bluuebunny/crossref_metadata_2025 huggingface dataset:
Alterations in Lipid Profile Upon Uterine Fibroids and Its Recurrence
Authors: Tonoyan Narine , Chagovets Vitaliy , Starodubtseva Natalia , Tokareva Alisa , Chingin Konstantin , Kozachenko Irena , Adamyan Leyla , Frankevich Vladimir
Published: January 2021

Background. Uterine fibroids (UF) is the most common (about 70% cases) type of gynecological disease, with the recurrence rate varying from 11% to 40%. Because UF has no distinct symptomatology and is often asymptomatic, the specific and sensitive diagnosis of UF as well as the assessment for the probability of UF recurrence pose considerable challenge.Aim. The aim of this study was to characterize alterations in the lipid profile of tissues associated with the first-time diagnosed UF and recurrent uterine fibroids (RUF) and to explore the potential of mass spectrometry (MS) lipidomics analysis of blood plasma samples for the sensitive and specific determination of UF and RUF with low invasiveness of analysis.Materials and methods. MS analysis of lipid levels in the myometrium tissues, fibroids tissues and blood plasma samples was carried out on 66 patients, including35 patients with first-time diagnosed UF and 31 patients with RUF. The control group consisted of 15 patients who underwent surgical treatment for the intrauterine septum. Fibroids and myometrium tissue samples were analyzed using direct MS approach. Blood plasma samples were analyzed using high performance liquid chromatography hyphened with mass spectrometry (HPLC/MS). MS data were processed by discriminant analysis with projection into latent structures (OPLS-DA).Results. Significant differences were found between the first-time UF, RUF and control group in the levels of lipids involved in the metabolism of glycerophospholipids, sphingolipids, lipids with an ether bond, triglycerides and fatty acids. Significant differences between the control group and the groups with UF and RUF were found in the blood plasma levels of cholesterol esters, triacylglycerols, (lyso) phosphatidylcholines and sphingomyelins. Significant differences between the UF and RUF groups were found in the blood plasma levels of cholesterol esters, phosphotidylcholines, sphingomyelins and triacylglycerols. Diagnostic models based on the selected differential lipids using logistic regression showed sensitivity and specificity of 88% and 86% for the diagnosis of first-time UF and 95% and 79% for RUF, accordingly.Conclusion. This study confirms the involvement of lipids in the pathogenesis of uterine fibroids. A diagnostically significant panel of differential lipid species has been identified for the diagnosis of UF and RUF by low-invasive blood plasma analysis. The developed diagnostic models demonstrated high potential for clinical use and further research in this direction.
Tinnitus Assessment : Chinese Version of Tinnitus Primary Function Questionnaire
Authors: XIN YING , Tyler Richard , Yao Zi-ming , Zhou Na , Tao Li-yuan , Ma Fu-rong , Pan Tao
Published: January 2021

OBJECTIVE: The aim of the study was to evaluate the Chinese version of Tinnitus Primary Function Questionnaire (TPFQ).DESIGN: Tinnitus patients were administered the TPFQ, the Tinnitus Handi­cap Inventory (THI), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and the Pittsburgh Sleep Quality Index (PSQI). Additionally, the magnitude estimate of tinnitus loudness, pure tone audiogram and tinnitus matching were obtained. The factor structure was measured by Kaiser-Meyer-Olkin. The internal consistency was examined using Cron­bach coefficient alpha. The relationships between the TPFQ scores and other measurements were compared with Spearman rank correlation coefficient.STUDY SAMPLE：116 patients whose tinnitus lasting longer than 3 months were included in this study.RESULTS: The Cronbach’s α of the 20-item version TPFQ was 0.94, and the 12-item version TPFQ was 0.92. Both the 20-item and 12-item version TPFQ were significantly correlated with magnitude estimation of tinnitus loudness, THI, PSQI, BDI and BAI. The average pure tone hearing thresholds were significantly correlated with the hearing subscale. CONCLUSIONS: The 20-item and 12-item versions of Chinese TPFQ are a reliable and valid measures of tinnitus. The TPFQ can be used in the assessment and management of tinnitus among the Chinese speaking population.
Association of TLR2 Haplotypes Encoding Q650 With Reduced Susceptibility to Ovine Johne’s Disease in Turkish Sheep
Authors: YAMAN Yalçın , AYMAZ Ramazan , KELEŞ Murat , BAY Veysel , ÜN Cemal , HEATON Michael P
Published: January 2021

Ovine Johne’s disease (OJD) is caused by Mycobacterium avium subsp. paratuberculosis (MAP) and carries a potential zoonotic risk for humans. Selective breeding strategies for reduced OJD susceptibility would be welcome tools in disease eradication efforts, if available. The Toll-like receptor 2 gene (TLR2) plays an important signaling role in immune response to MAP, and missense variants are associated with mycobacterial infections in mammals. Our aim was to identify and evaluate ovine TLR2 missense variants for association with OJD in Turkish sheep. Eleven TLR2 missense variants and 17 haplotype configurations were identified in genomic sequences of 221 sheep from 61 globally-distributed breeds. The five most frequent haplotypes were tested for OJD association in 102 matched pairs of infected and uninfected ewes identified in 2257 Turkish sheep. Ewes with one or two copies of TLR2 haplotypes encoding glutamine (Q) at position 650 (Q650) in the Tir domain were 6.6-fold more likely to be uninfected compared to ewes with arginine (R650) at that position (CI95 = 2.6 to 16.9, p-value = 3.7x10-6). The protective TLR2 Q650 allele was present in at least 25% of breeds tested and thus may facilitate selective breeding for sheep with reduced susceptibility to OJD.
Which Fracture Pattern Characteristics of Partial Articular Radial Head Fractures Are Associated With Concomitant Injuries of Elbow?
Authors: Zhu Jian , Deng Xiangtian , Cheng Xiaodong , Tan Zhanchao , Hu Hongzhi , Zhang Yingze
Published: January 2021

Background: Radial head fractures are the most common fractures around the elbow and about one third of patients have associated injuries. Identification of these injuries is important, because they often dictate the treatment. While it is not clear whether the fracture pattern characteristics of radial head were correlated with associated injuries. The aim of this study was to identify whether the fracture pattern characteristics of partial articular radial head fractures are correlated with associated elbow injuries.Methods: Patients who had a partial articular radial head fracture from 2015-2019 were retrospective analyzed. A three-dimension radial head model was created with MIMICS software to accurately measure the fracture pattern characteristics, including the size, the arc, and the location of the fragment as well as fracture comminution status and fracture fragment separation. Information of age, gender, side and associated injuries was extracted from clinical data. The patients with and without associated elbow injuries were compared. The multivariant logistic regression was used to examine the correlation between fracture pattern characteristics and associated injuries.Results: Of the 70 patients with partial articular radial head fractures, 41 had concomitant elbow injuries. Significant differences were not found in age，gender as well as affected side and articular surface involved. Patients with associated elbow injuries were more likely to have large fragment located in anteromedial quadrant and large arc of fracture fragment. In addition, they also had more frequently to have comminuted fracture pattern and separated fragments. However, in the multiple logistic regression analysis, large fragment located in anteromedial quadrant, comminuted fracture pattern and separated fragments remained significantly associated.Conclusions: The present study showed a large fragment located in anteromedial quadrant, comminuted fracture pattern and separated fragments are independent risk factors for elbow associated injury after radial head fractures.
Reallocations in Acne Healthcare: Exploring the Possible Roles and Added Value of Non-physicians by a Mixed-Methods Study Design
Authors: de Vries Femke , Welbie Marlies , Tjin Esther , Driessen Rieke , de Kerkhof Peter van
Published: January 2021

Background A highly promoted opportunity for optimizing healthcare services is to expand the role of non-physician care providers by care reallocation. Reallocating care from physicians to non-physicians can play an important role in solving systemic healthcare problems such as care delays, hospital overcrowding, long waiting lists, high work pressure and expanding healthcare costs. Dermatological healthcare services, such as the acne care provision, are well suited for exploring the opportunities for care reallocation as many different types of care professionals are involved in the care process. In the Netherlands, acne care is mainly delivered by general practitioners and dermatologists. The Dutch healthcare system also recognizes non-physician care providers, among which dermal therapists and beauticians are the most common professions. However, the role and added value of non-physicians is still unclear. The present study aimed to explore the possibilities for reallocating care to non-physicians and identify drivers for and barriers to reallocation. Methods A mixed-method design was used combining quantitative and qualitative data. 224 questionnaires were completed and 24 semi-structured interviews were conducted.Results A broad spectrum of non-physician tasks and responsibilities were delineated. Interviewed physicians considered acne as a low-complexity skin condition which made them willing to explore the possibilities for reallocating. A majority of all interviewees saw a key role for non-physicians in counselling and supporting patients during treatment, which they considered an important role for increasing patients’ adherence to proposed treatment regimes, contributing to successful clinical outcome. Also, the amount of time non-physicians spend on patients was experienced as driver for reallocation. Legislation and regulations, uncertainties about the extent of scientific evidence and proper protocols use within the non-physician clinical practice were experienced as barriers influencing the possibilities for reallocation. Conclusion Delineated roles and drivers demonstrate there is room and potential for reallocation between physicians and non-physicians within acne healthcare, when barriers are adequately addressed.
Inflammogenic Effect of Polyacrylic Acid in Rat Lung Following Intratracheal Instillation
Authors: Nishida Chinatsu , Tomonaga Taisuke , Izumi Hiroto , Wang Ke-Yong , Ishidao Toru , Takeshita Jun-ichi , Ono Ryohei , Sumiya Kazuki , Fujii Shota , Mochizuki Shinichi , Sakurai Kazuo , Yamasaki Kei , Yatera Kazuhiro , Morimoto Yasuo
Published: January 2021

BackgroundOrganic chemicals are known to cause allergic diseases such as bronchial asthma and hypersensitivity pneumonitis, and it has been considered that they do not cause irreversible pulmonary fibrosis. It has recently been reported, however, that cross-linked acrylic acid-based polymer, an organic chemical, might cause serious interstitial lung diseases, including pulmonary fibrosis. We investigated whether or not intratracheal instillation exposure to cross-linked polyacrylic acid (CL-PAA) can cause lung disorder in rats.MethodsMale F344 rats were intratracheally instilled with dispersed CL-PAA at low (0.2 mg/rat) and high (1.0 mg/rat) doses, and were sacrificed at 3 days, 1 week, 1 month, 3 months and 6 months after exposure to examine inflammatory and fibrotic responses and related gene expressions in the lungs. Rat lungs exposed to crystalline silica, asbestos (chrysotile), and NiO and CeO2 nanoparticles were used as comparators.ResultsPersistent increases in total cell count, neutrophil count and neutrophil percentage, and in the concentration of the cytokine-induced neutrophil chemoattractants (CINC)-1, CINC-2 and C-X-C motif chemokine 5 (CXCL5) (which had the highest expression of all chemokines by cDNA microarray using the lung tissue) were observed in bronchoalveolar lavage fluid (BALF) from 3 days until at least 1 month following CL-PAA intratracheal instillation. Persistent increases in heme oxygenase-1 (HO-1) in the lung tissue were also observed from 3 days to 6 months after exposure. Histopathological findings of the lungs demonstrated that extensive inflammation at 3 days was greater than that in exposure to silica, NiO nanoparticles and CeO2 nanoparticles, and equal to or greater than that in asbestos (chrysotile) exposure, and the inflammation continued until 1 month. Fibrotic changes also progressed after 1 month postexposure. Conclusion﻿Our results suggest that CL-PAA may potentially cause strong neutrophil inflammation in the rat and human lung.
Episodic Headaches with Spontaneous Hypothermia Reveal Shapiro’s Syndrome with Effectiveness of Clonidine Therapy
Authors: AUBIGNAT Mickael , Tir Melissa , Krystkowiak Pierre , Andriuta Daniela
Published: January 2021

Background: Episodic headaches with spontaneous hypothermia constitute an uncommon association and is not well recognized in the International Classification of Headache Disorders (ICHD-3). Spontaneous periodic hypothermia, also called Shapiro’s syndrome, is a rare disease characterized by hypothermia attacks associated or not with hyperhidrosis without any triggering factor.Case presentation: We report a rare case of Shapiro’s syndrome revealed by episodes of headache with spontaneous hypothermia with effectiveness of clonidine therapy in a 76-year-old Parkinson’s disease woman.Conclusions: In the literature, apart from Shapiro’s syndrome, headaches with hypothermia seem to occur very rarely. These symptoms may be considered as a very rare non-motor fluctuation of Parkinson’s disease.
Spatiotemporal Variation of the Indoor Mycobiome in Daycare Centers
Authors: Estensmo Eva Lena , Morgado Luis , Maurice Sundy , Martin-Sanchez Pedro Maria , Engh Ingeborg Bjorvand , Mattsson Johan , Kauserud Håvard , Skrede Inger
Published: January 2021

Background: Children spend considerable time in daycare centers in parts of the world, and are exposed to the indoor micro- and mycobiomes of these facilities. The level of exposure to microorganisms varies within and between buildings, depending on occupancy, climate and season. In order to evaluate indoor air quality, and the effect of usage and seasonality, we investigate the spatiotemporal variation in the indoor mycobiomes of two daycare centers. We collected dust samples from different rooms throughout a year and analyzed their mycobiomes using DNA metabarcoding. Results: The fungal community composition in rooms with limited occupancy (auxiliary rooms) was similar to the outdoor samples, and clearly different from the rooms with higher occupancy (main rooms). The main rooms had higher abundance of Ascomycota, while the auxiliary rooms contained comparably more Basidiomycota. We observed a strong seasonal pattern in the mycobiome composition, mainly structured by the outdoor climate. Most markedly, basidiomycetes of the orders Agaricales and Polyporales, mainly reflecting typical outdoor fungi, were more abundant during summer and fall. In contrast, ascomycetes of the orders Saccharomycetales and Capnodiales were dominant during winter and spring. Conclusions: Our findings provide clear evidences that the indoor mycobiome in daycare centers are structured by occupancy as well as outdoor seasonality. We conclude that the temporal variability should be accounted for in indoor mycobiome studies and in the evaluation of indoor air quality of buildings.
Ecology Impacts The Decrease of Spirochaetes and Prevotella In The Fecal Gut Microbiota of Urban Humans
Authors: Thingholm Louise B. , Bang Corinna , Rühlemann Malte C. , Starke Annika , Sicks Florian , Kaspari Verena , Jandowsky Anabell , Fröhlich Kai , Ismer Gabriele , Bernhard Andreas , Bombis Claudia , Struve Barbara , Rausch Philipp , Franke Andre
Published: January 2021

Background: Compared to the huge microbial diversity in most mammals, human gut microbiomes have lost diversity while becoming specialized for animal-based diets – especially compared to chimps, their genetically closest ancestors. The lowered microbial diversity within the gut of westernized populations has also been associated with different kinds of chronic inflammatory diseases in humans. To further deepen our knowledge on phylogenetic and ecologic impacts on human health and fitness, we established the herein presented biobank as well as its comprehensive microbiota analysis. In total, 424 stool samples from 40 different animal species, including Homo sapiens, belonging to four diverse mammalian orders were collected at seven different locations and analyzed by 16S rRNA gene amplicon sequencing. Comprehensive data analysis was performed to (i) determine the overall impact of host phylogeny vs. diet, location, and ecology and to (ii) examine the general pattern of fecal bacterial diversity across captive mammals and humans.Results: By using a controlled study design with captive mammals we could verify that host phylogeny is the most dominant driver of mammalian gut microbiota composition. However, the effect of ecology appears to be able to overcome host phylogeny and should therefore be studied in more detail in future studies. Most importantly, our study could observe a remarkable decrease of Spirochaetes and Prevotella in urban humans and New World monkeys, which is probably not only due to diet, but also to the social behavior of these communities.Conclusion: Our study highlights the importance of phylogenetic relationship and ecology within the evolution of mammals’ fecal microbiota composition. Particularly, the observed decrease of Spirochaetes and Prevotella in urban communities might be associated to lifestyle dependent rapid evolutionary changes, potentially involved in the establishment of dysbiotic microbiomes promoting the etiology of chronic diseases.
Clinical Study of Unilateral Extraforaminal Lumbar Interbody Fusion (ELIF) Revision For Lumbar Disc Herniation After Primary Discectomy
Authors: Lu Qilin , Tang Jin , Chen Long , Wang Xiao-zhen , Zhu Yi-liang , YANG Ao-fei
Published: January 2021

Background: Lumbar disc herniation (LDH) is a common spinal disorder. The discectomy with non-fusion operation is widely used. When the revision is needed, the options for revision way is still controversial. This study aims to introduce unilateral extraforaminal lumbar interbody fusion (ELIF) revision surgery, and to investigate the clinical efficacy and complication of Unilateral Extraforaminal Lumbar Interbody Fusion (ELIF) in revising primary discectomy for lumbar disc herniation. Methods:16 patients with incomplete removal and recurrence herniation of lumbar disc after minimally invasive treatment without fixation were treated by ELIF with unilateral pedicle screw(UPS) from April 2016 to October 2020. All those patietns including 11 male and 5 female aged 29-65 years were analyzed retrospectively. The clinical effects were evaluated by operation time, intraoperative blood loss, postoperative blood volume of drainage and complications. The Visual Analogue Scale(VAS), Oswestry Disability Index (ODI) were documented before, after surgery and at last follow--up. Results: The operation time was 95.73±10.5 min, the bleeding volume was 201.5±27.6 ml. Postoperative blood volume of drainage was 50.7±6.3 ml. 2 patients suffered dura tear. All patients were followed up for 12-26 months with 15.7 on average. VAS and ODI scores significantly improved at the preoperative, postoperative and the 12th month’s follow up (P < 0.05). Conclusion: The application of ELIF with unilateral fixation is a satisfied way to revise primary discectomy for lumbar disc herniation. However, the dura tear induced by scar tissue adhesion needs to be noticed.
Lower Grip Strength and Insufficient Physical Activity Can Increase Depressive Symptoms Among Middle-Aged and Older European Adults
Authors: Zheng Han , Jia Chongqi
Published: January 2021

Objectives: The present study aimed to explore the interaction between grip strength and physical activity on depression, and investigate the association of physical activity with the change in depression by different grip strength groups among middle-aged and older European adults.Methods: A total of 13936 participants aged 50 years or older from the Survey of Health, Ageing and Retirement in Europe 2007-2017 were included in this study. Group-based trajectory modeling was used to identify the low, middle and high group of grip strength by gender. Generalized estimated equations were fitted to analyze the interaction effect.Results: Significant interactions between grip strength group and physical inactivity were found (O interaction=16.70, p<0.001). Significant interactions between physical inactivity and time on depression were identified in low (b interaction=22.15, p<0.001) and moderate (j interaction=22.85, p<0.001) grip strength, but a similar result was not found in high grip strength (e interaction=3.20, p=0.526). Participants in the physical inactivity group had higher depression scores in the low and moderate grip strength group.Conclusions: Grip strength and physical inactivity have interaction with depression. Lower grip strength and insufficient physical activity could increase depressive symptoms. People with lower grip strength and physical inactivity should pay special attention to the prevention of depression.
The Clinical Characteristics and Risk Factors for Poor Prognosis Among HIV Patients with Talaromyces Marneffei Bloodstream Infection
Authors: Sun Jianjun , Sun Weiwei , Tang Yang , Zhang Renfang , Liu Li , Shen Yinzhong , Wang Jiangrong , Chen Jun , Qi Tangkai , Wang Zhenyan , Song Wei , Lin Yixiao , Xu Shuibao , Lu Hong-zhou
Published: January 2021

Background Talaromyces marneffei(TM) bloodstream infection is common in AIDS patients with extreme immunodeficiency in Southeast Asia and South China, however, clinical case study on TM bloodstream infection is scarce. We retrospectively analyze the clinical characteristics of TM bloodstream infection in hospitalized AIDS patients and determine the outcomes of hospitalization after diagnosis in our hospital over the past 5 years.Methods From January 2015 to July 2020, cases of TM detected by blood culture in patients admitted to our center were sorted and analyzed. The admission complaints, blood cells, biochemistry, CD4/CD8 count and 1,3-β-D-glucan, procalcitonin, CRP level on the day of blood culture test, and outcomes during hospitalization were analyzed. Logistic regression analysis was performed for the risk factors for poor prognosis. Spearman correlation analysis was used to analyze the correlation between peripheral blood cells, albumin and the time required for TM to become positive in blood culture. The difference was statistically significant when the P value was <0.05. Results A total of 87 patients were collected, with a median age of 34 years, a median hemoglobin of 94 g/L and CD4 count of 7/µl. The rate of TM bloodstream infection among all in-hospital patients increased from 0.99% in 2015 to 2.09% in 2020(half year). Patients with TM bloodstream infection with a CD8 count <200/µl had a 12.6-fold higher risk of poor prognosis than those with a CD8 count >200/µl (p=0.04), and those with 1,3-β-D-glucan <100 pg/mL had a 34.9-fold higher risk of poor prognosis than those with 1,3-beta-D-glucan >100 pg/mL (p=0.01).Conclusions TM bloodstream infection is becoming more common in advanced AIDS patients in endemic areas. For those patients with extremely low CD4 and CD8 cell counts below 200/µl, the 1,3-β-D-glucan <100 pg/mL are with an increased risk of poor prognosis.
Malnutrition According to GLIM Criteria Acts as a Risk Factor for Survival of Nasopharyngeal Carcinoma Patients Undergoing Radiotherapy : A Retrospective Study Highlighting the Nutritional Management in Radiotherapy
Authors: Wan Meng , Zhang Lichuan , Chen Changshun , Zhao Dan , Zheng Baomin , Xiao Shaowen , Liu Weixin , Xu Xiaolong , Wang Yujie , Zhuang Bing , Zhang Tong , Jin Sanli , Wang Weihu , Lu Qian , Sun Yan
Published: January 2021

Background Nutritional status of nasopharyngeal carcinoma (NPC) patients lying at a high risk of nutrition defect to a great extent determines the post-treatment outcomes, which deserves thorough observation. However, limited ever-conducted studies regarding the NPC patients’ malnutrition by effective methods like the Global Leadership Initiative in Malnutrition (GLIM) criteria heavily obstructed this prospect. Our study aimed to investigate the incidence of malnutrition in NPC cancer patients using GLIM criteria and explore the relationships between malnutrition and adverse effects, survival status.Methods A retrospective chart review of 113 patients with NPC from December 2016 to October 2019. The nutritional status of NPC undergoing radiotherapy (RT) was determined by GLIM criteria at three-time points: pre-RT, in the middle of RT, and at the end of RT. The adverse effects were graded according to the Radiation Therapy Oncology Group (RTOG) scoring criteria. Kaplan–Meier method was used to compare survival outcomes, and the differences were evaluated using the log-rank test.ResultsNineteen cases (16.8%) were malnutrition before radiotherapy; overall stage (p=0.017) and induction chemotherapy(p=0.002) contributed to pre-radiotherapy malnourishment, and the nutritional status worsened with radiotherapy. Of the phenotypic GLIM criteria, low fat free mass index (FFMI) before radiotherapy was associated with mucositis and radiodermatitis (p<0.05). With a median follow-up of 28.3 months, the Kaplan-Meier curve indicated that malnutritional patients had significantly poorer Progress Free survival (PFS); 2-year PFS was 88.9% in the well-nourishment group vs. 62.1% in the malnutrition group (p=0.015). In multivariate analysis, nutritional status and gender were independent prognostic factors of poorer PFS (HR 3.387, 95%CI 1.299-8.834, p=0.013 and HR 5.698, 95%CI 1.290-25.168, p=0.022).Conclusion Malnutrition is common in NPC patients, and it increases significantly during radiotherapy. Malnutrition, according to GLIM criteria, is correlated with survival. Our study could justify the effectiveness and usability of GLIM for NPC patients undergoing RT. Appropriate nutritional guidance or nutritional support should be taken to improve the NPC patients’ nutritional status during radiotherapy.
Outcomes and Limitations of Endoscopic Ultrasound-guided Hepaticogastrostomy in Malignant Biliary Obstruction
Authors: Jagielski Mateusz , Zieliński Michał , Piątkowski Jacek , Jackowski Marek
Published: January 2021

Background: Transpapillary biliary drainage in ERCP is an established method for symptomatic treatment of patients with irresectable malignant biliary obstruction. Percutaneous transhepatic biliary drainage frequently remains the treatment of choice when the transpapillary approach proves ineffective. Recently, EUS-guided extra-anatomical anastomoses of bile ducts to the gastrointestinal tract have been reported as an alternative to percutaneous biliary drainage. To assess the usefulness of extra-anatomical intrahepatic biliary duct anastomoses to the gastrointestinal tract as endotherapy for irresectable malignant biliary obstruction and to determine factors affecting the efficacy of treatment. Methods: A prospective analysis of the treatment results of all patients with irresectable biliary obstruction treated with endoscopic hepaticogastrostomy at our institution in the years 2016–2019. Results: Transmural intrahepatic biliary drainage (endoscopic hepaticogastrostomy) was performed due to the ineffectiveness of ERCP in 53 patients (38 males, 15 females; mean age 74.66 [56–89] years) with irresectable biliary obstruction. Technical success of endoscopic hepaticogastrostomy was achieved in 52/53 (98.11%) patients. Complications of endoscopic treatment were observed in 10/53 (18.87%) patients. Clinical success of endoscopic hepaticogastrostomy was achieved in 46/53 (86.79%) patients. Bismuth type II–IV cholangiocarcinoma, hepatic metastases, ascites, suppurative cholangitis, and high blood bilirubin levels exceeding 30 mg/dL were independent factors for increased complications and inefficacy of endoscopic hepaticogastrostomy. Conclusions: In the event of transpapillary biliary drainage proving ineffective, extra-anatomical anastomoses of bile ducts to the gastrointestinal tract provide an effective method for the treatment of patients with malignant biliary obstruction.
Hiccups Induced by Aripiprazole Combined With Sertraline in An Adolescent With Olfactory Reference Disorder: A Case Report
Authors: Li Zhe , Li Yang , Xiong Zhenzhen , Li Zhixiong , Yuan Yiwen , Deng Junfeng , Li Xiao
Published: January 2021

Background Hiccup can cause significant distress to patients and affect medication compliance. Individuals with olfactory reference disorder (ORD) who might develop persistent hiccups when treated with a combination of antidepressant and antipsychotic, leading to significant distress and impairment. Case presentation We report a rare case of an adolescent with ORD who was treated with aripiprazole combined with sertraline and who began to hiccup persistently after 6 days on this treatment. He stopped hiccupping after the aripiprazole had been suspended for 12 h. After discharge, the patient continued on sertraline alone and reported no hiccupping at one-month follow-up. Conclusions Clinicians should consider that the combination of aripiprazole and sertraline can induce hiccups during the acute administration period in adolescents with ORD.
Glucocorticoids Improves Pregnancy Rate and Outcome in Woman With Unexplained Positive Autoantibody: a Systematic Review and Meta-analysis
Authors: Li Ting , Yuan Yilin , Liu Huixin , Lu Qun , Mu Rong
Published: January 2021

Background: The effect of glucocorticoids (GCs) therapy for women with unexplained positive autoantibody is under debate. This systematic review and meta-analysis was performed to evaluate whether GCs administration can improve the pregnancy outcome of this population.Methods: A meta-analysis based on a systematic review of PubMed, Embase, EBSCO, and the Cochrane Central Register of Controlled Trials, until January 2021, was used to evaluate pregnancy outcome of GCs treatment for women with unexplained recurrent fetal loss or infertility whose autoantibody positive, but does not meet any classification criteria for autoimmune diseases.Results: We found GCs treatment improved clinical pregnancy rate (RR 2.19, 95% CI 1.64 to 2.92) and live birth rate (RR 1.92, 95% CI 1.17 to 3.16), especially when started GCs administration before pregnancy (clinical pregnancy rate: RR 2.30, 95% CI 1.58 to 3.34; live birth rate: RR 2.30, 95% CI 1.58 to 3.34). However, no effect of GCs on miscarriage rate was found (RR 0.75, 95% CI 0.55 to 1.02) regardless of time of drug administration.Conclusions: Our systematic review and meta-analysis surports the rational use of GCs in women with unexplained positive autoantibody.
Post-biopsy cell-free DNA from blood: an open window on primary prostate cancer genetics and biology
Authors: Corbetta Marinella , Chiereghin Chiara , simone Ilaria De , Soldà Giulia Maria Emilia Antonietta , Zuradelli Monica , Giunta Michele , Lughezzani Giovanni , Buffi Nicolò Maria , Hurle Rodolfo , Saita Alberto , Casale Paolo , Asselta Rosanna , Lazzeri Massimo , Guazzoni Giorgio , Duga Stefano
Published: January 2021

BackgroundCirculating cell-free DNA (ccfDNA), released from normal and cancerous cells, is a promising biomarker for cancer detection as in neoplastic patients it is enriched in tumor-derived DNA (ctDNA). ctDNA contains cancer-specific mutations and epigenetic modifications, which can have diagnostic/prognostic value. However, in primary tumors, and in particular in localized prostate cancer (PCa), the fraction of ctDNA is very low and conventional strategies to study ccfDNA are unsuccessful.MethodsccfDNA was isolated from plasma before and after prostate biopsy by using the Maxwell RSC ccfDNA Plasma Kit and quantitatively and qualitatively analyzed by a fluorometer and by the Agilent High Sensitivity D5000 ScreenTape System. Somatic mutations were searched for by targeted RNAseq on prostate biopsies, sequencing libraries were prepared using the TruSight RNA Pan-Cancer Panel from Illumina. Detection of selected somatic mutations in ccfDNA was performed by ultra-deep sequencing of amplicons, using the NEBNext® Ultra™ II DNA Library Prep Kit for library preparation. All libraries were sequenced on the NextSeq550 platform.ResultsHere we demonstrate that prostate biopsy, by causing multiple injuries to the organ, leads to a significant increase in plasma concentration of ccfDNA (P < 0.0024) in primary PCa patients. By calculating the minor allele fraction at patient-specific somatic mutations pre- and post-biopsy, we show that ctDNA is significantly enriched (from 3.9 to 164 fold) after biopsy, representing a transient “molecular window” to access and analyze ctDNA. Moreover, we show that newly released ccfDNA contains a larger fraction of di-, tri- and multi-nucleosome associated DNA fragments. This feature could be exploited to further enrich prostate-derived ccfDNA and to analyze epigenetic markers.ConclusionOur data represent a proof-of-concept that liquid tumor profiling from peripheral blood performed just after the biopsy procedure can open a “valuable molecular metastatic window” giving access to the tumor genetic asset, thus providing an opportunity for early cancer detection and individual genomic profiling in the view of PCa precision medicine.
Genome-wide analysis of DNA methylation identifies the apoptosis-related gene UQCRH in renal cancer
Authors: Miyakuni Kosuke , Nishida Jun , Koinuma Daizo , Nagae Genta , Aburatani Hiroyuki , Miyazono Kohei , Ehata Shogo
Published: January 2021

Background

DNA hypermethylation is frequently observed in clear cell renal cell carcinoma (ccRCC) and correlates with poor clinical outcomes. However, the detailed function is not fully uncovered.
Methods

A target for DNA methyltransferases (DNMTs) was explored in ccRCC cells. Highly malignant derivatives of human ccRCC cells were established via serial orthotopic inoculation in mice. Then, DNA methylated sites were genome-widely analyzed using methylation array in reference to RNA-sequencing data.
Results

We found that DNMT3B upregulation contributes to renal cancer progression and identified the ubiquinol cytochrome c reductase hinge protein (UQCRH) as a methylation target in advanced ccRCC. The expression of UQCRH in human ccRCC tissues was lower than that in normal adjacent tissues. Furthermore, its silencing attenuated cytochrome c release in response to apoptotic stimuli, resulting in enhanced primary tumor formation in vivo. Moreover, DNA demethylation enhanced the therapeutic efficiency of the mammalian target of rapamycin (mTOR) inhibitor everolimus in vivo.
Conclusions

These findings suggest that the DNMT3B-induced UQCRH methylation may contribute to renal cancer progression and that DNMT inhibitors exhibit potential clinical significance for ccRCC treatment.
Knowledge, Attitude, Practice and Associated Factors of Health Professionals Towards Podoconiosis in Gamo Zone, Ethiopia, 2019
Authors: Churko Chuchu , Asnakew Mekuria , Tunje Abayneh , Girma Eyayou , Zerdo Zerihun
Published: January 2021

Background: Podoconiosis is entirely preventable, non-communicable disease with high potential of elimination. One of the pillars for elimination of podoconiosis is morbidity control and management. Therefore, the present study was aimed to assess the knowledge, attitude, practices and associated factors of health professionals towards podoconiosis cause, prevention and treatments. Methods: facility based cross-sectional study was conducted. The source population was all health professionals currently working in public health facilities. The final estimated sample size was 349. A pretested self-administrated structured questionnaire was used to collect the data. The data were coded, entered, and cleaned by using Epi.info version7, and analyzed by using SPSS version 20. Result: a total of 320 health professionals were participated in the study. Sixty eight (23.1%) health professionals had poor knowledge towards podoconiosis. Seventy (21.9%) responded as podoconiosis is infectious disease. Profession, address of health facility, service year and attitude of participants became significantly associated with knowledge towards podoconiosis. More than half (56%) had favorable attitude towards podoconiosis patients. Knowledge score (95%CI: 1.389, 4.059, p-value= 0.002) was the independent predictor for attitude status. Very few (11.6%) respondents ever treated podoconiosis patients. Age group 45 years old and above and training on LMMDP was significantly associate with practice, (AOR=17.345; 95%CI: 4.62, 65.119) and (AOR=7.385; 95%CI: 2.5, 21.797), respectively. Conclusion: Despite, high percent of good knowledge and favorable attitude of health professionals towards podoconiosis, practice of study subjects was very low. In-service trainings will be given for health professionals to improve practice. In podoconiosis endemic districts hygiene supplies and other referencing materials should be made available for podoconiosis case management.
Characterization of the 5′ Regulatory Region of the Human RGS4 Gene In Vitro
Authors: Xu Feng-ling , Ding Mei , Li Ya , Xing Jia-xin , Xuan Jin-feng , Yao Jun , Wang Bao-jie
Published: January 2021

Background: In order to detect function of three SNPs (rs12041948, rs6678136 and rs7515900) in 5′ regulatory region of the human RGS4 gene, fragments of 5′ regulatory region of RGS4 (-1112–+365, TSS+1) was cloned into pGL3-Basic vector, and dual-luciferase reporter assay was conducted. We compared and analyzed the relative fluorescence intensities of eight haplotype recombined vectors. Results: In HEK-293 and SK-N-SH cells, the relative fluorescence intensities of haplotype 2 (ATA) was significantly increased when it was compared with haplotype 3 (ACA), 5 (ACC), 7 (GCA), and 8 (GCC). Therefore, haplotypes with C of rs6678136 decreased expression than theses with T. However, no significant difference was assessed in comparation among eight haplotypes, in the U87 cells. Conclusions: The mutant of T>C of rs6678136 might alter the binding of transcription factors to 5′ regulatory region of RGS4 gene, then change the expression. It was predicated that the rs6678136 might alter the binding region of GSX1, ALX3, BARHL1, and BARHL2. The binding is still worthy of further investigation.
Effects of Chlorpheniramine on Emergence Agitation After General Anesthesia for Ureteroscopic Stone Surgery: a Retrospective Cohort Study
Authors: Cho Choon-Kyu , Chang Minhye , Lee Seok-Jin , Sung Tae-Yun , Jee Young Seok
Published: January 2021

Background: The presence of a urinary catheter, postoperative pain, and postoperative nausea and vomiting are risk factors for emergence agitation (EA). Antimuscarinic agents have been the primary agents used for urinary catheter-related bladder discomfort prevention and treatment. Chlorpheniramine has antimuscarinic, antinociceptive, and antiemetic effects. This retrospective study investigated the effect of chlorpheniramine on EA prevention in patients following ureteroscopic stone surgery. Methods: Of 110 adult patients who underwent ureteroscopic stone surgery under general anesthesia between January and December 2019, the medical records of 93 patients were analyzed retrospectively. The patients were divided into control (n = 52) and chlorpheniramine (n = 41) groups according to they receipt of intravenous chlorpheniramine before the induction of anesthesia. The incidence and severity of EA were compared between the groups as primary and secondary endpoints, respectively. The effects of chlorpheniramine on the requirement for inhalation anesthetic (desflurane) during surgery, changes in mean blood pressure and heart rate during emergence, and adverse events were also compared. Results: The incidence (21.2% in the control group, 24.4% in the chlorpheniramine group) and severity of EA did not differ between groups. The intraoperative requirement for desflurane, changes in mean blood pressure and heart rate during emergence, and adverse events were also similar between groups. Conclusion: Chlorpheniramine did not affect EA in patients after ureteroscopic stone surgery.Trial registration: CRiS Registration number KCT0004879. Initial registration date was 3 April 2020 (Retrospectively registered).
Application of Gel to the Transducer of Cartilage Conduction Hearing Aids Improves Their Benefits
Authors: Nishimura Tadashi , Hosoi Hiroshi , Saito Osamu , Shimokura Ryota , Okayasu Tadao , Morimoto Chihiro , Kitahara Tadashi
Published: January 2021

Gel is a conduction medium used to improve signal transmission and is applied in ultrasonography to obtain high-quality images; however, it is rarely used in hearing devices. The application of gel to couple the transducer to the ear could potentially improve the benefits of hearing aids, particularly cartilage conduction (CC) hearing aids, which deliver signals by vibration. The aim of this study was to investigate the impact of gel application on the efficacy of CC hearing aids in 23 patients (30 ears). The aided thresholds, maximum speech recognition scores (SRSs), and hearing level at which the maximum SRS was observed were compared before and after the application of gel to the transducer of CC hearing aids. Subjective impressions of hearing improvement, on applying the gel, were also evaluated. The aided thresholds above 1 kHz significantly improved on applying the gel to the transducer. The effectiveness of gel application was better for patients who reported improvement in hearing. The audiometric results were consistent with subjective evaluations. The application of gel has minimal risk, and its benefits can be verified easily with subjective evaluation. Gel application can be considered an effective option for improving the benefits of CC hearing aids.
Discovery of Biomarkers for Amyotrophic Lateral Sclerosis and Frontotemporal Lobar Degeneration From Human Cerebrospinal Fluid Using Mass Spectrometry-Based Proteomics
Authors: Oh Sungtaek , Jang Yura , VandeVrede Lawren , Boxer Adam L , Sockanathan Shanthini , Na Chan-Hyun
Published: January 2021

BackgroundAmyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD) are progressive neurodegenerative diseases that share clinical and neuropathologic features. Critical to the mission of developing effective therapies for ALS and FTLD is the discovery of biomarkers that can illuminate shared mechanisms of neurodegeneration, which can then be evaluated for diagnostic, prognostic or pharmacodynamic value across the disease spectrums. MethodsHere, we merged unbiased discovery-based approaches and targeted quantitative comparative analyses between ALS and FTLD cerebrospinal fluid (CSF) to identify proteins that are altered in ALS and FTLD. ResultsDiscovery mass spectrometry (MS)-based proteomic approaches combined with tandem mass tags (TMT) quantification methods from 40 CSF samples comprising 20 patients with ALS and 20 healthy control (HC) individuals identified 19 differentially expressed candidate biomarker proteins after CSF fractionation. Notably, these candidate biomarkers included novel and previously identified proteins, thus validating our approach. Candidate biomarkers were subsequently examined using parallel reaction monitoring (PRM) MS methods on 80 unfractionated CSF samples comprising 30 patients with ALS, 19 patients with FTLD, and 31 HC individuals. Two candidate biomarkers (CNTNAP2 and CLSTN1) were downregulated in both ALS and FTLD compared to healthy controls, and 11 further candidate proteins were significantly downregulated in FTLD compared to HC. ConclusionsTaken together, this study identifies multiple novel proteins that are altered in ALS and FTLD, which provides the foundation for their evaluation and development as biomarkers for these diseases.
Effects of Infections of Helicobacter Pylori With Different Virulent Factors on Severity of Gastrointestinal Diseases
Authors: Zhang Yan , Fang Xiang-ming , Tian Kui
Published: January 2021

Background: Helicobacter Pylori (H. pylori) infection, one of the most common chronic bacterial infections, has been considered as a major cause of diseases such as lymphoma, gastritis, peptic ulcers, and stomach cancer. Here, we aimed to determine whether H. pylori strains with different virulence contribute to the gastrointestinal diseases differentially in clinical settings, which may provide future direction for eradication of H. pylori infection. Methods: We recruited 501 patients with gastrointestinal disorders for analysis of antibody types of H. pylori infection. Correlation analysis was done to determine the association of different virulence of H. pylori with patients’ baseline parameters and personal disease history. Next, subjects with each type of anti- H. pylori infection antibody were subjected to esophagogastro duodenoscopy（EGD) and colonoscopy examinations. The pathological diagnosis was also conducted in endoscopic samples. Chi-squared test was employed to compare the differences in endoscopic assessments and pathological findings among three types of H. pylori infection determined by the presence of antibodies to virulent factors. Results: There were 296 cases with Type I H. pylori infection, 120 cases with Type II H. pylori infection, and 85 cases without H. pylori infection (negative, Type III). No correlation was found between different virulence of H. pylori and participants’ baseline data (P > 0.05). EGD results showed that the incidences of peptic ulcer, bleeding and malignant lesions in Type I group were significantly higher than that in Type II and Type III (P＜0.05). Despite of increased trends of incidences of precancerous alterations and the malignance in Type I group compared with type II and III groups, there was no significant difference (P > 0.05). In addition, coloscopic features were similar among three groups. On the other hand, infections of H. pylori with cytotoxin-associated gene A (CagA) and/or vacuolating cytotoxin A (VacA) virulent factors resulted in more severe histopathological diseases than that with only Ure A/B factor and without infection (P < 0.05). Conclusions: Infections of H. pylori strains with CagA/VacA are likely to cause development of severe gastrointestinal diseases. These results are helpful to treat for H. pylori infection clinically.