bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical management of complicated gynecomastia (associated with foreign body injection) with single-port 3-dimensional videoscope-assisted endoscopic subcutaneous mastectomy and concurrent liposuction
Authors: Wen Tzu-Cheng , Lai Hung-Wen , Mok Chi Wei , Chen Shou-Tung , Chen Dar-Ren , Kuo Shou-Jen 
Published: June 2021

Abstract

Rationale:
Gynecomastia is a common benign breast disorder in men. Surgical management of gynecomastia includes that of a subcutaneous mastectomy with or without concurrent liposuction. Herein, the authors presented a case of complicated gynecomastia (gynecomastia with concurrent foreign body injection) which was successfully managed with an innovative technique that offered acceptable operative time, minimal complications, good recovery and satisfactory aesthetic outcome.

Patient Concerns:
A 39-year-old Taiwanese man who developed gynecomastia along with self-injection of foreign body (salad oil) over the past 10 years for breast enlargement presented as symptomatic bilateral breast lumps.

Diagnosis:
Bedside sonography revealed multiple large droplets of oil in the subcutaneous tissue bilaterally, resembling cystic lesions.

Intervention:
Bilateral single-port 3-dimensional videoscope-assisted endoscopic subcutaneous mastectomy was performed after bilateral breast liposuction. Operative findings include bilateral gynecomastia and previous bilateral breast foreign body material. The total weight of lipoaspirate was 400 grams and 300 grams for right and left side respectively. Subcutaneous mastectomy specimen weight was 820 grams and 661 grams for right and left breast tissue.

Outcomes:
Operative duration was 315 minutes and intraoperative blood loss at 150 ml. Patient was discharged 2 days after the operation, and subsequent follow up ultrasound showed complete removal of foreign bodies and fibrotic breast tissue. Patient was satisfied with the post-operative aesthetic outcomes.

Lessons:
Single-port 3-dimensional videoscope-assisted endoscopic subcutaneous mastectomy with concurrent liposuction is a promising and safe surgical option for patient with complicated gynecomastia and severe fibrosis.
The application value of continuous nursing intervention on quality of life in patients with stroke
Authors: Han Cai-Yan , Yu Xia 
Published: June 2021

Abstract

Background:
Individual characteristics, physical function disability, emotional, as well as cognitive symptoms, along with the general health discernment might be associated or impact the quality of life of patients suffering from stroke directly or indirectly. Appropriate continuous nursing intervention is required to enhance the quality of life of patients with stroke. Therefore, the present study will be conducted to systematically investigate the application value of continuous nursing intervention for improving the quality of life of patients experiencing stroke.

Methods:
We will conduct a comprehensive search of electronic databases such as MEDLINE, Cochrane Library, CINAHL, EMBASE, Scopus, Chinese National Knowledge Infrastructure, and WanFang databases to identify relevant publications. We will only include studies published in English or Chinese languages. Accordingly, randomized controlled trials evaluating the application value of continuous nursing intervention for improving the quality of life of patients suffering from stroke will be included. We will use 2 independent authors to conduct study selection, extract data, and evaluate the quality of the included studies. In case of any discrepancies, they will be addressed by consensus. Also, we will use RevMan 5.3 software to carry out the statistical analysis.

Results:
The current study will summarize high-quality evidence to systematically explore application value of continuous nursing intervention for improving the quality of life in patients with stroke.

Conclusion:
The present study will summarize the direct and indirect pieces of evidence to ascertain whether continuous nursing intervention can improve the quality of life in patients with stroke.

Ethics and dissemination:
Ethical approval will not be required.

Registration number:
April 25, 2021.osf.io/xnrzt/ (https://osf.io/xnrzt/).
Worldwide prevalence of early repolarization pattern in general population and physically active individuals
Authors: Ji Hong-Yan , Hu Nan , Liu Rui , Zhou Hai-Rong , Gao Wei-Liang , Quan Xiao-Qing 
Published: June 2021

Abstract

Background:
The early repolarization pattern (ERP) has recently been associated with cardiac events such as ventricular arrhythmias and sudden cardiac death. However, estimates of the prevalence of ERP vary widely, especially between the general population and physically active individuals. We performed this systematic review and meta-analysis to quantitatively evaluate the worldwide prevalence of ERP in the general population and physically active individuals.

Methods:
We thoroughly searched the PubMed, EMBASE, Web of science, the Cochrane Library, and Scopus databases for relevant studies published until December 20, 2020. Studies in which prevalence was presented or could be estimated from eligible data were included. The pooled prevalence was analyzed using a random-effect model.

Results:
Finally, we included 29 studies (182,135 subjects) in the general population and 14 studies (8087 subjects) in the physically active individuals. The worldwide pooled prevalence of ERP in the general population was 11.6% (95% confidence interval [CI]: 10.0%–13.3%). The incidence of ERP was 17.0% and 6.2% in men and women, respectively. The prevalence was 20.9% in blacks, 13.4% in Asians, and 10.1% in Caucasians. Additionally, the prevalence of ERP in physically active individuals was 33.9% (95% CI: 25.3%–42.6%).

Conclusion:
A significant difference in the worldwide prevalence of ERP is revealed in this study. The ERP is highly prevalent in men, blacks, and physically active individuals.
Effect assessment of evidence-based nursing in combination with clinical nursing pathway on nephrotic syndrome care in children
Authors: Yu Xia , Han Cai-Yan 
Published: June 2021

Abstract

Background:
Childhood nephrotic syndrome is widespread in pediatric nephrology. In most cases, it needs hospitalization for patient management. An increasing number of studies report that proper nursing care could promote the rate of treatment and improve post-treatment prognosis. Clinical nursing pathways refer to innovative nursing modes with high-quality, excellent efficacy, and low costing treatment. There are reports on how nursing methods that utilize data combine with clinical nursing pathway to enhance nephrotic syndrome care in kids. However, the results remain controversial. Therefore, it is necessary to conduct this study to systematically explore how evidence-based nursing combined with clinical nursing pathway plays a role in nephrotic syndrome care among children.

Methods:
This study protocol will conduct a comprehensive search on MEDLINE, Cochrane Library, CINAHL, EMBASE, Scopus, Chinese National Knowledge Infrastructure, WanFang, and Web of Science electronic databases to identify relevant research articles from inception to April 25, 2021. Studies in both English and Chinese languages are used for this study. This study protocol will analyze randomized controlled trials that investigated the role of evidence-based nursing combined with clinical nursing pathway to care for nephrotic syndrome in children. Two authors will independently screen the search results, select suitable studies for inclusion, extract the characteristics and outcome data of the selected studies, and evaluate the risk of bias based on standard Cochrane methodology. Any discrepancies will be resolved by consensus.

Results:
The present study will summarize high-quality evidence to systematically explore how a nursing model based on evidence combined with clinical nursing pathway influences the caring of children with nephrotic syndrome.

Conclusion:
The present study will summarize the direct and indirect evidence to judge whether evidence-based nursing combined with clinical nursing pathway can improve the treatment and post-treatment prognosis in children with nephrotic syndrome.

Ethics and dissemination:
This study does not require an ethical approval.

Registration number:
April 25, 2021.osf.io/bcrdk/ (https://osf.io/bcrdk/).
Efficacy of combined angiotensin II receptor blocker with tripterygium glycosides on diabetic nephropathy
Authors: Ma Chang-e , Yu Pei , Wei Wei , Chen Xiao-qin 
Published: June 2021

Abstract

Background:
Several studies have reported good results for angiotensin II receptor blockers (ARB) combined with tripterygium glycosides (TGs) in the treatment of diabetic nephropathy (DN). However, because a small number of cases were included in each study, the statistical power was limited. Therefore, we performed a protocol for meta-analysis to further evaluate the clinical efficacy and safety of combined ARB and TGs in treatment of DN.

Methods:
The protocol was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement guidelines. We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, Science Direct up to April 2021. Outcome measures were 24-h urinary total protein, urinary albumin excretion rate, serum creatinine, blood urea nitrogen, albumin, hemoglobin A1c, β2-microglobulin and serum glutamic pyruvic transaminase. The risk of bias assessment of the included studies was performed by two authors independently using the tool recommended in the Cochrane Handbook for Systematic Reviews of Interventions (version 5.1.0). We performed meta-analysis using STATA 11.0.

Results:
The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.

Conclusion:
The findings will provide helpful evidence for the application of combined ARB and TGs in the treatment of DN.

OSF registration number:
10.17605/OSF.IO/ARGE3
Estimation of renal function by three CKD-EPI equations in Chinese HIV/AIDS patients
Authors: Zhao Naxin , Zeng Zhili , Liang Hongyuan , Wang Fang , Yang Di , Xiao Jiang , Chen Meiling , Zhao Hongxin , Zhang Fujie , Gao Guiju 
Published: June 2021

Abstract
Assessing renal function accurately is important for human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) patients. Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) recommended three equations to calculate estimated glomerular filtration rate (eGFR). There is evidence that eGFR based on the combination of serum creatinine and cystatin C is the most accurate of the three equations. But there is limited data on the comparison of three CKD-EPI equations in Chinese HIV/AIDS patients. The aim of our study was to compare the three CKD-EPI equations in Chinese HIV/AIDS population and assess renal function.
Cross-sectional, single center, prospective study.
One hundred seventy two Chinese adult HIV/AIDS patients were enrolled, including 145 (84.3%) males and 27 (15.7%) females. Mean age was 40(±12) years old. Overall mean eGFR based on serum creatinine, cystatin C and the combination of the 2 markers was 112.6(±19.0) mL/min/1.73 m2, 92.0(±24.2)mL/min/1.73 m2, and 101.7(±21.8)mL/min/1.73 m2, respectively (P = .000). The eGFR calculated by serum creatinine alone is higher than eGFR calculated by combination of serum creatinine and cystatin C, and eGFR calculated by cystatin C individual is lower than eGFR calculated by combination of the 2 markers.
Of the 3 CKD-EPI equations, the CKD-EPIscr-cys equation may have the most accuracy in evaluating renal function in Chinese HIV/AIDS patients while the CKD-EPIscr equation may overestimate renal function and the CKD-EPIcys equation may underestimate renal function.
Activities of daily living associated with postoperative intensive care unit survival in elderly patients following elective major abdominal surgery
Authors: Kang Yu , Zhang Gui-Chen , Zhu Ji-Qiao , Fang Xiang-Yang , Niu Jing , Zhang Ying , Wang Xiao-Juan 
Published: June 2021

Abstract
Elderly patients who undergo major abdominal surgery are being in increasing numbers. Intensive care unit (ICU) survival is critical for surgical decision-making process. Activities of daily living (ADL) are associated with clinical outcomes in the elderly. We aimed to investigate the relationship between ADL and postoperative ICU survival in elderly patients following elective major abdominal surgery.
We conducted a retrospective cohort study involving patients aged ≥65 years admitted to the surgical intensive care unit (SICU) following elective major abdominal surgery. Data from all patients were extracted from the electronic medical records. The Barthel Index (BI) was used to assess the level of dependency in ADL at the time of hospital admission.
ICU survivors group had higher Barthel Index (BI) scores than non-survivors group (P < .001). With the increase of BI score, postoperative ICU survival rate gradually increased. The ICU survivals in patients with BI 0–20, BI 21–40, BI 41–60, BI 61–80 and BI 81–100 were 55.7%, 67.6%, 72.4%, 83.3% and 84.2%, respectively. In logistic regression, The Barthel Index (BI) was significantly correlated with the postoperative ICU survival in elderly patients following elective major abdominal surgery (OR = 1.33, 95% CI: 1.20–1.47, P = .02). The area under the receiver operating characteristic (ROC) curve of Barthel Index in predicting postoperative ICU survival was 0.704 (95% CI, 0.638–0.771). Kaplan–Meier survival curve in BI≥30 patients and BI < 30 patients showed significantly different.
Activity of daily living upon admission was associated with postoperative intensive care unit survival in elderly patients following elective major abdominal surgery. The Barthel Index(BI) ≥30 was associated with increased postoperative ICU survival. For the elderly with better functional status, they could be given more surgery opportunities. For those elderly patients BI < 30, these results provide useful information for clinicians, patients and their families to make palliative care decisions.
Knowledge about sexually transmitted infections among young men presenting to the Brazilian Army, 2016
Authors: Paganella Machline Paim , da Motta Leonardo Rapone , Adami Aline De Gregori , Sperhacke Rosa Dea , Kato Sérgio Kakuta , Pereira Gerson Fernando Mendes 
Published: June 2021

Abstract
Global burden of sexually transmitted infections (STIs) remains high and has a profound impact on health and lives of children, adolescents and adults worldwide. For over a decade, the Brazilian Department of Chronic Condition Diseases and Sexually Transmitted Infections and the Ministry of Defense have been conducting the Conscripts Survey aiming to assess the STI prevalence and obtain data on knowledge regarding STIs and risk factors among youth.
A cross-sectional study was conducted among conscripts across Brazil aged 17 to 22 years from August to December 2016. It included a self-reported questionnaire containing 74 questions, 25 questions related to awareness and knowledge of STIs and their associated symptoms, routes of transmission, complications and risk factors.
A total of 37,282 young men across Brazil were considered for the analysis. The majority resided in the Northeast and Southeast regions (38.9% and 30.0%, respectively), followed by the South (13.9%), North (9.7%), and Central-west (7.5%) regions. Of the conscripts, 97.2% have the knowledge they may be at risk if they do not use condoms during sex. Conscripts with a higher level of education have almost 2 times greater chance of having knowledge of having sex without a condom (OR 3.23 CI95% 2.82–3.70 P = .000) and sharing needles and syringes (OR 2.84 CI95% 2.62–3.07 P = .000) represents a risk. Those with higher education also have an almost 50% greater chance of having knowledge regarding STI transmission from mother to child (OR 1.54 CI95% 1.44–1.64 P = .000), and knowledge of no transmission by mosquito bite (OR 1.61 CI95%1.51–1.72 P = .000), by kissing (OR 1.45 CI95% 1.36–1.55 P = .000) or by using public toilets (OR 1.51 CI95% 1.41–1.61 P = .000). Television (71.8%) and internet (69.4%) are the preferred forms to obtain STIs information regardless of the level of education.
Conscripts with higher level of education have greater knowledge regarding transmission of STIs. However, there are gaps regarding their knowledge about HIV pre-exposure prophylaxis and the fact that other STIs can increase the chances of acquiring HIV.
Efficacy and safety of acupuncture for urinary retention after hysterectomy
Authors: Zhao Qinyu , Yan Chunchun , Dan Meng , Jia Hongling 
Published: June 2021

Abstract

Objective:
The aim of this study was to evaluate the efficacy and safety of acupuncture in the treatment of urinary retention after hysterectomy in women.

Methods:
This research searched for 6 database documents, and the deadline is July 23, 2020. This study included a randomized controlled trial of women with urinary retention after hysterectomy. These randomized controlled trials compare acupuncture with bladder function training or other nonacupuncture treatments, and measure urodynamics, effectiveness (BR), and urinary tract infection rates (UIR). Four independent reviewers participated in data extraction and evaluation. Assess the risk of bias in each article, and conduct a meta-analysis according to the type of acupuncture. The result is expressed as a mean difference (MD) or relative risk (RR) with a 95% confidence interval (CI).

Results:
The meta-analysis contains 12 studies. Most studies indicate low risk or unknown risk, but the GRADE scores of the combined results show low or moderate levels. After the combined analysis, we found that acupuncture versus bladder function exercise and other nonacupuncture therapies can significantly improve the values of post voided residual urine (PVR) (MD = −25.29; 95% CI [−30.45 to −20.73]), maximal cystometric capacity (MD = 39.54; 95% CI [10.30–68.78]), bladder capacity for first voiding desire (MD = −61.98; 95% CI [−90.69 to −33.26]) and maximal flow rate (MFR) (MD = 7.58; 95% CI [5.19–9.97]). And compared with the control group, acupuncture still has advantages in BR (RR = 1.36; 95% CI [1.18–1.56]) and UIR (RR = 0.22; 95% CI [0.08–0.82]). These heterogeneities have been resolved through subgroup analysis, and their main sources are related to different intervention times, the time to start the intervention, and different PVR requirements.

Conclusions:
There is insufficient evidence that acupuncture can increase the patient's MFR, BR, and UIR. However, acupuncture can effectively improve the PVR, maximal cystometric capacity, and bladder capacity for first voiding desire values of patients with urinary retention after hysterectomy. Although limited due to the quality and methodological limitations of the included studies, acupuncture can still be used as an effective and safe treatment for women with urinary retention after hysterectomy.

Registration:
The research has been registered and approved on the PROSPERO website. The registration number is CRD42019119238.
Effects of chromosomal abnormalities on pregnancy outcomes in female undergoing artificial insemination with donor's sperm
Authors: Liu Yu , Sun Tingting , Jiang Ronghua , Chen Ruiling , Liu Xiaoling , Chen Qiao , Song Ge 
Published: June 2021

Abstract
This study aimed to evaluate the clinical characteristics, pregnancy outcomes and prognostic factors for pregnancy of female with chromosomal abnormalities (CAs) after artificial insemination with donor's sperm (AID) treatment.
A retrospective case–control study was analyzed by using the data of 29 female patients with CA and 116 controlled patients with normal karyotype (1:4 ratio) who underwent AID cycles at Guangdong Family Planning Special Hospital from January 2011 to December 2017. In all cases, reproductive histories were collected, and the cytogenetic analysis was performed by Trypsin-Giemsa banding and karyotyping. The embryos were fertilized via intracervical or intrauterine insemination. Clinical characteristic variables were compared.
The prevalence of CA was found to be 0.29% in the whole AID population. The live birth rates of CA group and controlled group were 41.4% and 31.0% (P = .29) respectively. Compared to normal karyotype group, patients with CA showed higher rate of primary infertility (93.1% vs 75.9%, P = .049); Multivariate analysis demonstrated that ovarian stimulation (odds ratio, 3.055; 95% confidence interval, 1.421–6.568; P = .004) was associated with adverse pregnancy outcomes in female patients with AID treatment.
For the infertility CA patients who were phenotypically normal, AID was a suitable choice, whereas ovarian stimulation results in an improvement in the pregnancy rate.
Medial cortical positive support
Authors: Shi Xuchao , Han Mingyuan , Dai Bo 
Published: June 2021

Abstract
Treatments for proximal humerus fractures (PHFs) often fail to achieve anatomical reduction. The purpose of this study was to evaluate the role of positive medial cortical support (PMCS) in the nonanatomical reduction of PHFs.
A retrospective analysis was performed of 78 patients with PHFs who underwent surgery from August 2014 to September 2017 and whose treatments did not achieve anatomical reduction. Based on the results of standard AP radiographs of the shoulders 3, 6, and 12 months after surgery, the patients were divided into PMCS or negative medial cortical support (NMCS) groups. The postsurgical change in head-shaft angle (HSA) between the 2 groups was compared. Shoulder joint function and visual analog scale (VAS) scores of the 2 groups were also compared at the same time.
Of the 78 patients analyzed, 37 were in the PMCS group and, 41 in the NMCS group. There was no statistically significant difference in any of the characteristics of the 2 groups (P > .05), or in postsurgical HSA. However, the HSA of the 2 groups had become significantly different (P < .05) 3, 6, and 12 months following surgery. The changes in HSA of the 2 groups were different at various time points (P < .05). One year after surgery, the shoulder function score of the PMCS group was significantly better than that of the NMCS group, as was the VAS score (both P < .05).
Patients whose surgery for PHF does not achieve anatomical reduction during surgery can undergo PMCS to achieve improved results, postoperatively. NMCS should be avoided as far as possible.
A case report of CLIPPERS syndrome and literature review
Authors: Zhang Lei , Zhao Dan , Li Jia , Feng Jingqi , Zhang Qinghui , Liu Li , Liu Jingxin , Chen Jiajun 
Published: June 2021

Abstract

Rationale:
Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a chronic inflammatory disorder of the central nervous system. It is characterized by the appearance on magnetic resonance imaging of punctate and curvilinear gadolinium enhancement in the pons and cerebellum, and is exquisitely responsive to steroid treatment. The etiology of CLIPPERS remains unclear, although its pathogenesis reflects immune-mediated processes. The accurate diagnosis of this disease is very important for both its management and prognosis.

Patient concerns:
A 43-year-old woman presented with clinical and radiological features suggestive of CLIPPERS. Whole-exome sequencing of the patient's DNA revealed 76 mutations.

Diagnoses:
The patient was clinically diagnosed with CLIPPERS.

Interventions:
Hormone therapy was administered intravenously upon hospitalization and then gradually reduced to an oral dose.

Outcomes:
The clinical symptoms and imaging manifestations of the patient improved rapidly. This patient was followed up for more than 1 year, and there has been no recurrence or aggravation.

Lessons:
A gene variation library of CLIPPERS syndrome was established, which lays the foundation for the further accumulation of data, and will allow the etiology and pathogenesis of the disease to be explored.