bluuebunny/crossref_metadata_2025_split huggingface dataset:
Zenker's diverticulum treated with submucosal tunneling endoscopic septum division surgery
Authors: Shen Baile , Jiang Haizhong , Li Zhuoya , Wang Zheng , Song Haojun , Ding Xiaoyun 
Published: January 2020

Abstract

Introduction:
Zenker's diverticulum (ZD) refers to a pouch-like structure similar to the esophageal lumen formed from the herniation of the esophageal mucosa; this structure makes it difficult for food to pass through the esophagus to the stomach. The development of endoscopic technology has made minimally invasive surgical treatments for ZD possible.

Patient concerns:
A female 72-year-old patient was admitted to our hospital due to recurrent dysphagia for more than 5 years. A 62-year-old female patient underwent a gastroscopic examination due to recurrent dysphagia for 10 years and aggravated dysphagia accompanied by bad breath for 1 year.

Diagnosis:
A significant diverticulum with food residue at the entrance of the esophagus was found on gastroscopy in both cases.

Interventions:
After completing a relevant examination and excluding surgical contraindications, both patients underwent submucosal tunneling endoscopic septum division.

Outcomes:
Both patients were discharged after symptoms alleviated on postoperative day 4. A 3-month follow-up gastroscopy showed the disappearance of the diverticulum and recovery of the esophageal anatomical structure. No symptom relapse was found at the 6-month follow-up assessment.

Conclusion:
Submucosal tunneling endoscopic septum division has become the most common minimally invasive treatment option. It is efficient and safe for relieving symptomatic ZD in the short term.
Cardiac adverse events of PD-1 and PD-L1 inhibitors in cancer protocol for a systematic review and network meta-analysis
Authors: Han Deting , Dong Jianyong , Li Honglin , Ma Tao , Yu Wenjun , Song Lucheng 
Published: January 2020

Abstract

Introduction:
Programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors have been increasingly used in the treatment of cancer. Immunosuppressive therapy can control the cancer well and is suitable for the moderate to severe diseases. However, according to clinical observation, immune-related cardiac adverse events against PD-1or/and PD-L1 are inevitable, but generally reversible. Understanding the cardiac adverse events of PD-1 or/and PD-L1 inhibitors is crucial to improve the anti-cancer efficacy and ensure the life safety of patients. The variability of cardiac adverse events between different immunosuppressants and different cancers is not clear.

Methods and analysis:
This protocol established in this study has been reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will search the following electronic bibliographic databases: PubMed, Cochrane Library, EMBASE databases and ClinicalTrials.gov from their inception to December 2019. We will use a combination of Medical Subject Heading, and free-text terms with various synonyms to search based on the Eligibility criteria. We will include RCTs on PD-1 or/and PD-L1 inhibitors therapy to analyze. In addition, our study will include some clinical trials. All relevant RCTs will be included, such as early phase I/II, phase III experimental trials, prospective and retrospective observational studies. According to the inclusion and exclusion criteria outlined above, the full texts of each eligible study will be retrieved for further identification by one reviewer. Two authors will screen the titles and abstracts of all records retrieved in above electronic databases independently to find potentially eligible reviews. Data will be extracted by 2 reviewers independently using a pre-designed data extraction form. The other reviewer will validate data. I-square (I2) test, substantial heterogeneity, sensitivity analysis and publication bias assessment will be performed accordingly. For our network meta-analysis, we will use Stata 15.0 and WinBUGS 1.4.3.

Ethics and dissemination:
Ethics approval and patient consent would be not required because the data of this network meta-analysis mainly are obtained from existing resources. This network meta-analysis will be published in a peer-reviewed journal.

PROSPERO number:
CRD42019142865
Detecting trisomy in products of conception from first-trimester spontaneous miscarriages by next-generation sequencing (NGS)
Authors: Xu Jing , Chen Min , Liu Qi Yun , Hu Shun Qin , Li Li Rui , Li Jia , Ma Run Mei 
Published: January 2020

Abstract
Miscarriage is the spontaneous loss of a clinically established intrauterine pregnancy before the fetus has reached viability. In order to compare the performance of traditional G banding karyotyping with next-generation sequencing (NGS) for detecting common trisomies in products of conception (POC). Chromosome abnormalities were detected by high-resolution G banding karyotyping and NGS. A total of 48 miscarriage samples, including 20 samples without karyotype result and 28 with karyotype results were selected and coded for analysis by NGS. The multiplex PCR analysis of maternal and miscarriage DNA for single nucleotide polymorphism (SNP) markers were used to simultaneously monitor maternal cell contamination (MCC), chromosomal status, and sex of the miscarriage tissue. NGS detection results of 21 chromosome abnormalities were consisted with that in karyotyping examination. These chromosome abnormalities samples included 9 chromosome 16 trisomies, 3 chromosome 22 trisomies, 2 chromosome 7 trisomies, 2 chromosome 18 trisomies, 1 chromosome 4 trisomies, one chromosome 10 trisomies, 1 chromosome 13 trisomies, 1 chromosome 15 trisomies and 1 sex chromosomal aneuploidies (45, X). Meanwhile, NGS analysis of seven chromosome normalities was adapted to the karyotyping examination. Therefore, NGS combined with multiplex PCR is an effective method to test trisomies in POC. The results mentioned above will contribute to a detailed understanding of the first-trimester spontaneous miscarriages.
Smoking and alcohol drinking and risk of non-union or delayed union after fractures
Authors: Xu Bin , Chen Lingxiao , Lee Jae Hyup 
Published: January 2020

Abstract

Introduction:
To the best of our knowledge, there is no consensus on dose–response between smoking, alcohol drinking, and bone healing. The aim of the present study is to conduct a comprehensive systematic review and dose–response meta-analysis of studies to estimate the influence of smoking and alcohol use on the success of non-pathologic bone fracture healing in adult patients.

Methods:
A systematic search will be performed using MEDLINE, EMBASE and Cochrane CENTRAL, CINAHL, and AMED databases to identify randomized controlled trials and observational studies which have assessed the effect of smoking or alcohol drinking on fracture healing. Primary outcomes include delayed union or nonunion rate and time to union. Secondary outcomes are common complications which occur during bone healing including malunion and wound infection. Risk of bias will be evaluated using the Quality In Prognosis Studies (QUIPS) tool for quality assessment of each study. Dose–response meta-analysis will be performed between smoking, alcohol drinking, and bone healing. Evaluation of the quality of evidence will be conducted using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.

Results:
The present study will assess the effects of smoking and alcohol drinking on non-pathologic bone fracture healing in adult patients.

Conclusion:
We hope that this systematic review and dose–response meta-analysis will provide high quality evidence on dose–response between smoking, alcohol drinking, and bone fracture healing.

PROSPERO registration number:
CRD42019131454.
Association between C-reactive protein level and subsequent risk of ovarian cancer
Authors: Wang Yan , Zhang Zhiming , Wang Jing , Zhang Xiaowei 
Published: January 2020

Abstract

Background:
Though studies have shown association between C-reactive protein (CRP) level and the risk of ovarian cancer (OC), there have been some inconsistencies. The current metaanalysis was conducted to study the relationship between CRP and OC.

Patients and methods:
Three electronic databases of PubMed, Embase, and Cochrane Library were searched for prospective studies of OC from inception till May 2018. Relative risk (RR) was summarized using random-effects model, and the results of sensitivity, subgroup analyses, and publication biases were also calculated.

Results:
A total of 13 cohorts involving 1,852 OC patients were included for the final meta-analysis. The summary RRs indicated that high CRP was associated with an increased risk of all invasive OC (RR:1.36; 95% confidence interval [CI]:1.03–1.80; P = .032), while moderate CRP showed no significant impact on the risk of all invasive OC compared with low CRP (RR:1.17; 95% CI:0.97–1.41; P = .107). High (RR: 1.42; 95% CI: 0.85–2.37; P = .183) or moderate (RR: 1.29; 95% CI: 0.94–1.77; P = .119) CRP levels showed little or no effect on serous OC. Similarly, no significant differences for the comparisons of high versus low (RR: 1.82; 95% CI: 0.27–12.42; P = .540) or moderate versus low (RR: 0.72; 95% CI: 0.31–1.69; P = .455) CRP levels for the risk of mucinous OC were observed. Moreover, high (RR: 0.58; 95% CI: 0.13–2.54; P = .471) or moderate (RR: 0.81; 95% CI: 0.44–1.47; P = .484) CRP levels were not associated with the risk of endometrioid OC compared with low CRP levels.

Conclusion:
High CRP levels were associated with increased risk of invasive OC. The risk of other OC types with CRP levels showed no association.
Concurrent anti-neutrophil cytoplasmic antibody-associated glomerulonephritis and IgG4-associated tubulointerstitial nephritis with C3 glomerulonephritis
Authors: Feng Jianan , Yu Jinyu , Wang Xueyao , Wang Yue , Liu Yang , Xu Zhonggao , Sun Weixia 
Published: January 2020

Abstract

Rationale:
IgG4-related disease (IgG4-RD) is a slowly progressing inflammatory disease that can involve multiple organ systems. There is considerable overlap between IgG4-RDs and anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Herein, we present an unusual case of IgG4-associated tubulointerstitial nephritis (IgG4-TIN) and ANCA-associated glomerulonephritis (ANCA-GN) co-occurring with C3 glomerulonephritis (C3GN).

Patient concerns:
A 72-year-old male was admitted to hospital because of fever and fatigue. He was diagnosed with elevated serum creatinine and IgG4 levels, and was positive for ANCA.

Diagnosis:
Initially, the pathology supported a diagnosis of IgG4-TIN and ANCA-GN; however, further examination revealed he also had C3GN.

Interventions:
The patient was treated with methylprednisolone and cyclophosphamide and received regular follow-up care.

Outcomes:
After treatment, the patient no longer exhibited fever or fatigue and had no complications. The seven-month follow-up showed downward trends in IgG4 and MPO-ANCA levels and stable 24-hour urine protein, serum creatinine levels.

Lessons:
Anti-neutrophil cytoplasmic antibody-associated glomerulonephritis and IgG4-associated tubulointerstitial nephritis with C3glomerulonephritis rarely occur simultaneously. Laboratory analysis and pathology are both needed to ensure diagnostic accuracy. However, in this case, the three diseases overlapped to such a large extent that achieving a definitive diagnosis was particularly challenging. Timely and accurate diagnosis is crucial for selecting the best treatment course and optimizing patient outcome.
Risk assessment of first upper gastrointestinal bleeding using computerized tomoscanning in esophageal varices patients with cirrhosis and portal hypertension
Authors: Xie Wei , Chen Fa-xiang , Zhu Li-Yao , Wen Cheng-Cai , Zhang Xin 
Published: January 2020

Abstract
To evaluate the risk of first upper gastrointestinal bleeding by computerized tomoscanning (CT) for esophageal varices patients with cirrhotic portal hypertension.
One hundred thirty two esophageal varices patients with cirrhotic portal hypertension who are also complicated with gastrointestinal bleeding were recruited as bleeding group, while another 132 patients without bleeding as non-bleeding group. The diameter of esophageal varices, number of vascular sections, and total area of blood vessels were measured by CT scanning. The sensitivity and specificity of these indicators were calculated, and Youden index was adjusted with the critical point.
The diameter of esophageal varices was 7.83 ± 2.76 mm in bleeding group, and 6.57 ± 3.42 mm in non-bleeding group. The Youden index was 0.32 with the critical point 5.55 mm. The area under the receiver operating characteristics (AUROC) was 0.72. The number of venous vessels was 4.5 ± 2 in bleeding group, whereas being 4 ± 2 in non-bleeding group. The Youden index was 0.35 with a critical point 4, and the area under the curve (AUC) was 0.68. The blood vessel area was 1.73 ± 1.15 cm2 in bleeding group, and 1.12 ± 0.89 cm2 in non-bleeding group. The Youden index was 0.48 with the critical point being 1.03 cm2, and corresponding AUC was 0.82.
Among all 3 indicators of the total area, diameter, and number of sections of the esophageal varices, the total area of esophageal varices showed more accuracy as a potential and novel indicator for bleeding prediction.
Clinical characteristics of cytomegalovirus gastritis
Authors: Chen Dan , Zhao Ruijie , Cao Wei , Zhou Weixun , Jiang Ying , Zhang Shangzhu , Chen Yang , Fei Guijun , Li Ji , Qian Jiaming 
Published: January 2020

Abstract
Cytomegalovirus (CMV) gastritis is a rare opportunistic infection with diverse clinical manifestations. Our study aimed to investigate the clinical features of Chinese patients with CMV gastritis.
Six inpatients diagnosed with CMV gastritis were retrospectively enrolled, based on the finding of inclusion bodies in routine hematoxylin and eosin staining or positive anti-CMV monoclonal antibodies under immunohistochemistry in the gastric biopsy. Data, including demographics, diagnostic measurements, and medications, were collected.
Abdominal pain was the most frequently reported symptom, occurring in 4 patients. Five patients were immunocompromised with associated underlying diseases, and 3 patients had decreased leukocyte differentiation antigen 4 positive (CD4+) T lymphocyte counts. Only 3 patients had either positive cytomegalovirus (CMV)-immunoglobulin (Ig) M or increased copies of CMV-DNA peripherally. All patients had gastric lesions in the antrum of the stomach, including ulcers or erosions observed by gastroscopy. All patients received ganciclovir by intravenous injection (IV) as the first line anti-CMV therapy, and attained complete (4) or partial remission (2) during the follow-up.
CMV gastritis should be taken into consideration in patients with immunocompromised status who have abdominal pain, nausea, or vomiting. Gastroscopy and necessary biopsy are the major diagnostic methods for CMV gastritis. Early diagnosis leads to a better prognosis for these patients.
Soluble ST2 is associated with increased carotid intima-media thickness in patients with type 2 diabetes mellitus
Authors: Hu Xiaolei , Zhang Hengyan , Song Yuan , Yang Qingqing , Zhuang Langen , Jin Guoxi , Zhang Shirong , Sun Weihua , Shi Zhaoming 
Published: January 2020

Abstract
Soluble suppression of tumorigenicity 2 (sST2) is a free form of membrane-bound ST2, which is a member of the interleukin-1 receptor family. Previous research has shown that sST2 is associated with diabetes, but cardiovascular risk factors have not been established.
To analyze the relationship between sST2 and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM).
After screening, a total of 118 subjects with T2DM were divided into 2 groups according to the measurement of CIMT (normal CIMT (NCIMT), n = 58; abnormal CIMT (ACIMT), n = 60), and 60 healthy subjects (normal control (NC), n = 60) were recruited in this study. CIMT was measured by a color Doppler ultrasound, and sST2 and other metabolic parameters were measured as well.
The median concentration of sST2 was elevated in the ACIMT group (31.30 ng/ml) compared with the NCIMT group (28.29 ng/ml, P < .01) and the NC group (20.15 ng/ml, P < .01). After adjustment for age and sex, log sST2 was strongly associated with smoking history (β = 0.197, 95% CI, 0.084–0.311, P < .01), FPG level (β = 0.302, 95% CI, 0.162–0.442, P < .01) and HbA1c level (β = 0.296, 95% CI, 0.165–0.426, P < .01) and negatively correlated with HDL level (β = −0.153, 95% CI, −0.259 to −0.046, P < .01). Furthermore, sST2 level was a risk factor for increased CIMT in patients with T2DM.
Increased sST2 level not only was associated with indicators of glucose and lipid metabolism but also was a risk factor for increased CIMT in patients with T2DM. Thus, sST2 may be a potential novel marker to assess the progression of diabetic macrovascular complications.
Inter-segmental coordination of the spine is altered during lifting in patients with ankylosing spondylitis
Authors: Lin Huijie , Seerden Stefan , Zhang Xianyi , Fu Weijie , Vanwanseele Benedicte 
Published: January 2020

Abstract
The abnormal inter-segmental coordination of the spine during lifting could be used to monitor disease progression and rehabilitation efficacy in patients with ankylosing spondylitis (AS). This study aimed to compare the inter-segmental coordination patterns and variability of the spine during lifting between patients with AS (n = 9) and control (n = 15) groups.
Continuous relative (CRP) and deviation (DP) phases between each segment of the spine (two lumbar and three thorax segments) and lumbosacral joint were calculated. The CRP and DP curves among participants were decomposed into few functional principal components (FPC) via functional principal component analysis (FPCA). The FPC score of CRP or DP of the two groups were compared, and its relationship with the indexes of spinal mobility was investigated.
Compared with the control group, the AS patients showed more anti-phase coordination patterns in each relative upper spine segment and lumbosacral joint. In addition, either less or more variation was found in the coordination of each relative lower spine segment and lumbosacral joint during different time periods of lifting for these patients. Some cases were considerably related to spinal mobility.
the inter-segmental coordination of the spine was altered during lifting in AS patients to enable movement, albeit inefficient and might cause spinal mobility impairment.
Congenital factor V deficiency from compound heterozygous mutations with a novel variant c.2426del (p.Pro809Hisfs∗2) in the F5 gene
Authors: Park Chang-Hun , Park Min-Seung , Lee Ki-O , Kim Sun-Hee , Park Young Shil , Kim Hee-Jin 
Published: January 2020

Abstract

Introduction:
Congenital factor V deficiency (FVD) is a rare bleeding disorder characterized by low or undetectable plasma factor V (FV) levels leading to mild to severe bleeding symptoms. Currently, more than 100 mutations have been reported in F5. We herein report a patient with FVD from mutations in the F5 gene.

Patient concerns:
A 52-year-old man with prolonged prothrombin time and activated partial thromboplastin time corrected by mixing test on preoperative screening. His past medical or family history was not remarkable.

Diagnosis:
Factor assays revealed a markedly reduced FV activity at 7%. Other factors were not decreased. DNA sequencing analysis to detect F5 gene mutations showed the patient was compound heterozygous for c.286G>C (p.Asp96His) and c.2426del (p.Pro809Hisfs∗2). Asp96His was previously described missense mutation and Pro809Hisfs∗2 was a novel deleterious mutation.

Interventions:
Fresh-frozen plasma was administered to supplement FV before surgery.

Outcomes:
Subsequent factor assays revealed temporarily increased FV activity at 33%.

Conclusion:
As was the case in our patient, genotype-phenotype correlations are poor in FVD, and molecular genetic test is necessary to confirm the diagnosis.
Sedative reduction method for children with intussusception
Authors: Doo Jin Woong , Kim Soon Chul 
Published: January 2020

Abstract
Intussusception is common emergency condition in children. Pneumatic or hydrostatic reduction (HR) is considered the first-choice management strategy in cases lacking indications for surgical intervention. Generally, sedatives are not used in children undergoing interventional radiology procedures. Surgical management is associated with long hospitalization durations and high costs, unlike nonsurgical reduction. To avoid surgery, reduction procedures are repeated despite initial treatment failure. However, in cases involving repeated failures, children should be referred for surgery.
To ensure good response to reduction, we planned HR under sedation during the third reduction attempt. Sedative reduction (SR) was performed with the administration of ketamine, midazolam, and atropine. All patients with contraindications against HR underwent laparoscopic reduction (LR) without HR.
During 3 years, SR was performed in 43 patients, and in 28 (65.1%), the treatment was successful. Among the 15 patients in whom the procedure failed, 14 underwent LR without intestinal resection. There was no significant risk factor contributing to failed reduction under sedation.
During the second or third HR attempt, successful reduction may be ensured with the SR procedure with intravenous ketamine, midazolam, and atropine; this procedure may further reduce surgery rates in pediatric intussusception.
Percutaneous coronary intervention for congenital absence of the right coronary artery with acute myocardial infarction
Authors: Liu Wei-Chao , Qi Qiang , Geng Wei , Tian Xiang 
Published: January 2020

Abstract

Rationale:
Congenital absence of the right coronary artery with acute myocardial infarction (AMI) is a rare clinical situation that may lead to death. We report a case of successful percutaneous coronary intervention for congenital absence of the right coronary artery with AMI.

Patient concerns:
A 53-year-old woman had a 7-day history of chest discomfort that had worsened over 10 hours. She was diagnosed as having myocardial infarction and was admitted to hospital.

Diagnosis:
Coronary angiography showed absence of the right coronary artery; the left anterior descending (LAD) branch sent out the right ventricular branch and the posterior descending branch. The LAD branch was occluded and there was diffuse stenosis of the middle right ventricular branch and severe stenosis of the distal circumflex branch.

Interventions:
Percutaneous coronary intervention was performed. One stent was implanted in the LAD branch and another implanted in the right ventricular branch.

Outcomes:
The patient was discharged 3 weeks after surgery. The follow-up showed that the patient was asymptomatic without recurrence.

Lessons:
Although absence of the right coronary artery with AMI is a fatal condition, percutaneous coronary intervention remains an effective treatment.