bluuebunny/crossref_metadata_2025 huggingface dataset:
T-regulatory cell/T helper 17 cell imbalance functions as prognostic biomarker of oral squamous cell carcinoma – CONSORT
Authors: Wang Lin , Zhang Yingjie , Xie Fuqiang
Published: December 2020

Background:

The role of T cells in the pathogenesis of oral squamous cell carcinoma (OSCC) was clarified by examining the levels of differentiated CD4+CD25+FOXP3+ T-regulatory cells (Treg cells) and CD4+IL17+ T helper 17 (Th17) cells in OSCC patients.

Methods:

Flow cytometry was conducted to measure the proportions of Treg/Th17 cells in different sample groups to identify a proper maker indicative of the progression and prognosis of OSCC.

Results:

The results showed that a higher Treg/Th17 ratio led to poorer prognosis. Also, the proportions of both Treg cells and Th17 cells were significantly elevated in OSCC patients compared with those in the control groups, suggesting a correlation between Treg/Th17 imbalance and the prognosis of OSCC. Furthermore, the ratios of Treg/Th17 cells in OSCC patients differed at different time points of cancer progression. For example, stage III-IV patients showed the most evident increase in the Treg/Th17 ratio, while the Treg/Th17 ratio in control subjects was the lowest.

Conclusions:

Therefore, a higher ratio of Treg/Th17 indicated the progression of OSCC and a larger tumor size. Therefore, Treg and Th17 imbalance was implicated in OSCC progression.
Long term complications and prognostic factors in locally advanced nasopharyngeal carcinoma treated with docetaxel, cisplatin, 5-fluorouracil induction chemotherapy followed by concurrent chemoradiotherapy
Authors: Shim Hyun Jeong , Kim Hyeon Jong , Hwang Jun Eul , Bae Woo Kyun , Chung Ik Joo , Lee Dong Hoon , Mi Yoon Tae , Lee Joon Kyoo , Lim Sang Chul , Chung Jae Wook , Cho Sang Hee
Published: December 2020

This study was conducted to evaluate the long term complications and their risk factors including of survival outcomes in patients with locally advanced nasopharyngeal cancer (NPC) treated with docetaxel, cisplatin and 5-fluorouracil (TPF) induction chemotherapy followed by concurrent chemoradiotherapy (CCRT).

Among the patients who were diagnosed as NPC, we consecutively evaluated the late complications in 104 patients who completed 3 cycles of TPF induction chemotherapy followed by CCRT and received regular follow-up by otolaryngologist and oncologist. The prognostic factors for overall survival, relapse free survival and each complication were analyzed based on clinical characteristics.

Over a median follow-up of 54 months (range, 7.9–152.9 months), 5-year overall survival rate was 87% for stage II, 89% for stage III, 87% for stage IV patients. The significant prognostic factor for survival is complete response rate after CCRT in multivariate analysis. The most frequent toxicity was ear complication (29.8%) including of hearing loss requiring hearing aid (6.7%) and bone necrosis (3.8%). Decreased renal function over grade 2 was occurred in only 4 patients (3.8%) regardless of the cumulative dose of cisplatin. The long term complications did not affect the survival outcome. Patients who received radiation therapy more than 5400 cGy had better survival outcome than those who did not. However, ear complication was significantly related to radiation dose (≥ 6,600 cGy) and type of radiation therapy (conventional). Age over 65 years was a significant risk factor for both ear and renal toxicity. In conclusion, close follow-up to monitor long-term complications should be performed in patients treated with TPF induction chemotherapy followed by CCRT treatment, especially in elderly patients. Reestablishing the optimal chemotherapeutic agent during CCRT and adjustment of radiation dose after induction chemotherapy could be helpful to reduce the toxicity associated with the subsequent treatment strategy for locally advance NPC patients.
The association of CDKN2BAS gene polymorphisms and intracranial aneurysm
Authors: Yu Ting , Jiang Hailong , Fan Yunren , Xu Yunfeng , Wang Ning
Published: December 2020

Intracranial aneurysm (IA) is one of the main causes of subarachnoid hemorrhage (SAH) leading to a high percentage of disability and mortality worldwide. In addition to environmental factors, the risk of rupture or prognosis of intracranial aneurysm is also closely related to gene. Thus, a lot of genetic studies have been used to explore associated risk genes as well as variant loci of intracranial aneurysm and found several chromosome variates including 9p21.3 (CDKN2BAS) related to Intracranial aneurysm. However, due to differences in population and the existence of SNP, it is still not determined that whether these genetic changes can be identified as independent risk factors for intracranial aneurysm. Therefore, we performed a meta-analysis of CDKN2BAS SNPs to explore its association with intracranial aneurysms and the results show a significance relation between rs10757272, rs1333040, and rs6475606 with intracranial aneurysm. This will open a new perspective for future intracranial aneurysm gene research and therapy.
Clinical efficacy of phacoemulsification combined intraocular lens implantation for treatment of high myopia with cataract
Authors: Gao Lu , Li Mei
Published: December 2020

Background:

The purpose of this study is to assess the clinical efficacy of phacoemulsification combined intraocular lens implantation (PILI) for the treatment of high myopia with cataract (HMC).

Methods:

In this study, the electronic databases (PUBMED, EMBASE, Cochrane Library, Scopus, AMED, CINAHL, PsychINFO, CBM, and China National Knowledge Infrastructure) will be searched from inception to present. All randomized controlled trials on assessing the PILI for patients with HMC will be included. Two authors will carry out study selection, information extraction, and study quality assessment, respectively. We will invite another author to solve any disagreement through discussion. RevMan 5.3 software will be performed for data synthesis and analysis.

Results:

This study will present a detailed synthesis and/or descriptive analysis of the most recent evidence to evaluate the efficacy of PILI for HMC.

Conclusion:

The results of this study may provide possible guidance to determine whether or not PILI is effective on HMC.
Effect of Yiqihuoxue Formula for the treatment of ischemic stroke
Authors: Ren Dong-Feng , Wang Ting , Sun Guo-Fang , Jiang Chao
Published: December 2020

This retrospective study assessed the feasible effect of Yiqihuoxue Formula (YQHXF) for the treatment of patients with ischemic stroke (IS).

A total of 66 patients with IS were included in this retrospective study. All patients received routine treatment, and were divided into two groups: a treatment group (n = 33) and a control group (n = 33). In addition to the routine treatment, all patients in the treatment group also underwent YQHXF treatment. All patients in both groups were treated for a total of 8 weeks. The outcomes were assessed by National Institute of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), Barthel index scale (BIS), stroke-specific quality of life (SS-QOL) scale, and adverse events. All outcomes were measured before and after the treatment.

After treatment, patients in the treatment group showed better improvements in NIHSS scale (P = .01), mRS (P < .01), BIS (P = .04), and SS-QOL scale (P = .04), than patients in the control group. No treatment-associated adverse events were recorded in this study.

The results of this study indicated that YQHXF may benefit for patients with IS.
Evaluation of the association between vitamin D and lung cancer skin metastasis
Authors: Zhao Dan , Wang Tao , Li Yu-feng , Huang Jian-wei
Published: December 2020

Background:

This study aims to investigate the association between vitamin D (VD) and lung cancer skin metastasis (LCSM).

Methods:

The following databases will be retrieved from the beginning to the present of each database without language limitation: PUBMED, EMBASE, Cochrane Library, Web of Science, CBM, and CNKI. The reference lists of included trials and other sources will also be checked. Two researchers will independently undertake literature selection, data collection, and study quality evaluation. We will utilize a fixed or random-effect model to pool the data according to the heterogeneity test. The RevMan 5.3 software will be used to analyze the data and perform meta-analysis.

Results:

This study will summarize high quality study to explore the association between VD and LCSM.

Conclusion:

The findings of this study will help to judge whether there is association between VD and LCSM.

Ethics and dissemination:

No research ethical approval is required in this study, because it will only analyze published data. It is expected to disseminate through a peer-reviewed journal.

Study registration:

osf.io/ph2au.
Proton pump inhibitors for the treatment of laryngopharyngeal reflux disease
Authors: Liu Xiangyi , Jiang Ying , Luo Haiyan , Liu Haolin
Published: December 2020

Background:

Laryngopharyngeal Reflux disease refers to abnormal reflux of gastric contents through the esophagus into the throat, which irritates and damages the pharyngeal mucosa, and causes corresponding symptoms. Proton Pump Inhibitors are an important class of gastric acid secretion inhibitors after H2 receptor blockers, which can be used clinically to treat peptic ulcer, abnormal gastric acid secretion and other related diseases. The common clinical drugs include omeprazole, lansoprazole, rabeprazole and so on. Clinical practice has shown that Proton Pump Inhibitors have a good therapeutic effect on Laryngopharyngeal Reflux disease, but evidence of evidence-based medicine is lacking. The purpose of this protocol is to systematically evaluate the efficacy and safety of Proton Pump Inhibitors in the treatment of Laryngopharyngeal Reflux disease and to improve the evidence-based basis for the clinical application of Proton Pump Inhibitors in the treatment of Laryngopharyngeal Reflux disease.

Methods:

English computer retrieval database (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese computer retrieval database (Wanfang Database, VIP Information Chinese Journal Service Platform, Chinese Biomedical Database) . In addition, Baidu Scholar and Google Scholar were manually searched for randomized controlled clinical studies on the treatment of laryngeal reflux disease with Proton Pump Inhibitors from the establishment of the database to July 2020. Two researchers independently extracted and evaluated the data of the included studies, and meta-analysis was conducted on the included literatures with RevMan5.3 software without language restrictions.

Results:

In this study, the efficacy and safety of Proton Pump Inhibitors in the treatment of Laryngopharyngeal Reflux disease are evaluated by the overall response rate, clinical symptom remission rate and other indicators.

Conclusions:

This study will provide reliable evidence-based evidence for the clinical application of Proton Pump Inhibitors in the treatment of Laryngopharyngeal Reflux disease.

OSF Registration number: DOI 10.17605 / OSF.IO / NY6SC
Excessive splenic volume is an unfavorable prognostic factor in patients with non-small cell lung cancer treated with chemoradiotherapy
Authors: Guo Jianping , Wang Lei , Wang Xiaoyan , Li Luo , Lü Yajuan , Wang Congcong , Hao Chong , Zhang Jiandong
Published: December 2020

The relationship between splenic volume and the outcome of chemoradiotherapy for lung cancer has rarely been studied or addressed. The purpose of our study was to investigate whether splenic volume was associated with prognosis in patients treated with chemoradiotherapy for advanced or locally advanced non-small cell lung cancer (NSCLC).

A retrospective investigation was conducted. Finally, 202 patients met the criteria and were included in the study. All patients were divided into 2 groups according to the optimum cutoff value of splenic volume for overall survival (OS). The optimum cutoff value was identified by X-tile software, and the OS and disease-free survival (DFS) were compared between the 2 groups of patients. The impact of splenic volume and other clinical characteristics on OS and DFS was analyzed using the Kaplan–Meier method and Cox proportional hazards model. Clinical characteristics were compared using chi-square or Fisher exact tests.

The median (range) of splenic volume was 156.03 (28.55–828.11) cm3. The optimal cutoff value of splenic volume was 288.4 cm3. For univariate analyses, high splenic volume was associated with decreased OS (P = .025) and DFS (P = .044). In multivariate analyses, splenic volume remained an independent predictor of OS as a binary dependent variable (P = .003).

Excessive splenic volume was associated with decreased OS and DFS in patients with NSCLC treated with chemoradiotherapy. Splenic volume should be regarded as an independent prognostic factor for patients treated with chemoradiotherapy for advanced or locally advanced NSCLC.
Efficacy and safety of intra-articular injection of mesenchymal stem cells in the treatment of knee osteoarthritis
Authors: Ma Wei , Liu Cuimiao , Wang Shilu , Xu Honghao , Sun Haichao , Fan Xiao
Published: December 2020

Objective:

To evaluate the effects and safety of intra-articular injection of mesenchymal stem cells on patients with knee osteoarthritis by a systematic review and meta-analysis.

Methods:

PubMed, EMBASE, and Cochrane Library were retrieved. An assessment of the risk of bias was done through the Cochrane Collaborative Bias Risk Tool, publication bias was assessed by plotting funnel plots and Egger tests. Pain and functional improvements in patients with knee osteoarthritis were determined by changes in VAS scores and WOMAC scores at baseline and follow-up endpoints. For the evaluation of MRI, the WORMS score and changes in cartilage volume were used. In addition, the number of adverse events in the intervention group and the control group were counted to explore the safety.

Results:

A total of 10 randomized controlled trials involving 335 patients were included. In the pooled analysis, compared with the control groups, the VAS scores of MSC groups decreased significantly (MD,−19.24; 95% CI: −26.31 to −12.18, P < .00001. All of the WOMAC scores also improved significantly: the total scores (SMD, − 0.66; 95% CI: − 1.09 to −0.23, P = .003), pain scores (SMD, − 0.46; 95% CI: − 0.75 to −0.17, P = .002), stiffness scores (SMD, −0.32; 95% CI: −0.64 to 0.00 P = 0.05), and functional scores (SMD, −0.36; 95% CI: −0.69 to −0.04, P = .03). Two studies with non-double-blind designs were the main source of heterogeneity. In terms of cartilage repair, there was no significant difference in the WORMS score, but there was a significant increase in cartilage volume in the MSC group (SMD, 0.69; 95% CI: 0.25 to 1.13, P = .002). The proportion of patients with adverse events in the MSCs treatment group was significantly higher than that in the control group (OR, 3.20; 95% CI: 1.50 to 6.83, P = .003).

Conclusions:

Intra-articular injection of mesenchymal stem cells is effective and safety to relieve pain and improve motor function of patients with knee osteoarthritis in a short term which is different to conclusions of previous study.
Acupuncture for opioid-induced constipation
Authors: Yang Pu , Wang Yuanchun , Xiao Yingchun , Ma Qiaolin , Ma Runhong , Mi Jing , Hui Jianrong
Published: December 2020

Background:

Opioid-induced constipation (OIC) is one of the most common complications of analgesic therapy for cancer pain patients who suffer moderate to severe pain. Acupuncture as an effective treatment in constipation has been widely applied. But its efficacy has not been assessed systematically. Thus, the purpose of this study is to provide a protocol to explore the efficacy and safety of acupuncture for OIC.

Methods:

Randomized Controlled Trials (RCTs) of acupuncture treatment for OIC in 4 Chinese electronic databases (China National Knowledge Infrastructure, Chinese Biological and Medical Database, China Scientific Journal Database, Wan-Fang Data) and 3 English electronic databases (PubMed, Embase, Cochrane Library) will be searched from their inception to September 31, 2020. RevMan 5.3 software and Stata 14.0 software will be used for meta-analysis, EndNote X9.2 and Cochrane Risk of Bias Tool will be used for literature screening and quality assessment.

Results:

This study will present an assessment of the efficacy and safety of acupuncture treatment for OIC patients through summarize high-quality clinical evidence.

Conclusion:

The conclusion of our systematic review and meta-analysis may provide evidence of whether acupuncture treatment is beneficial to patients with OIC.

INPLASY registration number: INPLASY2020100026.
Clinical study on electroacupuncture for obese patients with binge eating disorder
Authors: Cheng Changcheng , Liu Xuzhen , Zhu Shuibing , Dong Can , Liu Lei , Lin Wanqi , Deng Han , Xu Yuqi , Ou Zengjian , Lyu Wanyong , Zhang Cairong
Published: December 2020

Binge eating disorder (BED) is a common dietary disorder among obese people. Obesity and eating disorders are related to mental health and physical health. At present, there is no definite and effective method for treatment in clinic. The curative effect of electroacupuncture on obesity is definite. Although there is no conclusive evidence to support its long-term benefits, electroacupuncture has been increasingly used in clinic. This retrospective study determined the prognosis and outcome of electro-acupuncture on obese patients with BED.

One hundred forty-three patients with BED and obesity were found from 658 people who participated in the scientific experiment of obesity treatment in Nanjing Hospital of Traditional Chinese Medicine and Nanjing Brain Hospital from March 2015 to June 2018, and 84 patients (aged 18–40 years old) with valid data and uninterrupted treatment were found to be eligible for this retrospective study. According to the intervention methods, the patients were divided into electro-acupuncture combined with cognitive group (n = 32), cognitive therapy group (n = 28), and control group (n = 24). In this study, the 5th edition of Diagnosis and Statistics Manual of Mental Diseases, fasting blood glucose, fasting insulin, total cholesterol (TC), triglyceride, high-density lipoprotein, low-density lipoprotein, body fat rate, muscle mass, visceral index grade, nutrient intake (energy, protein, fat, carbohydrate), body weight, and weight changes before and after treatment were observed.

Compared with the cognitive therapy group, negative emotion score, TC, triglyceride, high-density lipoprotein, waist circumference, BW, BMI, body fat percentage of the electroacupuncture combined with cognitive group were lower, while positive emotional scores were higher, and there were significant differences in negative emotional scores, TC, waist circumference and BMI (P < .05). The dietary energy and three major nutrients in the electroacupuncture combined with cognitive group were lower than those in the cognitive group and the blank group (P < .05).

The current results suggest that electroacupuncture combined with cognitive therapy is more effective than cognitive therapy alone in treating obese patients with BED. Future prospective studies are necessary to further study the mechanism of electroacupuncture on the obese with BED.
Auricular therapy for polycystic ovary syndrome
Authors: Li Yangyang , Zheng Xiaoying , Wang Yingji , Li Yan
Published: December 2020

Background:

This systematic review protocol aims to describe a meta-analysis to assess the effectiveness and safety of auricular therapy for patients with polycystic ovary syndrome (PCOS).

Methods:

Randomized controlled trials of auricular therapy in treating PCOS will be searched in PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wan-Fang Database, and Chinese Scientific Journal Database. The primary outcome is the body mass index. The study selection, data extraction, and study quality evaluation will be performed independently by 2 researchers. A meta-analysis will be performed using RevMan V5.3 statistical software if possible; otherwise, descriptive analysis or subgroup analysis will be conducted. The quality of evidence for outcomes will be assessed with the Grading of Recommendations Assessment, Development and Evaluation approach.

Results:

This study will evaluate the effect and safety of auricular therapy in treating PCOS.

Conclusions:

The evidence we generated from the present study will provide more options for PCOS management in clinical practice.

The registration DOI:

10.17605/OSF.IO/VBPSM.
The efficacy and safety of Xuebijing injection for corona virus disease 2019
Authors: Fu Jiaming , Wu Lili , Ma Yingying , Liang Qun
Published: December 2020

Background:

Corona virus disease 2019 (COVID-19) is an epidemic respiratory infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 infection. Now it is popular all over the world on a large scale. COVID-19 has the characteristics of rapid transmission, atypical clinical symptoms, easy missed diagnosis and misdiagnosis, and so on. which has seriously affected social and economic development and people's health. Severe acute respiratory syndrome corona virus type 2 infection may lead to systemic cytokine storm, which leads to a sharp deterioration of the condition of ordinary patients. At present, no specific drug has been found in the clinical treatment of covid-19, while Xuebijing injection has been widely used in severe patients in China as a traditional Chinese medicine. The aim of this study is to assess the effificacy and safety of Xuebijing injection for COVID-19.

Methods:

Before the research, we conducted a comprehensive search on relevant websites. Two professional researchers will gradually screen, read the title, abstract and full text if necessary, and independently select qualified documents according to the inclusion and exclusion criteria. We will conduct a meta-analysis of the results related to COVID-19 to assess the risks of bias and data extraction. The heterogeneity of data will be studied by Cochrane X
2 and I
2 tests. The evaluation of publication bias will be carried out by funnel chart analysis and Eger test.

Results:

This review will be disseminated in print by peer-review.

Conclusion:

Our research is to scientifically analyze the clinical evidence of Xuebijing injection in treating severe COVID-19 patients.
Wrist ankle acupuncture in the treatment of acute lumbar sprain
Authors: Liang Shumin , Zhang Guilong , Li Jianhong , Zhong Lei , Zhang Chi
Published: December 2020

Background:

Acute lumbar sprain (ALS) frequently occurs in the young and middle-aged people, causing great harm to people's quality of life. The systematic review program was designed to describe a meta-analysis to evaluate the efficacy and safety of wrist-ankle acupuncture (WAA) in treating patients with ALS.

Methods and analysis:

Our systematic review will search electronically and manually for WAA treatments for ALS by August, 2020, regardless of publication status and language. Databases include: MEDLINE, PubMed, EMBASE, Springer, Web of Science, Cochrane Library, WHO International Clinical Trial Registration Platform (ICTRP), Chinese Medicine Database (TCMD), China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), China Science Journal Database (VIP), and Wanfang Database. Other sources of information, including bibliographies and meeting minutes for identified publications, will also be searched. Manually search for grey literature, including unpublished conference articles. Any clinical randomized controlled trials related to WAA treatments for ALS, regardless of publication status and language limitations, will be included in the study. Study selection, data extraction, and research quality assessment will be done independently by 2 researchers. The primary outcome included the effective rate and visual analogue scale (VAS) or other validated scales used to relieve pain after the treatment. If possible, meta-analysis will be performed using RevMan V.5.3 statistical software. If it is not suitable for meta-analysis, a descriptive analysis or subgroup analysis is performed.

Results:

This study will provide a comprehensive review and evaluation of the available evidence for the treatment of ALS using WAA.

Conclusion:

This study will provide new evidence to evaluate the effectiveness and side effects of WAA on ALS. Because the data is not personalized, no formal ethical approval is required.

Registration number:

PROSPERO CRD42020162945
Long-term oncological outcomes of laparoscopic gastrectomy for grossly early gastric cancer-mimicking advanced gastric cancer
Authors: Oh Sung Eun , An Ji Yeong , Choi Min-Gew , Sohn Tae Sung , Bae Jae Moon , Lee Jun Ho
Published: December 2020

Laparoscopic gastrectomy became an option in the treatment of early gastric cancer (EGC) in clinical practice. However, whether laparoscopic surgery for grossly EGC-mimicking advanced gastric cancer (AGC) patients is oncologically safe long-term is still controversial.

We retrospectively analyzed 472 patients with AGC who were diagnosed as clinical EGC. Patients received laparoscopic or open gastrectomy with standard lymph node (LN) dissection from January 2007 to February 2015. We used a 1:3 propensity score matching method for the analysis. The matching factors were age, sex, body mass index, American Society of Anesthesiologists score and pathologic stage. After the matching process, we evaluated the 5-year overall survival and the cumulative incidence curve of recurrence.

All of the analyzed patients were pathologically diagnosed with AGC after surgery (grossly EGC-mimicking AGC). The median (range) duration of follow-up was 58.0 (0–132) months. After propensity score matching, 31.5% of patients in the laparoscopy group had D1+ LN dissection and 99.2% of patients in the open group had D2 LN dissection. The 5-year overall survival rate between the laparoscopy (n = 92) and open groups (n = 244) were not significantly different (95.3% versus 91.4%, P = .224). There was no significant difference between the cumulative recurrence incidence curves of the matched groups (P = .319).

Laparoscopic surgery for grossly EGC-mimicking AGC might be safe in terms of long-term survival outcome. After confirming grossly EGC-mimicking AGC in the final pathology report, no additional surgery might be required.
Effect of Chinese herbal medicine compound on breast hyperplasia
Authors: Guan Hui-lin , Wang Yu , Gui Yi-fang , Zhang Chun-lei
Published: December 2020

Background:

Data supporting the use of Chinese herbal medicine compound (CHMC) on breast hyperplasia (BH) based on the data from previous studies. However, the results are still contradictory. Thus, this study aims to compare the results obtained for effect on case-controlled study (CCS) of CHMC on BH.

Methods:

This study will include CCS assessing the effect of CHMC on BH. A literature search will be carried out in Cochrane Library, MEDLINE, EMBASE, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from inception to the present. We will not apply language limitation to any electronic database. Study quality will be evaluated using Newcastle-Ottawa Scale, and statistical analysis will be performed using RevMan 5.3 software.

Results:

This study will summarize the up-to-date evidence to assess the effect of CHMC on BH.

Conclusion:

The results of this study may exert helpful evidence to determine whether CHMC is effective on BH.

OSF registration number:

osf.io/3k8ch.
Predictors of prolonged mechanical ventilation identified at an emergency visit for elderly people
Authors: Mori Hideki , Yamasaki Kazumi , Itoh Takehiro , Saishoji Yusuke , Torisu Yuichi , Mori Takahiro , Izumi Yasumori
Published: December 2020

The aim of this study was to determine the factors that are associated with prolonged mechanical ventilation in elderly patients.

Retrospective cohort study

Single tertiary hospital in Japan

We retrospectively identified 228 patients aged 75 years or older who were admitted to a single tertiary care center in Japan between January 1, 2014 and December 31, 2017 because of endogenous diseases and underwent mechanical ventilation.

The primary outcome was extubation difficulty, which was defined as the need for mechanical ventilation for more than 14 days after intubation, reintubation within 72 hours after extubation, tracheotomy or extubation, or death within 14 days after intubation.

A multivariate analysis showed that age (odds ratio [OR] = 0.95; 95% confidence interval [CI] = 0.66–1.38; P = .80), gender (OR = 0.56; 95%CI = 0.27–1.17; P = .13), body mass index (BMI) (OR = 1.05; 95%CI = 0.98–1.14; P = .16), smoking history (OR = 0.64; 95%CI = 0.29–1.41; P = .27), Activities of daily living (ADL) (OR = 0.95; 95%CI = 0.49–1.83; P = .87), and modified acute physiology and chronic health evaluation (APACHE) II score (OR = 1.02; 95%CI = 0.95–1.09; P = .61) were not statistically significantly different. However, there were statistically significant differences in extubation difficulty between patients with diabetes mellitus (OR = 2.3; 95%CI = 1.01–5.12; P = .04) and those with cardiovascular disease diagnosis on admission (OR = 0.31; 95%CI = 0.1–0.97; P = .04).

Diabetes mellitus and cardiovascular disease diagnosis on admission were factors that were associated with prolonged mechanical ventilation in the elderly. The results of this study may help to support shared decision making with patients or surrogate decision makers at the start of intensive care in the elderly.
Effects of massage therapy for patients with thoracic facet joint disorders
Authors: Zhou Ke-Lin , Dong Shuo , Ji Wei , Yang Jing-Yi , Ren Mei-Ling , Mi Bao-Lai , Guo Sheng , Cai Ming-Heng
Published: December 2020

Background:

Thoracic facet joint disorder is a common thoracic disorder in clinic, inducing pain and discomfort at the dislocated thoracic vertebrae, radiating to pain of the neck and back. The incidence of thoracic facet joint disorder is higher than the facet disorder of the cervical and lumbar vertebrae. Therefore, an ideal strategy to relieve thoracic facet joint disorder is urgently needed. In recent years, massage therapy has been increasingly accepted by thoracic facet joint disorder patients due to its lower costs, fewer unwanted side effects and safety for clinical use. In this systematic review, we aim to evaluate the effectiveness and safety of massage therapy for patients with thoracic facet joint disorder.

Methods:

We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness of massage therapy in treating thoracic facet joint disorder: Wanfang and PubMed Database, CNKI, CENTRAL, CINAHL and EMBASE. Each database will be searched from inception to October 2020. The entire process will include study selection, data extraction, risk of bias assessment and meta-analyses.

Results:

This proposed study will evaluate the effectiveness of massage therapy for patients with thoracic facet joint disorder.

Conclusions:

This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of massage therapy for patients with thoracic facet joint disorder.

Dissemination and ethics:

The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process.

OSF Registration number:

DOI 10.17605/OSF.IO/XMEJD
Effectiveness of moxibustion therapy in the treatment of urticaria
Authors: Deng Gen , Ye Wenguo , Wan Qun , Wang Jinlong
Published: December 2020

Background:

Urticaria is a common skin disease in clinic. The main clinical symptoms are sudden attack, various forms, different sizes of wind, and erythema, accompanied by varying degrees of itching. At present, antihistamines, non-specific antiallergic agents, or glucocorticoids are the main treatment, with some side effects and adverse reactions. Moxibustion therapy has shown strong advantages in the treatment of urticaria, and the curative effect is accurate. Therefore, this paper will carry out a systematic evaluation and meta-analysis of the efficacy and safety of moxibustion in the treatment of urticaria.

Methods:

Eight electronic databases will be searched, including PubMed, Excerpta Medica Database, Web of Science, Cochrane Library, the China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang Database (WF), and Chinese Biomedical Literature Database (CBM). We will search above electronic databases from the beginning to October 2020, without any language restriction, but involving only the human subjects. Clinical efficacy, including total effective rate or cure rate, and recurrence rate will be accepted as the primary outcomes. The itch level, number of clusters, size of clusters, and laboratory test results will be used as secondary outcomes. The Cochrane Handbook of Systematic Review (5.3.0) RCT risk assessment tool will be used to evaluate the risk of bias by 2 independent researchers.

Results:

After the completion of this study, the results will be reported, so it is not possible to give accurate results at present.

Conclusions:

The results of this study will provide reliable evidence for the efficacy and safety of moxibustion in the treatment of urticaria.

INPLASY Registration number:

INPLASY2020100040.
Effects and safety of massage therapy for patients with metatarsal pain
Authors: Zhou Ke-Lin , Dong Shuo , Bai Xiao , Dai Xiao-Hui , Guo Sheng , Guan Qing , Wei Pei-Dong , Mi Bao-Lai , Ren Mei-Ling , Yang Yong
Published: December 2020

Background:

Metatarsalgia refers to localized or generalized forefoot pain in the region of the metatarsal heads. Often this pain is plantar, beneath the metatarsal heads, and arises from either mechanical or iatrogenic causes. The treatment of metatarsalgia remains controversial. A thorough understanding of the biomechanics of the forefoot and the underlying pathology of the particular type of metatarsalgia affecting the patient is a prerequisite to selecting the proper treatment. In recent years, massage therapy has been increasingly accepted by patients due to its lower costs, fewer unwanted side effects, and safety for clinical use. In this systematic review, we aim to evaluate the effectiveness and safety of massage therapy for patients with metatarsal pain.

Methods:

We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of massage therapy in treating metatarsal pain: Wanfang and PubMed Database, CNKI, CENTRAL, CINAHL, and EMBASE. Each database will be searched from inception to October 2020. The entire process will include study selection, data extraction, risk of bias assessment, and meta-analyses.

Results:

This proposed study will evaluate the effectiveness and safety of massage therapy for patients with metatarsal pain. The outcomes will include changes in metatarsal pain relief and adverse effect.

Conclusions:

This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of massage therapy for patients with metatarsalgia.

Dissemination and ethics:

The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process.

OSF Registration number:

DOI 10.17605/OSF.IO/C6KFJ
Epidermolysis bullosa acquisita as an adverse effect from rituximab therapy
Authors: Wu Xueqiong , Lv Zhenhui , Li Wenjia , Meng Zhaosheng , Wan Shaw P.
Published: December 2020

Rationale:

Rituximab is a monoclonal antibody directed against B cells and is a first-line agent for the treatment of B cell lymphoma and a second-line agent for the treatment of idiopathic thrombocytopenic purpura (ITP). It has also been used for the treatment of several other autoimmune diseases. Epidermolysis bullosa acquisita (EBA) has never been reported as an adverse effect resulted from rituximab therapy.

Patient concerns:

A 54-year-old female presented with relapse of the ITP for around eight months. She was treated with rituximab. Intramuscular chlorpheniramine and intravenous methylprednisolone and cimetidine were used as premedication before rituximab infusion. The infusion was initially started at 50 mg/h for 1 h followed by 100 mg/h till the end of infusion. The day after rituximab infusion, the patient noticed pruritic blisters on both arms and chest skin. The next day, the lesions increased in severity and extent.

Diagnosis:

The skin biopsy established the diagnosis of EBA. H&E staining revealed subepidermal blisters infiltrated by inflammatory cells, including eosinophils and lymphocytes. Direct immunofluorescence (DIF) showed linear deposition of IgG and C3 at the dermoepidermal junction. Indirect immunofluorescence with the patient's serum on salt-split skin revealed exclusive dermal binding of circulating IgG antibasement membrane antibodies at a titer of 1:160.

Interventions:

She was treated with intravenous methylprednisolone and was continued on oral prednisolone.

Outcomes:

The lesions regressed. Six weeks later, she had a recurrence of similar lesions but in milder form. This episode subsided in 4 to 5 days with topical steroid application.

Lessons:

Physicians should consider this diagnosis when a patient develops bullous skin eruptions while undergoing Rituximab therapy.
Neuroendocrine carcinoma of the nasal cavity with epiphora as the first symptom
Authors: Wu Weiqi , Gan Puying , Xu Qihua , Wang Yaohua , Liao Hongfei
Published: December 2020

Rationale:

Neuroendocrine carcinomas (NECs) are rare malignancies that originate from the hormone-producing cells of the neuroendocrine system. They can grow in most organs of the body but are commonly found in the gastrointestinal and respiratory tracts. The nasal cavity is a rare site for NECs.

Patient concerns:

We report a case of NECs in a 45-year-old woman who presented with epiphora in the right eye for a year owing to an unknown reason.

Diagnoses:

The diagnosis was initially confirmed via histological and immunohistochemical assays. Postoperatively, computed tomography of the neck revealed C4 vertebral bone metastasis.

Interventions:

The tumor was endoscopically removed from the right eye. The patient received a full course of adjuvant polychemotherapy.

Outcomes:

Six months after diagnosis, the patient died due to bone metastasis.

Lessons:

Diagnosing nasal neuroendocrine carcinoma is clinically challenging. It must be distinguished from other orbital masses, such as chronic dacryocystitis or nasal polyps. The treatment should be further investigated for this rare malignancy in near future.
Evaluation of the efficiency of propofol versus isoflurane anesthesia interventions in treating elderly patients with postoperative cognitive dysfunction
Authors: Shen Yan-Xi , Chen You-Ping , Zang Hong-Cheng , Shao Gang
Published: December 2020

Background:

The aim of this study was to systematically evaluate the efficiency of propofol versus isoflurane anesthesia interventions in treating elderly patients with postoperative cognitive dysfunction.

Methods:

We performed an in-depth search in the PubMed, EMBASE, Cochrane Library, Chongqing VIP, WanFang, China National Knowledge Infrastructure, and SinoMed. Additionally, we reviewed the reference lists of included studies. Two independent authors examined the quality of the study and the quality of the extracted data. Regarding the dichotomous outcomes, we stated the results as relative risk, with 95% confidence intervals. We further expressed incessant outcomes as mean difference with a confidence level of 95%.

Results:

The findings of the study will be published in a peer-reviewed journal.

Conclusion:

Findings of this study will help in providing insight to establish if propofol is a suitable intervention to treat postoperative cognitive dysfunction in elderly patients.

Systematic review registration number:

INPLASY202090042
Acupuncture for gouty arthritis
Authors: Lee Gamseong , Cho Foo Young , Goo Bonhyuk , Park Yeon-Cheol
Published: December 2020

Backgroud:

Patients with gouty arthritis suffer from intermittent attacks of pain, chronic inflammation, and joint damage. Acupuncture has been used in East Asian countries for centuries to treat various diseases, and several clinical studies have reported that acupuncture has beneficial effects on gouty arthritis. This study aims to evaluate the effect of acupuncture in patients with gouty arthritis by conducting a systematic review and meta-analysis.

Methods:

A comprehensive search of 8 electronic databases will be performed, including MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, 4 Korean databases (KoreaMed, Korean Studies Information Service System, Research Information Service System, and Oriental Medicine Advanced Searching Integrated System), and 1 Chinese database (China National Knowledge Infrastructure). Only randomized controlled trials comparing acupuncture to conventional treatment and acupuncture with conventional treatment to conventional treatment alone for gouty arthritis will be included. Pain intensity will be considered the primary outcome. The secondary outcomes will include the pain relief duration, total effective rate, blood uric acid level, inflammatory markers, and incidence of adverse events. Two independent researchers will perform the study selection, data extraction, and quality assessment. The methodological quality of the individual included studies will be assessed using the Cochrane risk of bias tool. In the meta-analysis, for dichotomous and continuous data, risk ratios and standardized mean differences, respectively, will be estimated in addition to 95% confidence intervals.

Results

: This systematic review will evaluate the effect of acupuncture treatment for patients with gouty arthritis with respect to clinical symptoms, laboratory indicators, and safety.

Conclusion

: Our findings will help to establish the evidence of acupuncture to treat gouty arthritis.

Registration number:

PROSPERO CRD42020169668.
Overexpression of TPX2 predicts poor clinical outcome and is associated with immune infiltration in hepatic cell cancer
Authors: Zhu Hongjun , Liu Jian , Feng Jia , Zhang Qing , Bian Tingting , Li Xiaoli , Sun Hui , Zhang Jianguo , Liu Yifei
Published: December 2020

Targeting protein for Xenopus kinesin-like protein 2 (TPX2) has been identified as an oncogene in multiple cancers. However, the associations among TPX2 expression, prognosis, and tumor immunity in hepatic cell cancer (HCC) have not been explored. We analyzed TPX2 expression by multiple gene expression databases, including Oncomine, TIMER, and UALCAN. The prognosis effect of TPX2 was analyzed by Kaplan--Meier plotter. The coexpressed genes with TPX2 were analyzed using Linked Omics. The association among TPX2 and immune infiltrates and immune checkpoints was determined by TIMER. It was found that TPX2 expression was notably upregulated in multiple HCC tissues. Overexpression of TPX2 has associations with race, age, weight, clinical stage and tumor grade, as well as poor prognosis in overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), and disease-specific survival (DSS). In addition, TPX2 expression has a positive association with the infiltration of immune cells and the expression of immune checkpoint molecules. Coexpressed genes and functional network analysis suggested several potential mechanisms of TPX2 affecting HCC progression. The findings reveal that TPX2 has associations with prognosis and infiltration of immune cells in HCC patients, which has laid a basis for in-depth study of TPX2 role in HCC.
Patient Experiences of Integrated Care in Medicare Accountable Care Organizations and Medicare Advantage Versus Traditional Fee-for-Service
Authors: Frean Molly , Covington Christian , Tietschert Maike , Bahadurzada Hassina , So Jodi , Singer Sara J.
Published: December 2020

Background:

Health insurance design can influence the extent to which clinical care is well-coordinated. Through alternative payment models, Medicare Advantage (MA) and Accountable Care Organizations (ACOs) have the potential to improve integration relative to traditional fee-for-service (FFS) Medicare.

Objective:

To characterize patient experiences of integrated care within Medicare and identify whether MA or ACO beneficiaries perceive greater integration than FFS beneficiaries.

Design:

Retrospective cross-sectional analysis of the 2015 Medicare Current Beneficiary Survey.

Subjects:

Nationally representative sample of 11,978 Medicare beneficiaries.

Measures:

Main outcomes included 8 previously derived domains of patient-perceived integrated care (PPIC), measured on a scale of 1–4.

Results:

The final sample was 55% female with a mean (SD) age of 71.1 (11.3). In unadjusted analyses, we observed considerable variation across PPIC domains in the full sample, but little variation across subsamples defined by coverage type within a given PPIC domain. In linear models adjusting for a rich set of patient characteristics, we observe no significant benefits of ACOs nor MA relative to FFS, a finding which is robust to alternative specifications and adjustment for multiple comparisons. We similarly observed no benefits in subgroup analyses restricted to states with relatively high market penetration of ACOs or MA.

Conclusions:

Despite characteristics of ACOs and MA that theoretically promote integrated care, we find that PPIC is largely similar across coverage types in Medicare.
Cardiac Inflammatory Myofibroblastic Tumor Causing Pulmonary Artery Obstruction: A Rare Case Report
Authors: Yildiz Kaan , Genc Halise Zeynep , Kir Mustafa , Unal Nurettin , Oto Oztekin , Paytoncu Sebnem , Yuzuguldu Resmiye Irmak , Ozer Erdener
Published: December 2020

Inflammatory myofibroblastic tumor (IMT) is a rare soft tissue tumor of the heart. In the literature, cardiac IMT is often described as an endocardial-based cavitary mass originating from the right side of the heart in infants and adolescents. In this article, we present a 5-year-old boy with a rare cardiac IMT who had no complaints and was diagnosed with murmur during his routine examination. Transthoracic echocardiography showed a homogeneous polypoid mass originating from the pulmonary valve, extending into the main pulmonary artery during systole and causing obstruction of the pulmonary artery and right ventricular outflow tract. Surgical resection of the tumor was performed successfully. There was no tumor recurrence in the control echocardiography at the postoperative first month.