bluuebunny/crossref_metadata_2025_split huggingface dataset:
The PITX gene family as potential biomarkers and therapeutic targets in lung adenocarcinoma
Authors: Zhang Chunyi , Chen Xing , Chen Yefeng , Cao Miaoying , Tang Jixian , Zhong Bo , He Meng 
Published: January 2021

Abstract
The PITX gene family of transcription factors have been reported to regulate the development of multiple organs. This study was designed to investigate the role of PITXs in lung adenocarcinoma (LUAD).
In this study, the transcriptional levels of the 3 identified PITXs in patients with LUAD were examined using the gene expression profiling interactive analysis interactive web server. Meanwhile, the immunohistochemical data of the 3 PITXs were obtained in the Human Protein Atlas website, and western blotting was additionally conducted for further verification. Moreover, the association between the levels of PITXs and the stage plot as well as overall survival of patients with LUAD was analyzed.
We found that the mRNA and protein levels of PITX1 and PITX2 were higher in LUAD tissues than those in normal lung tissues, while those of PITX3 displayed no significant differences. Additionally, PITX1 and PITX3 were found to be significantly associated with the stage of LUAD. The Kaplan-Meier Plot showed that the high level of PITX1 conferred a better overall survival of patients with LUAD while the high level of PITX3 was associated with poor prognosis.
Our study implied that PITX1 and PITX3 are potential targets of precision therapy for patients with LUAD while PITX1 and PITX2 are regarded as novel biomarkers for the diagnosis of LUAD.
Chronic respiratory dysfunction due to diaphragmatic paralysis following penetrating neck trauma
Authors: Wang Lian , Liu Tianshu , Liu Zhihai 
Published: January 2021

Abstract

Rationale:
Respiratory dysfunction resulting from unilateral diaphragmatic paralysis during neck trauma is very rare in adults. We describe the symptoms, diagnosis and treatment of 1 patient with chronic respiratory insufficiency, in whom the diaphragmatic paralysis was associated with phrenic nerve injury due to penetrating neck trauma.

Patient concerns:
A 50-year-old worker was admitted because of left penetrating neck trauma. Imaging investigations demonstrated elevation of the left hemidiaphragm and the C5 and C6 roots avulsion. He complained of gradually worsening dyspnea on exertion 2 months later.

Diagnoses:
The patient was diagnosed with chronic respiratory dysfunction secondary to diaphragmatic paralysis, which caused by phrenic nerve injury.

Interventions:
A conventional video-assisted thoracoscopic diaphragm plication was performed after failed conservative management.

Outcomes:
The respiratory status improved markedly, and he did well without recurrence until 2 years’ follow-up.

Lessons:
The possibilities of phrenic nerve palsy and diaphragmatic paralysis should not be overlooked during the evaluation of neck trauma.
Unveiling the comparative efficacy and tolerability of comprehensive treatments for migraine
Authors: Jin Boru , Liu Huayan , Qiao Lei 
Published: January 2021

Abstract

Background:
Migraine is a chronic paroxysmal incapacitating neurological disorder, which endangers the health of human worldwide ranking as the third most prevalent medical condition. There are no comprehensive estimates of treatments for migraine. We will conduct this systematic review and Bayesian network meta-analysis (NMA) to synthesis quantitative and comparative evidence on the efficacy and tolerability of all the known pharmacological and non-pharmacological interventions for migraine.

Method:
We will perform the systematic electronic search of the literature utilizing MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing & Allied Health (CINAHL), and PsycINFO. We will only include randomized controlled trials (RCTs) of high quality which appraise the efficacy or safety of any potential pharmacological or non-pharmacological interventions in the treatment of patients with migraine. The traditional pairwise meta-analyses will be performed to anticipate the heterogeneities and publication bias and the NMA will be conducted within a Bayesian hierarchical model framework to obtain estimates for all valuable treatments for migraine. The entire heterogeneity will be quantified by Q statistic and I
2 index. Other analyses included sensitivity analyses, meta-regression, and subgroup analyses will also be conducted. The whole process will be conducted using in R-3.6.0 software.

Results:
This study will obtain the efficacy and tolerability of all potential treatments for migraine, aiming at providing consolidated evidence to help make the best choice of interventions. The results will be published in a peer-reviewed journal.

Discussion:
This Bayesian network meta-analysis may be the first attempt to quantitatively synthesize the efficacy and tolerability of all potential treatments for migraine. And this method can ensure us to fully utilize both the direct and indirect evidence as well as gain the comparative estimates displayed in the derived hierarchies. Besides, we have registered this protocol on the international prospective register of systematic review (PROSPERO) (CRD42020157278).
Effect of education and muscle relaxation program on anxiety, depression and care burden in caregivers of acute stroke survivors
Authors: Wang Jinhong , Liu Jie , Li Ling , Man Jing , Yue Shihong , Liu Zhaojun 
Published: January 2021

Abstract
This study intended to discover the effect of education and muscle relaxation (EMR) program on anxiety, depression and care burden among caregivers of acute stroke survivors.
This randomized, controlled study enrolled a total of 110 caregivers of first-ever acute stroke patients, and randomly assigned to EMR (N = 55) and control (N = 55) groups. The caregivers in the EMR group received 12-month health education and progressive muscle relaxation, and those in control group were provided common rehabilitation advices. Hospital Anxiety and Depression Scale (HADS) and Zarit Caregiver Burden Scale in caregivers were evaluated at the time of patients’ discharge from hospital (M0), then at month(M) 3, M6 and M12 after the discharge.
HADS-anxiety score, anxiety rate and severity were similar at M0, M3, while were reduced at M6 and M12 in EMR group compared to control group. Furthermore, HADS-depression score was similar at M0 and M3 but was decreased at M6 and M12 in EMR group compared with control group, however, there was no difference of depression rate and severity between the 2 groups at each time point. Moreover, Zarit Caregiver Burden Scale score was similar at M0 and M3, but was decreased at M6 and M12; meanwhile, degree of care burden was similar at M0, M3 and M6, but was reduced at M12 in EMR group compared to control group.
EMR program decreases anxiety, depression and care burden in caregivers of acute stroke survivors, suggesting its potential in improving mental health and further promoting quality of lives in these caregivers.
Mutation differences in circulating tumor DNAs from non-small cell lung cancer patients between Uygur and Han populations
Authors: Wang Yuli , Li Jing , Huang Jian , Wu Chaoqun , Li Li , Gong Ping 
Published: January 2021

Abstract

Background:
The incidence of non-small cell lung cancer (NSCLC) in Uygur population is gradually increasing recently. In view of the great diagnostic and prognostic values of cell-free DNAs (cfDNA) detection, this study focus on a liquid biopsy to explore the value of cfDNA mutation in healthy and NSCLC patients in 2 ethnicities.

Methods:
The concentration and sequencing of cfDNA in NSCLC and healthy subjects was assessed with a standard information analysis procedure, including detection, annotation, and statistical analysis. Gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses were conducted to analyze the function of mutant genes and related pathways. Totally, 133 subjects, including 35 Uygur NSCLC patients, 10 Uygur healthy subjects, 63 cases of Han NSCLC patients and 25 Han health control, were admitted to the hospital.

Results:
There were a lower proportion of adenocarcinoma and higher percentage of smoking rate for Uygur patients. For cfDNA level between NSCLC and healthy subjects, Han patients exhibited sharp increase while there was no statistical difference in Uygur population. In addition, the mutation frequency of cfDNA in Han patients (72.6%) was significantly higher than Uygur patients (45.7%). There were 5 gene mutations only found in Han patients and ABCC11 showed a higher mutation frequency in Uygur population as a common one. Finally, Go and Kyoto Encyclopedia of Genes and Genomes analysis showed apprent functional enrichments and pathway changes between 2 ethnicities.

Conclusion:
There existed distinct distributions of cancer subtypes, smoking proportion, cfDNA level, and mutation patterns between Han and Uygur patients. The results may be a useful tool in NSCLC patients’ diagnosis as well as individualized therapy between ethnicities in future.
Screening the key genes of prognostic value in the microenvironment for head and neck squamous cell carcinoma
Authors: Meng Di , Liu Tongjun , Ma Feng , Wang Mingguo 
Published: January 2021

Abstract
Head and neck squamous cell carcinoma (HNSCC) is the sixth common malignancy worldwide. The tumor microenvironment is highly related to tumor initiation, progression, and prognosis. This study aims to screen the tumor microenvironment related key genes of prognostic value for HNSCC.
The gene expression and clinical data for HNSCC were downloaded from the cancer genome atlas (TCGA). The immune/stromal/ESTIMATE scores were downloaded from the website of the MD Anderson Cancer Center. Correlation of patient gender and tumor grade with immune/stromal/ESTIMATE score was tested. Patients were divided into low and high immune/stromal/ESTIMATE score subgroups. Survival analysis was performed to evaluate the prognostic value of the immune/stromal/ESTIMATE score. Tumor microenvironment related differentially expressed genes were determined and applied for functional enrichment analysis and protein-protein interaction network was predicted. The prediction value of the common differentially expressed genes on patient survival was tested.
Four hundred eighty samples with complete clinical, expression data, and immune/stromal/ESTIMATE scores were enrolled for analysis. Immune/stromal/ESTIMATE score was higher in female patients than males. A total of 44 common differentially expressed genes were screened in high and low immune/stromal/ESTIMATE score subgroups. Of the 44 genes, 7 genes (ADGRG7, CSN3, CST8, KRT81, MUC7, MYH6, and SEZ6) were found to be closely related to patient survival. Enrichment analysis showed that the differentially expressed genes mainly enriched in the protein-coupled receptor signaling pathway, extracellular region, G-protein coupled receptor activity, salivary secretion, and regulation of lipolysis in adipocytes. Protein-protein interaction analysis revealed that POSTN and OGN were crucial microenvironments related genes.
Tumor microenvironment related genes ADGRG7, CSN3, CST8, KRT81, MUC7, MYH6, and SEZ6 are valuable predictors for HNSCC patient survival. POSTN and OGN are crucial in modulating the microenvironment and tumor biology for HNSCC.
Nivolumab plus regorafenib in patients with small bowel adenocarcinoma
Authors: Zhang Gairong , Lin Li , Dong Dapeng , Qiu Hui , Liu Tao , Lian Li , Shen Ge 
Published: January 2021

Abstract

Introduction:
Small bowel adenocarcinomas (SBAs) are rare cancers that have a distinct clinical characteristic and genetic profile. The only potentially curative treatment for localized SBAs is surgery, and treatment options are limited for patients in the advanced stage of disease.

Patient concerns:
A 39-year-old woman presented in October 2015 with a complaint of persistent vomiting for 8 months.

Diagnosis:
The patient had obstruction caused by a 3 × 2 cm mass at the ascending part of the duodenum and suspected metastasis in the right adnexal region. Postoperative pathology showed a moderately differentiated adenocarcinoma with serosal invasion. The diagnosis was stage IV duodenum adenocarcinoma with right adnexal metastasis.

Interventions:
After the failure of multi-line treatment with chemotherapy and targeted therapy, she was treated with the immune checkpoint inhibitor nivolumab plus regorafenib.

Outcomes:
Disease control lasted for 15 months with markedly improved symptoms.

Conclusion:
To the best of our knowledge, this is the first case of small bowel adenocarcinoma that has been treated with nivolumab combined with regorafenib. This case highlights the potential efficacy of combining nivolumab and regorafenib in the treatment of SBAs.
Degeneration of core neural tracts for emotional regulation in a patient with traumatic brain injury
Authors: Choi Eun Bi , Jang Sung Ho 
Published: January 2021

Abstract

Rationale:
Several brain structures, including the orbital prefrontal cortex, ventrolateral prefrontal cortex, dorsolateral prefrontal cortex, amygdala, and anterior cingulate cortex, are considered key structures in the neural circuitry underlying emotion regulation. We report on a patient showing behavior changes and degeneration of core neural tracts for emotional regulation following traumatic brain injury (TBI).

Patient concerns:
A 51-year-old male patient suffered an in-car accident. The patient lost consciousness for approximately 30 days, and his Glasgow Coma Scale score was 3. He underwent stereotactic drainage for traumatic intraventricular and intracerebral hemorrhages. At approximately 6.5-year after onset, he began to show disinhibition behaviors such as shouting with anger, which worsened over time. At approximately 8-year after onset, he showed severe depression signs and disinhibition, including violence.

Diagnoses:
The patient who showed delayed-onset behavioral changes (disinhibition and depression).

Interventions:
Diffusion tensor imaging data were acquired at 3 months and 8 years after TBI onset.

Outcomes:
The patient showed degeneration of core neural tracts for emotional regulation that was associated with delayed behavioral changes following TBI. On both 3-month and 8-year diffusion tensor tractographies (DTTs), the right dorsolateral prefronto-thalamic tract, ventrolateral prefronto-thalamic tract, orbital prefronto-thalamic tract, uncinate fasciculus, and both cinguli were reconstructed whereas other neural tracts were not reconstructed. Compared with the 3-month DTT, all reconstructed neural tracts on the 8-year DTT were narrow, except for the left cingulum, which showed new transcallosal fibers between both anterior cingula. The fractional anisotropy and tract volume of all reconstructed neural tracts were lower on the 8-year DTT than the 3-month DTT, except for the tract volume of left cingulum.

Lessons:
The evaluation of dorsolateral, ventrolateral, and orbital prefronto-thalamic tract, uncinate fasciculus, and cingulum using follow-up DTTs is useful when a patient with TBI shows delayed-onset behavioral problems.
Anti-PD1/PD-L1 monotherapy vs standard of care in patients with recurrent or metastatic head and neck squamous cell carcinoma
Authors: Zhu Peng , Wang Yanwei , Zhang Wendi , Liu Xin 
Published: January 2021

Abstract

Background:
In recent years, a number of clinical trials for antibody drugs targeting programmed cell death protein 1 (PD1)/programmed cell death 1 ligand 1 (PD-L1) have been carried out on recurrent or metastatic head and neck squamous cell carcinoma (R/M SCCHN) and reported promising prospects. To further evaluate and understand the effects and risk of anti-PD1/PD-L1 monotherapy vs standard of care (SoC) in R/M SCCHN, we conducted this meta-analysis of published randomized controlled trials.

Method:
The potential eligible trials were searched from Cochrane library and Pubmed and Embase databases. Randomized controlled trials evaluating the effects and risk of anti-PD1/PD-L1 monotherapy vs SoC in platinum refractory R/M SCCHN were selected. The outcomes, including objective response rate, disease control rate, progression-free survival, overall survival, and treatment-related adverse events, were extracted and pooled.

Results:
1345 patients with R/M SCCHN from three randomized controlled trials were enrolled in this analysis. Compared with SoC, anti-PD1/PD-L1 monotherapy could provide statistically significant overall survival benefit, hazard ratio (95% confidence interval ) = 0.79 [0.70–0.90]. However, we observed no significant difference between 2 treatments in progression-free survival (hazard ratio [95% confidence interval] = 0.96 [0.85–1.09]). Furthermore, anti-PD1/PD-L1 monotherapy caused less treatment-related adverse events than standard of care.

Conclusion:
Anti-PD1/PD-L1 monotherapy could indeed reduce the risk of death in R/M SCCHN patients, and provide higher safety vs SoC. Expression level of PD-L1 may be a useful biomarker for selecting patients with better response to anti-PD1/PD-L1 monotherapy.
Advanced breast cancer with cachexia
Authors: Liu Nan , Li Shuting , Jia Junmei , Qiao Ying , Li Yuanfei 
Published: January 2021

Abstract

Rationale:
Cachexia is a clinically relevant syndrome in cancer that is associated with reduced tolerance to anticancer therapy, reduced quality of life, and reduced survival rates. Cachexia is most prevalent in pancreatic, gastric, colorectal, lung, and head and neck cancers. It is rarely documented in breast cancer patients.

Patient concerns:
In our case report of a breast cancer patient with bone metastasis who was monitored throughout the course of her treatment, we document the development of cachexia using image analyses in relation to her metastatic burden. In the 2-year period, from April 10, 2015, to February 09, 2017, she lost 16% of her baseline weight. During this time, she was repeatedly hospitalized for chest tightness, edema of both lower limbs, numbness and pain in the left lower extremity and backache.

Diagnoses:
Our patient was a 46-year-old premenopausal woman when she was firstly diagnosed. Several years after surgery for invasive ductal carcinoma of the left breast, she had multiple systemic bone metastases (the thoracic spine, the ribs, etc), lung metastasis, bilateral axillary lymph node metastasis, and metastasis of the right neck lymph node in IV area.

Interventions:
The patient completed 6 cycles of postoperative adjuvant chemotherapy and long-term endocrine therapy after a radical mastectomy for breast cancer. During the fourth progression, 6 cycles of rescue chemotherapy were performed. Local lumbosacral radiotherapy, and lumbar surgery were carried out to relieve symptoms after several progressions.

Outcomes:
She became extremely thin, weighing only 50 kg at admission on July 23, 2018. This eventually led to multiple organ failure and death.

Lessons:
We noted a strong negative correlation between the abdominal muscle area and the metastatic tumor area at the second lumbar vertebral (L2) level. The monitoring of abdominal muscle wasting may serve as a marker, and therefore a prognostic factor, for both cachexia and the extent of metastatic disease. This is especially true with breast cancer, where metastasis to bone is frequent. Our data from a computational tomography radiological quantification, may provide clinicians with early indications of the extent of cachexia in metastatic breast cancer patients.
Sex differences in association between body composition and frailty or physical performance in community-dwelling older adults
Authors: Soh Yunsoo , Won Chang Won 
Published: January 2021

Abstract
Frailty is a common geriatric condition due to aging, defined as a decrease in the functional reserve to maintain the homeostasis. As part of the aging process, body composition changes occur. This study investigated the relationship between body composition and frailty in a community-dwelling elderly Korean population.
This cross-sectional cohort study analyzed data of 2,385 elderly participants (aged 70–84 years, 1131 males and 1254 females) of the Korean Frailty and Aging Cohort Study from 2016 to 2017. Body composition, including total and trunk fat masses and fat-free mass, were measured with dual-energy X-ray absorptiometry. Fat mass index (FMI), trunk fat mass index, and fat-free mass index (FFMI) represented total fat mass, trunk fat mass, and fat-free mass according to height. Based on the frailty index developed by Fried, we compared the frail and non-frail groups. Poor physical performance assessed with the short physical performance battery score of < 9 is considered frailty. To evaluate the relationship between the variables, simple and fully adjusted multivariable logistic regression analyses were performed according to sex.
Among the participants, 462 (19.3%) were defined as the frail group, with a significantly high mean age of 77.9 ± 4.0 years. In the logistic regression analysis of frailty based on body mass index (BMI) categories, underweight (BMI < 18 kg/m2) participants showed a high incidence of frailty in both sexes. BMI showed an association with frailty only in males. Lower FFMI was associated with a higher incidence of frailty in both sexes, which was statistically significant in the fully adjusted models. In the female, fat-related indexes including body fat percentage, FMI, and trunk fat mass index showed a significant association with poor physical performance. In contrast, males with low FFMI only showed a significant association with poor physical performance.
Frailty was closely correlated with lower FFMI in both sexes. The poor physical performance associated with frailty correlated with fat-related body composition in females and fat-free mass in males, owing to the difference in body composition between the sexes. In the assessment of frailty, body composition and sex-related differences should be analyzed.
A comparison of the efficacy and safety of traditional Chinese medicine in preconditioning patients with diminished ovarian reserve that would undergo In Vitro fertilization
Authors: Qin Xiuyun , Gong Yongping , Yu Feng , Song Jiangquan , Dong Shuangqian , Zhang Ruoqian , Zhang Jianwei 
Published: January 2021

Abstract

Background:
Diminished Ovarian Reserve (DOR) is a common disease in reproductive-age women in the diagnosis and treatment of infertility. The incidence of DOR increased quickly in recent years and had became one of the most important factors that made the quality of women life decline. Gynecology and reproductive medicine professors have made great efforts to explore good treatment methods all over the world. Traditional Chinese Medicine has made some achievement in treating DOR as a kind of complementary and alternative therapy In Vitro Fertilization (IVF) in recent years, it is indispensable to propose a network meta-analysis (NMA) protocol to discuss the efficacy and safety of TCM in IVF.

Methods:
A literature search will be conducted in 8 electronic databases.

Results:
The efficacy and safety of traditional Chinese medicine in preconditioning patients with diminished ovarian reserve that would undergo In Vitro Fertilization will be evaluated.

Results:
The systematic review will evaluate the efficacy and safety of TCM in IVF.

Conclusion:
The result of this study will provide reliable evidence of the use of TCM in IVF.

INPLASY registration number:
INPLASY2020110062.

Ethics and dissemination:
This review does not require ethical approval.