bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical therapeutic effects of pulsed-radiofrequency combined with blockade in the treatment of patients with chronic migraine
Authors: Zhang Guang-Zhi , Chen Yao 
Published: November 2021

Abstract

Background:
Recently, researchers have emphasised on the clinical therapeutic effects of pulsed-radiofrequency combined with blockade to treat chronic migraine (CM) patients. However, there are controversial results. Therefore, the authors conduct the proposed research to assess the efficacy of pulsed-radiofrequency combined with blockade to teat CM patients.

Methods:
The authors will perform a comprehensive literature search on the following online-based databases from establishment till October 2021: Web of Science, EMBASE, PubMed, China National Knowledge Infrastructure, the Cochrane library, and WanFang database. We will consider all randomized controlled trials of pulsed-radiofrequency combined with blockade for CM for inclusion. There won’t be any language constraints. Following the search, a pair of reviewers will independently screen and choose related articles to include in the meta-analysis. The Cochrane risk of bias tool will be used to assess the systematic value of all included randomized controlled trials. The study will utilize the risk ratio, mean differences, or standardized mean differences and their 95% confidence intervals to perform an estimation of the pooled mean effect size. Lastly, the authors will employ funnel plot, Egger test, and sensitivity analysis to determine and describe possible heterogeneity.

Results:
The authors will publish the results in a peer-reviewed journal.

Conclusion:
The proposed study will be the first to evaluate the effectiveness of pulsed-radiofrequency combined with blockade in the treatment of patients with CM.

Ethics and dissemination:
Since the proposed study is a systematic review of published studies, an ethics approval is not needed.

Registration number:
Oct 12, 2021.osf.io/d2wx3. (https://osf.io/d2wx3/).
East Asian herbal medicine for cancer pain
Authors: Jo Hee-Geun , Lee Donghun 
Published: November 2021

Abstract

Background:
Cancer pain is an important factor in cancer management that affects a patient's quality of life and survival-related outcomes. The aim of this review is to systematically evaluate the efficacy and safety of oral administration East Asian herbal medicine (EAHM) for primary cancer pain, and to explore core herb patterns based on collected data.

Methods:
A comprehensive literature search will be conducted in 10 electronic databases including PubMed, Cochrane Library, Cumulative Index to Nursing & Allied Health Literature, EMBASE, Korean Studies Information Service System, Research Information Service System Oriental Medicine Advanced Searching Integrated System, Korea Citation Index, Chinese National Knowledge Infrastructure Database (CNKI), CiNii for randomized controlled trials from their inception until August 19, 2021. Statistical analysis will be performed in the software R version 4.1.1. and R studio program using the default settings of the ‘meta’ package. When heterogeneity in studies is detected, the cause will be identified through meta regression and subgroup analysis. Methodological quality will be assessed independently using the revised tool for risk of bias in randomized trials (Rob 2.0).

Results:
This study will provide more comprehensive and specific evidence of EAHM for cancer pain management.

Conclusions:
Based on the results of this review, it is expected that the efficacy and safety of East Asian herbal medicine for cancer pain may be confirmed. In addition, it will be possible to derivation of a core herb pattern related to this research topic through additional association rule mining analysis.
Posterior instrumented fusion on lumbar stenosis syndrome can bring benefit to proximal degenerative kyphosis
Authors: Xu Shuai , Guo Chen , Liang Yan , Zhu Zhenqi , Zhang Hongguang , Liu Haiying 
Published: November 2021

Abstract
The effect on degenerative thoracolumbar kyphosis (DTLK) after short-segment instrument for lumbar spinal stenosis syndrome (LSS) remains controversial. Based on the biomechanics and compensatory of the global spino-pelvic alignment, it was assumed that the interference on the lumbar spine, instead of the thoracolumbar segment, could still make a difference on the proximal spine.
To explore whether DTLK could improve with only surgery for LSS and identify influencing factors on postoperative TLK.
The study was performed from January 2016 to December 2018. Sixty-nine participants (25 male) diagnosed LSS with DTLK were enrolled and surgery was only for LSS. Radiological parameters included TLK, lumbar lordosis, pelvic incidence, pelvic tilt, sacral slope, and osteoporosis. Clinical outcomes were visual analogue scale and Oswestry disability index. According to lower instrumented vertebrae (LIV) on L5 or S1, inter-group comparisons were performed between LIV on L5 (L5 group) and S1 (S1 group).
Demographics were well-matched between L5 and S1 group with a mean follow-up of 24.3 ± 12.1 (m). TLK improved with a mean of 16.2 ± 7.6 (°) (P < .001). There was no significance on radiological and clinical parameters between L5 and S1 groups except for a larger pelvic tilt in S1 group (P = .046). Visual analogue scale (P = .787) and Oswestry disability index (P = .530) were both indifferent between normal TLK and DTLK at last (P > .05). Postoperative TLK was affected by osteoporosis and sacral slope, the latter was dominated by pelvic incidence and pelvic rotation. Osteoporosis was the risk factor for TLK correction (P = .001, odd risk = 9.58).
DTLK decreased if instrument only performed for LSS, where TLK and clinical outcomes are comparably affected whether L5 or S1 is selected as LIV. This study supplements the compensatory mechanism of spino-pelvic alignment, especially for cases with severe osteoporosis.
Molecular characterization of hemoglobinopathies and thalassemias in Northern Guangdong Province, China
Authors: Ma Zhanzhong , Fan Shushu , Liu Jun , Liu Yulan , Guo Yanle , Huang Wenbo 
Published: November 2021

Abstract
To detect the molecular characterization of hemoglobinopathies and thalassemias in Northern Guangdong Province of China.
We recruited 10,285 subjects who were screened for hemoglobin (Hb) variants and thalassaemia genotypes in the outpatient department of Yuebei People's Hospital from January 2018 to December 2020. The subjects collected venous blood samples for blood cell parameter analysis and Hb electrophoresis analysis. When the average red blood cell volume is <82 fL, or the average red blood cell Hb is <27 pg, or HbA2 > 3.5%, or HbA2 < 2.5%, or HbF > 2.0%, the screening is positive if one of them is satisfied. All subjects who were screened positive were tested for the thalassaemia gene by gap-polymerase chain reaction, PCR-based reverse dot blot, and DNA sequencing.
Among all subjects screened, the overall prevalence of hemoglobinopathies and thalassemias were 0.46% (47/10,285) and 21.02% (2162/10,285) in Northern Guangdong Province. We found that Hb Q-Thailand is the most common, and other types of hemoglobinopathies are followed by Hb E, Hb New York, Hb G-Chinese, Hb G-Coushatta, Hb J-Bangkok, Hb J-Broussais, Hb Ottawa, and Hb G-Taipei. We identified 1340 cases (13.03%) of α-thalassemia, mainly includes --SEA deletion (71.64%), –α3.7 deletion (12.01%), –α4.2 deletion (4.78%). And identified 652 cases (6.34%) of β-thalassemia, the most prevalent being CD 41/42(-TTCT) (35.89%), IVS-II-654 (C > T) (33.44%), CD 17 (A > T) (10.28%) and –28(A > G) (9.66%). Furthermore, there are 170 cases (1.65%) of α combined β thalassaemia. In addition, we found a rare case with –80 (T > A) of β-thalassemia. The results of this study found a high prevalence of hemoglobinopathies and thalassemias in Northern Guangdong Province, China. There were some differences molecular characterizations of thalassemia in different areas of China.
Our results enriched the related information of hemoglobinopathies and thalassemias in the region, which provided valuable references for the prevention and control of thalassemia.
Insufficient vaccination and inadequate immunization rates among Korean patients with inflammatory bowel diseases
Authors: Ryu Han Hee , Chang Kiju , Kim Nayoung , Lee Ho-Su , Hwang Sung Wook , Park Sang Hyoung , Yang Dong-Hoon , Byeon Jeong-Sik , Myung Seung-Jae , Yang Suk-Kyun , Ye Byong Duk 
Published: November 2021

Abstract
This study aimed to evaluate self-reported vaccination rates, immunity, knowledge of and attitudes toward vaccination among Korean patients with inflammatory bowel disease (IBD) as well as to identify factors associated with proper vaccination.
Between November 2013 and February 2015, consecutive patients with IBD were invited to complete a standardized questionnaire on vaccination. Moreover, immune status for common vaccine-preventable diseases was evaluated via serologic tests.
A total of 310 patients with IBD were invited to the questionnaire survey and 287 patients (92.6%) who completed the questionnaires were finally enrolled (men, 188 [65.5%], median age at survey, 29.9 years [interquartile range, 22.3–39.2], ulcerative colitis: Crohn disease = 165:122]. Self-reported vaccine uptake rates were as follows: hepatitis A virus (HAV; 13.2%), hepatitis B virus (HBV; 35.2%), seasonal influenza (43.2%), pneumococcus (4.9%). Most of the patients (87.1%) did not know that proper vaccination has been recommended for patients with IBD. Up to 64.8% and 32.8% of patients were negative for IgG anti-HAV antibody and IgG HBV surface antibody, respectively. In a multivariable analysis, newspaper subscription (aOR [adjusted odds ratio] 2.185, 95% confidence interval [CI] 1.136–4.203, P = .019), ever recommendation of vaccination by a physician (aOR 2.456, 95% CI 1.240–4.862, P = .010), and use of anti-tumor necrosis factor agents (aOR 4.966, 95% CI 1.098–22.464, P = .037) showed a significant association with uptake of adult vaccines recommended for patients with IBD.
Vaccine uptake rates, positivity of antibody to HAV and HBV, and knowledge of patients with IBD regarding vaccination were not sufficient. Proper educational information and recommendation from physicians could enhance awareness among patients with IBD about the need for vaccination and thereby improve vaccination rates.
Trial registration number: NCT01984879.
An HIV elite controller patient carrying the homozygous H63D variant in the homeostatic iron regulator gene
Authors: Zanella Isabella , Focà Emanuele , Degli-Antoni Melania , Castelli Francesco , Quiros-Roldan Eugenia 
Published: November 2021

Abstract

Rationale:
HIV elite controllers represent a rare subset of persons living with HIV, able to spontaneously control viral replication without antiviral therapy. HLA-B∗57 and HLA-B∗27 alleles are associated to efficient polyfunctional CD8+ T-cell response and are overrepresented in elite controllers but these alleles alone incompletely explain spontaneous HIV replication control in these subjects. Further mechanisms involved in innate and adaptive immune response and host genetics may contribute to this control. In this context, the homeostatic iron regulator (HFE) gene encodes a major histocompatibility complex-class-I-like molecule involved in both innate immunity, acting also through autophagy regulation, and iron homeostasis, strictly related to immune functions and susceptibility to infections.

Patient concerns:
Homozygousity for the p.His63Asp (H63D) variant in the HFE gene was identified in an 80-year-old HIV-infected woman with spontaneous control of viral replication.

Diagnosis:
HIV-1 RNA was undetectable in patient's serum with a routine assay and an ultra-sensitive assay (<1 copy/mL) during the 30 years follow-up. CD4+ and CD8+ T cell counts were stable and normal during all this period.

Interventions:
The patient had a history of absence of any physical ailment and no antiviral therapy has been prescribed during the 30 years of follow-up. The subject did not harbor HLA-B∗57 and HLA-B∗27 alleles. HFE gene was sequenced by Sanger, as part of a larger study on a cohort of HIV infected patients, aged >65 years and screened for polymorphisms in genes belonging to several pathways involved in neuroinflammation.

Outcomes:
The woman had CD4+ and CD8+ T cell normal values and spontaneously controlled serum HIV-1 RNA levels for 30 years.

Lessons:
We assume that the interplay between the HFE H63D variant in homozygosity and innate immunity, perhaps through autophagy regulation, could play a role in HIV-1 replication control in our patient. This hypothesis needs to be explored in in vitro and in vivo studies. Understanding mechanisms involved in spontaneous control of HIV-1 replication remains indeed a challenge due to its possible implications for HIV cure research.
Awake nasotracheal intubation under bronchoscopic guidance and anesthetic management in a patient undergoing excision of an endotracheal mass
Authors: Kim Jonghae , Park Bum Young , Lim Jung A. 
Published: November 2021

Abstract

Rationale:
The main challenge facing anesthesiologists during endotracheal mass resection is securing effective airway management during surgery. It is important to select an airway intubation and airway maintenance method according to the patient's condition and the characteristics of the mass.

Patient concerns:
A 74-year-old woman with aggravated dyspnea for 1 year was scheduled to undergo endotracheal mass excision under general anesthesia.

Diagnosis:
The mass was 4 × 3 × 3 cm ovoid-shaped, and located 4 cm above the carina, occupying 41% of the tracheal lumen in a preoperative chest computed tomography and bronchoscopy.

Interventions:
After preparing extracorporeal membrane oxygenation in case of the inability to ventilate and intubate, we attempted awake bronchoscopy-guided nasotracheal intubation using a reinforced endotracheal tube with an inner diameter of 5.5 mm and outer diameter of 7.8 mm after a translaryngeal block. The tube was passed around the mass without resistance and placed right above the carina. With the tube pulled back above the mass, another tube was introduced from the opened trachea below the mass to the right main bronchus. Following the resection of the tracheal portion containing the mass, the posterior wall of the remaining trachea was reconstructed. The tube placed in the right main bronchus was removed and the tube in the upper trachea was introduced right above the carina. The patient's head was kept flexed once the anastomosis of the trachea was completed, and the surgery ended uneventfully.

Outcomes:
The mass was confirmed as schwannoma by histopathological finding. The patient was discharged from the hospital on the 6th postoperative day without complication.

Lessons:
Awake bronchoscopy-guided intubation is a safe airway management method in patients with an endotracheal mass. Close cooperation between anesthesiologist and surgeon, and preparation for airway management before surgery is essential. It is necessary to establish alternative plans that can be implemented in the case that intubation and ventilation are not possible.
Peripheral neuropathy after extra-corporeal membrane oxygenation therapy in children
Authors: Ko Jun Young , Lee Mi rim , Ha Eun-Hye , Kim Aram 
Published: November 2021

Abstract

Rationale:
In recent years, the use of extracorporeal membrane oxygenation (ECMO) treatment for pediatric patients with cardiorespiratory failure has increased, with emphasis being given to the prevention of complications in ECMO-treated patients. Several studies have reported ECMO-related central nervous system complications, such as intracranial hemorrhage, cerebral infarction, and seizure. However, few cases of peripheral nerve injury have been reported in ECMO-treated adults; there have also been no reported cases of peripheral nerve injury in the pediatric population.

Patient Concerns:
Two pediatric patients aged 16 and 6 experienced motor weakness in the extremities after the insertion of ECMO equipment.

Diagnoses:
They were diagnosed with peripheral nerve injuries through an electrodiagnostic study that showed femoral/sciatic neuropathies and brachial plexopathy. Arteriography and doppler sonography was performed to find the cause of peripheral nerve injury, and this may be the results of vascular compromise and compressive injuries, respectively.

Interventions:
Surgical embolectomy was performed to remove thrombus in one patient. Two patients received orthosis, and physical therapy and occupational therapy were performed to prevent contracture and improve strength and functional use.

Outcomes:
Two pediatric patients showed a gradual improvement in motor power and function.

Lessons:
Through this case report, we present rare ECMO-related complications and emphasize the importance of early diagnosis and monitoring of peripheral nerve injury in ECMO-treated children.
The role of rehabilitation and vitamin D supplementation on motor and psychological outcomes in poststroke patients
Authors: Torrisi Michele , Bonanno Lilla , Formica Caterina , Arcadi Francesca Antonia , Cardile Davide , Cimino Vincenzo , Bramanti Placido , Morini Elisabetta 
Published: November 2021

Abstract
Post-Stroke depression affects between 12% and 72% of patients who have suffered a stroke. The association between low serum levels of 25-hydroxyvitamin D (25(OH) D) and increased risk of depression is reported in both stroke and non-stroke patients. Similarly, high 25(OH) D levels might be associated with greater functional improvement during rehabilitation program.
We wanted to investigate the effects of an intensive rehabilitation on poststroke outcomes. We wondered if the daily rehabilitation of motor and cognitive functions could also have an effect on mood and functional abilities in addition to or as an alternative to vitamin D supplementation.
We conducted a 12-week, randomized trial, double blind, parallel, monocentric clinical trial of 40 patients undergoing intensive neuro-rehabilitation treatment at a specialized care facility for ischemic or hemorrhagic brain stroke. Participants were randomly assigned, in a 1:1 ratio, to 1 of 2 parallel groups: in the experimental group, 2000 IU/day of oral cholecalciferol was administered; in the control group patients were not taking vitamin D supplementation. Patients underwent a text evaluation to investigate psychological and motor outcomes.
Significant intra-group difference in outcomes measures was found but not between control group and experimental group. In the vitamin D group, we highlighted significant differences between T0 and T1 in calcium (P < .001), vitamin D (P < .001), in Montgomery Aasberg Depression Rating Scale (P = .001), and in Functional Independent Measures (P < .001). In the health control group, we found a significant difference in calcium (P = .003), vitamin D (P < .001), Montgomery Aasberg Depression Rating Scale (P = 0.006), in general self-efficacy (P = .009), and in Functional Independent Measures (P < .001).
Our results show that the beneficial effect on mood and functional recovery is mainly due to neurorehabilitation rather than vitamin D supplementation.
Cardiogenic shock caused by Takotsubo syndrome complicated with severe anxiety
Authors: Fang Shu , Wang Yu , He Peng-Kang , Han Xiao-Ning , Yang Ying , Hong Tao , Gong Yan-Jun 
Published: November 2021

Abstract

Rationale:
Takotsubo syndrome (TTS) is characterized by transient and reversible left ventricular systolic dysfunction, which are often associated with acute physical or emotional stressors. Cancer is one of the comorbidities in TTS, and TTS is even considered as a paraneoplastic syndrome, but its mechanism remains unclear. We report a patient in whom cancer and untreated mental disorders triggered TTS.

Patient concerns:
A 59-year-old man was transferred to the Department of Cardiology because of acute onset of severe chest pain and dyspnea before cystoscopy. He presented with hematuria, had been diagnosed with a high-grade urothelial bladder cancer, and underwent transurethral resection of bladder tumors 4 months previously. He had severe anxiety regarding recurrence and death from cancer, especially after the hematuria recurred.

Diagnosis:
TTS and severe anxiety.

Interventions:
The results of coronary angiography, a left ventriculogram, echocardiography, and the clinical outcome led to the diagnosis of TTS. The patient was treated with extracorporeal membrane oxygenation support, mechanical ventilation, and drugs for heart failure and anxiety.

Outcomes:
Echocardiography showed normal wall motion on day 6 of symptom onset. Six months after symptom onset, the anxiety score was reduced from 12 to 11, and the patient had no episodes of any discomfort, and no evidence of cancer recurrence was observed.

Lessons:
Patients with cancer and TTS have a higher level of stress, and physicians need to pay more attention to early screening and early treatment of mental disorders in these patients. Prompt and effective multidisciplinary treatment, including psychological counseling and antianxiety drugs, can improve the prognosis in such cases.
Pulmonary sarcomatoid carcinoma mimicking pleural mesothelioma
Authors: Wang Le , Zhang Jing , Chen Xing , Liang Maoli , Li Shuo , Zhou Wei , Cao Jie 
Published: November 2021

Abstract

Introduction:
Pulmonary sarcomatoid carcinoma (PSC) is an extremely rare biphasic tumor characterized by a mixture of malignant epithelial and mesenchymal cells. Owing to the rarity, as well as the lack of typical manifestations and imaging signs, the rate of misdiagnosis is high. Herein, we present a case of PSC misdiagnosed as pleural mesothelioma in a 59-year-old man.

Patient concerns:
A 59-year-old man presented with recurrent coughing, fever, and chest pain.

Diagnosis:
Chest computed tomography showed 2 large and dense masses involving the inferior lobes of right lung, along with slight irregular pleural thickening and a small amount of effusion.

Interventions:
Chest computed tomography-guided tumor biopsy was performed. PSC was confirmed based on histopathology and immunohistochemistry. The patient refused treatment due to economic reasons.

Outcomes:
The patient developed adrenal, multiple lung and brain metastasis. The overall survival time was 11 months.

Conclusions:
PSC, despite its rarity, should be considered in the differential diagnosis of lung cancer. Besides, biopsy, histopathology, and specific immunohistochemical staining of larger tissue specimens can be contributing to the accurate diagnosis of PSC.
Totally thoracoscopic surgery for treating left atrial myxoma
Authors: Zhao Feng , Chen Tongyun , Tang Yipeng , Chen Qingliang , Jiang Nan , Guo Zhigang 
Published: November 2021

Abstract
We aimed to summarize the experience of totally thoracoscopic surgery for left atrial myxoma, together with analyzing the safety and feasibility. We retrospectively analyzed the clinical data of 15 patients with left atrial myxoma admitted to our hospital from October 2016 to October 2018. The auxiliary hole was located at the midline of the 5th intercostal space of the right chest. The endoscope hole was located at the front position of the fourth intercostal space. Specimens were sent to the pathology department for pathological examination. All the procedures were completed successfully. Extracorporeal circulation time was 46.5 ± 18.6 minute, cross-clamping time was 20.6 ± 6.7 minute, thoracic drainage fluid was 89+60.2 ml, ventilator assist time was 4.3 ± 2.6 hour, intensive care unit stay time was 14.5 ± 4.2 hour, the average postoperative hospital stay was 5.2 ± 1.2 day. There was no death, or red blood cell transfusion during and after surgery. No postoperative complications were reported by the patients. No recurrence of myxoma, residual shunt in the atrial septum and valvular lesions were found after 3months of postoperative cardiac ultrasound examination. Total thoracoscopic surgery for left atrial myxoma was less invasive with satisfactory cosmetic appearance with feasibility and safety. Besides, it caused no serious complications.