Chinese medicine for OSA.

Methods:

Data in PubMed, Embase, Web of Science, CNKI, WanFang, VIP databases were comprehensively searched. All the randomized controlled trials (RCTs) in OSA children were identified, in which the effects of Chinese medicine on a range of outcomes were compared. The search had a deadline of January 1, 2020. Two investigators independently conducted data extraction and assessed the literature quality of the included studies. The Revman5.3 software was used for meta-analysis of the included literature.

Results:

The efficacy and safety of Chinese medicine for OSA were evaluated in terms of apnea hypopnea index (AHI, the average and lowest blood oxygen, the Epworth Sleep Scale [ESS], and adverse effects).

Conclusions:

This study provides reliable evidence-based support for the clinical application of Chinese medicine for OSA.

PROSPERO registration number:

CRD42020154864.
A clinician survey for management of the secondary immunodeficiency caused by hematological malignancies in China
Authors: Ye Chunmei , Liu Juan , Song Xiaolu , Zheng Sujie , Liu Jinlin
Published: January 2021

Unlike Western countries, there are still few clinical immunology specialists in China, and the optimal care for secondary immunodeficiency caused by hematological malignancies is unknown. Therefore, we initiated this clinician survey study to describe the current situation of the care for malignancy patients with hypogammaglobulinemia in China.

We adapted a previously published online questionnaire of current clinical practices regarding the management of secondary immunodeficiency caused by hematological malignancies and then distributed the questionnaire to 52 hematologists in China via WeChat mobile software; the survey collected demographic details, starting dosage, target immunoglobulin (Ig) level, monitoring, criteria for stopping Ig replacement, vaccination use, and oral antibiotic prophylaxis for hypogammaglobulinemia patients.

Forty-eight hematologists responded. 28(58.33%) respondents had more than 10 years of experience. Nevertheless, 40(83.33%) respondents reported that they did not use any specific criteria for prophylactic Ig replacement in hypogammaglobulinemia patients. However, 27(56.25%) respondents reported that they had used intravenous immunoglobulin (IVIG); however, the starting dose, frequency, and target Ig level were significantly varied. Additionally, the criteria for stopping Ig replacement were significantly varied. Only one respondent (2.08%) used subcutaneous immunoglobulin (SCIG). Moreover, 35(72.92%) respondents reported no vaccination prior to Ig replacement, and 47(97.92%) respondents reported that they had not used antibiotic prophylaxis in secondary hypogammaglobulinemia patients.

Official guideline for the care for secondary immunodeficiency (SID) of the hematological malignancies patients should be issued in China, and significant attention of the hematologists should be paid to the use of prophylactic antibiotics and Ig replacement for the care of patients with hypogammaglobulinemia caused by hematological malignancies, as these agents could significantly reduce the infection rate in China.
Effectiveness and safety of fire needle for knee osteoarthritis
Authors: Lu Lunbin , Ye Jing , Xiong Jun , Chen Jun , Zhu Siyuan , Zhong Zhiying , Tang Genhua , Zhou Xingchen , Guo Han
Published: January 2021

Background:

There is a lack of curative medical treatment for patients with knee osteoarthritis (KOA). Acupuncture represents an important alternative therapy. In various forms of acupuncture and moxibustion, the fire needle is an indispensable part. Knee osteoarthritis (KOA) is a series of symptoms and signs of knee joint caused by local injury and inflammation and chronic strain of the knee joint resulting in cartilage degeneration of the articular surface and reactive bone loss of the subchondral bone plate. The results of clinical trial indicated that the fire needle therapy has obvious curative effect in treating KOA. This protocol is intended to describe how to collate and accumulate evidence for the current efficient and safe treatment of KOA with fire needle.

Methods:

Seven electronic databases were used to retrieve the literature for the KOA randomized controlled trials, including 3 English databases (PubMed, EMBASE, the Cochrane Central Register of Controlled Trials [Cochrane Library]), and 4 Chinese databases (Chinese National Knowledge Infrastructure, Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database). This systematic review will include all randomized controlled clinical trials using fire needle therapy for KOA. The observation Index is the Change of Western Ontario and McMaster Universities Osteoarthritis Index Total, first proposed by Bellamy in 1988. The selection of the study will be completed independently by 2 reviewers, extract the data, and evaluate the quality of the study before selecting the title, abstract, and full text. Revman 5.4 software will be used to perform meta-analyses of randomized controlled trials, where risk ratios for dichotomous data and standardized or weighted mean differences for continuous data are the results.

Result:

The results will be published in a peer-reviewed journal.

Conclusion:

This systematic review will provide the latest evidence to evaluate the safety and efficacy of fire needle therapy in patients with KOA.

Trial registration number:

INPLASY202080030
Clinical impact of 11C-Pittsburgh compound-B positron emission tomography in addition to magnetic resonance imaging and single-photon emission computed tomography on diagnosis of mild cognitive impairment to Alzheimer's disease
Authors: Kitajima Kazuhiro , Abe Kazuo , Takeda Masanaka , Yoshikawa Hiroo , Ohigashi Mana , Osugi Keiko , Koyama Hidenori , Yamakado Koichiro
Published: January 2021

This study aimed to evaluated the clinical impact of adding [11C] Pittsburgh compound-B (11C-PiB) PET for clinical diagnosis of mild cognitive impairment (MCI) to Alzheimer's disease (AD) dementia.

Twenty six (mean age 78.5 ± 5.18 years, 21 females) AD (n = 7), amnestic MCI (n = 12), non-amnestic MCI (n = 3), vascular dementia, progressive supranuclear palsy (PSP) with frontotemporal dementia (FTD), FTD (n = 1 each), and normal (n = 1) patients underwent 11C-PiB-PET, MRI, and SPECT scanning. 11C-PiB-PET was compared with MRI and SPECT for clinical impact.

11C-PiB-PET showed positivity in 6, 9, and 0 of the AD, amnestic MCI, and non-amnestic MCI patients, respectively, and 0 of those with another disease. Parahippocampal atrophy at VSASD was observed in 5 AD patients, 6 amnestic and PiB-positive MCI patients, 1 amnestic and PiB-negative MCI patient, and 1 vascular dementia patient. Parietal lobe hypoperfusion in SPECT findings was observed in 6, 4, and 2 of those, respectively, as well as 1 each of non-amnestic MCI, vascular dementia, and normal cases. Sensitivity/specificity/accuracy for selecting PiB-positive patients among the 15 MCI patients for 11C-PiB-PET were 100% (9/9)/100% (6/6)/100% (15/15), for VSRAD were 66.7% (6/9)/83.3% (5/6)/73.3% (11/15), and for SPECT were 44.4% (4/9)/50.0% (3/6)/46.7% (7/15), while those were 88.9% (8/9)/33.3% (2/6)/66.7% (10/15)/for combined VSRAD and SPECT. 11C-PiB-PET accuracy was significantly higher than that of SPECT.

11PiB-PET alone may be useful for selecting patients who will progress from MCI to AD in the future, although follow-up study is necessary to clarify the outcome of MCI patients.
Mapping research trends in diabetic retinopathy from 2010 to 2019
Authors: Dong Yi , Liu Yanli , Yu Jianguo , Qi Shixin , Liu Huijuan
Published: January 2021

Background:

Although many publications in diabetic retinopathy (DR) have been reported, there is no bibliometric analysis.

Purpose:

To perform a bibliometric analysis in the field of diabetic retinopathy (DR) research, to characterize the current international status of DR research, to identify the most effective factors involved in this field, and to explore research hotspots in DR research.

Methods:

Based on the Web of Science Core Collection (WoSCC), a bibliometric analysis was conducted to investigate the publication trends in research related to DR. Knowledge maps were constructed by VOSviewer v.1.6.10 to visualize the publications, the distribution of countries, international collaborations, author productivity, source journals, cited references and keywords, and research hotspots in this field.

Results:

In total, 11,839 peer-reviewed papers were retrieved on DR from 2010 to 2019, and the annual research output increased with time. The United States ranks highest among countries with the most publications. The most active institution is the University of Melbourne. Wong, TY contributed the largest number of publications in this field. Investigative Ophthalmology & Visual Science was the most prolific journal in DR research. The top-cited references mainly investigated the use of anti-vascular endothelial growth factor (VEGF) medications in the management of DR, and the keywords formed 6 clusters:

Discussion:

With the improvement of living standard, DR has gradually become one of the important causes of blindness, and has become a hot spot of public health research in many countries. The application of deep learning and artificial intelligence in diabetes screening and anti-VEGF medications in the management of DR have been the research hotspots in recent 10 years.

Conclusions:

Based on data extracted from the WoSCC, this study provides a broad view of the current status and trends in DR research and may provide clinicians and researchers with insight into DR research and valuable information to identify potential collaborators and partner institutions and better predict their dynamic directions.
Paeoniflorin inhibits the macrophage-related rosacea-like inflammatory reaction through the suppressor of cytokine signaling 3-apoptosis signal-regulating kinase 1-p38 pathway
Authors: Liu Zijing , Zhang Jiawen , Jiang Peiyu , Yin Zhi , Liu Yunyi , Liu Yixuan , Wang Xiaoyan , Hu Liang , Xu Yang , Liu Wentao
Published: January 2021

Rosacea is a facial chronic inflammatory skin disease with immune and vascular system dysfunction. Paeoniflorin (PF) is a traditional Chinese medicine with anti-inflammatory properties. However, its effects on rosacea remain unknown. Here, we investigated the mechanisms through which PF inhibits the macrophage-related rosacea-like inflammatory response. Immunohistochemical methods were used to detect differences in the inflammatory response and degree of macrophage infiltration in granulomatous rosacea lesions and their peripheral areas. Cell Counting Kit-8 was used to determine the cytotoxicity of PF towards RAW 264.7 cells. Reverse transcription-quantitative polymerase chain reaction and western blotting were used to measure the influence of PF on mRNA and protein expression levels of suppressor of cytokine signaling 3 (SOCS3), apoptosis signal-regulating kinase 1 (ASK1)-p38, Toll-like receptor 2, and cathelicidin antimicrobial peptide ( or LL37) in the lipopolysaccharide (LPS)-induced macrophage-related rosacea-like inflammatory response of RAW 264.7 cells. Inflammatory cell infiltration was more pronounced in granulomatous rosacea lesions than in peripheral areas. LL37 expression increased significantly, and the infiltration of a large number of CD68+ macrophages was observed in the lesions. PF promoted SOCS3 expression in RAW 264.7 cells and inhibited the LPS-induced increase in toll-like receptor 2 and LL37 expression through the ASK1-p38 cascade, thereby alleviating the macrophage-related rosacea-like inflammatory response. These changes could be abrogated by SOCS3 siRNA in vitro.

In conclusion, the pathogenesis of rosacea involves abnormal macrophage infiltration within the lesions. PF inhibits the macrophage-related rosacea-like inflammatory response through the SOCS3-ASK1-p38 pathway, demonstrating its potential application as a novel drug for rosacea therapy.
Usefulness of universal beta-blocker therapy in patients after ST-elevation myocardial infarction
Authors: Ferreira João André , Baptista Rui Miguel , Monteiro Sílvia Reis , Gonçalves Lino Manuel
Published: January 2021

The use of beta-blockers (BB) in the context of ST-segment elevation myocardial infarction (STEMI) was a universal practice in the pre-reperfusion era. Since then, evidence of their use for secondary prevention after STEMI is scarce. Our aim is to determine treatment results associated with BB therapy after a STEMI at 1-year follow-up in a contemporary nationwide cohort.

A prospective analysis involving 49 national centers, including patients admitted with STEMI, enrolled between October 2010 and September 2019 was conducted. The primary outcome was defined as the composite of all-cause mortality or hospital re-admission for a cardiovascular (CV) cause in the first year after STEMI. The patients were distributed into 2 groups, depending on whether they received therapy with BB at hospital discharge or not (BB and NB group, respectively).

A total of 3145 patients were included in the analysis, of which 2526 (80.3%) in the BB group. A total of 12.2% of patients reached the primary outcome. Regarding the univariate Cox regression analysis, the BB group presented lower mortality or re-admission for CV cause at 1-year follow-up [hazard ratio (HR) 0.69, confidence interval (CI) 95% 0.55–0.87, P = .001]. However, after adjustment for significant covariates, this association was lost (HR 0.73, CI 95% 0.51–1.04, P = .081). In patients with preserved (HR 0.73, CI 95% 0.51–1.04, P = .081) and mid-range (HR 1.01, CI 95% 0.64–1.61, P = .959) left ventricular ejection fraction (LVEF), the primary outcome was similar between the 2 groups, while in patients with reduced LVEF, the BB group presented a better prognosis, with fewer patients reaching the primary outcome (HR 0.431, CI 95% 0.262–0.703, P = .001).

BB universal therapy after STEMI has not proved useful, but it seems to be beneficial in patients with reduced LVEF.
Shear wave elastography of the tibial nerve in healthy subjects
Authors: Bedewi Mohamed A. , Elsifey Ayman A. , Alfaifi Tariq , Kotb Mamdouh A. , Abdelgawad Mohamed S. , Bediwy Abdelmohsen Mohamed , Swify Sherine Mohamed , Awad Ezzat M.
Published: January 2021

The purpose of this study is to investigate sonoelastographic features of the tibial nerve.

The study included 72 tibial nerves in 36 healthy subjects. High resolution ultrasound and Shear wave elastography were used to evaluate the tibial nerve. Cross sectional area and stiffness were measured.

The mean cross sectional area of the tibial nerve was 13.4 mm2. The mean shear elastic modulus of the tibial nerve in the short axis was 23.3 kPa. The mean shear elastic modulus of the tibial nerve in long axis was 26.1 kPa. The tibial nerve elastic modulus also showed no correlation with cross sectional area neither in the long axis nor short axis. Age, height, weight, and body mass index showed no correlation with tibial nerve elastic modulus in short or long axes.

The elastic modulus of the tibial nerve has been determined in healthy subjects and can serve as a reference for future assessment of polyneuropathy.
Synchronous gallbladder metastasis of renal cell carcinoma presenting as a gallbladder polyp
Authors: Cho Sung Hoon , Han Young Seok , Han Ja Ryung , Kwon Hyung Jun , Choi Seock Hwan , Kim Hyun Tae , Han Man-Hoon , Chun Jae Min
Published: January 2021

Rationale:

Gallbladder polyps are common in the general population, but gallbladder metastasis of renal cell carcinoma (RCC) is very rare. In a patient with RCC diagnosed with a small gallbladder polyp that does not meet the traditional size criteria, the surgeon faces a dilemma of whether cholecystectomy should be performed given the possibility of metastasis.

Patient concerns:

A 55-year-old man who had received a left nephrectomy for RCC presented with a gallbladder polyp that was noted at the time of the nephrectomy. Imaging showed the maximum diameter of the polyp had increased from 5 mm to 24 mm in the 40 months after the initial diagnosis.

Diagnosis:

Pathological and immunohistology findings confirmed the gallbladder polyp as a metastasis of clear-cell RCC.

Interventions

: We performed a laparoscopic cholecystectomy.

Outcomes:

Even though the synchronous solitary gallbladder metastasis was left untreated and a cholecystectomy was not performed over the 40 months, no metastasis occurred in other sites. The patient is free from disease 10 months after the cholecystectomy.

Lessons:

Solitary gallbladder metastasis of RCC may have more favorable outcomes than typical metastases. Although gallbladder metastasis of RCC occur rarely, it can occur, and any changes in gallbladder polyps in RCC patients should be managed under a strong suspicion of metastasis.
Prognostic value of lymphocyte-to-monocyte ratio previously determined to surgery in patients with non-metastatic renal cell carcinoma
Authors: Garcia-Rojo Dario , Prera Angel , Muñoz-Rodriguez Jesus , Oliva Joan Carles , Dominguez Arturo , Prats Joan
Published: January 2021

Background:

The prognostic value of pretreatment lymphocyte to monocyte ratio in patients with renal cell carcinoma and, especially, in non-metastatic patients remains controversial.

Methods:

We conducted a PRISMA-compliant meta-analysis to systematically assess the prognostic value of LMR in patients with non-metastatic RCC. Overall survival, cancer-specific survival, and disease-free survival were analyzed. Pooled hazard ratios and 95% confidence intervals were calculated.

Results:

Seven studies comprising 4666 patients were included in the analysis. Unlike those observed in a previous meta-analysis, a lower lymphocyte to monocyte ratio was associated with poorer cancer-specific survival (fix-effect model, hazard ratio 3.04, 95% confidence intervals 2.05–4.51, P < .05). Heterogeneity Chi-squared value Q exp = 0. (P = .82) (I2 = 0%). However, the association between a low lymphocyte to monocyte ratio and overall survival or disease-free survival did not obtain significance.

Conclusion:

A lower lymphocyte to monocyte ratio implied poor cancer-specific survival in patients with non-metastatic renal cell carcinoma. Prospective studies are required to confirm our findings.

Registration number:

ClinicalTrials.gov (identifier: NCT04213664)
Efficacy and safety of Reyanning mixture combined with conventional Western medicine for treating COVID-19
Authors: Li Yajuan , Zhang Jingxia , Li Shasha , Li Fan , Zhao Chongbo , Li Fang , Wang Weifeng , Wang Wei
Published: January 2021

Background:

Since its first report in December 2019, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly emerged as a pandemic affecting nearly all countries worldwide. So far, there is no specific anti-coronavirus therapy approved for the treatment of COVID-19. In China, some traditional Chinese medicines (TCM) have been successfully applied to the treatment of SARS-CoV-2 and have achieved good clinical results, including the Reyanning mixture, but there is no systematic review about it. This study will systematically evaluate its efficacy and safety in the treatment of COVID-19.

Methods:

The following electronic bibliographic databases will be searched to identify relevant studies: PubMed, MEDLINE, EMBASE, CNKI, CBM, and Wanfang databases. We will use the Cochrane Handbook for Systematic Reviews of Interventions to assess the risk of bias. The protocol will be conducted according to the approach and Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Manager 5.3 software and STATA 16.0 software were used to perform the meta-analysis.

Results:

The systematic review and meta-analysis aims to review and pool current clinical outcomes of Reyanning mixture for the treatment of COVID-19.

Conclusion:

The conclusion of this review will provide evidence to judge whether Reyanning mixture combined with Conventional Western Medicine is an effective and safe intervention for COVID-19.

INPLASY registration number:

INPLASY2020120044.
Community-level socioeconomic status and outcomes of patients with out-of-hospital cardiac arrest
Authors: Lee Sanghun , Ahn Ki Ok , Cha Myeong-il
Published: January 2021

Background:

The aim of this systematic review and meta-analysis was to investigate the associations of community-level socioeconomic status (SES) on outcomes of patients with out-of hospital cardiac arrest (OHCA).

Methods:

A systematic literature review was conducted using PubMed, EMBASE, and the Cochrane database according to guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We included literature that presented the outcomes based on community-level SES among patients with OHCA. SES indicators included economic indicators such as income, wealth, and occupation, as well as combined indicators, where any of these indicators were integrated. Outcomes were bystander cardiopulmonary resuscitation (CPR) and survival to discharge.

Results:

From 1394 titles, 10 cross-sectional observational studies fulfilled inclusion and exclusion criteria, representing 118,942 patients with OHCA. The odds ratios (ORs) of bystander CPR and survival to discharge for lower community-level SES patients were lower than those for higher community-level SES by economic SES indicators (bystander CPR OR 0.67; 95% CI 0.51–0.89, survival to discharge OR 0.60; 95% CI 0.35–1.02). Based on combined SES indicators the results showed similar patterns (bystander CPR OR 0.80; 95% CI 0.75–0.84, survival to discharge OR 0.76; 95% CI 0.63–0.92).

Conclusion:

In this meta-analysis, community-level SES was significantly associated with bystander CPR and survival among patients with OHCA.
Analysis of risk factors and construction of prediction model of drop out from peritoneal dialysis
Authors: Li Li , Pei Hualian , Liu Zhenhui , Zhang Jingjing
Published: January 2021

This study is to investigate the risk factors for the drop out from peritoneal dialysis.

We retrospectively analyzed patients who underwent catheterization between January 1, 2009 and September 30, 2019. The follow-up period ended on November 30, 2019. End point events were the cessation of peritoneal dialysis, including death, conversion to hemodialysis, and kidney transplantation. Kaplan–Meier method was used to analyze peritoneal dialysis curve. Significant factors were included in the multivariate Cox proportional hazards model. Calibration curve was plotted.

A total of 377 patients were included in this study. The dropout rate of peritoneal dialysis was 41.38%. The main drop out reason was conversion to hemodialysis, accounting for 41.67% of the total number of drop out, followed by kidney transplantation (28.21%) and death (25%). According to multivariable Cox proportional hazards model analysis, the medium education level (hazard ratio (HR): 2.53, 95% confidence interval (CI): 1.08–5.91, P = .03), high education level (HR: 2.47, 95% CI: 1.03–5.93, P = .04), diabetes (HR: 1.87, 95% CI: 1.24–2.83, P < .03), hypertension (HR: 2.40, 95% CI: 1.64–3.51, P < .01), repeated peritonitis (HR: 5.18, 95% CI: 3.04–8.80, P < .01), and repeated chest complications (HR: 4.98, 95% CI: 2.79–8.89, P < .01) were independent risk factors for dropping out from peritoneal dialysis, while the number of hospitalizations after catheterization (HR: 0.94, 95% CI: 0.89–0.98, P = .01) was protective factor for maintenance of peritoneal dialysis. The C index of the prediction model was 0.74.

Higher education level, diabetes, hypertension, repeated peritonitis, and repeated chest complications were the risk factors of dropping out from peritoneal dialysis, while higher number of hospitalizations after catheterization was a protective factor for the maintenance of peritoneal dialysis. The nomogram could predict the probability of dropping out from peritoneal dialysis.
Prevalence and factors of compassion fatigue among nurse in China
Authors: Jin Man , Wang Jialin , Zeng Li , Xie Wanqing , Tang Ping , Yuan Zhongqing
Published: January 2021

Background:

Compassion fatigue is defined as a detrimental consequence of experiencing work-related stress among nurses, which can affect the job performance and harm emotional and physical health. The high risk of compassion fatigue among nurses may be even more severe in China. Although several studies have explored the prevalence and factors of compassion fatigue among Chinese nurses, most data derived merely from the specialty units of the hospital or limited samples, and there is a large heterogeneity among studies. Thus, it is indispensable to systematically summarize the risk factors and prevalence of compassion fatigue among clinical nurse in China.

Methods:

Two reviewers will independently conduct comprehensively searches in 9 electronic databases including PubMed, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Web of science, MEDLINE, China National Knowledge Infrastructure (CNKI), WanFang and Chinese Biological Medical Database (CBM) with no search date restriction. Cross-sectional and prospective cohort studies that described the prevalence and factors of Chinese nurses compassion fatigue will be eligible for inclusion. The risk of bias and methodological quality of individual study will be assessed using an adapted quality assessment tool from the Agency for Healthcare Research and Quality (AHRQ). Stata 16.0 software will be used for meta-analysis.

Results:

The primary outcome will be the prevalence of 3 dimension of compassion fatigue in Chinese nurses. The secondary outcomes will be comparisons of compassion fatigue scores among Chinese nurse of different education background, marital status, employment forms and professional titles.

Conclusion:

This overview will contribute to reveal the prevalence and influencing factors in compassion fatigue among Chinese nurses and provide a scientific evidence for the prediction and prevention in compassion fatigue.

Registration number:

The registration DOI is 10.17605/OSF.IO/V34X6.
Hypertension in a patient with medullary sponge kidney
Authors: Wu Fengyuan , Zhang Ying , Cheng Yunpeng , Lu Yan , Jiang Yinong , Song Wei
Published: January 2021

Rationale:

Medullary sponge kidney (MSK) is a congenital renal disorder characterized by recurrent nephrolithiasis or nephrocalcinosis. Recently, it has been found that MSK can be also combined with other diseases, such as primary aldosteronism and Beckwith-Wiedemann, but whether it is associated with secondary hypertension remains unknown.

Patient concerns:

A 22-year-old hypertensive female presented to our hospital characterized by hypokalemia and hypertension.

Diagnosis:

The laboratory examination showed secondary aldosteronism. And the common causes for secondary aldosteronism include renal artery stenosis, glomerulonephritis, lupus nephropathy, and diabetic nephropathy, all of which were excluded except MSK.

Interventions:

She was treated with angiotensin-converting enzyme inhibitors.

Outcomes:

Her blood pressure, serum potassium, and plasma renin levels were reversed after treatment with angiotensin-converting enzyme inhibitors.

Lessons:

We presumed that MSK may be associated with secondary hypertension, and the mechanism may be the activation of the renin-angiotensin-aldosterone system.
Nasopharyngeal papillary adenocarcinoma harboring a fusion of ROS1 with GOPC
Authors: Wang Jinjing , Luo Shuai , Li Yao , Zheng Hong
Published: January 2021

Rationale:

Nasopharyngeal papillary adenocarcinoma is a region-specific tumor originating from the nasopharyngeal surface epithelium. Owing to its rarity, more attention has been paid to its clinicopathologic features, while little effort has been made to study the gene abnormalities that drive this tumor. We describe the first case of nasopharyngeal papillary adenocarcinoma harboring a fusion of ROS1 with GOPC.

Patient concerns:

A 22-year-old female patient was diagnosed with nasopharyngeal papillary adenocarcinoma in our hospital, and she had right nasal obstruction for more than 6 months. Nasal endoscopy revealed a mass on the posterior roof of the nasopharynx.

Diagnoses:

Immunohistochemical staining showed that the tumor cells were diffusely positive for transcription termination factor 1, vimentin, CK19, glypican-3, and CK7, and negative for melanocyte, CK5/6, CK20, P53, P63, S100, smooth muscle actin, p16, PAX8, and thyroglobulin. The Ki-67 index was approximately 5%; EBV-encoded small nuclear RNA was negative.

Interventions:

The tumor was completely excised on endoscopy with a negative surgical margin.

Outcomes:

No sign of recurrence was observed during the 3-year follow-up period.

Lessons:

Owing to its rarity, pathologists should be aware of this unusual neoplasm to avoid misdiagnosis. Further studies are needed to further characterize the relationship between ROS1-GOPC fusion and the pathogenesis of this carcinoma and its response to tyrosine kinase inhibitors in relapsed cases.
Metachronous primary colon and periampullary duodenal cancer
Authors: Li Tao , Wang Xinyu , Chen Chen , Song Xiaobin , Li Jiannan , Zhao Zeyun , Zhang Nan , Li Wei , Zhang Kai , Liu Tongjun
Published: January 2021

Rationale:

Primary periampullary duodenal cancer accounts for 3% to 17% of periampullary cancers. There are no previous reports of metachronous primary colon and periampullary duodenal cancer.

Patient concerns:

We present a case of primary periampullary duodenal cancer that occurred metachronously after colon cancer.

Diagnoses:

Imaging and endoscopic examinations, serum tumor marker levels, and pathology confirmed metachronous colon and periampullary duodenal cancer, with 14-month interval between the diagnoses of the 2 malignancies.

Intervention:

The patient received right hemicolectomy combined with mFOLFOX6 chemotherapy for colon cancer and pancreatoduodenectomy for periampullary duodenal cancer.

Outcomes:

The patient has been followed up for 6 years since the pancreatoduodenectomy and shows no signs of recurrence or metastasis.

Lessons:

The risk of developing a second malignancy may be associated with the site of the first tumor. Patients with right colon cancer may have particularly high risk of developing small intestinal cancer, including duodenal cancer. Early detection and active surgical treatments can improve prognosis. Long-term regular follow-up is necessary to detect new malignancies occurring after the diagnosis colon cancer.
Almonertinib-induced interstitial lung disease
Authors: Jiang Ting , Luo Yiyang , Wang Binbin
Published: January 2021

Rationale:

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) have elicited favorable anti-tumor activity in non-small cell lung cancer especially the lung adenocarcinoma. Interstitial lung disease (ILD) is 1 of the fatal side effects of EGFR-TKIs. However, such type of side effect has not been observed in the follow-up during the treatment of the third-generation EGFR-TKI Almonertinib (also called HS-10296). Here, we first report an Almonertinib-induced ILD in an elderly female patient.

Patient concerns:

A 70-year-old female diagnosed with “ lung adenocarcinoma with intracranial metastasis” harboring a mutation of EGFR 19DEL was administrated with Almonertinib 110 mg orally as the first-line treatment. However, she presented with chest tightness, and shortness of breath, accompanying with paroxysmal dry cough 3 months after the initiation of Almonertinib.

Diagnoses:

Extensive relevant examinations did not provide conclusive results and the chest computed tomography showed a diffuse ILD in bilateral pulmonary.

Interventions:

The patient was diagnosed with Almonertinib-induced ILD in the absence of no other potential causes. She discontinued Almonertinib and was treated with oxygen uptaken and methylprednisolone.

Outcomes:

The whole symptoms were eliminated and the chest computed tomography showed ILD got remission after the prescription of methylprednisolone.

Lessons:

Almonertinib has potential to cause the rare but severe interstitial lung disease. Clinicians should keep cautious of this when prescribing Almonertinib.
Efficacy and safety of traditional Chinese patent medicine on carotid artery atherosclerosis in adults
Authors: Sun Huiqing , Qu Wei , Chen Guangjia , Sun Xiaonan , Zhang Deqing , Shao Shichuan
Published: January 2021

Background:

Atherosclerosis (AS), the predominant pathological basis of ischemic cardiovascular and cerebrovascular diseases, remains a common and severe clinical problem. The experiments in vitro and in vivo indicate that Traditional Chinese patent medicine (TCPM) shows beneficial efficacy against AS through a variety of mechanisms. However, the existing therapeutic TCPM for the treatment of AS are diverse, and it is still significant to evaluate the pros and cons of a certain TCPM. Therefore, the study aims to compare the efficacy and outcomes of different anti-atherosclerotic TCPM in adults with the hope of providing references for clinical decision making.

Methods:

Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure Database, Wanfang Database, Chinese BioMedical Literature Database, and China Science and Technology Journal Database will be searched. Randomized controlled trials (RCTs) of TCPM for aortic AS in adults will be included in this study if they meet the Population/Intervention/Comparison/Outcomes/Study Design (PICOS) criteria. Two reviewers will independently perform citations screening, data extraction and risk of bias assessment. STATA 15.0 and WinBUGS 1.4.3 will be employed to conduct statistical analyses under the Bayesian framework.

Results:

The efficacy and safety of various TCPM strategies on aortic AS in adults will be compared.

Conclusion:

The study will expand the range of options for anti-atherosclerotic therapeutic strategies and encourages further clinical research in traditional Chinese medicine.

INPLASY registration number:

INPLASY2020120036.
Graft-Versus-Host-Disease of the Central Nervous System and Lung in a Patient With Acute Myeloid Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation: A Case Report
Authors: Li Zhihui , Wen Xiaopei , Geng Yanping , Wu Tong
Published: January 2021

Introduction:

The common etiology of central nervous system (CNS) complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT) includes CNS infection, metabolic abnormalities, drug toxicity, cerebrovascular events, Epstein-Barr virus–associated posttransplant lymphoproliferative diseases, and hematologic CNS relapse of leukemia. Although graft-versus-host disease (GVHD) is a major complication of allo-HSCT, its CNS involvement is exceedingly rare.

Case Presentation:

In this report, we describe a patient who exhibited acute myeloid leukemia with t(8;21) (q22;q22) and who suddenly lost visual acuity ~1 year after receipt of allo-HSCT. Given the observation of negative cerebrospinal fluid findings, cyclosporine-related encephalopathy, intracranial hemorrhage, CNS infection, leukemia recurrence, and tumors were excluded. He was diagnosed with both CNS and pulmonary GVHD. After steroid treatment, the lesions gradually reduced in images acquired via cranial and pulmonary computed tomography.

Conclusions:

CNS-GVHD is a rare, serious complication of allo-HSCT that is difficult to diagnose. Biopsy and autopsy may identify the CNS as the target of GVHD in some patients. Treatment is mainly based on the use of immunosuppressive drugs, including high doses of steroids. Early diagnosis and treatment can improve disease outcome.
Venetoclax and Decitabine in Pediatric Refractory T-cell Lymphoblastic Lymphoma
Authors: Baig Muhammad U. , Rytting Michael , Roth Michael , Morani Ajaykumar C. , Nunez Cesar , Lin Pei , Cuglievan Branko
Published: January 2021

Background:

Overall survival of adolescents with relapsed T-cell lymphoblastic lymphoma (T-LL) remains poor with limited options for salvage therapy. The BCL-2 inhibitor venetoclax combined with hypomethylating agents like decitabine, has shown favorable responses in elderly patients with acute myeloid leukemia.

Observation:

We present the case of a 19-year-old adolescent with stage III relapsed and refractory T-LL who did not respond to 3 lines of salvage therapy. The patient was treated with venetoclax and decitabine and achieved a dramatic response.

Conclusion:

This case highlights the potential clinical activity of venetoclax and decitabine in relapsed T-LL.
Homicide by Unspecified Means
Authors: Krywanczyk Alison , Gilson Thomas
Published: January 2021

The diagnosis homicide by unspecified means (HUM) is used to categorize deaths occurring under suspicious or criminal circumstances, but a specific cause of death cannot be identified. In 2010, Matshes and Lew (Am J Forensic Med Pathol. 2010;31(2):174–177) presented a HUM cases series, from which they derived 5 diagnostic criteria; however, the accuracy of these criteria has not been assessed.

To identify a validation cohort, Cuyahoga County Medical Examiner's Office records were searched from 2008 to 2019 for cases certified as HUM. Thirteen cases were identified; on review, all cases fulfilled criteria 1, 4, and 5. Only 1 case had a potential anatomic cause of death identified (criterion 2).

However, in 3 cases, toxicologic analyses could not be conducted because of skeletonization; in 2 cases, the decedents tested positive for cocaine/benzoylecgonine but were found in proximity to other victims for whom a specific violent cause of death was determined. By strict reading of criterion 3, these cases would have been excluded from the diagnosis of HUM. Perpetrators confessed to homicide in 7 cases, including the 5 cases that failed the toxicologic criterion. The 2010 diagnostic criteria are a reasonable foundation for the determination of HUM; modification of criterion 3 would provide improved flexibility based on clinical judgment.