bluuebunny/crossref_metadata_2025 huggingface dataset:
Infant with right hemiplegia due to acute encephalopathy with biphasic seizures and late reduced diffusion (AESD)
Authors: Takahashi Ai , Kamei Erina , Sato Yuri , Shimada Seiichiro , Tsubokawa Misao , Ohta Genrei , Ohshima Yusei , Matsumine Akihiko
Published: June 2021

Rationale:

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a condition characterized by biphasic convulsions and disturbance of consciousness. In Japan, the most common pediatric cases of acute encephalopathy are associated with infection. AESD usually occurs in early childhood, with the characteristic magnetic resonance imaging (MRI) appearance called “bright tree appearance.” The disease often has neurological sequelae and interferes with the schooling of children and their activities of daily living; however, there are few clinical case reports of hemiplegia caused by AESD.

Patient concerns:

A case with right-sided hemiplegia due to AESD in an 11-month-old girl who was followed up to 30 mo of age.

Diagnoses:

The patient was diagnosed with overlap AESD and hemiconvulsion-hemiplegia-epilepsy syndrome (HHE syndrome), based on the clinical course and imaging findings. DNA tests of her blood and cerebrospinal fluid revealed the presence of human herpesvirus 6.

Interventions:

Pharmacotherapy and rehabilitation therapy.

Outcome:

Gross motor function has recovered considerably, but she had a mild developmental delay at 30 mo old.

Lessons:

Hemiplegia due to AESD was extremely rare, and appropriate rehabilitation treatment resulted in recovery of physical function. However, as mild developmental delay was observed, the patient was referred to a specialized facility before entering school.
Yoga complemented cognitive behavioral therapy on job burnout among teachers of children with autism spectrum disorders
Authors: Dike Ibiwari C. , Onyishi Charity N. , Adimora Dorothy E. , Ugodulunwa Christiana A. , Adama Grace N. , Ugwu Gloria C. , Eze Uchenna N. , Eze Angela , Ogba Francisca N. , Obiwluozo Patience E. , Onu JaneFrances C. , Onu Augustine O. , Omenma Zipporah O. , Nwaeze Vivian C. , Ani Casimir , Ngwu Christopher N. , Uzodinma Uchenna E. , Iremeka Felicia U.
Published: June 2021

Background/objective:

Job burnout is a syndrome of reaction to chronic job-related stress which affects overall health, limits occupational efficacy, and personal accomplishments of employees thereby thwarting organizational outcomes. Burnout symptoms are common among teachers of children with autism spectrum disorders (ASD) and affect the academic progress of the children. This study investigated the effectiveness of Yoga-based cognitive behavioral therapy (Y-CBT) in reducing occupational burnout among teachers of children with autism in Lagos States, Nigeria.

Methods:

A group-randomized control-trial with immediate intervention and waitlist control groups was design was adopted. Participants included 58 teachers of children with autism in public and private special schools in the area. Participants were randomly assigned to Y-CBT (N = 29) and waitlist control (N = 29) groups. The Y-CBT group participated in a 2 hours Y-CBT program weekly for 12 weeks. Three instruments Demographic variable, Single Item Stress Questionnaire (SISQ), and Maslach Burnout Inventory-Educators’ Survey (MBI-ES) were used to collect data. Data were collected at baseline; post-test and follow-up evaluations. Data were analyzed using means, standard deviations, t test statistics, repeated measures analysis of variance, and bar charts.

Results:

Results revealed that job-burnout reduced significantly at post-test assessment among the Y-CBT group compared to the waitlisted group. The reduction in the participant was sustained across 3months follow-up evaluation.

Conclusion:

It was concluded that Y-CBT modalities could help to reduce the burnout symptoms among teachers of children with ASD.
A physician survey of poststroke aphasia diagnosis and treatment in China
Authors: Zhou Yuying , Du Xiaoxia , Xiao Jun , Cao Yunpeng , Guo Qihao , Zhou Aihong , Zhou Jiong , Li Nan , Wang Yinhua , Jiao Lifei
Published: June 2021

The current status of the diagnosis and management of poststroke aphasia (PSA) in China is unknown.

To analyze the physicians’ strategy and knowledge about the management of PSA in clinical practice and the needs for standardization of diagnosis and treatment.

This survey was conducted in March-August 2019 at 32 tertiary hospitals in 16 provinces/municipalities in China. The attending physicians from the Neurology and Neuro-rehabilitation/Rehabilitation Departments were included. The online questionnaire inquired about patient information, physicians’ diagnosis and treatment behavior for PSA, and physicians’ understanding of PSA.

A total of 236 physicians completed the survey. Regarding PSA assessment, 99.2% of the physicians reported using medical history and physical examination, 93.2% reported using neuroimaging, and 76.3% reported using dedicated scales. Most physicians used a combination of drug and non-drug treatment. Neuro-regenerators/cerebral activators and anti-dementia drugs were the most common pharmacotherapies; butylphthalide, edaravone, and memantine were most frequently prescribed. Six months poststroke was rendered as a spontaneous language recovery period, and a ≥6-month treatment for PSA was suggested by many physicians. The lack of standardized treatment regimen/clinical guidelines and the limited number of approved drugs for PSA were the primary challenges encountered by physicians during practice. The majority of the physicians agreed with the necessity of guidelines or consensus for the diagnosis and treatment of PSA.

The knowledge gaps exist among physicians in China regarding the assessment and management of PSA. The improved awareness of the available guidelines/consensus could improve the performance of the physicians.
The risk of colorectal neoplasm in ex- and never-smokers according to urinary cotinine level
Authors: Roh Seung Jae , Kim Bun , Oh Ju Yeon , Han Kyung Su , Kim Byung Chang , Hong Chang Won , Sohn Dae Kyung
Published: June 2021

To investigate the relationship between urinary cotinine and colorectal neoplasm (CRN).

The participants in the health screening cohort of the National Cancer Center who underwent screening colonoscopy between June 2007 and December 2009 were included. A total of 8121 subjects who underwent urinary cotinine measurement within 14 days from the index colonoscopy were included. Cotinine positivity was defined as having a urinary cotinine level ≥50 ng/mL. Follow-up colonoscopy data were collected by reviewing the patients’ medical records.

Patients were classified according to their urinary cotinine level and self-reported smoking status, and the number of patients with cotinine positivity was 1960 (24.1%). There was no significant difference in the cumulative CRN and advanced CRN (ACRN) risks according to the self-reported smoking status. However, cotinine positivity at the time of index colonoscopy was an independent risk factor for CRN (hazard ratio [HR]= 1.23, P = .006) in follow-up colonoscopy. Moreover, in never- and ex-smokers, cotinine positivity was an independent risk factor for CRN (HR = 1.95, P = .019; HR = 2.12, P = .003, respectively) and ACRN (HR = 8.89, P < .001; HR = 5.03, P = .003) during follow-up colonoscopy. The cumulative incidence of CRN and ACRN was higher in the cotinine-positive never- and ex-smokers than in the cotinine-negative never- and ex-smokers (P < .001 and P = .008, respectively).

CRN or ACRN is more likely to occur at follow-up colonoscopy in the urinary cotinine-positive never- and ex-smokers than in the urinary cotinine-negative group. Therefore, urinary cotinine measurements may provide useful information on never- or ex-smokers undergoing screening colonoscopy.
Solitary vulvar metastasis from early-stage endometrial cancer
Authors: Mandato Vincenzo Dario , Mastrofilippo Valentina , Palicelli Andrea , Silvotti Monica , Serra Silvia , Giaccherini Lucia , Aguzzoli Lorenzo
Published: June 2021

Rationale:

Endometrial cancer (EC) is the most common gynecological malignancy in developed countries. It is usually diagnosed at early-stage and presents a favorable prognosis. Conversely, advanced or recurrent disease shows poor outcome. Most recurrences occur within 2 years postoperatively, typically in pelvic and para-aortic lymph nodes, vagina, peritoneum, and lungs. Vulvar metastasis (VM) is indeed anecdotal probably because of the different regional lymphatic drainage from corpus uteri.

Patient concerns:

A 3 cm, reddish, bleeding lesion of the posterior commissura/right labia was found in a 74-year-old woman treated with radical hysterectomy, surgical staging, and adjuvant radiotherapy 1 year before for a grade 2 endometrioid type, International Federation of Gynecology and Obstetrics Stage IB. Vulvar biopsy confirmed the EC recurrence. Pelvic magnetic resonance imaging and positron emission tomography excluded other metastases so VM was radically resected.

Diagnosis:

Postoperative histopathology confirmed the diagnosis of grade 2 EC VM.

Interventions:

A radical excision of VM was performed.

Outcomes:

Patient died from a severe sepsis 27 months after first surgery.

Lessons:

Vulvar metastases can show different appearance, occurring as single or diffuse lesions on healthy or injured skin. The surgical approach seems not to influence the metastatic risk, but tumor seeding and vaginal injuries should be avoided. Whether isolated or associated with recurrence in other locations, vulvar metastases imply poor prognosis despite radical treatment. Therefore, any suspected vulvar lesion arisen during EC follow-up should be biopsied and monitored closely, despite that the vulva represents an unusual metastatic site.
Postoperative delirium after long-term general anesthesia in elderly patients, how to reduce it?
Authors: Sui Xiaoyuan , Duan Qingmei , Liu Kunling , Li Cuicui
Published: June 2021

Background:

Long operation duration (>4 hours’ anesthesia) of laparotomy in elderly patients would increase the risk of postoperative delirium (POD), which is characterized by acute cognitive dysfunction, changes in the level of consciousness, obvious attention disorder, emotional disorder, and sleep-waking cycle disorder. The occurrence of POD is closely related to the risk of death, and it will also seriously affect the cognitive function of patients, prolong postoperative hospital stays, and increase medical expenses. It is known that dexmetomidine could function in sedation, analgesia and anti-sympathetic effect, and it also could simulate the normal sleep state of human body, but there is still a lack of clinical study of dexmedetomidine on the incidence of POD in elderly patients undergoing long-term general anesthesia in laparotomy.

Methods:

This is a single-center, double-blinded, randomized controlled study. With the approval of the Ethics Committee of Chongqing Shapingba District People's Hospital, participants who meet the requirements will be randomly divided into the treatment group (continuous infusion of dexmetomidine) and the control group (continuous infusion of 0.9% sodium chloride solution) in a ratio of 1:1. The incidence of delirium, cognitive function score, inflammatory factors, and adverse reactions will be evaluated after the operation. Finally, the data will be analyzed by SPSS 22.0.

Conclusion:

The results of this study will explore the efficacy and safety of dexmetomidine in reducing the incidence of postoperative delirium in elderly patients undergoing long-term general anesthesia in laparotomy.

Trial registration:

OSF Registration number: DOI 10.17605/OSF.IO/2GJY6
Correlation between rs13347 polymorphism of CD44 gene and the risk of occurring breast cancer
Authors: Shao Zilong , Wang Zhibin , Shao Liwei , Jin Xiang
Published: June 2021

Background:

With the attention paid to the heritability of breast cancer, the search for the genetic susceptibility gene of breast cancer has become a hot spot. At present, a number of studies have explored the relationship between rs13347 polymorphism of cluster of differentiation 44 (CD44) gene and breast cancer, but the research conclusions are inconsistent. Therefore, we will use this meta-analysis to explore the role of this gene polymorphism in breast cancer susceptibility.

Methods:

The search time is set from the establishment of the database in March 2021 in this study. The search database include China National Knowledge Infrastructure, Wanfang, VIP Information Chinese Journal Service Platform, and China Biology Medicine disc, PubMed, EMBASE, Web of Science and the Cochrane Library. The subjects are observational studies on the relationship between rs13347 polymorphism of CD44 gene and breast cancer (including case-control study, cross-sectional study and a cohort study). The language is limited to English and Chinese. The data of the included study are extracted and the literature quality is evaluated by two researchers independently. The data are statistically analyzed by Stata 16.0 software.

Results:

Based on the existing studies, this study will systematically evaluate the relationship between CD44 gene rs13347 polymorphism and breast cancer.

Conclusion:

This study will provide evidence-based medical evidence to clarify the role of CD44 gene polymorphism in breast cancer, and provide help for the early detection and preventive intervention of breast cancer.

Ethics and dissemination:

Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.

OSF Registration number:

DOI 10.17605/OSF.IO/WBC7F
Comparison between acupuncture and antidepressant therapy for the treatment of poststroke depression
Authors: Zhang Lincheng , Chen Bing , Yao Qigu , Chen Weiyan , Yang Weinan , Yang Weiji , He Lan , Zhang Yuyan
Published: June 2021

Background:

In this paper, a systematic review and meta-analysis of published randomized controlled trials (RCTs) was conducted to compare the efficacies of acupuncture and antidepressant therapy for the treatment of poststroke depression (PSD).

Methods:

The research team searched RCTs published on PubMed; Medline; Cochrane library; Chinese National Knowledge Infrastructure (CNKI); Wanfang; Embase; Scopus, and Sinomed from their respective establishments to January 2019. We evaluated the Hamilton Depression Rating Scale (HAMD) scores, Treatment Emergent Symptom Scale (TESS) scores, National Institute of Health Stroke Scale (NIHSS) scores, and total clinical efficacy using fixed effects models.

Results:

Fourteen RCTs, representing a total of 1124 patients, were studied. Results showed that acupuncture was more effective in improving HAMD scores at 3 weeks after administration (mean difference [MD] = −1.17, 95%CI = −2.18 to −0.16), at 4 weeks (MD = −4.44, 95% CI = −5.64 to −3.23), at 6 weeks (MD = −1.02, 95% CI = −1.68 to −0.36), and at 8 weeks (MD = −4.33, 95% CI = −4.96 to −3.70). Similarly, acupuncture more dramatically decreased NIHSS scores (MD = −2.31, 95% CI = −2.53 to −2.09), and TESS scores (MD = −4.70, 95% CI = −4.93 to −4.48) than conventional Western medicinal therapy. Further, the total clinical efficacy in the acupuncture group was significantly higher than in the antidepressants group (risk ratio [RR] = 1.15, 95% CI = 1.08–1.21).

Conclusions:

The results of this study suggest that acupuncture not only can reduce the severity of PSD, but also has significant effects on decreasing the appearance of other adverse events.
Macular hole with inner limiting membrane peeling off spontaneously in Terson syndrome
Authors: Qi Hui , Yan Hongtao , Cheng Yan , Zuo Ling
Published: June 2021

Introduction:

Terson's syndrome with inner limiting membrane (ILM) peeled off spontaneously is rarely seen, and the mechanism of it is not clear. Here we report a case of Terson Syndrome with a rare finding: the ILM peeled off spontaneously associated with macular hole (MH).

Patient concerns:

A 36-year-old female patient was admitted to our hospital with decreased visual acuity in the right eye lasting for 1 month. She just had surgery for subarachnoid hemorrhage that occurred 1 month before due to the rupture of the intracranial aneurysm.

Diagnosis:

Terson syndrome was diagnosed according to her medical history and examination. A partial posterior vitreous detachment (PVD) and dense vitreous hemorrhage (VH) was confirmed in the right eye by performing ophthalmic B-scan ultrasonography examination. Head computed tomography showed the subarachnoid hemorrhage after aneurysmal rupture.

Interventions:

The patient underwent pars plana vitrectomy in her right eye to remove the VH. After removal of the VH, a full-thickness macular hole was noted with the ILM peeled off spontaneously. So we conducted gas tamponade, and face-down positioning after pas plana vitrectomy.

Outcomes:

At two weeks follow-up, her best corrected visual acuity was 0.15 in the right eye. Spectral domain optical coherence tomography showed that the MH was closed completely, while the thickness of the nasal retina of the foveal was thicker than that on the temporal side.

Lessons:

ILM peeled off spontaneously associated with MH is a rarely seen complication of Terson Syndrome. Due to the large-scale of the ILM peeling off, final visual acuity may be poor in patients, even though successful macular hole closure after the operation.
Potential value of MicroRNA-21 as a biomarker for predicting the prognosis of patients with breast cancer
Authors: Ding Yunfeng , Wu Wanbo , Ma Zhihong , Shao Xia , Zhang Ming , Wang Zhanwei
Published: June 2021

Background:

The latest global cancer data from 2020 shows that breast cancer has replaced lung cancer as the number one cancer in the world. Searching for new biomarkers of breast cancer has important clinical significance for early diagnosis, prediction of prognosis, and targeted therapy. MicroRNA-21 (miRNA-21) can be used as a new molecular marker for early diagnosis, prognosis, and treatment of tumors. However, the expression of miRNA-21 in breast cancer and its prognosis are not clear. Therefore, this study conducted a meta-analysis to further clarify the relationship between the expression of miRNA-21 in breast cancer and prognosis. At the same time, we carried out bioinformatics analysis to further analyze the possible molecular mechanism of miRNA-21, so as to provide potential clinical indicators for the diagnosis, treatment, and prognosis of patients.

Methods:

PubMed, Medline, Embase, Web of Science, Wanfang, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, and other databases were used to retrieve the published relevant literatures. Include the eligible research, extract the survival data hazard ratios and 95% confidence intervals and other information. STATA16.0 software was used for meta-analysis. Download the miRNA data of breast cancer through the Cancer Genome Atlas (TCGA) database and Gene Expression Omnibus (GEO) database. The data extracted for independent sample t test and ROC curve was drawn. OncomiR plotted the survival curve of miRNA-21 on the prognosis of breast cancer. The target genes of miRNA-21 were predicted, and the Gene Ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway were analyzed. STRING database and Cytoscape construct protein-protein interaction (PPI) network to obtain Hub gene. The correlation between the expression level of Hub gene in breast cancer and the abundance of immune cell infiltration was analyzed by TIMER database and verified by Kaplan–Meien plotter database.

Results:

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:

In this study, meta-analysis and bioinformatics analysis were used to further explore the prognosis, mechanism, and related pathways of miRNA-21 in breast cancer.

Ethics and dissemination:

The private information from individuals will not be published. This systematic review also should not damage participants’ rights. Ethical approval is not available. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF REGISTRATION NUMBER:

DOI 10.17605/OSF.IO/R32A9.
The value of contrast-enhanced ultrasound in predicting postoperative recurrence of hepatocellular carcinoma
Authors: Fu Jieying , Tang Jia , Luo Huan , Wu Wencui
Published: June 2021

Background:

As one of the key factors, postoperative recurrence of hepatocellular carcinoma (HCC) influences the therapeutic effects and survival period of patients. Therefore, the early diagnosis of postoperative recurrence of HCC plays an important role in improving the therapeutic effects and prognosis. Contrast-enhanced ultrasound (CEUS) plays an important role in the early diagnosis of postoperative recurrence of HCC. However, the accuracy of CEUS in predicting postoperative recurrence of HCC is still controversial. Therefore, in this study, a meta-analysis was carried out to further evaluate the accuracy of CEUS in predicting postoperative recurrence of HCC, thus providing evidence support for the early diagnosis of HCC.

Methods:

The literatures on the CEUS diagnosis of postoperative recurrence of HCC were collected by searching China National Knowledge Infrastructure, Wanfang, China Biology Medicine disc, PubMed, EMBASE, Cochrane Library, and Web of Science on computer. The retrieval time is set from the start of the database until April 2021. The meta-analysis of the literatures that meet the quality standards was conducted by Stata 16.0 software.

Results:

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:

This study will provide evidence support for the accuracy of CEUS in the diagnosis of postoperative recurrence of HCC.

Ethics and dissemination:

The private information from individuals will not be published. This systematic review also should not damage participants’ rights. Ethical approval is not available. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF Registration Number:

DOI 10.17605/OSF.IO/HB46W.
Analysis of the curative effect of percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture with intravertebral clefts
Authors: Li Dongfang , Zhou Yingjie , Cui Hongxun , Kong Liang , Zhu Wenxiao , Chai Xubin , Zhuo Hanjie
Published: June 2021

Kummell's disease is a delayed vertebral collapse fracture caused by posttraumatic osteonecrosis. It is a special type of osteoporotic vertebral fracture in the elderly. This study compares and analyzes the difference in the curative effect of 2 kinds of osteoporotic vertebral compression fracture (OVCF) in the presence of fracture or not in the vertebral body, and provides a clinical reference for the application of percutaneous kyphoplasty (PKP).

This research is a kind of retrospective analysis from January 2012 to January 2015, PKP was used to treat 165 patients with osteoporotic vertebral compression fracture. The patients were divided into 2 groups: Intravertebral clefts group (group A) and none-intravertebral clefts group in vertebral body (group B). Bone mineral density (BMD), bone cement injection (BCI), Visual analogue scale (VAS) score before and after surgery, anterior, central and posterior height of vertebral body (before and after surgery) and Cobb angle of injured vertebra (before and after surgery) were compared between the 2 groups.

Surgeries for 165 patients in the 2 groups were successfully completed, and 226 fractured vertebrae were performed through bilateral puncture approach to strengthen the vertebral body. Intraoperative injection of bone cement (ml) was 4.25 + 1.29 (range: 2.6–7.8). There were statistically significant differences in bone cement injection quantity between the 2 groups (P < .05), and in bone cement leakage (P > .05) as well as the Postoperative VAS score (P < .05). However, There was no statistical difference in VAS score before surgery between the 2 groups (P > .05). The results indicated that the pain relief degree of OVCF patients without intravertebral clefts is better than that in the vertebral body. No statistical difference was found in Cobb Angle before and after surgery (P > .05), as well as the correction rate of the injured vertebrae before and after surgery (P > .05). There was no statistical difference in the degree of recovery of the anterior, middle and posterior margins of the injured vertebrae after surgery (P > .05).

PKP treatment led to better degree of pain relief in OVCF patients without intravertebral clefts, and less bone cement was injected into the surgery.
Variations of bronchial artery origin in 600 patients
Authors: Choi Won Seok , Kim Min Uk , Kim Hyo-Cheol , Yoon Chang Jin , Lee Jae Hwan
Published: June 2021

To identify and evaluate the spectrum and prevalence of variations in bronchial artery (BA) origin by multidetector computed tomography (MDCT) and digital subtraction angiography (DSA) in a large population with hemoptysis.

From July 2008 to June 2015, data from 600 individuals with hemoptysis who underwent MDCT and DSA were retrospectively analyzed. The pattern of BA origin was investigated and classified according to distribution.

A total of 1674 BAs were evaluated, 866 were right BA and 808 were left BA. Most BAs originated from the upper descending thoracic aorta, classified as orthotopic origin (n = 1464, 87.5%). Among ectopic origin BAs (n = 210, 12.5%), concavity of the aortic arch was the most common (n = 107). The most common distribution pattern was a single artery in each side (n = 262). According to our classification, Type I was most common (n = 457), including BAs originating in orthotopic fashion from the descending thoracic aorta. Type II (n = 2) was defined as BAs originating from the aortic arch or ascending aorta. Type III (not found) was defined as BAs originating from subclavian arteries, common carotid arteries, and their branch vessels. Type IV (n = 92) was Type I and II combined, Type V (n = 41) was Type I and III combined, Type VI (not found) was Type II and III combined, and Type VII (n = 8) was Type I, II, and III combined.

Variations of BA origin could be systematically described in detail.
Identification and construction of lncRNA-associated ceRNA network in diabetic kidney disease
Authors: Wang Ya , Tan Jie , Xu Cheng , Wu Hongyan , Zhang Youshan , Xiong Ying , Yi Cunjian
Published: June 2021

Diabetic kidney disease (DKD) has become the major contributor to end-stage renal disease with high incidence and mortality. The functional roles and exact mechanisms of long noncoding RNA (lncRNA)-associated competing endogenous RNA (ceRNA) network in DKD are still largely unknown. This study sought to discover novel potential biomarkers and ceRNA network for DKD.

The candidate differentially expressed genes (DEGs), lncRNAs and microRNAs (miRNAs) in human glomerular and tubular tissues derived from Gene Expression Omnibus database were systematically selected and analyzed. Functional enrichment analysis and protein-protein interaction network analysis were conducted to identify hub genes and reveal their regulatory mechanisms involved in DKD. Following this, the integrated ceRNA network was constructed by bioinformatics methods.

A total of 164 DEGs, 6 lncRNAs and 18 miRNAs correlated with DKD were finally filtered and identified. It is noteworthy that the global lncRNA-associated ceRNA network related to DKD was constructed, among which lnc-HIST2H2AA4-1, VCAN-AS1 and MAGI2-AS1 were identified as the 3 key lncRNAs, and VCAN, FN1, CCL2, and KNG1 were identified as the predominant genes. Consistent with that observed in the training set, 3 of the key genes also showed significant differences in the 2 validation datasets. Integrating with functional enrichment analysis results, these key genes in the ceRNA network were mainly enriched in the immune and inflammation-related pathways.

This study first identified key lncRNAs, miRNAs and their targets, and further revealed a global view of lncRNA-associated ceRNA network involved in DKD by using whole gene transcripts analysis.
Anterior cervical surgery to treat diffuse idiopathic skeletal hypertrophic combined with cervical disc herniation
Authors: Gao Kun , Cao Yafei , Liu Weidong , Sun Shufen , Wu Yihong , Yu Weiji
Published: June 2021

Rationale:

Diffuse idiopathic skeletal hyperostosis (DISH) is a skeletal disease characterized by calcification of anterolateral ligaments of the spine and the rest of the body. DISH combined with disc herniation induces complex symptoms and is more difficult to treat. Here, we describe a complicated case of a patient diagnosed with DISH as well as cervical disc herniation that was successfully treated using anterior cervical surgery.

Patients concern:

A 69-year-old Asian male experienced dysphagia and weakness in his left limbs. He also experienced a stiff neck and right slant over a 6-month period.

Diagnosis:

An X-ray revealed calcification of the C4-7 vertebral front edge and a narrowed intervertebral space between C5/6. Coronal and sagittal computerized tomography (CT) and magnetic resonance imaging (MRI) both showed compression of the spinal cord at the cervical 5/6. Esophagography revealed that osteophytes in the anterior margin of vertebral body (C4-C7) oppressed the esophagus.

Interventions:

An operation focused on anterior cervical C5/6 disc fusion and anterior vertebral C4-7 osteophyte removal was performed.

Outcomes:

After the operation, X-ray and CT showed that most osteophytes were removed and spinal cord compression was relieved. One day following the operation, both dysphagia and numbness in limbs were improved. Strong recovery was observed at the three-month follow-up exam.

Lessons:

This complex DISH combined with disc herniation case is rarely observed in patients. Anterior cervical disc fusion and anterior vertebral osteophyte removal were effective treatment measures. This case study provides insight into treating cases presented with cervical spine complications associated with DISH combined with other ailments.
Correlation of microRNA-367 in the clinicopathologic features and prognosis of breast cancer patients
Authors: Liu Binghui , Pan Juhua , Fu Chenglin
Published: June 2021

Breast cancer (BC) is a malignant tumor originating from cells of the breast. Notably, microRNAs have been recognized as biomarkers of BC metastasis. The present study is designed to evaluate the association between microRNA (miR)-367 expression and BC with the variance of clinicopathologic features and prognosis.

Initially, 63 BC patients were allocated in the BC group, while the other 40 healthy volunteers were recruited as the control group. miR-367 expression in the serum of patients and healthy controls was detected using real-time polymerase chain reaction. Furthermore, the relation between miR-367 in serum and clinicopathologic features and prognosis of BC patients was accessed.

miR-367 expression in serum of the BC group was evidently lower than that in the control group (all P < .001). Besides, miR-367 underexpression in the BC group was closely associated with the variance in tumor nodes metastasis advanced stage, tumor diameter, and lymph node metastasis of BC (all P < .001). In addition, compared with the control group, poorly expressed miR-367 BC group had short period of disease-free survival and overall survival (all P < .001).

Our study demonstrated that miR-367 expression is associated with BC clinicopathologic features and prognosis. This investigation may offer new insight for BC treatment.
Association between the point-rating system used for oral health and the prevalence of Gram-negative bacilli in hematological inpatients
Authors: Yoshizawa Kunio , Moroi Akinori , Iguchi Ran , Yokomichi Hiroshi , Ogihara Shinji , Watanabe Kazuaki , Nakajima Kei , Kirito Keita , Ueki Koichiro
Published: June 2021

Gram-negative bacteremia is a major cause of death among hematology inpatients who require heavy-dose chemotherapy and hematopoietic stem cell transplantation. Gram-negative bacillus (GNB) is more likely to be detected when the oral health is poor. However, there is a dearth of studies on the relationship between oral assessment and prevalence of GNB in hematology inpatients.

This retrospective study aimed to evaluate the relationship between the original point-rating system for oral health examinations (point-oral exam) and the prevalence of GNB in hematology inpatients at the hematology ward of the Yamanashi University Hospital. GNB was detected by cultivating samples from the sputum and blood of each patient.

A total of 129 subjects underwent a medical checkup and point-oral exam. The sputum and blood culture results of 55 patients were included in this study. The total points of patients positive for GNB (n = 25, 45.5%) were significantly higher than those who were negative for GNB (total score: median, 25th, 75th, percentile; 6 [4, 7] vs 2 [1, 4]; P = .00016). Based on the receiver operating characteristic analysis, a cutoff score of 5 proved to be most useful to detect GNB.

An oral evaluation with a cutoff value of 5 or higher in the point-oral exam might indicate the need for a more thorough oral management to prevent the development of systemic infections from GNB.
Pacemaker dependency after transcatheter aortic valve replacement compared to surgical aortic valve replacement
Authors: Hwang You Mi , Kim Jun , Nam Gi Byoung , Choi Kee Joon , Park Duk-Woo , Kang Do-Yoon , Park Seung-Jung , Park Seo Young
Published: June 2021

Transcatheter aortic valve replacement (TAVR) is a standard treatment indicated for severe aortic stenosis in high-risk patients. The objective of this study was to evaluate the incidence of pacemaker dependency after permanent pacemaker implantation (PPI) following TAVR or surgical aortic valve replacement (SAVR) and the risk of mortality at a tertiary center in Korea.

In this retrospective study conducted at a single tertiary center, clinical outcomes related to pacemaker dependency were evaluated for patients implanted with pacemakers after TAVR from January 2012 to November 2018 and post-SAVR from January 2005 to May 2015. Investigators reviewed patients’ electrocardiograms and baseline rhythms as well as conduction abnormalities. Pacemaker dependency was defined as a ventricular pacing rate > 90% with an intrinsic rate of <40 bpm during interrogation.

Of 511 patients who underwent TAVR for severe AS, 37(7.3%) underwent PPI after a median duration of 6 (3–7) days, whereas pacemakers were implanted after a median interval of 13 (8–28) days post-SAVR in 10 of 663 patients (P < .001). Pacemaker dependency was observed in 36 (97.3%) patients during 7 days immediately post-TAVR and in 25 (64.9%) patients between 8 and 180 days post-TAVR. Pacemaker dependency occurred after 180 days in 17 (50%) patients with TAVR and in 4 (44.4%) patients with SAVR. Twelve (41.4%) patients were pacemaker-dependent after 365 days post-TAVR.

Pacemaker dependency did not differ at 6 months after TAVR vs SAVR. In patients undergoing post-TAVR PPI, 58.6% were not pacemaker-dependent at 1 year after the TAVR procedure.
Immune thrombocytopenia associated with Hashimoto thyroiditis in a pediatric patient
Authors: Tian Zhiqing , Gao Hu , Xiao Dongqiong , Li Xihong
Published: June 2021

Rationale:

Immune thrombocytopenia (ITP) is one of the most commonly acquired bleeding diseases in children. Infection and autoimmune disorders are the most common causes of ITP. The pathogenic mechanism of ITP is complex and is not completely understood. Understanding the underlying causes or disorders of ITP will improve the prognosis and make therapy more targeted.

Patient concerns:

An 8-year-old girl with ITP responded poorly to first- and second-line treatment. The patient showed multiple scattered petechiae, ecchymoses, and purpura in the skin and blood clots in the oral mucous membrane.

Diagnoses:

The patient was diagnosed with ITP associated with Hashimoto thyroiditis.

Interventions:

The patient was admitted to our emergency department and received platelet transfusion, IVIG, glucocorticoids and eltrombopag. The patient's thrombocytopenia resolved within 18 days after the administration of levothyroxine treatment.

Outcomes:

The patient was diagnosed with Hashimoto thyroiditis, and the platelet count recovered on the 3rd day of levothyroxine treatment. The platelet count became steadily normal with levothyroxine and prednisone treatment within 2 months of follow-up.

Lessons:

Early identification of the underlying reasons and treatment with multiple modalities may be useful in improving the prognosis of ITP. The treatment of thyroid disease and restoration of the euthyroid state impact the clinical outcome of ITP in children.
Intrathecal drug delivery to treat intractable neuropathic pain following Sjögren's syndrome-induced transverse myelitis
Authors: Kim Ji Yeong , Lee Yong Ho , Kim Ji Young , Lee Hyun Hwa , Kim Young Hoon
Published: June 2021

Rationale:

Transverse myelitis (TM) is a spinal cord inflammatory myelopathy that causes motor/sensory loss and urinary retention below the level of the affected spinal cord. Although a few case reports have described the control of neuropathic pain in patients with TM via spinal cord stimulation, no documented case regarding the control of severe allodynia following TM via intrathecal pump has been described.

Patient concerns:

A 37-year-old woman was referred to a pain clinic for severe intractable pain below the T5 level followed by Sjögren's syndrome-induced TM.

Diagnoses:

A neurological examination revealed paresthesia and allodynia below the T5 level. The sensory evaluation was limited by extreme pain and jerking movements. The muscle strength of both lower limbs was grade 3.

Interventions:

Intrathecal pump was inserted into the left lower abdomen. Catheter tip was placed at the midline of the T8 level.

Outcomes:

The numeric rating scale (NRS) for pain score decreased from 10 to 5. Functional Independence Measure score increased from 67 before implantation to 92 at the time of discharge, while the patient's Barthel score increased from 31 to 46.

Lessons:

Neuropathic pain due to Sjögren's syndrome-related TM could be controlled effectively using the intrathecal morphine pump.
Yunmen (LU 2) combined with neck-seven-acupoint acupuncture for arm numbness caused by cervical spondylotic radiculopathy
Authors: Zhang Yi-Mei , Han Xing-Jun , Wang Yong-Cheng , Jia Hong-Ling , Yuan Xiao-Fen , Meng Xian-Liang , Li Zhao-Yu , Zhou Guo-Feng
Published: June 2021

Rationale:

Cervical spondylotic radiculopathy (CSR) is a common sensory, motor, and reflex disorder. Numbness, a common subjective symptom of CSR, lacks objective quantitative indicators and recognized effective treatments, but is also difficult to recover from. We present a case report describing a traditional acupuncture treatment for CSR, utilizing a special acupuncture method and point, namely the Yunmen point.

Patient concerns:

A 40-year-old woman presented with unilateral arm numbness caused by CSR.

Diagnoses:

A diagnosis of CSR was made in the orthopedic department of a local hospital.

Interventions:

We attempted acupuncture at the Yunmen (LU 2) acupoint combined with neck-seven-acupoint under computed tomographic guidance.

Outcomes:

After 10 times treatment sessions, the patient no longer experienced weakness, coldness, or numbness in the affected upper limb. In addition, the stiffness in the neck and shoulders was reduced. On physical examination, the patient's left brachial plexus traction test was negative; reassessment of the CSR-20-point score scale showed a perfect score, and the visual analog scale score was 0.

Lessons:

Our report indicates that acupuncture at the LU 2 acupoint combined with neck-seven-acupoint is effective in treating numbness and coldness of the arm, and other neurological symptoms caused by cervical spondylosis. Moreover, with the appropriate acupuncture technique, the risk of acupuncture at the LU 2 acupoint can be minimized.
Effects of omalizumab in children with asthma
Authors: Chen Lu , Chen Yanping
Published: June 2021

Background:

It is still controversial in the current literature whether omalizumab is beneficial for children with asthma. Given that there is no high-quality meta-analysis to incorporate existing evidence, the purpose of this protocol is to design a systematic review and meta-analysis of the level I evidence to ascertain whether omalizumab is beneficial and safe for children with asthma.

Methods:

The systematic literature review is structured to adhere to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The following search terms will be used in PUBMED, Scopus, EMBASE, and Cochrane Library databases on June, 2021, as the search algorithm: (omalizumab) AND (asthma) AND (children). The primary outcome is the long-term safety and tolerability of omalizumab. The other outcomes include asthma control, quality of life, use of asthma controller medications, and spirometry measurements and emergency room visits due to asthma, and serum trough concentrations of omalizumab, free and total immunoglobulin E measured. Review Manager software (v 5.3; Cochrane Collaboration) will be used for the meta-analysis.

Results:

The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.

Registration number:

10.17605/OSF.IO/G6N3P.
Real-world evaluation of a computed tomography-first triage strategy for suspected Coronavirus disease 2019 in outpatients in Japan
Authors: Miyake Shigeta , Higurashi Takuma , Jono Takashi , Akimoto Taisuke , Ogawa Fumihiro , Oi Yasufumi , Tanaka Katsushi , Hara Yu , Kobayashi Nobuaki , Kato Hideaki , Yamashiro Tsuneo , Utsunomiya Daisuke , Nakajima Atsushi , Yamamoto Tetsuya , Maeda Shin , Kaneko Takeshi , Takeuchi Ichiro
Published: June 2021

The Coronavirus disease 2019 pandemic continues to spread worldwide. Because of the absence of reliable rapid diagnostic systems, patients with symptoms of Coronavirus disease 2019 are treated as suspected of the disease. Use of computed tomography findings in Coronavirus disease 2019 are expected to be a reasonable method for triaging patients, and computed tomography-first triage strategies have been proposed. However, clinical evaluation of a computed tomography-first triage protocol is lacking.

The aim of this study is to investigate the real-world efficacy and limitations of a computed tomography-first triage strategy in patients with suspected Coronavirus disease 2019.

This was a single-center cohort study evaluating outpatients with fever who received medical examination at Yokohama City University Hospital, prospectively registered between 9 February and 5 May 2020. We treated according to the computed tomography-first triage protocol. The primary outcome was efficacy of the computed tomography-first triage protocol for patients with fever in an outpatient clinic. Efficacy of the computed tomography-first triage protocol for outpatients with fever was evaluated using sensitivity, specificity, positive predictive value, and negative predictive value. We conducted additional analyses of the isolation time of feverish outpatients and final diagnoses.

In total, 108 consecutive outpatients with fever were examined at our hospital. Using the computed tomography-first triage protocol, 48 (44.9%) patients were classified as suspected Coronavirus disease 2019. Nine patients (18.8%) in this group were positive for severe acute respiratory syndrome coronavirus 2 using polymerase chain reaction; no patients in the group considered less likely to have Coronavirus disease 2019 tested positive for the virus. The protocol significantly shortened the duration of isolation for the not-suspected versus the suspected group (70.5 vs 1037.0 minutes, P < .001).

Our computed tomography-first triage protocol was acceptable for screening patients with suspected Coronavirus disease 2019. This protocol will be helpful for appropriate triage, especially in areas where polymerase chain reaction is inadequate.
Longitudinal decline in spoken word recognition and object knowledge in primary progressive aphasia
Authors: Sikora Jonathan , Stein Colin , Ubellacker Delaney , Walker Alexandra , Tippett Donna C.
Published: June 2021

The premise of this study is that spoken word recognition and object knowledge are impaired in semantic variant primary progressive aphasia (PPA) (svPPA) and are spared in logopenic variant (lvPPA) and nonfluent agrammatic primary progressive aphasia (nfaPPA) at disease onset. Over time, however, there may be heterogeneity in these abilities in lvPPA and nfaPPA. We hypothesized that individuals with svPPA would demonstrate poorer performance on baseline spoken word recognition and object knowledge than those with lvPPA and nfaPPA) as documented in the literature, but that rates of decline over time on spoken word recognition and object knowledge would be similar in all 3 PPA variants because these become less distinguishable with disease progression.

The aim of this study was to investigate longitudinal patterns of decline in spoken word recognition and object knowledge across PPA variants.

Ninety-five individuals with PPA completed the Semantic Word Picture Matching and Semantic Associates tests at baseline to establish expected performance in these areas. Thirty-five individuals completed follow-up testing.

The distributions of trichotomized mean rates of decline in object knowledge were similar for lvPPA and svPPA (P = .05). There were weak negative correlations between symptom duration and baseline scores on Semantic Word Picture Matching (r[37] = −0.399, P = .01), and baseline scores on Semantic Associates (r[37] = −0.394, P = .01) in lvPPA.

Degradation of spoken word recognition and object knowledge occurs over time in lvPPA. Further investigation of the receptive language deficits in PPA is warranted to characterize language changes that lessen the distinctions between PPA variants with disease progression.
Efficacy and safety of bloodletting for herpes zoster
Authors: Wang Xiaoyan , Huang Shaolei , Shao Guoliang , Zhang Jian , Wang Suyao , Lv Yanfei , Dong Feng , Han Jing , Yang Dianhui
Published: June 2021

Background:

The study aims to evaluate the effectiveness and safety of bloodletting therapy for herpes zoster.

Methods:

The following electronic databases will be searched from PubMed (1966 to March 2020), the Cochrane Central Register of Controlled Trials (update to March 2020), EMBASE (1980 to March 2020), China National Knowledge Infrastructure (1979 to March 2020), Wan Fang Data (1980 to March 2020), Chinese Scientific Journal Database (1989 to March 2020), Chinese Biomedical Database (1978 to March 2020) and traditional Chinese medicine Literature Analysis and Retrieval Database (1949 to March 2020). All randomized controlled trials without any limitation of blinding or publication language about this topic will be included, exclude cohort studies and case reports. Two independent researchers will operate article retrieval, duplication removing, screening, quality evaluation, and data analyses by Review Manager (V.5.3.5). Meta-analyses, subgroup analysis, and/or descriptive analysis will be performed based on the included data conditions.

Results:

High-quality synthesis and/or descriptive analysis of current evidence will be provided from cure rate, converting to clinical diagnosis rate, and side effects of bloodletting.

Conclusion:

This study will provide the evidence of whether bloodletting is an effective and safe intervention for herpes zoster.

PROSPERO registration number:

CRD42020171976