bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of dexmedetomidine on perioperative hemodynamics and organ protection in children with congenital heart disease
Authors: Ming Shaopeng , Xie Yongguo , Du Xueke , Huang Haiqing , Fan Yue , Liang Qingxuan , Xie Yubo 
Published: January 2021

Abstract

Background:
This study aimed to investigate the effects of dexmedetomidine (Dex) on hemodynamics and organ protection in congenital heart disease (CHD) children who underwent open-heart surgery under cryogenic cardiopulmonary bypass.

Methods:
Ninety children were randomly allocated to group C (0.9% saline 0.2 μg/kg/hour), group D1 (Dex 0.2 μg/kg/hour), and group D2 (Dex 0.4 μg/kg/hour) (n = 30 per group). All participants received fentanyl, propofol and 1% sevoflurane for anesthesia induction. Hemodynamic data were measured from T0 (before the induction) to T7 (30 minutes after extubation). The difference of arterial internal jugular vein bulbar oxygen difference and cerebral oxygen extraction ratio were calculated according to Fick formula. Enzyme-linked immunosorbent assay was performed to detect the serum myocardial, brain and kidney injury markers. The incidence of acute kidney injury (AKI) was calculated by serum creatinine level. Tracheal extubation time, postoperative pain score and emergence agitation score were also recorded.

Results:
Compared with group C, group D1, and D2 exhibited reduction in hemodynamic parameters, myocardial and brain injury indicators, and tracheal extubation time. There were no significant differences in blood urea nitrogen and neutrophil gelatinase-associated lipocalin or incidence of AKI among the 3 groups. Besides, the incidence of tachycardia, nausea, vomiting and moderate agitation, and the FLACC scale in group D1 and D2 were lower than those in group C. Moreover, Dex 0.4 g/kg/hour could further reduce the dosage of fentanyl and dopamine compared with Dex 0.2 g/kg/hour.

Conclusions:
Dex anesthesia can effectively maintain hemodynamic stability and diminish organ injuries in CHD children.
Pulmonary thromboembolism in coronavirus disease 2019 patients undergoing thromboprophylaxis
Authors: Schiaffino Simone , Giacomazzi Francesca , Esseridou Anastassia , Cozzi Andrea , Carriero Serena , Mazzaccaro Daniela P. , Nano Giovanni , Di Leo Giovanni , Spagnolo Pietro , Sardanelli Francesco 
Published: January 2021

Abstract
We aimed to investigate the prevalence of pulmonary thromboembolism (PTE) and its association with clinical variables in a cohort of hospitalized coronavirus disease 2019 (COVID-19) patients receiving low-molecular-weight heparin (LMWH) at prophylactic dosage.
In this retrospective observational study we included COVID-19 patients receiving prophylactic LMWH from admission but still referred for lower-limbs venous Doppler ultrasound (LL-US) and computed tomography pulmonary angiography (CTPA) for clinical PTE suspicion. A dedicated radiologist reviewed CTPA images to assess PTE presence/extension.
From March 1 to April 30, 2020, 45 patients were included (34 men, median age 67 years, interquartile range [IQR] 60–76). Twenty-seven (60%) had PTE signs at CTPA, 17/27 (63%) with bilateral involvement, none with main branch PTE. In 33/45 patients (73%) patients LL-US was performed before CTPA, with 3 patients having superficial vein thrombosis (9%, none with CTPA-confirmed PTE) and 1 patient having deep vein thrombosis (3%, with CTPA-confirmed PTE). Thirty-three patients (73%) had at least one comorbidity, mainly hypertension (23/45, 51%) and cardiovascular disease (15/45, 33%). Before CTPA, 5 patients had high D-dimer (11.21 μg/mL, IQR 9.10–13.02), 19 high fibrinogen (550 mg/dL, IQR 476–590), 26 high interleukin-6 (79 pg/mL, IQR 31–282), and 11 high C-reactive protein (9.60 mg/dL, IQR 6.75–10.65), C-reactive protein being the only laboratory parameter significantly differing between patients with and without PTE (P = .002)
High PTE incidence (60%) in COVID-19 hospitalized patients under prophylactic LMWH could substantiate further tailoring of anticoagulation therapy.
Effect of bilevel continuous positive airway pressure for patients with type II respiratory failure due to acute exacerbation of COPD
Authors: Teng Wenzhe , Chen Hu , Shi Siyao , Wang Yin , Cheng Kangyao 
Published: January 2021

Abstract

Background:
The purpose of this study is to determine the therapeutic efficacy of bi-level continuous positive airway pressure (BIPAP) intervention in patients with type II respiratory failure due to acute exacerbation of chronic obstructive pulmonary disease (COPD).

Methods:
This review will only include randomized controlled trials (RCTs). The search strategy will be applied to 4 Chinese databases: China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Science and Technology Journal Database (VIP), and Chinese Biomedical Literature Database (SinoMed); and 5 foreign literature databases: PubMed, Cochrane Library, Springer, EBSCO, and Web of Science. RCTs published from inception to October 2020 will be included. The 2 researchers will independently screen and extract the data and assess quality. The main results obtained through blood gas analysis and equipment observation, heterogeneity assessment, sensitivity analysis, funnel chart synthesis, data synthesis, and grouping analysis will be carried out using Review Manager 5.4 software. The trial sequential analysis will be completed using TSA v0.9 developed by the CTU at the Copenhagen Clinical Trial Center.

Results:
In the current meta-analysis, we will provide more practical and targeted results for the therapeutic efficacy of BIPAP in patients with type II respiratory failure due to acute exacerbation of COPD.

Conclusion:
This study will provide new evidence for the therapeutic efficacy of BIPAP in patients with type II respiratory failure due to acute exacerbation of COPD.

Registration number:
INPLASY2020110003 (DOI:10.37766/inplasy2020.11.0003).
A giant biliary cyst of Todani IA in a young woman
Authors: Mrowiec Sławomir , Jabłońska Beata , Baron Jan , Gajda Magdalena , Stelmach Anna , Zemła Patryk , Liszka Łukasz 
Published: January 2021

Abstract

Rationale:
Biliary cysts (BC) are rare dilatations of various parts of a biliary tract. They account for approximately 1% of all benign biliary diseases. Total cyst excision and Roux-Y hepaticojejunostomy is the treatment method of choice in most patients. In this paper, a novel surgical treatment with the use of internal biliary and pancreatic catheters was presented.

Patient concerns:
A 21-years-old woman with a giant choledochal cyst of Todani IA type presenting with abdominal pain, nausea, fever and palpable abdominal mass. It had been previously drained as a misdiagnosed pancreatic cyst in another hospital.

Diagnosis:
A very high amylase level (107140,0 U/l) in drain fluid was noted in laboratory tests. Endoscopic retrograde cholangiopancreatography revealed a biliary cyst located in the distal common bile duct and a pancreaticobiliary anomaly was suggested. A cholangiography per catheter inserted to the biliary cyst showed a large round contrast-filled cyst. A cholangiography following cyst decompression revealed a very long, tortuous bile duct entering the duodenum.

Interventions:
Cholecystectomy, cyst resection, Roux-Y hepaticojejunostomy, and implantation of catheters into pancreatic and bile duct were performed. The postoperative course was uneventful and she was discharged on 12th day without any complications. Histopathology revealed a cyst wall partially lined with biliary-type and mucinous epithelium, with dysplasia ranging from low to high grade (biliary intraepithelial neoplasia, high grade), without invasion.

Outcomes:
The biliary and pancreatic catheters were removed during endoscopic retrograde cholangiopancreatography 8 weeks following surgery without any complications. Fourteen months later, the patient reported good health.

Lessons:
Diagnosis of the abdominal cyst should be very precise in order to avoid misdiagnosis and inadequate management. The early diagnosis and proper treatment of BC are needed in order to avoid serious complications. The cholangiocarcinoma is the most dangerous potential complication of BC due to dysplasia within the cyst wall as in our young female patient.
The effectiveness of acupoint herbal patching for functional constipation
Authors: Yan Bing , Jiang Hailin , Cao Jiazhen , Liu Yanze , Liu Xiaona , Ha Lijuan , Li Tie , Wang Fuchun , Liu Chengyu 
Published: January 2021

Abstract

Background:
Functional constipation is a common functional problem of the digestive system that has a negative impact on physical, mental health of patients and quality of life. At present, acupoint herbal patching as an adjuvant therapy is currently undergoing clinical trials in different medical centers. However, no relevant systematic review or meta-analysis has been designed to evaluate the effects of acupoint herbal patching on functional constipation. There is also a lack of systematic evaluation and analysis of acupoints and herbs.

Methods:
We will search the following 8 databases from their inception to November 15, 2020, without language restrictions: the Cochrane Central Register of Controlled Trials, PubMed, Embase, the Web of Science, the Chinese Biomedical Literature Database, the Chinese Scientific Journal Database, the Wan-Fang Database and the China National Knowledge Infrastructure. The primary outcome measures will be clinical effective rate, functional outcomes, and quality of life. Data that meets the inclusion criteria will be extracted and analyzed using RevMan V.5.3 software. Two reviewers will evaluate the studies using the Cochrane Collaboration risk of bias tool. We will use the GRADE approach to assess the overall quality of evidence supporting the primary outcomes. We will also use Spass software (Version19.0) for complex network analysis to explore the potential core prescription of acupoint herbal patching for functional constipation.

Results:
This study will analyze the clinical effective rate, functional outcomes, quality of life, improvement of clinical symptoms of functional constipation, and effective prescriptions of acupoint herbal patching for patients with functional constipation.

Conclusion:
Our findings will provide evidence for the effectiveness and potential treatment prescriptions of acupoint herbal patching for patients with functional constipation.

PROSPERO registration number:
PROSPERO CRD 42020193489.
KCNQ1 G219E and TRPM4 T160M polymorphisms are involved in the pathogenesis of long QT syndrome
Authors: Zhao Yang , Feng Min , Shang Lu-Xiang , Sun Hua-xin , Zhou Xian-Hui , Lu Yan-Mei , Zhang Ling , Xing Qiang , Li Yao-dong , Tang Bao-Peng 
Published: January 2021

Abstract

Rationale:
Long QT syndrome (LQTS) is an inheritable disease characterized by prolonged QT interval on the electrocardiogram. The pathogenesis of LQTS is related to mutations in LQTS-susceptible genes encoding cardiac ion channel proteins or subunits.

Patient concerns:
Here, we reported a 37-year-old female Uygur patient with palpitation and loss of consciousness.

Diagnoses:
At the time of admission, a 12-lead electrocardiogram showed a QTc interval of 514 ms. Genetic analysis revealed KCNQ1 G219E and TRPM4 T160M mutations.

Interventions:
Although beta-blockers remain the mainstay in treating LQTS, the patient underwent implantation of an automatic cardioverter defibrillator due to life-threatening arrhythmias.

Outcomes:
To explore the effect of the calcium ion antagonist verapamil on ion channels, we generated human induced pluripotent stem cell cardiomyocytes (hiPSC-CMs) from the peripheral blood mononuclear cells of the patient. The changes of action potential duration in response to verapamil were observed.

Lessons:
Our results showed that patient-derived hiPSC-CMs could recapitulate the electrophysiological features of LQTS and display pharmaceutical responses to verapamil.
Contrast-enhanced ultrasound diagnosis of prostatic sarcoma
Authors: Wu Guozhu , Sun Ran , Hong Hua , Wang Yumin , Li Jing , Liu Qian , Sun Aitong 
Published: January 2021

Abstract

Rationale:
Prostatic sarcoma (PS) is a very rare malignant tumor that accounts for <0.1% of prostate malignancies, and Ewing's sarcoma is an extremely rare form of PS.

Patient concerns:
We reported on a 64-year-old patient with PS and a 36-year-old patient with Ewing's sarcoma, both of whom were examined by contrast-enhanced ultrasonography (CEUS) before surgery.

Diagnoses:
The 2 cases were proven to be prostatic stromal sarcoma, which was confirmed by imaging manifestations and histopathological findings.

Interventions:
The 64-year-old patient underwent radical prostatectomy, and the 36-year-old patient underwent chemotherapy combined with local radiotherapy.

Outcomes:
PS showed diffuse enlargement of the prostate on sonography, and the necrotic liquefying area within the large vessels could be clearly displayed by CEUS. CEUS can be advocated as a valuable noninvasive and safe imaging diagnosis method for PS.
Ectopic thyroid gland located on the L4 vertebral body
Authors: Lin Qihuan , Gao Qilu , Fan Rong , Zhang Li , Li Weijia , Liu Hongkun , Zheng Wenbin 
Published: January 2021

Abstract

Rationale:
The prevalence of ectopic thyroid is extremely low, with the condition observed in approximately 1 in 100,000 to 300,000 people. Thyroid gland ectopia develops as a result of the presence of developmental abnormalities during the migration of the thyroid anlage from the floor of the primitive foregut to its final position in the neck. Ectopic thyroid tissue is commonly observed in the lingual region, but can also present in other head and neck regions, as well as regions located at a large distance from the neck.

Patient concerns:
A 67-year-old woman who had experienced left lumbago and leg pain was transferred to our hospital following the worsening of her lumbago-related symptoms in the 2 months preceding her presentation. Seven years ago, the patient had recurrent lumbago and leg pain without obvious inducement, and visited a local clinic for treatment. The severity of her symptoms fluctuated; their intensity increased after participation in activities and decreased after rest.

Diagnoses:
The patient was diagnosed as having an ectopic thyroid gland that was located on the L4 vertebral body.

Interventions:
The patient chose to undergo surgery, with supportive care, following tumor discovery.

Outcomes:
After surgical treatment, the degree of lumbar spinal stenosis improved, and the patient's clinical symptoms were alleviated.

Lessons:
Clinically, ectopic goiter is diagnosed through radionuclide thyroid imaging, ultrasound examination, computed tomography, magnetic resonance imaging, and biopsy pathology. However, the imaging manifestations in this case were atypical, leading to greater diagnostic difficulties. A conclusion was finally reached based on pathology.
Herb-induced autoimmune-like hepatitis associated with Xiang-tian-guo (Swietenia macrophylla seeds)
Authors: Shao Yue-Ming , Zhang Yu , Yin Xin , Qin Ting-Ting , Jin Qing-Long , Wen Xiao-Yu 
Published: January 2021

Abstract

Rationale:
Drug-induced liver injury (DILI) has a relatively low incidence, whereas the incidence of herb-induced liver injury (HILI) is still under investigation. As a special type of DILI, the diagnosis of drug-induced autoimmune-like hepatitis presents a persistent challenge, because this condition has partial characteristics of both DILI and autoimmune hepatitis (AIH), such as a certain history of medication use and histology that similar is to AIH. Thus, the differential diagnosis between DILI and AIH can be confusing.

Patient concerns:
A 67-year-old woman taking xiang-tian-guo for 6 months was admitted to our hospital with a complaint of experiencing jaundice for 2 weeks.

Diagnosis:
A liver biopsy exhibited interface inflammation, foam cells, and “rosette” -like hepatocytes. She was diagnosed with herb-induced liver injury (hepatocellular and acute), a RUCAM score of 7 (probable), a severity for grade 4 liver injury, and accompanied autoimmune-like changes.

Interventions:
The patient was instructed to cease the administration of suspicious drugs. The patient also received liver protection and albumin transfusion.

Outcomes:
After 25 days of hospitalization, the patients aminotransferase levels returned to normal. No recurrence was observed after the administration of the treatments and a close follow-up.

Lessons:
We must to be vigilant about the safety of xiang-tian-guo as a herbal medicine. When faced with the difficulty of distinguishing between AIH and DILI, long-term follow-up observations for recurrence can aid clinicians in making a judgment.
Application of contrast-enhanced ultrasound in the diagnosis of post-transplant lymphoproliferative disease after hematopoietic stem cell transplantation
Authors: Chen Weinan , Li Jianchun , Fan Xiaoming , Zhang Yanming , Wang Li , Liu Yang , Cui Ailin , Wang Ligang 
Published: January 2021

Abstract

Introduction:
Post-transplant lymphoproliferative disease (PTLD) is a series of proliferative diseases of the lymphatic system. Among patients receiving hematopoietic stem cell transplantation (HSCT), PTLD is a prevalent complication that severely affects rates of survival. Ultrasound plays an essential role in the early diagnosis of PTLD. Contrast-enhanced ultrasonography (CEUS) and CEUS-guided biopsy are critical procedures for tumor diagnosis.

Patient concerns:
Herein, we report the case of a 40-year-old male patient with acute lymphoblastic leukemia who received HSCT more than 1 year ago. Sonography revealed a small hypoechoic nodule in the liver four months after HSCT. Eight months after HSCT, larger and more nodules were observed via ultrasound; CT was used to identify the lesions.

Diagnoses:
CEUS and CEUS-guided biopsy were performed, and the pathological diagnosis was PTLD.

Interventions:
The final clinical diagnosis was PTLD, and cyclophosphamide, epirubicin, and dexamethasone were administered as chemotherapy.

Outcomes:
The patient was discharged after his condition improved.

Conclusion:
Ultrasound can be used to effectively detect lesions of PTLD early after HSCT. Furthermore, CEUS and CEUS-guided biopsy were effective for early confirmatory diagnoses of PTLD after HSCT.
The safety and efficacy of astragalus for treating diabetic foot ulcers
Authors: Liu Donghao , Zhong Yanmei , Yan Hang , Hu Yuanzhang , Chen Yuzhu , Zhou Yi 
Published: January 2021

Abstract

Background:
Diabetic foot ulcers are the most common complication among diabetic patients, which may put the patients in a great danger of amputation. Astragalus as a Chinese herbal medicine has been reported in many publications that it has an efficacy toward diabetic foot ulcers. However, the systematic review and meta-analysis of its efficacy and safety are still absent. Therefore, we aim to evaluate the effectiveness and safety of Astragalus for diabetic foot ulcers.

Methods:
The following databases will be searched from January 1st, 2010 to September 2020: The Cochrane Library, Pubmed, EMBASE, Web of Science, China National Knowledge Infrastructure, and Wanfang Data. All the English and Chinese publications will be searched without any restriction of countries. Data will be extracted by 2 reviewers independently. RevMan 5.4.1. will be used to perform analysis and synthesis of data.

Results:
This meta-analysis of randomized controlled trials will evaluate the efficacy and safety of Astragalus for diabetic foot ulcers during the past 10 years.

Conclusion:
This study will provide an evidence to judge whether Astragalus is effective and safe for diabetic patients with foot ulcers.

INPLASY registration number:
Inplasy protocol 2020110059. (doi:10.37766/inplasy2020.11.00596).
Application of the transoral endoscopic vestibular approach for a benign upper neck mass
Authors: Lee Dong Won , Kim Jeong Kyu , Tae Kyung 
Published: January 2021

Abstract

Rationale:
Excision of a benign neck mass is traditionally performed via the transcervical approach. In order to avoid visible scars in the neck, various remote access surgical approaches have been developed. The aim of this report is to present the technique of a transoral endoscopic vestibular approach for treatment of a benign upper neck mass.

Patient concerns:
A 47-year-old female with an anterior upper neck mass and throat discomfort visited our institution.

Diagnosis:
The computed tomography (CT) scans and ultrasound (US) images demonstrated a benign-appearing mass on the anterior upper neck area.

Interventions:
The benign upper neck mass was successfully removed via the transoral endoscopic vestibular approach, without any complication.

Outcomes:
The final pathologic report indicated that the lesion was an epidermal cyst. The cosmetic result was excellent.

Lessons:
From this case study, we can learn to apply a transoral endoscopic vestibular approach for removal of a benign upper neck mass. Based on the outcomes, endoscopic removal of the benign upper neck mass via a transoral vestibular approach can be useful for patients who wish to hide any anterior neck scar.
Prenatal diagnosis and ultrasonographic findings of partial trisomy of chromosome 6q
Authors: Li Linlin , Yu Yang , Zhang Han , Jiang Yuting , Liu Ruizhi , Zhang Hongguo 
Published: January 2021

Abstract

Rationale:
Partial trisomy of the long arm of chromosome 6 syndrome is a rare chromosomal disorder with distinctive phenotypic expressivity, in which cytogenetic abnormalities are usually reported in infancy and childhood. Ultrasonographic findings on trisomy of the distal long arm of chromosome 6 in previous studies are limited.

Patient concerns:
A 32-year-old, gravida 6, para 1, pregnant woman who had 4 spontaneous abortions underwent a clinical ultrasound examination at 26 weeks of gestation.

Diagnoses:
Ultrasonographic findings were microcephaly, an acoustic image of a transparent septum, a flat nasal bridge, right pulmonary artery stenosis, and a single umbilical artery. Cytogenetic and single-nucleotide polymorphism array analyses were performed to estimate genetic factors of this diagnosis by amniocentesis.

Interventions:
After genetic counseling, the patient and her husband opted to terminate the pregnancy.

Outcomes:
Cytogenetic examination of the fetus showed the karyotype 46,XX,der(20)t(6;20)(q24;p13). The single-nucleotide polymorphism (SNP) array showed a 22.104-Mb duplication of 6q24.3q27 and a 0.784-Mb deletion of 20p13.

Lessons:
Ultrasonographic findings of fetal abnormalities, including microcephaly, an acoustic image of a transparent septum, a flat nasal bridge, right pulmonary artery stenosis, and a single umbilical artery, may be related to a 22.104-Mb duplication of 6q24.3q27 and a 0.784-Mb deletion of 20p13. More ultrasonographic and genotype studies are required to extend the phenotypic characterization of partial trisomy 6q syndrome.