bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sorafenib treatment on Chinese patients with advanced hepatocellular carcinoma
Authors: Lee Shou-Wu , Lee Teng-Yu , Peng Yen-Chun , Yang Sheng-Shun , Yeh Hong-Zen , Chang Chi-Sen 
Published: November 2019

Abstract
Sorafenib is of proven efficacy in treating patients of hepatocellular carcinoma (HCC). Our study was aimed to determine the factors influence the sorafenib efficacy.
We evaluated data of HCC patients receiving sorafenib from June 2012 to October 2016. All HCC cases were of the Barcelona Clinic Liver Cancer (BCLC) classification stage C. The exclusion criteria: those of BCLC classification stage A or B, with the absence or co-infection of hepatitis B (HBV) and hepatitis C (HCV). The presence of HBV, HCV, macoscopic vascular invasion (MVI) or extrahepatic spread (EHS) was recorded for each patient. Time-to-progression (TTP) and overall survival (OS) were analyzed.
Among a total of 90 HCC patients, 48 (53.3%) had HBV infection, 42 (46.7%) had HCV infection, 51 (56.7%) had MVI, and 39 (43.3%) had EHS. Patients with HCV infection showed better TTP and OS than those with HBV infection. Patients with EHS had a longer TTP and OS than those with MVI. For patients with HBV infection, those with EHS had a longer TTP (mean 4.60 vs 2.64 months, P = .002) and OS (mean 6.65 vs 4.53 months, P = .045) compared to those with MVI. Among those with MVI, patients with HBV infection had a poorer TTP (mean 2.64 vs 4.74 months, P = .019) and shorter OS (mean 4.53 vs 7.00 months, P = .059) compared to those with HCV infection.
HCC patients with HCV infection or with the presence of EHS showed better sorafenib efficacy.
High peroxidasin-like expression is a potential and independent prognostic biomarker in breast cancer
Authors: Li Yanqing , Jiao Yan , Luo Zhangping , Li Yang , Liu Yanan 
Published: November 2019

Abstract
Breast cancer is a frequent female malignant tumor with high mortality and poor prognosis. Peroxidasin like (PXDNL) has many biological functions, including characteristic activity of hormone biosynthesis, host defense, and cell motility. In addition, PXDNL is closely connected with the progression of breast cancer. In this study, we found that PXDNL may be an independent prognostic biomarker of breast cancer.
We tested the mRNA expression of PXDNL in breast cancer by detecting The Cancer Genome Atlas (TCGA) database. The chi-squared test was used to evaluate clinical correlation. The receiver operating characteristic (ROC) curves were drawn to evaluate diagnosis potential in breast cancer. Subsequently, survival analyses were performed to identify the relevance between the expression of PXDNL and the overall survival/relapse-free survival of patients with breast cancer. Univariate/multivariate Cox regression model was executed to detect risk factors affecting the prognosis of patients with breast cancer.
PXDNL is highly expressed in breast cancer tissues and is related to survival status of patients. The ROC curve showed that PXDNL had beneficial diagnostic ability in breast cancer. Survival analysis indicated that patients with breast cancer with high PXDNL expression generally had decreased overall survival/relapse-free survival. Univariate/multivariate Cox model analyses further suggested an association between PXDNL expression and prognosis of patients with breast cancer.
High PXDNL expression is a potential and independent prognostic biomarker in breast cancer.
Risk factors of invasive candidiasis in critical cancer patients after various gastrointestinal surgeries
Authors: Xia Rui , Wang Donghao 
Published: November 2019

Abstract
For early diagnosis and treatment of invasive candidiasis (IC), the well-known risk factors may not apply in the intensive care unit (ICU). This retrospective study identified the risk factors predicting IC and candidemia in cancer patients under intensive care after gastrointestinal surgery.
Enrolled were 229 cancer patients admitted to our oncology surgical ICU after gastrointestinal surgery between January 1, 2010 and October 31, 2014.
The most common types of solid gastrointestinal cancers were gastric (49.8%), colon (20.1%), and esophageal (18.3%). The percentage of patients with corrected Candida colonization index (CCI) ≥0.4 was 31.9%. IC was confirmed in 19 patients (8.3%), and the ICU mortality was 15.8%. Candida albicans accounted for 52.6% of the total number of pathogenic Candida isolates. Among patients with CCI ≥0.4, the cancers with the highest prevalence were cardiac (45%) and gastric (36%), with ICU mortalities of 20% and 4.9%, respectively. For the diagnosis of candidemia, (1-3)-β-D-glucan (BDG) ≥80 pg/mL showed a sensitivity and specificity of 25% and 82.7%, respectively, positive and negative predictive values 6.7% and 95.7%, and area under the receiver operating characteristic curve 0.512. CCI ≥0.4 was the only significant predictor of IC, and number of organ failures was the only predictor of candidemia (P = .000 and .026).
CCI ≥0.4 was the only significant risk factor predicting IC, with greater prediction of intra-abdominal candidiasis but failure to predict candidemia. Blood culture and BDG detection are recommended to supplement diagnosis. Patients may have multifocal and high-grade Candida colonization after cardiac surgery, and; therefore, are at high risk of IC, which should be taken seriously.
Medical, epidemiologic, and social aspects of aging urinary incontinence questionnaire
Authors: Sun Yuanjie , Liu Yan , Su Tongsheng , Yuan Jingxue , Liu Zhishun 
Published: November 2019

Abstract

Introduction:
Mixed urinary incontinence (MUI) is a coexistence of both urgency urinary incontinence and stress urinary incontinence. Medical, Epidemiologic, and Social aspects of Aging (MESA) questionnaire is a validated and commonly used tool to diagnose predominant components of it and assess the severity, which can offer help in clinic. However, MESA questionnaire is still not available in China. The aim of the study is to translate English MESA questionnaire into a Chinese version, adapt it in Chinese culture, and validate the measurement properties among female patients with MUI and urgency-predominant MUI.

Methods:
MESA questionnaire will be translated and culturally adapted in China. The validation will be embedded in a multicentered randomized controlled trial targeted at women with urgency-predominant MUI. Apart from MESA questionnaire, 3 groups of patients are to receive clinical extended assessment, keep 3-day voiding diary, and complete International Consultation on Incontinence Questionnaire Short Form to evaluate the measurement properties of reliability and validity (internal consistence, test-retest reliability, construct validity, and responsiveness).

Discussion:
If MESA questionnaire is of relatively high reliability and validity in diagnosing subtypes of MUI and assessing the severity, it can help to choose more appropriate therapy for patients and simplify the workload of clinicians.

Trial registration:
ClinicalTrials.gov NCT03803878, January 11, 2019.
Bladder cancer survival nomogram
Authors: Zhang Ye , Hong Ying-kai , Zhuang Dong-wu , He Xue-jun , Lin Ming-en 
Published: November 2019

Abstract
Bladder cancer (BC) is a common malignancy associated with high morbidity and mortality, however, accurate and convenient risk assessment tools applicable to BC patients are currently lacking. Previous studies using nomograms to evaluate bladder cancer (BC) survival have been based on small samples. Using a large dataset, this study aimed to construct more precise clinical nomograms to effectively predict bladder cancer survival.
Data on patients with pathologically-confirmed bladder cancer were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Additional BC patient data for an external validation cohort were extracted from the Cancer Genome Atlas (TCGA) database. Clinical parameters that constituted potential risk factors were reviewed and analyzed using univariate and multivariate Cox proportional hazards regression. A nomogram was constructed with parameters that significantly correlated with the overall survival (OS). Prognostic performance of a nomogram was assessed using the concordance index (c-index), area under the receiver operating characteristic curve (AUC), and a calibration curve. The model was then tested with data from an internal and external validation cohort. Patients’ survival was analyzed and compared with the Kaplan-Meier (KM) method.
Multivariate Cox regression showed that age, sex, race, stage_T1, stage_T2a, stage_T2b, stage_T3a, stage_Ta, stage_Tis, stage_N, stage_M were independent predictors of BC survival. A nomogram was constructed based on these factors. The c-index of the nomogram was 0.7916 (95% confidence interval CI, 0.79–0.80). The calibration curve showed excellent agreement between the predicted and observed values. The c-index for the internal validation cohort was 0.7917 (95% CI 0.79-0.80), which was higher than for the training cohort, suggesting robustness of the model. For the training cohort, the AUC for the 3- and the 5-year survival was 0.82 and 0.813, respectively. The c-index for the TNM-based model was superior to that for the AJCC-TNM classification.
The models presented in this study might be suitable for clinical use, supporting clinicians in their individualized assessment of expected survival in BC patients. They might also be used as a layered tool for clinical research.
The use of dermal regeneration template for treatment of complex wound with bone/tendon exposed at the forearm and hand, a prospective cohort study
Authors: LV Zhenmu , Yu Lili , Wang Qiusheng , Jia Rui , Ding Wenyuan , Shen Yong 
Published: November 2019

Abstract
The purpose of this study was to assess the efficacy and safety of Pelnac and split-thickness skin graft for management of complex wound with underlying bone/tendon exposure at forearm and hand.
This is a prospective study, beginning from March 2013 up to May 2017. There were 13 patients, with age of 31.2 years. All of them underwent the staged Pelnac and split-thickness skin graft to manage the complex wound with bone/tendon. Postoperatively, scheduled follow-up was conducted.
The average follow-up was 15 months. There were no infections, wound necrosis, hematoma, or seroma during the phase when Pelnac was applied. There was 100% “take” of the Pelnac in 12/13 patients. In 11 patients, there was complete skin graft “take”. Patients’ satisfaction for the esthetic appearance of the grafted area was 75.0 ± 8.5/100. The VSS value was 2.9 ± 2.5. Regarding the sensory recovery, the response of “normal or near normal” could be obtained in 7/13 patients, “slight loss” in 5 patients and “significant loss” in 1 case. The average DASH score was 27.2 ± 18.5, and most patients (12/13) could obtain an acceptable ability to perform the daily activities.
Pelnac dermal template is a favorable alternative to flap reconstruction in the treatment of complex wound with underlying tissues exposure.
Korean medicines for poor ovarian reserve in infertility
Authors: Choi Tae-Young , Jun Ji Hee , Lee Hye Won , Ang Lin , Kim Eun Seop , Go Ho Yeon , You Sooseong , Lee Myeong Soo 
Published: November 2019

Abstract

Introduction:
Many infertile patients have used Korean medicines (KMs) as a primary or adjuvant therapeutic method to improve in vitro fertilization success rates. The aim of this multicenter observational study is to investigate the effects of KMs on poor ovarian reserve (POR) in infertile patients.

Methods and analysis:
We will perform a prospective multicenter observational study. This study will recruit 50 women between 25 and 44 years of age with infertility caused by POR from among patients who visit the KM clinic. All participants will visit the KM clinic on the 2nd or 3rd day of menstruation to receive the KMs. KM treatment will be delivered for 3 menstrual cycles (3 months) and will include herbal decoction, acupuncture, or moxibustion on demand. Every participant will be assessed based on KM clinical symptoms, a quality of life questionnaire, and ovarian reserve test results.

Ethics and dissemination:
The study was approved by Institutional Review Board of Semyung University (SMU-IM-190501). The results will be published in a peer-reviewed journal and will be disseminated electronically and in print.

Trial registration number:
Clinical Research Information Service: KCT0004209.
Efficacy of contrast-enhanced ultrasound for diagnosis of cesarean scar pregnancy type
Authors: Wu Yun , Zhou Liuying , Chen Lin , Zhou Qian , Zeng Tao 
Published: November 2019

Abstract

Objectives:
We compared the clinical efficacy of contrast-enhanced ultrasound (CEUS) to transvaginal ultrasound (TVS) for diagnosing cesarean scar pregnancy (CSP).

Methods:
A total of 485 cases of suspected CSP were recruited from January 2017 to March 2018. All received TVS and CEUS by two sonologists blinded to diagnosis by the other. Diagnostic features of CSP that significantly differed between modalities by univariate analysis (P < .05) were included in a logistic regression model. The sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (−LR), and accuracy (ACC) of CSP diagnosis by TVS and CEUS were compared according to operational and pathological outcomes as the reference standard.

Results:
There were 220 CSP cases (including 85 cases of type I, 93 of type II, and 42 of type III). The sensitivities of CEUS for detection of types I − III CSP were 94.1%, 92.5%, and 97.6%, respectively, and corresponding sensitivities of TVS were 82.4%, 80.6%, and 95.2%. Compared to TVS, CEUS yielded significantly better overall sensitivity (97.27% vs 88.18%), specificity (96.60% vs 75.47%), +LR (28.60 vs 3.59), −LR (0.03 vs 0.16), and diagnostic ACC (96.9% vs 81.23%) (all P < .001).

Conclusions:
CEUS is superior to TVS for detecting cesarean scar pregnancy and distinguishing among CSP types.
Perinatal outcome in women with bacterial sepsis
Authors: Duan Ruiqi , Xu Xiumei , Wang Xiaodong , Yu Haiyan 
Published: November 2019

Abstract
Maternal bacterial sepsis during pregnancy and the postpartum period is a common cause of maternal mortality and fetal morbidity and mortality. This study was performed to analyze perinatal prognosis and related factors of maternal bacterial sepsis in west China.
We conducted a cross-sectional study of pregnant women with bacterial sepsis who were admitted into a tertiary care center in western China between 2011and 2015. Data from these cases were collected and analyzed.
Eighty six women were identified with bacterial sepsis in our hospital, and the incidence of maternal bacterial sepsis was 1.7 per 1000 maternities, the incidence of septic shock was 1.8 per 10,000 maternities, and 1 maternal death occurred. Among the 86 pregnant women with bacterial sepsis, genital tract infection was the most common source of infection (41/86, 47.7%). The most common bacteria in the Gram-positive bacteria group was Listeria monocytogenes and in the Gram-negative bacteria group was Escherichia coli. The premature delivery rate (65.7%) was substantially higher in the Gram-negative bacteria group (P = .011), and the miscarriage rate (31.3%) was higher in the Gram-positive bacteria group (P = .042). The fetal/neonatal mortality rate was 20% (21/105) and higher in the Gram-positive bacteria group (P = .008), and the infant mortality rate in 1 year was 7.1% (6/84).
Bacterial sepsis remains an alarming cause of both maternal and fetal morbidity and mortality, and infant mortality. Key treatment involves a multi-disciplinary group of clinicians with experience in all aspects of the care of pregnant women with sepsis and early initiation of appropriate antibiotics according to the type of bacterial infection. The effect of maternal sepsis on long-term fetal outcome should be investigated.
Dispatcher assisted cardiopulmonary resuscitation implementation in Kuwait
Authors: Hasan Dalal Al , Drennan Jonathan , Monger Eloise , Mahmid Salim Al , Ahmad Haitham , Ameen Mohmmad , Sayed Mazen El 
Published: November 2019

Abstract
Dispatcher assisted cardiopulmonary resuscitation (DACPR) by Emergency medical services has been shown to improve rates of early out of hospital cardiac arrest (OHCA) recognition and early cardiopulmonary resuscitation (CPR) for OHCA. This study measures the impact of introducing DACPR on OHCA recognition, CPR rates and on patient outcomes in a pilot region in Kuwait.
EMS treated OHCA data over 10 months period (February 21–December 31, 2017) before and after the intervention was prospectively collected and analyzed.
Comprehensive DACPR in the form of: a standardized dispatch protocol, 1-day training package and quality assurance and improvement measures were applied to Kuwait EMS central Dispatch unit only for pilot region. Primary outcomes: OHCA recognition rate, CPR instruction rate, and Bystander CPR rate. Secondary outcome: survival to hospital discharge.
A total of 332 OHCA cases from the EMS archived data were extracted and after exclusion 176 total OHCA cases remain. After DACPR implementation OHCA recognition rate increased from 2% to 12.9% (P = .037), CPR instruction rate increased from 0% to 10.4% (P = .022); however, no significant change was noted for bystander CPR rates or prehospital return of spontaneous circulation. Also, survival to hospital discharge rate did not change significantly (0% before, and 0.8% after, P = .53)
In summary, DACPR implementation had positive impacts on Kuwait EMS system operational outcomes; early OHCA recognition and CPR instruction rates in a pilot region of Kuwait. Expanding this initiative to other regions in Kuwait and coupling it with other OHCA system of care interventions are needed to improve OHCA survival rates.
A multicenter, randomized, double-blind, placebo-controlled trial evaluating the efficacy and safety of Taoren Honghua Jian granule in patients with stable coronary artery disease
Authors: Wang Yiru , Zhang Yiyi , Du Yiyue , Yang Ying , Wei Jing , Zhang Na , Mao Meijiao , Du Wenting , Liu Ping 
Published: November 2019

Abstract

Introduction:
Stable coronary artery disease (SCAD) is a common clinical style in patients with coronary artery disease. Inflammation and immune injury in SCAD have been proven. Current interventions can relieve patients’ symptoms, but none are stable to improve the immune damage significantly. Chinese herb is used to treat stable angina pectoris as an alternative therapy. Taoren Honghua Jian granule (THJG) is a classical formula from which patients can benefit, but lack convincing evidence. Therefore, we report a protocol of high-quality randomized controlled trial.

Methods/design:
We will conduct a randomized, double-blind, placebo-controlled clinical trial to assess the effect of THJG in relief of symptoms and blood immune indexes. A total of 80 patients with SCAD will be enrolled, and treated with THJG or placebo for 4 weeks. The primary outcome measurement is change of integral traditional Chinese medicine (TCM) syndrome score from baseline to 4 weeks’ treatment. The 2nd outcome measurements include change of integral TCM syndrome scores from baseline to 2 weeks’ treatment and another 4 weeks’ follow-up, inflammation indexes at baseline and 4 weeks’ treatment. It also includes Seattle Angina Questionnaire, major adverse cardiovascular events, Athens Insomnia scale, and 36-item short form health survey score from baseline to 2 weeks’ and 4 weeks’ treatment, and another 4 weeks’ follow-up. Adverse events will be evaluated throughout the trial.

Discussion:
The results of this trial will prove whether THJG could alleviate symptoms, control inflammation, and improve quality of life in patients with SCAD.

Trial registration:
ChiCTR1900021772, registered 8 March, 2019.
Lumbar disc reherniation prevention with a bone-anchored annular closure device
Authors: van den Brink Wimar , Flüh Charlotte , Miller Larry E. , Klassen Peter Douglas , Bostelmann Richard 
Published: November 2019

Abstract

Background:
The risk of recurrent herniation after lumbar discectomy is highest during the first postoperative year. The purpose of this study was to determine whether implantation of a bone-anchored annular closure device (ACD) following limited lumbar discectomy reduced the risk of recurrent herniation and complications during the first year of follow-up compared to limited lumbar discectomy alone (Controls) and whether this risk was influenced by patient characteristics.

Methods:
In this randomized multicenter trial, patients with symptomatic lumbar disc herniation and with a large annular defect following limited lumbar discectomy were randomized to bone-anchored ACD or Control groups. The risks of symptomatic reherniation, reoperation, and device- or procedure-related serious adverse events were reported over 1 year of follow-up.

Results:
Among 554 patients (ACD 276; Control 278), 94% returned for 1-year follow-up. Bone-anchored ACD resulted in lower risks of symptomatic reherniation (8.4% vs. 17.3%, P = .002) and reoperation (6.7% vs. 12.9%, P = .015) versus Controls. Device- or procedure-related serious adverse events through 1 year were reported in 7.1% of ACD patients and 13.9% of Controls (P = .009). No baseline patient characteristic significantly influenced these risks.

Conclusions:
Among patients with large annular defects following limited lumbar discectomy, additional implantation with a bone-anchored ACD lowered the risk of symptomatic reherniation and reoperation over 1 year follow-up. Device- or procedure-related serious adverse events occurred less frequently in the ACD group. These conclusions were not influenced by patient characteristics. ClinicalTrials.gov (NCT01283438).
JAK2 V617F-positive essential thrombocythemia with subsequent development of immune thrombocytopenia
Authors: Oda Yasuhiro , Sato Shuku , Kanbe Emiko , Kamata Wataru , Okada Satomi , Tamai Yotaro 
Published: November 2019

Abstract

Rationale:
Although essential thrombocythemia (ET) and immune thrombocytopenia (ITP) have different etiologies, 3 previous reports have described ET development in ITP patients, all of whom were positive for the JAK2 V617F mutation. Here, we report the first published case of ITP following ET in the absence of other platelet disorders.

Patient concerns:
A 70-year-old woman with a five-year history of ET with JAK2 V617F mutation treated with hydroxycarbamide for five months presented with petechiae on her limbs.

Diagnosis:
Her platelet count was 3 × 109/L, with the immature platelet fraction being 29%. White blood cell count and hemoglobin level were normal. Bone marrow examination showed increased number of megakaryocytes, but no morphologic dysplasia in any lineage. G-band analysis revealed no abnormalities. Platelet transfusion and cessation of hydroxycarbamide did not affect the platelet count. Thrombocytopenia was unlikely to have been induced by drugs, heparin, systemic lupus erythematosus, or human immunodeficiency virus. Hence, a diagnosis of ITP was made.

Interventions:
The patient received oral prednisolone combined with intravenous immunoglobulin.

Outcomes:
Her platelet count rose to 310 × 109/L and remained stable, while her steroid dose was reduced. Further blood tests revealed the presence of antibodies against Helicobacter pylori, and appropriate treatment was administered. Resumption of hydroxycarbamide did not induce thrombocytopenia.

Lessons:
Although ET and ITP have different etiologies, chronic inflammation and immune deregulation underlie both and may play an important role in the progression from one to the other. Further research is warranted to understand the relationship between ET and ITP.