bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and feasibility of umbilical cord blood transplantation in children with neuronal ceroid lipofuscinosis: a retrospective study
Authors: Bauchat Andrea , Polishchuk Veronika , Fabrizio Vanessa A , Brondon Jennifer E , Page Kristin M , Driscoll Timothy A , Martin Paul L , Mahadeo Kris M , Kurtzberg Joanne , Prasad Vinod K
Published: October 2024

Ceroid lipofuscinosis neuronal (CLN) encompasses rare inherited neurodegenerative disorders that present in childhood with clinical features including epilepsy, psychomotor delay, progressive vision loss, and premature death. Published experience utilizing umbilical cord blood transplant (UCBT) for these disorders is limited. This retrospective analysis includes patients with CLN (2, 3, and 5) who underwent UCBT from 2012 to 2020. All subjects (n = 8) received standard-of-care myeloablative conditioning. Four also enrolled in clinical trial NCT02254863 and received intrathecal DUOC-01 cells posttransplant. Median age at UCBT was 5.9 years. All subjects achieved neutrophil engraftment with >95% donor chimerism at a median of 28.5 days. Sinusoidal obstructive syndrome was not observed. Severe acute graft-versus-host disease occurred in 12.5%. Other complications included autoimmune hemolytic anemia (25%) and viral reactivation/infection (62.5%). No transplant-related mortality was observed. Two CLN2 patients died, 1 from progressive disease and 1 from unknown cause at days +362 and +937, respectively. With median follow-up of 8 years, overall survival at 100 days and 24 months was 100% and 88%, respectively. Three of 4 CLN3 subjects stabilized Hamburg motor and language scores. While UCBT appears safe and feasible in these patients, given the variable expression and natural history, extended follow-up and further studies are needed to elucidate the potential impact of UCBT on clinical outcomes.
Sensitivity of soybean (Glycine max L.) pathogens Diaporthe aspalathi, D. caulivora, and D. longicolla to Difenoconazole and Fluopyram fungicides
Authors: Mohan Karthika , Barnes Sarah , Rasuleva Dilorom , Mukaila Taofeek , Allen Tom , Bergstrom Gary C. , Bissonnette Kaitlyn , Bonkowski John , Bradley Carl A. , Buck James , Chilvers Martin I. , Dorrance Anne E. , Giesler Loren , Kelly Heather Marie , Kleczewski Nathan , Betts Alyssa , Lopez-Nicora Horacio , Malvick Dean , Mangel Dylan , Markell Samuel , Mueller Daren Shane , Shires Madalyn K. , Sikora Edward , Smith Damon L. , Telenko Darcy E. P. , Spurlock Terry , Yabwalo Dalitso , Wise Kiersten , Mathew Febina
Published: October 2024

Diseases of soybean (Glycine max L.) caused by species of Diaporthe have resulted in estimated yield losses totaling $248.2 million in the U.S. over the past 10 years. To effectively manage species of Diaporthe, it is important to use an integrated approach. In this study, we evaluated the in vitro sensitivity of isolates of the soybean pathogens Diaporthe aspalathi, D. caulivora, and D. longicolla from 18 U.S. states to difenoconazole (a demethylation inhibitor fungicide) and fluopyram (a succinate dehydrogenase inhibitor fungicide). The fungicides were incorporated into 2% water agar (WA) in petri dishes at various concentrations. A mycelial plug of each isolate (n=59 for difenoconazole and n=55 for fluopyram) obtained from a 7-day-old culture was placed at the center of the WA and incubated in the dark. After five days for D. caulivora and D. longicolla, and eight days for D. aspalathi, the colony diameter was measured, and the corresponding percent inhibition and effective concentration at which 50% mycelial growth was inhibited (EC50) were determined. Significant differences in EC50 values (P<0.0001) were observed among the isolates of D. aspalathi (0.227 µg/ml), D. caulivora (0.130 µg/ml), and D. longicolla (1.860 µg/ml) for difenoconazole. Similarly, for fluopyram, the EC50 values varied significantly (P<0.001) among the D. aspalathi (2.233 µg/ml), D. caulivora (1.610 µg/ml), and D. longicolla (0.347 µg/ml) isolates. This study established sensitivity profiles for difenoconazole and fluopyram fungicides for D. aspalathi, D. caulivora, and D. longicolla, and provides valuable information that may help in the development of Diaporthe disease management program.
Duct of Luschka leak
Authors: Van Wieren Alizabeth , Haseeb Abdul
Published: October 2024

Bile leakage is a serious early postoperative complication of cholecystectomy. A leak in the duct of Luschka, though rare, can cause significant patient morbidity after a cholecystectomy. Early recognition of this uncommon complication allows for early therapeutic intervention.
Improving Academic Promotion Success via Implementation of Targeted Preparation Strategies and Coaching Processes
Authors: Hill Jacqueline , Haddad Enam , Braet Sarah , Rush Eric , Bratcher Denise
Published: October 2024

Problem

Academic promotion is important for faculty career development and retention in academic medicine. However, the promotion process is time consuming, with little guidance offered to ensure successful outcomes. The authors describe their institution’s standardized approach to providing clear and reliable academic promotion support and share associated outcomes.

Approach

An academic promotion support process, comprising 4 targeted preparation strategies and 3 coaching processes, was implemented in 2020 at Children’s Mercy Kansas City to prepare faculty to submit promotion applications. Targeted preparation strategies include communication plans, an intent to apply process, how-to guides and templates, and institutional promotion committee review. Coaching processes include structured conversations with an immediate faculty leader, an Office of Faculty Development director, and, after committee review of applications, an institutional promotion committee reviewer. Descriptive statistics and promotion outcomes were compared preimplementation (2012–2019) and postimplementation (2020–2023).

Outcomes

In 2012–2019 (8 promotion cycles), prior to implementation of the academic promotion support process, 247 faculty applied for academic promotion. After implementation, in 2020–2023 (4 cycles), 196 faculty applied. From pre- to postimplementation, the mean volume of applications per cycle significantly increased from 31 to 49 (P = .03), and the proportion of approved promotion applications significantly increased from 89.5% (221/247) to 99.0% (194/196) (P < .001). No significant differences were observed in the proportions of applicants who were female (P = .77) or non-White (P = .51).

Next Steps

Creation of an institutional academic promotion support process can be effective in increasing the volume of applications and the likelihood of successful outcomes. Future research should focus on increasing the proportions of non-White faculty and female faculty who apply for promotion and analyzing longer-term outcomes for faculty who are promoted, such as progression to leadership roles.
Transjugular intrahepatic portosystemic shunt for the patients on the liver transplant list
Authors: Ripoll Cristina , Rauchfuss Falk , Aschenbach Rene , Settmacher Utz , Zipprich Alexander
Published: October 2024

Patients with cirrhosis-associated and portal hypertension–associated complications may benefit from TIPS and/or liver transplantation. In many patients, the decision of whether or not TIPS should be placed prior to liver transplantation is fairly clear-cut. Nevertheless, there are some patients in whom the decision can be more complex. On one hand, TIPS is easily available in contrast to liver transplantation, and patients with TIPS may have clinical improvement. On the other hand, although TIPS may improve the situation of the patient, this improvement may not be sufficient to significantly improve the quality of life. Furthermore, TIPS malposition may be challenging for liver transplantation surgery. This review approaches the advantages and disadvantages of TIPS placement in patients who are candidates for liver transplantation and proposes decision pathways for patients with complications of portal hypertension on the liver transplant waiting list.
The evolving role of medical thoracoscopy on therapeutic management of pleural disease
Authors: Fong Clare , Lee Y.C. Gary , Maskell Nick , Lee Pyng
Published: October 2024

Purpose of review

The use of medical thoracoscopy (MT) has gained widespread acceptance for the diagnosis and management of pleural disease. It is less invasive compared to video-assisted thoracoscopic surgery (VATS), can be performed in the endoscopy suite and in patients who are unfit to undergo general anaesthesia. It is safe, with high diagnostic yield, and enables pulmonologists to intervene therapeutically.

Recent findings

There have been several developments in this field, particularly for malignant pleural effusions (MPE). Specifically, we discuss further techniques that can be employed during MT to distinguish between benign and malignant pleural disease. There is also potential for combined thoracoscopic talc poudrage (TTP) and indwelling pleural catheter (IPC) insertion to shorten hospital stay.

Beyond MPE, we discuss the role of MT in patients with pneumothorax and pleural infection. We discuss the advantages and disadvantages of MT over traditional practices in a variety of conditions – diagnosis of exudative pleural effusions, prevention of recurrent MPE and pneumothoraces as well as treatment of pleural infections, so as to better aid physicians in selecting the optimum procedure for patients.
A preliminary exploration of quantitative models for evaluating binocular visual perception impairments among patients diagnosed with stroke
Authors: Liu Hua , Chu Hang , Liu Juan , Yang Heng , Yang Hong
Published: October 2024

The objective of this study is to formulate and implement graded biological models pertaining to binocular visual perception function with the use of computer algorithms. We aim to quantitatively assess the location, severity, and degree of impairment in binocular visual perception among patients who have suffered stroke, thereby providing valuable insights into the repercussions of cerebral tissue damage on the visual system. To overcome the shortcomings of previous instruments used to assess binocular function in terms of stereoscopic effects and the challenges posed by physiological and psychological interference during examinations, this study optimized its approach by integrating polarized stereovision technology with computer graphic modeling techniques. This study employed computer models to assess binocular visual perception function in stroke patients. Computer models refer to psychophysical testing methods used to measure binocular visual perception function, including various assessment tasks such as recognizing inverted letters and assessing stereopsis during high-speed movements. The cross-into-circle test was used as a means to quantify perceptual eye position. Subsequently, the collected data was analyzed to assess the magnitude of impairment in binocular visual perception. The results of the study revealed a spectrum of binocular visual perception impairment among patients diagnosed with stroke, demonstrating discernible variations in the recognition of inverted letters and stereopsis across different movement speeds. Importantly, perceptual eye position measurements offered valuable insights into ocular misalignment. The computational models effectively quantified both the spatial distribution and severity of these identified impairments. Damage to brain tissue resulting from a stroke can give rise to notable impairments in binocular visual perception function. Graded biological models, formulated through computer algorithms, provide a systematic framework for the comprehensive evaluation and quantification of these impairments. The comprehension of the nature and extent of visual impairments observed in patients with stroke establishes a basis for the development of personalized visual perception learning methodologies. Based on such tailored approaches, we aim to facilitate the recovery of impaired visual function, thereby contributing to the broader objective of neural system rehabilitation.
Diagnostic value of ultrasound for community-acquired pneumonia in children and its correlation with serum PCT level and PCIS
Authors: Liu Qing-Zhong , Feng Zi-Qiang , Huang Kai-Wei , Yang Zi-Jiang , Xu Li-Qin , Shen Yuan-Yuan
Published: October 2024

Objective:

This study aimed to evaluate the diagnostic value of ultrasound for community-acquired pneumonia (CAP) in children.

Methods:

Clinical information of children diagnosed with CAP and a control group of healthy children was collected, and lung ultrasound detection was performed. The lung ultrasound score (LUS) was assessed, and venous blood samples were collected. Serum indexes, including white blood cell count, were analyzed using an automatic immunoassay analyzer, while serum procalcitonin (PCT) level was measured using an enzyme-linked immunosorbent assay. The pediatric critical illness score (PCIS) was also performed for all subjects.

Results:

White blood cell count, absolute neutrophil count, and respiratory index were significantly higher in the CAP group than those in the control group, while the oxygenation index was markedly lower. Ultrasound detection results showed that the CAP group exhibited significantly higher detection rates of pleural effusion, interstitial lung changes, lung consolidation, B-lines, air bronchogram signs, and reduced or absent lung sliding signs compared with the control group. In addition, the LUS and PCT levels were markedly higher in the CAP group, while the PCIS was notably lower. Further analysis exhibited that the LUS in the CAP group was significantly positively correlated with PCT levels and negatively correlated with PCIS. The receiver operating characteristic curve indicated that the area under the curve of LUS for diagnosing children with lung infection was 0.841.

Conclusion:

LUS is closely related to serum PCT level and PCIS. Lung ultrasound detection demonstrates high sensitivity and specificity, indicating its valuable clinical diagnostic utility for CAP in children.
Systemic lupus erythematosus with podocyte infolding glomerulopathy: A case report and literature review
Authors: Zhang Huiqing , Lin Jie , Lu Hanqi , Zhong Yunliang , Deng Lie , Kuang Bin , Li Qiang
Published: October 2024

Rationale:

Podocyte infolding glomerulopathy (PIG) is a rare glomerular disease, its diagnosis mainly depends on pathological manifestations of the kidney. Few clinical cases of PIG have been reported, but it is sometimes associated with connective tissue diseases. Here we describe a case of systemic lupus erythematosus (SLE) with PIG and undertake a review of the literature.

Patient concerns:

A 34-year-old female patient was admitted to our hospital in August 2019 with repeated facial erythema and proteinuria for more than 10 years. The patient was previously diagnosed with SLE.

Diagnosis:

Systemic lupus erythematosus.

Interventions:

Renal biopsy was performed to investigate ongoing proteinuria and the results were consistent with PIG. Treatment with methylprednisolone, hydroxychloroquine sulfate, mycophenolate mofetil, and candesartan ester.

Outcomes:

Improved the patient’s condition and resolved the proteinuria.

Lessons:

This study reported a case of PIG and SLE. The patient was diagnosed according to biopsy, and the disease remain stable after immunosuppressive therapy. It is recommended to carefully study renal biopsies from patients with proteinuria and underlying autoimmune diseases to identify additional cases.
The impact of early speech and language cognitive training care on the developmental quotient of children with language impairments: A retrospective study
Authors: Xue Yan , Xu Jian , Liu Dandan
Published: October 2024

This study aims to investigate the effects of early speech and language cognitive training on the nursing outcomes of children with language impairments and their impact on developmental quotient. From October 2018 to October 2023, the data of 80 children with language impairments treated at our hospital were selected. They were divided into an observation group (n = 40) and a control group (n = 40) based on the treatment plan. The control group received routine rehabilitation training, while the observation group received early cognitive language rehabilitation training. The treatment efficacy of the 2 groups, as well as differences in Gesell Developmental Schedule scores and serum indicators before and after treatment, were observed and analyzed. The treatment efficacy in the observation group was superior to that in the control group (P < .05), with a total effective rate of 92.50% in the observation group. After 6 months of treatment, the scores for adaptability, gross motor skills, fine motor skills, personal–social behavior, and language development quotient in the observation group were (77.41 ± 10.21), (77.15 ± 10.43), (80.43 ± 11.19), (71.14 ± 10.42), and (81.21 ± 12.03), respectively, significantly higher than those in the control group (P < .05). After 6 months of treatment, the mental development index and psychomotor development index in the observation group were (107.28 ± 10.43) and (96.60 ± 9.03), respectively, which were markedly higher than those in the control group (P < .05). After 6 months of treatment, the serum levels of insulin-like growth factor-1, 25-hydroxyvitamin D [25(OH)D3], and gamma-aminobutyric acid in the observation group were (52.43 ± 9.44) ng/mL, (31.45 ± 4.82) ng/mL, and (76.65 ± 10.54) µmol/mL, respectively. These levels were not significantly different from those in the control group (P > .05). The blood flow velocities of the middle cerebral artery, anterior cerebral artery, basal artery, and vertebral artery in the observation group and control group were compared after 6 months of treatment (P > .05). Early speech and cognitive training have shown promising efficacy in the treatment of language disorders, as it can improve developmental quotient in affected children and increase serum levels of insulin-like growth factor-1, 25(OH)D3, and gamma-aminobutyric acid.
Efficacy and safety of traditional Chinese medicine for the treatment of epilepsy by wind quenching and phlegm resolving: A systematic review and meta-analysis
Authors: Cai Yufen , He Xiaofang , Ao Liting , Liu Yibo , Zhang Yanju , Yang Hui , Zhang Lin
Published: October 2024

Background:

Using wind-quenching and phlegm-resolving (WQPR) therapy for epilepsy has yielded beneficial results in various clinical studies. However, a comprehensive analysis of the WQPR approach to epilepsy has not yet conducted to date. This study aimed to evaluate the effectiveness and safety of the WQPR method in traditional Chinese medicine (TCM) for epilepsy.

Methods:

Eight databases, including The Cochrane Library, Web of Science, PubMed, Embase, Chinese Biomedical Database, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database (VIP), and WanFang Database, were comprehensively searched to include randomized controlled trials (RCTs) investigating the WQPR approach in epilepsy. Quality was evaluated by the Cochrane Handbook for Systematic Reviews of Interventions, and meta-analysis was conducted using the RevMan 5.4 and Stata 14.0 software. For the outcome indicators with the number of studies ≥ 10, funnel chart and Egger test were used to evaluate the bias, and the evidence quality was evaluated according to GRADEpro system.

Results:

We included 19 randomized controlled trials with 1475 participants. Compared to the control group, the WQPR approach showed clinical efficacy for epilepsy (odds ratio = 3.23, 95% confidence interval [CI] [2.19, 4.77], Z = 5.90, P < .00001), reduced seizure frequency (standardized mean differences = ‐1.24, 95% CI [‐1.62, −0.85], Z = 6.26, P < .00001), shortened seizure duration (standardized mean differences = ‐2.07, 95% CI [‐2.99, ‐1.14], Z = 4.39, P < .0001), improved patient’s quality of life (mean difference = 2.60, 95% CI [2.16, 3.03], Z = 11.62, P < .00001), and ameliorated TCM syndromes (mean difference = ‐4.37, 95% CI [‐6.19, ‐2.56], Z = 4.72, P < .00001). The reduced rate of adverse reactions (odds ratio = 0.56, 95% CI [0.37, 0.85], Z = 2.71, P = .007).

Conclusion:

WQPR therapy appears to be an effective and safe approach for treating epilepsy, increasing clinical efficacy, reducing seizures’ frequency and duration, improving patients’ quality of life, ameliorating TCM syndromes, and reducing adverse reaction rates.
Can extracorporeal shock wave therapy be effective in temporomandibular joint disorder?: A pilot study
Authors: Keskin Tunç Serap , Ünalan Değirmenci Beyza , Bilen Mustafa , Toprak Mehmet Emin , Kaplan Şehmus , Turan Mahfuz
Published: October 2024

Background:

This study aimed to compare extracorporeal shock wave therapy (ESWT) with the use of stabilization splint in nonsurgical temporomandibular disorders treatments, and to evaluate the effects.

Methods:

In this study, individuals, who are diagnosed with disc displacements with reduction according to the diagnostic criteria for temporomandibular disorder examination criteria. The patients in the first control group (n = 36) were applied a medical treatment + stabilization splint. The second group (n = 25) was applied the ESWT (2 days a week for 4 weeks) + medical treatment + stabilization splint. Visual Analog Scale scores, painless maximum painless mouth opening, and passive-forced mouth opening measurements were recorded for the first and second weeks.

Results:

The ESWT application significantly contributed to pain-reducing (Visual Analog Scale) in patients at short notice (P = .030) in the second group. There were statistically significant differences between the groups in painless maximum active mouth opening (P = .009) and passive forced measurements (P = .004) in the second week.

Conclusion:

This pilot study showed that short-term ESWT addition to stabilization splint and medical treatment may yield satisfactory outcomes.
Primary diffuse large B-cell lymphoma of bone in adults: A SEER population-based study
Authors: Li Jing , Li Xiangpeng , Gao Tong , Zhou Changkai , Guo Qie , Liu Donghua
Published: October 2024

Primary diffuse large B-cell lymphoma of the bone (PB-DLBCL) is an extremely rare type of extra-nodal lymphoma. The clinical characteristics, management, and survival outcomes of adult PB-DLBCL patients remain poorly defined. To explore the clinical manifestations, staging, therapeutic options, prognostic factors and outcomes of adult patients with PB-DLBCL and to create a model to predict survival outcomes. Data of adult PB-DLBCL patients were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program 18 registries database from 2000 to 2018. The Kaplan–Meier survival analysis was conducted to calculate survival rates. Univariate Cox regression, best subset selection (BESS), and least absolute shrinkage and selection operator (LASSO), followed by backward stepwise multivariable Cox regression, were used to construct the nomogram. The nomograms were evaluated using the concordance index (C-index), calibration curves and decision curve analysis (DCA). Diffuse large B-cell lymphoma (DLBCL) (67.51%) was the most frequent type of primary bone lymphoma. The most involved sites were the spine and lower-limb long bones. For the whole cohort, the 3-, 5-, 10- and 15-year overall survival (OS) rates were 74.9%, 70.5%, 60.0%, and 49.9%, and corresponding disease-specific survival (DSS) rates were 79.7%, 77.8%, 75.1%, and 71.4%, respectively. For OS, age, Ann Arbor stage, primary site and therapy were confirmed as final factors to develop the nomogram in adult PB-DLBCL patients, whereas for DSS, Age, marital status, Ann Arbor stage, number of bone lesions, therapy and year of diagnosis were confirmed as final factors in developing the nomogram. The nomograms demonstrated good accuracy and clinical utility. Established nomograms can accurately predict the survival of patients with PB-DLBCL and help clinicians optimize treatment.
Study on serum metabolomics characteristics of obese patients with erectile dysfunction
Authors: Lin Yong , Pan Rirun , Deng Risen , Fang Shengyi , Yang Hui , Zhang Xinan , Cheng Wanjun
Published: October 2024

Erectile dysfunction (ED) is a common male sexual health problem that can be associated with obesity. This study aimed to identify serum metabolic differences and pathways related to ED in obese men using non-targeted metabolomics techniques. We included 54 obese male patients with (n = 27) and without (n = 27) ED. We collected 5 mL of fasting elbow vein blood and analyzed serum metabolites using ultra-high-performance liquid chromatography–mass spectrometry. Multivariate statistical methods (principal component analysis and orthogonal partial least squares discriminant analysis) were used to identify differential metabolites between the groups. Finally, pathway analysis using the Kyoto encyclopedia of genes and genomes database identified 4 differential metabolic pathways in obese men with ED compared to obese men without ED. A total of 77 differential metabolites were identified in obese men with ED compared to the control group (obese men without ED) using a threshold of variable importance in the projection > 1 and P < .05. Pathway analysis revealed 4 main differences: glycine, serine and threonine metabolism, glycerophospholipid metabolism, aminoacyl-tRNA biosynthesis, and D-glutamine and D-glutamate metabolism. Specific metabolites associated with these pathways included betaine aldehyde, choline, L-threonine, phosphatidylcholine, L-serine, and D-glutamine. Our findings suggest abnormalities in fatty acid metabolism, phospholipid metabolism, and amino acid metabolism between obese men with and without ED. Metabolites such as betaine aldehyde, choline, L-threonine, phosphatidylcholine, L-serine, and D-glutamine may be potential biomarkers for distinguishing obese men with ED.
Epidemiological analysis of 2106 geriatric trauma patients in a level I trauma center in Lanzhou City, Gansu Province, China
Authors: Su Zhaoyin , Wei Hui , Wang Weining , Chen Jiaxiang , Wang Weitao , Lyu Yuan , Lin Rubing , Michael Nerich , Liu Yatao
Published: October 2024

As the global population ages, geriatric trauma gains attention. Limited studies on geriatric trauma in developing countries necessitate comprehensive investigation. This study aims to delineate the epidemiological characteristics of geriatric trauma, providing insights for prevention and enhanced elderly trauma care. Clinical data of 2106 geriatric trauma patients (age ≥ 60) treated from November 1, 2020, to October 31, 2023, at the trauma center of the First Hospital of Lanzhou University were retrospectively analyzed. Descriptive statistics covered temporal and monthly distribution, trauma sites, causes, and length of stay. Inclusive were 2106 geriatric patients (941 males, 1165 females; male-to-female ratio 1:1.24). Trauma incidence was higher in summer and autumn (May–October) than winter (November–December). Peak incidents occurred between 14:00–16:00, with concentrations at 12:00–16:00 and 20:00–22:00. Falls (59.35%), road traffic accidents (16.62%), other traumas (14.10%), cutting/stabbing (4.56%), violence (3.42%), mechanical injuries (1.61%), winter sports injuries (0.14%), burns (0.14%), and animal bites (0.06%) were major causes. Extremity and skin injuries prevailed, with significant site distribution differences (P < .001). Average length of stay at the trauma center was 78.35 ± 48.32 minutes. The gender distribution, timing, causes, and sites of trauma in the elderly differ significantly from other age groups. Unlike the higher occurrence of trauma in young men compared to women, among the elderly, it is more prevalent in women than men, mainly attributed to falls. It is crucial to implement specific measures to prevent trauma in the elderly, and the advancement of information technology in the trauma care system could additionally improve the quality of care.
Trousseau syndrome with recurrent cerebral infarction as the first oneset in a gastrointestinal malignant tumor patient: A case report
Authors: Meng Chaoyue , Feng Yuyao , Yang Yi , Zhang Kun , Wang Rui , Wang Ye , Tian Jing , Liu Xiaoyun
Published: October 2024

Rationale:

Trousseau syndrome (TS) is a thrombosis disorder characterized by a hypercoagulable state linked to underlying malignancies, resulting in various thrombotic events such as deep vein thrombosis, pulmonary embolism, and arterial thrombosis. This syndrome serves as a crucial indicator of malignancy and can often be the first sign of an underlying tumor. In this case, we report a case of gastrointestinal malignant tumor as the first onset, and analyzes its clinical characteristics to improve the clinicians’ understanding of this kind of disease.

Patient concerns:

A 69-year-old woman was admitted to the hospital 4 times in 1 month for cerebral infarction. The patient was admitted several times with a new cerebral infarction lesion and a high D-dimer level, a persistently positive fecal occult blood test, and a gastrointestinal tumor was later found.

Diagnosis:

The patient was diagnosed with TS, attributed to her underlying malignancy.

Interventions:

During hospitalization, the patients were treated with aspirin for antiplatelet, esomeprazole for protection of gastric mucosa, atorvastatin for lowering blood lipids, butylphthalein for improvement of collateral circulation, edaravone dextrocamphorol for scavenging oxygen free radicals, and betahistine hydrochloride tablets for preventing dizziness.

Outcomes:

The patient’s condition improved significantly after initial treatment, but died of the tumor a year after discharge.

Lessons:

Currently, TS has a complex and varied clinical presentation and is relatively difficult to diagnose, especially in patients with an unknown tumor history. Focus should be placed on patients with recurrent cerebral infarctions and increased D-dimer levels, and anticoagulation may be an effective treatment for patients with TS.
MicroRNAs and other biomarkers of atrial fibrillation in ischemic stroke patients
Authors: Janský Petr , Kaplan Vojtěch , Šrámková Tereza , Kolman Filip , Kloudová Petra , Benešová Kateřina , Olšerová Anna , Kešnerová Petra , Magerová Hana , Šulc Vlastimil , Halmová Hana , Kmetonyová Silvia , Paulasová-Schwabová Jaroslava , Šarbochová Ivana , Maťoška Václav , Tomek Aleš
Published: October 2024

This study aimed to evaluate the ability of selected microRNAs as biomarkers of atrial fibrillation (AF) in ischemic stroke patients in comparison with other established biochemical biomarkers. A prospective case–control study of consecutive ischemic stroke patients with AF admitted to a comprehensive stroke center was conducted. The control group consisted of patients with ischemic stroke with no AF detected on prolonged (at least 3 weeks) Holter ECG monitoring. As potential biomarkers of AF, we analyzed the plasma levels of microRNAs (miR-21, miR-29b, miR-133b, miR-142-5p, miR-150, miR-499, and miR-223-3p) and 13 biochemical biomarkers at admission. The predictive accuracy of biomarkers was assessed by calculating the area under the receiver operating characteristic curve. The data of 117 patients were analyzed (61 with AF, 56 with no AF, 46% men, median age 73 years, median National Institutes of Health Stroke Scale 6). Biochemical biomarkers (N-terminal pro-B-type natriuretic peptide [NT-proBNP], high-sensitivity cardiac troponin I, fibrinogen, C-reactive protein, eGFR, and total triglycerides) were significantly associated with AF. NT-proBNP had the best diagnostic performance for AF with area under the receiver operating characteristic curve 0.92 (95%, CI 0.86–0.98); a cutoff value of >528 ng/L had a sensitivity of 79% and a specificity of 97%. None of the other biomarkers, including microRNAs, was associated with AF. Conventional biochemical biomarkers (NT-proBNP, high-sensitivity cardiac troponin I, fibrinogen, C-reactive protein, eGFR, and triglycerides), but not microRNAs (miR-21, miR-29b, miR-133b, miR-142-5p, miR-150, miR-499, and miR-223-3p) were significantly associated with AF in our ischemic stroke cohort.
Identification of exosomal ceRNA networks as prognostic markers in clear cell renal cell carcinoma
Authors: Zhu Tao , Fu Haizhu , Wang Zhiqiang , Guo Shanchun , Zhang Shidong
Published: October 2024

Aggressive clear cell renal cell carcinoma (ccRCC) has a bad prognosis. We seek new ccRCC biomarkers for diagnosis and treatment. We used exoRBase and The Cancer Genome Atlas Database to compare DEmRNAs, DEmiRNAs, DElncRNAs, and DEcircRNAs in ccRCC and normal renal tissues. CircRNAs and circRNAs targeting microRNAs (miRNAs) were anticipated and taken intersections, and several databases assessed the targeted link between common miRNAs and messenger RNAs (mRNAs). The Cancer Genome Atlas database was used to create a predictive mRNA signature that was validated in E-MTAB-1980. Finally, we examined competing endogenous RNA network miRNAs and long noncoding RNAs for ccRCC predictive biomarkers using overall survival analysis. We built the first competing endogenous RNA regulation network of circRNA–lncRNA–miRNA–mRNA and found that it substantially correlates with ccRCC prognosis. We unveiled ccRCC’s posttranscriptional regulation mechanism in greater detail. Our findings identified novel biomarkers for ccRCC diagnosis, therapy, and prognosis.
Immune checkpoint inhibitor therapy for primary neuroendocrine carcinoma of the gallbladder: A case report and literature review
Authors: Li Chao , Lv Pan , Yanyan Liu , Yin Maohui , Li Hao
Published: October 2024

Rationale:

Gallbladder neuroendocrine carcinoma (GNEC) is indeed a relatively rare malignant tumor of the gallbladder with neuroendocrine differentiation and the ability to produce and secrete a number of neurotransmitters and hormones, characteristics that make its clinical presentation and biological behavior likely to be different from those of other types of gallbladder cancer. Current treatment mostly relies on surgery and adjuvant chemotherapy and radiotherapy.

Patient concerns:

We report a 53-year-old middle-aged male patient who underwent radical surgery for gallbladder malignancy after a diagnosis of neuroendocrine carcinoma of the gallbladder.

Diagnoses:

Diagnosis of neuroendocrine carcinoma of the gallbladder based on the return of pathologic findings.

Intervention:

After local progression of postoperative chemotherapy with the first-line regimen of etoposide + cisplatin, an immune checkpoint inhibitor (traplizumab) + FOLIFIRI (fluorouracil + calcium folinate + irinotecan) regimen was used.

Outcomes:

The patient achieved 20 months of clinical survival and ultimately died of myelosuppression.

Lessons:

The use of immune checkpoint inhibitors may become an effective tool in the treatment of neuroendocrine carcinoma of the gallbladder.
The correlated factors of anxiety and depression among Chinese hospital staff during the COVID-19 local outbreak
Authors: Li Guomiao , Wei Chun , Fang Kai , Jiang Hui , Liu Quanwei , Ou Jiang
Published: October 2024

Hospital staff in the COVID-19 local outbreak were facing different situations, their mental status and influencing factors were also different. The aim of this study is to investigate the anxiety and depression of hospital staff and its potential influence factors during the COVID-19 local outbreak. This was a cross-sectional survey based on a hospital with a local outbreak of COVID-19. We collected the demographic characteristics, COVID-19-related issues, self-rating anxiety scale (SAS), and self-rating depression scale (SDS) of participants through an anonymous questionnaire. Factors associated with anxiety and depression were explored through univariate and multivariate analyses. We also constructed nomograms and calibration curves to predict the probability of anxiety and depression. A total of 800 people completed the questionnaire. 239 (29.9%) of them were doctors, 249 (31.1%) of them were nurses and 312 (39.0%) of them were others. There were 173 (21.6%) cases had anxiety, including 36 (20.8%) doctors, 76 (43.9%) nurses and 61 (35.3%) from other occupations and 281 (35.1%) cases had depression, including 64 (22.8%) doctors, 101 (35.9%) nurses, and 116 (41.3%) from other occupations. Nurses had higher SAS and SDS score than doctors and others (F = 17.856, P < .001 and F = 14.376, P < .001). In addition, multivariate analysis found that occupation, education level, health condition, and reduced sleep were significant influences on anxiety and depression. At the same time, reduced income was also significantly associated with anxiety. During the local outbreak of COVID-19, hospital staff still had varying degrees anxiety and depression. Occupation, education level, health condition and reduced sleep were both significant influencing factors for anxiety and depression. The mental state of hospital staff, including nonmedical-related staff should still be taken seriously.
BTKi combined with chemical immunotherapy in the initial treatment of aggressive mantle cell lymphoma: A retrospective study
Authors: Ju Qianqian , Li Zhenling
Published: October 2024

To explore the safety and efficacy of Bruton’s tyrosine kinase inhibitor (BTKi) combined with immunological therapy in untreated patients with aggressive mantle cell lymphoma. A retrospective study was conducted on 9 previously untreated patients who received BTKi combined with immunological therapy, which means using immunological therapy and BTKi at the same time. The median age of the patients was 61 years, 7 were males, and the median follow-up time was 14 months. Among the 7 evaluable patients, the median follow-up was 14 months, and the objective remission rate was 100% (complete remission rate 86%, partial remission rate 14%), while the median progression-free survival and overall survival were not achieved. No patients were dead. The progression-free survival rate of 6 patients in the low-risk group was 100%. The combination of BTKi and chemoimmunotherapy has shown excellent therapeutic results in untreated patients of aggressive mantle cell lymphoma. At the same time, it also can prolong the survival time of high-risk patients. The combined therapy has acceptable safety in previously untreated patients. Hematological toxicity is the most common side effect and infection is the second one. A rash reaction was seen occasionally. There are no heart-related adverse events in the study. There are no new adverse effects caused by the combined treatment.
Ovarian carcinosarcoma with lung metastasis characterized by persistent fever: A case report and literature review
Authors: Wang Weijing , Ji Xuechao , Yang Hanchao , Wang Xinbo
Published: October 2024

Rationale:

Ovarian carcinosarcoma (OCS) is a rare malignant tumor prone to distant metastasis. Primary manifestations include pelvic and/or abdominal pain, bloating, and compression. Nevertheless, it is uncommon for OCS to present primarily with persistent fever. This is the first reported case of OCS with lung metastasis characterized by persistent fever.

Patient concerns:

A 61-year-old female patient complaining of abdominal pain and fever was admitted to our hospital. Computed tomography showed an irregular, slightly low-density mass on the left side of the uterus and multiple solid nodules in both lungs.

Diagnoses:

She underwent cytoreductive surgery for pathologically confirmed stage IVB OCS.

Interventions:

She was administered chemotherapy after cytoreductive surgery. Given the patient’s history of persistent fever and progressively enlarged pulmonary nodules, a pulmonary abscess was considered as a possible diagnosis. Following antibiotic therapy, the patient’s high body temperature did not decrease; however, following nonsteroidal anti-inflammatory drug therapy, it quickly decreased. These symptoms were eventually considered the consequence of neoplastic fever caused by lung metastases.

Outcomes:

Owing to the rapid progression of the disease, the patient ultimately died.

Lessons:

This study suggests that, for patients with pelvic and/or abdominal pain, bloating, and pelvic masses, especially those with suspicious lesions in other organs accompanied by fever of unknown origin, a diagnosis of cancer or sarcoma with metastasis should be considered after ruling out infectious fever.
Integrating network pharmacology, molecular docking, and experimental validation to reveal the mechanism of Radix Rehmanniae in psoriasis
Authors: Mo Nian , Zhou Panyu , Liu Fanlu , Su Haojie , Han Ling , Lu Chuanjian
Published: October 2024

Background:

Radix Rehmanniae (RR) plays an important role in treating psoriasis. However, the active compounds of RR and potential mechanisms are unclear. The current study was designed to investigate the potential active ingredients, targets, and mechanisms of RR in treating psoriasis through network pharmacology, molecular docking, and vitro experiments.

Methods:

Initially, the TCMSP database and literature retrieval were used to access the active ingredients of RR. The psoriasis target proteins were obtained from Therapeutic Target Database, OMIM, GeneCards, and DrugBank databases. The target proteins were then converted into target genes using Uniprot. Secondly, overlapping genes were obtained through Venn online tool. Then, protein–protein interactions network diagram is finished by STRING database. Next, Cytoscape software was used to acquire the top 10 hub proteins; gene ontology and Kyoto encyclopedia of genes and genomes enrichment analysis were then used to predict possible mechanisms. Afterwards, molecular docking validation of the active ingredients with the main targets was performed by AutoDock software. Finally, lipopolysaccharides induced RAW264.7, to assess the effects and molecular mechanisms by MTT, RT-qPCR, and Western blot assays.

Results:

Overall, there are 20 effective compounds and 33 targets involved in biological processes including apoptosis, intracellular signaling, vasodilation, and mitogen-activated protein kinase (MAPK) signaling cascade. The docking results showed strong binding capacity between the active ingredients and targets. We verified aucubin as the key active ingredient, tumor necrosis factor α, and IL6 as the core targets, and focused on the p38MAPK protein pathway. Cellular experiments showed that aucubin down-regulated the phosphorylated p38MAP protein and reduced the expression of tumor necrosis factor α mRNA, IL6 mRNA, and IL1βmRNA.

Conclusion:

In summary, RR is featured with multicomponent, multi-target, and multi-pathway in treating psoriasis; the preliminary mechanism may be associated with the down-regulation of p38MAPK phosphorylation and curbing the expression of inflammatory factor by aucubin. This paper provides the scientific basis for Traditional Chinese medicine treating psoriasis.
Bibliometric analysis of orexin: A promising neuropeptide
Authors: Sun Ning , Wei Rui , Jia Bochao , Lou Taiwei , Li Zirong , Nie Xiaowei , Yu Wenxiao , Zhao Ming , Li Qiuyan
Published: October 2024

Background:

Orexin is an excitatory neuropeptide produced in the lateral hypothalamus, playing a role in various physiological functions in humans. There is a growing body of literature on orexins. This paper utilizes CiteSpace software to organize and analyze a significant number of articles on orexin, providing readers with an intuitive overview of research trends and emerging hot topics in this field.

Methods:

The electronic database, Web of Science Core Collection (WoSCC), was searched for publications related to orexins. Annual publications, countries/regions, institutions, authors and keywords were analyzed, and the results were visualized via CiteSpace software.

Results:

A total of 5486 publications were included, with articles making up 85.30% and reviews 14.70%. The top 3 countries publishing the most papers on orexins were the United States (2057 papers), Japan (778), and China (556). The leading institutions included Research Libraries UK (278), Harvard University (250), and Stanford University (221). The most prolific authors in the field were Yves Dauvilliers (69), Abbas Haghparast (67), and Takeshi Sakurai (66). The most frequently used keywords were “neurons” (981), followed by “sleep” (824), “food intake” (612), “receptors” (547), and “neuropathology” (535). Recent research hotspots include melanin-concentrating hormone neurons, Alzheimer disease, gamma-aminobutyric acid neurons, oxidative stress, suvorexant, the orexin system, prevalence, and stress. Based on keyword clustering analysis, the top 5 research hotspots from 2003 to 2022 were: the effects of orexins on sleep and metabolism, potential pathways of orexin signaling, the relationship between orexin and immunity, new findings on depression and hypertension related to orexin, and possible targets for neurodegenerative diseases.

Conclusion:

Orexin, a neuropeptide linked to various physiological and pathological processes, plays a crucial role in sleep/wakefulness, reward mechanisms, stress responses, and neurodegenerative diseases. Its significant research value and potential medical applications are underscored by the rapid expansion of studies, particularly in the USA and Japan. However, the lack of collaboration among researchers highlights the need for enhanced academic exchange and cooperation to further advance the field of orexin research.
Metformin: Diverse molecular mechanisms, gastrointestinal effects and overcoming intolerance in type 2 Diabetes Mellitus: A review
Authors: Mohamed Sami
Published: October 2024

Metformin, the first line treatment for patients with type 2 diabetes mellitus, has alternative novel roles, including cancer and diabetes prevention. This narrative review aims to explore its diverse mechanisms, effects and intolerance, using sources obtained by searching Scopus, PubMed and Web of Science databases, and following Scale for the Assessment of Narrative Review Articles reporting guidelines. Metformin exerts it actions through duration influenced, and organ specific, diverse mechanisms. Its use is associated with inhibition of hepatic gluconeogenesis targeted by mitochondria and lysosomes, reduction of cholesterol levels involving brown adipose tissue, weight reduction influenced by growth differentiation factor 15 and novel commensal bacteria, in addition to counteraction of meta-inflammation alongside immuno-modulation. Interactions with the gastrointestinal tract include alteration of gut microbiota, enhancement of glucose uptake and glucagon like peptide 1 and reduction of bile acid absorption. Though beneficial, they may be linked to intolerance. Metformin related gastrointestinal adverse effects are associated with dose escalation, immediate release formulations, gut microbiota alteration, epigenetic predisposition, inhibition of organic cation transporters in addition to interactions with serotonin, histamine and the enterohepatic circulation. Potentially effective measures to overcome intolerance encompasses carefully objective targeted dose escalation, prescription of fixed dose combination, microbiome modulators and prebiotics, in addition to use of extended release formulations.