bluuebunny/crossref_metadata_2025 huggingface dataset:
MeVa2.1.dOVA and MeVa2.2.dOVA: two novel BRAFV600E-driven mouse melanoma cell lines to study tumor immune resistance
Authors: Rao Disha , Lacroix Ruben , Rooker Alex , Gomes Tainá , Stunnenberg Johanna A. , Valenti Mesele , Dimitriadis Petros , Lin Chun-Pu , de Bruijn Beaunelle , Krijgsman Oscar , Ligtenberg Maarten A. , Peeper Daniel S. , Blank Christian U.
Published: December 2022

While immunotherapy has become standard-of-care for cutaneous melanoma patients, primary and acquired resistance prevent long-term benefits for about half of the late-stage patients. Pre-clinical models are essential to increase our understanding of the resistance mechanisms of melanomas, aiming to improve the efficacy of immunotherapy. Here, we present two novel syngeneic transplantable murine melanoma cell lines derived from the same primary tumor induced onBrafV600E Pten−/−mice: MeVa2.1 and MeVa2.2. Derivatives of these cell lines expressing the foreign antigen ovalbumin (dOVA) showed contrasting immune-mediated tumor control. MeVa2.2.dOVA melanomas were initially controlled in immune-competent hosts until variants grew out that had lost their antigens. By contrast, MeVa2.1.dOVA tumors were not controlled despite presenting the strong OVA antigen, as well as infiltration of tumor-reactive CD8+T cells. MeVa2.1.dOVA displayed reduced sensitivity to T cell-mediated killing and growth inhibitionin vitroby both IFN-γ and TNF-α. MeVa2.1.dOVA tumors were transiently controlledin vivoby either targeted therapy, adoptive T cell transfer, regulatory T cell depletion, or immune checkpoint blockade. MeVa2.1.dOVA could thus become a valuable melanoma model to evaluate novel immunotherapy combinations aiming to overcome immune resistance mechanisms.
Intranasal dexmedetomidine sedation for paediatric MRI by radiology personnel: a retrospective observational study
Authors: Karlsson Jacob , Lewis Gabriella , Larsson Peter , Lönnqvist Per-Arne , Diaz Sandra
Published: December 2022

BACKGROUND

MRI often requires sedation or anaesthesia to ensure good image quality in paediatric patients. Access to paediatric anaesthesia services is, however, a limiting factor for effective paediatric MRI service, and alternative sedation methods are, therefore, warranted.

OBJECTIVE

To investigate the efficacy and safety of an intranasal dexmedetomidine sedation program for paediatric MRI, without immediate presence of anaesthesia personnel.

DESIGN

Single institution retrospective observational study.

SETTING

Tertiary care paediatric hospital.

PATIENTS

Children 0 to 12 years, ASA risk class 1 or 2 with heart rate within age-appropriate limit.

INTERVENTION

Radiology personnel administered an initial dose of intranasal dexmedetomidine of 4 μg kg−1 followed by a second dose of 2 μg kg−1 to the patients if needed. Recordings of image quality, critical events, heart rate, pulse oximetry saturation and noninvasive blood pressure before and after dexmedetomidine administration were made.

MAIN OUTCOME MEASURES

Changes in haemodynamic and respiratory data before vs. after intranasal dexmedetomidine were analysed for changes, and the incidence of critical events was evaluated as well as rate of successful MRI scans.

RESULTS

One thousand and ninety-one MRIs under intranasal dexmedetomidine sedation were included (mean age 34 months, 95% confidence interval (CI), 33 to 36, 599 male individuals). A success rate of 93% (95% CI, 91 to 94%) was found. No major critical events were recorded, total incidence of minor issues was 0.2% (95% CI, 0 to 0.7%). Five children had a heart rate under a preset minimal limit after dexmedetomidine (0.4%; 95% CI, 0.1 to 0.9%). Significant decreases in heart rate and mean arterial pressure, within acceptable limits not requiring intervention, was seen after dexmedetomidine administration.

CONCLUSION

Intranasal dexmedetomidine sedation without immediate presence of anaesthesia personnel appears to be well tolerated and associated with minimal interference on MRI image quality.

TRIAL REGISTRATION

clinicaltrials.org NCT05163704, retrospectively registered.
Evaluating the Differences Between Fluorescein Tear Break-up Time and Noninvasive Measurement Techniques
Authors: Itokawa Takashi , Suzuki Takashi , Koh Shizuka , Hori Yuichi
Published: December 2022

Objectives:

To compare fluorescein tear break-up time (BUT) and noninvasive BUT measured using interferometry and corneal topography.

Methods:

We investigated 34 eyes of 34 patients with dry eye (mean age 39.2±8.3 years) and 16 eyes of 16 non–dry eye subjects (33.5±6.5 years). Tear film stability was measured using fluorescein BUT, noninvasive BUT (NIBUT)-DR1 with an interferometer, and noninvasive keratographic BUT (NIKBUT)-first and average using corneal topography. Correlations between fluorescein BUT and noninvasive BUT parameters were determined statistically. The noninvasive BUTs were compared between the dry eye and non–dry eye groups. The agreement between fluorescein and noninvasive BUTs was described using Bland–Altman analysis.

Results:

Fluorescein BUT was significantly correlated with NIBUT-DR1, NIKBUT-first, and NIKBUT-average. The Bland–Altman analysis revealed bias and 95% limits of agreement between fluorescein BUT and noninvasive BUTs as follows: NIBUT-DR1: 2.07 s, −5.33 to 9.46 s; NIKBUT-first: 3.39 s, −5.46 to 12.24 s; NIKBUT-average: 6.61 s, −1.58 to 14.79 s. The noninvasive BUTs were significantly different between the two groups. When NIBUT-DR1, NIKBUT-first, and NIKBUT-average with Bland–Altman correction were used as an index for dry eye, the cut-off values were 7.1, 8.4, and 11.6 s, respectively. The sensitivities were 0.735, 0.818, and 0.727 and specificities were 0.500, 0.437, and 0.562, respectively.

Conclusion:

Fluorescein BUT and noninvasive BUTs were significantly correlated, and noninvasive BUTs had higher values than fluorescein BUT. Considering the differences between fluorescein BUT and noninvasive BUTs, noninvasive methods can be used as effective tool for diagnosing dry eye.
Research Progress of Genomic Variation in Psoriasis
Authors: Sun Liang-Dan
Published: December 2022

As a typical representative of global complex diseases, psoriasis has attracted widespread attention because of its high heritability, heterogeneity, and incidence. Environmentally induced activation of the inflammatory–immune axis in patients with psoriasis relies on genetic regulation of genomic variation. The heritability of psoriasis exceeds 80%, and research of genomic variation in psoriasis is of great significance to the interpretation of the biological pathogenesis of the disease. The development of genome-wide association studies (GWASs) has provided a powerful means for the capture of psoriasis susceptibility genes. More than 100 psoriasis susceptibility loci have been captured, enabling humans to gain a breakthrough understanding of the genetics and traits of psoriasis. With the advancement of research methods, increasingly more genetic methodologies are being used to capture the locations and types of variants outside the scope of GWAS scanning, making up for the inclinations and deficiencies of traditional GWAS capture of gene loci in a more detailed manner. This review covers several decades of research on genomic variation in psoriasis, including GWASs in psoriasis, the capture of functional gene variant types, and the translation of genomic variation into precision medicine; summarizes the research progress of genomic variation in psoriasis; and provides a theoretical reference for future genetic-based research of the mechanisms underlying psoriasis.
Understanding the Pathogenesis of Generalized Pustular Psoriasis Based on Molecular Genetics and Immunopathology
Authors: Zhao An-Qi , Li Ming
Published: December 2022

Generalized pustular psoriasis (GPP) is a rare and life-threatening autoinflammatory skin disease characterized by recurrent and sudden episodes of widespread rashes with scattered sterile pustules. Clinical and genetic evidence indicates that the pathogenesis of GPP both overlaps and is separate from psoriasis vulgaris (PV). Interleukin (IL)-23/IL-17 immune pathway is well known to play a critical role in the immunopathogenesis of PV, while the inflammation of GPP is more inclined to involve the innate immune response via the IL-1/IL-36–chemokine pathway. Mutations in IL36RN, CARD13, AP1S3, MPO, TNIP1, SERPINA3, and SERPINA1 have been shown to be associated with GPP, among which loss-of-function mutation in IL36RN is the dominant mutation with the highest prevalence. Recent studies have shown that interaction of the IL-36 pathway and the IL-23/IL-17 axis underlies the immunological disturbances of GPP, indicating that innate and adaptive immune responses intertwine in the pathogenesis of GPP. With this deeper understanding of the pathogenesis of GPP, treatment by biologics targeting the IL-1/IL-36 pathway appears to be promising. IL-1 inhibitors, anakinra, canakinumab, and gevokizumab have reportedly been effective in some cases. Spesolimab and imsidolimab, which are antibodies to the IL-36 receptor, are undergoing investigation in a phase II trial and showing promising results. In the present review, we illustrate the current understanding of the pathogenesis of GPP based on recent updates on the molecular genetics and immunopathology of GPP and review recent clinical trials and case reports of novel biologics in the treatment of GPP.
Efficacy of scalp acupuncture for migraine: A protocol for systematic review and meta-analysis
Authors: Kim Che-Yeon , Hwang Eui-Hyoung , Heo In , Park Sun-Young , Shin Byung-Cheul , Hwang Man-Suk
Published: December 2022

Introduction:

Migraine is a disorder that is prevalent worldwide. However, there is still no clear and effective treatment for migraine. Recently, acupuncture as a treatment has been attracting attention and studies have shown the value of scalp acupuncture. Therefore, this protocol for a systematic review and meta-analysis was created to assess the evidence of effectiveness and safety of scalp acupuncture in the treatment of migraine.

Methods:

All published randomized controlled trials (RCTs) in the following databases will be searched from their inception to September 2022: PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), OASIS, Korean Studies Information Service System (KISS), Korean Medical Database and NDSL, CiNii (Citation Information by NII), and the China National Knowledge Infrastructure (CNKI), without language restrictions. The data collection and analysis will be conducted independently by two reviewers. The Cochrane Collaboration tool will be used to evaluate the risk of bias by evaluating the available studies. A meta-analysis will be conducted using RevMan V.5.4 software.

Results:

The purpose of the proposed systemic review is to systematically assess the effectiveness and safety of scalp acupuncture for the treatment of migraine.

Conclusions:

To sum up, this review will assess the effectiveness and safety of scalp acupuncture for the treatment of migraine. The results of this review are expected to provide new guidelines for the treatment of migraine.

Ethics and dissemination:

The review and meta-analysis will not require ethical approval because personal information from individuals will not be involved. The results will be published in a peer-reviewed journal.
A survey of caregiver burden for stroke survivors in non-teaching hospitals in Western China
Authors: Cao Lu-Lu , Tang Yu-Feng , Xia Yan-Qiu , Wei Ji-Hong , Li Gui-Rong , Mu Xiao-Ming , Jiang Cheng-Zhi , Jin Qi-Zu , He Mei , Cui Li-Jun
Published: December 2022

The social factors that moderate stroke caregiver burden have been found to be culture- and gender-specific. We examined the factors that influence the social support and self-efficacy of caregivers of stroke survivors and the burden of caregiving in China. To determine the caregiver burden of stroke survivors, their social support, and their self-efficacy. A total of 328 stroke survivors and their caregivers were recruited from 4 tertiary medical centers to participate in this cross-sectional study. The sociodemographic and stroke-related characteristics of the participants were obtained. Perceived social support and self-efficacy were assessed using the Social Support Rating Scale and General Self-efficacy Scale, respectively. Caregiver burden was assessed using the Zarit Burden Interview Scale. Relationships between the variables were assessed using Pearson’s correlation, the chi-square test, and a paired t test. A total of 27.4% of the caregivers reported receiving adequate social support, while 20.7% reported high levels of self-efficacy. A total of 67.1% of the caregivers experienced varying degrees of care burden, while the remaining 32.9% felt no burden. Participants’ sociodemographic characteristics (age, daily care time, self-rated health, and financial situation) were significantly related to caregiver burden, social support, and self-efficacy (P < .001). The findings indicate an inverse relationship between caregiver burden, social support and self-efficacy. Adequate social support and self-efficacy can reduce stroke caregivers’ burden. Hospital departments should provide assistance to stroke caregivers through educational programs and group training to increase their social support and self-efficacy, thereby alleviating their burden.
The cGAS-STING pathway-related gene signature can predict patient prognosis and immunotherapy responses in prostate adenocarcinoma
Authors: Zhuo Xingxing , Dai Hao , Yu Sui
Published: December 2022

The cyclic GMP-AMP synthase-stimulator of the interferon genes (cGAS-STING) pathway is essential in inflammation-driven tumor occurrence and progression. However, the prognostic roles and immune functions of cGAS-STING pathway-related genes in patients with prostate adenocarcinoma (PRAD) remain unclear. cGAS-STING pathway-related genes were obtained from the gene set enrichment analysis (GSEA) website. Univariate Cox regression analysis was performed to screen the prognosis-related hub genes in the cancer genome atlas (TCGA) and GSE116918 datasets. Unsupervised clustering analysis was performed to identify different clusters. The least absolute shrinkage and selection operator and multivariate Cox regression analyses were applied to develop a prognostic risk model. The prognostic values and predictive performance of risk signature were assessed by the Kaplan–Meier curve and receiver operating characteristic curve. The IMvigor210 cohort was used to investigate the potential values of the risk score in immunotherapeutic responses. Two clusters were identified based on the expression matrix of 12 prognosis-related genes. Specifically, better overall survival was observed in cluster 2 than cluster 1 in both datasets. Inflammation-related pathway enrichment and immune cell infiltration levels were altered between 2 clusters. Moreover, 6 genes (CASP8, GRK6, IL3RA, PLCB1, TBKBP1, and TNFSF10) were identified to generate a cGAS-STING pathway-related signature (CPRS). Survival analysis showed that patients in the high-risk group showed a more dismal survival than those in the low-risk group in TCGA and GSE116918 datasets. Notably, the CPRS can differentiate responsive patients from non-responsive individuals treated with PD-L1 blockades in an independent cohort. In addition, higher CPRS was associated with a more favorable prognosis. The proposed risk model was developed based on 6 cGAS-STING pathway related-genes, which can be used as a promising predictor for patient survival and immunotherapeutic responses in PRAD, contributing to treatment strategy-related decision-making.
Posterior fossa decompression and duraplasty with and without tonsillar resection for the treatment of adult Chiari malformation type I and syringomyelia
Authors: Yang Ming , Niu Hai-Tao , Jiang Hong-Sheng , Wang Yan-Zhou
Published: December 2022

Background:

The current surgical management of adult Chiari malformation type I (CM-I) with associated syringomyelia remains controversial. The objective of this study was to explore posterior fossa decompression and duraplasty (PFDD) with and without tonsillar resection in adult patients with CM-I and syringomyelia.

Methods:

A total of 116 adult patients suffering from both CM-I and syringomyelia who were scheduled to undergo surgical decompression at our institution between 2012 and 2020 were randomly divided into 2 groups: the PFDD group (n = 64) underwent PFDD without tonsillar resection, while the PFDD-T group (n = 52) underwent PFDD with tonsillar resection. The primary outcome was improvement or resolution of the syrinx. The secondary outcome was an improvement in clinical outcome based on Chicago Chiari Outcome Scale (CCOS) scores. All participants were followed-up to 1-year postoperatively.

Results:

The proportions of patients who had >20% improvement in syrinx size were 60.9% and 78.8% in the PFDD and PFDD-T groups, respectively (P = .038). The improvement in clinical outcome based on CCOS scores was significantly different in the 2 groups (P = .004). The functionality sub-score was significantly different between the 2 groups (P = .027), but there were no significant differences in the pain symptoms, non-pain symptoms, and complications sub-scores. The total CCOS scores were higher in the PFDD-T group than in the PFDD group (P = .037).

Conclusion:

This study determined the role of tonsillar resection in achieving obvious syrinx improvement following PFDD-T. PFDD with tonsillar resection seems to be a safe and effective surgical option to treat adult CM-I patients with syringomyelia.
Effect of light needle in the treatment of opioid use disorder: A protocol for a randomized controlled trial
Authors: Lu Tsuo-Cheng , Kuo Chun-En , Wu Szu-Ying , Tsai Yi-Hsun , Hung Yu-Chiang , Hu Wen-Long , Tsai Meng-Chang
Published: December 2022

Background:

Opioid use disorder occurs worldwide and creates an increasing economic burden and public health crisis. Some problems are associated with using opioid agonists; therefore, there is a need to develop non-opioid treatments to improve acute and long-term opioid withdrawal syndromes.

Methods:

We will enroll 100 participants with opioid use disorders receiving methadone maintenance treatment at an addiction treatment center and randomly allocate them to an experimental or control group. The experimental group will receive 12 sessions of light needle therapy within 4 weeks, while the control group will receive sham light needle treatment without any laser output. Urinary morphine levels were assessed before and after treatment. Participants will be asked to self-report their number of episodes or days of heroin use and heroin craving/refusal to use heroin in the previous week before and after treatment on a visual analogue scale score of 0 to 10. Quality of life will be reported using the Short Form-12v2 before and after 4 weeks of treatment. Pulse diagnosis and heart rate variability will be evaluated before and after treatment. Baseline patient characteristics will be compared between the groups using the independent t test and the χ
2 test. Data between the 2 groups will be compared using generalized estimation equations, and paired t tests.

Objective:

This study aims to investigate the effect of adjuvant light needle therapy in patients with opioid use disorder on methadone maintenance treatment.
Comparative the efficacy and acceptability of immunosuppressive agents for myasthenia gravis: A protocol for systematic review and network meta-analysis
Authors: Xu Peng , Zhang Ying , Chang Tianying , Jiang Li , Lv Zhiguo , Zhang Yibin , Xu Hanying , Zhang Dongmei , Lan Tianye , Cui Yingzi , Hua Zhen , Gao Chengfei , Lu Jing , Huang Qingxia , Tian Jinhui , Ma Jihui , Wang Jian
Published: December 2022

Background:

Immunosuppressive drugs are routinely used to treat myasthenia gravis (MG). However, current recommendations provide limited evidence to support treatment options, leading to considerable variation in practice among healthcare specialists. Hence, we present a protocol for a systematic review and network meta-analysis (NMA) to update the evidence by comparing the efficacy and acceptability of oral immunosuppressive drugs for the treatment of MG.

Methods:

We will conduct a systematic review and NMA of all randomized controlled trials evaluating the following oral immunosuppressive drugs for the treatment of MG. Published studies will be searched using the following databases from inception to November 23, 2021: CENTRAL, the CINAHL, MEDLINE, Embase, PsycINFO, Web of Science, and 3 Chinese databases (Chinese Biomedical Literatures Database, CNKI, and Wan Fang database). Assessment of study eligibility and data extraction will be conducted independently by 2 reviewers. The main outcome will be a quantitative MG scoring system. We will conduct Bayesian NMA to synthesize all evidence for each outcome and obtain a comprehensive ranking of all treatments. The quality of the evidence will be evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations framework.

Results:

The objective of this study was to assess the relative clinical efficacy and acceptability of first-line immunosuppressants for the treatment of MG, using a systematic review and NMA approach.

Conclusion:

In the absence of head-to-head trials comparing therapies, evidence from this NMA of available clinical trials will inform clinicians, patients, and families the risk-benefit profiles of different treatment options.
Efficacy and safety of phenobarbital for benign convulsions with mild gastroenteritis: A prospective randomized controlled study
Authors: Zha Jian , Chen Yong , Yu Xiongying , Xie Jihua , Yi Zhaoshi , Chen Hui , Zhong Jianmin
Published: December 2022

Background

previous studies have shown that phenobarbital (PB) is a effective and safe drug in the treatment of benign convulsions with mild gastroenteritis (CwG), but there is a lack of large sample prospective randomized controlled study of different doses. This study was a prospective randomized controlled study on the efficacy and safety of different doses of phenobarbital for CwG. There has been no similar study.

Methods

One hundred twenty CwG cases were included in this study. All of them were hospitalized in the Department of Neurology of Jiangxi Provincial Children's Hospital from January 2019 to August 2021. They were randomly divided into 10 mg/kg single dose group (Group A, n = 60) and 5 mg/kg single dose group (Group B, n = 60). The criteria for judging the efficacy of PB in our study were there was no convulsion in the course of acute gastroenteritis within 2 weeks after using PB.

Results

The effective rate was 93.33% in group A and 80.00% in group B. There was significant difference between the 2 groups (P < .05). Drowsiness was the most frequent adverse reaction. 14 cases in group A and 7 cases in group B had drowsiness. There was no significant difference between the 2 groups in the incidence of adverse events such as somnolence, ataxia, abnormal liver function, anemia, abnormal leukocyte, respiratory depression, cognitive impairment, rash, abnormal platelet and abnormal renal function (P > .05). All side reaction were transient.

Conclusion

it is suggested that PB 10 mg/kg intravenously should be used as soon as possible for CwG, which has high effectiveness and safety.
Low dose of esketamine combined with propofol in painless fibronchoscopy in elderly patients
Authors: Feng Yankun , Du Tianming , Wang Jafang , Chen Zhijun
Published: December 2022

To explore the effects and safety of low dose of esketamine combined with propofol in elderly patients undergoing fibronchoscopy. Eighty elderly patients who underwent painless fibronchoscopy in our hospital from June 2021 to September 2021 were recruited,and randomly divided into experimental group (esketamine 0.15mg/ kg + propofol 1mg/ kg) and control group (sufentanil 0.1 μg/ kg + propofol 1mg/ kg), with 40 cases in each group. There were significant differences in MAP, HR and SpO2 of T2, T3 and T4 between the experimental and control groups (P < .05). Besides, there were significantly differences on the trend of change between the 2 groups, with a small and relatively stable fluctuation in the experimental group (P < .05). Compared with the control group, the total dosage of propofol in the experimental group was significantly lower, and the number of vasoactive drugs, the incidence of respiratory depression and bronchospasm were significantly lower (P < .05). There was no significant difference in microscopic examination time, wake-up time, visual analogue score, and agitation, mental symptoms, increased secretion, nausea and vomiting, choking cough and laryngeal spasm during awakening period between the 2 groups. The incidence of total adverse reactions in the experimental group were strongly lower than those in control group. (P < .05). Low dose of esketamine combined with propofol can be safely used for fibronchoscopy in elderly patients, with good effects, more stable respiration and circulation, and low incidence of adverse reactions.
Giant seminal vesicle cyst with hemorrhage in Zinner syndrome: A case report
Authors: Xing Qingfei , He Li , Gao Xinghua , Zhang Chunling , Luo Xudong , Gao Xiangqin , Wu Yanlin , Zhang Longyang , Guo Feng
Published: December 2022

Rationale:

Zinner syndrome (ZS) is a rare congenital malformation of the urogenital tract that is associated with seminal vesicle cysts, ejaculatory duct obstruction, and ipsilateral renal agenesis. This unique condition was first reported by Zinner (1914). ZS is caused by malformation of the distal mesonephric duct during embryogenesis. To our knowledge, no giant seminal vesicle cysts with hemorrhage in ZS have been reported in the current study.

Patient concerns:

A 63-year-old man presented with chronic hypogastralgia with no history of lower urinary tract symptoms, hematuria, or trauma. Physical examination revealed no localized uplift or percussive pain in either kidney. No tenderness in the ureter stroke region, no localized eminence in the suprapubic region of the bladder, and no tenderness in the bladder region was observed. Digital rectal examination revealed a cystic mass with a smooth surface in the anterior wall of the rectum with no tenderness or unclear boundaries. No blood staining was observed in the finger sheaths.

Diagnoses:

Computed tomography scan revealed that the right kidney was absent, with a mass similar to a cord above the right seminal vesicle cyst. Contrast-enhanced pelvic magnetic resonance imaging (MRI) confirmed a short T1 and T2 signal shadow similar to a cord above the right seminal vesicle cyst. The boundary was clear, with the upper part leading to the “renal region” and the lower part connecting to the right seminal vesicle cyst. Contrast-enhanced MRI showed local parenchymal cysts with cyst wall enhancement but no intrathecal enhancement. This suggested a hemorrhagic cyst. A diagnosis of Zinner syndrome was established.

Interventions:

The patient was diagnosed with a giant seminal vesicle cyst with hemorrhage in ZS. The patient had no obvious symptoms; therefore, regular follow-ups were performed.

Outcomes:

MRI of the patient 1 month later showed that the hematoma in the seminal vesicle cyst was not absorbed.

Lessons:

Giant seminal vesicle cysts with hemorrhage in ZS are rare. To patients without symptom, regular follow-up can be adopted.
Changes in perfusion angiography after IVC filter placement and retrieval
Authors: Shreve Lauren A. , Lam Alexander , Badin Dylan , Nelson Kari , Katrivesis James , Fernando Dayantha , Abi-Jaoudeh Nadine
Published: December 2022

Inferior vena cava (IVC) filters are posited to effect flow dynamics, causing turbulence, vascular remodeling and eventual thrombosis; however, minimal data exists evaluating hemodynamic effects of IVC filters in vivo. The purpose of this study was to determine differences in hemodynamic flow parameters acquired with two-dimension (2D)-perfusion angiography before and after IVC filter placement or retrieval. 2D-perfusion images were reconstructed retrospectively from digital subtraction angiography from a cohort of 37 patients (13F/24M) before and after filter placement (n = 18) or retrieval (n = 23). Average dwell time was 239.5 ± 132.1 days. Changes in the density per pixel per second within a region of interest (ROI) were used to calculate contrast arrival time (AT), time-to-peak (TTP), wash-in-rate (WIR), and mean transit time (MTT). Measurements were obtained superior to, inferior to, and within the filter. Differences in hemodynamic parameters before and after intervention were compared, as well as correlation between parameters versus filter dwell time. APvalue with Bonferroni correction of <.004 was considered statistically significant. After placement, there was no difference in any 2D-perfusion variable. After retrieval, ROIs within and inferior to the filter showed a significantly shorter TTP (1.7 vs 1.4 s,P = .004; 1.5 vs 1.3 s,P = .001, respectively) and MTT (1.7 vs 1.4 s,P = .003; 1.5 vs 1.2 s,P = .002, respectively). Difference in variables showed no significant correlation when compared to dwell time. 2D-perfusion angiography is feasible to evaluate hemodynamic effects of IVC filters in vivo. TTP and MTT within and below the filter after retrieval were significantly changed, without apparent correlation to dwell time, suggesting a functional hemodynamic delay secondary to filter presence.
Formation and composition of crust in the nephrostomy tube of patients undergoing percutaneous nephrostomy
Authors: Ding Jiyao , Yu Haiyang , Zhang Jiawei , Ruan Li , Gu Xiaocheng , Chen Wenhua , Jia Zhongzhi
Published: December 2022

To investigate the formation and composition of crust in the nephrostomy tube (NT) of patients undergoing percutaneous nephrostomy (PCN). Consecutive patients undergoing PCN for the treatment of obstructive nephropathy who then underwent NT exchange between January 2020 and May 2022 were included in the study. The composition of crust in NTs was analyzed using infrared spectrum automatic analysis system. A total of 46 NTs were collected from 46 consecutive patients (19 men, 27 women; mean age, 68.5 ± 13.4 years) who underwent PCN. The median indwelling time of NTs was 96 days (Q1, 90 days; Q3, 140 days). Among the 46 NTs, 20 (43.5%) were positive for the presence of crust. The mean indwelling time was significantly longer in NTs positive for crust than in those negative for crust (169.7 ± 55.7 days vs 86.5 ± 15.0 days; P < .01). In the NTs positive for crust, the crust was composed of mixed components (apatite carbonate and magnesium ammonium phosphate hexahydrate, n = 7; apatite carbonate and calcium oxalate monohydrate, n = 4) in 11 NTs and a single component (apatite carbonate, n = 5; anhydrous uric acid, n = 2; calcium oxalate monohydrate, n = 2) in 9 NTs. When the NT indwelling time was longer than 3 months, the incidence of crust formation in the NT was significantly increased. Crust was most commonly composed of mixed components. In light of these findings, we suggest that NTs should be exchanged every 3 to 4 months to prevent the formation of crust and thus prevent obstruction of the NT.
Role of Baduanjin exercise-based cardiac rehabilitation in coronary heart disease after percutaneous coronary intervention: A protocol for systematic review and meta-analysis of randomized controlled trials
Authors: Li Xingxing , Lin Quan , Liu Rongpeng , Wu Yang , Fan Zonging
Published: December 2022

Background:

This study aimed to explore the effects of Baduanjin-based cardiac rehabilitation on cardiac function and quality of life in patients with coronary heart disease who have undergone percutaneous coronary intervention.

Methods:

PubMed, the Excerpta Medica Database, the Cochrane Library, Web of Science, the Wanfang, SINOMED, the China Science and Technology Journal Database and China National Knowledge Infrastructure were searched for appropriate articles from their respective inception until March 30, 2021. Meta-analysis was conducted with the RevMan 5.3 software.

Results:

A total of 11 studies including 1025 patients were considered. Compared with conventional Western medicine, Baduanjin improved the left ventricular ejection fraction of patients [mean difference (MD) = 2.83, 95% confidence interval (CI) (2.05, 3.61), P < .00001], increased the Seattle angina questionnaire and SF-36 health survey scale scores [MD = 6.67, 95% CI (4.09, 9.26), P < .00001; standard mean difference  = 0.73, 95% CI (0.55, 0.91), P < .00001, respectively] and decreased the scores of Zung self-rating anxiety scale and self-rating depression scale [MD = –6.64, 95% CI (–7.69, –5.22), P < .00001; MD = –6.63, 95% CI (–7.60, –5.66), P < .00001, respectively].

Conclusion:

Our findings showed that Baduanjin exercise improved cardiac function and quality of life and alleviated patients’ anxiety and depression.
Effect and safety of Tubridge flow diverter in the treatment of unruptured intracranial aneurysms
Authors: Li Li , Shao Qiu-Ji , Li Tian-Xiao , Wang Zi-Liang , Zhang Kun , Gao Bu-Lang
Published: December 2022

The effect and safety of the Tubridge flow diverting device are unknown in the treatment of intracranial aneurysms after optimization of the device, improvement in the deployment of the device, and accumulation of experience of using the device. This retrospective one-center study was performed to investigate the clinical effect and safety of the Tubridge flow diverting device in the treatment of unruptured intracranial aneurysms. Twenty-three patients with 33 unruptured intracranial aneurysms which were treated with the Tubridge device were retrospectively enrolled. The clinical data, endovascular procedure, complications, and follow-up were analyzed. Twenty-seven Tubridge devices were deployed to treat the 33 aneurysms, and the deployment was failed in 1 case, resulting in the success stenting rate of 96.3%. In 5 (15.2%) aneurysms, coils were loosely packed. Peri-procedural complications occurred in 2 patients (8.7%), including 1 procedure-related complication in which the distal end of a Tubridge device herniated into the aneurysm cavity. In another case, weakness of left upper limb occurred on the second day post procedure, with instent thrombosis being suspected, which was recovered after medication. No other complications occurred. Twenty-three (100%) patients had clinical follow-up 6 months later, with the mRS of 0 in 21 patients, 1 in 1, and 2 in 1. Five (21.7%) patients with 11 aneurysms underwent digital subtraction angiography at 6-month follow-up, with 8 aneurysms being completely occluded (Raymond grade I) and 3 aneurysms still visible (Raymond grade III). The Tubridge flow diverter may be safe and effective in the treatment of unruptured intracranial aneurysms with low perioperative complications and good follow-up outcomes even though multi-center and prospective clinical studies with a large size sample are still needed to validate these results.
A multivariate prediction model and its application in forecasting acute ischemic stroke: Protocol for a retrospective clinical study
Authors: Yang Dongmei , Liu Xia , Lan Hui , Wang Li , Ma Xiao , Xie Yu , Li Jielian
Published: December 2022

Background:

Acute ischemic stroke (AIS) occurs due to brain ischemia as a result of thrombosis of a cerebral blood vessel. It is a common cerebral blood circulation disorder worldwide and an important cause of death and disability.

Objective:

This study aims to establish a prediction model of multiple single category indicators and a joint model, through which to plot multiple receiver operating characteristic curves and compare area under curve of the models so as to predict the occurrence of AIS, explore the pathogenesis of AIS, and provide reference for clinical diagnosis and treatment of AIS.

Methods:

A retrospective clinical study was conducted in a Level A tertiary hospital in Sichuan Province, China. The patients participated in this study were over 18 years of age and suffered from acute ischemic stroke. They were hospitalized in department of neurology from October 1, 2019 to September 30, 2022, and underwent coronary artery computed tomographic arteriography (CTA) and blood biomarker detection. We collected demographic information, CTA data and blood biomarker detection values of all these patients.

Conclusion:

Through analyzing the clinical data of high-risk groups, this study provides guidance for the prevention and treatment of AIS, and promote further research.
Effect of IoT-based power cycling and quadriceps training on pain and function in patients with knee osteoarthritis: A randomized controlled trial protocol
Authors: Wang Xiao-yi , Xie Su-hang , Zhang Yu-jia , Zhu Si-yi , Zhang Rui-shi , Wang Lin , Feng Yuan , Wu Wei-ran , Xiang Dan , Liao Yuan , He Cheng-qi
Published: December 2022

Background:

Knee osteoarthritis (KOA) is a chronic musculoskeletal disease affecting the entire joint. Exercise therapy is the core treatment plan for non-surgical treatment of KOA, and tele-rehabilitation is also applied to KOA, but there is a lack of research on the comparison of pain and function recovery between different exercise methods combined Internet respectively. The study aims to compare the effects of power cycling and quadriceps training combined with online guidance separately on KOA mitigation of pain, recovery of function, quality of life, and adherence of participants in the community, compared to the control group.

Methods:

This study is a single-blind, 12-week parallel randomized controlled trial. Seventy-two participants aged ≥ 50 years with KOA will be randomized into either the power cycling group, the quadriceps group or the control group. The intervention will be performed three times per week during 12 weeks. Outcome measures will be assessed at baseline, and at 4, 8, and 12 weeks after allocation. The primary outcome will be self-reported pain, assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale. Secondary outcomes will include mitigation of knee pain, quality of life, improvement of functional physical performance, adherence of participants.

Discussion:

By summarizing the study’s strengths and limitations, this trial results may guide tele-rehabilitation of KOA in the community.

Trial registration: The study was registered in the clinical trial registry ChiCTR2200059255, 27/04/2022.
Seven cardinal questions for the patient with ear, nose or throat complaints: Review
Authors: Gilani Sapideh
Published: December 2022

The incidence of otolaryngological problems in general medicine practice is highly seasonal and approaches 25% in some months of the year. Accurate diagnosis in the otolaryngology office often requires the use of binocular microscopy, nasal endoscopy, and flexible laryngoscopy, none of which are available in a general medicine office. Therefore, history taking and physical examination techniques available in the non-otolaryngology office are of utmost importance. Using evidence-based history taking for ear, nose, and throat (ENT) problems facilitates dealing with patients who present with otolaryngologic complaints. In this paper, I present 7 cardinal questions to be asked when taking the history of a patient with ENT complaints.
TFEB-associated renal cell carcinoma: A case report and literature review
Authors: Zhu Yong , Xia Chengxing , Ou Yitian , Zhang Chao , Li Lin , Yang Delin
Published: December 2022

Rationale:

TFEB-associated renal cell carcinoma is very rare and belongs to the microphthalmia — associated transcription family translocation renal cell carcinoma.

Patient concerns:

Hospitalized for fever, a 29-year-old male patient had a left kidney lesion without any additional discomfort.

Diagnoses:

Histopathological and immunohistochemical results were corresponding with TFEB renall cell carcinoma features.

Interventions:

Surgical resection of the tumor was performed.

Outcomes:

After 8 months of follow-up, no tumor recurrence was observed.

Lessons:

TFEB-associated renal cell carcinoma is rare. The diagnosis is explicit. However, the optimal treatment needs to be further explored.
An assessment of serum vitamin B12 and folate in patients with Crohn’s disease
Authors: Akbulut Sabiye
Published: December 2022

Crohn’s disease is a chronic inflammatory condition that can involve any area in the gastrointestinal tract often involving the distal ileum where vitamin B12 is specifically absorbed. The aim of this study was to ascertain serum vitamin B12 and folate levels in order to investigate the correlation among these vitamin levels and disease activation, localization, duration and age at the onset of the disease.

Study population included 103 patients with Crohn’s disease and a healthy control group of 114 individuals. C-reactive protein, vitamin B12, folate levels were studied along with hemogram analyses. The results were evaluated in statistical comparisons. While serum vitamin B12 levels and serum folate levels were 161.9 ± 63.2(73–496) pg/mL and 4.9 ± 1.4(1.2–9.4) ng/mL in the Crohn’s patient group respectively, they were 321.7 ± 126.3(85–680) pg/mL and 7.6 ± 3.8(3–25.1) ng/mL in the control group respectively. Vitamin B12 and folate levels were distinctly lower in patients with Chron’s disease than those of the control group (P < .001). The intragroup analysis of the patient group revealed that low vitamin B12 levels were significantly lower in the moderate group classified according to the Crohn’s Disease Activity Index (P < .001), along with those in the L1 group with terminal/distal ileal involvement (P < .001).

Vitamin B12 and folate deficiencies are quite prevalent in patients with Crohn’s disease while this condition can lead to various complications and they prove to be important risk factors associated especially with thrombosis and its complications. Patients must be regularly followed-up for vitamin B12 and folate levels to supplement them where needed.
To study the mechanism of panax notoginseng in the treatment of aspirin resistance in the secondary prevention of stroke based on TLR4/MyD88/NF-κB signaling pathway: A study protocol
Authors: Wang Hui , Yuan Jie , Wang Ying , Chen Jie
Published: December 2022

Introduction:

Aspirin, as an typical antiplatelet therapy for secondary stroke prevention, have been proved that can significantly reduce incidence and recurrence of cerebrovascular ischemic events. However, due to drugs biological characteristics, aspirin resistance (AR) often occurs in clinical practice, which significantly influence secondary prevention in stroke patients. The growing evidence of activating blood and removing stasis herbs medicine (Sanqi) for AR is promising. However, the efficacy and mechanism of Panax notoginseng (Sanqi) for AR in secondary stroke prevention has not been confirmed.

Methods/design:

This is a prospective 2-center, assessor and statistician blinded, randomized, controlled trial. We will allocate 106 subjects aged between 45 and 65 years old, diagnosed with aspirin semi-resistance after stroke to 2 groups randomly in a ratio of 1:1. Patients in the experimental group will be treated with conventional treatments plus Panax notoginseng (Sanqi) while the others in the control group will be treated with only conventional treatments. All will be given different medications for 30 days. Patients will be measured with the platelet aggregation rate and serum TLR4, MyD88, NF-κB, COX-2, IL-6, CRP, TXB2 level for clinical efficacy and mechanisms at baseline and the 14th, 30th day of treatment. Baseline characteristics of patients will be summarized by groups and compared with Chi-square for categorical variables, and Student’s independent t test or nonparametric Mann-Whitney U test for the continuous variables. Primary and secondary outcomes will be analyzed with 2-way repeated measures Anova, and Post Hoc test.

Conclusion:

The present study aims to investigate short-term add-on efficacy and mechanism of Panax notoginseng (Sanqi) for aspirin resistance in secondary stroke prevention via TLR4/MyD88/NF-κB signaling pathway. With this, we expect to find out an appropriate partial substitute of aspirin for aspirin resistance individuals.

Trial Registration:

The trial was registered on Chinese Clinical Trial Registry (http://www.chictr.org.cn/index.aspx) with the ID ChiCTR2100045773 at April 24, 2021.
Acupuncture and related therapies for atopic eczema: A protocol for systematic review and network meta-analysis
Authors: Li Wang , Zhang Kaiqi , Wang Dongxin , Jiao Ruimin , Li Sha , Zhai Xu
Published: December 2022

Background:

Atopic eczema (AE) is a chronic relapsing dermatological disease characterized by pruritus, dryness, erythema, and lichenification. Acupuncture as an alternative treatment can relieve symptoms, reduce the recurrence, and improve the quality of life (QoL) with less adverse reactions in treating AE. This network meta-analysis (NMA) will comprehensively access the efficacy and safety of different acupuncture therapies for patients with AE, and rank the different acupuncture therapies, in order to present evidence-based medicine evidence for clinical application extensively.

Method and analysis:

This study will search 8 electronic databases from the establishment of the database to August 30th, 2022. The screening of literature, data extraction, and risk of bias assessment will be conducted by 2 researchers, respectively. The quality of evidence will be judged by the Grading of Recommendations Assessment, Development and Evaluation system. This NMA will be analyzed with Stata Version. 14.0 and WinBUGS Version.1.4.3.

Results:

This study will comprehensively access the efficacy and safety of different acupuncture therapies for patients with AE on the severity, itch intensity, emotional symptoms, QoL, and recurrence rate. Moreover, it will further identify which acupuncture therapy is the most effective.

Conclusion:

The findings of this NMA may help patients and therapists choose the best acupuncture therapy in treating AE and furnish reliable evidence for guidelines.

Registration number:

PROSPERO CRD42020203437
Alterations of gut microbiota and cytokines in elevated serum diamine oxidase disorder
Authors: Shi Lintao , Li Yerong , Liu Yu , Jia Haiying
Published: December 2022

The present study aimed to explore gut microbiota alterations and host cytokine responses in a population with elevated serum diamine oxidase (DAO) disorder. A total of 53 study participants were included in this study, segregated into 2 groups: subjects with high-level DAO (DAO-H, n = 22) subjects with normal DAO level (DAO-N, n = 31). We investigated the clinical and demographic parameters of study participants. The fecal bacterial communities and serum cytokines in 2 groups were assessed by 16S ribosomal RNA gene sequencing and immunoassay. High-pressure liquid chromatography was used to determine hemoglobin Alc. Flow cytometry was used to find the cytokine level in the blood serum. There is no difference in age, total cholesterol (TCHO), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), hemoglobin Alc, fasting plasma glucose (FPG) and homocysteine between the 2 groups. No significant difference were found in α-diversity between the 2 groups, however, the gut microbiota of subjects in DAO-H were characterized by marked interindividual differences, decreased abundance of Phocaeicola, Lachnospira, Bacteroides, Alistipes, Agathobacter, Lachnospira and Bactetoides and increased abundances of Mediterraneibacter, Blautia, Faecallibacterium, Agathobacter, and Parasutterella. Furthermore, the cytokines were no related to the DAO level in both groups and exhibited no significant differences between DAO-H and DAO-N. This study adds a new dimension to our understanding of the DAO and gut microbiota, and revealed that an increase in the DAO level in the intestinal mucosa could alter the gut microbiota composition, which can cause gut-related complications. Research is needed to extensively evaluate downstream pathways and provide possible protective or treatment measures pertaining to relevant disorders.