bluuebunny/crossref_metadata_2025 huggingface dataset:
Whole-body vibration provides additional benefits to patients with patellofemoral pain: A protocol for systematic review and meta analysis of randomized controlled trials
Authors: Yang Xinyue , Yang Guang , Zuo Yunxia
Published: November 2022

Background:

The efficacy of the whole-body vibration (WBV) training for patients with patellofemoral pain (PFP) remains controversial. For this reason, we applied a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of WBV training in patients with PFP.

Methods:

Relevant studies found within PubMed, EMBASE, the Cochrane Library and Web of Science were examined from January 1, 1990 to December 30, 2021. Two evaluators independently screened the literatures, extracted relevant data and assessed the methodological quality of respective studies. Meta-analysis was conducted using RevMan 5.4 software.

Results:

A total of 5 RCTs with 174 patients were included. When comparing with exercise alone, WBV training in combination with exercise provided better reduction of pain assessed by visual analogue scale score (P = .04). There were no differences regarding changes of Kujala patellofemoral score, the physical component summary score for physical health, and the mental component summary score for mental health (P = .08, 0.76, 0.65 respectively) between patients with WBV training and those without WBV training.

Conclusions:

Compared to the sole performance of exercise, WBV training in combination with exercise showed better pain reduction, but no superior improvement in function and on quality of life.
Relationship between intraoperative tidal volume and acute kidney injury following off-pump coronary artery bypass grafting: A retrospective observational study
Authors: Bae Jinyoung , Lee Sang Jin , Lee Hyung-Chul , Lee Seohee , Ju Jae-Woo , Cho Youn Joung , Jeon Yunseok , Nam Karam
Published: November 2022

The effect of intraoperative tidal volume (VT) on clinical outcomes after off-pump coronary artery bypass grafting (OPCAB) has not been studied. The aim of this study was to assess the relationship between intraoperative tidal volume (VT) and acute kidney injury (AKI ) after OPCAB. A total of 1049 patients who underwent OPCAB between January 2009 and December 2018 were analyzed. Patients were divided into high (>8 ml/kg) and low VT (≤8 ml/kg) groups (intraoperative median VT standardized to predicted body weight). The data were fitted using a multivariable logistic regression model. Subgroup analyses were performed according to age, sex, comorbidities, preoperative laboratory variables, operative profiles, and Cleveland score. The risk of AKI was not significantly higher in the high than the low VT group (OR: 1.15, 95% CI: 0.80–1.66; P = .459); however, subgroup analyses revealed that a high VT may increase the risk of AKI in males, patients aged < 70 years, with chronic kidney disease, a left ventricular ejection fraction < 35%, or a long duration of surgery. High intraoperative VTs were not associated with an increased risk of AKI after OPCAB. Nonetheless, it may increase the risk of AKI in certain subgroups, such as younger age, male sex, reduced renal and cardiac function, and a long surgery time.
Impact of the medical care act amendment on the medical malpractice litigation in Taiwan
Authors: Tsai Hsing-Shan , Lee Thung-Lip , Hsuan Chen-Feng , Liang Huai-Wen
Published: November 2022

Medical malpractice leads to medical criminal liability and claims. The national data of medical criminal liabilities across various specializations, before and after the Medical Care Act amendment, was lacking in Taiwan. The aim of this study is to clarify the impact of the law amendment. A comprehensive retrospective analysis of medical crimes was conducted from January 2001 to December 2020 in Taiwan. The number of medical criminal litigation, defendants, people who plead guilty, conviction rate, and punishment sentences were analyzed. Additionally, the number of practicing physicians in the year was used as the baseline to determine the rate of the accused and guilty rate per 10,000 physician-years, respectively. From 2001 to 2020, there were 249 criminal litigations of medical professionals, which gave rise to 335 defendants. The proportion of defendants by specialization was 19.1% in internal medicine, 26.3% in surgery and orthopedics, 11.9% in obstetrics and gynecology, 3.3% in pediatrics, 25.7% in physicians (who were not related to the aforementioned 4 specializations), and 13.7% in non-physician staff. After the amendment to the Medical Care Act in 2017, the accused rates per 10,000 physician-years decreased significantly in aggregate and by specialization between 2016 and 2020; the guilty rate per 10,000 physician-years during 2016 to 2020 was the minimum, compared to the past. The amendment to the Medical Care Act in 2017 reduced the number of vexatious criminal proceedings. The amendment also reduced criminal liabilities by reducing the guilty rate during 2016 to 2020, compared to the previous period.
The serpentine pattern on MRI as an early prognostic factor after fusion for lumbar spinal stenosis
Authors: Bae In-Suk , Moon Byung Gwan , Kang Hee In , Kim Jae Hoon , Kim Deok Ryeong
Published: November 2022

This study aimed to determine the relationship between the serpentine pattern nerve roots (SNR) and prognosis after lumbar fusion for lumbar spinal stenosis (LSS) by comparing clinical outcomes in patients with or without a serpentine pattern. LSS patients with neurological symptoms often present with SNRs. Several studies have shown that LLS symptoms are worse in patients with SNRs. However, the relationship between SNR and outcome after spinal fusion surgery has not yet been established. A total of 332 patients who underwent spinal fusion surgery between January 1, 2010, and December 31, 2019, were enrolled. Patients were divided into those with a serpentine pattern (S group) and those without a serpentine pattern (N group). The prognosis of the 2 groups was compared using visual analog scale (VAS), Oswestry disability index, claudication distance, medication dose for leg dysesthesia, and glucose tolerance. A total of 113 patients had a serpentine pattern, while the remaining 219 did not. Symptom duration and presence of diabetes mellitus were significantly different between the 2 groups (N = 25.4, S = 32.6, P < .05). Changes in the VAS score for lower extremity pain between the 2 groups at 1 year after surgery showed that patients without a serpentine pattern had significantly better outcomes than those with a serpentine pattern (N: 2.7 ± 1.1 vs S: 4.1 ± 1.3; P < .001), despite the score change at 1 month showing no difference (N: 3.5 ± 0.9 vs S: 3.8 ± 1.0; P = .09). SNRs on MRI are more prevalent in diabetic patients and are a negative prognostic factor in lumbar fusion surgery for LSS. Our insights may help physicians decide the optimal surgical plan and predict the postoperative prognosis of patients with LSS.
Patterns of biopsy-proven renal diseases in geriatric patients: A single medical center experience
Authors: Huang Yung-Chieh , Wen Mei-Chin , Wu Ming-Ju , Tsai Shang-Feng , Yu Tung-Min , Chuang Ya-Wen , Huang Shih-Ting , Weng Shuo-Chun , Chung Mu-Chi , Hsu Chia-Tien , Wu Chun-Yi , Huang Chun-Te , Wang Tsai-Jung , Chiu Hsien-Fu , Chen Cheng-Hsu
Published: November 2022

The elderly population is expanding rapidly, and that has become a major healthcare burden in terms of chronic kidney disease. The distribution patterns of kidney diseases in these elderly patients remain largely unclear. Here, we compared biopsy-based renal disease patterns between elderly and nonelderly patients. We performed a single-center, retrospective study (1992–2008) on biopsy-proven renal diseases to compare results between geriatric patients (age ≥ 65 years; n = 254) and nongeriatric patients (18 ≤ age < 65 years; n = 2592). Renal pathology was interpreted by pathologists based on light microscopy, immunofluorescence, and electron microscopy. The ages of the geriatric and nongeriatric groups were 71.8 ± 4.5 (65.1–87.3) and 39.7 ± 17.6 (18–64.9) years, respectively, and 74% and 41% of them, respectively, were men. In the geriatric group, the most frequent diagnosis was membranous nephropathy (46.1%), followed by minimal change disease/focal segmental glomerulosclerosis (16.9%), diabetic nephropathy (8.3%), hypertensive nephrosclerosis (7.5%), and IgA nephropathy (5.9%). The geriatric group had more membranous nephropathy and less lupus nephritis and IgA nephropathy than the nongeriatric group. Furthermore, the 5-year survival rate of the geriatric group was significantly low. Our results demonstrated the different distributions of renal biopsy patterns in geriatric patients diagnosed with acute or chronic progressive kidney injury and proteinuria through renal biopsy.
A new predictive tool consolidating CURB-65 with procalcitonin and albumin to assess short-term mortality in hospitalized elderly patients with infectious disease: A retrospective study of a patient cohort
Authors: Higashikawa Toshihiro , Ito Tomohiko , Mizuno Takuro , Ishigami Keiichirou , Kuroki Kengo , Maekawa Naoto , Usuda Daisuke , Nakao Shinichiro , Hamada Kazu , Takagi Susumu , Terada Nao , Takeshima Kento , Yamada Shinya , Sangen Ryusho , Izumida Toshihide , Kiyosawa Jun , Saito Atsushi , Iguchi Masaharu , Wato Hiroyuki , Nakahashi Takeshi , Kasamaki Yuji , Fukuda Akihiro , Kanda Tsugiyasu , Okuro Masashi
Published: November 2022

Background:

Hospitalized elderly patients are often at risk of life-threatening infectious diseases such as pneumonia and urinary tract infection, thus diagnostic tools for bacterial infections are demanded. We developed a new predictive tool consolidating modified CURB-65, procalcitonin (PCT) and albumin (Alb).

Method:

This is a retrospective study. Modified CURB-65 (mCURB-65) score, PCT, Alb, and various cardiovascular/respiratory/renal functions were measured. Survival analyses were conducted to assess 30-days mortality of elderly patients using mCURB-65 score, PCT and Alb. The consolidated scores were compared with the number of patients died.

Results:

There were 445 elderly patients included. Kaplan–Meier survival curves showed significant differences between the high and low groups of mCURB-65, PCT and Alb (log-rank test, P < .001). Cox proportional regression showed that the hazard ratios (95% confidence intervals) for high mCURB-65, high Alb, and high PCT were all significant, 1.95 (1.24–3.05), 0.50 (0.32–0.77), and 2.09 (1.32–3.31), respectively. The consolidated scores showed tendency of increase with proportion of the number of patients died.

Conclusions:

The consolidated score consisted of mCURB-65, PCT and Alb can be a useful tool to predict short-term mortality of the hospitalized elderly patients with infectious disease.
Brain symmetry index predicts 3-month mortality in patients with acute large hemispheric infarction
Authors: Liu Lidou , Zhang Zhe , Zhou Yi , Pu Yuehua , Liu Dacheng , Tian Jia
Published: November 2022

Quantitative electroencephalography data are helpful to predict outcomes of cerebral infarction patients. The study was performed to evaluate the value of brain symmetry index by quantitative electroencephalography in predicting 3-month mortality of large hemispheric infarction. We studied a prospective, consecutive series of patients with large supratentorial cerebral infarction confirmed within 3 days from the onset in 2 intensive care units from August 2017 to February 2020. The electroencephalography was recorded once admission. The brain symmetry index (BSI) which is divided into BSIfast and BSIslow were calculated for each electrodes pair. The outcome was mortality at 3 months after the onset. A total of 38 patients were included. The subjects were divided into the mortality group (15 patients) and survival group (23 patients). Of the BSIfast and BSIslow at each electrodes pair, higher BSIfastC3–C4, higher BSIslowC3–C4, and higher BSIslowO1–O2 were noticed in the mortality group than that in the survival group at 3 months (P = .001; P = .010; P = .009). Multivariable analysis indicated that BSIfastC3–C4 was an independent predictor of 3-month mortality (odds ratio = 1.059, 95%CI 1.003, 1.119, P = .039). BSIfastC3–C4 could significant predict 3-month mortality (area under curve = 0.805, P = .005). And when we combined BSIfastC3–C4, Glasgow Coma Scale and infarct volume together to predict the 3-month mortality, the predicted value increased (area under curve = 0.840, P = .002). BSIfastC3–C4 could independently predict the 3-month mortality of large hemispheric infarction. The combination marker which includes Glasgow Coma Scale, infarct volume, and BSIfastC3–C4 has a better diagnostic value. Further clinical trials with a large sample size are still needed.
Minimally invasive fibrinolytic treatment and drainage in patients with acute subdural hemorrhage and underlying comorbidities
Authors: Ryu Han Seung , Hong Jong Hwan , Kim You-Sub , Kim Tae-Sun , Joo Sung-Pil
Published: November 2022

The incidence of acute subdural hemorrhage (ASDH), which is often caused by head trauma, is steadily increasing due to an increase in the elderly population and the use of anticoagulants. Urgent surgical treatment is recommended if the patient has impaired consciousness, worsening neurological symptoms, or brain midline shift (MLS) due to large hematomas on brain computed tomography (CT). Although large craniotomy is traditionally recommended for ASDH removal, old age, comorbidities, and antiplatelet drugs are considered risk factors for surgical complications, many neurosurgeons hesitate to perform aggressive surgical procedures in these patients. In this study, we introduced a method that can quickly and effectively remove ASDH without general anesthesia. We retrospectively reviewed 11 cases of patients with ASDH who underwent hematoma drainage between June 2019 and December 2020. We measured the maximum subdural hematoma thickness and MLS on brain CT of patients and recorded the Glasgow Coma Scale scores before and after the surgical procedure. All patients had multiple comorbidities, and seven patients received anticoagulant or antiplatelet therapy. On initial brain CT, the median subdural hemorrhage thickness was 21.36 mm, median MLS was 10.09 mm, and mean volume of the subdural hematoma was 163.64 mL. The mean evacuation rate of the subdural hematoma after drainage was 83.57%. There was no rebleeding or operation-related infection during the aspiration procedure, and the median MLS correction after the procedure was 7.0 mm. Our treatment strategies can be a reliable, less invasive, and alternative treatment option for patients at high risk of complications due to general anesthesia or patients who are reluctant to undergo a large craniotomy due to a high bleeding tendency.
Comparison between placenta accreta scoring system, ultrasound staging, and clinical classification
Authors: Yang Xinrui , Zheng Weiran , Yan Jie , Yang Huixia
Published: November 2022

Placenta accreta spectrum (PAS) is a series of disorders, which means that the placental trophoblast invades into the myometrium of the uterine wall. It is a serious obstetric complication which could be detected by ultrasound prenatally. In order to compare our placenta accreta scoring system with prenatal ultrasound staging system and International Federation of Gynecology and Obstetrics (FIGO) clinical classification, we did a retrospective study including 105 patients diagnosed with PAS disorders by operation or pathology at Peking University First Hospital, Beijing, China, between January, 2019 and December, 2020. Placenta accreta scoring system, prenatal ultrasound staging system and FIGO clinical classification were used on each patient. Basic information and clinical outcomes including gestational weeks, intraoperative hemorrhage, hysterectomy rate and blood transfusion were also counted. Both of placenta accreta scoring system, prenatal ultrasound staging system can give a rather clear prediction of placenta percreta, with their area under curve were 0.872 (95% confidential interval [CI]: 0.793–0.951) and 0.864 (95%CI: 0.779–0.949), P value were .000 compared with clinical classification. Beside for ultrasound staging system was designed for placenta previa patients, all those 3 criteria showed their relationships with preterm birth, hysterectomy rate and intraoperative bleeding. PAS scoring system also had the ability to predict a gestational week of delivery ≤34 weeks, intraoperative massive bleeding ≥2000 mL and hysterectomy at over 12 points. Our placenta accreta scoring system had good accordance with pre-operational ultrasound staging and FIGO clinical classification, with higher universality for patients without placenta previa.
Acquired uterine arteriovenous malformation in a patient with cornual pregnancy: A case report
Authors: Yan Yi , Jia Yong , Lategan Belinda , Alexander Zarine , Awadalla Alaa , Goubran Ashraf
Published: November 2022

Introduction:

Acquired uterine arteriovenous malformation (uAVM) is a rare disease and could occur after dilation and curettage, cesarean section, or neoplastic processes.

Patient concerns:

A 29-year-old female presented with acute right lower abdominal pain and positive beta human chorionic gonadotropin (β-hCG).

Diagnosis:

A 6 cm ectopic right cornual pregnancy was found on ultrasound examination.

Interventions:

She underwent a laparoscopic resection of the cornual ectopic pregnancy. She returned with extensive vaginal bleeding 6-month post surgery, and eventually diagnosed with arteriovenous malformation at the previous surgical site by Color Dopplor endovaginal ultrasound. Percutaneous transcatheter uterine artery embolization (UAE) was attempted, however, vaginal bleeding continued. She was taken to the operation room for a hysteroscopic ablation of uAVM.

Outcomes:

Complete cessation of the bleeding was achieved without hysterectomy.

Conclusion:

We report an extremely unusual case of acquired uAVM after a wedge resection of cornual pregnancy. Ultrasound evaluation of patients with post-operative persistent bleeding should be considered for evaluation of a possible arteriovenous malformation.
Long-term disease-free survival of an undifferentiated pleomorphic sarcoma of the spleen: A case report and literature review
Authors: Tomioka Atsushi , Asakuma Mitsuhiro , Kawaguchi Nao , Komeda Koji , Shimizu Tetsunosuke , Uchiyama Kazuhisa , Lee Sang-Woong
Published: November 2022

Introduction:

Undifferentiated pleomorphic sarcoma (UPS) primarily occurs in the soft tissues of the extremities, trunk, and retroperitoneum. As the primary UPS of the spleen (splenic UPS) is extremely rare, to the best of our knowledge, only 19 cases have been reported in English literature. No cases of long-term survival without a local or distant recurrence have been reported.

Patient concerns:

We report the case of a 37-year-old man who was referred to our hospital for a splenic tumor. He had no past medical or relevant familial history. On abdominal computed tomography (CT), a low attenuation solid mass and cystic component with mural calcifications were present at the lower pole of his spleen. The fluorodeoxyglucose-positron emission tomography (CT) indicated it as malignant tumor of the spleen.

Diagnoses:

The patient’s provisional diagnosis was deduced to be angiosarcoma, which was the most common malignant tumor of the spleen.

Interventions:

An elective laparoscopic splenectomy was performed, and the histology of the tumor was consistent with UPS (pT1, pN0, cM0, and AJCC8th). No adjuvant therapy was administered.

Outcomes:

Ten years have passed since the patient’s splenectomy, and he continues to do well, without evidence of local or distant recurrence.

Lessons:

To the best of our knowledge, this is the first case of long-term recurrence-free survival after surgical management of a splenic UPS. It is probable that radical splenectomy during the disease played the most important role in the patient’s long-term survival. Understanding the characteristic findings of a splenic UPS in an abdominal CT may help to diagnose properly.
Efficacy and safety of Fufang Biejia Ruangan Tablets as an adjuvant treatment for chronic hepatitis B liver fibrosis: A systematic review and meta-analysis
Authors: Meng Xiangbo , Pan Zhengqi , Zhao Jiawei , Feng Quansheng
Published: November 2022

Background:

Meta-analysis was used to evaluate the efficacy of Fufang Biejia Ruangan Tablets in the treatment of chronic hepatitis B (CHB) liver fibrosis.

Methods:

Databases, including PubMed, China Knowledge Network (CNKI), China Biomedical Database (CBM), Wan Fang, VIP database, Embase, and Cochrane Library were searched. The time was searched up to May 2022. The participant intervention comparator outcomes of this study were as follows: P, patients with CHB liver fibrosis; I, Fufang Biejia Ruangan Tablets; C, pharmacological placebo; O, the efficacy rate, alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB), procollagen III protein (PIIIP), hyaluronic acid (HA), laminin (LN), collagen C type IV (IV-C), portal vein diameter, spleen thickness and HBV‐DNA negative conversion rate. The Cochrane Risk of Bias tool, Begg’s test and Egger’s test were used to evaluate the methodological quality of eligible studies. A randomized controlled trial of Fufang Biejia Ruangan Tablets was used to treat CHB liver fibrosis. Three reviewers independently selected trials, extracted data, cross-checked, and performed methodological quality assessments. Data analysis was completed by Review Manager 5.3.

Results:

Twenty-six studies with 2717 patients were included in the meta‐analysis. The meta-analysis showed that Fufang Biejia Ruangan Tablets was effective by increasing the efficacy. Fufang Biejia Ruangan Tablets was more efficient in improving ALT, AST, TBIL, ALB, PIIIP, HA, LN, IV-C, portal vein diameter, spleen thickness, and HBV‐DNA negative conversion rate with no serious adverse reactions.

Conclusion:

It was shown that Fufang Biejia Ruangan Tablets can effectively improve liver function and relieve liver fibrosis, but future research should focus on rigorously designed, multicenter, and large randomized controlled trials.
Study on the mechanism of Jin Gui Shen Qi Pill in the treatment of erectile dysfunction based on bioinformatics analysis
Authors: Xiang Jingjing , Wang Chaoyang , Yu Xiaoming , He Jing
Published: November 2022

Erectile dysfunction (ED) is a male disease, which is easy to cause disharmony in sexual life. However, at present, there are few drugs with small side effects in clinic. Jin Gui Shen Qi Pill (JGSQP) is a traditional Chinese medicine compound with obvious clinical effect in treating ED. Therefore, it is imperative to explore clinical drugs based on inhibiting the pathological characteristics of ED. First, the active ingredients and action targets in JGSQP were screened by applying Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and SWISS Target Prediction. Further, a systematic pharmacological analysis platform for traditional Chinese medicine, and the ED targets were screened by applying Gene Cards and Online Mendelian Inheritance in Man databases to construct drug active ingredient-target-disease mapping, followed by gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and protein-protein interaction (PPI) network analysis. Finally, Molecular docking and molecular dynamics simulations were used to screen the active ingredients of JGSQP acting on PDE-5, and analyze the ligand-receptor interaction relationship and binding free energy. The results showed that there were 212 potential targets of JGSQP for ED disease, and GO analysis revealed that the main pathways were positive regulation of DNA-binding transcription factor activity, regulation of vascular diameter, and negative regulation of vascular diameter, etc. KEGG analysis revealed that the main pathways were HIF-1 signaling pathway, prolactin signaling pathway, fluid shear stress, and atherosclerosis, etc. PPI network analysis revealed that the core targets TGFB1 and EGFR have important roles. Molecular docking and molecular dynamics simulations showed that the main components acting on PDE-5 were MOL000546, MOL011169, MOL000279, MOL000273 and Sildenafil. MOL000546 was able to bind stably to PDE-5. The multi-component, multi-target, and multi-pathway action characteristics of JGSQP were confirmed by network pharmacology, which predicted the possible mechanism of action of JGSQP in the treatment of ED and provided a theoretical reference for further experimental validation.
Perceptions, motivation factors, and barriers to a COVID-19 booster immunization in a subpopulation of KSA: A cross-sectional study
Authors: Abullais Shahabe Saquib , Arora Suraj , Parveen Sumaila , Mahmood Syed Esam , Baba Suheel Manzoor , Khalid Imran , Khader Mohasin Abdul , Elgib Mohamed Fadul A.
Published: November 2022

The current cross-sectional survey was designed to evaluate the perception, motivation factors and barriers to a COVID-19 booster immunization in a subpopulation of the Kingdom of Saudi Arabia. A total of 520 respondents were selected by a simple random sampling method. The questionnaire was designed in multiple languages and categorized as; demographic details, perceptions, motivation factors, and barriers to acceptance of a booster dose of COVID-19 vaccine among the respondents. Both anonymous, self-administered, closed-ended online, and paper-based questionnaire was used to assess the above parameters. A higher proportion of the respondents were females (55.2%) with an age range of 36.7 ± 7.7 years. About 36.2% of respondents had a poor perception of the booster dose. Significant differences in the levels of perceptions were found among different age groups and also among the respondents with or without chronic medical conditions. Nearly 49.8% of respondents had hesitation about the booster dose, 58.8% of respondents recommended others to get the booster vaccine at the earliest and 49.8% preferred to develop natural immunity to infection. The hesitation for the booster was more among the female respondents and the older age groups (≥ 60 years) though a large number (43.2%) believe that the booster vaccination is going to end the pandemic worldwide. Further nationwide studies involving different subpopulations are recommended. Public health education is the need of the hour to reduce such barriers and hesitancy.
5-Fluorouracil and actinomycin D lead to erythema multiforme drug eruption in chemotherapy of invasive mole: Case report and literature review
Authors: Wang Shan , Li Tengfei , Wang Yuan , Wang Mengdi , Liu Yibin , Zhang Xiaoguang , Zhang Lijuan
Published: November 2022

Rationale:

5-Fluorouracil (5-FU) and actinomycin D (ActD) are often used in chemotherapy for various cancers. Side effects are more common in bone marrow suppression, liver function impairment, and gastrointestinal responses. Skin effects are rare and easy to be ignored by doctors and patients, which can lead to life-threatening consequence.

Patient concerns:

We reported a 45-year-old woman patient developed skin erythema and fingernail belt in chemotherapy of 5-FU and ActD.

Diagnosis:

Erythema multiforme drug eruption.

Interventions:

Laboratory tests including blood and urine routine, liver and kidney function, electrolytes and coagulation function and close observation.

Outcomes:

The rash was gone and the nail change returned.

Lessons:

Delays in diagnosis or treatment may lead to serious consequence. We should pay attention to the dosage of 5-FU and ActD, monitor adverse reactions strictly, to reduce occurrence of skin malignant events.
Retrospective analysis of genetic etiology and obstetric outcome of fetal cystic hygroma: A single-center study
Authors: Cai Meiying , Guo Nan , Lin Na , Huang Hailong , Xu Liangpu
Published: November 2022

Background:

Cystic hygroma (CH) is a relatively common observation in prenatal ultrasounds; however, there are few studies about copy number variations (CNVs) of fetuses with CH.

Methods:

We performed a retrospective analysis on 40 pregnant patients (out of 8000 pregnant patients) whose fetuses had CH from November 2016 to June 2021. Villus, amniotic fluid, or umbilical cord blood samples were collected, based on the corresponding gestational age, for karyotype analysis and single-nucleotide polymorphism array (SNP-array).

Results:

Among the 40 fetuses with CH, 16 (40.0%, 16/40) exhibited isolated CH and 24 (60.0%, 24/40) exhibited CH combined with other ultrasound abnormalities. The most common CH-comorbid ultrasound abnormalities observed in this study were congenital heart disease (25.0%, 6/24), thickened nuchal translucency (20.8%, 5/24), and fetal edema (12.5%, 3/24). Karyotype and SNP-array analysis resulted in an overall detection rate of 30.0% (12/40). Karyotype analysis led to the detection of eight cases of pathogenic CNVs, among which 45, X was the most common. In addition to the above pathogenic CNV, four additional cases were detected by SNP-array. There was no significant difference in the observed pathogenic CNVs between isolated CH and CH combined with other ultrasound (31.3% vs 29.2%,P > .99). Karyotype analysis and SNP-array results influence whether parents terminate the pregnancy. When genetic abnormalities are detected in the fetus, the parents often choose to terminate the pregnancy.

Conclusions:

Our study emphasizes that genomic examination should be performed on fetuses with CH to confirm the etiology as soon as possible. During genetic counseling, all fetal characteristics should be carefully and comprehensively evaluated.
Acupuncture improves the residual urine volume of bladder of middle age patients with urinary retention post-stroke: A protocol for systematic review and meta analysis
Authors: Cao Di , Yang Qiguang , Qi Fengjun , Gu Shuhong , Yu Tao , Zhu Lin , Liu YiMing , Gui Junjing , Yang Baoru , Zhang Xiaolin
Published: November 2022

Background:

There are 15 million new cases of stroke every year in the world, 65% of which have dysuria in the early stage of stroke, which seriously affects the quality of life of stroke patients. The purpose of this study is to evaluate the results of randomized controlled trials to determine whether acupuncture can improve the residual urine volume of the bladder in middle age patients with urinary retention post-stroke.

Methods:

Eight databases, including China National Knowledge Infrastructure, Chinese Scientific Journal Database, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, PubMed, Wanfang Database, and Web of Science, will be searched using English and Chinese search strategies. In addition, manual retrieval of research papers, conference papers, ongoing experiments, internal reports, etc, will supplement electronic retrieval. All eligible studies published on or before October 1, 2022 will be selected. To enhance the effectiveness of the study, only clinical randomized controlled trials related to the use of manual acupuncture for the treatment of urinary retention post-stroke will be included.

Conclusion:

The residual urine volume of bladder will be the primary outcome measure, whereas the Clinical efficiency will be the secondary outcomes. Side effects and adverse events will be included as safety evaluations. To ensure the quality of the systematic evaluation, study selection, data extraction, and quality assessment will be independently performed by two authors, whereas a third author will resolve any disagreement.
Efficacy, residual effectiveness and safety of diacerein in the treatment of knee osteoarthritis: A meta-analysis of randomized placebo-controlled trials
Authors: Li Guangting , Zhang Zhongming , Ye Yingying , Li Huiping , Luo Hanwen , Tang Kaijiang , Lai Yongrong
Published: November 2022

Background:

Osteoarthritis (OA) is the leading cause of disability in the elderly. Prevention and treatment of OA have become an urgent global demand. The pharmacologic role of diacerein in the treatment of osteoarthritis is controversial. We systematically reviewed the efficacy, safety, and residual effectiveness of diacerein.

Objectives:

To estimate the symptomatic efficacy, residual effect and safety of diacerein in the treatment of knee osteoarthritis, using a meta-analysis of published randomized controlled trials (RCTs).

Methods:

On December 1, 2021, we searched PubMed Medline, Web of Science, Cochrane Library databases, Wan Fang Medical Database, and National Knowledge Infrastructure. This study followed the inclusion criteria of the principle P(Population), I(Intervention), C(Comparison), O(Outcome), S (Study design) principle. All studies were randomized controlled trials of knee osteoarthritis. Cochrane bias risk assessment tool was used to assess the risk of bias. Meta-analyses were performed using a random-effects model. To explore sources of heterogeneity, subgroup analysis, sensitivity analysis, regression analysis and publication bias analysis were performed. Drug side effects with complete data were extracted from the included articles and then a combined analysis of these data was performed.

Results:

Eight studies were eligible and were included in our analysis (N = 1277 participants). All studies were randomized controlled trials of knee osteoarthritis. There was no significant difference in reduction of joint pain and improvement of function between diacerein and the control group. However, subgroup analysis suggested, compared with the placebo group, diacerein treatment yielded an improved mean reduction in visual analogue scale score of-0.44% (95% confidence interval [CI]-0.79 to 0.09), an improved the western Ontario and McMaster universities (physical function) score of -0.44% (95% CI-0.72 to -0.12). Follow-up analysis after discontinuation showed that diacerein treatment had a significant residual effect (95% CI-0.81 to- 0.24). Data on drug side effects described in the included articles were extracted for statistical analysis. There was an increased risk of diarrhea with diacerein (Risk Ratio [RR] = 1.95 [1.03 to 2.47]) and withdrawal event from therapy (RR = 0.93 [0.75 to 1.15]).

Conclusion:

Diacerein might be considered an effective drug for the treatment of patients with KOA, showing short-term residual effectiveness. Although it is associated with an increased risk of diarrhea, the adverse event is mostly tolerable.
Effects of traditional Chinese exercises on insomnia after coronavirus disease 2019: A protocol of systematic review and meta-analysis
Authors: Zhang Runtong , Song Wenjing , Zhu Luwen
Published: November 2022

Background:

There is growing evidence that coronavirus disease 2019 (COVID-19) can trigger acute episodes of insomnia. Reports on the treatment of COVID-19-related insomnia are limited. Therefore, our study aims to perform a systematic evaluation and meta-analysis of the effects of traditional Chinese exercises (TCEs) in patients with insomnia due to COVID-19.

Methods:

We will search the Embase, PubMed, Cochrane Library, Web of Science, MEDLINE, Scopus, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure Database, and Wan Fang Database from December 1, 2019 to October 2, 2022 to identify all articles on treatment of COVID-19-related insomnia using TCEs. Two researchers will screen the articles and extract the relevant information.

Results:

The results will provide a systematic overview of the current evidence on the use of TCE to treat patients with insomnia after COVID-19.

Conclusions:

The conclusions of this study will help clarify the effects of TCEs on patients with insomnia after COVID-19.
Magnetic resonance spectroscopy for quantification of liver iron deposition in hereditary hemochromatosis of a Chinese family: Four case reports
Authors: Zhang Jing , Liu Kefu , Sun Yan , Yu Jiafeng
Published: November 2022

Rationale:

Hereditary hemochromatosis (HH) is a major cause of liver iron overload. The gold standard for the diagnosis of liver iron overload is the histopathological analysis of a liver sample collected by biopsy. The biopsy procedure is both invasive and painful and carries some risks of complications. The multi-echo single-voxel magnetic resonance spectroscopy (HISTO) technique can be used for noninvasive, quantitative assessment of liver iron overload.

Patient concerns:

We report 4 Chinese Han men, who were relatives. Patient A was admitted with diabetes and presented with thrombocytopenia and skin hyperpigmentation. The other patients had no specific clinical presentation.

Diagnoses:

Patient A was suspected of having iron in the liver on routine magnetic resonance imaging, therefore, further HISTO, laboratory testing, and liver biopsy were performed, which confirmed iron metabolic abnormalities. Furthermore, we identified hepatic iron deposition using HISTO and laboratory testing of his son and 2 brothers. Combined with symptoms, auxiliary examinations, and liver biopsy, HH was considered.

Interventions:

As the 4 patients had no other discomfort other than patient A who had diabetes, patient A was placed on therapy comprising the insulin pump, acarbose, and platelet booster capsule.

Outcomes:

After treatment, the diabetic symptoms of patient A improved. The patient and his relatives were regularly followed-up for HH.

Lessons:

HH should be considered when hepatic iron deposition is suspected by routine magnetic resonance, as the HISTO sequence can quantitate liver iron deposition and leads to a promising diagnosis. HISTO is of great value in familial cases, especially in young patients requiring long-term follow-up.
Exploration of potential targets and mechanisms of Naringenin in treating autism spectrum disorder via network pharmacology and molecular docking
Authors: Gai Jialin , Xing Jinxiao , Wang Yangyang , Lei Junfang , Zhang Chengdong , Zhang Jinfei , Tang Jiqin
Published: November 2022

Naringenin (NR) is a kind of flavonoid which plays a great role in the treatment of autism spectrum disorder (ASD). However, the underlying mechanism of NR in treating ASD still remains unclear. This study used network pharmacology and molecular docking to examine the potential targets and pharmacological mechanism of NR on ASD. Targets related to NR were screened from Traditional Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP), Encyclopedia of Traditional Chinese Medicine Database (ETCM), Traditional Chinese Medicine Integrated Database (TCMID), PharmaMapper database, and targets related to ASD were screened from Online Mendelian Inheritance In Man (OMIM), Disgenet, GeneCards, Therapeutic Target Database (TTD), Drugbank, and ETCM. Screened of the intersected gene targets. Then, we used the protein–protein interaction (PPI) networks to construct a PPI network and used Network Analyzer plug-in to perform topological analysis to screen out the core target. We used Metascape platform to perform gene ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, and used Chem draw, Pymol, AutoDock 1.5.6 software for molecular docking verification with core targets. A total of 149 targets of NR and 1594 potential targets of ASD were screened, and 43 intersected targets and 8 key targets were obtained and screened. A total of 176 GO items were obtained by GO enrichment analysis (P< .05), 153 entries on biological process (BP), 12 entries on BP and 11entries on cell composition (CC) were included. A total of 100 signaling pathways were obtained by KEGG pathway enrichment screening (P< .05).The pathways that are closely related to the pathogenesis of ASD are estrogen signaling, thyroid hormone signaling pathway, prolactin signaling pathway, and endocrine resistance pathway. Molecular docking results showed that NR had the best docking activity with the core target CASP3, and had good binding ability with AKT1, ESR1, ACTB and MAPK3. Taken together, our findings support that NR exerts therapeutic effects on ASD with multi-target, and multi-pathway characteristics, which provides a preliminary theoretical basis for clinical trials. The mechanism of anti-oxidative stress response, anti-apoptosis, regulation of cell growth and metabolism, anti-inflammatory, balance hormone levels may be important for the therapeutic effect.
Uncovering the mechanism of Radix Paeoniae Alba in the treatment of restless legs syndrome based on network pharmacology and molecular docking
Authors: Liu Jun , Liu Suxian , Hao Liansheng , Liu Fangfang , Mu Shengkai , Wang Tengteng
Published: November 2022

Restless legs syndrome (RLS) is a neurological motor disorder with a high prevalence. The treatment efficacy of RLS is unsatisfactory. Radix Paeoniae Alba (RPA) can effectively treat RLS symptoms such as the discomfort of the legs. RPA has great potential for the development of new medications for RLS. Hence, we explored the mechanism of RPA in the treatment of RLS using network pharmacology and molecular docking. The active components and targets of RPA were obtained from the Traditional Chinese Medicine System Pharmacology database and analysis platform and PharmMapper platform. The RLS-related targets were found in GeneCards, OMIM, DrugBank, and DisGeNET databases. The overlapping targets of RPA and RLS were then collected. The “active components-overlapping targets” network was built, and network topology analysis was performed. Furthermore, Cytoscape 3.9.1 software was used to screen the key components of RPA in the treatment of RLS. Protein-protein interaction was performed using the Search Tool for the Retrieval of Interacting Genes. The gene ontology functions and Kyoto Encyclopedia of Genes and Genomes signaling pathways were analyzed using ClusterProfiler, PathView, and other R packages to reveal the main mechanism of RPA in treating RLS. Component and protein structures were downloaded from the Traditional Chinese Medicine System Pharmacology and Protein Data Bank databases, respectively. The AutoDock 4.2.6 software was used for molecular docking. A total of 12 active components and 109 targets of RPA, as well as 2387 RLS-related targets, were collected. Following that, 47 overlapping targets were obtained. Furthermore, 5 key components and 12 core targets were screened. The results of gene ontology functions were as follows: 2368 biological processes, 264 molecular functions, and 164 cellular components. A total of 207 Kyoto Encyclopedia of Genes and Genomes signaling pathways were obtained, including the lipid and atherosclerosis pathway, the endocrine resistance pathway, the prolactin signaling pathway, and the IL-17 signaling pathway. The components and the core targets completed molecular docking stably. RPA has multi-component, multi-target, and multi-pathway characteristics in treating RLS, which could provide a basis for future research and improve clinical efficacy.
Network module function enrichment analysis of lung squamous cell carcinoma and lung adenocarcinoma
Authors: Li Piaopiao , Yuan Hui , Kuang Xuemei , Zhang Tingting , Ma Lei
Published: November 2022

Background:

Lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD) are the two major subtypes of non-small cell lung cancer that pose a serious threat to human health. However, both subtypes currently lack effective indicators for early diagnosis.

Methods:

To identify tumor-specific indicators and predict cancer-related signaling pathways, LUSC and LUAD gene weighted co-expression networks were constructed. Combined with clinical data, core genes in LUSC and LUAD modules were then screened using protein-protein interaction networks and their functions and pathways were analyzed. Finally, the effect of core genes on survival of LUSC and LUAD patients was evaluated.

Results:

We identified 12 network modules in LUSC and LUAD, respectively. LUSC modules “purple” and “green” and LUAD modules “brown” and “pink” are significantly associated with overall survival and clinical traits of tumor node metastasis, respectively. Eleven genes from LUSC and eight genes from LUAD were identified as candidate core genes, respectively. Survival analysis showed that high expression of SLIT3, ABI3BP, MYOCD, PGM5, TNXB, and DNAH9 are associated with decreased survival in LUSC patients. Furthermore, high expression of BUB1, BUB1B, TTK, and UBE2C are associated with lower patient survival.

Conclusions:

We found biomarker genes and biological pathways for LUSC and LUAD. These network hub genes are associated with clinical characteristics and patient outcomes and they may play important roles in LUSC and LUAD.
Update on the natural orifice transluminal endoscopic surgery for gallbladder preserving gallstones therapy: A review
Authors: Shang Lifeng , Shen Xin , Niu Wenkai , Zhang Yi , Han Junwei , Liu Haiwang , Liu Lei , Chen Xinli , Zhang Yiyue , Hai Shi
Published: November 2022

Cholecystectomy remains the “gold standard” for the management of symptomatic gallstones. Minimally invasive laparoscopic cholecystectomy has been the treatment of choice for the past 3 decades. However, the technique of natural orifice transluminal endoscopic surgery cholecystolithotomy is evolving, with some experts advocating gallbladder stone removal without gallbladder excision in order to preserve gallbladder function and eliminate post-cholecystectomy syndromes, including complications of the surgical incision, bile duct injury, functional gastrointestinal, and psychological conditions, and possibly an increase in colon cancer. In addition, transluminal endoscopic cholecystolithotomy is an option for elderly patients who are not suitable candidates for open surgery and those who desire scar-free minimally invasive surgery with organ preservation. This article summarizes the established pure natural orifice transluminal endoscopic surgery gallbladder preserving gallstone removal techniques and highlights the pros and cons of different popular available endoscopic approaches to gallstone therapy and how flexible endoscopic surgery via the natural orifice is compared to the well-established cholecystectomy.