bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical characteristics, diagnosis, and predictors of neurosyphilis patients with human immunodeficiency virus co-infection
Authors: Yu Jianhua , Shi JinChuan , Wan Hu , Li Jianwei , Shao Ying , Ye Jiangzhu , Dai Lili , Wang Xiwen , Liu An 
Published: October 2021

Abstract
This study aimed to compare between the clinical and laboratory characteristics of neurosyphilis and those of syphilis in human immunodeficiency virus (HIV) positive and explore the risk factors associated with the occurrence of neurosyphilis in the HIV infected.
In-patients diagnosed with HIV and syphilis co-infection who underwent a lumbar puncture and completed cerebrospinal fluid (CSF) examination were divided into neurosyphilis group and syphilis group. The demographic characteristics, symptoms and signs, and laboratory tests of the 2 groups were comparatively analyzed. Logistic regression analysis was used to explore the risk factors associated with the occurrence of neurosyphilis.
Among 81 patients, 33 patients were assigned to the neurosyphilis group, and 48 to the syphilis group. There were no significant differences in the age, gender, marital status, acquired immunodeficiency syndrome course, opportunistic infections, serum HIV viral load, and history of syphilis treatment. The difference in HIV transmission route between the 2 groups was statistically significant (P = .010), and the patients from the neurosyphilis group were mainly infected via heterosexual contact. The proportion of serum toludine red unheated serum test (TRUST) titer ≥1:16 in the neurosyphilis group were 78.8%, which was significantly higher compared to the syphilis group (48.9%). The level of CSF white blood cell count, CSF protein, and CSF HIV viral load in the neurosyphilis group were significantly higher than those of the syphilis group. The proportion of patients with neurological symptoms and signs in the neurosyphilis group was significantly higher compared to the syphilis group (P < .001). Multivariate logistic regression analysis showed that heterosexual contact transmission route, not received antiretroviral therapy, lower CD4 cell count and higher serum TRUST titer, untreated with syphilis, and neurological symptoms and signs were risk factors associated with the occurrence of neurosyphilis.
The serum TRUST titer, CSF white blood cell count, CSF protein level, CSF HIV viral load, and the percentage of neurological symptoms and signs in the neurosyphilis group were higher. Heterosexual transmission route, not received antiretroviral therapy, and untreated with syphilis prompted the possibility of neurosyphilis occurrence.
Effect of Tai Chi on cardiac function in patients with myocardial infarction
Authors: Zhao ShuJun , Zu YuGang , Lu Man , Jia XinWei , Chen Xi 
Published: October 2021

Abstract

Background:
Myocardial infarction is 1 of the most serious cardiovascular diseases. Early interventional therapy preserves the cardiac function of patients with myocardial infarction to the greatest extent, but it is far from meeting people's need only limited to cardiac revascularization. It is also necessary to help patients improve their quality of life, exercise tolerance, and reduce the incidence of acute cardiac recurrence as much as possible. All these depend on cardiac rehabilitation (CR) are based on exercise. Early and correct CR helps to improve the patient's heart function and improve living standards. Traditional Chinese exercise Tai Chi as an alternative form of CR has gradually become popular, but it lacks large samples and high-quality clinical studies to verify it. This study aims to explore the effect of Tai Chi on the cardiac function of patients with myocardial infarction, and to provide a strong basis for patients to choose which CR exercise.

Methods:
This is a prospective randomized controlled trial. 272 patients with myocardial infarction will be randomly divided into an experimental group and a control group according to 1:1, with 136 cases in each group. The control group: conventional treatment; the experimental group: increase Tai Chi exercise on the basis of the control group. Both groups will receive standard treatment for 24 weeks and will be followed up for 3 months. Observation indicators include: total effective rate, 6 minutes walking test, brain natriuretic peptide, left ventricular ejection fraction, the adverse reaction rate, etc. The data will be analyzed by using SPSS 25.0 software.

Discussion:
This study will evaluate the effect of Tai Chi on the cardiac function of patients with myocardial infarction. The results of this test will provide clinical evidence for patients to choose which CR exercise.

Trial registration:
OSF Registration number: DOI 10.17605/OSF.IO/QKWDP.
Effects of maternal sugar intake during pregnancy on allergies in offspring
Authors: Wu Yijun , Chai Xiaoli 
Published: October 2021

Abstract

Background:
To our knowledge, there is no comprehensive evidence quantifying the plausibility of the association between maternal free sugar intake during pregnancy and the development of offspring's allergic diseases. Thus, this systematic review examines the weight of evidence for causality from cohort studies on the association between maternal free sugar intake during pregnancy and the development of allergies in offspring.

Methods:
The present meta-analysis is prepared and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We search PUBMED, Scopus, EMBASE, and Cochrane Library databases through October, 2021. All clinical trials to assess the efficacy of maternal sugar intake during pregnancy on allergies in offspring are considered eligible for analysis. The Comprehensive Meta-Analysis Software 2 program is used for statistical analyses of the pooled data. A P value < .05 is considered statistically significant. The outcome measure is development of allergic disease among offspring assessed by any method (parental history, doctor diagnosed, or questionnaire based).

Results:
It is hypothesized that high free sugar consumption during pregnancy may be associated with the development of allergies in offspring.
Comparison of therapeutic efficacy and toxicity of docetaxel, cisplatin, and fluorouracil (TPF)-based induction chemotherapy plus concurrent chemoradiotherapy and chemoradiotherapy alone in locally advanced nasopharyngeal carcinoma
Authors: Chen Ruijuan , Lu Yongkai , Zhang Yuemei , He Ruixin , Tang Fengwen , Yuan Wei , Li Yi , Zhang Xiaowei 
Published: October 2021

Abstract

Purpose:
In recent years, docetaxel, cisplatin, and fluorouracil (TPF)-based induction chemotherapy plus concurrent chemoradiotherapy (CCRT) has been commonly applied for locally advanced nasopharyngeal carcinoma (LA-NPC). However, whether TPF+CCRT regimen is the best choice for LA-NPC remains unclear. This meta-analysis aims to elucidate and compare the efficacy and toxicity of TPF+CCRT versus CCRT alone for LA-NPC.

Methods:
Two investigators independently and systematically searched relevant studies available on PubMed, Embase, Cochrane Library, and Web of Science published before January 7, 2021. Data were extracted from eligible studies for assessing their qualities, and calculating pooled hazard ratios (HR), odds ratio (OR) and 95% confidence intervals (CI) using Review Manager software 5.3 (RevMan 5.3).

Results:
Five studies involving 759 LA-NPC patients were analyzed in the meta-analysis. Compared to CCRT alone, TPF-based IC plus CCRT significantly improved overall survival (OS) (HR = 0.53, 95% CI: 0.35–0.81, P = .003), progression-free survival (PFS) (HR = 0.63, 95% CI: 0.46–0.86, P = .004), distant metastasis-free survival (DMFS) (HR = 0.58, 95% CI: 0.39–0.86, P = .008), and locoregional failure-free survival (LRFFS) (HR 0.62, 95% CI: 0.43–0.90, P = .01). In addition, TPF-based IC plus CCRT mainly increased risks of grade 3/4 acute hematological toxicity and non-hematological toxicities like leukopenia (OR = 1.84, 95% CI: 0.42–8.03, P = .42), neutropenia (OR = 1.78, 95% CI: 0.23–13.82, P = .58), thrombocytopenia (OR = 1.76, 95% CI: 0.53–5.81, P = .35), febrile neutropenia (OR = 2.76, 95% CI: 0.07–101.89, P = .58), vomiting (OR = 18.94, 95% CI: 0.99–362.02, P = .05) and dry mouth (OR = 2.23, 95% CI: 0.22–22.57, P = .50), which were uncomplicated and manageable.

Conclusions:
TPF + CCRT is superb than CCRT alone for the management of LA-NPC. However, TPF+CCRT increases the incidences of grade 3/4 acute hematological toxicity and some non-hematological toxicities.
The packaging and clean method contribute to insulation failure of electrosurgical instruments
Authors: Zhang Ying , Zhang Yanyan , Wang Yafei , Yang Lili , Hu Ruying 
Published: October 2021

Abstract
With the rapid development of medical technology, the use of electrosurgical instruments is dramatically increased in various types of surgery. However, the damage of the insulation layer of the reusable electrosurgical instrument often causes surgical accidents. The procedures of packaging and cleaning contribute to many damages to insulating layer of reusable electrosurgical instruments.
Various types of reusable electrosurgical instruments were detected for insulation failures, conduction failures, short-circuit by using a high-voltage detector, DIATEG (Morgate company). In addition, reusable electrosurgical instruments were detected for insulation failures after packaging and cleaning by different procedures.
13.1% (129/740) electrosurgical instruments had an insulation test failure; 6.2% (9/146) monopolar wires were with conduction failure; and 7.7% (16/207) bipolar wires were with short-circuit. Different packaging and cleaning procedures contribute to various degrees of damages to insulating property of reusable electrosurgical instruments.
Insulation failure was a wide problem of reusable electrosurgical instruments, while fixed packaging method and mild cleaning procedures result in fewer damages to insulating property of reusable electrosurgical instruments.
Epidemiological characteristics of COVID-19 clusters in Hainan, China
Authors: Xiao Sha , Liu Yunru , Liu Fang , Zhang Hanxi , Zhang Fan , Wang Lu 
Published: October 2021

Abstract
To analyze the epidemiological characteristics of coronavirus disease 2019 (COVID-19) clusters in Hainan, and to provide a basis for the prevention and control of disease clusters.
Descriptive epidemiology was used to retrospectively analyze the characteristics of disease clusters in 168 cases of COVID-19.
Of the 168 COVID-19 cases, 99 (58.93%) comprised 29 clusters, 22 (75.86%) of which were imported and included 63 cases (63.64%), while 7 clusters (24.14%) were local and included 36 cases (36.36%). Of the cluster cases, 49 were men (49.49%) and 50 were women (50.50%), the median age was 52 years, and the maximum number of cases from 41 to 60 was at 37 years (37.37%). There were 67 first generation cases (67.68%), 28 (28.28%) second generation, and 4 (4.04%) third generation. Of the clusters, 68.97% occurred from January 31 to February 7, with the highest peak on February 6. The local disease clusters occurred with a time lag. The 2 cities with the most reported incidents were Sanya (10 cases, 34.48%) and Haikou (5 cases, 17.24%). Family clusters were most frequent, with 18 clusters (62.07%) involving 62 cases (62.63%), followed by social clusters, with 3 clusters (10.34%). The most complex clusters involved 3 cluster types (family, travel, and community). There was a statistically significant difference in the infectivity of the imported clusters versus the local clusters, with imported clusters being lower (Z = –2.851, P = .004). The infectivity of all cases or family members was highest in Haikou and lowest in Sanya. The infectivity of all cases with an incubation period of ≤7 days was 1.53 ± 1.01, in which the infectivity of family members was 1.29 ± 1.10. The infectivity of all cases with an incubation period of ≤14 days was 1.89 ± 1.23, in which the infectivity of family members was 1.43 ± 1.37.
COVID-19 clusters in Hainan mainly occurred in families, and local clusters had high infectivity. Therefore, key populations and regions should be monitored, and targeted preventive measures should be carried out to provide a reference for the prevention and control of disease clusters.
Network meta-analysis of 6 kinds of Chinese patent medicines combined with mifepristone in the treatment of uterine fibroids
Authors: Bi Chenhao , Qiao Mingqi , Jia Yuqi , Wang Haijun 
Published: October 2021

Abstract

Background:
Uterine fibroids are benign. They belong to the category of “abdominal mass” in traditional Chinese medicine, and pathogenesis is mainly caused by weakness of the body, qi stagnation, and blood stasis. Drug therapy is the preferred treatment of uterine fibroids in clinical practice, and mifepristone is the most commonly used drug. In the past decade, a large number of clinical randomized controlled trials have proven that Chinese patent medicine combined with mifepristone in the treatment of uterine fibroids has a better curative effect, fewer adverse reactions, and higher safety than mifepristone alone. However, there is a lack of evidence-based research. This study aims to integrate clinical data through network meta-analysis to provide more evidence-based medical evidence for clinical medication.

Methods:
The comprehensive search included Chinese and other-language databases, such as MEDLINE (PubMed), Web of Science, The Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, China Scientific Journal Database, and China Biomedical Literature Database. Clinical randomized controlled trials of 6 Chinese patent medicines combined with mifepristone for the treatment of uterine fibroids, including Guizhi Fuling Capsule, Gongliuxiao Capsule, Gongliuqing Capsule, Danbie Capsule, Gongliuning Capsule, and Xiaojiean Capsule were retrieved. The search period was from January 2010 to April 2021. Two researchers screened the literature through EndNote and used Excel to extract data. RevMan 5.3 was used to evaluate the quality of the literature. Treatment measures were analyzed in R language, and a forest map and probability ranking map of various interventions were drawn. The network evidence map and correction comparison funnel map of various interventions were drawn by STATA 14.0 software.

Results:
This study provides the clinical efficacy and safety of network meta-analysis of 6 kinds of Chinese patent medicines combined with mifepristone in the treatment of uterine fibroids will be systematically evaluated or descriptively analyzed.

Conclusion:
This study's purpose is to provide a reference for the clinical treatment of uterine fibroids to choose more effective intervention therapies.
Comparison of epidural, spinal, and saddle block for holmium laser enucleation of prostate (HoLEP)
Authors: Kim Young Hoon , Kwon So Young , Jun Eun Hwa , Choi Seung Tae , Park Seong Jin , Kim Yumi 
Published: October 2021

Abstract

Background:
Holmium laser enucleation of the prostate (HoLEP) has become an important treatment modality for benign prostate hypertrophy. The aim of the present study was to compare regional anesthesia methods for HoLEP operation and to determine the optimal technique.

Methods:
Sixty patients with American Society of Anesthesiologists scores of I-III were randomly allocated into 3 groups. Patients in group E received an epidural block with 75 mg of bupivacaine plus 50 μg of fentanyl. In group S, 15 mg of bupivacaine and 50 μg fentanyl were used for spinal anesthesia. In group SA, patients received saddle block with 15 mg of bupivacaine and 50 μg of fentanyl.

Results:
Time to T10 dermatome block and to maximal level block were longest in group E (P < .05), and maximal sensorial block level was higher in group E than group SA (P < .05). There was a significant difference in postoperative motor block, but no difference in systolic blood pressure and heart rate.

Conclusion:
Among 3 techniques, saddle block might be preferable in HoLEP because an adequate sensorial level was achieved with lower motor block and stable hemodynamics.
NAXE gene mutation-related progressive encephalopathy
Authors: Chiu Li-Wei , Lin Sheng-Shing , Chen Chieh-Ho , Lin Chien-Heng , Lee Ni-Chung , Hong Syuan-Yu , Chou I-Ching , Lin Chien-Lin , Yang Pei-Yu 
Published: October 2021

Abstract

Rationale:
Progressive encephalopathy with brain edema and/or leukoencephalopathy-1 is an infantile, lethal neurometabolic disorder caused by a NAD(P)HX epimerase (NAXE) gene mutation. It is characterized by a fluctuating disease course with repeated episodes of improvement and regression. In this report, we present a rare case of NAXE gene mutation-related encephalopathy with unexpected neurological recovery and long survival time.

Patient concerns:
A 20-month-old girl presented with progressively unsteady gait and bilateral hand tremors after a trivial febrile illness. Her disease rapidly progressed to consciousness disturbance, 4-limb weakness (muscle power: 1/5 on the Medical Research Council scale), and respiratory failure. The patient gradually recovered 2 months later. However, another episode of severe fever-induced encephalopathy developed 2 years after the initial presentation.

Diagnoses:
Results of laboratory investigations, including complete blood count, blood chemistry, inflammatory markers, and cerebral spinal fluid analysis were unremarkable. Electroencephalography and nerve conduction velocity studies yielded normal results. Brain magnetic resonance imaging on diffusion-weighted imaging revealed abnormal sysmmetric hyperintensity in the bilateral middle cerebellar peduncles. A genetic study using whole exome sequencing confirmed the diagnosis of NAXE gene mutation-related encephalopathy.

Interventions:
Pulse therapy with methylprednisolone, intravenous immunoglobulin, coenzyme Q10, and carnitine were initially introduced. After a NAXE gene defect was detected, the vitamin B complex and coenzyme Q10 were administered. A continuous rehabilitation program was also implemented.

Outcomes:

NAXE gene mutation-related encephalopathy is usually regarded as a lethal neurometabolic disorder. However, the outcome in this case is better than that in the previous cases. She showed progressive neurological recovery and a longer survival time. The muscle power of the 4 limbs recovered to grade 4. At present (age of 5.5 years old), she can walk with an unsteady gait and go to school.

Lessons:
Although NAXE gene mutation-related encephalopathy is rare, it should be considered as a differential diagnosis of early onset progressive encephalopathy.
Pulmonary cavitations with increased 18F-FDG uptake revealing a thoracic endometriosis
Authors: Mulette Pauline , Jacquet Amaury , Durlach Anne , Papathanassiou Dimitri , Lalire Paul , Graesslin Olivier , Delepine Gonzague , Dury Sandra , Dormoy Valérian , Perotin Jeanne-Marie , Lebargy François , Deslée Gaëtan , Launois Claire 
Published: October 2021

Abstract

Rationale:
Thoracic endometriosis is a rare disorder that can involve airways, pleura and lung parenchyma. It is the most frequent form of extra-abdominopelvic endometriosis. Multiple lung cavitations are a rare feature of thoracic endometriosis.

Patient concerns:
A 46-year-old woman was referred to our hospital after incidental finding of multiple pulmonary cavitations with surrounding areas of ground glass opacity on a thoraco-abdominal computed tomography-scan performed for abdominal pain. Retrospectively, the patient also reported mild hemoptysis occurring 4 months ago.

Diagnoses:
Positron emission tomography–computed tomography scan revealed moderate and homogeneous [18F] fluoro-2-deoxy-D-glucose (18F-FDG) uptake in pulmonary cavitations (maximum standardized uptake value 5.7). The diagnosis of thoracic endometriosis was confirmed by histological examination of surgical resection of a left lower lobe cavitation.

Interventions and outcome:
Gonadotropin-releasing hormone analogues associated with add-back therapy was started. Four months after initiating pharmacological treatment, the chest computed tomography-scan showed a dramatic decrease in lung cavitations size.

Lessons:
Thoracic endometriosis is a rare disorder requiring a multidisciplinary management including gynaecologist, pulmonologist, radiologist, nuclear physician, pathologist and thoracic surgeon for early diagnosis and treatment. Our case report highlights that an increased 18F-FDG uptake can be found in thoracic endometriosis syndrome presenting as multiple lung cavitations.
Application of the neutrophil to lymphocyte ratio in the diagnosis and activity determination of ulcerative colitis
Authors: Ma Lushun , Pang Xinyuan , Ji Guofeng , Ma Xinrui , Li Jie , Chang Yuan , Ma Chong 
Published: October 2021

Abstract

Background:
The neutrophil to lymphocyte ratio (NLR) may be a potential biomarker to evaluate the condition of ulcerative colitis (UC), but whether it can determine the activity of UC is still controversial. So we conducted this meta-analysis to study the relationship between them.

Methods:
We searched the databases of Pubmed, Embase, Cochrane, Wanfang, and CNKI to collect qualified articles. Random effect or fixed effect model is used to calculate the standard mean difference (SMD) with 95% confidence interval (CI).

Results:
A total of 11 articles (including 1741 participants) were included in this meta-analysis. The results showed that the level of NLR in peripheral blood of patients with UC was significantly higher than that of control group (SMD = 1.04, 95% CI = 0.71-1.36). The NLR value of active patients was significantly higher than that of inactive patients (SMD = 1.35, 95% CI = 0.87-1.83).

Conclusion:
NLR may be a useful index to determine the severity and activity of UC, and it is expected to be widely used in clinical practice in the future.
Evaluation on curative effects of gabapentin for the prevention of chronic pain in adults following surgery
Authors: Chen Yao , Zhang Guang-Zhi 
Published: October 2021

Abstract

Background:
Chronic pain is a common postsurgery symptom. It has an adverse impact on patients’ overall wellbeing. Chronic pain after an operation is caused by intricate mechanisms that have not been well understood. The predictability of most surgical methods has enabled scholars to conduct randomized controlled trials (RCTs) involving pharmacological interventions to prevent chronic pain after a surgery. Therefore, the present study aims to evaluate the curative effects of gabapentin to prevent chronic pain in adults after surgery.

Methods:
The authors will collect RCTs related to the use of gabapentin to prevent chronic pain in adults following surgery. Accordingly, a comprehensive search will be performed in 4 online databases to find English language articles, including Cochrane Library, EMBASE, Web of Science, and PubMed. In addition, the search also includes 3 Chinese language databases: VIP data, WanFang database, and China National Knowledge Infrastructure. Each of the RCT published from their inception to September 2021 will be considered. The authors will carry out a meta-analysis of RCTs after screening the studies. Subsequently, the authors will use RevMan (v 5.3) to perform an assessment of bias risk, data synthesis, and subgroup analysis, provided inclusion criteria are met.

Results:
The results will provide clinical evidence for the curative effects of gabapentin to prevent chronic pain in adults after surgery.

Conclusion:
The summary provided in this systematic review will judge whether gabapentin intervention is effective and feasible to prevent chronic pain in adults following surgery.

Registration number: 10.17605/OSF.IO/XG4CK