bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of abiraterone and enzalutamide for castration-resistant prostate cancer
Authors: Zheng Xiaonan , Zhao Xiaohui , Xu Hang , Han Xin , Xu He , Dong Xin , Peng Ruilin , Yang Lu , Wei Qiang , Ai Jianzhong 
Published: November 2019

Abstract

Background:
Previous evidence directly evaluating the efficacy and safety of abiraterone and enzalutamide treatment for castration-resistant prostate cancer (CRPC) is limited. We aim to include more randomized controlled trials (RCTs) to comprehensively assess the efficacy and safety of abiraterone and enzalutamide treatment.

Methods:
PubMed, Embase, and ClinicalTrial.gov were systematically searched. Pooled hazard ratios (HRs) were calculated using Stata 12.0 software. The comparison of the prostate-specific antigen (PSA) response rate and adverse events (AEs) between the treatment and control groups were performed using RevMan 5.3 software.

Results:
Eight eligible RCTs with 6,490 patients were selected. Pooled HRs were 0.72 for overall survival, 0.45 for radiographic progression-free survival (rPFS), and 0.36 for PSA PFS. abiraterone and enzalutamide could significantly increase the PSA response rate OR = 8.67, 95%CI 4.42–17.04) and any AE occurrence (OR = 1.98, 95%CI 1.46–2.68). The treatment group had more occurrence of fatigue (OR = 1.34, 95%CI 1.20–1.49), back pain (OR = 1.15, 95%CI 1.01–1.15), hot flush (OR = 1.76, 95%CI 1.50–2.06), diarrhea (OR=1.22, 95%CI 1.07–2.40) and arthralgia (OR = 1.34, 95%CI 1.16–1.54). Particularly, AEs of special interest including any grade hypertension (OR = 2.06, 95%CI 1.71–2.47), hypokalemia (OR = 1.80, 95%CI 1.42–2.30) and fluid retention or edema (OR = 1.38, 95%CI 1.17–1.63) also occurred less in the control group. Moreover, a higher incidence of high-grade hypertension (OR = 2.60, 95%CI 1.79–3.79) and extremity pain (OR = 4.46, 95%CI 2.81–7.07) was observed in the treatment group.

Conclusion:
The survival benefits of abiraterone and enzalutamide for CRPC were evident and promising, while the risk of AE occurrence was also acceptably higher in the treatment group than in the placebo group.
Prophylactic intraoperative uterine or internal iliac artery embolization in planned cesarean for pernicious placenta previa in the third trimester of pregnancy
Authors: Wang Juan , Shi Xiu , Li Yan , Li Zhi , Chen Youguo , Zhou Jinhua 
Published: November 2019

Abstract
The aim of this study was to evaluate the efficacy and safety of prophylactic intraoperative bilateral uterine or internal iliac artery embolization in planned cesarean for pernicious placenta previa in the third trimester of pregnancy.
The patients with pernicious placenta previa were retrospectively included from January 2011 to May 2018, being divided into embolization group and control group. Intraoperative uterine artery embolization (UAE) or internal iliac artery embolization (IIAE) was undertaken to stop intrapartum and postpartum hemorrhage in embolization group.
There were no significant differences on age, pregnancy times, gestational age, neonatal weight, neonatal asphyxia, prenatal bleeding, placental implantation, and mortality between embolization group and control group (P
> .05). The amount of intraoperative and postoperative bleeding in embolization group was significantly greater than that in control group (P
< .05). However, the hysterectomy rate in the embolization group was significantly lower than that in the control group (P < .05). Two (6.25%, 2/32) cases had undergone the second time embolotherapy after 8 hours of cesarean surgery because of severe vaginal bleeding. One case (3.13%, 1/32) died of diffuse intravascular coagulation because of hemorrhagic shock in embolization group. Transient and self-remitted lumbosacral pain was present in 28 (95%, 28/32) patients and no other severe interventional complications were reported in embolization group. All babies in 2 groups were healthy at half to 5 years’ follow-up.
The prophylactic intraoperative embolization of bilateral UAE or IIAE may be an effective strategy to treat intractable peripartum hemorrhage and preserve the fertility in patients with pernicious placenta previa.
The prognostic analysis of different metastatic patterns in pancreatic neuroendocrine tumors patients
Authors: Wang Sumei , Zhang Jiandong , Liu Shuye , Zhang Jinjuan 
Published: November 2019

Abstract

Objective:
To evaluate the prognostic value of pancreatic neuroendocrine tumors (pNETs) with different metastatic patterns.

Methods:
Data of pNETs cases were extracted from the Surveillance, Epidemiology, and End Result (SEER) database. They were classified according to the different metastatic patterns. We utilized chi-square test to compare the clinical and metastasis characteristics among different groups. We used Kaplan–Meier analysis and log-rank testing for survival comparisons. Adjusted HRs with 95% CIs was calculated using Cox regression model to estimate prognostic factors. P < .05 was considered statistically significant.

Results:
Among the 3909 patients, liver is the most metastatic organ, and isolated brain metastasis is the least common. At the same time, many patients have had multiple metastases. We studied the overall survival (OS) and cancer-specific survival (CCS) of the groups. OS: Non-organ metastasis: 5-year OS = 77.1%; Bone metastasis: median survival time (MST) = 56 m, 5-year OS = 42.7%; Liver metastasis: MST = 24 m, 5-year OS = 25.5%; Lung metastasis: MST = 14 m, 5-year OS = 33.7%; multiple metastases: MST = 7m, 5-year OS = 12.0%. CCS: Non-organ metastasis: 5-year OS = 84.2%; Bone metastasis: 5-year OS = 52.5%; Liver metastasis: MST = 27 m, 5-year OS = 28.6%; Lung metastasis: MST = 49 m, 5-year OS = 40.1%; multiple metastases: MST = 8 m, 5-year OS = 14.5%. In addition, the results showed that there were all statistical significances between the surgery and the no surgery group (all, P < .001). Multivariate analysis revealed that brain metastasis, multiple metastases, age over 60 years, unmarried, grade III/IV, regional/distant and no surgery were independently associated with decreased OS and CCS.

Conclusions:
pNETs patients without organ metastasis had the best survival outcomes, while multiple had the worst outcomes. There were no significant differences in bone metastasis, liver metastasis and lung metastasis. Surgery was still an option for patients with metastasis.
A right eye amaurosis patient with congenital absence of the internal carotid artery
Authors: Ding Yun-Long , Niu Jia-Li , Ma Li , Gu Zhi-Qun , Zhai Ting-Ting , Liu Yan 
Published: November 2019

Abstract

Rationale:
Absence or hypoplasia of the internal carotid artery (ICA) are rare developmental anomalies. Usually, patients with ICA agenesis are asymptomatic due to collateral circulation, but they may present with seizures, headache, or transient ischemic attack. We report a patient with right ICA absence in whom “paroxysmal right eye amaurosis” was the main symptom.

Patient concerns:
A 76-year-old male patient suffered from “paroxysmal right eye amaurosis for 3 years”. Three years prior, the patient had suffered sudden one-minute right eye amaurosis without any obvious cause. The attack reoccurred 1–2 times/year until one week before admission when he experienced two sudden right eye amaurosis.

Diagnosis:
Congenital absence of the right ICA was diagnosed. In this patient with congenital absence of the right ICA, the ipsilateral anterior cerebral artery (ACA) was compensated by the anterior communicating artery (ACOM), and the ipsilateral middle cerebral artery (MCA) emerged from the carotid siphon of the contralateral ICA.

Interventions:
The patient was given antiplatelet treatment consisting of aspirin and atorvastatin after admission and instructed to maintain the treatment after discharge.

Outcomes:
No symptom onset was observed during follow-up.

Lessons:
Here, we report the patient's clinical manifestations and imaging findings and analyze the cause of the condition to provide a clinical reference for the study of congenital absence of the ICA.
Ureteral obstruction and hydronephrosis caused by foreign body
Authors: Zhao Zhe-Wei , Wu Xing-Cheng , Deng Jian-Hua , Lian Peng-Hu , Zhang Xue-Bin 
Published: November 2019

Abstract

Rationale:
Foreign bodies related ureteral obstruction and hydronephrosis is rare and usually cause numerous problems for clinical physicians.

Patient concerns:
We report a 36-year-old female who was referred to our hospital due to a 4-year history of dull pain on the left back.

Diagnosis:
X-ray and abdominal CT revealed a foreign body around the upper part of the left ureter with ureteral obstruction and hydronephrosis.

Interventions:
Laparoscopy was performed and a 3-cm sewing needle was removed successfully.

Outcomes:
After 6 months’ follow-up, the patient's ureteral obstruction and hydronephrosis were significantly reduced, and the double-J ureteral stent was removed.

Lessons:
This case indicated that ureteral obstruction and hydronephrosis caused by foreign bodies needed to be early diagnosed and located. Invasive therapies rather than conservative treatments are preferred to remove the FBs and relieve obstruction.
Association between Helicobacter pylori infection and nonalcoholic fatty liver
Authors: Liu Rongqiang , Liu Qiuli , He Ying , Shi Wenqing , Xu Qianhui , Yuan Qing , Lin Qi , Li Biao , Ye Lei , Min Youlan , Zhu Peiwen , Shao Yi 
Published: November 2019

Abstract

Background:
Opinion regarding whether Helicobacter pylori infection can promote the occurrence and development of nonalcoholic fatty liver (NAFLD) is divided. Therefore, we aimed to assess the exact relationship between H pylori infection and NAFLD by integrating all available data.

Methods:
The articles about H pylori infection and NAFLD were collected by searching the databases of PubMed, Embase, Web of Science, Scopus, China National Knowledge Infrastructure, and WanFang. The random-effects model was used for data analysis, followed by subgroup analysis and meta-regression to explore sources of heterogeneity.

Results:
Twenty-one articles were included in the study. Pooled analysis showed that H pylori infection indeed promoted NAFLD. Subgroup analysis and regression analysis showed that case-control ratio may be one of the sources of heterogeneity.

Conclusions:

H pylori infection is indeed one of the factors that promotes the progression of NAFLD for the Asian population. This provides new approaches for clinical prevention and treatment for NAFLD.
Congenital pyriform sinus fistula presenting as a neck abscess in a newborn
Authors: Teng Yishu , Huang Shuling , Chen Guowei , Xian Zhixiong , Han Saihong , Li Lan 
Published: November 2019

Abstract

Rationale:
Congenital pyriform sinus fistula (CPSF) is a branchial abnormality originating from the third or fourth branchial pouch and is an important cause of anterior cervical abscess in children. Here we present a case of neck abscess in a newborn that was diagnosed as CPSF.

Patient concerns:
A male infant with a birth weight of 3660 g was admitted to hospital 25 minutes after birth after discovery of a cystic mass with extensive skin swelling in the left side of the neck. B-mode ultrasonography of the left neck showed an anterior cervical cystic mass of indeterminate nature.

Diagnosis:
Congenital pyriform sinus fistula.

Interventions:
The neck abscess was incised and drained under general anesthesia. Examination under suspension laryngoscopy revealed a pyriform sinus fistula. Laser cauterization was performed simultaneously. The wound was dressed and anti-inflammatory treatment was provided.

Outcomes:
The neck wound healed uneventfully. After 3 months, the fistula was confirmed to be closed by laryngoscopy under general anesthesia. No recurrence was detected during 9 months of follow-up.

Lessons:
CPSF should be strongly suspected in a patient with an unexplained neck abscess or recurrent acute suppurative thyroiditis, especially on the left side.
Left stellate ganglion block, a rescue treatment for ventricular arrhythmia refractory to radiofrequency catheter ablation
Authors: Yang Shih-Chieh , Wu Chih-Cheng , Hsieh Yun-Jui 
Published: November 2019

Abstract

Rationale:
Stellate Ganglion Block (SGB) provides a blockade of sympathetic signals from the sympathetic chain and appears to be a promising method of controlling refractory ventricular arrhythmias, but there are scanty data in the literature.

Patient concerns:
Herein, we describe a 59-year-old male patient with a history of non-ischemic cardiomyopathy and suffering from frequent VT episodes, who received ICD implantation and regular amiodarone medication control.

Diagnoses:
Monomorphic VT refractory to standard medication control and focal extensive catheter ablation.

Interventions:
Left Stellate Ganglion Block (LSGB) was performed under ultrasound-assisted injection at the C6 level using a 10 ml solution of 0.4% lidocaine and 0.5% bupivacaine.

Outcomes:
In our case, refractory VT subsided and sinus rhythm was retained immediately after LSGB. There were no VT episodes for at least 3 hours during the inter-hospital transfer, which did not involve any specific complications.

Lessons:
LSGB may provide effective VT control and play an important role in rescue and bridge therapy before catheter ablation.
Pulmonary embolism with abdominal pain as the chief complaint
Authors: Han Yu , Gong Yuxin 
Published: November 2019

Abstract

Rationale:
Pulmonary embolism (PE) is one of the serious cardiopulmonary diseases that can endanger life. Early diagnosis and timely treatment are key factors to reduce its high mortality rate. Abdominal pain is not currently included in the symptoms of PE in textbooks and guidelines.

Patient concerns:
A 49-year-old man was hospitalized for an exacerbation of right upper quadrant abdominal pain and sudden left upper quadrant pain that lasted for 2 hours.

Diagnoses:
The patient was initially misdiagnosed as cholecystitis and pneumonia, and later was diagnosed as PE by computed tomography pulmonary angiography (CTPA).

Interventions:
The patient received low molecular weight heparin for anticoagulant therapy.

Outcomes:
His abdominal pain disappeared after one week. The patient was later discharged.

Lessons:
Sometimes abdominal pain may be the only manifestation of PE. However, most clinicians do not think of the possibility of PE in patients with abdominal pain. This might have contributed greatly to the rate of misdiagnosis of PE in the past. We hope to improve the alertness of the diagnosis of PE in clinical practice. In patients with abdominal pain, the possibility of PE should be considered to avoid mis- or under-diagnosis.
Treatment of Bing–Neel syndrome with first line sequential chemoimmunotherapy
Authors: Gavriatopoulou Maria , Ntanasis-Stathopoulos Ioannis , Moulopoulos Lia-Angela , Manaios Alexandros , Fotiou Despina , Eleutherakis-Papaiakovou Evangelos , Migkou Magdalini , Bourgioti Charis , Terpos Evangelos , Kastritis Efstathios , Dimopoulos Meletios-Athanasios 
Published: November 2019

Abstract

Rationale:
Bing–Neel syndrome (BNS) is a rare manifestation of Waldenström macroglobulinemia (WM) with <200 cases reported in the literature. Herein, we describe a case of newly diagnosed BNS treated with a novel therapeutic strategy.

Patient concerns:
A 67-year-old woman diagnosed with asymptomatic WM 3 years ago presented with gradual vision deterioration the past 3 months. Ophthalmologic examination revealed bilateral reduction in visual acuity (7/10) and bilateral optic disc swelling which was more prominent in the left eye.

Diagnoses:
Brain imaging revealed bilateral swelling of optic nerves extending from the retina to the optic chiasm and swelling of the left optic tract. Patchy enhancement of optic nerves was also shown upon intravenous contrast administration. Flow cytometry of the cerebrospinal fluid (CSF) revealed the presence of κ-light chain restricted, monoclonal B-lymphocytes. CSF protein electrophoresis showed a monoclonal band in the gamma region and immunofixation was positive for immunoglobulin M and kappa light chain. Thus, the diagnosis of BNS was established.

Interventions:
The patient was initially treated with intrathecal methotrexate and systemic chemotherapy. Following 2 intrathecal methotrexate infusions, CSF flow cytometry did not detect any cells, whereas the patient reported improvement in visual acuity. Therefore, we opted to start maintenance treatment with IV rituximab and per os ibrutinib.

Outcomes:
Following 1 year posttreatment initiation, visual problems have resolved completely and the patient remains on hematologic and imaging complete response.

Lessons:
We propose a novel sequential chemoimmunotherapy approach for BNS treatment aiming both at rapid disease control and deep and durable remission with minimization of induced toxicity.
Dieulafoy disease of the bronchus involving bilateral arteries
Authors: Tang Pan , Wu Tingting , Li Chaofen , Lv Chengna , Huang Jing , Deng Zaichun , Ding Qunli 
Published: November 2019

Abstract

Rationale:
Dieulafoy disease of the bronchus is a rare vascular deformity. To the best of our knowledge, reports of these involving both lung vascular are hitherto absent.

Patient concerns:
A 67-year-old male was admitted to our department due to agnogenic hemoptysis.

Diagnoses:
Bronchoscopy was performed and some smooth, pulsatile nodular lesions were found in the middle and lower lobes, Computed tomography angiography of the bronchial artery confirmed a left bronchial artery arising from the aortic arch at T4 level, and both bronchial arteries were dilated and tortuous.

Interventions:
Bronchial artery embolization was performed successfully.

Outcomes:
The patient was discharged with no hemoptysis. In addition, patient is under follow-up until today without any further incidents.

Lessons:
This case reminds us that Dieulafoy disease of the bronchus could be a potential etiology for unexplained hemoptysis. The clinician should be aware of this disease when bronchoscopy revealed multiple some smooth, pulsatile nodular lesions, thereafter, bronchoscope biopsy should be avoided, as it could lead to fatal hemoptysis.
Solitary cystic metastatic lymph node of occult human papillomavirus-related oropharyngeal cancer mimicking second branchial cleft cyst
Authors: Liang Han-Hsuan , Chen Chia-Yuen , Chen Wei-Yu , Chen Tsung-Ming , Chan Wing P. 
Published: November 2019

Abstract

Rationale:
Human papillomavirus (HPV)-related oropharyngeal cancer is becoming more common, the primary cancer AQ4 usually occult and appearing only as cystic cervical lymph node (LN) metastasis. Distinguishing between a benign cystic lesion and cystic LN metastasis is challenging given their similar radiologic and histologic appearances.

Patient concerns:
A 54-year-old man presented with a bulging cystic mass measuring 6.4cm on the right side of neck.

Diagnoses:
Postexcision diagnosis was second branchial cleft cyst. After 2 years, the cystic mass recurred, and HPV-related tonsillar squamous cell carcinoma with cystic metastatic LNs was confirmed after wide tonsillectomy and neck dissection. The previous cystic lesion proved to be a cystic metastatic LN from the same malignancy with additional p16 immunostain.

Interventions:
The patient was treated with adjuvant concurrent chemoradiation therapy.

Outcomes:
The patient was followed up in the outpatient department with no evidence of recurrence after 1 year.

Lessons:
When an adult has a cystic mass in the upper neck, we must rigorously exclude it as a cystic metastatic LN of occult HPV-related oropharyngeal cancer. Additional p16 staining might be helpful.
Carotid intima-media thickness values are significantly higher in patients with prediabetes compared to normal glucose metabolism
Authors: Bulut Atilla , Avci Begum 
Published: November 2019

Abstract
Carotid intima-media thickness (C-IMT) increases in patients with adult type-2 diabetes mellitus (DM) and is used for early detection of macrovascular complications. We aimed to investigate the change of C-IMT in prediabetes and type-2 DM patients compared to subjects with normal glucose metabolism (NGM).
A total of 180 individuals (60 subjects with NGM, 60 patients with prediabetes and 60 patients with type-2 DM) were included in this study. Routine laboratory and micro-macrovascular involvement were investigated. Urine albumin-creatinine ratio (ACR) was measured for urinary albuminuria detection. In addition to routine laboratory examination, right-left common and internal C-IMT (CC-IMT and IC-IMT) were measured.
Systolic and diastolic blood pressure values were found to be higher in prediabetes and type-2 DM groups than NGM group. The prevalence of nephropathy and presence of CAD were higher in type-2 DM groups than prediabetes. Glucose, glycated hemoglobin (HbA1c), total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, blood urea nitrogen, creatinine, high sensitive C reactive protein (hs-CRP) levels and urinary ACR were significantly higher in patients within prediabetes and type-2 DM groups than NGM group. Glucose, HbA1c and hs-CRP levels were found to be higher in type-2 DM groups than prediabetes. Estimated glomerular filtration rate and high-density lipoprotein (HDL) cholesterol level was found to be lower in patients within prediabetes and type-2 DM groups than NGM group. Right-left-mean CC-IMT and IC-IMT values were found to be higher in prediabetes and type-2 DM groups than NGM group. Left IC-IMT, left CC-IMT, and mean IC-IMT values were found to be higher in type-2 DM patients compared to prediabetes. LDL and HDL cholesterols, HbA1c, and hs-CRP levels were independently associated with IC-IMT and CC-IMT.
C-IMT values were significantly higher in impaired glucose metabolism compared to NGM. C-IMT measurement may be used as part of routine screening of macrovascular complication in patients with prediabetes and newly diagnosed type-2 DM.
Elemene injection combined with transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma
Authors: Yao Yuan , Chen Jianjian , Jiao Dechao , Li Yahua , Zhou Xueliang , Han Xinwei 
Published: November 2019

Abstract

Background:
To evaluate the short-term efficacy, long-term efficacy, and adverse events (AEs) of elemene plus transcatheter arterial chemoembolization (TACE) in comparison with TACE alone for the treatment of hepatocellular carcinoma (HCC).

Methods:
PubMed, EMBASE, the Cochrane Library, the Chinese Scientific Journal Full-text Database, Wanfang Data, CBM, and VIP were searched by 2 reviewers using the same search strategy for clinical studies on elemene plus TACE in the treatment of HCC. These articles were screened according to pre-established inclusion and exclusion criteria, and the qualities of the included studies were assessed using the Newcastle–Ottawa scale. The primary outcomes were the objective response rate (ORR), the 1-year survival rate and AEs. Review Manager 5.3 and Stata 15.0 were used for the meta-analysis.

Results:
A total of 10 studies involving 543 patients (TACE + elemene = 277, TACE alone = 266) were included. The results showed that the ORR was significantly improved in the combined treatment group compared to the TACE alone group (odds ratio [OR] = 2.72, 95% confidence interval [CI]: 1.84–4.00, P < .05). TACE + elemene significantly increased the 1-year survival rate (OR = 2.79, 95% CI: 1.58–4.95, P < .05). We also found no significant difference in gastrointestinal reactions (OR = 0.97, 95% CI: 0.57–1.64, P = .90), fever (OR = 0.80, 95% CI: 0.37–1.71, P = .56), or bone marrow suppression (OR = 0.73, 95% CI: 0.44–1.22, P = .23) between the 2 groups.

Conclusion:
Based on current findings, TACE + elemene injection may improve the ORR and the 1-year survival rate for HCC patients compared to TACE alone. Arterial perfusion may be superior to intravenous guttae.