bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of laparoscopic sleeve gastrectomy in obese patients with type 2 diabetes mellitus
Authors: Wei Wei-wei , Fu Xian-dong , Su De-wang , Ke De-zhi , Yao Rong-rong , Chen Ke-yan , Tian Hao
Published: June 2020

Background:

A numerous studies have reported that obese patients (OP) are easily to have type 2 diabetes mellitus (T2DM). Although a variety of managements are available to treat such disorder, their efficacy is still limited. Previous studies have reported that laparoscopic sleeve gastrectomy (LSGT) can benefit OP with T2DM. However, no study specifically and systematically explores this topic. Thus, this study will assess the efficacy and complications of LSGT for the management of OP with T2DM.

Methods:

The search strategy will be performed in the electronic databases from inception to the March 31, 2020 without limitations of language and publication time: PUBMED, EMBASE, Cochrane Library, Scopus, Web of Science, CINAHL, AMED, WANGFANG, VIP, and CNKI. Two authors will independently identify the articles, collect the data, and assess the risk of bias using Cochrane risk of bias tool. We will invite a third author to solve any differences between two authors. We will use RevMan 5.3 software to investigate the statistical analysis.

Results:

This study will supply a high-quality synthesis of randomized controlled trials (RCTs) on the analysis of LSGT for the management of OP with T2DM.

Conclusions:

This study will help to build proposals that aim at providing high quality RCTs in the management of LSGT in OP with T2DM.

Systematic review registration:

INPLASY202040128.
Effect and safety of Huangqi-Guizhi-Wuwu Decoction and Erxian Decoction in the treatment of frozen shoulder
Authors: Zhang You-Wei , Jiang Chao , Li Xiao-Hong , Li Kai
Published: June 2020

Background:

The purpose of this study is to evaluate the effect and safety of Huangqi-Guizhi-Wuwu Decoction (HGWD) and Erxian Decoction (EXD) in the treatment of frozen shoulder (FS).

Methods:

We will compressively search potential randomized controlled trials from electronic databases of MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO, Web of Science, Allied and Complementary Medicine Database, Google Scholar, and China National Knowledge Infrastructure. We will search all of them from inception of each electronic database up to the present without language limitations. Two researchers will conduct selection of study, data extraction, and study quality evaluation independently. Study quality will be identified using Cochrane risk of bias tool. Statistical analysis will be performed using RevMan 5.3 software.

Results:

This study will summarize high quality evidence of randomized controlled trials on exploring the effect and safety of HGWD and EXD in the treatment of FS.

Conclusions:

The results of this study will provide helpful evidence of the effect and safety of HGWD and EXD in the treatment of FS to facilitate the clinical practice and guideline development.

Study registration number:

INPLASY202040070.
Measurement accuracy of lung nodule volumetry in a phantom study
Authors: Lee Han Na , Kim Jung Im , Shin So Youn
Published: June 2020

An axial-volume scan with adaptive statistical iterative reconstruction-V (ASIR-V) is newly developed. Our goal was to identify the influence of axial-volume scan and ASIR-V on accuracy of automated nodule volumetry.

An “adult" chest phantom containing various nodules was scanned using both helical and axial-volume modes at different dose settings using 256-slice CT. All CT scans were reconstructed using 30% and 50% blending of ASIR-V and filtered back projection. Automated nodule volumetry was performed using commercial software. The image noise, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were measured.

The axial-volume scan reduced radiation dose by 19.7% compared with helical scan at all radiation dose settings without affecting the accuracy of nodule volumetric measurement (P = .375). Image noise, CNR, and SNR were not significantly different between two scan modes (all, P > .05).

The use of axial-volume scan with ASIR-V achieved effective radiation dose reduction while preserving the accuracy of nodule volumetry.
Comparative risk-benefit profiles of different femoral drilling techniques in anterior cruciate ligament reconstruction
Authors: Wang Ning , Zhu Zhenglei , Wu Ziying , He Hongyi , Wang Haochen , Li Wei , Xie Dongxing , Wang Yilun
Published: June 2020

Background:

Anterior cruciate ligament (ACL) injury experiences about 200,000 isolated cases annually, and ACL reconstruction has become the gold standard for the restoration of stability and functionality. In view of that incorrect graft placement is a common cause of ACL reconstruction failure, it is critically important to ensure that the tibial and femoral tunnels are properly placed during the operation. Therefore, we intend to conduct a network meta-analysis to comparatively evaluate the clinical outcomes among the different surgical techniques in ACL reconstruction.

Methods:

Embase, PubMed, and Cochrane Library will be searched through to retrieve the relevant literature up to April 2020. The outcomes include the International Knee Documentation Committee subjective/objective score, Lachman test, Lysholm score, laxity of knee joint, pivot-shift test, Tegner activity scale, and the number of adverse events. A Bayesian hierarchical framework will be used to evaluate the comparative efficacy among different fixation devices. Cochrane Q test and I2 statistics will be applied to evaluate the heterogeneity, and the Cochrane risk of bias assessment tool will be employed to evaluate the study quality and the risk of bias.

Results:

The comparative risk-benefit profiles of different femoral drilling techniques will be evaluated based on the existing evidence, in order to summarize a prioritization regimen.

Conclusion:

Findings from this network meta-analysis will provide useful reference to patients, surgeons, and guideline makers in the related fields.

Registration:

Open Science Framework (OSF) Preregistration. April 20, 2020. osf.io/uzahs
Effect of daily tadalafil on reported outcomes in patients with erectile dysfunction and depressive symptoms
Authors: Kim Kyu Shik , Jeong Tae Yoong , Moon Hong Sang
Published: June 2020

Erectile dysfunction (ED) and depression are closely related. We sought to determine ED and depression were improved by tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor, at 5 mg daily, in this case–control study.

Participants were men aged 20 to 65 years with ED for >3 months, International Index of Erectile Function-5 (IIEF) score <21 points, and Zung Self-Rating Depression Scale (SDS) survey result >50 points who were willing to participate.

On first visit (V1) and after 1 (V2) and 2 months (V3), clinical features were examined using IIEF-5 for diagnosing and evaluating ED, SDS for evaluating depression, and International Prostate Symptom Score and Quality of Life (IPSS/QoL) survey for examining lower urinary tract symptoms (LUTS). Tadalafil 5 mg was administered daily for 2 months.

A total of 60 participants were an average age of 58.68 ± 6.71 years. Patient overall average IIEF was 8.76 ± 5.98, showing mild ED symptoms, and total average IPSS 13.74 ± 7.55 showed moderate LUTS. Average overall SDS index was 58.93 ± 9.21, indicating moderate-to-severe findings. Average change in IIEF among all patients revealed significant improvement from V1 to V2 (−2.69 ± 1.22, P = .03) and V1 to V3 (−4.38 ± 1.20, P < 0.01). IPSS also significantly improved from V1 to V3 (3.48 ± 1.37, P = .01), as did SDS index (V1, V2: 4.69 ± 1.89, P = 0.02), (V1, V3: 5.43 ± 1.89, P < .01). Patients with severe IIEF scores (group 1, n = 27) experienced significantly greater improvement in IIEF from V1 to V2 and V1 and V3, compared to those with mild-to-moderate IIEF scores. Both groups improved in SDS index from V1 to V2 and V1 to V3, with the greatest improvement between V1 and V3 for group 1 and V1 and V2 for group 2.

Daily tadalafil 5 mg could be helpful for ED patients with depressive symptoms and improved LUTS and quality of life.
Comparison and evaluation of non-invasive models in predicting liver inflammation and fibrosis of chronic hepatitis B virus-infected patients with high hepatitis B virus DNA and normal or mildly elevated alanine transaminase levels
Authors: Wang Lingmei , Li Jiao , Yang Kai , Zhang Hao , Wang Qin , Lv Xiongwen , Guan Shihe
Published: June 2020

Few studies have paid attention to the performances of non-invasive models in diagnosing stages of liver fibrosis and inflammation, which are critical for early and accurate assessment of prognostication and decisions on antiviral treatment in chronic hepatitis B infection patients with high hepatitis B virus DNA and normal or mildly elevated alanine transaminase levels (≤2 times upper limit of normal (ULN)). This study aimed to investigate the value of routine serum markers in evaluation of liver inflammation and fibrosis in these patients.

A total of 370 consecutive chronic hepatitis B virus-infected patients who underwent liver biopsy were retrospectively analyzed. The Scheuer scoring system was adopted as the pathological standard for diagnosing liver inflammation and fibrosis. The receiver-operating characteristic curves (ROC) and the area under the ROC curves (AUROCs) were used to analyze the performances of the models, including aspartate transaminase to platelet ratio index (APRI), fibrosis index based on the 4 factors (FIB-4), red cell volume distribution width-to-platelet ratio (RPR), globulin-platelet model (GP), and gamma-glutamyl transpeptidase to platelet ratio index (GPR).

To predict significant inflammation (G ≥2), the AUROC of APRI was higher than that of FIB-4 (0.705 vs 0.629, P = .001), RPR (0.705 vs 0.593, P < .001) and GP (0.705 vs 0.620, P = .002), equivalent to that of GPR (0.705 vs 0.690, P = .606). As for severe inflammation (≥G3) and significant fibrosis (≥S2), there was no statistic difference among them. To predict severe fibrosis (≥ S3), the AUROC of FIB-4 was higher than that of RPR (0.805 vs 0.750, P = .006) and GP (0.805 vs 0.755, P = .046), comparable to that of APRI (0.805 vs 0.785, P = .550) and GPR (0.805 vs 0.818, P = .694). As for significant liver histological changes (G ≥ 2 or/and S ≥ 2), the performance of APRI was higher than that of RPR (0.717 vs 0.652, P = .006), GP (0.717 vs 0.659, p = .011), equivalent to that of FIB-4 (0.717 vs 0.692, P = .254) and GPR (0.717 vs 0.680, P = .166).

We found that APRI, GPR, and FIB-4 were more effective than RPR and GP for diagnosing liver inflammation and fibrosis.
Autologous blood or autologous serum acupoint injection therapy for psoriasis vulgaris
Authors: Wang Qiuyue , Li Mao , Hu Xingxin , Luo Qian , Hao Pingsheng
Published: June 2020

Background:

Psoriasis vulgaris (PV) is a refractory and relapsing skin disease that affects the physical and mental health of patients and leads to poor quality of life. Current conventional systemic therapy shows a large side effect, which can not be used for a long time, easy to relapse after drug withdrawal, long-term efficacy is poor. At present, traditional Chinese medicine treatment of psoriasis vulgaris effective, can alleviate symptoms, improve the quality of life, stabilize the condition, prolong the remission period. Whereas, there is no related systematic review and meta-analysis. Thus, we intend to conduct a systematic review and meta-analysis to testify autologous blood or autologous serum acupoint injection therapy for Psoriasis Vulgaris.

Methods:

Our systematic review will search all randomized controlled trials for autologous blood therapy of PV, electronically and manually, regardless of publication status and language, until March 19, 2020. Databases include PubMed, EMBASE, Web of Science, Cochrane Controlled Trials Register, China National Knowledge Infrastructure, China Biomedical Literature Database, Chinese Science Journal Database, and Wanfang database. Other sources, including reference lists of identified publications and meeting minutes, will also be searched. Manually search for grey literature, including unpublished conference articles.

Result:

The main outcomes contain the variation of Psoriasis area and severity index, dermatology life quality index, itching score, the effective rate and adverse events from baseline to the end of studies. This study will provide a comprehensive review of the available evidence for the treatment of PV with this therapy.

Conclusion:

We will summarize sufficient evidence to confirm the therapeutic effect and safety of autologous blood or autologous serum acupoint injection therapy for PV. Due to the data is not individualized, formal ethical approval is not required.

INPLASY registration number:

INPLASY202040052.
Injectable calcium sulfate vs mixed bone graft of autologous iliac bone and allogeneic bone
Authors: Li Jin , Rai Saroj , Ze Renhao , Tang Xin , Liu Ruikang , Hong Pan
Published: June 2020

Unicameral bone cyst (UBC) is a benign fluid-filled lesion, mainly located in the metaphyses of long bones in children and adolescents. Elastic stable intramedullary nail (ESIN) is adopted in our institute for UBCs since 2010, and bone grafting was performed simultaneously. This study aims to evaluate the efficacy of ESIN decompression combined with different bone graft materials.

All patients with the diagnoses of UBCs of the humerus, treated with ESINs and bone grafting between January 2010 and June 2018, were analyzed retrospectively. The bone grafting included injectable calcium sulfate, a mixture of the autologous iliac bone and allogeneic bone. All patients were categorized into 2 groups: ICS (injectable calcium sulfate) group and MIX (a mixture of the autologous iliac bone and allogeneic bone, ratio: 1:3) group. All the information was collected from the Hospital Database.

In all, 17 patients (8.8 ± 2.3-year-old, male 8, female 9) in the ICS group and 19 patients (8.9 ± 1.9-year-old, male 10, female 9) in the MIX group were included in this study. Patients in both groups were followed up for more than 2 years (average, 3.4 ± 1.3 years). No recurrence was observed in either group. There was no significant difference between the two groups concerning the patient's demographic parameters, including sex, age, and affected side. All patients in both groups displayed excellent and good shoulder function, and there was no significant difference between the 2 groups (P = .29). As for the Capanna classification, there was no significant difference between these 2 groups (P = .78).

Intramedullary nailing has the advantage of a minimally invasive procedure, immediate stability, and continuous decompression. ICS showed similar results as a mixture of the autologous iliac bone and allogeneic bone.
Prognostic and clinical implications of c-erbB-2 expression in patients with oral cancer
Authors: Meng Ying , Yang Peng , Ma Lili
Published: June 2020

Background:

Recently, many studies have suggested that the aberrant expression of c-erbB-2 existed in oral cancer (OC) patients and had a correlation with poor clinical features across OC patients. Considering the inconsistent results among published articles, we performed the meta-analysis to assess the prognostic and clinical effect of c-erbB-2 expression on oral tumors.

Methods:

Web of Science, Embase, and PubMed were retrieved to acquire relevant publications based on selection criteria, up to February 8, 2020. Pooled odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals (CI) were applied to evaluate the associations between c-erbB-2 expression and overall survival (OS), disease specific survival, disease-free survival as well as clinicopathology of OC.

Results:

A total of 30 literatures with 1499 patients for survival of OC were enrolled in this meta-analysis. The results indicated that c-erbB-2 overexpression was significantly associated with poor OS (HR = 2.40, 95% CI = 1.53–2.55, P < .05), disease specific survival (HR = 2.60, 95% CI = 1.11–4.10, P < .05) and disease-free survival (HR = 2.22, 95% CI = 1.46–2.99, P < .05). Subgroup analysis based on race showed that the significant prognostic value of c-erbB-2 in OC was found both in Caucasians and Asians (OS of Caucasians, HR = 2.90, 95% CI = 1.50–4.31, P < .05; OS of Asians, HR = 1.90, 95% CI = 1.27–2.53, P < .05). Moreover, OC patients with enhanced c-erbB-2 expression were prone to male (OR = 1.97, 95% CI = 1.22–3.19, P < .05), advanced TNM stage (OR = 1.84, 95% CI = 1.17–2.88, P < .05), lymph node metastasis (OR = 2.23, 95% CI = 1.47–3.36, P < .05) and advanced grade (OR = 1.98, 95% CI = 1.30–3.01, P < .05), but not associated with distant metastasis (OR = 1.65, 95% CI = 0.98–3.04, P > .05).

Conclusions:

c-erbB-2 may be a potential indicator in the prediction of prognosis and clinicopathological features in OC patients.
Urban-rural differences in parenting style in China
Authors: Zhang Junhua , Zhang Yu , Xu Fang
Published: June 2020

Background:

Existing literature shows several discrepancies in parenting style between urban and rural China, but conclusions are confusing. Therefore, the aim of this meta-analysis is to consider these inconsistencies and explore the influences of several moderator variables.

Methods:

Literature search will be conducted on PubMed, OVID, the Web of Knowledge, China National Knowledge Infrastructure, Wan fang and Chongqing VIP database without language/date/type of document restrictions. The Software Comprehensive Meta-Analysis 3.0 will be used to compare all the selected articles. Moreover, study quality was assessed with a checklist.

Method and analysis:

Literature search will be conducted on PubMed, OVID, the Web of Knowledge, China National Knowledge Infrastructure, Wan fang and Chongqing VIP database without language/date/type of document restrictions. We will use Comprehensive Meta-Analysis Software to conduct main meta-analysis. The primary outcomes are scores/subscores measured by the Chinese version of Egna Minnen Beträffande Uppfostran, Parental Bonding Instrument, and any other questionnaires including parenting style.

Ethics and Dissemination:

Not needed because no data will be collected.

Trials registration number:

INPLASY202050010.
Pretreatment C-reactive protein/albumin ratio for predicting overall survival in pancreatic cancer
Authors: Zang Ye , Fan Yu , Gao Zhenjun
Published: June 2020

Background:

Inconsistent findings have been reported regarding the association of C-reactive protein to albumin ratio (CAR) with survival outcome in patients with pancreatic cancer. We conducted the current meta-analysis to assess the prognostic utility of elevated baseline CAR in predicting overall survival (OS) in pancreatic cancer patients.

Methods:

A comprehensively literature search was performed in the PubMed and Embase database until February 10, 2019. Studies evaluating the association between pretreatment CAR and OS among pancreatic cancer were selected. Study quality was evaluated by using the Newcastle-Ottawa Scale.

Results:

Nine retrospective studies involving 1534 pancreatic cancer patients were identified. A meta-analysis using a random-effect model indicated that elevated CAR was associated with poor OS (hazard ratio 1.98; 95% confidence interval 1.58–2.48). Subgroup analysis produced similar prognostic values for OS in different geographical regions, sample sizes, thresholds of CAR, treating methods, and Newcastle-Ottawa Scale points.

Conclusion:

Elevated pretreatment CAR may independently predict poor OS in pancreatic cancer patients. Pretreatment CAR is possibly a simple and cost-effective blood-derived indicator for predicting survival outcome in patients with pancreatic cancer.
Clinical manifestations and genetic analysis of 4 children with chronic granulomatous disease
Authors: Guo Chunyan , Chen Xing , Wang Jinrong , Liu Fengqin , Liang Yan , Yang Juan , Dai Fangfang , Ding Ning
Published: June 2020

Pediatricians are unfamiliar with chronic granulomatous disease (CGD) because of its rarity and paucity of available data, potentially leading to misdiagnosis, late treatments, and mortality. The main purpose of this study was to summarize the clinical manifestations and auxiliary examination findings of four children with CGD confirmed by genetic testing.

This was a case series study of children hospitalized at the Pediatric Respiratory Department of Shandong Provincial Hospital. The clinical, laboratory, treatment, and prognosis data were analyzed.

All 4 children were boys. Two were brothers. The children's age was from 34 days to 3 years and 2 months at disease onset. The manifestations were repeated pulmonary infection, lymphadenitis, skin infection, and granuloma formation. Pulmonary infections were common. Abnormal responses were common after BCG vaccination. Thoracic computed tomography (CT) mainly showed nodules and masses, while the consolidation area in CT images reduced slowly. No abnormalities in cellular immune functions and immunoglobulin were found. The disease in all four children was confirmed by genetic testing. Long-term antibiotics and anti-fungal drugs were needed to prevent bacterial and fungal infections.

CGD should be considered in children with repeated severe bacterial and fungal infections. Abnormal responses after BCG vaccination and nodular or mass-shaped consolidation in thoracic CT images should hint toward CGD. Gene sequencing could provide molecular evidence for diagnosis. The treatments of CGD include the prevention and treatment of infections and complications. Immunologic reconstitution treatment is currently the only curative treatment for CGD.
The clinical effect and safety of the treatment of tibia intercondylar eminence fracture with cannulated screw and suture fixation under arthroscope
Authors: Xu Peng , Liu Lu-Chang , Chen Qi-Jun , Yang Ping , Chen Xiao-Bin , Xie Xiao-Ping
Published: June 2020

Background:

The clinical effects and safety over the treatment of tibia intercondylar eminence fracture (TIEF) with cannulated screw and suture fixation were evaluated under arthroscope systematically, providing evidence-based medical support for the selection of surgical methods in terms of minimally invasive arthroscopic treatment for TIEF.

Methods:

The English databases of PubMed, EMBASE, Cochrane Library, CNKI, SinoMed, VIP, and Wanfang databases were searched by computer. The randomized controlled trials were conducted to compare the clinical effects of TIEF with cannulated screw and suture fixation under arthroscope. The retrieval period is from the beginning of database building to January 2020. There is no language restriction. Chinese databases are searched by keywords, while English databases are searched by the combination of subject words and free words. According to the retrieval strategy, the two evaluators will lead the conforming documents into Note Express for repeated literature screening, and the two evaluators will extract and cross-check the conforming documents according to the pre-designed data extraction table. Two researchers adopted the modified Jadad scale independently to evaluate the quality of the literature. The RevMan 5.3 version software provided by the Cochrane Collaboration Network was adopted for statistical analysis.

Results:

The study will strictly review and extract the data included in the literature, and scientifically make statistical analysis for the pre-set outcome indicators. All the research processes will be conducted in strict accordance with the guidance of system evaluation. In this study, the differences between cannulated screw fixation and suture fixation under arthroscopy will be evaluated by comparing the relevant outcome indicators. All the results of this study will be published openly in a highly influential professional academic journal.

Conclusion:

The paper adopted Cochrane system evaluation method to collect and sort out the published literature about the treatment of tibial eminence fracture between cannulated screw fixation and suture fixation under arthroscopy, and to compare the clinical efficacy and safety of the two fixation methods utilizing meta-analysis and comparison of related outcome indicators. Through this study, we will draw a positive conclusion, which will provide a basis for the better treatment of tibial eminence fracture.

PROSPERO registration number:

PROSPERO CRD42020168433.
Gelomyrtol for acute or chronic sinusitis
Authors: Wu Yongcan , Wang Xiaomin , Huang Demei , Pei Caixia , Li Shuiqin , Wang Zhenxing
Published: June 2020

Background:

Sinusitis is a common condition worldwide, significantly affecting the quality of life of patients. Due to the limitations of conventional medicines, such as serious side effects and low efficacies, Gelomyrtol may be a promising treatment for sinusitis. As no related systematic review has been published, the purpose of this study will be to evaluate the safety and efficacy of Gelomyrtol for acute or chronic sinusitis.

Methods:

PubMed, EMBASE, the Cochrane Library, the Web of Science, the Chinese National Knowledge Infrastructure Database, the Chinese Biomedical Literature Database, the Wan Fang Database, and the Chongqing VIP Chinese Science, and Technology Periodical Database will be searched from their commencement until July 2020. Randomized controlled trials of Gelomyrtol for acute or chronic sinusitis will be selected in any language. Primary outcomes will include the Sino-Nasal Outcome Test-22 (SNOT-22) score, quality of life score as measured by SF-36, and the change in computed tomography (CT) score. Study selection, data extraction, and deviation risk assessment will be carried out by 2 investigators independently. RevMan V.5.3 software will be used to analyze the study data.

Results:

The study will provide high-quality evidence for estimating the efficacy and safety of Gelomyrtol in the treatment of acute or chronic sinusitis.

Conclusions:

This systematic review will explore whether Gelomyrtol is an effective and safe intervention in the treatment of acute or chronic sinusitis.

Ethics and dissemination:

As no patient data will be used in this study, ethical approval will not be required. The review will be published as an article or a conference presentation in a peer-reviewed journal.

Registration:

OSF registration number: DOI 10.17605/OSF.IO/MTEU2.
Effect of Chinese medicine prescription on nephrotic syndrome
Authors: Deng Yanli , Zhang Leixiao , Wen Aiwei , Xu Dongxian , Wang Wenping , Hou Yuhao , Liu Zhen , Yang Lin , Shen Tao , Luo Qin , Wu Wei , Ou Yuanshu
Published: June 2020

Background:

Nephrotic syndrome (NS) is a common chronic recurrent kidney disease. Many trials have shown that Chinese medicine prescription (CMP) can effectively treat NS. The program aims to evaluate the efficacy and safety of CMP for NS.

Methods:

This systematic evaluation will entail an electronic and manual search of all CMP for NS from inception to February, 2020, regardless of the publication status or language. Databases include PubMed, Embase, Springer, Web of Science, the Cochrane Library, the World Health Organization International Clinical Trial Registration Platform, the Chinese Medicine Database, the China National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the China Science Journal Database, and the Wanfang Database. Other sources of information, including bibliographies and meeting minutes for identified publications, will also be searched. A manual search for grey literature, including unpublished conference articles will be performed. Additionally, any clinical randomized controlled trials related to CMP for NS, regardless of the publication status and language limitations, will be included in the study. Study selection, data extraction, and research quality assessments will be conducted independently by 2 researchers. The main result was the total clinical efficacy rate or other validated scales after at least 2 weeks of treatment. Secondary outcomes included 24-hour urine protein quantification, blood urea nitrogen, serum creatinine, C-reactive protein, tumor necrosis factor-α, and interleukin 6, recurrence rates and adverse events during follow-up. Implement the Cochrane RevMan V5.3 bias assessment tool to assess bias risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). Mean difference, standard mean deviation and binary data will be used to represent continuous results.

Results:

This study will provide a comprehensive review and evaluation of CMP for the treatment of NS.

Conclusion:

This study will provide new evidence for evaluating the effectiveness and side effects of CMP on NS. Since the data is not personalized, formal ethical approval is not required.

INPLASY registration number:

INPLASY202040181.
Analysis of risk factors associated bowel resection in patients with incarcerated groin hernia
Authors: Chen Peng , Yang Wenming , Zhang Jianhao , Wang Cun , Yu Yongyang , Wang Yong , Yang Lie , Zhou Zongguang
Published: June 2020

Background:

Incarcerated groin hernia (IGH) is a common surgical emergency. However, there are few accurate and applicable predictors for differentiating patients with strangulated groin hernia from those with IGH. In this study, we aimed to identify the independent risk factors for bowel resection in patients with IGH.

Methods:

We retrospectively collected 323 patients who underwent emergency hernia repair surgery for IGH between January 2010 and October 2019. The patients were categorized into those who received bowel resection and those who did not require bowel resection. The receiver-operating characteristic curve was used to identify the best cutoff values for continuous variables. Following this, univariate and multivariate analyses were performed to identify potential risk factors for bowel resection in these patients.

Results:

Univariate analysis identified 6 variables that were significantly associated with bowel resection among patients with IGH. On multivariate analysis, neutrophil-to-lymphocyte ratio (NLR) (odds ratio [OR] = 3.362, 95% confidence interval [CI] 1.705–6.628, P = .000) and bowel obstruction (OR = 3.191, 95% CI 1.873–5.437, P = 0.000) were identified as independent risk factors for bowel resection among patients with IGH.

Conclusion:

In this study, an elevated NLR and those with bowel obstruction are associated with an increased risk of bowel resection among patients with IGH. Based on our findings, surgeons should prioritize prompt emergency surgical repair for patients who present with elevated NLR and bowel obstruction concurrent with IGH.
A retrospective study of probiotics for the treatment of children with antibiotic-associated diarrhea
Authors: Rui Xue , Ma Shu-xia
Published: June 2020

This retrospective study aimed to explore the benefits and safety of probiotics (live combined Bacillus subtilis and Enterococcus faecium granules with multivitamines) for the treatment of children with antibiotic-associated diarrhea (AAD).

A total of 72 children with AAD were analyzed in this study. Of these, 36 children received routine treatment plus probiotics, and were assigned to a treatment group. The other 36 children underwent routine treatment alone, and were assigned to a control group. Patients in both groups were treated for a total of 7 days. The efficacy and safety were evaluated by duration of diarrhea (days), number of dressings needed daily, abdominal pain intensity, stool consistency (as assessed by Bristol Stool Scale (BSS)), and any adverse events.

After treatment, probiotics showed encouraging benefits in decreasing duration of diarrhea (days) (P < .01), number of dressings needed every day (P < .01), abdominal pain intensity (P < .01), and stool consistency (BSS (3–5), P < .01; BSS (6–7), P < .01). In addition, no adverse events were documented in this study.

The findings of this study demonstrated that probiotics may provide promising benefit for children with AAD. Further studies are still needed to warrant theses findings.
Fixed effects analysis of the incidence of cardiovascular outcomes under managed care following the managed care backlash
Authors: Dugan Jerome A.
Published: June 2020

Abstracts

To examine the impact of increased managed care activity on 30-day readmission and mortality for acute myocardial infarctions and congestive heart failure in U.S. hospitals following the managed care backlash against managed care cost containment practices.

The Centers for Medicare and Medicaid Services (CMS) Hospital Compare files, CMS Hospital Cost Report, CMS Medicare Advantage Enrollment files, and Health Resources and Services Administration Area Resource File data for the period 2008 to 2011 were used to construct the study sample. Multivariate fixed effects regression with robust standard errors, hospital fixed effects, and year fixed effects were used to estimate the impact of managed care penetration on adverse cardiovascular outcomes. Our primary outcome measures were readmission and mortality for patients discharged with acute myocardial infarction and congestive heart failure for acute, non-federal hospitals with emergency rooms. To examine effects of hospital ownership status, not-for-profit hospitals were compared to proprietary hospitals.

The main analysis revealed that an increase in managed care penetration was associated with a decline in both 30-day readmission and mortality for acute myocardial infarction and congestive heart failure. In the hospital ownership analysis, only the acute myocardial infarction results for proprietary hospitals was statistically significant. All hospital types reported similar congestive heart failure trends as the full sample; however, proprietary hospitals reported greater declines in readmission and mortality.

Increased managed care activity is associated with reductions in hospital readmission and mortality following the legislative and consumer backlash against managed care, with differential impacts across hospital ownership type. These finding highlights the important role of managed care in creating quality improvements in the delivery of care in the hospital setting.
Comparisons on perinatal depression between the first-child women and the second-child women in West China under the universal 2-child policy
Authors: Guo Xiu-Jing , Chen Jing , Ren Jian-Hua , Deng Xue , Xu Liang-Zhi
Published: June 2020

Background:

Universal 2-child policy was proposed in 2015 in China, but it was still uncertain whether having a second child would have any impacts on maternal health, especially mental health. So, the aim of this study was to compare the incidence of perinatal depression between the first-child women and the second-child women and to describe the patterns of perinatal depression from the first and third trimesters to 6 weeks postpartum.

Methods:

A prospective cohort study was conducted in a university hospital, 969 first-child women and 492 second-child women registered in this hospital from Dec 2017 to Mar 2018 were involved in the study. The Mainland Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) was applied to screen perinatal depressive symptoms, while socio-demographic and obstetric data were obtained by self-administered questionnaires. Multiple logistic regression analyses were used to compare the risk of depression between 2 groups, and repeated measures of analysis of variances (ANOVAs) were used to determine the EPDS scores of 2 groups across 3 stages.

Results:

The incidence of perinatal depression was 21.78% to 24.87% and 18.29% to 22.15% in the first-child group and the second-child group, respectively. The second-child women were less likely to exhibit depressive symptoms than the first-child women in the first trimester (Adjusted OR = 0.630, 95%CI = 0.457–0.868, P = .005), but no significant difference was found between the 2 groups in the third trimester and at postpartum period. During the whole perinatal period, no significant difference was found in EPDS scores of the first-child group among the three stages. However, the EPDS scores of the second-child group were higher in the first trimester than that at the postpartum period.

Conclusion:

The risk of perinatal depression for the second-child women was no higher than for the first-child women, and the EPDS scores of the second-child women were decreasing during the perinatal period. So couples in West China are recommended to consider having a second child without much worry about its negative effects on mental health under the universal 2-child policy.
A simple new scoring system for predicting the mortality of severe acute pancreatitis
Authors: Wang Lei , Zeng Yan-Bo , Chen Jia-Yun , Luo Qian , Wang Rowan , Zhang Ruijie , Zheng Daniel , Dong Yuan-Hang , Zou Wen-Bin , Xie Xiaoqing , Du Yi-Qi , Li Zhao-Shen
Published: June 2020

It is critical to accurately identify patients with severe acute pancreatitis (SAP) in a timely manner. This study aimed to develop a new simplified AP scoring system based on data from Chinese population.

We retrospectively analyzed a consecutive series of 585 patients diagnosed with SAP at the Changhai hospital between 2009 and 2017. The new Chinese simple scoring system (CSSS) was derived using logistic regression analysis and was validated in comparison to 4 existing systems using receiver operating characteristic curves.

Six variables were selected for incorporation into CSSS, including serum creatinine, blood glucose, lactate dehydrogenase, heart rate, C-reactive protein, and extent of pancreatic necrosis. The new CSSS yields a maximum total score of 9 points. The cut-offs for predicting mortality and severity (discriminating moderately SAP from SAP) were set as 6 points and 4 points respectively. Compared with 4 existing scoring systems, the area under the receiver operating characteristic of CSSS for prediction of mortality was 0.838, similar to acute physiology and chronic health evaluation II (0.844) and higher than Ranson's score (0.702, P < .001), bedside index of severity in acute pancreatitis (0.615), and modified computed tomography severity index (MCTSI) (0.736). For predicting SAP severity, CSSS was the most accurate (0.834), followed by acute physiology and chronic health evaluation II (0.800), Ranson's score (0.702), MCTSI (0.660), and bedside index of severity in acute pancreatitis (0.570). Further, the accuracy of predicting pancreatic infection with CSSS was the highest (0.634), similar to that of MCTSI (0.641).

A new prognostic scoring system for SAP was derived and validated in a Chinese sample. This scoring system is a simple and accurate method for prediction of mortality.
A 3-month-old child with COVID-19
Authors: Li Chenxi , Luo Fan , Wu Bing
Published: June 2020

Introduction:

Coronavirus disease 2019 (COVID-19) is pandemic and is a medical issue. However, children account for a small portion of those with the disease, and there are few published reports of COVID-19 in children. The patient reported in this case report is the youngest case reported in Chengdu, China to date.

Patient concerns:

A 3-month-old male infant presented with cough and rhinorrhea.

Diagnosis:

Family members from Wuhan, the epicenter of the epidemic came to stay in the patient's home 16 days before the onset of his disease, and his mother had been diagnosed with COVID-19. He was diagnosed with COVID-19 based on a history of exposure and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), detected using reverse transcription polymerase chain reaction (RT-PCR).

Interventions:

The patient was admitted to hospital and treated symptomatically with oral medication.

Outcomes:

The patient recovered completely and was discharged after one month of hospitalization. He tested negative for SARS-CoV-2 using RT-PCR and a chest CT performed 4 weeks after admission showed marked improvement prior to discharge.

Conclusion:

Clinicians must be aware of the presentation of COVID-19 in children because it differs from that in adults.
Successful sirolimus therapy of an aplastic anemia patient with chronic kidney disease
Authors: Niu Haiyue , Qi Weiwei , Wang Yihao , Xing Limin , Fu Rong , Shao Zonghong , Wang Huaquan
Published: June 2020

Rationale:

It is very difficult to treat patients with aplastic anemia accompanied by chronic kidney disease. The nephrotoxicity of cyclosporine limits its use in these patients. Most of these patients also lack suitable sibling donors. Sirolimus, as a new type of immunosuppressive agent, has good therapeutic effect, lower toxicity, especially lower nephrotoxicity, thus attracting the attention of hematologists.

Patient concerns:

This 55-year-old Chinese male patient suffered from pancytopenia and renal insufficiency and has a poor quality of life.

Diagnosis:

The patient was diagnosed as severe aplastic anemia with chronic kidney disease-G3a.

Interventions:

We started the sirolimus therapy with the initial dose of 1 mg per day. Based on the good tolerability and clinical effect, we increased the dose of sirolimus to 2 mg per day after 2 weeks.

Outcomes:

By taking sirolimus, the patient's peripheral blood cell count gradually increased, and he achieved blood transfusion independent, and eventually the blood cell count was completely normal.

Lessons:

We consider that sirolimus is a safe, effective, and well-tolerated oral drug that can be used as a treatment for aplastic anemia patients with chronic kidney disease.
In Vivo Quantification of Water Diffusion, Stiffness, and Tissue Fluidity in Benign Prostatic Hyperplasia and Prostate Cancer
Authors: Asbach Patrick , Ro Sa-Ra , Aldoj Nader , Snellings Joachim , Reiter Rolf , Lenk Julian , Köhlitz Torsten , Haas Matthias , Guo Jing , Hamm Bernd , Braun Jürgen , Sack Ingolf
Published: June 2020

Objectives

Water diffusion, tissue stiffness, and viscosity characterize the biophysical behavior of tumors. However, little is known about how these parameters correlate in prostate cancer (PCa). Therefore, we paired tomoelastography of the prostate with diffusion-sensitive magnetic resonance imaging for the quantitative mapping of biophysical parameters in benign prostatic hyperplasia (BPH) and PCa.

Materials and Methods

Multifrequency magnetic resonance imaging elastography with tomoelastography processing was performed at 60, 70, and 80 Hz using externally placed compressed-air drivers. Shear-wave speed (SWS) and loss angle (φ) were analyzed as surrogate markers of stiffness and viscosity-related fluidity in the normal peripheral zone (PZ), hyperplastic transition zone (TZ), which is consistent with BPH, and PCa lesions. The SWS and φ were correlated with the normalized apparent diffusion coefficient (nADC).

Results

Thirty-nine men (median age/range, 67/49–88 years), 25 with BPH and 14 with biopsy-proven PCa, were prospectively enrolled in this institutional review board–approved study. The SWS in PCa (3.1 ± 0.6 m/s) was higher than in TZ (2.8 ± 0.3 m/s,P= 0.004) or tended to be higher than in PZ (2.8 ± 0.4 m/s,P= 0.025). Similarly, φ in PCa (1.1 ± 0.1 rad) was higher than in TZ (0.9 ± 0.2 m/s,P< 0.001) and PZ (0.9 ± 0.1 rad,P< 0.001), whereas nADC in PCa (1.3 ± 0.3) was lower than in TZ (2.2 ± 0.4,P< 0.001) and PZ (3.1 ± 0.7,P< 0.001). Pooled nADC was inversely correlated with φ (R= −0.6,P< 0.001) but not with SWS. TZ and PZ only differed in nADC (P< 0.001) but not in viscoelastic properties. Diagnostic differentiation of PCa from normal prostate tissues, as assessed by area under the curve greater than 0.9, was feasible using nADC and φ but not SWS.

Conclusions

Tomoelastography provides quantitative maps of tissue mechanical parameters of the prostate. Prostate cancer is characterized by stiff tissue properties and reduced water diffusion, whereas, at the same time, tissue fluidity is increased, suggesting greater mechanical friction inside the lesion. This biophysical signature correlates with known histopathological features including increased cell density and fibrous protein accumulation.
Automated Segmentation of the Craniofacial Skeleton With “Black Bone” Magnetic Resonance Imaging
Authors: Eley Karen A. , Delso Gaspar
Published: June 2020

Three-dimensional (3D) imaging of the craniofacial skeleton is integral in managing a wide range of bony pathologies. The authors have previously demonstrated the potential of “Black Bone” MRI (BB) as a non-ionizing alternative to CT. However, even in experienced hands 3D rendering of BB datasets can be challenging and time consuming. The objectives of this study were to develop and test a semi- and fully-automated segmentation algorithm for the craniofacial skeleton.

Previously acquired adult volunteer (n = 15) BB datasets of the head were utilized. Imaging was initially 3D rendered with our conventional manual technique. An algorithm to remove the outer soft-tissue envelope was developed and 3D rendering completed with the processed datasets (semi-automated). Finally, a fully automated 3D-rendering method was developed and applied to the datasets. All 3D rendering was completed with Fovia High Definition Volume Rendering (Fovia Inc, Palo Alto, CA). Analysis was undertaken of the 3D visual results and the time taken for data processing and interactive manipulation.

The mean time for manual segmentation was 12.8 minutes, 3.1 minutes for the semi-automated algorithm, and 0 minutes for the fully automated algorithm. Further fine adjustment was undertaken to enhance the automated segmentation results, taking a mean time of 1.4 minutes.

Automated segmentation demonstrates considerable potential, offering significant time saving in the production of 3D BB imaging in adult volunteers. the authors continue to undertake further development of our segmentation algorithms to permit adaption to the pediatric population in whom non-ionizing imaging confers the most potential benefit.
Aminoglycosides in Immunocompromised Critically Ill Patients With Bacterial Pneumonia and Septic Shock: A Post-Hoc Analysis of a Prospective Multicenter Multinational Cohort
Authors: Lopez René , Rello Jordi , Taccone Fabio Silvio , Salem Omar Ben Hadj , Bauer Philippe R. , Séguin Amélie , van de Louw Andry , Metaxa Victoria , Klouche Kada , Martin Loeches Ignacio , Montini Luca , Mehta Sangeeta , Bruneel Fabrice , Lisboa T. , Viana William , Pickkers Peter , Russell Lene , Rusinova Katerina , Kouatchet Achille , Barbier François , Mokart Djamel , Azoulay Elie , Darmon Michael
Published: June 2020

Background:

The routine use of empiric combination therapy with aminoglycosides during critical illness is associated with uncertain benefit and increased risk of acute kidney injury. This study aimed to assess the benefits of aminoglycosides in immunocompromised patients with suspected bacterial pneumonia and sepsis.

Methods:

Secondary analysis of a prospective multicenter study. Adult immunocompromised patients with suspected bacterial pneumonia and sepsis or septic shock were included. Primary outcome was hospital mortality. Secondary outcomes were needed for renal replacement therapy (RRT). Mortality was also assessed in neutropenic patients and in those with confirmed bacterial pneumonia. Results were further analyzed in a cohort matched on risk of receiving aminoglycosides combination.

Results:

Five hundred thirty-five patients were included in this analysis, of whom 187 (35%) received aminoglycosides in addition to another antibiotic effective against gram-negative bacteria. Overall hospital mortality was 59.6% (58.3% vs. 60.3% in patients receiving and not receiving combination therapy; P = 0.71). Lack of association between mortality and aminoglycosides was confirmed after adjustment for confounders and center effect (adjusted OR 1.14 [0.69–1.89]) and in a propensity matched cohort (adjusted OR = 0.89 [0.49–1.61]). No association was found between aminoglycosides and need for RRT (adjusted OR = 0.83 [0.49–1.39], P = 0.477), nor between aminoglycoside use and outcome in neutropenic patients or in patients with confirmed bacterial pneumonia (adjusted OR 0.66 [0.23–1.85] and 1.25 [0.61–2.57], respectively).

Conclusion:

Aminoglycoside combination therapy was not associated with hospital mortality or need for renal replacement therapy in immunocompromised patients with pulmonary sepsis.