bluuebunny/crossref_metadata_2025 huggingface dataset:
ICSI outcomes of fresh or cryopreserved spermatozoa from micro-TESE in patients with nonobstructive azoospermia
Authors: Zhang Zhihong , Jing Jili , Luo Lili , Li Leilei , Zhang Hongyang , Xi Qi , Liu Ruizhi
Published: March 2021

The aim of this study was to evaluate intracytoplasmic sperm injection (ICSI) outcomes of fresh and cryopreserved sperm via microdissection testicular sperm extraction (micro-TESE) in patients with nonobstructive azoospermia (NOA).

From March 2016 to February 2020, a total of 244 men with NOA underwent micro-TESE at the Center for Reproductive Medicine, First Hospital of Jilin University, P. R. China. These cases included 40 patients who underwent 40 ICSI cycles with fresh spermatozoa from micro-TESE (Group A) and 30 patients who underwent 30 ICSI cycles with cryopreserved spermatozoa from micro-TESE (Group B). The characteristics, embryonic development, and ICSI outcomes of patients were compared between groups A and B.

Our sperm retrieval rate (SRR) by micro-TESE in patients with NOA was 35.25%. No statistical differences in the patient characteristics and fertilization or quality embryo rates were observed between Groups A and B. Higher miscarriage rates and lower live births were observed in Group B than in Group A (both P < .05).

Fresh testicular spermatozoa seem to produce better ICSI outcomes than cryopreserved testicular spermatozoa from patients with NOA in the micro-TESE-ICSI cycle.
Clinicopathological significance of SOX4 and epithelial−mesenchymal transition markers in patients with laryngeal squamous cell carcinoma
Authors: Zhang Mingjie , Li Hui , Han Yuefeng , Wang Mengjun , Zhang Junjie , Ma Shiyin
Published: March 2021

Background and aim:

Sex-determining region-Y-related high-mobility-group box 4 (SOX4) is associated with the metastasis and prognosis of many cancer types. However, studies on the role of SOX4 in laryngeal squamous cell carcinoma (LSCC) are few, and hence the mechanism is unclear. Epithelial–mesenchymal transition (EMT) allows neoplastic cells to gain the plasticity and motility required for tumor progression and metastasis. This study aimed to analyze the relationship between SOX4 and EMT, and their relationship with clinicopathological factors and related prognosis.

Methods:

Immunohistochemical staining was used to detect the positive expression of SOX4 protein, EMT-related transcription factor protein, and related marker protein in 127 LSCC tissue samples. At the same time, data on various parameters of clinical pathology and postoperative survival were collected.

Results:

The positive expression rate of SOX4 and Slug in LSCC was related to pathological differentiation, lymphatic invasion, and pathological tumor node metastasis (TNM) of a tumor. The expression rates of ZEB1, Twist, E-cadherin, N-cadherin, and β-catenin in LSCC correlated with lymphatic invasion and pathological tumor node metastasis. The expression of SOX4, combined expression of SOX4 and ZEB1, and lymphatic invasion were independent prognostic factors for the total survival time of patients with LSCC.

Conclusions:

In summary, SOX4 was vital in the LSCC EMT process, which might be mediated by transcription factor ZEB1. SOX4 and ZEB1 might serve as potential biomarkers of metastasis and prognosis, as well as promising therapeutic targets of LSCC.
Effectiveness of traditional Chinese medicine music therapy on anxiety and depression emotions of lung cancer patients
Authors: Jiang Xiaolin , Gao Jing , Zheng Yuping
Published: March 2021

Background:

Lung cancer patients often accompanied with severe depression and anxiety emotions, and those negative emotions could affects the treatment and recovery of the illness, decrease the patients’ quality of life. In recent years, traditional Chinese medicine five-element music therapy (TCM-FEMT) is widely used for psychological problems of lung cancer patients for its unique advantages, TCM-FEMT applied to negative emotions management of lung cancer patients has been reported in many publications, but there is lacks evidence-based medicine, in this study, effectiveness of TCM-FEMT on anxiety and depression emotions of lung cancer patients will be systematically evaluated.

Methods:

PubMed, the Cochrane Library, Web of Science, Embase, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Database, WanFang Database were electronically searched to collect RCTs on the efficacy of TCM-FEMT on anxiety and depression emotions of lung cancer patients from inception to February 2021. In addition, retrospect the references of the included literature to supplement the relevant literature. Research selection, data extraction and quality evaluation of literature will be carried out by 2 researchers, respectively. RevMan 5.3 software will be used for statistical analysis.

Results:

This study will comprehensively summarize the current trials to determine the effectiveness of TCM-FEMT on anxiety and depression emotions of lung cancer patients.

Conclusion:

This study will provide comprehensive evidence for the efficacy of TCM-FEMT on anxiety and depression emotions of lung cancer patients.
Study on quantitative diagnosis model of TCM syndromes of post-stroke depression based on combination of disease and syndrome
Authors: Yang Ji-Peng , Zhao Hong , Du Yu-Zheng , Ma Hong-Wen , Zhao Qi , Li Chen , Zhang Yi , Li Bo , Guo Hong-Xia , Ban Hai-Peng , Lin Hai-Ping , Gu Wen-Long , Meng Xiang-Gang , Song Qian , Jin Xiao-Xian , Jiang Tao , Du Xin , Dong Yi-Xin , Jiang Hai-Lun , Wu Nan-Fang , Liu Wei , Rao Chang , Tong Yan-Jie , Li Yu , Liu Jing-Ying
Published: March 2021

Background:

Post-stroke depression (PSD) is one of the most common stroke complications with high morbidity. Researchers have done much clinical research on Traditional Chinese Medicine (TCM) treatment, but very little research on diagnosis. Based on the thought of combination of disease and syndrome, this study will establish a unified and objective quantitative diagnosis model of TCM syndromes of PSD, so as to improve the clinical diagnosis and treatment of PSD.

Objective:

First: To establish a unified and objective quantitative diagnosis model of TCM syndromes in PSD under different disease courses, and identify the corresponding main, secondary, and concurrent symptoms, which are based on the weighting factor of each TCM symptom. Second: To find out the relationship between different stages of PSD and TCM syndromes. Clarify the main syndrome types of PSD under different stages of disease. Reveal the evolution and progression mechanism of TCM syndromes of PSD.

Methods and analysis:

This is a retrospective study of PSD TCM diagnosis. Three hundred patients who were hospitalized in the First Teaching Hospital of Tianjin University of TCM with complete cases from January 2014 to January 2019 are planned to be recruited. The study will mainly collect the diagnostic information from the cases, find the related indicators of TCM and Western medicine in PSD, and clarify the relationship between different disease stages and TCM syndromes. Finally, the PSD TCM syndrome quantitative diagnosis model will be established based on the operation principle of Back Propagation (BP) artificial neural network.

Conclusion:

To collect sufficient medical records and establish models to speed up the process of TCM diagnosis.
Contralateral C7 nerve transfer through posterior vertebral approach combined with selective posterior rhizotomy of the affected cervical nerve in the treatment of central upper limb spastic paralysis
Authors: Guan Jingyu , Lin Jun , Guan Xueqing , Jin Qiang , Zhang Wenchuan
Published: March 2021

Introduction:

C7 nerve transfer alone can improve upper limb motor function and partial spasticity. Selective posterior rhizotomy (SPR) of the cervical nerve alone can comprehensively improve spasticity but without neuromotor regeneration. We propose a novel possible improvement of contralateral C7 (CC7) nerve transfer through the posterior vertebral approach, which was combined with SPR of the affected cervical nerve.

Patient Concerns:

A 33-year-old male patient presented with cerebral hemorrhage of the left basal ganglia, paralysis of the right limbs, and hypesthesia 8 months earlier. The dysfunction of the affected hand was already present at admission. The patient reported a previous history of hypertension for several years and oral antihypertensive drugs, and blood pressure was controlled within a normal range.

Diagnosis:

Central upper limb spastic paralysis. The muscle strength of the right lower limb was grade IV. The Fugl-Meyer score of the right upper limb was 7 points, and the modified Ashworth score was 10.

Interventions:

The patient underwent CC7 transfer and SPR.

Outcomes:

The patient successfully underwent CC7 transfer and SPR without complications. On the day after surgery, the left upper limb motions were normal. The Fugl-Meyer score was 9, and the modified Ashworth score of the right upper limb was 2.

Conclusions:

CC7 nerve transfer through the posterior vertebral approach combined with SPR of the affected cervical nerve can possibly improve the surgical outcomes of selected patients with upper limb motor dysfunction and partial spasticity. This method has not been reported in the literature before, and additional studies are necessary.
Sofosbuvir-based therapies associated with regression of liver fibrosis in patients with hepatitis C virus infection
Authors: Nozaki Akito , Chuma Makoto , Hara Koji , Moriya Satoshi , Fukuda Hiroyuki , Numata Kazushi , Tanaka Katsuaki , Morimoto Manabu , Sakamaki Kentaro , Yamanaka Takeharu , Kondo Masaaki , Maeda Shin
Published: March 2021

Oral direct-acting antiviral (DAA) treatment leads to >95% sustained virological response (SVR) and could be clinically useful in regression of liver fibrosis in chronic hepatitis C virus (HCV) infection. We evaluated if ledipasvir/sofosbuvir or sofosbuvir + ribavirin is associated with regression of fibrosis in HCV patients who achieved SVR.

In this prospective cohort study performed at 3 sites in Japan, patients with genotype 1 and genotype 2 were given standard treatment of ledipasvir 90 mg/sofosbuvir 400 mg and sofosbuvir 400 mg + 200–1000 mg/day ribavirin, respectively, for 12 weeks. Liver fibrosis was assessed using Mac-2-binding protein glycosylation isomer (M2BPGi) and other fibrosis markers (platelet count, Fib-4 index, liver stiffness measurement [LSM]) in patients who achieved SVR.

A total of 98.1% of (n = 101/103) patients in genotype 1 cohort and 100% (n = 16/16) in the genotype 2 cohort achieved SVR12. Based on per-protocol analysis, M2BPGi levels showed a significant decrease (–2.2  cut-off index [COI], P < .0001) at week 48 after treatment initiation. Forty-three patients showed a significant decrease in Fib-4 index (–1.2, P < .0001), and 44 patients showed improvement in LSM (–5.9 kPa, P < .0001).

Achievement of SVR after antiviral therapy was associated with fibrosis regression. M2BPGi correlated well with LSM at week 48 after treatment initiation, supporting the sustainable benefit of HCV therapy.
Two years follow-up of golimumab treatment in refractory enteropathic spondyloarthritis patients with Crohn disease
Authors: Conigliaro Paola , Chimenti Maria Sole , Triggianese Paola , D’Antonio Arianna , Sena Giorgia , Alfieri Norma , Biancone Livia , Perricone Roberto
Published: March 2021

Golimumab is a fully human monoclonal antibody against tumor necrosis factor (TNF) approved for the treatment of ulcerative colitis and not for Crohn disease (CD). Many CD patients experience primary, secondary failure, or intolerance to other TNF inhibitors (TNFi) approved in Italy for CD (adalimumab and infliximab). Spondyloarthritis (SpA) may be associated with CD (enteropathic, ESpA) in up to 50% of patients requiring a multidisciplinary and tailored approach. However, only few data from literature and no formal trials determined the efficacy and safety of golimumab in ESpA patients. We performed a case series on 12 patients affected by active CD and active ESpA were failure or intolerant to previous TNFi approved in Italy for both SpA and CD, infliximab and adalimumab. Golimumab was administered following rheumatologic dosage (subcutaneous 50 mg monthly; 100 mg monthly for patients ≥100 kg). Gastrointestinal and rheumatologic disease activity was evaluated with a follow-up of 2 years. A total of 9 patients were followed for 2 years of golimumab treatment. CD clinical activity ameliorated as shown by the reduction of Harvey–Bradshaw index and Crohn disease activity index (CDAI) at 12 and 24 months of treatment (P = .03 and P = .04, respectively) associated with reduction of C-reactive protein at 12 and 24 months (P = .04 for both comparisons) of treatment. SpA assessment revealed a significant reduction in tender joint count at 6 (P = .03), 12 (P = .03), and 24 months (P = .007) of treatment. Swollen joint count, pain, SpA disease activity, and disability reduced in several patients during the follow-up. No adverse events were registered in the follow-up. We demonstrate good clinical efficacy and safety profile of both gastrointestinal and rheumatologic involvement. This may indicate promising therapeutic option for ESpA patients affected by CD, and non-responsive to other TNFi.
Viral shedding in gastroenteritis in children caused by variants and novel recombinant norovirus infections
Authors: Cheng Hung-Yen , Lee Chung-Chan , Chang Yu-Chung , Tsai Chi-Neu , Chao Hsun-Ching , Tsai Yin-Tai , Hsieh Chia-Hsin , Su Sin-Sheng , Chen Shih-Yen
Published: March 2021

Human norovirus (NoV) is the leading cause of acute gastroenteritis and the rapid transmission of NoV renders infection control problematic. Our study aimed to investigate viral shedding in gastroenteritis in children caused by variants of emerging norovirus strains infections.

We used RNA-dependent RNA polymerase (RdRp) sequencing to measure NoV genome copies in stool to understand the relationship between the clinical manifestations and viral shedding in hospitalized patients. The near full-length NoV genome sequence was amplified via reverse transcription-polymerase chain reaction (RT-PCR) and NoV recombination was analyzed using the Recombination Analysis Tool (RAT).

From January 2015 to March 2018, 77 fecal specimens were collected from hospitalized pediatric patients with confirmed NoV gastroenteritis. The NoV genotypes were GII.4 (n = 22), non-GII.4 (n = 14), GII.4 Sydney (n = 21), and GII.P16–GII.2 (n = 20). Viral load increased from days 2 to 9 from the illness onset, resulting in an irregular plateau without peaks. After day 9, the viral load declined gradually and most viral shedding in feces ceased by day 15. The average viral load was highest in GII.4 Sydney followed by GII.P16–GII.2 infections and lowest in non-GII.4 infections. GII.4 unclassified infections showed the longest viral shedding time, followed by GII.4 Sydney infections, GII.P16–GII.2 recombinant infection resulted in the shortest duration. NoVs evolved to form a group of GII.P16–GII.2 variants during the 2017 to 2018 period.

The viral load and shedding period and was different in variants of NoV infections in children. High mutation rate of emerging and re-emerging variants was observed to an enhanced epidemic risk rendering continuous surveillance.
Clinical efficacy enhancement of a Chinese herbal injection in the treatment of mycoplasma pneumonia in children
Authors: Wang Mian , Li Hongying , Yang Jialing , Wang Meng , Liu Jie
Published: March 2021

Background:

Mycoplasma pneumonia is a common disease in pediatrics, and macrolides is the first choice for the treatment. However, the increase of antibiotic resistance of macrolides makes it more and more complicated for clinical treatment. Due to the long term treatment of macrolides, it may increase the incidence of nausea, vomiting, abdominal pain, diarrhea, and other gastrointestinal symptoms, vascular phlebitis, liver and kidney function damage. Tanreqing injection, a Chinese herbal extraction injection, has advantages in the treatment of mycoplasma pneumonia in children, and it could improve the curative effect, shortening the course of disease, and reducing the side effects. Yet there is a lack of standard clinical studies to verify it, so this randomized controlled trial (RCT) will evaluate the efficacy and safety of Tanreqing injection combined with azithromycin in the treatment of mycoplasma pneumonia in children.

Methods:

This is a prospective RCT to study the efficacy and safety of Tanreqing injection combined with azithromycin in the treatment of mycoplasma pneumonia in children. It is approved by the Clinical Research Society of our hospital. According to the 1:1 ratio, the patients will be randomly divided into Tanreqing injection combined with azithromycin group (observation group) and azithromycin group (control group). Duration of hospitalization, clinical improvement 7 days after admission, changing laboratory tests, pulmonary function, immunoglobulin level, and adverse reactions will be compared between the 2 groups. The data will be analyzed by SPSS 16.0 software.

Discussion:

This study will evaluate the efficacy and safety of Tanreqing injection combined with azithromycin in the treatment of mycoplasma pneumonia in children. The results of this experiment will provide clinical basis for the treatment of mycoplasma pneumonia in children with Tanreqing injection combined with azithromycin.

Trial registration:

OSF Registration number: DOI 10.17605/OSF.IO/X6VFS.
Is restrictive fluid resuscitation beneficial not only for hemorrhagic shock but also for septic shock?
Authors: Jiang Shuaiyu , Wu Mengmeng , Lu Xiaoguang , Zhong Yilong , Kang Xin , Song Yi , Fan Zhiwei
Published: March 2021

Background:

Whether to use limited fluid resuscitation (LFR) in patients with hemorrhagic shock or septic shock remains controversial. This research was aimed to assess the pros and cons of utilizing LFR in hemorrhagic shock or septic shock patients.

Methods:

PubMed, Cochrane Library, Embase, Web of science, CNKI, VIP, and Wan Fang database searches included for articles published before December 15, 2020. Randomized controlled trials of LFR or adequate fluid resuscitation in hemorrhagic shock or septic shock patients were selected.

Result:

This meta-analysis including 28 randomized controlled trials (RCTs) and registered 3288 patients. The 7 of 27 RCTs were the patients with septic shock. Others were traumatic hemorrhagic shock patients. Comparing LFR or adequate fluid resuscitation in hemorrhagic shock or septic shock patients, the summary odds ratio (OR) was 0.50 (95% confidence interval [CI] 0.42–0.60, P < .00001) for mortality, 0.46 (95% CI 0.31–0.70, P = .0002) for multiple organ dysfunction syndrome (MODS), 0.35 (95% CI 0.25–0.47) for acute respiratory distress syndrome (ARDS), and 0.33 (95% CI 0.20–0.56) for disseminated intravascular coagulation (DIC).

Conclusion:

Limited fluid resuscitation is the benefit of both traumatic hemorrhagic shock patients and septic shock patients.
The efficacy and safety of PD-1/PD-L1 inhibitors versus chemotherapy in patients with previously treated advanced non-small-cell lung cancer
Authors: Wu Lin-guang-jin , Zhou Dan-ni , Wang Ting , Ma Jun-zhi , Sui Hua , Deng Wan-li
Published: March 2021

Background:

Immune checkpoint inhibitor therapy for non-small cell lung cancer is widely used in clinical practice. However, there has not been a systematic statistical proof of the efficacy of PD-1 inhibitors in patients with advanced cancer. This meta-analysis aims to evaluate its efficacy and related influencing factors, so as to provide a basis for clinical diagnosis and treatment.

Objective:

To assess the effectiveness and safety of programmed death-1 (PD-1)/PD ligand 1 (PD-L1) inhibitors versus chemotherapy as second-line or late-line treatment for patients with advanced non-small-cell lung cancer (NSCLC) via a systematic review of published randomized controlled trials (RCTs).

Methods:

Studies were identified through PubMed, EMBASE, and Cochrane Library electronic databases. RevMan 5.3.5 was used to analyze the data extracted from all eligible studies.

Results:

All 4122 eligible patients from 8 RCTs were included in this study. The meta-analysis showed that PD-1/PD-L1 inhibitors could significantly improve overall survival (hazards ratio [HR] 0.71, 95% confidence interval [CI] 0.66–0.77, P < .001), progression-free survival (HR 0.88, 95%CI 0.81–0.94, P = .01), and objective response rate (HR 2.03, 95%CI 1.66–2.49, P < .001) compared with chemotherapy drugs. The incidence of side effects of any grade (HR 0.34, 95%CI 0.29–0.39, P < .001) or grades 3 to 5 (HR 0.15, 95%CI 0.10–0.23, P < .001) consistently showed that PD-1/PD-L1 inhibitors were safer than chemotherapy. Furthermore, subgroup analysis based on tumor proportion score or pathology classification revealed that PD-1/PD-L1 inhibitors significantly improved overall survival compared with chemotherapy.

Conclusion:

As a second-line or late-line treatment, PD-1/PD-L1 inhibitors are safer and more effective than chemotherapy in patients with advanced NSCLC.
Relationship between long non-coding RNA polymorphism and the risk of coronary artery disease
Authors: Wang Bolin , Su Zhihui , Wan Lijun , He Tao
Published: March 2021

Background:

Previous epidemiological studies displayed that long non-coding RNA (LncRNA) polymorphisms are associated with an increased risk of coronary artery disease, while the results are inconsistent. Therefore, we conducted a meta-analysis to more accurately determine the association between LncRNA polymorphism and the risk of coronary artery disease.

Methods:

PubMed, EmBase and Web of Science databases were searched, and the time to build the database was set until December 2020. The association between LncRNA polymorphism and the risk of coronary artery disease was collected and evaluated. Meta-analysis was performed by STATA 14.0 software, and the odds ratio and its 95% confidence interval (95%CI) were applied to estimate the association between LncRNA polymorphism and the risk of coronary artery disease.

Results:

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

Conclusion:

This meta-analysis will summarize the relationship between LncRNA polymorphism and coronary disease risk.

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. This review would be disseminated in a peer-reviewed journal or conference presentations.

OSF REGISTRATION NUMBER:

DOI 10.17605/OSF.IO/9XPHS.
Effectiveness and safety review of Chinese herbal sachets for external use in the treatment of COVID-19 pandemic
Authors: Ju Jing , Yan Chunchun , Wang Haoran , Ding Yi , Zhang Yongchen , Jia Hongling
Published: March 2021

Background:

COVID-19 has strong transmission power, and people are generally susceptible to it. Patients with weak constitution and low immunity function are more likely to be infected. Aromatic therapy of traditional Chinese medicine has the effect of inhibiting virus and sterilization, especially the external treatment of traditional Chinese medicine has played an important role in the fight against the epidemic situation.

Methods:

Nine databases will be searched under the guideline of research strategy, from their inception to March 31, 2021, for relevant randomized controlled trial (RCTs) published. These databases are Cochrane Library, PubMed, EMBASE, Web of Science, ScienceDirect, China National Knowledge Infrastructure, Wan-fang Data, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database. The types on Language of literature are English and Chinese. Researchers will independently operate the literature research, screening, quality evaluation, data collection, and data analysis with same research strategy and selection criteria. Methodological quality will be evaluated under the guideline of the Cochrane Collaboration's tool. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) will be used to determine confidence in the effect estimates. Meta-analysis or subgroup analysis will be performed according to the including data type. Meta-analysis will be performed with Stata 13.0 software.

Results:

Outcome will be displayed by effective rates, quality of life score, adverse effect.

Conclusion:

This systematic review will provide evidence whether Chinese herbal sachets are effective and safe intervention of COVID-19 Pandemic.

Registration number in PROSPERO

CRD42021238580
PD-L1 expression on peripheral T-cells and association with coronary heart disease patients
Authors: Zhang Chunwei , Yang Ke , Yang Ying , Zhao Gang
Published: March 2021

Background:

As immune checkpoint pathways, programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) can be exploited by tumor cells to evade immuno-surveillance. Inflammation and immune processes play decisive roles in the occurrence and development of coronary heart disease (CHD). The low expression level of PD-1/ PD-L1 or anti-PD-1/PD-L1 therapy can accelerate the immune processes in CHD and aggravates disease based on numerous studies. However, the expression of PD-L1 and CHD still remains controversial to date. We conducted this meta-analysis to detect the value of PD-L1 expression on peripheral T-cells in CHD.

Methods:

We will search PubMed, Embase, Web of Science, Google Scholar, Chinese National Knowledge Infrastructure, Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database for related published studies before February 2021. Two review authors will search and assess relevant studies independently. Case control studies and cohort studies will be included. The Revman 5.3 software was applied to carry out the meta-analysis for the included literature.

Results:

The findings of this systematic review will be disseminated in a peer-reviewed publication and/or presented at relevant conferences.

Conclusion:

This study will provide a new theoretical basis for the immunological prevention and treatment of CHD.

Trial registration number:

DOI 10.17605/OSF.IO/X3R52.

Ethics and dissemination:

Formal ethical approval is not required, as the data are not individualized.
Support with Impella versus intra-aortic balloon pump in acute myocardial infarction complicated by cardiogenic shock
Authors: Rao Lingzhang , Huang Xianli , Luo Jinlan
Published: March 2021

Background:

The survival benefit and safety of Impella support versus intra-aortic balloon counterpulsation (IABP) in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock were investigated in several observational trials that revealed mixed results. Thus, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a meta-analysis to assess the efficacy and safety of Impella versus IABP in AMI complicated by cardiogenic shock.

Methods:

We will search the EMBASE, Web of Knowledge, PubMed, ClinicalTrials.gov, and Cochrane Library from inception to Mar 2021 to retrieve relevant studies. Two independent authors will extract the information from the selected studies. Disagreements will be resolved through a discussion with a third review author. The outcomes include mortality and complications. The quality of randomized trials will be assessed by Cochrane risk of bias tool for randomized controlled trials and the risk of bias in non-randomized studies - of Interventions for non-randomized, observational studies. Review Manager software (v 5.4; Cochrane Collaboration) will be used for the meta-analysis.

Results:

The present meta-analysis will compare the efficacy and safety of Impella versus IABP in AMI complicated by cardiogenic shock.

Conclusions:

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/SKEQ7.

Ethics and dissemination:

Ethical approval and patient consent are not required because this study is a literature-based study. This systematic review and meta-analysis will be published in a peer-reviewed journal.
Rosai-Dorfman disease with infiltration of IgG4-bearing plasma cells presenting as laryngeal-nasal masses and cervical lymphadenopathy
Authors: Lee Miji , Ryu Kyeong Hwa , Baek Hye Jin , Moon Jin Il , Yoon Seokho , An Hyo Jung , Nam In Chul
Published: March 2021

Rationale:

Rosai-Dorfman disease (RDD) is a rare and self-limiting condition caused by the non-neoplastic proliferation of histiocytes/phagocytes in the sinusoids of lymph nodes and in extranodal tissues. Of the extranodal involvement, laryngeal involvement is extremely rare. Because of its rarity and nonspecific clinicoradiologic features, RDD is often difficult to differentiate from other benign or malignant lymphoproliferative diseases. We present a case of RDD with infiltration of IgG4-bearing plasma cells manifesting laryngeal and nasal masses with cervical lymphadenopathy.

Patient concerns:

A 45-year-old male patient presented with recurrent epistaxis and airway disturbance.

Diagnoses:

On endoscopy, there were submucosal masses in both nasal cavities and both sides of subglottic larynx. On neck CT, there were well-defined, enhancing soft tissue masses in both nasal cavities and both sides of subglottic larynx, resulting in mild airway narrowing. In addition, multiple enlarged lymph nodes showing homogeneous enhancement were noted in both parotid glands and both internal jugular chains. All lesions demonstrated marked FDG-uptake on PET/CT. Therefore, the initial radiologic differential diagnoses included lymphoma and IgG4-related disease. Biopsy was performed on the nasal and laryngeal lesions, and they revealed RDD with infiltration of IgG4-bearing plasma cells.

Intervention:

The patient underwent surgical resection of the masses in the nasal cavity and larynx to relieve airway narrowing.

Outcomes:

After surgery, airway obstruction was much improved and the patient was asymptomatic. On outpatient follow-up, he exhibited a stable condition and had no dyspnea on exercise.

Lessons:

Clinical awareness and suspicion are important for the accurate diagnosis and management of patients with homogeneous masses in the larynx or nasal cavity, even if there is no combined cervical lymphadenopathy.
Unilateral T-shaped incomplete duplex nephrectomy in an adolescent under laparoscopy
Authors: He HuaJie , Huang YuanBi , Yu Lu , Li QiGuang , Long Xian , Li YongPeng , Chen RongChao , Yi XianLin
Published: March 2021

Introduction:

Duplicate kidneys are the most common congenital abnormality of the urinary system. The location of duplicate kidneys varies. We report a case of an adolescent with upper and lower kidneys that are arranged vertically and approximately T-shaped.

Patient concerns:

A 16-year-old male teenager was examined for pain in the left side of the waist. The Computed Tomography scan revealed that the left kidney was incompletely duplicated and fused; the left upper urinary tract was incompletely obstructed.

Diagnosis:

The abdominal tomography confirmed the diagnosis of incomplete duplicate kidney.

Interventions:

The patient underwent laparoscopic surgery. The failure to ligate the renal pedicle resulted in increased bleeding during the operation and an open ureteral stump.

Outcomes:

No urine leakage occurred after the operation. Doppler ultrasound of the urinary system showed no hydronephrosis, and the patient was asymptomatic.

Conclusion:

Through this case report, we found that the duplicate kidneys could be arranged in a T-shape under laparoscopy. Although only the supply of the duplicate renal arteries can be ligated during surgical resection, the renal pedicle must also be ligated during the operation if there is a lot of bleeding.
Preoperative neoadjuvant targeted therapy with apatinib for inoperable differentiated thyroid cancer
Authors: Zhang Yingchao , Deng Xianzhao , Ding Zheng , Kang Jie , Wu Bo , Guo Bomin , Fan Youben
Published: March 2021

Rationale:

Though the majority of differentiated thyroid cancer (DTC) patients have a good prognosis after careful and standardized therapy, approximately 13% to 15% of DTC cases show surprisingly aggressive behavior and invasion of the surrounding structures, and a few progress to unresectable diseases. In this study, we report a case of an inoperable locally advanced DTC patient who underwent a curative operation after treatment of preoperative monotherapy of apatinib in a short time.

Patient concerns:

A 64-year-old woman complained of dysphagia due to large cervical mass, which severely invaded the left esophagus at the junction of the neck and thorax.

Diagnoses:

The female patient was diagnosed with locally advanced papillary thyroid cancer (PTC) by cytopathology and it was difficult to perform a safe and complete removal.

Interventions:

Apatinib (500 mg orally once a day) was initially used to treat this patient as a neoadjuvant therapy.

Outcomes:

Six weeks later, the tumor dramatically shrunk from 56 × 37 mm to 29 × 26 mm with well-controlled mild hypertension. After a 10-day interval of apatinib withdrawal, complete tumor excision was accomplished through cervical incision without esophageal fistula. Postoperative thyroid stimulating hormone suppression and radioiodine 131I ablation therapy were performed. At the 1-year follow-up evaluation, no tumor recurrence or metastasis was observed.

Lessons:

Preoperative short term targeted treatment with apatinib for locally advanced inoperable DTC may become a promising neoadjuvant therapy that, can reduce the tumor size and decrease stage, thus making the complete and safe removal of the lesion feasible.
Surgical treatment for upper cervical deformity with atlantoaxial joint dislocation using individualized 3D printing occipitocervical fusion instrument
Authors: Niu Guoqi , Chen Hui , Liu Lutan , Zhou Gong , Zhou Qiankun , Li Chao , Dai Jianhao , Nie Hu , Bai Jianzhong , Zhang Jingquan
Published: March 2021

To introduce a novel technique of using individualized 3D printing occipitocervical fusion instrument (3D-OCF) for the treatment of upper cervical deformity with atlantoaxial joint dislocation.

The surgery for deformity of the craniocervical junction area is a challenge in the field of spine. If the surgical deviation is too large to injure the spinal cord or vertebral artery, it will cause catastrophic damage to the patient. Therefore, it is controversial whether these patients should undergo surgical treatment. We provide a novel surgical approach for the challenging upper cervical surgery through 3D-OCF and a typical patient.

We present a 54-year-old female patient, who suffered from dizziness and numbness in her limbs for 8 months. After the patient was admitted, we performed the three-dimensional CT scan, modeled using Mimics software 17.0, and designed customized occipitocervical fusion instrument. Besides, we repeatedly perform simulated surgery based on 3D-printed models before surgery.

The operative time was 142 minutes and the intraoperative blood loss was 700 mL. X-ray showed reduction of atlantoaxial dislocation and accurate position of internal fixation. The patient's symptoms were significantly relieved: the sensation of dizziness and numbness of limbs was obviously relieved, and the sense of banding in chest, abdomen, and ankle was disappeared. At the last follow-up, imaging showed that 3D-OCF had bone-integration and Syringomyelia was disappeared. The patient's cervical JOA (Japanese Orthopaedic Association) score increased from 10 points to 17 points.

Individualized 3D-OCF can improve the safety and accuracy of upper cervical surgery, reduce the operative time and the number of fluoroscopy. Our study provides a novel surgical approach for the challenging upper cervical surgery.
Risk factors for and impact of poststroke pneumonia in patients with acute ischemic stroke
Authors: Yuan Minghao , Li Qi , Zhang Rongrong , Zhang Wenyu , Zou Ning , Qin Xinyue , Cai Zhiyou
Published: March 2021

Poststroke pneumonia (PSP) is a common complication of stroke and an important cause of death following stroke. However, the treatment of PSP remains inadequate due to severe impairment to the respiratory system by PSP. Thus, it is crucial to focus on preventing PSP to improve the prognosis of patients with stroke.

This prospective single-center Cohort study aimed to investigate the risk factors for pulmonary infection following an ischemic stroke and identify whether PSP significantly influences the prognosis of patients after stroke.

Altogether, 451 patients who were treated for acute ischemic stroke in the First Affiliated Hospital of Chongqing Medical University in China between April 2017 and April 2018 were enrolled. Clinical data from the patients from admission to 3 months after discharge were collected. PSP was the primary outcome and poor prognosis or death at 3 months following discharge was the secondary outcome observed in this study. We performed logistic regression analyses to identify the risk factors for PSP and test an association between pneumonia and poor prognosis or death after stroke.

Our findings revealed the following risk factors for PSP: atrial fibrillation odds ratio (OR) = 2.884, 95% confidence intervals (CI) = 1.316–6.322), being bedridden (OR = 2.797, 95%CI = 1.322–5.921), subject to an invasive procedure (OR = 12.838, 95%CI = 6.296–26.178), massive cerebral infarction (OR = 3.994, 95%CI = 1.496–10.666), and dysphagia (OR = 2.441, 95%CI = 1.114–5.351). Pneumonia was a risk factor for poor prognosis (OR = 2.967, 95%CI = 1.273–6.915) and death (OR = 5.493, 95%CI = 1.825–16.53) after stroke.

Hence, since pneumonia increases the risk of poor prognosis and death following acute ischemic stroke, preventing, and managing the risk factors for PSP may improve the prognosis and reduce the mortality after stroke.
Correlation of autopsy pathological findings and imaging features from 9 fatal cases of COVID-19 pneumonia
Authors: Zhao Lingyun , Wang Xi , Xiong Ying , Fan Yanqing , Zhou Yiwu , Zhu Wenzhen
Published: March 2021

We aimed to investigate the relationship of radiological features and the corresponding pulmonary pathology of patients with Coronavirus Disease (COVID-19) pneumonia.

In this multicenter study, serial chest CT and radiographic images from 9 patients (51–85 years old, 56% male) were reviewed and analyzed. Postmortem lungs were sampled and studied from these autopsies, with a special focus on several corresponding sites based on imaging features.

The predominant pattern of pulmonary injury in these 9 cases was diffuse alveolar damage (DAD) and interstitial inflammation. Moreover, acute fibrinous exudates, organization, inflammatory cell infiltration, hyaline membranes, pulmonary edema, pneumocyte hyperplasia, and fibrosis were all observed. The histopathology features varied according to the site and severity of each lesion. In most of the 9 cases, opacities started from a subpleural area and peripheral structures were more severely damaged based on gross views and pathological examinations. Fibrosis could occur in early stages of infection and this was supported by radiological and pathological findings. The radiological features of COVID-19 pneumonia, at the critically ill stage, were diffuse ground-glass opacities with consolidation, interstitial thickening, and fibrous stripes, which was based in the fibrous tissue proliferation in the alveolar and interlobular septa, and filled alveoli with organizing exudation. Fungal and bacterial co-infections were also observed in 6 cases.

Typical imaging features can be correlated with underlying pathological findings. Combining assessments of imaging features with pathological findings therefore can enhance our understanding of the histopathological mechanism of COVID-19 pneumonia, and facilitate early radiological diagnosis and prognosis estimation of COVID-19 pneumonia, which has important implications for the development of clinical targeted treatments and research related to COVID-19 pneumonia.
The efficacy of combined music therapy and Tai Chi for major depressive disorder
Authors: Xie Huixian , Tang Yiping , Cheng Fengmin , Chu Jucai
Published: March 2021

Background:

There are no clinical trials evaluating the efficacy of combined music and Tai Chi therapy for patients with major depression. Therefore, the primary objective of the present study was to evaluate the efficacy of Tai Chi and music therapy on psychological status and quality of life among patients with major depressive disorder in China.

Methods:

This work is a part of a comprehensive research project to assess and provide intervention that potentially improves psychological status and quality of life among patients with major depressive disorder. This research project has been received ethical approval from the Medical Research and Ethics Committee in Taizhou Second People's Hospital (no. tzey2020023). After the introductory briefing, the acceptance to take the presession questionnaire implied the participant's consent to participate in the study. Eligible participants are divided into 3 groups according to completely randomized design: combined group (music therapy + Tai Chi), music therapy alone group, and Tai Chi alone group. The analyses will be performed using SPSS 22.0.0 (SPSS Inc, Chicago, IL).

Results:

This protocol will provide a reliable theoretical basis for the following research.

Conclusion:

The sample came from a single health center. Therefore, the results cannot be generalized for the entire population.

Trial registration:

This study protocol was registered in Research Registry (researchregistry6597).
Knowledge of attention-deficit hyperactivity disorder among the general public, parents, and primary school teachers
Authors: See Lai-Chu , Li Hsin-Mei , Chao Kuo-Yu , Chung Chia-Chi , Li Pei-Ru , Lin Sheue-Rong
Published: March 2021

We compared the knowledge of attention-deficit hyperactivity disorder (ADHD) among the general public, parents of children with ADHD, and primary school teachers and identified factors associated with ADHD knowledge in each group, separately.

Secondary data analysis was made on the pre-lecture data from those (122 from the general public, 64 parents of children with ADHD, and 515 primary school teachers) attending education lectures by the Department of Public Health, New Taipei City Government, Taiwan, 2014.

ADHD onset age was least known in these 3 groups. Knowledge of ADHD was significantly better among teachers (test score, 75.3%) than among parents (65.5%) and the general public (59.2%). Among the general public, the test score significantly decreased with age and was worst in those who did not know their friends or relatives with ADHD. Among parents, service workers, and retired/unemployed knew significantly less about ADHD than housewife did. Among teachers, men knew significantly less than women; those who taught children with ADHD knew significantly more than those who did not.

Primary school teachers knew more about ADHD than parents and the general public. Factors associated with ADHD knowledge varied among the 3 groups.
18F-Fluorodeoxyglucose positron emission tomography computed tomography detection of single organ vasculitis of the breast
Authors: Harada Taku , Sasaki Yosuke , Tokunaga Takahiro , Yoshizawa Ayuha , Miura Sakiko , Ikeda Keiichiro , Saito Tsukasa , Hiroshige Juichi
Published: March 2021

Rationale:

Although single organ vasculitis (SOV) is a rare occurrence and it is difficult to diagnose, its possibility as a cause of fever of unknown origin (FUO) must be considered. Recently, the usefulness of 18F-fluorodeoxyglucose positron emission tomography computed tomography (FDG PET/CT) in the diagnosis of unknown fevers due to vasculitis, especially in cases of small and medium-sized vasculitis, has begun to be pointed out.

Patient concerns:

We report the case of an 84-year-old woman with persisting fever for more than 2 weeks. She had no accompanying symptoms, other than fever, and the physical examination, echocardiography, and contrast-enhanced CT did not reveal any diagnostic clue.

Diagnoses:

The FDG PET/CT revealed positive uptakes of FDG in the left breast, with a standardized uptake value (SUV) of 2.9. The biopsy specimen of the left breast lesion revealed rupture of the elastic plate and evidence of fibrinoid necrosis of arteries, leading to the diagnosis of polyarteritis (PAN). Further angiographic examination and additional imaging did not reveal the presence of other lesions. Therefore, the diagnosis was established as a PAN-SOV of the left breast.

Interventions:

This patient has improved with follow-up only.

Outcomes:

There has been no evidence of a relapse of PAN over a 5-year follow-up period.

Lessons:

SOV presenting with unspecific local symptoms is difficult to diagnose based on the medical history and clinical examination. Our findings show that early “Combination of PET-CT and biopsy” can be a powerful diagnostic tool in patients with FUO for whom diagnosis of the underlying cause is difficult despite appropriate clinical examination.
Use of subcutaneous immunoglobulin in stiff person syndrome
Authors: Aljarallah Salman , Newsome Scott D.
Published: March 2021

Introduction:

Intravenous immunoglobulin (IVIG) has been shown to be effective for the treatment of stiff person syndrome (SPS). However, some patients might not tolerate it. We report the tolerability profile of subcutaneous immunoglobulin (SCIg) in patients with SPS who did not tolerate IVIG. To our knowledge, the use of SCIg in SPS has not been reported before in a case series.

Patient concerns:

The five patients included in this case series presented with various combinations of symptoms of spasms, axial and limb stiffness, and exaggerated responses to outside stimuli. These symptoms often lead to gait and functional impairment.

Diagnosis:

Patients were diagnosed with classic SPS as they met the clinical criteria, which require the presence of spasms, axial rigidity, and hyperexcitability.

Interventions:

Subcutaneous immunoglobulin infusion.

Outcomes:

Five patients were identified that were treated with SCIg. Three tested positive for serum anti-glutamic acid decarboxylase 65 antibodies prior to any treatment. The mean age at SCIg initiation was 33 years (range: 22–47). The mean duration of SPS prior to SCIg initiation was 5.9 years (range: 2.5–7). All patients used IVIG for at least two months (up to 18 months) but switched to SCIg due to IVIG side effects. Duration of SCIg use ranged from 4 months to 6 years (mean, 19.2 months). Upon switching to SCIg, the SPS symptoms remained stable. SCIg was well-tolerated in most as only one patient discontinued SCIg due to side effects.

Conclusion:

This case series highlights that SCIg could be a treatment option for patients with SPS, especially when IVIG is not feasible. Injection site reactions might be a limiting factor in some patients treated with SCIg. Prospective controlled studies are needed to confirm SCIg treatment durability and efficacy.