bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Etonogestrel implants on pelvic pain and menstrual flow in women suffering from adenomyosis or endometriosis
Authors: Niu Xiaocen , Luo Qun , Wang Chunfen , Zhu Lihua , Huang Lili 
Published: February 2021

Abstract
Adenomyosis and endometriosis are common causes of pelvic pain in women of reproductive age. Furthermore, adenomyosis is a major cause of menorrhagia. This study aimed to evaluate the effects of Etonogestrel implants on pelvic pain and menstrual flow in women requiring long-acting reversible contraception and suffering from adenomyosis or endometriosis.
One hundred women with adenomyosis or endometriosis and asking for contraception with Etonogestrel implants were enrolled in this study and were followed-up for 24 months. Patients were interviewed on pelvic pain by visual analog scale (VAS) pain score, menstrual flow by the number of sanitary napkins, menstrual bleeding pattern, weight gain, breast pain, and any other treatment side effects.
Seventy four patients who were treated with Etonogestrel implants completed the 24-month follow-up in which we found a significant decrease in pelvic pain VAS scores comparing baseline scores to 6, 12, and 24 months (baseline: 6.39 ± 2.35 to 24-month: 0.17 ± 0.69, P < 0.05). The menstrual volume decreased significantly compared with that at baseline ((40.69 ± 30.92) %, P < 0.05). However, vaginal bleeding, amenorrhea, weight gain, and acne occurred after treatment in some patients.
Etonogestrel implants were effective in reducing pelvic pain and menstrual flow of adenomyosis or endometriosis.
Preanesthetic nebulized ketamine vs preanesthetic oral ketamine for sedation and postoperative pain management in children for elective surgery
Authors: Chen Chun , Cheng Xiaolin , Lin Lei , Fu Fangfang 
Published: February 2021

Abstract
Preoperative anxiety is a major problem in children leading to a poor outcome. Preanesthetic oral ketamine is generally used in children but has less bioavailability due to the first-pass effect. Even ketamine has an unpleasant taste. Preanesthetic inhaled ketamine is also reported effective and safe in children. The objectives of the study were to compare the effectiveness and safety of preanesthetic nebulized ketamine against preanesthetic oral ketamine for sedation and postoperative pain management in children.
Children received 10 mg/kg oral ketamine (children received preanesthetic oral ketamine [OK cohort], n = 142), or nebulized with 3 mg/kg ketamine (children were preanesthetic nebulized with ketamine [NK cohort], n = 115), or received apple juice (children suspectable to preoperative ketamine and received apple juice only [OA cohort], n = 126) before anesthesia for elective surgery. Data regarding preoperative hemodynamic parameters, sedation score measurements, postoperative pain management, postoperative nausea and vomiting management, and postoperative complications were collected and analyzed.
Preoperative hemodynamic parameters for oral and nebulized ketamine administration were stable. Nebulized ketamine was provided higher sedation than apple juice (P = .002, q = 4.859) and oral ketamine (P = .002, q = 3.526). Children of NK cohort had required fewer fentanyl consumption until discharge than those of OA (55.45 ± 7.19 μG/ child vs 65.15 ± 15.24 μG/ child, P < .0001, q = 9.859) and OK (55.45 ± 7.19 μG/child vs 60.19 ± 8.12 μG/child, P < .0001, q = 4.953) cohorts. Children of the NK cohort had consumed higher ondansetron syrup than those of the OA cohort but fewer than those of the OK cohort until discharge. Gastrointestinal side effects were reported in the OK cohort, and nose irritation and drowsiness were reported in the NK cohort.
Like preanesthetic oral ketamine, preanesthetic inhaled ketamine also has safety for children. Preanesthetic inhaled ketamine can provide effective sedation in low doses during operation than preanesthetic oral ketamine.

Level of evidence: III.
Association of 3 single nucleotide polymorphisms of the eighth chromosome with remodeling of the myocardium and carotid arteries in the Kazakh population
Authors: Raushan Karabayeva , Benberin Valeriy , Vochshenkova Tamara , Babenko Dmitriy , Sibagatova Ainur 
Published: February 2021

Abstract
Cardiovascular diseases are one of the key health issues in Kazakhstan. According to the WHO, the prevalence of arterial hypertension (AH) was 28% in males and 25% in females in 2015, which puts up vastly to premature mortality from non-communicable diseases.
The search for genetic features of target organ lesions processes in AH is relevant. The goal of this study was to search for the genetic markers of myocardial remodeling (MR) and carotid artery remodeling (CAR).
A total of 866 hypertensive individuals were recruited in Nur-Sultan, Kazakhstan. Their blood was genotyped for 9 single nucleotide polymorphisms (SNPs) of the eighth chromosome to find an association with remodeling. The analysis was carried out in the group pairs (control and CAR, control and MR, and control and CAR and MR). The genotype–phenotype association was assessed using 5 different inheritance models: dominant, codominant, recessive, overdominant, and log-additive.
Statistically significant results were found for 3 SNPs (rs2407103, rs11775334, rs2071518) which minor alleles enlarged risks of MR and CAR in AH in the studied population. Three polymorphisms have previously been associated with АН and some other traits like pulse pressure and blood glucose in other ethnic populations: rs2407103 – in Afro-American population, rs11775334 – in the European population, rs2071518 is well studied in various ethnic populations (European, South Asian, Afro-American, Hispanic, East Asian).
Laparoscopic vs open complete mesocolic excision with central vascular ligation for right-sided colon cancer
Authors: Koc Mehmet Ali , Celik Suleyman Utku , Guner Volkan , Akyol Cihangir 
Published: February 2021

Abstract
Complete mesocolic excision (CME) is being performed more frequently and has recently become an established oncologic surgical method for right hemicolectomy. Despite its advantages, such as its association with early mobilization, a short hospital stay, early bowel movement, mild postoperative pain, and good cosmesis, CME is technically demanding and carries the risk of severe complications. This study aims to compare the clinical, pathological, and oncological results of open and laparoscopic right hemicolectomy with CME.
The data of 76 patients who underwent right hemicolectomy with CME and high vascular ligation were reviewed retrospectively. The patients were divided into 2 groups according to whether the open or laparoscopic technique was used.
Thirty-two patients underwent open right hemicolectomy, and 44 patients underwent laparoscopic right hemicolectomy. The 2 groups were similar in age, sex, American Society of Anesthesiologists class, abdominal surgical history, tumor localization, and operation time. No significant differences were found regarding the specimen length, tumor size, harvested lymph nodes, number of metastatic lymph nodes, or tumor grade. According to the Clavien–Dindo classification system, the laparoscopic group had significantly fewer complications than did the open group (11.4% vs 31.2%; P = .04). The open group had a longer postoperative hospital stay than did the laparoscopic hemicolectomy group (9.9 ± 4.7 vs 7.2 ± 3.1 days; P = .002). In addition, the groups were similar with respect to disease-free survival (P = .14) and overall survival (P = .06).The data in this study demonstrated that no differences exist between the open and laparoscopic techniques concerning pathological and oncological results. However, significantly fewer complications and a shorter length of hospital stay were observed in the laparoscopic group than in the open group. Laparoscopic right hemicolectomy with CME and central vascular ligation is a safe and feasible surgical procedure and should be considered the standard technique for right-sided colon cancer.
Prediction and identification of CD4+ T cell epitope for the protective antigens of Mycobacterium tuberculosis
Authors: Liu Jing , Chen Xuefeng , Wang Ju , Wu Fang , Zhang Jie , Dong Jiangtao , Zhang Hui , Liu Xiaoling , Hu Na , Wu Jiangdong , Zhang Le , Cheng Wei , Zhang Chunjun , Zhang Wan jiang 
Published: February 2021

Abstract
CD4+T cell epitopes plays a key role in anti-tuberculosis (TB) immunity, CD4+T cell epitopes suitable for the domestic population are lacking. Therefore, we predicted and identified novel CD4+T cell epitopes.
The bioinformatics software, namely, DNAStar (DNASTAR of the United States), SYFPEITHI (INTERFACTORS INSTITUT Für ZELL Biologie of Germany), RANKPEP, and NetMHC IIpan (National Cancer Institute, United States of America), were used to comprehensively predict the CD4+T cell immune epitope of Mycobacterium TB, and the predicted epitope polypeptide was synthesized by the standard Fmoc scheme. The proliferation of PBMC and CD4+T cells stimulated by peptides was preliminarily detected by the CCK8 method. Then, the candidate polypeptides screened out by the CCK8 method were verified again by the BrdU assay, and flow cytometry was performed to analyze further the extent of their stimulation on the proliferation of CD4+T cells. The changes in the secreted cytokines IFN-γ, TNF-α, IL-2, and IL-10 before and after the candidate polypeptide stimulation of CD4+T lymphocytes were detected by ELISA. The preliminary humoral immunity test was conducted by indirect ELISA to evaluate the serological diagnostic value of the CD4+T cell epitope polypeptide.
In this study, 5 novel candidate CD4+T cell epitope polypeptides with the amino acid sequences of LQGQWRGAAGTAAQA, PVTLAETGSTLLYPL, AAAWGGSGSEAYQGV, QFVYAGAMSGLLDPS, and KAALTRTASNMNAAA and others that have not been reported in the research were predicted. For convenience, the 5 candidates were successively named as P39, P50, P40, P185, and P62. P39, P62, and the mixed peptide P39+P62 could effectively induce the proliferation of CD4+T cells and increase the secretion of IFN-γ, TNF-α, and IL-2 from the CD4+T cells, while reducing the content of IL-10. The serological test showed that the sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of P39 were 75%, 67.71%, and 0.844, respectively. The sensitivity, specificity, and AUC of P62 were 91.66%, 46.87%, and 0.649, respectively. The sensitivity of the mixed peptide P39+P62 was 95.83%, the specificity was 97.91%, and the AUC was 0.793.
The P39 and P62 polypeptides were predicted and identified as potential CD4+T cell immune epitope polypeptides of M. TB. The polypeptide had better diagnosis effect, which provided potential candidate epitope polypeptides for the development of TB-specific diagnosis reagents and novel TB epitope vaccines.
Acute esophageal necrosis after kidney transplantation
Authors: Kim Na Young , Lee Yoo Jin , Cho Kwang Bum , Jin Kyubok , Lee Ju Yup 
Published: February 2021

Abstract

Rationale:
Acute esophageal necrosis (AEN) is a rare syndrome with characteristic endoscopic and pathologic findings. It usually results from a combination of tissue hypoperfusion, impaired local defense barriers, and massive reflux of gastric contents. We report a case of AEN after a kidney transplant.

Patient concerns:
A 53-year-old man with hypertension and end-stage renal disease presented with abdominal pain and a single episode of hematemesis 14 days after kidney transplantation.

Diagnosis:
Upper endoscopy revealed circumferential black coloration in the mid to lower esophageal mucosa. Esophageal biopsy showed ulcer, and immunostains were negative for viral etiology.

Interventions:
Conservative management was done with total parenteral nutrition and proton pump inhibitor.

Outcomes:
The patient experienced no further episodes of hematemesis or abdominal pain and follow-up endoscopy showed remarkable changes from the black mucosa to a red friable mucosa with whitish exudates.

Lessons:
In the case, AEN occurred in the setting of normal blood pressure after major surgery despite the absence of preceding factors such as hypotension and infections. The possibility of AEN should be considered in patients with solid organ transplantation who present with abdominal pain, dysphagia, and hematemesis.
Rectal ectopic pregnancy
Authors: Thang Nguyen Manh , Thi Huyen Anh Nguyen , Hai Thanh Pham 
Published: February 2021

Abstract

Rationale:
Abdominal ectopic pregnancy is a very rare form of ectopic pregnancy, yet is associated with higher morbidity due to atypical clinical presentation and misdiagnosis. In this report, we present a case of abdominal ectopic pregnancy with placenta invading to the rectal wall.

Patient concerns:
A 32-year-old woman was admitted to our hospital with an increasing serum ß-hCG level after diagnostic laparoscopy for ectopic pregnancy in the provincial hospital. During the laparoscopy, no gestational sac was found. She was discharged and scheduled for a follow-up visit to assess the level of ß-hCG. One week later, her serum ß-hCG level increased from 7000 IU/l to 12000 IU/l. Transvaginal Doppler ultrasound and abdominal computed tomography (CT) angiography demonstrated a right adnexal mass adherent to the rectal wall.

Diagnosis:
A rectal ectopic pregnancy is suspected.

Interventions:
Laparoscopic surgery was successfully performed in our hospital to remove the products of conception.

Outcomes:
Histologic examination confirmed the diagnosis of a rectal ectopic pregnancy. The patient had an uneventful recovery and was discharged the next few days.

Lessons:
This case report reveals that an abdominal pregnancy is remarkably difficult to diagnose and manage. The gynecologists need to be aware of the possibility of gestational sac between the uterus and the rectum. To make early diagnosis of abdominal pregnancy, they need to combine clinical findings, imaging techniques (ultrasound, CT, MRI) and serial human chorionic gonadotropin measurements. Laparoscopic management should be considered in early abdominal pregnancy. A multidisciplinary team of gynecologists and gastrointestinal surgeons is required to deal with rectal ectopic pregnancy.
Brain imaging findings in Parkinson disease with Pisa syndrome
Authors: Hung Cheng-Jui Jamie , Wang Su-Chen , Cheng Yuan-Yang , Chang Shin-Tsu 
Published: February 2021

Abstract

Rationale:
The Pisa syndrome (PS) is defined as a kind of reversible postural deformity which causes a lateral trunk flexion of 10 degrees or more. A prevalence of approximately 7.4% to 10.3% of patients with Parkinson disease (PD) also have PS. Though unbalanced function of the basal ganglia network and impaired visual-spatial functions including parietal cortices in PS is known, the pathophysiology of PS remains to be unclear.

Patient concerns:
A 67-year-old male patient with PD visited our Rehabilitation outpatient department because of his trunk which involuntarily deviated to the left side when he stood up.

Diagnoses:
Based on the history, physical examination, X-ray images, Tc-99m brain TRODAT-1 single-photon emission computed tomography (SPECT), and regional cerebral perfusion Tc-99m ethyl cysteinate dimer SPECT, the patient was diagnosed with PD with PS.

Interventions:
The patient refused our recommendation of admission for pharmaceutical treatment due to personal reasons and was only willing to accept physical training programs at our outpatient department.

Outcomes:
We arranged functional neuroimaging of the brain to survey possible neurologic deficits. The patient's images of ethyl cysteinate dimer SPECT and TRODAT SPECT showed abnormalities, including hypoperfusion and diminished dopamine transporter uptake, in the areas of the basal ganglia network and other brain regions.

Lessons:
Based on previous literature and the imaging of our patient, we hypothesize that PS results from unbalanced function of the basal ganglia network and impaired visual-spatial functions of bilateral parietal cortices.
Systemic immune-inflammation index predicts prognosis in patients with different EGFR-mutant lung adenocarcinoma
Authors: Ju Qing , Huang Tingping , Zhang Yong , Wu Lei , Geng Jing , Mu Xiaoyan , Yan Tao , Zhang Jian 
Published: February 2021

Abstract
Lung cancer is the most common type of cancer worldwide with a high mortality rate. The specific tyrosine kinase inhibitors of epidermal growth factor receptor (EGFR) have made enormous strides in non-small-cell lung cancer (NSCLC) treatment. The novel systemic immune-inflammation index (SII), a parameter that integrates lymphocytes, neutrophils, and platelets, has been found to play the vital role of a marker for predicting survival and recrudescence in various tumors.
We retrospectively examined 102 patients with different EGFR-mutant lung adenocarcinomas. Survival analysis was performed using the Kaplan-Meier method with the log-rank test. Cut-off points were identified using the receiver operating characteristic curves with the maximum log-rank values. The Cox proportional hazards regression, expressed as p value, hazards regression, and 95% confidence interval, was conducted to assess the prognostic values of variables in overall survival (OS)/ progression-free survival (PFS).
Lower SII was associated with prolonged survival in patients with different EGFR mutant lung adenocarcinomas in both variable and multivariable analyses.
SII before treatment was a powerful indicator for the PFS and OS of patients who received the first-generation EGFR-TKI.
Characteristics of injuries according to types of personal mobility devices in a multicenter emergency department from 2011 to 2017
Authors: Kim Joo Yeong , Lee Seung Chul , Lee Sanghun , Lee Choung Ah , Ahn Ki Ok , Park Ju Ok 
Published: February 2021

Abstract
Personal mobility devices (PMDs) have emerged as new factors in motor vehicle accidents, and related injuries are increasing. We aimed to describe the characteristics of PMD-related injuries presented to emergency departments (EDs) through a cross-sectional study for 7 years.
This study is a multicenter cross-sectional study using the Emergency Department-based Injury In-Depth Surveillance database in South Korea. We identified all PMD-related injuries from 2011 to 2017 based on text searching. We categorized them into 3 groups based on their distinguishable characteristics: electric standing scooter (E-scooter), electric self-balancing wheel (E-wheel), and electronic board (E-board).
A total of 448 PMD-related injuries were observed during the observation period. E-scooter-, E-wheel-, and E-board-related injuries occurred in 284, 138, and 26 cases, respectively. Most patients were between the ages of 19 and 59 years (69.2%), men (66.3%), and injured because of leisure activity (61.2%). The mechanism of injury was mostly traffic accidents (75.2%), but regarding injuries involving E-wheel and E-board, 25.4% and 30.8% of patients slipped from the device. The most commonly injured body part was the head, which accounted for 58.1% of E-scooter injuries, 38.4% of E-wheel injuries, and 53.9% of E-board injuries. Only 6 of all patients wore a helmet at the time of accident.
PMD users and PMD-sharing programs are increasing, and more accidents are expected in the future. As PMDs are convenient to move and more people are willing to use them, proper riding and safety rules based on the type of PMD are needed to reduce the risk of injury. The results of this study can be used as basic data for developing safety policies.
Comparison of the effects of shortening rest intervals on the quality of cardiopulmonary resuscitation, physiological parameters, and hemodynamic parameters in well-trained rescuers
Authors: Kim Dong Hun , Lee Sang-Min , Kim Gyun Moo , Lee Kyung Woo , Ko Seung Hyun , Oh Ye Jin , Seo Young Woo , Lee Suk Hee , Jang Tae Chang 
Published: February 2021

Abstract

Background:
Cardiopulmonary resuscitation (CPR) performance depends on individual ability and training. Well-trained or professional rescuers can maintain high-quality CPR for longer than laypeople. This study aimed to examine the effects of reducing resting intervals on CPR performance, physiological parameters, and hemodynamic parameters during prolonged CPR in well-trained providers.

Methods:
The study enrolled 90 volunteers from the paramedic students of our institution. They were randomly divided into 3 groups: 2 minutes, 1 minute 45 seconds, and 1 minute 30 seconds rest groups. Each participant performed 5 cycles of chest compression only CPR (2 min/cycle) with different resting intervals according to grouping. CPR quality, physiological variations, and hemodynamic variations were measured for each cycle and compared across the groups.

Results:
Of the 90 volunteers, 79 well-trained providers were finally included. The variation of the average chest compression depth across the 5 cycles showed significant differences between the 3 groups: from cycle 1 to 2: 1.2 (3.1) mm, –0.8 (2.0) mm, and –2.0 (3.0) mm in the 2 minutes, 1 minute 45 seconds, and 1 minute 30 seconds groups, respectively (P < .001); from cycle 1 to 3: 0.0 (3.0) mm, –0.7 (3.2) mm, and –2.6 (3.9) mm, respectively (P = .030). However, all 3 groups maintained the recommended rate and chest compression depth for all 5 cycles. Physiological and hemodynamic parameters showed no significant differences between the groups.

Conclusions:
Well-trained providers were able to maintain high-quality CPR despite reducing rest intervals. Adjusting the rest interval may help maintain overall CPR quality in special situations or where layperson rescuers are involved.
PRRX1 promotes lymph node metastasis of gastric cancer by regulating epithelial-mesenchymal transition
Authors: Yao Jibin , Zhang Yongbin , Xia Yu , Zhu Chenglou , Wen Xiaoxiong , Liu Tianxiang , Da Mingxu 
Published: February 2021

Abstract

Background:
Gastric cancer has multiple metastasis pathways, of which lymph node metastasis plays a dominant role. However, the specific mechanism of lymph node metastasis is still not unclear.

Methods:
The bioinformatics technology was utilized to mine gene chip data related to gastric cancer and Epithelial-Mesenchymal Transition (EMT) in a high-throughput gene expression database (Gene Expression Omnibus, GEO), we screened out all genes that have differential expression levels in gastric cancer tissues and in adjacent normal gastric mucosa tissues. The corresponding function package of R language software were performed for gene annotation and cluster analysis, then enrichment analysis of genes with differential expression and protein interaction network diagram for correlation analysis were performed, we finally screened out the paired related homeobox 1 gene (PRRX1) related to EMT. Next, we collected 65 metastatic lymph node samples and 93 gastric cancer tissue samples. The expression levels of PRRX1 and EMT-related protein E-cadherin (E-ca) and vimentin (Vim) in gastric cancer tissues and metastatic lymph node tissues were determined by immunohistochemistry (IHC) staining of streptavidin-peroxidase (SP). The expression differences of PRRX1, E-ca and Vim in gastric cancer tissues and metastatic lymph node tissues as well as the correlation were analyzed by the experimental data, and the clinical significance was analyzed in combination with the clinicopathological data.

Results:
The PRRX1 expression levels in gastric cancer tissues are significantly higher than that in adjacent normal gastric mucosa tissues. The positive expression rates of PRRX1, Vim and E-ca in gastric cancer and in metastatic lymph node tissues were significantly different. Comparing with that in gastric cancer, expression of PRRX1 and Vim was significantly down-regulated, and E-ca expression was significantly up-regulated in metastatic lymph nodes.

Conclusion:
PRRX1 may promote lymph node metastasis of gastric cancer by regulating EMT, and then affect the prognosis of patients. PRRX1 may be used as a new biological indicator to predict or prevent lymph node metastasis in gastric cancer.