bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of stellate ganglion block on postoperative recovery of gastrointestinal function in patients undergoing surgery with general anaesthesia: a meta-analysis.
Authors: Wen Bei , Wang Yajie , Zhang Cong , Fu Zhijian 
Published: October 2020

Abstract
Background: The return of gastrointestinal function is an important sign of postoperative recovery in patients undergoing surgery with general anaesthesia. We aimed to summarize the effects of stellate ganglion block on the recovery of gastrointestinal function as a means of exploring methods through which anaesthesiologists can contribute to postoperative patient recovery. Methods: We performed a quantitative systematic review of randomized controlled trials published between January 1, 1988, and November 11, 2019, in PubMed, the Cochrane Library, China National Knowledge Infrastructure, Chinese VIP Information, and the Wanfang and SinoMed databases. Study quality was assessed using the revised Cochrane risk-of-bias tool for randomized trials. The time to peristaltic sound resumption, flatus, postoperative eating and the incidence of abdominal bloating in the stellate ganglion block and control groups were compared. The control group included patients in whom the stellate ganglion received an injection of normal saline or no treatment. Meta-analysis was performed using Review Manager software. Results: After searching for relevant articles, 281 studies were identified, and five articles with data on 274 patients were eligible. Regarding postoperative flatus time, stellate ganglion block resulted in a mean reduction of 15 hours (P=0.02); then a sensitivity analysis was performed, and the standard mean difference decreased to 6 hours (P=0.007). For gastrointestinal surgery, the mean reduction was approximately an entire day (P=0.0002). Regarding the evaluation of the recovery of peristaltic sounds, stellate ganglion block promoted the recovery of regular peristaltic bowel sounds an average of 14.67 hours earlier than in the control (P=0.0008). With regard to nutrients, stellate ganglion block shortened the total parenteral nutrition time by more than 50 hours in patients who had undergone gastrointestinal surgery (P＜0.00001). Finally, stellate ganglion block prevented the occurrence of postoperative abdominal bloating (P=0.001).) No complications related to stellate ganglion block were reported. Conclusion: Stellate ganglion block may promote postoperative gastrointestinal recovery in patients undergoing various surgeries under general anaesthesia. However, additional trials investigating the use of stellate ganglion block are necessary to confirm our finding. Trial registration: This meta-analysis has been registered at the International Prospective Register of Systematic Reviews (registration number CRD42020157602).
Urban malaria prevalence and its associated risk factors: the case of Batu town, East Shoa, Oromia Regional State, Ethiopia
Authors: Hassen Jifar , Dinka Hunduma 
Published: October 2020

Abstract
Background- Malaria is one of the leading causes of morbidity and mortality particularly in sub-Saharan Africa including Ethiopia. Approximately, 68% of its population is at a risk of malaria infection and nearly three-fourth of the Ethiopia landmass is considered as malarious. Most of the malaria related researches are being conducted in the rural areas; however, urban malaria should be also targeted without which malaria elimination is impossible. Therefore, the aim of this study was to assess the magnitude of malaria, prevalence of P. falciparum and P. vivax and its associated risk factors during low transmission season (April to July, 2018) in Batu town, East Shoa, Oromia Regional state, Ethiopia.Methods – Finger pricked blood samples were collected from 356 febrile individuals visiting health facilities in Batu town from April to July, 2018 supplemented with questionnaire survey to assess socio-demographic and risk factors associated with malaria infection.Results – In the current study an overall prevalence of 17.13% (61/356) malaria infection was observed of which 50.8% (31/61) were positive for P. vivax, 45.95% (28/61) were positive for P. falciparum and 3.3% (2/61) were mixed infections of P. falciparum and P. vivax. Male individuals (32 (9%)) were more infected with malaria than females (29 (8.2%)). Sex had no statistical significance association with malaria (χ2 = 2.026, P = 0.156). Logistic regression analysis revealed that individuals who possessed ITN (OR = 0.38, 95% CI (0.194, 0.743) and P = 0.005) and whose houses were sprayed with insecticides (OR = 0.18, 95% CI (0.097, 0.34) and P < 0.001) were found less likely to get malaria infection. Individuals living closer to stagnant water had more chance (almost three-fold times) of malaria infection than those who were found at a distant from stagnant water (OR= 2.97, 95% CI (1.68, 5.26) and P < 0.001).Conclusion- The current study revealed that malaria is still public health problem in Batu town, which might indicate the same in other urban areas of the country. Therefore, in order to get the national picture about the prevalence of urban malaria and its associated risk factors, we recommend large scale investigation of the situation.
Gene Therapy with Hepatocyte Growth Factor Improves Left Ventricular Systolic Function After Myocardial Infarction: A Systematic Review and Meta-analysis of Pig Models
Authors: Du Chong , Chen Xiao-Wen , Wang Ze-Mu , Meng Hao-Yu , Li Ya-Fei , Wei Tian-Wen , Wang Lian-Sheng 
Published: October 2020

Abstract
Background: Hepatocyte growth factor (HGF) is an angiogenic cytokine which can promote angiogenesis and inhibit fibrosis. Previous studies have shown that HGF may have significant therapeutic effects on ischaemic diseases, such as ischaemic heart disease and peripheral arterial occlusive disease. Due to insufficient clinical study evidence, we conducted a quantitative meta-analysis of HGF therapy in pigs with myocardial infarction (MI) to provide more reliable evidence for the feasibility and effectiveness of HGF therapy for MI patients. We also analysed the efficacy and characteristics of different gene therapy vectors and drug delivery routes.Methods: PubMed, EMBASE, and the China National Knowledge Infrastructure were searched for randomised studies that corresponded to our subject. The search terms included (hepatocyte growth factor OR HGF) AND (heart failure OR HF OR myocardial infarction OR MI OR AMI OR coronary heart disease OR CHD). The retrieved articles were screened strictly according to the inclusion criteria. The endpoints were the left ventricular ejection fraction (LVEF) and capillary density in the ischaemic regions in the model pigs.Results: A total of nine studies were eventually included in this meta-analysis. Our analysis showed that LVEF (with mean difference [MD]:9.73, 95%CI :8.70, 10.76, P < 0.00001) and capillary density (MD:79.98, 95%CI :24.58,135.39, P=0.005) in the HGF group were significantly higher than those in the control group several weeks after HGF treatment. Further analysis showed that there was no statistically significant difference in the improvement of LVEF caused by intracoronary adenovirus5-mediated HGF (Ad5-HGF) gene transfer and intramyocardial plasmid HGF injection (12.63±3.2 vs 9.4±1.09, P=0.06), while intramyocardial injection of plasmid HGF had a stronger angiogenic capacity than intramyocardial administration of Ad5-HGF and HGF in hydrogel (117.34±27.82 vs 26.45±22.11 vs 11.50±5.28, P＜0.00001).Conclusions: HGF therapy can effectively promote angiogenesis and recovery of cardiac function and is a promising cardiac repair method. Intracoronary Ad5 vector transfer and intramyocardial injection of plasmid vectors can be used as effective means of gene therapy, and hydrogel as a vector also has potential applications.
Effects of texture properties of semi-solid food on the sensory test for pharyngeal swallowing effort in the elderly
Authors: Park Jin-Woo , Lee Seul , Yoo Byoungseung , Nam Kiyeon 
Published: October 2020

Abstract
Background: Increasing viscosity can reduce the risk of aspiration into the airway, but conversely, very thick solid food may require greater strength and effort. We assumed that semi-solid foods with similar viscosities will behave differently in the oropharynx and there might exist the possibility that properties other than viscosity may have clinical relevance. This study aimed to find out the texture of semi-solid foods that affects the effort of pharyngeal swallow in the elderly. Methods: Nine kinds of semi-solid foods not requiring mastication were selected for texture profile analysis (TPA), and included whipped cream, mayonnaise, soft tofu, mango pudding, boiled mashed pumpkin, boiled mashed potatoes, boiled mashed sweet potatoes, red bean paste, and peanut butter. Hardness, adhesiveness and cohesiveness of each food were measured three times by using the rheometer. A blinded sensory test using a 9-point hedonic scale was also conducted in eighteen elderly people to investigate how much effort was required to swallow food, and how much of the food remained in the pharynx after swallowing. The correlation between texture and sensory outcome was statistically analyzed.Results: Foods that belonged to the same viscosity category showed different texture values, and the participants also rated different scores respectively. Only adhesiveness among three properties was significantly correlated with the sensory test. (r= 0.882, p=0.002 for difficult to swallow, r=0.879, p=0.002 for sense of residue).Conclusions: Adhesiveness was the most important property of the semi-solid foods, requiring most efforts in pharyngeal swallow in the elderly. If we select and provide food having low adhesiveness value in the same viscosity category, there might be the possibility to make it easier to swallow in older adults.
Serum interleukin-6 is an indicator for severity in 901 patients with SARS-CoV-2 infection: A cohort study
Authors: Zhang Jing , Hao Yiqun , Ou Wuling , Ming Fei , Liang Gai , Qian Yu , Cai Qian , Dong Shuang , Hu Sheng , Wang Weida , Wei Shaozhong 
Published: October 2020

Abstract
Background: Interleukin-6 (IL-6) was proposed to be associated with the severity of coronavirus disease 2019 (COVID-19). The present study aimed to explore the kinetics of IL-6 levels, validate this association in COVID-19 patients, and report preliminary data on the efficacy of IL-6 receptor blockade. Methods: We conducted a retrospective single-institutional study of 901 consecutive confirmed cases. Serum IL-6 concentrations were tested on admission and/or during hospital stay. Tocilizumab was given to 16 patients with elevated IL-6 concentration. Results: 366 patients were defined as common cases, 411 patients as severe, and 124 patients as critical according to the Chinese guideline on diagnosis and treatment of COVID-19. The median concentration of IL-6 was <1.5 pg/ml (IQR <1.50-2.15), 1.85 pg/ml (IQR <1.50-5.21), and 21.55 pg/ml (IQR 6.47-94.66) for the common, severe, and critical groups respectively (P＜0.001). The follow-up kinetics revealed serum IL-6 remained high in critical patients even when cured. An IL-6 concentration higher than 37.65 pg/ml was predictive of in-hospital death (AUC 0.97 [95%CI 0.95-0.99], P<0.001) with a sensitivity of 91.7% and a specificity of 95.7%. In the 16 patients who received tocilizumab, IL-6 concentrations were significantly increased after administration, and survival outcome was not significantly different from that of propensity-score matched counterparts (n=53, P=0.12). Conclusion: Serum IL-6 should be included in diagnostic work-up to stratify disease severity, but the benefit of tocilizumab needs further confirmation.Trial registration: retrospectively registered.
Correlation Between the Thyroid Hormone Levels and Nonalcoholic Fatty Liver Disease in Type 2 Diabetic Patients with Normal Thyroid Function
Authors: Zhang Yuanyuan , Liu Huaizhen , Li Juyi , Li Ling , Zhang Jinjun , Wang Yan , Zhang Zhimian 
Published: October 2020

Abstract
Background: The objective of this study is to retrospectively analyze the correlation between the thyroid hormones and nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) patients with normal thyroid function. Methods: Totally 586 T2DM patients with normal thyroid function participated in this research and were divided into T2DM without NAFLD (240 cases) group and T2DM with NAFLD (346 cases) group. The NAFLD fibrosis score (NFS) >0.676 was defined as progressive liver fibrosis and used to categorize the patients into T2DM without progressive liver fibrosis group (493 cases) and T2DM with progressive liver fibrosis group (93 cases). Results: The results indicated that the levels of free triiodothyronine (FT3) and total triiodomethylamine (TT3) were significantly higher while the free thyroxine (FT4) level was lower in T2DM with NAFLD group than that in T2DM2 without NAFLD group (p<0.05). The levels of FT3, FT4 and TT3 in patients with progressive liver fibrosis were significantly lower in patients with progressive liver fibrosis than that in patients without progressive liver fibrosis (p<0.05). Logistic regression analysis showed a negative relationship between FT4 level and NAFLD (p=0.026), between the levels of FT4,TT3 and total thyroxine (TT4) and the risk of progressive hepatic fibrosis (p=0.022, p=0.007,p=0.046).Conclusion: There is a certain correlation between thyroid hormone levels and NAFLD in T2DM patients, suggesting that the assessment of thyroid hormone levels in T2DM patients with normal thyroid function is of great significance in the prevention and treatment of NAFLD.
The transverse diameter of right common femoral vein by ultrasound in the supine position for predicting post-spinal hypotension during cesarean delivery.
Authors: Yao Shi-Fa , Zhao Yan-Hong , Zheng Jing , Qian Jie-Yan , Zhang Chen , Xu Zifeng , Xu Tao 
Published: October 2020

Abstract
Background: Post-spinal anesthesia hypotension during cesarean delivery is caused by decreased systemic vascular resistance due to the blockage of autonomic nerves, which is further worsened by inferior vena cava (IVC) compression by the gravid uterus. The aim of this study was to assess whether peak velocity and diameter of IVC below the xiphoid or the right common femoral vein (RCFV) in the inguinal region, as measured on ultrasound, could reflect the degree of IVC compression and further identify parturients at risk of post-spinal hypotension.
Methods: After ultrasound measurement of peak velocities and anteroposterior diameters of the IVC and peak velocities and transverse diameters of the RCFV before anesthesia, 56 parturients undergoing elective cesarean section with spinal anesthesia were enrolled in this study. Hypotension was defined as having a drop of systolic arterial pressure >20% from the baseline. The primary outcome was ultrasound measurements of IVC and RCFV, and their association with post-spinal hypotension during cesarean delivery. Multinomial logistic regression analysis was used to identify the association between the measurements of ICV, RCFV and post-spinal hypotension during cesarean delivery. Receiver operating characteristic curves were used to test the abilities of the identified parameters to predict post-spinal hypotension, and the areas under the curve and the optimum cut-off values for the predictive parameters were calculated.
Results: Longer transverse diameter of the RCFV was associated with the occurrence of post-spinal hypotension (odds ratio = 2.022, 95% confidence interval [CI] 1.261–3.243). The area under the receiver operating characteristics curve for the prediction of post-spinal hypotension was 0.759 (0.628–0.890; P = 0.001). A transverse diameter of the RCFV >12.2 mm could predict post-spinal hypotension during cesarean delivery.
Conclusions: We demonstrated a longer transverse diameter of RCFV was associated with hypotension and it could predict parturients at major risk of hypotension before anesthesia.
Does Patient Gender Influence Medical Care Among Students? Evaluation During an Objective Structured Clinical Examination
Authors: Boudec Joana Le , Félix Sylvie , Gachoud David , Monti Matteo , Barazzoni Mirjam Schuler , Clair Carole 
Published: October 2020

Abstract
Background: Gender bias induces gender inequality in health. In this study, we evaluated gender bias during a local objective structured clinical examination (OSCE). Methods: We assessed gender bias by using two clinical cases—generalized anxiety disorder (GAD) and ascending aorta dissection (AAD)—during an OSCE performed among fifth-year medical students. For each situation, half of the students encountered male and half encountered female standardized patients (SPs). Except for gender, variables were identical in each clinical case. Patients, students, and examiners were blinded to the purpose of the study. Medical history, clinical examination, diagnosis, and management were compared between male and female SPs. The interaction between student and SP gender was analyzed. Results: A total of 110 medical students were observed (55% women). For GAD, students arrived at the correct diagnosis more often for female SPs than for male SPs (diagnosis completed, partially completed, and not completed in 47%, 16%, and 36%, respectively, of female SPs vs. 22%, 20%, and 58%, respectively, of male SPs, p = 0.02). The nature of their symptoms was more often asked of male SPs (completed, partially completed, and not completed in 51%, 4%, and 0% of male SPs, respectively, vs. 38%, 17%, and 0% of female SPs, respectively, p = 0.002), and associated physical symptoms were more often explored in female SPs (completed and not completed in 84% and 16% of female SPs, respectively, vs. 65% and 35% of male SPs, respectively, p = 0.03). For AAD, an emergency was better identified in female SPs (95% identified in female SPs vs. 76% in male SPs, p = 0.005) and examination of femoral pulses was more often performed in female SPs (88% completed in female SPs vs. 54% in male SPs, p < 0.0001). The interaction between SP and student gender was not significant. Conclusion: The gender bias observed supports the need to address unconscious biases and to raise student awareness of gender stereotypes likely to lead to underrecognition or subtreatment of disease in patients of both genders.
Pulmonary cavitation – an under-recognized late complication of severe COVID-19 lung disease
Authors: Zoumot Zaid , Bonilla Maria-Fernanda , Wahla Ali S. , Shafiq Irfan , Uzbeck Mateen , El-Lababidi Rania M. , Hamed Fadi , Abuzakouk Mohamed , ElKaissi Mahmoud 
Published: October 2020

Abstract
Background: Pulmonary radiological findings of the novel coronavirus disease 2019 (COVID-19) have been well documented and range from scattered ground-glass infiltrates in milder cases to confluent ground-glass change, dense consolidation, and crazy paving in the critically ill. However, lung cavitation has not been commonly described in these patients. The objective of this study was to assess the incidence of pulmonary cavitation in patients with COVID-19 and describe its characteristics and evolution.Methods: We conducted a retrospective review of all patients admitted to our institution with COVID-19 and reviewed electronic medical records and imaging to identify patients who developed pulmonary cavitation.Results: Twelve out of 689 (1.7%) patients admitted to our institution with COVID-19 developed pulmonary cavitation, comprising 3.3% (n=12/359) of patients who developed COVID-19 pneumonia, and 11% (n=12/110) of those admitted to the intensive care unit. We describe the imaging characteristics of the cavitation and present the clinical, pharmacological, laboratory, and microbiological parameters for these patients. In this cohort six patients have died, two are recovering in hospital and four have been discharged home. Conclusion: Cavitary lung disease in patients with severe COVID-19 disease is not uncommon, and is associated with a high level of morbidity and mortality.
RNA-Sequencing Profiling Analysis of Pericyte-Derived Extracellular Vesicle-Mimetic Nanovesicles-Regulated Genes in Primary Cultured Fibroblasts From Normal and Peyronie’s Disease Penile Tunica Albuginea
Authors: Yin Guo Nan , Piao Shuguang , Liu Zhiyong , Wang Lei , Ock Jiyeon , Kwon Mi-Hye , Kim Do-Kyun , Gho Yong Song , Suh Jun-Kyu , Ryu Ji-Kan 
Published: October 2020

Abstract
BackgroundPeyronie’s disease (PD) is a severe fibrotic disease of the tunica albuginea that causes penis curvature and leads to penile pain, deformity, and erectile dysfunction. The role of pericytes in the pathogenesis of fibrosis has recently been determined. Extracellular vesicle (EV)-mimetic nanovesicles (NVs) have attracted attention regarding intercellular communication between cells in the field of fibrosis. However, the global gene expression of pericyte-derived EV-mimetic NVs (PC-NVs) in regulating fibrosis remains unknown. Here, we used RNA-sequencing technology to investigate the potential target genes regulated by PC-NVs in primary fibroblasts derived from human PD plaque. MethodsHuman primary fibroblasts derived from normal and PD patients was cultured and treated with cavernosum pericytes isolated extracellular vesicle (EV)-mimetic nanovesicles (NVs). A global gene expression RNA-sequencing assay was performed on normal fibroblasts, PD fibroblasts, and PD fibroblasts treated with PC-NVs. Reverse transcription polymerase chain reaction (RT-PCR) was used for sequencing data validation. ResultsA total of 4135 genes showed significantly differential expression in the normal fibroblasts, PD fibroblasts, and PD fibroblasts treated with PC-NVs. However, only 91 contra-regulated genes were detected among the three libraries. Furthermore, 20 contra-regulated genes were selected and 11 showed consistent changes in the RNA-sequencing assay, which were validated by RT-PCR. ConclusionThe gene expression profiling results suggested that these validated genes may be good targets for understanding potential mechanisms and conducting molecular studies into PD.
Preoperative Anemia and Thrombocytosis Predict Adverse Prognosis in Non-Metastatic Renal Cell Carcinoma With Tumor Thrombus
Authors: Ma Lulin , Ruotao Xiao , Chuxiao Xu , Wei He , Lei Liu , Hongxian Zhang , Cheng Liu 
Published: October 2020

Abstract
Objection: The aim of the study was to determine the prognostic value of preoperative blood parameters in patients with renal cell carcinoma (RCC) and tumor thrombus (TT) treated surgically.Method: we retrospectively analyzed 152 patients diagnosis with RCC and TT and treated surgically. Clinicopathologic data and blood parameter were obtained. Univariable and multivariable analysis using the Cox regression model were performed to determine risk factors that were associated with progression-free survival (PFS) and overall survival (OS). Kaplan-Meier curve and logistic regression were performed to analyze the risk factors.Results: Preoperative Hgb＜120g/L (HR=2.48, P=0.024) and lymph node metastasis (HR=3.98, P=0.032) were an independent prognostic factors associated with OS. Preoperative PLT≥300×109/L (HR=2.10, P=0.014) and lymph node metastasis (HR=3.42, P=0.021) were an independent prognostic factors associated with PFS. In Kaplan–Meier survival analysis, preoperative anemia had worse OS than without anemia (P=0.003) and thrombocytosis had worse PFS than without thrombocytosis (P=0.001). Preoperative anemia were associated with more symptomatic (P=0.009), surgical time≥6h (P=0.016), Blood loss≥1000ml (P=0.014), transfusion(P=0.012), higher thrombus level (III-IV) (P=0.004) and higher nuclear grade (III-IV) (P=0.002) while thrombocytosis were associated with more symptomatic (P=0.008) and higher nuclear grade (III-IV) (P=0.042)Conclusions: Preoperative anemia and thrombocytosis was associated with adverse prognosis in patients with non-metastatic RCC with TT. Both preoperative hemoglobin level and platelet count may be clinical useful for risk stratifying patients receiving operation for non-metastatic RCC with TT.