bluuebunny/crossref_metadata_2025 huggingface dataset:
Esophageal cancer risk is influenced by genetically determined blood metabolites
Authors: Deng Jieyin , Wu Silin , Huang Ye , Deng Yi , Yu Ke
Published: October 2024

It remains unclear what causes esophageal cancer (EC), but blood metabolites have been connected to it. Our study performed a Mendelian randomization (MR) analysis to assess the causality from genetically proxied 1400 blood metabolites to EC level. A two-sample MR analysis was employed to evaluate the causal relationship between 1400 blood metabolites and EC. Initially, the EC genome-wide association study (GWAS) data (from Jiang L et al) were examined, leading to the identification of certain metabolites. Subsequently, another set of EC GWAS data from FINNGEN was utilized to validate the findings. Causality was primarily determined through inverse variance weighting, with additional support from the MR-Egger, weighted median, and MR-PRESSO models. Heterogeneity was assessed using the MR Cochran Q test. The MR-Egger intercept and MR-PRESSO global methods were employed to detect multicollinearity. In this study, Bonferroni corrected P value was used for significance threshold. We found 2 metabolites with overlaps, which are lipids. Docosatrienoate (22:3n3) was found to be causally associated with a decreased risk of EC, as evidenced by the EC GWAS data (from Jiang et al) (odds ratio [OR] = 0.620, 95% confidence interval [CI] = 0.390–0.986, P = .044) and the EC GWAS data (from FINNGEN) (OR = 0.77, 95% CI = 0.6–0.99, P = .042), these results were consistent across both data sets. Another overlapping metabolite, glycosyl-N-(2-hydroxyneuramoyl)-sphingosine, was associated with the risk of ES, with EC GWAS data (from Jiang L et al) (OR = 1.536, 95% CI = 1.000–2.360, P = .049), while EC GWAS data (from FINNGEN) (OR = 0.733, 95% CI = 0.574–0.937, P = .013), the 2 data had opposite conclusions. The findings of this study indicate a potential association between lipid metabolites (Docosatrienoate (22:3n3) and glycosyl-N-(2-hydroxynervonoyl)-sphingosine (d18:1/24:1 (2OH))) and the risk of esophageal carcinogenesis.
Cytologic features of gastric-type endocervical adenocarcinoma: Three cases report and literature review
Authors: Liu Anchun , Yang Maiqing , Zou Hao , Gong Xiaolin , Zeng Chang
Published: October 2024

Rationale:

Cervical gastric-type adenocarcinoma shows gastric differentiation, and the tumor cell morphology appears benign and unrelated to human papillomavirus, which makes cervical gastric-type adenocarcinoma highly susceptible to misdiagnosis as normal glandular epithelium in cytologic diagnosis.

Patient concerns:

We present 3 cases of gastric-type adenocarcinoma, with the first being a 57-year-old female with abnormal uterine bleeding and fluid drainage. The second patient was a 63-year-old female, and the third was a 59-year-old female with irregular vaginal bleeding after menopause.

Diagnosis:

The 3 patients were diagnosed with cervical gastric-type adenocarcinoma by combining their history, clinical data, cytopathology, histopathology, and immunohistochemistry.

Interventions:

Patient 1 underwent total hysterectomy and adnexectomy, but refused radiotherapy and chemotherapy. Patient 2 received a chemotherapeutic regimen, and patient 3 was treated with traditional Chinese medicine.

Outcomes:

Patient 1 was followed-up for 9 months and is currently in good general condition, while patients 2 and 3 were not followed-up.

Lessons:

The “drunken honeycomb” cell arrangement is diagnostically important in liquid-based cytology, especially when three-dimensional spheroids are present, and may be a characteristic cytological finding of well-differentiated cervical gastric-type adenocarcinoma.
Bioinformatics and network pharmacology discover the molecular mechanism of Liuwei Dihuang pills in treating cerebral palsy
Authors: Wang Ling , Chen Bo , Xie Dongke , Wang Yuanhui
Published: October 2024

A collection of chronic central motor, postural, and activity restriction symptoms are referred to as cerebral palsy (CP). Previous research suggests that a number of perinatal variables, including hypoxia, may be linked to CP. And the pathophysiological process that causes brain injury in growing fetuses is mostly caused by amniotic fluid infection and intra-amniotic inflammation. Still, there is still much to learn about the molecular mechanism of CP. The goal of this study was to identify the molecular mechanism of Liuwei Dihuang pill (LWDHP) in the treatment of CP using network pharmacology and bioinformatics. The Chinese medicine database provided the LWDHP components and targets, the CP illness gene data set was gathered from a disease, and the expression profile of children with CP was chosen from anther database. Using the Kyoto Encyclopedia of Genes and Genomes and gene ontology databases, a network of interactions between proteins was created, and functional enrichment analysis was carried out. Analysis of traditional Chinese medicine found that the key active ingredients of LWDHP are quercetin, Stigmasterol and kaempferol. Through enrichment analysis, it was found that the hub genes for LWDHP treatment of CP are CXCL8, MMP9, EGF, PTGS2, SPP1, BCL2L1, MMP1, and AR. K EGG analysis found that LWDHP treatment of CP mainly regulates PI3K-Akt signaling pathway, IL-17 signaling pathway, Jak-STAT signaling pathway, NF-kappa B signaling pathway, etc. To summarize, LWDHP regulates immunological and inflammatory variables through a variety of components, targets, and signaling pathways, which plays a significant role in the development and management of CP.
Mortality of patients with sepsis in intensive care units at tertiary hospitals in Jordan: Prospective cohort study
Authors: Al Omar Saleh , Alshraideh Jafar Alasad , Oweidat Islam , Al Qadire Mohammad , Khalaf Atika , Abu Sumaqa Yasmeen , Al-Mugheed Khalid , Saeed Alabdullah Amany Anwar , Farghaly Abdelaliem Sally Mohammed
Published: October 2024

The aim of this study was to describe the 30-day mortality rate of adult patients with sepsis and septic shock in 6 intensive care units of 2 tertiary hospitals in Jordan. A prospective cohort design was used. Patients with sepsis and septic shock admitted to the medical and surgical intensive care units at 2 tertiary hospitals were followed up during the period between February 2022 and June 2022 (N = 148). Data were analyzed using SPSS, version 23. Moreover, descriptive statistics, chi-square, and binary logistic regression were used. Notably, 52.7% of patients with sepsis and septic shock died within 30 days of diagnosis of sepsis and septic shock. Sequential Organ Failure Assessment score and the history of having solid tumors significantly predicted the 30-day mortality rate. Moreover, 43 (29.0%) patients with sepsis and septic shock had positive blood cultures, and 46 (31.0%) had positive urine cultures. Patients with sepsis and septic shock have a notable mortality rate that can be predicted from total Sequential Organ Failure Assessment scores and from the history of having solid tumors. Early assessment and initiation of treatment for sepsis essentially would reduce the likelihood of progression of sepsis to septic shock and would reduce associated patients’ mortality.
The causality between gut microbiota and functional dyspepsia: A two-sample Mendelian randomization analysis
Authors: Jin Xiaojing , Xu Keli , Wu Jingyi , Yang Chenxi , Bao Jie , Du Lijun , Chen Binrui , Shao Xiaomei , Zhou Chuanlong
Published: October 2024

To investigate the potential link between gut microbiota and functional dyspepsia (FD). Genome-wide association studies (GWAS) of gut microbiota and FD were used in Mendelian randomization (MR) research. Using the GWAS of 18,340 people, instrumental variables related to gut microbiota as an exposure factor were identified. In a GWAS investigation, 189,695 control individuals and 4376 FD patients were included as outcome variables. The primary analysis technique was inverse variance weighted analysis. The reliability of MR analysis results is tested using sensitivity analysis. Two-sample Mendelian randomization analysis revealed the presence of 7 gut microbiota associated to FD. In the inverse variance weighted analysis method, Order Erysipelotrichales (odds ratio (OR): 1.301; 95% confidence interval (CI): 1.016, 1.665; P = .037), Family Erysipelotrichales (OR: 1.301; 95% CI: 1.016, 1.665; P = .037), Genus Haemophilus (OR: 1.236; 95% CI 1.059, 1.442; P = .007), Genus Ruminiclostridium 9 (OR: 1.422; 95% CI: 1.078, 1.877; P = .013), Genus Lachnospiraceae NK4A 136 group (OR: 1.297; 95% CI: 1.059, 1.589; P = .012) was positively associated with FD. Class Gammaproteobacteria (OR: 0.705; 95% CI: 0.522, 0.952; P = .022) and Genus Erysipelatoclostridium (OR: 0.747; 95% CI: 0.628, 0.888; P = .001) were found to be inversely related to FD. There was no evidence of pleiotropy or heterogeneity in the sensitivity analysis. Our research provides evidence for a possible link between FD and a number of gut microbiota. The role that gut microbiota plays in the development of FD requires more investigation.
Assessing the effects of HMGCR, LPL, and PCSK9 inhibition on sleep apnea: Mendelian randomization analysis of drug targets
Authors: Tan Wei , Deng Xiujuan , Tan Xiaoning , Tan Guangbo
Published: October 2024

To investigate the use of lipid-lowering drugs and abnormal serum lipid levels in patients at risk of sleep apnea syndrome. Three types of Mendelian randomization (MR) analyses were used. First, a 2-sample Mendelian randomization (TSMR) analysis was used to investigate the association between sleep apnea syndrome risk and serum lipid levels. Multivariate Mendelian randomization (MVMR) analysis was subsequently used to investigate the effects of confounding variables on SAS incidence of sleep apnea syndrome. Finally, drug-target Mendelian randomization (DMR) analysis was used to analyze the association between lipid-lowering drug use and sleep apnea syndrome risk. According to the TSMR analysis, the serum HDL-C concentration was negatively correlated with sleep apnea syndrome (OR = 0.904; 95% CI = 0.845–0.967; P = .003). Serum TG levels were positively correlated with sleep apnea syndrome (OR = 1.081; 95% CI = 1.003–1.163; P = .039). The association between serum HDL-C levels and sleep apnea syndrome in patients with MVMR was consistent with the results in patients with TSMR (OR = 0.731; 95% CI = 0.500–1.071; P = 3.94E−05). According to our DMR analysis, HMGCR and PCSK9, which act by lowering serum LDL-C levels, were inversely associated with the risk of sleep apnea syndrome (OR = 0.627; 95% CI = 0.511–0.767; P = 6.30E−06) (OR = 0.775; 95% CI = 0.677–0.888; P = .0002). LPL, that lowered serum TG levels, was positively associated with the risk of sleep apnea syndrome (OR = 1.193; 95% CI = 1.101–1.294; P = 1.77E−05). Our analysis suggested that high serum HDL-C levels may reduce the risk of sleep apnea syndrome. Low serum TG levels have a protective effect against sleep apnea syndrome. The DMR results suggested that the use of HMGCR lipid-lowering drugs (such as statins) and PCSK9 inhibitors has a protective effect against sleep apnea syndrome. However, LPL-based lipid-lowering drugs may increase the risk of sleep apnea syndrome.
Pathway analysis of the impact of health literacy, social support, and self-management on frailty in patients with chronic heart failure: A cross-sectional study
Authors: Cheng Yu , Peng Qin , Ding Hua , Hu Mengdie , Li Chaofeng
Published: October 2024

Chronic heart failure (CHF) is a significant global health challenge, and frailty is common among CHF patients. Although abundant evidence has revealed significant intercorrelations among health literacy, social support, self-management, and frailty, no study has explored their associations into 1 model based on a theoretical framework. The study aimed to test the Information-Motivation-Behavioral Skills Model in a sample of Chinese CHF patients and explore the potential relationships among social support, health literacy, self-management, and frailty. A cross-sectional study was conducted on CHF patients (n = 219) at a tertiary hospital in China. The Tilburg Frailty Indicator, Heart Failure Specific Health Literacy Scale, Social Support Rating Scale, and Self-management Scale of Heart Failure Patients were used to assess frailty, health literacy, social support, and self-management, respectively. Structural equation modeling with the bootstrapping method was used to test the hypothesized relationships among the variables. The results showed that 47.9% of the CHF patients suffered from frailty. Frailty was negatively correlated with health literacy (r = −0.268, P < .01) with a moderate effect size, social support (r = −0.537, P < .01) with a large effect size, and self-management (r = −0.416, P < .01) with a moderate effect size. The structural equation modeling model showed that social support was positively associated with health literacy (β = 0.419, P < .01) and self-management (β = 0.167, P < .01) while negatively associated with frailty (β = −0.494, P < .01). Health literacy was positively associated with self-management (β = 0.565, P < .01), and self-management was negatively associated with frailty (β = −0.272, P < .01). Our study suggests the potential positive impacts of health literacy, social support, and self-management on improving frailty in CHF patients. Healthcare providers should strengthen patient health education, improve their health literacy, enhance their social support, and promote their self-management so as to reverse frailty and reduce the risk of adverse outcomes.
Spontaneous rectus sheath hematoma complicated by deep venous thrombosis: A case report
Authors: Cheruiyot Isaac , Sehmi Prabjot , Kipkorir Vincent , Munguti Jeremiah , Ogeng’o Julius
Published: October 2024

Rationale:

Rectus sheath hematoma (RSH) is an unusual cause of acute abdominal pain. It is more common in elderly patients on anticoagulation. The diagnosis is often challenging, as it mimics other more common causes of acute abdomen. No standard treatment guidelines exist, presenting therapeutic dilemmas. Herein, we describe a case of spontaneous RSH complicated by deep venous thrombosis (DVT).

Patient concerns:

The patient was a 58-year-old female on follow-up for end-stage renal failure, admitted for management of uremic gastritis, fluid overload state, and bronchopneumonia. On the third day of admission, she developed worsening abdominal pains, associated with dizziness, headaches, hypotension, tachycardia, and desaturation. Abdominal examination revealed tender swelling, with localized guarding.

Diagnoses:

An urgent abdominal computed tomography scan demonstrated a large complex collection of approximately 12 cm × 10 cm in the left rectus sheath with intraperitoneal extension, consistent with RSH.

Interventions:

She underwent laparotomy with evacuation of 1.5 L of hematoma. Her postoperative recovery was complicated by the development of DVT on the sixth postoperative day. Due risk of rebleed, the inferior vena cava filter was favored over therapeutic anticoagulation. Her postoperative hospital stay was thereafter unremarkable.

Outcomes and lessons:

Although rare, RSH is a potential cause of acute abdomen, particularly among patients on anticoagulation, and can be life-threatening. A high index of suspicion is therefore important for early diagnosis. Clinicians should also appreciate the heightened risk of DVT in the immediate postoperative period despite mechanical anticoagulation.
No bidirectional relationship between constipation and colorectal cancer in European and Asian populations: A Mendelian randomization study
Authors: Aierken Ailikamu , Aizezi Yierzhati , Atabieke Falide , Rehaman Mayinuer , Aierken Munire , Li Shui-Xue
Published: October 2024

Traditional observational studies have reported a positive association between constipation and the risk of colorectal cancer (CRC). However, evidence from other approaches to pursue the causal relationship between constipation and CRC is scarce. In the study, 2-sample Mendelian randomization analysis was conducted to investigate the potential causal relationship between constipation and CRC. Analysis of the results showed that there was no causal association between constipation and CRC, either in European populations (CRC: odds ratio [OR] = 1.00, 95% confidence interval [CI] = 0.99–1.00, P = .49; rectal cancer: OR = 0.99, 95% CI = 0.99–1.00, P = .79) or in Asian populations (CRC: OR = 1.00, 95% CI = 0.99–1.01, P = .30). Also there was no inverse causal association between CRC and constipation, either in European populations (CRC: OR = 0.10, 95% CI = 2.76E-03–3.45, P = .20; rectal cancer: OR = 0.05, 95% CI = 9.14E-07–2.64E + 03, P = .59) or in Asian population (CRC: OR = 1.18, 95% CI = 0.92–1.52, P = .20), there was no horizontal diversity in the instrumental variables in the Mendelian randomization analyses of the present study (all F statistics >10), and no heterogeneity was found in the regression analyses. The findings from bidirectional 2-sample Mendelian randomization analyses indicate that there is no evidence of a bidirectional causal association between constipation and CRC. However, further investigation is warranted through additional clinical studies and trials to thoroughly explore the association between these 2 factors.
Improving pregnancy outcomes in patients with recurrent implantation failure: The power of RNA-seq-based endometrial receptivity testing
Authors: Li Jie , Liu Yan , Li Lin , Chen Weijun , Xu Dujuan , Xiao Aimei , Ma Ling , Jiang Wanxue , Yang Lijuan
Published: October 2024

To evaluate whether RNA-seq-based endometrial receptivity testing (rsERT) can improve pregnancy outcomes in personalized frozen-thawed embryo transfer (pFET) during hormone replacement therapy (HRT) cycles among patients with recurrent implantation failure (RIF). We conducted a retrospective cohort study involving 98 RIF patients undergoing HRT for FET. The experimental group consisted of 58 patients who underwent pFET after rsERT, while the control group included 40 patients who refused rsERT and underwent conventional ET. We recorded and examined the subsequent pregnancy outcomes from all cycles. The results of rsERT revealed that 67.24% of the experimental group were out of the “window of implantation” (WOI), with all cases showing a delay. The HCG-positive rate, implantation rate, and clinical pregnancy rate (CPR) in the experimental group were significantly higher than those in the control group, at 75.86% versus 50.00% (P = .030), 56.38% versus 31.43% (P = .002), and 68.97% versus 47.50% (P = .033), respectively. Our study demonstrated that utilizing rsERT technology to guide pFET in HRT cycles significantly enhances implantation and CPRs in RIF patients. Importantly, our findings confirm the effectiveness of rsERT technology and establish a scientific rationale for personalized reproductive medical interventions.
Research frontiers and hotspots in optical coherence tomography applications among patients with acute coronary syndromes: Bibliometric and visual analysis
Authors: Zhang BuChun , Zhang Yi , Li Hui , Chen Nan
Published: October 2024

Research on the use of optical coherence tomography (OCT) in acute coronary syndrome (ACS) has increased in recent years. However, a comprehensive analysis of the trends and hotspots in OCT research is currently lacking. The objective of this study was to identify global trends in research on OCT in ACS from a bibliometric perspective and to provide researchers with new research hotspots. Relevant literature from 1998 to 2023 was retrieved from the Web of Science Core Collection. CiteSpace and VOSviewer software were used to collect and analyze publication trends in related fields. A total of 965 publications from 58 countries and 1389 institutions were included in the present study. We found that Japan produced the most publications (20.83%, 201), followed by the United States (19.90%, 192), and China (14.09%, 136). However, the United States has the highest total number of citations in this field. Harvard Medical School and Harbin Medical University had the highest numbers of publications and citations. The journal with the most publications was the International Journal of Cardiology. Plaque erosion, calcified nodules, and intracoronary imaging are the most recent research hotspots and frontiers. Our work summarizes 25 years of OCT research in the ACS, highlighting hotspots, key themes, and emerging frontiers to help guide future research.
Correlation of exercise blood pressure levels with concomitant cardiovascular disease
Authors: Xinwen Liu , Cuicui Yang , Rongfang Zhou , Jianmei Zhou , Fang Ding
Published: October 2024

Hypertension is a fatal but preventable risk factor for cardiovascular disease and an important cause of death from cardiovascular disease. Exercise training has a definite clinical effect on blood pressure control. However, inappropriate exercise is ineffective and may also cause disease. The aim of this study was to evaluate the possible factors influencing blood pressure level in an exercise treadmill test and its relationship with accompanying clinical diseases. Five hundred sixty-four patients who underwent exercise treadmill test were selected and divided into the abnormal exercise blood pressure group (n = 156, age 60.46 ± 9.2 years) and normal exercise blood pressure group (n = 408, age 56.57 ± 8.8 years) according to whether the peak exercise systolic blood pressure was more than or equal to 180 mm Hg. General clinical data and associated clinical diseases were collected from both groups. The prevalence of hypertension and coronary atherosclerotic heart disease in the abnormal exercise blood pressure group was significantly higher than that in the normal exercise blood pressure group (all P < .05). At the same time, the smoking rate and glycohemoglobin level of the patients with abnormal exercise blood pressure were significantly increased (all P < .05), but there was no statistically significant difference in age, sex, body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and other indicators between the 2 groups (all P > .05). Patients with abnormal exercise blood pressure response have a higher prevalence of hypertension and coronary heart disease. Exercise blood pressure level may be an important factor affecting patients’ cardiovascular prognosis.
Cronkhite-Canada syndrome: A case report and literature review
Authors: Wang Nanping , Xiang Yue , Tao Liping , Ming Wen , Ren Lijun , Huang Tao , Yang GuoDong , Gao Jian , Ren Quan , Zhu Peng , Huang Min
Published: October 2024

Rationale:

Cronkhite-Canada syndrome (CCS) is a nonhereditary, rare polyposis condition, first documented by Cronkhite and Canada in 1955. The primary distinct features of this syndrome include ectodermal abnormalities and diffuse gastrointestinal polyp changes accompanied by protein loss. The primary clinical manifestations of CCS include hair loss, excessive pigmentation of the skin, and malnourishment of fingernails or toenails. Other notable symptoms include weight loss, protein-losing enteropathy, diarrhea, abdominal pain, nausea, vomiting, taste abnormalities, and atrophic glossitis, which predominantly occur in middle-aged and older males. CCS is characterized by an extremely rare, nonfamilial hamartomatous polyposis syndrome, in which polyps are distributed in the stomach and colon (90%), small intestine(80%), and rectum (67%), while sparing the esophagus.

Patient concerns:

This report describes a 72-year-old female, initially treated for intestinal obstruction, followed by a small intestine resection. She reported diarrhea, emaciation, and loss of appetite across various hospitals.

Diagnoses:

Endoscopic examination of the stomach and colon, plus capsule endoscopy, revealed multiple polyps throughout her gastrointestinal tract, except in the esophagus.

Interventions:

Treatment included hormones with antiallergic medication, acid-suppressing drugs, salicylates, and nutritional support with zinc sulfate, adding trace elements and amino acids.

Outcomes:

posttreatment, the patient demonstrated significant improvement in appetite and taste. Atrophic glossitis, upper limb pigmentation, and frequency of diarrhea also notably decreased. reexamination through endoscopy after 3 months of treatment revealed a substantial decrease in the number and size of gastrointestinal polyps.

Lessons:

In this case, from the lower esophageal sphincter to the rectum, there is an increasing trend of eosinophil and mast cell infiltration. These lesions can cause a positive IgG result. Pathological analysis indicates that the extent and severity of lesions in the middle and lower gastrointestinal tract are more substantial than in the upper tract. During treatment, endoscopic observations reveal that lesions in the middle and lower tract tend to resolve faster than those in the upper tract. Hormone therapy has demonstrated significant efficacy in treating this disease. Early treatment and regular follow-up for this disease can reduce the risk of cancerous changes and related complications.
Necessity sequential intermediate kissing balloon dilation for crush stenting: Further insights from metal/polymer vessel scaffolds bench testing
Authors: Tu Sheng , Zhang Linlin , Tian Qingqing , Hu Fudong , Wang Ying , Chen Lianglong
Published: October 2024

Sequential intermediate kissing balloon dilation (sIKBD) is crucial for crush stenting, but it require appropriate procedure remains unclear for crush stenting. This study aims to investigate whether sIKBD is necessary and how it can be properly performed during crush stenting. Mini-crush stenting (mini-CS) and sIKBD for mini-crush stenting (sIKBD-mini-CS) using metal drug-eluting stents/polymer bioresorbable vessel scaffolds (mDES/pBVS) were emulated in bifurcation models considering the branch diameter difference, and sIKBD was added to mini-CS for pretreating side-branch (SB) stent before main-branch (MB) stenting (second figure), respectively. Micro-computed tomography was used to assess the morphological parameters of bifurcated stents including length of overlapping stent segment, residual ostial stenosis of the SB, and neocarina length using quantitative methods. Further, optical coherence tomography was to analyze the incidence of stent malapposition. Quantitative analysis demonstrated that in mDES/pBVS phantom, the neocarina length (mDES: 0.45 ± 0.10 mm vs 0.30 ± 0.09 mm, P = .005; pBVS: 0.47 ± 0.11 mm vs 0.29 ± 0.09 mm, P = .001), residual ostial stenosis at the SB (mDES: 19.37 ± 8.21% vs 12.47 ± 2.05%, P = .001; pBVS: 21.89 ± 8.54% vs 9.98 ± 3.35%, P = .035), and stent malapposition in the overlapping segment (mDES: 10.29 ± 3.31% vs 3.83 ± 0.97%, P = .001; pBVS: 12.05 ± 3.87% vs 6.40 ± 1.59%, P = .003) were lower in the sIKBD-mini-CS group than those in the mini-CS group (P < .05 for all). The results of factorial analysis showed that mDES platform tended to have better morphological indicators than the pBVS platform. Adding the sIKBD to mini-CS showed better morphologic characteristics of mDES/pBVS phantoms when compared with mini-CS. Therefore, it should be considered as a critical and proper technique for crush stenting.
Effect of clustered nursing on liver function indexes, nutrition, and emotional status of patients with severe liver failure
Authors: Min Xiaoxia , Lu Li , Wen Bin
Published: October 2024

Liver failure is a metabolic disorder caused by a variety of mixed factors. For such diseases, adopting cluster care can effectively improve the relevant symptoms of patients. To explore the nursing effect of nutritional nursing combined with clustered nursing for patients with severe liver failure. A total of 129 patients with severe liver failure were selected as retrospective study subjects. Nine cases were due to an end event, such as death. The other patients were divided into control group and observation group according to different nursing methods. Among them, the control group adopted nutrition nursing, and the observation group implemented cluster nursing on this basis. The differences of liver function, anxiety and depression score, gastrointestinal recovery, nutritional status, and sleep quality were compared between the 2 groups before and after nursing. After nursing, the total bilirubin, albumin, and aspartate aminotransferase of the observation group were significantly higher than those of the control group (P < .05). The nursing staff used Self-Rating Anxiety Scale and Self-Rating Depression Scale of the observation group, which were slightly lower than those of the control group. The difference was statistically significant after testing (P < .05). After nursing, the observation group’s upper arm circumference, brachial tri-scalp fold thickness, and hemoglobin were better than those of the control group. Statistics showed that the difference was statistically significant (P < .05). The depth of sleep, time to fall asleep, number of awakenings, time to fall asleep after awakening, overall sleep quality, and intensive care unit environmental noise intensity in the Richards–Campbell Sleep Questionnaire sleep scale after nursing in the 2 groups were significantly higher than those before nursing, and the scores of the observation group were significantly lower than those in the observation group. In the control group, this difference was statistically significant (P < .05). Nutritional nursing combined with clustered nursing can effectively promote the recovery of gastrointestinal function in patients with severe liver failure.
Cysteine cathepsins and autoimmune diseases: A bidirectional Mendelian randomization
Authors: Wu Yetong , Li Qiaoqiao , Lou Yake , Zhou Zhongzheng , Huang Jing
Published: October 2024

Cysteine cathepsins are proteolytic enzymes crucial in various physiological and pathological processes, primarily operating within lysosomes. Their functions include protein degradation, immune system regulation, and involvement in various diseases. While some cysteine cathepsins play important roles in the immune system, their connection to autoimmune diseases remains unclear. This study proposes using Mendelian randomization to explore the causal relationship between cysteine cathepsins and autoimmune diseases. Single nucleotide polymorphisms (SNPs) for cysteine cathepsins were obtained from a publicly available genome-wide association study (GWAS) dataset, while outcome SNP data were sourced from 10 separate GWAS datasets. Mendelian randomization (MR) analysis employed the Wald ratio (WR) and inverse variance weighted (IVW) approach as primary methods, supplemented by the weighted median and MR-Egger methods. Heterogeneity was assessed using Cochran Q test, and sensitivity analysis was conducted using the MR-PRESSO method. The association strength between exposure and outcome was evaluated using odds ratios (OR) with 95% confidence intervals (CI). The study identified a potential positive correlation between elevated cathepsin B and psoriasis (Wald ratio OR = 1.449, 95% CI: 1.053–1.993, P = .0227). Elevated cathepsin F was potentially linked to ulcerative colitis (WR OR = 1.073, 95% CI: 1.021–1.127, P = .0056), ankylosing spondylitis (WR OR = 1.258, 95% CI: 1.082–1.463, P = .0029), and primary biliary cholangitis(PBC) (WR OR = 1.958, 95% CI: 1.326–2.889, P = .0007). Conversely, cathepsin H appeared protective against celiac disease (WR OR = 0.881, 95% CI: 0.838–0.926, P = 6.5e‐7), though elevated levels may increase the risk of type 1 diabetes (IVW OR = 1.121, 95% CI: 1.053–1.194, P = .0003) and PBC (WR OR = 1.792, 95% CI: 1.062–3.024, P = .0288). Cathepsin Z was also associated with an increased risk of type 1 diabetes (IVW OR = 1.090, 95% CI: 1.006–1.181, P = .0349). The MR analysis suggests potential risks of cathepsin B with psoriasis, cathepsin F with ulcerative colitis, ankylosing spondylitis, and PBC, and cathepsin Z with type 1 diabetes. Conversely, cathepsin H may protect against celiac disease but could increase the risk of type 1 diabetes and PBC.
A rare case report of concurrent cryptococcal, streptococcal, and tuberculous meningitis in a patient with pulmonary tuberculosis
Authors: Bi Dewu , Luo Xiaolu , Tang Xike , Luo Xiaocheng , Mo Lida
Published: October 2024

Rationale:

Meningitis caused by concurrent infections with Cryptococcus neoformans, Streptococcus equi subsp. equi, and Mycobacterium tuberculosis is extremely rare.

Patient concerns:

We present the case of a 63-year-old male patient who presented with headaches, dizziness, nausea, vomiting, and fever for the past 3 weeks.

Diagnoses:

The patient was diagnosed with concurrent cryptococcal, streptococcal, and tuberculous meningitis.

Interventions:

The patient received isoniazid, rifampicin, ethambutol, and levofloxacin for 1 month, in addition to liposomal amphotericin B with flucytosine for 2 weeks, followed by fluconazole with flucytosine for additional 2 weeks.

Outcomes:

The symptoms improved, and outpatient therapy was continued.

Lessons:

Infectious meningitis requires a combination of microscopy, culture, and rapid molecular diagnostics for early diagnosis and treatment.
What is the optimal range of fasting stress hyperglycemia ratio for all-cause mortality in American adults: An observational study
Authors: Li Jian , Yu Chao , Hu Xiaolu
Published: October 2024

To date, no studies have been conducted to assess the impact of fasting stress hyperglycemia ratio (SHR) on all-cause mortality. Therefore, the objective of our study is to investigate the association between SHR and all-cause mortality in a population of American adults. The study population was derived from NHANES data spanning from 2005 to 2018. The exposure variable SHR was derived from fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c%), and the specific calculation formula was as follows: (FBG (mmol/L))/(1.59 × HbA1c (%) − 2.59). The outcome variable was all-cause mortality. A total of 18,457 participants were enrolled in this prospective cohort study. Following a median follow-up period of 90 months, all-cause mortality was observed in 10.32% of the subjects. Cox proportional hazards regression model indicates that there is no significant difference between SHR and all-cause mortality in the fully adjusted model, whether analyzed as a continuous or categorical variable (P for trend > 0.05). Through the 2-piecewise Cox proportional hazards regression model, we have determined that the inflection point of SHR in relation to all-cause mortality is 0.88. It has also been observed that when the value of SHR is on the left side of the inflection point (SHR ≤ 0.88), there is a significant 77% (HR: 0.23; 95% CI: 0.10–0.50) reduction in all-cause mortality for each additional unit increase in SHR. Conversely, when the value of SHR exceeds 0.88, there is a substantial 2.40-fold (HR: 2.40; 95% CI: 1.61–3.58) increase in the risk of all-cause mortality (P for log likelihood ratio test < .001). The subgroup analysis results demonstrate that sex has the potential to modify the association between SHR and all-cause mortality within the population exhibiting SHR ≤ 0.88. The relationship between SHR and all-cause mortality follows a U-shaped pattern, where in the lowest risk of death for the average American adult is observed at an SHR value of 0.88. Furthermore, in men with SHR ≤ 0.88, there is a significant inverse relationship between the increase in SHR and the risk of all-cause mortality.
Magnetic resonance imaging quantitative assessment of corticospinal tract damage in basal ganglia infarction
Authors: Zhang Qiuyue , Jiang Hongxin , Han Shuman , Gao Tingting , Meng Linghui , Gao Bulang , Cao Lei , Wen Jinxu , Ju Yanmei , Wu Wenjuan
Published: October 2024

To retrospectively explore the role of magnetic resonance imaging (MRI) diffusion tensor imaging (DTI) in analyzing the corticospinal tract injury in acute cerebral anterior circulation infarction in the basal ganglia region and the correlation between DTI parameters and neurological function scores, patients with acute cerebral infarction and stroke had undergone plain MRI and DTI sequence scanning were enrolled. Diffusion tensor tractography was used to perform 3-dimensional reconstruction of bilateral corticospinal tracts (CST). The image data were processed to obtain fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values, and the correlation between the DTI parameters and neurological function scores of National Institutes of Health Stroke Scale (NIHSS) was evaluated. A total of thirty-two patients with acute ischemic cerebral infarction were retrospectively enrolled, including 19 males and 13 females with a mean age 63.22 ± 7.78 years. The CST score was 0 in 2 (6.25%) patients, 1 in 9 (28.13%), 2 in 9 (28.13%), 3 in 7 (21.88%), and 4 in 5 (15.63%). The FA value significantly (P = .01) decreased (0.52 ± 0.03 vs 0.62 ± 0.04) on the ischemic side compared with that on the normal side. A significant (P < .05) difference was detected in the number of nerve fibers (223.3 ± 110.0 vs 246.7 ± 104.4) rather than in the ADC values (0.86 ± 0.06 vs 0.84 ± 0.06) between the ischemic and healthy sides. The FA and ADC values were not significantly (P > .05) different according to the CST scores 0, 1, 2, 3, or 4 between the ischemic and healthy sides. There was a significant (P < .05) negative correlation between the FA value on the infarcted side and the NIHSS score. In conclusion, with the DTI technology, varying degrees of damage to the corticospinal tract at the infarcted side can be detected and important clinical information can be provided for the diagnosis and prognosis of acute cerebral infarction by evaluating the degree of corticospinal tract injury.
Asthma and eye diseases in middle-aged and elderly Chinese: A comprehensive analysis of CHARLS data
Authors: Wu Mengdi , Zheng Kun , Cao Yanjie , Wang Junhua , Yin Qiaoxiang , Li Tianqi , Guo Yujie , Xue Xiuxiu , Pan Xiuming , Yang Yifeng
Published: October 2024

With China’s aging population, the incidence of eye diseases is increasing, leading to urgent concerns about visual impairment and blindness. The cause-and-effect relationship between asthma and eye diseases in the Chinese population remains unclear. This study aimed to investigate the link between asthma and eye-related diseases, including cataracts and glaucoma, among Chinese adults. This study utilized data from the 4th wave of the China Health and Retirement Longitudinal Survey conducted in 2018, involving 19,816 Chinese participants. We first described baseline characteristics, then constructed 5 logistic regression models to study the relationship between asthma and eye diseases in the Chinese context. Additionally, subgroup analyses were performed with selected variables. Across 5 models adjusting for covariates, we found that asthma was significantly associated with cataracts (odds ratios [95% confidence intervals]: 1.36 [1.01–1.79], P = .034) and glaucoma (odds ratios [95% confidence intervals]: 1.92 [1.46–2.49], P < .001). Subgroup analyses revealed that Chinese women, former smokers, or drinkers were at higher risk of developing cataracts (all P < .001), while those aged ≤ 60 years were at higher risk of developing glaucoma (P < .001). Our study provides possible observational evidence linking asthma to cataracts, glaucoma, and visual impairment in the Chinese population. These findings are crucial for disease prevention strategies in China’s healthcare system.
Comparative efficacy of erector spinae plane and quadratus lumborum blocks in managing postoperative pain for total abdominal hysterectomy: A randomized controlled trial
Authors: Baran Onur , Şahin Ayhan , Arar Cavidan
Published: October 2024

Background:

Effective postoperative pain management after total abdominal hysterectomy is crucial for patient recovery and satisfaction. This study compared the efficacy of the erector spinae plane block (ESPB) and quadratus lumborum block (QLB) in reducing postoperative opioid consumption and pain in patients with total abdominal hysterectomy.

Methods:

In this prospective, randomized controlled trial, 90 patients undergoing total abdominal hysterectomy were divided into 3 groups: ESPB, QLB, and control. The primary outcome was postoperative opioid consumption. Secondary outcomes included pain scores assessed by the visual analog scale at predetermined times and the incidence of postoperative nausea and vomiting. Statistical significance was determined using analysis of variance, the Mann–Whitney U test, and the Kruskal–Wallis test.

Results:

The ESPB and QLB groups showed a significant reduction in postoperative opioid consumption compared with the control group (P < .001 for both comparisons). Pain scores were significantly lower in the ESPB and QLB groups than in the control group at 2, 6, and 24 hours postoperatively (P < .001 at each time point). The incidence of postoperative nausea and vomiting was lower in the ESPB and QLB groups than that in the control group; however, this difference was not statistically significant (P = .029). No significant differences were observed in opioid consumption or pain scores between the 2 groups.

Conclusion:

Both the erector spinae plane and quadratus lumborum blocks effectively reduced postoperative opioid consumption and pain in patients with total abdominal hysterectomy. These techniques offer a promising approach for postoperative pain management, potentially reducing the need for opioids.
Anticoagulation for Septic Cerebral Venous Thrombosis in Childhood
Authors: Seerha Hareen , Maher Kristin , Barry Dwight , Amlie-Lefond Catherine
Published: October 2024

Anticoagulation is recommended for most children with cerebral venous thrombosis (CVT) to prevent venous infarction and promote recanalization. An exception is CVT associated with head and neck infection (septic CVT), for which treatment of infection without concomitant use of anticoagulation is recommended. Despite this, the use of anticoagulation in septic CVT is controversial, and children with septic CVT are often anticoagulated due to concerns about thrombus progression and persistence despite infection treatment. A retrospective study of children with septic CVT cared for at Seattle Children’s Hospital between 2009 and 2023 was conducted to assess the safety and outcome of anticoagulation. Among 40 children with septic CVT, 25 (63%) received anticoagulation. None had bleeding complications. Performance of follow-up venous imaging was inconsistent and more commonly pursued in patients treated with anticoagulation. A total of 23/40 (58%) patients were evaluable at 1 month, among whom 26% (6/23) had resolution of thrombus and 74% (17/23) had persistence. A total of 22/40 (55%) patients were evaluable at 3 months, among whom 77% (17/22) had resolution of thrombus and 23% (5/22) had persistence. This supports the safety of anticoagulation, but further studies are needed to determine whether anticoagulation improves outcomes after septic CVT.
Association Between Adverse Childhood Experiences and Cognitive Decline
Authors: Chaudhari Gaurav , Vora Darshini , Trivedi Chintan , Reddy Preetam , Bodicherla Krishna Priya , Adnan Mahwish , Vadukapuram Ramu , Kodi Priya Durga , Shah Kaushal , Patel Sruti , Mansuri Zeeshan , Jain Shailesh
Published: October 2024

We aim to study Adverse childhood experiences' (ACEs') association with cognitive decline during adulthood. We reviewed data on subjective cognitive decline (SCD) for those ≥45 years of age. Logistic regression analysis, odds ratio, and 95% confidence interval (CI) assessed the association between ACEs and SCD. We analyzed an adult survey (N = 3900, mean age: 60.9 years, male: 46%). The most common ACE reported was household substance abuse (22.4%), followed by parental divorce/separation (20.9%). The prevalence of SCD in those having at least one ACE was higher than those without any (16.5% vs. 8.1%, p < 0.001). SCD positively correlated with the number of ACEs (p < 0.001). The odds of SCD increase in proportion to the increase in the number of ACEs experienced. These findings should be replicated in a larger population while controlling for confounding factors.
Best Fit for Nurse Advancement
Authors: Torres Dulce A. , Kapusta Seung , Hlebichuk Jeanne , Marzinski Sara J. , Tutino Jami
Published: October 2024

The retention of experienced nurses is a challenge for healthcare organizations in the current employment landscape. One retention tactic is to aid in their professional development. This article describes a program “Best Fit for Nurse Advancement” that provides dedicated time, resources, and support to explore career advancement pathways by breaking organizational progressional barriers. Results have shown retention within the organization, career role advancement, and positive program feedback.
Obstetric Anal Sphincter Injury and Female Sexual Dysfunction: A Systematic Review
Authors: Jericevic Schwartz Dora , Cervantes Isabella , Nwaba A. U. Amanda , Duarte Thibault Mary , Siddique Moiuri
Published: October 2024

Importance

This is the first systematic review on female sexual dysfunction (FSD) in patients who sustained obstetric anal sphincter injury (OASI).

Objective

The aim of the study was to characterize FSD following OASI.

Study Design

Between January and April 2024, we conducted a literature search of studies that explored outcomes of FSD following OASI, reporting on rates of dyspareunia and/or using questionnaires that measured female sexual function.

Results

Fourteen studies with 1,907 OASI patients met inclusion criteria. Rates of dyspareunia in the first year after OASI ranged from 27% to 35% with only 40%–57% of women having resumed sexual activity at 3 months postpartum. The Female Sexual Function Index (FSFI) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) were the most utilized questionnaires. Using the FSFI, the range of FSD was 47%–81% among patients with OASI. The FSFI subdomain scores (maximum 6) for desire and arousal had the least improvement with time, ranging from 1.3–2.1 at 2 months to 3–3.1 at 4 months. Pain, lubrication, and orgasm domains showed greater improvement with time, ranging from 1.4–1.6 at 2 months and up to 3.5–3.8 at 4 months. Five studies used the PISQ-12 with mean scores of 34.1–39 (range 0–48), 3 of which included a non-OASI control group and found similar PISQ-12 scores between groups. Physical therapy did not significantly impact FSD.

Conclusions

One-third of patients with OASI experience dyspareunia in the first year postpartum, 1in 2 patients do not resume intercourse at 3 months postpartum, and FSD, measured by the FSFI, may be present in 80% of women with OASI at 3 months postpartum.
Amycolatopsis melonis sp. nov., a novel protease-producing and cellulose-degrading actinobacterium isolated from soil
Authors: Xu Yan , Zhao Xue , Jin Jiaxin , Zhang Ran , Zhou Changjian , Wang Zishan , Yao Siqi , Wang Xiangjing , Xiang Wensheng , Song Jia
Published: October 2024

A novel protease-producing and cellulose-degrading actinobacterium, designated strain NEAU-NG30T, was isolated from a melon rhizosphere soil sample collected in Harbin, Heilongjiang Province, China, and established its status using a polyphasic taxonomic study. Phylogenetic analysis based on 16S rRNA gene sequences revealed that strain NEAU-NG30T was closely related to Amycolatopsis bullii DSM 45802T (98.7%) and Amycolatopsis vancoresmycina DSM 44592T (98.3%). The phospholipid profile contained diphosphatidylglycerol, phosphatidyl methylethanolamine, phosphatidylethanolamine and phosphatidylinositol. The diagnostic sugars in cell hydrolysates were determined to be galactose and arabinose. Cell walls contained meso-diaminopimelic acid as the diagnostic diamino acid. The predominant menaquinone was MK-9(H4). The major fatty acids were iso-C15:0 and iso-C16:0. Meanwhile, genome analysis of sequences revealed a genome size of 9 338 250 bp and a DNA G+C content of 71.6%. In addition, the average nucleotide identity values and the level of digital DNA–DNA hybridization between strain NEAU-NG30T and its reference strains fall below the thresholds typically used for delineating prokaryote species. According to phenotypic, chemotaxonomic and genotypic studies, it is indicated that strain NEAU-NG30T is considered to be a novel species of the genus Amycolatopsis, for which the name Amycolatopsis melonis sp. nov. is proposed, with NEAU-NG30T (=MCCC 1K08677T=JCM 35654T) as the type strain.