bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative study of verbal rating scale and numerical rating scale to assess postoperative pain intensity in the post anesthesia care unit
Authors: Lee Ho-Jin , Cho Yongjung , Joo Hyundeok , Jeon Jae Yeong , Jang Young-Eun , Kim Jin-Tae 
Published: February 2021

Abstract
Postsurgical patients usually have difficulty in answering the self-report pain scales due to the residual effects of anesthetic or sedative agents in the post-anesthesia care unit (PACU). A comparative analysis of pain assessment tools used in the PACU is lacking.
In this prospective observational study, we compared the intensity of pain using the 11-point numeric rating scale (NRS) and the 4-category verbal rating scale (VRS) thrice, 5 minutes after PACU admission, 20 minutes after the first assessment, and just before discharge from the PACU in 200 patients undergone surgery. Spearman rank correlation analysis was used to investigate the correlation between 2 scales, and the weighted kappa (κ) coefficient was performed to evaluate inter-scale reliability. Response rates of the 2 scales were also compared.
VRS and NRS were highly correlated during all 3 comparisons (r = 0.767, 0.714, and 0.653, respectively; P < .0001). Each category of VRS showed a statistically significant difference in pain intensity measured by NRS during all 3 assessments. Inter-scale reliability had a fair strength of agreement for all 3 measurements (weighted κ = 0.519, 95% CI: 0.421–0.618; weighted κ = 0.511, 95% C.I: 0.409–0.613; weighted κ = 0.452, 95% C.I: 0.352–0.551, respectively). VRS showed a higher response rate for PACU patients compared to NRS in all 3 measurements (96% vs 77.5%, 99% vs 81.5%, and 96.5% vs 86.5%, respectively; P < .0001).
In the PACU, VRS is a reasonable and practical pain intensity measurement tool for postsurgical patients, considering the high correlation between VRS and NRS, and a higher response rate.
Massage for simple obesity
Authors: Pang Yazheng , Wang Kai , Chen Shucheng , Huang Tian , Zhang Mengsen , Zhang Bin , Yu Juan 
Published: February 2021

Abstract

Background:
Obesity has become the most serious public health problem in developed and developing countries, and simple obesity accounts for approximately 95% of the total cases. This study aims to assess the effects and safety of massage therapy for the treatment of simple obesity.

Methods:
We will search foreign and Chinese databases, including PubMed, EMBASE, MEDLINE, CENTRAL, CNKI, WanFang Data, CBM, and VIP from the inception of the coverage of these databases to July 2020. Cochrane's collaboration tool will be used to assess the quality of the studies. RevMan 5.3 software will be used for the data analysis.

Results:
This study will evaluate whether massage therapy is an effective intervention for simple obesity.

Conclusion:
This study will provide evidence regarding whether massage therapy is beneficial for treating simple obesity in humans.

PROSPERO registration number:
NO.CRD42020197635.
Chinese herbal medicine for hypertension complicated with hyperlipidemia
Authors: Liu Yinan , Liu Yiqing , Yang Jing , Wang Xue , Xiu Chengkui , Hu Yanhong , Wu Dan , Wu Ye , Lei Yan 
Published: February 2021

Abstract

Background:
Hypertension combined with hyperlipidemia (HTN-HLP), as a common clinical chronic disease combination, will increase the incidence of cardiovascular and cerebrovascular diseases, increase the occurrence of sudden death and other adverse events. At present, the commonly used therapeutic drugs are mainly combined with antihypertensive drugs and lipid-lowering drugs, which not only have poor compliance, but also have adverse reactions. Currently, traditional Chinese medicine, as a traditional medicine in China, has been applied in clinical practice for thousands of years and has rich clinical experience in treating HTN-HLP. However, there is no systematic evaluation of the efficacy, safety and improvement of patients’ quality of life. This systematic review and meta-analysis will assess studies of the effects and safety of Chinese herbal medicine (CHM) for HTN-HLP patients.

Methods:
We will search PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science (ISI), China National Knowledge Infrastructure, Wan fang Database, Chinese Scientific Journals Full-Text Database (VIP) and China Biological Medicine Database from the time when databases were established to 01, February 2021. After a series of screening, randomized controlled trials (RCTs) will be included related to CHM for HTN-HLP. Two researchers will assess the RCTs through the Cochrane bias risk assessment tool. And the evidence grade of the results will be evaluated by GRADEprofiler software.

Results:
This study will provide a reliable evidence for the efficiency of antihypertensive and reducing blood lipids of CHM for HTN-HLP.

Conclusion:
We will summarize the methods and provide sufficient evidence to confirm the efficacy and safety of CHM for HTN-HLP.

INPLASY registration number:
INPLASY2020110144.
The relationship between CHRNA5/A3/B4 gene cluster polymorphisms and lung cancer risk
Authors: Yi Xingxu , Li Wanzhen , Wang Yiyuan , Chen Xueran , Ye Fang , Sun Gengyun , Chen Jingxian 
Published: February 2021

Abstract

Background:
Genetic polymorphisms in the 15q25 region have been associated with the risk of lung cancer (LC). However, studies have yielded conflicting results.

Methods:
Searches were conducted in databases, including PubMed, EMbase, Web of Science, CNKI, and Wanfang, for case-control studies up to August 1, 2019. After retrieving eligible studies and data extraction, we calculated pooled odds ratios with 95% confidence intervals. In the meta-analysis, we included 32 publications with a total of 52,795 patients with LC and 97,493 control cases to evaluate the polymorphisms in the CHRNA5/A3/B4 gene cluster in the 15q25 region.

Results:
Data of the meta-analysis showed a significantly increased risk of LC in the presence of genetic polymorphisms (rs1051730, rs16969968, rs8034191). In the smoking subgroup, the CHRNA3 rs1051730 polymorphism was found to contribute to LC risk using following 5 models: the allelic model, the homozygous model, the heterozygous model, the dominant model, and the recessive model. Thus, the rs1051730 polymorphism may modify LC susceptibility under the condition of smoking. Stratification studies for CHRNA5-rs8034191 showed that Caucasian groups with the wild-type genotype (C/C) may be susceptible to LC in all 5 models. No significant relationship between CHRNA3 rs6495309 or rs3743073 and LC susceptibility was found. However, Asians with the rs3743037 B-allele showed an obviously higher risk of LC susceptibility than the Caucasian population, observed via allelic, heterozygous, and dominant models.

Conclusions:
The 3 polymorphisms of rs1051730, rs16969968 and rs8034191 in the CHRNA5/A3/B4 gene cluster in the 15q25 region were associated with LC risk, which might be influenced by ethnicity and smoking status.
Successful management and technical aspects of major liver resection in children
Authors: Li Kewei , Jiang Fanwen , Aizpuru Matthew , Larson Ellen L. , Xie Xiaolong , Zhou Rongxing , Xiang Bo 
Published: February 2021

Abstract
Optimal treatment of patients with various types of liver tumors or certain liver diseases frequently demands major liver resection, which remains a clinical challenge especially in children.
Eighty seven consecutive pediatric liver resections including 51 (59%) major resections (resection of 3 or more hepatic segments) and 36 (41%) minor resections (resection of 1 or 2 segments) were analyzed. All patients were treated between January 2010 and March 2018. Perioperative outcomes were compared between major and minor hepatic resections.
The male to female ratio was 1.72:1. The median age at operation was 20 months (range, 0.33–150 months). There was no significant difference in demographics including age, weight, ASA class, and underlying pathology. The surgical management included functional assessment of the future liver remnant, critical perioperative management, enhanced understanding of hepatic segmental anatomy, and bleeding control, as well as refined surgical techniques. The median estimated blood loss was 40 ml in the minor liver resection group, and 90 ml in major liver resection group (P < .001). Children undergoing major liver resection had a significantly longer median operative time (80 vs 140 minutes), anesthesia time (140 vs 205 minutes), as well as higher median intraoperative total fluid input (255 vs 450 ml) (P < .001 for all). Fourteen (16.1%) patients had postoperative complications. By Clavien-Dindo classification, there were 8 grade I, 4 grade II, and 2 grade III-a complications. There were no significant differences in complication rates between groups (P = .902). Time to clear liquid diet (P = .381) and general diet (P = .473) was not significantly different. There was no difference in hospital length of stay (7 vs 7 days, P = .450). There were no 90-day readmissions or mortalities.
Major liver resection in children is not associated with an increased incidence of postoperative complications or prolonged postoperative hospital stay compared to minor liver resection. Techniques employed in this study offered good perioperative outcomes for children undergoing major liver resections.
Cross-sectional study of major procedure codes among hospitalized patients with traumatic brain injury by level of injury severity in the 2004 to 2014 Nationwide Inpatient Sample
Authors: Beydoun Hind A. , Butt Catherine , Beydoun May A. , Hossain Sharmin , Eid Shaker M. , Zonderman Alan B. 
Published: February 2021

Abstract
Despite its public health significance, TBI management across US healthcare institutions and patient characteristics with an emphasis on utilization and outcomes of TBI-specific procedures have not been evaluated at the national level.
We aimed to characterize top 10 procedure codes among hospitalized adults with TBI as primary diagnosis by injury severity.
A Cross-sectional study was conducted using 546, 548 hospitalization records from the 2004 to 2014 Nationwide Inpatient Sample were analyzed.
Data elements of interest included injury, patient, hospital characteristics, procedures, in-hospital death and length of stay.
Ten top procedure codes were “Closure of skin and subcutaneous tissue of other sites”, “Insertion of endotracheal tube”, “Continuous invasive mechanical ventilation for less than 96 consecutive hours”, “Venous catheterization (not elsewhere classified)”, “Continuous invasive mechanical ventilation for 96 consecutive hours or more”, “Transfusion of packed cells”, “Incision of cerebral meninges”, “Serum transfusion (not elsewhere classified)”, “Temporary tracheostomy”, and “Arterial catherization”. Prevalence rates ranged between 3.1% and 15.5%, with variations according to injury severity and over time. Whereas “Closure of skin and subcutaneous tissue of other sites” was associated with fewer in-hospital deaths and shorter hospitalizations, “Temporary tracheostomy” was associated with fewer in-hospital deaths among moderate-to-severe TBI patients, and “Continuous invasive mechanical ventilation for less than 96 consecutive hours” was associated with shorter hospitalizations among severe TBI patients. Other procedures were associated with worse outcomes.
Nationwide, the most frequently reported hospitalization procedure codes among TBI patients aimed at homeostatic stabilization and differed in prevalence, trends, and outcomes according to injury severity.
A double mutation of BRAF L597Q and V600E in situ and solitary brain metastasis of occult papillary thyroid carcinoma
Authors: Chen Ling , Wu Yue , Bai Huili , Liu Huandong , Li Xiaosong 
Published: February 2021

Abstract

Rationale:
The rare BRAF L597Q (c.T1790A) point mutation has been previously reported in childhood acute lymphoblastic leukemia. We present the first rare case of occult papillary thyroid carcinoma with BRAF L597Q mutation in a Tibetan patient.

Patient concerns:
A 57-year-old male patient presented with a protruding mass on the left forehead for 2 years and numbness in the right limb for 3 weeks.

Diagnoses:
The patient had a double mutation of BRAF L597Q and V600E in 2 separate lesions at thyroid and brain, the immunohistochemical staining showed that the cytokeratin (CK), thyroglobulin (Tg) and thyroid transforming factor-1 (TTF-1) were immunoreactive. All the findings supported the diagnosis of solitary brain metastasis of occult papillary thyroid carcinoma.

Interventions:
The patient underwent left frontal lobe metastasis (thyroid cancer) resection that involved craniectomy and artificial skull repair.

Outcomes:
During the 24-month follow-up, no postoperative complications or recurrence and metastasis were found.

Lessons:
This is the first case of solitary brain metastasis of occult papillary thyroid carcinoma with double mutation of BRAF L597Q and V600E in 2 separate lesions reported in the literature. Our study extends the disease spectrum of occult papillary thyroid carcinoma and suggests that the BRAF L597Q mutation might play a specific role in inducing the solitary brain metastasis of occult papillary thyroid carcinoma in a Chinese Tibetan patient, but the detailed molecular mechanism remains to be confirmed by a large number of functional experiments and clinical research.
Exosome as potential biomarkers for gastrointestinal tumors
Authors: Zhang Jinlong , Fu Shudan , Chen Wenshuo , Chen Haijin 
Published: February 2021

Abstract

Introduction:
Exosomes are polyvesicles that are formed by invagination of intracellular lysosomal particles, and are released into the extracellular matrix after the fusion of polyvesicular outer membrane and cell membrane. In the body, immune response, antigen presentation, cell migration, cell differentiation and tumor invasion are closely related to tumorigenesis and tumor progression. This study aimed to conduct a meta-analysis for evaluating the clinicopathological, diagnostic and prognostic significance of exosomal expression in gastrointestinal tumors.

Methods:
The original English articles were systematically searched in the online databases. The diagnostic accuracy, prognostic utility and clinicopathological correlation of gastrointestinal tumors were investigated. The quality assessment for studies of diagnostic accuracy II and Newcastle-Ottawa scale were used for quality evaluation, and the data was strictly extracted to judge the deviation of the study.

Results:
A total of 14 studies with 1837 gastrointestinal tumor patients were included. The change in exosomal expression showed significant correlation with poor clinicopathological parameters (tumor diameter: combined P = .00024394; differentiation: combined P = 2.796e-08; lymphatic metastasis: P = 9.610e-07; distant metastasis: combined P = .00017326; pathological classification: combined P = .00875213; invasion depth: combined P = 3.504e-08) carcinoembryonic antigen (combined P = . 04458857) and tumor location (combined P = .00145983). The difference in the area under the curve between gastrointestinal tumor patients and healthy people showed an area under the curve of 0.89 (95%Cl 0.85–0.91) and heterogeneity of 0.59, 95% CI=[0.55–0.68]. The sensitivity was 0.88 (95%Cl 0.83 mi 0.91), the specificity was 0.72 (95%Cl 0.63 mi 0.80), and the diagnostic odds ratio was 18 (10–33). The results of survival analysis revealed that the abnormally expressed exosomes were significantly correlated with poor overall survival (hazard ratio =2.81, 95% CI: 2.02–3.93, P=0.013∗ 62.7%∗).

Conclusion:
The abnormally expressed exosomes might act as auxiliary biomarkers in diagnosing gastrointestinal tumors and demonstrated good prognostic significance in predicting the survival of patients with gastrointestinal tumors.
The effects of IL-17/IL-17R inhibitors on atherosclerosis in psoriasis and psoriatic arthritis
Authors: Liu Ningyuan , Su Danni , Liu Keshuai , Liu Binbin , Wang Shibo , Zhang Xiaoyan 
Published: February 2021

Abstract

Background:
Psoriasis (PSO) is a systemic inflammatory disorder that presents with erythematous scaling of the skin and is associated with autoimmune dysfunction. Atherosclerosis is one of the major comorbidities of PSO. PSO-associated inflammatory factor IL-17 could lead to vascular endothelial cell injury and atherosclerosis. While some research results show that IL-17 helps stabilize plaque formation. Efficacy and safety on PSO and psoriatic arthritis (PSA) of existing IL-17/IL-17R biologics (secukinumab, ixekizumab, brodalumab, and bimekizumab) have been clinically validated, but whether they can improve atherosclerotic outcomes in psoriatic patients remains controversial.

Methods:
Seven electronic search engines will be searched from inception to December 1, 2020, including PubMed, Embase, Scopus, PsycINFO, Global Health, Web of Science and the Cochrane Library. Clinical trial registries, potential grey literature, relevant conference abstracts, and reference lists of identified studies will also be searched. Literature selection, data extraction, and quality assessment will be done by 2 independent authors. Based on the heterogeneity test, the fixed effect or random effect model will be used for data synthesis. Changes in lung function will be evaluated as the primary outcome. Assessment of symptoms, quality of life, medication use, exacerbations and adverse events will be assessed as secondary outcomes. RevMan V. 5.3.5 (The Nordic Cochrane Centre, Copenhagen, Denmark) will be used for meta-analysis.

Results:
This study will provide a synthesis of current evidence of IL-17/IL-17R inhibitors on atherosclerosis in PSO and PSA.

Conclusion:
The conclusion of our study will provide updated evidence to judge whether IL-17/IL-17R inhibitors is an effective solution to atherosclerosis as comorbidity of PSO and PSA.

PROSPERP registration number:
CRD42020209897
Prenatal detection of a 7q11.21 microdeletion (517–605 kb)
Authors: Zhang Hongguo , Li Leilei , Yu Yang , Li Linlin , Jiang Yuting , Liu Ruizhi 
Published: February 2021

Abstract
In the literature, 7q11 deletion was reported with various abnormalities. However, there were other genetic conditions combined with 7q11.21. It is necessary to have sufficient pure 7q11.21 microdeletions for classifying the pathogenic categories of variation.
Chromosomal karyotyping analysis was performed on cultured amniotic fluid cells. Eighteen pregnant women took chromosomal microarray using prenatal amniotic fluid samples at our center by Affymetrix CytoScan750K_Array. We followed the outcome of these pregnancies and determined postnatal health conditions.
Cytogenetic studies delineated that all patients had normal karyotypes. The exception was P17, who had 47, XN. Single nucleotide polymorphism array results showed 517 to 605 kb deletions of 7q11.21 (chr7: 64543313-65196780) in these cases. The microarray results were pure or combined 7q11.21 microdeletions. In 11 pure 7q11.21 microdeletions and 7 combined cases, there was no apparent abnormal phenotype associated with partial 7q11.21. Among them, only mothers of P10 and P17 decided to terminate the pregnancies due to 18 trisomy or ultrasound abnormal fetal strephenopodia. In the follow-up survey, the newborns had no apparent abnormalities.
In this study, we described 11 pure and 7 combined 7q11.21 microdeletions associating with no apparent postnatal phenotypic abnormalities. From this study, we can learn that the partial 7q11.21 deletion (chr7: 64543313-65196780) might be benign and have no association with human disorders.
Retrospective analysis of the bleeding risk induced by oral antiplatelet drugs during radiotherapy
Authors: Xi Dan , Jiang Wenjie , Shao Yingjie , Song Xing , Chen Yuan , Liu Mengjiao , Gu Wendong , Li Qilin 
Published: February 2021

Abstract
We conducted this retrospective analysis to assess whether oral antiplatelet drugs (APDs) during radiotherapy increase bleeding risk.
Patients who underwent radiotherapy for esophageal cancer (EC) in the Third Affiliated Hospital of Soochow University from January 2015 to December 2019 were screened. After the differences in clinical parameters were eliminated by a propensity-score matched (PSM) analysis at a 1:1 ratio, the thrombocytopenia, consumption of platelet-increasing drugs, suspension of radiotherapy, and bleeding in patients taking APDs were compared with those in the control group.
A total of 986 patients were included in the original dataset. Of these, 34 patients took APDs during radiotherapy. After matching, the APD and control groups each retained 31 patients. There was no significant difference in platelet concentrations between the two groups before radiotherapy (P = .524). The lowest platelet concentration during radiotherapy in the APD group was significantly lower (P = .033). The consumption of platelet-increasing drugs in the APD group was higher than that in the control group (P
< .05). However, there was no significant difference in the average number of days of radiotherapy suspension because of thrombocytopenia (P = .933) and no significant difference in the incidence of bleeding between the two groups (P = .605).
Oral APDs during radiotherapy lead to a further decrease in platelet concentration, but timely and adequate application of platelet-increasing drugs can avoid the increased risk of bleeding and the reduced efficacy of radiotherapy.
The frequency of gastroesophageal reflux when radiofrequency catheter ablation procedures for atrial fibrillation under general anesthesia with a supraglottic device
Authors: Ahn Jin Hee , Park Jiyeon , Jo Jae Seong , Lee Sung Hyun , On Young Keun , Park Kyoung-Min , Oh Eun Jeong , Ko Justin Sangwook , Jeong Ji Seon 
Published: February 2021

Abstract
Gastroesophageal reflux (GER) in radiofrequency catheter ablation (RFCA) occurs due to vagal plexus damage during pulmonary vein isolation. We hypothesized that the frequency of GER in the oropharynx will be less compared to other areas (low-esophagus, mid-esophagus). We confirmed the frequency of GER before and after RFCA in 3 areas.
We studied 30 patients who were scheduled for RFCA under general anesthesia. Anesthesia was performed using supraglottic devices (SGD) with a suction port. Two esophageal temperature probes capable of suction and measuring temperature were inserted through the suction port. The pH of the 3 areas was measured before and after the RFCA at 3 areas (mid-esophagus, low-esophagus, and oropharynx).
GER was observed in 13 of 30 patients (43%). In one patient, it was observed in the oropharynx, in 4 patients it was observed in the mid-esophagus, and in 13 patients, it was observed in the low-esophagus. For patients with GER at the oropharynx and mid-esophagus, it was also observed at the low-esophagus. The difference in the pH before and after the RFCA was not significant at the oropharynx and mid-esophagus (P = .726 and P = .424, respectively), but it was significantly different at the low-esophagus (P < .001). The total ablation time was longer in the GER group compared to the non-GER group (P = .021).
GER after RFCA occurred in 43% of patients, only 1 patient in the oropharynx. And aspiration pneumonia after SGD extubation did not occur. Therefore, the use of SGDs in RFCA does not completely eliminate the possibility of aspiration, so care should be taken.