bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surfactant protein A expression and distribution in human lung samples from smokers with or without chronic obstructive pulmonary disease in China
Authors: Liu Zhizhen , Chen Siyang , Xu Yongjian , Liu Xiansheng , Xiong Pian , Fu Yu 
Published: February 2020

Abstract
Cigarette smoking is considered the main risk factor for chronic obstructive pulmonary disease (COPD), although the mechanism remains unknown. surfactant protein A (SP-A) is thought to protect the lung from smoking-induced damage, but related studies performed in China are scarce. The aim of the study is to assess alterations of SP-A expression and distribution in lung samples from Chinese smokers with or without COPD.
This cross-sectional study assessed 45 men in Wuhan Tongji Hospital after lobectomy for lung cancer in June 2010 to September 2010. Peripheral lung specimens were collected from control nonsmokers without airflow obstruction (nonsmoking group, n = 15), smokers without airflow obstruction (smoking group, n = 15), and patients with COPD (COPD group, n = 15). SP-A expression levels in lung tissue samples and its distribution in lung cells, type II pneumocytes (PNII), and alveolar macrophages (MACR) were determined by immunoblotting and immunohistochemistry.
SP-A levels were significantly decreased in the COPD group (1.00 ± 0.25) compared with the smoking (2.31 ± 0.64) and nonsmoking (8.03 ± 2.80) groups; the smoking group also showed significantly reduced levels compared with the nonsmoking group (P < .05). PNII expressing SP-A were less abundant in the COPD group (39.3% ± 7.1%) compared with the smoking group (76.2% ± 29.8%), whereas SP-A+ MACR were more abundant (92.4% ± 7.1% vs 68.5% ± 20.2%) (all P < .05). Among the 30 smokers, forced expiratory volume in one second (% predicted) was positively correlated with SP-A levels (r = 0.739) and the rate of SP-A+ PNII (r = 0.811), and negatively correlated with the rate of SP-A+ MACR (r = −0.758) (all P < .05).
Changes in SP-A expression and distribution in lung tissues may be involved in COPD pathogenesis in smokers.
Effects of early virtual reality-based rehabilitation in patients with total knee arthroplasty
Authors: Gianola Silvia , Stucovitz Elena , Castellini Greta , Mascali Mariangela , Vanni Francesco , Tramacere Irene , Banfi Giuseppe , Tornese Davide 
Published: February 2020

Abstract

Background:
Virtual reality (VR)-based rehabilitation is a promising approach for improving recovery in many conditions to optimize functional results, enhancing the clinical and social benefits of surgery.

Objective:
To assess the efficacy of an early rehabilitation performed by the VR-based rehabilitation versus the traditional rehabilitation provided by physical therapists after primary total knee arthroplasty (TKA).

Methods:
In this randomized controlled clinical trial, 85 subjects met the inclusion criteria and were randomized 3 to 4 days after TKA to an inpatient VR-based rehabilitation and a traditional rehabilitation. Participants in both groups received 60 minutes/day sessions until discharge (around 10 days after surgery). The primary outcome was the pain intensity. The secondary outcomes were: the disability knee, the health related quality of life, the global perceived effect, the functional independent measure, the drugs assumption, the isometric strength of quadriceps and hamstrings, the flexion range of motion, and the ability to perform proprioception exercises. Outcomes were assessed at baseline (3–4 days after TKA) and at discharge.

Results:
VR-based or traditional rehabilitation, with 13% of dropout rate, shown no statistically significant pain reduction between groups (P = .2660) as well as in all other outcomes, whereas a statistically significant improvement was present in the global proprioception (P = .0020), in favor of the VR-based rehabilitation group.

Conclusions:
VR-based rehabilitation is not superior to traditional rehabilitation in terms of pain relief, drugs assumptions and other functional outcomes but seems to improve the global proprioception for patients received TKA.

Level of evidence
: Therapy, level 1b. CONSORT-compliant.

Trial registration
: http://www.clinicaltrials.gov, ClinicalTrials.gov, NCT02413996.
Efficacy and safety of oral traditional Chinese patent medicine in treatment of liver stagnation and spleen deficiency of depression
Authors: Yu Ying , Zhang Gong , Han Tao , Huang Hailiang 
Published: February 2020

Abstract

Background:
Depression is a kind of chronic and recurrent mental disorder, the main clinical characteristics of the patients are marked and persistent depression. At the same time, it is often accompanied by chronic physical disease, cognitive impairment, and functional damage, which is one of the common diseases that seriously threaten human health. At present, 3 kinds of oral Chinese patent medicine have clinical comparability in the treatment of depression of liver stagnation and spleen deficiency, but there is no evidence for clinical efficacy and safety. Therefore, this study aims to integrate the clinical related syndromes of direct and indirect comparison by using systematic evaluation and network meta-analysis (NMA). According to the data, the different Chinese patent medicines with the same evidence body for the treatment of the disease are collected, analyzed, and sequenced in a quantitative and comprehensive way, and then the advantages and disadvantages of the efficacy and safety between different Chinese patent medicines are screened out to get the best choice scheme, thus providing reference value and evidence-based theoretical evidence for the clinical optimization of drug selection.

Methods:
Comprehensive retrieval of China National Knowledge Infrastructure, Chinese scientific journal database (VIP), China biological feature database (CBM) and WANFANG Data Chinese electronic database and the Cochrane Library, PubMed, Web of Science, and EMBASE foreign database. Search and publish the clinical randomized controlled trials of these 3 Chinese patent medicines combined with fluoxetine compared with fluoxetine. The retrieval time is from the establishment of the database to October 31, 2019. The 2 first authors will screen the literatures that meet the inclusion criteria, extract the data independently according to the predesigned rules, and evaluate the literature quality and bias risk of the included research according to the Cochrane 5.1 manual standard. R and Aggregate Data Drug Information System software were used for data consolidation and NMA to evaluate the ranking probability of all interventions.

Results:
This result will show that the best oral Chinese patent medicine to assist the treatment of liver stagnation and spleen deficiency depression provides reliable evidence.

Conclusion:
This study will provide systematic evidence-based medicine evidence for TCM assisted treatment of depression of liver stagnation and spleen deficiency type, and help clinicians, patients with depression and decision-makers to make more effective, safer, and economic optimal treatment plan in the decision-making process.

PROSPERO registration number:
CRD42019115695.
Optical coherence tomography and fractional flow reserve guided treatment of woven coronary artery anomaly presenting as acute myocardial infarction
Authors: Wang Fangfang , Han Jiangli , Guo Lijun 
Published: February 2020

Abstract

Rationale:
Woven coronary artery is a very rare congenital anomaly which may lead to acute coronary syndrome in previous literatures. At present, there is no consensus on the treatment of this coronary artery abnormality.

Patient concerns:
A 48-year-old male was admitted to the other hospital because of persistent chest pain. The electrocardiogram showed an ST-segment elevation in the v1-v5 lead and the patient was diagnosed with acute anterior myocardial infarction. Coronary angiography revealed 2 lumens in the proximal segment of the left anterior descending artery. Then the patient was transferred to our hospital for further diagnosis and treatment.

Diagnoses:
The patient was diagnosed with acute myocardial infarction and woven coronary. Transthoracic echocardiography showed left ventricular anterior wall segmental motor abnormalities.

Interventions:
Optical coherence tomography (OCT) and fractional flow reserve (FFR) guided percutaneous coronary intervention was performed successfully.

Outcomes:
During the follow-up period of 4 years, the patient remained asymptomatic and no adverse events.

Lessons:
Although the significance of blood flow limitation in one of the lumens detected by FFR is unclear, this strategy of OCT and FFR-guided treatment in woven coronary artery combined with acute coronary events still shows its feasibility.
Serum non-high-density lipoprotein cholesterol is associated with the risk of sudden sensorineural hearing loss
Authors: Wang Saibin , Ye Qian , Pan Yibin 
Published: February 2020

AbstractThe aim of this study was to investigate the association between the non-high-density lipoprotein cholesterol (non-HDL-C) with sudden sensorineural hearing loss (SSHL) and the predictive value of non-HDL-C for SSHL.A total of 324 patients with SSHL and 972 well-matched controls were enrolled from 2009 to 2012 in Korea. The association of serum non-HDL-C with the risk of SSHL was evaluated using multivariate regression analysis, smooth curve fitting after adjusting for potential confounders. The discrimination ability of non-HDL-C in predicting SSHL was determined by calculating the area under the curve (AUC), and its clinical usefulness was evaluated by decision curve analysis. This was a secondary analysis of a case–control study.There was a non-linear relationship between the serum non-HDL-C and the incidence of SSHL. After adjustment for potential confounders, the incidence of SSHL rose significantly with ascending quartiles of serum non-HDL-C (using Q1 as the reference group, the OR [95% CI] of Q2, Q3, and Q4 were 4.34 [2.43–7.74], 7.08 [3.99–12.56], and 20.88 [11.86–36.75], respectively [Pfor trend <.0001]). The discrimination ability of serum non-HDL-C in predicting SSHL was 0.747 (95% CI, 0.717–0.776), and the AUC was 0.733 (95% CI, 0.705–0.777) in the internal validation.Elevated serum non-HDL-C was strongly associated with increased risk of SSHL, and it may play a role as a useful biomarker in predicting the risk of SSHL.
A case report of right coronary artery agenesis diagnosed by computed tomography coronary angiography
Authors: Forte Ernesto , Punzo Bruna , Agrusta Marco , Salvatore Marco , Spidalieri Gianluca , Cavaliere Carlo 
Published: February 2020

Abstract

Introduction:
Single coronary artery is a rare condition characterized by the origin of a coronary that supplies the entire heart from a single coronary ostium.

Patient concerns:
A 45-year-old woman with an altered exercise testing was addressed to a computed tomography coronary angiography (CTCA) to rule out coronary artery disease (CAD).

Diagnosis:
CTCA examination showed the absence of the right coronary artery (RCA). The left anterior descending artery and the left circumflex artery (LCX) presented regular origin and course and LCX provided the posterior interventricular artery and the posterolateral artery.

Interventions:
As CTCA highlighted the absence of potentially life-threatening features related to coronary anomaly, no surgical treatment was advised.

Outcomes:
The patient was dismissed, kept under pharmacological control and monitored over time.

Conclusion:
CTCA is the first-choice imaging modality in patients with ECG abnormalities properly allowing the differential diagnosis between CAD and congenital heart disease.
Ulinastatin reduces postoperative bleeding and red blood cell transfusion in patients undergoing cardiac surgery
Authors: Yao Yun-Tai , Fang Neng-Xin , Liu Ding-Hua , Li Li-Huan 
Published: February 2020

Abstract

Background:
Ulinastatin is a type of glycoprotein and a nonspecific wide-spectrum protease inhibitor like antifibrinolytic agent aprotinin. Whether Ulinastatin has similar beneficial effects on blood conservation in cardiac surgical patients as aprotinin remains undetermined. Therefore, a systematic review and meta-analysis were performed to evaluate the effects of Ulinastatin on perioperative bleeding and transfusion in patients who underwent cardiac surgery.

Methods:
Electronic databases were searched to identify all clinical trials comparing Ulinastatin with placebo/blank on postoperative bleeding and transfusion in patients undergoing cardiac surgery. Primary outcomes included perioperative blood loss, blood transfusion, postoperative re-exploration for bleeding. Secondary outcomes include perioperative hemoglobin level, platelet counts and functions, coagulation tests, inflammatory cytokines level, and so on. For continuous variables, treatment effects were calculated as weighted mean difference (WMD) and 95% confidential interval (CI). For dichotomous data, treatment effects were calculated as odds ratio and 95% CI. Statistical significance was defined as P < .05.

Results:
Our search yielded 21 studies including 1310 patients, and 617 patients were allocated into Ulinastatin group and 693 into Control (placebo/blank) group. There was no significant difference in intraoperative bleeding volume, postoperative re-exploration for bleeding incidence, intraoperative red blood cell transfusion units, postoperative fresh frozen plasma transfusion volumes and platelet concentrates transfusion units between the 2 groups (all P > .05). Ulinastatin reduces postoperative bleeding (WMD = −0.73, 95% CI: −1.17 to −0.28, P = .001) and red blood cell (RBC) transfusion (WMD = −0.70, 95% CI: −1.26 to −0.14, P = .01), inhibits hyperfibrinolysis as manifested by lower level of postoperative D-dimer (WMD = −0.87, 95% CI: −1.34 to −0.39, P = .0003).

Conclusion:
This meta-analysis has found some evidence showing that Ulinastatin reduces postoperative bleeding and RBC transfusion in patients undergoing cardiac surgery. However, these findings should be interpreted rigorously. Further well-conducted trials are required to assess the blood-saving effects and mechanisms of Ulinastatin.
The 360° circumferential opening of Schlemm's canal in normal individuals detected by enhanced depth imaging optical coherence tomography
Authors: Jing Sili , Chen Zhiqi , Chen Wei , Zhang Hong , Wang Junming 
Published: February 2020

Abstract
We aimed to observe the opening status and morphological parameters of Schlemm's canal (SC) in normal eyes using enhanced depth imaging optical coherence tomography (EDI-OCT).
Consecutive EDI-OCT scans were used to examine the right eye of 20 normal individuals. EDI-OCT was performed clockwise for 8 regions (at the 12:00, 1:30, 3:00, 4:30, 6:00, 7:30, 9:00 and 10:30 o’clock positions). Image processing and analysis in java software was used to measure the area, perimeter, and diameter of SC. Twenty-one serial scans of each region were evaluated and a total of 168 images were included in the analyses of each eye.
The SC was detected in 100.0% of the sections. The distribution of individual measurements of SC was highly variable. The mean values of SC size significantly differed among the different clock-face positions. The mean values of the area, perimeter, and diameter of SC in the 9:00 o’clock position were the lowest, and those at the 7:30 o’clock position were the highest (P < .05). There was no obvious association between intraocular pressure and SC size at any clock position.
Although SC tends to open circumferentially in normal individuals, the distribution of individual measurements is highly variable. Morphological manifestation of SC measured by EDI-OCT is a useful way to evaluate the circumferential opening status of SC.
Two surgical strategies for treating multilevel cervical spondylotic myelopathy combined with kyphotic deformity
Authors: Yeh Kuang-Ting , Chen Ing-Ho , Lee Ru-Ping , Yu Tzai-Chiu , Peng Cheng-Huan , Liu Kuan-Lin , Wang Jen-Hung , Wu Wen-Tien 
Published: February 2020

Abstract
This study compared the surgical outcomes of two surgical methods for treating multilevel cervical spondylotic myelopathy (MCSM) combined with cervical kyphotic deformity (CKD): (1) the ELTA method consisted of expansive open-door laminoplasty (EOLP) followed by three-segment anterior cervical discectomy fusion (ACDF), and (2) the LAPI method consisted of long-segment ACDF followed by long-level posterior instrumented fusion (PIF). Surgical treatment of CKD combined with MCSM remains challenging. Surgical considerations should include adequate spinal cord decompression and restoration of satisfactory cervical sagittal alignment (CSA). In certain situations, a solid PIF structure is vital to prevent failure.
We included 105 patients who underwent the aforementioned surgical methods for MCSM combined with CKD from January 2013 to December 2017. The minimum follow-up period was 1 year. Comparative analysis was performed to compare the two surgical strategies’ preoperative and postoperative functional outcomes, including a visual analog scale for neck pain, neck disability index, the Japanese Orthopedic Association cervical myelopathy score, and the Nurick score, as well as the CSA radiographic outcomes, including C2-7 Cobb angle, C2-7 sagittal vertical axis, and C7 slope. The risk factors related to reduced improvement in functional status were analyzed.
A total of 63 patients underwent ELTA and 42 patients underwent LAPI. Improvements in functional outcomes were considerable in both groups. The mean C2-7 Cobb angle was restored from 7.4° ± 2.1° kyphosis to 8.8° ± 4.7° lordosis in the ELTA group and from 15.3° ± 4.2° kyphosis to 15.8° ± 8.1° lordosis in the LAPI group. The maximal correction angle was 22.6° in the ELTA group and 42.6° in the LAPI group.
Although changes in CSA seemed to be significantly correlated with improvements of functional status, the ELTA and LAPI methods were both effective for treating MCSM combined with CKD, when appropriately selected. The ELTA method was indicated for MCSM patients who had a low degree of CKD, whereas the LAPI method was indicated for MCSM patients who had poor function scores and a high degree of CKD.
Role of injection laryngoplasty in preventing post-stroke aspiration pneumonia, case series report
Authors: Han Yeon Jae , Jang Yong Jun , Park Geun-Young , Joo Young Hoon , Im Sun 
Published: February 2020

Abstract

Introduction:
Injection laryngoplasty is a common procedure for patients with vocal fold dysfunction, but the literature on its benefits has been mainly focused on those related to structural lesions or laryngeal nerve involvement. Stroke patients may be at increased risk of aspiration due to insufficient vocal fold motion. However, how injection laryngoplasty can be of benefit in stroke patients has not been reported yet.

Patient concerns:
Six chronic stroke patients with long-standing swallowing difficulties and who showed severe aspiration despite long-term swallowing rehabilitation.

Diagnosis:
Laryngoscope evaluation revealed insufficient glottic closure as the cause of aspiration.

Interventions:
Injection laryngoplasty was done per-orally under local anaesthesia with calcium hydroxylapatite (Radiesse Voice, 1–1.5 mL) in an office setting. Respiratory pressures and peak cough flows were assessed at baseline and at 2 weeks follow-up.

Outcomes:
At 2 weeks, the mean peak cough flow (Δ = +95.09 L/min) increased significantly after the procedure. The maximal expiratory (Δ = +18.40 cm H2O) and inspiratory (Δ = +20.20 cm H2O) pressures also improved, indicating that injection laryngoplasty was effective in augmenting respiratory and cough parameters. All cases showed improvement in the Functional Oral Intake Scale (Δ = +4). Feeding tubes were successfully removed.

Conclusion:
Injection laryngoplasty proved to be both successful and safe in improving glottic closure with immediate results in those who had failed to show a positive response after long-term swallowing rehabilitation. The positive and dramatic clinical outcomes were observed through changes in the coughing force. Our case series support the use of injection larygnoplasty as a powerful adjunctive treatment method to prevent aspiration pneumonia in post-stroke patients with vocal fold insufficiency. Pre- and post-injection peak cough flow changes may reflect improvement in glottic closure and indicate the safety of swallowing with reduced risk of aspiration.
Dominative role of MMP-14 over MMP-15 in human urinary bladder carcinoma on the basis of its enhanced specific activity
Authors: Kudelski Jacek , Młynarczyk Grzegorz , Darewicz Barbara , Bruczko-Goralewska Marta , Romanowicz Lech 
Published: February 2020

Abstract

Background:
Human urinary bladder cancer is one of the most common cancers worldwide with the mortality rate of approximately 165,000 people annually. The modulation of extracellular matrix is a crucial event in the metastatic spread, among others in angiogenesis. It is initiated and prolonged by the cascade of matrix metalloproteinases. MMP-14 and MMP-15 are associated with a high degree of malignancy, aggressiveness, and survival prognosis by the activation of other matrix metalloproteinases (MMPs). This study was aimed at evaluating the expression and the activity of selected transmembrane metalloproteinases at different stages of human urinary bladder cancer.

Methods:
Western blot and enzyme linked immunosorbent assay (ELISA) method were used to evaluate the expression and content of MMPs and TIMP-1. The activity of studied enzymes was determined with fluorometric method.

Results:
Both transmembrane metalloproteinases are found in healthy or cancerous tissue in high molecular complexes of human urinary bladder. MMP-14 dominates over MMP-15, particularly in high-grade urinary bladder cancer. Their contents significantly change with the grade of bladder tumor. The amount of MMP-14 increases with increasing grade of tumor. MMP-15 content decreases in high-grade bladder cancer. With increasing grade of urinary bladder cancer their actual activity (per kg of total protein content) is varying in different ways. In all examined tissues, the specific activity of MMP-15 (per kg of the enzyme content) is much higher in comparison to MMP-14. Human urinary bladder cancer contains higher TIMP-1 amounts than control tissue but with the decrease with an increase in tumor grade.

Conclusion:
Comparison of investigated enzymes’ activity and the inhibitor content suggests it opposite effects, higher suppression of MMP-14 than MMP-15 activity in low-grade bladder cancer and reverse TIMP-1 action in high-grade cancer. The MMP-14 activity determination in urinary bladder cancer tissue may be used as a predictor of a risk of metastasis.