bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular genetics of head and neck squamous cell carcinoma
Authors: Saada-Bouzid Esma , Peyrade Frederic , Guigay Joël 
Published: March 2019

Purpose of review
The aim of this review is to summarize the current knowledge on the genomic characterization of squamous cell carcinomas of the head and neck (HNSCC) and discusses how these abnormalities could be incorporated into a therapeutic approach.

Recent findings
Tobacco and HPV infection, the two main risk factors of HNSCC, allow the definition of two groups with distinct anatomoclinical and genetic features. As tobacco and HPV infection are not exclusive, exposure to both risk factors is associated with an intermediate prognostic. HPV-positive, nontobacco-related HNSCCs are associated with a better prognosis, a rather more simple genomic profile, frequent activating mutations of genes involved in pi3kinase pathway, and the very low incidence of mutations of tumor suppressor genes. HPV-negative, tobacco-related HNSCC are genetically more complex. HPV-negative HNSCC are characterized by almost mandatory inactivating mutations/deletions of tumor suppressor genes (especially TP53 and CDKN2A) and the occurrence, though less frequent, of activating mutations or amplifications of some oncogenes that encode for cell cycle proteins or receptors with tyrosine kinase activity. Despite many efforts to improve therapeutic targeting in RM HNSCC, Cetuximab, a monoclonal antibody targeting REGF, remains the sole approved targeted treatment in RM HNSCC.

Summary
Despite the increasingly precise genomic characterization of HNSCCs, precision medicine is struggling to find its place in the management of HNSCCs. Inclusion of enriched populations in dedicated trials is likely to help implement precision medicine in the management of HNSCCs.
A case report of the rare fifteen-and-a-half syndrome
Authors: Li Mengmeng , Li Xuan , Liu Lina , Zhu Mingsu , Lu Dandan , Wang Pei 
Published: March 2019

Abstract

Rationale:
The dorsal tegmentum of the caudal pons, including the medial longitudinal fasciculus (MLF), the paramedian pontine reticular formation (PPRF), abducens nucleus, and the adjacent facial nerve is the anatomical basis of the the fifteen and a half syndrome (15½) syndrome. No patients of 15½ Syndrome presenting with bilateral peripheral facial paralysis and one-and-a-half simultaneously at the onset have been reported up to now.

Patient concerns:
A 54-year-old woman complained of diplopia, slurred speech, and slightly distal numbness of the left upper limb for 4 days in our hospital.

Diagnoses:
The diffusion weighted image (DWI) and apparent dispersion coefficient (ADC) of MRI revealed the causative lesion in pons including bilateral pontine tegmentum and a narrow lesion along the midline in the right of the pons. Her clinical manifestations with results of MRI resulted in the diagnosis of the fifteen-and-a-half-syndrome.

Interventions:
The patient received antiplatelet aggregation, plaque stabilization, free radicals elimination, circulation improvement, nerves nourishment, and other symptomatic treatments.

Outcomes:
Two months later, her ocular movement recovered, and the bilateral facial paresis showed some improvement.

Lessons:
First, our patient with 15½ syndrome maybe one of mutants whose bilateral pontine tegmentum is supplied by unilateral pontine paramedian perforator artery. Second, DWI combined with ADC may be applied in the diagnosis of fifteen-and-half syndrome when the lesions of infarction are too small to be revealed by MRI scan.
Surgical treatment of progressive cauda equina compression caused by spontaneous spinal subdural hematoma
Authors: Li Xigong , Yang Ge , Wen Zhiqiang , Lou Xianfeng , Lin Xiangjin 
Published: March 2019

Abstract

Rationale:
Spontaneous spinal subdural hematoma (SSDH) without an underlying pathology is a very rare condition. The treatment protocol for SSDH is early diagnosis and treatment before irreversible damage to neural tissue. However, there is no agreement on the etiopathogenesis, as well as the need for surgery to treat spontaneous SSDH. Here, we report a rare case of spontaneous SSDH with progressive deterioration and symptoms of cauda equina syndrome after ineffective conservative treatment.

Patient's concern:
A 38-year-old male patient presented with sudden lower back and bilateral leg pain.

Diagnosis:
A magnetic resonance imaging (MRI) scan on the third day after the onset of symptoms revealed a subdural hematoma from L1 to S1, presenting as hyperintensities on T1 weighted sequences and hypointensities to isointensities on T2 weighted sequences.

Intervention:
Laminectomy and subdural evacuation were performed immediately.

Outcomes:
An abnormal ligamentum flavum was observed intraoperatively. A histological examination revealed extravasation of blood in the degenerated ligamentum flavum. Postoperatively, the lower limb pain improved immediately. At the 6-month follow-up, the pain and numbness of the lower limb disappeared, and the muscle strength of both legs recovered completely with normal gait.

Lessons:
Spontaneous SSDH with ligamentum flavum hematoma was caused by a sudden increase of intravenous pressure, resulting from a marked surge in the intra-abdominal or intrathoracic pressure. Consecutive MRI scans provided valuable information, leading to a diagnosis of spontaneous SSDH. The treatment protocol for spontaneous SSDH should be determined based on the location and stage of the hematoma, as well as the subject's neurological status.
Next-generation sequencing (NGS) as a molecular diagnostic tool for hypertrophic cardiomyopathy in a Chinese boy due to novel compound heterozygous mutations in the MYBPC3 gene
Authors: Chen Xu , Jiang Jun , Zhu Weiliang , Wu Yuan , Su Maolong 
Published: March 2019

Abstract

Rationale:
Hypertrophic cardiomyopathy (HCM) is mainly caused by mutations in genes encoding sarcomeric proteins. One of the most commonly mutated HCM genes is the MYBPC3 gene. Mutations in this gene lead mainly to truncation of the protein, which gives rise to a relatively severe phenotype. Analyses of gene mutations associated with HCM are valuable for molecular diagnosis, genetic counseling, and management of familial HCM.

Patient concerns:
A 12-year-old boy presented with palpitations and dyspnea after exercise for 1 year. Echocardiography showed myocardial asymmetric hypertrophy of the ventricular septum, the anterior wall, and the lateral wall of the left ventricle. The thickness of the interventricular septum was estimated to be 33 mm. ECG showed left ventricular high voltage and ST-T changes. He had been diagnosed with HCM 3 months previously.

Diagnoses:
Due to his clinical presentation, he was determined to have HCM via a molecular analysis, revealing compound heterozygotes (p.R597W and p.Q1012Sfs∗8) in the MYBPC3 gene.

Interventions:
The patient was prescribed metoprolol to slow the heart rate and increase diastolic filling time.

Outcomes:
The boy was treated with metoprolol 6.75 mg b.i.d. Approximately 3 months later, review of the echocardiography showed that the peak velocity across the LVOT dropped to 2.3 m/seconds and that the pressure gradient dropped to 21 mm Hg.

Lessons:
A custom next-generation sequencing (NGS) technology for the HCM panel allowed us to identify compound heterozygous mutations in the MYBPC3 gene, confirming NGS as a molecular diagnostic tool.
Clinical features and antimicrobial susceptibility profiles of culture-proven neonatal sepsis in a tertiary children's hospital, 2013 to 2017
Authors: Li Xiaoxia , Ding Xiangyu , Shi Peng , Zhu Yiqing , Huang Yidie , Li Qin , Lu Jinmiao , Li Zhiping , Zhu Lin 
Published: March 2019

Abstract
Neonatal sepsis (NS) remains a major cause of morbidity and mortality in neonates, but data on the etiology and antibiotic susceptibility patterns of pathogens are limited. The aim of this study was to analyze the clinical characteristics, risk factors, and the antibiotic susceptibility patterns of pathogenic microbes associated with NS at a tertiary children's hospital in Shanghai, China.
Episodes of blood culture-proven sepsis in the neonatal intensive care unit (NICU) of Children's Hospital of Fudan University from January 2013 to August 2017 were retrospectively reviewed. Collected data included demographics, perinatal risk factors, clinical symptoms, laboratory values, microbiology results and their antimicrobial susceptibility. Data for early-onset neonatal sepsis (EONS) and late-onset neonatal sepsis (LONS) were compared.
The 341 of 976 culture-positive cases were selected, including 161 EONS cases (47.21% of 341) and 180 LONS cases (52.79% of 341). 635 incomplete cases were excluded. There was significant difference in risk factors between the EONS group and LONS group including birth weight, gestational age, 1-minute Apgar score, respiratory support, and the use of peripherally insertion central catheter (PICC). Clinical symptoms such as fever, feeding intolerance, abdominal distension, and neonatal jaundice, and laboratory results such as hemoglobin and lymphocyte counts also showed between-group differences. Staphylococcus epidermidis (22.87%), Escherichia coli (9.68%), Alcaligenes xylosoxidans (9.38%) and Klebsiella pneumoniae (9.09%) remain the principal organisms responsible for neonatal sepsis. Most isolates of Gram-positive bacteria were sensitive to vancomycin, linezolid, minocycline and tigecycline, of which more than 90% were resistant to penicillin. Most isolates of Gram-negative bacteria were sensitive to amikacin and imipenem and resistant to ampicillin. Fungus was sensitive to antifungal agents. Better medical decisions, especially early detection and appropriate initial antimicrobial therapy can be made after understanding the different clinical features and pathogens of EONS and LONS.
Lymph node metastasis outside of a tumor-bearing lobe in primary lung cancer and the status of interlobar fissures
Authors: Li Hui , Wang Ruimin , Zhang Dexian , Zhang Yongming , Li Wanhu , Zhang Baijiang , Liu Qi , Du Jiajun 
Published: March 2019

Abstract
The new Tumor Node Metastasis staging system does not recognize fissure status with respect to adjacent lobe invasion (ALI) in lung cancer. Furthermore, no specific surgical strategies have been recommended for lymph node dissections around adjacent nontumor-bearing lobes (NTBLs) according to fissure status. Therefore, this study was undertaken to investigate the necessity of removing additional adjacent lobe lymph nodes in patients with nonsmall cell lung cancer (NSCLC) for lesions limited to in the vicinity of the interlobar fissure.
From August 2013 to March 2015, the records of 332 patients, who underwent systematic mediastinal lymph node dissection, were reviewed in this retrospective study. The bronchial lymph nodes had been subjected to pathological examination, and the status of the fissures was also recorded. A statistical analysis was performed to identify the significant predictors of lymph node metastasis.
The patients were divided into a nonadjacent lobe invasion (NALI) group (n = 295) and an ALI group (n = 37). There was a significant difference in tumors with pN2 disease between the ALI and NALI groups (37.8% vs 8.8%, P = .001). ALI tumors had significantly more frequent pleural involvement than NALI tumors (62.2% vs 43.1%, P = .035). The frequency of N2 involvement among tumors invading across the complete fissure was higher than that of the tumors invading across the incomplete fissure (44.4% vs 14.3%, P = .015). However, the frequency of N1 involvement among tumors invading across the incomplete fissure was not statistically different than that of tumors not invading across incomplete fissure (32.1% vs 24.2%, P = .357). Regarding lymph node metastasis in NTBL, 15 (12.7%) patients had lymph node metastases in NTBLs. Pleural involvement was an independent predictor of lymph node metastasis in an NTBL.
A greater frequency of N2 lymph nodes existed in NSCLC with invading adjacent lobe across complete fissure, extensive lymphatic resection within the hilum, and NTBL in tumors with pleural involvement are justifiable and necessary.
Removal of an infant's gastric duplication cyst through endoscopic submucosal dissection
Authors: Fang Ying , Gao Tianjiao , Yang Hongbin , Ma Shiyang , Li Quanlin , Zhou Ping-Hong 
Published: March 2019

Abstract

Rationale:
Gastric duplication cyst is an anomaly that primarily occurs to children. Apart from the conventional use of surgical resection, few cases using endoscopic treatment have been reported.

Patient concerns:
A 5-month-old female infant was hospitalized with the chief complaint of gastric cyst. No significant abnormalities were identified by physical examination.

Interventions:
Endoscopic submucosal dissection (ESD) was performed successfully for the infant and the duration was less than 20 minutes. The patient showed no postoperative complications.

Outcomes:
At 4 months during the follow-up, upper endoscopy revealed a small scar at the previous site of the lesion and no recurrence.

Lessons:
According to the results of PUBMED review, she was the youngest with gastric duplication cyst removed with ESD. The less invasive ESD should be considered an effective therapeutic option to remove gastric duplication cyst in children.
Cerebral embolism during edoxaban administration for venous thromboembolism in a patient with lung adenocarcinoma
Authors: Nakao Satoshi , Masuda Takeshi , Sakamoto Shinjiro , Yamaguchi Kakuhiro , Horimasu Yasushi , Miyamoto Shintaro , Nakashima Taku , Iwamoto Hiroshi , Fujitaka Kazunori , Hamada Hironobu , Hattori Noboru 
Published: March 2019

Abstract

Rationale:
The efficacy of direct oral anticoagulants (DOACs) in the treatment and prophylaxis of cancer-related venous thromboembolism (VTE) is reportedly similar to that of heparin. However, the effect of DOACs on the prophylaxis of cancer-related arterial thromboembolism (ATE) remains unclear. To our knowledge, we present the 1st case where cerebral ATE was encountered during edoxaban administration for VTE in a patient with lung adenocarcinoma.

Patient concerns:
In March 2017, a 63-year-old female was diagnosed with lung adenocarcinoma (cT2aN3M1b stage IVa) along with having asymptomatic VTE; thus, 60 mg/day edoxaban administration was initiated. In addition, 1st-line chemotherapy generated a partial antitumoral response. However, owing to lung cancer progression, a secondary treatment with pembrolizumab administration was initiated. The patient suddenly experienced aphasia 11 days after pembrolizumab administration.

Diagnosis:
The patient was diagnosed as multiple cerebral ATE using brain magnetic resonance imaging. However, VTE recurrence was not observed. Based on the findings of lung cancer progression and increased coagulation, cerebral ATE was diagnosed as Trousseau syndrome.

Interventions:
DOAC administration was switched to heparin administration.

Outcomes:
Coagulation profile normalized and aphasia improved without any further disease symptoms.

Lessons:
We considered that DOACs are effective for the treatment and prophylaxis of VTE but may be insufficient for ATE prevention. Therefore, DOACs should be replaced with heparin to prevent ATE when cancer and coagulation become uncontrollable with DOAC.
Effect of statins on Parkinson's disease
Authors: Yan Junqiang , Qiao Liang , Tian Jing , Liu Anran , Wu Jiannan , Huang Jiarui , Shen Mengmeng , Lai Xiaoyi 
Published: March 2019

Abstract

Background:
Statins have key lipid-lowering, anti-inflammatory, and anti-oxidative effects. However, it remains unclear whether statins are beneficial to patients with Parkinson's disease (PD). This study aimed to evaluate the relationship between statins and PD through a systematic review.

Methods:
This study adhered to the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Potentially relevant case-control or cohort studies published before March 2018 were identified by searching the MEDLINE (PubMed), EMBASE (OVID), CENTRAL (Cochrane Library), CNKI, WANGANG, VIP, CBM, CMCC, Clinicaltrials.gov, ProQuest, Opengray, and ISI Proceedings databases and conducting a manual search. Summarized relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a fixed effect model. Sensitivity and subgroup analyses were also performed.

Results:
The meta-analysis included 17 studies (3,845,303 patients; 8 case-control and 9 cohort studies), including 5 articles not cited by other studies. We searched the Chinese database, but unfortunately, no Chinese literature can be included in the study. Briefly, statins could decrease the risk of PD, with a summary OR of 0.92 (95% CI: 0.86–0.99). A sensitivity analysis demonstrated the robustness of the results. Subgroup analyses revealed heterogeneity across the studies in terms of subject race, study type, reporting style, quality, statins type, and time for taking statins.

Conclusion:
Our study provides evidence that statins, especially atorvastatin, can reduce the risk of PD. Different time of statins using has different effects on PD. However, additional randomized controlled trials and observational studies are needed to confirm this conclusion.

Registration Id:
PROSPERO CRD: 42018095580
Combined exposure of emotional labor and job insecurity on depressive symptoms among female call-center workers
Authors: Cho Seong-Sik , Kim Hyunjoo , Lee JinWoo , Lim Sinye , Jeong Woo Chul 
Published: March 2019

Abstract
Call-center workers work under unfavorable psychosocial working conditions, including, emotional labor and job insecurity, which might be linked to depressive symptoms.
The purpose of this study was to explore the link between emotional labor and depressive symptoms and to investigate the influence of combined exposure to emotional labor and job insecurity on depressive symptoms.
A health survey was conducted among female call-center workers in Geumcheon-gu (a district in Seoul), South Korea, in November 2012. The short form of the Korean occupational stress scale was used to measure occupational stressors. A questionnaire with 8 items was employed to assess emotional labor. Depressive symptoms were estimated using the Korean Version of the Centre for Epidemiologic Studies Depression Scale (CES-D). The association of emotional labor and occupational stressors with depressive symptoms was assessed using multilevel mixed-effects logistic regression.
Overall, 699 female call-center workers were enrolled into this study. The odds ratios of experiencing depressive symptoms in workers exposed to emotional labor and job insecurity were 5.45 (95% confidence interval [CI]: 3.38–8.80) and 2.37 (95% CI: 0.86–6.50), respectively. When workers were simultaneously exposed to excessive emotional labor and high job insecurity levels, the odds ratio of experiencing depressive symptoms was 10.13 (95% CI: 3.51–29.23). The Relative Excess Risk due to the Interaction (RERI) of job insecurity and emotional labor was 3.30 (95% CI: −5.50 to 12.11); however, this was not statistically significant (P = .46).
Although a causal relationship could not be established due to the cross-sectional study design, the combined effect of emotional labor and job insecurity might have a serious influence on behavioral health among call-center female workers.
Prognositic significance of P-cadherin expression in breast cancer
Authors: Xi Yupeng , Zhang Xiwen , Yang Zizhen , Zhang Xing , Guo Qiujun , Zhang Zhenhua , Chen Shuntai , Zheng Honggang , Hua Baojin 
Published: March 2019

Abstract

Background:
P-cadherin is a calcium-dependent cell–cell adhesion glycoprotein. It has been implicated in invasiveness and metastasis. However, the clinical prognostic value of overexpression of P-cadherin in patients with breast cancer (BC) remains unsettled.

Methods:
A systematic literature search will be performed in all available databases to quantitatively review eligible studies and identify all relevant data, which could be used to detect the relationship between overexpression of P-cadherin and overall survival (OS), disease-free survival (DFS), and clinicopathological parameters. Hazard ratio and 95% confidence intervals (CIs) or P value will be employed as effect measures to estimate the correlation between P-cadherin and the oncologic outcomes including overall survival (OS), disease-free survival (DFS). Odds ratios (ORs) and the 95% CIs will be evaluated for the pooled analysis of the correlation between P-cadherin expression and clinicopathological features. We will use the Review Manager (Revman) 5.3.5 software (Cochrane Community, London, United Kingdom) and STATA 14 software (version 14.0; Stata Corp, College Station, TX) to perform the meta-analysis to calculate the data.

Results:
The review will provide a high-quality synthesis of current evidence of the prognostic role of P-cadherin in BCs. The results will be published in a peer-reviewed journal.

Conclusion:
We hope that the results of this study will provide significant evidence to assess whether the expression of P-cadherin is associated with poor prognosis in patients with BC.

PROSPERO registration number:
This meta-analysis protocol has been registered in the PROSPERO network with registration number: CRD42019119880.
Mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, dialysis adequacy influence all-cause mortality in hemodialysis patients
Authors: Duong Tuyen Van , Wu Pei-Yu , Wong Te-Chih , Chen Hsi-Hsien , Chen Tso-Hsiao , Hsu Yung-Ho , Peng Sheng-Jeng , Kuo Ko-Lin , Liu Hsiang-Chung , Lin En-Tzu , Feng Yi-Wei , Yang Shwu-Huey 
Published: March 2019

Abstract
Hemodialysis patients are at the high risk for morbidity and mortality. Evaluation and management of body composition and biochemical values are important to improve dialysis outcomes. We aimed to examine the effects of the mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, and dialysis adequacy on the mortality.
A prospective cohort study was conducted on 375 patients from 7 hospital-based dialysis centers. At baseline between September 2013 and April 2017, we assessed patients’ characteristics using chart review, body composition using the bioelectrical impedance analysis, and biochemical parameters using available laboratory tests. Patients were followed-up for all-cause mortality until April 2018. Kaplan–Meier Curves with Log-rank test, and Cox proportional hazards models were used to analyze the effects of assessed factors on the mortality.
During the median of follow-up time of 1.4 (1.0–3.2) years, 47 (12.5%) patients died. In the multivariate analysis, mid-arm circumference (hazard ratio, HR, 0.90; 95% confidence interval, 95%CI, 0.82–0.99; P = .036), body fat mass (HR, 0.95; 95%CI, 0.91–1.00; P = .031), percent body fat (HR, 0.96; 95%CI, 0.92–0.99; P = .024), serum creatinine (HR, 0.81; 95%CI, 0.68–0.96; P = .015), and eKt/V (HR, 0.07; 95%CI, 0.01–0.33; P = .001) reduced the mortality risk. Inflammation (HR, 2.90; 95%CI, 1.59–5.27; P < .001), hyperglycemia (HR, 2.16; 95%CI, 1.06–4.40; P = .033), and low serum uric acid (HR, 2.22; 95%CI, 1.15–4.31; P = .018) increased the death risk.
In hemodialysis patients, the higher values of the mid-arm circumference, body fat, serum creatinine, uric acid, and dialysis adequacy were associated with lower mortality, whereas, inflammation and hyperglycemia associated with higher mortality.