bluuebunny/crossref_metadata_2025 huggingface dataset:
Retention Sutures and Negative Pressure Wound Therapy for Delayed Primary Closure of Fasciotomy Wounds
Authors: Dekker Paige K. , Chang Brian L. , Fleury Christopher M. , Evans Karen K.
Published: April 2021

Achieving primary closure of lower extremity fasciotomy wounds is difficult. Surgeons are faced with the option of waiting potentially long periods of time for edema to reside, in order to attempt delayed primary closure (DPC) versus closing at an earlier time with a split thickness skin graft. DPC offers superior aesthetic outcomes than split thickness skin grafts but traditionally cannot occur until later in the clinical course once excessive edema has subsided. We present a case of a young athlete with compartment syndrome, which was managed with an alternative technique for achieving DPC: serial partial closure under tension with retention sutures and negative pressure wound therapy. The successful outcome in this single case should prompt further studies investigating the objective benefits of this novel method to achieve DPC following fasciotomy.
Do Wearable Activity Trackers Increase Physical Activity Among Cardiac Rehabilitation Participants? A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Ashur Carmel , Cascino Thomas M. , Lewis Christopher , Townsend Whitney , Sen Ananda , Pekmezi Dorothy , Richardson Caroline R. , Jackson Elizabeth A.
Published: April 2021

Purpose:

The objective of this study was to review randomized controlled trials (RCT), which included a wearable activity tracker in an intervention to promote physical activity among cardiac rehabilitation (CR) participants, and to conduct a meta-analysis for the outcomes of step counts and aerobic capacity (V˙o
2max).

Methods:

Eight databases were searched for RCTs that included an activity tracker, enrolled adults eligible for CR, and reported outcomes of step count or aerobic capacity. Mean differences were calculated for outcomes in the meta-analyses.

Results:

Nineteen RCTs with 2429 participants were included in the systematic review and 10 RCTs with 891 participants were included in the meta-analysis. Meta-analysis of three RCTs using a pedometer or accelerometer demonstrated a significant increase in daily step count compared with controls (n = 211, 2587 steps/d [95% CI, 916-5257]; I
2 = 74.6% and P = .002). Meta-analysis of three RCTs using a pedometer or accelerometer intervention demonstrated a significant increase in V˙o
2max compared with controls (n = 260, 2.6 mL/min/kg [95% CI, 1.6-3.6]; I
2 = 0.0% and P < .0001). Meta-analysis of four RCTs using a heart rate monitor demonstrated a significant increase in V˙o
2max compared with controls (n = 420, 1.4 mL/min/kg [95% CI, 0.4-2.3]; I
2 = 0.0% and P = .006).

Conclusions:

Use of activity trackers among CR participants was associated with significant increases in daily step count and aerobic capacity when compared with controls. However, study size was small and variability in intervention supports the need for larger trials to assess use of activity trackers in CR.
Bronchoalveolar Lavage Complements Transbronchial Cryobiopsy Diagnosis in Diffuse Interstitial Lung Diseases
Authors: Serra Candela , Torrego Alfons , Pajares Virginia , Millan-Billi Paloma , Barril Silvia , Alonso Ana , Navarro Marta , Lopez Laura , Franquet Tomas , Castillo Diego
Published: April 2021

Background:

Bronchoalveolar lavage (BAL) is a technique classically used for the study of diffuse interstitial lung diseases (DILDs). Given the recent advances in the diagnosis of DILD by transbronchial cryobiopsy (TBCB), it is relevant to assess what BAL can contribute to TBCB.

Patients and Methods:

This is a retrospective descriptive study that included patients with DILD who, between 2013 and 2017, underwent BAL and TBCB in the same bronchoscopy intervention. We evaluated the complementary information provided by BAL to TBCB that facilitated the diagnosis by a multidisciplinary committee. Epidemiological, clinical, and functional variables and high-resolution chest tomography findings were recorded, along with complications associated with the procedures.

Results:

A total of 60 patients were included. TBCB, conditioned by the underlying radiologic pattern, provided diagnostic information in 75% of cases. BAL provided complementary information that supported the diagnosis and treatment in 22% of cases. Differential BAL findings were related to microbiology, cell count, and immunology. Regarding the safety of the procedure, 47% of the patients experienced complications, although none were serious.

Conclusion:

BAL findings contribute to TBCB findings in the diagnosis of DILDs, with no serious complications associated with their combined use.
A panel of eight mRNA signatures improves prognosis prediction of osteosarcoma patients
Authors: Wu Bo , Wang Zhan , Lin Nong , Yan Xiaobo , Lv Zhangchun , Ying Zhimin , Ye Zhaoming
Published: April 2021

Genetic alterations are vital to the progression of osteosarcoma carcinoma. The present study investigated a panel of gene signatures that could evaluate prognosis in osteosarcoma based on data from the Therapeutically Applicable Research To Generate Effective Treatments initiative. Osteosarcoma messenger RNA (mRNA) profiles and clinical data were downloaded from the therapeutically applicable research to generate effective treatments database. Patients with osteosarcoma were divided into two groups based on findings at diagnosis: with and without metastasis. Differentially expressed mRNAs were compared and analyzed between groups. Univariate and multivariate Cox regression analyses identified a set of eight mRNAs with the ability to classify patients into high-risk and low-risk groups with significantly different overall survival times. Further analysis indicated that the eight-mRNA signature was an independent prognostic factor after adjusting for other clinical factors. Receiver operating characteristic curve analysis demonstrated a good performance of the eight-mRNA signature. Further, the biological processes and signaling pathways of the eight-mRNA signature were reviewed using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes resources. Finally, the results of the TCGA analysis were verified by other cohorts from Gene Expression Omnibus database. The identification of an eight-mRNA signature not only provides a prognostic biomarker of osteosarcoma but also offers the potential of novel therapeutic targets for its treatment.
Percutaneous removal of common bile duct stones using a modified balloon technique
Authors: Kim Yang Won , Lee Sang Min , Choi Ho Cheol , Won Jung Ho , Na Jae Boem , Cho Jae Min , Choi Dae Seob , Park Mi Jung , Shin Hwa Seon , Kim Ji Eun , Park Sung Eun , Shim Jong Joon
Published: April 2021

To evaluate the effectiveness of percutaneous removal of common bile duct (CBD) stones using a modified balloon technique (balloon catheter sphincteroplasty and expulsion of the stones using half-captured balloons within the sheath) in patients difficult to treat with endoscopy.

Fifty patients underwent a modified balloon technique (balloon group), and 53 patients underwent CBD stone removal by the basket method (stone basket group) between 2016 and 2019. We compared the balloon and stone basket groups to evaluate the effectiveness of the modified balloon technique. Outcome variables such as demographics, technical success rates, procedural details, and complications were analyzed. Statistical analysis was performed using Student t test, Fisher exact test, or the χ2 test.

The technical success rate in the balloon group was 66% (33/50) in 1 session, 32% (16/50) in 2 sessions, and 2% (1/50) in 3 sessions. That of the stone basket group was 45% (24/53) in 1 session, 38% (20/53) in 2 sessions, and 17% (9/53) in 3 sessions.

The total procedure time was significantly shorter in the balloon group (29.5 ± 15.1 minutes) than in the stone basket group (41.7 ± 20.2 minutes) (P < .01), whereas the number of stones was higher in the balloon group than in the stone basket group (P = .03). Maximal stone size, balloon size, pancreatitis, and hospitalization stay did not show statistical differences between the 2 groups. Most complications (9 patients, balloon group; 8 patients, stone basket group) were mild and transient. Major complications occurred in one patient in the stone basket group, who experienced hemobilia due to arterial injury caused by percutaneous transhepatic biliary drainage, which was treated by endovascular embolization without mortality.

The modified balloon technique is an effective and safe treatment method for CBD stone removal in patients presenting difficulties in the endoscopic approach.
The effects of peripheral anterior synechiae on refractive outcomes after cataract surgery in eyes with primary angle-closure disease
Authors: Lee Tae-Eun , Yoo Chungkwon , Kim Yong Yeon
Published: April 2021

Objective of the study was to investigate the effects of peripheral anterior synechiae (PAS) on refractive outcomes after cataract surgery in eyes with primary angle-closure disease (PACD).

This is a retrospective, cross-sectional study. Seventy eyes of 70 PACD patients who underwent phacoemulsification and intraocular lens implantation. Patients were divided into 2 groups based on the presence of PAS on preoperative gonioscopy. The predictive power of the intraocular lens was calculated by the SRK/T, Hoffer Q, Haigis, and Holladay formulae. The mean absolute error (MAE) and predicted refractive errors were compared between PAS (+) and PAS (–) groups. We also evaluated the refractive errors with regards to the extent of PAS in the subanalyses.

The mean MAE was greater in the PAS (+) group with all formulae (0.61–0.70 diopters [D] vs 0.33–0.45 D, all P < .05). The eyes with PAS tended towards myopia (−0.30 D to −0.51 D vs −0.05 D to +0.24 D, all P < .05). However, the MAEs or predicted refractive errors were not different, irrespective of the extent of PAS in the subanalyses (all, P > .05).

The presence or absence of PAS may influence the postoperative refractive outcomes in PACD patients.
The necessity or not of the addition of fusion to decompression for lumbar degenerative spondylolisthesis patients
Authors: Wu Jun , Zhang Jingwei , Xu Ting , Pan Yongli , Cui Baolong , Wei Wei , Gao Yunlong , Yu Haiguang , Huang Qingliang , Long Xin-quan , Zhou Yu-fan
Published: April 2021

Background:

The new emerging application of decompression combined with fusion comes with a concern of cost performance, however, it is a lack of big data support. We aimed to evaluate the necessity or not of the addition of fusion for decompression in patients with lumbar degenerative spondylolisthesis.

Methods:

Potential studies were selected from PubMed, Web of Science, and Cochrane Library, and gray relevant studies were manually searched. We set the searching time spanning from the creating date of electronic engines to August 2020. STATA version 11.0 was exerted to process the pooled data.

Results:

Six RCTs were included in this study. A total of 650 patients were divided into 275 in the decompression group and 375 in the fusion group. No statistic differences were found in the visual analog scales (VAS) score for low back pain (weighted mean difference [WMD], –0.045; 95% confidence interval [CI], –1.259–1.169; P = .942) and leg pain (WMD, 0.075; 95% CI, –1.201–1.35; P = .908), Oswestry Disability Index (ODI) score (WMD, 1.489; 95% CI, –7.232–10.211; P = .738), European Quality of Life-5 Dimensions (EQ-5D) score (WMD, 0.03; 95% CI, –0.05–0.12; P = .43), Odom classification (OR, 0.353; 95% CI 0.113–1.099; P = .072), postoperative complications (OR, 0.437; 95% CI, 0.065–2.949; P = .395), secondary operation (OR, 2.541; 95% CI 0.897–7.198; P = .079), and postoperative degenerative spondylolisthesis (OR = 8.59, P = .27). Subgroup analysis of VAS score on low back pain (OR = 0.77, 95% CI, 0.36–1.65; P = .50) was demonstrated as no significant difference as well.

Conclusion:

The overall efficacy of the decompression combined with fusion is not revealed to be superior to decompression alone. At the same time, more evidence-based performance is needed to supplement this opinion.
Ultrasound-guided needle-knife for De Quervain's disease
Authors: Jiang Li , Liu Huan , Li Huaiyu , Jiang Jiawang , Liu Xiaomin
Published: April 2021

Background:

De Quervain's disease is a kind of aseptic inflammation caused by repeated frictions of tendons in the tendon sheath of the styloid process of the radius. The main symptoms are protuberance and pain of the styloid process of the radius, accompanied by aggravation of pain during the movement of the wrist and thumb. The advantages of needle-knife are simple operation, obvious therapeutic effect and high safety. It can also be used to treat De Quervain's disease. Ultrasound gives a precise visualization of the thickness. The purpose of this study is to evaluate the efficacy and safety of ultrasound-guided needle-knife in the treatment of De Quervain's disease and to provide the latest basis for clinical application.

Methods:

The computer will be used to search all randomized controlled trials (RCTs) about ultrasound-guided needle-knife treatment of De Quervain's disease in the following database: PubMed, Web of Science, Cochrane Library, Cochrane Central controlled Trials Registry (CENTER), EMBASE, China National knowledge Infrastructure (CNKI), Wanfang data, Chinese Biomedical Literature Database (CBM), VIP Database (VIP). The effectiveness and safety of ultrasound-guided needle-knife in the treatment of De Quervain's disease were evaluated with pain intensity, wrist function as the main index and wrist range of motion, adverse events and quality of life as the secondary index. Revman5.3 software was used for data processing.

Results:

This study will provide the latest evidence for the Ultrasound-guided needle-knife for De Quervain's disease.

Conclusion:

The conclusion of this study is to evaluate the effectiveness and safety of ultrasound-guided needle-knife in the treatment of De Quervain's disease.

Unique INPLASY number:

INPLASY202110094.
HLA-DPB1 alleles in hepatitis B vaccine response
Authors: Ou Guojin , Liu Xiaojuan , Jiang Yongmei
Published: April 2021

Background:

The role of the HLA-DRB1 and HLA-DQB1 genes in the antibody response to hepatitis B (HB) vaccine has been well established; however, the involvement of the HLA-DPB1 allele in the HB vaccine immune response remained to be clarified by a systematic review.

Methods:

A meta-analysis was performed in which databases were searched for relevant studies published in English or Chinese up until June 1, 2020. Six studies were identified and a total of 10 alleles were processed into statistical processing in this meta-analysis.

Results:

Three thousand one hundred forty four subjects (including 2477 responders and 667 non-responders) were included in this research. Alleles HLA-DPB1∗02:02, DPB1∗03:01, DPB1∗04:01, DPB1∗04:02, and DPB1∗14:01 were found to be associated with a significant increase in the antibody response to HB vaccine, and their pooled odds ratios (ORs) were 4.53, 1.57, 3.33, 4.20, and 1.79, respectively; whereas DPB1∗05:01 (OR = 0.73) showed the opposite correlation.

Conclusions:

These findings suggested that specific HLA-DPB1 alleles are associated with the antibody response to HB vaccine.
Association of low fat mass with nontuberculous mycobacterial infection in patients with bronchiectasis
Authors: Lim Sung Yoon , Lee Yeon Joo , Park Jong Sun , Cho Young-Jae , Yoon Ho Il , Lee Choon-Taek , Lee Jae Ho
Published: April 2021

The incidence of pulmonary nontuberculous mycobacterial (NTM) infection is high in patients with underlying lung disease such as bronchiectasis. Although previous studies have reported many risk factors contributing to the development of NTM-lung disease (LD), only a few reports on the relationship of the characteristics of patients, such as body mass index (BMI), skeletal mass, and fat mass, with NTM-LD have been published. We aimed to investigate the association between these parameters and NTM-LD in patients with bronchiectasis.

A monocentric retrospective study in a university hospital was conducted over 4 years (2013–2016). Parameters including BMI, skeletal mass, and fat mass were measured using bioelectrical impedance analysis in noncystic fibrosis bronchiectasis patients. Patients were grouped by the presence or absence of NTM-LD, and the differences in BMI, skeletal mass, and fat mass between the 2 groups were compared. In the NTM-LD group, the progression of disease was also followed.

Two hundred forty-five patients with bronchiectasis were enrolled in the study. One hundred six subjects (48%) had NTM-LD. These patients with NTM-LD were predominantly female, and had a significantly lower body weight (58.20 ± 8.84 vs 54.16 ± 8.99, P < .001), BMI (22.67 ± 3.04 vs 21.20 ± 2.59 kg/m2, P < .001), fat mass (16.19 ± 6.60 vs 14.23 ± 5.79, P = .013), and fat mass index (FMI; 6.79 ± 2.70 vs 5.57 ± 2.27 kg/m2, P < .001). Multivariate regression analysis showed that both female sex and lower FMI but not skeletal muscle index were independent risk factors for NTM-LD after adjusting for age, bronchiectasis severity index, and BMI (odds ratio 3.86 (1.99–7.78); 0.72 (0.63–0.82), P < .001, respectively).

Our results suggest that lower FMI may contribute to susceptibility to NTM infection in patients with bronchiectasis, independent of age or its severity.
Staged vs simultaneous bilateral unicompartmental knee arthroplasty for clinical outcomes
Authors: Chen Wang , Sun Jianning , Zhang Ye , Hu Zhenghao , Chen Xiang-Yang , Feng Shuo
Published: April 2021

Background:

Bilateral unicompartmental knee arthroplasty (UKA) can be divided into one or two stages clinically. Compared with staged bilateral UKA, whether simultaneous bilateral UKA has better clinical efficacy remains to be verified.

Methods:

PubMed, EBSCO, and Web of Science were searched by us for meta-analysis. Studies were considered eligible for inclusion if they included simultaneous and staged UKA. We excluded studies unrelated to the research question, studies in non-selected languages, and studies where the full-text was not available. The data were extracted by two independent investigators, and disagreements were resolved through discussions with a third party. If important data or information about the content of the paper were not available, authors were contacted. Publication bias in studies has been assessed. Meta-analysis was done using Review Manager 5.3.

Results:

The systematic review and meta-analysis identified 3370 trials, of which 8 studies (963 patients) compared simultaneous with staged bilateral UKA. The meta-analysis showed that the clinical outcomes of simultaneous bilateral UKA goes down in operating time (weighted mean difference [WMD] = −19.34, 95% confidence interval [CI] −22.44 to −16.25, P < .00001), postoperative hemoglobin (Std. mean difference [SMD] = −0.46, 95% CI −0.71 to −0.20, P = .0004), length of stay (LOS) (WMD = −4.73, 95% CI −6.39 to −3.06, P < .00001), hospital cost (SMD = −5.42, 95% CI −6.54 to −4.30, P < .00001). There were no significant difference in blood transfusion, venous thrombosis, infection, cardiac complications, pulmonary complications, Oxford Knee Score (OKS) between simultaneous and staged bilateral UKA.

Conclusion:

Simultaneous bilateral UKA can effectively reduce the operating time, LOS, and hospital cost without increasing postoperative complications compared to stage bilateral UKA.

Registration number:

CRD42020160056 (www.crd.york.ac.uk/prospero/).
Immune-related adverse events with immune checkpoint inhibitors
Authors: Hirata Aya , Saraya Takeshi , Kobayashi Fumi , Noda Akinari , Aso Kaori , Sakuma Sho , Kurokawa Nozomi , Inoue Manami , Mikura Sunao , Oda Miku , Ishida Manabu , Honda Kojiro , Nakamoto Keitaro , Tamura Masaki , Takata Saori , Ishii Haruyuki , Takizawa Hajime
Published: April 2021

Immune checkpoint inhibitors (ICIs) have emerged as evolutionary treatments for malignant diseases. Although ICIs can cause immune-related adverse events (irAEs) in various organs, precise timing after ICI initiation has been scarcely reported. Elucidating the effects of irAEs, such as time to onset, involvement of major organs, influence on progression-free survival (PFS), and overall survival (OS), are critical issues for physicians. Furthermore, lung-irAE as a whole is not well known.

We conducted a retrospective study of 156 patients who were treated with ICIs and compared 82 irAE patients with 74 non-irAE patients.

This study clearly demonstrated that the preferred period after induction of ICIs was significantly longer in lung-irAE than in other major organs (skin, digestive tract, and endocrine). The effect of irAEs on PFS and OS was evident PFS in the irAE group (n = 82) (median 128 days, interquartile range [IQR] 62–269 days, P = .002) was significantly longer than that in the non-irAE group (n = 74) (median 53 days, IQR 33–151 days). Similarly, OS was significantly longer in the irAE group (median 578 days, IQR 274–1027 days, P = .007) than in the non-irAE group (median 464 days, IQR: 209–842 days). However, this positive effect of irAEs in the lungs was not proportional to the extent of severity.

Lung-irAEs can occur at a later phase than non-lung-irAEs and seemed not to prolong OS and PFS. However, further studies are needed to support these findings.
Maternal and neonatal outcomes after energy-restricted diet for women with gestational diabetes mellitus
Authors: Feng Yaofang , Zhao Zengcai , Fu Dayin , Gao Wen , Zhang Fei
Published: April 2021

Background:

Gestational diabetes mellitus (GDM) affects 1% to 14% of pregnant women annually worldwide and is one of the most common pregnancy complications.

Objective:

We reviewed studies on maternal and neonatal outcomes after dietary managements for women with GDM comparing caloric-restricted (intervention group) and unrestricted diets (control group).

Methods:

We systematically searched online databases including Medline, Cochrane Controlled Register of Trials (CENTRAL), ScienceDirect, and Google Scholar from inception until September 2019. We performed a meta-analysis with random-effects model and reported pooled risk ratios (RRs) or pooled mean differences (MD) with 95% confidence intervals (CIs).

Results:

We analyzed data from 6 randomized controlled trials including 1300 participants, most of them with high bias risks. We found that the women in the intervention group achieved slightly better glycemic control (pooled MD, −0.72 mg/dL; 95% CI, −7.10 to 5.66 mg/dL) and overall pregnancy outcomes (except neonatal hypoglycemia) than the women in the control group.

Conclusion:

An energy-restricted diet does not seem superior to the usual/standard GDM diet based on maternal or neonatal outcomes. But, clinical recommendations cannot be made as the evidence is inconclusive.
Low central blood pressure and sympathetic activity predispose for the development of intradialytic hypotension
Authors: Wu Han-Kuei , Chang Ming-Yang , Cheng Hao-Min , Hsu Po-Chi , Lo Lun-Chien , Chen Li-Chuan , Lin Kang-Ping , Chang Hen-Hong
Published: April 2021

Intradialytic hypotension (IDH) may lead to a poor life quality and was associated with cardiovascular mortality in patients under hemodialysis. This study investigated the autonomic nerve and cardiovascular function in the IDH episodes.

In this case-control study, 70 end stage renal disease patients (198 visits) were recruited. Pulse wave analysis and heart rate variability were evaluated before hemodialysis. Two definitions of IDH were confirmed by medical records. IDH-f indicated a drop of systolic blood pressure or mean arterial pressure, accompanied with symptoms; IDH-n indicated a low nadir systolic pressure during the hemodialysis. All parameters were evaluated for the possible predisposing factors under each definition.

A total of 24 IDH-f and 37 IDH-n were noted in 177 visits. For both definitions, central pulse pressure seemed to be a consistent predisposing factor. Furthermore, lower sympathetic activity (odds ratio [OR] 0.55; 95% confidence interval [CI] 0.35–0.87), lower pulse pressure (OR 0.95; 95% CI 0.92–0.98), and higher augmentation index (OR 17.36; 95% CI 1.48–204.10) were the possible predisposing factors for IDH-f. On the contrary, lower mean arterial pressure (OR 0.87; 95% CI 0.78–0.98) was identified as the possible factor for IDH-n.

It was suggested that the lower central pulse pressure and sympathetic activity might be involved in the development of IDH.
Correlations between chest-CT and laboratory parameters in SARS-CoV-2 pneumonia
Authors: Orlacchio Antonio , Gasparrini Fulvio , Roma Silvia , Ravà Matteo Santangelo , Salvatori Eva , Morosetti Daniele , Cossu Elsa , Legramante Jacopo Maria , Paganelli Carla , Bernardini Sergio , Minieri Marilena
Published: April 2021

To investigate the relationship between damaged lung assessed by chest computed tomography (CT) scan and laboratory biochemical parameters with the aim of finding other diagnostic tools.

Patients who underwent chest CT for suspected Corona Virus Disease-2019 (COVID-19) pneumonia at the emergency department admission in the first phase of COVID-19 epidemic in Italy were retrospectively analyzed. Patients with both negative chest CT and absence of the novel coronavirus in nasopharyngeal or oropharyngeal real-time reverse transcriptase polymerase chain reaction (RT-PCR) swabs were excluded from the study. A total of 462 patients with positive CT scans for interstitial pneumonia were included in the study (250 males and 212 females, mean age 57 ± 17 years, range 18–89). Of these, 344 were positive to RT-PCR test, 118 were negative to double RT-PCR tests.

CTs were analyzed for quantification of affected lung volume visually and by dedicated software. Statistical analysis to evaluate the relationship between laboratory analyses and CT patterns and amount of damaged lung related with COVID-19 pneumonia was performed in 2 groups of patients: positive RT-PCR COVID-19 group and negative RT-PCR COVID-19 group, but both with positive CT scans for interstitial pneumonia.

Lymphocytopenia, C-reactive protein (CRP), lactate dehydrogenase (LDH), d-dimer, and fibrinogen increased levels occurred in most patients without statistically significant differences between the 2 groups with CT scans suggestive for COVID-19. In fact, in both groups the volume of lung damage was strongly associated with altered laboratory test results, even for patients with negative RT-PCR test.

The decreased number of lymphocytes, and the increased levels of CRP, LDH, d-dimer, and fibrinogen levels are associated with SARS-CoV 2 related pneumonia. This may be useful as an additional diagnostic tool in patients with double negative RT-PCR assay and with highly suspected clinic and chest CT features for COVID-19 to isolate patients in a pandemic period.
A systematic review and meta-analysis of the safety and efficacy of remifentanil and dexmedetomidine for awake fiberoptic endoscope intubation
Authors: Tang Zhi-hang , Chen Qi , Wang Xia , Su Nan , Xia Zhengyuan , Wang Yong , Ma Wu-hua
Published: April 2021

Background:

Awake fiberoptic endoscope intubation (AFOI) is the primary strategy for managing anticipated difficult airways. Adequate sedation, most commonly being achieved with remifentanil and dexmedetomidine, is integral to this procedure. This meta-analysis aimed to compare the safety and efficacy of these 2 sedatives.

Methods:

We conducted electronic searches in Embase, Web of Science, PubMed, Google Scholar, Medline, Springer, and Web of Science with no language restrictions. Studies comparing safety and efficacy between the sole use of remifentanil and dexmedetomidine among patients who underwent AFOI were included. Eight randomized controlled trials, comprising 412 patients, met the inclusion criteria. The primary outcomes were first attempt intubation success rate and incidence of hypoxia. The secondary outcomes were the Ramsay Sedation Scale score at intubation, memory recall of endoscopy, and unstable hemodynamic parameters during intubation.

Results:

Dexmedetomidine significantly reduced the incidence of hypoxemia during AFOI (risk ratio: 2.47; 95% confidence [CI]: 1.32–4.64]) compared with remifentanil; however, the first intubation success rates were equivalent (risk ratio: 1.12; 95% CI: 0.87–1.46]. No significant differences between the 2 sedatives were found for the Ramsay Sedation Scale score at intubation (mean difference: −0.14; 95% CI: −0.66–0.38) or unstable hemodynamic parameters during intubation (risk ratio: 0.83; 95% CI: 0.59–1.17). Dexmedetomidine reduced memory recall of endoscopy (risk ratio: 1.39; 95% CI: 1.13–1.72).

Conclusions:

While both remifentanil and dexmedetomidine are effective for AFOI and well-tolerated, dexmedetomidine may be more effective in reducing the incidence of hypoxemia and memory recall of endoscopy.

PROSPERP registration number:

CRD42020169612.
Systemic immune-inflammation index predicts postoperative acute kidney injury in hepatocellular carcinoma patients after hepatectomy
Authors: Xu Jianjun , Hu Shaobo , Li Suzhen , Wang Weimin , Wu Yuzhe , Su Zhe , Zhou Xing , Gao Yang , Cheng Xiang , Zheng Qichang
Published: April 2021

The systemic immune-inflammation index (SII) is an independent prognostic predictor of hepatocellular carcinoma (HCC). The present investigation examined whether an association exists between preoperative SII value and postoperative acute kidney injury (pAKI) in HCC patients.

The study included 479 hepatitis B virus (HBV)-associated HCC patients undergoing hepatectomy. The SII was calculated as P × N/L, where P, N, and L represent the counts of platelets, neutrophils, and lymphocytes in routine blood test, respectively. After propensity score matching, logistic regression analysis was used to explore independent predictors of pAKI in HCC patients.

pAKI was confirmed in 51 patients (10.8%). The average SII value was higher in patients with pAKI than patients without pAKI. After multivariate logistic regression analysis, SII, history of hypertension, and tumor size, among others, were found to be predictors of pAKI. The optimal threshold value of SII for predicting pAKI was found to be 547.84 × 109/L. Multivariate analysis performed after propensity score matching confirmed that SII ≥ 547.84 × 109/L was an independent predictor of pAKI.

The preoperative SII qualifies as a novel, independent predictor of pAKI in HCC patients with HBV infection who underwent hepatectomy.
What are the predictors for recurrence of Crohn's disease after surgery?
Authors: Ozgur Ilker , Kulle Cemil Burak , Buyuk Melek , Ormeci Asli , Akyuz Filiz , Balik Emre , Bulut Turker , Keskin Metin
Published: April 2021

Surgical resection is an unavoidable part of the current treatment options for Crohn's disease (CD), and more than half of patients develop recurrence. The aim of this study was to investigate the predictors for recurrence in the long-term follow-up of CD patients after surgery.

Medical records of consecutive CD patients who were operated on between January 2003 and January 2015 were retrospectively analyzed. Data including demographic and clinical characteristics of the patients were recorded. Recurrence was evaluated based on the Crohn's Disease Activity Index or endoscopic findings.

The majority of 112 patients were males (n = 64, 57.1%), and 61 (54.4%) of them were active smokers. The median follow-up was 113 (range: 61–197) months. Disease recurrence occurred in 16 (14.3%) patients at a median of 13.5 months. The endoscopic recurrence rate was 8% (n = 9) at 1 year, 12.5% (n = 14) at 5 years, and 13.4% (n = 15) at 10 years. One (0.9%) patient underwent colonoscopic balloon dilatation at 1 year, and 7 (6.3%) patients needed re-resection at a median of 36 months. The age of the patient at the time of diagnosis (P = .033), penetrating disease behavior (P = .011), intra-abdominal abscess (P = 0.040) and, concomitant fistula and intra-abdominal abscess (P = .017) were associated with disease recurrence.

Our study results suggest that the patients’ age at the time of diagnosis, penetrating disease, intra-abdominal abscess, and concomitant fistula and abscess are the risk factors for CD recurrence after surgery.
Changes in the prefronto-thalamic tract following cranioplasty
Authors: Choi Eun Bi , Chang Chul Hoon , Jang Sung Ho
Published: April 2021

Rationale:

The prefrontothalamic tract (PTT) injury is associated with various neuropsychological impairments including cognitive impairment. We report on three women with hemorrhagic stroke who showed changes in the PTT following cranioplasty (C/P) using diffusion tensor tractography (DTT) images.

Patient concerns:

The 3 women with hemorrhagic stroke showed reductions of cognitive impairment following C/P. Mini-Mental State Examination scores (MMSE) were increased by 7-, 8-, and 5-point in patient 1, 2, and 3, respectively, after C/P compared with the patients’ pre-C/P MMSE scores.

Diagnosis:

Three patients were diagnosed with spontaneous intracerebral hemorrhage. Three patients underwent C/P using auto-bone at 7 (patient 1 and 3) and 13 (patient 2) weeks after onset.

Interventions:

Diffusion tensor imaging data were acquired within 3 days before and 21 days after C/P.

Outcomes:

The pre-C/P DTT results showed non-reconstruction of the dorsolateral prefrontal cortex (DLPFC; patient 2 and 3) on the contralateral operation (contra-OP) side and orbitofrontal cortex (OFC; patient 3) on both sides, but those were reconstructed on post-C/P DTT. Except for the contra-OP side OFC of patient 2, all fractional anisotropy values decreased on post-C/P DTT compared with pre-C/P DTT. The mean diffusivity values of the VLPFC and OFC were higher on post-C/P DTT except for the contra-OP side VLPFC of patient 1 and contra-OP side OFC of patient 2. The voxel numbers also increased except for the contra-OP side VLPFC of patient 1.

Lessons:

We demonstrated structural changes in the PTT along with concomitant reductions of cognitive impairments following C/P in 3 women with hemorrhagic stroke using DTT. The DTT changes suggest that C/P can affect the state of the PTT on both the OP and contra-OP sides. However, the limitation that DTT analysis may underestimate or overestimate fiber tract status due to regions of fiber complexity and crossing fiber should be considered.
Efficacy and safety of Shenling Atractylodes Powder in the treatment of ulcerative colitis
Authors: Zhang Quanhui , Deng Yongwen , Wang Jinlong , Haung Feihong , Zhou Yiduo , Jia Mingyan , Yi Haoran
Published: April 2021

Background:

Ulcerative colitis (UC) is a kind of chronic non-specific ulcerative colitis, which is characterized by repeated abdominal pain, diarrhea, and mucus purulent stool. The disease is more recurrent, easy to delay, and canceration, seriously affect the quality of life, increase the economic burden of patients and society, treatment is more difficult, the World Health Organization as one of the modern refractory diseases. Shenling Atractylodes Powder in the treatment of ulcerative colitis showed a strong advantage, the effect is accurate. Therefore, this paper will systematically evaluate and meta-analyze the efficacy and safety of heat-sensitive moxibustion in the treatment of ulcerative colitis.

Methods:

Eight electronic databases were searched, including the PubMed, Embase, Web of Science, Cochrane Library, China National knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and China Biomedical Literature Database. We will search in the above electronic database from early 2021 to December without any language restrictions. Outcome indicators, including colonic mucosal symptom score Mayo colonoscopy grading, total effective rate, total incidence of adverse reactions, clinical symptom score, recurrence rate, laboratory indicators: IL-6, IL-9, TNF-α, IL-4, IL-10 inflammation-related factor levels. Rev Man5.3 software will be used for statistical analysis. The efficacy and safety results of Shenling Atractylodes Powder in the treatment of ulcerative colitis will be used as the average difference between the risk ratio of dichotomy data and the 95% co-card interval of continuous data.

Results:

When this research program is completed, the relevant results can be obtained.

Ethics and dissemination:

This article does not need to pass the ethics committee review, because this article does not involve the ethics question, only collates the related literature research. The results of this study will be disseminated in the form of a paper to help better guide the clinical practice of heat-sensitive moxibustion in the treatment of ulcerative colitis.

Registration Number:

INPLASY202120018.
A simple method for discrimination of carcinomatous meningitis using CEA, total protein, and total cell count in the cerebrospinal fluid of primary lung cancer patients
Authors: Ogawa Yukari , Saraya Takeshi , Noda Akinari , Kurokawa Nozomi , Sakuma Sho , Aso Kaori , Mikura Sunao , Oda Miku , Ishida Manabu , Honda Kojiro , Nakamoto Keitaro , Tamura Masaki , Takata Saori , Ishii Haruyuki , Takizawa Hajime
Published: April 2021

Carcinomatous meningitis (CM) is a critical issue for physicians. However, no study has reported a simple and useful diagnostic or predictive marker for CM.

This study aimed to elucidate the potential markers for diagnosing CM derived from cerebrospinal fluid (CSF).

We retrospectively enrolled 78 lung cancer patients with suspected CM during the clinical course, including 42 CM and 36 non-CM patients. We compared the clinical and CSF findings, including carcinoembryonic antigen (CEA), between CM and non-CM patients, and explored the diagnostic markers for early identification of CM as well as the contributing factors for mortality.

On CSF analysis, with cutoff values of CEA ≥5 ng/ml, total protein (TP) in CSF ≥45 g/dl, and total cell count (TCC) ≥7 cells/μL, the sensitivity, specificity, and area under the curve (AUC) for CM were 85.7%, 84.6%, and 0.887 (95% CI: 0.758–1.0, P < .001); 80.5%, 69.4%, and 0.755 (95% CI: 0.646–0.865, P < .001); and 56.1%, 100%, and 0.817 (95% CI: 0.722–0.912, P < .001), respectively. TP levels in CSF ≥the patients’ age had a sensitivity, specificity, and an AUC of 48.8%, 77.8%, and 0.633 (95% CI: 0.722–0.912, P = .045) for CM, respectively. Among CM patients, patients with ‘TP in CSF (>patients’ age)” (n = 19, P = .008) showed significantly shorter 90-day survival probability than the residual patients (n = 20). None of the CSF parameters could predict the risk of mortality on Cox regression analysis.

The cutoff value of CEA ≥5 ng/ml in CSF is a simple and useful method with a high diagnostic value for CM diagnosis, but not a suitable predicting factor for mortality. ‘TP in CSF >patients’ age” might be a novel factor for assessing short-term mortality.
Construction of competing endogenous RNA network and identification of novel molecular biomarkers in colon cancer
Authors: Xi Gu , Ziyu Xu , Yiting Liu , Zonghang Liu , Lifeng Zheng
Published: April 2021

Colon cancer patients suffer from high incidence and mortality rates worldwide. More novel molecular biomarkers should be used for the diagnosis and treatment of colon cancer. Long noncoding RNAs (lncRNAs) are found to be involved in colon cancer tumorigenesis and metastasis. This study aimed to identify novel lncRNAs in colon cancer.

Two independent datasets (GSE70880 and GSE110715) were downloaded from the Gene Expression Omnibus database and merged with the sva package. R software was used to distinguish differentially expressed lncRNAs and mRNAs in the merged dataset. The competing endogenous RNA (ceRNA) network was constructed using differentially expressed lncRNAs and mRNAs with Cytoscape. Differentially expressed RNAs in the ceRNA network were further verified using the Cancer Genome Atlas database. Gene oncology analysis, Kyoto Encyclopedia of Genes and Genomes pathway enrichment and survival analysis were also performed to identify hub genes.

A total of 99 differentially expressed lncRNAs and 95 differentially expressed mRNAs were identified in the merged database. Ten lncRNAs, 8 miRNAs, and 6 mRNAs were involved in the ceRNA network, in which LINC00114 and UCA1 were highly expressed in colon cancer. They were both associated with early tumor stages and might be used for the early diagnosis of colon cancer. High expression of LINC00114 can lead to poor overall survival of colon cancer patients. Furthermore, new pathways such as LINC00114/miR-107/PCKS5, UCA1/miR-107/PCKS5, and UCA1/miR-129-5p/SEMA6A were identified.

Two novel lncRNAs (LINC00114 and UCA1) in colon cancer were identified by bioinformatics analysis. They might contribute to the occurrence and development of colon cancer. In addition, LINC00114 may be involved in the overall survival of colon cancer patients.
Efficacy and safety of thunder-fire moxibustion for patients with knee osteoarthritis
Authors: Huang Qiaotong , Chen Jun , Jiang Yunfeng , Lu Lunbin , Zhu Siyuan , Zhong Zhiying , Tang Genhua , Zhou Xingchen , Guo Han
Published: April 2021

Background:

Knee osteoarthritis (KOA) is a major public health issue because it causes pain and functional limitation in patients. Many studies have reported that moxibustion, a treatment in traditional Chinese medicine, is effective in treating KOA. The aim of this protocol is to develop a standard in advance for synthesize and assess the efficacy and safety of thunder-fire moxibustion for KOA from these randomized controlled trial.

Methods:

The 2 commentators will screen 7 databases (PubMed, EMBASE, the Cochrane Library, Chinese National Knowledge Infrastructure, Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database) for randomized controlled trials that can be included from the time the database is built up until publication in December 2020. The original study that randomized control trials of thunder-fire moxibustion for patients with KOA will be selected and is not limited by country or language. In addition, researches in progress, the reference lists, and the citation lists of identified publications will be retrieved similarly. Study selection, data extraction, and assessment of the quality will be performed independently by 2 reviewers who have been trained before data extraction. A meta-analysis will be conduct if the quantity and quality of the original studies included are satisfactory; otherwise, a descriptive analysis will be conducted. Review Manager 5.4 software (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark) will be using for data synthesis and assessment the risk of bias according to Cochrane Handbook.

Result:

This study will provide a comprehensive review of current evidence for the treatment of thunder-fire moxibustion on KOA.

Conclusion:

The conclusion of this study will provide a judging basis that whether the treatment of KOA with thunder-fire moxibustion is effective.

Registration number:

INPLASY2020100012.
Effect of traditional Chinese medicine emotional therapy on post-stroke depression
Authors: Yang Yanhong , Zhang Ming , Zhao Junjie , Song Shanshan , Hong Feifei , Zhang Guiqin
Published: April 2021

Background:

Post-stroke depression has seriously affected the rehabilitation and quality of life of patients, and there is no reliable treatment plan at present. Nursing plays an important role in the recovery of patients, some studies have pointed out that traditional Chinese medicine emotional therapy has advantages in improving post-stroke depression and promoting rehabilitation, but it is lack of evidence-based basis. The purpose of this study is to systematically evaluate the effect of traditional Chinese medicine emotional therapy on the improvement of post-stroke depression.

Method:

We will search CNKI, Wanfang, VIP and CBM, PubMed, Embase, Web of Science and the Cochrane Library database, and search the randomized controlled trial on traditional Chinese medicine emotional therapy in patients with post-stroke depression from the establishment of the database to February 2021. The language is limited to English and Chinese. The quality of the included study is independently extracted and the literature quality is evaluated by 2 researchers. And meta-analysis is performed on the included literature using RevMan5.3 software.

Result:

In this study, the effect of traditional Chinese medicine emotional therapy on the improvement of post-stroke depression is evaluated by patient psychiatric scale score, compliance evaluation, quality of life evaluation and other indicators.

Conclusion:

This study will provide reliable evidence-based basis for establishing a reasonable and effective nursing scheme for patients with post-stroke depression.

Ethics and dissemination:

Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.

OSF Registration number:

DOI 10.17605/OSF.IO/KA7G3
The combined therapy of fecal microbiota transplantation and laxatives for functional constipation in adults
Authors: Fang Sijia , Wu Shan , Ji Lina , Fan Yongsheng , Wang Xinchang , Yang Kepeng
Published: April 2021

Objective:

Functional constipation is a prevalent, burdensome gastrointestinal disorder whose treatment remains challenging. Combined therapy uniting multiple treatments may be promising. Fecal microbiota transplantation (FMT) which tends to be an etiological treatment has been increasingly investigated in its management. Meanwhile, laxatives are widely used to relieve constipation temporarily, but their overall efficacy is poor. Therefore, we performed meta-analyses of randomized controlled trials to evaluate the joint efficacy of FMT and laxatives in functional constipation.

Methods:

We performed a systematic literature search of 6 electronic databases as of August 11, 2020. Randomized controlled trial of FMT together with laxatives vs laxatives alone in functional constipation in adults were included. Two reviewers independently performed the screening, data extraction, and bias assessment. Dichotomous outcome data were synthesized by risk ratio, and measurement data by weighted mean difference (WMD).

Results:

A total of 1400 records were identified, of which 5 were eligible (409 patients). Overall, compared to laxatives alone, combined therapy of FMT and laxatives more significantly improved total effective rate (risk ratio: 1.35; 95% confidence interval [CI]: 1.14, 1.60; I

2
 = 13%), Bristol stool form scale score (WMD: 1.04; 95% CI: 0.57, 1.51; I

2
 = 76%), reduce Wexner score (WMD: −3.25; 95% CI: −5.58, −0.92; I2 = 92%), Knowles-Eccersley-Scott-Symptom (KESS) score (WMD: −5.65; 95% CI: −7.62, −3.69; I

2
 = 0%) and patient assessment of constipation quality of life score (WMD: −18.56; 95%; CI: −26.43, −10.68; I

2
 = 78%). No serious adverse events were reported. The majority of included studies had poor methodological quality.

Conclusion:

Combined therapy of FMT and laxatives may be a reasonably effective and safe treatment for people with functional constipation. However, caution is needed with the interpretation of these data due to the small sample size, high heterogeneity, and low quality of the studies. Besides, we expect that more studies will be performed exploring the efficacy and safety of combined therapy for functional constipation.