bluuebunny/crossref_metadata_2025 huggingface dataset:
Metabolic syndrome in Zambian adults with human immunodeficiency virus on antiretroviral therapy
Authors: Hamooya Benson M. , Mulenga Lloyd B. , Masenga Sepiso K. , Fwemba Isaac , Chirwa Lameck , Siwingwa Mpanji , Halwiindi Hikabasa , Koethe John R. , Lipworth Loren , Heimburger Douglas C. , Musonda Patrick , Mutale Wilbroad
Published: April 2021

Metabolic syndrome (MetS) is a constellation of factors including hypertension, abdominal obesity, dyslipidemia, and insulin resistance that separately and together significantly increase risk for cardiovascular disease (CVD) and diabetes. In sub-Saharan Africa, with a substantial burden of human immunodeficiency virus (HIV) and increasing prevalence of CVD and diabetes, there is a paucity of epidemiological data on demographic, laboratory, and clinical characteristics associated with MetS among people with HIV (people with human [PWH]). Therefore, this study aimed to determine the burden and factors influencing MetS in antiretroviral therapy (ART)-experienced individuals in Zambia.

We collected cross-sectional demographic, lifestyle, anthropometric, clinical, and laboratory data in a cohort of ART-experienced (on ART for ≥6 months) adults in 24 urban HIV treatment clinics of Zambia between August, 2016 and May, 2020. MetS was defined as having ≥3 of the following characteristics: low high density lipoprotein cholesterol (HDL-c) (<1.0 mmol/L for men, <1.3 for women), elevated waist circumference (≥94 cm for men, ≥80 cm for women), elevated triglycerides (≥1.7 mmol/L), elevated fasting blood glucose (≥5.6 mmol/L), and elevated blood pressure (BP) (systolic BP ≥130 or diastolic BP ≥85 mm Hg). Virological failure (VF) was defined as HIV viral load ≥1000 copies/mL. The following statistical methods were used: Chi-square test, Wilcoxon rank-sum test, and multivariable logistic regression.

Among 1108 participants, the median age (interquartile range [IQR]) was 41 years (34, 49); 666 (60.1%) were females. The prevalence of MetS was 26.3% (95% confidence interval [CI] 23.9–29.1). Age (adjusted odds ratio [OR] 1.07; 95% CI 1.04–1.11), female sex (OR 3.02; 95% CI 1.55–5.91), VF (OR 1.98; 95% CI 1.01–3.87), dolutegravir (DTG)-based regimen (OR 2.10; 95% CI 1.05–4.20), hip-circumference (OR 1.03; 95% CI 1.01–1.05), T-lymphocyte count (OR 2.23; 95% CI 1.44–3.43), high-sensitivity C-reactive protein (hsCRP) (OR 1.14; 95% CI 1.01–1.29), and fasting insulin (OR 1.02; 95% CI 1.01–1.04) were significantly associated with MetS.

Metabolic syndrome was highly prevalent among HIV+ adults receiving ART in Zambia and associated with demographic, clinical, anthropometric, and inflammatory characteristics. The association between MetS and dolutegravir requires further investigation, as does elucidation of the impact of MetS on ART outcomes in sub-Saharan African PWH.
Hoffa fracture combined with rotational dislocation of the knee joint
Authors: Huang Guanning , Zhang Minglei , Zhang Youjia , Wang Xukai , Zhang Mingran , Liu Guangyao
Published: April 2021

Rationale:

Hoffa fracture is a rare fracture confined to the coronal-plane involving femoral condyles. This occurs simultaneously with rotational dislocation of the knee joint is extremely rare. Up to now, there is no valid recommendation for the treatment of the Hoffa fracture.

Patient concerns:

A 50-year-old female patient broke her knee joint while skiing, experiencing severe pain in the right knee, which was swollen. She presented limited function of the knee and movement upon arrival in the emergency room.

Diagnosis:

Comminuted Hoffa fracture in the right knee associated with rotational dislocation in the knee joint

Interventions:

We treated the dislocated knee joint through manual reduction initially. During the operation, we used posterolateral approach to expose the fracture fragments, thereafter using headless compression screws and a buttress plate to provide sufficient stability for the fracture. Early postoperative rehabilitation was encouraged.

Outcomes:

The patient finally achieved fracture healing three months after operation. In addition, she achieved 0–130° range of function of the knee after four months post-operation, and the patient obtained a satisfactory prognosis after our treatment.

Lessons:

By using appropriate surgical approach to obtain enough exposure, headless compression screws and the buttress plate provided adequate stability during early active rehabilitation, which resulted in satisfactory results in the treatment of the injury. We reviewed literatures regarding the treatment of Hoffa fracture to demonstrate that our treatment was effective.
Opsoclonus-myoclonus syndrome with severe clinical course and beneficial outcome
Authors: Koziorowska-Gawron Ewa , Koszewicz Magdalena , Bladowska Joanna , Ejma Maria , Budrewicz Slawomir
Published: April 2021

Rationale:

Opsoclonus-myoclonus syndrome (OMS) is a rare immune-mediated movement disorder, mostly of paraneoplastic or idiopathic origin. The disease usually has an acute onset, serious course and leads rapidly to disability in adult patients. To the best of our knowledge, this is the fourth presented case of OMS with a severe course and complete reversibility of neurological symptoms in a pregnant woman. This report includes videos and a literature review.

Patient concerns:

A 30-year-old woman in the 12th week of pregnancy developed severe nausea and vomiting, after several days balance and gait disorders appeared. On admission to hospital, neurological examination revealed opsoclonus, dysarthria, myoclonic jerks with ataxia of the trunk and limbs with inability to sit, stand or walk.

Diagnosis:

Well-known causes of OMS were excluded. Although in our patient the idiopathic origin of the disorder was taken under consideration, diagnosis of opsoclonus-myoclonus related to the pregnancy was highly likely.

Interventions:

After administration of steroids and benzodiazepines the patient improved.

Outcomes:

In the 6th month of pregnancy, after termination of immunotherapy, she recovered completely and was able to sit, stand and walk independently. In the 39th week of pregnancy, she delivered a healthy child.

Lessons:

We confirm that understanding of clinical symptoms and rare causes of OMS contributes to early diagnosis and therapy, which ensures an optimal outcome. One probable cause of OMS could be a physiological change to immune system regulation during pregnancy. The relationship between OMS and pregnancy remains uncertain and needs further investigation.
Efficacy and safety of moxibustion for menstrual irregularities
Authors: Liu Li , Liu Min , Liu Meinian , Gui Yufang , Sun Lei , Zuo Xiaoyun
Published: April 2021

Background:

Menstrual irregularities (MI) is 1 of the most common clinical gynaecological diseases, with abnormal menstrual cycles, abnormal bleeding, and abdominal pain before or during menstruation as the main clinical manifestations. In modern medicine, abnormalities in the function of the pituitary gland, hypothalamus, and ovaries can affect menstruation. Currently, hormone levels in the body are mostly regulated by hormonal drugs, but these drugs can lead to hormonal imbalance, which can lead to adverse reactions. Many clinical studies have reported that moxibustion has a good effect on MI treatment, but there is no relevant systematic review. So the purpose of this study is to evaluate the effectiveness and safety of moxibustion in treating MI.

Methods:

The following 8 electronic databases will be searched, including PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Web of Science, Chinese Scientific Journal Database, Wanfang Database, and Chinese Biomedical Literatures Database from their inception to 1 December 2020 without any restrictions. Researchers retrieve the literature and extracted the data, evaluation of research methods, quality of literature. The outcomes will include total effective rate, incidence of any adverse events. We use the Cochrane Risk of a bias assessment tool to evaluate methodological qualities. Data synthesis will be completed by RevMan 5.3.0.

Results:

We will show the results of this study in a peer-reviewed journal.

Conclusions:

This meta-analysis will provide reliable evidence for treatment of menstrual irregularities.

INPLASY registration number:

INPLASY2020120042
Prognostic value of lactate dehydrogenase for melanoma patients receiving anti-PD-1/PD-L1 therapy
Authors: Xu Jun , Zhao Jianguo , Wang Jianfang , Sun Caiping , Zhu Xiaoling
Published: April 2021

Background:

Several studies indicate the level of pretreatment lactate dehydrogenase (LDH) may be associated with the prognosis of patients receiving immune checkpoint inhibitors targeting programmed death receptor-1 (PD-1)/programmed death ligand 1 (PD-L1) which had been reported to dramatically improve the survival of patients with advanced or metastatic melanoma; however, no consensus has been reached because the presence of controversial conclusions. This study was to perform a meta-analysis to comprehensively explore the prognostic values of LDH for melanoma patients receiving anti-PD1/PD-L1 monotherapy.

Methods:

A systematic electronic search in the databases of PubMed, EMBASE and the Cochrane library was performed to identify all related articles up to April, 2020. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were obtained to assess the prognostic values of pretreatment LDH in blood for overall survival (OS) and progression-free survival (PFS).

Results:

A total of 22 eligible studies involving 2745 patients were included. Of them, 19 studies with 20 results assessed the OS and the pooled analysis showed that an elevated pretreatment LDH level was significantly associated with a worse OS (HR = 2.44; 95% CI: 1.95–3.04, P < .001). Thirteen studies reported PFS and meta-analysis also revealed that a higher pretreatment LDH level predicted a significantly shorter PFS (HR, 1.61; 95% CI, 1.34–1.92; P < .001). Although heterogeneity existed among these studies, the same results were acquired in subgroup analyses based on sample size, country, study design, cut-off of LDH, type of PD-1/PD-L1 inhibitors and statistics for HRs (all HRs > 1 and P < .05).

Conclusion:

This meta-analysis suggests LDH may serve as a potential biomarker to identify patients who can benefit from anti-PD-1/PD-L1 and then schedule treatments.
Extensive analysis of the molecular biomarkers excision repair cross complementing 1, ribonucleotide reductase M1, β-tubulin III, thymidylate synthetase, and topoisomerase IIα in breast cancer
Authors: Li Juncheng , Sun Peng , Huang Tao , He Shengdong , Li Lingfan , Xue Gang
Published: April 2021

Excision repair cross complementing 1 (ERCC1), ribonucleotide reductase M1 (RRM1), β-tubulin III (TUBB3), thymidylate synthetase (TYMS), and topoisomerase IIα (TOP2A) genes have been shown to be associated with the pathogenesis and prognosis of various types of carcinomas; however, their roles in breast cancer have not been fully validated. In this study, we evaluated the correlations among these biomarkers and the associations between their expression intensity and the clinicopathological characteristics to investigate whether the above genes are underlying biomarkers for patients with breast cancer.

Ninety-seven tissue specimens collected from breast cancer patients. The expression levels of these biomarkers were measured by the multiplex branched DNA liquidchip (MBL) technology and clinicopathological characteristics were collected simultaneously.

The expression levels of ERCC1, TUBB3, TYMS, and TOP2A were significantly associated with the characteristics of menopausal status, tumor size, lymph node metastasis, hormone receptor status, triple-negative status, Ki-67 index, and epidermal growth factor receptor. The expression intensity of ERCC1 negatively associated with that of TUBB3 and TYMS, and positively associated with that of RRM1. The expression intensity of TOP2A positively associated with that of TYMS. Hierarchical clustering analysis and difference test indicated that breast cancer with higher levels of TUBB3, TYMS, and TOP2A, as well as lower levels of ERCC1 and RRM1 tended to have higher histological grade and Ki-67 index.

Our studies showed that ERCC1, TYMS, TUBB3, and TOP2A may be potential biomarkers for prognosis and individualized chemotherapy guidance, while there may be interactions between ERCC1 and RRM1, or TUBB3, or TYMS, as well as between TOP2A and TYMS in pathogenesis and development of breast cancer.
Pityriasis rosea Gibert triggered by SARS-CoV-2 infection
Authors: Birlutiu Victoria , Birlutiu Rares Mircea , Iancu Gabriela Mariana
Published: April 2021

Rationale:

Pityriasis rosea Gibert is an erythematous-papulosquamous dermatosis that frequently occurs in young adults. The etiopathogenesis of PR is still unknown, but is frequently associated with episodes of upper respiratory tract infections. It is likely that a new viral trigger of pityriasis rosea is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Patient concerns:

We present the case of a female patient in whom the diagnosis of pityriasis rosea led to the investigation and diagnosis of the SARS-CoV-2 infection. The patient presented to the Department of Dermatology for a 3 week duration of an extremely pruritic erythematous-squamous lesion, initially on the trunk and upper limbs, with extension to the lower limbs in the last week and the lesion respected the cephalic extremity, palms, and soles. One week before the rash, respiratory tract infection symptomatology was observed by the patient. At home, she underwent systemic treatment with antihistamines and topical medication with dermatocorticosteroids. The evolution was unfavorable, with the spread of the lesions and the accentuation of the pruritus.

Diagnoses:

Considering the actual epidemiological context, we performed a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay from nasal and pharyngeal swabs for coronavirus disease 2019 (COVID-19) to investigate the PR etiology. The patient had a positive RT-PCR result, and was confirmed with SARS-CoV-2 infection.

Interventions:

Treatment was initiated with systemic corticosteroid therapy - hydrocortisone hemisuccinate 200 mg/day for 7 days, and loratadine 10 mg 2 times a day. Also, topical medication with dermatocorticosteroids and emollients was associated.

Outcome:

Under the treatment that was initiated a partial remission of the lesions after 7 days was observed.

Lessons:

Our reported case adds to the other findings regarding the association of PR with SARS-CoV-2 infection, in the context of the pandemic, suggesting the need to test patients with PR skin lesions for SARS-CoV-2 infection.
Clinical efficacy of intravitreal aflibercept injection versus vitrectomy with panretinal photocoagulation for patients with proliferative diabetic retinopathy
Authors: Hu Yao , Shen Jinxia , Peng Yi
Published: April 2021

Background:

In the current literature, it is still controversial whether intravitreal aflibercept injection can provide better vision restoration compared with vitrectomy with panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR) patients. Given that there is no high-quality meta-analysis or review to incorporate existing evidence, the purpose of this study is to systematically review the level I evidence in the literature to ascertain whether intravitreal aflibercept injection can provide better vision restoration compared with vitrectomy with PRP for PDR patients.

Methods:

The systematic literature review is structured to adhere to PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses), which include requirements deemed essential for the transparent reporting of results. A systematic search will be performed in Web of Science, Embase, Scopus, Science Direct, Cochrane Library up to and inclusive of March 19, 2021. The method of data extraction will follow the approach outlined by the Cochrane Handbook for Systematic Reviews of Interventions. The primary outcome is change in best-corrected visual acuity. The secondary outcomes are change in area of neovascularization and change in area of retinal nonperfusion. Where disagreement occurs, this will be resolved through discussion. All outcomes are pooled on random-effect model. A P value of < .05 is considered to be statistically significant.

Results:

The results of our review will be reported strictly following the PRISMA criteria.

Conclusions:

The hypothesis of the study was that visual acuity recovery would be faster with vitrectomy because the blood is mechanically cleared during surgery.

Registration number:

10.17605/OSF.IO/NCAXW.
How to prophylactically alleviate postembolization syndrome following transarterial chemoembolization?
Authors: Pan Yi , Chang Rui , He Zhonglin , Hong Ming
Published: April 2021

Introduction:

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, and most patients in China are diagnosed at the intermediate or later stages, which is not suitable for the first line therapies. Transarterial chemoembolization (TACE) is a commonly selected therapeutic option for intermediate and later stage HCC in China, but patients often suffer from postembolization syndrome (PES), manifesting as fever, liver area pain, nausea, vomiting, paralyzed intestinal obstruction, and abdominal pain after TACE. We try to conduct a double blinded, randomized, placebo-controlled clinical trial to observe whether Chaihu Guizhi decoction (CGD), a classic traditional Chinese formula, could prophylactically alleviate the incidence of PES in HCC patients after TACE.

Methods:

Patients will be randomly assigned sequentially in a 1:1 ratio by using preformed randomization envelopes. After TACE procedures, patients in the treatment group will be administrated with Chinese herbal formula CGD, and patients in the control group with CGD simulations, twice a day, continuously for 7 days. The outcomes are the incidence of PES hospitalization and, complications. SPSS version 22 (IBM, Chicago, IL) will be used for the data, and a P < .05 will be considered statistically significant.

Conclusions:

The findings will explore the prophylactic effect of CGD in alleviating the incidence of PES following TACE in HCC patients.

Trial registration:

OSF Registration number: DOI 10.17605/OSF.IO/FKRSN
Comparison of outcomes of laser refractive surgery (LRS) alone and LRS with laser asymmetric keratectomy in patients with myopia
Authors: Min Ji Sang , Min Byung Moo
Published: April 2021

To compare and analyze the postoperative 1-year outcomes of laser refractive surgery (LRS) alone vs LRS with laser asymmetric keratectomy (LAK), in patients with myopia, for preventing and resolving LRS complications.

This retrospective study compared the preoperative and 1-year postoperative outcomes between the control and comparison groups using a sum of deviations in corneal thickness in 4 directions >80 μm. The control group included 41 patients with myopia (41 eyes) who underwent LRS. The comparison group included 33 patients (33 eyes) who received LAK-linked LRS. Age, spherical equivalent (SE), sphere, cylinder, uncorrected distance visual acuity (UDVA), pupil size, kappa angle, central corneal thickness, corneal irregularity in the 3.0 mm zone on Orbscan maps (SUM), distance between the maximum posterior elevation (best-fit-sphere) and the visual axis (DISTANCE), postoperative blurring scores, frequency of postoperative myopic regression, and efficiency index were compared.

Preoperative age (P = .198), SE (P = .686), sphere (P = .562), cylinder (P = .883), UDVA (P = .139), pupil size (P = .162), kappa angle (P = .807), central corneal thickness (P = .738), corneal irregularity (P = .826), SUM (P = .774), and DISTANCE (P = .716) were similar between the 2 groups. The 1-year postoperative SE (P = .024), sphere (P = .022), corneal irregularity (P = .033), SUM (P = .000), DISTANCE (P = .04), blurring scores (P = .000), and frequency of postoperative myopic regression (P = .004) were significantly decreased in the comparison group compared to the control group. UDVA (P = .014) and the efficiency index (P = .035) were higher in the comparison group.

LAK with LRS improved corneal symmetry by reducing the SUM and DISTANCE. UDVA and efficiency index were also improved and blurring and myopic regression were reduced postoperatively.
Frequent inappropriate implantable cardioverter defibrillator therapy was determined to be dual atrioventricular nodal non-reentrant tachycardia
Authors: Ma Chengming , Yin Xiaomeng , Xia Yunlong , Li Wenwen , Gao Lianjun , Dai Shiyu , Yu Xiaohong
Published: April 2021

Rationale:

Dual atrioventricular node non-reentrant tachycardia (DAVNNRT) is a rare arrhythmia. We present a case of inappropriate implantable cardioverter defibrillator (ICD) therapy caused by DAVNNRT. DAVNNRT is easily misdiagnosed as atrial fibrillation and is often identified as ventricular tachycardia (VT) by the supraventricular tachycardia-ventricular tachycardia (SVT-VT) discriminator of the ICD.

Patient concerns:

A 73-year-old man with ischemic heart disease (IHD) presented with palpitations accompanied by dyspnea and syncope. Frequent multifocal premature ventricular beats and non-sustained ventricular tachycardia were observed on ambulatory electrocardiography. The left ventricular ejection fraction decreased to 32%.

Diagnosis:

He was diagnosed with IHD, heart failure with reduced ejection fraction (HFrEF), and VT.

Interventions

: Initially, the patient received a single-chamber ICD implantation for secondary prevention of sudden death. He then suffered from inappropriate anti-tachycardia pacing (ATP)/shock therapy many times after the procedure. DAVNNRT was confirmed in an electrophysiology study (EPS), and radiofrequency ablation of the slow pathway successfully terminated this tachycardia.

Outcomes:

No episode of inappropriate ICD therapy or tachycardia occurred during the follow-up.

Lessons:

In conclusion, it is essential to have a full understanding of DAVNNRT and eliminate slow pathways for patients with DAVNNRT and be prepared to implant an ICD.
De Novo mutation of FOXF1 causes alveolar capillary dysplasia with misalignment of pulmonary veins
Authors: Deng Lili , Liu Xingzhu , Min Jieqing , Su Zhongjian , Yang Yanfei , Ge Liping , Yang Zuozhen , Li Bin , Zhang Xing
Published: April 2021

Rationale:

Alveolar capillary dysplasia with misalignment of the pulmonary veins (ACD/MPV) is a rare congenital malformation in neonates that results in severe respiratory distress and pulmonary hypertension. ACD/MPV is caused by mutations in the FOXF1 gene. Herein, a new case of a girl with ACD/MPV carrying a novel pathogenic variant of FOXF1 was reported.

Patient concerns:

A 3-month-old Chinese girl was admitted to the hospital presenting a complaint of cyanosis for 10 days and respiratory distress for 2 days. The history of foreign body inhalation was denied.

Diagnoses:

Blood routine, liver and kidney function, electrolytes, type B natriuretic peptide, electrocardiogram, cardiac computed tomography (CT), and echocardiography were done after admission. Dysplasia of the alveolar and the left upper pulmonary vein was displayed through cardiac CT. Echocardiography showed atrial septal defect, tricuspid valve malformation, and pulmonary hypertension. Sequence analysis of FOXF1 from genomic deoxyribonucleic acid (DNA) revealed that the patient was heterozygous for a novel missense variant (c.418 C>T, p.Pro140Gly). Furthermore, genetic analysis of both parents confirmed the de novo occurrence of the variant. Conservation analysis showed that the locus was highly conserved across species. Then, ACD/MPV was a clinical diagnosis.

Interventions:

After admission, nasal catheter oxygen inhalation, cefazoxime sodium, furosemide diuretic, milrinone lactate, and Bosentan were given to the patient.

Outcomes:

After 6 days of hospitalization, the patient's condition did not improved, the parents gave up treatment and discharged. The patient died half a month after discharge.

Lessons:

ACD/MPV is a rare congenital malformation with a poor prognosis. A new de novo mutation of FOXF1 was found in our case. Non-invasive methods such as DNA sequencing and FOXF1 analysis are helpful in the clinical diagnosis of ACD/MPV especially in early infants with respiratory distress and pulmonary hypertension.
Effects of moxibustion for COVID-19 convalescence
Authors: Zhou Yue , Yan Xiao , Ma Fengjun , Xia Qingchang , Lu Yunping , Li Wenyuan , Song Shuai , Sun Yan , Ma Yuxia , Ma Yuning
Published: April 2021

Background:

Coronavirus disease 2019 (COVID-19) is still spreading around the world. Moxibustion, as a significant therapy in traditional Chinese medicine (TCM), has been widely used to treat COVID-19, especially in recovery period. The study will aim to assess the efficacy and safety of moxibustion for COVID-19 convalescence.

Methods:

We will systematically search the relevant randomized controlled trials in the 7 databases from inception to February 2021, including PubMed, MEDLINE, Embase, Cochrane Clinical Trials Database, Web of Science, China National Knowledge Infrastructure and Chinese Biomedical Literature Database. No language and publication status restrictions will be applied. Two reviewers will independently conduct and screen all included studies and the meta-analysis will be performed with RevMan V5.3 (The Cochrane Collaboration, Oxford, England).

Results:

The study will provide a high-quality convincing assessment of the efficacy and safety of moxibustion for the treatment of COVID-19 convalescence, which will be published in a peer-reviewed journal.

Conclusion:

Our study will give more comprehensive evidence of the effectiveness of moxibustion for COVID-19 convalescence.

Trial registration number:

CRD42021230364.
Clinicopathological and prognostic significance of circRNAs in lung cancer
Authors: Zheng Yuxuan , Hu Jie , Li Yishuai , Hao Ran , Qi Yixin
Published: April 2021

Background:

Circular RNAs (circRNAs) regulate multiple pathways during lung cancer pathogenesis. Apart from functional significance, many circRNAs have been shown to be associated with clinicopathological characteristics and predict lung cancer prognosis. Our aim is to summarize the expanding knowledge of clinical roles of circRNAs in lung cancer.

Methods:

A thorough search of literature was conducted to identify articles about the correlation between circRNA expression and its prognostic and clinicopathological values. Biological mechanisms were summarized.

Results:

This study included 35 original articles and 32 circRNAs with prognostic roles for lung cancer. Increased expression of 25 circRNAs and decreased expression of 7 circRNAs predicted poor prognosis. For non-small cell lung cancer, changes of circRNAs were correlated with tumor size, lymph node metastasis, distant metastasis, tumor node metastasis (TNM) stage, and differentiation, indicating the major function of circRNAs is to promote lung cancer invasion and migration. Particularly, meta-analysis of ciRS-7, hsa_circ_0020123, hsa_circ_0067934 showed increase of the 3 circRNAs was associated with positive lymph node metastasis. Increase of ciRS-7 and hsa_circ_0067934 was also related with advanced TNM stage. The biological effects depend on the general function of circRNA as microRNA sponge.

Conclusions:

CircRNAs have the potential to function as prognostic markers and are associated with lung cancer progression and metastasis.
Artificial intelligence with kidney disease
Authors: Park Sihyung , Park Bong Soo , Lee Yoo Jin , Kim Il Hwan , Park Jin Han , Ko Junghae , Kim Yang Wook , Park Kang Min
Published: April 2021

Background:

Artificial intelligence (AI) has had a significant impact on our lives and plays many roles in various fields. By analyzing the past 30 years of AI trends in the field of nephrology, using a bibliography, we wanted to know the areas of interest and future direction of AI in research related to the kidney.

Methods:

Using the Institute for Scientific Information Web of Knowledge database, we searched for articles published from 1990 to 2019 in January 2020 using the keywords AI; deep learning; machine learning; and kidney (or renal). The selected articles were reviewed manually at the points of citation analysis.

Results:

From 218 related articles, we selected the top fifty with 1188 citations in total. The most-cited article was cited 84 times and the least-cited one was cited 12 times. These articles were published in 40 journals. Expert Systems with Applications (three articles) and Kidney International (three articles) were the most cited journals. Forty articles were published in the 2010s, and seven articles were published in the 2000s. The top-fifty most cited articles originated from 17 countries; the USA contributed 16 articles, followed by Turkey with four articles. The main topics in the top fifty consisted of tumors (11), acute kidney injury (10), dialysis-related (5), kidney-transplant related (4), nephrotoxicity (4), glomerular disease (4), chronic kidney disease (3), polycystic kidney disease (2), kidney stone (2), kidney image (2), renal pathology (2), and glomerular filtration rate measure (1).

Conclusions:

After 2010, the interest in AI and its achievements increased enormously. To date, AIs have been investigated using data that are relatively easy to access, for example, radiologic images and laboratory results in the fields of tumor and acute kidney injury. In the near future, a deeper and wider range of information, such as genetic and personalized database, will help enrich nephrology fields with AI technology.
Adjuvant psychotherapy in early-stage bipolar disorder
Authors: Chen Qianfang , Zhou Yuanyue , Lv Huifen , Ma Caie
Published: April 2021

Objective:

There is no systematic review or meta-analysis to evaluate the efficacy of adjuvant psychotherapy in early-stage bipolar disorder. Therefore, the goal of this meta-analysis is to examine the evidence supporting psychotherapy as an efficacious approach to treating bipolar disorder.

Methods:

Seven electronic databases including Web of Science, Embase, PubMed, Wanfang Data, Scopus, Science Direct, Cochrane Library were searched in March 2021 by two independent reviewers. Data extraction was performed independently, and any conflict was resolved before final analysis. Only randomized clinical trials were included in this study. The trial entails 1 primary outcome measure (relapse) and several secondary outcome measures: time to relapse, relapse rate, days missed at work/school (record, interview), and social functioning level. The risk of bias assessment of the included studies was performed by 2 authors independently using the tool recommended in the Cochrane Handbook for Systematic Reviews of Interventions.

Results:

We hypothesized that combined psychotherapy and pharmacological interventions would be superior to pharmacological interventions alone regarding the time to relapse into a manic or depressive episode.

Conclusion:

This study expects to provide credible and scientific clinical evidence for the efficacy and safety of combined psychotherapy and pharmacological interventions in the treatment of bipolar disorder.

OSF registration number:

10.17605/OSF.IO/ZGS6W
Expression and significance of PD-1 and PD-L1 in patients with recurrent spontaneous abortion
Authors: Li Tao , Chen Yihong , Lai Yi , He Guoqian , He Guolin
Published: April 2021

Background:

Recurrent spontaneous abortion (RSA) accounts for the most common complication of early pregnancy in humans. As an immune checkpoint pathway, programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) can be exploited by tumor cells to evade immuno-surveillance. Many studies have shown that the expression of PD-1/PD-L1 is involved in RSA. However, the correlation between the expression of PD-1/PD-L1 and RSA is still controversial. We conducted meta-analysis to further explore the correlation between the expression of PD-1/PD-L1 and RSA, to provide a basis for clinical prevention and treatment.

Methods:

We will search PubMed, Embase, Web of Science, Google Scholar, Chinese National Knowledge Infrastructure, Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database for related published studies before February 2021. Two review authors will search and assess relevant studies independently. Case control studies and cohort studies will be included. The Revman 5.3 software was applied to carry out the meta-analysis for the included literature.

Results:

The findings of this systematic review will be disseminated in a peer-reviewed publication and/or presented at relevant conferences.

Conclusion:

This study will provide a new theoretical basis for the prevention and treatment of RSA.

Trial registration number:

DOI 10.17605/OSF.IO/CZD23.

Ethics and dissemination: Formal ethical approval is not required, as the data are not individualized.
Prognostic value of aldo-keto reductase family 1 member B10 (AKR1B10) in digestive system cancers
Authors: Liu Rongqiang , Zheng Shiyang , Yang Cui yan , Yu Yajie , Peng Shengjia , Ge Qianmin , Lin Qi , Li Qiuyu , Shi Wenqing , Shao Yi
Published: April 2021

Background:

Numbers of studies have reported that the expression of aldo-keto reductase family 1 member B10 (AKR1B10) is abnormal in digestive system cancers, and could be used as a prognostic biomarker. However, the results are argued. Therefore, we conduct a meta-analysis to comprehensively evaluate the prognostic value of high AKR1B10 expression for overall survival (OS), disease specific survival (DSS), and disease-free survival/recurrence-free survival (DFS/PFS) in digestive system cancers.

Methods:

Hazard ratios (HRs) with its 95% confidence intervals (CIs) were calculated to assess the prognostic value of AKR1B10 by using the random effects model. The STATA version 12.0 software were used to perform all the analyses.

Results:

Eleven articles including 1428 patients involved in this meta-analysis. The pooled analysis suggested that high AKR1B10 expression was not associated with OS (HR: 1.18; 95% CI: 0.69–2.00) and DFS/PFS (HR: 1.08, 95% CI: 0.67–1.76) in digestive system cancers. However, Further analysis revealed that high AKR1B10 expression indicated poor OS in oral squamous cell carcinomas (OSCC) (HR: 2.92, 95% CI: 1.86–4.58) and favorable DSS in hepatocellular carcinoma (HCC) (HR: 0.71, 95% CI: 0.52–0.97).

Conclusions:

The prognostic value of high AKR1B10 expression varied in different types of digestive system cancers. Further studies exploring the prognostic role of AKR1B10 in digestive system cancers are needed.
Supraglottic foreign body in a woman with Down's syndrome and congenital heart disease
Authors: Liu Yuchao , Liu Zijia , Zha Yang , Yu Xuerong
Published: April 2021

Rationale:

An impacted foreign body (FB) in the larynx of an adult is a rare but potentially life-threatening occurrence. Patients with Down's syndrome (DS) are vulnerable to airway FB. However, the anesthesia for FB removal can be challenging. This report describes a case in which a FB was impacted between the vestibular folds in an adult with DS, congenital heart disease, and a difficult airway.

Patient concerns:

A 41-year-old woman swallowed a piece of sharp-tipped wooden skewer presented with a sudden onset of aphonia, dysphagia, and an acute sore throat without respiratory difficulty. The patient had DS, congenital heart disease, pulmonary arterial hypertension, and severe obstructive sleep apnea–hypopnea syndrome. The airway evaluation indicated that ventilation and intubation would be difficult due to retrognathia, macroglossia, adenotonsillar hypertrophy, and Mallampati's classification III.

Diagnosis:

The clinical symptoms and laboratory examination confirmed FB penetrated between the vestibular folds.

Interventions:

After careful multidisciplinary preoperative assessment and preparation, the FB was removed successfully by direct laryngoscopy under moderate sedation and spontaneous ventilation, with the application of 1% lidocaine as topical anesthesia.

Outcomes:

The laryngeal FB was removed successfully without any complications. And the patient was discharged home the next day.

Lessons:

This case report shows the importance of anesthetic depth for laryngeal FB removal. The use of moderate sedation (allowing spontaneous ventilation) and adequate analgesia combined with local anesthesia enabled the patient to withstand the stress of direct laryngoscopy. Appropriate assessment, careful preparation, and multidisciplinary collaboration yielded the smooth removal of a laryngeal FB in an adult with DS.
The application of chimeric deep circumflex iliac artery perforator flap for oromandibular reconstruction
Authors: Zhang Chengyao , Zeng Yi , Zhou Lian , Tang Xi
Published: April 2021

Rationale:

The free fibular flap is considered the gold standard, particularly for a mandibular defect combined with a significant soft tissue defect. However, the fibular flap has the disadvantages of a lack of height for postoperative dental restoration and donor site skin graft if the skin paddle is wider than 5 cm. The larger bone and soft tissue defects tend to be reconstructed using either a scapula or a combination of iliac artery and radial free flap. Few cases involving reconstruction using chimeric deep circumflex iliac artery perforator flap (DCIAPF) for mandibular defect combined with more significant soft tissue defects have been reported due to perforator variations. We successfully performed oromandibular reconstruction using chimeric DCIAPF.

Patient concerns:

A 56-year-old male patient was admitted due to “constant pain in the gradually enlarged right lower gingival mass since the previous four months.” The patient had no other obvious symptoms, and no history of diabetes or hypertension was reported. The patient reported long-term smoking and drinking habits.

Diagnoses:

Computed tomography (CT) revealed a neoplasm in the right buccal space, which is primarily considered a malignancy. The pathological results of a gingival mass biopsy presented squamous cell carcinoma.

Interventions:

No operative contraindications were confirmed after regular tests and examinations were undertaken. The patient underwent a primary extent resection of a 6-cm-long mandible, including mass and suprascapulohyoid neck dissection. The oromandibular defects were then reconstructed with chimeric DCIAPF, simultaneously using the iliac crest bone flap to repair the mandibular lateral segment defect and the skin paddle to repair the intraoral soft tissue defect of 5 × 10 cm.

Outcomes:

The total operating time was five and half hours and blood loss was approximately 500 ml. The operation was successful, with no infections or flap loss. Six months postoperatively, CT showed that the iliac crest bone had connected to the alveolar bone of the mandible. The height of the iliac crest bone was sufficient for postoperative dental restoration. The patient healed without obvious complications and no tumor recurrence.

Lessons:

Chimeric DCIAPF is an excellent option for mandibular angle or body segment defects combined with significant soft tissue defects.
Primary inguinal subcutaneous endometriosis accompanied with an inguinal hernia
Authors: Chen Pei-Chen , Cheng Chiu-Hsuan , Ding Dah-Ching
Published: April 2021

Rationale:

We report a case with inguinal subcutaneous endometriosis without typical cyclic dysmenorrhea and accompanied with a hernia sac treated with resection of the tumor and herniorrhaphy.

Patient concerns:

A 40-year-old woman had a painless enlarged inguinal nodule for 3 months.

Diagnoses:

Subcutaneous endometriosis accompanied with a hernia sac.

Interventions:

Ultrasonography showed a hypoechoic lesion (3.0 cm × 2.0 cm), and an inguinal subcutaneous tumor was first suspected. After surgical exploration, a cystic lesion was excised and the hernia hole was repaired by herniorrhaphy. The immunohistochemical analysis of the small endometriotic cyst-like lesion revealed calretinin (-) in epithelial cells and CD10 (+) in stromal cells, indicative of subcutaneous endometriosis accompanied with a hernia sac.

Outcomes:

The patient was followed up for 1 year and without recurrence.

Lessons:

Cutaneous endometriosis accompanied with a hernia sac can be presented without typical endometriosis-associated symptoms such as dysmenorrhea. Inguinal endometriosis might be the differential diagnosis of inguinal painless nodules.
Recurrent macular hole retinal detachment in a patient with pathologic myopia treated by additional intravitreal silicone oil injection
Authors: Kim Do Yeon , Kim Yu Cheol
Published: April 2021

Rationale:

Treatment of macular hole retinal detachment (MHRD) in patients with pathologic myopia may require multiple surgeries due to the risk of surgical failures or recurrences. Intravitreal silicone oil injection before an additional surgery may be another option for recurrent MHRD in aphakic eyes, but this procedure is rarely performed.

Patient concerns:

A 69-year-old man visited the hospital with a chief complaint of metamorphopsia in his right eye for 5 days. The right eye had undergone a cataract extraction 5 years prior and an Nd:YAG laser capsulotomy 1 year prior. The axial length was 36.18 mm; the fundus examination and optical coherence tomography (OCT) revealed inferior retinal detachment with a macular hole involving the posterior pole. Pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling, endolaser photocoagulation, and silicone oil tamponade were performed. Five months after the surgery, the retina was detached, and a macular hole was observed.

Diagnosis:

Recurrent MHRD in a patient with pathologic myopia.

Intervention:

PPV with ILM peeling, endolaser photocoagulation, and silicone oil tamponade at the initial visit and additional intravitreal silicone oil injection (0.5 ml) at follow-up visits.

Outcomes:

The retina was well-attached until 5 months after the additional intravitreal silicone oil injection.

Lessons:

Additional intravitreal silicone oil injection can be a good option for treating MHRD in aphakic eyes if the detachment of the retina is dependent on posturing. The surgeon should consider the volume of silicone oil or postoperative posturing in the treatment of MHRD.
Imaging features of myopericytoma arising from the parotid gland
Authors: Pan Yao , Chen Lu , Shi Dan , Chen Ying , Yu Ri-Sheng
Published: April 2021

Rationale:

Myopericytoma of the parotid gland is a rare condition of which preoperative definitive diagnosis is relatively challenging. The purpose of this case report is to highlight the radiologic features of myopericytoma of parotid gland.

Patient concerns:

A 62-year-old man presented with a history of a walnut-size mass in left parotid gland when yawned for half-month, and a 48-year-old woman complaint about a grape-size, painless mass behind the right ear for a month.

Diagnoses:

Radiological examinations suggested that both lesions were cyst-solid mixed lesions with relatively smoothed margins, with or without significant enhancement while the lesion without enhancement had a hemorrhage. Then a diagnosis of benign tumor arising from the parotid gland was made. Final diagnosis of myopericytoma was confirmed by histopathological and immunohistochemical examinations after surgical resection.

Interventions:

Both patients underwent excision of the tumor and the superficial parotidectomy with facial nerve preservation.

Outcomes:

Both patients recovered without any intraoperative or postoperative complication and had no signs of recurrence during a 17-month and 5-year follow-up.

Lessons:

Parotid gland myopericytoma is an exceedingly rare tumor which diagnosis can be challenging, and this is the first published report specifying the magnetic resonance features of the disease.
The relationship between polymorphisms of microRNA and preeclampsia
Authors: Li Tao , Chen Yihong , Lai Yi , He Guoqian , He Guolin
Published: April 2021

Background:

Preeclampsia has genetic correlation. Many studies have shown that microRNA (miRNA) polymorphism is highly associated with preeclampsia, but the results are inconsistent. The purpose of this study is to systematically evaluate the relationship between miRNA polymorphism and preeclampsia.

Methods:

In this study, the search time is set from the establishment of the database on January 2021. The search database include China National Knowledge Infrastructure (CNKI), Wanfang, VIP and China Biology Medicine disc (CBM), PubMed, EMBASE, and Web of Science, and the Cochrane Library. The subjects are case-control studies on the relationship between miRNA polymorphism and preeclampsia. The language is limited to English and Chinese. The data of the included study are extracted and the literature quality is evaluated by 2 researchers independently. The data are statistically analyzed through Stata 16.0 software. We also predicted the miRNA secondary structure and the binding sites of miRNA interaction with its target genes

Results:

This review will be disseminated in print by peer-review.

Conclusion:

This study will provide evidence-based medicine to elucidate the genetic tendency of preeclampsia.

Ethics and dissemination:

Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.

OSF Registration number:

DOI 10.17605/OSF.IO/MJY2X.
Study for cerebral central network mechanism of acupuncture stimulation quantity based on changes of cerebral functional connection of fMRI
Authors: Zhou Yihao , Shi Jing , Zhang Yi , Zhang Xuelian , Dai Anhong , Feng Sifeng , Luo Chunhong , Huang Zhilin , Huang Gan
Published: April 2021

Background:

Ischemic stroke is a major chronic noninfectious disease that seriously endangers health. Acupuncture is effective for ischemic stroke and less adverse reactions. However, there is not enough clinical trial data and solid evidence could confirm how acupuncture work to cerebral functional connectivity changes, and whether the changes is related to the different stimulation quantity.

Design:

This is a multicenter, central-randomized, controlled, double-blind, noninferiority, 2 factors and 3 levels orthogonal clinical trial. A total of 100 participants with ischemic stroke aged from 40 to 80 were randomized into experimental group and control group, the experimental group was divided into 9 groups (A1-A9) according to different factors or levels, and each group have 10 participants. The whole study period is 17 days, including 1 week for baseline observation, 3 days treatment and observation, and 1 week follow-up. Primary outcome is the fMRI based on blood oxygenation level dependent. Secondary outcomes included National Institute of Health Stroke Scale, Modified Barthel Index, Brunnstrom stroke recovery, stroke Chinese medicine symptom. Clinical assessments will be evaluated at before and the 0 hour, 24 hours, 36 hours after treatment, and 1 week follow-up. The primary outcome of the postacupuncture effect were investigated by paired T-test, and the continuous outcome variables will be analyzed with univariate repetitive measurement deviation analysis. Adverse events will be noted and recorded for the safety evaluation.

Conclusion:

The purpose of this study was to evaluate the central mechanism of acupuncture stimulation quantity using time and frequency as control conditions. This study will provide reasonable stimulation parameters and strong mechanism evidence of cerebral central network for the use of acupuncture for ischemic stroke.

CHICTR registration number:

ChiCTR1900023169. Registered 15 May 2019.