bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term remarkable remission of SAPHO syndrome in response to short-term systemic corticosteroids treatment in an immunoglobulin E elevated patient
Authors: Wang Lun , Li Chen , Yu Meiyan , Cao Yihan , Jing Hongli , Li Junqiu 
Published: July 2019

Abstract

Rationale:
Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare auto-inflammatory disease with no standardized treatment. Systemic corticosteroids are only transiently effective, but long-term use would bring complications and would not bring long-term remission. Bone scintigraphy is a first-line method for systematic evaluation of osteoarticular lesions but seems to show an “imprinting” pattern.

Patient concerns:
A 31-year-old female patient presented significant palmoplantar pustulosis and nail lesion as well as typical tracer accumulation feature on bone scintigraphy with normal hypersensitivity C-reactive protein and erythrocyte sedimentation rate, but an elevated serum immunoglobulin E level.

Diagnosis:
The diagnosis was made by dermatological manifestations and classical sign in bone scintigraphy in accordance with the diagnostic criteria proposed in 1988.

Interventions:
Methylprednisolone was given with a primary dose of 40 mg/day for 1 week followed with a subsequent 20 mg/day oral prednisone for another 1 week and then reduced in a rate of 5 mg/week until the eventual cessation.

Outcomes:
Long-term remarkable remission on clinical manifestations, MRI performance, and quantitative analysis of bone scintigraphy was achieved.

Lessons:
Identification of specific subtype of SAPHO patient according to skin and nail manifestations as well as immunoglobulin E level may guide the selection of short-term systemic corticosteroids strategy, leading to remarkable long-term remission. Besides, the lesions on bone scintigraphy can hardly disappear in SAPHO patients, and instead, the quantitative analysis of bone scintigraphy and MRI performances may better reflect the change of disease condition and serve as indicator for treatment efficiency.
Association between alcohol consumption and mild cognitive impairment
Authors: Hui Xu , Li Jing , Lao Yongfeng , Jia Bibo , Hou Lijuan , Lu Zhenxing , Gu Qinghong , Niu Junqiang , Bao Hairong , Yan Peijing , Yao Liang 
Published: July 2019

Abstract

Objective:
The objective of this study is to investigate the potential dose–response association between alcohol consumption and the risk of mild cognitive impairment (MCI).

Methods:
We will perform a dose–response meta-analysis (DRMA) of cohort studies to explore the dose–response relationship between alcohol intake and MCI. A comprehensive literature search of PubMed, EMBASE, The Cochrane Library, Chinese BioMedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), VIP, and Wan-Fang Database will be conducted. Two investigators will independently select studies, extract data, and assess the quality of the included study. The Newcastle-Ottawa Scale will be used to assess the quality of include studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and A MeaSurement Tool to Assess systematic Reviews (AMSTAR) will be used to assess the quality of evidence and methodological quality. Any disagreement will be resolved by the third investigator. We will use the hazard ratio as the effect indicator, and piecewise linear regression model and restricted cubic spline model will be used for linear and nonlinear trend estimation, respectively. There is no requirement of ethical approval and informed consent.

Discussion:
This is the first DRMA to explore the dose–response relationship between alcohol intake and MCI. We predict it will provide high-quality evidence to prevent clinical MCI and dementia.

Registration:
The DRMA is registered in the PROSPERO (CRD42019127261) international prospective register of systematic review.
Clinical efficacy of oral immunoglobulin Y in infant rotavirus enteritis
Authors: Wang Xiaotong , Song Lijun , Tan Wenpan , Zhao Wenchang 
Published: July 2019

AbstractBackground:Rotavirus (RV) can cause vomiting and diarrhea in infants and children, and could be treated clinically with immunoglobulin Y (IgY), which is an immunoglobulin extracted from chicken yolk. There is no systematic evaluation of immunoglobulin in the treatment of rotavirus enteritis. Therefore, we systematically evaluated rotavirus enteritis with oral immunoglobulin Y therapy using meta-analysis.Methods:We conducted a systematic search in CNKI, WANFANG DATA, VIP, PubMed, and the Cochrane Library databases (up to April 30, 2018). Using Revman 5.3 software for meta-analysis.Results:A total of 2626 subjects with rotavirus diarrhea from 17 randomized clinical trials were included in the meta-analysis. Of these, 1347 subjects received oral immunoglobulin Y and 1279 subjects received conventional treatment. The results of the meta-analysis indicated that the total number of effective cases and effective rates of immunoglobulin Y in treatment of rotavirus enteritis in infants and children was statistically different from that in the control group (odds ratio [OR] = 3.87, 95% confidence interval [CI] (3.17, 4.74),P < .00001) and (OR = 3.63, 95% CI [2.75, 4.80],P < .00001).Conclusions:Immunoglobulin Y is effective in the treatment of infantile rotavirus enteritis. Oral immunoglobulin Y can be widely used in the treatment of rotavirus enteritis in clinic.
Determinants of hypertension treatment adherence among a Chinese population using the therapeutic adherence scale for hypertensive patients
Authors: Pan Jingjing , Wu Lian , Wang Huichuan , Lei Tao , Hu Bin , Xue Xiaorong , Li Qiongge 
Published: July 2019

Abstract
To assess the adherence level of antihypertensive treatment and identify any associated risk factors in a sample of hypertensive patients from China.
A cross-sectional study involving 488 Chinese hypertensive patients was conducted in a tertiary hospital in Xi’an, China. Data were collected regarding socio-demographic factors and hypertension-related clinical characteristics. The adherence to treatment was assessed using the previously validated instrument: therapeutic adherence scale for hypertensive patients.
A total of 27.46% of patients were compliant with their antihypertensive treatments. Three factors were identified to be independently associated with antihypertensive treatment adherence: gender (P = .034), residence (P = .029), duration of high blood pressure (P < .001). Gender, residence, occupation, and the duration of antihypertensive drugs treatment used were found to have significant effects on treatment adherence in certain categories.
Treatment adherence among hypertensive patients in China was poor. More attention and effective strategies should be designed to address factors affecting treatment adherence. Education about hypertension knowledge should be strengthened for patients. Moreover, the importance of lifestyle modification during hypertension treatment is often neglected by patients, therefore, there is an urgent need to educate hypertensive patients about the adherence to lifestyle modifications.
Comparison of the effect of recombinant human pro-urokinase and tirofiban on myocardial blood flow perfusion in ST elevation myocardial infarction patients receiving primary percutaneous coronary intervention
Authors: Yao Zhuhua , Li Wenting , Cheng Lisong , Cao Mingying , Pang Zhihua , Li Yongbin 
Published: July 2019

Abstract
Ischemia/reperfusion (I/R) injury is associated with primary percutaneous coronary intervention (PPCI). The current study was performed to compare the effect of tirofiban and recombinant human pro-urokinase (rh-proUK) on the improvement of coronary slow blood after PPCI.
Sixty-five ST elevation myocardial infarction (STEMI) patients treated with rh-proUK and an equal number treated with tirofiban after PPCI were employed in the current study. The clinicopathological information regarding the biochemical parameters, thrombolysis in myocardial infarction (TIMI) grade, hemodynamics parameters, thrombus core (TS), sum-STR, left ventricular ejection fraction (LVEF), blood routine parameters, high-sensitivity C-reactive protein (CRP) level, uric acid, hepatorenal function, electrocardiogram (ECG), and echocardiography before and after the interventions were collected. The differences in those parameters between the 2 groups then compared with assess the treatment effect and side effects associated with the both therapies.
The results showed that the TIMI level post-intervention (P = .03), the proportion of TIMI myocardial perfusion grade level III (P = .04), the changes in thrombus score (P < .001) in rh-proUK group were significantly higher than those in tirofiban group while the corrected TIMI Frame Count (CTFC) (P = .02), the incidence of slow flow (P = .02), the thrombus score post-intervention (P < .001), the stent length (P = .02), and the number of receiving administration of sodium nitroprusside (P = .01) were significantly lower than those in tirofiban group. Moreover, the levels of CK (P < .001), CK-MB (P = .01), and NT-proBNP 24-hour post-intervention (P < .02) were significantly lower in rh-proUK group than those in tirofiban group and the sum-STR right after the intervention (P < .03) of rh-proUK group was significantly higher than that of tirofiban group. No significant difference was detected between the 2 therapies regarding major adverse cardiac events (MACE).
The findings outlined in the current study showed that the improvement effect of rh-proUK on blood flow condition was stronger right after the intervention and the therapy had a similar safety when compared with tirofiban during a 30-day follow-up.
Clinical characteristics and pregnancy outcomes of new onset epilepsy during pregnancy
Authors: Li Wei , Hao Nanya , Xiao Yingfeng , Zhou Dong 
Published: July 2019

Abstract
The occurrence of seizures during pregnancy is really a challenging situation which risks the health of both mothers and fetuses. However, new onset epilepsy is unpredictable in pregnancy, and its clinic feature is barely known. This study aimed to explore the clinical characteristics and pregnancy outcomes of new onset epilepsy during pregnancy.
We screened consecutive women with epilepsy and reproductive history from June 2013 to November 2018 from 3 hospitals in West China. Detailed demographics, clinical features, neurological status, related tests, managements, seizure and pregnancy outcomes were recorded and followed-up. Within them, patients with first seizure during pregnancy and spontaneous recurrent seizures after delivery or abortion were defined as new onset epilepsy during pregnancy.
We screened a total of 1041 consecutive women with epilepsy and reproductive history. Twenty-two of them (2.1%) had new onset epilepsy during pregnancy. The average age at seizure onset was 22.7 ± 3.0 years. All their first seizures occurred in pregnancy period, including 4 (18.2%) in the first trimester, ten (45.4%) in the second trimester and eight (36.4%) in the third trimester. Most patients delivered healthy babies, except one patient had to choose induced abortion because of the disappearance of fetal heart rate, one child was diagnosed with mild harelip and one was diagnosed with trisomy 21 syndrome, tetralogy of Fallot and congenital duodenal atresia. All 3 complications happened in patients with their first seizures in first trimester.
Although the risk of new onset epilepsy during pregnancy was relatively low, accurate diagnosis and appropriate treatment were required to reduce the damage to both mothers and fetuses. New onset epilepsy during pregnancy mostly began in middle and late pregnancy. However, seizures occurred from early pregnancy had bad effects on the embryo or fetus.
Embolization with microcoils for urethral hemorrhage
Authors: Liu Shiyi , Deng Jiangbei , Zeng Bin , Jia Yiping 
Published: July 2019

Abstract

Rationale:
Microcoils are a permanent embolic material, and blood vessels that have been embolized by a microcoil remain occluded for a prolonged period of time. The pudendal artery is an important functional vessel for penile erection. Whether simultaneous embolization of the bilateral pudendal artery using microcoils can seriously affect penile erection has not been sufficiently studied.

Patient concerns:
A 47-year-old male patient, after undergoing brain surgery, accidentally pulled out the Foley catheter causing a urethral hemorrhage. The patient was immediately treated using a new larger Foley catheter inserted under urethroscopic guidance and medication. However, massive bleeding occurred on the tenth day after the procedure.

Diagnosis:
A right internal iliac angiography performed after the bleeding event demonstrated a rupture at the end of the right internal pudendal artery with the contrast agent flowing out directly from the urethra. A super selective internal pudendal angiogram showed a small amount of hemorrhage at the end of the left internal pudendal artery.

Interventions:
The patient underwent interventional treatment. After the bilateral internal iliac angiography was performed, super-selective internal pudendal artery embolization with microcoils was performed. A subsequent bilateral internal pudendal angiogram did not show any abnormality.

Outcomes:
During the follow up period of 2 months, the patient had no complaints of difficulty in urination or sexual dysfunction.

Lessons:
Some doctors do not advocate the use of coils as embolic agents in bilateral pudendal artery lesions because of concerns over erectile dysfunction. There is rich vascular circulation in the perineum. Thus, in arterial embolization for the treatment of penile bleeding, regardless of the type of embolic material used, the key is to ensure accurate embolization to maintain good collateral circulation. This principle can help limit the occurrence of sexual dysfunction to the lowest possible levels after such procedures.
Nonsurgical integrative Korean Medicine treatment of discal cyst
Authors: Choi Hee-seung , Lee Sook-Hyun , Lee Yoon Jae , Ha In-Hyuk 
Published: July 2019

Abstract

Rationale:
Discal cysts are rare lesions characterized by pain caused by neurogenic compression with similar symptoms as those of disc herniation. This study aims to report the spontaneous regression of discal cyst achieved through nonsurgical integrative Korean Medicine treatment and the clinical epidemiological features of discal cyst cases collected from 4 institutions.

Patient concerns:
A 31-year-old woman had low back pain and radiating pain equivalent to a numeral rating scale (NRS) of 8 and had limitations in daily work and activities.

Diagnoses:
The patient was diagnosed as having discal cysts that compressed the left S1 based on findings of L-spine magnetic resonance imaging (MRI) performed at our hospital.

Interventions:
The patient received nonsurgical Korean Medicine treatment and after 24 days of treatment in the hospital, she underwent 16 additional treatments as an outpatient.

Outcomes:
Spontaneous regression was confirmed in the L-spine MRI follow-up at 36 days and 99 days after the initial test, and the patient underwent once-a-week follow up to examine NRS, Oswestry Disability Index (ODI), EuroQol-5 Dimensions (EQ-5D), and fear-avoidance beliefs questionnaire (FABQ) after 4 weeks, and 2, 3, and 6-month follow-ups after that. The patient was discharged in a painless condition, and she was able to carry on for 5 months without increased pain.

Lessons:
Discal cysts are more rapid progress than disc herniation, it seems valid to attempt nonsurgical treatment. Epidemiologically, this is the first study to present the clinical epidemiological characteristics of discal cysts, it would provide valuable information to clinicians who treat and study discal cysts.
Comparative study on the pregnancy outcomes of in vitro fertilization–embryo transfer between patients with different ovarian responses (a STROBE-compliant article)
Authors: Jin Hai-Xia , Lv Ai-Xiang , Wu Zhao-Ting , Wen Shuang , Zhang Xiang-Yang , Jin Da-Chuan , Sun Ying-Pu 
Published: July 2019

Abstract
There have been few studies on large-sample data of cleavage-stage embryo and blastocyst transfers. We compared the pregnancy outcomes of patients with different ovarian responses after the transfer of different numbers of embryos in different developmental stages.
Patients were divided into 3 groups including low response group, medium response group, and high response group according to different ovarian responses. Patients in each group were further divided into 4 subgroups including group A: transfer of 1 D3 embryo, group B: transfer of 2 D3 embryos; group C: transfer of 1 D5 blastocyst; and group D: transfer of 2 D5 blastocysts.
In low ovarian responders, the implantation rate, clinical pregnancy rate and live birth rate were significantly lower in the group A than in the groups B and C. In medium ovarian responders, the implantation rate was significantly higher, but the multiple pregnancy rate was significantly lower in the group C than in the group B. The multiple pregnancy rate was significantly higher in the group D than in the group C. In high ovarian responders, the implantation rate was significantly lower, but the multiple pregnancy rate was significantly higher in the group B than in group C.
Based on the above results, the single blastocyst transfer is preferable for the patients with different ovarian responses.
Impact of exercise on maternal gestational weight gain
Authors: Wang Jianying , Wen Danting , Liu Xiaofei , Liu Yingjie 
Published: July 2019

Abstract

Background:
Clinical evidence indicates that women will benefit from regular physical activity during pregnancy. This study aimed to summarize and update the evidence on the effect of exercise on maternal gestational weight gain (GWG).

Methods:
We conducted a systematic literature search of Pubmed, Embase, and Cochrane Library from inception until July, 2018 for randomized controlled trials (RCTs) that investigate the effect of physical exercises on the maternal GWG compared with that of no physical exercises or conventional medical care. We extracted data from eligible trials for study characteristics, interventions, patients’ baseline characteristics and outcomes for the study populations of interest. We conducted meta-analyses using random effects models.

Results:
From 844 citations, 23 RCTs including 4462 pregnant women met the inclusion criteria. Meta-analysis indicated that compared with that in women having conventional medical care, GWG was significantly decreased in pregnant women with physical exercise [weighted mean difference (WMD) −1.02, 95% CI −1.35 to −0.70; P < .01; I
2 = 48.4%]. Women appeared to benefit more for gestational weight control for exercise frequency of 3 times per week (WMD −1.22, 95% CI −1.55 to −0.90; I
2 = 40.3%) and exercise duration of 30 to 45 minutes each time (WMD −1.32, 95% CI −1.79 to −0.85; I
2 = 1.5%).

Conclusion:
This meta-analysis provides indications that exercise intervention can reduce maternal GWG for pregnant women, especially for those with exercise frequency of 3 times per week and duration of 30 to 45 minutes each time.
The association of 6 variants of 8q24 and the risk of glioma
Authors: Tong Yu , Ye Lv , Li Shiping , Zhao Fengyan , Ying Junjie , Qu Yi , Li Jinhui , Mu Dezhi 
Published: July 2019

Abstract
With the advances in sequencing technologies and genome-wide association studies (GWAS), several inherited variants that increase glioma risk have been identified. Ten studies including 8818 cases and 17,551 controls were collected to conduct a meta-analysis to evaluate the associations between 6 variants in 8q24 and glioma risk. Of the 6 variants located in 8q24, 2 have strong significant associations with the risk of glioma, including rs4295627 (P = .003, odds ratio [OR] = 1.21), rs55705857 (P = 2.31 × 10–35, OR = 3.54). In particular, both homozygous GG (P = 1.91 × 10–3, OR1 = 2.01) and heterozygous GT (P = 7.75 × 10–10, OR2 = 1.35) genotypes of rs4295627 were associated with glioma risk. Further studies are needed to explore the role of the 8q24 variants involved in the etiology of glioma.
Mortality rate and other clinical features observed in Open vs closed format intensive care units
Authors: Yang Qian , Du Jin Long , Shao Feng 
Published: July 2019

Abstract

Background:
Nowadays most of the intensive care units (ICUs) operate as a closed format in comparison to an open format. The new concept of a closed ICU is where patients are admitted under the full responsibility of a trained intensivist, whereas an open ICU is where patients are admitted under the care of another attending physician and intensivists are just available for consultation. In this analysis, we aimed to systematically compare mortality rate and other clinical features observed in open vs closed ICU formats.

Methods:
Biomedical and pharmacological bibliographic database Excerpta Medica database (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), the Cochrane Central and www.ClinicalTrials.gov were searched for required English publications. Mortality, the frequency of patients requiring mechanical ventilation, central line, arterial line and pulmonary arterial catheter were assessed respectively. Statistical analysis was carried out by the RevMan software. Odds ratios (OR) with 95% confidence intervals (CIs) were used to represent the data following analysis.

Results:
Five studies with a total number of 6160 participants enrolled between years 1992 to 2007 were included. Results of this analysis showed that mortality rate was significantly higher in the open format ICU (OR: 1.31, 95% CI: 1.17–1.48; P = .00001) (using a fixed effect model) and (OR: 1.31, 95% CI: 1.09–1.59; P = .005) (using a random effect model). Closed format ICUs were associated with significantly higher number of patients that required central line (OR: 0.56, 95% CI: 0.34–0.92; P = .02). Patients requiring mechanical ventilation (OR: 1.08, 95% CI: 0.65–1.78; P = .77), patients requiring arterial line (OR: 1.05, 95% CI: 0.49–2.29; P = .89) and patients requiring pulmonary arterial catheter (OR: 0.86, 95% CI: 0.40–1.87; P = .71) were similar in the open vs the closed setting.

Conclusion:
This analysis showed that mortality rate was significantly higher in an open as compared to a closed format ICU. However, the frequency of patients requiring mechanical ventilation, arterial line and pulmonary arterial catheter was similarly observed. Larger trials are expected to further confirm those hypotheses.
Propylthiouracil-induced organizing pneumonia
Authors: Xiao Xue-Wen , An Jian , Hu Cheng-Ping , Luo Bai-Ling 
Published: July 2019

Abstract

Rationale:
Propylthiouracil (PTU) is a common antithyroid drug which can treat hyperthyroidism effectively. PTU is, however, associated to multiple adverse effects. In rare case, PTU can cause interstitial pneumonia.

Patient concerns:
A 40-year-old woman presented with dyspnea and was diagnosed with pulmonary infection at the first time. After the treatment with moxifloxacin, her symptoms still got worse.

Diagnosis:
The lung tissues biopsy confirmed the diagnosis of organizing pneumonia (OP) and the administration of PTU suggested the diagnosis of PTU-induced OP.

Intervention:
Withdrawal of PTU and the administration of methylprednisolone.

Outcomes:
The patient's symptoms relieved significantly 1 month later and lung computed tomography (CT) scan also demonstrated significant reduction of lung lesions.

Lessons:
Here we report the first case of histologically confirmed OP induced by PTU and conduct a literature review of the cases of PTU-induced interstitial pneumonia. The awareness of PTU-induced OP can help physicians reduce the possibility of misdiagnosis.