bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of TCM therapy of tonifying lung–kidney's Qi-deficiency in a case of idiopathic pulmonary fibrosis
Authors: Chen Ming-Jun , Yang Ge-Lliang , Ding Yu-Xuan , Tong Zhan-Qi 
Published: May 2019

Abstract

Rationale:
Idiopathic pulmonary fibrosis (IPF) is a special form of spontaneous, chronic, progressive interstitial fibrotic pneumonia of unknown cause, and treatments for IPF have shown a poor prognosis. This study reports a new treatment, traditional Chinese medicine (TCM) therapy, for tonifying Qi-deficiency of lung–kidney in a 64-year-old patient with IPF.

Patient concerns:
A 64-year-old man, who complained of cough and asthma, was diagnosed as IPF with mild impairment in lung function by thoracic high-resolution computed tomography and pulmonary function test. He received an 18-month N-acetylcysteine monotherapy but had no improvement in lung function.

Diagnoses:
IPF with mild impairment in lung function was diagnosed.

Interventions:
The Chinese herbal medicine composition was decocted in 300 ml water for oral administration with 150 ml decoction twice daily in June 2017.

Outcomes:
The pulmonary function test showed that diffusing capacity for carbon monoxide had increased to 81% of predicted back to normal after 2-month TCM monotherapy. And diffusing capacity for carbon monoxide had increased to 89% of predicted, and forced expiratory volume in 1 s/forced vital capacity ratio increased to 92% at 14-month follow-up. No adverse events occurred during the 14 months of therapy and observation.

Lessons:
The treatment by TCM therapy of tonifying lung–kidney's Qi-deficiency for IPF can improve the pulmonary function and reverse disease progression; it may be considered as a complementary treatment for IPF with mild-to-moderate impairment. However, the insights provided in this case report require further exploration and verification.
Repeat microvascular decompression for patients with persistent or recurrent trigeminal neuralgia
Authors: Cheng Jian , Meng Jinli , Lei Ding , Hui Xuhui 
Published: May 2019

Abstract
Patients with persistent or recurrent trigeminal neuralgia (TN) after microvascular decompression (MVD) are frequently difficult to manage. This study aimed to analyze the safety and efficiency of repeat MVD, with the main focus on prognostic factors and long-term outcomes.
We performed a retrospective study of 41 TN patients (19 men, 22 women) who underwent repeat MVD due to persistent or recurrent pain from January 2008 to January 2016. These patients were followed up from 12 to 96 months (mean, 42 ± 17.3 months). Univariate analysis by Spearman's rank correlation coefficient was used for analysis of prognostic factors.
During the repeat MVD, compression of the trigeminal nerve was noted by an artery in 15 patients (36.6%), vein in 6 patients (14.6%), Teflon in 8 patients (19.5%), and no compression in 12 patients (29.3%). Twenty-one patients (51.2%) had already undergone 1 or more previous ablative procedures, either before the first MVD or between the surgeries. The complete pain relief rates of repeat MVD were 87.8% immediately after surgery and 75% at last follow-up. Thirteen patients (31.7%) had new or increased facial numbness after repeat surgery. Univariate analysis revealed 2 prognostic factors, negative finding during reoperation (P = .021) and no pain relief after the initial surgery (P = .038), that showed a negative influence on success rates after repeat MVD.
Repeat MVD can still achieve an excellent outcome in patients with persistent or recurrent pain. However, the risk of facial numbness is increased. Surgeons should be selective in performing repeat MVD, priority should be given to patients who have a pain-free interval after initial MVD or show demonstrable compression on imaging studies.
Rheumatoid arthritis-like active synovitis with T-cell activation in a case of idiopathic multicentric Castleman disease
Authors: Otsuka Mizuna , Koga Tomohiro , Sumiyoshi Remi , Okamoto Momoko , Endo Yushiro , Tsuji Sosuke , Takatani Ayuko , Shimizu Toshimasa , Igawa Takashi , Kawashiri Shin-ya , Iwamoto Naoki , Ichinose Kunihiro , Tamai Mami , Nakamura Hideki , Origuchi Tomoki , Daisuke Niino , Kawakami Atsushi 
Published: May 2019

Abstract

Rationale:
Idiopathic multicentric Castleman disease (iMCD) is a systemic disease with multiple regions of lymphadenopathy and systemic symptoms and associated with rheumatoid arthritis (RA) and collagen diseases. However, few reported have described the coexistence of iMCD and RA and the mechanisms by which iMCD induces arthritis remain elusive. We experienced a rare case of iMCD, wherein the patient exhibited symptoms of polyarthritis with high-grade fever.

Patient concerns:
A 34-year-old woman was admitted to our hospital for further evaluation of a high fever with polyarthritis. The levels of both rheumatoid factor and anticitrullinated protein antibody were negative. 18F-fluorodeoxyglucose/positron emission tomography-computed tomography showed lymphadenopathy with increased fluoro-2-deoxy-d-glucose uptake. Magnetic resonance imaging and musculoskeletal ultrasonography revealed active synovitis in the hands which was consistent with RA.

Diagnoses:
We diagnosed iMCD based on human herpesvirus 8 negativity, HIV negativity, systemic lymphadenopathy, and pathologic findings of the lymph nodes. The patient did not satisfy the 2010 American College of Rheumatology and European League Against Rheumatism classification criteria for RA. Cytokine assay showed elevated serum levels of interleukin-17 and CXCL10, comparable to those in patients with RA.

Interventions:
We administered 15 mg/d of predonisolone.

Outcomes:
After this treatment, the patient's symptoms showed improvement. As of this writing, we tapered the prednisolone to 7.5 mg/d, and the patient's remission has been maintained for >4 months.

Lessons:
The present case suggests that RA-like active synovitis may coexist in iMCD, resulting from aberrant T-cell activation and histologic examination using lymph node biopsy may help enable early diagnosis of iMCD.
Plasma exchange and rituximab treatments in primary membranous nephropathy combined with crescentic glomerulonephritis
Authors: Lu Hui , Cui Zhao , Zhou Xu-jie , Jin Qi-zhuang , Yu Xiao-juan , Wang Su-xia , Wang Yu , Zhou Fu-de , Zhao Ming-hui 
Published: May 2019

Abstract

Rationale:
Crescent formation is rare in primary membranous nephropathy (MN). Anti-phospholipase A2 receptor (PLA2R) antibodies are detectable in these patients. The mechanism and treatments are unknown.

Patient concerns:
A 72-year-old female patient who presented with nephrotic syndrome, hematuria, and rapidly progressive kidney dysfunction.

Diagnoses:
Kidney biopsy was performed and the diagnosis was MN in combination with crescentic glomerulonephritis. Circulating anti-PLA2R IgG3 and IgG4 were detected of high level.

Interventions:
The patient received plasma exchange and rituximab besides corticosteroids.

Outcomes:
The patient achieved complete remission of proteinuria and recovery of kidney function after the clearance of anti-PLA2R antibodies.

Lesson:
This case suggests a pathogenic role of anti-PLA2R antibodies in the mechanism of crescent formation in MN, which may need intensive therapy to eliminate the antibodies quickly.
Sanao decoction for asthma
Authors: Chen Guoming , Chen Yijun , Chen Ziyin , Gao Shuai , Zhang Peng , Zhang Honghui , Huang Yanfen , Lin Yingtong , Wei Li 
Published: May 2019

Abstract

Background:
Asthma is a chronic inflammatory disease characterized by recurrent attacks of breathlessness and wheezing, which often worsen at night or in the early morning and vary from person to person in severity and frequency. Sanao decoction (SAD), as a traditional Chinese medicine compound, has a long history of clinical application in the treatment of respiratory diseases. Whereas neither systematic nor meta-analysis of randomized controlled articles explain the efficacy of SAD in treating asthma. Therefore, we provide a protocol to evaluate the efficacy and safety of SAD for asthma.

Methods:
From the beginning to December 2018, the following electronic databases will be searched for studies in English or Chinese: the Cochrane Library, Embase, PubMed, Web of Science, the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the Chinese Scientific Journal Database, and the Wanfang Database. Total effective rate, peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC will be measured as primary outcomes. Meta-analysis will be performed using the Stata 15.

Results:
This study will provide the current evidence of asthma treated with SAD from the several points including PEF, FEV1, FVC, and FEV1/FVC.

Conclusion:
The consequence of this summary will furnish proof to evaluate if SAD is effective in the treatment of asthma.

PROSPERO registration number:
PROSPERO CRD42018117923.
Effects of photobiomodulation therapy in aerobic endurance training and detraining in humans
Authors: de Paiva Paulo Roberto Vicente , Casalechi Heliodora Leão , Tomazoni Shaiane Silva , Machado Caroline dos Santos Monteiro , Miranda Eduardo Foschini , Ribeiro Neide Firmo , Pereira Amanda Lima , da Costa Amanda Sampaio , Dias Luana Barbosa , Souza Bianca Cristina Gomes , Aguiar Lino Matheus Marinho , de Carvalho Paulo de Tarso Camillo , Leal-Junior Ernesto Cesar Pinto 
Published: May 2019

Abstract

Introduction:
Over the last 10 years, it has been demonstrated that photobiomodulation therapy (PBMT), also known as phototherapy, using low-level laser therapy (LLLT) and/or light-emitting diode therapy (LEDT) has ergogenic effects, improving athletic performance and also accelerating post-exercise recovery. However, many aspects related to these effects and its clinical applicability remain unknown. Therefore, the aim of this project is to evaluate the ergogenic effects of PBMT in detraining after an aerobic endurance training protocol.

Methods and analyzes:
A randomized, triple-blind, placebo-controlled clinical trial will be carried out. Healthy male volunteers will be randomly distributed into 4 experimental groups: PBMT before and after training sessions + PBMT during detraining, PBMT before and after training sessions + placebo during detraining, placebo before and after training sessions + PBMT during detraining, and placebo before and after training sessions + placebo during detraining. The aerobic endurance training sessions will be carried out using motorized treadmills during 12 weeks, and the detraining period will consist in the next 4 weeks after that. It will be analyzed the time until exhaustion, maximal oxygen uptake (VO2max), and fat percentage of volunteers.

Discussion:
Despite the increasing body of evidence for the use of PBMT as an ergogenic agent, several aspects remain unknown. The findings of this study will contribute to the advance of knowledge in this field regarding clinical applications.

Ethics and dissemination:
This study was approved by the Research Ethics Committee of Nove de Julho University. The results from this study will be further disseminated through scientific publications in international peer-reviewed journals and presentations at national and international scientific meetings.

Trial registration number:
NCT03879226.
Prevalence of mental health problems among medical students in China
Authors: Zeng Wen , Chen Ruiqi , Wang Xingyue , Zhang Qin , Deng Wei 
Published: May 2019

Abstract

Background:
The prevalence of mental health problems in medical students has continuously increased and is higher than the prevalence of mental health problems in students with other majors, which could lead to undesirable consequences for the students and their future patients. In China, the current states of medical education and healthcare workplaces differ in certain areas from those in Western or other Asian countries. However, the mental health status of Chinese medical students has not been systematically analyzed.

Objectives:
The purpose of this meta-analysis was to summarize the prevalence of mental health problems in Chinese medical students.

Methods:
All cross-sectional studies that investigated the prevalence of any mental health problem among Chinese medical students were retrieved from the following databases: EMBASE, PubMed, PsycINFO, OVID, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. We accepted each individual trial's inclusion and exclusion criteria for participants. The National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was adopted to appraise the methodological quality of each study. RevMan (version 5.3) was used to analyze the data.

Results:
Ten cross-sectional studies involving a total of 30,817 Chinese medical students were included. The prevalence of depression, anxiety, suicidal ideation, and eating disorders were 29%, 21%, 11%, and 2%, respectively. Subgroup analysis revealed no significant differences in the prevalence of depression and suicidal ideation between genders and no significant difference in the prevalence of depression between individuals of different ages (20 years and older or younger than 20 years).

Conclusions and implications of key findings:
Chinese medical students have relatively high prevalence of depression, anxiety, and suicidal ideation but a low prevalence of eating disorders. Mental health problems in Chinese medical students should be taken seriously, and timely screening of and proper intervention in these mental health problems are highly recommended.
Relationships among stress, emotional intelligence, cognitive intelligence, and cytokines
Authors: Jung Ye-Ha , Shin Na Young , Jang Joon Hwan , Lee Won Joon , Lee Dasom , Choi Yoobin , Choi Soo-Hee , Kang Do-Hyung 
Published: May 2019

AbstractThe brain has multiple functions, and its structures are very closely related to one another. Thus, the brain areas associated with stress, emotion, and intelligence are closely connected. The purpose of this study was to investigate the multiple associations between stress and emotional intelligence (EI), between EI and intelligence quotient (IQ), between cytokines and stress, and between cytokines and IQ. We measured the stress, EI, cognitive intelligence using IQ, and cytokine levels of 70 healthy subjects. We also analyzed the association of cytokines with IQ according to hemispheric dominance using the brain preference indicator (BPI). We found significant negative correlations between stress and the components of EI, such as emotional awareness and expression, emotional thinking, and emotional regulation. High levels of anger, which is a component of stress, were significantly related to poor emotional regulation. Additionally, emotional application was positively correlated with full-scale IQ scores and scores on the vocabulary, picture arrangement, and block design subtests of the IQ test. High IL-10 levels were significantly associated with low stress levels only in the right-brain-dominant group. High IL-10 and IFN-gamma levels have been associated with high scores of arithmetic intelligence. TNF-alpha and IL-6 were negatively associated with vocabulary scores and full-scale IQ, but IL-10 and IFN-gamma were positively associated with scores on the arithmetic subtest in left-brain-dominant subjects. On the other hand, IL-10 showed positive correlations with scores for vocabulary and for vocabulary and arithmetic in right-brain-dominant subjects. Furthermore, we found significant linear regression models which can show integrative associations and contribution on emotional and cognitive intelligence. Thus, we demonstrated that cytokines, stress, and emotional and cognitive intelligence are closely connected one another related to brain structure and functions. Also, the pro-inflammatory cytokines TNF-alpha and IL-6 had negative effects, whereas the anti-inflammatory cytokines (e.g., IL-10 and IFN-gamma) showed beneficial effects, on stress levels, and multiple dimensions of emotional and cognitive intelligence. Additionally, these relationships among cytokines, stress, and emotional and cognitive intelligence differed depending on right and left hemispheric dominance.
Metal nickel exposure increase the risk of congenital heart defects occurrence in offspring
Authors: Zhang Nannan , Chen Ming , Li Jun , Deng Ying , Li Sheng-li , Guo Yi-xiong , Li Nana , Lin Yuan , Yu Ping , Liu Zhen , Zhu Jun 
Published: May 2019

Abstract

Background:
Previous studies have investigated heavy metal exposure could increase the occurrence of congenital heart defects (CHDs). However, there are limited data regarding the relationship between exposure to nickel and CHDs occurrence in offspring. The aim of this study was to analyze the association between nickel exposure in mothers and the risk of CHDs in offspring.

Materials and methods:
To explore the association of nickel exposure and occurrence of CHD, a case-control study with 490 controls and 399 cases with CHDs in China were developed. The concentrations of nickel in hair of pregnant woman and fetal placental tissue were measured and used a logistic regression analysis to explore the relationship between nickel exposure and risk of CHD.

Results:
The median concentrations of nickel were 0.629 ng/mg, P < .05 (adjusted odds ratio [aOR], 1.326; 95% CI, 1.003–1.757) and 0.178 ng/mg, P < .05 (aOR, 2.204; 95% CI, 0.783–6.206), in maternal hair and in fetal placental tissue in the CHD group, respectively. Significant differences in the level of nickel in hair were also found in the different CHD subtypes including septal defects (P < .05), conotruncal defects (P < .05), right ventricular outflow tract obstruction (P < .01), and left ventricular outflow tract obstruction (P < .05). Dramatically different nickel concentrations in fetal placenta tissue were found in cases with other heart defects (P < .05).

Conclusions:
The finding suggested that the occurrence of CHDs may be associated with nickel exposure.
A meta-analysis of the impact of neutrophil-to-lymphocyte ratio on treatment outcomes after radiotherapy for solid tumors
Authors: Choi Noorie , Kim Jin Ho , Chie Eui Kyu , Gim Jungsoo , Kang Hyun-Cheol 
Published: May 2019

Abstract

Background:
To evaluate the impact of neutrophil-to-lymphocyte ratios (NLR) as a prognostic factor in predicting treatment outcomes after radiotherapy (RT) for solid tumors.

Methods:
PubMed and Embase databases were used to search for articles published by February 2019 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Hazard ratios (HR) with 95% confidence intervals (CI) were used to evaluate the association between NLR levels and treatment outcomes after RT. The primary endpoint was overall survival (OS) rates. Secondary endpoints included progression-free survival, disease-free survival, and disease-specific survival rates.

Results:
Thirty-eight datasets with a total of 7065 patients were included in the meta-analysis. Patients with high pretreatment NLR demonstrated significantly worse OS with a pooled HR of 1.90 (95% CI 1.66–2.17, P < .001). In patients receiving RT alone, the pooled HR for OS was 1.71 (95% CI 1.44–2.04, P < .001) with no between-study heterogeneity (I

2
= 0%, P = .46).

Conclusion:
Elevated pretreatment NLR is associated with poorer survival in cancer patients undergoing RT. Elevated pretreatment NLR prior to RT initiation may be a useful biomarker to predict treatment outcomes and select a subgroup of patients in need of a more aggressive treatment approach.
Safety and feasibility of in-hospital early chemotherapy initiation after surgery in patients with stage II–IV colon cancer
Authors: Kang Jeonghyun , Chong Su-Weon , Park Eun Jung , Baik Seung Hyuk , Lee Kang Young 
Published: May 2019

Abstract
Although it is recommended to initiate postoperative chemotherapy for colon cancer within 8 weeks after surgery, the feasibility and impact of initiating chemotherapy before discharge after surgical resection has not been investigated.
Patients with stage II–IV colon cancer who received postoperative chemotherapy were dichotomized into early (chemotherapy initiation before discharge) and control (chemotherapy initiation after discharge) groups. A multivariable logistic regression model was used to determine factors associated with delayed chemotherapy, defined as more than 6 or 8 weeks after surgery.
From January 2004 to December 2012, of 729 patients with stage II–IV colon adenocarcinoma, 555 patients (76.1%) underwent postoperative chemotherapy. Of them, 181 (32.6%) patients were included in the early group. Time to initiation of chemotherapy was significantly shorter in the early group than in the control group (14.9 days vs 31.5 days, P < . 001). Multivariate analysis revealed that tumor stage and chemotherapy initiation strategy (odds ratio 8.4; 95% confidence interval, 1–66, P = .041) were independent predictors of delayed initiation of chemotherapy at more than 8 weeks. There was no difference in the completion rate of planned chemotherapy cycles between the 2 groups (P > .05).
The strategy of initiating chemotherapy before discharge after surgery is safe and feasible and might reduce the potential delay in chemotherapy initiation in patients with colon cancer.
Excessive physical activity duration may be a risk factor for hypertension in young and middle-aged populations
Authors: Zhu Zhongkai , Feng Tianyu , Huang Yi , Liu Xinglan , Lei Han , Li Ge , Deng Dan , Zhang Nan , Huang Wei 
Published: May 2019

Abstract
Physical inactivity is known to cause many health problems globally each year. However, evidence regarding the interaction between excessive physical activity (PA) and blood pressure in young and middle-aged populations is limited.
A multistage, stratified, random cluster sampling design was adopted to recruit representative samples. Participants were asked to complete a questionnaire and undergo physical examinations. Associations between prehypertension, hypertension and PA durations were examined by multivariable logistic regression.
Overall, 8206 subjects (4110 men, 50.1%) aged 15 to 45 years were enrolled. The prevalence rates of prehypertension and hypertension were 45.7% and 5.0%, respectively. Among the 1913 participants who performed moderate-intensity PA for more than 700 min/wk, 118 had hypertension (6.2%) and 845 had prehypertension (44.2%). Among the 1003 participants who performed vigorous-intensity PA for more than 450 min/wk, 82 had hypertension (8.2%) and 479 had prehypertension (47.8%).
Long-term and sustained PA may increase the risk for hypertension in young and middle-aged subjects. An appropriate recommendation of PA duration should be encouraged in this cohort.