bluuebunny/crossref_metadata_2025_split huggingface dataset:
The biomechanical effects of foraminoplasty of different areas under lumbar percutaneous endoscopy on intervertebral discs
Authors: Xie YiZhou , Zhou Qun , Wang Xinling , Jian Qiang , Fan Xiaohong , Yu Yang , Gu Dangwei , Wu WeiDong 
Published: April 2020

Abstract

Background:
We set out to evaluate the biomechanical influence of foraminoplasty on intervertebral discs in different areas under lumber percutaneous endoscopy through the use of a three-dimensional finite element.

Methods:
We established a normal 3D finite element mode of L3–5, using simulate lumbar percutaneous endoscopy by carrying out cylindrical excision of a bone whose diameter was 7.5 mm on the L5 superior articular process and the L4 inferior articular process, respectively. We therefore obtained 3 models. The first was the normal lumbar model, the second the L4 inferior articular process shaped model, while the third was the L5 superior articular process shaped model. We compared the biomechanics of discs of L3/4 and L4/5 in states of forward flexion, backward extension, left and right flexion as well as left and right rotation.

Results:
When the L4 inferior articular process shaped model was in backward extension, left rotation, and right rotation, the stress of the L4/5 disc was greater than in the normal model, especially in the state of extension. When the L5 superior articular process shaped model was in left and right rotation, the biggest stress of the L4/5 disc increased slightly. However, no matter which way the L5 superior articular process or the L4 inferior articular process of model was shaped, the stress impact of the L3/4 disc was small.

Conclusions:
There is more biomechanical influence on the L4/5 disc when carrying out a foraminoplasty on L4 inferior articular process under a lumber percutaneous endoscopy. In addition, the influence of both types of surgery on the stress of L3/4 disc is small.
Pain acceptance levels of patients with chronic pain
Authors: Çinar Hava Gökdere , Yilmaz Dilek , Akin Esra 
Published: April 2020

Abstract
This study was conducted with the aim of determining pain acceptance levels in patients with chronic pain attending an algology outpatients’ department.
The research was conducted as a descriptive and cross-sectional study. The population of the study consisted of 97 patients with chronic pain who attended the Algology Outpatients’ Department of the Health Implementation and Research Center of Bursa Uludağ University. A Patient Description Form and a Chronic Pain Acceptance Questionnaire (CPAQ) were used to collect research data.
The participants’ mean sub-score for accomplishing activities by patients with chronic pain was found to be 31.10 ± 11.84, their mean sub-score for pain willingness was 36.65 ± 10.37, and their mean score for the total scale was 67.76 ± 18.30. A statistically significant difference was found between the participants’ total score means and their sub-score means according to their education level and frequency of experiencing pain (P < .05), but no statistically significant difference was found according to such factors as age, profession, marital status, or medications used (P > .05).
It was found that female sex was generally exposed to chronic pain, and factors such as age, marital status, and drug treatment did not differ in the rate of acceptance of chronic pain, and the rate of acceptance of pain in workers was higher, those with lower education level were lower. There is a need that new studies with larger sample groups regarding the factors affecting the acceptance of chronic pain.
Clinical implications of perineural invasion in patients with colorectal cancer
Authors: Hu Gang , Li Liang , Hu Kaibing 
Published: April 2020

Abstract
Perineural invasion (PNI) is a prominent characteristic of multiple solid tumors and indicates poor prognosis. Previous data concerning the impact of PNI on prognosis of patients with colorectal cancer (CRC) are conflicting, and little is known about risk factors of PNI. The aim of our study was to reveal the clinical implication of PNI on survival outcome and identify risk factors for the poor prognosis in patients with CRC.
We retrospectively reviewed 627 patients who were diagnosed with CRC and underwent curative surgical resection. The differences in several clinicopathologic characteristics were compared between PNI positive and PNI negative groups. Multivariate logistic regression analysis was performed to identify predictors of CRC with PNI. Five-year overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan–Meier method, and the difference in survival rate was assessed by the log-rank test. The variables that had prognostic potential, as indicated by univariate analyses, were subjected to multivariate analyses with the Cox proportional hazards regression model.
PNIs were identified in 79 patients (12.6%). Age, T classification, N classification, M classification, UICC classification, and lymphovascular invasion were significantly associated with PNI. Multivariate logistic regression analysis demonstrated that only lymphovascular invasion was a predictor of PNI. Pathologic evidence of PNI was not associated with survival outcome (the 5-year OS [P = .560] and DFS [P = .083]). Cox proportional hazards regression model revealed that age and N2/3 classification were independent prognostic factors for poorer OS and DFS. M1 stage (95% confidence interval [CI] = 0.228–0.585, P = .000), III/IV stage (95% CI = 0.335–0.920, P = .022), and number of sampled lymph nodes (95% CI = 0.951–0.987, P = .001) were independently prognostic for poorer OS, while history of other malignancy (95% CI = 1.133–2.813, P = .012) was identified as an independent prognostic factor for poorer DFS.
Our study indicates that PNI is not an independent poor prognostic factor in patients with CRC and those patients with PNI may not benefit from postoperative adjuvant chemotherapy.
The impact of educational attainment on cardiorespiratory fitness and metabolic syndrome in Korean adults
Authors: Chang Mineok , Lee Hea-Yeon , Seo Suk Min , Koh Yoon-Seok , Park Hun-Jun , Kim Pum-Joon , Seung Ki-Bae 
Published: April 2020

Abstract
The aim of this study was to evaluate the relationship between educational attainment and cardiorespiratory fitness (CRF) as a predictor of metabolic syndrome in a Korean population.
In this single-center, retrospective cross-sectional study, 988 healthy adults (601 men and 387 women) who underwent regular health check-up in Seoul St. Mary's Hospital were analyzed. Educational attainment was categorized into 3 groups according to their final grade of educational course: middle or high school (≤12 years of education), college or university (12–16 years of education), and postgraduate (≥16 years of education). CRF was assessed by cardiopulmonary exercise testing, biceps strength, hand grip strength, bioelectrical impedance analysis, and echocardiography. Metabolic syndrome was diagnosed according to the 3rd report of the National Cholesterol Education Program.
Among the subjects, 357 (36.1%) had metabolic syndrome. The postgraduate group had significantly higher peak oxygen consumption (VO2), biceps strength, hand grip strength, and peak expiratory flow than other groups (all P < .001). This group showed better left ventricular diastolic function, in terms of deceleration time of mitral inflow, maximal tricuspid valve regurgitation velocity, and left atrial volume index than other groups. Peak VO2 (%) was significantly correlated with all the parameters of metabolic syndrome, including insulin resistance (r = –0.106, P = .002), waist circumference (r = –0.387, P < .001), triglyceride (r = –0.109, P = .001), high density lipoprotein-cholesterol (r = 0.219, P < .001), systolic blood pressure (r = –0.143, P < .001), and diastolic blood pressure (r = –0.177, P < .001). And Peak VO2 (%) was found to be a predictor of metabolic syndrome (adjusted β = .988, P < .001). However, the level of education was not able to predict metabolic syndrome (postgraduate group; β = .955, P = .801).
Although the postgraduate group had better CRF than other groups, the educational attainment could not exclusively predict metabolic syndrome in this study. Further research is needed to reveal the socioeconomic mechanism of developing metabolic syndrome.
Diagnosing peripheral lung lesions using endobronchial ultrasonography with guide sheath
Authors: Bae Soohyun , Lim Soyeoun , Ahn Jong Joon , Jegal Yangjin , Seo Kwang Won , Ra Seung Won , Kang Byung Ju , Kim Jin Hyoung , Park Soon Eun , Han Ilsang , Kang Hojun , An Mingi , Ock Minsu , Park Eun Ji , Kwon Woon-Jung , Lee Taehoon 
Published: April 2020

Abstract
Bronchoscopy has a lower diagnostic yield for peripheral lung lesions (PLL). Endobronchial ultrasound guide sheath transbronchial lung biopsy (EBUS GS TBLB) has been used to overcome such limitation. Recent studies revealed that combined methods (e.g., EBUS GS TBLB plus electromagnetic navigation [EMN] or virtual bronchoscopic navigation [VBN]) further improve the diagnostic yield. However, those systems are associated with a high cost burden. Accordingly, we attempted to use VBN by computed tomography (CT) workstation (Aquarius iNtuition, TeraRecon) not dedicated only for VBN as an adjunctive tool for EBUS GS TBLB. We performed a prospective registry study to investigate whether VBN by CT workstation could improve the diagnostic yield of PLL.
Between February 2017 and February 2018, 128 patients with PLL were divided into 2 groups (VBN and non-VBN [NVBN]). In NVBN group (n = 64), EBUS GS TBLB was performed using a hand-drawn bronchial map based on CT images. VBN group (n = 64) underwent EBUS GS TBLB using VBN images.
VBN using CT workstation did not improve the diagnostic yield of EBUS GS TBLB for PLL (VBN vs NVBN, 72% vs 80%, P = .284). VBN slightly reduced procedure time (minute [mean ± SD], 25.31 ± 10.33 vs 25.81 ± 9.22), navigation time (time to find the lesion) (9.10 ± 7.88 vs 9.50 ± 7.14), and fluoroscopy time (2.23 ± 2.39 vs 2.86 ± 4.61), while these differences were not statistically significant.
The diagnostic yield of EBUS GS TBLB was not improved with VBN (compared with using a hand-drawn bronchial map). Although VBN slightly shortened the procedure-related times, which were not significantly different.
High neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio predict poor survival in rectal cancer patients receiving neoadjuvant concurrent chemoradiotherapy
Authors: Ke Te-Min , Lin Li-Ching , Huang Chun-Che , Chien Yu-Wen , Ting Wei-Chen , Yang Ching-Chieh 
Published: April 2020

Abstract
This study explored the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in rectal cancer patients receiving neoadjuvant concurrent chemoradiotherapy (CCRT).
Between January 2006 and December 2016, 184 patients with newly-diagnosed rectal cancer receiving neoadjuvant CCRT were enrolled. Risk of overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan-Meier method and Cox proportional hazard models. Stratified survival analyses were also performed between post-neoadjuvant pathological (yp) stage.
The mean follow-up time was 72.73 ± 36.82 months. High- and low-NLR patients differed significantly in both 5-year DFS (P = .026) and OS (P = .016). High- and low-PLR patients differed significantly in 5-year DFS (P = .011) but not OS (P = .185). Multivariate analyses revealed worse 5-year DFS (adjusted HR [aHR] = 2.8; 95% CI: 1.473–5.41; P = .002) and 5-year OS (aHR = 1.871; 95%CI: 1.029–3.4; P = .04) in the high-NLR group after adjusting for covariates. After adjustments, the high-PLR group had inferior 5-year DFS (aHR = 2.274; 95%CI: 1.473–5.419; P = .038) but not 5-year OS (aHR = 1.156; 95%CI: 0.650–2.056; P = .622). Further stratified analysis indicated that yp stage II and III patients with high NLR had worse 5-year DFS (aHR = 2.334; 95% CI: 1.158–4.725; P = .018) and OS (aHR = 2.226; 95% CI: 1.165–4.251; P = .015). Additionally, yp stage II and III patients with high PLR had inferior 5-year DFS (aHR = 2.012; 95% CI: 1.049–3.861; P = .036).
Pre-CCRT NLR and PLR are independent prognostic factors for rectal cancer patients and could be used as a potential biomarker to identify high-risk patients for more intense treatment and care.
Tracheoesophageal fistula associated with bevacizumab after thoracic radiotherapy in non-small cell lung cancer
Authors: Zhang Tao , Yang Yin , Cheng Guowei , Chen Ping , Bi Nan 
Published: April 2020

Abstract

Introduction:
Tracheoesophageal Fistula (TF) is a rare complication of Bevacizumab. Thoracic radiotherapy may be a contributing factor to TF formation. To the best of our knowledge, we report the first case of Chinese patient with non-small cell lung cancer (NSCLC) who developed TF after completion of chemotherapy with bevacizumab and thoracic radiotherapy.

Patient concerns:
A 54-year-old male patient was diagnosed with NSCLC. He received definitive thoracic radiotherapy with concurrent pemetrexed and cisplatin chemotherapy. Two months after the treatment, the disease progressed with enlargement of right inguinal lymph node and chemotherapy of docetaxel, carboplatin and bevacizumab was administrated. Eighteen days after 4 cycles, the patient presented a sudden onset of acute cough after drinking.

Diagnosis:
Esophageal barium swallow revealed a TF. Gastroscopy confirmed a fistula in the esophagus.

Interventions:
A jejunal feeding tube was placed for nutrition for a month. After that a covered esophageal stent was placed in the esophagus.

Outcomes:
At the 6-month follow-up visit, the patient recovered well and had not developed any complication related to the stent placement.

Conclusion:
TF is a rare but life-threatening complication of bevacizumab. Careful observation is imperative for those patients who are administered bevacizumab, particularly in patients treated previously with thoracic radiotherapy.
Meta-analysis of the association between dietary inflammatory index (DII) and upper aerodigestive tract cancer risk
Authors: Hua Rongyu , Liang Guanmian , Yang Fangying 
Published: April 2020

Abstract

Background:
Epidemiological studies have reported an inconsistent relationship between dietary inflammatory index (DII) and upper aerodigestive tract (UADT) cancer risk. However, no systematic review or meta-analysis has been reported up to now. To quantify the association between DII and UADT cancer risk, we performed this meta-analysis.

Methods:
The PubMed, EMBASE, Web of Science and Cochrane Library database were searched for relevant studies from inception December 2018. All case-control studies investigating the association between DII and UADT cancer risk were selected.

Results:
A total of 9 case-control studies were identified, involving 13,714 participants. The adjusted pooled OR of UADT cancer for the highest (the most pro-inflammatory diet) vs lowest (the most anti-inflammatory diet) DII categories were 2.27 (95% CI: 1.89–2.73). Subgroup analysis showed that individuals with the highest category of DII score were independently associated with esophagus cancer (OR = 2.53, 95% CI: 1.74–3.68), oral cavity cancer (OR = 2.23, 95% CI: 1.73–2.86), pharyngeal cancer (OR = 2.02, 95% CI: 1.54–2.64), and laryngeal cancer (OR = 2.05, 95% CI: 0.85–4.93).

Conclusion:
This meta-analysis suggested that the most pro-inflammatory diets (the highest DII scores) are associated with increased UADT cancer risk. However, the association between DII and laryngeal cancer risk need to be further investigated.
Use of methotrexate in the management of recurrent Tolosa-Hunt syndrome
Authors: Kwon Hyuk Sung , Kim Tae Yoon , Kim Ji Hyun , Bae Jeong Hoon , Koh Seong-Ho , Choi Hojin , Lee Kyu-Yong , Lee Young Joo , Kim Young Seo , Kim Hyun Young 
Published: April 2020

Abstract

Rationale:
Tolosa-Hunt syndrome (THS) is rare condition characterized by painful ophthalmoplegia that usually responds well to corticosteroid. About a half of THS patients experience recurrence within intervals of months to years from initial presentation. Recurrence is more common in younger patients, and can be ipsilateral, contralateral, or bilateral. Cyclosporine, azathioprine, methotrexate, mycophenolate mofetil, infliximab, and radiotherapy can be considered as second-line treatment. However, there is insufficient evidence for treatments preventing recurrence of THS.

Patient concerns:
We experienced two patients with THS that recurred twice while tapering or after ceasing corticosteroid administration.

Diagnosis:
Both patients were diagnosed as recurrent THS.

Interventions:
Methotrexate was treated with a combination of corticosteroid after THS recurred twice with corticosteroid therapy alone.

Outcomes:
After adding methotrexate to the steroid regimen, their symptoms were successfully regulated and ceased to recur

Lessons:
These cases add to the evidence for the use of methotrexate as a second-line therapeutic agent for those patients with recurrent THS attacks. Further studies are in need to prove the risk and benefits of second-line treatments in THS.
Dabigatran-induced esophagitis
Authors: Zhou Yi , Dai Yancheng , Lu Lei , Fu Zhiquan 
Published: April 2020

Abstract

Rationale:
Dabigatran is an anticoagulant medication that has been widely used to prevent strokes caused by atrial fibrillation, deep vein thrombosis, and pulmonary embolism. However, the potential adverse effect of dabigatran of gastrointestinal mucosal injury is often neglected, and even induces esophagitis.

Patient concerns:
A 77-year-old woman was admitted to the hospital with symptoms of progressive retrosternal pain, upper abdominal discomfort, and dysphagia.

Diagnosis:
Esophagogastroduodenoscopy showed longitudinal sloughing mucosal casts in the distal esophagus. Histological examination showed squamous epithelium with neutrophil infiltration, partial epithelial degeneration, and Helicobacter pylori. Based on a literature review, medical history, and imaging examination, the patient was diagnosed with dabigatran-induced esophagitis.

Interventions:
The patient recovered with standard H. pylori eradication therapy and proton pump inhibitor without discontinuing dabigatran.

Outcomes:
After 2 weeks, the retrosternal pain and dysphagia were relieved and upper abdominal discomfort was attenuated.

Lessons:
Our case highlights the importance of physicians’ awareness of the clinical and endoscopic characteristics of dabigatran-induced esophagitis and the importance of H. pylori-associated tests and eradication if necessary for patients with long-term dabigatran treatment.
High-normal blood pressure conferred higher risk of cardiovascular disease in a random population sample of 50-year-old men
Authors: Chen Xiaojing , Barywani Salim Bary , Hansson Per-Olof , Rosengren Annika , Thunström Erik , Zhong You , Ergatoudes Constantinos , Mandalenakis Zacharias , Caidahl Kenneth , Fu Michael 
Published: April 2020

Abstract
The relationship between various categories of blood pressure (BP), subtypes of hypertension, and development of cardiovascular disease (CVD) have not been extensively studied. Therefore, our study aimed to explore this relationship in a random population sample of men born in 1943, living in Sweden and followed over a 21-year period.
Participants were examined for the first time in 1993 (age 50 years), where data on medical history, concomitant diseases, and general health were collected. The examination was repeated in 2003 and with additional echocardiography also in 2014. Classification of participants according to their BP at the age of 50 years was as follows: optimal-normal BP (systolic blood pressure [SBP] <130 and diastolic BP [DBP] <85 mmHg), high-normal BP (130 ≤ SBP < 140, 85 ≤ DBP < 90 mmHg), isolated systolic-diastolic hypertension (ISH-IDH) (SBP ≥140 and DBP <90 or SBP <140 and DBP ≥90 mmHg), and systolic-diastolic hypertension (SDH) (SBP ≥140 and DBP ≥90 mmHg).
During the follow-up, the incidence of heart failure (HF), CVD, and coronary heart disease were all lowest for those with optimal-normal BP. Participants with high-normal BP showed greater wall thickness and left ventricular mass index, larger LV size and larger left atrial size when compared with the optimal-normal BP group. Furthermore, those with high-normal BP, ISH-IDH, and SDH had a higher risk of CVD than those with optimal-normal BP. The adjusted relative risk of CVD was highest for SDH (hazard ratio [HR] 1.95; 95% confidence interval [95% CI] 1.37–2.79), followed by ISH-IDH (HR 1.34; 95% CI 0.93–1.95) and high-normal BP (HR 1.31; 95% CI 0.91–1.89).
Over a 21-year follow-up, the participants with high-normal BP or ISH-IDH had a higher relative risk of CVD than those with optimal-normal BP.
A review of the mechanism of the central analgesic effect of lidocaine
Authors: Yang Xi , Wei Xinchuan , Mu Yi , Li Qian , Liu Jin 
Published: April 2020

Abstract
Lidocaine, as the only local anesthetic approved for intravenous administration in the clinic, can relieve neuropathic pain, hyperalgesia, and complex regional pain syndrome. Intravenous injection of lidocaine during surgery is considered as an effective strategy to control postoperative pain, but the mechanism of its analgesic effect has not been fully elucidated. This paper intends to review recent studies on the mechanism of the analgesic effect of lidocaine. To the end, we conducted an electronic search of the PubMed database. The search period was from 5 years before June 2019. Lidocaine was used as the search term. A total of 659 documents were obtained, we included 17 articles. These articles combined with the 34 articles found by hand searching made up the 51 articles that were ultimately included. We reviewed the analgesic mechanism of lidocaine in the central nervous system.
Adductor canal block versus periarticular infiltration for pain control following total knee arthroplasty
Authors: Yuan Na , Shi Jun , Lin Chunyan , Li Jiang 
Published: April 2020

Abstract

Background:
Periarticular infiltration (PAI) and adductor canal block (ACB) have become popular modes of pain management after total knee arthroplasty. The purpose of our study is to evaluate the efficacy of ACB in comparison with PAI for pain control in patients undergoing primary total knee arthroplasty.

Methods:
This study is a prospective, 2-arm, parallel-group, open-label randomized controlled trial that is conducted at a single university hospital in China. A total of 120 patients who meet inclusion criteria are randomized in a ratio of 1:1 to either ACB or PAI group. The primary outcome is visual analog scale score at rest 24 hours after surgery, whereas the secondary outcomes include visual analog scale score at 48 hours after surgery, satisfaction, opioid consumption, and complications. All pain scores are assessed by an independent observer who is blinded to the allocation of groups.

Results:
This study has limited inclusion and exclusion criteria and a well-controlled intervention. This clinical trial is expected to provide evidence of better therapy for the pain management after total knee arthroplasty.

Trial registration:
This study protocol was registered in Research Registry (researchregistry5410).