bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of dural puncture epidural technique combined with programmed intermittent epidural bolus on labor analgesia: A randomized, double-blind, parallel-group, controlled clinical trial
Authors: Zhou Rouxuan , Chen Daili , Li Yuantao , Huang Xiaolei , Wu Mingguang , Lin Qihua 
Published: November 2024

Background:
Labor analgesia can be achieved by different approaches. The efficacy and safety of combined dural puncture epidural (DPE) with program intermittent epidural bolus (PIEB) are not well characterized. This study aimed to compare the efficacy and safety of DPE combined with PIEB vs epidural (EP) combined with PIEB for labor analgesia.

Methods:
We performed a prospective, randomized, double-blind, parallel-group, controlled clinical trial. Eligible pregnant nulliparous women received either DPE combined with PIEB (group D) or epidural combined with PIEB (group E) for labor analgesia. Analgesia was initiated with 0.1% ropivacaine + 0.3 µg/mL sufentanil and maintained with PIEB at 12 mL/h. Primary outcome was the proportion of women with adequate analgesia within 10 minutes after the initiation of analgesics. Secondary outcomes (time to achieve analgesia, time to first request for additional analgesic, proportion of women required additional analgesic or epidural catheter adjustment and resetting, total labor duration, total analgesic consumption, level of anesthesia, and motor block), side effects, and patient satisfaction were also documented.

Results:
Out of 174 enrolled women, 160 were included in the analysis. Baseline characteristics were comparable. The proportion of women who achieved adequate analgesia in group D was significantly greater than that in group E (38.8% vs 20.0%, P < .05). Compared with group E, group D also showed advantages in faster adequate analgesic achievement, more likely to reach adequate analgesia, a longer time to maintain analgesia, lesser requirements for additional analgesic, and better sensory blocks. There were no significant inter-group differences in other outcome measures.

Conclusions:
Compared with epidural and PIEB mode, DPE and PIEB mode achieved better analgesia without increasing maternal or neonatal side-effects during labor.
Middle ear cholesteatoma and facial nerve hypertrophy mimicking schwannoma in Charcot-Marie-Tooth disease: A case report
Authors: Jang Minho , Hong ChanEui , Choi Jin Woo , Kim Chang-Hee 
Published: November 2024

Rationale:
Charcot-Marie-Tooth (CMT) disease, a hereditary motor and sensory neuropathy, presents with progressive chronic sensory and distal motor polyneuropathy. While sensorineural hearing loss and vestibular impairment have been documented in CMT patients, concurrent middle ear cholesteatoma and persistent direction-changing positional nystagmus have not.

Patient concerns:
This study details a 22-year-old man with CMT1 exhibiting these symptoms.

Diagnoses:
A 22-year-old man with CMT1 (PMP22, c.319+1G>T mutation) presented with rotatory vertigo, left-sided hearing loss, and aural fullness. Examination revealed middle ear effusion and a whitish mass behind the left tympanic membrane. Audiometry showed mixed hearing loss on the left side. Imaging indicated middle ear cholesteatoma and facial nerve hypertrophy.

Interventions:
Surgical removal of the cholesteatoma revealed a dehiscent hypertrophied facial nerve.

Outcomes:
Postoperative follow-up showed improved hearing and no recurrence.

Lessons:
This case highlights 3 key points: facial nerve hypertrophy in CMT requiring differentiation from schwannoma, the first reported instance of middle ear cholesteatoma in a CMT patient, and vertigo due to acute otitis media complicated by serous labyrinthitis, manifesting as direction-changing positional nystagmus. These findings underscore the need for thorough diagnosis and management in such presentations. This is the first report of concomitant middle ear cholesteatoma in a CMT patient, illustrating the complexity of diagnosis and treatment.
Traditional Chinese herbal compound as complementary treatment for nonspecific low back pain: A randomized controlled trial
Authors: Lao Yangjun , Fu Jialei , Chen Yangdahao , Xu Bin , Zhang Shuliang , Sheng Hongfeng , Liu Yiyang , Du Yibin 
Published: November 2024

Background:
This prospective randomized controlled trial was designed to evaluate the clinical efficacy and safety of Bu Shen Tong Luo herbal compound as a complementary treatment for nonspecific low back pain (NSLBP).

Methods:
A total of 76 patients with NSLBP included from January 2022 to June 2023 according to the criteria were randomly divided into Bushen Tongluo formula (BSTL) group (n = 38) and celecoxib group (n = 38). According to Traditional Chinese Medicine principles, patients of 2 groups were divided into 5 syndrome types. Celecoxib or BSTL herbal compound were used to treat NSLBP of each group for 3 weeks, every week the Visual Analog Scale (VAS), Oswestry Disability Index, and Japanese Orthopaedic Association scores of each patient was record and compared to evaluate the clinical efficacy, and adverse reaction was reported to evaluate the safety of 2 interventions.

Results:
A total of 71 patients finished the follow-up, including 36 patients in BSTL group and 35 patients in celecoxib group. The result showed that within 3 weeks, both BSTL and celecoxib interventions were able to treat NSLBP, with improvements in VAS scores and waist function index. However, there were no significant differences in clinical outcomes between these 2 interventions. Then we divided the patients into 5 syndromes on the basis of traditional Chinese medicine principles and observed their clinical outcomes. We found that celecoxib had similar improvements in VAS score and waist function index for each syndrome type and most of the syndromes in the BSTL group, except for the SRBZ syndrome. In the treatment of SRBZ syndrome, BSTL prescription showed no statistically significant clinical improvement. Meanwhile, in the treatment of HSBZ syndrome of NSLBP, BSTL prescription showed better clinical results than celecoxib, although there was no difference in VAS scores between the 2 groups, patients in BSXL group had better waist function than those in celecoxib group.

Conclusion:
Both BSTL herbal compound and celecoxib are effective and safe in the clinical treatment of NSLBP, and BSTL herbal compound had unique advantages in the treatment of HSBZ syndrome type of NSLBP especially in waist function improvement.
Meta-analysis of the efficacy and impact on cardiac function of sodium–glucose cotransporter 2 inhibitor Empagliflozin in heart failure patients
Authors: Li Weidong , Shen Xuanyang , Zhang Meiqi , Tan Wentao , Jiang Xiaolu , Wen Hongfu , Shen Yuan 
Published: November 2024

Background:
Currently, there is no comprehensive systematic review available to comprehensively assess the efficacy and safety of Empagliflozin and other sodium–glucose cotransporter 2 inhibitors in the treatment of heart failure (HF). This study employed a meta-analysis approach to systematically evaluate the therapeutic effects of Empagliflozin in HF patients and its impact on cardiac function.

Method:
The keywords including “heart failure,” “HF,” “cardiac failure,” “cardiac disease,” “Empagliflozin,” and “sodium–glucose cotransporter 2 inhibitors” were utilized to search for relevant clinical studies on Empagliflozin in the treatment of HF in various databases, such as China National Knowledge Infrastructure, Wanfang, VIP Chinese Medical Journal Database, PubMed, MEDLINE, Embase, Cochrane Library, Springer, and Science Direct. The studies included patients with HF who received drug treatment. Data on baseline characteristics and posttreatment outcomes, including HF hospitalization (HHF), cardiovascular mortality, all-cause mortality, estimated glomerular filtration rate changes, Kansas City Cardiomyopathy Questionnaire quality of life (QoL) scores, N-terminal pro-B-type natriuretic peptide, left ventricular ejection fraction, hematocrit, and other relevant indicators were collected. Meta-analysis was conducted using RevMan5.3 to analyze the extracted data.

Results:
A total of 15 studies were included in the final analysis, comprising 36,917 patients with HF. Among them, 18,486 patients were in Empagliflozin group, and 18,431 patients were in control (Ctrl) group. The results of the meta-analysis demonstrated that, relative to Ctrl group, Empagliflozin group showed a substantially lower HHF rate, a substantial improvement in estimated glomerular filtration rate changes, a reduced cardiovascular mortality rate, a higher Kansas City Cardiomyopathy Questionnaire QoL score, increased hematocrit values, reduced N-terminal pro-B-type natriuretic peptide changes, and enhanced left ventricular ejection fraction changes. These findings suggest that remarkable improvements in various outcomes compared to the Ctrl group.

Conclusion:
The sodium–glucose cotransporter 2 inhibitor Empagliflozin markedly reduces the HHF rate and cardiovascular mortality in HF patients. It also improves patients’ QoL, enhances renal function, and increases cardiac function while reducing both, the preload and afterload.
Umbilical cord mesenchymal stem cells combined with autologous platelet-rich plasma for lower extremity venous ulcers: A case report and literature review
Authors: Jiao Linlin , Nie Jing , Duan Limei , Qiao Xiaoping , Sui Yuanda 
Published: November 2024

Rationale:
Nonhealing ulcers are difficult to manage because they deviate from the normal wound healing process. Conventional therapy cannot achieve satisfactory therapeutic effects. To verify the effectiveness of combined treatment with human umbilical cord mesenchymal stem cells (hUMSCs) and platelet-rich plasma (PRP) for nonhealing ulcers, we studied a patient with left lower limb venous ulcer (LEVU) treated with combined injection therapy.

Patient concerns:
We present the case of a LEVU patient who has not healed for a long period of time (up to 1 year).

Diagnoses:
LEVU was diagnosed with clinical symptoms.

Interventions:
The hUMSCs plus PRP were injected into the wound edge and base (1 µL of cells/cm2 of wound surface), 0.5 mL at each point, with a distance of approximately 1 to 3 cm between points. The injection point was determined according to the extent of wound involvement.

Outcomes:
Seven days after hUMSC + PRP application, the wound area decreased by nearly 50%. The ulcers had almost completely healed by day 62, and no serious treatment-related toxic side effects were observed.

Lessons:
hUMSCs can improve wound healing through re-epithelialization, increased angiogenesis, and granulation tissue formation. PRP has also been suggested to promote wound healing through the secretion of various nutritional factors. The combination of hUMSCs and PRP has a mutually reinforcing effect, which may achieve a 1 + 1 > 2 effect. Therefore, the combination of hUMSCs and PRP may be a safe and effective treatment option for LEVU.
The impact of Tanreqing injection on mucus hypersecretion and cough in bronchiectasis: A meta-analysis of randomized controlled trials
Authors: Zhang Jinzhi , Yang Zi , Yuan Shasha , Duan Yuanyuan , Miao Qing 
Published: November 2024

Background:
Bronchiectasis clinically manifests airway mucus hypersecretion as mucopurulent sputum production and chronic cough. In the past decade, Tanreqing injection (TRQ) has been often used in clinical practice as an add-on treatment for bronchiectasis in China. Several in vivo studies have indicated that TRQ is effective in improving sputum expectoration and cough in acute exacerbation of bronchiectasis but results of individual studies are inconsistent. Therefore, systematically and critically evaluating the effectiveness and safety of TRQ on mucus hypersecretion and cough in bronchiectasis is necessary.

Methods:
Randomized controlled trials examining the treatment of bronchiectasis with TRQ were systematically searched from databases including PubMed, Cochrane Library, Embase, Web of Science, Chinese National Knowledge Infrastructure, Vip Information Database, Wanfang data, and Chinese Biomedical Literature Database, based on a preregistered protocol and adhering to Cochrane methods. Pertinent data were taken out from the included studies and a methodological quality assessment was done. R language (version 4.4.1) was used to perform the meta-analysis.

Results:
Twenty randomized controlled trials involving 1544 patients were analyzed. The results demonstrated that TRQ significantly improved mucus hypersecretion, shortened the duration of cough and phlegm, reduced symptom scores, and enhanced both forced expiratory volume in 1 second and forced vital capacity. Additionally, TRQ effectively lowered inflammatory markers, including C-reactive protein, procalcitonin, white blood cell count, neutrophil count, interleukin-6, and tumor necrosis factor-alpha. Moreover, TRQ increased the partial pressure of oxygen and decreased carbon dioxide pressure.

Conclusion:
The findings suggest that TRQ positively impacts mucus hypersecretion and mucociliary clearance, leading to improvements in sputum production and cough during bronchiectasis exacerbations, without increasing the risk of adverse effects. TRQ may be considered a viable option for managing bronchiectasis and could serve as a novel mucus-modifying agent.
Ultrasound-guided anterior iliopsoas muscle space block compared with fascia iliaca compartment block in elderly hip surgery: A randomized controlled trial
Authors: Niyonkuru Emery , Zeng Rui , Zhang Xu , Zhu Juan , Jiang Peng , Ma Peng 
Published: November 2024

Background:
Elderly hip fracture patients experience severe pain. Surgical stress and pain during position changes for spinal anesthesia puncture can adversely affect hemodynamics. The objective of this study was to compare the perioperative analgesic efficacy of anterior iliopsoas muscle space block with supra-inguinal fascia iliaca compartment block (S-FICB) in elderly patients undergoing hip surgery.

Method:
In this randomized control trial, 66 patients were randomly assigned to either the iliopsoas space or the S-FICB group. Each patient received 30 mL of ropivacaine 0.375%. Perioperative pain scores were assessed and compared in both groups. The primary outcome was pain scores during changes in position for neuraxial anesthesia. Secondary outcomes included postoperative pain intensity, inflammatory markers for 12 to 24 hours, and perioperative adverse reactions.

Results:
The iliopsoas space group demonstrated a faster median block onset of 7 [6–8] minutes compared to S-FICB 14.50 [13–16] minutes (P < .001). Neuraxial anesthesia position changes resulted in lower pain scores for iliopsoas 2 [1–2] versus S-FICB 3 [3–4] (P < .001). Resting pain scores were similar at 12 hours post-surgery, but during exercise, the iliopsoas group had significantly lower scores [1–2] compared to S-FICB 4 [2–4] (P < .001). After 24 hours, C-RP levels were lower in the iliopsoas group (14.86 ± 1.23 mg/L) than S-FICB (17.90 ± 1.25 mg/L) (P < .001). The 2 groups differed from one another (P < .001). These findings suggest that iliopsoas space block may offer faster, superior dynamic pain control, and potentially reduced inflammation compared to FICB block for postoperative pain management.

Conclusion:
In elderly hip fracture patients, the anterior iliopsoas space block works slightly better than S-FICB at providing effective perioperative analgesia.
The Use of Reinforced Ovine Mesh in Implant Breast Reconstruction: Equivalent Outcomes to Human Acellular Dermal Matrices and More Cost-effective
Authors: Sweitzer Keith , Arias-Camison Raquel , Cafro Carolyn , Langstein Howard 
Published: November 2024

Purpose
The use of “mesh” in implant-based reconstruction is widespread, with both acellular dermal matrices (ADMs) and extracellular matrices (ECMs) being used, especially in prepectoral device placement. This study compared Ovitex (ovine ECM) versus human cadaveric ADMs to determine safety profiles and cost-effectiveness.

Methods
A single surgeon's longitudinal experience with 2-stage, immediate tissue expander breast reconstruction from 2018 to 2023 was analyzed. Patients with AlloDerm and Cortiva (human ADM) were compared with those receiving Ovitex, and 90-day complications were analyzed by chi-squared and analysis of variance. Costs of each mesh were tabulated based on available market data.

Results
Patient demographics were comparable. Of 127 patients, 85 received ovine ECM (163 breasts) and 42 received cadaveric ADM (81 breasts). No significant difference between the groups for complications requiring return to the operating room (12.7% ovine vs 14.8% human (P = 0.31) or minor complications (9.8% ovine vs 7.4% human, P = 0.34). There was no difference between reconstructive success and failure between the 2 groups (P = 0.066). The cost of Ovitex was 24%–38% cheaper than Cortiva and AlloDerm, respectively.

Conclusions
In this longitudinal, single-surgeon study of 2 different types of meshes in 2-stage expander implant breast reconstruction, we found ovine multilaminated reinforced extracellular matrix (Ovitex) was comparable in outcomes with human acellular dermal matrices (AlloDerm and Cortiva). Ovine mesh was considerably cheaper. Multiple factors determine which mesh should be chosen for implant breast reconstruction. This study supports the use of Ovitex as a cost-effective substitute for human acellular dermal matrices in implant breast reconstruction.
The Role of Coronoidectomy in Complex Mandibular Reconstruction With Free Fibular Flap
Authors: Bangun Kristaninta , Tania Vika , Atmodiwirjo Parintosa , Ramadan Mohamad Rachadian , Rodjani Ines Hadianesti 
Published: November 2024

Introduction:
Complex mandibular reconstruction is at risk of postoperative restricted mouth opening. Temporomandibular joint pseudoankylosis can cause significant disability, leading to restricted mouth opening and an inability to create a proper seal with the mouth. Treating this condition often requires aggressive surgical intervention, primarily restoring the structure and functionality of the mandible. Coronoidectomy plays a vital role in improving mouth opening capacity.

Case Presentation:
Four patients with temporomandibular joint pseudoankylosis were included in this case series. The patients reported being unable to move their remaining lower jaw, having a perpetually open mouth, and constant drooling. All patients had a history of reconstructive surgery due to tumor or malignancy and could only open the mouth less than 10 mm. They underwent coronoidectomy followed by free fibular flap reconstruction. Postoperatively, all 4 patients exhibited a movable mandible and achieved proper occlusion. The maximum mouth opening increased by 25 to 45 mm; all flaps appeared vital, sutures remained intact, and no active bleeding.

Discussion:
Coronoidectomy is crucial for enhancing the ability to open the mouth. All of the patients underwent a coronoidectomy surgery followed by free fibular flap reconstruction. Immediately after the surgery, the mandibular projection appears nearly symmetrical, the patient opens their mouth, and occlusion is achieved subjectively. From our presented cases, after coronoidectomy, all patients had movable mandibula, and mouth opening was achieved. Coronoid process resection frees the mandible from the temporalis. Coronoidectomy and separation of the temporalis muscle from the mandible have excellent clinical efficacy for improving mouth opening and movement.

Conclusion:
Coronoidectomy followed by a free fibular flap should be considered the best surgical option for patients with restricted mouth opening after complex mandibular reconstruction.
Characteristics and Clinical Significance of Skull Defect Restoration in Young Patients: A Single-center Report and Literature Review
Authors: Zhou Jia-hua , Wang Ju-lei , Yang Di , Wu Ying-xi , Zhang Wei , Qin Huai-zhou , Wang Chao , Li Jiang 
Published: November 2024

Objective:
The objective of this study is to observe cranial regeneration following cranial defects in young patients and analyze the factors influencing the regeneration process.

Methods:
In this retrospective study, a comparative and analytical assessment was conducted on the clinical data of 2 distinct cohorts: the observation group comprised patients aged ≤22 years with a regenerated cranial area ≥4 cm2 following cranial defects, while the control group consisted of individuals with cranial defects persisting for over 1 year and a regenerated cranial area measuring <4 cm2. These patients had been admitted to our department from August 2008 to October 2022. In addition, an analysis was undertaken to discern the pertinent factors influencing the process of cranial regeneration.

Results:
Among the 32 patients in the observation group, 9 patients developed complications after decompressive craniectomy (DC) (hereafter referred to as post-DC complications); all the patients in this group, except one, underwent cranioplasty. The control group consisted of 12 patients, all of whom had post-DC complications and underwent cranioplasty; among them, 4 patients with a coexisting complication of hydrocephalus also underwent ventriculoperitoneal shunting. Cranial regeneration was observed in all 23 patients who did not have post-DC complications and in 9 of the 21 patients with post-DC complications. The rate of cranial regeneration was lower in the group with post-DC complications than in the group without post-DC complications, and the observation time (the time from cranial defect to the completion of cranioplasty) was longer in patients in the group with post-DC complications than those in the group without post-DC complications.

Conclusion:
Cranial bone regeneration can be achieved in young patients with cranial defects if factors favorable to cranial regeneration are effectively managed. These include preserving the dura mater, periosteum, and diploe during the surgery and maintaining good physical conditions postoperatively. The distribution pattern of the regenerated bones aligns with the shape of the flap. Post-DC complications represent adverse factors that can negatively affect cranial regeneration.
Do Open Access Articles Have a Citation Advantage Over Toll Access Articles? A Comparative Analysis of Articles Published in the Journal of Craniofacial Surgery From 2019 to 2023 Based on Web of Science Data
Authors: Şahin Şamil , Durna Yusuf Muhammed , Duymaz Yaşar Kemal , Bahşi İlhan 
Published: November 2024

Objective:
This study aimed to compare the citation rates of open access (OA), and toll access (TA) articles published in the Journal of Craniofacial Surgery between 2019 and 2023, and to examine whether OA articles received more citations.

Methods:
Using the Web of Science database, articles published in the Journal of Craniofacial Surgery between 2019 and 2023 were listed, excluding those with corrections or retractions. Articles were divided into 2 groups: OA and TA. The number of articles and citation counts for each group were analyzed by year. Citation rates were compared using the independent sample t test, with a p-value of <0.05 considered statistically significant.

Results:
A total of 4691 articles were analyzed, of which 7.14% were OA and 92.86% were TA. Published in 2021, 2020, and 2019, OA articles had statistically significantly higher citation counts than TA articles. OA articles were found to be funded at a higher rate than TA articles.

Conclusion:
This study demonstrated that OA articles received more citations over time and were more likely to be funded. Although it is not definitively clear whether the citation advantage stems from the quality of the articles or their open-access status, the citation advantage of OA articles is striking.