bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corneal complication after femtosecond laser-assisted cataract surgery
Authors: Chlasta-Twardzik Edyta , Nowińska Anna , Wylęgała Edward 
Published: January 2021

Abstract

Rationale:
The femtosecond laser LDV Z 8 is unique, and the only femtosecond laser used in ophthalmic microsurgery, which is characterized by low-energy near-infrared (1030 nm) femtosecond single pulses in the nano-Joule range and a very high repetition rate in the MHz range. To the best of our knowledge, this is the first description of unintentional partial corneal incision in the anterior part of a stroma by the femtosecond laser.

Patient concerns:
A 79-year-old patient was referred to our clinic for cataract surgery. On admission, we diagnosed mature cataract of the left eye and pseudophakic of the right eye. The patient was qualified for the Femtosecond Laser-Assisted Cataract Surgery (FLACS). Unexpectedly during FLACS procedure after lens fragmentation the surgeon observed unexpected paracentral incision in the cornea.

Diagnosis:
The corneal incision line between 4 to 8 o’clock was observed. In vivo confocal microscopy was performed to assess the morphology and depth of the corneal wound. The corneal incision covered the epithelium, Bowman's membrane and stroma of the cornea reached a depth of 336 um.

Interventions:
The patient was under increased ophthalmologic controls; follow up with typical ophthalmic examinations and confocal microscopy was performed.

Outcomes:
In 2-year follow-up period, this complication had no effect on postoperative visual function, the patient had no visual problems and obtained the final BCVA 5/5. There is no dislocation of the lens in 2 years follow-up.

Lessons:
Low pulse energy and high pulse frequency in the LDV Z8 causes a low traumatization of tissues. In a 2-year follow-up, the corneal incision line could be observed on the slit lamp examination without long-term visual consequences of this complication. In our opinion, the most likely cause of this complication was human error and lack of communication between medical personnel. The operation team should be alert and great caution must be exercised during the procedure and check the laser settings parameters carefully each time.
Genomic analysis of mutations in platelet mitochondria in a case of benzene-induced leukaemia
Authors: Wang Dianpeng , Yang Xiangli , Cai Diya , Li Peimao , Zhang Zhimin , Lin Dafeng , Zhang Yanfang 
Published: January 2021

Abstract

Introduction:
As a hematopoietic carcinogen, benzene induces human leukemia through its active metabolites such as benzoquinone, which may cause oxidative damage to cancer-related nuclear genes by increasing reactive oxygen species (ROS). Mitochondrion is the main regulatory organelle of ROS, genetic abnormality of mitochondrion can impede its regulation of ROS, leading to more severe oxidative damage. Mutations have been related to certain types of cancer in several mitochondrial genes, but they have never been completely analyzed genome-wide in leukemia.

Patient concerns:
The patient was a 52-year-old female who had chronic exposure to benzene for several years. Her symptoms mainly included recurrent dizziness, fatigue, and they had lasted for nearly 8 years and exacerbated in recent weeks before diagnosis.

Diagnosis:
Samples of peripheral blood were taken from the patient using evacuated tubes with EDTA anticoagulant on the second day of her hospitalization. At the same time blood routine and BCR/ABL genes of leukemic phenotype were tested. Platelets were isolated for mitochondrial DNA (mtDNA) extraction. The genetic analysis of ATP synthase Fo subunit 8 (complex V), ATP synthase Fo subunit 6 (complex V), cytochrome c oxidase subunit 1 (complex IV), cytochrome c oxidase subunit 2 (complex IV), cytochrome c oxidase subunit 3, Cytb, NADH dehydrogenase subunit 1 (complex I) (ND) 1, ND2, ND3, ND4, ND5, ND6, 12S-RNA, 16S-RNA, tRNA-Cysteine, A, N, tRNA-Leucine, E, displacement loop in platelet mtDNA were performed. All the detected gene mutations were validated using the conventional Sanger sequencing method.

Interventions:
The patient received imatinib, a small molecule kinase inhibitor, and symptomatic treatments.

Outcomes:
After 3 months treatment her blood routine test indicators were restored to normal.

Conclusion:
A total of 98 mutations were found, and 25 mutations were frame shift. The ND6 gene mutation rate was the highest among all mutation points. Frame shifts were identified in benzene-induced leukemia for the first time. Many mutations in the platelet mitochondrial genome were identified and considered to be potentially pathogenic in the female patient with benzene-induced leukemia. The mutation rate of platelet mitochondrial genome in the benzene-induced leukemia patient is relatively high, and the complete genome analysis is helpful to fully comprehend the disease characteristics.
A rare case report of an solitary neurofibroma in postcricoid region of hypopharynx
Authors: Li Dongjie , Niu Kai , Yuan Tingting , Zhu Wei , Wang Xin , Yin Wanzhong 
Published: January 2021

Abstract

Rationale:
Postcricoid neurofibroma is an extremely rare hypopharynx tumor that can be challenging in both diagnosis and treatment. This case sheds light on the possibility of treatment with transoral microsurgery before pursuing open cervical incisions.

Patient concerns
: A 43-year-old man presented with a four months history of a persistent foreign body sensation and mild dysphagia. Indirect and direct laryngoscopy at admission revealed a round and smooth submucosal mass in the postcricoid region.

Diagnosis:
A laryngeal enhanced computed tomography and laryngoscopy suggested that the tumor located in hypopharynx, with clear boundary and slightly strengthened edge. A supporting laryngoscopy surgery was performed under general anesthesia and a biopsy confirmed solitary neurofibroma of the postcricoid region.

Interventions:
The tumor was successfully resected en bloc transorally through supporting laryngoscope, and obviated the need for open cervical surgery and tracheostomy.

Outcomes:
The patient recovered well without any intraoperative or postoperative complication and was discharged from hospital 2 days after surgery. There was no recurrence after 6 months follow-up.

Lessons:
Postcricoid neurofibroma is an extremely rare hypopharynx tumor that can be diagnostically challenging. To the best of our knowledge, this is the first case reported of solitary neurofibroma originating from the postcricoid region of the hypopharynx and was surgically removed with transoral surgery through supporting laryngoscope.
Immunotherapy-related pneumonitis and bacterial pneumonia after the successful treatment of metastatic malignant melanoma with pembrolizumab
Authors: Ma Qin , Yang Lei , Gu Feng 
Published: January 2021

Abstract

Introduction:
Pembrolizumab, a monoclonal antibody targeting programmed cell death-1 (PD-1), is approved as a therapy for unresectable or metastatic melanoma. Immunotherapy-associated pneumonitis is an uncommon event.

Patient concerns:
A 73-year-old man was admitted to our hospital with a history of melanoma on the left side of the face (resected in December 2012) and metastasis to the left lung upper lobe (resected in November 2016). Recurrence of metastasis to the bilateral lungs and left pleura was detected in April 2018. A complete response was achieved following treatment with pembrolizumab, with lower limb rashes the only adverse events occurring during therapy. The patient was readmitted in March 2019 with a productive cough, shortness of breath, and mild fever, and sputum culture identified Escherichia coli.

Diagnosis:
A diagnosis of pneumonia was made, and although cough and shortness of breath responded to ceftazidime and levofloxacin, but fever and poor appetite persisted. Computed tomography showed no improvement in the bilateral lower lobe lesions. Prednisone was initiated based on a clinical diagnosis of immunotherapy-related pneumonitis. The response to prednisone confirmed the diagnosis.

Interventions:
The patient first received ceftazidime and levofloxacin, but the symptoms persisted. Prednisone was initiated based on a clinical diagnosis of immunotherapy-related pneumonitis.

Outcome:
Complete resolution of the bilateral lung lesions occurred after 45 days of prednisone therapy.

Conclusion:
This case report highlights that both pneumonitis and bacterial pneumonia can occur as complications of anti-PD-1 immunotherapy.
Juvenile-onset multifocal osteonecrosis in systemic lupus erythematosus
Authors: Jin Wenyuan , Yang Xinghui , Lu Meiping 
Published: January 2021

Abstract

Rationale:
Osteonecrosis (ON) is a devastating illness that leads to bone ischemia and potential joint destruction. Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease, with multi-system involvement which is closely associated with occurrence of ON. Multifocal ON, with an estimated morbidity of 3% in SLE patients, is extremely rare in juvenile subjects.

Patient concerns:
A 13.3-year-old female SLE patient was admitted to hospital 20 months following the SLE diagnosis because of a sudden aggravation of sore knees. She suffered from double knee joint pain and her left knee joint showed typical signs of inflammation including redness, swelling, heat, and pain.

Diagnoses:
The SLE patient was diagnosed with multifocal ON of her knee joint based on magnetic resonance imaging findings of bone destruction and osteoproliferation at the bilateral distal femur and proximal tibia.

Interventions:
The patient received high-dose methylprednisolone and intravenous cyclophosphamide pulse therapies for controlling active lupus and nephritis. Oral calcitriol and dipyridamole were administered to alleviate knee pain and inhibit thrombi formation, thereby suppressing ON progress.

Outcomes:
Three weeks following the treatment, the swelling in patient's left knee subsided. Her self-reporting pain score decreased from 9 to 4 and walking time increased from 45minutes to 90minutes per day. Nearly 5 weeks later, the pain in bilateral knee joints disappeared and the patient could walk without difficulties.

Lessons:
This patient is the youngest SLE patient who developed multifocal ON based on the reported literature. It suggests that ON can occur in young SLE patients. A combination of internal and external risk factors can promote the development of ON. The balanced approach to the application of corticosteroids and immunosuppressors in the treatment of SLE and prevention of ON is a challenging problem that deserves further exploration.
Left atrial spindle cell sarcoma
Authors: Qin Jin , Li Rui , Ma Fei , Li Haojie , Fang Zemin , Fei Yujie 
Published: January 2021

Abstract

Rationale:
Cardiac primary spindle cell sarcoma is 1 of the rarest cardiac malignancies, with only a few cases reported so far. Herein, we reported a case of left atrial spindle cell sarcoma diagnosed and treated by a multidisciplinary approach, and retrospectively reviewed other reported cases.

Patient concerns:
A 49-year-old woman presented to our hospital with 2 weeks of gradual onset of dyspnea on exertion, dry cough and subacute fever.

Diagnosis:
The patient was initially revealed a left atrium mass by 2-dimensional transthoracic echocardiography. Based on the contrast-enhanced echocardiography and cardiac magnetic resonance imaging, she was subsequently suggested to have a cardiac malignant tumor. And the post-operative histopathology confirmed the tumor to be a cardiac primary spindle cell sarcoma.

Interventions:
The tumor was completely resected using autotransplantation. The patient was referred for polychemotherapy afterwards.

Outcomes:
Our patient underwent the tumor resection, with subsequent adjuvant polychemotherapy, and the tumor has not recurred during 12 months of follow-up.

Lessons:
Due to the rarity of these tumors and nonspecific symptoms, they are often difficult to diagnose preoperatively and missed occasionally. Thus, improving our understanding of the disease and facilitating its early diagnosis are essential.
Shear wave elastography of the ulnar nerve at the forearm
Authors: Bedewi Mohamed Abdelmohsen , Kotb Mamdouh A. , Aldossary Nasser M. , Abodonya Ahmed M. , Alhariqi Bader A. , Swify Sherine Mohamed 
Published: January 2021

Abstract
The study included 38 ulnar nerves in 20 healthy subjects. High-resolution ultrasound and Shear wave elastography were used to evaluate the ulnar nerve at the mid forearm. The mean cross-sectional area of the ulnar nerve was 7.1 mm2. The mean shear elastic modulus of the nerve in the short axis was 27.4 kPa. The mean shear elastic modulus of the nerve in long axis was 24.7 kPa. No statistical relation could be noted between elasticity measurements in long and short axes. The ulnar nerve elastic modulus also showed no correlation with CSA neither in the long axis nor short axis. Age, height, weight, and body mass index showed no correlation with the ulnar elastic modulus in short or long axes. The elastic modulus of the ulnar nerve has been determined in healthy subjects and can serve as a reference for future assessment of compressive neuropathies of the ulnar nerve.
Analysis of antibiotic sensitivity and resistance genes of Bordetella pertussis in Chinese children
Authors: Lin XiaoJuan , Zou Jun , Yao Kaihu , Li Lijun , Zhong Lili 
Published: January 2021

Abstract

Objective:
To understood the pathogen detection status and clinical characteristics of suspected pertussis in children and to observe the drug sensitivity and drug resistance genes of Bordetella pertussis (B. pertussis).

Methods:
Three hundred fifty-one cases were collected and their nasopharyngeal swab samples were analyzed by culture and fluorescent quantitative polymerase chain reaction. The susceptibility to erythromycin, clindamycin, ampicillin, levofloxacin, and sulfamethoxazole-trimethoprim were tested by E-test for the positive strains, and the susceptibility to erythromycin was also tested for the KB disk diffusion method. The 23S rRNA gene of the positive strains was amplified and sequenced, and statistical analysis was performed in conjunction with clinical data.

Results:
The positive rate of bacterial culture was 16.8% (59/351), and the positive rate of PCR was 62.4% (219/351). Two cases were positive about bacterial culture and negative for PCR. There were 221 confirmed cases of pertussis. The E-test results showed that the rate of the sensitivity of the 55 strains of pertussis to erythromycin and clindamycin was 50.9% (28/55), the minimum antibiotic concentration50 (MIC50) and MIC90 values were 0.094/>256 and 0.75/>256 mg/L, respectively, and the MIC50/MIC90 to ampicillin, levofloxacin, and sulfamethoxazole were 0.125/0.19, 0.38/0.5, and 0.125/0.25 mg/L, respectively. The KB disk diffusion method showed 27 of the 55 strains 49.1% (27/55) was resistant to erythromycin; all of the resistant strains had the 23S rRNA gene A2047G mutation, and their MIC of erythromycin was >256 mg/L.

Conclusion:
The diagnosis of pertussis by a fluorescent quantitative polymerase chain reaction method is more sensitive than that of bacterial culture. The resistance of B. pertussis to erythromycin was prominent. All of the strains of B. pertussis resistant to erythromycin in our center had the A2047G mutation of the 23S rRNA gene.
Music-based interventions for pain relief in patients undergoing hemodialysis
Authors: Cheng Jingru , Zhang Hui , Bao Hong , Hong Hanxia 
Published: January 2021

Abstract

Background:
Music therapy and music-based interventions have been used widely in numerous medical procedures to reduce the physical and psychological disorders. However, the effect of music therapy on pain relief in hemodialysis patients still remains unclear.

Methods:
Electronic databases were comprehensively searched through MEDLINE, Web of Science, EMBASE, Cochrane, and WANFANG. All studies met inclusion criteria were eligible for systematic review and meta-analysis. Clinical variables were extracted and pooled results were obtained using STATA software.

Results:
A total of 10 studies with 722 participants were included for systematic review. Overall, music therapy showed a significantly favorable effect on reducing pain for patients undergoing hemodialysis (SMD: −0.90, 95%CIs: −1.25 to −0.55, P < .001). No publication bias was observed.

Conclusions:
Music-based interventions could significantly relieve pain for patients undergoing hemodialysis, which should be promoted as an effective and safe complementary method.
The effect of trifluridine/tipiracil for patients with heavily pretreated metastatic gastric cancer
Authors: He Xiaoyan , Zhang Tianyao , Wu Lijuan , Wu Yongcan , Zhou Xin 
Published: January 2021

Abstract

Background:
Gastric cancer is a global health problem with high incidence rate and mortality rate. Due to the limitations of traditional chemotherapy drugs, such as patient intolerance, low efficacies and serious adverse effects, trifluridine/tipiracil has been considered to be a promising treatment for patients with heavily pretreated metastatic gastric cancer. However, the relevant systematic review has not been occurring. The presentation of this protocol is to scientifically evaluate the efficacy and safety of trifluridine/tipiracil in patients with highly pretreated metastatic gastric cancer.

Methods:
The protocol followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. We will systematically search MEDLINE, PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure Database (CNKI), VIP Chinese Science and Technology Periodical Database (VIP), Wan Fang Database up to November 1, 2020 to identify published articles. Using the Cochrane risk assessment tool to assess the methodological quality of the RCTs, and all included studies will be analyzed according to the criteria in the Cochrane Handbook. Review Manager 5.3 software will be used for literature quality evaluation and data analysis.

Results:
Objective to evaluate the efficacy and safety of trifluridine/tipiracil in patients with heavily pretreated metastatic gastric cancer by analyzing the eligible data extracted under limited conditions.

Conclusion:
This study provides clear evidence to evaluate the effectiveness and safety of trifluridine/tipiracil for patients with highly pretreated metastatic gastric cancer, and the findings will also be published in a peer-reviewed journal.

Ethics and dissemination:
No ethical statement will be required for this study because there is no direct involvement of human. This review will be published in a peer-reviewed journal as a conference report or an article.

Registration:
OSF registration number: DOI 10.17605/OSF.IO/6MF5U.
A comparison of the efficacy and safety of traditional Chinese medicine external treatment for the knee osteoarthritis
Authors: Song Xuyu , Wang Zhao , Zhang Peng , Zhao Min , Yang Lingsen , Zhang Wei 
Published: January 2021

Abstract

Background:
Knee osteoarthritis (KOA), also known as degenerative osteoarthritis, is a common and frequently occurring disease in orthopedics with cartilage degeneration as the pathogenic cause and articular bone hyperplasia as the sign. Many studies have confirmed that KOA can be effectively treated by traditional Chinese medicine (TCM) external treatment. So we take advantage of the method of network meta-analysis to systematically compare the efficacy and safety of different types of TCM external treatment for the KOA.

Methods:
We will research on external treatment of KOA by traditional Chinese medicine using randomized controlled trials (RCTs) in search database (EMBASE, PubMed, Web of Science, Chinese National Knowledge Infrastructure [CNKI], Weipu database [VIP], Wanfang, and China BioMedical Literature [CBM]). The data and evidence obtained will be processed using Stata 15.0 and WinBUGS 1.4.3.

Results:
We will evaluate the efficacy and safety of traditional Chinese medicine external treatment for the knee osteoarthritis in this study.

Conclusion:
This study will provide a new regimen for KOA treatment. It has extremely high reference value.

INPLASY registration number:
INPLASY2020120001.

DOI number
: 10.37766/inplasy2020.12.0001.
Dexamethasone and post-adenotonsillectomy pain in children
Authors: Kang Young , Ku Eu Jeong , Jung Il Gu , Kang Min Hyuck , Choi Young-Seok , Jung Hahn Jin 
Published: January 2021

Abstract

Objective:
To assess the impact of intraoperative intravenous dexamethasone on the reduction of postoperative morbidity in children undergoing adenotonsillectomy.

Methods:
A double blind randomized controlled trial conducted among children undergoing adenotonsillectomy at a tertiary hospital in Korea from November 2018 to June 2019. Children were randomly assigned to receive dexamethasone (0.5 mg/kg, maximum dose 24 mg) or placebo intravenously after induction of anesthesia. The primary endpoint was the reduction of postoperative pain and postoperative nausea and vomiting (PONV); secondary endpoints were adverse effects like postoperative hemorrhage.

Results:
The study included 105 children, and 67 were male. Their mean age was 6.2 ± 2.1 years. There was no significant difference between the groups in terms of demographic data or the operation time. The pain scores of the dexamethasone group were lower than those of the control group, but no significant difference was found (all P > .05). The average pain visual analog scale (VAS) during the study period (day 0–7) was 3.67 ± 1.59 and 4.40 ± 2.01 in the dexamethasone group and control group, respectively (P-value = .107). When we compared early pain VAS (day 0–2) and late pain VAS (day 5–7), the dexamethasone group showed significantly lower early mean VAS compared to the control group (4.55 ± 1.78 vs 5.40 ± 2.05, P-value = .046). The mean VAS for PONV was significantly lower in the dexamethasone group than in the control group (1.89 ± 2.22 vs 3.00 ± 2.37, P value = .044).

Conclusion:
In children undergoing adenotonsillectomy, dexamethasone decreased the early postoperative pain and PONV without increasing postoperative hemorrhage.
Effectiveness and safety of traditional Chinese medicines for pulmonary heart disease
Authors: Hu Xinyu , Li Lulu , Song Yuanying , Lu Yun 
Published: January 2021

Abstract

Background:
Previous review indicate that the effect of traditional Chinese medicines (TCM) on pulmonary heart disease (PHD) remains uncertainty. Therefore, we designed this study to systematically evaluate the effectiveness and safety of TCM in the treatment of PHD.

Methods:
Nine online databases will be searched from inception to October 01, 2021, and we will not restrict the language on included trials. Randomized controlled trials that included patients with PHD receiving TCM therapy vs a control group will be included. Two of us will perform independently the selection of studies, risk of bias assessment, and data extraction. The RevMan V.5.2 software with fixed effects model or random effects model will be used to syntheses the data, according to the heterogeneity test to conduct the data synthesis. The dichotomous data and the continuous data will be presented with risk ratios with 95% confidence intervals and weighted mean differences or standardized mean differences with 95% confidence intervals. And we will use the Grading of Recommendations Assessment, Development, and Evaluation system to evaluate the evidence quality.

Result:
This study will assess effects and safety for TCM on PHD.

Conclusion:
The conclusion of this study will provide evidence to prove the safety and effectiveness of TCM on PHD.

Trial registration number:
INPLASY2020120024.