bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moxibustion therapy for treating patients with primary osteoporosis
Authors: Hui Xin , Wang Hao , Yao Qin , Zhao Baixiao , Ha Lue 
Published: December 2019

Abstract

Background:
Primary osteoporosis (POP) is a common disease among elderly, which increase the risk of fracture and impact to the quality of life. As a Chinese traditional therapy, moxibustion has been commonly applied in treating chronic musculoskeletal diseases in China. Many trails have shown that moxibustion therapy is effective in treating primary osteoporosis. The protocol aims to present the methods used to access the effectiveness and safety of moxibustion therapy for patients with primary osteoporosis.

Methods:
The following databases will be searched from their inception: the Cochrane Central Register of Controlled Trails(CENTRAL), Pubmed, EMBASE, China National Knowledge Infrastructure(CNKI), Chinese Biomedical Literature Database(CBM), Chinese Scientific Journal Database (VIP database), and Wan-Fang Database. Clinical randomized controlled trials related to moxibustion therapy for treating primary osteoporosis will be included, regardless of publication status and languages. Study selection, data collection, and quality assessment will be independently conducted by 2 researchers. We will select the fixed-effects or random-effects model according to the heterogeneity assessment for data synthesis. Bone mineral density(BMD) will be the primary outcomes. Visual analogue scale(VAS), response rate, TCM Syndrome scale(TCMSS), bone gla protein(BGP), alkaline phosphatase(BALP), blood calcium(Ca), blood phosphate(P), quality of life(QOL) will be the second outcomes. If it is appropriate for meta-analysis, RevMan V.5.3 statistical software will be used. Otherwise, a systematic narrative synthesis will be conducted. The results will be presented as risk ratio (RR) with 95% confidence intervals (CIs) for dichotomous data and weight mean difference(WMD) or standard mean difference (SMD) 95% CIs for continuous data.

Trial registration number:
PROSPERO CRD42019129507
The efficacy and safety of different doses of glucocorticoid for autoimmune hepatitis
Authors: Zhang Chi , Wu Shan-Shan , Dong Xiao-Qin , Wu Zhao , Zhao Hong , Wang Gui-Qiang 
Published: December 2019

AbstractBackground:Glucocorticoid as the standard treatment of autoimmune hepatitis has been recommended with different doses. The purpose of this study is to compare the efficacy and safety of high and low doses for clinical practice.Methods:Medline, Embase, and Cochrane Library were searched until January 16th, 2019 for cohort studies or randomized controlled trials in patients with autoimmune hepatitis. Glucocorticoid 60 mg/d or 1 mg/kg/d was defined as high dose and 40 to 50 mg/d or 0.5 mg/d as low dose. Outcome of interests includes the incidence of the biochemical remission, adverse event, and endpoint events. Double arcsine method with a random-effect model was used to combine the incidence. Potential heterogeneity was explored by meta-regression and subgroup analysis.Results:Overall, 25 studies (3305 patients) were included, with 10 studies in the high dose group and 15 in low dose group. The biochemical remission rate in the high and low dose group was 0.79 (95% confidence interval [CI] [0.72, 0.85]) and 0.72 (95% CI [0.65, 0.78]), respectively. The incidence of endpoint events and adverse event in the high were slightly higher (0.03, 95% CI [0.02, 0.04]; 0.42, 95% CI [0.30, 0.53]) than that of the low dose group (0.01, 95% CI [0.00, 0.01]; 0.39, 95% CI [0.15, 0.63]).Conclusions:For autoimmune hepatitis patients, 60 mg/d or 1 mg/kg/d of glucocorticoid gives higher biochemical remission rate and higher incidence of endpoint events and adverse events.
Comparison of recovery profiles in patients with Parkinson's disease for 2 types of neuromuscular blockade reversal agent following deep brain stimulator implantation
Authors: Park Yong-Seok , Kim Jaewon , Kim Sung-Hoon , Moon Young-Jin , Kwon Hye-Mee , Park Hee-Sun , Kim Wook-Jong , Ha Seungil 
Published: December 2019

Abstract
As an anesthetic reversal agent, there are concerns with cholinesterase inhibitors regarding worsening of Parkinson's disease (PD)-related symptoms. Sugammadex, a relatively new reversal agent, does not inhibit acetylcholinesterase and does not require co-administration of an antimuscarinic agent. The present study compared the recovery profiles of 2 agents initially administered for reversal of neuromuscular blockade in patients with advanced PD who underwent deep brain stimulator implantation.
A total of 121 patients with PD who underwent deep brain stimulator implantation were retrospectively analyzed. Patients were divided into 1 of 2 groups according to the type of neuromuscular blockade reversal agent (pyridostigmine vs sugammadex) initially administered. Recovery profiles reflecting time to extubation, reversal failure at first attempt, and hemodynamic stability, including incidence of hypertension or tachycardia during the emergence period, were compared.
Time to extubation in the sugammadex group was significantly shorter (P < .001). In the sugammadex group, reversal failure at first attempt did not occur in any patient, while it occurred in seven (9.7%) patients in the pyridostigmine group (P = .064), necessitating an additional dose of pyridostigmine (n = 3) or sugammadex (n = 4). The incidence of hemodynamic instability during anesthetic emergence was significantly lower in the sugammadex group than in the pyridostigmine group (P = .019).
Sugammadex yielded a recovery profile superior to that of pyridostigmine during the anesthesia emergence period in advanced PD patients. Sugammadex is also likely to be associated with fewer adverse effects than traditional reversal agents, which in turn would also improve overall postoperative management in this patient population.
Regression of a symptomatic varix after transarterial embolization of a brain arteriovenous malformation
Authors: Li Guichen , Wang Guangming , Yu Jing , Hou Kun , Yu Jinlu 
Published: December 2019

Abstract

Rationale:
Brain arteriovenous malformation (BAVM)-associated varix is always asymptomatic, and no special treatment is needed. However, there is no consensus regarding how to address a varix that has led to clinical manifestation.

Patient concerns:
An 11-year-old girl was admitted complaining of left hemiparesis for 4 days. She was previously healthy and denied any history of similar ictus. She was alert, and a physical examination performed upon admission was unremarkable except for the left hemiparesis.

Diagnoses:
Head magnetic resonance imaging (MRI) showed a linear and round flow void and perilesional edema in the region of the right basal ganglia, indicating a BAVM. Gadolinium-enhanced MRI showed peripheral enhancement of the round lesion. Computed tomography angiography (CTA) showed that the BAVM was fed by the ipsilateral posterior cerebral artery and anterior choroidal artery and drained into the vein of Galen. A large varix was also noted at the top of the BAVM and was consistent with the round flow void observed at the right basal ganglia on MRI. The Spetzler-Martin grading scale was grade IV

Interventions:
The patient experienced a TAE of the BAVM nidus with liquid embolic agent.

Outcomes:
A follow-up investigation showed regression of the varix, although there was still some residual BAVM. The patient experienced a favorable recovery.

Lessons:
In the case of a BAVM-associated symptomatic varix, if surgical resection cannot readily be performed, initial TAE of the BAVM nidus can be attempted.
Delayed spontaneous rupture of cavernous segment of the internal carotid artery following dual ophthalmic segment aneurysms treatment with pipeline embolization device
Authors: Ting Wang , Richard Seidu A. , Changwei Zhang , Chaohua Wang , Xiaodong Xie 
Published: December 2019

Abstract

Rationale:
The incidence of double aneurysms on the ophthalmic segment of the internal carotid artery (ICA) is very rare. Nevertheless, delayed rupture of a parent artery instead of the aneurysmal sac following pipeline embolization device (PLED) is unusual.

Patient concerns:
We present a 72-year-old female who was admitted at our facility with gradual onset of nonspecific visual changes.

Diagnosis:
Conventional angiography revealed 2 aneurysms located at the ophthalmic segment of the left ICA.

Interventions:
Both aneurysms were successfully treated with PLED.

Outcomes:
Two months after discharge, the patient was rushed into the emergency with bilateral conjunctival congestion. Computed tomography revealed intracranial hemorrhage at left temporal lobe while digital subtraction angiography established a left direct carotid cavernous fistula. We utilized stent (Solitaire 6∗30) assisted coils to occlude the fistula. The patient is well and go about her normal duties.

Lessions:
Manipulation of the tortuous parent artery resulted in a focal traumatic weakness in the artery and subsequently a delay tear. We are of the view that, endovascular surgeons should be on the lookout for this complication following flow deviation treatment modalities.
Verification a model of predicting vaginal birth after cesarean delivery in Chinese pregnant women
Authors: Xu Ping , Feng Ying , Shen Huaxiang , Luo Jing , Tao Yueping 
Published: December 2019

Abstract
The objective of our research was to confirm the prediction role of Grobman model for vaginal birth after cesarean (VBAC) in Chinese pregnant women. In this research, 535 pregnant who had once cesarean delivery and the least once subsequent try to a vaginal labor in Jiaxing of China were involved. The Grobman background factors and five new factors were included. Overall, in total of 456 women had successful VBAC, the success percent was 85.2%. The new background variable “maternal height” was considered as an additional predictor for VBAC. The Grobman model's area under the curve (AUC) was 0.811 (95% CI = 0.751–0.870) and the AUC of this modified model combined 2 new factors was 0.834 (95% CI = 0.781–0.886). Nevertheless, there has no markedly difference between these 2 models of the AUC. In conclusion, the Grobman model was suitable for Chinese pregnant. However, further improvements were needed to make a new predictive model of VBAC success rate for Chinese pregnant women through analyzing the clinical data of vaginal trial delivery after cesarean section.
Extramedullary plasmacytoma of the kidney in an HIV-positive patient
Authors: Li Yubing , Wang Chundan , Yan Jiashen , Jiang Shaobo 
Published: December 2019

Abstract

Rationale:
Extramedullary plasmacytoma (EMP) is a very rare malignant neoplasm arising from clonal proliferation of atypical plasma cells. Most EMPs involve mucosal lymphoid tissue, particularly in the nasopharyngeal area, respiratory tract, and head and neck region. Such neoplasms of the kidney in patients with a human immunodeficiency virus (HIV) infection are extremely rare.

Patient concerns:
A 55-year-old male who had been diagnosed with HIV 1 year previously presented with a 2-week history of intermittent right abdominal pain and gross hematuria.

Diagnoses:
Ultrasonography and computed tomography detected a mass that occupied the upper half of the right kidney. A clinical diagnosis of a renal tumor was suspected.

Interventions:
The patient subsequently underwent a retroperitoneal radical nephrectomy. The postoperative pathological diagnosis was solitary EMP of the kidney. Adjuvant radiation therapy was provided at doses of 50 Gy in 20 fractions.

Outcomes:
Currently, the patient is alive and disease free at 7 months postoperatively. To the best of our knowledge, this is the first case of a primary renal EMP in a patient with HIV.

Lessons:
The present case illustrates that this rare type of solitary EMP associated with acquired immune deficiency syndrome can occur in the kidney. Additionally, although rare, solitary EMP should be considered in the differential diagnosis of a renal mass in HIV-infected patients.
Ultrasound follow-up of spontaneous tears of the plantar fascia treated with conservative therapies
Authors: Cocco Giulio , Ricci Vincenzo , Boccatonda Andrea , Abate Michele , Guagnano Maria Teresa , Schiavone Cosima 
Published: December 2019

Abstract

Rationale:
The plantar fascia (PF) is an important anatomical structure that stabilizes the longitudinal arch of the foot. While plantar fasciitis is a common pathology affecting the foot, tears of the PF are uncommon injuries characterized by acute pain in the plantar aspect of the foot. The main purpose of this paper was to describe, in detail, how the ultrasonographic pattern of PF rupture can be combined with the clinical features to define the prognosis and promptly plan the therapeutic approach.

Patient concerns:
In the first case, a 39-year-old male patient was seen due to acute pain in the mid plantar foot which appeared 3 days after a tennis match. The pain was accompanied by a “snap” noise and intense pain. In the second case, a 44-year-old male patient was seen due to pain in the heel region which appeared 2 days after a running session.

Diagnosis:
One case of noninsertional complete tear of the central bundle of the PF with retraction of the 2 stumps and 1 case of partial tear of the central bundle of the PF at the level of the insertional region.

Interventions:
Both patients were treated with conservative therapies including load management, oral nonsteroidal anti-inflammatory drugs, foot orthosis, and restriction of sport activities.

Outcomes:
At follow-up, the patient with spontaneous complete tear of the PF (noninsertional area) showed a small fibrous bridge between the 2 stumps, with partial alignment of the proximal and distal portions, the ability to walk for a medium to long-distance, and difficulty going up and downstairs. The patient with the spontaneous partial tear (insertional area) showed complete fibrous scar tissue with restoration of the fascial continuity, and the ability to walk for a long-distance and go up and downstairs without pain.

Lessons:
Based on the clinical and ultrasonographic findings, we suggest that partial tear of the PF in the insertional region presents a favorable prognosis with complete recovery, both clinically and anatomically, while a complete tear in the noninsertional region is associated with partial functional and histological recovery when managed with a conservative approach. Therefore, coupling the clinical findings with the sonohistologic pattern is a valuable approach to plan the most suitable treatment for patients with spontaneous PF tear.
Giant lipoma in the hand
Authors: Kim Kwang Seog , Lee Hyeok , Lim Dong Seob , Hwang Jae Ha , Lee Sam Yong 
Published: December 2019

Abstract

Rationale:
Although lipomas are the most common benign form of soft tissue tumor in the body, giant lipomas of the hand, defined as >5 cm in diameter, are extremely rare.

Patient concerns:
A 49-year-old man presented with a soft and fixed lump in the left hypothenar area. The mass was not tender, but it was associated with symptoms of tingling sensation and paresthesia in the left ring and little fingers that had lasted for 4 years.

Diagnoses:
Preoperative image studies revealed an encapsulated and multilobulated mass, which measured 8 cm × 5 cm × 2 cm. Basic histologic examination identified the specimen as a lipoma and further immunohistochemical studies ruled out the possibility of malignancy.

Interventions:
To enable a complete excision of the mass, the palmar digital branch of the ulnar nerve for the little finger passing through the mass was temporarily transected. After complete excision of the mass, the branch was coapted again under microscopy.

Outcomes:
Complete sensory recovery was achieved 6 months after surgery, without any sign of recurrence.

Lessons:
Although giant lipomas in the hand can extend to vital components such as neurovascular structures, muscles, and tendons, meticulous en bloc resection can provide excellent results without any complications.
Diagnostic value of hemoglobin and neutrophil-to-lymphocyte ratio in Behcet Disease
Authors: Zhang Zunni , Su Qisheng , Zhang Liqian , Yang Zheng , Qiu Yuling , Mo Wuning 
Published: December 2019

Abstract
The purpose of our study was to investigate the diagnostic value of NLR, hemoglobin (HB) and combine NLR with HB in the BD patients.
Sixty-seven patients with BD were diagnosed in the rheumatology or dermatology between June 2015 and June 2019; 92 matching healthy physical examiners were included in our study. SPSS was used for statistical analysis.
Compared with the healthy control, NLR was increased (P < .001), while the HB level was decreased (P < .001) in the patients of BD. In addition, ESR and CRP were increased in BD patients. NLR has no relationship with CRP and ESR, while the HB levels were negatively correlated with CRP and ESR (r = –0.293, P = .046; r = –0.431, P = .002). ROC curve analysis revealed the AUC of NLR and HB were 0.797 and 0.798 (P < .001). When combined NLR with HB, the AUC was 0.897 (P < .001). Besides, logistic regression analysis demonstrated that NLR and HB were independent risk factors in the BD patients.
We observed that the diagnostic value of NLR, HB and combined NLR with HB in the BD patients were high, particularly when combine NLR with HB. NLR and HB were independent risk factors in the BD patients. In addition, HB levels related to the disease activity of BD patients.
Description of a transient proximal tubulopathy induced by amino acids perfusion in peptide receptor radionuclide therapy
Authors: Lenain Rémi , Hamroun Aghilès , Lion Georges , Chamley Paul , Bui Linh , Lionet Arnaud , Hazzan Marc , Provôt François 
Published: December 2019

Abstract

Rationale:
Peptide receptor radionuclide therapy (PRRT) with radiolabeled somatostatin analogs is a targeted internal radiotherapy method used to treat tumors expressing somatostatin receptors. Concomitant amino acids perfusion is systematically performed in order to inhibit the proximal tubular uptake of the radionuclide and thus prevent nephrotoxicity.

Patient concerns:
a 67-year-old woman with an intestinal neuroendocrine tumor with multiple lymphadenopathies and liver metastases. The patient displayed a carcinoid syndrome with flushes including facial erythrosis and paresthesia. During the treatment, the patient exhibited emesis and severe cramps.

Diagnosis:
We describe incomplete proximal tubulopathy induced by an amino acid therapy with [177Lu]-DOTA0-Tyr3-octreotate, which was reversible after treatment discontinuation. This diagnosis relies on metabolic acidosis, hypophosphatemia due to renal loss, tubular proteinuria and generalized aminoaciduria. Serum creatinine remained stable during and after the procedure.

Interventions:
PRRT with radiolabeled somatostatin analog ([177Lu]-DOTA0-Tyr3-octreotate). In order to prevent PRRT induced nephrotoxicity, we used a solution of 20 amino acids including 22 g/L Lysine and 16.8 g/L Arginine. Metoclopramide was successfully used to control vomiting. During the treatment and at the time of cramps, the blood sample showed hypophosphatemia at 0.3 mmol/L justifying intravenous phosphate supplementation. The cramps disappeared after this infusion.

Outcomes:
Hypophosphatemia with low TmPO4/GFR was observed as well as an increase in β2-microglobulinuria, urinary polyclonal light chains, and amino aciduria involving all amino acids. All these disturbances disappeared the day after the treatment and there was no acute kidney injury after 5 PRRT sessions. Six months after PRRT discontinuation, the patient had neither renal failure nor proximal tubulopathy. Aminoacid induced tubulopathy involves the main ligands of the megalin receptor. It has recently been demonstrated that cilastatin is a megalin inhibitor in the proximal tubule and therefore could represent an attractive alternative to amino acids for this purpose.

Lessons:
This case report is a description of a nephroprotective strategy in which partial, and transient tubulopathy is induced, in order to decrease proximal absorption of a tubulotoxic molecule. This little known strategy could be used to prevent proximal tubular injury caused by others megalin-mediated nephrotoxicity medication.
Bioinformatic analysis of the molecular mechanism underlying bronchial pulmonary dysplasia using a text mining approach
Authors: Zhou Weitao , Shao Fei , Li Jing 
Published: December 2019

Abstract
Bronchopulmonary dysplasia (BPD) is a common disease of premature infants with very low birth weight. The mechanism is inconclusive. The aim of this study is to systematically explore BPD-related genes and characterize their functions.
Natural language processing analysis was used to identify BPD-related genes. Gene data were extracted from PubMed database. Gene ontology, pathway, and network analysis were carried out, and the result was integrated with corresponding database.
In this study, 216 genes were identified as BPD-related genes with P < .05, and 30 pathways were identified as significant. A network of BPD-related genes was also constructed with 17 hub genes identified. In particular, phosphatidyl inositol-3-enzyme-serine/threonine kinase signaling pathway involved the largest number of genes. Insulin was found to be a promising candidate gene related with BPD, suggesting that it may serve as an effective therapeutic target.
Our data may help to better understand the molecular mechanisms underlying BPD. However, the mechanisms of BPD are elusive, and further studies are needed.
Efficacy of herbal medicine (Gegen Qinlian Decoction) on ulcerative colitis
Authors: Fan Yuling , Yi Wen , Huang Han , Mei Zhigang , Feng Zhitao 
Published: December 2019

AbstractBackground:This systematic review aims to evaluate the efficacy of Gegen Qinlian Decoction (GQD) for ulcerative colitis (UC).Methods:PubMed, EMBASE, Springer LINK, Cochrane Library, the China National Knowledge Infrastructure, Chongqing Weipu Database for Chinese Technical Periodicals, Wan-fang Database, and Chinese Biomedicine Database were searched from their inception to December 2018 for randomized controlled trials comparing the use of GQD alone or in combination with western medicine (WM) with that of WM therapies for UC. Outcomes on the therapy's effectiveness rate, ulcerative colitis endoscopic index of severity (UCEIS), recurrence rate, and adverse events were extracted and analyzed by Review Manager 5.3 software. Meta-analysis was combined with fixed or random-effects model, and risk ratios (RR) and 95% confidence intervals (CI) were calculated for all outcomes. Two researchers independently reviewed each trial to determine its inclusion. The Cochrane risk of bias assessment tool was used for quality assessment.Results:We included 22 trials involving 2028 patients with UC. When compared with WM therapy, GQD significantly improved the clinical effectiveness (n = 591, RR = 1.21, 95% CI: 1.12–1.31,P < .00001) and recurrence rate (n = 94, RR = 0.23, 95% CI: 0.10–0.54, P = .0006). GQD plus WM was more effective in improving the clinical effectiveness (n = 1337, RR = 1.21, 95% CI: 1.16–1.27, P < .00001), and decreasing UCEIS scores (n = 384, mean difference  = −0.63, 95% CI: −1.26–−0.01,P = .05), recurrence rate (n = 179, RR = 0.18, 95% CI: 0.06–0.61, P = .006). In addition, the adverse events for GQD (n = 238, RR = 0.20, 95% CI: 0.02–1.68, P = .14) and GQD plus WM (n = 427, RR = 0.37, 95% CI: 0.15–0.90, P = .03) was significantly lower than that for WM alone. Noted adverse events primarily included gastrointestinal symptoms, headache, dizziness, and leukocytopenia.Conclusions:This meta-analysis shows that GQD used alone or in combination with WM might have potential benefits in curing UC. However, there is no sufficient evidence to draw definite conclusion supporting the effect of GQD for UC due to poor methodological quality of the included trials. More rigorously designed investigations and studies with large sample sizes should be conducted to establish clinical evidence further.