bluuebunny/crossref_metadata_2025 huggingface dataset:
Axes and polarities in leaf vein formation
Authors: Scarpella Enrico
Published: June 2023

For multicellular organisms to develop, cells must grow, divide, and differentiate along preferential or exclusive orientations or directions. Moreover, those orientations, or axes, and directions, or polarities, must be coordinated between cells within and between tissues. Therefore, how axes and polarities are coordinated between cells is a key question in biology. In animals, such coordination mainly depends on cell migration and direct interaction between proteins protruding from the plasma membrane. Both cell movements and direct cell–cell interactions are prevented in plants by cell walls that surround plant cells and keep them apart and in place. Therefore, plants have evolved unique mechanisms to coordinate their cell axes and polarities. Here I will discuss evidence suggesting that understanding how leaf veins form may uncover those unique mechanisms. Indeed, unlike previously thought, the cell-to-cell polar transport of the plant hormone auxin along developing veins cannot account for many features of vein patterning. Instead, those features can be accounted for by models of vein patterning that combine polar auxin transport with auxin diffusion through plasmodesmata along the axis of developing veins. Though it remains unclear whether such a combination of polar transport and axial diffusion of auxin can account for the formation of the variety of vein patterns found in plant leaves, evidence suggests that such a combined mechanism may control plant developmental processes beyond vein patterning.
Aldehyde Dehydrogenase, a Marker of Normal and Malignant Stem Cells, Typifies Mesenchymal Progenitors in Perivascular Niches
Authors: Gomez-Salazar Mario A , Wang Yiyun , Thottappillil Neelima , Hardy Reef W , Alexandre Manon , Höller Fabian , Martin Niall , Gonzalez-Galofre Zaniah N , Stefancova Dorota , Medici Daniele , James Aaron W , Péault Bruno
Published: June 2023

Innate mesenchymal stem cells exhibiting multilineage differentiation and tissue (re)generative—or pathogenic—properties reside in perivascular niches. Subsets of these progenitors are committed to either osteo-, adipo-, or fibrogenesis, suggesting the existence of a developmental organization in blood vessel walls. We evaluated herein the activity of aldehyde dehydrogenase, a family of enzymes catalyzing the oxidation of aldehydes into carboxylic acids and a reported biomarker of normal and malignant stem cells, within human adipose tissue perivascular areas. A progression of ALDHLow to ALDHHigh CD34+ cells was identified in the tunica adventitia. Mesenchymal stem cell potential was confined to ALDHHigh cells, as assessed by proliferation and multilineage differentiation in vitro of cells sorted by flow cytometry with a fluorescent ALDH substrate. RNA sequencing confirmed and validated that ALDHHigh cells have a progenitor cell phenotype and provided evidence that the main isoform in this fraction is ALDH1A1, which was confirmed by immunohistochemistry. This demonstrates that ALDH activity, which marks hematopoietic progenitors and stem cells in diverse malignant tumors, also typifies native, blood vessel resident mesenchymal stem cells.
Comprehensive analysis of circRNAs for N7‐methylguanosine methylation modification in human oral squamous cell carcinoma
Authors: Sun Dongyuan , Song Ning , Li Minmin , Chen Xi , Zhang Xinyue , Yu Yang , Ying Jicheng , Xu Mengqi , Zheng Wentian , Han Chengbing , Ji Honghai , Jiang Yingying
Published: June 2023

N7‐methylguanosine (m7G) modification is closely related to the occurrence of tumors. However, the m7G modification of circRNAs in oral squamous cell carcinoma (OSCC) remains to be investigated. Methylated RNA immunoprecipitation sequencing (MeRIP‐seq) was used to measure the methylation levels of m7G and identify m7G sites in circRNAs in human OSCC and normal tissues. The host genes of differentially methylated and differentially expressed circRNAs were analyzed by Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses, and circRNA–miRNA–mRNA networks were predicted using the miRanda and miRDB databases. The analysis identified 2348 m7G peaks in 624 circRNAs in OSCC tissues. In addition, the source of m7G‐methylated circRNAs in OSCC was mainly the sense overlap region compared with normal tissues. The most conserved m7G motif in OSCC tissues was CCUGU, whereas the most conserved motif in normal tissues was RCCUG (R = G/A). Importantly, GO enrichment and KEGG pathway analysis showed that the host genes of differentially methylated and differentially expressed circRNAs were involved in many cellular biological functions. Furthermore, the significantly differentially expressed circRNAs were analyzed to predict the circRNA–miRNA–mRNA networks. This study revealed the whole profile of circRNAs of differential m7G methylation in OSCC and suggests that m7G‐modified circRNAs may impact the development of OSCC.
Beyond the Malleoli: Part 1—Avulsion Fractures of the Tibia and Fibula
Authors: Kani Kimia , Davis Derik L. , Jo Stephanie , Chew Felix S.
Published: June 2023

Avulsion fractures of the ankle and hindfoot are a diverse group of injuries occurring at level of retinacular, capsuloligamentous, and tendinous attachments. Even small fracture fragments have the potential to cause serious complications (such as ankle instability and accelerated osteoarthritis in the context of avulsion fractures of the surrounding capsuloligamentous supporting structures), if not treated appropriately. This article describes the relevant anatomy, injury mechanisms, classification, nomenclature, imaging, treatment, and complications of ankle and hindfoot avulsion fractures, with the exception of fractures occurring at and in the vicinity of the medial and lateral malleolar tips. In this part 1 of a two-part series, we provide a review of ankle retinacular and distal tibiofibular syndesmotic avulsion fractures.
Implications of left atrial volume index in patients with three-vessel coronary disease: A 6.6-year follow-up cohort study
Authors: Liu Ru , Song Lei , Zhang Ce , Jiang Lin , Tian Jian , Xu Lianjun , Feng Xinxing , Wan Linyuan , Zhao Xueyan , Xu Ou , Li Chongjian , Gao Runlin , Hui Rutai , Zhao Wei , Yuan Jinqing
Published: June 2023

Background:

Risk assessment and treatment stratification for three-vessel coronary disease (TVD) remain challenging. This study aimed to investigate the prognostic value of left atrial volume index (LAVI) with the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score II, and its association with the long-term prognosis after three strategies (percutaneous coronary intervention [PCI], coronary artery bypass grafting [CABG], and medical therapy [MT]) in patients with TVD.

Methods:

This study was a post hoc analysis of a large, prospective cohort of patients with TVD in China, that aimed to determine the long-term outcomes after PCI, CABG, or optimal MT alone. A total of 8943 patients with TVD were consecutively enrolled between 2004 and 2011 at Fuwai Hospital. A total of 7818 patients with available baseline LAVI data were included in the study. Baseline, procedural, and follow-up data were collected. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE), which was a composite of all-cause death, myocardial infarction (MI), and stroke. Secondary endpoints included all-cause death, cardiac death, MI, revascularization, and stroke. Long-term outcomes were evaluated among LAVI quartile groups.

Results:

During a median follow-up of 6.6 years, a higher LAVI was strongly associated with increased risk of MACCE (Q3: hazard ratio [HR] 1.20, 95% confidence interval [CI] 1.06–1.37, P = 0.005; Q4: HR 1.85, 95%CI 1.64–2.09, P <0.001), all-cause death (Q3: HR 1.41, 95% CI 1.17–1.69, P <0.001; Q4: HR 2.54, 95%CI 2.16–3.00, P <0.001), and cardiac death (Q3: HR 1.81, 95% CI 1.39–2.37, P <0.001; Q4: HR 3.47, 95%CI 2.71–4.43, P <0.001). Moreover, LAVI significantly improved discrimination and reclassification of the SYNTAX score II. Notably, there was a significant interaction between LAVI quartiles and treatment strategies for MACCE. CABG was associated with lower risk of MACCE than MT alone, regardless of LAVI quartiles. Among patients in the fourth quartile, PCI was associated with significantly increased risk of cardiac death compared with CABG (HR: 5.25, 95% CI: 1.97–14.03, P = 0.001).

Conclusions:

LAVI is a potential index for risk stratification and therapeutic decision-making in patients with three-vessel coronary disease. CABG is associated with improved long-term outcomes compared with MT alone, regardless of LAVI quartiles. When LAVI is severely elevated, PCI is associated with higher risk of cardiac death than CABG.
Prognostic Implications of Lateral Lymph Nodes in Rectal Cancer: A Population-Based Cross-Sectional Study with Standardized Radiological Evaluation after Dedicated Training
Authors: Sluckin Tania C. , van Geffen Eline G.M. , Hazen Sanne-Marije J.A. , Horsthuis Karin , Beets-Tan Regina G.H. , Marijnen Corrie A.M. , Tanis Pieter J. , Kusters Miranda
Published: June 2023

BACKGROUND:

There is an ongoing discussion regarding the prognostic implications of the presence, short-axis diameter and location of lateral lymph nodes.

OBJECTIVE:

To analyze lateral lymph node characteristics, the role of downsizing on restaging MRI and associated local recurrence rates for patients with cT3-4 rectal cancer after MRI re-review and training.

DESIGN:

Retrospective population-based cross-sectional study.

SETTINGS:

This collaborative project was led by local investigators from surgery and radiology departments in 60 Dutch hospitals.

PATIENTS:

A total of 3057 patients underwent rectal cancer surgery in 2016: 1109 had cT3-4 tumor located ≤8 cm from the anorectal junction of which 890 received neoadjuvant therapy.

MAIN OUTCOME MEASURES:

Local recurrence and ipsilateral local recurrence rates.

RESULTS:

Re-review identified 314 patients (35%) with visible lateral lymph nodes. 30 of these patients had either only long-stretched obturator (n = 13) or external iliac (n = 17) nodes and both did not lead to any lateral local recurrences. The presence of internal iliac/obturator lateral lymph nodes (n = 284) resulted in 4-year local recurrence and lateral local recurrence rates of 16.4% and 8.8%, respectively. Enlarged (≥7 mm) lateral lymph nodes (n = 122) resulted in higher 4-year local recurrence (20.8%, 13.1%, 0%, p < .001) and lateral local recurrence (14.7%, 4.4%, 0%, p < 0.001) rates compared to smaller and no lateral lymph nodes, respectively. Visible lateral lymph nodes (hazard ratio 1.8 [1.1-2.8]) and enlarged lateral lymph nodes (hazard ratio 1.9 [1.1-3.5]) were independently associated with local recurrence in multivariable analysis. Enlarged lateral lymph nodes with malignant features had higher 4-year LLR rates of 17.0%. Downsizing had no impact on lateral local recurrence rates. Enlarged lateral lymph nodes were associated with higher univariate 4-year distant metastasis rates (36.4% 24.4%, p = 0.021), but not in multivariable analysis (hazard ratio 1.3 [0.9-1.]), and did not worsen overall survival.

LIMITATIONS:

This study was limited by the retrospective design and total number of patients with lateral lymph nodes.

CONCLUSIONS:

The risk of lateral local recurrence due to (enlarged) lateral lymph nodes was confirmed, but without prognostic impact of downsizing after neoadjuvant therapy. These results point towards the incorporation of primary lateral lymph node size into treatment planning.
Incidence and Characteristics of Hypersensitivity Reactions to PEG-asparaginase Observed in 6136 Children With Acute Lymphoblastic Leukemia Enrolled in the AIEOP-BFM ALL 2009 Study Protocol
Authors: Rizzari Carmelo , Möricke Anja , Valsecchi Maria Grazia , Conter Valentino , Zimmermann Martin , Silvestri Daniela , Attarbaschi Andishe , Niggli Felix , Barbaric Draga , Stary Jan , Elitzur Sarah , Cario Gunnar , Vinti Luciana , Boos Joachim , Zucchetti Massimo , Lanvers-Kaminsky Claudia , von Stackelberg Arend , Biondi Andrea , Schrappe Martin
Published: June 2023

The incidence of hypersensitivity reactions (HSRs) to PEG-asparaginase (PEG-ASNase) was evaluated in 6136 children with ALL enrolled in the AIEOP-BFM ALL 2009 study. Patients with B-cell precursor-acute lymphoblastic leukemia (BCP-ALL) were stratified as standard-risk/medium-risk (MR)/high-risk (HR) and those with T-ALL as non-High/HR. PEG-ASNase was administered intravenously at 2500 IU/sqm/dose. All patients received 2 PEG-ASNase doses in induction; thereafter non-HR versus HR patients received 1 versus 6 PEG-ASNase doses, respectively. After the single regular dose of PEG-ASNase at the beginning of delayed intensification, BCP-ALL-MR patients were randomized to receive 9 additional PEG-ASNase doses every 2 weeks (experimental arm [EA]) versus none (standard arm [SA]); HR patients were randomized to receive, in consolidation, 4 weekly PEG-ASNase doses (EA) versus none (SA). The HSR cumulative incidence (CI) was estimated adjusting for competing risks. An HSR occurred in 472 of 6136 (7.7%) patients. T-non- HR/BCP-Standard-Risk, BCP-MR-SA, BCP-MR-EA, HR-SA and HR-EA patients had 1-year-CI-HSR (±SE) rates of 5.2% (0.5), 5.2% (0.5), 4.0% (0.8), 20.2% (1.2), and 6.4% (1.3), respectively. The randomized intensification of PEG-ASNase did not significantly impact on HSR incidence in BCP-MR patients (1-y-CI-HSR 3.8% [0.8] versus 3.2% [0.6] in MR-EA versus MR-SA; P = 0.55), while impacted significantly in HR patients (1-y-CI-HSR 6.4% [1.3] versus 17.9% [1.8] in HR-EA and HR-SA, respectively; P < 0.001). The CI-HSR was comparable among non-HR groups and was not increased by a substantial intensification of PEG-ASNase in the BCP-MR-EA group whilst it was markedly higher in HR-SA than in HR-EA patients, suggesting that, in such a chemotherapy context, a continuous exposure to PEG-ASNase reduces the risk of developing an HSR.
Advances in Multiplexed Microfluidics for Infectious Disease Detection
Authors: Shi Yiwei , Zhao Jiayi , Cao Guangwen
Published: June 2023

Microfluidics enables miniaturization, functionality, high throughput and reproducibility of multi-pathogen detection. Multiplexed microfluidic devices are electrochemical sensor-based, optical sensor-based, immunosensor-based and paper-based multiplexed microfluidics. However, the simultaneous detection of multiple pathogens is limited due to the complexity and diversity of infectious disease sources and mutual interference among analytes. This review provides an overview of recent advances in developing multiplex diagnostic microfluidic devices for detecting infectious diseases and discusses practical issues and perspectives. This review also covers microfluidic nucleic acid amplification strategies to improve detection sensitivity. Finally, we discuss the limitations and challenges in the design of multiplexed microfluidics.
Strong correlation between F2RL3 in the blood and osteoarthritis based on a retrospective cohort study
Authors: Su Qi , Shen Gufeng , Xu Guokang
Published: June 2023

Osteoarthritis (OA) is a common joint disease that mainly damages articular cartilage and involves the whole joint tissue. The purpose of this study was to explore the relationship between F2R Like Thrombin Or Trypsin Receptor 3 (F2RL3) and OA, so as to provide a new direction for the treatment of bone and joint. A total of 234 patients with OA were recruited. Clinical data was recorded and the expression levels of ELOVL Fatty Acid Elongase 7, F2RL3, glycoprotein IX platelet and Integrin Subunit Alpha 2b were measured. Pearson chi-square test and Spearman correlation coefficient were used to analyze the relationship between OA and related parameters. Univariate and multivariate Logistic regression were used for further analysis. Pearson chi-square test showed that F2RL3 (P < .001) was significantly associated with OA; Spearman correlation coefficient showed that OA and F2RL3 (ρ = −0.511, P < .001) significantly correlated; Univariate Logistic regression analysis showed that F2RL3 (odds ratio = 0.104, 95% confidence interval: 0.057–0.189, P < .001) was significantly associated with OA; multivariate logistic regression analysis showed that F2RL3 (odds ratio = 0.098, 95% confidence interval: 0.053–0.182, P < .001) were significantly associated with OA. The expression of F2RL3 is low in patients with OA. The lower the expression of F2RL3, the higher the probability of OA.
Geographical disparities in hepatitis b virus related hepatocellular carcinoma mortality rates worldwide from 1990 to 2019
Authors: Zhang Nancy S. , Wong Robert J.
Published: June 2023

This study aims to evaluate global trends in hepatitis B virus-related hepatocellular carcinoma (HBV-HCC) related mortality over the past 30 years. Despite improvements in the treatment of both HBV and HCC, disparities in access to care and treatment persist, and these disparities may have affected HBV-HCC outcomes across certain global regions disproportionately. Using data from the Global Burden of Diseases, Injury, and Risk Factors Study (GBD) from 1990 to 2019, we evaluated overall mortality rates related to HBV-HCC. From 1990 to 2019, overall global HBV-HCC mortality rate decreased by 30.3%. While most world regions experienced declines in HBV-HCC mortality, several regions also experienced significant increases in mortality, including Australasia, Central Asia, and Eastern Europe. When stratified by age, all age groups demonstrated declines in HBV-HCC mortality from 1990 to 2019. Similar trends were observed for both men and women. When stratified by world regions, HBV-HCC mortality in 2019 was highest in East Asia, which was significantly higher than the region with the next highest HBV-HCC mortality, Southeast Asia. Significant disparities in HBV-HCC mortality are observed among global regions. We observed higher HBV-HCC mortality rates with older age, higher mortality in males, and highest mortality in East Asia. The clinical significance of these findings are to highlight those regions that need more targeted resources to improve HBV testing and treatment to reduce the long term consequences of untreated HBV, such as HCC.
Obstetric, maternal, and neonatal outcomes after Pilates exercise during pregnancy: A systematic review and meta-analysis
Authors: Zaman Amal Yaseen
Published: June 2023

Background:

One of the major exercises to improve the psychological and physical functions of pregnant women is Pilate’s exercises. The aim of this study is to collect evidence about Pilates exercise effects on many consequences in pregnant women, such as maternal and neonatal outcomes and obstetric outcomes.

Methods:

PubMed, Clinical Key, Cochrane Library, Scopus, Embase, and Web of Science were scoured from their inception. Research comparing Pilates during pregnancy to other methods, or to the control was included. For randomized controlled trials (RCTs), The researcher utilized the Cochrane risk of bias tool; for non-RCTs, risk of bias tool to assess non-randomized studies of interventions, was used for cohort studies, and the national heart, lung, and blood institute tool. Meta-analysis was done using the Review manager 5.4. For continuous data, calculated the mean difference and 95% confidence interval (CI), and the risk ratio (RR) and 95% CI for dichotomous data.

Results:

Finally, 13 studies included with a total number of 719 pregnant women. The analysis showed that the Pilates group was significantly more likely to deliver vaginally than the control group (RR = 1.21, 95% CI [1.05 to 1.41], P value = .009). Women in the Pilates group were significantly lower than the control group to have Cesarean delivery (RR = 0.67, 95% CI [0.48–0.94], P value = .02). Moreover, Pilates-treated women were less likely to gain weight during pregnancy than control (mean difference = −3.48, 95% CI [−6.17 to −0.79], P value = .01).

Conclusion:

Pilates exercise improved the outcomes of pregnant women. It decreases the rate of Cesarean delivery and the time of delivery. Moreover, Pilates has a role in decreasing weight gain in pregnant women. As a result, that may improve the pregnancy experience for women. However, more RCTs needed with larger sample sizes to assess the Pilates effect on neonatal outcomes.
Efficacy and safety of a combination of emotional freedom technique with acupuncture versus acupuncture alone to treat psychiatric symptoms in Parkinson’s disease: A protocol for a randomized, assessor-blind, parallel-group clinical trial
Authors: Kang Dong-Hoon , Kim Ju-Yeon , Park Yang-Chun , Yoo Ho-Ryong , Jung In Chul
Published: June 2023

Background:

Parkinson’s disease (PD) is one of the most prevalent neurodegenerative diseases in world. As some psychiatric symptoms degrade the quality of life of patients with PD, a novel alternative non-pharmacological treatment is required. Acupuncture appears to be an effective and safe treatment for PD. The emotional freedom technique (EFT) is a type of psychological therapy that alleviates psychiatric symptoms by stimulating acupoints. In this study, we will compare the efficacy and safety of a combination of the EFT and acupuncture and acupuncture alone.

Methods:

This study is a randomized, assessor-blind, parallel-group clinical trial. Eighty participants will be equally divided into experimental and control groups. Each participant will receive a total of 24 interventions over 12 weeks. The experimental group will receive EFT combined with acupuncture and the control group will receive acupuncture alone. The primary outcome is the change in the Beck Depression Inventory score from baseline to 12 weeks, and the secondary outcomes include change in the following variables: Beck Depression Inventory, Parkinson’s disease sleep scale, State-Trait Anxiety Inventory, the Korean version of the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight questionnaire scale, and unified Parkinson’s disease rating scale III and exercises.

Discussion:

Acupuncture is a safe and effective treatment for motor and nonmotor symptoms in PD, and EFT appears to be safe and effective for a variety of psychiatric symptoms. In this study, we will investigate the potential of EFT combined with acupuncture to improve psychiatric symptoms in PD.
In silico analysis reveals PRR11 as a prognostic and oncogenic marker in lung adenocarcinoma
Authors: Hu Ankang , Tang Kaicheng , Liu Jing , Han Xufeng , Chen Quangang
Published: June 2023

Lung adenocarcinoma (LUAD) is a common lung cancer. Although there are various treatments for LUAD, its prognosis remains poor. Therefore, it is imperative to identify new targets and develop novel therapeutic strategies. In this study, we analyze the expression of proline rich 11 (PRR11) in pan cancer based on The Cancer Genome Atlas (TCGA) database, and explore the prognostic value of PRR11 in LUAD by GEPIA2 (Gene Expression Profiling Interactive Analysis, version 2) database. In addition, the relationship between PRR11 and the clinicopathological features of LUAD was analyzed using UALCAN database. The association between PRR11 expression and immune infiltration was accessed. The PRR11 related genes were screened using LinkOmics and GEPIA2. Gene Ontology Term Enrichment (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis was performed by David database. The results suggested that the expression of PRR11 in most tumor tissues was significantly higher than that in normal tissues. In LUAD patients, high expression of PRR11 was associated with shortened first progression survival (FPS), overall survival (OS) and post progression survival (PPS), and correlated with individual cancer stage, race, gender, smoking habit, and tissue subtype. Besides, the high expression of PRR11 was accompanied by a relatively higher infiltration level of cancer-associated fibroblasts (CAFs) and myeloid-derived suppressor cell (MDSC), and decreased infiltration level of CD8+ T cells in the tumor microenvironment. GO analyses showed that PRR11 participated in biological processes such as cell division and cell cycle, and was involved in protein binding and microtubule binding functions. KEGG analyses revealed that PRR11 was implicated in p53 signaling pathway. All the results indicated that PRR11 might be an independent prognostic biomarker and therapeutic target for LUAD.
Clinical efficacy of posterior endoscopic cervical modified trench technique in the treatment of cervical spondylotic myelopathy: A retrospective study
Authors: Gong Shuangquan , Cui Liqiang , Liu Hongjun , Ye Yu
Published: June 2023

To investigate the clinical efficacy of the posterior endoscopic cervical modified trench technique in the treatment of cervical spondylotic myelopathy (CSM). This retrospective study included 9 patients with single-segment CSM, who were treated with posterior endoscopic cervical modified trench technique. Related clinical data, the visual analog scale, Japanese Orthopedic Association (JOA) ratings, JOA improvement rate, the minimum sagittal diameter of the spinal canal, and surgical complications were recorded. There were 5 men and 4 females, with an average age of 60.44 ± 16.49 years. Without any significant side effects like paralysis, vascular damage, or cerebrospinal fluid leaking, all surgeries were successfully completed. One year’s worth of follow-up with patients lasted for 8.56 ± 3.68 months. When compared to before surgery, the postoperative visual analog scale ratings, JOA scores, and minimum sagittal diameter of the spinal canal value all showed a substantial improvement (P < .01). At the most recent follow-up, 2 patients had a JOA improvement rate of >75%, 6 patients had a JOA improvement rate of 74 to 50%, 1 patient had a JOA improvement rate of 49 to 25%, and none had a JOA improvement rate of <25%. The JOA improvement rate was above 90% for overall excellent and good ratings. In our study, the ventral epidural space may be maneuvered more easily and instrument-induced nerve discomfort is decreased when using the posterior endoscopic cervical modified trench approach with posterior endoscopy. The short-term clinical effect of the posterior endoscopic cervical modified trench technique for CSM is satisfactory.
Craniotomy hematoma was removed from the bone flap and multiple holes were drilled on the bone flap: A case report
Authors: Zhu Wei , Ma Lei , Li Tuo , Chen Hongguang
Published: June 2023

Background:

Chronic subdural hematoma (CSDH) is a common disease in neurosurgery department. Burr-hole drainage is the main surgical treatment. And the recurrence rate is as high as 25%.

Case Report:

In this case, a male patient with CSDH in the left frontotemporal parietal region underwent 2 drilling and drainage operations in the local hospital, but the hematoma recurred after operations. Being unable to bearing the repeated and progressive aggravation of headache, he came to our hospital for treatment. After considering the comprehensive situation, we use a new surgical method, removal of hematoma by drilling multiple holes in the lateral skull, to cure the patient.

Conclusions:

We get inspirations from the treatment of moyamoya disease surgery, through the bone holes the scalp forms many “meat column” like structures which have powerful capability in absorption, so the scalp could deep into the hematoma, then the CSDH could be cured. Provide a new surgical method for the treatment of refractory CSDH.
One-stage reconstruction using a fibula osteocutaneous free flap and an anterolateral thigh free flap for an extensive composite defect after en bloc resection of squamous cell carcinoma on the mouth floor, mandible, and anterior neck: A CARE-compliant case report
Authors: Shin SeHo , Kim KiHyun , Woo SangSeok , Kim KyungMin , Lee JunWon , Kim SeongHwan , Choi JaiKoo , Lee DongJin , Suh InSuck
Published: June 2023

Rationale:

Although regional metastasis to the lymph nodes is common in advanced oral cancer, extensive local invasion into surrounding structures such as the mandible, skin and soft tissue of the neck, and masticator space is relatively rare. Sometimes surgical treatment cannot be performed and only palliative chemotherapy and radiation therapy are offered to preserve the quality of life of patients with advanced oral cancer. Nevertheless, the surgical resection of tumors remains the most effective treatment. This study presents a case of aggressive mouth floor cancer in which extensive composite defects on the mouth floor, oral mucosa, mandible, skin and soft tissue of the neck caused by tumor resection were reconstructed.

Patient concerns:

A 66-year-old man and a 65-year-old man with no significant personal or family history visited our clinic due to a large and multiple masses on the floor of the mouth and both sides of the neck.

Diagnosis:

Histopathological evaluation of the biopsy specimen revealed squamous cell carcinoma.

Interventions:

A fibula osteocutaneous free flap and customized titanium plate were used for the intraoral lining. Mandibular reconstruction was performed using a 3D-printed bone model, and an anterolateral thigh free flap was used to resurface the anterior of the neck.

Outcomes:

Reconstruction using this method was successful, and excellent functional and aesthetic outcomes were achieved without cancer recurrence.

Lessons:

This study show that the reconstruction of extensive composite defects of the oral mucosa, mandible, and neck soft tissue following surgical resection of mouth floor cancer can be performed in a single-stage operation. Through a single-stage reconstruction, both excellent functional aspects without cancer recurrence and satisfactory aesthetic outcomes can be obtained.
The efficacy of vericiguat for heart failure: A meta-analysis of randomized controlled trials
Authors: Ma Guofang , Pan Yuefang , Qu Chaoyi , Li Feng
Published: June 2023

Background:

The efficacy of vericiguat was elusive for heart failure. This meta-analysis aimed to explore the efficacy of vericiguat for heart failure.

Methods:

PubMed, EMbase, Web of Science, EBSCO, and Cochrane library databases have been searched through October 2022 and we included randomized controlled trials reporting the effect of vericiguat versus placebo in patients with heart failure.

Results:

Four randomized controlled trials were included in the meta-analysis. Compared with placebo group for heart failure, vericiguat treatment was able to substantially improve the composite outcome of cardiovascular death or heart failure hospitalization (odds ratio [OR] = 0.87; 95% confidence interval [CI] = 0.78 to 0.97; P = .02), but unraveled no obvious impact on hospitalization for heart failure (OR = 0.89; 95% CI = 0.79 to 1.00; P = .05), death from cardiovascular causes (OR = 0.93; 95% CI = 0.77 to 1.13; P = .48), death from any cause (OR = 0.96; 95% CI = 0.84 to 1.10; P = .56), adverse events (OR = 0.95; 95% CI = 0.84 to 1.08; P = .42) or serious adverse events (OR = 0.92; 95% CI = 0.82 to 1.02; P = .12).

Conclusions:

Vericiguat treatment may benefit to treat heart failure.
Aggressive systemic mastocytosis of colon and lymph node: A case report
Authors: Xun-Ze Shen , Liu Fang , Lin Chen , Sun Yi-Feng
Published: June 2023

Rationale:

Mastocytosis is a group of rare neoplastic diseases characterized by monoclonal proliferation of mast cells in the skin or other tissues and organs, including cutaneous mastocytosis and systemic mastocytosis (SM). Mastocytosis can also occur in the gastrointestinal tract, mostly manifested as increased mast cells dispersed in various layers of the intestinal wall; a few may present as polypoid nodules, but rarely as soft tissue mass formation. Pulmonary fungal infections mostly occur in patients with low immune function and have not been reported in the literature as the initial manifestation in patients with mastocytosis. In this case report, we present the enhanced computed tomography (CT), fluorodeoxyglucose (FDG) positron emission tomography/CT, and colonoscopy findings of a pathologically confirmed patient with aggressive SM of the colon and lymph nodes and extensive fungal infection of both lungs.

Patient concerns:

A 55-year-old female patient visited our hospital because of repeated cough for more than half a month. Laboratory tests revealed a significantly high CA125 serum level. Chest CT showed multiple plaques and patchy high-density shadows in both lungs, and a small amount of ascites was observed in the lower-level image. Abdominal CT revealed a soft tissue mass with an ill-defined boundary in the lower ascending colon. Whole-body positron emission tomography/CT images showed multiple nodular and patchy density-increasing lesions with significantly increased FDG uptake in both lungs. The wall of the ascending colon in the lower segment was significantly thickened with soft tissue mass formation, and retroperitoneal lymph node enlargement was accompanied by increased uptake of FDG. Colonoscopy revealed a soft tissue mass at the base of the cecum.

Diagnosis:

Colonoscopic biopsy was performed and the specimen was diagnosed with mastocytosis. At the same time, a puncture biopsy was also performed on the patient’s lung lesions, and pulmonary cryptococcosis was considered a pathological diagnosis.

Interventions:

The patient was in remission after repeated treatment with imatinib and prednisone for 8 months.

Outcomes:

In the ninth month, the patient suddenly died of a cerebral hemorrhage.

Lessons:

Gastrointestinal involvement due to aggressive SM presents with nonspecific symptoms and different endoscopic and radiologic findings. This is the first report of a single patient with colon SM, retroperitoneal lymph node SM, and extensive fungal infection in both lungs.
Secondary hemophagocytic lymphohistiocytosis associated with heat stroke: A case report and review of literature
Authors: Wi Wongook , Yoon Kyoung Won , Kim Hyo Jin
Published: June 2023

Rationale:

Hemophagocytic lymphohistiocytosis (HLH) is a syndrome with potentially fatal consequences that results from an excessive immune response caused by malfunctioning natural killer cells and cytotoxic T lymphocytes. Secondary HLH, which is the predominant type in adults, is associated with various medical conditions, including infections, malignancies, and autoimmune diseases. Secondary HLH associated with heat stroke has not been reported.

Patient concerns:

A 74-year-old male was admitted to the emergency department after being unconscious in a 42°C hot public bath. The patient was witnessed to be in the water for more than 4 hours. The patient’s condition was complicated by rhabdomyolysis and septic shock, which were managed with mechanical ventilation, vasoactive agents, and continuous renal replacement therapy. The patient also showed evidence of diffuse cerebral dysfunction.

Diagnoses:

While the patient’s condition initially improved, the patient developed a fever, anemia, thrombocytopenia, and an acute rise in total bilirubin, which, we suspected, was caused by HLH. Further investigations revealed elevated serum ferritin and soluble interleukin-2 receptor levels.

Interventions:

The patient received 2 cycles of serial therapeutic plasma exchange to lower the endotoxin burden. To manage HLH, high-dose glucocorticoid therapy was done.

Outcomes:

Despite the best efforts, the patient did not recover and expired from progressive hepatic failure.

Lessons:

We report a novel case of secondary HLH associated with heat stroke. Diagnosing secondary HLH can be difficult since clinical manifestations of the underlying disease and HLH may present simultaneously. Early diagnosis and prompt initiation of treatment is required to improve the prognosis of the disease.
Next generation sequencing predicting clinical effect of immunotherapy on adult rhabdomyosarcoma patient: A case report
Authors: Sun Xiaogang , Wang Xinyu , Zhou Jun , Xu Yali , Zhang Hao , Xu Mian , Shen Jiaojiao , Shi Xiaoliang , Song Wei , Li Jun
Published: June 2023

Rationale:

Rhabdomyosarcoma (RMS) is a rare sarcoma that rarely occurs in adults and accounts for only 1% of all adult tumors. The standard treatment for RMS is surgical resection, radiotherapy, and chemotherapy.

Patient concerns:

Adult patients often present with an aggressive course and poor prognosis.

Diagnoses:

The patient was diagnosed with RMS in September 2019 and was confirmed by hematoxylin-eosin staining and immunohistochemistry after surgical resection.

Interventions:

The patient received surgical resection in September 2019. He was admitted to another hospital after the first recurrence in November 2019. After the second routine surgical resection, the patient underwent chemotherapy, radiotherapy, and anlotinib maintenance treatment. He relapsed again in October 2020 and was admitted to our hospital. Next-generation sequencing was performed on the punctured tissue of the patient’s lung metastatic lesion, and high tumor mutational burden (TMB-H), high microsatellite instability (MSI-H), and positive programmed death-ligand 1 (PD-L1) were observed. The patient then received toripalimab and anlotinib combined therapy and was evaluated for a partial response after 2 months.

Outcomes:

This benefit has persisted for more than 17 months.

Lessons:

This is the longest progression-free survival for PD-1 inhibitors in RMS, and there is a trend of continued extension of progression-free survival in this patient. This case supports the hypothesis that positive PD-L1, TMB-H, and MSI-H could be beneficial biomarkers for immunotherapy in adult RMS.
Influence of physicians’ seniority on efficacy of silver needle therapy for low back fasciitis: A prospective, cohort study
Authors: Tian Xiaojun , Li Wei , Zhou Bin , Zhang Bing , Wang Xuan , Yin Yanwei , Yu Junmin , Wu Xing , Sun Xiuming , Meng Chao
Published: June 2023

Background:

Physicians’ seniority has always been the focus of patients. Silver needle therapy (SNT) has been applied for more than 60 years. It is similar to moxibustion and has a good therapeutic effect on soft tissue pain. This study aimed to determine the influence of physicians’ seniority on the efficacy of SNT for patients with low back fasciitis.

Methods:

This was a prospective cohort study at the Affiliated Hospital of Qingdao University. Patients diagnosed with low back fasciitis were split into junior physician (JP) and senior physician (SP) groups (n = 30) based on the seniority of the physician. The numerical rating scale (NRS) was administered during the SNT, and operation time was recorded. The NRS, Oswestry Disability Index (ODI), and Short-Form 12 of quality of life (SF-12) scores at 1, 2, 6, and 12 months after the treatment and autonomic nervous system (ANS) activity were also observed.

Results:

Compared with the SP group, the NRS score during the SNT (5.20 ± 0.71 vs 2.53 ± 0.94) and operation time (11.7 ± 1.6 minutes vs 6.8 ± 1.1 minute) were higher in the JP group (P < .05). The NRS, ODI score, SF-12 score, and ANS activity after treatment were not significantly different between SP and JP groups. Additionally, in the multivariate linear regression analysis model, the physicians’ seniority was an independent factor affecting the NRS score during the SNT and operation time (P < .05).

Conclusion:

SNT could attenuate the pain of patients with low back fasciitis in the short and long term without severe complications. The physicians’ seniority did not influence the efficacy of SNT, but the JP group showed an increased operation time and a higher degree of pain during the operation.
Factors predicting good prognosis of failed intra-arterial thrombectomy cases: A retrospective study
Authors: Jo Hyunjun , Lee In-Hyoung , Ha Sung-Kon , Lim Dong-Jun , Choi Jong-Il
Published: June 2023

Intra-arterial thrombectomy (IAT) has been increasingly applied in the treatment of acute ischemic stroke (AIS) due to large-vessel occlusion, and many related studies have been published. However, limited studies on the prognosis of failed-IAT patients are available. In this study, factors that can predict a good prognosis in patients with failed IAT were studied. Among patients who visited our hospital between January 2016 and September 2022 and underwent IAT, we retrospectively analyzed those with failed IAT. A univariate analysis was performed on the radiological features, medical histories, and other patient characteristics expected to affect the prognosis, and a multivariate analysis was performed on some of these factors. In univariate analysis, a good collateral channel on susceptibility-weighted imaging (SWI), modified thrombolysis in cerebral infarction (mTICI) 2A recanalization, and the pre-procedural modified Rankin scale (mRS) were statistically significant. In the multivariate analysis, good collateral channels on SWI and computed tomography angiography (CTA) and mTICI 2A recanalization were statistically significant. Factors that can predict a good prognosis in patients with failed IAT include good leptomeningeal collateral channels evaluated by CTA and SWI and mTICI 2A recanalization.
Association between nonalcoholic fatty liver disease and colorectal cancer: A population-based study
Authors: Wu Po-Hsien , Chung Chi-Hsiang , Wang Ying-Hsiang , Hu Je-Ming , Chien Wu-Chien , Cheng Yi-Chiao
Published: June 2023

Colorectal cancer (CRC) and nonalcoholic fatty liver disease (NAFLD) have high prevalence rates and place a considerable burden on the health-care industry. The association between both diseases is controversial. Our aim was to examine the association between NAFLD and CRC. Using data extracted from the Taiwan National Health Insurance Research Database (NHIRD) from 2000 to 2015, we enrolled 60 298 patients with NAFLD. Of these, 52,986 met the inclusion criteria. A comparison group was selected using 4-fold propensity score matching by age, sex, and year of index date. The primary outcome was the cumulative incidence of CRC in patients with NAFLD. Over a mean follow-up period of 8.5 years, 160 new cases of CRC were identified. The incidence rate of CRC was higher in the NAFLD group (12.23 per 100,000 person-years) than in the comparison cohort (6.0 per 100,000 person-years). Cox proportional hazards regression analysis revealed that the adjusted hazard ratio (HR) of CRC was 1.259 in the study group (95% confidence interval [CI]: 1.047–1.486, P = .003). Using Kaplan–Meier analysis, we ascertained that the cumulative incidence of CRC was significantly high in the NAFLD group. Patients older than 50 years, with diabetes mellitus (DM), and with chronic liver disease also exhibited a high risk of CRC. NAFLD was associated with a high risk of CRC. CRC occurs more frequently in patients with NAFLD aged between 50 and 59 years and those older than 60 years with comorbidities, including DM and chronic liver disease. Physicians should consider the subsequent risk of CRC when treating patients with NAFLD.
A rare cause of hematochezia: colonic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALToma): A case report and literature review
Authors: Lu Chien-Hung , Kao Wei-Yu , Chang Chun-Chao , Kan Yu-An
Published: June 2023

Rationale:

Colonic extranodal mucosa-associated lymphoid tissue lymphoma as a cause of hematochezia is rare. Here, we report a case of colonic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALToma) with presentation of freshy bloody stool and successfully treated by endoscopic mucosal resection.

Patient concerns:

This case was a 69-year-old woman with history of hypertension, reflux esophagitis, and peptic ulcer. She had several episodes of hematochezia and thus sought medical attention at the outpatient clinic.

Diagnoses:

Colonoscopy revealed a 12-mm semipedunculated lesion in the ascending colon. Histopathological examination and immunochemistry were compatible with colonic extranodal mucosa-associated lymphoid tissue lymphoma.

Interventions:

Endoscopic mucosal resection was done for tumor removal and hemoclipping was done to achieve hemostasis.

Outcomes:

The patient remained well without recurrence during 3 years of outpatient follow-up.

Lesson:

Colonic MALToma is a rare disease, and could present as hematochezia. En bloc endoscopic resection could achieve long-term remission. The prognosis of colonic MALToma is excellent with its indolent characteristics.
Recovery of severe COVID-19 complicated with cerebral infarction: Considerations on a case report
Authors: Mao Erli , Qu Zhaohui , Jin Juan , Yao Cui , Lyu Wenjun , Jiang Feng , Ding Hui , Wu Chuyan
Published: June 2023

Rationale:

The standardization, individualization, and rationalization of intensive care and treatment for severe patients have improved. However, the combination of corona virus disease 2019 (COVID-19) and cerebral infarction presents new challenges beyond routine nursing care.

Patient concerns and diagnoses:

This paper examines the rehabilitation nursing of patients with both COVID-19 and cerebral infarction as an example. It is necessary to develop a nursing plan for COVID-19 patients and implement early rehabilitation nursing for cerebral infarction patients.

Interventions:

Timely rehabilitation nursing intervention is essential to enhance treatment outcomes and promote patient rehabilitation. After 20 days of rehabilitation nursing treatment, patients showed significant improvement in visual analogue scale score, drinking test, and upper and lower limb muscle strength.

Outcomes:

Treatment outcomes for complications, motor function, and daily activities also improved significantly.

Lessons:

Critical care and rehabilitation specialist care play a positive role in ensuring patient safety and improving their quality of life by adapting measures to local conditions and the timing of care.
Exploring the mechanism of Ginkgo biloba L. leaves in the treatment of vascular dementia based on network pharmacology, molecular docking, and molecular dynamics simulation
Authors: Pan Jienuo , Tang Jiqin , Gai Jialin , Jin Yilan , Tang Bingshun , Fan Xiaohua
Published: June 2023

Background:

Ginkgo biloba L. leaves (GBLs) play a substantial role in the treatment of vascular dementia (VD); however, the underlying mechanisms of action are unclear.

Objective:

This study was conducted to investigate the mechanisms of action of GBLs in the treatment of VD through network pharmacology, molecular docking, and molecular dynamics simulations.

Methods:

The active ingredients and related targets of GBLs were screened using the traditional Chinese medicine systems pharmacology, Swiss Target Prediction and GeneCards databases, and the VD-related targets were screened using the OMIM, DrugBank, GeneCards, and DisGeNET databases, and the potential targets were identified using a Venn diagram. We used Cytoscape 3.8.0 software and the STRING platform to construct traditional Chinese medicine–active ingredient–potential target and protein–protein interaction networks, respectively. After gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis of potential targets using the DAVID platform, the binding affinity between key active ingredients and targets was analyzed by molecular docking, and finally, the top 3 proteins–ligand pairs with the best binding were simulated by molecular dynamics to verify the molecular docking results.

Results:

A total of 27 active ingredients of GBLs were screened and 274 potential targets involved in the treatment of VD were identified. Quercetin, luteolin, kaempferol, and ginkgolide B were the core ingredients for treatment, and AKT1, TNF, IL6, VEGFA, IL1B, TP53, CASP3, SRC, EGFR, JUN, and EGFR were the main targets of action. The main biological processes involved apoptosis, inflammatory response, cell migration, lipopolysaccharide response, hypoxia response, and aging. PI3K/Akt appeared to be a key signaling pathway for GBLs in the treatment of VD. Molecular docking displayed strong binding affinity between the active ingredients and the targets. Molecular dynamics simulation results further verified the stability of their interactions.

Conclusion subsections:

This study revealed the potential molecular mechanisms involved in the treatment of VD by GBLs using multi-ingredient, multi-target, and multi-pathway interactions, providing a theoretical basis for the clinical treatment and lead drug development of VD.