bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paget's Disease of the Breast Presenting as Nipple Ulceration With Normal Mammogram
Authors: Brickley Sylvana A. , Mercurio Mary Gail 
Published: May 2020

ABSTRACT
Paget's disease of the breast (PDB) is a rare disorder of the nipple–areola complex that may present clinically as a unilateral, eczematous, or ulcerated papule or plaque. This case highlights the importance of either punch or incisional wedge biopsy to establish a diagnosis of PDB for patients who present with chronic cutaneous changes of the nipple, areola, or skin of the breast, regardless of any previous normal mammogram or breast ultrasound. Mammography alone cannot rule out a diagnosis of PDB in a patient with cutaneous changes of the breast.
Clinical and prognostic value of neutrophil-lymphocyte ratio for patients with thyroid cancer
Authors: Feng Jidong , Wang Yanyan , Shan Guohui , Gao Lei 
Published: May 2020

Abstract

Background:
Although the malignant degree is relatively low and overall prognosis is excellent, some patients with thyroid cancer still experience metastasis during the follow-up, which leads to their possible death. Pretreatment neutrophil-to-lymphocyte ratio (NLR) has been recommended as a biomarker for the prediction of metastasis and prognosis in patients with cancers. However, its value in thyroid cancer remains inconclusive. This study aimed to comprehensively evaluate the prognostic and clinicopathological significance of NLR for thyroid cancer by a meta-analysis.

Methods:
Eligible studies were identified by searching PubMed, EMBASE, and Cochrane Library databases. The associations between NLR level and disease-free survival (DFS) or clinicopathological parameters were estimated by calculating hazard ratio (HR) or effect size with 95% confidence interval (CI).

Results:
Nine studies consisting of 3081 patients were enrolled. Results of meta-analysis showed that elevated NLR was not significantly associated with unfavorable DFS overall, but subgroup analysis of multivariate-adjusted studies demonstrated an elevation in pretreatment NLR predicted poor DFS (HR = 3.51, 95%CI = 1.42–8.70). Overall, a high level of NLR was significantly correlated with larger tumor size (standardized mean difference [SMD] = 0.49, 95%CI = 0.33–0.64), and metastasis status (risk ratio [RR] = 1.70, 95%CI = 1.10–2.64). The association with tumor size was still significant in the stratified analyses by country and histology type (Asian: SMD = 0.719, 95%CI = 0.44–0.98; non-Asian: SMD = 0.36, 95%CI = 0.17–0.56; medullary thyroid carcinoma: SMD = 0.57, 95%CI = 0.09–1.05; papillary thyroid carcinoma: SMD = 0.48, 95%CI = 0.31–0.64). The association between NLR and metastasis was only significant for papillary thyroid carcinoma subtype (RR = 1.82, 95%CI = 1.04–3.20).

Conclusion:
Pretreatment NLR may serve as an excellent biomarker for prediction of tumor growth, metastasis, and prognosis in patients with thyroid cancer.
NAD(P)H: quinone oxidoreductase 1 gene rs1800566 polymorphism increases the risk of cervical cancer in a Chinese Han sample
Authors: Yang Shanshan , Zhao Jiannan , Li Li 
Published: May 2020

Abstract
Recently, 2 studies from Thai and American investigated the relationship between NAD(P)H: quinone oxidoreductase 1(NQO1) gene rs1800566 polymorphism and cervical cancer risk and generated contrary results. However, no Chinese reports have addressed this relationship until now. To explore the association between NQO1 gene rs1800566 polymorphism with cervical cancer, we performed a study in a Chinese Han sample.
Using a unmatched case-control design, we enrolled 450 cervical cancer patients and 568 controls in the Central Hospital of Wuhan from January 2010 to December 2016. The genotypes were determined by sequencing polymerase chain reaction product. Hardy-Weinberg equilibrium was assessed using the Chi-square test. The univariate and multi-variate logistic regression with odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the association between the NQO1 gene rs1800566 polymorphism and cervical cancer susceptibility.
The Chi-square test indicated that significant allele and genotype distributions differences were observed between case group and control group (P
<
.001). The logistic regression indicated that TT genotype was associated with higher risk of cervical cancer compare with those with the CT or CC genotype (TT vs CC: OR = 2.82, 95%CI: 1.91–4.17, P < .001; TT vs CT: OR = 2.02, 95%CI: 1.36–3.01, P < .001). The effects of NQO1 show dominant model (TT/CT vs CC: OR = 1.67, 95%CI: 1.30–2.15, P < .001) and recessive model (TT vs. CT/CC: OR = 2.43, 95%CI: 1.68–3.52, P < .001). The significant relationship between NQO1 rs1800566 polymorphism and cervical cancer risk was also found in stratified analyses. The cross-over analysis indicated that there are potential interactions between genetic factors and human papillomavirus infection/ contraceptive oral use for the risk of cervical cancer.
NQO1 gene rs1800566 polymorphism is associated with elevated risk of cervical cancer in Chinese Han women. The interactions between rs1800566 polymorphism and human papillomavirus infection/ contraceptive oral use further reinforce this association.
Prognostic value of maximum standard uptake value, metabolic tumor volume, and total lesion glycolysis of 18F-FDG PET/CT in patients with renal carcinoma
Authors: Xuan Dongchun , Wen Weibo , Tian Shengri , Piao Minhu , Xu Dongyuan , Liu Lan 
Published: May 2020

Abstract

Purpose:
We present a comprehensive systematic review of the documented literature on parameters derived from 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) and meta-analysis of the prognostic value of maximal standard uptake value (SUVmax), metabolic tumor volume (MTV) and total lesional glycolysis (TLG) in patients with renal carcinoma (RCC).

Patients and methods:
Relevant articles in English from PubMed, EMBASE, and the Cochrane Library were retrieved. Pooled hazard ratio (HR) values were used to assess the prognostic value of SUVmax, MTV, and TLG.

Results:
A total of 10 primary studies involving 780 patients with RCC were included. The combined HRs for event-free survival were 1.32 (95% CI 1.10–1.58) for SUVmax, 2.40 (95% CI 1.20–4.79) for MTV, and 3.31 (95% CI 1.68–6.50) for TLG. Pooled HRs for overall survival were 1.264 (95% CI 1.124–1.421) for SUVmax, 3.52 (95% CI 1.451–8.536) for MTV, and 6.33 (95% CI 1.32–30.30) for TLG. Subgroup analysis revealed SUVmax as an independent risk factor for patients with recurrence or metastasis.

Conclusion:
The present meta-analysis confirmed that despite the clinical heterogeneity of RCC and adoption of various methods between studies, high SUVmax is a significant prognostic factor, especially in patients with recurrence or metastasis. MTV and TLG were associated with prediction of higher risk of adverse events or death in patients with RCC.
A comparison of the clinical effects of arthroscopic treatment for popliteal cyst between techniques using one posteromedial portal and two posteromedial portals
Authors: Guo Dongsheng , Cheng Liang , Chen Guangxiang , Yu Xiao , Zhang Hong , She Yuanshi 
Published: May 2020

Abstract
There is a lack of research comparing the clinical effects of arthroscopic treatment of popliteal cysts between the one posteromedial portal (OPP) technique and the two posteromedial portals (TPP) technique. The aim of this study was to evaluate and compare the clinical efficacy of arthroscopic treatment for popliteal cysts between the 2 techniques.
Patients with symptomatic popliteal cysts after surgery were retrospectively invited to participate in this study. They received arthroscopy treatment via the OPP technique or the TPP technique. At the final follow-up, the Rauschning and Lindgren criteria and the Lysholm score were used for clinical evaluation. Moreover, magnetic resonance imaging was performed to detect the recurrence of cysts postoperatively.
Finally, 53 patients with symptomatic popliteal cysts were included in this study, including 25 in the OPP group and 28 in the TPP group. The operation time of the TPP group was significantly longer than that of the OPP group (P < .001). In the OPP group, the cysts disappeared in 17 patients and reduced in size in 8 patients. In the TPP group, the cysts disappeared in 23 patients and reduced in size in 5 patients. According to the Rauschning and Lindgren classification, the recurrence rate was significantly lower in the TPP group (0%) than in the OPP group (4%) (P = .03). In addition, there was no significant difference in the Lysholm score between the OPP group and the TPP group (P = .77).
TPP technique is more effective and superior than OPP technique for the treatment of popliteal cysts.
Prospective randomized controlled trial study of Luofengning granule in the treatment of unstable angina
Authors: Wang Kai , Cai Jun-Jun , Wu Yang , Wang Yu , Liu Lei-Lei , Shi Lei , Wang Xian 
Published: May 2020

Abstract

Introduction:
Although the current western treatment plans for unstable angina (UA) has been optimized in past decades, UA still is a common phenotype of acute coronary syndrome and significantly influence the quality of life and endanger lives. In China, the clinical application of Chinese herb medicine is considered as an effective approach to treating UA and widely recognized by patients. In clinical practices, we found Luofengning granule (LFN-G) could improve clinical manifestations of patients with UA, but there is lack of rigorous proof of evidence-based medicine. This trial aims to further evaluate the efficacy of LFN-G in the treatment of UA.

Methods:
A prospective, open-label, randomized, placebo-controlled clinical will be performed. A total of 60 patients diagnosed with UA will be randomly allocated to either the treatment group or the control group with a 1:1 ratio. The participants in the treatment group will receive LFN-G treatment and the participants in the control group will receive placebo. Meanwhile, both groups continue to undergo standard western medicine treatments. The duration of interventions is 4 weeks. The primary endpoint is the incidence of major cardiac adverse events, defined as a composite of recurrent angina, acute myocardial infarction (AMI), severe arrhythmia, heart failure, and cardiac death. Secondary outcomes include Seattle angina scale score, Chinese medicine syndromes and electrocardiograph (at weeks 0, 1, 2, 4), myocardial nuclides perfusion, measurement of wall motion score index and left ventricular ejection fraction, serum inflammation factors such as C-reactive protein, high sensitive-C-reactive protein, interleukin-6, matrix metalloproteinase-9, and so on (at weeks 0, 4). In addition, some biochemical indexes of blood and hematological indexes will be used to assess the safety of treatments. Any adverse effects of the treatment will be recorded.

Discussion:
The results of this trial will provide compelling evidence of the efficacy and safety of LFN-G for treatment of UA and preliminarily reveal the potential mechanism of how LFN-G acts. Finally, it will widen treatment options for patients with UA.
Evaluation and ultrastructural changes of amniotic membrane fragility after UVA/riboflavin cross-linking and its effects on biodegradation
Authors: Zhang Chenming , Du Tingting , Mu Guoying , Wang Jia , Gao Xin , Long Fumin , Wang Qiaoling 
Published: May 2020

Abstract
This study aims to evaluate the changes of fragility and ultrastructure of amniotic membrane after cross-linking by UVA/riboflavin.
Forty-nine fresh amniotic membranes were randomly divided into 3 groups. Eighteen were in group A (CX group) and immersed in 0.1% riboflavin solution for 10 min for UVA/riboflavin cross-linking. Sixteen were in group B (B2 group), soaked for 10 min with 0.1% riboflavin. After soaking, membranes in group A and B were transferred into corneal preservation solution. Fifteen pieces were in group C, directly into corneal preservation solution. The biomechanical and ultrastructural changes of the amniotic tissue before and after cross-linking were examined (CX group = 13, B2 group = 11, C group = 15). The amniotic membrane tissue of group A (n = 5) and B (n = 5) was transplanted into 16 eyes of the rabbits, respectively, and the dissolution time of the amniotic membrane tissue was investigated.
After cross-linking, compared with the control group, the elastic modulus of the low-stress area of the amniotic membrane (E
low) was higher, while the elastic modulus of the high-stress area of the amniotic membrane (E
high) was lower, with no significant difference in the tensile strength. Also, the collagen fibers showed coarse and bamboo-like changes. In group A, amniotic membranes began to dissolve 4 weeks after conjunctiva transplantation, and all amniotic membranes were dissolved and absorbed 6 weeks after conjunctiva transplantation. In group B, some amniotic membrane tissues were still visible 6 weeks after conjunctiva transplantation.
This study suggested that after amniotic membrane cross-linking, the brittleness was increased, the hardness was enhanced, and the morphology of the collagen fiber was changed. The cross-linked amniotic membrane showed resistance to tissue dissolution.
Prevalence and causes of visual impairment in population more than 50 years old
Authors: He Yuan , Nie Aiping , Pei Jinzhi , Ji Zhi , Jia Jun , Liu Huifeng , Wan Pengfei , Ji Mingli , Zhang Chuntao , Zhu Yanni , Wang Xia 
Published: May 2020

Abstract
To assess the prevalence and causes of visual impairment (VI) in the elderly Chinese rural population in Shaanxi Province.
A population-based, cross-sectional study design was used to determine the extent of VI in Chinese people over the age of 50 years in Shaanxi Province. Visual acuity and best-corrected visual acuity were measured using the logarithm of minimum angle of resolution chart. Blindness and low vision were defined according to WHO criteria. The major cause of VI was identified for all participants who were visually impaired.
A total of 1912 residents completed a standard questionnaire and underwent a detailed eye examination, and the response rate was 90%. The overall prevalence of blindness and low vision were 1.5% and 8.2%. There was no statistically significant differences between genders in the prevalence of blindness and low vision (P > .05). The prevalence of blindness and low vision was higher among older individuals (P < .05) and lower (P < .05) among those with the highest education level. Cataract, corneal opacity, and glaucoma were considered as the main causes of blindness, which accounted for 67.9%, 10.7%, and 7.1%, respectively. Cataract, refractive error, and age-related macular degeneration were always considered as the leading causes of low vision, which accounted for 66%, 14.7%, and 5.8%, respectively.
Cataract, corneal opacity, and glaucoma were the main causes of blindness and low vision in the population aged 50 years or more. The prevalence of these diseases that causes blindness and low vision was higher than that reported in other studies.
A study for precision diagnosing and treatment strategies in difficult-to-treat AIDS cases and HIV-infected patients with highly fatal or highly disabling opportunistic infections
Authors: Li Yao , Zeng Yan-Ming , Lu Yan-Qiu , Qin Yuan-Yuan , Chen Yao-Kai 
Published: May 2020

Abstract

Background:
An increased frequency of toxoplasma encephalitis, caused by Toxoplasma gondii, has been reported in AIDS patients, especially in those with CD4+ T cell counts <100 cells/μL. Several guidelines recommend the combination of pyrimethamine, sulfadiazine, and leucovorin as the preferred regimen for AIDS-associated toxoplasma encephalitis. However, it is not commonly used in China due to limited access to pyrimethamine and sulfadiazine. The synergistic sulfonamides tablet formulation is a combination of trimethoprim (TMP), sulfadiazine and sulfamethoxazole (SMX), and is readily available in China. Considering its constituent components, we hypothesize that this drug may be used as a substitute for sulfadiazine and TMP-SMX. We have therefore designed the present trial, and propose to investigate the efficacy and safety of synergistic sulfonamides combined with clindamycin for the treatment of toxoplasma encephalitis.

Methods/Design:
This study will be an open-labeled, multi-center, prospective, randomized, and controlled trial. A total of 200 patients will be randomized into TMP-SMX plus azithromycin group, and synergistic sulfonamides plus clindamycin group at a ratio of 1:1. All participants will be invited to participate in a 48-week follow-up schedule once enrolled. The primary outcomes will be clinical response rate and all-cause mortality at 12 weeks. The secondary outcomes will be clinical response rate and all-cause mortality at 48 weeks, and adverse events at each visit during the follow-up period.

Discussion:
We hope that the results of this study will be able to provide reliable evidence for the efficacy and safety of synergistic sulfonamides for its use in AIDS patients with toxoplasma encephalitis.

Trial registration:
This study was registered as one of 12 clinical trials under the name of a general project at chictr.gov on February 1, 2019, and the registration number of the general project is ChiCTR1900021195. This study is still recruiting now, and the first patient was screened on March 22, 2019.
Research “recover from illness defense complex” helper T cell immune mechanisms based on the “Fuxie” theory clearing away heat evil thoroughly nourishing kidney treatment of recurrent blood-heat syndrome Psoriasis
Authors: Li Mao , Hu Xia , Hao Ping-Sheng 
Published: May 2020

Abstract

Introduction:
Psoriasis vulgaris (PV) is a chronic, painful, disfiguring, and disabling dermatological disease, which affects the physical and mental health of patients and impacts their quality of life. Current conventional systemic therapies can be costly, present risks of side effects, have limited efficacy and commonly recur following treatment cessation. Some Chinese herbal medicine therapies have shown therapeutic benefits for psoriasis vulgaris, including relieving symptoms and improving quality of life, and a potential of reducing relapse rate. However, explicit evidence has not yet been obtained.

Methods and analysis:
This is a pilot randomized controlled trial with the objective of investigating the effect of Jia Wei Liang Xue Xiao Feng San granules on relapse rate of recurrent PV and the correlation between Psoriasis area severity index (PASI) and key psoriasis-related cytokine changes and the number of cells. A total of 102 participants were recruited for this study, including 72 patients with recurrent PV, 15 healthy volunteers and 15 patients with psoriasis vulgaris who have recovered for more than 1 year. A total of 72 patients, with recurrent PV, will be randomized (1:1) to receive the oral Chinese herbal medicine Jia Wei Liang Xue Xiao Feng San or the oral Acitretin Capsule treatments for a period of 8 weeks. After this period, participants whose PASI scores improvement reached more than 75%, will undergo a 52-week follow-up phase.
The primary outcome measures are as follows:
The secondary study outcomes will include:
This trial may provide a novel regimen for recurrent PV patients if the granules decrease recurrence rate without further adverse effects.

Ethics and dissemination:
The ethics approval was provided by the Sichuan Traditional Chinese medicine regional ethics review committee. The ethics approval number is 2018KL-055. The design and the results of the study will be disseminated through peer-reviewed publications and conference presentations.

Trial registration number:
Chinese Clinical Trial Registry (ChiCTR1900022766).
A scoring system based on clinical features for the prediction of sporadic renal angiomyolipoma rupture and hemorrhage
Authors: Xu Xiao-feng , Hu Xian-hui , Zuo Qi-ming , Zhang Jiao , Xu Hao-yu , Zhang Yao 
Published: May 2020

Abstract
The purpose of this study is to analyze the risk factors of sporadic renal hamartoma and establish a risk scoring system, and to intervene in patients with high-risk sporadic renal hamartoma who are prone to rupture and bleeding as soon as possible.
Retrospective univariate and multivariate logistic analyzes were conducted for clinical data of 332 sporadic renal hamartoma patients to screen out independent risk factors of tumor rupture. Score of each independent risk factor was calculated. (Calculation formula: the risk coefficient of each factor = the beta regression coefficient of each factor/the minimum value of the beta regression coefficient of all factors, the value of the smallest beta regression coefficient corresponding to all the factors was assigned 1 point. The score of each factor was equal to the risk coefficient of each variable was taken as an integer value by rounding.) The total score was equal to the sum of all factors. Then the area under the receiver operating characteristics (AUC) curve was compared between high risk factors and scoring system. Finally, the scoring system was evaluated by the area under the curve (AUC) and the Hosmer–Lemeshow method in an independent cohort of 130 patients.Factors such as symptoms at presentation, tumor size, tumor blood supply, and tumor growth pattern were significant predictors of sporadic renal angiomyolipoma rupture in both the univariate and multivariate analyses; these predictors were included in the scoring system to predict sporadic renal angiomyolipoma rupture. There were no significant differences in AUCs between high risk factors and scoring system (z = 0.6434, P = .583, AUC = 0.913, and 0.903 for high risk factors and scoring system, respectively). The sporadic renal angiomyolipoma patients who scored >6 points were prone to rupture. AUROC of the scoring system in the validation set was 0.854(95%CI:0.779, 0.928). Using the Hosmer–Lemeshow method, the value of X2 was 2.916, P = .893, suggesting the scoring system fitted well.
A scoring system based on clinical features is simple and effective in predicting sporadic angiolipoma rupture and hemorrhage. When the score is higher than 6 points, the probability of hamartoma rupture and hemorrhage is significantly increased and early intervention is needed.