bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of ulinastatin on post-operative blood loss and allogeneic transfusion in patients receiving cardiac surgery with cardiopulmonary bypass: a prospective randomized controlled study with 10-year follow-up
Authors: Zhang Peng , Lv Hong , Qi Xia , Xiao Wenjing , Xue Qinghua , Zhang Lei , Li Lihuan , Shi Jia 
Published: February 2020

Abstract
Background: Major bleeding and allogeneic transfusion leads to negative outcomes in patients receiving cardiac surgery with cardiopulmonary bypass (CPB). Ulinastatin, a urine trypsin inhibitor, relieves systemic inflammation and improves coagulation profiles with however sparse evidence of its effects on blood loss and allogeneic transfusion in this specific population.Methods: In this prospective randomized controlled trial, 426 consecutive patients receiving open heart surgery with CPB were randomly assigned into three groups to receive ulinastatin (group U, n=142), tranexamic acid (group T, n=143) or normal saline (group C, n=141). The primary outcome was the total volume of post-operative bleeding and the secondary outcome included the volume and exposure of allogeneic transfusion, the incidence of stroke, post-operative myocardial infarction, renal failure, respiratory failure and all-cause mortality. A ten-year follow-up was carried on to evaluate long-term outcomes.Results: Compared with placebo, ulinastatin significantly reduced the total volume of post-operative blood loss (801.7±460.14ml vs 1016.67±529.08ml, MD -214.98ml, p<0.001) and the volume of allogeneic erythrocyte transfusion (2.57±3.15 unit vs 3.73±4.21 unit, MD-1.16 unit, p=0.002). The bleeding and transfusion outcomes were comparable between the ulinastatin group and the tranexamic acid group. In-hospital outcomes and 10-year follow-up showed no statistical difference in mortality and major morbidity among groups.Conclusion: Ulinastatin reduced post-operative blood loss and allogeneic erythrocyte transfusion in open heart surgery with CPB. The mortality and major morbidity was comparable among the groups shown by the 10-year follow-up.Trial registration: The trial was retrospectively registered on February 2, 2010. Trial registration number: https://www.clinicaltrials.gov. Identifier: NCT01060189.
The value of clinical examination in preterm newborns after neonatal sepsis: a&nbsp;case control study.
Authors: Golin Marina Ortega , Souza Fabíola Isabel Suano , Paiva Laércio da Silva , Sarni Roseli Oselka Sacardo 
Published: February 2020

Abstract
Background Neonatal sepsis is an important risk factor for lesions in the white matter of the brain of preterm newborns (PTNB) and the most effective strategies to minimize its deleterious effects are early detection and intervention. However, no studies were found to analyze the neurological behavior of PTNBs with neonatal sepsis. Thus, the objective of the present study was to investigate the presence of neurological abnormalities in PTNBs, after neonatal sepsis, by neonatal clinical evaluation. Methods This is a prospective cross-sectional study with 100 PTNBs selected at random, 50 of the study group (sepsis) and 50 of the control group (non-sepsis) of the university municipal hospital. PTNBs were evaluated at adjusted gestational age (37 to 42 weeks). The neurological evaluation protocol adopted was the Hammersmith Neonatal Neurological Examination (HNNE), which consists of 34 items grouped into six categories. Statistical analysis: Statistical analysis was performed using the Chi-square, Mann-Whitney and Binary Logistic Regression tests using the assumption of each statistical test. The statistical program used was Stata version 11.0. Results The PTNBs of the sepsis group had total HNNE scores lower than expected for normality in 86% of the cases, and the non-sepsis group in 26% (p<0.001). Higher prevalence levels of altered scores in tone category (p<0.001), tone patterns (p=0.026), reflexes (p=0.002), movements (p<0.001), abnormal signs (p<0.001) and behavior (p<0.001), were also found in the sepsis group, as well as in 26 of the 34 evaluation items. Conclusion The preterm neonatal sepsis showed significant frequency of neurological alterations. Thus, it is concluded that neurological dysfunctions in preterm newborns after neonatal sepsis can be identified by clinical neonatal neurological evaluation.
Bone Mineral Density and Bone Microarchitecture in a Cohort of Patients with Erdheim-Chester Disease
Authors: He Tianhua , Cui Lijia , Niu Na , Wang Fengdan , Miao Huilei , Zhao Hao , Gao Xuemin , Liu Chang , Yu Fan , Jiang Yan , Wang Ou , Li Mei , Xing Xiaoping , Zhou Daobin , Li Jian , Cao Xin-Xin , Xia Weibo 
Published: February 2020

Abstract
Background: Erdheim-Chester Disease (ECD) is a rare type of non-Langerhans histiocytosis. Skeletal structures are affected in over 95% ECD patients. Due to the lack of proper imaging assessment tools, the alteration of bone microarchitecture in ECD has not been well studied. High-resolution peripheral quantitative computed tomography (HR-pQCT) is a newly developed assessment of bone mineral density and bone microarchitecture.Methods: We performed a cross-sectional study with thirteen patients diagnosed with ECD in Peking Union Medical College Hospital between October 2018 and June 2019. The diagnosis of ECD was based on typical pathological findings in the context of appropriate clinical and radiological manifestations. Bone geometry, volumetric bone mineral density and bone microarchitecture of those ECD patients were assessed using HR-pQCT at the non-dominant distal radius and distal tibia. Those HR-pQCT parameters were then compared to an ongoing population-based database of HR-pQCT for Mainland Chinese.Results: As a result, remarkable heterogeneity of osteosclerosis in HR-pQCT images was found in ECD patients, ranging from apparently normal structure, scattered thickening of trabecula, to homogenous consolidation. On quantitative measurements, total volumetric BMD (383.50mg/cm3, 1.352 times of normal mean, p=0.023) of the tibia differed significantly in ECD patients, attributing to the increased trabecular volumetric BMD (291 mg/cm3, 2.058 times of normal mean, p=0.003). The increased trabecular volumetric BMD of tibia was associated with remarkably increased number of trabecula (1.7/mm, 1.455 times of normal mean, p=0.002) and increased thickness of trabecula (0.37mm, 1.466 times of normal mean, p=0.003). These differences could be due to the existence of dense bone interposed in the trabecula.Conclusion: This study is the first to assess the volumetric bone mineral density and bone microstructure with HR-pQCT in a cohort of ECD patients, and indicated that the application of HR-pQCT may help to reveal the nature of bone lesions in the disease.
Optic neuritis at the nexus of peripheral autoimmunity and central nervous system demyelination: a nationwide cohort study
Authors: Lin Wei-Sheng , Chen Ho-Min , Yang Chih-Chao , Chen Ta-Ching , Lin Jou-Wei , Lee Wang-Tso 
Published: February 2020

Abstract
Background

Long-term course of optic neuritis is heterogeneous and varies across populations. We aim to investigate immune-related determinants that predict conversion of optic neuritis (ON) to multiple sclerosis (MS) or neuromyelitis optica (NMO) in a nationwide cohort.

Methods

We conducted the population-based cohort study using data from Taiwan’s National Health Insurance Research Database. Incident ON cases during 2003~2014 were followed until the end of 2015. Pediatric and adult sub-cohorts were examined separately. The associations between immune-related comorbidities or treatment and outcomes were analyzed using Cox proportional hazards models.

Results

A total of 11923 adult and 1365 pediatric ON patients were enrolled. The rates of conversion to MS were 2.7% for adult and 3.1% for pediatric ON with median follow-up duration of 6.3 and 7.3 years respectively, while 1.2% of pediatric and adult ON evolved to NMO. Comorbid systemic lupus erythematosus was associated with increased risks of subsequent development of MS in adult (adjusted hazard ratio [aHR], 2.80; 95% CI, 1.04-7.49) and pediatric ON patients (aHR, 21.65; 95% CI, 1.29-363.4). Adult ON patients were at increased risks of NMO if comorbid with myasthenia gravis (aHR, 9.13; 95% CI, 1.20-69.45) or Sjogren’s syndrome (aHR, 4.71; 95% CI, 1.74-12.76).

Conclusion

ON could be the sentinel event linking several peripheral autoimmune comorbidities to distinct forms of central nervous system demyelination. The clinical context in which ON occurs should be taken into account in the care and counseling of these patients.
Clinical outcomes and prognostic factors in bloodstream infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae among patients with malignancy: a meta-analysis
Authors: Jiang Ai-Min , Liu Na , Zhao Rui , Zheng Hao-Ran , Chen Xue , Fan Chao-Xin , Zhang Rui , Zheng Xiao-Qiang , Fu Xiao , Yao Yu , Tian Tao 
Published: February 2020

Abstract
Background The colonization of Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) in bloodstream infections (BSIs) has been increased dramatically worldwide, and it was associated with worse clinical outcomes in patients with malignancy. We performed the meta-analysis to investigate the prognosis and risk factors in BSIs caused by ESBL-PE in oncological patients. Methods PubMed and EMBASE were searched for related studies. All-cause mortality was considered as the primary outcome. Subgroup analyses, meta-regression analyses, and sensitivity analysis were used to investigate heterogeneity and reliability in results. Results 6729 patients from 25 studies were eligible. Six studies enrolled oncological patients with BSIs caused by ESBL-PE only, while 19 studies both enrolled ESBL-PE and non-ESBL-PE infections. The results showed that BSIs caused by ESBL-PE in patients with malignancy was associated with higher mortality than non-ESBL-PE infections (RR = 2.21, 95% CI: 1.60–3.06, P < 0.001), with a significant between-study heterogeneity (I2 = 78.3%, P < 0.001). Subgroup analyses showed that children (RR = 2.80, 95% CI: 2.29–3.43, P < 0.001) and hematological malignancy (RR =3.20, 95% CI: 2.54–4.03, P < 0.001) were associated with a higher mortality. Severe sepsis/ septic shock, pneumonia, and ICU admission were the most common predictors of mortality. Conclusions Our study identified that BSIs caused by ESBL-PE in patients with malignancy was associated with worse clinical outcomes compared with non-ESBL-PE infections. Furthermore, children and hematological malignancy were associated with higher mortality. Severe sepsis/ septic shock, pneumonia, and ICU admission were the most common predictors of mortality.
Placenta-Specific Protein 1 Enhances Metastatic Potential and is Associated with the PI3K/AKT/NF-κB Signaling Pathway in Colorectal Cancer
Authors: Ma Jiachi , Li Lei , Du Jun , Pan Chengwu , Zhang Chensong , Chen Yuzhong 
Published: February 2020

Abstract
Background To better explore the underlying mechanism of liver metastatic formation by placenta-specific protein 1 (PLAC1) in human colorectal cancer, we investigated the proliferation, invasion and angiogenic capabilities of human colorectal cancer cell lines with different liver metastatic potentials as well as the mechanism of action of PLAC1 in the metastatic process. Methods The expression of PLAC1 was detected by reverse transcriptase PCR, western blot and real-time PCR. The effect of PLAC1 on metastatic potential was determined by proliferation, invasion, and angiogenesis assays, including an in vitro coculture system consisting of cancer cells and vascular endothelial cells that were used to detect the relationship between cancer cells and angiogenesis. In addition, we also determined PLAC1 downstream targets that preferentially contribute to the metastatic process. Results PLAC1 was expressed in HT-29, WiDr and CaCo-2 colorectal cancer cells but not in Colo320 colorectal cancer cells. PLAC1 could not only significantly enhance the proliferation of CoLo320 and human umbilical vein endothelial cells (HUVECs) but could also promote the invasion of CoLo320 cells. The angiogenesis of HUVECs was enhanced by PLAC1 in a dose-dependent manner. In cocultured systems, angiogenesis was significantly increased by coculture with HT-29 cells. In addition, PLAC1 could promote angiogenesis in coculture with HT-29 cells. Furthermore, PLAC1-enhanced metastatic potential of colorectal cancer cells was dependent on activation of the PI3K/Akt/NF-κB pathway. Conclusions The activation of PI3K/Akt/NF-κB signaling by PLAC1 may be critical for the metastasis of colorectal cancer cells. According to our results, we suggest that modification of PLAC1 function might be a promising new therapeutic approach to inhibit the aggressive spread of colorectal cancer.
Epitome mapping of E6 and E7 proteins from high-risk oncogenic HPV types 16, 18 and 45
Authors: Xu Wan-Xiang , Tang Hai-Ping , Wang Jian , Zhan Jian-Min , Lian Wen-Bo , He Ya-Ping , Xue Feng , Wang Li , Xu Chen , Li Yijie , Zhang Ailian , Zhang Fuchun , Li Jinyao 
Published: February 2020

Abstract
Background It is crucial to reveal entire epitomes of more target homologous proteins and specificity of each mapped B cell epitope (BCE) within them for the development of high-risk (hr-) human papillomavirus (HPV) type-specific diagnostic reagents. Methods Recombinant E6 and -E7 oncoproteins from HPV16/18/45 were immunized mice to prepare Rabbit antisera. Overlapping 16mer/8mer-peptides for two rounds of antigenic peptide and fine BCE motif mapping were expressed as GST188 fusion proteins. Fine BCEs were delineated by Western blot and sequence alignment. Results In this work, we decoded six epitomes of E6 and E7 oncoproteins from three HPV types 16, 18 and 45 that are the most common hr-HPVs in cervical cancer patients worldwide, in which total 35 fine BCEs (8, 6 and 4 for E6; 7, 6 and 4 for E7) were mapped using rabbit antisera to respective recombinant proteins. The specificity of each mapped BCE among 20 defined or possible hr-HPVs was delineated by sequence alignment based on BCE minimal motif. According to similarities of immune responses to E6/E7 existed among rabbit and humans, 7 human-recognizing (HR) BCE motifs in HR-peptides of HPV16/18-E6 and E7 proteins were delimitated by comparing with corresponding rabbit-recognizing BCEs. Also, the unique BCE distribution within three delineated E7 epitomes was confirmed, in which almost mapped BCEs were clustered at the first half of the molecules, suggesting that it may be a common characteristic of hr-HPV E7 proteins. Conclusions The results would form the basis for identifying HR-BCEs and developing serodiagnostic reagents used in HPV-based cervical cancer screening and HPV-positive women managing.
Somatically derived Yolk Sac tumor of the urinary bladder: A case report and differential diagnosis
Authors: Espejo-Herrera Nadia , Mundó Enric Condom 
Published: February 2020

Abstract
Background: Yolk sac tumor is a germ cell neoplasm that arises predominantly in the gonads, but can also derive from somatic neoplasms in extragonadal locations. These cases have been denominated recently as “somatically derived Yolk sac tumors”, and have been documented in several locations, although reports from the urinary tract are scarce. To our knowledge, this is the first report of a Yolk sac tumor derived from urothelial carcinoma. Case presentation: We present a unique case of a 76-year-old man with a recurrent urinary bladder tumor, initially interpreted as a high grade urothelial carcinoma with glandular differentiation. In the recurrent tumor, diverse histological patterns were identified, including glandular, hepatoid and sarcomatoid. This tumor showed positivity for AFP, GLP3 and SALL4, and negativity for CK7 and EMA. Fluorescent in situ hybridization study showed a polysomic pattern of chromosome 12. All these findings led to the final diagnosis of a Yolk sac tumor derived from urothelial carcinoma. Conclusions: Somatically derived Yolk Sac tumors should be considered in the differential diagnosis of a high grade urothelial carcinoma, particularly when glandular and other unusual patterns are observed. Key words: Yolk sac tumor, somatically derived, urothelial carcinoma, urinary bladder, case report.
A longitudinal cohort of stress cardiomyopathy screening with speckle-tracking echocardiography after moderate to severe traumatic brain injury
Authors: Cinotti Raphael , Tourneau Thierry Le , Bach-Ngohou Kalyane , Manoir Maxime Le Courtois du , Masson Damien , Bouras Marwan , Mahé Pierre-Joachim , Roquilly Antoine , Rozec Bertrand , Asehnoune Karim 
Published: February 2020

Abstract
Background. Stress cardiomyopathy is common after subarachnoid haemorrhage but has been scarcely described after traumatic brain injury. Methods. Mono-centric longitudinal study in moderate to severe traumatic brain injury (Glasgow coma score ≤ 12). Evaluation of global longitudinal strain and 2-dimension trans-thoracic echography at day-1, day-3 and day-7. The primary outcome was the incidence of stress cardiomyopathy assessed with global longitudinal strain. Secondary outcomes were the relationship between global longitudinal strain and mortality, plasma levels of metanephrine and normetanephrine in patients with traumatic brain injury and subarachnoid haemorrhage to explore the mechanisms of stress cardiomyopathy. Results. We included 100 patients from March 2014 to August 2017. Twenty (20%) patients died in the intensive care unit. At day 1, global longitudinal strain (-20.3(±3.6)%) and left ventricular ejection fraction (65.9 (±10.8)%) were preserved. Nine (9%) patients displayed impaired global longitudinal strain (-13.3[-14.5/-11.6]%) at baseline, with significant improvement at day-3 and day-7 (p<0.0001), compatible with stress cardiomyopathy. There was a slight global longitudinal strain improvement at day-3 in the overall population ((-22.2 (± 3.6)%, p=0.004), but was similar to baseline at day-7 (-20.7(± 3.3)%). Global longitudinal strain was not related to mortality (p=1). In 15 subarachnoid haemorrhage and 15 traumatic brain injury patients matched with age and severity, there were no differences in baseline normetanephrine or metanephrine plasma levels. Conclusions. Stress cardiomyopathy could occur after traumatic brain injury, but global longitudinal strain remains preserved. The raised baseline metanephrine and normetanephrine is comparable in traumatic brain injury and subarachnoid haemorrhage patients. Thus, sympathetic hyperactivation is probably not the only mechanism involved in stress cardiomyopathy.
A novel and simple risk model predicts the prognosis for patients with paraquat poisoning
Authors: Gao Yanxia , Liu Liwen , Li Tiegang , Yuan Ding , Wang Yibo , Xu Zhigao , Cui Guangying , Hou Linlin , Zhang Yan , Duan Guoyu , Sun Changhua , Zhou Heqi , Che Lu , Li Sujuan , Li Yi , Ren Zhigang 
Published: February 2020

Abstract
Background: Acute paraquat (PQ) poisoning is characterized by multi-organ failure and lacking effective therapies. Therefore, identifying risk factors and developing model that could predict early prognosis for patients with PQ poisoning is of great importance. Methods: This was a retrospective cohort study employed with patients suffered from acute PQ poisoning (n=1199). Patients (n=913) with PQ poisoning from 2011 to 2018 were randomly divided into 2 mutually exclusive groups: training (609 patients) and test (304 patients). Another 2 external cohorts containing 207 cases from Zhengzhou 2019 were used as validation from different time and 79 from Shenyang as validation from different site. Risk factors were identified by a logistic model with Markov Chain Monte Carlo (MCMC) simulation and further evaluated by a latent class analysis. The prediction score of this model was developed based on the training sample and was further evaluated using the testing and validation samples. Results: Eight risk factors including age, ingestion volume, CK-MB, platelet (PLT), white blood cell (WBC), neutrophil counts (N), gamma-glutamyl transferase (GGT) and serum creatinine (Cr) were identified as in dependent risk indicators of in-hospital death events. The risk model had a C statistic of 0.895 (95% CI 0.855-0.928), 0.891 (95% CI 0.848-0.932) and 0.829 (95% CI 0.455-1.000) and a predictive range of 4.6%-98.2%, 2.3%-94.9% and 0%-12.5% for the test, validation_time and validation_site group, respectively. In the training group, the risk model classified 18.4%, 59.9% and 21.7% of patients into the high, average and low-risk groups, with corresponding probabilities of 0.985, 0.365, and 0.03 for in-hospital death events. Conclusion: Eight risk factors were identified in this study. And we developed and evaluated a simple risk model to predict the prognosis of patients with acute PQ poisoning. This simple and reliable risk score system could be helpful in recognizing high-risk patients and reducing in-hospital death rate due to PQ poisoning.
Molecular Characterization of Virulence Factors and Microbial Resistance of Different Bacterial Isolates in some Dairy Products
Authors: Alkhafaje Waleed K. , Ali Safaa Mohamed , Olama Zakia A. 
Published: February 2020

Abstract
Background: Bacterial contamination of milk and dairy products is a common problem. Foodborne microbial diseases reason for 20 million cases annually in the world. In the last two years, foodborne diseases caused by the intake of dairy products have been mostly disturbed with Salmonella entertica, Listeria monocytogenes Escherichia coli 0157:H7 and Campylobacter jejune. Aim of the study is to isolate MDR bacteria in dairy product and study of molecular characterization of that isolates.Results: A total 30 out of 131 bacterial isolates were MDR and distributed as 50 % from white cheese, 36.7% from industrial white cheese, 13.3 from old cheese and 6.6 % roomy cheese. The incidence of MDR bacterial isolates revealed the abundance of Staphylococcus sp. with 43.3% among all the tested bacterial isolates, while the other tested isolates showed Bacillus sp 16.7%, Salmonella 13.3%, E.coli 10 %, Enterococcus 6.7 % Psedoumonas 3.3 %, Shegella 3.3 % and Proteous 3.3 %. Molecular studies of genes presence or absence for class A (TEM, CTX and BSHV), class B (VIM, IMP, KPC and NDM), class C (FOX) and class D (OXA-10, OXA-24 and OXA-58) were tested. NDM, TEM, CITM and (OXA -10) genes were the most abundant the selected bacterial isolates.Conclusions: The results of this study indicate that cheese made from unpasteurized milk can pose a significant risk to consumers. Product manufacturing processes should be subject to health control-to-control pathogens. Reducing the surface area exposed to air reduces harmful microbial growth in dairy products.