bluuebunny/crossref_metadata_2025 huggingface dataset:
Construction and analysis of a survival-associated competing endogenous RNA network in breast cancer
Authors: Chen Gang , Li Yalun , Cao Jianqiao , Dai Yuanping , Cong Yizi , Qiao Guangdong
Published: January 2023

Background

Recently, increasing studies have shown that non-coding RNAs are closely associated with the progression and metastasis of cancer by participating in competing endogenous RNA (ceRNA) networks. However, the role of survival-associated ceRNAs in breast cancer (BC) remains unknown.

Methods

The Gene Expression Omnibus database and The Cancer Genome Atlas BRCA_dataset were used to identify differentially expressed RNAs. Furthermore, circRNA-miRNA interactions were predicted based on CircInteractome, while miRNA-mRNA interactions were predicted based on TargetScan, miRDB, and miRTarBase. The survival-associated ceRNA networks were constructed based on the predicted circRNA-miRNA and miRNA-mRNA pairs. Finally, the mechanism of miRNA-mRNA pairs was determined. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of survival-related mRNAs were performed using the hypergeometric distribution formula in R software.The prognosis of hub genes was confirmed using gene set enrichment analysis.

Results

Based on the DE-circRNAs of the top 10 initial candidates, 162 DE-miRNAsand 34 DE-miRNAs associated with significant overall survival were obtained. The miRNA target genes were then identified using online tools and verified using the Cancer Genome Atlas (TCGA) database. Overall, 46 survival-associated DE-mRNAs were obtained. The results of GO and KEGG pathway enrichment analyses implied that up-regulated survival-related DE-mRNAs were mostly enriched in the “regulation of cell cycle” and “chromatin” pathways, while down-regulated survival-related DE-mRNAs were mostly enriched in “negative regulation of neurotrophin TRK receptor signaling” and “interleukin-6 receptor complex” pathways. Finally, the survival-associated circRNA-miRNA-mRNA ceRNA network was constructed using 34 miRNAs, 46 mRNAs, and 10 circRNAs. Based on the PPI network, two ceRNA axes were identified. These ceRNA axescould be considered biomarkers for BC.GSEA results revealed that the hub genes were correlated with “VANTVEER_BREAST_CANCER_POOR_PROGNOSIS”, and the hub genes were verified using BC patients' tissues.

Conclusions

In this study, we constructed a circRNA-mediated ceRNA network related to BC. This network provides new insight into discovering potential biomarkers for diagnosing and treating BC.
Efficacy and safety of prophylactic intraoperative sac embolization in EVAR for abdominal aortic aneurysm: A meta-analysis
Authors: Chen Quan , Zhang Yuan , Lei Kangqing , Fu Liangyin , Zhang Dengxiao , Sun Wanli , Shi Chaohai , Niu Qibing
Published: January 2023

Objective

We aimed to investigate the effectiveness and safety of prophylactic sac embolization during endovascular aneurysm repair (EVAR) in patients suffering from abdominal aortic aneurysms.

Methods

We performed a systematic literature search of PubMed, Web of Science, EMbase, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP, Wanfang and China Biomedical Literature Database (CBM) to identify studies evaluating the outcomes of sac embolization vs. no embolization among patients who had received EVAR. The time limit of the search was from the establishing database to July 22, 2022. Outcome measures involved the type II endoleak rate, the other endoleak rate, the reintervention rate, mortality, and operation time. Fixed (no heterogeneity) or random effects models were constructed for each outcome. The outcomes are represented as the odds ratio (OR) with a 95% confidence interval (CI).

Results

Among the 2,622 studies screened, 13 studies involving 747 participants were included in the review. The incidence of early-term type II endoleak (OR = 0.2, 95% CI (0.13,0.31), P < 0.00001), mid-term type II endoleak (OR = 0.23, 95% CI (0.15,0.37), P < 0.00001), late-term type II endoleak (OR = 0.27, 95% CI (0.16,0.46), P < 0.00001) and reintervention (OR = 0.50, 95% CI (0.37,0.78), P = 0.002) within the sac embolization group were significantly lower than those in the non-embolization group. No significant differences were observed between the two groups were found for the other endoleak rates (OR = 0.67, 95% CI (0.34,1.32), P = 0.25), mortality (OR = 0.64, 95% CI (0.25,1.66), P = 0.36) and operation time operation (MD = 5.76, 95% CI (-8.30,19.83), P = 0.42).

Conclusions

EVAR combined with sac embolization effectively reduces the incidence of type II endoleak and the reintervention rate without enhancing the operation time. Therefore, more high-quality studies are still needed for validation due to the limited amount and quality of included literature.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022365648.
Prognostic significance of tumor regression grade in esophageal squamous cell carcinoma after neoadjuvant chemoradiation
Authors: Zhang Chi , Xu Fei , Qiang Yong , Cong Zhuang-Zhuang , Wang Qin , Zhang Zheng , Luo Chao , Qiu Bing-Mei , Hu Li-Wen , Shen Yi
Published: January 2023

Backgrounds

Trimodal therapy (neoadjuvant chemoradiotherapy followed by esophagectomy) for locally advanced esophageal squamous cell carcinoma (ESCC) is associated with a significant survival benefit. Modified Ryan score is an effective tool to evaluated the tumor regression grade (TRG) after neoadjuvant therapy. The aim of this study was to evaluate the prognostic value of TRG for overall survival (OS) and disease-free survival (DFS) in ESCC patients undergoing neoadjuvant chemoradiation.

Methods

The study retrospectively reviewed 523 ESCC patients who underwent neoadjuvant chemoradiotherapy and radical esophagectomy at Jinling Hospital from January 2014 to July 2020. Kaplan–Meier curves with log-rank test and Cox regression model were used to evaluate the prognostic factor of TRG based on modified Ryan scoring system on OS and DFS.

Results

After application of inclusion and exclusion criteria, 494 patients with ESCC following neoadjuvant chemoradiotherapy and radical esophagectomy were available for analysis. The TRG scores are significantly associated with smoke history (p = 0.02), lymphovascular invasion (LVI) and/or peripheral nerve invasion (PNI) (p < 0.01), and postoperative adjuvant therapy (p < 0.01). Meanwhile, tumor characteristics including tumor length (p < 0.01) and tumor differentiation grade (p < 0.01) are also significantly associated with TRG score. The results of multivariable Cox regression modal showed that TRG is not an independently prognostic factor for OS (p = 0.922) or DFS (p = 0.526) but tumor length is an independently prognostic factor for DFS (p = 0.046).

Conclusions

This study evaluated the prognostic value of modified Ryan scoring system for ESCC after trimodal therapy and concluded that modified Ryan scoring system can predict survival and recurrence rates but is not an independently prognostic factor for OS and DFS.
Opioid-free anesthesia for postoperative recovery after video-assisted thoracic surgery: A prospective, randomized controlled trial
Authors: Wang Xu-ru , Jia Xiao-yu , Jiang Yan-yu , Li Zhen-ping , Zhou Qing-he
Published: January 2023

Purpose

Opioid-based anesthesia is a traditional form of anesthesia that has a significant analgesic effect; however, it can cause nausea, vomiting, delirium, and other side effects. Opioid-free anesthesia with dexmedetomidine and lidocaine has attracted widespread attention. This study aimed to compare the effects of opioid-free and opioid-based anesthesia (OFA and OBA, respectively) on postoperative recovery in patients who had undergone video-assisted thoracic surgery.

Methods

Eighty patients undergoing video-assisted thoracic surgery were assigned to receive either opioid-free anesthesia (OFA group) or opioid-based anesthesia (OBA group) according to random grouping. The primary outcome of the study was the quality of recovery-40 scores (QoR-40) 24 h postoperatively. The secondary outcome measure was numerical rating scale (NRS) scores at different times 48 h postoperatively. In addition to these measurements, other related parameters were recorded.

Results

Patients who received opioid-free anesthesia had higher QoR-40 scores (169.1 ± 5.1 vs. 166.8 ± 4.4, p = 0.034), and the differences were mainly reflected in their comfort and emotional state; however, the difference between the two groups was less than the minimal clinically important difference of 6.3. We also found that the NRS scores were lower in the OFA group than in the OBA group at 0.5 h (both p < 0.05) and 1 h (both p < 0.05) postoperatively and the cumulative 0–24 h postoperative dosage of sufentanil in the OBA group was higher than that in the OFA group (p = 0.030). There were no significant differences in postoperative nausea and vomiting (PONV) (p = 0.159). No surgical or block complications were observed between the groups.

Conclusion

Opioid-free analgesia potentially increased the postoperative recovery in patients who underwent video-assisted thoracic surgery.

Trial registration

The study protocol was registered in the Chinese Clinical Trial Register under the number ChiCTR2100045344 (http://www.chictr.org.cn/showproj.aspx?proj=125033) on April 13, 2021.
Clinical significance and prognostic value of receptor conversion after neoadjuvant chemotherapy in breast cancer patients
Authors: He Yang , Zhang Jing , Chen Hui , Zhou Ying , Hong Liping , Ma Yue , Chen Nannan , Zhao Weipeng , Tong Zhongsheng
Published: January 2023

The hormone receptor (HR) status and human epidermal growth hormone receptor 2 (HER2) status of patients with breast cancer may change following neoadjuvant chemotherapy (NAC). We retrospectively analyzed the clinical data of 294 patients with stage II/III breast cancer to evaluate the clinical significance and prognostic value of receptor transformation after NAC in breast cancer patients. Pathological complete response after NAC was achieved in 10.7% of patients. HR, estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki-67 conversion rates were 9.2%, 6.5%, 13.0%, 4.4%, and 33.7%, respectively. Patients with stable HR (P = 0.01) and HER2 (P = 0.048) expression had more favorable overall survival (OS). Low or reduced Ki-67 expression was associated with better disease-free survival (DFS) (P < 0.001) and OS (P < 0.01). Multivariate analysis showed that the number of lymph nodes after NAC, HR conversion, and radiotherapy were independent prognostic factors for overall survival. HR conversion implied a higher risk of death [hazard ratio, 2.56 (95% confidence interval: 1.19–5.51); P = 0.016]. Patients with HR conversion after NAC who received endocrine therapy had better DFS (P = 0.674) and OS (P = 0.363) than those who did not receive endocrine therapy, even if the HR changed from positive to negative. In conclusion, pathological testing should be performed before and after NAC, and even patients with HR conversion after NAC might benefit from endocrine therapy.
Recurrent lung adenocarcinoma benefits from microwave ablation following multidisciplinary treatments: A case with long-term survival
Authors: Jiang Guanyu , Song Chenghu , Xu Yongrui , Wang Shengfei , Li Huixing , Lu Rongguo , Wang Xiaokun , Chen Ruo , Mao Wenjun , Zheng Mingfeng
Published: January 2023

Lung cancer has become the leading cause of cancer death all over the world. Nowadays, there is a consensus that the treatment of non-small cell lung cancer (NSCLC) prefers a combination of multidisciplinary comprehensive treatment and individualized treatment, which can significantly improve the prognosis of patients. Here, we report a female patient with recurrence-prone NSCLC. She had a decade-long disease course, during which the lesion recurred twice and finally cured with Multi-Disciplinary Treatment (MDT). An elderly female patient was admitted to the hospital after diagnosis of lung cancer, and treated with surgery and postoperative adjuvant chemotherapy. Five years later, suspicious lesions were found by computed tomography (CT) reexamination, and then confirmed tumor recurrence by puncture biopsy. Based on the genetic test results, gefitinib was used for subsequent targeted therapy, and the lesion gradually shrunk to disappear. However, the lesion appeared again two years later, after consultation the microwave ablation was adopted and the curative effect was excellent. At last, regular reexamination showed no abnormality, the patient has survived so far. The case proves the great benefit of multidisciplinary comprehensive treatment, especially microwave ablation for patient with recurrence-prone NSCLC. And the effect of systemic anti-tumor immune response induced by microwave ablation on lung cancer also needs to be further explored.
Short- and long-term outcomes of laparoscopic low anterior resection with “dog ear” invagination anastomosis for mid and distal rectal cancer a propensity score matched analysis
Authors: Zhang L. , Xie Z. , Gong L. , Lv X.
Published: January 2023

Background

The lateral intersecting margin (dog-ear) was a weak spot of the double stapled technique (DST), We designed “dog-ear” invagination anastomosis (DAIA), which could eliminate the “dog-ear” in laparoscopic anterior resection.

Patients and methods

A total of 202 patients underwent elective curative LLAR + DST (n = 143) or LLAR + DAIA (n = 59) were enrolled in the study. Propensity score matching (PSM) was used to minimize the adverse effects. The clinical data between LLAR + DST and LLAR + DAIA was compared, and the effect of factors on overall survival (OS) and disease-free survival (DFS) was analyzed.

Results

After PSM, 53 pairs of the LLRA + DST and LLRA + DAIA patients were enrolled in the study. The LLRA + DAIA group has a higher level (3.50 ± 1.03 vs. 2.87 ± 1.10, P = 0.01) of the anastomosis than that of the LLRA + DST group. Patients in LLAR + DAIA group have a lower incidence of protecting loop ileostomy compared to LLAR + DST group (20.75% vs. 5.66%, P < 0.05). The LLRA + DAIA patients presented better rates of LARS compare to LLRA + DST patients at 6 months (major LARS 37.74% (n = 20) vs. 67.93% (n = 36); P = 0.007) and 12 months (major LARS 13.21% (n = 7) vs. 20.37% (n = 11); P = 0.03) after surgery. The OS and DFS rates were similar (P > 0.05).

Conclusion

Laparoscopic low anterior resection with “dog-ear” invagination anastomosis technique are well-established procedures for patients with low rectal cancer. “Dog-ear” invagination anastomosis technique may reduce the incidence of protecting loop ileostomy and significantly affect LARS score, and demonstrate a positive impact on the quality of life after surgery.
Anesthesia mumps with airway obstruction after radical nephrectomy: A case report and literature review
Authors: Li Wanqiang , Liao Zhengquan , Yao Ling , Zhang Lusheng , Li Xuesong , Dong Ziqiang
Published: January 2023

Anesthesia mumps have rarely been reported. This article presents the diagnosis and treatment of a case of anesthesia mumps with airway obstruction in the urology department and reviews previous cases of the disease. A 58-year-old man had a history of hypertension and diabetes, and his blood pressure and glucose levels were well controlled. He underwent laparoscopic radical nephrectomy for a right renal tumor. Postoperatively, a swelling of approximately 5 × 4 cm was observed in the left parotid region and left eyelid, no palpable crepitation was detected, and the skin overlying the left parotid gland was mildly hyperemic and tender. Enhanced computed tomography of the head and neck revealed obvious swelling of the laryngopharyngeal airway, and electronic laryngoscopy showed narrow airway. Laboratory test results including white blood cell count, C-reactive protein, serum amylase, and lipase levels were normal. Glycosylated hemoglobin level was 6.8%, and the salivary culture from Stensen's duct was negative. The patient was managed with endotracheal intubation and a ventilator to maintain breathing along with anti-infection, expectorant, and symptomatic treatment. The swelling in the left parotid gland gradually resolved without recurrence, and the patient was extubated on the 7th postoperative day. In this case, the pathophysiology of anesthesia mumps may have been related to the incorrect positioning of the thick short neck and the use of a head ring, which can result in the squeezing of vessels. In most cases, the salivary gland swelling resolves with observation and symptomatic treatment. In patients with anesthesia mumps, emergency airway management and careful observation are necessary if upper airway obstruction occurs. This case report should increase awareness of anesthesia mumps and its complications among anesthesiologists, surgeons, and postoperative caregivers.
Clinical characteristics and identification of risk factors of testicular torsion in children: A retrospective study in a single institution
Authors: Zhang Kaiping , Zhang Yin , Chao Min
Published: January 2023

Background

Testicular torsion (TT) is a common urological emergency posing serious health problem in children. Prompt diagnosis and treatment of TT are very important for children to protect the affected testis. The aim of this study was to evaluate the historical features, physical examination findings, laboratory tests, and ultrasound examinations in children with TT, as well as to identify the predictors of testicular salvage in children.

Materials and methods

We conducted a retrospective record of clinical findings, laboratory data, ultrasound findings, operating results, and the results of follow-up in hospitalized children with TT from November 2004 to December 2021. A multivariable logistic regression model was used to identify predictors of testicular salvage.

Results

A total 102 hospitalized children who presented with TT were included. Patients were aged from 1 month to 16 years, with a median age of 7.71 years. TT is significantly more common in the winter. Of these patients, 77 torsions were left-sided, 24 were on the right side, and only 1 was on bilateral sides. Meanwhile, we detected that 88 children suffering from TT had intravaginal torsion of the spermatic cord, and the rest were outside. Anticlockwise torsion was found in 65 cases (63.73%) and clockwise torsion in 37 (36.27%). As a result, 60 underwent orchidectomy, while 42 had a scrotal exploration with fixation of the testis. Multivariate analysis showed that cause of TT, time to intervention, white blood cell (WBC), and mean platelet volume (MPV) were correlated with the risk of a surgical outcome.

Conclusion

Only a small proportion of TT children received timely surgical management. Testicular salvage can be predicted by cause of TT, time to intervention, WBC, and MPV. Early scrotal exploration based on careful physical examination decreases the risk of misdiagnosis of spermatic cord torsion. A certain percentage of children with TT presenting with scrotal trauma or epididymo-orchitis should have their testicles checked to make sure that they do not have torsion, especially those who visit in the cold season.
The combined transarterial and transvenous onyx embolization of dural arteriovenous fistula of hypoglossal canal via the external jugular vein and facial vein: A case report
Authors: Yang Biao , Ren Yeqing , Wu Yongqiang , Zhang Wenju , Sun Yanqi , Guo Xiaolong , Lv Ming , Guo Geng
Published: January 2023

Dural arteriovenous fistulas of the hypoglossal canal (HCDAVFs) involving the anterior condylar confluence (ACC) and anterior condylar vein (ACV) are infrequent. Although transvenous embolization through the internal jugular vein (IJV) is the preferred treatment option for type I and II fistulas, it can be difficult if the IJV is unavailable. Here we report a rare case of HCDAVF in which the most common transvenous embolization access via IJV was not available. The patient underwent transarterial and transvenous onyx embolization. Transarterial embolization (TAE) aimed at controlling the arterial inflow and subsequently TVE was performed via the external jugular vein (EJV), the facial vein, the ophthalmic vein, the cavernous sinus, ACC, and ultimately to the fistula pouch. Complete obliteration of the HCDAVF was achieved without complications. We suggest that transvenous embolization (TVE) via the EJV and the facial vein can be effective in cases where trans-IJV is not possible.
The effect of subacromial decompression on the curative effect of arthroscopic treatment of shoulder calcific tendinitis
Authors: Zhao Feng , Wu Jianbo , Wang Dong , Li Peng , Tian Wei , Li Wenzheng , Chai Bo , Zhang Yuming
Published: January 2023

Objective

To observe and analyze the surgical efficacy of arthroscopic debridement of calcified deposits and arthroscopic debridement combined with subacromial decompression in patients with supraspinatus tendon calcific myositis. To observe the effect of Subacromial decompression on the efficacy of arthroscopic treatment of shoulder calcific tendinitis.

Patients and methods

From 2016 to 2021, 48 cases of shoulder arthroscopic debridement due to supraspinatus calcific tendinitis met the inclusion criteria and were included, with 24 cases assigned to the arthroscopic debridement group and 24 cases to the arthroscopic debridement combined with subacromial decompression group. Changes between preoperative and postoperative shoulder pain and shoulder function were statistically analyzed.

Results

The 24 patients in the arthroscopic debridement group were better than the arthroscopic debridement combined with subacromial decompression group in terms of short-term postoperative shoulder pain and shoulder joint function recovery (P < 0.05). There was no significant difference in the postoperative long-term shoulder pain and shoulder function recovery between the two groups (P > 0.05).

Conclusions

Compared with arthroscopic debridement combined with subacromial decompression, arthroscopic debridement alone is a better surgical option for the treatment of calcific tendinitis.
Application of a free preputial tube graft coupled with urethral plate urethroplasty combined with a Buck's fascia integral covering for the single-stage repair of severe hypospadias
Authors: Zhou Wei , Li Changpei , Xia Fan , Zhang Qi , Chen Yanxing
Published: January 2023

Objective

To assess the outcome of a free preputial tube graft coupled with urethral plate urethroplasty combined with a Buck's fascia integral covering (BFIC) for the single-stage repair of severe hypospadias in children.

Materials and methods

A retrospective study was performed on 40 children with hypospadias who were treated in our hospital from December 2017 to February 2022. The inclusion criteria were as follows: (1) the patient had proximal hypospadias, or penile curvature over 30° after degloving the penis; and (2) the patient underwent surgery for hypospadias for the first time. A free preputial tube graft coupled with urethral plate urethroplasty combined with a Buck's fascia integral covering was performed, and all patients were followed up for more than 6 months.

Results

After degloving the foreskin, the urethral orifice was retracted to the perineum and scrotum in 20 cases, penoscrotal in 8 cases, and penile in 12 cases. Single-stage repair was achieved without complications in 34 (85%) patients. The remaining six patients experienced postoperative complications: urethrocutaneous fistula occurred in five cases and glans dehiscence with urethrocutaneous fistula in one case. No urethral diverticulum occurred in any case. A neomeatus with a vertically oriented slit-like appearance was achieved at the tip of the glans in all cases, with one exception.

Conclusion

The single-stage operation with a free preputial tube graft coupled with urethral plate urethroplasty combined with a Buck's fascia integral covering in the treatment of severe hypospadias achieves favorable functional and cosmetic outcomes.
The role of upfront primary tumor resection in asymptomatic patients with unresectable stage IV colorectal cancer: A systematic review and meta-analysis
Authors: Liang Zongyu , Liu Zhiyuan , Huang Chengzhi , Chen Xin , Zhang Zhaojun , Xiang Meijuan , Hu Weixian , Wang Junjiang , Feng Xingyu , Yao Xueqing
Published: January 2023

Background

Controversy exists over the role of upfront primary tumor resection (PTR) in asymptomatic patients with unresectable stage IV colorectal cancer (CRC). The purpose of this study was to evaluate the effect of upfront PTR on survival outcomes and adverse outcomes.

Methods

Searches were conducted on PubMed, EMBASE, Web of Science, and Cochrane Library from inception to August 2021. Studies comparing survival outcomes with or without adverse outcomes between PTR and non-PTR treatments were included. Review Manager 5.3 was applied for meta-analyses with a random-effects model whenever possible.

Results

Overall, 20 studies with 3,088 patients were finally included in this systematic review. Compared with non-PTR, upfront PTR was associated with better 3-year (HR: 0.69, 95% CI, 0.57–0.83, P = 0.0001) and 5-year overall survival (OS) (HR: 0.77, 95% CI, 0.62–0.95, P = 0.01), while subgroup analysis indicated that there was no significant difference between upfront PTR and upfront chemotherapy (CT) group. In addition, grade 3 or higher adverse effects due to CT were more frequent in the PTR group with marginal significance (OR: 1.74, 95% CI, 0.99–3.06, P = 0.05), and other adverse outcomes were comparable.

Conclusions

PTR might be related to improved OS for asymptomatic patients with unresectable stage IV CRC, whereas receiving upfront CT is a rational alternative without detrimental influence on survival or adverse outcomes compared with upfront PTR.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=272675
Application and practice of trimodal prehabilitation model in preoperative management of patients with lung cancer undergoing video-assisted thoracoscopic surgery
Authors: Yao Liping , Chen Hui , Xue Bei
Published: January 2023

Lung cancer is one of the malignant tumors with high mortality worldwide. To date, the most effective treatment of non—small cell lung cancer (NSCLC) is still surgical resection. Video-assisted thoracoscopic surgery has become the main surgical approach. Tumor patients are the high-risk perioperative population. At present, how to optimize perioperative management measures to improve the patient's body function and promote the rehabilitation after video-assisted thoracoscopic surgery is a hot research topic for medical staff. In this study, 148 patients with lung cancer were selected as the research object, to analyze and discuss the application value of trimodal prehabilitation model in preoperative management of patients with lung cancer undergoing video-assisted thoracoscopic surgery.
Clinical outcomes following surgical mitral valve plasty or replacement in patients with infectious endocarditis: A meta-analysis
Authors: Wang Song , Zhou Ting , Bian Jinhui , Li Geng , Zhang Wenjing , Chen Si , Jiang Yefan
Published: January 2023

Background

For degenerative mitral disease, more and more evidences support that mitral valve plasty (MVP) has much better clincial outcomes than mitral valve replacement (MVR). However, the advantages of MVP in patients suffering from infectious endocarditis (IE) are unclear. To evaluate the appropriateness of MVP in IE patients, we conducted this meta-analysis. Based on the difference between active and healed phase, we not only compared the result of patients with IE, but also identified the subgroup with active IE.

Methods

We systematically searched the clinical trials comparing clinical outcomes of MVP and MVR in patients suffering from IE. Relevant articles were searched from January 1, 2000 to March 18, 2021 in Pubmed and Cochrane Library. Studies were excluded if they were with Newcastle–Ottawa Scale (NOS) score less than 6 or lacking of direct comparisons between MVP and MVR.

Results

23 studies were involved and 25,615 patients were included. Pooled analysis showed fewer adverse events and early or long-term death in the MVP group. However, more reoperations existed in this patient group. And the reinfection rate was close between two groups. Similar results were observed after identifying active IE subgroup, but there is no difference in the freedom from reoperation due to all-events.

Conclusions

Although limitimations exited in this study, patients suffering from IE can benefit from both MVP and MVR. For surgeons with consummate skills, MVP can be the preferred choice for suitable IE patients.
Acute abdomen after vertebroplasty-A rare complication
Authors: Zhao Xiao-ming , Lou Xiao-xiao , Chen An-fa , Zhang Yin-gang
Published: January 2023

Introduction

In recent years, as the concept of minimally invasive treatment has been accepted by the majority of patients, the application of percutaneous vertebroplasty in osteoporotic vertebral compression fractures has gradually increased, and research on the adverse complications of bone cement leakage has gradually deepened.

Case

Here, we report a rare case of acute pancreatitis after vertebroplasty. The patient had no previous history of pancreatitis and presented with obvious abdominal pain after vertebroplasty. Abdominal CT examination revealed that the leaking bone cement penetrated the anterior wall of the L1 vertebral body into the diaphragm, and the heat released by the polymerization reaction caused inflammation and damage to the adjacent pancreas, resulting in poor blood flow to the pancreatic tissue and leading to acute pancreatitis. Early postoperative symptomatic treatment was given to the patient, and the corresponding symptoms were gradually relieved. During postoperative follow-up, the leaking cement did not degrade, but the patient had no symptoms.

Conclusion

Lesions of adjacent organs caused by bone cement leakage are rare, and clinicians often ignore the association between such complications and vertebroplasty. This case report will provide guidance and a reference for clinicians.
Curative effect and technical key points of laparoscopic surgery for choledochal cysts in children
Authors: Bian Zedong , Zhi Yong , Zeng Xinhao , Wang Xiaoyong
Published: January 2023

Objective

The purpose of this study was to investigate the curative effect of and experience with laparoscopic surgery for congenital choledochal cysts in children.

Methods

This is a retrospective analysis of 33 children diagnosed with congenital choledochal cyst in the pediatric surgery department of the Affiliated Hospital of Southwest Medical University between January 2019 and December 2021. The cohort included 8 males and 25 females aged 0.25–13.7 years (median age, 3.2 years), including 21 cases of type I and 12 cases of type IV choledochal cyst (Todani classification). Laparoscopic choledochal cyst resection and hepaticojejunostomy with Roux-en-Y anastomosis were performed in all the patients.

Results

Laparoscopy without transit opening was successfully performed in the 33 cases. The duration of the procedure was 235–460 min (mean ± SD, 316 ± 61 min), and intraoperative blood loss volume was 15–40 ml (23 ± 7.6 ml). Postoperative hospital stay was 7–14 days (9 ± 1.8 days). Postoperative biliary fistula and pancreatitis occurred in two cases each, and all four patients were successfully treated with conservative treatment. No anastomotic stenosis, delayed bleeding, cholangitis, intestinal obstruction, or other complications occurred. All the children were followed up for 2–36 months (median period, 17.2 months). The clinical symptoms disappeared, and no obvious hepatic dysfunction was found on abdominal color ultrasound and liver function examination.

Conclusion

Laparoscopic surgery for congenital choledochal cyst in children is safe and effective, as it is a minimally invasive surgery that is associated with a low degree of trauma and bleeding, rapid postoperative recovery, and satisfactory aesthetic appearance.
Traumatic oculomotor nerve palsy treated with transnasal endoscopic decompression through the optic strut
Authors: Wang Anqi , Wang Mian , Wu Yanqiao , Zhao Yifan , Wang Zhimin , Shen Likui
Published: January 2023

Objective

To present a surgical treatment regimen of transnasal endoscopic decompression through the optic strut for traumatic oculomotor nerve palsy based on the anatomical study of the superior orbital fissure and the oculomotor nerve fissure segment.

Methods

The bone structure of the oculomotor nerve fissure segment and the important bone anatomical landmarks of the lateral wall of the sphenoidal sinus were identified on a dried skull and a cadaveric head, respectively, using a nasal endoscope, and a surgical plan was determined. Decompression was conducted on the orbital apex, the superior orbital fissure, the optic canal and the optic strut of the two patients in sequence, after which the degree and range of decompression were identified by three-dimensional (3D) computed tomography (CT).

Results

The oculomotor nerve had a close correlation with the lateral surface of the optic strut. The transnasal endoscope was employed to identify the lateral optic-carotid recess (LOCR), as well as the positions of the optic nerve, internal carotid artery (ICA), and superior orbital fissure, collectively called the “optic strut triangle”. The surgical plans for decompression of the orbital apex, superior orbital fissure, optic canal, and optic strut and the necessity of optic strut drilling were determined, and the surgical procedures for safe drilling of the optic strut were elaborated. After surgery, the two patients had significantly improved symptoms, without complications. In addition, their postoperative CT showed that the medial margin of the superior orbital fissure was fully decompressed.

Conclusion

The optic strut triangle is a crucial anatomical landmark in the decompression of the oculomotor nerve, and optic strut drilling is necessary for such decompression. For patients with traumatic oculomotor nerve palsy and fractures of the medial wall of the superior orbital fissure on CT, the oculomotor nerve fissure segment can be decompressed in an effective, complete and safe manner as per the surgical plan of decompressing the orbital apex, superior orbital fissure, optic canal and optic strut in turn under a transnasal endoscope, conducive to the recovery of neurological function of patients.
Case report and literature review: Robot-assisted laparoscopic left renal mucinous cystadenocarcinoma radical nephrectomy
Authors: Ning Zikuan , Zhang Haoxun , Wang Bowen , Wang Yingwei , Liu Yiwen , Tao Boju , Zhang Guoling , Liu Hua , Wang Chunyang
Published: January 2023

Background

Mucinous cystadenocarcinoma (MC) of the kidney is a rare renal epithelial tumor originating from the renal pelvic urothelium. There are only a few published reports on MC. Due to its rare and unknown tissue origin, its diagnosis is difficult which almost can be diagnosed through the pathological method.

Case presentation

In this case report, we report a female patient whose chief complaint was low back pain lasting for one month. The three-dimensional computed tomography scan of the urinary system detected approximately 7 cm of a left renal cystic mass. The renal cystic mass was diagnosed as MC after robot-assisted laparoscopic radical nephrectomy. The MC originated from the kidney after completing colorectal adenocarcinoma and ovarian adenocarcinoma.

Conclusions

We reported a case of MC of the kidney which was a rare renal tumor. We not only aimed to present an unusual case of MC and review the previous literature on its pathology and differential diagnosis, but also used new method to treat this type of tumor.
Effect comparison of neuroendoscopic vs. craniotomy in the treatment of adult intracranial arachnoid cyst
Authors: Liang Jianfeng , Li Kai , Luo Bin , Zhang Jun , Zhao Peng , Lu Changyu
Published: January 2023

Purpose

Intracranial arachnoid cysts are common, accounting for about 1%–2% of intracranial space-occupying lesions. There is controversy over the method of surgical intervention, and in order to provide guidance for surgical decision making, this study compares the efficacy of craniotomy vs. neuroendoscopic surgery in treating arachnoid cysts.

Methods

The adult patients with arachnoid cyst admitted to our department from October 2016 to August 2021 were retrospectively analyzed. Thirteen adult patients were recruited, and divided into two groups: neuroendoscopic group (group A) and craniotomy group (group B). We compared the gender, age, clinical symptoms, preoperative and postoperative cyst sizes, symptom improvement, complications, length of hospital stay, and hospital costs between two groups to analyze the therapeutic effects of these two surgical methods.

Results

The cost of hospitalization in group A was significantly lower than that in group B (47,292.8 vs. 65,151.8 yuan, P < 0.05), and there was no difference in the length of hospital stay between the two groups. The preoperative cysts in group A were significantly larger than those in group B (6.38 vs. 2.97 cm, P < 0.05). In groups A and B, the short-term symptom improvement rates were 100% and 75.0%, respectively. The long-term symptom improvement rates were 77.78% and 75.0% (P > 0.05), respectively.

Conclusion

Both neuroendoscopic and craniotomy have good curative effects for the treatment of intracranial arachnoid cysts. There was no significant difference in the outcomes between the two surgical techniques. The cost of hospitalization can be reduced with neuroendoscopic surgery. Neuroendoscopic treatment is recommended for large intracranial arachnoid cysts, and craniotomy is suitable for small intracranial arachnoid cysts.
Avoiding misdiagnosis of duodenal papilla adenocarcinoma in a situs inversus totalis patient via laparoscopic pancreaticoduodenectomy: A rare case report
Authors: Liang Hao , Wu Ya-kun , Pang Wu , Chen Ming-liang , Zhu Yu
Published: January 2023

Situs inversus totalis is a rare congenital anatomical anomaly that causes some difficult problems for surgeons when performing an operation. However, without histopathology specimens from surgery, a misdiagnosis of cancer may be unavoidable, in addition to affecting the improvement of prognosis. This study reports a rare patient with situs inversus totalis who presented with the main complaints of pruritus and vague abdominal pain. She was first misdiagnosed with cholangiocarcinoma and was finally diagnosed with duodenal papilla adenocarcinoma via laparoscopic pancreaticoduodenectomy. Situs inversus totalis was not a contraindication for surgery. Skilled surgeons and complete preparation during the perioperative period are two important keys to successful surgeries. Performing laparoscopic pancreaticoduodenectomy for patients with situs inversus totalis to avoid misdiagnosis of cancer and tailor appropriate therapy plans is cost-effective.
Subclavian steal syndrome associated with right aortic arch: A case report
Authors: Cai Jing , Xie Chao , Wang Xianwei
Published: January 2023

The right aortic arch (RAA) is a rare congenital vascular variant disease. We reported a case of subclavian steal syndrome associated with RAA. The primary clinical symptoms were vertigo and ischemic symptoms of the left upper extremity. We diagnosed the condition using aortic computed tomography angiography and digital subtraction angiography. The patient underwent carotid-subclavian bypass surgery.
The role of endoscopic ultrasound-guided fine-needle aspiration/biopsy in the diagnosis of mediastinal lesions
Authors: Zhou Jingjing , Cai Ting , Wu Dongwen , Chen Xiong , Wang Fen
Published: January 2023

Objective

Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) is an accurate technique for sampling the pancreas and mediastinum. The aim of this study was to determine the value of EUS-FNA/FNB in the diagnosis of mediastinal lesions.

Methods

Data from 107 patients who underwent EUS-FNA/FNB for mediastinal lesions were evaluated.

Results

The sensitivity, specificity, positive predictive value, and negative predictive value of EUS-FNA/FNB for mediastinal lesions were 92.00%, 100%, 100%, and 85%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of EUS-FNA for malignant mediastinal lesions were 92.00%, 100%, 100%, and 86.00%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of EUS-FNB for malignant mediastinal lesions were 92.00%, 100%, 100%, and 82.00%, respectively. Except for the discomfort caused by conventional gastroscopy, none of the patients had any complications, such as damage to surrounding large blood vessels or nerves.

Conclusion

EUS-FNA/FNB is an effective tool for diagnosing unknown mediastinal lesions, without any obvious complications.
Accuracy of narrow band imaging for detecting the malignant transformation of oral potentially malignant disorders: A systematic review and meta-analysis
Authors: Zhang You , Wu Yuqi , Pan Dan , Zhang Zhenyu , Jiang Lu , Feng Xiaodong , Jiang Yuchen , Luo Xiaobo , Chen Qianming
Published: January 2023

Objective

Oral potentially malignant disorders (OPMDs) are a spectrum of diseases that harbor the potential of malignant transformation and developing into oral squamous cell carcinoma (OSCC). Narrow band imaging (NBI) has been clinically utilized for the adjuvant diagnosis of OPMD and OSCC. This study aimed to comprehensively evaluate the diagnostic accuracy of NBI for malignant transformations of OPMD by applying the intraepithelial papillary capillary loop (IPCL) classification approach.

Methods

Studies reporting the diagnostic validity of NBI in the detection of OPMD/OSCC were selected. Four databases were searched and 11 articles were included in the meta-analysis. We performed four subgroup analyses by defining IPCL I/II as negative diagnostic results and no/mild dysplasia as negative pathological outcome. Pooled data were analyzed using random-effects models. Meta-regression analysis was performed to explore heterogeneity.

Results

After pooled analysis of the four subgroups, we found that subgroup 1, defining IPCL II and above as a clinically positive result, demonstrated the most optimal overall diagnostic accuracy for the malignant transformation of OPMDs, with a sensitivity and specificity of NBI of 0.87 (95% confidence interval (CI) [0.67, 0.96], p < 0.001) and 0.83 [95% CI (0.56, 0.95), p < 0.001], respectively; while the other 3 subgroups displayed relatively low sensitivity or specificity.

Conclusions

NBI is a promising and non-invasive adjunctive tool for identifying malignant transformations of OPMDs. The IPCL grading is currently a sound criterion for the clinical application of NBI. After excluding potentially false positive results, these oral lesions classified as IPCL II or above are suggested to undergo biopsy for early and accurate diagnosis as well as management.
Characteristics of multicystic biliary hamartoma: A case report
Authors: Lian Jia , Sun Lixia , Yang Yankai , Li Jun , Zhang Ye , Liu Guiqiu , Hu Weijuan
Published: January 2023

Introduction

Multicystic biliary hamartoma (MCBH) is a very rare hepatic benign neoplasm that manifests as a localized cystic-solid mass. Only 17 cases have been described in the literature to date. MCBH diagnosis is currently dependent on imaging and pathology following surgical resection and no precise standards are in place.

Case Presentation

This case study involves a middle-aged male patient with a history of drinking but no other liver diseases. A routine ultrasound examination showed a 6.0 × 5.5 cm inhomogeneous echo mass in the right lobe of the liver. The patient experienced no discomfort or other symptoms, and blood tests were normal. Imaging revealed a localized cystic-solid neoplasm in segment 6 of the liver that did not have the features of a malignant tumor. Surgical resection was performed. Based on imaging, macroscopic examination, and histological results, a final diagnosis of MCBH was made.

Conclusion

The imaging and pathological features of MCBH were summarized based on the published case reports to date. As a non-invasive examination, the imaging features will aid in the diagnosis of MCBH. Furthermore, these features, along with tumor size and patient symptoms, will facilitate clinicians in selecting surgical resection or follow-up for individual patients.
Comparison of end-to-side versus side-to-side anastomosis in upper limb arteriovenous fistula in hemodialysis patients: A systematic review and meta-analysis
Authors: Zhou Yu , Wu Hongyan
Published: January 2023

Objective

It is currently unclear if the anastomosis technique impacts the patency of upper arm arteriovenous fistula (AVF) in hemodialysis patients. This review compared outcomes of end-to-side and side-to-side anastomosis for AVF fistula in hemodialysis patients.

Methods

PubMed, CENTRAL, Web of Science, and Embase were searched for all types of studies published between 1st January 2000 to 3rd September 2022. Patency rates at 6, 12 months, maturation time, and complications were compared between ETS and STS groups.

Results

Sixteen studies including six randomized controlled trials (RCTs) were included. Meta-analysis showed no difference in patency rates between ETS and STS group at 6 months (OR: 1.15 95% CI: 0.72, 1.83 I2 = 52% p = 0.56) but better patency with STS at 12 months (OR: 0.63 95% CI: 0.41, 0.95 I2 = 21% p = 0.03). The difference was non-significant in a subgroup analysis of RCTs and non-RCTs. In the absence of distal vein ligation in the STS group, the ETS group had significantly better patency at 6 months but with distal vein ligation, STS had higher patency at 12 months. Meta-analysis demonstrated no difference in maturation time between the two groups (MD: 0.10 95% CI: 0.29, 0.49 I2 = 89% p = 0.61). Only a descriptive analysis of complications could be carried out with no major difference.

Conclusion

Our review demonstrates that the STS anastomosis technique with distal vein ligation may result in significantly better patency rates as compared to the standard ETS technique. Data for complication rates are scarce and varied but without any significant differences between the two techniques.
Case report: Endovascular intervention of internal carotid artery pseudoaneurysm secondary to nasopharyngeal carcinoma radiotherapy
Authors: Li Chao , Lu Jiachao , Luo Yu , Feng Daqin
Published: January 2023

Background

Internal carotid artery pseudoaneurysm (PSA) is a serious complication after radiotherapy for nasopharyngeal carcinoma, and once it ruptures and bleeds, it will seriously affect the patient's survival and prognosis. However, because of its relatively low incidence, many medical institutions lack experience in managing this type of emergency.

Case information

In this case report, we described two cases suffered ruptured internal carotid artery PSA after radiotherapy for nasopharyngeal carcinoma, including their history, diagnosis, and treatment. Both cases underwent emergency endovascular interventions, one of which with long-term healing after embolization of the PSA, and the other one with re-bleeding after embolization and was eventually stopped by embolization of the parent artery. Ultimately, both cases received timely and effective treatment.

Conclusion

This case report detailed the diagnosis and treatment course of internal carotid artery PSA after radiotherapy for nasopharyngeal carcinoma, which enhanced the understanding of this emergency, and provided valuable information and experience for the treatment strategy of similar PSA on the internal carotid artery.