bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of exercise for improving functional outcomes for patients undergoing total hip arthroplasty
Authors: Wu Jia-Qi , Mao Lin-Bo , Wu Jian 
Published: March 2019

Abstract

Background:
The objective of this meta-analysis was aimed to illustrate the functional outcomes of exercise for total hip arthroplasty (THA) patients.

Methods:
In July, 2018, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, and Google database. Data on exercise for functional outcomes for THA patients were retrieved. The primary endpoint was walking speed. Other outcomes included physical activity scale, Harris hip score, pain scores, abduction strength, and the length of hospital stay. After testing for publication bias and heterogeneity between studies, data were aggregated for random-effects models when necessary.

Results:
Ten clinical studies with 441 patients were ultimately included in the meta-analysis. Compared with the control group, exercise was associated with an increase of the walking speed by 0.15 m/s than control group (weighted mean difference [WMD] 0.15; 95% confidence interval [CI] 0.08, 0.22; P = .000). Also, exercise group could also increase Harris hip score (WMD 8.49; 95% CI 5.19, 11.78; P = .000) and abduction strength than control group (WMD 9.75; 95% CI 5.33, 14.17; P = .000). What is more, exercise has a beneficial role in reducing the pain scores (WMD −1.32; 95% CI −2.07, −0.57; P = .001) and the length of hospital stay (WMD −0.68; 95% CI −1.07, −0.29; P = .001) than the control group. However, there was no significant difference between the physical activity scale (WMD −2.13; 95% CI −6.31, 2.05; P = .317).

Conclusions:
Compared with control group in the management of THA, postoperative exercise has a better pain relief and clinical outcomes. Considering the beneficial of the postoperative exercise, we take a positive attitude toward use exercise for patients with THA.
Multiple schwannomas of the digital nerves and common palmar digital nerves
Authors: Jiang Shuai , Shen Hui , Lu Hui 
Published: March 2019

Abstract

Rationale:
Benign schwannoma is the most common tumor of peripheral nerves while plexiform multiple schwannomas are rare conditions. This manuscript reported a case of multiple Schwannomas characterized by unusual location.

Patient concerns:
We report a 34-year-old workman presented with multiple nodules in his forefinger, middle finger and palm respectively for 5 years. He felt pain combined with paraesthesias in fingers and palm. The symptoms could be eased through rest and drugs medication.

Diagnosis:
Three Schwannomas were found in surgery respectively. Histologic findings confirmed the diagnosis of schwannomas.

Interventions:
We removed all of the 3 schwannomas completely without damaging the continuity of the nerve.

Outcomes:
Six months after the surgery, the patient had had not experienced any symptom recurrence.

Lessons:
Successful treatment of multiple schwannomas depends upon accurate diagnosis. Early surgery can improve the treatment outcome of multiple schwannomas.
Increased expression of plakophilin 3 is associated with poor prognosis in ovarian cancer
Authors: Qian Hua , Yuan Donglan , Bao Jingjing , Liu Fuxing , Zhang Wenyan , Yang Xumei , Han Gaohua , Huang Junxing , Sheng Haihui , Yu Hong 
Published: March 2019

Abstract
Considering the essential role of plakophilin 3 (PKP3) in the maintenance cell-cell adhesion, dysregulation of PKP3 is involved in human diseases. This study aimed to explore the clinical significance of PKP3 in ovarian cancer. Immunohistochemistry was performed to examine the PKP3 expression in 157 cancer specimens from primary ovarian cancer patients. PKP3 was expressed in both the cytoplasm and nucleus. Eighty-one (51.6%) out of 157 ovarian cancer tissues showed PKP3 expression, while absent expression was observed in normal ovarian tissues. High PKP3 expression was associated with lymph node metastasis (LNM, P = .004) and advanced International Federation of Gynecology and Obstetrics (FIGO) stage (P = .013). Patients with high PKP3 expression had shorter overall survival (OS) than those with low PKP3 expression (60.2 months vs 74.2 months, P = .021). However, no association between PKP3 expression and progression-free survival (PFS) was observed (P = .790). Cox regression analysis indicated that PKP3 expression was an independently predictive factor for the OS of patient with ovarian cancer (adjusted HR = 1.601, 95%CI: 1.014-2.528, P = .043), especially those with FIGO stages III and IV disease (adjusted HR = 1.607, 95%CI: 1.006–2.567, P = .047). The gene expression profiling interactive analysis (GEPIA) databases also showed that PKP3 was upregulated in ovarian cancer (P < .001) and patients with high PKP3 expression had shorter OS (P = .004). In conclusion, our findings suggest that PKP3 is upregulated in ovarian cancer and is likely involved in the progression of ovarian cancer. PKP3 might therefore serve as a prognostic biomarker for patients with ovarian cancer.
Outcomes and modifiable resuscitative characteristics amongst pan-Asian out-of-hospital cardiac arrest occurring at night
Authors: Ho Andrew Fu Wah , Hao Ying , Pek Pin Pin , Shahidah Nur , Yap Susan , Ng Yih Yng , Wong Kwanhathai Darin , Lee Eui Jung , Khruekarnchana Pairoj , Wah Win , Liu Nan , Tanaka Hideharu , Shin Sang Do , Ma Matthew Huei-Ming , Ong Marcus Eng Hock 
Published: March 2019

Abstract
Studies are divided on the effect of day-night temporal differences on clinical outcomes in out-of-hospital cardiac arrest (OHCA). This study aimed to elucidate any differences in OHCA survival between day and night occurrence, and the factors associated with differences in survival.
This was a prospective, observational study of OHCA cases across multinational Pan-Asian sites. Cases were divided according to time call received by dispatch centers into day (0700H–1900H) and night (1900H–0659H). Primary outcome was 30-day survival. Secondary outcomes were prehospital and hospital modifiable resuscitative characteristics.
About 22,501 out of 55,881 cases occurred at night. Night cases were less likely to be witnessed (40.2% vs. 43.1%, P < .001), more likely to occur at home (32.5% vs. 29%, P < .001), had non-shockable initial rhythms (90.8% vs. 89.4%, P < .001), lower bystander CPR rates (36.2 vs. 37.6%, P = .001), lower bystander AED application rate (0.3% vs. 0.7%, P < .001), lower rates of prehospital defibrillation (13% vs. 14.4%, P < .001), and were less likely to receive prehospital adrenaline (9.8% vs. 11%, P < .001). 30-day survival at night was lower with an adjusted odds ratio of 0.79 (95% CI 0.73–0.86, P < .001). On multivariate logistic regression, occurrence at night was associated with decreased provision of bystander CPR, bystander AED application, and prehospital adrenaline.
30-day survival was worse in OHCA occurring at night. There were circadian patterns in incidence. Bystander CPR and bystander AED application were significantly lower at night in multivariate analysis. This would at least partially explain the decreased survival at night.
Diagnosis of pulmonary aspergillosis-related broncholithiasis in a child undergoing bronchoscopy
Authors: Meng Chen , Zhang Zhongxiao , Liu Xia , Yan Xiuli , Shi Chong , Liu Na , Wang Xinxin , Ma Jing 
Published: March 2019

Abstract

Rationale:
Broncholithiasis is a rare disease and is characterized by calcification in the tracheobronchial tree. This disease has a predilection in the adult and occurrence is rare in children. Considering its infrequency, we report a rare clinical case, with the aim of sharing our experience during the diagnosis and treatment procedures.

Patient concerns:
We report a 9-year- and 6-month-old girl who complained of chronic cough and recurrent wheeze for 2 months.

Diagnosis:
Bronchialithiasis were found under bronchoscope. Pathologic examination revealed aspergillosis.

Interventions:
The stone and surrounding granulation tissue were removed using a bronchoscope and the patient was treated with antifungal therapy.

Outcomes:
The patient was in good general health without any clinical symptoms during the follow-up period.

Lessons:
Pulmonary Aspergillus infection can cause bronchiolithiasis. Stones were removed under bronchoscope, and anti-Aspergillus therapy was effective.
Continuous versus intermittent infusions of antibiotics for the treatment of infectious diseases
Authors: Chen Chang-Hua , Chen Yu-Min , Chang Yu-Jun , Wang Shu-Hui , Chang Chih-Yen , Yen Hua-Cheng 
Published: March 2019

AbstractBackground:Severe sepsis and pneumonia are common problems in the intensive care units (ICUs) and cause high morbidity and mortality. Optimal doses and appropriate routes of antibiotics are critical to improve their efficacy, but their appropriate routes remain controversial.Objective:The efficacy of antibiotic administration among critically ill patient populations remains controversial. Therefore, the present meta-analysis aimed to investigate the effectiveness of antibiotic administration in patients with infection and to assess whether the effect differs between the two antibiotic administration types.Methods:A systematic search of studies on continuous infusions of intravenous antibiotics and traditional intermittent infusions of antibiotics for patients with infection was performed mainly in PubMed. The odds ratios (ORs) of the microbiological results as primary outcome and mortality rate, length of stay, and duration of antibiotic treatment as secondary outcomes were evaluated.Results:The meta-analysis comprised 9 randomized controlled trials (RCTs) and 4 retrospective studies comprising 1957 participants. Current analysis showed that the overall OR of clinical success between the continuous and intermittent groups was 0.675 (95% confidence interval [CI]: 0.523–0.870). Comparing continuous and intermittent groups, the subgroup analysis showed a lower ICU stay (OR 0.834, 95% CI: 0.542–1.282), a higher mortality (OR 1.433, 95% CI: 1.139–1.801), and a longer antibiotic duration (OR 1.055, 95% CI: 0.659–1.689), but the results of present meta-analysis were not significant because of the limited number of enrolled trials.Limitations:Heterogeneity of included trials and studies.Conclusions:The results of present meta-analysis were insufficient to recommend continuous infusion of intravenous antibiotics better than traditional intermittent infusions of antibiotics at routine clinical care. Hope large-scale RCT to provide more rebuts evidence for making recommendations to warrant continuous infusions of intravenous antibiotics at clinical practice.
Beneficial effect of polaprezinc on cardiac function post-myocardial infarction
Authors: Yoshikawa Fumitsugu , Nakajima Tetsu , Hanada Masaharu , Hirata Kazuo , Masuyama Tohru , Aikawa Ryuichi 
Published: March 2019

Abstract

Background:
Polaprezinc is clinically used for the treatment of gastric ulcers. It induces the mobilization of mesenchymal stem cells and the mRNA expression of insulin-like growth factor-1 in vascular endothelial cells in order to protect injured gastric tissue or skin.

Methods:
The current study population included 50 patients with primary acute myocardial infarction (AMI). After percutaneous coronary intervention, the subjects were randomly divided into 2 groups, namely, the nonpolaprezinc and polaprezinc groups. Peripheral blood and urinary samples were collected in a specific time to analyze zinc concentration, cardiac enzymes, and the levels of the inflammation marker interleukin-6. To evaluate the cardiac function, echocardiography was performed upon admission to the hospital and at 9 months post-AMI.

Results:
The urine and blood zinc levels of the polaprezinc group were higher compared with those of the non-polaprezinc group at 8 days after percutaneous coronary intervention. The mean interleukin-6/maximal creatine phosphokinase level was significantly reduced in the polaprezinc group (0.024 [0.003–0.066] vs. 0.076 [0.015–0.212], respectively; P = .045). In addition, echocardiography revealed that the ejection fraction of the nonpolaprezinc group was not significantly increased between day 3 and 9 months post-AMI (53 [49–60.8] vs. 59.5 [52–69.3], respectively; P = .015). However, a significant increase was detected in the ejection fraction of the polaprezinc group at the 2 time points (54 [51–57] vs. 62 [55–71], respectively; P < .01).

Conclusions:
The results of the present study suggest that polaprezinc has an anti-inflammatory effect and improves cardiac function after AMI.
Protocol of global incidence and progression of age-related macular degeneration
Authors: Zhao Shan , Lan Xiaowen , Wu Jingyang , Yue Song , Zhang Han , Wu Qiang , Zhang Guisen , Liu Lei 
Published: March 2019

Abstract

Background:
There have been many reports on the prevalence and incidence of age-related macular degeneration (AMD), and there are some systematic reviews reporting on the pooled prevalence of AMD. However, there is no systematic review of incidence or progression of AMD worldwide. Given the few evidences regarding the pooled incidence or progression of AMD, we performed this meta-analysis protocol to investigate the global incidence or progression of AMD. In addition, we will investigate the risk factors for AMD incidence or progression using meta-analysis.

Methods:
Four English databases (PubMed, EMBASE, Cochrane Library, and Web of Science) and four Chinese databases (CMB, CNKI, VIP, and Wanfang database) will be searched to identify relevant studies. The primary outcome of this meta-analysis is the incidence or progression of AMD. The second outcome of this meta-analysis is risk factors for the incidence or progression of AMD. Meta-analysis was performed to calculate the pooled incidence or progression rate and 95% confidence interval of AMD. Pooled risk ratios of risk factors (age, gender, smoking, and hypertension) for AMD incidence or progression were computed as the Mantel–Haenszel-weighted average of the risk ratios for all included studies. Sensitivity analysis, subgroup analysis, quality assessment, and publication bias analysis will be performed to ensure the reliability of our findings.

Results:
This study will provide a current evidence of global pooled incidence or progression of AMD. Further, current study will provide evidence-based risk factors for AMD incidence or progression. Moreover, our study will project the incident number of people with AMD from 2030 to 2050.

Conclusion:
This systematic review and meta-analysis will provide evidence to develop major public health strategies for preventing AMD. Ethics and dissemination: ethical approval is not required because our systematic review and meta-analysis will be based on published data without interventions on patients. The findings of this study will be published in a peer-reviewed journal.
Thoracotomy versus video-assisted thoracoscopic resection of lung cancer
Authors: Chai Tianci , Lin Yuhan , Kang Mingqiang , Lin Jiangbo 
Published: March 2019

Abstract

Background:
Video-assisted thoracoscopic surgery (VATS) is a kind of minimally invasive surgery with the advantages of small surgical incision, less surgical bleeding, and fewer hospitalization days. However, traditional thoracotomy has advantages in lymph node dissection and radical resection of tumors and the benefits of VATS compared with thoracotomy for lung cancer are controversial. This systematic review and meta-analysis will be conducted to evaluate the advantages and disadvantages of the 2 different surgical methods.

Methods and Analysis:
PubMed (Medline), Embase, Cochrane Central Register of Controlled Trials, and Google Scholar will be searched for relevant randomized controlled trials (RCTs), quasi-RCTs, and Hi-Q (high quality) prospective cohort trials published or unpublished in any language before March 1, 2019. Subgroup analysis will be performed in type of operation, tumor pathological stage, and ethnicity.

Results:
The results of this study will be published in a peer-reviewed journal.

Conclusion:
As far as we know, this study will be the first time to compare and meta-analyze the efficacy of thoracoscopic lung cancer resection and thoracotomy. This study will provide high-quality and reliable evidence for clinicians’ decision-making by comparing published or completed but unpublished trials data. Because of the characteristics of disease and intervention methods, large sample size and RCTs may be insufficient. We will carefully consider the inclusion of small sample RCTs, but this may lead to high heterogeneity and affect the reliability of research results.

PROSPERO registration number:
CRD42018118427
A technique to establish fistuloclysis for high-output jejunocutaneous fistula through percutaneous enterostomy
Authors: Niu Dong-Guang , Yang Fan , Tian Wei-Liang , Zhao Yun-Zhao , Li Chen , Ding Lian-An , Fang Hong-Chun , Huang Qian 
Published: March 2019

Abstract

Rationale:
Currently, fistucolysis helps to establish intestinal nutrition and succus entericus reinfusion in the case of controllable mature high-output enterocutaneous fistula. However, if the tube cannot reach the distal limb of a fistula, fistuloclysis is not achieved. We proposed a strategy to establish succus entericus reinfusion for intractable intestinal fistula through percutaneous enterostomy.

Patient concerns:
A 43-year-old man was transferred to our facility for postoperative enterocutaneous fistulae, sepsis, malnutrition, and electrolyte and fluid imbalance. The contrast X-ray demonstrated the breakdown of the primary anastomosis, with fistula output ranging from 1500 to 2000 mL/d, despite the administration of medications to reduce gastrointestinal secretions.

Diagnoses:
The patient was diagnosed with high-output anastomosis fistula by gastrointestinal radiography.

Interventions:
We used percutaneous enterostomy to establish fistuloclysis.

Outcomes:
Fistuloclysis was established by percutaneous enterostomy successfully. No complications were found during the past 4-month follow-up after percutaneous enterostomy. He is waiting for reconstruction surgery after 6 months’ enteral nutrition (EN).

Lessons:
Fistuloclysis-assisted EN, if used appropriately, avoids the complications of long-term parenteral nutrition (PN) and may promote faster fistula healing.
Risk factors for lower respiratory tract infection in children with tracheobronchial foreign body aspiration
Authors: Zhong Bing , Sun Si-Lu , Du Jin-Tao , Deng Di , Liu Feng , Liu Ya-Feng , Shi-Xi Liu , Chen Fei 
Published: March 2019

Abstract
The aim of this study was to determine the risk factors for lower respiratory tract infection (LRTI) in children caused by tracheobronchial foreign body aspiration (TFBA).
A total of 351 patients were retrospectively reviewed; all patients were diagnosed with TFBA at West China Hospital of Sichuan University from 2015 to 2017. Univariate analyses and multivariate analysis were used.
Age (<2 years) (P < .001), type of foreign body (plant) (P < .001), shape of foreign body (nonsmooth) (P < .001), and residence time of foreign body (>7 days) (P = .001) were risk factors for LRTI on univariate analysis. Multivariate analysis showed age (<2 years) (hazard ratio [HR] = 4.457; 95% confidence interval [CI] = 2.031–6.884; P < .001), type of foreign body (plant) (HR = 2.686; 95% CI = 1.577–3.452; P < .001), shape of foreign body (nonsmooth) (HR = 1.649; 95% CI = 1.437–3.663; P < .008), and residence time of foreign body (>7 days) (HR = 1.751; 95% CI = 1.329–3.554; P = .004) were independent risk factors for LRTI. Furthermore, children with LRTI also had longer lengths of hospital stays and antibiotic use than did children without LRTI.
Age, plant foreign body, nonsmooth foreign body, and long-term incarceration were all independent risk factors for LRTI in children. These results can help us to select more appropriate intervention times and stratified treatment for children with TFBA.
Learning curve and short-term outcomes of modularized LADG for advanced gastric cancer
Authors: Liao Gang , Wang Ziwei , Li Hui , Min Jiang , Zhong Jinkun , Mariella Sandrie , Qian Kun , Zhang Wei 
Published: March 2019

Abstract
Laparoscopy-assisted distal gastrectomy (LADG) is a complicated procedure. To reduce the difficulty of the operation and standardize the surgical procedure, we explored a new operation mode, which we termed modularized LADG (MLADG). To further extend the new operation mode, we conducted this study to evaluate the short-term outcomes of MLADG for advanced gastric cancer, and determine the learning curve.
Data from 100 consecutive patients who received LADG between October 2016 and October 2017 were retrospectively analyzed. Short-term outcomes, such as operation time and intraoperative blood loss, were evaluated, and the learning curve was calculated.
For MLADG, the mean operation time was 168.2 ± 13.0 minutes, the mean intraoperative blood loss was 93.6 ± 29.1 ml, the mean number of harvested lymph nodes was 28.6 ± 4.2, and conversion to open surgery occurred in only 1 case. In addition, MLADG had an acceptable postoperative complication incidence and fast postoperative recovery. After the first 20 cases, the operation skill reached a mature and stable level.
Our results indicate that MLADG is an oncologically feasible and technically safe surgical procedure. For the trainees with rich experience in open distal gastrectomy, the learning curve is considered to be completed after 20 MLADG cases.
Computed tomography-guided navigation assisted drainage for inaccessible deep neck abscess
Authors: Han Sung Min , Chae Hee Sung , Lee Ha Neul , Jeon Hyun Jong , Bong Jeong Pyo , Kim Ji Hoon 
Published: March 2019

Abstract

Rationale:
Deep neck infections (DNIs) in the head and neck area are difficult to treat due to the anatomical complexity of the cervical region. Since inflammation causes changes in anatomy, it is often difficult to find the exact location of the abscess, which leads to failed surgical drainage.

Patient concern:
A 76-year-old female patient was referred to our clinic with trismus and right-side facial swelling. After extraction of her lower third molar 2 weeks ago, due to chronic periodontitis, her trismus had aggravated and her maximal mouth opening was 20 mm.

Diagnoses:
Computed tomography (CT) revealed an approximately 2.5 cm-sized abscess pocket with cellulitis in the right pterygomandibular space.

Interventions:
Since the first surgical drainage attempt using the intraoral approach under general anesthesia had failed and conservative antibiotic treatment was also ineffective, a second surgical procedure with a CT-guided navigation system was performed and the pus was successfully evacuated.

Outcomes:
After drainage with CT-guided navigation, the clinical symptoms and septic conditions of the patient showed remarkable improvement, and there was no recurrence of infection within a year after the procedure.

Lessons:
Drainage with CT-guided navigation can be used as a successful surgical tool to aid in the surgery of patients with DNI when it is difficult to accurately target the abscess due to inflammation.