bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of olopatadine hydrochloride eye drops for allergic conjunctivitis
Authors: Zi Yingxin , Deng Yu , Ji Meiqi , Qin Yali , Nong Luqi , Liu Ziqiang , Jin Ming
Published: February 2020

Background:

Allergic conjunctivitis (AC) is a multifactorial and common type of ocular surface disease that affects many people. The quality of life for AC patients can be significantly decreased caused by symptoms of ocular itching, swelling, redness, and tearing. Topical antihistaminics, mast cell stabilizers, non-steroidal anti-inflammatory drugs (NSAIDs), and steroids have been widely used to treat AC. Many clinical trials have indicated that olopatadine hydrochloride eye drops can provide quick relief of symptoms and signs. The purpose of this review is to evaluate systematically the effectiveness of olopatadine hydrochloride eye drops for treating AC.

Methods:

A systematic review of all of the randomized controlled trials on the effectiveness and safety of olopatadine hydrochloride eye drops for AC will be conducted. We will search PubMed, Web of Science (WOS), EMBASE (OVID), the Cochrane Library, Google Scholar, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal database (VIP), Wanfang Database, and CBM, from the database inception date to October 31, 2019. There are no language or publication status restrictions. Registers of clinical trials, potential gray literature, reference lists of studies, and conference abstracts will also be searched. Two reviewers will independently read the articles, extract the data information, and assess the quality of the studies. Data will be synthesized by a heterogeneity test. The primary outcomes include the main symptom and sign scores before and after treatment, the eye redness index, the presence of eosinophils in the conjunctival scraping. Quality of life, the total treatment efficacy, and safety will be evaluated as the secondary outcomes. RevMan V.5.3 software will be used for the meta-analysis.

Results:

The study will provide an objective and normative systematic review to evaluate the effectiveness and safety of olopatadine hydrochloride eye drops for the treatment of AC.

Conclusion:

Our review will provide useful information to judge whether olopatadine hydrochloride eye drops is an effective intervention for patients with AC.

Ethics and dissemination:

It is not necessary to obtain ethical approval as participants are not involved patients. The protocol and results will be published in a peer-reviewed journal. The systematic review will also be disseminated electronically and in print to help guide health care practice and policy.

Prospero registration number:

PROSPERO CRD42019132232.
Management of severe complications following penile surgery for erectile dysfunction and Peyronie disease
Authors: Bettocchi Carlo , Santoro Valeria , Sebastiani Francesco , Lucarelli Giuseppe , Colombo Fulvio , Ralph David John , Habous Mohamad , Ditonno Pasquale , Battaglia Michele , Spilotros Marco
Published: February 2020

Rationale:

Erectile dysfunction (ED) and Peyronie's disease (PD) are conditions commonly observed in andrology. Despite the surgical refinement and the technical improvement in this field, even in expert hands, detrimental consequences have been reported and it can be related to patient's comorbidities or misconduct in the postoperative period. In this article we report anecdotal cases of severe complications following penile surgery for ED and PD in high volume centers, describe the strategies adopted to treat it and discuss the options that would have helped preventing these events.

Patients’ concerns:

The first case describes a patient with history of ED and PD causing penile shortening and a slight dorsal deviation of penile shaft. In the second case it is described a corporeal necrosis and urethral fistula following inflatable penile prosthesis implant. In the last case it is described the migration of reservoir into the abdomen after inflatable penile prosthesis implantation post-radical prostatectomy.

Diagnosis:

All 3 patients were investigated with a penile doppler ultrasound with PGE1 intracorporeal injection for ED and PD diagnosis. An abdominal computed tomography scan and magnetic resonance imaging were ordered for patient of case three.

Interventions:

The patients underwent different combined procedures depending on the case and including: glansectomy, penile prosthesis implantation associated with a penile elongation with double dorsal-ventral patch graft (“sliding technique”), penile urethroplasty with buccal mucosa graft, and laparotomy for reservoir removal.

Outcomes:

No further serious complications were reported after the procedures described.

Lessons:

Penile surgery in patients with concomitant PD and systemic comorbidities can be at high risk of complications. As shown in this series there are possible dramatic evolution of these complications that may cause irreversible consequences to the patient. For this reason, a dedicated surgical and nursing team is necessary to reduce the chances that it happens. When this event occurs, a team trained in their management can improve the patient outcome
Thiamine status and lactate concentration in sepsis
Authors: Heming Nicholas , Salah Amor , Meng Paris , Sivanandamoorthy Sivanthiny , Bounab Rania , Chevret Sylvie , Annane Djillali
Published: February 2020

Thiamine is an essential co-factor for aerobic metabolism. Both thiamine deficiency and sepsis may be associated with hyperlactatemia and hypotension. We assessed the relationship between thiamine compounds, lactate concentrations and clinical outcomes in septic patients.

We undertook a prospective observational single-center study. Erythrocyte levels of total thiamine, free thiamine, thiamine mono, di and triphosphate (TMP, TDP, and TTP respectively), the erythrocyte transketolase activity (ETKA) and the effect of thiamine diphosphate on ETKA were measured in septic patients by high performance liquid chromatography and correlated with arterial lactate. Vital status at the end of intensive care unit stay was recorded.

Overall, 28 patients suffering from sepsis were included. Median (interquartile range [IQR]) age was 60 [44–77.3] years, 15 (53.6%) patients were male, median [IQR] simplified acute physiology score II was 40 [27–50]. There was no correlation between total thiamine and lactate levels (P = .33). There was no correlation between free thiamine (P = .81), TMP (P = .71), TDP (P = .31), TTP (P = .86), and lactate levels in our population. There was no correlation between ETKA (P = .58) or the effect of TDP on ETKA (P = .40) and lactate concentration. Total thiamine and TDP concentration were significantly higher in intensive care unit (ICU) survivors than in nonsurvivors (P = .03 and P = .03). The effect of TDP on ETKA was significantly higher in nonsurvivors compared to survivors (P = .04).

We found no correlation between thiamine compounds and lactate concentration in sepsis. Thiamine deficiency in sepsis may be associated with ICU-mortality.
Brain functional changes in tibetan with obstructive sleep apnea hypopnea syndrome
Authors: Kang Dongjie , Qin Zongyuan , Wang Wen , Zheng Yun , Hu Huiying , Bao Yuanyuan , Bao Haihua
Published: February 2020

Tibetan is a major ethnic group living on the Qinghai-Tibet Plateau in China. Due to their high-altitude hypoxia environment, sleeping disorder and obstructive sleep apnea hypopnea syndrome (OSAHS) are more prone to occur. In this study, we investigated the brain structural and functional differences between Tibetans OSAHS patients and Tibetans healthy controls using high resolution three-dimensional T1 weighted magnetic resonance imaging (MRI) and resting state functional MRI. The analysis was based on voxel-based morphology, regional homogeneity (ReHo), amplitude of low-frequence fluctuation (ALFF) and functional connection (FC) methods. A total of 14 OSAHS patients and 16 healthy control, all Tibetan male, matched closely in terms of age, education and living altitude, were recruited. The relationship between the ReHo and ALFF values at different brain areas and clinical features, including the apnea hypopnea index (AHI) in the OSAHS group, was analyzed using Pearson correlation. Compared with healthy control, OSAHS patients showed no significant gray matter volume or FC change. OSAHS group showed significantly increased ReHo values in the superior frontal gyrus dorsolateral, the left middle frontal gyrus, and the superior frontal gyrus medial. In contrast, OSAHS group showed decreased ReHo value in the left fusiform gyrus and cerebellum lobule 6. OSAHS group showed significantly increased ALFF values in the right inferior frontal gyrus orbital part, the right median cingulate and paracingulate gyri, the right Inferior frontal gyrus triangular part, the right insula and the left superior frontal gyrus dorsolateral. In the OSAHS group, the AHI showed a positive correlation with the ReHo value at the left cerebellum lobule 6 (r = 0.562, P = .037). Tibetan OSAHS patients had no significant change in brain structure and FC, which may be due to their adaption to the hypoxia environment. ReHo values and ALFF values changes in multiple brain areas in Tibetan OSAHS patients indicated brain functional impairment in multiple brain regions. The left cerebellum lobule 6 gradually compensates brain function as OSAHS progresses.
Chinese herbal preparations for chronic heart failure
Authors: Li Yong , Zhang Xiaohua , Chen Xiaoxiao , Chen Dezhu , Yu Qian , Yang Shenglan , Lang Mingjian
Published: February 2020

Background:

Chinese herbal preparations (CHPs) have been reported to be effective in the management of chronic heart failure (CHF); they are beneficial in improving cardiac function, reducing hospital stays and readmission. However, the credibility of their effectiveness evidence has not been evaluated. We aim to summarize and evaluate current effectiveness evidence of traditional Chinese medicine in the management of CHF.

Methods:

We will search PubMed, Embase, the Cochrane Database of Systemic Review (CDSR), and Web of Science from inception to December 2019 for systematic reviews that assessing the effectiveness of CHPs for CHF. The search will be performed without language restriction. Experimental interventions will include any type of CHPs, and control interventions will include placebo, sham interventions, usual care, or no controls. The primary outcome will be the changes in heart function classification defined by the New York Heart Association. Secondary outcomes include left ventricular ejection fraction, Six Minute Walk Test, other efficacy outcomes, and adverse events. We will use I
2 statistics to assess the between-study heterogeneity in each meta-analysis, Eager test to detect publication bias, and the ratio of observed versus expected number of trials with positive findings. We will summarize the evidence and classify them into convincing, highly suggestive, suggestive, or weak.

Results:

The results of this study will be published in a peer-reviewed journal.

Ethics and dissemination:

No ethical approval and patient consent are required since this study data is based on published literature. The results of the study will be submitted to a peer-reviewed journal.

Protocol registration number:

PROSPERO CRD 42019139649 (https://www.crd.york.ac.uk/PROSPERO/#joinuppage)
Recovering autonomy is a key advantage of home-based immunoglobulin therapy in patients with myositis
Authors: Chérin Patrick , Pindi Sala Taylor , Clerson Pierre , Dokhan Annaïk , Fardini Yann , Duracinsky Martin , Crave Jean-Charles , Chassany Olivier
Published: February 2020

Immunoglobulins are 2nd or 3rd-line treatments in dermatomyositis (DM) or polymyositis (PM) refractory to high-dose corticosteroids and immunosuppressants. Immunoglobulins (2 g/kg/mo) are usually administered intravenously (IVIg) once a month and the patients stay at hospital for a few days. Recently, subcutaneous injections (SCIg) were proposed 2 to 3 times per week, in some dysimmune diseases. SCIg are administered at home preferably by the patient or by a nurse. We investigated the needs and attitudes of DM and PM patients with experience of IVIg and SCIg.

Seven patients (6 PM and 1 DM) from a single center participated in a focus group (N = 6) or underwent in-depth interview (N = 1). Six had the experience of both IVIg at hospital and SCIg at home; 1 has received only IVIg at hospital. Verbatim was recorded and transcribed for further content analysis and computer-aided textual analysis.

Clinical profiles and stories were heterogeneous. At diagnosis, muscle weakness, severe pain, and fatigue were at the forefront of patients’ complaints impairing daily life. Patients reported considerable improvement with immunoglobulins. SCIg were described as easy, less disruptive for daily life, well tolerated, and less time-consuming. SCIg self-administration at home restored the feeling of autonomy and control.

Interviews of DM and PM patients revealed that recovering autonomy and control was a central advantage of home-based SCIg that were efficient, well tolerated, and perceived as a good compromise between treatment burden and efficacy.
Identification of hub genes, key pathways, and therapeutic agents in Hutchinson–Gilford Progeria syndrome using bioinformatics analysis
Authors: Wang Dengchuan , Liu Shengshuo , Xu Shi
Published: February 2020

Background:

Hutchinson–Gilford Progeria syndrome (HGPS) is a rare lethal premature and accelerated aging disease caused by mutations in the lamin A/C gene. Nevertheless, the mechanisms of cellular damage, senescence, and accelerated aging in HGPS are not fully understood. Therefore, we aimed to screen potential key genes, pathways, and therapeutic agents of HGPS by using bioinformatics methods in this study.

Methods:

The gene expression profile of GSE113648 and GSE41751 were retrieved from the gene expression omnibus database and analyzed to identify the differentially expressed genes (DEGs) between HGPS and normal controls. Then, gene ontology and the Kyoto encyclopedia of genes and genomes pathway enrichment analysis were carried out. To construct the protein-protein interaction (PPI) network, we used STRING and Cytoscape to make module analysis of these DEGs. Besides, the connectivity map (cMAP) tool was used as well to predict potential drugs.

Results:

As a result, 180 upregulated DEGs and 345 downregulated DEGs were identified, which were significantly enriched in pathways in cancer and PI3K-Akt signaling pathway. The top centrality hub genes fibroblast growth factor 2, decorin, matrix metallopeptidase2, and Fos proto-oncogene, AP-1 transcription factor subunit were screened out as the critical genes among the DEGs from the PPI network. Dexibuprofen and parthenolide were predicted to be the possible agents for the treatment of HGPS by cMAP analysis.

Conclusion:

This study identified key genes, signal pathways and therapeutic agents, which might help us improve our understanding of the mechanisms of HGPS and identify some new therapeutic agents for HGPS.
Intradural disc herniation at L4/5 level causing Cauda equina syndrome
Authors: Luo Dawei , Ji Changbin , Xu Hui , Feng Hongyong , Zhang Honglei , Li Kunpeng
Published: February 2020

Rationale:

Intradural disc herniation has been documented rarely and the pathogenesis remains unclear. The region most frequently affected by intradural lumbar disc herniations is L4–5 level, and the average age of intradural disc herniations is between 50 and 60 years. Although magnetic resonance imaging is a valuable tool in the diagnosis of this disease, it is still difficult to make a definite diagnosis preoperatively.

Patient concerns:

In this report, we described a 58-year-old male patient who presented with intermittent pain of low back and radiating pain of the both lower extremities for 2 years as well as decreased muscle strength of the both legs and dysfunction of urinary and defecation for 1 month.

Diagnosis:

Lumbar disc herniation was diagnosed during the first clinical examination in the local hospital. Magnetic resonance imaging revealed a mass disc filling almost the entire spinal canal at the L4/5 level and a stalk connecting the mass to the intervertebral disc was detected in the sagittal T2-weighted image. The massive lesion caused cauda equina compression, resulting in dysfunction of urinary and defecation.

Interventions:

Considering the mass's volume, bilateral hemilaminectomy, and transforaminal lumbar interbody infusion were performed. During the surgery, we found a perforation in the ventral dura and major part of herniated disc was located in the intradural space through it. The disc was carefully dissected from the surrounding nerve roots and the ventral dura and then totally removed. The defect on the ventral dura was sutured to prevent cerebrospinal fluid leakage.

Outcomes:

The patient presented complete recovery of the radiculopathy and cauda equina syndrome and significant improvement of muscle strength of both legs at 12 months follow-up.

Lessons:

The diagnosis of intradural disc herniations is very difficult and mainly based on intraoperative and histopathological results. Surgical intervention is only effective method to manage this disease and to relieve symptoms and prevent severe neurological deficits.
Biomechanical analysis and optimization of screw fixation technique for the cortical bone channel of lower thorax
Authors: Yu Yang , Xie YiZhou , Jian Qiang , Shi Yin , Zhang Guilong , Fan Xiaohong
Published: February 2020

Introduction: It is well known that the main segments of spinal fracture is thoracolumbar (T11-L11). Therefore, in addition to the lumbar, the lower thoracic vertebra (T9-T12) often has the clinical needs of implantation of cortical bone trajectory (CBT) screws. However, the anatomic parameters of the lower thoracic vertebrae are quite different from those of the lumbar vertebrae, which means that if CBT screws are to be implanted in the lower thoracic vertebrae, the selection of the screw entry point, the length, diameter, angle and path of the screws in each segment need to be redefined. Methods In this part, 3-dimensional finite element model was established to analyze the stress and fixation efficiency of CBT screws in thoracic vertebrae after 5000 times of fatigue loading of normal model and osteoporosis model. Discussion If the outcomes indicate the trial is feasible and there is evidence to provide some basic anatomical parameters for CBT screw implantation in the lower thoracic spine, so that the ideal insertion point, length, diameter, and angle of CBT screw in different segments of the lower thoracic spine were determined.

Trial Registration Chinese Clinical Trial Registry, ChiCTR1900026915.Registered on September 26, 2019.
Subtotal colectomy with antiperistaltic cecosigmoidal anastomosis may be another suitable option for slow transit constipation
Authors: Yang Yong-Ping , Shi Jian , Zhao Ze-Yun , Yu Ling-Yun , Liu Tong-Jun
Published: February 2020

The objective of this paper is to demonstrate, considering the experiences from Chinese people, if slow transit constipation (STC) can be accurately diagnosed, choosing patients qualifying for surgery, subtotal colectomy with antiperistaltic cecosigmoidal anastomosis (STC-Anti-CSA) may come with more acceptable short and long-term outcomes.

A retrospective study was performed at a department of colorectal and anal surgery. A cohort of 29 patients were coming with up to 5 years’ follow-up care, who were in a diverse range of age, BMI, laxative medicine histories, including both males and females. Pre-surgery work-up strictly followed a protocol designed to rule out the patients who were not suitable for surgery treatments. Classification of STC was followed after diagnosis. STC-Anti-CSA was performed in all cases. The operative time, blood loss, average post-operative length of stay (LOS), frequency of BMs, stool consistency and patients satisfaction, by using Wexner constipation score (WCS), numerical rating scale (NRS), and abdominal bloating score (ABS), over the study period were recorded.

In this study, there were 14 males and 15 females, with mean age 51, and BMI from 20.14 to 31.62 kg/m2. The period of laxative medicine history was 4.8 years (2–13 years). The mean operative time was 152 ± 34 min, and the mean perioperative blood loss was 123 ± 51 mL. Average post-operative LOS (LOS) was 8 days. There were no severe post-operative complications, peri-operative mortality, anastomotic leaks, or revisions of the original surgery. Initial post-operative BMs averaged 6 times/day. During the period of 1 month to 12 months follow-up care, BMs fell down to 2 or 3 times/day. By the 1st to 3rd year follow-up care, BMs averaged 5 to 7 times/week. However, from the 4th year to 5th year, constipations recurred somehow. However, most patients were satisfied with their bowel patterns.

STC-Anti-CSA can receive acceptable postoperative outcomes as long as the patients can be accurately diagnosed and classified as severe STC. Among the surgical procedures for STC, this procedure may be another suitable option, especially for Chinese people.
Prevalence of and associations between metabolic syndrome and the constitutions defined by Korean Eight Constitution Medicine
Authors: Kim Hee-Ju , Jang Bo-Hyoung , Kim Myoung Jin , Kim Kyong-Chol , Kuon Woo-Jun , Kim Chang-Keun
Published: February 2020

Eight Constitution Medicine (ECM) is a Korean constitutional medicine system that classifies people into 8 types: Pulmotonia (PUL), Colonotonia (COL), Renotonia (REN), Vesicotonia (VES), Pancreotonia (PAN), Gastrotonia (GAS), Hepatonia (HEP), and Cholecystonia (CHO). Metabolic syndrome (MS) is a major public health problem worldwide. We assessed the prevalence of and associations between ECM and MS. Cross-sectional convenience sample of 245 adults was used at a medical check-up center in Seoul, South Korea, from 2010 to 2015. Adults were classified into 1 of 8 constitutions by an ECM specialist. MS was diagnosed on the basis of National Cholesterol Education Program Adult Treatment Panel III and Asian Pacific Criteria for abdominal obesity. We also computed the prevalence by percentage and calculated odds ratios (ORs) for MS among 6 constitutions with PUL as the reference.

Among 245 adults, 20 (8.2%) were diagnosed with PUL, 43 (17.6%) with COL, 35(14.3%) with REN, 4 (1.6%) with VES, 71 (29.0%) with PAN, 0 (0.0%) with GAS, 54 (22.0%) with HEP, and 18 (7.3%) with CHO. The prevalence of MS in the constitutions was significantly different: CHO, 38.9%; HEP, 35.2%; PAN, 18.3%; COL, 11.6%; PUL, 5.0%; REN, 2.9% (P = .001). We observed higher ORs for HEP and CHO (OR = 13.03, 95% confidence interval [CI] = 1.61–105.70; and OR = 13.19, 95% CI = 1.39–125.46, respectively) than for the other constitutions.

People with HEP and CHO constitutions could be at higher risk for MS. Therefore, ECM-based diagnosis may be useful for preventing and managing MS.
A rare case report of bilateral recurrent inguinal hernia due to persistent Müllerian duct syndrome treated by transabdominal preperitoneal repair
Authors: Tanabe Kan , Mori Shinichiro , Kita Yoshiaki , Wada Masumi , Kenji Baba , Itaru Omoto , Takaaki Arigami , Satoshi Iino , Kosei Maemura , Natsugoe Shoji
Published: February 2020

Introduction:

Persistent Müllerian duct syndrome (PMDS) is a rare disease occurring in men with an otherwise completely normal phenotype, in which female internal sex organs are present, including a uterus, fallopian tubes, cervix, and vagina. We report a case of bilateral recurrent inguinal hernia due to PMDS treated by transabdominal preperitoneal repair (TAPP).

Patient concerns:

A 72-year-old male presented with a complaint of swelling on both sides of the groin. The patient had undergone bilateral inguinal hernia suture repair 50 years ago.

Diagnosis:

Bilateral recurrent inguinal hernia

Interventions:

TAPP was performed. There was a fibrous structure linking the left and right hernia orifice and a muscular structure in the hernia sac on the left. We noticed that the muscular structure was a vagina and fibrous structure was the salpinx, and we diagnosed the patient with PMDS. Supravaginal hysterectomy and right salpingectomy were performed. After that a preperitoneal mesh repair was performed for bilateral inguinal hernia.

Outcomes:

Histologically, the diagnosis was confirmed as PMDS. The patient had an uneventful recovery.

Conclusion:

This case is the first case of bilateral recurrent inguinal hernia due to PMDS managed by TAPP.
Effectiveness, immunogenicity, and safety of influenza vaccines with MF59 adjuvant in healthy people of different age groups
Authors: Yang Jing , Zhang Jiayou , Han Tian , Liu Chen , Li Xinghang , Yan Luyao , Yang Baifeng , Yang Xiaoming
Published: February 2020

Background:

Influenza is a severe disease burden among all age groups. This study aimed to review the efficacy of inactivated influenza vaccines with MF59 adjuvant and non-adjuvanted inactivated influenza vaccines among all age groups against specific influenza vaccine strains.

Methods:

Literature search of PubMed, Embase, Medline, OVID, and Cochrane Library Trials (CENTRAL) was implemented up to March 1, 2019. Homogeneity qualified studies were included for

Data were extracted such as study country location, demographic characteristics, and measure outcomes, and were analyzed by a random effect model and sensitivity analyses to identify heterogeneity. Risk of bias was evaluated using the Cochrane Risk of Bias Tool.

Results:

We retrieved 1,021 publications and selected 31 studies for full review, including 17 trials for meta-analysis and 6 trials for qualitative synthesis. MF59-adjuvanted influenza vaccines demonstrated better immunogenicity against specific vaccine virus strains compared to non-adjuvanted influenza vaccine both in healthy adult group (RR = 2.10; 95% CI: 1.28–3.44) and the healthy aged (RR = 1.26; 95% CI: 1.10–1.44).

Conclusion:

The quality of evidence is moderate to high for seroconversion and seroprotection rates of influenza vaccine. MF59-adjuvanted influenza vaccines are superior to non-adjuvanted influenza vaccines to enhance immune responses of vaccination in healthy adults and older adults, and could be considered for routine use especially the monovalent prepandemic influenza vaccines.
Efficacy of prebiotics and probiotics for functional dyspepsia
Authors: Zhang Jiaqi , Wu Hao Meng , Wang Xue , Xie Jingyi , Li Xia , Ma Jinxin , Wang Fengyun , Tang Xudong
Published: February 2020

Background:

Functional dyspepsia (FD) is a functional gastrointestinal disorder. Evidence suggests that disturbance of the gastrointestinal microbiota may be implicated in FD. We performed a systematic review and meta-analysis to examine the efficacy of prebiotics and probiotics for FD.

Methods:

MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched (through September 2018). Randomized controlled trials (RCTs) that recruited adults with FD and that compared prebiotics, probiotics, or synbiotics with placebo or no therapy were eligible. Eligibility assessment and data extraction were performed by two independent researchers. Dichotomous symptom data were pooled to obtain a relative risk (RR) with a 95% confidence interval (CI) of remaining symptomatic after therapy. Continuous data were pooled using a standardized or weighted mean difference with a 95% CI.

Results:

The search strategy identified 1062 citations. Five RCTs were eligible for inclusion. The RR of FD symptoms improving with probiotics or probiotics vs placebo was 1.15 (95% CI 1.01–1.30). Probiotics and prebiotics had beneficial effects on symptom scores of FD. Data for synbiotics in the context of FD were sparse, and no definite conclusions could be drawn.

Ethics and dissemination:

This study belongs to the category of systematic reviews, not clinical trials. Therefore, it does not require ethical approval. The results of this study will be published in influential international academic journals related to this topic.

Conclusion:

Probiotics and prebiotics seemed to be effective treatments for FD, although the individual species and strains that are the most beneficial remain unclear. Using only probiotics failed to improve the symptoms of FD. Further evidence is required before the role of probiotics, prebiotics, and synbiotics in FD can be fully understood.
Acupuncture therapy for postoperative pain of anorectal diseases
Authors: Zhao Ying , Zhang Leixiao , Wang Yanan , Liao Chenxi , Chen Ying , Zhen Qianhua , Li Ying
Published: February 2020

Background:

The incidence of anorectal diseases has been increasing year by year, and the acupuncture treatment for postoperative pain of anorectal diseases has the excellent therapeutic effect. Currently, there are no relevant articles for systematic review.

Methods:

We will search the randomized controlled trials related to acupuncture therapy and postoperative anorectal diseases from inception to January 2020. The following database is our focus area: PubMed, EMBASE, Springer, EBSCO, Web of Science, Cochrane, Controlled Trials Register (CENTRAL), the Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wan-Fang Database and Chinese Scientific Journal Database (VIP database). The primary outcome is the pain of visual analogue scale (VAS). The secondary outcomes are the Symptom Checklist, Wong-Baker Faces Pain Rating (WB) Scale, verbalrating scale (VRS), and 36-Item Short Form Health Survey (SF-36) scale. We will use Review Manager Software (RevMan) V.5.2 for data analysis and quantitative data synthesis. The Cochrane collaborative tool will be used to assess the risk of bias in the included studies.

Results:

Given the available evidence, this study will provide high level results for acupuncture therapy in treating postoperative pain of anorectal diseases.

Conclusion:

The conclusions of this study will provide evidence for whether acupuncture is effective in treating postoperative pain of anorectal diseases.

PROSPERO registration number:

CRD42020150015.
Patient-reported vision-related quality of life after laser in situ keratomileusis, surface ablation, and phakic intraocular lens
Authors: Hieda Osamu , Nakamura Yo , Wakimasu Koichi , Yamamura Kiyoshi , Suzukamo Yoshimi , Kinoshita Shigeru , Sotozono Chie
Published: February 2020

To evaluate the long-term efficacy of refractive surgery of all cases in a single center via the use of a patient-reported outcome (PRO) refractive status questionnaire using descriptive statistics. This study was prospective, single-center, cohort study that involved 1422 patients who underwent refractive surgery (laser in situ keratomileusis, surface ablation, and phakic intraocular lens) at Baptist Eye Institute, Kyoto, Japan. The patients were asked to answer the Refractive Status and Vision Profile (RSVP) questionnaire before the surgery after 6 months (n = 1133 patients) and after 5.5 years (n = 232 patients). During the same period, examination by slit-lamp biomicroscopy and visual acuity tests were performed. Moreover, the patients were asked to rate their satisfaction with the surgery 6 months and 5.5 years after it. We examined overall RSVP scale (S), 8 RSVP subscales, rate of satisfaction with surgical outcome, slit-lamp biomicroscopy findings, and refractive error. The mean preoperative S was 36, yet that score significantly improved to 19 at 6 postoperative months postoperatively (P < .01), and basically remained the same (i.e., 20) throughout the 5.5-year postoperative period. During the 5-year follow-up period, mean refractive error became slightly myopic (0.3 D). No change in the rate of satisfaction was observed at both 6 months and 5.5 years postoperative period. The findings of this study help to clarify long-term PRO quality of vision (QOV) postrefractive surgery in a single center, and show that minor change in refractive error during 5 years postoperative period had no influence on the mean RSVP scores among outpatients. Nearly all patients reported short-term improvement of QOV, which continued throughout the long-term follow-up period.
The diagnostic accuracy of artificial intelligence in thoracic diseases
Authors: Yang Yi , Jin Gang , Pang Yao , Wang Wenhao , Zhang Hongyi , Tuo Guangxin , Wu Peng , Wang Zequan , Zhu Zijiang
Published: February 2020

Introduction:

Thoracic diseases include a variety of common human primary malignant tumors, among which lung cancer and esophageal cancer are among the top 10 in cancer incidence and mortality. Early diagnosis is an important part of cancer treatment, so artificial intelligence (AI) systems have been developed for the accurate and automated detection and diagnosis of thoracic tumors. However, the complicated AI structure and image processing made the diagnosis result of AI-based system unstable. The purpose of this study is to systematically review published evidence to explore the accuracy of AI systems in diagnosing thoracic cancers.

Methods and analysis:

We will conduct a systematic review and meta-analysis of the diagnostic accuracy of AI systems for the prediction of thoracic diseases. The primary objective is to assess the diagnostic accuracy of thoracic cancers, including assessing potential biases and calculating combined estimates of sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). The secondary objective is to evaluate the factors associated with different models, classifiers, and radiomics information. We will search databases such as PubMed/MEDLINE, Embase (via OVID), and the Cochrane Library. Two reviewers will independently screen titles and abstracts, perform full article reviews and extract study data. We will report study characteristics and assess methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. RevMan 5.3 and Meta-disc 1.4 software will be used for data synthesis. If pooling is appropriate, we will produce summary receiver operating characteristic (SROC) curves, summary operating points (pooled sensitivity and specificity), and 95% confidence intervals around the summary operating points. Methodological subgroup and sensitivity analyses will be performed to explore heterogeneity.

PROSPERO registration number:

CRD42019135247
Comparison of sugammadex and pyridostigmine bromide for reversal of rocuronium-induced neuromuscular blockade in short-term pediatric surgery
Authors: An Jihyun , Lee Ji-Hyang , Kim Eunju , Woo Kyeongyoon , Kim Hyunkyum , Lee Donghwan
Published: February 2020

Background:

Sugammadex reverses rocuronium-induced neuromuscular blockade quickly and effectively. This study compared efficacy of sugammadex and pyridostigmine for reversal of rocuronium-induced light block or minimal block in children scheduled for elective entropion surgery.

Methods:

A prospective randomized study was conducted on 60 pediatric patients aged 1 to 11 years and scheduled for entropion surgery under sevoflurane anesthesia. Neuromuscular blockade was achieved by administration of 0.6 mg/kg rocuronium and assessed using train-of-four (TOF) ulnar nerve stimulation. Patients were randomly assigned to 2 groups receiving sugammadex 2 mg/kg or pyridostigmine 0.2 mg/kg plus glycopyrrolate 0.01 mg/kg. Primary outcomes were time from reversal agents administration to TOF ratio 0.9 and time from reversal agent administration to TOF ratio 1.0. Time from TOF ratio 0.9 to extubation, time from TOF ratio 1.0 to extubation, and postoperative adverse events were also recorded.

Results:

There were no substantial differences in demographic variables. Time from reversal agents administration to TOF ratio 0.9 and time from reversal agents to TOF ratio 1.0 were significantly faster in sugammadex group: 1.30 ± 0.84 versus 3.53 ± 2.73 minutes (P < .001) and 2.75 ± 1.00 versus 5.73 ± 2.83 minutes (P < .001). Extubation time was shorter in sugammadex group. Incidence of skin rash, nausea, vomiting, and postoperative residual neuromuscular blockade (airway obstruction) was not statistically different between groups. Incidence of patients agitation in recovery room was lower in sugammadex group.

Conclusion:

Sugammadex provided more rapid reversal of rocuronium-induced neuromuscular blockade in pediatric patients undergoing surgery lasting 30 to 60 minutes than did pyridostigmine plus glycopyrrolate, with no differences in incidence of adverse events between groups.
Comparative risk of Selective Serotonin Reuptake Inhibitors (SSRIs)-induced nausea among Chinese senile depression patients
Authors: Guo Shengyu , Yang Yan , Pei Xi jun , Liu Fei yue
Published: February 2020

Objectives:

To compare the therapeutic effect of 6 SSRIs among the Chinese senile depression patients. And drug-induced nausea leads to low compliance in elderly depression patients in China, it is urgent to assess the safety of 6 SSRIs with respect to induced-nausea among the Chinese senile depression patients.

Method:

In the present study, a network of meta-analysis was conducted to assess the efficacy of 6 SSRIs among the Chinese senile depression patients, in addition, the safety of 6 SSRIs with respect to induced-nausea among the Chinese senile depression patients was also evaluated. PubMed, Embase databases, WanFang, CNKI, ChongqingWeiPu were searched for the related articles. The primary outcome of this study were the number of effective cases of SSRIs and the number of cases of nausea caused by SSRIs in Chinese elderly depressed patients. Odds ratios (ORs) and corresponding 95% confidence intervals(95%CIs) were calculated within pairwise and network meta-analysis.

Results:

Twenty eight trials were identified, including 2246 patients, the network meta-analysis indicated that Escitalopram was associated with a lower risk of nausea compared Paroxetine (odds ratios 0.49, 95%CI = 0.34–0.69) when they were used in Chinese elderly depressed patients. Escitalopram also exhibited distinct advantages compared other SSRIs.

In terms of drug efficacy, Escitalopram was significantly superior to Paroxetine (OR = 2.26, 95%CI = 1.55–3.37).

Conclusion:

The rank of SSRIs with respect to induced-nausea was: Combination of EP > Fluoxetine > Paroxetine > Citalopram > Sertraline > Fluvoxamine > Escitalopram, respectively.
A possible prediction of dystocia at the time of cesarean delivery
Authors: You Tian , Yang Bei , Zhang Xin-tao , Ren Shi-you , Bai Lu , Jiao Fu-jia , Jiang Xiao-cheng , Guan Si-yao , Zhang Wen-tao
Published: February 2020

The study assessed the pelvic dimensions by computed tomography (CT) performed for gluteal muscle contracture women, and evaluated the impact of malformations on several essential obstetric parameters.

The CT pelvimetry was retrospectively performed in 25 gluteal muscle contracture women selected consecutively whether they had delivery history or not. Among the pelvic inlet plane, the mid plane and the outlet plane, 12 indicators including the transverse diameter of the pelvic inlet, the conjugate vera, the diagonal conjugate, the biischial diameter, the anteroposterior diameter of the middle pelvis, transverse outlet, the posterior sagittal diameter of outlet, the conjugate of the outlet, the anterior sagittal diameter of the outlet, the curvature and length of the sacrum, the angle of pubic arch were collected.

Finally, the mean age of these women was 26.6 ± 5.0 years. Most pelvises had anteroposterior elliptical appearance in inlet and size of the female pelvis. The most statistically different and most clinically significant indicator was the biischial diameter, gluteal muscle contracture women were 95.6 ± 9.3 mm and the normal women from other study were 105.0 ± 7.9 mm, the comparison showed a significant difference (P < .001).

Generally, most gluteal muscle contracture women had features of anthropoid pelvis which were quite different from normal Chinese female. These results may serve as a basis for future studies to assess its utility and prognostic value for a safe vaginal delivery in gluteal muscle contracture women.
Diabetes pay-for-performance program can reduce all-cause mortality in patients with newly diagnosed type 2 diabetes mellitus
Authors: Kung Fang-Ping , Tsai Ching-Fang , Lu Chin-Li , Huang Li-Chung , Lu Chieh-Hsiang
Published: February 2020

This study aimed to examine the effect of a diabetes pay-for-performance (P4P) program on all-cause mortality in patients with newly diagnosed type 2 diabetes mellitus. Using a Taiwanese representative nationwide cohort, we recruited 5478 patients with newly diagnosed type 2 diabetes enrolled in the P4P program within 5 years after a diagnosis of diabetes between January 1, 2002 and December 31, 2010 and individuals not enrolled in the P4P program were recruited as the control group matched 1:1 with the study group. We used multivariate Cox proportional hazard models analysis to investigate the effect of the P4P program and adherence on all-cause mortality. A total of 250 patients died in the P4P group compared to 395 in the control group (mortality rate 104 vs 169 per 10,000 person-years, respectively, P < .0001). The control group also had more comorbidities. Patients enrolled in the P4P program demonstrated significant long-term survival benefits, of which the adjusted hazard ratio (aHR) for all-cause mortality was 0.58 [95% CI (0.48–0.69)]. In the study group, better adherence to the P4P program resulted in a greater reduction in mortality, with aHRs [95% CI] of 0.48 [0.38–0.62] and 0.36 [0.26–0.49] in subjects with a minimum 1-year and 2-year good P4P adherence, respectively. Participating in the P4P program within 5 years after the diagnosis of diabetes resulted in a significant reduction in all-cause mortality, and this effect was particularly pronounced in the patients with better adherence to the P4P program.
The awareness rate of mental health knowledge Among Chinese adolescent
Authors: Guo Shengyu , Yang Yan , Liu Feiyue , Li Fuying
Published: February 2020

Background:

Mental health knowledge is an important part of mental health literacy, which is related to one's attitude and coping style when facing mental illness. The awareness rate of mental health knowledge among adolescents is an effective index to evaluate the effect of school mental health education, and the awareness rate of mental health knowledge among Chinese adolescents has not been effectively evaluated.

Methods:

Two electronic databases for English language and 3 electronic databases for Chinese language were searched for relevant studies. Meta-analysis was conducted to analyze the awareness rate among Chinese adolescents. The normal distribution test was conducted using 5 methods. Homogeneity test was conducted, and I
2 > 50% indicates existence of heterogeneity and in this case, the random model was adopted; otherwise, we adopt the fixed model. Funnel plot and Egger test was used to confirm whether publication bias existed.

Results:

Seventeen studies were included in this study, comprising 22,164 students from different stages of education (10,437 senior middle-school students, 5589 junior middle-school students, and 6138 college students). The awareness rate of mental health knowledge among Chinese adolescents was only 66%; for university students and middle-school students, their awareness rate was 73% and 61%, respectively. The awareness rate among senior middle-school students was as low as that of junior middle-school students. The awareness rate among college students in developed regions was higher than that in developing regions.

Conclusions:

The awareness rate of mental health knowledge among Chinese adolescents was lower than the goal set in the national mental health work plan. There are gaps in mental health education in different developed areas. The mental health education among adolescent in Chinese mainland needs to be further strengthened.
Impact of 68Ga-DOTATOC PET/CT in comparison to 111In-Octreotide SPECT/CT in management of neuro-endocrine tumors
Authors: Tolomeo Anna , Lopopolo Gaetano , Dimiccoli Vincenzo , Perioli Luana , Modoni Sergio , Scilimati Antonio
Published: February 2020

Rationale:

In the diagnostics of neuroendocrine tumors (NETs), scintigraphy and Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) with 111Indium-Octreotide occupy a prominent place.

The introduction in clinical practice of 68Gallium-labelled somatostatin analogues (DOTA-TOC, DOTA-TATE, DOTA-NOC) for Positron Emission Tomography/Computed Tomography (PET/CT), significantly improved NETs diagnostics due to greater sensitivity and improved lesion detection in addition to better patient convenience and decreased radiation dose.

Patient concerns:

We report a case of a patient who was diagnosed with a neuroendocrine tumor of the ileocecal valve.

Diagnoses:

Diagnosis was made by ultrasonography, CT, and colonoscopy. Hystology after surgery was G2 NET of ileo-cecal valve. Restaging was carried out by 111In-Octreotide SPECT/CT and, 1 month later, by 68Ga-DOTATOC PET/CT. 18F-FDG PET/C was also carried out.

Interventions:

68Ga-DOTATOC PET/CT showed larger disease that modified disease management from surgery to medical treatment.

Outcomes:

After an initial improvement in the patient clinical condition, the tumor caused a worsening with the appearance of ascites.

Lessons:

68Ga-DOTA-conjugate PET/CT is appropriate in low and intermediate NET (Ki67 index respectively ≤3% and 3%–20%) characterized by better survival and better response after Peptide Receptor Radionuclide Therapy.

18F-FDG is mostly useful in high grade (G3) of disease, so that 68Ga-DOTA-conjugate SUV and 18F-FDG SUV have an opposite trend in relation to the tumor grade. 68Ga-DOTATOC PET/CT changes, as in our case, therapeutic management in about 40% of cases.
Primary retroperitoneal germ cell tumor in an adult female
Authors: Lou Qitian , Wang Weigen , Liang Wenjie
Published: February 2020

Rationale:

Primary retroperitoneal germ cell tumors are uncommon and especially rare in female patients. However, this type should be included in the differential diagnosis of retroperitoneal tumors that may metastasize from the gonads and be a primary tumor.

Patient concerns:

An abdominal mass was detected in a 38-year-old woman during physical examination, which was accompanied by left renal obstructive hydrops. She was admitted to our institution for further investigation. The patient had no obvious clinical symptoms, and the levels of serum tumor markers did not signifificantly increase. Abdominal noncontrast enhanced and contrast-enhanced computed tomography revealed a retroperitoneal neoplasm that invaded the left ureter, thereby causing left hydronephrosis.

Diagnoses:

Imaging examination characterized the tumor as malignant based on its invasion in the left ureter. Histopathology and immunohistochemistry confifirmed the resected tumor as a dysgerminoma. The primary gonad-derived germ cell tumor was not found in the pelvis; therefore, the patient was fifinally diagnosed with primary retroperitoneal germ cell tumor.

Interventions:

Preoperative examination was completed, and the retroperitoneal mass was resected.

Outcomes:

During the short-term follow-up, no tumor recurrence was detected.

Lessons:

Primary retroperitoneal seminoma should be included in the differential diagnosis of primary retroperitoneal tumors in female patients. The primary retroperitoneal seminoma/anaplastic tumor has an obvious occupying effect and can easily invade the surrounding structures. However, surgical resection of such tumors is an optional treatment strategy.