bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebral large artery occlusion in chronic graft-versus-host disease
Authors: Li Ying , Gao Feng , Sun Wei , Wang Zhaoxia , Jin Haiqiang 
Published: December 2021

Abstract

Rationale:
Cerebral large artery occlusion in chronic central nervous system graft-versus-host disease after allogeneic hematopoietic stem cell transplantation (allo-HSCT) was very scarce. We described a young patient with bilateral white matter lesions and symptomatic internal carotid artery occlusion after allo-HSCT with the history of aplastic anemia.

Patient concerns:
A 17-year-old girl with the history of aplastic anemia developed recurrent headache and sudden hemiplegia of right limbs 2 years after allo-HSCT.

Diagnoses:
She was diagnosed with skin chronic graft-versus-host disease 19 months after allo-HSCT. Brain magnetic resonance imaging showed bilateral subcortical white matter abnormal signals and hyperintensity of left fronto-parietal lobe on diffusion weighted imaging and corresponding hypointense apparent diffusion coefficients indicating acute infarction. CT angiography revealed thrombosis in left internal carotid artery. Carotid plaque high-resolution magnetic resonance imaging showed annular enhancement of vascular wall revealing signs of vasculitis.

Interventions:
Intravenous immunoglobulin, methylprednisolone, and anticoagulant therapy were used to treat the patient.

Outcomes:
The patient's symptoms gradually resolved and she could walk with assistance after 3 weeks before returned home.

Lessons:
Chronic graft-versus-host disease-associated vasculitis could involve cerebral large vessels which warrants further study.
Isolated tuberculosis of the lumbar facet joint
Authors: Wang Linan , Yang Zongqiang , Wang Chaoran , Zhu Xi , Shi Jiandang , Niu Ningkui 
Published: December 2021

Abstract

Rationale:
Spinal tuberculosis (TB) is the most common in bone and joint TB, of which vertebral TB is more common, while accessory TB is rare. The incidence of isolated adnexal lesions in spinal TB is 2% to 3%. It is difficult to distinguish the imaging changes of spinal adnexal TB from other types of spinal infections and spinal tumors, and the pathological diagnosis of spinal TB is often atypical. Here, we report a case of isolated lumbar facet joint TB.

Patient concerns:
A 64-year-old female patient had an 8-month history of low back pain, decreased pinprick sensation in the left anterior middle thigh area, weakening of the patellar tendon reflex of the left lower limb, and enhanced MRI of the lumbar vertebrae showed bone destruction at the left superior and inferior articular process of the lumbar 2 to 3 and the encapsulated calcification containing the lesion around the articular process. The enhanced scan showed solid part and septal enhancement, and the lesion protruded to the left and posterior side of the spinal canal, and the left posterior edge of the dural sac was compressed at the same level. Conservative treatment for 8 months was ineffective.

Diagnoses:
L2–3 vertebral lamina, facet joint, and intraspinal space-occupying Lamina TB.

Interventions:
The diagnostic treatment scheme for anti-TB drugs was routinely administered before the operation. Isoniazid (300 mg), rifampicin (450 mg), ethambutol (750 mg), and pyrazinamide (1500 mg) were administered orally once daily after breakfast for 1 month, as anti-TB treatment for 1 month. Posterior lumbar total laminectomy and decompression, pedicle screw internal fixation, TB focus debridement, lumbar intertransverse process bone graft fusion was performed 1 month later.

Outcomes:
The patient was relieved of symptoms after surgical treatment and anti-tubercular medication.

Lessons:
We present a case of isolated TB of the lumbar facet joint, which was initially diagnosed as L2–3 vertebral lamina, facet joint, and intraspinal space-occupying osteochondroma. For patients with long-term low back pain, it is suggested to follow-up with lumbar computed tomography and lumbar magnetic resonance imaging when conventional X-ray examination does not show any lesion. Despite its rarity, isolated TB of the lumbar facet joint should be highly suspected in elderly patients with pulmonary TB, low-grade fever, and waist pain.
Management of inflammatory bowel disease and serum level of infliximab in newborn exposed to anti-TNF therapy during pregnancy
Authors: de Aragão Maria Cecília , Beraldo Rodrigo Fedatto , Marcondes Mariana Barros , de Barros Jaqueline Ribeiro , Herrerias Giédre Soares Prates , Saad-Hossne Rogerio , Baima Júlio Pinheiro , Sassaki Ligia Yukie 
Published: December 2021

Abstract

Rationale:
Heightened inflammatory bowel disease (IBD) activity during pregnancy is associated with higher rates of preterm birth, miscarriage, and low birth weight. Therefore, its adequate treatment is essential, considering the risk–benefit of medication use. Although previous literature has described the management of IBD during pregnancy, few studies have assessed the pharmacokinetics of IBD drugs in the newborn. In this case report, we describe the management of ulcerative colitis during pregnancy and discuss the benefits of checking serum levels of infliximab in newborns exposed to the medication during pregnancy.

Patient concern:
A 37-year-old patient with ulcerative colitis in clinical and endoscopic remission had been undergoing treated with infliximab since 2008. The patient became pregnant in 2018.

Diagnosis and intervention:
Infliximab medication was discontinued at the 29th week of pregnancy.

Outcomes:
The pregnancy was uneventful, and the levels of infliximab in the umbilical cord were >20 μg/dL. Live vaccinations were postponed until the baby was 6 months old, when a new serum drug level proved to be undetectable.

Lessons:
Our case suggests that the use of infliximab is safe in pregnancy, and drug discontinuation could be considered from the 24th week of pregnancy onward to reduce placental transfer to the newborn in patients at low risk of relapse. Vaccines with live attenuated organisms should be delayed for at least 6 months or until the serum level of the medication is undetectable.
Coping styles play intermediary roles between resilience and clinical communication ability among nursing students in traditional Chinese Medical university
Authors: Li Ling , Hua Rongyu , Yang Lili 
Published: December 2021

Abstract
To prove the positive association between resilience and clinical communication ability among Chinese nursing students, and to determine whether coping styles play a mediating role in the relationship between them.
Four hundred and seventy-one nursing students from a traditional Chinese Medical university were enrolled in this study. They completed some questionnaires, which included the Chinese Version of the Simplified Coping Style Questionnaire (SCSQ), Connor-Davidson Resilience Scale Chinese Version, and Clinical Communication Ability Scale. Structural equation modeling was utilized to analyses the relationships between coping styles, resilience, and clinical communication ability.
Resilience was positively associated with clinical communication ability (P < .01). Coping styles which included positive coping and negative coping both significantly affected clinical communication ability (P < .01) and intermediated the relationship between resilience and clinical communication ability (P < .01).
Resilience is positively related to clinical communication ability among Chinese nursing students, and coping styles intermediated the relationship between them, which may provide scientific evidence to aid in developing intervention strategies to improve interpersonal skills.
Efficacy and safety of Xijiao Dihuang decoction in treating Henoch-Schönlein purpura
Authors: Kong Zhiqian , Zheng Jiaming , Wu Junwei , Ou Jianzhao , Zhou Xinyu , Huang Haiyan 
Published: December 2021

Abstract

Background:
Henoch-Schönlein purpura is one of the most common systemic vascular inflflammatory disease in childhood with purpuric rash, arthritis, renal involvement, and abdominal pain. As a treatment for it, Xijiao Dihuang decoction, a traditional herbal formula, has been used. The object of this systematic review and meta-analysis is to assess the effificacy and safety on Xijiao Dihuang decoction in treating allergic purpura.

Methods:
The following electronic databases will be systematically searched up to November 7, 2019 for eligible studies: The Cochrane Library, Embase, PubMed, Web of Science, the Chinese National Knowledge Infrastructure (CNKI), the Chinese Biomedical LiteratureDatabase (CBM), the Chinese Scientifific Journal Database (VIP), andtheWanfang Database. Thetreatment group in the included studies will receive both routine western medicines and Xijiao Dihuang decoction, while the control group will receive routine western medicines. Data extraction and risk of bias assessments will be conducted by 2 independent reviewers. Heterogeneity will be assessed by I2 statistics, while reporting bias will be evaluated by funnel plots and Begg and Egger test. Sensitivity analysis and Subgroup analysis will be performed when necessary. Review Manager software (RevManV.5.3.0) and Stata will be used for all statistical analyses. Ethics approval is not required as no privacy data were involved. This systematic review and meta analysis will be published in a peer-reviewed journal.

Results:
This study could provide a systematically evaluated therapeutic efficacy and safety of XJDHD on patients with HSP via including RCTs that matches the needs. And we also expect to find predictors of treatment through subgroup analysis, helping patients with HSP detect as well as cope with the disease as early as possible.

Conclusion:
The conclusion of our study will provide the systematical review of the efficacy and safety of XJDHD on patients with HSP, and provide predictors of treatment.

PROSPERO registration number:
PROSPERO CRD 42018111293
Effects of mindfulness-based intervention on adolescents emotional disorders
Authors: Tang Dan-Feng , Mo Li-Qiong , Zhou Xin-Chu , Shu Jun-Hong , Wu Lei , Wang Dong , Dai Fei 
Published: December 2021

Abstract

Background:
The vulnerability of adolescents to emotional disorders such as stress, anxiety, anger, depression, and emotional breakdown is a matter of great concern and urgent need. Studies in several countries and regions have reported higher prevalence of depression, stress, and anxiety in adolescents. Several studies have shown that mindfulness-based interventions have an ameliorative effect on both emotional disorders and psychological problems in adolescents. The purpose of this study is to systematically analyze the effects of mindfulness-based intervention on emotional disorders and psychological problems in adolescents, and to provide a reasonable mindfulness-based intervention program for adolescents with emotional disorders.

Methods:
Electronic databases including Google Scholar, EMBASE, Web of Science, PubMed, the CNKI, the Chinese Science and Technology Periodical Database, VIP, Wanfang, and Cochrane Library. These databases will be searched to identify randomized controlled trials (RCTs) published before October 2021. Only Chinese and English literature will be included. We will use the criteria provided in Cochrane Handbook 5.3.0 for quality assessment and risk assessment and Revman 5.3 software for meta-analysis. The primary outcome are mainly evaluated by PHCSS, SDS and SAS in adolescents.

Conclusion:
The results of this study may provide a strong basis for improving emotional disorders and psychological problems in adolescents.
Systematic review registration: INPLASY2021110054.
The role of serum creatine kinase levels in anterior cervical spinal surgery
Authors: Sang Peiming , Ma Yanyan , Chen Binhui , Zhang Ming 
Published: December 2021

Abstract
This study aimed to describe change trends in serum creatine kinase (CK) values for patients undergoing anterior cervical spinal surgery and identify risk factors that affect the CK values perioperatively, intending to decrease the degree of the iatrogenic invasiveness of the procedure.
We retrospectively analyzed 122 patients undergoing anterior cervical spinal surgery from January 2019 to May 2020. For all patients, CK level was measured 1 day before the operation. Daily CK levels were evaluated on postoperative days 1 to 7. These data were analyzed in terms of age, gender, the use of microendoscopy during surgery, the number of cervical operative segments, and operative methods to determine whether these risk factors influenced postoperative CK increases.
A total of 122 patients were enrolled. The preoperative average CK level was 72.7 U/L, and the average CK levels were 130.6, 122.4, 99.1, 82.8, 73.7, 63.9, and 55.4 U/L from the postoperative day (POD) 1 to POD7, respectively. CK level changes on POD1 increased with the number of operated cervical segments. However, changes were not related to age, gender, microendoscopy, or the operative method.
Increased serum CK level was associated with the number of cervical operative segments, rather than age, gender, the use of microendoscopy, or the operative methods. These findings suggest that the number of cervical operative segments determined the degree of iatrogenic injury for anterior cervical spinal surgery.
Effect of a multi-disciplinary active aging intervention among community elders
Authors: Chi Ying-Chen , Wu Chen-Long , Liu Hsiang-Te 
Published: December 2021

Abstract

Background:
Active aging has been the paradigm of the old-age lifestyle. We aimed to investigate the efficacy of a multi-disciplinary intervention program in community-based elderly.

Methods:
We conducted a 2-arm trial comparing the effectiveness between the study group and the control group. The intervention contents included active aging concepts and preparation, physical activity, health care management, cognitive training, emotional awareness and coping skills, family relationship and resilience, and internet use. A questionnaire tapping into the constructs of the expanded healthy life, mental health, social participation, and active aging was administered at baseline, 7th week, and 19th week.

Results:
The generalized estimating equations analysis revealed that the study group exhibited significant improvements in healthy life, mental health, social participation, and active aging compared with the control group (P < .001).

Conclusions:
This study provided a good evidence supporting the effectiveness of a multi-disciplinary intervention program in improving the cognition of healthy life, mental health status, social participation activities, and active aging. A promotion of similar intervention is recommended.
Prediction of renal function improvement in azotemic patients using glomerular filtration rate from 99mTc-DTPA renal scan
Authors: Yu Hoon , Kim Hyosang , Shin Hyung Soo , Lee Hyo Sang 
Published: December 2021

Abstract
This study aimed to evaluate the ratio of glomerular filtration rate (GFR) from 99mTc-diethylenetriamine-pentaacetic acid dynamic renal scan (GFRSCAN) to estimated GFR (eGFR) as a predictor of renal function improvement in patients with azotemia.
A retrospective review of medical records was conducted to identify consecutive patients with newly discovered or aggravated azotemia who underwent 99mTc-diethylenetriamine-pentaacetic acid renal scan. Significant renal function improvement was defined as ≥100% and ≥10 mL/min improvement of eGFR at 12 weeks compared to eGFR on the day of renal scan (eGFR0). The GFRSCAN/eGFR0 ratio was evaluated as a predictor of significant renal function improvement using logistic regression and receiver operating characteristic (ROC) curve analyses. Added value of the GFRSCAN/eGFR0 ratio in the prediction of significant renal function improvement were demonstrated by adjusting for best clinical predictor variables.
The eligibility criteria were met by 224 patients, among whom 22 patients (9.8%) showed significant renal function improvement. The odds ratios of the GFRSCAN/eGFR0 ratio for predicting significant renal function improvement were 1.76 (95% confidence interval [CI]: 1.26–2.45, P < .001) in the univariable analysis and 1.70 (95% CI: 1.19–2.42, P = .003) after adjusting for clinical variables. The area under the ROC curve of the GFRSCAN/eGFR0 ratio for predicting significant renal function improvement was 0.762 (95% CI: 0.648–0.871). The addition of the GFRSCAN/eGFR0 ratio to the best clinical prediction model raised the area under the ROC curve from 0.726 to 0.794, and this increment was statistically significant (P = .02).
The GFRSCAN/eGFR ratio can predict renal function improvement in patients with azotemia. Future prospective studies are necessary to validate its potential clinical utilities.
Acute aortic occlusion after microendoscopic laminectomy in a patient with lumbar spinal stenosis
Authors: Inoue Hirokazu , Sugaya Akira , Kimura Yuya , Shiraishi Yasuyuki , Sugawara Ryo , Kimura Atsushi , Takeshita Katsushi 
Published: December 2021

Abstract

Rationale:
Acute aortic occlusion is an uncommon disease with a high morbidity and high mortality. Clinical symptoms typically include acute lower limb pain, acute paralysis, and absent pulses. We report a very rare case of acute aortic occlusion causing complete paralysis of bilateral lower limbs following microendoscopic laminectomy.

Patient concerns:
A 64-year-old man with hypertension, hyperlipidemia, diabetes, and atrial fibrillation underwent microendoscopic laminectomy for lumbar spinal stenosis. After the operation, intermittent claudication improved significantly without neurological deficit. However, 7 days later, he developed complete paralysis of the bilateral lower limbs, extreme pain of the bilateral lower limbs, and mottling of the left extremity.

Diagnosis:
An emergency magnetic resonance imaging examination revealed no epidural hematoma behind the spinal cord, proscribing spinal cord compression. Computed tomography revealed occlusion of the infrarenal abdominal aorta. Blood tests revealed high values of total plasminogen activator inhibitor-1 before surgery.

Interventions:
The acute aortic occlusion was verified and underwent thrombectomy and right axillary-bifemoral bypass.

Outcomes:
Following the revascularization, the neurological deficit of the lower limbs improved. On follow-up after 1 year, the muscle strength of the bilateral lower limbs had returned to normal.

Lessons:
This case presentation highlights the necessity of early diagnosis and early revascularization. Moreover, a preoperative high value of plasminogen activator inhibitor-1 may indicate vascular complications including Acute Aortic Occlusion.
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma with squamous differentiation in the posterior nasal septum
Authors: Yi Li , Liu Honglei 
Published: December 2021

Abstract

Rationale:
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is a rare neoplasm characterized by papillary epithelial proliferation and abnormal expression of thyroid transcription factor-1. To our knowledge, squamous differentiation in TL-LGNPPA is an unusual phenomenon, and only 1 case has been reported to date. The tumor occurs mainly on the roof of the nasopharynx. Herein, we report a case of TL-LGNPPA with squamous differentiation located on the posterior nasal septum.

Patient concerns:
A 45-year-old Chinese women presented to our hospital with a complaint of nasal obstruction for 10 years and the symptom has been getting worse for recent 3 years.

Diagnoses:
Microscopic examination of the tumor tissue revealed findings typical of TL-LGNPPA, and in addition to the typical components, squamous differentiation could be found in some areas within the fibrovascular cores of the papillary components. Immunohistochemically, the squamous cells were positive for P40 and P63 but negative for thyroid transcription factor-1.

Interventions:
The patient underwent complete resection of the tumor.

Outcomes:
Follow up results showed that the patient had no recurrence 41 months after removal of the tumor.

Lessons:
Our report anticipates that, although TL-LGNPPA with squamous differentiation in the posterior nasal septum is rare, this report will expand the existing knowledge associated with TL-LGNPPA.
Effectiveness and safety of Shugan Jianpi (SGJP) formula in the treatment of nonalcoholic steatohepatitis (NASH)
Authors: Chen Mingtai , Gu Yanghui , Huang Furong , Zhong Guofu , Men Ling , Liu Qiang , Luan Jienan , Tong Guangdong 
Published: December 2021

Abstract

Background:
It is known that nonalcoholic steatohepatitis (NASH) has been more and more popular in clinical practice. Apart from lifestyle modification, pharmacological therapy treating NASH has still been limited and insufficient. A growing number of studies demonstrated that Shugan Jianpi (SGJP) formula, as a kind of Chinese herbal medicine prescription, could improve blood lipid indexes, liver function, and other clinical measures in NASH patients. Nevertheless, there still has been a lack of study to systematically assess the efficacy and safety of SGJP formula treating NASH. Therefore, it is necessary to conduct this systematic review and meta-analysis.

Methods:
A systematic literature search for articles up to December 2021 will be performed in following electronic databases: MEDLINE, Embase, the Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database Database, Chinese Biomedical Database, Chinese Biomedical Literature Service System, and Wanfang Database. Inclusion criteria are randomized controlled trials of SGJP formula applied on NASH patients. The primary outcome measures will be liver function, blood lipid indexes, ultrasound, or radiological imaging examination. The safety outcome measures will be adverse events and kidney function. RevMan 5.3 software will be used for data synthesis, sensitivity analysis, subgroup analysis, and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias. Stata 12.0 will be used for meta-regression and Egger tests. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence.
Discussion: This study will provide a high-quality synthesis of the efficacy and safety of SGJP for NASH patients.

Ethics and dissemination:
This systematic review does not require ethics approval and will be submitted to a peer-reviewed journal.

Trial registration number:
PROSPERO CRD42021259097.