bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between polymorphisms of epidermal growth factor 61 and susceptibility of lung cancer
Authors: Chen Quan , Zheng Yiming , Wu Bingbing , Chen Xia , Ge Pengfei , Wang Pengcheng
Published: April 2020

To explore the association between epidermal growth factor (EGF) 61A/G polymorphism and lung cancer.

All eligible case-control studies published up to August, 2019 were identified by searching PubMed, The excerpta medica database, China Academic Journals Full-text Database, China Biology Medicine, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang databases. Two researchers independently identified the literature, extracted data, and evaluated quality according to inclusion and exclusion criteria. Meta-analysis was performed by Stata 15.0.

A total of 6 studies is included, including 1487 cases and 2044 control subjects. Compared with allele A, allele G was considered to have no association with the risk of lung cancer, odds ratio = 1.07 (95% confidence interval: 0.98–1.15). GG recessive genotype, GG + GA dominant genotype, GG homozygote genotype and GA heterozygote genotype were found out that all of them are not associated with the risk of lung cancer. No association between EGF 61A/G polymorphism and lung cancer was found out by ethnical subgroup analysis. However, in view of the limitations of this study, such as the results of quantitative and sensitivity analysis may be lack of accuracy, so the conclusions of allele model and recessive gene model should be made carefully.

It suggested that there was no association between polymorphism of EGF 61A/G and susceptibility of lung cancer.
Inter-practitioner comparisons of nerve conduction studies with standardized techniques in normal subjects
Authors: Zhao Bing , Diao Hong-Mei , Wen Qing-Xian , Sui Ke-Xv , Zhang Yong-Qing
Published: April 2020

This 2-group study was carried out to determine the inter-practitioner difference of nerve conduction studies with standardized techniques.

56 normal subjects of 19 to 49 year-old were recruited, 29, and 27 in the 2 labs respectively. Tests were carried out unilaterally on: 5 motor nerve distal latency, conduction velocities (MNCV) and minimum latency of F wave, 3 sensory nerves with negative amplitude, onset, and peak distal latency, sensory nerve distal latency.

T-test disclosed 4(15.4%) attributes with statistical significance (P < .05). They were 2 of 4 (50%) compound motor action potentials, which were ulnar and tibial nerve, and 2 of 6 (33.3%) MNCVs, which were elbow-to-wrist MNCV of median nerve and cross-fibula MNCV of peroneal nerve. No differences were disclosed in motor nerve distal latencys, minimum latency of F waves and all sensory attributes.

Inconsistency pattern of certain attributes were found. This could be explained with the insufficient definition of related techniques.
Two head positions for orotracheal intubation with the trachway videolight intubating stylet with manual in-line stabilization
Authors: Chan Wei-Hung , Cheng Chiao-Pei , Chiu Yu-Lung , Hsu Yung-Chi , Hu Mei-Hua , Huang Go-Shine
Published: April 2020

Background:

The Trachway Videolight Intubating Stylet is a video-assisted system with a rigid but malleable intubating stylet that facilitates endotracheal intubation. Minimizing cervical spine movement with manual in-line stabilization is essential for patients with cervical spine injuries such as multiple trauma. However, the intubation time of the Trachway Videolight Intubating Stylet and complications associated with intubation in patients with manual in-line stabilization in the neutral-head and head-lift positions remain unclear.

Methods:

Patients (20–80 years old) who were scheduled to undergo surgery that required general anesthesia with tracheal intubation were randomly allocated to either a neutral-head (n = 62) or a head-lift position (n = 62) group. Manual in-line stabilization was performed to limit cervical spine mobility. We aimed to evaluate orotracheal intubation time and success rate in these 2 positions with the Trachway Videolight Intubating Stylet.

Results:

Intubation was faster in the head-lift than in the neutral-head position (20 ± 10 and 25 ± 13 seconds, respectively, P = .000); intubation was equally successful in the 2 positions (96.8% vs 96.8%). Responses to intubation did not differ between positions (heart rate, P = .142; visual analog scale scores for throat soreness, P = .54). The only significant predictor of intubation time was the body mass index in the head-lift position group (P = .005).

Conclusions:

Intubation using the Trachway Videolight Intubating Stylet with manual in-line stabilization is faster in the head-lift position, and therefore preferable. However, if the head-lift position is not suitable, the neutral-head position is a sensible alternative, with comparable intubation success rate, heart rate change, and postoperative throat soreness.
Aberrant expression of miR-21 in patients with inflammatory bowel disease
Authors: Yan Huimin , Zhang Xinyu , Xu Yi
Published: April 2020

Background:

microRNAs have drawn more attention due to their function on the inflammatory process. The association between microRNA-21 (miR-21) expression and risk of inflammatory bowel diseases (IBD) remain inconclusive. This study was aimed to acquire a more exact estimation of this relationship.

Methods:

Relevant studies were identified through searching PubMed, Embase, Wanfang, and China National Knowledge Infrastructure database. Pooled standardized mean difference and 95% confidence intervals were calculated using a random-effect model. Publication bias test, sensitivity analysis and subgroup analysis were carried out.

Results:

A total of 20 relevant articles comprising 540 patients with ulcerative colitis (UC), 459 patients with Crohn disease (CD) and 511 non-IBD controls were included in this analysis. The expression of miR-21 was significantly increased in colon tissue of both UC and CD patients compared with non-IBD controls. However, there were no significant differences between patients with UC and CD. Moreover, increased miR-21 expression was associated with disease activity status in UC patients, but not in CD patients.

Conclusions:

This meta-analysis demonstrates that the higher miR-21 expression in colon tissue is positively associated with the development of UC and CD, and miR-21 might serve as a disease marker of IBD.
Synchronous hybrid procedure combining interventional radiology and endoscopy for esophagogastric varices with large gastro-renal shunt
Authors: Zhao Yiming , Wang Shufang , Li Congyong , Guo Liangliang , Li Chao , Zhao Li , Tian Le , Zheng Siyang , Liu Jiangtao , Sun Gang
Published: April 2020

Successful treatment of esophagogastric varices (EGV) with giant portal-systemic shunt is challenging. To explore the feasibility and safety of a novel hybrid procedure involving interventional radiology and endoscopy in the same sitting.

Three cases clinically diagnosed to have decompensated cirrhosis and EGV with giant gastrorenal shunt (GRS) on contrast-enhanced computed tomography (CT) were included. The hybrid procedures included: indirect portography, hepatic vein pressure gradient (HVPG) measurement, HVPG-based partial splenic embolization (PSE), retrospective GRS balloon occlusion, endoscopic histoacryl injection (EHI), balloon catheter radiography and withdrawal. All the procedures were done in the same operation room. Main outcomes measurements included operation time, complications, and re-bleeding events.

Hybrid interventions were performed successfully in 3 cases with a mean operation time of 63.3 minutes without any major intra- and post-operation complications. No rebleeding occurred at 6-month follow-up.

Synchronous hybrid intervention combining radiology and endoscopy is feasible and safe for patients with EGV and giant GRS, preliminary study with limited cases deserves further exploration.
Type II caesarean scar pregnancy management by ultrasound-guided local lauromacrogol injection in combination with suction curettage
Authors: Wei Shuang-shuang , Li Ding-heng , Zhang Zhi-fen , Sun Wen-chao , Jia Cen-lin
Published: April 2020

Introduction:

The implantation of a gestational sac within the scar of a previous caesarean delivery is defined as caesarean scar pregnancy (CSP), which is classified into two types: CSP I and CSP II. CSP II is life threatening, and no clear consensus for CSP II management exists.

Patient concerns:

A 31-year-old woman, gravida 1, para 1, with a previous caesarean delivery due to macrosomia, presented with an estimated 45 days of amenorrhea. The patient presented to the emergency department with vaginal bleeding for 1 day and no abdominal pain.

Diagnoses:

An ultrasound examination was performed demonstrating a viable fetus that was embedded in the caesarean scar area and was bulging through the wall of the uterus into the bladder without contact with the uterine cavity or cervical canal. A diagnosis of type II caesarean scar pregnancy was made.

Interventions:

Local lauromacrogol was used to reduce the gestational sac blood supply. Suction curettage was performed under the guidance of abdominal ultrasound 24 h later, and the amount of bleeding was 20 mL. The response to the treatment was monitored by serial beta-human chorionic gonadotropin (β-hCG).

Outcomes:

Patient was followed up with β-hCG weekly levels which became <10 mIU/mL after 4 weeks of treatment.

Conclusion:

Ultrasound-guided local lauromacrogol injection combined with suction curettage may be a safer and novel therapeutic method.
Efficacy and safety of valganciclovir in patients with symptomatic congenital cytomegalovirus disease
Authors: Morioka Ichiro , Kakei Yasumasa , Omori Takashi , Nozu Kandai , Fujioka Kazumichi , Yoshikawa Tetsushi , Moriuchi Hiroyuki , Ito Yoshinori , Oka Akira
Published: April 2020

Background:

Congenital cytomegalovirus (CMV) disease, a common mother-to-child infection, can lead to neurological sequelae. Some clinical trials have shown that oral valganciclovir (VGCV) can improve hearing and neurodevelopmental impairment in infants with congenital CMV disease. However, VGCV has neither been approved in Japan nor other countries as a treatment for this disease by the government health insurance.

Methods:

This study is a non-randomized, prospective, open-label, multicenter, single-arm clinical trial and will include subjects meeting the following criteria: confirmation of positive CMV-DNA amplification in urine by an in vitro diagnostic test within 21 days of age; congenital CMV disease with one or more central nervous system disorders—microcephaly, hydrocephalus or ventricular enlargement, periventricular calcification, cortical hypoplasia or white matter injury, retinal choroiditis, and abnormal auditory brainstem response (ABR); and infants within 2 months of age with a gestational age ≥32 weeks at birth and weighing ≥1800 g at the time of registration. Subjects will be orally administered 16 mg/kg VGCV twice daily for 6 months. The target number of cases for enrollment between February 3, 2020 and July 31, 2021 is 25. Primary endpoint is the change in whole blood CMV loads before and after 6 months of treatment. The important secondary endpoint is the change in ABR (both best and total ear hearing assessments) before and after 6 months of treatment. The safety endpoints are adverse events and drug side effects.

Discussion:

To the best of our knowledge, this multicenter, open-label, single-arm study will be the first well-designed clinical trial to evaluate the efficacy of oral VGCV in infants with congenital CMV diseases. The findings will reveal the efficacy and safety of oral VGCV treatments and enable the approval of oral VGCV as a treatment for infants with congenital CMV disease by the government health insurance of Japan.
Effects of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on all-cause mortality, cardiovascular death, and cardiovascular events among peritoneal dialysis patients
Authors: Nochaiwong Surapon , Ruengorn Chidchanok , Mongkhon Pajaree , Thavorn Kednapa , Awiphan Ratanaporn , Noppakun Kajohnsak , Vongsanim Surachet , Chongruksut Wilaiwan , Hutton Brian , Sood Manish M. , Knoll Greg A.
Published: April 2020

Background:

Based on the International Society for peritoneal dialysis (PD) recommendations, blockade of renin-angiotensin systems with an angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) improves residual kidney function in PD patients. However, the long-term effectiveness of ACEI/ARB use in PD patients has not been fully elucidated. We, therefore, intend to perform a systematic review and meta-analysis to summarize the effects of ACEI/ARB use on long-term mortality, cardiovascular outcomes, and adverse events among PD patients.

Methods:

This systematic review will include both randomized controlled trials and non-randomized studies in adult PD patients. We also plan to incorporate data from our cohort study in Thai PD population into this review. We will search PubMed, Medline, EMBASE, Cochrane Library, Web of Science, Scopus, CINAHL, and grey literature from inception to February 29, 2019, with no language restrictions. The process of study screening, selection, data extraction, risk of bias assessment, and grading the strength of evidence will be performed independently by a pair of reviewers. Any discrepancy will be resolved through a team discussion and/or consultation with the third reviewer. The pooled effects estimate and 95% confidence intervals will be estimated using DerSimonian-Laird random-effects models. Heterogeneity will be assessed by the Cochran Q test, I
2 index and tau-squared statistics. The funnel plots along with the Begg and Egger test and trim and fill method will be performed to investigate any evidence of publication bias. Preplanned subgroup analyses and random-effects univariate meta-regressions will be performed to quantify the potential sources of heterogeneity based on studies- and patient-characteristics.

Results:

This will be the first systematic review and meta-analysis to summarize the long-term effectiveness of renin-angiotensin system inhibitors in PD populations.

Conclusion:

In summary, this systematic review and meta-analysis will summarize the effectiveness of ACEI/ARB on long-term mortality, cardiovascular outcomes, and adverse events among adult PD patients by integrated all available evidences.

Ethics and dissemination:

Based on the existing published data, an ethical approval is not required. The findings will be disseminated through scientific meetings and publications in peer-reviewed journals.

PROSPERO registration number: CRD42019129492.
A prospective observational study to investigate the correlation analysis between neonatal hyperbilirubinemia and deafness gene
Authors: Wu Xiaohui , Gao Xingqiang , Li Gang , Cao Qiuxue , Guo Yufeng , Deng Haiyan , Zheng Yun
Published: April 2020

Introduction:

There are many studies on the relationship between serum levels of hyperbilirubinemia and hearing impairment. However, the mechanism of hyperbilirubinemia on auditory impairment is not clear.

Methods and analysis:

A total of 1000 children with hyperbilirubinemia who are mainly indirectly elevated bilirubin in the full-term neonatal ward of Xiamen Children's Hospital from March 2020 to September 2020 will be enrolled. Using second-generation high-throughput sequencing technology, 127 deaf-related genes were sequenced from the collected samples. At the same time, physical audiometry was performed on the selected persons and audiometry data were recorded.

Discussion:

In this study, we will combine gene sequencing with clinical indications of hyperbilirubinemia to find the loci suitable for high-frequency pathogenic deafness related to hyperbilirubinemia, so as to provide early guidance for deafness gene screening in children with hyperbilirubinemia.

Trial registration:

Chinese Clinical trial registry: ChiCTR2000030075.
The effects of psychotherapy for depressed or posttraumatic stress disorder women with childhood sexual abuse history
Authors: Lu Jhih-Yuan , Tung Tao-Hsin , Shen Sheng-Ang , Huang Chien , Chen Pei-Shih
Published: April 2020

Background:

Depression and posttraumatic stress disorder (PTSD) are the most common mental disorders of women suffered from childhood sexual abuse histories. It has been widely recognized that depression and PTSD may decrease patients’ quality of life. The objective of this study is conducted to explore the effects of psychotherapy for depressed or PTSD women with childhood sexual abuse history.

Methods:

We searched the PubMed and Cochrane Library from inception to June 30, 2019. The search strategy is (sexual assault OR sexual crime OR sexual abuse) AND (depression OR PTSD) AND (treatment OR intervention OR psychotherapy) with no restriction on language. Two authors independently selected the studies, assessed the quality of the included studies, and extracted data.

Results:

Nine randomized control trials with 761 participants met the inclusion criteria. There were 340 participants in the psychotherapy group and 421 participants in the control group (usual treatment or waiting list). Compared to usual care, improvements were significantly greater in the psychotherapy group. The Beck depression inventory score for depression diagnosis of the psychotherapy group is lower from 4.27 to 8.96 (P < .05) than the control group. The client assessment protocols for PTSD, the diagnosis is also lower from 12.4 to 13.71 than the control group (P < .05).

Conclusion:

The results suggested that psychotherapy is effective in reducing depressed or PTSD women with childhood sexual abuse. Further large-scale high-quality randomized controlled trials with long-term follow-up are warranted for confirming this finding.
Healthcare students’ personality traits and competence-based learning methodologies
Authors: López-López María José , Navarro-Abal Yolanda , Climent-Rodríguez José Antonio , Gómez-Salgado Juan
Published: April 2020

The European Higher Education Area was implemented more than a decade ago with the aim of improving internationally the competitiveness of European university education putting the spotlight on skills and competence development (and not only on knowledge acquisition). This work intends to analyze the impact of competence-based teaching methodologies on university students, as well as to contribute to the study of the individual personality traits differences regarding this impact. For this, a descriptive, quantitative, cross-sectional study was conducted with a non-randomised sample of university students. The sample was composed of a total of 499 students of the University of Huelva (350 from the Health Sciences degree, and 149 form other degrees), who completed a questionnaire on professional skills and teaching methods developed ad hoc for this research, as well as the brief version of the Spanish adaptation of the NEO Five-Factor Inventory. The results show that Health Sciences students feel more satisfied with the most participative and active methodologies, and they consider these better contribute to their future professional competence development. On the other hand, in relation to the big 5 personality traits studied, links have been found between competence development perception and personal preferences and the dimensions of extraversion, agreeableness, conscientiousness and openness to experience. This last factor, openness to experience, appears when analyzing the main differences among both groups, being Health Sciences students more intellectually curious, showing more openness and diversity of interests, in addition to being more creative, innovative, and flexible.
Effect of Bicalutamide on the proliferation and invasion of human triple negative breast cancer MDA-MB-231 cells
Authors: Kong Yan , Qu Fanjie , Yuan Xiaolin , Yan Xin , Yu Weiwei
Published: April 2020

Previous studies have shown androgen receptor (AR) is associated with the occurrence, development, recurrence, metastasis, and prognosis of triple negative breast cancer (TNBC). More and more experts have noticed that AR signaling pathway plays an important role in the occurrence and development of TNBC. The purpose of this study is to detect the inhibitory efficacy and mechanism of Bicalutamide on the proliferation and invasion of TNBC cells.

MDA-MB-231 cells of human breast cancer cells were treated with 0, 25, 100 μmol/L of Bicalutamide, cell proliferation assay was performed to assess cell proliferation viability by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide, Thiazolyl Blue Tetrazolium Bromide assay and cell invasion was evaluated by Transwell assay. Meanwhile, flow cytometric analysis and western blotting were performed to investigate the mechanism of Bicalutamide on the proliferation and invasion of MDA-MB-231 cells.

Bicalutamide could efficiently inhibit the proliferation and invasion of MDA-MB-231 cells in a dose-dependent manner. In addition, Bicalutamide could significantly induce the cell cycle arrest at G0/G1 phase and decrease the protein expression of AR, cyclin D1, matrix metalloprotease-2 (MMP-2), and matrix metalloprotease-9 (MMP-9).

The present study indicated the Bicalutamide inhibited the proliferation and invasion process of triple negative breast cancer cells by targeting AR signaling pathway and down-regulating MMP-2/-9 protein expression levels.
The effect of probiotics used as a single therapy on functional constipation
Authors: Wen Yong , Li Jun , Tang Xuegui
Published: April 2020

Background:

Constipation is a frequent gastrointestinal symptom. It is intimately related to many diseases. 1st-line therapy can not alleviate constipation for some patients. Alternative treatments are therefore commonly used, such as probiotics. Nevertheless, the efficacy and safety of probiotics used as a single treatment are still uncertain. A systematic review and meta-analysis will be carried out to answer the issue.

Methods:

The protocol accompanied Preferred Reporting Items for Systematic Reviews and Protocol Meta-Analysis. PubMed, Cochrane, Embase, and Web of Science databases were practiced for randomized controlled trials without language constraint. In addition, We have also conducted backward (manually) and forward (with Google Scholar) citation checks to identify any additional relevant papers.

Two reviewers will conduct studies selection, data extraction, and risk of bias assessment independently. The primary outcome is treatment success (spontaneous bowel movements (sBMs) >3 times per week), defecation frequency. The second result will be consistency, fecal incontinence, other symptoms (e.g. flatulence, abdominal pain), and adverse event rates and types.

Results:

This study provides helpful information about whether probiotics can be used as a single therapy on functional constipation

Conclusion:

The findings of the review will be disseminated through peer-review publications
Social and environmental risk factors for road traffic injuries among children under five in rural China
Authors: Liu Yuxi , Wang Meixian , Kang Leni , He Chunhua , Miao Lei , Chen Lingxiao , Zhong Siyan , Zhu Jun , Liang Juan , Li Qi , Wang Yanping , Liu Hanmin
Published: April 2020

Background:

Road traffic injuries (RTIs) have become a considerable issue for children. In China, RTIs are among the top 3 contributors to injury-related mortality and disability-adjusted life years. The present study aimed to evaluate social and environmental factors that may contribute to RTIs among children under 5 in rural areas of China.

Methods:

The study was based on 1 year of data (October 1, 2015 to September 30, 2016) from the National Maternal and Child Health Surveillance System (NMCHSS) from all districts in 334 National Maternal and Child Health Surveillance Districts in 30 Chinese provinces, autonomous regions, and municipalities. Data were analyzed to identify environmental, social, and primary caregiver factors related to RTIs among children under 5.

Results:

Based on data for the 279 children registered in the NMCHSS during the study period, incidence of RTIs increased with increasing age and was higher for boys than girls. Risk of RTIs depended on distances from the child's home to roads and playgrounds. Enrollment in kindergarten and characteristics of primary caregivers affected risky road behaviors by children. Most primary caregivers (67.4%) reported never using child car seats, and 70.6% reported never using a child helmet. Among primary caregivers without a driver's license, 24.8% reported having driven motor vehicles or motorcycles.

Conclusions:

The living environment and behaviors of primary caregivers can affect risk of RTIs in children younger than 5 years in rural China. Road safety awareness should be strengthened at the community and kindergarten levels.
Prognostic factors associated with postoperative adverse outcomes in patients with aortic valve prolapse
Authors: Ruan Yanping , Liu Xiaowei , Meng Xu , Zhang Haibo , He Yihua
Published: April 2020

Background and aim:

Aortic valve (AV) cusp prolapse and subsequent aortic insufficiency (AI) are 2 of factors leading to left ventricular (LV) enlargement and decreased LV function. Aortic valve replacement (AVR) has been the standard surgical procedure for AI. However, few data is available on the prognosis of these patients undergoing AVR procedure, especially in Chinese population. The study aims to evaluate the potential risk factors affecting the mid-term adverse outcomes after AVR.

Methods:

One hundred thirty-four patients (mean age: 46.7 years old) with AV cusp prolapse and severe AI who all received surgical aortic valve replacement were recruited in our hospital between January 1, 2009 and December 30, 2017. The clinical characteristics, echocardiography parameters, as well as operative parameters were obtained. The primary endpoint included death, heart failure development, and reoperation.

Results:

There were 14 adverse events altogether with the primary endpoint during a median follow-up of 8.6 (6–10) months. The multivariable Cox regression analysis revealed that baseline LVEDD (hazard rate, HR = 1.08, 95% CI: 1.01–1.15, P = .021), moderate pulmonary hypertension (HR = 9.36, 95% CI: 1.81–48.28, P = .008), and the time of assisted mechanical ventilation (HR = 1.01, 95% CI: 1.00–1.01, P = .022) were independently associated with the primary endpoint. Kaplan–Meier survival curve showed a significant worse survival free of the endpoint for patients with LVEDD≥70 mm, indexed LVEDD≥37.3 mm/m2 (the mean in this study), indexed LVESD≥25 mm/m2 or baseline LVEF <50% (all P<.05).

Conclusion:

Baseline enlarged LV dimensions, low LV function, moderate pulmonary hypertension, and prolonged assisted mechanical ventilation may predict the poor mid-term postoperative outcomes for AV cusp prolapse patients undergoing AVR procedure.
Overall prevalence of human parvovirus B19 among blood donors in mainland China
Authors: Li Xin , Lin Zheng , Liu Jiayan , Tang Yuanyuan , Yuan Xiaohong , Li Nainong , Lin Zhenxing , Chen Yuanzhong , Liu Ailin
Published: April 2020

Background:

Human parvovirus B19 (B19V) infection exhibits a broad range of clinical outcomes. Blood transfusion is a common route of B19V transmission. However, information about the overall prevalence of B19V infection and B19V genotypes among blood donors in mainland China is lacking.

Methods:

This meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search for studies reporting the B19V prevalence among blood donors in mainland China from 2000 to 2018 was performed. The prevalence of B19V was estimated through a meta-analysis of the relevant literature. A comprehensive meta-analysis program was used for data processing and statistical analysis.

Results:

Twenty-one eligible articles were included, involving 48,923 participants assessed for B19V-DNA, 12,948 participants assessed for anti-B19V immunoglobulin M (IgM), and 8244 participants assessed for anti-B19V immunoglobulin G (IgG). The analysis revealed the pooled estimates of the prevalence rates of B19V-DNA, anti-B19V IgM, and anti-B19V IgG among blood donors to be 0.7% (95% confidence interval [CI] 0.2–2.4%), 2.7% (95% CI 1.7–4.3%), and 33.6% (95% CI 28.2–39.4%), respectively. Moreover, phylogenetic analyses indicated that 142 of 169 (84.0%) B19V isolates belonged to Genotype 1.

Conclusions:

The overall prevalence of B19V among blood donors is not high in mainland China, and most isolates belong to Genotype 1.
Clinical study for external washing by traditional Chinese medicine in the treatment of multiple infectious wounds of diabetic foot
Authors: Zhang Yuan , Yuan Haipo , Kang Jian , Xie Hongyan , Long Xinhua , Qi Luguang , Xie Chunguang , Gong Guangming
Published: April 2020

Background:

Diabetic foot (DF) is among the most serious complications of type 2 diabetes. DF infection (DFI) is a key factor in the deterioration and development of DF, so controlling infection plays an important role in the treatment of the disease. Traditional Chinese medicine foot bath has been widely used in China as a complementary and alternative therapy to improve circulation and infection control of DF. However, the existing evidence shows that its efficacy and safety are still insufficient. We report a study protocol about a multicenter, double-blind, randomized, placebo controlled trial which aims to make well-designed clinical trials to evaluate the efficacy and safety of herbal medicine foot bath decoction (FBD) and explore the mechanism of external washing of Chinese herbs in DFI.

Methods:

This study is a multicenter, double-blind, randomized, placebo controlled clinical trial in which 60 eligible participants were randomly divided into an experimental group and control group at a 1:2 ratio. Both groups received the same basic treatment for DF disease, the experimental group used FBD and ordinary dressing changes, while half of the patients in the control group received placebo and ordinary dressings, and the other half received placebo and silver ion dressings. Patients in both groups will be evaluated weekly for efficacy during the intervention. The primary efficacy indicators include the types of wound pathogens, interleukin 6 and tumor necrosis factor α. Secondary efficacy indicators included blood glucose, blood lipids, wound area, lower extremity blood vessel diameter, blood flow speed, walking speed, walking distance, and traditional Chinese medicine syndrome scores. We will also conduct a safety evaluation of the drug at the end of the trial.

Discussion:

This multicenter, double-blind, randomized, placebo clinical trial not only provides data on the efficacy and safety of FBD, but also provides a novel treatment strategy for clinicians and DF patients.
A randomized controlled clinical study of acupuncture therapy for Seborrheic alopecia in young and middle ages
Authors: Chen Qiulian , Tao Yun , Wang Longjun , Zhang Jinfang , Sun Bichen , Yang Xiaoli
Published: April 2020

Introduction:

Seborrheic alopecia (SA) has clinical manifestations, duration of disease, and priorities. In the current situation where there are many and complicated clinical treatments, Western medicine treatment can delay and control the development of the disease and promote hair regeneration. However, some patients may aggravate symptoms after taking the drug, and the condition is easy to repeat after stopping the drug. Acupuncture is an important method for non-surgical treatment of SA, and it has various methods, low side effects, high safety, and simple and economical. Therefore, we will use a clinical randomized controlled study to explore the effect of acupuncture on SA, and provide a new idea and reference for the treatment of this disease.

Methods/design:

We will select 60 patients diagnosed with SA. They will be randomly divided into intervention group and control groups. The control group will be given conventional treatment measures. The intervention group will receive acupuncture. Efficacy will be evaluated by comparing the skin lesion score and dermatological quality of life index before and after treatment.

Discussion:

This trial may provide evidence regarding the clinical effectiveness, safety, and cost-effectiveness of acupuncture for patients with SA.

Trial registration number:

CTR2000030430
The efficacy of jade moxibustion in knee osteoarthritis
Authors: Chen Lusheng , Huang Zouqin , Cheng Ke , Wu Fan , Deng Haiping , Lin Lin , Zhao Ling , Shen Xueyong
Published: April 2020

Introduction:

This study aims to compare clinical effect between Jade moxibustion and traditional moxibustion, and to determine the clinical effect of Jade moxibustion on knee osteoarthritis (KOA).

Methods/Design:

This is a 2-parallel-group, randomized controlled trial. A total of 148 subjects with KOA (Kellgren–Lawrence grade II or III) will be recruited and randomized to receive Jade moxibustion treatment or a traditional moxibustion treatment in a 1:1 ratio. Jade moxibustion group: The affected knee of the subjects will be covered with jade kneepad. Traditional moxibustion group: Chosen the ST35, ST34, EX-LE4, SP10 and Ashi points at the affected knee. The subjects will receive treatment three times a week, altogether 12 times in 4 weeks. The main outcomes are WOMAC knee pain score, knee function score and SF-36 quality of life questionnaire changes at the 4th week. Secondary outcomes include WOMAC knee pain score and knee function score, overall clinical efficacy evaluation, medication, safety evaluation at the 2nd, 12th, and 24th week, and cytokines related to osteoarthritis in serum.

Discussion:

This randomized controlled trial used traditional moxibustion as a control group to provide rigorous evidence for the clinical efficacy and safety of Jade moxibustion in treatment of KOA.

Trial Registration:

ISRCTN registry, No 21174552. Registered on 28 February 2020.
Induction of apoptosis by Xiakemycin A in human hepatoma HepG2 cells
Authors: Chen Chuan , Han Zhu , Yang Minjie , Jiang Zhongke , Ou Xiuyuan
Published: April 2020

Xiakemycin A (XKA), a new antibiotic in the pyranonaphthoquinone family, shows antitumor activity. However, the type of cell death induced by XKA remains elusive. In this study, we aim to investigate the type of death induced by XKA in hepatic cancer.

The apoptotic features, such as chromatic agglutination, reactive oxygen species generation and membrane potential of mitochondria, in HepG2 cells treated by XKA were measured by Hoechst 33342 staining and flow cytometry. Apoptosis of HepG2 cells treated with XKA was determined by Annexin V-FITC/propidium iodide double staining and Western blot analysis, respectively.

XKA had a significant dose-dependent elevation of chromatic agglutination, reactive oxygen species generation, Annexin V and propidium iodide staining, decrease of membrane potential. Meanwhile, in apoptotic HepG2 cells induced by XKA, robust increment was noticed in p53 expression, cleavage of PARP, caspase-3, and caspase-9.

XKA showed potent inhibitory effects on the proliferation of HepG2 cells. Such phenomenon may be related to activation of the apoptotic pathway.
Successful transurethral resection of the prostate in ectopic prostate pheochromocytoma
Authors: Zhou Jin , Wu Wen-Feng , Zhang Wenbin , Xin Jun , Lei Wen-Hui
Published: April 2020

Introduction:

Most pheochromocytomas of the urinary tract are located in the bladder. However, ectopic prostate pheochromocytomas have rarely been reported. We herein report an unusual case of ectopic prostate pheochromocytoma successfully treated by transurethral resection of the prostate (TURP).

Patient concerns:

A 44-year-old Asian man with no significant previous medical history such as hypertension, presented to the urologist complaining of palpitations and anxiety on urination for more than 1 month.

Diagnoses:

Pathological examination confirmed ectopic prostate pheochromocytoma.

Interventions:

An ectopic prostate pheochromocytoma without definite metastasis was confirmed. The lesion was successfully treated via TURP.

Outcomes:

All of his symptoms completely and immediately disappeared after surgery. Over a 21-month follow-up period, a repeat abdominal computed tomography (CT) scan did not show any evidence of recurrence.

Conclusion:

When patients present with symptoms of catecholamine excess on urination, extra-adrenal pheochromocytoma in the prostate should also be considered. TURP may be a viable option for therapy.
Effects of surgical approaches and morphological characteristics on the follow up outcomes of patients with posterolateral tibial plateau fractures
Authors: Huo Yongfeng , Xu Gang , Yin Zhaoyang , Yu Jian , Sun Xiao , Li Leiming , Gu Guangxue , Sheng Luxin , Sun Hong
Published: April 2020

This study aimed to study the effects of surgical approaches and identify the morphological characteristics associated with the 1-year follow-up outcome of patients with posterolateral tibial plateau fractures after successful surgery.

We followed 200 postoperative patients for 1 year. The modified Hospital for Special Knee Surgery score (HSS score) was used to evaluate the functional recovery of the knee. We supposed 4 morphological characteristics in CT images acting as possible risk factors, including the anteroposterior diameters of posterolateral broken bone fragments (fragment-diameter), the damage to the posterolateral cortex of the tibial head (cortex-damage), the combinational fracture of the proximal fibula (fibula-fracture) or fracture of the medial tibial condyle (medial-condyle-fracture). Multivariate regression models were used to analyze the effect of these factors on the HSS score after adjusting the 2 surgical approaches and other confounders.

The average HSS score was 85.1 ± 5.8 for all the patients. We treated 155 patients with the anterolateral approach and 45 patients with the posterolateral approach. The surgical approach, fragment-diameter, fibula-fracture, and medial-condyle-fracture were correlated with the HSS scores (P < .05). After adjusting for the above factors, the Schatzker type, age and gender, compared with anterolateral approach, the posterolateral approach could improve the HSS scores by an average of 3.7 points. The fragment-diameter <20 mm and posterolateral approach interacted on the HSS scores. Comparing posterolateral and anterolateral approaches, we found that the HSS scores of patients with fragment-diameter <20 mm increased by 6.1 points (95% CI: 4.1–8.2) in the posterolateral approach, while those with fragment-diameter ≥20 mm did not significantly improve the HSS scores.

The surgical approach, fragment-diameter, fibula-fracture, and medial-condyle-fracture were independent risk factors associated with the follow-up outcome of patients with posterolateral tibial plateau fractures after successful surgery. The posterolateral approach could significantly improve the HSS score in the studied hospital.
Treatment of medial humeral epicondyle fractures in children using absorbable self-reinforced polylactide pins
Authors: Su Yuxi , Nan Guoxin
Published: April 2020

The best treatment for medial humeral epicondyle fractures in children has been debated. In case of incarceration of the epicondylar fragment, particularly after elbow dislocation, several materials are used for fixation, including Kirschner wires (K-wires), metallic compression screws, tension band wire, and suture anchors. Herein, we introduce a new fixation material: the absorbable self-reinforced polylactide (SR-PLA) pin.

The aim of the study was to prove the feasibility of a new fixation material (absorbable SR-PLA pins) for the treatment of medial epicondyle fracture in children.

Thirty-two patients who underwent surgery in our hospital from August 2007 to January 2012 were retrospectively analyzed. The patients were divided into group A (K-wires) and group B (absorbable SR-PLA pin). Group A comprised 11 males and 4 females, aged 8 to 14 years (average, 12.6 years), with 12 patients with elbow dislocation. Group B comprised 13 males and 4 females, aged 7 to 15 years (average, 11.8 years), with 13 patients with elbow dislocation. The same approach was used for all patients by the same team of surgeons, and all the patients were followed up for over 12 months. In all patients, rehabilitation training was started after 3 weeks. The Broberg and Morrey elbow scale was used to evaluate elbow function at follow-up.

Four patients from group A developed pin-track infections that gradually resolved after removal of the K-wires, whereas no infections occurred in group B. One patient refractured her humerus after K-wire removal. Using the Broberg and Morrey elbow scale, outcomes in group A were classified as excellent in 5 patients (33.33%), good in 7 patients (46.67%), fair in 2 patients (13.33%), and poor in 1 (0.07%). Group B outcomes were scored as excellent in 12 patients (70.58%), good in 4 (23.53%), and fair in 1 (0.06%) and no patient (0.00%) had a poor outcome. The average Broberg and Morrey score for group A was significantly lower than that for group B (83.27 ± 7.02 vs 95.21 ± 5.04; P = .0238).

Absorbable SR-PLA pins can be safely used for medial epicondyle fractures in children. Our results indicate that SR-PLA pins are associated with better short-term functional outcome than K-wires.

Level of evidence: III
Effect of different electrical stimulation protocols for pelvic floor rehabilitation of postpartum women with extremely weak muscle strength
Authors: Li Wenjuan , Hu Qing , Zhang Zhujuan , Shen Fengxian , Xie Zhenwei
Published: April 2020

Background:

Pregnancy is one of the main risk factor of pelvic floor muscle dysfunction. Postpartum women with extremely weak muscle strength have difficulty to do voluntary pelvic floor muscle training. This study aims to evaluate the effects of different protocols of electrical stimulation in the treatment of postpartum women with extremely weak muscle strength.

Methods:

A total of 67 women were randomized into 2 groups: group A received transvaginal electrical stimulation (TVES) for 5 times, and group B received TVES for 3 times with electromyogram (EMG)-triggered neuromuscular stimulation twice. Subjects were evaluated before and after treatment. Pelvic muscle strength was measured by both digital vaginal palpation and EMG variables, and quality of life was investigated by 4 kinds of pelvic floor disease-related questionnaires.

Results:

According to the intention-to-treat principle, compared with baseline, in group A, EMG of contractile amplitude of endurance phase was significantly elevated (P = .03), variation of contractile amplitude in tonic phase was more stable after treatment (P = .004), and EMG of mean value of final rest was significantly elevated after treatment (P 
= .047). After 5 times treatments, the incidence of correct pelvic floor muscle contraction in group A was significantly elevated (P = .045). No significant difference of muscle strength test by digital vaginal palpation was detected between the 2 groups, so did questionnaires.

Conclusion:

For postpartum women with extremely weak muscle strength, TVES for 5 times might be more benefit for control ability of pelvic muscle contractions and elevating muscle strength even in short-time treatment.
Anatomical structure responsible for direction changing bilateral gaze-evoked nystagmus in patients with unilateral cerebellar infarction
Authors: Lee Hyung , Kim Hyun Ah
Published: April 2020

The direction-changing bilateral gaze-evoked nystagmus (GEN) (BGEN) is a more specific sign for a gaze-holding deficit than unilateral GEN (UGEN) in a central lesion. We sought to clarify which cerebellar structure is responsible for the generation of BGEN compared with UGEN.

We studied 47 cases of UGEN or BGEN associated with isolated unilateral cerebellar infarction in the territories of the cerebellar arteries diagnosed by brain magnetic resonance image (MRI) from June 2007 to April 2014. To identify the structures involved in the generation of BGEN, the overlapped lesions of the BGEN group were subtracted from those of UGEN group and vice versa.

About half of the patients (25/47, 53%) showed BGEN and others showed UGEN. There was no difference in the interval from symptom onset to examination between 2 groups (1.3 days vs 2.5 days, P = .24). Thirty-five patients (35/47, 75%) with GEN also showed spontaneous nystagmus. Lesion subtraction analyses revealed that both of the patients with BGEN and UGEN had damage around the vermal pyramid, the uvula and the tonsil, parts of the biventer lobule, and the inferior semilunar lobule.

Midline and lower cerebellar structures are related to both BGEN and UGEN in patients with unilateral cerebellar infarction. Regardless of unilateral or bilateral, GEN may represent damage of the gaze-holding neural integrator control system in human.
Electroacupuncture for lumbar disc herniation
Authors: Shen Yuquan , Zhou Qun , Zhang Leixiao , Gao Liang , Zhang Di , Wang Xinling , Yu Yang , Zhang Zhengsong , Liu Jianjia , Liang Shumi , Zhang Guilong
Published: April 2020

Background:

This systematic review aims to evaluate the effectiveness of electroacupuncture in treatment of lumbar disc herniation (LDH).

Methods:

Electronic databases of all electroacupuncture for LDH will be searched at PubMed, Cochrane Library, Springer, EMBASE, China National Knowledge Infrastructure (CNKI), Wan-Fang, and Chinese Biological Medical disc, (CBM) from inception to February 29, 2020, with language restricted in Chinese and English. The primary outcome is Japanese Orthopedic Association Scores, a quantification scale for a comprehensive assessment according to patients’ subjects feeling and objective function. Secondary outcomes included visual analogue scale (VAS), Oswestry dysfunction index (ODI), Pittsburgh sleep quality index (PSQI), Self-rating anxiety scale (SAS), self-depression rating scale (SDS), follow-up relapse rate. The systematic review and searches for randomized controlled trials of this therapy for LDH. The Cochrane RevMan V5.3 bias assessment tool is implemented to assess bias risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). Mean difference (MD), standard mean deviation (SMD) and binary data will be used to represent continuous results.

Results:

This study will provide a comprehensive review and evaluation of the available evidence for the treatment of LDH with this therapy.

Conclusion:

This study will provide new evidence to evaluate the effectiveness and side effects of electroacupuncture for LDH. Due to the data is not personalized, no formal ethical approval is required.
Primary health care physicians’ knowledge and adherence regarding hypertension management guidelines in southwest of Saudi Arabia
Authors: Shnaimer Jubran A. , Gosadi Ibrahim M.
Published: April 2020

To measure Primary Health Care physicians’ knowledge of and adherence to the Saudi Hypertension Management Guidelines (SHMGs) in Southwest of Saudi Arabia.

This study was a cross-sectional investigation where data was collected via a self-administered questionnaire. The demographics of the physicians, data related to the source of the guidelines for hypertension management, knowledge about the SHMGs and physicians’ adherence to the SHMG were collected. Student's t test was used to assess the presence of any statistical difference between the level of knowledge and adherence according to the study's measured variables.

A total of 316 physicians participated in this investigation, representing 65% of all the PHC physicians in the Jazan region. The number of correct answers measuring knowledge about various topics varied between 18% and 94% with a mean overall score of 7.9/16. The number of reported practices adherent to the guidelines varied between 2% and 97%, and the mean overall score was 7.2/11. Receiving hypertension management guidelines from the Directory of Health was statistically associated with a higher level of knowledge (P value < .05). Undergoing clinical training for hypertension management and seeing fewer numbers of patients on a daily basis was associated with a statistically higher level of adherence to the guidelines (P value < .05).

Improper distribution of guidelines, lack of continuous clinical training, negative attitude of physicians toward guidelines and large number of patients seen by physicians are likely to hinder translating guidelines to actual clinical practice.