bluuebunny/crossref_metadata_2025 huggingface dataset:
Advancements in sacroiliac joint reduction for enhancing lumbosacral pain relief and achieving balanced gait: A literature review
Authors: Zheng Jingjing , Duan Chen , Ma Chaoyang
Published: December 2024

This article provides a comprehensive review of recent research advancements in sacroiliac joint reduction therapy for addressing lumbosacral pain and gait balance issues, delving into its application efficacy, future outlook, and existing challenges. Current literatures were searched on sacroiliac joint reduction therapy, lumbosacral pain and gait balance disorders using the databases PubMed and Cochrane. There were no restrictions when conducting the literature search with regard to publication date, study language, or study type. Research indicates notable enhancements in various gait parameters, including stride length, gait speed, and cycle uniformity, among patients undergoing sacroiliac joint reduction therapy. These improvements translate into augmented walking stability and a reduced risk of falls. Despite its clinical efficacy, this therapeutic modality encounters several challenges in practical implementation. One major hurdle is the absence of standardized international diagnostic criteria for sacroiliac joint dysfunction, hindering the widespread adoption and standardization of this treatment approach. Further clinical investigations and longitudinal data are imperative to ascertain the long-term efficacy and potential risks associated with this therapy. Future research avenues should prioritize the development of precise diagnostic tools and standardized treatment protocols to enhance the efficacy and safety of sacroiliac joint reduction therapy. Moreover, interdisciplinary collaboration is paramount, leveraging the expertise of physical therapists, rehabilitation specialists, and spine surgeons to offer comprehensive treatment solutions. Sacroiliac joint reduction therapy emerges as a compelling therapeutic option for individuals grappling with lumbosacral pain and gait instability, showcasing significant clinical potential and promising future prospects.
Immediate effects of Kinesio taping on pain, proprioception, and posture in round shoulder individuals with subacromial impingement syndrome: A randomized, double-blinded controlled trial
Authors: Demircioğlu Gamze , Genç Hazal
Published: December 2024

Background:

Round shoulder posture (RSP), characterized by forward shoulder positioning from weakened and tense muscles, disrupts normal biomechanics and can cause Subacromial impingement syndrome (SIS), resulting in pain during specific movements or positions. This study examines the immediate effects of Kinesio taping (KT) on pain, proprioception, and posture in individuals in round shoulder individuals with SIS.

Methods:

The study involved 114 patients diagnosed with RSP and SIS. Pain intensity was assessed using a Visual Analog Scale (VAS), proprioception was measured with an inclinometer, and posture was evaluated using The New York Posture Rating Chart (NYPRC). Participants were randomly assigned to experimental group (EG) (n = 57), which received KT application, or to sham group (SG) (n = 57), which underwent a sham procedure. KT was applied to the affected shoulder and scapular regions. Assessments were conducted both before and after the application of Kinesio tape.

Results:

According to the study results, the differences in VAS scores (P = .002), proprioception abduction (P = .023) and NYPRC scores (P = .04), were statistically significant in the EG compared to the SG (P < .05). However, there was no significant difference in proprioception flexion between the groups (P > .05).

Conclusion:

KT demonstrates immediate benefits in reducing pain and improving scapular alignment in individuals with RSP and chronic shoulder pain. These findings underscore its potential effectiveness as a therapeutic intervention for managing symptoms associated with RSP and impingement syndrome, particularly in terms of pain relief and posture enhancement.
The causal association between body composition and 25-hydroxyvitamin D levels: A bidirectional Mendelian randomization analysis
Authors: Jixin Li , Wang Wenru , Qiu Linjie , Ren Yan , Li Meijie , Li Wenjie , Zhang Jin
Published: December 2024

Observational studies and meta-analyses have indicated a notable correlation between obesity and vitamin D deficiency, yet the causal relationship between the 2 remains contentious. This study employed a bidirectional Mendelian randomization (MR) analysis to explore the interrelation between obesity-associated body metrics: specifically body mass index (BMI), waist-to-hip ratio (WHR), body fat percentage (BFP), whole-body fat percentage (WHF), and 25-hydroxyvitamin D (25(OH)D) levels. Instrumental variables for BMI, WHR, BFP, whole body fat mass (WFM), and 25(OH)D were carefully selected based on predefined thresholds. The association between these metrics and 25(OH)D levels was assessed using the TwoSampleMR package in R 4.2.3. Analysis methods included inverse variance weighted (IVW), MR Egger regression, weighted median, weighted mode, and simple mode. Sensitivity analyses were conducted employing the TwoSampleMR and MR-PRESSO software packages in R 4.2.3 to evaluate heterogeneity and multiplicity of findings. All 4 body components exhibited statistically significant causal associations with decreased 25(OH)D levels: BMI (IVW: odds ratio [OR] = 0.912, 95% confidence interval [CI]: 0.888–0.937, P < .001), WHR (IVW: OR = 0.927, 95% CI: 0.882–0.975, P = .003), BFP (IVW: OR = 0.883, 95% CI: 0.867–0.899, P < .001), and WFM (IVW: OR = 0.850, 95% CI: 0.829–0.872, P < .001). However, no statistically significant inverse causative association was observed between these body components and 25(OH)D levels. Sensitivity analyses revealed no substantial heterogeneity or pleiotropy, ensuring robustness of the findings. This study substantiates a significant causal link between 4 obesity-related body components and decreased 25(OH)D levels, excluding reverse causality.
Clinical value of fractional flow reserve in coronary heart disease: A retrospective study
Authors: Zhang Liying , Xie Dingxiong , Gan Yirong , Zhang Zheng , Wang Yanzhen , Xie Jing , Zhang Bo , Kou Zongke , Zhang Yunlong , Li Bing , Kou Xiaoqing , Mao Rui , Jin Jianjian , Liang Tianxiang , Li Sheng
Published: December 2024

This study investigated the clinical value of coronary arteriography (CAG) combined with fractional flow reserve (FFR) in the treatment of coronary heart disease (CHD) with coronary artery stenosis exceeding 70%. A retrospective analysis was conducted on 344 patients with CHD treated at the Gansu Institute of Cardiovascular Science from January 2020 to May 2022. The patients were divided into the CAG group (n = 138) and the CAG + FFR group (n = 206). Among these patients, those with coronary artery stenosis exceeding 70% underwent an FFR functional examination to accurately determine indicators for coronary intervention. The data collected included demographic information, number of stents, number of vascular lesions, treatment methods, and the occurrence of major adverse cardiovascular events (MACE) at the 6-month follow-up. No significant differences were found between the 2 groups in terms of age, gender, underlying diseases, body mass index (BMI), smoking history, and blood lipid profile. The rate of surgical treatment in the CAG group and the CAG + FFR group was 88.41% and 43.69%, respectively. The CAG + FFR group showed a 44.72% reduction in the need for surgical treatment and a reduced number of stents placed, which helped prevent overtreatment. Additionally, there was no statistical difference between the 2 groups in MACE such as angina pectoris, myocardial infarction, and sudden cardiac death at the 6-month follow-up. After combined CAG examination with FFR measurement, the number of CHD patients with coronary artery stenosis exceeding 70% requiring surgical intervention decreased by 44.72%. FFR could significantly prevent overtreatment and provide more precise guidance for CHD treatments.
The causal association of smoking, alcohol intake, and coffee intake with the risk of bacterial pneumonia: A Mendelian randomization study
Authors: He Zhendong , Zheng Leting , Chen Zhanrui , Wen Jing , Qin Fang , Mo Hanyou
Published: December 2024

Background:

At present, the association of smoking, alcohol intake, and coffee intake with the risk of bacterial pneumonia (BP) remains controversial. In this study, we used a 2-sample Mendelian randomization (MR) analysis to estimate the association of smoking, alcohol intake, and coffee intake with the risk of BP.

Methods:

We extracted genetic variants associated with smoking initiation and cigarettes per day from the Genome-Wide Association Study and Sequencing Consortium of Alcohol and Nicotine Use database (944,625 individuals). We also extracted genetic variants associated with past tobacco smoking, alcohol intake frequency, and coffee intake from the UK Biobank database (1,316,166 individuals). BP outcomes were chosen from the FinnGen genome-wide association studies (GWAS) database (7987 patients and 188,868 controls). The inverse variance-weighted method was used primarily to calculate odds ratios (OR) and 95% confidence intervals (CI). Sensitivity analysis using different approaches such as weighted median, MR Egger, and MR pleiotropy residual sum and outlier (MR-PRESSO) have been implemented, as well as leave-one-out analysis to identify pleiotropy.

Results:

The 2-sample MR analysis supported the causal association of genetically predicted cigarettes per day (OR: 1.23, 95% CI: [1.08–1.39], P < .01] and smoking initiation (OR: 1.22, 95% CI: [1.03–1.44], P = .02) with the risk of BP, but not past tobacco smoking, alcohol intake frequency, and coffee intake. Heterogeneity (P > .05) and pleiotropy (P > .05) tests provided confirmatory evidence for the validity of our MR estimates.

Conclusion:

Our findings provide relevant evidence for a favorable causal association of genetically predicted smoking initiation and cigarettes per day with BP risk. However, there may not be a causal association between past tobacco smoking, alcohol intake, and coffee intake with increased BP incidence rates.
Retrospective cohort study on the safety and efficacy of paclitaxel-coated balloon in the treatment of diabetic subpatellar artery disease
Authors: Lin Feng , Chen Lingxiong , Liu Yu , Yang Ruidang , Zhang Xuming , Lin Tanhui
Published: December 2024

Paclitaxel can inhibit smooth muscle cell proliferation and migration, and reduce the risk of vascular restenosis after balloon dilation. Our study investigated the safety and efficacy of paclitaxel-coated balloon (PCB) treatment for diabetic subpatellar artery disease. In this study, 140 patients with diabetic subknee arterial disease treated in our hospital from January 2022 to December 2023 were selected as the study objects, and were divided into the control group (conventional balloon interventionization angioplasty) and the observation group (PCB interventionization angioplasty), with 70 cases in each group according to the differences in previous balloon interventionization. The safety and efficacy of the 2 treatments were compared. There was no significant difference in the primary patency rate 6 months after operation between the 2 groups (P > .05). There was significant difference in restenosis rate at 12 months after operation (P < .05). There was no significant difference in ankle–brachial index between the 2 groups before and 6 months after operation (P > .05). At 12 months after operation, ankle–brachial index of observation group was higher than that of control group, and the differences were statistically significant (P < .05). The improvement rate of walking impairment and 6 minutes walking distance in the observation group were significantly better than those in the control group, the difference was statistically significant (P < .05). There was no significant difference in the occurrence of adverse events between the 2 groups after operation (P > .05). For diabetic patients with subknee arterial disease, PCB treatment can ensure safety and improve clinical symptoms, and has good practical value.
Relationship between multi-nutrient intake and bone loss and osteoporosis in U.S. adults: Findings from NHANES
Authors: Hu Wenfeng , Feng Xiaotong , Wen Chaoqun
Published: December 2024

The relationship between dietary nutrient intake and bone mineral density (BMD) has not been clarified. In the U.S. population, we have demonstrated that dietary intake of multiple nutrients (potassium, magnesium, and sodium) is positively associated with BMD and negatively associated with the prevalence of osteopenia. This study examined whether there is an association between dietary potassium, magnesium, and sodium intake and BMD, osteopenia, and osteoporosis, using data from the National Health and Nutrition Examination Surveys from 2005 to 2010, 2013 to 2014, and 2017 to 2018. We assessed the association of dietary potassium, magnesium, and sodium intake with BMD in 10,355 National Health and Nutrition Examination Survey participants during 2005 to 2010, 2013 to 2014, and 2017 to 2018. BMD of the whole femur was estimated by dual-energy X-ray absorptiometry. We utilized multiple linear regression models to examine the associations of dietary potassium, magnesium, and sodium intake with femoral BMD, osteopenia, and osteoporosis, after adjusting for various confounders. Dietary potassium, magnesium, and sodium intake are positively correlated with femur BMD when corrected for the confounders of age, sex, race/ethnicity, smoking behavior, education level, body mass index, poverty income ratio, serum uric acid, serum cholesterol, potential renal acid load, dietary calcium intake, dietary protein intake, and dietary vitamin D intake. Dietary intake of potassium, magnesium, and sodium was adversely correlated with the development of osteopenia and osteoporosis. Our study showed that intake of dietary nutrients (potassium, magnesium, and sodium) was correlated positively to femur BMD and adversely to osteopenia and osteoporosis in the U.S. population. Further research is needed on the association of dietary elemental intake with BMD.
Pembrolizumab alone or combined with chemotherapy versus chemotherapy for the treatment of metastatic cancer: A meta-analysis of randomized clinical trials
Authors: Yue Yumin , Wang Quan , Wei Mingtian , Ding Fanghui , Li Jiang , Zheng Bobo
Published: December 2024

Background:

Whether pembrolizumab alone or in combination with chemotherapy is superior to chemotherapy in metastatic cancer remains controversial. The study aims to give the effectiveness and safety of pembrolizumab-related interventions compared to chemotherapy in metastatic cancer.

Methods:

Electronic databases were systematically searched until November 20, 2023, for all randomized controlled trials comparing Pembrolizumab alone or in combination with chemotherapy versus chemotherapy for metastatic cancer. The primary outcomes were overall survival (OS) and progression-free survival (PFS). Hazard ratios (HRs) and odds ratios with 95% confidence intervals (CI) were calculated for OS, PFS, overall response rate, and overall adverse events (AEs) by random effects models.

Results:

16 Randomized controlled trials with 9148 patients were included. Compared with chemotherapy, pembrolizumab was associated with longer OS (HR 0.82; 95% CI 0.73–0.91, P = .0004), more immune-mediated AEs, fewer overall AEs, and grade 3 or 4 AEs, however, no significant difference was found in PFS, overall response rate, and events leading to death. Pembrolizumab with chemotherapy was associated with longer OS (HR 0.74; 95% CI 0.61–0.90, P = .002) and PFS (HR 0.63; 95% CI 0.50–0.79, P < .0001), higher overall response rate, and more immune-mediated AEs comparing to chemotherapy alone, however, no significant advantages were observed in disease control rates, overall AEs, grade 3 or 4 AEs and events leading to death. The patients with programmed cell death ligand 1 tumor proportion scores of at least 50% or combined positive scores (CPS) of at least 10 could derive significantly better OS and PFS benefits from pembrolizumab alone or combined with chemotherapy. Similar OS results were found for first-line treatment and lung cancer subgroup analysis.

Conclusions:

Pembrolizumab alone or combined with chemotherapy indicates an effective and safe treatment for metastatic cancer. Pembrolizumab alone or combined with chemotherapy provides a better survival advantage under first-line treatment or programmed cell death ligand 1 combined positive scores of at least 10 or programmed cell death ligand 1 tumor proportion scores of at least 50%. However, we found that the specific efficacy of pembrolizumab in unused tumor types could not be effectively evaluated.
Undiagnosed mirror syndrome with maternal hypoxemia onset during an emergency cesarean section: A case report
Authors: Ichikawa Shino , Saito Junichi , Noguchi Satoko , Saito Kurumi , Hirota Kazuyoshi
Published: December 2024

Rationale:

Mirror syndrome is a rare pregnancy condition in which maternal edema is associated with fetal hydrops. Because of its rarity and overlapping symptoms, this condition is often misdiagnosed as another pregnancy complication.

Patient concerns:

A 28-year-old pregnant Japanese woman presented with sudden 7.5-kg weight gain, leg edema, and increased d-dimer level.

Diagnoses:

Ultrasound revealed polyhydramnios and fetal hydrops, and findings of maternal edema and blood test results were suggestive of Miller syndrome. Although, the patient was initially misdiagnosed due to a lack of information and the rarity of this disease.

Interventions:

An emergency cesarean section was performed under spinal anesthesia at 36 weeks and 2 days of- pregnancy. We could not diagnose mirror syndrome.

Outcomes:

The newborn’s Apgar scores were 2 and 5 at 1 and 5 minutes after delivery, respectively. The patient’s SpO2 suddenly decreased to 86% during cesarean section and persisted for 2 days. Chest computed tomography revealed pleural effusion and pulmonary edema. The pleural effusions and lung edema spontaneously resolved after the cesarean section.

Lessons:

This case reports on Miller syndrome with maternal hypoxemia onset during an emergency cesarean section and highlights the potential for better perioperative management and improvement in maternal mortality through prompt diagnosis and appropriate treatment shared not only among obstetricians and pediatricians but also among anesthesiologists.
Association of NLR with all-cause and cardiovascular mortality in adults with coronary heart disease: 1999–2018 NHANES data analysis
Authors: Chen Qian , Dai Xiao-Wei , Dong Qi-Qi , Zhang Xin-Xin , Ma Wen-Ting
Published: December 2024

The neutrophil-to-lymphocyte ratio (NLR) is an important inflammatory marker. However, the relationship between NLR and the prognosis of patients with coronary heart disease (CHD) remains unclear. The purpose of this study is to explore the relationship between NLR and all-cause mortality and cardiovascular mortality in CHD patients. This study analyzed data from 1625 CHD patients who participated in the National Health and Nutrition Examination Survey from 1999 to 2018. Multivariate Cox regression analysis was used to explore the relationship between mortality risk and NLR. The optimal NLR cutoff value related to survival outcomes was determined using the maximum selected rank method. Restricted cubic spline analysis was performed to investigate the correlation between NLR and mortality risk in CHD patients. Moreover, subgroup analyses were conducted to assess the relationship between NLR and all-cause and cardiovascular mortality in different populations. Additionally, time-dependent receiver operating characteristic curves were used to evaluate the accuracy of NLR in predicting survival outcomes. During a median follow-up of 88 months, a total of 475 patients experienced all-cause mortality, and 278 patients experienced cardiovascular mortality. After adjusting for confounding factors, compared with CHD patients with higher NLR, those with lower NLR had a 43% reduced risk of all-cause mortality (hazard ratio: 0.57, 95% CI: 0.41–0.8) and a 51% reduced risk of cardiovascular mortality (hazard ratio: 0.49, 95% CI: 0.3–0.78). Kaplan–Meier analysis showed that the survival rate in the high NLR group was significantly lower in terms of all-cause and cardiovascular mortality rates than in the low NLR group (P < .0001). The results of the restricted cubic spline analysis indicated a nonlinear relationship between NLR and all-cause mortality as well as cardiovascular mortality in CHD patients. In addition, receiver operating characteristic analysis showed that the area under the curve for all-cause mortality at 3 years, 5 years, and 10 years were 0.596, 0.591, and 0.604, while the area under the curve for cardiovascular mortality were 0.623, 0.617, and 0.623, in CHD patients. Elevated NLR is associated with increased risk of cardiovascular and all-cause mortality in CHD patients, and NLR can independently predict the prognosis of CHD patients.
The effects of common peroneal nerve electrical stimulation on lower extremity deep venous hemodynamics: A randomized, crossover and controlled study
Authors: Zou Zhao-Jun , Song Hai-Xin , Wang Ting , Ma Hai-Yun , Cao Li-Ping , Wu Tao
Published: December 2024

Background:

Intermittent pneumatic compression (IPC) and neuromuscular electrical stimulation can improve deep vein hemodynamics in the lower limbs. We developed a new, small and convenient, and easy to wear common peroneal nerve electrical stimulator (CPNES) and to investigate the effectiveness and safety of CPNES intervention on deep venous hemodynamics.

Methods:

Thirty healthy volunteers were recruited and randomly divided into group A and B. In group A, the hemodynamics of the left superficial femoral artery and the superficial femoral vein were measured after IPC compression, and then the CPNES was activated and the hemodynamics was measured again. In group B, the order of intervention was reversed.

Results:

In group A, the peak velocity, time average blood flow velocity (TAMV), and flow velocity of femoral vein after IPC and CPNES intervention were higher than these of the baseline (P < .05, respectively). No significant differences of these blood flow parameters were found between IPC and CPNES intervention (P > .05, respectively). In group B, these blood flow parameters of femoral vein after IPC and CPNES intervention were higher than these of the baseline (P < .05, respectively). No significant difference of these blood flow parameters (P > .05, respectively) were noted between IPC and CPNES intervention as well. No differential change of these flow velocity of femoral artery after IPC and CPNES intervention in group A or group B. The hemodynamics of superficial femoral arteries and veins after intervention in group A and B were similar (P > .05, respectively).

Conclusion:

The effectiveness of CPNES intervention on the hemodynamics of the lower extremity is similar with that of IPC, increasing blood flow and may prevent venous thrombosis without adverse reaction.
Comparative evaluation of 2D and 3D YouTube videos as supplementary educational resources for vitreoretinal surgery training
Authors: Yozgat Zubeyir , Sahin Halime Kubra , Dumlupinar Gizem Ilayda , Sabaner Mehmet Cem
Published: December 2024

Ophthalmologists and ophthalmology residents (ORs) are increasingly turning to the internet for medical information, underscoring the significant role that YouTube videos, particularly three-dimensional (3D) ones, play in lifelong learning. This study aimed to compare the content and quality of 3D YouTube videos with two-dimensional (2D) videos as supplementary educational tools for vitreoretinal surgery. Data collected included video length (minutes), time elapsed since upload (days), number of views, likes, dislikes, vitreoretinal surgery type, and visualization system. Video popularity and interaction were calculated using the video power index, interaction index, and viewing rate. Two senior ophthalmologists (SOs) and 2 ORs evaluated the videos using the DISCERN, Global Quality Score, and usefulness scoring systems. Inter-rater reliability was assessed using the intra-class correlation coefficient. A total of 392 videos were screened, with 67 2D and 67 3D videos deemed appropriate for inclusion. While 2D videos had significantly more views, likes, interaction index, and viewing rate than 3D videos (P < .001 for all), 3D videos were rated higher by ORs across all scoring systems (P < .05 for all). Inter-rater reliability was confirmed to be good, with the lowest intra-class correlation coefficient being 0.796 for SOs (95% confidence interval: 0.668–0.875) and 0.814 for ORs (95% confidence interval: 0.698–0.886). In conclusion, side-by-side 3D YouTube videos offer a valuable supplementary educational tool, enhancing depth perception and enabling both SOs and ORs to better understand the complexities of ocular surgeries, particularly vitreoretinal procedures. These videos can also be used to observe new procedures and refresh previously acquired knowledge of past surgeries.
Clinical application of intramedullary nail fixation assisted by locking plates in segmental tibia fractures: A retrospective study
Authors: Wu Wangsheng , Wang Huajuan , Zheng Qunyang , Mao Yi , Liu Bingsheng
Published: December 2024

It is unclear whether small plates are needed for augment fixation to provide a more stable mechanical environment in segmental fractures of the tibia treated with intramedullary nail. The purpose of this study was to investigate the efficacy of intramedullary nailing combined with locking plates in the treatment of segmental fractures of the tibia. This study included 41 patients with segmental tibia fractures between January 1, 2018 and January 1, 2023. Eighteen patients were treated with an intramedullary nail assisted by a locking plate (combination group), and 23 patients were treated with an intramedullary nail without a plate (nail group). The perioperative parameters of all patients were recorded, and clinical efficacy was evaluated during follow-up. The operation time was shorter but the incision was longer in the combination group (P < .05). The numbers of fluoroscopy procedures and the time to union were shorter in the combination group (P < .05). The rate of malunion in the nail group (4, 17.4%) was significantly greater than that in the combination group (0, 0%). At the last follow-up, no statistically significant differences in walking ability were detected. Our results suggest that a locking plate combined with an intramedullary nail for segmental tibial fractures may require a longer surgical incision, but it has significant advantages such as a shorter operative time and time to union, a shorter fluoroscopy time, and a lower rate of malunion and nonunion. Intramedullary nail fixation assisted by a locking plate is an effective method for treating segmental fractures of the tibia.
The nonpathogenic role of hyponatremia in the onset of osteoporosis: A Mendelian randomization study
Authors: Hongxing Zhang , Jiafeng Peng , Minglei Gao , Danyang Li , Zhu Junchen
Published: December 2024

The relationship between hyponatremia and osteoporosis is controversial, and it remains unclear if there is a causal link between the two. This study employed a 2-sample Mendelian randomization (MR) analysis to investigate the potential causal relationship between hyponatremia and osteoporosis. The instrumental variables were derived from genome-wide association studies conducted in European populations. These included hyponatremia (n = 465,348) as the exposure factor, with genetic summary data for bone mineral density (BMD) at the forearm (n = 8134), femoral neck (n = 32,735), lumbar spine (n = 28,498), and heel (n = 265,627) as outcomes. The inverse variance weighted method did not identify any causal effect of hyponatremia on BMD. Additionally, other methods, such as MR-Egger, weighted median, simple mode, and weighted mode, also did not show evidence of a causal relationship between hyponatremia and BMD. Pleiotropy and heterogeneity analyses indicated that the MR findings were robust. There is no significant causal relationship between hyponatremia and osteoporosis. The previously observed associations may be due to confounding factors. It is unlikely that hyponatremia is a causal factor for osteoporosis.
The catch-up growth follow-up management system use and need for the parents of premature infants after discharge based on a WeChat mini program: A cross-sectional survey in China
Authors: Chen Renyi , Xie Hong , Duan Shijie , Kang Bingyao , Peng Wentao
Published: December 2024

Preterm birth is a significant public health concern. To achieve a growth trajectory consistent with the genetic law, a catch-up growth strategy must be adopted for these infants to achieve normal growth and development. The aim of this study is to investigate the use requirements of a WeChat mini program-based post-discharge catch-up growth follow-up management system for the parents of preterm infants. A cross-sectional survey method was used to collect data from 417 parents of preterm infants in the child health unit of a hospital in Sichuan Province, China, between December 1, 2021 and August 23, 2022. This study used a questionnaire composed of 2 sections, including basic information of parents of preterm babies and their functional requirements for a WeChat mini program-based post-discharge catch-up growth follow-up management of preterm infants (content validity was 0.921 and Cronbach alpha coefficient was 0.891). The 417 parents who completed the questionnaire were between 22 and 46 years old, with an average age of 32.54 ± 3.92 years. The factors that influence the demand for WeChat mini program functions for managing the catch-up growth of preterm infants after discharge include occupation, education level, family structure, number of births, residential area, and frequency of using WeChat (P < .05). The demand for the WeChat mini program for post-discharge catch-up growth management among parents of preterm babies is high. The contents and functions of the WeChat mini program can be further enriched and improved to meet the needs of parents of preterm infants of different birth ages.
Risk factors for falls in older adults with type 2 diabetes: A cross-sectional study
Authors: Lin Chia-Ling , Wu Hsueh-Ching , Yu Neng-Chun , Liu Yuan-Ching , Chiu I-Ying , Chien Wu-Chien
Published: December 2024

The study was to estimate the prevalence of falls with type 2 diabetes (T2D) and investigate the associated risk factors. The study design employed was cross-sectional. The participants for this study were recruited from a community-based diabetes specialist clinic. Data were collected from medical records and structured questionnaires, which included assessments of activities of daily living, instrumental activities of daily living, the Mini-Mental State Examination, the Taiwan Geriatric Depression Scale, and Chinese version of the Tilburg frailty indicator. Multivariate logistic regression was used to analyze the related factors. The study analyzed a total of 242 T2D patients with a mean age of 73.9 ± 5.9 years. The overall fall prevalence rate was 19.7%. The faller trait tendency to female, lower education, history of falls, body mass index ≥ 29 kg/m2, instrumental activities of daily living ≥ 1 task disability, cognitive impairment, depression, poor grip strength, and longer walking time. After adjusting for confounding, showed each additional unit on the depression score increases the fall risk by 11.9% (AOR, 1.19; 95% CI, 1.02–1.38, P = .027). Depression was a significant factor for falls in older adults with T2D. The study highlights the importance of targeted, multifaceted clinical interventions focusing on gender, age, and mental health to effectively reduce fall probability and improve the quality of life for the older adults.
The role of the microbiota-gut-brain axis and artificial intelligence in cognitive health of pediatric obstructive sleep apnea: A narrative review
Authors: Lv Yunjiao , Xian Yongtao , Lei Xinye , Xie Siqi , Zhang Biyun
Published: December 2024

Pediatric obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder associated with significant neurocognitive and behavioral impairments. Recent studies have highlighted the role of gut microbiota and the microbiota-gut-brain axis (MGBA) in influencing cognitive health in children with OSA. This narrative review aims to summarize current knowledge on the relationship between gut microbiota, MGBA, and cognitive function in pediatric OSA. It also explores the potential of artificial intelligence and machine learning in advancing this field and identifying novel therapeutic strategies. Pediatric OSA is associated with gut dysbiosis, reduced microbial diversity, and metabolic disruptions. MGBA mechanisms, such as endocrine, immune, and neural pathways, link gut microbiota to cognitive outcomes. Artificial intelligence and machine learning methodologies offer promising tools to uncover microbial markers and mechanisms associated with cognitive deficits in OSA. Future research should focus on validating these findings through clinical trials and developing personalized therapeutic approaches targeting the gut microbiota.
Low-grade appendiceal mucinous neoplasm: A case report
Authors: Guo Zhitang , Long Kui , Chen Zhanbin , Zhang Wei , Chu Quanxian
Published: December 2024

Rationale:

Low-grade appendiceal mucinous neoplasm (LAMN) is a clinically rare tumor that predominantly occurs in females and presents with nonspecific symptoms, often resulting in misdiagnosis. While postoperative pathology remains the gold standard for diagnosis, accurate preoperative identification through various diagnostic methods is essential for effective treatment planning. To raise awareness of this condition, we present a case of a middle-aged male diagnosed with LAMN.

Patient concerns:

A 52-year-old male presented to outpatient clinic with right lower abdominal pain lasting 1 day. He described the pain as continuous cramping, exacerbated by movement and coughing, with associated nausea.

Diagnosis:

Physical examination revealed tenderness in the right lower quadrant and a palpable mass measuring approximately 6.5 cm × 5.0 cm, with poor definition and limited mobility. An elevated white blood cell count (16.2 × 109/L) and a mixed cystic and solid mass were noted, prompting admission for further evaluation. Further, abdominal enhanced computed tomography revealed a mixed-density lesion in the right ileocecal region, measuring approximately 6.5 cm × 5.0 cm. This finding was suggestive of an appendiceal mucinous neoplasm, with mucinous adenocarcinoma remaining a possibility that could not be excluded.

Interventions:

The patient underwent a laparoscopic right hemicolectomy on June 5, 2024, and the gross specimen showed: a 6.5 cm × 5.0 cm mass was found in the appendix area on the surface of the intestinal tube, a large amount of jelly was found after incision, and the mass was connected to the intestinal cavity.

Outcomes:

The patient recovered well after surgery, the abdominal drainage tube was pulled out on the 8th day after surgery, and the patient was discharged on the 13th day after surgery. Postoperative examination showed LAMN and mucus accumulation in the wall of the appendix with a foreign body giant cell reaction, acute attack of chronic appendicitis, and suppurative inflammation with peripheral inflammation. Postoperative diagnosis: LAMN; acute chronic appendicitis attack.

Lessons:

As a rare clinical gastrointestinal tumor, LAMN lacks specific clinical manifestations, and its diagnosis depends on postoperative examination; however, the indications for surgery are clear and the clinical prognosis is good. The key to surgery is to protect the tumor body to avoid rupture and cause the development of peritoneal pseudomyxoma (PMP).
Retrospective comparative analysis of human fascioliasis versus bacterial liver abscess
Authors: Huang Lihua , Luo Jiao , Li Nan , Bao Zhenzhong , Gu Wei
Published: December 2024

This study aimed to compare the clinical characteristics of human fascioliasis and bacterial liver abscesses to provide a reference for the early and effective differentiation of these 2 diseases to avoid misdiagnosis. We retrospectively compared the epidemiological and clinical characteristics of 95 patients with human fascioliasis and 95 with bacterial liver abscess admitted to the First Affiliated Hospital of Dali University between January 2013 and March 30, 2023. The human fascioliasis group exhibited a higher proportion of female patients and a greater frequency of abdominal pain and lesions affecting both lobes of the liver. Additionally, eosinophil count, percentage of eosinophils, red blood cells, hemoglobin, total protein, albumin, carbohydrate antigen-125 (CA-125), CA-199, and CA-724 levels were elevated compared to the bacterial liver abscess group. Conversely, the proportion of patients with diabetes, duration of hospital stay, and the incidence of lesions affecting the right lobe of the liver, cavity formation, ascites, pleural effusion, white blood cells, total bilirubin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels were lower in the fascioliasis group compared to the bacterial liver abscess group. Furthermore, higher thrombin time and fibrinogen levels were observed in the fascioliasis group than in the bacterial liver abscess group (P < .05). Human fascioliasis predominantly occurs from August to November, while bacterial liver abscess exhibits a consistent incidence throughout the year. Human fascioliasis predominantly affects young women and demonstrates a seasonal pattern. It is associated with severe abdominal symptoms, widespread lesions, significantly elevated eosinophil levels, and seasonal incidence. Bacterial liver abscess predominantly affects elderly men with diabetes, and it is associated with localized lesions and severe inflammatory manifestations and occurs throughout the year.
Moral distress, professional value, and vocational choice among senior nursing students: A cross-sectional study
Authors: Lee Myung Kyung , Oh Jihyun
Published: December 2024

During clinical placement, nursing students may experience unease and moral distress, which negatively impacts their professional values and vocational choices. However, no instrument exists to measure moral distress in nursing students. Thus, this study constructs measurement items for moral distress and explores the factors that influence the vocational choices of nursing students. The participants were recruited from three universities in South Korea Between September and October 2021. This study was adopted with a convenience sample of 270 Korean fourth-year nursing students who completed their clinical practice at tertiary general hospitals in three provinces in the North, Middle, and South areas of South Korea. Data were collected through a self-administered structured questionnaire. The study developed the items and subscales of the Moral Distress Scale using multistep methods following the recommendations of the Consensus-Based Standards for the Selection of Health Status Measurement Instrument. The study constructed 22 items of the three factors of Moral Distress Scale. The three factors of the Moral Distress Scale were “moral distress by low quality of care,” “moral distress by a heavy workload and an insufficient workforce,” and “unfair and distrust.” The factors influencing the vocational choice of the nursing students were high professional values, intention not to choose nursing as a future career, lacking vision for choosing nursing, democratic family climate, and having at least one parent who was a medical professional. Moral distress in undergraduate nursing students may not influence their intention to choose the nursing profession. Fostering the professionalism and professional values of nursing students through university education curricula may help maintain their professional identity.
Considering SOD and miRNA analysis as potential prognostic markers in white lesion malignant transformation: A report of two cases
Authors: Drotárová Zuzana , Rabajdová Miroslava , Mareková Mária , Kizek Peter , Vašková Janka
Published: December 2024

Rationale:

Predictive biomarkers can be effective in the identification of the oral leukoplakia with an increased probability of malignant transformation.

Patients concerns:

A 63-year-old patient presents with persistent burning sensations throughout the oral cavity, accompanied by a white lesion on the tongue. Additionally, a 57-year-old patient with multiple white lesions in the oral cavity.

Diagnosis:

Histopathological analysis of the excised tissue.

Interventions:

Changes in the expression miRNAs (miR17, miR206, and miR23), the activity of antioxidant enzymes (superoxide dismutase, glutathione peroxidase, glutathione reductase, and glutathione-S-transferase), and concentration of reduced glutathione were detected, followed by meta-analysis of previous studies.

Outcomes:

In both patients (verrucous leukoplakia, oral squamous cell carcinoma) upregulated expression of miR-23a, miR-17, and downregulated expression of miR206 were detected when compared to healthy individuals. In the plasma of a patient diagnosed with carcinoma, higher activity of antioxidant enzymes connected to glutathione was measured in comparison to healthy individuals.

Lessons:

The connection between miRNA expression changes, the increase in glutathione-S-transferase and especially the decrease in superoxide dismutase activities in patients with white lesion potential malignant transformation using the provided statistical analysis was confirmed.
Network pharmacology integrated with molecular docking and molecular dynamics simulations to explore the mechanism of Shaoyao Gancao Tang in the treatment of asthma and irritable bowel syndrome
Authors: Ren Mengjiao , Ma Jian , Qu Minye
Published: December 2024

Background:

Numerous studies have demonstrated a correlation between asthma and irritable bowel syndrome (IBS). The Chinese herbal compound Shaoyao Gancao Tang (SYGCT) has been found to have therapeutic effects on both asthma and IBS, but the underlying mechanisms are not yet fully understood. This study aims to explore the key components, key targets, and potential mechanisms of SYGCT in treating asthma with IBS by using network pharmacology, molecular docking techniques and molecular dynamics simulation.

Methods:

The major chemical components and potential target genes of SYGCT were screened by bioinformatics. The key targets of Asthma-IBS comorbidity were identified based on network modules. The intersection of the drug targets and disease targets was identified as the potential targets of SYGCT in treating asthma-IBS. Gene Ontology functional annotation and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were performed to identify the biological processes and signaling pathways involved in these potential targets. A protein–protein interaction network was constructed to identify hub targets, while a drug-compound-target topological network was built to screen key compounds. Molecular docking was used to verify the affinity between the hub targets and key compounds. Molecular dynamics analysis was utilized to assess the binding stability of these interactions.

Results:

Network pharmacology analysis revealed that the therapeutic effect of SYGCT on asthma-IBS involved multiple biological processes and signaling pathways. It may exert therapeutic effects primarily through signaling pathways such as IL-17, TNF, and Th17 cell differentiation. The possible targets of SYGCT in the treatment of asthma-IBS could be IL6, TNF, JUN, PTGS2, STAT3, IL1B, CASP3, NFKBIA, IL10, and PPARG. Molecular docking verification showed that the predicted targets had good binding affinity with the compounds, among which PTGS2, CASP3, and PPARG had higher binding energy. Molecular dynamics simulation revealed that PTGS2, CASP3, and PPARG proteins had good stability and high binding strength with the compounds 2-[(3R)-8,8-dimethyl-3,4-dihydro-2H-pyrano[6,5-f]chromen-3-yl]-5-methoxyphenol and shinpterocarpin.

Conclusion:

SYGCT plays a therapeutic role in asthma and IBS through multiple targets and pathways, providing a theoretical basis for explaining the mechanism and clinical application of SYGCT in treating different diseases with the same treatment in asthma and IBS.
Use of continuous infusion technique with pre-filled elastic pumps for prevention of centrally inserted central catheter occlusion in critically ill patients: A feasibility study
Authors: Jia Wei , Wu Kaiping , Song Kaifei , Yun Wenjuan , Wang Jin , Yi Yaping , Xu Lingyun
Published: December 2024

Background:

Flushing catheter seems to be a crucial procedure for preventing centrally inserted central catheter (CICC) occlusion, which can flush the liquid and blood attached to the lumen into the bloodstream. The continuous infusion technique is characterized by continuous perfusion of flushing fluid and maintaining positive pressure in the lumen, which has been demonstrated to effectively prevent peripheral indwelling needle occlusion. However, the use of continuous infusion technique in CICC care among critically ill patients has been rarely described.

Objective:

To determine the feasibility and direct outcomes of continuous infusion technique in preventing CICC occlusion among critically ill patients.

Methods:

Participants from the intensive care unit who had a new centrally inserted central catheter placed within 24 hours were randomly assigned to 2 groups at a ratio of 1:1. They received pulsed infusion or continuous catheter infusion using pre-filled elastic pumps. During the trial period, on days 3 and 7 and whenever there were signs of catheter occlusion, whether the catheter occlusion was evaluated by the Catheter Injection and Aspiration Classification. Moreover, nurses meticulously observed the incidence of catheter-related complications, altered vital signs, and dysfunctions of elastic pump.

Results:

The catheter occlusion rates were 17.4% and 43.5% in participants who received continuous infusion (n = 23) and those who received pulsed infusion (n = 23), respectively. There was no significant difference in catheter occlusion rate between the 2 groups (χ² = 3.696, P = .06). The Kaplan–Meier curve results showed that the cumulative probability of central catheter occlusion events (within 7 days) in the continuous infusion group decreased (χ²=4.322, Log rank P = .04). Moreover, multivariate Cox regression indicated that the continuous infusion can reduce the risk of occlusion within 7 days by 91.8% (hazard ratio = 0.082, 95% confidence interval [0.014–0.487], P = .006). During the trial, no cases of detrimental altered vital signs and catheter-related complications in addition to occlusion were documented.

Conclusions:

In this study, continuous infusion technique with pre-filled elastic pumps was successfully used in critically ill patients for prevention of CICC occlusion, without major undesired effects. A larger cohort and a randomized clinical trial are warranted in order to establish its absolute efficacy in CICC care.