bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraoperative Ultrasound-Guided Resection for Extracranial Arteriovenous Malformations of the Head and Neck
Authors: Colletti Giacomo , Nocini Riccardo , Rozell-Shannon Linda , Chiarini Luigi , Anesi Alexandre , Dessy Margherita
Published: November 2022

Objectives:

Arteriovenous malformations (AVM) are a highly aggressive and difficult to manage disease. Treatments such as proximal ligation, partial embolization, and incomplete surgical removal often lead to a relapse that is worse than the “virgin” condition. Thus, when surgery is chosen with curative purposes, a radical resection must be obtained. Color Doppler can offer a way to more reliably plan resection margins and, if needed, extend the excision of the AVM to obtain radicality.

Methods:

Nine patients with S1–S3 facial AVMs underwent radical surgical resection with the aid of Color Doppler Ultrasound (CDUS). CDUS was used to define the margins of the exeresis, to check for residual disease and, in case, to extend the resection. Primary closure or local flaps were used to reconstruct the defect.

Results:

Histology showed AVM-free margins in the 5 patients where CDUS showed no signs of residual disease. In 4 cases, the resection was secondarily widened according to the US findings. Here, the histology showed remnants of the nidus in the part close to the original resection and no disease elsewhere in the remainder of the specimen. At a 24–62 months follow-up, no patient showed signs of relapse.

Conclusion:

The use of CDUS seems to guarantee a higher degree of cure rate for “healable” AVMs that are managed by means of surgery. Since its introduction in our clinical practice, we routinely use this method in the management of AVMs that are amenable to radical removal.
Efficacy of High-Dose Corticosteroid Therapy in Acute Stage Severe Facial Palsy in Children
Authors: Baba Shintaro , Kondo Kenji , Yoshitomi Ai , Taniguchi Kenshiro , Nakaya Muneo , Yamasoba Tatsuya
Published: November 2022

Objectives

To evaluate the efficacy of high-dose corticosteroid for severe acute facial paralysis in children.

Methods

The present study enrolled 10 pediatric patients with House-Brackmann (H-B) Grade VI facial paralysis who received prednisolone (PSL) 3 to 4 mg/kg/d for 2 to 3 days followed by a 10-day taper (the child high-dose group). Eight pediatric patients who received PSL 0.5 to 1 mg/kg/d were enrolled in a child low-dose group, and nine adult patients (25–64 yr) who received a high-dose PSL 200 mg equivalent for 2 to 3 days followed by a 10-day taper were enrolled in an adult high-dose group. On the initial and follow-up visits, facial movements were evaluated using the H-B grading system. The degree of oral-ocular synkinesis was evaluated by the degree of asymmetry in eye-opening width during mouth movements. The synkinesis index was defined as a percentage of the interpalpebral space width ([normal side − affected side]/normal side).

Results

The child high-dose group achieved a significantly better H-B score than the child low-dose group (p < 0.01). The synkinesis index was significantly lower in the child high-dose group than in the child low-dose group or the adult high-dose group (p < 0.05).

Conclusion

Children receiving PSL 3 to 4 mg/kg/d achieved better recovery and less synkinesis than those treated with low-dose PSL (0.5–1 mg/kg/d).
Meta-analysis and trial sequential analysis of acupoint catgut embedding in the treatment of ulcerative colitis: Acupoint catgut embedding treating ulcerative colitis meta-analysis
Authors: Yu Yunfeng , Zhou Manli , Tong Yaling , Yin Shuang , Hu Gang , Jian Weixiong , Zhu Ying
Published: November 2022

Background:

Although anti-inflammatory and immunomodulatory measures have delayed the progression of ulcerative colitis (UC) to a certain extent, the adverse drug reactions and recurrence after recovery still trouble clinicians. Acupoint catgut embedding is a possible alternative strategy for the treatment of UC, but its clinical efficacy remains controversial. Therefore, this study systematically evaluated the clinical efficacy and safety of acupoint catgut embedding compared with conventional western medicine in the treatment of UC.

Methods:

VIP, Wanfang, China National Knowledge Infrastructure, China Biology Medicine, PubMed, Embase, Web of Science, the Cochrane Library databases were searched. And the publication time of the literature was limited from the time that the database was established to February 2022. Two researchers independently screened the literature, extracted data, and assessed risk of bias as required. Meta-analysis was performed with Revman 5.3. Trial sequential analysis (TSA) was performed with TSA 0.9.5.10 Beta. Publication bias was assessed by Stata 15.0. And evidence quality was appraised with GRADEpro3.6.

Results:

A total of 10 studies were listed, with a total sample size of 782 cases. Meta-analysis showed that compared with conventional western medicine, acupoint catgut embedding can effectively improve the total effective rate of clinical symptoms (relative risk [RR] = 1.16, 95% confidence interval [CI] = [1.09,1.24], P < .00001), endoscopic total effective rate (RR = 1.16, 95%CI = [1.08,1.25], P < .0001), clinical symptom cure rate (RR = 1.80, 95%CI = [1.37,2.38], P < .0001), and endoscopic cure rate (RR = 1.97, 95%CI = [1.36,2.86], P = .0004) of UC, but the adverse event rate (RR = 0.20, 95%CI = [0.01,4.00], P = .29) was similar. Trial sequential analysis indicated that the efficacy endpoint was conclusive. Harbord test confirmed no significant publication bias. The quality of evidence for these outcomes ranges from low to medium.

Conclusion:

The clinical efficacy of acupoint catgut embedding in the treatment of UC is superior to that of conventional western medicine, and the safety may be equivalent to that of conventional western medicine, which has the value of further research and exploration.
More advantages of trocar compared than steel needle in deep venipuncture catheterization
Authors: Du Suzhen , Zhang Yanbo , Wang Hui , Fan Yan , Jiao Bao-Jie , Wang Dong-Ni , Qi Man-Man , Sun Xiu-Wei
Published: November 2022

Background:

Deep venipuncture catheterization is widely used in clinical anesthesia. However, it is worth thinking about how to improve the rate of successful catheter insertion, and relieve patients’ discomfort. This paper aimed to compare the clinical advantages between trocar and steel needle.

Methods:

Total 503 adult patients were recruited and randomly assigned. The control group was punctured with steel needle, and the experimental group was punctured with trocar needle. Clinical and followed-up information was recorded. Pearson’s chi-squared and spearman test were performed to analyze the correlation between intervention and relative parameters. Univariate logistic regression was performed to verify the odds ratio of trocar needle compared with steel needle.

Results:

Pearson’s chi-square test and Spearman’s correlation test showed a significant correlation between puncture success, puncture comfort, successful catheter insertion, puncture time, thrombosis, catheter fever, bleeding, infection and interventions (P < .05). Univariate logistic regression showed that there existed better puncture comfort (odds ratio [OR] = 6.548, 95% confidence interval [CI]: 4.320–9.925, P < .001), higher successful catheter insertion (OR = 6.060, 95% CI: 3.278–11.204, P < .001), shorter puncture time (OR = 0.147, 95% CI: 0.093–0.233, P < .001), lesser thrombosis (OR = 0.194, 95% CI: 0.121–0.312, P < .001), lesser catheter fever (OR = 0.263, 95% CI: 0.158–0.438, P < .001), lesser bleeding (OR = 0.082, 95% CI: 0.045–0.150, P < .001) and lesser infection (OR = 0.340, 95% CI: 0.202–0.571, P < .001) in trocar group compared with steel needle group.

Conclusion:

Trocar application in deep venipuncture catheterization can improve successful catheter insertion, relieve pain and discomfort of patients, reduce incidence of complications, and provide better security for patients.
The importance of renal function in anemic patients treated with edoxaban after orthopedic surgery in a real-world clinical setting: A retrospective study
Authors: Izushi Yasuhisa , Takami Yoichiro , Ushio Soichiro , Tetsunaga Tomonori , Shiota Naofumi , Yamamoto Hiroshi , Sato Toru , Kitamura Yoshihisa
Published: November 2022

Edoxaban (Edx) has been approved to prevent venous thromboembolism after total knee and/or hip arthroplasty in Japan. However, the risk of anemia with Edx treatment remains elusive. No risk factors for Edx-associated anemia after orthopedic surgery have been reported. This study aimed to clarify the risk of anemia associated with Edx treatment and determine the risk factors for Edx-associated anemia after orthopedic surgery with a high risk for bleeding. First, the association between Edx treatment and the incidence of anemia-related events was retrospectively investigated by pharmacovigilance analyses using data from 5769,866 reports between the first quarters of 2016 and 2020 in the Food and Drug Administration Adverse Event Reporting System and 2752,050 reports between the fourth quarters of 2011 and 2019 in the Japanese Adverse Drug Event Report. Second, 221 patients who underwent Edx treatment after total knee and/or hip arthroplasty between July 2011 and June 2012 at a single center were included in a case−control study to clarify the risk factors for anemia. Edx treatment was associated with an increased risk of anemia-related events in orthopedic patients. Reduced renal function was identified as a critical risk factor for Edx-associated anemia after orthopedic surgery. The present study indicates that renal function should be considered in the risk management of increased Edx-associated anemia after orthopedic surgery.
Correlation between acellular dermal matrix (ADM) volume and breast implant size selection among patients undergoing prepectoral direct-to-implant (DTI) breast reconstruction using complete ADM
Authors: Kim Yoon Soo , Kim Ho Sung , In Seok Kyung , Kim Byeong Seok , Kim Hyo Young , Kim Hong Il , Yi Hyung Suk , Park Jin Hyung
Published: November 2022

Background:

In prepectoral direct-to-implant breast reconstruction using the acellular dermal matrix (ADM)-assisted technique, breast volume asymmetry can occur. We hypothesized that ADM size influences implant size selection in prepectoral breast reconstruction with implant coverage using an ADM. We investigated factors influencing implant size selection and provide guidelines for surgeons.

Methods:

A retrospective chart review was performed to identify all patients who underwent prepectoral direct-to-implant breast reconstruction between January 2017 and October 2020. We assessed patient characteristics, preoperative expected implant volume, ADM size, volume of implant used in surgery, and symmetry scale of aesthetic item scale (AIS) 6 months after surgery. We compared the symmetry score of AIS between a group in which the preoperative expected silicone implant size (ES) was used and a group in which a silicone implant of a smaller size than planned (SS) was used.

Results:

Patient characteristics, including age, body mass index (BMI), and excised breast volume, were similar between the groups (P > .05). ADM size had a significant effect on implant size selection (odds ratio = 1.760, P < .01). The symmetry score of AIS was higher in the SS group.

Conclusions:

ADM size must be considered when selecting implant size in prepectoral direct-to-implant breast reconstruction using the ADM-assisted technique.
Efficacy of ginseng oral administration and ginseng injections on cancer-related fatigue: A meta-analysis
Authors: Li Huijing , Hou Tianwen , Sun Shijiang , Huang Jing , Wang Xueqi , Liang Xi , Zhao Tianhe , Hu Jingnan , Ge Jianli , Bai Haiyan , He Jianming
Published: November 2022

Background:

Up to 90% of patients who are under the active treatment suffer from cancer-related fatigue (CRF). CRF can persist about 10 years after diagnosis and/or treatment. Accumulating reports support that ginseng and ginseng injections are both potential drugs for the treatment of CRF but few studies put them together for analysis.

Methods:

Two reviewers independently extracted data in 3 databases (PubMed, Cochrane Library and China National Knowledge Infrastructure) from their inception to May 24, 2021. The primary outcome was the effect of ginseng in alleviating CRF. The secondary outcome was ginseng in alleviating emotional or cognitive fatigue. Standardized mean difference (SMD) was employed.

Results:

Twelve studies were included to evaluate efficacy of ginseng oral administration and ginseng injections on CRF. The pooled SMD was 0.40 (95% confidence Interval [95% CI] [0.29–0.51], P < .00001). Six studies were included to evaluate efficacy of ginseng oral administration on CRF and the SMD was 0.29 (95% CI [0.15–0.42], P < .0001). The order was 2000 mg/d, 3000 mg/d, 1000 mg/d and placebo from high efficacy to low. Ten studies were included to evaluate efficacy of ginseng injections on CRF and the SMD was 0.74 (95% CI [0.59–0.90], P < .00001). Emotional fatigue was reported in 4 studies, ginseng oral administration in 2 and ginseng injections in 2. The pooled SMD was 0.12 (95% CI [−0.04 to 0.29], P = .15). Cognitive fatigue was reported in 4 studies focusing on ginseng injections and the SMD was 0.72 (95% CI [0.48–0.96], P < .00001).

Conclusion:

Ginseng can improve CRF. Intravenous injection might be better than oral administration. Ginseng injections may alleviate cognitive fatigue. No evidence was found to support that ginseng could alleviate emotional fatigue.
Association of HIV, cardiovascular risk factors, and carotid intimal media thickness: A cross-sectional study in Western Kenya
Authors: Farrant Maritza T. , Masyuko Sarah J. , Kinuthia John , Osoti Alfred O. , Mogaka Jerusha N. , Temu Tecla M. , Zifodya Jerry S. , Nakanjako Damalie , Ameda Faith , Farquhar Carey , Page Stephanie T.
Published: November 2022

The carotid intimal media thickness (CIMT) is a validated measure of subclinical atherosclerosis. Human immunodeficiency virus (HIV) is a risk factor for cardiovascular disease (CVD) and has been associated with CIMT in North America and Europe; however, there are limited data from Sub-Saharan Africa (SSA). In this cross-sectional study, we measured CIMT in a cohort of 262 people living with HIV (PLHIV) on antiretroviral therapy (ART) for ≥6 months and HIV-negative adults in western Kenya. Using linear regression, we examined the associations between CVD risk factors and CIMT, both overall and stratified according to the HIV status. Among the PLHIV, we examined the association between CIMT and HIV-related factors. Of 262 participants, approximately half were women. The HIV-negative group had a higher prevalence of age ≥55 years (P = .002), previously diagnosed hypertension (P = .02), treatment for hypertension (P = .03), and elevated blood pressure (BP) (P = .01). Overall prevalence of carotid plaques was low (15/262 [6.0%]). HIV-positive status was not significantly associated with a greater mean CIMT (P = .19). In multivariable regression models, PLHIV with elevated blood pressure or treatment for hypertension had a greater mean CIMT (P = .002). However, the CD4 count, viral load, and ART regimen were not associated with differences in CIMT. In the HIV-negative group, older age (P = .006), high total cholesterol levels (P = .01), and diabetes (P = .02) were associated with a greater mean CIMT. In this cross-sectional study of Kenyan adults, traditional CVD risk factors were found to be more prevalent among HIV-negative participants. After multivariable regression analysis, we found no association between HIV status and CIMT, and PLHIV had fewer CVD risk factors associated with CIMT than HIV-negative participants did. HIV-specific factors were not associated with the CIMT.
Pulmonary blastoma that was first diagnosed as dedifferentiated chondrosarcoma using medical thoracoscopy: A case report
Authors: Kim Tae Hun , Jeon Jae Hyun , Chung Jin-Haeng , Cho Young-Jae
Published: November 2022

Rationale:

Pulmonary blastoma is an extremely rare and highly aggressive tumor. Only a few hundred cases of pulmonary blastoma have been reported. In other cases, a definitive diagnosis is often made through surgical resection. The use of preoperative histopathological sampling in diagnosing was of limited value because of the variety of pulmonary blastoma histology. And there was no literature that the first biopsy was attempted with medical thoracoscopy for diagnosis.

Patient concerns:

A 65-year-old man presented to our hospital with pleural effusion and lung mass.

Diagnoses:

The patient was initially diagnosed with dedifferentiated chondrosarcoma by medical thoracoscopic biopsy but the final diagnosis was pulmonary blastoma through bilobectomy.

Interventions:

Medical thoracoscopy, and video-assisted thoracoscopic surgery (bilobectomy) followed by adjuvant chemotherapy.

Outcomes:

After surgical resection of the tumor, adjuvant chemotherapy has been performed 5 cycles at 3 weeks intervals, and there was no evidence of recurrence on follow-up computed tomography performed 4 months after surgery.

Lessons:

Medical thoracoscopy is useful for the diagnosis of indeterminate pleural effusion; however, caution is needed when confirming rare malignancies, such as pulmonary blastoma. Although surgical resection is the treatment of choice, appropriate adjuvant chemotherapy to improve the prognosis may be necessary if there is pleural metastasis.
Treatment of ursodeoxycholic acid with glucocorticoids and immunosuppressants may improve the long-term survival rate in primary biliary cholangitis patients
Authors: Wang Zi-Long , Jin Rui , Hao Mei , Xie Yan-Di , Liu Zhi-Cheng , Wang Xiao-Xiao , Feng Bo
Published: November 2022

Primary biliary cholangitis (PBC) is an autoimmune cholestatic liver disease. The clinical effectiveness of ursodeoxycholic acid (UDCA) plus glucocorticoids and/or immunosuppressants remains controversial in PBC patients. The study aimed to compare the efficacy of monotherapy and combination therapy in patients with PBC and to assess the factors affecting the efficacy. In this retrospective study, 266 patients diagnosed with PBC were divided into monotherapy group (UDCA), double therapy group (UDCA plus glucocorticoids or immunosuppressants), and triple therapy group (UDCA plus glucocorticoids and immunosuppressants) according to different treatments. Demographic characteristics, immune parameters, biochemistry profiles, and other indicators were evaluated at baseline, 6 months, and 1 year following treatment. The prognosis was evaluated using the Paris II standard. The liver transplant-free survival at 3, 5, 10, and 15 years was predicted by GLOBE score. All statistical analyses were conducted using SPSS (version 24) software (SPSS Inc, Chicago, IL). The long-term survival rate of the triple therapy group was significantly improved compared with the monotherapy group (P = .005). In addition, multivariate analysis showed that abnormal platelet count, alkaline phosphatase, and albumin levels were risk factors for poor response. When IgG levels were elevated but below twice the upper limit of normal, the clinical benefit was not significant compared with monotherapy (P > .05). Compared with monotherapy and double therapy, triple therapy may improve the long-term survival rate of PBC patients. Abnormal platelet count, alkaline phosphatase, and albumin levels were associated with a poor prognosis.
Increased hemoglobin concentration and related factors in maintenance hemodialysis patients in Anhui, China
Authors: Qian Guangrong , Zhu Yuyu , Tao Shuman , Li Xiuyong , Liu Zhi , Bai Youwei , Wang Deguang
Published: November 2022

To investigate the hemoglobin (Hb) concentration and related factors among maintenance hemodialysis (MHD) patients in Anhui province in 2020, so as to compare with the results in 2014. The cases of 3025 MHD patients were investigated in 27 hemodialysis centers of Anhui province from January 2020 to December 2020. The data of age, sex, primary disease, dialysis age, dialysis mode, drug use and laboratory tests were collected and analyzed. Compared with the survey in 2014, the average Hb level of MHD patients in Anhui province was increased (107.41 ± 20.40 g/L vs 100.2 ± 28.1 g/L), the anemia prevalence was decreased (65.9% vs 82.4%), and the percentage of patients with standard Hb level was increased significantly (47.1% vs 32.9%). Compared with low-Hb patients (Hb < 110 g/L), patients with Hb ≥ 110 g/L had lower age, higher proportion of males, longer dialysis age, higher levels of serum Alb, creatinine, total cholesterol, triglyceride, low density lipoprotein, calcium, phosphorus, magnesium, and lower high-density lipoprotein (P < .05). The multivariate logistic regression analysis results showed that male, longer duration of dialysis therapy, treatment with iron, higher triglyceride and albumin were protective factors of anemia, but older age was independent risk factors. The anemia treatment in MHD patients in Anhui province was significantly improved. Male, long dialysis age, use of iron, high serum albumin and triglyceride levels may be protective factors for Hb reaching standard level, and old age may be an independent risk factor.
Abdominal examination using pressure pain threshold algometer reflecting clinical characteristics of complementary and alternative medicine in Korea: A systematic review and a brief proposal
Authors: Kim Yohwan , Kim Kyuseok
Published: November 2022

Background:

A review was conducted to determine a pressure algometry measurement during abdominal examination that reflects clinical settings of traditional Korean medicine.

Methods:

After reviewing the previous studies, we have proposed a reference index, common posture and method for performing pressure algometry during abdominal examination. Keyword search using eight databases was performed. To identify the characteristics of pressure algometry during abdominal examination, keywords (e.g., abdomen, abdominal examination) were searched in national Korean databases, including Korean studies Information System (KISS), Research Information Sharing Service (RISS), and Oriental Medicine Advanced Searching Integrated System (OASIS). To examine the methods of measuring pressure pain threshold (PPT) with validity and reliability, combination keywords (e.g., PPT, pressure algometry, pressure pain, validity, reliability) were searched in Pubmed, Cochrane library, Google scholar, Ovid Embase, and China Knowledge Resource Integrated Database (CNKI).

Results:

A total of 652 articles were identified, and 22 relevant articles were included. The following main indices are proposed as a standardized pressure algometry method during abdominal examination: unit of measurements, measuring tools, target locations, pressure area, pressure rate, posture of patients, and evaluators. Based on the results of the review combined with clinical practice, useful indices for pressure algometer during abdominal examination were derived (target location: CV 12, unit of measurement: MPa, pressure area: 4 cm2, pressure rate: 0.098 MPa/s, posture of patient: supine position, number, and intervals of measurement: three consecutive measurements at intervals of 30 seconds, 5 minutes rest prior to commencement). Postures and method sequence of pressure algometry during abdominal examination are also proposed.

Conclusions:

Using standardized indices, postures and method for abdominal examination in clinical settings will help make objective assessments.
The value of the glenohumeral joint cross-sectional area as a morphological parameter of glenohumeral osteoarthritis
Authors: Bang Yun-Sic , Lee Da Yeong , Kim Taeyeun , Su Min-Ying , Park SoYoon , Lee Sooho , Yi Jungmin , Kim Hyunhae , Kim Young Uk
Published: November 2022

Glenohumeral joint (GHJ) space narrowing has been demonstrated to be an important morphologic parameter of glenohumeral osteoarthritis (GHO). However, the morphology of GHJ space is irregular because of degeneration of subchondral bone and articular cartilage. Thus, we devised GHJ cartilage cross-sectional area (GHJCCSA) as a new diagnostic morphological parameter to assess the irregular morphologic change of GHJ. GHJ samples were acquired from 33 patients with GHO and from 33 normal controls without evidence of GHO based on shoulder magnetic resonance imaging. T2-weighted coronal MRIs were collected at the GHJ level for all individuals. GHJCCSA and GHJ cartilage thickness (GHJCT) at the GHJ were measured on MRIs using a graphic measuring system. The GHJCCSA was measured as the whole cartilage cross-sectional area of the GHJ. The average GHJCCSA was 115.28 ± 17.36 mm2 in normal individuals and 61.77 ± 13.74 mm2 in the GHO group. The mean GHJCT was 2.06 ± 0.35 mm in normal individuals and 1.50 ± 0.28 mm in the GHO group. GHO patients had significantly lower GHJCCSA (P < .001) and GHJCT (P < .001) than normal individuals. Receiver operator characteristics curve analysis revealed that the optimal cutoff score of the GHJCCSA was 82.21 mm2, with a sensitivity of 97.0%, a specificity of 97.0%, and an area under the curve of 0.99 (95% CI: 0.97–1.00). Although GHJCCSA and GHJCT were both significantly associated with GHO, the GHJCCSA was a more sensitive measurement parameter.
A clinical guideline-based management of type 2 diabetes by ayurvedic practitioners in Nepal: A feasibility cluster randomized controlled trial protocol
Authors: Chattopadhyay Kaushik , Dhimal Meghnath , Karki Shristi , Regmi Prerok , Bista Bihungum , Biswas Tuhin Kanti , Heinrich Michael , Panniyammakal Jeemon , Tandon Nikhil , Leonardi-Bee Jo , Kinra Sanjay , Greenfield Sheila Margaret , Lewis Sarah Anne , Upadhyay Vasudev , Gyanwali Pradip
Published: November 2022

Introduction:

Type 2 diabetes mellitus (T2DM) is a common chronic condition with significant health and socioeconomic consequences. In Nepal, T2DM is a common disease for which people consult ayurvedic (traditional medical system) practitioners and use ayurvedic medicines. Strong concerns remain about the suboptimal T2DM management of many patients by ayurvedic practitioners, and therefore, based on the best available scientific evidence, we have developed a clinical guideline for managing T2DM by ayurvedic practitioners. The research question to be addressed by a definitive cluster randomized controlled trial (RCT) is whether the introduction of a clinical guideline can improve the management of T2DM by ayurvedic practitioners in Nepal as compared to usual ayurvedic management (i.e., without any clinical guideline). In preparation for this future work, this current study aims to determine the feasibility of undertaking the definitive cluster RCT.

Methods:

This is a 2-arm, feasibility cluster RCT with a blinded outcome assessment and a qualitative evaluation. The study is conducted in 12 public and private ayurveda centers in and outside the Kathmandu Valley in Nepal (1:1 intervention:control). Eligible participants should be new T2DM adult patients (i.e., treatment naïve) - the glycated hemoglobin level should be 6.5% or above but less than 9%. At least 120 participants (60/group) will be recruited and followed up for 6 months. Important parameters, needed to design the definitive trial, will be estimated, such as the standard deviation of the outcome measure (i.e., glycated hemoglobin level at 6-month follow-up), intraclass correlation coefficient, cluster size, recruitment, the time needed to recruit participants, follow-up, and adherence to the recommended ayurvedic medicine. Semi-structured qualitative interviews will be conducted with around 20 to 30 participants and all the participating ayurvedic practitioners to explore their experiences and perspectives of taking part in the study and of the intervention and a sample of eligible people declining to participate in the study to explore the reasons behind nonparticipation.

Discussion:

We are now conducting a feasibility cluster RCT in Nepal to determine the feasibility of undertaking the definitive cluster trial. The first participant was recruited on 17 July 2022. If the feasibility is promising (such as recruitment, follow-up, and adherence to the recommended ayurvedic medicine), then the parameters estimated will be used to design the definitive cluster trial. Decisions over whether to modify the protocol will mainly be informed by the qualitative data.
A comparative investigator-initiated pilot study on the efficacy and safety of biodegradable microneedle acupuncture and conventional intradermal acupuncture for dry eye patient: A superiority, assessor-blinded, randomized controlled trial
Authors: Song Ji-Hoon , Park Soo-Yeon
Published: November 2022

Background:

The prevalence of dry eye, which is a common lacrimal disease, is steadily increasing in modern society. However, fundamental treatment for it has not yet been established. This study aims to assess the efficacy and safety of a novel medical device, the biodegradable microneedle acupuncture (BMA), using a traditional intradermal acupuncture needle as the control acupuncture for dry eye.

Method:

This study will be an investigator-initiated, assessor-blinded, comparative, superiority pilot randomized controlled trial. A total of 30 patients with dry eye will be randomly assigned to the experimental or the control group in equal proportion. For the experimental group, the BMA will be applied to both sides of 5 acupoints including BL2, GB14, TE23, EX-HN5, and ST1. For the control group, conventional intradermal acupuncture will be applied to the same acupoints. The needles will be attached for 4 hours. Over 4 weeks, both the interventions will be performed 12 times in total. The primary outcome would be the ocular surface disease index. The secondary outcomes would be the visual analog scale for subjective symptoms, quality of life, Schirmer I test, and general assessment.

Discussion:

The findings of this study on the efficacy and safety of the BMA would be helpful for patients with dry eye in clinical practice. Further, these results would provide for the foundation of a large-scale BMA study.
Effectiveness of Sopoongsan for chronic upper body pruritus in patients with atopic or seborrheic dermatitis: A pilot study protocol for a randomized, double-blind, placebo-controlled, parallel trial
Authors: Jang Jung-Hee , Jun Purumea , Park Gunhyuk , Kwon Ojin , Choi Yujin , Lim Hye-Sun , Moon Byeong Cheol , Kim Kyuseok
Published: November 2022

Introduction:

Chronic pruritus persists for > 6 weeks and is known to decrease patients’ quality of life. Due to the complex pathological mechanism of chronic pruritus, there is still a lack of satisfactory therapeutic agents; therefore, complementary therapies are required to improve itching symptoms. In the Republic of Korea, Sopoongsan, an herbal formula, has been used to treat itching, dizziness, and skin paralysis. To our knowledge, this is the first study to evaluate whether Sopoongsan improves chronic pruritus and to identify Sopoongsan-related changes in the immune response in patients with chronic upper body pruritus.

Methods:

A randomized, double-blind, placebo-controlled parallel trial will be conducted to assess 20 patients with chronic upper body pruritus for 3 months who have been diagnosed with allergic atopic dermatitis or seborrheic dermatitis. The patients will be randomly allocated to either the placebo-control (n = 10) or treatment (n = 10) group. The total study period will be 8 weeks (i.e., administration of Sopoongsan or placebo drugs for 4 wk and follow-up for 4 wk). Participants will be allowed to receive external treatment, except for antipruritic medications administered orally, throughout the study period. The primary outcome measure will be the numeric rating scale results for itching, whereas the secondary outcome measures will be questionnaire survey (Dermatological Life Quality Index and Epworth Sleepiness Scale) findings and the immune response index, including interferon gamma, interleukin-4, immunoglobulin E, thymic stromal lymphopoietic protein, and histamine, to investigate the biological mechanisms underlying chronic pruritus.

Discussion and Conclusions:

We expect that the results of this study will provide important clinical evidence regarding the effectiveness of Sopoongsan on itching symptoms, quality of life, sleep disturbance, and changes in the immune response. The findings will help elucidate the mechanism underlying the therapeutic effect of Sopoongsan for chronic pruritus and lay the foundation for further studies in this area.
Porridge for influenza: Protocol for a systematic review and meta-analysis
Authors: Sun Haoxiang , Mei Manxue , Xu Jiayu , Chen Xiaofang , Zhu Wei , Song Jianping
Published: November 2022

Background:

Influenza is a common disease. If it is not treated in time, it may induce related chronic respiratory diseases and seriously endanger people’s health. Porridge, as a food of the East, has been recorded by doctors of all ages to treat influenza with porridge. However, due to insufficient research, there is a certain controversy about porridge in the treatment of influenza. We therefore plan to conduct a systematic review and meta-analysis to collect data from all published studies on this issue in order to obtain reliable evidence.

Method and analysis:

We will search for relevant trials in various databases published by December 2022. To study the efficacy and safety of a RCT of porridge in the treatment of influenza. Standardized data tables will be used to complete data search and extraction in duplicate. All differences will be resolved by consensus. The main result was to observe the symptom score of influenza patients, and the secondary results included body temperature, nasal secretions, nasal resistance and viral culture titers in the nasal secretions. Data synthesis and statistical analysis will be performed for each outcome with Stata V.14.0.

Results:

Our study will be a systematic review and meta-analysis to evaluate the efficacy and safety of porridge in the treatment of influenza.

Conclusion:

The conclusion of this study has a certain reference value for the clinical use of porridge in the treatment of influenza.
Durable response to low-dose pralsetinib in a renal insufficient patient with NSCLC harboring concurrent CCDC6-RET, LINCO1264-RET, and SEMA5A-RET fusions: A case report
Authors: Gu Linping , Ji Wenxiang , Xu Yunhua , Han Yuchen , Jian Hong
Published: November 2022

Introduction:

RET-rearranged fusions have been considered as oncogenic drivers in 1% to 2% of non-small cell lung cancers (NSCLC). ARROW study has demonstrated a new selective RET tyrosine kinase inhibitors (TKIs) shows remarkable and durable responses in RET-rearranged NCSLC. In this study mainly recruited patients with common fusion partners KIF5B and CCDC6. There is still a lack of definitive conclusions about effective of rare RET fusion variants to anti-RET therapies.

Case report:

A Chinese 58-year-old female renal insufficient patient with no history of smoking was diagnosed as stage IIIA (T2N2M0) lung adenocarcinoma. Next-generation sequencing targeting 520 cancer-related genes was performed on the pleural effusion samples and revealed 2 novel RET fusions LINCO1264-RET and SEMA5A-RET, concomitant with a common CCDC6-RET.

Management and outcome:

The patient was first treated with multiple lines of chemotherapy and switched to lenvatinib but failed to respond. Due to renal insufficiency, she subsequently received pralsetinib with gradually reduced dosages (400 mg-300 mg-200 mg-100 mg qd) and achieved a partial response (PR) lasting for more than 10 months, accompanied by the declined allele frequencies of all 3 RET fusions.

Discussion/conclusions:

We reported the first case of the pralsetinib efficacy in NSCLC with 3 concurrent RET fusions. Our case also indicates the sensitivity of the newly identified RET fusions to this RET selective inhibitor pralsetinib, and highlights the low-dose treatment option for patients with renal insufficient background.
Value of CT spectral imaging in the differential diagnosis of sarcoidosis and Hodgkin’s lymphoma based on mediastinal enlarged lymph node: A STARD compliant article
Authors: Cao Lixiu , Wu Huijing , Liu Yongliang
Published: November 2022

To investigate the imaging characteristics of sarcoidosis and Hodgkin’s lymphoma based on mediastinal enlarged lymph node using spectral CT and evaluate whether the quantitative information can improve the differential diagnosis of these diseases. This retrospective study was approved by the institutional review board, and written informed consent was obtained from all patients. Overall, 21 patients with sarcoidosis and 39 patients with Hodgkin’s lymphoma were examined with CT spectral imaging during the arterial phase (AP) and venous phase (VP). The CT values on 40 to 140 keV monochromatic images and iodine (water) concentrations of enlarged lymph nodes were obtained in AP and VP. Iodine concentrations (ICs) were normalized to the iodine concentration in the aorta. The differences in normalized iodine concentrations (NICs) and hounsfield units (HU) curve slop (λHU) were calculated. Anatomical distribution of mediastinal lymph nodes and morphologic features were also compared. Receiver operating characteristic curves were generated to help establish threshold values for the parameters required for the significant differentiation of sarcoidosis from lymphomas. The CT values on 40 to 100 keV monochromatic images in AP and 40 to 50 keV in VP were higher in sarcoidosis than those in Hodgkin’s lymphoma, the differences were statistically significant (P < .05); NICs during the AP and λHU during the AP (VP) in patients with sarcoidosis differed significantly from those in patients with Hodgkin’s lymphoma. Receiver operating characteristic curves analysis showed that the monochromatic CT value on 40 keV in AP had the highest sensitivity (71.4%) and specificity (100%) in differentiating sarcoidosis from Hodgkin’s lymphoma. The anatomic distribution, coalescence, calcification, compression, enhancement pattern and enhancement degree of the mediastinal enlarged lymph node differed significantly between the groups (P < .05). The combination of monochromatic CT value, NICs and λHU had higher sensitivity and specificity than did those of conventional qualitative CT image analysis during the combined phases. CT spectral imaging has promising potential for the diagnostic differentiation of Hodgkin’s lymphomas and sarcoidosis. The monochromatic CT value, iodine content and λHU could be valuable parameters for differentiating Hodgkin’s lymphomas and sarcoidosis based on mediastinal enlarged lymph node.
An examination of cyberchondria’s relationship with trait anxiety and psychological well-being in women of reproductive age: A cross-sectional study
Authors: Sezer Önder , Başoğlu Mehmet Akif , Dağdeviren Hamdi Nezih
Published: November 2022

Online environments have become the main sources of health-related information. However, if used incorrectly, this can decrease the level of well-being. Cyberchondria corresponds to the hypochondria in the digital age. We aimed to investigate the relationship between cyberchondria and trait anxiety, psychological well-being, and other factors in women of reproductive age.

This study used a descriptive cross-sectional design. Face-to-face questionnaires were administered to women aged 18 to 49. The sample size was formed and stratified according to the population of the 47 family health centers to reflect the entire population. The questionnaire included a sociodemographic information form, the Cyberchondria Severity Scale (CSS), the State-Trait Anxiety Inventory, and the Psychological Well-Being Scale (PWBS).

This study included 422 participants. The average daily use of the Internet was 2.14 ± 1.837 hours, while that of social media was 2.69 ± 2.027 hours. The mean CSS score was 89.42 ± 21.688; the mean trait anxiety score was 44.34 ± 8.791, and the mean PWBS score was 324.26 ± 35.944. Factors that interacted with the level of cyberchondria were the trait anxiety score, PWBS score, alcohol consumption, and average daily use of the internet and social media.

Increased online time, alcohol consumption, trait anxiety levels, and psychological well-being increase cyberchondria levels. Improvements must be made in the accuracy of online information, which is unsupervised and easily accessible to society as a source of information. Future studies should focus on the prevention, detection, and treatment of cyberchondriasis. Identifying and improving the factors affecting women’s and mothers’ cyberchondria will also increase the chances of providing primary protection against certain diseases.
Efficacy and safety of Chinese herbal medicine Danggui Sini decoction for knee osteoarthritis: A protocol for systematic review and meta-analysis
Authors: Zhou Xing , Xiang Ke-Meng , Li Jinlei , Yang Guang , Wang Yanbo , Xia Hanting , Zhuang Rujie
Published: November 2022

Background:

Knee osteoarthritis (KOA) often causes joint pain, weakness and mobility disorders, which seriously affects people’s daily life and makes them unable to work and study normally. Traditional Chinese medicine (TCM) prescription Danggui Sini Decoction (DGSND) has been widely used in clinical practice and achieved good results. But there is no high-level evidence to support this result. The aim of this study is to evaluate DGSND’s efficacy and safety in the management of KOA.

Methods:

We will search 7 electronic databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang Data (WF), Chinese Scientific Journals Database (VIP), Chinese databases SinoMed (CBM), PubMed, Embase, and Cochrane Library databases. All the publications, with no time restrictions, will be searched without any restriction of language and status, the time from the establishment of the database to September 2022. Two reviewers will independently assess the quality of the selected studies, NoteExpress and Excel software will be used to extract data, and the content will be stored in an electronic chart. Different researchers will separately screen the titles and abstracts of records acquired potential eligibility which comes from the electronic databases. Full-text screening and data extraction will be conducted afterward independently. Statistical analysis will be conducted using RevMan 5.4 software.

Results:

This study will compare the effects of DGSND and any other different methods on patients with KOA to provide high-quality, evidence-based clinical recommendations.

Conclusion:

The study provides a trustable clinical foundation for DGSND in the treatment of KOA.
Lung ultrasound for the diagnosis of pulmonary atelectasis in both adults and pediatrics: A protocol for systematic review and meta-analysis
Authors: Liu Wenlong , Zhang Xu , Liu Kai , Kang Zhongjing
Published: November 2022

Background:

The use of lung ultrasound for the diagnosis of pulmonary atelectasis remains controversial. Therefore, we performed a protocol for systematic review and meta-analysis to evaluate the diagnostic accuracy of lung ultrasound for the diagnosis of pulmonary atelectasis both in adults and pediatrics.

Methods:

A comprehensive search of several databases from 1966 to October 2022 will be conducted. The databases include Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and PubMed. After screening and diluting out the articles that met inclusion criteria to be used for statistical analysis, the pooled evaluation indexes including sensitivity and specificity as well as hierarchical summary receiver operating characteristic curves with 95% confidence interval were calculated. All statistical analyses were calculated with STATA, version 12.0 (StataCorp, College Station, TX).

Result:

We will synthesize the current studies to evaluate the diagnostic accuracy of lung ultrasound for the diagnosis of pulmonary atelectasis.

Conclusion:

The result of this review will provide more reliable references to help clinicians make decisions for the diagnosis of pulmonary atelectasis.
Premature mortality from four chronic diseases in Wuhai, China and impact on life expectancy, 2015 to 2020
Authors: Wang Zhifang , Xu Danni , Liu Ying , Zhao Jing , Li Hongwei , Song Yang , Gao Yumin , Li Hailing
Published: November 2022

To analyze the change trend of life expectancy, the change trend of premature death due to 4 major chronic diseases, and its impact on the life expectancy of Wuhai residents from 2015 to 2020, and to provide evidence for the prevention and control of chronic diseases in this area. The data on population death comes from the Wuhai City Residents’ Causes of Death Network Reporting System and the total population is calculated using statistics from Wuhai City’s permanent population management, from 2015 to 2020. Premature mortality from the 4 main chronic illnesses was calculated using the abridged life table approach. The impact of premature death from chronic diseases on life expectancy was analyzed using the Arriaga method. The increasing trend of life expectancy of Wuhai citizens was not statistically significant from 2015 to 2020 (t = 2.570, P = .062). Each year, men had a lower life expectancy than women (P < .05). From 2015 to 2020, the downward trend of premature deaths caused by the 4 major non-communicable diseases in Wuhai City was statistically significant (EAPC = −7.74%, P = .041). Premature death from cancer and chronic respiratory disorders decreased, both of which were statistically significant (EAPC < 0, P < .05). The decline in premature mortality from cancer, cardiovascular and cerebrovascular disorders, and chronic respiratory system diseases has contributed to increased life expectancy. Diabetes’s rise in premature mortality made a possible “negative contribution” to life expectancy (−0.036 years, −1.79%). From 2015 to 2020, the decreasing trend of the overall premature mortality caused by the 4 major non-communicable diseases in Wuhai was statistically significant, and the life expectancy of females was higher than that of males. We should concentrate on the prevention and control of major chronic illnesses in males, as well as the influence of changes in diabetes-related early mortality on life expectancy.
Efficacy and safety of Yaobitong capsule for acute lumbar disc herniation: A protocol for a multi-center randomized controlled trial
Authors: Zhang Xianshuai , Yang Kexin , Wang Siyi , Tang Bin , Yin He , Lei Qunhui , Zhou Guohui , Gu Mingyu , Shi Mingpeng , Zhao Changwei , Li Shaojun , Li Zhenhua
Published: November 2022

Background:

There are few effective conservative therapies for acute lumbar disc herniation (LDH), and the choice of nonsteroidal anti-inflammatory drugs is not recommended for all patients. The purpose of this study was to compare the effect of Yaobitong capsule with celecoxib capsule, and to further confirm the safety and efficacy of Yaobitong capsule.

Methods:

This study is a large sample multicenter randomized controlled trial. Eight hospitals served as sub centers to recruit patients. A total of 258 patients are divided into Yaobitong group and celecoxib group according to the ratio of 1:1. Celecoxib or Yaobitong capsule was taken orally for 14 days. Patients will complete the trial after 3 months of follow-up, and independent statisticians who are blinded to random assignment will analyze the data using SAS 9.3 software. The primary outcome was the visual analogue scale (VAS) score after 14 days of treatment, and Japanese Orthopaedic Association (JOA), Oswestry Disability Index (ODI), and SF-12 will be regarded as secondary outcomes. Safety indexes will be recorded before and after treatment, and adverse events (AEs) will be recorded throughout this trial.

Discussion:

This study will evaluate the efficacy and safety of Yaobitong capsule in treating LDH. The experimental results will provide evidence support to treat LDH with Yaobitong capsule.