bluuebunny/crossref_metadata_2025 huggingface dataset:
Drug induced oral erythema multiforme
Authors: Asif Shaik Mohamed , Shamsudeen Shaik Mohamed , Assiri Khalil Ibrahim , Muburak Hussain Mohammed Al , Kaleem Sultan Mohammed , Khan Abdul Ahad , Shariff Mansoor
Published: April 2021

Introduction:

Drug induced oral erythema multiforme a rare clinical entity which involves only the lips and oral mucosa without skin involvement. These lesions are difficult in diagnosing with other oral ulcerative lesions with similar clinical manifestations.

Patient concerns:

This article presents 2 case reports of Oral erythema multiforme in which drugs were the precipitating factor. Its etiopathogenesis, differential diagnosis and treatment modalities of the disease is discussed.

Diagnosis:

Based on patient's complaints, drug history and clinical appearance, provisional diagnosis of drug induced erythema multiforme was considered.

Intervention:

For case 1, patient was instructed to discontinue usage of drug and prescribed systemic steroid (Prednisolone 10 mg/d) for a week along with germicidal drugs to prevent secondary infection. Medication was tapered to 5 mg/d after first week.

For case 2, patient was instructed to discontinue the drug and systemic steroid prednisolone 20 mg /d for 1 week with tapering dose of 10 mg/d for the second week was administered.

Outcome:

For case 1 and case 2 healing of the lesions were evident on third week of follow up.

Conclusion:

Medications should be taken under medical supervision. Over the counter drugs might lead to allergic reactions like drug induced oral erythema multiforme, which is a rare variant and needs to be differentiate from other oral ulcerative lesion for prompt management and follow-up.
Serum midkine is a more sensitive predictor for hepatocellular carcinoma than Dickkopf-1 and alpha-L-fucosidase in cirrhotic HCV patients
Authors: El-Shayeb Ayman F. , El-Habachi Nihal M. , Mansour Amal R. , Zaghloul Mariam S.
Published: April 2021

Alpha fetoprotein (AFP) level is the gold standard diagnostic tool for detection and monitoring hepatocellular carcinoma (HCC) but with low sensitivity. Thus, the identification of alternative or combined serum markers of HCC is highly needed. Therefore, the aim of this work was to verify the value of serum midkine (MDK), Dickkopf-related protein 1 (DKK1), and alpha-L-fucosidase (AFU) in detection of HCC.

We recruited 244 subjects to the present study; 89 with liver cirrhosis, 86 cirrhotic hepatitis C virus (HCV) induced HCC, and 69 apparently healthy volunteers as controls. Serum AFP, MDK, DKK1, and AFU were measured by ELISA.

Patients with HCC showed significantly higher serum MDK, DKK1, and AFU levels compared with those patients with liver cirrhosis and healthy controls (X
2 = 179.56, 153.94, and 90.07 respectively) (P < .001 in all). In HCC cases, neither of MDK, DKK1, or AFU was correlated with tumor number. On the other hand, only serum DKK1 was significantly higher in lesions >5 cm, those with portal vein thrombosis and advanced HCC stage. Receiver operator characteristic (ROC) curve analysis showed that serum MDK levels discriminated between cirrhosis and HCC at a sensitivity of 100%, a specificity of 90% at cut-off value of >5.1 ng/mL.

Although our results showed that serum MDK, DKK-1, and AFU are increased in HCC cases only MDK may be considered as the most promising serological marker for the prediction of the development of HCC in cirrhotic HCV patients.
Current smoking predicts inadequate response to methotrexate monotherapy in rheumatoid arthritis patients naïve to DMARDs
Authors: Floris Alberto , Perra Daniela , Cangemi Ignazio , Congia Mattia , Chessa Elisabetta , Angioni Maria Maddalena , Mangoni Arduino Aleksander , Erre Gian Luca , Mathieu Alessandro , Piga Matteo , Cauli Alberto
Published: April 2021

Identifying predictors of inadequate response to methotrexate (MTX) in rheumatoid arthritis (RA) is key to move from a “trial and error” to a “personalized medicine” treatment approach where patients less likely to adequately respond to MTX monotherapy could start combination therapy at an earlier stage. This study aimed to identify potential predictors of inadequate response to MTX in RA patients naïve to disease modifying anti-rheumatic drugs.

Data from a real-life cohort of newly diagnosed RA patients starting MTX (baseline, T0) as first-line therapy were analyzed. Outcomes, assessed after 6 months (T1), were defined as failure to achieve a disease activity score 28 (DAS28) low disease activity (LDA) or a good/moderate response to MTX, according to the European League Against Rheumatism (EULAR) response criteria. Logistic regression was used to assess the associations between baseline variables and the study outcomes.

Overall, 294 patients (60.5% females, median age 54.5 years) with a median disease duration of 7.9 months were recruited. At T1, 47.3% of subjects failed to achieve LDA, and 29.3% did not have any EULAR-response. In multivariate analysis, significant associations were observed between no LDA and current smoking (adjusted odds ratio [adjOR] 1.79, P = .037), female gender (adjOR 1.68, P = .048), and higher DAS28 (adjOR 1.31, P = .013); and between no EULAR-response and current smoking (adjOR: 2.04, P = .019), age (adjOR: 0.72 per 10-years increases, P = .001), and higher erythrocyte sedimentation rate (adjOR: 0.49; P = .020). By contrast, there were no associations between past smoker status and study outcomes.

In summary, in our real-life cohort of disease modifying anti-rheumatic drug naïve RA patients, current smoking habit independently predicts inadequate response to MTX. This, together with other independent predictors of response to treatment identified in our study, might assist with personalized monitoring in RA patients. Further studies are required to investigate whether smoking quitting strategies enhance the therapeutic response to MTX.
A randomized phase II trial comparing capecitabine with oxaliplatin or docetaxel as first-line treatment in advanced gastric and gastroesophageal adenocarcinomas
Authors: Ni Lu , Zhang Weihan , Chen Ye , Leng Weibing , Gou Hongfeng , Hu Jiankun , Qiu Meng
Published: April 2021

Background:

A combination of fluoropyrimidines and platinum is widely accepted as the standard first-line treatment for advanced gastric and gastroesophageal adenocarcinomas. However, the benefit compared with platinum-free chemotherapeutic regimens remains controversial. We compared the efficacy and safety of capecitabine with oxaliplatin or docetaxel, as first-line therapy in advanced gastric cancer.

Methods:

Eligible patients were randomly assigned to receive either capecitabine and oxaliplatin (XELOX) (capecitabine 1,000 mg/m2; twice daily for 14 days with oxaliplatin 130 mg/m2 on day 1, every 21 days), or DX (capecitabine 1,000 mg/m2; twice daily for 14 days with docetaxel 75 mg/m2 on day 1, every 21 days). The primary endpoint was the objective response rate (ORR). Secondary endpoints included the disease control rate (DCR), progression-free survival, overall survival, and prespecified safety endpoints.

Results:

Ninety patients were enrolled in the West China Hospital from April 2012 to August 2016; a total of 83 and 66 patients were eligible for safety and efficacy analyses, respectively. Between the XELOX and DX groups, ORR (24.2% vs 24.2%, p = 1.000), DCR (90.9% vs 75.8%, p = 0.099), progression-free survival (6.1m vs 4.1m, p = 0.346), and overall survival (8.8m vs 9.0m, p = 0.973) were similar. There was no significant difference in toxicity between the two regimens. The frequent grade 3 or higher toxicities in the XELOX and DX groups were peripheral neuropathy and hematological toxicity, respectively. Toxicity was tolerable; no treatment-related deaths occurred in either group.

Conclusions:

The DX regimen was not superior to XELOX, but instead, similar. The platinum-containing regimen remains the preferred first-line option for advanced gastric and gastroesophageal adenocarcinomas, and DX might be considered as an alternative for patients unsuitable for platinum-containing chemotherapy.
Human immunodeficiency virus case detection and antiretroviral therapy enrollment among children below and above 18 months old
Authors: Yumo Habakkuk A. , Ndenkeh Jackson N. , Sieleunou Isidore , Nsame Denis N. , Kuwoh Pius B. , Beissner Marcus , Loscher Thomas , Kuaban Christopher
Published: April 2021

While pediatric human immunodeficiency virus (HIV) testing has been more focused on children below 18 months through prevention of mother to child transmission of HIV (PMTCT), the yield of this approach remains unclear comparatively to testing children above 18 months through routine provider-initiated testing and counselling (PITC). This study aimed at assessing and comparing the HIV case detection and antiretroviral therapy (ART) enrolment among children below and above 18 months of age in Cameroon. This information is required to guide the investments in HIV testing among children and adolescents.

We conducted a cross-sectional study where we invited parents visiting or receiving HIV care in 3 hospitals to have their children tested for HIV. HIV testing was done using polymerase chain reaction (PCR) and antibody rapid tests for children <18 months and those ≥18 months, respectively. We compared HIV case detection and ART initiation between the 2 subgroups of children and this using Chi-square test at 5% significant level.

A total of 4079 children aged 6 weeks to 15 years were included in the analysis. Compared with children <18 months, children group ≥18 months was 4-fold higher among those who enrolled in the study (80.3% vs 19.7%, P < .001); 3.5-fold higher among those who tested for HIV (77.6% vs 22.4%, P < .001); 6-fold higher among those who tested HIV+ (85.7% vs 14.3%, P = .24), and 11-fold higher among those who enrolled on ART (91.7% vs 8.3%, P = .02).

Our results show that 4 out of 5 children who tested HIV+ and over 90% of ART enrolled cases were children ≥18 months. Thus, while rolling out PCR HIV testing technology for neonates and infants, committing adequate and proportionate resources in antibody rapid testing for older children is a sine quo none condition to achieve an acquired immunodeficiency syndrome (AIDS)-free generation.
Intensive pulmonary rehabilitation in a pediatric lung transplantation patient
Authors: Choi Eun Jung , Kim Won , Jeon Jae Yong , Ko Eun Jae , Yu Jinho , Choi Se Hoon , Lee Seung Hak , Sung In Young
Published: April 2021

Background:

The pediatric lung transplant is a very important treatment for patients with end-stage lung diseae, and pulmonary rehabilitation (PR) is also an important factor in determining the prognosis. However, there is no much literature available on pulmonary rehabilitation in pediatric patients’ post lung transplant. Through this case report, we would like to present our intensive PR program for pediatric patients’ post-lung transplant.

Patient concerns:

The 10-year-old boy's breathing before receiving a lung transplant continued to deteriorate and he eventually became dependent on a wheelchair.

Diagnosis:

He was diagnosed with infantile acute lymphoblastic leukemia at 6 months of age. At the age of one year, he underwent allogeneic bone marrow transplantation, but was diagnosed with post-transplantation bronchiolitis obliterans (PTBO) two months later. He had a lung transplant at the age of 10.

Interventions:

He was hospitalized and received an initial assessment. This assessment included functional, cognitive, and psychological evaluations. He additionally completed PR exercises twice daily for two weeks. After discharge, he continued to participate in an outpatient-based PR program for three months. During the outpatient phase, PR exercises were performed once weekly, in addition to home-based cognitive training.

Outcomes:

Our intensive post-lung PR program improved our patient's exercise capacity, lung function, and quality of life. As a comprehensive rehabilitation service, our program also included a cognitive training component.

Conclusion:

We describe an intensive PR program tailored to pediatric patients’ post-lung transplant. The program was feasible and resulted in improvements in functional exercise capacity, lung function, and quality of life. Future research into our method is necessary for continued improvement of this novel program.
Impact of administration of nicorandil prior to percutaneous coronary intervention in treatment of acute myocardial infarction
Authors: Li Weijun , Zhang Guozhi
Published: April 2021

Background:

In order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the efficacy and safety of nicorandil prior to percutaneous coronary intervention in acute myocardial infarction (AMI) patients.

Methods:

This systematic review and meta-analysis will be performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers independently will search randomized controlled trials or observational studies about the treatment of nicorandil on AMI patients. Retrieved databases include Web of Science, ClinicalTrials.gov, Pubmed, Embase, and Cochrane Library. And retrieval time is limited from inception to June 2021. Key words are nicorandil, myocardial infarction, or similar expansion words without publication limitation. Biomechanical studies, in vitro studies, review articles, techniques, case reports, letters to the editor, and editorials are excluded.

Results:

The results of our review will be reported strictly following the PRISMA criteria and the review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.

OSF registration number:

10.17605/OSF.IO/UEPKB.
Risk factors for surgical site infection following spinal surgery in Saudi Arabia
Authors: AlGamdi Saleh Saad , Alawi Maha , Bokhari Rakan , Bajunaid Khalid , Mukhtar Abdelmoniem , Baeesa Saleh S.
Published: April 2021

Surgical site infections (SSIs) are common complications after spinal surgery that result in increased morbidity, mortality, and healthcare costs. It was estimated that SSIs after spinal surgery resulted in a 4-fold increase in health care costs. The reported SSI rate following spinal surgery remains highly variable between approximately 0.5% and 18%. In this study, we aimed to estimate the SSI rate and identify possible risk factors for SSI after spinal surgery in our Saudi patient population.

We conducted a single-center, retrospective case–control study in Saudi Arabia that included patients who developed SSIs, while the controls were all consecutive patients who underwent spinal surgery between January 2014 and December 2016. We extracted data on patient characteristics, anthropometric measurements, preoperative laboratory investigations, preoperative infection prevention measures, intraoperative measures, comorbidities, and postoperative care.

We included 201 consecutive patients in our study; their median age was 56.9 years, and 51.2% were men. Only 4% (n = 8) of these patients developed SSIs postoperatively. Postoperative SSIs were significantly associated with longer postoperative hospital stays, hypertension, higher American Society of Anesthesia (ASA) scores, longer procedure durations, and the use of a greater number of blood transfusion units.

This study revealed a low SSI rate following spinal surgery. We identified a history of hypertension, prolonged hospitalization, longer operative time, blood transfusion, and higher ASA score as risk factors for SSI in spine surgery in our population. As our findings are from a single institute, we believe that a national research collaboration among multiple disciplines should be performed to provide better estimates of SSI risk factors in our patient population.
False positive technetium-99m pyrophosphate scintigraphy in a patient with cardiac amyloidosis light chain
Authors: Zeng Yu , Poterucha Timothy J. , Einstein Andrew J. , Zhang Qing , Chen Yucheng , Xie Hangyu , Wan Ke , Liang Yujia , Chen Juncheng , Tang Gongshun
Published: April 2021

Introduction:

Patients with cardiac amyloidosis light chain (AL) present with negative Tc-99m pyrophosphate (PYP) scintigraphy (absent or mild heart uptake). On the contrary, patients with cardiac amyloidosis transthyretin (ATTR) present with positive Tc-99m PYP scanning (intensive heart uptake). We present a false positive Tc-99m PYP scintigraphy (grade 2, the heart-to-contralateral ratio is 1.65) in a patient with AL.

Patient concerns:

A 42-year-old Chinese man complained of effort intolerance, chest discomfort, and short of breath progressively over 1 year. New York Heart Association Class III. Physical examination showed legs swelling. Laboratory revealed elevated brain natriuretic peptide of 23,031 ng/mL (0–88) and Troponin-T of 273.4 ng/mL (0–14).

Diagnosis:

Cardiac amyloidosis light chain. Evidences: free light chains (FLCs): decreased serum free kappa/lambda ratio of 0.043 (0.31–1.56). Immunofixation electrophoresis: a positive lambda light chain monoclonal protein. Cardiac biopsy: HE: Ambiguity Congo red strain. Myocardial immunofluorescence: positive lambda light chain. Myocardial immunohistochemistry: positive lambda light chain, negative kappa light chain, and TTR.

Interventions:

Furosemide 40 mg qd, torasemide 20 mg qd, spirolactone 20 mg qd, potassium chloride 10 mL per 500 mL urine, atorvastatin calcium tablet 20 mg qd, aspirin enteric-coated tablets 100 mg qd during the 2-weeks in-hospital.

Outcomes:

The patient died 2 months later after discharge.

Conclusion:

False positive Tc-99m PYP scintigraphy may rarely presented in patients with cardiac amyloidosis light chain. So, the clonal plasma cell process based on the FLCs and immunofixation is a base to rule out AL cardiac amyloidosis when we interpret a positive Tc-99m PYP scintigraphy.
Long noncoding RNA as a biomarker for the prognosis of ischemic stroke
Authors: Fu Jing , Yu Qian , Xiao Jun , Li Suping
Published: April 2021

Background:

As the most common type of cerebrovascular disease, ischemic stroke is the disturbance of cerebrovascular circulation caused by various factors, with complex pathogenesis. At present, the molecular mechanism of ischemic stroke is still unclear, and there lacks early diagnostic markers. Therefore, there is an urgent need to find effective preventive measures, active diagnostic methods and rapid treatment measures. In recent years, related studies have displayed that long noncoding RNAs (lncRNAs) is related to the prognosis of ischemic stroke. However, the results are not supported by some evidence. Therefore, in this study, meta-analysis was used to analyze the relationship between lncRNAs and the prognosis of ischemic stroke. In addition, we carried out bioinformatics analysis to study the action mechanism and related pathways of lncRNAs in ischemic stroke.

Methods:

Literature search was operated on databases up to March 2021, including China National Knowledge Infrastructure, Chinese Biomedical literature Database, Chinese Scientific and Journal Database, Wan Fang database, Web of Science, PubMed, and EMBASE. The relationship between lncRNAs expression and survival outcome was estimated by hazard ratio (HR) and 95% confidence interval (CI). Meta-analysis was conducted on the Stata 16.0. Starbase v2.0 software predicts microRNAs (miRNAs) that interacts with lncRNAs. In addition, HMDD v2.0 database filters out miRNAs related to ischemic stroke. Furthermore, Consite transcription factor database was used to predict the transcription factors of each lncRNAs and miRNA. At the same time, the transcription factors related to ischemic stroke were screened out after intersection. miRwalk online software was applied to predict the target mRNA of each miRNA, and the common target genes were screened by consistent method. The molecular regulatory network map of lncRNAs in ischemic stroke was drawn. Based on the overlapping target genes, gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and protein-protein interaction (PPI) network analysis were carried out to explore the possible mechanism.

Results:

The results of this meta-analysis would be submitted to peer-reviewed journals for publication.

Conclusion:

This study will provide evidence-based medical evidence for the relationship between lncRNA and the prognosis of ischemic stroke. What is more, bioinformatics analysis will provide ideas for the study of ischemic stroke mechanism.

Ethics and dissemination:

The private information from individuals will not be published. This systematic review also should not damage participants’ rights. Ethical approval is not available. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF Registration Number:

DOI 10.17605/OSF.IO/QBZW6.
Clinical efficacy and acceptability of panretinal photocoagulation combined with conbercept for patients with proliferative diabetic retinopathy
Authors: Wang Liangyu , Chen Zhaoli , Wang Xiaoxue
Published: April 2021

Background:

Although conbercept has been used for other diseases associated with new vascular formation, the effect of single-dose conbercept in combination with proliferative diabetic retinopathy (PDR) have not been established. We thus conducted this protocol for systematic review and meta-analysis to compare the efficacy and acceptability of panretinal photocoagulation (PRP) associated with intravitreal conbercept injections versus PRP alone in the treatment of patients with PDR.

Methods:

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols reporting guidelines and the recommendations of the Cochrane Collaboration were followed to conduct this study. Reviewers will search the PubMed, Cochrane Library, Web of Science, and EMBASE online databases using the key phrases “panretinal photocoagulation,” “conbercept,” and “proliferative diabetic retinopathy” for all cohort studies published up to May 2021. The studies on cohort study focusing on PRP + conbercept and PRP alone for PDR patients will be included in our meta-analysis. At least one of the following outcomes should have been measured: PRP completion rate, proportion of eyes with visual gain/loss, central macular thickness, and incidence of complication. Review Manager software (v 5.4; Cochrane Collaboration) is used for the meta-analysis.

Results:

It was hypothesized that intravitreal conbercept plus PRP was more effective than PRP alone.

OSF registration number:

10.17605/OSF.IO/HCQ2S.
Evaluation of the efficiency of peptide receptor radionuclide therapy in patients with metastatic prostate carcinoma
Authors: Liu Gang , Tang Tang , Liu Xiao-Peng , Zhou Zhong-Hua , Li Feng-Jiao
Published: April 2021

Background:

Metastatic prostate carcinoma has poor prognoses with a median survival period ranging from 2 to 5 years with existing therapeutic challenges. Currently, peptide receptor radionuclide therapy is permitted as a treatment method for metastatic prostate carcinoma patients. Therefore, it is crucial to comprehend the efficiency and safety of peptide receptor radionuclide therapy among this patient population. This study aims to analyse the efficacy of peptide receptor radionuclide therapy when used to treat metastatic prostate carcinoma patients.

Methods:

This research will perform a methodological search in the following electronic databases to find related randomized controlled trials: Cochrane Library, EMBASE, PubMed, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), WanFang database, and Chinese BioMedical Literature. All the databases are searched from their inauguration till November 2020. Two independent authors will screen and select literature for review. The two authors will independently utilize the Cochrane Risk of Bias tool to assess the bias risk in studies. This study also plans to conduct subgroup and sensitivity analyses to evaluate the robustness in the results. Statistical analyses will be conducted with the RevMan 5.3 software.

Results:

A high-quality synthesis of existing evidence related to peptide receptor radionuclide therapy in the treatment of metastatic prostate carcinoma will be presented in this study.

Conclusion:

Our findings will provide evidence to judge whether peptide receptor radionuclide treatment is efficient for metastatic prostate carcinoma patients.

Ethics and dissemination:

An ethics approval is not required because the data of the present study are primarily obtained from published studies.

OSF registration number: December 1, 2020.osf.io/3psx7. (https://osf.io/3psx7/).
Absence of association between pretransplant serum soluble programmed death protein-1 level and prognosis following living donor liver transplantation in patients with hepatocellular carcinoma
Authors: Na Byeong-Gon , Kim Yun Kyu , Hwang Shin , Lee Kyung Jin , Park Gil-Chun , Ahn Chul-Soo , Kim Ki-Hun , Moon Deok-Bog , Ha Tae-Yong , Song Gi-Won , Jung Dong-Hwan , Yang Hunji , Yoon Young-In , Tak Eunyoung , Park Yo-Han , Lee Sung-Gyu
Published: April 2021

Programmed death protein 1 (PD-1) pathway is one of the most critical mechanisms in tumor biology of hepatocellular carcinoma (HCC). The study aimed to assess the prognostic influence of pretransplant serum soluble PD-1 (sPD-1) in patients undergoing liver transplantation for treatment of HCC.

Data from 229 patients with HCC who underwent living donor liver transplantation between January 2010 and December 2015 were retrospectively evaluated. Stored serum samples were used to measure sPD-1 concentrations.

Overall survival (OS) and disease-free survival (DFS) rates were 94.3% and 74.5% at 1 year; 78.2% and 59.2% at 3 years; and 75.4% and 55.5% at 5 years, respectively. Prognostic analysis using pretransplant serum sPD-1 with a cut-off of 93.6 μg/mL (median value of the study cohort) did not have significant prognostic influence on OS (P = .69) and DFS (P = .26). Prognostic analysis using sPD-1 with a cut-off of 300 μg/mL showed similar OS (P = .46) and marginally lower DFS (P = .070). Combination of Milan criteria and sPD-1 with a cutoff of 300 μg/mL showed similar outcomes of OS and DFS in patients within and beyond Milan criteria. Multivariate analysis revealed that only Milan criteria was an independent prognostic for OS and DFS, but pretransplant sPD1 with a cut-off of 300 μg/mL did not become a prognostic factor.

The results of this study demonstrate that pretransplant serum sPD-1 did not show significant influences on post-transplant outcomes in patients with HCC. Further large-scale, multicenter studies are necessary to clarify the role of serum sPD-1 in liver transplantation recipients.
Robot-assisted versus laparoscopic minor hepatectomy
Authors: Wang Ji-Ming , Li Jiang-Fa , Yuan Guan-Dou , He Song-Qing
Published: April 2021

Background:

Robot-assisted and laparoscopic surgery are the most minimally invasive surgical approaches for the removal of liver lesions. Minor hepatectomy is a common surgical procedure. In this study, we evaluated the advantages and disadvantages of robot-assisted vs laparoscopic minor hepatectomy (LMH).

Methods:

A systematic literature search was performed in PubMed, Embase, and the Cochrane Library to identify comparative studies on robot-assisted vs. laparoscopicminor hepatectomy up to February, 2020. The odds ratios (OR) and mean differences with 95% confidence intervals were calculated using the fixed-effects model or random-effects model.

Results:

A total of 12 studies involving 751 patients were included in the meta-analysis. Among them, 297 patients were in the robot-assisted minor hepatectomy (RMH) group and 454 patients were in the LMH group. There were no significant differences in intraoperative blood loss (P = .43), transfusion rates (P = .14), length of hospital stay (P > .64), conversion rate (P = .62), R0 resection rate (P = .56), complications (P = .92), or mortaliy (P = .37) between the 2 groups. However, the RMH group was associated with a longer operative time (P = .0003), and higher cost (P < .00001) compared to the LMH group. No significant differences in overall survival or disease free survival between the 2 groups were observed. In the subgroup analysis of left lateral sectionectomies, RMH was still associated with a longer operative time, but no other differences in clinical outcomes were observed.

Conclusions:

Although RMH is associated with longer operation times and higher costs, it exhibits the same safety and effectiveness as LMH. Prospective randomized controlled clinical trials should now be considered to obtain better evidence for clinical consensus.
Effects of different doses of dexamethasone as local anesthetic adjuvant on brachial plexus block
Authors: Zhang Shuai , Song Meiyan , An Wei , Wang Zhongyi
Published: April 2021

Background:

Dexamethasone has been widely used in brachial plexus block to enhance the effects of brachial plexus block. However, the clinical findings are not consistent with the dosage of dexamethasone prolonging local anesthetic nerve block. Therefore, the purpose of this study was to explore the effects of different doses of dexamethasone as local anesthetic adjuvant on brachial plexus block through network meta-analysis.

Methods:

We searched PubMed, Web of Science, Cochrane Library, and Embase databases to collect all randomized controlled trials (RCTs) of different doses of dexamethasone as local anesthetic adjuvant on brachial plexus block until March 2021. Two researchers then independently screened articles, extracted data, and evaluated the quality of selected literatures. All data was processed by Stata 14.0 and WinBUGS 1.4.3.software.

Results:

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:

Our study is expected to provide high-quality evidence-based medicine advice for the effects of different doses of dexamethasone as local anesthetic adjuvant on brachial plexus block.

Ethics and dissemination:

Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms.

OSF REGISTRATION NUMBER:

DOI 10.17605/OSF.IO/PZ5WR.
Efficacy of modified pressure cuff for thrombolytic treatment on lower extremity deep venous thrombosis
Authors: Li Yan , Sutedjo Janesya , Chen Yu-Chen , Gu Jian-Ping
Published: April 2021

To compare the effectiveness and patient comfort between two methods that block superficial venous blood flow during the thrombolytic treatment of lower extremity deep venous thrombosis (DVT) to provide evidence that informs clinical choice.

One hundred twenty patients with lower extremity DVT were randomly divided into sphygmomanometer (group A, n = 40), tourniquet (group B, n = 40), and control group (no blocking, n = 40). All the patients were treated with a daily dosage of urokinase using a dial sphygmomanometer cuff and tourniquet to block lower extremity superficial vein blood flow. The pressure of the dial sphygmomanometer blocking lower extremity superficial vein blood flow was measured during lower extremity venography. Leg swelling reduction rate, venous patency, thrombus removal rate, and average comfort index were observed during the blocking process.

The average pressure value for group A was 70  ± 10 mm Hg. The differences in the swelling reduction rate and venous patency were significant between the groups. Comparing the two groups at different time points, the average thrombus clearance rate of group A was higher than that of group B and control group. The leg pain scores of group A were lower than those of group B and control group. The postoperative comfort ratio of group A was higher than that of group B, and the proportion of severe discomfort in group A was lower than that in group B.

Compared with the tourniquet, using a dial sphygmomanometer cuff to block lower extremity superficial vein blood flow achieved a better thrombolytic effect on DVT and provided higher patient comfort during treatment.
Auricular acupuncture for shoulder pain
Authors: Hou Xinju , Xiong Wei , Lin Xingzhen , Zhu Yu , Yang Ruifeng , Huang Jiayang , Chen Ziyin , Ma Hongmei
Published: April 2021

Background:

Shoulder pain is a common problem in outpatient medical practice. Recent studies show that acupuncture has therapeutic effect on releasing symptoms of shoulder pain. The aim of this systematic review and meta-analysis is to access the efficacy and safety of auricular acupuncture for shoulder pain.

Methods:

Eight databases will be searched for randomized controlled trials of auricular acupuncture in the treatment of shoulder pain with retrieval time up to September 2020, including PubMed, Embase, The Cochrane Library, Web of science, CNKI, VIP, CBM, and Wangfang Data databases. We will evaluate the methodological quality of the included studies by using Cochrane Risk of Bias tool and conduct data analysis with Review Manager Software.

Results:

The results of this study will be disseminated through a peer-reviewed journal publication.

Conclusion:

The systematic review will provide up-to-date evidence for the efficacy and safety of auricular acupuncture in treating shoulder pain.

PROSPERO registration number:

CRD 42021238797
Effects of Baduanjin on postoperative rehabilitation of patients with breast cancer
Authors: Chen Guangyan , Lin Yuqin , Zhao Xiyun , Pu Bin
Published: April 2021

Background:

Baduanjin, as an ancient Chinese exercise, is beneficial to both physical and mental health. Moreover, researchers discovered that Baduanjin has effects on the recovery of postoperative breast cancer patients. Yet, nobody focused on the systematic review, which can provide convincing evidence to verify the effect of Baduanjin in breast cancer patients. Therefore, our study will conduct a systematic review to fill in the blank, besides we will offer new evidence for clinical workers.

Methods:

PubMed, Embase.com, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and SinoMed will be used for literature search, retrieve time is up to June 1, 2021. We will include randomized controlled trials that evaluate the effects of Baduanjin on postoperative rehabilitation for breast cancer patients. Two independent researchers will perform study selection and data extraction. The risk of bias will be assessed by the Cochrane bias assessment tool. We will use funnel plot and Egger test to evaluate publication bias. Stata 13.0, as a necessary software, will be used to perform statistical analysis. Also, we will utilize subgroup analyses and sensitivity analyses to explore the sources of heterogeneity.

Results:

The results of this study will be published in a peer-reviewed journal.

Conclusion:

Evidence that adequately assesses the effect of Baduanjin in the recovery of breast cancer patients will be confirmed through this systematic review. Our study will offer a guideline for clinical workers, besides we will supply a new way for the rehabilitation of breast cancer patients.
Effect of self-acupressure on middle ear barotrauma associated with hyperbaric oxygen therapy
Authors: Chen Jen-Ming , Lu Zheng-Nan , Wu Re-Wen , Bi Kuo-Wei , Liu Chun-Ting
Published: April 2021

Background:

In hyperbaric oxygen therapy (HBOT), a patient is exposed to pure oxygen in a chamber. While HBOT is a long-standing and well-established treatment for a wide variety of medical conditions, one of the main complications is middle ear barotrauma (MEB), which can lead to complaints of ear discomfort, stuffiness or fullness in the ear, and difficulties in equalizing ear pressure. The aim of this study is to evaluate the efficacy of self-acupressure in preventing and reducing the degree of MEB associated with HBOT.

Methods:

This is a prospective nonrandomized controlled study. A sample of 152 participants will be assigned to 2 groups in a 1:1 ratio. The participants in the control group will receive conventional Valsalva and Toynbee maneuvers, while those in the experimental group will be given additional self-acupressure therapy. The acupoints used will be TE17 (Yifeng), TE21 (Ermen), SI19 (Tinggong), and GB2 (Tinghui). The Modified Teed Classification, symptoms of MEB, and overall ear discomfort levels will be assessed. Data will be analyzed using the Chi-Squared test or t test.

Objectives:

This study aims to evaluate the efficacy of self-acupressure for preventing and reducing the degree of MEB associated with HBOT.

Trial registration:

ClinicalTrials.gov Identifier: NCT04311437. Registered on 17 March, 2020.
Moxibustion therapy for treating patients with postpartum urinary retention
Authors: Li Tianjiao , Hui Xin , Wang Hao , Lin Yao , Zhao Baixiao
Published: April 2021

Background:

Postpartum urinary retention (PUR) is one of the most common complications after parturition which affect women's recovery after childbirth. Many clinical trials have shown that moxibustion, a traditional Chinese medicine therapy, is effective in treating PUR. But its effectiveness has not been evaluated scientifically and systematically. Therefore, this review aims to evaluate the safety and effectiveness of moxibustion therapy in treating patients with PUR.

Methods:

We will search the following electronic databases, regardless of publication status and languages, from their respective inception dates to February 2021: the Cochrane Central Register of Controlled Trails, Pubmed, EMBASE, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan-Fang Database. Clinical randomized controlled trials (RCTs) related to moxibustion therapy for treating PUR will be included. Study selection, data collection, and quality assessment will be independently conducted by 2 researchers. For data synthesis, we will select either the fixed-effects or random-effects model according to heterogeneity assessment. Cure rates and postvoid residual volume (PVRV) will be the primary outcomes. The total effective rate and first urination time will be the second outcomes. Review Manager Software (RevMan) V.5.3 will be used if it is appropriate for meta-analysis. Otherwise, a systematic narrative synthesis will be conducted. The results will be presented as risk ratio (RR) with 95% confidence interval (CI) for dichotomous data and weight mean difference (WMD) or standard mean difference (SMD) 95% CI for continuous data.

Trial registration number:

INPLASY 202140037.
Neonatal consequences of maternal exposure to the chikungunya virus
Authors: Fajardo Thamirys Cosmo Grillo , Gazeta Rosa Estela , Catalan Daniel Thome , Mello Alexandra Siqueira , Silva Andrea Cristina Botelho da , Bertozzi Ana Paula Antunes Pascalicchio , Santos Geovane Ribeiro Dos , Pinto Clóvis Antonio Lopes , Monteiro Cairo Oliveira , Machado Rafael Rahal Guaragna , Oliveira Danielle Bruna Leal , Durigon Edison Luiz , Passos Saulo Duarte
Published: April 2021

Rationale:

The chikungunya virus (CHIKV) was first isolated in a Tanzanian epidemic area between 1952 and 1953. The best description of the CHIKV transmission during pregnancy can be found in a well-documented epidemic in 2005, in the “La Reunion” island, a French territory located in the Indian Ocean, in which about one-third of the population was infected. Reports of arbovirus infections in pregnancy are increasing over time, but the spectrum of clinical findings remains an incognita among researchers, including CHIKV.

Patient concerns:

In this report, it was possible to verify 2 cases exposed to CHIKV during foetal period and the possible implications of the infection on gestational structures and exposed children after the birth.

Diagnosis:

In both cases, the mothers were positive by laboratory tests in serologic analysis for CHIKV, as ezyme-linked immunossorbent assay (ELISA), plaque reduction neutralisation testing (PRNT) and immunofluorescence (IF); but there were no positive tests in quantitative polymerase chain reaction (qPCR) for mothers or children.

Interventions:

The exposed children were followed up in a paediatrics clinic in order not only to provide the medical assistance, but also to verify child development and the possible implications and neurocognitive changes caused by gestational infection.

Outcomes:

There were neurological and developmental changes in one of the children followed up on an outpatient basis. There was an improvement in the neurological situation and symptoms only 3 years and 1 month after birth.

Lessons:

Based on the cases presented, we can conclude that clinical symptoms of CHIKV maternal infection may occur late in new-borns and can affect their development.
Moxibustion for stable chronic obstructive pulmonary disease
Authors: Wang Yanping , Huang Mingru , Tang Liping , Xu Lingxia , Wu Jiangfeng , Wang Fei , Zhang Ying
Published: April 2021

Background:

There is no optimal treatment to alleviate the decline of lung function in the stable phase of chronic obstructive pulmonary disease (COPD). The effectiveness of moxibustion as an adjunctive treatment for COPD in the stable phase has been reported clinically, but the conclusions on efficacy and safety have not been unified. This study will systematically evaluate the efficacy and safety of moxibustion on the treatment of COPD in the stable phase, providing clinical-based evidence

Methods:

We will systematically search 7 literature databases and 2 clinical trial registration platforms. The searching time will be conducted from the establishment of databases to March 31, 2021, regardless of language. We will include the randomized controlled trial (RCT) evaluation of moxibustion combined with basic therapy vs basic therapy alone for the treatment of stable COPD. We will assess the risk of bias for individual RCTs using the Cochrane Handbook 5.1.0 evaluation tool. The primary outcome is forced expiratory volume in 1 second/forced vital capacity. The secondary outcomes include forced expiratory volume in 1 second, forced vital capacity, six-minute walking distance, COPD assessment test score, maximum ventilation, response to treatment, and incidence of adverse events. We will collect the effective data of individual RCT through systematic analysis of the random effect model. Heterogeneity will be tested by Cochran Q test and I-squared statistics. Two subgroup analyses will be performed to explore the sources of heterogeneity based on clinical experience. Excluding RCTs with a high risk of bias, fixed-effect model will be used for sensitivity analysis to test the robustness of the meta-analysis results. The publication bias will be assessed by funnel plot and Egger test.

Results:

This study will provide systematic evidence on the efficacy and safety of moxibustion on the treatment of patients with stable COPD through strict quality assessment and reasonable data synthesis. We hope that the results will be submitted to a peer-reviewed journal for publication.

Conclusion:

This systematic review will provide the best current evidence for the adjuvant treatment of stable COPD with moxibustion.

INPLASY registration number:

INPLASY202140047.
Angiotensin converting enzyme inhibitors and risk of lung cancer
Authors: Batais Mohammed , Almigbal Turky , Alotaibi Khalid , Alodhayani Abdulaziz , Alkhushail Abdullah , Altheaby Abdulrahman , Alhantoushi Mashhor , Alsaad Saad , Dalbhi Sultan Al , Alghamdi Yasser
Published: April 2021

Background:

We performed a meta-analysis to determine whether a consistent relationship exists between the use of angiotensin converting enzyme inhibitors (ACEIs) and the risk of lung cancer. Accordingly, we summarized and reviewed previously published quantitative studies.

Methods:

Eligible studies with reference lists published before June 1st, 2019 were obtained from searching several databases. Random effects’ models were used to summarize the overall estimate of the multivariate adjusted odds ratios (ORs) with 95% confidence intervals (CIs)

Results:

Thirteen observational studies involving 458,686 ACEI users were included in the analysis, Overall, pooled risk ratios indicate that ACEIs use was not a risk factor for lung cancer (RR 0.982, 95% C.I. 0.873 – 1.104; P = .76). There was significant heterogeneity between the studies (Q = 52.54; P < .001; I2 = 86.07). There was no significant association between ACEIs use and lung cancer in studies with over five years of ACEIs exposure (RR 0.95, 95% C.I. 0.75 – 1.20; P = .70); and ≤ 5years of exposure to ACEIs (RR 0.98, 95% C.I. 0.83 – 1.15; P = .77). There were no statistically significant differences in the pooled risk ratio obtained according to the study design (Q = 0.65; P = .723) and the comparator regimen (Q = 3.37; P = .19).

Conclusions:

The use of ACEIs was not associated with an increased risk of lung cancer. Nevertheless, well-designed observational studies with different ethnic populations are still needed to evaluate the long-term (over 10 years) association between ACEIs use and lung cancer.
Effectiveness and safety of Chinese medicine combined with omeprazole in the treatment of gastric ulcer
Authors: Xie Cheng , Liu Langhui , Zhu Suyou , Wei Mingquan
Published: April 2021

Background:

Gastric ulcer (GU) is a common digestive system disease, and the main clinical manifestations are nausea and epigastric pain. In recent years, due to increased life pressure, unhealthy eating habits and environment, the incidence of gastric ulcer has increased year by year. Because the disease has a long treatment cycle and is prone to relapse, if it cannot be controlled in time, it can cause the disease to prolong, affect the daily life and health of the patient, and even cause complications such as upper gastrointestinal bleeding, ulcer perforation, and pyloric obstruction. Helicobacter pylori infection is one of the main causes of GU. Clinically, the curative effect of western medicine or traditional Chinese medicine cannot reach the ideal level, so in recent years, the combination of traditional Chinese and western medicine has been highly praised. The aim of this systematic review is to evaluate the effectiveness and safety of Chinese medicine combined with omeprazole for GU.

Methods:

The data and information will be retrieved from the databases of PubMed, Embase, Cochrane Library, CNKI, VIP, and Wanfang data. Literature search is limited to Chinese and English. The search time range is from the establishment of the database to April 7, 2021. The search strategy uses a combination of subject terms and free words to search. In order to avoid omissions, the search scope includes subject terms, keywords, or full text. Two reviewers will independently exclude substandard articles and extract eligible data. The risk of bias will be assessed using the Cochrane Handbook 5.1.0 for Systematic Reviews of Interventions. RevMan 5.3 will be used for systematic review and meta-analysis. This protocol will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and the systematic review will be reported with the PRISMA statement.

Results and conclusion:

The efficacy and safety of Chinese medicine combined with omeprazole for the treatment of GU will be evaluated, and the conclusion will be published to provide medical evidence for a better clinical decision of patients with GU.