bluuebunny/crossref_metadata_2025 huggingface dataset:
Cisplatin plus pemetrexed therapy and subsequent immune checkpoint inhibitor administration for malignant peritoneal mesothelioma without pleural lesions
Authors: Ikushima Hiroaki , Sakatani Toshio , Ohara Sayaka , Takeshima Hideyuki , Horiuchi Hajime , Morikawa Teppei , Usui Kazuhiro
Published: May 2020

Rationale:

Malignant peritoneal mesothelioma is a rare tumor with a poor prognosis and has no recommended therapy after first-line pemetrexed and platinum-based chemotherapy. Moreover, effects of immune checkpoint inhibitors on peritoneal mesothelioma remains to be elucidated. We herein report the case of a 75-year-old man with peritoneal mesothelioma treated with cisplatin plus pemetrexed and subsequent nivolumab.

Patient concerns:

A 75-year-old man was referred to our hospital due to lower abdominal pain.

Diagnosis:

Positron emission tomography-computed tomography (CT) showed the accumulation of fluorodeoxyglucose in an intraperitoneal mass. A histological examination of a laparoscopic biopsy specimen revealed malignant peritoneal mesothelioma.

Interventions:

After 4 cycles of cisplatin plus pemetrexed and 13 subsequent cycles of pemetrexed maintenance therapy showed beneficial responses until CT revealed liver metastasis. Nivolumab was then administered as the second-line therapy.

Outcomes:

After 3 cycles of biweekly nivolumab administration, he developed severe abdominal distention. CT revealed an intraperitoneal mass growing much more rapidly than ever, indicating hyperprogressive disease after nivolumab treatment. He ultimately died 51 days after the initial nivolumab administration.

Lessons:

To our knowledge, this is the first report of hyperprogressive disease in a case of peritoneal mesothelioma after nivolumab treatment. While immune checkpoint inhibitors may be promising therapeutic strategies for treating malignant peritoneal mesothelioma, careful monitoring must be practiced with their application.
Utility of neutrophil-to-lymphocyte ratio to identify long-term survivors among HCC patients treated with sorafenib
Authors: Casadei-Gardini Andrea , Dadduzio Vincenzo , Rovesti Giulia , Cabibbo Giuseppe , Vukotic Ranka , Rizzato Mario Domenico , Orsi Giulia , Rossi Margherita , Guarneri Valeria , Lonardi Sara , D’agostino Dario , Celsa Ciro , Andreone Pietro , Zagonel Vittorina , Scartozzi Mario , Cascinu Stefano , Cucchetti Alessandro
Published: May 2020

Sorafenib is the first multikinase inhibitor demonstrating a survival benefit for patients suffering from advanced hepatocellular carcinoma (HCC). However, 1 issue remains open: what is the factor able to predict which patients will be long survivors?

In the present study, we harnessed the potential of conditional survival, aiming at estimating the probability that a patient receiving sorafenib survives for more than 3 years.

The present multicentric study was conducted on a cohort of 438 HCC patients. The primary end point was conditional overall survival. Kaplan–Meier survival analysis was used to calculate conditional overall survival probabilities at 3 years.

The 3-year conditional survival of patients without disease progression highlights that NLR and ECOG are the factors that most accurately predict the probability of long survival. The 3-year conditional survival of patients with disease progression showed a medium effect size for HCV status, alpha-fetoprotein and NLR at all time-points. Macro-vascular portal vein invasion, extra hepatic disease, and BCLC we have a large effect size at 6 months and a medium effect size at 12 and 24 months.

Our findings support the use of baseline NLR for the identification of patients with a higher probability of long-survival. NLR should be used as a stratification factor in the forthcoming clinical trials on the drugs for the advanced HCC now in pipeline.
Radiological diagnostic accuracy study comparing Lenke, Bridwell, BSF, and CT-HU fusion grading scales for minimally invasive lumbar interbody fusion spine surgery and its correlation to clinical outcome
Authors: Soriano Sánchez José Antonio , Soriano Solís Sergio , Soto García Manuel Eduardo , Soriano Solís Héctor Antonio , Torres Briscia Yazmin Aranda , Romero Rangel José Alberto Israel
Published: May 2020

Prospective randomized double-blinded diagnostic accuracy study about radiological grading of fusion after minimally invasive lumbar interbody fusion procedures (MI-LIFP).

To determinate the intra and the inter-observer correlation between different radiological lumbar interbody fusion grading scales (RLIFGS) in patients undergoing MI-LIFP and their correlation to clinical outcome.

Besides technological improvements in medical diagnosis and the many existing RLIFGS, surgical exploration continues to be the gold-standard to assess fusion in patients with radiological pseudarthrosis, with little if any research on the relationship between RLIFGS and clinical outcome.

We collected data from patients undergoing MI-LIFP procedures operated by a single surgeon from 2009 to 2017, which had follow-up and CT-scan control greater than 12 months, whose clinical registers specified lumbar and radicular visual analogue scale (L and R-VAS) and Oswestry Disability Index (ODI) score preoperatively and at the end of follow-up. Interbody fusion levels were coded for blinded evaluation by three different minimally invasive spine (MIS) surgeons, using Lenke, Bridwell, BSF (Brantigan, Steffe, Fraser), and CT-HU RLIFGS. We established fusion criteria, as described in their original papers. Another independent spine surgeon blindly evaluated successful clinical outcome (SCO), defined as a significant improvement in 2 of 3 of the following issues: L-VAS, R-VAS, or ODI score at follow-up; otherwise, rated as clinical pseudarthrosis. Radiological and clinical data was coded and statistically analyzed using Student T-Test, Pearson P-Test, and ANOVA with statistical package for the social sciences 21 by another blinded researcher, positive and negative predictive values were also calculated for each RLFGS.

We found a significant clinical improvement with a moderate intra-observer correlation between scales and no inter-observer or clinical correlation, with no sub-group statistically significant differences.

This paper represents the first study about the diagnostic accuracy of RLFGS, we concluded that their diagnostic accuracy is pretty low to determine fusion or pseudoarthrosis based on its low correlation to clinical outcome, we recommend surgeons rely on clinical findings to decide whether a patient has clinical fusion or pseudoarthrosis based on successful clinical outcome.
The diagnostic value of miRNA-141 in prostate cancer
Authors: Ye Yun , Yuan Xiao-Hua , Wang Jian-Jun , Wang Yu-Chen , Li Su-Liang
Published: May 2020

Background:

miR-141 has gradually demonstrated its value in the diagnosis of prostate cancer. However, the diagnostic parameters in previous studies differ. A systematic review was conducted to explore the diagnostic value of miR-141 in prostate cancer.

Methods:

A comprehensive search of the literature in the PubMed, Medline, Cochrane Library, and Embase databases was performed. The included 7 studies assessed the diagnostic value of miR-141 in patients with prostate cancer up to October 31, 2019. We used meta-disc version 1.4 and STATA software version 12.0 to analyze the data.

Results:

The pooled sensitivity and specificity were 0.70 (95% confidence interval [CI] 0.64–0.75) and 0.73 (95% CI 0.64–0.80), respectively. The positive likelihood ratio was 2.88 (95% CI 1.40–5.93), and the negative likelihood ratio was 0.38 (95% CI 0.20–0.71). Further, we note that the pooled diagnostic odds ratio of miR-141 for prostate cancer was 9.94 (95% CI: 2.55–38.80). The summary area under the receiver operating characteristic curve was 0.83 (95% CI: 0.79–0.86). The results of meta-regression suggested that heterogeneity was mainly derived from patient age. The results of the Fagan nomogram showed that it was increased significantly by testing miR-141 for diagnosing prostate cancer.

Conclusion:

This meta-analysis suggests that miR-141 has a high diagnostic value for prostate cancer. In the future, large-scale prospective studies are needed to verify and evaluate this result.
Proximal versus distal adductor canal blocks for total knee arthroplasty
Authors: Wang Quan , Zhang Yijun , Du Jingyu , Lin Xiangjin
Published: May 2020

Background:

Currently, there remains a paucity of literature about the efficiency of proximal adductor canal block (PACB) versus distal adductor canal block (DACB) for pain management after total knee arthroplasty (TKA). The purpose of this study is to perform a randomized controlled trial to compare the efficiency of PACB versus DACB for early postoperative pain treatment after TKA.

Methods:

This study is a 2-arm, parallel-group, randomized controlled trial that is conducted at a single university hospital in China. Subjects presenting for unilateral TKA are randomized in a 1:1 ratio to either a PACB or DACB group. The primary outcome of this noninferiority study is opioid consumption within the first 24 hours following surgery. Secondary outcomes include quadriceps strength, pain scores, distance ambulated, and patient satisfaction. Continuous variables are compared using Student t test.

Results:

This clinical trial is expected to provide evidence of whether the PACB and DACB provide similar analgesia after TKA.

Trial registration:

This study protocol was registered in Research Registry (researchregistry5440).
Changes in the concentrations of mediators in exhaled breath condensate during cardiac valve replacement under cardiopulmonary bypass and their relations with postoperative acute respiratory distress syndrome
Authors: Song Jie , Yao Lei , Zhao Lulin , Du Boxiang , Liu Lin , Chen Jinliang
Published: May 2020

To investigate the changes in the concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), and 8-iso-prostaglandin F2α (8-isoPGF2α) in exhaled breath condensate (EBC) in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB) and its relationship with postoperative acute respiratory distress syndrome (ARDS).

A prospective, case–control study was performed on 55 patients undergoing elective cardiac valve replacement under cardiopulmonary bypass, between November 2017 and May 2019. According to the diagnosis of postoperative ARDS, the patients were divided into ARDS group and control group. We compared the clinical characteristics, outcomes, respiratory mechanics, oxygenation parameters, and mediators in the 2 groups immediately after tracheal intubation (T1), at the end of CPB (T2), and 2 hours (T3) and 6 hours (T4) after CPB, and calculated the receiver operating characteristic curve (ROC), sensitivity, and specificity of the corresponding mediators.

ARDS occurred in 29 patients after CPB. The ARDS group exhibited prolonged postoperative ventilator support, time to extubation, length of stay in the ICU, and postoperative length of stay. The peak airway pressure (Ppeak) and plat airway pressure (Pplat) at T4 were higher in the ARDS group compared with the control group. The alveolar-arterial oxygen partial pressure [P(A-a)O2] and respiratory index (RI) were higher and PaO2/FiO2 was lower in the ARDS group at T2–4 compared with the control group. The levels of EBC and serum mediators in the ARDS group were significantly higher at T2–4 compared with those in the control group. All the mediators in EBC were correlated significantly with those in the serum in the ARDS group (r = 0.7314, 0.898, 0.8386, 0.792) and control group (r = 0.6093, 0.8524, r = 0.7828, r = 0.6575) (P < .001). Meanwhile, the area under the curve (AUC) of IL-8 in EBC was significantly lower at T2 and the AUC of IL-6 in EBC was significantly higher at T4 than in serum (P < .05). In addition, all of the mediators in EBC had a certain accuracy in diagnose of postoperative ARDS.

EBC analysis could be used to predict the high incidence of ARDS after cardiac valve replacement under CPB.
Observation of the molecular genetics among children with acute lymphoblastic leukemia
Authors: Sun Ying , Long Sili , Liu Wenjun
Published: May 2020

Acute lymphoblastic leukemia (ALL) is one of the most common malignancies of the hematologic system in children. Typically, ALL children with various genetic changes show different incidences, development, and prognoses. This study aimed to analyze the incidence of molecular genetic subtype among ALL children based on their clinical information, and to further investigate the relationship of genetic varieties with the prognostic factors.

From 2010 to 2016, a total of 888 ALL children with TEL-AML1 fusion gene, hyperdiploidy, hypodiloidy, IL3-IGH rearranged, E2A PBX1 fusion gene, BCR-ABL1 fusion gene, or mixed lineage leukemia (MML) rearranged were selected and analyzed through the Surveillance, Epidemiology, and End Results database.

Our results suggested that, ALL children who lived in the Northern Plains were more likely to experience genetic varieties. In addition, the TEL-AML1 fusion gene, hyperdiploidy, and hypodiloidy were more likely to be detected in ALL children aged 1 to 9 years, while MLL rearrangement was probably detected among ALL children aged <1 year. On the other hand, the 5-year overall survival varied depending on different regions (East: 42.21%; Alaska: 0.001%; Northern Plains: 1.8%; Pacific Coast: 16.3%; and Southwest: 8%), races (African American: 44.5%; white: 18.2%; and Other: 16.3%), and genetic features (TEL-AML1: 10.1%; hyperdiploidy: 19.4%; hypodiloidy: 64.7%; IL3-IGH: 0.01%; E2A PBX1: 14.2%; BCR-ABL1: 15.2%; MLL rearranged: 12.3%).

In conclusion, our study found that genetic varieties among ALL children were closely related to their prognoses, and the detection rate of genetic molecules was associated with the age, race, and living area of children.
Regional variation in states’ naloxone accessibility laws in association with opioid overdose death rates-Observational study (STROBE compliant)
Authors: You Hyo-Sun , Ha Jane , Kang Cyra-Y. , Kim Leeseul , Kim Jinah , Shen Jay J. , Park Seong-Min , Chun Sung-Youn , Hwang Jinwook , Yamashita Takashi , Lee Se Won , Dounis Georgia , Lee Yong-Jae , Han Dong-Hun , Byun David , Yoo Ji Won , Kang Hee-Taik
Published: May 2020

Though overall death from opioid overdose are increasing in the United States, the death rate in some states and population groups is stabilizing or even decreasing. Several states have enacted a Naloxone Accessibility Laws to increase naloxone availability as an opioid antidote. The extent to which these laws permit layperson distribution and possession varies. The aim of this study is to investigate differences in provisions of Naloxone Accessibility Laws by states mainly in the Northeast and West regions, and the impact of naloxone availability on the rates of drug overdose deaths.

This cross-sectional study was based on the National Vital Statistics System multiple cause-of-death mortality files. The average changes in drug overdose death rates between 2013 and 2017 in relevant states of the Northeast and West regions were compared according to availability of naloxone to laypersons.

Seven states in the Northeast region and 10 states in the Western region allowed layperson distribution of naloxone. Layperson possession of naloxone was allowed in 3 states each in the Northeast and the Western regions. The average drug overdose death rates increased in many states in the both regions regardless of legalization of layperson naloxone distribution. The average death rates of 3 states that legalized layperson possession in the West region decreased (-0.33 per 100,000 person); however, in states in the West region that did not allow layperson possession and states in the Northeast region regardless of layperson possession increased between 2013 and 2017.

The provision to legalize layperson possession of naloxone was associated with decreased average opioid overdose death rates in 3 states of the West region.
The “Warrior” system: a new useful emergency simulator to train clinical pharmacists in emergency medicine
Authors: Huang Cong , Wang Yang-yang , Zhou Jing-jie , Liu Yan-fei , He Xin
Published: May 2020

Clinical pharmacists are indispensable providers of emergency medical services. However, the training of Chinese clinical pharmacists in medical emergency skills is apparently insufficient.

The current study aimed to evaluate the effect of the “Warrior” emergency simulator application in the emergency medical education of clinical pharmacy students (CP students).

The “Warrior” system, which contains a pharmacokinetics/pharmacodynamics-linked model and a drug database, was successfully employed to train CP students and improve their capability to deal with various medical emergency situations. Both an objective (in-class) test and the subjective Dundee Ready Education Environment Measure (DREEM) were administered to 20 CP students, randomly divided into an intervention group and a control group, to estimate the teaching effect of the “Warrior” system.

The scores of CP students from the intervention group were significantly higher (P < .01) in the in-class test than the scores of students from the control group due to the diverse situational teaching using the “Warrior” system. The results of the DREEM showed that CP students from the intervention group obtained considerably better (P < .01) marks for “students’ perceptions of learning” and “students’ perceptions of atmosphere” than those from the control group. Furthermore, the intervention group scored much higher (P < .01) than the control group on the total DREEM.

The “Warrior” system provides an excellent training path for clinical pharmacists that supplies a more realistic clinical simulation experience and significantly improves the teaching effect. The “Warrior” system exhibits high potential for future development in emergency medical education.
Intraocular deposits and cataracts after long-term rifabutin intake
Authors: Harada Kohei , Uematsu Masafumi , Ueki Ryotaro , Kusano Mao , Yamada Yoshihisa , Mohamed Yasser Helmy , Kitaoka Takashi
Published: May 2020

Rationale:

Rifabutin is a broad-spectrum antibiotic known to cause deposits on the corneal endothelium and lens. We report a patient in whom cataracts developed and progressive pigment deposits were seen on the corneal endothelium, lens, and iridocorneal angle.

Patient concerns:

The patient was a 45-year-old woman who had been received long-term treatment with a combination of various anti-mycobacterial drugs for multidrug-resistant tuberculosis starting in 2004. Rifabutin was started in 2009, and she was referred to our department in 2017 for detailed ophthalmological examination.

Diagnoses:

Both eyes showed pigmented deposits over the entire corneal endothelium, the entire periphery of the iridocorneal angle, and the anterior surface of the lens. Mild cataracts were also diagnosed bilaterally. Pigment deposits on the anterior surface of the lens and the cataracts in both eyes gradually progressed. These lesions were assumed to be associated with long term rifabutin intake.

Interventions:

Rifabutin intake was discontinued after progression of intraocular deposits, cataracts, and ERG deterioration.

Outcomes:

Visual acuity improved, although cataracts, deposits, and ERG deterioration remained.

Lessons:

Rifabutin may induce not only corneal endothelial deposits, but also cataracts and iridocorneal angle deposits.
Observational study on effectiveness and safety of integrative Korean medicine treatment for inpatients with sciatica due to lumbar intervertebral disc herniation
Authors: Lee Yoon Jae , Kim Jongho , Kim Me-riong , Kim Joowon , Kim Min-Young , Cho Hyun-Woo , Lee Sook-Hyun , Ha Inhyuk
Published: May 2020

We developed a protocol for a prospective registry to prove the effectiveness and safety of integrative Korean medicine treatment for inpatients with sciatica due to lumbar intervertebral disc herniation. We plan on recruiting 1000 inpatients receiving integrative Korean medicine treatment for lumbar intervertebral disc herniation at four spine specialized Korean medical hospitals. Patients enrolled in the registry will be evaluated at the time of hospitalization, 2 weeks after hospitalization, at discharge, and 6 months after hospitalization on predefined outcome variables such as intensity of back and leg pain, Oswestry Disability Index, quality of life, Patient Global Impression of Change, and adverse effects. The protocol of this study was registered in CRIS (KCT0003709) and Clinical trial gov (NCT03750591). This study is significant in that it cannot only be a basis for safety-related evidence of complementary alternative medicine, which has been lacking, but it also gives clear evidence on the effectiveness and validity of treatment effects such as accompaniment of stenosis, sex, age, and type of disc herniation.
Rehabilitative management of an infant with Pelizaeus–Merzbacher disease
Authors: Jang Yun-Chol , Mun Bo-ra , Choi In Sung , Song Min-Keun
Published: May 2020

Rationale:

Pelizaeus–Merzbacher disease (PMD) is an X-linked recessive trait and a rare disease characterized by abnormal myelin formation in the central nervous system. Since Pelizaeus and Merzbacher reported the pathology of PMD in the 1990s most studies have examined pharmacological treatments. No studies have reported the effects of rehabilitation on patients with PMD aimed at improving their functional abilities. We report the first case of improved development after rehabilitation in a patient with Pelizaeus–Merzbacher disease.

Patient concerns:

A 1-month-boy developed focal seizures, nystagmus, and jerky head movements. He was brought to our outpatient clinic for rehabilitation of developmental delay at 11 months of age. He showed hypotonia, nystagmus, and developmental delay of 4 to 5 months in his gross and fine motor ability.

Diagnoses:

Developmental delay in a patient with PMD.

Interventions:

A child with PMD was hospitalized 3 times for 3 months and underwent rehabilitation to improve developmental delay. Developmental assessments were conducted before and after each admission for rehabilitation training.

Outcomes:

Before training, the patient was unable to maintain a sitting position. After the first and second training sessions, his gross motor ability had improved, and he could sit with a mild assist. Fine motor function also improved. Before training, the patient was able to transfer a cube from one hand to the other. After training, he could perform a pincher grasp.

Lessons:

Rehabilitation training can help PMD patients achieve maximal function and catch-up in their growth.
Percutaneous transforaminal endoscopic decompression for the treatment of intraspinal tophaceous gout
Authors: Chen Xinji , Xu Guokang , Hu Qingfeng , Zhao Tingxiao , Bi Qing , Huang Yazeng , Shao Haiyu , Zhang Jun
Published: May 2020

Rationale:

Intraspinal tophaceous gout is relatively rare condition presenting with major clinical manifestations, such as spinal cord or nerve roots compressions (radiculopathy). It is usually difficult to differentiate intraspinal tophaceous gout, lumbar disc herniation, stenosis of spinal canal, ossification of ligamentum flavum, and other degenerative spinal disorders from each other.

Patient concerns:

A 64-year-old man was admitted with a history of progressive low back pain for 11 months. He also presented with radiculopathy and numbness of his left lower extremity.

Diagnoses:

Preoperative computed tomography (CT) and magnetic resonance imaging (MRI) showed L4/5 disc herniation and lateral recess stenosis on the left side. During the operation of percutaneous transforaminal endoscopic decompression, intraspinal chalky white material was seen. Post-operative pathologic results confirmed the diagnosis of gouty tophi.

Interventions:

Percutaneous transforaminal endoscopic decompression was performed as treatment. Intraspinal chalky white material was seen. We removed most of the chalky white material and extruded nucleus.

Outcomes:

His symptom subsided rapidly and no deterioration was noted 1 year post-operatively.

Lessons:

Although intraspinal tophaceous gout is not commonly seen, clinicians should take it into consideration as a possible differential diagnosis when the patient exhibits axial pain or neurological deficits with risk factors of gout. We identified and treated this case with percutaneous transforaminal endoscopic decompression for the first time and got an excellent outcome. Percutaneous transforaminal endoscopic surgery proved to be an effective and minimally invasive alternative for identifying and treating intraspinal tophaceous gout.
Thromboprophylaxis in elective spinal surgery
Authors: Colomina María J. , Bagó Joan , Pérez-Bracchiglione Javier , Nishishinya Aquino Maria Betina , Salas Karla R. , Requeijo Carolina , Urrútia Gerard
Published: May 2020

Background:

Venous thromboembolism (VTE) is a serious, sometimes life-threatening complication that can occur following spine surgery. The incidence of VTE, and the optimal type and timing of thromboprophylaxis for this complication in elective spine surgery is a matter of debate.

Objective:

To perform a systematic review with the aim of clarifying the efficacy and adverse effects of mechanical and chemical prophylaxis for preventing thromboembolic complications in elective spine surgery for conditions other than trauma and malignant disease.

Methods/design:

A search strategy of related articles up to March 2018 was designed and executed in Medline and Embase. Patients: adolescents (>10 years) and adults undergoing elective surgery for spinal deformity or degenerative disease (from C1 to S1). Intervention: Perioperative mechanical and chemical thromboprophylaxis. Studies could be randomized controlled trials or observational studies that reported data on any relevant clinical outcomes.

Results:

In total, 2451 uniquecitations were identified and 35 studies were ultimately included in the systematic review. The overall mean incidence of complications was 3.7% for deep venous thrombosis, 0.0% for pulmonary embolism, and 3.7% for bleeding in chemoprophylaxis group; 2.9% for deep venous thrombosis, 0.4% for pulmonary embolism and 0.0% for bleeding in mechanoprophylaxis; and 0.7% for deep venous thrombosis, 0.1% for pulmonary embolism and 0.2% for bleeding in mixed prophylaxis group with no specific data on these rates for the type of patient and type and location of surgery. None of the articles retrieved provided information on the adolescent population.

Discussion and Conclusions:

The poor design and high variability among the studies regarding characteristics of study population, details of interventions, and definitions of outcomes, determines a low quality of the available evidence and limits the interpretation of the results. We were unable to identify a clear advantage of one type of thromboprophylaxis over the other, although there was an increased risk of bleeding with chemoprophylaxis, which could favor the use of mechanoprophylaxis in this scenario.
Efficacy of transcranial magnetic stimulation and fluoxetine in the treatment of postpartum depression
Authors: Guo Yan-Jun , Shan Yong-Ming , Wang Zhi-Jian , Shen Zhong-Fei
Published: May 2020

Background:

Numerous studies have reported that transcranial magnetic stimulation (TMS) and fluoxetine is used in the treatment of postpartum depression (PPD). Currently, no study has systematically investigated the efficacy and safety of TMS and fluoxetine for the treatment of patients with PPD. Thus, this study will assess the efficacy and safety of TMS and fluoxetine for treating PPD.

Methods:

Relevant studies involving TMS and fluoxetine for the treatment of patients with PPD will be comprehensively searched from the electronic databases from inception to the February 1, 2020: Cochrane Library, EMBASE, MEDILINE, CINAHL, AMED, WANGFANG, VIP, and CNKI databases. No language and publication time restrictions will be applied. RevMan 5.3 software will be utilized for data pooling, data analysis, and risk of bias evaluation. If necessary, we will also assess reporting bias using funnel plot and Egger test.

Results:

This study will comprehensively summarize the existing evidence to assess the efficacy and safety of TMS and fluoxetine for treating PPD.

Conclusion:

The findings of this study may help to establish a better approach to treat PPD using TMS and fluoxetine.

Dissemination and ethics:

This study will be disseminated through a peer-reviewed journal. This study does not need ethical approval as no primary patient data will be used.

Systematic review registration:

INPLASY202040017.
Acupuncture and moxibustion for pain relief and quality of life improvement in patients with knee osteoarthritis
Authors: Cheng Shirui , Zhou Jun , Xu Guixing , Xin Ming , Cheng Ying , Qu Yuzhu , Zhou Yuanfang , Liu Mi , Chang Xiaorong , Liu Mailan
Published: May 2020

Objective:

The aim of this systematic review and meta-analysis is to assess the efficacy of acupuncture and moxibustion in pain relief and quality of life improvement of knee osteoarthritis (KOA) patients.

Methods:

The following databases will be searched: MEDLINE, EMBASE, the Cochrane Library, Web of Science, Chinese Biomedical Literature Database, Chinese Nation Knowledge Infrastructure, Wanfang Database, the Chongqing VIP from inception to May 1, 2020. All randomized controlled trials (RCTs) used acupuncture or moxibustion to relieve pain and improve quality of life (QoL) among KOA patients will be included. Study selection, data extraction, quality assessment and assessment of risk bias will be performed by 2 reviewers independently. Data synthesis will be performed using Review Manager V5.3 software. A meta-analysis will be performed when there is sufficient available data.

PROSPERO registration number:

CRD42020169724
Clinical observation of Dan-Hong Hua-Yu oral solution in treating retinal vein occlusion
Authors: Li Tie-Jun , Sun Yu-Chen , Ma Qiu-Yan , Wu Yan , Yang Chao , Zhang Nan , Yang Yue , Yang Ying-Xin
Published: May 2020

Introduction:

Retinal vein occlusion refers to diseases with decreased vision, dilated tortuous retinal veins visible on the fundus, and retinal hemorrhage, edema, and osmosis distributed along the vein. There is still no ideal intervention to treat central retinal vein occlusion. This study plan to observe the efficacy of Dan-Hong Hua-Yu oral solution in treating non-ischemic retinal vein occlusion, in order to provide new treatment ideas.

Methods/Design:

We plan to use random number table method, 64 cases of non-ischemic central retinal vein occlusion that meet the inclusion criteria will be randomly divided into a treatment group and a control group. The intervention group will be treated with Dan-Hong Hua-Yu oral solution according to the syndrome differentiation of Traditional Chinese medicine and the patient's fundus condition. Each group will take 4 weeks as a course of treatment and three consecutive courses of treatment without any interval during the course of treatment. Changes of visual acuity, fundus performance, and total clinical symptoms of patients before and after treatment will be observed.

Discussion:

This study will observe the efficacy of Dan-Hong Hua-Yu oral solution in the treatment of non-ischemic central retinal vein occlusion, with a view to providing new treatment ideas.

Trial registration:

ClinicalTrials.gov, ChiCTR2000030625, Registered on March 08, 2020.
Pathologic mallet fracture of distal phalanx enchondroma
Authors: Kim Byungsung , Nho Jae-Hwi , Kim Woo Jong , Park Sungyong , Kim Hak Soo , Kim Jahyung , Kim Hyoung Ye , Jung Ki Jin
Published: May 2020

Introduction:

Enchondromas arise from cartilaginous cells derived from the physis that persists throughout development. They are difficult to diagnose and are often discovered on radiographs after a trauma.

Patient concerns:

We discuss the case of a 32-year-old woman with a pathologic mallet fracture of the distal phalanx that was initially misdiagnosed as common mallet fracture.

Diagnosis:

Magnetic resonance imaging revealed an eccentrically located lesion expanding to the cortex, with a high signal intensity at T2 weighted image, suggesting pathologic fracture.

Interventions:

We performed a operation, involving curettage and bone grafting. Complete removal of the lesion was confirmed intraoperatively with the image intensifier, and the cavity was irrigated and subsequently filled with allogenous bone and demineralized bone matrix.

Outcomes:

With an uneventful recovery, she gradually return to normal function within 3 months. Her symptoms improved and nearly full range of motion of the finger was seen at 1-year follow-up.

Conclusion:

Our case of pathologic mallet fracture was misdiagnosed as a simple fracture, suggesting that the mechanism of fracture and radiological diagnosis should be carefully considered.
Recurrent eosinophilic pleuritis caused by sparganum infection
Authors: Fang Liangjie , Wang Yuehong , Gao Qiqi , Yan Bing , Zhou Jianying
Published: May 2020

Rationale:

Sparganosis is an infectious disease caused by a larval tapeworm of the genus Spirometra, which commonly invades subcutaneous tissues. Pulmonary and pleural involvement due to sparganum has been rarely reported previously.

Patient concerns:

We herein described a case of recurrent eosinophilic pleuritis in a 24-year-old woman. She was admitted with persistent cough and shortness of breath for more than 1 month. Initial chest computed tomography scan suggested right pleural effusion and diffuse pleural thickening. Slightly elevated eosinophil counts were found in both the peripheral blood and pleural fluid. She underwent right pleurectomy but histological examination failed to obtain an etiological diagnosis. Moreover, eosinophilic pleural effusion re-appeared in the contralateral thoracic cavity one month later. After re-admission, we reviewed her medical history meticulously and found she had a history of ingesting raw snake gallbladders before hospitalization. The final diagnosis was confirmed by the markedly positive reaction against sparganum antigen in both serum and pleural fluid sample.

Diagnosis:

Eosinophilic pleuritis caused by sparganum infection.

Interventions:

After the diagnosis, the patient was treated with praziquantel at 75 mg/kg/d for 3 days.

Outcomes:

Pleural effusion absorbed completely and eosinophil count in peripheral blood returned to normal range. No evidence of recurrent pleural effusion had been observed in over one year of follow-up.

Lessons:

Clinicians need to be aware the possibility of sparganum infection in cases of eosinophilic pleuritis. The specific enzyme-linked immunosorbent assay remains a useful method in acquiring a rapid diagnosis, especially when histological examination is unable to detect the larvae in the thoracic cavity.
Evaluation on the effect of acupuncture on patients with sepsis-induced myopathy (ACU-SIM pilot study)
Authors: Chen Wei-Tao , Sun Ce , Zhou Ying-Bin , Liu Dong-Hua , Peng Zhi-Long , Chen Jing , Xu Nuo , Lei Yan-Yan , He Jun , Tang Chun-Zhi , Lin Xin-Feng , Xu Neng-Gui , Xian Shao-Xiang , Lu Li-Ming
Published: May 2020

Background:

Sepsis-induced myopathy (SIM) is a disease that causes motor dysfunction in patients with sepsis. There is currently no targeted treatment for this disease. Acupuncture has shown considerable efficacy in the treatment of sepsis and muscle weakness. Therefore, our research aims to explore the effects of acupuncture on the improvement of muscle structure and function in SIM patients and on activities of daily living.

Methods:

The ACU-SIM pilot study is a single-center, propensity-score stratified, assessor-blinded, prospective pragmatic controlled trial (pCT) with a 1-year follow-up period. This study will be deployed in a multi-professional critical care department at a tertiary teaching hospital in Guangzhou, China. Ninety-eight intensive care unit subjects will be recruited and assigned to either the control group or the acupuncture group. Both groups will receive basic treatment for sepsis, and the acupuncture group will additionally receive acupuncture treatment. The primary outcomes will be the rectus femoris cross-sectional area, the Medical Research Council sum-score and time-to-event (defined as all-cause mortality or unplanned readmission to the intensive care unit due to invasive ventilation). The activities of daily living will be accessed by the motor item of the Functional Independence Measure. Recruitment will last for 2 years, and each patient will have a 1-year follow-up after the intervention.

Discussion:

There is currently no research on the therapeutic effects of acupuncture on SIM. The results of this study may contribute to new knowledge regarding early muscle atrophy and the treatment effect of acupuncture in SIM patients, and the results may also direct new approaches and interventions in these patients. This trial will serve as a pilot study for an upcoming multicenter real-world study.

Trial registration:

Chinese Clinical Trials Registry: ChiCTR-1900026308, registered on September 29th, 2019.
Is there a potential link between keratoconus and autism spectrum disorders?
Authors: Stanojlovic Svetlana , Milovancevic Milica Pejovic , Stankovic Branislav
Published: May 2020

Rationale:

Eye rubbing (ER) is a proven factor that can trigger the onset and progression of keratoconus (KC). Apart from allergy, ER is a repetitive motor stereotypy. Eye rubbing is frequently observed in children with autism spectrum disorders (ASDs) and in individuals who may be at risk for developing KC. We present a child with ASD who developed progressive KC following standard corneal cross-linking (CXL), most likely because of abnormal ER associated with allergy and repetitive behavior due to ASD symptoms.

Patient concerns:

A 14-year-old boy was referred to our clinic because of asymmetric visual acuity reduction.

Diagnosis:

The child was diagnosed as having keratoconus. He had a strong ER habit. The child had been previously diagnosed as having ASD.

Interventions:

Corneal cross-linking was performed in both the eyes. On account of keratoconus progression, most likely associated with persistent ER habit, he was retreated with CXL in the right eye. Behavioral modification intervention for ER habit reversal was also applied.

Outcomes:

Corneal cross-linking in combination with behavioral modification intervention for ER habit reversal prevented further KC progression.

Lessons:

Behavioral interventions are likely to provide positive results in an ER habit reversal in children with ASD. Keratoconus treatment with CXL combined with behavioral management for ER reversal seemed effective in halting keratoconus progression in a young patient with ASD.
Effect of high-quality nursing intervention on anxiety and depression in patients with chronic heart failure companied malnutrition
Authors: Yang Xiao-mei , Li Qiu-mei , Gao Qing-ning
Published: May 2020

Background:

This study will assess the effect of high-quality nursing intervention (HQNI) on anxiety and depression in patients with chronic heart failure companied malnutrition (CHFM).

Methods:

We will retrieve electronic databases from the respective dates to February 29, 2020 without language and publication status restrictions: Cochrane Library, Web of Science, MEDLINE, EMBASE, Scopus, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All potential randomized controlled trials (RCTs), which examined the effect of HQNI on anxiety and depression in patients with CHFM will be included. Two team members will separately perform article retrieval, duplicates excluding, scanning, data collection, and study quality assessment. In addition, this study will carry out data analysis by RevMan 5.3 software.

Results:

This study will provide high-quality synthesis and/or descriptive analysis of the latest evidence to assess the effect of HQNI on anxiety and depression in patients with CHFM.

Conclusion:

The findings of this study will exert evidence to judge whether or not HQNI is effective on anxiety and depression in patients with CHFM.

Registration number:

INPLASY202040069.
Effect of grelin on TRX expression in chronic heart failure tissue
Authors: Chen Zhe , Feng Yao , Zhang Ru-bing , Li Xin , Xu Jian-bo
Published: May 2020

Background:

The aim of this study is to explore the effect of grelin on TRX expression (TRXE) in chronic heart failure tissue (CHFT).

Methods:

We will search electronic databases from inception to the March 1, 2020 in MEDLINE, EMBASE, Cochrane Library, CINAHL, PEDro, the Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. We will not apply any limitations to the language and publication status. Any randomized controlled trials (RCTs) that studied the effect of grelin on TRXE in CHFT will be included. Study quality will be checked by Cochrane risk of bias and evidence quality will be appraised by Grading of Recommendations Assessment Development and Evaluation. All extracted data will be analyzed by RevMan 5.3 Software.

Results:

This study will summarize the present RCTs to assess the effect of grelin on TRXE in CHFT.

Conclusion:

The results of this study will provide conclusive evidence of the effect of grelin on TRXE in CHFT.

Systematic review registration:

INPLASY202040078.
Efficacy of docetaxel combined carboplatin for the treatment of patients with castration-resistant prostate cancer
Authors: Pu Chun-Lin , Li Jiu-Zhi , Fan Wen-Long
Published: May 2020

Background:

A numerous published studies have reported that docetaxel combined carboplatin (DC) has been utilized for the treatment of patients with castration-resistant prostate cancer (CRPC). However, there are still contradictory results. Therefore, this systematic review and meta-analysis will explore the efficacy and safety of DC for the treatment of patients with CRPC.

Methods:

We will systematically and comprehensively search MEDLINE, EMBASE, Cochrane Library, Web of Science, CINAHL, WANGFANG, CBM, and CNKI from the beginning up to the March 1, 2020, regardless language and publication time. We will consider randomized controlled trials that evaluated the efficacy and safety of DC for the treatment of patients with CRPC. The treatment effects of all dichotomous data will be estimated as risk ratio and 95% confidence intervals (CIs), and that of continuous outcomes will be calculated as standardized mean difference or mean difference and 95% CIs. Methodological quality will be appraised by Cochrane risk of bias tool, and quality of evidence will be identified by Grading of Recommendations Assessment Development and Evaluation. Statistical analysis will be undertaken by RevMan 5.3 software.

Results:

This study will systematically explore the efficacy and safety of DC for the treatment of patients with CRPC.

Conclusion:

This study may provide helpful evidence to determine whether DC is an effective treatment for patients with CRPC or not.

Systematic review registration:

INPLASY202040076.
Comparison of ropivacaine with ropivacaine and fentanyl in continuous epidural analgesia for postherpetic neuralgia
Authors: Kang Hee Yong , Lee Chung Hun , Choi Sang Sik , Lee Mi Kyoung , Park Jong Sun , Oh Jung Suk
Published: May 2020

Continuous epidural analgesia (CEA) using local anesthetics is frequently used to control herpes zoster pain and prevent postherpetic neuralgia (PHN). However, few studies have been conducted to determine the efficacy of epidural drugs administered as CEA to manage PHN. This retrospective study was designed to evaluate the effectiveness of CEA with ropivacaine alone or with ropivacaine and fentanyl for controlling pain caused by PHN.

We reviewed the medical records of 71 patients. We studied 2 groups: epidural ropivacaine (ER; CEA with ropivacaine alone; n = 44) and epidural ropivacaine and fentanyl (Epidural ropivacaine and fentanyl (ERF); CEA with ropivacaine and fentanyl; n = 27). To evaluate pain, a numeric rating scale (NRS) was evaluated at 6 time points: immediately before the procedure (baseline NRS score); 1 hour after the procedure; 14 days after the procedure; and 1, 3, and 6 months after the procedure. Complication rates were recorded during CEA. We also investigated whether additional invasive procedures were needed due to insufficient pain control during the 6-month follow-up period.

After adjusting for confounding variables, there were no significant differences in the NRS scores between the 2 groups at any time point. The adjusted odds ratio for additional invasive procedures within 6 months after CEA was 1.03-times higher in the ERF group than in the ER group, but this difference was not statistically significant (95% confidence interval: 0.33–3.23, P = .96). Rates of complication (dysuria, vomiting, nausea, itching sensation, and hypotension) during CEA were higher in the ERF group than in the ER group. However, the differences were not statistically significant.

There was no difference in the management of pain in patients with PHN between the groups. Epidural administration of fentanyl with ropivacaine did not improve pain management when compared to ropivacaine alone. Although not statistically significant, the incidence of complications during CEA was higher in the opioid combination group.
Contribution of xeroderma pigmentosum complementation group D gene polymorphisms in breast and ovarian cancer susceptibility
Authors: Tian Yumei , Lin Xiaojuan , Yang Fan , Zhao Jitong , Yao Kui , Bian Ce
Published: May 2020

Background:

The role of xeroderma pigmentosum complementation group D (XPD) gene polymorphisms in breast and ovarian cancer development has long been controversial and existing data were inconsistent. Here, we conducted a comprehensive systemic review and meta-analysis to better clarify the association.

Methods:

Relevant case-control studies published in electronic data base from October 1999 to September 2019 were assessed. The statistical analyses of the pooled odds ratios (ORs) and the corresponding 95% confidence intervals (95%CIs) were calculated by using Revman 5.2 software (Cochrane Collaboration, Copenhagen).

Results:

31 articles including 38 case-control studies and 2 XPD polymorphisms (rs1799793 and rs238406) were analyzed. The results showed statistical significance in heterozygous mutants among Asian population for rs1799793 (GA vs GG + AA: OR = 1.38, 95%CI = 1.21–1.56), and Caucasian population for rs238406 (CA vs AA + CC: OR = 0.63, 95%CI = 0.49–0.80), while the rest comparisons including overall groups and subgroups stratified by cancer types and ethnicity failed to indicate any association with breast and ovarian cancer risk.

Conclusions:

The current meta-analysis suggested no concrete correlation of XPD rs1799793(G/A) and rs238406(C/A) polymorphisms with breast cancer or ovarian cancer susceptibility. However, it indicated that heterozygous genotypes might share different pathophysiologic mechanism from not only homozygous wildtypes but also homozygous mutants. More case–control studies with well-adjusted data and diverse populations are essential for validation of our conclusion.