bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Epididymal Sperm Aspiration on Microsurgical Vasoepididymostomy Outcomes in Patients with Obstructive Azoospermia-Report of 21 Cases Attached
Authors: Li Qunsheng , Zhou Lei , Li Dongrun , Yang Wentao , Zhou Yingmei , Shen Zhennan
Published: December 2023

Background:

To explore the impact of epididymal sperm aspiration on microsurgical vasoepididymostomy (MVE) outcomes in patients with obstructive azoospermia (OA).

Methods:

A retrospective analysis was conducted on 21 patients with OA who underwent epididymal sperm aspiration and received treatment at the department of andrology, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from September 2016 to March 2023. Under microscopic scrutiny, the structure of the epididymis and any injuries to its ducts were observed and compared during MVE.

Results:

Microscopic analysis of 21 patients revealed notable changes in the appearance of the epididymis, showcasing substantial scar contracture and evident adhesion between the epididymal fascia and tunica vaginalis within the sheath, posing challenges in their separation. Among them, 12 patients exhibited fractured, shrunk, fibrotic, and semen-devoid epididymal ducts. Consequently, MVE could not be completed in 15 patients because of these factors, and only six patients underwent MVE. Among the patients who successfully underwent MVE, three patients had sperm in the follow-up examination 3 months after surgery, accounting for 50%.

Conclusion:

Epididymal sperm aspiration can damage the normal structure of the epididymis and epididymal duct, often leading to surgical termination during operation and a decrease in the long-term patency rate following surgery. Therefore, patients with OA are recommended to undergo MVE as the initial procedure. In case the surgery prove unsuccessful, epididymal or testicular sperm aspiration can be performed for intracytoplasmic sperm injection (ICSI) assisted reproduction. Additionally, patients with OA are advised to avoid diagnostic epididymal sperm aspiration.
Disagreement FDA and EMA on RSV Maternal Vaccination: Possible Consequence for Global Mortality
Authors: Willemsen Joukje E. , Borghans José A. M. , Bont Louis J. , Drylewicz Julia
Published: December 2023

The European Medicines Agency and the US Food and Drug Administration have recently approved a maternal vaccine for respiratory syncytial virus. The US Food and Drug Administration limits vaccination to later in pregnancy. Mathematical modeling demonstrates that this vaccination window may reduce the global mortality impact of the vaccine by 12%. Policymakers should carefully consider vaccine risks and benefits to safeguard vulnerable infants effectively.
Advanced hepatocellular carcinoma with major portal vein invasion: Therapeutic outcomes of hepatic arterial infusion chemotherapy vs concurrent radiotherapy
Authors: Chiang Chia-Ling , Liang Huei-Lung , Chang Kuo-Chen , Tsai Wei-Lun , Yu Hsien-Chung , Lin Kung-Hung , Li Ming-Feng
Published: December 2023

Background:

Hepatocellular carcinoma (HCC) with major portal vein invasion (MPVI) presents very poor outcomes. Hepatic artery infusion chemotherapy (HAIC) and radiation therapy (RT) have both been found to be effective for advanced HCC. In this retrospective study, we compared the therapeutic outcomes of our “new” HAIC regimen with and without concurrent RT, before and after propensity score matching (PSM) in treating HCC patients with MPVI.

Methods:

One hundred forty patients with MPVI received HAIC alone and 35 patients underwent concurrent HAIC and RT during a 16-year period. The left subclavian artery was adopted as the entry site for a temporary catheter placement for a 5-day chemoinfusion. The Modified Response Evaluation Criteria in Solid Tumors (mRECIST) was adopted to assess the objective response rate (ORR). The Kaplan-Meier curve was used to calculate progression-free survival (PFS) and overall survival (OS) between the two groups. Univariate and multivariate analyses by Cox regression model were used to assess hazard ratios.

Results:

Of the 140 patients with Child-Pugh A liver function, the median OS was 17.0 months. In the initial cohort, higher ORR and PFS were found in the concurrent RT group than in the HAIC alone group (80% vs 66.4% and 9 vs 8 months, respectively) but shorter OS (10.5 vs 14.5 months, p = 0.039) was observed. After PSM, the OS was 10 and 15 months (p = 0.012), respectively. Multivariable Cox regression analysis revealed that the significant factors for adjusting hazard ratios for OS were Child-Pugh classification, alpha fetal protein (AFP) level, and hepatic vein invasion.

Conclusion:

HAIC is an effective treatment for advanced HCC patients with MPVI. Concurrent HAIC and full-dose RT were associated with worse clinical outcomes.
Mediators of the Association Between Cognitive Function and Self-care Behaviors in Patients Hospitalized With an Exacerbation of Heart Failure
Authors: Wu Jia-Rong , Lin Chin-Yen , Latimer Abigail , Hammash Muna , Moser Debra K.
Published: December 2023

Background

Patients with heart failure (HF) must engage in self-care, yet their self-care is often poor. Cognitive function commonly is impaired in HF and is associated with poor self-care. Heart failure knowledge and self-care confidence also are needed to preform self-care. Few investigators have examined mediators of the association of cognitive function with self-care.

Objectives

The aim of this study was to determine whether HF knowledge and self-care confidence mediated the association of cognitive function with self-care maintenance and management among patients with HF.

Methods

This was a cross-sectional observational study of 164 patients with HF. Cognitive function was assessed using the Montreal Cognitive Assessment. Self-care maintenance and self-care management behaviors and self-care confidence were measured using the Self-care of Heart Failure Index. Heart failure knowledge was measured using the Dutch Heart Failure Knowledge Scale. We conducted 2 parallel mediation analyses using the PROCESS macro in SPSS, one for self-care maintenance and one for self-care management.

Results

Cognitive function was indirectly associated with self-care maintenance through HF knowledge (indirect effect, 0.54; 95% confidence interval, 0.10–1.02) and self-care confidence (indirect effect, 0.26; 95% confidence interval, 0.04–0.54). Those with better cognitive function had more HF knowledge and self-care confidence. Better cognitive function was not directly associated with self-care management but indirectly associated with better self-care management through higher self-care confidence (indirect effect, 0.50; 95% confidence interval, 0.04–1.05).

Conclusions

Both HF knowledge and self-care confidence mediated the association of cognitive function with self-care maintenance, and only self-care confidence mediated the association between cognitive function and self-care management. Interventions targeting HF knowledge and self-care confidence may improve self-care even for those with lower cognitive function and need to be developed and tested.
Dignity, Resilience, and Quality of Life in Patients With Cardiac Disease
Authors: Huang Chien-Lung , Hsu Ching-Hwa , Hsu Shu-Fen , Tung Heng-Hsin
Published: December 2023

Background

Health-related quality of life (HRQoL) is an important indicator of patient's satisfaction about their disease course. Many factors are influential to life quality, such as dignity and resilience. Dignity is mostly explored in populations with cancer, but the understanding of dignity and its relationship with resilience and HRQoL is limited.

Objective

The aim of this study was to explore the relationships between dignity, resilience, and HRQoL among patients with cardiac disease.

Methods

A purposive sample of patients with cardiac disease with a cross-sectional design was used for this study. Four structured questionnaires were used for data collection. Dignity was measured by the Patient Dignity Inventory-Mandarin version; resilience was measured by the Chinese version of the Resilience Scale; HRQoL was measured by EuroQol 5 Dimensions. Partial least squares structural equation modeling was applied to test the hypothesized structural model. Reporting was consistent with the Strengthening the Reporting of Observational Studies in Epidemiology checklist.

Results

The mean age of all 101 participants was 72.2 years, 88.1% had coronary artery disease, and the prevalence of heart failure was 43.0%. In patients with cardiac disease, their sense of dignity was significantly associated with HRQoL, and resilience was associated with both dignity and quality of life. Notably, resilience had a mediating effect between dignity and HRQoL; dignity and resilience explained 73.0% of the variance of HRQoL.

Conclusions

Dignity is a new concern in cardiac disease research, which is influential to patients' perception of disease and their HRQoL. Patients with cardiac disease with higher resilience tend to have a better HRQoL.
Selected updates on chronic obstructive pulmonary disease
Authors: Mah Jordina , Ritchie Andrew I. , Finney Lydia J.
Published: December 2023

Purpose of review

Chronic obstructive pulmonary disease (COPD) is preventable disease and yet it remains the third greatest cause of death worldwide. This review focuses on recent updates in COPD research which have had an impact on our understanding of the epidemiology and pathophysiology of COPD.

Recent findings

Epidemiological studies of COPD have moved towards trying to understand the global impact of COPD particularly in low- and middle-income countries where disease prevalence continues to increase. In addition, we are beginning to uncover the impact of air pollution on COPD development with recent work showing a relationship between air pollution and COPD exacerbations. Advances in understanding early origins and early development of COPD have the potential to intervene earlier in the disease course to prevent disease progression. Although biomarkers such as peripheral blood eosinophilia have led to trials of biologic agents in COPD suggesting we may be entering an exciting new biologic era in COPD.

Recent advances suggest there may be a relationship between air pollution and COPD exacerbations. This requires further research to influence environmental policy. New clinical trials of biologics targeting TH2 inflammation in COPD suggest that targeted treatments with biologics may be a possibility COPD.
Neuromechanism, recovery effect and case study of swimming training intervention in children with cerebral palsy: A case report
Authors: Zeng Jing , Hao Shuang , Wang Yuxuan , Liu Qing
Published: December 2023

Background:

Cerebral palsy, hereinafter referred to as “cerebral palsy”, refers to a non progressive injury that occurs during the development of brain tissue in fetuses or infants. The patients often have walking dysfunction, abnormal balance ability and abnormal body stability, which are mainly caused by Cranial nerves injury.

Patient concerns:

One child diagnosed with ataxia cerebral palsy by the hospital was recruited, aged 6 years and 9 months. The symptoms were: lower limb adduction and internal rotation, left neck tilt to the left due to insufficient muscle tension, and eyes squint to the right. The movement is clumsy and the coordination ability of limbs is poor; Its body balance function is poor, the sitting and standing position cannot keep the body upright and balanced for a long time, and the coordination of the random movement of hands and eyes is poor; Weak spatial cognition and orientation ability; Have persistent central motor dysfunction. When walking, the body leans forward and sideways, and the gait is staggered, which is easy to fall; In terms of expression, it shows vague language and unclear speech; Relatively retarded in intelligence.

Diagnosis and intervention:

The study used swimming training intervention to report a twelve months training intervention program for a child with ataxic cerebral palsy, and evaluated it with Berg balance scale and modified Ashworth scale.

Outcomes:

Swimming training has a significant effect on the rehabilitation of children with ataxic cerebral palsy; The forces from different directions in the water can improve the balance of children with cerebral palsy; Muscle endurance training with medium load intensity can help restore unilateral muscle tension deficiency to a certain extent, and make bilateral muscle tension gradually becomes.

consistent, thus enhancing the balance ability, gait and body stability of children with cerebral palsy.
Exploration of the pathogenesis of polycystic ovary syndrome based on gut microbiota: A review
Authors: Guo Hua , Luo Jing , Lin Hanmei
Published: December 2023

Polycystic ovary syndrome (PCOS) is a complex disorde7r influenced by genetic, neuroendocrine, metabolic, environmental, and lifestyle factors. This paper delves into the increasingly recognized role of gut microbiota dysbiosis in the onset and progression of PCOS. Utilizing advances in next-generation sequencing and metabolomics, the research examines the intricate interaction between the gut microbiota and the central nervous system via the gut-brain axis. The paper highlights how disruptions in gut microbiota contribute significantly to PCOS by modulating the release of gut-brain peptides and activating inflammatory pathways. Through such mechanisms, gut microbiota dysbiosis is implicated in hyperandrogenism, insulin resistance, chronic inflammation, and metabolic disorders associated with PCOS. While the relationship between gut microbiota and PCOS has begun to be elucidated, this paper underscores the need for further research to identify specific bacterial strains and their metabolic byproducts as potential therapeutic targets. Therefore, comprehensive studies are urgently needed to understand and fundamentally treat the pathophysiological processes of PCOS, offering valuable insights for future treatment and prevention strategies.
Colonic stent as a bridge to surgery versus emergency rection for malignant left-sided colorectal obstruction: A systematic review and meta-analysis of randomized controlled trials
Authors: Shang Rumin , Han Xiangming , Zeng Cui , Lv Fei , Fang Rong , Tian Xiaochang , Ding Xiangwu
Published: December 2023

Introduction:

The role of self-expanding metal stent (SEMS) implantation as a bridge to surgery in malignant left-sided colorectal obstruction (MLCO) remains controversial.

Objective:

To evaluate the safety of SEMS implantation versus emergency surgery (ER) in the treatment of MLCO.

Methods:

Four major literature databases (Cochrane Library, Embase, PubMed, and Web of Science) were searched to collect articles published before April 20, 2023. After determining random or fixed-effect models based on heterogeneity tests, odds ratios (RR) or standardized mean differences (SMD) with their respective 95% confidence intervals (CI) were calculated.

Results:

Nineteen randomized controlled studies were included. The main outcomes included overall tumor recurrence rate, 30-day mortality rate, and overall incidence of complications. Secondary outcomes included mortality-related indicators, tumor recurrence-related indicators, surgery-related indicators, and other relevant indicators. The study found that there was no significant difference in the 30-day mortality rate between the SEMS group and the er group. However, the SEMS group had a lower overall incidence of complications (RR = 0.787, P = .004), lower incision infection rate (RR = 0.472, P = .003), shorter operation time (SMD = −0.591, P = .000), lower intraoperative blood loss (SMD = −1.046, P = .000), lower intraoperative transfusion rate (RR = 0.624, P = .021), lower permanent stoma rate (RR = 0.499, P = .000), lower overall stoma rate (RR = 0.520,P = .000), shorter hospital stay (SMD = −0.643, P = .014), and more lymph node dissections during surgery (SMD = 0.222, 95% CI: 0.021–0.423, P = .031), as well as a higher primary anastomosis rate (RR = 0.472, 95% CI: 0.286–0.7 77, P = .003), among other advantages. However, the SEMS group had a higher overall tumor recurrence rate (RR = 1.339, P = .048).

Conclusion:

SEMS has significant advantages over er in relieving clinical symptoms and facilitating postoperative recovery in MLCO, but does not reduce the tumor recurrence rate. Neoadjuvant chemotherapy combined with SEMS may provide a new approach to the treatment of MLCO.
Exploratory study on the mechanism of necrotic effect of nourishing cells in the context of genital tract infection in premature rupture of membranes
Authors: Qian Yunying , Qian Guiying , Ni Haiyan , Zhu Danying , Gu Weiqun , Cai Ximei
Published: December 2023

To explore the mechanism of necrotic effect of nourishing cells in the context of genital tract infection in premature rupture of membranes (PROM). One hundred eight patients with PROM treated at our hospital from June 2020 to June 2022 were selected as the PROM group. Simultaneously, 108 cases of normal full-term pregnant women were chosen as the control group. Western blot analysis was performed to measure the relative expression levels of cysteinyl aspartate specific proteinase-1 (Caspase-1), cysteinyl aspartate specific proteinase-3 (Caspase-3), nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3), and interleukin (IL)-1β proteins, which are associated with necrosis of placental nourishing cells, in the placenta of both groups. TUNEL staining was used to detect the number of apoptotic placental nourishing cells. The differences in necrotic factors of placental nourishing cells were analyzed between full-term and preterm cases in the PROM group, as well as among patients with different genital tract infections. The apoptotic count of placental nourishing cells in the PROM group was 58.46 ± 11.26 cells/field, which was markedly higher than that of the control group (P < .05). The relative expression levels of the necrotic factors Caspase-1, Caspase-3, NLRP3, and IL-1β proteins in placental nourishing cells of the PROM group were 1.32 ± 0.26, 1.19 ± 0.30, 1.29 ± 0.28, and 1.23 ± 0.24, respectively. These values were significantly higher than those of the control group (P < .05). The relative expression levels of the necrotic factors Caspase-1, Caspase-3, NLRP3, and IL-1β proteins in placental nourishing cells were compared between full-term and preterm patients in the PROM group (P > .05). The relative expression levels of the necrotic factors Caspase-1, Caspase-3, NLRP3, and IL-1β proteins in placental nourishing cells were higher in patients with multiple genital tract infections compared to those with single infections or no infections in the PROM group (P < .05). PROM is associated with a significant upregulation of placental nourishing cell apoptosis and necrotic factors, including Caspase-1, Caspase-3, NLRP3, and IL-1β proteins. This upregulation is correlated with the presence of genital tract infections.
Integrative approach for women with fibromyalgia in a Veterans Affairs Medical Center: An observational study
Authors: Grewal Harminder , Zhuang Cindy , Iqbal Mahwish , Ur Rehman Bushra Atta , Norton Julia , Vernon Catherine M. , Deol Simrita , Brose Steven W.
Published: December 2023

Fibromyalgia, a complex condition characterized by widespread musculoskeletal pain, presents a significant burden on individuals and healthcare systems. This observational study aims to explore the potential of an outpatient integrative care model for the management of fibromyalgia in women, focusing on personalized goals, patient education, non-pharmaceutical treatments, and lifestyle modifications. The primary objective is to assess patient satisfaction and its correlation with pain, quality of life, depression, and post-traumatic stress disorder (PTSD) symptoms. This pilot study seeks to determine the effectiveness of this model in the alleviation of fibromyalgia-related pain and the improvement of overall well-being. Twenty-five women diagnosed with fibromyalgia participated in a 14-week outpatient treatment program at a Veterans Affairs Medical Center, involving weekly patient-directed, integrative group visits and health coaching. Pre- and post-evaluation questionnaires were administered to assess patient satisfaction, patients’ subjective sense of empowerment in the management of fibromyalgia, and symptom improvement (i.e., pain, quality of life, depression, and PTSD). In addition, the study evaluated the correlation of patient empowerment with symptom improvement. The integrative care model received high patient satisfaction, with a mean score of 8.04 out of 10. Significant pain reduction was observed based on the Numeric Rating Scale (n = 22, P < .001). Quality of life showed significant improvement according to the Fibromyalgia Impact Questionnaire (n = 24, P = .01). Furthermore, depression symptoms improved significantly, as assessed by Patient Health Questionnaire (n = 24, P = .04). However, there was no statistically significant change in PTSD scores (n = 22, P = .3). Patient empowerment was strongly correlated with pain reduction (n = 25, r = .78, P < .001), quality of life (n = 25, r = .57, P < .001), and improvement in depression symptoms (n = 22, r = .50, P = .004). Pairwise deletion was used for each outcome. This integrative care model demonstrated promising results in effectively managing fibromyalgia-related pain and enhancing quality of life and depression symptoms in women. This model presents a feasible and potentially effective treatment approach for fibromyalgia. Further research with larger sample sizes and control groups is warranted to validate these findings and encourage broader implementation.
Quality of care perceived by patients during cystoscopy and affecting factors
Authors: Saray Kiliç Hülya , Pazar Berrin , İbrahimoğlu Özlem , Naldan Muhammet Emin
Published: December 2023

It is necessary and important for quality of care to ensure the comfort of patients during the procedure, as well as before and after surgery. According to literature, it is necessary to know what patients experience and how they perceive the care they receive. This study aimed to investigate the quality of care perceived by patients during cystoscopy and the factors affecting it. This descriptive study was conducted in the surgical clinic of a teaching and research hospital, with 105 patients who underwent cystoscopy in 2022. Data collection forms consisting of a Sociodemographic and Disease Characteristics Questionnaire and the Good Perioperative Nursing Care Scale (for Patients) (GPNCS) were used for data collection, with face-to-face interviews on the first day after the procedure. This study was conducted in accordance with the principles of the Declaration of Helsinki. The study included patients with urinary tract stones, transurethral prostatectomy, and transurethral bladder resection. Of the participants, 72.4% were male, and 81.9% were married. The mean age of the patients was 50.09 ± 16.79 years. The mean total score was 143.56 ± 16.62. It was higher in single patients and those who had not previously undergone surgery. It was found that the mean of the environment sub-dimension was the highest at 18.57 ± 2.51 and the mean of the support sub-dimension was the lowest at 16.01 ± 3.44. The results of this study showed that patients undergoing cystoscopy have a good perception of the quality of their peri-operative nursing care.
Comparison of traction, side-bending and dead-hang radiographs in preoperative evaluation and postoperative correction prediction in adolescent idiopathic scoliosis: A retrospective analysis of a novel flexibility radiograph
Authors: Ovali Sancar Alp , Us Ali Kemal
Published: December 2023

A retrospective study comparing traction, dead-hang, and side-bending radiographs in adolescent idiopathic scoliosis to compare the effectiveness of dead-hang radiography in structural and nonstructural curves and evaluate it in terms of postoperative correction prediction. In the surgical correction of adolescent idiopathic scoliosis, flexibility radiographs have an important role in determining fusion levels and in surgical decision-making. Supine bending radiographs are presently considered the gold standard, but their reliability, reproducibility, and standardization along with traction films, are a subject of debate. In our clinic, dead-hang radiographs are also used as an alternative flexibility film. The role of dead-hang radiography against other flexibility radiographs is unknown. A total of 33 patients with adolescent idiopathic scoliosis were evaluated with preoperative standing, lateral, supine traction, dead-hang, supine side-bending, and postoperative standing films. Flexibility and correction rates were assessed. In structural main thoracic (MT) and thoracolumbar/lumbar (TL/L) curves, dead-hang showed significantly higher flexibility compared with traction (P < .001). In MT curves > 60°, dead-hang was superior to side-bending and traction, whereas in MT curves < 50°, side-bending showed more improvement (P < .05). Side-bending showed higher flexibility in TL/L curves < 50° (P < .05). No predictive value was found in structural curves for all 3 radiographs. In nonstructural curves, side-bending films showed over-correction while traction radiographs remained below postoperative correction. Dead-hang radiographs showed very similar flexibility to postoperative correction. Dead-hang radiograph is superior to traction. In MT curves > 60°, dead hang shows greater flexibility than side-bending. Dead-hang technique, which shows equal results with side-bending except in TL/L curves < 50°, is a successful flexibility radiograph and provides predictive value for nonstructural curves in terms of postoperative correction.
Proteomic analysis of glomeruli, tubules and renal interstitium in idiopathic membranous nephropathy (IMN): A statistically observational study
Authors: Lu Chang , Luo Zhi-Feng , Tang Donge , Zheng Fengping , Li Shanshan , Liu Shizhen , Qiu Jing , Liu Fanna , Dai Yong , Sui Wei-Guo , Yan Qiang
Published: December 2023

Idiopathic membranous nephropathy (IMN) is a common type of primary glomerulonephritis, which pathogenesis are highly involved protein and immune regulation. Therefore, we investigated protein expression in different microregions of the IMN kidney tissue. We used laser capture microdissection and mass spectrometry to identify the proteins in the kidney tissue. Using MSstats software to identify the differently expressed protein (DEP). Gene ontology analysis and Kyoto Encyclopedia of Genes and Genomes pathway analysis were used to predict and enrich the potential functions of the DEPs, and DEPs were compared to the Public data in the gene expression omnibus (GEO) database for screening biomarkers of IMN. Immune infiltration analysis was used to analyze the immune proportion in IMN. Three significantly up-regulated proteins were identified in the glomeruli of patients with IMN; 9 significantly up-regulated and 6 significantly down-regulated proteins were identified in the interstitium of patients with IMN. Gene ontology analysis showed that the DEPs in the glomerulus and interstitium were mostly enriched in “biological regulation, the immune system, and metabolic processes.” Kyoto Encyclopedia of Genes and Genomes analysis showed that the DEPs in the glomerulus and interstitium were mostly enriched in the “immune system” and the “complement and coagulation cascades. ” According to the public information of the GEO database, DEPs in our study, Coatomer subunit delta Archain 1, Laminin subunit alpha-5, and Galectin-1 were highly expressed in the IMN samples from the GEO database; in the immune infiltration analysis, the proportion of resting memory CD4 T cells and activated NK cells in IMN were significantly higher than in the normal group. This study confirmed that there were significant differences in protein expression in different micro-regions of patients with IMN, The protein Coatomer subunit delta Archain 1, Laminin subunit alpha 5, Galectin-1 are potential biomarkers of IMN, the memory T cells CD4 and NK cells, maybe involved in the immunologic mechanism in the development of IMN.
Association between dietary antioxidant and fatty acids and low muscle mass in obese and non-obese community-dwelling older adults: An NHANES analysis
Authors: Jia Guhua , Wu Chieh-Chen , Su Chun-Hsien
Published: December 2023

Sarcopenia increases disability, hospital stays, readmissions, and mortality in older adults. Antioxidative nutrients and fatty acids consumption may help maintain muscle mass by reducing oxidative stress. This study aims to assess the association between antioxidant and fatty acid intake and low muscle mass in community-dwelling older people. This retrospective analysis used data from the National Health and Nutrition Examination Survey from 1999 to 2004. Participants ≥ 60 years with information on muscle mass measured by Dual energy X-ray absorptiometry (DXA) were included. Appendicular skeletal muscle mass was assessed. Associations between antioxidants and fatty acids intake, and low muscle mass were evaluated using logistic regressions. 3648 (1748 men and 1900 women) were included. The prevalence of low muscle mass was 41% and 26% among men and women ≥ 75 years, and 45.2% and 28.4% among obese men and women. In obese males, a natural-log-unit increase of vitamin A (aOR = 0.806, 95% CI: 0.652–0.996), vitamin C (aOR = 0.878, 95% CI: 0.779–0.990), selenium intake (aOR = 0.716, 95% CI: 0.517–0.993), and higher saturated fatty acids (aOR = 0.956, 95% CI: 0.915–0.998) and monounsaturated fatty acids (aOR = 0.959, 95% CI: 0.925–0.994) intake were associated with decreased odds for low muscle mass. Among obese females, a natural-log-unit increase of vitamin E (P = .036), vitamin B12 (P = .014), total folate (P = .015), zinc (P = .005), and selenium intake (P = .018) were associated with increased odds of low muscle mass, whereas higher saturated fatty acids (P < .001), monounsaturated fatty acids (P = .001), and polyunsaturated fatty acids intake (P = .006) were associated with decreased odds for low muscle mass. Antioxidants (vitamin A, C, E, B6, B12, total folate, zinc, magnesium, selenium) intake does not consistently relate to low muscle mass across age and sex. Higher intake of saturated, monounsaturated, and polyunsaturated fatty acids are independently associated with reduced likelihood of low muscle mass in both obese older men and women.
End stage renal disease in patient with microscopic polyangiitis and atypical hemolytic-uremic syndrome arose 3 weeks after the third dose of anti-SARS-CoV2 vaccine mRNA-1273: A case report with literature revision
Authors: Moronti Veronica , Carubbi Francesco , Sollima Laura , Piscitani Luca , Ferri Claudio
Published: December 2023

Rationale:

Immune system deregulation, including AAV, is a key event that may potentially evolve into ESRD. Abnormal activation of the cAP is also a cardinal feature of TMA, particularly aHUS. The kidney is the most frequently involved organ, and renal-limited forms of TMA are often encountered in clinical practice. Isolated case reports described the occurrence of renal TMA in AAV patients. Some cases of both de novo and relapses of AAV and/or TMAs after anti-SARS-CoV2 vaccination have been reported. We reported, for the 1st time, a case of patients with new-onset MPA and aHUS occurring 3 weeks after the third dose of mRNA-1273 vaccine anti-SARS-CoV2.

Patient concerns:

We present a 67-year-old man, affected by arterial hypertension, reported, after mRNA-1273 vaccine anti-SARS-CoV2, anuria, fatigue, anorexia and nausea. Laboratory data revealed acute renal failure.

Diagnosis:

Positivity of MPO-ANCA was observed. 7 days after admission, we observed a worsening of anemia and thrombocytopenia with haptoglobin reduction, LDH increase and presence of schistocytes. Plasma levels of ADAMTS-13 were normal. A renal biopsy was performed, and findings were consistent with microscopic polyangiitis, with features of micro-thrombotic glomerulopathy. Genetic tests revealed absence of hybrid genes associated with the increased risk of aHUS.

Interventions and outcomes:

We started renal replacement treatment, including hemodialysis, and pulsed methylprednisolone, with no improvement of laboratory parameters. Then, plasma exchange was performed leading to partial haematological response. Only with Eculizumab, a human C5 inhibitor, we observed a normalization of haptoglobin levels and platelets’ count. However, three months after discharge, the patient still required hemodialysis.

Lessons:

To our knowledge we observed the first case aHUS, without genetic predisposition, associated with MPA occurring after the third dose of anti-SARS-CoV2 vaccine. This case report highlights the potential link between anti-SARS-CoV2 vaccine as a trigger of MPA and aHUS. This systematic review offers additional perspectives. It is plausible to hypothesize that the vaccine was the trigger for the development of these 2 diseases.

Solid evidence on the mechanisms of interaction between vaccine and immune system, the role of genetic predisposition, and other variables, will shed additional light on the controversial link between anti-SARS-CoV2 vaccine and autoimmunity.
A gastric neuroendocrine carcinoma with good prognosis after chemotherapy combined with immunotherapy: A case report (CARE-compliant)
Authors: Zhao Yuanzheng , Yang Rong , Lu Hongxia
Published: December 2023

Introduction:

Gastric neuroendocrine carcinoma (GNENs), as a highly malignant gastrointestinal tumor, is characterized by easy postoperative metastasis, and its prognosis has always been poor compared to other gastrointestinal tumors. Due to its rarity, there have been few case reports and studies on it. As of now, there is no clear diagnosis and treatment sequence and guidelines. In this report, we present a case of GNENs that underwent first-line treatment after surgery. The patient achieved an excellent prognosis and survival after a combination of chemotherapy resistance and immunotherapy. This report aims to provide valuable reference and guidance for the treatment of GNENs in the future. Therefore, we conducted a literature review on GNENs.

Patient concerns:

A 61-year-old man was admitted to the hospital with complaints of upper abdominal distension and discomfort that had been persistent for 1 month. During the endoscopy examination, a 2.5 cm irregular deep mucosal defect was observed at the center of the gastric angle. The defect appeared covered with dirty moss, had a hard texture, and exhibited a tendency to bleed upon contact.

Diagnosis:

Biopsy results confirmed the presence of a medium to poorly differentiated adenocarcinoma in the gastric horn. Subsequently, the patient underwent surgery, and the removed specimen was diagnosed as GNENs.

Intervention:

Postoperative chemotherapy combined with immunotherapy

Outcome:

The patient in this case achieved a good prognosis and extremely long survival [overall survival > 3 years+] after receiving first-line treatment, which included chemotherapy, drug resistance and immunotherapy, and is currently in good health condition. The tumor is not sensitive to the standard EP regimen for neuroendocrine carcinoma, but after being replaced with oxaliplatin based regimen combined with immunotherapy, partial response was obtained, indicating a synergistic effect between chemotherapy and immunity. After treatment, it remained stable for a considerable period of time.

Conclusion:

Immunotherapy, as a new mode of cancer treatment can provide new guidance and ideas for the treatment of GNENs.
Magnetic resonance imaging for the diagnosis of malignant mixed Mullerian tumor of ovary: Two case reports
Authors: Jin Xiaofeng , Zhu Ping , Fan Shufeng , Dai Jingru
Published: December 2023

Rationale:

Malignant mixed Mullerian tumor (MMMT) is also known as carcinosarcoma, mostly occurring in the uterus, and occurred in ovary is very rare. The disease is highly aggressive. Two cases of MMMT of ovary and their imaging characteristics were collected in our study.

Patient concerns:

A 77-year-old and an 80-year-old woman were admitted to the obstetrics and gynecology department of our hospital on June 22, 2019, and December 10, 2019, respectively. The first patient presented with abdominal distension with poor appetite without obvious triggers. Another patient had been menopausal for 18 years and presented with vaginal bleeding with dull pain in the left lower abdomen without obvious cause.

Diagnoses:

Both patients underwent pelvic magnetic resonance imaging plain and enhanced scan after admission, which indicated pelvic mass. Postoperative pathology confirmed MMMT in the adnexal region.

Interventions:

Both patients underwent total hysterectomy and bilateral adnexectomy.

Outcomes:

Postoperatively, the first patient developed complications such as renal failure and gastrointestinal bleeding and was sometimes unconscious. Symptomatic treatment was not effective, and the patient died about 1 month after discharge. The other patient recovered well after surgery, and imaging examinations confirmed no evidence of regrowth of the tumor during an average 36-month follow-up.

Lessons:

The disease is highly malignant and progresses rapidly. The elevation of CA125 should be taken seriously. The imaging findings of MMMT has certain characteristics. Multi-sequence magnetic resonance imaging may help to distinguish this disease from other pelvic tumors. Once found, surgical treatment is needed as soon as possible, followed by postoperative adjuvant radiotherapy and chemotherapy.
Acupuncture for abdominal wall endometriosis: A case report
Authors: Du Xiufan , Tang Jiahao , Zhang Lixia , Yi Wei
Published: December 2023

Introduction:

Endometriosis refers to a series of symptoms caused by the presence of endometrial-like tissue outside the uterine cavity. In extrapelvic endometriosis, abdominal wall endometriosis (AWE) is very common. Acupuncture therapy has been widely used as an alternative therapy to treat multiple diseases, such as sequelae of stroke, pain, and facial paralysis. To our knowledge, case reports of acupuncture for the treatment of AWE has not been reported. We report a case of acupuncture in the treatment of abdominal endometriosis.

Rationale:

AWE could result in symptoms including pelvic pain, dysmenorrhea, and infertility. Acupuncture might be effective in the treatment of the disease.

Patient concerns:

A 38-year-old woman complained of the aggregation of pain in a mass, which is located in her abdominal wall.

Diagnoses:

The patient was diagnosed with AWE, surgical history (excision of deep abdominal wall mass, repair of abdominal wall defect with patch). According to traditional Chinese medicine theory, traditional Chinese medicine diagnosis is Zhengjia (qi stagnation and blood stasis pattern).

Interventions:

Combined with the theory of disentanglement, we use acupuncture, cupping, and needle therapy to promote qi circulation, activate blood circulation, relieve pain, and dissipate masses.

Outcomes:

After treatment, abdominal ultrasound showed that the mass gradually decreased.

Conclusion:

Acupuncture can effectively relieve the pain caused by abdominal endometriosis and reduce the size of abdominal endometriosis masses.
Efficacy of posterior fixation and bone graft fusion for treatment of lumbar brucellosis spondylitis
Authors: Li Yu , Fei Le , Shi Jiandang
Published: December 2023

The purpose of this study is to verify whether early stage patients with single-segment lumbar Brucella spondylitis can still be cured through simple posterior fixation and bone grafting, even without debridement. A retrospective study was conducted on 63 patients diagnosed with single-segment lumbar brucellosis spondylitis, who underwent posterior-only debridement (or not), bone grafting, and instrumentation from June 2016 to June 2019. Group A comprised 34 patients who did not undergo debridement, while group B comprised 29 patients who underwent debridement. The clinical data and imaging results of the patients were compared between the 2 groups to evaluate the clinical effects of debridement or not. Both groups of patients completed at least 1 year of follow-up. The group A had significantly lower values for operation time, blood loss, and hospital stay compared to the group B (P < .05). There were no significant differences between the 2 groups in terms of erythrocyte sedimentation rate, C-reactive protein, visual analogue scores, improvement of Japanese Orthopaedic Association Evaluation of treatment score, and Cobb angle. The bone fusion rate was 92% (31 patients) in group A and 96% (28 patients) in group B, with no significant difference between the 2 groups (P > .05). In summary, these findings suggest that posterior fixation and bone graft fusion are effective treatments for single-segment lumbar brucellosis spondylitis in early stages even without debridement. Importantly, these procedures offer several benefits, such as minimal trauma, short operation times, rapid postoperative recovery, and favorable bone graft fusion outcomes.
SEPT9, H4C6, and RASSF1A methylation in nasopharyngeal swabs: A reflection of potential minimally invasive biomarkers for early screening of nasopharyngeal cancer
Authors: Qian Tai , Zhou Zhiwei , Zhang Qiongxia , Liou Yu-Light , Zhou Honghao
Published: December 2023

The potential value of epigenetic DNA methylation in early cancer screening has been demonstrated. Therefore, in this study, we performed QMS-PCR and quantitative reverse transcription PCR on the genes RASSF1A, H4C6, SEPT9, GSTP1, PAX1, SHOX2, and SOX2, which are common in epithelial cancers. We found hypermethylation in RASSF1A, H4C6 and SEPT9. The mRNA expressions of RASSF1A, H4C6 and SEPT9 in tumor group were significantly different from those in the inflammatory group and healthy group (P < .05). Receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) of RASSF1A, H4C6 and SEPT9 genes were 0.831, 0.856 and 0.767, respectively. The areas under the AUC curve of SEPT9 + H4C6, SEPT9 + RASSF1A and H4C6 + RASSF1A are 0.946, 0.912 and 0.851, respectively. The diagnostic ability of dual gene combination is better than that of single gene combination, among which SEPT9 and H4C6 combination has the best diagnostic effect. In conclusion, our findings suggest that H4C6, RASSF1A, and SEPT9 methylation occur more frequently in nasopharyngeal carcinoma, and their detection in nasopharyngeal swabs may be a minimally invasive tool for diagnosis of nasopharyngeal carcinoma.
Effect and prediction of physical exercise and diet on blood pressure control in patients with hypertension
Authors: Ma Qiang , Cheng Cheng , Chen Yuenan , Wang Qianya , Li Baozhu , Wang Ping
Published: December 2023

The study aims to explore the current status of hypertension control and its predictors in patients with hypertension in China and provide evidence for preventing and controlling hypertension. A questionnaire survey was conducted among 300 hypertensive patients who visited the Second Affiliated Hospital of Anhui Medical University from February 20, 2023 to March 11, 2023. The patients were divided into a well-controlled group and an untargeted-control group according to their hypertension control status. A total of 294 subjects, including 83 in the well-controlled group and 211 in the untargeted-control group, were included in the analysis. Multivariate logistic regression analysis showed that hypertensive patients with high BMI and family history of hypertension were risk factors for hypertension control. Married status was a protective factor for hypertension control. SVM optimized the model with γ = 0.001 and a penalty factor of C = 0.001. The prediction accuracy of the final model was 80.9%. The findings indicated that BMI, family history of hypertension, and marital status were independent predictors of blood pressure control. Further studies are warranted to illustrate potential mechanisms for improving hypertensive patients’ blood pressure control.
The association between appendicular skeletal muscle index and bone mineral density in children and adolescents with chronic kidney disease: A cross-sectional study
Authors: Qin Xuankai , Wei Jiahui , Wei Jinshuang , Wei Junyu , Chen Jie , Lei Fengying , Qin Yuanhan
Published: December 2023

Chronic kidney disease (CKD), a pervasive public health concern, can lead to complications like sarcopenia and reduced bone mineral density (BMD). However, it is still unclear exactly how muscle mass correlates with BMD in youngsters and adolescents with CKD. We aimed to investigate the association between appendicular skeletal muscle index (ASMI) and BMD among children and adolescents with CKD. In our research, we utilized data from the National Health and Nutrition Examination Survey (NHANES) collected between 2011 and 2014 to investigate the association of ASMI with BMD among this population. The association linking ASMI with total BMD was examined through multivariate linear regression models. Furthermore, fitted smoothing curves were employed, as well as generalized additive models. Our analysis finally included 503 CKD participants aged between 8 and 19 years. We found a significant association linking ASMI with total BMD among children and adolescents with CKD. The connection persisted even after accounting for covariates. Upon subgroup analysis, there was a statistically significant association of ASMI with total BMD for both males and females, as well as for Mexican-American and non-Hispanic White populations. However, no significant association was observed in other Hispanic, non-Hispanic Black, or populations of other races. We discovered a positive correlation linking the ASMI and the total BMD in children and teenagers with CKD. In CKD patients, maintaining skeletal muscle mass may be crucial for managing and preventing renal osteodystrophy.
Comparison study of anterior cervical zero-profile fusion cage (ROI-C) and traditional titanium plate plus fusion technique for the treatment of spinal cord type cervical spondylosis
Authors: Gao Haoran , Tian Zhen , Wang Yong , Lou Zhaohui
Published: December 2023

A retrospective comparative study. To compare and analyze the differences in the efficiency and safety of ROI-C and traditional titanium plate with fusion cage for the treatment of CSM patients. Clinical data of 105 patients with CSM who underwent surgical treatment at our hospital from January 2019 to December 2020 were retrospectively reviewed. Patients were divided into ROI-C and traditional groups according to the different fusion methods. The operation time, intraoperative blood loss, preoperative and postoperative JOA score, NDI score, cervical Cobb angle, intervertebral space height, and postoperative complications were recorded and compared between the 2 groups. A total of 105 patients were included in this study, with 57 patients in the ROI-C group and 48 patients in the traditional group. The baseline data were similar between the 2 groups (P > .05). The operative time, intraoperative blood loss, and the incidence of postoperative dysphagia were significantly lower in the ROI-C group than in the traditional group (P < .05). There were no significant differences in the JOA score, NDI score, cervical Cobb angle, intervertebral space height, the incidence of postoperative axial symptoms, and adjacent segment degeneration between the 2 groups (P > .05). However, both groups showed significant improvement in the JOA score, NDI score, cervical Cobb angle, and intervertebral space height compared with before surgery (P < .05). The ROI-C zero-profile internal fixation system and traditional titanium plates with fusion cages can achieve satisfactory clinical treatment results for CSM patients. However, ROI-C has advantages of a shorter operative time, less blood loss, and less postoperative dysphagia. Therefore, the ROI-C zero-profile internal fixation system can be safely and effectively used to treat patients with CSM.