bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Risk Factors for Postoperative Neurocognitive Disorder in Elderly Patients Following Coronary Artery Bypass Grafting.
Authors: Huang Xiao , Zhang Juxia , Luo Ting , Wei Changwei , Wu Anshi 
Published: May 2020

Abstract
Background The incidence and risk factors of postoperative neurocognitive disorder (PND) following coronary artery bypass grafting (CABG) is still controversial. Exploring an effective and reliable predictor of PND is essential to the prevention of PND. This prospective observational study aimed to find the incidence rate as well as possible risk factors of PND in CABG.Methods Patients who underwent CABG were included. A battery of neuropsychological tests was performed preoperatively and 7 days after surgery. We used the Z score to analyze and comprehensively evaluate PND. The clinical characteristics of the patients were recorded. The levels of TNF-α, IL-1 (interleukin-1), IL-6 (interleukin-6), S100β, MDA (malondialdehyde) and T-AOC (total antioxidant capacity) were measured at different time points.Results A total of 82 patients were enrolled in the study. The incidence of PND was 25.6% 7 days after surgery. Patients were divided into the control group (N = 61) and the PND group (N = 21). The average age of patients in the PND group was 68.1 years, which was 64 years in the control group (P < 0.05). The average years of education in the PND group were significantly shorter than those in the control group (P < 0.05). The serum levels of IL-6, MDA, Il-1, and S100β in the PND group were significantly lower than those in the control group 1 day after surgery, and the T-AOC level was higher than that in the control group (P < 0.05) 1 day after surgery. The concentration of S100β in the PND group significantly higher than that in the control group 3 days after surgery (P < 0.05). Age, years of education, IL6, TAOC, MDA, IL1, and S100B were included in the multiple regression to search for risk factors of PND. The results showed that higher age (95%CI = 0.776–0.984, P = 0.026), lower years of education (95%CI = 1.006–1.736, P = 0.045) and higher MDA level (95%CI = 0.304–0.964, P = 0.037) were risk factors for PND.Conclusions Older age, lower educational level and higher MDA might be risk factors for PND 7 days after surgery. More researches in the future on this field needs to be conducted to prevent PND effectively and timely.Trail registration: The trail has been registered to the Chinese Clinical Trail Registry (ID: ChiCTR1800015606) on April 11, 2018.
Therapeutic value of curcumin on the initiation and development of inflammation in Takayasu’s arteritis mediated by HSP65-induced CCL2 overexpression
Authors: Wu Sifan , Wang Yujiao , Kong Xiufang , Fan Xiaoyong , Huang Qingrong , Sun Ying , Chen Rongyi , Yu Wensu , Ma Lili , Jiang Lindi 
Published: May 2020

Abstract
Background

Takayasu’s arteritis (TAK) is a chronic inflammatory disease characterized by macrophage infiltration. During the active stage, aorta adventitial fibroblasts (AAFs) proliferate excessively and produce numerous pro-inflammatory factors in the adventitia, the primary target of TAK therapy. Although the monocyte chemokine, CCL2, may contribute to macrophage infiltration in TAK arteries, whether there is an associated relationship with HSP65 remains unknown. Moreover, there are no reports of the activation of AAFs to produce inflammatory factors involvement in TAK pathogenesis. TAK treatment is associated with several challenges and contradictions. Curcumin is a traditional Chinese medicine with anti-inflammatory effects; however, its effectiveness for TAK and the underlying mechanism remains unclear.
Methods

We first verified high HSP65 expression in the aortic adventitia of TAK patients by IHC. mRNA-seq was used to profile differentially expressed genes (DEGs) between AAFs stimulated by HSP65 with or without pretreatment with curcumin, and untreated AAFs. The key chemokine, CCL2, screened by mRNA-seq was detected in the adventitia of the TAK aorta, and its correlation with HSP65 expression was analyzed by double-labelled immunofluorescence. We subsequently explored how HSP65 affected the production of inflammatory factors by AAFs at a cellular level and the related signaling pathway. We explored whether curcumin could hinder this process and verified the effect of curcumin on the level of serum CCL2 in patients with TAK.
Results

HSP65 was highly expressed in the adventitia of TAK arteries. The DEG analysis showed a key role of CCL2. The expression of CCL2 in the adventitia of TAK arteries was significantly higher than that of healthy subjects, and was correlated with HSP65. HSP65 facilitated the production of CCL2, IL-6, and IL-1β by AAFs via activation of the TLR4-JAK2/AKT/STAT3 pathway, among which the change in CCL2 was the greatest. Curcumin treatment reversed HSP65-induced CCL2 upregulation in vitro, which was more obvious than that of MTX and tofacitinib. Finally, curcumin significantly downregulated the level of serum CCL2 in TAK patients.
Conclusion

HSP65 initiates and promotes TAK inflammation by upregulating CCL2 in AAFs through the JAK2/AKT/STAT3 pathway, whereas curcumin could reverse this process and slow the initiation and development of TAK.
Increased MLKL mRNA level in the PBMCs is correlated with autoantibody production, renal involvement and SLE disease activity
Authors: Zhang Mingjiao , Jie Hongyu , Wu Yong , Han Xinai , Li Xing , He Yi , Shi Xingliang , Luo Yuwei , Sun Ying , Yang Jinlong , Yang Jing , Quan Shulv , Lao Xiaobin , Tan Liping , Sun Erwei 
Published: May 2020

Abstract
Background
Necroptosis is a form of regulated necrosis that is involved in various autoimmune diseases. Mixed lineage kinase domain-like pseudokinase (MLKL) has been identified as a key executor of necroptosis, however, the significance of MLKL in peripheral blood mononuclear cells (PBMCs) of systemic lupus erythematosus (SLE) has not been investigated. In this study, we aimed to determine the mRNA level of MLKL in PBMCs and examine its relationship with clinical features and serological parameters in SLE.
Methods
Real-time transcription-polymerase chain reaction analysis (RT-PCR) was used to determine expression of MLKL mRNA in PBMCs from 59 patients with SLE, 25 patients with rheumatoid arthritis (RA) and 30 age- and sex-matched healthy controls(HC). Spearman's correlation test was performed to assess the correlation of MLKL mRNA with clinical variables. The receiver operating characteristic curve (ROC) was created to evaluate the diagnostic value.
Results
Our results showed MLKL mRNA in PBMCs was upregulated in SLE patients compared to that in RA and HC individuals. SLE patients positive for anti-nuclear antibodies had significantly higher MLKL mRNA than antibody-negative patients. In SLE patients, MLKL mRNA was found to be upregulated in patients with lupus nephritis (LN) as compared with patients without LN, and also higher in active patients than in stable patients. MLKL mRNA level was significantly and positively correlated with c-reaction protein (CRP) (r = 0.3577, p = 0.0237), erythrocyte sedimentation rate (ESR) (r = 0.4091, p = 0.0043), serum immunoglobulin G (IgG) concentration (r = 0.3546, p = 0.0289) and the numbers of positive antinuclear antibodies (ANAs) (r = 0.3945, p = 0.0432). ROC analysis showed that MLKL mRNA in PBMCs had an area under the curve of 0.9277 (95% CI 0.8779–0.9775, p < 0.001) to discriminate SLE from controls.
Conclusions
These results suggest that increased MLKL mRNA level in the PBMCs of SLE patients is correlated with renal involvement and disease activity, identifying a subgroup of patients with SLE or LN who may benefit from early diagnosis and therapies targeting MLKL.
A novel prognostic model predicts overall survival in patients with nasopharyngeal carcinoma based on clinical features and blood biomarkers
Authors: Lai Changchun , Zhang Chunning , Lv Hualiang , Huang Hanqing , Ke Xia , Zhou Chuchan , Chen Hao , Chen Shulin , Zhou Lei 
Published: May 2020

Abstract
Background
To develop and validate a novel prognostic model to estimate overall survival (OS) in nasopharyngeal carcinoma (NPC) patients based on clinical features and blood biomarkers. And assess its incremental value to TNM staging system, clinical treatment, and Epstein-Barr virus DNA (EBV DNA) for individual OS estimation.
Methods
We retrospectively analyzed 519 consecutive NPC. A prognostic model was generated by using the Lasso-Cox regression model in training cohort (n = 346). Then comparison of predictive accuracy between the novel prognostic model, TNM staging, clinical treatment, and EBV DNA using concordance index (C-index), time-dependent ROC (tdROC), and decision curve analysis (DCA). Subsequently, a nomogram for OS incorporating the prognostic model, TNM staging and clinical treatment was built. Finally, we stratified patients into high- risk and low-risk groups according to the model risk score, and the survival time of these two groups was analyzed using Kaplan–Meier survival plots. All the results were validated in the independent validation cohort (n = 173).
Results
Using the Lasso-Cox regression, a prognostic model was established consisting of 13 variables with respect to patient prognosis. The C-index, tdROC and DCA all showed the prognostic model had good predictive accuracy and discriminatory power than TNM staging, clinical treatment and EBV DNA in training cohort. Nomogram consisting of the prognostic model, TNM staging, clinical treatment and EBV DNA shown some superior net benefit. According to the model risk score, we split the patients into two subgroups: low- risk (risk score ≤ -1.423) and high-risk (risk score > -1.423). There had significant differences in OS between the two subgroups of patients. In the validation cohort, similar results were obtained.
Conclusion
The proposed novel prognostic model based on clinical features and serological markers represents a promising signature for estimating OS in NPC patients.
Connection for TESPA1 Polymorphisms to ankylosing spondylitis incidence in the Chinese Population
Authors: Liu Hua-Wei , Wei Dai-Xu , He Da-Wei , Deng Jiu-Zheng , Zhu Jian-Jin , Xu Kai , Hu Dong , Li Jing , Hu Wen-Hao , Wang Yan- , Xiao Song-Hua , Fu Li-Gong 
Published: May 2020

Abstract
Background

The aim of this study was to investigate whether thymocyte-expressed, positive selection-associated 1 (TESPA1) gene polymorphisms were associated with increased risk of developing ankylosing spondylitis(AS) in a Chinese Han population.
Methods

A total of 99 AS patients were recruited as case group and 96 healthy individuals were collected as control group. TESPA1 polymorphisms were genotyped by polymerase chain reaction (PCR) and sequencing methods. The genotype distribution of TESPA1 gene rs4758993 and rs4758994 polymorphism was detected by Hardy-Weinberg equilibrium (HWE). The genotype and allele distributions of each polymorphism were also compared between groups. Moreover, odds ratios (OR) with 95% confidence intervals (95%CI) were calculated using the χ2 test to evaluate the association between AS susceptibility and TESPA1 polymorphisms.
Results

rs4758993 and rs4758994 polymorphisms were conformed to be in HWE in genotypes distribution of the control group (P > 0.05 for both). A remarkable decrease trend of rs4758993 AG genotype and A allele were detected in AS patients than in healthy controls (P = 0.01 and 0.02, respectively), indicating that they obviously decreased the risk of AS in a Chinese Han population (OR = 0.303, 95%CI = 0.144–0.637; OR = 0.002, 95%CI = 0.173–0.703). However, No significant differences were detected for TESPA1 gene rs4758994 polymorphism in both genotype and allele distributions between case and control groups (P > 0.05).
Conclusions

Our findings suggest that TESPA1 gene rs4758993 polymorphism was significantly associated with AS susceptibility in the Chinese Han population and the mutant A allele severed as a protect factor for the development of AS.
Effect of carbon nanotubes on the microstructure and properties of CPED ceramic coating
Authors: Wang Ping , Chen Xiaomin , Zhang Chunqing , Jiao Di , Jiao Shangyi , Yao Min 
Published: May 2020

Abstract
Cathode plasma electrolytic deposition ceramic coating modified by carbon nanotubes was prepared on Al-Si alloy. The microstructure and the heat insulation performance, fracture toughness and bending strength of the coating were investigated by SEM, XRD, the heat insulation test device and tensile testing machine. Carbon nanotubes(CNTs) are staggered in the ceramic layer and partially filled with plasma discharge micropores. To some extent, CNTs can promote the cathode plasma discharge and improve the film formation rate. The content of α-Al2O3 and t-ZrO2 phases increased with the increase of CNTs concentration. A certain amount of carbon nanotubes can effectively improve the insulation temperature of ceramic layer. With the increase of the content of carbon nanotubes, the fracture toughness and bending strength gradually increase.
Nationwide survey of patients’ and doctors’ perceptions of what is needed in doctor - patient communication in a Southeast Asian context
Authors: Tran Trung Quang , Dalen Jan van , Scherpbier Albert , Do Dung van , Wright E. Pamela 
Published: May 2020

Abstract
Background Asian countries are trying to apply the partnership model in doctor-patient communication that has been effectively applied in Western countries. The study aimed to investigate whether communication model used in the Western world are appropriate in Southeast Asia and to identify key items in doctor-patient communication that should be included in a doctor-patient communication model for training in Vietnam (a Southeast Asian country).Methods In six provinces, collaborating medical schools collected data from 480 patients interviewed using a structured guideline after a consultation session and from 473 doctors using a cross-sectional survey on how they conduct consultation sessions with patients. Data collection tools covered a list of communication skills based on Western models, adapted to fit with local legislation.Results Both patients and doctors considered most elements in the list necessary for good doctor-patient communication. Both also felt that while actual communication was generally good, there was also room for improvements. Furthermore, the doctors had higher expectations than the patients. Four items in the Western model for doctor-patient communication, all promoting the partnership relation between them, appeared to have lower priority for both patients and doctors in Vietnam.Conclusion The communication model used in the Western world could be applied in Vietnam with minor adaptations. Increasing patients’ understanding of their partner role needs to be considered. The implications for medical training in universities are to focus first on the key skills perceived as needed to be strengthened by both doctors and patients. In the longer term, all of these items should be included in the training to prepare for the future.
Comprehensive analysis of alternative splicing and transcriptome related to the prognosis of cervical squamous cell cancer
Authors: Li Chen , Yan Fang , Chen Gang , Li Qiang , Xian Hua , Xie Jingdun 
Published: May 2020

Abstract
Background: Cervical squamous cell cancer (CESC) is a common malignancy tumor with high incidence and mortality in women globally. Increasing studies have indicated that there was an indivisible association between alternative mRNA splicing (AS) and multiple types of cancer. However, comprehensive analysis of alternative mRNA splicing events is scarce in CESC. Methods: In this study, alternative mRNA splicing events data and clinical information of 216 CESC patients were downloaded from TCGA SpliceSeq database and TCGA website. We used identified survival-associated splicing events (SASEs) to construct prognostic signatures. Kaplan-Meier survival analysis and receiver operating characteristic (ROC) curve were performed to evaluate the clinical value of prognostic signatures. A nomogram was carried out to quantitatively predict individuals’ survival probability. Regulatory network between splicing factors (SFs) and SASE was analyzed to explore the upstream regulators of a certain SASE. Additionally, we explored potential downstream pathways of a certain SASE. Results: A total of 41776 alternative splicing events in 9961 genes were collected. After sorting out SASEs, multivariable regression analysis was used to acquire 70 SASEs that could be independent prognostic factors for overall survival in CESC. Kaplan-Meier survival analyses showed that the difference was statistically significant (P＜0.01). The area under ROC curve (AUC) for all AS pattern was 0.932. A nomogram was constructed with a concordance index of 0.82 to predict individuals’ survival probability. EIF3A positively regulated SEC23A-27346-AP with highest correlation coefficient (P＜0.001, R=0.69). Besides, the most significant SASEs and KEGG pathways were SEC23A-27346-AP and adherens junction pathway (P=0.02, R=0.65). Conclusions: Prognostic signatures of survival-associated splicing events were independent prognostic factors for overall survival among CESC patients. A nomogram could quantitatively predict individuals’ survival probability. Moreover, we proposed that splicing factor EIF3A positively regulated SEC23A-27346-AP, and adherens junction pathway may be the downstream pathway of SEC23A-27346-AP. The aforementioned signaling pathway could play a crucial role in the development of CESC.
Clinical symptoms and treatment of common respiratory tract infections in relation to microbiological profiles in rural health facilities in China: implications for antibiotic stewardship
Authors: Shen Xingrong , Shen Jilu , Pan Yaping , Cheng Jing , Chai Jing , Bowker Karen , MacGowan Alasdair , Oliver Isabel , Lambert Helen , Wang Debin 
Published: May 2020

Abstract
Background

This study aims to identify the extent to which current clinical practice in the treatment of common respiratory tract infections (RTIs) is consistent with presenting symptoms and microbiological characteristics at health care settings in rural Anhui Province and implications for future antibiotic stewardship.
Methods

The study was implemented in one village clinic and one township health center in each of four rural residential areas in Anhui Province, China. Observations, structured and semi-structured interviews in village clinics and township health centers were conducted to investigate antibiotic use. Sputum and throat swabs were collected for bacterial culture and susceptibility testing.
Results

A total of 1068 (51.0% males and 49.0% females) completed the study. Antibiotics were prescribed for 87.8% of RTI patients. Of all the specimens tested, 329 (30.8%) specimens were isolated with bacteria. The most frequently detected bacteria were K. pneumonia (24.15% in all specimens), H. influenza (16.19%), H. parainfluenzae (14.77%), S.aureus (5.11%), M. catarrhalis (3.41%) and S. pneumoniae (2.27%). The bacteria detection was associated with age (OR = 1.91), season (OR = 0.41 to 0.60), days since infection onset (OR = 1.54 to 1.81), and runny or blocked nose (OR = 1.39 to 1.61), cough with green or white sputum (OR = 1.47 to 1.59). Antibiotic use was only linked with limited non-specific clinical manifestations e.g., days since infection onset (OR = 0.53) and sore throat (OR = 1.64).
Conclusions

The study reveals that antibiotics prescription is still very common in rural China which is driven mainly by patient reassurance and other non-pathological factors rather than treatment of bacterial infections. The study establishes the feasibility of conducting microbiological testing outside Tier 2 and 3 hospitals in rural China.
Bone mineral density in adults with osteoarthritis or rheumatoid arthritis: a cross-sectional study of a nationwide population.
Authors: Zhu Zhongxin , Hu Gangfeng , Jin Hongting , Tong Peijian 
Published: May 2020

Abstract
Background

It is reported that osteoporosis commonly occurs in rheumatoid arthritis (RA), whereas there is a controversial relationship with osteoarthritis (OA). In this study, we aimed to investigate the relations between OA, RA and bone mineral density (BMD) in adults aged 20–59 years.
Methods

We merged and analyzed the database from the National Health and Nutrition Examination Survey (NHANES) 2011–2018. Arthritis status and types of arthritis were obtained from questionnaires. Lumbar BMD was measured by dual-energy X-ray absorptiometry. The associations between OA, RA and lumbar BMD were evaluated using logistic regression models. Subgroup analyses stratified by gender and race were performed. The association between disease duration of arthritis and lumbar BMD was also investigated.
Results

A total of 11094 adults aged 20–59 years were analyzed in this study. Compared with the non-arthritis group, participants with OA had a higher lumbar BMD (β = 0.023; 95% CI: 0.011–0.035), while no significant association was observed in rheumatoid arthritis (β = 0.014; 95% CI: -0.003–0.031). In the subgroup analyses stratified by gender, males with OA had a higher lumbar BMD compared with those without (β = 0.014; 95% CI: -0.003–0.031). However, this association changed in females (β = 0.007; 95% CI: -0.008–0.021). On the other hand, no significant association was observed in RA in both males and females (males: β = 0.023; 95% CI: -0.003–0.048, females: β = 0.008; 95% CI: -0.015–0.031). Moreover, the disease duration of arthritis was not associated with lumbar BMD in both OA (β=-0.0001; 95% CI: -0.0017–0.0015) and RA (β = 0.0006; 95% CI: -0.0012–0.0025).
Conclusions

The correlation between OA and lumbar BMD differed by sex. Patients with OA were more likely to have higher lumbar BMD in males, but not in females. On the other hand, no significant association was found in RA both in males and females.