bluuebunny/crossref_metadata_2025 huggingface dataset:
A chest tube may not necessary in children thoracoscopic lobectomy
Authors: Cheng Kaisheng , Yuan Miao , Xu Chang , Yang Gang , Liu Min
Published: June 2019

Drainage of the thorax postoperatively using chest tubes is a standard procedure in thoracic surgery. However, chest tubes can induce pain and immobilization, increase risk of infection, deteriorate the ventilation capacity, and increase difficulty of postoperative management, particularly in children. This study aimed to investigate the safety and effect of excluding chest tubes after performing thoracoscopic lobectomy in selected children.

A retrospective review of medical records was performed in West China Hospital of Sichuan University from January 2014 to June 2018. Patients who underwent thoracoscopic lobectomy without chest tubes were recorded. Patients with accompanying severe pulmonary infection, extensive thoracic adhesions, or undeveloped interlobar fissure were excluded.

In total, 246 patients underwent thoracoscopic lobectomy without a chest tube, and none required chest drain insertion or reintervention during hospitalization and follow-up at 90 days postoperatively. Among them, 2 (0.81%) patients developed a delayed pneumothorax which was found after being discharged, and resolved spontaneously in 2 weeks. No hemothorax, atelectasis, and bronchial fistula were found. Furthermore, 202 (82.1%) patients developed subcutaneous emphysema, which was asymptomatic and spontaneously resolved within 3 to 7 days. The length of postoperative hospital stay was 2 days; patients were discharged in the 3rd day postoperatively. Patients could recover to free mobilization and resume regular diet at 6 hours postoperatively. All patients were followed up for at least 3 months; no other complications were found, and all patients recovered well.

This study showed that chest tube placement in selected patients may be unnecessary in children undergoing thoracoscopic lobectomy. The minimally invasive procedure and meticulous resection have been the preconditions of this procedure, which may contribute to a rapid recovery and can avoid the chest tube-related complications effectively.
Long-term treatment with eteplirsen in nonambulatory patients with Duchenne muscular dystrophy
Authors: Alfano Lindsay N. , Charleston Jay S. , Connolly Anne M. , Cripe Linda , Donoghue Cas , Dracker Robert , Dworzak Johannes , Eliopoulos Helen , Frank Diane E. , Lewis Sarah , Lucas Karin , Lynch Jessie , Milici A. J. , Flynt Amy , Naughton Emily , Rodino-Klapac Louise R. , Sahenk Zarife , Schnell Frederick J. , Young G. David , Mendell Jerry R. , Lowes Linda P.
Published: June 2019

This analysis aims to describe the outcomes of two nonambulatory patients with Duchenne muscular dystrophy (DMD) who participated in two clinical studies. The two consecutive trials of eteplirsen (studies 201 and 202) were conducted in patients with DMD (N = 12) and confirmed genetic mutations amenable to exon 51 skipping.

In study 201, 12 patients were randomized to receive once-weekly, double-blind intravenous infusions of eteplirsen 30 or 50 mg/kg or placebo for 24 weeks; patients then received open-label eteplirsen during weeks 25 through 28. All 12 patients continued onto open-label extension study 202 and received long-term treatment with eteplirsen. We compared cardiac, pulmonary, and upper limb function and dystrophin production in the nonambulatory twin patients versus the 10 ambulatory patients through 240 combined treatment weeks.

Ten study patients remained ambulatory through both studies, while the identical twin patients both experienced early, rapid loss of ambulation. The twin patients had greater disease severity at baseline (6-minute walk test [6MWT], 330 and 256 m) versus the other patients (n = 10; 6MWT range, 341–418 m). They maintained cardiac and upper limb function through combined week 240, with outcomes similar to those of the patients who remained ambulatory. Dystrophin production was confirmed following eteplirsen treatment.

Despite the loss of ambulation, other markers of disease progression remained relatively stable in the eteplirsen-treated twin patients and were similar to those of the ambulatory patients.
Single-cell RNA sequencing reveals novel gene expression signatures of trastuzumab treatment in HER2+ breast cancer
Authors: Wang Jun , Xu Rengen , Yuan Haiyan , Zhang Yunning , Cheng Sean
Published: June 2019

Human epidermal growth factor receptor 2-positive (HER2+) breast cancer accounts for ∼20% of invasive breast cancers and is associated with poor prognostics. The recent outcome of HER2+ breast cancer treatment has been vastly improved owing to the application of antibody-targeted therapies. Trastuzumab (Herceptin) is a monoclonal antibody designed to target HER2+ breast cancer cells. In addition to improved survival in the adjuvant treatment of HER2+ breast cancer, trastuzumab treatment has also been associated with cardiotoxicity side effect. However, the molecular mechanisms of trastuzumab action and trastuzumab-mediated cardiotoxicity are still not fully understood. Previous research utilized bulk transcriptomics analysis to study the underlining mechanisms, which relied on averaging molecular signals from bulk tumor samples and might have overlooked key expression features within breast cancer tumor. In contrast to previous research, we compared the single cancer cell level transcriptome profile between trastuzumab-treated and nontreated patients to reveal a more in-depth transcriptome profile. A total of 461 significantly differential expressed genes were identified, including previously defined and novel gene expression signatures. In addition, we found that trastuzumab-enhanced MGP gene expression could be used as prognostics marker for longer patient survival in breast invasive carcinoma patients, and validated our finding using TCGA (The Cancer Genome Atlas) breast cancer dataset. Moreover, our study revealed a 48-gene expression signature that is associated with cell death of cardiomyocytes, which could be used as early biomarkers for trastuzumab-mediated cardiotoxicity. This work is the first study to look at single cell level transcriptome profile of trastuzumab-treated patients, providing a new understanding of the molecular mechanism(s) of trastuzumab action and trastuzumab-induced cardiotoxicity side effects.
Prednisone is not beneficial for the treatment of severe drug-induced liver injury
Authors: Wan Yue-Meng , Wu Jie-Fang , Li Yu-Hua , Wu Hua-Mei , Wu Xi-Nan , Xu Ying
Published: June 2019

There is limited information about the effects of corticosteroids on severe drug-induced liver injury (DILI). This study aimed to investigate the efficacy and safety of prednisone in severe DILI.

Ninety patients with severe DILI were enrolled and studied retrospectively. They were divided into prednisone (n = 66) and control groups (n = 24), undergoing the same treatment regimen except that patients in the prednisone group received a median daily dose of 40 mg prednisone. The primary endpoint was severity reduction (serum total bilirubin [TBIL] <86 μmol/L).

During the study, the cumulative rates of severity reduction at 4-, 8-, and 12 days were comparable between the 2 groups (prednisone versus control: 7.6%, 33.3%, and 60.6% versus 12.5%, 37.5%, and 66.7%, P = .331), and were markedly lower in the high-dose group than in the low-dose group (0%, 28.6%, and 35.7% versus 9.6%, 34.6%, and 67.3%, P = .012) or in the control group (0%, 28.6%, and 35.7% versus 12.5%, 37.5%, and 66.7%, P = .023). The 30-day overall survival rate in the prednisone group was significantly higher than in the control group (100% versus 91.7%, P = .018). Serum bilirubin and transaminase values gradually decreased in both groups, which were not significantly different mostly. Cox-regression models revealed that baseline TBIL (hazard ratio: 0.235; 95% confidence interval: 0.084–0.665; P = .006) was the only predictor for severity reduction. No severe adverse event was noted in both groups.

Prednisone therapy is safe but not beneficial, and even detrimental at a daily dose > 40 mg for the treatment of severe DILI.
Contribution of the polymorphism rs1800469 of transforming growth factor β in the development of myocardial infarction: meta-analysis of 5460 cases and 8413 controls (MOOSE-compliant article)
Authors: Du Ling , Gong Tao , Yao Minghui , Dai Henghua , Ren Hong Gang , Wang Haitao
Published: June 2019

Studies investigating the association between transforming growth factor (TGF-β-509C/T, rs1800469) promoter polymorphism and myocardial infarction (MI) risk reported inconsistent results. The aim of our study was to assess the association between the 509C/T polymorphism of the TGF-β gene (rs1800469) and MI risk.

A total of 5460 cases and 8413 controls in 7 case–control studies were incorporated in our current meta-analysis. The original studies were selected through searching the databases of the PubMed and EMBASE. The odds ratio (OR) and 95% confidence interval (95% CI) of TGF-β 509C/T (rs1800469) for MI risk were applied to estimate the strength of the association.

Our results showed that T allele carriers had a 13% increased risk of MI, when compared with the C allele carriers (OR = 1.13, 95% CI: 1.00–1.27). In the subset analysis by the type of MI, significantly elevated risk of MI was associated with the homozygote TT and heterozygote C/T in no-AMI subjects, when compared with the CC homozygote carriers (OR = 1.12, 95% CI:1.02–1.23).

Our meta-analysis shows that the polymorphism with homozygote TT and heterozygote C/T of TGF-β 509C/T (rs1800469) is significantly associated with the increased risk of MI.
Clinical risk factors for new-onset atrial fibrillation in acute myocardial infarction
Authors: He Jing , Yang Yi , Zhang Gui , Lu Xiu-Hong
Published: June 2019

New-onset atrial fibrillation (NOAF) remains common arrhythmia in acute myocardial infarction (AMI), and is closely associated with increased subsequent cardiovascular mortality. Our meta-analysis aims to summarize more clinical risk factors for NOAF.

Comprehensive systematic search of MEDLINE, EMBASE, and the Cochrane Library were carried out to find relevant studies inception to December 2017. Pooled mean difference (MD) and 95% confidence interval (CI) were calculated to evaluate the value of clinical risk factors in the prediction of NOAF after AMI.

Eleven studies containing 9570 patients were included in the meta-analysis. Overall, older age and increased heart rate (HR) levels had a significant positive association with NOAF in patients with AMI. The MD in age between the patients with, and those without NOAF, was 8.22 units (95% confidence interval [CI]: 7.44–9.01), test for overall effect z score = 20.51 (P < .00001, I
2 = 0%). Moreover, the MD in a subgroup analysis for HR levels between the patients with, and those without NOAF was 4.34 units (95% Cl: 2.56–6.11), test for overall effect z score = 4.78 (P < .00001, I
2 = 31%).

In patient with AMI, our meta-analysis demonstrated that older age and increased HR levels on admission are related to greater risk of NOAF.
Tumor necrosis factor-α-308 polymorphism is not associated with Kawasaki disease
Authors: Yuan Ye , Piao Jinhua , Lu Na
Published: June 2019

Background:

Genetic factors in the pathogenesis of Kawasaki disease (KD) have received a lot of attention during the past decade. Some studies have reported that tumor necrosis factor (TNF)-α-308 polymorphism has been associated with KD. However, there have been inconsonant results among different studies. To increase the power for clarifying the influence of TNF on KD, a meta-analysis of case–control studies were performed.

Methods:

The following databases were searched to identify related studies: PubMed, Embase, Cochrane Library, CNKI, Wanfang, and VIP databases according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Search terms included “Kawasaki disease” or “KD,” “tumor necrosis factor-alpha” or “TNF-α,” and “polymorphism” or “mutation.” Two reviewers independently extracted data and assessed study quality using Newcastle–Ottawa Scale. Odds ratios (ORs) with corresponding 95% confidence intervals (CI) were used to assess the strength of the association. Accounting for heterogeneity, a fixed or random effects model was respectively adopted. Heterogeneity was checked using the Q test and the I
2 statistic. A cumulative meta-analysis was conducted to estimate the tendency of pooled OR. Funnel plots and Egger tests were performed to test for possible publication bias and sensitivity analyses were done to ensure authenticity of the outcome.

Results:

Eleven separate studies were suitable for the inclusion criterion. The selected studies contained 2582 participants, including 841 in KD group and 1741controls. The pooled odds ratio of G versus A with the random effect model was 1.09 (95% CI = 0.69–1.70, P = .72) and the genotype effects for GG versus GA+AA was 1.14 (95% CI = 0.68–1.90, P = .62) in the whole population separately. Unfortunately, no significant association was detected between the TNF-α-308 polymorphism and KD risk under allele and genotype model.

Conclusion:

No association between the TNF-α-308 polymorphism and KD was found in our meta-analysis and further studies with larger sample size and more ethnicities are expected to be conducted in the future to validate the results.
Cardiovascular risk in primary aldosteronism
Authors: Wu Xueyi , Yu Jie , Tian Haoming
Published: June 2019

Aim:

This study aimed to evaluate whether the increased cardiovascular risk and the incidence of cerebrovascular (CCV) events in hypertensive patients were related to primary aldosteronism (PA).

Methods:

The PubMed, EmBase, and the Cochrane Central Register of Controlled Trials were searched to evaluate the risk of CCV in PA patients and compared to essential hypertension (EH) patients. The mean differences (MD) and the risk ratios (RR) were calculated to assess the risk of main outcomes, such as stroke, coronary artery disease, left ventricular hypertrophy (LVH), levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose, and urinary potassium.

Results:

We identified 31 individual studies including 4546 patients in PA group and 52,284 patients in EH group. Our results revealed that PA was significantly associated with increased risk of stroke (RR=2.03, 95% CI = 1.71–2.39, P
heterogeneity = .331, I

2
 = 12.7%), coronary artery disease (RR = 1.67, 95% CI = 1.23–2.25, P
heterogeneity = .043, I

2
 = 48.3%), and LVH (RR = 1.54, 95% CI = 1.29–1.83, P
heterogeneity = .004, I

2
 = 62.6%) when compared with those in the EH group. Moreover, PA group had significantly increased levels of SBP (WMD = 4.14, 95% CI = 2.60–5.68, P
heterogeneity < .001, I

2
 = 84.3%), DBP (WMD = 2.65, 95% CI = 1.83–3.47, P
heterogeneity < .001, I

2
 = 77.7%), and urinary potassium (SMD = 0.04, 95% CI = -0.03–0.11, P
heterogeneity = .827, I

2
 = 0%) when compared to EH group. However, no significant difference was observed in the levels of blood glucose between the groups.

Conclusions:

These findings suggested that PA significantly increased the risk of cardiac and cerebrovascular complications. In addition, patients with PA might benefit from a periodic assessment of CCV risk.
The usefulness of ultrasonography to diagnose the early stage of carpal tunnel syndrome in proximal to the carpal tunnel inlet
Authors: Bang Myeonghwan , Kim Jong Moon , Kim Hyoung Seop
Published: June 2019

This study aimed to investigate the relationship between the change of median nerve cross-sectional area (CSA) and the severity of carpal tunnel syndrome (CTS) determined by electrodiagnostic study based on the area immediately proximal to the carpal tunnel inlet (IPCTI).

From December 2016 to August 2017, 34 patients (8 men and 26 women; mean age, 61.68 years ± 11.83; range, 28–80 years) with CTS symptoms were recruited. Electrodiagnostic study was performed in all patients to categorize the severity of CTS according to Bland classification. The CSA of median nerve and carpal tunnel at IPCTI, and carpal tunnel inlet/outlet level was measured by one physician. The Kruskal-Wallis test was used for comparing the CSA of the median nerve and carpal tunnel among CTS severity groups divided by electrodiagnostic study. The Dunn procedure was used for post-hoc comparison.

At IPCTI and the carpal tunnel inlet level, the CSA of the median nerve was statistically larger depending on the severity of CTS (P < .01, P < .01). In the post-hoc comparison, only the CSA measured at the IPCTI level could differentiate normal reference values from mild CTS indicating the early stage (P < .05).

Measuring the CSA of median nerve in IPCTI level is the most sensitive method to diagnose the early stage CTS.
Relationship between objectively measured lifestyle factors and health factors in patients with knee osteoarthritis
Authors: Jeong Ji-Na , Kim Si-Hyun , Park Kyue-Nam
Published: June 2019

The purpose of this study was to investigate the association between objectively-measured lifestyle factors and health factors in patients with knee osteoarthritis (OA).

In this cross-sectional study, 52 patients with knee OA were examined. Lifestyle factors were measured using a wearable smartwatch (step counts, walking distance, calorie consumption, sleep hours) and by self-report (eating speed). Body mass index (BMI), waist circumference, blood pressure, muscle strength of knee extensor and hip abductor, knee pain, symptoms, daily living function, sports recreation function, quality of life by knee injury and OA outcome score (KOOS) were measured to obtain data on health factors. Correlations and regression analysis were used to analyze the relationship between lifestyle factors and health factors.

KOOS subscales (pain, symptom, daily living function) and hip abductor strength were positively correlated with daily step count, which was the only independently contributing lifestyle factor. Additionally, knee pain duration and diastolic blood pressure were negatively correlated with daily step count. BMI and waist circumference showed no correlation with physical activity data, but were negatively correlated with sleep duration and eating speed.

The findings of this study contribute to expanding the knowledge on how lifestyle habits of older patients with knee OA contribute to their health status. Daily step counts were associated with knee OA-related pain, symptom, function in daily living, duration of knee pain, blood pressure, and strength of hip abductor. BMI and waist circumference were associated with sleep duration and eating speed.
A retrospective analysis of treatment outcomes of drug-susceptible TB in Kazakhstan, 2013–2016
Authors: Sadykova Laura , Abramavičius Silvijus , Maimakov Talgat , Berikova Elmira , Kurakbayev Kural , Carr Nathan T. , Padaiga Žilvinas , Naudžiūnas Albinas , Stankevičius Edgaras
Published: June 2019

Kazakhstan has a high burden of multidrug-resistant tuberculosis (TB). The patient-centered National Program for the treatment and prevention of TB has been implemented in Kazakhstan. The program is aimed at meeting the needs of patients and expansion of the outpatient treatment of TB in the country.

The aim of the study was to compare the efficacy of the outpatient and inpatient treatment of drug-susceptible TB.

This study was a retrospective cohort study.

A total of 36.926 TB cases were included. The majority of patients were treated as inpatients. The socioeconomic factors, sex, age, HIV status, and other diagnostic factors (e.g., sputum smear results, extrapulmonary disease) may serve as risk factors to estimate the likely TB treatment outcome. The outpatient treatment of drug-susceptible TB seems to be a comparable option to the inpatient treatment in terms of efficacy.

The socioeconomic factors are the main modifiable risk factors for treatment failure. The outpatient treatment of drug-susceptible TB is safe and effective.
Circular RNA expression profile in peripheral blood mononuclear cells from Crohn disease patients
Authors: Yin Juan , Hu Tong , Xu Lijuan , Li Ping , Li Meifen , Ye Yulan , Pang Zhi
Published: June 2019

Crohn disease (CD) is a multifactorial autoimmune disease which is characterized by chronic and recurrent gastrointestinal tract inflammatory disorder. However, the molecular mechanisms of CD remain unclear. Increasing evidences have demonstrated that circular RNAs (circRNAs) participate in the pathogenesis of a variety of disease and were considered as ideal biomarkers in human disease. This study aimed to investigate circRNA expression profiles and detect new biomarkers in inflammatory bowel disease (IBD). Differentially expression of circRNAs between CD and HCs (health controls) were screened by microarray analysis. Peripheral blood mononuclear cells (PBMCs) from 5 CD patients and 5 HCs were included in the microarray analysis. Then, the differences were validated by quantitative polymerase chain reaction (qPCR) following reverse transcription polymerase chain reaction (RT-PCR) in the patients of CD and sex- and age-matched HCs. The most differential expressed circRNA was further validated in ulcerative colitis (UC) patients. Statistical significance between CD, UC, and HCs was analyzed by Student t test for unpaired samples or one-way analysis of variance (ANOVA). Diagnostic value of each circRNA was assessed by receiver operating characteristic (ROC) curve. We identified 155 up-regulated circRNAs and 229 down-regulated ones by microarray analysis in PBMCs from CD patients compared with HCs. Besides, 4 circRNAs (092520, 102610, 004662, and 103124) were significantly up-regulated validated by RT-PCR and qPCR between CD and HCs. ROC curve analysis suggested important values of circRNAs (092520, 102610, 004662, and 103124) in CD diagnosis, with area under the curve (AUC) as 0.66, 0.78, 0.85, and 0.74, respectively. Then, we further identified that the relative expression levels of circRNA_004662 was upregulated significantly in CD patients compared with UC patients. Herein, the upregulation of the 4 circRNAs (092520, 102610, 004662, or 103124) in PBMCs can be served as potential diagnostic biomarkers of CD, and circRNA_004662 might be a novel candidate for differentiating CD from UC. Moreover, a circRNA–microRNA-mRNA network predicted that circRNA_004662 appeared to be correlated with mammalian target of rapamycin (mTOR) pathway.
Can heme oxygenase-1 be a prognostic factor in patients with hepatocellular carcinoma?
Authors: Park Cheon-Soo , Eom Dae-Woon , Ahn Yongchel , Jang Hyuk Jai , Hwang Shin , Lee Sung-Gyu
Published: June 2019

Heme oxygenase-1 (HO-1) is an important catalytic enzyme in heme degradation, which increases during stressful conditions. It plays a major role in antioxidative and antiapoptotic processes and is associated with tumor growth and metastasis.

This study aimed to evaluate the degree of HO-1 expressions in hepatocellular carcinoma (HCC) surgical specimens and the correlation between HO-1 expression and patient prognosis. Formalin-fixed, paraffin-embedded HCC tissue samples (n = 96) were included in the analysis, and the expression of HO-1 was evaluated by immunohistochemical staining. We reviewed clinical features of patients and evaluated the prognostic role of HO-1 in patient survival and recurrence.

Positive HO-1 expression was identified in 43 cases (44.8%) and was frequently found in patients with advanced histology (Edmondson–Steiner [E-S] grade 2, 3, 4), α-fetoprotein (AFP) level of more than 200 IU/mL, and the presence of microvascular and capsular invasion (P < .05). In the univariate analysis, the overall survival (OS) and disease-free survival (DFS) of patients with HO-1-positive HCC were not statistically different from those with HO-1-negative HCC. Moreover, HO-1 expression was not associated with patient survival and recurrence based on the multivariate analysis. In the subgroup analysis of patients without preoperative transarterial chemoembolization (TACE) (n = 61), HO-1 was not also associated with tumor recurrence (P = .681).

The clinical implication of HO-1 activity is controversial in various malignancies. However, HO-1 expression did not seem to influence the prognosis of HCC patients.
Effects of brain activity, morning salivary cortisol, and emotion regulation on cognitive impairment in elderly people
Authors: Sroykham Watchara , Wongsawat Yodchanan
Published: June 2019

Objective:

Cognitive impairment subjects exhibit high cortisol levels that are associated with low brain activity, but negative emotions with high cortisol are associated with high brain activity and reduced cognition. Emotion regulation, glucocorticoid hormones, and brain activity all interact with cognitive impairment. Therefore, we aimed to investigate cognitive impairment differences related to sex, morning salivary cortisol, emotion regulation, and brain activity in elderly people.

Methods:

A total of 64 participants (19 males and 45 females) were tested by the Montreal cognitive assessment. Next, morning saliva was collected from each participant and analyzed by enzyme-linked immunosorbent assay, and the brain activity of the participants was subsequently recorded. Finally, emotion regulation was assessed via the Brunel mood scale questionnaire.

Results:

The results revealed that attention was significantly lower in elderly females than in elderly males. Depression and vigor were significantly higher in elderly females than in elderly males. Brain activity of the slow (delta and theta) and fast (beta and high beta) waves was significantly higher in elderly females than in elderly males. Moreover, attention was negatively correlated with the theta wave, whereas delayed recall was positively correlated with the theta wave and salivary cortisol. Depression was positively correlated with the high beta wave and language skill, whereas the high beta wave was negatively correlated with visuoconstructional skill.

Conclusion:

The brain activity, emotion, and cortisol were influenced by cognitive impairments, although the relation of brain activity with glucocorticoid hormones remains inconclusive. This finding may be useful to the brain aging process, promote healthy brain aging, and prevent neurodegenerative conditions.
HIV-related lymphomas in adults served in the public health network
Authors: da Silva Nascimento Janaíra , Sérgio Ramos de Araújo Paulo , Romão de Souza Júnior Valter , Lopes de Melo Fábio , Sá Araújo Lins Carvalho Daniel , Magalhães Vera
Published: June 2019

Individuals infected with human immunodeficiency virus (HIV) have higher morbidity and mortality due to cancer, which is the third most common cause of death in this group, despite the high effectiveness of antiretroviral therapy (ART). We describe the clinical and laboratory characteristics, initial staging and outcome of HIV-related lymphoma.

We included 18 patients in the study, of whom 61.1% were male, mean age 41 years. Nine of the 18 patients (50%) had a diagnosis of HIV infection concurrent with the diagnosis of lymphoma.

The most common histological types were diffuse non-Hodgkin B-cell lymphoma, 8 patients (44.4%); and Burkitt lymphoma, 5 (27.8%) cases. The Cotswold revision of the Ann Arbor staging classification in 14 patients (77.7%) was between III and IV. B Symptoms were present in 11 patients (61.1%), bulky mass was observed in 11 cases (61.1%) and had extra-nodal involvement in 8 patients (44.4%).

Of the 18 cases analyzed, 8 followed on to second-line treatment, wherein the CODOX-M/IVAC scheme (cyclophosphamide, adriamycin, vincristine, methotrexate/ifosfamide, etoposide, and cytosine arabinoside) was used in 3 of the cases. The second most common scheme was etoposide, doxorubicin, vincristine and cyclophosphamide (EPOCH), used in 2 cases (25%), while in single cases (12.5% each) cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone (CHOEP), ifosfamide, etoposide, and carboplatin (ICE) and dexamethasone, cisplatin, and cytarabine (DHAP) were used.

In this series, we observed very high mortality, equivalent to 44.4%, and a complete response in only 11.1%, much lower than that observed by other authors.

We found that patients diagnosed with lymphoma associated with HIV had an advanced early clinical staging, and evolved with low response rates to chemotherapy.
The influence of different blood samples treatment methods on pro-gastrin-releasing peptide
Authors: Jiang Huiqin , Luo Ling , Xiong Kang , He Chengwen , Wang Huaizhou , Qin Yanghua
Published: June 2019

Pro-gastrin-releasing peptide (ProGRP) is the promising molecular tumor marker of small cell lung cancer (SCLC). Here we study the influence of different blood samples treatment methods on ProGRP.

Serum with and without separation gel and heparin plasma from 10 SCLC patients and 5 healthy individuals were assayed for ProGRP immediately and 2, 4, 6, 8, 24, and 48 hours after collection.

ProGRP of serum with and without separation gel and heparin plasma detected immediately was basically consistent, whereas there was a significant difference in the level of them assayed after 2 hours. No significant variation with time was observed in heparin plasma, but in serum with and without separation gel, ProGRP concentrations gradually declined with time, with statistical significance. When assayed within 2 hours, each time point of ProGRP in heparin plasma had no significant difference and the difference of PrpGRP in serum separating gel existed at 1.5 hours.

Heparin plasma is the best option for clinical test of ProGRP. If serum with separation gel is used, optimization methods of turn-around-time which guarantee samples detected within 1 hour after collection can make results more instructive for clinical treatment.
Correlation between the rs7101 and rs1063169 polymorphisms in the FOS noncoding region and susceptibility to and prognosis of colorectal cancer
Authors: Chen Hongshu , Ji Lijuan , Liu Xiuzhen , Zhong Jihong
Published: June 2019

Background:

The FOS gene is located on human chromosome 14q21–31 and encodes the nuclear oncoprotein c-Fos. This study analyzed the correlation between the FOS noncoding region rs7101 and rs1063169 polymorphisms and colorectal cancer susceptibility and prognosis.

Methods:

We analyzed the FOS genotypes in 432 colorectal cancer patients and 315 healthy subjects by PCR/Sanger sequencing. Survival was analyzed by Kaplan–Meier and Cox regression analysis. Western blot was used to detect the expression of c-Fos protein in cancer tissues and adjacent tissues in colorectal cancer patients with different genotypes.

Results:

The presence of a T allele at rs7101 and a T allele at rs1063169 in FOS carried a higher risk of colorectal cancer [adjusted odds ratio (OR) = 1.237, 95% confidence interval (95% CI) = 1.131–1.346, P ≤ .001 and adjusted OR = 1.218, 95% CI = 1.111–1.327, P ≤ .001, respectively]. c-Fos protein levels were significantly higher in variant cancer tissues than in normal mucosa tissues (P < .05), and c-Fos proteins levels were also higher in homozygous variant cancer tissues than in heterozygous variant cancer tissues. The 3-year survival rate of patients with wild-type FOS was higher than that of patients with variant FOS (P < .05).

Conclusion:

The rs7101 and rs1063169 polymorphisms in the noncoding region of FOS are associated with the risk of developing colorectal cancer and the progression of colorectal cancer, which may be because the mutation enhances the expression of c-Fos protein to promote the incidence and development of colorectal cancer.
Traditional Chinese medicine on treating chronic prostatitis/chronic pelvic pain syndrome
Authors: Xue Yahui , Duan Yunyun , Gong Xiaoyong , Zheng Wei , Li Yongqiang
Published: June 2019

Background:

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common urinary system disease in the male population. Recent studies have shown that traditional Chinese medicine (TCM) can alleviate the pain caused by CP/CPPS to a certain extent and improve the quality of life of patients. In this systematic review, we aim to evaluate the effectiveness and safety of TCM for chronic prostatitis/chronic pelvic pain syndrome.

Methods and analysis:

We will search for PubMed, Cochrane Library, AMED, EMbase, WorldSciNet; Nature, Science online and China Journal Full-text Database (CNKI), China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to May 2019. The quality of the included randomized controlled trials (RCTs) will be evaluated with the risk of bias (ROB) tool and evidence will be evaluated by Grading of Recommendations Assessment Development and Evaluation (GRADE). STATA 13.0 and Revman 5.3 will be used to perform a systematic review and meta-analysis to synthesize direct and indirect evidence.

Ethics and dissemination:

This systematic review will evaluate the efficacy and safety of TCM for treating chronic prostatitis/chronic pelvic pain syndrome. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process trial.

Trial registration number:

PROSPERO CRD42019131527
Auricular acupressure for overweight and obese individuals
Authors: Huang Ching-Feng , Guo Su-Er , Chou Fan-Hao
Published: June 2019

Background:

Auricular acupressure has been used for treating obesity, but inconsistent outcomes have been reported. Moreover, systematic reviews and meta-analyses have seldom addressed the effects of auricular acupressure and duration of treatment in overweight/obese individuals. This study reviewed research articles on auricular acupressure for weight reduction, analyzed the related effects on obesity, and explored the relationships between weight reduction and treatment duration, as well as outcome variables.

Methods:

We searched PubMed, Cochrane Library, CINAHL, MEDLINE with Full Text, National Digital Library of Theses and Dissertation in Taiwan, and Airiti Library for articles up to July 4, 2018. Eight eligible trials were identified for qualitative synthesis, and one of them was excluded from quantitative synthesis. Inclusion criteria were as follows: intervention contained auricular acupressure, study subjects were overweight and/or obese, as defined by published authors, and the study design had 2 or more arms for comparison.

Results:

Pooled analysis of the 7 remaining studies revealed that auricular acupressure alone, or with diet and/or exercise, was effective for weight reduction, particularly for decreasing body weight (BW), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), body fat mass (BFM), and body fat percentage (BFP), compared with no treatment, sham treatment, or use of surgical tape with diet and/or exercise. However, there was no effect on hip circumference. A 12-week acupressure intervention was associated with a larger effect on lowering BW and BMI compared with 4-, 6-, and 8-week interventions. The methodologic quality of trials included in the quantitative synthesis ranged from scores 2 to 6 based on the modified Jadad scale. Additionally, this meta-analysis combined studies that used different acupoints and outcomes evaluated at different timepoints, which may have been potential sources of bias.

Conclusion:

The study results indicate that auricular acupressure is effective for weight reduction. However, further vigorous studies that use double-blind randomized controlled design are needed to verify these findings. WC, WHR, BFP, or BFM should be used as obesity-related parameters in weight reduction studies to detect changes in fat, muscle, and skeletal weight.
Comparisons of therapeutic outcomes in patients with nonampullary duodenal neuroendocrine tumors (NADNETs)
Authors: Lee Seung Woo , Sung Jae Kyu , Cho Young Sin , Bang Ki Bae , Kang Sun Hyung , Kim Ki Bae , Kim Sae Hee , Moon Hee Seok , Song Kyung Ho , Kim Sun Moon , Chung Il-Kwun , Lee Dong Soo , Jeong Hyun Yong , Youn Sei Jin
Published: June 2019

Duodenal neuroendocrine tumors (DNETs) are rare tumors that are occasionally found during upper endoscopies. The incidence of DNETs is increasing, although the data regarding treatment outcomes are insufficient. The aim of this study was to evaluate the treatment outcomes in patients with nonampullary DNETs who underwent endoscopic resection or surgery. We evaluated the medical records of patients who were diagnosed with nonampullary DNETs from 2004 to 2017 in 7 university hospitals. We retrospectively analyzed clinical characteristics and compared therapeutic outcomes based on the endoscopic lesion size and treatment method. We ultimately enrolled 60 patients with nonampullary DNETs who underwent endoscopic and surgical treatments. In the endoscopic treatment group, the en bloc resection, endoscopic complete resection (CR) and pathologic CR rates were 88%, 92%, and 50%, respectively. The endoscopic treatment group was divided into 3 subgroups based on the lesion size (1–5 mm, 6–10 mm, and ≥11 mm). The pathologic CR rate was significantly lower in the subgroup with a lesion size ≥11 mm (0%, P = .003) than those in the other 2 subgroups. Lymphovascular invasion occurred significantly more frequently (33.3%, P = .043) among those with a lesion size ≥11 mm. The pathologic CR rate in the surgical treatment group was higher (90.9%) than that in the endoscopic treatment group (50%, P = .017). Surgical treatment appears to be a more appropriate choice because of the risks of incomplete resection and lymphovascular invasion after endoscopic treatment for lesions larger than 11 mm.
Characteristics of meibomian gland dysfunction in patients with Stevens–Johnson syndrome
Authors: Shrestha Tina , Moon Hyun Sik , Choi Won , Yoon Hyeon Jeong , Ji Yong Sok , Ueta Mayumi , Yoon Kyung Chul
Published: June 2019

To evaluate the characteristics of meibomian gland dysfunction (MGD) in patients with Stevens–Johnson Syndrome (SJS) and investigate the risk factors for severe MGD.

Sixteen patients with a history of SJS were evaluated for MGD. To assess the SJS severity acute ocular involvement score (AOS), acute systemic involvement score (ASS), and chronic ocular manifestation score (COMS) were measured. Meibomian gland parameters were evaluated using meibomian gland dropout score (meiboscore - using a Keratograph 5 M), meibum expression score (MES), meibum quality score (MQS), and lid margin abnormality score (LMAS). Correlations between severity of meibomian gland parameters and degree of ocular and systemic involvement of SJS were analyzed. Risk factors for development of severe MGD were identified.

The patients’ mean age was 32.0 ± 14.3 years. Four patients were men and 12 were women. MGD had developed in 14 patients (87.5%). The meibomian gland parameters were significantly correlated with ocular and systemic degree of SJS as evaluated using AOS (P < .01), ASS (P < .01), and COMS (P < .01). Patients with severe MGD had a higher AOS (P < .01) and COMS (P = .02) values than those without severe MGD. On multivariate analysis, AOS higher than 2 was a significant risk factor for developing severe MGD (P = .03).

MGD was a common ocular manifestation with SJS patients. Severity of meibomian gland parameters was correlated with AOS, ASS, and COMS, and the presence of acute ocular complications was a risk factor for severe MGD in patients with SJS.
Safety and efficacy of pulsed low-dose rate radiotherapy for local recurrent esophageal squamous cell carcinoma after radiotherapy
Authors: Li Jie , Zhao Zhenhua , Du Guobo , Dai Tangzhi , Zhen Xuhai , Cai Hongwei , Liao Dongbiao , Xiang Miao , Wen Yixue , Geng Lidan , Yang Xiyue , Feng Gang , Zhang Yu , Bai Jie , Liu Lei , Du Xiaobo
Published: June 2019

Introduction:

Re-irradiation after radiotherapy is a common treatment for locally recurrent esophageal cancer. However, the side effects of re-irradiation are serious. The most serious adverse reactions of re-irradiation include esophageal perforation and hemorrhage caused by esophageal perforation. Studies have shown that pulsed low-dose rate radiotherapy (PLDR) induces a hypersensitivity effect on tumor tissue and a hyper-repair effect on normal tissue, which can simultaneously reduce damage on the normal tissue and increase the therapeutic effect on the tumor. The objective of this study is to explore whether PLDR can reduce rate of esophageal perforation and improve efficacy in patients with recurrent esophageal squamous cell carcinoma (ESCC) after radiotherapy.

Methods and analysis:

This study is a prospective, multi-center, open, single-arm clinical trial designed to enroll 27 patients with locally recurrent ESCC after radiotherapy with or without chemotherapy. Re-irradiation will be performed using intensity modulated radiation therapy in 50 Gy/25 fractions. The strategy of PLDR includes dividing 2 Gy into 10 fractions, and administering each irradiating dose of 20 cGy at an interval of 3 minutes before the next low-dose irradiation. The actual dose rate of administration each time will be 16.67 cGy /minute. The primary endpoint in this study is the rate of esophageal perforation. The secondary endpoints are the objective remission rate, the palliative effect on quality of life and pain, and the time of disease progression. The observation time is 2 years after the end of the study.

Trial registration:

Clinical trial number: ChiCTR1900020609.
Invasive fungal infection in liver transplant recipients in a prophylactic era
Authors: Kim Youn Jeong , Kim Sang Il , Choi Jong Young , Yoon Seung Kew , Na Gun Hyung , You Young Kyoung , Kim Dong Goo , Kim Myoung Soo , Lee Jae Geun , Joo Dong Jin , Kim Soon Il , Kim Yu Seun , Lee Sang-Oh , Hwang Shin , Sim Eungeol
Published: June 2019

The epidemiology of invasive fungal infections (IFIs) after liver transplantation (LT) is continuing to evolve in the current era of antifungal prophylactic therapy. This multicenter retrospective cohort study aimed to evaluate the epidemiology, risk factors, and outcomes of IFIs among LT recipients in the current era.

We analyzed a total of 482 LT recipients aged 18 years and older who were admitted to 3 tertiary hospitals in Korea between January 2009 and February 2012.

Twenty-four episodes of IFIs occurred in 23 patients (4.77%; 23/482). Of these episodes, 20 were proven cases and 4 were probable cases according to EORTC/MSG criteria. Among these cases, IFI developed within 30 days of transplantation in 47.8% of recipients, from 31 to 180 days in 34.8% of recipients, and from 181 to 365 days in 17.4% of recipients. The most common isolates were Candida species (n = 12, 52.2%; Candida albicans, 6 cases; Candida tropicalis, 1 case; Candida glabrata, 1 case; Candida parapsilosis, 1 case; and unspecified Candida species, 1 case) and Aspergillus species (n = 7, 30.4%). The mortality in patients with IFIs was significantly higher than that in patients without IFIs (47.83% [11/23] vs 7.18% [33/459], P < .001). The incidence of late-onset IFIs is increasing in the antifungal prophylactic era, and fluconazole-resistant non-albicans Candida species have not yet emerged in Korea.
A predictive model for progression of CKD
Authors: Chang Hsueh-Lu , Wu Chia-Chao , Lee Shu-Pei , Chen Ying-Kai , Su Wen , Su Sui-Lung
Published: June 2019

The prevalence of chronic kidney disease (CKD) in Taiwan is 11.9%, and the incidence and prevalence of end-stage renal disease (ESRD) is ranked first in the world. The severity of CKD progression to ESRD is dependent on glomerular filtration rate and proteinuria. However, the risk factors for ESRD also include diabetes, hypertension, hyperlipidemia, age, sex, and so on, and predicting CKD progression using few variables is insufficient. Currently, there are no models with high accuracy and high explanatory power that could predict the risk of progression to dialysis in CKD patients in Taiwan. Our aim was to establish an optimal prediction model for CKD progression in patients

This study was a retrospective cohort study, which reviewed data from the “Public health insurance Pre-ESRD preventive program and patient health education program” that was implemented by the National Health Insurance Administration, Ministry of Health and Welfare. From 2006 to 2013, data of CKD patients from the Tri-Service General Hospital in Neihu District, Taipei City was examined. The data collected in this study included demographic variables, past medical history, and blood biochemical values. After exclusion of variables with >30% missing data, the remaining variables were interpolated using multiple imputations and inputted into the prediction model for analysis. The Cox proportion hazard model was used to investigate the influence of CKD risk factors on progression to dialysis. The strengths of various models were evaluated using likelihood ratios (LR), in order to identify a model which uses the least factors but has the strongest explanatory power.

The study results included 1549 CKD patients, of whom 1017 eventually had dialysis. This study found that in the prediction model with the best explanatory power, the influencing factors and hazard ratios (HR) were: age 0.95 (0.91–0.99), creatinine 1.03 (1.02–1.05), urea nitrogen 1.18 (1.14–1.23), and comorbid systemic diabetes 1.65 (1.45–1.88).

A prediction model was developed in this study, which could be used to carry out predictions based on blood biochemical values from patients, in order to accurately predict the risk of CKD progression to dialysis.
Clinical feasibility and effectiveness of bedside peripherally inserted central catheter using portable digital radiography for patients in an intensive care unit
Authors: Cho Soo Buem , Baek Hye Jin , Park Sung Eun , Choi Ho Cheol , Lee Sang Min , Bae Kyungsoo , Jeon Kyung Nyeo , Ryu Kyeong Hwa , Moon Jin Il , Choi Bo Hwa , Ha Ji Young
Published: June 2019

The aim of this study was to evaluate the clinical feasibility and effectiveness of bedside peripherally inserted central catheter (PICC) using portable digital radiography (DR) in intensive care unit (ICU) patients.

Sixty-five ICU patients who underwent PICC were enrolled in this study between May 2016 and May 2017. Of these 65 patients, 45 (69.2%) underwent the procedures bedside in ICU using portable DR, and 20 (30.8%) underwent the procedures at the intervention clinic, both performed by a single interventional radiologist. We retrospectively reviewed electronic medical records for clinical presentation, total procedural time, total radiation dose, total patient transfer time, and clinical outcomes. We performed an independent t test to compare the clinical effectiveness between the 2 groups.

The technical and clinical success rates were 100% in both groups, and there were no procedure-related complications. The total radiation dose of bedside PICC at ICU was significantly lower than that of conventional PICC at the intervention clinic (557.9 mGy∗cm
2 ± 209.2 vs 985.2 mGy∗cm
2 ± 547.6, P < .001). The total procedure time was significantly different between the bedside and conventional PICC groups (26.8 minutes ± 3.9 vs 24.1 minutes ± 5.55, P 
= .028). The average patient transfer time to the intervention clinic was 26.6 minutes ± 9.8.

Bedside PICC using portable DR is a safe and effective procedure option to manage ICU patients in daily clinical practice.