bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative efficacy and safety of topical hemostatic agents in primary total knee arthroplasty
Authors: Li Shaoshuo , Chen Baixing , Hua Zhen , Shao Yang , Yin Heng , Wang Jianwei 
Published: March 2021

Abstract

Background:
Topical hemostatic agents are commonly used for reducing perioperative blood loss and transfusion requirement in primary total knee arthroplasty (TKA), although the optimal option has yet to be defined. This study aimed to evaluate the efficacy and safety of topical hemostatic agents and rank the best intervention using the network meta-analysis (NMA) method.

Methods:
We searched Web of science, PubMed, and Cochrane Library database up to April 2020, for randomized controlled trials (RCTs) on topical hemostatic agents in primary TKA. The quality of included studies was assessed using the Cochrane “risk of bias” tool. Direct and indirect comparisons were performed for the result of network meta-analysis followed by consistency test.

Results:
Thirty seven RCTs with 3792 patients were included in this NMA and the pooled results indicated that tranexamic acid plus diluted epinephrine (TXA+DEP) displayed the highest efficacy in reducing total blood loss, hemoglobin drop and transfusion requirement. None of the included treatments was found to increase risk of thromboembolic events compared to placebo. According to the results of ranking probabilities, TXA+DEP had the highest possibility to be the best topical hemostatic agent with regard to the greatest comparative efficacy and a relatively high safety level.

Conclusion:
Current evidence supports that administration of TXA+DEP may be the optimal topical hemostatic agent to decrease blood loss and transfusion requirement in primary TKA. More direct studies that focused on the topical application of TXA+DEP versus other treatments are needed in the future.
Clinical therapy of platelet-rich plasma vs hyaluronic acid injections in patients with knee osteoarthritis
Authors: Gong Hao , Li Kaiming , Xie Rui , Du Guoqing , Li Linghui , Wang Shangquan , Yin Jing , Gu Jinyu , Wang Ping , Chen Ming , Hou Xiaozhou 
Published: March 2021

Abstract

Objective:
Knee osteoarthritis (KOA) is the most common degenerative disease of the joints caused by articular cartilage injury, degeneration of joint edges and hyperplasia of subchondral bone. The purpose of this study is to investigate the efficacy and safety of clinical therapy of platelet-rich plasma vs hyaluronic acid injections in patients with KOA.

Methods:
We systematically investigated Pubmed, Embase, and the Cochrane Library for all related articles published through May 2020. Any study was included that compared the effect of platelet-rich plasma (PRP) and hyaluronic acid (HA) in patients with KOA. The search terms included “platelet-rich plasma,” “PRP,” “hyaluronic acid,” “HA,” “knee,” “osteoarthritis,” “arthritis,” “KOA”. Review Manager 5.3 was used to analyze and calculate data regarding these outcome indicators.

Results:
In this study,

Conclusion:
In improving knee function and quality of life, PRP showed superiority over HA in long-term follow-up from well-designed double-blind trials, but a large number of high-quality multi-center studies are still needed to provide more sufficient evidence.
The efficacy and safety of traditional Chinese medicine's tonifying-kidney, strengthening-spleen, and invigorating-blood circulation (Bushen-Jianpi-Huoxue) principle for type 2 diabetes mellitus with osteoporosis
Authors: Zhao Yu , Qiu Jingjing , Chen Tongying , Wang Shihao , Liu Shuhua , Huang Hongxing , Wan Lei 
Published: March 2021

Abstract

Background:
Type 2 diabetes mellitus (T2D) and osteoporosis (OP) often coexist, and both are systemic metabolic diseases and seriously increase the risk of fragility fracture. However, there is no specific Western medicine for the treatment of T2D with OP (T2DOP). As reported in clinical and experimental studies, traditional Chinese medicine (TCM) based on principle of tonifying-kidney, strengthening-spleen, and invigorating blood circulation (Bushen-Jianpi-Huoxue) (BSJPHX) has significant efficacy against T2DOP. This protocol will be designed for a systematic review and meta-analysis to assess the efficacy and safety of TCM BSJPHX principle in the treatment of T2DOP.

Methods:
All relevant randomized controlled trials (RCTs) related to TCM therapies conducted in BSJPHX principle for T2DOP will be searched in the 8 electronic databases: PubMed, Cochrane Library, Wed of Science, EMBASE, Chinese National Knowledge Infrastructure Database (CNKI), Chinese Biomedical Literatures Database (CBM), Chinese Scientific Journal Database (VIP), Wanfang Database, from inception to October 2020. The main outcomes will contain: fasting blood glucose (FPG), 2 hours postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), serum calcium, bone mineral density (BMD), TCM syndrome integral, and the additional outcomes will consist of visual analog scale (VAS), and adverse events. Two reviewers will independently carry out literature search, data selection and synthesis, and literature quality assessment. In case of any dispute, it will be settled by group discussion. Assessment of risk of bias, reporting bias, and data synthesis would be performed with Review Manager software (Rev-Man 5.3).

Result:
This study will collate and summarize the various current evidences of TCM BSJPHX principle for T2DOP.

Conclusion:
This study will offer convincing evidence for judging the efficacy and safety of TCM BSJPHX principle for T2DOP.

PROSPERO registration number:
CRD42020218877.
Which of the acupuncture treatment regimen for lumbar disc herniation is more effective and safer
Authors: Zhong Xiaoying , Liu Jiaxin , Wang Yanping , Zhang Linzi , Zhang Honglai 
Published: March 2021

Abstract

Introduction:
Lumbar disc herniation (LDH) is the most common cause of low back pain and severely affects people's quality of life and ability to work. Although many clinical trials and medical reports conducted over the years have shown that acupuncture treatments are effective for LDH, the comparative effectiveness of these different acupuncture therapies is still unclear. This protocol of a network meta-analysis was designed to compare the effects and safety of acupuncture treatment regimens on LDH using both direct and indirect evidence.

Methods and analysis:
This protocol is reported according to the 2015 PRISMA-P and PRISMA guidelines for acupuncture. Eight databases and two platforms will be searched for articles published from their establishment to 1 December 2020 with medical subject heading terms and keywords. Three reviewers will verify the eligible randomized controlled trials independently. NoteExpress (3.2.0) software will be utilized to manage the literature. The overall quality of evidence will be evaluated by Confidence In Network Meta-Analysis (CINeMA). Additionally, we will conduct a meta-analysis of the effectiveness, recurrence rate, and symptom score of acupuncture in treating LDH using Review Manager (RevManV.5.4.1) and R4.0.2 software (The R Foundation for Statistical Computing).

Results:
The results of the study will be published in journals or relevant conferences.

Conclusion:
This proposed systematic review will evaluate the comparative efficacy and safety of various acupuncture methods and combination protocols for LDH.
The efficacy and safety of interscalene blockade versus local infiltration analgesia in primary total shoulder arthroplasty?
Authors: Wu Yanhui , Chen Yuan , Ji Cheng , Ye Wen 
Published: March 2021

Abstract

Background:
None of review has been conducted to compare the efficacy of interscalene blockade (ISB) with that of local infiltration analgesia (LIA) in patients undergoing total shoulder arthroplasty (TSA). We thus conduct a high-quality meta-analysis of randomized controlled trials (RCTs) to investigate which analgesic provides better pain relief.

Methods:
A comprehensive search of the published literature in PUBMED, Scopus, EMBASE, and Cochrane Library databases will be performed. Only RCTs evaluating LIA versus ISB in TSA are included in this study. The primary outcome was pain score. Secondary outcome measures included opioid consumption, postoperative adverse event, and length of stay. The Cochrane risk of bias tool is used to evaluate the risk of bias of included RCTs by 2 independent reviewers.

Results:
The results of this research will be delivered in a peer-reviewed journal.

Conclusions:
This study expects to provide credible and scientific evidence for the efficacy and safety of ISB and LIA for early postoperative pain control after TSA.

Systematic review registration number:
10.17605/OSF.IO/S3MBP.

Ethical approval:
Since this study is on the basis of published or registered RCTs, ethical approval and informed consent of patients are not required.
Lentinan combined with cisplatin for the treatment of non-small cell lung cancer
Authors: Zhao Chenchen , Yan Haifeng , Pang Wentai , Wu Tong , Kong Xianbin , Li Xiaojiang , Liu Honggen , Zhao Linlin , Liang Feng , Jia Yingjie 
Published: March 2021

Abstract

Background:
A growing number of studies suggest that lentinan combined with cisplatin thoracic injection for the treatment of lung cancer is an effective combination of traditional Chinese and Western medicine, which has a continuous and beneficial effect on eliminating clinical symptoms and improving cachexia in lung cancer patients. However, whether this treatment is effective and safe for lung cancer patients or not, evidence supporting the effectiveness and safety of this treatment is still incomplete. Besides, there is lack of systematic review to assess the detailed situation (including risk of bias and methodology) of current related clinical studies.

Objective:
This study aimed to evaluate the effectiveness and safety of lentinan combined with cisplatin thoracic injection in the treatment of lung cancer.

Methods:
The major databases (Embase, PubMed, the Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database [VIP] Database, Chinese Biomedical Literature Service System [SinoMed], and Wanfang Database) were searched from inception to March 1, 2020. Randomized controlled trials (RCTs) of lentinan combined with cisplatin chest injection on patients with non-small cell lung cancer (NSCLC) were identified. Two assessors reviewed each trial independently. The methodological quality of the eligible studies was evaluated according to the Cochrane Collaboration's tool for assessing risk of bias. Both the data extraction and the literature quality screening evaluation were conducted independently by 2 researchers.

Results:
Totally 17 clinical RCTs were included in this study, involving 1390 patients. Meta-analysis results showed that the clinical efficacy (risk ratio [RR] = 1.34, 95% confidence interval [CI] 1.21–1.48), effective subgroup analysis (RR = 1.51, 95% CI 1.3–1.77), and quality of life (RR = 1.48, 95% CI 1.27–1.72), the differences are statistically significant. In terms of adverse reactions, mainly related to gastrointestinal reactions and bone marrow suppression, the incidence and degree of adverse reactions of lentinan combined with cisplatin thoracic injection group were lower than those of cisplatin thoracic injection group alone.

Conclusions:
The current evidence prompted that Lentinan combined with cisplatin in thoracic injection might benefit patients with NSCLC on a certain extent; this systematic review revealed some definite conclusions about the application of Lentinan combined with cisplatin in thoracic injection for NSCLC. Due to the low methodological quality, high risk of bias, and inadequate reporting on clinical data, these results still require verification by a large number of well designed, heterogeneous RCT studies. More rigorous, multicenter, sufficient-sample, and double-blind RCTs are warranted.
The risk assessment model of fracture nonunion after intramedullary nailing for subtrochanteric femur fracture
Authors: Wang ZhengHao , Li KaiNan , Gu ZuChao , Fan HaiQuan , Li HaiBo 
Published: March 2021

Abstract
To investigate the influencing factors of fracture nonunion after intramedullary nailing for subtrochanteric fractures and to construct a risk assessment model.
Based on the multicenter retrospective analysis of 251 patients, all patients were divided into modeling group and verification group. In the modeling group, postoperative fracture nonunion rate, general data, fracture-related factors, surgical reduction-related factors, mechanical and biological factors were calculated, and the influencing factors of fracture nonunion were screened by univariate analysis. Logistic regression model was used for multifactor analysis to construct the risk assessment model. Based on the logistic regression model, the risk prediction model was constructed by drawing the Nomogram diagram. Through the verification group, the influencing factors were evaluated again, and the differentiation and calibration of the model were evaluated. The calibration degree was evaluated by Hosmer-Lemeshow test, goodness of fit test, and calibration curve. The discriminant degree was evaluated by the receiver operating characteristic curve.
Fracture nonunion occurred in 34 of 149 patients in the modeling group. Among the 14 potential influencing factors, univariate analysis and logistic regression analysis showed that postoperative hip varus, intramedullary nail fixation failure, and reduction of fracture with large incision were the risk factors of fracture nonunion. The medial cortex fracture was seen reduced on X-Ray was a protective factor for fracture nonunion, and a regression equation was established. Based on the logistic regression model, the Nomogram diagram is drawn. Twenty-four cases of fracture nonunion occurred in the verification group. The area under the receiver operating characteristic curve was area under curve =0.883 > 0.7, indicating that there was a moderate differentiation to evaluate the occurrence of fracture nonunion after operation. The goodness of fit test: the Hosmers-Lemeshow test (X
2 = 2.921, P = .712 > .05) showed that the model had a good calibration.
After intramedullary nailing of subtrochanteric fracture, hip varus, failure of intramedullary nail fixation and wide surgical dissection are the risk factors of fracture nonunion, and the postoperative reduction of medial cortex fracture is protective factor.
National key research and development projects: 2016YFC0105806
Preconception, Antepartum, and Peripartum Care for the Woman With a Spinal Cord Injury: A Review of the Literature
Authors: Wendel Michael P. , Whittington Julie R. , Pagan Megan E. , Whitcombe Dayna D. , Pates Jason A. , McCarthy Richard E. , Magann Everett F. 
Published: March 2021

Importance
Spinal cord injury (SCI) may result in temporary or permanent loss of sensory, motor, and autonomic function, presenting unique medical and psychosocial challenges in women during their childbearing years.

Objective
The aim of this study was to review the literature and describe the spectrum of pregnancy considerations, complications, and evidence-based obstetric practices in women with SCI.

Evidence Acquisition
A literature search was undertaken using the search engines of PubMed and Web of Science using the terms “spinal cord injury” or “spinal cord complications” and “pregnancy outcomes” or “pregnancy complications.” The search was limited to the English language, and there was no restriction on the years searched.

Results
The search identified 174 abstracts, 50 of which are the basis for this review. Pregnancy in women who have experienced an SCI requires a multidisciplinary approach. Common complications during pregnancy include recurrent urinary tract infection, upper respiratory tract infection, hypertension, venous thromboembolism, and autonomic dysreflexia (AD), which is a potentially life-threatening complication. Obstetricians should avoid potential triggers and be familiar with acute management of AD. Postpartum complications include difficulty initiating and maintaining breastfeeding and increased risk of postpartum depression and other mental health issues.

Conclusions and Relevance
Obstetricians caring for women with an SCI must be familiar with the unique challenges and complications that may occur during pregnancy and puerperium.

Relevance Statement
An evidence-based literature review of the care of pregnant women with spinal cord injury.

Target Audience
Obstetricians, Obstetric Anesthesiologists

Learning Objectives
After completing this activity, the learner should be better able to evaluate published literature regarding SCI in pregnant patients; explain the unique complications that can occur in these patients; identify potential risk factors and management strategies of AD; and devise treatment and recommendations for optimal patient outcomes.
Spinal Muscular Atrophy: Inheritance, Screening, and Counseling for the Obstetric Provider
Authors: Hopkins Maeve K. , Dugoff Lorraine , Kuller Jeffrey A. 
Published: March 2021

Importance
Spinal muscular atrophy (SMA) confers significant risk of neonatal and infant morbidity and mortality. Screening women during or before pregnancy for carrier status of SMA presents an opportunity to identify pregnancies at risk for this potentially devastating condition.

Objective
The objective of this review is to describe the different forms of SMA and their inheritance. In addition, this review guides obstetric providers in interpreting results of carrier screening.

Evidence Acquisition
A MEDLINE search of “prenatal genetic testing,” “spinal muscular atrophy,” and “inheritance of spinal muscular atrophy” in the review was performed.

Results
The evidence cited in this review includes 4 medical society committee opinions and 14 additional peer-reviewed journal articles that were original research or expert opinion summaries.

Conclusions and Relevance
Spinal muscular atrophy is a severe, heterogeneous neurodegenerative disorder. The American College of Obstetricians and Gynecologists recommends that obstetricians offer carrier screening for SMA to all pregnant women. Given the different types and inheritance of SMA, understanding of the disease and interpreting carrier screening results is of paramount importance to the prenatal care provider.

Target Audience
Obstetrician-gynecologist, family medicine, or other practitioner(s) providing prenatal care.

Learning Objectives
After participating in this activity, physicians should be better able to identify indications for carrier testing for SMA; compare types of SMA based on age of onset and phenotype; interpret results of SMA carrier screening; counsel patients regarding residual risk after negative SMA carrier screening; and refer patients with positive SMA carrier screening.
Maternal Plasma Genome-Wide Cell-Free DNA Can Detect Fetal Aneuploidy in Early and Recurrent Pregnancy Loss and Can Be Used to Direct Further Workup
Authors: Yaron Yuval , Pauta Montse , Badenas Celia , Soler Anna , Borobio Virginia , Illanes Carmen , Paz-y-Miño Fernanda , Martinez-Portilla Raigam , Borrell Antoni 
Published: March 2021

(Abstracted from Hum Reprod 2020;35(5):1222–1229)
Traditional diagnostic investigations of recurrent pregnancy loss (RPL) identify an etiology in fewer than half of cases. The single most common etiology is random chromosomal anomalies, and it has been established that 50% to 70% of early pregnancy losses (EPLs) are caused by numeric chromosomal anomalies.
Endometrial Cancer
Authors: Lu Karen H. , Broaddus Russell R. 
Published: March 2021

(Abstracted from N Engl J Med 2020;383:2053–2064)
Incidence rates and associated mortality of endometrial cancer continue to rise in the United States, including a sustained rise in cases among women younger than 50 years. This trend is partially driven by the rising rates of obesity, one of the most important risk factors for this disease.
Vaginal Estrogen Therapy Is Associated With Increased Lactobacillus in the Urine of Postmenopausal Women With Overactive Bladder Symptoms
Authors: Thomas-White Krystal , Taege Susanne , Limeira Roberto , Brincat Cynthia , Joyce Cara , Hilt Evann E. , Mac-Daniel Laura , Radek Katherine A. , Brubaker Linda , Mueller Elizabeth R. , Wolfe Alan J. 
Published: March 2021

(Abstracted from Am J Obstet Gynecol 2020;223:727.e1–727.e11)
Menopause is primarily the consequence of estrogen loss. It is associated with a wide variety of uncomfortable symptoms that affect the quality of life of postmenopausal women.
Associations Between Elevated Systolic Blood Pressure and Outcomes in Critically Ill Patients: A Retrospective Cohort Study and Propensity Analysis
Authors: Hu An-Min , Hai Chao , Wang Hai-Bo , Zhang Zhongheng , Sun Ling-Bin , Zhang Zhong-Jun , Li Hui-Ping 
Published: March 2021

ABSTRACT

Introduction:
Studies have shown nonlinear relationships between systolic blood pressure (SBP) and outcomes, with increased risk observed at both low and high blood pressure levels. However, the relationships between cumulative times at different SBP levels and outcomes in critically ill patients remain unclear. We hypothesized that an appropriate SBP level is associated with a decrease in adverse outcomes after intensive care unit (ICU) admission.

Methods:
This study was a retrospective analysis of data from the Medical Information Mart for Intensive Care (MIMIC) III database, which includes more than 1,000,000 SBP records from 12,820 patients. Associations of cumulative times at four SBP ranges (<100 mm Hg, 100–120 mm Hg, 120–140 mm Hg, and ≥140 mm Hg) with mortality (12-, 3-, 1-month mortality and in-hospital mortality) were evaluated. Restricted cubic splines and multivariable Cox regression models were employed to assess associations between mortality and cumulative times at SBP levels (4 levels: <2, 2–12, 12–36, and ≥36 h) over 72 h of ICU admission. Additionally, 120 mm Hg to 140 mm Hg was subdivided into <12 h (Group L) and ≥12 h (Group M) subsets and subjected to propensity-score matching and subgroup analyses.

Results:
At 120 mm Hg to 140 mm Hg, level-4 SBP was associated with lower adjusted risks of mortality at 12 months (OR, 0.71; CI, 0.61–0.81), 3 months (OR, 0.72; CI, 0.61–0.85), and 1 month (OR, 0.61; CI, 0.48–0.79) and in the hospital (OR, 0.71; CI, 0.58–0.88) than level-1 SBP. The cumulative times at the other 3 SBP ranges (<100 mm Hg, 100–120 mm Hg, and ≥140 mm Hg) were not independent risk predictors of prognosis. Furthermore, Group M had lower 12-month mortality than Group L, which remained in the propensity-score matched and subgroup analyses.

Conclusions:
SBP at 120 mm Hg to 140 mm Hg was associated with decreased adverse outcomes. Randomized trials are required to determine whether the outcomes in critically ill patients improve with early maintenance of a SBP level at 120 mm Hg to 140 mm Hg.