bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of transcatheter arterial embolization for first-line treatment of colonic diverticular bleeding with extravasation on contrast-enhanced computed tomography
Authors: Kojima Yuki , Katano Takahito , Shimura Takaya , Shimohira Masashi , Sugiyama Tomoya , Ebi Masahide , Harada Takahito , Yamamoto Yuki , Hirata Yoshikazu , Kataoka Hiromi
Published: November 2022

Colonic diverticular bleeding (CDB) is the most frequent cause of acute lower gastrointestinal bleeding. The aim of this study was to evaluate the efficacy and safety of transcatheter arterial embolization (TAE) for CDB as first-line treatment with extravasation on contrast-enhanced computed tomography (CECT), compared with endoscopic hemostasis. Three Japanese institutions participated in this retrospective cohort study. Data from consecutive patients admitted with a diagnosis of CDB with extravasation on CECT were reviewed. One hospital performed TAE and the others conducted urgent colonoscopy (CS) as the first-line treatment for CDB with extravasation on CECT. The primary outcome was rebleeding rate within 30 days after first-line treatment. In total, 165 CDB cases with extravasation on CECT (TAE group, n = 39; CS group, n = 126) were analyzed in this study. The rebleeding rate within 30 days was significantly lower in the TAE group (7.69%) than in the CS group (23.02%; P = .038). The bleeding point detection rate was significantly higher in the TAE group (89.74%, 35/39) than in the CS group (37.30%, 47/126; P < .0001). Even in those cases in which a bleeding point was detected, the rebleeding rate was significantly lower in the TAE group (0%) than in the endoscopic hemostasis-success group (23.91%; P = .005). No severe complications of Grade 3 or more were seen with TAE. We showed that TAE is an effective, safe hemostatic method, and a useful alternative to endoscopic hemostasis for first-line treatment of CDB.
The efficacy and safety of catheter balloon dilatation in the treatment of dysphagia after stroke: A protocol for systematic review and meta-analysis
Authors: Wang Lin , Yao Jian , Guan Bugao , Xu Jin , Yu Haitao , Li Hongbo
Published: November 2022

Background:

Dysphagia is a serious complication after stroke, which has a significant influence on the health as well as life quality of global people. Patients with dysphagia tend to be a higher risk rate of an aspiration than general person. Catheter balloon dilatation is an additional therapy for treating dysphagia in recent years, which can improve the symptom of achalasia of cricopharyngeal muscle. This research will be used for confirming the efficacy and safety of the catheter balloon dilatation for resolving dysphagia.

Methods:

We intend to search literature related to the research in different databases, for instance, China National Knowledge Infrastructure, Wanfang Data, PubMed, Cochrane Library, and Embase up to January 2022. Literature selection, data collection, as well as assessment of bias risk, will be carried out by 2 independent researchers. Data analysis will be conducted by using Stata and review manager 5.4.

Results:

The results will be submitted to a peer-reviewed journal.

Conclusion:

The research will verify whether or not catheter balloon dilatation can improve dysphagia by submitting high-quality data syntheses.

Registration number:

CRD42022358433.
Scalp acupuncture for stroke: A protocol for an overview of systematic reviews and meta-analysis
Authors: Park Sun-Young , Kim Hyun-Tae , Heo In , Hwang Man-Suk , Hwang Eui-Hyoung , Shin Byung-Cheul
Published: November 2022

Background:

Scalp acupuncture (SA) is a new acupuncture method that connects head acupoints and aculines, and many systematic reviews (SRs) have been published on its use against neuropsychiatric diseases. However, no overview of SRs on the effectiveness of SA in stroke recovery has been conducted. Therefore, our overview aims to evaluate the methodological bias and reliability of the conclusions of SRs regarding SA for stroke recovery and help clinical decision-makers translate this research into clinical policy and practice.

Methods:

We will consider SRs and meta-analyses of randomized controlled trials to evaluate the effects of SA on stroke recovery. Two reviewers will identify relevant studies, extract data information, and assess the methodological quality using the Assessment of Multiple Systematic Reviews-2 tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses report checklist will also be included in the study to assess the quality of the reports. We will use evaluations of the Grading of Recommendations Assessment, Development and Evaluation of the authors of the included SRs. The Risk of Bias in Systematic Review tool will be used to assess the risk of bias of SRs. The screening of SRs, eligibility evaluation, data extraction, methodological quality, and quality of evidence will be conducted by independent reviewers in pairs. The outcomes of interest include the Modified Edinburgh–Scandinavian Stroke Scale, Ability of Daily Living, Functional Independence Measure, Barthel index, Fugl–Meyer assessment, clinical effective rate, and adverse events. Data will be extracted using predefined forms designed to summarize the important characteristics of each review. The evidence will be a descriptive synthesis of the type and content of the intervention and the results reported.

Results:

The results will be published in a peer-reviewed journal.

Conclusions:

We expect to organize evidence from multiple SRs on the effectiveness of SA for stroke recovery and synthesize the findings in an accessible and useful documentation.
Pre- and intraoperative cerebral near-infrared spectroscopy and postoperative delirium: Results of a prospective cross-sectional trial
Authors: Fischer-Kumbruch Moritz , Jung Carolin , Hinken Lukas , Trübenbach Dominik , Fielbrand Rieke , Schenk Isabel , Diegmann Oliver , Krauß Terence , Scheinichen Dirk , Schultz Barbara
Published: November 2022

Postoperative delirium (PODE) is a serious complication that can occur during the first few days after surgery. A number of causes can make delirium more likely; one factor to consider is hypoxia during anesthesia. In this study, the pre- and intraoperative cerebral regional oxygen saturation (rSO2) as measured by near-infrared spectroscopy (NIRS) was to be examined with regard to an association with the occurrence of PODE in patients undergoing major abdominal procedures. Data from 80 patients (33 women, 47 men) was examined. The mean age was 66.31 ± 10.55 years (between 42 and 84 years). Thirteen patients developed PODE. The preoperative rSO2 values (P = .10) and the rSO2 values during the steady state of anesthesia (P = .06) tended to be lower in the delirium group than in the non-delirium group. There was a significant correlation between the preoperative rSO2 and the preoperative hemoglobin values (P < .001). The variance of rSO2 during the steady state of anesthesia was significantly greater in the delirium group compared to the non-delirium group (P = .03). In two patients from the delirium group, rSO2 dropped below 50%; they also had a minimum mean arterial pressure below 50 mmHg, which could have disturbed cerebral autoregulation. The duration of rSO2 decreases (>10%, >15%, >20%) and increases (>10%) compared to the preoperative values was not significantly different between patients with and without PODE. The results suggest that NIRS could be a useful monitoring method for patients undergoing abdominal surgical procedures, on the one hand to recognize patients with low pre- or intraoperative rSO2 values, and on the other hand to detect changes in rSO2 values during anesthesia.
Elevated serum alkaline phosphatase correlates with postoperative cognitive dysfunction: A retrospective cohort study based on STROBE statement
Authors: Li Xiaoli , Zhao Lili , Shi Huijuan , Wang Huimin , Wang Xin , Wang Lingling
Published: November 2022

Little is known about the association between serum alkaline phosphatase (ALP) levels and postoperative cognitive dysfunction (POCD) after general anesthesia. Thus, we investigated the association of serum ALP levels with POCD in patients who underwent surgery with general anesthesia in a retrospective cohort study. We retrospectively collected data from patients who underwent surgery with general anesthesia between May 2016 and June 2020. Serum ALP activity was detected using a p-nitrophenyl phosphate assay. Pre-and postoperative cognitive function were evaluated using the Chinese version of the Mini-Mental State Examination. Univariate and multivariate logistic regression were used to explore the effect of ALP on cognitive function. The incidence of POCD was 13.5%. Compared with the control group, the POCD group had higher ALP levels. The neuropsychological test results suggested that the scores of most items were lower in the POCD group than in the non-POCD group. Univariate logistic regression indicated that increased ALP levels were significantly associated with cognitive dysfunction (odds ratio = 1.15, 95% confidence interval: 1.13–1.18, P = .000). Multivariate regression showed that elevated ALP was still associated with POCD after adjusting for confounding factors (odds ratio = 1.16, 95% confidence interval: 1.13–1.18, P = .000). The spline regression model indicated the dose–response associations between ALP level and POCD risk (P for nonlinear trend < .001). Our study indicated that elevated serum ALP was an independent predictive factor of POCD at the 3-month follow-up. The occurrence of POCD could be associated with inflammatory status.
MIS-TLIF or CLIF for single segmental lumbar degenerative disease
Authors: Nazierhan Shaxika , Li Chenxi , Guo Rui , Lu Linsong , Aikeremu Dilimulati , Xu Kuo , Wang Hao
Published: November 2022

We aimed to compare the effect of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and Crenel lateral interbody fusion (CLIF) on single segmental lumbar degenerative disease. Patients with single segmental lumbar degenerative disease undergoing MIS-TLIF (n = 28) and CLIF (n = 28) were enrolled from April to October 2017. Preoperative medical history, anthropometric data, and clinical data were recorded. Visual analogue scores and Oswestry disability index (ODI) were assessed. Radiography was performed before and after surgery. X-ray films were evaluated according to the Bridwell method, visual analogue scores and ODI scores were evaluated. There were no significant differences in the gender, age, clinical diagnosis, involved segment or preoperative ODI score between 2 groups (P > .05). During 12-month follow-up, MIS-TLIF group had less intraoperative blood loss, drainage, postoperative bedridden time, and hospital stay (P < .05), but more operation time and radiation exposure time compared with CLIF group (P < .05). CLIF group reported less pain than MIS-TLIF group (P > .05). Both groups had similar lumbar fusion rate (P > .05). Overall, CLIF has less complications, less trauma and faster recovery for the treatment of single segmental lumbar degenerate disease when compared with MIS-TLIF. Evaluation of more patients and long-term follow-up are still needed to further validate our findings.
Feasibility of endoscopic ultrasound-guided hepaticogastrostomy using a 22-gauge needle
Authors: Takahashi Koji , Ohyama Hiroshi , Ouchi Mayu , Kan Motoyasu , Nagashima Hiroki , Iino Yotaro , Kusakabe Yuko , Okitsu Kohichiroh , Ohno Izumi , Takiguchi Yuichi , Kato Naoya
Published: November 2022

This study aimed to evaluate the feasibility of performing endoscopic ultrasound-guided hepaticogastrostomy using a 22-gauge fine-needle aspiration needle. This was a single-center retrospective study. Fourteen patients who underwent endoscopic ultrasound-guided hepaticogastrostomy with a 22-gauge fine-needle aspiration needle were examined. Fourteen eligible patients were included in this study. The age of patients ranged from 55 to 93 years, with a median of 76 years. Of patients with existing underlying diseases, there were 8 cases of pancreatic cancer (57.1%), 2 cases of metastatic liver tumor (14.3%), 2 cases of bile duct stones (14.3%), 1 case of hilar cholangiocarcinoma (7.1%), and 1 case of gallbladder cancer (7.1%). Regarding gastrointestinal anatomy, there were 11 cases (78.6%) of normal and 3 cases (21.4%) of gastric resection with Roux-en-Y. Reasons for endoscopic ultrasound-guided hepaticogastrostomy were duodenal obstruction in 7 cases (50.0%), surgically altered anatomy in 3 cases (21.4%), and 4 cases (28.6%) of failed endoscopic retrograde cholangiopancreatography. Technical success was achieved in 11 cases (78.6%). Subsequently, 11 cases of technical success were analyzed. There were 5 cases of puncturing B2 (45.5%). The puncture bile duct diameter ranged from 3.1 to 5.7 mm, with a median of 4.4 mm. endoscopic ultrasound-guided antegrade procedures was combined with endoscopic ultrasound-guided hepaticogastrostomy in 2 cases (18.2%). Clinical success was achieved in all the cases. The procedure time ranged from 15 to 93 minutes, with a median duration of 35 minutes. Regarding the type of stent placed in hepaticogastrostomy, a plastic stent was placed in 10 cases (90.9%) and a metal stent was placed in 1 case (9.1%). Early adverse events occurred in 4 cases (36.4%), and all of these cases developed biliary peritonitis, late adverse events occurred in 1 case (9.1%), this was biloma. A change to a 0.025-inch guidewire during the procedure was required in 8 cases (72.7%). Esophageal puncture was not performed. endoscopic ultrasound-guided hepaticogastrostomy using a 22-gauge fine-needle aspiration needle is effective. However, in 72.7% of the cases started using the 0.018-inch guidewire, the guidewire was exchanged for a 0.025-inch guidewire during procedure.
Effect of cataract surgery on the progression of age-related macular degeneration
Authors: Chen Zhaoyan , Zeng Ya , Tian Fangyuan
Published: November 2022

Background:

Cataracts and age-related macular degeneration (AMD) are common causes of decreased vision and blindness in individuals over age 50. Although surgery is the most effective treatment for cataracts, it may accelerate the progression of AMD, so this study further evaluated the influence of cataract surgery for AMD through a systematic review and meta-analysis.

Methods:

The Cochrane Systematic Evaluation method was adopted, and computer searches were conducted for the China Knowledge Network, Wanfang, Vipul, SinoMed, PubMed, SpringerLink, Clinicalkey, Medline, Cochrane Library, Web of Science, OVID, and Embase databases of cohort studies on the impact of cataract surgery on AMD, with search timeframes up to May 2022. Meta-analysis was performed using Stata/12.0.

Results:

A total of 8 cohort studies were included in the study. The results showed that the relative risk (RR) of AMD progression after cataract surgery was not significantly different, RR 1.194 [95% credibility interval (CI) 0.897‐1.591]; the risk remained increased more than 5 years after surgery, RR 1.372 (95% CI 1.062‐1.772).

Conclusion:

There is still a significant positive correlation between cataract surgery and increase the risk of worsening of AMD progression, and faster progression of early-to-late AMD found in cataract surgery with longer follow-up of patients.
Prevalence and risk factors associated with poor sleep among firefighters in Taiwan: An observational study
Authors: Lin Cheng-Yao , Su Shih-Bin , Hu Ya-Ting , Peng Cheau-Jane , Chen Kou-Huang , Chen Kow-Tong
Published: November 2022

Sleep quality is directly correlated with overall health and quality of life. Firefighters have a higher workload and injury rate than those in other occupations. This study investigated the prevalence of and risk factors for poor sleep quality among firefighters in Taiwan. This cross-sectional study was conducted between November 2019 and August 2020. Sociodemographic information of the study participants was collected using a structured self-administered questionnaire. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the subjective sleep quantity and quality of firefighters during the previous month. A t test for continuous variables and χ
2 test for categorical variables were performed for univariate analysis. Logistic regression analysis was conducted for multivariate analysis. Eight hundred eighty-nine firefighters completed the questionnaire during the study period, with a response rate of 88.9%. Among them, 447 (50.3%) reported poor sleep quality. Logistic regression analysis showed that female sex, longer work duration (>5 years) for firefighters, on-call shift work, and no leisure-time physical activity (LTPA) was significantly correlated with an increased risk of poor sleep quality. Advanced analysis of partaking in LTPA revealed that high-intensity LTPA is significantly associated with higher rates of poor sleep quality. In contrast, adequate rest after LTPA correlated with lower rates of poor sleep quality. Firefighters are at higher risk of poor sleep quality. Emphasis should be placed on firefighters’ regular LTPA, particularly when experiencing sleep problems.
Laparoscopic triple-ureteral ureteroureterostomy in a patient with ureteral triplication: A case report
Authors: Liu Saisai , Lu Rugang , Guo Yunfei , Xiucheng Gao
Published: November 2022

Rationale:

Ureteral triplication (UT) is a very rare disorder, with a challenging diagnosis and varied therapeutic methods. In the past, the treatment usually involved heminephrureterectomy of the stunted moiety. Here, we reported a case of complete UT that was treated by laparoscopic triple-ureteral ureteroureterostomy (UU).

Patient concerns:

A 2-year-old girl presented with frequent urine incontinence. Intravenous pyelography and voiding cystourethrography revealed a 3-segment left kidney with pelvi-ureteric dilation of the upper and middle moieties and grade IV to V vesicoureteral reflux. Laparoscopic triple-UU was successfully performed in the child, after which vesicoureteral reflux and urinary incontinence disappeared completely, hydronephrosis was improved, and hemirenal resection was avoided.

Diagnosis:

Based on the imageological examination results, the final diagnosis of the 2-year-old girl was as follows: left 3 renal pelvis with complete ureteral duplication, combined with upper and middle hydronephrosis, and upper and middle vesicoureteral reflux grade IV to V.

Intervention:

Laparoscopic triple-ureteral ureteroureterostomy was performed under general anesthesia.

Outcomes:

The patient recovered smoothly without complications after surgery. At 6 months follow-up, ultrasonography of the urinary system showed that hydronephrosis of the dilated kidney segment was attenuated.

Lessons:

Laparoscopic triple-ureteral UU was successful in our patient. For children with duplex kidney and multiple ureteral duplications, minimally invasive urinary tract reconstruction can be a suitable intervention.
The association between serum albumin levels and related metabolic factors and atrial fibrillation: A retrospective study
Authors: Zhao Dongsheng , Jiao Huachen , Zhong Xia , Wang Wei , Li Lianlian
Published: November 2022

The association between serum albumin (ALB) and cardiovascular events has been well established, but the relationship with atrial fibrillation (AF) remains controversial. This study aims to evaluate the association between ALB and AF in a Chinese population. We reviewed the medical records of 2000 hospitalized patients, 1000 patients with AF were included in the AF group, and 1000 age- and sex-matched patients with sinus rhythm and no history of AF were included in the control group. The T test or chi-square test were conducted to analyze clinical baseline data. Logistic regression analysis was conducted to assess the relationship between AF and ALB. The interrelationships of ALB were analyzed by Pearson correlation analyses. The appropriate cutoff value of ALB for AF was analyzed by receiver operating characteristic curves. ALB levels were lower in the AF group than in the control group (P < .05). After multivariable adjustment, ALB was independently negatively associated with AF (odds ratio = 0.935, 95% confidence interval: 0.905–0.965, P < .05). ALB levels were positively correlated with serum globulin, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, serum apolipoprotein A1, and serum apolipoprotein B levels (P < .05), but negatively correlated with serum creatinine levels (P < .05). The optimal cutoff value of ALB for predicting AF was 37.25 g/L, the sensitivity was 78.0%, and the specificity was 4.6%. Low ALB level is independently associated with AF. Since the current study design cannot establish causalities, further prospective cohort studies are needed to determine this finding.
Identification of ferroptosis-related genes in syncytiotrophoblast-derived extracellular vesicles of preeclampsia
Authors: Wu Quanfeng , Ying Xiang , Yu Weiwei , Li Huanxi , Wei Wei , Lin Xueyan , Zhang Xueqin
Published: November 2022

Preeclampsia (PE), defined as new-onset hypertension and multi-organ systemic complication during pregnancy, is the leading cause of maternal and neonatal mortality and morbidity. With extracellular vesicles research progresses, current data refers to the possibility that ferroptosis may play a role in exosomal effects. Evidence has suggested that ferroptosis may contribute to the pathogenesis of preeclampsia by bioinformatics analyses. The purpose of the current study is to identify the potential ferroptosis-related genes in syncytiotrophoblast-derived extracellular vesicles (STB-EVs) of preeclampsia using bioinformatics analyses. Clinical characteristics and gene expression data of all samples were obtained from the NCBI GEO database. The differentially expressed mRNAs (DE-mRNAs) in STB-EVs of preeclampsia were screened and then were intersected with ferroptosis genes. Functional and pathway enrichment analyses of ferroptosis-related DE-mRNAs in STB-EVs were performed. Ferroptosis-related hub genes in STB-EVs were identified by Cytoscape plugin CytoHubba with a Degree algorithm using a protein-protein interaction network built constructed from the STRING database. The predictive performance of ferroptosis-related hub genes was determined by a univariate analysis of receiver operating characteristic (ROC). The miRNA-hub gene regulatory network was constructed using the miRwalk database. A total of 1976 DE-mRNAs in STB-EVs were identified and the most enriched item identified by gene set enrichment analysis was signaling by G Protein-Coupled Receptors (normalized enrichment score = 1.238). These DE-mRNAs obtained 26 ferroptosis-related DE-mRNAs. Ferroptosis-related DE-mRNAs of gene ontology terms and Encyclopedia of Genes and Genomes pathway enrichment analysis were enriched significantly in response to oxidative stress and ferroptosis. Five hub genes (ALB, NOX4, CDKN2A, TXNRD1, and CAV1) were found in the constructed protein-protein interaction network with ferroptosis-related DE-mRNAs and the areas under the ROC curves for ALB, NOX4, CDKN2A, TXNRD1, and CAV1 were 0.938 (CI: 0.815−1.000), 0.833 (CI: 0.612−1.000), 0.875 (CI: 0.704−1.000), 0.958 (CI: 0.862−1.000), and 0.854 (CI: 0.652−1.000) in univariate analysis of ROC. We constructed a regulatory network of miRNA-hub gene and the findings demonstrate that hsa-miR-26b-5p, hsa-miR-192-5p, hsa-miR-124-3p, hsa-miR-492, hsa-miR-34a-5p and hsa-miR-155-5p could regulate most hub genes. In this study, we identified several central genes closely related to ferroptosis in STB-EVs (ALB, NOX4, CDKN2A, TXNRD1, and CAV1) that are potential biomarkers related to ferroptosis in preeclampsia. Our findings will provide evidence for the involvement of ferroptosis in preeclampsia and improve the understanding of ferroptosis-related molecular pathways in the pathogenesis of preeclampsia.
Incidence and risk factors of vertebral body collapse after posterior instrumented spinal fusion in elderly patients: An observational study
Authors: Kao Feng-Chen , Hsu Yao-Chun , Chen Tzu-Shan , Tu Yuan-Kun , Liu Pao-Hsin
Published: November 2022

This study investigates the incidence and risk factors of new vertebral body collapse (VC) after posterior instrumented spinal fusion in patients older than 70 years. This retrospective study analyzed the data of elderly patients who underwent posterior instrumented spinal fusion in the thoracolumbar spine between January 2013 and December 2017. The 2 subsamples comprised of patients who had experienced vertebral compression fracture (VCF) before the index spinal surgery (group 1, n = 324) and those who had not (group 2, n = 1040). We recorded and analyzed their baseline characteristics, their underlying comorbidities, and the details of their current instrumented spinal fusion. The incidences of new VC and screw loosening were recorded. In groups 1 and 2, the incidences of new VC were 31.8% and 22.7%, respectively, and those of new VC with screw loosening were 25.6% and 33%, respectively. The risk factor was upper screw level at the thoracolumbar junction (hazard ratio [HR] = 2.181, 95% confidence interval [CI]: 1.135–4.190) with previous VCF. The risk factors were age ≥ 80 years (HR = 1.782, 95% CI: 1.132–2.805), instrumented levels > 4 (HR = 1.774, 95% CI: 1.292–2.437), and peptic ulcer (HR = 20.219, 95% CI: 2.262–180.731) without previous VCF. Clinicians should closely monitor new VC after posterior instrumented spinal fusion in elderly patients with previous VCF with upper screw level at the thoracolumbar junction and in patients without previous VCF aged ≥ 80 years, with instrumented levels > 4 and peptic ulcer.
Study on syndrome rules of stagnated heat in liver and stomach of non-erosive reflux disease based on microecology of tongue coating
Authors: Jiang Xinqi , Cheng Hongjie , Zhang Naiwei , Xu Shanshan , An Libao , Yan Ling , Niu Fang , Jia Boyi
Published: November 2022

Introduction:

At present, the pathogenesis of non-erosive reflux disease (NERD) is still unclear, and proton pump inhibitors are the main treatment drug. However, the effect is limited. Traditional Chinese medicine treatment of NERD has advantages. Stagnated heat in liver and stomach syndrome is the most important traditional Chinese medicine syndrome type of this disease. Tongue diagnosis is an important basis for the diagnosis of stagnated heat in liver and stomach syndrome. The microecology of tongue coating suggests the occurrence and development of disease. The purpose of this study aims to clarify the regular changes of tongue coating microecology in stagnated heat in liver and stomach syndrome of NERD.

Methods and analysis:

This is a cross-sectional clinical trial. This study is divided into NERD stagnated heat in liver and stomach syndrome group, qi stagnation, and phlegm obstruction syndrome control group and normal control group, with 20 cases in each group. Tongue coating samples will be collected from 3 groups, and 16SrRNA gene sequencing technology will be used to detect the genome of tongue coating flora in patients with NERD with stagnated heat in liver and stomach syndrome, control group with qi stagnation and phlegm obstruction syndrome and normal control group. The main outcome measures are the distribution, diversity, and richness of the tongue flora in patients and healthy controls.

Discussion:

The results of this study will clarify the internal relationship between NERD stagnated heat in liver and stomach syndrome and the microecological changes in tongue coating.
Anaesthesia administered as S(+)-ketamine for cardiac intervention in children with common congenital heart disease
Authors: Liu Wenjun , Xu Fei , Guo Liyong , Li Hong , Zhao Liyun , Ma Jun
Published: November 2022

Background:

Safety and efficacy were assessed of different S(+)-ketamine doses combined with propofol administered as anesthesia to common pediatric congenital heart disease (CHD) patients undergoing cardiac interventional surgery to provide reference data as guidance for use in clinical settings.

Methods:

Sixty CHD children admitted to Beijing Anzhen Hospital, Capital Medical University from December 2020 to December 2021 who underwent elective cardiac intervention were assigned to 3 groups (H, L, M, 20 patients/group) using a random number table-based method. Patients received 1% propofol (2 mg/kg) and intravenous injections of S(+)-ketamine (Group L, 0.4 mg/kg; Group M, 0.5 mg/kg; Group H, 0.6 mg/kg) followed by intravenous pumping of 1% propofol (4–6 mg/kg/h). Heart rate (HR), mean arterial pressure, and pulse oxygen saturation were recorded preoperatively (T0), at the time of anesthesia maintenance (T1), at the time of arteriovenous puncture (T2), and when they awakened (T3). Additionally, propofol dose and incidence rates of intraoperative body movement, postoperative agitation, and postoperative nausea/vomiting were recorded.

Results:

For the 3 groups, Group H awakening time was significantly longer than that of Group L (P = .039). Notably, intergroup intraoperative propofol times differed significantly (P = .009). Meanwhile, T0 to T3 intragroup HR values differences were significant (P = .017; P = .001; P = .005, respectively). Group L HR was significantly elevated at T2 relative to T0 (P = .003), Group M HR was significantly elevated at T1 and T2 relative to T0 (P = .019; P = .003, respectively), and Group H HR values were significantly elevated at T1 and T2 relative to T0 (P = .012; P = .005, respectively). At all 4 time points no statistically significant intergroup differences in mean arterial pressure values were observed (P = .587). T1 to T3 pulse oxygen saturation values for all 3 groups were significantly greater than corresponding T0 values. Although intergroup intraoperative body movement incidence differed significantly (P = .044), intergroup differences in awakening time agitation and postoperative nausea/vomiting incidence rates were insignificant (P = .732, P = .887, respectively).

Conclusion:

Use of 0.6 mg/kg S(+)-ketamine with propofol was most effective as anesthesia for common pediatric CHD patients undergoing cardiac interventional surgery.
Clear cell sarcoma of soft tissue with plasmacytoid morphology: A rare case report
Authors: Han Xu , Li Qingchang , Wang En-Hua , Liu Nan
Published: November 2022

Rationale:

Clear cell sarcoma of soft tissue (CCSST) is a rare malignant tumor that occurs in the extremities of young adults. CCSST has been documented to have atypical histopathological features, such as epidermotropism or myxoid differentiation, which may set pitfalls in the differential diagnosis. We report a case of CCSST with plasmacytoid morphology which has never been described.

Patient concerns:

A 15-year-old male, presented with a 5-cm mass in his left inguinal area.

Diagnosis:

Positron emission tomography-computed tomography examination showed nodules in the left groin and the lung, the latter was considered metastasis. A core needle biopsy with the diagnosis of CCSST with plasmacytoid morphology was made according to histology, immunostaining, and molecular analysis.

Interventions:

The patient received chemotherapy of doxorubicin and ifosfamide.

Outcomes:

The patient failed to respond to the standard chemotherapy and deceased twelve months after diagnosis.

Lessons:

This special case of CCSST with plasmacytoid features demonstrated a morphological variation never been documented and may easily lead to misdiagnosis. For such cases, molecular analysis is essential to provide solid evidence for accurate diagnosis.
Impact of early mobilization on the duration of delirium in elderly hospitalized patients: A retrospective cohort pilot study
Authors: Anada Satoshi , Iigaya Miho , Takahashi Megumi , Soda Kazue , Wada Namiko
Published: November 2022

Development of delirium during hospitalization impairs the activities of daily living in elderly hospitalized patients. In clinical practice, early mobilization from bed is recommended to reduce delirium incidence and hospitalization stay. However, the effects of early mobilization on elderly inpatients with delirium have not been established yet. The aim of this study was to investigate the association between early mobilization and the duration of delirium in elderly inpatients with delirium. This retrospective cohort pilot study examined 45 participants (23 males, 22 females; mean age: 84.5 ± 6.6 years), who developed delirium during hospitalization. Of the participants, 28 were surgically treated and 17 were non-surgically treated. We classified early or delayed mobilization based on the median number of days until the start of mobilization and compared after propensity score matching to adjust for baseline characteristics. Additionally, we examined the correlation between the number of days until the start of mobilization and the duration of delirium. The duration of delirium was significantly shorter in the early mobilization group, particularly in terms of sitting on the bed and wheelchair use than that in the delayed mobilization group {median: 4.0 [interquartile range (IQR): 2.0–6.0] vs 8.0 [IQR: 7.0–14.5] days, P = .013; median: 3.0 [IQR: 2.0–5.5] vs 11.0 [IQR: 7.5–14.5] days, P = .004, respectively}. Moreover, the duration of delirium significantly positively moderate correlated with the time until the start of sitting on the bed and wheelchair use (Spearman r = 0.527; P = .012, Spearman r = 0.630; P = .002, respectively). The results of this study suggest that early mobilization from sitting on the bed or wheelchair use after hospitalization or surgery may shorten the duration of delirium. Because the sample size of this pilot study is small, careful interpretation is needed, and further research is warranted.
Characteristics of prostate biopsy in patients under the dutasteride treatment
Authors: Obinata Daisuke , Nakahara Ken , Yoshizawa Tsuyoshi , Mochida Junichi , Yamaguchi Kenya , Takahashi Satoru
Published: November 2022

We performed a retrospective study to clarify the characteristics of prostate biopsies in patients treated with dutasteride, a benign prostate hyperplasia treatment drug that inhibits 5α-reductase. We studied the digital clinical data of 677 patients, including 96 cases treated with dutasteride, with suspected localized prostate cancer. All patients underwent transrectal ultrasonography-guided prostate biopsy between 2014 and 2017 in our department. A propensity score matching analysis was performed based on prostate-specific antigen (PSA) (calculated as double the PSA value for the dutasteride group) and age. Ninety-six patients in each of the dutasteride and control groups were assessed and their characteristics were compared. The characteristics of the patients in the dutasteride and control groups were well balanced by matching. There were fewer prostate cancer-positive patients in the dutasteride group. When comparing only the prostate cancer-positive patients in each group, there were significantly more cases of high-grade cancers and abnormal magnetic resonance imaging (MRI) findings in the dutasteride group. In the dutasteride group, abnormal MRI findings and advanced age were significant predictors of high grade cancer. This study shows the characteristics of prostate biopsies in patients treated with dutasteride and indicates that patients on dutasteride with advanced age and abnormal MRI findings should undergo prostate biopsy.
Differentiation of pilocytic astrocytoma, medulloblastoma, and hemangioblastoma on diffusion-weighted and dynamic susceptibility contrast perfusion MRI
Authors: Kurokawa Ryo , Kurokawa Mariko , Baba Akira , Kim John , Capizzano Aristides , Bapuraj Jayapalli , Srinivasan Ashok , Moritani Toshio
Published: November 2022

This study aimed to evaluate the diagnostic performance of dynamic susceptibility contrast (DSC) perfusion magnetic resonance imaging and apparent diffusion coefficient (ADC) for differentiating common posterior fossa tumors, pilocytic astrocytoma (PA), medulloblastoma (MB), and hemangioblastoma (HB). Between January 2016 and April 2022, we enrolled 23 (median age, 7 years [range, 2–26]; 12 female), 13 (10 years [1–24]; 3 female), and 12 (43 years [23–73]; 7 female) patients with PA, MB, and HB, respectively. Normalized relative cerebral blood volume and flow (nrCBV and nrCBF) and normalized mean ADC (nADCmean) were calculated from volume-of-interest and statistically compared. nADCmean was significantly higher in PA than in MB (PA: median, 2.2 [range, 1.59–2.65] vs MB: 0.93 [0.70–1.37], P < .001). nrCBF was significantly higher in HB than in PA and MB (PA: 1.10 [0.54–2.26] vs MB: 1.62 [0.93–3.16] vs HB: 7.83 [2.75–20.1], all P < .001). nrCBV was significantly different between all 3 tumor types (PA: 0.89 [0.34–2.28] vs MB: 1.69 [0.93–4.23] vs HB: 8.48 [4.59–16.3], P = .008 for PA vs MB; P < .001 for PA vs HB and MB vs HB). All tumors were successfully differentiated using an algorithmic approach with a threshold value of 4.58 for nrCBV and subsequent threshold value of 1.38 for nADCmean. DSC parameters and nADCmean were significantly different between PA, MB, and HB. An algorithmic approach combining nrCBV and nADCmean may be useful for differentiating these tumor types.
The tilts, twists, and turns of torticollis
Authors: Gross Preston W. , Chipman Danielle E. , Doyle Shevaun M.
Published: November 2022

Purpose of review

The purpose of this review is to outline the most recent understanding of torticollis in the pediatric population.

Recent findings

It is important to diagnose the underlying condition of torticollis early in childhood, as some conditions that cause torticollis may result in major developmental delays in early motor milestones. Recent studies have highlighted that many of the rarer causes of torticollis are often misdiagnosed as congenital muscular torticollis, suggesting that physicians should pay close attention to the results of clinical and radiographic examinations when patients present with torticollis.

Congenital muscular torticollis is the most common cause of torticollis. Other, less common causes of torticollis include vertebral abnormalities, ocular torticollis, gastrointestinal disorders, soft tissue infections of the neck, posterior fossa tumors, and benign paroxysmal torticollis. Although rare, these differential diagnoses should be considered during a clinical work-up for a patient who presents with torticollis.
Changes in Substance Use and Sexual Behaviors After a Sexually Transmitted Infection Diagnosis Among a Cohort of Men Who Have Sex With Men in Los Angeles, CA
Authors: Javanbakht Marjan , Miller Amanda P. , Moran Alexander , Ragsdale Amy , Bolan Robert , Shoptaw Steve , Gorbach Pamina M.
Published: November 2022

Despite declines in substance use and sexual behaviors after a sexually transmitted infection, reinfections were high suggesting that men who have sex with men with sexually transmitted infections occupy sexual networks with high transmission probabilities and prevention efforts should consider sexual network characteristics.

Background

Sexually transmitted infections (STIs), STI reinfection, human immunodeficiency virus (HIV) acquisition, and changes in behaviors after an STI were examined in a cohort of men who have sex with men (MSM) in Los Angeles, CA.

Methods

Data from a longitudinal study of MSM enrolled from 2014 with at least 1 follow-up visit through March 2020 were analyzed (n = 447; 1854 visits). Study visits every 6 months included self-interviews for sexual behaviors, substance use, and specimen collection for chlamydia, gonorrhea, syphilis, and HIV testing. Changes in behaviors were assessed using the McNemar test, and participants not diagnosed with an STI served as controls for a difference-in-difference (DiD) analysis of changes over time.

Results

Cumulative incidence of an STI was 55% (248 of 447). At 24 months after STI diagnosis, methamphetamine use declined from 50% to 35% (P < 0.01), and median number of sex partners declined from 5 (interquartile range, 2–11) to 2 (interquartile range, 1–6; P < 0.01). Among participants at risk for HIV and diagnosed with an STI (n = 102), postexposure prophylaxis use was 35% and HIV seroconversion was 6%. Based on DiD analyses, participants diagnosed with an STI had higher levels of substance and a higher number of sex partners when compared with those with no STIs; however, declines in these behaviors were comparable to participants not diagnosed with an STI (P
DID > 0.05).

Conclusions

Despite behavior modifications after an STI diagnosis, STI/HIV incidence was high, suggesting that MSM with STIs occupy sexual networks where reductions in sexual and substance using behaviors do not protect them from ongoing exposure to STIs and HIV.
Superiority of 68Ga-FAPI-04 in Delineation of Soft Tissue and Liver Metastases in Chromophobe Renal Cell Carcinoma for Restaging
Authors: Xie Fei , Fu Lilan , Zhou Wenlan
Published: November 2022

Chromophobe renal cell carcinoma (RCC) is a rare tumor. We described findings of 18F-FDG PET/CT and 68Ga-FAPI-04 PET/CT of metastatic chromophobe RCC in a 56-year-old woman. 68Ga-FAPI-04 PET/CT demonstrated that the metastatic lesions in the liver, left posterior abdominal wall, and the left waist had intense uptake of 68Ga-FAPI-04, which was higher than that of 18F-FDG on 18F-FDG PET/CT. 68Ga-FAPI-04 PET/CT also delineated the metastatic lesions more clearly than 18F-FDG PET/CT. This case highlights 68Ga-FAPI-04 PET/CT may be promising in restaging of chromophobe RCC.
Therapeutic Efficacy and Prediction of 18F-FDG PET/CT-Assisted Botulinum Toxin Therapy in Patients With Idiopathic Cervical Dystonia
Authors: Kwon Hye Ryeong , Lee Hyunjong , Sung Duk Hyun , Choi Joon Young
Published: November 2022

Purpose

This study aimed to investigate the therapeutic efficacy of 18F-FDG PET/CT-assisted botulinum toxin (BTX) injection therapy and predictive PET findings in relation to a good response in patients with idiopathic cervical dystonia (ICD).

Materials and Methods

A total of 78 patients was enrolled from November 2007 to July 2018. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) score was determined at baseline and 4 weeks after BTX injection guided by electromyography and PET/CT. The number of hypermetabolic muscles, the highest SUVmax among hypermetabolic muscles, and the total SUVmax of hypermetabolic muscles were evaluated as pretreatment PET parameters. A good response was defined as a reduction rate ≥30% and a point decrease ≥15 of the TWSTRS total score.

Results

Half of the subjects showed a good response. Good responders had significantly higher baseline TWSTRS scores than poor responders (total score, P < 0.001; severity, P < 0.001; disability, P < 0.001; pain, P = 0.026). Good responders also had significantly higher numbers of hypermetabolic muscles and BTX-injected hypermetabolic muscles (P < 0.001, both). In multivariable analysis, the baseline TWSTRS disability subscale score and the number of BTX-injected hypermetabolic muscles were significant predictors for good response (P = 0.001 and P = 0.028). The aforementioned 3 PET parameters were positively correlated with the baseline TWSTRS scores. In addition, PET/CT well detected dystonic deep cervical muscles.

Conclusions

FDG PET/CT-assisted BTX injection therapy showed good therapeutic efficacy in ICD patients. The numbers of hypermetabolic cervical muscles and BTX-injected hypermetabolic muscles may be helpful in predicting a good response.
The 99mTc-MIP-1404 PSMA Uptake in the Isolated Paratracheal Lymph Node From the Prostate Adenocarcinoma
Authors: Jonusas Justinas , Tiskevicius Sigitas , Janulionis Ernestas
Published: November 2022

The oncologist consulted a 56-year-old man after receiving prostate-specific antigen screening results. Prostate-specific antigen level during the screen time was 33 ng/mL. As a result, poorly differentiated prostate adenocarcinoma with a Gleason score of 9 (5 + 4) was diagnosed. SPECT/CT scan with 99mTc-MIP-1404 PSMA tracer was performed. The 99mTc-PSMA–positive lesions were detected in the prostate, external iliac, obturator lymph nodes of the pelvis, para-aortic, and the right lower paratracheal space. The patient was prescribed androgen deprivation therapy and early chemotherapy with docetaxel (6 fractions), after which radiation therapy to prostate and seminal vesicles was planned.
Increased 68Ga-DOTATATE Uptake in Supraclavicular Brown Adipose Tissue
Authors: Li Li , Li Guannan , Tian Rong , Shen Guohua
Published: November 2022

Characterization of brown adipose tissue (BAT) 18F-FDG uptake has been well reported; however, 68Ga-DOTA–conjugated somatostatin receptor targeting peptides uptake in BAT is rarely documented. Herein, we report an interesting case of increased 68Ga-DOTATATE uptake in supraclavicular BAT in a young boy with paroxysmal hypertension. The low body mass index and increased perfusion of BAT in response to cold may be significant influencing factors.
The Manifestation of a Patient With Myelofibrosis in 68Ga-DOTA-FAPI-04 PET/CT Mimicking “Super Bone Imaging”
Authors: Li Xue , Zhao Qian , Luo Qianfeng , Chen Liming , Huang Zhanwen
Published: November 2022

Primary myelofibrosis is a chronic inflammatory disease of the bone marrow. It progresses from an early robust inflammatory state to a more advanced fibrotic response, representing the advanced stage of the disease. We report a 50-year-old woman who was diagnosed with primary myelofibrosis. 18F-FDG PET/CT showed mild uptake in diffuse sclerotic lesions in the bone matrix, whereas 68Ga-DOTA-FAPI-04 showed intense uptake at the whole skeleton.
Counterdiabatic driving for periodically driven open quantum systems
Authors: Takahashi Kazutaka
Published: November 2022

We discuss dynamics of periodically driven open quantum systems. The time evolution of the quantum state is described by the quantum master equation, and the form of the dissipator is chosen so that the instantaneous stationary state is given by the Gibbs distribution. We find that the correlation between the population part and the coherence part of the density operator is induced by an adiabatic gauge potential. Although the introduction of the counterdiabatic term eliminates the correlation, additional correlations prevent convergence to the Gibbs distribution. We study the performance of the control by the counterdiabatic term. The system has three different scales and the performance strongly depends on the relations between their magnitudes.

This article is part of the theme issue ‘Shortcuts to adiabaticity: theoretical, experimental and interdisciplinary perspectives’.
Dynamical invariant formalism of shortcuts to adiabaticity
Authors: Takahashi Kazutaka
Published: November 2022

We give a pedagogical introduction to dynamical invariant formalism of shortcuts to adiabaticity. For a given operator form of the Hamiltonian with undetermined coefficients, the dynamical invariant is introduced to design the coefficients. We discuss how the method allows us to mimic adiabatic dynamics and describe a relation to the counterdiabatic formalism. The equation for the dynamical invariant takes a familiar form and is often used in various fields of physics. We introduce examples of Lax pair, quantum brachistochrone and flow equation.

This article is part of the theme issue ‘Shortcuts to adiabaticity: theoretical, experimental and interdisciplinary perspectives’.