bluuebunny/crossref_metadata_2025 huggingface dataset:
Acupoint injection therapy for diabetic retinopathy
Authors: Zhou Yanni , Li Hui , Luo Lisi , Chen Yue , Chen Qiang , Bian Wei , Yang Yanlin , Tang Ju
Published: January 2021

Background:

Diabetic retinopathy (DR) is a common diabetic microvascular complication, and it is also the main cause of blindness in adults. At present, some studies have reported acupoint injection for the treatment of DR. However, the effectiveness and safety are still uncertain. This study aims to evaluate the efficacy and safety of acupoint injection for the treatment of patients with DR.

Methods:

The databases of English databases (PubMed, Embase, Cochrane Library, Web of Science) and Chinese databases (China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang Database, and Chinese Biomedical Literatures Database) will be retrieved. Published randomized controlled trials and quasi-randomized controlled trials on the topic will be retrieved by 2 investigators independently. We will apply a fixed-effect model or random effect model basis on the heterogeneity test and employ with RevMan 5.3 software for data synthesis. The total effective rate will be selected as the primary outcome, visual acuity, hemorrhage areas, exudates, capillary nonperfusion areas, hemorheological indicators, mean defect of visual field, glycated hemoglobin, and adverse events as secondary outcomes.

Results:

This study will comprehensively summarize the high-quality trials to determine the effectiveness and safety of acupoint injection treatment for patients with DR.

Conclusion:

The systematic review of this study will summarize the currently published evidence of acupoint injection treatment for DR to further guide its promotion and application.

Protocol registration number:

INPLASY2020110026
Therapy of diarrhea in COVID-19 with external treatment of traditional Chinese medicine
Authors: Cheng Cheng , Huang Yashuang , Xie Li , Zhu Xinghui , Chen Dongmei , Cheng Cisong
Published: January 2021

Background:

Evaluating the effectiveness and safety of external treatment of traditional Chinese medicine therapy for COVID-19 with diarrhea is the primary purpose of this systematic evaluation program.

Methods:

We will search the randomized controlled trials from inception to November 2020. The following database is our focus area: Cochrane Central Register of Controlled Trials, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), VIP database for Chinese technical Periodicals, and Wanfang Database. We will choose articles published both in Chinese and English. Two reviewers will conduct the study selection, data extraction, and assessment independently. The assessment of risk of bias and data synthesis will be carried out using Review Manager Software V.5.3.

Results:

The results will provide high-quality synthesis of current evidence for researchers in this subject area.

Conclusion:

This studys decision will provide evidence of whether external treatment of traditional Chinese medicine is an effective and safe intervention for coronavirus disease 2019 with diarrhea.

Registration number:

INPLASY2020110095 (DOI number: 10.37766/inplasy2020.11.0095).
The effectiveness and safety of sanfu acupoint herbal patching for treating allergic rhinitis
Authors: Zhu Qiaochu , Zhou Zhongyu , Wei Dan , Jiao Yang , Zhang Yangpu , Tian Xiaohui , Wang Yan , Dong Fu , Song Aiqun
Published: January 2021

Background:

Allergic rhinitis (AR) is one of the most common chronic disease of the nasal mucosa globally. Several clinical studies have shown that sanfu acupoint herbal patching (SAHP) has obvious advantages in treating AR. Therefore, the purpose of this systematic review is to evaluate the effectiveness and safety of SAHP for treating AR.

Method:

The following 9 electronic databases will be searched from January 2010 to October 2020: PubMed/Medline, Web of Science, Cochrane Library, EMBASE, China National Knowledge Infrastructure, VIP Database, WANFANG Database, China Biology Medicine disc. The selection of the studies and the extraction of the data are independently completed by 2 reviewers. The qualities of the studies are evaluated by Cochrane risk-of-bias tool. The main outcome of included studies is total effective rate. Secondary outcomes are Total Nasal Symptom Score, recurrence rate, Rhinitis Quality of Life Questionnaire, adverse events and laboratory indicators: serum immunoglobulin E (IgE). And the STATA 14.0 software will be implemented for data synthesis and meta-analysis.

Results:

The review is ongoing, no results can be reported.

Conclusions:

The systematic review will provide a better option for patients to treat AR.

Registration number:

INPLASY2020100101.
Role of shear-wave and strain elastography to differentiate malignant vs benign subpleural lung lesions
Authors: Boccatonda Andrea , Susca Valentina , Primomo Gian Luca , Cocco Giulio , Cinalli Sebastiano , Di Resta Velia , Martino Laura , Mucilli Felice , Marinari Stefano , Cipollone Francesco , Schiavone Cosima
Published: January 2021

Elastosonography is a non-invasive diagnostic method to evaluate tissue stiffness. The aim of our study was to demonstrate the applicability and efficacy of elastosonography to differentiate benign vs malignant subpleural lung lesions compared to clinical, radiological and histological findings.

We performed both strain and shear wave velocity (SWV) elastosonography on subpleural lung lesions. Moreover, we elaborated a composite score called ”elasto index”.

Fourteen patients, 10 males and 4 females were recruited. On strain elastography, 9 lesions showed a hard pattern (type 3), 3 lesions showed an intermediate pattern (type 2), and 2 lesions a soft pattern (type 1). All lesions showed a mean SWV value of 4.46 ± 2.37 m/second. The mean SWV for malignant lesions (n = 6) was 5.92 ± 2.8 m/second. The mean SWV for benign lesions (n = 8) was 3.36 ± 1.20 m/second. SWV shows an area under the curve (AUC) of 0.792, and the Youden index shows a value of 3.6 m/second. The ROC curve elaborated for the diagnosis of malignancy by strain elastography showed an AUC of 0.688. ROC curve for the diagnosis of malignancy by elasto index demonstrated an AUC of 0.802.

SWV values obtained by ARFI elastosonographic method are higher in malignant lung lesions (mean SWV: 5.92 m/second) than in benign ones (mean SWV: 3.36); a composite score (elasto index) is characterized by better statistical significance for the differentiation of the lesions.
Different moxibustion therapies for urinary retention after anorectal surgery
Authors: Hu Jinwen , Sun Yuepeng , Cao Lili , Shen Shulan , Hu Xiaoyang
Published: January 2021

Background:

Postoperative urinary retention is a disease that seriously affects human daily work and life, and greatly reduces people's quality of life and affects human health all over the world. Now, many studies have shown that moxibustion has a significant effect on postoperative urinary retention. In this study, network meta-analysis was used to analyze and compare the clinical efficacy and difference of different moxibustion treatments on postoperative urinary retention.

Methods:

Only randomized controlled trials (RCTs) will be included and all patients were diagnosed as postoperative urinary retention. Computer search Chinese databases: CNKI, Wanfang (WANFANG), VIP (VIP), Chinese Biomedical Literature Database (SinoMed), English database search PubMed, Cochrane library, Web of Science. The search period limit is from the time the date of database establishment to November 17, 2020. To avoid omissions, we will manually search for relevant reference materials and conference papers. The risk of bias in the final included studies will be assessed according to the guidelines of the Cochrane System Intervention Review Manual. All data analysis will be conducted by Revman5.3, Gemtc 0.14.3, and Stata 14.2.

Results:

The effectiveness of each intervention was quantified. The main results included effective rate, first urination time, and residual urine volume.

Conclusion:

Objective to provide evidence-based medicine basis for clinicians to choose more effective moxibustion therapy for postoperative urinary retention.
Hepatitis C virus genotype and subtype distribution among ethnic minorities in Liaoning Province of China
Authors: Li Rongkuan , Xie Ying , Liu Wenzhi , Ma Yu
Published: January 2021

To provide information and a basis for improved hepatitis C prevention and treatment, we aimed to determine the distribution of hepatitis C virus (HCV) genotypes among patients with hepatitis C from 4 ethnic minorities in Liaoning Province of China over the past 8 years and analyze and explore the virus’ genotype evolution and possible clinical significance.

For gene-sequencing, we collected peripheral blood samples of HCV-infected patients belonging to the Korean, Hui, Mongol, and Manchu ethnic minorities in Liaoning Province who were diagnosed at the Second Hospital of Dalian Medical University, Anshan Central Hospital, and the Second People's Hospital of Fuxin City between November 2011 and November 2019. To analyze genotype evolution and possible influencing factors, we determined the ratio of various genotypes. Among the 102 HCV-infected patients from 4 ethnic minorities in Liaoning Province, 46 had gene typing (GT)1b (45.10%), 15 had GT2a (14.71%), 14 had GT3a (13.73%), 13 had GT6a (12.75%), 3 had GT1a (2.94%), and 11 had an unclassified genotype (10.78%). The distribution of various genotypes in the Korean, Mongol, and Manchu ethnic minorities was significantly different (χ2 = 10.788, P = .029; χ2 = 7.846, P = .049; and χ2 = 22.400, P = .000, respectively). All ethnic minorities exhibited >40% of GT1b. In the Korean (14/33) and Manchu (14/30) ethnic minorities, the proportion of GT1b was significantly higher than those of other genotypes (P < .05). The ethnic Koreans had a high proportion of GT3a (18.18%, 6/33), whereas the ethnic Mongolians had a high proportion of GT6a (23.08%, 6/26). GT1a was only found in the Korean (6.06%, 2/33) and Manchu (3.33%, 1/30) ethnic minorities; in the Hui ethnic minority, only 3 genotypes were prevalent: GT1b, GT2, and GT3a. The ethnic minorities in Liaoning Province currently have diverse HCV genotypes; the most prevalent genotype is GT1b, followed by GT2a and GT3a, and the prevalence of GT3 and GT6 has increased. The distribution of HCV genotypes varies across different ethnic minorities. The Korean and Manchu ethnic minorities have the most prevalent genotypes, whereas the Hui ethnic minority has a relatively single distribution of the HCV genotype.
Effects of preoperative, scheduled administration of antiemetics in reducing postoperative nausea and vomiting in patients undergoing total knee arthroplasty
Authors: Park Hyung Jun , Chang Moon Jong , Kang Seung-Baik , Hwang Il-ung , Kim Jong Seop , Chang Chong Bum
Published: January 2021

There is no established protocol regarding the timing of administration of antiemetics in patients undergoing total knee arthroplasty (TKA). The purpose of this study was to determine whether preoperative, rather than postoperative administration of an antiemetic could reduce postoperative nausea and vomiting (PONV) in patients undergoing TKA, and whether there was a difference in postoperative pain, patient satisfaction and complications after TKA between the 2 different administration times.

The included patients (N = 101) either received intravenous administration of the ramosetron 1 hour before surgery (N = 50) or at the end of surgery (N = 51) consecutively order. The incidence of PONV and the frequency of rescue medicine use were recorded until 48 hours postoperatively. The severity of postoperative pain and patient satisfaction were assessed using the visual analogue scale. The incidence of complications associated with use of antiemetic was assessed.

Preoperative administration of ramosetron did not decrease PONV during the first 48 hours. There was no significant difference in the incidence of nausea and vomiting, use of rescue antiemetics, and the severity of nausea (P > .05). Postoperative pain, satisfaction scores, and the incidence of complications were not different between the 2 groups (P > .05).

Preoperative administration of ramosetron did not show clinical advantage in reducing POVN, postoperative pain and improving patient satisfaction. However, the outcomes of complications were not inferior to those of postoperative administration. Therefore, under the current protocol of multimodal therapies, timing of administration of pre-emptive antiemetic did not have significant effect on PONV.
Nationwide temporal trend analysis of reperfusion therapy utilization and mortality in acute ischemic stroke patients in Japan
Authors: Maeda Megumi , Fukuda Haruhisa , Matsuo Ryu , Kiyuna Fumi , Ago Tetsuro , Kitazono Takanari , Kamouchi Masahiro
Published: January 2021

This study aimed to elucidate nationwide trends in reperfusion therapy utilization and subsequent 30-day mortality in acute ischemic stroke patients in Japan. The analysis focused on intravenous recombinant tissue plasminogen activator (IV rt-PA) and endovascular thrombectomy (EVT).

Using health insurance claims data, we calculated the age- and sex-adjusted monthly number of acute ischemic stroke patients who received IV rt-PA and/or EVT in Japan from April 2010 to March 2016, and investigated the 30-day all-cause mortality rates after undergoing these therapies. Through an interrupted time-series analysis, we examined the

During the study period, 69,920 patients with acute ischemic stroke (mean age ± standard deviation: 74.9 ± 12.0 years; 41.4% women) received IV rt-PA and/or EVT. The age- and sex-adjusted number of patients receiving IV rt-PA monotherapy increased immediately after the time window extension ( P < .001), but did not change during the pre- (P = .90) and post-extension (P = .58) periods. In contrast, the number of patients receiving EVT with or without IV rt-PA continuously increased during the pre-extension period (P < .001), and further increased during the post-extension period (P <.001); however, this number decreased immediately after the extension (P < .001). There were no significant changes in 30-day all-cause mortality during the pre- (P = .40) and post-extension (P = .64) periods, as well as immediately after the extension (P = .53).

The extension of the IV rt-PA therapeutic time window and progressively widespread use of EVT in Japan have increased the number of acute ischemic stroke patients eligible for reperfusion therapy. These trends were not accompanied by a higher risk of post-reperfusion mortality.
A survey on the application of oral propranolol and atenolol for the management of infantile hemangiomas in mainland China
Authors: Zhao Ze-Liang , Liu Chao , Wang Qi-Zhang , Zhang Wen-Bo , Shao Lu , Wu Hai-Wei , Zheng Jia-Wei
Published: January 2021

Since 2008, oral propranolol has evolved as the first-line therapy for infantile hemangiomas (IHs). Meanwhile, oral atenolol gradually shows comparative effectiveness versus oral propranolol with few side effects. Here, we conducted a mobile internal survey among a group of Chinese clinicians about how they choose the dosage, dose regimen, and dose escalation methods of propranolol and atenolol for the treatment of IH.

A mobile-ready internal survey on the application of oral propranolol and oral atenolol for IH in mainland China was performed and distributed to 333 potential clinicians from different levels of healthcare institutions in mainland China. Eighty-one doctors responded to the survey. All the respondents had the experience of treating IH with oral propranolol and 32 had the experience with oral atenolol.

Most of the doctors from tertiary hospitals chose 2 mg/kg/d twice daily, while most of those with the experience of propranolol from private hospitals chose 1 mg/kg/d once daily. More doctors from tertiary hospitals had the experience of atenolol than those from private hospitals.

Oral atenolol has become another medication intervention option for IH in mainland China. This survey is helpful to standardize and develop a guideline of oral atenolol therapy for IH.
Predictive factors of unacceptable movement and motor-evoked potentials during intraoperative neurophysiological monitoring in adult patients undergoing brain surgery
Authors: Lee Soowon , Jeon Young-Tae , Oh Tak Kyu , Lee Jungmin , Choi Eun-Su
Published: January 2021

Motor-evoked potential (MEP) monitoring is an essential monitoring for clinicians to improve outcomes. Although unacceptable movement during MEP is a rare complication but it can lead to terrible results. The aim of this study was to evaluate the risk factors associated with unacceptable movements in patients undergoing brain surgery with MEP monitoring.

We performed a retrospective observational study of patients who underwent brain surgery with MEP monitoring under general anesthesia while using a partial neuromuscular blocker in a tertiary care hospital from January 2014 to August 2017. Unacceptable movement was defined as a condition in which MEP stimulation induced vigorous movement of patient hindered the smooth progress of the operation. We compared the baseline patient characteristics and laboratory results according to unacceptable movements during surgery to identify factors associated with unacceptable movement during MEP monitoring.

768 patients were included in this analysis, and unacceptable movements were observed in 278 patients (36.2%). A multivariate logistic regression analysis revealed that an increase in ionized calcium was associated with the most strongly unpredictable movement during surgery [odds ratio (OR): 1.79, 95% confidence interval (CI): 1.37–2.36, P < .001]. In addition, age (OR, 0.98; 95% CI, 0.96–0.99; P = .001), male sex (OR, 1.59; 95% CI, 1.09-2.33; P = .017), and body mass index (OR, 0.90; 95% CI, 0.86-0.95; P <0.0010) were also associated with unacceptable movement. Serum ionized calcium concentration was the best predictor associated with unacceptable movement with MEP monitoring under general anesthesia.

Serum ionized calcium concentration was the best predictor associated with unacceptable movement with MEP monitoring under general anesthesia.
Management of acute coronary syndrome in the context of coronavirus disease 2019
Authors: Liang Xi-Ying , Shang Yao-Sheng , Bai Nan , Zhong Peng-Yu , Zhang Wen-Jiao , Wang Zhi-Lu
Published: January 2021

Coronavirus disease 2019 (COVID-19) is still developing worldwide. The prognosis of the disease will become worse and mortality will be even higher when it is combined with cardiovascular disease. Furthermore, COVID-19 is highly infectious and requires strict isolation measures. For acute coronary syndromes (ACS), a common cardiovascular disease, infection may aggravate the occurrence and development of ACS, making the management of more difficult. It will be an enormous challenge for clinical practice to deal with ACS in this setting of COVID-19.

Aim to reduce the mortality of ACS patients during the epidemic of COVID-19 by standardizing procedures as much as possible.

Pubmed and other relevant databases were searched to retrieve articles on COVID-19 and articles on ACS management strategies during previous influenza epidemics. The data was described and synthesized to summarize the diagnosis and management strategy of ACS, the preparation of catheter laboratory, and the protection of the medical staff in the context of COVID-19. Ethical approval is not required in this study, because it is a review with no recourse to patient identifiable information.

Standardized diagnosis and treatment advice can help reduce the mortality of COVID-19 patients with ACS. In the absence of contraindications, the third generation of thrombolytic drugs should be the first choice for thrombolytic treatment in the isolation ward. For patients who have to receive PCI, this article provides detailed protective measures to avoid nosocomial infection.
Safety and feasibility of 3-month interval access and flushing for maintenance of totally implantable central venous port system in colorectal cancer patients after completion of curative intended treatments
Authors: Oh Sang-Bo , Park Kwonoh , Kim Jae-Joon , Oh So-Yeon , Jung Ki-Sun , Park Byung-Soo , Son Gyung-Mo , Kim Hyun-Sung , Kim Dong-Hyun , Jung Hyuk-Jae , Lee Sang-Su
Published: January 2021

Patients with colorectal cancer (CRC) treated with curative intent surgery undergo continuous fluorouracil (5-FU) infusion-based chemotherapy using totally implantable central venous port system (TICVPS) in cases with high risk of recurrence. Approximately 30% of patients relapse after therapy completion, especially within 2 years. Hence, many patients with high risk CRC keep the TICVPS for 6 to 24 months after treatment with regular intervals of TICVPS flushing. However, little is known about the proper interval duration of the port. The aim of this study is to investigate whether a 3 months extended interval is safe and if port maintenance is feasible.

A retrospective cohort was compiled of patients with CRC who underwent curative intent surgery and perioperative chemotherapy using TICVPS between 2010 and 2017. The primary end point was TICVPS maintenance rate, including maintenance of TICVPS for at least 6 months, planned TICVPS removal after 6 months, and regaining the use of TICVPS at the time of recurrence.

A total of 214 patients with CRC underwent curative intent treatments during the study period. Among them, 60 patients were excluded, including 6 patients for early recurrence within 3 months and 54 patients with violation of flushing interval. Finally, 154 patients were analyzed. Mean flushing interval was 98.4 days (95% confidence interval [CI], 96.2–100.6; range, 60–120). In December 2018, 35 patients kept the TICVPS, 92 patients had planned removal, 25 patients reused the TICVPS, and 2 patients had to unexpectedly remove the TICVPS due to site infection and pain. Thus, the functional TICVPS maintenance rate was 98.8% (152/154). Thirty-eight patients relapsed, and 30 patients were treated with intravenous chemotherapy. Among them, 25 patients (83.3%) reused the maintained TICVPS without a reinsertion procedures.

Our study demonstrated that 3-month interval access and flushing is safe and feasible for maintaining TICVPS during surveillance of patients with CRC. An extended interval up to 3 months can be considered because it is compatible with CRC surveillance visit schedules.
Effect of pelvic floor electrical stimulation on diaphragm excursion and rib cage movement during tidal and forceful breathing and coughing in women with stress urinary incontinence
Authors: Hwang Ui-jae , Lee Min-seok , Jung Sung-hoon , Ahn Sun-hee , Kwon Oh-yun
Published: January 2021

Background:

The pelvic floor muscle (PFM) is associated with respiratory function. We investigated the effects of PFM training by pelvic floor electrical stimulation (PFES) on PFM strength, diaphragm excursion, and upper rib cage movement during tidal and forceful breathing and coughing in women with stress urinary incontinence (SUI).

Methods:

In total, 33 participants with SUI were divided into PFES and control groups. The two groups were measured pre- and post-8 weeks of training. Diaphragm excursion and upper rib cage movement during tidal and forceful breathing and coughing and PFM strength were measured using sonography, electromagnetic sensors, and perineometry.

Results:

There were significant difference of main effect between pre- and post-training and between groups in PFM strength (between groups: P = .001, between time: P < .001) and diaphragm excursion during forceful breathing (between groups: P = .015, between time: P = .026) and coughing (between groups: P = .035, between time: P = .006). There were significant differences in diaphragm excursion during tidal (P = .002) and forceful breathing (P = .005) and coughing (P < .001) between pre- and post-training in the PFES group. Elevation of the upper rib cage during tidal (P < .001) and forceful breathing (P = .001) was significantly decreased after 8 weeks of training in the PFES group. Widening in the horizontal plane in the upper rib cage during forceful breathing (P < .001) was significantly increased after 8 weeks of training in the PFES group. PFM strength (P < .001) was significantly increased after 8 weeks of training in the PFES group.

Conclusions:

Pelvic floor muscles training by electrical stimulation can improve diaphragm excursion and breathing patterns in women with SUI.
Intraoperative monitoring parameters and postoperative delirium
Authors: Jung Carolin , Hinken Lukas , Fischer-Kumbruch Moritz , Trübenbach Dominik , Fielbrand Rieke , Schenk Isabel , Diegmann Oliver , Krauß Terence , Scheinichen Dirk , Schultz Barbara
Published: January 2021

Postoperative delirium (PODE) can be associated with severe clinical complications; therefore, preventive measures are important. The objective of this trial was to elucidate whether haemodynamic or electroencephalographic (EEG) monitoring parameters during general anaesthesia or sevoflurane dosage correlate with the incidence of PODE. In addition, sevoflurane dosages and EEG stages during the steady state of anaesthesia were analyzed in patients of different ages.

Eighty adult patients undergoing elective abdominal surgery received anaesthesia with sevoflurane and sufentanil according to the clinical routine. Anaesthesiologists were blinded to the EEG. Haemodynamic parameters, EEG parameters, sevoflurane dosage, and occurrence of PODE were analyzed.

Thirteen patients (4 out of 33 women, 9 out of 47 men) developed PODE. Patients with PODE had a greater mean arterial pressure (MAP) variance (267.26 (139.40) vs 192.56 (99.64) mmHg2, P = .04), had a longer duration of EEG burst suppression or suppression (27.09 (45.32) vs 5.23 (10.80) minutes, P = .03), and received higher minimum alveolar sevoflurane concentrations (MAC) (1.22 (0.22) vs 1.09 (0.17), P = .03) than patients without PODE. MAC values were associated with wide ranges of EEG index values representing different levels of hypnosis.

The results suggest that, in order to prevent PODE, a great variance of MAP, higher doses of sevoflurane, and deep levels of anaesthesia should be avoided. Titrating sevoflurane according to end-tidal gas monitoring and vital signs can lead to unnecessarily deep or light hypnosis. Intraoperative EEG monitoring may help to prevent PODE.
Comparison of polyurethane foam dressing and hydrocolloid dressing in patients with pressure ulcers
Authors: Jin Yan , Li Jun , Wu Shuai , Zhou Fei
Published: January 2021

Background:

We conduct this randomized controlled trial protocol for the comparison of the influence of the hydrocolloid dressing and polyurethane foam dressing in the treatment of pressure ulcers (PUs) patients.

Methods:

This study will be implemented from February 2021 to February 2022 at Hangzhou Geriatric Hospital. The experiment was granted through the Research Ethics Committee of Hangzhou Geriatric Hospital (C5259033). Criteria for inclusion: patients older than 18 years of age who have been diagnosed with PU. If the patient suffers from more than a PU, only the ulcer with largest diameter is evaluated.

Criteria for exclusion:

The major result is rate of PU healing or ulcer epithelialization tissue. The secondary result is the changes in the area of ulcer in cm and cost-effectiveness. The analysis of all the data are conducted with the software of IBM SPSS Statistics for Windows, version 20 (IBM Corp., Armonk, NY).

Results:

Table 1 will show the comparison of clinical outcomes between 2 groups.

Conclusion:

This study can develop an evidence-based protocol to identify optimal dressings for patients with PUs.

Trial registration number:

researchregistry6294
Anterior cruciate ligament injury patterns and their relationship to fatigue and physical fitness levels – a cross-sectional study
Authors: Alsubaie Saud F. , Abdelbasset Walid Kamal , Alkathiry Abdulaziz A. , Alshehri Waleed M. , Azyabi Mohammed M. , Alanazi Basil B. , Alomereni Abdulaziz A. , Asiri Faisal Y.
Published: January 2021

Anterior cruciate ligament (ACL) injury is one of the most common knee injuries that leads to many consequences such as early osteoarthritis and knee joint instability.

To explore the association of the types of ACL tear (complete and partial) and side of injury (dominant vs nondominate) with types of playing surfaces, sports, shoes, and mechanism of injuries as well as to determine whether higher levels of fatigue and physical fitness are risk factors for complete ACL tear.

This cross-sectional study used a questionnaire to collect information from young male adults with a confirmed ACL injury who were attending rehabilitation programs. The outcomes of interest were patterns of ACL injury, levels of fatigue before the injury on a 0 to 10 scale, and levels of physical fitness (hours per week). Mann–Whitney U and Kruskal Wallis tests were used to assess the differences between groups, while the odds ratios were calculated to evaluate risk factors for complete ACL tear.

One hundred thirteen young male adults with a confirmed ACL injury were enrolled. Most of the reported ACL injuries in this study were complete tear (80.5%) and occurred more frequently in the dominant leg (74.6%) due to noncontact mechanism (63.6%). More ACL injuries happened while playing soccer (97.2%) on artificial turf (53.3%). The level of fatigue before ACL injury was significantly higher in partial ACL tear injuries compared to complete ACL tear injuries (P = .014). For every 1-point increase in the level of fatigue on a 0–10 scale, there was a 25% reduction in complete ACL injury risk (P = .023).

The pattern of ACL types of tear and side of injury varies in different playing surfaces and mechanisms of injuries. Higher levels of fatigue seem to be associated with a partial tear of the ACL and reduction of a complete ACL tear risk factor.
Identification of potential biomarkers of peripheral blood mononuclear cell in hepatocellular carcinoma using bioinformatic analysis
Authors: Peng Jin-lin , Wu Ji-zhou , Li Guo-jian , Wu Jian-lin , Xi Yu-mei , Li Xiao-qing , Wang Lei
Published: January 2021

Background:

Hepatocellular carcinoma (HCC) is the cause of an overwhelming number of cancer-related deaths across the world. Developing precise and noninvasive biomarkers is critical for diagnosing HCC. Our research was designed to explore potentially useful biomarkers of host peripheral blood mononuclear cell (PBMC) in HCC by integrating comprehensive bioinformatic analysis.

Methods:

Gene expression data of PBMC in both healthy individuals and patients with HCC were extracted from the Gene Expression Omnibus (GEO) to identify differentially expressed genes (DEGs). The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were applied to annotate the function of DEGs. Protein-protein interaction analysis was performed to screen the hub genes from DEGs. cBioportal database analysis was performed to assess the prognostic significance of hub genes. The Cancer Cell Line Encyclopedia (CCLE) and The Human Protein Atlas (HPA) database analyses were performed to confirm the expression levels of the hub genes in HCC cells and tissue.

Results:

A total of 95 DEGs were screened. Results of the GO analysis revealed that DEGs were primarily involved in platelet degranulation, cytoplasm, and protein binding. Results of the KEGG analysis indicated that DEGs were primarily enriched in focal adhesion. Five genes, namely, myosin light chain kinase (MYLK), interleukin 1 beta (IL1B), phospholipase D1 (PLD1), cortactin (CTTN), and moesin (MSN), were identified as hub genes. A search in the CCLE and HPA database showed that the expression levels of these hub genes were remarkably increased in the HCC samples. Survival analysis revealed that the overexpression of MYLK, IL1B, and PLD1 may have a significant effect on HCC survival. The aberrant high expression levels of MYLK, IL1B, and PLD1 strongly indicated worse prognosis in patients with HCC.

Conclusions:

The identified hub genes may be closely linked with HCC tumorigenicity and may act as potentially useful biomarkers for the prognostic prediction of HCC in PBMC samples.
Prospective study of EUS-guided tissue acquisition with a 20G core biopsy needle with a forward bevel for solid pancreatic mass
Authors: Kanata Ryo , Sasaki Takashi , Matsuyama Masato , Ishigaki Kazunaga , Yamada Ikuhiro , Ozaka Masato , Takano Koichi , Takazawa Yutaka , Ishizuka Naoki , Sasahira Naoki
Published: January 2021

There is a growing need for tissue collection for immunostaining and genetic testing. Recently, several fine-needle biopsy needles are commercially available for endoscopic ultrasound-guided tissue acquisition.

This prospective historical controlled study evaluates a 20G core biopsy needle with a forward bevel for solid pancreatic masses larger than 15 mm in diameter. The primary endpoint was the accuracy of histological diagnosis. The secondary endpoints included technical success rate, sample adequacy for histology, cytological diagnostic accuracy, and adverse events.

Seventy consecutive patients were enrolled between January and October 2017. We achieved technical success in all cases regardless of the puncture sites or the endosonographer's experience. The final diagnoses were neoplasms in 67 patients (95.7%; pancreatic cancer in 65 patients, neuroendocrine neoplasm in 1, and malignant lymphoma in 1) and benign lesions in 3 patients (4.3%; autoimmune pancreatitis in 2 patients and mass-forming pancreatitis in 1). The obtained specimens were adequate for histological evaluation in all cases and the histological accuracy was 91.4% (95% confidence interval, 82.3–96.8%, P < .05) with the sensitivity and specificity of 91.0% and 100%, respectively. The cytological diagnostic accuracy was 95.7% and all patients were accurately diagnosed by combining cytological and histological examinations. As for adverse events, an asymptomatic needle fracture occurred in 1 case (1.4%).

This 20G core biopsy needle with a forward bevel showed a high accuracy of histological diagnosis for solid pancreatic masses.
Recovery of uterine and ovarian function in patients with complete placenta previa after caesarean delivery
Authors: Li Xiaoxue , Musoba Paul M. , Zhou Xuan , Lai ShaoYang , Yang Wan , Wang Li Na , Chantholleng Dara D. , Zhao Jie
Published: January 2021

This retrospective study was designed to explore the recovery of uterine and ovarian function in patients with complete placenta previa (PP) after caesarean delivery (CD). 136 complete placenta previa patients (group completed placenta previa) and 140 patients without complete PP (group non-PP, control group) were included in this study from Jan 2016 to Dec 2018. Subgroup analysis of patients with complete PP was made to determine the impact of different hemostatic methods used during CD on the recovery of uterine function. There were no statistically significant differences between the 2 groups in postpartum menstrual cycle changes, ovarian hormone, and uterine vascular supply as measured by pulsatility index and systolic/diastolic ratio (P > .05). However, the group with complete PP had a reduced endometrial thickness (0.47 ± 0.11 vs 0.50 ± 0.12, P < .001), a lower uterine resistance index at 42nd days (0.84 ± 0.03 vs 0.90 ± 0.03, P < .001), and a delayed resumption menstruation (7.07 ± 2.61 vs 5.31 ± 2.16, P < .001) when compared with control group. Subgroup analysis showed that RI index of all subgroups in completed PP group was lower, endometrial thickness was thinner and the time to menstrual recovery was longer than that of non-PP group. In conclusion, the endometrial thickness and blood supply at 42nd days, not ovarian function, maybe affected after CD in patients with complete PP.
Acupuncture therapy strategy options in postoperative management after laparoscopic cholecystectomy
Authors: Zhao Dong-qin , Qian Guang-yu , Jin Jing , Yao Yin-ping , Bian Xing-mao , Zhang Wei-ping
Published: January 2021

Background:

Laparoscopic cholecystectomy (LC) is a common surgery accompanied by some unpleasant adverse effects. Clinical trials indicated that acupuncture therapy may help reduce complications in LC. However, no systematic reviews have been conducted on the topic. Therefore, we will evaluate the current evidence and provide a rank for the efficacy of acupuncture therapy in LC by performing Bayesian network meta-analysis.

Methods:

A total of 9 databases will be searched from inception to 10 December 2020. Randomized control trails met the criterion will be included. Quality evaluation of included studies will be performed using Cochrane risk-of-bias tool. STATA 14.0, Addis 1.16.8, R 3.6.3, and OpenBUGS 3.2.3 will be used to conduct pairwise meta-analysis and network meta-analysis. The evidence will be assessed by the Grades of Recommendations Assessment Development and Evaluation.

Results:

This review will be based on clinical evidence to choose the best choice of acupuncture treatment for LC. And the results will be submitted to a peer-reviewed journal for publication.

Conclusion:

Through this systematic review, we will summarize the best available evidence of acupuncture therapy in LC and help to improve the clinical decision-making ability in LC domain.

Systematic review registration:

The protocol has been registered on INPLASY2020120056.
The effects of health-preserving sports on the treatment of COVID-19
Authors: Ji Yu , Qiu Guorong , Song Dandan , Liu Hezhi , Chen Li
Published: January 2021

Background:

From the end of 2019, COVID-19 has become a global epidemic, threatening the physical and mental health of everyone. How to effectively prevent and treat COVID-19 is concerned. Some studies have shown that Health-Preserving Sports plays an active role in the prognosis treatment of COVID-19. Therefore, this study aims to provide a method to assess the efficacy and safety of Health-Preserving Sports for the prognosis of COVID-19.

Methods:

This protocol is guided by the Preferred Reporting Items for Systematic Reviews. The following electronic databases will be searched: PubMed, the Cochrane Central Register of Controlled Trials, Excerpta Medica Database, MEDLINE, Web of Science, China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, China Science and Technology Journal Database, and Wan-Fang Database. We will be screened for data extraction and analysis, to summarize the therapeutic effect of Health-Preserving Sports on the treatment of COVID-19.

Result:

This study will provide a reliable evidence for the treatment of COVID-19 by Health-Preserving Sports.

Conclusion:

To provide a method to assess the efficacy and safety of Health-Preserving Sports for the prognosis of COVID-19, and guide future researches.

PROSPERO registration number:

CRD42020219526.
Impact of lifestyle education for type 2 diabetes mellitus
Authors: Zhu Jingjing , Chen Min , Pang Yuzi , Li Shumin
Published: January 2021

Objective:

To explore the influence of the education of lifestyle in the type 2 diabetes mellitus (T2DM) patients with microalbuminuria as a part of the enhanced multifactorial intervention.

Methods:

This study will be conducted from May 2021 to August 2022 at Ningbo No.6 hospital. The experiment was granted through the Research Ethics Committee of Ningbo No.6 hospital (539D035). The patients will be included if they are between 18 and 65 years old and are diagnosed with T2DM with microalbuminuria and the patients who have signed the written informed consent. While the patients will be excluded if they have serious physical comorbidities and patients who are unwilling to offer the informed consent to take part in this experiment. We measure the clinical examination (fasting blood-glucose, glycosylated hemoglobin and routine urine test) timely. Detail of daily dietary intake and lifestyle factors are also recorded.

Results:

Table 1 reflects the comparison of the biochemical and clinical variables and the lifestyle factors.

Conclusion:

Lifestyle education is effective in facilitating the control of T2DM and reducing microalbuminuria.

Trial registration number:

researchregistry6348.
Which is the better choice? A clinical cohort study protocol evaluating the differences between standard medial parapatellar and minimally invasive approaches in total knee replacement
Authors: Jia Qiong , Chen Xin , Zhang Jun , Hu Yang
Published: January 2021

Background:

There is still a lack of consensus on the best approach for total knee replacement (TKR). We carried out this present retrospective cohort study to assess the overall safety and effectiveness of a minimally invasive approach without the use of computer navigation in comparison with conventional TKR.

Methods:

A retrospective review of patients who receiving the primary TKR in the same institution from 2014 to 2016 was conducted. The inclusion criteria for the study indicated that the patient required a unilateral or bilateral TKR was between 18 and 80 years’ old, provided informed consent, was followed up for at least 2 years, and was in stable health. There was no treatment for any condition or condition that might pose a risk of excessive surgery. The same TKR standard rehabilitation program was provided to all patients. Data were collected on patient demographics, anesthesia style, American Society of Anesthesiology scores, tourniquet duration, and surgical drainage loss. Our primary outcome measure was discharge time. Secondary outcomes included duration of surgery, incidence of postoperative complications, imaging location 6 weeks after surgery, Oxford Knee Score, Western Ontario and McMaster Universities Arthritis Index, and knee ROM. Complications were recorded and classified as surgical site, thromboembolic, systemic, or requiring reoperation.

Results:

It was assumed that there is a remarkable difference in postoperative outcomes between the 2 groups.

Conclusion:

The limitations of our present research include the inherent limitations in any retrospective cohort research, including the observation bias and possibility of selection.

Trial registration:

This study protocol was registered in Research Registry (researchregistry6349).
Use of N-butyl cyanoacrylate in the successful transcatheter arterial embolization of an arteriovenous fistula caused by blunt pelvic fracture
Authors: Cho Hye Soo , Kim Yook , Lee Jisun , Yi Kyung Sik , Choi Chi-Hoon
Published: January 2021

Rationale:

Traumatic arteriovenous fistulas (AVFs) of the pelvis are uncommon and present with a variety of clinical manifestations; their detection may be difficult. An endovascular approach is usually the first choice of treatment, because surgical intervention is complicated due to the location of the lesions.

Patient concerns:

A 68-year-old man was admitted with severe pelvic pain following a fall.

Diagnosis:

A pelvic bone fracture (Young and Burgess Classification, lateral compression type II) was revealed on pelvic computed tomography (CT), while a pelvic sidewall hematoma, unaccompanied by any vascular injury, was detected on multidetector CT.

Interventions:

Pelvic angiography revealed an AVF between the internal iliac artery and vein, which was undetected by MDCT. The AVF was successfully treated using transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA).

Outcomes:

The patient recovered well and was discharged 4 weeks later. No complications were noted at the 8-month follow-up.

Lessons:

AVF may occur as a complication of blunt pelvic bone fracture. A high index of suspicion, angiography, and prompt diagnosis resulted in the successful management of our patient who presented with risk factors. Furthermore, TAE using NBCA enables a minimally invasive and effective treatment of traumatic pelvic AVF.
Atrioesophageal fistula after atrial fibrillation catheter ablation
Authors: He Fan , Zhang Wei-Min , Xu Bi-Jun , Huang Gang-Ping , Chen Huai-Dong
Published: January 2021

Rationale:

Atrioesophageal fistula (AEF) is a rare but serious complication of atrial fibrillation (AF) catheter ablation with associated high mortality rates.

Patient concerns:

A 42-year-old male patient who underwent catheter ablation in local hospital 20 days ago because of persistent AF was admitted to our Emergency Room with unconsciousness and high axillary temperature and white blood cell count. Craniocerebral CT scan found multiple infarct lesions in both frontal and occipital lobes. Pneumatosis between the left atrium and the esophagus was observed in the chest CT.

Diagnoses:

AEF.

Interventions:

We performed a salvage operation of the left atrium debridement, and left atrium patch repairing under extracorporeal circulation. We opened the mediastinum, and dissected the esophageal perforation. A special irrigating catheter with multiple side ports on the tip was placed from the esophagus to the posterior mediastinum through the esophageal orificium fistulae. We also inserted a gastrointestinal tube to the jejunum under gastroscopy. Three additional drainage tubes were inserted into the esophageal bed and the right thoracic cavity.

Outcomes:

The procedure was successful. But 7 days later, the patient's family chose to forgo treatment due to multiple cerebral infarcts, respiratory and blood system infection, liver failure, and other complications.

Lessons:

AEF is a rare but fatal complication after catheter ablation. Heightened vigilance is required for early recognition of the AEF. Surgical treatment should be performed as early as possible, especially before the neurological complications occur.
Delayed pulmonary embolism after unicompartmental knee arthroplasty
Authors: Guan Yun , Zeng Zhimin
Published: January 2021

Introduction:

Although venous thromboembolism (VTE) is relatively rare after unicompartmental knee arthroplasty (UKA), symptomatic pulmonary embolism (PE) can be fatal. Whether routine thromboprophylaxis or thrombolytic treatment is necessary for patients undergoing UKA remains unclear. Here, we present a case of delayed pulmonary embolism after UKA.

Patient concerns:

A 57-year-old women underwent cemented UKA for left localized medial knee pain. There were no risk factors of VTE besides high BMI before surgery. 2 months after surgery, the patient presented with dyspnea and palpitation, and these symptoms could not be alleviated after rest.

Diagnosis:

An arterial blood gas analysis showed decreased PO2, SO2 and PCO2. Pulmonary CTA showed multiple pulmonary embolism in the trunk of the right lower pulmonary artery and the branch of the left lower pulmonary arteries. The final diagnosis was delayed pulmonary embolism after UKA.

Interventions:

Urokinase thrombolysis was administered intravenously. Low molecular weight heparin and warfarin were prescribed for anticoagulation.

Outcomes:

The patient's symptoms abated, and chest CTA showed that the pulmonary embolism had dissolved. No further thrombosis has been observed for more than 6 years.

Conclusions:

We presented an unusual case of delayed pulmonary embolism after UKA. Despite the low incidence, its life-threatening nature makes it imperative for surgeons to be well-informed about thrombosis and pay more attention to its prevention strategies.