bluuebunny/crossref_metadata_2025 huggingface dataset:
LDHA deficiency inhibits trophoblast proliferation via the PI3K/AKT/FOXO1/CyclinD1 signaling pathway in unexplained recurrent spontaneous abortion
Authors: Zhu Yueyue , Wu Fan , Hu Jianing , Xu Yichi , Zhang Jinwen , Li Yan , Lin Yi , Liu Xiaorui
Published: December 2022

Dysregulated trophoblast proliferation, invasion, and apoptosis may cause several pregnancy‐associated complications, such as unexplained recurrent spontaneous abortion (URSA). Recent studies have shown that metabolic abnormalities, including glycolysis inhibition, may dysregulate trophoblast function, leading to URSA. However, the underlying mechanisms remain unclear. Herein, we found that lactate dehydrogenase A (LDHA), a key enzyme in glycolysis, was significantly reduced in the placental villus of URSA patients. The human trophoblast cell line HTR‐8/SVneo was used to investigate the possible LDHA‐mediated regulation of trophoblast function. LDHA knockdown in HTR‐8/SVneo cells induced G0/G1 phase arrest and increased apoptosis, whereas LDHA overexpression reversed these effects. Next, RNA sequencing combined with Kyoto Encyclopedia of Genes and Genomes analysis demonstrated that the PI3K/AKT signaling pathway is potentially affected by downstream genes of LDHA. Especially, we found that LDHA knockdown decreased the phosphorylation levels of PI3K, AKT, and FOXO1, resulting in a significant downregulation of CyclinD1. In addition, treatment with an AKT inhibitor or FOXO1 inhibitor also verified that the PI3K/AKT/FOXO1 signaling pathway influenced the gene expression of CyclinD1 in trophoblast. Moreover, p‐AKT expression correlated positively with LDHA expression in syncytiotrophoblasts and extravillous trophoblasts in first‐trimester villus. Collectively, this study revealed a new regulatory pathway for LDHA/PI3K/AKT/FOXO1/CyclinD1 in the trophoblast cell cycle and proliferation.
Influenza virus replication is affected by glutaredoxin1‐mediated protein deglutathionylation
Authors: Checconi Paola , Coni Cristiana , Limongi Dolores , Baldelli Sara , Ciccarone Fabio , De Angelis Marta , Mengozzi Manuela , Ghezzi Pietro , Ciriolo Maria Rosa , Nencioni Lucia , Palamara Anna Teresa
Published: December 2022

Several redox modifications have been described during viral infection, including influenza virus infection, but little is known about glutathionylation and this respiratory virus. Glutathionylation is a reversible, post‐translational modification, in which protein cysteine forms transient disulfides with glutathione (GSH), catalyzed by cellular oxidoreductases and in particular by glutaredoxin (Grx). We show here that (i) influenza virus infection induces protein glutathionylation, including that of viral proteins such as hemagglutinin (HA); (ii) Grx1‐mediated deglutathionylation is important for the viral life cycle, as its inhibition, either with an inhibitor of its enzymatic activity or by siRNA, decreases viral replication. Overall these data contribute to the characterization of the complex picture of redox regulation of the influenza virus replication cycle and could help to identify new targets to control respiratory viral infection.
Xanthine oxidoreductase mediates genotoxic drug‐induced autophagy and apoptosis resistance by uric acid accumulation and TGF‐β‐activated kinase 1 (TAK1) activation
Authors: Wang Jingxiang , Hu Yanhua , Liu Penggang , Xu Xiulong
Published: December 2022

Autophagy is a highly conserved cellular process that profoundly impacts the efficacy of genotoxic chemotherapeutic drugs. TGF‐β‐activated kinase 1 (TAK1) is a serine/threonine kinase that activates several signaling pathways involved in inducing autophagy and suppressing cell death. Xanthine oxidoreductase (XOR) is a rate‐limiting enzyme that converts hypoxanthine to xanthine, and xanthine to uric acid and hydrogen peroxide in the purine catabolism pathway. Recent studies showed that uric acid can bind to TAK1 and prolong its activation. We hypothesized that genotoxic drugs may induce autophagy and apoptosis resistance by activating TAK1 through XOR‐generated uric acid. Here, we report that gemcitabine and 5‐fluorouracil (5‐FU), two genotoxic drugs, induced autophagy in HeLa and HT‐29 cells by activating TAK1 and its two downstream kinases, AMP‐activated kinase (AMPK) and c‐Jun terminal kinase (JNK). XOR knockdown and the XOR inhibitor allopurinol blocked gemcitabine‐induced TAK1, JNK, AMPK, and Unc51‐like kinase 1 (ULK1)S555 phosphorylation and gemcitabine‐induced autophagy. Inhibition of the ATM‐Chk pathway, which inhibits genotoxic drug‐induced uric acid production, blocked gemcitabine‐induced autophagy by inhibiting TAK1 activation. Exogenous uric acid in its salt form, monosodium urate (MSU), induced autophagy by activating TAK1 and its downstream kinases JNK and AMPK. Gene knockdown or the inhibitors of these kinases blocked gemcitabine‐ and MSU‐induced autophagy. Inhibition of autophagy by allopurinol, chloroquine, and 5Z‐7‐oxozeaenol (5Z), a TAK1‐specific inhibitor, enhanced gemcitabine‐induced apoptosis. Our study uncovers a previously unrecognized role of XOR in regulating genotoxic drug‐induced autophagy and apoptosis and has implications for designing novel therapeutic strategies for cancer treatment.
The Utility of IR-Guided Biopsy in the Treatment of Pediatric Osteomyelitis
Authors: Gajewski Christopher R. , Chen Kevin , Upfill-Brown Alexander , Silva Mauricio , Thompson Rachel M.
Published: December 2022

Background:

Accurate and efficient diagnosis, as well as a consistent and effective treatment of acute hematogenous osteomyelitis, are paramount to ensure successful clinical outcomes. Noninvasive measures of isolating the causative pathogen from blood cultures have low sensitivity, with published rates often <50%. The use of interventional radiology (IR)-guided percutaneous biopsy has gained traction as a nonsurgical means of obtaining tissue cultures with a reported increased sensitivity of >90%. This study aims to determine the utility of IR-guided biopsy in the management of pediatric patients with acute hematogenous pediatric osteomyelitis (OM).

Methods:

An IRB-approved retrospective review was completed of children younger than 18 years admitted to a single institution for treatment of magnetic resonance imaging or culture/biopsy-proven acute hematogenous OM. Patients were excluded for the diagnosis of chronic recurrent multifocal OM, incomplete documentation, treatment initiation at an outside institution, open surgical debridement, and concomitant septic arthritis. Patients who underwent IR-guided biopsy were compared with those treated empirically without biopsy.

Results:

Fifty patients were included for analysis. Fifteen (30%) had IR-guided biopsies; 35 (70%) were treated empirically. The average age at diagnosis was 11.8 years old (SD: 4.9). Of the 15 patients who underwent IR-guided biopsy, a pathogen was identified in 12 cases (80%); 14 of these patients had concomitant blood cultures with only 1 (7%) positive result (P<0.01). Of the 11 patients with positive IR-guided biopsy results in the setting of negative blood cultures, 9 (82%) had alterations in their antibiotic regimen as a result of the biopsy. The average time from blood sample collection to definitive antibiotic initiation was nearly double that of time from IR-guided biopsy collection to definitive antibiotic initiation (70.8 vs. 36 h; P<0.01).

Conclusion:

IR-guided biopsy increased pathogen identification by 47% over blood cultures alone and decreased the time to definitive antibiotics. As such, IR-guided biopsy is an effective and safe diagnostic tool for pathogen identification and appropriate antibiotic selection. Orthopaedic surgeons are encouraged to incorporate IR-guided biopsy early in the treatment pathway for patients with acute OM without an indication for open surgical intervention.

Level of Evidence:

Level III; retrospective comparative study.
Prognostic Factors Associated With Extubation Failure in Acutely Brain-Injured Patients: A Systematic Review and Meta-Analysis*
Authors: Taran Shaurya , Angeloni Natalia , Pinto Ruxandra , Lee Shawn , McCredie Victoria A. , Schultz Marcus J. , Robba Chiara , Taccone Fabio S. , Adhikari Neill K. J.
Published: December 2022

Objective:

Extubation failure in brain-injured patients is associated with increased morbidity. Our objective was to systematically review prognostic factors associated with extubation failure in acutely brain-injured adult patients receiving invasive ventilation in an ICU.

Data Sources:

MEDLINE, Embase, and Cochrane Central were searched from inception to January 31, 2022.

Study Selection:

Two reviewers independently screened citations and selected English-language cohort studies and randomized trials examining the association of prognostic factors with extubation failure. Studies were considered if they included greater than or equal to 80% adult patients with acute brain injury admitted to the ICU and mechanically ventilated for greater than or equal to 24 hours.

Data Extraction:

Two reviewers extracted data on population, prognostic factors, extubation outcomes, and risk of bias (using the quality in prognostic factors tool).

Data Synthesis:

In the primary analysis, adjusted odds ratios (aOR) for each prognostic factor were pooled using random-effects models. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. The search identified 7,626 citations, of which 21 studies met selection criteria. Moderate-certainty evidence suggested increased risk of extubation failure with older age (aOR, 3.0 for upper vs lower tertile; 95% CI, 1.78–5.07) and longer duration of mechanical ventilation (aOR, 3.47 for upper vs lower tertile; 95% CI, 1.68–7.19). Presence of cough (aOR, 0.40; 95% CI, 0.28–0.57) and intact swallow (aOR, 0.34; 95% CI, 0.21–0.54) probably decreased risk of extubation failure (moderate certainty). Associations of other factors with extubation failure were informed by low or very low certainty evidence.

Conclusions:

Patient age, duration of mechanical ventilation, and airway reflexes were associated with extubation failure in brain-injured patients with moderate certainty. Future studies are needed to determine the optimal application of these variables in clinical practice.
Molecular mechanisms and roles of pyroptosis in acute lung injury
Authors: Wei Tianchang , Zhang Cuiping , Song Yuanlin
Published: December 2022

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), which are characterized by excessive inflammation and accompanied by diffuse injury of alveoli, can result in severe respiratory failures. The morbidity and mortality of patients remain high because the major treatments for ALI/ARDS are mainly supportive due to the lack of effective therapies. Numerous studies have demonstrated that the aggravation of coronavirus disease 2019 (COVID-19) leads to severe pneumonia and even ARDS. Pyroptosis, a biological process identified as a type of programed cell death, is mainly triggered by inflammatory caspase activation and is directly meditated by the gasdermin protein family, as well as being associated with the secretion and release of pro-inflammatory cytokines. Clinical and experimental evidence corroborates that pyroptosis of various cells in the lung, such as immune cells and structural cells, may play an important role in the pathogenesis of “cytokine storms” in ALI/ARDS, including those induced by COVID-19. Here, with a focus on ALI/ARDS and COVID-19, we summarized the recent advances in this field and proposed the theory of an inflammatory cascade in pyroptosis to identify new targets and pave the way for new approaches to treat these diseases.
Urine excretion of C3dg and sC5b-9 coincide with proteinuria and development of preeclampsia in pregnant women with type-1 diabetes
Authors: Isaksson Gustaf L. , Nielsen Lise H. , Palarasah Yaseelan , Jensen Dorte M. , Andersen Lise L. T. , Madsen Kirsten , Bistrup Claus , Jørgensen Jan S. , Ovesen Per G. , Jensen Boye L.
Published: December 2022

Objective:

Pregnant women with type-1 diabetes have an increased risk of preeclampsia with kidney injury and cardiovascular complications. Urine excretion of plasmin and soluble membrane attack complex (sC5b-9) is elevated in severe preeclampsia. We hypothesized a coupling between these events and that active plasmin promotes intratubular complement activation and membrane deposition.

Methods:

Stored urine and plasma samples from pregnant women with type-1 diabetes (n = 88) collected at gestational weeks 12, 20, 28, 32, 36 and 38 were used. In the cohort, 14 women developed preeclampsia and were compared with 16 nonpreeclampsia controls.

Results:

Urine C3dg and sC5b-9-associated C9 neoantigen/creatinine ratios increased and were significantly higher in women who developed preeclampsia. Plasma concentrations did not change with gestation. Urine plasmin(ogen) correlated to urine C3dg (r = 0.51, P < 0.001) and C9 neoantigen (r = 0.68, P < 0.001); urine albumin correlated to C3dg (r = 0.44, P < 0.001) and C9 (r = 0.59, P < 0.001). Membrane-associated C3dg and C9 neoantigen was detected in urinary extracellular vesicles from patients but not controls at 36 weeks. Receiver operating characteristic curves showed that C3dg and C9 neoantigen were inferior to albumin as predictive biomarkers for preeclampsia.

Conclusion:

In preeclampsia, urinary excretion of activated complement relates significantly to albuminuria and to plasmin(ogen) but not to activation in plasma. Intratubular complement activation in preeclampsia is a postfiltration event tightly related to proteinuria/plasminogenuria and a possible mechanistic link to cellular damage and kidney injury.
Time of blood pressure in target range in acute ischemic stroke
Authors: Kakaletsis Nikolaos , Ntaios George , Milionis Haralampos , Protogerou Athanasios D. , Karagiannaki Anastasia , Chouvarda Ioanna , Dourliou Vasiliki , Ladakis Ioannis , Kaiafa Georgia , Daios Stylianos , Doumas Michael , Savopoulos Christos
Published: December 2022

Objective:

The purpose of this study was to investigate the association of blood pressure (BP) time-in-target range (TTR) derived from 24-h ambulatory BP monitoring (ABPM) during the acute phase of ischemic stroke (AIS), with the severity of stroke and its predictive value for the 3 months outcome.

Methods:

A total of 228 AIS patients (prospective multicenter follow-up study) underwent ABPM every 20 min within 48 h from stroke onset using an automated oscillometric device. Clinical and laboratory findings were recorded. Mean BP parameters, BP variability and TTR for SBP (90–140 mmHg), DBP (60–90 mmHg), and mean arterial pressure (MAP) were calculated. Endpoints were death and disability/death at 3 months.

Results:

A total of 14 942 BP measurements were recorded (∼66 per AIS patient) within 72 h of stroke onset. Patient's 24-h TTR was 34.7 ± 29.9, 64.3 ± 24.2, and 55.3 ± 29.4% for SBP, DBP and MAP, respectively. In patients without prior hypertension, TTR was lower as stroke severity increased for both DBP (P = 0.031) and MAP (P = 0.016). In 175 patients without prior disability, increase in TTR of DBP and MAP associated significantly with a decreased risk of disability/death (hazard ratio 0.96, 95% CI 0.95–0.99, P = 0.007 and hazard ratio 0.97, 95% CI 0.96–0.99, P = 0.007). TTR of SBP in 130–180 mmHg and 110–160 mmHg ranges seems to be related with mortality and disability outcomes, respectively.

Conclusion:

TTR can be included for a more detailed description of BP course, according to stroke severity, and for the evaluation of BP predictive role, in addition to mean BP values, derived from ABPM during the acute phase of AIS.

Clinical Trial Registration-URL:

http://www.clinicaltrials.gov. Unique identifier: NCT01915862.
Unmasking left ventricular systolic dysfunction in masked hypertension: looking at myocardial strain. A review and meta-analysis
Authors: Cuspidi Cesare , Gherbesi Elisa , Faggiano Andrea , Sala Carla , Grassi Guido , Tadic Marijana
Published: December 2022

Background and Aim:

A growing body of evidence supports the view that masked hypertension (MH) (i.e. normal office and elevated out-of-office BP) is a blood pressure (BP) phenotype associated with increased risk of subclinical organ damage, cardiovascular disease and death as compared to true normotension. Whether left ventricular (LV) systolic function is impaired in individuals with MH is still a poorly defined topic. Therefore, we aimed to provide a new piece of information on LV systolic dysfunction in the untreated MH setting, focusing on speckle tracking echocardiography (STE) studies investigating LV global longitudinal strain (GLS), a more sensitive index of systolic function than conventional LV ejection fraction (LVEF).

Methods:

A computerized search was performed using Pub-Med, OVID, EMBASE and Cochrane library databases from inception until June 30, 2022. Full articles reporting data on LV GLS in MH, as assessed by ambulatory BP monitoring (ABPM), and normotensive controls were considered suitable for the purposes of review and meta-analysis.

Results:

A total of 329 untreated individuals with MH and 376 normotensive controls were included in six studies. While pooled average LVEF was not different between groups [64.5 ± 1.5 and 64.5 ± 1.3%, respectively, standard means difference (SMD): −0.002 ± 0.08, confidence interval (CI): 0.15/−0.15, P = 0.98), LV GLS was worse in MH patients than in normotensive counterparts (−18.5 ± 0.70 vs. −20.0 ± 0.34%, SMD: 0.68 ± 0.28, CI: 0.12/1.24, P < 0.01).

Conclusions:

Our findings suggest that early changes in LV systolic function not detectable by conventional echocardiography in the MH setting can be unmasked by STE and that its implementation of STE in current practice may improve the detection of subclinical organ damage of adverse prognostic significance.
Endodiathermal Tautening of Floppy or Irregular Iris in Endothelial Keratoplasty (Iridodiathermy)
Authors: Jacob Soosan , Agarwal Amar , Rechichi Miguel , Parker Jack , Kumar Dhivya Ashok , Kumar Arun
Published: December 2022

Floppy or irregular irides may be seen during endothelial keratoplasty in complex cases or in eyes with damaged irides and may cause uneven air fill, retro-pupillary air escape, anterior bowing of iris, forward movement of lens–iris diaphragm, shallowing of anterior chamber (AC), bellowing and floppiness of iris, uneven AC depth, difficulty in inserting and opening graft, iris trauma, intraoperative bleeding, and iridodialysis. We present a technique of iridodiathermy for tautening and flattening such irides. With continuous irrigation using AC maintainer, the bipolar endodiathermy probe tip is applied in localized spots to midperipheral iris in the affected area with power and duration adjusted to induce mild localized shrinkage and tightening of iris stroma. Such iris tautening decreases its floppiness and prevents anterior bowing, excessive mobility, irido-corneal touch, and peripheral anterior synechiae formation. It provides a stable AC with regular depth and improved, uniform, and nonmigratory air fill, thus decreasing intraoperative challenges.
Comparison of the Modified Jones Tube Technique and the DMEK EndoGlide Technique With and Without Viscoelastic Material for DMEK Tissue Preparation
Authors: Christopher Karen L. , Terrin Staci , Lohmeier John , Hartman Matthew , Davidson Richard S. , Taravella Michael J.
Published: December 2022

Purpose:

The aim of this study was to compare endothelial cell loss for DMEK (Descemet membrane endothelial keratoplasty) tissue preparation techniques using the modified Jones tube and the DMEK EndoGlide with and without viscoelastic material to protect the endothelium.

Methods:

This ex vivo study included 10 DMEK grafts prepared using each of the 3 abovementioned techniques. After tissue preparation, transport conditions were simulated for a minimum of 45 hours before deployment of the DMEK tissue and quantification of endothelial cell loss. Comparisons between preparation technique groups were made using the Wilcoxon rank-sum test.

Results:

The Jones tube group had a mean endothelial cell loss of 11.0 ± 4.8% compared with the EndoGlide group with 12.9 ± 6.7% and the EndoGlide with viscoelastic group with 25.7 ± 15.0%. The differences between the EndoGlide with viscoelastic group and the other 2 were statistically significant both before (P < 0.01 and P = 0.01) and after (P = 0.01 and P = 0.02) adjusting for baseline characteristics. The difference between the EndoGlide and Jones tube groups was not significant (P = 0.73 and P = 0.53 after adjustment). Microscopy revealed endothelial cell loss in the area of viscoelastic use for the EndoGlide with viscoelastic group.

Conclusions:

Both the Jones tube and DMEK EndoGlide resulted in similar low rates of endothelial cell loss after tissue preparation, transport, and deployment. However, use of viscoelastic material to protect the endothelium using the DMEK technique actually resulted in increased cell loss in the area of its application resulting in overall higher rates of cell loss across the DMEK tissue.
Utility of In Vivo Confocal Microscopy in Diagnosis of Acanthamoeba Keratitis: A Comparison of Patient Outcomes
Authors: Lee Hyunjoo J. , Alipour Fateme , Cruzat Andrea , Posarelli Matteo , Zheng Lixin , Hamrah Pedram
Published: December 2022

Purpose:

The aim of this study was to compare outcomes between cases of Acanthamoeba keratitis (AK) diagnosed and treated with or without the use of in vivo confocal microscopy (IVCM).

Methods:

We performed a retrospective comparative case series of 26 eyes of 23 patients diagnosed with AK at the Massachusetts Eye and Ear Infirmary over a 5-year period. The characteristics of all identified cases were summarized. We compared the time from presentation to diagnosis of AK (primary outcome), visual acuity, and rates of therapeutic penetrating keratoplasty between eyes diagnosed by culture-only group (n = 8) and by IVCM to diagnose AK (n = 9) and later confirmed by culture (IVCM/C group).

Results:

The diagnostic delay was significantly longer in the culture only group (25 ± 29 days) compared with the IVCM/C group (3 ± 3 days, P < 0.01). At 6 months, there was a significant difference in best-corrected visual acuity between the culture-only group (1.46 ± 1.07, n = 7) and the IVCM/C group (0.22 ± 0.22, n = 8), after adjusting for initial baseline visual acuity (P = 0.02). Therapeutic penetrating keratoplasty was performed in 50% of culture-only (n = 7) and 11% of IVCM/C group eyes (n = 9), but this was not statistically significant (P = 0.13).

Conclusions:

IVCM can expedite the diagnosis of AK, and its use as an adjunct tool in the diagnosis of AK may result in better patient outcomes compared with basing treatment decisions on corneal cultures alone.
Transmission of Knowledge and Practice between Cultures: A Case Study of Chinese Medicine Integration in the United States
Authors: Morris William
Published: December 2022

Medicine operates within the world views of the culture that it serves, and the widespread Chinese diaspora has carried medical practices with it. The resulting creolization takes shape at the borders of intersecting cultures in a distinct form of integration. This article explores the intersections of integration relative to the spread of Chinese medicine in the United States in practical, cognitive, and theoretical terms. This article could be a reference to practitioners, academics, and policymakers in the areas of integrative and Chinese medicine.
Shen in Acupuncture for Chronic Pain
Authors: Bei Yong-Shun
Published: December 2022

Chronic pain is one of the major complaints from patients seen in all acupuncture clinics. The most common principle to treat pain with acupuncture is to activate channels to relieve pain; however, little attention has been paid to treating the patient’s shen when treating their pain. This article is an introduction to the incorporation of the treatment of shen when treating chronic pain with acupuncture. The discussion of the shen and its treatments in this article are based on the review and study of the theories and principles in the ancient classics of traditional Chinese medicine. Shen is the interaction between yin and yang. Shen is the governor of life; it controls all physical and mental activities. Shen enables us to feel pain. The disorders of shen in pain sufferers can negatively affect how they feel or recognize pain, how they response to pain and how they report their pain level. We should pay more attention to the treatment of patient’s shen during the entire treatment course of chronic pain. Guarding shen is the key to acupuncture efficacy; the essential principles are harmonizing yin and yang by needling techniques and regulating hun and po at the needling sites.
TCM in Canada: Health Care and the Importance of Alternative Medicines that Complement Medical Practice
Authors: France Honoré
Published: December 2022

This article explores the introduction and growth of traditional Chinese medicine (TCM) through the lens of Chinese immigration to Canada. It further explores how it has spread to other cultural groups in Canada. Several theories are described to explain why it has attracted attention by non-Chinese ethnicities: the interest in organic and nature-based approaches, the underfunding health care, lack of family doctors, expensive drugs from big pharmaceutical companies, and respect for Chinese cultural practices. The regulatory practice of TCM is described along with the organization, types of educational program and certification as well as a patient’s perspective of TCM treatment.
Efficacy and safety of weekly versus triweekly cisplatin concurrent with radiotherapy in nasopharyngeal carcinoma: A meta-analysis
Authors: Chen Long , Li Yi-Chang , Hu Min , Zhao Shi-Jie , Yang Qiang-Wei
Published: December 2022

Background:

Cisplatin-based concurrent chemoradiotherapy is a standard of care for locally advanced nasopharyngeal carcinoma (NPC), and weekly and triweekly cisplatin are both alternative regimens based on the results of squamous cell carcinoma of the head and neck. However, there is a lack of direct evidence on the efficacy and safety of weekly versus triweekly cisplatin concurrent with radiotherapy in NPC alone. This meta-analysis aimed to identify which regimen is more superior between weekly and triweekly cisplatin in patients with NPC treated with concurrent chemoradiotherapy.

Methods:

The PubMed, Embase, and Cochrane Library were searched for eligible literatures. Clinical outcome measures including 1-year overall survival (OS), 3-year OS, 5-year OS, 5-year loco-regional failure-free survival, 5-year distant metastasis-free survial and the most common 3 grade or higher acute toxicities (hematological toxicity, mucositis and nausea and vomiting) were analyzed by RevMan 5.4 software; significance level was 0.05.

Results:

Seven clinical controlled studies with 1795 patients were included in the meta-analysis. There were no significant differences between weekly and triweekly cisplatin in 1-year OS, 3-year OS, 5-year OS, 5-year loco-regional failure-free survival, and 5-year distant metastasis-free survial) (all P > .05). Grade 3 or higher mucositis and nausea and vomiting showed similar between the 2 arms. However, grade 3 or higher hematological toxicity of weekly cisplatin was significantly higher than that of triweekly cisplatin (1.55; 95% CI, 1.22–1.98, P = .0004).

Conclusions:

Weekly cisplatin resulted in similar survival benifit as triweekly cisplatin, but with higher hematological toxicity.
Rescue of exotropia subsequent to pulled-in-two syndrome of the medial rectus muscle occurring during surgery for high myopic strabismus fixus: A case report
Authors: Nakao Shinya , Miyata Manabu , Hirai Mariko , Mizoguchi Shusaku , Ohashi Hirokazu , Nishiwaki Hirokazu
Published: December 2022

Rationale:

Pulled-in-two syndrome is one of the significant complications of strabismus surgery. This study aimed to report a case of pulled-in-two syndrome of the contractured medial rectus muscle (MR) that occurred during strabismus surgery for strabismus fixus due to high myopia, and to describe a rescue of this complication.

Patient concerns:

A woman in her 60s presented to our Ophthalmology Department with the main complaint of unilateral high myopia and severe myopic strabismus fixus. Esotropia exceeded 45° and hypotropia exceeded 15° in her right eye in the Hirschberg test. Right eye duction was markedly limited in every gaze direction. Orbital magnetic resonance images showed rupture of the superior rectus to lateral rectus band ligament and lengthening of the distance between the SR and LR muscles in the right eye.

Diagnosis:

Due to the patient's ophthalmic examination and imaging results, she was diagnosed with high myopic strabismus fixus.

Interventions:

We performed MR recession and Yokoyama surgery to correct right eye hypoesotropia. In the MR recession procedure, pulled-in-two syndrome (MR muscle tear) occurred. Thus, no additional procedure was performed on the MR. After the surgery, she presented 45 prism diopter exotropia and 18 prism diopter residual right hypotropia in a Krimsky test. We performed a second surgery, combining MR muscle advancement and inferior rectus (IR) muscle recession, 3 months after the first surgery.

Outcomes:

One and a half years after the second surgery, she presented exotropia of 14 prism diopters without hypotropia in the Krimsky test and was satisfied with her ocular position and improved motility.

Lessons:

We experienced pulled-in-two syndrome in a case with severe myopic strabismus fixus and achieved a good outcome by performing additional surgery 3 months later, in which the lost MR muscle was advanced. This case underscores that, if the lost muscle cannot be found during surgery, one should maintain composure and perform a reoperation a few months after the initial surgery, if necessary. This case report can aid in making rescue treatment decisions when pulled-in-two syndrome occurs.
Prognostic value of MSI2 expression in human malignancies: A PRISMA-compliant meta-analysis
Authors: Wu Wei , Li Jialin , Dong Dejia , Dou Fafu , Lin Yong , Yang Xiaoye , Zhou Yan , Xie Jun
Published: December 2022

Background:

The prognostic value of Musashi-2 (MSI2) in human malignancies remains controversial. We thus conducted this meta-analysis to evaluate the association between MSI2 expression and prognosis of patients with malignancies.

Materials and Methods:

We searched EMBASE, PubMed and Web of Science up to June 2021 for eligible studies. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated to assess the prognostic value of MSI2 expression. Odds ratios (ORs) with 95% CIs were calculated to evaluate the association between MSI2 expression and clinicopathological traits.

Results:

Sixteen studies involving 2203 patients were finally included in this meta-analysis. We found that high MSI2 expression might predict unfavorable OS (HR = 1.85, 95% CI: 1.62–2.10, P < .0001) and DFS/RFS (HR = 2.19, 95% CI: 1.87–2.57, P < .0001). Besides, the pooled results indicated that increased MSI2 expression correlated with large tumor size, poor tumor differentiation, positive lymph node metastasis and advanced tumor stage.

Conclusions:

Taken together, our data implies that MSI2 overexpression is related to poor survival outcomes in patients with malignancy. Therefore, MSI2 may serve as a novel prognostic biomarker and therapeutic target of malignancies. However, large-scale prospective and homogeneous investigations should be conducted in the future to further validate our findings.
Remotely monitored Baduanjin exercise in moderate-to-severe chronic obstructive pulmonary disease patients (BROCADE): A study protocol
Authors: Xu Shuanglan , Yin Zhifei , Chen Zi , Zhang Dandan , Ye Sheng , Zhou Ping , Chen Aiping , Wu Di , Liu Weihua , Zhang Liuchao , Guo Liquan , Xu Guangxu , Zhou Linfu
Published: December 2022

Background:

Baduanjin is a traditional Chinese exercise regimen used to treat various chronic illnesses and is associated with both psychological and physical benefits. However, its benefits for patients suffering from chronic obstructive pulmonary disease (COPD) are unclear. This study aims to assess the efficacy, safety, and underlying mechanisms of Baduanjin exercise in patients with moderate-to-severe COPD (BROCADE) by remote monitoring.

Methods:

This study protocol describes a multicenter, open-label, prospective randomized computed tomography. A total of 150 individuals who meet the inclusion criteria after the screening and consent processes will take part in the study. All participants will be provided routine medication and lifestyle interventions. They will be randomly assigned to a control group, a classical pulmonary rehabilitation group, or a Baduanjin group, which will undergo remotely monitored Baduanjin exercises for a cumulative duration of 1 hour per day, three times per week for 12 weeks. The participants will be followed for 24 weeks. The primary outcomes will be a 6-minutes walking distance and St. George’s Respiratory Questionnaire index. The secondary outcomes will be lung function, cross-sectional area of the pectoralis major and subcutaneous fat, modified Medical Research Council score, COPD assessment test questionnaire results, extremity muscle strength, and quality of life. Any adverse events that may occur will be monitored and recorded.

Results:

This study is ongoing and will be submitted to a peer-reviewed journal for publication once completed.

Conclusion:

A novel neutrophil-related inflammatory mechanism will potentially be identified. In addition, the study results will provide a safe, effective, simple and operational Baduanjin exercise protocol for moderate-to-severe COPD patients aimed at improving prognosis and quality of life.
Effectiveness of combined pregabalin and celecoxib for treatment of acute postoperative pain: A meta-analysis and systematic review
Authors: Ni Jing-Mei , Zhu Xuan , Wang Ping
Published: December 2022

Objective:

To estimate the acute analgesic efficacy of combined Pregabalin and Celecoxib after operation via a systematic review and meta-analysis.

Methods:

Studies for inclusion were randomized controlled trials, reporting on relevant outcomes (0–6 hours, 24 hours, 7 days pain scores) with treatment with combined Pregabalin and Celecoxib.

Results:

The pooled results from meta-analysis demonstrated that compared with placebo, combined Pregabalin and Celecoxib reduced pain scores at 0 to 6 hours in 3 articles, 24 hours in 5 articles, 7 days in 2 articles (standard mean difference [SMD], −3.10 at 0–6 hours, −2.80 at 24 hours, −1.32 at 7 days, respectively). Combined Pregabalin and Celecoxib could significantly reduce the postoperative narcotic consumption in 3 studies (SMD, −1.99 at 36 hour).

Discussion:

This work suggested that combined Pregabalin and Celecoxib were efficacious in reduction of postoperative pain and narcotic requirements after surgery, whereas more trials are needed to further identify the efficacy of combined Pregabalin and Celecoxib in the management of acute postoperative pain.
Effects of light music played by piano intervention on satisfaction, anxiety, and pain in patients undergoing colonoscopy: A randomized controlled trial
Authors: Sun Dong-Jie , You Yi-Xiang , He Xiao-Jian , Li Hai-Tao , Zeng Xiang-Peng , Li Da-Zhou , Wang Wen
Published: December 2022

Background:

Colonoscopy is the main kind of way to detect and treat diseases about large intestine, but during the examination and preparation, these 2 processes are able to lead abdominal pain, abdominal distention and other discomfort feel, which will cause patients to refuse the examination and become anxious. Painless and sedative endoscopy may reduce discomfort of patients, but there is a risk of adverse effects. Many studies have shown that playing music during colonoscopy can reduce discomfort and increase acceptance of colonoscopy, but the conclusion remains controversial. The 3 approaches of random, single-blind, controlled method were used to investigate the interventions effects of piano light music on satisfaction, anxiety and pain in patients undergoing colonoscopy.

Methods:

A total of 216 patients were randomly divided into piano music group (n = 112, piano music played during colonoscopy) and control group (n = 104, no music during colonoscopy) to compare patients satisfaction, anxiety score, pain score, vital signs, endoscopic difficulty score, and willingness to undergo colonoscopy again.

Results:

There were no significant differences in vital signs, pre-colonoscopic state anxiety score, and trait anxiety score before and after colonoscopy, and willingness to undergo colonoscopy again between the 2 groups (P > .05). The difficulty of colonoscopy operation and the score of state anxiety after colonoscopy in the piano group were lower than those in the control group (P < .05), and the satisfaction of colonoscopy process, pain management and overall service satisfaction were better than those of the control group (P < .05), and they were more likely to listen to music in the next examination (P < .001).

Conclusion:

The light music played by piano can relieve patients’ anxiety, improve the satisfaction of colonoscopy process, pain management and service satisfaction, reduce the difficulty of colonoscopy, which have no obvious adverse reactions. Therefore, it is worthy of promotion.
Efficacy and safety of acupuncture in combination with Chinese herbal medicine in dealing with osteoporosis: A protocol for a systematic review and network meta-analysis
Authors: Long Piao , Ju Shicong , Wang Jun
Published: December 2022

Background:

Osteoporosis (OP) has emerged as a major global public health issue due to its high prevalence, unknown pathogenesis, and lack of specific drugs for prevention and treatment. Studies have demonstrated that acupuncture in combination with Chinese herbal medicine (CHM) is effective in treating OP. However, there is a scarcity of experience and high-quality evidence. A network meta-analysis and systematic review were used to evaluate the efficacy and safety of acupuncture in combination with CHM for the treatment of OP.

Methods:

Comprehensive search of Chinese databases such as China National Knowledge Infrastructure, VIP, Wanfang, China Biomedical Literature Database and English databases for example PubMed, Cochrane Library, EMbase, etc. The search period was extended from the creation of the database to November 2022. All randomized controlled trials on acupuncture in combination with CHM in dealing with OP were collected. After literature analysis and data extraction, the Cochrance system was used to evaluate the high quality of the included articles and Stata 14.0 was used for the network meta-analysis.

Results:

The current systematic review and network meta-analysis will provide the effectiveness and safety of acupuncture in combination with CHM in dealing with OP.

Conclusion:

The research will provide reliable evidence for the clinical use of acupuncture in combination with CHM in dealing with OP.
Pre and postoperative nurse-guided incentive spirometry versus physiotherapist-guided pre and postoperative breathing exercises in patients undergoing cardiac surgery: An evaluation of postoperative complications and length of hospital stay
Authors: Su Hui , Zhang Jun , Liu Yunxue , Peng Hui , Zhang Longfei
Published: December 2022

Atelectasis is the most occurring postoperative complication after cardiac surgeries. Postoperative respiratory exercises and incentive spirometry led to decrease in postoperative complications, especially atelectasis and hospital stay. The objectives of the study were to evaluate postoperative complications and length of hospital stay of patients who received pre and postoperative nurse-guided incentive spirometry against those of patients who received pre and postoperative breathing exercises by the physiotherapist in patients who underwent cardiac surgery. Data of patients who received 2 days preoperative and 2 days postoperative nurse-guided incentive spirometry with a spirometer (PPN cohort, n = 102) or received 2 days preoperative and 2 days postoperative breathing exercises by physiotherapist without spirometer (PPP cohort, n = 105), or 2 days postoperative physiotherapist-guided breathing exercises only without spirometer (PPB cohort, n = 114) were collected and analyzed. The acute or chronic collapse of part or entire lung was defined as atelectasis. The length of stay in the hospital was from the day of admission to discharge. Patients of the PPN cohort had fewer numbers of incidences of atelectasis, dyspnea, and sweating >1 day after operations compared to those of the PPB and the PPP cohorts (P < .05 for all). The partial pressure of oxygen and oxygen saturation of arterial blood ≥6 hours after operations reported higher, the duration of ventilation was shorter, and numbers of re-intubation processes reported fewer for patients of the PPN cohort than those of the PPB and the PPP cohorts (P < .05 for all). The hospital length of the stay of patients in the PPN cohort was fewer than those of the PPB and the PPP (P < .0001 for both) cohorts. Pre and postoperative nurse-guided incentive spirometry with a spirometer following cardiac surgeries would have better postoperative pulmonary outcomes and fewer hospital stays than those of postoperative-only or pre and postoperative physiotherapist-guided breathing exercises (level of evidence: IV; technical efficacy stage: 5).
Ultrasound examination assisted clinical diagnosis of Leydig cell tumor of ovary: An extremely rare case report
Authors: Tian Cai , Li Xiaodong , Fu Zijie , Han Yiwei , Liu Jingqiao
Published: December 2022

Introduction:

Leydig cell tumor (LCT) is a sex cord-stromal tumor, which is a clinically rare ovarian tumor. It is characterized by endocrine hormonal changes and usually occurs in postmenopausal women.

Patient concerns:

We report the clinical case of a 38-year-old female of childbearing age with LCT of the right ovary who presented with significantly decreased menstrual flow and elevated androgen levels, with persistent hypoechoic areas in the ovary as demonstrated by transvaginal ultrasound.

Diagnosis:

The transvaginal ultrasound suggested the presence of a hypoechoic area in the right ovary with elevated androgens, interstitial tumor of the ovarian sex cord may be considered.

Interventions:

The patient underwent laparoscopic right adnexectomy.

Outcomes:

Postoperative pathology confirmed the morphology and immunohistochemistry of the right adnexa consistent with LCT, and no areas of malignant transformation were found on multiple sections of the surgical specimen. The patient had normal androgen levels at postoperative day 2, day 45 and month 3. There was no sign of recurrence.

Conclusion:

This case suggests that when women of childbearing age have abruptly decreased menstrual flow with increased testosterone, clinicians should pay attention to intra-ovarian occupying lesions and consider the possibility of LCT. In such cases, ultrasound examination can determine the presence, location, shape and size of occupying ovarian lesions and play an important role in the diagnosis of condition.
The clinical prognostic value of lncRNA LINC00473 in cancer patients: A meta-analysis
Authors: He Yuanyang , Chen Zheng , He Jingyu
Published: December 2022

Background:

LINC00473 is a promising long non-coding RNA. There is increasing evidence that SNHG7 is abnormally expressed in various tumors and is associated with cancer prognosis. However, identification of the effect of long non-coding RNA LINC00473 in tumors remains necessary.

Methods:

Up to August 15, 2021, we searched electronic databases, including PubMed, Cochrane Library, EMBASE, Medline, and Web of Science. The results were evaluated by pooled odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs).

Results:

There weres 13 included literature totaling cancer patients involved in this meta-analysis. The aggregated results revealed that high expression of LINC00473 was significantly associated with unfavorable overall survival (HR = 1.66, 95% CI: 1.48–1.86, P < .00001), disease-free survival (HR = 1.59, 95% CI: 1.09–2.32, P = .02) in a variety of cancers. Additionally, increased LINC00473 expression was also correlated with tumor node metastasis stage ((III/IV vs I/II) OR = 4.67, 95% CI = 3.11–7.02, P < .00001), differentiation ((poor/moderately vs well) OR = 3.25, 95% CI = 1.41–7.50, P = .006), tumor size ((larger vs smaller) OR = 2.49, 95% CI = 1.26–4.91, P = .03), and lymph node metastasis ((positive vs negative) OR = 3.10, 95% CI = 2.13–4.51, P = .008) in patients with cancers. Besides, the Gene Expression Profiling Interactive Analysis dataset evaluated that LINC00473 was upregulated in a variety of tumors and predicted worse prognosis.

Conclusion:

Our results of this meta-analysis demonstrated that high LINC00473 expression may become a potential target for predicting prognosis of human cancers.
The investigation of levels of endothelial cell-specific molecule, progranuline, clusterin, and human epididymis protein 4 in the differential diagnosis of malignant pleural effusions
Authors: Demirbas Soner , Yerlikaya Fatma Hümeyra , Yosunkaya Sebnem , Can Ummugulsum , Celalettin Korkmaz
Published: December 2022

Background:

Progranulin (PGRN), endothelial cell-specific molecule-1, clusterin (CLU), and human epididymis protein 4 (HE-4) are novel proteins reported to have diagnostic and prognostic potential in lung cancer. Here, we aimed to identify the markers with high sensitivity and specificity in distinguishing malignant pleural fluids from other pleural fluids.

Methods:

This prospective, descriptive study was conducted at a medical faculty hospital between 2016 and 2019. The study population consisted of 90 patients <18 years of age with pleural effusion (PE). Levels of pleural fluids of PGRN, endothelial cell-specific molecule-1, CLU, and HE-4 were measured with enzyme-linked immunosorbent assay kits under the manufacturer’s manual.

Results:

Of 90 patients, 54 were men, and 36 were women (mean age 65 ± 16 years). Of pleural fluids investigated, 23 (25%) and 67 (74%) were transudates and exudates, respectively. Of exudates, while 27 (40%) and 19 (28%) were parapneumonic PE and tuberculous PE, respectively, 20 (29%) were malignant pleural effusion (MPE). Levels of all biomarkers in exudate fluids were found significantly higher than those of transudate fluids. CLU, HE-4, and PGRN levels in MPE were also found significantly higher than benign fluids (P < .05). Cutoff values were achieved by receiver operating characteristics analysis for CLU, HE-4, and PGRN to distinguish between malignant and benign groups. For diagnosis of MPE, the sensitivity and specificity values were found as 0.66 and 0.67 for a cutoff value of CLU of 18.29 mg/L (P = .00), as 0.76 and 0.76 for a cutoff value of HE-4 of 9.33 mg/L (P = .00), and as 0.66 and 0.67 for a cutoff value of PGRN of 105.91 mg/L (P = .001).

Conclusion:

HE-4 having high sensitivity and specificity can be a potential diagnostic marker in distinguishing between malignant and benign effusions, and these findings can constitute a basis for future research.