bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of disease activity with depression and anxiety in systemic lupus erythematosus: a comparison of SLEDAI-2K and SLE-DAS
Authors: Yang Leilei , Gu Bingjie , Wang Xiaoqin , Ren Qijie , Shen Minning , Su Dinglei
Published: February 2024

Objective

To explore the association of disease activity, as evaluated by both the Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) and the SLEDAI-2000 (SLEDAI-2K), with depression and anxiety in patients with SLE.

Methods

A cross-sectional study was conducted among 85 Chinese patients with SLE. Disease activity was measured using SLEDAI-2K and SLE-DAS scoring systems. Depression and anxiety were assessed using Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7, respectively. Multivariate logistic regression analysis was performed to evaluate the association of disease activity scores, as well as specific clinical and laboratory items, with depression and anxiety.

Results

There was a robust correlation between SLEDAI-2K and SLE-DAS scores in overall patient population (Spearman’s r = 0.764, 95% CI 0.655–0.842; P < 0.001) and in those with moderate-to-high disease activity (Spearman’s r = 0.792, 95% CI 0.616–0.892; P < 0.0001). However, the correlation weakened for patients with mild disease activity or remission (Spearman’s r = 0.450, 95%CI 0.188–0.652; P = 0.001). Multivariate logistic regression analysis did not show a significant correlation between SLEDAI-2K and SLE-DAS scores and depression/anxiety. The presence of mucosal ulcer/serositis significantly increased the risk of depression (odds ratio = 4.472, 95% CI 1.035–19.328; P = 0.045) and anxiety (odds ratio = 3.978, 95% CI 1.051–15.049; P = 0.042).

Conclusion

The SLE-DAS scoring system demonstrated a comparable ability to assess disease activity in SLE compared with SLEDAI-2K. Though neither scoring system showed significant associations with depression and anxiety, the presence of mucosal ulcer/serositis markedly heightened the risk of both among SLE patients.
Effects of acrylamide exposure during pregnancy and lactation on the development of myelin sheath of corpus callosum in offspring rats
Authors: Liu Shuping , Yang Dehui , Dong Suqiu , Luo Yuyou , Zhang Tong , Li Siyuan , Bai Yanxian , Li Lixia , Ma Yuxin , Liu Jing
Published: February 2024

Acrylamide is an alkene known to induce neurotoxicity in humans and experimental animals. However, the effects of acrylamide on the development of myelin sheath are unclear. The present study was to explore the effects of acrylamide exposure during pregnancy and lactation on the development of myelin sheath in offspring rats. Four groups of thirty-two pregnant Sprague–Dawley rats were exposed to 0, 4.5, 9 and 18 mg/kg BW acrylamide by gavage from gestational day 15 to postnatal day 13. The corpus callosum of nine offspring rats per group were dissected in postpartum day 14. Structural changes and lipid contents in myelin sheaths were examined by transmission electron microscopy(TEM) and Luxol Fast Blue staining(LFB). The expression of MBP and PLP was evaluated by immunohistochemistry and Western blotting. TEM showed that the myelin sheaths in the 18 mg/kg group were disordered compared with control group. Luxol Fast Blue staining gradually decreased with increasing acrylamide maternal exposure. The immunohistochemistry and Western Blotting results showed that maternal exposure to acrylamide caused a decreasing trend in MBP and PLP in the corpus callosum of rats at postnatal day 14. Furthermore, these reduced protein levels may be neurodevelopmental toxicity’s mechanism in response to maternal exposure to acrylamide.
Elucidating the Mode of Action of Hybrid Nanoparticles of Cu/Zn Against Copper-Tolerant Xanthomonas euvesicatoria
Authors: Carvalho Renato , Tapia Jose H. , Minsavage Gerald V. , Jones Jeffrey B. , Paret Mathews L.
Published: February 2024

The widespread presence of tolerance to copper in Xanthomonas species has resulted in the need to develop alternative approaches to control plant diseases caused by xanthomonads. In recent years, nanotechnological approaches have resulted in the identification of novel materials to control plant pathogens. With many metal-based nanomaterials having shown promise for disease control, an important question relates to the mode of action of these new materials. In this study, we used several approaches, such as scanning electron microscopy, propidium monoazide quantitative polymerase chain reaction, epifluorescence microscopy, and RNA sequencing to elucidate the mode of action of a Cu/Zn hybrid nanoparticle against copper-tolerant strains of Xanthomonas euvesicatoria. We demonstrate that Cu/Zn did not activate copper resistance genes (i.e., copA and copB) in the copper-tolerant bacterium but functioned by disrupting the bacterial cell structure and perturbing important biological processes such as cell respiration and chemical homeostasis.
Validation of ChatGPT 3.5 as a Tool to Optimize Readability of Patient-facing Craniofacial Education Materials
Authors: Vallurupalli Medha , Shah Nikhil D. , Vyas Raj M.
Published: February 2024

Background:

To address patient health literacy, the American Medical Association recommends that readability of patient education materials should not exceed a sixth grade reading level; the National Institutes of Health recommend no greater than an eigth-grade reading level. However, patient-facing materials in plastic surgery often remain at an above-recommended average reading level. The purpose of this study was to evaluate ChatGPT 3.5 as a tool for optimizing patient-facing craniofacial education materials.

Methods:

Eighteen patient-facing craniofacial education materials were evaluated for readability by a traditional calculator and ChatGPT 3.5. The resulting scores were compared. The original excerpts were then inputted to ChatGPT 3.5 and simplified by the artificial intelligence tool. The simplified excerpts were scored by the calculators.

Results:

The difference in scores for the original excerpts between the online calculator and ChatGPT 3.5 were not significant (P= 0.441). Additionally, the simplified excerpts’ scores were significantly lower than the originals (P < 0.001), and the mean of the simplified excerpts was 7.78, less than the maximum recommended 8.

Conclusions:

The use of ChatGPT 3.5 for simplification and readability analysis of patient-facing craniofacial materials is efficient and may help facilitate the conveyance of important health information. ChatGPT 3.5 rendered readability scores comparable to traditional readability calculators, in addition to excerpt-specific feedback. It was also able to simplify materials to the recommended grade levels. With human oversight, we validate this tool for readability analysis and simplification.
Clinical performance after implantation of an EDOF intraocular lens in the dominant eye and a presbyopia-correcting intraocular lens in the nondominant eye
Authors: Soscia William L. , DeRojas Joaquin O. , Mathews Priya M. , Brutsky Amy , Solomon Kerry D. , Potvin Richard , Sandoval Helga P.
Published: February 2024

Purpose:

To evaluate subjective and objective outcomes after combined implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) and a combined technology multifocal lens (CT-IOL).

Setting:

2 clinical practices (Carolina Eyecare Physicians, Center For Sight) in the United States.

Design:

Prospective, unmasked, multicenter, nonrandomized bilateral eye study.

Methods:

Patients interested in reducing their dependence on spectacles were implanted with an EDOF IOL in the dominant eye and a CT-IOL in the nondominant eye. Refractive and visual acuity (VA) data at various distances (4 m, 66 cm, 40 cm, and 33 cm) were collected 3 months postsurgery, along with the distance-corrected binocular defocus curve and responses to questionnaires related to spectacle independence, visual disturbances, and overall visual function.

Results:

Data from 37 participants were analyzed. The distance-corrected binocular defocus curve showed a mean VA better than 0.1 logMAR (20/25) at all vergences from +1.00 to −2.50 diopters (D). 36 participants (97%) had an uncorrected binocular VA of 0.3 logMAR or better, at all test distances. 70% of participants (26/37) reported never wearing spectacles at any distance, and 84% (31/37) were “completely” or “mostly” satisfied with their overall vision after surgery. Halos were the disturbance reported most frequently and reported as most bothersome, with difficulty driving at night the most common visual function issue. Difficulty reading was the next most reported issue. Overall eyesight was rated as “excellent” or “good” by 92% (34/37) of participants.

Conclusions:

This combined EDOF/CT-IOL approach was well-tolerated by participants and provided some potential benefits relative to bilateral implantation of either lens.
Limited health insurance coverage of injectable neurotoxins and fillers for gender affirmation: a cross-sectional study of Affordable Care Act silver and Medicaid plans
Authors: Roszell Karin , Shumer Daniel , Orringer Jeffrey , Wang Frank
Published: February 2024

Background:

Injectable neurotoxins and fillers are potential options for facial gender affirmation for transgender/nonbinary patients. However, the largest barrier to access is cost/insurance coverage.

Objective:

The purpose of this article is to assess the extent to which Affordable Care Act (ACA) silver plans and Medicaid policies cover gender-affirming injectable neurotoxin and filler procedures.

Methods:

A cross-sectional study of all ACA silver plans and Medicaid policies was performed from June 22 to August 15, 2021. Plan-specific certificates of coverage, clinical policies of insurance providers, and Medicaid documents were evaluated.

Results:

A total of 915 plans were reviewed (864 ACA silver plans and all 51 Medicaid policies). None potentially covered neurotoxins. Only 72 (71 ACA and 1 Medicaid) potentially covered fillers, specifically collagen injections and lipofilling. Coverage required demonstration of medical necessity or significant variation of physical appearance from the patient’s experienced gender. However, of the 71 ACA plans, 69 outlined cosmetic exclusions, possibly nullifying this coverage.

Limitations:

Data were sourced from publicly available online information in 2021. Additionally, we were unable to confirm explicit coverage of these procedures with insurance companies.

Conclusion:

The majority of ACA silver and Medicaid plans did not cover gender-affirming neurotoxin or filler procedures, limiting access to this gender-affirming care.
Clinical efficacy of subthreshold micropulse laser combined with anti-VEGF drugs in the treatment of diabetic macular edema: A meta-analysis
Authors: Xu Dahua , Zhu Ting , Huang Lin , Wang Xiaolin , Chen Mei
Published: February 2024

Background:

To systematically evaluate the efficacy and safety of subthreshold micropulse laser (SML) combined with anti-vascular endothelial growth factor (VEGF) drugs for the treatment of diabetic macular edema (DME).

Methods:

The randomized controlled trials on SML combined with anti-VEGF drugs for DME were retrieved from China National Knowledge Infrastructure, Wan Fang Data, VIP Data, Sino Med (China Biomedical Literature Database), PubMed, Web of Science, The Cochrane Library, and Embase by computer from inception to April 19, 2022. The observation group was treated with SML combined with anti-VEGF drugs, while the control group was treated with anti-VEGF agents alone or SML. And the references of the included literature were manually searched. The Meta-analysis was performed using Revman 5.4 and STATA SE 15.

Results:

This study finally included 15 randomized controlled trials involving 891 eyes for Meta-analysis. The results showed that there was no statistically significant difference between the 2 groups in best-corrected visual acuity at 1, 3, 6, 9, and 12 months after treatment. There was no statistical difference between the 2 groups in central macular thickness (CMT) at 1, 3, and 6 months after treatment (P > .05). CMT in the observation group was lower than that in the control group at 9 and 12 months (P < .05). There was no statistical difference between the 2 groups in total macular volume at 3, 6, 9, and 12 months in CMT (P > .05). The number of anti-VEGF drugs injections in the observation was lower than that in the control group (P < .05). The occurrence of complications between the 2 groups was not statistically significant difference (P > .05).

Conclusion:

SML in combination with anti-VEGF drugs in patients with DME are comparable in reducing the number of anti-VEGF drugs injections and CMT, thereby reducing the financial burden on patients. It does not differ in best-corrected visual acuity and total macular volume.
Association of asthma and lung cancer risk: A pool of cohort studies and Mendelian randomization analysis
Authors: Huang Qinyao , Huang Yunxia , Xu Senkai , Yuan Xiaojun , Liu Xinqi , Chen Zisheng
Published: February 2024

Background:

Over the past 2 decades, population-based studies have shown an increased association between asthma and the risk of lung cancer. However, the causal links between these 2 conditions remain poorly understood.

Methods:

We conducted a comprehensive search of various databases, including PubMed, Embase, Web of Science, and Cochrane Library, up until May 04, 2023. Only articles published in English were included in our study. We performed a meta-analysis using random-effects models to calculate the odds ratio (OR) and corresponding 95% confidence interval (CI). Subgroup analyses were conducted based on study design, gender, and histologic types. We also conducted a 2-sample Mendelian randomization (MR) using the genome-wide association study pooled data (408,422 people) published by the UK Biobank to explore further the potential causal relationship between asthma and lung cancer.

Results:

Our meta-analysis reviewed 24 population-based cohort studies involving 1072,502 patients, revealing that asthma is significantly associated with an increased risk of lung cancer (OR = 1.29, 95% CI 1.19–1.38) in all individuals. Subgroup analysis showed a significantly higher risk of lung cancer in females with asthma (OR = 1.23, 95% CI 1.01–1.49). We found no significant association between asthma and lung adenocarcinoma (LUAD) (OR = 0.76, 95% CI 0.54–1.05), lung squamous carcinomas (LUSC) (OR = 1.09, 95% CI 0.79–1.50), or small-cell lung cancer (SCLC) (OR = 1.00, 95% CI 0.68–1.49). Interestingly, our MR analysis supported an increasing causality between asthma and lung cancer (OR = 1.11, 95% CI 1.04–1.17, P = .0008), specifically in those who ever smoker (OR = 1.09, 95% CI 1.01–1.16, P = .0173) and LUSC pathological type (OR = 1.15, 95% CI 1.05–1.26, P = .0038).

Conclusion:

Through meta-analysis, our study confirms that patients with asthma have a higher risk of developing lung cancer. Our MR study further support an increasing causal relationship between asthma and the risk of lung cancer, particularly in smokers and LUSC. Future studies examining the link between asthma and the risk of developing lung cancer should consider the bias of controlled and uncontrolled asthma.
Exploring the mechanism of LncRNA CASC15 affecting hepatocellular carcinoma through miRNA
Authors: Cai Qingshan , Wu Dongyang , Shen Yueling , Li Shudong , Liu Liyou , Liu Dong , Li Yong , Chen Xiaonan , Wang Limin , Zheng Jianxing
Published: February 2024

This study aimed to determine the potential mechanisms through which long noncoding (Lnc) RNA cancer susceptibility candidate 15 (CASC15) affects hepatocellular carcinoma (HCC). We retrieved HCC RNA-seq and clinical information from the UCSC Xena database. The differential expression (DE) of CASC15 was detected. Overall survival was analyzed using Kaplan–Meier (K–M) curves. Molecular function and signaling pathways affected by CASC15 were determined using Gene Set Enrichment Analysis. Associations between CASC15 and the HCC microenvironment were investigated using immuno-infiltration assays. A differential CASC15-miRNA-mRNA network and HCC-specific CASC15-miRNA-mRNA ceRNA network were constructed. The overexpression of CASC15 in HCC tissues was associated with histological grade, clinical stage, pathological T stage, poor survival, more complex immune cell components, and 12 immune checkpoints. We identified 27 DE miRNAs and 270 DE mRNAs in the differential CASC15-miRNA-mRNA network, and 10 key genes that were enriched in 12 cancer-related signaling pathways. Extraction of the HCC-specific CASC15-miRNA-mRNA network revealed that IGF1R, MET, and KRAS were associated with HCC progression and occurrence. Our bioinformatic findings confirmed that CASC15 is a promising prognostic biomarker for HCC, and elevated levels in HCC are associated with the tumor microenvironment. We also constructed a disease-specific CASC15-miRNA-mRNA regulatory ceRNA network that provides a new perspective for the precise indexing of patients with elevated levels of CASC15.
Antidepressant mechanism of traditional Chinese medicine: Involving regulation of circadian clock genes
Authors: Lv Shimeng , Huang Yufei , Ma Yuexiang , Teng Jing
Published: February 2024

Numerous studies have demonstrated an intimate relationship between circadian rhythm disorders and the development and prevention of depression. The biological clock genes, which constitute the molecular basis of endogenous circadian rhythms, hold promising prospects for depression treatment. Based on an extensive review of recent domestic and international research, this article presents a comprehensive analysis of how traditional Chinese medicine (TCM) intervenes in depression by regulating circadian rhythms. The findings indicate that TCM exerts its antidepressant effects by targeting specific biological clock genes such as Bmal1, clock, Arntl, Per1, Per2, Per3, Nr1d1, Cry2, and Dbp, as well as regulating circadian rhythms of hormone secretion. However, most current research is still confined to basic experimental studies, lacking clinical double-blind control trials to further validate these viewpoints. Furthermore, there is insufficient research on the signal transduction pathway between biological clock genes and pathological changes in depression. Additionally, further clarification is needed regarding the specific targets of TCM on the biological clock genes.
A case report: Nonsecretory multiple myeloma presenting with bone pain
Authors: Geng Qianshuang , Li Jie , Li Xi , Zhang Wenjie , Zhang Guoxiang , Ge Li , Liang Li
Published: February 2024

Rationale:

Nonsecretory multiple myeloma (NSMM) is a rare subtype of multiple myelom, occurring in 1% to 2% of multiple myelom and characterized by the inability of clonal plasma cells to synthesize or secrete immunoglobulins. We describe a 71-year-old male patient who began with bone pain and was referred to hospital several times, but was not properly diagnosed and effectively treated.

Patient concerns:

A 71-year-old male patient visited our hematology department, complaining of lumbago for 1 year and back pain for half a year.

Diagnoses:

Low-dose whole-body bone computed tomography: multiple bone destruction of the sternum, ribs, multiple vertebrae and accessories of the spine, pelvis, bilateral humerus, and proximal femur. Monoclonal plasma cells accounted for 17.5% of nuclear cells in bone marrow puncture smear. Fluorescence in situ hybridization detected amplification of CKS1B (1q21) gene. Immunofixation electrophoresis negative. About 10.72% of monoclonal plasma cells were detected by flow cytometry. Finally, he was diagnosed with NSMM.

Interventions:

The patients received VCD chemotherapy (bortezomib 1.3 mg/m2, d1, d4, d8, d11; cyclophosphamide 300 mg/m2, d1–2, d8–9; dexamethasone sodium phosphate 20 mg, d1–2, d4–5, d8–9, d11–12, once every 21 days).

Outcomes:

After 2 cycles of VCD treatment, the symptoms of bone pain were significantly relieved, and the efficacy was evaluated as partial response. Follow-up chemotherapy will continue to be completed on schedule. We will continue to follow up to further evaluate the overall survival and progression-free survival.

Lessons:

This case shows that NSMM is easily missed or misdiagnosed.
Lung carcinoma with diffuse cysts repeatedly misdiagnosed as pulmonary infections and lymphoid interstitial pneumonia: A case report
Authors: Li Yishi , Lu Junyu , Yuan Jinhe
Published: February 2024

Introduction:

Diffuse cystic lung diseases comprise a heterogeneous group of pulmonary disorders, with most cases being benign and malignant instances being rare.

Case report:

We present an unusual case of lung adenocarcinoma characterized by the progressive diffusion of cystic lesions. The patient, initially diagnosed with a pulmonary infection and lymphoid interstitial pneumonia, underwent repeated misdiagnoses. Ultimately, the diagnosis was confirmed using radial endobronchial ultrasound-guided–transbronchial cryobiopsy (rEBUS–TBCB). A 44-year-old male was admitted to the hospital with a persistent cough and expectoration of bloody sputum for over 6 months. Thoracic computed tomography revealed widespread cystic lesions and nodules. Despite multiple misdiagnoses, rEBUS–TBCB successfully confirmed the presence of lung adenocarcinoma and identified an echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) E13:A20 gene rearrangement. The patient was subsequently transferred to a local hospital for oral targeted drug therapy, which resulted in a favorable response.

Conclusion:

In conclusions, transbronchial lung biopsies often provide inadequate specimens for confirming diffuse cystic lung diseases. In contrast, the utilization of rEBUS-guided TBCB offers superior diagnostic capabilities, as it enables the collection of larger lung biopsies with higher diagnostic yields and fewer complications compared to surgical lung biopsy.
Efficacy of traditional Chinese medicine combined with Silibinin on nonalcoholic fatty liver disease: A meta-analysis and systematic review
Authors: Zhang Xiang , Jiang Zhenghao , Jin Xiaoliang , Zhou Qiujun
Published: February 2024

Background:

The efficacy and safety of traditional Chinese medicine (TCM) combined with Silibinin in the treatment of nonalcoholic fatty liver disease (NAFLD) are still inconclusive. This meta-analysis intends to evaluation to explore the clinical efficacy and quality assessment of traditional Chinese medicine in combination with Silymarin in the treatment of NAFLD, aiming to aims to provide evidence-based data analysis for researchers and clinical practitioners involved in TCM research for NAFLD, with the hope of facilitating wider adoption and application

Methods:

In this meta-analysis, we searched PubMed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP and CBM databases from the establishment of the databases to Oct 2023. The study proposed to include studies that reported combination of TCM with Silibinin and Silibinin alone in the treatment of NAFLD, excluding studies for which full text was not available or for which data extraction was not possible; studies using animal studies; reviews and systematic reviews. All data were processed by STATA15.1 statistical software.

Results:

16 randomized controlled trials (RCTs) were included in this meta-analysis. The sample size ranged from 48 to 120, with a total of 1335 patients, including 669 in the Combined treatment group and 384 in the Silibinin group. The findings indicated that the total effective rate of combined treatment group was significantly higher than that of Silibinin alone. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglycerides (TG), and gamma glutamyl transpeptidase (GGT) of combined treatment group were all significantly lower than that of western medicine alone. Additionally, after treating NAFLD with a combination of TCM and Silibinin, the TCM syndrome score were significantly lower than those observed with Silibinin alone.

Conclusion:

Traditional Chinese medicine in conjunction with Silibinin capsules has shown significant efficacy in the treatment of NAFLD, improving clinical symptoms, blood lipid levels, and liver function. Furthermore, it is essential to engage in multi-omics research, investigate iron death, and explore the gut microbiota as potential observational indicators for the diagnosis and inclusion criteria. Conducting more high-quality clinical experiments is necessary to further validate these findings.
Exploring effect of herbal monomers in treating gouty arthritis based on nuclear factor-kappa B signaling: A review
Authors: Guo Zhanghao , Ye Guisheng , Tang Chengjian , Xiong Hui
Published: February 2024

Gouty arthritis (GA) is an inflammatory disease caused by disorders of the purine metabolism. Although increasing number of drugs have been used to treat GA with the deepening of relevant research, GA still cannot be cured by simple drug therapy. The nuclear factor-kappa B (NF-κB) signaling pathway plays a key role in the pathogenesis of GA. A considerable number of Chinese herbal medicines have emerged as new drugs for the treatment of GA. This article collected relevant research on traditional Chinese medicine monomers in the treatment of GA using NF-κB, GA, etc. as keywords; and conducted a systematic search of relevant published articles using the PubMed database. In this study, we analyzed the therapeutic effects of traditional Chinese medicine monomers on GA in the existing literature through in vivo and in vitro experiments using animal and cell models. Based on this review, we believe that traditional Chinese medicine monomers that can treat GA through the NF-κB signaling pathway are potential new drug development targets. This study provides research ideas for the development and application of new drugs for GA.
Combined transhepatic and transsplenic recanalization of chronic splenic vein occlusion to treat left-sided portal hypertension: A cases report
Authors: Liang Jie , Feng Xu , Peng Min , Duan Jin-Tao , Chen Yao-Yong , Zhu Jun
Published: February 2024

Rationale:

This report describes a unique case of a combination transhepatic and transsplenic recanalization of chronic splenic vein occlusion to treat left-sided portal hypertension (LSPH).

Patient concerns:

In this case report, we report a 49-year-old male who was admitted due to LSPH causing black stools for 2 days and vomiting blood for 1 hour.

Diagnoses:

The patient has a history of multiple episodes of pancreatitis in the past. After admission, abdominal contrast-enhanced CT scan showed the appearance of pancreatitis, with extensive splenic vein occlusion and accompanied by gastric varicose veins, indicating the formation of LSPH.

Intervention:

The patient received treatment with a combination of splenic and hepatic splenic venoplasty.

Outcomes:

Follow up for 1 year, CT and gastroscopy showed disappearance of gastric varices.

Lessons:

Splenic venoplasty is an effective method for treating LSPH. When it is difficult to pass through the occluded segment of the splenic vein through a single approach, percutaneous double approach splenic venoplasty can be attempted for treatment.
A case report: Castleman disease treated by the trinity of internal and external treatment of “Fuzheng, phlegm-resolving, and detoxification method”
Authors: Yuan Xinbei , Fu Hua , Xu Min , Shen Wei , Zhou Wenyi , Li Xi , Gan Xinjin
Published: February 2024

Rationale:

Castleman disease (CD) was first included in the CSCO lymphoma diagnosis and treatment guidelines in 2021. Its diagnosis relies on lymph node pathological examination. Observation, surgical resection of the lesion, radiotherapy, chemotherapy, and medical therapy (e.g., rituximab, siltuximab, steroids) can be used. Due to the traumatic, incurable, and recurrent nature of surgical treatment, drug therapy has many side effects and is expensive. Exploring effective traditional Chinese medicine (TCM) comprehensive treatment methods for this disease is important and necessary.

Patient concerns:

The main symptom was recurrent lymphadenopathy, which had been surgically removed 5 times in the past. This time, lymph node enlargement occurred again, and the local hospital recommended surgical resection again. The patient could not tolerate another surgical treatment. Other targeted treatments are not available due to financial constraints.

Diagnoses:

The case was diagnosed as CD by pathological examination, which is an important basis for the diagnosis of this disease.

Interventions:

The patient was treated with surgery in the early stage several times, later came to our hospital for the trinity of TCM integrated treatment program, which combines oral TCM with external application of TCM and intravenous drip of TCM as a syndrome of positive deficiency and phlegm-toxin internalization, and the therapeutic principle.

Outcomes:

After nearly 3 years of comprehensive treatment with TCM, the enlarged lymph nodes could not be touched, and there was no fatigue, fever, or weight loss. During this period, the patient did not undergo surgery, chemotherapy and other western medicine treatment, and lived a normal life. It not only met the patient’s expectation but also confirmed that the TCM treatment was indeed effective.

Lessons:

This case report confirms that TCM is safe and effective in the treatment of CD, which is worthy of promotion. In clinical practice, the individualized treatment for the patient, the duration of treatment, and the different disease states also affect the treatment outcome.
Endothelial marker profiles in cerebral radiation-induced vasculopathy: A comparative immunohistochemical analysis
Authors: Mosleh Mohammad Mohsen , Sohn Moon-Jun , Kim Han Seong
Published: February 2024

Radiation therapy results in radiation-induced vasculopathy, characterized by alterations in the vascular architecture stemming from radiation exposure. The exact molecular pathways and associated pathologies of this condition have yet to be comprehensively understood. This study aimed to identify specific markers’ roles in cerebral vascular endothelial injury pathogenesis after radiosurgery and explore their unique expression patterns in diverse pathologies post-stereotactic radiosurgery. A retrospective cohort study was conducted to assess the expression profiles of endothelial markers via immunohistochemical analysis in 25 adult patients (13 males and 12 females) who had undergone neurosurgical resection for various central nervous system pathologies following stereotactic radiosurgery or radiotherapy from 2001 to 2015. Our findings revealed strong immunohistochemical expression of ICAM-1 and E-selectin across various disease states, while MMP-9, PAI-1, and eNOS exhibited moderate expression levels. In contrast, VCAM-1 and P-Selectin had the weakest expression across all groups. Notably, while individual markers showed significant variations in expression levels when comparing different diseases (P < .001), no substantial differences were found in the overall immunohistochemical expression patterns across the 5 distinct pathologies studied (P = .407, via 2-way ANOVA). Despite the varied long-term effects of radiotherapy on the vascular endothelium, a common thread of inflammation runs through the pathology of these conditions. The distinct patterns of marker expression identified in our study suggest that different markers play unique roles in the development of radiation-induced vasculopathy. These findings offer insights that could lead to the development of novel preventive strategies and treatments.
Closing the diagnostic gap: Liquid biopsy potential to transform ovarian cancer outcomes in sub-Saharan Africa
Authors: Kokori Emmanuel , Olatunji Gbolahan , Ogieuhi Ikponmwosa Jude , Muogbo Ifeanyichukwu , Isarinade David , Ukoaka Bonaventure , Ajayi Irene , Ezenwoba Chidiogo , Samuel Owolabi , Nurudeen-Busari Habeebat , Olawade David B. , Aderinto Nicholas
Published: February 2024

Ovarian cancer presents a significant health challenge in sub-Saharan Africa (SSA), where late-stage diagnosis contributes to high mortality rates. This diagnostic gap arises from limited resources, poor healthcare infrastructure, and a lack of awareness about the disease. However, a potential game-changer is emerging in the form of liquid biopsy (LB), a minimally invasive diagnostic method. This paper analyses the current diagnostic gap in ovarian cancer in SSA, highlighting the socio-economic, cultural, and infrastructural factors that hinder early diagnosis and treatment. It discusses the challenges and potential of LB in the context of SSA, emphasizing its cost-effectiveness and adaptability to resource-limited settings. The transformative potential of LB in SSA is promising, offering a safer, more accessible, and cost-effective approach to ovarian cancer diagnosis. This paper provides recommendations for future directions, emphasizing the need for research, infrastructure development, stakeholder engagement, and international collaboration. By recognizing the transformative potential of LB and addressing the diagnostic gap, we can pave the way for early detection, improved treatment, and better outcomes for ovarian cancer patients in SSA. This paper sheds light on a path toward better healthcare access and equity in the region.
Ornidazole induced Stevens–Johnson syndrome without body surface involved: A case report
Authors: Bai Hehe , Wang Xiaodong , Wang Yuanji , Li Yanhong , Guo Weiyan , Lv Juan , Li Yamei , Hao Zhaoqin , Pan Xiaoyan
Published: February 2024

Rationale:

Ornidazole is a synthetic nitroimidazole derivative that is commonly prescribed for antiparasitic or anti-anaerobic infections. It is generally well tolerated, with known side effects including gastrointestinal tract, anaphylaxis, and central nervous system reactions. Ornidazole-induced binocular reactive keratitis and several mucocutaneous lesions have been rarely reported.

Patient concerns:

A 52-year-old woman who suffered from vaginitis and received an ornidazole vaginal plug (0.5 g). Approximately 20 minutes after the suppository was inserted into the vagina, her lips were swollen and valva and labia were burning. Her eyes were red, sore, and watery.

Diagnosis:

She was diagnosed as Steven–Johnson syndrome by the ophthalmologist. According to the Naranjo scale, the adverse drug reaction was evaluated to be probable and severe.

Interventions:

Dexamethasone was intravenous administrated as anti-inflammatory therapy for 10 days. Eye drops were locally given to relieve edema and promote healing of the epithelium. The symptoms of her eyes, lips, vulva and crissum were soon relieved.

Outcomes:

The patient was discharge from hospital with improved symptoms.

Lessons:

In order to avoid severe adverse effect, the patient should not use metronidazole ether orally or vaginally. The case emphasized the importance of rapid and accurate diagnosis of Steven–Johnson syndrome induced by ornidazole vaginal plug, especially when the eye symptoms were the chief complaint without body skin involved.
18F-FDG PET/CT Findings of Tibia Metastasis From Endometrial Adenocarcinoma
Authors: Chen Jian , Ma Liqiong , Zhao Tingting , Yang Jiqin , Li Yanmei
Published: February 2024

Bone metastases from endometrial carcinoma are rare, especially when the bone is the sole metastatic site. A 55-year-old woman with a history of endometrial carcinoma was referred for FGD PET/CT scan due to pain in the left knee. The images showed that multiple lesions with intense activity were detected in the left tibia. Histopathological examination and immunohistochemistry of the left tibial lesion confirmed metastases from the endometrial adenocarcinoma.
Postoperative Hyperamylasemia (POH) is an Early Predictor of Pancreatic Fistula Occurrence and Severity after Distal Pancreatectomy
Authors: Perri Giampaolo , Romandini Elisa , Marchegiani Giovanni , Ghorbani Poya , Sahakyan Musheg , Holmberg Marcus , Cattelani Alice , Fretland Åsmund , Montorsi Roberto , Rodrigues Isabella D , Kleive Dyre , Bannone Elisa , Edwin Bjørn , Gilg Stefan , Labori Knut , Sparrelid Ernesto , Salvia Roberto
Published: February 2024

Objectives:

The aim of this international multicentric study is to characterize postoperative hyperamylasemia (POH) after distal pancreatectomy (DP), with particular focus on its relationship with postoperative pancreatic fistula (POPF) occurrence and severity.

Background

The clinical relevance of POH after DP and its relationship with the occurrence and severity of POPF have not been explored yet.

Methods

All patients undergoing DP for any indication between 2015 and 2021 at three European referral Centers for pancreatic surgery were retrospectively analyzed. Drain fluid amylase (DFA), C-reactive protein (C-RP), and serum amylase were examined from postoperative-day (POD) 1 to 3. Biochemical leak (BL), POPF, POH, and post-pancreatectomy hemorrhage (PPH) were defined and graded according to ISGPS definitions.

Results

In total 1192 patients were included. Overall rates of POH and POPF were 18% (n= 210) and 29% (n= 344), respectively. The presence of DFA ≥2000 U/L on POD 1 (OR=2.11, 95% CI 1.68-2.86), C-RP ≥200 mg/L on POD 3 (OR=2.19, 95% CI 1.68-2.86), and POH (OR=1.58, 95% CI 1.14-2.19) were all independent early predictors of POPF (all P< 0.01). The presence of POH almost doubled the rate of POPF (43% vs. 26%, P<0.001), and higher POPF severity presented also higher POH rates (no POPF= 12%; BL= 19%; B POPF= 24%; C POPF= 52%). Among patients developing POPF, patients with POH had higher rates of PPH (22% vs 9%, P= 0.001), sepsis (24% vs 13%; P=0.011), re-operation (21% vs 8%; P< 0.01), and mortality (3% vs 0.3%; P= 0.025).

Conclusions:

The occurrence of POH is an early predictor of POPF and its severity after DP. The diagnosis of POH might define patients at higher risk for a complicated course, targeting them for prevention / mitigation strategies against pancreas specific complications.
Pediatric Intraoperative Neurophysiologic Mapping and Monitoring in Brain Surgery
Authors: Alsallom Faisal , Simon Mirela V.
Published: February 2024

Similar to adults, children undergoing brain surgery can significantly benefit from intraoperative neurophysiologic mapping and monitoring. Although young brains present the advantage of increased plasticity, during procedures in close proximity to eloquent regions, the risk of irreversible neurological compromise remains and can be lowered further by these techniques. More so, pathologies specific to the pediatric population, such as neurodevelopmental lesions, often result in medically refractory epilepsy. Thus, their successful surgical treatment also relies on accurate demarcation and resection of the epileptogenic zone, processes in which intraoperative electrocorticography is often employed. However, stemming from the development and maturation of the central and peripheral nervous systems as the child grows, intraoperative neurophysiologic testing in this population poses methodologic and interpretative challenges even to experienced clinical neurophysiologists. For example, it is difficult to perform awake craniotomies and language testing in the majority of pediatric patients. In addition, children may be more prone to intraoperative seizures and exhibit afterdischarges more frequently during functional mapping using electrical cortical stimulation because of high stimulation thresholds needed to depolarize immature cortex. Moreover, choice of anesthetic regimen and doses may be different in pediatric patients, as is the effect of these drugs on immature brain; these factors add additional complexity in terms of interpretation and analysis of neurophysiologic recordings. Below, we are describing the modalities commonly used during intraoperative neurophysiologic testing in pediatric brain surgery, with emphasis on age-specific clinical indications, methodology, and challenges.
Hispolon inhibits neuronal ferroptosis by promoting the expression of Nrf-2
Authors: Hong Xin , Deng Qian , Zhao Chunming , Zhang Yanan , Wu Gang
Published: February 2024

Research has shown that neuronal ferroptosis is associated with various central nervous system diseases, including Parkinson’s disease, acute brain injury, and spinal cord injury. Inhibiting neuronal ferroptosis can greatly alleviate the progression of these diseases. However, there is currently a lack of effective drugs to inhibit neuronal ferroptosis. In this study, we pretreated neuronal cells with Hispolon and subsequently induced a neuronal ferroptosis model using Erastin. We further assessed the changes in the protein expression levels of SLC7A11, GPX4, ACSL4, Nrf-2, and HO-1 using Western blot and immunofluorescence techniques. Additionally, we measured the intracellular levels of Fe2+, GSH, and MDA using relevant assay kits. The research findings revealed that after Hispolon treatment, the expression of the pro-ferroptosis protein ACSL4 decreased, while the expression of the ferroptosis-regulating proteins GPX4 and SLC7A11 increased. Moreover, the use of an Nrf-2-specific inhibitor was able to reverse the effects of Hispolon as mentioned above. In this study, we discovered that Hispolon can promote the expression of Nrf-2 and inhibit the occurrence of neuronal ferroptosis induced by Erastin.
Imperatorin inhibits oxidative stress injury and neuroinflammation via the PI3K/AKT signaling pathway in the MPTP-induced Parkinson’s disease mouse
Authors: Liu Li , Jiang Lei , Zhang Jinglan , Ma Yan , Wan Min , Hu Xueqing , Yang Lian
Published: February 2024

Parkinson’s disease (PD) is a disorder of neurodegeneration. Imperatorin is an active natural furocoumarin characterized by antioxidant, anti-inflammatory, and potent vasodilatory properties. Therefore, we aimed to investigate the biological functions of imperatorin and its mechanisms against PD progression. C57BL/6 mice were intraperitoneally injected with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP; 30 mg/kg) daily for 5 consecutive days to mimic PD conditions in vivo. The MPTP-induced PD model mice were intraperitoneally injected with imperatorin (5 mg/kg) for 25 consecutive days after MPTP administration. The motor and cognitive functions of mice were examined by rotarod test, hanging test, narrow beam test and Morris water maze test. After analysis of MWM test, the expression levels of tyrosine hydroxylase and Iba-1 in the substantia nigra pars compacta were measured by immunohistochemistry staining, immunofluorescence staining and western blotting. The expression levels of striatal dopamine and its metabolite 3,4-dihydroxyphenylacetic acid were also measured. The protein levels of inducible nitric-oxide synthase, cyclooxygenase-2, phosphorylated phosphatidylinositol 3-kinase (PI3K) and phosphorylated protein kinase B (Akt) in the mouse striatum were estimated by western blotting. The expression levels of proinflammatory cytokines including tumor necrosis factor, interleukin (IL)-1β and IL-6 in the mouse striatum were measured by ELISA kits. The expression levels of superoxide dismutase, malondialdehyde and glutathione in the mouse midbrains were measured with commercially available kits. TUNEL staining was performed to identify the apoptosis of midbrain cells. Histopathologic changes in the mouse striata were assessed by hematoxylin-eosin staining. Imperatorin treatment markedly improved spatial learning and memory abilities of MPTP-induced PD mice. The MPTP-induced dopaminergic neuron loss in the mouse striata was inhibited by imperatorin. Imperatorin also suppressed neuroinflammation and neuronal oxidative stress in the midbrains of MPTP-induced PD mice. Mechanistically, imperatorin treatment inhibited the MPTP-induced reduction in the PI3K/Akt pathway. Imperatorin treatment can prevent dopaminergic neuron degeneration and improve cognitive functions via its potent antioxidant and anti-inflammatory properties in an MPTP-induced PD model in mice by regulating the PI3K/Akt pathway.
Alpha-lipoic acid (ALA) ameliorates early brain injury after subarachnoid hemorrhage in Sprague–Dawley (SD) rats via inhibiting STING-NLRP3 inflammatory signaling
Authors: Lin Chunnan , He Chunliu , Li Liuqing , Liu Yongqiang , Tang Liangang , Ni Zepeng , Zhang Naichong , Lai Tinghai , Chen Xiaohong , Wang Xiangyu
Published: February 2024

Neuroinflammation is intimately associated with poor prognosis in patients with subarachnoid hemorrhage (SAH). Alpha-lipoic acid (ALA), a disulfide antioxidant, has been shown to be neuroprotective in an in vivo model of neurological injury; however, the role of ALA in SAH has never been evaluated. In this study, the Sprague–Dawley rats SAH model was induced by endovascular perforation method. ALA was transplanted intravenously into rats, and SR-717, a stimulator of interferon genes (STING) agonist, was injected intraperitoneally. The effects of ALA on early brain injury were assayed by neurological score, hematoxylin and eosin staining and Nissl staining. Immunohistochemistry staining and Western blotting were used to analyze various proteins. ALA significantly reduced STING- NLRP3 protein expression and decreased cell death, which in turn mitigated the neurobehavioral dysfunction following SAH. Furthermore, coadministration of ALA and SR-717 promoted STING-NLRP3 signaling pathway activation following SAH, which reversed the inhibitory effect of ALA on STING-NLRP3 protein activation and increased the neurological deficits. In conclusion, ALA may be a promising therapeutic strategy for alleviating early brain injury after SAH.
Myelin basic proteins charge isomers interact differently with the peptidyl arginine deiminase-2
Authors: Mamulashvili Nino , Chikviladze Marika , Shanshiashvili Lali , Mikeladze David
Published: February 2024

The deamination of arginine and its conversion to citrulline is a modification observed in positively charged proteins such as histones or myelin basic protein (MBP). This reaction is catalyzed by peptidyl arginine deiminase (PAD), whose abnormal activation is associated with autoimmune diseases like rheumatoid arthritis and multiple sclerosis. However, the mechanisms that trigger PAD activation and the pathophysiological processes involved in hypercitrullination remain unknown. In this study, we investigated the interaction between PAD and various charged isomers of MBP, each differing in the degree of post-translational modification. Immunoprecipitation experiments were conducted to examine the binding between PAD and the different charge isomers of MBP. Our findings revealed that the phosphorylated forms of MBP (C3 and C4) exhibited a higher affinity for PAD compared to the unmodified (C1) and fully citrullinated forms (C8). Additionally, we observed that only in the presence of the unmodified C1 isomer did PAD undergo autocitrullination, which was inhibited by the endogenous guanidine-containing component, creatine. In the presence of other isomers, PAD did not undergo autocitrullination. Furthermore, we found that the unmodified isomer of MBP-C1 contains methylated arginines, which were not affected by the pre-treatment with PAD. Based on our findings, we propose that the increased phosphorylation of central threonines in the original MBP may trigger PAD activation, leading to increased citrullination of the protein and subsequent disorganization of the myelin sheath. These insights contribute to a better understanding of the underlying mechanisms in autoimmune diseases associated with hypercitrullination, potentially opening new avenues for therapeutic interventions.