bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic myeloid leukemia with two rare fusion gene transcripts of atypical BCR::ABL: A case report and literature review
Authors: Li Yuxin , Zhang Yilin , Meng Xin , Chen Sheping , Wang Ting , Zhang Longjin , Ma Xiaorong
Published: January 2024

Rationale:

Imatinib is a standard treatment for Philadelphia (Ph) chromosome-positive chronic myeloid leukemia (CML), but its efficacy in rare BCR::ABL variants is underexplored.

Patient concerns:

A 67-year-old woman was admitted to the Second Affiliated Hospital of Xi’an Jiaotong University in March 2022 due to elevated white blood cells.

Diagnosis:

Karyotype analysis revealed clonal abnormalities involving the variant t(9;22) and positive results for atypical BCR::ABL variants (e14a3 and e13a3). The clinical diagnosis was CML, chronic phase, Ph+, with rare BCR::ABL-e13a3- and BCR::ABL-e14a3-positive findings.

Intervention:

The patient was administered daily imatinib mesylate (400 mg).

Outcomes:

After 4 weeks, a swift molecular response was observed: BCR::ABL-e13a3 transcript level at 2.82 × 10−1 (28.24%), and BCR::ABL-e14a3 transcript level at 4.68 × 10−1 (46.76%). Within 3 months, a complete cytogenetic response was achieved, with a Ph chromosome ratio of 0. Early molecular response was evident as BCR::ABL-e13a3 transcript level reached 5.11 × 10−3 (0.51%), and BCR::ABL-e14a3 transcript level at 6.26 × 10−3 (0.63%). The imatinib mesylate treatment continued without significant toxicity.

Lessons:

This case emphasizes the potential effectiveness of imatinib mesylate in managing rare BCR::ABL fusion gene variants of CML. Screening for these atypical variants is advised for suspected CML patients who test negative for common BCR::ABL fusion gene variants. The presented case underscores the positive outcomes achieved with imatinib treatment for a patient with rare BCR::ABL variants, contributing valuable insights for the management of similar cases. Screening for unusual fusion gene variants should be a consideration in CML diagnosis for comprehensive treatment strategies.
Efficacy and safety of neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy in locally advanced esophageal cancer: An updated meta-analysis
Authors: Liang Zhanpeng , Chen Ting , Li Wenxia , Lai Huiqin , Li Luzhen , Wu Jiaming , Zhang Huatang , Fang Cantu
Published: January 2024

Background:

Currently, the optimal treatment for neoadjuvant therapy for locally advanced esophageal cancer is not clear, and there is no evidence that neoadjuvant chemoradiotherapy (nCRT) is superior to neoadjuvant chemotherapy (nCT). Due to the publication of new clinical trials and defects in previous meta-analyses, we conducted an updated meta-analysis to evaluate the efficacy and safety of nCRT and nCT.

Methods:

The following databases were searched for studies: PubMed, EMBASE, and Cochrane library (updated to April 22, 2023). All randomized trials comparing nCRT with nCT in locally advanced esophageal cancer met the inclusion criteria. Data were analyzed using Review Manager 5.4.1 (Cochrane collaboration software). Primary outcomes assessed from the trials included overall survival (OS), progression-free survival (PFS), pathological complete response (pCR), R0 resection rate, postoperative complications, postoperative mortality, and grade 3 or higher adverse events (3 + AEs).

Results:

This systematic review and meta-analysis included 7 randomized controlled studies involving 1372 patients (686 receiving nCRT and 686 receiving nCT). Compared with nCT, nCRT significantly improved OS (HR = 0.80; 95% CI: 0.68–0.94), PFS (HR = 0.78; 95% CI: 0.66–0.93), pCR (OR = 13.00; 95% CI: 7.82–21.61) and R0 resection (OR = 1.84; 95% CI: 1.32–2.57), but was associated with higher postoperative mortality (OR = 2.31; 95% CI: 1.26–4.25) and grade 3 + AEs (OR = 2.21; 95% CI: 1.36–3.58). There was no significant difference in postoperative complications between nCRT and nCT (OR = 1.15; 95% CI: 0.82–1.61). Subgroup analysis showed significant survival benefit in squamous cell carcinoma (HR = 0.80; 95% CI: 0.68–0.98), but not in adenocarcinoma (HR = 0.80; 95% CI: 0.63–1.08).

Conclusions:

Our meta-analysis found superior efficacy associated with nCRT compared with nCT in both tumor regression and prolonged survival, but increased the risk of postoperative mortality and grade 3 + AEs. Esophageal squamous cell carcinoma was more likely to benefit from nCRT than esophageal adenocarcinoma in the term of OS.
The long-term efficacy and safety of apatinib are inferior to sorafenib in the first-line treatment of advanced hepatocellular carcinoma: A systematic review and meta-analysis
Authors: Li Dailong , Zhang Chunzhen , Yang Kui , Ma Zhiwei , Ma Lili , Cheng Chunlai , Xu Lu , Wan Sha
Published: January 2024

Background:

Apatinib, a novel tyrosine kinase inhibitor independently developed by China, has been widely used in the treatment of advanced hepatocellular carcinoma (HCC) in recent years. For more than a decade, sorafenib has been the classic first-line treatment option for patients with advanced HCC. However, the results of clinical studies comparing the efficacy and safety of these 2 drugs are still controversial. Therefore, the aim of this meta-analysis is to evaluate the efficacy and safety of apatinib versus sorafenib as first-line treatment for advanced HCC.

Methods:

Up to August 14, 2023, the databases of PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov, China National Knowledge Infrastructure, and Wanfang were searched, and clinical studies of experimental group (apatinib or apatinib plus transarterial chemoembolization [TACE]) versus control group (sorafenib or sorafenib plus TACE) in the first-line treatment of advanced HCC were included. Two researchers evaluated the quality of the included studies and extracted the data. Revman 5.4 software was used for meta-analysis.

Results:

A total of 12 studies involving 1150 patients were included. Five studies are apatinib alone versus sorafenib alone, and the other 7 studies are apatinib plus TACE versus sorafenib plus TACE. The results of the meta-analysis showed that compared with sorafenib alone, apatinib could improve (OR = 3.06, 95%CI: 1.76–5.31), had no advantage in improving DCR (OR = 1.52, 95%CI: 0.86–2.68) and prolonging PFS (HR = 1.35, 95%CI: 0.94–1.96), and was significantly worse in prolonging OS (HR = 1.43, 95%CI: 1.08–1.88). Similarly, apatinib plus TACE was inferior to sorafenib plus TACE in prolonging OS (HR = 1.15, 95%CI: 1.03–1.28), although it improved ORR (OR = 1.49, 95%CI: 1.03–2.16). In terms of adverse drug events, the overall incidence of adverse events, and the incidence of drug reduction and discontinuation in the experimental group were significantly higher than those in the control group (P < .05). The incidence of hypertension, proteinuria, and oral mucositis in the experimental group was significantly higher than that in the control group (P < .05).

Conclusion:

In the setting of first-line treatment of advanced HCC, apatinib has improved short-term efficacy (ORR) compared with sorafenib, but the safety and long-term efficacy of apatinib are inferior to sorafenib.
The impact of COVID-19 pandemic and lockdown on emergency psychiatry department admissions
Authors: Aksoy Poyraz Cana , Uçar Bostan Büşra , Ersungur Çelik Elif Burcu , Kara Esen Beril
Published: January 2024

This study aimed to explore the impact of the coronavirus disease 2019 pandemic and lockdown period measures on patients’ visits to the psychiatric emergency department (PED) of a University Hospital in İstanbul. We compared the number and characteristics of patients during the initial lockdown with visits in the pre- and post-lockdown months. We also investigated the number of monthly PED visits and hospitalizations between March 11, 2020 and 2021 and compared it to the same period in 2019 and between March 2021 and 2022. PED visits in the initial lockdown period in our university increased by 109% compared to the prelockdown months in the previous year. Anxiety and depressive disorders were responsible for most of this increase. The decline in PED visits was 3.1% and 42% during the first and second year of the pandemic, respectively; however, among the major diagnostic categories, we found that the rates of anxiety, depressive disorders, and obsessive-compulsive disorder increased significantly in the first year, while psychotic disorders declined and bipolar disorders remained the same. In the second year, there was a trend toward prepandemic year ratios. These findings show that the pandemic affects PED admissions in different ways at different periods. These data may also help shaping the public policies necessary to meet the evolving needs in the field of mental health of society at different public crises in the future.
CX3CR1 is a potential biomarker of immune microenvironment and prognosis in epithelial ovarian cancer
Authors: Shao Danfeng , Zhou Honger , Yu Huaiying , Zhu Xiaoqing
Published: January 2024

Immunotherapy is less efficient for epithelial ovarian cancer and lacks ideal biomarkers to select the best beneficiaries for immunotherapy. CX3CR1 as chemokine receptor mainly expressed on immune cell membranes, and combined with its unique ligand CX3CL1, mediates tissue chemotaxis and adhesion of immune cells. However, the immune functional and prognostic value of CX3CR1 in epithelial ovarian cancer has not been clarified. A comprehensive retrospective analysis was performed by using the online database to identify the underlying immunological mechanisms and prognostic value of CX3CR1. The Human Protein Atlas, gene expression profiling interactive analysis, and TISIDB (an integrated repository portal for tumor-immune system interactions) database showed that CX3CR1 expressed higher in epithelial ovarian cancer than that in normal ovarian tissue. Four hundred twenty-two cases from Gene Expression Profiling Interactive Analysis and 1656 cases from Kaplan–Meier plotter database showed higher expression of CX3CR1 (above median) was associated with unfavorable overall survival. TIMER, UALCAN, and TISIDB database were applied to validate CX3CR1 negative impact on overall survival. In addition, correlation analysis showed that the expression level of CX3CR1 was positive association with infiltrating levels of B cells (R = 0.31, P = 3.10e−12), CD8+ T cells (R = 0.26, P = 7.93e−09), CD4+ T cells (R = 0.11, P = 1.41e−02), macrophages (R = 0.32, P = 4.29e−13), dendritic cells (R = 0.27, P = 2.98e−09), and neutrophil (R = 0.25, P = 3.25e−08) in epithelial ovarian cancer. Therefore, CX3CR1 involved in reshaping the immune microenvironment for epithelial ovarian cancer and maybe a potential immunotherapy target and prognostic marker for ovarian cancer.
A comprehensive review of heart failure: Unraveling the etiology, decoding pathophysiological mechanisms, navigating diagnostic modalities, exploring pharmacological interventions, advocating lifestyle modifications, and charting the horizon of emerging therapies in the complex landscape of chronic cardiac dysfunction
Authors: Elendu Chukwuka , Amaechi Dependable C. , Elendu Tochi C. , Fiemotonghan Border-ere , Okoye Osinachi K. , Agu-Ben Chigozirim M. , Onyekweli Samuel O. , Amapu Dorcas A. , Ikpegbu Richard , Asekhauno Mercy , Pius Erica , Bayo-Shodipo Adediwura T. , Okezie-Okoye Chidera A. , Bello Nurudeen , Oguine Chibuike , Edochie Promise , Dike Nkechinyere , Amos Ibirongbe , Asekhauno Joan , Wusu-Ejalonibu Tanitoluwa M. , Ozigi Emmanuella E. , Otobo Grace O. , Olokodana Aderinsola R. , Ayabazu Chiagozie P. , Nwafor Raphael T. , Gonji Nandir J. , Akpovona Otite , Awotoye Temitope I. , Ozigis Mutalib O. , Afolabi Oluwatosin , Alabi Omotayo S. , Adebayo Mololuwa
Published: January 2024

Heart failure (HF) poses a significant global health burden, necessitating a profound understanding of its multifaceted dimensions. This comprehensive review aims to unravel the etiology, decode pathophysiological mechanisms, navigate diagnostic modalities, explore pharmacological interventions, advocate lifestyle modifications, and chart the horizon of emerging therapies in the complex landscape of chronic cardiac dysfunction. The exploration of HF begins with an insightful journey into its diverse etiological factors, encompassing genetic predispositions, hypertension, and coronary artery disease. Delving into pathophysiological mechanisms, this review elucidates the intricate processes of cardiac remodeling, neurohormonal activation, and cellular dysfunction that underlie the progression of HF. Diagnostic modalities play a pivotal role in unraveling the mysteries of HF by examining advanced imaging techniques, biomarkers, and comprehensive clinical assessments. The pharmacological interventions section provides an in-depth analysis of traditional medications, such as diuretics and angiotensin-converting enzyme inhibitors, while highlighting the emergence of novel drug classes transforming HF management. Advocating lifestyle modifications emphasizes the crucial role of diet, exercise, smoking cessation, and alcohol moderation in enhancing patient outcomes. Lastly, the review delves into the promising horizon of emerging therapies, offering a glimpse into current research, innovative treatment approaches, and potential breakthroughs. As HF management faces challenges in patient compliance, healthcare access, and education, this comprehensive review aims to equip healthcare professionals and researchers with a holistic understanding of chronic cardiac dysfunction’s intricacies. In conclusion, synthesizing key findings emphasizes the need for an integrated and multidimensional approach to effectively address the complex landscape of heart failure.
Effect of individualized narrative nursing mode on recovery of elderly patients with fracture complicated with cerebrovascular accident
Authors: Wang Yurong , Zhang Fang , Li Cuihua
Published: January 2024

Fractures often occur in elderly patients. Osteoporosis caused by massive loss of calcium ions in the bones of elderly patients can easily lead to femoral fractures after suffering a low- and medium-energy injury. With the gradual entry of the aging society in China, the incidence of senile fracture is also gradually increasing. However, there is no report on the application of personalized narrative nursing to the mental health, cognitive function, and limb function recovery of elderly patients with fracture complicated with cerebrovascular accident, in order to enhance the cognitive level of elderly patients with fracture complicated with cerebrovascular accident. This study was specially conducted with a positive attitude toward the disease and improving the life quality. During July 2018 to July 2021, 80 elderly patients with fracture complicated with cerebrovascular accident cured were selected in our hospital. The patients were arbitrarily classified into an assigned control group (n = 40) and a study group (n = 40). The former received routine nursing, and the latter received personalized narrative nursing mode. The nursing satisfaction, functional independence scale (FIM), self-rating anxiety scale (SAS), self-rating depression scale (SDS), cognitive function, fracture healing time, length of hospital stays, and hospitalization expenses were compared. The study group had a satisfaction rate of 100.00%, while the control group had 87.50%. The nursing satisfaction of the study group was higher (P < .05). After 3 months of nursing, the FIM scores augmented. The FIM scores of upper and lower limbs in the study group were remarkably higher (P < .05). A decrease in SAS and SDS scores was observed. The SAS and SDS scores of the study group were lower (P < .05). Three months after discharge, the cognitive function score augmented. At 3 months after discharge, the study group had a higher cognitive function score (P < .05). The fracture healing time, length of stay, and cost of hospitalization in the study group were lower (P < .05). Personalized narrative nursing model can successfully enhance the mental health and cognitive function of elderly patients with fracture complicated with cerebrovascular accident, enhance the recovery of limb function, promote patients’ nursing satisfaction, and alleviate the economic burden.
Breast cancer: A review of risk factors and diagnosis
Authors: Obeagu Emmanuel Ifeanyi , Obeagu Getrude Uzoma
Published: January 2024

Breast cancer remains a complex and prevalent health concern affecting millions of individuals worldwide. This review paper presents a comprehensive analysis of the multifaceted landscape of breast cancer, elucidating the diverse spectrum of risk factors contributing to its occurrence and exploring advancements in diagnostic methodologies. Through an extensive examination of current literature, various risk factors have been identified, encompassing genetic predispositions such as BRCA mutations, hormonal influences, lifestyle factors, and reproductive patterns. Age, family history, and environmental factors further contribute to the intricate tapestry of breast cancer etiology. Moreover, this review delineates the pivotal role of diagnostic tools in the early detection and management of breast cancer. Mammography, the cornerstone of breast cancer screening, is augmented by emerging technologies like magnetic resonance imaging and molecular testing, enabling improved sensitivity and specificity in diagnosing breast malignancies. Despite these advancements, challenges persist in ensuring widespread accessibility to screening programs, particularly in resource-limited settings. In conclusion, this review underscores the importance of understanding diverse risk factors in the development of breast cancer and emphasizes the critical role of evolving diagnostic modalities in enhancing early detection. The synthesis of current knowledge in this review aims to contribute to a deeper comprehension of breast cancer’s multifactorial nature and inform future directions in research, screening strategies, and preventive interventions.
Patent vitellointestinal duct with ileal prolapse in a newborn: A case report and literature review
Authors: Chen Feng , Zeng Yong , Yue Lin-Lin , Xie Ming-Feng , Liu Hai-Jin
Published: January 2024

Rationale:

Patent vitellointestinal duct is the most common omphalomesenteric duct anomaly to present with symptoms.

Patient concerns:

A 10-day-old child presented with increase in the size of a polypoidal lesion into a large, “Y”-shaped reddish, prolapsing lesion, discharging gaseous, and fecal matter at her umbilicus. A laparoscopic exploration was performed, followed by wedge resection and anastomosis. No complications occurred during postoperative follow-up.

Diagnoses:

A patent vitellointestinal duct with ileal prolapse.

Interventions:

The resection of extended intraperitoneal intestinal tube was performed.

Outcomes:

During the follow-up 3 months after surgery, the umbilical cord of the child healed well after surgery.

Lessons:

Timely surgical treatment can minimize the occurrence of complications, and the overall prognosis is good after surgery.
Public knowledge and willingness in the use of public access defibrillation of Hubei Province in China: A cross-sectional study
Authors: Chen Kaiqi , Yuan Quan , Zeng Qianwen , Liu Mengwan , Hu Cuihuan
Published: January 2024

To understand the current status of public knowledge of automated external defibrillator (AED) and their willingness to use public AED in Hubei Province, along with the influencing factors. A self-designed questionnaire was used for convenience sampling of the public in Hubei Province. The questionnaire consists of three parts: basic information, AED knowledge questions, and willingness to use public AED and influencing factors. Data was collected between May 2022 and March 2023. A total of 1561 valid questionnaires were collected from 1602 distributed. In the study conducted in Hubei Province, it was found that 875 respondents (56.05%) had knowledge of automated external defibrillator, and they achieved an average score of 39.27 ± 29.17. The pass rate for the survey was 28.11%. Several factors were identified as significant influencing factors, including gender, age, education level, occupation related to medicine, residential location in the past three years, family members with cardiovascular disease, marital status, residential population density, whether there are family members over 65 years old, and participation in AED-related training (P < .05).Furthermore, 692 respondents (72.99%) expressed their willingness to cardiopulmonary resuscitation for someone experiencing cardiac arrest. On the other hand, 686 respondents (43.95%) had no knowledge of AED. Among those who were not willing to perform defibrillation, the highest percentages cited “fear of incorrect use” (129, 31.2%) and “fear of harming the patient” (121, 29.3%) as their reasons. The study also found statistically significant differences in the willingness to use public AED based on participation in training, education level, residential location, family members with cardiovascular disease, population density, and the presence of elderly family members aged 65 or over (P < .05). In conclusion, the study highlights the general lack of public knowledge regarding AED in Hubei Province. However, there is a strong willingness among respondents to provide help during cardiac arrest situations. To improve the chances of survival for cardiac arrest patients, it is crucial to strengthen public AED training programs.
Seroprevalence of varicella-zoster virus as measured by fluorescent antibody to membrane antigen assay and glycoprotein enzyme-linked immunosorbent assay more than 10 years after initiation of a universal vaccination program: An observational study
Authors: Ji Hye Seon , Kang Kyu Ri , Kang Hyun Mi , Choi Ui Yoon , Lee Soo Young , Kang Jin Han
Published: January 2024

Universal varicella vaccination (UVV), as a single dose to children aged 12 to 15 months, was introduced in Korea in 2005. A seroprevalence study is required to upgrade this UVV strategy. The fluorescent antibody to membrane antigen (FAMA) assay is the gold standard for varicella-zoster virus (VZV) immunity testing. However, no standard operating procedure (SOP) has been developed for the FAMA assay, in which either glutaraldehyde or acetone may be used for VZV-infected cell fixation. In this observational study, we aimed to investigate the age-specific seroprevalence in Korean children and adults. Additionally, with glycoprotein enzyme-linked immunosorbent assay (gpELISA) as the reference, we evaluated the performance of the FAMA assay using acetone-fixed cells.

Four hundred sera were analyzed using the FAMA assay (acetone-fixed cells) and gpELISA, comprising 50 subjects from each age category. In the FAMA assay, the seropositivity rate decreased from 82.0% in the 1 to 4-year-old group to 58.0% in the 5 to 9-year-old group (95% confidence interval [CI]: 69.2–90.2 and 44.2–70.6, respectively; P = .009), while that in the gpELISA decreased from 80.0% to 52.0% (95% CI: 67.0–88.8 and 38.5–65.2, respectively; P = .003). In both methods, the seropositivity rates ranged from 95% to 100% in the population aged ≥ 20 years. We observed a significant correlation between the 2 methods, with a correlation coefficient of 0.795 (P < .001). In receiver operating characteristic analysis using the gpELISA results as a reference, the area under the curve for the FAMA assay was very high at 0.995 (95% CI: 0.990–1.000; P < .001). Compared to the gpELISA, the sensitivity, specificity, and kappa value of the FAMA assay were 99.4%, 79.3%, and 0.84 (nearly perfect), respectively. The seropositivity rate of the 5 to 9-year-old group indicated waning immunity over time and supported implementation of a second dose in the UVV program. The results of the FAMA assay were comparable to those of the gpELISA. Although further study is needed to standardize procedures, our results suggest that the FAMA assay using acetone-fixed cells can be used widely and can be included in a universal FAMA assay SOP.
Analysis of the safety and effectiveness of endoscopic nasal dacryocystorhinostomy in the remedy of chronic dacryocystitis
Authors: Li Mingzhe , Li Wenping , Sha Qian , Yu Liuying , Wang Xuefei
Published: January 2024

To estimate the safety and effectiveness of endoscopic nasal dacryocystorhinostomy in the remedy of chronic dacryocystitis. The clinical data of 105 subjects with chronic dacryocystitis enrolled into our hospital were analyzed retrospectively. The subjects were distinguished into nasal endoscopic group (endoscopic dacryocystorhinostomy; i.e., 51 cases) according to their surgical methods and external-route group (external-route dacryocystorhinostomy; i.e., 54 cases). The therapeutic effect, lacrimal gland secretion function, tear film stability, degree of epiphora, lacrimal passage patency, complications, and recurrence rate were contrasted between the 2 groups. The nasal endoscopic group exhibited a higher effective remedy rate (98.04%) compared with the external-route group (83.33%). Three months postoperation, both groups showed improvements in lacrimal gland secretion function and tear film stability, with the nasal endoscopic group demonstrating more significant enhancement in lacrimal gland secretion function than the external-route group. Six months postoperation, a reduction in the degree of epiphora was observed in both groups, with the nasal endoscopic group displaying a more pronounced decrease in epiphora severity and a higher lacrimal passage patency rate than the external-route group. Furthermore, the nasal endoscopic group experienced lower incidences of postoperative complications and recurrence rates. Endoscopic dacryocystorhinostomy is safe and effective in the remedy of chronic dacryocystitis.
Value of Bax and Bcl2 expression in peripheral blood mononuclear cells for clinical prognosis of patients with chronic heart failure
Authors: Chen Yangang , Li Shuiquan , Yang Zhenwen , Wang Tianlu , Yin Fahui , Zhao Xiangyu , Zhang Yong
Published: January 2024

To investigate the expression of Bax and Bcl2 protein in peripheral blood mononuclear cells (PBMC) of patients with chronic heart failure (CHF), and to analyze their value for predicting major adverse cardiovascular event (MACE) in CHF patients. A total of 154 fasting venous blood samples from CHF patients were collected in our hospital from January 2017 to June 2019, and they were divided into 2 group according to whether MACE occurred during 3 years follow-up, MACE group and No-MACE group. Levels of Bax and Bcl2 protein expression in PBMC of CHF patients using enzyme-linked immunosorbent assay (ELISA), and then evaluated the predictive power of Bax and Bcl2 expression for MACE using logistic regression analysis and ROC curve. 62 (40.26%) of 154 CHF patients occurred MACE during follow-up, and there were significant differences in age, diabetes, LVEF, LDL-C and NYHA grade between MACE group and No-MACE group. Levels of Bax protein expression in PBMC of CHF patients in MACE group were significantly higher than those in No-MACE group, while levels of Bcl2 protein expression were significantly lower than those in No-MACE group, and Bax and Bcl2 protein levels increased and decreased with NYHA grades in MACE group and No-MACE group, respectively. Results of univariate and multivariate logistic regression analysis showed that Bax (OR, 1.026; 95% CI, 1.003–1.049; P = .027) and Bcl2 levels (OR, 0.952; 95% CI, 0.908–0.998; P = .041) were independent predictive factors for MACE in CHF patients. In addition, Bax and Bcl2 levels could be used to differentiate CHF patients at risk for MACE with an AUC of 0.744 (95% CI: 0.660–0.827) and an AUC of 0.743 (95% CI: 0.667–0.819), respectively. Levels of Bax and Bcl2 protein in PBMC could be used as independent predictive factors for MACE in CHF patients.
Banxia Baizhu Tianma Tang decoction and modified Taohong Siwu combined with Western medicine to treat a patient with severe stenosis of the middle cerebral artery: A case report
Authors: Shu Lingfeng , Dai Qinghai , Zhu Pengcheng , Tan Hongtu , Wu Tao
Published: January 2024

Rationale:

Intracranial artery stenosis is an important cause of ischemic stroke, and MCA is one of the most common vessels causing intracranial artery stenosis. At present, there are 3 main treatments for MCA stenosis: medical drug therapy, surgery, and endovascular interventional therapy.

Patient concerns:

We report a patient with severe middle cerebral artery stenosis, including his imaging and clinical manifestations.

Diagnosis:

Severe stenosis of middle cerebral artery.

Interventions:

Banxia Baizhu Tianma decoction combined with Taohong Siwu decoction combined with western medicine.

Outcomes:

The stenosis of M1 segment of middle cerebral artery was significantly improved, the stenosis rate was reduced from 70% to 30%, and the clinical symptoms of the patients basically disappeared.

Lessons:

Banxia Baizhu Tianma decoction combined with Taohong Siwu plus subtraction combined with western medicine is effective in the treatment of middle cerebral artery stenosis.
Can 3D radiological calculations predict operational difficulties for rectal cancer?: A single center retrospective analysis
Authors: Yasar Necdet Fatih , Gundogdu Elif , Yilmaz Arda Sakir , Badak Bartu , Bayav Fatma Didem , Ozen Alaattin , Oner Setenay
Published: January 2024

Low anterior resection, performing total mesorectal excision with appropriate pelvic dissection to prevent local recurrence, is probably the most challenging type of surgery in colorectal surgery, especially in a narrow pelvis. In this study, we aimed to predict the operation difficulty of rectal cancer by comparing the operation time with 2D and 3D pelvimetry. Sixty-six patients who underwent total mesorectal excision after neoadjuvant chemoradiotherapy due to primary rectal cancer located in the middle and lower rectum (10 cm from the anus) were included in the study. Surgery notes were reviewed and data on demographic factors, tumor stage, duration of surgery, and types of surgery were collected, as well as pelvimetric parameters. All protocols had 2D T2-weighted sequences in 3 planes (axial, sagittal, and coronal). Pelvimetric measurements were made by measuring 8 pelvic lengths and 2 angles. Pelvis and tumor volume were measured by manual margin monitoring. In each slice, both pelvis and tumor boundaries were manually drawn individually in the sagittal plane. Pelvis and tumor volumes were calculated from the set of adjacent images by summing slice thickness and products of area measurements within the pelvis and tumor boundaries. In our results, no correlation was observed with operation time, including pelvic volume. Exception for this were interacetabular distance and tumor volume. In the regression test, the only parameter that correlated with the operation time was tumor volume. In conclusion, we believe that tumor volumetric calculations may be useful in predicting difficult distal rectal carcinoma surgeries.
Investigation of the recurrent vitreous hemorrhage risk factors after early 25G vitrectomy in diabetic vitreous hemorrhage
Authors: Yilmaz Uğur , Akçaoğlu Tahsin , Avunduk Murat Avni , Kaya Hüseyin , Parça Osman
Published: January 2024

Vitreous hemorrhage (VH) is one of the main causes of vision loss in diabetic retinopathy (DRP). Early surgery increases the visibility of the retina, allowing early recognition of DRP complications and additional treatments. One of the most important reasons affecting success after surgery is recurrent vitreous hemorrhage (RVH). We aimed to investigate the risk factors for RVH after early 25G vitrectomy in diabetic VH. Eighty eyes of eighty patients who underwent early 25G PPV surgery with a diagnosis of VH due to proliferative diabetic retinopathy (PDR) were included in this retrospective study. Vision acuity changes and intraocular pressure (IOP) changes were compared. The effect of arterial hypertension (HT), coronary artery disease (CAD), preoperative antiglaucomatous usage, and anticoagulant usage on RVH was investigated. A value of P < .05 was accepted as statistically significant. Postoperative RVH was observed in 18 (22.5%) patients. There was no correlation between the age of the patients and the development of postoperative RVH (r = −0.197, P = .08). The rate of HT and the mean HbA1C levels were found to be higher in the patients who developed RVH than in those who did not (P = .04 and < 0.001, respectively). The presence of CAD, preoperative glaucoma disease, and the use of anticoagulants did not have any effect on RVH (P = .229, 0.843, 0.932, respectively). HT and increased HbA1c were found to be risk factors for RVH in VH patients who underwent 25G vitrectomy in the early period in our study.
Perceptions of organizational value and unethical/deviant behaviors among lecturers in Archeology and Religion and Cultural Studies: An intervention study
Authors: Chukwuma Joseph Nnaemeka , Ede Moses Onyemaechi , Chukwuma Ifeoma Salome , Izueke Eddy M. , Ejikeme Joy Nneka Uchenye , Madukwe Chinyere Isaac , Ibenwa Christopher N. , Uzochukwu Nnadi Fabian , Anyaehie Michael Chigozie , Omali Obiageli Kay Nkechi , Nnadi Christian Ikechukwu , Ijeudo Nnamdi Ugochukwu , Ononogbu David C. , Ngele Omaka Kalu , Nyakuwa Robert , Ogbochie Andrew Nnabuchi
Published: January 2024

Background:

Understanding an organization’s ethical standards assists employees in abiding by stipulated rules and regulations and reduces the prevalent rate of inappropriate behaviors. Unfortunately, some workers do not know and as a result, they become dysfunctional, affecting their professional identities. Given this, scholars have called for psychoeducational strategies that coach workers to improve their perceptions. With this in mind, we investigated the impact of psychoeducational coaching on workplace ethical perceptions and deviant behaviors among lecturers in Archeology and Religion and Cultural Studies.

Methods:

A group randomized control design was adopted, and a sample of lecturers was assigned to intervention and control groups using a simple allocation sequence method. Three dependent measures were used to assess the participants’ irrational beliefs, work values, and deviant behaviors before the intervention, after, and 2 months later as a follow-up test. Data collected were cued into SPSS version 28. A multivariate analysis was performed to test postulated hypotheses at .05 probability level.

Results:

The results showed that rational-emotive behavior occupational coaching has a significant impact on reducing unethical work values and work-deviant behaviors among lecturers in Archeology and Religion and Cultural Studies. The finding of this study justified the effectiveness of rational-emotive behavior therapy (REBT) approaches in treating irrational beliefs that occasioned work-deviant behaviors among the employees.

Conclusion:

It is concluded in this study that rational-emotive behavior occupational coaching is beneficial and effective in decreasing unethical work values and work-deviant behaviors among lecturers in Archeology and Religion and Cultural Studies. Therefore, REBT practitioners should liaise with lecturers in Archeology and Religion and Cultural Studies to advance the practice of REBT in workplaces.
Unraveling the mystery of fever of unknown origin: a remarkable journey towards the diagnosis of peripheral T-cell lymphoma-T follicular helper type: A rare case report
Authors: Trifonov Petar I. , Koltchakov Vesselin K. , Mihaylova-Garnizova Raynichka P. , Yordanov Aleksandar Y. , Sokolova Liliya , Nikolov Rosen K. , Krastev Zahariy A.
Published: January 2024

Introduction:

Fever of unknown origin (FUO) remains one of the most challenging clinical conditions. It demands an exhaustive diagnostic approach, considering its varied etiologies spanning infectious, autoimmune, inflammatory, and malignant causes.

Patient concerns:

This report shows the journey of diagnosing a 28-year-old male who presented with persistent fever and lower-extremity weakness over 9 months. Despite seeking care at multiple hospitals, a definitive diagnosis remained elusive.

Diagnosis:

The patient underwent a series of evaluations in various specialties, including gastroenterology, infectious diseases, rheumatology, hematology, and cardiology. Multiple tests and treatments were administered, including antiviral therapy for hepatitis B and antibiotics for suspected infections.

Interventions:

After an initial misdiagnosis and unsuccessful treatments, a positron emission tomography-computed tomography scan and lymph node biopsy ultimately led to the diagnosis of peripheral T-cell lymphoma-T follicular helper type (PTCL-TFH) lymphoma. The patient was referred to the hematology clinic and initiated on CHOEP (cyclophosphamide, vincristine, etoposide, and prednisone) chemotherapy.

Outcomes:

The patient showed a positive response to CHOEP therapy, as indicated by a posttreatment positron emission tomography-computed tomography scan. He reported a significant improvement in his quality of life. Additional rounds of the same regimen were planned to further manage the lymphoma.

Conclusion:

This case emphasizes the importance of a comprehensive and persistent diagnostic approach in managing FUO. Initially, the focus on infectious causes led to extensive treatments, but the disease’s progression and complications shifted attention to other specialties. The eventual diagnosis of PTCL-TFH lymphoma highlights the significance of advanced imaging techniques and multidisciplinary collaboration in uncovering elusive diagnoses. Thorough surveillance, timely reassessments, and repeated testing can uncover definitive changes critical for diagnosis. PTCL-TFH lymphoma, although rare, should be considered in the differential diagnosis of FUO, especially when initial evaluations are inconclusive.
Global trends and development of acupuncture for stroke: A review and bibliometric analysis
Authors: Cheng Chang-Jiang , Yu Hai-Bo
Published: January 2024

The objective of this review is to elaborate on the status, hotspots, and trends of researches on acupuncture for stroke over the past 26 years. Publications about acupuncture for stroke were downloaded from the Web of Science Core Collection, and these papers were published up to December 31, 2022. A bibliometric analysis of acupuncture for stroke was conducted by CiteSpace (6.2.R4) and VOSviewer (1.6.17). In this study, VOSviewer was used for visual analysis of countries, institutions, authors, journals, keywords, and co-cited references. CiteSpace was used to draw a keyword burst map and a co-cited reference burst map. A total of 534 papers were obtained from the Web of Science Core Collection. The number of papers per year showed a rapid upward trend. The most productive country and institution in this field were China (452) and the Fujian University of Traditional Chinese Medicine (43), respectively. Tao Jing had the highest number of articles (34), and EZ Longa was the most popular author (129 co-citations). Neural Regeneration Research (51) was the most productive journal, and Stroke (1346) was the most co-cited journal. An paper written by EZ Longa was the most influential reference, with the highest citation count. The hotspots and frontiers of this area of research were focused on the mechanisms of acupuncture, especially its neural regenerative or neuroprotective effects. This study used CiteSpace and VOSviewer for bibliometric analysis to provide researchers with information on the research status, hotspots, and trends in acupuncture for stroke research over the past 26 years.
Lung adenocarcinoma with brain metastasis detected dual fusion of LOC399815-ALK and ALK-EML4 in combined treatment of Alectinib and CyberKnife: A case report
Authors: Li Yumei , Lu Shijin , Yao Ping , Huang Wenchuang , Huang Yong , Zhou Ying , Yuan Ying , Cheng Shaochen , Wu Fasheng
Published: January 2024

Introduction:

The anaplastic lymphoma kinase (ALK) gene fusion occurs in approximately 3% to 7% of nonsmall cell lung cancer (NSCLC), in which occurs approximately 23% to 31% of brain metastasis patients in poor prognosis. ALK tyrosine kinase inhibitors have shown efficacy in treating ALK-positive (ALK+) NSCLC. More than 90 distinct subtypes of ALK fusions have been identified through sequencing technique and would lead to significant differences in clinical efficacy, it is necessary to guide clinical treatment effectively by gene detection.

Patient concerns:

A 56-year-old nonsmoking female admitted to hospital due to cough, expectoration, and chest pain. Chest computed tomography revealed a space-occupying lesion in the upper left lobe (5.0 cm × 2.4 cm × 2.9 cm), multiple enlarged lymph nodes in mediastinum 3A and 5 (largest size 1.5 cm × 1.4 cm), and evidence of thoracic vertebral metastasis, brain magnetic resonance imaging also showed brain metastasis.

Diagnoses:

Lung adenocarcinoma with brain metastasis.

Interventions:

The patient initially received conventional first-line chemotherapy, which led to a deteriorated condition. Blood-base liquid biopsy by next-generation sequencing resulted in double ALK fusions, in which with a neo-partner of lncRNA (LOC399815-ALK). Following subsequent treatment with Alectinib and stereotactic radiotherapy (CyberKnife) was subsequently employed to manage the brain metastatic lesions, resulting in a substantial decreased in both the number and size of tumor lesions.

Outcomes:

The patient’s response to therapy efficacy resulted in a substantial decreased in both the number and size of tumor lesions that assessed comprehensively evaluated through computed tomography imaging and ctDNA sequencing. Patient’s condition has been under control for over 29 months.

Conclusion:

Liquid biopsy may reveal the rare fusion forms of ALK, precisely guiding personalized treatment, and providing a reference method for longitudinal monitoring and efficacy evaluation of ALK-tyrosine kinase inhibitors in NSCLC patients.
Primary multiple endocrine insufficiency during immune checkpoint inhibitor treatment: A case report
Authors: Wang Yaning , Zhao Peng , Zhao Ziyun , Yang Hai , Zhang Fanghua
Published: January 2024

Rationale:

Immunotherapy with immune checkpoint inhibitors (ICI) has shown promising activity against many tumor types. However, they can also induce a wide array of immune-related adverse events, ranging from mild to fatal. Primary 3 endocrine gland insufficiency during treatment with ICI has rarely been reported.

Patient concerns:

We report the case of a 33-year-old man with Ewing sarcoma who was treated with toripalimab as a second-line treatment. Approximately 11 months after initiating treatment, the patient developed subclinical hypothyroidism, which was followed by adrenal insufficiency and hypogonadism 6 months later. Consequently, the decision was made to discontinue ICI therapy and initiate hormone replacement therapy to manage endocrine deficiencies.

Diagnoses:

Serum adrenocorticotropic hormone, thyroid stimulating hormone, and prolactin levels increased significantly, while cortisol, estradiol, and testosterone levels decreased (Table 1). The patient had negative findings on the pituitary MRI.

Intervention:

As part of the management strategy, ICI therapy was ceased and hormone replacement therapy was commenced to address endocrine deficiencies.

Outcomes:

After hormone replacement therapy, his symptoms improved and follow-up examinations showed normalization of hormone levels.

Lessons:

Clinicians should be aware of the potential of immune checkpoint inhibitor therapy to cause endocrine dysfunction. Prompt recognition and management of these adverse events are crucial for patient health and quality of life.
Huge hypertrophic scar secondary to chronic ingrown toe nail mimicking tumor: A case report
Authors: Ju Baruenchan , Lee Young Sang , Kim Dong Hee , Lee Kwang-Bok
Published: January 2024

Rationale:

A huge hypertrophic scar formation secondary to chronic ingrown toe nail mimicking tumor is a rare disease. It is not only causing concerns cosmetically, but also hindering normal daily activities physically and socially. In this paper, we present an unusual case of bilateral ingrown nails with different phases. One resulted in a large hypertrophic scar caused by stimulation from secondary to chronic ingrown nail.

Patient concerns and diagnosis:

A 44-year-old man with a huge mass (7 × 4 × 8.5 cm) in his right great toe and inflamed ingrown nail in his left great toe visited the clinic. The mass in the right toe showed an irregular and bizarre shape with a stellate ulcer (2 × 2 cm) at the distal end. After removing an ingrown nail 3 years ago with minor repetitive trauma, self-managed wound has grown into a tumor-like mass, resulting in intolerable discomfort. In gross appearance, a stalk appeared to originate from the lateral side of the nail bed with the ingrown nail in the great toe showing inflamed medial and lateral gutter and causing redness and tenderness. Huge hypertrophic scar formation secondary to chronic ingrown toe nail mimicking tumor is a rare disease that is not only causing a cosmetic concern, but also hindering normal daily activities physically and socially.

Intervention and outcomes:

Excisional biopsy was performed for both great toes. Biopsy confirmed chronic ulcerative inflammation with a hypertrophic scar. The resection site healed and persisted well at 12 months after surgery.

Conclusion:

Our unusual case suggests that the natural course of an untreated ingrown toe nail may result in hypertrophic scar extending far to mimic tumorous conditions.
Solid basal adenoid cystic carcinoma of the breast: A case report and literature review
Authors: Gou Wen Bin , Yang Yong Qiang , Song Bei Wen , He Pei
Published: January 2024

Rationale:

Adenoid cystic carcinoma (AdCC) is a rare malignancy of the breast with a low Ki-67 index and good prognosis. Owing to the rarity of breast AdCC, the misdiagnosis rate is as high as 50%, and there is no consensus or recognized guidelines for the treatment of this disease. Therefore, it is necessary to conduct a detailed clinical and pathological analysis in combination with a literature review to improve our understanding, diagnosis, and treatment of the disease.

Methods:

A 68-year-old woman sought medical attention due to a recently increasing mass in the breast. The left breast mass was 1.3 cm × 1 cm in size. We analyzed the morphology, immunohistochemistry, and molecular characteristics of the tumor removed by surgery, and reviewed relevant literature.

Diagnoses:

Solid basal AdCC of the breast.

Interventions:

We performed biopsy, immunohistochemistry and molecular testing on surgical resection specimens.

Outcomes:

Combining morphological and immunohistochemical features, it is consistent with solid basal AdCC of the breast, and Fish detected MYB gene break.

Lessons:

Due to the high misdiagnosis rate of AdCC, accurate histopathological diagnosis is particularly important. At present, breast conserving surgery and local tumor resection are mainly used for the treatment of breast AdCC, and postoperative adjuvant radiotherapy is feasible.