bluuebunny/crossref_metadata_2025 huggingface dataset:
Abdominal Mesh Use in Pedicled Rectus Abdominis Flaps for Pelvic Reconstruction
Authors: Barnes Laura L. , Holland Michael C. , Lentz Rachel , Knox Jacquelyn A. , Sbitany Hani , Piper Merisa
Published: August 2024

Background:

Rectus abdominis flap coverage of high-risk perineal wounds following extirpative pelvic procedures can result in improved perineal outcomes. However, rectus abdominis flap harvest has morbidity associated with the donor site, including hernia or bulge development. The risk–benefit profile of mesh use in this scenario is not well-defined in the literature.

Methods:

We performed a retrospective chart review of all patients who underwent rectus abdominis flap coverage of pelvic defects at our institution during July 2012–January 2021. Patient characteristics and postoperative outcomes were assessed. Patients were stratified into groups based on whether mesh was used and whether primary fascial closure was achieved. Donor site outcomes were analyzed between groups.

Results:

One hundred consecutive patients were included. When considering all patients in whom primary fascial closure was achieved, the use of mesh did not significantly decrease rates of hernia development. Mesh use in this setting was associated with significantly greater rates of infection, requiring procedural intervention (12% versus 0%, P = 0.044). When considering all patients in whom mesh was used, primary fascial closure was associated with decreased rates of hernia development, and this trended toward significance (16.1% versus 0.0%, P = 0.058).

Conclusions:

When closing a pedicled rectus abdominis flap donor site, if primary fascial closure is achievable, the addition of mesh to reinforce the repair does not have an added benefit. Mesh use in this setting was not shown to prevent hernia or bulge development, and was found to be associated with significantly greater rates of infection, requiring procedural intervention.
Comparison of blood-based liver fibrosis scores in the Mount Sinai Health System, MASLD Registry, and NHANES 2017–2020 study
Authors: Chen Robert , Petrazzini Ben Omega , Nadkarni Girish , Rocheleau Ghislain , Bansal Meena B. , Do Ron
Published: August 2024

Background:

Liver fibrosis is a critical public health concern, necessitating early detection to prevent progression. This study evaluates the recently developed LiverRisk score and steatosis-associated Fibrosis Estimator (SAFE) score against established indices for prognostication and/or fibrosis prediction in 4diverse cohorts, including participants with metabolic dysfunction–associated steatotic liver disease (MASLD).

Methods:

We used data from the Mount Sinai Data Warehouse (32,828 participants without liver disease diagnoses), the Mount Sinai MASLD/MASH Longitudinal Registry (422 participants with MASLD), and National Health and Nutrition Examination Survey 2017–2020 (4133 participants representing the general population) to compare LiverRisk score, FIB-4 index, APRI, and SAFE score. Analyses included Cox proportional hazards regressions, Kaplan-Meier estimates, and classification metrics to evaluate performance in prognostication and fibrosis prediction.

Results:

In Mount Sinai Data Warehouse, LiverRisk score was significantly associated with future liver-related outcomes but did not significantly outperform FIB-4 or APRI for predicting any of the outcomes. In the general population, LiverRisk score and SAFE score outperformed FIB-4 and APRI in identifying fibrosis, but LiverRisk score underperformed among participants who were non-White or had type 2 diabetes. Among participants with MASLD, SAFE score outperformed FIB-4 and APRI in 1 of 2 cohorts, but there were generally few significant performance differences between all 4 scores.

Conclusions:

LiverRisk score does not consistently outperform existing predictors in diverse populations, and further validation is needed before adoption in settings with significant differences from the original derivation cohorts. It remains necessary to replicate the ability of these scores to predict liver-specific mortality, as well as to develop diagnostic tools for liver fibrosis that are accessible and substantially better than current scores, especially among patients with MASLD and other chronic liver conditions.
Genetic variants associated with immune-mediated liver injury from checkpoint inhibitors
Authors: Fontana Robert J. , Li Yi-Ju , Chen Vincent , Kleiner David , Stolz Andrew , Odin Joe , Vuppalanchi Raj , Gu Jiezhun , Dara Lily , Barnhart Huiman ,   on behalf of the Drug-Induced Liver Injury Network
Published: August 2024

Background:

The clinical features, liver histology, and genetic variants in 57 patients with moderate to severe immune-mediated liver injury from checkpoint inhibitors (ILICI) are presented.

Methods:

Between 2010 and 2022, 57 high-causality ILICI cases were enrolled in the Drug-Induced Liver Injury Network. HLA and selected candidate gene variants were tested for association with ILICI risk compared to the general population and other DILI controls.

Results:

The 57 high-causality cases were attributed to pembrolizumab (16), ipilimumab (15), ipilimumab and nivolumab (13), and other immune checkpoint inhibitors (13) and occurred at a median of 72 days after the first infusion. Median age was 57.8 years, 66% male, and 89% were non-Hispanic Whites. At DILI onset, 53% had hepatocellular, 35% mixed, and 15% cholestatic, with younger patients more likely to have hepatocellular injury. The incidence of ANA, smooth muscle antibody, and elevated IgG levels was low (17%, 23%, and 0%), but corticosteroids were given to 86%. Microgranulomas and hepatic steatosis were seen in 54% and 46% of the 26 liver biopsies, respectively. The HLA alleles associated with autoimmune hepatitis were not over-represented, but 2 host immune response genes (EDIL3 and SAMA5A) and 3 other genes (GABRP, SMAD3, and SLCO1B1) were associated with ILICI (OR: 2.08–2.4, p<0.01).

Conclusions:

ILICI typically arises within 12 weeks of initiating immunotherapy and is self-limited in most cases. Genetic variants involved in host T-cell regulation and drug disposition were identified, implicating these pathways in the pathogenesis of ILICI. If validated, these findings could lead to improved diagnostic instruments and possible treatments for ILICI.
Exploring Functional Improvements by Sex in Six-Minute Walk Test, Exertional Angina, and Dyspnea After Enhanced External Counterpulsation Therapy
Authors: Pecha Anton , White Brian , Yan Huimin
Published: August 2024

Purpose:

The objective of this study was to explore functional improvements by sex for patients with refractory angina pectoris using a 6-min walk test (6MWT) after enhanced external counterpulsation (EECP) therapy.

Methods:

All patients who completed EECP from 2015 to 2023 were identified for analysis retrospectively, utilizing the electronic medical record. Patients completed 35 1-hr EECP sessions 5 d/wk over 7 wk. All baseline and post-EECP intervention 6MWT, exertional angina, and dyspnea measurements were assessed on the first and last sessions, respectively. Paired and unpaired t tests and linear and stepwise multivariable regression analyses were performed.

Results:

The cohort consisted of 116 patients (24 female) with a mean age of 69 ± 13 yr. After EECP, there was a mean improvement of 128 m (72%) in distance walked during the 6MWT (P < .001) with 126 ± 91 m improvement in males and 134 ± 73 m in females. The improvement in angina and dyspnea scores was 3.5 ± 2.1 and 4.2 ± 2.4, respectively. There were no differences between the sexes for improvements in 6MWT distance, angina, or dyspnea. Univariate associations for change in 6MWT distance included body mass index (BMI; adjusted R
2 = .05) and being a nonsmoker (adjusted R
2 = .03). The only independent predictor for increasing distance during 6MWT was BMI (adjusted R
2 = .1; P = .001).

Conclusion:

Patients who have refractory angina pectoris can improve their functional capacity while simultaneously decreasing exertional angina and dyspnea using EECP. This study highlights the equal efficacy of EECP therapy for females.
Efficacy and Safety of Valbenazine in Elderly and Nonelderly Japanese Patients With Tardive Dyskinesia
Authors: Watanabe Yumi , Susuta Yutaka , Nagano Mieko , Masui Hideaki , Kanahara Nobuhisa
Published: August 2024

Purpose

The efficacy and safety of valbenazine, a selective vesicular monoamine transporter 2 inhibitor, has been confirmed for treatment of tardive dyskinesia (TD) in patients aged ≥65 years in non-Asian clinical trials; however, data are lacking in elderly Asian patients. This post hoc analysis of J-KINECT aimed to evaluate the efficacy and safety of valbenazine in elderly Japanese patients with TD.

Methods

J-KINECT was a randomized, double-blind, placebo-controlled study with a 6-week double-blind, placebo-controlled period; 42-week double-blind, valbenazine extension period; and 4-week posttreatment observation period. Outcomes were summarized by age (≥65 years [elderly] and <65 [nonelderly]) and treatment group.

Results

The safety analysis set included 100 and 153 patients aged ≥65 and <65 years, respectively (intention-to-treat set: 98 and 151 patients, respectively). In the elderly group, the difference versus placebo in least-squares mean change from baseline in the Abnormal Involuntary Movement Scale total score at week 6 was −3.1 (95% confidence interval: −4.5, −1.7) and −5.5 (−7.0, −3.9) with valbenazine 40 and 80 mg, respectively; in the nonelderly group, respective differences were −1.5 (−2.6, −0.4) and −2.5 (−3.6, −1.3). Both age groups showed improvement in Clinical Global Impression of Change–Tardive Dyskinesia scores with valbenazine. The incidence of treatment-emergent adverse events (TEAEs) leading to treatment discontinuation was higher in the elderly versus nonelderly group. There was no trend toward higher incidences of TEAEs or related TEAEs in the elderly group.

Conclusions

The findings suggest that valbenazine may be used effectively and safely as a treatment for TD, even in elderly patients.
The clinical relevance of the new criteria for cirrhotic cardiomyopathy and future directions
Authors: Myers Sarah , Gupta Deepak K. , Izzy Manhal
Published: August 2024

Cardiac dysfunction in patients with liver disease has been recognized since the 1950s. Initially attributed to shared risk factors, it is now evident that cardiac dysfunction in patients with cirrhosis can occur in the absence of known cardiac, that is, coronary artery and valvular heart disease, and across all etiologies for cirrhosis. In 1996, this myocardial dysfunction was termed cirrhotic cardiomyopathy (CCM). The pathophysiologic mechanisms underlying CCM include impaired beta-adrenergic membrane function and circulating proinflammatory and cardiotoxic substances. In 2005, the first diagnostic criteria for CCM were introduced enabling greater sensitivity and accuracy of diagnosis. Since 2005, advancements in echocardiographic methods and a better understanding of the pathophysiology of cardiac dysfunction in patients with cirrhosis necessitated a revision of CCM criteria. Changes in CCM criteria included the removal of blunted contractile or heart rate response on stress testing and the addition of global longitudinal systolic strain. The refinement of criteria for diastolic dysfunction was also incorporated into the new diagnostic approach. Since 2020, the prevalence of the disorder and clinical considerations for pretransplant, peritransplant, and posttransplant patients with cirrhosis have been further evaluated, and CCM was found to adversely impact clinical outcomes during all 3 phases of care. Future research considerations should address the timing of universal echocardiographic screening for patients with cirrhosis, the utility of biomarkers in aiding CCM diagnosis, the impact of CCM on right heart function, and the role of anti-remodeling agents after liver transplant.
Evaluation of Semicircular Canal Function in Relapsing Polychondritis Patients With Dizziness and Sensorineural Hearing Loss Using Video Head Impulse Test
Authors: Hoshino Kimiko , Fujiwara Keishi , Morita Shinya , Fukuda Atsushi , Takeda Hideaki , Nakamaru Yuji , Homma Akihiro
Published: August 2024

Objective

To evaluate semicircular canal function using video head impulse test (vHIT) in relapsing polychondritis (RP) patients presenting with dizziness and sensorineural hearing loss.

Study Design

Retrospective case review.

Setting

Tertiary referral center.

Patients

Three patients with RP underwent vHIT and hearing tests.

Intervention

Diagnostic.

Main Outcome Measures

The gain in vestibulo-ocular reflex (VOR) and the presence of catch-up saccade were examined, and the correlation between semicircular canal dysfunction and hearing loss was investigated.

Results

Of the six ears, five exhibited semicircular canal dysfunction. Among these, one ear showed dysfunction in two semicircular canals, while the remaining four ears demonstrated dysfunction in all three semicircular canals. Sensorineural hearing loss, ranging from moderate to profound, was detected by pure-tone audiometry in all six ears. Furthermore, a significant correlation was observed between VOR gain in the horizontal semicircular canal (HSC) and hearing level.

Conclusions

This study demonstrated semicircular canal dysfunction in RP patients presenting with dizziness and hearing loss using vHIT. Moreover, a significant correlation was found between HSC dysfunction and the severity of hearing loss. While inner ear involvement is a key clinical symptom included in the diagnostic criteria for RP, there have been few reports evaluating vestibular dysfunction, and this is the first report on the evaluation of several cases using vHIT. Accurate assessment of vestibular function by vHIT may facilitate early diagnosis and intervention in RP, potentially improving patient outcomes.
Evaluation of Clinical Performance of Ponto Implantation Using a Minimally Invasive Surgical Technique—A Prospective Multicenter Study
Authors: Teunissen Emma M. , Aukema Tjerk W. , Banga Rupan , Eeg-Olofsson Måns , Hol Myrthe K. S. , Hougaard Dan D. , Tysome James R. , Johansson Martin L. , Svensson Sara , Powell Harry R. F.
Published: August 2024

Objective

To investigate the clinical outcomes of bone-anchored hearing implant surgery using the MONO procedure.

Study Design

Multicenter, multinational, single-arm, prospective trial with a 12-month follow-up.

Setting

Seven European university hospitals from the United Kingdom, Sweden, Denmark, and The Netherlands.

Patients

Fifty-one adult patients requiring surgical intervention for bone conduction hearing.

Intervention

Bone-anchored hearing implant surgery using the MONO procedure.

Main Outcome Measures

The primary endpoint assessed implant usability 3 months after surgery. Implant status, soft tissue reactions, pain and numbness, postoperative events, and sound processor usage were assessed at all follow-up visits. Hearing-related quality of life was evaluated using the Glasgow Benefit Inventory (GBI).

Results

At 3 months, 94.2% of the implant/abutment complexes provided reliable anchorage for sound processor usage. No severe intraoperative complications occurred. Sixty-nine percent of surgeries were performed under local anesthesia, with surgery lasting 10 minutes on average. Four implants were lost due to trauma (n = 2), spontaneous loss of osseointegration (n = 1), or incomplete insertion (n = 1). Adverse soft tissue reactions occurred in 2.6% of visits, with a maximum Holgers grade of 3 (n = 1) and grade 2 (n = 5) across patients. Hearing-related quality of life at 3 months improved in 96% of patients.

Conclusion

The MONO procedure provides a safe and efficient surgical technique for inserting bone-anchored hearing implants with few and minor intra- and postoperative complications.
Protective Effect of Memantine on Cisplatin-Induced Ototoxicity: An In Vitro Study
Authors: Choi Soo Jeong , Lee Soo Jin , Lee Dabin , Im Gi Jung , Jung Hak Hyun , Lee Sun-Uk , Park Euyhyun
Published: August 2024

Hypothesis

Memantine, an N-methyl-d-aspartate receptor antagonist, is widely used to treat Alzheimer's disease and has been found to have potential neuroprotective effects. In this study, we evaluated the protective effects of memantine against cisplatin-induced ototoxicity.

Background

Cisplatin is a widely used anticancer drug for various cancers; however, its use is limited by its side effects, including ototoxicity. Several drugs have been developed to reduce cisplatin toxicity. In this study, we treated cisplatin-damaged cochlear hair cells with memantine and evaluated its protective effects.

Method

House Ear Institute Organ of Corti 1 (HEI-OC1) cells and cochlear explants were treated with cisplatin or memantine. Cell viability, apoptotic patterns, reactive oxygen species (ROS) production, Bcl-2/caspase-3 activity, and cell numbers were measured to evaluate the anti-apoptotic and antioxidative effects of memantine.

Result

Memantine treatment significantly improved cell viability and reduced cisplatin-induced apoptosis in auditory cells. Bcl-2/caspase-3 activity was also significantly increased, suggesting anti-apoptotic effects against cisplatin-induced ototoxicity.

Conclusion

Our results suggest that memantine protects against cisplatin-induced ototoxicity in vitro, providing a potential new strategy for preventing hearing loss in patients undergoing cisplatin chemotherapy.
Efficacy and safety of deferoxamine in moderately ill COVID-19 patients: An open label, randomized controlled trial
Authors: Ameri Ali , Pourseyedi Farnaz , Davoodian Parivash , Safa Omid , Hassanipour Soheil , Fathalipour Mohammad
Published: August 2024

Background:

Deferoxamine is a potent iron chelator that could remove iron from the virus, and severe acute respiratory syndrome coronavirus 2 requires iron to replication. Also, deferoxamine has antioxidant and cytokine-modulating effects. Therefore, we evaluated the efficacy and safety of deferoxamine in patients with moderate coronavirus disease 2019 (COVID-19).

Methods:

In this randomized controlled trial, patients with moderate COVID-19 were randomly assigned in a 1:1 ratio to the deferoxamine group (received a solution of 500 mg deferoxamine divided into 4 doses a day through a nebulizer for 7 days) and the control group. The main outcomes were viral clearance, oxygen saturation (SPO2), body temperature, and respiratory rate (RR). Intensive care unit admission, hospital length of stay, and hospital mortality were also assessed.

Results:

A total of 62 patients, with 30 in the deferoxamine group and 32 in the control group, were randomly assigned. There was no statistically significant improvement in viral clearance after the intervention ended in the deferoxamine group (36.7%) compared to the control group (34.4%). The results showed there was no significant difference between the analyzed groups in terms of SPO2, body temperature, RR, and the number of patients with a worse prognosis (SPO2 < 96%, temperature ≥ 37.5 °C, or RR ≥ 16/min) at the end of the study. There were no significant differences seen between the groups in terms of intensive care unit admission, hospital length of stay, hospital mortality, and the occurrence of adverse medication events during the follow-up period.

Conclusion:

Deferoxamine had no significant impact on improving moderately ill patients with COVID-19. However, it was well-tolerated in the patients, and this intervention demonstrated a safe profile of adverse events.
Prediction modeling of postoperative pulmonary complications following lung resection based on random forest algorithm
Authors: Li Lu , Wu Yinxiang , Chen Jiquan
Published: August 2024

Postoperative pulmonary complications (PPCs) are a significant concern following lung resection due to prolonged hospital stays and increased morbidity and mortality among patients. This study aims to develop and validate a risk prediction model for PPCs after lung resection using the random forest (RF) algorithm to enhance early detection and intervention. Data from 180 patients who underwent lung resections at the Third Affiliated Hospital of the Naval Medical University between September 2022 and February 2024 were retrospectively analyzed. The patients were randomly allocated into a training set and a test set in an 8:2 ratio. An RF model was constructed using Python, with feature importance ranked based on the mean Gini index. The predictive performance of the model was evaluated through analyses of the receiver operating characteristic curve, calibration curve, and decision curve. Among the 180 patients included, 47 (26.1%) developed PPCs. The top 5 predictive factors identified by the RF model were blood loss, maximal length of resection, number of lymph nodes removed, forced expiratory volume in the first second as a percentage of predicted value, and age. The receiver operating characteristic curve and calibration curve analyses demonstrated favorable discrimination and calibration capabilities of the model, while decision curve analysis indicated its clinical applicability. The RF algorithm is effective in predicting PPCs following lung resection and holds promise for clinical application.
PD-1 inhibitor combined with SBRT, GM-CSF, and thymosin alpha-1 in metastatic breast cancer: A case report and literature review
Authors: Yu Jiamin , Wang Qiang , Wang Lijun , Zong Dan , He Xia
Published: August 2024

Rationale:

Triple-negative breast cancer is characterized by a worse prognosis compared with other breast cancer subtypes, especially in the case of pretreated metastatic triple-negative breast cancer (mTNBC). Because of the limited treatment options and suboptimal response rates, there is a pressing need to explore novel treatment protocols.

Patient concerns:

A 48-year-old female patient diagnosed with mTNBC who had not responded to multiple lines of therapy (including surgery, chemotherapy, and radiotherapy) but demonstrated significant efficacy and abscopal effects after enrolling in our clinical trial.

Diagnoses:

Triple-negative breast cancer with lung metastases.

Interventions:

The clinical trial combined stereotactic body radiotherapy, immunotherapy, granulocyte-macrophage colony-stimulating factor, and thymosin alpha-1 to treat previously treated metastatic solid cancers.

Outcomes:

This combined treatment regimen implemented in this clinical trial yielded the patient’s notable efficacy, accompanied by abscopal effects. The target lesion and the 3 observed lesions achieved a partial response according to the RECIST v1.1 criteria. reevaluation scans after 2 cycles of immunotherapy indicated a regression rate of −78.97% for the target lesion and −56.73% for the observed lesions. Hematological indexes were stable, and there was no apparent myelosuppression. Also, the tumor marker CA-199 exhibited a downward trend. During the course of treatment, the patient experienced a grade 2 skin reaction, which improved after receiving antiallergic treatment. No further adverse effects were observed.

Lessons:

This treatment regimen may offer a promising treatment strategy for patients with mTNBC and other metastatic solid cancers.
The analysis of GM (1, 1) grey model to predict the health resource allocation in Jilin Province, China: An observational study
Authors: Pu Wanxu , Yue Xitao , Xiong Qi , Jia Kaikai , Zou Yuanjun
Published: August 2024

To predict the development of health resource allocation in Jilin Province during the 14th 5-Year Plan period, and to provide a scientific basis for promoting the improvement of its service capacity. The data of the health resource from 2015 to 2022 were obtained from the Jilin Statistical Yearbook, and the number of medical institutions, medical beds, health technicians, licensed (assistant) physicians, registered nurses and pharmacists were selected as evaluation indicators, and the grey prediction model constructed by Python was used to predict the development from 2023 to 2025. In the 14th 5-Year Plan period, the health resource in Jilin Province showed an increasing trend, and it is predicted that in 2025, the number of medical institutions, medical beds, health technicians, licensed (assistant) physicians, registered nurses, and pharmacists in Jilin Province will reach 28,999, 196,328, 262,219, 101,273, 129,586, and 9469, respectively. Except that the pharmacist team failed to meet the planning objectives of the 14th 5-Year Plan, the remaining health resources could meet the planning requirements. The allocation level of health resources in Jilin Province has been continuously improved, but it still faces the problems that the allocation of medical beds needs to be optimized, the doctor-nurse ratio needs to be improved, the reserve of registered nurses is insufficient, there is a gap in the pharmacist team, and the development of pharmacy services is slow.
Exploring the role of long noncoding RNAs in autophagy and cuproptosis processes via immune pathways in head and neck squamous carcinoma: A systematic review of the literature
Authors: Xiao Yao , Li Qianrong , Li Yan
Published: August 2024

Cuproptosis, a copper-dependent programmed cell death process, holds promise for controlling cell death in tumor cells. Autophagy, a fundamental cellular process, has been linked to various aspects of cancer, such as proliferation, migration, and drug resistance. This research is centered on the investigation of autophagy- and cuproptosis-related long noncoding RNAs (lncRNAs) and the establishment of a prognostic model for head and neck squamous cell carcinoma. RNA sequencing data from head and neck squamous cell carcinoma patients in The Cancer Genome Atlas database identified cuproptosis-related lncRNAs via Pearson analysis. Patients were divided into training and testing sets. A prognostic model developed in the training set using univariate-least absolute shrinkage and selection operator (Lasso) and multivariate Cox regression was tested for accuracy. Kaplan–Meier analysis showed high-risk patients had poorer outcomes. Cox regression confirmed the model’s risk score as an independent prognostic indicator, with receiver operating characteristic and decision curve analyses validating its predictive accuracy. Thirteen lncRNAs associated with autophagy and cuproptosis were identified through bioinformatics analysis. Lasso regression narrowed this to 3 significant prognostic lncRNAs. Based on median risk scores, patients were classified into high-risk and low-risk groups. Kaplan–Meier survival curves revealed significant differences between these groups (P < .01). Through a set of bioinformatics analyses, we identified 13 autophagy- and cuproptosis-related lncRNAs. By Lasso regression, 3 prognostic-related lncRNAs were further selected. We also investigated these 3 lncRNAs in relation to clinicopathologic features. The principal component analysis visually showed differences between the high-risk and low-risk groups.
Two delayed-diagnosis case reports of long-lasting thrombocytopenia with splenomegaly
Authors: Chen Bing , Dai Wenchu , Xu Yuni , Wang Feng , Liu Jinlin
Published: August 2024

Rationale:

Gaucher disease (GD) is a rare hereditary lysosomal storage disorder disease progression and inappropriate treatment. However, not all patients with GD receive timely diagnosis and treatment.

Patient concerns:

Early diagnosis is important for initiating proper treatment and preventing complications.

Diagnoses:

Two patients were diagnosed as GD in this study.

Interventions and outcomes:

These 2 patients received the imiglucerase enzyme replacement and symptoms significantly improved by the follow-up.

Lessons:

Herein, we report 2 patients with a delayed diagnosis of GD to increase awareness and improve education regarding rare diseases. However, noninvasive β-glucocerebrosidase activity or GBA gene testing had not been done before bone marrow aspiration, which are the noninvasive and reliable tests that indicate the diagnosis of GD.
Female patients with hepatitis B may exhibit a reduced risk of breast cancer: A review of NHANES data
Authors: Han Mengyao , Zhao Ruiqi , Lin Sen , Feng Jiaxin , Yang Siqi , Zhu Wenyuan , Chen Yi
Published: August 2024

Hepatic viral infections and breast cancer (BC) constitute major global health challenges, yet the interconnection between these hepatic infections and BC continues to be ambiguous. Conducting a comprehensive evaluation of the link between hepatitis virus infection and the incidence of BC and leveraging data from the National Health and Nutrition Examination Survey covering the period from 1999 to March 2022, we utilized logistic regression and subgroup analysis, among other methodologies, to execute a cross-sectional investigation. The univariate logistic regression analysis elucidates that individuals classified as non-Hispanic White exhibit a markedly higher incidence of BC at 2.620 (95% confidence interval [CI], 1.117–7.676; P = .045); moreover, advanced age at 1.063 (95% CI, 1.036–1.093; P < .001), elevated educational attainment at 1.962 (95% CI, 1.17–3.366; P = .012), and higher income levels at 2.835 (95% CI, 1.303–7.439; P = .017) emerge as significant predisposing factors for BC. In contrast, a greater number of live births significantly diminishes the risk of BC, reducing the incidence to 81.1% with each additional birth. Pertaining to hepatitis and vaccination status, our analysis distinctly demonstrates that only hepatitis B at 0.110 (95% CI, 0.018–0.353; P = .002) bears a significant inverse relationship with BC risk, suggesting a protective effect. The multivariate logistic regression analysis further reveals a negative association between hepatitis B infection and BC incidence, whereas hepatitis B vaccination shows a positive correlation with the disease incidence. After adjusting for all covariates, model 3 delineates odds ratios (95% CI) as follows: 0.14 (0.02–0.50; P = .009) and 1.92 (0.99–3.62; P = .046). Our investigation uncovers that within the general populace, there exists an inverse correlation between hepatitis B infection and BC incidence; in addition, the administration of the hepatitis B virus vaccine is potentially positively associated with the prevalence of BC.
Network pharmacology and molecular docking reveal potential mechanisms of ginseng in the treatment of diabetes mellitus-induced erectile dysfunction and asthenospermia
Authors: Liu Liming , Zhang Yuanfeng , Yang Jiashu , Chen Wenfang , Lan Kaijian , Shi Yibo , Zhang Xiaogang , Xing Xiping
Published: August 2024

Diabetes mellitus (DM) is a chronic metabolic disease that predisposes to chronic damage and dysfunction of various organs, including leading to erectile dysfunction (ED) and asthenospermia. Literature suggests that ginseng plays an important role in the treatment and management of DM. Ginseng may have a therapeutic effect on the complications of DM-induced ED and asthenospermia. The study aimed to explore the mechanisms of ginseng in the treatment of DM-induced ED and asthenospermia following the Traditional Chinese Medicine (TCM) theory of “treating different diseases with the same treatment.” This study used network pharmacology and molecular docking to examine the potential targets and pharmacological mechanism of Ginseng for the treatment of DM-induced ED and asthenospermia. The chemical ingredients and targets of ginseng were acquired using the Traditional Chinese Medicine Systems Pharmacology database and analysis platform. The targets of DM, ED, and asthenospermia were extracted with the GeneCards and Online Mendelian Inheritance in Man databases. A protein–protein interaction network analysis was constructed. The Metascape platform was applied for analyzing the gene ontology and Kyoto Encyclopedia of Genes and Genomes pathways. AutoDock Vina was used to perform molecular docking. Network pharmacology revealed that the main active components of the target of action were kaempferol, beta-sitosterol, ginsenoside rh2, stigmasterol, and fumarine. Core targets of the protein–protein interaction network included TNF, IL-1β, AKT1, PTGS2, BCL2, and JUN. Kyoto Encyclopedia of Genes and Genomes enrichment analysis showed that they were mainly involved in AGE-RAGE signaling pathway in diabetic complications, TNF signaling pathway, Lipid and atherosclerosis. The interactions of core active components and targets were analyzed by molecular docking. Ginseng may play a comprehensive therapeutic role in the treatment of DM-induced ED and asthenospermia through “multicomponent, multi-target, and multi-pathway” biological mechanisms such as inflammation and oxidative stress.
Mechanism of inhibition of TLR4/NFκB/NLRP3 inflammatory pathway against AD based on the network pharmacology of Erjing Pills
Authors: Zhang Chen , Lu Mingjing , Li CunNeng , Qi Chao , Lin Qian , Huang LiPing , Ding Hailing
Published: August 2024

Alzheimer disease is an irreversible neurodegenerative disease, and its pathogenesis involves various mechanisms such as neuroinflammation and β-amyloid deposition. Erjing Pills can inhibit neuroinflammation by inhibiting toll-like receptor 4/nuclear factor kappa-B/nucleotide-binding domain leucine-rich repeat and pyrin domain-containing protein 3; however, qualitative analysis of the material basis is lacking. Therefore, it is necessary to analyze and explore the material basis of network pharmacology research. This study employed a multifaceted approach, including drug-like screening, molecular docking, and bioinformatic analysis. Preliminary screening identified 59 drug ingredients in Erjing Pills that met the Absorption, Distribution, Metabolism, Excretion and Toxicity screening criteria. Among these, 7 ingredients, including diosgenin, exhibited superior binding properties compared with the positive drugs in molecular docking. Gene ontology annotation and pathway analysis revealed their involvement in crucial biological processes, such as hormone response, insulin resistance, and steroid hormone biosynthesis signaling pathways, which are known for their anti-inflammatory and cognitive enhancement effects. A meta-analysis of relevant literature corroborated the anti-inflammatory activities of diosgenin and 5 other ingredients. These 5 ingredients, with diosgenin as a prominent candidate, exert anti-inflammatory effects by targeting key components of the toll-like receptor 4/nuclear factor kappa-B/nucleotide-binding domain leucine-rich repeat and pyrin domain-containing protein 3 inflammatory pathway, thereby presenting potential efficacy in the treatment of Alzheimer disease.
A study on the impact of gargling with compound Scutellaria baicalensis Georgi on oral health and microflora changes in fixed orthodontic patients: An experimental study
Authors: Zhang Peng , Chen Shen Guo , Wang Jia Ting , Wang Jin Dong , Chen Zai Hong , Lin Hai Sheng
Published: August 2024

Purpose:

To investigate the effect of Scutellaria baicalensis Georgi gargle on oral health and changes in oral bacteria among orthodontic patients.

Methods:

About 110 cases of oral fixed orthodontic patients were screened from January 2020 to June 2022 at Taizhou Hospital in Zhejiang Province. They were randomly divided into the experimental group (receiving compound S. baicalensis Georgi gargle once a day) and the control group (receiving 0.9% NS gargle once a day), with 55 cases in each group. Gingival samples were collected from both groups before and 3 months after the orthodontic surgery for bacterial culture, and the differences between the 2 groups of patients in Plaque Index (PLI), gingival bleeding index (sBl), and periodontal depth (PD) before and after the operation were compared. Results: The detection levels of PLI, PD, and sBI in the experimental group were lower than those in the control group (P < .05) 3 months after orthodontic surgery (P < .05); after orthodontic correction for 3 months, there was a significant difference in coccus, bacillus, Campylobacter, Clostridium, Helicobacter, and filamentous bacteria between the experimental group and the control group (P < .05); and Porphyromonas gingivalis, Fusobacterium nucleatum, Bacteroides forsythus (B.f), and Agglomerata actinomycetes in the 2 groups were statistically significant after 3 months of orthodontic treatment (P < .05).

Conclusion subsections:

In fixed orthodontic treatment, S. baicalensis Georgi gargle can effectively inhibit oral pathogens and maintain periodontal health.
The mechanisms of Ca2+ regulating autophagy and its research progress in neurodegenerative diseases: A review
Authors: Hou Meng , Zhang Zhixiao , Fan Zexin , Huang Lei , Wang Li
Published: August 2024

Neurodegenerative diseases are complex disorders that significantly challenge human health, with their incidence increasing with age. A key pathological feature of these diseases is the accumulation of misfolded proteins. The underlying mechanisms involve an imbalance in calcium homeostasis and disturbances in autophagy, indicating a likely correlation between them. As the most important second messenger, Ca2+ plays a vital role in regulating various cell activities, including autophagy. Different organelles within cells serve as Ca2+ storage chambers and regulate Ca2+ levels under different conditions. Ca2+ in these compartments can affect autophagy via Ca2+ channels or other related signaling proteins. Researchers propose that Ca2+ regulates autophagy through distinct signal transduction mechanisms, under normal or stressful conditions, and thereby contributing to the occurrence and development of neurodegenerative diseases. This review provides a systematic examination of the regulatory mechanisms of Ca2+ in cell membranes and different organelles, as well as its downstream pathways that influence autophagy and its implications for neurodegenerative diseases. This comprehensive analysis may facilitate the development of new drugs and provide more precise treatments for neurodegenerative diseases.
Exploration of PVT1 as a biomarker in prostate cancer
Authors: Liang Xiangdong , Liu Bin
Published: August 2024

Prostate cancer is a malignant tumor originating from the prostate gland, significantly affecting patients’ quality of life and survival rates. Public data was utilized to identify differentially expressed genes (DEGs). Weighted gene co-expression network analysis was constructed to classify gene modules. Functional enrichment analysis was performed through Kyoto Encyclopedia of Genes and Genomes and gene ontology annotations, with results visualized using the Metascape database. Additionally, gene set enrichment analysis evaluated gene expression profiles and related pathways, constructed a protein–protein interaction network to predict core genes, analyzed survival data, plotted heatmaps and radar charts, and predicted microRNAs for core genes through miRTarBase. Two prostate cancer datasets (GSE46602 and GSE55909) were analyzed, identifying 710 DEGs. Gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses revealed that DEGs were primarily involved in organic acid metabolism and the P53 signaling pathway. Gene set enrichment analysis and Metascape analyses further confirmed the significance of these pathways. After constructing the weighted gene co-expression network analysis network, 3 core genes (DDX21, NOP56, plasmacytoma variant translocation 1 [PVT1]) were identified. Survival analysis indicated that core genes are closely related to patient prognosis. Through comparative toxicogenomics database and miRNA prediction analysis, PVT1 was considered to play a crucial role in the development of prostate cancer. The PVT1 gene is highly expressed in prostate cancer and has the potential to become a diagnostic biomarker and therapeutic target for prostate cancer.
Observational study of in-hospital mortality risk from bladder cancer: Five years of experience at a tertiary referral hospital in Indonesia
Authors: Djatisoesanto Wahjoe , Azmi Yufi Aulia , Yatindra Ida Bagus Gde Tirta Yoga , Mudjanarko Sony Wibisono , Umijati Sri
Published: August 2024

Bladder cancer (BC) is a neoplasm arising from the bladder. It requires appropriate management and its prognosis depends on many factors. This study aimed to analyze the factors that influence outcomes in BC management. This was a retrospective study. Data were collected at one of Indonesia’s largest tertiary referral hospitals. All patients diagnosed with BC from January 2019 to December 2023 were included. The outcome measured was survival or death. Statistical analysis was conducted using SPSS version 26.0 software. The study included 219 patients with a median age of 57.97 years, of which 99 (45.2 %) patients died. In a bivariate analysis, sex, active smoking status, Karnofsky score, metastasis status, chronic kidney disease, type 2 diabetes mellitus, chemotherapy, radiotherapy, and alternative medicine were found to affect mortality status. Based on multivariate analysis, the route of admission (odds ratio [OR] 0.19), irregular visit (OR 6.21), metastasis (OR 3.58), radiotherapy (OR 21.12), and traditional medicine (OR 0.21) were independent factors of in-hospital mortality. The mortality rate for BC was considerably high. Irregular visits, metastasis, type 2 diabetes, and radiotherapy were independent risk factors for mortality.
Advances in autogenous dentin matrix graft as a promising biomaterial for guided bone regeneration in maxillofacial region: A review
Authors: Sun Honglan , Yin Xiaoyunqing , Yang Chao , Kuang Huifang , Luo Wen
Published: August 2024

Autogenous dentin matrix (ADM), derived from a patient’s extracted tooth, can be repurposed as an autologous grafting material in reconstructive dentistry. Extracted teeth provide a source for ADM, which distinguishes itself with its low rejection rate, osteoinductive capabilities and ease of preparation. Consequently, it presents a viable alternative to autogenous bone. Animal studies have substantiated its effective osteoinductive properties, while its clinical applications encompass post-extraction site preservation, maxillary sinus floor augmentation, and guided bone tissue regeneration. Nevertheless, the long-term efficacy of ADM applied in bone regeneration remains underexplored and there is a lack of standardization in the preparation processes. This paper comprehensively explores the composition, mechanisms underlying osteoinductivity, preparation methods, and clinical applications of ADM with the aim of establishing a fundamental reference for future studies on this subject.
Psychological status of patients with skeletal Class III malocclusion undergoing bimaxillary surgery: A comparative study
Authors: Wang Bei Lei , Yang Min Li
Published: August 2024

Skeletal Class III malocclusion can significantly impact psychological well-being. Although bimaxillary surgery is a well-established corrective intervention, its psychological effects are not fully understood. This study aims to investigate changes in self-esteem, sensitivity to criticism, and social appearance anxiety following surgery to inform targeted nursing interventions for psychological adaptation. This comparative study included 205 participants: 150 patients with skeletal Class III malocclusion who underwent bimaxillary surgery, and a control group of 55 individuals without malocclusion. The malocclusion group had a mean age of 21.99 ± 2.28 years (96 males, 109 females). The control group consisted of department interns with Class I occlusion, normal overjet and overbite, and typical facial appearance, with a mean age of 21.61 ± 2.40 years (26 males, 29 females). Psychological assessments, validated for reliability, measured self-esteem, sensitivity to criticism, and social appearance anxiety before and after surgery. Statistical analyses, including independent sample t tests and one-way ANOVA, were performed to compare outcomes between the groups, with a significance level set at P < .05. Preoperative assessments revealed that patients with skeletal Class III malocclusion had significantly lower self-esteem and higher sensitivity to criticism and social appearance anxiety compared to the control group (P < .05). Postoperatively, there were modest improvements in self-esteem and significant reductions in sensitivity to criticism and social appearance anxiety, though levels of social appearance anxiety remained higher than those in the control group (P < .05). No significant differences in self-esteem and sensitivity to criticism were observed between the surgical and control groups postoperatively (P > .05). Within-group comparisons showed significant improvements in all measures after surgery (P < .05). Bimaxillary surgery positively affects the psychological well-being of patients with skeletal Class III malocclusion, enhancing self-esteem and reducing sensitivity to criticism and social appearance anxiety. However, some psychological concerns persist, indicating a need for targeted nursing interventions to further support these patients’ psychological well-being.
Navigating complex cardiac complications: A case report of alcoholic cardiomyopathy and right atrial thrombosis
Authors: Abboud Fares , Nakhal Ranim , Alshwaiki Afif , Hanna Majd , Ishkhan Khachig
Published: August 2024

Rationale:

Alcoholic cardiomyopathy (ACM) is associated with various cardiac complications, but the development of isolated right atrial (RA) thrombus without deep vein thrombosis is rare and presents diagnostic challenges.

Patient concerns:

A 53-year-old Hispanic male presented with shortness of breath, chills, cough, bilateral lower extremity edema, and distended abdomen.

Diagnoses:

The patient was diagnosed with ACM, liver cirrhosis, and a large RA thrombus. Initial transthoracic echocardiography showed severe left ventricular systolic dysfunction but failed to detect the RA mass. Subsequent computed tomography scan and transesophageal echocardiography revealed a large oval mass in the RA, measuring 40 mm × 22 mm × 18 mm.

Interventions:

The patient received guideline-directed medical therapy for heart failure and anticoagulation with enoxaparin. He underwent cardiac catheterization for mechanical thrombectomy, which was minimally successful.

Outcomes:

The patient’s condition was managed with the prescribed interventions. Regular follow-up was planned to assess thrombolysis.

Lessons:

RA thrombosis is an uncommon complication of ACM. A multimodal imaging approach, with a low threshold for transesophageal echocardiography, is crucial in evaluating patients with ACM who present with cardiac complications. This approach enables accurate diagnosis and management of rare conditions like isolated RA thrombosis.
Gitelman syndrome with primary hyperparathyroidism: A case report
Authors: Yu Shanshen , Sun Jia , Mou Lijun
Published: August 2024

Background:

Gitelman syndrome (GS) is a rare autosomal recessive inherited salt-losing tubulopathy, typically devoid of hypercalcemia. Herein, we described one patient of GS presenting with hypercalcemia concomitant with primary hyperparathyroidism (PHPT).

Methods:

On September 28, 2020, a middle-aged female patient was admitted to our hospital with a 12-year history of hypokalemia and hypomagnesemia. Laboratory examinations unveiled hypokalemia with renal potassium wasting, hypomagnesemia, metabolic alkalosis, hypocalciuria, and gene sequencing revealed a homozygous mutation in SLC12A3 (c.179C > T [p.T60M]). Subsequently, the diagnosis of GS was confirmed. In addition, the patient exhibited hypercalcemia and elevated levels of parathyroid hormone. Parathyroid ultrasound revealed left parathyroid hyperplasia, consistent with PHPT. Following aggressive treatment with potassium chloride and magnesium oxide, her serum potassium rose to 3.23 mmol/L, serum magnesium was 0.29 mmol/L, and her joint pain was relieved.

Results:

Based on the patient’s medical history, laboratory findings, and gene sequencing results, the definitive diagnosis was GS concomitant with PHPT.

Conclusion:

PHPT should be taken into consideration when patients diagnosed with GS exhibit hypercalcemia. While the serum potassium level readily exceeded the target threshold, correcting hypomagnesemia proved challenging, primarily because PHPT augments urinary magnesium excretion.