bluuebunny/crossref_metadata_2025 huggingface dataset:
Wound Dehiscence Following Upper Blepharoplasty: A Review of 2,376 Cases
Authors: Homer Natalie A. , Zhou Siwei , Watson Alison H. , Durairaj Vikram D. , Nakra Tanuj
Published: August 2020

Purpose:

There have been limited studies evaluating specifically the incidence of wound dehiscence following isolated upper blepharoplasty. This is a large-scale upper blepharoplasty review to evaluate the rate of wound dehiscence, to assess risk factors, and to analyze management outcomes.

Methods:

A retrospective review was performed of all patients who underwent upper blepharoplasty at a single surgery center. All incisions were closed using either 6-0 fast-absorbing plain gut or polypropylene suture in a running fashion, with an additional interrupted suture near the lateral wound edge. Incidence of wound dehiscence was determined and further assessed by patient age (≤67 or >67 years), gender, preexisting medical conditions, smoking history, and suture type.

Results:

A total of 1,190 patients (2,376 eyelids) met inclusion criteria. In total, there were 34 instances (1.4%) of wound dehiscence in 32 patients at an average 9 days (range, 0–30 days) following surgery. Evaluation of wound dehiscence rates by demographic factors revealed male gender to be a significant predictor of wound dehiscence (p = 0.0062). Age, hypertension, heart disease, and diabetes were not predictors of wound dehiscence. Lifetime smoking history increased risk for wound dehiscence (p < 0.0001). Use of fast-absorbing plain gut suture was also significantly associated with dehiscence, when compared with polypropylene (p = 0.0025). Multivariate analysis revealed male gender and fast-absorbing plain gut suture to be independent risk factors for wound dehiscence. Seventeen eyelids with wound separation were observed for second-intention healing, 1 underwent delayed scar revision. Fourteen eyelids were repaired primarily using suture and 3 with cyanoacrylate surgical skin adhesive. All patients reported satisfaction with their final outcome, and objective final healing was deemed satisfactory.

Conclusions:

Wound dehiscence following isolated upper blepharoplasty is rare and associated with male gender and fast-absorbing plain gut suture. Patients with wound separation may be successfully managed with individualized care.
Sport Motivation as a Possible Indicator of Concussion Reporting Intentions Among Young Athletes
Authors: Warmath Dee , Winterstein Andrew P. , Myrden Susan
Published: August 2020

Objective:

To assess the relationship between sport motivation and intentions to report concussion symptoms among young adult athletes.

Design:

Cross-sectional study (level of evidence: 3).

Subjects:

One thousand three hundred five young adult athletes of various sports and levels of competitiveness from the Survey Sampling International panel.

Methods:

Data were collected through an online survey. Ordinary least squares regression was used to examine the relationship between motivation and reporting intentions controlling for competitiveness and perceived risk of injury.

Results:

Athletes who play their sport for self-regulated (autonomous) reasons have higher intentions to seek care for concussion-like symptoms, whereas those who play to achieve gains external to the sport or avoid punishment (controlled motivation) have lower intentions. A one-point increase in autonomous motivation was associated with an 11.5-point increase in reporting intention (t = 6.629, P < 0.001), whereas a one-point increase in controlled motivation was associated with an 8.1-point decrease in reporting intention (t = −4.562, P < 0.001). Betas from the model suggested that autonomous motivation had a stronger effect than controlled motivation (0.226 vs −0.163).

Conclusions:

Innovation in care, concussion education, and cultivation of team culture supportive of autonomous motivation could increase concussion reporting. Measuring sport motivation may reveal which athletes require more proactive attention to ensure symptoms are not concealed. Furthermore, messages to reinforce autonomous motivation may increase willingness to report.
Single-Task and Dual-Task Tandem Gait Performance Across Clinical Concussion Milestones in Collegiate Student-Athletes
Authors: Oldham Jessie R. , Howell David R. , Knight Christopher A. , Crenshaw Jeremy R. , Buckley Thomas A.
Published: August 2020

Objective:

To determine the length of time after concussion that impaired tandem gait performance is observed.

Design:

Clinical measurement, prospective longitudinal.

Setting:

NCAA collegiate athletic facility.

Participants:

Eighty-eight concussed NCAA Division I student-athletes and 30 healthy controls.

Independent Variables:

Group (concussion/control) and time (Baseline, Acute, Asymptomatic, and RTP).

Main Outcome Measures:

Participants completed 4 single-task and dual-task tandem gait trials. The concussion group completed tests at the following time points: preseason (Baseline), within 48 hours after concussion (Acute), on the day symptoms were no longer reported (Asymptomatic), and when cleared to return to sports (RTP). Controls completed the same protocol at similar intervals. The dual-task trials involved minimental style cognitive questions answered simultaneously during tandem gait. We analyzed the best time of the 4 trials, comparing groups with a linear mixed model.

Results:

Acutely after concussion, the concussion group performed single-task tandem gait slower (worse) than controls (concussion: 11.36 ± 2.43 seconds, controls: 9.07 ± 1.78 seconds,P< 0.001). The concussion group remained significantly slower than controls (9.95 ± 2.21 vs 8.89 ± 1.65 seconds,P= 0.03) at Asymptomatic day but not RTP. There were significant group (P< 0.001) and time (P< 0.001) effects for dual-task tandem gait. The groups were not significantly different at baseline for single-task (P= 0.95) or dual-task (P= 0.22) tandem gait.

Conclusions:

Our results indicate that tandem gait performance is significantly impaired acutely after concussion, compared with both preseason measures and controls. Postural control impairments were not present when the student-athletes were cleared for RTP. This information can assist clinicians when assessing postural control and determining recovery after a concussive injury.
Comparison of magnetic resonance imaging and 18-fludeoxyglucose positron emission tomography/computed tomography in the diagnostic accuracy of staging in patients with cholangiocarcinoma
Authors: Huang Xujian , Yang Jialin , Li Jingdong , Xiong Yongfu
Published: August 2020

Background:

Accurate clinical staging of patients with cholangiocarcinoma (CCA) has a significant impact on treatment decisions. In this study, we aimed to compare the diagnostic value of magnetic resonance imaging (MRI) and 18-fludeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for staging of CCA.

Methods:

We performed comprehensive systematic search in Web of Science (including MEDLINE) and Excerpta Medica Database for relevant diagnostic studies in accordance with the preferred reporting items for systematic reviews and meta-analysis statement. Based on data extracted from patient-based analysis, we calculated the pooled sensitivity and specificity with the 95% confidence intervals (CIs). In addition, the publication bias was assessed by Deek funnel plot of the asymmetry test. The potential heterogeneity was explored by threshold effect analysis and subgroup analyses.

Results:

Thirty-two studies with 1626 patients were included in present analysis. In T stage, the pooled sensitivity and specificity of MRI were 0.90 (95% CI 0.86–0.93), 0.84 (95% CI 0.73–0.91) respectively. The pooled sensitivity and specificity of 18F-FDG PET/CT were 0.91 (95% CI 0.83–0.95) and 0.85 (0.64–0.95) respectively. In N stage, the pooled sensitivity and specificity of MRI were 0.64 (95% CI 0.52–0.74) and 0.69 (95% CI 0.51–0.87) respectively. The pooled sensitivity and specificity of PET/CT were 0.52 (95% CI 0.37–0.66) and 0.92 (95% CI 0.79–0.97) respectively. In M stage, the pooled sensitivity and specificity of 18F-FDG PET/CT were 0.56 (95% CI, 0.42–0.69) and 0.95 (95% CI, 0.91–0.97) respectively. The Deek test revealed no significant publication bias. No threshold effect was identified. The subgroup analyses showed that pathological type (extrahepatic cholangiocarcinoma vs hilar cholangiocarcinoma/intrahepatic cholangiocarcinoma), country (Asia vs non-Asia) and type of MRI (1.5T vs. 3.0T) were potential causes for the heterogeneity of MRI studies and country (Asia vs non-Asia) was a potential source for 18F-FDG PET/CT studies.

Conclusion:

The analysis suggested that both modalities provide reasonable diagnostic accuracy in T stage without significant differences between them. We recommend that both modalities be considered based on local availability and practice for the diagnosis of primary CCA tumors. In N stage, the diagnosis of lymph node metastasis (N) of CCA is still limited by MRI and 18F-FDG PET/CT, due to unsatisfactory diagnostic accuracy of both. Nevertheless, 18F-FDG PET/CT can be used to confirm lymph node metastasis while a negative result may not rule out metastasis. Furthermore, 18F-FDG PET/CT have a low sensitivity and a high specificity for detection of distant metastasis.
The efficacy and safety of acupuncture and moxibustion combined with western medicine for obsessive-compulsive disorder
Authors: Tian Chunying , Fan Yihua , Xu Jingyu , Huang Yang , Wang Wen , Wang Shenjun , Song Ruiwen , Li Xinju
Published: August 2020

Background:

Obsessive-compulsive disorder is common, chronic mental disorder, which is characterized by recurrent, unwanted, or intrusive thoughts and repetitive behaviors or mental action. Acupuncture and moxibustion, as a popular form of complementary and alternative therapy, have the advantages of low side effects, high safety, and low cost. The research showed that acupuncture and moxibustion have a good clinical efficacy on obsessive-compulsive disorder. However, there is no literature to systematically evaluate the efficacy and safety of acupuncture and moxibustion in treating obsessive-compulsive disorder. Thus, this study is aimed to evaluate the efficacy and safety of acupuncture and moxibustion for obsessive-compulsive disorder patients, providing reliable evidence for clinical application.

Methods:

Randomized controlled trials of acupuncture and moxibustion combined with western medicine for the treatment of obsessive-compulsive disorder will be searched in the databases including PubMed, EMBASE, the Cochrane library, Web of science, China National Knowledge Infrastructure(CNKI), WanFang, the Chongqing VIP Chinese Science and Technology Periodical Database, and China biomedical literature database (CBM) from inception to June, 2020. In addition, Baidu, Google Scholar, International Clinical Trials Registry Platform, and Chinese Clinical Trials Registry will be searched to obtain the gray literature and relevant data that have not yet been published. Two qualified researchers will extract data and assess the risk of bias from included studies dependently. Statistical analysis is performed in RevMan 5.3 software.

Results:

The efficacy and safety of acupuncture and moxibustion combined with western medicine for obsessive-compulsive disorder will be assessed based on the total effective rate, Hamilton Anxiety Scale score, Hamilton Rating Scale for Depression score, Clinical Global Impression score, side effects, and so on.

Conclusions:

The proposed systematic review and meta-analysis of acupuncture and moxibustion combined with western medicine for treating obsessive-compulsive disorder is expected to provide reliable evidence for clinical application.

Ethics and dissemination:

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

OSF Registration number:

DOI 10.17605/OSF.IO/CDGTW
Celiac disease serology and gut microbiome following protein pump inhibitor treatment
Authors: Jang Sophie , Lebwohl Benjamin , Abrams Julian A. , Green Peter H.R. , Freedberg Daniel E. , Alaedini Armin
Published: August 2020

Background:

Celiac disease is an autoimmune enteropathy characterized by an aberrant immune response to ingested gluten in genetically predisposed individuals. Studies have pointed to a rising prevalence of celiac disease in recent decades. Changes in diet and use of medication that may impact the gut microbiome have been suggested as potential contributors. Exposure to protein pump inhibitors (PPIs) was recently found to be associated with an increased risk for subsequent diagnosis of celiac disease. We aimed to investigate potential mechanisms for this link by examining the relationship between PPI use and gluten-related immune responses in the context of changes in gut microbiome.

Methods:

We performed a post hoc analysis of blood and fecal samples from a recent randomized trial in order to assess the potential association between PPI use and development of celiac disease serology in conjunction with alterations in gastrointestinal microbial composition. The study included 12 healthy participants who were administered a PPI (Omeprazole; 40 mg twice daily) for 4 or 8 weeks.

Results:

The analysis did not reveal an overall significant change in levels of serologic markers of celiac disease for the study cohort in response to PPI treatment. However, one individual developed a marked increase in the celiac disease-specific autoantibody response to transglutaminase 2 in conjunction with enhanced immune reactivity to gluten during the trial. Genotyping revealed positivity for the celiac disease-associated HLA-DQ2 and -DQ8 alleles. Furthermore, the observed elevation in antibody responses was closely associated with a sharp increase in fecal abundance of bacteria of the order Actinomycetales.

Conclusions:

The results of this exploratory analysis support further investigation of molecular mechanisms involved in the contribution of PPIs to celiac disease risk through the potential enhancement of gluten immunopathology and changes in gut microbial population.
Improved Parkinsons disease motor score in a single-arm open-label trial of febuxostat and inosine
Authors: Watanabe Hirohisa , Hattori Tatsuya , Kume Akito , Misu Kenichiro , Ito Takashi , Koike Yu , Johnson Todd A. , Kamitsuji Shigeo , Kamatani Naoyuki , Sobue Gen
Published: August 2020

Background:

Cellular energetics play an important role in Parkinsons disease etiology, but no treatments directly address this deficiency. Our past research showed that treatment with febuxostat and inosine increased blood hypoxanthine and ATP in healthy adults, and a preliminary trial in 3 Parkinson's disease patients suggested some symptomatic improvements with no adverse effects.

Methods:

To examine the efficacy on symptoms and safety in a larger group of Parkinsons disease patients, we conducted a single-arm, open-label trial at 5 Japanese neurology clinics and enrolled thirty patients (n

males
 = 11; n

females
 = 19); 26 patients completed the study (n

males
 = 10; n

females
 = 16). Each patient was administered febuxostat 20 mg and inosine 500 mg twice-per-day (after breakfast and dinner) for 8 weeks. The primary endpoint was the difference of MDS-UPDRS Part III score immediately before and after 57 days of treatment.

Results:

Serum hypoxanthine concentrations were raised significantly after treatment (Pre = 11.4 μM; Post = 38.1 μM; P < .0001). MDS-UPDRS Part III score was significantly lower after treatment (Pre = 28.1 ± 9.3; Post = 24.7 ± 10.8; mean ± SD; P = .0146). Sixteen adverse events occurred in 13/29 (44.8%) patients, including 1 serious adverse event (fracture of the second lumbar vertebra) that was considered not related to the treatment.

Conclusions:

The results of this study suggest that co-administration of febuxostat and inosine is relatively safe and effective for improving symptoms of Parkinsons disease patients. Further controlled trials need to be performed to confirm the symptomatic improvement and to examine the disease-modifying effect in long-term trials.
Delirium screening tools
Authors: Liu YuJuan , Zhang Qian , Zhao Yayun , Gao Zhuying , Wei Zhengyong , Guo Ziqi , Chen Meixi , Zhang Qing , Yang Xuemei
Published: August 2020

Background:

Delirium is a frequent form of acute brain dysfunction in mechanically ventilated patients. Screening tools have been developed to identify delirium, but it is unclear which tool is the most accurate. Therefore, we provide a protocol of systematic evaluation to assess the accuracy of delirium screening tools in mechanically ventilated patients.

Methods:

PubMed, PsycINFO, EMBASE, and the Cochrane Library will be searched. Studies involving mechanically ventilated patients which compared diagnostic tools with the Diagnostic and Statistical Manual of Mental Disorders criteria as a reference standard will be included. We will use MetaDiSC and STATA 15.1 to analyze carefully when a network meta-analysis is allowed.

Results:

This study will provide a high-quality synthesis to assess the accuracy of different screening methods in mechanically ventilated patients.

Conclusion:

The conclusion of our systematic review will provide evidence to judge which screening method is the best for mechanically ventilated patients.
Comparison of the safety of outpatient cervical disc replacement with inpatient cervical disc replacement
Authors: Wang Xiaofei , Meng Yang , Liu Hao , Hong Ying , Wang Beiyu
Published: August 2020

Background:

Cervical disc replacement (CDR) has been widely used as an effective treatment for cervical degenerative disc diseases in recent years. However, the cost of this procedure is very high and may bring a great economic burden to patients and the health care system. It is reported that outpatient procedures can reduce nearly 30% of the costs associated with hospitalization compared with inpatient procedures. However, the safety profile surrounding outpatient CDR remains poorly resolved. This study aims to evaluate the current evidence on the safety of outpatient CDR

Methods:

Four English databases were searched. The inclusion and exclusion criteria were developed according to the PICOS principle. The titles and abstracts of the records will be screened by 2 authors independently. Records that meet the eligibility criteria will be screened for a second time by reading the full text. An extraction form will be established for data extraction. Risk of bias assessment will be performed by 2 authors independently using Cochrane risk of bias tool or Newcastle–Ottawa scale. Data synthesis will be conducted using Stata software. Heterogeneity among studies will be assessed using I
2 test. The funnel plot, Egger regression test, and Begg rank correlation test will be used to examine the publication bias.

Results:

The results of this meta-analysis will be published in a peer-review journal.

Conclusion:

This will be the first meta-analysis that compares the safety of outpatient CDR with inpatient CDR. Our study will help surgeons fully understand the complications and safety profile surrounding outpatient CDR.

OSF registration number:

doi.org/10.17605/OSF.IO/3597Z
Hypertonic saline and mannitol in patients with traumatic brain injury
Authors: Shi Jiamin , Tan Linhua , Ye Jing , Hu Lei
Published: August 2020

Background:

To compare the effects of 3% hypertonic saline solution and 20% mannitol solution on intracranial hypertension.

Methods:

WAN-FANGDATA, CNKI, and CQVIP databases were searched, and relevant literatures of randomized controlled trials comparing 3% hypertonic saline solution with mannitol in reducing intracranial hypertension from 2010 to October 2019 were collected. Meta-analysis was performed using RevMan software.

Results

: As a result, 10 articles that met the inclusion criteria were finally included. A total of 544 patients were enrolled in the study, 270 in the hypertonic saline group and 274 in the mannitol group. There was no significant difference in the decrease of intracranial pressure and the onset time of drug between the 2 groups after intervention (all P > .05). There was a statistically significant difference between the hypertonic saline group and the mannitol group in terms of duration of effect in reducing intracranial pressure (95% confidence interval: 0.64–1.05, Z = 8.09, P < .00001) and cerebral perfusion pressure after intervention (95% confidence interval: 0.15–0.92, Z = 2.72, P = .007).

Conclusion:

Both 3% hypertonic saline and mannitol can effectively reduce intracranial pressure, but 3% hypertonic saline has a more sustained effect on intracranial pressure and can effectively increase cerebral perfusion pressure.
Which acupuncture and moxibustion technique is more effective for primary dysmenorrhea
Authors: Wu Zenan , Yang Yi , Xiong Jun , Yu Xinyu , Zuo Zhengyun , Xie Qiongshan
Published: August 2020

Background:

Primary dysmenorrhea (PD), also called functional dysmenorrhea, refers to a woman's menstrual period in genital no organic disease, abdominal pain, under the belly and other discomfort for the characteristics of disease of department of gynecology. Acupuncture and moxibustion have been accepted as treatment options for PD. So far, there are so many therapies for PD and their efficacy has been assessed by several systematic reviews. Therefore, this study aims at evaluating the effectiveness which acupuncture and moxibustion technique is more effective for primary dysmenorrhea.

Methods and analysis:

The following electronic databases will be searched in this study: the Cochrane Central Register of Controlled Trials (CENTRAL);PubMed; EMBASE; China National Knowledge Infrastructure (CNKI); Chinese Biomedical Literature Database (CBM);Chinese Scientific Journal Database (VIP database); and Wan-Fang Database(WF). More than two authors independently assessed the quality of the evidence by AMSTAR2, PRISMA, PRISMA-A, and GRADE approach. Two of our researchers will use the bias risk tool provided by the Cochrane Collaboration to evaluate the quality of the literature using WinBUGS 1.4.3 and STATA softwares. The primary outcomes include the extent of pain in the lower abdomen measured by visual analog scale (VAS) and relief from symptoms. The quality of life (QoL) and Adverse events will be considered as Additional outcome(s). Their reference lists and the citation lists of studies meeting the inclusion criteria and relevant systematic reviews will also be searched to identify further studies for inclusion. Before this review completed, the 2 reviewers will conduct the search once again to ensure the latest studies could be included.

Ethics and dissemination:

This review does not require ethical approval.

Results:

The results will be published in a peer-reviewed journal.

Conclusion:

This study will provide comprehensive evidence of acupuncture and moxibustion for patients with PD.

INPLASY registration number:

INPLASY2020500106.
Efficacy of oral Vitamin D supplementation in reducing body mass index and lipid profile in adolescents and young adults in Colombia
Authors: Serrano Norma C. , Romero Sandra L. , Suárez Diana P. , Rojas Lyda Z. , Gamboa-Delgado Edna Magaly , Forero Mario , Guio Elizabeth , Quintero-Lesmes Doris Cristina
Published: August 2020

Background:

In recent years, the role of vitamin D (VD) as a protective factor in cardiovascular disease has been recognized. Thus, there is a need to study the effect of vitamin D supplementation in the control of different cardiovascular risk factors and metabolic syndrome, especially in young populations where few studies have been conducted.

Methods:

Pilot study of a randomized, parallel two-arm, triple-blind clinical controlled trial in 150 adolescents and young adults in the city of Bucaramanga-Colombia. The intervention group will receive 1000 IU of VD and the control group 200 IU of VD daily for 15 weeks. The main outcomes are: serum calcifediol levels (25(OH) D), body mass index and lipid profile; secondary outcomes are complementary to the previous ones (skin folds, waist-hip ratio). Other variables will be analyzed such as assessment of dietary intake, physical activity, sun exposure, cigarette and tobacco consumption and compliance with VD supplementation.

Discussion:

This study is innovative since there is little evidence from clinical trials in adolescents and young adults; similar studies are not known in our context. The results of this study may facilitate the recommendation of oral vitamin D supplementation in the population of interest. In addition, it is a low-cost and easy-to-apply intervention that could contribute to the formulation and implementation of health policies.

Trial registration:

NCT04377386
Traditional Chinese medicine for corona virus disease 2019
Authors: Huang Ju , Wu Liu , Ren Xiaodan , Wu Xinhui , Chen Yong , Ran Guoping , Huang Anming , Huang Liangxin , Zhong Dan
Published: August 2020

Background:

Assessing the effectiveness and safety of Traditional Chinese medicine for treating patients with corona virus disease 2019 (COVID-19) is the main purpose of this systematic review protocol.

Methods:

The following electronic databases will be searched from inception to April 2020: Cochrane Central Register of Controlled Trials, PubMed, Web of Science, EMBASE, China National Knowledge Infrastructure, Traditional Chinese Medicine, Chinese Biomedical Literature Database, Wan-Fang Database, and Chinese Scientific Journal Database. All published randomized controlled trials in English or Chinese related to Traditional Chinese medicine for COVID-19 will be included. Primary outcomes are time of disappearance of main symptoms and serum cytokine levels. Secondary outcomes is Accompanying symptoms disappear rate, negative COVID-19 results rate on 2 consecutive occasions CT image improvement, average hospitalization time, occurrence rate of common type to severe form, clinical cure rate, and mortality. Two reviewers will conduct the study selection, data extraction, and assessment independently. The assessment of risk of bias and data synthesis will be conducted with Review Manager Software V.5.2.

Results:

The results will provide a high-quality synthesis of current evidence for researchers in this subject area.

Conclusion:

The conclusion of our study will provide evidence to judge whether traditional Chinese medicine is an effective intervention for COVID-19 patients.

PROSPERO registration number:

CRD42020181006.
Effects and safety of tanreqing injection on viral pneumonia
Authors: Liu Hui , Ding Xue-Fei , Guo Rui , Zhao Meng-Fan , Deng Di , Hao Yu , Wang Yi
Published: August 2020

Background:

Viral pneumonia is a common respiratory disease that leads to high mortality around the world. Tanreqing (TRQ) injection has been widely used to treat viral pneumonia in China. However, the efficiency and safety of TRQ injection for viral pneumonia have not been scientifically and methodically evaluated up to now. Thus, this protocol describes a plan of performing a systematic review and meta-analysis to evaluate the efficacy and safety of TRQ injection on patients with viral pneumonia.

Methods:

Only randomized controlled trials will be enrolled in our study, and we will search eligible studies in the following electronic databases: PubMed, Embase, Cochrane Central Register of Controlled Trials, Clinical Trials, China National Knowledge Infrastructure, the Wanfang database, the Chinese Scientific Journal Database, and the Sinomed. The total effective rate of clinical efficacy will be used as primary outcome. Time to relieve symptoms, incidence of adverse reactions, and the laboratory parameters will be used as secondary outcomes. Any side effects and adverse events will be recorded and assessed as safety outcomes. Study inclusion, data extraction, and quality assessment will be performed independently by 2 reviewers, and any disagreement will be resolved by a third reviewer. After that, data synthesis and subgroup analysis will be conducted with the Review Manager V.5.3.3 software.

Results:

This review will provide a high-quality synthesis to assess the effectiveness and safety of TRQ injection for viral pneumonia patients.

Conclusion:

Our study will provide comprehensive evidence to decide whether TRQ injection is effective and safe for viral pneumonia patients.

Prospero registration number:

PROSPERO CRD42020164164
Viral exanthema as manifestation of SARS-CoV-2 infection
Authors: Iancu Gabriela Mariana , Solomon Adelaida , Birlutiu Victoria
Published: August 2020

Rationale:

The clinical manifestations of the SARS-CoV-2 infection are mainly respiratory but the virus can cause a variety of symptoms. Dermatological findings are less well-characterized. Data is scarce on their timing, type and correlation with the immune response.

Patient concerns:

We present the case of SARS-CoV-2 infection in a previously healthy woman who presented with respiratory symptoms and developed anosmia, diarrhea, and an erythematous maculo-papular rash on day 15 from symptom onset.

Diagnosis:

The nasopharyngeal swab tested by real time PCR for COVID-19 was positive. We interpreted this as a viral exanthema likely caused by an immune response to SARS-CoV-2 nucleotides.

Interventions:

She was treated with Hydroxychloroquine, Azithromycin and Lopinavir/Ritonavir, and the rash with topical corticosteroids.

Outcomes:

All symptoms resolved except for anosmia which persisted for 6 weeks. At the 4- and 6-weeks follow-up the IgG titers for SARS-CoV-2 were high.

Lessons:

We must consider that SARS-CoV-2 has a multi-organ tropism. In our case, the SARS-CoV-2 infection had lung, nasopharyngeal, neurological, digestive, and skin manifestations. Identifying the different manifestations is useful for understanding the extent of SARS-CoV-2 infection. We not only present a rare manifestation but also suggest that cutaneous manifestations may correlate with immunity.
Pregnancy outcomes and the dose-related effects of acupuncture therapies in women undergoing in vitro fertilization
Authors: Zou Zihao , Zheng Qianhua , Wen Xin , Yang Zuoqin , Hou Tinghui , Hao Xinyu , Zhou Siyuan , Li Ying
Published: August 2020

Background:

Previous studies have given an inaccurate assessment of the role of acupuncture in in vitro fertilization (IVF). We will use acupuncture doses as an entry point, discussing the dose-related effects of acupuncture therapy in women undergoing IVF.

Methods:

This study will search the following database: EMBASE, PubMed, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), and 4 Chinese databases. All databases will be searched from the date of database establishment to January 31, 2019. In addition, we will search possible studies which were included in previous meta-analyses. The primary outcomes are the clinical pregnancy rate (CPR) and the live birth rate (LBR). The secondary outcomes involved the biochemical pregnancy rate (BPR), the ongoing pregnancy rate (OPR), serum hormone level, the incidence of ovarian hyper-stimulation syndrome (OHSS), the cycle cancellation rates, and adverse events (AEs). After checking and integrating the raw data, we will use a 2-step to conduct the meta-analysis. Firstly, we will assess the effect of acupuncture on in vitro fertilization and embryo transfer (IVF-ET). Secondly, the meta-analysis will be performed for studies with similar total number of treatment sessions to investigate the dose-related effects of acupuncture. RevMan V.5.3 statistical software will be used for meta-analysis. If it is not appropriate for a meta-analysis, then a descriptive analysis will be conducted.

Results:

This study will investigate the relationship between pregnancy outcomes and the doses of acupuncture therapy in women undergoing IVF, and answer whether a higher-doses of acupuncture treatment will contribute to a better outcome of IVF-ET.

Conclusion:

The funding of this meta-analysis may provide convincing evidence for clinicians, benefitting more patients who crave children.

INPLASY registration number:

INPLASY202070072
A PRISMA-compliant systematic review and meta-analysis of integrated Chinese and Western medicine in treating hepatitis C
Authors: Li Xiuqin , Jia Lili , Ouyang Jing , An Ying , Luo Guihua , Song Rui , Liu Qiling , Zhang Bei , Zhang Rongqiang
Published: August 2020

Objective:

To conduct a meta-analysis evaluating the effect of combining traditional Chinese medicine (TCM) with Western medicine in treating hepatitis C, and to provide an evidence-based medical strategy.

Methods:

Randomized controlled trials (RCTs) comparing the effect of pegylated interferon (Peginterferon) combined with ribavirin (PR) alone and its combination with TCM were manually retrieved from the Weipu Information Resources System (VIP), Wan Fang Database, PubMed, and the Chinese Journal Full Text Database (CNKI). Studies meeting the inclusion criteria were selected and analyzed using the Review Manager 5.3 software. Suitable tests were also performed to determine the quality, heterogeneity, and sensitivity of the studies included in the meta-analysis.

Results:

Twenty-eight RCTs met the inclusion criteria. The combination therapy or intervention group showed significantly greater HCV-RNA negative rate post-treatment compared to the monotherapy or the control group (P < .05). In addition, the serum levels of the liver function indicators alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (ALB) were significantly improved after the combination therapy compared to PR alone (P < .05), while total bilirubin (TB) and r-glutamyltransferase (GGT) levels were not affected by TCM (P > .05). Finally, the parameters of liver fibrosis were also reduced by the combination therapy more effectively than the monotherapy.

Conclusion:

The combination of TCM and PR can improve the Comprehensive Clinical Efficacy of hepatitis C and have a better negative rate of HCV-RNA with a better benefit in the liver function. The effect of TCM + PR is better than that of PR alone in treating hepatitis C.
Effects of high-quality nursing care on psychological outcomes and quality of life in patients with hepatocellular carcinoma
Authors: Zhang Lei , Zhang Xuan , Cui Zhaokun , Zhou Lijuan , Qu Kai , Wang Nannan
Published: August 2020

Background:

High quality nursing care (HQNC) has been reported to effectively prevent psychological disorders and improve the quality of life (QoL) in patients with hepatocellular carcinoma (HCC) during the treatment. However, the exact effect of HQNC remains controversial. This systematic review will be aimed to assess the effectiveness of HQNC on psychological disorders and QoL in patients with HCC.

Methods:

Eligible prospective controlled clinical trials were searched from Google Scholar, Medline, Excerpt Medica Database (Embase), PubMed, Web of Science (WOS), Cochrane Library, China Scientific Journal Database (CSJD), China National Knowledge Infrastructure (CNKI), Chinese BioMedical Database (CBM) and Wanfang Database. Papers in English or Chinese published from January 2000 to July 2020 will be included without any restrictions. The clinical outcomes including psychological outcomes, QoL, and adverse events of HQNC in patients with HCC were systematically evaluated.

Study selection and data extraction will be performed independently by two reviewers. Stata 14.0 and Review Manager 5.3 were used for data analysis. Methodological quality for each eligible study will be assessed by using Cochrane risk of bias tool. Subgroup and meta-regression analysis will be carried out depending on the availability of sufficient data.

Results:

The results of this systematic review will be published in a peer-reviewed journal.

Conclusion:

The results of this study may provide helpful evidence of HQNC on psychological effects and QoL in patients with HCC.

INPLASY registration number:

INPLASY202070096.
The efficacy and safety of acupuncture or combined with western medicine for dry eye
Authors: Wang Xu , Fan Yihua , Lan Hongyi , Song Yanjin , Shi Zongyan , Zhang Zhillong , Li Xinju
Published: August 2020

Background:

As a traditional Chinese medicine external treatment method, acupuncture is characterized by simple operation, significant treatment effect and few side effects. Dry eye, also known as conjunctival xerosis, refers to pathological changes in tissues of ocular surface caused by abnormal tear quality and quantity or dynamics due to various reasons, which can cause red and swollen eyes, congestion, and severe cases may result in lesions of the conjunctiva. Clinical practice shows that acupuncture has a certain therapeutic effect on dry eye, but there is a lack of medical evidence. The objective of the research carried out in this program is to evaluate the effectiveness and safety of acupuncture combined with western medicine in the treatment of dry eye.

Methods:

Computer retrieval English database (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese database (CNKI, WF, VIP, CBMDISC), moreover manual retrieval of clinical research on the treatment of dry eyes by acupuncture in combination with western medicine from Baidu academic and Google Academic from database building to May 2020, the quality included in the study was evaluated and data extraction was completed by 2 independent researchers. RevMan5.3 software was utilized for meta-analysis to the included literature.

Results:

In this study, the effectiveness and safety of acupuncture combined with western medicine in the treatment of dry eye were evaluated by several indicators, such as the score of the ocular surface disease index, the amount of tear secretion and the tear film rupture time.

Conclusions:

This study will provide reliable evidence for the clinical application of acupuncture combined with western medicine in the treatment of dry eyes.

OSF Registration number:

DOI 10.17605/OSF.IO/5DJ9W.
Association of nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing protein 3 polymorphisms with systemic lupus erythematosus disease activity and biomarker levels
Authors: Su Zhenzhen , Niu Qian , Huang Zhuochun , Yang Bin , Zhang Junlong
Published: August 2020

Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease with considerable genetic predisposition. Nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing protein 3 (NLRP3) is crucial for the innate immunity and implicated in SLE pathogenesis. Accordingly, we conducted a case-control study to find the association of NLRP3 variations with SLE susceptibility and disease activity.

Three single nucleotide polymorphisms of NLRP3 (rs3806268, rs4612666, and rs10754558) were genotyped in 400 SLE patients and 400 healthy controls; the patients were further divided into mild-to-moderate or high disease activity subgroup. Serum cytokines, complements, and autoantibodies were also detected.

We found that rs4612666 TT genotype conferred a higher risk of severe disease activity with adjusted odds ratio = 2.08, P = .02 and adjusted odds ratio  = 2.34, P = .01 in the codominant and recessive model, respectively. Nevertheless, there was no association between the 3 single nucleotide polymorphisms of NLRP3 gene and SLE susceptibility. In addition, C4 decreased significantly in rs3806268 GG (P < .001) and rs4612666 TT genotype carriers (P = .03). A higher trend of interleukin-1β and interleukin-γ release were identified in rs3806268 AA and rs10754558 CC genotype carriers, respectively.

NLRP3 polymorphisms are associated with SLE disease activity and hypocomplementemia. Interleukin-1β and interleukin-γ levels in SLE patients are correlated with NLRP3 variants as well.
Allogeneic red blood cell transfusion is an independent risk factor for 1-year mortality in elderly patients undergoing femoral neck fracture surgery
Authors: Shin Hyeon Ju , Kim Jong Hun , Han Seung-Beom , Park Jong Hoon , Jang Woo Young
Published: August 2020

Allogeneic red blood cell transfusion (ABT) is 1 of the poor prognostic factors for morbidity and mortality in patients with hip fracture, particularly among elderly patients. This study aimed to investigate the risk factors for ABT and 1-year mortality in elderly patients undergoing surgery for femoral neck fracture.

A total of 225 elderly patients who underwent femoral neck fracture surgery between May 2013 and November 2015 at a tertiary medical center were retrospectively recruited. Medical records were analyzed.

The median patient age was 80 years and 28.4% were men. A total of 113 patients received ABT (50.2%). Multivariate logistic regression analysis showed that female sex (odds ratio [OR] 2.606, 95% confidence interval [CI] 1.283–5.295, P = .008), malignancy (OR 5.098, 95% CI 1.725–15.061, P = .003), chronic kidney disease stage ≥ 3 (OR 3.258, 95% CI 1.603–6.622, P = .001), and anemia (hemoglobin < 12 g/dL) (OR 4.684, 95% CI 2.230–9.837, P < .001) were significantly associated with ABT. The 1-year mortality rate after surgery was 15.1%. Male sex (OR 2.477, 95% CI 1.101–5.575, P = .028), ABT (OR 2.367, 95% CI 1.036–5.410, P = .041), and intensive care unit admission (OR 5.564, 95% CI 1.457–21.249, P = .012) were significantly associated with 1-year mortality.

In this study, underlying comorbidities such as chronic kidney disease and malignancy were associated with ABT. Furthermore, ABT was a significant independent risk factor for 1-year mortality. These findings suggest that underlying comorbidities and the need for ABT should be considered in the risk assessment of elderly patients with femoral neck fracture to improve the outcomes after surgery.
The impact of miR-9 in osteosarcoma
Authors: Wu Fengfeng , Jiang Xuesheng , Wang Qun , Lu Qian , He Fengxiang , Li Jianyou , Li Xiongfeng , Jin Mingchao , Xu Juntao
Published: August 2020

The function of miR-9 in osteosarcoma is not well-investigated and controversial. Therefore, we conducted meta-analysis to explore the role of miR-9 in osteosarcoma, and collected relevant TCGA data to further testify the result. In addition, bioinformatics analysis was conducted to investigate the mechanism and related pathways of miR-9-3p in osteosarcoma.

Literature search was operated on databases up to February 19, 2020, including PubMed, Web of Science, Science Direct, Cochrane Central Register of Controlled Trials, and Wiley Online Library, China National Knowledge Infrastructure, China Biology Medicine disc, Chongqing VIP, and Wan Fang Data. The relation of miR-9 expression with survival outcome was estimated by hazard ratio (HRs) and 95% CIs. Meta-analysis was conducted on the Stata 12.0 (Stata Corporation, TX). To further assess the function of miR-9 in osteosarcoma, relevant data from the TCGA database was collected. Three databases, miRDB, miRPathDB 2.0, and Targetscan 7.2, were used for prediction of target genes. Genes present in these 3 databases were considered as predicted target genes of miR-9-3p. Venny 2.1 were used for intersection analysis. Subsequently, GO, KEGG, and PPI network analysis were conducted based on the overlapping target genes of miR-9-3p to explore the possible molecular mechanism in osteosarcoma.

Meta-analysis shown that overexpression of miR-9 was associated with worse overall survival (OS) (HR = 4.180, 95% CI: 2.880–6.066, P < .001, I2 = 23.5%). Based on TCGA data, osteosarcoma patients with overexpression of miR-9-3p (HR = 1.603, 95% CI: 1.028–2.499, P = .037) and miR-9-5p (HR = 1.698, 95% CI: 1.133–2.545, P = .01) also suffered poor OS. In bioinformatics analysis, 2 significant and important pathways were enriched: Wnt signaling pathway from gene ontology analysis (gene ontology:0016055, P-adjust = .008); hippo signaling pathway from Kyoto Encyclopedia of Genes and Genomes analysis (P-adjust = .007). Moreover, network analysis relevant protein-protein interaction was visualized, revealing 117 nodes and 161 edges.

High miR-9 expression was associated with poor prognosis. Based on bioinformatics analysis, this study enhanced the understanding of the mechanism and related pathways of miR-9 in osteosarcoma.
Clinical evaluation of traditional Chinese medicine on mild active ulcerative colitis
Authors: Kou Fu-Shun , Shi Lei , Li Jun-Xiang , Wang Zhi-Bin , Shi Rui , Mao Tang-You , Ke Xiao , Zhang Bei-Ping , Yang Xiao-Jun , Wen Xin-Li , Zheng Wei-Yang , Han Xiao , Ding Pang-Hua , Dong Jun
Published: August 2020

Introduction:

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) characterized by a relapsing-remitting course owing to recurrent intestinal inflammation. UC often has symptoms such as intermittent rectal bleeding, diarrhea, and abdominal pain. As the precise etiology of UC has not completely clarified, UC has become a public health challenge worldwide. According to an epidemiological survey, there were about 350,000 new cases of IBD in China from 2005 to 2014. By 2025, the number of IBD patients in China will reach 1.5 million. Traditional Chinese medicine (TCM) has been widely used to treat UC in China, however, it is still challenging to systematically determine the efficacy of in UC. Therefore, this trial aims to evaluate the clinical efficacy and safety of CHM in the treatment of mild active UC patients.

Methods:

A multi-center, double-blinding, double-dummy, active-controlled, randomized trial will be established. A total of 240 patients in 6 centers with mild active UC (Mayo score is 3–5 points) and TCM syndrome of damp-heat stasis blocking and spleen-qi deficiency will be randomly allocated in the ratio of 1:1 to 2 groups: the experimental group and the control group. The experimental group will receive Hudi enteric-coated capsules (HEC) and enteric-coated mesalazine tablets placebo; the control group will receive enteric-coated mesalazine tablets and HEC placebo. Each group will be treated for 8 weeks. The primary therapeutic outcome: the rate of clinical efficacy and clinical remission at 8 weeks of treatment (last survey point) according to the modified Mayo score. The secondary outcomes: individual symptom score, TCM syndrome score, endoscopic response rate, mucosal healing rate, and quality of life scale score. Outcomes will be assessed at baseline and the end of the trial. Besides, intestinal mucosa, stools and blood biopsies from the mild active UC patients before and after treatment will be collected to reveal the underlying mechanisms.

Discussion:

The results of this trial will provide compelling evidence of the efficacy and safety of HEC for treatment of mild active UC and preliminarily show the potential mechanism of how HEC acts. Finally, it will widen treatment options for patients with mild active UC.
The resolution of carotid arterial thrombus by oral anticoagulation after IV thrombolysis for chemotherapy-induced stroke
Authors: Wu Bo-Chang , Hu Ming-Hung , Wang Vinchi
Published: August 2020

Rationale:

Cancer-related stroke has been regarded as an emerging subtype of ischemic event. Acute treatment for this subtype may include the antiplatelet agents, anticoagulants, or endovascular intervention.

Patient concerns:

A 63-year-old woman with sudden-onset right hemiparesis and conscious change was sent to our emergency department. The patient had underlying sigmoid adenocarcinoma and received chemotherapy FOLFIRI (FOL, folinic acid; F, fluorouracil; and IRI, irinotecan) with targeted therapy cetuximab following lower anterior resection since the diagnosis was made.

Diagnoses:

Brain magnetic resonance angiography revealed a filling defect in left carotid bulb, and neurosonography showed a thick atherosclerotic plaque (size 4.9 mm) in the left internal carotid artery on day 5 after the onset of stroke.

Interventions:

During the first three hours after onset, administration of IV tissue plasminogen activator did not resolve the thrombus. Dabigatran (110 mg bid) started on day 7.

Outcomes:

The atherosclerotic plaque dissolved on day 24. The patient recovered her muscle strength but still had nonfluent speech in mild extent.

Lessons:

Thrombolytic and anticoagulant medications in this patient suggested the thrombus formation with fibrin-rich content which may be attributable to both cancer and chemotherapy. Dabigatran, an oral anticoagulant, had a benefit for this subtype of ischemic stroke among patients with cancer.