bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combination of isoflurane and propofol, a means for general anesthesia in the orthopedic surgery of perioperative cerebral hypoperfusion rats to avoid cognitive impairment Anesthesia of perioperative cerebral hypoperfusion
Authors: Bu Xinyue , Li Tang , Wang Haiyun , Xia Zhengyuan , Guo Di , Wang Jinxin , Sun Yi , Yang Chenyi , Liu Guoqiang , Ma Ji , Yang Zhuo , Wang Guolin 
Published: November 2019

Abstract
Background: Perioperative cerebral hypoperfusion often occurs. However, the underlying mechanism of cognitive impairment resulting when perioperative cerebral hypoperfusion occurs remain mostly to be determined. Anesthetic isoflurane induces neuronal injury via endoplasmic reticulum (ER) stress, whereas sub-anesthetic dose of propofol improves postoperative cognitive function. However, the effects of the combination of isoflurane plus propofol, which is a common combination of anesthesia for patient, on ER stress and the associated cognitive function remain unknown.
Methods: We therefore set out to determine the effects of isoflurane plus propofol on the ER stress and cognitive function in the rats insulted by cerebral hypoperfusion. In order to get closer to the actual situation in the clinic, high incidence of fracture forces aging people to undergo surgeries needs general anesthesia, we introduce a surgery of tibial fracture with internal fixation to aging rats. The rats received isoflurane alone (1.9%), propofol alone (40 mg·kg-1·h-1) or a combination of isoflurane and propofol (1% and 20 mg·kg-1·h-1 or 1.4% and 10 mg·kg-1·h-1). Behavior studies (Fear Conditioning test), histological analyses (Nissl staining) and biochemical analyses (western blotting for the harvested rat brain tissues) were employed in the studies.
Results: We found that the combination of 1% isoflurane plus 20 mg·kg-1·h-1 propofol attenuated the cerebral hypoperfusion-induced cognitive impairment and the ER stress.
Conclusions: These data suggest that ER stress contributes to the underlying mechanism of cognitive impairment and the combination of isoflurane and propofol was able to preserve cognitive function in the rats after cerebral hypoperfusion via prevention of ER stress. These findings have established a system to study the strategy in preventing and treating perioperative cerebral hypoperfusion, leading to promotion of the future larger scale studies.
Comparative Efficacy of Glucocorticoid Receptor Agonists on Th2 Cell Function and Attenuation by Progesterone
Authors: Luchak Alexander , Author) Lauren A Solomon(Former Corresponding , Kanagalingam Tharsan , Vijeyakumaran Meerah , Rowe Brian H , Author) Lisa Cameron(New Corresponding 
Published: November 2019

Abstract
Background: Corticosteroids (CS) suppress cytokine production and induce apoptosis of inflammatory cells. Prednisone and dexamethasone are oral CS prescribed for treating asthma exacerbations. While prednisone is more commonly prescribed, dexamethasone is long acting and a more potent glucocorticoid receptor (GR) agonist. It can be administered as a one or two dose regime, unlike the five to seven days required for prednisone, a feature that increases compliance. We compared the relative ability of these two oral CS to suppress type 2 inflammation. Since progesterone has affinity for the GR and women are more likely to relapse following an asthma exacerbation, we assessed its influence on CS action. Results: Dexamethasone suppressed the level of IL-5 and IL-13 mRNA within Th2 cells with 10-fold less than prednisolone (the active form of prednisone). Dexamethasone induced a higher proportion of apoptotic and dying cells than prednisolone, at all concentrations examined. Addition of progesterone reduced their capacity to drive cell death, though dexamethasone maintained significantly more killing activity. Progesterone blunted dexamethasone-induction of FKBP5 mRNA, indicating the mechanism of action was by interference of the GC:GR complex. Conclusions: Dexamethasone is both more potent and effective than prednisolone in suppressing type 2 cytokine levels and mediating apoptosis. Progesterone attenuated these anti-inflammatory effects, indicating its potential influence on corticosteroid responses in vivo . Collectively, our data suggest that when oral corticosteroid is required, dexamethasone may be better able to control type 2 inflammation, eliminate Th2 cells and ultimately lead to improved long-term outcomes. Further research in asthmatics is needed
Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation
Authors: An Likun , Zhang Tongtong , Sun Xiangyao , Zhang Xinuo , Sun Siyuan , Hai Yong , Lu Shibao 
Published: November 2019

Abstract
Background: The thresholds of risk factors of kyphosis recurrence in thoracolumbar burst fracture patients were still controversial. The aim of this multi-center study was to identify these thresholds.
Methods: 169 patients were included in this study. Upper intervertebral angle (UIVA), lower intervertebral angle (LIVA), Cobb angle (CA), anterior vertebral height ratio (AVH%), regional angle (RA), posterior vertebral height ratio (PVH%), vertebral wedge angle (VWA), anteroposterior ratio (A/P%), Clinical assessment included Load Sharing Classification (LSC) score, Thoracolumbar Injury Classification and Severity (TLICS) score, Visual Analogue Scale (VAS), and Body mass index (BMI) were perioperatively evaluated. Patients were divided into KR group and none KR (NKR) group according to whether the loss of CA correction was less than 5˚ or not. The risk factors of KR before or after implant removal were analyzed, respectively.
Results: There were significant improvements in postoperative parameters compared with preoperative parameters, such as AVH%, A/P%, VAS, CA, VWA, PVH% (P < 0.001, respectively), and UIVA (P = 0.02). Age (AUC = 0.828) and BMI (AUC = 0.846) were good predictors of KR before implant removal. BMI (AUC = 0.871) was a good predictor of KR after implant removal.
Conclusions: There were significant differences in risk factors of KR at different postoperative follow-up stages: age > 49 years, BMI > 24 were risk factors of KR before implant removal; BMI > 25.17 was a risk factor of KR after implant removal.
Immediate implant placement in anterior teeth with grafting material of autogenous tooth bone vs xenogenic bone
Authors: Wu Dong , Zhou Lin , Lin Jichao , Chen Jiang , huang wenxiu , Chen Yonghui 
Published: November 2019

Abstract
Background: The aim of the study was to compare the efficacy of the autogenous tooth bone and xenogenic bone grafted in immediate implant placement with bone defect. Methods: Thirty patients whose compromised anterior teeth need immediate implant placement were enrolled. Autogenous tooth bone made from the extracted teeth by chair-side or the xenogenic bone were used to repaired bone defect. Clinical examination, radiographic assessment about the horizontal bone change in the level of 0mm, 3mm and 6mm below the implant neck and the marginal bone loss were made immediately, 6 and 12 months after implant placement. Questionnaire of the feelings about the surgery were made at the time of removing the sutures. Results: All implants achieved the success criteria without any complications at the follow-up period. The percent of the horizontal bone change and the marginal bone loss at 6 and 12 months were almost the same between two groups (P>.05). The horizontal bone loss at the first or the latter 6 months was almost the same (P>.05). But the horizontal bone loss at the 6 mm level was less than the 0 mm and 3 mm levels at 6 and 12 months (P<.05). Meanwhile patients seem more satisfied with the autogenous tooth bone derived from the questionnaire. Conclusion: The bone volume change in the facial part of the implant after immediate placement is almost the same between two groups. Providing clinical evidence that the autogenous tooth bone made from compromised tooth can be an acceptable bone graft material.
Percutaneous Mastoid Electrical Stimulator improves poststroke depression and cognitive function in patients with ischemic stroke
Authors: Lu Taoli , he lanying , Zhang Bei , Wang Jian , Zhang Lili , Dong WeiWei , Yang Hao 
Published: November 2019

Abstract
Backgrond Poststroke depression could lead to functional dependence, cognitive impairment and reduced quality of life. The aim of this study was to evaluate the effects of percutaneous mastoid electrical stimulator (PMES) plus antidepressant on poststroke depression and cognitive function.Methods 258 clinically depressed ischemic stroke patients within 14 d of index stroke were randomly assigned to PMES plus antidepressant (PMES group) and sham plus antidepressant (sham group). All patients underwent Montreal Cognitive Assessment (MoCA) and Hamilton Rating Scale for Depression (HRSD) test at 2 weeks (baseline), and 6 months after the stroke. The clinical outcome was defined as treatment response (≥50% reduction in HRSD) and depression remission (HRSD≤9) at 6 months.Results Compared with the sham group, PEMS group significantly improved MoCA and HRSD scoreat the end of the 6-month treatment period (P<0.001). The mean value of MoCA score change (3.50±2.55 vs 2.72±2.52; P=0.005), and HRSD score change (-11.93 ±5.32 vs -10.48 ± 6.10, P = 0.041) was significantly greater in the PMES group compared to sham group at 6 months. In fully adjusted models, PMES plus antidepressant was associated with increased treatment response rate [adjusted odds ratio (OR), 2.04; 95% confidence interval (CI), 1.15-3.63; P=0.015], and depression remission rate [adjusted OR, 1.83; 95% CI, 1.05-3.18; P=0.032]. In fully adjust models, PMES plus antidepressant was associated with decreased risk of 6-month MoCA score <26 (adjusted OR, 0.25; 95%CI, 0.09–0.70; P=0.008).Conclusion These findings demonstrate that PMES adjunctive to antidepressant therapy is highly effective in reducing depression, achieving remission in the short term, and improving cognition.
Evaluating differences in disease occurrence between two groups to determine the effect size of an observed factor based on a multi-variate model
Authors: Liu Hui 
Published: November 2019

Abstract
Background To describe a method to determine the effect size of an observed factor for a disease by evaluating the difference in the frequency of disease occurrence between exposed and unexposed groups.Methods A model of multiple pathogenic factors was established by analyzing the number and distribution of observed factors in a study population. The difference in the incidence between two groups (exposed and unexposed) was calculated according to the model.Results The distribution of observed factors in the population did not influence the difference in disease incidence between the two groups. However, the difference in incidence between the two groups was able to correctly reflect the number of factors combined in the models, and therefore, indicates that group differences in incidence is a reasonable indicator of effect size. Difference scores <0.25 indicate that one of four or more factors plays a role in a disease; scores >0.50 indicate one of two factors plays a role in disease and implies a high intensity level of the factor.Conclusions A difference in incidence between two groups over 0.25 is suggested as an indicator of a substantial effect size.
Nonlinear Trajectory of Estimated GFR Progression in HIV-Positive Patients with Normal Renal Function on Tenofovir - based Therapy in China: a retrospective observational cohort study
Authors: Liu Fang , Xu Aifang , Zhao Huaqing , Yang Zongxing , Chen Chen , Ranieri Brona , Bao Jianfeng , Zheng Guoxiang , Wang Miaochan , Wang Ying , Xun Yunhao 
Published: November 2019

Abstract
Background Estimated glomerular filtration rate (eGFR) trajectory in HIV-1-infected patients on tenofovir disoproxil fumarate (TDF) – based therapy has been widely assessed using linear models, but this linearity assumption is disputable and the nonlinearity of eGFR change remains unknown in patients with initially normal renal function. Methods This is a retrospective, observational cohort study in treatment-naïve HIV-1-infected patients in Hangzhou, China. Estimated GFR (calculated by MDRD equation) trajectories were compared by one-linear and piecewise-linear mixed effects models, before and after propensity matching, respectively. Whether the incidence of renal dysfunction (reduced renal function [RRF], eGFR < 90 mL/min/1.73 m² and rapid kidney function decline [RKFD], eGFR > -3 mL/min/1.73 m² /year) follows nonlinearity was assessed by logistic regression. Results We examined 823 (299 of TDF users and 524 of non-TDF users) treatment-naïve HIV-1-infected participants (age≥17 years) with initial eGFR greater than 90 mL/min/1.73m² . The median follow-up time was 10 (interquartile range, 2-20) months, during which 178 (21.6%) experienced RRF, and 451 (54.8%) experienced RKFD. In nonlinear adjusted model, the eGFR of TDF users decreased over time before 1.40 years (-5.31 mL/min/1.73 m² /year; 95% CI: -6.57, -4.06), and after 2.30 years (-3.71 mL/min/1.73 m² /year; 95% CI: -5.97, -1.45). However, the eGFR significantly improved from years 1.40 to 2.30 (4.83 mL/min/1.73 m² /year; 95% CI: 1.38, 8.28). Within this particular time frame, each year of TDF exposure was associated with a 78% decreased risk of RKFD (95% CI: -91%, -49%). In comparison, eGFR increased slightly at the initiation of antiviral therapy, declined after 2.15 years (-4.96 mL/min/1.73 m² /year; 95% CI: -5.76, -4.17) among non-TDF users. Such a progression nonlinear trajectory was missed on the assumption of one-linearity, whether in TDF or non-TDF users. Conclusion For HIV-1-infected Chinese initiated antiviral therapy with normal renal function, the nonlinear trajectory of renal function do exist, as revealed by the piecewise mixed effects model with advantage of speaking to the true nature of the exposure outcome relationships. Routine screen based on this nonlinear progression of eGFR, could be helpful for patient management.
Sex-specific patterns of senescence in artificial insect populations varying in sex-ratio to manipulate reproductive effort
Authors: Jehan Charly , Chogne Manon , Rigaud Thierry , Moret Yannick 
Published: November 2019

Abstract
Background The disposable soma theory of ageing assumes that organisms optimally trade-off limited resources between reproduction and longevity to maximize fitness. Early reproduction should especially trade-off against late reproduction and longevity because of reduced investment into somatic protection, including immunity. Moreover, as optimal reproductive strategies of males and females differ, sexually dimorphic patterns of senescence may evolve. In particular, as males gain fitness through mating success, sexual competition should be a major factor accelerating male senescence. In a single experiment, we examined these possibilities by establishing artificial populations of the mealworm beetle, Tenebrio molitor , in which we manipulated the sex-ratio to generate variable levels of investment into reproductive effort and sexual competition in males and females.Results As predicted, variation in sex-ratio affected male and female reproductive efforts, with contrasted sex-specific trade-offs between lifetime reproduction, survival and immunity. High effort of reproduction accelerated mortality in females, without affecting immunity, but high early reproductive success was observed only in balanced sex-ratio condition. Male reproduction was costly on longevity and immunity, mainly because of their investment into copulations rather than in sexual competition.Conclusions Our results suggest that T. molitor males, like females, maximize fitness through enhanced longevity, partly explaining their comparable longevity.
Pre-Hospital Low ALT Activity, a Marker of Sarcopenia and Frailty, is Associated with Increased Long-Term Mortality after COPD Exacerbations. Historic Prospective Cohort Study.
Authors: Lasman Nir , Shalom Matan , Turpashvili Natia , Goldhaber Gal , Lifshitz Yulia , Leibowitz Eyal , Berger Gideon , Zalzman-Shenhav Gilat , Brom Adi , Cohen Dor , Avaki Chen , Segal Gad 
Published: November 2019

Abstract
Background COPD exacerbations have negative impact on patients' survival. Several risk factors for grave outcomes of such exacerbations have been descried. Muscle dysfunction and mass loss were shown to impact negatively on prognosis and survival. Low activity of the enzyme ALT (Alanine amino-transferase) in the blood is a known indicator for sarcopenia and frailty, however, no previous studies addressed the association of low ALT amongst patients hospitalized due to COPD exacerbation and long-term survival. Methods. This is a historic prospective cohort study of patients hospitalized due to acute COPD exacerbation. Results. Included were 232 consecutive COPD exacerbation patients. The median time of follow-up was 34.9 months (IQR 23.13 – 41.73 months). During this period 104 (44.8%) patients died. All patients were grouped to quartiles according to blood ALT levels (after exclusion of cases considered to have hepatitis (ALT > 40 IU)). The risk of long-term mortality increased, in a statistically significant manner, amongst patients with low ALT values: the median survival of patients with ALT < 11 IU was 18.5 months only while the median survival for the rest of the study group was not reached. For ALT < 11IU; 12-16IU; 17-20IU and >21IU the mortality rates were 69%; 40.9%; 36.3% and 25% respectively (p < 0.001 for comparison of lower quartile with upper three quartiles). The crude hazard ratio for mortality amongst patients with ALT levels lower than 11IU was 2.37 (95% CI; 1.6 – 3.5). This increased risk of mortality remained significant after adjustment for age, weight, creatinine, albumin concentration and cardiovascular diseases (HR = 1.83; 95% CI 1.08 – 3.1, p < 0.05). Conclusions. Low ALT values, a biomarker of sarcopenia and frailty, are associated with poor long-term survival amongst patients hospitalized due to COPD exacerbation.
Clinical Characteristics and Organ System Involvement of the University of Minnesota Sarcoidosis Cohort
Authors: Sreng Hok , Perlman David M , Shenoy Chetan , Steinberger Daniel J , Cogswell Rebecca J , Roukoz Henri , Peterson Erik J , Zhang Lin , Allen Tadashi L , Bhargava Maneesh 
Published: November 2019

Abstract
Background: Sarcoidosis is a systemic granulomatous disease of unknown etiology. Clinical cohort studies of different populations are important to understand the high variability in clinical presentation and disease course of sarcoidosis. The aim of the study is to evaluate clinical characteristics, including organ involvement, pulmonary function tests, and laboratory parameters, in a sarcoidosis cohort at the University of Minnesota. Methods: We conducted a retrospective data collection and analysis of 187 subjects with biopsy-proven sarcoidosis seen at a tertiary center. Chi-square test or Fischer’s exact test was conducted for categorical variables, while Student’s t-test or analysis of variance was conducted for continuous variables, with p < 0.05 considered statistically significant. Results: Mean subject age at diagnosis was 45.8 ± 12.4, with a higher proportion of males (55.1%), and a higher proportion of blacks (17.1%) compared to the racial distribution of Minnesota residents (5.95%). The majority (71.1%) of subjects required anti-inflammatory therapy for at least 1 month. Compared to the A Case Control Etiologic Study of Sarcoidosis cohort, there was a higher frequency of extra-thoracic lymph node (34.2% vs. 15.2%), eye (20.9% vs. 11.8%), liver (17.6% vs. 11.5%), spleen (20.9% vs. 6.7%), musculoskeletal (9.6% vs. 0.5%), and cardiac (10.7% vs. 2.3%) involvement in our cohort. A multisystem disease with at least five different organs involved was identified in 13.4% of subjects. A restrictive physiological pattern was observed in 21.6% of subjects, followed by an obstructive pattern in 17.3% and mixed pattern in 2.2%. Almost half (49.2%) were Scadding stages II/III. Commonly employed disease activity markers, including soluble interleukin-2 receptor, angiotensin-converting enzymes, and C-reactive protein, did not differ between treated and untreated groups. Conclusions: This cohort features a relatively high frequency of high-risk sarcoidosis phenotypes including cardiac and multiorgan disease. Commonly-utilized serum biomarkers do not identify subpopulations that require or do better with treatment. Findings from this study present further the high-variability nature of sarcoidosis and the need for a more reliable biomarker to predict and measure disease severity and outcomes for better clinical management for sarcoidosis patients.
Pulmonary mucoepidermoid carcinoma: Clinicopathological characteristics of 20 cases and a literature review
Authors: Zhang Jing , Chen Yan Xiao , Qian Jun Zi , Yue Ping , Wang Jialei , Xiang Yi 
Published: November 2019

Abstract
Background: Pulmonary mucoepidermoid carcinoma is a rare tumor of the lung. The clinicopathological characteristics of pulmonary mucoepidermoid carcinoma are not well defined due to the low incidence. This study was performed to provide more supplementary clues for the identification and understanding of pulmonary mucoepidermoid carcinoma. Methods: We reviewed the medical records since January 1, 2000 to December 31, 2018. The patients’ medical records，including age at the time of diagnosis , gender, smoking history, preoperative evaluations, operative procedures, tumor location, tumor size, tumor stage, lymph node metastasis, pathological markers, prognosis and survival information were extracted and reviewed. Categorical variables were presented as parameters and percentages. A comparison was performed between patients with high and low grade of pulmonary mucoepidermoid carcinoma. Results: 20 patients were identified and the age span is from 18 to 67 year-old with the average age is 45. Mucoepidermoid carcinomas were commonly found in men（60%）. 80% patients had clinical presentations and the positive rate of tumor markers was 78%, although no specific tumor markers were found. TTF-1 were negative in all cases. ALK rearrangement was identified in a non-smoking woman with high grade pulmonary mucoepidermoid carcinoma. Surgery is the main procedure. 3-year survival rate is 72% and 80% patients achieved disease-free alive. High-grade patients tend to harbor older age (p=0.035), larger tumor volume (p=0.026) and higher index of ki-67(p=0.0005). Conclusions: Pulmonary mucoepidermoid carcinoma could occur in a wide age span. Early diagnosis and complete surgical resection may promise a good prognosis. Grading is a key factor to predict the overall survival time. Combined TTF-1 and MAML2 will benefit the identification of pulmonary mucoepidermoid carcinoma from other lung tumors. Future prospective randomized controlled trials and larger, multi-centric series are needed.