bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stent insertion with high-intensity focused ultrasound ablation for malignant biliary obstruction
Authors: Cai Peng-Fei , Gu Hong , Zhu Lei-Juan , Xu Yuan-Shun , Deng Hong-Yan 
Published: January 2021

Abstract

Background:
This meta-analysis was conducted in order to understand the clinical efficacy of stent insertion with high-intensity focused ultrasound (HIFU) ablation for the treatment of malignant biliary obstruction (MBO).

Methods:
The Pubmed, Embase, and Cochrane Library databases were searched for all relevant studies published through July 2020. The meta-analysis was conducted using RevMan v5.3, with analyzed study endpoints including the rate of stent dysfunction, time to stent dysfunction, stent patency, complication rate, and overall survival (OS).

Results:
In total, 35 potentially relevant studies were initially identified, of which 6 were ultimately included in the present meta-analysis. These 6 studies included 429 MBO patients that were treated either only via stenting (n = 221) or via stenting in combination with HIFU ablation (n = 208). Pooled stent dysfunction rates in the stent and stent with HIFU groups were 25.9% and 18.0%, respectively (OR: 1.59; 95% CI: 0.88, 2.84, P = .12). The average time to stent dysfunction was significantly longer in the stent with HIFU group relative to the stent group (MD: −3.15; 95% CI: −3.53, −2.77, P < .0001). Pooled complication rates in the stent and stent with HIFU groups were 17.1% and 19.6%, respectively (OR: 0.88; 95% CI: 0.49, 1.58, P = .67). Stent patency and OS were both significantly longer in the stent with HIFU group relative to the stent group (P < .0001 and.0001, respectively). Funnel plot analyses did not reveal any significant evidence of publication bias linked to the selected study endpoints.

Conclusions:
This meta-analysis found that a combined stenting and HIFU ablation approach can achieve better stent patency and OS in MBO patients relative to stent insertion alone.
Covered vs bare stent for distal malignant biliary obstruction due to primary common biliary cancer
Authors: Tang Ling , Bao Kai-Hu , Xu Yuan-Shun , Liu Peng-Hui 
Published: January 2021

Abstract
This study was designed as a means of comparing the clinical efficacy and long-term outcomes of covered vs bare stent insertion as a treatment for distal malignant biliary obstruction (DMBO) caused by primary common biliary cancer (PCBC).
This retrospective study was designed using data collected between January 2012 and December 2019 to assess the short- and long-term outcomes in patients with DMBO caused by PCBC treated by inserting either bare or covered stents were compared.
Ninety two patients with DMBO caused by PCBC were divided between bare (n = 51) or covered (n = 41) stent groups. Technical success rates in both groups were 100%. Clinical success of bare vs covered stent use were 96.1% and 97.6% (P = 1.00). Stent dysfunction was seen in 17 and 6 patients in the bare and covered stent groups, respectively (P = .04). The median stent patency for bare and covered stents was 177 and 195 days, respectively (P = .51). The median survival was 188 and 200 days in the bare and covered stent groups, respectively (P = .85).
For patients with DMBO caused by PCBC, using bare vs covered stents yields similar clinical efficacy and long term outcomes.
Changes in fasting bile acid profiles after Roux-en-Y gastric bypass and sleeve gastrectomy
Authors: Zhang Chunlan , Zhang Jingjing , Zhou Zhiguang 
Published: January 2021

Abstract

Background:
Bile acid is an essential factor that plays a role in metabolic regulation, but how bile acid is regulated after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) remains unclear. This meta-analysis aimed to investigate changes in the levels of fasting bile acids following RYGB and SG.

Methods:
A systematic literature search of the PubMed, EMBASE, Cochrane Library and Web of Science databases through July 2020 was performed in accordance with the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The concentrations of bile acids were evaluated.

Results:
Thirteen studies with 289 patients were included. Our results showed that patients who underwent RYGB had increased levels of fasting total bile acids, primary bile acids, secondary bile acids, conjugated bile acids, and unconjugated bile acids, but no significant differences in all these bile acid levels were observed in patients who underwent SG. Furthermore, 12a-hydroxylated bile acid levels and the 12a-hydroxylated/non-12a-hydroxylated bile acid ratio also increased following RYGB.

Conclusion:
In this study, we found that fasting bile acid levels, especially 12a-hydroxylated bile acids levels, were increased after RYGB. However, no differences in fasting bile acid levels were observed following SG.
Impact of regulatory T cells on the prognosis of hepatocellular carcinoma
Authors: Shi Xinhui , Li Qisong , Wang Yungang 
Published: January 2021

Abstract

Background:
This meta-analysis aimed to systematically review current available literature to assess the impact of regulatory T cells (Tregs) on the prognosis of hepatocellular carcinoma (HCC).

Methods:
We will browse the online databases of PubMed and Cochrane Library. The summary hazard ratio (HR) and their 95% confidence intervals (CIs) will be combined to present the value reported in the study.

Conclusion:
Our meta-analysis will provide useful guidance in treatment of HCC based on the reported evidences regarding the impact of Tregs on the prognosis of HCC.

OSF registration number:
10.17605/OSF.IO/3Q8PW
Efficacy and safety of montelukast for pediatric obstructive sleep apnea syndrome
Authors: Bao Jun-Li , Xinyuan-Gao  , Han Yu-Bo , Zhang Ke , Liu Li 
Published: January 2021

Abstract

Background:
Pediatric obstructive sleep apnea syndrome (OSAS) is significant public concern. Clinical practice indicates that montelukast has certain therapeutic advantages, while there is a lack of evidence-based medicine support. The aim of this study is to synthesize related data to explore efficacy and safety of montelukast for pediatric OSAS.

Methods:
Data in Pubmed, EMBASE, CENTRAL, CBM, CNKI, WanFang, VIP databases were comprehensively searched. All the randomized controlled trials (RCTs) in OSAS children were identified, in which the effects of montelukast on a range of outcomes were compared. The search had a deadline of January 1, 2020. Two investigators independently conducted data extraction and assessed the literature quality of the included studies. The Revman5.3 software was used for meta-analysis of the included literature.

Results:
The efficacy and safety of montelukast in the treatment of pediatric OSAS were evaluated in terms of apnea hypopnea index (AHI), the Pittsburgh Sleep Quality Index, the Epworth Sleep Scale (ESS), neck circumference, important index in Polysomnography: sleep efficiency, desaturation index, total sleep time.

Conclusions:
This study provides reliable evidence-based support for the clinical application of montelukast in the treatment of pediatric OSAS.

PROSPERO registration number:
CRD42020146940.
Computed tomography-guided cutting needle biopsy for lung nodules
Authors: Zhang Hui-Mei , Huo Xiao-Bing , Wang Hua-Long , Zhang Xiao , Fu Yu-Fei 
Published: January 2021

Abstract
We aim to compare the diagnostic accuracy, safety, and radiation exposure between low-dose and standard-dose computed tomography (CT)-guided cutting needle biopsy (CNB) for lung nodules.
From January 2016 to August 2017, all consecutive patients admitted with lung nodule underwent low-dose or standard-dose CT-guided CNB procedure in our center. Diagnostic accuracy and radiation dose were compared.
A total of 67 and 69 patients who underwent low-dose and standard-dose CT-guided CNB procedure were included in this study. Each patient underwent CT-guided CNB for 1 nodule. The technical success rates were 100% in both groups. The sensitivity, specificity, and overall diagnostic accuracy were 97.7%, 100%, and 98.5% for low-dose group and 91.5%, 100%, and 94.2% for standard-dose group. There was no significant difference in diagnostic accuracy (P = .380) between 2 groups. Pneumothorax was found in 8 and 15 patients in the low-dose and standard-dose groups, respectively (11.9% vs 21.7%, P = .127). Hemoptysis was found in 10 and 10 patients in the low-dose and standard-dose groups, respectively (14.9% vs 14.5%, P = .943). The mean dose-length product was 38.2 ± 17.2 mGy-cm and 375.3 ± 115.7 mGy-cm in the low-dose and standard-dose groups (P < .001). The mean dose-length product was 38.2 ± 17.2 mGy-cm and 375.3 ± 115.7 mGy-cm in the low-dose and standard-dose groups, respectively (P < .001). The mean effective dose was 0.5 ± 0.2 mSv and 5.3 ± 1.6 mSv in the low-dose and standard-dose groups, respectively (P < .001).
Low-dose CT-guided CNB of lung nodules significantly decreased radiation dose compared with standard-dose CT. The low-dose protocol could provide similar diagnostic accuracy and safety as standard-dose CT-guided CNB for lung nodules.
Retinitis pigmentosa sine pigmento masqueraded as myopia
Authors: Lu Yi , Sun Xiaodong 
Published: January 2021

Abstract

Introduction:
Retinitis pigmentosa is a major cause of visual disability and blindness. Photopsia is usually presented in patients with retinal traction caused by posterior vitreous detachment in clinic, which would occur more commonly in those suffer from moderate or high myopia. We describe a patient with leopard-like retinopathy initially complaining of photopsia caused not by myopia but by retinitis pigmentosa.

Patient concerns:
A 39-year-old woman with a history of moderate myopia presented to us complaining of photopsia for several days.

Diagnosis:
Fundus examination revealed leopard-like retinopathy with normal optic disc and macula appearance in both eyes. The atrophy of retinal pigment epithelium was found in peripheral retina while no bone spicule was present. Retinal multimodal imaging helped in the correct diagnosis of retinitis pigmentosa (sine pigmento), later confirmed by genetic testing.

Interventions:
At current no specific treatment was applied, but the patient was required for follow-up observation every six months.

Outcomes:
Follow-up observation

Conclusion:
This case highlights the potential for retinitis pigmentosa sine pigmento to present with photopsia under cover of myopia and the importance of performing multimodal imaging including fundus autofluorescence for fundus disorders. Careful history review and multimodal imaging with genetic testing would help for the correct diagnosis of retinitis pigmentosa sine pigmento.
A case report of pulmonary artery sling and situs inversus incompletes
Authors: Xu Yingchun , Xu Dan , Cheng Beilei , Tang Lanfang , Chen Zhimin , Du Lizhong 
Published: January 2021

Abstract

Rationale:
Pulmonary artery sling (PAS) is a rare congenital anomaly. Associated airway anomalies and/or those of the cardiovascular system are present in about half the patients. Situs inversus is a rare disease in which organs of the chest and/or abdomen are arranged in a mirror image reversal of their normal position. Herein, we report a rare case of pulmonary artery sling and situs inversus incompletus, which has not yet been reported.

Patient concerns:
A 10-year-old girl was admitted because of heart murmur for more than 9 years. On physical examination, the second heart sound was prominent, and a grade 2/6 systolic murmur was heard at the left mid-sternal border. Echocardiography revealed PAS and atrial septal defect (8.6 mm). A chest computer tomography angiograph demonstrated that she had lung inversus, right aortic arch, and right lung hypoplasia in addition to PAS, with a normal positioning of the heart. The PAS intersected and twisted across the bronchus, which was obviously narrowed. The PAS was type II B, since the carina was at the T6 level without a separate right upper lobe bronchus.

Diagnoses:
Her final diagnosis was that of PAS, tracheal stenosis, situs inversus incompletus, right lung hypoplasia, right aortic arch, ASD and PDA.

Interventions:
She underwent one-stage total correction for her initial cardiovascular defects through median sternotomy under cardiopulmonary bypass support.

Outcomes:
She had an uneventful recovery and completely healthy following the procedure.

Lessons:
A thorough examination before PAS surgery was essential in discovering and carefully evaluating complicated heart and lung anomalies.
Life-threatening bleeding in a patient with pemphigoid-induced acquired hemophilia A and successfully treated with rituximab and rFVIIa
Authors: Ma Hongbing , Chang Hong 
Published: January 2021

Abstract

Rationale:
Acquired hemophilia A (AHA) is a rare bleeding disorder with prolonged activated partial thromboplastin time (aPTT). Severe hemorrhage may occur, especially in refractory AHA.

Patient concerns:
We reported a 63-year-old man who suffered from life-threatening bleeding after the onset in lower limbs.

Diagnoses:
The patient was diagnosed as AHA which was related to pemphigoid.

Interventions:
The patient had no response to the first-line treatment with corticosteroid and cyclophosphamide. Meanwhile, fatal hemorrhage occurred successively in thoracic cavity and right frontal lobe. rFVIIa and rituximab were administered.

Outcomes:
The patient survived from the life-threatening hemorrhage with a normal aPTT. His aPTT and FVIII:C level was normal during the follow-up of 6 months.

Lessons:
Rituximab and rFVIIa can play a critical role in rescuing AHA that is refractory to the first-line treatment.
Granulomatosis with polyangiitis with obstructive pneumonia progressing to hypertrophic pachymeningitis
Authors: Hayashi Keigo , Watanabe Haruki , Yamamura Yuriko , Asano Yosuke , Katayama Yu , Hiramatsu-Asano Sumie , Ohashi Keiji , Morishita Michiko , Narazaki Mariko , Matsumoto Yoshinori , Sada Ken-Ei , Wada Jun 
Published: January 2021

Abstract

Rationale:
Bronchial involvement alone is a rare initial manifestation of granulomatosis with polyangiitis (GPA). Herein, we report a case of refractory GPA with obstructive pneumonia caused by bronchial involvement.

Patient concerns:
A 65-year-old man complained of a 2-week cough and fever.

Diagnoses:
Considering the presence of opacities and multiple consolidations in both lungs due to obstruction or stenosis on the bronchus, which did not respond to antibiotics, and proteinase-3-antineutrophil cytoplasmic autoantibody positivity, he was diagnosed with GPA. Positron emission tomography- computed tomography scan revealed no abnormal findings in the upper respiratory tract.

Interventions:
He was treated with prednisolone (PSL, 50 mg/d) and intravenous cyclophosphamide.

Outcomes:
His general and respiratory symptoms improved. However, 8 weeks after PSL treatment at 20 mg/d, he developed a relapse of vasculitis along with sinusitis and hypertrophic pachymeningitis. Hence, PSL treatment was resumed to 50 mg/d, and weekly administration of rituximab was initiated. Consequently, the symptoms gradually mitigated.

Lessons:
GPA with bronchial involvement is often intractable and requires careful follow-up, which should include upper respiratory tract and hypertrophic pachymeningitis assessment.
Simultaneous ipsilateral distal radius and radial head fractures
Authors: Park Il-Jung , Sur Yoo Joon , Kim Jongmin , Jeon Jin Hwa , Park Ho Youn 
Published: January 2021

Abstract

Rationale:
Distal radius fracture with simultaneous ipsilateral radial head fracture is a very rare pattern of injury. This type of injury is referred to as ‘radius bipolar fracture’. Treatments for this injury pattern can be challenging because both the wrist and elbow need to be considered. There are currently no guidelines for the treatment of this specific type of injury. We report two cases of this unusual pattern of injury treated in our hospital.

Patient concerns:
Case 1 was a 78-year-old female patient and case 2 was a 19-year-old female patient who visited our emergency department with left elbow and wrist pain after slipping and falling.

Diagnosis:
Plain radiography and computed tomography revealed radius bipolar fracture. Case 1 had an AO type C3 distal radius fracture, a Mason type III radial head fracture. Case 2 had an AO type B2 undisplaced distal radius fracture and a Mason type III radial head fracture.

Interventions:
In case 1, open reduction and internal fixation (ORIF) was performed for the distal radius fracture and radial head replacement arthroplasty for the radial head fracture. In case 2, distal radius fracture was treated conservatively and ORIF was performed for the radial head fracture.

Outcomes:
Bony union as achieved in both cases. At 1-year follow-up, case 1 showed slight limited range of motion of the wrist. Case 2 showed no radius shortening and full range of motion of the wrist and elbow. The Quick disabilities of the arm, shoulder and hand score was 18 and 16, respectively.

Lessons:
After this type of injury, the radius length can be changed, and as a result, ulnar variance can be affected. When radial head replaced is considered, it would be better to operate on the wrist first, and then perform radial head replacement. In this way, radiocapitellar overstuffing or instability can be prevented. However, if ORIF is planned for proximal radius fracture, either the proximal or distal radius can be fixed first. Surgeons should try to preserve radial length during treatment to optimize patient outcomes.
Acupoint for angina pectoris
Authors: Jiang Li , Deng Zhaoxia , Zhang Hongcai , Li Yuan , Wang Tingting , Xie Wen 
Published: January 2021

Abstract

Introduction:
Patients with angina pectoris (AP) often experience heavy psychological distress, especially anxiety and depression, which results in poorer quality of life, shorter survival time. Acupoint therapies, including massage, acupuncture, acupoints injection, acupressure, and moxibustion, showed clinical and long-lasting benefits for AP, but the efficiency of acupoint therapies was poorly evaluated. The current review is attempted to evaluate the efficacy and safety of the different acupoint-based therapies for AP.

Methods and analysis:
A literature search will be conducted in MEDLINE, EMBASE, Web of Science, Cochrane Library, Web of Science, PubMed, Science Direct, Wan Fang Data Knowledge Service Platform, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP database), and China National Knowledge Infrastructure (CNKI). Observational studies regarding the association between liver cancer and depression and anxiety written in English or Chinese will be included. Study inclusion, data extraction, and quality assessment will be performed independently by 2 reviewers. We will use RevMan V.5.0 and STATA V.12.0 software for statistical analysis. The I
2 test will be used to identify the extent of heterogeneity. Publication bias will be assessed by generating a funnel plot and performing the Begg and Egger test. The quality of the systematic review will be evaluated using the Measurement Tool to Assess Systematic Reviews (AMSTAR) and Grading of Recommendations Assessment Development and Evaluation (GRADE) criteria. With the permitted numeric data, we will carry out a meta-analysis.

Results:
This study will provide a high-quality synthesis of pain VAS and functional disability or the quality of life, the success treatment rate, the recurrent rate and the complications rate to assess the effectiveness and safety of acupoint for AP patients. This systematic review will provide evidence to judge whether acupoint is an effective intervention for patients with AP.

Conclusion:
This systematic review and meta-analysis will provide evidence to judge whether acupoint is an effective intervention for patients with AP and provide evidence for designing early targeted interventions for high-risk survivors that can attenuate negative reactions.

PROSPERO registration number:
10.17605/OSF.IO/VNXWE.
Arthroscopic-assisted bone grafting and percutaneous K-wires fixation for the treatment of scaphoid nonunion in the skeletally immature patient
Authors: Lee Young-Keun , Kim Ki-Bum 
Published: January 2021

Abstract

Rationale:
The treatment methods of pediatric scaphoid nonunion are still controversial. To our knowledge, arthroscopic-assisted treatments for pediatric scaphoid nonunion has not been reported in the English-language literature. Therefore, the purpose of this study is to report the use of arthroscopic-assisted bone grafting for scaphoid nonunion fracture in 3 patients and present a literature review.

Patients concerns:
Two 15-year-old patients developed carpal joint injuries over a year, prior to their hospital presentation, since they had not received adequate treatment. The third patient, 12 years of age, was diagnosed with scaphoid fracture after a traffic accident and underwent conservative treatment but presented to the hospital due to issues related with bone union.

Diagnosis:
All 3 patients were diagnosed with scaphoid nonunion at our hospital, using plain wrist radiographs and computed tomography.

Interventions:
All the patients underwent arthroscopic debridement; 2 patients received autogenous iliac cancellous bone graft, while the other patient received a bone substitute graft. The internal fixation of the scaphoid was performed with K-wires.

Outcomes:
Bone unions were achieved in all patients, and the final follow-up resulted in successful outcomes.

Lessons:
Arthroscopic-assisted bone grafting and percutaneous K-wire fixation can be considered as a good method for the treatment of pediatric scaphoid nonunion fractures. Therefore, it is a primary treatment option for symptomatic scaphoid nonunion fracture and displaced fractures.
Medium and long-term complications difference between laparoscopic transcystic common bile duct exploration versus endoscopic sphincterotomy against choledocholithiasis
Authors: Liu Quanxin , Li Tao , Feng Zhangdong , Han Wei 
Published: January 2021

Abstract

Background:
Common bile duct stone (CBDS) is typically manifested with abdominal pain, chills, fever, and jaundice. Laparoscopic transcystic common bile duct exploration (LTCBDE) and endoscopic sphincterotomy (EST) are currently the main minimally invasive methods for the treatment of CBDS. However, there are few studies about the differences of medium and long-term complication after EST or LTCBDE. Therefore, we will conduct a meta-analysis and systematic review to systematically evaluate the difference of medium and long-term complications between EST and LTCBDE against CBDS.

Methods:
Randomized controlled trials of EST or LTCBDE against CBDS will be searched in several English and Chinese databases with the following vocabularies: “laparoscopic transcystic common bile duct exploration,” “endoscopic sphincterotomy,” “choledocholithiasis,” “common bile duct stone” until December, 2020. Two reviewers will independently conduct the literature extraction, risk of bias assessment, and statistical analysis.

Results and Conclusions:
The study will help to systematically evaluate the difference of medium and long-term complication between EST and LTCBDE against CBDS.

OSF Registration number:
DOI 10.17605/OSF.IO/5U7SA.