bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of corneal biomechanical properties in healthy thin corneas with matched keratoconus eyes
Authors: Sedaghat Mohammad-Reza , Momeni-Moghaddam Hamed , Ehsaei Asieh , Vinciguerra Riccardo , Zamani Omid , Robabi Hassan
Published: November 2022

Purpose:

To compare corneal biomechanical parameters of normal thin corneas with matched keratoconus eyes.

Setting:

Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Design:

Cross-sectional comparative study.

Methods:

Dynamic corneal response parameters of Corvis ST were compared in 61 eyes with keratoconus with 61 matched healthy thin corneas (corneal thinnest point <500 μm), while corneal thickness, biomechanically corrected intraocular pressure, and age were considered covariates. The receiving operator sensitivity curve analysis was used to determine the cutoff point with the highest sensitivity and specificity, and the area under the curve (AUC) for each parameter.

Results:

All biomechanical parameters were statistically significant between the 2 groups except for the first (P = .947) and second (P = .582) applanation length, first (P = .783) and second (P = .301) applanation velocity, and deformation amplitude in the highest concavity phase (P = .106). The highest mean difference between groups (12.89 ± 2.03 mm Hg/mm) was related to the stiffness parameter at the first applanation (SPA1). Although the Corvis biomechanical index and tomographic biomechanical index had the highest detection ability based on their AUC (0.912 and 0.959, respectively), among the standard and combined biomechanical parameters except for keratoconus screening parameters, the highest discriminative ability was related to SPA1 with AUC, sensitivity, and specificity of 0.793, 60.66%, and 90.16%, respectively.

Conclusions:

Keratoconus corneas were significantly softer compared with healthy thin corneas of matched thickness. Optimal cutoff points close to the maximum value defined for screening parameters limit their clinical use for differentiation purposes in these particular types of cases.
Patterns of patient outcomes following specialist pain management in Australasia: a latent class analysis using the electronic Persistent Pain Outcomes Collaboration database
Authors: Tardif Hilarie , Allingham Samuel F. , Rahman Mijanur , Daly Anne
Published: November 2022

The increasing demand for pain management and limited resources available highlight the need to measure treatment effectiveness. We analysed data collected at 75 specialist persistent pain services located in Australia and New Zealand to calculate the overall treatment outcome for patients receiving care during 2014 to 2020. Sociodemographic and clinical information was provided for 23,915 patients, along with patient-reported measures assessing pain, pain interference, depression, anxiety, stress, pain catastrophizing, and pain self-efficacy. Latent class analysis identified 4 distinct outcomes based on patients' pattern of responses across the assessment tools at treatment end. Group 1 (n = 8369, 35%) reported low/mild severity across all clinical domains at the end of care, while group 4 (n= 7081, 30%) were more likely to report moderate/high severity on all domains. Group 2 (n = 1991, 8%) reported low/mild pain with moderate/high psychological distress at treatment end, and group 3 (n = 6474, 27%) reported moderate/high pain with low/mild psychological distress. Multivariable logistic regression identified those factors associated with the different groups. In particular, factors most predictive of a poor (group 4) vs good outcome (group 1) were unemployment (due to pain or other reasons), requiring an interpreter, widespread pain, pain of longer duration, and attributing the pain to an injury at work. The results may allow identification of those most likely to benefit from the services currently provided and inform development of alternative or enhanced services for those at risk of a poor outcome.
The systemic oral health connection: Biofilms
Authors: Kurtzman Gregori M. , Horowitz Robert A. , Johnson Richard , Prestiano Ryan A. , Klein Benjamin I.
Published: November 2022

Frequently, periodontal health and it’s associated oral biofilm has not been addressed in those patients who have systemic health issues, especially those who are not responding to medical treatment via their physician. Oral biofilm may be present in the periodontal sulcus in the absence of clinical disease of periodontal disease (bleeding on probing, gingival inflammation) and periodontal reaction is dependent on the patient’s immune response to the associated bacterial and their byproducts. Increasing evidence has been emerging the past decade connecting oral biofilm with systemic conditions, either initiating them or complicating those medical conditions. The patient’s health needs to be thought of as a whole-body system with connections that may originate in the oral cavity and have distant affects throughout the body. To maximize total health, a coordination in healthcare needs to be a symbiosis between the physician and dentist to eliminate the oral biofilm and aid in prevention of systemic disease or minimize those effects to improve the patient’s overall health and quality of life. Various areas of systemic health have been associated with the bacteria and their byproducts in the oral biofilm. Those include cardiovascular disease, chronic kidney disease, diabetes, pulmonary disease, prostate cancer, colon cancer, pancreatic cancer, pre-term pregnancy, erectile dysfunction Alzheimer’s disease and Rheumatoid arthritis. This article will discuss oral biofilm, its affects systemically and review the medical conditions associated with the oral systemic connection with an extensive review of the literature.
A novel Anoikis and immune-related genes marked prognostic signature for colorectal cancer
Authors: Cai Zhiqiang , Zhou Fuxiang
Published: November 2022

Colorectal cancer (CRC) is second most commonly diagnosed cancer with high morbidity and mortality. The heterogeneity of CRC makes clinical treatment tremendously challenging. Here, we aimed to comprehensively analyze the prognosis of CRC patients based on ANOIKIS- and immune-related genes. ANOIKIS-related genes were identified by differentially analysis of high anoikis score group (ANOIKIS_high group) and low anoikis score group (ANOIKIS_low group) divided by the cutoff value of anoikis score. Immune-related genes were screened by differentially analysis of high immune score group (ImmuneScore_high group) and low immune score group (ImmuneScore_low group) classified by the cutoff value of ImmuneScore. Prognostic ANOIKIS- and immune-related genes were identified by univariate Cox regression analysis. Multivariate Cox regression analysis were used for prognostic model construction. Ferroptosis expression profiles, the infiltration of immune cells, and the somatic mutation status were analyzed and compared. Univariate and multivariate Cox-regression analyses were performed to identify independent prognostic factors for CRC patient. Nomogram that contained the independent prognostic factors was established to predict 1-, 3-, and 5-year OS probability of CRC patients. Three ANOIKIS- and immune-related signatures were applied to construct a prognostic model, which divided the CRC patients into high-risk and low-risk groups. The patients with high-risk scores had obviously shorter OSs than those with low-risk scores. The time dependent ROC curve indicated that the risk score model had a stable performance to predict survival rates. Notably, the age, pathologic T, and risk score could be used independent indicators for CRC prognosis prediction. A nomogram containing the independent prognostic factors showed that the nomogram accurately predicted 1-, 3-, and 5-year survival rates of CRC patients. In our research, a novel prognostic model was developed based on ANOIKIS- and immune-related genes in CRC, which could be used for prognostic prediction of CRC patients.
The links between adipose tissue DNA methylation, obesity, and insulin resistance: A protocol for systematic review
Authors: Li Suwen , Wang Yan , Li Zinan , Long Cong , Zhou Qian , Chen Qiu
Published: November 2022

Background and rationale:

Obesity is a metabolic condition brought on by the interplay of hereditary and environmental factors, making it one of the most common diseases in the world. Insulin resistance (IR) and obesity have a close connection and can both be advantageous. One of the main methods of epigenetic regulation is DNA methylation modification. Studies have demonstrated over the past few years that DNA methylation is crucial to the emergence of obesity and DNA methylation can lead to IR. Adipose tissue participates in the physiopathological processes of obesity and IR and functions as an endocrine organ controlling the body’s balanced metabolism, thus, adipose tissue-associated gene DNA methylation affects the development of obesity and IR by influencing the function of adipose tissue. Hence, an explanation of current research on DNA methylation, IR, and obesity, following the most recent developments, exploring changes in DNA methylation in different types of adipose tissue in insulin-resistant patients and obese patients may enable the identification of novel targets in clinical obesity prevention and treatment.

Method and analysis:

The following electronic bibliographic databases will be searched from inception for peer-reviewed original research published: MEDLINE (through PubMed), Scopus, and EMBASE. Cochrane Library, Cochrane Clinical Trials Registry, the National Institutes for Health Clinical Trials Registry, and the WHO International Clinical Trials Registry Platform from inception to December 31, 2021 will be conducted. Systematic reviews will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. The development of search strategies will make use of medical issue phrases and keywords associated with DNA methylation, Adipose tissue DNA methylation, obesity, and IR. Identified citations will be independently reviewed by two authors to determine eligibility at the title and abstract level, and then at the full text and data extraction phases. Disagreements and conflicts will be resolved through discussion with a third author. Two authors will extract the necessary data from the included studies independently, and The Cochrane Risk of Bias Assessment Tool will be used to assess the bias of randomized controlled studies, and the Newcastle–Ottawa scale for nonrandomized controlled studies. If the interventions and outcomes evaluated are sufficiently homogeneous, results from subgroups of studies will be pooled together in a meta-analysis.
The efficacy and safety of traditional Chinese medicine treating diabetic cardiomyopathy: A protocol for systematic review and meta-analysis
Authors: Han Shuo , Hou Yuan , Liu Huaman , Zhao Quanlin
Published: November 2022

Background:

Diabetic cardiomyopathy, secondary to diabetes, is the main cause of death in patients with diabetes. In China, traditional Chinese medicine has achieved good performance in treating diabetic cardiomyopathy. However, to date, no systematic review or meta-analysis has been published on the treatment of diabetic cardiomyopathy by traditional Chinese medicine.

Methods:

This study strictly followed the preferred guidelines for systematic review. Two researchers searched seven databases: EMbase, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journal Database, and WANFANG Database. The retrieval time limit ranged from the establishment of the database to August 2022. All clinical randomized controlled trials that met the inclusion and exclusion criteria were included in this study. Statistical analysis was performed using RevMan 5.3.

Results:

This study analyzed the clinical efficacy and safety of traditional Chinese medicine in the treatment of diabetic cardiomyopathy.

Conclusion:

The results of this study provide evidence-based medical evidence for the clinical use of traditional Chinese medicine in the treatment of diabetic heart disease in the future.
A case report of secondary parathyroid adenomatous hyperplasia with carcinoma
Authors: Chen Simei , Sui Xin , Zhao Bingxin , Liu Zongjie , Dai Xinpeng , Ding Yang
Published: November 2022

Introduction:

Secondary parathyroid hyperplasia canceration is very rare and thus easily be overlooked during parathyroid ultrasound examination. However, secondary parathyroid hyperplasia still has the possibility of canceration, and it is still important to be alert to its occurrence when performing ultrasound examinations and clinical treatment.

Patient concerns:

A 49-years-old man visited our outpatient department with generalized weakness and pain in both lower extremities a month ago.

Diagnosis:

Hyperparathyroidism secondary to chronic renal failure.

Interventions:

The patient underwent ultrasound and other preoperative examinations. The preoperative ultrasound showed 3 parathyroid enlargements, 2 on the left and 1 on the right. The patient then underwent surgical treatment.

Outcomes:

Ultrasonography suggested the presence of 3 parathyroid hyperplasias, and ectopic right inferior parathyroid gland was visible during intraoperative examination. 10 days after surgery, the patient’s Parathyroid Hormone returned to the normal range.

Conclusion:

Secondary parathyroid hyperplasia has the potential to become cancerous, so doctors should be alert to its occurrence when conducting ultrasound examinations. Ultrasound examination is the key to its diagnosis and subsequent treatment.
Network pharmacology-based strategy to investigate pharmacological mechanism of Liuwei Dihuang Pill against postmenopausal osteoporosis
Authors: Wang Qingchan , Huang Ping , Xia Chenjie , Fu Danqing
Published: November 2022

Postmenopausal osteoporosis (PMOP) has became 1 of most prevalent bone disorders with aging population. Liuwei Dihuang (LWDH) Pill, a classical kidney-tonifying prescription, is extensively used to treat PMOP in China. The aim of this study is to explore the pharmacological mechanisms of LWDH Pill against PMOP via network pharmacological strategy. The active ingredients of LWDH Pill were screened out from the Traditional Chinese Medicine System Pharmacology, Encyclopedia of Traditional Chinese Medicine and Bioinformatics Analysis Tool for Molecular mechANism of Traditional Chinese Medicine Databases, and their related target genes were fished in the UniProt database. Simultaneously, the GeneCards and DisGeNET databases were used to identify the target genes of PMOP. Through establishing a protein-protein interaction network, the overlapping genes between LWDH Pill and PMOP were identified to analyze their interactions and the hub target genes. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed to predict the underlying biological processes (BP) and signaling pathways, respectively. A total of 64 active ingredients and 653 related target genes were identified in LWDH Pill, and 292 target genes were closely associated with PMOP. After matching the target genes between LWDH Pill and PMOP, 84 overlapping targets were obtained and considered as therapeutically relevant. Through construction of a protein-protein interaction network, we identified 20 hub target genes including IL6, INS, tumor necrosis factor, AKT1, vascular endothelial growth factor A, IGF1, TP53, IL1B, MMP9, JUN, LEP, CTNNB1, EGF, PTGS2, PPARG, CXCL8, IL10, CCL2, FOS and ESR1. Gene Ontology enrichment analysis suggested that LWDH Pill exerted anti-PMOP effects via regulating multiple BP including cell proliferation and apoptosis, oxidative stress, inflammation and angiogenesis. Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed several pathways, such as PI3K-AKT pathway, mitogen-activated protein kinase pathway, hypoxia-inducible factors-1 pathway, tumor necrosis factor pathway, interleukin-17 (IL-17) pathway and FoxO pathway that might be involved in modulating the above BP. Through network pharmacological approach, we investigated the potential therapeutic mechanism of LWDH Pill against postmenopausal osteoporosis in a systemic perspective. These identified multi-targets and multi-pathways provide promising directions for further revealing more exact mechanisms.
Refractory psychiatric symptoms and seizure associated with Dandy-Walker syndrome: A case report and literature review
Authors: Chen Yijing , Zhu Junhong , Zhang Di , Han Li , Wang Juan , Yang Weiwei
Published: November 2022

Backgrounds:

Dandy-Walker syndrome (DWS) is a group of brain malformations which occasionally accompanied by psychotic symptoms. The co-occurrence of DWS and epilepsy in children is quite rare.

Case description:

We reported a 14-year-old male who presented with a 8-month history of inconsistent upper limb tremor and accidental seizure. The MRI showed the typical alterations of DWS: cystic dilatation of the fourth ventricle, vermian hypoplasia, enlarged posterior fossa. He received the ventriculoperitoneal shunting (VPS) placement for hydrocephalus and had a symptom-free period for 8 days. Then he experienced a recurrence of involuntary upper limb tremor and behavior disturbance after decreasing the pressure of cerebrospinal fluid (CSF) from 150 to 130 mm Hg. After being treated with Olanzapine 10 mg/d, Clonazepam 3 mg/qn and Valproate acid (VPA) 500 mg/bid for nearly a month, his mental status and psychotic symptoms fluctuated. A search of Pub Med showed little report of hydrocephalus and DWS comorbidity with seizure and psychosis. Here we presented the whole process of a rare disease from the very beginning with all his symptoms, examinations and treatments.

Conclusion:

VPS placement surgery at an earlier stage may be an effective way to avoid inevitable brain damage so as to improve the clinical outcomes for patients with DWS. Continued treatment with regard to DWS condition may include shunt placement, but it mainly focus on developmental concerns, with occupational and physical therapy along with ongoing supportive psychotherapy to improve the coping skills and quality of life.
Telenursing in the sexual function of women with breast cancer: A study protocol
Authors: Silva Ferreira Iarlla , Carvalho Fernandes Ana Fátima , Moura Barbosa Castro Régia Christina , Rodrigues Bezerra Andrea , Velasco Yanez Romel Jonathan
Published: November 2022

Introduction:

Most women with breast cancer have sexual function problems related to cancer diagnosis and treatment. These problems harm the quality of life and relationships. However, most patients do not receive care or guidance regarding sexuality from healthcare providers. This study aimed to test the effect of telenursing counseling on sexual functioning in women undergoing breast cancer treatment.

Methods:

This randomized clinical trial was conducted at 2 reference hospitals for cancer treatment. One hundred eight women with stage I–IV breast cancer undergoing treatment (surgery, chemotherapy, radiotherapy or hormone therapy) with a partner will be included in this study. The study was authorized by the Ethics Committee of the Federal University of Ceará (Opinion number: 46,13,609) and the Maternity School Assis Chateaubriand (Opinion number: 47,42,687). Patients will be allocated to the following groups: the control group, which will not receive an active intervention, and the intervention group, which will receive 3 telenursing counseling sessions for 6 weeks. The levels of sexual function in these patients before the intervention, soon after the intervention and at 12 weeks were compared and analyzed. All data will be collected and analyzed by the JASP program.

Results:

Differences in levels of sexual function among women allocated to the control and intervention groups in the analyzed periods.

Conclusion:

This evidence-based nursing care strategy can be used to improve the sexual function of breast cancer patients and consequently their quality of life and marital relationship.
Efficacy of traditional Chinese exercises in patients with post-COVID-19 chronic fatigue syndrome: A protocol for systematic review and meta-analysis
Authors: Liu Zhen , Lv Zhizhen , Zhou Xingchen , Shi Jiao , Hong Shuangwei , Huang Huazhi , Lv Lijiang
Published: November 2022

Background:

Some patients develop long-term symptoms after Corona virus disease 2019 (COVID-19), and chronic fatigue syndrome (CFS) is one of the main symptoms. CFS is characterized by fatigue lasting for more than 6 months accompanied by sleep disorders, anxiety, and depression, which causes a certain degree of harm to both physiological and psychological aspects of the individual. Traditional Chinese exercises (TCEs) are an ancient Chinese therapy and has recently been reported to be effective for CFS. Therefore, we will conduct a systematic review and meta-analysis aiming to accurately evaluate the efficacy of TCEs on post-COVID-19 CFS and provide an alternative treatment for post-COVID-19 CFS.

Methods:

Seven databases (PubMed, Ovid Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), and Wanfang) will be searched from establishment to August 2022, and we will only include randomized controlled trials of TCEs for post-COVID-19 CFS. Two reviews will independently include the research according to the inclusion and exclusion criteria. Review Manager 5.2 software will be used to analyze the accepted literature, and the relative risk ratio (RR) and 95% confidence interval (CI) will be used as effect indicators for the outcome indicator dichotomous variables. For continuous variables, weighted mean difference (MD) and 95% CI will be used as effect indicators. The heterogeneity test will be assessed using the I
2 statistic and Q statistic. The PEDro scale was used to evaluate the methodological quality of the included studies. Subgroup analysis was performed according to different TCEs, age, gender, and duration of CFS.

Results:

This systematic review and meta-analysis will evaluate the efficacy of TCEs in post-COVID-19 CFS.

Conclusion:

The results of this study will provide reliable evidence for the effects of TCEs for post-COVID-19 CFS on patients’ fatigue, anxiety, depression, sleep, and quality of life.
Rare finding of duodenal lymphangioma in a patient with Helicobacter pylori associated gastritis: A case report
Authors: Waheed Summaiya , Seetlani Naresh Kumar , Ashfaq Fatima , Tahir Muhammad Junaid , Abbasher Hussien Mohamed Ahmed Khabab , Kumari Vineeta , Yousaf Zohaib
Published: November 2022

Rationale:

Lymphangiomas are lymphatic malformations most commonly found in the head, neck and axilla. Their incidence in gastrointestinal tract, especially duodenum is very rare. They are mostly congenital and are usually seen in children. Owing to their asymptomatic nature, these tumors are often diagnosed incidentally. Surgical resection is the definite treatment.

Patient concerns:

We represent a case of a 30-year-old male with duodenal lymphangioma with presentation of intermittent dyspepsia for 1 year, partially relieved by a proton pump inhibitor.

Diagnoses:

Upon physical examination, there was mild tenderness observed in the epigastrium. The rest of the physical examination was unremarkable. His complete blood count report was unremarkable. Upon a negative stool for Helicobacter pylori antigen test, the patient underwent an esophagogastroduodenoscopy which revealed H pylori gastritis and a duodenal lymphangioma.

Interventions:

Patient was put on triple therapy (clarithromycin, amoxicillin and omeprazole) for 14 days and his symptoms improved. The lymphangioma was not resected owing to small size.

Outcomes:

Patient was followed till 1 year and his symptoms had improved.

Lessons:

The case describes a correlation between H pylori gastritis and a duodenal lymphangioma. There is likely to be an association between the two and therefore, further studies are required to find out any relationship that may exist between the 2 conditions.
Successful treatment of phlegmasia cerulea dolens with percutaneous thrombectomy and catheter-directed thrombolysis: A case report
Authors: Chang Ching-Tang , Chang Ching-Di
Published: November 2022

Introduction:

Phlegmasia cerulea dolens (PCD) is an uncommon condition of acute deep vein thrombosis, characterized by marked swelling of the affected limb with pain and cyanosis. High mortality and morbidity rates have been reported. Early diagnosis, quick and effective treatment are crucial for preventing potential limb loss or even death.

Patient concerns:

A 39-year-old woman presented to our emergency department with painful swelling and cyanotic discoloration of the left lower limb for 2 days.

Diagnoses:

Computed tomography revealed thrombosis in the left common iliac vein and inferior vena cava. Angiography demonstrated extensive venous occlusion from the lower inferior vena cava to the left popliteal vein. The diagnosis of PCD was made.

Interventions:

Systemic anticoagulation with intravenous unfractionated heparin was initiated immediately. Mechanical thrombectomy with Angiojet and angioplasty were performed, and catheter-directed thrombolysis (CDT) was administered subsequently.

Outcomes:

Follow-up angiography revealed regression of the thrombosis and the opacification of the deep vein was restored. The patient was discharged from the hospital uneventfully.

Conclusions:

PCD is a rare but potentially limb and life-threatening condition that requires immediate recognition. Treatment should be in a timely manner. Anticoagulation alone may be inadequate and more aggressive management such as CDT and thrombectomy should be considered.
Effect of moxibustion on meridian in a warm needling model: A protocol for a prospective observational study
Authors: Hsieh Chiao-Hsuan , Tseng Shih-Ting , Hung Yu-Chiang , Chang Ting-Chang , Hu Wen-Long , Lin Chien-Hung
Published: November 2022

Background:

Warm needling is a type of traditional Chinese medicine (TCM), which uses burned moxa to generate warmth and exerts a therapeutic effect on human skin. Additionally, based on TCM theory, warm needling could improve deficiency-cold syndrome. Research has found that warm needling has analgesic effects as well as effects on the immune system, endocrine system, nervous system, and lower urinary tract symptoms. However, the mechanism of warm needling on the meridians is not fully understood. In modern studies, the electric characteristics of the meridians have been discovered and the combination of semiconductor and TCM theory could explain the meridian phenomena through physics. However, there is no known research exploring the relationship between thermal effect and electric property on the meridians.

Methods:

A total of 30 healthy participants older than 20 years of age will be recruited for this study. The participants would first be administered acupuncture, following which the electric characteristics will be measured using the semiconductor analyzer Agilent B1500A/Agilent 4156C. The visual analog score (VAS) will also be rated. Thereafter, a burned moxa will be added to the acupuncture needles as a method for warm needling. The electric characteristics and VAS will be measured again. We will use the paired t-test and repeated measure two-way ANOVA to compare the electric characteristics and VAS before and after warm needling in each participant.

Objectives:

This protocol aims to explore the thermal effect on the electric characteristics of meridians in a warm needling model and provide a scientific explanation of TCM through the aspect of physics.
A novel minimally invasive broken nail extractor for cannulated intramedullary nails: Trial and application in a few cases
Authors: Zhou Zihong , Jiang Yan , Dai Beichen , Mao Guoshu , Liu Yu , Wei Changbao , Lin Weidong
Published: November 2022

Successful and minimally invasive extraction of a broken distal end of an intramedullary nail is challenging. This study introduces a simple and reproducible technique for the extraction of broken cannulated intramedullary nails using a novel minimally invasive broken nail extractor. Five amputated adult lower-leg specimens were used to create models of the broken distal end of the cannulated intramedullary nails remaining in the medullary cavity of the distal tibia. Two orthopedic resident physicians with experience in tibial intramedullary nail implantation were selected to blindly extract the broken intramedullary nail using the novel minimally invasive broken nail extractor. The extraction outcome was assessed. The broken nail extractor was applied to 3 patients with broken intramedullary nails remaining in the medullary cavity of the distal tibia. In the lower-leg specimens, the extraction success rate was 100%, the median number of extraction times was 1.9 (range 1–3.5), and the median duration of extraction was 38 s (range 20–52 s). All the broken intramedullary nails in the 3 patients were successfully extracted without complications related to the surgery. The study shows that our technique is simple, reproducible, and has a high extraction success rate, but more case applications are needed to verify its effect.
Epibulbar osseous choristoma with dermolipoma: A case report and review of literature
Authors: Kim Ju Mi , Son Woo Young , Sul Hae Joung , Shin Jeongah , Cho Won-Kyung
Published: November 2022

Background:

A choristoma is defined as a growth of histologically normal tissue in an abnormal location. Epibulbar osseous choristoma is the rarest type among all ocular choristoma with less than 100 cases reported. Here, we report a case of epibulbar osseous choristoma combined with dermolipoma and a literature review

Methods:

A 15-year-old female patient presented with an accidentally found subconjunctival mass in her left eye. Slit lamp examination revealed a 10 × 10 mm elevated, sigmoid-shaped mass in the supratemporal quadrant of the bulbar conjunctiva. We performed a debulking excisional biopsy of the mass.

Results:

The pathology confirmed osseous tissue surrounded by mature adipose tissue. At 1 week after the operation, the wound was clear and the patient was satisfied with the treatment. A systematic literature review of 14 previously published cases taken from PubMed dating back to 1987 along with ours was undertaken. The average age at presentation was 11.6 years and there was a female preponderance with 10 cases being female and the other 5 cases being male. Supratemporal conjunctiva was the most common site of presentation. There was no systemic disease associated with any of the cases. Since it is a benign tumor, it can be managed by observation, but if necessary, it can be treated by surgical removal.

Conclusion:

In pediatric subconjunctival mass, particularly located in supratemporal quadrant of bulbar conjunctiva, osseous choristoma should be considered in the differential diagnosis. Pre-operative CT scans will helpful to not also reduce complication with surgical excision but also helpful in prediction of diagnosis and prognosis.
miR-195-3p/BDNF axis regulates hypoxic injury by targeting P-ERK1/2 expression
Authors: Zhang Wenjing , Liu Bingshi , Wang Yanfang , Sun PHD Lixian , Liu Chao , Zhang Haoran , Qin Wei , Liu Jingyi , Han Leng , Shan Weichao
Published: November 2022

Objectives:

Coronary heart disease (CHD) is the most common heart disease and the leading cause of cardiovascular deaths worldwide. Decreased endothelial cell (EC) proliferation, increased apoptosis, inflammation, and vascular dysfunction are considered vital factors in CHD. In this study, we aimed to determine the expression and role of microRNA-195-3p and brain-derived neurotrophic factor (BDNF) in hypoxic-treated human umbilical vein endothelial cells (HUVECs).

Measures:

We induced hypoxia in HUVECs using the “anaerobic tank method.”

Results:

We found that the levels of microRNA-195-3p and BDNF were upregulated and apoptosis was increased. Furthermore, we found that BDNF/P-ERK1/2 regulated the expression of the mitochondrial apoptosis pathway proteins Bcl-2/BAX, which was downregulated under hypoxic conditions. Finally, the microRNA-195-3p inhibitor downregulated BDNF and P-ERK1/2, upregulated the Bcl-2/BAX axis, and partially reversed the effects of hypoxic-induced injury in HUVECs.

Conclusions:

Therapeutic intervention using the microRNA-195-3p/BDNF/P-ERK1/2/Bcl-2/BAX axis could maintain EC function under hypoxic conditions, improve cell activity, and serve as a new treatment strategy for CHDs.
The role of tolvaptan in pulmonary hypertension: A retrospective study
Authors: Chen Qiaoli , Luo Heng , Li Yuping
Published: November 2022

Pulmonary hypertension (PH) is a severe form of pulmonary vascular disease that can lead to right heart failure (RHF). Nearly 2-thirds of patients with PH die within 5 years. Studies suggest that a new diuretic medication, called tolvaptan (TLV), can be used to treat PH. However, there is still insufficient evidence to confirm its effectiveness. Therefore, we investigated the role of TLV in patients with PH. This retrospective study included 73 patients with PH hospitalized in Shanghai Pulmonary Hospital between November 2019 and March 2022. All patients received 7.5 to 15.0 mg of TLV for 3 to 21 days starting at admission, in addition to targeted drugs and traditional diuretic therapy. The outcomes included the blood pressure, urine and water intake volumes, electrolyte concentrations, and renal, liver, and cardiac function indexes before and after TLV treatment. In addition, we assessed the clinical symptoms and adverse reactions during the treatment. After TLV treatment, the water intake and urine volumes significantly increased, and body weight, diastolic blood pressure (DBP) and mean arterial pressure significantly decreased. Total bilirubin, direct bilirubin, N-terminal pro-brain natriuretic peptide, and serum uric acid (UA) levels after TLV treatment were significantly lower than before treatment. After TLV treatment, dyspnea significantly improved in 71 of 73 patients, and lower limb edema disappeared in 42 of 53 patients. No obvious adverse reactions occurred during the TLV treatment period. These results suggest that adding TLV to targeted drug and traditional diuretic therapies is effective for patients with PH. However, more data are required to support these findings.
Viral meningitis in Sudanese children: Differentiation, etiology and review of literature
Authors: Abdelrahim Nada Abdelghani , Mohammed Nahla , Evander Magnus , Ahlm Clas , Fadl-Elmula Imad Mohammed
Published: November 2022

Diagnosis of viral meningitis (VM) is uncommon practice in Sudan and there is no local viral etiological map. We therefore intended to differentiate VM using standardized clinical codes and determine the involvement of herpes simplex virus types-1 and 2 (HSV-1/2), varicella zoster virus, non-polio human enteroviruses (HEVs), and human parechoviruses in meningeal infections in children in Sudan. This is a cross-sectional hospital-based study. Viral meningitis was differentiated in 503 suspected febrile attendee of Omdurman Hospital for Children following the criteria listed in the Clinical Case Definition for Aseptic/Viral Meningitis. Patients were children age 0 to 15 years. Viral nucleic acids (DNA/RNA) were extracted from cerebrospinal fluid (CSF) specimens using QIAamp® UltraSens Virus Technology. Complementary DNA was prepared from viral RNA using GoScriptTM Reverse Transcription System. Viral nucleic acids were amplified and detected using quantitative TaqMan® Real-Time and conventional polymerase chain reactions (PCRs). Hospital diagnosis of VM was assigned to 0%, when clinical codes were applied; we considered 3.2% as having VM among the total study population and as 40% among those with proven infectious meningitis. Two (0.4%) out of total 503 CSF specimens were positive for HSV-1; Ct values were 37.05 and 39.10 and virus copies were 652/PCR run (261 × 103/mL CSF) and 123/PCR run (49.3 × 103/mL CSF), respectively. Other 2 (0.4%) CSF specimens were positive for non-polio HEVs; Ct values were 37.70 and 38.30, and the approximate virus copies were 5E2/PCR run (~2E5/mL CSF) and 2E2/PCR run (~8E4/mL CSF), respectively. No genetic materials were detected for HSV-2, varicella zoster virus, and human parechoviruses. The diagnosis of VM was never assigned by the hospital despite fulfilling the clinical case definition. Virus detection rate was 10% among cases with proven infectious meningitis. Detected viruses were HSV-1 and non-polio HEVs. Positive virus PCRs in CSFs with normal cellular counts were seen.
Construction of prognosis model of pyroptosis gene and characterization of tumor microenvironment infiltration in cervical cancer
Authors: Zhang Min , Wu Peng
Published: November 2022

Pyroptosis has been demonstrated in recent years to be an inflammatory form of programmed cell death. However, the prognostic evaluation of cervical cancer (CESC) to pyroptosis is insufficient and their correlations with prognosis remain unclear. In this study, we identified 15 differentially expressed pyroptosis-related genes between tumor samples and normal samples. By using Cox regression analysis, a 3-gene risk signature was built and classified all CESC patients in the cancer genome atlas cohort into a low-risk or high-risk group. CESC patients in the low-risk group showed significantly higher survival probabilities than those in the high-risk group (P < .05). And the risk score was found to be an independent factor for predicting the overall survival of CESC patients. Besides, based on 33 pyroptosis-related genes, all CESC cases could be divided into 3 clusters with consensus clustering analysis. We characterized and analyzed the characteristics of tumor microenvironment infiltration in different clusters. Our findings provide a foundation for future research targeting pyroptosis and its immune microenvironment to improve prognosis in CESC patients.
High-intensity focused ultrasound ablation combined with systemic methotrexate treatment of intramural ectopic pregnancy: A case report
Authors: Peng Yan , Dai Yu , Yu Guiyuan , Jin Ping
Published: November 2022

Rationale:

Intramural ectopic pregnancy (IMP) is a rare ectopic pregnancy with an unclear etiology, and standard treatment guidelines currently remain unclear. The main treatment option is local excision of IMP via laparoscopy or laparotomy.

Patient concerns:

A 32-year-old woman with adenomyosis presented with amenorrhea for 7 weeks and a serum β-human chorionic gonadotropin (HCG) level of 6882 IU/L. The patient had a history of laparotomy for adenomyosis 5 years previously. Three-dimensional ultrasonography showed a live gestational sac (GS) of 9 × 15 × 18 mm located in the left posterior wall of the uterus and a sinus tract connecting the sac and the endometrial cavity. MRI revealed the GS located in the adenomyosis and a 1.0-cm sinus tract connecting the GS and the endometrial cavity.

Diagnoses:

IMP with adenomyosis.

Interventions:

High-intensity focused ultrasound (HIFU) treatment combined with systemic methotrexate (MTX) was performed to treat IMP, which would avoid operation and massive bleeding.

Outcomes:

Serum β-HCG levels decreased to normal 4 weeks after HIFU treatment and the GS was not found on MRI after 4 months. The sinus tract was significantly shortened after the HIFU treatment.

Lessons:

HIFU ablation combined with systemic MTX is effective for the treatment of IMP and is favorable for maintaining fertility.
Single-port inflatable mediastinoscopic esophagectomy is a cure for esophageal cancer patients: Case report
Authors: Yibulayin Xiayimaierdan , Xu Keming , Yibulayin Waresijiang , Abulaiti Abulimiti , Wu Zhenhua , He Dan , Ran Anpeng , Ma Lei , Sun Xiaohong
Published: November 2022

Rationale:

It is often difficult to perform transthoracic esophagectomy (TTE) in patients with chest deformities, as these patients may be lost to surgery for non-oncological reasons.

Patient concerns:

In this case, we had a patient with esophageal squamous cell carcinoma (ESCC) who was not suitable for TTE because of extensive thoracic adhesions caused by the left pneumonectomy 8 years ago.

Diagnoses:

ESCC.

Interventions:

Based on Professor Fujiwara’s surgical method, we further improved it by proposing a single-port inflatable mediastinoscopy combined with laparoscopic-assisted esophagectomy.

Outcomes:

At the time of this writing, computed tomography and gastroscopy revealed no stenosis of anastomosis, and no evidence of disease recurrence.

Lessons:

To the best of our knowledge, the present case is the first single-port inflatable mediastinoscopic esophagectomy performed on a patient undergoing pneumonectomy.
Association of KCNJ11 and ABCC8 single-nucleotide polymorphisms with type 2 diabetes mellitus in a Kinh Vietnamese population
Authors: Tran Nam Quang , Truong Steven D. , Ma Phat Tung , Hoang Chi Khanh , Le Bao Hoang , Dinh Thang Tat Ngo , Van Tran Luong , Tran Thang Viet , Le Linh Hoang Gia , Le Khuong Thai , Nguyen Hien Thanh , Vu Hoang Anh , Mai Thao Phuong , Do Minh Duc
Published: November 2022

Type 2 diabetes mellitus (T2DM) is a genetically influenced disease, but few studies have been performed to investigate the genetic basis of T2DM in Vietnamese subjects. Thus, the potential associations of KCNJ11 and ABCC8 single nucleotide polymorphisms (SNPs) with T2DM were investigated in a Kinh Vietnamese population. A cross-sectional study consisting of 404 subjects including 202 T2DM cases and 202 non-T2DM controls was designed to examine the potential associations of 4 KCNJ11 and ABCC8 SNPs (rs5219, rs2285676, rs1799859, and rs757110) with T2DM. Genotypes were identified based on restriction fragment length polymorphism and tetra-primer amplification refractory mutation system polymerase chain reaction. After statistically adjusting for age, sex, and BMI, rs5219 was found to be associated with an increased risk of T2DM under 2 inheritance models: codominant (OR = 2.15, 95% confidence intervals [CI] = 1.09–4.22) and recessive (OR = 2.08, 95%CI = 1.09–3.94). On the other hand, rs2285676, rs1799859, and rs757110 were not associated with an increased risk of T2DM. Haplotype analysis elucidated a strong linkage disequilibrium between the 3 SNPs, rs5219, rs2285676, and rs757110. The haplotype rs5219(A)/rs2285676(T)/rs757110(G) was associated with an increased risk of T2DM (OR = 1.42, 95%CI = 1.01–1.99). The results show that rs5219 is a lead candidate SNP associated with an increased risk of developing T2DM in the Kinh Vietnamese population. Further functional characterization is needed to uncover the mechanism underlying the potential genotype-phenotype associations.
Mediating effects of emotional intelligence on the relationship between empathy and humanistic care ability in nursing students: A cross-sectional descriptive study
Authors: Lina Meng , Qin Guan , Yang Li
Published: November 2022

Patient-centered nursing holistic care is of utmost important to the nursing profession, and humanistic care cultivation has become a global nursing education concern. This study aimed to examine the relationship among emotional intelligence, empathy and humanistic care ability in nursing students, and to determine whether positive emotional intelligence could mediate the relationship between empathy and humanistic care ability. This study used a cross-sectional, descriptive design. A total of 323 nursing students was enrolled from one medical university in Heilongjiang Province, China. The emotional intelligence questionnaires, empathy scale and humanistic care ability scale were used to quantify participants’ responses. There was no significant difference in gender, residence, single-child family and leader experience of nursing students’ humanistic care ability. However, the significant differences were found in grade (t = 4.55, P < .01) and major interests (t = 7.06, P < .01). Obviously, there was positive correlation between positive emotional intelligence and empathy (R = 0.37, P < .01), and positive correlation between humanistic care ability and emotional intelligence (R = 0.62, P < .01), and empathy (R = 0.57, P < .01). Furthermore, emotional intelligence (β = 0.21, P < .01) had a significant mediating effect on the relationship between humanistic care ability and empathy. Nurse educators should improve the empathy of nursing students by developing and implementing emotional intelligence programs, in order to improve their humanistic care ability.
Efficacy and safety of Tonifying Qi and activating blood Chinese herbal prescriptions for myocardial infarction: Study protocol for a multi-centered RCT
Authors: Shang Juju , Qiu Shenglei , Zhou Yingjie , Liu Sina , Wang Zi , Lai Xiaolei , Liu Hongxu , Zhou Mingxue , Zhang Zhenmin , Liu Pengyu , Zhang Fangfang , Meng Xianghui
Published: November 2022

Introduction:

Acute myocardial infarction (AMI) is a common cause of death worldwide and heart failure (HF) is the main complication. Although the increase in percutaneous coronary intervention and drug treatment can reduce in-hospital mortality after AMI, the incidence of HF after AMI and the resulting risk of death are still rising, which causes difficulties in the rehabilitation of AMI patients after reperfusion.

Methods:

In this prospective, multicenter, randomized, double-blind, double-dummy, placebo-controlled trial, we will assigned 673 eligible patients with AMI after reperfusion into 4 groups: receiving Nao-Xin-Tong capsule (NXT), Bu-Yang-Huan-Wu (BYHW) granule (BYHW), Yang-Yin-Tong-Nao granule (YYTN), or placebo. The course of treatment will be 3 months. The primary outcome is HF incidence within 180 days. Nao-Xin-Tong capsule, BYHW granule, and Yang-Yin-Tong-Nao granule are different traditional Chinese medicines used for tonifying Qi and activating blood (TQAB).

Results:

Three months of TQAB combined with Western medicine may reduce the incidence of HF after reperfusion of AMI and improve patients’ quality of life.

Discussion:

This study will provide an important basis for the application of traditional Chinese medicine in patients with AMI after reperfusion and provide an evidence-based basis for the prevention and treatment strategy of HF after AMI.