bluuebunny/crossref_metadata_2025 huggingface dataset:
Bridged combined fixation system versus locking plate in the treatment of patients with implant periprosthetic refracture following proximal femoral fracture surgery: A retrospective observational study
Authors: Zhang Junjie , Xu Nanwei , Yang Zhicheng , Niu Wenli , Zhou Guoxin , Yu Zhongjie , Jia Xiaojun , Zhou Xindie , Huang Yong
Published: December 2022

Locking plate (LP) re-fixation is mainly used to treat postoperative implant periprosthetic refractures; however, the extensive trauma and the fixation form of LP make the operation difficult. The bridge combined fixation system (BCFS) is a new clip-rod internal fixation system, and its clinical application is in its infancy. To compare the clinical effect of BCFS and LP in the treatment of geriatric postoperative implant periprosthetic refracture following proximal femoral fracture surgery. Thirty-two patients (14 with BCFS and 18 with LP) with postoperative implant periprosthetic refracture following proximal femoral fracture surgery, who underwent surgery in our hospital, were analyzed retrospectively. The incision length, operation time, intraoperative bleeding volume, postoperative drainage volume, postoperative hospital stay, fracture healing time and complications of each patient were recorded. Regular radiographs were taken after the operation to evaluate the fracture reduction and fixation. All the patients were followed for 12 months to evaluate their limb function by Johner‐Wruhs scoring criteria. The patients were followed for an average of 24.1 months, and all achieved bony union, with no complications such as infection, nonunion, and internal fixation instrument falling off and loosening after the operation. Delayed healing occurred in two cases in the LP group. The average value of surgical incision length, operation time, postoperative hospitalization time and fracture healing time in the BCFS group were significantly smaller than those in the LP group, accompanied by a decrease in intraoperative bleeding and postoperative drainage volumes (P < .05). The rate of limb function in the BCFS group (85.7%) was higher than that in the LP group (83.3%), with no significance (P > .05). The BCFS in the refracture around the implant of the proximal femoral fracture exhibited many advantages such as simple operation, strong plasticity, effective reduction of surgical trauma, promotion of fracture healing and early functional rehabilitation, etc, making it an advantageous clinical application.
Spatial heterogeneity of risk factors associated with HIV prevalence among men who inject drugs in India: An analysis of the data from the integrated bio-behavioral surveillance, India
Authors: Aridoss Santhakumar , David Joseph K. , Jaganathasamy Nagaraj , Mathiyazhakan Malathi , Balasubramanian Ganesh , Natesan Manikandan , V.M. Padmapriya , Kumar Pradeep , Rajan Shobini , Arumugam Elangovan
Published: December 2022

People who inject drugs (PWID) are India’s third-largest vulnerable population to human immunodeficiency virus (HIV) infection. PWID in India are confined to certain geographic locations and exhibit varying injecting and sexual risk behaviors, contributing considerably to increasing HIV trends in specific regions. Spatial heterogeneity in risk factors among vulnerable PWID influences HIV prevalence, transmission dynamics, and disease management. Stratified analysis of HIV prevalence based on risk behaviors and geographic locations of PWID will be instrumental in strategic interventions. To stratify the male PWID based on their risk behaviors in each state and determine the HIV prevalence for each stratum. The behavioral data and HIV prevalence of the national integrated biological and behavioural surveillance (IBBS), a nationwide cross-sectional community-based study conducted in 2014 to 2015, was analyzed. Data from 19,902 men who inject drugs across 53 domains in 29 states of India were included. Women who inject drugs were excluded at the time of IBBS, and hence PWID in this study refers to only men who inject drugs. PWID were categorized based on their risk profile, and the corresponding HIV prevalence for each state was determined. HIV prevalence was the highest (29.6%) in Uttar Pradesh, with a high prevalence of risk behaviors among PWID. High HIV prevalence ranging between 12.1% and 22.4% was observed in a few states in East and North-East India and most states in central and North India. Unsafe injecting and sexual practices were significantly (P < .05) associated with higher HIV prevalence and more significantly in National Capital Territory of Delhi (P < .001). Unsafe injecting practices among PWID were proportionally higher in Western and Central India, whereas unsafe sexual behaviors were widespread among most states. Unsafe sexual practices among male PWID were common. The high prevalence of unsafe injecting had significant HIV infection and transmission risks in Western and Central India. The results emphasize the need for stratified, region-specific interventions and combination approaches for harm reduction among PWID. Strengthening the measures that facilitate the reduction of high-risk behaviors, adoption of safe practices, and utilization of HIV services will positively impact HIV prevention measures among PWID.
Reliability of electroencephalogram indicator and event related potential in subacute stroke
Authors: Yun Dong Hyuk , Sohn Min Kyun , Choi Jae Eun , Jee Sungju
Published: December 2022

Cognitive impairment is observed in 12% to 56% of stroke patients, and screening for cognitive impairment is often complex and time-consuming, with results dependent on patient compliance. Therefore, there is a need for an objective method to assess cognitive impairment regardless of patient compliance. Objective evaluation methods include electroencephalogram (EEG) and event-related potential (ERP). This study was conducted to assess intra-tester reliability of resting EEG-based spectral features and auditory/visual P300 latency/amplitude in patients with subacute ischemic stroke.

Twenty patients with subacute ischemic stroke were included in the study. The resting EEG and P300 wave using an auditory and visual oddball paradigm were measured at baseline and once again in 24 hours. The following electrode positions (10–20 system) were constantly recorded: F3 (Frontal), Fz, F4, C3 (Central), Cz, C4, P3 (Parietal), Pz, P4. DAR (delta/alpha ratio) and BSI (brain symmetry index) were determined using EEG data. F3 and F4, C3 and C4 and P3 and P4 were switched according to the stroke side and classified as affected hemisphere (AH) and unaffected hemisphere (UH) after the evaluation. In ERP, the amplitude and latency of P300 were obtained.

In reliability analysis of EEG-based spectral characteristics, significant reliability was observed for DAR (ICC = 0.447), BSldir (ICC = 0.713) and BSIdirtheta (ICC = 0.724) (Table 4). DAR was showed a poor ICC level, and BSIdir and BSIdirtheta had a moderate ICC level. Visual P300 latency showed excellent intraclass correlation coefficient (ICC) in several montages (PUH = 0.972, Pz = 0.945). In 6 montages, auditory P300 latency was reliable, while in 9 montages, visual P300 latency was reliable. In 4 montages, auditory P300 amplitude was reliable, while visual P300 amplitude was reliable in 7.

The visual P300 was more reliable than the auditory P300. The ICC values for P300 latency were greater than those for amplitude. Therefore, when ERP is performed on subacute stroke patients, visual has higher reliability than auditory.
Diagnostic value of EBV-DNA in CSF for PCNSL in AIDS patients with focal brain lesions: A meta-analysis of diagnostic test
Authors: Ding Xinghuan , Liang Tingyu , Liang Bo , Gao Haili , Wang Jianbo , Liu Hongxing , Wang Fang , Zheng Xinmei , Li Peiliang , Chen Shichao , Feng Enshan
Published: December 2022

Background:

Epstein-Barr virus (EBV) infection plays a crucial role in the progression of acquired immunodeficiency syndrome related primary central nervous system lymphoma (AR-PCNSL). This study aimed at evaluating the diagnostic value of cerebrospinal spinal fluid (CSF) EBV-deoxyribonucleic acid (DNA) for PCNSL in patients with infection of human immunodeficiency (HIV) virus through a meta-analysis of diagnostic test.

Methods:

A systematic search in PubMed, Embase, Web of Science, Wanfang, Chinese Biomedical Database and Chinese National Knowledge Infrastructure was conducted before May 10, 2022. Heterogeneity among the studies was assessed using Q test and I2 statistics. Publication bias was assessed using the Deek’s funnel plot asymmetry test. Statistical analyses were performed using Stata 16.0 software. The pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratios (DOR) and 95% confidence intervals (CI) were caculated to evaluate the diagnostic value. A symmetric receiver operating characteristic (SROC) curve and the area under the SROC curve (AUC) were constructed to evaluate the test-performance.

Results:

Twelve studies were included in the final analyses, with a total of 141 patients with AR-PCNSL and 590 controls. The pooled diagnostic values were sensitivity of 0.83 (95% CI: 0.73–0.90), specificity of 0.95 (95%CI: 0.89–0.98), PLR of 17.8 (95%CI: 6.8–46.1), NLR of 0.17 (95%CI: 0.10–0.30), DOR of 102 (95%CI: 28–379), and AUC of 0.94 (95%CI: 0.91–0.96).

Conclusion:

In summary the overall diagnostic value of CSF EBV-DNA is very high and it can be a reliable diagnostic biomarker for AR-PCNSL.
Progress of Psf1 and prospects in the tumor: A review
Authors: Zhao Xuekai , Duan Botao , Zhou Lei
Published: December 2022

Partner of Sld5-1(Psf1) is a member of Gins complex, which was discovered in 2003. It consists of the predominantly α-helical A-domain and the massively β-stranded B-domain. Some researches indicate that Psf1 plays a prominent part in DNA replication through cell cycle regulation, and plays a key role in early embryo development and tissue regeneration. The overexpression of Psf1 in active proliferating cells is closely correlated with the occurrence of tumors. On the side, tumor cells with high Psf1 expression showed high heterogeneity and poor clinical prognosis. In this review, we will review the research progress of Psf1 in cell cycle regulation, immature cell proliferation and oncology.
Risk factors for capsular contracture after breast reconstruction with tissue expanders and silicone implants in nonirradiated patients: A retrospective observational cohort study
Authors: Iwahira Yoshiko , Nakagami Gojiro , Sanada Hiromi
Published: December 2022

Breast reconstruction surgery with tissue expanders and silicone implants is widely performed; however, risk factors for late complications such as capsular contracture have not been fully investigated despite their high prevalence. We investigated the association between expander and implant positions and the development of capsular contracture in patients who underwent breast reconstruction surgery over 10 years previously. In this retrospective observational study, we analyzed 239 patients, among whom 69 (28.9%) had developed capsular contracture of Baker Classification grade II or higher. The position of the expander was classified into six categories based on the inferior margin of the healthy breast. The position of the implant was defined as an upward movement from the position of the expander and was classified into three categories based on the inferior margin of the breast at the time of expander insertion. Using multivariate logistic regression analysis, we assessed whether the misalignment of the expander and silicone implant positions affected capsular contracture development. Both expander and implant positions were significantly different between the groups. The odds ratios, adjusted for confounding variables, were 3.4 and 5.2 for an expander position of 1 and 2 lateral fingers upward, respectively, and 4.8 and 45.4 for a silicone implant position of 2 and 3 lateral fingers upward, respectively. We identified malposition of expanders and silicone implants as risk factors for developing capsular contracture. Correct insertion and adequate dilatation of the expander in the correct position could reduce the risk for capsular contracture.
Potential impact of texture analysis in contrast enhanced CT in non-small cell lung cancer as a marker of survival: A retrospective feasibility study
Authors: Andersen Michael Brun , Harders Stefan Walbom , Thygesen Jesper , Ganeshan Balaji , Torp Madsen Hans Henrik , Rasmussen Finn
Published: December 2022

The objective of this feasibility study was to assess computed tomography (CT) texture analysis (CTTA) of pulmonary lesions as a predictor of overall survival in patients with suspected lung cancer on contrast-enhanced computed tomography (CECT). In a retrospective pilot study, 94 patients (52 men and 42 women; mean age, 67.2 ± 10.8 yrs) from 1 center with non-small cell lung cancer (NSCLC) underwent CTTA on the primary lesion by 2 individual readers. Both simple and multivariate Cox regression analyses correlating textural parameters with overall survival were performed. Statistically significant parameters were selected, and optimal cutoff values were determined. Kaplan–Meier plots based on these results were produced. Simple Cox regression analysis showed that normalized uniformity had a hazard ratio (HR) of 16.059 (3.861–66.788, P < .001), and skewness had an HR of 1.914 (1.330–2.754, P < .001). The optimal cutoff values for both parameters were 0.8602 and 0.1554, respectively. Normalized uniformity, clinical stage, and skewness were found to be prognostic factors for overall survival in multivariate analysis. Tumor heterogeneity, assessed by normalized uniformity and skewness on CECT may be a prognostic factor for overall survival.
Surgical outcome of minimal invasive oblique lateral interbody fusion with percutaneous pedicle screw fixation in the treatment of adult degenerative scoliosis
Authors: Lee Jun Seok , Son Dong Wuk , Lee Su Hun , Sung Soon Ki , Lee Sang Weon , Song Geun Sung , Kim Young Ha , Choi Chang Hwa
Published: December 2022

Oblique lateral interbody fusion is performed for lumbar spinal restoration and stabilization, without extensive paraspinal muscle damage or massive bleeding. This study aimed to confirm the radiological and clinical outcomes of minimally invasive oblique lateral interbody fusion (OLIF) with percutaneous pedicle screw fixation (PPSF) as treatment for adult degenerative lumbar scoliosis. Medical records of 40 patients with degenerative lumbar spinal deformities who underwent selective OLIF and PPSF at our hospital between April 2018 and February 2021 were retrospectively reviewed. The study population comprised 7 male and 33 female patients aged 55–79 years. Standing radiography was performed, and the coronal cobb angle, distance between the C7 plumb line and central sacral vertical line, sagittal vertical axis, pelvic tilt, lumbar lordosis (LL), pelvic incidence (PI), and difference between PI and LL (PI-LL) were measured. Coronal scoliosis was defined as a lumbar coronal plane curve of > 15°. All patients achieved statistically significant improvements in coronal and sagittal alignment. The coronal cobb angle was corrected from 18.82° to 11.52°, and the central sacral vertical line was reduced from 18.30 mm to 15.47 mm. The sagittal vertical axis was significantly reduced from 45.95 mm to 32.72 mm. In contrast, the pelvic tilt and LL were minimally changed. For subgroup analyses, patients were divided into the convex and concave groups according to the direction of coronal curve correction. Vertebral body rotation was superior in the convex group than in the concave group. Furthermore, we checked for asymmetric facet degeneration at the upper instrumented vertebra (UIV) level at 1 year postoperatively. Of the 22 patients who underwent more than 3 level fusion surgery, 8 patients were confirmed the postoperative asymmetric facet degeneration in above UIV. Minor complications occurred in 16 patients, who recovered without any problems. Revision surgery was not performed in all cases. Minimally invasive OLIF with PPSF has a lower risk of complications and favorable surgical outcomes in patients with adult degenerative lumbar scoliosis. Access from the convex side is advantageous for the correction of the rotated vertebra. Extending the UIV level to the neutral vertebra can reduce the occurrence of postoperative asymmetric facet degeneration.
A single-center randomized controlled study of intraperitoneal hyperthermic chemoperfusion in combination of recombinant human tumor necrosis factor (TNF) in treatment of malignant ascites caused by advanced abdominal cancers
Authors: Wu Lexia , Zhu Wanshan , Meng Jincheng , Wu Jiaming , Li Luzhen , Fang Cantu , Zhang Huatang
Published: December 2022

Introduction:

Malignant peritoneal effusion is a common complication of advanced malignancies, which has a poor prognosis for patients. Hyperthermic intraperitoneal chemotherapy (HIPEC) has been widely used in the treatment of advanced gynecological tumors, especially ovarian cancer (OC). Relative studies have indicated that HIPEC allows for direct exposure of tumor cells to high peritoneal concentrations of cytotoxic drugs without increasing systemic toxicity compared with intravenous treatment. Recombinant human tumor necrosis factor for injection (rmhTNF-NC) is a safely tolerated immunotherapeutic drug that has becoming a mainstay of treatment for malignant effusions. Currently, a prospective study is required to determining the efficacy of rmhTNF-NC plus cisplatin for the treatment of malignant peritoneal effusion for OC.

Methods:

Design and setting: This is a single-center, open trial will be performed in Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine.

Participants:

Eligible patients will be those with advanced gynecologic cancers and who would be suitable for HIPEC.

Intervention and Control:

HIPEC with cisplatin and intraperitoneal perfusion with rmhTNF-NC.

Co-interventions:

Further chemotherapy will be offered to patients as per current practice.

Outcomes

Pilot study: Patients and clinicians’ acceptability of the trial to assist in optimization of recruitment.

Primary outcome: One-year overall survival (OS).

Secondary outcomes: Progression-free survival (PFS), adverse events.

Follow-up: One-year follow-up for OS.

Sample size: Twenty patients to demonstrate therapeutic effect of peritoneal effusion caused by OC.

Discussion:

This trial will determine the effectiveness of HIPEC with cisplatin and intraperitoneal perfusion with rmhTNF-NC for advanced gynecologic cancers, and guide the optimal treatment for these patients.
A case report of Wernicke Korsakoff syndrome in a patient with cholangiocellular carcinoma: An underestimated cause of encephalopathy in cancer patients
Authors: Koca Oguzhan , Demir Bilal , Derin Sumeyra , Turna Zeynep Hande
Published: December 2022

Introduction:

Wernicke’s encephalopathy, a disorder caused by thiamin deficiency, is characterized by a classical triad of encephalopathy, ataxia, and ophthalmoplegia. Although alcoholism is the most common predisposing factor, it can also be associated with nonalcoholic states (hyperemesis gravidarum, intestinal obstruction, bariatric surgery, and others). This work presents a case of nonalcoholic Wernicke-Korsakoff syndrome diagnosed in a cholangiocellular carcinoma patient and literature review.

Case report:

A 65-year-old male patient with a history of cholangiocellular carcinoma (Klatskin tumor) was treated with radiotherapy at the operation site after Roux-en-Y hepaticojejunostomy. During follow-up, the patient developed gastric outlet obstruction and was diagnosed with peritoneal carcinomatosis after a palliative gastrojejunostomy. As the patient could not tolerate oral nutrition during hospitalization, total parenteral nutrition was administered. After 10 days of admission, the patient showed decreased response to verbal stimuli as well as bilateral horizontal nystagmus, lethargy, and disorientation. Furthermore, the patient displayed confabulation. Clinical and imaging findings were consistent with Wernicke’s encephalopathy. Therefore, treatment with intravenous thiamin replacement was initiated. The patient’s encephalopathy regressed on the second day after treatment, and he recovered the place-person-time orientation. In the following month, the abnormal imaging findings were almost entirely resolved.

Conclusion:

In order to prevent irreversible brain damage induced by chronic thiamin deficiency, thiamin replacement therapy with parenteral nutrition solutions should be included as a treatment for hospitalized cancer patients unable to receive enteral nutrition for a long time.
Knowledge and behaviors of using vitamin D to boost immunity against COVID-19 pandemic: A cross-sectional study in Saudi Arabia
Authors: Shamlan Ghalia , Aleanizy Fadilah Sfouq
Published: December 2022

The coronavirus 2019 (COVID-19) pandemic has globally impacted all aspects of life since its emergence and spread. There is a strong biological assumption and progressing epidemiological data supporting the role of vitamin D (VD) in COVID-19 infection. This study aims to determine the knowledge about VD supplements to boost immunity against COVID-19 and if participation in specific behaviors has increased the consumption of VD supplements during social distance restriction in Saudi Arabia (SA) in May 2021. This cross-sectional study used a structured online questionnaire for 2369 SA people, including demographic characteristics and knowledge about VD supplements to boost immunity against COVID-19 showed that there was a significant association between sex and vitamin D deficiency (VDD) (P = .000), and having VDD was strongly associated with having another vitamin deficiency (P = .008). Additionally, there was a statistically significant difference between VDD and cardiovascular (P = .027) and respiratory diseases (P = .019). Almost half of the participants used VD supplements to reduce or heal their COVID-19 symptoms. The adverse association between having VDD and understanding of COVID-19 symptoms was statistically significant (P = .01). Ginger is commonly used as an alternative medicine for the treatment of VD. The administration of VD is now known to be of physiological significance for general health, and evidence suggesting the beneficial role of VD in the prevention and/or treatment of diseases, particularly infectious diseases, such as COVID-19, is increasing.
Risk and outcome of second primary malignancy in patients with classical Hodgkin lymphoma
Authors: Wang Fan
Published: December 2022

Background:

Hodgkin lymphoma survivors demonstrated increased risk of secondary primary malignancies (SPMs), but comprehensive analysis of the risk and outcome of SPMs in classical Hodgkin lymphoma (cHL) patients has not yet been reported.

Methods:

Patients with cHL from 1975 to 2017 were identified from the Surveillance, Epidemiology and End Results (SEER) database. Standardized incidence ratios were calculated for the risk of solid and hematologic SPMs in cHL patients compared to the general population. The outcome of cHL patients developing SPMs were assessed by performing survival, competing risks regression, and cox proportional regression analyses.

Results:

In a follow-up of 26,493 cHL survivors for 365,156 person years, 3866 (14.59%) secondary cancers were identified, with an standardized incidence ratio of 2.09 (95% CI: 2.02–2.15). The increased risk was still notable after follow-up of 10 years or more, and the risk is more pronounced for patients with female gender, younger age, advanced stage, chemotherapy, and radiation therapy. The overall survival is worse for cHL patients with SPMs after 11 years of follow-up (P < .0001). The main cause of death for cHL patients with SPMs is not cHL but other causes including SPMs. Multivariate Cox regression analysis confirmed SPMs as an independently adverse prognostic factor for cHL survivors (hazard ratio, 1.13; 95% CI, 1.05–1.21, P = .001).

Conclusions:

There is a significantly increased risk of developing SPMs for cHL survivors. The overall survival is worse for cHL patients and SPMs is an independent prognostic factor for cHL.
Treatment outcomes of primary surgery versus chemoradiotherapy for T4 oropharyngeal cancers
Authors: Yen Ching-Heng , Ho Sheng-Yow , Lee Sung-Wei , Chen Chia-Chun , Shieh Li-Tsun
Published: December 2022

Concurrent chemoradiotherapy (CCRT) has been the standard of care for locally advanced diseases regardless of human papillomavirus infection status. Other treatment options include surgery followed by adjuvant therapy and induction chemotherapy followed by CCRT or radiotherapy. However, for locally advanced T4 laryngeal or hypopharyngeal diseases, surgery is preferred over CCRT. Given the improvement in the functional outcomes of surgery, examining the oncologic outcomes in OPSCC patients is critical. This study aimed to determine whether differences in overall survival (OS) exist between surgery and CCRT. Oropharyngeal cancer patients included in the cancer registry of our hospital from January 2014 to December 2018 were retrospectively analyzed. Patients with T4 disease who underwent curative treatment were identified. In this study, the primary and secondary outcomes were OS and disease-free survival (DFS), respectively. Potential confounding factors were also evaluated. Details regarding recurrence pattern were listed. From 2014 to 2018, 74 newly diagnosed oropharyngeal cancer patients were identified from our cancer registry database, 60 of whom satisfied our inclusion criteria. Our findings showed an OS of 25.5 months and DFS of 17.5 months. No significant difference in both of OS and DFS were observed between the surgery and CCRT cohorts. Sex, stage, second primary cancer, IC, and primary treatment were not correlated with DFS. Male sex was the only significant factor identified, with an HR of 0.2 for OS (95% confidence interval, 0.06–0.71). No significant difference in both OS and DFS were observed between the CCRT and surgery cohorts. CCRT remains the standard of care for locally advanced disease.
Renin-angiotensin-aldosterone system blockers in Bulgarian COVID-19 patients with or without chronic kidney disease
Authors: Filev Rumen , Rostaing Lionel , Lyubomirova Mila , Bogov Boris , Kalinov Krassimir , Svinarov Dobrin
Published: December 2022

When angiotensin-converting enzyme inhibitor/angiotensin receptor blocker-treated patients present with SARS-CoV-2 infection there is a debate to know whether renin-angiotensin-aldosterone (RAAS) blockers should be stopped or not. We conducted a prospective observational study in Bulgarian COVID-19-infected patients with or without chronic kidney disease (CKD) to assess whether maintenance RAAS blocker therapy has an impact on SARS-CoV-2 infection and its complications. We included 120 in-patient COVID-19 subjects, of whom 70 had CKD and 50 had normal renal function. A total of 30% of the patients (total number of 36 patients, 21 females) were receiving RAAS therapy at admission and it was maintained throughout hospitalization. The overall mortality was 19.2% (23 patients); there was no significant difference across the 2 groups (P-value = .21), except in RAAS blockers-treated hypertensive patients who had a significantly lower mortality as compared to non-RAAS-blockers-treated hypertensive patients (P = .04). Regarding subsequent intensive-care unit admission, there were 50% less patients in the RAAS group (4 out of 36, i.e., 11%) as compared to 19 out of 84 from the non-RAAS group, that is, 22.6% (P = .29). Overall, 37 patients developed acute kidney injury (any stage by KDIGO); of them 14 (37.8%) were receiving RAAS blockers. Acute kidney injury was not significantly associated with the use of RAAS blockers (P-value = .28). Likewise, both in non-CKD and in CKD patients the use of RAAS blockers did not have an impact on renal function recovery after SARS-CoV-2 infection. Finally, regarding RAAS blockers and the biological parameters outcome only D-dimers were significantly lower at the follow-up as compared to that in non-RAAS blocker treated patients. RAAS blockers benefited patients with hypertension by lowering mortality rate. Other than that, RAAS blocker therapy continuation during SARS-CoV-2 infection in CKD and non-CKD patients had no significant impact upon major outcomes.
Association between various breathing indexes during sleep and the Epworth Sleepiness Scale score in adults
Authors: Hsieh Pei-Shan , Hwang Sheng-Wei , Hwang Shang-Rung , Hwang Juen-Haur
Published: December 2022

Some breathing indexes during sleep, including the apnea-hypopnea index, oxygen desaturation index, and oxygen saturation during sleep, can be recorded by overnight polysomnography. We aimed to investigate the association of various breathing indexes during sleep with the Epworth Sleepiness Scale (ESS) score in adults. We retrospectively collected the clinical and overnight polysomnography data of 2829 adults aged 20 years or older from November 2011 to June 2017. The association of various breathing indexes during sleep and ESS score was analyzed using univariate and multivariate logistic regression analysis for all adults (20–91 years), and in each sex and of body mass index (<26 kg/m2 vs ≥26 kg/m2). The mean ESS score was 6.2 (standard deviation = 4.3; range = 0–24) for all adults. After adjustment for age, sex, many common diseases, and health-related habits, apnea-hypopnea index, oxygen desaturation index, percentage of oxygen saturation below 90% during sleep, and percentage of oxygen saturation below 85% during sleep were significantly positively associated with ESS score in all adults, whereas mean oxygen saturation during sleep, minimal oxygen saturation during sleep, and awake oxygen saturation during sleep were significantly negatively associated with ESS score in all adults. In subgroup analysis, we found that the association between breathing indexes during sleep and ESS score was similar in both sex, but was significant in subjects of body mass index ≥ 26 kg/m2. All breathing indexes during sleep had significant positive or negative correlation with ESS score in all adults, especially in obese subjects.
Efficacy and safety of HIFU in combination with TACE in unresectable pediatric HB: A randomized, controlled, single-center clinical trial
Authors: Tang Xinliang , He Xiaobing , Jiang Han
Published: December 2022

Background:

Hepatoblastoma (HB) is the most common liver tumor in children, and the main treatment for HB is currently surgery. Studies have shown that transcatheter arterial chemoembolization (TACE) combined with high intensity focused ultrasound (HIFU) has significant efficacy, but there are relatively few studies on TACE combined with HIFU in China.

Objective:

To investigate the effect of using HIFU combined with TACE on patients’ liver function impairment and immune function in pediatric HB patients and to analyze the effectiveness and safety.

Materials and methods:

The clinical data of 110 unresectable pediatric HB patients treated in our hospital from December 2019 to December 2021 were selected as the subjects and divided into 2 groups. The comparison group was treated with TACE, and the combination group was treated with HIFU on the basis of the comparison group. The differences in immune function, survival, treatment side effects and clinical efficacy between the 2 groups were observed.

Results:

In the combined group, the 1-year survival rate was 100%, the 3-year survival rate was 84.0%, the 5-year survival rate was 16.0%; while in comparison group, it was 82%, 16%, 0%, respectively. The ratio of CD4+/CD8+ in the combined group were significantly higher than in the comparison group after treatment (P < .05). Granulocytopenia, mucositis, thrombocytopenia, and cardiac and renal toxicity were significantly lower in the combined group than in the comparison group, and the effective rate of the combined group was 98.00% which was significantly higher than that of the control group (76.00%) (P < .05).

Conclusion:

Comparative study of HB in children treated with HIFU combined with TACE is more effective, effectively improving the immune level of patients, significantly increasing the remission rate, which can improve the tumor necrosis and improve the survival quality of patients, and is a better choice for HB in children.
A review of the effectiveness of telemedicine in glycemic control in diabetes mellitus patients
Authors: Kusuma Clara Fernanda , Aristawidya Levina , Susanti Chairani Putri , Kautsar Angga Prawira
Published: December 2022

This review aimed to evaluate the effectiveness of telemedicine as an intervention for patients with diabetes mellitus, considering blood glucose levels as the primary outcome. A comprehensive literature search was performed using the PubMed, Embase, Web of Science, and EBSCO databases. This narrative review covered randomized controlled trials published in English. The process of selecting studies adhered to the preferred reporting items for systematic reviews and meta-analyses guidelines. Nine studies were selected, and their data were analyzed and summarized. Five of the nine reviewed studies found that telemedicine counseling was effective in decreasing glycated hemoglobin A (HbA1c) levels in the blood. Due to methodological limitations, one study could not report HbA1c results, and two studies reported that telemedicine counseling did not lead to any significant changes in HbA1c levels. One study found that while HbA1c levels did not show a marked decrease, patients’ treatment adherence and quality of life improved when telemedicine was combined with health counseling. Moreover, six studies found that telemedicine counseling was more effective than traditional counseling regarding secondary outcomes. The overall findings of this review suggest that telemedicine counseling is more effective than conventional counseling in achieving decreased blood glucose levels in patients with diabetes mellitus while increasing their treatment adherence and improving their quality of life.
Severe lower gastrointestinal bleeding caused by rectal Dieulafoy’s lesion: Case reports and literature review
Authors: Han Ping , Lei Yu , Hou Wei , Chen Nianjun , Liu Jingmei , Tian Dean , Guo Qiaozhen , Yan Wei
Published: December 2022

Rationale:

Dieulafoy’s lesion are relatively rare and can cause severe gastrointestinal bleeding. A Dieulafoy’s lesion is defined as an artery that erodes the overlying epithelium without the presence of an ulcer. Bleeding in Dieulafoy’s lesion predominantly involves the proximal stomach and upper gastrointestinal tract and is rarely observed in the lower gastrointestinal tract.

Patient concerns:

Case 1 was a 58-year-old woman complaining of sudden headache and vomiting who was diagnosed with subarachnoid hemorrhage. She underwent transcatheter embolization for intracranial aneurysm treatment but had an acute profuse hematochezia on the 11th day of admission. Case 2 was a 63-year-old man admitted to the respiratory intensive care unit because of fever with altered consciousness level for a week. He was diagnosed with advanced lung cancer that had metastasized to multiple organs one month prior. On the third day of admission, he had an attack of profuse hematochezia, and quickly developed shock and apathy.

Diagnosis:

Both patients were diagnosed with actively bleeding rectal Dieulafoy’s lesion by bedside emergency colonoscopy.

Interventions:

Endoscopic hemostatic clipping was performed in 2 patients.

Outcomes:

Hemostasis was successfully achieved in these 2 patients, and there was no recurrence of symptoms during follow-up.

Conclusions:

We propose that hemostatic clipping is one of the options in the treatment of rectal Dieulafoy’s lesions.
Traditional Chinese acupoint massage, acupuncture, and moxibustion for people with diabetic gastroparesis: A systematic review and meta-analysis
Authors: Li Xiaoming , Yan Zongbao , Xia Jin , Sun Yanan , Gong Peijun , Fan Yuncui , Wang Xiaodong , Cui Xinjie
Published: December 2022

Background:

Traditional Chinese acupoint therapy has been used for thousands of years on gastrointestinal diseases. In this work, we evaluated the efficiency and safety of traditional Chinese acupoint therapies versus standard therapies, nursing or recovery treatments in the treatment of diabetic gastroparesis.e expect that traditional Chinese medicine acupoint therapy can be noticed by more people, so as to provide more high-quality clinical evidence.

Methods:

Randomized controlled trials were included in this meta-analysis. The treatment groups received traditional Chinese acupoint therapy, while the control groups received standard therapies, nursing, or recovery treatments. The relative risk and weighted mean difference with 95% confidence interval for the total effective rate, gastrin level, gastric-emptying time, fasting blood glucose level, 2-hour blood glucose level, and glycosylated hemoglobin level were evaluated using RevMan 5.3 software. Bias assessment was performed using the Cochrane risk-of-bias tool.

Results:

A total of 59 articles were included in the analysis. In comparison with the control groups, the acupoint therapy groups showed higher total effective rates (P < .00001), enhanced gastric-emptying rates (P < .00001), and reduced glycosylated hemoglobin levels.

Conclusion:

In comparison with Western medicine or conventional care, traditional Chinese acupoint therapies showed a significant advantage in the treatment of diabetic gastroparesis. However, considering the low quality and high risk of the included studies, more high-quality randomized controlled trials are needed to confirm the results.
Risk factors of cardiovascular and cerebrovascular diseases in young and middle-aged adults: A meta-analysis
Authors: Wu Yinghua , Xiong Yan , Wang Ping , Liu Rui , Jia Xiaoling , Kong Yuyan , Li Fangfang , Chen Chen , Zhang Xia , Zheng Yuzhen
Published: December 2022

Background:

The risk factors for cardiovascular and cerebrovascular diseases in young and middle-aged people have not yet been determined. We conducted a meta-analysis to find the risk factors for cardiovascular and cerebrovascular diseases, in order to provide guidance for the prevention of diseases in the young and middle-aged population.

Methods:

We searched PubMed, Embase, Cochrane Library from the establishment of the database to Mar 2022. We included case-control or cohort studies reporting risk factors for cardiovascular and cerebrovascular disease in young and middle-aged adults. We excluded repeated publication, research without full text, incomplete information or inability to conduct data extraction and animal experiments, reviews and systematic reviews. STATA 15.1 was used to analyze the data.

Results:

The pooled results indicated that increased systolic blood pressure was significantly associated with increased risk of any stroke, ischemic stroke and hemorrhagic stroke. Body Mass Index (BMI), current smoking, hypertension, and diabetes were significantly associated with increased risk of any stroke and ischemic stroke. Atrial fibrillation was only significantly associated with increased risk of any stroke. Increased total cholesterol was significantly associated with an increased risk of ischemic stroke, whereas increased triglycerides were significantly associated with a decreased risk of ischemic stroke. In addition, increased hypertension was also significantly associated with an increased risk of acute coronary syndrome.

Conclusion:

Our pooled results show that BMI, current smoking, atrial fibrillation, hypertension, systolic blood pressure, and total cholesterol can be used as risk factors for cardiovascular and cerebrovascular diseases in young people, while triglycerides can be used as protective factors for cardiovascular and cerebrovascular diseases in young and middle-aged adults.
New technologies in airway management: A review
Authors: Vasconcelos Pereira Ana , Simões André Vicente , Rego Luísa , Pereira João Gonçalves
Published: December 2022

The evolution of medical knowledge and technological growth have contributed to the development of different techniques and devices for airway management. These appear to play a role in optimizing the number of attempts and overall success, ultimately reducing the negative consequences of airway manipulation. In this literature review, we highlight the recent evidence regarding new technologies applied to airway management.

Before intubation, every patient should have an individualized structured airway management plan. Technology can help with both airway evaluation and tracheal intubation. Point-of-care cervical ultrasound and artificial intelligence models with automated facial analysis have been used to predict difficult airways. Various devices can be used in airway management. This includes a robotic video endoscope that guides intubation based on real image recognition, a laryngeal mask with a non-inflatable cuff that tries to reduce local complications, video laryngeal masks that are able to confirm the correct position and facilitate intubation, Viescope™, a videolaryngoscope developed for combat medicine with a unique circular blade, a system that uses cervical transillumination for glottis identification in difficult airways and Vivasight SL™ tracheal tube, which has a high-resolution camera at its tip guaranteeing visual assurance of tube position as well as guiding bronchial blocker position.

To conclude, we detailed the challenges in airway management outside the operating room as well as described suction-assisted laryngoscopy and airway decontamination technique for contaminated airways.

Further research in the clinical setting is recommended to better support the use of these technologies
Efficacy and safety of Yinchenwuling Powder for nonalcoholic fatty liver disease: A protocol for systematic review and meta-analysis of randomized controlled trials
Authors: Wu Peishan , Zhang Jiaqi , Xiao Jingjing , Huang Guangwen , Li Jiahui , Zhou Zheng
Published: December 2022

Background:

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. Owing to the complexity of NAFLD pathogenesis, there is still no specific medication for NAFLD that is safe and effective. Yinchenwuling Powder (YCWLP), a classic Chinese formula, has been widely applied to NAFLD and its efficacy has been proven in numerous studies. However, systematic evaluation of the efficacy and safety of YCWLP for NAFLD is still lacking.

Methods:

We will search 8 databases to collect randomized controlled trials of patients with NAFLD treated in the YCWLP from the database inception to September 30, 2022. Two researchers will independently perform the selection of studies, data extraction, and assessment of the risk of bias. The Cochrane Review Manager (RevMan5.4) software will be used for data synthesis and analysis.

Results:

Comprehensive evidence of YCWLP for the treatment of NAFLD will be provided in this study.

Conclusion:

The efficacy and safety of YCWLP in treating NAFLD will be proved, providing feasible and effective clinical recommendations for the treatment of NAFLD.
Positive response of a recurrent clear cell sarcoma to anlotinib combined with chemotherapy: A case report
Authors: Tao Junyue , Yang Hao , Hao Zongyao , Liang Chaozhao , Du Yingying , Zhang Chao , Yin Yu , Zhou Jun
Published: December 2022

Rationale:

Renal clear cell sarcoma is a rare and highly invasive malignant renal tumor that easily relapses after treatment. Recurrent recurrent clear cell carcinoma (CCSK) responds poorly to chemotherapy and has no established standardized treatment, and need to be explored potentially useful treatments.

Patient concerns:

A 18-years-old patient with renal clear cell sarcoma recurrence after open radical nephrectomy.

Diagnosis:

Recurrent clear cell sarcoma.

Interventions:

After chemotherapy alone failed, the patient received 6 courses of anlotinib combined with chemotherapy. The tumor had significantly reduced in size and the recurrent tumor and part of the liver were resected.

Outcomes:

No tumor recurrence or metastasis was detected during the follow-up 8 months after the operation.

Lessons:

This is the first report describing the use of anlotinib in treating CCSK. We believe that anlotinib combined with chemotherapy may be a useful treatment option for patients with recurrent CCSK.
Gastrointestinal bleeding caused by rupture of a posterior inferior pancreaticoduodenal artery pseudoaneurysm: A case report
Authors: Cui JinHua , Liu YaMan , Li Jian
Published: December 2022

Background:

Gastrointestinal bleeding caused by a ruptured pancreatic pseudoaneurysm is rare, and a pseudoaneurysm of the posterior inferior pancreaticoduodenal artery is especially rare. A 68-year-old man was hospitalized after presenting intermittent black stools and dyspnea accompanied by severe anemia. Angiographic examination revealed that Pseudoaneurysm of the posterior inferior pancreaticoduodenal artery.

Methods:

Angiography was performed and revealed a pseudoaneurysm of the posterior inferior pancreaticoduodenal artery. Subsequently, a blood transfusion and endovascular embolization were performed.

Results:

The patient’s gastrointestinal bleeding stopped, and the hemoglobin level remained stable. During 1 year of follow-up, the patient remained in a generally good condition.

Conclusion:

posterior inferior pancreaticoduodenal artery pseudoaneurysmIt is rare and difficult to diagnose, gastrointestinal bleeding is a serious complication, vascular interventional embolization is effective.
Analysis of clinical characteristics of centrally mediated abdominal pain syndrome, exploration of diagnostic markers and its relationship with the efficacy of duloxetine treatment
Authors: Tang Yuming , Song Jiani , Zhu Ying , Chen Hefeng , Yao Weiyan , Zou Duowu
Published: December 2022

Introduction:

Centrally mediated abdominal pain syndrome (CAPS) is characterized by severe abdominal pain. Diagnosis of CAPS is still an exclusionary diagnosis, there remain no effective diagnostic biomarkers so far. Duloxetine is the major pharmacotherapy of CAPS, while some CAPS patients do not respond to duloxetine treatment. However, there is a lack of molecular markers to predict the efficacy of duloxetine. In our pilot study, we have found differential expression profiles of serum miRNAs between CAPS patients and healthy controls. Our study aims to explore the clinical characteristics, specific miRNAs in serum as diagnostic biomarkers of CAPS and predictive biomarkers of the efficacy of duloxetine.

Methods/design:

In this prospective cohort study, we plan to enroll 430 participants including 215 CAPS patients and 215 healthy controls. The CAPS group takes duloxetine 30 mg per day as an initial dose. Patients will have 24-week medication period and follow up at week 0, 4, 12, 24 and 36. Blood samples will be obtained from patients at every visits and health controls at the initial visit and a series of questionnaires will be completed by the participants. The primary end points are: The differential expression of miRNAs between CAPS groups and healthy control groups at baseline. The changes in abdominal pain scores before and after duloxetine treatment in patients with CAPS and their relationship with the changes in miRNAs. The secondary end point is the changes in scores of depression, anxiety, sleep quality and quality of life before and after duloxetine treatment in patients with CAPS and their relationship with changes in miRNAs.

Discussion:

Findings of study will provide the reliable basis for diagnosis and the predictor of duloxetine efficacy of CAPS. Importantly, findings grant patients a chance to benefit from treatment.