bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of different plant extracts in the prevention of radiation dermatitis in radiotherapy patients with nasopharyngeal carcinoma
Authors: Yi Yi , You Xingli , Long Ying , Huang Ya
Published: December 2020

Background:

Radiation dermatitis is a common complication in patients with nasopharyngeal carcinoma (NPC) when treated with radiotherapy. Plant extracts have good effects on the prevention of radiation dermatitis in patients with NPC when treated with radiotherapy. However, there is insufficient comparison among the currently used plant extracts. Therefore, the purpose of this study was to explore the efficacy of different plant extracts in the prevention of radiation dermatitis in patients with NPC by Bayesian network meta-analysis.

Methods:

We searched Chinese and English databases to collect all randomized controlled trials (RCT) of plant extracts for the prevention of radiation dermatitis in NPC patients who underwent radiotherapy up to October 2020. Two researchers then independently screened articles, extracted data and evaluated the quality selected literatures. All data were processed by Stata 14.0 and WinBUGS V.1.4.3.

Results:

We applied Bayesian statistical model for network meta-analysis, ranked the effects of various plant extracts, and adopted GRADE method to explain the results.

Conclusion:

Our study is expected to provide high-quality evidence-based medicine advice for the prevention of radiation dermatitis in patients suffering from NPC undergoing radiotherapy.

Ethics and dissemination:

Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and will be shared on social media platforms. This review would be disseminated in a peer-reviewed journal or conference presentations.

OSF REGISTRATION NUMBER:

DOI 10.17605/OSF.IO/6SV45.
Relationship between long non-coding RNA and prognosis of patients with coronary heart disease after percutaneous coronary intervention
Authors: Wang Fei , Cai Xiaoqing , Jiao Piqi , Liu Yan , Yuan Bin , Zhang Peng , Liu Hongbin , Ma Ling
Published: December 2020

Background:

Long non-coding RNA (lncRNA) can predict the prognosis of patients with coronary heart disease (CHD) after obtaining percutaneous coronary intervention (PCI), while this conclusion still needs to be further confirmed. Therefore, this study attempted to explore the relationship between lncRNA and prognosis in CHD patients after PCI.

Methods:

The database was retrieved from China National Knowledge Infrastructure (CNKI), Chinese Biomedical literature Database (CBM), Chinese Scientific and Journal Database (VIP), Wan Fang database, PubMed, and EMBASE. Hazard ratios (HRs) and its 95% confidence interval (CIs) were applied to assess the prognostic effects of lncRNA on overall survival (OS). RevMan 5.3 and STATA 16.0 software were used to perform meta-analysis.

Results:

The results of this meta-analysis would be submitted to peer-reviewed journals for publication.

Conclusion:

This review provided a comprehensive overview of the relationship between lncRNA and prognosis in CHD patients after PCI, and offered recommendations for clinical practices or guidelines.
Platinum versus immunotherapy for unresectable esophageal cancer
Authors: Qian Jiekun , Tong Zhangwei , Zhang Yannan , Chen Chun
Published: December 2020

Background:

Esophageal cancer is one of the most common malignant tumors, with early metastasis, highly malignant characteristics. Morbidity ranks 7th among all malignant tumors, and mortality ranks 6th. Esophageal adjuvant therapy can significantly improve overall survival in unresectable esophageal cancer patients. With the breakthrough and progress of immunotherapy, the possibility of curing esophageal cancer has greatly increased. Some clinical trials have reported that compared with traditional platinum-based chemotherapy, the use of programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) inhibitors alone can benefit patients and effectively prolong their overall survival. We compare the efficacy of single immunotherapy with traditional platinum-based chemotherapy in a systematic review and meta-analysis to provide a reliable basis for clinicians.

Methods:

We will search PubMed, Medline, Embase, Web of Science, Cancerlit, Google Scholar, and the Cochrane Central Register of Controlled Trials for related studies published before December 1, 2019 without language restrictions. Two review authors will search and assess relevant studies independently. Randomized controlled trials (RCTs) or quasi-RCTs, and prospective cohort studies will be included. We will perform subgroup analysis in sex, age, ethnicity, and tumor stage of esophageal cancer patients.

Results:

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

Conclusion:

The results of this systematic review and meta-analysis will provide a basis for clinicians to formulate the best chemotherapy regimen for patients, as well as a research clue for clinical researchers in this field. The results of this study will expand the treatment options for esophageal patients, but due to the nature of the disease and intervention, large sample clinical trials are not abundant, so we will include some high-quality small sample trials, which may cause high heterogeneity.

INPLASY registration number:

INPLASY2020110012.
Efficacy and safety of massage in the treatment of post-stroke insomnia
Authors: Zhang Yajing , He Xingwei , Hu Shasha , Hu Songfeng , He Fan , Shen Yu , Zhao Fenfen , Zhang Qin , Liu Tingping , Wang Changkang
Published: December 2020

Background

: Post-stroke insomnia (PSI) is a serious problem which has significant adverse effects on the subsequent recovery of patients and the quality of their daily life. Massage is effective in improving the quality of sleep for stroke patients displaying no significant adverse reactions. Up to now, however, there are still no systematic studies conducted to provide compelling evidence for its effectiveness in treating PSI. Allowing for this, this project is purposed to make a thorough summary of the efficacy of massage therapy in treating PSI and the safety of this practice.

Methods

: Without considering the status of publication and language, a meticulous search will be conducted, covering the Web of Science, the Cochrane Library search, PubMed, EMBASE, Chinese biomedical literature database, Chongqing VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang. All randomized controlled trials of PSI will be retrieved. The deadline is set as October 23, 2020. The team will be comprised of 2 experienced researchers who will apply RevMan V.5.3 software to conduct literature selection, data collection, data analysis, and data synthesis, respectively. In addition, the Cochrane risk Assessment tool will be taken as the top choice to evaluate the quality of the trials involved in this study.

Results

: The effectiveness and safety of massage therapy intended for PSI will be subject to a systematic evaluation under this program.

Conclusion

: It will be substantiated in this review whether massage therapy is a reliable intervention for PSI by examining the evidence collected.
Effects of houttuynia cordata thunb. on rhinosinusitis by nasal irrigation
Authors: Wang Dandan , Tian Tian , Liao Chao , Liu Ting , Tang Guangjun , Tian Li
Published: December 2020

Background:

The herba Houttuynia cordata Thunb. (HC) has anti-inflammatory, antibacterial and antiviral effects. Through nasal irrigation, the related preparation of HC is beneficial for treating rhinosinusitis or promoting recovery after an endoscopic sinus surgery. However, it remains controversial whether nasal irrigation with HC preparation can provide evidence-based clinical benefits for rhinosinusitis patients.

Methods:

With reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 8 databases are perused to perform a methodical investigation of nasal irrigation with HC preparation and health-related results amongst rhinosinusitis patients. The main research purpose is to determine the influence of PRISMA standards on medical results pertaining to rhinosinusitis patients, including quantitative symptom recording and effective rate. With reference to the Cochrane Handbook, quality assessment of qualified papers is conducted using the Cochrane Risk Assessment Tool.

Results:

The results will be publicised through a peer-reviewed journal publication.

Conclusion:

The results of the systematic review will summarise evidences for the efficacy of nasal irrigation with HC preparation in rhinosinusitis treatment.

Ethics and dissemination:

Since this study involves a methodical investigation of issued medical papers, ethical authorisation and informed patient consent are not necessary.
Therapeutic efficacy and immunoregulatory effect of Qiangji Jianli Capsule for patients with myasthenia gravis
Authors: Weng Senhui , Fan Zhixin , Qiu Guoyu , Liu Fengbin , Huang Linwen , Li Jinghao , Jiang Xiaotao , Song Zhixuan , Gao Yuxia , Zhong Zhuotai , He Long , Kang Liping , Wu Yunlong , Chen Benshu , Jiang Qilong
Published: December 2020

Introduction:

Myasthenia gravis (MG) is an autoimmune disease in which antibodies directly target components of the neuromuscular junction, causing neuromuscular conduction damage that leads to muscle weakness. The current pharmaceutical treatment for MG is still not ideal to address the problems of disease progression, high recurrence rate, and drug side effects. Clinical observations suggest that traditional Chinese medicine (TCM) can strengthen immunity and improve symptoms of MG patients, delay the progression of the disease, reduce or even prevent the need for immunosuppressive therapy when used in combination with acetylcholinesterase inhibitors or low-dose prednisone, as well as improve the quality of life of patients. The Qiangji Jianli Capsule (QJC) is a combination of medicinal herbs which is used in traditional Chinese medicine. Since MG is a rare disorder, randomized controlled trials comparing large cohorts are difficult to conduct. Therefore, we proposed to aggregate data from a small series of N-of-1 trials to assess the effect of the Chinese medical prescription QJC, which strengthens the spleen and nourishes Qi, as an add-on treatment for MG with spleen and stomach Qi deficiency syndrome.

Methods and analysis:

Single-center, randomized, double-blind, multiple crossover N-of-1 studies will compare QJC versus placebo in 5 adult MG patients with spleen and stomach Qi deficiency syndrome. Patients will undergo 3 cycles of two 4-week intervention periods. According to the treatment schedule, patients will continue to be treated with pyridine bromide tablets, prednisone acetate, tablets and/or tacrolimus capsules throughout the entire trial. Each period consisting of 4-week oral add-on treatment with QJC will be compared with 4-week add-on treatment with a placebo. The primary endpoints are quantitative myasthenia gravis (QMG) test; measurement of the amount of Treg cells and cytokines such as interferon-γ (IFN-γ), interleukin-4 (IL-4), interleukin-17A (IL-17A), and transforming growth factor-β (TGF-β); and corticosteroid or immunosuppressive agent dosage. Secondary outcome measures: Clinical: Evaluation of the effect of TCM syndromes; MG-activities of daily living (MG-ADL) scales; adverse events.

Ethics and dissemination:

This study was approved by The First Affiliated Hospital of Guangzhou University of Chinese Medicine (GZUCM), No. ZYYECK[2019]038. The results will be published in a peer-reviewed publication. Regulatory stakeholders will comment on the suitability of the trial for market authorization and reimbursement purposes. Trial registration: Chinese Clinical Trial Register, ID: ChiCTR2000033516. Registered on 3 June 2020, http://www.chictr.org.cn/showprojen.aspx?proj=54618.
C-reactive protein for simple prediction of mortality in patients with acute non-variceal upper gastrointestinal bleeding
Authors: Park Se Hwan , Mun Yoon Gwon , Lim Chul-Hyun , Cho Yu Kyung , Park Jae Myung
Published: December 2020

In upper gastrointestinal bleeding (UGIB), scoring systems using multiple variables were developed to predict patient outcomes. We evaluated serum C-reactive protein (CRP) for simple prediction of patient mortality after acute non-variceal UGIB.

The associated factors for 30-day mortality was investigated by regression analysis in patients with acute non-variceal UGIB (N = 1232). The area under the receiver operating characteristics (AUROC) curve was analyzed with serum CRP in these patients and a prospective cohort (N = 435). The discriminant validity of serum CRP was compared to other prognostic scoring systems by means of AUROC curve analysis.

Serum CRP was significantly higher in the expired than survived patients (median, 4.53 vs 0.49; P < .001). The odds ratio of serum CRP was 4.18 (2.10–9.27) in multivariate analysis. The odds ratio of high serum CRP was higher than Rockall score (4.15 vs 1.29), AIMS65 (3.55 vs 1.71) and Glasgow-Blatchford score (4.32 vs 1.08) in multivariate analyses. The AUROC of serum CRP at bleeding was 0.78 for 30-day mortality (P < .001). In the validation set, serum CRP was also significantly higher in the expired than survived patients, of which AUROC was 0.73 (P < .001). In predicting 30-day mortality, the AUROC with serum CRP was not inferior to that of other scoring systems.

Serum CRP at bleeding can be simply used to identify the patients with high mortality after acute non-variceal UGIB.
Efficacy and safety of modified Yupingfeng formula in treating allergic rhinitis
Authors: Liao Chao , Liu Ting , Zeng Zhen , Wang Dandan , Tang Guangjun , Wang Huan , Tian Li
Published: December 2020

Background:

Allergic rhinitis (AR) is a non-infectious chronic nasal mucosal disease mediated mainly by IgE, which affects 40% of the global population and has a recurrence rate of more than 50%. The modified Yupingfeng formula (MYPFF) is widely used in the treatment of allergic rhinitis in China. However, there is no evidence-based medical evidence for the efficacy and safety of MYPFF in the treatment of allergic rhinitis.

Methods:

Database as China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database (VIP database), Wan-Fang Database, the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, and Web of Science will be searched for relevant literature from inception to September 2020. Data extraction will be performed on the obtained literature. Then RevMan V.5.3 will be used for the assessment of the risk of bias and data synthesis.

Results:

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

Conclusion:

The conclusion of the study will provide an evidence to efficacy and safety of MYPFF in treating allergic rhinitis, which will be of significant meaning for further research and clinical practice.

OSF registration number:

10.17605/OSF.IO/RV9P4.
Evaluation of an effectiveness and safety of the electroacupuncture in the management of intractable neuropathic pain
Authors: Moon Jee Youn , Lee Chang-Soon , Yoo Yongjae , Lee Suji , Lee Sang Hoon , Lee Seunghoon
Published: December 2020

Background:

There is no sufficient evidence on the effectiveness of acupuncture for neuropathic pain. This protocol describes a study that aims to evaluate the effectiveness and safety of electroacupuncture combined with conventional medicine for patients with intractable neuropathic pain, when compared with conventional medicine alone.

Methods/design:

This study is a prospective, open-labeled, randomized, cross-over clinical trial. A total of 40 patients with neuropathic pain who had a numeric rating scale (NRS) score of over 4 despite receiving conventional treatment for more than 3 months will be enrolled. Participants will receive conventional treatment for neuropathic pain (treatment C) or treatment C combined with 12 additional sessions of electroacupuncture treatment (treatment A) for 6 weeks. Participants will be randomly assigned to 1 of the 2 sequence groups (AC and CA group) with a 1:1 allocation. The differences of responder in the composite efficacy outcomes, which consist of the NRS, Brief Pain Inventory-Short Form (BPI-SF) pain subscale, and global assessment at 6 weeks after randomization will be examined as the primary outcome. Secondary outcomes include differences in the NRS, the Short-Form McGill Pain Questionnaire, BPI-SF, Fatigue Severity Scale, Hospital Anxiety and Depression Scale, Medical Outcomes Study Sleep Scale, global assessment, EQ-5D, and incremental cost-effective ratio at 6 and 15 weeks after randomization. Adverse events, vital signs, and physical examinations will be recorded to evaluate safety.

Discussion:

The study protocol for this trial will provide up-to-date evidence on the effectiveness and safety of electroacupuncture for patients with intractable neuropathic pain. The results will be disseminated through a peer-reviewed journal and conference presentations.

Trial registration:

Clinical Research Information Service, ID: KCT0003615. Registered on March 12, 2019. https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=13410& ltype=&rtype=
Jingui Shenqi pill for nocturia due to nocturnal polyuria
Authors: Fan Zhipeng , Wang Zhaodi , Deng Jiashuai , Jiang Yong
Published: December 2020

Background:

The incidence of nocturia is high and will seriously affect patients’ physical and mental health. Nocturnal polyuria is the most critical cause of nocturia, There are few drugs currently used to treat nocturia due to Nocturnal Polyuria (NP). The guide highly recommends only Desmopressin. There is an urgent need to find new drugs. Jingui Shenqi pill (JSP) is a Chinese patent medicine, it is widely used in China to treat NP. However, there is no evidence-based medical evidence to prove its safety and effectiveness. The purpose of this systematic review is to evaluate the efficacy and safety of JSP in the treatment of NP.

Methods:

We will search the randomized controlled trials (RCTs) including JSP for NP and published from the inception of the database to Oct 2020 by the following eight databases: Embase, Cochrane Library, PubMed, MEDLINE, the China National Knowledge Infrastructure, Cqvip Database, and Wanfang Data, the Chinese Biomedical Literature Database. There is no language and publication status restriction. The primary outcomes will include Nocturnal urine volume, the number of nocturnal voids, Nocturnal polyuria index (Nocturnal total urine volume /24 h total urine volume). We will perform the data synthesis, sensitivity analysis, subgroup analysis, and bias assessment risk using RevMan V.5.3. The reporting bias will be assessed using a funnel plot and Egger test.

Results:

This study may provide additional evidence of JSP for NP in the effectiveness and safety and alternative therapy for NP.

Conclusions:

In this systematic review, we will assess whether JSP is an effective and safe medicine for nocturia.
A protocol for an interventional study on the impact of transcutaneous parasacral nerve stimulation in children with functional constipation
Authors: Coelho Giovanna Maria , Machado Nilton Carlos , Carvalho Mary de Assis , Rego Rebeca Mayara Padilha , Vieira Stefani Rabelo , Ortolan Erika Veruska Paiva , Lourenção Pedro Luiz Toledo de Arruda
Published: December 2020

Introduction:

Transcutaneous parasacral nerve stimulation (TPNS) via electrodes placed over the sacrum can activate afferent neuronal networks noninvasively, leading to sacral reflexes that may improve colonic motility. Thus, TPNS can be considered a promising, noninvasive, and safe method for the treatment of constipation. However, there is no published study investigating its use in children with functional constipation. This is a single-center, prospective, longitudinal, and interventional study designed to assess the applicability and clinical outcomes of TPNS in functionally constipated children.

Patient concerns:

Parents or guardians of patients will be informed of the purpose of the study and will sign an informed consent form. The participants may leave the study at any time without any restrictions.

Diagnosis:

Twenty-eight children (7–18 years old) who were diagnosed with intestinal constipation (Rome IV criteria) will be included.

Interventions:

The patients will be submitted to daily sessions of TPNS for a period of 4 or 8 weeks and will be invited to participate in semistructured interviews at 3 or 4 moments: 1 week before the beginning of TPNS; immediately after the 4 and/or 8 weeks of TPNS; and 4 weeks after the end of the intervention period. In these appointments, the aspects related to bowel habits and quality of life will be assessed.

Outcomes:

This study will evaluate the increase in the number of bowel movements and stool consistency, the decrease in the number of episodes of retentive fecal incontinence, and the indirect improvement in the overall quality of life.

Conclusion:

we expect that this study protocol can show the efficacy of this promising method to assist the treatment of children with functional constipation.
Comparative efficacy and safety of traditional Chinese patent medicine in the treatment of Mycoplasma pneumoniae pneumonia in children
Authors: He Hongan , Wang Xiao , Xiao Yanyan , Zheng Jialin , Wang Jinjuan , Zhang Baoqing
Published: December 2020

Background:

Mycoplasma pneumoniae pneumonia (MPP) is a common respiratory disease in children. Its incidence rate is increasing year by year. The drug resistance rate of macrolide antibiotics and other conventional treatment methods is higher, and there are limitations in clinical application. Traditional Chinese patent medicine (TCPM) is a powerful weapon to treat this disease. At present, there is no comparison of the safety and effectiveness of multiple TCPMs in the treatment of MPP in children. Therefore, we take the method of network meta-analysis to systematically compare the efficacy of various TCPMs in the treatment of this disease.

Methods:

We will conduct comprehensive searches of Cochrane Library, PubMed, Web of Science, Clinical Trials, China National Knowledge Infrastructure, Chinese Scientific Journals Database, Chinese BioMedical Literature, Wanfang Database, and other electronic databases. The time frame is set from the establishment of the database to October 2020. All randomized controlled trials that meet the inclusion criteria will be included in this study. The 2 researchers will independently screen the literature according to the inclusion criteria, extract the data, and assess the bias risk of the included study. We will evaluate all the obtained data and evidence through Bayesian network meta-analysis, and use Stata 15.0 to process and analyze the data.

Results:

Through this study, we will evaluate the efficacy and safety of a variety of TCPMs for the treatment of MPP in children.

Conclusion:

The purpose of this study is to provide a strong reference for clinical application of TCPMs in the treatment of MPP in children, and to provide an important basis for clinicians to make correct judgments and put forward accurate treatment plans.

Ethics and dissemination:

This review does not involve any human or animal experiments and therefore does not require ethical approval.

INPLASY registration number:

INPLASY 2020100108
Proprioceptive training on the recovery of total knee arthroplasty patients
Authors: Wu Jia-qi , Bao Hong-wei , Mao Lin-bo , Liu Ling-feng , Li Yong-mei , Hou Jing-zhao , Wu Can-hua , Zhou Yue-jiang , Wang Zhao , Cheng Yan-xiao , Wu Jian
Published: December 2020

Background:

Total knee arthroplasty is a common surgery for end-stage of knee osteoarthritis. Proprioceptive training has become an important part in athletes training programmes in different sports. However, the effects of proprioceptive training on the recovery of total knee arthroplasty were unknown. This meta-analysis, with its comprehensive and rigorous methodology, will provide better insight into this problem.

Methods and analysis:

Electronic databases including PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI) database, Wanfang Database and Chinese Biomedical Literature Database (CBM) were searched from its inception to October 21, 2020. We only included proprioceptive training vs placebo in patients after total knee arthroplasty and pooled results were summarized by STATA 12.0 software. Two researchers independently selected the study and assessed the quality of the included studies. The heterogeneity was measured by I
2 tests (I
2 < 50 indicates little heterogeneity, I
2 ≥ 50 indicates high heterogeneity). Publication bias was ruled out by funnel plot and statistically assessed by Beggs test (P > .05 as no publication bias).

Results:

Results will be published in relevant peer-reviewed journals.

Conclusion:

Our study aims to systematically present the clinical effects of proprioceptive training after total knee arthroplasty patients, which will be provide clinical guidance for total knee arthroplasty patients.
Appearance and morphologic features of laryngeal tuberculosis using laryngoscopy
Authors: Zang Jian , Tian Ying , Jiang Xuejun , Lin Xu-Yong
Published: December 2020

Laryngeal tuberculosis (LTB) is highly contagious and can cause permanent laryngeal damage. Therefore, correctly identifying laryngoscopic LTB lesion locations, sizes, and morphologic features are essential for LTB diagnoses. This study aimed to explore the appearance and morphologic features of LTB and correlated these features with clinical symptoms.

We retrospectively analysed 39 LTB patients in our hospital between January 2013 and December 2019. Medical records, including clinical presentation, lesion appearance (locations, sizes, and morphology), complementary examination results, and histopathologic features were summarized and analysed.

In this patient cohort, dysphonia and sore throat were the two most common clinical symptoms. In LTB patients with extensive lesions, ulcerative lesions were most common, and the proportion of cases with concurrent pulmonary tuberculosis (86.4%, P = .033) infection was higher, as were the positive rates of sputum smears (72.7%, P = .011) and cultures (86.4%, P = .002) than patients without concurrent pulmonary TB and with more localized and exophytic lesions. The histopathologic features of LTB-related ulcerative lesions included fewer granulomas and more areas with caseous necrosis. These lesions were more likely to have acid-fast bacilli detected with a Ziehl–Neelsen stain than exophytic lesions that rarely showed detectable bacilli.

A complete knowledge regarding the visual and morphologic features of LTB on laryngoscopy is needed for the early detection and diagnosis of LTB. Our study revealed the lesion sites, sizes, and morphologic features of LTB. These parameters were also correlated with patient clinical symptoms. Future studies are needed to support and expand the results of this retrospective study.
Long-term risk of pneumothorax in asthmatic children
Authors: Lin Chien-Heng , Lin Cheng-Li , Lin Wei-Ching , Wei Chang-Ching
Published: December 2020

Pneumothorax is a life-threatening complication during acute asthma attack. However, long-term risk of pneumothorax in asthmatic children remains unknown.

In this retrospective cohort study, 333,657 children were defined as asthma cohort and a 1:1 matched non-asthma cohort were generated from 2000 to 2011. At the end of 2012, the incidence of pneumothorax in asthma and non-asthma cohorts and asthma to non-asthma hazard ratios (HRs) with confidence intervals (CIs) of pneumothorax were analyzed.

The incidence of pneumothorax was 1.35-fold higher in the asthma cohort than that in the non-asthma cohort. The asthma to non-asthma HRs of pneumothorax were higher in children younger than 6 years (1.76, 95% CI: 1.21–2.57) and in girls (2.27; 95% CI: 1.23–4.16). The HRs of pneumothorax were higher in asthmatic children with more asthma-related out-patient clinic visits/per year (>5 visits; HR: 2.81; 95% CI: 1.79–4.42), more emergency department visits/per year (>4 visits; HR: 1.68; 95% CI: 1.02–2.78), and longer hospitalization days due to asthma (>4 days; HR: 3.42; 95% CI: 1.52–6.94) (P < .0001, the trend test).

Asthmatic children had greater risk for pneumothorax, particularly in young children and in those with severe and uncontrolled asthma.
Effects of neuro-adaptive electrostimulation therapy on pain and disability in fibromyalgia
Authors: Udina-Cortés Carlos , Fernández-Carnero Josué , Romano Alberto Arribas , Cuenca-Zaldívar Juan Nicolás , Villafañe Jorge Hugo , Castro-Marrero Jesús , Alguacil-Diego Isabel Maria
Published: December 2020

Background:

To evaluate the effectiveness of non-invasive neuro-adaptive electrostimulation (NAE) therapy for treating chronic pain and disability in patients with fibromyalgia.

Method/design:

A prospective, randomized, sham-controlled study was conducted in 37 women with fibromyalgia. Participants were randomly assigned to receive either active NAE (n = 20) or stimulation with a sham device (n = 17). Participants in the experimental arm received eight 30-minute sessions over 4 weeks (2 sessions per week). The sham group received eight 30-minute sessions of sham stimulation. Therapeutic effects on pain relief, disability, and quality of life were evaluated using outcome measures at baseline, at 4 weeks, and after 3 months’ follow-up.

Results:

The findings indicated a significant reduction of pain in the active NAE group compared with the sham group immediately post-intervention, with a difference on the Visual Analog Scale (VAS) of 3 points (P = .001), and at 3 months’ follow-up (P = .02). There were significant intragroup differences between the groups (P < .05) at post-intervention. After the intervention, both groups presented significant reductions on the Fibromyalgia Impact Questionnaire (FIQ) with respect to baseline (P = .004), but not at the 3-month follow-up. In the conditioned pain modulation (CPM) in thumb variable we found significant differences between the groups at the 3-month follow-up (P = .02). No additional benefits for conditioned pain modulation and disability were observed between groups at the 3-month follow-up. Furthermore, anxiety/depression and catastrophizing improved in both groups, but no differences between groups were found.

Conclusions:

In this fibromyalgia cohort, NAE therapy significantly improved pain and quality of life at 4 weeks, but not at 3-month follow-up, compared with the sham stimulation group. Future investigations are needed in larger populations to confirm these findings.
Do patients with gestational diabetes mellitus and their own blood glucose meter have better pregnancy outcomes than those not using a glucose meter?
Authors: Dong Wei , Li Yan , Sun Jun-jie , Chen Li-hong , Guo Jia , Dong Ling
Published: December 2020

To compare pregnancy outcomes between patients with gestational diabetes mellitus (GDM) with and without their own blood glucose meter.

We conducted a retrospective-cohort study of 835 women with GDM at the Second Hospital of Tianjin Medical University, Tianjin, China from 1 January 2016 to 31 December 2018. Perinatal outcomes of these patients were monitored and collected in the Tianjin Maternal and Child Health System. Each patient was advised by a certified clinical nutritionist regarding dietary analysis and lifestyle recommendations. All pregnant women with GDM were divided into the following 2 groups according to whether they had their own blood glucose meter: women with self-measured blood glucose levels with a routine obstetric examination in the study group (n = 424); and those with non-self-measured blood glucose levels with a double obstetric examination in the control group (n = 411). Maternal and fetal pregnancy outcomes were compared between these 2 groups. According to different self-management modes, the women were also divided into eight subgroups to compare blood sugar control and compliance with recommended insulin therapy.

The cesarean section rate was significantly lower in the study group than in the control group (P < .05). The prevalence of large-for-gestational age (P < .05) and macrosomia was significantly lower in the study group than in the control group (both P < .05). The prevalence of appropriate-for-gestational age was significantly higher in the study group than in the control group (P < .05). Birth weight was significantly lower in the study group than in the control group (P < .05). The mean times for blood sugar control and from the doctor recommendation for insulin treatment to the patient compliance in the study group were significantly shorter than those in the control group (both P < .05). The proportion of insulin required in the study group was significantly lower than that in the control group (P < .05). There were no significant differences in the time of controlling blood sugar and compliance among the 4 subgroups of the study group. However, subgroups with a dietary diary in the control group were better.

Self-monitoring blood sugar plus a routine obstetric examination can help patients with GDM control blood sugar, even without dietary diaries and treadmills. In addition to increasing the number of obstetric examinations, recording dietary diaries is helpful for controlling blood sugar in patients with GDM who are unwilling to measure blood sugar by themselves.
Recurrence pattern and its predictors for advanced gastric cancer after total gastrectomy
Authors: Jiao Xuguang , Wang Yu , Wang Feng , Wang Xinbo
Published: December 2020

This study aimed to investigate the recurrence patterns of advanced gastric cancer (AGC) after curative total gastrectomy and further explore predictors for each pattern of recurrence.

Data of 299 AGC patients between 2010 and 2014 were retrospectively analyzed to investigate the clinicopathologic factors affecting the recurrence pattern of AGC patients underwent curative total gastrectomy.

Sixty-eight (22.7%) AGC patients had recurrence after total gastrectomy. Distant metastasis (DM) was the most prevalent pattern with 29 (42.6%) cases, followed by peritoneal recurrence (PR) with 25 (36.8%) patients, and locoregional recurrence (LR) occurred in 23 (33.8%) patients. The recurrence rates within 2 and 5 years were 77.9% and 97.1%. Extent of lymphadenectomy (P < .001, χ
2 = 17.366), depth of tumor invasion (P < .001, χ
2 = 21.638), lymph node metastasis (P = .046, χ
2 = 9.707), and number of negative lymph nodes (P = .017, χ
2 = 2.406) were associated with tumor recurrence by univariate analysis. Multivariate analyses revealed that the extent of lymphadenectomy (P = .034, 95% CI: 1.074–6.414) and T4b status (P = .015, 95% CI: 0.108–0.785) were independent predictors for LR; histological type (P = .041, 95% CI: 0.016–0.920) and T4b status (P = .007, 95% CI: 0.102–0.690) for PR; and pN status (P = .032) for DM.

In AGC patients following total gastrectomy, recurrent predictors various among locoregional, peritoneal, and distant recurrence. Recurrent predictors of tumor invasion, lymph node metastasis, and histological type could guide follow-up and risk-oriented adjuvant treatment, extended lymphadenectomy was considered to reduce LR of AGC patients after curative total gastrectomy.
A randomized controlled study for the treatment of middle-aged and old-aged lumbar disc herniation by Shis spine balance manipulation combined with bone and muscle guidance
Authors: Xu Jinhai , Ding Xing , Wu Jinze , Zhou Xiaoning , Jin Kun , Yan Ming , Ma Junming , Wu Xuequn , Ye Jie , Mo Wen
Published: December 2020

Ninety percent of elderly patients with lumbar disc herniation (LDH) have problems with the mechanics of the spine and muscle tissue. Shi-style spine balance manipulation combined with guidance (Daoyin) of muscle and bone as an alternative therapy for LDH can tone the muscle groups around the spine and maintain optimal mechanical and static sagittal balance of the spine. This study will be performed to investigate the effect of a combination of Shi-style spine balance manipulation and Daoyin therapy on LDH in middle-aged and elderly patients. In this non-blinded, randomized controlled trial, 72 eligible patients will be randomly divided into a treatment group (Shi-style spine balance manipulation combined with Daoyin therapy) and a control group (lumbar mechanical traction). Before and after the intervention, lumbar X-ray and magnetic resonance imaging examinations will be performed to observe the sagittal balance parameters of the spine and pelvis and the lumbar muscle strength. The visual analog scale score, Oswestry disability index score, and pressure pain threshold will be evaluated at baseline and at 2, 4, 12, and 24 weeks. During the treatment period, any signs of acute adverse events, such as paralysis of the lower extremities or cauda equina syndrome, will be recorded at each visit. Although Shi-style spine manipulation combined with Daoyin therapy has been used in the treatment of LDH in middle-aged and elderly people in China for many years, there is no consensus on its effectiveness. This experiment will provide convincing evidence of the efficacy of Shi-style spine manipulation combined with Daoyin therapy in the treatment of LDH in middle-aged and elderly people.
Efficacy and safety of pasireotide for Cushing's disease
Authors: Zhao Nairui , Yang Xinxin , Li Cuiliu , Ma Jie , Yin Xiuping
Published: December 2020

Background:

Cushing's disease (CD) is associated with increased risk of mortality, myocardial infarction, stroke, peptic ulcers, fractures and infections. The prevalence of CD is nearly 40 per million and higher in women than in men. When surgery has failed, is not feasible, or has been refused, pharmacotherapy can be considered a valuable option. Pasireotide is the first medical therapy officially approved for adult patients with CD. We will conduct a comprehensive systematic review and meta-analysis to systematically evaluate the efficacy and safety of pasireotide for CD.

Methods:

Five English databases (PubMed, Web of Science, Embase, Cochrane Library, and OVID) and 3 Chinese databases (China National Knowledge Infrastructure, China Science and Technology Journal Database, and Chinese Biomedical Literature Database) will be searched from their respective inception of databases to December 2020. Two reviewers will select articles, extract data and assess the risk of bias independently. Any disagreement will be resolved by discussion with the third reviewer. Review Manager 5.3 software will be used for data synthesis. The Cochrane risk of bias assessment tool will be used to evaluate the bias risk.

Results:

This systematic review and meta-analysis will conduct a comprehensive literature search and provide a systematic synthesis of current published data to explore the efficacy and safety of pasireotide for CD.

Conclusions:

This systematic review and meta-analysis will provide clinical evidence for the efficacy and safety of pasireotide for CD, and inform our understanding of the value of pasireotide in improving CD clinical signs and symptoms. The conclusions drawn from this study may be beneficial to patients, clinicians, and health-related policy makers.

Study registration number:

INPLASY2020110070.
The relationship between hepatoma-derived growth factor and prognosis in non-small cell lung cancer
Authors: Koh Hyun Min , Hyun Chang Lim , Jang Bo Gun , Lee Hyun Ju
Published: December 2020

Background:

Hepatoma-derived growth factor (HDGF) promotes cancer progression and metastasis by interacting with vascular endothelial growth factor, thereby inducing epithelial-to-mesenchymal transition and angiogenesis. Recent studies have correlated increased HDGF levels with poor prognosis in various malignancies, including lung cancer. This meta-analysis systematically assessed the prognostic significance of HDGF expression in patients with non-small cell lung cancer (NSCLC).

Methods:

Eligible studies were identified by searching literature in PubMed, Embase, Scopus, and the Cochrane library until June 2020. The pooled hazard ratio (HR) or odds ratio (OR) with 95% confidence interval (CI) was determined to assess the relationship between HDGF expression and clinical outcome in patients with NSCLC.

Results:

The pooled HRs between high HDGF expression and clinical outcome were 2.20 (95% CI 1.75–2.76, P < .001) and 2.77 (95% CI 1.79–4.29, P < .001) for overall survival and disease-free survival, respectively. High HDGF expression was significantly correlated with a larger tumor size (OR 1.59, 95% CI 1.02–2.46, P = .040).

Conclusion:

HDGF expression is related to clinical outcome and may be a prognostic marker in patients with NSCLC.
Subarachnoid hemorrhage and COVID-19
Authors: Cezar-Junior Auricelio Batista , Faquini Igor Vilela , Silva José Laercio Junior , de Carvalho Junior Eduardo Vieira , Lemos Luiz Euripedes Almondes Santana , Freire Filho João Batista Monte , de Lira Filho Hetevaldo Tavares , Pontes Erton Cesar de Albuquerque , Almeida Nivaldo Sena , Azevedo-Filho Hildo Rocha Cirne
Published: December 2020

Some evidences suggest the involvement of the central nervous system in patients infected with SARS-CoV-2. We aim to analyze possible associations between coronavirus disease 2019 (COVID-19) pandemic and spontaneous subarachnoid hemorrhage (SAH), in a comprehensive neurological center.

We conducted a retrospective case series of 4 patients infected by COVID-19, who developed spontaneous SAH. Clinical data were extracted from electronic medical records.

Between March 24, 2020, and May 22, 2020, 4 cases (3 females; 1 male) of SAH were identified in patients infected with SARS-CoV-2, in a comprehensive neurological center in Brazil. The median age was 55.25 years (range 36 -71). COVID-19-related pneumonia was severe in 3 out of 4 cases, and all patients required critical care support during hospitalization. The patients developed Fisher grade III and IV SAH. Digital subtraction angiography (DSA) was performed in 3 of the 4 patients. However, in only 1 case, an aneurysm was identified. Inflammatory blood tests were elevated in all cases, with an average D-dimer of 2336 μg/L and mean C-reactive protein (CRP) of 3835 mg/dl The outcome was poor in the majority of the patients, with 1 death (25%); 2 (50%) remained severely neurologically affected (mRS:4); and 1 (25%) had slight disability (mRS:2).

This study shows a series of 4 rare cases of SHA associated with COVID-19. The possible mechanisms underlying the involvement of SARSCoV-2 and SHA is yet to be fully understood. Therefore, SHA should be included in severe neurological manifestations in patients infected by this virus.
Modular transitional nursing intervention improves pain-related self-management for cancer patients
Authors: Miao Beibei , Sun Yali , Gong Ling , Liu Wei
Published: December 2020

Objective:

To explore the effect of modular transitional nursing intervention on the improvement of self-management of the patients with cancer pain.

Method:

This study will be conducted from March 2021 to May 2022 at Affiliated Hospital of Beihua University. The experiment was granted through the Research Ethics Committee of Affiliated Hospital of Beihua University (4348–019). Eighty patients are analyzed in our study. The patients will be included if they are between 18 and 70 years old and are diagnosed with cancer, the pain intensity score on moderate level, the pain lasts for more than 3 days, and the patients who have signed the written informed consent. While the patients will be excluded if they have a documented history of drug or alcohol abuse, and patients with limited performance, and patients have a surgery in the past 3 days. The primary result mainly expresses as intergroup differences in self-management disorders (Barriers Questionnaire-II) associated with the cancer pain. And the secondary results include the quality of life (QOL) and pain intensity. All the analyses are implemented with SPSS for Windows Version 20.0.

Results:

Table 1

will show the clinical outcomes between the 2 groups.

Conclusion:

A modular transitional nursing intervention appears to reduce pain in cancer patients.

Trial registration number:

researchregistry6262.
Autonomous robots: a new reality in healthcare? A project by European Association of Urology-Young Academic Urologist group
Authors: Gómez Rivas Juan , Toribio-Vázquez Carlos , Taratkin Mark , Marenco Jose Luis , Grossmann Rafael
Published: December 2020

Purpose of review

Artificial intelligence appears as a potential revolution in the general process of medical training, disease diagnosis and treatment. A novel disruptive technology of the 21st century will be ‘learner’ robots from artificial intelligence systems able to use all the combination of the available knowledge in medical repositories to give the best standard of care.

Recent findings

The autonomy level of robots depends on three factors: the complexity of the task; the environment in which the robot operates, and the required level of human–robot interaction. Autonomous robots in healthcare may be classified in delivery, nurse, and surgical robots. The increasing capability of robots to perform independent actions and complex tasks raises responsibility and accountability issues in a wide variety of application domains. Ethical analyses of these issues are underway and are mostly oriented toward the development of ethical policies requiring a law frame on robotic autonomous behaviors.

Autonomous robots have the potential to improve current medical practice offering a more secure, reliable, and reproducible medicine. Many advancements are required for these new technologies to be fully integrated. Furthermore, the ethical implications of these technologies are yet to be evaluated.
Alternative Birth Plans and Unintended Maternal and Neonatal Consequences: A Review of the Literature
Authors: Whittington Julie R. , Rumpel Jennifer A. , Shnaekel Kelsey L. , Peeples Sara E. , Magann Everett F. , Burke Bryan L.
Published: December 2020

Importance

Birth plans are an important part of childbirth preparation for many women.

Objective

The aim of this review was to discuss some common requests, specifically home birth, water birth, placentophagy, lotus birth, vaccination refusal, and vaginal seeding, including evidence-based recommendations, perceived benefits, and potential maternal and neonatal consequences.

Evidence Acquisition

A literature search for each topic was undertaken using PubMed and Web of Science. For the home birth section, the MeSH terms home AND birth OR childbirth AND outcomes OR complications OR recommendations OR guidelines were used. For the vaccination section, birth OR childbirth OR maternal AND vaccination refusal were searched. For the remainder of the sections, umbilical cord AND nonseverance OR placentophagy OR vaginal seeding OR lotus birth were searched. A total of 523 articles were identified. The abstracts were reviewed by 2 authors (J.R.W. and J.A.R.); 60 of these articles were selected and used for this review.

Results

Home birth is currently not recommended in the United States. Immersion in water for labor is acceptable, but delivery should not occur in water. Placentophagy and lotus birth should be discouraged because of risk of neonatal infection. Vaccines should be administered in accordance with national guidelines. Vaginal seeding should be discouraged until more is known about the practice.

Conclusion and Relevance

These evidence-based recommendations provide clear guidance for physicians so that the birthing experience can be enhanced for both mother and neonate without compromising safety.

Relevance Statement

This is an evidence-based literature review of alternative birth plans and recommendations for directive counseling.

Target Audience

Obstetricians, midwives, family practitioners, pediatricians, and nurse practitioners who provide obstetric and/or pediatric care.

Learning Objectives

After completing this activity, the learner should be better able to counsel patients on the risks and benefits of alternative birth plans; distinguish which maternal requests are associated with increased risk of neonatal infections; and risk stratify patients for home birth and identify absolute contraindications to home birth.