bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis and treatment of uterine artery pseudoaneurysm
Authors: Wu Tingting , Lin Beibei , Li Kui , Ye Jinying , Wu Ruijin 
Published: December 2021

Abstract

Background:
Uterine artery pseudoaneurysm (UAP) is a rare but potentially life-threatening cause of hemorrhage. Nonetheless, its knowledge could be insufficient among obstetricians, gynecologists, and radiologists. We aimed to clarify the clinical characteristics, management, and outcomes of UAP.

Methods:
We retrospectively analyzed nine female patients diagnosed with UAP at our institute between 2013 and 2020.

Results:
Seven cases presented with a history of traumatic surgery including cesarean section, dilation and curettage, laparoscopic myomectomy, and cervical conization. Two cases occurred after spontaneous vaginal delivery and second-trimester pregnancy termination. The main symptom was heavy/massive/prolonged vaginal bleeding. All patients were first evaluated by color Doppler ultrasonography and three cases were confirmed by magnetic resonance imaging. Severn patients underwent transarterial embolization (TAE) of the uterine arteries, and two were managed conservatively. All patients had good outcomes.

Conclusions:
UAP can develop after traumatic pelvic operations and non-traumatic delivery/abortion. It may be more common than previously considered. The risk of rupture may be correlated with multiple factors other than the mass size. TAE of the uterine artery could be an effective management strategy for ruptured UAP. However, some cases can resolve spontaneously without TAE, suggesting that conservative management can be employed in some women.
Diagnostic accuracy of three-dimensional contrast-enhanced ultrasound for focal liver lesions
Authors: Qu Meijng , Jia Zhaohua , Sun Lipeng , Wang Hui 
Published: December 2021

Abstract

Background:
Contrast-enhanced ultrasound (CEUS) examination is a well-established technique for this purpose with several unique advantages. It is a real-time technology with high temporal resolution. With its unique ability to detect microvascular perfusion, it helps in better characterization of FLL.
[1–4]
Three-dimensional (3D) CEUS with quantitative analysis is updated in recent years. 3D-CEUS is a new ultrasonic diagnostic technique, which can observe the nourishing vessels of lesions from multiple angles. Previous studies showed that 3D-CEUS can detect tumor nourishing vessels to differentiate benign from malignant focal liver lesions (FLLs). However, the results of these studies have been contradictory. Therefore, this meta-analysis tested the hypothesis that 3D-CEUS is accurate in distinguishing benign and malignant FLLs.

Methods:
We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the April 30, 2021, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software will be used for data analysis.

Results:
This systematic review will determine the accuracy of 3D-CEUS in the differential diagnosis between benign and malignant FLLs.

Conclusion:
Its findings will provide helpful evidence for the accuracy of 3D-CEUS in the differential diagnosis between benign and malignant FLLs.

Systematic review registration:
INPLASY202150096.
Analysis and classification of radiological results and epidemiology of patients with COVID-19 pneumonia
Authors: Fayadoglu Mustafa , Ekinci İlksen Berfin , Fayadoglu Elif , Arslan Hüseyin , Uzunkulaoğlu Tülin 
Published: December 2021

AbstractThe coronavirus disease-2019 (COVID-19) pneumonia which is caused by the severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) virus is the current urgent issue world over. According to the Health Ministry of Turkey, the first COVID-19 patient was diagnosed on March 11, 2020. Since then, approximately 5.5 million patients have been confirmed to be positive SARS CoV-2 virus. In this retrospective study, we aimed at analyzing the epidemiological and radiological findings of COVID-19 cases at the Hospital of Grand National Assembly of Turkey from April 1, 2020 to December 31, 2020.A total of 130 patients (84 male, 25–87 years) were diagnosed as positive with High Resolution Computed Tomography (HRCT) scans and 71 of them confirmed with positive Real Time Polymerase Chain Reaction using the patients’ nasopharyngeal and throat samples.HRCT scans were classified into 4 stages. Stage I (39.2%) patients’ group; the HRCT results were found to be mosaic perfusion, whereas Stage II (39.2%) were found to be Ground Glass Opacity. Also, consolidation was detected in Stage III (20%). Finally, Stage IV, considered the most severe lung findings, and named as a crazy paving pattern was determined in 2 patients (1.53%). Furthermore, 20% of patients were found to be positive using IgG antibody against to SARS CoV-2 virus.Our findings showed that HRCT could be most prominent technique compared to real time polymerase chain reaction for the diagnosis of COVID-19 pneumonia. The novel classification of HRCT findings will be helpful to early diagnosis of the disease, time saving and eventually cost-effective.
An open label, multicenter clinical trial that investigated the efficacy and safety of leuprorelin treatment of central precocious puberty in Chinese children
Authors: Luo Xiaoping , Hou Ling , Zhong Yan , You Cheng , Yang Yu , Wu Xian , Li Pin , Zhou Shasha , Qiu Wenjuan , Zhang Huiwen , Liu Ying , Qian Ye , Luo Feihong , Cheng Ruoqian , Hu Yuhua , Gong Haihong , Wang Qing , Xu Zhuangjian , Du Hongwei , Lu Feiyu , Fu Junfen , Chen Xuefeng , Wang Winston , Guo Ziheng 
Published: December 2021

Abstract

Background:
Leuprorelin is an analog of gonadotropin-releasing hormone that is used for the therapy of central precocious puberty (CPP). The aims of this prospective, open label, multicenter clinical trial were to establish its efficacy and safety during long-term use.

Methods:
Patients, who were all children, were treated with 1.88 to 3.75 mg leuprorelin subcutaneously once every 4 weeks for a total of 96 weeks between 2015 and 2018. The primary endpoint was the rate of occurrence of adverse events (AEs) and the secondary endpoint was no progression in the Tanner stage or regression by week 96 compared to baseline.

Results:
A total of 307 CPP patients, 305 (99.3%) females and 2 males (0.7%), completed the 96-weeks of treatment. Due to limited data for male patients, they are not discussed in the efficacy results. Treatment-emergent AEs (TEAEs) were reported for 252 (82.1%) patients, mostly (79.5%) being mild or moderate and only 33 (10.7%) of patients experienced TEAEs related to leuprorelin therapy. The most frequent (>2%) drug-related TEAEs were injection site induration (4.6%, 14/307) and vaginal bleeding (2.3%, 7/305). After treatment, 83.5% of patients had regression or no progression in the Tanner stage (95% confidence interval: 78.68%, 87.62%) and the majority had decreased gonadotropin-releasing hormone-stimulated peak luteinizing hormone and follicle-stimulating hormone concentrations, as well as reduced sex hormone concentrations and a reduction in the bone age/chronological age ratio compared to baseline.

Conclusions:
The trial revealed that CPP was effectively treated in most patients who received leuprorelin for nearly 2 years. Any drug-related AEs were reported with low incidence (<5%) and were consistent with the known safety profile of leuprorelin.

Trial registration:
The trial was registered at ClinicalTrials.gov (registration number: NCT02427958).
Electroacupuncture for the treatment of frozen shoulder
Authors: Heo Jeong-Weon , Jo Jeong-Hun , Lee Jung-Ju , Kang Hee , Choi Tae-Young , Lee Myeong-Soo , Kim Jong-In 
Published: December 2021

Abstract

Background:
Electroacupuncture has been reported to successfully control pain. Currently, no systematic reviews of the effects of electroacupuncture on frozen shoulder patients have been performed. This review aims to provide current evidence on the efficacy of electroacupuncture for the management of pain in frozen shoulder.

Methods and analyses:
Eleven databases will be searched from their inception: PubMed, AMED, EMBASE, the Cochrane Library, 6 Korean medical databases, and 1 Chinese medical database. Study selection, data extraction, and assessment will be performed independently by 2 researchers. Risk of bias will be assessed using the Cochrane risk of bias assessment tool.

Ethics and dissemination:
Ethical approvals and patient consent are not required because the meta-analysis will be based on published research. This systematic review will be published in a peer-reviewed journal and disseminated both electronically and in print. The review will be updated to inform and guide health care practice and policy.

Trial registration number:
PROSPERO 2021 CRD42021247090.
Exploration of genes and tumor infiltrating lymphocytes in female lung adenocarcinoma microenvironment that predicted prognosis
Authors: Wang Lijun , Wang Hao , Wei Song , Zhang Zhihong 
Published: December 2021

Abstract
The tumor microenvironment has an important impact on tumor growth, invasion, metastasis, anti-tumor immune tolerance, and prognosis. The present study aimed to explore female lung adenocarcinoma microenvironment-associated tumor infiltrating lymphocytes (TILs) and genes that predict prognosis in The Cancer Genome Atlas (TCGA) database. Gene expression profiles of female patients with lung adenocarcinoma were downloaded from TCGA. Base on the CIBERSORT algorithm, we determined the fractions of TILs. By applying the ESTIMATE algorithm, immune scores and stromal scores were derived. According to the immune and stromal scores, we categorized the female patients with lung adenocarcinoma into high and low score groups. We also identified the fractions of TILs and differentially expressed genes (DEGs) that were significantly related with prognosis. The proportion of M1 macrophages was significantly negatively related to overall survival in female patients with lung adenocarcinoma. There were 269 upregulated genes and 35 downregulated genes both in immune scores and stromal scores. PTPRC (protein tyrosine phosphatase receptor type C) and GIMAP6 (GTPase, IMAP family member 6) were not only hub genes, but also were significantly related to overall survival in the Kaplan–Meier Plotter online and TCGA databases. In summary, our study provided new insight into the tumor microenvironment-related cellular and molecular mechanisms of women with lung adenocarcinoma. The results will be useful for future clinical studies.
Diagnosis and treatment of uterine sarcoma
Authors: Li Kemin , Yin Rutie , Li Li , Wang Danqing , Li Li , Ma Cailing , Ren Qianchuan , Wang Guqing , Fan Yang , Zhou Honggui , Liu Zi , Li Tao , Luo Kunrong , Kui Dingqing , Wang Jingyi 
Published: December 2021

Abstract
A detailed understanding of the diagnosis and treatment of uterine sarcoma in the real world is required due to its low incidence, high malignancy, lack of specific symptoms, and lack of high-level evidence supporting its clinical diagnosis and treatment. This study aimed to provide a basis for the standardized diagnosis and treatment of uterine sarcoma. It retrospectively analyzed the real-world data on the diagnosis, treatment, and prognosis of uterine sarcoma in western China.
The clinical and pathological data of patients with uterine sarcoma diagnosed and treated between January 2009 and January 2019 in 13 medical centers from 4 western provinces of China, Sichuan, Guangxi, Shaanxi, and Xinjiang, were collected and further examined by univariate and multivariate analyses to find possible risk factors affecting the prognosis of uterine sarcoma.
A total of 299 patients with various pathological types of uterine sarcoma were included, with an average age of 47.7 ± 11.1 years. The univariate and multivariate analyses showed that age (P = .0081), family history (P = .0358), and chemotherapy regimen (P = .0005) significantly correlated with progression-free survival; while age (P = .0393) and International Federation of Gynecology and Obstetrics staging (P = .0141) significantly correlated with overall survival.
As age increased, the risk of death in patients with uterine sarcoma increased; The disease tended to progress faster in lower-age patients. A family history of tumors had an impact on disease progression; however, the way in which it affected needs further exploration. Different chemotherapy regimens affected the patient's disease progression. This study suggested that the anthracycline chemotherapy regimen was slightly better.
Risk factors of cerebral small vessel disease
Authors: Wang Zheng , Chen Qin , Chen Jiajie , Yang Ni , Zheng Kai 
Published: December 2021

Abstract

Background:
Cerebral small vessel disease (CSVD) is a common neurological disease under the effect of multiple factors. Although some literature analyzes and summarizes the risk factors of CSVD, the conclusions are controversial. To determine the risk factors of CSVD, we conducted this meta-analysis.

Methods:
Five authoritative databases of PubMed, Embase, Cochrane Library, CNKI, and Wan Fang were searched to find related studies published before November 30, 2020. The literature was screened according to the inclusion and exclusion criteria. We used RevMan 5.4 software to analyze the data after extraction.

Results:
A total of 29 studies involving 16,587 participants were included. The meta-analysis showed that hypertension (odds ratio [OR] 3.16, 95% confidence interval [CI] 2.22-4.49), diabetes (OR 2.15, 95% CI 1.59-2.90), hyperlipidemia (OR 1.64, 95% CI 1.11-2.40), smoking (OR 1.47, 95% CI 1.15-1.89) were significantly related to the risk of lacune, while drinking (OR 1.03, 95% CI 0.87-1.23) was not. And hypertension (OR 3.31, 95% CI 2.65-4.14), diabetes (OR 1.66, 95% CI 2.65-1.84), hyperlipidemia (OR 1.88, 95% CI 1.08-3.25), smoking (OR 1.48, 95% CI 1.07-2.04) were significantly related to the risk of white matter hyperintensity, while drinking (OR 1.41, 95% CI 0.97-2.05) was not.

Conclusions:
This study suggested that hypertension, diabetes, hyperlipidemia, and smoking are risk factors of CSVD, and we should take measures to control these risk factors for the purpose of preventing CSVD.
Gastric-type endocervical adenocarcinoma with mucoepithelial metaplasia combined with a serous borderline tumor
Authors: Yin Man , Yang Linqing , Wang Yunfei 
Published: December 2021

Abstract

Rationale:
Gastric-type endocervical adenocarcinoma (GAS) is a rare type of cervical adenocarcinoma that is a mucinous adenocarcinoma with a variety of gastral patterns. To date, there are no systematic clinical diagnosis and treatment guidelines.

Patient concerns:
In our case, a 49-year-old woman underwent pelvic magnetic resonance imaging (MRI) due to a pelvic mass, and cervical lesions were unexpectedly found. After receiving relevant surgical treatment, the pathological results showed the particularity of the tumor type—cervical gastric adenocarcinoma with a borderline serous tumor of both appendages and the right ovary.

Diagnoses:
Postoperative routine pathological examination showed mucoepithelial metaplasia accompanied by a borderline serous tumor.

Interventions:
After gynecological/urinary ultrasound, blood tests, MRI, cervical biopsy, and uterine curettage, “robot-assisted laparoscopic radical hysterectomy + bilateral salpingectomy-ovariectomy + pelvic lymph node dissection + pelvic adhesiolysis” were performed. After the surgery, the patient was treated with radiotherapy and concurrent chemotherapy.

Outcomes:
After the operation, radiotherapy, and chemotherapy, the patient had no tumor recurrence and is still in good condition.

Lessons:
The diagnosis of GAS is relatively difficult, its clinical manifestations lack specificity, and the pathogenesis has nothing to do with human papillomavirus infection. The patient was misdiagnosed with vaginitis at a local hospital. However, we found that MRI and pathological examination were helpful for the diagnosis of the disease. Although there are no relevant guidelines to explain the treatment principles of GAS, we believe that early surgery is conducive to the prognosis of the disease because GAS has a certain tolerance to radiotherapy and chemotherapy.
Quantitative assessment of macular function after surgery for optic disc pit maculopathy
Authors: Inami Wataru , Yoshikawa Yuji , Shibuya Masayuki , Kanno Junji , Kikuchi Shunsuke , Sakaki Yu , Katsumoto Takeshi , Shoji Takuhei , Makita Jun , Shinoda Kei 
Published: December 2021

Abstract

Rationale:
We describe a case of optic disc pit maculopathy (ODP-M) in which vitrectomy with juxtapapillary laser (JPL) treatment led to the reattachment of retinoschisis (RS) as well as serous retinal detachment (SRD).

Patient concerns:
An 80-year-old man complained of distorted vision and decreased visual acuity (VA) in his left eye for 12 months.

Diagnosis:
We conducted quantitative functional evaluation on the area of RS and SRD using the Humphrey visual field analyzer. Fundus examination and optical coherence tomography showed SRD and RS in connection with the optic disc. The best-corrected logarithm of the minimum angle of resolution (logMAR) VA was 0.7.

Interventions:
The patient underwent JPL treatment combined with pars plana vitrectomy. During surgery, posterior vitreous detachment and tamponade were created with sulfur hexafluoride.

Outcomes:
After surgery, SRD (and subsequently RS) gradually reduced and had completely disappeared at 31 months. VA gradually improved and was 0.0 (logMAR) at 28 months. The analysis of the mean macular thickness of the central 3-mm diameter showed that the macula thickness recovered to 300 μm at 17 months postoperatively. Retinal sensitivity began to improve at 24 months postoperatively and had increased at 48 months postoperatively.

Lessons:
In conclusion, vitrectomy with JPL treatment for ODP-M had a favorable anatomical outcome as well as a long-term functional outcome. These findings provide useful information for clinicians who are planning a therapeutic strategy, including the choice of surgical procedure for ODP-M.
Centralization of ulna with wrist fusion for failure of reconstructed distal radius by allograft bone or prosthesis
Authors: Li Zuchang , Yang Yong , Li Bin , Li Feng , Huang Xingjian 
Published: December 2021

Abstract

Rationale:
Centralization of the ulna is commonly used in the treatment of radius developmental deformity in children. The secondary distal radius deficiency in adults is different from the developmental deformity of the radius in children. There is no report on the ulna centralization with wrist fusion for the failure of the reconstructed distal radius by allograft bone or prosthesis for osteosarcoma in adults.

Patient concerns:
2 patients with a bone tumor on the distal radius underwent tumor resection and distal radius reconstruction by allograft bone or prosthesis and suffered distal radius collapsed fracture and radiocarpal joint dislocation accompanied with moderate pain, severe deformity, and poor grip and pinching power several months follow primary surgery.

Diagnoses:
X-ray images revealed collapsed fracture of distal radius and dislocation of the radiocarpal joint.

Interventions:
The 2 patients were operated on by the same technique under brachial plexus anesthesia. The allograft bone or prosthesis and the lunate were removed. The capitate was trimmed with a groove, and the cartilage surface with the subchondral bone of the distal ulna was resected to match the groove of the capitate. A straight plate with screws was used for internal fixation.

Outcomes:
Bone healing was achieved at 3 to 4 months after the surgery. After a minimum of 1-year follow-up, pain symptom was relieved, palmar flexion deformity was corrected, and grip and pinch strength were restored. The 2 patients were both satisfied with the improvement in appearance and function.

Lessons:
For adult patients who have failed resection and reconstruction of giant cell tumors, osteosarcoma, and other tumors of bone on the distal radius, ulna centralization is a simple and effective option.
Mortality predictors in ANCA-associated vasculitis
Authors: Dagostin Marilia A. , Nunes Sergio L.O. , Shinjo Samuel K. , Pereira Rosa M.R. 
Published: December 2021

Abstract
The mortality rate of patients with anti-neutrophil cytoplasm antibody -associated vasculitis (AAV) is higher than the general population. To date, no studies have evaluated the factors associated with unfavorable outcomes in Brazilian patients, who represent a miscegenated population. Our objective was to identify clinical and laboratory features associated with mortality in Brazilian patients with AAV.
One hundred twenty eight patients fulfilling the American College of Rheumatology and Chapel Hill Classification Criteria followed between 2000 and 2018 in our Rheumatology Outpatient Clinics were included. Data were obtained from an ongoing electronic database. Patients were divided into 2 groups (dead or alive in 2018), and disease activity (Birmingham vasculitis activity score [BVAS]), vasculitis-related damage (VDI), and laboratory parameters were compared at the most recent attendance and at the last attendance before death.
Of the 128 patients followed, 78.9% had granulomatosis with polyangiitis, 16.4% had eosinophilic granulomatosis with polyangiitis, and 4.6% had microscopic polyangiitis. In 2018, 78 patients were alive, 25 had died, and 25 had lost contact. The main cause of death was infection. According to the univariate analysis, the Birmingham vasculitis activity score, VDI, and glucocorticoid dose were higher in the group of patients who died. Laboratorial features related to mortality were creatinine, hemoglobin, erythrocyte sedimentation ratio, and C-reactive protein (CRP). Logistic regression analysis showed that high VDI, creatinine levels, and CRP levels were independent factors associated with mortality. Survival was significantly decreased in patients with renal impairment.
This is the first study to use this approach performed in a Brazilian population and it showed that damage index, renal impairment, and CRP levels were associated with mortality in a miscegenated population with AAV.