bluuebunny/crossref_metadata_2025_split huggingface dataset:
A systematic review and meta-analysis to compare the efficacy of conbercept with ranibizumab in patients with macular edema secondary to retinal vein occlusion
Authors: Liu Weishai , Li Yanjie , Cao Rongxia , Bai Zichao , Liu Weiqin 
Published: May 2020

Abstract

Background:
The objective of this review and meta-analysis is to investigate the efficacy of conbercept and ranibizumab, combined with or without laser photocoagulation, in patients with macular edema secondary to retinal vein occlusion (RVO-ME).

Methods:
Several databases have been used to identify relevant publications. After screening, a meta-analysis was conducted to compare conbercept and ranibizumab with the support of RevMan 5.3 (Cochrane Library Software, Oxford, UK).

Results:
In this study, 9 randomized controlled trials and 6 retrospective trials were included with a total of 1180 patients. No significant difference was found in best corrected visual acuity (BCVA) or central macular thickness (CMT) in the baseline parameters [BCVA (weighted mean difference (WMD): –0.01; 95% confidence interval CI: –0.03 to 0.01; P = .17), CMT (WMD: 20.14; 95% CI: –26.70 to 66.97; P = .40). No significant differences were found in the improvements of BCVA and adverse events (AEs) between the 2 groups after injection of loading dosage [the 1st month BCVA (WMD: –0.01; 95% CI: –0.04 to 0.02; P = .54),the 3rd month BCVA (WMD: –0.02; 95% CI: -–0.05 to 0.01; P = .23), the 6th month BCVA (WMD: –0.02; 95% CI: –0.05 to 0.01; P = .27), AEs (odds ratio: 0.84; 95% CI: 0.38 to 1.84; P = .66)]. However, there were significant differences between conbercept and ranibizumab treatment in terms of CMT [1st month CMT (WMD: –11.70; 95% CI: –19.71 to –3.68; P < .01), 3rd month CMT (WMD: –10.08; 95% CI: –15.62 to –4.53; P < .01), 6th month CMT (WMD: –15.83; 95% CI: –22.88 to –8.78; P < .01)] and the number of injections (WMD, –0.36; 95% CI: –0.68 to –0.04; P = .03).

Conclusion:
The current pooled evidence suggested that both therapies of intravitreal conbercept and intravitreal ranibizumab with or without laser photocoagulation are effective in vision function in RVO-ME patients, and confirmed that conbercept has advantages over ranibizumab in terms of CMT and the number of injections for treating RVO-ME. In addition, conbercept has the statistically same visual gains and safety as ranibizumab in RVO-ME patients. Longer-term follow-up surveys on the safety and effectiveness of these 2 treatment regimens are required.
Isolated left bronchial isomerism that was incidentally detected as a severe obstructive ventilatory disturbance in an asymptomatic adult patient
Authors: Heo Manbong , Jeong Jong Hwan , You Jung Wan , Kim Ju-Young , Park Mi Jung , Jeon Kyung Nyeo , Lee Jong Deog , Lee Seung Jun 
Published: May 2020

Abstract

Rationale:
Left bronchial isomerism is generally associated with abnormal arrangement of the atrium and abdominal viscera; therefore, its diagnosis is confirmed in early childhood.

Patient concerns:
Here we report a rare case involving a 36-year-old man with isolated left bronchial isomerism that presented as an asymptomatic severe obstructive ventilatory disturbance during pulmonary function tests performed as part of routine assessments for an orbital wall fracture. The patient was a current smoker and did not show any respiratory symptoms.

Diagnosis:
Chest computed tomography revealed left bronchial isomerism, and further tests showed that there was no involvement of other organs.

Interventions:
We recommended smoking cessation and the long-term use of an inhaled long-acting bronchodilator.

Outcomes:
The findings from this case highlight the causative role of left bronchial isomerism in asymptomatic adults with chronic obstructive pulmonary disease.

Lessons:
Physicians should consider this condition as a cause of obstructive ventilatory disturbances in asymptomatic adult patients.
Motor recovery by the aberrant pyramidal pathway in a patient with cerebral infarct
Authors: Jang Sung Ho , Lee Jun , Seo You Sung 
Published: May 2020

Abstract

Introduction:
The aberrant pyramidal tract (APT) refers to the collateral pathway of the pyramidal tract (PT) descending through the medial lemniscus in the midbrain and pons. We report on a patient who showed changes of the APT from the early stage to the chronic stage concurrent with motor recovery following an infarct in the cerebral peduncle.

Patient concerns:
An 84-year-old female patient presented with moderate motor weakness of her upper and lower extremities (2+/2+) due to cerebral infarct on the right cerebral peduncle of midbrain. One week after her stroke, her motor weakness was similar to that at the onset (2+/2+). During 5 weeks’ rehabilitation, her motor weakness recovered to the point that she was able to move upper and lower extremities against gravity with some resistance (4-/4-).

Diagnosis:
Cerebral infarct on the right cerebral peduncle of midbrain

Interventions:
She participated in a comprehensive rehabilitative management program, including movement therapy, neurotrophic drugs, and neuromuscular electrical stimulation therapy of the left finger extensor and ankle dorsiflexor muscles.

Outcomes:
On 1-week and 6-week diffusion tensor tractographys (DTTs), the right PT was not reconstructed, but the right APT, which descended through the medial lemniscus pathway at the midbrain and pons and the pyramid at the medulla, was observed. The right APT became thicker on six-week DTT compared with 1-week DTT. On 1-week transcranial magnetic stimulation study, an motor evoked potential with delayed latency and decreased amplitude was evoked from the affected (right) hemisphere (latency: 24.4 msec and amplitude: 0.2uV). In contrast, its latency was decreased and amplitude was increased on six-week transcranial magnetic stimulation study (latency: 21.8 msec, amplitude: 0.8 uV)

Conclusions:
We demonstrated changes in the APT from the early stage to the chronic stage concurrent with motor recovery in a patient with an infarct in the cerebral peduncle. Our findings have important implications that a spared APT could contribute to the motor recovery in patients with cerebral infarct when the PTis completely injured at the onset of cerebral infarct,.
The start of gastrectomy at different time-of-day influences postoperative outcomes
Authors: Wang Bin , Yao Yizhou , Wang Xuchao , Li Hao , Qian Huan , Jiang Linhua , Zhu Xinguo 
Published: May 2020

Abstract
Gastric cancer (GC) continues to be 1 of the malignant tumors with high morbidity and mortality worldwide. Although the improvements in targeted inhibitor therapy have promoted survival, the first choice for GC patients is still surgery. However, prolonged surgery may tire surgeons and affect surgical outcomes.
To detect whether different time-of-day radical gastrectomy influenced short-term and long-term surgical outcomes.
This study included 117 patients between 2008 and 2012 who underwent a radical gastrectomy. These patients were grouped into the morning (before 13:00) and afternoon (after 13:00) groups or divided into 2 groups according to the median operation start time (before or after 11:23). Then, the relevant influence of the surgical start time was analyzed.
The morning group (before 13:00) and the front median group (before 11:23) showed longer operative time (P = .008 and P = .016, respectively), lower estimated blood loss (P < .001 and P = .158, respectively), and longer time before resuming oral intake (P < .001 and P < .173, respectively) than the afternoon group (after 13:00) or latter median group (after 11:23). Starting the operation in the morning had no effect on the rate of postoperative complications. The operation start time had no significant influence on the overall survival of patients who underwent a radical gastrectomy. However, in subgroup analysis, patients who underwent a distal gastrectomy faced poor prognosis when their surgery started after 13:00 (P = .030).
The results suggest that the operation start time might be an indicator of total operative time, estimated blood loss, and the time to resuming oral intake. The operation start time may also influence the prognosis of radical gastrectomy in patients with GC.
Standardization of rehabilitation program for post-apoplectic limb spasm treated by Tongjing Tiaoxing tuina and scalp acupuncture with physical therapy
Authors: Zhang Qiongshuai , Wang Yufeng , Ji Guangcheng , Cao Fang , Hu Guanyu , Cong Deyu , Xu Xiaohong , Song Bailin 
Published: May 2020

Abstract

Background:
Tong Jing Tiao Xing tuina (TJTX) is a Chinese massage method. Excising with scalp acupuncture (ESA) is a treatment combining scalp electroacupuncture with physical therapy (PT), and yinao fujian formula (YNFJ) is a Chinese oral herbal granule medicine. The combination of the 3 methods is called the “Zhishen Tiaoxing” (ZSTX) rehabilitation program, which is used as an alternative of limb spasm after stroke. There is little available evidence demonstrating its safety and efficacy.

Methods:
This will be a subject-blind, randomized controlled trial conducted in 3 medical centers. It will strictly follow the Standards for Reporting Interventions in Clinical Trials of Acupuncture, 2010. We will recruit 316 patients with limb spasm after stroke, 200 from the Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China, 80 from the Second Affiliated Hospital of Heilongjiang University of Chinese medicine, Harbin, China, and 36 from Huashan Hospital of Fudan University, Shanghai, China. A block randomization sequence stratified by centers will be generated using SAS Version 9.2 software (SAS Institute, Cary, NC, USA), which was performed at the Guangdong Provincial Hospital of Chinese Medicine's Key Unit of Methodology in Clinical Research. The treatment group is treated with TJTX (once a day), ESA (once a day), and oral YNFJ (twice a day). The control group will be treated with PT. Two groups of patients will be treated 5 sessions a week for 4 weeks, and there will be 6-month follow-up. The outcome evaluators will be blinded to patient grouping. The primary outcome will be modified Ashworth scales. The secondary outcome indexes will be the simplified Fugl–Meyer assessment scale, surface electromyogram root mean square value, modified Barthel index, stroke-specific quality of life scale, health scale of traditional Chinese medicine, visual analogue scale (VAS), and the Hamilton depression scale.

Discussion:
The Randomized Controlled Trial (RCT) mainly aim to evaluate the effectiveness and safety of traditional Chinese medicine rehabilitation program, by comparing the treatment of ZSTX with the PT for the treatment of limb spasm after stroke.

Trial registration:
Chinese Clinical Trial Registry: ChiCTR 1900024255. Registered on July 3, 2019.
Appraisal and recommendation synthesis of guidelines and consensuses for interventions of pressure ulcers
Authors: Geng Jie , Yang Ke-Lu , Cai Yi-Tong , Shi Ji-Yuan , Yin Min , Wang Xiao-Ping 
Published: May 2020

Abstract

Background:
Pressure ulcers (PU) bring a considerable physical and mental burden on patients and their families, and have put families and government under tremendous pressure to cover the cost for treatment. Therefore, this protocol proposes to evaluate the quality of existing PU clinical practice guidelines (CPGs) and compare the similarities and differences between its recommendations in order to improve the treatment efficacy and reduce the PU treatment cost.

Methods:
Electronic databases and specific databases of CPGs will be searched. Study selection and data collection will be performed independently by two reviewers. The Appraisal of Guidelines for Research & Evaluation II (AGREE II) Instrument and Reporting Items for Practice Guidelines in Healthcare (RIGHT) will be used to assess the methodological quality and reporting quality of included CPGs. Bubble plot will be used to describe the difference of the quality, and mind mapping will be plotted to illustrate the comparison of recommendations of a guideline when needed. R software, MindMaster and Excel will be used.

Results:
The results of this study will be submitted to a peer-reviewed journal for publication.

Conclusion:
This systematic review will provide comprehensive evidence of CPGs of PU.

PROSPERO registration number:
CRD42020149176.
The study on the risk of other endocrine glands autoimmune diseases in patients with type 1 diabetes mellitus
Authors: Liu Yang , Chen Shuchun , Zhang Dongmei , Li Zelin , Wang Xing , Xie Xing , Zhu Haijiao , Ren Luping , Wang Liqin 
Published: May 2020

Abstract
To study the changes of pancreas, thyroid, adrenal, parathyroid and gonadal organ-specific antibodies in patients with type 1 diabetic patients and to explore the risk of development to other endocrine gland autoimmune diseases.
Fifty one patients with type 1 diabetes mellitus were selected. ELISA was used to detect islet, adrenal gland, Parathyroid, gonadal organ-specific antibody levels, the level of thyroid-related antibodies by lectrochemiluminescence.
Compared with the healthy control group, the levels of the 17-α-OHAb, 21-OHAb, NALP5Ab, P450sccAb, and CaSRAb in the T1DM group were significantly higher. GADAb-positive patients were more likely to have TPOAb-positive patients than GADAb-negative patients, and the positive rate of 2 thyroid antibodies in GADAb-positive patients was significantly higher than that in GADAb-negative patients. The presence of these antibodies is related to the age of onset of type 1 diabetes or Patient age. In combination with 1 or 2 islet antibody-positive patients, the combined non-islet antibody positive rate was higher than that of islet antibody-negative patients.
Patients with type 1 diabetes with other autoimmune diseases at risk significantly increased compared with normal, of which the most common thyroid autoimmune disease, thyroid antibodies and hormone levels should be routinely detected at the first visit and long-term follow-up.
Characteristics of diffusion tensor imaging of central nervous system in children with tourette's disease
Authors: Xia Xianwu , Lin Yeqing , Lang Boxu , Yuan Jianjun , Sheng Liang , Yang Dengfa , Shen Jianmin 
Published: May 2020

Abstract
To investigate the characteristics of diffusion tensor imaging (DTI) of the central nervous system in children with Tourette syndrome (TS).
Fifteen children with TS (TS group) and 15 normal children (control group) were studied, and all of them underwent DTI. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) parameters were calculated using the DTIStudio software. The region of interest was delineated manually. The ADC and FA values of the bilateral caudate nucleus, bilateral globus pallidus, bilateral putamen, bilateral thalamus, and bilateral frontal lobe white matter were measured using the region of interest editor software. The differences of FA values and ADC values between the same brain areas were compared. The associations between ADC, FA values and Yale Global Tic Severity Scale (YGTSS) scores were evaluated by Pearson correlation analyses.
The FA values of left globus pallidus and left thalamus were significantly lower in the TS group than in the control group (P < .05), while the ADC values of the right caudate nucleus and bilateral thalamus were significantly higher in the TS group than in the control group (P < .05). The decrease in FA in the left thalamus significantly correlated with the YGTSS score (r = 0.692; P < .05). No correlation was found between FA and ADC values in other brain regions and the YGTSS score (P > .05).
After the DTI analyses, abnormalities were found in the left globus pallidus, right caudate nucleus, and bilateral thalamus in children with TS. Especially the changes in the left thalamus structure was crucial in the pathophysiological clock of TS.
Congenital microcephaly with early onset epileptic encephalopathy caused by ASNS gene mutation
Authors: Chen Chen , Hao Yunpeng , Liang Jianmin , Liu Xuncan 
Published: May 2020

Abstract

Rationale:
Asparagine synthetase deficiency (ASNSD) refers to a congenital metabolic abnormality caused by mutation in the asparagine synthetase (ASNS) gene encoded by chromosome 7q21. Herein, we report the first case of ASNSD in China, in which novel ASNS mutations were identified.

Patient concerns:
A 6-month-old boy presented with a 4-month history of microcephaly and psychomotor developmental retardation and a 2-month history of epilepsy. Four months after birth, magnetic resonance imaging demonstrated a giant cyst in the right lateral ventricle, and a ventriculoperitoneal shunt was placed. Video electroencephalography showed a hypsarrhythmia pattern with a string of tonic-clonic and myoclonic seizures. On admission, physical examination showed microcephaly. Neurologic examination showed a decreased tension in the trunk muscles and an increased tension in the extremity muscles; tendon hyperreflexia was noted, and bilateral pathologic reflexes were positive.

Diagnosis:
A diagnosed of congenital microcephaly was made. Whole-exome sequencing revealed a heterozygous deletion mutation c.666_667delCT (p.L2221Lfs∗5) in exon 6 of the ASNS gene and a heterozygous missense mutation c.1424C>T (p.T457I) in exon 13 of the ASNS gene.

Interventions:
After admission, intravenous adrenocorticotropic hormone and oral topiramate was administrated for 4 weeks, while the seizures persisted. Then, levetiracetam and clonazepam were added.

Outcomes:
After the follow-up period of 18 months, video electroencephalography showed that complex episodes disappeared with changes in multiple focal spike and sharp waves; 1 focal attack arising from the left occipital region and 2 focal attacks arising from the right middle temporal and the right occipital region were recorded.

Lessons:
This is the first case of ASNSD in China. We identified 2 novel mutations (c.666_667delCT and c.1424C>T) in the ASNS gene, which expands the ASNS gene mutation profile and will be beneficial for genetic diagnosis.
Hemostatic potential of cold-stored non-leukoreduced whole blood over time: An assessment of platelet function and thrombin generation for optimal shelf life
Authors: Assen Scott , Cardenas Jessica , George Mitchell , Wang Yao-Wei , Wade Charles E. , Meyer David , Cotton Bryan A. 
Published: May 2020

OBJECTIVES
Cold-stored low-titer whole blood (WB) is becoming increasingly used as the preferred product for initial hemorrhagic shock resuscitation. The purpose of this study was to identify whether the current 21-day shelf life is the optimal duration for storage of WB, maintaining hemostatic efficacy.

METHODS
Five units of fresh low-titer group O WB (non-leukoreduced) were acquired from our regional blood center. These units were stored at 4°C for up to 21 days as per current clinical storage guidelines in our emergency department. Hemostatic parameters were measured in vitro at 0 days, 7 days, 14 days, and 21 days. Assessments of hemostatic potential included cell count, rapid thrombelastography (r-TEG) and kaolin thrombelastography (TEG), multiplate impedance aggregometry, and calibrated automated thrombogram (CAT). Univariate analysis, including one-way analysis of variance with repeated measures, was performed (STATA 12.1).

RESULTS
Compared with baseline product (0 days), both platelet count and platelet function of WB showed sharp decreases at 7 days and again at 14 days. Platelet function deterioration was noted by r-TEG c (MA), TEG-MA, and multiplate arachidonic acid and adenosine diphosphate (all p < 0.001). With respect to clot initiation, r-TEG ACT and TEG R-time were similar over the 21-day shelf life (p = 0.058 and p = 0.620, respectively). Thrombin generation assessed by CAT demonstrated stable endogenous thrombin potential over the course of storage (p = 0.162), but increased peak thrombin generation and quicker time to peak generation after 7 days.

CONCLUSION
While the platelet function of WB degrades significantly at 7 days (and again at 14 days), clot initiation remains stable over time, and thrombin generation appears to be improved at 7 days. This study supports a current storage limit for cold-stored, low-titer WB of 14 days.
Graft-versus-host Disease Prophylaxis With Abatacept Reduces Severe Acute Graft-versus-host Disease in Allogeneic Hematopoietic Stem Cell Transplant for Beta-thalassemia Major With Busulfan, Fludarabine, and Thiotepa
Authors: Khandelwal Pooja , Yeh Rosa F. , Yu Louie , Lane Adam , Dandoy Christopher E. , El-Bietar Javier , Davies Stella M. , Grimley Michael S. 
Published: May 2020

Background.
We hypothesized that the addition of 4 doses of abatacept to our standard acute graft-versus-host disease (GVHD) prophylaxis would reduce the incidence of day +100 severe acute GVHD in children with transfusion-dependent beta-thalassemia major undergoing a myeloablative allogeneic hematopoietic stem cell transplant (HSCT), without impacting engraftment.

Methods.
Twenty-four children with beta-thalassemia major received abatacept at a dose of 10 mg/kg intravenously on days –1, +5, +14, and +28 after HSCT in addition to calcineurin inhibitors and methylprednisolone. Outcomes were compared to 8 beta-thalassemia patients who received standard acute GVHD prophylaxis.

Results.
There was no difference in engraftment between the 2 groups. No patient had grades III–IV acute GVHD by day +100 in the abatacept cohort compared with 50% in the standard acute GVHD prophylaxis group (P = 0.001). Viral reactivation occurred in 5 children in the standard acute GVHD cohort and in 20 children in the abatacept cohort (P = 0.2). Thalassemia-free survival after HSCT was 100% in the abatacept cohort compared to 62.5% in the standard cohort at last follow-up (P = 0.007).

Conclusions.
Adding abatacept to our routine GVHD prophylaxis reduced the incidence of day +100 severe acute GVHD without impacting engraftment or survival.
The Meaning Behind the Scar: Anonymous Live Liver Donors’ Perceptions of Their Surgical Scars
Authors: Krause Sandra , Pritlove Cheryl , Abbey Susan , Jung Judy 
Published: May 2020

Background.
Scarring can greatly impact quality of life for individuals (ie, causing depression posttraumatic stress disorder and body image issues). Those who wish to be anonymous live liver donors are warned of the potential negative psychological impacts associated with the large scar left from liver donation surgery. Given the unique degree of autonomy that these patients have over their surgery, we explore whether a sample of 26 anonymous live liver donors experience a unique relationship with their scar.

Methods.
Anonymous donors participated in a semistructured qualitative interview examining their experience with donation. Interviews were audio-recorded, transcribed, and analyzed using the constant comparison method for themes pertaining, to participants’ perception of their scar.

Results.
Five main themes were identified—a marker of satisfaction about the donation experience, a physical reminder of donation, a trigger for recipient-related thoughts, an awareness tool, and a potential threat to anonymity. Donors did not voice any body image or cosmetic concerns due to their scars. Instead, discussions about the negative aspects of scarring centered around the identifying nature of their scar.

Conclusions.
These findings help underscore the distinctiveness of anonymous living liver donors as a patient population. Preparing anonymous living liver donors for different types of cosmetic issues relating to their scar (ie, as a possible threat to their desired anonymity) may be more appropriate than preparing them in the same way as other donor populations.