bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical outcomes of laparoscopic versus open right hepatectomy for liver tumors
Authors: Hong Qiang , Wang Jianjun , Wang Yong , Fu Baojuan , Fang Yuejun , Tong Qin , Liu Tao , Wu Zhangqiang , Zhou Junchao 
Published: January 2020

Abstract

Background:
Laparoscopic right hepatectomy (LRH) is one of the most challenging procedures. Right liver resections have been always performed in open procedure and open right hepatectomy (ORH) was initially considered as routine way. Moreover, it is unclear how beneficial the minimally invasive technique is to patients; thus, we conducted a meta-analysis to acquire a more reliable conclusion about the feasibility and safety of LRH compared with ORH.

Methods:
We comprehensively searched the electronic databases of PubMed, Embase, and the Cochrane Library using the key words. Meta-analysis was performed using the Review Manager, with results expressed as odds ratio and weighted mean difference with 95% confidence intervals. The fixed-effect model was selected initially if high heterogeneity was not present between the studies; otherwise, the randomized-effect model was used. Subgroup analysis was performed based on different surgical methods of pure laparoscopic operation or hand-assisted operation.

Results:
Seven studies with 467 patients were included. In the overall analysis, less intraoperative blood loss (MD = –155.17; 95% CI, –238.89, –71.45; P = .0003) and a shorter length of stay (MD = –4.45; 95% CI, –5.84, –3.07; P < .00001) were observed in the LRH group compared to the ORH group. There were fewer overall complications (OR = 0.30; 95% CI, 0.10, 0.90; P = 0.03) and severe complications (OR = 0.24; 95% CI, 0.10, 0.58; P = .002;) in the LRH group than in the ORH group. The disadvantage of LRH was the longer operative time (MD = 49.39; 95% CI, 5.33, 93.45; P = .03). No significant difference was observed between the 2 groups in portal occlusion, rate of R0 resection, transfusion rate, mild complications, and postoperative mortality. In the subgroup analysis, intraoperative blood loss was significantly lower in the pure LRH group and hand-assist LRH group compared with ORH group. Length of stay was shorter by use of pure LRH and hand-assisted LRH manners than ORH. The incidence rate of complications was lower in the pure LRH group than in the ORH group. In contrast, there was no significant difference between hand-assisted LRH group and ORH group.

Conclusion:
Compared to ORH, LRH has short-term surgical advantages and leads to a shorter recovery time in selected patients. We speculate that the operative time of LRH is closer with ORH. Overall, LRH can be considered a feasible choice in routine clinical practice with experienced surgeons, although more evidence is needed to make a definitive conclusion.
Antidepressant-induced reduction in betel-quid use in patients with depression
Authors: Hung Chung-Chieh , Lee Chien-Hung , Chung Chia-Min , Nithiyanantham Srinivasan , Lane Hsien-Yuan , Ko Ying-Chin 
Published: January 2020

AbstractBetel-quid is commonly used around the world and is listed as a Group I carcinogen. Prior research has suggested a possible association between antidepressants and betel-quid use. We aimed to clarify the effects of antidepressant therapy in betel-quid chewers in the population of patients with depression.We enrolled 204 patients with depressive disorders, collected their demographic information, and administered the Substance Use Severity Rating Scale for alcohol, cigarettes, and betel-quid and the Hamilton Depression Rating Scale. We compared betel-quid and non-betel-quid chewers and examined the effects of antidepressant therapy on betel-quid abstinence after previous exposure to betel-quid.Patients with depression were reported a higher prevalence of 26% betel-quid chewing habits and patients who chewed betel-quid showed more severe depressive symptoms. After antidepressant therapy, the addictiveness of betel-quid was significantly reduced by 4 times.This was a pioneering study showing that antidepressants could be a candidate for betel-quid cessation therapy. Future clinical trials are needed to verify their efficacy in reducing consumption for betel-quid addiction treatment.
Comparison of median effective concentration of ropivacaine in multiparas or primiparas during epidural labor analgesia
Authors: Peng Qinghua , Yang Zeyong , Zhang Wangping , Wu Xiaomin 
Published: January 2020

Abstract
The documents on the median effective concentration of local analgesic were many in primiparas during labor analgesia. However, the studies were fewer in multiparas. To explore the analgesic requirements in multiparas during epidural labor analgesia, we investigated the median effective concentration of ropivacaine with 2 μg/mL fentanyl for epidural labor analgesia in multiparas.
Sixty-two women were recruited and assigned to the primipara group and multipara group in this prospective study. All the parturients received ropivacaine combined with 2 μg/mL fentanyl for epidural labor analgesia. The concentration of ropivacaine was determined by the up and down method and an initial concentration was set as 0.1% with a 0.01% interval. Effective analgesia was defined as the visual analog scale (VAS) ≤3 within 30 minutes after epidural administration when cervical dilatation is about 2 cm. The median effective concentration of ropivacaine was calculated by the up and down sequential method. The pain intensity was assessed using VAS. Hemodynamic parameters, the labor stages, and neonatal Apgar scores were recorded. Umbilical artery blood was drawn to analyze. The side effects, if any, were also recorded.
The median effective concentration of ropivacaine was 0.057% (95% confidence interval [CI], 0.051–0.064%) in primiparas during epidural labor analgesia, and 0.068% (95% CI, 0.063–0.072%) in multiparas during epidural labor analgesia, there was significant difference between the groups (P = .02).
This study indicated that the median effective concentration of ropivacaine with fentanyl for epidural labor analgesia was 0.068% (95% CI, 0.063–0.072%) and increased in multiparas compared with the primiparas (www.chictr.org.cn, registration number: ChiCTR-1800016486)
Antiviral therapy and hepatocellular carcinoma risk in hepatitis B patients with cirrhosis
Authors: Gao Xuesong , Yang Hwai-I , Trinh Huy , Jeong Donghak , Li Jiayi , Zhang Jian , Le An , Hoang Joseph , Nguyen Pauline , Henry Linda , Nguyen Mindie H. 
Published: January 2020

Objectives:
Our goal was to evaluate the effect of antiviral therapy on hepatocellular carcinoma incidence for cirrhotic patients with lower hepatitis B virus DNA levels.

Methods:
Consecutive cirrhosis patients from a US cohort (n = 381) and 408 patients from a Taiwan cohort were enrolled. Patients were classified into a low (<20 IU/ml) and high hepatitis B virus DNA group (≥20 IU/ml), and each was further stratified into treated and untreated subgroups.

Results:
Except for hepatitis B e antigen, baseline characteristics were similar for both hepatitis B virus DNA groups. Antiviral therapy significantly reduced hepatocellular carcinoma incidence in cirrhotic patients with hepatitis B virus DNA ≥20 IU/ml at 5-years (12.2% vs. 22.8%) and 10-years (23.3% vs. 37.2%) (P = 0.0018). For cirrhotic patients with hepatitis B virus DNA <20 IU/ml, there was no statistically significant difference in cumulative hepatocellular carcinoma incidence between the treated and untreated groups. After adjusting for age, sex, and hepatitis B e antigen status, antiviral therapy was an independent predictor (hazard ratio 0.43, P < 0.0001) for reduced hepatocellular carcinoma risk in patients with hepatitis B virus DNA ≥20 IU/ml.

Conclusion:
Antiviral therapy was associated with a 57% reduction in hepatocellular carcinoma incidence in chronic hepatitis B patients with cirrhosis and hepatitis B virus DNA as low as 20 IU/ml (but no lower). However, hepatocellular carcinoma incidence remained substantial, regardless of hepatitis B virus DNA levels and treatment status, highlighting the need for ongoing hepatocellular carcinoma surveillance for all cirrhotic hepatitis B virus patients.
Biological response under treatment and prognostic value of protein induced by vitamin K absence or antagonist-II in a French cohort of patients with hepatocellular carcinoma
Authors: Payancé Audrey , Dioguardi Burgio Marco , Peoc’h Katell , Achahboun Mohamed , Albuquerque Miguel , Devictor Julie , Chor Hélène , Manceau Hana , Soubrane Olivier , Durand François , Castera Laurent , Bouattour Mohamed , Paradis Valérie 
Published: January 2020

Objectives
We have confirmed the diagnostic value of protein induced by vitamin K absence or antagonist-II (PIVKA-II) in a French cohort of patients with hepatocellular carcinoma (HCC). Herein, we aim to study the biological response under treatment and the prognostic value of PIVKA-II serum level in patients treated for HCC.

Methods
Patients with primary HCC developed chronic liver disease with serum PIVKA-II, and alpha-fetoprotein (AFP) levels available at baseline and after first HCC treatment [within 3 months (M1–M3) and/or within 6–9 months (M6–M9)] were included.

Results
A total of 94 patients were included. Median follow-up was 23 months (range 11–31 months). PIVKA-II levels significantly decreased from baseline to M1–M3 (P = 0.002) and to M6–M9 (P = 0.035). By multivariate analysis, biological response (M1–M3/baseline PIVKA-II ratio) independently and significantly predicted overall survival (OS). A ratio below 0.73 was able to identify patients with the better prognosis in the total population [OS: 27 months (range 17–31) vs. 17 (range 9–25); P = 0.008] and in patients who had transarterial chemoembolization or selective internal radiation therapy as first treatment approach [OS: 26 months (range 14–31) vs. 16 (range 9–25); P = 0.002 and 2-year OS of 73% vs. 30%; P = 0.009]. PIVKA-II serum levels at baseline and PIVKA-II biological response were significantly associated with radiological response.

Conclusion
PIVKA-II serum level seems to be a good prognostic and promising biomarker for early monitoring treatment outcomes for patients with HCC.
Low-free triiodothyronine is associated with poor prognosis of portal hypertension in cirrhosis
Authors: Huang Xiaoquan , Jiang Siyu , Fan Xiaowen , Jiang Yingyi , Wu Ling , Li Feng , Wang Jian , Chen Shiyao 
Published: January 2020

Background and aims
The role of thyroid function in the portal hypertension development and prognosis remains unclear. This study aimed to investigate the correlation between serum-free triiodothyronine (fT3) levels and the outcomes of cirrhotic portal hypertension.

Methods
A total of 385 cirrhotic patients with confirmed portal hypertension underwent computed tomography angiography and thyroid function test at a tertiary care referral center from January 2009 to December 2017. The patients were assigned to the low-fT3 (n = 98) and normal-fT3 groups (n = 287).

Results
Child-Pugh (8.88 ± 0.22 vs. 7.09 ± 0.12, P < 0.001) and model for end-stage liver disease (MELD) scores (14.75 ± 0.57 vs. 10.59 ± 0.23, P < 0.001) significantly increased in the low-fT3 group. The hemoglobin level correlated with fT3 (R = 0.299, P < 0.0001) and fT4 (R = 0.310, P < 0.0001), while only fT3 significantly correlated with the albumin level (R = 0.537, P < 0.001). The Kaplan–Meier analysis indicated that the two-year survival rate was 74.51% in the low-fT3 group vs. 94.25% in the normal-fT3 group (P < 0.0001). The Cox regression analysis demonstrated that the serum level of fT3 [hazard ratio: 0.478; 95% confidence interval (CI) 0.391–0.758; P = 0.002] and prothrombin time (hazard ratio: 2.247; 95% CI: 1.316–3.838; P = 0.003) were independent prognostic factors in cirrhotic patients.

Conclusion
The low fT3 level was associated with poor prognosis and the progression of cirrhotic portal hypertension.
Cost effectiveness of treatment models of care for hepatitis C: the South Australian state-wide experience
Authors: Ramachandran Jeyamani , Kaambwa Billingsley , Muller Kate , Haridy James , Tse Edmund , Tilley Emma , Altus Rosalie , Waddell Victoria , Gordon David , Shaw David , Huynh Dep , Stewart Jeffrey , Nelson Renjy , Warner Morgyn , Boyd Mark A. , Chinnaratha Mohamed A. , Harding Damian , Ralton Lucy , Colman Anton , Woodman Richard , Wigg Alan J. 
Published: January 2020

Aim
The objective was to study the long-term (lifetime) cost effectiveness of four different hepatitis C virus (HCV) treatment models of care (MOC) with directly acting antiviral drugs.

Methods
A cohort Markov model-based probabilistic cost-effectiveness analysis (CEA) was undertaken extrapolating to up to 30 years from cost and outcome data collected from a primary study involving a real-life Australian cohort. In this study, noncirrhotic patients treated for HCV from 1 March 2016 to 28 February 2017 at four major public hospitals and liaising sites in South Australia were studied retrospectively. The MOC were classified depending on the person providing patient workup, treatment and monitoring into MOC1 (specialist), MOC2 (mixed specialist and hepatitis nurse), MOC3 (hepatitis nurse) and MOC4 (general practitioner, GP). Incremental costs were estimated from the Medicare perspective. Incremental outcomes were estimated based on the quality-adjusted life years (QALY) gained by achieving a sustained virological response. A cost-effectiveness threshold of Australian dollar 50 000 per QALY gained, the implicit criterion used for assessing the cost-effectiveness of new pharmaceuticals and medical services in Australia was assumed. Net monetary benefit (NMB) estimates based on this threshold were calculated.

Results
A total of 1373 patients, 64% males, mean age 50 (SD ±11) years, were studied. In the CEA, MOC4 and MOC2 clearly dominated MOC1 over 30 years with lower costs and higher QALYs. Similarly, NMB was the highest in MOC4, followed by MOC2.

Conclusion
Decentralized care using GP and mixed consultant nurse models were cost-effective ways of promoting HCV treatment uptake in the setting of unrestricted access to new antivirals.
A ‘real-world’ analysis of risk factors for post liver transplant delirium and the effect on length of stay
Authors: Tavabie Oliver D. , Colwill Michael , Adamson Robbie , McPhail Mark J.W. , Bernal William , Jassem Wayel , Prachialias Andreas , Heneghan Michael , Aluvihare Varuna R. , Agarwal Kosh 
Published: January 2020

Background
The development of delirium has been previously demonstrated to be associated with an increased risk of mortality and length of stay post liver transplant (LTx) with multiple risk factors being identified in previous studies. In this study, we have aimed to identify the most important variables associated with the onset of post-LTx delirium and understand the effect on length of stay (LOS).

Methods
All liver transplants for chronic liver disease between 1 August 2012 and 1 August 2017 were included (n = 793). Data were collected for analysis retrospectively from electronic patient records.

Results
Delirium is associated with an overall increased hospital and ICU LOS but not one-year mortality. The risk of developing post-LTx delirium was the greatest among patients: with post-LTx sepsis, who required renal sparing immunosuppression, who received donation after cardiac death (DCD) grafts and who were older. Patients with autoimmune hepatitis, primary biliary cholangitis or primary sclerosing cholangitis seemed to be at lower risk of post-LTx delirium. However, global patient LOS was only prolonged in patients with sepsis and renal failure.

Conclusion
Many of the risk factors previously described to be associated with the development of post-LTx delirium were not demonstrated to be significant in this study. Sepsis, renal failure, older age and DCD use are associated with delirium post-LTx. It is unclear if this syndrome is an independent risk factor for increased LOS or if it is a symptom of well established syndromes associated with increased LOS. The role for prophylactic strategies to reduce the incidence of post-LTx delirium is therefore unclear.
The safety and efficacy of tenofovir disoproxil fumarate used throughout pregnancy for mothers with chronic hepatitis B
Authors: Gao Xuesong , Duan Xuefei , Cai Haodong , Hu Yuhong , Liu Min , Kang Kai , Zhou Mingfang , Fu Dong , Yi Wei 
Published: January 2020

Background
Antiviral therapy throughout pregnancy in women with chronic hepatitis B (CHB) during pregnancy has been suggested; however, the data of tenofovir disoproxil fumarate (TDF) are limited. The aim of this study was to evaluate the safety and efficiency in women with CHB.

Methods
It was a single-center, retrospectively study. Eighty-one women received TDF 300 mg/day before pregnancy. Sixty-three women did not receive antiviral treatment. All infants in both groups received immunoprophylaxis. Mothers and infants were followed at least postpartum 7 months. The primary endpoint was the safety of mothers and infants. The secondary endpoints were mother-to-child transmission (MTCT) rate and hepatitis B virus (HBV) DNA suppression.

Results
TDF was well tolerated in the mothers. The rates of neonatal congenital abnormalities were similar between the two groups (3.7% or 3/81 versus 3.3% or 2/63, P = 1.000). There were also no significant differences in infant length and weight, Apgar score (1 minute), rate of low birth weight, gestational age, or rate of cesarean section between the two groups. TDF significantly reduced the viral load (3.4 ± 0.5 log IU/mL versus 6.3 ± 1.5 log IU/mL, P < 0.001) and the ALT levels (19.9 ± 10.2 versus 46.8 ± 44.8 U/L, P < 0.001) before delivery. At 7-month postpartum, the MTCT rate was 0% in the TDF-treated group when compared with 6.3% (4/63) in the untreated group (P = 0.035).

Conclusion
TDF used throughout pregnancy can safely reduce the rate of MTCT.
Application of Computer-Aided Navigation Technology in the Extraction of Foreign Body From the Face
Authors: Lan Lin , He Yang , An Jingang , Zhang Yi 
Published: January 2020

Abstract
In the oral and maxillofacial foreign body (FB) extraction surgery, computer-aided navigation technical surgery is minimally invasive and safe, and can improve the accuracy, especially for areas with relatively complex and dangerous anatomical structures. A total of 11 patients, including 8 males and 3 females, who underwent the extraction surgery of FB from oral and maxillofacial regions using computer-aided navigation technical surgery were reviewed. According to the positional relationship between the maxillofacial region and the bone tissue, the FBs were divided into 3 categories: FB in the bone; FB aside the bone; and soft-tissue FB. During the operation, the BrainLab Navigation system was used to observe and guide the operation in real-time to evaluate the effectiveness and accuracy of computer-aided navigation technical surgery in the extraction of FBs from the maxillofacial regions. The FBs were successfully located and removed in 11 patients. No adjacent nerves, blood vessels, and other important anatomical structures were injured during the operation. The postoperative function and shape were not significantly affected.
Risk Factors of Acute Gastrointestinal Failure in Critically Ill Patients With Traumatic Brain Injury
Authors: Fu Weijun , Shi Nengxian , Wan Yahui , Mei Fen , Qiu Binghui , Bao Yun , Zhang Yu , Hao Jingwen , He Jing , Peng Xiaojie 
Published: January 2020

Objective:
To assess the risk factors associated with acute gastrointestinal failure (AGF) in critically ill patients with traumatic brain injury (TBI).

Methods:
Prospective, observational study was conducted in NanFang Hospital, Southern Medical University. All patients admitted to the Department of Critical Care Medicine and Department of Neurosurgery from June 1, 2017 to December 1, 2018 with TBI were enrolled.

Results:
Overall, 199 patients were enrolled. About 62 episodes (31%) of AGF were diagnosed. In the multivariate analysis, women, severe Glasgow Coma Scale (GCS) classification, frontal lobe injury, abnormal serum sodium, pulmonary infection, and intracranial infection are significantly associated with developing AGF, independent of other prognostic factors.

Conclusion:
The AGF occurs frequently in intensive care unit patients who are suffering from TBI. In critically ill patients with TBI, women, severe GCS classification, frontal lobe injury, abnormal serum sodium, pulmonary infection, and intracranial infection are independent risk factors for AGF.
A Rare Instance of Chordoid Glioma With Large Calcification Mimicking Craniopharyngioma
Authors: Cui Zhenwen , Mu Cuiping , Yang Fengyu , Li Huanting , Liu Wei , Feng Yugong 
Published: January 2020

Abstract
Chordoid glioma (CG) is a world health organization classified grade II tumor whose typical localization is in the anterior part of the third ventricle. It's clinical, neuroimaging, and pathologic features may vary and furthermore mimic other types of benign lesions usually associated with a better outcome, thus representing a potential radiological and diagnostic pitfall. In this article, the authors present a novel case of a 51-year-old male who underwent gross total removal of the tumor of the third ventricle with high calcification. The imaging studies and the intraoperative examination led at first to a hypothesis of craniopharyngioma. In this case, the patient underwent successful operative management and has remained well throughout follow-up.
Endovascular Treatment of Carotid Pseudoaneurysm Bleeding Due to Parapharyngeal Abscess
Authors: Çiçek Mehmet Turan , Yildirim Ismail Okan , Gündüz Emrah 
Published: January 2020

Abstract
Carotid artery pseudoaneurysm are a rare complication of deep neck infections, especially in the antibiotic era. Although it is rare, it may result in life-threatening conditions. Here, the authors present a case of pseudoaneurysm of the carotid artery caused by parapharyngeal abscess and causing massive oropharyngeal bleeding and treat with endovascular approach in a 40-year-old woman presenting with neck swelling and fever.
Suberoylanilide Hydroxamic Acid Alleviates Acute Lung Injury Induced by Severe Hemorrhagic Shock and Resuscitation in Rats
Authors: Li Wei , Gao Xiaohua , Liu Weifeng , Liang Jinwei , Zhou Yingying , Chen Weican , He Hefan 
Published: January 2020

ABSTRACT

Background:
This study aimed to assess the severity of acute lung injury after mild or severe hemorrhagic shock and resuscitation, and to examine the therapeutic effects of suberoylanilide hydroxamic acid (SAHA) on lung injury.

Methods:
Mild and severe hemorrhagic shock were induced by total blood volume loss of 20% or 40%, respectively, which was maintained for 60 min. Then, resuscitation was performed by autologous blood and SAHA or a vehicle solution accordingly. Mean arterial pressure, heart rate, and arterial blood gas were measured during the experiment. Histological assays, wet/dry weight ratio, inflammatory cytokines, and the extent of histone acetylation were evaluated at 3 h post-resuscitation.

Results:
There were no significant differences of the most indicators measured between the mild hemorrhagic shock and Sham groups. Although in severe hemorrhagic shock group, mean arterial pressure was markedly reduced, lactic acid was significantly increased after hemorrhage. Moreover, the lung injury score was increased, the wet/dry weight ratio was elevated, inflammatory factor expression levels were upregulated, the expression of phosphorylated NF-κB/p65 was enhanced, and the extent of histone acetylation was decreased at 3 h post-resuscitation. Remarkably, adjuvant treatment with SAHA decreased the lactic acid, the pathological injury score, the wet/dry weight ratio, the content of inflammatory factor, as well as the level of activated NF-κB/p65, but promoted the expression of acetylated H4.

Conclusions:
Total blood volume loss of 40% results in acute lung injury, whereas loss of 20% does not. Treatment with SAHA alleviates lung injury induced by severe hemorrhagic shock and resuscitation and the underlying mechanism involves a reversal of decreased histone acetylation and inhibition of the NF-κB pathway.