bluuebunny/crossref_metadata_2025 huggingface dataset:
Disease-specific mortality and major adverse cardiovascular events after bariatric surgery: a meta-analysis of age, sex, and BMI-matched cohort studies
Authors: Cui Beibei , Wang Guohui , Li Pengzhou , Li Weizheng , Song Zhi , Sun Xulong , Zhu Liyong , Zhu Shaihong
Published: March 2023

Background:

Obesity is associated with a significant predisposition towards cardiovascular events and acts as an important risk factor for mortality. Herein, we conducted a comprehensive meta-analysis to estimate the protective effect of bariatric surgery on disease-specific mortality and major adverse cardiovascular events (MACEs) in patients with severe obesity.

Methods:

PubMed and Embase were searched from inception to 4 June 2022. Eligible studies were age, sex, and BMI-matched cohort studies. The protocol for this meta-analysis was registered on PROSPERO (ID: CRD42022337319).

Results:

Forty matched cohort studies were identified. Bariatric surgery was associated with a lower risk of disease-specific mortality including cancer mortality [hazard ratio with 95% confidence interval: 0.46 (0.37–0.58)], cardiovascular mortality [0.38 (0.29–0.50)], and diabetes mortality [0.25 (0.11–0.57)]. Bariatric surgery was associated with a lower incidence of MACEs [0.58 (0.51–0.66)] and its components including all-cause mortality [0.52 (0.47–0.58)], atrial fibrillation [0.79 (0.68–0.92)], heart failure [0.52 (0.42–0.65)], myocardial infarction [0.55 (0.41–0.74)], and stroke [0.75 (0.63–0.89)]. According to subgroup analysis on all-cause mortality, patients with severe obesity and type 2 diabetes benefited more from bariatric surgery than those with severe obesity only (heterogeneity between groups: P=0.001), while different surgical approaches brought similar benefits (heterogeneity between groups: P=0.87).

Conclusions:

This meta-analysis of 40 matched cohort studies supports that bariatric surgery reduces disease-specific mortality and incidence of both MACEs and its components in patients with severe obesity compared with nonsurgical subjects. Bariatric surgery deserves a more aggressive consideration in the management of severe obesity.
Early implementation of full-practice authority: A survey of Massachusetts nurse practitioners
Authors: O'Reilly-Jacob Monica , Zwilling Jana , Perloff Jennifer , Freeman Patricia , Brown Emily , Donelan Karen
Published: March 2023

Background:

In January 2021, Massachusetts granted nurse practitioners (NPs) full-practice authority (FPA). Little is known about how FPA changes the day-to-day work of NPs.

Purpose:

To examine changes in practice barriers and care delivery in the early stages of FPA.

Methodology:

Descriptive analysis of a web-based survey of clinically active NPs in Massachusetts from October to December 2021, using Fisher exact tests to examine the associations between the perception that FPA improved work and other variables.

Results:

Survey response rate was 50.3% (N = 147). Overall, 79% of NPs believe that clinical work is unchanged by FPA. Practicing outside institutions is a significant predictor of FPA improving work (p < .05). Larger proportions of respondents feel that efficiency (22%), patient centeredness (20%), and timeliness (20%) are improved by FPA compared with effectiveness (16%), equity (14%), and safety (10%). Almost half of those reporting that FPA improves overall care also report improved efficiency (50%, p < .0001), but only 22% report improved safety (p < .05). Of those believing that FPA improved work, a minority no longer need physician review of new controlled substance prescriptions (29%, p < .01), a practice agreement (32%, p < .05), or physician signature on clinical documentation (22%, p < .05).

Conclusions:

Almost 1 year after FPA was passed in Massachusetts, the large majority of NPs report no changes in their day-to-day work, suggesting that FPA implementation is slow.

Implications:

Concerted efforts by regulators, employers, and individual NPs are needed to ensure that legislated FPA is effectively implemented inside organizations and among payers.
Early Predictive Value of Different Indicators for Persistent Organ Failure in Acute Pancreatitis
Authors: Wang Huan , Lü Muhan , Li Wei , Shi Jingfen , Peng Lan
Published: March 2023

Goals:

In this study, we conducted this network meta-analysis (based on the ANOVA model) to evaluate the predictive efficacy of each early predictor.

Background:

Persistent organ failure (POF) is one of the determining factors in patients with acute pancreatitis (AP); however, the diagnosis of POF has a long-time lag (>48 h). It is of great clinical significance for the early noninvasive prediction of POF.

Study:

We conducted a comprehensive and systematic search in PubMed, Cochrane library, Embase, and Web of Science to identify relevant clinical trials, case-control studies, or cohort studies, extracted the early indicators of POF in studies, and summarized the predictive efficacy of each indicator through network meta-analysis. The diagnostic odds ratio (DOR) was used to rank the prediction efficiency of each indicator.

Results:

We identified 23 studies in this network meta-analysis, including 10,393 patients with AP, of which 2014 patients had POF. A total of 10 early prediction indicators were extracted. The mean and 95% CI lower limit of each predictive indicator were greater than 1.0. Albumin had the largest diagnostic odds ratio, followed by high-density lipoprotein-cholesterol (HDL-C), Ranson Score, beside index for severity in acute pancreatitis Score, acute physiology and chronic health evaluation II, C-reactive protein (CRP), Interleukin 6 (IL-6), Interleukin 8 (IL-8), Systemic Inflammatory Response Syndrome (SIRS) and blood urea nitrogen.

Conclusions:

Albumin, high-density lipoprotein-cholesterol, Ranson Score, and beside index for severity in acute pancreatitis Score are effective in the early prediction of POF in patients with AP, which can provide evidence for developing effective prediction systems. However, due to the limitations of the extraction method of predictive indicators in this study, some effective indicators may not be included in this meta-analysis.
Microbiota and growth among infants and children in low-income and middle-income settings
Authors: Njunge James M. , Walson Judd L.
Published: March 2023

Purpose of review

Adequate nutrition is essential but insufficient for optimal childhood growth and development. Increasingly, it is clear that the gut microbiota modulates childhood growth and may be particularly important in low-income and middle-income countries (LMIC), where growth faltering, undernutrition, environmental contamination and enteric pathogens are more common. We summarize recent evidence demonstrating the role of the gut microbiota in impacting childhood growth and interventions targeting the gut microbiota to impact growth in children in LMIC settings.

Recent findings

Recent studies show that maturation of the infant microbiota is linked with the development of the immune system, which is key to host–microbe symbiosis. Infants lacking Bifidobacterium longum subsp. Infantis, which predominates breastfed microbiome, display immune activation while supplementation is linked to increased immune tolerance and among undernourished children, promotes growth. Microbiome-directed complimentary foods (MDCF) containing local ingredients is a novel strategy to promote gut microbiota development, especially among undernourished children and improve growth. Dietary patterns during pregnancy may drive selection of gut microbial species that impact infant health and growth.

Growth patterns among children in LMIC settings are closely associated with the diversity and maturity of the infant microbiome. Prebiotics, probiotics, and synbiotics targeting microbiota dysbiosis may impact birth outcomes, infant immune development and infections, and childhood growth in LMIC settings.
Pulmonary infection of Schizophyllum commune diagnosed by metagenomic next- generation sequencing: A case report
Authors: Zhang Jing , Xu Guoliang , Shen Jiumei , Ye Gangfu
Published: March 2023

Rationale:

Fungal infection is common and difficult to be diagnosed timely in clinical, for its various kinds and similar manifestations. The rare pulmonary fungal infection such as Schizophyllum commune was one of the harder ones and misdiagnosed in usual.

Patient concerns:

We report a 32-year-old female which was diagnosed with Metagenomic Next-Generation Sequencing (mNGS). She was hospitalized with the complaint of 4 months and more of repeated cough and expectorating. The chest computer tomography revealed left lower lobe pathological changes, but antibiotics were ineffective. No positive results were found in laboratory tests, including sputum culture and the pathology of lung puncture biopsy.

Diagnoses:

mNGS of lung biopsy was performed and detected the sequence number of Schizophyllum for 11.

Interventions:

The patient was treated with voriconazole and itraconazole successively.

Outcomes:

She recovered to health. There was no recurrence during follow-up.

Lessons:

mNGS as a diagnostic method could quickly detect pathogens through the processing of fragment, synthesis, comparison, and analysis of sample genes. It is suitable for detecting especially rare and polymicrobial infections. To our best knowledge, infection of Schizophyllum commune have not been reported in English literature with diagnostic method of mNGS.
Clinical efficacy of minimally invasive puncture and drainage versus trepanation and drainage for chronic subdural hematoma: Systematic review and meta-analysis
Authors: Li Guangfeng , Du Lele , Yu Fuhua
Published: March 2023

Background:

This study aimed to evaluate the clinical efficacy of minimally invasive puncture and drainage (MIPD) versus trepanation and drainage in the treatment of chronic subdural hematoma (CSDH).

Methods:

PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang database were searched for studies on the treatment of CSDH by MIPD and trepanation and drainage. By reading the title, abstract and full text, and screening according to the inclusion and exclusion criteria, the qualified articles were confirmed. Subsequently, the literature quality was evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions, and the data of the research subjects and the primary outcome measures were extracted for meta-analysis with RevMan 5.1 software.

Results:

Ten articles were included, with a total of 1000 patients. According to the meta-analysis, the 2 groups showed no statistical difference in CSDH recurrence rate (P > .05). The operation time, intraoperative blood loss, and incidence of postoperative adverse reactions were lower and the cure rate was higher in the MIPD group compared with trepanation and drainage group (all P < .05). By drawing the funnel plot of the outcome measures with heterogeneity, it can be seen that the distribution on both sides of the funnel was basically symmetrical, suggesting a low deviation possibility of the analysis results and reliable reference significance of our findings.

Conclusion:

Compared with trepanation and drainage, MIPD has better clinical effects and higher safety in treating CSDH and can effectively reduce surgery-induced damage, which is worth popularizing in clinical practice.
Prevalence and association of diabetic nephropathy in newly diagnosed Chinese patients with diabetes in the Hebei province: A single-center case-control study
Authors: Ren Xiaoya , Kang Ninglin , Yu Xianghui , Li Xiaolei , Tang Yange , Wu Jie
Published: March 2023

Diabetes is a chronic disease and has huge pressure on patients and the medical system, especially for patients with diabetic complications, for example, diabetic nephropathy. Diabetic nephropathy is a diabetic complication associated with damage to the kidney. To improve the quality of life of patients with diabetes, it is necessary to understand the factors that are associated with diabetic nephropathy. The objective of the study was to find the prevalence of diabetic nephropathy in newly diagnosed patients with diabetes and to develop the association between clinicopathological parameters and diabetic nephropathy. In a case-control study, demographics, anthropometric, and clinicopathological parameters of a total of 305 newly diagnosed patients with diabetes (the fasting blood glucose ≥ 7.0 mM/L and/or glycosylated hemoglobin ≥ 6.5 mM/L) in Hebei province were included in the analysis. If the urine albumin to creatinine ratio was ≥ 30 (microalbuminuria) then patients were considered diabetic nephropathy. Among enrolled patients, 206 (68%) were males and 99 (32%) were females and they were 46 to 71 years old. Demographic variables and health-related behaviors were the same among patients with diabetes either with nephropathy (case group, n = 135) or patients without nephropathy (control group, n = 170, P > .05 for all). The prevalence of diabetic nephropathy was 44%. Female to male ratio was 1:1.7 in the case group. Patients with diabetic nephropathy had higher body weight (P < .0001), waist circumference (P = .0006), and body mass index (P = .0002) than those of patients without nephropathy. Abnormal urinary globulin (P = .041, odd ratio (OR): 1.1231) was associated with diabetic nephropathy. Aspartate transaminase (P = .0651, OR: 0.8541), alkaline phosphatase (P = .0661, OR: 0.8122), hypertension (P = .0821, OR: 0.8214), and blood urea nitrogen (P = .0842, OR: 0.9411) were not significantly associated with diabetic neuropathy. However, they are near the statistical cutoff value. The prevalence of diabetic nephropathy in newly diagnosed diabetic patients of Hebei province is higher than those of the other provinces. Urinary globulin excretion had a weak association with the presence of nephropathy defined by urinary albumin excretion in patients with diabetes. The presence of other diabetic complications is also an essential parameter for diabetic nephropathy. Males are more susceptible to diabetic nephropathy than females if diabetic (Evidence Level: V; Technical Efficacy: Stage 3).
Application of enhanced recovery after surgery in perioperative patients undergoing laparoscopic surgery for gastric cancer: A meta-analysis
Authors: Yuan Wei , Huang Guigui , Dai Peng , Zhong You , Ai Qiubao , Liao Qinghui
Published: March 2023

Background:

To analyze the effect of enhanced recovery after surgery (ERAS) in perioperative patients undergoing laparoscopic surgery for gastric cancer (GC).

Methods:

We searched the literature databases of PubMed (https://pubmed.ncbi.nlm.nih.gov/) and Web of Science (https://www.webofscience.com/) for studies related to ERAS and laparoscopic surgery for GC from their inception till October 2022, and the retrieved articles were further screened for analysis. The literature quality was evaluated based on the Cochrane risk of bias tool. The endpoints included the first postoperative exhaust time, first postoperative bowel movement, length of stay, complications and hospitalization expenses. The meta-analysis was performed using RevMan 5.4 software.

Results:

11 studies were included, involving 2039 patients. Meta-analysis showed that the first postoperative exhaust and bowel movement were earlier and the length of stay was shorter in the experimental group (e.g.,) than in the control group (CG) (P < .05). Moreover, a lower incidence of complications and markedly reduced hospitalization expenses were determined in for example (P < .05). Due to the heterogeneity in the comparison of indicators such as the first postoperative exhaust and bowel movement across articles, a funnel plot was drawn for observations. The plot was found to be basically symmetrical, indicating small results bias and reliable reference significance of our findings.

Conclusion:

ERAS for perioperative patients undergoing laparoscopic surgery for GC can effectively shorten the postoperative rehabilitation cycle of patients, improve surgical safety and reduce treatment costs.
Inflammatory bowel disease can reduce ovarian reserve function in women: A systematic review and meta-analysis
Authors: Guo Lin , Liu Yi , Li Jiansheng , Liu Quan , Liu Bing , Shi Xuewen
Published: March 2023

Purpose:

We conducted a systematic review and meta-analysis to examine the role of inflammatory bowel disease (IBD) in ovarian reserve functions.

Methods:

The PECO strategy was employed. Women of reproductive age (Population) and with IBD (Exposure) were compared with healthy women of reproductive age (Comparison) to evaluate the ovarian reserve function (Outcome). Two reviewers searched three databases as well as relevant gray literature. After following the PRISMA 2020 guidelines, RevMan 5.0 software and Newcastle–Ottawa Scale (NOS) scoring were used to analyze and summarize the data included in the studies. The protocol was registered on PROSPERO (CRD42021267804).

Results:

The search yielded 367 studies, out of which 13 were selected for full-text evaluation, and finally, seven studies were included in our research. An analysis of ovarian reserve function in IBD women of reproductive age and healthy women revealed that the ovarian reserve function was lower in IBD women of reproductive age than in healthy women (P < .01, I
2 = 81%); the ovarian reserve function was significantly lower in women with IBD in remission than in healthy women (P < .01, I
2 = 0%), and ovarian reserve function was lower in IBD women of reproductive age taking thalidomide than in healthy women (P < .01, I
2 = 18%).

Conclusion:

IBD could reduce ovarian reserve function in women of reproductive age, and patients should plan for conception as soon as possible under permissible conditions.
Bioinformatics analysis of Omp19 and Omp25 proteins for designing multi-epitope vaccines against Brucella
Authors: Shi Donghao , Chen Yuan , Chen Muzhi , Zhou Tingting , Xu Feili , Zhang Chao , Wang Changmin , Li Zhiwei
Published: March 2023

Brucellosis is a zoonotic disease caused by Brucella. There is no effective vaccine against human brucellosis. Omp19 and Omp25 are the outer membrane proteins of Brucella. They are widely expressed and highly conserved in Brucella and have high immunogenicity. Herein, we aim to identify multi-epitope vaccine candidates based on Omp19 and Omp25. We analyzed the physicochemical properties and protein structure of Omp19 and Omp25, and predicted the corresponding B cell and T cell epitopes using bioinformatics analysis. Omp19 and Omp25 were composed of 177 amino acids and 213 amino acids, respectively. They were both stable hydrophilic proteins. The instability indices were 44.8 and 23, respectively. The hydrophilicity was −0.1 and −0.317, respectively. In the secondary structure of Omp19 and Omp25 proteins, the α-helix accounted for 12.43% and 23.94%, the β-sheet was 18.64% and 23.47%, the β-turn was 6.78% and 4.23%, and the random coil was 62.15% and 48.36%. Finally, 5 B cell epitopes, 3 Th-cell epitopes and 5 CTL cell epitopes of Omp19 protein, and 4 B cell epitopes, 3 Th-cell epitopes, and 5 CTL cell epitopes of Omp25 protein were selected as vaccine candidates. In conclusion, we obtained potential B cell and T cell epitopes of the Brucella outer membrane Omp19 and Omp25 proteins. This lays the foundation for the further design of multi-epitope vaccine of Brucella.
Development of technical skills in simulated cerebral aneurysm coiling
Authors: Zaika Oleksiy , Boulton Mel , Eagleson Roy , de Ribaupierre Sandrine
Published: March 2023

Endovascular surgical procedures require visual-spatial coordination in workspaces with restricted motions and temporally limited imaging. The development of the skills needed for these procedures can be facilitated by 3D simulator-based training. Cerebral angiography (CA) has lagged behind in this training approach due to the lack of validated, realistic training models, relying strictly on clinical case exposure frequency (“number of hours logged”) as a means of assessing proficiency. The ANGIO Mentor visual-haptic simulator is regarded as an effective training tool, however, this simulator has not been tested thoroughly in its ability to train interventional skills. In particular, the details of the aneurysm coiling process during simulation-based training have not been assessed.

In this study, 12 novice medical students were given simulation-based diagnostic CA training until a procedural plateau in performance, established in our previous work. Subsequently, they were trained using video tutorials and written instructions to identify, measure and intervene with cerebral aneurysms using endovascular coils. Over the span of 6 sessions, participants were assessed on their procedural task time, coiling quantity and quality, and perforation rates. Prior to commencing the study, participant spatial ability was assessed using a mental rotation test (MRT) and used as a comparative baseline for the performance analysis.

We found that all individuals were able to perform the procedure faster after 6 sessions, reducing their average time from 42 to 24 minutes. Coil success rate improved over from 82% to 88% and coil packing rate remained consistent at 30% throughout testing. High perforation rate seen at the start of the study showed a trend of decreasing over the latter sessions, however, over half of aneurysms were still being perforated by the novice participants. No change in aneurysm coiling quality was found, with a slight decrease in number of parent artery coil protrusions. High MRT individuals were better able to establish necessary tools prior to coiling, however, no other MRT-specific changes were seen.

This work identifies the utility of simulation-based CA training in identifying the particular difficulties trainees experience in learning procedural skills, including prevention of perforations, proper positioning and success of coils within the aneurysm.
Adjusted mortality of extracorporeal membrane oxygenation for acute myocardial infarction patients in cardiogenic shock
Authors: Choe Jeong Cheon , Lee Sun-Hack , Ahn Jin Hee , Lee Hye Won , Oh Jun-Hyok , Choi Jung Hyun , Lee Han Cheol , Cha Kwang Soo , Jeong Myung Ho , Angiolillo Dominick J , Park Jin Sup
Published: March 2023

Cardiogenic shock (CS) is a common cause of death following acute myocardial infarction (MI). This study aimed to evaluate the adjusted mortality of venoarterial extracorporeal membrane oxygenation (VA-ECMO) with intra-aortic balloon counterpulsation (IABP) for patients with MI-CS. We included 300 MI patients selected from a multinational registry and categorized into VA-ECMO + IABP (N = 39) and no VA-ECMO (medical management ± IABP) (N = 261) groups. Both groups’ 30-day and 1-year mortality were compared using the weighted Kaplan–Meier, propensity score, and inverse probability of treatment weighting methods. Adjusted incidences of 30-day (VA-ECMO + IABP vs No VA-ECMO, 77.7% vs 50.7; P = .083) and 1-year mortality (92.3% vs 84.8%; P = .223) along with propensity-adjusted and inverse probability of treatment weighting models in 30-day (hazard ratio [HR], 1.57; 95% confidence interval [CI], 0.92–2.77; P = .346 and HR, 1.44; 95% CI, 0.42–3.17; P = .452, respectively) and 1-year mortality (HR, 1.56; 95% CI, 0.95–2.56; P = .076 and HR, 1.33; 95% CI, 0.57–3.06; P = .51, respectively) did not differ between the groups. However, better survival benefit 30 days post-ECMO could be supposed (31.6% vs 83.4%; P = .022). Therefore, patients with MI-CS treated with IABP with additional VA-ECMO and those not supported with ECMO have comparable overall 30-day and 1-year mortality risks. However, VA-ECMO-supported survivors might have better long-term clinical outcomes.
Association between congenital heart disease and autism spectrum disorders: A protocol for a systematic review and meta-analysis
Authors: Ma Dan , Huang Jing-Lan , Xiong Tao
Published: March 2023

Background:

Congenital heart disease (CHD), the most common heart defect in children, refers to congenital disease with abnormal development of the heart or large blood vessels during the fetal period. The researchers suggest that children with CHD show more obvious neurodevelopmental disorders than children with normal development, and children with CHD may have a higher risk of social interaction and communication disorders. This is similar to the characteristics of children with autism spectrum disorder (ASD). However, the association between type of CHD and ASD is not well understood. This systematic review and meta-analysis will reveal the relationship between type of CHD and ASD.

Methods:

We will search the Cochrane Library, Embase, PubMed, China National Knowledge Infrastructure, Wanfang, Chinese Scientific Journals Full text, and China Biology Medicine disc databases using relevant subject terms and free words. We will use a fixed effects model or random effects model for meta-analysis. The risk of bias will be assessed by the Newcastle–Ottawa Scale and the agency for health care research and quality. Heterogeneity will be tested by Q statistics and I² values. Publication bias will be detected by funnel plots and Egger test. Subgroup analyses and sensitivity analyses will also be used to explore and interpret the heterogeneity.

Results:

The study will afford additional insight into the investigation the association between type of CHD and ASD.

Conclusions:

The results will provide evidence for the early identification and early intervention of ASD in children with CHD, which may contribute to improving the neurodevelopmental outcome of children with CHD.
Development of a novel prognostic assessment model for hepatitis B virus-related acute-on-chronic liver failure based on reexamination results
Authors: Gan Dakai , Zeng Yuyu , Zhang Kaige , He Yang , Wan Jiao , Zhang Xiaoqing , Zhang Zhen , Zhu Longchuan , Long Tao , Xie Nengwen , Zou Bo , Zhang Xuezhen , Xiong Yunfeng , Feng Guoliang , Luo Daya , Xiong Molong
Published: March 2023

Acute-on-chronic liver failure (ACLF) is a common clinical emergency and critical illness with rapid progression and poor prognosis. This study aims to establish a more efficient system for the prognostic assessment of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), which will provide a guiding scheme for subsequent treatment and improve the survival rate of patients. Data on 623 patients with HBV-ACLF were recorded. Univariate and multivariate analyses were performed to determine the discriminative abilities of the novel prognostic assessment model in predicting 90-day mortality. The area under the receiver operating characteristic curve was used to evaluate the accuracy of the models. Patients were divided into high- and low-scoring groups based on the best critical values, and survival rates were analyzed using Kaplan–Meier survival analysis and compared by applying log-rank tests. The area under the curve of the new scoring system established using the results of the first reexamination, the results of the first examination, the mean daily change in these results (MDCR) and the results of other first examinations were 0.911 (95% confidence interval [CI]: 0.889, 0.933), 0.893 (95% CI: 0.868, 0.917), and 0.895 (95% CI: 0.871, 0.919), respectively. The final prognostic scoring system established using the results of the first reexamination was chosen as a novel prognostic assessment model, and patients with lower scores (first reexamination results [FRER] score ≤ 3.65) had longer survival times (P < .001). The prognostic scoring system established using the FRER combined with other examination results can better assess the prognosis of HBV-ACLF at 90 days.
Effect of demographic features on morphometric variables of the knee joint: Sample of a 20 to 40-year-old Turkish population
Authors: Gültekin Muhammet Zeki , Keskin Zeynep , Dinçel Yaşar Mahsut , Arslan Tuğba
Published: March 2023

This study aimed to investigate the relationship between body mass index (BMI), age, and sex and morphological risk factors that may cause internal knee injuries. The magnetic resonance images of 728 participants who met the inclusion criteria and had a mean age of 34.4 ± 6.8 years were analyzed retrospectively. Demographic differences were analyzed by measuring 17 morphological parameters known to be associated with internal knee injuries. Men had a higher anterior cruciate ligament length (ACLL), anterior cruciate ligament width, (ACLW) lateral femoral condylar width (LFCW), medial femoral condylar width (MFCW), lateral femoral condylar depth (LFCD), distal femoral width (DFW), and intercondylar femoral width (IFW) than women (P < .05). By contrast, the medial meniscus bone angle (MMBA) was lower in men than in women (P < .05). Women aged 31 to 40 years had a lower Insall–Salvati index (ISI) and lateral tibial posterior slope (LTPS) than those aged 21 to 30 years (P < .05), whereas men aged 31 to 40 years had a lower ISI than those aged 21 to 30 years (P < .05). Women with BMI ≥ 30 had a higher LFCW and MFCW but a lower ISI than those with BMI < 30 (P < .05). Men with BMI ≥ 30 had a higher LFCW, MFCW, DFW, and MMBA than those with BMI < 30 (P < .05). The use of value ranges structured according to demographic characteristics, rather than a single value range for all patient groups, may contribute to the evaluation and treatment of the morphological features that are thought to be effective in the development of internal knee injuries. These values may also shed light on future radiological risk scoring systems and artificial intelligence applications in medicine.
Reproductive outcomes of women with moderate to severe intrauterine adhesions after transcervical resection of adhesion: A systematic review and meta-analysis
Authors: He Meifang , Chen Qiuli , He Jinlian , Zhao Qingqing , Jiang Hong , Xia Yong
Published: March 2023

Background:

Intrauterine adhesions (IUA) refers to the adhesion of the inner wall of the uterus, resulting in complete or partial occlusion of the uterine cavity, which causes a series of symptoms. Transcervical resection of adhesion (TCRA) is the standard surgical method for patients with IUA. However, the recurrence rate of women with moderate to severe IUA is high and it has raised a big concern about the reproductive outcomes.

Methods:

We conducted a scoping review by using 4 databases, including Google Scholar, PubMed, Scopus, Embase, and web of science, to retrieve relevant literature from September 1, 2001, to February 1, 2023, and to explore the reproductive outcomes in women with moderate to severe IUA after TCRA treatment. Following defined guidelines, data extraction was carried out by 2 researchers, and the findings were examined by 2 senior academics. The papers were evaluated by 2 reviewers using the inclusion and exclusion criteria. Using a form developed especially for this study, pertinent information was retrieved, including the first author, research design, study duration, age, intervention measurement, pregnancy rate, techniques of conception, and live birth rate. Two researchers conducted a quality assessment to determine any potential bias using the Cochrane technique and the Newcastle-Ottawa scale. RevMan 5.4.1 (The Cochrane Collaboration, London, United Kingdom) was used for data analysis, while I
2 was used to evaluate heterogeneity.

Results:

In total, this study included 2099 participants. After a detailed systematic review and meta-analyses, the results showed that pregnancy and live birth rates were increased significantly after TCRA, and the risk difference of the pregnancy rate was 1.75 [1.17, 2.62]. Besides, in 2 retrospective studies, the risk difference of live birth rate was 2.26, with a 95% confidence interval of 1.99 to 2.58. Moreover, the menstrual status of women also was improved, and the risk difference of hypermenorrhoea and amenorrhea were −0.28 [−0.37, −0.19] and −0.06 [0.26, 0.13], respectively.

Conclusions:

Taken together, TCRA is the useful strategy for the treatment of moderate to severe IUA to enhance the reproductive outcomes in women.
The reliability and validity of the Korean version of the reaching performance scale for stroke after translation and cross-cultural adaptation
Authors: Park Ji Eun , Park So Hyun , Lee Jun Hee , Ryu Byung-Ju , Hwang Soon-Young , Baek Seung Jun , Yang Seung Nam
Published: March 2023

The reaching performance scale for stroke evaluates reach-to grasp movement of the upper extremity and compensatory movements. The objective of the study was to translate and cross-culturally adapt the reaching performance scale for stroke into Korean and assess its reliability and validity. An expert committee supervised the forward and backward translation and the final translated Korean version of reaching performance scale for stroke (K-RPSS). Ninety-eight individuals (mean age 63.63 ± 13.13 years), with hemiplegia after stroke (97.82 ± 191.50 weeks) were evaluated independently by physiatrist and occupational therapist using K-RPSS. Degree of the motor impairment and functional status of patients were evaluated with the Fugl-Meyer assessment for upper limb and manual function test. The K-RPSS demonstrated excellent intra-rater (intraclass correlation coefficient = 0.9865), inter-rater (intraclass correlation coefficient 0.9866) reliability, and internal consistency (Cronbach α = 0.977 for total score). The validity of K-RPSS was confirmed with strong correlation with Fugl-Meyer assessment and manual function test. The K-RPSS had ceiling effect and the 3 points is the score change needed to indicate a change in a patient. K-RPSS has been shown to be a reliable and valid tool for assessing the compensation and movement quality of the upper limb and trunk when performing a reach-to grasp task. The K-RPSS is expected to be used widely by Korean speaking clinicians and researchers.
The effectiveness of acupuncture as an adjunctive therapy to oral pharmacological medication in patient with knee osteoarthritis: A systematic review and meta-analysis
Authors: Kwak Sang Gyu , Kwon Jae Bum , Seo Young Woo , Choi Won-Kee
Published: March 2023

Background:

We aimed to find out whether the combined treatment of acupuncture and oral medication is more effective than sole oral medication in reducing pain and improving knee function at the end of treatment and after short-term period (4–6 weeks after treatment). Second, if it is effective, we investigated whether the effect surpasses the minimal clinically important difference.

Methods:

Articles published between January 1, 1992, and August 31, 2022, were searched in PubMed, Cochrane, and Embase. The PICO (population, intervention, comparison, and outcome) of this study are as follows: Population: knee osteoarthritis patients; Intervention: acupuncture (non-sham acupuncture) + oral medication (analgesic or non-steroidal anti-inflammatory drugs); Comparison: oral medication (analgesic or non-steroidal anti-inflammatory drugs); Outcome: visual analog scale (VAS) or Western Ontario and McMaster University (WOMAC) osteoarthritis index

Results:

The combined treatment of oral medication and adjuvant acupuncture showed statistically significant improvement in VAS and WOMAC scores at the end of acupuncture treatment and short-term follow-up time (between 4 and 6 weeks after acupuncture). In addition, the degree of improvement of VAS and WOMAC index showed effects beyond minimal clinically important differences compared to pretreatment at both the end of acupuncture treatment and the short-term follow-up of acupuncture treatment.

Conclusion:

The existing evidence suggests that adjuvant acupuncture may play a role in the treatment of knee osteoarthritis. However, physicians should be aware of adverse effects such as hematoma in adjuvant acupuncture treatment.
A case report of primary complex anal fistula with 7 external openings treated with combined preoperative 3D MRI model
Authors: Hong Yongping , Qiu Yonggang , Li Guofeng
Published: March 2023

Introduction:

Anal fistula is a common perianal disease, but primary complex anal fistulas with 7 external openings is extremely rare.

Patient concerns:

We report a case of a 36-year-old man with a 10-year history of recurrent pus flow from paranal mass.

Diagnosis:

Primary complex anal fistula.

Interventions:

The patient underwent fistulotomy plus seton, which we successfully completed with the aid of 3-dimensional (3D) reconstruction model created from magnetic resonance imaging (MRI).

Outcomes:

The wound healed well and there was no recurrence 8 months after surgery.

Conclusion:

In the treatment of complex anal fistula, the combined application of 3D MRI model will be beneficial to obtain better surgical results.
Rare paratesticular localization of dedifferentiated liposarcoma: Case report and review of the literature
Authors: Deacu Mariana , Aschie Mariana , Bosoteanu Madalina , Vamesu Sorin , Baltatescu Gabriela-Izabela , Cozaru Georgeta Camelia , Orasanu Cristian Ionut , Voda Raluca Ioana
Published: March 2023

Rationale:

Dedifferentiated liposarcoma is defined as a malignant tumor that changes its shape from a well-differentiated liposarcoma to a non-liposarcomatous form. Most paratesticular liposarcomas manifest as an inguinal, painless, slow-growing mass. The standard treatment is extensive surgical excision, radiotherapy being proposed for cases with positive margins, those with recurrence, or in cases of the existence of unfavorable prognostic factors.

Patient concerns:

We present the case of a young patient diagnosed initially with left hydrocele, which after 2 years proved to mask a differentiated liposarcoma of the spermatic cord. The initial clinical manifestations were represented by the increase in volume of the left groin-scrotal region and pain at this level.

Diagnosis:

Microscopic examination in hematoxylin-eosin staining highlighted the presence of lipoblasts and fibroblasts in association with areas of hemorrhage and tumor necrosis. The performed immunohistochemical tests confirmed the diagnosis of dedifferentiated liposarcoma. To support and confirm the presence of the mouse double minute 2 homolog gene mutation, chromogenic in situ hybridization analysis was performed.

Interventions:

The initial treatment was the surgical one. After 2 weeks, the patient received zolendronic acid for hypercalcemia which was caused by the osseous metastasis.

Outcomes:

The patient died secondary to acute renal failure caused by hypercalcemia despite the treatment received.

Lessons:

This case underlines the importance of both the correct management of oncological patients, as well as immunohistochemical and genetic tests in the identification of prognostic factors, with the ultimate goal of administering an appropriate oncological treatment.
Efficacy of cisplatin combined with vinorelbine as second- or higher-line palliative chemotherapy in patients with advanced ovarian cancer
Authors: Yeon Sang Hoon , Lee Myung-Won , Ryu Hyewon , Song Ik-Chan , Yun Hwan-Jung , Jo Deog-Yeon , Ko Young Bok , Lee Hyo Jin
Published: March 2023

The aim of this study was to assess the therapeutic efficacy of a cisplatin and vinorelbine combination as second- or higher-line palliative chemotherapy in patients with advanced ovarian cancer. We retrospectively reviewed the medical records of patients with advanced ovarian cancer who were treated with cisplatin (60 mg/m2 on day 1) and vinorelbine (25 mg/m2 on days 1 and 8) every 3 weeks between January 2004 and March 2021. Treatment responses, progression-free survival (PFS), and overall survival (OS) were assessed; laboratory data were reviewed to determine toxicity. Thirty-two patients with advanced ovarian cancer were treated with a combination of vinorelbine and cisplatin. The objective response rate (ORR) was 18.8% and the disease control rate was 75.1%. The median PFS was 4.13 months (95% confidence interval [CI], 2.4–5.8 months). The median OS was 56.9 months (95% CI, 50.5–63.7 months). The ORR (42.9% vs 9.1%; P = .035) was higher in the platinum-sensitive group than in the platinum-resistant group. The median PFS tended to be longer in the platinum-sensitive group (5.3 vs 3.8 months; P = .339) and the median OS was significantly longer in the platinum-sensitive group than in the platinum-resistant group (69.6 vs 24 months; P < .001). All patients developed hematological toxicities, with 56% experiencing grade 3 to 4 neutropenia. Two (6.2%) patients developed febrile neutropenia, but no treatment-related death occurred. This combination therapy may be effective in patients with heavily treated advanced ovarian cancer, particularly in platinum-sensitive patients.
The potential mechanism of the Ruhao Dashi formula in treating acute pneumonia via network pharmacology and molecular docking
Authors: Yi Xiu-Xiu , Zhou Hui-Fen , He Yu , Yang Can , Yu Li , Wan Hai-Tong , Chen Jing
Published: March 2023

Background:

Acute pneumonia (AP) has a high seasonal prevalence every year, which seriously threatens the lives and health of patients. Six traditional Chinese medicines in Ruhao Dashi formula (RDF) have excellent antiinflammatory, antibacterial, and antiviral effects. RDF is commonly used in the clinical treatment of AP. However, the mechanism and target of RDF are unclear. Therefore, this study aimed to use network pharmacology and molecular docking to evaluate the target and mechanism of RDF in the treatment of AP.

Methods:

The Herbs and Disease Gene databases were searched to identify common targets of AP and RDF. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, and Protein-Protein Interaction (PPI) network analyses were performed to identify the potential molecular mechanisms behind RDF. Molecular docking was performed to compare the binding activities of the active molecules with that of the target protein.

Results:

The “drug-component-common target” network contained 64 active compounds and 134 targets. GO and KEGG analyses indicated that RDF could act by regulating cell death, cell proliferation, apoptosis, and hypoxic response. The PPI network and “pathway-target” network identified 31 core targets. Molecular docking revealed that the 14 active ingredients of RDF bind vigorously to the core targets.

Conclusion:

Through network pharmacology and molecular docking, we found that RDF contains 14 active components and 31 core AP targets. These targets were linked to the development of an antiinflammatory response and could be used to develop new drugs to treat AP.
Primary clear cell adenocarcinoma of the rectovaginal septum: A rare case report
Authors: Li Zhifang , Zhou Guiju , Duan Shuqiang , Li Qing
Published: March 2023

Rationale:

Primary clear cell adenocarcinoma of the rectovaginal septum is a very rare event.

Patient Concerns:

We reported a case of a 55-year-old woman diagnosed with a lump in the vaginal rectal septum after undergoing hysterectomy with bilateral salpingo-oophorectomy in 2017, who was admitted to our department due to vaginal bleeding. Magnetic resonance imaging of the pelvis indicated the vaginal rectal space cystic and solid mass about 110 mm × 100 mm × 140 mm in size.

Diagnosis:

The pathological diagnosis of postoperative was clear cell adenocarcinoma.

Interventions:

Abdominal laparotomy showed a solid block of the vaginal rectal septum. Surgery was performed to reduce the tumor.

Outcomes:

This patient received 8 courses of combined chemotherapy courses after surgery for the residual lesion and achieved a complete response.

Lessons:

Due to the rare observation of the growth pattern, the cell morphology and immune phenotype are not specific, and clinical and pathological diagnosis is difficult. Introducing the diagnosis and treatment of this case and reviewing the literature provide a relevant reference for clinicians identification and diagnosis and treatment of this rare case.
Can neutrophil-lymphocyte ratio and mean platelet volume be used to predict metastasis in individuals with lung cancer?
Authors: Kiliç Öztürk Yasemin , İleri Hande , Şen Şahin Burcu , Dağci Merve
Published: March 2023

Chronic inflammation plays an important role in the etiopathogenesis of many life-threatening chronic diseases, including cancer. Currently, the relationship between inflammation, native immunity and cancer is widely accepted; however, many of the mechanisms mediating this relationship remain undetermined and the clinical significance of these markers is unclear. The purpose of this study was to investigate the potential of neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) to indicate the existence of metastasis in lung cancer. This retrospective cross-sectional study evaluated patients with lung cancer of any pathological type who was admitted to the Palliative Care Unit of the referral hospital in the region between January 2019 and February 2020. Patient characteristics, distant organ metastasis, treatments, NLR and MPV values were noted. Patients were grouped as with or without metastasis. Characters, NLR, MPV values were compared. One hundred twenty-six patients were included. The mean age of the patients was 61.17 ± 9.4 years and 7.9% (n = 10) were female. The patients with a history of chemotherapy were 47% (n = 60) and distant organ metastases were present in 38.9% (n = 49) of the patients. The mean MPV value of 49 patients with distant metastasis was 8.34 ± 0.8 fL. MPV values of those with metastasis were found to be significantly higher than those without (P = .010). There was no significant difference in NLR values between groups (P = .920). Lung cancer patients with metastasis were found with higher MPV values. MPV can be effective and most accessible test in prediction of metastasis in lung cancer patients regardless of the pathological type.
COL3A1, CXCL8, VCAN, THBS2, and COL1A2 are correlated with the onset of biliary atresia
Authors: Li Hui , Cao Lei , Li Hong
Published: March 2023

Background:

Biliary atresia (BA) is a devastating progressive fibro inflammatory disorder in infants. The exact etiology of BA is still unclear. This study aimed screen key genes potentially associated with the occurrence of BA.

Methods:

All BA data was obtained from GSE46960 dataset. The limma package in R language was used for differentially expressed gene (DEG) analyses. gene ontology and Kyoto encyclopedia of genes and genomes enrichment analysis were performed on the screened DEGs, using “clusterProfiler” package. protein-protein interaction network was built based on STRING Cytoscape software (Bethesda, Rockville, MD). The logistic regression model was constructed based on the selected DEGs.

Results:

There were totally 78 DEGs in BA samples compared with normal samples, which were significantly enriched in 200 biological process terms, 37 molecular function terms, 17 cellular component terms, and 18 Kyoto encyclopedia of genes and genomes pathways. Among which, the top 10 genes with the highest importance in protein-protein interaction network were selected. Subsequently, on the basis of the stepwise regression method and 5-fold cross-validation, the logistic regression model constructed based on COL3A1, CXCL8, VCAN, THBS2, and COL1A2 was finally evidenced to predict the BA sample relatively reliably.

Conclusions:

In conclusion, COL3A1, CXCL8, VCAN, THBS2, and COL1A2 are potentially crucial genes in BA. The logistic regression model constructed based on them could predict the BA sample relatively reliably.