bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased self-care activities and glycemic control rate in relation to health education via Wechat among diabetes patients
Authors: Dong Yonghui , Wang Ping , Dai Zhipeng , Liu Ke , Jin Yi , Li Ang , Wang Shengji , Zheng Jia 
Published: December 2018

Abstract

Background:
Health education has been considered as the effectiveness method to increase the self-care skills of diabetes patients. However, limited studies to investigate the association of health education via Wechat platform on increased the basic self-care skills and glycemic control rate in patients with type 2 diabetes.

Methods:
A total number of 120 type 2 diabetes patients were randomized into intervention (health education by Wechat platform plus usual care) and the control group (usual care). Biochemical parameters including fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG), glycosylated hemoglobin A1c (HbA1c) were measured among the 2 groups at baseline 6-month and 12-month. Diabetes Management Self-Efficacy (SE) Scale was completed at baseline 6-month and 12-month.

Results:
Significant difference of HbA1c concentration and SE were found between intervention and control groups at 6-month and 12-month (P <.05). The effect of groups and health education duration times was found on reduced HbA1c concentration and increased the total score of SE (P <.05). No significant difference of FPG and 2hPG concentrations were found between intervention and control groups at 6 months and 12 months (P >.05).

Conclusion:
Health education of diabetic individuals via Wechat platform in conjunction with conventional diabetes treatment could improve glycemic control and positively influence other aspects of diabetes self-care skills.
Clinical efficacy and safety of apatinib in patients with advanced colorectal cancer as the late-line treatment
Authors: Liao Xiaoli , Li Hualan , Liu Zhihui , Liao Sina , Li Qian , Liang Chaoyong , Huang Yu , Xie Mingzhi , Wei Junbao , Li Yongqiang 
Published: December 2018

Abstract
There is currently no standard therapeutic regimen available for patients with advanced colorectal cancer in whom the disease continues to progress after 2 or more lines of chemotherapy. The purpose of this study is to investigate the efficacy and safety of apatinib in patients with advanced colorectal cancer for whom at least two lines of prior chemotherapy had failed.
Twenty seven patients with advanced colorectal cancer who had failed at least 2 lines chemotherapy were treated with apatinib (500 mg/day). As a comparison control, 26 advanced colorectal cancer patients with comparable clinical baseline characteristics including age, sex, Eastern Cooperative Oncology Group (ECOG) score, pathological type, carcinoembryonic antigen (CEA) level, tumor location, number and location(s) of metastasis, and previous chemotherapies were subject to observation. Survival analyses were performed via the Kaplan–Meier method. The toxicity were evaluated in all patients this study according to the National Cancer Institute Common Toxicity Criteria 4 (NCI CTC version 4.0).
A total of 53 well-matched patients with advanced colorectal cancer were retrospectively analyzed. The median follow-up time was 6.0 months (2.0–16.0 months). The median PFS was significantly longer for apatinib group than for observation group (2.0 vs. 1.1 months; HR = 3.88; 95% confidence interval [CI], 1.91–7.88; P < .001). However, there was no significant difference between the 2 groups for median OS (5.0 vs. 4.0 months; HR = 1.03; 95% CI, 0.56–1.90; P = .914). The disease control rate of the apatinib group was significantly better than that of the observation group (70.4% vs 26.9%, P = .002). There was no significant difference in the overall remission rate between the 2 groups (3.7% vs 0%, P = .322). Advanced colorectal cancer patients with 2 or fewer metastatic sites experienced longer PFS than those with more than 2 sites. High ECOG scores, cancer localization to the right side of colon and lymph node metastasis were associated with increased risk of death and all remained independent factors affecting OS. The most common grade 3/4 treatment-related adverse events were hypertension and hand-foot skin syndrome.
Apatinib treatment for patients with advanced colorectal cancer who had failed chemotherapy achieved better disease control and prolonged PFS relative to untreated controls. The toxicity was manageable.
Surgical removal of adult recurrent neuroblastoma located in the posterior mediastinum and retroperitoneum
Authors: Ma Xiang , Yang Yunchuan , Wang Zhaoying , Sun Wanliang , Zhang Dengyong , Wu Binquan , Wu Hua , Lu Zheng , Cui Peiyuan 
Published: December 2018

Abstract

Rationale:
Adult recurrent neuroblastoma is extremely rare, especially in the posterior mediastinum and retroperitoneal cavity. The surgical treatment of this special part of the tumor is also a clinical difficulty.

Patient concerns:
This study reports a case of a 24-year-old man with a history of treated posterior mediastinal neuroblastoma. Enhanced computed tomography found a heterogeneously enhancing mass occupying the retroperitoneal and posterior mediastinum, and the initial impression was recurrent neuroblastoma.

Diagnoses:
The patient was diagnosed with recurrent neuroblastoma based on his medical history and histopathological results.

Interventions:
The young adult underwent radical resection of recurrent neuroblastoma in posterior mediastinum and retroperitoneum through thoracoabdominal incision.

Outcomes:
The young patient recovered to normal within 10 days after surgery and had no relapse for following-up 12 months.

Lessons:
Despite the difficulty of surgery, it is feasible to remove the tumor in the posterior mediastinum and retroperitoneal cavity safely.
The efficacy and safety of tranexamic acid in reducing perioperative blood loss in patients with multilevel thoracic spinal stenosis
Authors: Xue Peng , Yang Junsong , Xu Xiaozhou , Liu Tuanjiang , Huang Yansheng , Qiao Feng , Huang Xiaoqiang 
Published: December 2018

Abstract

Study Design:
A retrospective study.

Objective:
To investigate the effectiveness and safety of intravenous tranexamic acid for reducing perioperative blood loss in patients with multilevel thoracic spinal stenosis (TSS).

Methods:
This is a retrospective observational study of 42 patients with multilevel TSS admitted from December 2016 to October 2017 to the spine department of Honghui Hospital who underwent posterolateral bone graft fusion with posterior laminectomy and decompression fixation. The patients were divided into 2 groups. All the surgeries were completed by the same surgeon. Group A received an intravenous infusion of 15 mg/kg 15 min prior to surgery. Continuous infuse on of tranexamic acid (TXA) at a dose of 1 mg/kg/h was provided throughout the operation until the skin was closed. Group B received no TXA as a blank control group. Group A comprised 10 males and 10 females with an average age of 53.41 ± 7.93 years; group B comprised 11 males and 11 females with an average age of 55.10 ± 8.43 years. The need for blood transfusion, volume of blood transfusion, blood coagulation function, extubation time, postoperative hospital stay and incidence of postoperative deep venous thrombosis (DVT) were recorded during and after the operation for the 2 groups.

Results:
There was no significant difference between the 2 groups in general characteristics, such as age, sex and body mass index (BMI) (P > .05). There was no significant difference between the 2 groups in the levels are instrumented and the laminectomy levels in each group. The average postoperative blood loss, need for blood transfusion, time to postoperative extubation and length of postoperative hospital stay in group A were lower than those in group B, and there was a significant difference between the 2 groups (P < .05). The preoperative and postoperative coagulation, and postoperative DVT did not occur 48 h after operation.

Conclusion:
In the treatment of multilevel thoracic spinal canal stenosis using trabeculectomy with posterior laminectomy and posterolateral bone graft fusion, TXA can reduce the amount of blood transfused and the need for blood transfusion and can shorten the extubation time and the length of postoperative hospital stay without increasing the incidence of postoperative coagulation dysfunction or postoperative DVT.
Level of Evidence: 4
Craniofacial anomalies associated with spondyloenchondrodysplasia
Authors: Hong Seok Woo , Huh Kyung-Hoe , Lee Jeong Keun , Kang Jeong-Hyun 
Published: December 2018

Abstract

Rationale:
Spondyloenchondrodysplasia (SPENCD) is an autosomal recessive skeletal dysplasia by biallelic mutations in ACP5 gene encoding tartrate-resistant acid phosphatase (TRAP). The extra-osseous phenotype of SPENCD is pleiotropic and involves neurological impairment and immune dysfunction. Dentofacial abnormalities and orofacial symptoms in SPENCD patients have been little discussed in the literature.

Patients concerns:
Herein we present clinical and radiological data regarding 2 siblings with SPENCD. Both patients exhibited short stature, cervical platyspondyly, growth disturbance with multiple skeletal deformities of the wrist, and systemic lupus erythematosus related autoimmunity. They experienced prolonged pain in the temporomandibular joint (TMJ) area and exhibited delayed dental development. One patient presented with midface hypoplasia, retrognathic mandible, and anterior openbite. Computed tomographic images demonstrated delayed spheno-occipital synchondrosis, obtuse cranial base angle, overdeveloped and anteriorly displaced sphenoidal sinuses, and compressed ethmoidal sinuses.

Diagnosis:
The genetic analysis revealed heterozygous for a missense mutations at ACP5 in both probands.

Interventions:
Routine follow-up with conservative treatment were conducted for 12 months.

Outcomes:
The elder sister's orofacial pain was relieved but the boy showed sustained masticatory and cervical muscle pain and TMJ arthralgia which had changed in accordance with systemic condition. No further teeth eruption or skeletal growth was observed in 2 siblings during the follow-up period.

Lessons:
These findings extend the phenotypic spectrum of SPENCD and indicate that compromised endochondral ossification and the loss of TRAP activity may affect altered dentofacial development and orofacial symptoms.
Infective endocarditis caused by Lactococcus lactis subsp. lactis and Pediococcus pentosaceus
Authors: Chen Fei , Zhang Zhigang , Chen Jianzhong 
Published: December 2018

Abstract

Rationale:

Lactococcus lactis and Pediococcus pentosaceus are rare pathogens which rarely caused infections in humans. Several cases with L. lactis endocarditis have been reported in the literature, among them few were caused by L. lactis subsp. Lactis. Opportunistic P. pentosaceus infections were rarely reported.

Patient concerns:
A 66-year-old man presented to our hospital due to persistent fever for 15 days. A physical checking revealed a grade II holosystolic murmur at the heart apex. A chest computed tomography (CT) scan suggested bronchitis. L. lactis subsp. lactis was identified in blood cultures. Transthoracic and transesophageal echocardiography revealed the presence of a large hyperechogenic mass in the left atrium, and a large floating vegetation on the mitral valve with a severe mitral regurgitation.

Diagnosis:
Infectious endocarditis caused by L. lactis subsp. Lactis was diagnosed.

Interventions:
Levofloxacin (0.5 g/day) was used for 20 days; however, L. lactis subsp. lactis remained to be isolated from blood culture. Therefore, vancomycin (2 g/day) was used to replace levofloxacin. Six days after the treatment with vancomycin, the blood culture revealed no L. lactis subspecies lactis, but yielded a growth of gram-positive and non-spore forming cocci; and P. pentosaceus was identified. Antimicrobial susceptibility test revealed P. pentosaceus was sensitive to penicillin and levofloxacin. Vancomycin was discontinued, and levofloxacin (0.5 g/day) was restarted and treated for another 7 days. The patient recovered with negative blood culture results, and discharged from the hospital.

Outcomes:
The patient recovered with negative blood culture results, and discharged from the hospital.

Lessons:
Our patient had a long-period of antibiotic treatment with strategy alterations. Standard interpretation criteria of Clinical and Laboratory Standards Institute (CLSI) for L. lactis should be established, and molecular tests will increase the identification rate of L. lactis infections.
Male asymptomatic hyperuricemia patients display a lower number of NKG2D+ NK cells before and after a low-purine diet
Authors: Gao Lichao , Jiang Yanfang , Wang Yichen , Qu Xiaozhang , Li Lei , Lou Xiaoqian , Wang Ye , Guo Hui , Liu Ya 
Published: December 2018

Abstract

Background:
Aberrant activation of the immune system has been reported in asymptomatic hyperuricemia (HUA) patients. However, very few studies have elucidated the role of natural killer (NK) cells in this disease.

Methods:
In this study, we evaluated the relationship between NK cells and HUA in 16 control subjects and 20 patients, who were all on a low-purine diet. We analyzed the number of circulating NK cells, its subsets, interferon-γ+, and CD107+ NK cells, by flow cytometry, before and after 4 and 24 weeks of diet control. We also assessed the potential association of the NK cells with clinical measures.

Results:
The patients consistently had a lower number of NKG2D+ NK cells before and after low-purine diet, even the serum uric acid (SUA) levels <7 mg/dL after diet control. Moreover, a lower number of NK cells and a higher number of CD107a+ NK cells were observed on recruitment. Low-purine diet was benefit on the improvement of the SUA levels, body mass index (BMI), and the number and functions of NK cells. Furthermore, the number of CD3−CD56+ NK cells and NKG2D+ NK cells negatively correlated with the BMI before and after diet control.

Conclusion:
The consistent lower number of NKG2D+ NK cells and correlated with BMI before and after low-purine diet may be involved in the occurrence and development of HUA.
Modified Buzhong Yiqi decoction for myasthenia gravis
Authors: Jiang Xiaotao , Chen Guoming , Huang Jiahua , Xie Linling , Shen Danting , Jiang Kailin , Xu Hua 
Published: December 2018

Abstract

Background:
Myasthenia gravis (MG) is an autoimmune disease caused by the transmission of dysfunction in the neuromuscular junction, manifesting partial or systemic skeletal muscle weakness and fatigue, which are exacerbated by activities and relieved after rest. Currently, the conventional therapy is applying cholinesterase inhibitors, steroids, immunosuppressant, and thymectomy. However, these drugs have obvious side effects. According to traditional Chinese medicine (TCM) theory, Buzhong Yiqi decoction (BYD) is a Qi-supplementing formula which is suitable for MG management as MG is generally diagnosed as “flaccidity syndrome” and considered caused by Qi-deficiency. An increasing number of clinical controlled studies also have found that BYD could improve the efficacy and reduced adverse effects in treating MG, but there is no systematic review of it. Therefore, we will use meta-analysis to evaluate the efficacy and safety of BYD for MG.

Methods:
PubMed, MEDLINE, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang data, Chinese Scientific Journals Database (VIP), and China biomedical literature database (CBM) will be searched to obtain the eligible studies published up to June 1, 2018. The primary outcome will be clinical absolute score before and after treatment, clinical relative score as well as effective rate. The secondary outcome will be the concentration of acetylcholine receptor antibody (AchRAb) in serum and adverse events incidence. Data analysis will be conducted using RevMan5.3 and Stata V.9.0 software. Trial sequential analysis (TSA) will be performed to assess the risk of random error and the validity of conclusion using TSA program version 0.9 beta.

Results:
This systematic review will provide a high-quality synthesis of BYD and its modified forms for MG from various evaluation aspects including clinical absolute score before and after treatment, clinical relative score, effective rate, the concentration of AchRAb in serum and adverse events incidence.

Conclusion:
The systematic review will provide evidence to assess the efficacy and safety of BYD and its modified forms in the treatment of MG.

Prospero registration number:
PROSPERO CRD42018095241.
Short- and long-term outcomes of laparoscopic versus open surgery for rectal cancer
Authors: Lin Zhong , Jiang Zheng-Li , Chen Dan-Yang , Chen Min-Fang , Chen Li-Hua , Zhou Peng , Xia Ai-Xiao , Zhu Yan-Wu , Jin Hui , Ge Qiang-Qiang 
Published: December 2018

Abstract

Objectives:
The present meta-analysis aimed to evaluate the short- and long-term outcomes of laparoscopic surgery (LS) versus open surgery (OS) for rectal cancer.

Methods:
PubMed, Web of Science, and Cochrane Library, were searched for eligible randomized controlled trials (RCTs) published up to June 2017. Operation related index, postoperative complication, and long-term survival rate and disease-free survival rate were evaluated by meta-analytical techniques.

Result:
Nine RCTs enrolling 4126 patients were included in the present meta-analysis. Compared to OS, LS had similar positive circumferential resection margin (CRM) and number of lymph nodes extracted (LNE) as well as long term 5 years survival rate and disease-free survival rate, but of which the risk tendency was higher in LS group. The short-term outcomes of major and total postoperative complication were lower in LS group.

Conclusions:
LS for rectal cancer was as safe and effective as OS in terms of long-term outcomes, but with lower postoperative complication.
Axillary lymph node metastasis as the first manifestation of male occult breast cancer
Authors: Wang Xinyu , Fan Liwen , Yan Wenxing , Zhang Qi , Bao Shunchao , Wang Ying , Bao Xin , Liu Linlin 
Published: December 2018

Abstract

Rational:
Occult breast cancer (OBC) is an extremely rare breast cancer and is defined by the presence of axillary metastasis without a primary tumor in the breasts or any abnormality on radiologic examination.

Patient concerns:
This case report presents a 49-year-old man who was diagnosed with male OBC, which first manifested as an axillary lymph node metastasis followed by the emergence of infraclavicular lymph node metastasis. Neither the breast nor other organs had any abnormality.

Diagnosis:
The pathological examination revealed metastatic adenocarcinoma. Immunohistochemical (IHC) staining results were positive for estrogen receptor (ER), progesterone receptor (PR), and gross cystic disease fluid protein-15 (GCDFP-15); and negative for human epidermal receptor-2 (Her-2) 1+, cytokeratin (CK) 7, CK20, and thyroid transcription factor-1 (TTF-1).

Interventions:
The patient underwent left axillary lymph node dissection but not a mastectomy. After the operation, the patient subsequently underwent chemotherapy, radiotherapy, and endocrinotherapy.

Outcomes:
Currently, he has been followed-up for >4 years without any signs of recurrence.

Lessons:
Careful physical and imaging examinations combined with pathological analysis are essential in the diagnosis of male OBC. Early surgery remains the primary treatment.
Effects of apolipoprotein E on nutritional metabolism in dementia
Authors: Farmer Brandon C. , Johnson Lance A. , Hanson Angela J. 
Published: December 2018

Purpose of review
Various groups have explored the effect of apolipoprotein E (APOE) on neurodegeneration through nutritional and metabolic alterations. In this review, we hope to summarize recent findings in humans as well as preclinical APOE models.

Recent findings
Metabolic pathways including lipid metabolism appear to play a large role in the pathophysiology of Alzheimer's disease. Carrier status of the E4 variant of the APOE gene is the strongest genetic risk factor for Alzheimer's disease, and increasing evidence suggests that E4 carriers may respond differently to a host of dietary and metabolic-related treatments. A new appreciation is forming for the role of APOE in cerebral metabolism, and how nutritional factors may impact this role.

Summary
Considering the role dietary factors play in APOE-associated cognitive decline will help us to understand how nutritional interventions may facilitate or mitigate disease progression.
Lipoprotein metabolism in liver diseases
Authors: Perez-Matos Maria Camila , Sandhu Bynvant , Bonder Alan , Jiang Zhenghui Gordon 
Published: December 2018

Purpose of review
The liver is the central hub of lipoprotein metabolism. A complex relationship exists between dyslipidemia and chronic liver diseases (CLDs). Recent advances in the genetics of nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) exemplify the pivotal role of lipoprotein metabolism in the pathogenesis of CLD. We review these relationships in four quintessential forms of CLD: NAFLD, ALD, cholestatic liver disease and cirrhosis, with a focus on recent discoveries.

Recent findings
An I148 M variant in patatin-like phospholipase domain-containing protein 3 (PNPLA3) and an E167K variant in transmembrane 6 superfamily 2 (TM6SF2) are major genetic risk factors for the development and progression of NAFLD. These genetic variants also increase the risk of ALD. Both PNPLA3 and TM6SF2 are involved in the hepatic assembly of very low-density lipoprotein. The discovery of these two genetic variants highlights the risk of CLD when environmental factors are combined with functional modifications in the lipoprotein metabolism pathway.

Summary
The relationship between CLD and lipoprotein metabolism is reciprocal. On the one hand, the progression of CLD impairs lipoprotein metabolism; on the other hand, modifications in lipoprotein metabolism can substantially increase the risk of CLD. These relationships are at play among the most common forms of CLD affecting a significant proportion of the population.
Impact of a Nutrition-Focused Quality Improvement Intervention on Hospital Length of Stay
Authors: Siegel Sharon , Fan Linlin , Goldman Amanda , Higgins Joseph , Goates Scott , Partridge Jamie 
Published: December 2018

Background:Despite its high prevalence, malnutrition in hospitalized patients often goes unrecognized and undertreated.Local Problem:A hospital system sought to improve nutrition care by implementing a quality improvement initiative. Nurses screened patients upon admission using the Malnutrition Screening Tool and initiated oral nutrition supplements for patients at risk.Methods:We retrospectively reviewed the medical records of 20 697 adult patients to determine whether early initiation of nutrition therapy had reduced hospital length of stay and 30-day readmission rates.Results:We found the average time from hospital admission to oral nutrition supplement initiation was reduced by 20 hours (20.8%) after the quality improvement initiative was introduced (P< .01). Length of stay decreased 0.88 days (P< .05) more for patients at nutritional risk than patients not at nutritional risk; the probability of 30-day hospital readmission did not differ between groups.Conclusion:These results highlight the importance of adequate nutrition screening, diagnosis, and treatment for hospitalized patients.
Uterine Preservation vs Hysterectomy in Pelvic Organ Prolapse Surgery: A Systematic Review With Meta-analysis and Clinical Practice Guidelines
Authors: Meriwether Kate V. , Antosh Danielle D. , Olivera Cedric K. , Kim-Fine Shunaha , Balk Ethan M. , Murphy Miles , Grimes Cara L. , Sleemi Ambereen , Singh Ruchira , Dieter Alexis A. , Crisp Catrina C. , Rahn David D. 
Published: December 2018

(Abstracted from Am J Obstet Gynecol 2018;219:129–146.e2)
Hysterectomy performed at the time of pelvic organ prolapse (POP) repair allows the surgeon to gain access to tissues used for apical suspension. However, hysterectomy adds surgical time and costs and may increase morbidity.