bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative Analysis of Hypervascular Hepatic Metastases and Hepatocellular Carcinoma using Spectral CT Imaging
Authors: Yang Zhiqiang , Wang Xinyi , Shi Hao 
Published: November 2019

Abstract
Objective The goal of this study is to evaluate the performance of spectral CT-based quantitative analysis in differential diagnosis of hypervascular hepatic metastasis (HVHM) and hepatocellular carcinoma (HCC). Methods Spectral CT scans were performed for 47 patients with hepatic malignant tumors, including 20 patients with HVHM and 27 patients with HCC, which generated the following sets of data: single energy images in the arterial phase; iodine and water maps; marginal areas of lesions that manifested apparent signal intensification; and energy spectral parameters of normal liver tissues and abdominal aorta. Subsequently, we calculated the normalized iodine concentrations (NIC), lesion-normal parenchyma iodine concentration ratio (LNR), iodine concentration difference (ICD) between the arterial phase and the venous phase, and the spectral curve slope. An independent samples t test and receiver operating characteristic (ROC) curve analysis were applied to examine these quantitative parameters. Results In the arterial phase, the HVHM and HCC groups displayed no differences in NIC, LNR, or spectral curve slope (P > 0.05). In the venous phase, the two groups displayed significant differences in NIC, LNR, and spectral curve slope; the NIC was 0.59 ± 0.08 for the HVHM group and 0.4 5 ± 0.10 for the HCC group; the LNR was 1.17 ± 0.22 and 0.92 ± 0.16, respectively; the spectral curve slope was 1.85 ± 0.49 and 1.18 ± 0.34, respectively. In addition, there was no significant difference in ICD between the HVHM group (0.54 ± 0.39 g/L) and HCC group (0.45 ± 0.39 g/L) (P > 0.05). Finally, there were no significant differences of water or iodine concentration between the arterial phase and venous phase (P > 0.05). Taken together, the spectral curve slope in the portal venous phase had the best performance in differentiating HVHM from HCC. Conclusions HVHM and HCC have apparent differences in spectral curve and concentrations of radiocontrast agents in the portal venous phase. Hence, spectral CT imaging provides a new multiparameter quantitative approach for differentiating HVHM and HCC.
Comparative Efficacy of Neuraxial and General anesthesia for hip fracture surgery: A meta-analysis of randomized clinical trials
Authors: Zheng Xinxun , Tang Yuming , Gao Yuan , Liu Zhiheng 
Published: November 2019

Abstract
Background: The choice of anesthesia technique remains debatable in patients undergoing surgical repair of hip fracture. This meta-analysis was performed to compare the effect of neuraxial (epidural/spinal) versus general anesthesia on perioperative outcomes in patients undergoing hip fracture surgery. Methods: Medline, Cochrane Library, Science-Direct, and EMBASE databases were searched to identify eligible studies focused on the comparison between neuraxial and general anesthesia in hip fracture patients between January 2000 and May 2019. Perioperative outcomes were extracted for systemic analysis. The sensitivity analyses were performed by the leave-one-out approach. The evidence quality for each outcome was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: Nine randomized controlled trials (RCTs) including 1084 patients fulfilled our selection criteria. The results showed that there were no significant differences in the 30-day mortality, length of stay, and the prevalence of delirium, acute myocardial infarction, and pneumonia for neuraxial anesthesia compared to general anesthesia. There was a significant difference in terms of blood loss in favor of the neuraxial anesthesia. The evidence quality for each outcome evaluated by the GRADE system was low. Conclusions: In summary, our present study demonstrated that neuraxial anesthesia is significantly superior to general anesthesia regarding blood loss in patients undergoing hip fracture surgery. Due to small sample size and enormous inconsistency in the choice of outcome measures, more high-quality studies with large sample size are needed to to clarify this issue.
Identification of Potential core genes in Sevoflurance induced Myocardial Energy Metabolism in Patients Undergoing Off-pump Coronary Artery Bypass Graft Surgery using Bioinformatics analysis
Authors: Lin Hua 
Published: November 2019

Abstract
Background: Myocardial ischemia-reperfusion injury always happened after Oﬀ-pump coronary artery bypass graft(OPCABG), and this can not be avoided altogether. In this study, we tried to detect potential genes of sevoflurane-induced myocardial energy metabolism in patients undergoing OPCABG using bioinformatics analysis. Methods: We download and analyze the gene expression profile data from the Gene Expression Omnibus(GEO) database using bioinformatics methods. We downloded the gene expression data from the Gene Expression Omnibus(GEO) database using bioinformatics methods. Gene Ontology(GO) functional annotation analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis were used to analysis the screened differentially expressed genes(DEGs). Then, we established a protein–protein interaction (PPI) network to find hub genes associated with myocardial energy metabolism. Results: Through PPI network, we find ten hub genes, including JUN, EGR1, ATF3, FOSB, JUNB, DUSP1, EGR2, NR4A1, BTG2, NR4A2. Conclusions: In conclusion, the proteins encoded by EGR1，ATF3，c-Fos，Btg2，JunB，DUSP1，NR4A1，BTG2 and NR4A2 were related to cardiac function. ATF3, FOSB, JUNB, DUSP1, NR4A1, NR4A2 are related to apoptosis of cardiomyocytes. The protein encoded by BTG2 is related to hypertrophy. Sevoflurane regulates cell transcription, inflammatory and apoptosis through those hub genes to protect myocardial.
The draft genome of horseshoe crab Tachypleus tridentatus reveals its evolutionary scenario and well-developed innate immunity
Authors: Zhou Yan , Liang Yuan , Yan Qing , Zhang Liang , Chen Dianbao , Ruan Lingwei , Kong Yuan , Shi Hong , Chen Mingliang , Chen Jianming 
Published: November 2019

Abstract
Background: Horseshoe crabs are ancient marine arthropods with a long evolutionary history extending back approximately 450 million years that rely entirely on their innate immune system and have developed multiple defence systems. However, the genetic mechanisms underlying their abilities of distinguishing and defending against invading microbes are still unclear.
Results: Here, we describe the 2.06 Gbp genome assembly of Tachypleus tridentatus with 24,222 predicted protein-coding genes. Comparative genomics shows that T. tridentatus and the Atlantic horseshoe crab Limulus polyphemus have the most orthologues shared among two species, including genes involved in the immune-related JAK-STAT signalling pathway. Divergence time dating results show that the last common ancestor of Asian horseshoe crabs (including T. tridentatus) and L. polyphemus appeared approximately 130 Mya (121-141), and the split of the two Asian horseshoe crabs was dated to approximately 63 Mya (57-69). Hox gene analysis suggests two clusters in both horseshoe crab assemblies. Surprisingly, selective analysis of immune-related gene families revealed the high expansion of conserved pattern recognition receptors. Genes involved in the IMD and JAK-STAT signal transduction pathways also exhibited a certain degree of expansion in both genomes. Intact coagulation cascade-related genes were present in the T. tridentatus genome with a higher number of coagulation factor genes. Moreover, most reported antibacterial peptides have been identified in T. tridentatus with their potentially effective antimicrobial sites.
Conclusions: The draft genome of T. tridentatus would provide an important source for eliminating the uncertainty in the evolutionary relationship of Chelicerata. The expansion of conserved immune signalling pathway genes, coagulation factors and intact antimicrobial peptides in T. tridentatus constitutes its robust and effective innate immunity for self-defence in marine environments with an enormous number of invading pathogens and may affect the quality of the adaptive properties with regard to complicated marine environments.
Clinical and epidemiological features and organ dysfunction in newborns with neonatal sepsis
Authors: Khaertynov Kh. S. , Anokhin V. A. , Khaliullina S. V. , Lubin S. A. , Dontsova N. V. , Koroleva P. V. , Koshkina A. D. , Khasanova G. R. 
Published: November 2019

Purpose. To evaluate clinical and epidemiological features of neonatal sepsis and assess the impact of organ dysfunction on its outcome.Characteristics of children and research methods. The authors carried out a retrospective analysis of 66 patients with neonatal sepsis hospitalized to the neonatal intensive care unit of the Kazan City Children’s Hospital No. 1 from 2013 to 2017. The diagnosis was based on the development of a systemic inflammatory response syndrome, an increase in C-reactive protein concentration in the blood more than 1 mg/dl, the presence of one or more foci of infection, the development of organ dysfunction and the isolation of the microorganism from venous blood. Bacteremia was a mandatory inclusion criterion.Results. In the most cases (54.5%) neonatal sepsis was caused by gram-negative bacteria. 41 and 4.5% of cases were caused by gram-positive bacteria and fungi, respectively. Among the gram-negative bacteria, the main causative agents of sepsis were Klebsiella pneumoniae (27 cases, 41%), among the gram-positive bacteria –staphylococci (24 cases, 36.5%). Fungal sepsis was caused by Candida kruzei (2 cases) and Candida albicans (1 case). In 11 (17%) cases there was a dysfunction of a single organ, in 31 (47%) cases – dysfunction of 2 organs and in 24 (36%) cases – dysfunction of more than 2 organs. The most common impairments were respiratory dysfunction (86%) and hemostatic disorders in the form of thrombocytopenia (58%). Neonatal sepsis was fatal in 11 (17%) cases. It was found that the multiple organ dysfunction was associated with a risk of death (odds ratio – OR = 29.3; 95% CI 3.4–249.7). Among the signs of organ dysfunction, coma (OR = 30.8; 95% CI 3.0–316.6), elevated blood lactate level of more than 5 mmol/l (OR = 22.1; 95% CI 3.5–139,6) and a low platelet count of less than 50 · 109/l (OR = 5; 95% CI 1.2–21.3) had the prognostic significance.Conclusion. Modern neonatal sepsis has a diverse etiology with gram-negative bacteria as causative agents in half of the cases. Despite modern treatment methods, neonatal sepsis remains a formidable infectious pathology. The risk of fatal outcome is associated with organ dysfunction. Coma, elevated blood lactate level and severe thrombocytopenia are the most significant predictors of fatal outcome in neonatal sepsis.
Circaid adjustable inelastic compression wraps for the treatment of lower limb edema in the venous system pathology
Authors: Semenov A. Yu. , Malakhov A. M. 
Published: November 2019

Symptoms of chronic venous insufficiency have been known since antiquity. The prevalence of chronic venous insufficiency in Western Europe and the USA has been reported within the range from from 1 to 40% in women and from 1 to 17% in men [1]. As reported by the European authors, the average prevalence of chronic venous insufficiency with class C2-C6 (according to the CEAP classification) among the European population reaches 30% [2]. Edema syndrome remains one of the leading manifestations of chronic venous disease. Compression therapy is one of the main ways to combat edema. The arsenal of devices for the treatment of edematous syndrome is steadily expanding with the development of medical science. Today, in addition to inelastic compression wrap and elastic compression garments, brand-new compression products, circaid adjustable inelastic compression wraps are available.
Evaluation of the efficacy and safety of compression garments in the treatment of patients with chronic lower limb vein diseases
Authors: Katorkin S. E. , Kravtsov P. F. , Melnikov M. A. 
Published: November 2019

Aim. To evaluate clinical efficacy, safety and compliance level of outpatient application of “TONUS ELAST” compression garments in patients with chronic diseases of lower limbs of C3-C4 clinical classes according to CEAP.Material and methods. Continuous compression therapy during 6 months with the use of “TONUS ELAST” garments was received by 34 patients (12 men and 22 women) with chronic diseases of the lower limbs of C3-C4 clinical classes. The average age was 67 ± 3.2 years. There were 26 (76%) patients with varicosity and 8 (24%) patients with postthrombophlebitic stage of different recanalization. Anamnesis duration was 16 ± 3.9 years. Dynamic analysis of subjective and objective clinical symptomatology, results of legometry, volumetry and ultrasound examination with registration of blood flow rate in the femoral vein according to the developed protocol was carried out.Results of the study. Clinical observation in the dynamics of the study and instrumental methods of examination confirm the significant clinical efficacy of “TONUS ELAST” garments of the 2nd class of compression as a means of conservative treatment of chronic diseases of C3-C4 clinical classes. Positive dynamics of subjective symptomatology with the achievement of the most successful result in the management of convulsive (96.6%) and painful (93.8%) syndromes was revealed. Reduction of the shin circumference was recorded in 100% of observations on the left lower limb and in 96,7% on the right one. Statistically significant positive dynamics of volumetric parameters was achieved after 3 months of compression therapy. The tendency to acceleration of blood flow in the femoral vein in 71,4% of observations was revealed. Laboratory analysis of hemostasiological parameters demonstrated compensatory normocoagulation. Absence of cases of individual intolerance and adverse effects of compression products indicates their safety. A high level of adherence of patients to the therapy is registered. Doctors and patients gave a positive subjective assessment of the effectiveness and consumer properties of the studied product.Conclusion. Compression garment “TONUS ELAST” of the 2nd class of compression can be recommended as a safe, effective and comfortable means of outpatient therapy and prevention of chronic diseases of lower limbs veins.
Selection of local antiseptic for treatment and prevention of wound infection
Authors: Rodin A. V. 
Published: November 2019

The advantages and disadvantages of modern antiseptics for local treatment and prevention of wound infections are considered. On the basis of data of comparative clinical studies the advantages of topical drugs based on octenidine dihydrochloride in combination with phenoxyethanol are presented. The advantages of octenidine dihydrochloride/ phenoxyethanol as a local antiseptic for treatment and prevention of wound infections in case of wound defects, burns are described.
Selection of antibiotics to prevent recurrence of erysipelas
Authors: Rodin A. V. , Shilina A. A. 
Published: November 2019

Erysipelas is an acute infectious disease of streptococcal etiology. Currently, many people lead an active lifestyle, including sports activities both in outdoor areas and in gyms. There is always a risk of various wounds, which are the entry gate for infection, in particular Streptococcus pyogenes. Infection often occurs against the background of weakened immunity. Reduced immune properties can result from frequent stress and chronic fatigue due to severe physical and psycho-emotional stress at work. All these factors in combination create favorable conditions for the development of erysipelas. The peculiarity of face inflammation is that the disease can take a recurrent course. The most important place in the complex treatment of patients with erysipelas is taken by antibiotic therapy. In the treatment of patients in the conditions of the polyclinic it is possible to prescribe antibiotics orally. In the severe course of the disease and the development of complications it is justified to prescribe parenteral therapy. Penicillins are the drugs of choice, because until now penicillins are almost 100% active against Streptococcus pyogenes. During antibiotic therapy it is desirable to combine such properties of the preparation as long-term bactericidal concentration against Streptococcus pyogenes in tissues and, consequently, much lower multiplicity of injections in comparison with benzylpenicillin. These requirements are met by benzathine benzylpenicillin, benzylpenicillin procaine. Based on the results of clinical studies, the advantages of benzathine benzylpenicillin are shown, including in combination with benzylpenicillin procaine to prevent recurrence of erysipelas.
Experience of application of nadroparin calcium in a patient with melanoma after organ-preserving surgery with musculocutaneous flap-plasty on the vascular pedicle of the defect
Authors: Myasnyankin M. Yu. , Anisimov V. V. 
Published: November 2019

Patients with malignant diseases belong to the high risk group for thrombosis and pulmonary embolism development [1-3]. Any reconstructive plastic surgery in such patients has potential complications that can reduce all efforts to zero [4-6]. Antithrombotic therapy is a complex problem of modern oncology [7-9]. For a long time, all patients with subungual melanoma underwent only one type of operation – amputation [10, 11]. In order to avoid mutilating surgery and preserve the maximum functionality of the limb, we have developed and proposed an organ-preserving operation with an optimal antithrombotic approach in the postoperative period. In the present scientificpractical article the clinical observation of the patient after removal of subungual melanoma (SM) with musculocutaneous flap-plasty on the vascular pedicle of the defect with the developed optimal approach of thrombosis and thromboembolism prophylaxis with the use of fraxyparine is presented. In the case of sonodoplerographic imaging of vessels of the I finger of the left hand, the passage of a. digitalis palmaris proprius is marked. A dissection of the vascular pedicle containing a. digitalis palmaris proprius, a fragment of m. interosseus dorsalis I, subcutaneous adipose tissue with subcutaneous venous system branches along the side surface of the I finger of the left hand to the projection of the phalangeal joint was performed. Mobilized musculocutaneous flap was placed on the defect and was fixed to the wound edges. The control of the vascular pedicle permeability by means of color and energy mapping of the blood flow was performed. The control of the flap was carried out on the 7th, 15th, 21st day [12, 13]. The flap engraftment is 100 %. The patient could already write with a pen and cut paper with scissors on the 7-10th day. She is currently in full clinical remission and has returned to her working life. Without proper thrombosis prophylaxis, it would be impossible to maintain the functionality of the vascular stem and, given the nature of malignant neoplasms, to reduce the risk of thromboembolism [14-17]. Presented experience of antithrombotic therapy opens new possibilities of surgical treatment with reconstructive-plastic component in patients with malignant neoplasms.
Comparative assessment of the clinical efficacy of first-generation phlebotonics in the complex treatment of patients with chronic venous diseases of the lower limbs
Authors: Katorkin S. E. , Myshentsev P. N. , Lisin O. E. , Rozanova A. A. 
Published: November 2019

Target. Comparative assessment of the clinical efficacy of Aescusan I generation phlebotonics application in the complex treatment of patients with CVD.Material and methods.Analysis of treatment of 380 patients who applied for a phlebological appointment at the polyclinic department of SamSMU Clinics for the period from September 2017 to March 2019 was conducted. Group I (n = 104) included patients with even outpatient card numbers who were prescribed Troxevasin as a first-generation phlebotonic according to the scheme recommended by manufacturers Group II (n = 276) included patients with odd outpatient card numbers who were prescribed Aescusan (an extract of horse chestnut seeds Aesculus hippocastanum, active ingredient of which is aescin) as phlebotonics of the first generation according to the scheme recommended by the manufacturers. All patients were examined by a phlebologist before and after 1 course of treatment. Clinical efficacy of the therapy was assessed by the severity of the pain syndrome, feeling of heaviness, swelling and seizures using visual analogue scale (VAS). In addition, the effectiveness of conservative therapy was assessed through interviews and questionnaires. For a comparative assessment of the severity of edema syndrome, the lower limb circumference was measured at ankle level using a graduated tape.Results. No side effects were detected during clinical observation of the use of drugs. After the course of treatment, most of the observations showed positive dynamics. Changes in clinical symptoms (pain, seizures, heavy legs) in Group I were statistically unreliable (p>0.05). In the second group there was a decrease of pain syndrome intensity by 73,2%, a decrease of convulsions - by 63,5%, a decreaseof heaviness feeling – by 73,7%. In the course of the survey, 272 patients (98.5%) of Group II evaluated the treatment results as good, 4 patients (1.5%) did not notice any treatment results.In the course of repeated examination after the treatment 96,5% of doctors noted the result in Group II as good, 3,5% - as satisfactory. Conclusion. Thus, the results of complex treatment of patients with CVD showed that the use of 1st generation phlebotonics should be considered not only as pathogenetically justified, but also effective from the clinical point of view. Application of Aescusan drug leads to statistically significant reduction of clinical symptoms (subjective and objective) of lower limbs CVD.
Systematic review of indicators for the assessment of water consumption rates at hospitals
Authors: Batista Karmem Julya Miron , Rosa da Silva Simone , Rabbani Emilia Rahnemay Kohlman , Zlatar Tomi 
Published: November 2019

Abstract
This study reviews the pertinent literature and summarizes water consumption indicators (CI) for hospitals. To facilitate comparison, two consistent metrics are highlighted, namely the annual water usage per bed (m3/bed/year) and per built area (m3/m2/year) for the different locations. Overall, the review reveals a wide variation among water consumption indicators. Hospitals in Italy have a reported use of 458 m3/bed/year, the highest indicator reported; the lowest CI among the reviewed articles was for German public hospitals at 103 m3/bed/year. Not surprisingly, higher water tariffs tend to reduce consumption, while higher per capita income increases consumption. Yet overall CI values tended to reflect a variety of causes, including activity level, laundry arrangements, water costs, the application of sustainable practices, environmental certification and other considerations. Given the high indicator values identified for Brazilian hospitals, future research might consider a more detailed study of how their water consumption might be better managed.