bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular mechanism of reproductive toxicity induced by Tripterygium Wilfordii based on network pharmacology
Authors: Ding Qing , Wu Yuanhao , Liu Wei 
Published: July 2021

Abstract
To explore the possible molecular mechanism of reproductive toxicity of Tripterygium wilfordii from the perspective of network pharmacology and bioinformatics.
The compounds of T wilfordii were obtained by querying the relevant Chinese medicine database, the effective compounds were screened and the corresponding targets were obtained, and then compared with the reproductive toxicities related to disease targets obtained from the disease gene database to infer the potential toxic targets of reproductive toxicity of T wilfordii. Then, the key targets of reproductive toxicity of T wilfordii were screened using Search Tool for the Retrieval of Interacting Genes/Protein and Cytoscape. The gene ontology function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, as well as module analysis, were performed on the key targets using Database for Annotation, Visualization, and Integrated Discovery and Cytoscape, respectively. Finally, the network between effective compounds-toxic targets was conducted to see how the compounds interacted.
A total of 48 effective compounds and 482 potential toxic targets related to the reproductive toxicity of T wilfordii were screened. The enrichment analysis results showed that the key targets were mainly enriched in biological processes such as response to drug, ionotropic glutamate receptor signaling pathway, and KEGG pathways such as neuroactive ligand-receptor interaction, cAMP signaling pathway. In the protein-protein interaction network of potential toxic targets, there were 78 key targets such as TP53, INS, IL6, AGT, ADCY3, and so on. Enrichment analysis of the top module with 19 genes from module analysis indicated that T wilfordii might cause reproductive toxicity by gene ontology terms and KEGG pathways such as regulation of vasoconstriction, G-protein coupled receptor signaling pathway, inflammatory response, cAMP signaling pathway, and so on. In the network between effective compounds of T wilfordii and key targets, there were 5 compounds with high degree including Tingenone, Wilfordic Acid, Abruslactone A, Nobilin, and Wilforlide B.
The complex molecular mechanism of reproductive toxicity of T wilfordii can be preliminarily elucidated with the help of the network pharmacology method, and the analysis results can provide some reference for the further mechanism research of reproductive toxicity of T wilfordii.
Nomogram for predicting survival of patients with metastatic nonfunctioning pancreatic neuroendocrine tumors
Authors: Ge Lina , Li Haijin , Dong Liang , Shang Guanmin , Wang Weiying , Li Ying , Qi Liping , Zhao Jiangang , Peng Dengfu , Tong Guoqi 
Published: July 2021

Abstract
More attention has been placed on nonfunctioning pancreatic neuroendocrine tumors due to the increase in its incidence in recent years. Whether tumor resection at the primary site of metastatic NFpNET is effective remains controversial. Moreover, clinicians need a more precise prognostic tool to estimate the survival of these patients.
Patients with metastatic NFpNET were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Significant prognostic factors were identified using a multivariate Cox regression model and included in the nomogram. Coarsened exact matching analysis was used to balance the clinical variables between the non-surgical and surgical groups in our study.
A total of 1464 patients with metastatic nonfunctioning pancreatic neuroendocrine tumors (NFpNETs) were included in our cohort. Multivariate analysis identified age, sex, tumor size, differentiated grade, lymph node metastases, resection of primary tumors, and marital status as independent predictors of metastatic NFpNET. The nomogram showed excellent accuracy in predicting 1-, 3-, and 5-year overall survival, with a C-index of 0.812. The calibration curve revealed good consistency between the predicted and actual survival.
Coarsened exact matching analysis using SEER data indicated the survival advantages of resection of primary tumors. Our study is the first to build a nomogram model for patients with metastatic NFpNETs. This predictive tool can help clinicians identify high-risk patients and more accurately assess patient survival times.
Predictors of recurrence in patients with high-grade cervical intraepithelial neoplasia after cervical conization
Authors: Ge Yan , Liu Yongli , Cheng Yun , Liu Yanbo 
Published: July 2021

Abstract
This study was to identify the predictors of recurrence in patients with high-grade cervical intraepithelial neoplasia (CIN) after cervical conization.
Totally 415 patients with CIN ≥ II who underwent loop electrosurgical excision procedure (LEEP) or cold knife conization (CKC) were included in this retrospective study. Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) regarding the association between postoperative recurrence and clinicopathological data.
After the mean follow-up of (21.48 ± 5.82) months, 90 (21.69%) out of 415 cases were subjected to recurrence after cervical conization. The influencing factors for postoperative recurrence included times of full-term birth, history of preterm birth, history of abortion, positive margin, cone length, width, depth, smoking, and history of complicating diseases (P < .05). Multivariate Cox model indicated the positive margin (HR = 2.144, 95% CI: 1.317–3.492, P < .05), history of preterm birth (HR = 4.515, 95% CI: 1.598–12.754, P < .05), history of complicating diseases (HR = 3.552, 95% CI: 1.952–6.462, P < .05) were independent risk factors for recurrence after cervical conization. The restricted cubic diagram showed that the cone depth >0.5 cm was a protective factor for postoperative recurrence.
For the patients with high-grade CIN after cervical conization, positive margins, histories of preterm birth, and complicating diseases were associated with increased risk of recurrence, but cone depth (>0.5 cm) with lower risk of recurrence.
Efficacy of ultrasound-accelerated versus traditional catheter-directed thrombolysis in treatment of lower extremity deep venous thrombosis
Authors: Ma Shan , Zhao Zhizhen , Song Zhijun , Wang Li 
Published: July 2021

Abstract

Background:
There is no meta-analysis or review in the literature to compare and evaluate the difference and effectiveness of ultrasonic-accelerated thrombolysis (UAT) and catheter directed thrombolysis (CDT) in lower extremity deep vein thrombosis (DVT) patients. Therefore, we conducted this protocol of systematic review and meta-analysis to evaluate the efficacy between UAT and CDT for patients with lower extremity DVT.

Methods:
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols reporting guidelines to conduct this study. Reviewers will search the PubMed, Cochrane Library, Web of Science, and EMBASE online databases using the key phrases “deep venous thrombosis,” “thrombolysis,” and “ultrasound-accelerated” for all cohort studies published up to July 22, 2021. There is no restriction in the dates of publication or language in the search for the current review. The primary outcome is major bleeding. Secondary outcomes include health-related quality of life and complications such as recurrent venous thromboembolism, pulmonary embolism, in-stent thrombosis, and death. Review Manager software (v 5.4; Cochrane Collaboration) will be used for the meta-analysis. A P value of < .05 is considered to be statistically significant.

Results:
We hypothesized that these two methods would provide similar therapeutic benefits.

OSF registration number:
10.17605/OSF.IO/YZB3H.
Ovarian teratoma in a teenager causing ureterohydronephrosis
Authors: Anton-Păduraru Dana-Teodora , Miron Ingrith Crenguta , Lupu Vasile Valeriu , Lupu Ancuta , Hanganu Elena 
Published: July 2021

Abstract

Rationale:
Teratomas are solid tumors that may occur in both gonadal and extragonadal locations, depending on the age of the child. Benign cystic teratomas are relatively common tumors among women of reproductive age, but they can occur at any age. The clinical presentation is not specific. They can be found incidentally when patients are investigated for other conditions or they can present as emergencies when the ovarian teratoma is torsioned or ruptured.

Patient concerns:
We present the case of a 17-year-old adolescent girl that was seen in our emergency department on several occasions for recurrent episodes of abdominal pain ongoing for 6 months.

Diagnosis:
An ultrasonography (US) was performed as an outpatient and a left ovarian mass was found along with right ureterohydronephrosis (UHN). Further assessment of the mass was done by abdominal and pelvic CT and tumoral markers. CT appearance was more suggestive of a teratoma.

Interventions:
She underwent laparotomy with complete excision of the tumor.

Outcome:
The patient had an uneventful recovery. A renal US follow up showed reduction of the dilatation, demonstrating that the condition was secondary to tumor compression.

Lessons:
In a teenager with nonspecific symptoms, a high suspicion index for tumors is mandatory. An early diagnosis and management avoid complications like UHN.
Validation of the mandarin tinnitus evaluation questionnaire
Authors: Chen Zhiji , Zheng Yun , Fei Yingping , Wu Di , Yang Xiameng 
Published: July 2021

Abstract
This study sought to validate the applicability of the mandarin Tinnitus Evaluation Questionnaire (TEQ), a brief score method administered by clinicians to quantify the tinnitus severity.
A descriptive observational questionnaire study in regard to psychometric properties and practicability was conducted with a total of 414 primary tinnitus outpatients, in which 173 of 414 patients completed the follow-up after receiving an intervention based on the tinnitus educational counseling and the life-style adjustment guidance. For quantifying the tinnitus severity, the TEQ and other 2 self-report questionnaires, Tinnitus Handicap Inventory and visual analog scale, were administered on patients’ first-visit and follow-up. With the psychometric analysis, we evaluated the performance of TEQ in tinnitus management, including distinguishing patients with varying severity and detecting the treatment-related outcome.
At the first visit, the TEQ showed an excellent inter-rater reliability (Pearson correlation, 0.97, P < .01), a good internal consistency reliability (Cronbach's α, 0.79), and an acceptable convergent validity (Pearson correlation, 0.78 with the Tinnitus Handicap Inventory; 0.62 with a single-question visual analog scale, P < .01). In detecting the treatment-related change, a large effect size of TEQ verified a sensitive responsiveness. After estimating the test-error, a 2-point reduction (2/21) of the TEQ was recommend to be considered a reference outcome indicator for the effective intervention.
Even though the TEQ is scored by clinician, it can reflect the clinical features of tinnitus patient. Flexible and simple assessing process makes it a practical tool for patient intake, intervention selection, and outcome measurement.
The correlation between mental health status, sleep quality, and inflammatory markers, virus negative conversion time among patients confirmed with 2019-nCoV during the COVID-19 outbreak in China
Authors: Li Xixi , Cai Quan , Jia Ziyi , Zhou Yifang , Liu Linzi , Zhou Yuning , Zhang Baoyan , Ren Luyu , Tang Yanqing 
Published: July 2021

AbstractThe 2019 coronavirus disease (COVID-19) has spread to the whole world. Psychological and sleep problems among confirmed patients have drawn extensive attention which may be highly related to immune function and inflammatory responses of people. The aim of this study is to examine the correlation of mental health status, sleep quality, and inflammatory markers, virus negative conversion time (NCT) among confirmed patients during the COVID-19 outbreak.A cross-sectional survey was conducted in this study. Data from 66 patients assessed with demographic information, anxious symptom, depressive symptom, stress, and sleep quality were collected using a smartphone-based questionnaire platform and then clinical characteristics and laboratory indicators were collected using case review.Nearly 30% of the participants reported depression, anxiety, perceived pressure, and poor sleep quality. Compared with the group without depression, neutrophil count, and ratio of neutrophil count to lymphocyte count (NLR) in the depression disorder group were increased (P = .028, 0.043). There was also a significant difference in NLR and NCT between the anxiety group and the non-anxiety group (P = .021, .024). Similarly, compared with the good sleep quality group, NLR in the poor sleep quality group was increased (P = .011). Correlation analysis indicated that Self-Rating Depression Scale score was positively related to neutrophil count and NLR (r = 0.366, 0.330,P = .016, .031). The total score of Pittsburgh Sleep Quality Index (PSQI) was negatively related to lymphocyte count (r = −0.317,P = .049), and the sleep disturbance as 1 of the 7 dimensions of PSQI scale was positively correlated with NCT and NLR (r = 0.370, 0.340,P = .020, .034).In our study, confirmed patients were prone to have psychological and sleep problems. The level of inflammation in patients with psychological and sleep problems was higher than that in patients without corresponding problems. The inflammatory level increased with the increase of Self-Rating Depression Scale score, and the lymphocyte count decreased with the increase of the PSQI score. NCT was prolonged in the anxiety group and sleep disturbance was positively correlated with NCT.
Effects of enhanced external counterpulsation on exercise capacity and quality of life in patients with chronic heart failure
Authors: Zhou Zhao-Feng , Wang Da-jie , Li Xu-Mei , Zhang Cheng-Lin , Wu Chun-Yang 
Published: July 2021

Abstract

Background:
This meta-analysis aimed to synthesize randomized controlled trials to evaluate the effects of enhanced external counterpulsation (EECP) on exercise capacity and quality of life in patients with chronic heart failure (CHF).

Methods:
Both English and Chinese databases were searched from their inception to June 30, 2020 (PubMed, EMBASE, Cochrane Library, CINAHL (EBSCO), Web of Science for English publications and Chinese Biomedical Database, China National Knowledge Infrastructure, Wanfang Data for Chinese publication). Titles, abstracts, and full-text articles were screened against study inclusion criteria: randomized controlled trials studying EECP intervention for patients with CHF. The meta-analysis was conducted with Revman 5.3 or STATA 16.0.

Results:
Eight randomized controlled trials were included. EECP induced significant improvement in 6-min walking distance (WMD=84.79 m; 95% CI, 47.64 to 121.95; P < .00001). Moreover, EECP was beneficial for left ventricular ejection fraction (SMD = 0.64; 95% CI,0.29 to 1.00; P = .0004), and N-terminal pro brain natriuretic peptide (SMD = −0.61; 95%CI, −1.20 to −0.01; P = 0.04).However, compared with the control groups, EECP did not significantly reduce the Minnesota Living with Heart Failure Questionnaire scores(WMD, −9.28; 95% CI, −19.30 to 0.75; P = 0.07).

Conclusions:
Despite heterogeneity and risk of bias, this meta-analysis confirms that EECP can improve exercise capacity in CHF patients, especially the elderly. However, the evidence that EECP improves the quality of life in patients with CHF is still insufficient. More and larger well-designed randomized controlled trials are still warranted.

Registration information:
PROSPERO registration no. CRD 42020188848.
Implementation of collaborative care for depressive disorder treatment among accountable care organizations
Authors: Newton Helen , Busch Susan H. , Brunette Mary , Maust Donovan T. , O’Malley James , Meara Ellen R. 
Published: July 2021

Abstract
Collaborative care – primary care models combining care management, consulting behavioral health clinicians, and registries to target mental health treatment – is a cost-effective depression treatment model, but little is known about uptake of collaborative care in a national setting. Alternative payment models such as accountable care organizations (ACOs), in which ACOs are responsible for quality and cost for defined patient populations, may encourage collaborative care use.
Determine prevalence of collaborative care implementation among ACOs and whether ACO structure or contract characteristics are associated with implementation.
Cross-sectional analysis of 2017–2018 National Survey of ACOs (NSACO). Overall, 55% of ACOs returned a survey (69% of Medicare, 36% of non-Medicare ACOs); 48% completed at least half of core survey questions. We used logistic regression to examine the association between implementation of core collaborative care components – care management, a consulting mental health clinician, and a patient registry to track mental health symptoms – and ACO characteristics.
Four hundred five National Survey of ACOs respondents answering questions on collaborative care implementation.
Only 17% of ACOs reported implementing all collaborative care components. Most reported using care managers (71%) and consulting mental health clinicians (58%), =just 26% reported using patient registries. After adjusting for multiple ACO characteristics, ACOs responsible for mental health care quality measures were 15 percentage points (95% CI 5–23) more likely to implement collaborative care.
Most ACOs are not utilizing behavioral health collaborative care. Including mental health care quality measures in payment contracts may facilitate implementation of this cost-effective model. Improving provider capacity to track and target depression treatment with patient registries is warranted as payment contracts focus on treatment outcomes.
Financial burden of postoperative complications following colonic resection
Authors: Louis Maleck , Johnston Samuel A. , Churilov Leonid , Ma Ronald , Christophi Christopher , Weinberg Laurence 
Published: July 2021

Abstract

Background:
Colonic resection is a common surgical procedure that is associated with a high rate of postoperative complications. Postoperative complications are expected to be major contributors to hospital costs. Therefore, this systematic review aims to outline the health costs of postoperative complications following colon resection surgery.

Methods:
MEDLINE, Excerpta Medica database, Cochrane, and Economics literature medical databases were searched from 2010 to 2019 to identify English studies containing an economic evaluation of postoperative complications following colonic resection in adult patients. All surgical techniques and indications for colon resection were included. Eligible study designs included randomized trials, comparative observational studies, and conference abstracts.

Results:
Thirty-four articles met the eligibility criteria. We found a high overall complication incidence with associated increased costs ranging from $2290 to $43,146. Surgical site infections and anastomotic leak were shown to be associated with greater resource utilization relative to other postoperative complications. Postoperative complications were associated with greater incidence of hospital readmission, which in turn is highlighted as a significant financial burden. Weak evidence demonstrates increased complication incidence and costlier complications with open colon surgery as compared to laparoscopic surgery. Notably, we identified a vast degree of heterogeneity in study design, complication reporting and costing methodology preventing quantitative analysis of cost results.

Conclusions:
Postoperative complications in colonic resection appear to be associated with a significant financial burden. Therefore, large, prospective, cost-benefit clinical trials investigating preventative strategies, with detailed and consistent methodology and reporting standards, are required to improve patient outcomes and the cost-effectiveness of our health care systems.
The prognostic value of preoperative serum albumin in patients with bladder urothelial carcinoma undergoing transurethral resection of bladder tumor
Authors: Shen Chen , Zhou Kechong , Wang Wei , Zhang Yue , Liu Xiaoqiang 
Published: July 2021

Abstract

Background:
To evaluate whether the preoperative serum albumin level can predict the survival outcome in patients with bladder urothelial carcinoma (BUC) undergoing transurethral resection of bladder tumor (TURBT).

Methods:
Four hundred fifty six newly diagnosed patients with BUC who underwent TURBT between January 2014 and December 2017 were retrospectively enrolled. Patients were categorized into low albumin (<40 g/L) and high albumin (≥40 g/L) groups. Survival was estimated using the Kaplan–Meier method and compared using the log-rank test. Univariate and multivariate Cox proportional analyses were used to determine the hazard ratios (HRs) for overall survival (OS). Of patients with available data, 108 (24%) and 348 (76%) patients were classified into the low albumin (<40 g/L) and high albumin (≥40 g/L) groups, respectively.

Results:
The results of the Kaplan–Meier analysis and log-rank test showed a significantly worse 5-year OS (P = .003) in the low albumin group than in the high albumin group. In the multivariate Cox regression analysis, after adjusting for confounding variables, the preoperative albumin level remained an independent predictor for 5-year OS (HR: 0.434, 95% confidence interval: 0.221–0.852; P = .015).

Conclusion:
Our study determined that a low preoperative albumin level predicted poor OS in patients with BUC who underwent TURBT. Preoperative serum albumin is an inexpensive and easily available marker that has the potential to be a good prognostic factor for predicting mortality in patients with BUC treated with TURBT.