bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiac implantable electronic device infections
Authors: Refaat Marwan , Zakka Patrick , Khoury Maurice , Chami Hassan , Mansour Shareef , Harbieh Bernard , Abi-Saleh Bernard , Bizri Abdul Rahman
Published: April 2019

With increasing rates of device implantation, there is an increased recognition of device infection. We conducted a retrospective observational study in a tertiary care center in Lebanon, with data collected from medical records of patients presenting with cardiac implantable electronic device (CIED) infection from 2000 to 2017 with the purpose of identifying etiologies, risk factors and other parameters, and comparing them to available data from the rest of the world. We identified a total of 22 CIED infections. The most common microbial etiologies, including involvement in polymicrobial infection, were coagulase-negative staphylococci (45.5%) andStaphylococcus aureus(22.7%). Rare cases ofBrucella melitensis,Sphingomonas paucimobilis, andKytococcus schroeteridevice infection were seen. Heart failure was seen in 77.3% of patients, hypertension in 68.2%, and chronic kidney disease in 50%. Skin changes were the most common presenting symptoms (86.4%). Antibiotics were given to all patients and all had their devices removed, with 36.4% undergoing new device implantation. This is the first study of CIED infections in Lebanon and the Middle East. Local epidemiology and occupational exposure must be considered while contemplating the microbial etiology of infection. Close monitoring after device implantation is important in preventing device infection that carries high risk of morbidity and mortality.
General anesthesia vs spinal anesthesia for patients undergoing total-hip arthroplasty
Authors: Pu Xiang , Sun Jian-ming
Published: April 2019

Background:

The optimal anesthetic technique remains debated in patients undergoing total-hip arthroplasty (THA). The purpose of this meta-analysis was to test the efficacy of general and spinal anesthesia for patients undergoing THA.

Methods:

In January 2018, we searched PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews, and the Google database. Data from randomized controlled trials (RCTs) that compared the use of general and spinal anesthesia for patients undergoing THA were retrieved. The primary outcome was to compare the total blood loss. The secondary outcomes were the occurrence of deep venous thrombosis (DVT), the occurrence of nausea, and the length of hospital stay. Software Stata 12.0 was used for meta-analysis.

Results:

Five RCTs with 487 THAs were finally included for meta-analysis. There was no significant difference between the general anesthesia and spinal anesthesia in terms of the total blood loss (weighted mean difference [WMD] = −20.72, 95% confidence interval [CI] −84.50 to 43.05, P = .524; I
2 = 87.8%) and the occurrence of DVT (risk ratio (RR) = 0.85, 95% CI 0.24–3.01, P = .805; I
2 = 70.5%). Compared with general anesthesia, spinal anesthesia was a significant reduction in the occurrence of nausea (RR = 3.04, 95% CI 1.69–5.50, P = .000; I
2 = 0.0%) and the length of hospital stay (WMD = 1.00, 95% CI 0.59–1.41, P = .000; I
2 = 94.7%).

Conclusion:

Spinal anesthesia was superior than general anesthesia in terms of the occurrence of nausea and shorten the length of hospital stay. The quality and number of included studies was limited; thus, a greater number of high-quality RCTs is still needed to further identify the effects of spinal anesthesia on reducing the blood loss after THA.
Metabolic characteristics of obese children with fatty liver
Authors: Zhao Kanglu , Ju Hongzhen , Wang Haili
Published: April 2019

To investigate metabolic differences between simple obese children and those comorbid with fatty liver disease.

Obese children hospitalized in our center from 2014 to 2016 were included and divided into simple obese group and obese with fatty liver group by ultrasound-based diagnosis of fatty liver. Epidemiology data and serum biochemical studies were recorded. Body Mass Index (BMI) and homeostasis model insulin resistance index (HOMA-IR) were calculated accordingly.

A total of 186 obese children were enrolled in this study, including 93 cases of obese children and 93 obese patients’ comorbid with fatty liver. The proportion of male, age, waist circumference (WC), BMI, fasting blood-glucose (FBG), glycosylated hemoglobin A1c (HbA1c), fasting insulin (FINS), and HOMA-IR were significantly higher in obese patients with fatty liver (P <.05). Age and BMI were found to be independent risk factors for fatty liver disease (OR >1, P <.05).

Among obese children, male and elder patients and individuals with higher uric acid are more susceptible to fatty liver.
Clinical course and risk factors of recurrent corneal erosion
Authors: Nanba Hisataka , Mimura Tatsuya , Mizuno Yoshinobu , Matsumoto Koichi , Hamano Shigeki , Ubukata Shoko , Yamamoto Megumi , Watanabe Emiko , Mizota Atsushi
Published: April 2019

Recurrent corneal erosion (RCE) is a common disorder causing ocular pain, tearing, photophobia, and visual impairments. Various factors such as ocular trauma, ocular surgery, corneal dystrophy, contact lens wear, and diabetes mellitus (DM) can cause RCE. The purpose of this study was to determine the causative factors and clinical course of RCE.

We retrospectively examined 21 eyes of 21 patients with RCE and investigated the patients’ background, type of treatments, and clinical course after the treatments. All patients were treated with eye drops, ocular lubrication, or contact lens bandage for the RCE.

Among the 21 patients with RCE, 9 were caused by trauma (Trauma group), 8 by DM (DM group), 1 by bacterial corneal ulcer, 1 by lagophthalmus and bacterial corneal ulcer, 1 by bandkeratopathy, and 1 by eyelid tumor (one eye). The mean age of the patients was 57.8 years with a range 34–91 years. The mean duration from the trauma to the onset of RCE was 5.2 ± 5.0 months (mean ± SD). The time required for a complete recovery of RCE was longer in the DM group (10.3 ± 3.1 weeks) than in the Trauma group (2.7 ± 1.1 weeks, P < .01). The presence of DM was significantly associated with the recovery duration of RCE (r = 0.72; P 
< .01). Multivariate analyses showed that the recovery duration of RCE was associated with the presence of DM (odds ratio = 139.8, P = .04). On the other hand, the type of treatments had no effect on the recovery duration of RCE.

These findings suggest that trauma and DM are important causes of RCE. Wound recovery after RCE may be delayed in patients with DM.
Effect of beraprost on pulmonary hypertension due to left ventricular systolic dysfunction
Authors: Wang Li , Zhu Xinyi , Zhao Liang-Ping , Wang Maosong , Liu Xiang , Chen Yuqi , Chen JianChang , Xu WeiTing
Published: April 2019

Beraprost is used to treat peripheral chronic arterial occlusive disease. However, the efficacy and safety of beraprost in patients with pulmonary hypertension (PH) due to left ventricular systolic dysfunction (PH-HFrEF) remains unknown. The primary objective of this study was to determine the effects of beraprost on PH-HFrEF.

We prospectively recruited patients with PH-HFrEF as determined by echocardiography and right cardiac catheterization. Beraprost sodium was given orally (1 μg/kg/d) added to the usual treatment, and patients were evaluated at 1-year follow-up.

Twenty-five patients were recruited with baseline systolic pulmonary artery pressure (PAP) of 49.5 ± 10.8 mm Hg. Systolic PAP results at 3, 6, 9, and 12 months were 39.1 ± 8.1, 30.4 ± 5.2, 27.7 ± 3.0, and 27.0 ± 4.7 mm Hg, respectively, which were all significantly lower than systolic PAP at baseline (P < .05). Left ventricular ejection fraction results at 6 months (43.5 ± 7.0%), 9 months (47.0 ± 5.5%), and 12 months (48.2 ± 4.8%) were significantly higher than at baseline (34.7 ± 9.2%) (P < .05). Six-minute walking distance at 3 months (282.8 ± 80.6 m), 6 months (367.1 ± 81.2 m), 9 months (389.8 ± 87.1 m), and 12 months (395.7 ± 83.4 m) increased with time, and all were significantly higher than baseline (190.1 ± 75.5 m) (P < .05). One patient developed atrial fibrillation and recovered to sinus rhythm after intravenous administration of amiodarone. There were no instances of cardiac-related death, severe bleeding, or severe impairment of liver function.

Routine oral administration of beraprost sodium added to the usual treatment may improve cardiopulmonary hemodynamics and exercise capacityin patients with PH-HFrEF.
Pregnancy and offspring outcomes after artificial insemination with donor sperm
Authors: Zhang Aiping , Ma Xiaoling , Zhang Lili , Zhang Xuehong , Wang Weihua
Published: April 2019

Artificial insemination with donor sperm (AID) is a widely used procedure, but its success rate in China remains uncharacterized. This study investigated the factors associated with occurrence of clinical pregnancy and live birth and evaluated the birth outcomes in the offspring after AID in Northwest China.

We retrospectively reviewed the results of 1805 AID courses in 1046 couples during 2006–2015. We analyzed whether the number of AID cycles, age of the female patient, and number of sperm with progressive motility were associated with the occurrence of clinical pregnancy and live birth. We also evaluated the birth outcomes in the offspring.

Among the 1805 cycles, 447 (24.8%) resulted in clinical pregnancy and 384 (21.3%) resulted in a live birth. Miscarriage occurred in 57 of the 447 cases of clinical pregnancy (12.8%). The proportion of cycles resulting in a live birth decreased significantly with age (P < .001). The proportion of clinical pregnancies that resulted in miscarriage increased with age (P < .001). Cumulative pregnancy rate (the proportion of patients achieving a clinical pregnancy) increased progressively from 23.0% after 1 cycle to 42.7% after ≥5 cycles. The proportion of cycles resulting in clinical pregnancy did not vary with the total number of sperm with progressive motility administered per cycle. Multivariate logistic regression analysis revealed that superovulation treatment and number of cycles were factors associated with clinical pregnancy, while superovulation treatment, number of cycles, and patient age were factors associated with live birth. Among the 384 live births, only one case (0.3%) of birth defect (hexadactyly) was observed.

In patients undergoing AID, clinical pregnancy is associated with superovulation treatment and number of cycles, and live birth is associated with superovulation treatment, number of cycles, and patient age. The risk of birth defects in the offspring after AID is low.
Variant angina induced by carbon monoxide poisoning
Authors: Song Lisha , Bian Ge , Yang Weimin , Li Hai-Feng
Published: April 2019

Rationale:

Carbon monoxide (CO) poisoning can cause severe damage to the nervous system, and can also cause serious damage to organs, such as the heart, kidneys, and lungs. CO damage to myocardial cells has been previously reported. This can lead to serious complications, such as myocardial infarction.

Patient concerns:

A 47-year-old female patient complained of sudden chest pain for 30 minutes. Before admission, the patient had non-radiating burning chest pain after inhalation of soot.

Diagnosis:

An electrocardiogram showed that myocardial ischemia was progressively aggravated, manifested by progressive ST-segment elevation, and accompanied by T wave inversion and other changes. No obvious coronary stenosis was observed in a coronary angiographic examination. Therefore, the patient was considered to have developed variant angina resulting from CO poisoning-induced coronary artery spasm.

Interventions:

The patient was treated with drugs for improving blood circulation and preventing thrombosis, and underwent hyperbaric oxygen therapy.

Outcomes:

Clinical symptoms relieved after the treatment.

Lessons:

Findings from this case suggest that CO can cause coronary artery spasm and it is one of the predisposing factors of variant angina. For these patients, hyperbaric oxygen therapy can improve blood circulation and prevent formation of thrombus and encephalopathy.
Prognostic significance of nuclear Yes-associated protein 1 in patients with nonsmall cell lung cancer
Authors: Zhu Lingling , Ma Guangzhi , Liu Jiewei , Deng Yunfu , Wu Qiang , Chen Wenjie , Zhou Qinghua
Published: April 2019

Background:

Nuclear Yes-associated protein 1 (YAP1) has often been regarded as an adverse prognostic indicator in various tumors. Recent studies have associated YAP1 with unfavorable prognosis in nonsmall cell lung cancer (NSCLC). However, due to small sample sizes, the prognostic value of nuclear YAP1 in NSCLC patients is not well understood. In the present study, we evaluated the prognostic role of nuclear YAP1 in NSCLC patients via a systematic review and meta-analysis.

Methods:

We searched the PubMed, EMBASE, Cochrane, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Databases for papers investigating the prognostic significance of nuclear YAP1 expression in NSCLC patients. Hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were calculated with reference to overall survival (OS) and progression-free survival (PFS) of NSCLC patients to provide synthesized estimates of the effects of nuclear YAP1 expression.

Results:

Among 414 cases, higher nuclear YAP1 expression presented as a predictive factor of poorer OS (HR = 1.52; 95% CI: 1.11–2.08; P = .01; I
2 = 0.0%) and decreased PFS (HR = 2.11; 95% CI: 1.52–2.93; P < .001; I
2 = 44.2%) in NSCLC patients. Subgroup analysis revealed shortened OS (HR = 1.63; 95% CI: 1.14–2.34; P = .007; I
2 = 0.0%) and worse PFS (HR = 2.25; 95% CI: 1.53–3.30; P < .001; I
2 = 0.0%) in patients from Asia with higher nuclear YAP1 expression. Prognosis was also worse in patients with III–IV stage cancer (PFSHR = 2.09; 95% CI: 1.45–3.01; P < .001; I
2 = 58.1%) and in patients treated with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) (OS HR = 1.59; 95% CI: 1.00–2.51; P = .048; I
2 = 15.5%, and PFS HR = 2.35, 95% CI: 1.62–3.42; P < .001; I
2 = 0.0%).

Conclusion:

High expression of nuclear YAP1 was associated with shorter survival outcome in patients with NSCLC.
The frequency and determinants of blood pressure measurement by a health professional in Germany
Authors: Diederichs Claudia , Neuhauser Hannelore
Published: April 2019

Strong evidence exists for the benefits of screening for hypertension to reduce the risk of cardiovascular disease and death. The aim of this study was to analyze the frequency and determinants of blood pressure (BP) measurement by a health professional in the general population and in individuals without hypertension in Germany.

Data from 17,431 participants 15+ years from the cross-sectional GEDA2014/2015-EHIS survey were used to calculate the percentage of the population who had no BP measurement within the last year and the last 3 years. In multivariate models, the determinants of no BP measurement were analyzed. The frequency of BP measurement was compared between 30 European countries.

In Germany, 27.5% of men and 16.6% of women had no BP measurement by a health professional within the last year and 10.9%, respectively 5.4% not within the last 3 years. In individuals without known hypertension, 34.1% of men and 23.6% of women aged 15 to 19 years had no BP measurement in the last 3 years compared to 5.2% of men and 4.8% of women 70+ years. Independent predictors of not receiving a BP measurement in the last 3 years besides age were male sex, good self-rated health, low health awareness, and no medical consultations but not educational level. Germany has low proportions of no BP measurement compared to other European countries.

Hypertension screening needs improvement in all age groups, especially in the young who have the lowest screening proportions but also in the elderly who have the highest hypertension risk.
Condyloma acuminata on the nipple and coronary sulcus of the penis
Authors: Wu Yan , Song Ge , Li Man , Lun Wenhui
Published: April 2019

Rationale:

Condyloma acuminatum (CA) is a benign tumor primarily caused by infection with human papillomavirus (HPV) type-6 or type-11, lesions of which are most frequently found on the genital and perianal squamous mucosa and skin. CA outside the genitals is not common.

Patient concerns:

A 29-year-old male presented with lesions on the left nipple and coronary sulcus after heterosexual contact.

Diagnoses:

Histopathological examination and HPV detection made a definite diagnosis of CA.

Intervention:

The patient was treated with microwave and topical imiquimod cream.

Outcomes:

After 6 months follow-up, there was no sign of recurrence.

Lessons:

This case shows that we should pay more attention to CA outside the genitals in the process of diagnosis and treatment.
Association between heart rate on admission and in-hospital mortality among general inpatients
Authors: Yamamoto Marumi , Ohta Yoshinori , Sakuma Mio , Takeuchi Jiro , Matsumoto Chisa , Morimoto Takeshi
Published: April 2019

Association between heart rate (HR) and in-hospital mortality in general patients irrespective of underlying diseases were not well scrutinized. We assessed the relationship between HR on admission and in-hospital mortality among general inpatients.

We used data from Japan Adverse Drug Events (JADE) study, a prospective cohort study. One tertiary care hospital in Japan with 13 medical and 12 surgical wards, and an intensive care unit (ICU). Patients (n = 2360) were ≥12 years old and admitted to this hospital within 3 months; and pregnant women were excluded. We assessed the relationship between HR and mortality in five (<60, 60–79, 80–99, 100–119, ≥120 beats per minutes [bpm]) groups. We also compared the five HR groups according to the age (<70 years; ≥70 years) and wards (medical; surgical; ICU).

We enrolled 2360 patients (median age, 71 [interquartile range (IQR) 58–81] years) including 1147, 1068, and 145 patients in the medical and surgical wards, and the ICU, respectively. The median (IQR) HR on admission was 78 (68–91) bpm. Ninety-five patients died during hospitalization. Mortalities in the <60, 60–79, 80–99, 100–119, and ≥120 bpm groups were 2.9% (5/175), 2.7% (28/1047), 3.4% (26/762), 8.2% (24/291), and 14.3% (12/84), respectively (P < .001). The adjusted odds ratios of in-hospital mortality was 3.64 (95% CI 1.88–7.05, P < .001) when HR was ≥100 bpm in the medical ward; and 5.69 (95% CI 1.72–18.82, P = .004) when HR ≥120 bpm in the surgical ward. There was no statistically significant relationship with the ICU.

In conclusion, higher HR should be associated with in-hospital mortality among patients with general diseases. Even with less severe condition or outside ICU, HR should be directed attention to and patients with high HR on admission should be taken additional therapy to reduce the further risk of deterioration.
Impact of full field digital mammography diagnosis for female patients with breast cancer
Authors: Wang Tuan , Shuai Jian-jun , Li Xing , Wen Zhi
Published: April 2019

Background:

Previous clinical studies have reported that full field digital mammography (FFDM) can be used for diagnosis on breast cancer (BC) with promising outcome results. However, no study systematically investigates its diagnostic impact on female patients with BC. Thus, this systematic review will assess the accurate of FFDM diagnosis on BC.

Methods:

In this study, we will perform a comprehensive search strategy in the databases as follows: Cochrane Library, EMBASE, MEDILINE, PSYCINFO, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Information, and Wanfang Data from inception to February 28, 2019. All case-controlled studies exploring the impacts of FFDM diagnosis for patients BC will be fully considered for inclusion in this study. Two authors will independently scan the title and abstracts for relevance, and assess full texts for inclusion. They will also independently extract data and will assess methodological qualify for each included study by using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. RevMan V.5.3 software (London, UK) and Stata V.12.0 software (Texas, USA) will be used to pool the data and to conduct the meta-analysis.

Results:

The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of FFDM will be used to determine the diagnostic accuracy of FFDM for the diagnosis of patients with BC.

Conclusion:

Its findings will provide latest evidence for the diagnostic accuracy of FFDM in female patients with BC.

Systematic review registration:

PROSPERO CRD42019125338.
Contribution of prostate stem cell antigen variation rs2294008 to the risk of bladder cancer
Authors: Deng Shi , Ren Zheng Ju , Jin Tao , Yang Bo , Dong Qiang
Published: April 2019

Objective:

Number of studies have been performed to evaluate the relationship between prostate stem cell antigen (PSCA) variation rs2294008 and bladder cancer risk, but the sample size was small and the results were conflicting. This meta-analysis was conducted to comprehensively evaluate the overall association.

Methods:

Pubmed, Web of science, Embase, China biology medical literature database (CBM), China National Knowledge Infrastructure (CNKI), Wan Fang and Weipu databases were searched before June 30, 2018. The strength of associations was assessed using odds ratios (ORs) and 95% confidence intervals (CIs). All of the statistical analyses were conducted using Review Manager 5.3 and Stata 14.0.

Results:

Ten studies involved 14,021 cases and 26,871 controls. Overall, significant association was observed between the PSCA gene variant rs2294008 polymorphism and bladder cancer (T vs C: OR = 1.16, 95%CI = 1.12−1.20; TT vs CC: OR = 1.32, 95%CI = 1.24−1.41; TT vs CT+CC: OR = 1.15, 95%CI = 1.09−1.22; TT+CT vs CC: OR = 1.27, 95%CI = 1.21−1.34). In subgroup analysis by ethnic group, a statistically significant association was observed in Asians (T vs C: OR = 1.23, 95%CI = 1.15−1.31) and Caucasians (T vs C: OR = 1.14, 95%CI = 1.10−1.18). The sensitivity analysis confirmed the reliability and stability of the meta-analysis.

Conclusion:

Our meta-analysis supports that the PSCA gene variant rs2294008 polymorphism might contribute to individual susceptibility to bladder cancer.
Tension pneumothorax-induced Takotsubo syndrome
Authors: Chen Wei-Siang , Hung Ming-Jui
Published: April 2019

Rationale:

Takotsubo syndrome (TTS) is a form of acute and usually reversible heart failure syndrome. Transient left ventricular dysfunction and electrocardiographic changes could mimic acute coronary syndrome but there are actually no obstructive coronary lesions.

Patient concerns:

A 76-year-old woman with chronic lung disease developed spontaneous tension pneumothorax with the presentation of severe dyspnea, respiratory failure, left ventricular dysfunction, and anterior wall ST-segment elevation on 12-lead electrocardiogram. Acute coronary syndrome was excluded by normal coronary angiograms.

Diagnosis:

The patient was diagnosed as tension pneumothorax complicated by TTS.

Interventions:

The woman underwent tubal thoracostomy for tension pneumothorax-induced obstructive shock. However, the patient further underwent ligation bullectomy for persistent air leakage 2 weeks later.

Outcomes:

The left ventricular dysfunction recovered 1 week after resolution of tension pneumothorax. Anterior wall ST-segment elevation resolved 25 days after admission.

Lessons:

Concurrent electrocardiograms and echocardiographic serial evaluations should be performed to provide more comprehensive information when dealing with tension pneumothorax patients.
Platelet and peripheral white blood cell counts at diagnosis predict the response of adult immune thrombocytopenia to recombinant human interleukin-11
Authors: Jin Chenghao , Wang Yulu , Cheng Hongbo , Liu Haiyun , Liu Tingting , Ke Bo , Li Anna , Yang Liu , Zhu Qingxiu , Ding Weirong , Luo Minzhi , Wei Yujing , Kong Chunfang
Published: April 2019

This study evaluated the effectiveness of recombinant human interleukin-11 (rhIL-11) in the treatment of immune thrombocytopenia (ITP) and determined whether clinical and laboratory findings predicted the treatment response.

This retrospective, single-center, case–control study included 103 adult patients with ITP treated between July 2010 and April 2014 at Jiangxi Province People's Hospital. About 49 patients in the pred+IL group received prednisone (conventional dose) combined with an rhIL-11 regimen, and 54 patients in the pred alone group received prednisone (conventional dose) alone. Demographic data, initial and follow-up platelet counts, proportions of patients achieving platelet counts ≥30 × 109/L (response) and ≥100 × 109/L (complete response) at different time points, and adverse reactions were compared between groups.

Complete response rates were similar between groups overall but higher in the pred+IL group than in the pred alone group for newly diagnosed patients and those with severe ITP (P < .05). Proportions of patients achieving response or complete response at different time points were similar between groups overall but higher in the pred+IL group than in the pred alone group for newly diagnosed patients and those with severe ITP (P < .05). Posttreatment platelet count correlated negatively with platelet count at diagnosis and white blood cell (WBC) count at diagnosis in patients with newly diagnosed ITP (r = −0.337,P = .073 andr = −0.367,P = .050, respectively) or ITP with bleeding-related episodes (r = −0.357,P = .020 andr = −0.434,P = .004, respectively). No immediate or postinfusion severe adverse reactions were observed.

rhIL-11 increased CR and improved hemostasis in patients with newly diagnosed or severe ITP. Platelet and WBC counts at diagnosis can predict the response to rhIL-11.
Upregulation of lncRNA SNHG1 is associated with metastasis and poor prognosis in cancers
Authors: Yu Jing , Yan Yunmeng , Hua Chunlan , Ming Liang
Published: April 2019

Background:

Accumulating evidence suggested that the expression level of long noncoding RNA small nucleolar RNA host gene 1 (lncRNA SNHG1) was upregulated in various cancers, and high expression of SNHG1 was associated with metastasis and prognosis in patients with cancer.

The relationship between SNHG1 expression and metastasis or prognosis in malignant tumors was investigated in this meta-analysis.

Methods:

A systematic search was performed in PubMed, Web of Science, and Cochrane Library from inception until May 31, 2018. Hazard ratio (HR) or odds ratio (OR) with 95% confidence intervals (95% CIs) were calculated to demonstrate prognostic value of SNHG1 using Stata 12.0 software.

Results:

A total of 10 studies including 1129 patients were finally enrolled in the meta-analysis based on the inclusion and exclusion criteria. Increased SNHG1 expression was significantly associated with lymph node metastasis (OR = 3.28, 95% CI = 2.02–5.33) and advanced TNM stage (OR = 0.26, 95% CI = 0.16–0.43). Moreover, high expression of SNHG1 could predict poor overall survival (HR = 2.32, 95% CI = 1.90–2.83), event-free survival (HR = 1.58, 95% CI = 1.06–2.35), recurrence-free survival (HR = 2.15, 95% CI = 1.23–3.77), progression-free survival (HR = 2.75, 95% CI = 1.70–4.46), and disease-free survival (HR = 1.93, 95% CI = 1.10–3.40) in patients with cancer.

Conclusion:

The present meta-analysis demonstrated that upregulation of lncRNA SNHG1 might serve as a useful prognostic biomarker in various cancers.
Role of programmed cell death ligand-1 expression on prognostic and overall survival of breast cancer
Authors: Li Shichao , Chen Li , Jiang Jun
Published: April 2019

Background:

Recently, the correlation of immunological checkpoint marker programmed cell death ligand-1 (PD-L1) and the prognosis of various cancers has been a research hotspot. The aim of this study is to examine the prognostic effect of PD-L1 in breast cancer.

Methods:

PubMed, EMBASE, Web of Science, the Cochrane Library database were searched for eligible studies and additional hand-searching were reviewed as an augmentation. Pooled hazard ratios (HR) and 95% confidence interval (CI) for overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS)/recurrence-free survival (RFS), and metastasis-free survival (MFS) were estimated using fixed- or random-effect models.

Results:

Data from 19 studies involving 12,505 patients were collected. Study quality was assessed according to guidelines for assessing quality in prognostic studies. PD-L1 expression was significantly associated with lymph node metastasis (P < .001), high tumor grade (P < .001), negative hormone receptor (P < .001), human epidermal growth factor receptor 2 (HER2) positivity (P < .001), high Ki67 (P < .001), and high tumor-infiltrating lymphocytes (TILs) (P < .001). PD-L1 expression had no significant impact on CSS (pooled HR 0.83, 95% CI = 0.64–1.09, P = .19) or MFS (pooled HR 1.11, 95% CI = 0.62–1.97, P = .72), but significantly correlated with shortened OS (pooled HR 1.52, 95% CI = 1.14–2.03, P = .004) and DFS (pooled HR 1.31, 95% CI = 1.14–1.51, P < .000). Subgroup analysis showed that not PD-L1 RNA expression, but protein expression was associated with shorter survival, in addition, the adverse prognostic effect of PD-L1 expression remained in luminal A, luminal B, and HER2 subtype, not in basal-like or triple-negative subtype.

Conclusions:

An elevated PD-L1 expression significantly correlates with high-risk prognostic indicators and decreased survival in patients with breast cancer.
Role of tranexamic acid in nasal surgery
Authors: Ping Wei-dong , Zhao Qi-ming , Sun Hua-feng , Lu Hai-shan , Li Fei
Published: April 2019

Objective:

Nasal surgeries (such as Functional Endoscopic Sinus Surgery, Rhinoplasty, and Septorhinoplasty) are popular procedures. But perioperative bleeding, eyelid edema, and periorbital ecchymosis remain problems. Tranexamic acid (TXA) is an antifibrinolytic, and it was used to reduce the perioperative bleeding. However, there is no enough evidence judging its safety and efficiency. Therefore, a meta-analysis is conducted by us to evaluate the role of TXA in patients undergoing nasal surgeries.

Method:

A search of the literature was performed until June 2018; the PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched for related articles using search strategy. Two authors independently assessed the methodological quality of the included studies and extracted data. Surgical information and postoperative outcomes were analyzed. Only randomized controlled trial (RCT) articles were included, and subgroup analysis was established to deal with heterogeneity. RevMan 5.3 software was selected to conduct the meta-analysis.

Result:

Eleven RCTs were included in our meta-analysis. There were significant differences in blood loss (P < .001), surgical field quality (P < .001), edema rating of upper (P < .001) and lower (P < .001) eyelid, ecchymosis rating of upper (P < .001) and lower eyelid (P < .001) when comparing the TXA group to the placebo group. However, the difference in operation time (P = .57) was not significant between the two groups.

Conclusion:

Perioperative TXA could reduce the blood loss and improve the quality of surgery field during nasal surgery, and it was helpful for reducing the edema and ecchymosis after nasal surgeries, but it has little influence in reducing the operation time.
Targeted sequencing analysis of the adiponectin gene identifies variants associated with obstructive sleep apnoea in Chinese Han population
Authors: Yang Yunyun , Yang Song , Jiao Xiaolu , Li Juan , Wu Hao , Sun Haili , Yang Yunxiao , Zhang Ming , Wei Yongxiang , Qin Yanwen
Published: April 2019

Obstructive sleep apnoea (OSA) is a prevalent sleep disorder considered as an independent risk factor for cardiovascular consequences. It has a strong genetic background and is associated with hypoadiponectinaemia.

Target sequencing of whole ADIPONQ gene was performed in 340 participants including 247 patients with OSA and 93 non-OSA participants. Polysomnography was used to diagnose OSA. The associations between variants and OSA were determined by multivariate regression analysis.

Thirteen single nucleotide polymorphisms of ADIPOQ were identified in all subjects. Genotype frequencies at rs4686803 (P = .034), rs3774262 (P = .034), and rs2082940 (P = .045) were significantly different between OSA and non-OSA groups. Individuals carrying the CT/TT genotypes of rs4686803, GA/AA genotypes of rs3774262, and CT/TT genotypes of rs1063537 were associated with 2.295-, 2.295- and 2.155-fold increased risk of OSA respectively in dominant model, after adjusting for confounding effects. The subjects with the rs2082940 CC genotype were associated with decreased risk of OSA (OR: 0.455) in recessive model. Additionally, the apnoea–hypopnea index (AHI) was significantly increased in rs3774262 (GA/AA) (P = .001), rs4686803 (CT/TT) (P = .001), and rs1063537 (CT/TT) (P = .004) genotype individuals than those with rs3774262 (GG), rs4686803 (CC), and rs1063537 (CC) genotypes, respectively. The AHI was significantly decreased in individuals with ADIPOQ rs2082940 CC genotypes than in those with the CT and TT genotype (P = .007). Moreover, the stratified analysis found that the genotype of rs3774262 (GA/AA), rs4686803 (CT/TT), and rs1063537 (CT/TT) variants were associated with increased risk of OSA by 2.935-, 2.935- and 2.786-fold in overweight participants. The genotype of rs2082940 CC variants was associated with decreased risk of OSA (OR: 0.373) in overweight participants compared with rs2082940 CT/ TT genotypes.

ADIPOQ variants rs3774262, rs4686803, rs1063537, and rs2082940 were associated with the prevalence of OSA in Chinese Han individuals.
Risk factors related to acupuncture response in postmenopausal women with stress urinary incontinence
Authors: Jiao Ruimin , Liu Yan , Liu Baoyan , Liu Zhishun
Published: April 2019

Postmenopausal women are at a higher risk of stress urinary incontinence (SUI). In a previous trial, electroacupuncture (EA) was shown to be an effective treatment for women with SUI. Here we present a secondary analysis to investigate the specific factors associated with response to acupuncture therapy among postmenopausal women with SUI.

We conducted secondary analysis of data from a multicenter randomized controlled trial. This trial included a baseline period of 1 week and a treatment period of 6 weeks with electroacupuncture (EA) or sham electroacupuncture (SA). The patients were randomly assigned to 2 groups (EA group or SA group). Participants who showed a decrease in urine leakage by at least 50% from baseline level, as measured by 1-hour pad at week 6, were defined as responders. Baseline characteristics associated with response to acupuncture therapy (e.g., demographic, comorbidities, and lifestyle-related factors) were identified by logistic regression analysis and the interactions between treatment assignment and baseline characteristics assessed.

This analysis included a total of 349 postmenopausal women, of whom 137 (39.3%) were classified as responders. Response rate in the EA group was significantly higher than that in the SA group (60.9% vs 18.9%, respectively;P < .001). On multivariable logistic regression analysis, only “mean number of urine pads used before treatment” remained a significant predictor of response to therapy (EA or SA). Greater weekly mean number of urine pads used before treatment showed a correlation with non-response to therapy, as the likelihood of clinical response reduced by 5.26% with increase in the weekly mean number of urine pads used (odds ratio 0.947, 95% confidence interval 0.902–0.993;P = .020). The interaction terms were not statistically significant.

Postmenopausal women with SUI who used fewer number of pads per week before treatment were more likely to respond to therapy. This study provides valuable insights for pretreatment selection of women with SUI. Specific factors related to the therapeutic effects of acupuncture were not identified and need to be explored in future studies.

Trial registration:Clinical Trials.gov: NCT01784172.
Efficacy of rivaroxaban for pulmonary embolism
Authors: Jia Juan , Xue Shi-min , Xu Ning
Published: April 2019

Background:

Previous clinical trials have addressed that rivaroxaban is effective for the treatment of patients with pulmonary embolism (PE). This study will systematically assess its efficacy and safety for PE.

Methods:

We will carry out this study by searching the following electronic databases from inception to March 1, 2019 without language restrictions: Cochrane Library, EMBASE, PUBMED, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. In addition, we will also search clinical trial registries, dissertations, and conference abstracts to avoid any missing potential studies. All randomized controlled trials of rivaroxaban for patients with PE will be fully considered. Two researchers will independently perform literature selection, data collection, and methodological quality assessment. If it is appropriate, outcome data will be pooled by using a fixed-effect model or random-effect model, and meta-analysis will be considered for operation.

Results:

All efficacy and safety of rivaroxaban for PE will be assessed through all primary and secondary outcomes. The primary outcomes are all-cause mortality and major bleeding. The secondary outcomes are recurrent venous thromboembolism, duration of hospital stay, quality of life, patient satisfaction, and adverse events.

Conclusion:

The findings of this study will summarize updated evidence on the efficacy and safety of rivaroxaban for patients with PE.

Ethics and dissemination:

It is not necessary to inquire ethical approval for this study, because it will not analyze any individual patient data. The results of this study will be published through peer-reviewed journals.

Systematic review registration:

PROSPERO CRD42019126095.
Knowledge and attitudes regarding hospice care among outpatients and family members in two hospitals in China
Authors: Ni Kaiwen , Gong Yining , Li Furong , Cao Xi , Zhang Hua , Chu Hongling , Li Tong , Mairipaiti Abulikemu , Zhao Yiming , Li Nan
Published: April 2019

Access to hospice care is widely provided in Western countries, but the supply of such service is still in its initiative stage in China. As relatives are often involved in end-of-life decision making in China, a better understanding of their cognitions toward hospice care would help policy makers and physicians to overcome the barriers of providing such service. Thus, we conducted the study to assess the level of knowledge and attitudes among Chinese outpatients and family members regarding hospice care.

A cross-sectional study was conducted in Peking University Third Hospital and Peking University Shougang Hospital. Trained interviewers recruited outpatients or family members in two hospitals as a convenience sample to complete an anonymous face-to-face survey on demographic information, knowledge, and attitudes regarding hospice care.

A total of 550 respondents completed this survey. Only 107 (19.5%) reported that they had known or heard of hospice care, with a mean knowledge score of 2.8 (standard deviation = 1.6). Of the respondents, 69.5% answered “strongly agree” or “agree” regarding the importance of providing hospice care in China. Participants who had known of hospice care were more likely to have favorite attitudes toward it.

The awareness rate of hospice care is low in the study, which may lead to poor attitude and low enrollment rate. Considering the increasing evidence to support the improved outcomes of patients and family members associated with hospice care, the public education on its scope of services, benefits, and limitations is needed in China.
The clinicopathological significance of ubiquitin-conjugating enzyme E2C, leucine-rich repeated-containing G protein-coupled receptor, WW domain-containing oxidoreductase, and vasculogenic mimicry in invasive breast carcinoma
Authors: Shen Rong , Wu Ting , Huang Pan , Shao Qixiang , Chen Miao
Published: April 2019

Ubiquitin-conjugating enzyme E2C (UBE2C), a crucial part of the ubiquitin—conjugating enzyme complex, is reported to promote progression of various cancers. Leucine-rich repeated-containing G protein-coupled receptor (LGR5), a biomarker of cancer stem cells, is reported to be responsible for the initiation and progression of cancers. WW domain-containing oxidoreductase (WWOX), a suppressor of tumor, is reported to inhibit initiation and progression of cancers. Vasculogenic mimicry (VM), a new blood supply pattern, is associated with progression of cancers. However, the clinicopathological significance of UBE2C, LGR5, WWOX, and VM in invasive breast carcinoma (IBC) remains elusive. The aim of this study is to investigate the positive rate of UBE2C, LGR5, WWOX, and VM in IBC and their clinical significance.

Positive rates of UBE2C, LGR5, WWOX, and VM in 247 whole IBC samples were detected through immunohistochemistry. Patients data (including clinical, demography, follow-up) were collected.

Levels of UBE2C, LGR5, VM, and microvessel density (MVD) were significantly higher, and level of WWOX was significantly lower in IBC specimens when compared with normal mammary gland tissues. Levels of UBE2C, LGR5, VM, and MVD were all positively associated with tumor stages, lymph node metastasis (LNM) stages, tumor grades, and tumor-node-metastasis (TNM) stages, and unfavorably with patients’ overall survival (OS) and disease-free survival (DFS). Level of WWOX was negatively associated with tumor stages, LNM stages, grades, and TNM stages, and favorably with patients’ OS and DFS. Multivariate analysis indicated that levels of UBE2C, LGR5, VM, MVD, and WWOX, as well as TNM stages were independently prognostic factors for OS and DFS in patients with IBC.

UBE2C, LGR5, VM, MVD, and WWOX may be considered as promising indicator of IBC prognosis.
Rare pancreatic carcinosarcoma in a patient with medical history of esophageal cancer
Authors: Liu Yang , Hao Han , Guo Xiaowan , Xu Jieping , Kang Lin , Zheng Guona , Zhao Huanfen
Published: April 2019

Rationale:

Pancreatic carcinosarcoma (PCS) is a very rare pancreatic cancer with an extremely poor prognosis. Interestingly, PCS can coexist with other metachronous malignant cancers. Here we report a case of PCS combined with esophageal cancer (EC).

Patient concerns:

The patient was a 66-year-old man who presented with abdominal pain and progressive nausea. He had undergone esophagectomy for EC 5 years previously.

Diagnosis:

Both EC and PCS were confirmed via postoperative pathological diagnosis.

Interventions:

Owing to the patient's previous esophagectomy for EC, pancreaticoduodenectomy for the PCS could not be performed. Instead, he underwent cholecystectomy with bile duct-jejunum Roux-en-Y anastomosis and radioactive seed implantation.

Outcomes:

The patient is still alive for >1 year.

Lessons:

To our knowledge, this is the first report of PCS combined with EC and thus of metachronous multiple primary carcinoma. A detailed literature review of the clinical and histologic features of PCS reveals important information about the epidemiology and biology of this rare disease.
Pediatric ovarian tumors, a challenge for pediatrician and gynecologist
Authors: Mărginean Cristina Oana , Mărginean Claudiu , Chinceşan Mihaela , Mărginean Maria Oana , Meliţ Lorena Elena , Săsăran Vlăduţ , Mărginean Cristian Dan
Published: April 2019

Rationale:

Ovarian or adnexal tumors are very rare in patients below the age of 18 years, most of them being functional cysts, only 10% being malignant. We report 3 cases of ovarian tumors with the aim of revealing the particularities regarding the diagnosis and management of benign and malignant ovarian tumors in pediatric patients.

Patient concerns:

The 1st case, a 9-year-old girl presented for diffuse abdominal pain, distended abdomen and rapid increase in abdominal volume. The 2nd case describes a 13-year-old female patient admitted for acute abdominal pain and nausea, and the 3rd one was an 18-year-old female teenager who presented for distended abdomen, intermittent diffuse abdominal pain and rapid increase in abdomen volume.

Diagnoses:

The abdominal ultrasound revealed in all 3 patients suggestive signs for ovarian tumors.

Interventions:

The 1st patient underwent laparotomy with adnexectomy, and the histopathological exam showed the diagnosis of dysgerminoma. The 2nd patient underwent laparoscopy with adnexectomy, and the histopathological exam revealed a borderline tumor. The 3rd patient benefited by a laparotomy with left ovariectomy, and the histopathological exam pointed out a mature teratoma.

Outcomes:

The outcome was favorable in all 3 cases, but the patients with dysgerminoma and mature teratoma were further referred to the oncologist for proper assessment.

Lessons:

Laparoscopy may represent the first choice for uncomplicated ovarian masses. The diagnosis and the therapeutic plan must be based on symptoms, pelvic ultrasound, the time of menarche and the potential serum markers.
An occult urothelial carcinoma with wide multiorgan metastases and its genetic alteration profiling
Authors: Bu Kunpeng , Shi Zeyan , Lu Yang , Zhao Juan , Li Bixun
Published: April 2019

Rationale:

Urothelial carcinoma, also named transitional cell carcinoma, is the most frequent occurring malignancy in the urinary system. It mainly invades the surrounding tissues and metastasizes to distant organs in later stages.

Patient concerns:

Here, we presented an unusual case of occult urothelial carcinoma primarily manifested as a multiorgan metastatic cancer in a 59-year-old man. The patient complained of pain on the left thigh root for a month. The imaging and histopathological examination revealed multiple malignancies in lung, bone, and liver.

Diagnoses:

The histological evaluation and the immunohistochemistry (IHC) profile of liver, lung, and bone were consistent with the diagnosis of metastases from the original urothelial cancer, while imaging examination was not able to detect a primary lesion in the urinary system.

Interventions:

Based on the mutation of STK11 M51Ifs∗106 detected by next generation sequencing (NGS), we started targeted therapy with everolimus.

Outcomes:

The patient deteriorated after 3 months of treatment and passed away.

Lessons:

In this initial report of occult urothelial carcinoma, we obtained information on genetic variations of tumor tissue which could provide important information for subsequent studies on this kind of disease.