bluuebunny/crossref_metadata_2025 huggingface dataset:
Combination of enoxaparin and low-dose aspirin for thromboprophylaxis in selective patients after primary total joint arthroplasty in a Taiwanese population
Authors: Tsai Shang-Wen , Chang Wei-Lin , Pai Fu-Yuan , Chou Te-Feng Arthur , Chen Cheng-Fong , Wu Po-Kuei , Chen Wei-Ming
Published: August 2023

Background:

The incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) after total joint arthroplasty (TJA) procedures are lower in Asian populations than in Caucasian populations. Therefore, the need for thromboprophylaxis in Asian patients undergoing TJA remains inconclusive. The aim of this study was to validate the clinical outcomes of thromboprophylaxis in selective TJA patients in a Taiwanese population.

Methods:

We retrospectively reviewed records of patients who underwent TJA procedures performed by a single-surgeon between January 2010 through December 2019. Patients received thromboprophylaxis with a combination of enoxaparin and low-dose aspirin if they fulfilled any of the following criteria: 1) body mass index >30 (kg/m2), 2) presence of varicose veins, 3) history of DVT or PE, or 4) simultaneous bilateral TJA procedure. We assessed the incidence of DVT and PE, 90-day postoperative complications, length of stay, in-hospital mortality, 30-day and 90-day readmission, and 1-year reoperation.

Results:

Of the 7511 patients included in this study, 2295 (30.6%) patients received thromboprophylaxis. For patients who received thromboprophylaxis(N = 2295), the incidence of DVT and PE were 0.44% and 0%, respectively. For patients who did not receive thromboprophylaxis (N = 5216), the incidence of DVT and PE was 0.46% and 0.04%, respectively. The overall rates of 90-day postoperative complications (2.3%), 30-day (1.8%) and 90-day readmission (2.3%), and 1-year reoperation (1.1%) were low.

Conclusion:

Providing thromboprophylaxis for selective TJA patients within the Taiwanese population was effective, as indicated by the low incidence of DVT and PE. Complications, such as surgical site infection, should be carefully weighed and managed.
Amplified HIV Transmission Risk Among People Living With HIV in Southeast Brazil
Authors: Reis Renata Karina , Antonini Marcela , Milanês Sousa Laelson Rochelle , Rocha Karyanna Alves de Alencar , Naiff Ferreira Glenda Roberta Oliveira , Vettore Mario Vianna , Gir Elucir
Published: August 2023

This study investigated the factors associated with amplified HIV transmission risk among people living with HIV from a city in southeast Brazil. A cross-sectional study was conducted with 397 people living with HIV recruited in infectious diseases clinics. Data on risk of HIV transmission, sociodemographic characteristics, sexual behaviors, professional counseling, serological HIV status, HIV-related clinical data, and beliefs about risk of HIV transmission were collected through interviews and medical records. Hierarchical ordered multinomial regression analyses were performed. Amplified HIV risk transmission was associated with lower age, alcohol consumption before having sex, illicit drug use before sexual intercourse, and not receiving professional counseling about HIV transmission. The belief that HIV can be transmitted to a partner not living with HIV was associated with lower likelihood of amplified risk for HIV transmission. Our findings suggest the importance of minimizing substance use before having sex, professional counseling, and beliefs about HIV transmission on amplified HIV risk transmission.
Impact of Bad Ragaz ring in hot spring water on knee osteoarthritis: A prospective observational study
Authors: Wang Jianqiang , Chen Zeng , Chen Xiaoqing , Yang Yang , Gan Wei , Wang Fachao
Published: August 2023

To evaluate the impact of the Bad Ragaz ring method (BRRM) in hot spring water for knee osteoarthritis (KOA), this prospective study enrolled KOA patients treated at the hospital between March 2020 and December 2020. The primary outcome was the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index score. A total of 60 patients were included, with 30 participants in the BRRM group and 30 patients in the non-BRRM group, respectively. The mean age was 56.4 ± 10.2 years (13 females), and the duration of disease was 5.0 ± 2.2 years in the BRRM group. The mean age was 56.0 ± 11.3 years (14 females), and the disease duration was 4.7 ± 2.1 years in the non-BRRM group. There were no differences between the 2 groups in the pain, stiffness, and function scores of the WOMAC (all P > .05) before treatment. The pre post difference in total WOMAC scores (56.57 ± 12.45 vs 36.81 ± 13.51, Cohen d = 1.52, P < .01) between the 2 groups was statistically significant. Compared with the non-BRRM group, the BRRM group showed lower scores for pain (6.5 ± 1.5 vs 8.1 ± 2.9, Cohen d = −0.69, P = .01), stiffness (2.7 ± 1.0 vs 5.0 ± 1.2, Cohen d = −1.93, P < .01), and function (14.8 ± 6.6 vs 26.7 ± 7.5, Cohen d = −1.68, P < .01) after treatment. In conclusion, the BRRM might improve the pain and function of patients with KOA.
Determinants of life dissatisfaction among adults in the United States: A cross-sectional analysis of the National Health Interview Survey
Authors: Miller Anna L. , Bhattacharyya Mehul , Bhattacharyya Ruemon , Frankhauser Frederick , Miller Larry E.
Published: August 2023

The number of Americans who report dissatisfaction with their quality of life has increased over the past several decades. This study investigated social- and health-related determinants of life dissatisfaction among adults in the United States (US). We conducted a cross-sectional observational study using data from the 2021 National Health Interview Survey, a nationally representative sample of adults in the US. We analyzed the association between self-reported life dissatisfaction and independent variables including demographics, family-level information, health status and conditions, functioning and disability, health insurance coverage, chronic pain, occupational variables, socioeconomic indicators, health-related behaviors, and psychological distress indicators. Survey multivariable logistic regression was used to determine the association among social- and health-related determinants and life dissatisfaction. The relative importance of each variable in the final model was determined using Shapley Additive Explanations values (0–100% scale). Among the 253.2 million civilian noninstitutionalized adults, 12.2 million (4.8%) reported life dissatisfaction. Recent psychological distress, unmarried status, poor general health, lack of social/emotional support, and lower food security were independently associated with life dissatisfaction (all P < .001). The relative importance of these variables in predicting life dissatisfaction was 39.3% for recent psychological distress, 22.2% for unmarried status, 18.3% for poor general health, 13.4% for lack of social/emotional support, and 6.9% for lower food security. Additionally, racial inequities were identified in the prevalence of these factors. Life dissatisfaction among adults in the US is associated with social- and health-related factors that are more prevalent in racial minority groups. The study findings suggest that resource prioritization should be targeted towards individuals with these factors, with particular emphasis on racial minority groups. This study aligns with US health policy initiatives and the results may help policymakers address the underlying factors contributing to life dissatisfaction among the US population.
Deep brain stimulation of the subthalamic nucleus improves sleep in Parkinson disease patients: A systematic review and meta-analysis
Authors: Zhu Keying , Peng Sun , Wu Yulun , Zhao Yuanyuan , Lu Zhonglei
Published: August 2023

Background:

Sleep disorders significantly affect the quality of life in Parkinson disease (PD) patients. Deep brain stimulation of the subthalamic nucleus has been reported to improve motor symptoms and decrease medication usage. However, the impact of subthalamic nucleus deep brain stimulation (STN-DBS) on sleep quality in PD patients remains to be definitively determined. This systematic review and meta-analysis, conducted following the preferred reporting items for systematic reviews and meta-analyses guidelines, aimed to clarify the effect of STN-DBS on sleep quality in PD patients.

Methods:

A rigorous literature search identified 6 studies, including 1 randomized controlled trial and 5 self-controlled trials, totaling 154 patients who underwent deep brain stimulation, providing 308 pairs of data for analysis. Parkinson disease sleep scale was the primary measure of interest, while the Movement Disorder Society-sponsored revision of the unified Parkinson disease rating scale was documented in all trials. Study quality was assessed using the Newcastle-Ottawa scale.

Results:

STN-DBS significantly improved Parkinson disease sleep scale scores (mean difference = 20.41, 95% CI: [13.03, 27.79], I² = 60.8%, P < .001), indicating enhanced sleep quality. Furthermore, a significant reduction in movement disorder society unified Parkinson disease rating scale part III scores postoperatively (mean difference = −12.59, 95% CI: [−14.70, −10.49], I² = 89.9%, P < .001) suggested improved motor function. PD medication usage was also significantly reduced postoperatively (mean difference = −314.71, 95% CI: [−468.13, −161.28], I² = 52.9%, P < .001). A sensitivity analysis confirmed the robustness of the main findings. The sample size was adequate, allowing for conclusive inferences.

Conclusion:

The present study, which comprises a comprehensive systematic review and meta-analysis, offers compelling evidence that STN-DBS can ameliorate sleep quality, augment motor function, and curtail medication consumption among individuals afflicted with PD.
Treatment of infected placenta accreta in the uterine horn by transabdominal temporary occlusion of internal iliac arteries: A case report and literature review
Authors: Xu Wenzhi , Liu Zhibao , Ren Qianqian , Dai Chang , Wang Bo , Peng Yangying , Gao Ling
Published: August 2023

Rationale:

This case report aims to describe the treatment of infected placenta accreta in the uterine horn by transabdominal temporary occlusion of internal iliac arteries.

Patient concerns:

A 29-year-old female patient had a history of retained placenta for 28 days after labor induction in the second trimester of pregnancy because of fetal malformation.

Diagnoses:

Placenta accreta in the uterine horn was diagnosed by 3-dimensional ultrasound and magnetic resonance imaging, and the diagnosis was confirmed during the operation.

Interventions:

Laparotomy was performed to remove the placenta and repair the uterine defect after temporary occlusion of both internal iliac arteries.

Outcomes:

Body temperature and inflammatory markers were elevated at admission but returned to normal on the second day after surgery. Normal menstruation resumed approximately 1 month postoperatively. Ultrasound examination showed that the shape of the uterine cavity was normal. No postoperative complications were observed.

Lessons:

Temporary occlusion of the internal iliac artery can help effectively manage infected placenta accreta in the uterine horn.
Periumbilical giant abscess and intestinal leakage in late pregnancy: A rare case report and literature review
Authors: Chen Xiaobin , Xu Lei , Xu Zhaojun , Fan Zuyou , Wang Lie , Qi Yafeng , Lin Chen
Published: August 2023

Background:

Complicated Periumbilical abscess in late pregnancy is rare in clinical practice. Pubmed searches for articles published from January 1980 to September 2021. Such related reports did not retrieve article about “pregnancy” and “periumbilical abscess.”

Case presentation:

We reported on a 34-year-old female patient who was admitted to the hospital with periumbilical pain for 3 days at 34 + 1 weeks of pregnancy. The result of imaging examination showed that there was an inflammatory mass in the middle and lower abdominal wall in the third trimester of pregnancy. The periumbilical abscess was punctured and drained first, and then the pregnant woman was assisted to give birth to a baby girl through vagina after the condition was stable.

Subsequently, laparotomy + abdominal abscess resection and drainage + partial small bowel resection + ileostomy were performed. Pathology showed inflammatory mass.

Conclusions:

Periumbilical abscess in the third trimester of pregnancy is rare clinically. For some pregnant women with previous trauma and surgical history, obstetric examination should not be restricted. For example, pregnant women with a history of abdominal surgery should expand the range of abdominal color Doppler ultrasound during the prenatal examination. When necessary, combine with computed tomography for diagnosis and treatment, avoid missed diagnosis, which will make the treatment more difficult and increase the risk. If the pregnant women has corresponding symptoms in the third trimester, vaginal delivery can be performed to terminate the pregnancy, and then the periumbilical abscess can be removed. At the same time, closely monitor the vital signs of newborn and mothers.
The effectiveness and safety of eyelid defect reconstruction after sebaceous carcinoma of the eyelid surgery: A protocol for systematic review and meta-analysis
Authors: Zhao Yu , Bai Rong , Hao Hongyan , Qi Wei , Li Sheng , Li Jun
Published: August 2023

Introduction:

Sebaceous carcinoma of the eyelid is the third most common eyelid malignancy, after basal cell carcinoma and squamous cell carcinoma. It is highly malignant and potentially aggressive. Surgical excision is currently the best treatment option for this condition. Patients often require reconstruction surgery to repair eyelid defects to achieve normal eyelid function and appearance. However, no comprehensive systematic review has assessed the efficacy and safety of eyelid defect reconstruction. This protocol was developed to conduct a systematic review and meta-analysis to evaluate evidence related to the efficacy and safety of reconstruction.

Methods:

We will systematically search the Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure, WanFang Database, and Chinese Biomedical Literature Database from their inception to February 2023 for studies on eyelid defect reconstruction. We will identify other potential studies using multiple methods such as manual searching. The outcomes were eyelid function, eyelid morphology, patient satisfaction, recurrence rate, metastasis rate, tumor-related mortality, and adverse events. Two researchers will independently screen titles and abstracts, identify full-text studies for inclusion, extract data, and appraise the risk of bias in the included studies. A meta-analysis will be conducted using Review Manager 5.4 and R software. The certainty of evidence will be appraised by grading of recommendations, assessment, development, and evaluation system.

Results:

This full-text will adhere to the preferred reporting items for systematic reviews and meta-analyses statement to ensure clarity and completeness of reporting in all phases of the systematic review.

Discussion:

This study provides evidence of the efficacy and safety of reconstruction methods for sebaceous carcinoma of the eyelid.
Evaluation of ABO/Rh blood group distributions in papillary thyroid cancer patients
Authors: Dogan Ozlem
Published: August 2023

The study aimed to evaluate the ABO/Rh blood group distributions and their relationship with clinical-pathological features in papillary thyroid cancer patients. It was planned as a retrospective case-controlled study. The blood group distributions of the patients were contrasted with that of the general population. Additionally, the association between clinical-pathological variables and blood group distribution was assessed. Two hundred and ninety-three patients were involved in the study. The median age was 48 years, and the majority of patients were female (84.3%). The most common variants of papillary thyroid cancer were follicular, classical, and oncocytic. The majority of the patients had stage 1 (91.1%) disease at the time of diagnosis. ABO blood group distributions in the patient (47.4% A, 11.9% B, 8.2% AB, 32.4% O) and control (42% A, 16% B, 8% AB, 34% O) groups were found to be similar (P = .8). In terms of Rh factor, there was a comparable distribution for the characteristics of the patient and healthy control group (P = .6). There was no association between clinical and pathological variables and blood group distributions (gender, age, tumor stage, tumor location, and pathological tumor variant). Comparing patients with papillary thyroid carcinoma to the healthy control group, the prevalence of the A blood group numerically increased while the prevalence of the B blood group numerically decreased, but it was not statistically significant. In addition, ABO/Rh blood type and clinical and pathological variables did not relate.
Corneal biomechanics after small incision lenticule extraction and femtosecond laser in situ keratomileusis: A systematic review and meta-analysis
Authors: Chen Songbai , Ma Hongjie , Zhao Congling
Published: August 2023

Background:

Small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK) have been extensively studied as the main surgical methods for corneal refractive surgery. However, there is no consensus on whether SMILE is superior to FS-LASIK in corneal biomechanics. Therefore, this systematic review and meta-analysis used the results of ocular response analyzer and corvis ST to explore whether SMILE is superior to FS-LASIK in corneal biomechanics.

Methods:

The literature was searched in PubMed, EMBASE, and Controlled Trials Register databases. The Cochrane Collaboration’s “risk of bias” tool was used to evaluate the quality of the included randomized clinical trials, and the Newcastle-Ottawa Scale was used to evaluate the included non-randomized controlled trials. The results were analyzed using Revman 5.3.

Results:

Sixteen studies (3 randomized clinical trials and 13 non-randomized controlled trials) were included in this meta-analysis. There was no statistical difference in corneal biomechanics between SMILE and FS-LASIK in corneal hysteresis [mean difference (MD), 0.20; 95% confidence interval (CI): −0.09, 0.49; P = .18] and corneal resistant factor (MD, 0.31; 95% CI: −0.09, 0.71; P = .13), A1 time (MD, −0.02; 95% CI: −0.11, 0.07; P = .66), A1 length (MD, 0.01; 95% CI: −0.01, 0.03; P = .42), A1 velocity (MD, 0.00; 95% CI: −0.01, 0.01; P = .85), A2 velocity (MD, −0.01; 95% CI: −0.11, 0.09; P = .86), HC time (MD, 0.12; 95% CI: −0.13, 0.38; P = .35), The stiffness parameter at first applanation (MD, −7.91; 95% CI: −17.96, 2.14; P = .12), The ratio between the deformation amplitude 2 mm away from apex and the apical deformation (MD, 0.01; 95% CI: −0.26, 0.27; P = .96).

Conclusion:

A comprehensive assessment of the parameters of ocular response analyzer and corvis ST showed that SMILE is not superior to LASIK in corneal biomechanics 3 months post-surgery.
The “Trunk sign”: A novel X-ray sign in galactography of patients with nipple discharge suggesting malignancy
Authors: Wu Tujin , Zhang Kai , Wang Yawen , Ma Rong
Published: August 2023

The etiology of nipple discharge is often unclear, and there are few studies exploring diagnostic approaches of nipple discharge. Galactography is a common method for clinical diagnosis of patients with nipple discharge. Therefore, this study aimed to evaluate the use of galactography in differentiating between benign and malignant lesions in patients with nipple discharge. A retrospective study of 161 patients with nipple discharges, who were evaluated with galactography and underwent surgery in Qilu Hospital of Shangdong University between January 2018 and December 2019, was conducted. Baseline characteristics were obtained from their electronic records including age, menstruation status, physical examination, galactography, cytology, and pathology. There were 110 cases of benign disease, 12 cases of high-risk disease, and 39 cases of malignant disease. With respect to benign diseases there were 26 (23.6%) patients with hyperplasia and ductal ectasia, and 94 (76.4%) with intraductal papilloma. With respect to high risk diseases, there were 2 (16.7%) patients with atypical intraductal papilloma and 10 (83.4%) with atypical hyperplasia. With respect to malignant lesions, 19 (48.7%) patients had intraductal carcinoma, 4 (10.3%) had solid papillary carcinoma, and 16 (41.0%) had invasive carcinoma. The significant findings of our study are as follows: patients with malignant diseases had a higher proportion of concomitant masses (74.4% vs 41.7% vs 22.7%, P < .001), positive spill cytology (51.3% vs 41.7% vs 2.7%, P < .001), and trunk signs (71.8% vs 33.3% vs 10.9%, P < .001). A forest plot revealed that trunk signs were related to an increased risk of malignant diseases in almost all the subgroups. Galactography is important for the differential diagnosis of benign and malignant lesions in nipple discharge, and the “Trunk sign” is an important radiographic sign of malignant lesions. Combining galactography with other methods is advisable to improve the accuracy of diagnosis in patients with nipple discharge.
Investigation of target genes and potential mechanisms related to compound Xiao-ai-fei honey ointment based on network pharmacology and bioinformatics analysis
Authors: Abudurousuli Kayisaier , Talihati Ziruo , Hailati Sendaer , Han Meng Yuan , Nuer Muhadaisi , Khan Nawaz , Maihemuti Nulibiya , Dilimulati Dilihuma , Nueraihemaiti Nuerbiye , Simayi Jimilihan , Zhou Wenting
Published: August 2023

Background:

Compound Xiao-ai-fei honey ointment (CXHO) is an anticancer preparation with a long history in Uyghur folk medicine in China and has been used for the treatment of gastric cancer (GC) in Xinjiang, China. Nevertheless, the mechanism of its anticancer effect remains to be investigated.

Methods:

Bioactive ingredients of CXHO were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database. Target genes of ingredients were acquired via the PubChem and Swiss target prediction database. Gene expression profiling of GC was obtained from GSE54129 in the GEO database and analyzed using the limma package in R. The hub genes associated with CXHO in GC were validated using the TIMER2.0 database, GEPIA2 database and Auto Dock tools. The effect of CXHO on migration of GC cells was detected by Transwell chamber assay and Wound healing assay. The effect of CXHO on expression levels of MMP2/MMP9 and NF-κb, PI3K/AKT signaling pathway was detected by Western blot assay.

Results:

Forty-five bioactive ingredients and their 819 related genes were found. A total of 462 differentially expressed genes were identified between GC patients and healthy controls. Seventeen common target genes were identified as hub genes CXHO against GC. Among them, MMP2 and MMP9 were significantly associated with tumor immune infiltrates and had good binding affinity with effective ingredients. Moreover, we validated the mRNA and protein expression levels and prognostic value of MMP2 and MMP9 by different databases. In addition, Kyoto encyclopedia of genes and genomes and gene ontology analyses showed that the 17 common target genes were mainly involved in steroid hormone biosynthesis and cancer-related pathways. Experimental results showed that CXHO inhibited migration of GC cells and down regulated the expression levels of MMP2/MMP9, NF-κb. In addition, CXHO can inhibited PI3K/AKT signaling pathway.

Conclusion:

We identified and experimental validated 2 pivotal target genes of CXHO against GC and preliminarily analyzed the potential mechanisms by which CXHO inhibits the development of GC. All these findings support CXHO as a promising drug for the treatment of GC.
Chinese medical students reflections on medical professionalism: A qualitative thematic analysis
Authors: Wang You-Yang , Chang Chuheng , Shi Wen , Huang Xiao-Ming , Jiao Yang
Published: August 2023

There is no common medical professionalism framework in China, mandating work to conceptualize professionalism from various perspectives. Studies on students viewpoints about medical professionalism are limited. Therefore, this study aimed to investigate how Chinese medical students perceive professionalism to provide a reference for future medical education reform and policy development. Fifty-four written reflections on medical professionalism were collected from first-year students of China 4 + 4 medical education program enrolled in 2020 to 2021 academic years. Essays were subjected to thematic analysis using NVivo 12. Three main themes emerged: inter-personal, intra-personal, and public professionalism. Students emphasized the importance of physician-patient relationships, proficiency of medical knowledge, and enthusiasm for promoting health-related issues. By contrast, teamwork and confidentiality were not considered essential aspects of professionalism. The medical professionalism framework articulated by students in China was roughly the same as in other countries. Where there were differences, these may have been due to the unique sociocultural environment. Future medical professionalism education should be adjusted according to students understanding of professionalism.
Are iodophor-impregnated drapes associated with lower intraoperative contamination compared to no adhesive drape?: A protocol for systematic review and meta analysis
Authors: González-Sagredo Albert , Carnaval Thiago , Granados-Suárez Silvia , Peralta Robert Josua Cedeño , López-García Paula , Durall Albert Castellà , Videla Sebastián , Vila Ramon , Iborra Elena
Published: August 2023

Background:

Surgical site infection (SSI) is one of the most frightening complications after surgery. Adhesive drapes (AD) are widely used as an infection prevention tool. They can be non-impregnated or iodophor-impregnated, although non-impregnated are less used as they might be related to higher number of infections. One of the most common ways to study their efficacy is by analyzing the intraoperative contamination, which is a useful primary endpoint as it does not need follow-up and it has been strongly associated with infections. Therefore, we believe a systematic review (SR) and meta-analysis is needed to determine which is the literature available about this topic and to explore their results.

Methods:

All randomized controlled trials (RCT) published since 1984 through to January 15, 2023 will be included. Non-human and experimental studies will be excluded. We will only include studies written in English. We will conduct searches in the following electronic databases: MEDLINE (via PubMed), SCOPUS and Web Of Science. The protocol of the SR was registered in PROSPERO under the number CRD42023391651 and was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol guidelines.

Discussion:

The evidence regarding the benefits of using iodophor-impregnated adhesive drapes (IIAD) is scarce. Therefore, this SR and meta-analysis is required to determine if they are related with a lower intraoperative contamination incidence, compared to no AD.
The effects of propranolol on the biology and Notch signaling pathway of human umbilical vein endothelial cells
Authors: Chen Shuming , Zhao Xuekai , Huang Junjie , Lin Na , Xu Qianhui , Chen Jianwei , Huang Jianqiang , Wang Lie , Lin Chen , Zhang Zaizhong
Published: August 2023

Background:

Propranolol is the first choice for treating infantile hemangioma (IH). How propranolol works in IH remains unclear. Infantile hemangioma endothelial cells (HemECs) express Notch1, Jagged, Hey1, and other molecules in the Notch pathway, suggesting that Notch pathway-related molecules play an important role in affecting vascular endothelial cell proliferation. Whether propranolol can affect the Notch signaling pathway in IH treatment is unclear.

Methods:

We performed this study to observe the effect of propranolol on the expression of Notch signaling pathway molecules in human umbilical vein endothelial cells (HUVECs) and to explore the therapeutic mechanism of propranolol on IH. HUVECs cultured in vitro were exposed to 60, 120, 240, 360, or 480 µM propranolol. The morphological changes of the HUVECs were observed under an inverted microscope. HUVECs proliferation was detected with Cell Counting Kit-8 (CCK-8). The effects of propranolol on HUVECs apoptosis were detected by flow cytometry. The role of Notch in propranolol inhibition of HUVEC proliferation was analyzed with real-time polymerase chain reaction (PCR) and western blotting.

Results:

Propranolol reduced HUVECs numbers and altered their morphology. The inhibitory effect of propranolol on cell proliferation was dependent on the reaction time and drug concentration. Propranolol upregulated Jagged1, Notch1, and Hey1 expression and downregulated delta-like ligand4 (DLL4) expression.

Conclusions:

Propranolol may play a role in IH treatment by increasing Jagged1 expression in endothelial cells, activating the Notch pathway and inducing the upregulation of the downstream target gene HEY1.
Intestinal flora in the constipation patients before versus after lactulose intervention
Authors: Ma Jianxia , Ma Houlian , Zheng Songbai , Yu Xiaofeng , Wang Ke , Wang Jun , Pan Yiru , Yao Jianfeng
Published: August 2023

This study aimed to investigate the characteristics of intestinal flora in patients with chronic functional constipation before and after lactulose intervention. Twenty-nine patients with constipation in the treatment group received oral lactulose (15 mL/d) for a month. Twenty healthy subjects served as controls. Stool specimens were collected before and after lactulose treatment. Fecal bacteria were examined by 16SrRNA gene sequencing and bioinformatics analysis. After lactulose treatment, most bacteria in the constipation group, including Bifidobacteria, Bacillus cereus, Prevotella, Bacillus, Anaerostipes, Oribacterium, and Mogibacterium increased as compared to those in the healthy control group. Anaerotruncus declined in the healthy control group after lactulose treatment. Our study shows lactulose can increase the abundance of probiotics, optimize the intestinal microenvironment, and alleviate constipation.
Efficacy of Baduanjin for treatment of fatigue: A systematic review and meta-analysis of randomized controlled trials
Authors: Liu Haoyu , Liu Siling , Xiong Lu , Luo Bingquan
Published: August 2023

Background:

Numerous studies have suggested that Baduanjin, a traditional Chinese exercise, can alleviate fatigue symptoms in patients with various illnesses. The aim of this review was to evaluate the efficacy of Baduanjin in reducing fatigue symptoms.

Methods:

A comprehensive literature search was conducted using several databases, including PubMed, Web of Science, Embase, Medline, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang, from inception to June 2023. Relevant studies reporting on the effects of Baduanjin on fatigue symptoms were included. A random-effects meta-analysis model with standardized mean differences was used to estimate the treatment effects. Moderator analyses were conducted using continuous variables and meta-regression. This review was registered in the International Prospective Register of Systematic Reviews (identifier CRD42023411532). Grading of recommendations, assessment, development and evaluations framework was used to assess the certainty of evidence.

Results:

Ten randomized controlled trials with patients diagnosed with 9 different diseases were included in the meta-analysis. The Baduanjin intervention groups showed significant improvements in total fatigue intensity (standard mean difference = −0.49, 95% confidence interval = −0.69 to −0.30, P = .000; I2
= 56%, P = .009). The statistically significant differences in the subgroup analyses, including intervention durations, age of participants, fatigue types, and practice location, remained unchanged. Meta-regression showed that practice place might have significant effect on the results. The certainty of the evidence was moderate for participants 55-year younger or in hospital training. However, fatigue, different groups, participants 55-year or older, training at home, and different fatigue types had lower evidence certainty.

Conclusion:

Baduanjin can effectively alleviate fatigue symptoms with relatively flexible requirements. However, studies investigating the same disease types and including non-Chinese populations are scarce. Therefore, further studies with long-term interventions, larger sample sizes, and well-designed methodologies are warranted.
Pharmacologic treatment of a postpartum ovarian vein thrombosis: Case report
Authors: Gao Qianqian , Xiong Jinqiu , Jiang Hong
Published: August 2023

Introduction:

Postpartum ovarian vein thrombosis (POVT) is a rare disease, and could cause severe complications if ignored. We report a case of POVT, including the patient clinical features, diagnostic methods, treatment, and follow-up results.

Case presentation:

A 30-year-old Asian woman was admitted to our hospital because of spontaneous abortion. After the miscarriage, she presented with fever and right lower abdominal pain. A physical examination revealed abdominal tenderness in the right lower quadrant with a palpable mass. Laboratory tests showed leucocytosis and elevated C-reactive protein. Abdominal ultrasound (US) and computed tomography revealed right ovarian vein thrombosis (OVT). The patient was treated with systemic anticoagulation and antibiotics and was discharged 22 days later on a regimen of an oral anticoagulant. 1.5 months after discharge, an US with a color Doppler examination showed no OVT.

Conclusion:

A high index of suspicion is required in cases of abdominal pain and fever after delivery, especially if unresponsive to antibiotics. It should be differentiated from acute appendicitis, accessory abscess, endometritis, ovarian torsion, and other acute abdominal diseases. For a POVT case with a definite diagnosis, drug treatment may be effective enough.
Association between creatine phosphokinase level within normal range and bone mineral density in adolescents
Authors: Wang Zhenwei , Du Weibin , Han Meichun , He Lihong , Zhang Hongwei , Hu Jintao , Quan Renfu
Published: August 2023

Currently, it is unclear whether creatine phosphokinase (CPK) affects bone mineral density (BMD) in adolescents. We sought to clarify the relationship between CPK and total BMD in adolescents aged 12 to 19 years within normal values by conducting this study. A cross-sectional study was conducted using the 2011 to 2018 National Health and Nutrition Survey data to examine 1188 males (average age, 15.2 years) and 1629 females (average age, 15.4 years). In this study, CPK was the independent variable and total BMD was the outcome variable. In addition to using multivariate linear regression models, subgroup analyses were also conducted in order to examine the relationship between CPK levels and total BMD within normal ranges. Significant positive association was observed between the CPK levels and total BMD in adolescents (model 1: 0.0003 [0.0002, 0.0004], model 2: 0.0004 [0.0003, 0.0005] and model 3: 0.0004 [0.0003, 0.0004]). After adjusting for age, gender, race/ethnicity, body mass index, dietary protein intake, dietary protein intake, dietary fiber intake, poverty to income ratio, physical activities, total cholesterol, total protein, blood urea nitrogen, phosphorus, and serum calcium, CPK levels remained significantly associated with BMD (regression coefficients for quartiles 2 to 4 vs quartile1 were 0.0002, 0.0072, and 0.0154, respectively; P for trend <.001). The association was positive even when stratified by age, gender, and race. Further, adolescents aged 16 to 19 years were more likely to report positive relationships than adolescents aged 12 to 15 years. And the phase relationship between total BMD and CPK was further enhanced in boys. The results of our study show that CPK levels within the normal range are positively associated with total BMD in adolescents aged 12 to 19 years. Additionally, CPK may be a potential biomarker of bone health among adolescents.
Efficacy and safety of alfentanil plus propofol versus propofol only in painless gastrointestinal endoscopy: A meta-analysis
Authors: Yang Huan , Shi Xiaoling , Li Jinping , Yang Longqiu
Published: August 2023

Background:

To systematically evaluate the efficacy and safety of alfentanil plus propofol versus propofol only for painless gastrointestinal endoscopy.

Methods:

The Cochrane Library, PubMed, Embase, China Biology Medicine, CNKI, WanFang, and VIP databases were searched to identify randomized controlled trials on alfentanil combined with propofol versus propofol only for painless gastrointestinal endoscopy from the inception of the database to August 2022. The Rev Man 5.4 software was used for statistical analyses.

Results:

Thirteen randomized controlled trials involving 1762 patients were identified as eligible for this study. The meta-analysis showed that compared with propofol, alfentanil combined with propofol had a more stable mean arterial pressure [mean difference (MD) = 5.38, 95% confidence interval (CI): 1.97–8.80; P = .002], heart rate (MD = 3.78, 95% CI: 1.30–6.26; P = .003) and pulse oxygen saturation (MD = 1.90, 95% CI: 0.93–2.78; P = .0001); a lower propofol dose (standard mean difference = −2.82, 95% CI: −3.70 to −1.94; P < .00001), lower awakening time (MD = −3.23, 95% CI: −4.01 to −2.45; P < .00001) and lower directional force recovery time (MD = −3.62, 95% CI: −4.22 to −3.03; P < .00001); a lower incidence of nausea and vomiting (relative risk [RR] = 0.32, 95% CI: 0.14–0.71; P = .005), body movement (RR = 0.27, 95% CI: 0.13–0.54; P = .0002), hypotension (RR = 0.23, 95% CI: 0.12–0.46; P < .0001), respiratory depression (RR = 0.37, 95% CI: 0.15–0.89; P = .03) and cough reflex (RR = 0.33, 95% CI: 0.12–0.89; P = .03).

Conclusion:

This meta-study found that current evidence indicates that alfentanil plus propofol is better than propofol alone for painless gastrointestinal endoscopy and is associated with a lower incidence of adverse reactions. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to validate these above conclusions.
The correlation between serum levels of alkaline phosphatase and bone mineral density in adults aged 20 to 59 years
Authors: Cheng Xiaosong , Zhao Chengjin
Published: August 2023

Serum alkaline phosphatase (ALP) plays an important role in bone metabolism. However, the association between serum ALP and bone mineral density (BMD) remains inconclusive. Therefore, this study aimed to explore the relationship between serum ALP levels and pelvic BMD in young adults. We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey conducted from 2011 to 2016. Serum ALP levels and pelvic BMD were analyzed as independent and dependent variables, respectively. Weighted multivariate linear regression models and stratified analysis by age, sex, and race/ethnicity were applied after controlling for confounding factors to assess the relationship between serum ALP and pelvic BMD. Smooth curve fitting and threshold effect analysis were used to describe the nonlinear relationship between the 2 variables. A total of 7796 participants (4063 males and 3733 females) aged 20 to 59 years were included in this study. When serum ALP was represented as a continuous variable and fully adjusted in the regression model, ALP was significantly negatively correlated with pelvic BMD (β = −0.0008, 95% confidence interval: −0.0010 to −0.0006, P < .000001); this significant negative correlation persisted when ALP was transformed into a categorical variable, and was consistent in subgroup analyses. Additionally, smooth curve fitting and threshold effect analysis showed a persistent negative correlation between serum ALP and pelvic BMD, with a saturation effect at 97 U/L. Our results revealed a negative correlation between serum ALP levels and pelvic BMD in young adults. Monitoring serum ALP levels could help in the early detection of risks for bone metabolic disorders such as osteoporosis.
The application of cognitive behavioral therapy in patients with schizophrenia: A review
Authors: Xu Feifei , Zhang Hang
Published: August 2023

The aim of this review is to explore the clinical nursing application of cognitive behavioral therapy (CBT) in patients with schizophrenia. A literature search was conducted using the CINAHL and MEDLINE databases. The database search occurred during the month of December 2022. This article comprehensively summarizes the theoretical basis of CBT in improving schizophrenia in clinical nursing, its application in managing symptoms and improving social function, as well as research progress in this field. There are still inconsistencies in the research results on CBT, but overall, psychological intervention combined with drug treatment is more effective than conventional treatment alone. If social function training can be added at the same time, it is believed that it will have better effects on clinical treatment and can maintain long-lasting effectiveness. Only in this way can patients truly understand and recognize the disease, improve treatment compliance, and ultimately achieve the goal of improving prognosis and quality of life.
Polycythemia as an Uncommon Finding in 2 Children, One With Systemic Capillary Leak Syndrome and the Other With Protein-losing Enteropathy Caused by CD55 Deficiency
Authors: Kaya Zühre , Derinöz Okşan
Published: August 2023

We report 2 children with distinct causes of polycythemia, 1 from systemic capillary leak syndrome (SCLS) and the other from protein-losing enteropathy (PLE) caused by CD55 deficiency. There is only a single case series about polycythemia in children with SCLS, but none on polycythemia in children with PLE. We present a 10-year-old girl with hypoalbuminemia, polycythemia, and edema who died as a result of an SCLS attack and a 1-year-old girl with PLE who was successfully treated with eculizumab. Our experience suggests that hematologists should be alert for SCLS and PLE in children with relative polycythemia.
Clarithromycin-induced acute liver injury in a patient with positive Helicobacter pylori: a case report and review of the literature
Authors: Sharma Nava Raj , Wagle Abhishesh , Bist Manoj , Panthi Bishal , Pokhrel Dahal Ritu , Rokaya Rajesh , Shrestha Rayana , Pokhrel Madalasa
Published: August 2023

Introduction and importance:

While 14-day triple therapy with clarithromycin is a common approach for eradicating Helicobacter pylori infection, it is essential to note that this treatment does not come without potential side effects.

Case presentation:

We present the case of a 34-year-old male who presented to the emergency department with severe vomiting and abdominal pain. Subsequent evaluation revealed that the patient had developed drug-induced liver injury (DILI).

Clinical discussion:

DILI can cause acute hepatocellular or cholestatic damage, and chronic injury can lead to hepatocellular, cholestatic, vascular, or neoplastic manifestations.

Conclusion:

Clinicians should exercise caution and be alert to the potential hepatotoxic effects of medications, especially when initiating triple therapy for H. pylori infection.
Exploring the transformative influence of neuroplasticity on stroke rehabilitation: a narrative review of current evidence
Authors: Aderinto Nicholas , AbdulBasit Muili O. , Olatunji Gbolahan , Adejumo Temilade
Published: August 2023

This review aims to assess the role of neuroplasticity in facilitating stroke recovery and identify the challenges and limitations associated with its implementation. A comprehensive literature search was conducted to identify relevant studies, which were meticulously evaluated to determine the potential solutions for effectively harnessing neuroplasticity. The results indicate that neuroplasticity holds significant promise in stroke rehabilitation; however, individual variability in response to interventions, timing and duration of interventions and sociocultural and clinical factors pose challenges. Tailoring interventions to individual patient characteristics is crucial for optimising the impact of neuroplasticity. Despite challenges and limitations, the transformative potential of neuroplasticity in stroke rehabilitation is undeniable. The abstract concludes by emphasising the importance of a comprehensive understanding of individual variability, optimising intervention timing and duration and considering sociocultural and clinical factors. Future research and clinical practice should prioritise personalised interventions and interdisciplinary collaborations to fully exploit the vast potential of neuroplasticity in stroke recovery.
Long COVID syndrome: psychological and sexual dysfunction among survivors of COVID-19 infection
Authors: Khan Sana A. , Ashkar Rabeeah , Kumari Sona , Khenhrani Raja R. , Ullah Shafqat , Rajpar Rahimeen , Arshad Hareem , Haque Johum Aziz , Abbas Kiran , Khan Javeria , Poudel Bipin , Bhandari Sushmita , Ahmed Moiz , Dars Jawed A.
Published: August 2023

Background:

To explore the neuropsychiatric symptoms, sleep disturbances, and sexual dysfunction in patients with long COVID syndrome, which can help in building better follow-up strategies for coronavirus disease 2019 (COVID-19) survivors.

Material and methods:

A cross-sectional research was undertaken at the premises of a psychiatry unit at a tertiary care unit in Karachi, Pakistan, between August 2022 and April 2023. All individuals aged 18 years or older, who had a history of contracting COVID-19 infection in the last 12 months presented to the department of Psychiatry with neuropsychiatric symptoms were recruited. Using a predefined questionnaire, data was collected from the participants. A linear logistic regression was used to find the impact of age, sex, hospitalization, and duration of home isolation on the likelihood of persistent neuropsychiatric symptoms or sexual dysfunction.

Results:

A total of 457 patients were included. It was found that individuals were less likely to experience neuropsychiatric symptoms as age increased (OR=0.968, 95% CI: 0.949–0.986, P=0.001). Females were 4.8 times more likely to experience neuropsychiatric symptoms than males, and the association was extremely significant (OR=4.851, 95% CI: 3.085–7.626, P<0.0001). An increase in age raised the odds of having sleep disturbances among the survivors by 2.7 times (OR=2.672, 95% CI: 2.654–2.684, P<0.0001). The odds of having sleep disturbances were three times more likely in female participants as compared to male participants (OR=3.00, 95% CI: 1.771–5.094, P<0.0001).

Conclusion:

The majority of the COVID-19 survivors are presenting with persistent neuropsychiatric and sexual symptoms in our setting. Therefore, it is necessary to maintain proper follow-up with the survivors of COVID-19 and counsel the patients to inform the family physician if these symptoms persist for longer than a month. Increasing such practices of regular follow-ups with COVID-19 survivors can help in detecting early neuropsychiatric and sexual changes.