bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicopathological features and prognosis factors for survival in elderly patients with pancreatic neuroendocrine tumor
Authors: Li Gang , Tian Mao-lin , Bing Yun-tao , Tao Lian-yuan , Wang Hang-yan , Jiang Bin , Yuan Chun-hui , Xiu Dian-rong 
Published: March 2019

Abstract
To investigate the features and prognosis of the elderly patients with pancreatic neuroendocrine tumor (pNET).
The patients diagnosed with pNETs between 2004 and 2014 were identified from the Surveillance Epidemiology and End Results database. The ethical approval was waived because the present study was analysis of the data from Surveillance Epidemiology and End Results database.
A total of 4608 patients with “one primary only” histologically pNETs were confirmed and 653 were older than 75 years. Cancer-specific survival (CSS) and overall survival (OS) were examined. The elderly patients (≥75 years) have disadvantage in CSS and OS compared with younger cohort. Multivariate logistic regression revealed that the elderly patients have increased poorly differentiated composition, and decreased proportion of Black patients, receipt of surgery, married status, and number of removed lymph node. Multivariate Cox regression analysis demonstrated worse differentiation. Patients of T3–4 and M1 stage were associated with poor CSS, while patients of being female, tumor locating at pancreatic body/tail, receipt of surgery, and being married were associated with better CSS in the elderly patients. Meanwhile, patients with higher histological grade and M1 stage have poor OS, while patients with the characteristics of female, being married, tumor location at pancreatic body/tail and tumor surgery have better OS. Distant metastatic elderly patients underwent primary site surgery had better CSS and OS than the patients without surgery.
The elderly patients have increased possibility of poorly differentiated tumor, and decreased proportion of Black patients, surgery of primary site, number of removed lymph node and married status. Worse differentiation and tumor metastasis were independent risk factors for both CSS and OS, while primary tumor located in body/tail of pancreas, female patients, surgery of tumor primary site, and being married were protective factors.
Clinical efficacy of adenomyomectomy using “H” type incision combined with Mirena in the treatment of adenomyosis
Authors: Gao Yanfei , Shan Shuzhi , Zhao Xin , Jiang Jing , Li Dongxiao , Shi Bin 
Published: March 2019

Abstract
To evaluate the clinical efficacy and safety of adenomyomectomy using “H” type incision combined with Mirena (LNG-IUS) in the treatment of adenomyosis.
A total of 57 women with adenomyosis who underwent adenomyomectomy using “H” type incision combined with LNG-IUS were selected. Visual analog scale (VAS), menstrual flow, uterine volume, serum CA125 levels and hemoglobin amounts were compared before and after the surgery. Meanwhile, postoperative pregnancy, adverse reactions, and recurrence were observed.
VAS score, menstrual flow, uterine volume, and serum CA125 levels in 53 patients were significantly reduced after surgery (P < . 001). Moreover, statistical significances were obtained for VAS score at 13 and 6 months, menstrual flow at 1, 3, 6, 12, and 24 months, uterine volume at 1, 3, 6, 12, 24, and 36 months and CA125 levels at 1 and 3 months (P < .05). Of the 5 patients with fertility requirements, 1 became pregnant after IVF-ET, progressed to preterm, and delivered healthy twins. Among all related adverse reactions, amenorrhea was the most common (n = 20, 37.7%). There were no cases of LNG-IUS removal, ectopia, expulsion, and incarceration, except in 2 patients due to pregnancy, 1 due to uterine bleeding, and 1 due to Mirena perforation from incision of the uterine fundus. All patients showed no relapse.
Adenomyomectomy using “H” type incision combined with Mirena constitutes a novel and effective conservative surgical procedure for adenomyosis treatment.
Clinicopathological and prognostic significance of p16 protein in nasopharynx cancer patients
Authors: Sun Lingling , Song Jingjing , Huang Qingli 
Published: March 2019

Abstract

Background:
p16 protein is significantly down-regulated in several cancers, which reveals that it may be a potential biomarker for cancers. However, the clinicopathological and prognostic value of p16 protein in nasopharynx cancer patients remains unclear. Therefore, we performed a meta-analysis to assess the relationships of p16 protein expression with the clinicopathological features and prognosis of nasopharynx cancer.

Methods:
PubMed, Web of Science, Embase, and Chinese CNKI were searched to obtain eligible data. The relationships of p16 protein expression with risk, clinicopathological features, and prognosis of nasopharynx cancer were analyzed with stata 14.0 software. The pooled odds ratio (OR) with 95% CI (confidence interval) and hazards ratio (HR) with 95% CI were calculated to evaluate the association between p16 protein expression and nasopharynx cancer.

Results:
A total of 28 studies with 2612 nasopharynx cancer patients were included in the meta-analysis. p16 protein expression was significantly associated with the risk, lymph node metastasis, TNM-stage (tumor-node-metastasis), distant metastasis, and T stage of nasopharynx cancer (Risk, OR = 17.82, 95% CI = 11.20–28.35; Lymph node metastasis, OR = 2.11, 95% CI = 1.42–3.14; TNM-stage, OR = 2.25, 95% CI = 1.54–3.28; Distant metastasis, OR = 3.43, 95% CI = 1.55–7.58; T-stage, OR = 1.72, 95% CI = 1.27–2.33). The negative rate of p16 protein expression in control group was 8.77%, while the negative rate of p16 protein expression in the nasopharynx cancer tissue was 63.78%. However, no significant associations of p16 expression with the overall survival and progression-free survival of nasopharynx cancer were found.

Conclusion:
The meta-analysis revealed that downregulated p16 expression was significantly associated with the risk, lymph node metastasis, TNM-stage, distant metastasis, and T stage of nasopharynx cancer. No significant association between p16 protein expression and prognosis of nasopharynx cancer was found. However, additional high-quality and multicenter studies should be conducted to validate these findings in the future.
Clinical efficacy and safety of Tripterygium wilfordii Hook in the treatment of diabetic kidney disease stage IV
Authors: Ren Daijin , Zuo Chao , Xu Gaosi 
Published: March 2019

Abstract

Background:
The present study aims to evaluate the clinical efficacy and safety of Tripterygium wilfordii Hook (TwH) combined with angiotensin receptor blockers/ACE inhibitors (ARB/ACEI) in the treatment of diabetic kidney disease (DKD) stage IV.

Methods:
We searched China National Knowledge Internet (CNKI), the Chinese Biomedical Database, Embase and PubMed for articles about TwH combined with ARB/ACEI in treating DKD stage IV and set the study inclusion and elimination standards.

Results:
A total of 22 randomized controlled trials (RCTs) with 1414 participants were collected for detailed evaluation. The meta-analysis results suggested that compared with the controls, the combined group showed significant effects in reducing 24-h urinary protein [mean difference (MD) = −0.87, 95% confidence interval (CI) = (−1.03, −0.71)], raising serum albumin [MD = 4.14, 95% CI (3.43, 4.85)] and the total efficiency [odds ratio (OR) = 4.84, 95% CI (3.33, 7.03)], with no statistical difference in serum creatinine between both groups [MD = −3.02, 95% CI (−6.40, 0.37), P > .05]. However, the risk of adverse reactions increased by 8% [Risk Difference (RD) = 0.08, 95% CI (0.05, 0.11)] in the combination.

Conclusions:
TwH combined with ARB/ACEI in the treatment of DKD stage IV is superior to the monotherapy of ARB/ACEI.
Development of prognostic signature and nomogram for patients with breast cancer
Authors: Su Jiao , Miao Li-Feng , Ye Xiang-Hua , Cui Meng-Shen , He Xiao-Feng 
Published: March 2019

Abstract
To identify prognostic signature that could predict the survival of patients with breast cancer (BC).
Breast cancer samples and normal breast tissues in the TCGA-BRCA and GSE7390 were included. Differentially expressed genes (DEGs) were identified using the “limma” method. Overall survival (OS) associated with DEGs were obtained using univariate and multivariable Cox proportional-hazards regression analysis, and the corresponding prognostic signature and nomogram were constructed. Calibration analysis and decision curve analysis (DCA) were performed.
In all, 742 DEGs were identified, 19 of which were independently correlated with the OS of BC patients. The OS of patients in the 19-gene signature low-risk group was significantly better than that in high-risk group (hazard ratio [HR] 0.3506, 95% confidence interval [CI] 0.2488–0.4939), and the 19-gene based signature was demonstrated to be an independent prognostic factor in patient with BC in the TCGA-BRCA cohort (HR 1.501, 95% CI 1.374–1.640) and validation cohort GSE7392 ((HR 0.3557, 95% CI 0.2155–0.5871, P < .0001)). The primary and internally validated C-indexes for the 19-gene signature-based nomogram were 0.817 and 8.013, respectively. The results of calibration analysis and DCA analysis confirmed the robustness and the clinical usability of the nomogram.
We constructed a prognostic signature and nomogram for patient with BC, which showed good application prospect.
A quick decrease of bone marrow edema in sacroiliac joint could be served as a novel marker for dose tapering of etanercept in ankylosing spondylitis patients
Authors: Yang Ruishan , Liu Hongda , Fan Mengpo 
Published: March 2019

Abstract
The purpose of this study was to investigate the correlation of bone marrow edema (BME) in sacroiliac joint (SIJ) with clinical characteristics and clinical response, and whether the quick decrease of BME could be served as a novel marker for dose tapering of etanercept in ankylosing spondylitis (AS) patients.
Ninety active AS patients underwent etanercept treatment for 6 months were enrolled consecutively and classified into standard dose group (n = 37) and dose tapering group (n = 53). BME in SIJ and clinical response were assessed by SPARCC criteria and ASAS 40 response criteria, respectively. “Quick decrease of BME in SIJ” was defined as the decrease of SPARCC score≥50% from M0 to M1.
BME in SIJ was positively correlated with pain VAS score, BASDAI score, CRP, IL-1β, IL-17, and TNF-α levels. ASAS 40 response rate at M6 was lower in dose tapering group than standard dose group, while higher in patients with a quick decrease of BME in SIJ than other patients. Besides, the ASAS 40 response rate in dose tapering group was similar to standard dose group in patients with a quick decrease of BME in SIJ but was lower than standard dose group in patients without a quick decrease of BME in SIJ at M6.
A quick decrease of BME in SIJ predicts better treatment response to etanercept, and it might be served as a novel marker for dose tapering initiation of etanercept in AS patients.
Detecting autonomic dysfunction in patients with glaucoma using dynamic pupillometry
Authors: Park Hae-Young Lopilly , Jung Suk Hoon , Park Sung-Hwan , Park Chan Kee 
Published: March 2019

Abstract
Autonomic dysfunction is a feature of glaucoma patients, which are reported to be related to glaucoma progression. We investigated pupil responses to a light flash using dynamic pupillometry in glaucoma patients to assess autonomic nervous system status. In total, 97 glaucoma patients, including 21 eyes of 21 glaucoma patients with cardiac autonomic dysfunction, were enrolled. Pupil reactions were assessed using 1 flash of white light after 2 minutes of dark adaptation and recorded using dynamic pupillometry. Changes in the radius of the pupil were evaluated as a function of several time-dependent and pupil/iris (P/I) diameter ratio parameters. Autonomic function was assessed using a cardiac heart-rate-variability test which performs 5 autonomic function tests and classifies patients with cardiac autonomic neuropathy (CAN). Comparison of pupil parameters between eyes with and without disc hemorrhage indicated larger P/I ratios in darkness, greater changes in the P/I ratio during examination, shorter latency to plateau, and shorter duration of constriction in eyes with disc hemorrhages. A comparison of pupil parameters between eyes with and without CAN showed larger P/I ratios in darkness, larger P/I ratios at maximum constriction, and prolonged latency to maximum constriction. The presence of CAN was significantly related to the P/I ratio in darkness and the latency of maximum constriction. Using dynamic pupillometry, we found that glaucoma patients with CAN dysfunction have larger baseline pupils in darkness and different constriction responses to light. Assessing the pupils might be a good method of identifying patients with autonomic dysfunction.
Clinical analysis of hepatic angioleiomyoma
Authors: Jiang Bin , Chen Qiu-Ni , Qi Fu-Zhen , Xu Jian-Bo , Yu Ya-Bin , Song Yan 
Published: March 2019

Abstract

Rationale:
Angioleiomyoma is an uncommon benign tumor that originates from the vascular smooth muscle cells and contains thick-walled vessels. It can appear anywhere in the body but more frequently in the extremities (especially in the lower limbs) and rarely invades the internal organs.

Patient concerns:
A 52-year-old Chinese woman was referred to our hospital because of finding liver neoplasm 2 weeks ago (case first) and a 64-year-old Chinese woman was admitted to hospital with enlargement of the hepatic neoplasm revealed in follow-up, who was diagnosed with angioleiomyoma of left kidney 2 years ago (case second).

Diagnosis:
All patients were diagnosed with hepatic angioleiomyoma by pathological results.

Interventions:
All patients received surgical treatment, with laparoscopic hepatectomy of the IVb segment in case 1 and laparoscopic hepatic left lateral lobectomy in case 2.

Outcomes:
The 2 patients have eventually recovered, and no recurrences or other complications have been observed so far.

Lessons:
Because of atypical clinical symptoms, no specificity in laboratory examination, and lack of characteristic imaging findings, angioleiomyoma is easily misdiagnosed for another disease of the liver. But with complete resection, the prognosis is generally good.
Total hospital cost, length of stay, and complications between simultaneous and staged bilateral total hip arthroplasty
Authors: Tan Zhen , Cao Guorui , Wang Guanglin , Zhou Zongke , Pei Fuxing 
Published: March 2019

Abstract
This retrospective cohort study aimed to compare the total hospital cost, length of stay (LOS), and incidence of complications between simultaneous bilateral total hip arthroplasty (simBTHA) and staged bilateral total hip arthroplasty (staBTHA).
We identified 256 patients who underwent staBTHA and matched them to a control group of 256 patients who underwent simBTHA from 2013 to 2016. Patients’ demographics, total hospital costs, complication rates, and LOS were recorded and compared.
Patients undergoing simBTHA were younger (52.0 ± 12.0 vs 54.9 ± 13.2 years, P = .01), were more likely to be men (55.9% vs 46.9%, P = .04). There was no significant difference in total hospital costs or complications within 90 days for simBTHA compared with staBTHA. The transfusion rate was higher (49.3% vs 10.4%, P < .01), but the LOS was shorter in the simBTHA group (8.7 ± 5.3 vs 12.1 ± 5.6 days, P < .01).
There were no differences in total hospital costs or complications within 90 days if patients were carefully selected for simBTHA. Considering the difference in baseline characteristics and the low level of evidence, further randomized controlled studies are necessary.
The association between vascular endothelial growth factor gene polymorphisms and stroke
Authors: Xu Bingdong , Zhan Rui , Mai Hongcheng , Wu Zhengdong , Zhu Peizhi , Liang Yubin , Zhang Yusheng 
Published: March 2019

Abstract

Background:
Numerous studies showed that vascular endothelial growth factor (VEGF) gene polymorphisms were linked with the regularity of stroke, but the results remained controversial. The aim of this meta-analysis was to determine the associations between VEGF gene polymorphisms and the risk of stroke.

Methods:
A systematic literature search of PubMed, Embase, Wed of Science, The Cochrane Library, Elsevier, China National Knowledge Infrastructure, China Biology Medicine disc, WanFang Data, VIP Database for Chinese Technical Periodicals, and Science paper Online was conducted. Two authors independently assessed trial quality and extracted data. The pooled odds ratio (OR) with 95% confidence interval (CI) was used to assess the strength of associations. Begger funnel plot and Egger test were used to estimate the publication bias of included studies. Heterogeneity assumption was assessed by Cochran Chi-squared-based Q-statistic test and I
2 test.

Results:
Thirteen publications including 23 trails with a total of 3794 stroke patients and 3094 control subjects were enrolled. About 3747 cases and 2868 controls for +936C/T, 2134 cases and 1424 controls for −2578C/A, and 2187 cases and 1650 controls for −1154G/A were examined, respectively. The results indicated that VEGF +936C/T (T vs C, OR = 1.19, 95% CI = 1.01–1.40) or −2578C/A (A vs C, OR = 1.13, 95% CI = 1.02–1.27) was positively associated with the risk of stroke, whereas there was no association between −1154G/A (A vs G, OR = 0.99, 95% CI = 0.87–1.11) polymorphism and stroke risk in our study. Among the subgroup analyses on ethnicity, the results showed that VEGF +936C/T was an increased risk of stroke in Asian population (T vs C, OR = 1.21, 95% CI = 1.01–1.44), but not −1154G/A.

Conclusion:
Our findings suggest that VEGF +936C/T and −2578C/A might be related to the risk of stroke, especially in the Asian population, but not −1154G/A.
Laparoscopic management of enterohepatic migrated fish bone mimicking liver neoplasm
Authors: Chen Jun , Wang Chao , Zhuo Jianyong , Wen Xue , Ling Qi , Liu Zhikun , Guo Haijun , Xu Xiao , Zheng Shusen 
Published: March 2019

Abstract

Rationale:
Accidental ingestion of a foreign body is common in daily life. But the hepatic migration of perforated foreign body is rather rare.

Patient concerns:
A 37-year-old man presented with a history of vague epigastric discomfort for about 2 months.

Diagnosis:
A diagnosis of the foreign body induced hepatic inflammatory mass was made based on abdominal computed tomographic scan and upper gastrointestinal endoscopy.

Interventions:
The patient underwent laparoscopic laparotomy. During the operation, inflammatory signs were seen in the lesser omentum and segment 3 of liver. B- Ultrasound guided excision of the mass (in segment 3) was performed. Dissecting the specimen revealed a fish bone measuring 1.7 cm in length.

Outcomes:
The patient recovered uneventfully and was discharged on day 5 after surgery.

Lessons:
This study shows the usefulness of endoscopy for final diagnosis and treatment in foreign body ingestion. Early diagnosis and decisive treatment in time are lifesaving for patients with this potentially lethal condition.
Villi development core-related gene expression associated with lung squamous cancer prognosis
Authors: Yin Liyuan , Wang Yonggang , Ma Guangzhi , Deng Yunfu , Zhou Qinghua 
Published: March 2019

Abstract
Similarities between embryonic development and tumorigenesis are reflected in biological behavior and gene expression. Although the gene signature during development and the clinical phenotype of different cancers show certain correlation pattern, the correlation between early embryo development and cancer remains largely unexplored. To compare the gene expression profile between development and cancer, our study analyzed the gene expression of chorionic villi samples at different gestational ages (6, 7, 8, 9, 10, 40 weeks) obtained from gene expression omnibus (GEO) datasets using correlation test. Then the villi development-related genes that gradually showed a positive correlation (upregulated) (n = 394) or negative correlation (downregulated) (n = 325) with time were used to construct protein-protein interaction (PPI) networks. Three subnetworks among the gradually upregulated genes and 3 subnetworks among the downregulated genes were identified using the molecular complex detection (MCODE) plugin in Cytoscape software. The most significant GO terms for villi-correlated genes were immune, inflammatory response and cell division. These gene clusters were also dysregulated in lung squamous cell carcinoma (SCC). Moreover the prognostic value of the gene clusters was then analyzed with TCGA lung SCC data, which showed 4 clusters that were associated with prognosis. Our results demonstrate the gene expression similarity between development and lung SCC and identified development-associated gene clusters that could contain prognostic information for lung SCC patients.
A new inclusion technique through an upper partial sternotomy for complicated Stanford B-type aortic dissection with an aberrant right subclavian artery
Authors: Huang Maoxun , Piao Hulin , Li Bo , Wang Yong , Wang Tiance , Zhu Zhicheng , Li Dan , Liu Kexiang 
Published: March 2019

Abstract

Rationale:
An aberrant right subclavian artery (ARSA), arising from the proximal descending aorta, is a common aortic arch anomaly, with an incidence of 0.5% to 2%. However, coexistence of dissection and an ARSA is extremely rare. We presented the first case of successful management of complicated Stanford B-type aortic dissection combined with an ARSA with a new inclusion technique and stent graft (SG) implantation through an upper partial sternotomy.

Patient concerns:
A 39-year-old woman with a history of severe hypertension was admitted to our hospital because of sudden-onset chest and upper back pain.

Diagnoses:
Aortic computed tomography angiography (CTA) demonstrated complicated Stanford B-type dissection with ARSA.

Interventions:
A new inclusion technique and SG implantation through an upper partial sternotomy were performed for the patient, whose aortic arch branch vessels, including ARSA, were fully preserved.

Outcomes:
The patient had an uneventful postoperative course without neurologic deficits, and no blood transfusion was required during the hospitalization. The false lumen completely disappeared on postoperative CTA.

Lessons:
This new inclusion technique through an upper partial sternotomy is a safe and feasible treatment for complicated Stanford B-type aortic dissection with an ARSA with the primary tear located in the aortic arch.