bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of cerebral infarction after transient cerebral ischemic attack by ABCD2 score combined with the position of intracranial vascular stenosis
Authors: Xi Hong-Yan , Si Zhi-Hua , Li Jia-Cheng , Zhu Jian-Guo , Yan Hai-Yan 
Published: April 2019

Abstract
This study aims to investigate the value of the ABCD2 score combined with the position of the offending vessel stenosis in predicting the risk of transient ischemic attack (TIA) to develop into cerebral infarction.
The ABCD2 score and head magnetic resonance imaging + magnetic resonance angiography (MRA) results of 192 patients with TIA were retrospectively analyzed. With the 7th day as the endpoint time, these patients were divided into 3 groups, according to ABCD2 scores: low-risk group (n = 105), moderate-risk group (n = 60), and high-risk group (n = 27). Blood vessels were screened using head MRA results, and patients were accordingly divided into 2 groups: proximal vascular stenosis group (n = 71) and nonproximal vascular stenosis group (n = 171). Then, the association of the position of the intracranial vascular stenosis and ABCD2 score with short-term prognosis was analyzed.
Based on the ABCD2 score, the incidence of cerebral infarction after 1 week was significantly higher in the high-risk group (85.7%) than in the moderate-risk group (16.7%) and low-risk group (1.9%), and the differences were statistically significant (P < .05). When the ABCD2 score was ≥4 points, the incidence of cerebral infarction after 1 week was significantly higher in the proximal vascular stenosis group (59.1%) than in the nonproximal vascular stenosis group (30.8%), and the difference was statistically significant (P < .05). When the ABCD2 score was <4 points, the incidence of cerebral infarction after 1 week in the proximal stenosis group (2%) was not significantly different from that in the nonproximal stenosis group (1.9%, P > .05).
The ABCD2 score combined with proximal offending vessel stenosis can improve the short-term prediction of cerebral infarction in patients with TIA.
The absolute counts of peripheral T lymphocyte subsets in patient with ankylosing spondylitis and the effect of low-dose interleukin-2
Authors: An Haizhuan , Li Xin , Li Fang , Gao Chong , Li Xiaofeng , Luo Jing 
Published: April 2019

Abstract
The aim of this analysis is to investigate the level of T cell subsets in ankylosing spondylitis (AS) and the effect of low-dose interleukin 2 (IL-2).
This is a retrospective cohort study, we collected basic information, inflammatory markers, BASDAI scores, and T lymphocyte subsets of peripheral blood in patients with AS, baseline analysis, correlation analysis and comparative analysis before and after treatment were performed.
Data from 73 patients (of these, 36 patients were treated with IL-2) and 85 the health were included. The absolute numbers of peripheral CD4+ Treg and CD8+ Treg cells were lower, while the Th17 cell number and the ratio of Th17/CD4+ Treg and CD4+/CD8+ Treg were higher. The CD4+ Treg levels and the ratio of Th17/CD4+ Tregs were correlated with BASDAI. The CD4+ Treg, CD8+ Treg, and Th17 cells were increased after treatment with IL-2 and the ratio of Th17/CD4+ Treg was decreased.
Increase in ratio of Th17/CD4+ Treg involved in the occurrence of AS. At the same time, low-dose IL-2 could decrease the ratio of Th17/CD4+ Treg in short time, low-dose IL-2 can be used to treat autoimmune diseases to avoid adverse reactions caused by immunosuppressants. Further clinical study is needed on the efficacy of IL-2.
Factors predicting the colorectal adenoma detection rate in colonoscopic screening of a Chinese population
Authors: Wang Han , Wang Pu , Liu Xiaogang , Li Liangping , Xiao Xun , Liu Peixi , Zhang Di , Li Yi , Xu Guangre , Tu Mengtian , Song Yan 
Published: April 2019

Abstract
Colorectal cancer has high incidence and mortality. Early diagnosis could increase patient survival, but early diagnosis has been poor in China for the past decades. The purpose of this study is to assess the polyp detection rate (PDR) and adenoma detection rate (ADR) by colonoscopy in a Chinese population, and to determine the risk factors for adenoma.
This prospective study at Sichuan Provincial People's Hospital evaluated patients who underwent colonoscopy in September 2017 to February 2018. Basic information, exact insertion and withdrawal times, PDR, and ADR were assessed. Risk factors for colorectal adenoma in the adenoma-positive and adenoma-negative groups (based on pathology) were assessed by multivariable logistic regression analysis.
A total of 1058 procedures with 767 polyps were analyzed. The overall PDR and ADR were 36.96% (391/1058) and 24.67% (261/1058), respectively. Occurrence of adenoma was associated with age, gender, body mass index (BMI), family history of colon cancer, personal history of adenoma, diabetes mellitus, and tobacco use. There was a significant association between withdrawal time and ADR (P < .001). In the multivariable analysis, age (OR = 1.041, 95%CI 1.028–1.055; P < .001), insertion time (OR = 0.999, 95%CI 0.998–1.000; P = .009), withdrawal time (OR = 1.009, 95%CI 1.007–1.011; P < .001), personal history of adenoma (OR = 2.572, 95%CI 1.115–5.932; P = .027), and diabetes mellitus (OR = 2.221, 95%CI 1.084–4.549; P = .029) were risk factors for colorectal adenoma detection.
In a Chinese population, ADR increases with age, withdrawal time, a personal history of adenoma, and diabetes. Age, insertion and withdrawal times, and a personal history of adenoma may independently predict colorectal adenoma detection.
Acupuncture for primary osteoporosis
Authors: Huang Fan , Zhao Siyi , Qiu Mingwang , Li Yitong , Zhan Xiaoxuan , Wu Cunshu , Shi Chushuo , Sun Weipeng , Chen Guizhen , Xu Yunxiang 
Published: April 2019

Abstract

Background:
A large number of randomized controlled trials (RCTs) have shown that acupuncture (ACU) has certain advantages over pharmacotherapies in the treatment of primary osteoporosis (POP). However, due to the diversity of ACU treatments, its relative effectiveness have not yet been studied and explained. Therefore, based on the network meta-analysis (NMA), this study will compare the differences in the efficacy of multiacupuncture in the treatment of POP, to provide a reference for clinical treatment.

Methods:
We will search PubMed, MEDLINE, Embase, the Cochrane Library, China National Knowledge Infrastructure (CHKD-CNKI), WANFANG database (Chinese Medicine Premier), Chinese Biomedical Literature database (CBM), and VIP for relevant RCTs of ACU treatments for POP, from their inceptions to January 2019. STATA 15.0 and GEMTC software will be used to perform a NMA. The evidence will be evaluated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach and the type 1 error rate will be assessed by trial sequential analysis (TSA).

Results:
The results of this review will be submitted to a recognized journal for publication.

Conclusion:
This proposed systematic review will evaluate the different advantages of various types of ACU in the treatment of POP.

Registration:
PROSPERO (registration number CRD42019122724).
The effect of antimicrobial photodynamic therapy on infected dentin in primary teeth
Authors: Costa-Santos Larissa , Silva-Júnior Zenildo Santos , Sfalcin Ravana Angelini , Mota Ana Carolina Costa da , Horliana Anna Carolina Ratto Tempestini , Motta Lara Jansinki , Mesquita-Ferrari Raquel Agnelli , Fernandes Kristianne Porta Santos , Prates Renato Araújo , Silva Daniela Fátima Teixeira , Deana Alessandro , Bussadori Sandra Kalil 
Published: April 2019

Abstract

Background:
Antimicrobial photodynamic therapy (aPDT) has been used for the treatment of dental caries. Papacarie is a gel composed of papain and chloramine employed for the partial removal of carious tissue, effective against bacteria, however, some studies report that this antibacterial action is not quite so evident. The aim of this study is to evaluate the clinical effect of aPDT on infected dentin in dental caries lesion in primary teeth.

Methods:
Thirty-two primary molars with deep occlusal dental caries will be selected and divided in 2 groups: G1 – caries removal with a low-speed drill and G2 – application of aPDT with PapacarieMBlue. After treatment, all the teeth will be restored with glass ionomer cement and followed up clinically and radiographically, with evaluations at 3, 6, and 12 months. Dentin samples before and after treatment will be analyzed microbiologically. The data will be submitted to descriptive statistical analysis of the association between the categorical variables and both age and gender using the chi-square test and Fisher exact text. The Student t test and analysis of variance will be used for the comparison of mean signs and symptoms of reversible pulpitis. Pearson correlation coefficients will be calculated for the analysis of correlations among the continuous variables.

Discussion:
Adding methylene blue dye to the formula of PapacarieMBlue might potentiate the antimicrobial action of aPDT and work more effectively on the infected dentin combined with a conservative, minimally invasive treatment.

Trial registration:
NCT02734420 on 10 march 2016.
Combined epidural adhesiolysis and balloon decompression can be effective in intractable lumbar spinal stenosis patients unresponsive to previous epidural adhesiolysis
Authors: Karm Myong-Hwan , Yoon Syn-Hae , Seo Dong-Kyun , Lee Sookyung , Lee Yongsoo , Cho Seong-Sik , Choi Seong-Soo 
Published: April 2019

Abstract
Moderate evidence exists regarding percutaneous epidural adhesiolysis (PEA) being an effective treatment for lumbar spinal stenosis (LSS). Although PEA is successfully performed using balloon-less epidural catheters, many patients with severe adhesions cannot obtain satisfactory results. Combined treatment with balloon-inflatable catheters for PEA and balloon decompression recently demonstrated sufficient pain relief and functional improvement in patients with intractable LSS. We compared the effects of PEA and balloon decompression in patients with intractable LSS who did not undergo PEA and those who were unresponsive to previous PEA with a balloon-less catheter.
We examined 315 patients who underwent PEA and balloon decompression with balloon-inflatable catheters. Patients with intractable LSS were divided into those without previous PEA (No-PEA) and those unresponsive to previous PEA using balloon-less catheters (Prev-PEA). The numeric rating scale, Oswestry disability index, and global perceived effect of satisfaction scale were measured at 0, 1, 3, and 6 months after the intervention. Responder analysis was performed based on changes in measured scales and indices.
A successful treatment response was observed at 1, 3, and 6 months after the intervention in 56.4%, 42.7%, and 32.9%, respectively, of the No-PEA group and in 48.9%, 37.8%, and 25.6%, respectively, of the Prev-PEA group. No significant between-group differences were detected. Pain intensities and functional status improved and were maintained throughout follow-up after PEA with balloon decompression using balloon-inflatable catheters.
This modality may represent a useful alternative to overcome the limitations of preexisting adhesiolysis procedures.
Association between inflammation factors and Mycoplasma pneumoniae in children
Authors: He Jin-e , Qu Hui , Gao Chun-Yan 
Published: April 2019

Abstract

Background:
Several clinical studies have reported that inflammation factors (IF) are associated with Mycoplasma pneumoniae in children. However, no study systematically investigated the association between IF and M pneumoniae in pediatric population. Thus, this study will explore the association between IF and pediatric M pneumoniae systematically.

Methods:
This study will search following databases of PUBMED, PsycINFO, Scopus, Cochrane Library, EMBASE, Web of Science, and Chinese Biomedical Literature Database from inception to the February 28, 2019 without any language limitations. We will cover clinical studies of M pneumoniae that report associations between IF and M pneumoniae. In addition, reference lists of relevant studies will also be identified to avoid missing any eligible studies. Two investigators will independently screen and select studies, and will assess the methodological quality for each study, which is evaluated by using Newcastle Ottawa Scale. Any disagreements will be settled down through discussion with a third investigator until consensus is reached.

Results:
This study will explore the associations between IF and M pneumoniae by assessing the changes of IF, such as interleukin (IL)-4, IL-5, IL-6, IL-10, IL-13, and IL-17 at different stages of M pneumoniae.

Conclusion:
The findings of this study may provide most recent evidence for the associations between IF and M pneumoniae in pediatric populations.

Ethics and dissemination:
Ethical approval is not needed in this study, because no individual patient data will be utilized in this study. The findings of this study are expected to be published at peer-reviewed journal or will be presented at professional conference.

PROSPERO registration number:
PROSPERO CRD42019125359.
Efficacy of laser acupuncture for patients with chronic Bell's palsy
Authors: Ton Gil , Lee Li-Wen , Ng Hui-Ping , Liao Hsien-Yin , Chen Yi- Hung , Tu Cheng-Hao , Tseng Chun-Hung , Ho Wen-Chao , Lee Yu-Chen 
Published: April 2019

Abstract

Background:
Bell's palsy is the most frequent cause of unilateral peripheral facial palsy, a common condition that third of patients can have inadequate recovery and subsequent physical and social impairments. The largely ineffective and even controversial nature of the various medical and surgical treatment options means that novel, alternative approaches are needed. In preclinical and clinical evidence, low-level laser therapy (LLLT) has demonstrated the ability to regenerate peripheral nerves. Laser acupuncture treatment (LAT), the stimulation of traditional acupoints with low-intensity, non-thermal laser irradiation, is a common treatment modality, but its efficacy in chronic Bell's palsy is undetermined. This study aims to evaluate the efficacy of LAT in patients experiencing inadequate recovery from Bell's palsy.

Methods:
This 2-armed, parallel, randomized, subject-assessor-blinded, single-center, sham-controlled pilot trial will randomly assign 32 eligible patients into either a real LAT group (n = 16) or a sham LAT group (n = 16). The real LAT group will receive 3 LAT sessions each week for 6 weeks (a total of 18 sessions), delivered to acupoints corresponding with the affected side of the face. The sham LAT group will receive the same treatment as the real LAT group, but with a sham laser device. The primary outcome measure will be the change from baseline at week 6 in the Facial Disability Index score. Secondary outcomes will monitor changes during treatment in the House-Brackmann and Sunnybrook facial nerve grading systems and stiffness scale, at weeks 1, 3, and 6.

Discussion:
To the best of our knowledge, this double-blind, randomized, sham-controlled trial is the first such investigation into the efficacy of LAT in chronic Bell's palsy. Clinical trials using LLLT have shown positive therapeutic effects in acute Bell's palsy, although as yet, the feasibility and efficacy of LAT remain unclear in patients experiencing inadequate recovery from Bell's palsy.

Trial registration:
This trial protocol has been approved by the Research Ethics Committee of the China Medical University Hospital, Taichung, Taiwan (Protocol ID: CMUH107-REC1-030) also registered at ClinicalTrials.gov (identifier no. NCT03592797).
Strain histograms used for differential diagnosis of breast masses according to hardness percentage
Authors: Xue Yan , Zou Hongsheng , Ou Yang , Li Sheng , Zhao Yuehuan , Li Yun , Li Yunling 
Published: April 2019

Abstract
To evaluate the diagnostic performance of percentage of hard component (PHC) versus strain ratio (SR) in focal breast lesion diagnosis.
Ultrasonography and elastography images of 245 malignant and 255 benign breast lesions were obtained and analyzed according to the Breast Imaging-Reporting and Data System of the American College of Radiology. PHC and SR were measured for each lesion and receiver operating characteristic (ROC) curve analysis was performed to evaluate and compare the diagnostic performance of conventional ultrasound (CU) only, PHC with CU, and SR with CU.
Mean PHC differed significantly between malignant (90.46 ± 13.29) and benign (62.03 ± 25.61) lesions. Mean SR differed significantly between malignant (4.61 ± 1.75) and benign (2.34 ± 1.80) lesions. ROC curve threshold values were 82.45 for PHC and 2.69 for SR. The area under the curve values for CU, SR with CU, and PHC with CU were 0.956, 0.960, and 0.956, respectively, with no significant differences among them (P < .05).
PHC was comparable to SR for differentiating malignant from benign breast masses and may be an auxiliary tool for breast lesion stiffness evaluation. ROC data for CU, SR with CU, and PHC with CU were statistically similar.
Treatment experience for full-thickness wound dehiscence with cerebrospinal fluid leakage following posterior primary spine surgery
Authors: Feng Chen , Qianqian Shao , Jianhua Hu , Yu Zhao , Yipeng Wang , Jianguo Zhang , Guixing Qiu 
Published: April 2019

Abstract

Rationale:
Full-thickness wound dehiscence with cerebrospinal fluid (CSF) leakage following posterior spine surgery is a rare but troublesome complication. In the present study, 3 clinical cases associated with this entity are reported.

Patient concerns:
The first case developed incision effusion 5 days after posterior decompression and internal fixation for lumbar spinal stenosis. The second case has the same diagnosis and treatment with the first case. She developed intraoperative CSF leak and incision effusion 7 days after the surgery. The third case developed incision effusion 6 days after posterior single door laminoplasty for cervical spondylosis.

Diagnosis:
All cases developed CSF leak, incision effusion and finally full-thickness wound dehiscence on the postoperative period.

Interventions:
Bed rest, drainage, vacuum sealing drainage (VSD), and reoperations were applied in all of the patients. Trapezius flap transfer was applied to the third case. One lumbar patient developed deep infection and meningitis; thus, the internal fixation and bone graft were removed.

Outcomes:
All of the patients received wound healing finally and were followed up for >6 months. No incision complications reoccurred, and preoperative symptoms significantly relieved.

Lessons:
Several techniques can be adopted to minimize the incidence of complications and proper surgical repair is the most important. Lumbar cistern drainage and VSD are recommended. Some other available options of management will also help.
Iatrogenic bile duct Injury with a retained T-tube in common bile duct for 10 years
Authors: Wang Li , Dong Ping , Zhang Yi , Liu Xubao , Tian Bole 
Published: April 2019

Abstract

Rationale:
Bile duct injury (BDI), a major complication of cholecystectomy, usually needs hepaticojejunostomy or primary repair over T-tube in severe cases. There were few cases about retained fragments of T-tube. Whereas, intact T-tube retained in common bile duct (CBD) for years after BDI was very rare.

Patient Concerns:
A 55-year-old female complaining of a retained T-tube in the right upper quadrant for 10 years with bilious exudation for 3 months.

Diagnosis:
Based on the medical history of reoperation after the initial laparoscopic cholecystectomy (LC), the retained T-tube, the bilious exudation, and the feature of image modalities, she was diagnosed with retained biliary T-tube, biliary leak, hepatolithiasis, and BDI.

Interventions:
After nonsurgical management at local hospitals, the patient had her indwelling T-tube removal during laparotomy in our center finally. During this procedure, bile duct exploration, hilar bile ducts reconstruction, and primary Roux-en-Y hepaticojejunostomy were performed.

Outcomes:
Unfortunately, bile leakage occurred postoperatively. After drainage of the peritoneal bilious fluid, the patient recovered gradually without further complication.

Lessons:
T-tube in CBD could act as nidus for stone formation after long-time placement. As a result of gradual stone formation on T-tube, severe hepatic ducts dilatation may occur without the presence of jaundice. Timely follow-up and proper surgical intervention should be suggested for patients with T-tube placement or iatrogenic BDI to avoid further impacts.
Assessing treatment and monitoring of musculoskeletal conditions using opioid versus nonopioid therapy
Authors: Pierce Derek P.R. , Pierce Brett , Cheng Chin-I , Perzhinsky Juliette 
Published: April 2019

Abstract
The purpose of this study is to examine the treatment of noncancer musculoskeletal pain in different clinical settings by assessing patient demographics, pain diagnoses, opioid analgesic monitoring, and alternative treatments.
Data was collected in a retrospective chart review involving 300 randomly selected charts with an active musculoskeletal diagnosis based on the 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes. The population consisted of primary care outpatient clinic and emergency department encounters during the timeframe of January 1, 2016 to March 31, 2016 in a predominantly rural community in Michigan. Variables included prescription medications, musculoskeletal conditions, and prescription drug monitoring modalities. Statistical analysis was accomplished using means, standard deviations, proportions, 2-sample proportional tests, multivariable logistic regression, and multinomial regression models.
Opioid prescribing was observed in 64% of outpatient and 68.9% of emergency department encounters. Back pain was the most common problem with 61.9% patients prescribed opioids having at least 1 diagnosis of back pain. Patients on opioids were older (mean age 58) than patients taking nonopioids (mean age 50). For every year of increasing age, there is a 3.1% increase in the odds of an opioid being prescribed (odds ratio 1.03, confidence interval 1.012–1.049, P = .001). Documentation was extremely low with only 15.2%, 1.5%, and 1.5% of patient charts prescribed opioids demonstrating documentation of urine drug screens, pain agreements, and review of a state prescription drug monitoring program, respectively.
Despite drug monitoring recommendations, low rates of monitoring were observed. Back pain was the largest contributing pain location and had higher opioid use compared to other sites. Many patients had additional pain medications being concurrently prescribed with opioids suggesting that musculoskeletal pain is not often controlled by a single medication type. Reported alcohol abuse, active tobacco use, and illicit substance use can serve as predictors when assessing patients for pain management options. The use of alternative measures and integrative treatment modalities (which saw low utilization in this study) should be implemented as either primary or supplementary therapy as a way to reduce the pharmacologic burden on the patient.