bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness and safety of reduced-port laparoscopic surgery vs conventional multi-port laparoscopic surgery in the treatment of gastric diseases
Authors: Yang Xu , Bu Zhaoting , He Maoqin , Lin Yue , Jiang Yuting , Chen Da , Liu Kaibing , Zhou Jun
Published: January 2021

This study aimed to compare the effectiveness and safety of reduced-port laparoscopic surgery (RPLS) and conventional multi-port laparoscopic (CMPLS) surgery in the treatment of gastric diseases.

The PubMed, Embase, Cochrane Library, Web of Science, and Chinese Biomedical Literature databases were systematically searched for randomized controlled trials, cohort studies, and case control studies on the use of RPLS vs conventional multi-port laparoscopic surgery in treating gastric diseases from their inception until March 10, 2019. The evaluated outcomes were the operative time, blood loss, length of hospital stay, number of dissected lymph nodes, postoperative complications, and conversions. All of these were compared using Stata software version 12.0.

A total of 18 studies were included, which involved 2938 patients. In studies referring to the comparison between RPLS and CMPLS in treating gastric diseases, the former showed significantly inferior in terms of operative time (P = .011) and number of dissected lymph nodes (P = .031); but superior results in terms of the estimated blood loss (P = .000) and length of hospital stay (P = .001) than the latter did; however, the rates of postoperative complications (P = .830) and conversions (P = .102) were not statistically significant between the 2 groups.

RPLS and CMPLS showed comparable effectiveness and safety in the treatment of gastric diseases in our meta-analysis. Based on the current evidence, we believe that RPLS is an efficacious surgical alternative to CMPLS in the management of gastric diseases because of the shorter hospital stay and reduced blood loss. However, large-scale, well-designed, multicenter studies are needed to further confirm the results of this study.
New insights into erythropoietin and erythropoietin receptor in laryngeal cancer tissue
Authors: Vukelic Jelena , Dobrila-Dintinjana Renata , Marijic Blazen , Marzic Diana , Braut Tamara , Velepic Marko
Published: January 2021

To investigate whether laryngeal cancer cells express erythropoietin (Epo) and erythropoietin receptor (EpoR) and what is their possible relationship with clinical and pathological features of the tumor.

We performed immunohistochemical analysis of Epo and EpoR expression on 78 tissue samples of invasive and in situ squamous cell laryngeal carcinoma.

The statistical analysis showed a weak positive and statistically significant correlation of EpoHS and EpoR HS expression levels. Epo HS and EpoR HS levels did not correlate with patient sex or age, type of diagnosis, cancer stage, histological tumor grade, presence or absence of disease recurrence, type of oncologic cancer therapy provided, or results of selected laboratory blood work. The results show a statistically significant difference in Epo expression with respect to survival.

We confirmed the presence of Epo an EpoR in malignant laryngeal tumors and demonstrated the correlation between Epo expression and survival. Further studies are needed to more precisely define the role of Epo and EpoR in treatment of patients with laryngeal cancer.
Efficacy and safety of thyroxine therapy on patients with heart failure and subclinical hypothyroidism
Authors: Shi Hongshuo , Kan Zunqi , Liu Yufan , Li Wenwen , Peng Min , Yang Tiantian
Published: January 2021

Background:

Subclinical hypothyroidism (SCH) can increase the risk of heart failure (HF) clinically. However, thyroxine therapy for patients with HF and SCH has the risk of developing tachyarrhythmias. At present, there is no sufficient evidence-based medical evidence for levothyroxine in the therapy of this situation, and the treatment issue is still controversial. Therefore, our meta-analysis aims to assess the effectiveness and safety of thyroxine therapy for patients with HF and SCH.

Methods:

We searched the related randomized controlled trials that have been published in the following 7 electronic databases: PubMed, Cochrane Library, EMBASE, Chongqing VIP, China National Knowledge Infrastructure, Chinese biomedical literature database, and Wan Fang database. The treatment group was treated with routine HF therapy plus thyroxine, while the control group was treated with HF routine therapy. Main outcome measures effective rate and New York Heart Association classification; Secondary outcome measures included: left ventricular ejection fraction, quality of life score, brain natriuretic peptide / N-terminal pro brain natriuretic peptide, 6-minute walk test, and adverse events. After screening studies and extracting data, we will use Cochrane collaborative tools to evaluate the risk of bias to assess the methodological quality of the included randomized controlled trials. We will use STATA 14.0 software for data synthesis and statistical analysis. Both subgroup analysis and sensitivity analysis will be used to detect potential sources of heterogeneity. In addition, we will use sensitivity analysis to test the stability of the outcomes. If possible, we will perform a funnel chart and Eggers test evaluate publication bias. The quality of the evidence will be evaluated through the grades of recommendations assessment, development, and evaluation system.

Results:

Our findings will be published in peer-reviewed journals.

Conclusion:

This research will provide evidence about the efficacy and safety of thyroxine in the treatment of patients with HF and SCH. Objective to provide evidence-based medicine basis for thyroxine treatment of patients with SCH and HF.

Registration number:

INPLASY2020100062.
Efficacy and safety of traditional Chinese medicine decoction combined with chemotherapy in the treatment of advanced colorectal cancer
Authors: Liao Shufan , Jia Xue-li , Yang Yan , Sun Yu-xiang , Gong Si-miao , Li Min
Published: January 2021

Background:

Colorectal cancer has become a major chronic and difficult disease endangering human health. After thousands of years of precipitation, traditional Chinese medicine in China is now also being applied in clinical treatment, with its unique advantages in the treatment of cancer. However, the efficacy of traditional Chinese medicine in the treatment of advanced colorectal cancer still cannot reach consensus in the world. Therefore, the aim of this study was to provide a scheme to evaluate the efficacy and safety of traditional Chinese medicine decoction in the treatment of advanced colorectal cancer, thus providing clinical decision-making.

Methods and analysis:

The systematic review and meta-analysis will be conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The following 8databases will be searched: China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Wan Fang Data, the Chinese Science and Technology Periodical Database (VIP), PubMed, Cochrane Library, Embase, and Web of Science. Relevant data will be performed by Revman 5.3 software provided (Cochrane Collaboration) and Stata 14.0 statistical software.

Results:

The results of this systematic review and meta-analysis will be published in a peer-reviewed journal.

INPLASY registration number:

INPLASY202080102.
Was femoral nerve block effective for pain control of medial opening-wedge high tibial osteotomy?
Authors: Ren Yi-Ming , Tian Meng-Qiang , Duan Yuan-Hui , Sun Yun-Bo , Yang Tao , Hou Wei-Yu , Xie Shu-Hua
Published: January 2021

Background and Purpose:

Medial compartment femoro–tibial osteoarthritis (OA) is a common disease and opening-wedge high tibial osteotomy (OWHTO) is the common surgical procedure carried out for these patients. While most researchers are focusing on the surgical techniques during operation, the aim of this study is to evaluate the pain control effect of femoral nerve block (FNB) for OWHTO patients.

Methods:

In this prospective, single-center, randomized controlled trial (RCT) study, 41 patients were operated on by OWHTO for OA during 2017 to 2018. Twenty of them (group A) accepted epidural anesthesia with FNB and 21 patients (group B) only had their single epidural anesthesia. All blocks were successful and all the 41 patients recruited were included in the analysis and there was no loss to follow-up or withdrawal. Systematic records of visual analog scores (VAS), quadriceps strength, mean number of times of patient-controlled intravenous analgesia (PCIA), using of additional opioids or nonsteroidal anti-inflammatory drugs (NSAIDs), and complications were done after hospitalization. The Student t test and Chi-Squared test was used and all P values ≤.05 were considered statistically significant.

Results:

VAS scores at rest (3.48 ± 1.0 vs 4.68 ± 1.1) and on movemment (4.51 ± 0.6 vs 4.97 ± 0.8) decreased more in group A than group B with significance at follow-up of 12 hours. The quadriceps strength, consumption of additional opioids or NSAID injections and mean number of times that the patients pushed the PCIA button didnot differ significantly within each group.

Conclusion:

This RCT study shows that FNB in patients undergoing OWHTO for unicompartmental osteoarthritis of the knee could result in significant reduction in VAS scores at 12 hours postoperatively.

Research registry, Researchregistry4792. Registered April 7, 2019 - Retrospectively registered, http://www.researchregistry.com.
Electromagnetic Navigation Bronchoscopy Combined Endobronchial Ultrasound in the Diagnosis of Lung Nodules
Authors: Wang Nan , Ma Haitao , Huang Haitao , Feng Yu
Published: January 2021

Electromagnetic navigational bronchoscopy (ENB) combined with a radial endobronchial ultrasound probe realizes a combination of magnetic navigation and ultrasound imaging, allowing for the accurate navigation of peripheral lung lesions in real time during surgery. ENB has been evaluated in many studies. However, a comparative report on the feasibility of ENB combined radial endobronchial ultrasound diagnosis in different density lung nodules was small, and few of these studies have reported long-term follow-up results to exclude false negative results. The aim of this study is to explore the applicability of ENB combined radial endobronchial ultrasound in the diagnosis of lung nodules with different densities.

Patients underwent biopsy in our medical center from 2016-09 to 2019-03 were divided into 2 groups: the solid nodule group and the subsolid pulmonary nodule group. We collected and analyzed the diagnostic accuracy, the diagnostic yield, the false negative rate and the incidence of complications between these 2 groups.

A total of 37 lesions in 25 patients were biopsied, 14 lesions were subsolid pulmonary nodules and 23 were solid nodules. The diagnostic accuracy (success rate to obtain meaningful pathology tissues) was 34/37 (91.8%). Lost to follow-up in 1 case and three cases were undiagnosed. After at least 12 months of follow-up, the total diagnostic yield (true positive rate+ true negative rate) was 27/36 (75%) (P = .006). The false negative rate was 9/19 (47.3%) (P = .26). Complications occurred in 1/36 (2.7%) lesions. For the subsolid pulmonary nodule group, the diagnostic accuracy was 13/14 (92.8%) and the diagnostic yield was 7/14 (50%). For the solid nodule group, the diagnostic accuracy was 21/23 (91.3%), and the diagnostic yield was 20/22 (90.9%).

Electromagnetic navigational bronchoscopy combined with radial endobronchial ultrasound in peripheral lung nodule biopsies is safe and effective, especially for solid nodules, but the diagnostic yield in subsolid nodule biopsies remains to be improved.
Adnexal torsion in pregnancy after in vitro fertilization
Authors: Yu Meiling , Liu Yanhong , Jia Dongyun , Tian Tian , Xi Qi
Published: January 2021

Rationale:

Torsion is the most common gynecologic emergency of the adnexal mass occurring during pregnancy. We report the clinical data of a case of twin pregnancy with adnexal torsion after in vitro fertilization (IVF) and embryo transfer, in which the patient underwent surgery for adnexal detorsion and experienced preterm delivery. One child died as a neonate, and the other child was diagnosed with hematological disease, which, to our knowledge, has not been reported previously. We also performed a systematic literature review to increase knowledge of the need for prompt surgical intervention.

Patient concerns:

The patient was a 32-year-old pregnant woman, who presented to our center with acute onset of stabbing and non-radiating continuous lower left abdominal pain after urination, of 6 hours duration.

Diagnosis:

Physical examination revealed that the lower abdominal tenderness was worse on the left side, and there were no signs of peritonitis. Transvaginal ultrasonographic examination indicated a multiloculated left ovary measuring 12.1 × 7.1 cm with sparse blood flow. The size of the largest cyst was 7.2 × 6.6 cm, the right ovary appeared normal, and two live fetuses were seen.

Interventions:

laparoscopy was performed 1.5 hours later, which revealed a cystic and multilocular left ovary with a black purplish surface and thin wall. The left ovary and left fallopian tube had undergone 720° torsion (3 rotations), and detorsion was performed laparoscopy.

Outcomes:

The left adnexa recovered to near normal appearance 20 minutes postoperatively. The patient was discharged from hospital 5 days postsurgery, without complications. Unfortunately, the patient delivered two preterm babies at 30 weeks of gestation.

Conclusions:

We should be alert to the possible risk of adnexal torsion in pregnant women after IVF. Adnexal torsion necessitates prompt surgical intervention, detorsion and preserving ovarian function are the main treatment methods. Furthermore, the possibility of recurrence, and pregnancy outcomes for the patient, as well as newborn health, should be considered.
Symptomatic postoperative discal pseudocyst following percutaneous endoscopic lumbar discectomy
Authors: Li Junjie , Liang Shuhan , Xie Wei , Luo Jinxin , Tang Jin , Liu Liu , Li Ying , Wu Congjun , Li Xugui
Published: January 2021

Rationale:

Percutaneous endoscopic lumbar discectomy (PELD) is an effective treatment for lumbar disc herniation and postoperative discal pseudocyst (PDP) can rarely develop after PELD.

Patient concerns:

A 30-year-old man experienced low back pain and pain in the right lower extremity for 1 month, which aggravated for 3 days.

Diagnoses:

Preoperative CT and MRI showed lumbar disc herniation at the L4/5 level. Then the patient underwent PELD under local anesthesia and his symptoms disappeared immediately after surgery. After 37 days of PELD, the patient complained of recurrent low back pain on the right side, and pain on the outer side of his lower leg. MR imaging revealed cystic mass with low signal on T1-weighted images (T1WI), and high signal on T2-weighted images (T2WI). The patient was diagnosed with a symptomatic PDP after PELD.

Interventions:

Initially, the patient was treated with conservative treatment, including administration of aescin and mannitol by intravenous infusion, physical therapy, sacral canal injection. Then he underwent discography at L4/5 and ozone ablation under local anesthesia.

Outcomes:

The patient's condition improved significantly after 1 week of surgery and was discharged. One-year and 3-month follow-up revealed no recurrence of low back pain and leg pain.

Lessons:

PDP is one of the rare complications of PELD, usually occurs in young patients. Patients with PDP have a low signal intensity on T1WI and high signal intensity on T2WI, which can be treated by conservative treatment, interventional therapy, and surgical treatment.
Primary diffuse large B-cell lymphoma of the fallopian tube treated with a combination of surgery and chemotherapy
Authors: Zhou Ye , Zhang Chao , Gong Yingying , Yang Linqing , Wang Yunfei
Published: January 2021

Rationale:

Primary female genital tract lymphomas are sporadic neoplasms, accounting for 0.2% to 1.1% of all cases of extranodal lymphoma. The most common genital localizations are the cervix, the uterine corpus and the ovary, while primary lymphomas of the fallopian tube are quite unusual. According to literature searching in PubMed, this is the first reported case of primary diffuse large B-cell lymphoma of the fallopian tube.

Patient concerns:

A 52-year-old woman presented with a more than 2 months history of intermittent lower abdominal pain. The gynecological examination showed that the uterus, as big as 3 months of pregnancy, had weak activity and no tenderness. The uterine rectum lacuna was like a hard nodule of about 3 × 2 cm, and an irregular solid mass was fixed and inactive in the right adnexa.

Diagnoses:

In accordance with Ann Arbor staging system, a stage IE primary diffuse large B-cell lymphoma of fallopian tube was diagnosed for this patient, based on the tumor pathology, the results of bone marrow biopsy and computed tomography (CT) scan.

Interventions:

After gynecological/urinary ultrasound, blood test, pelvic contrast enhanced CT scan and CT angiography of iliac artery, exploratory laparoscopy and following hysterectomy with bilateral salpingo-oophorectomy were performed. After the surgery, the patient was treated with combined Rituximab and chemotherapy and got complete response (CR).

Outcomes:

After the operation and R-CHPOP, following up for more than 1 year so far, the patient has no tumor recurrence and is still in good condition.

Lessons:

It is very difficult to diagnose the primary diffuse large B-cell lymphoma of fallopian tube, not only because of its rarity, but also because of its non-specific clinical manifestations. It easily be treated as late ovarian cancer by gynecologist. So the pathology diagnosis and surgeons’ decision is very important. Because lymphoma is pretty sensitive to chemotherapy and easy to get complete response, so we no need to do an operation like ovarian cancer and should put chemotherapy as a primary method for lymphomas of the female genital tract.
Associations between adolescents’ earphone usage in noisy environments, hearing loss, and self-reported hearing problems in a nationally representative sample of South Korean middle and high school students
Authors: Byeon Haewon
Published: January 2021

Few epidemiological studies have examined the relationship between earphone usage and hearing loss in adolescents. This study identified the prevalence of hearing loss in South Korean adolescents using representative national survey data and evaluated the relationship between earphone usage in a noisy environment and hearing loss. This study analyzed 532 subjects (12–19 years) who participated in a 2012 national survey and completed health and noise environment exposure questionnaires and pure tone audiometry (PTA) test. Hearing loss was defined as an average hearing threshold of 26 Decibel-A (dBA) or higher in PTA. The relationship between earphone usage and hearing loss was analyzed using a hierarchical logistic regression model. Adolescents who were exposed to high noise levels via headphones in a noisy environment had a hearing loss prevalence of 22.6% and adolescents who used earphones 80 minutes or more per day on average had the hearing loss prevalence of 22.3%. The results of the logistic regression analysis revealed that adolescents who used earphones in a noisy environment had a 4.5-fold higher risk of hearing loss and an 8.4 times higher risk of having a subjective hearing problem than those who did not use earphones (prevalence odds ratio (pOR) = 4.54, 95% confidence interval (CI): 1.35–15.24; pOR = 8.39, 95% CI: 1.12–62.83, respectively). Additionally, adolescents who used earphones more than 80 minutes per day in a noisy environment had a 4.7 times higher risk of hearing loss than those who used them less than 80 minutes per day (pOR = 4.68, 95% CI: 1.08–20.22). Longitudinal studies are needed to provide evidence of causality between earphone usage and hearing loss.
Fecal calprotectin as a noninvasive test to predict deep remission in patients with ulcerative colitis
Authors: Malvão Ludimilla dos Reis , Madi Kalil , Esberard Barbara Cathalá , de Amorim Renata Fernandes , Silva Kelly dos Santos , Farias e Silva Katia , de Souza Heitor Siffert Pereira , Carvalho Ana Teresa Pugas
Published: January 2021

Mucosal healing (MH) has become a major target in the management of ulcerative colitis (UC). Because repeat endoscopy is expensive and invasive, we aimed to evaluate fecal calprotectin (FC) as an alternative marker to predict MH in UC.

Eighty patients with UC in clinical remission were consecutively included in a prospective observational study. FC was measured using a quantitative enzyme-linked immunosorbent assay. The colonic mucosa was assessed for endoscopic and histological measures of inflammatory status. Endoscopic and histological remission were defined according to the Mayo endoscopic subscore (MES) and Geboes score (GS), respectively. Deep remission was defined as a combination of the MES and GS. FC performance and cutoff values for identifying MH and deep remission were determined using contingency tables and receiver operator characteristic (ROC) and area under the curve (AUC) analysis.

The median FC concentration in patients who met the criteria for deep remission (MES ≤1 and GS < 3.1) was 65.5 μg/g, while that in patients with disease activity was 389.6 μg/g (P = .025). A FC cutoff value of 100 μg/g, determined by the ROC analysis, resulted in sensitivity and specificity of 91.7% and 57.1%, respectively, for histological remission, and 82.4% and 60.9%, respectively, for deep mucosal remission. Positive correlations were detected between FC concentrations with the histologic (CC: 0.435; P < .001) and the combined endoscopic and histologic (CC: 0.413; P < .001) scores.

FC can be used confidently as a noninvasive biomarker to predict deep remission in patients with UC in clinical remission when concentrations are below 100 μg/g.
Wuhan mobile cabin hospital
Authors: Zhang Yuyao , Shi Leiyu , Cao Yidan , Chen Haiqian , Wang Xiaohan , Sun Gang
Published: January 2021

This study aimed to systematically analyze the effect of Wuhan mobile cabin hospitals (WMCHs) on the novel coronavirus-caused pneumonia (COVID-19) prevention and control in China. Between February 5, 2020 and March 10, 2020, a total of 16 mobile cabin hospitals were constructed in 3 batches to offer over 13,000 beds and admitted more than 12,000 patients in Wuhan City. The strategy of implementing WMCHs in 3 batches played a key role in fighting against COVID-19 in China. (1) The first batch of WMCHs increased hospital admission capacity of COVID-19 patients in Wuhan, which showed initial effect on COVID-19 epidemic control. (2) The operation of the second batch of WMCHs greatly contributed to the rapid growth in discharged patients. (3) After launching the third batch of WMCHs, the COVID-19 epidemic situation in Wuhan improved considerably. The last batch of WMCHs made a substantial contribution to defeating the COVID-19 epidemic in Wuhan.
Salviae miltiorrhizae and ligustrazine hydrochloride injection combined with mecobalamin for treating diabetic peripheral neuropathy
Authors: Deng Zhiyuan , Wang Manjia , Fan Yaohua , Liu Min
Published: January 2021

Objective:

Currently, it is unclear whether the salviae miltiorrhizae (Danshen Salvia) and ligustrazine hydrochloride (Chuanxiong Chuanxiong) (SMLH) injection combined with mecobalamin can improve diabetic peripheral neuropathy (DPN). We conducted a systematic analysis to evaluate the clinical effects of SMLH injection combined with mecobalamin for treating DPN.

Methods:

Seven databases, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Database (Wang Fang), Chinese Biomedical Literature Database (CBM), and VIP Database for Chinese Technical Periodicals (VIP) were searched for systematic literature retrieval. Each database was searched up to 2020 to identify randomized controlled trials on DPN treated with SMLH injection combined with mecobalamin. We used the RevMan 5.3 and Stata 14.0 software to assess the risk of bias in the included trials.

Results:

A total of 15 publications, including 1349 samples, were reviewed. The total effective rate of SMLH injection combined with mecobalamin was 31% higher than that of mecobalamin alone (95% confidence interval [CI] = 1.23–1.38; P < .00001). The experimental group showed a significant increase in the motor conduction velocity (MCV) of the peroneal nerve (weighted mean difference [WMD] = 4.81, 95% CI 3.53–6.09; P < .00001). In addition, SMLH injection combined with mecobalamin showed a statistical significant effect on the sensory conduction velocity (SCV) of the peroneal nerve (WMD = 5.03, 95% CI = 4.16–5.90; P < .00001), and MCV of the median nerve (WMD = 5.38, 95% CI = 4.05–6.72; P < .00001). The WMD for the change in SCV in the median nerve was 4.89 m/s (95% CI = 3.88–5.89; P < .00001). The P-values of the Egger and Begg tests were 0.967 and 0.961, respectively, indicating no publication bias. Subgroup and sensitivity analyses indicated that the results for MCV and SCV of the peroneal nerve and the median nerve were stable.

Conclusion:

SMLH injection combined with mecobalamin can improve DPN, compared with mecobalamin alone.
Shenfu injection combined with furosemide in the treatment of chronic heart failure in patients with coronary heart disease
Authors: Gao Yibing , Gao Ying , Zhu Rong , Tan Xiao
Published: January 2021

Background:

Coronary heart disease (CHD) is an important cause of chronic heart failure, and chronic heart failure is also a serious complication in the end stage of coronary heart disease. At present, there is no specific treatment plan. Shenfu injection has advantages in the treatment of heart failure in patients with coronary heart disease, but there is a lack of standard clinical study to verify this. Therefore, the purpose of this randomized controlled trial is to evaluate the efficacy and safety of Shenfu injection combined with furosemide in the treatment of chronic heart failure in patients with coronary heart disease.

Methods:

This is a prospective randomized controlled trial to study the efficacy and safety of Shenfu injection combined with furosemide in the treatment of coronary heart disease and chronic heart failure. This study will be approved by the clinical research ethics committee of our hospital. The patients will be randomly divided into two groups according to 1:1:(a) Shenfu injection combined with furosemide group and (b) simple furosemide group. Standard treatment for 7 days followed up for 30 days at the same time, pay attention to its efficacy and safety indicators. The total effective rate of cardiac function improvement, left ventricular ejection fraction (LVEF), N-terminal pro-brain natriuretic peptide (NT-pro BNP), 6-minute walk test (6-MWTD), and adverse reactions will be observed. Data will be analyzed using the statistical software package SPSS version 25.0 (Chicago, IL).

Discussion:

This study will evaluate the efficacy and safety of Shenfu injection combined with furosemide in the treatment of coronary heart disease with chronic heart failure. The results of this experiment will provide a clinical basis for Shenfu injection combined with furosemide in the treatment of coronary heart disease and chronic heart failure.

OSF Registration number:

doi: 10.17605/OSF.IO/27FPM
Impact of surgical margin on survival in extremity soft tissue sarcoma
Authors: Jang Woo Young , Kim Han-Soo , Han Ilkyu
Published: January 2021

Background:

The impact of surgical margin status on the survival of patients with extremity soft tissue sarcoma (STS) remains to be clearly defined. The evidence regarding the impact of surgical margins on survival is limited by retrospective single-institution cohort studies. We conducted a systematic review and meta-analysis to examine the impact of surgical margin status on patient survival in extremity STS.

Methods:

A literature search in the PubMed, EMBASE, and Cochrane Controlled Trials Register electronic databases, and a manual search of reference lists of original studies was performed. The following text words and/or Medical Subject Heading terms were searched: (neoplasm) or/and (sarcoma) and/or (connective tissue) and/or (soft tissue) and/or (extremity) and/or (extremity) and/or (surgical margin).

Results:

Six selected studies that reported a total of 2917 cases of extremity STS were published between 1994 and 2013. All the eligible studies were observational cohort studies, and the sample size ranged from 95 to 1261 patients. A meta-analysis of 6 studies showed that a positive surgical margin predicted poor 5-year OS in a random-effects model (summary hazard ratio, 1.56; 95% confidence interval, 1.12–2.17). Moderate heterogeneity was observed among the studies (P < .075; heterogeneity, 45.6%).

Conclusions:

This meta-analysis supports the hypothesis that adequate surgical margins are associated with improved survival in extremity STS.
The therapeutic efficacy of Xuanfei Baidu Formula combined with conventional drug in the treatment of coronavirus disease 2019
Authors: Li Fan , Li Yajuan , Zhang Jingxia , Li Shasha , Mao Ajuan , Zhao Chongbo , Wang Weifeng , Li Fang
Published: January 2021

Background:

Coronavirus disease 2019 (COVID-19) is a new acute espiratory infectious disease that has been in a public health emergency of international concern. In China, the combination of Xuanfei Baidu Formula (XBF) and conventional drug is used in the clinical treatment of patients with new coronary pneumonia, However, there is no comprehensive and systematic evidence on the effectiveness and safety of XBF.

Materials and Methods:

We search for research in PubMed, China National Knowledge Infrastructure, Wan-fang Database, China Biomedical Database, and Chinese Science Citation Database. For “Xuanfei Baidu Formula” and “COVID-19,” we screened suitable articles without language restrictions on keywords, Review Manager 5.3 and STATA 14.2 software was used for the data analysis.

Results:

The systematic review and meta-analysis will evaluate the efficacy and safety of XBF combined with conventional drug in the treatment of COVID-19.

Conclusion:

We will provide evidence of XBF for the treatment on COVID-19 patients.

INPLASY Registration number:

INPLASY2020120011
The self-psychological safety maintenance and its influencing factors of community frontline staff during COVID-19 pandemic
Authors: Xia Yinghua , Zhang Hao , Xia Yingjie , Li Hui , Zhai Lili , Wang Hong
Published: January 2021

The present study was designed to determine the self-psychological safety maintenance and its influencing factors of community staff on the front-line during Coronavirus Disease 2019 (COVID-19) pandemic.

A total of 126 frontline staff in community were involved in the current cross-section study. Online questionnaires including the anxiety sensitivity index-3 (ASI-3), patient health questionnaire (PHQ-9), simple coping style questionnaire (SCSQ) and general self-efficacy scale (GSES) were utilized to analyze psychological state, coping style and self-efficacy of the surveyed staff.

The ASI-3 standard score of 126 community frontline staff was 10.01 ± 2.82, of which 21 community frontline staff scored > 16, and the detection rate of anxiety was 16.67%. The anxiety state of doctors and nursing staff was significantly lower than that of administrative staff, logistics staff and other staff, and the rate of anxiety of having colleagues with suspected symptoms was significantly higher than that without colleagues with suspected symptoms (P < .05). The PHQ-9 standard score was 2.03 ± 0.16, of which 19 frontline staff in the community scored more than 5, and the detection rate of depression was 15.08%. Among them, the depression state of those with bachelor degree or above was significantly lower than that of those with junior college education, and the rate of depressive symptoms of community frontline staff with colleagues harboring suspected symptoms were significantly higher than those without colleagues with suspected symptoms (P < .05). The aggregated results showed that most of the community frontline staff in anxiety state group and depression group adopted negative coping style while most of the community frontline staff in the non-anxiety group and the non-depression group adopted positive coping style (P < .05). Additionally, lower score of self-efficacy of the community frontline staff was observed in the anxiety state group and the depression state group (P < .05).

During the outbreak of COVID-19, several community frontline staff showed negative psychology of anxiety and depression, which could affect their coping style and self-efficacy. Early and effective psychological safety maintenance was required to alleviate the negative psychology of community frontline staff.
Clinicopathological and prognostic value of preoperative lymphocyte to monocyte ratio for hepatocellular carcinoma following curative resection
Authors: Lin Shuwen , Lin Ye , Fang Yinghua , Mo Zhikang , Hong Xiaocheng , Ji Chenggang , Jian Zhixiang
Published: January 2021

Background:

Previous studies have reported that lymphocyte-to-monocyte ratio (LMR) had novel prognostic value in hepatocellular carcinoma (HCC). The purpose of this meta-analysis was to synthetically evaluate the prognostic role of preoperative LMR in HCC patients following curative resection.

Methods:

Eligible studies were acquired through searching Pubmed, Web of Science, Cochrane Library and EMbase update to September 2019. Merged hazard ratios (HRs) and 95% confidence intervals (CIs) were applied as effect sizes.

Results:

A total of ten studies containing 4,092 patients following liver resection were enrolled in this meta-analysis. The pooled results demonstrated that preoperative elevated LMR indicated superior survival outcome (HR: 0.58, 95% CI: 0.34–0.96, P = .035) and recurrence-free survival (RFS)/disease-free survival/time to recurrence (HR = 0.76, 95% CI: 0.58–0.98, P = .034). The significant prognostic role of preoperative LMR was detected in the subgroup of all publication year, country of origin, sample sizes <300, TNM stage of I–IV and LMR cut-off value ≤4. Furthermore, high LMR was significantly associated with male, high AFP, large tumor size, incomplete tumor capsule, advanced TNM stage and BCLC stage, and presence of PVTT.

Conclusion:

Elevated preoperative LMR indicated superior survival outcome in HCC patients following curative resection, and might serve as a novel prognostic biomarker.
Association of myostatin, a cytokine released by muscle, with inflammation in rheumatoid arthritis
Authors: Murillo-Saich Jessica D. , Vazquez-Villegas Maria Luisa , Ramirez-Villafaña Melissa , Saldaña-Cruz Ana Miriam , Aceves-Aceves Javier A. , Gonzalez-Lopez Laura , Guma Monica , Gamez-Nava Jorge I.
Published: January 2021

Myostatin is a cytokine produced and released by myocytes that might have an outstanding role not only in muscle wasting during cachexia but also in inflammation. Herein we explore the association between myostatin levels and inflammatory parameters in rheumatoid arthritis (RA).

One hundred twenty-seven women without rheumatic diseases and 84 women with a diagnosis of RA were assessed in a cross-sectional study. Outcomes reflecting the activity of the arthritis including Disease Activity Score (DAS28-ESR) and impairment in functioning by the Health Assessment Questionnaire-Disability Index were assessed in RA. We obtained Skeletal muscle mass index (SMI), fat-free mass index (FFMI), and fat mass index using dual-energy x-ray absorptiometry. Serum myostatin was determined by enzyme-linked immunosorbent assay. Myostatin levels were correlated with disease activity and parameters of muscle mass.

The SMI was lower and concentration of myostatin was higher in RA patients than in controls (P = .008 and P < .001, respectively). Myostatin significantly positively correlated with C-reactive protein (rho = 0.48, P < .001), erythrocyte sedimentation rate (rho 
= 0.28, P = .009), and DAS28-ESR (rho = 0.22, P 
= .04), and negatively correlated with SMI (rho = −0.29, P = .008), (FFMI) (rho = −0.24, P = .027). In the multivariate logistic regression analysis, levels of myostatin remained associated with disease activity in RA (P = .027).

In our study, myostatin was associated with disease activity in RA patients, suggesting a mechanistic link between myostatin, muscle wasting and inflammation in RA.
The effectiveness and safety of Chinese herbal formulas on skin photoaging
Authors: He Ji-Yong , Yv Xiao-Yv , Wu Jing-Dong , Lv Ling , Zhang Xiao-Qing , Ma Tie-Ming , Zhang Yu
Published: January 2021

Background:

Skin photoaging (SP) is a complex and complicated process of skin characteristic changes caused by excessive sunlight. Wrinkles, looseness, coarseness, and increase or loss of pigment are the main clinical manifestations of the disease. The pathogenesis of SP mainly involving oxidative stress, inflammatory reaction, immune dysregulation and DNA damage, and so on. In recent years, traditional Chinese medicine, as an significant form of complementary and alternative medicine, has attracted the more and more attention within the field of health care and indicated a desirable effect on SP. Chinese herbal formula (CHF) is an essential part of traditional Chinese medicine interventions, and the number of clinical trails on SP treated by CHFs have shown a growing trend. Therefore, we developed this systematic review and meta-analysis protocol to assess the effectiveness and safety of CHFs in the therapy of SP, so as to provide reliable evidence-based evidence for clinical decision-making.

Methods:

A overall literature retrieval will be carried out in 9 electronic journal database. We will include randomized controlled trials (RCTs) on CHFs alone or combined with routine western medicine measures in the treatment of SP. The outcomes we focused on are consists of symptom score (skin relaxation, telangiectasia, pore coarseness, pigmentation, etc), total effective rate, and adverse reactions. Meta-analysis will be performed using Stata 13.0 software. Literature retrieval and screening, data extraction, risk of bias assessment of RCTs, evidence confidence rating by grading of recommendations assessment, development, and evaluation method and methodological quality assessment of systematic review by assessment of multiple systematic reviews-2 will be conducted independently by 2 reviewers, and disagreements will be resolved through discussion or judged by a third senior reviewer.

Results:

This systematic review and meta-analysis will pool the proof of RCTs on SP treated by CHFs alone or combined with conventional western medicine treatments. The findings of this study will be presented at relevant conferences and submitted to peer-reviewed journals for publication.

Conclusion:

We expect that the results of this systematic review will provide comprehensive and reliable evidence for clinicians and policy makers.

Registration number:

INPLASY 2020120005
Primary extranodal natural Killer/T-cell lymphoma in a child in the colon
Authors: Duan Yi , Huang Juan , Haybaeck Johannes , Yang ZhiHui
Published: January 2021

Rationale:

Primary extranodal natural killer (NK)/T-cell lymphoma (ENKTL) rarely occurs in childhood and adolescence. To the best of our knowledge, ENKTL of childhood in the gastrointestinal (GI) tract has not been reported yet.

Patient concerns:

A 12-year-old Chinese boy complained of abdominal pain and persistent fever for 1 month.

Diagnosis:

Grossly an ulcerated tumor with perforation was located at the proximal ascending colon, 5 cm × 4 cm × 1.5 cm in diameter. The tumor was poorly circumscribed, tan-white and solid. Histological evaluation revealed medium-sized atypical lymphoid cells with large areas of necrosis distributed throughout all layers of the colon. Small blood vessels with destroyed walls were surrounded by lymphoid cells. Immunohistochemistry (IHC) highlighted tumor cells as strongly positive for CD3, CD56, CD5, CD2, CD8, CD4, CD43, T-cell restricted intracellular antigen 1 (TIA-1) and granzyme B. The proliferation index, measured by Ki-67 expression was high with 60%. The In situ hybridization (ISH) for EBER was positive. TCR was negative. Therefore, the final diagnosis was ENKTL of childhood in the colon.

Interventions:

The patient underwent right hemicolectomy and ileocolostomy.

Outcomes:

We recommended further evaluation and treatment, but the patient and patient family rejected further treatment of his condition. The patient died within 1 month after being discharged from hospital as a result of his disease.

Lessons:

ENKTL of childhood in the GI tract is extremely rare. Due to the non-specific clinical symptoms, it is easy it is easy not to think of this differential diagnosis at early stage. If patients have GI symptoms, ENKTL cannot easily be ignored. It is necessary to diagnose ENKTL of childhood in the GI tract by morphology and immunohistochemistry, and to differentiate from the GI T-cell lymphomas. We hope this case may serve as a reference improving clinical diagnosis and treatment.
Contrast-enhanced ultrasonographic imaging of hepatic splenosis
Authors: Zhong Xiaofei , Yang Lulu , Huang Jiayan , Deng Liping , Nie Ling , Lu Qiang
Published: January 2021

Rationale:

Hepatic splenosis or heterotopic auto-transplantation of spleen in the liver usually occurs after either spleen trauma or surgery. It is of great importance for the differential diagnosis of hepatic splenosis and other liver tumors because surgery is usually not needed if a diagnosis of splenosis is confirmed.

Patient concerns:

Multiple hepatic masses were revealed by grayscale ultrasound in a 55-year-old man complaining of persistent colic in the upper abdomen after greasy food.

Diagnosis:

Benign neoplasm with enlarged lymph node in the gastro-hepatic ligament was suspected by contrast enhanced US. The nature of the hepatic mass was undetermined by CECT.

Interventions:

The lesions were surgically removed.

Outcomes:

Multiple splenic tissue implants in the liver and peritoneum were confirmed by pathology after surgery. The patient recovered well and was followed up for more than 1 year without recurrence.

Lessons:

Splenosis should be included in the differential diagnosis of focal liver lesion in patients with a history of spleen trauma or surgery. In spite of nonspecific findings on pre-contrast ultrasound, splenosis shows characteristic homogeneous hyperenhancement in arterial and portal phases, as well as prolonged hyperenhancement in the late phase for more than 5 minutes. Furthermore, the confidence of the diagnosis of splenosis may be enhanced by identifying multiple masses with similar enhancing patterns in other regions of the abdominal cavity.
Factors associated with mental health of graduate nursing students in China
Authors: Li Xing , Song Wen , Zhang Jia-Yi , Lu Chang , Wang Ya-Xi , Zheng Yan-Xue , Hao Wen-Nv
Published: January 2021

The increasing number of graduate nursing students in China has resulted in the wide concern for their mental health problems. Quantitative studies using validated questionnaires on mental health of graduate nursing students are rare. This study aimed to investigate the factors potentially involved in the level of mental health of graduate nursing students.

The sample consisted of 339 graduate nursing students from 5 universities of China. The participants were evaluated using the Symptom Checklist-90 (SCL-90) and Chinese Perceived Stress Scale (CPSS) between March and November 2020. Multivariate stepwise linear regression analysis and spearman correlation test were performed to assess the association between various factors associated with mental health.

The SCL-90 total score was 109.00 (96.00 –134.00) and psychological abnormalities (total score > 160) accounted for 14.2%. The highest score in the nine dimensions was compulsion dimension. The positive detection rate of compulsion dimension was 21.5% (dimensions score > 2),and the average of compulsion score was 1.50(1.20 –2.00). Multivariable stepwise linear regression analysis showed that grade, environmental adaptation level, number of good friends were independently associated with lower SCL-90 scores (both P < .05). SCL-90 scores were correlated with Chinese Perceived Stress Scale (r = .159, P = .003).

Results indicate that learning about ways to adapt to the environment, strengthening good friends support and alleviating perceived stress can help improve graduate nursing students’ level of mental health. The conclusions of this study can provide a reference to improve the psychological intervention strategies for graduate nursing students.
Prognosis and predictive value of heat-shock proteins expression in oral cancer
Authors: Lu Wei , Wang Yongwu , Gan Min , Duan Qingyun
Published: January 2021

Background:

Heat-shock proteins (HSP) is a key chaperone protein which maintains intracellular proteostasis and is expressed on the surface of solid and hematological malignancies. Several studies have reported paradoxical evidence of the association between HSP expression and prognosis of oral cancer. To address the discrepancy, we carried out the meta-analysis to assess the role of HSP such as: HSP70, HSP90, HSP27, HSP60, and HSP105 in susceptibility, progression, and prognosis of oral cancer.

Materials and methods:

We retrieved the PubMed, Embase, Web of science, China National Knowledge Infrastructure (CNKI), and Wanfang databases to acquire the eligible studies which were associated with HSP70, HSP90, HSP27, HSP60, and HSP105 protein expression and oral cancer. We applied hazard ratio (HR) and its 95% confidence interval (95% CI) to assess the value of HSP protein expression in overall survival of oral cancer; odds ratio (OR) and its 95% CI were used to evaluate the association of risk and clinical features of oral cancer. Funnel plot, Begg test, and Egger line regression test were utilized to observe publication bias among studies. All statistical analysis was performed with Stata 14.0 software (Stata Corporation, College Station, TX).

Results:

A total of 26 studies were included in the present meta-analysis. On based of the results, HSP70 and HSP27 had no significant association with progression of oral cancer. However, the pooled HR and 95% CI revealed a significant well effects of HSP70 and HSP27 expression on survival of oral cancer. Moreover, the susceptibility of oral cancer was significantly associated with HSP70 and HSP60 overexpression.

Conclusion:

HSP70 and HSP27 protein overexpression might be valuable biomarkers for the prognosis of oral cancer. And HSP70 and HSP60 might have potential predictive effects on the risk of oral cancer.