bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of IL-17 and its gene promoter methylation status are associated with the progression of chronic hepatitis B virus infection
Authors: Tian Cui-Huan , Dai Jun , Zhang Wei , Liu Yan , Yang Yan 
Published: June 2019

Abstract
To explore interleukin-17 (IL-17) and its epigenetic regulation during the progression of chronic hepatitis B virus (HBV) infection.
A total of 162 patients with chronic HBV infection, including 75 with chronic hepatitis B (CHB), 54 with hepatitis B-associated liver cirrhosis and 33 with hepatitis B-associated hepatocellular carcinoma (HBV-HCC), were enrolled in this study. Thirty healthy adults of the same ethnicity were enrolled in the control group. Whole venous blood was obtained from the patients and normal controls (n = 30). Clinical and laboratory parameters were assessed, and we performed enzyme-linked immunosorbent assay and quantitative real-time PCR to measure the serum levels and relative mRNA expression of IL-17, respectively. IL-17 promoter methylation in peripheral blood mononuclear cells was assessed by methylation-specific PCR. We analyzed the serum and mRNA levels of IL-17 and IL-17 promoter methylation in the 4 groups as well as the effect of methylation on serum IL-17 levels. Correlations between the IL-17 promoter methylation status and clinical parameters were analyzed by Spearman correlation analysis.
Compared to the normal control group, the patient groups exhibited significantly higher serum and relative mRNA levels of IL-17. The methylation distribution among the patients was significantly lower than that among the normal controls (P < .05), with the HBV-HCC group showing the lowest IL-17 gene methylation frequency. The average IL-17 promoter CG methylation level was negatively correlated with IL-17 mRNA expression (r = −0.39, P = .03), and negative correlations between IL-17 promoter methylation and prothrombin time activity (r = −0.585, P = .035), alanine aminotransferase (r = −0.522, P < .01), aspartate aminotransferase (r = −0.315, P < .05), and the model for end-stage liver disease score (r = −0.461, P < .05) were observed. IL-17 serum levels in the methylated-promoter groups were significantly lower than those in the unmethylated-promoter groups.
IL-17 expression and promoter methylation were associated with chronic HBV infection progression, especially in the HBV-HCC group. The IL-17 promoter status may help clinicians initiate the correct treatment strategy at the CHB stage.
Application of the cuff rectum drainage tube in total mesorectal excision for low rectal cancer
Authors: Ye Weipeng , Zhu Zhipeng , Liu Gang , Chen Borong , Zeng Junjie , Gao Jin , Wang Shengjie , Cai Hejie , Xu Guoxing , Huang Zhengjie 
Published: June 2019

Abstract
To investigate therapeutic effect of cuff rectum drainage tube (CDT) in preventing the postoperative complications of total mesorectal excision (TME) and promoting the recovery of the patients.
The clinical data of 84 cases of low rectal cancer performed TME from June 2015 to June 2017 in the First Affiliated Hospital of Xiamen University were analyzed retrospectively. All the cases were performed anus-retained operation without preventive colostomy. Patients were divided into 2 groups according to the material of the anorectal drainage tube placed in the colonic cavity. Group I (CDT group) was transanal cuff rectal drainage tube placement (Patent No. ZL 201320384337.8) (n = 48), and group II (conventional group) was transanal clinical conventional drainage tube placement (n = 36). Anastomotic fistula incidence, the time of anal exsufflation, postoperative first ambulation time, intestinal function recovery time, the incidence of interrelated complications of drainage tube and postoperative hospital stay between 2 groups were analyzed retrospectively.
Both postoperative first ambulation and anal exhaust time in CDT group were shorter than those in the conventional group ([2.3 ± 0.4] d vs [3.0 ± 0.2] d, P < .05; [3.3 ± 0.3] d vs [3.9 ± 0.5] d, P < .05). Meanwhile, the postoperative hospital stay of CDT group was significantly decreased than that in the conventional group ([10.3 ± 1.6] d vs [11.8 ± 1.1] d, P < .05). Significant different occurrence of complications existed in anastomotic fistula (2.1% [1/48] vs 16.7% [6/36], P < .05), frequent defecation (8.3% [4/48] vs 27.8% [10/36], P < .05), defecating unfinished feeling (12.5% [6/48] vs 30.6% [11/36], P < .05), drainage tube complication (4.2% [2/48] vs 22.2% [8/36], P < .05).
The cuff rectum drainage tube may reduce incidence of anastomotic fistula after TME, shorten postoperative first ambulation and anal exsufflation time, enable faster recovery with good toleration and decrease postoperative hospital stay.
Quick-SOFA score to predict mortality among geriatric patients with influenza in the emergency department
Authors: Chang Su-Hen , Yeh Chien-Chun , Chen Yen-An , Hsu Chien-Chin , Chen Jiann-Hwa , Chen Wei-Lung , Huang Chien-Cheng , Chung Jui-Yuan 
Published: June 2019

Abstract
The quick sequential organ failure assessment (qSOFA) score is widely used to assess the risk of sepsis and predict in-hospital mortality in patients with suspected infection. However, its ability to predict mortality among geriatric patients with influenza in the emergency department (ED) remains unclear. Therefore, this study was conducted to delineate this issue.
A retrospective case–control study was conducted on geriatric patients (age ≥65 years) with influenza who visited the ED of a medical center between January 01, 2010, and December 31, 2015. Demographic data, vital signs, past histories, influenza subtypes, and treatment outcomes were included in the analysis. We assessed the accuracy of the qSOFA score in predicting 30-day mortality via logistic regression. Covariate adjustment of the area under the receiver operating characteristic curve (AUROC) via regression modeling was performed too.
In total, 409 geriatric ED patients with mean age of 79.5 years and nearly equal sex ratio were recruited. The mean qSOFA score was 0.55 ± 0.7. The Hosmer–Lemeshow goodness-of-fit test was 0.79 for qSOFA score. Patients with qSOFA score of ≥2 (odds ratio, 4.21; 95% confidence interval [CI], 1.56–11.40) had increased in-hospital mortality. qSOFA score of ≥2 also had excellent in-hospital mortality discrimination with an adjusted AUROC of 0.81 (95% CI, 0.71–0.90). A qSOFA of ≥2 had prominent specificity of 0.89 (95% CI, 0.86–0.92).
An increase in qSOFA score of 2 greatly predicts mortality in geriatric patients with influenza.
Impacts of nurse-led clinic and nurse-led prescription on hemoglobin A1c control in type 2 diabetes
Authors: Wang Qun , Shen Yan , Chen Yongmin , Li Xiaohua 
Published: June 2019

Abstract

Background:
To evaluate the impacts of nurse-led clinic and nurse-led prescription on hemoglobin A1c (HbA1c) control in type 2 diabetes.

Methods:
We searched relevant publications in English and Chinese database and conducted meta-analysis by Stata 12.0. We divided the case groups of included studies into 2 categories according to the role of nurse: nurse-led clinic and nurse-led prescription. Nurse-led clinic was implemented on the basis of standard diabetes care provided by doctor, and control group also receive the standard diabetes care but without nurse-led clinic. The doctor mentioned above might work alone or in a health care team. Nurse-led prescription was prescribed by nurse independently and compared with that of doctor.

Results:
The meta-analysis shown that, compared with the standard diabetes care, nurse-led clinic significantly decreases HbA1c level (standard mean difference [SMD] = −0.767; 95% confidence interval [CI]: −1.062, −0.471; P < .001). In subgroup analysis, nurse-led clinic also had positive impacts on controlling HbA1c level, no matter in developed countries (SMD = −0.353; 95% CI: −0.6, −0.106; P = .005) or developing countries (SMD = −1.114; 95% CI: −1.498, −0.73; P < .001). Additionally, there was no significant difference between nurse-led prescription and doctor prescription in controlling HbA1c levels (SMD = −0.203; 95% CI: −0.434, 0.029; P = .086).

Conclusion:
The nurse-led clinic had positive significance for HbA1c control. Meanwhile, the impact of nurse-led prescription on controlling HbA1c is comparable to that of doctor. It is valuable to provide nurse-led clinic on the basis of standard diabetes care provided by doctor to better control HbA1c, and nurse-led prescription should be provided when doctor-led service is limited.
Base excess in predicting the prognosis of patients with paraquat poisoning
Authors: Zhang Feng Wei , Gao Jie , Zhang Su Li , Wu Cheng Pu , Li Yong , Bai Wen Jing , Feng Shun Yi 
Published: June 2019

Abstract

Background:
Although the prognostic significance of base excess (BE) in patients with paraquat (PQ) poisoning has been investigated for several years, the results remain controversial. Thus, we performed for the first time a comprehensive meta-analysis to explore the value of BE in predicting the prognosis of patients with PQ poisoning.

Methods:
We searched PubMed, EMBase, Web of Science, ScienceDirect, Cochrane Library, and the Chinese National Knowledge Infrastructure to identify all relevant papers that were published up to August 2018. The data were extracted for pooled analysis, heterogeneity testing, sensitivity analysis, publication bias analysis, and subgroup analysis.

Results:
Pooled analysis revealed that a decreased BE is correlated with poor mortality (pooled OR = 21.358, 95% CI: 12.716–35.873, P < .001). Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 78% (95% CI: 0.66–0.86), 88% (95% CI: 0.66–0.97), 6.6 (95% CI: 2.2–19.9), 0.25 (95% CI: 0.18–0.36), and 26 (10–69), respectively. No publication bias was detected by Egger test (P = .263) and Begg test (P = .462). Sensitivity analyses indicated no important differences among the estimates of effects.

Conclusion:
Our findings show that BE is useful for predicting the prognosis of PQ poisoning.
Evaluation of the effects of aerobic training during hemodialysis on autonomic heart rate modulation in patients with chronic renal disease
Authors: Morais Mauro J.D. , Raimundo Rodrigo D. , Oliveira Fabiano S. , Abreu Luiz C. de , Bezerra Italla M.P. , Silva Romeu P.M. , Rodrigues Alliny S. , Valenti Vitor E. , Pérez-Riera Andrés R. 
Published: June 2019

Abstract

Introduction:
Chronic renal disease (CRD) affects a large portion of the population and is directly related to cardiovascular problems and hypertension, among others. Studies show that heart rate variability is directly affected by these problems. Physical-oriented exercises have been shown to be of fundamental importance in improving the adverse effects to dialysis treatment.

Objective:
To analyze the effects of aerobic training during hemodialysis on autonomic heart rate modulation in patients with CRD.

Method:
Experimental study of an open, single group clinical trial. In this clinical trial, patients with CRD will initially undergo international physical activity questionnaire and kidney disease quality of life short form protocols, as well as monitoring of heart rate systolic, and diastolic blood pressure. After evaluation of the initial parameters, patients will undergo an aerobic exercise program for 12 weeks, in 3 weekly sessions, lasting 30 minutes a session. These evaluations will allow for a greater control of the disease, and monitoring of any improvements in the quality of life and self-esteem of these patients.

Ethics and dissemination:
This study was approved following the guidelines and norms that regulate research involving human subjects, in Resolution No. 466/12 of the National Health Council. It was approved by the Research Ethics Committee of the Faculty of Juazeiro do Norte, with the number 1962 092. All patients who agree to participate in the research will sign the informed consent form. The results will be disseminated through peer-reviewed journal articles and conferences.
The clinical outcomes for chordomas in the cranial base and spine
Authors: Zhou Yibiao , Hu Bolin , Wu Zhiwei , Cheng Hanxiong , Dai Min , Zhang Bin 
Published: June 2019

Abstract
Owing to the special growth pattern of chordomas and the limited treatment options currently available, the treatment of chordoma still remains difficult. In this study, we hope to further clarify the relationship between surgical treatment and radiotherapy of chordoma and disease progression.
All patients with a primary histopathological diagnosis of clival or spinal chordomas recorded in our institution between 1976 and 2017 were examined.
A total of 60 patients (location: skull base/clival, n = 24; vertebral column, n = 5; sacrum, n = 31) had a mean follow-up time of 7.7 years (range 12 months–35 years). Compared with patients who received subtotal resection (n = 5, 5-year and 10-year survival = 61% and 39%, respectively), the annual survival rate of patients who received total resection (n = 55, 5-year and 10-year survival = 67%, respectively) was significantly higher. The overall 10-year survival rate (58%) of patients treated with surgery alone was significantly different from those treated with a combination of surgery and radiation (73%). The long-term prognosis of sacral chordoma was the worst (10-year survival rate = 48%).
The best treatment strategy for improved long-term survival in chordoma was a combination of surgical resection and radiation therapy. Adjuvant radiotherapy for chordoma significantly improves disease-free survival, although the long-term survival benefit remains to be determined. A worse prognosis and poor long-term survival are seen in sacral chordomas.
Medical malpractice related to drug-induced anaphylaxis
Authors: Hyeon Cheol Won , Lee Ji Young , Jang SeungGyeong , Cho Soo Ick , Kim SoYoon , Lee Won , Shin SuHwan 
Published: June 2019

Abstract
Drug-induced anaphylaxis (DIA) is a highly paradoxical disorder involving a fatal response to medicines prescribed for therapeutic purposes. This study aimed to improve the awareness on DIA and to prevent errors through an analysis of lawsuit judgments.
Sentenced judgments involving DIA from 1998 to 2017 using the database of the Korean Supreme Court Judgment System were collected. General characteristics, results, and recognized negligence of DIA litigation cases were analyzed.
Of 27 lawsuit cases included, antibiotics (n = 6, 22.2%), radiocontrast media (n = 6, 22.2%), and non-steroidal anti-inflammatory drugs (n = 5, 18.5%) were the most common drugs that had caused DIA. Cardiac arrest was reported in 23 cases (85.2%). The median time interval from drug administration to diagnosis and from diagnosis to cardiac arrest were 7 (interquartile range, IQR = 0–35) and 5 minutes (IQR = 0–33), respectively, suggesting insufficient time to cope with anaphylaxis. Consequently, either death (n = 18, 66.7%) or ischemic brain injury (n = 9, 33.3%) occurred in all cases. Violation of duty of care was recognized in 19 cases (70.4%) with median awarded amount of $106,060 (IQR = $70,296–$168,363). The recognized negligence included inadequate observation after drug administration (n = 6), delayed or missed epinephrine administration (n = 6), ignoring a history of allergy or drug hypersensitivity (n = 6), and prescription error (n = 5).
It is necessary to improve the awareness on DIA, because making a trivial error in any process of history taking, drug prescription and administration, observation, and/or emergency treatment may have fatal consequences that can lead to indemnity.
Facial reanimation: an update on nerve transfers in facial paralysis
Authors: Jandali Danny , Revenaugh Peter C. 
Published: June 2019

Purpose of review
The aim of this article is to review the recent literature on nerve transfers in facial paralysis. The discussion focuses on direct nerve repair and three types of nerve transfers, cross facial nerve graft, hypoglossal, and masseter nerve transfers.

Recent findings
Masseteric nerve transfers have a high probability of creating significant movement, although tone is poor. The hypoglossal to facial nerve transfer is reliable in affording facial tone and has been updated to involve a transposition technique that offers good results with minimal morbidity. Combination nerve transfer techniques using multiple cranial nerves or cross-face nerves are increasingly described.

Summary
Reinnervation of the facial nerve and neural regeneration in general are areas of intense research and novel surgical approaches continue to be explored. Although direct nerve repair is the most ideal, other nerve transfers can be performed with good results. More specifically, the masseteric nerve transfer can provide excellent movement and the hypoglossal transfer good tone. Combination transfers may afford the benefits of multiple nerves.
Carbapenemase-producing organisms in solid organ transplantation
Authors: Wong Darren , van Duin David 
Published: June 2019

Purpose of review
Carbapenem-resistant enterobacteriaceae (CRE) are a critical healthcare threat. Infections caused by CRE disproportionately affect transplant patients. Retrospective case studies suggest that up to 10% of transplant recipients develop a CRE infection. The current literature is reviewed with a particular focus on transplant-specific implications.

Recent findings
There are specific risks inherent to transplant recipients that result in an elevated risk for CRE carriage and subsequent infection. Additionally, the manifestations of these infections are dependent on the specific transplant type. The optimal treatment of CRE infections in transplant recipients has not been defined.

Summary
A reduction in the regional community CRE burden can lead to a secondary reduction in their occurrence within vulnerable transplant populations. Therefore, core principles of antibiotic stewardship and infection control within all levels of the healthcare system remains the most effective strategy for addressing the current health crisis. Simultaneously, an integrated approach to risk stratification and an approach to treatment is postulated for management of CRE infection within the solid-organ transplant population.
Successful Colonoscopy‐assisted Cecostomy Tube Replacement to Salvage Lost Cecostomy Tract Access in Children
Authors: Dike Chinenye , Rahhal Riad 
Published: June 2019

ABSTRACTObjectives:Cecostomy tubes are commonly used for antegrade enema delivery in children with spinal defects and anorectal malformations to help address chronic constipation and fecal incontinence. Once surgically or radiologically placed, cecostomy tubes require changes by a percutaneous approach, which may be unsuccessful requiring repeat laparoscopy or open surgery to re‐establish the cecostomy tract. The role of colonoscopy assistance to salvage lost cecostomy access in children who fail percutaneous replacement is not well described. The primary aim was to describe the safety and effectiveness of a colonoscopy‐assisted approach to re‐establish lost cecostomy access in children.Methods:This was a retrospective cohort study of the methods, success and complication rates associated with colonoscopy assisted cecostomy tube replacement in children between 2000 and 2017 at a pediatric tertiary care center.Results:Ninety‐five patients with 841 attempted procedures were included with only 1% of procedures requiring endoscopic assistance. These included 7 colonoscopy‐assisted cecostomy tube replacement procedures in 6 patients (median age 9.2 years, median weight 26.3 kg, 33% girls). The most common reason for using colonoscopy assistance was a failed percutaneous approach. The colonoscopy‐assisted approach was successful in all cases without documented complications.Conclusions:Colonoscopy‐assisted cecostomy tube replacement is safe and highly successful in re‐establishing lost cecostomy access in children after failed attempts with percutaneous or fluoroscopic‐guided approaches.
Does formal vs home-based physical therapy predict outcomes after ankle fracture or ankle fracture-dislocation?
Authors: Ferguson Chad M. , Harmer Luke , Seymour Rachel B. , Ellington John Kent , Bosse Michael J. , Hsu Joseph R. , Karunakar Madhav , Sims Stephen , Ruffolo Michael , Churchill Christine , Anderson Robert , Cohen Bruce , Davis Hodges , Jones Carroll , Roznowski Amy 
Published: June 2019

Abstract

Background:
Ankle fractures are among the most common injuries treated by orthopaedic surgeons. Various postoperative rehabilitation strategies have been promoted, but the ability to improve patient-reported functional outcome has not been clearly demonstrated. We aim to evaluate outcomes associated with clinic-based, physical therapist-supervised rehabilitation (Formal-PT) compared to surgeon-directed rehabilitation (Home-PT).

Methods:
This prospective observational study included patients with operative bimalleolar or trimalleolar ankle fractures with or without dislocation (n = 80) at a Level I trauma center. Patients were prescribed PT per the surgeon's practice pattern. Patient-reported functional outcomes at 6 months and complication rates were compared between groups.

Results:
Of the 80 patients, 38 (47.5%) patients received Formal-PT; the remaining received Home-PT. Thirty-four patients (89.5%) attended ≥1 PT session. Number of sessions attended ranged from 1 to 36 (mean = 16). Receipt of Formal-PT did not differ by injury characteristics or demographics. Of patients with private insurance, 57% were prescribed Formal-PT vs 7% of uninsured patients (P = .033). FAAM and Combination SMFA scores at 6 months were similar between groups (Formal-PT: 69.7, 20.1; Home-PT: 70.9, 24.4; P = .868, .454, respectively). Postoperative complications were rare and equivalent between groups.

Conclusions:
Comparison of outcomes between patients with operatively treated displaced ankle fractures/dislocations with Formal-PT vs Home-PT showed no difference in SMFA and FAAM scores. These findings suggest patients receiving supervised PT produced a similar outcome to those under routine physician-directed rehabilitation at 6 months. The cost for therapy averaged $2012.96 per patient receiving Formal-PT.