bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of meningoencephalitis caused by Listeria monocytogenes with ischemic stroke-like onset using metagenomics next-generation sequencing
Authors: Zhang Xiaobo , Wang Ruying , Luo Jie , Xia Danni , Zhou Chaojun
Published: August 2021

Rationale:

Listeria monocytogenes (L. monocytogenes) is a compatible intracellular bacterial pathogen that can invade different mammalian cells and reach the central nervous system (CNS), leading to meningoencephalitis and brain abscesses. In the diagnosis of L. monocytogenes meningoencephalitis (LMM), conventional tests are often reported as negative due to antibiotic therapy or low bacterial content in cerebrospinal fluid. To date, prompt diagnosis and accurate treatment remain a challenge for patients with Listeria infections.

Patient concerns:

Here, we report a case of a 64-year-old male diagnosed with LMM by using metagenomics next-generation sequencing (mNGS).

Diagnosis:

LMM was confirmed by mNGS analysis of cerebrospinal fluid.

Interventions:

The patient was treated with piperacillin and sensitive antibiotics.

Outcomes:

The patient could walk independently about 1 month after admission and was discharged from the hospital.

Lessons:

This case highlights the value of mNGS in the diagnosis of LMM and emphasizes the inadequate sensitivity of conventional diagnostic methods for Listeria infection.
Calcifying aponeurotic fibroma around posterior tibialis tendon in an elderly patient with flatfoot
Authors: Won Sung Hun , Kim Jahyung , Cho Jaeho , Chun Dong-Il , Kim Kwonwoo , Yi Young
Published: August 2021

Rationale:

Calcifying aponeurotic fibroma (CAF) is a rare benign fibroblastic tumor that is commonly in the hand or foot of children or adolescents.

Patient concerns:

A 74-year-old female presented with a progressive pain on the medial foot for 3 years ago. The pain aggravated while walking or in a standing position for more than 20 minutes. She also complained of skin contact along the medial aspect of the foot while trying to wear a shoe.

Diagnosis:

Physical examination revealed a firm, immobile, nontender mass accompanied with flexible flatfoot. On the single heel raise test, loss of the balance and intensification of the pain were observed. Faintly calcified soft tissue mass is shown in plain radiographs without bone involvement. Magnetic resonance imaging revealed a subcutaneous mass with ill-defined circumscribed subcutaneous mass adherent to the thickened PTT.

Interventions:

The patient underwent a complete excisional biopsy, followed by medial displacement calcaneal osteotomy.

Outcomes:

The excised mass was diagnosed to be CAF on the histologic examination. At the 1-year follow-up, patient remained asymptomatic with no evidence of recurrence and all the radiographic parameters demonstrating flat foot improved.

Lessons:

This is the first case of CAF located at PTT presenting with both foot pain and functional disability. In this case, complete excision of the causative structure along with alignment correction can contribute to successful postoperative outcome.
Impacts of postoperative changes of segmental mobility on neurological improvement after laminoplasty for cervical ossification of the posterior longitudinal ligament
Authors: Ohnishi Atsunori , Sakaura Hironobu , Akira Yamagishi , Ohwada Tetsuo
Published: August 2021

Several studies have demonstrated that the dynamic factor at the mobile segment affects the severity of myelopathy in patients with cervical ossification of the posterior longitudinal ligament (C-OPLL), and posterior decompression supplemented with posterior instrumented fusion at the mobile segment provides good neurological improvement. However, there have been few reports of changes in range of motion at the mobile segment (segmental ROM) after laminoplasty (LP). The aim of this study was thus to retrospectively investigate changes in segmental ROM after LP and the impacts of these changes on neurological improvement in patients with C-OPLL.

A total of 51 consecutive patients who underwent LP for C-OPLL since May 2010 and were followed for at least 2 years after surgery were included in this study. Neurological status was assessed using the Japanese Orthopaedic Association (JOA) score before surgery and at 2-year follow-up. Segmental ROM at the responsible level for myelopathy was measured preoperatively and at 2-year follow-up using lateral flexion-extension radiographs of the cervical spine.

The mean JOA score improved significantly from 10.7 points preoperatively to 13.5 points at 2 years after surgery (mean recovery rate, 45.0%). The mean segmental ROM decreased significantly from 6.5 degrees before surgery to 3.2 degrees at 2 years after surgery. In the good clinical outcome group (recovery rate of the JOA score ≥50%; n = 22), the mean segmental ROM decreased significantly from 5.8 degrees preoperatively to 3.0 degrees postoperatively. It also decreased significantly from 7.1 degrees to 3.4 degrees in the poor clinical outcome group (recovery rate of the JOA score <50%; n = 29).

This study showed that segmental ROM was stabilized after LP in most patients with C-OPLL. Neither preoperative nor postoperative segmental ROM showed significant differences between the good and poor clinical outcome groups and neither a postoperative increase nor decrease of segmental ROM significantly affected the recovery rate of the JOA score.
Effects of pulmonary rehabilitation training based on WeChat App on pulmonary function, adverse mood and quality of life of COVID-19 patients
Authors: Ding Lili , Xu Zhiyu , Zhao Zhongyan , Li Haiping , Xu Aihong
Published: August 2021

Background:

Coronavirus disease 2019 (COVID-19) as a fatal epidemic has swept across the world, especially in India where the epidemic situation is the most serious. For COVID-19 patients, pulmonary rehabilitation training plays a significant role. However, it is still a controversial issue regarding the efficacy of WeChat APP-based pulmonary rehabilitation training in improving lung function, quality of life and bad mood of COVID-19 patients. To clarify this issue, a meta-analysis was conducted in this present study, so as to provide a basis for rehabilitation guidance of COVID-19 patients.

Methods:

We systematically searched PubMed, medRxiv, Web of Science, Scopus, Chinese Science Citation Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan-fang databases in May 2021 to identify randomized controlled trials and evaluate the effects of WeChat APP-based pulmonary rehabilitation training for COVID-19. Two researchers independently carried out data extraction. On the other hand, literature quality evaluation on the quality and meta-analysis of the included literature was performed with Revman5.3 software.

Results:

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

Conclusion:

This study will provide reliable evidence-based evidence on the effects of WeChat APP-based pulmonary rehabilitation training on lung function, bad mood, and quality of life in patients with COVID-19.

Ethics and dissemination:

Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms.

OSF Registration number:

DOI 10.17605/OSF.IO/MKXCH.
The application value of operating room ventilation with laminar airflow for surgical site infection
Authors: Liu Yuan-Yuan , Shi Ling-Yun , Duan Yong-Mei , Li Xiu-Mei
Published: August 2021

Background:

The presence of biological particles in the air inside operating theatres has the potential to cause severe surgical site infections. Recently, laminar airflow systems have been regarded as a means to reducing surgical site infections using airborne microbes. Still, other publications have argued the benefits of laminar airflow systems, stating the likelihood of adverse effects. Therefore, we will conduct this systematic study to evaluate the applicational value of adopting laminar airflow systems in operating theatres to minimize surgical site infections.

Methods:

Reporting of this study adheres to the guidelines of Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. The authors will perform a systematic search on MEDLINE, Web of Science, EMBASE, the China national knowledge infrastructure, and the Cochrane Library from their commencement until June 2021. The search will identify relevant randomized and non-randomized controlled trials that evaluates the applicational value of using laminar airflow ventilation in surgical theatres to minimize surgical site infections. There are no restrictions on language. Two authors will independently screen the identified studies, perform data extraction, and use an appropriate method to evaluate the bias risk in the included studies.

Results:

The work done in the present study will enhance the existing literature on the applicational value of laminar airflow ventilation in surgical theatre to reduce surgical site infections.

Conclusion:

The outcomes are a reference for healthcare practitioners and patients when making informed decisions regarding care during surgeries.
The incidence and risk factors of contralateral knee arthroplasty after primary unilateral unicompartmental knee arthroplasty
Authors: Huang Xiaodan , Li Hua , Chen Baicheng , Shao Decheng , Niu Haiyun , Wang Jianchao , Yang Guang
Published: August 2021

Unicompartmental knee arthroplasty (UKA) is one of the commonly used surgical methods for unicompartmental osteoarthritis in recent years. Although the prognosis of the operated knee has been widely studied, there are relatively little data on the natural history of the contralateral knee after unilateral replacement. The aim of this study was to explore the incidence and risk factors of consequential knee arthroplasty in patients with bilateral knee osteoarthritis (KOA) after receiving primary unilateral UKA, so as to provide a theoretical basis for making a more comprehensive treatment strategy for patients with KOA.

We conducted a retrospective study and enrolled patients with bilateral KOA received unilateral UKA from June 2015 to December 2019 in the third department of joint orthopedics, the third hospital of Hebei Medical University. The patients were divided into replacement group and non-replacement group according to whether the contralateral knee joint received knee arthroplasty. Information about treatment of contralateral knee joint was collected from medical records to determine the incidence. Univariate analysis and multivariate logistic regression analysis were performed to identify the independent risk factors.

A total of 502 patients were enrolled in this study. The incidence of contralateral knee arthroplasty was 38.64%. In the univariate analysis, vertical angle of mechanical axis, knee joint's internal and external joint space, Kellgren–Lawrence (K-L) classification, femoral tibial angle were the significant risk factors for contralateral knee arthroplasty. In the multivariate model, only vertical angle of mechanical axis ≥3.03° (odds ratio [OR] 4.36, 95% confidence interval [CI], 2.47–9.11), K-L classification grades 3 and 4 (OR 2.46,3.72; 95%CI, 1.31–4.25, 1.98–6.87), and femoral tibial angle ≥187.32° (OR 6.32, 95%, 2.23–18.87) remained associated with the occurrence of knee arthroplasty.

About a quarter of patients with bilateral KOA received unilateral UKA will receive contralateral knee arthroplasty. Higher K-L classification, femoral tibial angle, and mechanical axis vertical angle are identified risk factors.
Prognostic factors for overall survival in patients with clear cell metastatic renal cell carcinoma
Authors: Shin Dongrul , Jeong Chang Wook , Song Cheryn , Kang Minyong , Seo Seong Il , Kim Jung Kwon , Lee Hakmin , Chung Jinsoo , Hong Sung-Hoo , Hwang Eu Chang , Kwak Cheol , Park Jae Young
Published: August 2021

To develop a new prognostic model for the overall survival of patients with clear cell metastatic renal cell carcinoma (mRCC) using Korean Renal Cancer Study Group (KRoCS) database and compared it with 2 renowned prognostic models: the Memorial Sloan Kettering Cancer Center (MSKCC) and the international metastatic renal cell carcinoma database consortium (IMDC) models.

Data of 790 patients diagnosed with mRCC and receiving targeted therapy as their first-line treatment were pooled to this study. Data from 4 hospitals (n = 619) were used to develop the new model and those from other 5 hospitals (n = 171) were used for external validation. After detecting prognostic factors in multivariable Cox proportional-hazards regression analysis, patients were classified into 3 risk groups, favorable (0), intermediate (1–2), and poor (3 and more) by the number of prognostic factors.

Seven variables such as more than 2 metastasis sites, no prior nephrectomy, Eastern Cooperative Oncology Group performance status ≥2, low hemoglobin, high serum corrected calcium, high neutrophil, high serum alkaline phosphatase were identified as prognostic factors for poor overall survival. Also, risk groups were categorized into 3 groups; median overall survival was 61.1 months in favorable, 26.5 months in intermediate, and 6.8 months in poor group. KRoCS ranked the first in all 3 statistical parameters including akaike information criterion (AIC), concordance index and generalized R2 among other prognostic models.

We developed the KRoCS model and validated it externally with demonstrating its superiority over MSKCC and IMDC models. The KRoCS model can provide useful information for counseling patients with clear cell mRCC regarding life-expectancy.
Mental health of nurses involved with COVID-19 patients in Japan, intention to resign, and influencing factors
Authors: Ohue Takashi , Togo Eiichi , Ohue Yuka , Mitoku Kazuko
Published: August 2021

The purpose of this study was to investigate the association between mental health (posttraumatic stress disorder, depression, anxiety disorder, and burnout) and intention to resign, and influencing factors regarding nurses involved with COVID-19 patients in A Prefecture as subjects.

The design is a cross-sectional questionnaire-based study.

Methods are conducted between August 4 and October 26, 2020. Basic attributes (gender, age, years of experience, etc.) were examined. Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, Impact of Event Scale-Revised, Maslach Burnout Inventory, “intent to resign,” were used to collect data from nurses working at hospitals treating patients with COVID-19 in Japan.

As a result, between 20% and 30% of nurses involved with patients with COVID-19 are in a state of high mental distress. Regarding the associations between psychiatric symptoms and intention to resign, “I want to quit being a nurse” was affected by “cynicism” and “professional efficacy”; “I want to change hospitals/wards” was affected by “cynicism”; and “subthreshold depression,” “anxiety disorder,” and “burnout” affected “I want to continue working as a nurse.” The increase in the number of patients with COVID-19 was a factor affecting mental health and intention to resign. When the number of patients increased, anxiety disorders and intention to resign also increased. Damage from harmful rumors increased the severity of every psychiatric symptom. To prepare for a pandemic such as COVID-19, it is necessary in normal times to construct psychological support systems and community systems to prevent damage from harmful rumors.
Potential association of prolonged patient interval and advanced anatomic stage in breast cancer patients in the area affected by the 2011 triple disaster in Fukushima, Japan
Authors: Ozaki Akihiko , Toyoaki Sawano , Tsukada Manabu , Shimada Yuki , Kawamoto Ayumu , Wang Ji-Wei , Bhandari Divya , Tsubokura Masaharu , Ohira Hiromichi
Published: August 2021

For five years after the 2011 triple disaster (earthquake, tsunami, and nuclear disaster) in Japan, the proportion of patients with undiagnosed symptomatic breast cancer remained elevated in the coastal area of Fukushima. These individuals experienced a prolonged interval from first symptom recognition to initial medical consultation (hereafter referred to as the patient interval). We aimed to investigate how this prolonged patient interval affected disease staging.

Using patient records, we retrospectively extracted females with newly and pathologically diagnosed breast cancer who initially presented to Minamisoma Municipal General Hospital from March 2011 to March 2016. We estimated the proportion with advanced-stage disease (III, IV) according to the patient interval duration (<3 months, 3–12 months, and 12 months plus). A cut-off patient interval value was determined based on the previous evidence with regards to impacts on survival prospects. Logistic regression approaches were used to fulfill the study outcome.

The proportion of patients with advanced-stage disease was 10.3% for < 3 months (7/68), 18.2% for 3–12 months (2/11), and 66.7% for more than 12 months (12/18). We found a similar trend using the multivariate logistic regression analyses.

Prolongation of the patient interval was associated with advanced-stage disease among female patients with breast cancer.
Roles of preoperative anxiety and depression in the outcomes of microvascular decompression in hemifacial spasm for adolescent patients
Authors: Wu Fan , Wei Pingcun , Wang Gang , Wu Changsong , Hu Yunlong , Hu Jinwang
Published: August 2021

Hemifacial spasm (HFS) has been recognized as the frequently occurring disease of cranial nerve. At the same time, several articles indicate that, dystonia results in certain psychological disorders. Consequently, this study aimed to examine the association of preoperative depression and anxiety with HFS severity; meanwhile, the role in microvascular decompression (MVD) outcomes after surgery among adolescent patients was also examined.

All cases had been classified as two groups based on MVD outcomes among HFS cases; in addition, the preoperative Hamilton anxiety rating scale (HARS) and the Hamilton depression rating scale (HDRS) scores were compared between patients not and still suffering from spasm. Moreover, the multiple logistic regression model was employed in assessing the relationship between preoperative HARS as well as HDRS scores and outcomes of adolescent cases undergoing MVD.

The preoperative HARS and HDRS scores showed positive correlation with Cohen spasm grades in HFS patients. Meanwhile, compared with spasm-free group, patients of persistent spams group had apparently higher preoperative HARS and HDRS scores.

Our results suggest that, preoperative anxiety and depression status show close association with HFS severity, and they could also impact the MVD outcomes for adolescent cases.
Effect of psychosocial trauma and stress on sexual dysfunction in women with endometriosis
Authors: Fiala Ludek , Lenz Jiri , Bob Petr
Published: August 2021

Background:

Endometrial tissue plays an important role in the regulation of female fertility and there is evidence that endometrial pathology (including endometriosis) is closely related to endocrine disorders. On the other hand, various neuroendocrine changes can be significantly affected by psychosocial stress. In connection with these findings, we tested the relationship between neuroendocrine changes, sexual dysfunction, psychosocial/traumatic stress, and dissociative symptoms in women with endometriosis.

Methods:

A total of 65 patients with endometriosis were included in the study. Clinical examinations were focused on the biochemical analysis of neuroendocrine markers of endometriosis (cancer antigen 125 [CA 125] and cancer antigen 19-9 [CA 19-9]), estradiol, psychometric evaluation of sexual dysfunction, psychosocial/traumatic stress, and dissociative symptoms.

Results:

The results showed significant Spearman correlations between the values of the revised range of sexual difficulties for sexual dysfunction (Revised Female Sexual Distress Scale), psychosocial/traumatic stress (Trauma Symptoms Checklist) (R = 0.31), and dissociative symptoms (Somatoform Dissociation Questionnaire) (R = 0.33). Positive correlations were also found between CA 125 and CA 19-9 (R = 0.63), and between CA 125 and the results of the values of the revised scale of sexual difficulties for sexual dysfunction (Revised Female Sexual Distress Scale) (R = 0.29). Also psychosocial/traumatic stress (Trauma Symptoms Checklist) significantly correlated with CA 125 (R = 0.38) and with CA 19-9 (R = 0.33).

Conclusion:

These results represent the first findings regarding the relationship of the neuroendocrine markers CA 125 and CA 19-9 and sexual dysfunction with trauma/stress-related symptoms and dissociative symptoms in women with endometriosis.
Primary signet ring cell carcinoma of the uterine cervix
Authors: Kim Yeon Hee , Lee Su Jeong , Lee Seon Ui , Hwang In Sun , Yim Kwang Il , Kim Jin Hwi
Published: August 2021

Rationale:

Primary signet ring cell carcinoma of the uterine cervix is extremely rare and the clinical characteristics and prognosis are not well known and there are no specific guidelines for treatment.

Patient concerns:

A 43-year-old woman was referred to our hospital for abnormal uterine bleeding lasting 1 month.

Diagnoses:

Histological examination revealed a signet ring cell carcinoma of the uterine cervix. After evaluation of extragenital origin, the patient was diagnosed International Federation of Gynecology and Obstetrics stage IIIC1 primary signet ring cell carcinoma or the uterine cervix.

Intervention:

The patient was prescribed concomitant chemo-radiation followed by intracavitary brachytherapy.

Outcomes:

She showed no evidence of disease after treatment but, it recurred after 7 months of last treatment.

Lessons:

Different approaches to diagnosis and treatment of this rare disease are needed and molecular pathological studies related to the onset of the disease are required.
Effect of molecular targeted agents in chemotherapy for treating platinum-resistant recurrent ovarian cancer
Authors: Liu Luting , Xiong Wanchun
Published: August 2021

This study aimed to investigate the effect of molecular targeted agents (MTAs) in chemo on platinum-resistant recurrent ovarian cancer (ROC). We performed this meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements. Randomized controlled trials reporting data about platinum-resistant ovarian cancer treated by MTAs were included. The endpoints for the present study included overall survival and progression-free survival. We analyzed 9 randomized controlled trials including 3631 patients with ROC. The pooled analysis indicated that a combination of MTAs with chemo could markedly increase objective response rate in those patients (P = .012). Nevertheless, the survival rate of those patients was not markedly changed (P = .19). Besides, the combination of MTAs with chemo dramatically aggravated the occurrence of adverse events (P < .05). Moreover, it resulted in the termination of treatment (P = .044) in those patients, but it had no effect on fatal adverse events (P = .16). Our results indicated that the combination of MTAs with chemo notably improved objective response rate in patients with platinum-resistant ROC, but its benefit did not translate into survival benefits.
Role of a rapid response system and code status discussion as determinants of prognosis for critical inpatients
Authors: Higashino Makoto , Hiraoka Eiji , Kudo Yoshiko , Hoshina Yuiko , Kitamura Koichi , Sakai Masahiro , Ito Shinsuke , Fujimoto Yoshihisa , Hiasa Yoichi , Hayashi Koichi , Fujitani Shigeki , Suzuki Toshihiko
Published: August 2021

Rapid response systems (RRS) have been introduced worldwide to reduce unpredicted in-hospital cardiac arrest (IHCA) and in-hospital mortality. The role of advance care planning (ACP) in the management of critical patients has not yet been fully determined in Japan.

We retrospectively assessed the characteristics of all inpatients with unpredicted IHCA in our hospital between 2016 and 2018. Yearly changes in the number of RRS activations and the incidence of unpredicted IHCA with or without code status discussion were evaluated from 2014 to 2018. Hospital standardized mortality ratios were assessed from the data reported in the annual reports by the National Hospital Organization.

A total of 81 patients (age: 70.9 ± 13.3 years) suffered an unpredicted IHCA and had multiple background diseases, including heart disease (75.3%), chronic kidney disease (25.9%), and postoperative status (cardiovascular surgery, 18.5%). Most of the patients manifested non-shockable rhythms (69.1%); survival to hospital discharge rate was markedly lower than that with shockable rhythms (26.8% vs 72.0%, P < .001). The hospital standardized mortality ratios was maintained nearly constant at approximately 50.0% for 3 consecutive years. The number of cases of RRS activation markedly increased from 75 in 2014 to 274 patients in 2018; conversely, the number of unpredicted IHCA cases was reduced from 40 in 2014 to 18 in 2018 (P < .001). Considering the data obtained in 2014 and 2015 as references, the RRS led to a reduction in the relative risk of unpredicted IHCA from 2016 to 2018 (ie, 0.618, 95% confidence interval 0.453–0.843). The reduction in unpredicted IHCA was attributed partly to the increased number of patients who had discussed the code status, and a significant correlation was observed between these parameters (R
2 = 0.992, P < .001). The reduction in the number of patients with end-stage disease, including congestive heart failure and chronic renal failure, paralleled the incidence of unpredicted IHCA.

Both RRS and ACP reduced the incidence of unpredicted IHCA; RRS prevents progression to unpredicted IHCA, whereas ACP decreases the number of patients with no code status discussion and thus potentially reducing the patient subgroup progressing to an unpredicted IHCA.
Effect assessment of the application value of evidence-based nursing intervention in operating room nursing
Authors: Zhou You , Li Xin
Published: August 2021

Background:

The advantages of evidence-based nursing (EBN) intervention in health care settings have been widely disseminated to nurses throughout the world. More researches are reporting the effectiveness of EBN intervention in operating room nursing. However, the results are inconsistent. This study focuses on conducting a meta-analysis and systematic evaluation aimed at determining the usefulness of EBN intervention in operating room nursing.

Methods:

The Preferred Reporting Items for Systematic Reviews and Meta-analysis for Protocols criteria were used to write this paper. We will look for relevant studies from 2 Chinese databases (China National Knowledge Infrastructure and Wanfang database and also from 3 English databases such as Web of Science, Cochrane Library, PubMed, and EMBASE), to locate all relevant randomized controlled trials and observational studies assessing the application value of EBN intervention in operating room nursing from their commencement to June 2021. Separately, 2 authors will choose the studies, do the data extract and conduct the assessment probing into the likelihood of bias. If there is a disagreement, it will be resolved by the third author. RevMan 5.3 software and Stata 15.0 software will be used to conduct the meta-analysis.

Results:

The usefulness of EBN intervention in operating room nursing will be assessed in this study.

Conclusion:

The purpose of this research is to conclude the value of EBN intervention in operating room nursing and the quality of current data.

Ethics and dissemination:

Since there is no requirement for data on the individual patient, hence there will be no need for ethical approval.

OSF Number:

DOI 10.17605/OSF.IO/MSXNF
Impacts of the perioperative fast track surgery concept on the physical and psychological rehabilitation of total hip arthroplasty
Authors: Zhong Meiyan , Liu Dehuai , Tang Haijun , Zheng Yadong , Bai Yu , Liang Qinghua , Yang Xining
Published: August 2021

Studies have shown that rapid rehabilitation surgery has a positive effect on recovery after major orthopedic surgery. However, very few studies have examined the impact of fast track surgery on physical and psychological rehabilitation in patients who have undergone total hip replacement.

This study aimed to investigate the value of the rapid rehabilitation surgical model for patients undergoing total hip arthroplasty during the perioperative period.

We conducted a prospective cohort study that included patients who underwent total hip arthroplasty at our hospital from January 2015 to December 2018. We divided the patients into 2 groups – the rapid rehabilitation group and the conventional rehabilitation group – and compared their length of hospital stay, time to off-bed activity, pain score, Self-Rating Anxiety Scale scores, Self-Rating Depression Scale scores, complication rate, and rate of satisfaction during hospitalization.

A total of 348 patients were included in the study. Of these, 180 received rapid rehabilitation nursing and 168 patients received conventional nursing. Compared with the patients in the conventional rehabilitation group, those in the rapid rehabilitation group had shorter hospital stays (11.5 ± 1.2 day vs 15.5 ± 2.3 day, P = .021), resumed off-bed activities sooner (20.5 ± 3.4 hours vs 61.8 ± 4.7 hours, P = .001, had less postoperative pain (4.0 ± 1.2 vs 6.5 ± 1.1, P < .001), and lower anxiety and depression scores (anxiety score: 24.4 ± 2.1 vs 47.9 ± 2.9; depression score: 25.8 ± 1.8 vs 43.7 ± 1.7, P < .001).

The application of rapid rehabilitation surgery in total hip arthroplasty can accelerate patients’ postoperative recovery, relieve anxiety and depression, and increase the patient's satisfaction with the treatment.
The association between overweight and obesity on bone mineral density in 12 to 15 years old adolescents in China
Authors: Wang Leishen , Xu Zhongxian , Li Nan , Meng Xuemei , Wang Shuo , Yu Chengshu , Leng Junhong , Zhao Ming , Li Weiqin , Deng Yanmei
Published: August 2021

Overweight/obesity can influence bone mineral accretion, but the conclusions are not consistent. We aimed to examine the association between bone mineral density (BMD) levels and body mass index (BMI) in 12 to 15 years old adolescents.

We performed a cross-sectional study including 8365 adolescents. BMD was evaluated using a quantitative ultrasound device. Z scores for BMI were evaluated using World Health Organization references. Logistic regression models were performed to evaluate the association between BMD levels and BMI.

Totally 1866 (22.3%) adolescents had low /reduced BMD, and boys had a higher rate than girls (72.6% vs 27.4%, P < .001). The rates of thinness, normal weight, overweight, and obesity were 2.8%, 57.1%, 22.3%, and 17.8%, respectively. The multivariable-adjusted (age, sex, systolic blood pressure, and height Z score) ORs (95% CIs) of low/reduced BMD associated with BMI groups (thinness, normal [reference], overweight, and obesity) were 0.59 (0.39–0.89), 1.00, 1.61 (1.41–1.84), and 1.98 (1.69–2.30), respectively (P
trend < .001). This positive association existed in boys and girls though the differences were not significant between normal weight and thin girls. The multivariable-adjusted ORs for each 1-unit increase in BMI Z score were 1.36 (1.24–1.49) for girls, and 1.23 (1.16–1.30) for boys, and 1.26 (1.20–1.32) for all participants.

We observed a positive association between BMI and low/reduced BMD in 12 to 15 years old adolescents. More attention should be paid on overweight and obese adolescents to reduce the risk of low BMD. Further studies are needed to explore the mechanisms of this association.
Oral health status of inpatients with varying physical activity limitations in rehabilitation wards
Authors: Mun So Jung , Jeon Hyun Sun , Choi Eun Sil , Lee Ree , Kim Sung Hoon , Han Sun Young
Published: August 2021

Poor oral hygiene can be potentially life-threatening in inpatients. However, no basic protocol on oral hygiene customized for inpatients exists, and lack of oral care related knowledge, attitude, and skills among caregivers could be detrimental to the general health of patients. This study sought to identify the oral care practices and oral health status of inpatients with varying physical activity limitations in a rehabilitation ward.

Sixty-one inpatients in a rehabilitation ward were evaluated for their medical and physical conditions and oral health status. These were assessed using the bedside oral exam, decayed, missing, filled teeth index, plaque index, gingival index, and caries activity test.

In total, 40 men and 21 women (mean age, 56.6 years) were included in this study. Among them, 50.8% of the patients could brush their teeth unassisted, whereas 49.2% required assistance from an assistant for oral care. The proportion of patients receiving nasogastric tube feeding was higher in the group that could not provide oral self-care; 36.7% and 33.3% of these patients showed moderate and severe dysfunction, respectively, based on bedside oral exam. Scores for the swallowing, tongue, and total domains of bedside oral exam were poorer for patients who could not provide oral self-care (P < .01). The caries activity test indicated a moderate risk for both groups.

Our findings suggest that an oral care protocol that considers the physical activity limitations in inpatients in rehabilitation wards is necessary to minimize negative influences on the systemic health of these patients.
Network pharmacology study on the mechanism of the Chinese medicine Radix Isatidis (Banlangen) for COVID-19
Authors: Yu Bin , Lin Fei , Ning Hong , Ling Baodong
Published: August 2021

Radix Isatidis (Banlangen) is a well-known traditional Chinese medicine for the treatment of different diseases and prevention of many body disorders. Besides, it also plays a pivotal role in novel coronavirus pneumonia, coronavirus disease 2019 (COVID-19). However, few researchers know its active ingredients and mechanism of action for COVID-19. To find whether Banlangen has a pharmacological effect on COVID-19. In this research, we systematically analyze Banlangen and COVID-19 through network pharmacology technology. A total of 33 active ingredients in Banlangen, 92 targets of the active ingredients, and 259 appropriate targets of COVID-19 were obtained, with 11 common targets. The analysis of the biological process of gene ontology and the enrichment of Kyoto Encyclopedia of Genes and Genomes signaling pathway suggests that Banlangen participated in the biological processes of protein phosphatase binding, tetrapyrrole binding, the apoptotic process involving cysteine-type endopeptidase activity, etc. The COVID-19 may be treated by regulating advanced glycation end products/a receptor for advanced glycation end products signaling pathway, interleukin-17 signaling pathway, tumor necrosis factor signaling pathway, sphingolipid signaling pathway, and p53 signaling pathway. Banlangen has a potential pharmacological effect on COVID-19, which has the value of further exploration in the following experiment and clinical application.
Retrospective study of perioperative cardiac arrest from a Chinese tertiary hospital
Authors: Kan Huili , Ding Yonghong , Wu Shanshan , Zhang Zongwang
Published: August 2021

Studies on perioperative cardiac arrest in Chinese hospitals have rarely been retrieved from international journals. This survey evaluated the incidence, causes, and outcomes of perioperative cardiac arrests in a Chinese tertiary general hospital between July 2013 and December 2020. The incidence of cardiac arrest within 24 hours of anesthesia administration was retrospectively identified using an anesthesia database in Liaocheng People's Hospital. During the study period, there were 118,152 anesthetics. Data collected included patient characteristics, surgical procedures (elective or emergency), American Society of Anesthesiologists (ASA) physical status score, type of surgery, anesthesia technique, and outcome. Cardiac arrests were grouped into one of 3 groups: totally anesthesia-related, partially anesthesia-related, or anesthesia-unrelated. In total, 41 cardiac arrests (3.5:10,000) and 26 deaths (2.2:10,000) were found. Major risk factors for cardiac arrest were children under 1 year, adults between 19 and 65 years, and the elderly (>80 years) (P < .001), male patients (P = .02), emergency surgery (P < .001), and ASA grade V patients without anesthesia (P = .009). There were 19 anesthesia-related cardiac arrests (1.6:10,000) – 2 were totally related, and 17 were partially related to anesthesia. There were 9 anesthesia-related deaths (0.8:10,000), all of which were partially related to anesthesia. Perioperative cardiac arrests were correlated with age, gender, ASA grade and surgical procedures. The 2 most important patient factors leading to cardiac arrest were hemorrhagic shock from trauma and septic shock, respectively.
Improved and new-onset anemia during follow-up in patients with acute decompensated heart failure
Authors: Seko Yuta , Kato Takao , Morimoto Takeshi , Yaku Hidenori , Inuzuka Yasutaka , Tamaki Yodo , Ozasa Neiko , Shiba Masayuki , Yamamoto Erika , Yoshikawa Yusuke , Kitai Takeshi , Yamashita Yugo , Iguchi Moritake , Nagao Kazuya , Kawase Yuichi , Morinaga Takashi , Toyofuku Mamoru , Furukawa Yutaka , Ando Kenji , Kadota Kazushige , Sato Yukihito , Kuwahara Koichiro , Kimura Takeshi
Published: August 2021

There was no previous report on the prognostic impact of new-onset or improved anemia after discharge from acute decompensated heart failure (ADHF).

We analyzed 771 patients with ADHF and who were followed in multicenters in Japan was divided into 4 groups based on the hemoglobin values at discharge and 6-month index visit: 373 patients (48.4%) with persistent anemia, 87 patients (11.3%) with new-onset anemia, 91 patients (11.8%) with improved anemia, and 220 patients (28.5%) without anemia.

The primary outcome measure was a composite of all-cause death or HF hospitalization after index visit. The cumulative 6-month incidences of the primary outcome measure were 25.2% for persistent anemia, 18.5% for new onset anemia, 9.0% for improved anemia, and 9.2% for no anemia (log-rank P < .001). Compared with the no anemia group, the excess risk for the primary outcome measure remained significant in the persistent anemia group [hazard ratio (HR) 2.70, 95% confidence interval (95% CI), 1.45–5.44, P = .001] and in the new-onset anemia group (HR 2.73, 95% CI 1.19–6.25, P = .02), while it was not significant in the improved anemia group (HR 1.69, 95% CI 0.68–4.03, P = .25).

Persistent and new-onset anemia at 6-month visit were associated with a subsequent higher risk for all-cause death or HF hospitalization in patients with ADHF, suggesting the importance of detecting anemia during follow-up.
Comparison of chest computed tomography features between pulmonary tuberculosis patients with culture-positive and culture-negative sputum for non-mycobacteria
Authors: Kan Takamasa , Komiya Kosaku , Yamasue Mari , Itai Mariko , Tanaka Ai , Takeno Yukiko , Takikawa Shuichi , Hiramatsu Kazufumi , Kadota Jun-ichi
Published: August 2021

Although complication with non-mycobacterial pneumonia among patients with pulmonary tuberculosis (TB) may lead to poor prognosis, discrimination between TB complicated with and without non-mycobacterial pneumonia using radiological imaging has not been fully elucidated. We aimed to clarify the differences in chest computed tomography (CT) features between pulmonary TB patients with culture-positive and culture-negative sputum for non-mycobacteria.

We retrospectively included consecutive patients admitted to our hospital from January 2013 to December 2015 for bacteriologically-confirmed pulmonary TB, who were tested by sputum culture for non-mycobacteria, and who underwent chest CT within 2 weeks before or after admission. Chest CT features were compared between pulmonary TB patients who had positive non-mycobacterial cultures and in those who had not.

Of 202 patients with pulmonary TB, 186 (92%) were tested by sputum culture for non-mycobacteria and underwent chest CT. Among these, non-mycobacteria were isolated in 118 patients (63%), while 68 patients (37%) had negative cultures. Patients with a positive culture for non-mycobacteria were significantly older and had lower levels of physical activity and albumin, higher levels of C-reactive protein, and a greater number of respiratory failures. By CT, emphysematous lesions, ground-glass opacities, airspace consolidation, air-bronchogram, interlobular septal thickening, bronchiectasis, pleural effusion, pleural thickening, and lymph node enlargement were more frequently in patients with a positive culture for non-mycobacteria. These chest CT features could be helpful for detecting complication with non-mycobacterial pneumonia in patients with pulmonary TB.
Baduanjin exercise can alleviate anxiety and depression of patients with COVID-19 in Square cabin hospital
Authors: Zhang Xiao-Bo , Zhang Jin-Long , Li Ming-Xia , Yuan Ying-Pu , Sun Juan
Published: August 2021

To investigate the anxiety and depression of patients with the coronavirus disease 2019 (COVID-19) who participated in Baduanjin exercise.

From February 20, 2020 to March 7, 2020, the Hospital Anxiety and Depression scale (HAD) were used to investigate the anxiety and depression levels of patients with COVID-19 who participated in Baduanjin exercise. Ninety one questionnaires were received, including 40 males and 51 females. Stepwise regression analysis was used to analyze the effects of related factors on anxiety and depression levels.

In Square cabin hospital, 91% of patients participated in Baduanjin exercise had no obvious anxiety and 82% had no obvious depression. The scores of anxiety and depression of female patients were significantly higher than that of male patients. Bachelor degree or above with low scores for anxiety and depression. The frequency of Baduanjin exercise was negatively correlated with anxiety and depression score.

The development of Baduanjin exercise has a certain positive influence on the COVID-19 patients in the Square cabin hospital, which is conducive to alleviate anxiety and depression symptoms of the patients.
Left atrial myxoma with left ventricular myxoma diagnosed by ultrasound examination
Authors: Ji Xiang , Zhang Xia
Published: August 2021

Rationale:

Left ventricular (LV) myxoma is a rare type of benign cardiac tumor, which may result in unfavorable consequences due to embolism, arrhythmia, obstruction to the outflow tract, and other constitutional symptoms. LV myxoma can be easily misdiagnosed as LV thrombosis. Although some literatures have reported LV myxoma, the echocardiographic features of Left atrial (LA) myxoma with LV myxoma have rarely been reported till date. Here, we report case of LA myxoma with LV myxoma diagnosed by echocardiographic examination.

Patient concerns:

A 56-year-old male patient suffering from chest tightness and asthma for 6 months and progressive aggravation for 1 month was admitted to our hospital.

Diagnosis:

Echocardiographic imaging gave the suspicion of LA myxoma with LV myxoma, which was confirmed by pathology.

Interventions:

This patient was treated surgically.

Outcomes:

The patient had no postoperative complications and is currently under regular follow-up.

Lessons:

Echocardiography can be an effective imaging method for the evaluation of LV myxoma. The combination of echocardiography and clinical symptoms may help to make an accurate diagnosis.
A fenestrated persistent primitive hypoglossal artery harboring a ruptured aneurysm
Authors: He Sen , Wei Ming-Li , Xie Fei , Richard Seidu A.
Published: August 2021

Rationale:

Persistent primitive hypoglossal artery (PPHA) is a rare and permanent carotid-vertebrobasilar anastomoses. Patients with PPHA usually have higher changes of developing intracranial aneurysms due the high intracranial hemodynamics. Although cases of PPHA alone and PPHA with aneurysms have been reported in literature, cases of fenestrated PPHA harboring a ruptured aneurysm have seldomly be reported in literature. We present a rare occurrence of a fenestrated PPHA harboring a reputed aneurysm.

Patients concerns:

A 43-year-old woman was presented with a sudden-onset severe headache and nausea.

Diagnosis:

Computerized tomography scan showed third, fourth, and bilateral ventricular hemorrhages. Computed tomographic angiogram showed a PPHA with fenestration malformation and a cystic protrusion consistent with an aneurysm.

Intervention:

The patient underwent a successful stent-assisted coil embolization via the trans-arterial route under general anesthesia.

Outcomes:

Two years follow-up revealed no recurrence of her symptomatology and she is currently well and go about her normal daily life.

Conclusion:

Fenestrated PPHAs harboring aneurysms may be more prone to rupture because of the fenestration and connective tissue weakness of the artery as well as changes in hemodynamics of the already malformed and weak artery.
Mercury poisoning complicated by acquired neuromyotonia syndrome
Authors: Ran Enrong , Wang Maohe , Yi Yanxia , Feng Mei , Liu Yuanjun
Published: August 2021

Rationale:

Acquired neuromyotonia syndrome is a rare form of peripheral nerve hyperexcitability syndrome. It is characterized by spontaneous and continuous muscle contractions. Acquired neuromyotonia syndrome is mainly observed in patients with autoimmune diseases or tumors, but it is a rare neurological clinical manifestation in patients with mercury poisoning.

Patient concerns:

A 56-year-old woman presented with continuous and involuntary muscle twitching in her legs for 2 months; it was accompanied by a burning sensation in the lower limbs, insomnia, fatigue, and night sweats. These symptoms did not disappear during sleep.

Diagnoses:

Toxicological blood analysis via atomic fluorescence spectrometry revealed that the level of mercury was 0.07 μmol/L (normal level: <0.05 μmol/L). Her urinary mercury level measured using the cold atomic absorption method was 217.50 μmol/mol creatinine, which was considerably higher than the reference range (0–2.25 μmol/mol creatinine for people not in contact with mercury, 0–20 μmol/mol creatinine following long-term exposure). Upon further testing, a high level of mercury (10,572 mg/kg) was detected in the patient's cream. Accordingly, this patient was diagnosed with mercury poisoning.

Interventions:

Treatment with 2,3-dimercapto-1-propanesulfonic acid (DMPS) was initiated. Her urinary mercury level decreased to 9.67 μmol/mol creatinine, and her neuromyotonia syndrome and hyponatremia were relieved, with urine protein completely disappearing after 3 months of treatment.

Outcomes:

After DMPS treatment, the clinical manifestations of the nervous system disappeared and electrolyte parameters returned to normal levels.

Lessons:

Acquired neuromyotonia syndrome is a rare disorder caused by the hyperexcitability of peripheral nerves, resulting in spontaneous and continuous muscle contraction. Mercury poisoning should be considered in patients with neuromyotonia syndrome. Early detection of mercury poisoning can prevent unnecessary examinations and treatments.