bluuebunny/crossref_metadata_2025 huggingface dataset:
ANCA-negative eosinophilic granulomatosis with polyangiitis complicated by peripheral nerve damage: A case report
Authors: Chen Yongzhen , Wan Qiuxia , Liu Bo
Published: August 2023

Rationale:

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare autoimmune disease that can affect multiple systems of the body and is characterized by asthma, blood and tissue eosinophilia, and small vascular inflammation. Eosinophilic tissue infiltration and extravascular granuloma formation can lead to any organ damage, but peripheral neuropathy is relatively rare.

Patient concerns:

A 29-year-old male patient was admitted to the hospital due to fever and rash on both lower extremities for 18 days. The patient complained of muscle pain in both lower extremities, with nausea, anorexia, abdominal pain, and diarrhea. He had a 2-year history of asthma and bronchiectasis. The physical examination results were as follows: temperature, 37.8 °C; multiple patchy red rashes on both lower extremities; and no obvious abnormalities in other systems. The patient was negative for anti-neutrophil cytoplasmic antibody (ANCA). Chest computed tomography showed bilateral ground-glass opacities, small nodules, and bronchiectasis. Histopathology of rectal tissues revealed numerous eosinophilic infiltrations. One week after admission, the patient developed symptoms of peripheral nerve damage, presenting with distal weakness in both lower extremities, foot drop, cross-threshold gait, and hypoalgesia on the lateral sides of both lower legs. Electromyography showed that the motor sensory fibers of the lower extremities were damaged.

Diagnoses:

Referring to the diagnostic criteria of the American College of Rheumatology in 1990, the patient was diagnosed with systemic EGPA (vasculitic phase) with rare peripheral nerve damage.

Interventions:

After diagnosis, the patient was administered oral prednisone (60 mg/d; 1.0 mg/kg/d), and cyclophosphamide (900 mg) was infused on the 5th and 18th days of hormone therapy. Prednisone was reduced to 50 mg/d 1 month thereafter.

Outcomes:

After 1+ months of treatment, most of the symptoms disappeared. Limb weakness did not improve. Currently, the patient is undergoing outpatient follow-up and is adhering to treatment.

Lessons:

EGPA is a rare disease that can affect multiple systems and has diverse clinical manifestations, with no specific manifestations in the early stage. Diagnosis is difficult, and there is a high misdiagnosis rate. The rate of ANCA positivity for this disease is not high, and clinicians should consider the possibility of ANCA-negative EGPA.
Necrotizing fasciitis after total abdominal hysterectomy: A case report
Authors: Pantelić Miloš , Stojić Marko Sinisa , Petrović Đorđe , Mladenović-Segedi Ljiljana , Baturan Branislava , Tesić Igor , Golijan Borislav
Published: August 2023

Rationale:

Necrotizing fasciitis is rapidly progressive infection with high mortality rate. This study aimed to summarize the clinical and pathological presentation of this case.

Patient concerns:

A 46-year-old woman patient presented to our emergency department of an obstetric and gynecology clinic on the 8th day after total abdominal hysterectomy. The abdominal wall showed pronounced signs of inflammation. Abundant purulent content was oozing from the abdominal wound.

Diagnoses:

The patient underwent surgery. Areas of necrosis were observed on the skin around the wound, the subcutaneous fatty tissue was necrotic around the incision site, and the fascia was completely dehisced.

Interventions:

Wound debridement and flap cutting of the anterior abdominal wall were performed. Metronidazole, ceftriaxone, and vancomycin were administered intravenously. A plastic surgeon suggested daily debridement and toileting of the wound in the operating room. Swabs of the abdominal cavity, abscess cavity, and abdominal wound were obtained, and Enterococcus faecalis was isolated. After the negativism of microbiological swabs, excochleation of granulation tissue was performed by a plastic surgeon.

Outcomes:

Nineteen days after the relaparotomy, the patient was discharged in good general condition with advice for further monitoring and therapy.

Lessons:

Successful treatment of necrotizing fasciitis can be achieved through an initial diagnosis, adequate debridement, empirical broad-spectrum antibiotic coverage, and multidisciplinary treatment.
Identification of novel immune-related biomarker and therapeutic drugs in Parkinson disease via integrated bioinformatics analysis
Authors: Yang Xiaoxia , Wang Zhiyun
Published: August 2023

Background:

The present study was designed to identify immune-related biomarker and candidate drugs for Parkinson disease (PD) by weighted gene co-expression network analysis.

Methods:

Differentially expressed genes were identified in PD and healthy samples in the Gene Expression Omnibus (GEO) database. Besides, immune-related genes were obtained from the immunology database. Then, a co-expression network was constructed by the weighted gene co-expression network analysis package. Diagnostic model for PD was constructed by Lasso and multivariate Cox regression. Furthermore, differentially expressed genes (DEGs) were used to establish PPI and competing endogenous RNA (ceRNA) networks. Functional enrichment and pathway analysis were performed. Drug-hub gene interaction analysis was performed via DGIdb database.

Results:

PD samples and normal samples were found to have 220 upregulated genes and 216 downregulated genes in the GSE6613 dataset. The differentially expressed genes contained 50 immune-related genes, with 40 upregulated genes and 10 downregulated genes. We obtained 7 hub genes by intersecting the DEGs and candidate hub genes. As potential diagnostic markers, 2 immune-related DEGs were identified among the 7 hub genes. According to functional enrichment analysis, these DEGs were mainly enriched in immune response, inflammatory response, and cytokine-cytokine receptor interactions. Totally, we obtained 182 drug-gene interaction pairs in Drug-Gene Interaction database (DGIdb).

Conclusion:

Our results revealed crucial genes and candidate drugs for PD patients and deepen our understanding of the molecular mechanisms involved in PD.
Protection of high-frequency low-intensity pulsed electric fields and brain-derived neurotrophic factor for SH-SY5Y cells against hydrogen peroxide-induced cell damage
Authors: Lin Guan-Bo , Chen Wei-Ting , Kuo Yu-Yi , Chen You-Ming , Liu Hsu-Hsiang , Chao Chih-Yu
Published: August 2023

Neurodegenerative diseases (NDDs) pose a significant global health threat. In particular, Alzheimer disease, the most common type causing dementia, remains an incurable disease. Alzheimer disease is thought to be associated with an imbalance of reactive oxygen species (ROS) in neurons, and scientists considered ROS modulation as a promising strategy for novel remedies. In the study, human neural cell line SH-SY5Y was used in probing the effect of combining noninvasive high-frequency low-intensity pulsed electric field (H-LIPEF) and brain-derived neurotrophic factor (BDNF) in protection against hydrogen peroxide (H2O2)-induced neuron damage. Our result finds that the combination approach has intensified the neuroprotective effect significantly, perhaps due to H-LIPEF and BDNF synergistically increasing the expression level of the phosphorylated epidermal growth factor receptor (p-EGFR), which induces the survival-related mitogen-activated protein kinases (MAPK) proteins. The study confirmed the activation of extracellular signal-regulated kinase (ERK) and the downstream pro-survival and antioxidant proteins as the mechanism underlying neuron protection. These findings highlighted the potential of H-LIPEF combined with BDNF in the treatment of NDDs. Furthermore, BDNF-mimetic drugs combining with noninvasive H-LIPEF to patients is a promising approach worthy of further research. This points to strategies for selecting drugs to cooperate with electric fields in treating neurodegenerative disorders.
Contribution of lowered hemoglobin threshold value in the diagnosis of polycythemia vera: Comparison of 2016 and 2008 WHO criteria
Authors: Gulturk Emine , Yilmaz Deniz , Sonmezoz Gulru Birce , Yildirim Ezgi Simge
Published: August 2023

Polycythemia vera (PV) diagnosis remains a difficult task despite various updates in the 2016 World Health Organization (WHO) diagnostic criteria compared to 2008 criteria. This study aimed to examine the biochemical and clinical features of patients diagnosed with PV using the WHO 2016 criteria but would have been missed by the WHO 2008 criteria, and to ascertain the impact of the lowered thresholds on PV diagnosis. A total of 229 patients with suspected myeloproliferative neoplasms were included in this cross sectional study. The study group was divided with regard to hemoglobin values. Group A consisted of 126 patients with hemoglobin values of ≤ 18.5 g/dL in males and ≤ 16.5 g/dL in females. Group B comprised 103 patients with hemoglobin values of > 18.5 g/dL in males and > 16.5 g/dL in females. The number of PV diagnoses increased to 145 from 87 (increased by 66.67%) when the 2016 diagnostic criteria were employed rather that the 2008 criteria. Mean age and the frequency of female subjects were lower in Group A compared to Group B. The groups were similar in terms of chronic obstructive pulmonary disease/obstructive sleep apnea syndrome, spleen status, smoking status, and mean corpuscular volume, white blood count, neutrophil, eosinophil and platelet values. red blood cells and lactate dehydrogenase values were significantly higher, while lymphocyte counts were significantly lower in Group B. With the introduction of WHO 2016 criteria, we found a significant increase in the number of patients who were candidates for PV testing and were ultimately diagnosed with PV. These findings support the diagnostic value of the 2016 WHO criteria, and by extension, the lowered thresholds for detection of patients requiring further analysis.
Tissue quantitative RT–PCR test for diagnostic significance of cytomegalovirus infection in patients with inflammatory bowel disease and treatment response: Cytomegalovirus infection in patients with inflammatory bowel disease
Authors: Ozdemir Burcu , Atay Ali , Kayhan Meral Akdogan , Ozin Yasemin Ozderin , Gokce Dilara Turan , Altunsoy Adalet , Guner Rahmet
Published: August 2023

Cytomegalovirus (CMV) is an opportunistic pathogen that exacerbates inflammatory bowel disease (IBD). There are no clear diagnostic criteria for CMV infection in IBD patients. The aim of this study was to evaluate the importance of the diagnosis of CMV infection with CMV-DNA polymerase chain reaction (PCR) in the colonic mucosa and the response to antiviral treatment. We retrospectively analyzed the clinical data of 30 patients with IBD (24 men, 6 women; median age: 42 years) who were hospitalized because of IBD exacerbation and whose samples were assessed by tissue CMV-DNA PCR positivity. Most of the IBD patients had ulcerative colitis (90%). The CMV-DNA PCR median value was 8848 copies/mL of tissue (range 90–242,936 copies/mL). Blood CMV-DNA PCR was found to be positive in a small group (33.3%, 10/30) of tissue CMV-DNA PCR-positive cases. immunohistochemistry tests were positive in only 5 of the 23 patients positive for CMV-DNA PCR in the colonic mucosa, and high remission (25/30, 83.3%) was detected with antiviral therapy. Recurrence of CMV colitis infection was observed in 9 of 25 patients who had remission with antiviral therapy. The tissue CMV-DNA PCR test was found to be more useful than blood CMV-DNA PCR and immunohistochemistry tests for diagnosing CMV colitis, and the tissue CMV-DNA PCR test enabled rapid and appropriate treatment.
Network pharmacological analysis on the mechanism of Coix seed decoction for osteoarthritis of the knee
Authors: Qiu Junjie , Chen Rui , Song Chao , Wang Xiaoqiang , Xiang Wei , Huang Sanjun , Su Qifan , Deng Guanghui , Wu Jiaqi , Chen Xiaojun
Published: August 2023

Based on network pharmacology methods, we explored the mechanism of the classic Chinese medicine formula Coix seed decoction (CSD) in treating knee osteoarthritis (KOA). We searched each single drug in the CSD in the traditional Chinese medicine systematic pharmacology database in turn to obtain information on the active ingredients and target proteins of the CSD, and obtain the name of the genes corresponding to the target proteins through the UniProt database. We collected KOA-related genes from DisGeNET, GeneCards, comparative toxicogenomics database, and MalaCards database. The Venny online tool identified potential therapeutic targets by intersecting CSD and KOA target genes, while gene ontology and Kyoto encyclopedia of genes and genomes analysis was performed using the Oebiotech Cloud Platform. A protein-protein interaction network was established using the String database; a “CSD-active ingredient-target gene-KOA” network plot was constructed using Cytoscape 3.9.1 software and screened for key targets and hub targets. Finally, molecular docking was performed for hub genes with high Degree values. A total of 227 effective target genes for CSD and 8816 KOA-related target genes were obtained, as well as 191 cross-target genes for CSD and KOA. We screened 37 key gene targets and identified the top 10 hub target genes in descending order of Degree value using protein-protein interaction and Cytoscape 3.9.1 software (TNF, IL-6, MMP-9, IL-1β, AKT-1, VEGFα, STAT-3, PTGS-2, IL-4, TP53). Gene ontology analysis showed that the biological process of CSD treatment of KOA mainly involves cytokine-mediated signaling pathway, negative regulation of apoptotic process, cellular response to hypoxia, cellular response to cadmium ion, response to estradiol, and extrinsic apoptotic signaling pathway in absence of ligand. Kyoto encyclopedia of genes and genomes analysis revealed major signaling pathways including Cellular senescence, TNF signaling pathway, and PI3K-Akt signaling pathway. The molecular docking results show that the core components bind well to the core targets. In conclusion, CSD may exert therapeutic effects on KOA by inhibiting pathological processes such as inflammatory response, apoptosis, cellular senescence, and oxidative stress.
Body mass index and carpal tunnel syndrome: A case-control study
Authors: Chen Jia-Qing , Wang Duo , Liu Bin
Published: August 2023

To investigate the electrophysiological characteristics of carpal tunnel syndrome (CTS) and to evaluate the relationship between electrophysiological indexes and body mass index (BMI). In the analysis of 153 hospitalized patients with CTS, the median motor conduction velocity, motor conduction amplitude, motor conduction latency, sensor conduction velocity, sensor conduction amplitude and median sensory latency were analyzed. BMI was calculated. Total 171 healthy individuals were selected as control group. According to Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults, patients were divided into groups A, B and C. Patients with BMI (kg/m2) <24 were classified into group A; those with 24 ≤ BMI < 28 were regarded as overweight and classified into group B; and those with BMI ≥ 28 were regarded as obese and classified into group C. The BMI of CTS patients was significantly higher than that of healthy individuals (P < .05). For the sensory nerve, with the increase of BMI, the incubation period was gradually prolonged and the conduction velocity gradually decreases (P < .05). In terms of motor latency, with an increase in BMI, the latency showed a trend of first decreasing and then increasing, while the conduction velocity showed a trend of first increasing and then decreasing (P < .05). Electrophysiological examination plays an important supporting role in the diagnosis of CTS. BMI is positively correlated with the degree of CTS injury to a certain extent. Weight loss can effectively prevent the occurrence of CTS and slow the progression of nerve damage in CTS patients.
Effects of different medical masks on acoustic and aerodynamic voice assessment during the COVID-19 pandemic
Authors: Yu Mingwen , Jin Qianqian , Zhang Weiming , Sun Xin , Sun Yuxin , Xie Qing
Published: August 2023

The purpose of the study was to investigate the effect of the surgical masks and N95 masks on the acoustic and aerodynamic parameters of voice assessment during the coronavirus disease 2019 pandemic. The challenge of the study was to enable each inexperienced participant to perform a number of acoustic and aerodynamic voice assessment in a qualified and homogeneous manner without and with medical masks, and to minimize the individual differences. There were 32 healthy participants recruited in the study, including 16 males and 16 females. The acoustic parameters analyzed included fundamental frequency, standard deviation of fundamental frequency (fundamental frequency standard deviation), percentage of jitter (%), percentage of shimmer (%), glottal-to-noise excitation ratio (GNE), and the parameters of irregularity, noise and overall severity. The aerodynamic parameters included s time, z time, s/z ratio and maximum phonation time. When wearing surgical masks, the GNE ratio (P = .043) significantly increased, whereas noise (P = .039) and s time (P = .018) significantly decreased. When wearing N95 masks, the percentage of shimmer (P = .049), s time (P = .037) and s/z ratio (P = .048) significantly decrease. In general, performing voice assessment with a medical mask proved to be reliable for most of the acoustic and aerodynamic parameters. It is worth noting that the shimmer (%), could be slightly impacted when wearing N95 masks. Wearing surgical masks might slightly influence the measurement of noise and higher GNE ratio. The s/z ratio could be affected when wearing N95 masks. The contribution of the study is to explore acoustic and aerodynamic parameters that might be easily affected by wearing masks during the voice assessment, and provide references for clinical evaluation of voice disorders during the pandemic of coronavirus disease 2019.
Analysis of the kinematic variables that predict jump serve efficacy among volleyball players
Authors: Bari Mohd Arshad , Al Mijbilee Ali Azeez Aneed , Nuhmani Shibili , Iqbal Amir , Alghadir Ahmad H.
Published: August 2023

In volleyball, a strong correlation exists between the proper application of kinematics factors and the serve results. Therefore, this study compared the kinematics parameters of the volleyball jump serve among different functional classes and established an appropriate multilinear regression model of performance. This correlational observational study involved thirty male collegiate volleyball players categorized into under twenty-three (U-23) men, under twenty-one (U-21) junior men, and under nineteen (U-19) youth boys. Data acquisition entailed the utilization of synchronized cameras to capture the volleyball serves meticulously, while subsequent data analysis was conducted through the implementation of silicon coach–pro 8 motion analysis software. Analysis of variance and multiple linear regressions were performed to analyze data, with a predetermined significance level of P < .05. Jump serve analysis showed significant mean differences in selected major kinematic variables among all 3 classes (U-23 men, U-21 junior men, and U-19 youth boys). U-23 men Model-3, which includes 3 independent variables (approach velocity [AV], shoulder extension angles during the cocking phase, and center of gravity [CG] height), predicted velocity with an R-square of 1.00, indicating that the selected independent variable caused 100% variation in ball velocity (BV), whereas models 1 and 2 showed 99% variation in BV, respectively. The U-21 Junior men Model-2, which includes 2 independent variables (height of CG and shoulder extension angles during the cocking phase), predicted velocity with an R-square of 9.80, indicating that the selected independent variable caused a 98% variation in BV. In contrast, model 1 showed a 94% variation in BV, respectively. U-19 youth boys Model-1, which includes one independent variable (AV), predicted velocity with an R-square of 0.89, indicating that the selected independent variable caused 89% variation in BV. The jump serve exhibits similar biomechanical characteristics across different classes. However, the major independent variables of the jump serve: U-23 men were AV, shoulder extension angles at cocking phase (SEACP), the height of CG, U-21 junior men were SEACP and height of CG, and U-19 youth boys were SEACP and height of CG AV showed significant with the dependent variable (BV).
SARS-CoV-2 infections and MIS-C among children: A narrative review
Authors: Shati Ayed A. , Mahmood Syed Esam , Alsuheel Asseri Ali , Alhanshani Ahmad A. , Alqahtani Youssef A. , Ahmad Ausaf
Published: August 2023

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has less of an impact among the babies and teenagers, than it does on adults as a whole. Children turned out to be less symptomatic during the coronavirus disease (COVID-19) surge worldwide. Researchers discovered the ways of protection by preemptive care, like, treatment, variants, vaccination, social distancing, and cohorting among children as soon as their medical and epidemiological factors were assessed while being exposed to SARS-CoV-2 transmission. The actual pervasiveness of asymptomatic SARS-CoV-2 contagion is possibly undervalued because of less examination of the asymptomatic children. A half of young-aged people who tested SARS-CoV-2 positive don’t show any symptoms as per the study of serology. Nevertheless, there is wide circulation of information reporting a post-infectious acute illness known as multisystem inflammatory syndrome in children (MIS-C) or multisystem hyperinflammatory syndrome. Therefore, we undertook this narrative review to synthesize the evidence from existing studies to assess the relationship between SARS-CoV-2 infections and MIS-C among Children. We reviewed PubMed, Science Direct, and Google Scholar to find the pertinent scientific papers published in English that were available for such analysis. The main purpose of this article is to present, on this limited topic, a better-comprehended review covering pertinent material and data to be informed on SARS-CoV-2 infections and MIS-C among Children.
IL12B and IL17 genes polymorphisms associated with differential susceptibility to juvenile idiopathic arthritis and juvenile-onset systemic lupus erythematosus in Chinese children
Authors: Zhang Menglan , Peng Leiwen , Li Wensheng , Duan Yifei , Liu Xiaoqin , Chen Shasha , Deng Jiamin , Liu Xinle
Published: August 2023

Genetic factors play a crucial role in the immune response of juvenile idiopathic arthritis (JIA) and juvenile-onset systemic lupus erythematosus (JSLE). This study aimed to investigate the association of IL12B (rs3212227, rs6887695) and IL17 (rs2275913, rs763780) gene polymorphisms with the susceptibility of JIA and JSLE in Chinese children. A total of 303 healthy controls and 304 patients including 160 JIA and 144 patients were analyzed, and the genetic polymorphisms were genotyped by using a Sequenom MassArray system. There was a significant association between the IL12B rs3212227 genotype and the increased risk of JSLE (P = .01). For rs6887695, the minor allele C was significantly associated with the increased risk of JIA (odds ratio = 1.48, 95% confidence interval [CI] = 1.12–1.95, P = .005). Moreover, rs6887695 genotype was significantly associated with both JIA and JSLE susceptibility (P < .05). Besides, IL12B haplotype GC significantly associated with the increased risk of JIA (P = .016). However, no significant difference was found between the IL17 (rs2275913, rs763780) gene polymorphisms and JIA or JSLE susceptibility (P > .05). And similar genotype distributions of IL12B and IL17 polymorphisms were found between the patients with nephritis and without nephritis in JSLE (P > .05). Our results indicated that IL12B polymorphisms was associated with an increased risk for the development of JIA and JSLE in Chinese children, highlighting the involvement of inflammation in the pathogenesis of JIA and JSLE. Moreover, there was a risk haplotype in IL12B which could increase the risk of JIA.
High expression of ENPP2 is an independent predictor of poor prognosis in liver cancer
Authors: Meng Jiyu , Ruan Xuelian , Wei Fangyi , Xue Qin
Published: August 2023

Ectonucleotide pyrophosphatase/phosphodiesterase 2 (ENPP2) has been identified as a potential biomarker in lung and prostate cancers; however, its expression and clinical relevance in hepatocellular carcinoma (HCC) remain incompletely understood. This study comprehensively assessed ENPP2 expression in pan-cancer using bioinformatics. We analyzed the expression of ENPP2 mRNA in primary liver cancer and adjacent tissues of patients with HCC using data from the TCGA database. Cox regression and Kaplan–Meier methods were used to identify clinicopathological factors associated with survival, and the diagnostic value of ENPP2 expression was evaluated using receiver operating characteristic curve analysis. We also validated our findings by performing real-time PCR on clinical liver cancer samples. Furthermore, we conducted gene set enrichment analysis using the Cancer Genome Atlas dataset to gain additional insights into the biological significance of ENPP2 in HCC. High ENPP2 expression in HCC patients is associated with gender and clinical stage, and is a significant prognostic factor for worse outcomes. ENPP2 expression is an independent risk factor for progression-free and disease-specific survival in both cohorts, suggesting its potential as an HCC biomarker. ENPP2’s diagnostic value in HCC patients was confirmed by the area under the receiver operating characteristic curve, which was 0.806. real-time PCR analysis validated the higher expression of ENPP2 in clinical liver cancer tissues. Gene set enrichment analysis identified pathways enriched in HCC patients with high ENPP2 expression, including those related to the cell cycle, MTOR and T cell receptor signaling, and phosphatidylinositol signaling systems. We have demonstrated that ENPP2 is highly expressed in HCC and is a potential independent molecular marker for the diagnosis and prognosis of HCC.
The development of a clinical nomogram to predict medication nonadherence in patients with knee osteoarthritis
Authors: Zhang Qingzhu , Li Jianhui , Yao Yinhui , Hu Junhui , Lin Yingxue , Meng Xin , Zhao Yanwu , Wang Ying
Published: August 2023

Knee osteoarthritis (KOA) is a common bone disease in older patients. Medication adherence is of great significance in the prognosis of this disease. Therefore, this study analyzed the high-risk factors that lead to medication nonadherence in patients with KOA and constructed a nomogram risk prediction model. The basic information and clinical characteristics of inpatients diagnosed with KOA at the Department of Orthopedics, The Affiliated Hospital of Chengde Medical University, were collected from January 2020 to January 2022. The Chinese version of the eight-item Morisky scale was used to evaluate medication adherence. The Kellgren-Lawrence (KL) classification was performed in combination with the imaging data of patients. Least absolute shrinkage and selection operator regression analysis and logistic multivariate regression analysis were used to analyze high-risk factors leading to medication nonadherence, and a prediction model of the nomogram was constructed. The model was internally verified using bootstrap self-sampling. The index of concordance (C-index), area under the operating characteristic curve (AUC), decision curve, correction curve, and clinical impact curve were used to evaluate the model. A total of 236 patients with KOA were included in this study, and the non-adherence rate to medication was 55.08%. Seven influencing factors were included in the nomogram prediction: age, underlying diseases, diabetes, age-adjusted Charlson comorbidity index (aCCI), payment method, painkillers, and use of traditional Chinese medicine. The C-index and AUC was 0.935. The threshold probability of the decision curve analysis was 0.02–0.98. The nomogram model can be effectively applied to predict the risk of medication adherence in patients with KOA, which is helpful for medical workers to identify and predict the risk of individualized medication adherence in patients with KOA at an early stage of treatment, and then carry out early intervention.
Construction of gene subgroups of Crohn disease based on transcriptome data
Authors: Ma Jianglei , Zhang Huijie , Zhang Yuanyuan , Wang Guangming
Published: August 2023

Background:

The global prevalence of Crohn disease (CD), a chronic inflammatory disease of the intestine, has been increasing; however, the etiology and pathogenesis of this disease have not been fully elucidated. Therefore, in the present study, we aimed to better understand the molecular mechanisms underlying CD to aid the development of novel therapeutic strategies for this condition.

Methods:

Based on the transcriptome data from patients with CD, this study used an unsupervised learning method to construct gene co-expression molecular subgroups and the R and SPSS software to identify the biological, clinical, and genetic characteristics and signatures of each subgroup.

Results:

Two subgroups were analyzed. Compared to subgroup II, subgroup I consisted of older patients with a more limited range of disease presentation and had a higher number of smokers. The specific genes associated with this subgroup, including CDKN2B, solute carrier family 22 member 5, and phytanoyl-CoA 2-hydroxylase, can be targeted for managing intestinal dysbacteriosis. The number of patients showing infiltrating lesions was higher, the number of smokers was lower, and CD severity was worse in patients in subgroup II than those in subgroup I. The specific genes relevant to subgroup II included cluster of differentiation 44, tryptophanyl-tRNA synthetase, and interleukin 10 receptor, alpha subunit, which may be related to viral infection.

Conclusion:

The present study segregated patients with CD into 2 subgroups; the findings reported herein provide a new theoretical basis for the diagnosis and treatment of CD and could aid a thorough identification of potential therapeutic targets for this disease.
Effects of occupational therapy on quality of life in breast cancer patients: A systematic review and meta-analysis
Authors: He Kang , Jiang Junjie , Chen Mengmeng , Wang Taiwei , Huang Xuemiao , Zhu Ruiting , Zhang Zhiyuan , Chen Junyu , Zhao Lijing
Published: August 2023

Background:

The objective was to discuss the impact of occupational therapy on different domains of quality of life in breast cancer patients. We performed a literature search to identify articles published before June 27, 2023, using the following databases: PubMed, Embase, Web of Science, Cochrane Library, and Scopus.

Objective:

The objective was to discuss the impact of occupational therapy on different domains of quality of life in breast cancer patients.

Data sources:

We performed a literature search to identify articles published before June 27, 2023, using the following databases: PubMed, Embase, Web of Science, Cochrane Library, and Scopus.

Methods:

This study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Randomized controlled trials that reported the effects of occupational therapy on quality of life in breast cancer patients were identified. Two reviewers independently assessed eligibility, extracted data, and determined risks of bias. Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were estimated using random-effects meta-analyses. Galbraith plots, meta-regression analysis, subgroup analysis, and sensitivity analysis were used to identify heterogeneity in treatment effects.

Results:

Eight studies were included, with a total of 543 patients. The experimental group exhibited better global health (pooled SMD = 0.640, 95% CI = 0.251–1.028, P = .001), physical health (pooled SMD = 0.640, 95% CI = 0.251–1.028, P = .019), social health (pooled SMD = 0.251, 95% CI = 0.011–0.490, P = .040), and cognitive function (pooled SMD = 0.863, 95% CI = 0.266–1.460, P = .05) and improve fatigue (pooled SMD = −0.389, 95% CI = −0.586 to −0.192, P = .000), and role function (pooled SMD = 0.287, 95% CI = 0.029–0.546, P = .029) than the control group. The 2 groups exhibited comparable emotional health (pooled SMD = 0.243, 95% CI = −0.051 to 0.536, P = .105) and pain (pooled SMD = −0.312, 95% CI = −0.660 to 0.036, P = .079).

Conclusion:

The current evidence shows that occupational therapy can improve the quality of life of breast cancer patients, especially their global health, physical health, social health, cognitive function, fatigue, and role function.
Recurrent osteoid osteoma of the index proximal phalanx: A case report with a new resection technique
Authors: Mouawad Joseph Antoine , Honeine Mohamad Omar Youssef , Ghanimeh Joe Georges , Audi Perla Naji , Khalil Khalil Tanios
Published: August 2023

Rationale:

Osteoid osteoma is a relatively common benign bone-forming lesion that often occurs in young adults with a predilection for the lower limbs and spine. It is characterized by the formation of osteoid tissue, a precursor to bone, and can cause pain and restricted mobility in affected areas. Osteoid osteoma of the hand and fingers is rare, thus representing a diagnostic challenge. A written informed consent was provided from the patient’s father for the publication and sharing all images and clinical data concerning the patient.

Patient concerns:

We are reporting a case of an 11-year-old girl who presented with persistent pain and swelling in her left index finger, as well as limited mobility, over the course of 1 year. Nonsteroidal anti-inflammatory drugs eased the pain, but it resurfaced once the medication was discontinued.

Diagnoses:

A series of investigations, showed a lytic lesion at the second proximal phalangeal neck, with features indicative of osteoid osteoma.

Interventions:

Excision with bone grafting was performed as definitive therapy with pathological confirmation of the osteoid osteoma diagnosis. Nevertheless, the patient returned 2 years later with a recurrence of her previous symptoms, and further tests suggested a recurrence of osteoid osteoma. To address the recurrence, a modified open thermoablation technique was used. Thermoablation is a minimally invasive procedure that uses heat to destroy the tumor cells, and it has been shown to be effective in treating osteoid osteoma. The modified open approach involves making a small incision to access the tumor and delivering heat directly through a previously CT-guided inserted Kirschner wire to the affected area.

Outcomes:

The patient reported no pain at 1 month and 1 year after the surgery, with no radiological signs of recurrence, indicating complete excision of the lesion.

Lessons:

Overall, this case highlights the challenges of diagnosing and treating osteoid osteoma in the hands and fingers. Further research is needed to better understand the underlying causes, potential risk factors, and optimal treatment for osteoid osteoma recurrence.
Efficacy and safety of different subsequent therapies after fertility preserving surgery for endometriosis: A systematic review and network meta-analysis
Authors: Zheng Yu , Ma Ruyue , Xu Hong , Wang Lian , Zhang Lei , Mao Huiqun , Zhao Ruiheng
Published: August 2023

Background:

Endometriosis (EMT) is a benign and common estrogen-dependent disease. Hormonal therapy improves pain symptoms in most women with EMT. However, in many cases, laparoscopic fertility preservation surgery is considered a common treatment for EMT. The present study aimed to evaluate the efficacy and safety of dienogest, leuprolide, danazol, gestrinone, mifepristone and levonorgestrel intrauterine system (LNG-IUS) in relieving symptoms and delaying the recurrence of EMT cysts after fertility protection surgery.

Methods:

We searched PubMed, the Cochrane Library, Web of Science, EMBase, China National Knowledge Infrastructure, VIP Database, China Biology Medicine disc, WanFang Data databases to collect randomized controlled trials (RCT) related to dienogest, leuprolide, danazol, gestrinone, mifepristone and LNG-IUS as a follow-up treatment after fertility preserving surgery for EMT. After literature screening, data extraction and quality evaluation, effective rate, recurrence rate, pregnancy rate and adverse reaction rate were used as outcome indicators to evaluate the efficacy and safety of drugs. Evidence networks included in the study were drawn and publication bias was assessed. The drugs most likely to be the best postoperative treatment were explored through mixed comparison of different drugs and efficacy ranking.

Result:

Effective rate: dienogest, leprerelin, gestrinone and LNG-IUS were better than placebo after EMT fertility preservation surgery; dienogest was superior to mifepristone and danazol. LNG-IUS is superior to danazol. LNG-IUS has the highest potential for improving the effectiveness of EMT symptoms. Recurrence rate: the application of dienogest, leuprolide, gestrinone, mifepristone and LNG-IUS after EMT fertility preservation surgery was lower than that of placebo; dienogest and LNG-IUS were lower than danazol. The recurrence rate of dinorgestrel was the last place with the highest performance. Pregnancy rate: in the cases with fertility requirements, dienogest and,leuprolide were better than placebo after EMT fertility preservation surgery; dienogest was superior to danazol, gestrinone and mifepristone. Leuprolide is superior to danazol and gestrinone. The first rank of dienogest pregnancy rate was the highest. Adverse reaction rate: the application of dienogest, leuprolide, danazol, gestrinone, mifepristone and LNG-IUS after EMT fertility preservation surgery was higher than that of placebo. After placebo, LNG-IUS had the highest adverse reaction rate.

Conclusion:

For patients after fertility preserving surgery for EMT, the recurrence rate of dienogest was the last place with highest preference. The first rank of dienogest pregnancy was the highest.
Effect of neoadjuvant chemotherapy on survival in patients with T1 high-grade non-muscle-invasive bladder cancer who underwent radical cystectomy
Authors: Huang Long , Jia Kang , Yao Kai , Liu Dongliang , Xu Yan , Liu Quanda
Published: August 2023

Patients with non-muscle-invasive bladder cancer (NMIBC) who are at high and very high risk of disease progression are recommended for radical cystectomy (RC). However, the impact of neoadjuvant chemotherapy (NAC) on survival outcomes in NMIBC patients undergoing RC remains unclear. Patients diagnosed with T1 high-grade NMIBC who underwent RC were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Overall survival (OS) was assessed using the Kaplan–Meier technique, and multivariable Cox regression analysis was conducted to determine the independent factors of OS. A total of 1268 T1 high-grade NMIBC patients who underwent RC between 2004 and 2015 were included in the study. NAC was administered to 76 (6.0%) patients. At a median follow-up of 75 months, there was no significant difference in the OS between the NAC and non-NAC groups (HR = 0.89, 95% CI 0.61–1.30, P = .539). However, in the multivariate Cox regression model, NAC demonstrated a more pronounced improvement in OS approaching statistical significance (HR = 0.7, 95% CI 0.47–1.05, P = .088). Subgroup analysis revealed a survival benefit of NAC in patients with lymph node metastasis. In summary, the results of this study suggest that NAC has the potential to confer a survival advantage in patients diagnosed with T1 high-grade NMIBC who undergo RC, but additional studies are needed. Nonetheless, the survival benefits of NAC in patients with lymph node involvement are apparent.
A novel cuproptosis-related genes model in breast cancer prognosis
Authors: Zheng Qun , Shi Shuai , Zhang Ning , Chen Haohao
Published: August 2023

Breast cancer (BRCA) is a highly heterogeneous malignancy with an urgent need to build a proper model to predict its prognosis. Cuproptosis is a recently discovered form of cell death, mediated by protein fatty acylation and tightly associated with mitochondrial metabolism. The role of cuproptosis-related genes (CRGs) in BRCA remains to be explored. We aimed to investigate the applications of CRGs in BRCA prognosis in different clinical contexts, including chemotherapy and immunotherapy, via bioinformatics analysis of the messenger RNA profiles and clinical data obtained from public databases. Molecular subtyping of CRGs was performed through consistent clustering analysis. Differentially expressed genes between different CRG clusters were identified. The differentially expressed genes were then used to build a risk assessment model using least absolute shrinkage and selection operator regression to predict patient survival with BRCA. The model was then validated with the data from the Molecular Taxonomy of Breast Cancer International Consortium, GSE96058, and GSE20685. Differences in somatic mutations, copy number variations, hallmark pathways, drug responses, and prognosis of immunotherapy and chemotherapy were analyzed by comparing the high-risk and low-risk groups. Patients with high-risk scores showed worse overall survival than those with low-risk scores. The results indicated significant differences between the 2 groups immune-related biological pathways and the variable immune status. It also suggests the differential sensitivity to chemotherapy between the 2 groups. The CRGs model showed the promise to predict the prognosis of BRCA patients and shed light on their treatment.
Transversus abdominis plane block versus local anesthetic infiltration for anesthetic effect in peritoneal dialysis catheter insertion: A systematic review and meta-analysis
Authors: Qi Qingling , Zhou Zijun , Qiao Yanheng , Ren Tong , Yang Bo
Published: August 2023

Background:

The transversus abdominis plane (TAP) block is commonly used in surgical practice for postoperative analgesia in abdominal surgery. However, numerous studies have demonstrated that TAP block is also suitable for intraoperative anesthesia of peritoneal dialysis catheter (PDC) insertion, although its efficacy and safety are still controversial. Local anesthetic infiltration (LAI) is currently the most general anesthesia strategy for PDC insertion. Consequently, we conducted this systematic review and meta-analysis to identify which anesthesia strategy is better between TAP block and LAI.

Methods:

A systematic and comprehensive search was conducted on 5 databases, retrieving published and registered randomized controlled trials as of March 10, 2022, comparing the anesthesia effects of TAP block and LAI. The primary outcomes are the visual analogue scale (VAS) pain score of patients at various time points in the surgery. The secondary outcomes are the VAS pain score at rest at 2 and 24 hours postoperatively, intraoperative rescue anesthesia, general anesthesia switching rate, and PD-related complications.

Results:

There were 9 trials with 432 patients identified. TAP block was more effective than LAI at reducing intraoperative and postoperative VAS pain scores in patients. Compared to LAI, TAP block significantly reduces the dosage of anesthetics used to rescue anesthesia during surgery, the general anesthesia switching rate, and the incidence of postoperative PD-related complications in patients.

Conclusions:

Our systematic review and meta-analysis proved that TAP block could be used as the primary anesthetic technique for PDC insertion, with superior anesthetic effects to LAI.
Recurrent malignant solitary fibrous tumor of pelvis: A case report and treatment approach
Authors: Zhou Panpan , Xu Xiaopei
Published: August 2023

Rationale:

Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms that typically arise from the pleura but can also occur in various locations throughout the body. Although there are increasingly more reports of extra-pleural SFTs, reports of SFTs in bone are very rare, and a malignant SFT accompanying recurrence of pelvis has not yet been reported.

Patient concerns:

We herein present the case of a 15-year-old male who experienced intermittent numbness in his right buttock, accompanied by radiating pain in his lower limbs for 6 months. Radiological examinations revealed an expansive, heterogeneous enhanced mass in the sacral and iliac regions, with a branch of the right internal iliac artery feeding the tumor.

Diagnoses:

The histological examination suggest a diagnosis of a malignant SFT with high proliferation activity.

Interventions:

The sacral mass was surgically excised.

Outcomes:

Following the surgery, the patient experienced a local recurrence of the tumor at 9 months and was administered adjuvant imatinib treatment. Recent magnetic resonance imaging contrast-enhanced displayed shrinkage of the tumor, which may provide certain evidence for chemotherapy for the treatment of recurrence of malignant SFTs in the pelvic region.

Lessons:

Complete surgical excision is the recommended treatment for this rare disease entity, and the role of adjuvant therapies is controversial due to their rarity. Our case underscores the challenges in managing recurrent malignant SFTs and highlights the importance of a thorough diagnostic workup. Further research is needed to establish the role of adjuvant therapies in the management of these tumors.
Serum IgG4-negative IgG4-related disease with a cardiac mass: A case report
Authors: Namba Kensuke , Sakai Daiki , Mikamo Hiroshi , Sugizaki Yuta , Sugiura Yoshiya , Hiruta Nobuyuki , Matsuzawa Yasuo , Kaneko Kaichi
Published: August 2023

Rationale:

Although IgG4-related disease (IgG4-RD) can affect various organs, its association with a cardiac mass is exceptionally rare. Here, we report a case of a woman with IgG4-RD and a cardiac mass and discuss 10 similar cases reported previously.

Patient concerns:

A 65-year-old woman was referred to our hospital for chest discomfort and back pain.

Diagnoses:

In accordance with the 2019 ACR/EULAR diagnostic criteria for IgG4-RD, she was diagnosed with IgG4-RD based on dense lymphocytic infiltration on histopathology, IgG/IgG4-positive cell ratio <40%, >10/hpf IgG4-positive cells on immunostaining, and paraspinal zone soft tissue lesions in the chest.

Interventions:

An external pacemaker was implanted for the complete atrioventricular block on the electrocardiogram. After the diagnosis of IgG4-RD, she was treated with glucocorticoids and rituximab.

Outcomes:

She remains under observation without disease recurrence.

Lessons:

IgG4-RD are usually treated with glucocorticoids; however, in cases of a cardiac mass, life-threatening complications may occur and surgery is often needed. Combination therapy with glucocorticoids and rituximab may be effective even in patients with IgG4-RD and cardiac mass, which may avoid the need of invasive treatments, such as surgery.