bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of bevacizumab in primary malignant tumors of the central nervous system: A single-center experience
Authors: Pehlivan Metin , Ekenel Meltem
Published: October 2023

Primary central nervous system tumors rank 8 among other cancers in patients over 40 years of age. Glioblastoma is the most common primary central nervous system malignancy, accounting for 48 percent of the cases. The present study evaluates the effect of bevacizumab on the disease course in patients who received bevacizumab therapy due to primary central nervous system tumors in our clinic. The study was designed as a retrospective study. The records of patients treated between January 2000 and August 2021 were reviewed and patients who received bevacizumab therapy due to primary central nervous system tumor were included in the study to evaluate the effect of the therapy on disease course among the subgroups of patients. The study included 70 patients. Of these patients, 40 were male (57.1%) and 30 (42.9%) were female. The median duration of follow-up was 28 months (8–209 months). The median age of the patients was 47 years. The median duration of exposure to bevacizumab was 5 months (1–33 months). Forty-nine patients (71.4%) were histologically diagnosed with glioblastoma multiforme. The median progression-free survival (PFS) was 5 months (95% confidence interval 4–6). The median overall survival (OS) was 8 months (95% confidence interval 6.97–9.02). No statistically significant difference in OS or PFS was observed in any patient subgroup. The therapy was discontinued only in 2 patients (2.9%) due to side effects (1 patient with pulmonary embolism and 1 patient with intracranial hemorrhage). The present study found that the use of bevacizumab is safe in terms of side effects. No statistically significant difference in OS or PFS was observed in any patient subgroup. There is a need for studies on a larger number of patients to find out which patient subgroup benefit the most from bevacizumab therapy.
An unusual coincidence of giant cervical leiomyoma and incidental ovarian granulosa cell tumor: A case report
Authors: Kotowski Krzysztof , Małyszczak Paulina , Towarek Magdalena , Jagasyk Arkadiusz , Murawski Marek , Sozański Rafał
Published: October 2023

Rationale:

Leiomyomas are the most common benign tumors of smooth muscle origin in women. They are most frequently found in the submucosal tissue of the uterine corpus; however, they also occur in other areas of the uterus, including the cervix. Their size usually varies between 0.5 to 1.0 cm; however, they can reach great dimensions. A strong correlation between the onset and growth of leiomyomas and estrogen levels was observed. Granulosa cell tumor (GCT) is an infrequent sex cord-stromal ovarian neoplasm. Despite their malignancy, GCTs have a good long-term prognosis. In this study, we present a unique case of coincidence of 2 tumors: leiomyoma of rare location (cervix uteri) and extraordinary size (9, 04 cm diameter) with an adult granulosa cell tumor.

Patient concerns:

A 67-year-old Caucasian woman was transported from an emergency ward to a gynecological surgery department due to a massive vaginal hemorrhage.

Diagnoses:

Preliminary examination showed a presence of an enormous uteri cervix tumor.

Interventions:

Initially, the patient underwent physical and ultrasound examinations. To prevent further bleeding, an urgent surgery (hysterectomy) with bilateral salpingo-oophorectomy was performed.

Outcome:

Postoperative histopathological examination revealed a cervical leiomyoma and the incidental occurrence of an adult GCT in the right ovary.

Lessons:

This case shares an interesting coincidence between a rare variant of leiomyoma and GCT. The study suggests that the potential reason for this can be estrogen secreted by the GCT, which causes the enormous size of the patient’s cervical leiomyoma and the severe vaginal bleeding. Therefore, we advise it is important in abnormal cases to search for other hidden explanations, as in cases of GCT.
Primary gastric tuberculosis was misdiagnosed as submucosal mass: A rare case report and review of literature
Authors: Feng Shuyan , He Yi , Zhang Chi , Chen Dandan , Zhong Jihong , Zhang Shuo
Published: October 2023

Background:

Tuberculosis of stomach is the rarest form of the tuberculosis family. It is not only lacks specificity in clinical symptoms, but also lacks specificity in auxiliary examination results such as upper gastrointestinal barium meal and gastroscopy. In addition, gastric tuberculosis can coexist with gastric ulcer or gastric cancer, which is difficult to confirm the diagnosis and easy to misdiagnose.

Case summary:

We report a patient who presented with gastric discomfort as the main symptom and was diagnosed with gastric submucosal mass at a local hospital several months ago. For further endoscopic treatment, the patient came to our hospital for hospitalization.

Conclusion:

We performed endoscopic ultrasonography and histopathological biopsy for the patient, and found that the “submucosal mass” was actually a gastric tuberculosis lesion. After confirming the diagnosis of gastric tuberculosis, we transferred the patient to a tuberculosis specialist hospital for antituberculosis treatment.

Through a series of literature review, we rediscuss the diagnosis and differential diagnosis of gastric tuberculosis, aiming at improving the understanding of gastroenterologists to this disease, so as to timely diagnose and treat patients with gastric tuberculosis.
Development and validation of a prognostic nomogram for predicting cancer-specific survival in lymph node-negative elderly esophageal cancer patients: A SEER-based study
Authors: Qin Lang , Chen Lianlian , Tie Xiaowei , Guo Xinwei , Yang Faming , Liu Yangchen
Published: October 2023

In this study, we explored the prognostic risk factors of elderly patients (≥65 years old) with lymph node-negative esophageal cancer (EC) and established a nomogram to evaluate the cancer-specific survival of patients. The surveillance, epidemiology, and end results database was used to collect data on patients diagnosed with EC. Univariate and multivariate Cox analyses were used to determine independent prognostic factors, and the nomogram for predicting cancer-specific survival of EC patients was constructed based on the independent prognostic factors obtained from the multivariate Cox analysis. To evaluate the predictive ability of the nomogram, calibration curves, concordance index (C-index), receiver operating characteristic curves, and decision curve analysis were conducted. Kaplan–Meier method was used to analyze the long-term outcomes of EC patients with different risk stratifications. A total of 3050 cases with lymph node-negative EC were randomized into the training cohort (1525) and the validation cohort (1525). Cancer-specific mortality at 1, 3, and 5 years in the entire cohort was 30.7%, 41.8%, and 59.2%, respectively. In multivariate Cox analysis, age (P < .001), marital status (P < .001), tumor size (P < .001), Tumor-node-metastasis stage (P < .001), chemotherapy (P = .011), radiotherapy (P < .001), and surgery (P < .001) were independent prognostic factors. The C-index for the training cohort was 0.740 (95% confidence interval [CI]: 0.722–0.758), and the C-index for the validation cohort was 0.738 (95% CI: 0.722–0.754). The calibration curve demonstrated the great calibration ability of the nomogram. Based on the area under the receiver operating characteristic curve, the nomogram demonstrated a higher sensitivity than the tumor-node-metastasis stage. Decision curve analysis showed the good clinical utility of the nomogram. The risk stratification system was established using the Kaplan–Meier curve and verified by the log-rank test (P < .001). The nomogram and risk stratification system can improve the accuracy of prediction to help clinicians identify high-risk patients and make treatment decisions.
Exercise-based cardiac rehabilitation programmers for patients after transcatheter aortic valve implantation: A systematic review and meta-analysis
Authors: Li Zhanjun , Song Wei , Yang Na , Ding Yanyan
Published: October 2023

Background:

Currently, transcatheter aortic valve implantation (TAVI) is presently a recognized treatment modality for patients with severe aortic stenosis who are often old, disabled, frail, and have low exercise capacity (ExCap). It is further expected from this therapy to improve quality of life by improving of the cardio function performance. The aim of this study is to evaluate the effect of exercise-based cardiac rehabilitation (CR) on patients after TAVI.

Methods:

PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to December 10, 2022 for relevant studies that evaluated the effect of CR on patients after TAVI. The primary outcome was the improvement of 6-minute walked distance and Barthel index score after CR. The secondary outcomes included other parameters such as SF-12 scale, HADS score, Morse Fall Scale, Frailty-Index, ExCap, and FIM score. All statistical analyses were performed using the standard statistical procedures provided in Review Manager 5.2.

Results:

A total of 12 observational studies were identified, with 2365 participants. Pooled data indicated that CR programmers significantly improved the 6-minute walked distance (SMD 0.65; 95% confidence intervals [CI] 0.51–0.79) and Barthel index score (SMD 0.83; 95% CI 0.61–1.06). In addition, compared with admission, patients experienced significant improvement in SF-12 scale at CR discharge, with a pooled mean differences (MD) of 2.74 (95% CI 0.86–4.61) in physical component score and 2.76 (95% CI 0.59–4.93) in mental component score. Similar results were also observed in ExCap (MD 8.10 W; 95% CI 1.57 W–14.63 W) and FIM score (MD 11.0; 95% CI 6.22–15.78).

Conclusions:

Our analysis indicated that exercise-based CR programmers had significant effect on patients after TAVI in improving exercise tolerance and functional independence.
Correlation between 10-meter walking speed and exercise capacity in patients with surgical resection for lung cancer
Authors: Kim Han Tae , Jo Soo Jeong , Jo Joong Ho , Kim Dohun , Kim Si-Wook , Nam Seung Hyuk , Kong Hyun-Ho
Published: October 2023

Surgical resection for lung cancer adversely impacts exercise capacity. The 6-minute walk test (6MinWT) and cardiopulmonary exercise test (CPET) are commonly used to assess exercise capacity. However, these tests are difficult to use clinically because they must be performed by a trained technician using specialized equipment according to a prescribed method. This study aims to analyze correlations between walking speed in a 10-meter walk test and exercise capacity measured by the 6MinWT or CPET in patients with lung resection for lung cancer. A total of 50 patients who were diagnosed with lung cancer and underwent lung resection were included in the analysis. The 6MinWT and CPET were performed to measure exercise capacity, and the 10-meter walk test was used to evaluate the short-duration walking speed. The population was divided into 2 groups –low and high exercise capacity – based on threshold values (6MinWT, 500 m; CPET, 20 mL·kg−1·min−1); we analyzed the correlation according to the level of exercise capacity. In the correlation analysis between the 10-meter walking speed and exercise capacity, the 10-meter walking speed showed a strong correlation (R = 0.70, P < .001) with the 6MinWT and a moderate correlation (R = 0.47, P < .001) with the CPET, respectively. The low exercise capacity group showed a significant correlation (6MinWT, ρ = 0.70; CPET, ρ = 0.54) between the 10-meter walking speed and exercise capacity, while the high exercise capacity group did not. In patients who underwent lung resection for lung cancer, the 10-meter walking speed was significantly correlated with exercise capacity, especially in subjects with low exercise capacity that require pulmonary rehabilitation.
Pan-cancer analysis of the prognostic and immunological role of matrix metalloproteinase 9
Authors: Zhang Jie , Xu Lei , Zhang Jingjun , Liu Ying , Li Xiang , Ren Tao , Liu Hairong
Published: October 2023

Matrix metalloproteinase 9 (MMP9), a zinc ion-dependent endopeptidase, is one of the most complex matrix metalloproteinases in the gelatinase family. During tissue remodeling, MMP9 leads to gelatin and collagen degradation, which in turn promotes tumor invasion and metastasis. However, comprehensive pan-cancer analysis has not been performed for MMP9. In addition, the diagnostic and prognostic value of MMP9 as a cancer biomarker remain poorly understood, as well as the utility of MMP9 expression as a predictor of immunological responses. Based on a comprehensive analysis of bioinformatics information, we investigated MMP9 expression in different cancers, correlations between MMP9 expression and cancer prognosis and gene mutations, and relationships between MMP9 expression and immune cell infiltration. Our results indicated that MMP9 was highly expressed in most malignant cancers. MMP9 expression was significantly positively or negatively associated with the clinical prognoses of patients with different kinds of cancer. Furthermore, MMP9 expression significantly correlated with infiltrating cells and the expression levels of immune checkpoint genes. This pan-cancer analysis provides comprehensive information on the potential value of MMP9 as a theranostic biomarker.
Antenatal diagnosis and management of pregnancy luteoma: A case report and literature review
Authors: Shen Junhua , Li Jingyi , Tao Xia , Feng Yan , Li Baohua
Published: October 2023

Background:

Pregnancy luoteomas are tumor-like ovarian lesions that emerge during pregnancy and spontaneously regress after delivery. Antenatal diagnosis is infrequently reported, and unnecessary surgery appears to be common in literature reports.

Case summary:

A 28-year-old primigravida with bilateral adnexal masses was discovered at 32 + 5 weeks during prenatal ultrasound evaluation. Combined with clinical presentation, auxiliary examinations including blood test, magnetic resonance imaging, gastroscopy, and consultation of multi-disciplinary team, we successfully made a diagnosis of pregnancy luteoma and provided conservative management recommendations. A cesarean section was conducted on this patient at 34 + 2 weeks of gestation due to fetal distress. The newborn was small for gestational age but normal in appearance. We performed biopsies of the adnexal masses, which were confirmed to be pregnancy luteomas using both intraoperative frozen section and final pathological diagnosis. Serum testosterone, cancer antigen 125, and alpha-fetoprotein levels gradually declined and normalized on postoperative day 28. The masses significantly decreased in size as shown by ultrasonic and magnetic resonance imaging examination on postoperative day 7, with the ovaries returning to their normal size by postoperative day 30.

Conclusion:

Prenatal diagnosis of pregnancy luteoma poses a challenge, requiring hormonal examinations, ultrasound, magnetic resonance imaging, and gastrointestinal endoscopy for identification. Caution must be exercised to avoid overtreatment. While additional cases are needed to summarize the imaging features and effects of excess hormones on the both mother and fetus, further research is necessary for a comprehensive understanding.
Machine learning-based metabolism-related genes signature, single-cell RNA sequencing, and experimental validation in hypersensitivity pneumonitis
Authors: He Jie , Wang Bo , Chen Meifeng , Song Lingmeng , Li Hezhi
Published: October 2023

Metabolism is involved in the pathogenesis of hypersensitivity pneumonitis. To identify diagnostic feature biomarkers based on metabolism-related genes (MRGs) and determine the correlation between MRGs and M2 macrophages in patients with hypersensitivity pneumonitis (HP). We retrieved the gene expression matrix from the Gene Expression Omnibus database. The differentially expressed MRGs (DE-MRGs) between healthy control (HC) and patients with HP were identified using the “DESeq2” R package. The “clusterProfiler” R package was used to perform “Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses” on DE-MRGs. We used machine learning algorithms for screening diagnostic feature biomarkers for HP. The “receiver operating characteristic curve” was used to evaluate diagnostic feature biomarkers’ discriminating ability. Next, we used the “Cell-type Identification by Estimating Relative Subsets of RNA Transcripts” algorithm to determine the infiltration status of 22 types of immune cells in the HC and HP groups. Single-cell sequencing and qRT-PCR were used to validate the diagnostic feature biomarkers. Furthermore, the status of macrophage polarization in the peripheral blood of patients with HP was determined using flow cytometry. Finally, the correlation between the proportion of M2 macrophages in peripheral blood and the diagnostic biomarker expression profile in HP patients was determined using Spearman analysis. We identified a total of 311 DE-MRGs. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis showed that DE-MRGs were primarily enriched in processes like steroid hormone biosynthesis, drug metabolism, retinol metabolism, etc. Finally, we identified NPR3, GPX3, and SULF1 as diagnostic feature biomarkers for HP using machine learning algorithms. The bioinformatic results were validated using the experimental results. The CIERSORT algorithm and flow cytometry showed a significant difference in the proportion of M2 macrophages in the HC and HP groups. The expression of SULF1 was positively correlated with the proportion of M2-type macrophages. In addition, a positive correlation was observed between SULF1 expression and M2 macrophage proportion. Finally, we identified NPR3, GPX3, and SULF1 as diagnostic feature biomarkers for HP. Further, a correlation between SULF1 and M2 macrophages was observed, providing a novel perspective for treating patients with HP and future studies.
Distribution of small bowel involvement and its association with clinical outcomes in patients with Crohn’s disease
Authors: Park Jin , Kim Hae Young , Lee Yoon Jin , Yoon Hyuk , Shin Cheol Min , Park Young Soo , Kim Nayoung , Lee Dong Ho
Published: October 2023

We aimed to evaluate the distribution of small-bowel involvement in Crohn’s disease (CD) and its association with clinical outcomes. This study included CD patients who underwent computed tomography (CT) at initial diagnosis from June 2006 to April 2021. Two abdominal radiologists reviewed the CT images, and independently rated the presence of “bowel wall thickening,” “stricture,” and “fistula or abscess” in the small bowel segments of jejunum, distal jejunum/proximal ileum, distal ileum, and terminal ileum, respectively. Based on findings of the image review, each patient’s “disease-extent imaging score” and “behavior-weighted imaging score” (a higher score indicative of more structuring or penetrating disease) were calculated. Major clinical outcomes (emergency department [ED] visit, operation, and use of corticosteroids or biologics) were compared according to the 2 scores and L4 involvement by the Montreal classification. The proportions of involvement in the jejunum, distal jejunum/proximal ileum, distal ileum, and terminal ileum were 2.0%, 30.3%, 82.2%, and 71.7%, respectively, identifying 30.3% of patients as having L4 disease and 69.7% of patients as having involvement of multiple segments. Clinical outcomes were not significantly associated with the disease-extent imaging score or L4 involvement. However, significant differences were noted for the ED visits and the use of biologics, according to the behavior-weighted imaging score. Moreover, in multivariable analysis, disease behavior was the only factor associated with all clinical outcomes (ED visit, hazard ratio [HR] 2.127 [1.356–3.337], P = .001; operation, HR 8.216 [2.629–25.683], P < .001; use of corticosteroid, HR 1.816 [1.249–2.642], P = .002; and use of biologics, HR 2.352 [1.492–3.708], P < .001). Initial disease behavior seems to be a more critical factor for clinical outcomes of CD than the extent or distribution of small-bowel involvement on CT.
Competing risk analysis of cardiovascular-specific mortality in typical carcinoid neoplasms of the lung: A SEER database analysis
Authors: Xing Hongquan , Wu Cong , Zhang Dongdong , Zhang Xinyi
Published: October 2023

Cardiovascular mortality (CVM) is a growing concern for cancer survivors. This study aimed to investigate the mortality patterns of individuals with typical carcinoid (TC) tumors, identify independent predictors of CVM, and compare these risk variables with those associated with TC deaths. The Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2019 was utilized for obtaining data on patients with TC. Standardized mortality rates were employed to evaluate the risk of CVM while multivariate competing risk models were used to determine the association between patient characteristics and the probability of CVM or TC-related deaths. Our findings show that TC patients had an increased risk of CVM, with an standardized mortality rates of 1.12 (95% CI:1.01–1.25). Furthermore, we discovered that age at diagnosis, marital status, year of diagnosis, SEER stage, site, year of diagnosis, surgery, radiotherapy, and chemotherapy all contributed independently to the risk of CVM in patients with TC, whereas age at diagnosis, sex, race, SEER stage, site, year of diagnosis, surgery, radiotherapy, and chemotherapy all contributed significantly to TC mortality. Compared to the general population in the United States, patients with TC are significantly more likely to acquire CVM. Timely introduction of cardioprotective treatments is critical for preventing CVM in patients with TC.
Integrated bioinformatics analysis and network pharmacology to explore the potential mechanism of Patrinia heterophylla Bunge against acute promyelocytic leukemia
Authors: Feng Liya , Zhu Sha , Ma Jian , Hong Yali , Wan Meixia , Qiu Qian , Li Hongjing , Li Juan
Published: October 2023

Introduction:

Current treatment with arsenic trioxide and all-trans retinoic acid has greatly improved the therapeutic efficacy and prognosis of acute promyelocytic leukemia (APL), but may cause numerous adverse effects. Patrinia heterophylla Bunge (PHEB), commonly known as “Mu-Tou-Hui” in China, is effective in treating leukemia. However, no studies have reported the use of PHEB for APL treatment. In this study, we aimed to investigate the potential anticancer mechanism of PHEB against APL.

Methods:

Public databases were used to search for bioactive compounds in PHEB, their potential targets, differentially expressed genes associated with APL, and therapeutic targets for APL. The core targets and signaling pathways of PHEB against APL were identified by the protein–protein interaction network, Kaplan–Meier curves, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes pathway enrichment, and compound-target-pathway network analysis. Molecular docking was performed to predict the binding activity between the most active compounds and the key targets.

Results:

Quercetin and 2 other active components of PHEB may exert anti-APL effects through proteoglycans in cancer, estrogen signaling, and acute myeloid leukemia pathways. We also identified 6 core targets of the bioactive compounds of PHEB, including protein tyrosine phosphatase receptor type C, proto-oncogene tyrosine-protein kinase Src, mitogen-activated protein kinase phosphatase 3 (MAPK3), matrix metalloproteinase-9, vascular endothelial growth factor receptor-2, and myeloperoxidase, most of which were validated to improve the 5-year survival of patients. Molecular docking results showed that the active compound bound well to key targets.

Conclusion:

The results not only predict the active ingredients and potential molecular mechanisms of PHEB against APL, but also help to guide further investigation into the anti-APL application of PHEB.
Research trends in chemogenetics for neuroscience in recent 14 years: A bibliometric study in CiteSpace
Authors: Chen Yuerong , Xu Yunyun , Dai Jiale , Ni Wenqin , Ding Qike , Wu Xinyuan , Fang Jianqiao , Wu Yuanyuan
Published: October 2023

Background:

Chemogenetics has been widely adopted in Neuroscience. Neuroscience has become a hot research topic for scientists. Therefore, the purpose of this study is to explore the current status and trends in the global application of chemogenetics in neuroscience over the last 14 years via CiteSpace.

Methods:

Publications related to chemogenetics in neuroscience were retrieved from the Science Citation Index-Extended Web of Science from 2008 to 2021. We used CiteSpace to analyze publications, citations, cited journals, countries, institutions, authors, cited authors, cited references, and keywords.

Results:

A total of 947 records were retrieved from 2008 to 2021 on February 21, 2022. The number and rate of publications and citations increased significantly. Journal of Neuroscience was the most cited journal, and BRAIN RES BULL ranked first in the centrality of cited journals. The United States of America (USA) had the highest number of publications among the countries. Takashi Minamoto was the most prolific author and Armbruster BN ranked the first among authors cited. The first article in the frequency ranking of the references cited was published by Roth BL. The keyword of “nucleus accumben (NAc)” had the highest frequency. The top 3 keywords with the strongest citation bursts include “transgenic mice,” “cancer,” and “blood-brain barrier.”

Conclusion:

The period 2008 to 2021 has seen a marked increase in research on chemogenetics in neuroscience. The application of chemogenetics is indispensable for research in the field of neuroscience. This bibliometrics study provides the current situation and trend in chemogenetic methods in neuroscience in recent 14 years, which may help researchers to identify the hot topics and frontiers for future studies in this field.
Short-term results of endoscopic calcaneoplasty and retrocalcaneal bursectomy for insertional Achilles tendinopathy
Authors: Lee Se-Hwan , Lee Kwang-Bok
Published: October 2023

Although open surgery has traditionally been used as a surgical treatment for insertional Achilles tendinopathy, there is a possibility of serious complications (avulsion, scarring, contracture, sensory changes, and infection) due to the anatomical characteristics of the area. Endoscopic surgery has some advantages due to the smaller incision needed. The purpose of this study was to evaluate the effectiveness of endoscopic surgery in insertional Achilles tendinopathy. Twelve patients (15 feet) who underwent endoscopic surgery between 2015 and 2021 were included in this study. Clinical results were evaluated before and after surgery by visual analog scale (VAS) and, Ogilvie-Harris scores and complications. For radiological evaluation, the Fowler-Philip angle, and positive parallel pitch line were measured. VAS scores decreased from 7.6 preoperatively to 2.3 at the last postoperative follow-up, and Ogilvie–Harris values showed excellent results in 5 cases, good results in 8 cases, and fair results in 2 cases. In the radiographic results, there was no bone prominence above the Pavlov calcaneus pitch line in any case, and the Fowler-Philip angle decreased from an average of 57.5 degrees to 50.2 degrees. Only 1 patient underwent reoperation due to the recurrence of symptoms 33 months after the first surgery. After the second operation, the VAS score decreased to 3 points. No complications occurred. Endoscopic surgery is an effective and minimally invasive procedure, showing fewer complications and similar satisfaction as the open procedure. Therefore, it can be a good treatment option for patients with insertional Achilles tendinopathy as it provides the patient with a quick return to daily life.
Efficacy and safety of acupuncture therapy combined with conventional pharmacotherapy in the treatment of systemic lupus erythematosus: A systematic review and meta-analysis
Authors: Wang Hanzheng , Wang Baizhou , Huang Jinge , Yang Zi , Song Ziyu , Zhu Qingmiao , Xie Zhijun , Sun Qice , Zhao Ting
Published: October 2023

Background:

Currently, the mainstream treatments for systemic lupus erythematosus (SLE) are based on glucocorticoids and immunosuppressants, which are known to have considerable adverse effects. This meta-analysis is aimed at confirming the efficacy and safety of acupuncture therapy in combination with traditional medications in the treatment of SLE.

Methods:

Multiple databases were searched for randomized controlled trials using acupuncture therapy in combination with conventional pharmacotherapy for the treatment of SLE, from the establishment of the database to March 2023. Study selection, data collection, as well as quality assessment were conducted by 2 reviewers independently. RevMan 5.4 and Stata 17 software were used for Meta-analysis.

Results:

Seven eligible studies involving 514 patients with SLE were included. Meta-analysis demonstrated that in SLE patients, extra treatment with acupuncture was superior to drug therapy alone in improving the overall response rate (RR = 1.20, 95% confidence intervals [1.11, 1.29], P < .00001, heterogeneity P = .69, I2 = 0%) and regulating immunological indicators (C3, C4, IgG, T lymphocyte subpopulation, IL-6, ds-DNA, ESR) while reducing TCM symptom scores, the SLE Disease Activity Index (SLEDAI) and the incidence of adverse events on treatment (P ≤ 0.05). Additionally, it was able to reduce BUN, Scr and 24 hours urine protein, suggesting that acupuncture treatment had a protective effect on the kidneys.

Conclusions:

Acupuncture therapy combined with conventional pharmacotherapy is an efficient and safe way in the treatment of SLE. However, the conclusions drawn from this meta-analysis have some limitations due to the small number and uneven quality of the included studies, leading to heterogeneity and bias. Thus more relevant high-quality randomized controlled trials are needed for further evaluation in the future.
Efficacy and safety analysis of dexamethasone + palonosetron in prevention of post-embolization syndrome after D-TACE: A retrospective study
Authors: Lu Haohao , Zheng Chuansheng , Liang Bin , Xia Xiangwen
Published: October 2023

To investigate the efficacy and safety of dexamethasone + palonosetron in the prevention of post-embolization syndrome after drug-eluting beads transcatheter arterial chemoembolization (D-TACE). The data of 278 patients who received D-TACE from January 2018 to December 2021 were collected and divided into 2 groups: D-TACE group (N = 145) and D-TACE + dexamethasone + palonosetron group (N = 133). The incidence of post-embolization syndrome and infection after D-TACE was assessed in both groups. Incidence of abdominal pain: D-TACE group versus D-TACE + dexamethasone + palonosetron group, 56.6% versus 40.6%, P = .008; incidence of fever: D-TACE group versus D-TACE + dexamethasone + palonosetron group, 40.0% versus 14.3%, P = .000; incidence of nausea: D-TACE group versus D-TACE + dexamethasone + palonosetron group, 61.4% versus 39.8%, P = .001; incidence of vomiting: D-TACE group versus D-TACE + dexamethasone + palonosetron group, 48.3% versus 21.1%, P = .000; incidence of infection: D-TACE group versus D-TACE + dexamethasone + palonosetron group, 1.4% versus 1.5%, P = .931. The combined use of dexamethasone and palonosetron before D-TACE can effectively reduce the incidence of post-embolization syndrome and reduce the degree of side effects, but it will not increase the risk of infection.
Effects of medical and nursing group rounds combined with emotional nursing on quality of life and emotion in patients with malignant lymphoma
Authors: Zhang Dan , Wang Weijuan , Wei Feng , Lu Yin , Ji Ying
Published: October 2023

To investigate the effects of medical and nursing visits in the same group combined with emotional care on the quality of life and emotions of patients with malignant lymphoma. One hundred sixty cases of malignant lymphoma patients admitted to our hospital from March 2020 to July 2022 were selected as retrospective study subjects and divided into 80 cases each in the control group and the observation group according to the different nursing methods. Among them, the control group implemented conventional emotional care, and the observation group implemented medical and nursing visits in the same group on the basis of the control group. The differences in quality of life, anxiety-related scores and sleep quality between the 2 groups of patients with malignant lymphoma before and after nursing were compared. After nursing, the mental vitality (P = .015), social interaction (P < .001), emotional restriction (P = .007), and mental status (P = .028) scores of patients in the observation group were higher than those in the control group. After nursing, the Self-Rating Anxiety Scale (P < .001) and Hamilton Anxiety Scale (P < .001) of malignant lymphoma patients in the observation group were significantly lower than those in the control group, and the sleep quality (P < .001), increased awakening (P < .001), sleep disturbance (P < .001), night terrors (P < .001) scores in the observation group were significantly lower than those in the control group. The combination of medical and nursing group checkups and emotional care can effectively improve the quality of life and sleep of patients with malignant lymphoma and reduce adverse emotions, which is beneficial to patient prognosis and clinical treatment. It has certain reference value for the care of patients with malignant lymphoma.
Effect of different interventions on the efficacy of postpartum urinary incontinence in China: A systematic review and network meta-analysis
Authors: Liu Du chen , Gao Lei , Liu Ying , Wang Jianhua , Li Ying , Xu Ruo yuan
Published: October 2023

Background:

Currently, numerous treatment measures exist for postpartum stress urinary incontinence (PSUI); however, the study results are inconsistent.

Method:

Computer searches of PubMed, Embase, Web of Science, CKNI, and Wanfang databases were conducted to search the literature on 13 different intervention modalities for PSUI from the date of establishment to January 2023 for analysis. The literature was independently screened, and the information was extracted by 2 researchers. A reticulated meta-analysis was conducted using Stata software.

Results:

The findings of the reticulated meta-analysis revealed that, in terms of the effectiveness of the 13 interventions for treating PSUI from highest to lowest, the most effective was acupressure + pelvic floor muscle training (94.6%). Following this, the interventions ranked from best to worst were electroacupuncture + trans moxibustion (79.1%), pelvic floor muscle training + acupuncture (64.3%), pelvic floor muscle training + pelvic floor electrical stimulation (60.3%), biofeedback electrical stimulation + acupuncture (60.0%), pelvic floor muscle training + biofeedback electrical stimulation (59.8%), biofeedback electrical stimulation + acupuncture + herbal hot compresses (56.6%), moxibustion + pelvic floor muscle training (56.6%), pelvic floor muscle training + pelvic floor electrical stimulation + acupuncture (53.1%), biofeedback electrical stimulation + moxibustion (52.1%), pelvic floor muscle training (17.6%), biofeedback electrical stimulation (16.1%), and health coaching (0.2%). The evidence indicates that acupressure + pelvic floor muscle training may be the most effective intervention for treating PSUI occurrence.

Conclusion:

Improvement in 13 clinical indicators was observed in patients with PSUI, and significant enhancement was achieved through acupressure + pelvic floor muscle training.
A web-based nomogram to predict overall survival for postresection leiomyosarcoma patients with lung metastasis
Authors: Wei Junqiang , Liu Lirui , Li Zhehong , Ren Zhiwu , Zhang Chao , Cao Haiying , Fen Zhen
Published: October 2023

To investigate the overall survival of post-resection leiomyosarcoma (LMS) patients with lung metastasis, data of post-resection LMS patients with lung metastasis between 2010 and 2016 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The clinical characteristics and survival data for post-resection LMS patients with lung metastasis at Tianjin Medical University Cancer Hospital & Institute (TJMUCH) between October 2010 and July 2018 were collected. Patients derived from the SEER database and TJMUCH were divided into training and validation cohorts, respectively. Univariate and multivariate Cox regression analyses were performed and a nomogram was established. The area under the curve (AUC) and the calibration curve were used to evaluate the nomogram. A web-based nomogram was developed based on the established nomogram. Eventually, 226 patients from the SEER database who were diagnosed with LMS and underwent primary lesion resection combined with lung metastasis were enrolled in the training cohort, and 17 patients from TJMUCH were enrolled in the validation cohort. Sex, race, grade, tumor size, chemotherapy, and bone metastasis were correlated with overall survival in patients with LMS. The C-index were 0.65 and 0.75 in the SEER and Chinese set, respectively. Furthermore, the applicable AUC values of the ROC curve in the SEER cohort to predict the 1-, 3-, 5- years survival rate were 0.646, 0.682, and 0.689, respectively. The corresponding AUC values in the Chinese cohort were 0.970, 0.913, and 0.881, respectively. The calibration curve showed that the nomogram performed well in predicting the overall survival in post-resection LMS patients with lung metastasis. A web-based nomogram (https://weijunqiang.shinyapps.io/survival_lms_lungmet/) was established. The web-based nomogram (https://weijunqiang.shinyapps.io/survival_lms_lungmet/) is an accurate and personalized tool for predicting the overall survival of post-resection LMS with lung metastasis.
(RE-)AIMing for Rapid Uptake
Authors: Heavey Sarah Cercone , Beehler Gregory P. , Funderburk Jennifer
Published: October 2023

Objective:

Medication for opioid use disorder (MOUD) is an effective, evidence-based treatment, but significant gaps in implementation remain. We evaluate one novel approach to address this gap: a Hub and Spoke model to increase buprenorphine access and management.

Methods:

This outcome evaluation was guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework using secondary data analysis of clinical and administrative data to characterize program outcomes for program Reach, Effectiveness, Adoption, and Maintenance. Implementation was assessed through a chart review of provider progress notes and through key informant interviews with program staff to understand why this site was able to introduce a novel approach to MOUD.

Results:

Nearly half of patients with opioid use disorder (45.48%, n=156) were reached by the program over 2 years. Of those, 91.67% had 1 or more program visits after an initial intake appointment, and 78.85% had a buprenorphine prescription. Patients in the program were 2.44 times more likely to have a buprenorphine prescription than those in comparator site that did not have a Hub and Spoke program (95% CI: 1.77–3.37; P<0.001). There was significantly greater program reach in year 1 than year 2, suggesting rapid initial uptake followed by modest program growth. Key informant interviews illustrated several themes regrading program implementation, including the importance of process champions, the beneficial impact of MOUD for patients, and addressing facility performance metrics. A supportive organizational culture and a receptive climate were also key factors for implementation.

Conclusions:

This program led to rapid improvement in MOUD uptake across the facility. Future efforts should focus on improving program maintenance, including supporting the exchange of patients from the hub to appropriate spokes.
Neuroimaging to guide neuroprognostication in the neonatal intensive care unit
Authors: Christensen Rhandi , de Vries Linda S. , Cizmeci Mehmet N.
Published: October 2023

Purpose of review

Neurological problems are common in infants admitted to the neonatal intensive care unit (NICU). Various neuroimaging modalities are available for neonatal brain imaging and are selected based on presenting problem, timing and patient stability.

Recent findings

Neuroimaging findings, taken together with clinical factors and serial neurological examination can be used to predict future neurodevelopmental outcomes. In this narrative review, we discuss neonatal neuroimaging modalities, and how these can be optimally utilized to assess infants in the NICU. We will review common patterns of brain injury and neurodevelopmental outcomes in hypoxic-ischemic encephalopathy, perinatal arterial ischemic stroke and preterm brain injury.

Timely and accurate neuroprognostication can identify infants at risk for neurodevelopmental impairment and allow for early intervention and targeted therapies to improve outcomes.
Acute disseminated encephalomyelitis following the COVID-19 Vaccine Sinopharm in low- and middle-income country: a case report
Authors: Shrestha Abhigan B. , Mokbul Mobin I. , Chowdhury Tonmoy , Shrestha Shubham , Shrestha Sajina , Raut Rupesh , Nuruzzaman Md.
Published: October 2023

Introduction and importance:

Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and various vaccines against it have been developed. Acute disseminated encephalomyelitis (ADEM) is a disease of the central nervous system that cause inflammation and demyelination and manifests as a multi-symptom acute neurological condition. Although infections are usually the cause of ADEM, vaccines may cause 5–10% of cases.

Case presentation:

A 40-year-old woman had received a second dose of the Sinopharm COVID-19 vaccine 4 months before her visit and experienced sudden gait imbalance and vertigo a day after her vaccination, which lasted for more than a month. On examination, no signs of skin bruising or bleeding were observed, and her vital signs were within the normal range. On neurological assessment, the patient had a Glasgow Coma Scale score of 14/15 (E4V5M5), had normal pupil size and light reaction, normal fundus, normal deep tendon reflexes and bilateral extensor plantar response. Meningeal symptoms were absent, and SARS-CoV-2 RNA tests using NAAT (Nucleic Acid Amplification Test) were negative. Development of central nervous system (CNS) manifestations during the recovery phase of fever, along with typical MRI findings; the diagnosis of para-infectious ADEM with COVID-19 vaccination was made. After the treatment with methylprednisolone sodium succinate injection, the patient showed improvement.

Clinical discussion:

ADEM associated with post-vaccinations is a rare condition. There has been growing evidence that shared epitopes between neuronal proteins and SARS-CoV-2 antigens may trigger autoimmune reactions against the CNS through molecular mimicry as its pathogenesis.

Conclusion:

We suggest the need for a strict vaccine safety monitoring system and post-vaccine monitoring and surveillance.
Photon-Counting Detector Computed Tomography Versus Energy-Integrating Detector Computed Tomography for Coronary Artery Calcium Quantitation
Authors: McCollough Cynthia H. , Winfree Tim N. , Melka Elnata F. , Rajendran Kishore , Carter Rickey E. , Leng Shuai
Published: October 2023

Objectives

Photon-counting detector (PCD) computed tomography (CT) offers improved spatial and contrast resolution, which can impact quantitative measurements. This work aims to determine in human subjects the effect of dual-source PCD-CT on the quantitation of coronary artery calcification (CAC) compared with dual-source energy-integrating detector (EID) CT in both 1- and 3-mm images.

Methods

This prospective study enrolled patients receiving a clinical EID-CT CAC examination to undergo a research PCD-CT CAC examination. Axial images were reconstructed with a 512 × 512 matrix, 200-mm field of view, 3-mm section thickness/1.5-mm interval using a quantitative kernel (Qr36). Sharper kernels (Qr56/QIR strength 4 for PCD and Qr49/ADMIRE strength 5 for EID) were used to reconstruct images with 1-mm section thickness/0.5-mm interval. Pooled analysis was performed for all calcifications with nonzero values, and volume and Agatston scores were compared between EID-CT and PCD-CT. A Wilcoxon signed-rank test was performed with P < 0.05 considered statistically significant.

Results

In 21 subjects (median age, 58 years; range, 50–75 years; 13 male [62%]) with a total of 42 calcified arteries detected at 3 mm and 46 calcified arteries at 1-mm images, EID-CT CAC volume and Agatston scores were significantly lower than those of PCD-CT (P ≤ 0.001). At 3-mm thickness, the mean (standard deviation) volume and Agatston score for EID-CT were 55.5 (63.4) mm3 and 63.8 (76.9), respectively, and 61.5 (69.4) mm3 and 70.4 (85.3) for PCD-CT (P = 0.0001 and P = 0.0013). At 1-mm thickness, the mean (standard deviation) volume and score for EID-CT were 50.0 (56.3) mm3 and 61.1 (69.3), respectively, and 59.5 (63.9) mm3 and 72.5 (79.9) for PCD-CT (P < 0.0001 for both). The applied radiation dose (volume CT dose index) for the PCD-CT scan was 2.1 ± 0.6 mGy, which was 13% lower than for the EID-CT scan (2.4 ± 0.7 mGy, P < 0.001).

Conclusions

Relative to EID-CT, PCD-CT demonstrated a small but significant increase in coronary artery calcium volume and Agatston score.
Hyperphosphatemia-Related False-Positive 99mTc-Pyrophosphate Myocardial Scan: A Case Report With Endomyocardial Biopsy Result
Authors: Hu Lien-Hsin , Kuo Yu , Chang Fu-Pang , Wang Wei-Ting , Yang Bang-Hung , Huang Wen-Sheng , Wang Yuh-Feng
Published: October 2023

With documented high specificity, 99mTc-pyrophosphate (PYP) scan enables the diagnosis of transthyretin cardiomyopathy to be made reliably without endomyocardial biopsy in patients who do not have monoclonal gammopathy. We report a case with extensive myocardial uptake of Perugini 3 score in the 3-hour 99mTc-PYP myocardial SPECT that suggested transthyretin cardiac amyloidosis. However, a followed endomyocardial biopsy revealed no amyloid deposition. In this case, hyperphosphatemia was the most likely and presumptive cause of the false-positive 99mTc-PYP scan. With this case, our experiences of the potential causes of false-positive results of 99mTc-PYP are further expanded.
Image-Guided Fine-Needle Aspiration Cytology for BRCA Mutation Assessment of PSMA-Positive Lymph Node Metastases in a Patient With Metastatic Castration-Resistant Prostate Cancer
Authors: Werner Anke , Seifert Philipp , Theis Bernhard , Freesmeyer Martin , Leder Theresa
Published: October 2023

A 64-year-old man with metastatic castration-resistant prostate cancer presented for prostate-specific membrane antigen (PSMA) PET/CT in preparation for 177Lu-PSMA radioligand therapy. For precedent BRCA mutation assessment, fine-needle aspiration cytology of 2 PSMA-positive lymph node metastases was conducted. The acquired material was suitable for next-generation sequencing-based gene panel diagnostics and did not show a BRCA1/2 mutation, thus PSMA radioligand therapy was initiated. Fine-needle aspiration cytology of lymph node metastases may be a viable option in evaluating further therapeutic alternatives.
False-Positive 131I Uptake After Posttraumatic Scab in a Patient With Papillary Thyroid Carcinoma
Authors: Yang Jun , Zhou Pingping , Su Xinhui
Published: October 2023

A 41-year-old woman with right papillary thyroid carcinoma underwent 131I therapy (3.7 GBq). Posttherapy whole-body scintigraphy acquired 2 days later revealed a focus of intense activity in the anterior aspect of the left knee. The activity corresponding to the posttraumatic scab. Posttraumatic scab should be considerable a cause of false-positive whole-body scintigraphy findings.