bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review and meta-analysis of the efficacy and safety of traditional Chinese medicine in the treatment of rhinosinusitis
Authors: Huang Zhihao , Xuan Xin , Liu Shan , Lin Jinglan , Qian Zhijun , Chen Lifen , Qiu Ruoqing , Cai Yanwen
Published: November 2024

Background:

Rhinosinusitis (RS), a common inflammatory disorder, adversely affects quality of life and can progress to serious complications without intervention. Conventional therapies, including antibiotics and corticosteroids, exhibit inherent limitations and risks. Traditional Chinese medicine (TCM), with its extensive historical use in RS management, remains understudied in contemporary evaluations. This systematic review evaluates the efficacy and safety of TCM in RS treatment, aiming to guide clinical decision-making.

Methods:

A systematic search was undertaken in Chinese and English databases, such as CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, Web of Science, and other relevant databases, to gather randomized controlled trials of TCM for patients with RS from January 2014 to February 2024. Two researchers independently curated and synthesized data from eligible literature, conducted meta-analyses with ReviewManager 5.4.1, and assessed evidence quality via GRADEPro GDT.

Results:

A total of 48 articles included 4490 patients, of which 2249 were control group and 2241 were in the experimental group. Meta-analytic outcomes revealed that the integration of TCM with western medicine conventional treatment significantly enhanced the total effective rate [risk ratio=1.20, 95% confidence interval (CI) (1.17, 1.23), P < 0.05] and yielded a notable reduction in Lund–Kennedy score [mean difference (MD)=−1.32, 95% CI (−1.72, −0.93), P < 0.05], Lund–Mackay score [MD=−1.13, 95% CI (−1.27, −1.00), P < 0.05], SNOT-20 score [MD=−3.02, 95% CI (−4.34, −1.69), P < 0.05], nasal congestion Visual Analogue Scale (VAS) score [MD=−1.05, 95% CI (−1.65, −0.45), P < 0.05], runny nose VAS score [MD=−0.84, 95% CI (−1.13, −0.54), P < 0.05], headache VAS score [MD=−0.90, 95% CI (−1.45, −0.35), P < 0.05], olfactory impairment VAS score [MD=−1.43, 95% CI (−1.75, −1.11), P < 0.05], and total TCM syndrome score [standardized mean difference (SMD)=−1.78, 95% CI (−2.58, −0.97), P < 0.05]. Additionally, significant decreases were observed in levels of tumor necrosis factor-α [SMD=−2.14, 95% CI (−3.42, −0.87), P < 0.05] and interleukin-6 [SMD=−1.64, 95% CI (−2.08, −1.21), P < 0.05], with statistical significance achieved for all measured outcomes. Regarding safety considerations, an insignificant variance was observed between the 2 therapeutic approaches, with no statistically discernible difference (P > 0.05).

Conclusion:

Combining TCM with western medicine in RS treatment yields superior outcomes over western medicine alone, with enhanced efficacy, reduced nasal symptoms, and lower inflammation. Rigorous multicenter RCTs are warranted to affirm these advantages and bolster the evidence for TCM in RS management.
Analysis of the efficacy of two kinds of loss restoration of posterior teeth using 3D printing temporary crown during the second phase of implant surgery
Authors: Cao Yannan , Hu Meichun , Zhang JinLin , Yu Liuping , Gao Yufeng , Ding Zhuang , Ma Hong , Zhu Fangyong
Published: November 2024

Background:

This study aimed to analyze the effect of 3D printing temporary crowns on the single and continuous loss restoration of posterior teeth during secondary implant surgery.

Methods:

This study adopted a single-center, randomized, single-blind, parallel-controlled trial design. Thirty patients who were admitted to the Department of Stomatology, Affiliated Hospital of Jiangnan University between January 2020 and February 2023 and who had >2 consecutive missing posterior teeth were implanted with the same implant system. A simple random method was adopted to assign 30 patients to group A (using 3D-printed temporary crowns) and group B (control group) in a 1:1 ratio, with 15 patients in each group. The final prosthesis in Experimental group A was done based on the adjustment of the temporary crown and tooth. Both groups were compared based on total time, accuracy, and patient satisfaction of the final prosthesis. Additionally, 30 patients who had undergone single posterior tooth implantation during the same period were selected as the study objects and divided into 2 groups using the random comparison table method. The patients in the experimental group C (15 cases) were provided with 3D-printed temporary crowns, and the other 15 patients were assigned to the control group D (15 cases).

Results:

In the experimental group A, the total time spent on dentures was 10.1 ± 1.3 minutes, which was lesser compared with that spent in the control group B (P < .05). Experimental group A exhibited a significantly higher accuracy of prosthesis (P < .05), as well as significantly higher satisfaction of patients (P < .05). Regarding the food impaction rate, after formal implantation and restoration, the food impaction rate of the experimental group C at 1 month and 6 months was compared with that of the traditional 2-stage surgery group D.

Conclusion:

Three-dimensional printing temporary crowns exhibited significantly better therapeutic effects for restoration in patients with continuous missing implants in posterior teeth. 3D printing temporary crowns in patients with single posterior tooth implant restoration showed promising results, which improved food immobilization and actively and effectively reduced the complications associated with a single posterior tooth implant.
A new nonsense mutation of PTCH1 gene in mother and daughter with late-onset nevus basal cell carcinoma syndrome: Case report
Authors: Li Xin , Ai Liya , Han Chun-Yu , Cao Ya-Qi , Han Jian-Wen
Published: November 2024

Rationale:

Nevoid basal cell carcinoma syndrome (NBCCS) is a rare clinical disease characterized by a disproportionate number of basal cell carcinoma to sun exposure and skin types. Patched 1 (PTCH1) gene is proposed to be implicated in the pathogenesis of NBCCS. This study aimed to investigate whether PTCH1 gene is the causative gene in Chinese patients with NBCCS.

Patient concerns:

Here we detected the first nonsense mutation in PTCH1 gene by Sanger sequencing of blood samples from a mother and her second daughter (NM000264: exon14: c.2080C>T: p.Q694X).

Diagnoses:

Both of the mother and her second daughter had ovarian mature teratomas.

Interventions:

The mother received liquid nitrogen cryotherapy, surgical resection, and radiation therapy, while her second daughter was treated with a GX-III multifunctional ion surgical therapy machine and surgery.

Outcomes:

New rashes continued to appear and contractures of the right eyelid healed in the mother, while her second daughter had multiple pitting depressions on the palms and soles of both hands and feet.

Conclusion:

We detected a new mutation in PTCH1 gene in 2 patients with NBCCS, and both of them had ovarian mature teratomas, which are related to NM000264: exon14: c.2080C>T: p.Q694X.
Childhood obesity and risk of inflammatory bowel disease in adulthood: A Mendelian randomization study
Authors: Luan Zhe , Wang Jing , Zhao Zhizhuang , Chen Yi , Zhang Hanwen , Wu Junling , Wang Shufang , Sun Gang
Published: November 2024

It is well-known that childhood obesity is associated with various adult gastrointestinal diseases, inflammatory bowel disease (IBD) being no exception. However, previous epidemiological observational studies, while reporting a correlation between the 2, have left the question of a causal relationship inconclusive. This study aims to use a 2-sample Mendelian randomization (MR) analysis to assess the causal relationship between childhood obesity and IBD as well as its subtypes (ulcerative colitis [UC] and Crohn disease [CD]). Data on childhood obesity, IBD, and its subtypes (UC and CD) were sourced from IEU OpenGWAS (https://gwas.mrcieu.ac.uk/datasets/ieu-a-1096/) and IIBDGC (https://www.ibdgenetics.org/). The data were analyzed using the inverse variance weighted (IVW), MR-Egger, weighted median, simple mode, and weighted mode methods. The MR analysis indicates no causal relationship between childhood obesity and IBD or its subtypes (UC and CD). The consistency of the results across the IVW, MR-Egger, weighted median, simple mode, and weighted mode methods suggests the reliability of the findings. We found that childhood obesity is not causally related to IBD or its subtypes (UC and CD). This differs from prior studies. The observed discrepancies may be due to common biological or environmental confounding factors.
Early use of low-dose hydrocortisone can reduce in-hospital mortality in patients with septic shock: A systematic review and meta-analysis
Authors: Song Binglin , Zheng Xiangde , Fu Kangrui , Liu Chun
Published: November 2024

Background:

This study aimed to assess the impact of the timing of low-dose hydrocortisone adjuvant therapy initiation on clinical outcomes in patients with septic shock by a systematic review and meta-analysis.

Methods:

We conducted a comprehensive search of all randomized controlled trials (RCTs) and cohort studies available in the PubMed, Web of Science, and Embase databases. The search included articles published from the founding of these databases until August 1, 2024. The purpose of the search was to compare the results of initiating low-dose hydrocortisone (HC) adjuvant therapy at different time periods. The main reported results included short-term mortality (ICU mortality and hospital mortality) as key outcomes, and secondary outcomes such as the rate of renal replacement treatment continuous renal replacement therapy (CRRT), length of stay in the intensive care unit (ICU), and rate of shock reversal.

Results:

Seven trials, with a total of 3063 patients, were included. The main finding of this meta-analysis indicates that the early treatment group, which received low-dose hydrocortisone, had a lower ICU mortality rate compared to the late treatment group. Additionally, the hospital mortality rate in the early treatment group was lower than that in the late treatment group. There was a correlation between the timing of beginning of HC and the short-term mortality of patients with septic shock. The secondary findings indicated that there were no notable disparities in the rates of CRRT, the rate of reversing shock, and the duration of stay in the ICU.

Conclusion:

Administering low doses of HC early on can decrease the risk of death in septic shock patients in the short-term mortality. There were no substantial disparities observed in the rate of CRRT, the rate of reversal of shock, and the duration of stay in the ICU. Additional extensive RCTs are required to validate this conclusion.
Multimodal imaging of mixed epithelial and stromal tumor of the kidney: Case series
Authors: Wang Ning , Zhang Li , Wang Shuo , Chang Xiang-Yang , Zhao Bao-Gen , Wang Yong
Published: November 2024

Background:

To investigate the clinical features, imaging manifestations, and pathological characteristics of mixed epithelial stromal tumor of the kidney (MESTK) to improve the understanding of MESTK and the accuracy of preoperative imaging diagnosis.

Methods:

The clinical, imaging, and pathological data of 3 patients with MESTK confirmed by postoperative pathology were retrospectively analyzed.

Results:

Three patients with MESTK were middle-aged women with no obvious clinical symptoms. The main image representation showed a multilocular cystic or solid-cystic mass, with the larger masses protruding from the kidney contour, with multiple separations, which could be of unequal thickness. The cystic component showed no enhancement on enhancement scans, whereas the segregations and solid components showed gradual and obvious enhancement. Microscopic pathology was characterized by the biphasic differentiation of mesenchymal and epithelial components.

Conclusion:

MESTK is a rare, mostly benign tumor that appears as a multilocular cystic or cystic solid, with progressive marked enhancement of the septal and solid components on enhanced scans. This imaging feature is helpful for the diagnosis of MESTK.
Impact of surgeon volume on the risk of complications following volar locking plating of unstable distal radius fracture
Authors: Liang Zhiquan , Zhang Wenhao , Deng Yingjie , Guo Hao , Li Leijiang , Xiang Wenyuan , Fang Rui
Published: November 2024

Complications following volar locking plating (VLP) of distal radius fracture (DRF) are frequent. Increasing evidence has shown an inverse relationship between increased surgeon experience and fewer complications in a variety of surgeries, and this study aimed to verify whether this relationship existed when specified in the DRF surgically treated with VLP. Patients with an unstable DRF surgically treated by VLP in our institution between January 2016 and December 2021 were included. Data on complication were obtained by inquiring the medical charts and the follow-up register, also the covariables for adjustment. Surgeon volume was defined by the number of VLP procedures within 12 months preceding index surgery, and its optimal cutoff was determined by constructing the receiver operator characteristic, in which high- or low-volume was dichotomized. The relationship between surgeon volume and risk of complications was investigated using a univariate and multivariate logistic regression model. Five hundred sixty-one patients were enrolled and operated on by 21 surgeons, with a median of 14 for each surgeon. The 1-year complication rate was 13.5%, with tenosynovitis (4.1%), carpal tunnel syndrome (2.7%), and complex regional pain syndrome type 1 (2.3%) being the most common. The optimal cutoff was 8, and 69.2% of patients were operated by high-volume surgeons, with a 7.5% incidence; 30.8% of the patients were operated by low-volume surgeons, with a 27.2% incidence. Low-volume was associated with an increase in the risk of general complications by 4.8 times (95% confidential interval, 2.9–8.2). Subgroup analyses showed that this trend was intensified for AO type C fracture (odds ratio, 5.9), slightly mitigated for type B (odds ratio, 3.7), but not significant for type A. The finding highlighted the need to maintain 8 cases/year to improve the complications of DRFs, and for severe cases, centralized treatment is recommended.
Identification of KCNQ1 as a diagnostic biomarker related to endoplasmic reticulum stress for intervertebral disc degeneration based on machine learning and experimental evidence
Authors: Wu Feng , Hu Xin , Li Xing , Huang Yongquan
Published: November 2024

Intervertebral disc degeneration (IDD) is a primary cause of low back pain and disability. Cellular senescence and apoptosis due to endoplasmic reticulum stress (ERS) are key in IDD pathology. Identifying biomarkers linked to ERS in IDD is crucial for diagnosis and treatment. We utilized machine learning on gene expression profiles from the Gene Expression Omnibus database to discover biomarkers associated with ERS in IDD. Gene set enrichment analysis (GSEA) and single-sample GSEA were applied to evaluate the immunological features and biological functions of these biomarkers. The expression of KCNQ1 was experimentally validated. Machine learning identified KCNQ1 as a diagnostic biomarker for ERS in IDD, confirmed by Western blotting. GSEA indicated that KCNQ1 influences IDD primarily through the Notch signaling pathway and by regulating macrophage and monocyte infiltration. KCNQ1, identified as an ERS-associated biomarker in IDD, impacts the Notch signaling pathway and immune cell infiltration, suggesting its potential as a therapeutic target for IDD. Further validation through prospective studies and additional experimental methods is necessary to elucidate the role of KCNQ1 in IDD comprehensively.
Iwilfin (eflornithine) approved by the FDA as the first and only oral maintenance therapy for high-risk neuroblastoma in adult and pediatric patients: Narrative review
Authors: Shakeel Ayesha , Baloch Aniqa , Kumari Versha , Kazmi Syeda Kainat Zehra , Aftab Kanza , Abid Shiza , Syed Amna , Yousuf Juvairia , Hasanain Muhammad , Anjum Muhammad Umair , Mahmmoud Fadelallah Eljack Mohammed
Published: November 2024

Neural crest progenitor cells give rise to neuroblasts, the growing nerve cells of the sympathetic nervous system. These cells can undergo changes leading to neuroblastoma, a malignancy responsible for 15% of all pediatric cancer-related deaths. The molecular pathogenesis of this pediatric cancer involves complex genetic alterations, such as MYCN amplification, chromosomal abnormalities, and gene expression changes. Despite aggressive therapies, survival rates for children with high-risk neuroblastoma (HRNB) have not improved significantly compared to those with less severe forms of the disease. This highlights the challenge of managing HRNB and underscores the need for new, effective treatments. A comprehensive treatment regimen, including immunotherapy, radiation therapy, myeloablative chemotherapy, and surgical removal, has been employed to achieve remission in HRNB patients. While dinutuximab beta immunotherapy is an effective and widely used treatment, it has several potential side effects that must be carefully monitored. New drugs are being developed to reduce these side effects without compromising efficacy. One such drug is DL-alpha-difluoromethylornithine (DFMO), approved by the FDA under the brand name Iwilfin. Numerous clinical trials have shown that DFMO, when used as maintenance therapy, significantly improves event-free survival and overall survival in neuroblastoma patients. However, DFMO has adverse effects that require continuous monitoring. Further research is needed to minimize these side effects and improve its efficacy, particularly in addressing resistance caused by long-term use.
Prevalence of and risk factors associated with chronic opioid use after traumatic injury: A historical cohort study using the Korean National Health Insurance Service sample cohort data
Authors: Kim Kun Hyung , MacLeod David , Cho Hyunmin , Kim Seon Hee
Published: November 2024

Chronic opioid use (COU) after traumatic injuries is a global health concern. COU after trauma delays recovery and increases the risk of long-term drug dependence. However, the population-prevalence and factors associated with COU after traumatic injury in South Korea remain unclear. We aimed to estimate the prevalence of COU and associated risk factors in patients after trauma in South Korea. A historical cohort study using the population-representative database including 1,103,405 South Korean subjects, patients admitted due to a newly diagnosed trauma (n = 65,444) or nontraumatic etiologies (n = 338,321) from January 1, 2003, to June 30, 2015, were analyzed. COU was defined as the prescription of opioid in the first 3 to 6 months from the index date. Prevalence of COU was summarized. A multivariable logistic regression analysis was conducted to investigate association of COU with traumatic injuries, accounting for a priori sociodemographic and clinical risk factors. A total of 13.5% and 12.6% of patients were found to be chronic opioid users in the trauma and the control group, respectively. The adjusted odds ratio (aOR) (95% CI) of COU in the injured compared to the noninjured was 1.13 (1.01 to 1.16), when controlling for age group, sex, calendar year, area of residence, previous opioid use, comorbidity, surgery during the index admission and intensive care unit care. Risk factors included being aged 65 to 74 years (aOR = 2.87; 95% CI = 2.73 to 3.01), aged ≥ 75 years (aOR = 2.48; 95% CI = 2.35 to 2.62), and history of previous opioid use (aOR = 3.27; 95% CI = 3.21 to 3.34) were the most significant risk factors of COU, independent of injury. COU was prevalent both in the injured and noninjured patients, with slightly increased risk of COU in those sustaining traumatic injury compared to those who were noninjured. Further stud y to address prevalent COU in South Korea is required to avoid opioid-related harms.
Talus osteoid osteoma misdiagnosed as ankle synovitis: A case report in rehabilitation therapy
Authors: Xu Jincheng , Zhang Yan , Yang Shuming
Published: November 2024

Rationale:

Osteoid osteoma, accounting for approximately 10% of benign bone tumors, is predominantly found in long bones and rarely in the foot bones, such as the talus. Its nonspecific symptoms, such as nocturnal pain and swelling, often lead to misdiagnosis, especially when it mimics conditions like ankle synovitis.

Patient concerns:

A 27-year-old male presented with persistent pain and swelling in his left ankle following an injury at the gym. Initial treatments, including arthroscopic debridement, failed to resolve his symptoms.

Diagnoses:

Comprehensive evaluation using magnetic resonance imaging and computed tomography scans, coupled with input from a multidisciplinary team of specialists, confirmed the diagnosis of ankle osteoid osteoma.

Interventions:

Following the confirmation of the diagnosis, the patient underwent surgical interventions, including peripheral nerve transfer, joint debridement, resection of calcaneal and talus lesions, and tendon release. These procedures were designed to address the underlying tumor and restore joint function.

Outcomes:

After surgical intervention, the patient experienced substantial relief from pain and significant improvement in functional recovery. Postoperative rehabilitation further facilitated the restoration of mobility and strength, with no recurrence of symptoms observed during follow-up.

Lessons:

This case highlights the diagnostic complexity of ankle osteoid osteoma and underscores the importance of a multidisciplinary approach. Rehabilitation therapists play a crucial role in managing such conditions, ensuring optimal patient outcomes through functional assessment and progress monitoring. Timely and accurate diagnosis is essential for effective treatment and improved patient quality of life.
Auditory mismatch negativity is larger during exhalation than inhalation
Authors: Mizuhara Keita , Li Lingjun , Nittono Hiroshi
Published: November 2024

Background:

Previous research has shown that internal signals from the body can modulate the processing of external stimuli. This study investigated whether respiratory phases influence auditory deviance detection by recording mismatch negativity (MMN) responses of event-related brain potentials.

Methods:

By reanalyzing the data from a previous study examining the effect of cardiac phases on MMN (Li et al, 2024), we calculated the amplitude of MMN elicited by intensity-deviant stimuli separately for inhalation and exhalation phases in the participants (N = 37).

Results:

Results showed that the MMN amplitude was significantly larger during exhalation than inhalation. One possible explanation for this amplitude difference is a greater focus on internal bodily processes during exhalation than inhalation.

Conclusion:

This study provides further evidence that respiratory phases influence the auditory processing of external events.
Pro-inflammatory diet and risk of prostate diseases, lower urinary tract symptoms: A cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) 2003 to 2008
Authors: Yang Zhengping , He Jibao , Hong Anjie , Zhang Li , Zhao Haoyu , Wei Chongrui , Niu XueYan , Zhang Zhijie
Published: November 2024

Evidence suggests a strong association between prostate diseases, lower urinary tract symptoms (LUTS), and pro-inflammatory diets. Our study was conducted to assess the relationship between the Dietary Inflammatory Index (DII) and prostate diseases, LUTS using the 2003 to 2008 U.S. National Health and Nutrition Examination Survey (NHANES) database. After the chi-square test to investigate whether demographic data and prostate diseases, LUTS were correlated, for positive results, we performed weighted multivariable logistic regression models analysis. In addition, we performed nonlinear tests using restricted cubic spline (RCS) and assessed the stability between different subgroups by subgroup and interaction analyses. The study included 30,619 subjects. After adjusting the regression model for fully confounding variables, DII was only correlated with benign prostatic hyperplasia (BPH) (OR = 1.074, 95% CI = 1.016–1.136; P = .012). And, the RCS relationship between DII and BPH was positively correlated (nonlinear: P = .830). We did not find statistically significant interactions in all subgroups. At the same time, we did not find any correlation between DII and other prostate diseases and LUTS. Pro-inflammatory diets are associated with an increased risk of BPH. Dietary modifications to reduce the intake of pro-inflammatory nutrients can be helpful in mitigating the development of BPH.
Risk factors of acute urinary retention after spine surgery
Authors: Chiu Han-Hsi , Liu Jui-Ming , Yu Kai-Jie , Wu Chun-Te , Pang See-Tong , Lin Po-Hung
Published: November 2024

Acute postoperative urinary retention (APOUR) is 1 of the most common complications of spinal surgery, impacting both postoperative care and the patients’ quality of life. This study is designed to investigate the risk factors and the incidence of APOUR after spinal surgery in Taiwan. We conducted a retrospective analysis using the Taiwanese National Health Insurance Research Database (NHIRD), a nationwide cohort of patients who underwent spinal surgery from the year 2000 to 2013. Patients suffering from APOUR were collected and perioperative parameters were recorded. The risk factors related to APOUR after spinal surgery were examined using multivariate logistic regression analysis. A total of 16,160 patients who underwent spinal surgery were retrieved from NHIRD. Among them, 432 (2.67%) suffered from acute urinary retention after surgery. Multivariate logistic regression analysis revealed that age (adjusted odds ratio [OR] = 1.02, 95% CI = 1.01–1.02), male gender (adjusted OR = 1.35, 95% CI = 1.10–1.60) and undergoing spinal surgery more than 2 times (adjusted OR = 4.78, 95% CI = 2.49–9.20) were statistically significant risk factors for APOUR after spinal surgery. The results of this retrospective cohort study suggest that patients undergoing spinal surgery more than 2 times, male gender and advanced age are significantly associated with an increased risk of APOUR after spinal surgery. This information may assist surgeons to identify patients who have a high risk of APOUR after spinal surgery and proactively provide them with early intervention.
Effects of Bailing capsules combined with levothyroxine sodium on autoimmune thyroiditis
Authors: Su Bai-Yu , Wu Tao , Huo Li-Shuang , Qu Zhe , Gao Bu-Lang
Published: November 2024

To explore the clinical effects and adverse reactions of Bailing capsules combined with levothyroxine sodium for autoimmune thyroiditis, 70 patients with autoimmune thyroiditis were retrospectively enrolled and divided into the Bailing treatment group and the control, both consisting of 35 patients. The control group was treated with levothyroxine sodium alone, and the treatment group with Bailing capsules combined with levothyroxine sodium. The clinical efficacy, thyroid function indicators, antibodies and inflammatory indicators, and adverse drug reactions were analyzed. The total treatment effective rate was significantly (P = .04) higher in the treatment (94.29%) than in the control group (77.14%). After treatment, the levels of free triiodothyronine (8.69 ± 1.02 vs 6.70 ± 1.12 pmol/L) and free thyroxine (FT4) (20.05 ± 2.33 vs 13.00 ± 2.41 pmol/L) were significantly (P < .001) higher in the treatment group than those in the control group, the levels of thyroid peroxidase antibody (TPOAb) (298.70 ± 65.08 vs 735.15 ± 93.39 U/mL) and thyroglobulin antibodies (TgAb) (93.37 ± 21.10 vs 194.20 ± 37.48 U/mL) in the treatment group were significantly (P < .05) lower than those in the control group, and the interleukin-6 (IL-6) (82.83 ± 3.15 vs 97.17 ± 2.27 ng/L) and interleukin-17 (6.02 ± 0.67 vs 6.89 ± 0.72 ng/L) indicators in the treatment group were significantly (P < .05) lower than those in the control group. No significant (P = .393) difference was found in the adverse drug reaction. In conclusion, Bailing capsules combined with levothyroxine sodium are effective and safe for autoimmune thyroiditis, with good control of disease progression, improvement of thyroid function, reduction of thyroid function-related antibody level, and inhibition of inflammation.
Network pharmacology and molecular docking identified IL-6 as a critical target of Qing Yan He Ji against COVID-19
Authors: Xiong Lijuan , Chen Qiang , Liu Hong
Published: November 2024

Since the coronavirus disease 2019 (COVID-19) outbreak, although have controlled, severe acute respiratory syndrome coronavirus 2 is constantly mutating and affects people’s health. FDA has approved Paxlovid and Molnupiravir for COVID-19 treatment, however, they have not been approved for children under 12 years old. Therefore, it is urgent to explore new drugs for treating COVID-19 in children. As a traditional Chinese medicine, Qing Yan He Ji (QYHJ) has been widely used as an antiviral in our hospital. Therefore, we presumed that it may be ideal for treating COVID-19 and explored its therapeutic effect in patients with COVID-19. The targets and underlying mechanisms of QYHJ against COVID-19 in children were investigated using bioinformatics. QYHJ target sets, and related target genes of COVID-19 were retrieved from public databases. Subsequently, gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed to investigate the potential mechanism of QYHJ against COVID-19. Finally, molecular docking was carried out to analyze the affinity between the effective molecule and the target protein. A total of 15 bioactive ingredients of QYHJ and 111 predicted potential targets of QYHJ against COVID-19 were screened. A protein–protein interaction network and subnetworks identified 21 core target genes. Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis indicated that QYHJ functions against COVID-19 primarily through antiviral and anti-inflammatory effects. Molecular docking of interleukin-6 (IL-6) revealed that 5 active compounds had relatively stable binding activities with IL-6. Molecular dynamics simulation was performed for molecular docking results, showing IL-6–(4aS,6aR,6aS,6bR,8aR,10R,12aR,14bS)-10-hydroxy-2,2,6a,6b,9,9,12a-heptamethyl-1,3,4,5,6,6a,7,8,8a,10,11,12,13,14b-tetradecahydropicene-4a-carboxylic acid (4aS) complex, IL-6–stigmasterol complex, IL-6–poriferasterol complex, IL-6–sitosterol complex, and IL-6–beta-sitosterol complex had relatively good binding stability. In conclusion, the multi-component and multi-target intervention of QYHJ against COVID-19 is closely related to antiviral and anti-inflammatory activities, which provides a theoretical basis for clinical application.
Effects of individualized dietary programs provided by nurses on nutrition and micro-inflammation of patients undergoing peritoneal dialysis (PD): A non-randomized controlled study
Authors: Shu Peng , Lv Yani , Guo Li , Xu Fang
Published: November 2024

This study aimed to assess the effects of individualized dietary programs provided by nurses on the nutrition and micro-inflammation of patients undergoing peritoneal dialysis (PD). This study employed the convenience sampling method for selecting participants. Accordingly, 60 patients undergoing PD who visited a PD center from January to June 2022 were selected as the control group, and 60 patients undergoing PD who visited the same PD center from November 2022 to April 2023 were selected as the intervention group. Participants in the intervention group received individualized dietary nutrition programs, whereas those in the control group received general nursing programs. The nutritional and micro-inflammatory statuses of participants in both groups were assessed after 6 months. The nutritional status was assessed based on nutritional scores and blood tests (red blood cells, pre-albumin, albumin, ultrasensitive C-reactive protein, white blood cells, lymphocytes, neutrophils, and globulins), and the micro-inflammatory status was assessed based on blood tests. After 6 months, the intervention group outperformed the control group in terms of lymphocyte percentage, ultrasensitive C-reactive protein level, lymphocyte count, and white blood cell count (P < .05). In addition, globulin, preprotein, albumin, and hemoglobin levels, and red blood cell count were higher in the intervention group compared to the control group (P < .05). The results also showed a lower prevalence of peritonitis in the intervention group (P < .05). The participants in the intervention group obtained lower nutritional scores than those in the control group (P < .05). There were no significant differences between the pre- and post-intervention indexes in the control group (P > .05). In contrast, the studied indexes significantly improved in the intervention group (P < .05). The study findings suggested that individualized dietary programs provided by nurses can improve malnutrition, micro-inflammatory, and peritonitis in patients with PD.
Sensitivity of major chronic diseases and patients of different ages to the collapse of the healthcare system during the COVID-19 pandemic in China
Authors: Qamar Ayub , Hui Liu
Published: November 2024

This study evaluates the sensitivity of major chronic diseases to the collapse of the healthcare system for developing prevention and control strategies under normal and emergency conditions. Data for the years 2018, 2019, and 2020 (coronavirus disease 2019 [COVID-19] pandemic) were curated from the National Disease Mortality Surveillance System, Chinese Center for Disease Control and Prevention for diseases such as cancer, heart disease (HD), cerebrovascular disease (CVD), and chronic obstructive pulmonary disease (COPD). The yearly death rate change for 2018, 2019, and 2020 were calculated. Similarly, expected and observed death cases, 95% confidence intervals, and Z-score were calculated for the year 2020 (COVID-19 pandemic). Furthermore, linear regression analysis was performed to analyze a correlation between the median age of various groups and the mortality rate. The observed death cases for cerebrovascular, heart, and other chronic diseases, were more than the expected death cases (430,007 vs 421,317, 369,684 vs 368,957, and 302,974 vs 300,366) as well as an upper limit of 95% confidence interval. The observed death cases for COPD and cancer are less than the expected death cases (127,786 vs 140,524, 450,346 vs 463,961) and lower limit of the 95% confidence interval. The highest Z-score was noted for cerebrovascular disease (105.14). The disease impact of severity was CVD, other chronic diseases, and HD in descending order. The unexpected decline in deaths was found for COPD and cancers with Z-scores (-166.45 and −116.32). The severity of impact was CVD, other chronic diseases, HD, cancer, and COPD in descending order. The COVID-19 pandemic has also resulted in an increase in deaths of the relatively young population as shown by the difference in rate of slop. The healthcare system collapsed due to prevention, control measures and increased burden of COVID-19 patients, affected chronic disease treatment/management and as a consequence variation in death rates occurs in different chronic diseases. A marked increase in mortality was observed in cerebrovascular disease. The unexpected decline in deaths from COPD and cancers, and increase in deaths of the relatively young population suggests that there may be opportunities for improvement in chronic disease management.
Association between the lowest level of serum albumin during hospitalization and adverse outcomes in older adults with COVID-19
Authors: Liu Qiaoli , Miao Haifeng , Shi Chunwei , Hu Piao , An Suhong
Published: November 2024

Serum albumin on admission has been investigated among inpatients with COVID-19. However, studies on the lowest level of serum albumin during hospitalization and adverse outcomes are limited. This research aimed to explore association between them in older adults with COVID-19. A retrospective study was conducted with 300 patients aged 60 or older with first confirmed COVID-19 from January to February 2023. An adverse outcome was defined as development of acute respiratory failure, shock, or death. Data on demographics, comorbidities, laboratory parameters, the initial phase of COVID-19, coinfection, sepsis, receipt of antiviral treatment and outcomes were gathered from the electronic medical records. The association between the lowest level of serum albumin and adverse outcomes was analyzed using univariate and multivariate regression models, along with generalized additive models. After adjusting potential confounders, nonlinear relationship with an inflection point of 29.1 g/L was detected between the lowest level of serum albumin and adverse outcomes in the elderly. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 0.667 (0.520, 0.856) and 1.171 (0.875, 1.568), respectively. This demonstrated that the lowest level of serum albumin was negatively correlated with adverse outcomes when albumin was <29.1 g/L. A rise of 1 unit in the lowest level of albumin equated to a 33.3% decrease in the risk of adverse outcomes. The correlation between the lowest level of serum albumin and adverse outcomes of COVID-19 is a nonlinear. this study indicates that serum albumin levels should be sustained above the critical inflection point identified to reduce the risk of adverse outcomes.
Does socioeconomic factors and child behavior contribute to caregiver’s stress in families of children with disabilities in Jordan: A cross-sectional study
Authors: AlHeresh Rawan , Ko Joy , Vo Tri , Young Megan , Hillegass Sarah , Bakhsh Hadeel R.
Published: November 2024

This study explored whether socioeconomic factors and child behavior are associated with caregiver stress in families of children with disabilities aged 2 to 17 living in Jordan. This study employed a cross-sectional design using an online survey. The survey, distributed mainly on social media, consisted of questions on demographics, child disability using the Washington Group Short Set on Functioning (WG-SS), caregiver stress levels using the Kessler Psychological Distress Scale (K6), and child behavior using the Strengths and Difficulties Questionnaire (SDQ). Descriptive statistics, correlation testing (Pearson and Spearman tests), and stepwise multiple regression analysis were used to identify whether caregiver stress was associated with child disability and behavior and 4 socioeconomic factors (caregiver age, employment status, child disability, and child gender). In total, 161 caregivers completed the survey. Being older, employed, and having a female child were associated with less caregiver stress (P = .010, P = .017, and P = .009, respectively). Having a child with a higher disability score and more behavioral problems was associated with higher caregiver stress. Our findings highlight the importance of developing a comprehensive evaluation process to identify how child disability affects different areas of caregivers’ lives, and interventions to address caregiver stress. We recommend implementing policies to increase access to mental health services and parenting resources, particularly for young and unemployed caregivers.
Fatal abdominal hemorrhage following surgery to remove a retroperitoneal MPNST associated with NF1: A case report
Authors: Pei Yu-Yang , Yang Tian-Tong , Zhang Hai-dong , Yu Tian-Shui
Published: November 2024

Rationale:

Individuals diagnosed with neurofibromatosis type I (NF1) commonly present with neurofibromas, and a subset may progress to develop malignant peripheral nerve sheath tumors (MPNST) during their lifetime. Diagnosing and treating MPNST, typically linked to NF1, poses challenges for clinicians due to its histopathological complexity.

Patient concerns:

A 25-year-old male presented with postprandial discomfort and vomiting, subsequently developing left mid-abdominal pain.

Diagnoses:

The patient was admitted to the hospital, where a low-density retroperitoneal mass was detected via computed tomography (CT). Histopathological examination revealed spindle-shaped tumor cells characterized by abundant cytoplasm and highly pigmented nuclei, demonstrating pathological nuclear division. The tumor cells exhibited partial cytoplasmic positive for S-100 and focal cytoplasmic positive for cytokeratin (CK) and desmin, as determined by immunohistochemical staining. Genetic analysis of blood and extracted tissues identified an NF1 missense mutation. Prior research corroborated the pathological diagnosis of MPNST exhibiting both epithelial and myogenic differentiation.

Interventions:

A retroperitoneal mass excision was conducted, revealing a mass located in the retroperitoneal omental sac.

Outcomes:

Approximately 5 hours after surgery, the patient’s blood pressure exhibited a gradual decline. An emergency laparotomy was conducted. Approximately 3000 mL of blood was identified in the upper abdominal cavity. The patient’s blood pressure consistently declined and ultimately resulted in death after 2 days.

Lessons:

It is crucial to assess the potential for heterogeneous differentiation in MPNST during pathological diagnosis. In the treatment of MPNST with heterogeneous differentiation, particularly in cases with significant tumor bulk, surgeons must anticipate potential hemorrhagic complications and adopt a cautious approach to surgical intervention.
The correlation between driving risk and visual attention when using smartphones while driving in novice drivers
Authors: Lee Jae-Hong , Choi Seong-Youl , Kim Seon-A. , Kim Han-Som , Lee Ye-Eun
Published: November 2024

Although many countries restrict the use of smartphones while driving, smartphones are utilized in various ways as there are limits to enforcement. Accordingly, efforts are made to determine the risks of novice drivers with low safety awareness and higher risk. This study observed and analyzed changes in visual attention and driving risks according to the way smartphones are used while driving and the scientific relationship between the 2 variables. Forty-five novice drivers were asked to simultaneously perform 4 types of tasks during a driving simulation: hand-held calls, portable hands-free (Bluetooth) calls, sending messages, and not using smartphones. In this process, visual attention was tested using an eye tracker, and the driving function was examined using scenario driving results. Afterward, the differences in visual attention and driving function by task category and the correlation between the 2 variables were analyzed. Significant differences were confirmed in the following categories of novice drivers’ smartphone use while driving: eye blink duration, eye fixation frequency, average eye fixation duration, frequency of saccadic eye movement, average saccade duration, and amplitude and speed of saccade. Additionally, there was a significant relationship between driving risk in speeding rate, centerline crossing rate, road edge excursion rate, average deviation rate, number of off-road accidents, and the number of collision accidents. Lastly, visual attention indices had different significant positive or negative correlations with driving functions. When novice drivers use smartphones while driving compared to when they do not use smartphones, changes in visual attention characteristics in the number and duration of eye blinks, eye fixations, and saccades increased the risk of accidents due to deceleration and lane departure. In particular, the risk increased the most when sending messages, and the risk of accidents continued although the increased burden due to smartphone use was compensated for by slowing down the speed. We hope that the findings of this study will be actively used in efforts to change novice drivers’ traffic safety attitudes while driving.
Evaluating a specialized workshop on otorhinolaryngology emergencies for junior doctors: Empowering the next generation of healers
Authors: Giri Sandarva , Khan Sajjad Ahmed , Parajuli Surya Bahadur , Rauniyar Zenith , Rimal Anurag
Published: November 2024

Otorhinolaryngology (ORL) emergencies, including airway obstructions, epistaxis, and foreign body removal, require prompt and specialized medical intervention. Junior doctors, particularly those in the early stages of their careers, often face challenges in managing these conditions due to limited exposure to ORL-specific training during their internships. While general medical education provides foundational skills, it may not sufficiently prepare junior doctors to handle the complexities of ORL emergencies. As junior doctors are often the first point of contact for urgent ORL cases in emergency departments, targeted training is critical to enhance their competence and improve patient outcomes.

This study assessed the effectiveness of a specialized workshop focused on ORL emergencies, attended by 41 junior doctors. The cohort had varying levels of clinical experience, with 31 having completed 6 months and 10 having completed 12 months of internship. Of the participants, 25 had prior exposure to ORL during their internship rotations, while 16 had not. The cohort had a mean age of 24.73 years (SD = ±1.30), with a gender distribution of 21 females and 20 males. None of the participants had previously attended formal training specifically focused on ORL emergencies. Knowledge improvement was measured using pre- and posttest scores, with statistical analysis to assess the significance of the change. The mean pretest score was 9.95 (SD = 2.97), and the mean posttest score was 12.78 (SD = 2.73). The improvement in scores was statistically significant (P < .0001), indicating that the workshop was effective in enhancing participants’ knowledge of ORL emergencies.

The workshop significantly improved junior doctors’ knowledge of ORL emergencies, addressing important gaps in their training. By providing specialized education to a diverse group of early-career doctors, the initiative enhanced their preparedness to manage urgent ORL conditions, ultimately contributing to better patient care and safety in emergency settings.
High C-reactive protein is associated with the efficacy of neoadjuvant chemotherapy for hormone receptor-positive breast cancer
Authors: Hu Jiawei , Luo Zixuan , Song Junlong , Kong Deguang , Li Zhiyu , Chen Chuang , Sun Shengrong
Published: November 2024

C-reactive protein (CRP) is a nonspecific biomarker for systemic inflammatory response and is linked to the prognosis of breast cancer (BC); however, few studies have investigated the correlation between CRP and the effectiveness of neoadjuvant chemotherapy treatment for BC. We recruited 177 patients with BC who underwent neoadjuvant chemotherapy in our clinical trial. the median CRP level (0.24 mg/L), patients were categorized into high and low groups. We examined the relationship between CRP levels and various clinicopathological factors, including pathological complete response (pCR), using the chi-square test or Fisher exact test. Furthermore, we evaluated the predictive capacity of CRP for different molecular subtypes by constructing receiver operating characteristic curves. To identify the independent variables associated with pCR, we conducted logistic regression multivariate analysis. No association was found between C-reactive levels at baseline and pCR rates. CRP level was significantly associated with higher body mass index, and the high CRP group had more overweight patients (47.06% vs. 16.30%, P < .001). In hormone receptor-positive patients, the high CRP group demonstrated a significantly higher pCR rate (OR = 4.115, 95% CI: 1.481–11.36, P = .009). The areas under the curve was 0.670 (95% CI: 0.550–0.792, P < .001). Multivariate logistic analysis showed that the CRP level was a significant independent predictor of pCR (OR = 5.882, 95% CI: 1.470–28.57, P = .017). High CRP levels were found to be associated with a higher pCR rate, indicating their independent predictive value in determining the efficacy of neoadjuvant chemotherapy in hormone receptor-positive BC patients.