bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of an anoikis-related gene signature and characterization of immune infiltration in skin cutaneous melanoma
Authors: Xu Ziqian , Huang Juntao , Shi Weimin , Qi Ying , Yuan Feng , Lin Bingjiang
Published: April 2024

Anoikis is considered strongly associated with a biological procession of tumors. Herein, we utilized anoikis-related genes (ARGs) to predict the prognosis and immunotherapeutic efficacy for skin cutaneous melanoma (SKCM). RNA-seq data were obtained from The Cancer Genome Atlas and Gene Expression Omnibus databases. After dividing patients into novel subtypes based on the expression of prognostic ARGs, K–M survival was conducted to compare the survival status. Subsequently, differentially expressed ARGs were identified and the predictive model was established. The predictive effects were validated using the areas under the curve about the receiver operating characteristic. Moreover, tumor mutation burden, the enriched functional pathway, immune cells and functions, and the immunotherapeutic response were also analyzed and compared. The distribution of model genes at cell level was visualized by the single-cell seq with tumor immune single-cell hub database. Patients of The Cancer Genome Atlas–SKCM cohort were divided into 2 clusters, the cluster 1 performed a better prognosis. Cluster 2 was more enriched in metabolism-related pathways whereas cluster 1 was more associated with immune pathways. A predictive risk model was established with 6 ARGs, showing the areas under the curves of 1-year, 3-year, and 5-year ROC were 0.715, 0,720, and 0.731, respectively. Moreover, risk score was negatively associated with tumor mutation burden and immune-related pathways enrichment. In addition, patients with high-risk scores performed immunosuppressive status but the decreasing scores enhanced immune cell infiltration, immune function activation, and immunotherapeutic response. In this study, we established a novel signature in predicting prognosis and immunotherapy. It can be considered reliable to formulate the complex treatment for SKCM patients.
Exploring the mechanism of action of the combination of cinnamon and motherwort in the treatment of benign prostatic hyperplasia: A network pharmacology study
Authors: Yang Jiutian , Ma Dongyue , Zhao Ziwei , Guo Jun , Ren Kai , Wang Fu , Guo Jun
Published: April 2024

Cinnamon and motherwort are traditional Chinese medicines and are often combined to treat benign prostatic hyperplasia; however, the specific therapeutic mechanisms involved remain unclear. Therefore, in this study, we applied a network pharmacology approach to investigate the potential mechanisms of action of the drug pair cinnamon and motherwort (PCM) for the treatment of benign prostatic hyperplasia. Relevant targets for the use of PCM to treat benign prostatic hyperplasia were obtained through databases. Protein–protein interactions were then identified by the STRING database and core targets were screened. Enrichment analysis was conducted through the Metascape platform. Finally, molecular docking experiments were carried out to evaluate the affinity between the target proteins and ligands of PCM. We identified 22 active ingredients in PCM, 315 corresponding targets and 130 effective targets of PCM for the treatment of benign prostatic hyperplasia. These targets were related to the PI3K-Akt, MAPK, FoxO, TNF, and IL-17 signaling pathways. Network pharmacology was used to identify the effective components and action targets of PCM. We also identified potential mechanisms of action for PCM in the treatment of benign prostatic hyperplasia. Our results provide a foundation for expanding the clinical application of PCM and provide new ideas and directions for further research on the mechanisms of action of PCM and its components for the treatment of benign prostatic hyperplasia.
Estimating the prevalence of depression in people with acute coronary syndromes: A systematic review and meta-analysis
Authors: Dong Zheng , Yang Qianfang , Chen Huijun
Published: April 2024

Background:

The epidemic of acute coronary syndromes (ACS) poses a great challenge to depression. However, the prevalence of depression among ACS patients has not been fully determined. This meta-analysis aimed to provide an estimation of the global prevalence of depression among ACS patients (ACS depression).

Methods:

Online databases including PubMed, Cochrane Library, Web of Science, and Scopus were searched for all relevant studies that reported the prevalence of ACS depression through March 2023. Pooled prevalence of ACS depression with 95% confidence interval (CI) was estimated by the random-effect model. All statistical analyses were performed using comprehensive meta-analysis software. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42023409338).

Results:

A total of 28 studies (17 cohort studies, 9 cross-sectional studies, and 2 case–control studies) were included. The overall pooled prevalence of depression in ACS, derived from 28 studies, was 28.5% (95% CI: 0.28–0.29, P = .000, I
2 = 99%). 21 included studies showed a prevalence of 20.3% (95% CI: 0.20–0.21, P = .000, I
2 = 96%) in men, and the prevalence in women was 13.6% (95% CI: 0.13–0.14, P = .000, I
2 = 95%). Subgroup analysis showed the lowest prevalence in Europe (20.7%, 95% CI: 0.20–0.22, P = .000, I
2 = 98%); On different diagnostic criteria, the diagnostic and statistical manual of mental disorders (DSM-IV) (36.8%, 95% CI: 0.35–0.38, P = .000, I
2 = 96%) has the highest prevalence. In terms of end year of data collection, the prevalence of ACS depression was lower for studies that ended data collection after 2012 (25.7%, 95% CI: 0.25–0.27, P = .000, I
2 = 99%) than in studies before 2012 (30%, 95% CI: 0.29–0.31, P = .000, I
2 = 98%).

Conclusion subsections:

This systematic review and meta-analysis suggest high global prevalence of depression among ACS patients, underlining the necessity of more preventive interventions among ACS patients especially in Asian and North American regions.
Prediction of severe hypertriglyceridemia-associated acute pancreatitis using a nomogram based on CT findings and blood biomarkers
Authors: Dong Jun , Shen Yuhang , Wang Zhihuai , Zhang Jiankang , Qin Xihu , Zhu Chunfu , Gao Yuan , Yu Qiang
Published: April 2024

Hypertriglyceridemia is a common cause of acute pancreatitis (AP). Fatty liver, a manifestation of metabolic syndrome, is related to the severity of AP. The present study aimed to construct an accurate predictive model for severe AP (SAP) by combining the fatty liver infiltration on a computerized tomography (CT) scan with a series of blood biomarkers in patients with hypertriglyceridemia-associated AP (HTG-AP). A total of 213 patients diagnosed with HTG-AP were included in the present retrospective study. Clinical information and imageological findings were retrospectively analyzed. The model was constructed from independent risk factors using univariate analysis, the least absolute shrinkage and selection operator method. Subsequently, the data from the training group of 111 patients with HTG-AP was analyzed using logistic regression analysis. The efficacy of the model was verified using an external validation group of 102 patients through the receiver operating characteristic curve (ROC). Independent predictors, including serum calcium, C-reactive protein, lactate dehydrogenase and liver-to-spleen CT attenuation ratio (L/S ratio), were incorporated into the nomogram model for SAP in HTG-AP. The model achieved a sensitivity of 91.3% and a specificity of 88.6% in the training group. Compared with the Ranson model, the established nomogram model exhibited a better discriminative ability in the training group [area under the curve (AUC): 0.957] and external validation group (AUC: 0.930), as well as better calibration and clinical benefits. The present study demonstrates that the constructed nomogram based on CT findings and blood biomarkers is useful for the accurate prediction of SAP in HTG-AP.
Efficacy of Shensong Yangxin capsule combined with dronedarone in paroxysmal atrial fibrillation after ablation
Authors: Zhou Tao , Gong Ping , Xu Ming , Yan Leikun , Zhang Yongda
Published: April 2024

Objective:

To investigate whether postoperative administration of Shensong Yangxin capsules (SSYX) and dronedarone for atrial fibrillation (AF) can reduce the recurrence of paroxysmal AF after radiofrequency ablation, thus providing a more optimal choice of antiarrhythmic medication during the blank period.

Methods:

We included 120 patients with paroxysmal AF who underwent radiofrequency ablation at our hospital between July 2020 and July 2022. They underwent routine circumferential pulmonary vein ablation and, subsequently, left and right atrial pressure monitoring to assess sinoatrial node recovery time under burst 400/300 ms stimulation. Postoperatively, the patients were randomly divided into 2 groups (60 patients each). The control group was administered dronedarone orally for 3 months and the study group was treated with SSYX combined with dronedarone. This study aimed to compare differences in clinical efficacy of the treatment between the 2 groups.

Results:

The left and right atrial pressures in both groups were higher than those in the preoperative period (P < .05), with no statistically significant differences between the 2 groups (P > .05). Sinoatrial node recovery time under burst 400/300 ms stimulation showed no statistical difference between the 2 groups (P > .05). At 3 months and 1 year postoperatively, the AFEQT scale scores for both groups were lower than those before treatment (P < .05), with the study group scoring lower than the control group at 3 months (P < .05). However, no statistically significant difference was observed between the 2 groups at 1 year postoperatively (P > .05). At 3 months postoperatively, the sinus rhythm maintenance rate and heart rate were higher in the intervention group than in the control group (P < .05); however, these differences between the 2 groups were not statistically significant at 1 year postoperatively (P > .05).

Conclusion subsections:

The combination of SSYX and dronedarone could effectively reduce the early recurrence of paroxysmal AF after radiofrequency ablation, increase heart rate, and improve the quality of life.
IgG4-related autoimmune pancreatitis and sclerosing cholangitis: A case report and literature review
Authors: Wang Nanping , Zhu Peng , Xiang Yue , Tao Liping , Huang Tao , Feng Zhisong
Published: April 2024

Rationale:

Immunoglobulin G4-related disease (IgG4-RD) can involve various organs throughout the body, primarily manifesting as endocrine dysfunction, visual impairment, jaundice, and limited sexual function. IgG4-related autoimmune pancreatitis is triggered by autoimmune reactions and characterized by structural changes in the pancreas and pancreatic ducts. The disease mainly affects middle-aged and elderly males, typically presenting as progressive painless jaundice and misdiagnosed as cholangiocarcinoma or pancreatic cancer.

Patient concerns:

This study reports a 54-year-old male who consulted with different institutions multiple times due to diabetes, pancreatitis, elevated liver enzymes, and jaundice.

Diagnoses:

Magnetic resonance imaging revealed swollen head of the pancreas and atrophic tail. Liver and pancreatic tissue pathology showed IgG4 plasma cell infiltration, while liver biopsy indicated interface hepatitis, liver fibrosis, and pseudolobule formation, with no evidence of bile duct damage.

Interventions:

Following hormone therapy, the patient’s serum IgG4 levels and liver enzyme levels returned to normal.

Outcomes:

The disease relapsed 2 years after maintaining hormone therapy, and the patient underwent additional hormone-induced remission therapy combined with azathioprine.

Lessons:

The purpose of this research report is to enhance the awareness and understanding of IgG4-RD, emphasizing the necessity for personalized treatment strategies that take into account its recurrence, associations, and imaging features. This report provides valuable insights and guidance for clinicians in managing and diagnosing patients with IgG4-RD.
Experience of multi-disciplinary treatment of multiple cerebellar diffuse large B-cell lymphoma: A case report
Authors: Guo Yongji , Li Juntao , Li Mengda , Li Zhixiao , Cui Yongxia , Li Yan , Zhao Ruijiao , Han Qian , Yang Hongqi , Ma Chunxiao
Published: April 2024

Rationale:

Primary central nervous system lymphoma (PCNSL) is a rare, highly malignant form of non-Hodgkin lymphoma categorized under the diffuse large B-cell type. It accounts for merely 1% of all non-Hodgkin lymphoma cases and comprises approximately 3% of all brain tumors. The involvement of the cerebellum is observed in only 9% of these cases. Recently, we came across an unusual instance: a young man presenting with multiple lesions located specifically within the cerebellum.

Patient concerns:

A 26-year-old male was admitted to the hospital due to severe headaches. He has a medical history of sporadic headaches, accompanied by dizziness, nausea, and vomiting persisting for a month. Over the last 10 days, his headaches have intensified, coupled with decreased vision and protrusion of the eyeballs. Magnetic resonance imaging (MRI) revealed abnormal signals in both cerebellar hemispheres.

Diagnoses, interventions, and outcomes:

Diagnostic procedures included cerebellar biopsy, posterior fossa decompression, and lateral ventricle drainage. Histopathological examination identified diffuse large B-cell lymphoma (DLBCL) with high proliferative activity. To minimize neurotoxicity, chemotherapy involved intrathecal methotrexate (MTX) injections combined with the CHOP program. The patient has shown good tolerance to the treatment so far.

Lessons:

While the definitive optimal treatment approach remains elusive, current chemotherapy centered on high-dose MTX stands as the standard induction therapy. Integrating surgery with radiotherapy and chemotherapy significantly extends patient survival.
Effect of acupuncture combined with Ningshen mixture on climacteric insomnia: A randomized controlled trial
Authors: Cai Yan , Zhang Xiaodan , Li Jiaying , Yang Wei
Published: April 2024

Background:

In recent years, the incidence of menopause insomnia has gradually increased, seriously affecting women's physical and mental health.

Methods:

Total 82 climacteric insomnia patients received from January 2021 to January 2023 were divided into 2 groups at random. In control group, 41 cases received conventional Western medicine, and in study group, 41 cases received acupuncture combined with Ningshen mixture. Clinical effectiveness of both groups was compared, neurotransmitter levels, TCM syndrome integral and Pittsburgh Sleep Quality Index (PSQI) were assessed in both groups. Meanwhile, the recurrence rate and safety were evaluated in 2 groups.

Results:

The curative effect in study group was better than that in control group (P < .05). After treatment, the expressions of 5-hydroxytryptamine and β-endorphin (β-EP) in study group were higher than control group (P < .05); TCM syndrome scores and PSQI scores in study group were lower than control group (P < .05). The total recurrence rate in study group was obviously lower than control group at 3 months after treatment (P < .05). There were no serious adverse reactions in both group, and no distinct difference between 2 groups was found (P > .05).

Conclusion:

Acupuncture united with Ningshen mixture has a significant therapeutic effect and high safety in climacteric insomnia patients. It can effectively improve the neurotransmitter levels, clinical symptoms and sleep quality, and reduce the recurrence rate of climacteric insomnia patients, which has high clinical application value and is worthy of clinical promotion.
Parathyroid hormone related-protein (PTHrP) in tissues with poor prognosis in prostate cancer patients
Authors: Zhao Yan , Lu Sheng-Ming , Zhong Bing , Wang Gong-Cheng , Jia Rui-Peng , Wang Qian , Long Jian-Hua
Published: April 2024

Background:

Parathyroid hormone-related peptide (PTHrP) is known to have a pivotal role in the progression of various solid tumors, among which prostate cancer stands out. However, the extent of PTHrP expression and its clinical implications in prostate cancer patients remain shrouded in obscurity. The primary objective of this research endeavor was to shed light on the relevance of PTHrP in the context of prostate cancer patients and to uncover the potential underlying mechanisms.

Methods:

The expression of PTHrP, E-cadherin, and vimentin in tumor tissues of 88 prostate cancer patients was evaluated by immunohistochemical technique. Subsequently, the associations between PTHrP and clinicopathological parameters and prognosis of patients with prostate cancer were analyzed.

Results:

Immunohistochemical analysis showed that the expression rates of PTHrP, E-cadherin, and vimentin in prostate cancer tissues were 95.5%, 88.6%, and 84.1%, respectively. Patients with a high level of PTHrP had a decreased expression of E-cadherin (P = .013) and an increased expression of vimentin (P = .010) compared with patients with a low level of PTHrP. Besides, the high expression of PTHrP was significantly correlated with a higher level of initial prostate-specific antigen (P = .026), positive lymph node metastasis (P = .010), osseous metastasis (P = .004), and Gleason score (P = .026). Moreover, patients with a high level of PTHrP had shorter progression-free survival (P = .002) than patients with a low level of PTHrP.

Conclusion:

The present study indicates that PTHrP is associated with risk factors of poor outcomes in prostate cancer, while epithelial-mesenchymal transition may be involved in this process.
Predictive factors associated with technical difficulty in colorectal endoscopic submucosal dissection: A Honam Association for the Study of Intestinal Disease (HASID) multicenter study
Authors: Oh Hyung-Hoon , Jung Yong-Wook , Jin Byung-Chul , Hwang Jae-Taek , Song Hyo-Yeop , Kim Seong-Jung , Kim Dong-Hyun , Myung Dae-Seong , Lee Jun , Kim Sang-Wook , Seo Geom-Seog , Joo Young-Eun , Kim Hyun-Soo
Published: April 2024

Colorectal endoscopic submucosal dissection (ESD) is a promising but challenging procedure. It is not widely performed due to its technical difficulty. We aimed to find the predictive factors associated with technical difficulty in colorectal ESD before the procedure. Clinical data from patients who underwent ESD for colorectal tumors in 5 hospitals in Honam province of South Korea between 2015 and 2020 were reviewed retrospectively. Technically difficult colorectal ESD procedure was defined in 3 points. Long procedure time (longer than 60 minutes), occurrence of perforation, and failure of en bloc resection. Factors associated with technically difficult ESD were included as main outcome measure. 1446 patients were identified and their data were analyzed. Median procedure time was 30.0 minutes and median long axis of the tumor was 20.1 mm. Technically difficult procedures including long procedure time were 231 cases (16.0%), perforation occurred in 34 cases (2.3%), and en bloc resection was done in 1292 cases (89.3%). Tumor size larger than 35 mm (odd ratio [OR]: 1.474, P = .047), central depression or ulceration in the lesion (OR: 1.474, P = .013), previous endoscopic mucosal resection (EMR) or polypectomy procedure (OR: 2.428, P = .020) were associated with technically difficult ESD. Descending colon-located tumor (OR: 5.355, P < .001), and use of IT knife (OR: 4.157, P = .003) were associated with perforation. Recognizing factors associated with technically difficult ESD can help in planning the ESD procedure beforehand.
Management of diabetes mellitus patients with sickle cell anemia: Challenges and therapeutic approaches
Authors: Obeagu Emmanuel Ifeanyi , Obeagu Getrude Uzoma
Published: April 2024

The coexistence of diabetes mellitus (DM) and sickle cell anemia (SCA) poses significant challenges in clinical management due to the complex interactions and overlapping complications associated with both conditions. Managing diabetes in individuals with SCA requires a comprehensive approach that addresses the unique physiological and pathological aspects of both diseases. This paper reviews the challenges encountered in the management of DM in patients with SCA and explores therapeutic strategies and approaches to optimize patient care. Challenges in the management of DM in individuals with SCA stem from several factors, including the impact of hemoglobin variants on glycemic control assessment, increased susceptibility to infections, altered immune response, and complications associated with both diseases. Moreover, the coexistence of SCA and DM heightens the susceptibility to infections due to compromised immune function, emphasizing the need for vigilant preventive measures, including vaccinations and close monitoring for infectious complications. Close collaboration among healthcare providers specializing in diabetes, hematology, and other relevant fields is crucial for developing comprehensive care plans. Individualized treatment strategies that balance glycemic control, pain management, and preventive care are essential to mitigate complications and optimize the overall health outcomes of patients with both DM and SCA. In conclusion, managing diabetes in the context of SCA necessitates a nuanced and patient-centered approach. By addressing the challenges and employing tailored therapeutic strategies, healthcare providers can improve the quality of life and health outcomes for individuals affected by both conditions.
Global scientific trends on the islet transplantation in the 21st century: A bibliometric and visualized analysis
Authors: Chen Sheng , Wu PeiZhong , Zhang Ting , Zhang Jianqiang , Gao Hongjun
Published: April 2024

Background:

Islet transplantation (IT) has emerged as a significant research area for the treatment of diabetes mellitus and has witnessed a surge in scholarly attention. Despite its growing importance, there is a lack of bibliometric analyses that encapsulate the evolution and scientific underpinnings of this field. This study aims to fill this gap by conducting a comprehensive bibliometric analysis to delineate current research hotspots and forecast future trajectories within the IT domain with a particular focus on evidence-based medicine practices.

Methods:

This analysis scrutinized literature from January 1, 2000, to October 1, 2023, using the Web of Science Core Collection (WoSCC). Employing bibliometric tools such as VOSviewer, CiteSpace, and the R package “bibliometrix,” we systematically evaluated the literature to uncover scientific trends and collaboration networks in IT research.

Results:

The analysis revealed 8388 publications from 82 countries, predominantly the United States and China. However, global cross-institutional collaboration in IT research requires further strengthening. The number of IT-related publications has increased annually. Leading research institutions in this field include Harvard University, the University of Alberta, the University of Miami, and the University of Minnesota. “Transplantation” emerges as the most frequently cited journal in this area. Shapiro and Ricordi were the most prolific authors, with 126 and 121 publications, respectively. Shapiro also led to co-citations, totaling 4808. Key research focuses on IT sites and procedures as well as novel therapies in IT. Emerging research hotspots are identified by terms like “xenotransplantation,” “apoptosis,” “stem cells,” “immunosuppression,” and “microencapsulation.”

Conclusions:

The findings underscore a mounting anticipation for future IT research, which is expected to delve deeper into evidence-based methodologies for IT sites, procedures, and novel therapeutic interventions. This shift toward evidence-based medicine underscores the field’s commitment to enhancing the efficacy and safety of IT for diabetes treatment, signaling a promising direction for future investigations aimed at optimizing patient outcomes.
Diabetes-related stress in older adults with type 2 diabetes and chronic complication: Multiple effects of social-ecological support on self-management behavior
Authors: Sun Xiao , Shi Yan , Wang Xue , Zhou Rongrong , Deng Wei
Published: April 2024

This study aims to explore the relationship among diabetes-related distress, social-ecological support, and self-management behavior in older adults with type 2 diabetes mellitus (T2DM) and chronic complications. This cross-sectional study included older adults with T2DM in Shanghai, China, between January and July 2022. The problem areas in diabetes scale (PAID), the chronic illness resource survey (CIRS), and the diabetes self-management behavior for older (DSMB-O) were employed. A total of 264 participants (157 [59.47%] males, aged 71.07 ± 6.47 years) were included; their T2DM duration ranged from 5 to 30 years, with an average of 11.19 ± 6.96 years. The DSMB-O scores were negatively correlated with the PAID scores and positively correlated with CIRS scores. The CIRS scores were negatively correlated with the PAID scores. CIRS had a positive direct effect on DSMB-O, and CIRS had an indirect effect on DSMB-O through PAID. CIRS had a total effect on DSMB-O through PAID. The mediating effect made up 28.89% of the total effect. In older adults with T2DM and chronic complications, chronic illness resources were correlated with diabetes-related distress and self-management behavior. Chronic illness resources had both a direct effect on self-management behavior and an indirect effect through diabetes-related distress.
The value of thromboelastography in evaluating the efficacy of Xueshuantong combined with edaravone in the treatment of acute cerebral infarction
Authors: Wang Yu , Li Litao , Hu Xiaojie , Huang Liqiu , Li Zheng
Published: April 2024

To explore the value of thromboelastography (TEG) in evaluating the efficacy of Xueshuantong combined with edaravone for the treatment of acute cerebral infarction (ACI). We retrospectively analyzed the clinical data of 96 patients with ACI treated with Xueshuantong combined with edaravone and monitored by TEG. The correlation between the results of TEG examination and treatment outcomes in patients after treatment was analyzed. After treatment, 65 of 96 patients showed good efficacy and 31 had poor efficacy. kinetic time (KT), reaction time (RT), and the percentage of clot lysis at 30 minutes after Ma value (LY30) of patients with good therapeutic effects were significantly higher than those with poor therapeutic effects; However, maximum amplitude (MA) and coagulation index (CI) were significantly lower than those with poor efficacy (P < .05). There was a significant positive correlation between KT, RT, and LY30 and the therapeutic effect of ACI, and a significant negative correlation between the therapeutic effects of MA, CI, and ACI (P < .05). Logistic analysis confirmed that KT, RT, and LY30 were protective factors for the therapeutic effect of ACI; MA and CI were risk factors for the therapeutic effect of ACI (P < .05). TEG has a high value in evaluating the efficacy of Xueshuantong combined with edaravone in the treatment of ACI. It can clarify changes in the coagulation function of patients, thereby guiding clinical follow-up treatment.
An observation study of the effect of “Internet + Nursing” on psychological status and quality of life of patients with thyroid eye disease
Authors: Li Jianrong , Sun Ran
Published: April 2024

“Internet + Nursing” refers to medical institutions using Internet technologies and big data to provide nursing services to discharged patients or those with severe illnesses unable to visit hospitals, through online applications and offline care provision. This study aimed to explore the influence of “Internet + Nursing” on the psychological status and quality of life of patients with thyroid eye disease. Sixty-eight patients with thyroid eye disease from January 2021 to December 2022 were divided into a research group (n = 34, joined the platform) and control group (n = 34, not joined the platform) based on their voluntary participation in our hospital’s “Internet + Nursing Platform.” The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores of the research group were lower than those of the control group (P < .05). The short form-36 health survey (SF-36) scores in various dimensions were higher in the research group compared to the control group (P < .05). The incidence rates of retinal detachment, vitreous hemorrhage, diabetic retinopathy, and iris neovascularization were lower in the research group compared to the control group (P < .05). After nursing, exophthalmos, blink frequency, and eyelid height of the research group were lower than those of the control group, while tear film breakup time was higher than that of the control group (P < .05). The visual acuity of the research group was higher than that of the control group (P < .05). After nursing, the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) scores in various dimensions were significantly higher in the research group than those in the control group (P < .05). Additionally, after nursing, the levels of interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in the research group were lower than those in the control group (P < .05). The patients in the research group exhibited higher recognition scores of nursing compared to those in the control group (P < .05). Through the implementation of “Internet + Nursing” for patients with thyroid eye disease discharged from our hospital, we can provide better out-of-hospital nursing for patients, reduce the occurrence of complications, improve ocular surface symptoms, promote visual acuity recovery, and improve patients’ psychological status and quality of life.
Dose adjustment strategy of levetiracetam in pregnant patients with epilepsy: Case report and literature review
Authors: Liu Renzhu , Xiao Lu , Liu Xiang , Xiao Can
Published: April 2024

Rationale:

Pregnant patients with epilepsy are prone to preterm delivery, stillbirth, or cesarean section, and their mortality rate is almost 10 times higher than that of normal pregnant women. The potential negative influences of antiepileptic drugs (AEDs) on the fetus are weighed against the necessity for achieving optimal control of seizures. Treatment with AEDs during pregnancy is a major challenge for pregnant women and healthcare teams.

Patient concerns:

This paper reports two cases of young women diagnosed with pregnancy and epilepsy.

Intervention:

The dose of levetiracetam was adjusted under the guidance of therapeutic drug monitoring to reduce the effects of seizures on the fetus and the incidence of reproductive toxicity caused by adverse drug reactions.

Outcomes:

Epilepsy was well controlled in the two pregnant patients, and the newborns had no genetic disorders.

Lessons:

It is recommended to regularly monitor the serum LEV level in pregnant patients with epilepsy. This practice serves as a foundation for adjusting the drug treatment plan and offering more precise guidance for medication management during pregnancy.
The influence of COMT and ABCB1 gene polymorphisms on sufentanil analgesic effect for postoperative pain in children with fracture
Authors: Wang Hui , An Jianzhong , Zhong Shan , Qiao Shigang , Zhang Li , Zhao Longde , Wang Chen
Published: April 2024

The aim of this observational study was to investigate the effects of catechol-O-methyltransferase (COMT) and ATP-binding cassette transporter B1 (ABCB1) gene polymorphisms on the postoperative analgesic effect of sufentanil in Chinese Han pediatric patients with fractures. A total of 185 pediatric patients who underwent fracture surgery were included. Polymerase chain reaction-restriction fragment length polymorphism was used to detect the polymorphisms of COMT and ABCB1 genes. Sufentanil was used for postoperative analgesia. The pain level of the patients was evaluated using the face, legs, activity, cry, and consolability scale before surgery, during awakening, at 2, 6, 12, and 24 hours after surgery. The postoperative Ramsay sedation score, sufentanil consumption, and incidence of adverse reactions were also recorded. Pediatric patients with different genotypes of ABCB1 and COMT showed no statistically significant differences in general data such as age, gender, weight, height, surgical duration, and American Society of Anesthesiologists classification (P > .05). There were no statistically significant differences in sedation scores after surgery between different genotypes of ABCB1 and COMT (P > .05). Among patients with CC genotype in ABCB1, the pain scores and total consumption of sufentanil at awakening, 2 and 6 hours after surgery were higher compared to TT and CT genotypes (P < .05), while there were no statistically significant differences between TT and CT genotypes (P > .05). Among patients with AA genotype in COMT, the pain scores and total consumption of sufentanil at awakening, 2, 6, 12, and 24 hours after surgery were higher compared to AG and GG genotypes (P < .05), while there were no statistically significant differences between AG and GG genotypes (P > .05). There were no statistically significant differences in adverse reactions between different genotypes of ABCB1 and COMT (P > .05). The polymorphisms of COMT gene rs4680 and ABCB1 gene rs1045642 are associated with the analgesic effect and consumption of sufentanil in pediatric patients after fracture surgery.
Joubert syndrome presenting bilateral peroneal neuropathies: A case report
Authors: Kim Hyeong-Min , Jo Hyun-Seok , Han Jae-Young , Choi In-Sung , Song Min-Keun , Park Hyeng-Kyu
Published: April 2024

Rationale:

Joubert syndrome (JS) is a rare genetic disorder that presents with various neurological symptoms, primarily involving central nervous system dysfunction. Considering the etiology of JS, peripheral nervous system abnormalities cannot be excluded; however, cases of JS accompanied by peripheral nervous system abnormalities have not yet been reported. Distinct radiological findings on brain magnetic resonance imaging were considered essential for the diagnosis of JS. However, recently, cases of JS with normal or nearly normal brain morphology have been reported. To date, there is no consensus on the most appropriate diagnostic method for JS when imaging-based diagnostic approach is challenging. This report describes the case of an adult patient who exhibited bilateral peroneal neuropathies and was finally diagnosed with JS through genetic testing.

Patient concerns and diagnosis:

A 27-year-old man visited our outpatient clinic due to a gait disturbance that started at a very young age. The patient exhibited difficulty maintaining balance, especially when walking slowly. Oculomotor apraxia was observed on ophthalmic evaluation. During diagnostic workups, including brain imaging and direct DNA sequencing, no conclusive findings were detected. Only nerve conduction studies revealed profound bilateral peroneal neuropathies. We performed whole genome sequencing to obtain a proper diagnosis and identify the gene mutation responsible for JS.

Lessons:

This case represents the first instance of peripheral nerve dysfunction in JS. Further research is needed to explore the association between JS and peripheral nervous system abnormalities. Detailed genetic testing may serve as a valuable tool for diagnosing JS when no prominent abnormalities are detected in brain imaging studies.
The potential roles of exosomes in pathological cardiomyocyte hypertrophy mechanisms and therapy: A review
Authors: Zhang Lijun , Xie Fang , Zhang Fengmei , Lu Beiyao
Published: April 2024

Pathological cardiac hypertrophy, characterized by the enlargement of cardiac muscle cells, leads to serious cardiac conditions and stands as a major global health issue. Exosomes, comprising small lipid bilayer vesicles, are produced by various cell types and found in numerous bodily fluids. They play a pivotal role in intercellular communication by transferring bioactive cargos to recipient cells or activating signaling pathways in target cells. Exosomes from cardiomyocytes, endothelial cells, fibroblasts, and stem cells are key in regulating processes like cardiac hypertrophy, cardiomyocyte survival, apoptosis, fibrosis, and angiogenesis within the context of cardiovascular diseases. This review delves into exosomes’ roles in pathological cardiac hypertrophy, first elucidating their impact on cell communication and signaling pathways. It then advances to discuss how exosomes affect key hypertrophic processes, including metabolism, fibrosis, oxidative stress, and angiogenesis. The review culminates by evaluating the potential of exosomes as biomarkers and their significance in targeted therapeutic strategies, thus emphasizing their critical role in the pathophysiology and management of cardiac hypertrophy.
Geriatric nutritional risk index predicts postoperative prognosis in older patients with hip fracture: A meta-analysis
Authors: Liu Xiu , Xie Dongmei
Published: April 2024

Background:

Hip fracture is common in elderly individuals and is accompanied by a relatively high mortality rate. However, it is currently difficult to accurately predict postoperative prognosis for older patients with hip fractures. The aim of this meta-analysis was to further determine the prognostic value of the geriatric nutritional risk index (GNRI) for patients who underwent hip fracture surgery.

Methods:

The Medline, EMBASE, Web of Science, and CNKI databases were searched up to September 19, 2023, for available studies. The primary and secondary outcomes were the mortality and complication rates, respectively. Hazard ratios (HRs) and relative risks with corresponding 95% confidence intervals (CIs) were separately combined to assess the associations between the GNRI and mortality and complication rates. All the statistical analyses were performed with STATA 15.0 and SPSS 22.0 software.

Results:

A total of 9 studies with 3959 patients were included. The pooled results demonstrated that a lower GNRI was significantly related to an increased risk of postoperative mortality (HR = 0.82, 95% CI = 0.72–0.92, P = .001). In addition, the GNRI predicted the risk of overall postoperative complications (52% vs 35.5%, P = .04) and pneumonia (33.3% vs 13.6%, P = .010).

Conclusion:

The GNRI might serve as a novel prognostic indicator for older patients with hip fractures, and a lower GNRI indicates an increased risk of postoperative mortality and complication rates.
Manufacturing of PEEK orthodontic baseplate and 3D-printed alloy components from an intraoral scan
Authors: Al Mortadi Noor A. , Khasawneh Lina , Alzoubi Karem H.
Published: April 2024

This paper demonstrates a digital manufacturing technique of a removable orthodontic appliance from an intraoral scan. An intraoral scan was made for the maxillary and mandibular arches. 3Shape Orthodontics Appliance Designer produced the virtual Hawley retainer, consisting of alloy components (Adam Clasps and Fitted Labial bow) and a base plate. The base plate design was modified to adapt to inserting the alloy components, which were combined using cold-cured acrylic. The finished Hawley retainer was assessed intraorally. The described technique emphasizes the design specifications of digitally designed and manufactured removable orthodontic appliances. A combination of additive and subtractive techniques was successfully employed to manufacture the alloy components and base plate. This novel method provides an alternative approach to manufacturing removable appliances with computer-aided design (CAD)/computer-aided manufacturing (CAM) technologies. The described process offers a precursor to digital manufacturing of other developed designs of dental appliances.
A real-world study of different doses of rivaroxaban in patients with nonvalvular atrial fibrillation
Authors: Yan Xinsheng , Zhang Litao , Zhang Dan , Wang Xiaosu
Published: April 2024

To explore the anticoagulant effect and safety of utilizing different doses of rivaroxaban for the treatment of patients with atrial fibrillation (AF) in the real world. A retrospective case-control analysis was performed by applying the hospital database, and 3595 patients with non-valvular atrial fibrillation (NVAF) who were hospitalized and taking rivaroxaban at Wuhan Asia Heart Hospital and Wuhan Asia General Hospital from March 2018 to December 2021 were included in the study, and were divided into the rivaroxaban 10 mg and 15 mg groups according to the daily prescribed dose, of which 443 cases were in the 10 mg group and 3152 cases were in the 15 mg group. The patients were followed up regularly, and the incidence of thrombotic events, bleeding events and all-cause deaths were recorded and compared between the 2 groups, and logistic regression was applied to analyze the influencing factors for the occurrence of adverse events. Comparison of the incidence of thrombosis, bleeding and all-cause death between the 2 groups of patients showed that the 10 mg group was higher than the 15 mg group, but the difference was not statistically significant (χ
2 = 0.36, 3.26, 1.99, all P > .05); the incidence of total adverse events between the 2 groups of patients was higher in the 10 mg group than in the 15 mg group, with a statistically significant difference (χ
2 = 4.53, P = .033); multifactorial logistic regression results showed that age [OR (95% CI) = 1.02 (1.00–1.04)], diabetes mellitus [OR (95% CI) = 1.69 (1.09–2.62)], D-dimer level [OR (95% CI) = 1.06 (1.00–1.11)] and persistent AF [OR (95% CI) = 1.54 (1.03–2.31)] were risk factors for adverse events (P < .05). In the real world, Asian clinicians recommend rivaroxaban 10 mg once daily for NVAF patients for a variety of reasons; however, this dose is not superior or even inferior to the 15 mg group in terms of effectiveness and safety. Advanced age, elevated D-dimer levels, history of diabetes mellitus, and persistent AF are risk factors for adverse events, and the optimal dosage of rivaroxaban or optimal anticoagulation strategy for Asian patients with nonvalvular AF requires further study.
Late surgical correction after complex unstable pelvic fracture 61 C3 (OTA/AO) of an 18-year-old woman
Authors: Rikhter Oleksandr
Published: April 2024

Surgical fixation of pelvic fractures is often necessary to restore fracture stability and improve patient outcomes. However, early operative management of pelvis fractures is not widely available in many health systems, resulting in conservative treatment approaches. Conservative approaches can lead to uncorrected pelvic deformities, which are challenging to treat and increase the risk of serious complications such as malunion. Treatment of pelvic malunion requires specialized care, access to necessary equipment, and a clearly defined treatment protocol. However, there is a lack of literature describing treatment algorithms for pelvic fracture malunion. This case report aims to incrementally fill this gap in the literature and highlight a logical step-by-step approach for reconstruction of pelvic malunion. This report is a single case of an 18-year-old woman who sustained complex unstable pelvic fracture, indicated for a 3-step reconstruction at a hospital with limited resources but access to computed tomography scan and some specialized pelvis reduction instruments. Postoperative imaging of the pelvis indicated satisfactory reduction and stable fixation of the pelvic reconstruction. After surgery, the patient was able to perform full axial load with no reported pain. This report provides a detailed description of each step of the operative management of a pelvic malunion case with clearly defined sequences, reduction tools, and positioning maneuvers necessary. Demonstrated in this case report, strategic preoperative planning is critical to successfully treating pelvic malunion and improving patient outcomes. This case report provides the necessary information on the management of pelvic reconstruction to inform other surgeons in underserved regions.
Association of Residual Low-frequency Hearing Loss in Children and Type of Ventilation Tube Placed During Myringotomy With Tympanostomy Tube Placement
Authors: Drew Kristin , Yergin Celeste Goh , Snoap Adam , James Victoria Claire , Collins William , Schrepfer Thomas
Published: April 2024

Objective:

Assess whether titanium Tytan tympanostomy tubes result in a larger air-bone gap (ABG) at lower frequencies compared to Armstrong and Paparella tubes.

Study Design:

Retrospective cohort study.

Setting:

Pediatric otolaryngology department of a 1000-bed academic center.

Patients:

A cohort of 110 children, aged 4–16 years, who had no sensorineural hearing loss or congenital syndromes and underwent tympanostomy tube placement between August 2018 and February 2021.

Interventions:

Tympanostomy procedures using Tytan, Armstrong, or Paparella tubes.

Main Outcome Measure:

Evaluation of pure tone average (PTA) and ABG at frequencies of 500 and 250 Hz.

Results:

Tytan tubes enhanced PTA and ABGs across studied frequencies. Nonetheless, post-Tytan tube placement exhibited significantly worse PTA and 500 Hz ABG compared to Armstrong and Paparella tubes (P < 0.05; P < 0.0001). Additionally, 250 Hz ABG post-Tytan was inferior to post-Armstrong (P < 0.0001). Relative risks of persistent ABG ≥ 15 dB with Tytan versus Armstrong tubes were 2.36 (1.62–3.44) at 500 Hz and 1.49 (1.09–1.99) at 250 Hz. Against Paparella tubes, these were 2.11 (1.28–3.72) at 500 Hz and 1.12 (0.81–1.67) at 250 Hz, the latter being not significant.

Conclusion:

While Tytan tubes optimize PTA, they are linked to enduring ABG ≥ 15 dB at lower frequencies. Notably, they perform less favorably in terms of 500 Hz PTA and ABG compared to both Armstrong and Paparella and demonstrate poorer 250 Hz ABG when juxtaposed with Armstrong tubes.
Mitochondrial Health, Physical Functioning, and Daily Affect: Bioenergetic Mechanisms of Dementia Caregiver Well-Being
Authors: Wu-Chung E. Lydia , Medina Luis D. , Paoletti-Hatcher Jensine , Lai Vincent , Stinson Jennifer M. , Mahant Itee , Schulz Paul E. , Heijnen Cobi J. , Fagundes Christopher P.
Published: April 2024

Objective

Chronic stress adversely affects mental and physical well-being. However, health outcomes vary among people experiencing the same stressor. Individual differences in physical and emotional well-being may depend on mitochondrial biology, as energy production is crucial for stress regulation. This study investigated whether mitochondrial respiratory capacity corresponds to individual differences in dementia spousal caregivers’ mental and physical health.

Methods

Spousal caregivers of individuals with Alzheimer’s disease and related dementias (N = 102, mean age = 71, 78% female, 83% White) provided peripheral blood samples and completed self-report questionnaires on quality of life, caregiver burden, and a 7-day affect scale. Multiple and mixed linear regressions were used to test the relationship between mitochondrial biology and well-being.

Results

Spare respiratory capacity (b = 12.76, confidence interval [CI] = 5.23–20.28, p = .001), maximum respiratory capacity (b = 8.45, CI = 4.54–12.35, p < .0001), and ATP-linked respiration (b = 10.11, CI = 5.05–15.18, p = .0001) were positively associated with physical functioning. At average (b = −2.23, CI = −3.64 to −0.82, p = .002) and below average (b = −4.96, CI = −7.22 to 2.70, p < .0001) levels of spare respiratory capacity, caregiver burden was negatively associated with daily positive affect. At above average levels of spare respiratory capacity, caregiver burden was not associated with positive affect (p = .65).

Conclusions

Findings suggest that higher mitochondrial respiratory capacity is associated with better psychological and physical health—a pattern consistent with related research. These findings provide some of the earliest evidence that cellular bioenergetics are related to well-being.