bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical outcomes of high-flow nasal cannula oxygen therapy in acute heart failure patients with hypoxemia: A retrospective cohort study
Authors: Tong Xiao , Tong Ningning , Yao Feifei , Yan Jing , Ci Caizhe
Published: October 2022

Acute heart failure (AHF) is life-threatening medical condition requiring hospital admission and appropriate oxygen therapy. High flow nasal cannula oxygen therapy (HFNC) has gained its popularity in treatment of AHF, however, there were less studies have demonstrated the physiological efficacy of HFNC. Purpose of this study was to evaluated the physiological responses and clinical outcomes of HFNC by comparing with noninvasive positive pressure ventilation (NPPV) therapy. A retrospective cohort investigation was conducted at emergency intensive care unit (EICU) and cardiovascular center of our hospital from June 2019 to March 2022, AHF patients with hypoxemia were reviewed. According to the received oxygen therapy model, patients were divided into HFNC and NPPV groups. Demographic data, arterial blood gas (ABG) parameter, echocardiography findings, complications and other related variables were extracted and collected from the electronic medical records (EMRs) by well-trained investigators. Physiological responses and clinical outcomes within and between 2 groups were analyzed. Finally, 156 patients with a mean age of 69.3 ± 7.1 years were reviewed, there were 82 (52.6%) male and 74 (47.4%) female patients in the sample and 70 (44.9%) and 86 (55.1%) patients classified III and IV score were included in this study, 80 patients received HFNC and 76 underwent NPPV oxygen therapy. There were no significant differences of baseline characteristics for the 2 groups patients. Changes of left ventricular function parameters, ABG and clinical outcomes were all improved satisfactorily after 24 h medical interventions in both group, what’s more, patients underwent HFNC therapy could acquire a better amelioration when compared with NPPV groups (P < .05). HFNC may be an ideal model for patients with AHF, particularly those with hypoxemia. HFNC therapy could significantly improve several objective parameters of physiological responses and clinical outcomes.
Gene locus polymorphisms and expression levels of interleukin-1 in lumbar disc disease: A MOOSE-compliant meta-analysis and immunohistochemical study
Authors: Yang Kunxue , Xiao Qianyi , Zhang Ruijun , Meng Dihua , Wang Jiaqi , Wei Qingjun , Jiang Hua
Published: October 2022

Objective:

To investigate the association between interleukin (IL)-1α (rs1800587), IL-1β (rs1143634) and IL-1 receptor antagonist (RN) variable number tandem repeat polymorphisms, expression levels and lumbar disc disease (LDD).

Methods:

All relevant articles were searched from 4 databases including PubMed, Embase, Web of Science and China National Knowledge Infrastructure. Odds ratios (OR) with 95% confidence intervals (CI) were calculated to evaluate the association between IL-1 gene locus polymorphisms (rs1800587 in IL-1α, rs1143634 in IL-1β, variable number tandem repeat in interleukin-1 receptor antagonist) and LDD susceptibility. Statistical analysis was conducted by Review Manager (Revman) 5.31 software (Nordic Cochrane Centre, Cochrane Collaboration, Copenhagen, Denmark). Furthermore, qRT-PCR and immunohistochemistry were performed to evaluate IL-1α, IL-1β and interleukin-1 receptor antagonist expressions in the normal and degenerated disc.

Results:

A total of 15 case-control studies (1455 cases and 2362 controls) were included in our meta-analysis. The pooled results suggested that IL-1α rs1800587 polymorphism was associated with an increased risk of LDD in overall population (T vs. C, OR = 1.21, 95% CI = 1.04–1.40, P = .01). The subgroup analysis found a significant association between IL-1β rs1143634 polymorphism and LDD in Asian population (T vs. C, OR = 0.61, 95% CI = 0.39–0.96, P = .03). Results of qRT-PCR and immunohistochemistry demonstrated that expressions of IL-1α and IL-1β were significantly increased in the degenerated disc. (all P < .05)

Conclusion:

IL-1α rs1800587 and IL-1β rs1143634 polymorphisms were significantly associated with LDD in overall population and in Asian population, respectively. The increased expression levels of IL-1α and IL-1β may be the important risk factors for LDD.
Knotting together of gastric and tracheal tubes inserted under general anesthesia: A CARE-compliant case report
Authors: Deng Jingjing , Pan Ting , Li Hui , Lin Qing , Zhang Yuenong
Published: October 2022

Rationale:

Gastric tube implantation is a routine part of preoperative preparation. Indwelling gastric tubes in patients under general anesthesia maintain gastrointestinal decompression and prevent gastrointestinal expansion.

Patient concerns:

Gastric tube insertion can be associated with many complications, of which gastric tube knotting is a rare and often overlooked complication.

Diagnoses:

Knotting together of gastric and tracheal tubes.

Interventions:

During the operation, the gastric tube was explored by endoscope and hand.

Lessons:

Rare complications of knotted gastric and endotracheal tubes are identified and treated promptly.

Conclusion:

We recommend that the gastric tube be intubated first before insertion of the endotracheal tube, and visualization tools should be used in time if the insertion of the gastric tube is unsuccessful.
The past and future of Piezo: A scientometric review
Authors: Li Shuai , Song Banglong , Jiang Nan , Pan Ciming , Ren Xue , Dai Qianqian , Chu Quangen
Published: October 2022

Background:

As we all know, this Nobel Prize is awarded to uncover the mechanism of “a glass of cold milk providing instant relief when eating a spicy hot pot”; the key factor, Piezo, has therefore become a clinical research hotspot. Most importantly, the factor of Piezo has been increasingly considered when analyzing the majority of common clinical diseases. The Piezo has entered a new stage and has made a series of progress. This study mainly outlines the knowledge map and detects the potential research hotspots by using bibliometric analysis.

Methods:

The core collection database of WoS was used to retrieve the bibliographic records related to Piezos from January 1, 2010 to October 8, 2021. CiteSpace was utilized to generate and analyze visual representations of the complex data input.

Results:

Overall, the number of Piezos publications has shown a significant upward trend since 2010. There were 902 research publications referenced a total of 19,095 times. The United States and China are the two nations with the highest number of published articles in this discipline. The institutions with the most publications are Scripps Research Institute and the University at Buffalo (SUNY-Buffalo). The primary topics of investigation are “endothelial cell” “xerocytosis” “current” “calcium”, “mutation” “activated ion channel” “Ca2+ influx” “protein” “smooth muscle” and “nociception”. Ardem Patapoutian and Frederick Sachs are the two most prolific authors of scholarly articles. The gene expression is the current focus of research in this topic.

Conclusions:

Piezo is rapidly developing. This knowledge will be utilized extensively in the process of developing treatments for many diseases. Current research focuses mostly on gene expression.
Unintentional fatal toxicity due to nicotine chewing gum: A case report
Authors: Lee Jung Eun , Jang Tae Chang , Seo Young Woo
Published: October 2022

Rationale:

Since tobacco contains numerous harmful substances, besides nicotine, which is addictive, smoking cessation products and tobacco alternatives, such as electronic (e-) cigarettes, nicotine chewing gums, and patches, are being widely used. Nicotine gums are consumed orally. The nicotine from the gum is absorbed at a slower rate than that from e-cigarettes, and the former remains in the bloodstream for a longer period. In addition, the maximum number of daily doses is high, and it can be purchased without a doctor’s prescription in many countries.

Patient concerns:

A 29-year-old male patient consumed 5 2-mg nicotine gums at a time, twice a day, for 4 days (total amount: 70 mg). However, he visited the emergency unit with the chief complaint of involuntary limb movements after consuming an additional 15 gums 3 hour before the visit. At admission, his consciousness was clear, although 2 hour later, he experienced sudden loss of consciousness with worsening hypoxia and respiratory acidosis.

Diagnosis:

The patient’s vital signs were stable at the time of admission, and blood test results showed no specific findings other than a white blood cell count of 14,800/µL, lactate level of 6.4 mmol/L, and prolactin level of 119.02 ng/mL. In addition, chest radiography and head computed tomography scans showed no acute phase abnormalities. Two hours later, he experienced loss of consciousness and respiratory failure, and the results of blood tests performed at this time showed that his blood cotinine level was 3491 ng/mL.

Interventions:

Supportive treatment, including endotracheal intubation followed by mechanical ventilation, was provided.

Outcome:

The patient’s vital signs stabilized 3 days after treatment, and his consciousness and respiratory status had improved; therefore, mechanical ventilation was stopped. His condition was stable for the next 2 days, and he was discharged on the fifth day.

Lessons:

Acute respiratory exacerbation due to nicotine poisoning (from levels exceeding the lethal dose of 30–60 mg) was observed, although the gums were consumed over several days. Patients with nicotine poisoning may show acute respiratory failure and should be monitored carefully. Further studies are required to determine the toxic effects of nicotine replacement therapies.
Acupuncture for dry eye disease after recovery from COVID-19: A protocol for systematic review and meta-analysis
Authors: Lu Xiaofang , Li Jian , Ye Shuhan , Wang Runyi , Xiao Yao , Liu Lu , Lan Wanning , Chen Yijun , Liao Zongli
Published: October 2022

Background:

Dry eye disease (DED) is a condition occurring worldwide. Studies have found that coronavirus disease 2019 (COVID-19) patients may have persistent dry eye symptoms for weeks and months after recovery, and the prevalence of dry eye is higher in COVID-19 patients than in people without COVID-19 infection. As one of the common ophthalmic diseases, the clinical application of acupuncture in the treatment of DED is not widely used nowadays.

Methods:

According to the retrieval strategies, randomized controlled trials (RCT) on the acupuncture for DED after recovery from COVID-19 were obtained from Embase, The Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure database, Chinese Biomedical Database, Chinese Science and Technology Periodical database, The WanFang database. Studies were screened based on inclusion and exclusion criteria, and the Cochrane risk bias assessment tool was used to evaluate the quality of the studies. The meta-analysis was performed using Review Manager (RevMan 5.3) and STATA 14.2 software. Ultimately, the evidentiary grade for the results will be evaluated.

Results:

The study will provide a high-quality and convincing assessment of the efficacy and safety of acupuncture for DED after recovery from COVID-19 and will be published in peer-reviewed journals.

Conclusion:

Our findings will provide references for future clinical decision and guidance development.
UnPrEPed for HIV prevention services: Hesitancy among US primary care providers
Authors: Spence Amanda Blair , Wang Cuiwei , Michel Katherine G. , Merenstein Daniel , Kharfen Michael , Goparaju Lakshmi , Kassaye Seble
Published: October 2022

Provision of HIV prevention services by primary care (PCP) healthcare providers is critical to reduce the number of new HIV infections. We examined the performance of HIV risk assessments and provision of HIV prevention services by PCPs. In our cohort, less than one-half of respondents asked about sex and drug use all or most of the time, and among those that did not routinely ask about sex and drug use only 66% and 59%, respectively, would ask given more time. Less than a quarter of respondents noted that HIV prevention services were part of their clinical practice. These findings demonstrate gaps in the provision of HIV prevention services by a key population of healthcare providers.
Application of acupuncture in the emergency department for patients with ileus: A pilot prospective cohort clinical study
Authors: Su San-Hua , Lai Pei-Fang , Yu Hsin-Yuan , Chen Kun-Chuan , Wu Kari , Huang Chih-Kai , Tseng Wei-Chun , Lai Chun-Yu , Huang Chun-Ping , Ho Tsung-Jung
Published: October 2022

Acupuncture can be conveniently used for pain control in patients with a variety of conditions, and it has obvious effects on various acute pains. In 2018, we implemented a program for emergency treatment with Chinese medicine to promote the integration of Chinese and Western medicine at the Emergency Department (ED). Ileus is a common cause of abdominal pain among patients in the ED, and it is an indication for emergency treatment with Chinese medicine. This study investigated the efficacy of acupuncture as a traditional Chinese medicine (TCM)-based treatment method for the treatment of patients with ileus in the ED. We analyzed data of patients with ileus, who visited ED between January and December 2019, and compared the length of ED stay between the Western medicine group and the Western medicine plus acupuncture group. Furthermore, pain intensity was measured by a visual analogue scale before and after acupuncture. We found that the length of ED stay was 10.8 hours lesser in the Western medicine plus acupuncture group than in the Western medicine group (P = .04), and the visual analogue scale score decreased by 2.0 on average from before to after acupuncture treatment (P = .02). Acupuncture treatment was effective and rapid in relieving the symptoms and discomfort in patients with ileus and in reducing their length of stay in the ED.
Comparison of the needle tip location with the operator’s position during ultrasound-guided internal jugular vein catheterization: A randomized controlled study
Authors: Min Seong-Won , Kim Hyerim , Won Dongwook , Chang Jee-Eun , Lee Jung-Man , Hwang Jin-Young , Kim Tae Kyong
Published: October 2022

Objective:

We hypothesized that when a right-handed operator catheterizes the left internal jugular vein (IJV), the tip of the needle might be positioned closer to the center of the vessel after puncture if the operator is standing in the patient’s left axillary line, rather than standing cephalad to the patient.

Methods:

The study randomly allocated 44 patients undergoing elective surgery under general anesthesia with planned left central venous catheterization to either conventional (operator stood cephalad to the patient) or intervention (operator stood in the patient’s axillary line) groups. The left IJV was catheterized by 18 anesthesiologists. The distance between the center of the vessel and the needle tip, first-attempt success rate, and procedure time were compared.

Results:

The distance from the needle tip to the center of the IJV after needle puncture was 3.5 (1.9–5.5) and 3.2 (1.7–4.9) cm in the conventional and intervention groups, respectively (P = .47). The first-attempt success rate was significantly higher in the intervention group (100% vs 68.2%, P = .01). Overall time to successful guidewire insertion was faster in the intervention group (P = .007).

Conclusions:

There was no significant difference in needle tip position when the right-handed operator was standing in the patient’s left axillary line compared to standing cephalad to the patient during left IJV catheterization. However, it increased the first-attempt success rate and reduced the overall time for guidewire insertion.
Brief mindful coloring for stress reduction in nurses working in a Hong Kong hospital during COVID-19 pandemic: A randomized controlled trial
Authors: Fong Janet Shuk Yan , Hui Anna Na Na , Ho Ka Man , Chan Albert Kam Ming , Lee Anna
Published: October 2022

Background:

Effective interventions to promote well-being at work are required to reduce the prevalence and consequences of stress and burnout especially during the COVID-19 pandemic. This study determined the effects of mindful coloring on perceived stress levels, mental well-being, burnout, and state and trait mindfulness levels for nurses during COVID-19.

Methods:

This was a single-center, two-armed, parallel, superiority, blinded randomized controlled trial. Seventy-seven participants were randomly allocated (by computer-generated sequence) to either mindful coloring (n = 39) or waitlist control groups (n = 38). Twenty-seven nurses in the mindful coloring group and 32 in the control group were included in the full compliance per protocol analysis. The mindful coloring intervention included participants viewing a 3-minutes instructional video and coloring mandalas for at least 5 working days or 100 minutes in total during a 10-day period. Participants in both groups completed the Perceived Stress Scale (total score 0–40), short Warwick-Edinburgh Mental Well-being Scale (total score 7–35), Maslach Burnout Inventory-Human Services Survey for Medical Personnel (3 subscales), Five Facets Mindfulness Questionnaire-Short Form (total score 24–120) and Mindful Attention Awareness Scale-State version (total score 0–30) instruments. The primary outcome was the perceived stress level.

Results:

Baseline prevalence of moderate to high perceived stress level was high (79.2%). There was a large mindful coloring effect on reducing mean perceived stress levels (Mean difference [MD] in change between groups −3.0, 95% CI: −5.0 to −1.00; Cohen’s d = 0.80). Mindful coloring may lead to a small improvement in mental well-being level (P = .08), with an improvement found in the intervention group (MD 0.9, 95% CI 0.0–1.8, P = .04) through enhanced state mindfulness (P < .001). There were no effects on changing burnout subscales or trait mindfulness levels. No adverse reactions were reported.

Conclusion:

Coloring mandalas may be an effective low-cost brief intervention to reduce perceived stress levels through enhancing state mindfulness and it may promote mental well-being. Hospitals may promote or provide mindful coloring as a self-care and stress-relief practice for nurses during their off hours or work breaks.
3% nebulized hypertonic saline versus normal saline for infants with acute bronchiolitis: A systematic review and meta-analysis of randomized controlled trials
Authors: Yu Jin-Feng , Zhang Yan , Liu Zhan-Bo , Wang Jing , Bai Li-Ping
Published: October 2022

Background:

This study evaluated the efficacy and safety of 3% nebulized hypertonic saline (NHS) in infants with acute bronchiolitis (AB).

Methods:

We systematically searched the PUBMED, EMBASE, Cochrane Library, China National Knowledge Infrastructure Database, WANFANG, and VIP databases from inception to June 1, 2022. We included randomized controlled trials comparing NHS with 0.9% saline. Outcomes included the length of hospital stay (LOS), rate of hospitalization (ROH), clinical severity score (CSS), rate of readmission, respiratory distress assessment instrument, and adverse events. RevMan V5.4 software was used for statistical analysis.

Results:

A total of 27 trials involving 3495 infants were included in this study. Compared to normal saline, infants received 3% NHS showed better outcomes in LOS reduction (MD = −0.60, 95% CI [−1.04, −0.17], I
2 = 92%, P = .007), ROH decrease (OR = 0.74, 95% CI [0.59, 0.91], I
2 = 0%, P = .005), CSS improvement at day 1 (MD = −0.79, 95% CI [−1.23, −0.34], I
2 = 74%, P < .001), day 2 (MD = −1.26, 95% CI [−2.02, −0.49], I
2 = 91%, P = .001), and day 3 and over (MD = −1.27, 95% CI [−1.92, −0.61], I
2 = 79%, P < .001), and respiratory distress assessment instrument enhancement (MD = −0.60, 95% CI [−0.95, −0.26], I
2 = 0%, P < .001). No significant adverse events related to 3% NHS were observed.

Conclusion:

This study showed that 3% NHS was better than 0.9% normal saline in reducing LOS, decreasing ROH, improving CSS, and in enhancing the severity of respiratory distress. Further studies are needed to validate these findings.
Effects of different stretch durations on the strength of the proximal and distal group of muscles – a randomized trial
Authors: Alghadir Ahmad H. , Khan Masood , Quddus Nishat , Chawla Chandan
Published: October 2022

Background:

Different researchers have studied the effects of different types of stretching on different muscle groups. Since distal muscles are fully activated and proximal muscles are sub-optimally activated; thus, we might see different responses to stretching in the proximal and distal groups of muscles depending on their muscle activation. Therefore, this study aimed to compare the acute effects of 2, 4, and 8 minutes of intermittent static stretching (SS) on the isometric maximum voluntary contraction force (MVCF) of proximal (Hamstring) and distal (Calf) groups of muscles.

Methods:

Two groups pretest-posttest experimental design was used. A total of thirty participants were randomly assigned into two groups, and twenty-eight completed the intervention. In both groups, participants participated in three experimental trials (SS2, SS4, and SS8) on 3 days. 2-minute intermittent stretching (SS2) was performed on day-I, 4-minute (SS4) on day II, and 8-minute (SS8) on day III. Isometric MVCF was measured at pre-intervention, 0-, 10-, and 20-minute post-intervention periods in both groups.

Results:

In the proximal group: SS2, SS4, and SS8 did not affect isometric MVCF at the 0-, 10-, and 20-minute post-intervention periods (P > .05). In distal group: SS2 did not affect isometric MVCF at 0- and 10-minute post-intervention periods (P > .05), however at 20-minute, MVCF increased by 11.06% (P < .05). SS4 and SS8 also did not alter isometric MVCF in the Calf at 0-, 10-, and 20-minute post-intervention periods (P > .05). No significant differences were observed between the proximal and distal groups (P > .05).

Conclusion:

2-, 4-, and 8-minute intermittent SS did not affect the isometric strength in both muscle groups. In addition, proximal and distal groups of muscles responded similarly to three different duration intermittent SS.
HIV fragments detected in Kaposi sarcoma tumor cells in HIV-infected patients
Authors: Chen Tung-Ying , Yang Horng-Woei , Lin Dar-Shong , Huang Zo-Darr , Chang Lung
Published: October 2022

Kaposi sarcoma (KS) is a malignant vascular neoplasm caused by KS-associated herpesvirus (KSHV) infection. HIV plays a major role in KS pathogenesis. KS in HIV usually produces more malignant features than classic KS. Despite the close KS–HIV relationship, no study has reported the existence of HIV in KS tissue. We used ddPCR to detect HIV and KSHV in HIV+ KS samples and classic KS control. We verified KS cell types through immunohistochemistry and applied hypersensitive in situ hybridization (ISH) to detect HIV and KSHV in tumor cells. Furthermore, we co-stained samples with ISH and immunohistochemistry to identify HIV and KSHV in specific cell types. Regarding pathological stages, the KS were nodular (58.3%), plaque (33.3%), and patch (8.3%) tumors. Moreover, ddPCR revealed HIV in 58.3% of the KS samples. ISH revealed positive Pol/Gag mRNA signals in CD34 + tumor cells from HIV + patients (95.8%). HIV signals were absent in macrophages and other inflammatory cells. Most HIV + KS cells showed scattered reactive particles of HIV and KSHV. We demonstrated that HIV could infect CD34 + tumor cells and coexist with KSHV in KS, constituting a novel finding. We hypothesized that the direct KSHV–HIV interaction at the cellular level contributes to KS oncogenesis.
Rate and risk factors of metabolic components and component combinations according to hypertension status in Tibetans in a cross-sectional study
Authors: Hu Jihong , Thompson Brian , Wang Shuxia , Guo Minhao , Yan Chunjuan , Ding Fengfeng , Guo Peng , Chen Li , Cao Zhuoma , Wang Jianzong
Published: October 2022

To estimate the prevalence of metabolic syndrome (MS) and metabolic components and their associated factors and component combinations according to hypertension status in Tibetans living at high altitude. Multistage sampling of 1473 participants (799 hypertensive patients and 674 normotensive subjects). MS prevalence and the number of metabolic components ≥ 3 were significantly higher in the hypertensive than normotensives. In hypertensive patients, the most common component was central obesity and it combined with: high blood pressure, in those with 2 risk factors, plus fasting hyperglycemia, in those with 3 risk factors, and high triglyceride, in those with 4 risk factors. In normotensive subjects, the most common single component was low high-density-lipoprotein cholesterol, and most component combination included central obesity and hyperglycemia in those with 2 risk factors, plus high blood pressure in those with 3 risk factors, and high triglycerides in those with 4 risk factors. Body mass index and female both were associated with increased possibilities of MS in hypertensive and normotensive participants. Low incoming, and high educational levels were associated with an elevated probability of MS in normotensive Tibetans also. The priority of prevention from cardiovascular diseases by targeting metabolic components in the hypertensive was different from normotensives. Different MS components had various lifestyle and socioeconomic factors.
Effects of GLP-1 receptor agonists on asprosin levels in normal weight or overweight/obesity patients with type 2 diabetes mellitus
Authors: Dai Chenggang , Zhu Weifeng
Published: October 2022

Asprosin is a newly identified adipokine with glucose-raising and appetite-enhancing effects which acts differently from the known hepatic glucose utilization pathway. This study investigated changes in serum asprosin levels in normal weight or overweight/obese liraglutide-treated patients with type 2 diabetes (T2DM). This study is a non-randomized, prospective observational study. The metabolic parameters and asprosin levels were compared between 90 people with T2DM and 66 people who had normal glucose tolerance (NGT). During the treatment phase, only T2DM patients were given liraglutide at doses of 0.6 mg/d for the first 2 weeks, 1.2 mg/d for the subsequent 4 weeks, and 1.8 mg/d for the following 16 weeks. T2DM patients were separated into a normal weight group and an overweight/obesity group to compare changes in asprosin and parameters pre- and post-treatment. The T2DM group had significantly higher fasting asprosin and 2h-postprandial asprosin levels than the NGT group (all P < .001). Fasting asprosin and postprandial asprosin positively correlated with BMI, 2hPG, HbA1c, TG, and HOMA-IR, and negatively correlated with HDL-C in both the T2DM and NGT groups. Asprosin levels decreased after liraglutide treatment in both normal and overweight/obesity T2DM groups (all P < .001), with significantly reduced body weight and BMI in overweight/obese T2DM patients (all P < .001). Fasting and postprandial serum asprosin concentrations are higher in T2DM patients compared to normal glucose controls. Fasting and postprandial asprosin positively correlated with BMI, 2hPG, HbA1c, TG, and HOMA-IR and negatively correlated with HDL-C in all participants. Liraglutide lowers asprosin levels in T2DM patients and can reduce weight and BMI in overweight or obese type 2 diabetics.
Stratified analysis of multiple management of gastric cancer: A population-based study of incidence, mortality and DALY
Authors: Zheng Linlin , Zhao Ping , Ding Hang , Zhou Yunhui , Liu Ningning , Zhou Xinyi , Kong Xiaohua , Zhou Lin
Published: October 2022

The aim was to illuminate the difference in incidence, mortality, and disability-adjusted life-years (DALYs) of gastric cancer (GC) between the United States of America (US) and China. The multiple management was analyzed with stratification to explore an effective survival improvement strategy. The Global Burden of Disease Study data was analyzed to assess GC morbidity, mortality and DALYs from 1990 to 2019 in the US and China. The age-period-cohort model was established to generate estimation of metrics. Verification was completed and stratified analysis of the multiple management was performed by accessing data of Surveillance, Epidemiology, and End Results database in 1992 to 2019. Continuous downtrends in GC incidence, mortality and DALYs from 1990 to 2019 and persistent uptrends in 1-, 3-year survival from 1992 to 2019 were observed in the US population. In the Chinese population, the overall trends of incidence, mortality and DALYs decreased with a fluctuating manner. The lower overall survival rates were observed in elderly, unmarried patients, distant disease and poor grade, as well as patients lacking of medical treatment (P < .05). In stratified analyses, single local therapy decreased and the other modalities increased over time across different stages. Moreover, combined treatment and single systemic therapy decreased, but single local and conservative therapy increased with age. The study quantified the incidence, GC-specific mortality and DALYs in the US and China and estimated stage profiles, 1- and 3-year survival in the US. The heavy burden on later-onset GC (>70) and potential increase on early-onset GC (<40) needed to be addressed. Combined modalities and single chemotherapy were becoming more widely used over time, however, their uses decreased with age because of poor physical fitness. Our findings provide new insights into management tailoring appropriately to specific subgroups contributes to the increasing survival rate.
Risk factors for pathological upgrading in perimenopausal women with cervical intraepithelial neoplasia grade 2/3 following conization
Authors: Jia Mingyu , Lan Chong , Niu Jumin , Liang Yin
Published: October 2022

Postmenopausal women have a high risk for pathological upgrading in conization specimens due to pathological changes of the cervix. This study aimed to investigate the risk factors for pathological upgrading in conization specimens in Chinese women with cervical intraepithelial neoplasia grade 2/3 (Cervical intraepithelial neoplasia 2/3) ≥ 50 years of age. From January 2015 to December 2019, 443 CIN2/3 patients ≥ 50 years of age were retrospectively included and divided into the upgrade group (n = 47) and the non-upgrade group (n = 396) according to the presence or absence of pathological upgrading in the conization specimens. Multivariate logistic regression model was performed to analyze risk factors associated with pathological upgrading. The upgrade group was more likely to have gravidity < 2 times, postmenopausal period ≥ 5 years, higher incidences of endocervical glandular involvement (EGI) and human papillomavirus (HPV) 16/18 infection, as well as a lower incidence of cervical contactive bleeding and fewer cases undergoing endocervical curettage (all P < .05) than the non-upgrade group. Multivariate model showed that factors associated with pathological upgrading were postmenopausal period ≥ 5 years (OR = 2.55), EGI (OR = 17.71), endocervical curettage (OR = 0.33), and HPV type 16/18 (OR = 3.41) (all P < .05). The receiver operating characteristic analysis showed an area under curve of 0.782 (P < .001). Pathological upgrading in conization specimens is not uncommon in Chinese CIN2/3 patients ≥ 50 years of age. For those with high-risk factors of pathological upgrading (postmenopausal period ≥ 5 years, EGI, and HPV 16/18 infection), the follow-up interval can be appropriately shortened, and active intervention could be considered.
Comparison of the effects of sevoflurane and desflurane on the severity score of postoperative pain and discomfort after thyroidectomy: A prospective, double-blinded, randomized controlled study
Authors: Park Jun-Mo
Published: October 2022

Background:

Thyroidectomy is performed under general anesthesia using inhaled anesthetics such as sevoflurane or desflurane in many cases. The objective of this study was to investigate whether the incidence of postoperative pain and discomfort after thyroidectomy differed with the type of inhaled anesthetic.

Methods:

Eighty-one female patients who underwent thyroidectomy were randomly assigned to the Sevo group (n = 42) or the Des group (n = 39). On the day of surgery and on the first, third, and seventh days after surgery, one registered nurse in charge of the entire questionnaire survey conducted the questionnaire assessment through face-to-face interviews or phone calls with the patients. The questionnaire evaluated the severity scores for seven items (sore throat, wound pain, nausea and vomiting, dizziness, occipital headache, posterior neck pain, and shoulder pain) regarding postoperative pain and discomfort experienced by patients and assessed which of these seven items caused the greatest discomfort to the patient on each day.

Results:

Except for the severity score for dizziness on the day of surgery, the severity scores of postoperative pain and discomfort experienced by patients on the day of surgery and on the first, third, and seventh days after surgery showed no statistically significant differences between the two groups. In addition, on the day of surgery and on the first, third, and seventh days after surgery, patients reported that sore throat caused the greatest discomfort.

Conclusion:

In patients undergoing thyroidectomy under general anesthesia using sevoflurane or desflurane, except for dizziness on the day of surgery, no other manifestation of postoperative pain and discomfort was influenced by the type of inhaled anesthetic. Moreover, after thyroidectomy, postoperative sore throat caused the greatest discomfort to patients from the day of surgery to the seventh day after surgery.
Effect of endotracheal tube size on airway resistance and dynamic lung compliance
Authors: Li Yiming , Lu Yan , Tan Xinmin , Zhang Zilong , Feng Feng , Li Ruhong
Published: October 2022

There are different results on the effect of endotracheal tube (ETT) size on respiratory mechanics in patients undergoing mechanical ventilation, and there are few reports in adult laparoscopic surgery. The aim of this study was to investigate the effect of ETT size on airway resistance (RAW) and dynamic lung compliance (COMPL) in patients undergoing laparoscopic colorectal surgery. Seventy-two patients undergoing laparoscopic radical surgery for colorectal cancer under general anesthesia with endotracheal intubation were selected and divided into 3 groups (n = 24) using the random number table method Group A (ETT ID 7.0), Group B (ETT ID 7.5), and Group C (ETT ID 8.0). After mechanical ventilation, intraoperative RAW and COMPL were monitored in each of the 3 groups. In the non-pneumoperitoneal state, RAW in group ID7.0 is significantly higher than this in group ID7.5 and group ID8.0 (P < .05); the RAW between the 2 groups with ID7.5 and ID8.0 was not statistically significant (P > .05). The difference of COMPL between the 3 groups was statistically significant (P < .05); the COMPL of Group ID7.0 is lower than Group ID7.5, and Group ID7.5 is lower than Group ID8.0. In the pneumoperitoneal state, the RAW between ID7.0 group and ID8.0 group was statistically significant, the RAW difference between ID7.0 group and ID7.5 group, ID7.5 group and ID8.0 group not statistically significant (P > .05);the COMPL between the 3 groups was not statistically significant (P > .05). In the non-pneumoperitoneal state, the smaller the ETT internal diameter within a certain range, the higher RAW and the lower COMPL; in the pneumoperitoneal state, the RAW with the ID7.0 ETT was higher than that with the ID8.0 ETT, and the ETT size within a certain range had no effect on COMPL.
Traditional Chinese medicine combined with Moxibustion in the treatment of “long-COVID”: A protocol for systematic review and meta-analysis
Authors: Luo Dongqiang , Liu Bin , Wang Pengxin , Liao Hui , Mao Shuxian , Chen Huicong , Huang Yuxin , Liu Lu , Lan Wanning , Liu Feng
Published: October 2022

Background:

From the end of 2019 to now, COVID-19 is still prevalent, which poses a great threat to international public health. With the increasing number of people infected, the number of patients with COVID-19 sequelae is also increasing, but there is no specific drug for COVID-19 sequelae. In China, traditional Chinese medicine combined with acupuncture has been widely used in COVID-19 sequelae, but there is still a lack of evidence-based medicine evaluation. The purpose of this study was to evaluate the efficacy and safety of traditional Chinese medicine combined with moxibustion in the treatment of COVID-19 sequelae.

Methods:

According to the retrieval strategy, the “long COVID” randomized controlled trial of traditional Chinese medicine combined with moxibustion will be search in eight databases composed of PubMed, Embase, Web of Science, China National knowledge Infrastructure Database, China Biomedical Database and China Science and Technology Journal Database, regardless of publication date or language. The study was screened according to the inclusion and exclusion criteria, and the Cochrane risk bias assessment tool was used to evaluate the quality of the study. Meta-analysis was carried out using RevMan5.3 and STATA12.0 software. Finally, the level of evidence of the results will be evaluated.

Results:

This study will evaluate whether traditional Chinese medicine combined with moxibustion can effectively treat the symptoms of COVID-19 sequelae.

Conclusion:

This study will provide evidence whether there is benefit of traditional Chinese medicine combined with moxibustion in the treatment of COVID-19 sequelae. At the same time, our research results will provide a reference for clinical decision-making and guiding development in the future.
External treatment of traditional Chinese medicine for functional dyspepsia in children: Protocol for a systematic review and network meta-analysis
Authors: Cui Junyu , Wang Jiaxin , Wang Ying , Zhang Chuang , Hu Guanyu , Wang Zhihong
Published: October 2022

Background:

Functional dyspepsia (FD) is a common digestive system disease in pediatrics, usually affects normal growth and increases health care expenditure. Many investigations have demonstrated that external treatment of traditional Chinese medicine (TCM) has certain advantages in the treatment of FD children, but the effectiveness, safety, and advantages of various methods have not been confirmed by high-quality meta-analyses. This study will conduct a systematic review and network meta-analysis to evaluate the differences and effectiveness in external treatments of TCM, in order to provide a reference for further clinical treatment for FD in children.

Methods:

Nine electronic databases, including PubMed, Medline, Embase, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, Wan-Fang Database and one clinical trial register platforms: ClinicalTrials.gov (www.ClinicalTrials.gov/) will be searched using English and Chinese search strategies. All eligible studies are randomized controlled trials of TCM external treatment for FD in children, published on or before July 20, 2022. The screening process will be developed by 2 independent authors, and network meta-analysis will be performed with RevMan (V5.3) software.

Results:

This study will provide a high-quality synthesis to assess the effectiveness and safety on the external treatment of TCM for children with FD.

Conclusion:

The results of this study will provide evidence to judge whether the external treatment of TCM are effective interventions for children with FD.

Ethics and dissemination:

The results of this meta-analysis and meta-regression will be disseminated through publication in a peer-reviewed journal and presented at a relevant conference. The information used in the network meta-analysis does not contain individual patient data. Therefore, ethical approval was not required.

PROSPERO registration number:

CRD42022360429.
The use of a low-flux hemo-dialyzer is associated with impaired platelet aggregation in patients undergoing chronic hemodialysis
Authors: Chen Ching-Yang , Liou Hung-Hsiang , Chang Min-Yu , Wang Hsi-Hao , Lee Yi-Che , Ho Li-Chun , Lin Tsun-Mei , Hung Shih-Yuan
Published: October 2022

In patients with chronic hemodialysis (HD), both abnormal thrombotic and bleeding events are commonly observed. Uremic platelet dysfunction is one of the important attributing factors. Moreover, HD may also result in aggregation dysfunction of platelets during the therapeutic procedure. However, how the HD process affects platelet and coagulation function is unknown and dialyzer membrane flux could have an impact on it. We aimed to compare the impacts of low-flux and high-flux HD on the platelet function of patients undergoing chronic HD. This was a cross-sectional study conducted in the HD unit of E-Da hospital in Taiwan. A total of 78 patients with maintenance HD three times per week for more than one year, including 40 with high- and 38 with low-flux hemodialysis, were recruited. Their platelet functions were evaluated using an in vitro platelet function analyzer (PFA-100) before and after the HD session. Of the 78 patients undergoing HD, 60 (76%) had prolonged pre-dialysis collagen/epinephrine (CEPI) and collagen/adenosine diphosphate closure times. Those receiving low-flux dialyzer had a significant increase in CEPI closure time (pre-dialysis 212.3 ± 62.1 seconds. post-dialysis 241.5 ± 64.3 seconds, P = .01), but not collagen/adenosine diphosphate closure time, after HD. After adjusting confounding factors, only the low-flux dialyzer demonstrated an independent association with the prolonged CEPI closure time after HD therapy (odds ratio = 23.31, 95% CI: 1.94–280.61, P = .01). We observed that impaired platelet aggregation is prevalent in patients undergoing chronic HD. Therefore, the use of low-flux dialyzers may further worsen platelet aggregation after dialysis. Patients with uremic bleeding diathesis should take precautions. We suggest that further studies using flow cytometry should be conducted to explore the mechanism of dialysis flux and platelet activity during HD.
Clinical efficacy and safety of the combination of mesenchymal stem cells and scaffolds in the treatment of knee osteoarthritis: Protocol for systematic review and meta-analysis
Authors: Wu Qinglin , Wu Zuqing , Lu Zhifu
Published: October 2022

Background:

Mesenchymal stem cells (MSCs) injection combined scaffolds for knee osteoarthritis (OA) is a relatively new treatment for knee OA and has not yet gained popularity. So, the effectiveness, safety is worthy to be explored. We performed a protocol for systematic review and meta-analysis to evaluate the efficacy and safety of the combination of MSCs and scaffolds in the treatment of knee OA.

Methods:

A literature search was performed in October 2022 without restriction to regions, publication types or languages. The primary sources were the electronic databases of PubMed, EMBASE, Cochrane Library, Web of Science and the ClinicalTrials.gov. Risk of bias was assessed using the Cochrane Collaboration’s risk of bias tool for randomized controlled trials. Statistical analyses were performed utilizing Review Manager 5 (The Nordic Cochrane Center, Copenhagen, Denmark).

Results:

Visual analog scale score, Western Ontario and McMaster Universities Osteoarthritis Index, Lysholm knee scale and adverse events will be assessed.

Conclusion:

The systematic review will provide evidence to assess the effectiveness and safety of MSCs combined scaffolds for the treatment of knee OA.
Granulomatosis with polyangiitis presenting with multisystem impairment
Authors: Li Wenjing , Zhao Feng , Wang Jing
Published: October 2022

Rationale:

Granulomatosis with polyangiitis (GPA) mostly affects the upper and lower respiratory tracts and the kidneys. Although it may also affect other systems, multiorgan damage to the upper respiratory tract, lungs, kidneys, skin, hearing, and vision is rare.

Patient concerns:

A 52-year-old man was admitted to our hospital with fever, epistaxis, anosmia, blood in sputum, proteinuria, limb rashes, hearing loss, diplopia, night sweats, and chest pain. The patient had no history of any illness.

Diagnoses:

GPA was established based on multisystem clinical manifestations, nasal tissue biopsy, and positive serum antibodies.

Interventions:

Medical treatment with glucocorticoid and immunosuppressants was given to the patient.

Outcomes:

The patient’s condition improved; computed tomography scan of the lung indicated shrinkage of the lesion, and there were no complications or recurrence within the 5-month follow-up period.

Lessons:

For GPA patients with multisystem involvement, detailed physical examination is required to improve the survival rate and prognosis.
Direct Oral Anticoagulant Reversal in the Pediatric Emergency Department
Authors: Otero Jessica , Mazor Suzan S. , Leoni James
Published: October 2022

Direct oral anticoagulants have been used in the adult population for years and are being used more frequently in pediatrics. Direct oral anticoagulants are chosen preferentially because they do not require close outpatient monitoring, have an equal or better safety profile, and are easy for patients to take. Warfarin is the previous, more commonly used oral anticoagulant and acts as a vitamin K antagonist. Direct oral anticoagulants mechanism of action is different in that they directly inhibit part of the coagulation cascade accomplishing the same end goal. Given their differing mechanisms, they require alternate medications for proper reversal when concerned about overdose of life-threatening bleeds. This review will outline the most commonly used direct oral anticoagulants in pediatric populations and the supporting (mainly adult) data available for proper reversal of these medications in times of need.
Predictors of Persistent Somatic Symptoms in the General Population: A systematic review of cohort studies
Authors: Kitselaar Willeke M. , van der Vaart Rosalie , Perschl Johanna , Numans Mattijs E. , Evers Andrea W.M.
Published: October 2022

Objective

Up to 10% of the general population experiences persistent somatic symptoms (PSS). Numerous studies in a variety of health domains are dedicated to identifying factors that are associated with PSS onset. The present study aimed to provide an overview of predictors for PSS onset in the general population and the related health domains.

Methods

A systematic search was performed identifying longitudinal cohort studies that examined factors associated with PSS onset in the general population. Included studies measured potential predictors before PSS onset and were categorized according to the dynamic biopsychosocial model. Four levels of evidence were discerned for predictors, based on the number of studies and percentage of consistent findings.

Results

In the 154 articles eligible for analysis, 27 PSS-subtypes were studied, with primary focus on fibromyalgia (25.0%) and irritable bowel syndrome (23.3%). Of the >250 predictors of PSS onset, 46 were investigated more than once and showed consistent results. Strong evidence identifies biological (e.g., infections, body weight-related metrics), psychological (e.g., sleep problems, psychopathology), interpersonal (life events, childhood/interpersonal stress), contextual (employment), and health behavioral (health care utilization) predictors.

Conclusions

The results provide strong evidence for factors from all dynamic biopsychosocial domains, although interpersonal and health behavioral factors are relatively under investigated. Thus, evidence suggests that reduction of predictors of PSS onset to a specific factor/domain may be too restrictive. There is no evidence that this differs per PSS-subtype. Exploring all domains and measuring common factors across subtypes is essential to improve the clinical course of PSS.