bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association of Th17/Treg cells expression in peripheral blood and chronic spontaneous urticaria
Authors: Yu Qianying , Lin Wenxia , Zhang Jie , Peng Li , Kong Qiaoqiao , Zhong Rubin , Lan Yan , Xiao Min , Chen Mingling 
Published: September 2020

Abstract

Background:
The pathogenesis of chronic spontaneous urticaria (CSU) is not clear, but its occurrence is closely related to the immune state of the body, that is, the balance of T cell subsets. Previous studies have confirmed that the dynamic imbalance of Th1/Th2 cells in CD4+T cell subsets of T cell subsets is closely related to the pathogenesis of CSU, but there are few studies on the relationship between the dynamic imbalance of Th17/Treg cells in CD4+T cell subsets and the pathogenesis of CSU. The purpose of this study is to evaluate the relationship between Th17/Treg cells expression in peripheral blood and CSU, so as to provide a reference basis for the pathogenesis of CSU.

Methods:
PubMed, Embase, CENTRAL, Web of Science, China Biology Medicine Database, China National Knowledge Database, Wan Fang Database, and Chongqing VIP Database will be searched to collect case-control studies and cohort studies evaluating the relationship between Th17/Treg cells expression in peripheral blood and CSU. The search time limits will be from the establishment of the database to December 2020. The meta-analysis will be carried out with the RevMan V.5.3 statistical software. The quality of all included studies will be evaluated by the Newcastle-Ottawa scale.

Results:
The results of this study will comprehensively evaluate the Th17/Treg cells expression levels in peripheral blood of patients with CSU, and provide a reference basis for the pathogenesis of CSU.

Conclusion:
The findings of this study may provide new evidence for the relationship between Th17/Treg cells balance in peripheral blood and CSU.

OSF registration number:
DOI 10.17605/OSF.IO/S8MYW
Qingfei Paidu decoction for treating COVID-19
Authors: Zhang Yuan , Xie Hongyan , Li Yan , Li Tianhao , Yuan Haipo , Fu Xiaoxu , Xie Chunguang 
Published: September 2020

Abstract

Background:
Coronavirus disease 2019 (COVID-19) is one of the infectious diseases that have seriously threatened global public health since its outbreak in 2019. Due to the complicated Pathogenesis, high infectivity and high fatality rate of COVID-19, there is currently no effective treatment for such epidemic disease. Traditional Chinese medicine has a long clinical history for the prevention and treatment of this kind of acute infectious disease. Qingfei Paidu Decoction (QFPD) is widely used in treating COVID-19 in China. However, there is still a lack of comprehensive and systematic evidence on the effectiveness and safety of Qingfei Paidu Decoction.

Methods:
We will search each database from the built-in until May 2020. The English literature mainly searches Cochrane Library, PubMed, EMBASE, and Web of Science, while the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Simultaneously we will retrieval clinical registration tests and grey literatures. This study only screen the clinical randomized controlled trials (RCTs) about QFPD for COVID-19 to assess its efficacy and safety. The two researchers worked independently on literature selection, data extraction, and quality assessment. The dichotomous data is represented by relative risk (RR), and the continuous is expressed by mean difference (MD) or standard mean difference (SMD), eventually the data is synthesized using a fixed effect model (FEM) or a random effect model (REM) depending on whether or not heterogeneity exists. Total clinical effective rate, improvement rate of lung CT, adverse events were evaluated as the main outcomes. Effective rate of clinical symptoms, treatment time were secondary outcomes. Finally, meta-analysis was conducted by RevMan software version 5.3.

Results:
The results of our research will be published in a peer-reviewed journal.

Conclusion:
This systematic review aims to provide new evidence of QFPD for COVID-19 in terms of its efficacy and safety.

PROSPERO registration number:
CRD42020200894.
A protocol for systematic review and meta-analysis of optimizing treatment for malaria
Authors: Zhang Renyan , Dong Xing , Wang Junyao , Guo Ying , Dai Yong 
Published: September 2020

Abstract

Background:
Malaria remains a global health threat for centuries. In recent years, a rising resistance of Plasmodium falciparum to current standard artemisinin-based combination therapies (ACTs) leads to increasing treatment failures and requires for optimized treatment. Here, we intend to make a systematic review and meta-analysis of optimizing treatment for malaria, so as to find a potential optimal treatment.

Methods:
We will search electronic databases: the Cochrane Infectious Diseases Group (CIDG) Specialized Register, the Cochrane Central Register of Controlled Trials (CEN-TRAL), PubMed, Embase, Web of Science from their inception to 1 July, 2020. We will also search International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov, and contact with authors when necessary. Two authors will independently collect and select data, and the statistical analyses will be conducted by Revman V.5.3 software.

Results:
We will evaluate efficacy and safety of modified ACTs for uncomplicate malaria, comparing with standard ACTs in all eligible clinical studies.

Conclusion:
In this study, we will offer clinical evidence for optimizing treatment for malaria.

Registration number:
INPLASY202070115
Comparative effectiveness of prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) for resected low-grade appendiceal mucinous neoplasm (LAMN)
Authors: Yang Wenming , Nie Pan , Liu Xueting , Peng Jikui 
Published: September 2020

Abstract

Background:
Whether prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) offers long-term survival benefit to patients with low-grade appendiceal mucinous neoplasms (LAMNs) after resection surgery is still under heated debate. The aim of the present meta-analysis is to investigate the comparative effectiveness and safety of prophylactic HIPEC regimens in LAMNs

Methods:
A systematic search of MEDLINE, EMBASE, PubMed, Web of Science, the Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform (ICTRP), clinicaltrials.gov and controlledtrials.com will be performed. All published RCTs and quasi-RCTs through July 20, 2020 with language restricted in English will be included in this review study. Two reviewers will independently conduct the procedures of study identification, data collection, and methodological quality assessment. The primary outcomes are overall survival (OS) and disease-free survival (DFS). The secondary outcomes consist of peritonitis and sepsis, colonic fistula, chemotherapy-associated adverse events, and adhesive intestinal obstruction. The pooled odds ratios (ORs) or hazard ratios (HRs) and relative 95% confident intervals (CIs) of each outcome measurement will be calculated. EndNote X9 software will be applied to manage all citations. The Stata software version 14.0 and R x64 software version 3.5.1 will be employed for main statistical analyses.

Discussion:
This study will employ a network meta-analysis to summarize direct and indirect evidence in the specific area to provide detailed individualized guidance on surgical management for LAMNs.

Registration:
This protocol was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on 25 July 2020 (registration number INPLASY202070112).
Immunoglobulin G4-related disease in the stomach presenting as a gastric subepithelial tumor
Authors: Cho Min Ji , Moon Hee Seok , Lee Hyeon Seok , Park Jae Ho , Kim Ju Seok , Kang Sun Hyung , Lee Eaum Seok , Kim Seok Hyun , Sung Jae Kyu , Lee Byung Seok , Jeong Hyun Yong 
Published: September 2020

Abstract

Introduction:
Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory disorder characterized by specific pathologic findings and often, but not in all cases, elevated serum IgG4 concentration. Although it can virtually involve every organ system, cases involving the gastrointestinal tract and especially gastric mass lesions have rarely been reported.

Patient concerns:
A 45-year-old man, who was incidentally discovered asymptomatic subepithelial tumor (SET), by endoscopy, on the greater curvature of the upper gastric body, was referred to our hospital for further evaluation.

Diagnosis:
The patient was postoperatively diagnosed with IgG4-RD by histopathologic results.

Interventions:
The patient underwent laparoscopic wedge resection.

Outcomes:
The patient is presently followed up annually in our clinic and had no problems and showed no signs of recurrence in examination.

Conclusion:
We reported a rare case of IgG4-RD presenting as a gastric SET. The first line treatment of IgG4-RD is glucocorticoid administration. However, because pathologic examination is challenging owing to the lesion location, preoperative diagnosis is difficult and may lead to unnecessary gastric resection. Thus, using alternative preoperative diagnostic methods such as endoscopic ultrasound-guided fine-needle biopsy or the biopsy unroofing technique could spare the patient from unnecessary surgical treatment.
Leydig cell tumor of a testis with azoospermia
Authors: Kong Qingkuo , Yu Yang , Tian Tian , Zhang Hongguo , Sun Meiling , Liu Ruizhi , Liu Yanhong 
Published: September 2020

Abstract

Rationale:
Testicular tumors represent 1% to 1.5% of all tumors in men. Those derived from Leydig cells are rare and account for 1% of testicular tumors. Leydig tumor cells can produce steroid hormones such as estrogen, progesterone and testosterone. The amount and type of hormones secreted by these tumors may produce complicated clinical characteristics in these patients.

Patient concerns:
Here, we report a patient with azoospermia, a testicular Leydig cell tumor (LCT), and elevated plasma testosterone levels. We describe the diagnostic and therapeutic experience of this case, and our follow-up of the patient's clinical indicators and fertility status.

Diagnosis:
The patient was diagnosed with azoospermia and a testicular LCT.

Interventions:
The patient underwent testicular tumor removal and long-term follow-up.

Outcomes:
After 4 months of follow-up, the patient's semen examination index significantly improved and his wife became naturally pregnant. At 4 months of gestation, the fetus was delivered because of a ruptured amniotic cavity. Twenty-six months after tumor removal, the patient's sex hormone levels had completely returned to normal and spermatogenic function had partially recovered, but there was no natural pregnancy with his partner.

Conclusion:
For LCTs, testis sparing surgery may provide a safe and feasible option to restore spermatogenic function, although longer-term follow-up is required. Drug assistance may be required to maintain spermatogenic function and achieve fertility, and further research is required.
Chinese herbal fumigant and lotion for postoperative complication in surgical wound of anal fistula
Authors: Zhu Liying , Ma Sisi , Jia Chunhua , Zhang Bei , Ma Zimi , Park EunHee 
Published: September 2020

Abstract

Background:
Surgery is the most common and effective therapy for anal fistula, while the postoperative complication, such as pain, edema, pruritus, turgescence, and exudation in surgical wound, can have serious impact on wound healing and patients’ quality of life. Chinese herbal fumigant and lotion have been commonly used in postoperative treatment and achieved satisfied effect in China. However, clinical evidence-based literature of Chinese herbal fumigant and lotion for postoperative anal fistula is not sufficient. This protocol is described for a systematic review to investigate the beneficial effects.

Methods:
A systematic search will be conducted in database involving PubMed, the Cochrane library, Embase, Web of Science, Google Scholar, SinoMed, China National Knowledge Infrastructure(CNKI), VIP, Wanfang Database, CiNii(National Institute of Informatics), and KISS(Koreanstudies Information Service System) from inceptions to December 31, 2019. We will include randomized controlled trials (RCT) regarding Chinese herbal fumigant and lotion in the treatment of complication in surgical wound of anal fistula. Quality of included RCTs will be assessed according to the Cochrane Handbook 5.1.0. GRADE will be used to assess the quality of evidence. The summary results will be pooled using the random-effects model or fixed-effects model according to the heterogeneity of included studies.

Results:
After peer-review, the study will be disseminated in scientific journals and conferences.

Conclusion:
This systematic review will provide evidence for the efficacy of Chinese herbal fumigant and lotion for curing postoperative complication of anal fistula. In addition, it might provide suggestions for Chinese medicine clinical practice or guideline.

PROSPERO registration:
CRD42020164975.
Short-term clinical efficacy of the pulsed Nd:YAG laser therapy on chronic nonspecific low back pain
Authors: Abdelbasset Walid Kamal , Nambi Gopal , Elsayed Shereen H. , Alrawaili Saud M. , Ataalla Nahla N. , Abodonya Ahmed M. , Saleh Ayman K. , Moawd Samah A. 
Published: September 2020

Abstract

Background:
Chronic non-specific low back pain (LBP) is gradually increasing among populations worldwide and affects their activities. Recently, the Nd:YAG laser has been presented in the rehabilitation field.

Objectives:
This study aims to explore the short-term effects of the Nd:YAG laser on chronic non-specific LBP individuals.

Methods:
Thirty-five individuals with chronic nonspecific LBP were included in the study from December 2019 to March 2020. Randomly, they were categorized to Nd:YAG group (n = 18) and sham laser as a control (n = 17) thrice weekly for a 6-week intervention. Modified Oswestry disability index (MODI), pain disability index (PDI), visual analogue scale (VAS), and lumbar flexion range of motion (ROM) have been assessed pre and post-6 weeks of the intervention.

Results:
Significant improvements were observed in the Nd:YAG group (MODI, P < .001; PDI, P = .007; VAS, P < .001; lumbar ROM, P = .002), whereas the sham group showed no significant changes (MODI, P = .451; PDI, P = .339; VAS, P = .107; lumbar ROM, P = .296) after 6-week intervention. Between-group comparisons showed significant differences in tending toward the Nd:YAG group (MODI, P < .001; PDI, P = .046; VAS, P < .001; lumbar ROM, P = .003).

Conclusions:
Regarding the present study outcomes, short-term pulsed Nd:YAG laser (6 weeks) may reduce functional disabilities and pain intensity, and improve the lumbar flexion ROM in patients with chronic nonspecific LBP. Further well-designed randomized controlled studies with large sample sizes should be conducted regarding laser treatment.
Primary gastric squamous cell carcinoma presenting as a large submucosal mass
Authors: Gao Lei , Tang Xiaolong , Qu Hui , He Qingsi , Sun Guorui , Shi Jingbo , Ye Jianhong , Liang Yahang 
Published: September 2020

Abstract

Rationale:
Primary gastric squamous cell carcinoma (SCC) is rarely encountered clinically. SCC, which presents as a submucosal tumor, is even rarer. Without the support of pathological evidence, it is difficult to make a correct preoperative diagnosis. Due to limited clinical data, the pathogenesis and treatment of gastric SCC remain unclear.

Patient concerns:
A 69-year-old man was admitted to our hospital with unexplained weight loss. Endoscopy revealed a submucosal mass without any ulcer on its surface located on the body of the stomach. The results of 2 gastroscopic mucosal biopsies were chronic inflammation.

Diagnoses:
The clinical diagnosis by computed tomography (CT) and gastroscopy was gastrointestinal stromal tumor (GIST) preoperatively. The postoperative pathological examination demonstrated this tumor as moderately differentiated SCC.

Interventions:
Total gastrectomy, distal pancreatectomy, and splenectomy were performed.

Outcomes:
The patient was discharged 7 days after the surgery without any complications. The follow-up CT scan showed no evidence of metastatic disease 6 months after surgery.

Lessons:
Large primary gastric SCC could present as a submucosal mass. Gastroscopic mucosal biopsy may not be able to get tumor tissue due to inflammatory reaction.
First-line pemetrexed and carboplatin plus anlotinib for epidermal growth factor receptor wild-type and anaplastic lymphoma kinase-negative lung adenocarcinoma with brain metastasis
Authors: Zhang Chu , Kong Feng-Wei , Wu Wen-Bin , Zhang Miao , Yu Guang-Mao , Wang Xiang , Liu Yuan-Yuan 
Published: September 2020

Abstract

Rationale:
Brain metastasis (BM) is a serious complication in non-small cell lung cancer (NSCLC) patients. Pemetrexed is one of the preferred agents in nonsquamous NSCLC with BM; however, the traditional chemotherapy demonstrated limited efficacy partly due to drug resistance and the blood-brain barrier.

Patient concerns:
A 52-year-old male non-smoker was admitted for irritating cough, chest distress, and back pain.

Diagnoses:
Epidermal growth factor receptor wild-type, anaplastic lymphoma kinase-negative primary lung adenocarcinoma with an asymptomatic solitary BM (cTxNxM1b, IVA).

Interventions:
Pemetrexed (500 mg/m2 of body surface area) and carboplatin (area under the curve of 5) were firstly administered every 3 weeks for 3 cycles, followed by pemetrexed/carboplatin plus anlotinib (12 mg daily; 2 weeks on and 1 week off) for another 3 cycles. Then maintenance anlotinib monotherapy was continued for a year, without unacceptable adverse events.

Outcomes:
The BM was slightly enlarged after 3 cycles of pemetrexed/carboplatin; however, a complete remission was achieved after the combination therapy. His intracranial progression-free survival was more than 2 years.

Lessons:
Pemetrexed/carboplatin plus anlotinib could be considered for the treatment of epidermal growth factor receptor wild-type, anaplastic lymphoma kinase-negative lung adenocarcinoma with BM. Further well-designed trials are warranted to verify this occasional finding.
Impact of bedside assistant on outcomes of robotic thyroid surgery
Authors: Kwon Hyungju 
Published: September 2020

Abstract
The importance of bedside assistants has been well established in various robotic procedures. However, the effect of assistants on the surgical outcomes of thyroid surgery remains unclear. We investigated the effects of a dedicated robot assistant (DRA) in robotic thyroidectomy. We also evaluated the learning curve of the DRA.
Between January 2016 and December 2019, 191 patients underwent robotic total thyroidectomy, all of which were performed by a single surgeon. The DRA participated in 93 cases, while non-dedicated assistants (NRAs) helped with 98 cases. Demographic data, pathologic data, operative times, and postoperative complications were recorded and analyzed.
Robotic thyroidectomy was successful in all 191 patients, and none required conversion to the conventional open procedure. Mean operative time was shorter in the DRA group than in the NRA group (183.2 ± 33.6 minutes vs 203.1 ± 37.9 minutes; P < .001). There were no significant differences in terms of sex distribution, age, preoperative serum thyroid stimulating hormone level, or pathologic characteristics between the groups. Cumulative summation analysis showed that it took 36 cases for the DRA to significantly reduce operative time. Mean operative time decreased significantly in the subgroup including the 37th to the 93rd DRA cases compared with the subgroup including only the first 36 DRA cases (199.7 ± 37.3 minutes vs 172.8 ± 26.4 minutes; P < .001). NRA group showed no definite decrease of operation time, which indicated that the NRAs did not significantly deviate from the mean performance.
Increased experience of the bedside assistant reduced operative times in the robotic thyroidectomy. Assistant training should be considered as a component of robotic surgery training programs.
Immune benefit of combined heart and liver transplantation
Authors: Ortega-Legaspi Juan M. , Hoteit Maarouf , Wald Joyce 
Published: September 2020

Purpose of review
Understanding the mechanisms involved in immune protection provided by a hepatic allograft is imperative as further therapies for highly sensitized patients could be developed and thus expanding the donor pool and improving outcomes.

Recent findings
The clinical data from immune protection comes mainly from combined liver and kidney transplants with excellent results in overall survival and also that of the allograft. This phenomenon has also been observed in dual liver transplants with heart, lung, skin and intestines, albeit with less data. In heart transplant recipients, the liver allograft has proven to be protective even in cases of highly sensitized patients with at least equal survival and rejection outcomes to recipients of heart alone. Although not fully understood, the mechanisms for immune benefit proposed are extensive at different levels of the hepatic immune system. Some of these mechanisms include chimerism, T-cell deletion, the presence of peripheral regulatory T cells and donor-specific antibody neutralization.

Summary
Combined heart and liver transplantation is an infrequent but growing procedure due to increasing need in the adult congenital heart disease and cardiac amyloid populations. Given the ever expanding need for heart transplantation, understanding immunological phenomena that could expand the donor pool could, subsequently, increase the number of transplants.
Pathomics in urology
Authors: Schuettfort Victor M. , Pradere Benjamin , Rink Michael , Comperat Eva , Shariat Shahrokh F. 
Published: September 2020

Purpose of review
Pathomics, the fusion of digitalized pathology and artificial intelligence, is currently changing the landscape of medical pathology and biologic disease classification. In this review, we give an overview of Pathomics and summarize its most relevant applications in urology.

Recent findings
There is a steady rise in the number of studies employing Pathomics, and especially deep learning, in urology. In prostate cancer, several algorithms have been developed for the automatic differentiation between benign and malignant lesions and to differentiate Gleason scores. Furthermore, several applications have been developed for the automatic cancer cell detection in urine and for tumor assessment in renal cancer. Despite the explosion in research, Pathomics is not fully ready yet for widespread clinical application.

Summary
In prostate cancer and other urologic pathologies, Pathomics is avidly being researched with commercial applications on the close horizon. Pathomics is set to improve the accuracy, speed, reliability, cost-effectiveness and generalizability of pathology, especially in uro-oncology.