bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors of haemorrhagic transformation for acute ischaemic stroke in Chinese patients receiving intravenous thrombolysis
Authors: Wen Lihong , Zhang Song , Wan Kunzhen , Zhang Hong , Zhang Xiaoyun 
Published: February 2020

Abstract

Aim:
To determine the risk factors related to hemorrhagic transformation in Chinese patients with acute ischemic stroke treated with intravenous thrombolysis.

Methods:
Studies published in different languages were retrieved by systematically searching PubMed, EMBASE, Vip, CNKI, and WanFang Data from the establishment of the library to December 31, 2018, as well as manually examining the references of the original articles. The outcome measures of efficacy covered risk factors. Safety evaluation was measured by relative ratio of complications.

Results:
A total of 36 studies involving 5597 participants were covered in this meta-analysis. The results indicated that age [WMD = 2.44, 95% CI (1.39,3.48)], male [OR = 1.21, 95% CI (1.02, 1.44)], diabetes [OR = 2.05, 95%CI (1.72,2.44)], atrial fibrillation [OR = 2.85, 95%CI (2.40, 3.39)], previous stroke [OR = 1.8, 95%CI (1.33, 2.44)], onset to treatment time (OTT) [WMD = 3.74, 95%CI (2.91, 4.58)], National Institute of Health stroke scale scores (NIHSS) [WMD = 4.17, 95% CI (3.37, 4.97)], infarct size [WMD = 4.11, 95% CI (3.15, 5.37)], ischemic signs of computed tomography (CT) [OR = 3.49, 95%CI (2.47, 4.93)] were associated with increased risk of hemorrhagic transformation after intravenous thrombolysis.

Conclusion:
The systematic review showed that male, age, diabetes, NIHSS, OTT, atrial fibrillation, post stroke, infarct size, and ischemic signs of CT were significantly correlated with hemorrhagic transformation (HT).

PROSPERO Registration number:
CRD42019127499.
Clinical analysis of 20 patients with non-Hodgkin lymphoma and autoimmune hemolytic anemia
Authors: Zhou Ji-cheng , Wu Mei-qing , Peng Zheng-mian , Zhao Wei-hua , Bai Zhen-jie 
Published: February 2020

Abstract
Non-Hodgkin lymphoma (NHL) can co-exist with autoimmune hemolytic anemia (AIHA), a phenomenon known as AIHA-associated NHL (AIHA/NHL). However, few studies have reported AIHA/NHL incidence or its clinical characteristics. We conducted a retrospective analysis of 20 AIHA/NHL patients treated at our hospital from 2009 to 2018. AIHA/NHL was presented by only 0.91% of the NHL and 9.8% of the AIHA patients. In addition, AIHA occurred most frequently with angioimmunoblastic T-cell lymphoma (AITL) (7.31%), followed by marginal zone B-cell lymphoma (MZBL) (6.25%), B-cell lymphoma-unclassified (BCL-U) (4.25%), chronic lymphocytic leukemia/small lymphocyte lymphoma (CLL/SLL) (2.50%), and mantle cell lymphoma (MCL) (2.30%). In addition to the CLL/SLL patients with impaired bone marrow, 66.7% of the AIHA/NHL patients had lymphoma bone marrow infiltration (LBMI), of which 4 patients presented LBMI in bone marrow smears (BMS) but not in bone marrow biopsy (BMB) and 6 were positive for BMB but not BMS. The 1-, 3- and 5-year survival rates of AIHA/NHL patients were 70%, 30% and 20%, respectively, and they responded poorly to chemotherapy. In conclusion, AIHA can co-exist with various NHLs and the defining clinical characteristic of AIHA/NHL is the high incidence of LBMI. However, both BMS and BMB should be performed to avoid missed diagnosis.
Traumatic intradural ruptured lumbar disc with a spinal compression fracture
Authors: Lee Gwangjun , Han Moon-Soo , Lee Seul-Ki , Moon Bongju , Lee Jung-Kil 
Published: February 2020

Abstract

Rationale:
We present a rare case of a traumatic intradural ruptured disc associated with a mild vertebral body compression fracture along with a review of the relevant medical literature. An intradural ruptured disc often occurs due to chronic degenerative diseases and is rarely due to trauma. It can cause irreversible neurological complications if the appropriate treatment is not planned.

Patient concerns:
A 32-year-old male presented with motor paraparesis (grade 3/5), right ankle dorsiflexion, and great toe dorsiflexion (grade 1/5), along with radiating pain at his right L4 and L5 sensory dermatome following a fall.

Diagnoses:
Computed tomography revealed a compression fracture of the L2 body. Lumbar magnetic resonance imaging showed an intradural mass-like lesion on the ventral side of his spinal cord and an epidural mass-like lesion on the dorsal side of his spinal cord, indicating a hematoma.

Interventions:
An emergency L2 laminectomy was performed to remove the space-occupying lesions and to decompress the cauda equina and nerve root. The mass-like lesion was removed. No other lesions were found in the spinal canal.

Outcomes:
Pathologic examination of the intradural mass lesion revealed fibrocartilage similar to that found in disc material. The patient still continued to experience motor weakness at the 1-year follow-up examination.

Lessons:
We report a rare case of a traumatic lumbar disc rupture into the dural sac associated with a mild vertebral body compression fracture. Early diagnosis and prompt surgical intervention are essential, as is performing a magnetic resonance imaging or computed tomography myelogram promptly to evaluate the spinal canal when there are unexplained neurologic symptoms. An intraspinal canal evaluation should be completed before the postural reduction of the vertebral body fracture to prevent any neurological complications.
Long-term follow-up results of femoral varus osteotomy in the treatment of Perthes disease, and comparison of open-wedge and closed-wedge osteotomy techniques
Authors: Citlak Atilla 
Published: February 2020

Abstract
In this retrospective observational study, I aimed to report long-term follow-up results of femoral varus osteotomy in the treatment of Perthes disease patients who were between 6 and 8 years old at the onset of the disease with Herring B and C hip involvement. I also aimed to compare 2 different osteotomy techniques: open-wedge and closed-wedge femoral varus osteotomies.
Patients with Perthes disease treated with femoral varus osteotomies were invited for final examination. Twenty two hips of 19 patients were evaluated. Mean follow-up period was 15.2 years. Patients were divided into 2 homogenous groups according to femoral osteotomy technique. In Group A (12 hips) open-wedge osteotomy, and in Group B (10 hips) closed-wedge osteotomy was performed.
There were 15 male (78.9%) and 4 female (21.1%) patients. The median age at the onset of the disease was 7 years in Group A and B. The mean follow-up period was 16.2 years in Group A, and 11.4 years in Group B. According to Stulberg classification 5 hips (22.7%) were healed as Class I, 4 hips (18.2%) were healed as Class II, 12 hips (55.5%) were healed as Class III, and 1 hip (4.6%) was healed as Class IV. Also in Group A 4 hips (33.3%) were healed as Class I or II, 7 hips (58.3%) were healed as Class III, and 1 hip (8.3%) was healed as Class IV; in Group B 5 hips (50.0%) were healed as Class I or II, and 5 hips were healed as Class III (50.0%). There was no significant difference between the groups. According to Iowa scale, mean values were 92.6 in Group A and 92.4 in Group B. There was no significant difference between the groups. At the final follow-up mean center-edge angles of Group A and B were 16 and 22, the difference was significant.
Long-term follow-up results showed that femoral varus osteotomy was an effective treatment method in Perthes disease patients who were between 6 and 8 years old with Herring B and C hip involvement at the onset of the disease. Hip joint congruency was obtained with femoral varus osteotomies, and closed-wedge osteotomy served more favorable center-edge angle results.
Effects of teriparatide compared with risedronate in the treatment of osteoporosis
Authors: Yang Chengzhi , Le Guoping , Lu Changwei , Wei Renjie , Lan Wanjie , Tang Jingli , Zhan Xinli 
Published: February 2020

Abstract

Background:
This meta-analysis was conducted to compare the effects and safety of teriparatide with risedronate in the treatment of osteoporosis.

Material and methods:
PubMed, Embase, Web of Science and Cochrane library database were systematically reviewed for studies published up to February 24, 2019. Eligible studies that compared the effects of teriparatide with risedronate in osteoporosis were included in this meta-analysis. The outcomes included percentage change in bone mineral density (BMD) of lumbar spine, femoral neck, and total hip, the incidence of clinical fractures, serum bone markers, and adverse events. A random-effects or fixed-effects model was used to pool the estimate, according to the heterogeneity among the included studies.

Results:
Seven studies were included in this meta-analysis. Compared with risedronate, teriparatide was associated with a significant increase in lumbar spine BMD [weight mean difference (WMD)=4.24, 95%CI: 3.11, 5.36; P < .001], femoral neck BMD (WMD=2.28, 95%CI: 1.39, 3.18; P < .001), and total hip BMD (WMD = 1.19, 95%CI: 0.47, 1.91; P = .001). Moreover, patients in teriparatide group had significantly lower incidences of clinical fracture (risk ratio [RR] = 0.48, 95%CI: 0.32, 0.72; P < .001), new vertebral fracture (RR = 0.45, 95%CI: 0.32, 0.63; P < .001), and non-vertebral fracture (RR = 0.63, 95%CI: 0.40, 0.98; P = .042) than those in risedronate group. There were significant differences between the 2 groups in serum change, including P1NP (WMD = 122.34, 95%CI: 68.89, 175.99; P < .001), CTx (WMD = 0.62, 95%CI: 0.29, 0.96; P < .001), and iPTH (WMD = -13.18, 95%CI: -15.04, -11.33; P < .001). The incidence of adverse events was similar between the 2 groups (RR = 0.93, 95%CI: 0.69, 1.25; P = .610).

Conclusion:
This study suggested that teriparatide was more effective than risedronate for increasing the BMD in lumbar spine, femoral neck, and total hip, as well as reducing the incidences of clinical fracture, new vertebral fracture and non-vertebral fracture. There was no significant difference in incidence of adverse events between the 2 drugs. Considering the potential limitations in the present study, further large-scale, well-performed randomized trials are needed to verify our findings.
Long-term outcomes of acute acalculous cholecystitis treated by non-surgical management
Authors: Kim Sung Bum , Gu Min Geun , Kim Kook Hyun , Kim Tae Nyeun 
Published: February 2020

Abstract
Although cholecystectomy is generally recommended for acute acalculous cholecystitis (AAC) treatment, non-surgical management can be considered in patients at a high risk for surgery. This study compared outcomes of surgical and non-surgical management and analyzed the long-term outcomes of AAC patients managed non-surgically.
We retrospectively analyzed 89 patients diagnosed with AAC between January 1, 2007 and April 30, 2014. These patients were divided into 2 groups: non-surgical (n = 41) and surgical (n = 48). Non-surgical management methods were percutaneous cholecystostomy (PC, n = 14) and antibiotics only (n = 27). The non-surgical group was followed up for >3 years after treatment.
The mean age was slightly higher in the non-surgical group than in the surgical group without significant difference. The prevalence of cerebrovascular accident in the non-surgical group was significantly higher than that in the surgical group (26.8% vs 8.3%, P = .020). Mean hospital stay was not statistically different between two groups. The surgical group had a significantly higher incidence of posttreatment complications than the non-surgical group (18.8% vs 2.4%, P = .015). During the mean follow-up of 5.7 years, AAC recurred in 4 (9.8%) patients in the non-surgical group. Three patients underwent cholecystectomy, 1 was treated with antibiotics, and no recurrence-related death occurred. The recurrence rate of AAC was not different between PC and antibiotics only groups (14.3% vs 7.4%, P = .596).
Recurrence was observed in 9.8% of AAC patients treated non-surgically and the outcome in the non-surgical group was not inferior to that in the surgical group.
The renin–angiotensin system blockers and survival in digestive system malignancies
Authors: Zhou Qi , Chen Di-Shi , Xin Lin , Zhou Li-Qiang , Zhang Hou-Ting , Liu Li , Yuan Yi-Wu , Li Shi-Hao 
Published: February 2020

Abstract

Background:
Accumulating pre-clinical and clinical studies suggested that the renin–angiotensin system blockers (RASBs) possess anti-carcinogenic properties, and their use is associated with favorable outcomes in many types of cancers.

Methods:
A systematic literature search of relevant databases through January 2019 was conducted to identify studies assessing the RASBs on prognostic outcomes in digestive system malignancies patients on the basis of predetermined selection criteria for pooled hazard ratio (HR) with 95% confidence intervals (CIs). A total of 13 studies were included in the meta-analysis.

Results:
The meta-analysis showed that the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) resulted in a significant improvement in overall survival (HR 0.79; 95%CI 0.70–0.89; P < .000), cancer-specific survival (HR 0.81; 95%CI 0.73–0.90; P < .000) and recurrence-free survival (HR 0.68; 95%CI 0.54–0.85; P = .001), but not progression-free survival (HR 0.88; 95%CI 0.73–1.07; P = .183) and disease-free survival (HR 0.50; 95%CI 0.11–2.39; P = .103). Subgroup analysis indicated that the use of RASBs has a significant improvement of overall survival (OS) in pancreatic cancer, liver cancer, and gastric cancer. Two studies evaluated the dose–response relationship between ACEIs/ARBs therapy and survival and showed higher doses and better survival [(1–364 defined daily doses: odds ratio (OR) 0.89, 95%CI 0.78–1.01, P = .076), (≥365 defined daily doses: OR 0.54, 95%CI: 0.24–1.24, P = .148].

Conclusions:
Meta-analysis of studies supports a beneficial association between use of RASBs and survival of digestive system malignancies.
Clinical, histopathologic, subtype, and immunohistochemical analysis of jaw phosphaturic mesenchymal tumors
Authors: Li Dongmei , Zhu Ran , Zhou Lian , Zhong Dingrong 
Published: February 2020

Abstract
Jaw phosphaturic mesenchymal tumors (PMTs) are a rare neoplasm with uncertain histogenesis. This study aimed to clarify the clinical and pathological features of jaw PMTs.
We reviewed the clinical records of 39 patients diagnosed with PMTs in the jaws, and investigated clinical and morphologic characteristics, histologic subtypes, and immunophenotypes of all cases.
Microscopic analyses revealed 2 major histologic tumor subtypes: “phosphaturic mesenchymal tumors of mixed epithelial and connective tissue” (PMTMECT), and “phosphaturic mesenchymal tumors of mixed connective tissue” (PMTMCT). PMTMECTs and PMTMCTs accounted for 29 and 10 cases of PMTs, respectively. Most PMTMECT diagnoses were made predominantly in males aged <45 years, and the incidence was similar in both the mandible and maxilla. In contrast, patients with PMTMCTs are predominantly females aged ≥45 years, and all tumors were in the mandible. Histologically, PMTMECT had lower cellularity and a more elongated and spindled mesenchymal component with less elaborate intrinsic microvasculature than PMTMCT. Immunohistochemically, the epithelia of all PMTMECTs was immunoreactive for AE1/AE3. Other immunohistochemical staining of PMTMECTs revealed positive expression of vimentin, SATB2, ERG, CD99, Bcl-2, CD56, S-100, D2-40, CD68, SMA, and CD34 in either one or both components. Immunohistochemical staining of PMTMCTs was diffusely positive for vimentin and a varied ratio of positivity for SATB2, ERG, CD99, Bcl-2, CD56, S-100, D2-40, CD68, SMA, and CD34, but negative for AE1/AE3. Most patients were cured by complete resection, except 2 patients who had repeated recurrences, one of which also had multiple metastasis.
Jaw PMT can be divided into 2 major histological subtypes. PMTMECTs are more common than are PMTMCTs, and can transform into malignant PMTMCTs during the progression. PMTMECTs were more commonly observed in males and the incidence was similar in both the maxilla and mandible. PMTMCTs were almost always observed in the mandible of females. Compared with PMTMCTs, PMTMECTs have an admixture of epithelial components with less prominent vasculature and lower cellularity. There were no statistically significant differences in the expression of immunohistochemical markers except AE1/AE3 between PMTMECTs and PMTMCTs. However, immunohistochemical markers have great significance for differentiating other mesenchymal tumors.
Immature platelet fraction: A useful marker for identifying the cause of thrombocytopenia and predicting platelet recovery
Authors: Jeon Kibum , Kim Miyoung , Lee Jiwon , Lee Jee-Soo , Kim Han-Sung , Kang Hee Jung , Lee Young Kyung 
Published: February 2020

Abstract

Introduction:
The assessment of bone marrow thrombopoietic activity in patients with thrombocytopenia is necessary to achieve an accurate diagnosis and administer effective treatment. We evaluated the discriminatory power of the immature platelet fraction (IPF) in differentiating hyperdestructive/consumptive thrombocytopenia from hypoproductive thrombocytopenia and its potential use as a predictive marker for platelet recovery.

Methods:
In this observational study, platelet indices, including IPF, were measured in 105 healthy individuals, 27 patients with hyperdestructive/consumptive thrombocytopenia (all with immune thrombocytopenic purpura [ITP]), and 35 patients with hypoproductive thrombocytopenia (5 with aplastic anemia and 30 with cancer who were undergoing chemotherapy) using a Sysmex XN-3000 hematology analyzer.

Results:
The platelet distribution width, mean platelet volume, platelet large cell ratio, IPF, and absolute immature platelet count (AIPC) were significantly higher in the hyperdestructive/consumptive thrombocytopenia group than in the hypoproductive thrombocytopenia group (P < .001). The IPF showed the highest difference between the two patient groups (200%). Receiver operating characteristics analysis that showed the IPF had the largest area under the curve among all the platelet indices analyzed; its cut-off value was 2.3%. The IPF decreased 3 to 4 days in advance of platelet count elevation in patients with ITP, whereas the delta AIPC increased 3 days in advance. Furthermore, the IPF and delta AIPC increased 5.5 days and 8.5 days, respectively, before platelet counts increased up to 130.0 × 109/L in cancer patients receiving chemotherapy.

Conclusion:
These data demonstrated that the IPF and delta AIPC are both excellent indicators of the etiology of thrombocytopenia and predictive markers for platelet recovery.
Traditional chinese medicine for diabetic retinopathy
Authors: Pang Bing , Li Qing-Wei , Qin Ya-Li , Dong Guang-Tong , Feng Shuo , Wang Jia , Tong Xiao-Lin , Ni Qing 
Published: February 2020

Abstract

Background:
Traditional Chinese medicine (TCM) has been used to treat diabetic complications including diabetic retinopathy for many years.

Objectives:
This review was performed to systematically assess the efficacy and safety of TCM for treating non- proliferative diabetic retinopathy (NPDR).

Methods:
Retrieval from 7 electronic databases was conducted to determine eligible trials published until March 1, 2018. Randomized controlled trials of NPDR that comparing compound Chinese medicine containing the therapeutic method of activating blood and remove stasis versus controls were included for analysis. Primary outcomes were progression of retinopathy. Secondary outcomes included visual acuity, mean defect of visual field, micro-aneurysms, hemorrhage areas, exudates, capillary nonperfusion areas, hemorheological indicators, oscillatory potentials (Ops), glycated haemoglobin (HbA1c), and adverse events. Data extraction and quality assessment were performed. Results expressing as risk ratios (RRs) or mean differences (MD) were analyzed with a fixed- or random- effect model. I
2 statistics were used to assess heterogeneity.

Results:
A total of 33 trials and 3373 participants were included. Findings revealed that no included studies reported the progression of retinopathy. Compared with conventional medicine, TCM was significantly better at improving visual acuity (MD, −0.10; 95% confidence interval [CI] −0.16 to −0.05) and Ops (MD, −4.68, 95% CI −8.51 to −0.85), and reducing the mean defect of visual field (MD, −1.43; 95%CI, −2.17 to −0.68), micro-aneurysms (MD, −4.51; 95% CI, −6.23 to −2.79), hemorrhage areas (MD, −0.62; 95% CI, −1.06 to −0.19), plasma viscosity (MD, −0.10; 95% CI, −0.20 to 0.00), and HbA1c (MD, −0.22; 95% CI, −0.42 to −0.03). Compared with placebo, TCM was also associated with a decline in the number of microaneurysms (MD, −4.35; 95% CI, −6.25 to −2.45), exudates (MD, −0.17; 95% CI −0.31 to −0.03), capillary nonperfusion areas (MD, −0.18; 95% CI, −0.31 to −0.04), and HbA1c (MD, −0.88; 95% CI, −1.44 to −0.32). Compared with blank groups, TCM was superior at decreasing the mean defect of visual field (MD, −0.87; 95% CI −0.95 to −0.79) and the numbers of micro-aneurysms (MD, −3.35; 95% CI, −4.73 to −1.97). Adverse events were also assessed.

Conclusion:
Activating blood compound Chinese herbal medicine could help to improve visual acuity, micro-aneurysms and HbA1c. Further trials are needed to provide more reliable evidence.
Carbon monoxide breath test assessment of mild hemolysis in Gilbert's syndrome
Authors: Kang Ling-Ling , Ma Yong-Jian , Zhang Hou-De 
Published: February 2020

Abstract

Background:
Mild hemolysis is difficult to determinate by traditional methods, and its role in Gilbert's syndrome (GS) is unclear. The main aims were to inspect the erythrocyte (RBC) survival in GS by using Levitt's carbon monoxide (CO) breath test and to assess its contribution to unconjugated hyperbilirubinemia.

Methods:
Fifty subjects with GS and 1 with type-II Crigler–Najjar syndrome (CN2) received RBC lifespan measurement with Levitt's CO breath test. Mean RBC lifespan was compared with normal referral value. Correlations of serum total bilirubin (TB) with RBC lifespan, blood panel data, demographic factors, and uridine diphosphate glucuronosyltransferase (UGT1A1) mutation load were calculated by Spearman analysis. Susceptibility factors for mild hemolysis were analyzed by multivariate regression analysis.

Results:
The mean RBC lifespan of the GS subjects was significantly shorter than the normal reference value (95.4 ± 28.9 days vs 126 days; t = −7.504, P < .01), with 30.0% below the lower limit of the normal reference range (75 days). The RBC lifespan of the participant with CN2 was 82 days. Serum TB correlated positively with UGT1A1 mutation load (γ = 0.281, P = .048), hemoglobin (γ = .359, P = .010) and hematocrit (γ = 0.365, P = .010), but negatively with RBC lifespan (γ = −0.336, P = .017). No significant susceptibility factors for mild hemolysis were found.

Conclusions:
The results indicate that mild hemolysis indeed, exists in a portion of patients with GS and might serve as an important contributor to unconjugated hyperbilirubinemia in addition to UGT1A1 polymorphism. Further studies on the mechanism and the potential risks in various medical treatments might be wanted.