bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of berberine in the treatment of type 2 diabetes with insulin resistance
Authors: Wang Yinshan , Yan Aihua , Li Shanshan , Liu Bei , Li Huimin , Yan Yong 
Published: August 2019

Abstract

Background:
The incidence of diabetes mellitus (DM) is increasing year by year, and various complications can endanger the lives of patients. Type 2 diabetes mellitus (T2DM) accounts for more than 90% of DM, most of which is associated with insulin resistance (IR), and IR has been shown to be closely related to the onset of T2DM and the presence of DM complications. Berberine (BBR) has been shown to improve T2DM with IR in a number of ways. In this study, we aim to evaluate the efficacy and safety of BBR in the treatment of T2DM with IR to provide the newest evidence for clinical use.

Methods and analysis:
Literature research will be divided into 2 parts: electronic search and manual search. We will search PubMed, EMBASE, The Cochrane Library, the China National Knowledge Infrastructure, China Biology Medicine disc, the China Science and Technology Journal database, and the Wanfang database online. We will select the eligible studies published up to June 30, 2019. Dissertations, conference papers, ongoing trials, internal reports, etc., are searched by manual search methods. We use Homeostatic Model Assessment for IR (HOMA-IR) as the primary outcome of T2DM with IR, and we will also focus on the patient's blood glucose levels and all adverse reactions that occur during medication.
Two reviewers will read the articles, extract the data information, and assess the risk of bias independently. Data analysis will use the software such as RevMan 5.3.5, ENDNOTE X7, and STATA 13.0.

Results:
This study will provide a high-quality synthesis of current evidence of BBR for T2DM with IR from several aspects including HOMA-IR, blood glucose levels, and adverse events.

Conclusion:
This systematic review will provide evidence to assess the efficacy and safety of BBR in the treatment of T2DM with IR.

Ethics and dissemination:
Because all of the data used in this systematic review has been published, ethical approval is not required.

Trial registration number:
PROSPERO CRD42019123225.
Robotic arm-assisted vs conventional unicompartmental knee arthroplasty
Authors: Zhang Fengjun , Li Hongcai , Ba Zhaochen , Bo Chunguang , Li Kai 
Published: August 2019

Abstract

Background:
Robotic arm-assisted unicompartmental knee arthroplasty (UKA) has been recommended for treatment of unicompartmental knee osteoarthritis. However, its effectiveness and safeness remain controversial compared with conventional UKA. Therefore, the goal of this study was to perform a meta-analysis to re-evaluate the effects of robotic arm-assisted UKA on clinical functional outcomes.

Methods:
PubMed, Embase, and Cochrane Library databases were searched to screen the relevant studies. Continuous data (surgical time, knee excursion during weight acceptance, American knee society score [AKSS], Oxford knee score [OKS], forgotten joint score [FJS], visual analog scale [VAS], and range of motion [ROM]) were pooled using a standardized mean difference (SMD) with their corresponding 95% confidence intervals (CIs) to estimate the effect size, while dichotomous data (complication rate, revision rate) were pooled to obtain the relative risk (RR) with a 95% CI by STATA 13.0 software.

Results:
Eleven studies involving 498 patients undergoing robotic-assisted UKA and 589 patients receiving conventional UKA were included. Our pooled results demonstrated that robotic-assisted could significantly reduce the complication rate (RR: 0.62, 95% CI: 0.45–0.85; P = .0041) and improve the knee excursion during weight acceptance (SMD: 0.62, 95% CI: 0.25–1.00; P = .001), but prolonged the surgical time (SMD: 0.74, 95% CI: 0.40–1.08; P < .001). No significant difference in the revision rate, AKSS, OKS, FJS, VAS, and ROM between robotic-assisted and conventional UKA groups.

Conclusion:
This meta-analysis demonstrates robotic-assisted UKA may be an effective and safe surgical procedure for treatment of unicompartmental knee osteoarthritis.
Association of rs10204525 genotype GG and rs2227982 CC combination in programmed cell death 1 with hepatitis B virus infection risk
Authors: Huang Chunhong , Ge Tiantian , Xia Caixia , Zhu Wei , Xu Lichen , Wang Yunyun , Wu Fengtian , Liu Feifei , Zheng Min , Chen Zhi 
Published: August 2019

Abstract
Single nuclear polymorphism (SNP) of programmed cell death 1 (PD-1) was reported associated with hepatitis B virus (HBV) infection, but the SNP sites studied were limited. Whether the combination of 2 or more SNP sites could better represent the relationship between PD-1 SNP and HBV infection was not studied.
Eight hundred ninety-eight HBV-infected patients (222 asymptomatic carriers [AsC], 276 chronic hepatitis B, 105 acute-on-chronic liver failure, and 295 liver cirrhosis) and 364 health controls of South China were enrolled in this study. Four PD-1 SNPs (rs10204525, rs2227982, rs41386349, and rs36084323) were selected and detected by TaqMan probe. The frequency of allele, genotype, and combination of different SNPs were compared between different groups.
For allele frequency analysis, G allele of rs10204525 was protective factor (odds ratio (OR) = 0.823, 95% confidence interval (CI) = 0.679–0.997, P = .046) and T allele of rs2227982 was predisposing factor (OR = 1.231, 95% CI = 1.036–1.463, P = .018) in HBV infection. When analyzed in genotype frequency, the genotype GG of rs10204525 and CC of rs2227982 were protective factor of HBV infection. Combination of rs10204525 GG and rs2227982 CC was potent protective factor of HBV infection (OR = 0.552, 95% CI = 0.356–0.857, P = .007) and was also associated with lower HBV load (OR = 0.201, 95% CI = 0.056–0.728, P = .008) in AsC. The 4 SNP sites were not associated with progression of HBV-related liver disease.
Rs10204525 and rs2227982 of PD-1 associate with HBV infection and combination of the 2 SNP sites can better predict host susceptibility in HBV infection.
Parvovirus B19 infection presenting with neutropenia and thrombocytopenia
Authors: Shin Hyoshim , Park Sungwoo , Lee Gyeong-Won , Koh Eun-Ha , Kim Hyun-Young 
Published: August 2019

Abstract

Rationale:
Parvovirus B19 (PV) infection is usually symptomless and can cause benign, short-lived conditions. Anemia associated with PRCA is the most representative hematologic manifestation, but neutropenia and thrombocytopenia have been rarely reported.

Patient concerns:
Three patients were admitted to the hospital with neutropenia and thrombocytopenia. The accompanying symptoms were fever, myalgia, rash, or arthralgia, and all patients were previously healthy.

Diagnosis:
Patients were positive for PV PCR and diagnosed with PV infection. Before the diagnosis of PV infection, 2 patients underwent BM study and almost absence of erythroid progenitor cells in BM aspiration were a clue for the PV infection. Other BM findings were hypocellular marrow and a few hemophagocytic histiocytes.

Interventions:
Patients received supportive care with follow-up of CBC.

Outcomes:
All 3 patients spontaneously recovered from neutropenia and thrombocytopenia within 3 weeks without severe complications.

Lessons:
The evaluation of PV infection should be considered in situations where there is neutropenia and thrombocytopenia in healthy individuals even without anemia as a differential diagnosis.
Down syndrome with primary thyroid diffuse large B-cell lymphoma and Hashimoto thyroiditis
Authors: Wei Luyang , Zhao Ning , Li Yalun , Zheng Xiaodan , Zhang Huaxin , Zhang Zhongtao 
Published: August 2019

Abstract

Rationale:
Adult patients with Down syndrome (DS) commonly develop Hashimoto thyroiditis (HT). However, primary diffuse large B-cell lymphoma (DLBCL) of the thyroid is uncommon, and its simultaneous occurrence with HT is very rare. To our knowledge, coexisting DLBCL and HT in a patient with DS has not been reported in the medical literature.

Patient concerns:
We present a 43-year-old woman with DS who reported progressive swelling of the neck on the right side and dyspnea over the previous 1 month, with associated neck ache, hoarseness, and dysphagia. Thyroid ultrasonography and computed tomography of the neck revealed a large mass in the right lobe compressing the surrounding tissues.

Diagnoses:
Based on the clinical and histopathologic findings, the patient was diagnosed with coexisting primary thyroid DLBCL and HT.

Interventions:
A palliative unilateral thyroidectomy was performed; postoperative histopathology and immunohistochemistry revealed thyroid DLBCL and HT. The patient was scheduled for chemotherapy and targeted therapy after recovering from surgery.

Outcomes:
The patient died 3 weeks after surgery due to asphyxia caused by uncontrollable growth of recurrent tumor.

Lessons:
The coexistence of DS, primary thyroid DLBCL, and HT is very rare. There is no standardized approach to the clinical identification of primary thyroid lymphoma (PTL), making early diagnosis difficult. A multidisciplinary approach and close follow-up are needed. The mechanisms of the link between DS and PTL are poorly understood and remain to be elucidated.
Treatment of postpill amenorrhea with abdominal obesity by traditional Korean medicine treatment focused on pharmacopuncture and moxibustion
Authors: Hwang Ji Hye 
Published: August 2019

Abstract

Rationale:
Hormone imbalance and menstrual irregularities are normal for postpill women. Pharmacopuncture and moxibustion can stimulate acupoints with herbal extract and heat, respectively, to regulate the function of qi and blood, expel pathogens, and support health.

Patient concerns:
A 39-year-old female patient presented with amenorrhea, >6 months after she had stopped taking the oral contraceptive pill, which she had taken for more than 10 years, and possible associated infertility. Additionally, she reported sudden weight gain of approximately 12 kg in 1 year.

Diagnoses:
In this study, we examined the amenorrhea lasted more than 6 months for postpill patient.

Interventions:
She refused a strong acupuncture stimulus; she underwent lower abdomen pharmacopuncture with wild ginseng complex (WGC) and moxibustion at CV4, 5 times during 1 month. As a secondary treatment, 1 g Geoseub-hwan pills were prescribed for overeating and during social events. After 5 weekly primary treatments, Geoseub-hwan was prescribed intermittently.

Outcome:
After 3 primary treatments, she began menstruation without menstrual cramps or discomfort. After 5 treatments, she exhibited improvement of body weight and body composition. At 1- and 3-month follow-up examinations, she confirmed regular menstruation without discomfort.

Lessons:
Pharmacopuncture with WGC and moxibustion may be effective for the treatment of postpill amenorrhea with abdominal obesity and can be used for patients with fear of a strong acupuncture stimulus.
Challenges of transarterial therapy for hepatocellular carcinoma in patients with chronic kidney disease
Authors: Lin Wei-Chen , Chang Chen-Wang , Chang Ching-Wei , Wang Tsang-En , Chen Ming-Jen , Wang Horng-Yuan 
Published: August 2019

Abstract
Poor outcomes of hepatocellular carcinomas (HCC) in chronic kidney disease (CKD) patients are well described. Transarterial therapy is the standard treatment for HCC, following which regular contrast-enhanced imaging for residual disease is recommended. CKD is considered a relative contraindication for transarterial therapy owing to renal failure.
This retrospective study investigated the outcomes of transarterial therapy in HCC patients with CKD. In total, 132 HCC patients who received transarterial therapy were enrolled, of whom 36 had CKD. Most CKD patients were elderly, with mean age of diagnosis of 69.7 ± 11.4 years. Hypertension (odds ratio [OR]; 5.06; 95% confidence interval [Cl]; 1.83–13.94), hepatitis C virus carrier rate (OR; 4.12, 95% CI; 1.13–14.99) and diabetes (OR; 3.62, 95% CI; 1.22–10.72) were significant predictors for CKD in HCC patients. Post therapy, the estimated glomerular filtration rate significantly decreased 13.7% from baseline in the CKD patients (P = .03). There were more post-therapy complications than in the non-CKD group, e.g. acute renal failure and sepsis (P < .01 vs P < .01). Overall survival in the CKD group was significantly poor (10.9 ± 8.5 vs 23.5 ± 16.3 months, P < .01).
The lower survival of CKD patients was unrelated to treatment modality or less contrast-enhanced imaging follow-up. Further research on patient care and factors leading to poor outcomes for CKD is needed.
Are heart doses associated with survival in patients with non-small cell lung cancer who received post-operative thoracic radiotherapy?
Authors: Lee Chia Ching , Chua Gail Wan Ying , Zheng Huili , Soon Yu Yang , Foo Ling Li , Thiagarajan Anuradha , Yap Swee Peng , Siow Tian Rui , Ng Wee Loon , Chua Kevin Lee Min , Yip Connie , Chia Brendan Seng Hup , Ng Yan Yee , Master Zubin , Tan Poh Wee , Tan Yun Inn , Leong Yuh Fun , Loria Joan Faith Evacula , Vellayappan Balamurugan , Koh Wee Yao , Leong Cheng Nang , Tey Jeremy Chee Seong , Tham Ivan Weng Keong , Fong Kam Weng 
Published: August 2019

Abstract
The aim of this retrospective national cohort study is to assess the association between various radiation heart dosimetric parameters (RHDPs), acute myocardial infarct (AMI) and overall survival (OS) outcomes in non-small cell lung cancer (NSCLC) patients treated with post-operative thoracic radiotherapy (PORT) using contemporary radiation techniques.
We identified patients with stage I to III NSCLC treated with PORT at the 2 national cancer institutions from 2007 to 2014. We linked their electronic medical records to the national AMI and death registries. Univariable Cox regression was performed to assess the association between various RHDPs, AMI, and OS.
We included 43 eligible patients with median follow-up of 36.6 months. Median age was 64 years. Majority of the patients had pathological stage III disease (72%). Median prescription dose was 60Gy. Median mean heart dose (MHD) was 9.4Gy. There were no AMI events. The 5-year OS was 34%. Univariable Cox regression showed that age was significantly associated with OS (hazard ratio, 1.06; 95% confidence interval, 1.01 to 1.10; P = .008). Radiation heart doses, including MHD, volume of heart receiving at least 5, 25, 30, 40, 50Gy and dose to 30% of heart volume, were not significantly associated with OS.
There is insufficient evidence to conclude that RHDPs are associated with OS for patients with NSCLC treated with PORT in this study. Studies with larger sample size and longer term follow-up are needed to assess AMI outcome.
“Tube in tube” interlaminar endoscopic decompression for the treatment of lumbar spinal stenosis
Authors: Cao Shiqi , Cui Hongpeng , Lu Zhengcao , Zhu Kai , Fu Bensheng , Li Wen , Zhang Jianjun , Ding Yu 
Published: August 2019

Abstract
To describe the Tube in Tube interlaminar endoscopic decompression method and investigate its efficacy and safety in treating lumbar spinal stenosis (LSS).
Utilizing the advantages of the micro-endoscopic decompression (MED) operation channel tube, we used a water-medium spinal endoscopy to perform trans-interlaminar canal decompression, that is, the “Tube in Tube” technique. A retrospective study was performed on 35 patients with LSS who were treated with the Tube in Tube technique. All patients were followed up to 12 months postoperatively. Visual analog scale (VAS), Japanese Orthopaedic Association (JOA) score, and Oswestry Disability Index (ODI) were collected preoperatively and at 3, 6, and 12 months postoperatively. Short-form (36) health survey (SF-36) score was used to examine the general health-related quality of life (HRQoL) of patients preoperatively and at 3 and 12 months postoperatively. Modified Macnab criteria were used to examine the clinical outcomes at 3 and 12 months post-surgery.
The clinical outcomes were satisfactory, with an improvement in all scoring systems. The VAS, JOA, and ODI scores improved from 6.46 ± 1.85, 12.03 ± 4.96, and 42.17 ± 12.22 preoperatively to 2.20 ± 1.14, 21.40 ± 5.86, and 13.14 ± 7.52 at 12 months postoperatively, respectively (P < .001). The Macnab excellent or good rates reached 65.7% and 77.1% at the 3 and 12 months follow-ups. No severe complications occurred.
The Tube in Tube technique had a positive clinical outcome in LSS patients and is safe, reliable, and efficacious. However, a larger number of cases and a multi-center research design will be needed further develop the technique.

Level of Evidence: IV.
Adjuvant treatment with Xiaoqinglong formula for bronchial asthma
Authors: Wang Long , Zheng Xiuli , Hui Yi , Wang Baojia , Yang Yu , Feng Xianrong , Zhang Tianyao , Ma Li , Zhang Xiaobo 
Published: August 2019

Abstract

Background:
Bronchial asthma is one of the most common chronic diseases in the world and has become a serious public health problem. Combination therapy has become the first choice for clinical treatment of bronchial asthma. In addition to the combined use of routine medication, traditional Chinese medicine as an adjuvant therapy is also considered. Xiaoqinglong Decoction (XQLD) is an effective prescription of traditional Chinese medicine in treating asthma, and there are more and more clinical reports about its combination with western medicine in treating asthma. Therefore, we designed this study protocol to evaluate the adjuvant role of XQLD in the treatment of bronchial asthma.

Method:
The following electronic databases will be systematically searched from inception to April 2019: PubMed, EMBASE database, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang, Chinese Scientific Journals Database (VIP), and China Biology Medicine disc, (CBM). And the following primary outcomes will be tested, including effective rate (ER), pulmonary function (FEV1, PEF, FEV1/FVC), adverse reactions (AR). RevMan5 software will be used for literature quality evaluation and stata14.0 software will be used for data synthesis and analysis.

Result:
To evaluate the efficacy and safety of Xiaoqinglong decoction in combination therapy by observing the outcomes of efficacy, adverse reactions and pulmonary function.

Conclusion:
This study protocol will be used to evaluate the efficacy and safety of XQLD in combination with conventional drugs in the treatment of bronchial asthma, as well as the adjuvant role of XQLD in combination.

PROSPERO registration number:
CRD42019133549
Delta neutrophil index as a predictor of disease severity, surgical outcomes, and mortality rates in gastrointestinal diseases
Authors: Choi Jae Ho , Bang Chang Seok , Lee Jae Jun , Baik Gwang Ho 
Published: August 2019

Abstract

Background:
Delta neutrophil index (DNI) is the ratio of the number of immature granulocytes and the total neutrophil count in peripheral circulation. DNI precedes changes in white blood cell or neutrophil counts due to the course of granular leukocyte differentiation in infectious and inflammatory conditions, beginning with immature granulocyte formation. The role of DNI as a biomarker of various infectious or inflammatory conditions has been reported. However, no studies explored the potential role of DNI as an initial biomarker for predicting disease severity, surgical outcomes, and mortality rates of gastrointestinal diseases with pooled diagnostic test accuracy. This study aims to provide evidence that DNI is a predictor of disease severity, surgical outcomes, and mortality rates in patients with gastrointestinal diseases in emergency medical departments.

Methods:
MEDLINE, EMBASE, and the Cochrane Library will be searched using common keywords (inception to July 2019) by 2 independent evaluators. Inclusion criteria will be patients with gastrointestinal diseases, DNI measurements performed in the emergency department, indices of diagnostic performance (sensitivity, specificity, predictive values, and likelihood ratios) of DNI for predicting severity, surgical outcomes, and mortality rate of gastrointestinal diseases. True and false positives and negatives will be calculated based on the diagnostic indices of each study. All types of study designs with full-text literature written in English will be included. Risk of bias will be assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Descriptive data synthesis will be conducted and quantitative synthesis (bivariate and hierarchical summary receiver operating characteristic model) will be performed if the included studies are sufficiently homogenous. Meta-regression, sensitivity analysis, publication bias, and Fagan nomogram will be analyzed and described.

Results:
The pooled synthesis of the diagnostic performance of various gastrointestinal diseases with different cut-off values for DNI may limit the interpretation of uniform diagnostic validity. The authors will contact the corresponding authors for the missing values, requesting the original data in each study. However, if there are no responses from these authors, these studies will be excluded.

Conclusion:
This study will provide diagnostic validity of DNI as an initial marker for the prediction of severity, surgery, and mortality of gastrointestinal diseases.
Clinical predictors and impact of bacteremia in cirrhotic patients with acute skin and skin structure infection
Authors: Lin Chun-Nan , Hsiao Cheng-Ting , Fann Wen-Chih , Wu Shu-Ruei , Chang Chia-Peng 
Published: August 2019

Objective
Acute bacterial skin and skin structure infection (ABSSSI) is a common cause of acute admissions in patients with cirrhosis worldwide, but the disease is not well-understood epidemiologically with respect to factors that determine positive blood cultures or patient mortality. The aim of this study was to understand the utility of blood cultures and the association between bacteremia and mortality in cirrhotic patients with ABSSSI. We conducted a retrospective study to investigate factors associated with positive blood cultures and mortality in cirrhotic patients with ABSSSI.

Methods
A retrospective cohort study of hospitalized adult cirrhotic patients with ABSSSI was conducted in a tertiary hospital in Taiwan between March 2015 and December 2016.

Results
A total of 122 hospitalized cirrhotic patients with ABSSSI were included. The overall mortality rate was 9% (11/122), and 23 patients had positive blood culture results. Comorbidities that were significant risk factors for a positive blood culture included diabetes mellitus, acute kidney injury (AKI), and acute-on-chronic liver failure (ACLF). Significant risk factors evident in laboratory evaluations included higher model for end-stage liver disease (MELD) score, higher serum lactate, and lower serum albumin level. Bacteremia was also a significant factor associated with mortality.

Conclusion
A blood culture should be considered for cirrhotic patients with ABSSSI with diabetes mellitus, AKI, ACLF or those exhibiting abnormal albumin, lactate levels, or high MELD score because of the positive correlation between bacteremia and mortality.