bluuebunny/crossref_metadata_2025_split huggingface dataset:
Danhong injection for the treatment of early diabetic nephropathy
Authors: Huang Caixia , Huang Cuiling , Zhou Guomin 
Published: October 2020

Abstract

Background:
Diabetic nephropathy (DN) is the one that of the most common complications of diabetes mellitus (DM). Diabetic patients will experience a high mortality rate when DN progress to end-stage. So, it is extremely important to early treat DN. Although several interventions have been used to treat DN, a conclusive finding has not already been achieved. As one of the most common Chinese medicines, danhong injection (DHI) which has been shown to have various functions has also been prescribed to be as the alternative treatment option. However, no systematic review and meta-analysis has been conducted to objectively and comprehensively investigate its effectiveness and safety. Thus, we designed the current systematic review and meta-analysis to answer whether DHI can be preferably used to timely treat DN.

Methods:
We will perform a systematic search to capture any potentially eligible studies in several electronic databases including PubMed, Cochrane library, Embase, China National Knowledgement Infrastructure (CNKI), Wanfang database, and Chinese sci-tech periodical full-text database (VIP) from their inception to August 31, 2020. We will assign 2 independent reviewers to select eligible studies, and assess the quality of included studies with Cochrane risk of bias assessment tool. We will perform all statistical analyses using RevMan 5.3 software.

Ethics and dissemination:
We will submit our findings to be taken into consideration for publication in a peer-reviewed academic journal. Meanwhile, we will also communicate our findings in important conferences.

Protocol registry:
The protocol of this systematic review and meta-analysis has been registered at the International Plateform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) platform (https://inplasy.com/inplasy-2020-9-0005/, registry number: INPLASY202090005) and this protocol was funded through a protocol registry.
Carbapenems versus alternative β-lactams monotherapy or in combination for febrile neutropenia
Authors: Tang Xiuge , Chen Lingyuan , Li Yan , Jiang Junsong , Li Xianshu , Liang Xueyan 
Published: October 2020

Abstract

Background:
Febrile neutropenia (FN) in cancer patients can be life threatening and require the timely antimicrobial agents treatment.

Methods:
To compare the effectiveness and safety of carbapenems versus β-lactams for FN. PubMed, Medline (Ovid SP), Cochrane CENTRAL, and Embase were searched up to March 2019. FN in patients due to undergoing chemotherapy and treated with carbapenems and β-lactams were included. Odds ratio (OR) and 95% confidence interval (CI) were estimated.

Results:
Fifty randomized controlled trials (RCTs) studies involving 10,995 participants were included. Carbapenems were more likely to experience treatment success without modification (OR = 1.34, 95% CI = 1.24–1.46) compared with β-lactams. Meropenem (OR = 1.36, 95% CI = 1.18–1.56; OR = 1.24, 95% CI = 1.01–1.53), imipenem/cilastatin (OR = 1.40, 95% CI = 1.19–1.65; OR = 1.31, 95% CI = 1.04–1.67) showed higher effectiveness from that by β-lactams monotherapy or in combination with aminoglycoside, respectively. Carbapenems–aminoglycoside combination therapy does not provide an advantage over carbapenems alone. Meropenem showed similar risk of adverse events (AEs) versus β-lactams. Imipenem/cilastatin was related to higher risk of AEs compared with β-lactams. There was no significant difference between carbapenems and β-lactams monotherapy or in combination.

Conclusion:
Meropenem and imipenem/cilastatin monotherapy appears to be available treatment for FN compared with β-lactams. Imipenem/cilastatin was related to higher risk of AEs. Balancing the evidence for drug efficacy and side effects, meropenem monotherapy appears to be available treatment for FN. Individual centers should select the best matching therapy regimens according to local epidemiology and susceptibility patterns.
Efficacy of a single injection compared with triple injections using a costoclavicular approach for infraclavicular brachial plexus block during forearm and hand surgery
Authors: Lee Mi Geum , Jung Wol Seon , Go Doo Yeon , Choi Sung Uk , Shin Hye Won , Choi Yun Suk , Shin Hyeon Ju 
Published: October 2020

Abstract

Objectives:
It was recently proposed that a costoclavicular (CC) approach can be used in ultrasound (US)-guided infraclavicular brachial plexus block (BPB). In this study, we hypothesized that triple injections in each of the 3 cords in the CC space would result in a greater spread in the 4 major terminal nerves of the brachial plexus than a single injection in the CC space without increasing the local anesthetic (LA) volume.

Methods:
Sixty-eight patients who underwent upper extremity surgery randomly received either a single injection (SI group, n = 34) or a triple injection (TI group, n = 34) using the CC approach. Ten milliliters of 2% lidocaine, 10 mL of 0.75% ropivacaine, and 5 mL of normal saline were used for BPB in each group (total 25 mL). Sensory-motor blockade of the ipsilateral median, radial, ulnar, and musculocutaneous nerves was assessed by a blinded observer at 5 minutes intervals for 30 minutes immediately after LA administration.

Results:
Thirty minutes after the block, the blockage rate of all 4 nerves was significantly higher in the TI group than in the SI group (52.9% in the SI group vs 85.3% in the TI group, P = .004). But there was no significant difference in the anesthesia grade between the 2 groups (P = .262). The performance time was similar in the 2 groups (3.0 ± 0.9 minutes in the SI group vs 3.2 ± 1.2 minutes in the TI group, respectively; P = .54).

Discussion:
The TI of CC approach increased the consistency of US-guided infraclavicular BPB in terms of the rate of blocking all 4 nerves without increasing the procedure time despite administering the same volume of the LA.
Comparative efficacy of bariatric surgery for type 2 diabetes mellitus
Authors: Wang Xixiong , Chen Cunren , Zheng Buping , Yang Xiaolong , Zhang Xiaoxin , Yang Chenchen 
Published: October 2020

Abstract

Background:
The comparative efficacy of bariatric surgical procedures for type 2 diabetes mellitus (T2DM) has not been completely elucidated. To investigate this question, we conduct a systematic review and network meta-analysis.

Methods:
The protocol followed preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) checklist. Two review authors will independently search the PubMed, Embase (Ovid), and the Cochrane Central Register of Controlled Trials databases. The primary outcome is T2DM remission. The secondary outcomes include BMI, HbA1c (%), and percentage excess weight loss (% EWL). Results from the network meta-analysis will be presented as summary relative effect sizes (WMD or RR) and relative 95% CIs for each possible pair of treatments. Outcomes will be combined based on different periods of follow-up (12 months, 36 months, and 60 months).

Results:
The results will provide useful information about the efficacy of bariatric surgical procedures in patients with T2DM.

Conclusion:
The findings of the study will be disseminated through peer-reviewed journal.

INPLASY registration number:
INPLASY202050053.
The efficacy of a phone assistance nursing program for functional outcomes in patients after shoulder instability surgery
Authors: Zheng Yongling , Wang Hongli , Wang Huali , Xu Junchang , Chen Ping 
Published: October 2020

Abstract

Objective:
We conduct this research protocol for the assessment of the effect of phone-assisted care programs on functional outcomes in patients receiving shoulder instability surgery.

Methods:
This is a randomized controlled, single center trial which will be implemented from October 2020 to December 2021. This trial is conducted according to the SPIRIT Checklist of randomized researches. It was authorized via the Ethics Committee of the First People's Hospital of Xiangyang city affiliated to Hubei Medical College (XY234-026). Ninety participants who undergo shoulder instability surgery are analyzed. Patients are randomly divided into control group (standard management group, with 45 patients) and study group (the phone program group, with 45 patients). In control group, the exercises at home are not monitored. Whereas in study group, patients are asked about their at-home activities, and the extra coaching sessions are provided to patients on self-care, exercise guidance, and the importance of exercise at home, and then answers to their questions. The primary outcome is the range of motion of the shoulder joint, and the pain arcs are determined through the range of motion. The extra assessments include the shoulder functional outcome, pain, and the quality of life. All the analysis needed in this study is implemented with SPSS (IBM, Chicago, USA) for Windows Version 19.0.

Results:
The clinical outcome variables between groups are shown in Table.

Conclusion:
This investigation can offer a reliable basis for the effectiveness of phone assistance nursing program in patients after shoulder instability surgery.

Trial registration number:
researchregistry6010
Quality of life among patients with autoimmune hepatitis in remission
Authors: Takahashi Atsushi , Abe Masanori , Yasunaka Tetsuya , Arinaga-Hino Teruko , Abe Kazumichi , Takaki Akinobu , Torimura Takuji , Zeniya Mikio , Yoshizawea Kaname , Kang Jong-Hon , Suzuki Yoshiyuki , Nakamoto Nobuhiro , Inui Ayano , Tanaka Atsushi , Takikawa Hajime , Ohira Hiromasa 
Published: October 2020

Abstract
Health-related quality of life (HRQOL) is lower in individuals with autoimmune hepatitis (AIH) than in the general population. However, previous evaluations of HRQOL for AIH have included a broad range of disease activities. The aim of this study was to clarify HRQOL among patients with AIH in remission.
We assessed HRQOL in patients with AIH in remission, patients with chronic hepatitis C (CHC) with eradicated hepatitis C virus (HCV) and patients with primary biliary cholangitis (PBC) using the Japanese version of the Chronic Liver Disease Questionnaire (CLDQ).
Participants comprised 62 patients with AIH in remission, 39 patients with CHC with eradicated HCV and 66 patients with PBC. Median ages of patients were 63, 69, and 64 years, respectively. Overall score (5.6 vs 5.9, P = .02) and fatigue (5.2 vs 5.6, P = .01) and worry (5.6 vs 6.0, P = .01) domain scores of the CLDQ were significantly lower in patients with AIH in remission than in CHC with eradicated HCV, and similar to scores except for the systemic symptoms domain in patients with PBC. Disease duration was associated with lower scores on systemic symptoms and activity domains of the CLDQ in patients with AIH in remission.
Patients with AIH in remission show impaired HRQOL associated with disease duration.
The importance of overweight in COVID-19
Authors: Rao Xinrui , Wu Chuangyan , Wang Sihua , Tong Song , Wang Geng , Wu Gang , Zhou Rui 
Published: October 2020

Abstract
The aim of this study was to evaluate the association between overweight and severity, drug response, and clinical outcomes of novel coronavirus disease 2019 (COVID-19).
In this retrospective cohort study, we reviewed medical records of 240 COVID-19 patients admitted to Union Hospital in Wuhan, China, between December 24, 2019, and March 25, 2020. Physical, clinical, laboratory, radiological characteristics, treatment, and outcome data were abstracted. Patients who were obese [body mass index (BMI) ≥28 kg/m2], underweight (BMI < 18.5 kg/m2), under 18 years old, pregnant, or still in hospital were excluded. Disease severity was classified as moderate or severe pneumonia based on the World Health Organization interim guidance. Overweight was defined as BMI ≥24 kg/m2 and <28 kg/m2. Patients were followed for discharge or death through April 10, 2020. We used logistic regression models to identify risk factors for severe disease, Cox proportional hazard models to explore associations between medications and patient outcomes (discharge or in-hospital death), and Kaplan–Meier survival curves and Cox regression models to evaluate risk factors for in-hospital death.
One-half of patients (120, 50.0%) had severe pneumonia, while nearly one-half (114, 47.5%) were overweight. Among patients over 45 years old, overweight patients had significantly lower rates of fatigue, higher rates of headache, and higher median C-reactive protein levels. Patients under 45 years old had higher rates of cough and myalgia and higher proportions of increased alanine aminotransferase and lactic dehydrogenase, as well as more pulmonary lobes involved in the pneumonia revealed by chest computed tomography scans. Overweight patients were at higher risk of developing severe pneumonia. Although weight was not a risk factor for in-hospital death, overweight patients showed different responses to medications compared with normal weight patients. Intravenous interferon-α, intravenous glucocorticoids, and antifungal drugs were associated with reduced mortality in overweight patients. Intravenous immunoglobulin, oseltamivir, and ribavirin were associated with reduced mortality in normal weight patients.
Overweight is a worldwide health problem. We found overweight to be related to the COVID-19 severity but not to in-hospital death. Clinicians should be aware that overweight COVID-19 patients require increased attention for different clinical features and treatment response.
Morphological study of safe fixation region of temporomandibular joint prosthesis in Chinese northeast population with 3-dimensional computed tomographic image
Authors: Zhong Zhuan , Sun Jialiang , Yu Zhentao , Han Yingying , Kang Chunyang 
Published: October 2020

Abstract
This study aimed to measure temporomandibular joint (TMJ) with 3-dimensional (3D) reconstruction technique in Chinese northeast population, and to clarify the region for fixation and to provide morphological basis for the application of TMJ prosthesis in Chinese setting.
Computed tomography (CT) scan and 3D reconstruction were performed with 132 individuals. Structural markers and measurements were further performed with a 3D model of the total TMJ, including the width, thickness and angle of zygomatic arch, the width and height of articular fossa, as well as the area, width, thickness and angle of mandible in the fixation region of the TMJ prosthesis. All the measured indicators values were compared between bilateral sides and gender groups.
There was no statistical difference in the measured indicators between the left side and the right side (P > .05). However, certain parameters, including S, L5, L7, P4, and P5, were significantly different among males and females (P < .05).
In this study, 3D CT image was used to obtain the measurement data of TMJ, which provided data support for the clinical application of TMJ prosthesis in Chinese population.
In situ buccal carcinoma in a teenager after hematopoietic stem cell transplantation
Authors: Liu Yanbin , Yuan Wei , Li Man , Cheng Long , Yang Jinsuo , Yin Boya , Huang Xin 
Published: October 2020

Abstract

Rationale:
Hematopoietic stem cell transplantation (HSCT) is the most effective treatment for the majority of patients who have malignant haemolytic disease. Although the success rate of HSCT has increased, the increasing number of cases suffering from secondary solid malignancies after HSCT has attracted more interest recently.

Patient concerns:
A 16-year-old female patient from China presented with a crusty and painful lesion on the left buccal mucosa with a history of chronic graft-versus-host disease following allogeneic HSCT for acute myeloid leukaemia.

Diagnosis:
An incisional biopsy of the lesion showed stratified squamous epithelium mucosa with severe dysplasia (carcinoma in situ). Subsequently, a wide local excision was performed and histological examination revealed early infiltrating squamous epithelial mucosa (carcinoma in situ).

Interventions:
She was being treated in the oral and maxillofacial surgery clinic with an incisional biopsy of the left buccal mucosa. She also received a wide local excision.

Outcomes:
Follow-up for 4 years showed no recurrence.

Lessons:
This case helps raise awareness of the diagnosis of oral symptoms in young patients after HSCT. Due to the increasing application of HSCT, raising awareness in oral and dental physicians may be required to improve long-term clinical outcome of patients who underwent HSCT.
Chemoradiotherapy combined with NK cell transfer in a patient with recurrent and metastatic nasopharyngeal carcinoma inducing long-term tumor control
Authors: Jin Yuan-yuan , Yang Wen-zhuo , Zou Sen , Sun Zheng-yang , Wu Chun-tao , Yang Zhao-yong 
Published: October 2020

Abstract

Rationale:
Nasopharyngeal carcinoma (NPC) is one of the most common malignancies in Southern China. Although combined chemotherapy with radiotherapy has been widely used in treating locally advanced lesions, relapse and metastases remain the primary cause of treatment failure, and are associated with an extremely poor prognosis. Therefore, more efficient and milder therapies are needed.

Patient concerns:
Herein, we report a patient with advanced NPC with intracranial metastases who showed progression during conventional treatment.

Diagnoses:
Nonkeratinizing undifferentiated nasopharyngeal carcinoma (stage IV).

Interventions:
After the completion of initial chemoradiotherapy and targeted therapy, metastases to brain occurred during follow-up. Ex vivo-cultured allogeneic NK cell infusion was offered.

Outcomes:
Although the intracranial metastases did not decrease 10 months after the NK cell treatment, they decreased significantly at 31 months after the treatment and partially disappeared. The tumor response indicated partial response. Furthermore, all of the intracranial metastases continued to decrease at about 42 months after treatment.

Lessons:
The brain metastases of NPC are rare with poor prognosis. Radiotherapy in NPC can disrupt the blood–brain barrier, which may contribute to the metastases of brain. This case report will provide rationale for NK cell infusion following regular chemoradiotherapy.
Rapid-onset acute respiratory distress syndrome after mastectomy in a breast cancer patient
Authors: Chien Shih-Chao , Chien Shih-Chun , Hu Ting-Yu 
Published: October 2020

Abstract

Rationale:
Postoperative acute respiratory distress syndrome (ARDS) often results in severe morbidity and mortality in surgical patients. The etiology of this condition is complex, especially in cancer patients.

Patient concerns:
We encountered a 53-year-old woman with left breast cancer, cT1cN2M0, stage IIIA with left axillary lymph node metastasis. She had received chemotherapy with 4 cycles of doxorubicin plus cyclophosphamide, and 4 cycles of trastuzumab plus docetaxel within a span of 6 months. Subsequently, she underwent left simple mastectomy and axillary lymph node dissection, shortly after which she developed respiratory distress with progressive desaturation and hemoptysis.

Diagnosis:
ARDS was diagnosed using the Berlin criteria. Her arterial blood gas analysis revealed profound hypoxemia and her chest imaging was suggestive of pulmonary edema. She developed diffuse alveolar hemorrhage (DAH) that was confirmed with bronchoscopy and hemorrhagic samples on bronchoalveolar lavage.

Interventions:
She was mechanically ventilated with lung protective measures for management of ARDS. In addition to antibiotic cover with amoxicillin sodium-potassium clavulanate for occult infections during her stay in the intensive care unit, we administered epinephrine inhalations, intravenous treatment with tranexamic acid, and methylprednisolone for DAH.

Outcomes:
Her clinical course improved; she was extubated successfully on day 7 and discharged home on day 11.

Lessons subsections:
Chemotherapeutic agents may cause pulmonary toxicity through a direct cytotoxic effect or immune-mediated reactions and result in an increased risk of development of ARDS. Furthermore, surgery may trigger a systemic inflammatory response syndrome that can also induce ARDS. In our patient, the development of ARDS was attributed to the combined effects of surgery and chemotherapeutic agents (trastuzumab or docetaxel). When patients undergo major surgery after receiving chemotherapeutic agents, careful consideration is necessary to prevent the development of ARDS.
Soothing liver-qi stagnation method for cancer-related depression
Authors: Zhang Jianfeng , Liu Yunxia , Xu Yefeng 
Published: October 2020

Abstract

Background:
Cancer-related depression (CRD) is the most common mood disorder in patients with malignant tumors, negatively influencing the patient's daily life. Traditional Chinese medicine, as an alternative CRD therapy, has shown good treatment performance in recently years. Soothing liver-qi stagnation, as a classic therapy for depression, is based on traditional Chinese medicine theory. However, there is no evidence-based medical confirmation for the soothing liver-qi stagnation method for CRD treatment.

Methods:
We will systematically search relevant articles from their inception to July 1, 2019 in the following electronic databases: the Cochrane Library, PubMed, EMBASE, Chinese National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, Chinese Science and Technique Journals Database, and the Wan-fang Database. The primary outcome is the total scores of the Hamilton rating scale for depression and, the efficacy rate of reducing Hamilton rating scale for depression scores. The secondary outcomes are adverse reactions and quality of life as assessed by standard instruments. Two researchers will independently perform study selection, data extraction, and quality assessment. If there is any disagreement, it will be settled through third-party negotiations. We will assess the risk of bias and data synthesis using Review Manager (the Cochrane Collaboration) software, Version 5.3.0.

Results:
This work will evaluate the clinical effectiveness and safety of the soothing liver-qi stagnation method for CRD.

Conclusion:
This study may provide evidence-based medical corroboration for clinical application of the soothing liver-qi stagnation method for CRD treatment.

PROSPERO registration number:
CRD42019145678.