bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring potential mechanisms of Suhexiang Pill against COVID-19 based on network pharmacology and molecular docking
Authors: Li Jialin , Huang Zhihong , Lu Shan , Luo Hua , Tan Yingying , Ye Peizhi , Liu Xinkui , Wu Zhishan , Wu Chao , Stalin Antony , Wang Haojia , Liu Yingying , Shen Liangliang , Fan Xiaotian , Zhang Bei , Yi Jianping , Yao Lu , Xu Yi , Wu Jiarui , Duan Xianchun
Published: December 2021

Background:

The traditional Chinese medicine prescription Suhexiang Pill (SHXP), a classic prescription for the treatment of plague, has been recommended in the 2019 Guideline for coronavirus disease 2019 (COVID-19) diagnosis and treatment of a severe type of COVID-19. However, the bioactive compounds and underlying mechanisms of SHXP for COVID-19 prevention and treatment have not yet been elucidated. This study investigates the mechanisms of SHXP in the treatment of COVID-19 based on network pharmacology and molecular docking.

Methods:

First, the bioactive ingredients and corresponding target genes of the SHXP were screened from the traditional Chinese medicine systems pharmacology database and analysis platform database. Then, we compiled COVID-19 disease targets from the GeneCards gene database and literature search. Subsequently, we constructed the core compound-target network, the protein-protein interaction network of the intersection of compound targets and disease targets, the drug-core compound-hub gene-pathway network, module analysis, and hub gene search by the Cytoscape software. The Metascape database and R language software were applied to analyze gene ontology biological processes and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. Finally, AutoDock software was used for molecular docking of hub genes and core compounds.

Results:

A total of 326 compounds, 2450 target genes of SHXP, and 251 genes related to COVID-19 were collected, among which there were 6 hub genes of SHXP associated with the treatment of COVID-19, namely interleukin 6, interleukin 10, vascular endothelial growth factor A, signal transducer and activator of transcription 3 (STAT3), tumor necrosis factor (TNF), and epidermal growth factor. Functional enrichment analysis suggested that the effect of SHXP against COVID-19 is mediated by synergistic regulation of several biological signaling pathways, including Janus kinase/ STAT3, phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt), T cell receptor, TNF, Nuclear factor kappa-B,Toll-like receptor, interleukin 17, Chemokine, and hypoxia-inducible factor 1 signaling pathways.SHXP may play a vital role in the treatment of COVID-19 by suppressing the inflammatory storm, regulating immune function, and resisting viral invasion. Furthermore, the molecular docking results showed an excellent binding affinity between the core compounds and the hub genes.

Conclusion:

This study preliminarily predicted the potential therapeutic targets, signaling pathways, and molecular mechanisms of SHXP in the treatment of severe COVID-19, which include the moderate immune system, relieves the “cytokine storm,” and anti-viral entry into cells.
FANCI may serve as a prognostic biomarker for cervical cancer
Authors: Liu Xiaoling , Liu Xiqin , Han Xia
Published: December 2021

Background:

DNA damage is a fundamental process that plays a considerable role in generating protein diversity. FANCI, loaded on the altered chromatin, plays a vital role in DNA damage. Abnormal FANCI expression is potentially associated with carcinogenesis.However, the biological role of FANCI in cervical cancer is yet to be determined.

Methods:

We analyzed FANCI expression via multiple gene expression databases. Genes co-expressed with FANCI and its regulators were identified using LinkedOmics. The correlations between FANCI and cancer immune infiltrates were investigated via Tumor Immune Estimation Resource (TIMER).

Results:

FANCI was found upregulated with amplification in tumor tissues of multiple cervical cancer cohorts. High FANCI expression was associated with poorer overall survival (OS). Functional network analysis suggested that FANCI regulates spliceosome, DNA replication, and cell cycle signaling via pathways involving several cancer-related kinases and the E2F family. In additional, FANCI expression was positively correlated with infiltrating levels of CD4+ T and CD8+ T cells, and neutrophils. FANCI expression also showed strong correlations with diverse immune marker sets in cervical cancer.

Conclusion:

These findings suggested that FANCI is correlated with prognosis of and immune infiltration in cervical cancer, laying a foundation for further study of the immune regulatory role of FANCI in cervical cancer.
Management of pancreatic arteriovenous malformation
Authors: Wu Wei , An Feng-Duo , Piao Cheng-Lin , Tan Ming-Kun , Si Zhen-Duo , Xin Lan , Zhao Na , Leng Jian-Jun
Published: December 2021

Introduction:

Pancreatic arteriovenous malformation (P-AVM) is a rare vascular malformation. Fewer than 200 cases have been reported. The clinical manifestations lack specificity. Common symptoms include abdominal pain, gastrointestinal hemorrhage, and jaundice, which is easily confused with other disorders.

Patient concerns:

A 42-year-old man received TAE due to abdominal pain caused by P-AVM in a local hospital, melena and abdominal pain occurred in a short time after TAE.

Diagnosis:

The patient was diagnosed as P-AVM which was confirmed by computed tomography and digital subtraction angiography.

Interventions:

A pylorus-preserving pancreatoduodenectomy was successfully performed after diagnosis was made.

Outcomes:

The patient recovered with no complications two weeks after surgery, and no sign of recurrence was found during the 4-mo follow-up period.

Conclusion:

In our experience, TAE may have limitations in the treatment of P-AVM and surgical resection should be considered as the treatment of choice.
Identification of triple gene fusion ALK-LRRN2, LTBP1-ALK, and HIP1-ALK in advanced lung adenocarcinoma and response to alectinib
Authors: Ning Shangkun , Shi Congcong , Zhang Huifang , Li Jinpeng
Published: December 2021

Rationale:

Anaplastic lymphoma kinase (ALK) rearrangement is the second most common targetable oncogene-dirven gene in nonsmall cell lung cancer. Owing to the advanced sequencing technologies, new partner genes of ALK have been constantly detected.

Patient concerns:

A 42-year-old Chinese woman went to our hospital with the chief complaint of cough and expectoration for 1 month. The patient had no fever, chest pain, and hemoptysis.

Diagnoses:

She was diagnosed with advanced lung adenocarcinoma. The patient underwent lung biopsy guided by computed tomography and pathology showed poorly differentiated adenocarcinoma. To explore possibility of targeted therapy, the tumor samples were subjected to next-generation sequencing, and a rare 3 ALK fusion variant ALK-LRRN2, LTBP1-ALK, and HIP1-ALK was identified.

Interventions and outcomes:

The patient subsequently received alectinib treatment, and achieved partial response. No significant drug related adverse reactions were found during alectinib treatment. The progression-free survival achieved 25 months.

Lessons:

Together, we identified a rare triple ALK fusion variant, ALK-LRRN2, LTBP1-ALK and HIP1-ALK, in a patient with lung adenocarcinoma. The patient benefited from alectinib treatment, which could provide a certain reference for the patients with such gene alteration.
Buzhong Tiaogan Formula for delaying colorectal liver metastasis (liver depression spleen deficient type)
Authors: Wang Zhi-Jie , Zheng Shi-Hang , Wang Xiao-Han , Zhang Yi-Zhe , Hao Shu-Lan , Liu Li-Kun , Wang Xi-Xing
Published: December 2021

Introduction:

Colorectal cancer has been ranked third among the most common cancers worldwide and raised to the second leading cause of cancer death with nearly one-tenth of cancer-related deaths globally, and nearly half of colorectal cancer patients present with or develop colorectal cancer liver metastasis (CRLM). Buzhong Tiaogan Formula (BTF) has been proven to treat CRLM in our team, but there are lacking of evidence on its effective in delaying colorectal liver metastasis (liver depression spleen deficiency type), so we will evaluate the efficacy and safety of BTF in preventing the occurrence of CRLM.

Methods:

This randomized controlled trial (RCT) will be carried out in 3 different hospitals in Shanxi Province planning to recruit 150 CRLM patients with the type of liver depression spleen deficiency. The control group will be treated by basic antitumor therapy and the treatment group will use BTF plus basic antitumor therapy. The primary outcomes will be quality of life of included patients, the time of occurrence of liver metastasis, the score of traditional Chinese medicine symptom for the type of liver depression spleen deficiency; and the secondary outcomes will include overall survival, progression-free survival, DFS, tumor microenvironment and immune state of the included patient. Safety evaluation will be recorded during the whole study. All data in this RCT will be analyzed by SPSS 23.0 software. This study has been approved by the Clinical Research Ethics Committee of Shanxi Province Hospital of Traditional Chinese medicine (2021Y-06016).

Discussion:

The results of this RCT will contribute to BTF for delaying colorectal liver metastasis (liver depression spleen deficient type). And the results from this RCT will be published in a relevant journal after finished.

Trial registration:

ChiMCTR2100005268 (September 4, 2021).
Effect and safety of anlotinib combined with S-1 for recurrent or metastatic esophageal cancer patients who refused or were intolerant to intravenous chemotherapy
Authors: Cai Jing , Zhou Shan , Luo Yuxi , Liu Anwen
Published: December 2021

This study aimed to evaluate the effect and safety of anlotinib combined with S-1 in the treatment of recurrent or metastatic esophageal cancer patients who refused or were intolerant to intravenous chemotherapy.

This study retrospectively reviewed 22 recurrent or metastatic esophageal cancer patients who refused or were intolerant to intravenous chemotherapy between June 1, 2018 and February 28, 2019. All patients did not previously receive anlotinib or S-1.

Of 22 patients, 20 patients had squamous cell cancer. Seventeen patients received at least 2 cycles of anlotinib plus S-1. The objective response rate (ORR) was 35.3%, and the disease control rate (DCR) was 82.4%. The median progression-free survival (PFS) was 3.5 months, and median overall survival (OS) was 5.2 months. In the first-line treatment subgroup, the ORR was 50%, the DCR was 80%, the median PFS was 4.5 months, and the median OS was 5.8 months. In the second-line and above treatment subgroup, the ORR was 14.3%, the DCR was 85.7%, the median PFS was 3.0 months, and the median OS was 3.7 months. The main adverse events (AEs) of anlotinib combined with S-1 were fatigue (58.8%), hypertension (47.1%), hemoptysis (29.4%), anemia (29.4%), nausea (23.5%), liver function damage (23.5%), albuminuria (17.6%), abdominal pain (17.6%), leukopenia (17.6%), neutropenia (11.8%), fever (11.8%), and hand-foot syndrome (11.8%). Grade 3 AEs included nausea (5.9%) and hypertension (5.9%), and no grade 4 or more AEs were reported.

Anlotinib combined with S-1 achieved promising disease control and satisfactory survival with tolerable safety in recurrent metastatic esophageal cancer who refused or were intolerant to intravenous chemotherapy.
The effect of non-pharmacological interventions on psychological stress and quality of life of parents of children with retinoblastoma
Authors: Wu Lei , Xiang Xitao , Guo Hong , Tan Hui
Published: December 2021

Background:

Retinoblastoma is the most common malignant tumor in infancy and early childhood. Due to the high incidences of intracranial metastasis and distant metastasis, retinoblastoma not only threatens the life of affected children, but also brings heavy mental stress to their parents. A strong mental stress often leads to anxiety, depression, and other adverse emotions, which is very unfavorable to the treatment and prognosis by generating great psychological pressure and reducing the quality of life of the family. Reducing the psychological stress of the parents and improving the quality of life of the family are beneficial to the treatment and prognosis of retinoblastoma in children. However, there are no recommended non-pharmacological therapies to reduce the psychological stress and improve the quality of life of the parents of children with retinoblastoma. This study aims to evaluate the effects of non-pharmacological therapies on psychological stress and quality of life of parents of children with retinoblastoma through a meta-analysis, thus providing clinical evidence.

Methods:

Randomized controlled trials reporting the effects of non-pharmacological therapies on psychological stress and quality of life of parents of children with retinoblastoma published before 2021 November will be searched in online databases, including the China National Knowledge Infrastructure, Wanfang, Chinese Scientific Journal Database, China Biomedical Literature Database, PubMed, Embase, The Cochrane Library, and Web of Science databases. The Cochrane Quality Assessment Manual will be used to assess the quality of the included literatures. Meta-analysis will be performed using Revman 5.4 software.

Results:

This study will evaluate the effects of non-pharmacological therapies on psychological stress and quality of life of parents of children with retinoblastoma via grading anxiety scores, depression scores, and quality-of-life scores.

Conclusion:

This study will provide a reliable evidence-based basis for non-pharmacological interventions on parents of children with retinoblastoma.

Ethics and dissemination:

Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. This review would be disseminated in a peer-reviewed journal or conference presentations.

OSF REGISTRATION NUMBER:
Long-acting versus short-acting granulocyte colony-stimulating factors among cancer patients after chemotherapy in China
Authors: Wang Genzhu , Zhang Yonghe , Wang Xiaoying , Sun Qiang , Xun Zhikun , Yuan Minglu , Li Zhongdong
Published: December 2021

Background:

Granulocyte colony-stimulating factors (G-CSFs) include long-acting ones and short-acting ones. They have been mainly applied in Chinese clinical practice for years to prevent neutropenia. However, which type of G-CSF is more superior has not been conclusively determined.

Methods:

A systematic literature search was conducted using the PubMed, Embase, Cochrane Library, clinical trials.gov, China National Knowledge Infrastructure, and WAN FANG databases for related studies published till August 2021. Revman 5.3 software was used to assess the effectiveness and safety of these 2 types of G-CSFs in patients undergoing chemotherapy.

Results:

Ten studies involving 1916 patients were included in our meta-analysis to compare the effectiveness and safety of long-acting G-CSFs and short-acting G-CSFs. We found that the incidence of febrile neutropenia (relative risk [RR] 0.82; 95% confidence interval [CI] 0.57–1.17), the recovery time of the absolute neutrophil count (mean difference –0.23; 95% CI –0.49 to 0.03), and the fatigue rate (RR 0.82; 95% CI 0.62–1.07) were similar between the long- and the short-acting G-CSFs. However, the long-acting G-CSFs significantly decreased the incidence (RR 0.86; 95% CI 0.76–0.96) and shortened the duration (mean difference –0.19; 95% CI –0.38 to 0.00) of severe (grade ≥3) neutropenia, and decreased the rate of bone and/or muscle pain (RR 0.75; 95% CI 0.58–0.98).

Conclusion:

Primary prophylaxis with long-acting G-CSFs was more effective and safer than primary prophylaxis with short-acting G-CSFs in Chinese adults undergoing chemotherapy.
Efficacy and safety of tacrolimus monotherapy versus tacrolimus-corticosteroid combination therapy for idiopathic membranous nephropathy
Authors: Gong Lifeng , Xu Min , Xu Wei , Tang Weigang , Lu Jingkui , Jiang Wei , Xie Fengyan , Ding Liping , Qian Xiaoli
Published: December 2021

Objective:

The objective of this meta-analysis was to compare the efficacy and safety of tacrolimus (TAC) monotherapy versus TAC-corticosteroid combination therapy in idiopathic membranous nephropathy (IMN) patients.

Methods:

Databases including PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang database were searched from inception to January 10, 2021. Eligible studies comparing TAC monotherapy and TAC-corticosteroid combination therapy in IMN patients were included. Data were analysed using Review Manager Version 5.3.

Results:

Seven studies were included in the meta-analysis. One randomized controlled trial and six cohort studies involving 372 patients were identified. Compared with TAC monotherapy, TAC-corticosteroid had a higher total remission at the sixth month (odd ratio (OR) 0.49, 95% confidence interval (CI) 0.31–0.78, P < .01). The two therapy regimens had similar complete remission rates (OR 0.79, 95% CI 0.43–1.48, P = .47) at the sixth month and similar relapse rates (OR 1.44, 95% CI 0.70–2.92, P = .32). TAC-corticosteroid combination therapy had a higher incidence of infection (OR 0.38, 95% CI 0.18–0.81, P = .01). The two therapy regimens had similar incidences of gastrointestinal symptoms (OR 0.96, 95% CI 0.34–2.70, P = .93), abnormal aminotransferase (OR 0.90, 95% CI 0.34–2.38, P = .84), and glucose intolerance (OR 0.58, 95% CI 0.32–1.07, P = .08).

Conclusion:

TAC-corticosteroid combination therapy had a higher total remission rate at the sixth month but had a higher incidence of infection than TAC monotherapy in the treatment of IMN. The two therapeutic regimens had similar relapse rates.
The value of intraoperative nerve monitoring against recurrent laryngeal nerve injury in thyroid reoperations
Authors: Pei Maowei , Zhu Siqi , Zhang Chunjie , Wang Guoliang , Hu Mingrong
Published: December 2021

Reoperative thyroidectomy is challenging for surgeons because of the higher incidence of recurrent laryngeal nerve (RLN) palsy. RLN identification is the gold standard during thyroidectomy; however, it is sometimes difficult to perform thyroid reoperations. In recent years, intraoperative nerve monitoring (IONM) has gained increased acceptance, and the use of IONM can be a valuable adjunct to visual identification. The aim of this study was to evaluate the value of IONM during thyroid reoperation.

A total of 109 patients who met our criteria at the Affiliated Hospital of Hangzhou Normal University from January 2010 to June 2020 were retrospectively analyzed and divided into the IONM group and the visualization-alone group (VA group) according to whether neuromonitoring was used during the operation. The patients’ characteristics, perioperative data, and intraoperative information including the RLN identification, time of RLNs confirmation, operative time, intraoperative blood loss, and the rate of RLN injury were collected.

Sixty-five procedures (94 RLNs at risk) were performed in the IONM group, whereas 44 (65 RLNs at risk) were in the VA group. The rate of RLN identification was 96.8% in the IONM group and 75.4% in the VA group (P < .05). The incidence of RLN injury was 5.3% in the IONM group and 13.8% in the VA group (P > .05). The incidence of surgeon-related RLN injury rate was 0% in the IONM group compared to 7.7% in the VA group (P < .05), but the tumor-related or scar-related RLN injury rate between the 2 groups were not significantly different (4.3% vs 3.1%, 1.1% vs 3.1%, P > .05).

IONM in thyroid reoperation was helpful in improving the RLN identification rate and reducing the surgeon-related RLN injury rate, but was ineffective in reducing the tumor-related and scar-related RLN injury rate. In the future, multicenter prospective studies with large sample sizes may be needed to further assess the role of IONM in thyroid reoperations.
Musculoskeletal manifestations in Alkaptonuria
Authors: Khan Aysha Habib , Afroze Bushra , Majid Hafsa , Zaidi Yusra , Jamil Azeema , Jafri Lena
Published: December 2021

This study aimed to determine the patient characteristics and clinical presentation of Alkaptonuria cases reported by the Biochemical Genetics Lab.

An observational study was conducted at the Biochemical Genetics Lab. Alkaptonuria patients were diagnosed based on the homogentisic acid peak in urine and their demographics and clinical data collected from to 2013 to 2019. Clinical history related to joint diseases, ochronotic presentation, and urine darkening on standing was collected.

During 7 years, 21 Alkaptonuria cases were reported from BGL; mean age 19.4 ± 24.5 years (range 0.2–66 years) and male to female ratio of 2:1. Of the total, only 9 were adults (mean age, 44 ± 12 years). Most adult patients had musculoskeletal involvement, with joint pain (n = 9) and ochronotic pigmentation (n = 6), whereas all patients presented with a history of urine darkening on standing (21/21 cases).

The high prevalence of musculoskeletal involvement observed in patients with albuminuria is likely to be missed by physicians unless specifically tested for in such cases.
Bordetella bronchiseptica infections in patients with HIV/AIDS
Authors: Gujju Veena R. , Akram Bushra , Shibib Dena R. , McGhee Miranda A. , Drevets Douglas A.
Published: December 2021

Rationale:

Bordetella bronchiseptica is a common cause of upper respiratory tract infections in domesticated dogs and cats and a rare zoonotic pathogen in immunocompromised humans. With increasing numbers of people acquiring pets and spending time with them in confined spaces due to COVID-19 lockdowns, it is important to be aware of adverse health consequences brought about by this interaction. We present a case of B bronchiseptica pneumonia in a patient with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and review key characteristics of an additional 30 cases of B bronchiseptica infections in 29 patients with HIV/AIDS that were identified by literature review.

Patient concerns:

A 61-year-old male with HIV/AIDS who was not on antiretroviral therapy and had advanced immunosuppression with a CD4+ T-lymphocyte count of 3 cells/μL sought medical attention for multiple somatic issues including subjective fevers, shortness of breath, and intermittent chest pain.

Diagnosis:

Computed tomography of the chest identified bilateral nodular opacities in the lower lobes with scattered areas of ground glass opacities. B bronchiseptica was identified in sputum culture by mass spectrometry followed by supplementary biochemical testing.

Interventions:

Empiric broad-spectrum antibiotics were initiated and changed to levofloxacin after susceptibility testing was completed.

Outcomes:

The patient was discharged after symptomatic improvement with levofloxacin.

Lessons:

Pneumonia with interstitial infiltrates in the setting of advanced CD4 lymphocyte depletion is the most common clinical syndrome caused by B bronchiseptica in patients with HIV/AIDS, and may be accompanied by sepsis. Advanced immune suppression, as well as chronic medical conditions, for example, alcoholism, diabetes, and renal failure that compromise host defenses are also commonly found in cases of B bronchiseptica infection in patients who do not have HIV infection. Reported animal contact among patients was not universal. Isolates were susceptible to aminoglycosides, carbapenems, fluoroquinolones, but typically resistant to most cephalosporins.
CCDC40 mutation as a cause of infertility in a Chinese family with primary ciliary dyskinesia
Authors: Liu Li , Zhou Kechong , Song Yuxuan , Liu Xiaoqiang
Published: December 2021

Trial design:

Primary ciliary dyskinesia (PCD) is a genetical disease that inherited in an autosomal-recessive way. Its clinical manifestations (such as male infertility) are mainly caused by defects of motion-related cilia that encoded by mutated genes. Although some mutation has been verified, a number of mutations of PCD remain elusive. The main purpose of this study is to identify mutant genes in a Chinese family with PCD, and to verify the safety and effectiveness of intracytoplasmic sperm injection (ICSI) of infertility caused by PCD.

Methods:

Imaging examination was used to exclude pulmonary inflammation and visceral translocation. Semen analysis was used to assess the quality of the proband's sperm. Transmission electron microscopy (TEM) was conducted to assess the ultrastructure of flagella and cilia. Targeted next generation sequencing and Sanger sequencing and qPCR (real-time quantitative polymerase chain reaction detecting system) were applied to identified mutation of Chinese Family suspected of having PCD. Viable sperm were selected by hypo-osmotic swelling test (HOST) for ICSI.

Results:

We report 2 novel mutations in CCDC40 gene (c.1259delA and EX17_20 deletion) resulted in immobility of sperm and infertility of the proband. These mutations were confirmed in the proband's sister (heterozygous) and his parents (recessive carrier) by Sanger sequencing and qPCR. All the spermatozoa from the proband were immotile. Ultrastructural defects were found in flagella and cilia of proband and his sister. Viable sperms were selected by HOST for ICSI and fertilized 9 of 21 eggs. Two frozen embryos were transplanted and a healthy 3500 g boy was delivered at 40 + 4 weeks’ gestation. And then, we summarized the genes related to PCD and the mutant sites of CCDC40 gene.

Conclusion:

We reported 2 novel mutants in CCDC40 gene (c.1259delA and EX17_20 deletion), which could be candidates for genetic diagnosis in PCD patients. The combination of targeted next generation sequencing and Sanger sequencing may be a useful tool to diagnose PCD. ICSI is a considerable method in treatment of infertility caused by PCD.
Efficacy and safety of the combination of modern medicine and traditional Chinese medicine in pulmonary fibrosis caused by novel coronavirus disease
Authors: Li Feiran , Wang Guanyu , Zhang Wei , Zhang Caiqing
Published: December 2021

Background:

Novel coronavirus disease (COVID-19) is a kind of pulmonary inflammation induced by New Coronavirus. It seriously threatens people's health and safety. Clinical studies have found that some patients have different degrees of inflammation after discharge from hospital, especially in patients with severe inflammatory lung fibrosis. Early combination of Chinese medicine and modern medicine has important clinical significance. There are still many deficiencies in the current research. We studied the effectiveness of the combination of traditional Chinese medicine and modern medicine in the treatment of pulmonary fibrosis caused by COVID-19, and proposed a network meta-analysis (NMA) scheme.

Methods:

According to the search strategy, we will search Chinese and English databases to collect all randomized controlled trials of traditional Chinese medicine combined with modern drugs or only using traditional Chinese medicine for new coronavirus-19-induced pulmonary fibrosis between December 1, 2019 and November 15, 2021. First, the literature was screened according to the eligibility criteria, endnotex9 was used to manage the literature, and the Cochrane Collaboration's tool was used to assess the quality of the included literature. Revman 5.3, Stata 14.2, and gemtc14.3 meta-analysis software was then used for data processing and analysis, and the grading of recommendations assessment will be used to develop and evaluate a hierarchy for classifying the quality of evidence for NMA.

Results:

Through the analysis, the ranking of efficacy and safety of various treatments for pulmonary fibrosis caused by COVID-19 will be drawn, thus providing stronger evidence support for the choice of clinical treatment methods.

Conclusion:

Traditional Chinese medicine (TCM) combined with modern drugs has played a positive role in the treatment of pulmonary fibrosis caused by COVID-19, and this study may provide more references for the clinical medication of pulmonary fibrosis caused by COVID-19.

INPLASY registration number:

INPLASY2021110061.
Nebulized enriched heparin to treat no critical patients with Sars-Cov-2
Authors: Bertanha Matheus , Rodrigues Lenize da Silva , Mellucci Filho Pedro Luciano , Moroz Andrei , Pardini Maria Inês de Moura Campos , Sobreira Marcone Lima , Durigon Edison Luiz , Machado Rafael Rahal Guaragna , Grotto Rejane Maria Tommasini , Lima Marcelo Andrade de , Nader Helena Bonciani , Moraes Marli Leite de , Barbosa Alexandre Naime , Medolago Natália Bronzatto , Cardoso Fábio Florença , Magro Angelo José , Carvalho Cristiane Rodrigues Guzzo , Moraes Leonardo Nazário de , Alvarado Rita de Cássia , Nunes Helga Caputo , Campos Gustavo Constantino de , Grillo Vinicius Tadeu Ramos da Silva , Sertorio Nathalia Dias , Fortaleza Carlos Magno Castelo Branco
Published: December 2021

Background:

Coronavirus disease 2019 (COVID-19) is a viral respiratory disease that spreads rapidly, reaching pandemic status, causing the collapse of numerous health systems, and a strong economic and social impact. The treatment so far has not been well established and there are several clinical trials testing known drugs that have antiviral activity, due to the urgency that the global situation imposes. Drugs with specific mechanisms of action can take years to be discovered, while vaccines may also take a long time to be widely distributed while new virus variants emerge. Thus, drug repositioning has been shown to be a good strategy for defining new therapeutic approaches. Studies of the effect of enriched heparin in the replication of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) in vitro assays justify the advance for clinical tests.

Methods and analysis:

A phase I/II triple-blind parallel clinical trial will be conducted. Fifty participants with radiological diagnosis of grade IIA pneumonia will be selected, which will be allocated in 2 arms. Participants allocated in Group 1 (placebo) will receive nebulized 0.9% saline. Participants allocated in Group 2 (intervention) will receive nebulized enriched heparin (2.5 mg/mL 0.9% saline). Both groups will receive the respective solutions on a 4/4 hour basis, for 7 days. The main outcomes of interest will be safety (absence of serious adverse events) and efficacy (measured by the viral load).

Protocols will be filled on a daily basis, ranging from day 0 (diagnosis) until day 8.
Effectiveness and safety of Wendan decoction for post-stroke depression
Authors: Hou Yonghui , Pang Wenen , Gao Jing , Si Wei , Ning Baile , Fu Wenbin
Published: December 2021

Background:

Post-stroke depression (PSD) refers to a series of affective disorder syndromes that occur after stroke and are often accompanied by physical symptoms. PSD presents with low mood and lack of interest as the main characteristics along with the symptoms of stroke. The physical symptoms of PSD include sleep disorder, loss of appetite, and reluctance to communicate. Although Wendan decoction has been suggested to be effective in the treatment of PSD, there is no meta-analysis providing evidence for the usefulness of Wendan decoction for treating PSD.

Methods:

The following electronic databases will be searched: the Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, Wan Fang databases, Chinese Biomedical Literature Database, and China Science and Technology Journal Database. Each database will be searched from its inception to November 2021. Two independent researchers will conduct study selection, data extraction, and risk bias assessment. Any discrepancies will be resolved through consultation with a third researcher. If the included data are suitable, we will conduct a meta-analysis using RevMan v5.4 software.

Results:

In this systematic review, the effectiveness and safety of Wendan decoction in the treatment of PSD will be evaluated.

Conclusion:

The findings of this meta-analysis will provide evidence-based data for the application of Wendan decoction in the treatment of PSD.

Ethics and dissemination:

Individual patient data and privacy will not be involved in this research,so ethics approval is not required.

INPLASY registration number:

INPLASY2021110018
Usefulness of delta neutrophil index as a biomarker to predict postoperative complication in patients who underwent esophagectomy
Authors: Gong Seong Chan , Ryu Hoon , Jang Ji Young
Published: December 2021

Esophagectomy demonstrates a high incidence of complications owing to its complexity and invasiveness; hence, early detection of complications is important. We aimed to evaluate the predictive value of the delta neutrophil index (DNI) for complications after esophagectomy.

We retrospectively analyzed patients who underwent esophagectomy in the department of general surgery at a single institution between January 2011 and October 2020. Patient characteristics, laboratory findings, and clinical outcomes were assessed.

Fifty-seven patients were enrolled in this study, of whom 31 (54.4%) had complications. The complication group had significantly longer mean mechanical ventilation, hospital stay and intensive care unit stay periods, and higher acute physiology, age, chronic health evaluation score and mortality rate than the noncomplication group. DNI on postoperative day (POD) 2 was also significantly higher in the complication group. Logistic regression analysis showed that DNI on POD 2 was an independent risk factor associated with the complications. Receiver operating characteristic curve analysis showed that the area under curve of DNI on POD 2 was 0.712 (cutoff value: 2.15%, sensitivity 61.5%, and specificity 70.8%).

Our study indicated that postoperative DNI can be useful as an early predictive biomarker of the complications after esophagectomy.
Neoadjuvant intra-arterial versus intravenous chemotherapy in colorectal cancer
Authors: Peng Shu hui , Mbarak Hussein Said , Li Yan-Hui , Ma Cong , Shang Quan-Liang , Chen Zhu , Bian Du-Jun , Xiao En-Hua
Published: December 2021

To investigate the clinical benefits of transcatheter arterial infusion chemotherapy compared with intravenous chemotherapy in patients with colorectal cancer (CRC).

From May 2013 to March 2018, 83 patients (50 men and 33 women) with surgically proven CRC were retrospectively included. Before surgery, 62 patients received conventional systemic chemotherapy, and 21 transcatheter arterial chemotherapy. Basic characteristics, disease control rate (DC), adverse reactions, postoperative complications, and toxicity profiles were collected and compared between the 2 groups.

The sigmoid colon (43.37%) was the most common primary tumor location, and the least was the transverse colon (6.02%). Most lesions invaded the subserosa or other structures T3-4 (78.31%), and other lesions invaded the muscular layer T1-2 (21. 69%). The overall DC was 80.65% in the intravenous chemotherapy group and 90.48% in the arterial chemotherapy group (P < .05). Adverse events included myelosuppression and gastrointestinal reactions such as nausea, vomiting, diarrhea, abnormal liver function, and neurotoxicity, which were significantly less common in the intra-arterial group than in the intravenous group (P < .05). Postoperative complications included abdominal infection (11.29% vs 14.29%), intestinal obstruction (6.45% vs 4.76%), anastomotic bleeding (1.61% vs 0.00%), and anastomotic fistula (6.45% vs 4.76%) in the intravenous and intra-arterial groups, respectively (P > .05).

Preoperative transcatheter arterial infusion chemotherapy is a safe and effective neoadjuvant chemotherapy measure for CRC with fewer adverse reactions and a higher overall DC.
Effects of nasal irrigation after endoscopic transsphenoidal resection in patients with pituitary adenomas
Authors: Xu Peng , Liu Shuling , Dong Yahong , Liang Wei , Li Zijun , Liu Fang
Published: December 2021

Purpose:

We aimed to explore the methods to reduce or prevent nasal complications after endoscopic transsphenoidal pituitary adenoma resection. We also examined the effects of nasal irrigation after this procedure was performed.

Methods:

A randomized controlled trial was performed. Sixty patients of a tertiary hospital were enrolled in this study. The subjects were randomly divided into a control group and an intervention group. The subjects of the control group were given routine guidance, and 20 mL of normal saline was atomized through inhalation. The gauze was removed 7 days after surgery. The patients of the intervention group were given 50 mL of a 2% saline solution at 37°C to 38°C for bilateral nasal irrigation for 1 week. After that, patients were given 50 mL of a 0.9% normal saline solution at 37°C to 38°C for bilateral nasal irrigations. The complications of the two groups were collected at baseline, 1 week after intervention, 1 month, and 3 months after intervention. The data were analyzed using the chi-square test.

Results:

A 1-month after intervention, there were significant differences in dysosmia, epistaxis, and nasal adhesion between the intervention and control groups. A 3-month after intervention, only olfactory disturbances were significantly different between the two groups.

Conclusions:

Nasal irrigation helps reduce the incidence of complications such as epistaxis and nasal adhesions in the early postoperative period. It can also promote the elimination or reduction of olfactory disturbances.
Comparison of 6 equations for estimating glomerular filtration rate in a Chinese benign hypertensive nephrosclerosis population
Authors: Ke Guibao , Xie Zhibin , Xiao Jie , Zhang Yamei , Hu Yao , Li Bohou , Jiang Nan , Chen Xueqin , Liu Shuangxin , Shi Wei
Published: December 2021

Equations to estimate glomerular filtration rate (eGFR) are useful for monitoring tje renal status of benign hypertensive nephrosclerosis (BHN). This study aimed to compare the applicability of 6 equations (Cockcroft-Gault [CG] adjusted for body surface area, original modification of diet in renal disease [MDRD], American abbreviated MDRD, Chinese modified MDRD, Chinese abbreviated MDRD, and Chronic Kidney Disease Epidemiology [CKD-EPI]) to estimate GFR in a Chinese BHN population. A total of 179 patients diagnosed with BHN were enrolled. The GFR estimated by each equation was compared to the reference GFR (rGFR) measured using the dual plasma sampling technetium-labeled diethylenetriaminepentaacetic acid method. The Chinese modified and Chinese abbreviated MDRD equations overestimated the rGFR, while the CG, CG adjusted for body surface area, original MDRD, American abbreviated MDRD, and CKD-EPI equations underestimated the rGFR. The difference in performance between estimated GFR (eGFR) based on the American abbreviated MDRD equation and the rGFR was not statistically significant (P = .191), while differences in the others were statistically significant (P < .05). Furthermore, the advantages in deviation, absolute deviation, deviation degree, precision, and accuracy were also significantly different from those of the other equations. Our findings suggest that eGFR based on the American abbreviated MDRD equation is suitable for the Chinese BHN population.
Compartmentalized T cell profile in the lungs of patients with HIV-1-associated pulmonary Kaposi sarcoma
Authors: Matiza Tarisiro , Boyd Kathryn F. , Lyall Rebecca A. , Kwon Douglas S. , McGregor Alan M. , Fiorillo Suzanne , Campbell Thomas B. , Borok Margaret , Corleis Björn
Published: December 2021

Pulmonary Kaposi sarcoma (pKS) caused by Human herpesvirus 8 (HHV-8) is a devastating form of KS in patients with advanced acquired immunodeficiency syndrome (AIDS) and is associated with increased morbidity and mortality. Blood T cells play a central role in the response of HIV-1 and HHV-8. However, little information is available on T cells in the alveolar space of HIV-1-associated pKS patients.

Therefore, we examined CD8+ and CD4+ T cells in the alveolar space in comparison with the blood of patients with pKS. We recruited 26 HIV-1 positive patients with KS, including 15 patients with pKS. Bronchoalveolar lavage (BAL) cells and blood mononuclear cells were analyzed for T cell memory phenotypes, surface markers associated with exhaustion, and intracellular cytokine staining (ICS) using flow cytometry. HIV-1 and HHV-8 viral loads were measured in plasma by quantitative PCR.

BAL T cells showed reduced inflammatory capacities and significantly diminished polyfunctionality compared to blood T cells from patients with pKS. This was not accompanied by increased expression of exhaustion markers, such as TIM-3 and PD-1.

More importantly, we found a negative correlation between the production of MIP1-β and TNF-α in T cells in BAL and blood, indicating compartmentalised immune responses to pKS and accentuated chronic HIV-1/HHV-8 pathogenesis via T cells in the lungs of people with pKS.
GnRHa as a treatment for letrozole-resistant recurrent adult granulosa cell tumors
Authors: Zhuang Yuan , Zhang Shushan , Liu Yao , Yang Hua
Published: December 2021

Introduction:

The optimal management of recurrent ovarian granulosa cell tumors is still unknown, and hormone therapy may be an alternative for chemotherapy-resistant cases.

Patient concerns:

A 46-year-old woman presented with a third recurrence after primary treatment of granulosa cell tumors. She developed tumor progression and drug-induced nephritis after 6 cycles of combined treatment with cisplatin and paclitaxel for the second recurrence and failed to benefit from chemotherapy, after the third optimal cytoreduction and tumor progression after 6 months of letrozole treatment.

Diagnosis:

Letrozole-resistant recurrent ovarian granulosa cell tumors

Interventions:

Intramuscular Diphereline 3.75 mg q28d.

Outcomes:

Computed tomography showed the metastatic neoplasm resolved. Progression-free survival is 20 months.

Conclusion:

Hormone therapy may be an alternative to treat recurrent granulosa cell tumors, and gonadotropin-releasing hormone agonists may be a rescue treatment for aromatase inhibitor-resistant cases.
Diagnostic accuracy of ICD code versus discharge summary-based query for endocarditis cohort identification
Authors: Kim H. Nina , Gupta Ayushi , Lan Kristine , Stewart Jenell , Dhanireddy Shireesha , Corcorran Maria A.
Published: December 2021

Studies of infective endocarditis (IE) have relied on International Classification of Disease (ICD) codes to identify cases, a method vulnerable to misclassification. Clinical narrative data could offer greater accuracy and richness to cohort identification. We evaluated two algorithms:

Further coding extracted valve involved and organism responsible if present. All cases were chart reviewed using pre-specified criteria. Positive predictive value (PPV), sensitivity and specificity were calculated. The ICD-based query identified 612 individuals from July 2015 to July 2019 who had a hospital billing code for infective endocarditis; of these, 534 had an echocardiogram. The DS query identified 387 cases. PPV for the DS query was 84.5% (95% CI 80.6%, 87.8%) compared with 72.4% (95% CI 68.7%, 75.8%) for ICD only (P < .001) and 75.8% (95% CI 72.0%, 79.3%) for ICD + echo queries (P = .002). Sensitivity was 75.9% for DS query and 86.8% to 93.4% for ICD queries (P < .02 for these comparisons). Specificity was high for all queries >94%. The DS query also yielded valve data (prosthetic, tricuspid, aortic, etc) in 60% and microbiologic agent in 73% of identified cases with an accuracy of 94% and 90%, respectively when assessed by chart review. Compared with ICD-based queries, text-based queries of discharge summaries have the potential to improve precision of IE case ascertainment and extract key clinical variables.
Antiretroviral treatment failure and associated factors among HIV patients on the first-line antiretroviral therapy at Mizan-Tepi University teaching hospital, Southwest Ethiopia
Authors: Siraj Jafer , Feyissa Desalegn , Mamo Yitagesu , Zewudie Ameha , Regesa Tolcha , Ejeta Fikadu , Feyisa Diriba , Hasen Gemmechu , Mohammed Tesfaye , Aferu Temesgen
Published: December 2021

The use of Antiretroviral therapy (ART) has become a standard of care for the treatment of HIV infection. The therapy restores immune function and reduces HIV-related adverse outcomes. However, treatment failure erodes this advantage and leads to an increased morbidity and compromised quality of life in HIV patients. Thus, this study aimed to assess anti-retroviral treatment failure and associated factors among HIV patients on the first line ART at Mizan-Tepi University Teaching Hospital. A cross-sectional study was undertaken among adult patient who have been on ART and attending ART Clinic of Mizan-Tepi University Teaching Hospital from September 2014 to September 2018. Data were collected retrospectively by reviewing patients’ medical charts using a standard structured questionnaire. Data were entered into Epi data version 4.0.2 and then exported to SPSS version 21.0 for analysis. To identify the predictors of anti-retroviral treatment failure, multiple stepwise backward logistic regression analysis were done. P value < .05 was considered as statistically significant. Among 221 patients included in the study, 118 (53.39%) were females. The mean weight of study participants at ART initiation was 57.04 kg. Of the 221 patients on the first line ART, 10 (4.5%) experienced treatment failure. Of these patients, 5 (50%) and 3 (30%) experienced virological failure and clinical failure, respectively. Functional status (AOR: 3, CI: [1.13–6.5], P < .001) and low baseline CD4 cell count (AOR: 4.3, CI: [3.4–10.6], P < .0001) were found to be an independent predictors of treatment failure. The rate of first-line ART treatment failure in the study setting was substantial. Functional status and low baseline CD4 cell count were found to be an independent predictors of virological, clinical and immunological failure. Therefore, more attention should be given for the lifestyle of pateints’ on ART and maximize virological tests for monitoring treatment failures.
Anxiety and depression in recurrent gastric cancer
Authors: Zhang Lisha
Published: December 2021

Various anxiety and depression-related risk factors have been reported in cancer patients. However, little is known about the anxiety and depression-related risk factors in recurrent gastric cancer patients. Therefore, our aim was to investigate the prevalence and risk factors for anxiety and depression in recurrent gastric cancer patients.

Totally 82 recurrent gastric cancer patients were consecutively recruited, and their clinical features were collected from hospital's electronic medical records. Besides, 80 newly diagnosed gastric cancer patients and 80 healthy controls were enrolled. Their anxiety and depression status was assessed using Hospital Anxiety and Depression Scale (HADS).

The HADS-anxiety score (9.1 ± 3.4, 7.2 ± 3.0, 4.8 ± 2.7, respectively) and the percentage of anxiety patients (52.4%, 33.8%, 11.3%, respectively) were increased in recurrent gastric cancer patients compared to newly diagnosed gastric cancer patients and healthy controls; Also, the HADS-depression score (7.9 ± 3.1, 6.7 ± 2.6, 4.1 ± 2.8, respectively) and the percentage of depression patients (41.5%, 25.0%, 8.8%, respectively) had similar trends. Forward stepwise multivariate logistic regression revealed that age ≥60 years, diabetes, tumor-node-metastasis (TNM) stage at diagnosis, shorter time to recurrence and distant metastasis at recurrence were independent risk factors for anxiety occurrence, whereas age ≥60 years, diabetes, tumor location at diagnosis (cardia vs gastric antrum) and shorter time to recurrence were independent risk factors for depression occurrence.

The prevalence of anxiety and depression is such high, and their relevant risk factors include age ≥60 years, diabetes and shorter time to recurrence in recurrent gastric cancer patients.