bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of qiming granule combined with laser in the treatment of diabetic retinopathy
Authors: Zhou Chuiren , Long Bi , Huang Wei , Jiang Ling 
Published: March 2021

Abstract

Background:
Diabetic retinopathy is not only the most common complication of diabetes, but also 1 of the main causes of blindness, which seriously affects the physical and mental health of patients. Panretinal photocoagulation is a common method for the treatment of diabetic retinopathy, but it has some defects. Qiming granule has advantages in the treatment of diabetic retinopathy, but there is a lack of standard clinical research to verify it. Therefore, the purpose of this randomized controlled trial is to evaluate the efficacy and safety of qiming granule combined with laser in the treatment of diabetic retinopathy.

Methods:
This is a prospective randomized controlled trial to study the efficacy and safety of Qiming granule combined with laser in the treatment of diabetic retinopathy. Approved by the Clinical Research Society of our hospital. The patients are randomly divided into a treatment group (Qiming granule combined with laser treatment group) or control group (simple laser treatment group). The patients are followed up for 12 months after 6 months of treatment. Observation indexes include total effective rate, corrected visual acuity, macular fovea thickness, adverse reactions and so on. Data are analyzed using the statistical software package SPSS version 18.0 (Chicago, IL).

Discussion:
This study will evaluate the clinical efficacy and safety of qiming granule combined with laser in the treatment of diabetic retinopathy. The experimental results of this study will provide a reliable reference basis for clinical use of qiming granule combined with laser in the treatment of diabetic retinopathy.

Trial registration:
OSF Registration number: DOI 10.17605/OSF.IO/ZEQPB.
Pathogenic variants of PROC gene caused type II activity deficiency in a Chinese family
Authors: Zhu Hui , Liu Hongchao , Liu Jingyao 
Published: March 2021

Abstract

Rationale:
Hereditary Protein C (PC) deficiency is a rare genetic disorder caused by PROC gene mutation. In this article, we report a case of PC deficiency in a Chinese family due to a novel PROC gene mutation.

Study Subject:
The proband presented with recurrent cerebral infarction over the course of the previous 3 years. He was admitted to the hospital due to signs of mental retardation.

Diagnoses:
Physical examination, laboratory tests, and magnetic resonance imaging demonstrated that the proband had a manifestation of PC deficiency that included acute cerebral infarction. DNA sequencing analysis revealed a missense variant, c.1015G > A (p.V339 M from valine to methionine) in exon 9 of the PROC gene. In addition, Sanger sequencing confirmed that the proband's son was heterozygous for the same variant. Therefore, the PROC gene mutation was transmitted in an autosomal dominant inheritance manner.

Interventions:
The patient was treated with a daily dosage of Warfarin (3.5 mg) and was scheduled to undergo regular blood coagulation tests.

Outcomes:
At the 3-month follow-up appointment, the patient showed improvements in his overall health condition.

Lessons:
We identified a novel missense mutation in the PROC gene in a Chinese family which caused a decrease in the PC antigen level and recurrent cerebral infarction.
Pilonidal sinus involving the breast in a man
Authors: Shi Rong , Liu Peng , Zhang Xuan-Fen 
Published: March 2021

Abstract

Rationale:
Pilonidal sinus disease (PSD) involving the breast is extremely rare and has not been described in man.

Patient concerns:
This current case report presents a case of a pilonidal cyst in a 46-year-old man which was surgically treated. He had intermittent pain in his left breast for 2 months and came for local rupture and discharge for 1 week.

Diagnosis:
The initial diagnosis is male mastitis, on the basis of the histological features of H&E-stained specimens and immunohistochemistry of the resected lump, this case was diagnosed as PSD.

Interventions:
The patient underwent “enlarged resection of the left breast lesion” under local anesthesia.

Outcomes:
The patient's surgical area healed well, without any signs of recurrence.

Conclusion:
PSD involving the breast is extremely rare in man, with no typically clinical manifestations, and could be easily ignored. This disease requires great attentions from clinicians.
Radiological manifestation of familial acute necrotizing encephalopathy with RANBP2 mutation in a Far-East Asian family
Authors: Park Yu-Jung , Hwang Jae-Yeon , Kim Yong-Woo , Lee Yun-Jin , Ko Ara 
Published: March 2021

Abstract

Rationale:
Acute necrotizing encephalopathy (ANE) is a specific type of encephalopathy usually followed by febrile infection. It has an aggressive clinical course; however, it usually does not recur after recovery in cases of spontaneous ANE. Nevertheless, there are several studies reporting recurrences in familial ANE with RAN-binding protein 2 (RANBP2) mutation. There are few cases of familial ANE with RANBP2 mutation in Asian populations.

Patient's concerns:
A 21-month-old Korean boy who was previously healthy, presented with seizure following parainfluenza – a virus and bocavirus infection, followed by 2 recurrent seizure episodes and encephalitis after febrile respiratory illnesses. Meanwhile, his 3-year-old sister had focal brain lesions on neuroimaging studies when evaluated for head trauma. The siblings also had an older brother who presented status epilepticus after febrile respiratory illness at the age of 10 months old.

Diagnosis:
Brain magnetic resonance imaging was performed to evaluate the seizure and neurologic symptoms. Imaging findings showed variable spectrum – from non-specific diffuse white matter injury pattern to typical “tricolor pattern” of the ANE on diffusion-weighted images. The other 2 siblings showed focal lesions in both external capsules and severe diffuse brain edema. Genetic tests identified a heterozygous missense mutation in the RANBP2 [c.1754C>T (p.Thr585Met)] in 2 siblings and their mother.

Interventions:
Patients were treated conservatively with anticonvulsive agents, intravascular immunoglobulin, and steroids.

Outcomes:
Among the 3 siblings, 2 male siblings died from familial ANE, whereas the female sibling was asymptomatic.

Lessons:
These cases highlight the radiological aspects of familial ANE with incomplete penetrance of the RANBP2 gene in 3 family members, showing variable involvements of the brain and natural history on magnetic resonance images. Radiologists should be aware of the typical and atypical imaging findings of familial ANE for prompt management of affected patients.
Role of tocilizumab for concomitant systemic fungal infection in severe COVID-19 patient
Authors: Sari Anggraini Permata , Darnindro Nikko , Yohanes Aryan , Mokoagow Muhammad Ikhsan 
Published: March 2021

Abstract

Rationale:
Bacterial and fungal infections in Coronavirus Disease-19 (COVID-19) patients have been inadequately investigated and reported thus far. The safety profile of tocilizumab (TCZ) administration in candidemia patient still debatable.

Patient concerns:
A 54 year-old woman presenting with weakness on the left side of her body was diagnosed with COVID-19. After 7 days of admission, her condition worsened and developed respiratory distress and was having respiratory distress despite standard treatment.

Diagnoses:
Acute respiratory distress syndrome (ARDS) in COVID 19 was diagnoses based on real time-PCR swab, deterioration of PaO2/FiO2 and increased of acute phase reactants.

Interventions:
Anti Interleukin–6 (IL-6) was considered to tackle her inflammatory condition. Prior to TCZ administration, blood culture was performed and the result came with Candida tropicalis in the absence of bacterial growth.

Outcomes:
No major complications associated with intravenous antifungal or TCZ occurred. After 40 days of hospitalization, the patient's clinical condition improved and was finally discharged.

Lessons:
This case underscores the safety profile of giving TCZ in candidemia as a secondary infection in severe COVID-19 patient.
Overexpression of macrophage-colony stimulating factor-1 receptor as a prognostic factor for survival in cancer
Authors: Mo Huaqing , Hao Yanrong , Lv Yanru , Chen Zenan , Shen Jingyi , Zhou Shu , Yin MengJie 
Published: March 2021

Abstract

Background:
The relation between the expression of macrophage-colony stimulating factor-1 receptor (CSF-1R) and prognosis of cancer patients has been evaluated in multiple studies, but the results remain controversial. We, therefore, performed a meta-analysis and systematic review to figure out the role of CSF-1R in the prognosis of patients with cancer.

Methods:
Several databases were searched, including Web of Science, PubMed, and EMBASE. All human studies were published as full text. The Newcastle–Ottawa risk of bias scale was applied to evaluate the research. We extracted hazard ratios (HRs) with 95% confidence interval (95% CI) which assessed progression-free survival (PFS) and overall survival (OS) in order to assess the impacts of CSF-1R on the prognosis of cancer patients.

Results:
A total of 12 citations were identified, with studies including 2260 patients in different cancer types that met the eligibility criteria. It was suggested in a pooled analysis that the over-expression of CSF-1R was significantly related to worse PFS (HR: 1.68; P < .001, 1.25–2.10, 95% CI) and also poorer OS (HR=1.28; P < .001, 1.03–1.54, 95% CI). Analysis in subgroups indicated over-expressed CSF-1R was significantly associated with worse OS in hematological malignancy (HR = 2.29; P < .001, 1.49–3.09, 95% CI; model of fixed-effects; I
2 = 0.0%, P < .001). Sensitivity analysis suggested that there was no study influencing the stability of the results.

Conclusions:
The overexpression of CSF-1R was significantly predictive of worse prognosis in those who suffer from different kinds of malignancies, particularly in hematological malignancy, which indicates that it might be a potential biomarker of prognosis in cancer survival and a potential molecular target in the treatment of malignant tumors.
Epidemiology of asymptomatic and symptomatic Coronavirus Disease 2019 confirmed cases in the Emirate of Abu Dhabi, United Arab Emirates
Authors: Hosani Farida Al , Aden Bashir , Memari Shammah Al , Mazrouei Shereena Al , Ajab Suad , Abid Muhammad , Alsuwaidi Ahmed R. , Grivna Michal , Paulo Marília Silva , Sheek-Hussein Mohamud 
Published: March 2021

Abstract
This study was conducted to describe demographics, clinical features, and outcomes of 3827 confirmed cases of Coronavirus Disease 2019 between March 12 and April 22, 2020 in the Emirates of Abu Dhabi, United Arab Emirates (UAE).
Data were extracted from the Infectious Diseases Notification Surveillance System of the Department of Health. The descriptive analysis was done using Statistical Package for Social Sciences v26 and reported according to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.
We analyzed 3827 cases; 82% were men, 18% women, 14% UAE citizens, and 86% were of other nationalities. Most cases (72%) had lower exposure to low-risk occupations of infectious disease as per the classification of the department of health while high exposure risk occupations, which included healthcare worker accounts only for 3%. While 43% of cases were asymptomatic, 57% displayed symptoms, which were mostly mild. Only 12% of patients had comorbidities, which were significantly higher in men (9%) than women (3%). Among those who have comorbid conditions; hypertension (27%) and diabetes (21%) were the most common comorbidities. Viral pneumonia (11%) was the most common sequela documented in records. Only 51 patients (4%) required admission to the intensive care units, and 4 patients died (0.1%).
The significant number of asymptomatic patients was identified by active case finding and contact tracing from the early period of the epidemic. A small percentage of severe, critical cases, and death reported in the Emirate of Abu Dhabi which may have been due to public health measures implemented for early detection, contact tracing, and treatment.
MRGBP is a potential novel prognostic biomarker and is correlated with immune infiltrates in hepatocellular carcinoma
Authors: Huang Juanjun , Chen Xiaoli , Zhu Wei 
Published: March 2021

Abstract
This study investigated the expression change, prognostic values, and potential regulatory mechanisms of mortality factor on chromosome 4 (MORF4)-related gene-binding protein (MRGBP) in hepatocellular carcinoma (HCC).
MRGBP expression and clinical data from The Cancer Genome Atlas were used to evaluate the associations between MRGBP expression and clinicopathological characteristics. Kaplan–Meier and Cox regression analyses were performed to assess the factors contributing to prognosis. Gene set enrichment analysis (GSEA) was used to identify pathways associated with MRGBP expression. Single-sample gene set enrichment analysis (ssGSEA) was used to comprehensively analyze the relative immune infiltration levels.
High MRGBP expression was significantly associated with a higher T stage, pathologic stage, histologic grade, vascular invasion, tumor protein p53 status, and worse overall survival. MRGBP exhibited high diagnostic accuracy with an area under the receiver operating characteristic curve value of 0.980. GSEA revealed the enrichment of pathways related to tumorigenesis in the MRGBP high-expression phenotype, such as cell cycle and DNA replication pathways. ssGSEA revealed that MRGBP expression was significantly correlated with 15 types of immune cell infiltration levels. The Wilcoxon rank sum test revealed significantly high T helper (Th), T follicular helper, CD56 bright natural killer, and Th2 cell enrichment scores in the high MRGBP expression group and significantly low neutrophil, Th17, dendritic cell (DC), gamma delta T, cytotoxic cell, regulatory T cell, plasmacytoid DC, and immature DC enrichment scores.
MRGBP may be a novel prognostic biomarker and a therapeutic target correlated with immune infiltrates in HCC.
Efficacy of active forced air warming during induction of anesthesia to prevent inadvertent perioperative hypothermia in intraoperative warming patients
Authors: Yoo Jae Hwa , Ok Si Young , Kim Sang Ho , Chung Ji Won , Park Sun Young , Kim Mun Gyu , Cho Ho Bum , Song Sang Hoon , Cho Chae Yeon , Oh Hong Chul 
Published: March 2021

Abstract

Background:
This study aimed to evaluate the efficacy of peri-induction forced air warming to prevent inadvertent perioperative hypothermia, defined as a reduction in body temperature to <36.0°C during the perioperative period, in intraoperatively warmed patients receiving major surgery lasting >120 minutes.

Methods:
In total, 130 patients scheduled for elective surgery under general anesthesia lasting >120 minutes were divided into 2 groups: peri-induction warming (n = 65) and control (n = 65). Patients in the peri-induction warming group were warmed during the anesthetic induction period using a forced-air warmer set at 47°C, whereas patients in the control group were covered passively with a cotton blanket. All patients were warmed with a forced-air warmer during surgery. Body temperature was measured using a tympanic membrane thermometer in the pre- and postoperative periods and using a nasopharyngeal temperature probe during surgery. Patients were evaluated for shivering scale score, thermal comfort scale score, and satisfaction score in the post-anesthesia care unit.

Results:
The incidence rates of intraoperative and postoperative hypothermia were lower in the peri-induction warming group than in the control group (19.0% vs 57.1%, P < .001; 3.3% vs 16.9%, P = .013, respectively). Body temperature was higher in the peri-induction warming group (P < .001). However, intraoperative blood loss, as well as postoperative thermal comfort scale score, shivering scale score, and patient satisfaction score, were similar between groups. Post-anesthesia care unit duration was also similar between groups.

Conclusions:
Peri-induction active forced air warming is an effective, simple, and convenient method to prevent inadvertent perioperative hypothermia in intraoperatively warmed patients undergoing major surgery lasting >120 minutes.
Improvement in the cardiovascular profile of patients with morbid obesity following bariatric surgery
Authors: Marco Ana , Marco Pascual 
Published: March 2021

Abstract
Obesity is an inflammatory state related to vascular endothelium dysfunction. It generates a biological situation of hypercoagulability increasing the risk of thrombosis. This prothrombotic condition could be improved by bariatric surgery.
The main objective was to analyze the impact of bariatric surgery on cardiovascular risk factors (CVRF) associated with changes in thrombin generation and procoagulant activity of microparticles (MP).
We present a prospective longitudinal study including consecutive patients candidate for bariatric surgery. We performed 3 sequential clinical visits: at inclusion, before surgery after completing the modified fasting phase, and 6 months after surgery. We analyzed CVRF, thrombin generation, and MP activity. The data analysis was performed using a logistic regression model to determine changes over time of hemostatic parameters and body mass index (BMI). McNemar test for binary variables was used to analyze the CVRF.
We included 94 patients (66 women), with an average age of 45.7 ± 10.1 years. The mean BMI reduction at the end of the follow-up was 15.5 ± 4.2 kg/m2. We detected a statistically significant improvement in CVRF: hypertension, diabetes mellitus, dyslipidemia, and obstructive sleep apnea, as well as a significant reduction in thrombin generation capacity and procoagulant MP activity.
Massive weight loss induced by bariatric surgery improves the cardiovascular profile, associated with a reduction in the hypercoagulable status.
Comparison of rotational atherectomy and modified balloons prior to drug-eluting stent implantation for the treatment of heavily calcified coronary lesions
Authors: Hong Xu-Lin , Li Ya , Zhou Bin-Quan , Fu Guo-Sheng , Zhang Wen-Bin 
Published: March 2021

Abstract
The optimal strategy for lesion preparation in heavily calcified coronary lesions (HCCL) prior to drug-eluting stent (DES) implantation remains debatable. This study sought to compare the performance of rotational atherectomy (RA) and modified balloon (MB)-based strategy in patients with HCCL receiving current-generation DES.
This retrospective study comprised 564 consecutive patients who underwent RA (n = 229) or MB (n = 335) for HCCL at our hospital and were treated with DES. Baseline clinical and angiographic data was obtained from our database. Patients were clinically monitored for the occurrence of any adverse events during the hospitalization. One-year follow-up was conducted by either telephone contact or outpatient visits. 1:1 propensity score matching (PSM) was performed to balance the baseline covariates. After PSM, the clinical outcomes between the 2 groups were compared.
After PSM, except more target lesion in right coronary artery existing in the RA group (P = .008), no significant statistical differences were shown in regard of the other angiographic and procedural characteristics of the 2 groups. Strategy success rates were all 100% in both groups. In the unadjusted Cox proportional hazard analysis, participants with RA had a significantly lower risk of target lesion revascularization (TLR) (hazard ratio, HR 0.275, 95% confidence intervals, CI 0.119–0.635, P = .003) and major adverse cardiac event (MACE) (HR 0.488, 95% 0.277–0.859, P = .013). After adjusting for potential confounding variables, RA was significantly associated with TLR (HR 0.32, 95% 0.12–0.853, P = .023), but no longer significantly associated with MACE (HR 0.674, 95% 0.329–1.381, P = .282).
In patients with HCCL, lesion preparation with RA was safe and could improve strategy success rate. There was lower rate of TLR with RA, however, no significant difference was found in the MACE rate at 1-year follow-up between RA and MB-based strategy.
Age‐Dependent Trends in the Celiac Disease
Authors: Krauthammer Alexander , Guz‐Mark Anat , Zevit Noam , Marderfeld Luba , Waisbourd‐Zinman Orith , Silbermintz Ari , Mozer‐Glassberg Yael , Nachmias Friedler Vered , Rozenfeld Bar Lev Michal , Matar Manar , Assa Amit , Shamir Raanan 
Published: March 2021

ABSTRACTObjectives:Celiac disease (CD) is a common intestinal autoimmune disorder with diverse presenting features. We aimed to determine age‐dependent patterns in CD presentation, diagnosis and management at a large tertiary referral center.Methods:A retrospective review of electronic medical records of pediatric patients diagnosed with CD between January 1999 and December 2018 at Schneider Children's Medical Center of Israel. We compared demographics, clinical and laboratory parameters between four age groups at CD presentation.Results:A cohort of 932 children was divided into four groups by age (in years) at diagnosis: 0–3 (17.9%), 3–6 (31.8%), 6–12 (34.5%), 12–18 (15.8%). The youngest age group presented more frequently with diarrhea, weight loss, abdominal distention, vomiting and lower weight z scores, P < 0.01. Hypoalbuminemia and zinc deficiency were also more frequent in this age group, compared to older patients (P < 0.05, each). Rates of anemia were higher in younger age groups (0–3 and 3–6 years), compared to older age groups, P < 0.05. Patients in the younger age groups (0–3 and 3–6 years) presented more frequently with tissue transglutaminase (TTG) levels above 10 times the upper limit of normal (ULN; P < 0.05), and more often normalized their CD serologies by 24 months of gluten‐free diets (GFD) compared to older age groups (P < 0.05).Conclusion:There is an age‐dependent variation in CD presentation during childhood. Younger patients present more often with malabsorptive features, and higher TTG levels, yet normalize TTG while on GFD more rapidly than older patients. Clinicians should be aware of the diversity in CD presentation and course at the various presentation age.