bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-Term Outcomes With Pharmacological Ovarian Suppression During Chemotherapy in Premenopausal Early Breast Cancer Patients
Authors: Lambertini Matteo , Boni Luca , Michelotti Andrea , Magnolfi Emanuela , Cogoni Alessio Aligi , Mosconi Anna Maria , Giordano Monica , Garrone Ornella , Arpino Grazia , Poggio Francesca , Cinacchi Paola , Bighin Claudia , Fregatti Piero , Pronzato Paolo , Blondeaux Eva , Del Mastro Lucia ,   the GIM study group
Published: November 2021

Background

Although use of gonadotropin-releasing hormone agonist (GnRHa) during chemotherapy is an established strategy to protect ovarian function in premenopausal breast cancer patients, no long-term safety data are available, raising some concerns in women with hormone receptor–positive disease. There are controversial data on its fertility preservation potential.

Methods

The Prevention of Menopause Induced by Chemotherapy: a Study in Early Breast Cancer Patients—Gruppo Italiano Mammella 6 (PROMISE-GIM6) trial is a multicenter, randomized, open-label, phase III superiority trial conducted at 16 Italian centers from October 2003 to January 2008. Eligible patients were randomly assigned to (neo)adjuvant chemotherapy alone (control arm) or combined with the GnRHa triptorelin (GnRHa arm). The primary planned endpoint was incidence of chemotherapy-induced premature ovarian insufficiency. Post hoc endpoints were disease-free survival (DFS), overall survival (OS), and post-treatment pregnancies. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated.

Results

Of 281 randomly assigned patients, 80.4% had hormone receptor–positive breast cancer. Median follow-up was 12.4 years (interquartile range = 11.3-13.2 years). No differences in 12-year DFS (65.7% [95% CI = 57.0% to 73.1%] in the GnRHa arm vs 69.2% [95% CI = 60.3% to 76.5%] in the control arm; HR = 1.16, 95% CI = 0.76 to 1.77) or in 12-year OS (81.2% [95% CI = 73.6% to 86.8%] in the GnRHa arm vs 81.3% [95% CI = 73.1% to 87.2%] in the control arm; HR = 1.17, 95% CI = 0.67 to 2.03) were observed. In patients with hormone receptor–positive disease, the hazard ratio was 1.02 (95% CI = 0.63 to 1.63) for DFS and 1.12 (95% CI = 0.59 to 2.11) for OS. In the GnRHa and control arms, 9 and 4 patients had a posttreatment pregnancy, respectively (HR = 2.14, 95% CI = 0.66 to 6.92).

Conclusions

Final analysis of the PROMISE-GIM6 trial provides reassuring results on the safety of GnRHa use during chemotherapy as a strategy to preserve ovarian function in premenopausal patients with early breast cancer, including those with hormone receptor–positive disease.
Recurrent Gastrointestinal Bleeding in a Middle-Aged Man
Authors: Gowani Faaria , Phillips Bonnie , Leveque Christopher , Castillo Brian , Chen Jian , Chandler Wayne , Rice Lawrence , Salazar Eric
Published: November 2021

Acquired von Willebrand disease (avWD) arises because of mechanisms that destroy, decrease, absorb, or clear von Willebrand factor (vWF). A 59-year-old man presented with a 3-year history of recurrent gastrointestinal bleeding. Laboratory workup revealed a prolonged platelet function assay-100. The vWF antigen was decreased, and a low vWF immunofunctional activity/antigen ratio, low collagen binding/antigen ratio, and decreased intermediate and high molecular weight multimers were noted. The patient had no high-shear stress conditions, and an antibody-mediated process was suspected. A vWF mixing study showed complete correction of vWF activity, suggesting no direct functional inhibitor. The patient was given a bolus of vWF concentrate with serial measurements of vWF; the vWF half-life was 2.5 hours. The vWF propeptide/antigen ratio was 4:1, supporting a diagnosis of aVWD resulting from increased antibody-mediated vWF clearance. This case study emphasizes the laboratory’s role in the diagnosis and treatment of rare, overlooked acquired bleeding disorders.
Unique properties of spacer acquisition by the type III-A CRISPR-Cas system
Authors: Zhang Xinfu , Garrett Sandra , Graveley Brenton R , Terns Michael P
Published: November 2021

Type III CRISPR-Cas systems have a unique mode of interference, involving crRNA-guided recognition of nascent RNA and leading to DNA and RNA degradation. How type III systems acquire new CRISPR spacers is currently not well understood. Here, we characterize CRISPR spacer uptake by a type III-A system within its native host, Streptococcus thermophilus. Adaptation by the type II-A system in the same host provided a basis for comparison. Cas1 and Cas2 proteins were critical for type III adaptation but deletion of genes responsible for crRNA biogenesis or interference did not detectably change spacer uptake patterns, except those related to host counter-selection. Unlike the type II-A system, type III spacers are acquired in a PAM- and orientation-independent manner. Interestingly, certain regions of plasmids and the host genome were particularly well-sampled during type III-A, but not type II-A, spacer uptake. These regions included the single-stranded origins of rolling-circle replicating plasmids, rRNA and tRNA encoding gene clusters, promoter regions of expressed genes and 5′ UTR regions involved in transcription attenuation. These features share the potential to form DNA secondary structures, suggesting a preferred substrate for type III adaptation. Lastly, the type III-A system adapted to and protected host cells from lytic phage infection.
Chondroprotective effects of CDK4/6 inhibition via enhanced ubiquitin-dependent degradation of JUN in synovial fibroblasts
Authors: Hosoya Tadashi , Saito Tetsuya , Baba Hiroyuki , Tanaka Nao , Noda Seiji , Komiya Youji , Tagawa Yasuhiro , Yamamoto Akio , Mizoguchi Fumitaka , Kawahata Kimito , Miyasaka Nobuyuki , Kohsaka Hitoshi , Yasuda Shinsuke
Published: November 2021

Objective

Targeting synovial fibroblasts (SF) using a cyclin-dependent kinase (CDK) 4/6 inhibitor (CDKI) could be a potent therapy for RA via inhibition of proliferation and MMP-3 production. This study was designed to elucidate the mechanism of chondroprotective effects on SFs by CDK 4/6 inhibition.

Methods

CDK4/6 activity was inhibited using CDKI treatment or enhanced by adenoviral gene transduction. Chondroprotective effects were evaluated using a collagen-induced arthritis model (CIA). Gene and protein expression were evaluated with quantitative PCR, ELISA and Western blotting. The binding of nuclear extracts to DNA was assessed with an electrophoresis mobility shift assay. RNA-Seq was performed to identify gene sets affected by CDKI treatment.

Results

CDKI attenuated cartilage destruction and MMP-3 production in CIA. In RASFs, CDKI impaired the binding of AP-1 components to DNA and inhibited the production of MMP-1 and MMP-3, which contain the AP-1 binding sequence in their promoter. CDK4/6 protected JUN from proteasome-dependent degradation by inhibiting ubiquitination. The RNA-Seq analysis identified CDKI-sensitive inflammatory genes, which were associated with the pathway of RA-associated genes, cytokine-cytokine receptor interaction and IL-17 signalling. Notably, the AP-1 motif was enriched in these genes.

Conclusion

The mechanism of chondroprotective effects by CDK4/6 inhibition was achieved by the attenuation of AP-1 transcriptional activity via the impaired stability of JUN. Because the pharmacologic inhibition of CDK4/6 has been established as tolerable in cancer treatment, it could also be beneficial in patients with RA due to its chondroprotective and anti-inflammatory effects.
Rheumatoid arthritis patients treated with Janus kinase inhibitors show reduced humoral immune responses following BNT162b2 vaccination
Authors: Iancovici Liat , Khateeb Dina , Harel Ofer , Peri Regina , Slobodin Gleb , Hazan Yoav , Melamed Doron , Kessel Aharon , Bar-On Yotam
Published: November 2021

Objectives

The mRNA-based COVID-19 vaccines are now employed globally and have shown high efficacy in preventing SARS-CoV-2 infection. However, less is known about the vaccine efficacy in immune-suppressed individuals. This study sought to explore whether humoral immunity to the COVID-19 vaccine BNT162b2 is altered in RA patients treated with Janus kinase inhibitors by analysing their antibodies titre, neutralization activity and B cell responses.

Methods

We collected plasma samples from 12 RA patients who were treated with Janus kinase inhibitors and received two doses of the BNT162b2 vaccine, as well as 26 healthy individuals who were vaccinated with the same vaccine. We analysed the quantity of the anti-spike IgG and IgA antibodies that were elicited following the BNT162b2 vaccination, the plasma neutralization capacity and the responsiveness of the B-lymphocytes. We used ELISA to quantify the antibody titres, and a plasma neutralization assay was used to determine the virus neutralization capacity. Alteration in expression of the genes that are associated with B cell activation and the germinal centre response were analysed by quantitative PCR.

Results

Reduced levels of anti-spike IgG antibodies and neutralization capacity were seen in the RA patients who were treated with JAK inhibitors in comparison with healthy individuals. Furthermore, B cell responsiveness to the SARS-CoV-2 spike protein was reduced in the RA patients.

Conclusion

RA patients who are treated with JAK inhibitors show a suppressed humoral response following BNT162b2 vaccination, as revealed by the quantity and quality of the anti-spike antibodies.
Women, Mobility, and Education in Twentieth-century England and Wales: A New Analytical Approach
Authors: de Bellaigue Christina , Worth Eve , Bennett Charlotte , Eli Karin , Ulijaszek Stanley
Published: November 2021

The twentieth century saw substantial changes in the educational and occupational opportunities available to women in Britain. These may have been supposed to foster new patterns of female mobility. Yet studies of women’s intergenerational mobility are rare and tend not to focus on education. This article develops a historically informed gauge of educational attainment—the Educational Cohort Code (ECC). Applying that gauge to the experiences of women in twentieth-century UK, we make two key claims: first, that despite the prevalence of narratives of progress and mobility in individual and collective accounts of women’s education, there were considerable intergenerational continuities in women’s educational status across the period. Second, that the expansion of educational opportunities across the twentieth century had a differential impact for women and for men and that this differentiation destabilizes categorizations of class solely based on male occupational hierarchies. By applying the ECC method to family data, rather than focusing only on individuals, the article identifies trends within families and the possible influence of family cultures of education and employment on intergenerational mobility.
Characterizing the development of photosynthetic capacity in relation to chloroplast structure and mineral nutrition in leaves of three woody fruit species
Authors: Fu Xinyu , Zhang Jingyi , Zhou Linyao , Mo Weiping , Wang Huicong , Huang Xuming
Published: November 2021

Plants have evolved different developmental patterns of photosynthetic capacity to better adapt to changing environmental conditions. Natural variation in photosynthetic development offers great potential for improving crop productivity. In this study, leaf developmental patterns were characterized in three woody fruit tree species with distinct photosynthetic capacity and growth habits. Changes in the photosynthetic rate, photosystem II (PSII) efficiency, chloroplast ultrastructure, activities of photosynthetic enzymes, and contents of carbohydrates and mineral nutrients were examined at five developmental stages to explore the interspecific variation in photosynthetic development. Rapid development of photosynthetic machinery and high photosynthetic capacity were found in Indian jujube (Ziziphus mauritiana) and apple (Malus domestica), whose net CO2 assimilation rate (A) peaked at full leaf expansion (FLE). Litchi (Litchi chinensis), a delayed-greening species, showed slow development of photosynthetic competence, with A peaked after FLE. The low photosynthetic capacity of litchi during early leaf expansion was associated with its delayed chloroplast development, low accumulation of starch, and low activities of ribulose-1,5-bisphosphate carboxylase/oxygenase and NADP-glyceraldehyde-3-phosphate dehydrogenase. Correlations between mineral contents and A across leaf stages and species identified manganese as the rate-limiting nutrients in photosynthetic development in new leaves. Foliar spray of MnSO4 solution (1 g l−1) induced a short-term increase in photosynthesis in young leaves of litchi. These findings suggest that a better understanding of interspecific variation in photosynthetic development facilitates the development of new strategies for improving the photosynthetic efficiency of woody fruit trees.
How the discovery of oligochaete regeneration during the Enlightenment was pivotal to the advancement of annelid research
Authors: Rota Emilia
Published: November 2021

Within a few months of the year 1741, Lyonet and Trembley in Holland, Bonnet in Geneva and Réaumur in Paris all experimented industriously with the regeneration of various invertebrates, including the still unknown microdrile oligochaetes. Some of these worms were prone to spontaneous fragmentation as a natural mode of asexual multiplication, preceded (paratomy) or followed (architomy) by regenerative processes. Bonnet and Réaumur raised the stakes and began to study regeneration in earthworms, a challenge that, especially in Italy, inspired scholars and educated people among the clergy and aristocracy. Spallanzani conducted the most rigorous experiments and was the first to obtain consecutive regenerations of the head in one and the same megadrile. He saw detached mid-body sections becoming complete with a new head and a new tail, and he determined the points of the body where regeneration does not take place and how much length to leave for each section so that it could reintegrate. Above all, Spallanzani obtained regeneration of the gonadic segments, both in terrestrial and in freshwater megadriles, the latter today identified as Criodrilus lacuum. This and other important anatomical and physiological findings by Spallanzani, largely unpublished during his lifetime and for a long time after, preceded the discoveries of later authors by almost 50 years.
Effects of therapeutic plasma exchange on survival in patients with postoperative liver failure: a retrospective single-center study
Authors: Kobe Yoshiro , Tateishi Yoshihisa , Oda Shigeto
Published: November 2021

Background:

Recent decreases in the incidence of postoperative liver failure (POLF) have been attributed to advances in surgical techniques, critical care, and postoperative management. However, POLF management remains a challenge, and worsening POLF is a significant cause of morbidity and mortality. Therapeutic plasma exchange (TPE) is used as a salvage strategy for POLF in some countries, and several studies conducted between 1980 and 1990 have reported the use of TPE for POLF. We conducted this retrospective single-center study to investigate the outcomes of patients with POLF treated with TPE.

Methods:

We retrospectively reviewed the charts of patients with POLF admitted to the intensive care unit who underwent TPE between November 2010 and March 2017. POLF was defined as the presence of persistent hyperbilirubinemia. Data on patient demographics, Glasgow Coma Scale score, platelet count, prothrombin time, and serum total bilirubin level were collected, and their Sequential Organ Failure Assessment scores were calculated. The lengths of postoperative hospital stays, lengths of post-TPE hospital stays, and patient outcomes were also analyzed.

Results:

TPE was performed in 20 patients with POLF during the study period. TPE was initiated on the 49th postoperative day and was performed for a median of five sessions. TPE improved hyperbilirubinemia and coagulopathy but had no effect on neurological and clinical symptoms. All 20 patients treated with TPE died after the 36th day (median) from the initial TPE.

Conclusions:

Although TPE may improve laboratory values in patients with POLF, the current study suggests that it has no survival benefit.
The PIEZO1 gene mutation (c.2005G>T) causes iron overload cardiomyopathy: a case report
Authors: Cui Sumei , Lu Huixia , Wei Shujian , Li Chuanbao , Xu Feng , Chen Yuguo
Published: November 2021

Background:

Cardiomyopathy has a variety of etiologies. Here, we report a case of iron overload cardiomyopathy (IOC) in combination with hereditary stomatocytosis (HST) due to a rare mutation in the PIEZO1 gene.

Case summary:

A 31-year-old man presented to the clinic with a new onset of fatigue and abdominal distension. He had a history of 9-year cholelithiasis, 4-year hemolytic anemia, 7-month diabetes mellitus (DM), and 6-month low sex drive. The specific features of bronze skin, liver palms, yellow eyes, DM, and cardiomyopathy raised our suspicion of hemochromatosis, which was confirmed by an elevated serum ferritin concentration and high transferrin saturation. Echocardiography and cardiovascular magnetic resonance (CMR) imaging demonstrated dilation of all cardiac cavities with a left ventricular ejection fraction of 30%. CMR T2∗ mapping showed myocardial, hepatic, and pancreatic siderosis. Next-generation sequencing identified one missense variant in the PIEZO1 gene (c.2005G>T), which conferred HST and hyperferritinemia. We screened his close family members and identified his son as a heterozygous carrier of this variant, who had intermittent jaundice.

Conclusion:

In this case, the PIEZO1 c.2005G>T mutation conferred HST and IOC, complicated with cholelithiasis, DM, and low sex drive. Bronze skin, liver cirrhosis, cardiomyopathy, and DM are red flags, while magnetic resonance imaging T2∗ mapping, blood iron metabolism markers, and gene testing are valuable in the diagnosis.
Candidates and allocation time for extracorporeal membrane oxygenation in patients with cardiogenic shock
Authors: Huang Baotao
Published: November 2021

Extracorporeal membrane oxygenation (ECMO) is a last resort life support in several patients with cardiogenic shock. However, appropriate candidates and optimal timing of ECMO initiation need to be established. The present report reviewed relevant literatures to refine the allocation of ECMO in patients with cardiogenic shock. The PubMed database was searched from inception to October 5, 2020, using the following search terms: “extracorporeal membrane oxygenation” or “mechanical circulatory support” AND “cardiogenic shock” or “cardiac arrest” or “myocardial infarction” or “fulminant myocarditis.” The etiology of cardiogenic shock, widened QRS duration, QTc interval prolongation, cardiac arrest, dynamic narrowing of pulse pressure, and speed of lactate accumulation per unit time can be associated with the course of cardiogenic shock, and typically warn that advanced medical circulatory support is required. In the critical moment when the circulatory status deteriorates sharply, an immediate physical examination combined with ready-to-use tools such as monitoring data or blood gas analysis results is crucial for assessing the appropriateness and timing of ECMO initiation.
Touching-bone acupuncture in the treatment of chronic pain
Authors: Li Xiaoping , Wei Wan , Wang Yuan , Wang Qiang , Liu Zhibin
Published: November 2021

Background:

Chronic pain is the most common disease in the world, which lead the patients to suffer the disability both physically and psychologically. The chronic pain can affects the patients to work, socialize, sleep and can lead to depressive illness, decreased motivation, and a reduction in physical activity. Acupuncture is a promising treatment for the chronic pain which has a long history of use in China. This protocol aims to assess the effectiveness and safety of touching periosteum acupuncture therapy on patients with chronic pain.

Methods:

Randomized controlled trial literatures which include touching periosteum acupuncture therapy for treating chronic pain will be searched from 8 electronic databases including China Biology Medicine disc, VIP database, WanFang database, China National Knowledge Infrastructure, PubMed, Cochrane Library, Excerpt Medical Database, and Web of Science. The language will be restricted to Chinese and English. The primary outcome is to measure the relief of the pain by Visual Analogue Scale. Two or 3 reviewers will conduct the study selection, data extraction and the evaluation of the risk of bias. RevMan software (V.5.3) will be used to perform the assessment of the risk of bias and data synthesis.

Results:

From this study, we will confirm the effectiveness of safety of in the treatment of chronic pain.

Conclusions:

We will ascertain the effectiveness of safety of touching periosteum acupuncture therapy in the treatment of chronic pain, to provide evidence to guide touching periosteum acupuncture therapy for patients with chronic pain in the future.

Ethics and dissemination:

Ethics approval will not be necessary, because the included publications in our study are all from published articles. This systematic review will be published in a peer-reviewed journal or conference report to provide a reference in this field.

Trial registration:

CRD42021243387.
Long-term outcomes of delayed percutaneous coronary intervention for patients with ST-segment elevation myocardial infarction
Authors: Xue Yu-Long , Ma Yue-Teng , Gao Yu-Ping , Zhang Sheng-Xiao , Su Qin-Yi , Li Yu-Feng , Zhang Lei , Ding Peng-Fei , Li Xue-Wen
Published: November 2021

The best time window of percutaneous coronary intervention (PCI) is within 12 hours for ST-segment elevation myocardial infarction (STEMI). However, there is limited evidence about the proper time of PCI for delayed STEMI patients.

From June 2014 to June 2015, a total of 268 patients receiving PCI with second-generation drug-eluting stent in a Chinese hospital after 3 days of STEMI onset were enrolled in this retrospective study, who were divided into the early group (3–14 days) and the late group (>14 days). A propensity score match was conducted to reduce the baseline difference. The primary endpoint of all-cause death and secondary endpoints of major adverse cardiac and cerebrovascular event (myocardial infarction [MI], stroke, emergent revascularization, and rehospitalization due to heart failure) were compared using survival analysis.

At last, 182 cases were matched after propensity score match, with no statistical difference in baseline characteristics and PCI data. Kaplan-Meier survival curve demonstrated no difference in all-cause death of the 2 groups (P = .512). However, the early group presented a higher incidence of MI than the late group (P = .036). The multivariate Cox regression analysis also demonstrated that the early PCI was an independent risk factor for MI compared with late PCI (hazard ratio = 3.83, 95%CI [1.91–8.82], P = .001). There was no statistical difference in other major adverse cardiac and cerebrovascular event, including stroke, emergent revascularization, and rehospitalization due to heart failure.

Using the 2nd drug-eluting stent, early PCI (3–14 days) and late PCI (>14 days) have comparable efficacy and outcomes. However, patients receiving early PCI are subjected to a relatively higher risk of recurrent MI.
The efficacy and safety of acupoint catgut embedding for peripheral facial paralysis
Authors: Wang Fengyi , Li Qinglin , Yu Qiaoyun , Liang Junquan , Xu Yunxiang , Chen Guizhen
Published: November 2021

Background:

Peripheral facial paralysis (PFP) is a consequence of the peripheral neuronal lesion of the facial nerve. It can be either primary (Bell palsy) or secondary. The incidence of PFP is 11.5 to 40.2 per 100,000 people a year. Nearly 70% of patients with PFP recover completely, but almost 30% of patients leave multiple sequelae which caused impacts on the patient's quality of life, both physically and psychologically. The conventional treatments of PFP are limited for some person because of side-effects. Previous studies have suggested that using acupoint catgut embedding (ACE) alone or combined with other therapeutic methods is effective for PFP. However, whether ACE is effective for PFP is still unknown. The purpose of this systematic review (SR) and meta-analysis will summarize the present evidence of ACE used as an intervention for PFP.

Method/Design:

Randomized controlled clinical trials that use ACE for PFP will be searched from four international electronic databases (PubMed, Cochrane Library, EMBASE, and Web of Science) and 4 Chinese electronic databases (China National Knowledge Infrastructure, VIP, Wanfang, and China Biology Medicine) to search for relevant literature. We only include studies that were published from the initiation to May 2021. The primary outcomes include effectiveness rate based on House-Brackmann Facial Nerve Grading System. Secondary outcomes will include Sunnybrook facial nerve grading system, Portmann score, facial nerve conduction velocity, Facial Disability Index Scale, adverse events. Two reviewers will perform study selection, data extraction, data synthesis, and quality assessment independently. Assessment of risk of bias and data synthesis will be conducted by using Review Manager 5.3 software. Grade system will be used to evaluate the quality of evidence.

Discussion:

This systematic review will help establish clinical evidence regarding the efficacy and safety of acupoint catgut embedding for peripheral facial paralysis.

Trial registration number:

CRD42021243212 (PROSPERO)
Efficacy of Shaobei injection in the treatment of grade II–III hemorrhoids and the effect on fibulin protein expression
Authors: Yue Bin , Wang Yangang , Zhang Chunxia , Ding Yunlong , Liu Zhipeng
Published: November 2021

Background:

Hemorrhoids are a common and seriously disruptive condition that seriously affects people's lives in terms of treatment. Injection therapy is an effective minimally invasive scheme for the treatment of grade II–III hemorrhoids, but its clinical application is limited by the adverse reactions caused by injection drugs. Some clinical studies have confirmed the efficacy and safety of Shaobei injection as a traditional Chinese medicine extract. However, there is no standard randomized controlled study to verify its efficacy and explore its potential mechanism.

Methods:

This is a prospective, randomized, single blind, parallel controlled trial to study the efficacy of Shaobei injection in the treatment of grade II–III hemorrhoids and its effect on the expression of fibulin-3 and fibulin-5 in fibulin protein family. The patients will be randomly divided into a treatment group and control group. The treatment group will be treated with Shaobei injection, and the control group will be treated with rubber band ligation. The observation indexes include: visual analysis scale, postoperative hospital stay, total use of painkillers, fibulin-3 and fibulin-5, hemorrhoids recurrence, and adverse events. Finally, the data will be statistically analyzed by SPASS 18.0 software.

Discussion:

This study will compare the efficacy of Shaobei injection with the rubber band ligation method in the treatment of grade II–III haemorrhoids and investigate its effect on the expression of fibulin-3 and fibulin-5 in the fibulin protein family. The results of this study will provide a basis for the clinical use of Paeoniflora injection as an alternative to traditional sclerosing agent in the treatment of grade II–III haemorrhoids.

Trial registration: OSF Registration number:DOI 10.17605/OSF.IO/MKVDB
Prognostic value of microRNAs in heart failure
Authors: Yang Jie , Yang Xue-Song , Fan Shao-Wei , Zhao Xiao-Yu , Li Chao , Zhao Zheng-Yao , Pei Hui-Juan , Qiu Lu , Zhuang Xin , Yang Chuan-Hua
Published: November 2021

Background:

Reported studies have shown that expression levels of microRNAs (miRNAs) are related to survival time of patients with heart failure (HF). A systematic review and meta-analysis were conducted to study circulating miRNAs expression and patient outcome.

Methods:

Meta-analysis estimating expression levels of circulating miRNAs in HF patients from January 2010 until June 30, 2018, through conducting online searches in Pub Med, Cochrane Database of Systematic, EMBASE and Web of Science and reviewed by 2 independent researchers. Using pooled hazard ratio with a 95% confidence interval to assess the correlation between miRNAs expression levels and overall survival.

Results:

Four relevant articles assessing 19 circulating miRNAs in 867 patients were included. In conclusion, the meta-analysis results suggest that HF patients with low expression of serum miR-1, miR-423-5p, miR-126, miR-21, miR-23, miR-30d, miR-18a-5p, miR-16-5p, miR-18b-5p, miR-27a-3p, miR-26b-5p, miR-30e-5p, miR-106a-5p, miR-233-3P, miR-301a-3p, miR-423-3P, and miR-128 have significantly worse overall survival (P 
< 
.05). Among them, miR-18a-5p, miR-18b-5p, miR-30d, miR-30e-5p, and miR-423-5p are strong biomarkers of prognosis in HF.
Efficacy and safety of abdominal acupuncture for insomnia
Authors: Feng Zhitao , Wang Zhihong , Qiu Zhanshuang , Li Tie , Zhang Lili , Wang Jiajia , Ying Dashi
Published: November 2021

Background:

Insomnia is characterized by high incidence, easy recurrence, and difficulty in curing. Serious insomnia not only seriously affects the body organ function, but psychological patients also cause great damage. Abdominal acupuncture (AA) has fewer side effects and is increasingly used to treat insomnia. This study aimed to systematically review the effectiveness and safety of abdominal acupuncture in the treatment of insomnia.

Methods:

Literature on abdominal acupuncture for insomnia in the PubMed, Excerpt Medica Database(Embase), Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure Database, China Biomedical Literature Database, Chinese Scientific Journal Database, and Wan Fang databases were searched from the creation of these databases to October 3, 2021. In addition, the reference lists of studies meeting the inclusion criteria will also be searched to achieve a comprehensive retrieval of the maximum. All randomized controlled trials of AA for treating insomnia were included. Two reviewers will conduct literature screening, data extraction, and quality evaluation respectively. The main outcome was the Pittsburgh Sleep Quality Index, and the secondary outcomes included clinical efficacy and safety. RevMan 5.4.1 software was used for mate analysis.

Results:

This study aimed to evaluate the current status of AA treatment for insomnia, with the aim of illustrating the effectiveness and safety of abdominal acupuncture.

Conclusion:

This study will provide high-quality evidence to evaluate the effectiveness and safety of AA in treating insomnia.

Registration: INPLASY2021100088
Cross-sectional study of the association of 5 single nucleotide polymorphisms with enalapril treatment response among South African adults with hypertension
Authors: Masilela Charity , Pearce Brendon , Ongole Joven Jebio , Adeniyi Oladele Vincent , Johnson Rabia , Benjeddou Mongi
Published: November 2021

This study investigates the association of 5 single nucleotide polymorphisms (SNPs) in selected genes (ABO, VEGFA, BDKRB2, NOS3, and ADRB2) with blood pressure (BP) response to enalapril. The study further assessed genetic interactions that exist within these genes and their implications in enalapril treatment response among South African adults with hypertension.

A total of 284 participants belonging to the Nguni tribe of South Africa on continuous treatment for hypertension were recruited. Five SNPs in enalapril pharmacogenes were selected and genotyped using MassArray. Uncontrolled hypertension was defined as BP ≥140/90 mm Hg. The association between genotypes, alleles, and BP response to treatment was determined by fitting multivariate logistic regression model analysis, and genetic interactions between SNPs were assessed by multifactor dimensionality reduction.

Majority of the study participants were female (75.00%), Xhosa (78.87%), and had uncontrolled hypertension (69.37%). All 5 SNPs were exclusively detected among Swati and Zulu participants. In the multivariate (adjusted) logistic model analysis, ADRB2 rs1042714 GC (adjusted odds ratio [AOR] = 2.31; 95% confidence interval [CI] 1.02–5.23; P = .044) and BDKRB2 rs1799722 CT (AOR = 2.74; 95% CI 1.19–6.28; P = .017) were independently associated with controlled hypertension in response to enalapril. While the C allele of VEGFA rs699947 (AOR = 0.37; 95% CI 0.15–0.94; P = .037) was significantly associated with uncontrolled hypertension. A significant interaction between rs699947, rs495828, and rs2070744 (cross-validation consistency = 10/10; P = .0005) in response to enalapril was observed.

We confirmed the association of rs1042714 (ADRB2) and rs1799722 (BDKRB2) with controlled hypertension and established an interaction between rs699947 (VEGFA), rs495828 (ABO), and rs2070744 (NOS3) with BP response to enalapril. Our findings have provided substantial evidence for the use of SNPs as predictors for enalapril response among South Africans adults with hypertension.
Periprocedural complications of cardiac implantable electronic device implantation in very elderly patients with cognitive impairment
Authors: Guan Fu , Peng Jianjun , Hou Shu , Ren Lihui , Yue Yunan , Li Guangping
Published: November 2021

Very elderly people (over 80 years) with cardiac implantable electronic devices (CIEDs) indications often have a higher prevalence of aging comorbidity, among which cognitive impairment is not uncommon. This study aimed to investigate periprocedural complications of CIED implantation among very elderly patients with and without cognitive impairment. One hundred eighty patients ≥80 years of age indicated for CIED implantation were included in our study. During hospitalization, the cognitive evaluation was performed according to the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). According to the cognitive test results, patients were divided into 2 groups (90 patients with normal cognitive function and 90 patients with cognitive impairment). Meanwhile, their physical parameters and laboratory measurements were completed. The procedural data and periprocedural complications were collected from both groups. The association between cognitive impairment and periprocedural complications was analyzed using univariate and multiple logistic regression analyses. During a one-month follow-up, the most frequent periprocedural complications in very elderly patients were pocket hematoma and thrombosis events. Cognitively impaired patients had a higher incidence of complications than normal cognitive patients. Multivariate regression analysis showed that cognitive impairment was positively correlated with periprocedural complications in very elderly patients. Cognitive impairment is associated with increased periprocedural complications of CIED implantation in very elderly patients.
Association between helicobacter pylori infection and subclinical atherosclerosis
Authors: Wang Xianghong , He Qian , Jin Donghua , Ma Baohua , Yao Kecheng , Zou Xiulan
Published: November 2021

Background:

The relationship between Helicobacter pylori (H. pylori) infection and subclinical atherosclerosis has been confirmed, but these conclusions are still controversial. Therefore, we have performed a systematic review and meta-analysis to assess the association between H. pylori infection and subclinical atherosclerosis.

Methods:

Databases including PubMed, Embase, Web of Science were searched for the articles on the association of carotid intima-media thickness or pulse wave velocity with H. pylori infection published up to January 1, 2020. Stata 12.0 was used to calculate standardized mean difference (SMD) and 95% confidence interval (95% CI); the I

2
test was used to evaluate heterogeneity between studies and sensitivity analysis and subgroup analysis were used to explore the source of heterogeneity. Funnel plot, Begg test, and Egger test were used to estimate publication bias.

Results:

Data were extracted from 18 studies involving 6776 subjects with H. pylori positive and 7794 with H. pylori negative. H. pylori positive subjects is significantly associated with increased subclinical atherosclerosis as determined by carotid intima-media thickness (SMD: 0.376 mm; 95% CI: 0.178, 0.574; P < .001, I2 = 90.6%), pulse wave velocity (SMD: 0.320 m/s; 95% CI: 0.242, 0.398; P < .001, I2 = 52.6%), compared with H. pylori negative. Similar results were observed when subgroups analysis were stratified according to age, male ratio, geographical location, H. pylori diagnosis, and study design. Sensitivity analyses showed that our results were robust. The Begg test or Egger test showed no significant publication bias (all P > .05).

Conclusions:

This meta-analysis confirmed a significant association between H. pylori and subclinical atherosclerosis, which will help H. pylori patients to establish effective strategies for the prevention and control of cardiovascular events.
Association of tuberculosis treatment with pregnancy complications
Authors: Kgathi Moloko A. , Phoswa Wendy N.
Published: November 2021

Background:

The increasing burden of tuberculosis (TB) remains a very serious concern around the world, and account for a decreased quantity and quality of life. However, there is a limited epidemiology of the association of TB treatment with pregnancy. We aim to assess the effects of TB treatment in pregnancy complications.

Methods:

This will be a systematic review and meta-analysis of published studies on the association of TB treatment with pregnancy, retrieved from ScienceDirect, Web of Science, LILACS, Pubmed, Google scholar, Embase, Medline, ResearchGate, EBSCOhost and Cochrane library databases. The eligibility of the studies will be screened in accordance to the selection criteria by two independent reviewers. The quality and risk of bias of eligible studies will be performed by both reviewers using the Hoy tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool in accordance to the measured outcomes (Hypertension in pregnancy, Pre-eclampsia, Hypertensive disorders of pregnancy, Fetal growth restriction, Miscarriage and Recurrent spontaneous abortion). A data charting table will be used to extract background information and process the data items from each eligible study. The data will be analysed using Review Manager 5.3 (RevMan 5.3) software. Generic Inverse Variance method will be used for meta-analysis of both, individually and cluster randomized trials.

Ethics and dissemination:

The review and meta-analysis will not require ethical approval and the findings will be published in peer-reviewed journals and presented at local and international conferences. In addition, the study findings will be made accessible to the national committee of TB to formulate TB guidelines for their respective settings.

Systematic review registration:

International prospective Register of Systematic Reviews (PROSERO) number: CRD42021231872.
Mobile computed tomography for the efficient allocation of medical resources in patients with COVID-19 pneumonia
Authors: Jung Jae Wan , Kim Hak Ryul , Yoon Kwon Ha , Park Chul
Published: November 2021

Rationale:

The highly contagious Coronavirus 2019 (COVID-19) infection raise social and economic burden. Medical staff and resources are being diverted for the care of patients with COVID-19. There are problems for healthcare systems, including burnout syndrome for the medical staff and exhaustion of medical resources.

Patient concerns:

The patient was a 65-year-old woman presenting with fever, cough, and dyspnea due to COVID-19 pneumonia. She received antiviral agents, broad-spectrum antibiotics, and conservative treatment. Although her clinical condition improved, there was no significant improvement in portable chest X-ray results.

Diagnoses:

Due to concerns over the propagation of infection when transferring to patients for scanning and the need for excessive medical personnel to move patients, we moved a mobile chest computed tomography (CT) machine to an isolation ward for CT scanning.

Interventions:

We report our experience using mobile chest CT to effectively allocate medical resources and assess treatment response in patient with COVID-19 pneumonia.

Outcomes:

Follow-up mobile CT scans disclosed progressive resolution of the multifocal ground-glass opacities and mixed consolidations distributed peripheral to subpleural spaces. During the mobile chest CT scan, there were no adverse or unforeseen events. Three medical personnel were required to performed mobile chest CT, including a clinician, a nurse, and a radiologist.

Lessons:

As a result of using mobile chest CT on COVID-19 patients, the number of medical personnel required for CT scanning decreased by about 83%, rapid, and safe compared with a patient who performed conventional CT.
Parosteal lipoma of the forearm
Authors: Al-Mnayyis Asma’a , Al Sharie Sarah , Araydah Mohammad , Talafha Muna , Haddad Fadi
Published: November 2021

Rationale:

Parosteal lipomas are rare neoplasms comprising mature adipocytes situated in a proximity to bone. Although these tumors follow a benign course, the reactive osseous changes that may occur with such lesions might raise the suspicion of malignancy.

Patient Concerns:

Here we present a case of a 33-year-old male patient complaining of pain and swelling in the right anterior forearm without history of trauma.

Diagnosis:

An magnetic resonance imaging of the region revealed a lobulated intramuscular fat intensity mass within the supinator muscle. Bony projection inseparable from the anterolateral radial diaphyseal cortex and periosteum was also seen. The radiological features suggested the diagnosis of parosteal lipoma.

Intervention:

After the radiological diagnosis of a parosteal lipoma, the patient was offered a total surgical excision of the mass.

Outcomes:

The mass was removed successfully. Histopathology showed mature benign adipose tissue bordered by thin fibrous septa confirming the diagnosis of parosteal lipoma. Follow-up magnetic resonance imaging after 6 months did not reveal any signs of complications or recurrence.

Lessons:

Distinction of the features of parosteal lipomas is needed to establish the accurate diagnosis, discriminate it from malignant lesions, predict potential neurovascular compromises, and follow up until a curative action is planned.
Bilateral cavernous sinus dural arteriovenous fistula with initial ocular symptom
Authors: Zhang Qian , Xu Xiao-Ling , Sun Ya-Li , Wang Zi-Wei , Lai Xian-Liang , Xiong Yu
Published: November 2021

Rationale:

Cavernous sinus dural arteriovenous fistula (CSDAVF) is a rare intracranial vascular malformation. Because of its complicated clinical manifestations, it is easy to miss or misdiagnose CSDAVF.

Patient concerns:

A 42-year-old female had chief complaint that the right eyeball had conjunctival congestion for half a year. She was given levofloxacin eye drops to treat the right eye with anti-inflammatory treatment, but the symptoms did not improve. Cranial magnetic resonance and cerebrovascular imaging showed that the right lateral rectus muscle was slightly enlarged, the right eyeball was prominent, but there was no abnormality in the brain.

Diagnoses:

Based on clinical and imaging examinations and digital subtraction angiography (DSA), she was diagnosed as low-flow CSDAVF.

Interventions:

The patient received interventional embolization with transvenous combined arterial approach using coils and Onyx liquid glue.

Outcomes:

The patient's exophthalmos and congestion symptoms were improved.

Conclusion:

DAS is the gold standard for the diagnose of CSDAVF. Intravascular embolization interventional therapy is an effective treatment for CSDAVF.
Effectiveness and safety of Xinkeshu on coronary artery disease patients combined with anxiety and depression symptoms after percutaneous coronary intervention
Authors: Chen Mingtai , Zhong Guofu , Men Ling , Liu Qiang , Luan Jienan
Published: November 2021

Background:

It's known that coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI) was significantly associated with anxiety and depression symptoms. Several studies have showed that Xinkeshu tablet (XKS), a kind of Chinese herbal medicine, could effectively improve post-PCI postoperative mood disorders in CHD patients. However, the intensity of evidence has been poor, limiting the further clinical application of XKS to patients above. This systematic review and meta-analysis will assess the effectiveness and safety of studies of XKS in CHD patients with anxiety and depression symptoms after PCI.

Methods:

A systematic literature search for articles up to December 2021 will be performed in following electronic databases: PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database Database, Chinese Biomedical Database, Chinese Biomedical Literature Service System, and Wanfang Database. Inclusion criteria are randomized controlled trials of XKS applied on patients with CHD and depression. The primary outcome measures will be CHD-related clinical evaluation (frequency of acute attack angina, severity of angina pectoris, electrocardiographic changes, amount of nitroglycerin) and the scores or reducing fractions of depressive and anxiety measuring scales (the Hospital Anxiety/Depression Scale or other widely used anxiety/depression scale). The safety outcome measures will be adverse events, liver and kidney function. RevMan 5.3 software will be used for data synthesis, sensitivity analysis, subgroup analysis, and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias. Stata 12.0 will be used for meta-regression and Egger tests. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence.

Discussion:

This study will provide a high-quality synthesis of the effects and safety of XKS for CHD patients with anxiety and depression symptoms after PCI.

Ethics and dissemination:

This systematic review does not require ethics approval and will be submitted to a peer-reviewed journal.

Trial registration number PROSPERO CRD42019131346.
Comparison of microendoscopic discectomy and percutaneous transforaminal endoscopic discectomy for upper lumbar disc herniation
Authors: Xu WeiJun , Yang Bingxuan , Lai Xidan , Hong Xinxin , Chen Zihao , Yu Dongqing
Published: November 2021

Background:

Microendoscopic discectomy (MED) and percutaneous transforaminal endoscopic discectomy (PTED), as two alternative surgical techniques in minimally invasive spine surgery (MISS), are widely conducted in the treatment of upper lumbar disc herniation (ULDH). This study will systematically assess and compare the clinical outcomes of MED and PTED in treating ULDH combining with the meta-analysis.

Methods:

All the randomized controlled trials (RCTs) will be searched at the databases including PubMed, EMBASE, Cochrane Library and Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP), and WANFANG Database from inception to December 2025. The primary outcome will involve Japanese Orthopedic Association (JOA), Oswestry disability index (ODI), and visual analog scale (VAS) scores. The secondary outcomes will be the short-form 36-item (SF-36) health survey questionnaire and the modified MacNab criterion. We will perform data synthesis, subgroup analysis, sensitivity analysis, meta-regression analysis, and the assessment of reporting bias using RevMan 5.3 software.

Results:

This systematic review will comprehensively evaluate the clinical outcomes of comparison of MED and PTED in the treatment of ULDH and provide a reliable and high-quality evidence.

Conclusion:

The conclusion of this study will elucidate the clinical outcomes of MED compared with PTED and clarify whether PTED generates better clinical effects than MED in treating ULDH.

PROSPERO registration number:

CRD 42021244204