bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uterine adhesion
Authors: Fei Yilin , Wen Jie , Li Xingmiao , Wang Ning , Chen Mo , Jiang Xiuxiu 
Published: September 2021

Abstract
To compare the patients’ outcomes of Asherman syndrome who underwent uterine adhesiolysis in luteal phase or follicular phase.
A retrospective cohort study.
A tertiary hospital in China.
Four hundred sixty-four women suffered intrauterine adhesion who underwent monopolar adhesiolysis from March 2014 to March 2017 were analyzed. One hundred seventy-eight patients underwent operations in follicular phase (OFP) and 286 underwent operations in luteal phase (OLP).
Hormone therapy was accompanied with an intrauterine device and a second-look hysteroscopy was performed postoperatively.
Endometrial thickness in women was analyzed by a transvaginal 3-dimensional ultrasound examination. Re-adhesion was confirmed by a second-look hysteroscopy 3 months after hysteroscopic adhesiolysis. Pregnancy rate was acquired by questionnaires 3 months after a second-look hysteroscopy.
OLP has advantages with thicker luteal endometrium (P = .001), higher pregnancy rates (P < .001), and lower re-adhesion rates (P = 0015) compared to these values of OFP.
For Asherman syndrome, our study showed that OLP is more feasible than OFP in intrauterine adhesiolysis.
Efficacy and safety of Shenfu injection in the treatment of sepsis
Authors: Luo Shu , Gou Lianping , Liu Shiping , Cao Xiaoping 
Published: September 2021

Abstract

Background:
Sepsis is a syndrome of infection-induced systemic inflammatory response. Conventional treatment combined with Shenfu injection (SFI) has been previously validated clinical effective in alleviating inflammatory response in patients with septic shock. However, evidence-based medical evidence is scant. Herein, we designed the protocol of a proposed study based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, aiming to systematically evaluate the efficacy and safety of SFI in patients with sepsis.

Methods:
Eligible studies reporting the efficacy and safety of SFI in the treatment of sepsis published before August 2021 will be searched from online databases, including the PubMed, Web of Science, EMBASE, Ovid, the Cochrane Library, Wanfang Database, China National Knowledge Infrastructure, and China Biology Medicine Disc. The literature selection process will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. After data extraction and methodological quality evaluation, Stata 12.0 software will be used to synthesize the data through fixed/random effects of meta-analysis models.

Results:
The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:
This study will provide reliable evidence-based basis for the clinical application of SFI in the treatment of sepsis.

OSF Registration number:
DOI 10.17605/OSF.IO/KCMDQ.
Synergistic association of hyperuricemia and hyperhomocysteinemia with chronic kidney disease in middle-aged adults and the elderly population
Authors: Liu Peng-Tzu , Chen Jong-Dar 
Published: September 2021

Abstract
Chronic kidney disease (CKD) is a major global public health issue. Both hyperhomocysteinemia (HHcy) and hyperuricemia are independent risk factors for CKD. In this study, we evaluated the association of HHcy and hyperuricemia with CKD in the middle-aged and elderly populations in Taiwan.
In this cross-sectional study, we collected the data of 5910 patients aged ≥50 years after their self-paid health examination at a single medical center. Homocysteine (Hcy) levels were divided into 4 quartiles (Q1, <8.2; Q2, 8.2–9.8; Q3, 9.9–11.7; and Q4, >11.7 μM/L). Renal function was determined using the Chronic Kidney Disease Epidemiology Collaboration equation. Patients were considered to have CKD if their estimated glomerular filtration rate was < 60 mL/min/1.73 m2.
The prevalence of CKD significantly increased with the quartiles of uric acid (UA) and Hcy. In multiple logistic regression analysis, the odds ratios (ORs) of CKD increased with the quartiles of Hcy, independent of UA. There was 22.9 in Q4 in the normal serum UA group and 18.3 in the hyperuricemia group compared with Q1 of Hcy. Both hyperuricemia (OR 2.9) and Q4 of Hcy (OR 8.1) were significant independent risk factors for CKD. Furthermore, hyperuricemia and HHcy had significant synergistic association (synergy index, 1.7) with CKD.
The ORs of CKD increased with the quartiles of Hcy, independent of hyperuricemia. Hyperuricemia and HHcy had synergistic association with CKD.
Association between clinical phenotypes of dermatomyositis and polymyositis with myositis-specific antibodies and overlap systemic autoimmune diseases
Authors: Chiang Hui-Ling , Tung Chien-Hsueh , Huang Kuang-Yung , Hsu Bao-Bao , Wu Cheng-Han , Hsu Chia-Wen , Lu Ming-Chi , Lai Ning-Sheng 
Published: September 2021

Abstract
The aim of this study was to evaluate the association between clinical phenotypes of dermatomyositis (DM) and polymyositis (PM) with myositis-specific antibodies (MSAs), and overlap diagnosis of systemic autoimmune diseases.
This cross-sectional study was conducted on 67 patients with DM and 27 patients with PM recruited from a regional hospital in southern Taiwan. Clinical phenotypes of DM and PM were assessed and MSAs were measured using a commercial line blot assay. The association of clinical phenotypes of DM and PM with MSAs and overlap diagnosis of systemic autoimmune diseases was performed using univariate and multiple logistic regression analyses.
Clinically, patients with DM and PM and overlap diagnosis of systemic sclerosis were associated with a higher risk of interstitial lung diseases (ILDs) (odds ratio [OR] = 6.73; P = .048), Raynaud phenomenon (OR = 7.30; P = .034), and malignancy (OR = 350.77; P = .013). The risk of malignancy was also associated with older age (OR 1.31; P = .012), and male patients were associated with a higher risk of fever. For MSAs, anti-aminoacyl-tRNA synthetase antibodies were associated with ILD, antinuclear antibody were associated with a lower risk of arthritis, anti-transcription intermediary factor 1-gamma antibodies were associated with milder symptoms of muscle weakness, anti-Ku antibodies were associated with overlap diagnosis of systemic lupus erythematosus, and anti-Ro52 antibodies were associated with the development of Raynaud phenomenon and Sjögren syndrome.
MSAs and overlap diagnosis of systemic sclerosis were significantly associated with clinical phenotypes of DM and PM. Physicians should be vigilant for malignancy in older DM and PM patients with overlap diagnosis of systeic sclerosis. The possibility of developing ILD in patients with overlap diagnosis of systemic sclerosis or serum positivity of anti-aminoacyl-tRNA synthetase antibodies should be considered.
Cross-sectional assessment of sleep and fatigue in middle-aged Japanese women with primary Sjogren syndrome or rheumatoid arthritis using self-reports and wrist actigraphy
Authors: Miyauchi Kiyoko , Fujimoto Kaoru , Abe Takayuki , Takei Masami , Ogawa Kukiko 
Published: September 2021

Abstract
To investigate fatigue, health-related quality of life (HR-QOL), and sleep quality in women with primary Sjogren syndrome (pSS) or rheumatoid arthritis (RA) as compared with healthy controls using self-reports and wrist actigraphy.
In this cross-sectional observational study, we evaluated a total of 25 patients (aged 40–75 years) with pSS, 10 with RA, and 17 healthy control subjects living in Japan. The HR-QOL was assessed using the Short Form-36. Fatigue was evaluated using the Short Form-36 vitality score, visual analog scale (VAS) for fatigue, and 2 questionnaire items using scores based on a 4-point Likert scale. Sleep quality was measured using the Japanese version of the Pittsburgh Sleep Quality Index, VAS for sleep quality, and wrist actigraphy for 14 days.
Patients with pSS reported severer fatigue and lower HR-QOL than healthy controls, especially in mental health. Based on the Pittsburgh Sleep Quality Index score, 56% of the patients with pSS were poor sleepers, which was higher than healthy controls (29.4%). Furthermore, the patients with pSS scored significantly lower on the VAS for sleep quality than healthy controls (40.5 vs 63.7, P = .001). Although subjective assessments revealed slight sleep disturbances in patients with pSS, wrist actigraphy revealed no differences when compared with healthy controls for total sleep time (421.8 minutes vs 426.5 minutes), sleep efficiency (95.2% vs 96.4%), number of awakenings (1.4 vs 0.9), and wake after sleep onset (22.4 minutes vs 16.1 minutes). Poor subjective sleep quality was associated with enhanced fatigue. However, sleep efficiency, as determined by actigraphy, was not associated with fatigue. Notably, the patients with RA and healthy controls did not differ significantly in terms of fatigue or sleep quality, although patients with RA experienced more nocturnal awakenings than healthy controls (1.7 vs 0.9, P = .04).
Patients with pSS experience severe fatigue, poor HR-QOL, and sleep disturbances, which are associated with fatigue. However, wrist actigraphy did not reveal differences in sleep quality, suggesting that it may not be an appropriate measure of sleep in patients with pSS.
Investigation of blood leptin and adropin levels in patients with multiple sclerosis
Authors: Cinkir Ufuk , Bir Levent Sinan , Topsakal Senay , Avci Cicek Esin , Tekin Selma 
Published: September 2021

Abstract

Background:
The effects of adipokines have been investigated in multiple sclerosis (MS) in the literature. Results are uncertain, and subgroups like adropin have not been previously studied. We primarily aimed to determine leptin and adropin levels in MS and their potential use as a biomarker.

Methods:
This study was an experimental research. While 44 MS patients diagnosed according to McDonald criteria were included in the patient group, 40 people without MS diagnosis and risk factors took part in the control group. Demographic data, height, weight, body mass index, blood glucose, thyroid-stimulating hormone, alanine transaminase, aspartate transaminase, creatinine, low-density lipoprotein, leptin, adropin levels, presence of hypertension, diabetes mellitus, coronary artery disease were recorded. Expanded disability status scale and disease duration were also evaluated in the patient group. Our data were presented as mean ± standard deviations.

Results:
The mean blood leptin value of the patient group (6.12 ± 5.34 ng/mL) was significantly lower than the value of the control group (13.02 ± 8.25 ng/mL) (P < .001). The patient group had a mean adropin level of 504.12 ± 311.17 ng/mL, which was significantly lower than that of the control group (747.0 ± 309.42 ng/mL) (P < .001). Statistically insignificant differences were found between their body mass index, glucose, alanine transaminase, aspartate transaminase, thyroid-stimulating hormone, low-density lipoprotein levels (P > .001).

Conclusion:
This is the first study that has evaluated adropin levels in patients with MS. The relationship between MS and leptin levels is still unclear. Therefore, our study might be helpful to elucidate MS pathogenesis and provide supportive criteria for diagnosis.
Effect of baduanjin on the fall and balance function in middle-aged and elderly people
Authors: Xiao Yao , Luo Qin , Yu Yunyang , Cao Biwei , Wu Miao , Luo Yujun , Zhao Yan , Zhou Jing 
Published: September 2021

AbstractBackground:The risk of fall seriously affects the health and quality of life of the middle-aged and elderly people, especially the injury and disability caused by fall of the middle-aged and elderly people, which imposes a huge burden on family and social medical care. Baduanjin exercise may be an effective intervention to enhance the muscle strength and stability of lower limbs, improve the balance ability and gait of middle-aged and elderly people, reduce the incidence of falls, improve the quality of life, and promote the health of middle-aged and elderly people. The aim of this study is to summarize evidence and systematically review the efficacy and safety of Baduanjin on the fall and balance function in middle-aged and elderly people.Methods:We conducted a systematic search of English and Chinese RCTs in the following 8 electronic databases: PubMed, EMBASE, Web of Science, The Cochrane Library, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang Database, from their respective dates of inception to July 2021. Other resources will be searched if necessary. The primary outcome is the fall rate in middle-aged and elderly people and the secondary outcomes include the Single-Leg Standing (SLS) Test, Berg Balance Scale (BBS), Timed Up and Go (TUG) Test. The study selection, data extraction, risk of bias, data synthesis and analysis, reporting biases, and the quality of evidence will be independently conducted by 2 reviewers who use the EndNote X9 software, Cochrane handbook assessment tool, RevMan 5.3 software, a funnel plot and GRADE system.Results:This study will evaluate the effect of Baduanjin on falls and balance function of middle-aged and elderly people from multiple outcome evaluation indicators such as fall rate, and provide high-quality evidence.Conclusion:This study will provide evidence for whether Baduanjin has an effect on falls and balance function in middle-aged and elderly people.Ethics and dissemination:Ethics approval is not required for systematic review, since it does not infringe on personal interests. The results will be submitted to peer-review journals or disseminated at scientific conferences.
Identifying key genes and small molecule compounds for nasopharyngeal carcinoma by various bioinformatic analysis
Authors: Fang Lucheng , Shi Licai , Wang Wen , Chen Qinjuan , Rao Xingwang 
Published: September 2021

Abstract
Nasopharyngeal carcinoma (NPC) is one of the most prevalent head and neck cancer in southeast Asia. It is necessary to proceed further studies on the mechanism of occurrence and development of NPC.
In this study, we employed the microarray dataset GSE12452 and GSE53819 including 28 normal samples and 49 nasopharyngeal carcinoma samples downloaded from the Gene Expression Omnibus(GEO) to analysis. R software, STRING, CMap, and various databases were used to screen differentially expressed genes (DEGs), construct the protein–protein interaction (PPI) network, and proceed small molecule compounds analysis, among others.
Totally, 424 DEGs were selected from the dataset. DEGs were mainly enriched in extracellular matrix organization, cilium organization, PI3K-Akt signaling pathway, collagen-containing extracellular matrix, and extracellular matrix-receptor interaction, among others. Top 10 upregulated and top 10 downregulated hub genes were identified as hub DEGs. Piperlongumine, apigenin, menadione, 1,4-chrysenequinone, and chrysin were identified as potential drugs to prevent and treat NPC. Besides, the effect of genes CDK1, CDC45, RSPH4A, and ZMYND10 on survival of NPC was validated in GEPIA database.
The data revealed novel aberrantly expressed genes and pathways in NPC by bioinformatics analysis, potentially providing novel insights for the molecular mechanisms governing NPC progression. Although further studies needed, the results demonstrated that the expression levels of CDK1, CDC45, RSPH4A, and ZMYND10 probably affected survival of NPC patients.
General movement assessment is correlated with neonatal behavior neurological assessment/cerebral magnetic resonance imaging in preterm infants
Authors: Zhou Jinjun , Li Shuangshuang , Gu Li , Zhang Xiaohua , Tang Zhen 
Published: September 2021

Abstract
To explore the relationship between general movements (GMs) and neonatal behavior neurological assessment (NBNA)/cerebral magnetic resonance imaging (MRI) in preterm infants.
Forty preterm infants were examined with GMs assessment before gestational age of 40 weeks; NBNA was performed at the age of 40 weeks; cerebral MRI was performed at the age of 42 weeks.
Our experiment showed that preterm infants with poor GMs scores are more likely to have low NBNA scores (P = .001); preterm infants with abnormal cerebral MRI are more likely to have low NBNA scores (P = .002); preterm infants with poor GMs scores are more likely to have abnormal cerebral MRI (P = .012).
GM assessment is correlated with NBNA and MRI results in preterm infants for neurological development.
Immediate family support is important to discharge home for cancer patient with bone metastasis after rehabilitation
Authors: Ikeguchi Ryosuke , Nankaku Manabu , Yamawaki Rie , Tanaka Hiroki , Hamada Ryota , Kawano Takumi , Murao Masanobu , Kitamura Gakuto , Sato Tatsuya , Nishikawa Toru , Noguchi Takashi , Kuriyama Shinichi , Sakamoto Akio , Matsuda Shuichi 
Published: September 2021

Abstract
The purpose of this study is to investigate the predictive factors of home discharge for rehabilitation patients with cancer bone metastasis.
Cancer patients with bone metastasis who underwent rehabilitation between April 2014 and March 2017 were retrospectively enrolled. Data on discharge destination were collected from medical records as outcomes. Multiple regression analyses were carried out to investigate the predictive factors of home discharge.
Ninety-eight patients (mean age: 68.6 years, 42 females and 56 males) were included. Fifty patients were discharged home, 38 patients were discharged to other facilities, and 10 patients died. There were no skeletal-related events among these patients during their hospital stay. The receiver-operating curve for the predictive factors for home discharge of the Barthel Index at admission, Eastern Cooperative Oncology Group Performance Status at admission, and number of immediate family members living at home were 60 points (area under the curve [AUC] = 0.74, sensitivity = 0.6400, 1-specificity = 0.2766), 2 score (AUC = 0.65, sensitivity = 0.5400, 1-specificity = 0.2222), and 1 family member (AUC = 0.65, sensitivity = 0.9592, 1-specificity = 0.7222), respectively.
In order to plan for cancer patients with bone metastasis to be discharged home, it is important to take into consideration the patients’ Barthel Index and Performance Status at the time of hospital admission and the number of immediate family members living at home.
Thoracic stereotactic body radiation therapy plus first-line tyrosine kinase inhibitors for patients with epidermal growth factor receptor-mutant polymetastatic non-small-cell lung cancer
Authors: Wang Xia , Lu Zhiqin , Zeng Zhimin , Cai Jing , Xu Peng , Liu Anwen 
Published: September 2021

Abstract
The role of thoracic stereotactic body radiation therapy (SBRT) in addition to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in EGFR-mutant polymetastatic non-small-cell lung cancer (NSCLC) has not been well established. This retrospective study aimed to evaluate the efficacy and safety of EGFR-TKIs with thoracic SBRT for the treatment of this patient group.
Polymetastatic NSCLC was defined as having >5 metastatic lesions. Patients with polymetastatic NSCLC harboring positive EGFR mutations after initial TKI therapy for at least 8 weeks were eligible for SBRT between August 2016and August 2019. Eligible patients were treated with thoracic SBRT, and TKIs were administered for the duration of SBRT and continued after SBRT until they were considered ineffective. The control group was treated with TKI monotherapy. Propensity score matching (ratio of 1:4) was used to account for differences in baseline characteristics. Progression-free survival (PFS), overall survival, and treatment safety were evaluated.
In total, 136 patients were included in the study population. Among them, 120 patients received TKIs alone, and 16 patients received TKIs with thoracic SBRT. The baseline characteristics did not significantly differ between the two cohorts after propensity score matching. The median PFS was 17.8 months in the thoracic SBRT group and 10.8 months in the control group (P = .033). In the multivariate analysis, a Cox regression model showed that thoracic SBRT was an independent statistically significant positive predictor of improved survival, with a hazard ratio of 0.54 (P = .046). We recorded no severe toxic effects or grade 4 to 5 toxicities.
Real-world data demonstrate that thoracic SBRT significantly extends PFS in EGFR-mutant polymetastatic NSCLC patients with tolerable toxicity. Given these results, randomized studies are warranted.
Premature atrial contractions with multiple patterns of aberrant conduction followed by torsade de pointes in a patient with polymyalgia rheumatica
Authors: Takahashi Koji , Yamashita Mina , Sakaue Tomoki , Enomoto Daijiro , Uemura Shigeki , Okura Takafumi , Ikeda Shuntaro , Takemoto Masafumi , Utsunomiya Yutaka , Hyodo Takashi , Ochi Masayuki , Higuchi Satoshi 
Published: September 2021

Abstract

Rationale:
Recent studies have shown that QT interval prolongation is associated with disease severity and predicts mortality in systemic inflammatory diseases, particularly rheumatoid arthritis. Systemic pro-inflammatory cytokines released from synovial tissues in rheumatoid arthritis, such as interleukin (IL)-1β, IL-6, and tumor necrosis factor-α, could have direct effects on cardiac electrophysiology, particularly changes in the expression and function of potassium and calcium channels, resulting in QT interval prolongation on surface electrocardiogram (ECG) and an increased predisposition to develop lethal ventricular arrhythmias. However, reports on torsade de pointes (TdP) due to acquired long QT syndrome in patients with polymyalgia rheumatica (PMR) are limited.

Patient concerns:
An 85-year-old Japanese woman with active PMR developed first syncope.

Diagnosis:
Frequent premature atrial contractions (PACs) with multiple patterns of aberrant conduction, QT interval prolongation, and morphological T-U wave variability followed by TdP were documented. PACs were the first beat of TdP.

Interventions:
Amiodarone, together with magnesium and potassium, was intravenously administered. However, TdP resulted in a ventricular arrhythmic storm, for which sedation with mechanical ventilatory support, temporary overdrive cardiac pacing, and intravenous landiolol administration in addition to multiple direct current shocks were effective.

Outcomes:
Approximately 2 years later, the patient was treated with amiodarone, propranolol, and prednisolone. She did not undergo implantable cardioverter-defibrillator implantation and was quite well, with no recurrence of ventricular tachyarrhythmia.

Lessons:
IL-6 hyperproduction in inflamed tissues has been widely confirmed in PMR. Frequent PACs with various patterns of aberrant conduction, QT interval prolongation, and morphological T-U wave variability followed by TdP, for which IL-6-mediated enhancement of L-type Ca2+ current and inhibition of the rapid component of the delayed rectifier K+ current are the most likely mechanisms, were documented in an elderly Japanese woman with PMR. ECG may be recorded once in patients with active PMR even when these patients do not complain of palpitation or syncope. If QT interval prolongation or arrhythmia, including even PACs, is observed, follow-up ECG may be warranted, particularly for patients with some risk factors for QT prolongation that could lead to TdP, such as advanced age, female sex, hypopotassemia, and polypharmacy.