bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of acupuncture in women with advanced reproductive age undergoing in vitro fertilization-embryo transfer: A randomized controlled trial and follicular fluid metabolomics study
Authors: Xia Qingchang , Yu Lingyu , Song Jingyan , Sun Zhengao
Published: September 2023

Background:

The objective of this study was to determine the efficacy of acupuncture on the outcome of in vitro fertilization (IVF) in elderly infertile patients with kidney qi deficiency, and to explore its possible mechanism from the perspective of pseudo-targeted metabolomics of follicular fluid.

Methods:

Sixty cases of elderly women undergoing IVF were sampled and randomly divided into 2 equal groups: the treatment and the elderly control (HA) group. In the treatment group, routine ovulation induction combined with acupuncture treatment was used. Routine ovulation induction combined with sham acupuncture was used in the HA group. Reproductive outcomes of the 2 groups were compared. The follicular fluid of patients obtained on the day of oocyte retrieval was analyzed by the ultra-high-performance liquid chromatography-mass spectrometry analysis system.

Results:

Compared with the HA group, the score of kidney qi deficiency syndrome in the treatment group was significantly decreased, and the 2 PN fertilization rate, high-quality embryo rate and cumulative pregnancy rate were significantly increased (P < .05). Through the identification of target metabolites, 3 metabolic pathways were found to be closely related to the developmental potential of oocytes, namely: Retinol metabolism pathway; Glycine, serine, and threonine metabolism pathway; Glycerophospholipid metabolism pathway.

Conclusion:

From our findings, acupuncture can improve the quality of oocytes thus bettering the outcome of IVF-assisted pregnancy in elderly patients with kidney qi deficiency.

Trial registration:

ChiCTR1800018329.
Preoperative serum CA125 level is a good prognostic predictor in patients with intrahepatic cholangiocarcinoma after hepatectomy: A single-center retrospective study
Authors: Meng Jie , Weng Jun , Wu Jian , Mao Han , Huang Peilu , Chen Shule , Liu Lingyun
Published: September 2023

Serum carbohydrate antigen 125 (CA125) is associated with the prognosis of various malignancies, including ovarian and pancreatic cancer. The relationship between preoperative serum CA125 level and the survival of patients with intrahepatic cholangiocarcinoma (ICC) has not been fully studied. The aim of this study was to explore the prognostic value of CA125 in ICC after hepatectomy. We retrospectively reviewed the clinicopathological data of 178 ICC patients who underwent hepatic resection. Receiver operating characteristic analyses were performed to estimate the relationships of serum CA125, α-fetoprotein, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 with the prognosis of ICC. The predictive value of CA125 for the prognosis of ICC patients was demonstrated by univariate analyses and Cox proportional hazards models. CA125 was correlated with tumor size, differentiation, capsulation, tumor node-metastasis stage, recurrence, and CEA. Univariate analysis indicated that CA125, sex, tumor number, tumor size, differentiation, surgical resection margin, tumor node metastasis stage, and CEA were risk factors for both the overall survival and the disease-free survival of ICC patients. Cox proportional hazards models showed that preoperative elevated CA125, a tumor size > 5 cm, and an R1 surgical resection margin were independent prognostic predictors of overall survival and disease-free survival. CA125 also had strong predictive value for the prognosis of different ICC subgroups, including patients without lymph node metastasis and with elevated carbohydrate antigen 19-9 levels. Preoperative elevated serum CA125 level is a noninvasive, simple, and reliable indicator of the prognosis of ICC patients after hepatectomy.
Intraocular pressure measurement using ICare rebound tonometer in different positions of eye and different locations on cornea
Authors: Wongwanwatana Sirada , Treesit Isaraporn , Funarunart Panrapee , Iemsomboon Wallop , Choontanom Raveewan
Published: September 2023

Intraocular pressure (IOP) is one of the most crucial aspects for diagnosis and treatment plan among patients with glaucoma. Although the gold standard for IOP measurement is Goldmann applanation tonometer (GAT)[1], it must be mounted to a slit lamp biomicroscope. However, rebound tonometer has become popular due to its ease of operation and portable design, does not require topical anesthesia, and results do not differ significantly from those of GAT[2].

The purpose of this cross-sectional study is to investigate the difference in IOP measurement with iCare IC200 in different angles of the eye and different corneal locations. All participants underwent IOP measurement by GAT twice. Then, IOP was measured with iCare by a single physician. IOP was measured in a straight manner in the upright patient position; then participants were asked to look at fixation targets, which located in four different points. IOP was measured in upgaze, downgaze, medial gaze, and lateral gaze. Then, IOP was measured at 2 mm from limbus in superior, inferior, nasal, and temporal cornea. All methods were measured twice, and the mean was used for calculation. The physician who measured IOP by iCare was masked from GAT results. A total of 168 eyes were tested with a mean age of 62.15 ± 12.34 years. Mean IOP measured by GAT and iCare at the central cornea was 15.53 ± 5.57 and 14.78 ± 6.14 mmHg, respectively. The standardized mean difference (SMD) between iCare and GAT was 0.13 (-0.09-0.34), which is insignificant. The average IOP was 0.6, 0.47, 0.91, and 0.44 mmHg lower than the primary position in upgaze, downgaze, medial gaze, and lateral gaze 15 degrees angulated positions respectively (p<.01). IOPs at 2 mm from limbus in the inferior, nasal, and temporal cornea were 0.5, 0.69, and 0.57 mmHg lower than IOP measured at the central cornea (p=<.01). IOP measurements with iCare in different angles of eye were statistically significantly lower than in the primary position. Similarly, IOPs at different locations on cornea were lower than at the central cornea. However, the difference in IOP measurements with iCare in different angles of the eye and different corneal locations was in the trivial range and might be clinically insignificant.
Biosynthesis, structure and biological function of cholesterol glucoside in Helicobacter pylori: A review
Authors: Zhang Lanchi , Xie Jingri
Published: September 2023

Helicobacter pylori (H pylori) is a common pathogen, and about 50% of the world population have been infected with it, so the infection of H pylori has been an urgent public health problem worldwide. H pylori has evolved a variety of strategies to help itself colonize, adapt to the environment and proliferate. Cholesterol glucoside (CG), a characteristic substance in H pylori, is related to the membrane stability, morphology, inflammation induction and immune evasion of H pylori. Therefore, CG may be a new target to weaken the infection effect of H pylori. The biosynthesis process, structure and biological function of CG specific to H pylori, as well as anti-CG drugs are discussed and analyzed in this review, in order to explore whether the inhibition of CG synthesis can be an effective strategy to eradicate H pylori.
Survival and prognosis analysis of systemic lupus erythematosus patients with pulmonary hypertension: A systematic review and meta-analysis
Authors: Yang Jianguo , Zhou Fuyu , Zhou Xinpeng , Sun Yuying , Lun Xueping , Cao Jiaojiao , Fan Bing
Published: September 2023

Background:

The study aimed to evaluate survival rates and prognosis in systemic lupus erythematosus (SLE) patients with pulmonary hypertension (PH) using meta-analysis.

Methods:

PubMed, EMBASE, Cochrane central register of controlled trials, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wan-Fang Database, and Chinese biomedical database were searched. Information and data were screened and extracted by 2 researchers. The obtained data were analyzed using the R software meta package. Quality assessment was conducted using Newcastle-Ottawa Scale. The causes of heterogeneity were analyzed using subgroup analysis and sensitivity analysis. Publication bias was evaluated using Begger funnel plots and Egger test.

Results:

The search strategy yielded a total of 21 studies involving 875 patients included in the final analysis. The pooled 1-, 3- and 5-year survival rates of patients with SLE-PH were 0.9020 (95%CI: 0.8576; 0.9397), 0.8363 (96%CI: 0.7813; 0.8852), 0.7301 (95%CI: 0.6327; 0.8181). The 1-, 3- and 5-year survival rates of echocardiography subgroup were 0.9000 (95%CI: 0.8480; 0.9551), 0.8435 (95%CI: 0.7744; 0.9187), 0.6795 (95%CI: 0.5746; 0.8035), respectively; and there were 0.9174 (95%CI: 0.8951; 0.9402), 0.8529 (95%CI: 0.8255; 0.8812), 0.7757 (95%CI: 0.7409; 0.8121) at right heart catheterization subgroup in the meantime. Multivariate analysis for predicting mortality in SLE-PH patients revealed that diminishing left ventricular ejection fraction, New York Heart Association classification, lupus nephritis, lower cardiac index, and higher red blood cell distribution width level were significantly associated with a higher mortality rate. Treatment with huge doses of cyclophosphamide, tricuspid annular plane systolic excursion/pulmonary artery systolic pressure, and Raynaud phenomenon signaled favorable outcomes.

Conclusion:

The 1-, 3-, and 5-year survival rates of SLE-PH patients in recent years (0.9020, 0.8363, 0.7301) were estimated in this study. SLE-PH patients diagnosed by echocardiography have a worse long-term prognosis than those diagnosed by right heart catheterization. Studies after 2015 have shown significantly better survival than earlier studies.
CT showed multiple pulmonary balloon lesions with intermediate balloon calcification in a case of nodular pulmonary amyloidosis: A case report
Authors: Yin Mingquan , Ouyang Lecong , Tan Jianlong , Liu Wei , Zhang Weidong
Published: September 2023

Rationale:

Amyloidosis is a rare disease characterized by the misfolding of autologous proteins and extracellular deposition of fibrils, which can involve 1 or more vital organs in the body. Nodular pulmonary amyloidosis with extensive pulmonary cysts is even less common. This study discusses the diagnosis and treatment of a case of pulmonary nodular amyloidosis with extensive pulmonary cysts and calcification in the middle of the cysts on chest computed tomography, and reviews the related literature. We hope that this rare case will raise awareness of this disease among clinicians.

Patient concerns:

Multiple pulmonary nodules and cysts were found on computed tomography of the chest, and the patient was eager to further clarify the nature of the nodules and the next treatment plan.

Diagnoses:

Amyloidosis of pulmonary nodules.

Interventions and outcomes:

Since the patient’s primary lesion was outside the bronchial lumen near the hilum, we opted for endobronchial ultrasound-guided tunnel biopsy to obtain pathological specimens, and confirmed the diagnosis of nodular pulmonary amyloidosis. After a definite diagnosis, the patient was regularly followed without any specific treatment.

Lessons:

For patients with multiple pulmonary nodules combined with extensive pulmonary cysts, we also need to be alert to the possibility of pulmonary nodule amyloidosis. Secondly, when the main lesion is located outside the bronchial cavity near the hilum of the lung, the method of pathological tissue biopsy should also consider endobronchial ultrasound-guided tunnel biopsy.
Chylous aqueous humor caused by hyperlipidemia: A case report and literature review
Authors: Zhao Jing , Zou He , Xiao Jun
Published: September 2023

Rationale:

Generally, there is no lipoprotein in aqueous humor, and chyle usually exists transiently in the body. Therefore, persistent chylous aqueous humor is rare.

Patient concerns:

We report a case of a 39-year-old man with persistent milky white appearance over the right eye.

Diagnoses:

The patient had a history of poorly controlled diabetes for the past 2 years and central retinal vein occlusion of the same eye for the past 2 weeks. The patient’s right eye had a uniform milky appearance in the anterior chamber, transparent cornea, and no keratic precipitate in the posterior cornea. Color Doppler ultrasound of the affected eye showed no obvious inflammation in the vitreous cavity. Laboratory tests revealed severe chylemia. The patient was finally diagnosed as chylous aqueous humor.

Interventions and outcomes:

After conventional hypolipidemia and hypoglycemia treatment and locally glucocorticoid treatment. The milky white changes in the anterior chamber improved considerably and finally disappeared.

Lessons:

Although the impact of hyperlipidemia on the cardiovascular system and digestive system is well known, its impact on the eyes is often overlooked. We report a rare case of unilateral chylous aqueous humor caused by hyperlipidemia. Through the analysis of this special case, we recommend that ophthalmologists should pay attention to the impact of blood lipid change on eyes.
Biomechanical study of the fixation ability of the dorsal and volar locking plate for transverse metacarpal neck fractures
Authors: Ho Tsung-Yu , Hsu Cheng-En , Wang Wei-Chih , Ting Yen-Nien , Tsai Ming-Tzu , Chiu Yung-Cheng , Hsu Jui-Ting
Published: September 2023

Metacarpal neck fracture is one of the most common types of hand fractures; the literature suggests that applying a bone plate on the dorsal side provides higher fixation strength than that provided by other fixation methods. However, bone plate fixation on the dorsal side may result in postoperative tendon adhesion. So far, no studies have investigated the fixation of metacarpal neck fractures on the volar side by using a bone plate. The objective of this study was to investigate the differences in the fixation results between bone plate fixation on the dorsal side and bone plate fixation on the volar side of the metacarpal in the case of a metacarpal neck fracture. A saw blade was used to create a transverse metacarpal neck fracture on 14 artificial metacarpal bone specimens. The specimens were divided into 2 groups depending on the fixation method: a volar locking plate (VLP) group and a dorsal locking plate (DLP) group. All specimens were subjected to a cantilever bending test on a material testing system, and a force–displacement curve was used to measure the yield force and stiffness, which served as an indicator of the fixation ability of the 2 fracture fixation methods. For the experimental results, the Mann–Whitney U test was used to compare the fixation abilities of the 2 fixation methods. In terms of yield force, the DLP group (266.9 ± 68.3 N) scored significantly higher than the VLP group (32.6 ± 2.7 N) (P < .05); expressed in terms of median, the DLP group scored 8.2 times higher than the VLP group. Similarly, in terms of stiffness, the DLP group (69.0 ± 13.4 N/mm, median ± interquartile range) scored significantly higher than the VLP group (12.9 ± 1.4 N/mm) (P < .05); expressed in terms of median, the DLP group scored 5.3 times higher than the VLP group. The fixation strength of volar bone plates is only about one-third of that of dorsal bone plates.
Effects of the beta-blocker carvedilol on arrhythmia and long-term clinical outcomes in benign prostate hypertrophy patients
Authors: Kim Soo Jin , Park Han Su , Kang Pil Moon , Kim Bong Joon , Kim Hyun Su , Heo Jung Ho , Kim Taek Sang , Im Sung Il
Published: September 2023

Benign prostatic hypertrophy (BPH) is associated with autonomic dysfunction and sympathetic nervous system mediated by the alpha receptor. However, limited data exist regarding the effects of the beta-blocker (BB) carvedilol on arrhythmia and urologic outcomes in BPH patients. Our database of patients diagnosed with BPH from 2015 to 2020 was used to obtain echocardiography and electrocardiogram data. Inclusion criteria were BPH patients taking BBs. International Prostate Symptom Score questionnaire were used to evaluate the urinary symptoms and quality of life. Among 448 patients with BPH (69.2 ± 10.9 years) taking BBs, 219 patients took carvedilol (48.9%) and 229 patients took a non-carvedilol BB (51.1%; bisoprolol, 184 patients, 80% or nebivolol, 45 patients, 20%). Difference in the baseline characteristics was not observed. During the median 36-month follow-up, a lower incidence of arrhythmic events (P = .029), total urologic events (P < .001), and less use of additive alpha-blocker was observed in the carvedilol group (P = .022). In multivariate analysis, less carvedilol use (P = .019), heart failure (P < .001), stroke (P < .001), and cardiomyopathy (P = .046) were independent risk factors for arrhythmic events. In addition, less carvedilol use (P = .009) and older age (P = .005) were independent risk factors for urologic events based on BB type at the median 36-month follow-up. The use of carvedilol was associated with less arrhythmic events in BPH patients with palpitation and decreased the incidence of urologic events in BPH compared with the use of non-carvedilol BBs in long-term follow-up.
Distribution of bacteria and risk factors in patients with multidrug-resistant pneumonia in a single center rehabilitation ward
Authors: Wu Bangqi , Peng Maohan , Tong Yuanyuan , Wang Xuhui , Ding Yi , Cheng Xinyue
Published: September 2023

Stroke patients may have dysphagia and frequent aspiration increasing exposure to antibiotics and the chance of multidrug-resistant (MDR) bacteria infection. This study investigated clinical risk factors and related antibiotic use of MDR bacteria infection in stroke patients in the rehabilitation ward, hoping that it can help prevent and reduce the condition of MDR bacteria. A retrospective cohort study was conducted using the database of stroke patients with pneumonia admitted to the rehabilitation ward from January 1, 2020, to June 30, 2022. The selected stroke patients were divided into the MDR and non-MDR groups. Analyze the infection bacteria of the 2 groups. Forward logistic regression was applied to identify possible independent MDR bacteria infection risk factors. A total of 323 patients were included. The top 3 common MDR pathogens were Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii. Almost all Pseudomonas aeruginosa and Acinetobacter baumannii are resistant to ertapenem. National Institute of Health stroke scale at admission was associated with MDR bacteria infection pneumonia (OR [odds ratio] = 1.078, 95%CI [1.017, 1.142]). Long-term tracheotomy (OR = 2.695, 95%CI [1.232, 5.897]), hypoalbuminemia (OR = 473, 95%CI [1.318, 4.642]), and bilateral cerebral hemisphere stroke (OR = 4.021, 95%CI [2.009, 8.048]) were significant clinical risk factors of MDR pneumonia after stroke. The detection rate of MDR bacteria has increased. Understanding the distribution and drug resistance of MDR bacteria in stroke patients with pneumonia in the neurological rehabilitation ward and the related susceptibility of MDR bacteria infection is necessary. This way, the treatment plan can be adjusted more timely, avoiding the abuse of antibiotics.
Effect of platelet content on occurrence and prognosis of distal radius fracture
Authors: Ding Danyang , Zhu Hao , Zheng Meiliang , Kang Chunbo
Published: September 2023

Fractures of the distal radius are a common fracture with an increasing incidence. However, the underlying factors for distal radius fractures (DRFs) remain unclear. A total of 123 patients with distal radial fractures were recruited. To document clinical and follow-up data, and measure the levels of white blood cells, hemoglobin, platelets, and red blood cells in the bloodstream for qualitative observation of their expression effects within the human body, specifically assessing whether the magnitudes of these indicators are associated with potential factors influencing DRF. Pearson chi-square test and Spearman correlation were used to analyze the relationship between DRF and related parameters. Univariate and multivariate logistic regression and multivariate Cox proportional risk regression were used for further analysis. Pearson chi-square test and Spearman correlation analysis showed a significant correlation between platelet and red blood cell levels and the occurrence of DRFs. Univariate logistic regression analysis demonstrated a significant correlation between platelet count (OR [odds ratio] = 6.286, 95% CI [confidence interval]: 2.862–13.808, P < .001) and red blood cell count (OR = 2.780, 95% CI: 1.322–5.843, P = .007) with DRFs. Increasing levels of both indicators were associated with a higher susceptibility to DRFs. Multivariate logistic regression showed that platelets (OR = 6.344, 95% CI: 2.709–14.855, P < .001) were significantly associated with DRFs. Multivariate Cox regression analysis showed sex (HR [hazard ratio] = 0.596, 95% CI: 0.381–0.931, P = .023) and platelet (HR = 3.721, 95% CI: 2.364–5.855, P < .001) were significantly associated with maintenance time from recovery to recurrence (MTRR) of DRFs. In other words, the platelet content in the body of different genders is different, and the MTRR of DRF is different. Platelets were significantly associated with DRFs. The higher the platelet count, the higher the risk of DRF and the shorter the time of DRF recurrence.
Intervention study of tai chi training on the intestinal flora of college student basketball players
Authors: Kang Dongyang , Wang Xiaorong , Wang Jiahong
Published: September 2023

Background:

In recent years, the interactions between host and host-associated gut flora have received increasingly widespread attention. Tai chi is a traditional Chinese exercise, which can significantly benefit adults with health condition. But the studies on the function of intestinal flora and its correlation with tai chi exercise, are limited. In addition, the influence of tai chi on intestinal flora has largely been understudied. In this study, we investigated the changes in intestinal microflora by 16S rRNA sequencing to clarify the specific mechanism of tai chi on the regulation of intestinal flora and seek to formulate a reasonable “exercise prescription.”

Methods:

Design: randomized controlled trial. Participants: thirty college basketball players randomly divided into control (n = 15) and test (n = 15) groups. Intervention: experimental group practiced 24-style simplified tai chi ≥ 6 times/week for 20 weeks. Outcomes: serum biochemical markers, blood pressure, and intestinal microbial composition measured post-intervention. Analysis: intent-to-treat analysis.

Results:

Primary outcomes: after tai chi intervention, the level of high-density lipoprotein cholesterol (1.22 mmol/L) and triglycerides (0.64 mmol/L) were significantly decreased. Secondary outcomes: aspartate transaminase, alanine aminotransferase, total cholesterol, and low-density lipoprotein remained unchanged. Microbiota: α-diversity index significantly increased, particularly with increased Blautia. Blood pressure: test group showed significantly lower diastolic blood pressure (83–95 mm Hg) compared to control.

Discussion:

Considering other markers, increased gut flora diversity during exercise may imply a healthier gut environment. Physical exercise promotes a decrease in the inflammatory process by reducing the levels of bacteria associated with pro-inflammation, such as Proteobacteria. Further research is required to understand the nuanced link between gut flora diversity and exercise intensity.

Conclusion:

24-style simplified tai chi enhances human intestinal flora diversity. Improvements observed in blood lipid profiles and blood pressure levels.
Analysis of the influence factors of cervical lymph node metastasis in Papillary thyroid carcinoma: A retrospective observational study
Authors: Lou Jinfeng , Yang Jiahui , Luo Yong , Zhu Ye , Xu Zheng , Hua Tebo
Published: September 2023

Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, and surgery is crucial for curing PTC. PTC patients often experience lymph node metastasis (LNM) in the neck, and central lymph node metastasis (CLNM) significantly affects the recurrence rate of PTC. Therefore, the thoroughness of the surgery is particularly important for the treatment of PTC. However, there is still controversy regarding the choice of surgical approach. This study retrospectively analyzed the clinical data of 69 PTC patients treated at our hospital from December 2019 to April 2022 and clinically analyzed the high-risk factors for neck LNM. In this study, the patients aged ≤ 55 years were examined in which the number of patients with CLNM were 42 cases (80.77%), tumor diameter >2 cm were 15 cases (100%), the multifocal carcinoma were 38 cases (88.37%) and the involvement of membrane were 38 cases (80.85%), the number of patients whose had lateral cervical lymph node metastasis (LLNM), respectively 43 cases (82.69%), 14 cases (93.33%), 39 cases (90.7%) and 40 cases (85.11%),all of these factors were associated with cervical LNM (P < .05), but was not correlation with sex, double lobe carcinoma, extra glandular invasion and hashimoto (P > .05). The patient’s age and number of cancers were independent risk factors for LNM in the central region of the neck (P < .05), while the patient’s age, tumor size and number of cancers were significant risk factors for LNM in the lateral cervical region (P < .05). We concluded that cervical LNM was related with the high-risk factors of patient’s age, tumor size, multifocal carcinoma in PTC. Especially, modified radical cervical dissection or selective cervical dissection was suggested in the PTC patients who were younger than 42.5 years old, with tumor diameter larger than 2 cm and multifocal carcinoma.
Effects of liraglutide on extraglycemic inflammatory markers and renal hemodynamic parameters in diabetic kidney disease (DKD)
Authors: Song Wenjuan , Xu Mei , Sun Xuemei , Rao Xiaopang
Published: September 2023

Diabetic kidney disease (DKD) was the leading cause of kidney disease, which has been a crucial public health. Liraglutide is a drug, widely used for DKD treatment globally. However, the extraglycemic inflammatory markers and renal hemodynamic parameters of DKD patients treated with liraglutide has been not reported. In this study, 160 patients with early DKD were enrolled, 80 cases in the control group and 80 cases in the treatment group, respectively. The individuals in the control group were treated with metformin, while the individuals in the treatment group were treated with liraglutide and metformin for 3 months. The urinary microalbumin and urinary creatinine was measured to calculate the ratio (UACR), while the Doppler ultrasound were measured before and after treatment. After 3 months of treatment, body mass index (BMI), waist circumference (WC) and low-density lipoprotein cholesterol (LDL) in the treatment group were significantly decreased compared with before and after treatment in the control group; the levels of cystatin and UACR in treatment group were lower than before treatment and control group; The end-diastolic blood flow velocity (EDV) of renal artery and segment artery in treatment group was significantly higher than that before treatment and control group; The levels of CRP, TNF-α and IL-6 in the treatment group after treatment were lower than those before treatment and those in the control group. After 3 months of treatment, blood cystatin in the treatment group decreased significantly compared with before treatment and after treatment in the control group, with statistical significance After 3 months of treatment, the EDV of renal artery and renal segment in treatment group was significantly higher than that before treatment and control group, the peak systolic blood flow velocity (PSV) and EDV of renal interlobar artery in treatment group were significantly higher than those before treatment and control group. The resistance index (RI) was significantly lower than that before treatment and control group. Liraglutide can reduce inflammatory indicators, renal artery blood flow and renal function indicators in early DKD patients.
Appropriateness of rivaroxaban and apixaban dosing in hospitalized patients with a newly diagnosed nonvalvular atrial fibrillation at a single tertiary hospital
Authors: Alshibani Mohannad
Published: September 2023

Possible challenges in dosing non-vitamin K antagonist oral anticoagulants in nonvalvular atrial fibrillation (NVAF) and limited evidence in Saudi Arabia make it difficult to assess their appropriateness. This study aimed to assess the appropriateness of prescribing rivaroxaban and apixaban in hospitalized patients with newly diagnosed NVAF. This single-center, descriptive, retrospective study was conducted at a tertiary hospital in Saudi Arabia between December 2018 and December 2019. The included patients were aged 18 years and older with newly diagnosed NVAF who received either rivaroxaban or apixaban during hospitalization. The primary outcome was the dosing appropriateness of rivaroxaban and apixaban in NVAF based on recent food and drug administration prescribing guidelines. Descriptive statistics including frequencies and percentages as well as mean ± standard deviation was used to summarize the data. Pearson Chi-square was used to test for significant difference in proportions of appropriate and inappropriate dosing. Pearson Correlation was used to test for associations between underdosing and overdosing with other patients characteristics. A priori P value < .05 was considered significant throughout. A total of 203 patients were included in our analysis. Majority of the patients {125 (61.6%), P = .001} received rivaroxaban. Overall, the dosing appropriateness observed in 143 (70.5%) of the patients who received the rivaroxaban and apixaban was significantly higher than the dosing inappropriateness observed in 60 (29.5%) of the patients who received the same drugs, P < .001. Apixaban had the highest proportion of patients, 45 (57.7%) with dosing inappropriateness. Overall, underdosing was the most common dosing inappropriateness observed in 53 (26.1%) of the patients. There was a significant negative correlation between the drugs underdosing and creatinine clearance, r = −0.223, P = .001. The findings in our present study showed that majority of the patients received appropriate dosing of rivaroxaban and apixaban in hospitalized patients with NVAF. Healthcare providers should update themselves with the recent dosing recommendations for the non-vitamin K-antagonist oral anticoagulants in NVAF to further improve the dosing appropriateness in hospitalized patients with NVAF.
Update on respiratory lesions in patients with IgG4-related autoimmune pancreatitis
Authors: Kawakami Satoshi , Yamamoto Hiroshi , Komatsu Masamichi , Todoroki Keisuke , Nakamura Akira , Oguchi Takaya , Uehara Takeshi , Umemura Takeji , Fujinaga Yasunari
Published: September 2023

We previously reported respiratory involvement in 25 patients with autoimmune pancreatitis, a pancreatic manifestation of IgG4-related disease that responds well to glucocorticoid treatment. However, whether all respiratory lesions in patients with autoimmune pancreatitis have genuine respiratory involvement is unclear. This study aimed to update respiratory lesions’ clinical and radiological characteristics in patients with autoimmune pancreatitis. We retrospectively reviewed the clinical and radiological data of 74 consecutive patients diagnosed with autoimmune pancreatitis at Shinshu University Hospital and treated with glucocorticoid. Clinical features and chest high-resolution computed tomography findings before and after therapy were reviewed. Fifty-one patients (68.9%) had respiratory lesions. In 65 of the 74 patients, chest high-resolution computed tomography results were evaluated before and after treatment. Patients with IgG4-related disease and respiratory lesions showed significantly higher serum IgG4 levels and hypocomplementemia than those without respiratory lesions; they also had more affected organs. While most abnormal thoracic findings improved, 4 cases of 7 with reticular opacities and all 11 cases with emphysema did not improve. Therefore, these lesions with poor response to glucocorticoid treatment should not be considered due to respiratory involvement of autoimmune pancreatitis based on the current classification criteria for IgG4-related disease. Patients with autoimmune pancreatitis and respiratory lesions exhibited higher disease activity than those without. Most chest high-resolution computed tomography lesions were responsive to glucocorticoid treatment, whereas reticular opacities and emphysema were poorly responsive.
Mechanism of Simiao Decoction in the treatment of atherosclerosis based on network pharmacology prediction and molecular docking
Authors: Li Qian , Chai Yihui , Li Wen , Guan Liancheng , Fan Yizi , Chen Yunzhi
Published: September 2023

To explore the molecular mechanism of Simiao Decoction (SMD) intervening atherosclerosis (AS). The main components and potential mechanisms of SMD remain unknown. This study aims to initially clarify the potential mechanism of SMD in the treatment of AS based on network pharmacology and molecular docking techniques. The principal components and corresponding protein targets of SMD were searched on Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform and the compound-target network was constructed by Cytoscape3.9.1. AS targets were searched on DrugBank, OMIM, and TTD databases. The intersection of compound target and disease target was obtained and the coincidence target was imported into STRING database to construct a protein–protein interaction network. We further performed Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis on the targets. The molecular docking method was used to verify the interaction between core components of SMD and targets. We created the active compounds-targets network and the active compounds-AS-targets network based on the network database containing Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform, DrugBank, OMIM, and TTD. We discovered that the therapy of AS with SMD involves 3 key substances—quercetin, kaempferol, and luteolin—as well as 5 crucial targets—ALB, AKT1, TNF, IL6, and TP53. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed that the shared targets involved a number of signaling pathways, including the advanced glycosylation end product-receptor of AGE signaling pathway in diabetic complications, Hepatitis B, Lipid and atherosclerosis, Chemical Carcinogenesis-Receptor Activation, and Pathways in Cancer. The molecular docking demonstrated that the binding energies of quercetin, kaempferol, and luteolin with 5 important targets were favorable. This study reveals the active ingredients and potential molecular mechanism of SMD in the treatment of AS, and provides a reference for subsequent basic research.
Capsule endoscopy retention in the upper esophagus: A comprehensive literature review
Authors: Arzivian Arteen , Wiseman Elke , Ko Yanna
Published: September 2023

Capsule endoscopy is the first-line investigation for small bowel disorders. Capsule retention in the small bowel is the most common adverse event. Retention has also been reported in the upper esophagus; however, guidance for diagnosis and management is lacking. This review aims to summarize the diagnostic workup and management of this complication. We conducted a systematic literature review by searching 5 databases; relevant keywords and MeSH terms were used. Exclusion criteria included publications of non-adult patients in non-English languages. Data from eligible studies were analyzed using IBM SPSS 29. Twelve case reports were found (9 males, median age of 76 years); 10 capsule retentions in Zenker’s diverticulum and 2 in the cricopharyngeus. Most patients were asymptomatic before capsule endoscopy. Capsule retention was symptomatic in half of the patients (6/12). A neck X-ray confirmed the diagnosis in all patients. Endoscopic capsule retrieval was achieved by different tools (9/12) (Roth’s net was the most used tool, 6 patients); retrieval required rigid endoscopy in a few cases (3/12). Endoscopic capsule re-insertion was successful; using an overtube to bypass the upper esophagus was the safest method. In conclusion, capsule retention in the upper esophagus is uncommon yet exposes patients to the risk of unnecessary procedures. Symptoms of swallowing and medium-to-large size Zenker’s diverticulum should be considered contra-indications for capsule endoscopy. Neck and chest X-rays are required for elderly patients who do not pass the capsule 2 weeks after ingestion. Endoscopic retrieval using Roth’s net and re-insertion through an overtube should be considered first-line management.
Conservative rehabilitation therapy for respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor: A case series study
Authors: Fang Yu , Wu Jun , Zhang Maolin , Yang Yang , Yao Lijun , Liu Lu , Luo Jun , Li Linjun , Zhang Cheng , Qin Zhiming
Published: September 2023

Rationale:

Cases of respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor have rarely been studied in detail. Diaphragmatic dysfunction in such cases can lead to potentially fatal respiratory and circulatory disturbances. Therefore, timely diagnosis and intervention are important. Conservative rehabilitation therapy is the first choice for respiratory dysfunction due to diaphragmatic dysfunction.

Patient concerns, Diagnoses and Interventions:

We present 3 patients with respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor. The diagnostic methods and therapeutic procedures for diaphragmatic dysfunction for each patient are described in detail. This study highlights the role of ventilator support combined with physical therapy in the treatment of respiratory dysfunction in such cases. The diagnosis of diaphragmatic dysfunction as well as the risk assessment of phrenic nerve involvement are also discussed. The modalities of ventilator support, including modes and parameters, are listed.

Outcomes and Lessons:

This study provides experiences of diagnosis and treatment of respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor. Timely diagnosis of diaphragmatic dysfunction primarily relies on clinical manifestations and radiography. Conservative rehabilitation therapy can improve or restore diaphragmatic function in majority of patients, and avert or delay the need for surgical intervention. Preoperative assessment of the risk of phrenic nerve involvement is important in such cases.
Investigation of epigenetics insights of hypertension: A bibliometric analysis
Authors: Liu Nannan , Xia Lina
Published: September 2023

Purpose:

Hypertension remains a major risk factor for myocardial infarction, heart failure, end-stage renal disease, and stroke. Multiple genes are involved in the process of hypertension with an additional dimension of interaction with the environment. This study conducted a bibliometric analysis of publications in the field of hypertension and epigenetics over the past 10 years to summarize the current status of the field and analyze the trends in the field.

Methods:

On February 5, 2023, we chose the web of science core collection database as the study data source. VOS viewer 1.6.18 and Cite Space 6.1.6 were used to examine publications of research on hypertension and epigenetics that were published between 2013 and 2022. We looked through the papers for journals, organizations, nations and regions, authors, and key terms.

Results:

This analysis covered a total of 1535 papers on studies into hypertension and epigenetics. There were 7279 authors, 83 nations, 1983 organizations, and 606 journals in all of the articles. In the USA, 540 publications were the most. The institution with the most publications was Harvard Medical School. The author with the most articles was Zhao Lubo.

Conclusion:

This study summarizes the global research trends in hypertension and epigenetics. Publications in this field have increased year by year in the last decade and the field of research on hypertension and epigenetics has good prospects for growth.
Anger and aggression research: A bibliometric analysis from 2012 to 2022
Authors: Sun Xiaowen , Yu Xufeng , Li Kejian
Published: September 2023

Anger and aggression are common sources of distress and impairment. There is, however, no available data on anger and aggression based on bibliometric analysis. This study uses bibliometric analysis to analyze research hotspots and trends in anger and aggression. Publications on anger and aggression within the last ten years were collected from the Web of Science Core Collection. Using descriptive bibliometrics, journals, countries, institutions, authors, references, and keywords in anger and aggression research were visually analyzed via CiteSpace. A total of 3114 articles were included, and studies on anger and aggression increased yearly. The publications are mainly from 106 countries led by the USA and 381 institutions led by Univ Penn. We identified 505 authors, where Emil F. Coccaro had the highest number of articles, while Buss A.H. was the most frequently co-cited author. AGGRESSIVE BEHAVIOR is the journal that bore most of the studies, while PLOS ONE was the most cited journal. Our analysis demonstrated that research on anger and aggression is flourishing. Behaviors of anger and aggression, risk factors, neural mechanisms, personality, and adolescence have been researched hotspots in the past ten years. Besides, victimization, drosophila melanogaster, psychopathic traits, and perpetration are emerging anger and aggression research trends.
The feasibility of using the compound kushen injection to treat cervical cancer based on network pharmacology and transcriptomics
Authors: Zhang Yiting , Xu Linjing , Li Ling
Published: September 2023

Background:

To investigate the molecular targets and mechanisms of compound kushen injection (CKI) in the prevention and treatment of cervical cancer based on network pharmacology and transcriptomics.

Methods:

In this study, we used network pharmacology methods to screen for effective compounds, integrated the results of network pharmacology and RNA-seq to comprehensively screen and predict target genes, analyze the biological functions and signaling pathways of target genes, and construct a PPI network to screen for hub genes. The results were further verified by biological experiments, molecular docking, RT-PCR, and western blot analysis.

Results:

The results showed that the hub genes CXCL2, anti-vascular endothelial growth factor, hexokinase 2 are therapeutic targets of CKI for the treatment of Cervical Cancer. These targets were significantly enriched in pathways mainly including pathways in cancer, cell cycle, MAPK signaling pathways, etc. In vitro cell experiments showed that CKI could effectively inhibit the proliferation of cancer cells, promote apoptosis, and induce cell cycle arrest. RT-PCR and western blot experiments showed that the expression of hub genes was significantly decreased. The compounds have good binding activity to hub genes.

Conclusion:

CKI, based on its active ingredients and through multiple targets and multiple pathways, can stop the growth of cervical cancer cells at a certain phase of the cell cycle and cause apoptosis, which proved CKI’s effect in treating cervical cancer.
Safety Considerations for Home Care Providers
Authors: Lucas Michelle , Elliott Brenda
Published: September 2023

Home care is one of the fastest growing industries in the United States, projected to continue increasing as the population ages. However, there are unique safety concerns associated with home care compared to the more controlled hospital or clinic settings, such as driving distractions, potentially dangerous neighborhoods, and in-home risks categorized as environmental, biological, chemical, and emotional. Each home is essentially a new worksite with its own set of safety hazards, increasing the need for home care providers to be aware of safety risks in these ever-changing environments. Ensuring worker safety is essential to the recruitment and retention of home care workers. This article discusses safety risks unique to home care and offers solutions that increase the safety of home care providers. Education around workplace violence, implementation of evidence-based practices, and establishing and adhering to safety policies are paramount.
Weathering the Storm of Caregiving for Persons with Alzheimer's Disease
Authors: Kokoszka Lori
Published: September 2023

Alzheimer's disease (AD) is a progressive incurable disease affecting an individual's cognitive, behavioral, and physical systems. As individuals become more impaired, assistance is required and care may be provided by spouses, family members, or other close companions who serve as informal caregivers. To examine the perceptions and meaning of caring for a person with AD an interpretive descriptive study was used. Semistructured interviews were conducted with 13 informal caregivers. Data analysis revealed two themes: Grappling with the Responsibilities of Invisible Care and Weathering the Storm of Visible Care. Both themes relate to the stress and struggle of the visible and invisible roles of caregivers. The results of the study strengthen the need for home care clinicians to support caregivers who provide both visible and invisible care for persons with AD.
Literature Review and a Relevant Case of Pediatric Collagenous Gastritis: A Rare but Important Etiology of Iron-Deficiency Anemia
Authors: Romano Madison , Plott Natalia , Galligan Andrew , Khalaf Racha
Published: September 2023

An adolescent male with fatigue, weight loss, and iron-deficiency anemia failed to improve with iron supplementation and a gluten-free diet. Endoscopy revealed collagenous gastritis. Pediatric patients with refractory iron deficiency and family history of autoimmune disorders should be referred to pediatric gastroenterology for evaluation of collagenous gastritis and celiac disease.