bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pituitary stalk interruption syndrome
Authors: Zhang Wei , Qian Fang , Lu Guan , Wu Yao , Li Rui , Xia Lijuan , Zhao Rui , Lin Yi , Gu Mingyu , Chen Weiwen 
Published: December 2020

Abstract

Rationale:
Pituitary stalk interruption syndrome (PSIS) is a congenital pituitary anatomical defect. It is characterized by the triad of thin or interrupted pituitary stalk, absent or ectopic posterior lobe, and hypoplastic or aplastic anterior lobe. Moreover, this condition is considered rare.

Patient concerns:
A 23-year-old male patient presented with a history of short stature and hypogonadism. Laboratory assessment revealed low thyroxine, cortisol, and adrenocorticotropic hormone levels, which are consistent with adrenal insufficiency without hypoglycemia. The insulin-induced hypoglycemia tolerance test finding indicated growth hormone (GH) deficiency. Moreover, magnetic resonance imaging revealed an interrupted pituitary stalk, ectopic posterior pituitary, and hypoplastic anterior pituitary. This triad of symptoms was indicative of PSIS.

Diagnosis:

Interventions:
The patient was deficient in adrenaline, thyroxine, gonadal steroid, and GH. Thus, glucocorticoid replacement therapy was initiated, followed by euthyrox, androgen, and human chorionic gonadotropin treatment. Calcium tablets, calcitriol, and alendronate sodium were used for the management of osteoporosis. The patient was 164 cm tall, and his bone age was approximately 15 years old. However, owing to a poor economic condition, the family did not proceed with GH therapy.

Outcomes:
The patient did not present with adrenal or hypothyroidism crisis after receiving poly-hormonal replacement therapy. His secondary sexual characteristics began to develop. However, owing to a short treatment window period, the patient could not receive the required treatment. Hence, whether the patient would have a normal fertility function needs to be confirmed.

Lessons:
PSIS is a rare disease with various clinical characteristics. During the neonatal period and infancy, the signs and symptoms of PSIS are often not evident. Therefore, diagnosis is delayed. The early detection of hormone deficiency and treatment initiation can affect both the quality of life and the prognosis of patients with PSIS. Thus, the diagnosis and treatment of this disease must be improved to help patients achieve a better quality of life and to prevent reproductive health problems.
External therapy of Chinese medicine for postherpetic neuralgia
Authors: Wang Zheyi , Sun Yize , Liu Biyuan , Fan Zhu , Tian Jinzhou , Lu Tao 
Published: December 2020

Abstract

Background:
Postherpetic neuralgia (PHN), the most common complication of herpes zoster, brings about a health-care burden at both the individual and societal levels. External therapy of Chinese medicine (ETCM) is an effective treatment of PHN generally available in China, yet there is incomplete evidence to evaluate the efficacy and safety of it.

Methods:
This protocol is based on the previous reporting items. We will search 3 English databases (PubMed, EMBASE, and the Cochrane Library) and 3 Chinese databases (CNKI, CBM, and Wan Fang Database) until January 2020. RCTs to evaluate the efficacy and safety of external therapy of Chinese medicine for postherpetic neuralgia will be included. The primary outcome will be assessed by VAS or NRS. We will use the criteria provided by Cochrane Handbook 5.3.0 for quality evaluation and risk assessment, and use the Revman 5.3 software for meta-analysis.

Ethics and dissemination:
Ethical approval is not required for systematic review and meta- analysis. The results of this review will be disseminated in a peer-review journal.

PROSPERO registration number:
CRD42020163511.
Comparison of the practicability of ultrasound and spiral computed tomography in the diagnosis of colon cancer
Authors: Zhao Fan , Yang Qingya , Meng Cunzhong , Jiang Tao 
Published: December 2020

Abstract

Background:
Colon cancer is a common malignant tumor of the gastrointestinal tract. Therefore, a clear diagnosis is particularly important for the treatment of colon cancer. Ultrasound and spiral computed tomography (CT) can both be used in the diagnosis, but each has its own advantages and disadvantages, which could cause confusion in clinical choice. The purpose of this study was to systematically evaluate the practicability of spiral CT and ultrasound in the diagnosis of colon cancer.

Methods:
A systematic search was performed by retrieving on English databases (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese databases (CNKI, Wanfang, Weipu [VIP], CBM). Besides, manually search for Google and Baidu academic of diagnostic experimental study of ultrasound and spiral CT in the diagnosis of Colon Cancer. The retrieval time limit was from the establishment of the database to October 2020. Two researchers independently extracted and evaluated the quality of the data in the included study. A meta-analysis was performed using Meta Disc1.4 and RevMan5.3 software.

Results:
Sensitivity, specificity, positive Likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were used to determine the diagnostic efficacy of ultrasonography and helical CT in colorectal cancer.

Conclusions:
This study will compare the practicability of CT and ultrasound in the diagnosis of colon cancer and provide reliable evidence-based basis for clinicians to choose the appropriate or best evidence-based basis.

Ethics and dissemination:
The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF Registration number:
DOI 10.17605/OSF.IO/WAJHQ
Herbal medicines for the prevention and treatment of cerebral vasospasm after subarachnoid hemorrhage
Authors: Seo Yuna , Lee Han-Gyul , Jin Chul , Yang Seung-bo , Cho Seung-Yeon , Park Seong-Uk , Jung Woo-Sang , Moon Sang-Kwan , Park Jung-Mi , Ko Chang-Nam , Cho Ki-Ho , Kwon Seungwon 
Published: December 2020

Abstract

Background:
Despite the rapid advances in medical technology, including endovascular interventions and medications, cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) is still one of the major threats to the lives of patients with SAH. In East Asian countries, various types of herbal medicines have been used to treat cerebrovascular diseases, including SAH. In this review, we aim to evaluate the efficacy and safety of herbal medicines for the prevention and treatment of CVS after SAH.

Methods and analysis:
Seven databases will be searched for relevant studies from inception to the present date “June 2020”. Only randomized controlled trials (RCTs) that assess the effect and safety of herbal medicines for the prevention and treatment of CVS after SAH will be included. The methodological quality will be evaluated using the Cochrane risk of bias assessment tool. After selecting the appropriate studies, a meta-analysis of the RCTs will be performed.

Results:
This study will provide a high-quality synthesis of current evidence of herbal medicines for CVS after SAH.

Conclusion:
Our systematic review will provide evidence to judge whether herbal medicines are effective interventions for patients with CVS after SAH.

Ethics and dissemination:
Ethical approval is not required, as this study is based on a review of published research. This review will be published in a peer-reviewed journal and disseminated electronically and in print.

Trial registration number:
Research registry reviewregistry923.
Effects of intravenous thrombolysis with alteplase combined with edaravone on cerebral hemodynamics and T lymphocyte level in patients with acute cerebral infarction
Authors: Li Xiu-Xiu , Liu Shi-Hui , Zhuang Su-Jing , Guo Shi-Feng , Pang Shou-Liang 
Published: December 2020

Abstract
Our study aimed to investigate the effect of intravenous thrombolysis with alteplase and edaravone on cerebral hemodynamics and T lymphocyte level in patients harboring acute cerebral infarction.
There involved a total of 118 patients with acute cerebral infarction from November 2017 to May 2019 in our hospital were randomly divided into 2 groups: the observation group (59 patients were treated with intravenous thrombolysis with alteplase combined with edaravone) and the control group (59 patients were treated with intravenous thrombolysis of alteplase). The clinical effect, neurological function, cerebral hemodynamic index, T lymphocyte level, oxygen free radical scavenging level and oxidative stress index of the 2 groups were observed and compared.
Before the treatment, there were no significant differences in neurological function, cerebral hemodynamic indexes, T-lymphocyte level, oxygen free radical scavenging level and oxidative stress indexes between the 2 groups (P > .05). After the treatment, the neurological function, cerebral hemodynamic indexes, T-lymphocyte level, oxygen free radical scavenging level and oxidative stress indexes of the 2 groups were significantly improved. In addition, the observation group exerted greater beneficial effect in terms of the clinical effect, neurologic function, cerebral hemodynamic index, T lymphocyte level, oxygen free radical scavenging level and oxidative stress index than those of the control group (P < .05).
The intravenous thrombolysis with alteplase and edaravone is effective in the treatment of acute cerebral infarction, which also provides better results in terms of improving the clinical efficacy and prognosis of patients and might be an alternative option for clinical practice.
Comparison of pleiotropic effects of statins vs fibrates on laboratory parameters in patients with dyslipidemia
Authors: Takeuchi Satoshi , Takahashi Yasuo , Asai Satoshi 
Published: December 2020

Abstract
Differences in the mechanism of action and potential pleiotropic effects between statins and fibrates would potentially drive a different effect on various laboratory parameters, but this remains controversial because of a paucity of reports comparing them. Therefore, the aim of this study was to compare the effects of statins and fibrates on laboratory parameters in Japanese patients in routine clinical practice.
This retrospective cohort study included patients with dyslipidemia who had been newly treated with statin or fibrate monotherapy between January 2005 and December 2017. Patients were randomly matched into two sets of pairs by sex, age, and baseline triglyceride (TG) or low-density lipoprotein (LDL) cholesterol level. The 830 patients in TG-matched pairs (415 fibrate users and 415 matched statin users) and 1172 patients in LDL cholesterol-matched pairs (586 fibrate users and 586 matched statin users) were included in this study. Generalized estimating equations were used to estimate the effects of the drugs on serum creatinine level, estimated glomerular filtration rate (eGFR), urea nitrogen, hemoglobin A1c, aspartate aminotransferase, and alanine aminotransferase (ALT), in addition to LDL cholesterol and TG levels, and red blood cell (RBC) and platelet (PLT) counts, up to 12 months after the start of study drug administration.
In TG-matched pairs, the increases in creatinine and urea nitrogen levels (P = .010 and P < .001, respectively) and the decreases in eGFR, ALT level and RBC count (P < .001, P = .003, and P = .014, respectively) were greater in fibrate users than in statin users. The decrease in PLT count was greater in statin users than in fibrate users (P < .001). The mean changes in aspartate aminotransferase and hemoglobin A1c levels were not significantly different between statin users and fibrate users. In LDL cholesterol-matched pairs, the differences in changes of all laboratory parameter levels between statin users and fibrate users were similar to those in TG-matched pairs.
We demonstrate here that fibrates have a greater effect of increasing creatinine and urea nitrogen levels and of reducing eGFR, ALT level, and RBC count than statins, and that the lowering effect on PLT count is greater with statins than with fibrates.
Proton pump inhibitor use is associated with a variety of infections in patients with liver cirrhosis
Authors: Labenz Christian , Kostev Karel , Galle Peter R. , Wörns Marcus-Alexander , Labenz Joachim , Tanislav Christian , Adarkwah Charles Christian 
Published: December 2020

Abstract
There is evidence that intake of proton pump inhibitors (PPI) increases the risk for spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis. However, data regarding the impact of PPI intake on occurrence of infections other than SBP are still lacking.
We hypothesized that PPI use is associated with a higher rate of infections other than SBP in patients with liver cirrhosis.
The current case-control study sample included patients with liver cirrhosis from the Disease Analyzer database (IQVIA), which compiles data such as risk factors, drug prescriptions and diagnoses obtained from general practitioners and specialists in Germany. In total, 2,823 patients with infections were matched with 2,823 patients without infections by propensity scores. For quantification of PPI use the prescribed quantity of PPI during the past 12 months before index date was analyzed.
Frequency of PPI users was significantly higher in patients with infections than in patients without infections (47.9% vs 37.9%). In regression analysis, PPI use was significantly associated with the occurrence of infections overall (OR 1.55, 95% CI 1.39–1.72, P < .001), and associated with the occurrence of lower respiratory tract infections, urinary tract infections and infectious gastroenteritis. There was no association between PPI use and skin infections. Pantoprazole and omeprazole were the most frequently prescribed PPIs and were both independently associated with the occurrence of infections.
PPI use may be associated with infections other than SBP in patients with liver cirrhosis. Prescription of PPI should be limited to patients with a clear indication.
Impact of the coronavirus disease 2019 outbreak on the transportation of patients requiring emergency care
Authors: Kim Hyun Soo , Jang Tae Chang , Kim Gyun Moo , Lee Suk Hee , Ko Seung Hyun , Seo Young Woo 
Published: December 2020

Abstract
The first confirmed community transmission of coronavirus disease 2019 in Daegu Metropolitan City, South Korea, occurred on February 18, 2020. In the following 70-day period, approximately 6000 new cases occurred, severely impacting the medical service system. This study investigated the crisis-impact on the local emergency transport system.
Emergency medical service activity reports were retrospectively reviewed to determine patient demographics and initial vital signs. Delay in reaching the patient, transporting the patient to the hospital, and returning to the fire station were assessed and categorized based on patients’ initial vital signs. The study period was divided into 4 groups (1/1–2/18, 2/19–3/3, 3/4–3/31, and 4/1–04/30) and intergroup differences were analyzed.
When compared to Period 1, the time-difference between the request to attend a scene and arrival at the scene was delayed in Periods 2, 3, and 4 by 4 minute 58 s, 3  minute 24 seconds, and 2 minute 20 seconds, respectively; that between arriving at the scene and at the hospital was delayed by 7  minute 43 seconds, 6 minutes 59 seconds, and 4 minutes 30 seconds, respectively; and that between arriving at the hospital and returning to the fire station was delayed by 29  minute 3 second, 25  minute 55 second, and 18  minute 44 second, respectively. In Period 2, for patients with symptoms of severe illness when compared to patients lacking such symptoms, the time-difference between the request to attend the scene and arrival at a hospital and between arrival at the hospital and returning to the fire station were 6 to 23 minute and 12 to 48 minute longer, respectively. Most of the delays impacted patients with a fever. In terms of condition, the statistical effect size for delay in transport time was from large to small: fever, hypoxia, abnormal respiratory rate, respiratory symptom, and hypotension.
Outbreaks of infectious disease cause a paradoxical state in emergency medical transport systems, inducing delays in the transport of severely ill patients. Therefore, maintenance and improvement of the medical service system for both patients with infectious disease and those with other severe illnesses is required.
Association between time spent outdoors and myopia among junior high school students
Authors: Zhang Linjie , Wang Weidong , Dong Xiaoyang , Zhao Li , Peng Jia , Wang Ronghai 
Published: December 2020

Abstract
This study sought to investigate the recent incidence rate of myopia in Chinese junior high school students and analyze the effect of time spent outdoors on myopia, in addition to facilitating the prevention and control of myopia among students.
This study was derived from a national panel study, the China Education Panel Survey. We conducted three rounds of follow-up visits among 10,279 seventh grade students from 112 middle schools in 20 provinces in 2013. In total, 3571 students were selected for the analysis in 2020 by excluding those lost to follow-up and students who were myopic in the first round. The primary outcomes were the prevalence of myopia and the effect of time outdoors on myopia. The baseline characteristics of the included students were described, and the correlation between time spent outdoors and myopia in the three rounds of data was analyzed by a correlation chi-square test. Then, the generalized estimation equation (GEE) was used to estimate the influence of time spent outdoors on myopia after follow-up.
There were 3571 students with normal baseline vision, and 1508 (42.23%) students progressed from having a normal vision to myopia in the third round, of whom 706 (46.82%) were male and 802 (53.18%) were female. The results of the chi-square test showed that the time spent outdoors of all students and girls, specifically, was related to myopia (P < .05). Next, the GEE was used to analyze the influence of time spent outdoors on myopia after follow-up. After two model adjustments (individual and family-related characteristics of students), students with < 7 hours/week time spent outdoors retained a high myopia rate than ≥14 hours/week (OR = 1.250; 95% CI: 1.070–1.460). Among boys, there was no statistical correlation between time spent outdoors and myopia (P > .05). For girls, compared with students who spent ≥14 hours/week outdoors, students with <7 hours/week spent outdoors retained a higher myopia rate (OR = 1.355; 95%CI: 1.067–1.720).
Increased time spent outdoors can delay the development of myopia. In terms of gender, girls should be targeted to more effectively prevent and control the development and progression of myopia.
Successful pregnancy and live birth in woman with congenital adrenal hyperplasia
Authors: Xiong Wei , Huang Guiqiong , Wang Xiaodong , Tan Shiqiao 
Published: December 2020

Abstract

Rationale:
Women with congenital adrenal hyperplasia (CAH) can suffer from impaired fertility rates as a result of increased androgen secretion or impaired sex steroid production. CAH patients have lower pregnancy rate compared to normal women. Only a few cases with successful pregnancy have been reported in the literature. This report described a case of CAH with successful pregnancy and live birth.

Patient concerns:
A 23-year-old woman visited our endocrinology department for clitoral hypertrophy and primary amenorrhea.

Diagnoses:
The patient was diagnosed as CAH.

Intervention:
Prednisone was initially started to improve the patient's symptoms. Then she underwent clitoral resection and vaginoplasty several months later. She continuously took the prednisolone after the operation and had been undergoing regular checkups.

Outcomes:
She was pregnant spontaneously without assisted reproductive technology and had a successful live birth. Her baby had shown normal external genitalia with normal karyotype and normal development up to 6 years of age.

Lessons:
Some mild CAH patients with certain types can achieved successful pregnancy without any assisted reproductive technology after treatment with steroid. The pregnancy rate among CAH women who wish to conceive may be much more optimistic than previous researches.
Synovial sarcoma of the spine in the lumbar vertebral body
Authors: Feng Qi , Guo Peng , Wang Donglai , Lv Jian , Feng Jiangang 
Published: December 2020

Abstract

Rationale:
Synovial sarcoma (SS) is a soft tissue neoplasm that rarely occurs in the vertebral body and should be considered in the differential diagnosis in patients with SS and vertebral lesions. SS often presents as a painless mass in the spine, which may undergo slow enlargement, resulting in sustained symptoms of neurologic deficit and pain. Due to the difficulty in differentiating between SS from other soft tissue tumors and metastatic tumors, careful histological confirmation is required for definite diagnosis. Furthermore, due to its malignancy, the appropriate treatment procedure for SS should be carefully considered.

Patient concerns:
A 56-year-old female patient had low back pain. Radiological examination revealed bony erosion of the L-2 vertebral body, and no soft tissue mass around the lumbar spine.

Diagnosis:
Histopathological and immunohistochemical examination revealed SS.

Interventions:
The initial treatment of posterior laminectomy decompression and percutaneous vertebro plasty (PVP) was performed, however, this initial treatment course was inappropriate, but she eventually underwent L-2 complete resection and internal fixation. After the second surgery, she was treated by external beam radiation therapy.

Outcomes:
operation radiotherapy was finally performed. No local recurrence in L-2 vertebral body or distant metastasis was found at 1-year follow up postoperation; the neurologic symptom gradually relieved, and no other symptom was noted. And no local recurrence in L-2 vertebral body and distant metastasis was found in 1 year follow up postoperation.

Lessons:
Solitary spinal SS is extremely rare. Early surgery for total resection and adjuvant radiotherapy/chemotherapy should be emphasized.