bluuebunny/crossref_metadata_2025_split huggingface dataset:
High expression of ghrelin and obestatin prepropeptide in tumor tissues predicted adverse overall survival in gastric carcinoma patients
Authors: Wu Xiandan , Wu Yongning , Ye Binhua , Wu Fubin , Wang Peien 
Published: June 2020

Abstract

Background:
Gastric cancer (GC) is the most prevailing digestive tract malignant tumor worldwide with high mortality and recurrence rates. However, its potential molecular mechanism and prognostic biomarkers are still not fully understood. We aim to screen novel prognostic biomarkers related to GC prognosis using comprehensive bioinformatic tools.

Methods:
Four gene expression microarray data were downloaded from the Gene Expression Omnibus (GEO) database (GSE26942, GSE33335, GSE63089, and GSE79973). Differentially expressed genes (DEGs) between gastric carcinoma and normal gastric tissue samples were identified by an integrated bioinformatic analysis. Gene Ontology (GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed using statistical software R. STRING and Cytoscape software were employed to construct protein–protein interaction (PPI) networks. Hub genes with a high score of connectivity identified from the PPI network were identified. Prognostic values of hub genes were evaluated in GSE15459 dataset. Hub genes related to GC overall survival were further validated in GEPIA (Gene Expression Profiling Interactive Analysis) online tool.

Results:
A total of 12 upregulated DEGs and 59 downregulated DEGs were identified when the 4 microarray data overlapped. Among them, 10 hub genes with a high score of connectivity were identified. High expression of ghrelin and obestatin prepropeptide (GHRL), BGN, TIMP metallopeptidase inhibitor 1, thrombospondin 2, secreted phosphoprotein 1, and low expression of CHGA were associated with a poor overall survival of gastric cancer (all log rank P < .05). After validation in GEPIA database, only GHRL was confirmed associated with a poor overall survival of gastric cancer (log rank P = .04).

Conclusions:
GHRL could be used as a novel biomarker for the prediction of a poor overall survival of gastric cancer, and could be a novel therapeutic target for gastric cancer treatment. However, future experimental studies are still required to validate these findings.
Association between pentraxin-3 and the risk of preeclampsia
Authors: Xiong Zhihui , Wang Xinchen , Jiang Sicong , Jin Meiyuan , Chen Wenzeng 
Published: June 2020

Abstract
An association between circulating pentraxin-3 (PTX3) and the risk of preeclampsia (PE) remains to be established. We performed a meta-analysis of observational studies to evaluate their relationship.
The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and WanFang databases were searched for related observational studies evaluating PTX3 and PE risk. A random-effects or a fixed-effects model was used in the meta-analysis, depending on the heterogeneity among the included studies.
Nine case–control studies were included, with 396 PE patients and 438 controls. The results showed that PTX3 was significantly higher in pregnant women with PE as compared to those without PE (standardized mean difference [SMD] = 2.48, P < .001), with significant heterogeneity (I2 = 98%), particularly for those over 30 years old (SMD = 3.75, P < .001). Subsequent analyses showed that patients with severe or early-onset PE had higher PTX3 levels compared to those with mild or late-onset PE (SMD = 0.93, P = .01), suggesting that PTX3 may be a marker of PE severity. The association between PTX3 and PE was not significantly affected by the statistical method used. Sensitivity analyses by omitting one study at a time did not significantly affect the results. However, the funnel plots were asymmetric, suggesting the potential existence of publication bias.
PTX3 may be related to the risk and severity of PE in pregnant women. These results should be evaluated and confirmed in cohort studies.
Effects of hepatic arterial infusion chemotherapy in the treatment of hepatocellular carcinoma
Authors: Long Guan-Bao , Xiao Chao-Wen , Zhao Xin-Yang , Zhang Jun , Li Xin 
Published: June 2020

Abstract

Background:
The potential benefits and safety of hepatic arterial infusion chemotherapy (HAIC) for the treatment of patients with hepatocellular carcinoma (HCC) remains inconsistent. Therefore, we conducted this meta-analysis of evaluate the efficacy and safety of HAIC in the treatment of HCC.

Methods:
A comprehensive literature search was performed using PubMed, Embase, Web of Science, and the Cochrane library to identify eligible studies that compared HAIC with other therapies for patients with HCC. The main outcomes of our interest, including overall survival (OS), disease free survival (DFS), objective response rate (ORR), disease control rate (DCR), and adverse events, were calculated using the meta-analysis. The pooled estimates were expressed with hazard ratio (HR) with 95%confidence intervals (95%CIs) or risk ratio (RR) with 95%CIs.

Results:
A total of 13 studies met the inclusion criteria and were included in this meta-analysis. Pooled estimates showed that, HAIC was associated with significantly improved OS (HR = 0.61, 95%CI: 0.48, 0.77; P < .001) and DFS (HR = 0.66, 95%CI: 0.52, 0.84; P = .001) as compared with other therapies. The ORR (RR = 2.28, 95%CI: 1.77, 2.94; P < .001) and DCR (RR = 1.47, 95%CI: 1.23, 1.77; P < .001) were also significantly higher in HAIC group than in control group. Most of the common adverse events were comparably occurred in the 2 groups, except for nausea/vomiting, hypoalbuminemia, pain, anemia and hepatic toxicity. Subgroup analysis suggested that, the improved OS and DFS associated with HAIC were only observed in patients with colorectal liver metastases (CRLM), or advanced HCC, but not in those with unresectable HCC or pancreatic liver metastases.

Conclusion:
Based on the present data, HAIC showed benefit effect in HCC patients, with pronged OS and DFS, as well as increased ORR and DCR. These benefit effects were more obvious in CRLM or advanced HCC patients. However, considering the potential limitations, more large-scale, randomized trials are needed to verify our findings.
Effect of Xingnaojing injection for the treatment of acute alcoholism
Authors: Wu Xian , Yang Li-jie , Gao Peng , Qiao Zhi-li , Xu Dan , Zhang Fu-hua 
Published: June 2020

Abstract

Background
This study will assess the effect of Xingnaojing injection (XNJI) for the treatment of acute alcoholism (AAH).

Methods:
The bibliographic literature sources will be systematically searched in MEDLINE, EMBASE, Cochrane Library, China National Knowledge Infrastructure Database, Wan fang Database, and VIP Science Technology Periodical Database. All above electronic databases will be sought from inception to the April 1, 2020. We will not apply any limitations to language and publication time. In addition, we will also search other literature sources. Two reviewers will carry out study selection, data extraction, and methodological quality evaluation, respectively. Any divergences will be resolved by a third reviewer through discussion. We will use RevMan 5.3 software to analyze data analysis.

Results:
This study will summarize present evidence to assess the effect of XNJI for the treatment of AAH.

Conclusion:
This study will investigate whether XNJI is effective and safety for AAH.

Systematic review registration:
INPLASY202040197.
Efficacy of deep convolutional neural network algorithm for the identification and classification of dental implant systems, using panoramic and periapical radiographs
Authors: Lee Jae-Hong , Jeong Seong-Nyum 
Published: June 2020

Abstract
Convolutional neural networks (CNNs), a particular type of deep learning architecture, are positioned to become one of the most transformative technologies for medical applications. The aim of the current study was to evaluate the efficacy of deep CNN algorithm for the identification and classification of dental implant systems.
A total of 5390 panoramic and 5380 periapical radiographic images from 3 types of dental implant systems, with similar shape and internal conical connection, were randomly divided into training and validation dataset (80%) and a test dataset (20%). We performed image preprocessing and transfer learning techniques, based on fine-tuned and pre-trained deep CNN architecture (GoogLeNet Inception-v3). The test dataset was used to assess the accuracy, sensitivity, specificity, receiver operating characteristic curve, area under the receiver operating characteristic curve (AUC), and confusion matrix compared between deep CNN and periodontal specialist.
We found that the deep CNN architecture (AUC = 0.971, 95% confidence interval 0.963–0.978) and board-certified periodontist (AUC = 0.925, 95% confidence interval 0.913–0.935) showed reliable classification accuracies.
This study demonstrated that deep CNN architecture is useful for the identification and classification of dental implant systems using panoramic and periapical radiographic images.
Clinical effects of slim-diet, with lifestyle modification for childhood obesity in community-based healthcare program
Authors: Kim Koh-Woon , Kim So-Jin , Kim Hojun , Shin Seung-Uoo , Song Jaechul , Chung Won-Seok 
Published: June 2020

Abstract

Rationale:
Although there are several reports on the effect of herbal medicine on weight loss in adults, evidence supporting its efficacy and safety in obese pediatrics is insufficient. Herein, we clinically investigated the preliminary experience of community-based healthcare program in cases of childhood obesity treated with an herbal complex, Slim-diet (SD), along with lifestyle modification.

Patient concerns:
Seventeen subjects with childhood obesity participated in a community-based healthcare program, which consisted of twice-a-week play type physical activity and dietary counseling program with simultaneous twice-a-day administration of SD for 4 weeks.

Diagnoses:
The data of 13 obese pediatrics (body mass index [BMI] ≥ the 95th percentile for children of the same age and sex) in their 3rd to 6th grade who finally completed at least 6 visits out of a total of 8 visits of the program including baseline and endpoint assessments were analyzed.

Interventions:
Participants received 20 g of SD daily. Simultaneously, play-type physical activity program with an exercise therapist and dietary counseling with a dietitian for lifestyle modification were conducted at every visit. Body composition, blood chemistry, the Korean Youth Physical Activity Questionnaire (KYPAQ) score, and the preference for salt density and sugar content were assessed at baseline and endpoint.

Outcomes:
After SD administration, body mass index decreased from 26.74 ± 2.11 kg/m2 to 26.50 ± 2.20 kg/m2 (P < .05) with statistically significant increases in height, weight, and skeletal muscle mass. The results of blood chemistry and the KYPAQ score showed no significant change. The preferences for salt density were improved in 8, maintained in 2, and worsened in 3 participants and those for sugar content were improved in 6 and maintained in 7 participants with no worsening.

Lessons:
In the present study, we showed the clinical effects of SD with lifestyle modification in patients with childhood obesity who participated in community-based healthcare program. Further clinical studies investigating the effects of SD are required.
Gout and the risk of epilepsy
Authors: Chen Hung-Lin , Hsu Yi-Chao , Chen Chang-Hsu , Wang Pei-Jen , Lin Cheng-Li , Cheng Sheng-Han , Chang Kuang-Hsi 
Published: June 2020

Abstract
Gout is a chronic disease related to uric acid metabolism. It involves crystals of uric acid accumulating in the joints, causing joint pain and releasing cytokines that trigger inflammation. Inflammation is a key component in the pathogenesis of epilepsy. Thus, we conducted a cohort study to investigate if epilepsy is associated with gout and determine the risk of epilepsy in patients with gout.
The gout cohort was obtained from the Registry of Catastrophic Illnesses Patient Database (RCIPD). We identified 104,238 patients who were aged 20 years or more and newly diagnosed with gout between 2000 and 2011 and 3 outpatient visits or history of gout-specific hospitalization between 2000 and 2011. Patients without gout were frequency matched with the gout cohort at a 2:1 ratio according to age, sex, comorbidities, and year of gout diagnosis.
The gout cohort showed a 1.27-fold higher overall crude hazard ratio (HR) for epilepsy compared with the control cohort. After we adjusted the analyses by age, sex, and comorbidities the gout patients displayed an increased risk of epilepsy compared with the control group (adjusted HR = 1.25, 95% confidence interval = 1.15–1.36).
This study revealed a significantly higher risk of epilepsy in patients with gout. It provides further evidence for the debate around the effect of gout on brain health.
Effects of ipratropium bromide on the occurrence of postoperative respiratory complications in craniectomy patients with COPD
Authors: Du Zhuoying , Huang Xiaoqian , Feng Yi , Yan Wei , Xu Dan , Sun Xiaoou , Wu Chao , Zheng Yongke , Zeng Longhuan , Xiong Xiaowei , Liu Yuankun , Zhang Chenbo , Luo Jianfeng , Hu Jin 
Published: June 2020

Abstract

Introduction:
Postoperative pulmonary complications (PPCs) are common and associated with increased morbidity, mortality, and medical cost. They are gaining increasing concerns among patients receiving neurological surgery. Chronic obstructive pulmonary disease (COPD) affect a large section of whole population and is also one of the risk factors of PPCs in the perioperative setting. Ipratropium bromide is the inhalation solution for the treatment of COPD. Studies showed the perioperative nebulization of ipratropium bromide could increase the lung function and decrease the incidence of postoperative pneumonia in COPD patients underwent thoracic surgery. The purpose of this study is to investigate the effect of perioperative nebulization of ipratropium bromide on PPCs in COPD patients underwent neurosurgical surgery.

Methods and analysis:
This study is a multicenter retrospective study in China. Patients who meet the inclusion/exclusion criteria are selected from 7 neurosurgical centers in China. According to whether ipratropium bromide is used in perioperative period, the patients are divided into exposure group and control group. The primary outcome is the incidence of postoperative pneumonia. Secondary outcomes are unplanned intubation, postoperative mechanical ventilation ≥ 48 hours, respiratory failure, atelectasis, death, and length of stay.

Ethics and dissemination:
This study was approved by the ethics committee (EC) of the School of Public Health, Fudan University, Shanghai, China. Waived by the ethics committee, no written consent form was obtained since we used the registry data. The study results will be communicated via publication.

Trial Registration Number:
ChiCTR1900022552.
Spontaneous subepithelial hemorrhage of renal pelvis and ureter (Antopol-Goldman lesion) in hemophilia A patient with inhibitor
Authors: Sahin Taha Koray , Aladag Elifcan , Setterzade Emil , Guven Gulay Sain , Haznedaroglu Ibrahim Celalettin , Aksu Salih 
Published: June 2020

Abstract

Introduction:
The Antopol-Goldman lesion (AGL), which expresses subepithelial hemorrhage in the renal pelvis, was first defined by Antopol and Goldman in 1948. The objective of this study is to report the first case of AGL in patients with congenital hemophilia and review the relevant literature.

Patient concerns:
A 32-year-old male patient diagnosed with congenital hemophilia A (FVIII = %4) with high responding inhibitors (7.4 BU) was admitted to our emergency department with gross hematuria and sudden onset flank pain.

Diagnosis:
Abdominal computed tomography (CT-scan) presented a hyperdense lesion in the left ureteropelvic junction with Hounsfield Units of 56 compatibles with hemorrhage.

Interventions:
The patient was given 4500 IU of factor eight inhibitor bypass activity (FEIBA) intravenously twice daily for 5 days. Subsequently, 4500 IU of FEIBA was administrated once a day for 2 days.

Outcomes:
The patient's complaints disappeared on the fourth day of treatment. Macroscopic and microscopic hematuria was not seen in the following days. Follow-up CT was done 3 months after discharge and showed normal left renal pelvis without hyperdenosis. Follow-up CT was performed 3 months after discharge and presented normal left renal pelvis with no hyperdense lesion.

Conclusion:
Although very rare, AGL should be kept in mind in the differential diagnosis of renal pelvic hemorrhage. In the patient who has an underlying history of coagulopathy nephrectomy can be avoided when there is awareness of AGL.
A combination of bimalleolar fracture and fracture on talar body and neck
Authors: Chen Kuan-Ju , Ko Chih-Yuan , Ho Tsung-Yu , Chen Hsien-Te , Hsu Horng-Chaung , Hung Chih-Hung 
Published: June 2020

Abstract

Rationale:
Talar fracture accompanied with malleolar fracture is rare, and its management is complex. Ankle soft tissue is much thinner than other parts of the human body, and the shape of the ankle makes wounds difficult to close immediately after surgery, which may result in poor skin condition if the wound tension is too high. However, joint congruity and osteonecrosis are the main concerns of talar fracture.

Patient concerns:
A 57-year-old man presented at the emergency department following a motorcycle accident.

Diagnoses:
Physical examination revealed swelling and tenderness of the left ankle and midfoot. The patient had comminuted talar fracture and was indicated for dual-screw fixation or even plate with screw fixation.

Interventions:
We performed single screw fixation after assessing the soft tissue condition and employed a technique of using continuous longitudinal force to bring together fracture fragments (ankle ligamentotaxis) during surgery. Open reduction with a mini-hook plate and tension band wire was used for bimalleolar fracture repair using the combined anteromedial and anterolateral approach with extension of the incision. Kirschner wire for temporary fixation was performed using ligamentotaxis, and a 2.4 headless screw was inserted from the posteromedial to the anterolateral direction.

Outcomes:
The patient was discharged with a standard short leg splint and was instructed not to bear weight on the affected ankle for 2 months. The patient walked well without discomfort, and the Hawkins sign was clearly visible. Single screw fixation preserves the integrity of the talus bone as minimal space is used for this operative technique. Single screw fixation preserves more bony stock when most of the internal fixator is located within the bone. Additionally, surgery time is shorter than multiple implantations even when performing the same procedure; as a result, there was less ankle soft tissue swelling.

Lessons:
This case provides evidence of using the single screw fixation technique for addressing both malleolar and talar fractures, and that talar fracture management can be less aggressive with limited weight bearing and initial limited range of motion given the presence of malleolar fracture. The alignment and stability of bony fragments also benefit from ankle ligamentotaxis.
Clinical massage therapy for patients with exercise-induced fatigue
Authors: Zhou Ke-Lin , Dong Shuo , Wang Kang , Fu Guo-Bing , Cui Shu-Sheng , Guo Sheng 
Published: June 2020

Abstract

Background:
Exercise-induced fatigue (EF) has been a major area of interest within the field of sports and clinical medicine. Implemented on people's skin, muscles, and joints as an important part of complementary and alternative medicine , massage therapy has a positive effect on the recovery of EF and sports injuries. In this systematic review, we aim to evaluate the effectiveness and safety of massage therapy for patients with EF.

Methods:
We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of massage therapy in treating EF: China National Knowledge Infrastructure, Wanfang and PubMed Database, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, and Medical Literature Analysis and Retrieval System Online. Each database will be searched from inception to May 2020. The entire process will include study selection, data extraction, risk of bias assessment and meta-analyses.

Results:
This proposed study will evaluate the effectiveness and safety of massage therapy for patients with EF. The outcomes will include change in fatigue relief and adverse effect.

Conclusions:
This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of massage therapy for patients with EF.

Dissemination and ethics:
The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process.
Titration of extra-PEEP against intrinsic-PEEP in severe asthma by electrical impedance tomography
Authors: He Huaiwu , Yuan Siyi , Yi Chi , Long Yun , Zhang Rui , Zhao Zhanqi 
Published: June 2020

Abstract

Rationale:
The use of extra-positive end-expiratory pressure (PEEP) at a level of 80% intrinsic-PEEP (iPEEP) to improve ventilation in severe asthma patients with control ventilation remains controversial. Electrical impedance tomography (EIT) may provide regional information for determining the optimal extra-PEEP to overcome gas trapping and distribution. Moreover, the experience of using EIT to determine extra-PEEP in severe asthma patients with controlled ventilation is limited.

Patients concerns:
A severe asthma patient had 12-cmH2O iPEEP using the end-expiratory airway occlusion method at Zero positive end-expiratory pressures (ZEEP). How to titrate the extra-PEEP to against iPEEP at bedside?

Diagnoses and Interventions:
An incremental PEEP titration was performed in the severe asthma patient with mechanical ventilation. An occult pendelluft phenomenon of the ventral and dorsal regions was found during the early and late expiration periods when the extra-PEEP was set to <6 cmH2O. If the extra-PEEP was elevated from 4 to 6 cmH2O, a decrease in the end-expiratory lung impedance (EELI) and a disappearance of the pendelluft phenomenon were observed during the PEEP titration. Moreover, there was broad disagreement as to the “best” extra-PEEP settings according to the various EIT parameters. The regional ventilation delay had the lowest extra-PEEP value (10 cmH2O), whereas the value was 12 cmH2O for the lung collapse/overdistension index and 14 cmH2O for global inhomogeneity.

Outcomes:
The extra-PEEP was set at 6 cmH2O, and the severe whistling sound was improved. The patient's condition further became better under the integrated therapy.

Lessons:
A broad literature review shows that this was the 3rd case of using EIT to titrate an extra-PEEP to against PEEPi. Importantly, the visualization of occult pendelluft and possible air release during incremental PEEP titration was documented for the first time during incremental PEEP titration in patients with severe asthma. Examining the presence of the occult pendelluft phenomenon and changes in the EELI by EIT might be an alternative means for determining an individual's extra-PEEP.