bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomized controlled clinical study of acupuncture therapy for Seborrheic alopecia in young and middle ages
Authors: Chen Qiulian , Tao Yun , Wang Longjun , Zhang Jinfang , Sun Bichen , Yang Xiaoli 
Published: April 2020

Abstract

Introduction:
Seborrheic alopecia (SA) has clinical manifestations, duration of disease, and priorities. In the current situation where there are many and complicated clinical treatments, Western medicine treatment can delay and control the development of the disease and promote hair regeneration. However, some patients may aggravate symptoms after taking the drug, and the condition is easy to repeat after stopping the drug. Acupuncture is an important method for non-surgical treatment of SA, and it has various methods, low side effects, high safety, and simple and economical. Therefore, we will use a clinical randomized controlled study to explore the effect of acupuncture on SA, and provide a new idea and reference for the treatment of this disease.

Methods/design:
We will select 60 patients diagnosed with SA. They will be randomly divided into intervention group and control groups. The control group will be given conventional treatment measures. The intervention group will receive acupuncture. Efficacy will be evaluated by comparing the skin lesion score and dermatological quality of life index before and after treatment.

Discussion:
This trial may provide evidence regarding the clinical effectiveness, safety, and cost-effectiveness of acupuncture for patients with SA.

Trial registration number:
CTR2000030430
The efficacy of jade moxibustion in knee osteoarthritis
Authors: Chen Lusheng , Huang Zouqin , Cheng Ke , Wu Fan , Deng Haiping , Lin Lin , Zhao Ling , Shen Xueyong 
Published: April 2020

Abstract

Introduction:
This study aims to compare clinical effect between Jade moxibustion and traditional moxibustion, and to determine the clinical effect of Jade moxibustion on knee osteoarthritis (KOA).

Methods/Design:
This is a 2-parallel-group, randomized controlled trial. A total of 148 subjects with KOA (Kellgren–Lawrence grade II or III) will be recruited and randomized to receive Jade moxibustion treatment or a traditional moxibustion treatment in a 1:1 ratio. Jade moxibustion group: The affected knee of the subjects will be covered with jade kneepad. Traditional moxibustion group: Chosen the ST35, ST34, EX-LE4, SP10 and Ashi points at the affected knee. The subjects will receive treatment three times a week, altogether 12 times in 4 weeks. The main outcomes are WOMAC knee pain score, knee function score and SF-36 quality of life questionnaire changes at the 4th week. Secondary outcomes include WOMAC knee pain score and knee function score, overall clinical efficacy evaluation, medication, safety evaluation at the 2nd, 12th, and 24th week, and cytokines related to osteoarthritis in serum.

Discussion:
This randomized controlled trial used traditional moxibustion as a control group to provide rigorous evidence for the clinical efficacy and safety of Jade moxibustion in treatment of KOA.

Trial Registration:
ISRCTN registry, No 21174552. Registered on 28 February 2020.
Induction of apoptosis by Xiakemycin A in human hepatoma HepG2 cells
Authors: Chen Chuan , Han Zhu , Yang Minjie , Jiang Zhongke , Ou Xiuyuan 
Published: April 2020

Abstract
Xiakemycin A (XKA), a new antibiotic in the pyranonaphthoquinone family, shows antitumor activity. However, the type of cell death induced by XKA remains elusive. In this study, we aim to investigate the type of death induced by XKA in hepatic cancer.
The apoptotic features, such as chromatic agglutination, reactive oxygen species generation and membrane potential of mitochondria, in HepG2 cells treated by XKA were measured by Hoechst 33342 staining and flow cytometry. Apoptosis of HepG2 cells treated with XKA was determined by Annexin V-FITC/propidium iodide double staining and Western blot analysis, respectively.
XKA had a significant dose-dependent elevation of chromatic agglutination, reactive oxygen species generation, Annexin V and propidium iodide staining, decrease of membrane potential. Meanwhile, in apoptotic HepG2 cells induced by XKA, robust increment was noticed in p53 expression, cleavage of PARP, caspase-3, and caspase-9.
XKA showed potent inhibitory effects on the proliferation of HepG2 cells. Such phenomenon may be related to activation of the apoptotic pathway.
Successful transurethral resection of the prostate in ectopic prostate pheochromocytoma
Authors: Zhou Jin , Wu Wen-Feng , Zhang Wenbin , Xin Jun , Lei Wen-Hui 
Published: April 2020

AbstractIntroduction:Most pheochromocytomas of the urinary tract are located in the bladder. However, ectopic prostate pheochromocytomas have rarely been reported. We herein report an unusual case of ectopic prostate pheochromocytoma successfully treated by transurethral resection of the prostate (TURP).Patient concerns:A 44-year-old Asian man with no significant previous medical history such as hypertension, presented to the urologist complaining of palpitations and anxiety on urination for more than 1 month.Diagnoses:Pathological examination confirmed ectopic prostate pheochromocytoma.Interventions:An ectopic prostate pheochromocytoma without definite metastasis was confirmed. The lesion was successfully treated via TURP.Outcomes:All of his symptoms completely and immediately disappeared after surgery. Over a 21-month follow-up period, a repeat abdominal computed tomography (CT) scan did not show any evidence of recurrence.Conclusion:When patients present with symptoms of catecholamine excess on urination, extra-adrenal pheochromocytoma in the prostate should also be considered. TURP may be a viable option for therapy.
Effects of surgical approaches and morphological characteristics on the follow up outcomes of patients with posterolateral tibial plateau fractures
Authors: Huo Yongfeng , Xu Gang , Yin Zhaoyang , Yu Jian , Sun Xiao , Li Leiming , Gu Guangxue , Sheng Luxin , Sun Hong 
Published: April 2020

Abstract
This study aimed to study the effects of surgical approaches and identify the morphological characteristics associated with the 1-year follow-up outcome of patients with posterolateral tibial plateau fractures after successful surgery.
We followed 200 postoperative patients for 1 year. The modified Hospital for Special Knee Surgery score (HSS score) was used to evaluate the functional recovery of the knee. We supposed 4 morphological characteristics in CT images acting as possible risk factors, including the anteroposterior diameters of posterolateral broken bone fragments (fragment-diameter), the damage to the posterolateral cortex of the tibial head (cortex-damage), the combinational fracture of the proximal fibula (fibula-fracture) or fracture of the medial tibial condyle (medial-condyle-fracture). Multivariate regression models were used to analyze the effect of these factors on the HSS score after adjusting the 2 surgical approaches and other confounders.
The average HSS score was 85.1 ± 5.8 for all the patients. We treated 155 patients with the anterolateral approach and 45 patients with the posterolateral approach. The surgical approach, fragment-diameter, fibula-fracture, and medial-condyle-fracture were correlated with the HSS scores (P < .05). After adjusting for the above factors, the Schatzker type, age and gender, compared with anterolateral approach, the posterolateral approach could improve the HSS scores by an average of 3.7 points. The fragment-diameter <20 mm and posterolateral approach interacted on the HSS scores. Comparing posterolateral and anterolateral approaches, we found that the HSS scores of patients with fragment-diameter <20 mm increased by 6.1 points (95% CI: 4.1–8.2) in the posterolateral approach, while those with fragment-diameter ≥20 mm did not significantly improve the HSS scores.
The surgical approach, fragment-diameter, fibula-fracture, and medial-condyle-fracture were independent risk factors associated with the follow-up outcome of patients with posterolateral tibial plateau fractures after successful surgery. The posterolateral approach could significantly improve the HSS score in the studied hospital.
Treatment of medial humeral epicondyle fractures in children using absorbable self-reinforced polylactide pins
Authors: Su Yuxi , Nan Guoxin 
Published: April 2020

Abstract
The best treatment for medial humeral epicondyle fractures in children has been debated. In case of incarceration of the epicondylar fragment, particularly after elbow dislocation, several materials are used for fixation, including Kirschner wires (K-wires), metallic compression screws, tension band wire, and suture anchors. Herein, we introduce a new fixation material: the absorbable self-reinforced polylactide (SR-PLA) pin.
The aim of the study was to prove the feasibility of a new fixation material (absorbable SR-PLA pins) for the treatment of medial epicondyle fracture in children.
Thirty-two patients who underwent surgery in our hospital from August 2007 to January 2012 were retrospectively analyzed. The patients were divided into group A (K-wires) and group B (absorbable SR-PLA pin). Group A comprised 11 males and 4 females, aged 8 to 14 years (average, 12.6 years), with 12 patients with elbow dislocation. Group B comprised 13 males and 4 females, aged 7 to 15 years (average, 11.8 years), with 13 patients with elbow dislocation. The same approach was used for all patients by the same team of surgeons, and all the patients were followed up for over 12 months. In all patients, rehabilitation training was started after 3 weeks. The Broberg and Morrey elbow scale was used to evaluate elbow function at follow-up.
Four patients from group A developed pin-track infections that gradually resolved after removal of the K-wires, whereas no infections occurred in group B. One patient refractured her humerus after K-wire removal. Using the Broberg and Morrey elbow scale, outcomes in group A were classified as excellent in 5 patients (33.33%), good in 7 patients (46.67%), fair in 2 patients (13.33%), and poor in 1 (0.07%). Group B outcomes were scored as excellent in 12 patients (70.58%), good in 4 (23.53%), and fair in 1 (0.06%) and no patient (0.00%) had a poor outcome. The average Broberg and Morrey score for group A was significantly lower than that for group B (83.27 ± 7.02 vs 95.21 ± 5.04; P = .0238).
Absorbable SR-PLA pins can be safely used for medial epicondyle fractures in children. Our results indicate that SR-PLA pins are associated with better short-term functional outcome than K-wires.

Level of evidence: III
Effect of different electrical stimulation protocols for pelvic floor rehabilitation of postpartum women with extremely weak muscle strength
Authors: Li Wenjuan , Hu Qing , Zhang Zhujuan , Shen Fengxian , Xie Zhenwei 
Published: April 2020

Abstract

Background:
Pregnancy is one of the main risk factor of pelvic floor muscle dysfunction. Postpartum women with extremely weak muscle strength have difficulty to do voluntary pelvic floor muscle training. This study aims to evaluate the effects of different protocols of electrical stimulation in the treatment of postpartum women with extremely weak muscle strength.

Methods:
A total of 67 women were randomized into 2 groups: group A received transvaginal electrical stimulation (TVES) for 5 times, and group B received TVES for 3 times with electromyogram (EMG)-triggered neuromuscular stimulation twice. Subjects were evaluated before and after treatment. Pelvic muscle strength was measured by both digital vaginal palpation and EMG variables, and quality of life was investigated by 4 kinds of pelvic floor disease-related questionnaires.

Results:
According to the intention-to-treat principle, compared with baseline, in group A, EMG of contractile amplitude of endurance phase was significantly elevated (P = .03), variation of contractile amplitude in tonic phase was more stable after treatment (P = .004), and EMG of mean value of final rest was significantly elevated after treatment (P
= .047). After 5 times treatments, the incidence of correct pelvic floor muscle contraction in group A was significantly elevated (P = .045). No significant difference of muscle strength test by digital vaginal palpation was detected between the 2 groups, so did questionnaires.

Conclusion:
For postpartum women with extremely weak muscle strength, TVES for 5 times might be more benefit for control ability of pelvic muscle contractions and elevating muscle strength even in short-time treatment.
Anatomical structure responsible for direction changing bilateral gaze-evoked nystagmus in patients with unilateral cerebellar infarction
Authors: Lee Hyung , Kim Hyun Ah 
Published: April 2020

Abstract
The direction-changing bilateral gaze-evoked nystagmus (GEN) (BGEN) is a more specific sign for a gaze-holding deficit than unilateral GEN (UGEN) in a central lesion. We sought to clarify which cerebellar structure is responsible for the generation of BGEN compared with UGEN.
We studied 47 cases of UGEN or BGEN associated with isolated unilateral cerebellar infarction in the territories of the cerebellar arteries diagnosed by brain magnetic resonance image (MRI) from June 2007 to April 2014. To identify the structures involved in the generation of BGEN, the overlapped lesions of the BGEN group were subtracted from those of UGEN group and vice versa.
About half of the patients (25/47, 53%) showed BGEN and others showed UGEN. There was no difference in the interval from symptom onset to examination between 2 groups (1.3 days vs 2.5 days, P = .24). Thirty-five patients (35/47, 75%) with GEN also showed spontaneous nystagmus. Lesion subtraction analyses revealed that both of the patients with BGEN and UGEN had damage around the vermal pyramid, the uvula and the tonsil, parts of the biventer lobule, and the inferior semilunar lobule.
Midline and lower cerebellar structures are related to both BGEN and UGEN in patients with unilateral cerebellar infarction. Regardless of unilateral or bilateral, GEN may represent damage of the gaze-holding neural integrator control system in human.
Electroacupuncture for lumbar disc herniation
Authors: Shen Yuquan , Zhou Qun , Zhang Leixiao , Gao Liang , Zhang Di , Wang Xinling , Yu Yang , Zhang Zhengsong , Liu Jianjia , Liang Shumi , Zhang Guilong 
Published: April 2020

Abstract

Background:
This systematic review aims to evaluate the effectiveness of electroacupuncture in treatment of lumbar disc herniation (LDH).

Methods:
Electronic databases of all electroacupuncture for LDH will be searched at PubMed, Cochrane Library, Springer, EMBASE, China National Knowledge Infrastructure (CNKI), Wan-Fang, and Chinese Biological Medical disc, (CBM) from inception to February 29, 2020, with language restricted in Chinese and English. The primary outcome is Japanese Orthopedic Association Scores, a quantification scale for a comprehensive assessment according to patients’ subjects feeling and objective function. Secondary outcomes included visual analogue scale (VAS), Oswestry dysfunction index (ODI), Pittsburgh sleep quality index (PSQI), Self-rating anxiety scale (SAS), self-depression rating scale (SDS), follow-up relapse rate. The systematic review and searches for randomized controlled trials of this therapy for LDH. The Cochrane RevMan V5.3 bias assessment tool is implemented to assess bias risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). Mean difference (MD), standard mean deviation (SMD) and binary data will be used to represent continuous results.

Results:
This study will provide a comprehensive review and evaluation of the available evidence for the treatment of LDH with this therapy.

Conclusion:
This study will provide new evidence to evaluate the effectiveness and side effects of electroacupuncture for LDH. Due to the data is not personalized, no formal ethical approval is required.
Primary health care physicians’ knowledge and adherence regarding hypertension management guidelines in southwest of Saudi Arabia
Authors: Shnaimer Jubran A. , Gosadi Ibrahim M. 
Published: April 2020

Abstract
To measure Primary Health Care physicians’ knowledge of and adherence to the Saudi Hypertension Management Guidelines (SHMGs) in Southwest of Saudi Arabia.
This study was a cross-sectional investigation where data was collected via a self-administered questionnaire. The demographics of the physicians, data related to the source of the guidelines for hypertension management, knowledge about the SHMGs and physicians’ adherence to the SHMG were collected. Student's t test was used to assess the presence of any statistical difference between the level of knowledge and adherence according to the study's measured variables.
A total of 316 physicians participated in this investigation, representing 65% of all the PHC physicians in the Jazan region. The number of correct answers measuring knowledge about various topics varied between 18% and 94% with a mean overall score of 7.9/16. The number of reported practices adherent to the guidelines varied between 2% and 97%, and the mean overall score was 7.2/11. Receiving hypertension management guidelines from the Directory of Health was statistically associated with a higher level of knowledge (P value < .05). Undergoing clinical training for hypertension management and seeing fewer numbers of patients on a daily basis was associated with a statistically higher level of adherence to the guidelines (P value < .05).
Improper distribution of guidelines, lack of continuous clinical training, negative attitude of physicians toward guidelines and large number of patients seen by physicians are likely to hinder translating guidelines to actual clinical practice.
One-year follow-up of heart transplant recipient with cardiac rehabilitation
Authors: Choi Hee-Eun , Kim Chul , Park Se-Heum 
Published: April 2020

Abstract

Introduction:
Heart transplantation (HT) is known to be the final therapy for patients with advanced heart failure; however, the exercise capacity of these patients remains under the aged-predicted value after HT. Many studies have described the effectiveness and safety of cardiac rehabilitation (CR) in HT recipients. Nevertheless, long-term follow-up data of HT recipients undergoing CR are insufficient, and there is a lack of evidence on the long-term effects of CR. In this case report, we present the long-term benefits of CR in an HT recipient, including serial follow-up clinical data over 1 year.

Patient concerns:
A 48-year-old female patient underwent HT because of advanced dilated cardiomyopathy.

Diagnosis:
Cardiopulmonary exercise test showed reduced exercise capacity and pulmonary function. The grip power and quadriceps muscle strength were also decreased after HT.

Interventions:
The patient underwent a phase I CR program for 3 months, followed by a phase III CR program for 7 months. In the beginning, moderate-intensity continuous training was conducted. Thereafter, high-intensity interval training was implemented after a period of adjustment for interval training.

Outcomes:
The exercise capacity, 6-min walk distance, muscle strength, and vital capacity were improved after CR.

Conclusion:
CR in HT recipients may improve muscle strength and pulmonary function as well as exercise capacity, without serious cardiovascular complications. Phase III CR may help maintain exercise capacity in these patients.
Cesarean section rates in Brazil
Authors: Rudey Edson Luciano , Leal Maria do Carmo , Rego Guilhermina 
Published: April 2020

Abstract
Cesarean section (CS) is a surgical procedure used to deliver babies that is medically indicated to prevent maternal and neonatal mortality. However, it is associated with short- and long-term risks. CS rates have increased, and efforts are being made to ensure that CS is performed only when necessary. The Robson classification system is considered useful for studying, evaluating, monitoring, and comparing CS rates within and between healthcare facilities. In Brazil, there are few studies on this subject, and no large epidemiological studies on this topic utilizing the Robson classification have been reported. This study aimed to report and analyze CS rates in Brazil using the Robson classification system, and subsequently suggest possible measures to address it.
Data were collected from the Brazilian Live Birth Information System (Sistema de Informações sobre Nascidos Vivos) that contains data of the entire obstetric population, from 2014 to 2017. All births in the country during this period were analyzed according to the Robson classification.
A total of 11,774,665 live births were reported in Brazil during 2014 to 2017, most of which were mostly via CS (55.8%). Regions with high human development indexes had significantly higher CS rates than those with low human development indexes. The Robson group (RG) 1 to 4 accounts for 60.2% of live births and 47.1% of all CSs. RG5 was larger than all the other groups and contributed to the highest global rate of CS (31.3%), in addition to being the group who presented the largest growth.
Although RG 1 to 4 present favorable initial conditions for vaginal delivery, CS accounted for almost half of births in these groups. The size of RG1 and RG2 in Brazil was comparable to that in countries with low CS rates; however, CS rates in these groups were 3 times higher in Brazil. Nulliparous women in RG1 and RG2 who undergo CS are subsequently categorized into RG5, increasing the global CS rate by 1% annually.
We suggest the implementation of health policies to avoid the unnecessary performance of CS in RG1 and RG2 to decrease the CS rates in Brazil.
Identification of gastrointestinal stromal tumors from leiomyomas in the esophagogastric junction
Authors: Yin Xiaonan , Yin Yuan , Liu Xijiao , Yang Caiwei , Chen Xin , Shen Chaoyong , Chen Zhixin , Zhang Bo , Cao Dan 
Published: April 2020

Abstract
To identify significant clinical and CT features for the differentiation of gastrointestinal stromal tumors (GISTs) from leiomyomas in the esophagogastric junction (EGJ).
One hundred thirty six patients with pathologically proven GISTs (n = 87) and leiomyomas (n = 49) in the EGJ were enrolled. And preoperative CT images were available in 73 GISTs cases and 34 leiomyoma cases. Two radiologists reviewed the CT images by consensus with regard to tumor size, shape, growth pattern, surface, enhancement pattern, enhancement degree, attention at each phasic image and the presence of surface ulcer, calcification, and intralesional low attention.
Eight significant clinical and CT features were identified for differentiating GISTs from leiomyomas: older age (>46.5 years), tumor long diameter >4.5 cm, heterogeneous enhancement, high degree enhancement, mean CT attenuation >69.2 HU, presences of intralesional low attenuation and surface ulcer, absences of calcification (P < .05). On the receiver operating characteristic curve analysis, an optimal cutoff score of 3.5 was achieved for differentiating GISTs from leiomyomas with an AUC of 0.844 (sensitivity: 76.7%, specificity: 76.5%).
older age (>46.5 years), tumor long diameter >4.5 cm, heterogeneous enhancement, high degree enhancement, mean CT attenuation >69.2 HU, presences of intralesional low attenuation and surface ulcer, absence of calcification are significant features highly suggestive of GISTs in differentiation from leiomyomas in the EGJ.