bluuebunny/crossref_metadata_2025 huggingface dataset:
Microarray analysis of differentially expressed microRNAs in myelodysplastic syndromes
Authors: Wan Chengyao , Wen Jing , Huang Ying , Li Hongying , Wu Wenqi , Xie Qiongni , Liang Xiaolin , Tang Zhongyuan , Zhao Weihua , Cheng Peng , Liu Zhenfang
Published: June 2020

Background:

Our study aimed to analyze differential microRNA expression between myelodysplastic syndromes (MDS) and normal bone marrow, and to identify novel microRNAs relevant to MDS pathogenesis.

Methods:

MiRNA microarray analysis was used to profile microRNA expression levels in MDS and normal bone marrow. Quantitative real-time polymerase chain reaction was employed to verify differentially expressed microRNAs.

Results:

MiRNA microarray analysis showed 96 significantly upregulated (eg, miR-146a-5p, miR-151a-3p, miR-125b-5p) and 198 significantly downregulated (eg, miR-181a-2-3p, miR-124-3p, miR-550a-3p) microRNAs in MDS compared with normal bone marrow. The quantitative real-time polymerase chain reaction confirmed the microarray analysis: expression of six microRNAs (miR-155-5p, miR-146a-5p, miR-151a-3p, miR-221-3p, miR-125b-5p, and miR-10a-5p) was significantly higher in MDS, while 3 microRNAs (miR-181a-2-3p, miR-124-3p, and miR-550a-3p) were significantly downregulated in MDS. Bioinformatics analysis demonstrated that differentially expressed microRNAs might participate in MDS pathogenesis by regulating hematopoiesis, leukocyte migration, leukocyte apoptotic process, and hematopoietic cell lineage.

Conclusions:

Our study indicates that differentially expressed microRNAs might play a key role in MDS pathogenesis by regulating potential relevant functional and signaling pathways. Targeting these microRNAs may provide new treatment modalities for MDS.
Effects of Gushukang for postmenopausal osteoporosis
Authors: Wang Guangwei , Huo Liwei , Chen Guocai , He Huayong
Published: June 2020

Background:

Postmenopausal osteoporosis (PMO) is one of the most common systemic bone diseases with a high risk of fracture. Traditional herbal formula Gushukang (GSK) has been used to treat PMO. However, there is no systematic review related to GSK for PMO. The object of this work is to evaluate the efficacy and safety of GSK in the management of PMO.

Methods:

We will search the PubMed, Embase, MEDLINE, Cochrane Library Central Register of Controlled Trials, China national knowledge infrastructure database (CNKI), Wan fang database, Chongqing VIP information, and SinoMed from their inception to May 2020. All randomized controlled trials (RCTs) of GSK for the treatment of PMO will be included. The improvement of vertebral fracture and bone mineral density (BMD) will be accepted as the primary outcomes. The meta-analyses will be performed by using the RevMan 5.3.

Results:

This study will provide a high-quality comprehensive evaluation of the efficacy and safety of GSK for treating patients with PMO.

Conclusion:

The conclusion of our systematic review will provide evidence to judge whether GSK is an effective intervention for patients with PMO.

Trial registration number:

10.17605/OSF.IO/MKN3F.
The efficacy of acupuncture for the treatment and the fertility improvement in child-bearing period female with Hashimoto Disease
Authors: Li Fangyuan , Qi Zhang , Hua Lu , Wang Xinxin , Ling Mi , Juan Du
Published: June 2020

Background:

Hashimoto thyroiditis (HT) is highly prevalent among reproductive-aged women and has a substantial negative impact on fertility. Currently, there is no specific treatment for Hashimoto thyroiditis. We hypothesize that acupuncture can halt or delay the progression of HT and improve fertility in child-bearing period female. We therefore designed a randomized controlled trial to test this hypothesis by comparing the therapeutic effect of acupuncture vs sham acupuncture in patients with Hashimoto thyroiditis.

Methods:

In this randomized controlled study, a total of 284 eligible patients will be assigned to acupuncture group (n = 142) or sham acupuncture group (n = 142) in a 1:1 ratio. All patients will receive 36 sessions in total for 12 consecutive weeks with the same acupoint prescription (RN23, ST9, RN17, RN4, RN6, ST36, SP6, KI6). The primary assessment is the titers of thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibody (TGAb). Secondary outcomes include the thyroid function, ovarian function, the rate of primary ovarian insufficiency, and pregnancy outcome. The thyroid function and thyroid antibodies tests will be measured at weeks 0, 4, 8, and 12 after randomization. The ovarian function will be examined on the 2nd to 4th day of the menstrual period in the 1st month, 2nd month and 3rd month compared with baseline. Both the pregnancy outcome and the rate of primary ovarian insufficiency will be evaluated 1 year after treatment.

Discussion:

This will be the first large-scale trial specifically evaluating acupuncture therapy in child-bearing period female with Hashimoto thyroiditis. If the study confirms the effectiveness of acupuncture treatment, more consistent acupuncture therapy can be set up for clinical practice.

Trial registration:

Chinese Clinical Trials Register identifier, ChiCTR2000031320, registered on 27 March 2020.
Higher neutrophil-lymphocyte ratio is associated with better prognosis of hepatocellular carcinoma
Authors: Li Sheng-chao , Xu Zhuo , Deng Yan-li , Wang Ya-ni , Jia Yu-ming
Published: June 2020

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide; its morbidity and mortality have both recently increased. Lately, the role played by the neutrophil-lymphocyte ratio (NLR) in the development of HCC has attracted attention. However, the exact relationship is not fully understood.

A total of 538 participants diagnosed with HCC were recruited between 2010 and 2018. Their relevant routine blood parameters were measured, including NLR. Pearson Chi-Squared test, Spearman Rho test, and logistic regression analysis were performed to explore any correlations between NLR and HCC. A receiver operating characteristic (ROC) curve analysis was performed to determine the usefulness of NLR for predicting HCC. Univariate and multivariate Cox regression analysis for relevant routine blood parameters and any relationships with overall survival (OS) were performed. The Kaplan–Meier method was used to explore any further relationships with OS.

NLR was significantly correlated with HCC tumor size by Pearson Chi-Squared test (P = .008). Furthermore, Spearman correlation coefficient showed that HCC tumor size was significantly correlated with NLR (P = .115, P = .008). NLR could sensitively and specifically predict HCC tumor size (area under the curve [AUC], 0.605; 95% confidence interval [CI], 0.429–0.743; P = .000). Higher NLR in patients with HCC was correlated with better OS (hazard ratio [HR] = 0.584; P = .000).

A close correlation existed between increased NLR and HCC; NLR could sensitively and specifically predict HCC. High NLR might be an independent protective factor in the prognosis of patients with HCC.
Tailgut cyst with adenocarcinoma transition
Authors: Wang Min , Liu Guoliang , Mu Yu , He Hongyu , Wang Shuang , Li Jiannan
Published: June 2020

Rationale:

Tailgut cyst (TGC) is a rare congenital disease that originates from residues of the tail intestine during the embryonic period. Most TGCs are benign lesions and the malignant transition is very rare.

Patient concerns:

A 50-year-old woman attended our department complaining of defecation difficulty for more than 2 months. She reported irregular defecation with a small amount of liquid stool, 3 to 4 times per day.

Diagnosis:

Biochemical analysis showed high levels of carcinoembryonic antigen (79.89 ng/mL; normal, 0–3 ng/mL) and carbohydrate antigen 199 (57.60 U/mL; normal, 0–35 U/mL). Abdominal computer tomography and magnetic resonance imaging showed a large cystic mass with enhanced signals. Post-surgical histopathology indicated that the mass was a TGC with adenocarcinoma transition.

Interventions:

The cyst was completely resected. Symptomatic treatment was further performed, and the patient recovered well.

Lessons:

We reported a rare case of a large TGC with adenocarcinoma transition. CT, MRI, and histopathology are important to diagnose TGC. Complete surgical resection is the first choice to treat TGC.
Effect of the international pharmacy education programs
Authors: Yi Zhan-Miao , Zhou Liang-Yu , Yang Li , Yang Ling , Liu Wenxi , Zhao Rong-Sheng , Zhai Suo-Di
Published: June 2020

Globalization has attracted much attention to universities over the past decade. The aim of this study was to evaluate the effect of the United States-China international pharmacy education programs (IPEP) in China.

Kirkpatrick's model of evaluation was used to evaluate IPEP from reaction and learning levels. In the reaction level, a questionnaire survey with a Likert scale was used. In the learning level, data from “Assessment Record of Advanced Clinical Pharmacy Practice of Peking University” were collected. Cronbach’ α coefficient of reliability was calculated, principal component analysis and independent t-test were conducted.

All of the students who attended IPEP (n = 36) completed the questionnaire survey. The scores of benefits were increased in 4 categories, including “Clinical practice competency improvement” (mean ranking [MR] = 3.11 points), “Understanding of doctor of Pharmacy education mode” (MR = 3.48 points), “English competency improvement” (MR = 3.64 points) and “International collaboration” (MR = 3.92 points). Meanwhile, the overall satisfaction was relatively high with the IPEP (MR = 4.22 points). In the learning level, a total of 22 records was obtained. Students who attended (n = 5) the IPEP achieved higher scores than those did not attend (n = 17) in the assessment records, although no statistical significant differences were observed. Personal in-depth interviews further supported the overall benefit of IPEP.

The Kirkpatrick model of evaluation can be used for IPEP. The benefit and satisfaction of students attended the IPEP were high in the reaction level; even though no statistically significant difference was shown in the learning level, higher scores were still demonstrated.
Coronavirus disease 2019 (COVID-19) pneumonia in a hemodialysis patient
Authors: Huang Luyan , Wang Yiru , Wang Lisheng , Lv Yongman , Liu Qingquan
Published: June 2020

Rationale:

The 2019 novel coronavirus disease (COVID-19) causes a novel, atypical pneumonia that has brought huge public health challenges across the globe. There is limited data about patients with end-stage renal disease who also suffer from COVID-19. In this report, we discuss the case of a hemodialysis patient who developed COVID-19 pneumonia in the clinical course.

Patient concerns:

A 79-year-old man who had end-stage renal disease (ESRD) and was taking regular hemodialysis was admitted to hospital for a fever and dry cough. The patient, who also had cardiovascular disease, had no history of contact with COVID-2019 patients.

Diagnosis:

The patient was diagnosed with COVID-2019 by the reverse-transcriptase polymerase chain reaction (RT-PCR), and his pharyngeal swab for SARS-CoV-2 was positive.

Intervention:

The treatment was mainly supportive and the patient was intensively monitored. He was treated with oxygen, broad-spectrum antibiotics, antiviral drugs, and methylprednisolone. The patient took continuous renal replacement therapy (CRRT) every 2 days.

Outcomes:

After 19 days, an RT-PCR assay for SARS-CoV-2 was negative, and computed tomography (CT) of the patient's thorax indicated that the pulmonary inflammatory exudation was absorbed and pulmonary infection improved significantly. He was discharged on day 29 after recovering from COVID-2019 pneumonia.

Lessons:

The courses of disease and treatment options for this individual were significantly more complicated than those for ordinary patients. Therefore, it was necessary to monitor the condition of the patient closely and to protect the dialysis unit staff from being infected. Compared with other severe COVID-2019 cases, this patient recovered more quickly following treatment, which was likely due to the removal of inflammatory mediators by CRRT. This implies that blood purification might be an important option for hemodialysis patients with COVID-19.
Safety and efficacy of INTRABEAM intraoperative radiotherapy for invasive thymoma
Authors: Cui Tian-xiang , Dai Ji-gang , Li Jing-meng , Qian Jin-dong , Li Guang-hui , Sun Jian-guo
Published: June 2020

Intraoperative radiotherapy (IORT) has been used to treat different residual solid tumors after tumor removal and has shown many advantages over other treatment methods. However, the use of IORT for invasive thymoma has not been reported. Therefore, in this study, we tried to determine the safety and efficacy of INTRABEAM IORT for the treatment of invasive thymoma.

Among the patients admitted to our hospital from September to December 2016 who were diagnosed with invasive thymoma, 14 were selected as study subjects. With medical histories taken beforehand, 8 of these patients were diagnosed with Masaoka stage IIA and 6 with Masaoka stage IIB; furthermore, 5 of the patients were diagnosed with myasthenia gravis (MG). INTRABEAM radiation (8–10 Gy, low energy) was delivered to the postoperative tumor bed of each patient during surgery. The intra- and postoperative complications were observed and evaluated, and the improvement in symptoms was assessed. An additional 23 patients with stage II thymoma undergoing radical surgery from April to August 2016 were chosen as the control group.

One month after the operation, only 1 patient in the IORT group had cough, increased levels of leucocytes and neutrophils, and pulmonary inflammation on chest computed tomography. Reactive inflammation and pleural effusion in the 2 groups were similar (P > .05). There was no significant difference between the 2 groups in the improvement of myasthenia gravis (P > .05). Postoperative chest computed tomography and routine blood examination at 3 and 12 months showed that all the patients recovered, with normal hemogram levels and no pulmonary fibrosis around the radiation field. In addition, ultrasonic cardiography and electrocardiography demonstrated no significant difference before or after surgery within the IORT group. At the end of the follow-up, all the patients were alive, no relapse or remote metastasis was observed in the IORT group, and 2 inpatients in the control group had experienced relapse at 24 and 26 months. There was a significant difference in disease-free survival between the 2 groups (P = .00).

It is safe to administer low-energy INTRABEAM IORT at a dose of approximately 10 Gy in patients with stage II invasive thymoma. INTRABEAM IORT does not significantly increase operation- or radiation-related complications and has no significant effect on vital organs such as the lungs and heart. Its long-term efficacy is worth expecting.
Exploring smoking cessation behaviors of outpatients in outpatient clinics
Authors: Hsu Ching-Yi , Liao Hung-En , Huang Li-Chun
Published: June 2020

To examine the knowledge, attitudes, and behaviors of smokers towards smoking prevention and provide high-quality smoking cessation services and education on tobacco prevention and establish a smoke-free care network.

This study is a cross-sectional survey. The research tool is a questionnaire composed of 4 sub-scales, namely, “tobacco harm awareness,” “tobacco prevention attitude,” “quitting smoking self-efficacy scale,” and “intentional behavior to quit smoking.”

A positive correlation was identified between cessation-specific knowledge, attitude to quit smoking, and intentional behavior to quit smoking among outpatients. Following the regression analysis, 2 factors (cessation-specific knowledge and attitude toward quitting the smoking habit) were considered in the model and its total variance explained reached 53.2%.

Regular smoking cessation classes should be conducted to increase the awareness of smoking hazards and improve the positive attitude toward smoking cessation to avoid smoking hazards.
A deep learning-based automated diagnostic system for classifying mammographic lesions
Authors: Yamaguchi Takeshi , Inoue Kenichi , Tsunoda Hiroko , Uematsu Takayoshi , Shinohara Norimitsu , Mukai Hirofumi
Published: June 2020

Background:

Screening mammography has led to reduced breast cancer-specific mortality and is recommended worldwide. However, the resultant doctors’ workload of reading mammographic scans needs to be addressed. Although computer-aided detection (CAD) systems have been developed to support readers, the findings are conflicting regarding whether traditional CAD systems improve reading performance. Rapid progress in the artificial intelligence (AI) field has led to the advent of newer CAD systems using deep learning-based algorithms which have the potential to reach human performance levels. Those systems, however, have been developed using mammography images mainly from women in western countries. Because Asian women characteristically have higher-density breasts, it is uncertain whether those AI systems can apply to Japanese women. In this study, we will construct a deep learning-based CAD system trained using mammography images from a large number of Japanese women with high quality reading.

Methods:

We will collect digital mammography images taken for screening or diagnostic purposes at multiple institutions in Japan. A total of 15,000 images, consisting of 5000 images with breast cancer and 10,000 images with benign lesions, will be collected. At least 1000 images of normal breasts will also be collected for use as reference data. With these data, we will construct a deep learning-based AI system to detect breast cancer on mammograms. The primary endpoint will be the sensitivity and specificity of the AI system with the test image set.

Discussion:

When the ability of AI reading is shown to be on a par with that of human reading, images of normal breasts or benign lesions that do not have to be read by a human can be selected by AI beforehand. Our AI might work well in Asian women who have similar breast density, size, and shape to those of Japanese women.

Trial registration:

UMIN, trial number UMIN000039009. Registered 26 December 2019, https://www.umin.ac.jp/ctr/
The role of non-vitamin K antagonist oral anticoagulants in Asian patients with atrial fibrillation
Authors: Liu Xuyang , Huang Manxiang , Ye Caisheng , Zeng Junquan , Zeng Changai , Ma Jianyong
Published: June 2020

Background:

Given the huge burden of atrial fibrillation (AF) and AF-related stroke in Asia, stroke prevention represents an urgent issue in this region. We herein performed a network meta-analysis to examine the role of non-vitamin K antagonist oral anticoagulants (NOACs) in Asian patients with AF.

Methods:

A systematic search of the publications was conducted in PubMed and Embase databases for eligible studies until July 2019. The odds ratios (ORs) and 95% confidence intervals (CIs) were regarded as the effect estimates. The surface under the cumulative ranking area (SUCRA) for the ranking probabilities was calculated.

Results:

A total of 17 studies were included. For comparisons of NOACs vs warfarin, dabigatran (OR = 0.77, 95% CI 0.68–0.86), rivaroxaban (OR = 0.72, 95% CI 0.65–0.81), apixaban (OR = 0.56, 95% CI 0.49–0.65), but not edoxaban reduced the risk of stroke or systemic embolism, wheres dabigatran (OR = 0.56, 95% CI 0.41–0.76), rivaroxaban (OR = 0.66, 95% CI 0.50–0.86), apixaban (OR = 0.49, 95% CI 0.36–0.66), and edoxaban (OR = 0.34, 95% CI 0.24–0.49) decreased the risk of major bleeding. In reducing the risk of stroke or systemic embolism, apixaban and rivaroxaban ranked the best and second best (SUCRA 0.2% and 31.4%, respectively), followed by dabigatran (50.2%), edoxaban (75.2%), and warfarin (93.0%). In reducing the risk of major bleeding, edoxaban, and apixaban ranked the best and second best (1.5% and 30.8%, respectively), followed by dabigatran (48.4%), rivaroxaban (69.2%), and warfarin (100%).

Conclusion:

NOACs were at least as effective as warfarin, but more safer in Asians with AF. Apixaban was superior to other NOACs for reducing stroke or systemic embolism, while edoxaban showed a better safety profile than other NOACs.
Guipi decoction for insomnia
Authors: Li Mao , Lan Rui , Wen Yong , Shi Kejin , Yang Dongdong
Published: June 2020

Background:

Insomnia is a common sleep disorder with symptoms including difficulty falling asleep and early awakening. Guipi decoction is widely used in clinical treatment of insomnia in China. However, there is a lack of systematic evaluation and analysis of Guipi decoction. Therefore, our study will provide efficacy assessments and adverse events assessments.

Methods:

A comprehensive search for randomized controlled trials of Gupi decoction treatments for insomnia will be carried in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trial (CENTRAL), CINAHL, AMED and Chinese databases include CBM, CNKI, CQVIP, and Wanfang from their inceptions to May 2020. Relevant reference lists, Baidu Scholar and grey literature will also be checked. Two experienced reviewers will independently search all databases. Primary outcomes include Pittsburgh sleep quality index and clinical effective rate, and secondary outcomes include traditional Chinese medicine syndrome, adverse events, and Epworth Sleepiness Scale. Review Manager 5.3 software will be used analyze all data.

Results:

This article will be dedicated to assessing the efficacy and safety of Guipi decoction for insomnia.

Conclusion:

The conclusion of this systematic review will provide evidence to judge whether Guipi Decoction is an effective therapeutic intervention for patient with insomnia. Maybe these results could potentially be helpful for improving the therapeutic strategy of patients with insomnia.

PROSPERO registration number:

CRD 42020164911.
Nucleoside analogs assisted with Chinese compound prescription in treating hepatic fibrosis of chronic hepatitis B patients
Authors: Cheng Maoyuan , Feng Xianrong , Wang Long , Yang Yu , Ma Li , Wang Baojia
Published: June 2020

Background:

Chronic hepatitis B is often complicated with different degrees of hepatic fibrosis, which affects the quality of life. Nucleoside analogs are recommended by almost all guidelines in the world for the treatment of chronic hepatitis B. At present, there is no specific and effective chemical and biological agents for hepatic fibrosis. In China, Chinese compound prescription combined with nucleoside analogs have been used to treat hepatic fibrosis of chronic hepatitis B patients in more and more cases, and good results have been achieved. Several Chinese compound prescriptions that have been made into proprietary Chinese medicine for the convenience of use. This article aims to systematically evaluate the efficacy and safety of Chinese medicine compounds assisting nucleoside analogs in the treatment of hepatic fibrosis in chronic hepatitis B patients.

Method:

The following databases will be searched from their inception to September 2019: PubMed, EMBASE, EBSCOhost, The Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical literature Database (CBM), VIP Database, Wanfang Database. Languages are limited to Chinese and English. The study includes randomized controlled trials using Chinese compound prescription combined with entecavir and Chinese compound prescription combined with tenofovir disoproxil fumarate to treat hepatic fibrosis of chronic hepatitis B patients. The primary outcomes including effective rate and biochemical parameters (levels of hyaluronic acid, laminin, pre-type-III collagen and type IV collagen will be tested. Additional outcomes include liver function indexes (levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin) and levels of hepatitis B virus DNA. Stata14.0 software will be used for meta-analysis.

Result:

The efficacy and safety of Chinese compound prescriptions assisting nucleoside analogs for hepatic fibrosis of chronic hepatitis B patients will be assessed from the effective rate, biochemical parameters, liver function indexes, and levels of hepatitis B virus DNA.

Conclusion:

The conclusion of this study will be used to evaluate the efficacy and safety of Chinese compound prescriptions assisting nucleoside analogs in the treatment of hepatic fibrosis of chronic hepatitis B patients, as well as the adjuvant effectiveness of Chinese compound prescriptions in combined therapy.

PROSPERO registration number:

CRD42020156859.
Distal third femoral shaft fractures in school-aged children
Authors: Li Jin , Rai Saroj , Ze Renhao , Tang Xin , Liu Ruikang , Hong Pan
Published: June 2020

Internal fixation such as elastic stable intramedullary(ESIN) nail and submuscular plate (SMP) is gaining popularity for femoral shaft fractures in school-aged children. However, external fixation (ExFix) might be a valuable option for the distal third femoral shaft fractures, where the fracture heals rapidly, but it is crucial to avoid angular malunion. This study aims to compare the clinical outcomes, postoperative complications of distal third femoral shaft fractures in school-aged children treated by ESIN versus ExFix.

Patients aged 5 to 11 years with distal third femoral shaft fractures treated at our institute from January 2014 to January 2016 were included and categorized into ESIN (n = 33) and ExFix (n = 38) group. The preoperative data, including baseline information of the patients, radiographic parameters, and type of surgical procedure, were collected from the hospital database, and postoperative data, including complications, were collected during the follow-up visit.

In all, 33 patients (average, 8.0 ± 2.1 years, male 20, female 13) in the ESIN group and 38 patients (average, 8.3 ± 2.3 years, male 23, female 15) in the ExFix group were included in this study. There was significantly less operative time for the ExFix group (45.4 ± 7.8 min) as compared to the ESIN group (57.8 ± 11.3 min) (P < .01), reduced estimated blood loss (EBL) in the ExFix group (9.9 ± 3.5) as compared to the ESIN group (16.4 ± 6.5) (P < .01). As for the frequency of fluoroscopy, there was a significant difference between the ExFix group (13.9 ± 2.4) and the ESIN group (15.5 ± 3.2) (P = .02). The rate of major complications was not significantly different between the 2 groups (P = .19). The rate of implant irritation was significantly higher in the ExFix group (28/38, 73.7%) than the ESIN group (12/33, 36.4%) (P < .01). The rate of surgical site infection (SSI) is significantly higher in the ExFix group (18/38, 47.4%)) than the ESIN group (1/33, 3%) (P < .01). The rate of scar concern was significantly higher in the ExFix (9/38, 23.7%) than the ESIN (2/33, 6.1%), (P = .04). According to the Flynn scoring system, 30(90.9%) patients in the ESIN group and 24(89.5%) patients in the ExFix group were rated as excellent. None of the patients had poor outcomes.

Both ESIN and ExFix produced satisfactory outcomes in distal third femoral shaft fractures. ExFix remains a viable choice for selected cases, especially in resource-challenged and austere settings.
Prevalence of food allergen and aeroallergen sensitization among children in Sichuan province
Authors: Liu Ting , Lai Shu-yu , Li Wen-sheng , Jiang Yong-mei
Published: June 2020

Food allergen and aeroallergen sensitization are common allergic diseases worldwide, with widely varying estimates of prevalence in children. Our study investigated the characteristics of ingestion and inhalation allergy among children from Sichuan province in Southwest China, so as to get public awareness of these disorders.

A total of 1722 children between 0 and 14 years’ old were enrolled in this study. They were outpatients in the West China Second University Hospital during June 2019 to September 2019. Serum specific IgE specific to 10 types of food allergen and 10 types of aeroallergen were estimated. Nutrition indicators were tested by electrochemical luminescence.

59.70% children were allergic to at least 1 allergen, comprising 24.90% to aeroallergen and 38.81% to food allergen, respectively, whereas 36.28% children were allergic to both aeroallergen and food allergen. Milk was the most common food allergen, and egg came in second place. With regard to aeroallergen, house dust mite held the maximum proportion (65.02%), whereas dust mite followed behind. Inhalation allergy was more commonly seen in boys than girls. Bronchitis was the most common symptom of both allergies. In addition, the highest incidence age for children to be sensitive to food allergen and aeroallergen were 0∼2 years’ old and 3∼5 years’ old, respectively. It is worth mentioning that there was no significant difference in nutritional status between children with or without allergic diseases.

Our findings reveal that milk, egg, house dust mite, and dust mite are the most common allergens among children in Sichuan province. Boys are more susceptible to aeroallergen than girls. Furthermore, the prevalence of ingestion and inhalation allergy varies from different age groups, and has no correlation with nutritional status. In brief, the analysis of the pattern of food allergen and aeroallergen sensitization is invaluable to effective diagnosis and treatment of allergic diseases.
Low-dose CT combined mammography in diagnosis of overflow breast disease
Authors: Tian Hao , Hu Shao-jun , Tang Qun , Ma Fei-hong , Yao Rong-rong
Published: June 2020

Background:

Overflow breast disease (OBD), also known as breast nipple discharge, refers fluid or liquid that comes out of nipple. Many patients with breast cancer experience such condition. However, it is not easy to detect it at early stage, especially for pathological OBD. Previous study found low-dose CT combined mammography (LDCTMG) could help in diagnosis of OBD. However, there is no systematic review investigating this issue. Therefore, this study will examine the accuracy of LDCTMG in diagnosis of OBD.

Methods:

This study protocol will search literature sources in electronic databases and other sources. The electronic databases will be retrieved in The Cochrane Library, the Cochrane Register of Diagnostic Test Accuracy Studies, PUBMED, EMBASE, Web of Science, CINAHL, CNKI, and WANGFANG from inception to the present. We will also search other sources. All literature sources will be sought without restrictions to the language and publication status. Two researchers will independently carry out study selection, data extraction, and study quality assessment. Statistical analysis will be performed using RevMan 5.3.

Results:

This study will exert a high-quality synthesis of eligible studies on the analysis of LDCTMG in diagnosis of OBD.

Conclusions:

The results of this study may provide evidence to help judge whether LDCTMG is accurate in diagnosis of OBD.

Study registration:

INPLASY202050116.
Association between arginine catabolism and major depressive disorder
Authors: Cao Bing , Deng Runze , Wang Dongfang , Li Li , Ren Zhongyu , Xu Lixin , Gao Xiao
Published: June 2020

Background:

Alterations in the levels of arginine and its related catabolic products (ie, ornithine, citrulline, and argininosuccinate) in the urea and nitric oxide cycles were reported to play roles in the pathogenesis of major depressive disorder (MDD). The aim of this meta-analysis study is to explore the associations between arginine with its related catabolic products and MDD, and to discuss the possible role of arginine catabolism in the pathoetiology of MDD.

Methods:

This study will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The English language literature published in the databases of PubMed, EMBASE, PsycINFO and Web of Science will be systematically searched. Forest plots will be used to estimate the associations between arginine and its related catabolic products with MDD. Subgroup analysis and meta-regression will also be performed to investigate the source of the potential heterogeneity. Sensitivity analysis will be performed to strengthen the results and to investigate whether any single study would have a significant effect on the results of meta-analysis. Publication bias will be tested for using the funnel plot with Begg test and Egger test. The Newcastle-Ottawa Scale will be applied to assess the risk of bias of observational studies.

Results:

An integrated assessment of arginine with its related catabolic products may contribute to predict the risk of MDD.

Ethics and dissemination:

The results of associations between arginine with its related catabolic products and MDD will be reported in a peer-reviewed publication. With our findings from this meta-analysis, we hope to provide the most up-to-date evidence for the contributions of arginine and related catabolic products to predict the risk of MDD.

Systematic review registration:

The protocol of current meta-analysis has been registered at the Open Science Framework [Available at: https://doi.org/10.17605/osf.io/7fn59].
Clinical research for whether the Traditional Chinese medicine could promote the resorption of lumbar disc herniation: a randomized controlled trial
Authors: Liu Jintao , Zhu Yu , Wang Zhiqiang , Yu Pengfei , Xue Chunchun , Jiang Hong , Li Xiaofeng , Tang Dezhi
Published: June 2020

Lumbar disc herniation (LDH) is a common, disabling musculoskeletal disorder. Magnetic resonance imaging has clarified the natural history of lumbar disc lesions and has documented that disc lesions can become smaller and can even be completely resorbed. Previous studies have confirmed that some traditional Chinese medicine (TCM) therapies can promote resorption of the protrusion. However, high-quality research evidence is needed to support the effectiveness of the protocol.

Objective:

This clinical trial aims to establish whether TCM can promote the resorption of LDH and to assess the efficacy of such therapy for LDH, thereby evaluating its clinical effect.

Methods:

The present study design is for a single-center, 2-arm, open-label randomized controlled trial. A total of 150 eligible LDH patients will be randomly assigned to either a TCM treatment group or a control group in a 1:1 ratio. Patients in the TCM group will be administered a TCM decoction for 4 weeks. Patients in the conventional drug control group will be instructed to take a specific daily dose of celecoxib. The primary outcome measure is the change from baseline in the volume of the protrusion, as assessed using MR images. Secondary outcome measures include visual analog scale pain scores and Japanese Orthopaedic Association scores assessed at 3 and 6 months.

Discussion:

The design and methodological rigor of this trial will allow evaluation of the basic clinical efficacy and safety data for TCM in the treatment of patients with LDH. The trial will also assess whether TCM can promote the resorption of LDH. This research will therefore help provide a solid foundation for the clinical treatment of LDH and for future research in TCM therapy.

Trial registration:

ChiCTR1900022377.
The analgesic efficiency of pregabalin for the treatment of postoperative pain in total hip arthroplasty
Authors: Zhang Yuangui , Wang Xiaoqian , Dong Guimin
Published: June 2020

Background:

Only few studies have yet investigated whether perioperative administration of pregabalin can reduce the incidence of postoperative chronic neuropathic pain after total hip arthroplasty (THA). This prospective, randomized study compared placebo with pregabalin in the hope that a lower pregabalin dose would improve analgesia without increasing side-effects after THA.

Methods:

This study was a prospective randomized blinded study, with a parallel design and an allocation ratio of 1:1 for the treatment groups. The study was approved by the Institutional Review Board in Weifang People's Hospital and written informed consent was obtained from all subjects before enrolment. A total of 120 patients who meet inclusion criteria are randomized to either pregabalin or placebo group. The primary objective of the study was visual analog scale score. As secondary outcomes, opioid consumption measurement, Harris Hip Score, hip range of motion, patient satisfaction, and complications were made at different time points throughout the study for comparison.

Results:

The null hypothesis of this study was that pregabalin would reduce pain after THA.

Trial registration:

This study protocol was registered in Research Registry (researchregistry5669).
Rapid induction of clinical remission in SAPHO syndrome using high-dose Tripterygium glycosides
Authors: Gong Liang , Wang Lun , Cao Yihan , Li Chen
Published: June 2020

Rationale:

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare disease without standard treatments. Tripterygium wilfordii hook f (TwHF) is a traditional Chinese herb with anti-inflammatory effect, and 1.0 mg/(kg·d) dose of Tripterygium glycosides has been reported to significantly improve the disease activity of a SAPHO patient in a case report. However, the optimal dose of TwHF is still unclear. Here, we report the first case of SAPHO patient who achieved rapid remission in clinical symptoms after receiving 1.5 mg/(kg·d) dose of Tripterygium glycosides treatment.

Patient concerns:

A 67-year-old woman noted palmoplantar pustulosis and pain in the anterior chest wall and waist. Bone scintigraphy demonstrated the typical tracer accumulation feature and magnetic resonance images showed bone marrow edema in lumbosacral vertebra.

Diagnoses:

The diagnosis was made by dermatological and osteoarticular manifestations and classical signs in bone scintigraphy in accordance with the diagnostic criteria proposed in 2012.

Interventions:

Tripterygium glycosides was given with a primary dose of 1.5 mg/(kg·d) for 1 month and then reduced at a rate of 10 mg every 2 weeks until 1.0 mg/(kg·d) for a long-term maintenance.

Outcomes:

Fast-induced remission on clinical manifestations was achieved and magnetic resonance imaging abnormality was improved significantly. Additionally, no apparent side effects were observed.

Lessons:

1.5 mg/(kg·d) dose of Tripterygium glycosides seems to have fast-induced remission than 1.0 mg/(kg·d) with reliable safety. Besides, Tripterygium glycosides may also have a pharmacological effect of inhibiting osteolysis and enhancing bone strength.
Recurrent ascending cholangitis with acute pancreatitis and pancreatic atrophy caused by a juxtapapillary duodenal diverticulum
Authors: Alzerwi Nasser A.N.
Published: June 2020

Rationale:

Intermittent combined pancreaticobiliary obstruction may lead to multiple episodes of ascending cholangitis and pancreatitis, usually due to choledocholithiasis or periampullary mass. However, one of the rare causes is periampullary or juxtapapillary duodenal diverticulum. Although duodenal diverticula are relatively common in the general population, the overwhelming majority are asymptomatic. Duodenal diverticula can cause combined pancreaticobiliary obstruction through multiple mechanisms such as stasis-induced primary choledocholithiasis, stasis-induced intradiverticular enterolith, or longstanding diverticulitis, causing stenosing fibrosing papillitis or a combination of more than one of these mechanisms. Herein, I report a case of Lemmel syndrome due to a combination of multiple mechanisms and review the available literature on the epidemiology, pathogenesis, clinical presentation, diagnostic work-up, and management of juxtapapillary duodenal diverticulum.

Patient concerns:

Multiple episodes of abdominal pain, jaundice, anorexia, fever, and significant unintentional weight loss.

Diagnoses and interventions:

Primary choledocholithiasis, recurrent ascending cholangitis, recurrent acute pancreatitis, and pancreatic atrophy due to giant juxtapapillary duodenal diverticulum, with unsuccessful endoscopic retrograde cholangiopancreatography that was completely resolved after open transduodenal sphincteroplasty and septoplasty, transampullary and transcystic common bile duct exploration and stone extraction, and duodenal diverticular inversion.

Outcome:

Complete resolution of combined pancreaticobiliary obstruction without recurrence for 2 years after surgery.

Lessons:

Surgeons should be aware of such rare syndromes to avoid misdiagnosis and delayed or inappropriate management. Furthermore, they should understand the different available operative options for cases that are refractory to endoscopic approach.
Detection of anatomical variation during left internal jugular vein cannulation under ultrasound
Authors: Cho Hobum , Kim Geontae , Song Sanghoon , Yoo Jaehwa , Kim Mungyu , Chung Jiwon , Kim Sangho , Park Sunyoung
Published: June 2020

Rationale:

The left internal jugular vein has a higher possibility of anatomical variation than the right side. Therefore, the complication risk during cannulation is expected to be higher.

Patient concerns:

A 74-year-old woman was scheduled for elective surgery for left upper lobe wedge resection. We observed an anatomical abnormality at the location of the common carotid artery (CCA) and left internal jugular vein (IJV).

Diagnosis:

During the ultrasound, the left IJV was detected at the medial side of the CCA, and this anatomical variation was confirmed by color Doppler ultrasonography. Enhanced chest computed tomography showed that the left CCA ran across the left IJV from medial to lateral at the level of the clavicle.

Intervention:

A triple-lumen central venous catheter was inserted at the right IJV to avoid complications caused by the anatomical variation.

Outcomes:

There were no intraoperative or postoperative complications.

Lessons:

Anesthesiologists should consider anatomical variation during central venous cannulation, especially with the left IJV approach. Because of anatomical variation, ultrasound-guided intervention is highly recommended to prevent procedure-related complications.
An observational study on diagnosis index of metabolic disease with blood-stasis
Authors: Ko Mi Mi , Jang Soobin , Jung Jeeyoun
Published: June 2020

Introduction:

Treating blood stasis is effective in treating obesity and metabolic diseases in traditional Korean medicine. The aim of this prospective observational study is to determine the effectiveness of the diagnosis index for metabolic diseases with blood stasis by analyzing clinical data and blood samples.

Methods and analysis:

We will perform a prospective observational study. Participants who meet the inclusion criteria will be recruited from the Dongguk university Ilsan Oriental hospital. The outcomes are resistin, serum amyloid P component, C-reactive protein, D-dimer, and blood stasis scores. In addition, the blood pressure, ankle–brachial pressure index, brachial–ankle pulse wave velocity, body mass index, waist circumference, and levels of blood lipid will be assessed.

Discussion:

Through this study, we could collect specific data for diagnosing metabolic diseases with blood stasis. Therefore, the findings of this study will provide a summary of the current state of evidence regarding the effectiveness of the diagnosis index in managing metabolic disease with blood stasis.

Ethics and dissemination:

The study was approved by the Institutional Review Board of the Dongguk University Ilsan Oriental Hospital (DUIOH-2018-09-001-007). The results will be published in a peer-reviewed journal and will be disseminated electronically and in print.

Trial registration number:

Clinical Research Information Service: KCT0003548
Intentional Asphyxiation Using Baby Wipes
Authors: Gerber Nicole , Iyer Shweta , Parra Didier Murillo , Legano Lori , Tunik Michael
Published: June 2020

Abusive suffocation with foreign bodies is an uncommon form of child abuse. We present the case of a 2-month-old infant with colic who was forcibly suffocated with a baby wipe by a female babysitter. He presented to the emergency department in respiratory distress, and the foreign body was removed in the operating room by otorhinolaryngology. He was found to have intraoral lacerations and a left diaphyseal humeral fracture. To our knowledge, there is only 1 other collection of case reports of abusive suffocation with baby wipes. This case highlights the importance of considering abuse in cases of oral injury and foreign body aspiration in pediatric patients.
Using Geographic Catchment Areas to Measure Population-based Access to Kidney Transplant in the United States
Authors: Ross-Driscoll Katherine , Axelrod David , Lynch Raymond , Patzer Rachel E.
Published: June 2020

Background.

Monitoring efforts to improve access to transplantation requires a definition of the population attributable to a transplant center. Previously, assessment of variation in transplant care has focused on differences between administrative units—such as states—rather than units derived from observed care patterns. We defined catchment areas (transplant referral regions [TRRs]) from transplant center care patterns for population-based assessment of transplant access.

Methods.

We used US adult transplant listings (2006–2016) and Dartmouth Atlas catchment areas to assess the optimal method of defining TRRs. We used US Renal Data System and Scientific Registry of Transplant Recipient data to compare waitlist- and population-based kidney transplant rates.

Results.

We identified 110 kidney, 67 liver, 85 pancreas, 68 heart, and 43 lung TRRs. Most patients were listed in their assigned TRR (kidney: 76%; liver: 75%; pancreas: 75%; heart: 74%; lung: 72%), although the proportion varied by organ (interquartile range for kidney, 65.7%–82.5%; liver, 58.2%–78.8%; pancreas, 58.4%–81.1%; heart, 63.1%–80.9%; lung, 61.6%–76.3%). Patterns of population- and waitlist-based kidney transplant rates differed, most notably in the Northeast and Midwest.

Conclusions.

Patterns of TRR-based kidney transplant rates differ from waitlist-based rates, indicating that current metrics may not reflect transplant access in the broader population. TRRs define populations served by transplant centers and could enable future studies of how transplant centers can improve access for patients in their communities.
CoViD-19 outbreak in Northern Italy: Did particulate matter really play a key role?
Authors: Collivignarelli Maria Cristina , Abbà Alessandro , Caccamo Francesca Maria , Bertanza Giorgio , Pedrazzani Roberta , Baldi Marco , Ricciardi Paola , Miino Marco Carnevale
Published: June 2020

Northern Italian regions have been the most affected from CoViD-19 compared to other Italian areas and are also the zones where air pollutants concentration has been higher than in the rest of Italy. The aim of the research is analysing possible correlations between air pollutants PM10 and PM2.5 and the rapidity of the spread of the infection caused by CoViD-19 in Northern Italy. PM10 and PM2.5 data for all the 41 studied cities were collected from the local environmental protection agencies. In order to compare air quality data with epidemiological data (Td), a statistical analysis was conducted identifying the correlation matrices of Pearson and Spearman, considering the possible incubation period of the disease. The results exclude a strong direct correlation between PM in the air and the diffusion rate of CoViD-19. Further developments are necessary for a better comprehension of the influence of atmospheric pollution parameters on the rapidity of spread of the virus SARS-CoV-2, since a synergistic action with other factors, such as meteorological factors, could not be excluded.